Status of anemic among kindergarten children within Suzhou urban area from 2018 to 2022 / 中国学校卫生

Objective@#To understand the current situation and trends of anemia among kindergarten children in urban area of Suzhou from 2018 to 2022, so as to provide a theoretical basis for prevention and intervention in anemia among kindergarten children.@*Methods@#From March 2023, a total of 24 178 person times of children from 59 kindergartens selected by random number table method were enrolled, and their physical examination data from 2018 to 2022 were collected, including hemoglobin (Hb), height, gender, weight. The period of 2018-2019 was defined as before the COVID-19 epidemic, and period of 2020-2022 was defined as the COVID-19 epidemic. Data were analyzed using the Mann Whitney U test, χ 2 test and Spearman s correlation analysis.@*Results@#From 2018 to 2019, the M ( P 25 ， P 75 ) of Hb levels of children in nursery, middle, and senior class were 118 (112, 129), 120 (112, 132) and 122 (113, 134)g/L, respectively, which were higher than that of during 2020-2022 [116(110, 123), 117(111, 124) , 119(112, 126)g/L, Z =-10.7, -12.7, -12.9, P <0.05]. A total of 4 584 person times of children were anemic, with a detection rate of 19.0%. The overall anemia detection rate of kindergarten children during 2018-2019 was lower than that in 2020-2022 (15.3% vs 20.7%, χ 2=100.8, P <0.05). The anemia detection rate of kindergarten children in 2022 (24.5%) was higher than that in 2020 (20.6%) and in 2021 (17.0%) ( χ 2=93.9, P <0.05). The anemia prevalence of children in the nursery, middle, and senior class were 13.9%, 14.7% and 17.1% during 2018-2019, 19.3%, 15.9% and 26.6% during 2020-2022, and 17.6%, 15.5% and 23.6% during 2018-2022, respectively ( χ 2=10.7, 204.6, 186.8, P <0.01). There was no statistically significant correlation between Hb values and body mass index (BMI) in boys and girls with anemia, and all children in kindergarten ( r=0.03, 0.03, 0.09, P ＞0.05).@*Conclusion@#The prevalence of anemia among kindergarten children in the urban area of Suzhou is relatively high. The COVID-19 pandemic may have increased the risk of anemia among children.

Mechanism of cell autophagy for regulating skeletal muscle wasting of rats after severe burns / 中华烧伤杂志

Objective@#To investigate the mechanism of cell autophagy for regulating skeletal muscle wasting of rats after severe burns.@*Methods@#Seventy-two Sprague-Dawley rats were collected and divided into sham injury group, simple burn group, burn+ phosphate buffer solution (PBS) group, and burn+ 3-methyladenine (3-MA) group according to the random number table, with 18 rats in each group. Rats in simple burn group, burn+ PBS group, and burn+ 3-MA group were inflicted with 30% total body surface area full-thickness scald (hereinafter referred to as burns). Rats in sham injury group were sham injured. Immediately after burns and fluid resuscitation, rats in burn+ PBS group were intraperitoneally injected with 1 mL PBS, and rats in burn+ 3-MA group were intraperitoneally injected with 1 mL 3-MA (125 g/L). On post injury day 3 and 7, the weights of anterior tibial muscle of right hind limbs and body of rats were measured to calculate percentage of anterior tibial muscle of right hind limbs weight. Protein expressions of microtubule related protein 1 light chain 3A (LC3A) and Beclin-1 of anterior tibial muscle were observed by immunofluorescence method and detected by Western blotting, and ratio of microtubule related protein 1 LC3A-Ⅱ to LC3A-Ⅰ was calculated. Data were processed with analysis of variance of factorial design, one-way analysis of variance, t-test and Bonferroni correction.@*Results@#On post injury day 3 and 7, percentages of anterior tibial muscle of right hind limbs weight of rats in simple burn group were (0.148±0.009)% and (0.134±0.018)%, respectively, which were significantly lower than those in sham injury group [(0.203±0.009)%, (0.181±0.015)%, t=10.585, 4.913, P<0.01]. Percentages of anterior tibial muscle of right hind limbs weight of rats in burn+ 3-MA group were (0.187±0.004)% and (0.192±0.009)%, respectively, which were obviously higher than those in burn+ PBS group [(0.162±0.005)%, (0.167±0.005)%, t=9.564, 5.948, P<0.01]. On post injury day 3 and 7, protein expressions of Beclin-1 and microtubule related protein 1 LC3A of anterior tibial muscle of rats in simple burn group were significantly higher than those in sham injury group, while protein expressions of Beclin-1 and microtubule related protein 1 LC3A of anterior tibial muscle of rats in burn+ 3-MA group were significantly lower than those in burn+ PBS group. Ratios of microtubule related protein 1 LC3A-Ⅱ to LC3A-Ⅰ of anterior tibial muscle of rats in simple burn group were significantly higher than those in sham injury group (t=3.461, 3.353, P<0.05), while ratios of microtubule related protein 1 LC3A-Ⅱ to LC3A-Ⅰ of anterior tibial muscle of rats in burn+ 3-MA group were significantly lower than those in burn+ PBS group (t=3.129, 3.977, P<0.05).@*Conclusions@#Cell autophagy induced by severe burns is involved in the process of skeletal muscle wasting of rats, and inhibition of cell autophagy may contribute to the remission of skeletal muscle wasting of rats induced by burns.

