Multicellular coupling fermentation for 3'-sialyllactose conversion using N-acetyl-glucosamine and lactose / 生物工程学报

Sialyllactose is one of the most abundant sialylated oligosaccharides in human milk oligosaccharides (HMOs), which plays an important role in the healthy development of infants and young children. However, its efficient and cheap production technology is still lacking presently. This study developed a two-step process employing multiple-strains for the production of sialyllactose. In the first step, two engineered strains, E. coli JM109(DE3)/ pET28a-BT0453 and JM109(DE3)/pET28a-nanA, were constructed to synthesize the intermediate N-acetylneuraminic acid. When the ratio of the biomass of the two engineered strains was 1:1 and the reaction time was 32 hours, the maximum yield of N-acetylneuraminic acid was 20.4 g/L. In the second step, E. coli JM109(DE3)/ pET28a-neuA, JM109(DE3)/ pET28a-nst and Baker's yeast were added to the above fermentation broth to synthesize 3'-sialyllactose (3'-SL). Using optimal conditions including 200 mmol/L N-acetyl-glucosamine and lactose, 150 g/L Baker's yeast, 20 mmol/L Mg2+, the maximum yield of 3'-SL in the fermentation broth reached 55.04 g/L after 24 hours of fermentation and the conversion rate of the substrate N-acetyl-glucosamine was 43.47%. This research provides an alternative technical route for economical production of 3'-SL.

Effectiveness of fascial tissue flaps and skin flaps with layered sutures for repair of wounds after excision of sacrococcygeal pilonidal sinus / 中国修复重建外科杂志

OBJECTIVE@#To investigate the feasibility and effectiveness of fascial tissue flaps and skin flaps with layered sutures for repairing wounds after excision of sacrococcygeal pilonidal sinus.@*METHODS@#Between March 2019 and August 2022, 9 patients with sacrococcygeal pilonidal sinus were admitted, including 7 males and 2 females with an average age of 29.4 years (range, 17-53 years). The disease duration ranged from 1 to 36 months, with a median of 6 months. There were 7 cases with obesity and dense hair, 3 cases with infection, and 2 cases with positive bacterial culture of sinus secretion. The wound area after excision ranged from 3 cm×3 cm to 8 cm×4 cm, with a depth of 3-5 cm, reaching the perianal or caudal bone; there were 2 cases with perianal abscess formation and 1 case with caudal bone inflammatory edema. Enlarged resection was performed during operation, and the fascial tissue flap and skin flap were designed and excised at both left and right sides of the buttock, ranging from 3.0 cm×1.5 cm to 8.0 cm×2.0 cm. A cross drainage tube was placed at the bottom of the wound, and the fascial tissue flap and skin flap were advanced and sutured in three layers, namely, 8-string sutures in the fascial layer, barbed wire reduction sutures in the dermis, and interrupted skin sutures.@*RESULTS@#All 9 patients were followed up 3-36 months, with an average of 12 months. All incisions healed by first intention, and no complication such as incisional dehiscence or infection in the operative area occurred. There was no recurrence of sinus tracts, the shape of gluteal sulcus was satisfactory, both sides of buttocks were symmetrical, local incision scar was concealed, and the shape disruption was minimal.@*CONCLUSION@#Fascial tissue flaps and skin flaps with layered sutures for repairing wounds after excision of sacrococcygeal pilonidal sinus can effectively fill the cavity and reduce the incidence of poor incision healing, with the advantages of small trauma and simple operation.

Application of hairpin shaped incision combined with cover-lifting flap in plastic surgery of huge fat pad on nape and back / 中国修复重建外科杂志

