A quantitative study of airway ultrasound in predicting difficult laryngoscopy: A prospective study / 中华创伤杂志(英文版)

PURPOSE@#As common clinical screening tests cannot effectively predict a difficult airway, and unanticipated difficult laryngoscopy remains a challenge for physicians. We herein used ultrasound to develop some point-of-care predictors for difficult laryngoscopy.@*METHODS@#This prospective observational study included 502 patients who underwent laryngoscopy and a detailed sonographic assessment. Patients under 18 years old, or with maxillofacial deformities or fractures, limited mouth opening, limited neck movement or history of neck surgery were excluded from the study. Laryngoscopic views of all patients were scored and grouping using the modified Cormack-Lehane (CL) scoring system. The measurements acquired comprised tongue width, the longitudinal cross-sectional area of the tongue, tongue volume, the mandible-hyoid bone distance, the hyoid bone-glottis distance, the mandible-hyoid bone-glottis angle, the skin-thyrohyoid membrane distance, the glottis-superior edge of the thyroid cartilage distance (DGTC), the skin-hyoid bone distance, and the epiglottis midway-skin distance. ANOVA and Chi-square were used to compare differences between groups. Logistic regression was used to identify risk factors for difficult laryngoscopy and it was visualized by receiver operating characteristic curves and nomogram. R version 3.6.3 and SPSS version 26.0 were used for statistical analyses.@*RESULTS@#Difficult laryngoscopy was indicated in 49 patients (CL grade Ⅲ - Ⅳ) and easy laryngoscopy in 453 patients (CL grade Ⅰ - Ⅱ). The ultrasound-measured mandible-hyoid bone-glottis angle and DGTC significantly differed between the 2 groups (p < 0.001). Difficult laryngoscopy was predicted by an area under the curve (AUC) of 0.930 with a threshold mandible-hyoid bone-glottis angle of 125.5° and by an AUC of 0.722 with a threshold DGTC of 1.22 cm. The longitudinal cross-sectional area of the tongue, tongue width, tongue volume, the mandible-hyoid distance, and the hyoid-glottis distance did not significantly differ between the groups.@*CONCLUSION@#Difficult laryngoscopy may be anticipated in patients in whom the mandible-hyoid bone-glottis angle is smaller than 125.5° or DGTC is larger than 1.22 cm.

HIV infection status in male outpatients in sexually transmitted disease clinics in Tianjin, 2016-2020 / 中华流行病学杂志

Objective: To understand the HIV infection status in male outpatients in sexually transmitted disease (STD) clinics in Tianjin from 2016 to 2020. Methods: According to the sentinel surveillance protocol, continuous cross-sectional studies were conducted between April and June during 2016-2020 to collect the information about the awareness of AIDS related knowledge, related sex behaviors, HIV infection, syphilis prevalence and HCV infection of male STD outpatients in Tianjin with a sample seize of 400 in each sentinel clinic. Results: From 2016 to 2020, a total of 4 000 male STD outpatients were surveyed. The HIV positive rate increased from 1.13% (9/800) to 2.25% (18/800) (trend χ2=14.22, P<0.001), the positive rate of syphilis increased from 9.38% (75/800) to 13.00% (104/800) (trend χ2=7.30, P=0.007) in this population during this period. The overall HCV positive rate was 0.45% (18/4 000). Multivariate logistic regression analysis showed that compared with those who were unmarried, had registered residence in Tianjin, had no temporary sexual behavior in the past 3 months, had no anal sex and had negative syphilis test result, the risk factors of HIV infection in the male STD outpatients included cohabitation (aOR=7.53, 95%CI:2.13-26.62), being from other provinces (aOR=3.64,95%CI:1.58-8.38), having temporary sexual behavior in the past 3 months (aOR=2.24,95%CI:1.03-4.89), having homosexual anal sex (aOR=85.99,95%CI:38.76-190.74) and suffering from syphilis (aOR=6.06,95%CI:3.18-11.56). Conclusion: The detection rates of HIV infection and syphilis in male STD outpatients in Tianjin showed upward trends from 2016 to 2020. Having temporary sexual behavior and anal sex, and suffering from syphilis were the main risk factors of HIV infection in male STD outpatients.

