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PURPOSE@#To evaluate the outcomes with and without aid of a computer-assisted surgical navigation system (CASNS) for treatment of unilateral orbital wall fracture (OWF).@*METHODS@#Patients who came to our hospital for repairing unilateral traumatic OWF from 2014 to 2017 were included in this study. The patients were divided into the navigation group who accepted orbital wall reconstruction aided by CASNS and the conventional group. We evaluated the surgical precision in the navigation group by analyzing the difference between actual postoperative computed tomography data and preoperative virtual surgical plan through color order ratios. We also compared the duration of surgery, enophthalmos correction, restoration of orbital volumes, and improvement of clinical symptoms in both groups systemically. Quantitative data were presented as mean ± SD. Significance was determined by the two-sample t-test using SPSS Version 19.0 A p < 0.05 was considered statistically significant.@*RESULTS@#Seventy patients with unilateral OWF were included in the study cohort. The mean difference between preoperative virtual planning and actual reconstruction outcome was (0.869 ± 0.472) mm, which means the reconstruction result could match the navigation planning accurately. The mean duration of surgery in the navigation group was shorter than it is in the control group, but not significantly. Discrepancies between the reconstructed and unaffected orbital-cavity volume and eyeball projection in the navigation group were significantly less than that in the conventional group. One patient had remnant diplopia and two patients had enophthalmos after surgery in the navigation group; two patients had postoperative diplopia and four patients had postoperative enophthalmos in the conventional group.@*CONCLUSION@#Compare with the conventional treatment for OWF, the use of CASNS can provide a significantly better surgical precision, greater improvements in orbital-cavity volume and eyeball projection, and better clinical results, without increasing the duration of surgery.
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Objective To investigate the effectiveness and cost of 50% and 80% wettable powder of niclosamide ethanolamine salt (NESWP) and 26% metaldehyde and niclosamide suspension concentrate (MNSC) in hilly schistosomiasis-endemic regions, so as to provide insights into the selection of chemical molluscicides in hilly regions. Methods In September 2020, a wasteland in Guanshanqiao Village, Yanrui Township, Yushan County of Jiangxi Province was selected as the experimental region, which was sectioned into five blocks and defined as four experimental groups (A1, A2, B, C) and a blank control group (D). 80% NESWP were given at doses of 1 g/m2 and 1.5 g/m2 in groups A1 and A2 using the spraying method, 50% NESWP was given at a dose of 2 g/m2 in Group B using the spraying method, and 26% MNSC was at a dose of 4 g/m2 in Group C using the spraying method, while no chemical treatment was given in Group D. Snail survey was performed using a systematic sampling method before chemical treatment and 1, 3, 7 d and 15 d post-treatment to examine the molluscicidal effect, and all molluscicidal costs were estimated to calculate the cost of chemical treatment per 1 m2 and the cost of the reduction in the mean density of living snails per 1%. Results The highest mortality of snails was 78.95% and the lowest density of living snails was 0.2388 snails/0.1 m2 in the experimental groups within 7 d of chemical treatment, and the highest mortality of snails was 94.74% and the lowest density of living snails was 0.058 0 snails/0.1 m2 7 d post-treatment. There were no significant differences in the snail mortality among the A1, A2, B and C groups 1 (χ2 = 2.250, P > 0.05), 3 (χ2 = 1.779, P > 0.05) or 15 d post-treatment (χ2 = 2.286, P > 0.05), while a significant difference was detected in the snail mortality among the four groups 7 d post-treatment (χ2 = 7.990, P = 0.046). In addition, there were no significant differences in the snail mortality between A1 and A2 groups 1 (χ2 = 0.724, P > 0.05), 3 (χ2 = 0.584, P > 0.05), 7 (χ2 = 0.400, P > 0.05) or 15 d post-treatment (χ2 = 0.251, P > 0.05). The costs of chemical treatment per 1 m2 were 0.58, 0.60, 0.64 Yuan and 0.73 Yuan in groups A1, A2, B and C, and the costs of the mean density of living snail per 1% reduction were 19.29, 20.44, 21.68 Yuan and 23.53 Yuan in groups A1, A2, B and C, respectively. Conclusion 80% NESWP shows a high molluscicidal efficacy and low cost in hilly schistosomiasis-endemic regions.
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This paper systematically discusses the construction of clinical skills information platform, including the goal, function design, module, content analysis of practical skills training and management system. The information platform for clinical skills training has played a significant role in innovating the teaching and management mode of clinical practice skills training, establishing a scientific assessment system, improving the clinical practice skills training system and enriching the teaching contents and means. At the same time, it has also promoted the communication between teachers and students during the clinical practice skills training, improved teachers' information-based teaching ability, and speeded up the construction of high-quality teachers.
