Comparison of the anterior and posterior approach in treating four-level cervical spondylotic myelopathy / 中华医学杂志(英文版)

BACKGROUND@#The optimal surgical approach for four-level cervical spondylotic myelopathy remains controversial. The purpose of this study was to compare clinical and radiological outcomes and complications between the anterior and posterior approaches for four-level cervical spondylotic myelopathy.@*METHODS@#A total of 19 patients underwent anterior decompression and fusion and 25 patients underwent posterior laminoplasty and instrumentation in this study. Perioperative information, intraoperative blood loss, clinical and radiological outcomes, and complications were recorded. Japanese Orthopedic Association (JOA) score, 36-item short form survey (SF-36) score and cervical alignment were assessed.@*RESULTS@#There were no significant differences in JOA scores between the anterior and posterior group preoperatively (11.6 ± 1.6 vs. 12.1 ± 1.5), immediately postoperatively (14.4 ± 1.1 vs. 13.8 ± 1.3), or at the last follow-up (14.6 ± 1.0 vs. 14.2 ± 1.1) (P > 0.05). The JOA scores significantly improved immediately postoperatively and at the last follow-up in both groups compared with their preoperative values. The recovery rate was significantly higher in the anterior group both immediately postoperatively and at the last follow-up. The SF-36 score was significantly higher in the anterior group at the last follow-up compared with the preoperative value (69.4 vs. 61.7). Imaging revealed that there was no significant difference in the Cobb angle at C2-C7 between the two groups preoperatively (-2.0° ± 7.3° vs. -1.4° ± 7.5°). The Cobb angle significantly improved immediately postoperatively (12.3° ± 4.2° vs. 9.2° ± 3.6°) and at the last follow-up (12.4° ± 3.5° vs. 9.0° ± 2.6°) in both groups compared with their preoperative values (P = 0.00). Three patients had temporary dysphagia in the anterior group and four patients had persistent axial symptoms in the posterior group.@*CONCLUSIONS@#Both the anterior and posterior approaches were effective in treating four-level cervical spondylotic myelopathy in terms of neurological clinical outcomes and radiological features. However, the JOA score recovery rate and SF-36 score in the anterior group were significantly higher. Persistent axial pain could be a major concern when undertaking the posterior approach.

Venous thromboembolism in the emergency department: A survey of current best practice awareness in physicians and nurses in China / 世界急诊医学杂志（英文）

BACKGROUND@# For emergency department (ED) patients, risk assessment, prophylaxis, early diagnosis and appropriate treatment of venous thromboembolism (VTE) are essential for preventing morbidity and mortality. This study aimes to investigate knowledge amongst emergency medical staff in the management of VTE.@*METHODS@# We designed a questionnaire based on multiple scales. The questionnaire was distributed to the medical and nursing clinical staff in the large urban ED of a medical center in Northern China. Data was described with percentages and the Kruskal-Wallis test was used to compare ranked data between different groups. The statistical analysis was done using the SPSS 22.0 software.@*RESULTS@# In this survey, 180 questionnaires were distributed and 174 valid responses (response rate of 96.67%) were collected and analyzed. In scores of VTE knowledge, no significant differences were found with respect to job (doctor vs. nurse), the number of years working in clinical medicine, education level, and current position, previous hospital experience and nurses' current work location within the ED. However, in pair wise comparison, we found participants who worked in ED for more than 5 years (n=83) scored significantly higher on the questionnaire than those under 5 years (n=91) (95.75 vs. 79.97, P=0.039). There was a significant difference in some questions based on gender, age, job, and nurse work location, number of working years, education level, and different ED working lifetime.@*CONCLUSION@# Our survey has shown deficiencies among ED medical staff in knowledge and awareness of the management of VTE. We recommend several changes be considered, such as the introduction of an interdisciplinary workshop for medical staff; the introduction of a standardized VTE protocol; a mandatory study module on VTE for new physicians and nurses; the introduction of a mandatory reporting system for adverse events (including VTE).

