Impact of preoperative anemia on perioperative blood transfusion and outcomes in patients undergoing mitral valve surgery / 中国输血杂志

【Objective】 To explore the relationship between preoperative anemia and perioperative red blood cell (RBC) transfusion and postoperative outcomes in patients undergoing mitral valve surgery. 【Methods】 The clinical data, laboratory findings, blood transfused and outcomes data of 493 patients who underwent mitral valve surgery in Fuwai Hospital in 2017 were collected by blood transfusion management system and retrospectively analyzed by SPSS. The patients were divided into anemia group (n=34, male Hb<120 g/L and female Hb<110 g/L) and non-anemia group (n=459) .The measurement data were statistically analyzed with t test or rank sum test, and enumeration data by Fisher test and Chi-square test, and then all analyzed by binary logistics regression. 【Results】 The incidence of anemia before mitral valve surgery was 6.90% (34/493). Perioperative erythrocyte dosage (U) (median), erythrocyte transfusion rate, ICU stay time (d) (median) and hospital mortality rate(%) in anemia group and non-anemia group were 4.00 vs 0.00 (OR: 2.55, 95% CI: 1.70~3.40, P<0.05), 67.65% vs 21.35% (OR: 12.98, 95% Cl: 5.21~31.15, P<0.05), 2.50 vs 2.00 (B: 0.71, 95% Cl: 0.08~1.33, P<0.05) and 5.88 vs 0.22(P<0.05)respectively. 【Conclusion】 Preoperative anemic is independently associated with perioperative RBC transfusion in patients undergoing mitral valve surgery, and may increase ICU length of stay and hospital mortality.

Effect of advanced maternal age on development of hippocampal neural stem cells in offspring rats / 中国当代儿科杂志

OBJECTIVE@#To study the effect of advanced maternal age (AMA) on the development of hippocampal neural stem cells in offspring rats.@*METHODS@#Ten 3-month-old and ten 12-month-old female Sprague-Dawley rats were housed individually with 3-month-old male rats (1:1, n=20), whose offspring rats were assigned to a control group and an AMA group. A total of 40 rats were randomly selected from each group. Immunofluorescence assay and Western blot were used to localize and determine the levels of protein expression of Nestin and doublecortin (DCX) on day 7 as well as neuronal nuclear antigen (NeuN) and glial fibrillary acidic protein (GFAP) on day 28 (n=8 for each marker). Immunofluorescence assay was also used to localize the hippocampal expression of polysialylated isoforms of neural cell adhesion molecule (PSA-NCAM) on day 14 (n=8 for each marker).@*RESULTS@#According to the Western blot results, the AMA group had significantly lower protein expression of DCX than the control group (P0.05). According to the results of immunofluorescence assay, the AMA group had significantly lower protein expression of Nestin, DCX, and PSA-NCAM in the hippocampal dentate gyrus (DG) region than the control group (P0.05). The AMA group had significantly higher expression of NeuN in the hippocampal CA1 region than the control group (P0.05). The AMA group had significantly lower expression of GFAP in the hippocampal CA1, CA3, and DG regions than the control group (P<0.05).@*CONCLUSIONS@#AMA may cause inhibition of proliferation, survival, and migration of hippocampal neural stem cells. AMA may also affect their differentiation into neurons and astrocytes, which will eventually lead to developmental disorders of hippocampal neural stem cells in offspring rats.

Molecular diagnosis and functional study of a pedigree affected with Lubs X-linked mental retardation syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a pedigree affected with X-linked mental retardation.@*METHODS@#The proband was subjected to chromosomal karyotyping, FMR1 mutation testing and copy number variation analysis with a single nucleotide polymorphism microarray (SNP array). His family members were subjected to multiplex ligation-dependent probe amplification (MLPA) assaying. Expression of genes within the repeated region were analyzed.@*RESULTS@#The proband had a normal chromosomal karyotype and normal number of CGG repeats within the FMR1 gene. SNP array identified a 370 kb duplication in Xq28 (ChrX: 153 027 633-153 398 515), which encompassed 14 genes including MECP2. The patient was diagnosed as Lubs X-linked mental retardation syndrome (MRXSL). MLPA confirmed the presence of copy number variation, its co-segregation with the disease, in addition with the carrier status of females. Genes from the duplicated region showed higher levels of expression (1.79 to 5.38 folds) within peripheral blood nucleated cells of the proband.@*CONCLUSION@#The patients were diagnosed with MRXSL. The expression of affected genes was up-regulated due to the duplication. Genetic counseling and prenatal diagnosis may be provided based on the results.