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Objective To investigate the prevalence of Schistosoma japonicum infections in Elaphurus davidianus released to Poyang Lake areas and evaluate the impact of the project of “E. davidianus released to wild environments for natural reproduction and growth” “(E. davidianus return home project”) on the transmission of schistosomiasis in Poyang Lake areas. Methods During the period from April 2018 to December 2019, the population distribution, inhabiting activity and natural reproduction of E. davidianus released to Poyang Lake areas were investigated by means of GPS and artificial observations. The S. japonicum infection was identified in animal feces in E. davidianus inhabitats using a hatching test, and snail distribution was surveyed in E. davidianus inhabiting grass islands using a systematic sampling method. Results A total of 51 E. davidianus were released to the Poyang Lake areas in 2018, which subsequently produced 5 E. davidianus habitats in Yinlong Lake, Longkou, Nanchi Lake, Lianzi Lake and Zhu Lake. E. davidianus was found to predominantly inhibit in grass islands, farmlands and forest lands in hilly regions around the Poyang Lake areas. The natural reproduction rate of E. davidianus was 25% in the habitats in 2019, and the mean density of snails was 0.009 to 0.039 snails/0.1 m2 in E. davidianus inhabitats; however, no S. japonicum infection was identified in snails. In addition, the mean densities of wild E. davidianus and bovine feces were 4.6 samples/hm2 and 2.1 samples/hm2, Conclusions The E. davidianus released to Poyang Lake areas may get infections with S. japonicum, and cause schistosomiasis transmission through fecal contamination in grass islands. The impact on and the prevalence of S. japonicum infection was 4.35% and 13.16% (P = 0.236), respectively; however, the intensities of S. japonicum infections were “+++” and “+”, respectively. Conclusions The E. davidianus released to Poyang Lake areas may get infections with S. japonicum, and cause schistosomiasis transmission through fecal contamination in grass islands. The impact on local schistosomiasis transmission and the response strategy requires to be investigated following the release of E. davidianus to lake regions, to ensure the achievement of the goal of schistosomiasis elimination and the successful implementation of the “E. davidianus return home project” in Poyang Lake areas.
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Objective::To construct the color matching template irrelevant to size and rotation according to the types and distribution characteristics of colors in images of Chinese herbal pieces, in order to establish color characterization and image identification methods for Chinese herbal pieces. Method::Totally 20 types of Chinese herbal pieces were selected, including rhizomes, flowers, seeds and fruits.For each sample, two observation surfaces were selected to extract color parameters in foreground through image processing such as image segmentation, model transformation from RGB to L*a*b*.Color vectors of the two observation surfaces were sequenced in a descending order, scaled to a certain size by interpolating, and combined into an integrated color vector in a weight ratio of 1∶1.As for centripetally distributed observation surface images(e.g.transverse section), corrosion operation was conducted to extract the color components of each ring from outer to inner by circles, which were then ordered and scaled.The integrated color vector was used as initial template for training, the correlation coefficient between each sample and the template was calculated, and the interval estimation of positive samples were carried out by t test.With the total recognition rate as an indicator, the optimal template dimensions, width of ring and training volume were ultimately determined. Result::The visualization results of the trained templates of the varied herbal pieces were easy to be visually distinguished.After 260 samples of the herbal pieces were tested, the template of a and b components was better than that of L*, a* and b* in terms of recognition performance, with a* recognition accuracy of 95.8%(249/200). Conclusion::Color characteristics of images from two observation surfaces of Chinese herbal pieces are integrated to obtain the combined color feature vector, so as to achieve preferable recognition results for samples from both the same and different medicinal parts.This method boasts a strong anti-interference ability of random variation of sample shape, sampling part and color.