Mortality Risk Attributed to Ambient Temperature in Nanjing, China / 生物医学与环境科学（英文）

We examined the attributed fractions of all-cause, cardiovascular, and respiratory mortality that were attributed to extreme and moderate cold and heat during 2010-2016 in Nanjing. Our results showed that 12.81%, 19.78%, and 25.33% of all-cause, cardiovascular, and respiratory mortalities, respectively, were attributed to temperature. The highest attributed fractions for three types of mortality were at 4 ℃ and the attributed fractions were high around 4 ℃, which falls within the moderate cold temperatures. Although moderate cold has lower RR than extreme cold, it occurred on more days than did extreme cold. Therefore, health burden caused by moderate cold requires further attention in the future.

Advantage of cyclosporine A and methotrexate rotational therapy in long-term systemic treatment for chronic plaque psoriasis / 实用医学杂志

Objective To evaluate the safety of cyclosporine(CsA)and methotrexate(MTX)in the treat-ment of psoriasis and to analyze the risk factors of side effects in the course of treatment. Methods In this retro-spective study,the patients with psoriasis treated with CsA and MTX were enrolled from April 2012 to April 2016 in Hainan Province. The clinical data and medication status of the patients were retrospectively collected. All pa-tients underwent laboratory tests such as blood,liver enzyme,renal function,and urine tests before treatment and during the follow-up. During the course of the study,any adverse events were recorded in the rotation treatment. Results A total of 42 psoriatic patients were enrolled. After screening,42 patients with psoriasis were enrolled. The average dosage and cumulative dose were(456.79 ± 472.14)days,and(134.68 ± 183.24)g for cyclosporine and(274.51 ± 215.32)days,(418.62 ± 435.63)mg for methotrexate.Four patients had abnormal laboratory tests after treatment:4 patients(9.5%)had abnormal transaminases and 2(4.8%)were accompanied by abnormal uric acid. The renal function tests(serum creatinine and blood urea nitrogen),blood cell count and urine tests for all patients were in the normal range. Conclusions In the long-term systemic treatment of chronic plaque psoriasis, the use of cyclosporine A and methotrexate therapy can largely reduce the side effects of drugs,especially the oc-currence of renal toxicity. In the course of treatment,the epidemiology of patient,duration of disease,severity of the disease,the dose and duration of drugs are not high risk factors for the side effects of drugs.

Analysis on supply management system of emergency drugs in China: From the perspectives of policy network theory / 中国卫生政策研究

Objective:To analyze the supply management of emergency drugs from the perspective of policy network theory and to provide a reference for the establishment of timely,reasonable and effective emergency drug management system in China.Methods:The policy network theory was used to examine the existing problems in the current supply management system of emergency drugs in China and to optimize the policy network of emergency drug supply in China.Results:The policy network theory is applicable to the emergency drug system in China.From the perspective of policy network theory,the following aspects of supply management system of emergency drugs should be improved,including a clear government responsibility at all levels,strengthening the work of medical emergency funding and legal protection,and building up a policy network of public information platform for emergency drugs.Conclusion:Based on the findings of this analysis,optimizing the supply management system of China's emergency drugs is one of the important directions of the construction of national emergency system in China.The emergency work of the drugs needs to run benignly in a network with stable structure,balance of interests and integration of resources,so as to obtain reasonable and efficient results.