A preliminary study on the bone-targeting potential of a new type of bisphosphonate in rabbits / 中国药学杂志

OBJECTIVE: To study the bone-targeting potential and dynamic changing process in vivo of a new type of anti-osteoporosis bisphosphonate drug under research (SC). METHODS: The distribution in rabbits and bone-targeting of SC was observed by isotope tracer technique. 99Tcm-SC was injected into the rabbits, then the SPECT images were collected and analyzed in 12 h. RESULTS: The labeling rate of 99Tcm-SC could be maintained above 90% within 12 h, which proved the good stability of 99Tcm-SC in vitro. The rabbit bone imaging showed that the targeting of SC to bone was equivalent to MDP, a bone imaging agent. CONCLUSION: This study provides valuable data for the non-clinical and clinical studies of SC. SC has a good potential for being developed into a new generation of anti-osteoporosis drug.

An investigation on status of health literacy and its influencing factors among residents in Qiandao Lake town / 预防医学

Objective To understand the status of health literacy of residents in Qiandao Lake town in order to complete the surveillance system.Methods A total of 484 residents aged 15 to 69 years old from 9 communities were selected using cluster random sampling method.Then the household interview was conducted.Results The overall level of health literacy of residents was 26.03%.As for the 4 health literacy related aspects including basic health knowledge,health lifestyle and behaviors,health related skill and health beliefs,the rates were 32.54% ,4.77% ,60.30% and 92.62%,respectively. The multivariate logistic regression analysis showed that the level of health literacy of residents was related to age and education.Conclusion The health education in Qiandao Lake town has got some achievements.

Lamivudine, interferon-alpha and oxymatrine treatment for the surviving hepatic failure patients with hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effect of lamivudine, interferon alpha and oxymatrine treatment for surviving hepatic failure patients with hepatitis B.</p><p><b>METHODS</b>200 hepatitis B patients, including 100 subacute or acute-on-chronic hepatic failure survivals (group A), and 100 chronic (group B, n=100) hepatic failure survivals, were enrolled in this study. Patients in group A received interferon alpha (n=35), lamivudine (n=33) , or combinational lamivudine and oxymatrine (n=32) therapy for six months; Patients in group B received lamivudine (n=49), or combinational lamivudine and oxymatrine (n=51) therapy for six months, respectively. After the treatment, all patients were followed-up for six months.</p><p><b>RESULTS</b>At the end of follow-up, all patients in group A survived, while in group B three patients (6.1%) receiving lamivudine, and four (7.8%, P>0.05) receiving combinational therapy died; more than 90% of all survivals had their HBV DNA loss. The HBeAg/anti-HBe seroconversion rate in patients of group A treated with interferon alpha (9/17, 52.9%) was higher than that in patients treated with combinational lamivudine and matrine (5/16, 31.3%, P<0.05), which was higher than that in the patients treated with lamivudine alone (1/17, 5.9%, P<0.01), and the Knodell histological activity index score in patients treated with lamivudine (7.2+/-0.8, P<0.05) was lower than that in patients treated with interferon alpha (8.2+/-1.3, P<0.05), and the best efficacy was found in receiving combinational therapy (6.9+/-0.7, P<0.01); Lamivudine or lamivudine in combination with matrine significantly inhibited the intrahepatic inflammatory activities, but had no effect on the existing fibrosis in group B patients.</p><p><b>CONCLUSION</b>Long term nucleotide analogues treatment may delay the progress of fibrosis in hepatitis B-induced hepatic failure survivals, and the administration of matrine in time may further enhance the anti-fibrotic effect of nucleotide analogues.</p>

Analysis of 112 cases with diffuse axonal injury / 法医学杂志

OBJECTIVE@#To investigate the relationship between the diffuse axonal injury (DAI) and cerebral contusion, primary brain stem injury and brain concussion.@*METHODS@#One hundred and twelve cases with DAI were analyzed according to the characteristics of clinical signs and imaging features.@*RESULTS@#Of 112 cases of DAI, 70.5% injured in traffic accident, 60.7% injured with blunt trauma more than one time and 71.4% injured with cerebral contusion. And 90 cases with brain with hemorrhage were found in CT or MRI imaging.@*CONCLUSION@#DAI may be associated with cortical contusion and primary brain stem injury. The CT or MRI is useful to investigate the cause of death and to evaluate the personal disability.