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Objective To understand the situation of Schistosoma japonicum infections in wild animals in transmission-controlled schistosomiasis-endemic areas in Jiangxi Province, so as to provide scientific evidence for implementing precision control interventions and achieving the goal of transmission interruption and elimination of schistosomiasis. Methods Five endemic villages from Ruichang City and Pengze County that were heavily endemic for schistosomiasis in Jiangxi Province, were selected as the study villages. Wild animals like wild mice were captured, and the livers of wild animals were purchased from the snail habitats in the study villages for detection of S. japonicum infections. In the study villages, S. japonicum human infections were screened using indirect hemagglutination assay (IHA) followed by parasitological examinations with miracidial hatching test and Kato-Katz method, and the S. japonicum infection in livestock was tested using a miracidial hatching test with a plastic tube. In addition, snail survey was conducted in the study villages by means of systematic sampling combined with environmental sampling, and the S. japonicum infection in snails was detected using a loop-mediated isothermal amplification (LAMP) assay. Results A total of 240 liver specimens were sampled or purchased from 5 species of wild animals in the study villages, including wild mice, weasels, pigs, deer and rabbits. A total of 172 wild mice were captured, with a 2.91% rate of S. japonicum infection, and there was no S. japonicum infection detected in other wild animals. The prevalence of Capillaria hepatica infection was 12.21%, 1.96% and 12.50% in wild mice, deer and pigs, respectively. In addition, there was no S. japonicum infection found in either humans or livestock in the study villages, and the mean snail density varied from 0.13 to 0.80 snails/0.1 m2 in the study villages. LAMP assay detected S. japonicum infection in 2 tubes in a study village. Conclusions The role of wild animals in schistosomiasis transmission and their potential risks can not be neglected in hilly schistosomiasis-endemic areas of Jiangsu Province after transmission control. Intensified surveillance and targeted control measures should be implemented to consolidate schistosomiasis control achievements.
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Objective To understand the situation of Schistosoma japonicum infections in wild animals in transmission-controlled schistosomiasis-endemic areas in Jiangxi Province, so as to provide scientific evidence for implementing precision control interventions and achieving the goal of transmission interruption and elimination of schistosomiasis. Methods Five endemic villages from Ruichang City and Pengze County that were heavily endemic for schistosomiasis in Jiangxi Province, were selected as the study villages. Wild animals like wild mice were captured, and the livers of wild animals were purchased from the snail habitats in the study villages for detection of S. japonicum infections. In the study villages, S. japonicum human infections were screened using indirect hemagglutination assay (IHA) followed by parasitological examinations with miracidial hatching test and Kato-Katz method, and the S. japonicum infection in livestock was tested using a miracidial hatching test with a plastic tube. In addition, snail survey was conducted in the study villages by means of systematic sampling combined with environmental sampling, and the S. japonicum infection in snails was detected using a loop-mediated isothermal amplification (LAMP) assay. Results A total of 240 liver specimens were sampled or purchased from 5 species of wild animals in the study villages, including wild mice, weasels, pigs, deer and rabbits. A total of 172 wild mice were captured, with a 2.91% rate of S. japonicum infection, and there was no S. japonicum infection detected in other wild animals. The prevalence of Capillaria hepatica infection was 12.21%, 1.96% and 12.50% in wild mice, deer and pigs, respectively. In addition, there was no S. japonicum infection found in either humans or livestock in the study villages, and the mean snail density varied from 0.13 to 0.80 snails/0.1 m2 in the study villages. LAMP assay detected S. japonicum infection in 2 tubes in a study village. Conclusions The role of wild animals in schistosomiasis transmission and their potential risks can not be neglected in hilly schistosomiasis-endemic areas of Jiangsu Province after transmission control. Intensified surveillance and targeted control measures should be implemented to consolidate schistosomiasis control achievements.
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Objective:To build a gray-level matching template by using the gray level information of the microscopic image of the transverse section of Chinese medicinal materials,in order to realize the automatic recognition of the images of Chinese medicinal materials independent of scale and orientation. Method:By using the embedding method of polyethylene glycol (PEG),the transverse slices of 19 kinds of common rhizomatous medicinal materials were obtained. The images of the slices were taken by digital microscopic imaging technology,and the mosaic grayscale images were obtained by image registration,noise removal and boundary location. The center of the structure of the materials in the images was selected to establish the polar coordinate system, so as to divide grids from the radial and angular directions. By counting the gray information in each grid,the gray information digital matrix that can characterize the microscopic identification characteristics of the materials was obtained. Images in an appropriate sample size was used to train the matrix for generalization of the matrix. The covariance coefficients between the matrix of positive or negative verification sample and the template matrix were calculated to set the best identification parameters. For each medicinal material,80 fan-shaped images were prepared,including 70% of training samples,15% of validation samples and 15% of test samples,and single template and template set were tested with test samples. Result:In the test of 240 images including non-template-set medicinal materials,the correct recognition rate of single-template test was 90.1%,and that of template-set test was 92.5%. Conclusion:This method can well characterize the microscopic identification characteristics of Chinese medicinal materials, with a strong anti-interference ability and less subjective-errors, acquire sample images easily, and provide technical support for the digitization of morphological quality control of Chinese medicinal materials.
