Effects and pathophysiological significance of intestinal flora on the enteric neuro-endocrine-immune system / 生理学报

Interactions among the nervous, the endocrine and the immune systems enable the gut to respond to the dietary products, pathogens and microbiota, which maintains the homeostasis of the body. However, dysbiosis may induce or aggravate the gastrointestinal (GI) and extra-GI diseases through changing the activities of enteric nervous system (ENS), enteroendocrine cells and enteric immune cells. Here we review recent advances in the understandings on how intestinal flora may impact the enteric neuro-endocrine-immune system in the gut, thereby contributing to the regulation of pathophysiological processes.

Analysis of risk factors for perinatal hysterectomy / 中国实用妇科与产科杂志

OBJECTIVE: To analyze the risk factors for peripartum hysterectomy.METHODS: Retrospectively analyze the clinical data of 36 cases of peripartum hysterectomy in Shijiazhuang Obstetrics and Gynecology Hospital from January2012 to December 2018. The impact factors for peripartum hysterectomy were divided into clinical characteristics and obstetric treatment capacity. The annual rates of peripartum hysterectomy were compared and the risk factors for peripartum hysterectomy were analyzed by multi-factor Logistic regression analysisRESULTS: The indications of 36 cases of peripartum hysterectomy were intractable postpartum hemorrhage. The causes of hysterectomy included placenta implantation,amniotic fluid embolism,uterine atony and secondary infection. The annual rate of peripartum hysterectomy decreased gradually due to the promotion of obstetric treatment capacity. The peripartum hysterectomy rate in 2018 decreased significantly（P<0.001,P<0.001,P=0.004,P=0.009）compared with that of 2012,2013,2014 and 2015. Multifactor Logistic regression analysis showed that cesearen-section scar was a risk factor for peripartum hysterectomy（OR=1.403,P=0.018）.CONCLUSION: The severity of disease results in peripartum hysterectomy. The reduction of the peripartum hysterectomy rate lies in the promotion of obstetric treatment capacity,including improving maternal health care,reducing obstetric complications and improving the timely and effective treatment of patients with postpartum hemorrhage.

Comparative study on hearing status of preeclampsia infants with different degrees of hypertensive disorder complicating pregnancy and preeclampsia infants without hypertensive disorder complicating pregnancy / 中国实用妇科与产科杂志

OBJECTIVE: To explore the influence and significance of preeclampsia with different degrees of gestational hypertension on infant hearing.METHODS: Totally 1046 newborns whose mothers had a history of pre-eclampsia with hypertensive disorder complicating pregnancy were divided into groups according to the severity of pre-eclampsia and whether they were premature or not from Jan. 2015 to Dec. 2017 in the Forth Hospital of Shijiazhuang.Hearing tests were conducted and compared with newborns whose mothers had no history of pre-eclampsia with hypertensive disorder complicating pregnancy.RESULTS: Of the 14 741 infants studied,57 were finally diagnosed with sensorineural hearing loss,with a total abnormality rate of 0.39%(57/14 741).Among them,34 infants with pre-eclampsia without hypertensive disorder complicating pregnancy had an abnormality rate of 0.25%.There were 12 infants with mild preeclampsia in their mothers,with an abnormality rate of 1.47%.There were 11 infants whose mothers had severe preeclampsia,with an abnormality rate of 4.76%.There were significant differences between mild group and control group,severe group and control group,and severe group and mild group(P0.05),but there was significant difference between the severe group and the control group,and between the severe group and the mild group(P<0.01 and P<0.05,respectively).CONCLUSION: Premature infants with severe hypertensive disorder complicating pregnancy and preeclampsia are at high risk of hearing impairment.The higher the degree of hypertension,the higher the rate of hearing impairment.The emphasis should be put on strengthening the hearing monitoring and follow-up of such children.