Design and application of adjustable triangle external fixator for the treatment of calcaneal fractures / 中国骨伤

<p><b>OBJECTIVE</b>To design a kind of adjustable triangle external fixator, and to use it for treating calcaneal fractures.</p><p><b>METHODS</b>The external fixator was installed into extremity near the both sides of three Kirschner wires crossing the calcaneal tubercle, the lower end of the tibia and the first cuneiform. The support rod length was adjusted to ensure the Kirschner wires affecting the calcaneal tubercle, so the Böhler angle and anteroposterior diameter of the calcaneus were recovered. From April in 2003 to April in 2008, the external fixators were used to treat 34 patients with calcaneal fractures, including 30 males and 4 females, ranging in age from 19 to 54 years, with an average of 36.7 years. The Böhler angles were -5 degree to 15 degree, with an average of 13.5 degrees. According to Sander's classification, 2 patients were type II, 20 patients were type III, and 12 patients were type IV.</p><p><b>RESULTS</b>Thirty-four patients were followed up, and the duration ranged from 3 months to 4 years, averaged 25 months. The Böhler angle recovered to 30 degree to 40 degrees, with a mean of 32.5 degrees. The Maryland mean score improved from preoperative (24.76+/-15.05) to postoperative (83.26+/-16.81). Based on Maryland criteria, 8 patients got an excellent result, 21 good, 3 fair and 2 bad.</p><p><b>CONCLUSION</b>The adjustable triangle external fixator for treating calcaneal fractures has the following advantages : simple approach, good recovery, little reinjury and complications, effectiveness to recovery Böhler angle and anteroposterior diameter of calcaneal, which is an ideal method to treat calcaneal fractures.</p>

Application of purified recombinant outer membrane lipoprotein LipL32 in detecting antibodies among leptospirosis cases / 中华流行病学杂志

Objective To establish recombinant outer membrane lipoprotein LipL32-based antibody detection assays in identifying leptospirosis. Methods Recombinant leptospiral outer membrane protein LipL32 was obtained by genetic engineering method. This purified protein was used in the indirect and sandwich ELISA assays to test the antibodies in sera of human beings and rats, and the results were compared with those obtained by microscopy agglutination test (MAT) and imported ELISA kit. Results When the acute and convalescent phase specimens from 9 leptospiral patients were tested, the detected rates of three ELISAs were similar to the MAT. Among the 45 probable cases which MAT showed positive, 32 (71.11%) samples were positive by r32-I-ELISA, 36(80.00%) by r32-S-ELISA,while 28.89% (13/45) samples were positive and 55.56% (25/45)were suspicious by D.A.I-ELISA. The specificity of r32-I-ELISA and r32-S-ELISA were 97.10 % (67/69) for 69 specimens. 43 healthy specimens were negative by both r32-I-ELISA and r32-S-ELISA, 14 healthy specimens were negative by D.A.I-ELISA. Among 16 non-leptospirosis patients, two specimens were positive by r32-I-ELISA and r32-S-ELISA, D.A.I-ELISA and identified one positive specimen, while 12 specimens were suspicious by D.A.I-ELISA. For 10 syphilis specimens, data obtained through three ELISAs were in consistent with that by MAT. A sandwiched ELISA, using rLipL32 protein as the antigen was developed to detect rat sera. Considering MAT as standard test, the sensitivity and specificity were 86.75 % (131/151), 99.19 % (122/123) respectively with coincidence rate as 92.34% (253/274). Conclusion The recombinant protein LipL32 had high immunoresctivity and could be used as an antigen for the detection of panthogenic leptospirosis. In summary, the novel sandwiched ELISA with rLipL32 showed similar sensitivity and specificity to that of MAT in the antibody detection of rat leptospirosis. It was suitable for large scales field sero-epidemiological studies.

Autologous bone marrow stem cell transplantation for treatment terminal liver diseases / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of autologous bone marrow-derived stem cell (BMSCs) transplantation in the treatment of liver failure and decompensated hepatic cirrhosis.</p><p><b>METHODS</b>Bone marrow was harvested (65-95 ml) from 24 patients in the transplantation group. The BMSCs were isolated and infused into liver or spleen of patients via hepatic or splenic artery. At different time points after the transplantation, the patients' liver function and prothrombin time (PT) were evaluated, and the survival rate and symptoms of the patients were recorded.</p><p><b>RESULTS</b>All the serum biochemical indexes remained stable 2 weeks after the transplantation, and at 4 weeks after transplantation, albumin level increased significantly in comparison with the preoperative level (P<0.05). At 12 weeks, the albumin level further increased (P<0.01) along with Pre-ALB (P<0.01), while total bilirubin, tolal bile acid, PT and fibrinogen were all significantly lowered (P<0.05), and globulin, ALT, and AST remained unchanged (P>0.05). One week after the transplantation, improved appetite was observed in 22 cases (91.67%), and 21 cases (87.5%) showed better physical strength; at 2 weeks, hepatic face improved in 15 cases (62.5%), and spider telangiectasia was significantly reduced in one case; at 12 weeks, the survival rate of the patients was 62.5%, and 9 died or gave up treatment due to chronic liver failure complicated by spontaneous bacterial peritonitis, hepatorenal syndrome, or DIC. No complications associated with the transplantation occurred in these patients.</p><p><b>CONCLUSION</b>BMSC transplantation can significantly improve the liver function of patients with terminal liver disease with good safety and effectiveness.</p>