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OBJECTIVE@#To study the role of gamma-delta T (γδ T) cells and its subsets in the immunopathogenesis of Henoch-Schönlein purpura (HSP) in children, and to provide new ideas for the treatment of HSP in children from the aspect of γδ T cell regulation.@*METHODS@#A total of 33 children with HSP were enrolled as the HSP group, and 21 healthy children were enrolled as the healthy control group. The percentages of γδ T cells and its subsets Vδ1 T and Vδ2 T cells among peripheral blood mononuclear cells (PBMCs) were measured, as well as the apoptosis rate of γδ T cell and plasma level of interleukin-17 (IL-17).@*RESULTS@#Compared with the healthy control group, the HSP group had significantly lower percentages of lymphocytes in PBMCs and Vδ2 T cells in γδ T cells (P<0.05). The HSP group had significantly higher percentage of Vδ1 T cells in γδ T cells and plasma level of IL-17 than the healthy control group. The HSP group had a significantly higher overall apoptosis rate of γδ T cells than the healthy control group (P<0.05), especially early apoptosis. The percentage of Vδ2 T cells was positively correlated with overall apoptosis rate (r=0.615, P<0.05) and was negatively correlated with IL-17 level (r=-0.398, P<0.05).@*CONCLUSIONS@#Vδ1/Vδ2 T cell immune imbalance mediated by γδ T cells and over-activation of IL-17 may be involved in the development of HSP, among which the disturbance of immune tolerance induced by Vδ2 T cells plays an important role in the pathophysiology of the disease.
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Child , Humans , Leukocytes, Mononuclear , IgA Vasculitis , Receptors, Antigen, T-Cell, gamma-delta , T-LymphocytesABSTRACT
Astragalus membranaceus (Radix Astragali, RA) and Atractylodes macrocephala (Rhizoma Atractylodis Macrocephalae, RAM) are often used to treat gastrointestinal diseases. In the present study, we determined the effects of polysaccharides extracts from these two herbs on IEC-6 cell migration and explored the potential underlying mechanisms. A migration model with IEC-6 cells was induced using a single-edged razor blade along the diameter of cell layers in six-well polystyrene plates. The cells were grown in control media or media containing spermidine (5 μmol·L, SPD), alpha-difluoromethylornithine (2.5 mmol·L, DFMO), 4-Aminopyridine (40 μmol·L, 4-AP), the polysaccharide extracts of RA or RAM (50, 100, or 200 mg·L), DFMO plus SPD, or DFMO plus polysaccharide extracts of RA or RAM for 12 or 24 h. Next, cytosolic free Ca ([Ca]) was measured using laser confocal microscopy, and cellular polyamine content was quantified with HPLC. Kv1.1 mRNA expression was assessed using RT-qPCR and Kv1.1 and RhoA protein expressions were measured with Western blotting analysis. A cell migration assay was carried out using Image-Pro Plus software. In addition, GC-MS was introduced to analyze the monosaccharide composition of both polysaccharide extracts. The resutls showed that treatment with polysaccharide extracts of RA or RAM significantly increased cellular polyamine content, elevated [Ca] and accelerated migration of IEC-6 cells, compared with the controls (P < 0.01). Polysaccharide extracts not only reversed the inhibitory effects of DFMO on cellular polyamine content and [Ca], but also restored IEC-6 cell migration to control level (P < 0.01 or < 0.05). Kv1.1 mRNA and protein expressions were increased (P < 0.05) after polysaccharide extract treatment in polyamine-deficient IEC-6 cells and RhoA protein expression was increased. Molar ratios of D-ribose, D-arabinose, L-rhamnose, D-mannose, D-glucose, and D-galactose was 1.0 : 14.1 : 0.3 : 19.9 : 181.3 : 6.3 in RA and 1.0 : 4.3 : 0.1 : 5.7 : 2.8 : 2.2 in RAM. In conclusion, treatment with RA and RAM polysaccharide extracts stimulated migration of intestinal epithelial cells via a polyamine-Kv1.1 channel activated signaling pathway, which facilitated intestinal injury healing.