OBJECTIVE@#To explore the effectiveness of hairpin shaped incision combined with cover-lifting flap in plastic surgery of huge fat pad on nape and back.@*METHODS@#Between March 2019 and March 2023, 10 patients with huge fat pad on the nape and back were treated. There was 1 male and 9 females with an average age of 52 years (range, 39-57 years). All patients had soft tissue bulge on the nape and back. Preoperative MRI showed the subcutaneous fat thickening. The length of the longitudinal axis of the fat pad ranged from 10.0 to 25.0 cm (mean, 14.1 cm), the length of the transverse axis ranged from 6.0 to 15.0 cm (mean, 10.8 cm); the thickness of the fat pad ranged from 2.5 to 5.1 cm (mean, 3.9 cm). Under general anesthesia, the patient was placed in a prone position and a hairpin shaped incision was made. The flap was lifted to remove the fat pad according to the marked area. The dressing was changed every 2 days after operation.@*RESULTS@#The operation time was 35-110 minutes (mean, 72 minutes). The intraoperative blood loss was 35-80 mL (mean, 49.5 mL). The drainage tube was removed at 2-5 days after operation (mean, 3.4 days). All incisions healed by first intention without incision dehiscence, infection, subcutaneous bruising, hematoma, or other related complications. All patients were followed up 2-24 months (mean, 12 months). All patients had a good shape of the nape and back and no noticeable scar on the incision. According to the Vancouver Scar Scale evaluation criteria, the incision scar score was 3-5 (mean, 3.7) at 2 months after operation. Patients had good neck movement with no recurrence.@*CONCLUSION@#For the huge fat pad on the nape and back, the plastic surgery using hairpin shaped incision and cover-lifting flap has the advantages of fully exposing the fat pad, concealed incision, simple operation, and natural shape of the nape and back after operation.

Prevalence and Risk Factors of Sarcopenia Among Community Dwelling Older Adults in Klang Valley

@#Introduction: Sarcopenia is one of the geriatric syndromes affecting the ability of older adults to lead an independent living. However, its risk factors among Malaysian older adults are yet to be determined. This study investigated the prevalence and risk factors of sarcopenia among community-dwelling older adults in Klang Valley. Methods: This cross-sectional study involved 393 Malaysians aged 60 and above, residing in urban areas of Klang Valley recruited through convenience sampling. Socio-demographic and food intake information were obtained using validated questionnaires. Cut-off points for sarcopenia screening were obtained from the Asian Working Group of Sarcopenia(AWGS) while body impedance analysis(BIA) was employed to determine skeletal muscle index. A handgrip dynamometer was used to assess dominant handgrip strength and a 6-meter gait speed test was used to determine walking speed. Binary logistic regression analysis was used to determine the risk factors of sarcopenia. Results: Prevalence of sarcopenia was 33.6% and women(35.9%) were more affected compared to men(30.1%). The mean age of women assessed to have sarcopenia(69.1±6.5 years old) was higher compared to men(68.3±5.8 years old) (p<0.05). After adjusting for confounding factors, older adults with one year increased in age and one mg decreased in habitual dietary iron intake were estimated to be 1.08 times and 0.93 times the chances to have sarcopenia respectively. Conclusion: Approximately one-third of community-dwelling older adults in Klang Valley were assessed to have sarcopenia. Older adults aged 60 years and above and those with low dietary iron intake were at an increased risk of developing sarcopenia.

Factors Associated With Pressure Ulcer Risk Among Spinal Cord Injury Adults in Kuala Lumpur, Malaysia: A Community-based Study

@#Introduction: Pressure ulcers (PUs) are a leading health problem among spinal cord injury(SCI) patients. Therefore, this comprehensive study was aimed at determining the association between potential factors and the occurrence of PUs among SCI adults in community settings. Methods: A cross-sectional study was conducted among adults with SCI aged 18 years and above from five selected locations in Kuala Lumpur, Malaysia. The study was carried out through interviews based on validated questionnaires such as the Dietary History Questionnaire (DHQ), Spinal Nutrition Screening Tool (SNST), Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), Barthel Index for Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL). Estimated weight and height were obtained using recumbent formula. The stages of their PUs were assessed based on National Pressure Ulcer Advisory Panel (NPUAP) grading system. Results: A total of 40 subjects participated in the study, 25% of whom were having PUs. Their nutritional inadequacies were identified, whereby 90%, 70% and 85.5% of them were receiving below their daily requirement of energy, carbohydrate and protein, respectively. The fat and sodium intakes of 55% of them were above the Malaysian Recommended Nutrient Intakes(RNI). It was successfully found that physical activity could decrease the risk of PUs(R2=0.654, OR=0.310, p<0.05). Conclusion: Overall, 25% of the subjects had PUs that were associated with physical inactivity. The majority of the subjects did not meet their nutrient requirements. Therefore, there is a need for increased physical activity and improved nutrient intake in order to reduce the risk of pressure ulcers among SCI adults in communities.