Transmembrane domain dependent inhibitory function of FcγRIIB

FcγRIIB, the only inhibitory IgG Fc receptor, functions to suppress the hyper-activation of immune cells. Numerous studies have illustrated its inhibitory function through the ITIM motif in the cytoplasmic tail of FcγRIIB. However, later studies revealed that in addition to the ITIM, the transmembrane (TM) domain of FcγRIIB is also indispensable for its inhibitory function. Indeed, recent epidemiological studies revealed that a non-synonymous single nucleotide polymorphism (rs1050501) within the TM domain of FcγRIIB, responsible for the I232T substitution, is associated with the susceptibility to systemic lupus erythematosus (SLE). In this review, we will summarize these epidemiological and functional studies of FcγRIIB-I232T in the past few years, and will further discuss the mechanisms accounting for the functional loss of FcγRIIB-I232T. Our review will help the reader gain a deeper understanding of the importance of the TM domain in mediating the inhibitory function of FcγRIIB and may provide insights to a new therapeutic target for the associated diseases.

Advances in the research of characteristics and treatment of burns in the elderly / 中华烧伤杂志

With the development of society and the improvement of medical level, the average life span of human has been increasing year by year. The proportion of elderly burn patients is also increasing yearly, which has become a social problem that can not be ignored. Because of physiological characteristics, such as decreased function of heart, lung, and kidney, degenerative changes of neural system, reduced gastrointestinal function and immunological function, and mostly accompanied by primary diseases of diabetes and cardiovascular diseases, elderly burn patients suffer from high shock rate and mortality, and their wounds are not easy to heal. With the purpose of providing ideas for prevention and treatment of elderly burn patients, this review summarizes the physiological characteristics, wound treatment, fluid resuscitation, organ protection, nutrition support, and psychological guidance of elderly burn patients.

Discussion on the related problems of pediatric burn treatment / 中华烧伤杂志

The incidence of pediatric burn is high currently. Many clinical problems in the treatment of pediatric burn are composed of fluid replacement during shock stage, wound treatment, nutrition and metabolism etc, which urgently need to be sorted out and updated again to make corresponding clinical guidelines, criteria, or consensus for standardizing the clinical diagnosis and treatment, so as to improve the clinical treatment level of pediatric burn.

Enlightenment and deliberation after treatment for extraordinary injuries / 中华烧伤杂志

With the development of modern society, the range of disease spectrum is changing, and risk factors leading to human trauma and damage are also in the shift. In addition to the extraordinary burns in the traditional sense, we also call extraordinary injury as damage induced by some of extraordinary insults in the past. In recent years, damage to skin and soft tissue caused by an extraordinary injury showed a gradually increasing trend. Manifestations of the wound of an extraordinary injury are various and its clinical treatment is very difficult, often requiring exceptional systemic comprehensive treatments. Currently, it is the duty of colleagues in the burn unit to actively deliberate about their realities regarding the following aspects: to accurately define the concept and scope of extraordinary injury, to include it into the range of clinical research and treatment of burns, to fully use professional skills of burn surgeons in dealing with wounds, and to effectively treat the patients through learning and mastering treatment skills of other clinical disciplines for treatment of extraordinary injury.