Subject(s)
Animals , Rats , Astragalus propinquus , Chemistry , Atractylodes , Chemistry , Cell Line , Cell Movement , Drugs, Chinese Herbal , Chemistry , Pharmacology , Epithelial Cells , Cell Biology , Metabolism , Intestines , Cell Biology , Genetics , Metabolism , Polyamines , Metabolism , Polysaccharides , Chemistry , Pharmacology , Rhizome , Chemistry , Signal Transduction , rhoA GTP-Binding Protein , MetabolismABSTRACT
To grasp the status of Oncomelania hupensis snail-infested environments in schistosomiasis endemic areas of Jiangxi Province, and establish the spatial database of snail-infested environments with the administrative village as the unit.The spatial and temporal distributions of the historical snail environments, existing snail environments, and suspicious snail-infested environments were analyzed by the historical data review and field investigations.The distribution of snail-infested environments in Jiangxi Province included two popular types of lakeshore and hills. The O. hupensis snail-infested environments were mainly concentrated in the Poyang Lake area, which accounting for 66.97% of the total snail-infested areas. The potential snail-infested environment area was 204 745.48 hm2, among which the potential snail-infested environment areas in the lakeshore and hills were 146 548.58 hm2 and 58 196.90 hm2, accounting for 71.58% and 28.42%, respectively. The real existing snail area was 83 234.50 hm2, among which the real existing snail areas in the lakeshore and hills were 80 890.81 hm2 and 2 343.69 hm2, accounting for 97.18% and 2.82%, respectively. The compressed snail area was 114 253.30 hm2 with a compression rate of 57.85%, of which the compression rates in the lakeshore and hills were 46.51% and 94.97%, respectively. In the four types of snail-infested environments, the areas of Type I, Type II, Type III and Type IV accounted for 55.77%, 25.75%, 13.91% and 4.57% of the total area, respectively.The spatial database of O. hupensis snail-infested environments is established comprehensively and systematically, that will be conducive to tracking and performing the dynamic updates of the data of snails, so as to provide an important technical support for investigation and monitoring in the future.
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Objective To investigate the effects of 5-hydroxytryptamine-2C subunit receptor (5-HT 2C R)on long-term potentiation (LTP)of V1M region visual cortex of form deprivation adult amblyopia rats. Methods Sixteen two weeks old Sp-argue Dawley rats were randomly divided into normal control group and monocular form deprivation group,with 8 rats in each group. The rats in the normal control group were not given any intervention;the rats in the monocular form deprivation group were sutured the right eye lid to establish the monocular form deprivation amblyopia model. All rats were fed for 6 weeks after establishing the model successfully,then the rats in the two groups were sacrificed and the coronal examination of 400 μm thick cortical brain slices were incubated in artificial cerebrospinal fluid artificial cerebrospinal fluid (ACSF). According to the difference of drugs in ACSF,the visual cortex slices of rats in normal control group were selected as group A;the contralateral visual cortex slices of the deprivation eye were divided into group B,group C,group D and group E;the ipsilateral visual cortex slices of the deprivation eye were divided into group F,group G,group H and group I. The ACSF of group A,B and F did not added any drugs;the ACSF of group C and group G were added with physiological saline;the ACSF of group D and group H were added with 10 μmol · L - 15-hydroxytryptamine hydrochloride;the ACSF of group E and group I were added with 10 μmol·L - 1 SB 242084 and 10 μmol·L - 15-hydroxytryptamine hydrochloride. The electrophysiology experiment was per-formed in all of the visual cortex slices by extracellular microelectrode recording and the visual cortex fidd postsynaptic poten-tial(fPSP)slope of V1M region of the visual cortex was recorded. Results The fPSP in group A,B,C,D,E,F,G,H,I was (198. 1 ± 13. 5)％,(106. 3 ± 8. 3)％,(106. 3 ± 8. 3)％,(157. 1 ± 9. 7)％,(102. 6 ± 4. 7)％,(144. 5 ± 2. 9)％,(144. 5 ± 2. 9)％,(192. 2 ± 8. 6)％ and (129. 7 ± 13. 5)％,respectively. There was statistic difference in fPSP slope of visual cortex a-mong the group A,B,F(P < 0. 001);the fPSP slope of visual cortex of rats in group A was significantly higher than that in the group B and group F(P < 0. 001);the fPSP slope of visual cortex of rats in group B was significantly lower than that in the group F(P < 0. 001). The fPSP slope of visual cortex in group D was significantly higher than that in the group C (t = - 10. 833,P < 0. 001);the fPSP slope of visual cortex in group H was significantly higher than that in the group D and group G(t = - 6. 841,- 10. 616;P < 0. 001). The fPSP slope of visual cortex in group E was significantly lower than that in the group D and group I(t = 11. 872,- 3. 910;P < 0. 001,P < 0. 05);the fPSP slope of visual cortex in group I was signifi-cantly lower than that in the group H(t = 9. 911,P < 0. 001). Conclusion Monocular deprivation can lead to the dysfunction of bilateral visual cortex neurons and 5-hydroxytryptamine hydrochloride can reverse this phenomenon through 5-HT2C R.