Statistical Analysis of the Heart and Lung Mass in Forensic Anatomical Cases and Its Forensic Significance / 法医学杂志

Objective To investigate the differences of heart mass and lung mass in forensic autopsy cases and to explore their application value in forensic identification. Methods The data from 1 614 autopsy cases accepted by center of Medico-legal Investigation of China Medical University between 2007 to 2016 were collected. The correlation of heart and lung mass with age, height, body weight, and body mass index （BMI）, as well as differences in different causes of death were analyzed by GraphPad Prism 6.0 software. Results The heart mass and lung mass of males were higher than those of females （P<0.05）. The heart mass of males and females was positively correlated with age, height, body weight and body mass index （BMI） （P<0.05）. The heart mass of patients dying from sudden cardiac death （SCD） was significantly higher than those dying from other causes of death. The lung mass of patients dying from drowning and delayed treatment was higher than those dying from other causes of death （P<0.05）. Conclusion In forensic practice, measurement of the heart mass and lung mass has certain significance for differential diagnosis and diagnosis of different causes of death.

Expression of CD63 in Lung Tissue of Guinea Pigs Dying of Anaphylactic Shock / 法医学杂志

Objective To study the protein expression of cluster of differentiation 63 （CD63） in lung tissues of guinea pigs that died of anaphylactic shock and discuss the diagnostic value of CD63 for death from anaphylactic shock. Methods Twenty guinea pigs were randomly divided into control group, anaphylactic shock immediate death group, cold storage group （4 ℃ for 48 h） and frozen group （-20 ℃ for 7 d）. The animal model of guinea pigs that died of anaphylactic shock was established with human mixed serum injection. The expression changes of CD63 protein and CD63 mRNA in lung tissues were detected by hematoxylin-eosin （HE） staining, immunohistochemical staining, Western blotting, enzyme-linked immunosorbent assay （ELISA） and real-time RT-PCR. Results HE staining results showed congestion, and edema of lung tissues, and eosinophil infiltration in the anaphylactic shock groups. Western blotting analysis results showed that the expression of CD63 protein in the lung tissues of guinea pigs that died of anaphylactic shock was significantly higher than that in the control group （P<0.05）. Comparison between the anaphylactic shock groups was made, and the differences had no statistical significance. The results of immunohistochemical staining and real-time RT-PCR were consistent with that of Western blotting. ELISA results showed that CD63 protein expression in the immediate death group was higher than that in the control group （P<0.05）. Conclusion The expression of CD63 protein and CD63 mRNA in the lung tissues of guinea pigs that died of anaphylactic shock is significantly enhanced. Animal carcasses which were put in cold storage for 48 h and frozen for 7 d do not affect the examination of the above indicators. CD63 protein is expected to become an auxiliary diagnostic indicator of death from anaphylactic shock.

Clinical effects of robot-assisted total knee arthroplasty compared with traditional surgery: a Meta-analysis / 中国骨伤

OBJECTIVE@#To compare the difference between robotic-assisted TKA and traditional TKA by Meta-annlysis in order to determine whether robotic-assisted TKA can provide better lower limb force line and clinical prognosis.@*METHODS@#Computerized searches of Embase, Pubmed, Web of Science and CNKI, Wanfang and VIP databases were conducted until November 2018 to find out the difference between robotic assisted TKA and traditional TKA. After screening, quality evaluation and data extraction according to inclusion and exclusion criteria, Revman 5.3 software was used for meta-analysis of literature data.@*RESULTS@#Six clinical controlled studies were included, 253 in robot-assisted TKA group and 231 in traditional TKA group. Meta-analysis showed that the incidence of coronal force line angle[WMD=-1.00, 95%CI(-1.66, -0.35), =0.003], coronal force line inversion or valgus>3°[RR=0.04, 95% CI(0.01, 0.13), =0.000 01] in robot-assisted TKA group was significantly better than that in traditional TKA group, but there were no statistical differences between two groups in range of knee joint motion[WMD=0.06, 95%CI(-5.43, 5.55)], =0.98], anterior position tibial angle[WMD=-0.19, 95% CI(-0.81, 0.43), 95%, =0.55] and lateral tibial angle[WMD=-1.37, 95%CI(-3.73, 0.99), =0.25], anterior position femoral angle[WMD=0.30, 95%CI(-1.37, 1.96), =0.72] and lateral femoral angle[WMD=-0.93, 95%CI(-1.98, 0.013), =0.08], the incidence of complications[RR=0.84, 95%CI(0.45, 1.58), =0.60]. The operation time of robot-cassisted TKA group was longer than that of traditional TKA group[WMD=14.28, 95%CI(0.79, 27.77), =0.04].@*CONCLUSIONS@#The application of robotic assistant system in TKA surgery can significantly improve the accuracy of prosthesis fixation, better reconstruct the lower limb line of force, and has the potential advantages of reducing postoperative pain and promoting the recovery of knee joint function. Due to the limitation of the quantity and quality of the included literature, a high-quality randomized controlled study with long-term follow-up is still needed in the future to support the conclusions of this paper.