Efficacy analysis of antibiotic bone cement in treating infectious wound of lower extremity / 中国骨伤

OBJECTIVE@#To discuss the clinical effect of antibiotic bone cement in the treatment of infectious wound of lower extremity.@*METHODS@#From January 2016 to January 2019, 28 patients who had infection wounds of lower extremity were treated by antibiotic bone cement, including 21 males and 7 females with age of 34 to 76 (53.8±16.5) years old. The wound area after the initial debridement was 4 cm×3 cm to 12 cm×8 cm. All patients were treated with the antibiotic bone cement, when infection was controlled and fresh granulation tissue grew on the wound surface, local sutures or skin grafts were performed. The changes of white blood cell (WBC), erythrocyte sedimentation rate(ESR), C reactive protein(CRP) and positive rate of bacterial culture of wound secretions were recorded andcompared before and after 2 weeks of the operation. The healing time, recurrence rate and complications of fresh granulation on wound surface were calculated.@*RESULTS@#All patients were followed up for 3 to 6(4.3±1.2) months. After the recurrence of diabetic foot wound infection, 3 patients presented different degree of rupture, and the remaining patients had good wound healing. No serious complications such as aggravation of infection and amputation occurred. The WBC, ESR and CRP of the patients were decreased significantly after operation compared with that before operation (9.1±1.2)×109/L vs. (11.4±2.2)×109/L, (23.5±7.6) mm/ h vs. (57.1±14.9) mg/L, (44.2±13.1) mg/L vs. (89.2±26.7) mg/L (@*CONCLUSION@#The antibiotic bone cement can control infection of lower extremity wound effectively, promote the growth of fresh granulation tissue and wound healing.

Superoxide dismutase 3 as an inflammatory suppressor in A549 cells infected with Mycoplasma pneumoniae

Herein, we found that serum concentration of superoxide dismutase 3 (SOD3) was significantly reduced inchildren with mycoplasma pneumonia (MP) infection. To study the roles of SOD3 in inflammatory regulationof MP infection, human A549 type II alveolar epithelial cells were stimulated with 107 CCU/ml of MP to buildMP infection in vitro. Secretion of pro-inflammatory cytokine interleukin (IL)-8 and tumor necrosis factor(TNF)-a were measured via enzyme-linked immunosorbent assay (ELISA) to assess the inflammatory responseof A549 cells. Levofloxacin (LVFX) was used as an anti-inflammatory drug while recombinant TNF-a wasused as an inflammatory promotor in MP-infected cells. Transcriptional activity of nuclear factor (NF)-rB wasassessed by detecting protein levels of nuclear NF-rB and cytoplasm NF-rB using Western blot analysis. Ourdata suggested that the expression of SOD3 mRNA and protein, as well as content of SOD3 in culturedsupernatant, were time-dependently inhibited in MP-infected A549 cells. However, lentiviruses-mediatedSOD3 overexpression alleviated inflammatory response of MP-infected A549 cells, and prevented the uncleartranslocation of NF-rB, as evidenced by obviously reducing the production of IL-8 and TNF-a in cell culturedsupernatant, as well as decreasing nuclear NF-rB while increasing cytoplasm NF-rB. Inspiringly, SOD3overexpression induced anti-inflammatory effect and the inactivation of NF-rB was similar to that of 2 lg/mlof LVFX, but reversed by additional TNF-a treatment. Therefore, we can conclude that transcriptional activityof NF-jB was the underlying mechanism, by which SOD3 regulated inflammatory response in MP infectionin vitro

Transient Receptor Potential Canonical 4 and 5 Channel Antagonist ML204 Depolarized Pacemaker Potentials of Interstitial Cells of Cajal