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Astragalus membranaceus (Radix Astragali, RA) and Atractylodes macrocephala (Rhizoma Atractylodis Macrocephalae, RAM) are often used to treat gastrointestinal diseases. In the present study, we determined the effects of polysaccharides extracts from these two herbs on IEC-6 cell migration and explored the potential underlying mechanisms. A migration model with IEC-6 cells was induced using a single-edged razor blade along the diameter of cell layers in six-well polystyrene plates. The cells were grown in control media or media containing spermidine (5 μmol·L, SPD), alpha-difluoromethylornithine (2.5 mmol·L, DFMO), 4-Aminopyridine (40 μmol·L, 4-AP), the polysaccharide extracts of RA or RAM (50, 100, or 200 mg·L), DFMO plus SPD, or DFMO plus polysaccharide extracts of RA or RAM for 12 or 24 h. Next, cytosolic free Ca ([Ca]) was measured using laser confocal microscopy, and cellular polyamine content was quantified with HPLC. Kv1.1 mRNA expression was assessed using RT-qPCR and Kv1.1 and RhoA protein expressions were measured with Western blotting analysis. A cell migration assay was carried out using Image-Pro Plus software. In addition, GC-MS was introduced to analyze the monosaccharide composition of both polysaccharide extracts. The resutls showed that treatment with polysaccharide extracts of RA or RAM significantly increased cellular polyamine content, elevated [Ca] and accelerated migration of IEC-6 cells, compared with the controls (P < 0.01). Polysaccharide extracts not only reversed the inhibitory effects of DFMO on cellular polyamine content and [Ca], but also restored IEC-6 cell migration to control level (P < 0.01 or < 0.05). Kv1.1 mRNA and protein expressions were increased (P < 0.05) after polysaccharide extract treatment in polyamine-deficient IEC-6 cells and RhoA protein expression was increased. Molar ratios of D-ribose, D-arabinose, L-rhamnose, D-mannose, D-glucose, and D-galactose was 1.0 : 14.1 : 0.3 : 19.9 : 181.3 : 6.3 in RA and 1.0 : 4.3 : 0.1 : 5.7 : 2.8 : 2.2 in RAM. In conclusion, treatment with RA and RAM polysaccharide extracts stimulated migration of intestinal epithelial cells via a polyamine-Kv1.1 channel activated signaling pathway, which facilitated intestinal injury healing.
Subject(s)
Animals , Rats , Astragalus propinquus , Chemistry , Atractylodes , Chemistry , Cell Line , Cell Movement , Drugs, Chinese Herbal , Chemistry , Pharmacology , Epithelial Cells , Cell Biology , Metabolism , Intestines , Cell Biology , Genetics , Metabolism , Polyamines , Metabolism , Polysaccharides , Chemistry , Pharmacology , Rhizome , Chemistry , Signal Transduction , rhoA GTP-Binding Protein , MetabolismABSTRACT
Standardized residency training is the only way for medical students to grow into clin-icians. At present, the number of under training residents in China has reached 190000 (excluding special-ized degree graduate students). It is very important to manage each stage of this training well, which is an guarantee for improving the effect of standardized training. The residents who attend the training are com-posed of "unit personnel" and "intra-industry social personnel", and after standardized and homogenized training, the two types of students have officially become the new force in the medical industry after passing the final examination. In order to do a good job in the management of standardized residency training, to achieve fine management at all stages , this paper focuses on the differences between the two types of students, analyzes in detail the characteristics of these two types of students in the recruitment, training and welfare guarantee stages. "Unit personnel" are given the security, supervision and containment of the origi-nal unit, while due to the pressure of job-hunting and the uncertainty of future welfare, "intra-industry so-cial personnel" are equipped with more initiative. Based on advanced management experience in Beijing,Shanghai, Sichuan and Tianjin, this paper aims to summarize the key points in management of the two types of students in training, propose countermeasures to the difficulties in management, innovative management solutions, and provide reference for the optimization management of standardized residency training.