Microstructure Study of Normal Lunates with Micro-computed Tomography / 华中科技大学学报（医学）（英德文版）

In order to study the microstructure characteristics of normal lunate bones,eight fresh cadaver normal lunates were scanned with micro-computed tomography.High-resolution images of the micro-structure of normal lunates were obtained and we analyzed the nutrient foramina.Then nine regions of interest (ROI) were chosen in the central sagittal plane so that we could obtain the parameters of trabecular bones of ROIs.The distal lamellar-like compact structure had statistically significant differences when it was compared with the ROIs in the volar and dorsal ends of the distal cortex.The difference of diameter between the volar and dorsal foramina was significant (P＜0.05).However,there was no significant difference regarding the number.The trabecular bones of the volar and dorsal distal ends had lower intensity than those of the distal central subchondral bone plate.The diameters of the nutrient foramina on the volar cortex were larger than those on the dorsal.This research provided more detailed information about microstructure of normal lunate and the nutrient foramina on cortex,and a reference for further study about diseased lunate.

Feasibility study of the use of left atrial appendage occluder LACBES with animal experiment / 介入放射学杂志

Objective To introduce a self-developed left atrial appendage occluder,LACBES,and to explore the clinical feasibility of using it for the occlusion of left atrial appendage (LAA).Methods Eight healthy canines were used in this experimental study.The LAA of each canine was occluded with LACBES occluder through trans-femoral vein approach.After the procedure of occlusion,the compression ratio of the occluder was calculated,the residual shunt was assessed by left atrial angiography.The left atrium pressure was monitored before and after the procedure,and the immediate effect of LAA occlusion on the left atrium pressure was statistically analyzed.Results Implantation of LACBES occluder was successfully accomplished in all the eight canines.The compression ratio of the occluders ranged from 10％ to 15％.Small amount of postoperative residual shunt was detected in one canine.After occlusion two canines died of procedure-related complications,including shifting of occluder and formation of hematoma at puncturing site.No device-associated death occurred.After occlusion,the left atrial systolic pressure increased instantly,which went up from preoperative (25.4±2.8) mmHg to postoperative (27.5±3.4) mmHg (P＜0.05),but it returned to the baseline of (25.4±2.8) mmHg within 15 minutes.Conclusion For the occlusion of LAA,the use of LACBES occluder carries higher instant success rate and lower residual shunt rate with less device-associated complications,although the left atrial systolic pressure has a transient rising immediately after the occlusion.Therefore,it is expected that LACBES will be able to be applied in clinical practice.

Analysis on supply management system of emergency drugs in China: From the perspectives of policy network theory / 中国卫生政策研究

Objective:To analyze the supply management of emergency drugs from the perspective of policy network theory and to provide a reference for the establishment of timely,reasonable and effective emergency drug management system in China.Methods:The policy network theory was used to examine the existing problems in the current supply management system of emergency drugs in China and to optimize the policy network of emergency drug supply in China.Results:The policy network theory is applicable to the emergency drug system in China.From the perspective of policy network theory,the following aspects of supply management system of emergency drugs should be improved,including a clear government responsibility at all levels,strengthening the work of medical emergency funding and legal protection,and building up a policy network of public information platform for emergency drugs.Conclusion:Based on the findings of this analysis,optimizing the supply management system of China's emergency drugs is one of the important directions of the construction of national emergency system in China.The emergency work of the drugs needs to run benignly in a network with stable structure,balance of interests and integration of resources,so as to obtain reasonable and efficient results.