Adrenal hemorrhage in a patient with systemic lupus erythematosus / 北京大学学报(医学版)

A 58-year-old female was referred to our department with intermittent suffocation for 1.5 years, aggravated for a month. 1.5 years before she developed oral ulcer, raynaud phenomenon, proteinuria, bilateral pleural effusion, ANA and anti-dsDNA positive. This patient was diagnosed with systemic lupus erythematosus (SLE). After given hormones, hydroxychloroquine sulfate (HCQ), her symptom relieved soon. The patient stopped her pills 1 year ago. One month ago, she had chest tightness, increased urine foam, and suffered from oliguria. Her admission medical examination: blood pressure (BP) 130/80 mmHg, conjunctiva pale, and lower lung breath sounds reduced. There was no tenderness, rebound pain and abdominal muscle tension in the abdomen. Liver and spleen rib inferior, mobile dullness negative, and lower extremity edema. Blood routine tests were performed with hemoglobin (HGB) 57 g/L. Urine routine: BLD (3+). 24-hour urinary protein 3.2 g. serum albumin 20.5 g/L, C-reactive protein (CRP) 12.85 mg/L, erythrocyte sedimentation rate (ESR) 140 mm/h. Antinuclear antibody (ANA) (H)1:10 000, anti-dsDNA antibody 1:3 200; anti-Smith antibody, anti-U1-snRNP/Sm antibody were positive, blood complement 3(C3) 0.43 g/L, complement 4(C4) 0.07 g /L. Anticardiolipin antibody (ACL), anti-β2-GP1, lupus anticoagulant (LA) were negative; HRCT suggested bilateral medial pleural cavity product liquid. Admission diagnosis: SLE lupus nephritis, anemia, pleural effusion, and hypoproteinemia. We treated her with methylprednisolone 1 000 mg×3 d, late to 48 mg/d and cyclophosphamide 1.0 g, HCQ 0.2 g bid, gamma globulin 10 g×5 d. Day 2 of treatment, this patient developed acute right upper quadrant pain, not accompanied by nausea, vomiting, blood stool and diarrhea. Antipyretic antispasmodic treatment was invalid, after the morning to ease their own abdominal pain. Day 4 of treatment, daytime blood HGB 77 g/L. Bilateral renal vascular ultrasound: bilateral renal artery blood flow velocity was reduced. The abdominal pain of the above symptoms recurred at night, BP was 120/80 mmHg, and no positive signs were found on abdominal examination. No abnormality was found in the vertical abdominal plain film. Blood routine examination: HGB 53 g/L, Plasma D dimer 2 515 μg/L, amylase in hematuria was normal, the stool occult blood was negative. Abdominal computed tomography (CT): normal structure of right adrenal gland disappeared, irregular mass shadow could be seen in adrenal region, CT value was about 50 HU. Morphological density of left adrenal gland was not abnormal. The retroperitoneum descended along the inferior vena cava to the right iliac blood vessel and showed a bolus shadow. The density of some segments increased. The lesion involved the right renal periphery and reached the left side of abdominal aorta. Most lesions surrounded the inferior vena cava, the right renal vein and part of the small intestine. The boundary between the upper lesion and the vena cava was unclear. Iodinecontaining contrast agent was taken orally. No sign of contrast agent overflowing was found in the abdominal cavity. Hematoma and exudative changes were considered in retroperitoneum. CONCLUSION of contrast-enhanced ultrasound of blood vessels: The retroperitoneal inferior vena cava (volume 3.5 cm×3.5 cm×1.5 cm) was hypoechoic and had no blood flow lesion. The adrenal gland had a high possibility of origin. Left renal vein thrombosis extended to inferior vena cava. According to the above data, it was analyzed that the cause of retroperitoneal hematoma of the patient was left adrenal vein thrombosis caused by hypercoagulable state, which led to vascular rupture and hemorrhage caused by increased vascular pressure in adrenal gland. Therefore, on the basis of continuing to actively treat the primary disease, and on the basis of dynamic observation of no active hemorrhage for 3 days, the anticoagulant therapy was continued with 10 mg/d of apixaban. Clinical symptoms were gradually eased, HGB did not decrease. Two weeks later, the ultrasonic examination showed that the irregular cluster hypoechoic range behind the inferior vena cava was significantly smaller than that before (1.8 cm×1.2 cm×0.7 cm). Abdominal CT examination after 1 month showed that there was no abnormal morphological density of bilateral adrenal glands and basic absorption of retroperitoneal exudation. Adrenal hemorrhage is uncommon. SLE with adrenal hemorrhage is rarer. In SLE patients, especially those complicated with APS, if abdominal pain accompanied by HGB decrease occurs, except after gastrointestinal hemorrhage, the possibility of adrenal hemorrhage should be warned.