Background/Aims@#To investigate an effect of ML204 (an inhibitor of transient receptor potential canonical 4 and 5 [TRPC4/5] channels) on interstitial cells of Cajal (ICCs) and therefore determine whether TRPC4/5 channels act on ICC-generated pacemaker activity. @*Methods@#We enforced whole cell patch clamp analysis, measurements of the intracellular Ca2+ concentration, and reverse transcription polymerase chain reaction to determine the effect of ML204 (10 μM) or englerin A (a selective activator of TRPC4/5 channeles, 10 μM) and the existence of TRPC4/5 in mouse small intestinal ICC. @*Results@#Treatment of ICCs with ML204 or englerin A caused the membrane potentials to depolarize. This depolarization effect of membrane potentials by ML204 in ICCs was observed to be concentration-dependent. After treating Ca 2+ - and Na + -free solutions or flufenamic acid (a non-selective cation channel blocker), the pacemaker potentials in the ICCs were abolished. A specific anoctamin 1 channel blocker did not have any effect on the pacemaker activity in ML204-untreated control cells; however, they blocked ML204-induced pacemaker activity in ICCs. Specific primers designed against TRPC4 and TRPC5 detected the presence of TRPC4/5 in small intestinal ICCs, and the application of ML204 increased raise the frequency of Ca2+ oscillations in ICCs, as assessed using Fluo-4 AM. @*Conclusion@#The results implied that ML204 could not inhibit the pacemaker activity but depolarized the membrane potential of ICCs by regulating intracellular Ca2+oscillations and anoctamin 1 channels.

Application of venous superdrainage technique based anterolateral thigh flap based on oblique branch for the soft tissue defect of proximal shank / 中华显微外科杂志

Objective To investigate the application of venous superdrainage technique based anterolateral thigh flap based on oblique branch for the soft tissue defect of proximal shank.Methods Between October,2012 and March,2017,11 cases of the soft tissue defect in proximal shank were treated.There were 8 males and 3 females with a mean age of 43 (range,26-59) years.Causes of injury:7 cases of traffic injury,3 cases of bruise,1 case of machine wound;The defect sizes ranged from 10 cm×5 cm to 13 cm×10 cm,with fracture or plate exposure.Accord ing to the size of the defect,the distally based anterolateral thigh flap was designed to repair the defect.The flap sizes ranged from 14 cm×6 cm to 16 cm×8 cm.The oblique branch and their accompanying vein with great saphenous vein was anastomosed to construct the venous superdrainage,and the donor site suture directly.Three cases followed-up by WeChat,and 8 cases by return visit.Results Distally based anterolateral thigh flaps were derived from oblique branches,and no arteriovenous crisis occurred postoperatively.Eleven flaps healed well after operation.There were no distal end blood supply disorder.Followed-up for 6-12 months,the flaps survived well.The texture was closed to the surrounding skin,and no ulcer exposed.There were no serious complications in donor site.And the thighs were linear scars.Conclusion The distally based anterolateral thigh flap based on oblique branch have a long vascular pedicle.The venous superdrainage technique can effectively avoid venous crisis,and improve the survival quality of the flap and the survival rate.

Relationship between Traditional Malaysian Vegetables (Ulam) Intake and Cognitive Status Among Middle-aged Adults from Low Cost Residential Areas / Jurnal Sains Kesihatan Malaysia

@#Ulam is fresh traditional Malaysian vegetables which normally consumed in raw form or after a short blanching process. It contains high antioxidants and polyphenols. However, there is limited study about the relationship between ulam consumption and cognitive status. Thus, a cross sectional study was conducted to determine the relation with cognitive function among 132 middle-aged Malays adults (45-59 years old), recruited by convenient sampling from low income residences in Klang Valley. Respondents were interviewed to obtain data on sociodemography, dietary intake and total ulam intake and also measured for anthropometric parameters at respective community centres. Cognitive status was measured using Digit Span (attention and working memory), Rey auditory verbal learning test (RAVLT) (verbal memory) and comprehensive trail making test (CTMT) (cognitive flexibility). The average ulam intake by the respondents was 15.1 ± 8.2g/day and the top five highest consumed ulam were petai (68.1%), pucuk paku (62.9%), ulam raja (56.8%), pegaga (54.6%) and kesum (44.7%).There was a significant correlation between ulam intake with Digit Span (r = 0.265, p = 0.006), total immediate recall of RAVLT (r = 0.427, p < 0.001) and CTMT (r = 0.257, p = 0.007). Analysis of multiple regression indicated that total ulam intake was a significant predictor for Digit Span (R2 = 0.152, p < 0.05), RAVLT (R2 = 0.335, p = 0.001) and CTMT (R2 = 0.310, p < 0.001). In conclusion, this study showed that ulam has the potential to protect against cognitive decline, however, randomized control trials should be conducted to determine the efficacy of the ulam as neuroprotective agent.