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Objectives To explore the genetic diagnosis of fructose 1,6 diphosphatase deficiency and analysis of mutation sites of its pathogenic genes. Methods The clinical data and the related results of gene panel screening in one child with fructose 1, 6 diphosphatase (FBPase) deficiency were retrospectively reviewed. Results The 2-year-old girl suffered repeated infection, nausea, vomiting, mental illness, and drowsiness, accompanied by intermittent convulsions. Blood biochemical tests sμggested hypoglycemia and acidosis.The FBP1 gene had a missense mutation,c.355G>A,p.Asp119Asn(isozygoty).Both her parents carried the locus variation (heterozygous). Conclusions Fructose 1, 6 diphosphatase deficiency should be considered when child with hypoglycemia after repeated infection, acidosis, and ketosis.
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<p><b>BACKGROUND</b>The CHA2DS2-VASc score is used clinically for stroke risk stratification in patients with atrial fibrillation (AF). We sought to investigate whether the CHA2DS2-VASc score predicts stroke and death in Chinese patients with sick sinus syndrome (SSS) after pacemaker implantation and to evaluate whether the predictive power of the CHA2DS2-VASc score could be improved by combining it with left atrial diameter (LAD) and amino-terminal pro-brain natriuretic peptide (NT-proBNP).</p><p><b>METHODS</b>A total of 481 consecutive patients with SSS who underwent pacemaker implantation from January 2004 to December 2014 in our department were included. The CHA2DS2-VASc scores were retrospectively calculated according to the hospital medical records before pacemaker implantation. The outcome data (stroke and death) were collected by pacemaker follow-up visits and telephonic follow-up until December 31, 2015.</p><p><b>RESULTS</b>During 2151 person-years of follow-up, 46 patients (9.6%) suffered stroke and 52 (10.8%) died. The CHA2DS2-VASc score showed a significant association with the development of stroke (hazard ratio [HR] 1.45, 95% confidence interval [CI] 1.20-1.75, P< 0.001) and death (HR 1.45, 95% CI 1.22-1.71, P< 0.001). The combination of increased LAD and the CHA2DS2-VASc score improved the predictive power for stroke (C-stat 0.69, 95% CI 0.61-0.77 vs. C-stat 0.66, 95% CI 0.57-0.74, P= 0.013), and the combination of increased NT-proBNP and the CHA2DS2-VASc score improved the predictive power for death (C-stat 0.70, 95% CI 0.64-0.77 vs. C-stat 0.67, 95% CI 0.60--0.75, P= 0.023).</p><p><b>CONCLUSIONS</b>CHA2DS2-VASc score is valuable for predicting stroke and death risk in patients with SSS after pacemaker implantation. The addition of LAD and NT-proBNP to the CHA2DS2-VASc score improved its predictive power for stroke and death, respectively, in this patient cohort. Future prospective studies are warranted to validate the benefit of adding LAD and NT-proBNP to the CHA2DS2-VASc score for predicting stroke and death risk in non-AF populations.</p>
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Objective To determine the mutation spectrum of the PAH gene in PKU children in Ningxia, six exons of PAH gene were sequenced in each of the 30 phenylketonuria (PKU) children. Methods 30 children diagnosed as PKU by the neonatal sereening and/or GC/MS analysis in Ningxia were enrolled in this study. Meanwhile, 30 normal children were served as controls. The exons 3、5、6、7、11 and 12 of the PAH gene were ampliifed by polymerase chain reaction. The amplicons were analyzed by single strand conformation polymorphism and sequencing. Results Mutations were identiifed for 51 of 60 alleles in this study, representing a mutation detection rate of 85%. A total of 16 different causative mutations were detected, including 8 missense mutations (R 241 C、R 243 Q、R 252 Q、G 257 V、R 359 K、R 408 Q、R 413 P、Q 419 R), 3 splicing mutations (IVS 4-1 G?>?A、Y 204 C、IVS 7+2 T?>?A), 3 nonsense mutations (R 111 X、Q 160 X、Y 356 X), 1 synonymous mutation (V 399 V) and 1 deletion (N 183 del). R 243 Q ( 18 . 3%) had the highest frequency of PAH mutations, and then Y 204 C ( 11 . 7%)、IVS 4-1 G?>?A ( 10 . 0%)、R 111 X ( 6 . 7%) and IVS 7+2 T?>?A ( 6 . 7%). For the ifrst time in China, two novel mutations, deletion mutation N 183 del (C. 547-549 delGAA) in exon 6 and missense mutation R 359 K (C. 1078 G?>?A) in exon 11 , were identiifed in PKU children. Two silent mutations, V 245 V (C. 735 G?>?A) and Q 232 Q (C. 696 A?>?G), were observed in PKU children and the controls, but there were no signiifcant difference between them (P?>?0 . 05 ). Conclusions The most common mutations were missense and R 243 Q had the highest frequency of mutation. The identiifcation of 2 novel mutations expands the spectrum of Chinese PAH mutations.