Pleurodesis in the treatment of systemic lupus erythematosus complicated with refrac-tory pleural effusion / 军事医学

Objective To investigate the effect and feasibility of pleurodesis in the treatment of systemic lupus erythematosus(SLE)complicated with refractory pleural effusion.Methods The clinical data on four patients were diagnosed with SLE complicated with refractory pleural effusion and received pleurodesis was retrospectively analyzed.At the same time,using such terms as"lupus"and"pleural effusion",we searched English literature in Pubmed and in Wan-Fang Database of China.Results A total of 7 cases with relative complete data were found from the literature.Six patients were female,and one was male.Three cases had bilateral pleural effusion,two had left pleural effusion,and two had right pleural effusion.Then,these eleven patients were analyed together.Those patients who suffered significant dyspnea were related to chronic pleural effusion.They were all treated with a large dose of corticosteroid and immunosuppressive agents before pleurodesis,but none of the therapies was valid.They had undergone frequent multiple fluid aspirations.The total aspirated volume of one patient exceeded 80 L before pleurodesis.The patients with pleurodesis were well tolerated and had no complications after operation.There was no relapse in follow-up.After pleurodesis,the pleural effusion of all the patients was completely improved.Conclusion The clinical manifestations of refractory pleural effusion are relatively rare in patients with SLE.Drug therapy has poor effect,while traditionally used pleurodesis may be safer and preferred in such cases.It can effectively improve patients′prognosis and quality of life,but due to the small number of reported patients,the best type of intervention waits to be found.

Expression of long non-coding RNA DGCR5 in gastric cancer and its clinical significance / 医学研究生学报

Objective Recent evidence points towards a close relationship between dysregulation of long non-coding RNA (lncRNA) and carcinogenesis and progression of various tumors including gastric cancer. The aim of this study was to investigate the expression of lncRNA DGCR5 in the gastric cancer tissue and plasma and its influence on the biological behavior of gastric cancer cells. Methods We collected tumorous and adjacent normal tissues from 96 gastric adenocarcinoma patients as well as plasma samples from 34 gastric cancer patients and another 34 healthy controls. We deter-mined the expression of DGCR5 by real-time fluorescent quantitative PCR,analyzed its correlation with the clinicopathological features of gastric cancer,observed the apoptosis, proliferation and invasiveness of the gastric cancer cells after overexpressing DGCR5, and detected the expressions of epithelial-mesenchymal transition (EMT)-associat-ed genes and proteins by Western blot. Results The expression of DGCR5 was significantly decreased in tumor tissue of the gastric canc-er patients as compared with that in the adjacent normal tissue,which was correlated with the advanced TNM stage and lymph node metastasis, and so was it in the plasma of the patients, which was also correlated with the TNM stage. The area under the ROC curve for the diagnosis of gastric cancer by the expression level of plasma DGCR5 was 0.722. Overexpressed DGCR5 induced significant apoptosis and inhibited the proliferation and invasion of gastric cancer cells,markedly promoted the expression of E-cadherin,and suppressed the expressions of N-cadherin,vimentin and Twist. Conclu-sion The expression of DGCR5 is significantly decreased in the tumor tissue and plasma of gastric cancer patients. The DGCR5 level in the plasma has a certain diagnostic value for gastric cancer. Overexpressed DGCR5 can reduce the proliferation and invasiveness of gastric cancer cells,increase their apoptosis,and inhibit EMT.