USM ExerHunt: A Building Image Recognition-Based Exergame

@#Introduction: Exergames is defined as a technology-driven physical activity, which is an innovative way of physical activity that integrates interactive gameplay in the exercise process. The exergames may provide enjoyable experiences that could motivate people to participate and continue playing the game play, while also exercising at the same time. Methods: This article presents a treasure hunt-based walking exergames on android platform with the implementation of intelligence-based image recognition. The exergame, termed USM ExerHunt uses images of Universiti Sains Malaysia buildings as the hints. The participant of the game supposes to find a building shown in the hint, and once reaching the destination captures the image of the building. Then, the application will calculate the total steps taken and calories burnt by the participant using an implementation of accelerometer from the mobile phone. Results: The developed USM ExerHunt application is able to achieve accurate image recognition of USM building, with the accuracy rate of 92%. Besides that, the application is capable of calculating the number of total steps and calories burnt after an exercise routine is completed. Conclusion: This android application has shown a proof of concept in incorporating machine intelligence into an exergame application, with pilot study within the USM community.

A Qualitative Study on Feeding Practices Among Caregivers of Malay Children and Adolescents with Autism / Jurnal Sains Kesihatan Malaysia

@#Atypical dietary behaviour of children and adolescents with autism make it challenging for their parents to feed a balance diet to them. This qualitative study aims to explore food practices and source of information regarding food practices among caregivers of Malay children and adolescent with autism. A total of 19 caregivers (aged 35-53 years) of Malay children and adolescents with autism (aged 7-18 years) participated in focus group discussions. Respondents were selected using purposive sampling method from three selected special children's educational centers in Selangor and Negeri Sembilan areas. This focus group discussion was transcribed verbatim and analyzed with the assisted qualitative software (NVivo version 11), which several themes were formed. This study found that majority of respondents offered their children sunnah food, Omega-3 supplements and vitamin and mineral supplements, omitted food additives, gluten and casein, seafood, egg and legumes as they thought these may help in improving their children’s behavior and health. The main sources of information regarding these food practices were Autism Club Malaysia, internet, doctor and religious teacher. Majority of respondents had never consulted both dietitians or nutritionists. Nutritionists or dietitians should provide scientific evidence information on nutritional practices through autism association and internet to ensure that caregivers can manage their children’s nutritional problems more effectively.

Effect of sodium carboxymethyl starch on erythrocyte rheology and oxygen carrying function / 国际药学研究杂志

Objective: To investigate the physicochemical properties of sodium carboxymethyl starch(CMS) and its effect on erythrocyte rheology and oxygen carrying function. Methods According to the requirements of Chinese Pharmacopoeia,the physicochemical properties were determined for CMS120,CMS380 and hydroxyethyl starch 130 (HES130),including pH value,osmotic pressure molar concentration and viscosity. Normal saline,CMS120,CMS380 and HES130 were mixed with whole blood(7:3,V/V),respectively,and the experimental groups were set as whole blood group,whole blood+normal saline(NSB)group,whole blood+CMS120(CMS120B)group,whole blood+CMS380 (CMS380B)group,and whole blood+HES130(HES130B)group. The colloid osmotic pressure,blood viscosity,eryth- rocyte deformation and aggregation,and the partial pressure of oxygen when blood oxygen saturation was 50%(P50)val- ue were measured for each of these groups. Results: The osmotic pressure molar concentration and the viscosity of CMS120 and CMS380 were both significantly higher than those of HES130(all P<0.05)as indicated by the determina- tion of physicochemical properties. Compared with the whole blood group,the colloid osmotic pressure was significantly increased in the CMS380B and CMS120B groups(P<0.05),which was also significantly higher than that in the HES130B group(P<0.05). At low shear rate(10/s),compared with the whole blood group,the whole blood and the plasma vis- cosities were significantly increased in the NSB,CMS380B and CMS120B groups(all P<0.05),but the whole blood viscosity was significantly decreased in the HES130B group(P<0.05). Under the conditions of shear rate 10/s,50/s and 150/s,compared with the HBS130B group,the whole blood and the plasma viscosities were both significantly in- creased in the CMS120B and CMS380 groups(all P<0.05). At the effect of high shear rate,both the CMS380 and HES130 groups showed a tendency to promote erythrocyte deformation,and the CMS120B and CMS380B groups promot- ed erythrocyte aggregation,while the HES130B group inhibited erythrocyte aggregation amplitude(P<0.05). The P50 value was significantly higher in the CMS380B group than in the HES130B group(P<0.05). Conclusion: CMS130 and CMS380 could improve the rheological properties of erythrocytes and CMS380 could also promote the oxygen release of erythrocytes.