Activation of hepatocyte growth factor-induced apoptosis in hepatic stellate cells / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine whether apoptosis is induced in rat hepatic stellate cells (HSCs) in response to activation of the hepatocyte growth factor (HGF) by hepatocyte growth factor activator (HGFA) by using a co-culture system of bone marrow mesenchymal stem cells (BMSCs) and HSCs.</p><p><b>METHODS</b>In this study, cells were divided into the following five groups: HSC control group: HSCs co-cultured with fibroblast cells; HSCs blank group: HSCs cultured alone; BMSCs blank group: BMSCs cultured alone; Experimental group: BMSCs + HSCs; HGFA intervention group: HSCs treated with 70 ng/mL of HGFA. The culture systems were established in culture plates with transwell inserts, and cells were assessed at 24, 48, and 72 h of growth. Dynamic changes in cell morphology were observed under an inverted phase contrast microscope. The surface markers of BMSCs and the apoptosis rate of HSCs were detected by Annexin-V-FITC/propidium iodide (PI). Expression of a-smooth muscle actin (SMA) in HSCs was evaluated by immunohistochemistry. The presence of activated HGF (HGF-a chain) was determined by immunofluorescent staining. HSC proliferation was measured by MTT assay, and the concentrations of HGF and HGFA were quantified by enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>MTT results indicated that treatment with HGF alone had no effect on HSC proliferation rate (vs. HSC blank group, P more than 0.05), but that 24 h treatment with HGFA significantly inhibited the proliferation rate (0.26 ± 0.00 vs. blank group: 0.13 ± 0.04, P = 0.02); moreover, this effect was concentration-dependent. Expression of HGF-a was lower in the experimental group than in the HGFA intervention group at 72 h (37.24 ± 1.03 vs. 40.44 ± 0.77, P = 0.04), and both of these groups had higher expression than the control group at all time points examined (P less than 0.05). The apoptosis rate was consistently higher in the experimental group than in the HGFA intervention group, but most robustly at 72 h (40.77 ± 1.16% vs. 33.35 ± 2.04%, P = 0.00); moreover, the apoptosis rate was significantly higher than that in the control group at all time points examined (P less than 0.01). The concentration of HGF in the experimental group and the HGFA intervention group showed a time-dependent reduction, and was consistently lower than that in the HSCs control group (P less than 0.05). Finally, the concentration of HGFA was higher in the experimental group than in the blank group at all time points examined (P less than 0.05).</p><p><b>CONCLUSION</b>The BMSC-HSC co-culture system can promote secretion of HGFA from HSCs and HGF activation, thereby inducing apoptosis of HSCs.</p>

Survey on recent infection of human immunodeficiency virus among men who have sex with men in Tianjin during 2008-2009 / 中华流行病学杂志

Objective To study the situation of HIV infections among men who have sex with men (MSM) in Tianjin during 2008-2009 and to provide reasonable evidence for intervention strategy.Methods Transect investigations in MSM were conducted three times during 2008-2009.Blood samples were collected and detected to identify the recent HIV infection with IgG-capture BED-enzyme immunoassay (BED-CEIA) before HIV incidence was estimated.Results 1799 specimens were tested and the HIV prevalence rates of each study were 6.7％,8.6％ and 6.2％,while the incidence rates were 2.7％,2.5％ and 2.8％,respectively.The estimated incidence rates among these testees were 5.36％ and 5.52％ per year in 2008 and 2009.Conclusion Results of this study showed that the HIV incidence stabilized at high level among MSM in Tianjin,calling for the effective interventions be taken for HIV/AIDS control and prevention.