Effect of Resveratrol on Preventing Steroid-induced Osteonecrosis in a Rabbit Model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Prevention of osteonecrosis (ON) has seldom been addressed. The purpose of this study was to evaluate the effect of resveratrol on preventing steroid-induced ON in rabbits.</p><p><b>METHODS</b>Seventy-two rabbits were divided into four groups: (1) NEC (ON) group: thirty rabbits were treated with lipopolysaccharide (LPS) once, then with methylprednisolone (MPS) daily for 3 days; (2) PRE (prevention) group: thirty rabbits were given one dose of LPS, then MPS daily for 3 days, and resveratrol on day 0 and daily for 2 weeks; (3) RES (resveratrol) group: six rabbits were given resveratrol for 2 weeks but without LPS/MPS; (4) CON (control) group: six rabbits were given alcohol for 2 weeks but without LPS/MPS. Levels of plasma tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), thrombomodulin (TM), vascular endothelial growth factor (VEGF), maximum enhancement (ME) by magnetic resonance imaging, and ON incidence were evaluated.</p><p><b>RESULTS</b>The PRE group had a lower ON incidence than the NEC group, but with no significant differences at 2 weeks and 12 weeks. The RES and CON groups did not develop ON. TM and VEGF were significantly higher in the NEC group compared with the PRE group at weeks 1, 2, and 4 (TM: 1 week, P = 0.029; 2 weeks, P = 0.005; and 4 weeks, P = 0.047; VEGF: 1 week, P = 0.039; 2 weeks, P = 0.021; 4 weeks, P = 0.014), but the difference disappeared at 12 weeks. The levels of t-PA and PAI-1 were not significantly different between the NEC and PRE groups. The TM, t-PA, PAI-1, and VEGF concentrations in the RES and CON groups did not change over time. Compared to the baseline, ME in the NEC group decreased significantly (P = 0.025) at week 1, increased significantly (P = 0.021) at week 2, and was decreased at week 12. The variance was insignificant in the PRE group.</p><p><b>CONCLUSIONS</b>Resveratrol may improve blood supply to bone in a rabbit model of ON of the femoral head via anti-inflammatory effects to protect the vascular endothelium and reduce thrombosis.</p>

Surgical Fixation of Fourth and Fifth Metacarpal Shaft Fractures with Flexible Intramedullary Absorbable Rods: Early Clinical Outcomes and Implications / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>To avoid the irritation of tendons and soft tissues as well as hardware-related problems, we designed an intramedullary fixation with bioabsorbable rods for the treatment of the metacarpal shaft fractures.</p><p><b>METHODS</b>Five patients with nine shaft fractures of the fourth and fifth metacarpi were treated with intramedullary absorbable implants and followed up with an average of 4.2 months postoperatively.</p><p><b>RESULTS</b>At final follow-up, all patients achieved fracture union with no signs of inflammatory or subcutaneous effusion. There was no shortening, angulatory, or rotatory deformity. There was almost full active extension range of motion (ROM) of the metacarpophalangeal joints while the active flexion ROM of these joints was 80.7 ± 9.6°. Compared with the contralateral hand, the grip strength of the injured hand was 94.0 ± 9.6%. X-rays showed that the arch of the second to fifth metacarpal heads was smooth. There were no intramedullary lytic changes and soft tissue swellings.</p><p><b>CONCLUSION</b>The intramedullary absorbable implants are a safe, simple, and practical treatment for fourth and fifth metacarpal fractures with good early clinical outcomes and no significant complications.</p>

Association between Ambient Air Pollution and Hospital Emergency Admissions for Respiratory and Cardiovascular Diseases in Beijing: a Time Series Study / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the association between ambient air pollution and hospital emergency admissions in Beijing.</p><p><b>METHODS</b>In this study, a semi-parametric generalized additive model (GAM) was used to evaluate the specific influences of air pollutants (PM10, SO2, and NO2) on hospital emergency admissions with different lag structures from 2009 to 2011, the sex and age specific influences of air pollution and the modifying effect of seasons on air pollution to analyze the possible interaction.</p><p><b>RESULTS</b>It was found that a 10 μg/m3 increase in concentration of PM10 at lag 03 day, SO2 and NO2 at lag 0 day were associated with an increase of 0.88%, 0.76%, and 1.82% respectively in overall emergency admissions. A 10 μg/m3 increase in concentration of PM10, SO2 and NO2 at lag 5 day were associated with an increase of 1.39%, 1.56%, and 1.18% respectively in cardiovascular disease emergency admissions. For lag 02, a 10 μg/m3 increase in concentration of PM10, SO2 and NO2 were associated with 1.72%, 1.34%, and 2.57% increases respectively in respiratory disease emergency admissions.</p><p><b>CONCLUSION</b>This study further confirmed that short-term exposure to ambient air pollution was associated with increased risk of hospital emergency admissions in Beijing.</p>