Mycoplasma pneumoniae capsular polysaccharides inhibit phagocytosis and membrane molecules expression of dendritic cells / 中国免疫学杂志

Objective:To study the influences of Mycoplasma penumoniae capsular polysaccharide (CPS) on the phagocytosis and membrane molecules expression of the human peripheral blood mononuclear cells derived dendritic cells by binding to dendritic cell-specific intercellular adhesion molecule-3-grabbing nonintegrin (DC-SIGN),so as to know the effect of CPS on the maturation of dendritic cells.Methods:M.pneumoniae strain was cultivated and CPS was extracted.Human peripheral blood mononuclear cells were separated and induced to dendritic cells,then identified the cells by flow cytometry and observation under the microscope.CPS was used to treat dendritic cells or cells pretreated with DC-SIGN monoclonal antibody,and then FITC-dextran phagocytosis and surface markers CD83,HLA-DR,CD80 and CD86 were detected by flow cytometry.Results:The dendritic cells tended to form colony groups.The positive rate of CD11c molecule in the cultured dendritic cells was about 86.27％.After stimulated by CPS,the FITC-dextran fluorescence mean intake by dendritic cells were increased (P＜0.05),while the cell surface membrane molecules CD83,HLA-DR,CD80 and CD86 were decreased significantly when compared with the PBS treated control cells(P＜0.05).When blocked DC-SIGN with the monoclonal antibody,the FITC-dextran fluorescence mean and membrane molecules expression had no statistical difference with the control cells(P＞0.05).Conclusion:M.pneumoniae CPS can promote the phagocytic function of DC and inhibit the expression of CD83,HLA-DR,CD80 and CD86.

Advances in the research of function of Merkel cells in tactile formation of skin / 中华烧伤杂志

Skin is the largest sense organ of human, with many mechanoreceptor cells under epidermis or dermis of skin and Merkel cell is one of them. It has been confirmed that Merkel cells play an important role in the process of mechanical transmission of mammalian soft tactile stimulation. Researches showed that Merkel cells had close relation to tactile formation and functioned by Merkel cell-neurite complexes and ion channels Piezo2. This article reviews Merkel cells and the function, problem and prospect of Merkel cells in tactile formation.