Treatment of 568 patients with frostbite in northeastern China with an analysis of rate of amputation / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the key points of treatment and amputation in patients with frostbite, so as to increase the successful rate of the treatment.</p><p><b>METHODS</b>Five hundred and sixty-eight patients with frostbite admitted to our department from January 2005 to December 2014. (1) For the patients admitted to our department within one week after injury, the frostbite wounds were soaked in 42 °C herbal fluid (twice per day, 30 min for each time) and irradiated with infrared or red light (three times per day, 40 min for each time) from the day of admission to the 7th day after injury. Meanwhile, treatment for improvement of microcirculation, vasodilation, and anti-infection were also given. Then they received infrared or red light irradiation to the wound sites. For the patients admitted to our department longer than one week after frostbite, the frostbite wounds were irradiated with infrared or red light, and treated with antibiotics if inflammation was found around the wound. Among all the patients, 5 cases suffered from frozen stiff, and they were given fluid resuscitation as well as above-mentioned treatments after admission. (2) All patients were given wound treatment immediately after admission. The superficial partial-thickness wounds and deep partial-thickness wounds of 264 patients were given routine dressing change. The full-thickness wounds in 79 patients were treated with exposure therapy after routine dressing change first, and then granulation tissue of these wounds were grafted with autologous thigh split-thickness skin grafts. After debridement and exposure therapy, amputation was done in 225 patients 3 to 4 weeks after injury when the underlying bone was exposed. In 4 patients with exposure of calcaneus, the wounds were covered with reverse sural nerve nutrient vessels island flap. Mean healing time of superficial partial-thickness wound and deep partial-thickness wound, survival rate of skin graft in full-thickness wound, and survival rate of flap covering wound deep to bone at the heel were all recorded. The amputation rate of patients injured in December, January, February, and other months, that of patients admitted shorter than 1 day after frostbite, 1 to 3 days after frostbite, longer than 3 days and shorter than or equal to 5 days after frostbite, and longer than 5 days after frostbite, that of patients caused by drunkenness, mental disorders, improper protection, going astray, and trauma including traffic accident etc., and that of patients treated with rewarming under room temperature, rubbing with snow, wrapping with quilt, and soaking in warm water before admission were all recorded and analyzed. Parts of the data were processed with χ(2) test.</p><p><b>RESULTS</b>All patients were survived after treatment. Average wound healing time of superficial partial -thickness wound and deep partial-thickness wound was respectively 10 and 23 days. The survival rate of skin graft on full-thickness wound was about 95%. Survival rate of flap on wound deep to bone at the heel was 100%. Amputation rates of patients injured in December and January were respectively 47.46% (84/177), 42.56% (103/242), and both were significantly higher than those of patients injured in February and the other months [respectively 29.55% (26/88), 13.11% (8/61), with χ(2) values from 42.595 to 220.900, P values below 0.01]. Amputation rate of patients with admission time shorter than 1 day after frostbite was 32.06% (84/262), which was obviously lower than that of patients with admission time from 1 to 3 days after frostbite, longer than 3 days and less than or equal to 5 days after frostbite, or longer than 5 days after frostbite [respectively 40.48% (68/168), 49.02% (50/102), 52.78% (19/36), with χ(2) values from 107.284 to 165.350, P values below 0.01]. Amputation rates of patients with frostbite occurring after getting drunkenness, mental disorders, and trauma including traffic accident etc. were respectively 42.06% (106/252), 43.48% (60/138), and 53.12% (17/32), and they were all significantly higher than those of patients with frostbite caused by improper protection and going astray [respectively 27.45% (28/102), 22.73% (10/44), with χ(2) values from 187.260 to 209.738, P values below 0.01]. Amputation rates of patients undergoing treatment of rewarming under room temperature, rubbing with snow, wrapping with quilt before admission were respectively 44.29% (62/140), 48.28% (84/174), and 35.38% (46/130), and they were significantly higher than the amputation rate of patients who received the treatment of soaking in warm water [23.39% (29/124), with χ(2) values from 97.364 to 136.189, P values below 0.01].</p><p><b>CONCLUSIONS</b>Early diagnosis and treatment, properly rewarming at early stage, and correct wound treatment are the key points for reducing amputation rate of patients after frostbite. Attention should be paid to the occurrence of frostbite in December and January, and also to protection of high-risk groups (patients with mental disorders and drunker).</p>

Expression of vascular endothelial growth factor and microvessel density in different brain regions in aged rats / 中南大学学报(医学版)

Objective:To observe the distribution of vascular endothelial growth factor (VEGF) and microvessel density (MVD) in different brain regions in aged rats and determine the role of VEGF and MVD in the aging process of the nervous system. Methods:We observed the expression of VEGF and MVD in different parts of rat brain in the 3- month group and 30-month group with immunohistochemical technique. Results:Compared with the 3-month group, the 30-month group showed fewer VEGF-positive cells and MVD in the brain (P<0.01), and the number varied signiifcantly in different brain regions(P<0.01). The motor cortex region contained more VEGF-positive cells and MVD than the hippocampus and cerebellum. Conclusion:VEGF-positive cells and MVD are decreased in every brain region of aged rats, and the motor cortex region contains more positive cells, suggesting exogenous VEGF may enhance the formation of microvessels and delay the aging of the nervous system.