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Objective To explore the correlation and clinical diagnostic significance between EGF ,PAF‐AH on henoch‐schonlein purpura (HSP) renal damage in children ,in order to provide a new way of thinking for early diagnosis and clinical prog ‐nosis for HSP nephritis(HSPN) .Methods Totally 86 cases of children with HSP from September 2013 to January 2014 in hospital were collected .According to the presence of renal damage ,the patients were divided into non‐HSPN group and HSPN group ,50 ca‐ses of healthy children as control group ,and 30 casea were diagnosied as bronchial pneumonia .Using PCR technique to detect the change of blood EGF and PAF‐AH ,and using ELISA to detect the change of blood EGF ,PAF‐AH and urine EGF .Results Detec‐tion of blood PAF‐AH mRNA ,EGF mRNA in case group obviously higher than control group ,and detection of blood PAF‐AH mRNA in HSPN group were also hgher than non‐HSPN group(P 0 .05) .Detection of serum PAF‐AH ,EGF and urine EGF in case group obviously higher than control group and the case group significantly lower recovery than acute stage (P<0 .05) .Conclusion Blood EGF ,PAF‐AH and urine EGF process involved in the pathogenesis of HSP ,and is related to renal dam‐age .
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BACKGROUND:Once lumbar degenerative diseases merge with lumbar spinal stenosis, lumbar instability and degenerative scoliosis, surgical therapy is required for corresponding clinical symptoms, and the usage of internal fixators cannot be inevitable. Osteoporosis is rather common in the elderly. Therefore, how to implant stable pedicle screw fixation system in serious osteoporosis patients wil be a big difficulty. In recent years, some studies have proven the biomechanical stability of polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw in the vertebral body, so it becomes very hot in the spine surgery. OBJECTIVE: To explore the clinical efficacy of the use of polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation for the treatment of lumbar degenerative disease accompanied with osteoporosis. METHODS:Thirty-one patients with lumbar degenerative disease accompanied with osteoporosis from Jun 2008 to Jan 2013 were selected, including 11 males and 20 females with an average age of 73.5 years (range, 65-86 years). There were 14 cases of lumbar degenerative stenosis, 9 of lumbar intervertebral disc herniation combined with segmental instability, 6 of lumbar degenerative spondylolisthesis, and 2 of lumbar degenerative scoliosis. The patients were treated with lumbar canal decompression, fusion and polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation according to their clinical features and imaging data. Visual analog scale for pain evaluation was used before and after fixation, the Japanese Orthopaedic Association (JOA) scale was used for assessment of neurological function and life skils before internal fixation and during folow-up. RESULTS AND CONCLUSION:Al cases were folowed up for 40 months (range, 36-48months). No screw breakage, rod breakage, screw extraction, loosening, pseudoarticulation formation, or incision infection was found. The postoperative visual analog scale score and the JOA score was remarkably improved (P < 0.05). For patients suffering from lumbar degenerative disease accompanied with osteoporosis, polymethylmethacrylate augmentation of a cannulated and fenestrated pedicle screw fixation is helpful for increasing the stabilization of screw and preventing from loosening and dislocation of the screws, and thereby beneficial for improvement and maintenance of clinical efficacy.
ABSTRACT
Objective To explore the application value of liquid chromotography tandem mass spectrometry (LC-MS/MS) in screening of inherited metabolic disease risk children ,and to provide a reference for the scientific prevention and control .Methods 246 cases of patients with inherited metabolic children blood samples were collected through the blood spots ,LC-MS/MS was used to examine blood samples from high risk cases of inherited metabolic who came from general hospital of Ningxia medical university . Results 30 cases were confirmed with inherited metabolic disease by the LC-MS/MS ,the positive rate was 12 .2% ,including 9 ca-ses of methylmalonic academia ,4 cases of isovaleric acidemia ,6 cases of phenylketonuria ,2 cases of propionic acidemia ,2 cases of citrullinemia ,1 cases of very long-chain acyl-CoA dehydrogenase ,1 cases of mitochondrial trifunctional protein deficiency ,1 cases of maple syrup urine disease ,3 cases of homocystinuria ,2 cases of argininesuccinic aciduria .Conclusion Liquid chromatography tan-dem mass spectrometry(L-MS/MS) technology is highly efficient and high reliability method in screening inherited metabolic dis-ease .