Clinical characteristic of 74 cases of malignant tumor in rheumatoid arthritis / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinical characteristics of rheumatoid arthritis (RA) patients with malignant tumor.@*METHODS@#Retrospective summary was made of 1 562 in patients of RA from January 2011 to June 2017. In the study, 74 RA patients with malignant tumor were reviewed and analyzed, and the general conditions, tumor types, RA and tumor onset sequence, and the medication situation were analyzed.@*RESULTS@#The incidence of malignant tumor in the patients with rheumatoid arthritis in our center was 4.16%. The 74 patients were complicated with malignant tumor, of whom 53 were female, and 21 male. The age of RA at presentation was (52.6±17.8) years. The average disease duration of malignant tumor was (63.4 ± 12.7) years. The onset time of rheumatoid arthritis was earlier than that of malignant tumors in 51 cases (51/74), with an average of (17.2±14.2) years between 2 and 60 years. The incidence of malignant tumor was earlier than that of rheumatoid arthritis in 16 cases (16/74), with an average of (6.2±5.9) years between 1 and 21 years, of which 10 cases were sex hormone related tumors. Seven cases (7/74) were diagnosed with RA at the same time, and the time interval between the two diseases was within 1 year. All the patients were over 60 years old with digestive tract tumors. All the 7 patients showed polyarthritis, significantly increased erythrocyte sedimentation rate and C-reactive protein, including 4 rheumatoid factor positive cases and 2 anti-CCP antibody positive cases. The effect of non-steroidal anti-inflammatory drugs and traditional drugs to improve the condition of the disease was poor in the 7 patients, and the condition was relieved after using low-dose glucocorticoids. Gastrointestinal tumors, breast and reproductive system tumors were the most common, followed by respiratory, urological and blood system tumors.@*CONCLUSION@#The risk in patients of rheumatoid arthritis complicated with malignant tumor is higher than that of the general population. A variety of factors play an important role in cancer risk of RA, including disease activity, some estrogen metabolites, the use of drugs and so on. Therefore, all RA patients should be screened for malignant tumor during diagnosis, and malignant tumor surveillance is mandatory for all rheumatoid arthritis patients after diagnosis.

Stress-related arterial hypertension in Gper-deficient rats / 生理学报

Numerous studies have demonstrated that estrogens may exert multifaceted effects on the cardiovascular system via activating the classical nuclear receptors ERα or ERβ and the novel G protein coupled estrogen receptor (Gper). However, some studies have reported inconsistent cardiovascular phenotypes in Gper-deficient mice. The current study was aimed to reveal the effects of genetic deletion of Gper on the arterial blood pressure (ABP) and heart rate in rats. Gper-deficient Sprague-Dawley rats were generated by utilizing the CRISPR-Cas9 gene-editing technique. ABP of 10-week old male (n = 6) and 12-week old female (n = 6) Gper-deficient rats and age-matched wild type (WT) rats (6 females and 6 males) were measured under awake and restrained conditions through the non-invasive tail-cuff method daily for 8 (females) or 9 days (males). In the male WT rats, ABP and heart rate were slightly higher in day 1 to 4 than those in day 5 to 9, indicative of stress-related sympathoexcitation in the first few days and gradual adaptation to the restrained stress in later days. Gper-deficient rats had significantly higher ABP initially (male: day 1 to day 5; female: day 1 to day 3) and similar ABP in later days of measurement compared with the WT rats. The heart rate of male Gper-deficient rats was consistently higher than that of the male WT rats from day 1 to day 8. Both male and female Gper-deficient rats appeared to show slower body weight gain than the WT counterparts during the study period. Under anesthesia, ABP of Gper-deficient rats was not significantly different from their WT counterparts. These results indicate that Gper-deficient rats may be more sensitive to stress-induced sympathoexcitation and highlight the importance of Gper in the regulation of the cardiovascular function in stressful conditions.