Oral fibrinogen-depleting agent lumbrokinase for secondary ischemic stroke prevention: results from a multicenter, randomized, parallel-group and controlled clinical trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Elevated fibrinogen (Fg) level is a known risk factor for ischemic stroke. There are few clinical trials on oral fibrinogen-depleting therapies for secondary ischemic stroke prevention. We aimed to assess the effects of one-year therapy with oral lumbrokinase enteric-coated capsules on secondary ischemic stroke prevention.</p><p><b>METHODS</b>This is a multicenter, randomized, parallel group and controlled study that began treatment in hospitalized patients with ischemic stroke and continued for 12 months. Patients were randomized to either the control group that received the standard stroke treatment or the fibrinogen-depleting group that received the standard stroke treatment plus enteric-coated lumbrokinase capsules. The NIH Stroke Scale scores (NIHSSs) and plasma Fg level were recorded. The carotid artery intima-media thickness (IMT) and status of plaques were examined through carotid ultrasound examination. Primary outcomes included all-cause mortality, any event of recurrent ischemic stroke/transient ischemic attack (TIA), hemorrhagic stroke, myocardial infarction and angina, and other noncerebral ischemia or hemorrhage. Kaplan-Meier survival analysis and the Long-rank test were used to compare total vascular end point incidence between the two groups. Comparison of median values between two groups was done by the Student t test, one-way analysis of variance (ANOVA), or non-parametric rank sum test.</p><p><b>RESULTS</b>A total of 310 patients were enrolled, 192 patients in the treatment group and 118 patients in the control group. Compared to the control group, the treatment group showed favorable outcomes in the Fg level, carotid IMT, the detection rate of vulnerable plaques, the volume of carotid plaques, NIHSS scores, and incidence of total vascular (6.78% and 2.08%, respectively) and cerebral vascular events (5.93% and 1.04%, respectively) (P < 0.05). In the treatment group, the volume of carotid plaques was significantly related to the carotid IMT, the plaque diameter, width and number (P = 0.000, 0.000, 0.000, 0.022; F = 13.51, 2.52, 11.33, -3.29, but there was a weak correlation with the Fg level (P = 0.056). After 1-year therapy, the incidence of overall vascular end points was reduced by 4.7%.</p><p><b>CONCLUSION</b>Long-term oral fibrinogen-depleting therapy may be beneficial for secondary ischemic stroke prevention.</p>

Analysis of risk factors for spontaneous rupture of hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To assess the risk factors for spontaneous rupture of hepatocellular carcinoma (SRHC).</p><p><b>METHODS</b>A retrospective analysis of 34 consecutive patients with SRHC treated by emergency interventional embolization in our hospital from July 2003 to July 2011 was conducted. General condition, laboratory examination and imaging data were analyzed, and compared with the data of 34 patients with primary hepatocellular carcinoma but without rupture, randomly selected from 215 concurrent patients. The patients with SRHC were selected for risk factor analysis, and the non-SRHC patients were taken as control group.</p><p><b>RESULTS</b>No significant difference between the SRHC group and control group was found in age, sex, Child-Turcotte-Pugh (CTP) grade, Barcelona clinic liver cancer (BCLC) stage, HBsAg, HBsAb, HBeAg, HBeAb, HBcAb, prothrombin time (PT), thrombin time (TT), international normalized ratio (INR), glucose (GLU), cirrhosis, portal tumor thrombus, the maximum diameter of tumor, location, and cholecystitis or cholelithiasis. The univariate analysis showed that activated partial thromboplastin time (APTT), lower or normal plasma fibrinogen (FIB) level, alpha fetoprotein (AFP), tumor protrusion > 1 cm above the liver surface were all associated with increased risk of SRHC (P < 0.05). Multivariate analysis only showed that lower or normal level of FIB (P = 0.033) and tumor protrusion > 1 cm above the liver surface (P = 0.041) were significant independent risk factors for SRHC.</p><p><b>CONCLUSION</b>Lower or normal level of FIB and tumor protrusion > 1 cm above the liver surface are significant independent risk factors for spontaneous rupture of hepatocellular carcinoma.</p>

Analysis of human brucellosis surveillance in Weinan city of Shaanxi province in 2009 / 中国地方病学杂志

Objective To survey and analyze characteristics of brucellosis epidemic in Weinan city of Shaanxi province for the purpose of setting up prevention and control measures for the disease. Methods According to "The Executing Plan for the Work of Surveying Brucellosis Disease in Shaanxi Province", 35 villages(towns) of designated monitoring locations and 24 villages (towns) of randomized monitoring locations in five countries of Weinan were chosen to survey brucellosis disease. The five countries were Chengcheng, Dali, Heyang, Tongguan and Hancheng. High risk populations with a history of contacting livestock and livestock products aged between 7 and 60 underwent clinical and serology examination[rose bengal plate agglutination test(RBPT) and standard tube agglutination test(SAT)]. All manipulation methods and judging standards were in accord with the "Diagnostic Standard for Brucellosis" (WS 269-2007). Results In the designated monitoring location, a total of 8664 people at high risk were investigated, among whom 1407 people were tested by RBPT test and 27 people were positive,the positive rate was 1.92%(27/1407); 27 people were tested by SAT test and 27 people were positive, the positive rate was 100% (27/27); 25 people were diagnosed and the diagnosis rate was 92.59%(25/27). In the randomized monitoring location, a total of 3464 people at high risk were investigated, among whom 411 people were tested by RBPT test and 3 people were positive, the positive rate was 0.73%(3/411 ), 3 people were tested by SAT test which were all positive and made a definite diagnosis. Twenty-eight new cases were made a definite diagnosis and its incidence was 2.06 in a hundred thousand(28/1 361 618). Conclusions The infection of human brucellosis in Weinan city stays at higher level. The governments should increase input for the monitoring,investigating and disinfecting to prevent the disease from increasing and outspreading.