Clinical observation of highly active antiretroviral therapy in 70 pediatric patients with acquired immunodeficiency syndrome / 中华传染病杂志

Objective To observe the treatment response and potential issues related to antiretroviral therapy (ART) in pediatric patients with acquired immunodeficiency syndrome (AIDS) and to provide a basis for revising the treatment guideline and improving the clinical practice. Methods Children eligible for ART according to the current treatment guideline were recruited from Dehong area. Enrolled patients were provided with ART and followed up for regular clinical check and laboratory tests. Results By the end of March 2009, a total of 70 children had received ART. Among them, 60 patients were treated with regimen including zidovudine (AZT)+ lamivudine (3TC)+nevirapine (NVP). Twelve, eighteen, twenty-three and nineteen patients have tested for HIV viral load after 3 month, 6 month, 12 month and 18 month treatment, respectively. Among them, 7, 12,14 and 14 patients respectively achieved HIV viral load lower than 1000 copy/mL. Average CD4+ Tlymphocyte count increased from (317.8±288.8) × 106/L at baseline to (1037.2±1086. 1) × 106/Lafter 18 month treatment. Side effects mainly occurred within the first 3 months of treatment. Nearly 50% of children had gastrointestinal symptoms. Resistance to 3TC, NVP and efavirenz (EFV) were found in five patients who have completed 12 months of treatment. Conclusions Pediatric AIDS patients show good compliance and treatment response to ART. Most side effects happen in the first 3months of treatment and the most common side effects are gastrointestinal symptoms.

Distal pedical fibular osteoseptocutaneous flap transfer for the lateral forefoot defect / 中华显微外科杂志

Objective The anterior-lateral defect of foot that lost one of the three supporting point of foot can lead to collapse of the lateral longitudinal arch, overload of the first metatarsal heads, and painful callus formation. It is meaningful to investigate the effect of reconstructing the lateral forefoot defect with pedical fibular osteoseptocutaneous flap. Methods From March 1989 to June 2008, there were 38 patients with anterior-lateral defect of foot were constructed. The supporting point with the local distal based pedical fibular osteoseptocutaneous flap was constracted. Results All the 38 flaps survived. All 38 patients had been followed up from 6 months to 10 years (mean 23.5 months) postoperatively. The constructed supporting point of the foot was functional. The patients could walk freely with no pain, and was satisfied with the operation. Assessed with the rating system for foot and ankle established by the American Orthopaedic Foot And Anke Society, 8 patients got a score above 85, 23 patients between 75 to 85, 7 patients between 60 to 75. Conclusion It is effective that transferring local distal based pedical fibular osteoseptocutaneous flap to repair the anterior-lateral defect of foot.

Treatment of humerus nonunion using lilac bone graft limited internal fixation combined with external fixation in 13 cases / 中国组织工程研究

BACKGROUND: There is lack of effective method for treating humerus nonunion, lilac plate can maintain the compact contact between fracture end and bone graft, accelerate bone union, as well as provide stability for bone union. OBJECTIVE: To evaluate the clinical effects of treating humerus nonunion by using lilac bone graft as plate combined with the external fixation.METHODS: Thirteen patients with nonunion of the humorous at Department of Orthopedic Trauma Surgery, Jinan Command General Hospital of Chinese PLA were selected, including 11 males and 2 females, aged 20 51 years, mean aged 35.5 years. All the patients were treated with Uiac bone graft and screws combined with the mono lateral external fixation. The bone healing was observed by X-ray film. Shoulder function and complications were measured by Neer score.RESULTS AND CONCLUSION: All patients were followed up for 7-64 months, mean 38 months. Bony union was achieved in all patients within 6-10 months (mean 8.1 months). The activity function of shoulder and elbow was normal; and Neer scores were 71-96 (mean 87 scores). No infection, pain, prevalent fracture or nonunion occurred. The results demonstrated that using lilac bone graft as plate combined with the mono lateral external fixation is a good salvage operation for nonunion of the humerus.