UPLC/ESI-QTOF-MS-based metabolomics survey on the toxicity of triptolide and detoxication of licorice / 中国天然药物

Triptolide (TP) from Tripterygium wilfordii has been demonstrated to possess anti-inflammatory, immunosuppressive, and anticancer activities. TP is specially used for the treatment of awkward rheumatoid arthritis, but its clinical application is confined by intense side effects. It is reported that licorice can obviously reduce the toxicity of TP, but the detailed mechanisms involved have not been comprehensively investigated. The current study aimed to explore metabolomics characteristics of the toxic reaction induced by TP and the intervention effect of licorice water extraction (LWE) against such toxicity. Obtained urine samples from control, TP and TP + LWE treated rats were analyzed by UPLC/ESI-QTOF-MS. The metabolic profiles of the control and the TP group were well differentiated by the principal component analysis and orthogonal partial least squares-discriminant analysis. The toxicity of TP was demonstrated to be evolving along with the exposure time of TP. Eight potential biomarkers related to TP toxicity were successfully identified in urine samples. Furthermore, LWE treatment could attenuate the change in six of the eight identified biomarkers. Functional pathway analysis revealed that the alterations in these metabolites were associated with tryptophan, pantothenic acid, and porphyrin metabolism. Therefore, it was concluded that LWE demonstrated interventional effects on TP toxicity through regulation of tryptophan, pantothenic acid, and porphyrin metabolism pathways, which provided novel insights into the possible mechanisms of TP toxicity as well as the potential therapeutic effects of LWE against such toxicity.

Time-dependent Protein Expressions of MMP-2 and MMP-9 in Liver Contusion Rats after Impact / 法医学杂志

Objective To observe the protein expression patterns of matrix metalloproteinase (MMP)-2 and MMP-9 in the liver tissue of liver contusion rats at different time after impact. Methods Fifty healthy adult male SD rats were randomly and evenly divided into control group and experimental groups (1 h, 3 h, 6 h, 12 h, 18 h, 24 h, 3 d, 5 d, 7 d after liver contusion). A rat liver contusion model was established by a free-falling device. The rats were killed at corresponding time, and the contused hepatic lobes were extracted. The protein expressions of MMP-2 and MMP-9 in contused liver tissue of the rats in each group were observed by immunohistochemical staining (SP method) and Western blotting. Results After the liver contusion, the expression of positive cell and the protein semiquantitative result showed that the protein expression of MMP-2 enhanced at 6 h and peaked at 24 h, then decreased gradually at 3-5 d, and returned to normal levels at 7 d. The difference of expression between group and its previous adjacent group after 6 h (except 18 h) had statistical significance (P<0.05). The protein expression of MMP-9 rose obviously at 1 h after liver contusion and peaked at 18 h, then decreased gradually at 3-7 d which still higher than control group. The expression difference between group and its previous adjacent group (except 12 h and 24 h) had statistical significance (P<0.05). Conclusion The protein expressions of MMP-2 and MMP-9 in contused liver tissue after impact show good time-dependent patterns, which may provide important reference indicators for the time estimation of liver contusion.

Valuation on the immunization efficacy on the 23 years who had received plasma-derived HBV vaccine as newborns / 中华流行病学杂志

<p><b>OBJECTIVE</b>To observe the long-term effect of plasma-derived HBV vaccine.</p><p><b>METHODS</b>The effect of a plasma-derived HBV vaccine which was given to children born in 1986 in Huangpu district in Shanghai were followed up once every two years and testing for HBsAg, anti-HBs and anti-HBc was carried out. Compared to background results from cross-sectional survey of hepatitis B virus in 1984 and 1985 (as internal control) as well as finding of survey targeted in non-plasma-derived HBV vaccine of children born in the same time in the nearby area from results investigated in 1991 (as external control), positive rate was calculated to assess the effect of protection.</p><p><b>RESULTS</b>The population immunized was followed up for 23 years and 5993 blood samples were collected. During the period of follow-up, the positive rate of anti-HBs decreased from 89.01% to 18.77% and the average level was 40.39%. The average positive rate of anti-HBc was 1.87%. The annual positive rate fluctuated around the average level. HBsAg positive rate remained less than 1.00% (0.46% - 0.98%), with an average of 0.62% (37/5993). Ranges of positive efficacy were from 81.37% to 95.78% against background control and 72.76% against external control.</p><p><b>CONCLUSION</b>The plasma-derived HBV vaccine showed a good long-term protective effect and there was no need for boosting the immunization 23 years later.</p>