Low- and high-dose hydrogen peroxide regulation of transcription factor NF-E2-related factor 2 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Reactive oxygen species (ROS) may play both physiological and pathophysiological roles. Transcription factor NF-E2-related factor 2 (Nrf2) regulates antioxidant response element (ARE)-mediated genes expression and coordinates induction of chemoprotective proteins in response to physical and chemical stresses. The exact role of Nrf2 in cellular responses to different levels of oxidative stresses remains unknown.</p><p><b>METHODS</b>Rat pulmonary microvascular endothelial cells were cultured and treated with 0 mmol/L, 0.125 mmol/L, 0.25 mmol/L, 0.5 mmol/L, 1.0 mmol/L and 2.0 mmol/L hydrogen peroxide solution for 2 hours. Nrf2 gene expression was assayed by reverse transcription-PCR, Nrf2-ARE binding activity was assayed with electrophoretic mobility shift assay (EMSA), and localization of Nrf2 was detected with immunohistochemistry.</p><p><b>RESULTS</b>Low and moderate (0.125 mmol/L, 0.25 mmol/L and 0.5 mmol/L) doses hydrogen peroxide exposure of rat pulmonary microvascular endothelial cells led to the nuclear accumulation of Nrf2, increased activity of transcription regulation and up-regulation of ARE-medicated gene expression. In contrast, high doses of hydrogen peroxide (1 mmol/L, 2 mmol/L) exposure of the cells led to the nuclear exclusion of Nrf2, decreased activity transcription regulation and down-regulation of ARE-mediated gene expression.</p><p><b>CONCLUSION</b>Low and moderate doses of hydrogen peroxide play protective roles by increasing transcription activity of Nrf2, whereas high- dose hydrogen peroxide plays a deleterious role by decreasing transcription activity of Nrf2.</p>

Effect of substance P on the migration and differentiation of cultured epidermal stem cells to hair follicle in vitro / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effect of substance P (SP) on the migration and differentiation of epidermal stem cells (ESCs) to hair follicle, and its mechanism.</p><p><b>METHODS</b>ESCs were cultured in vitro, and confirmed by positive staining of K19 and integrin beta1 with immunohistochemistry. SP was added into the culture of ESCs which were labelled with 5-BrdU, and the cell cultures were divided into control, 10(-5) mol/L SP, 10(-6) mol/L SP, and 10(-7) mol/L SP groups according to the different doses of SP addition. Cell suspension (0.3 ml) containing SP was injected into the dermis in the back of nude mice. Repeated injection of the equal amount of cell suspension in the same place was carried out on 4, 7, 10 and 14 days after first injection. The cells in control group received the same treatment but without SP. The skin specimens in the area of cell culture injection and the normal skin remote from cell injection were harvested for the histological examination and hair follicle counting by immunohistochemistry and electronmicroscope 28 days after injections.</p><p><b>RESULTS</b>Hair follicles in scattered distribution were observed in 10(-5) mol/L SP group,but some of them were defective in development. Hypoplasic hair follicle and a few hair follicles with distinct structure were observed in 10(-5) mol/L SP group. Large amounts of hair follicles with distinct structure in deep dermis and subcutaneous tissue were observed in 10(-6) mol/L SP, 10(-7) mol/L SP groups, and some of them showed positive staining of brown BrdU in the hair root, and most of them showed positive staining of brown beta-catenin, but a few of them showed developmental defect. In contrast, hypoplasia of hair follicle underneath epidermis and deep layer of dermis with positive staining of brown BrdU and beta-catenin in epidermis were observed in control group. The number of hair follicles in 10(-6)mol/L SP, 10(-7) mol/L SP groups [(1.9 +/- 1.2 ), (1.3 +/- 0.8)] was obviously less than that in control group [(10. 5 +/- 1.2), P < 0.01].</p><p><b>CONCLUSION</b>SP can induce ESCs to migrate from the basal layer into hair follicle, and this effect is dependent on the SP concentration. SP can also elevate the expression of beta-catenin in ESCs,which induces its differentiation to hair follicles.</p>