Establishment of hamster- and human-PRNP transgenic mice / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To create transgenic mice expressing hamster- and human-PRNP as a model for understanding the physiological function and pathology of prion protein (PrP), as well as the mechanism of cross-species transmission of transmissible spongiform encephalopathies (TSEs).</p><p><b>METHODS</b>Hamster and human-PRNP transgenic mice were established by conventional methods. The copy number of integrated PRNP in various mouse lines was mapped by real-time PCR. PRNP mRNA and protein levels were determined by semi-quantitative RT-PCR, real-time RT-PCR, and western blot analysis. Histological analyses of transgenic mice were performed by hematoxylin and eosin (H & E) staining and immunohistochemical (IHC) methods.</p><p><b>RESULTS</b>Integrated PRNP copy number in various mouse lines was 53 (Tg-haPrP1), 18 (Tg-huPrP1), 3 (Tg-huPrP2), and 16 (Tg-huPrP5), respectively. Exogenous PrPs were expressed at both the transcriptional and translational level. Histological assays did not detect any abnormalities in brain or other organs.</p><p><b>CONCLUSION</b>We have established one hamster-PRNP transgenic mouse line and three human-PRNP transgenic mouse lines. These four transgenic mouse lines provide ideal models for additional research.</p>

The enhancement of DNA binding ability of a mutated E2 (A338V) protein of HPV-2 / 病毒学报

HPV-2 is a very common type of HPV which causes common warts. The E2 protein of virus can repress the activity of the viral early promoter through binding to the specific binding sites in viral LCR. Previously we reported that the repression of a mutated E2 protein of HPV-2 isolated from a patient with huge common wart on the viral early promoter was obviously decreased, and A338V mutation located at the C terminal DNA binding region of E2 protein. In this study, we expressed and purified the recombinant mutated and prototype E2 fusion proteins, both in the contexts of the C terminal and the full length, by prokaryotic expression system. The electrophoretic mobility shift assay showed E2 protein could bind to double-stranded DNA oligos labeled with biotin that covered two E2 binding sites. The DNA binding abilities of both C terminal and full-length mutated E2 proteins were stronger than the prototype analogs. This result indicates that the enhancement of the mutated E2 DNA binding ability may be the molecular mechanism for its impact on the activity of viral promoter, which correlates with the phenotype of extensive common wart.

Kinetics model of spherical immobilized cellulase / 生物工程学报

A kinetics model was developed for predicting and simulating immobilized cellulase performance, which follows Michaelis-Menten kinetics with competitive product inhibition. Taking into account the effects of competitive product inhibition, inner diffusional limitation, substrate concentration and carrier size, the substrate distribution and the product distribution in carriers were investigated, and the effectiveness factors were also calculated over a wide range of parameters. The effects of competitive product inhibition are shown to increase the substrate concentration in the carrier, and, additionally, to increase the effectiveness factors slightly. With the increase of inner diffusion coefficient, both the effectiveness factors and the substrate concentration in the carrier increase. As the carrier size increases, on the other hand, these values decrease. The effectiveness factors and the substrate concentration in the carrier are found to increase when substrate concentration in the reaction system increases.

Role of the central interleukin-1 in stress responses / 生理学报

The molecules of interleukin-1 (IL-1) system are widely distributed in central nervous system. As a classical pro-inflammatory factor, central IL-1 has diverse biological functions and plays a pivotal role in a number of important physiological and pathophysiological processes. During the past few years, particular attentions have been directed to the stress mediator actions of central IL-1. This paper reviews some recent findings in the studies of central IL-1 functions in stress responses, including the effects of stress on central IL-1, the roles of IL-1 in the initiation of stress responses, the neural circuitries and intracellular signal transduction pathways involved in the central IL-1 mediated stress responses, as well as the actions of central IL-1 on brain high function and behavior under stressful conditions.