Evaluation on the immunization efficacy on the 23 years who had received plasma-derived HBV vaccine as newborns / 中华流行病学杂志

Objective To observe the long-term effect of plasma-derived HBV vaccine.Methods The effect of a plasma-derived HBV vaccine which was given to children born in 1986 in Huangpu district in Shanghai were followed up once every two years and testing for HBsAg,anti-HBs and anti-HBc was carried out.Compared to background results from cross-sectional survey of hepatitis B virus in 1984 and 1985 (as internal control) as well as finding of survey targeted in non-plasma-derived HBV vaccine of children born in the same time in the nearby area from results investigated in 1991 (as external control),positive rate was calculated to assess the effect of protection.Results The population immunized was followed up for 23 years and 5993 blood samples were collected.During the period of follow-up,the positive rate of anti-HBs decreased from 89.01％ to 18.77％ and the average level was 40.39％.The average positive rate of anti-HBc was 1.87％.The annual positive rate fluctuated around the average level.HBsAg positive rate remained less than 1.00％ (0.46％-0.98％),with an average of 0.62％ (37/5993).Ranges of positive efficacy were from 81.37％ to 95.78％ against background control and 72.76％ against external control.Conclusion The plasma-derived HBV vaccine showed a good long-term protective effect and there was no need for boosting the immunization 23 years later.

Evaluation on the immunization efficacy on the 23 years who had received plasma-derived HBV vaccine as newborns / 中华流行病学杂志

Objective To observe the long-term effect of plasma-derived HBV vaccine.Methods The effect of a plasma-derived HBV vaccine which was given to children born in 1986 in Huangpu district in Shanghai were followed up once every two years and testing for HBsAg,anti-HBs and anti-HBc was carried out.Compared to background results from cross-sectional survey of hepatitis B virus in 1984 and 1985 (as internal control) as well as finding of survey targeted in non-plasma-derived HBV vaccine of children born in the same time in the nearby area from results investigated in 1991 (as external control),positive rate was calculated to assess the effect of protection.Results The population immunized was followed up for 23 years and 5993 blood samples were collected.During the period of follow-up,the positive rate of anti-HBs decreased from 89.01％ to 18.77％ and the average level was 40.39％.The average positive rate of anti-HBc was 1.87％.The annual positive rate fluctuated around the average level.HBsAg positive rate remained less than 1.00％ (0.46％-0.98％),with an average of 0.62％ (37/5993).Ranges of positive efficacy were from 81.37％ to 95.78％ against background control and 72.76％ against external control.Conclusion The plasma-derived HBV vaccine showed a good long-term protective effect and there was no need for boosting the immunization 23 years later.

Endovascular aneurysm repair in high-surgical-risk abdominal aortic aneurysm patients: initial and long-term results / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the initial and long-term results of endovascular aneurysm repair (EVAR) in high-surgical-risk abdominal aortic aneurysm (AAA) patients.</p><p><b>METHODS</b>From July 1997 to July 2011, 120 consecutive high-surgical-risk patients with AAA who were treated electively using a bifurcated aortic endograft were entered in a registry. There were 96 male and 24 female patients, aged from 52 to 95 years with a mean of 74 years. Follow-up protocol consisted of computed tomography angiograms or ultrasound performed at 3, 6, 9, 12 months, and annually thereafter. The main goal was evaluation of the operative mortality and the long-term survival of these patients. Secondary goals were determination of the frequency of secondary operations, the outcome of the aneurysm sac, and primary and secondary patency rates after aortic endograft placement.</p><p><b>RESULTS</b>Mean aneurysm diameter was (57 ± 8) mm. Thirty-seven patients were operated under local anesthesia and eighty-three under general anesthesia. Five type I endoleaks, twenty-five type II endoleaks and one type III endoleak occurred during the perioperative period. The technical success rate was 95%. Operative mortality was 2.5%. The survival rates at 1-, 3- and 5-year were 92%, 75% and 43% respectively. The mean follow up was (36 ± 3) months. Primary and secondary patency rates at 3 year were respectively 97% and 100%. Secondary intervention rate was 10% (12/120) at 5 year. The reasons included endoleaks for 7 patients, stent-grafts fracture for 2 patients, stent-grafts migration for 2 patients and stent-graft thrombosis for 1 patients.</p><p><b>CONCLUSIONS</b>Initial and long-term results with endograft repair of AAA in high-surgical-risk patients were satisfactory. These results appear to justify endovascular repair for this patient population.</p>