A survey of levels of antibodies against influenza viruses in the population of Wuxi City / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate levels of antibodies against type A and type C influenza viruses and those against the 2009 H1N1 influenza A virus (before and after the 2009 H1N1 pandemic) among residents in Wuxi. To compare levels of antibodies against the 2009 H1N1 influenza virus (one year after the pandemic) in the unvaccinated population with those in the population who received vaccine.</p><p><b>METHODS</b>Serum samples were collected from subjects (aged 1-60 years) during September 2008 to May 2009, and during September 2010 to January 2011. Also collected were serum samples from adults who had received vaccines for pandemic (H1N1) 2009 for one year. Antibody response to influenza viruses was measured using hemagglutination inhibition (HI) assay. Seropositivity rate, seroprotection rate and geometric mean titer (GMT) were compared for each age group during different periods.</p><p><b>RESULTS</b>Before the outbreak of the 2009 H1N1 pandemic, seropositivity rate, seroprotection rate and GMT among the study subjects in were 2.86% (4/140), 0.71% (1/140) and 5.23, respectively. One year after the outbreak, seropositivity rate, seroprotection rate and GMT among the study subjects were 66.33%, 37.76% and 19.17, respectively. Among them, adult subjects showed 50.00% seropositivity rate, 19.44% seroprotection rate and 13.09 GMT, while adult subjects who had received vaccine for one year showed 61.36% seropositivity rate, 22.73% seroprotection rate and 14.14 GMT. No significant difference was observed between these two populations (P > 0.05 for all three indexes). Furthermore, before the outbreak of the 2009 H1N1 pandemic, levels of antibodies against seasonal influenza viruses among the study subjects were as follows: for H1N1 virus, seropositivity rate, seroprotection rate and GMT were 55.00%, 35.00% and 16.90, respectively; for H3N2 virus, seropositivity rate, seroprotection rate and GMT were 86.40%, 84.30% and 58.56, respectively.</p><p><b>CONCLUSION</b>One year after the 2009 H1N1 influenza A virus had spread to Wuxi, the population levels of antibodies against this virus have approached those against seasonal influenza viruses, as reflected by seropositivity rates, seroproection rates and GMT. Moreover, considerable levels of antibodies against seasonal influenza viruses were observed in populations, indicating no seasonal influenza outbreak would occur recently.</p>

Analysis and assessment of real-time contrast-enhanced ultrasonography in the diagnosis of breast masses / 中华医学超声杂志（电子版）

Objective To investigate the perfusion characteristics of intraductal breast lesion by real-time gray-scale contrast ultrasound and to determine the value of real contrast ultrasound in the diagnosis of breast masses.Methods A total of 30 breast lumps by ultrasound contrast enhancement were observed from the enhanced level.An enhanced mode and enhanced border were observed when the lesion was clear.The perfusion characteristics were compared between the benign and malignant lesions.Results Thirty breast lumps include 17 benign lumps and 13 benign lumps by pathological operation.After injected with the microbubble contrast medium,all breast lumps enhanced to varied extent.And malignant lesions showed significant enhancement for more than 3 grade(69.2%,9/13).The radial enhancement around lesion were mainly observed in the malignant lesions (P＜0.05).Conclusion The microvascular perfusion of breast intraductal lesions can be clearly displayed by real-time gray-scale contrast-enhanced ultrasound.The feasibility of differentiation between benign and malignant lesions according to their perfusion characteristics appears to be promising.