Dynamic relationship between changes of mortality rate and urban development level in Shanghai / 上海预防医学

ObjectiveTo analyze the dynamic response relationship between urban development and mortality rate in Shanghai， and to predict the trend of mortality rate changes. MethodsBy analyzing the total mortality rate （TMR）， gross domestic product （GDP） and socio-demographic index （SDI） in Shanghai from 1978 to 2017， a vector autoregressive （VAR） model was constructed to evaluate the impact of urban development on the mortality rate. ResultsThe fitted R2 of the VAR model was 0.92. The short-term effect of GDP on the improvement of death level was negative， while the long-term effect was positive， and the SDI was negative regardless of the short-term and long-term effects. By the tenth year， GDP and SDI contributed 10.61% and 27.25% to TMR changes， respectively. The model predicted that the mortality rate in Shanghai would be 9.17 per thousand by 2030. ConclusionLong-term economic growth can effectively promote a decline in population mortality. However， as the economy develops vigorously， the adverse effects of declining birth rates and population aging on population health during the era of high-level population development should not be ignored.

Trend and gender difference of mortality rate of senile dementia： based on the method of annual percent change / 上海预防医学

ObjectiveTo investigate the characteristics of gender difference and the trend of the mortality rate of senile dementia in registered population in Shanghai from year 2002 to 2018， and to provide the basis for formulating relative intervention measures before and after senile dementia from an public-health view. MethodsBased on the collected data of death registration， focused on the senile dementia disease codes F03，G30.0，G30.1，G30.8，G30.9 according to The International Classification of Diseases 10th revision （ICD-10）. We analyzed the characteristics of gender difference in the mortality rate of senile dementia in registered population in Shanghai from year 2002 to 2018. According to ASR， we calculated the standardized mortality rate of senile dementia， and used the chi-square test to compare the difference between the gender mortality rates. The trend and the turning point of the mortality rate of senile dementia were determined by linear regression analysis by Join-point. ResultsThe crude mortality rate of senile dementia in the registered population in Shanghai from year 2002 to 2018 was 5.46/105， 3.50/105 in males and 7.43/105 in females. The standardized mortality rate of senile dementia was 2.61/105， 1.67/105 in males and 3.56/105 in females. The trend of the standardized mortality rate of senile dementia in 17 years decreased ［APC=-5.5（-6.5，-4.5）%，P<0.01］. The trend of the standardized mortality rate of senile dementia decreased in both males ［APC=-4.9（-6.2，-3.6）%，P<0.01］ and females ［APC=-5.9（-6.9，-4.9）%，P<0.01］. The trend of the gender difference decreased ［APC=-6.8（-8.2，-5.3）%，P<0.01］. The mortality rate of senile dementia was higher in females than in males ［（χ2=33.63，P<0.01）］. ConclusionThe mortality rate of senile dementia in females is higher than in males in Shanghai， though the trend of the gender difference decreased. This gender difference is worth of attention.

Systematic review of synergistic effect between air pollutants and temperature on human mortality in China / 环境与职业医学

Background Air pollutants and extreme temperature both pose significant threats to human health, but the synergistic effect between air pollutants and temperature on health is inconsistent. Objective To explore a potential synergistic effect between air pollutants and temperature on the mortality in China through literature review. Methods Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure, VIP Information Chinese Journal Service Platform, PubMed, Web of Science, Science Direct, and Embase databases were searched. "Temperature" "air pollution" "mortality" were selected as keywords to collect literature on synergistic effect between air pollutants and temperature on mortality in China. Literature was published from 2000-01-01 to 2022-07-31 in Chinese or English. Two researchers screened the literature independently according to the inclusion criteria, and the results were integrated and analyzed after data extraction. The "meta" package of R software was used for meta-analysis. Results Twenty-seven studies met the inclusion criteria and associated air pollutants included PM10, PM2.5, O3, SO2, NO2, and CO. The impact of PM10 and PM2.5 on mortality in high temperature days was higher than that in moderate temperature days. In high temperature days, a 10 μg·m−3 increment in PM10 concentration corresponded to pooled estimates of 2.30% (95%CI: 1.34%-3.26%), 1.23% (95%CI: 0.64%-1.82%), and 1.42% (95%CI: 0.63%-2.22%) increase in non-accidental, cardiovascular, and respiratory mortalities, respectively. A 10 μg·m−3 increment in PM2.5 concentration corresponded to pooled estimates of 2.56% (95%CI: 2.00%-3.13%), 2.37% (95%CI: 1.64%-3.12%), and 2.14% (95%CI: 1.03%-3.25%) increase in non-accidental, cardiovascular, and respiratory mortalities, respectively. The synergistic effect of SO2 and NO2 on cardiovascular and respiratory mortalities in low temperature days was higher than that in moderate temperature days. Conclusion The synergistic effects of air pollutants and temperature on mortality in low temperature days or in high temperature days are higher than that in moderate temperature days. The health protection related to these pollutants should be strengthened in these days.