The expression of GABA(A) receptor alpha1 and GABA(B) receptor 1 in medulla oblongata solitary nucleus and ambiguous nucleus in the cases of tramadol intoxication / 法医学杂志

OBJECTIVE@#To observe the expression of GABA(A) receptor alpha1 (GABA(A)alpha1) and GABA(B) receptor 1 (GABA(B)1) in human medulla oblongata solitary nucleus and ambiguous nucleus due to tramadol-induced death.@*METHODS@#GABA(A)alpha1 and GABA(B)1 were detected by immunohistochemical SP method in tramadol-induced death group and control group. All results were evaluated by images analysis system.@*RESULTS@#Low expression of GABA(A)alpha1 and GABA(B)1 were detected in solitary nucleus and ambiguous nucleus in the control brain tissue. In cases of tramadol-induced death, the expression of GABA(A)alpha1 and GABA(B)1 significantly increased.@*CONCLUSION@#The mechanism of tramadol intoxication death could be caused by respiratory depression induced by over-expression of GABA(A)alpha1 and GABA(B)1 in medulla oblongata solitary nucleus and ambiguous nucleus.

Clinical analysis of patients with Wegener's granulomatosis complicated with pulmonary infection / 中华风湿病学杂志

ObjectiveTo investigate the clinical features and risk factors of patient with Wegener's granulomatosis complicated with pulmonary infection.Methods Patients with Wegener's granulomatosis admitted to our hospital in the past 11 years were retrospectively analyzed.Comparisons between groups were performed by t tests or Fisher test.ResultsPulmonary infection occurred in 27 cases with an incidence rate of 29％.Twenty-six percent of pulmonary infections occurred at the initial diagnosis,and 44％ occurred within 6 months,while 30％ occurred later than 6 months.The clinical manifestations of pulmonary infection were productive cough (89％),hemoptysis (63％),fever and fatigue (56％),chest pain and pactoralgia (33％).The most common causative pathogen were bacteria(59％ ),fungi(37％ ),and tubercle bacillus(37％ ).Sinus infection(P=0.01),hypoproteinemia(P=0.03),hypoimmunoglobulinemia (P=0.007),and methylprednisolone pulse therapy(P=0.002) were the risk factors for pulmonary infection.ConclusionThe occurrence of Wegener's granulomatosis complicated with pulmonary infection is high within 6 months.The most common clinical manifestation is productive cough.The most common causative pathogens are bacteria,tubercle bacillus and fungi.Sinus infection,hypoproteinemia,hypoimmunoglobulinemia,and methylprednisolone pulse therapy are risk factors of pulmonary infection.

Surgical treatment of peripheral arterial aneurysms: a report of 35 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the treatment strategies of peripheral arterial aneurysms.</p><p><b>METHODS</b>Thirty-five cases were reviewed from July 1998 to December 2007, and 28 cases were male, 7 cases were female. Eleven cases were popliteal artery aneurysms, 15 cases were femoral artery aneurysms, 4 cases were extracranial carotid aneurysms and 5 cases were subclavian artery aneurysms. All cases had either open procedures or endovascular procedures.</p><p><b>RESULTS</b>Surgical open procedures were performed on 24 cases, and endovascular procedures were performed on 11 cases. The perioperative complication rate were 16.7% (4/24) and 0% for open and endovascular groups respectively. The average follow-up time was 41 months (7 months to 8 years). The accumulative five year patency were 61% and 48% for surgical grafts and stent grafts respectively. Two cases died of diseases and one had stroke during follow-up.</p><p><b>CONCLUSIONS</b>Surgical open repair is still standard procedure for most peripheral arterial aneurysms and endovascular repair may have its own advantage for high risk patients.</p>