Cognitive impairment in children with benign childhood epilepsy with centrotemporal spikes and attention deficit hyperactivity disorder: a prospective study / 中国当代儿科杂志

OBJECTIVES@#To study the difference in cognitive impairment between the children with benign childhood epilepsy with centrotemporal spikes (BECT) and attention deficit hyperactivity disorder (ADHD) and those with BECT or ADHD alone.@*METHODS@#A prospective study was performed on 80 children with BECT and ADHD, 91 children with BECT, and 70 children with ADHD , who were diagnosed with the diseases for the first time. Seventy children of the same age who underwent physical examination were enrolled as the healthy control group. Event-related potential P300, Wechsler Intelligence Scale for Children, and integrated visual and auditory continuous performance test were used to measure and compare each index between groups.@*RESULTS@#Compared with the healthy control group, the BECT+ADHD group, the BECT group, and the ADHD group had a significantly prolonged P300 latency, a significant reduction in the amplitude of P300, and significant reductions in the scores of verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), processing speed index (PSI), full scale intelligence quotient (FSIQ), auditory response control quotient (ARCQ), visual response control quotient, full response control quotient (FRCQ), auditory attention quotient (AAQ), visual attention quotient, and full attention quotient (@*CONCLUSIONS@#Compared with the children with BECT or ADHD alone, the children with both BECT and ADHD have basically the same fields of cognitive impairment but a higher degree of cognitive impairment in some fields.

Development in methods and application of healthy life expectancy / 上海预防医学

With the development of social economy and improvement of people's health condition， life expectancy continues to extend and people are more concerned about the quality of life. Nowadays people's attention has shifted from living longer lives to living healthier lives. Life expectancy can only reflect the length of life， but not the health condition and quality of life. Meanwhile， healthy life expectancy contains death and disability information， which comprehensively reflects the length and quality of life and evaluates the health status of the population comprehensively. Through literature search and review， the article summarized the research on healthy life expectancy in recent years， including the concept proposal， index development， calculation， and application progress of health life expectancy. The research methods of healthy life expectancy are summarized in order to provide academic reference for further research.

Method and accuracy of determining the jaw position of repositioning splint with the aid of digital technique / 北京大学学报(医学版)

OBJECTIVE@#To establish the workflow of determining the jaw position of repositioning splint with the aid of digital technique, and to evaluate the accuracy of this workflow and compare the accuracy of raising different vertical dimensions in vitro.@*METHODS@#A volunteer was recruited. The data of full-arch scans, cone beam computed tomography (CBCT) image and ultrasonic jaw motion tracking of the volunteer were acquired. The full-arch scans were merged with the CBCT image, which were then matched to the jaw motion tracking reference system. The jaw position of repositioning splint was determined when the anterior teeth opening was 3 mm and the condyle was in centric relation of the fossa in the sagittal plane. A digital repositioning splint was designed in the software based on virtual articulator and fabricated with additive manufacturing technique. After the splint was tried in, another CBCT image was taken and a qualitative analysis was conducted to compare the position of condyle between these two CBCT images. In the in vitro study, standard dental plaster casts with resin ball markers attached to the base were mounted onto a fully adjustable articulator in the intercuspal position. The dental casts were scanned by an extraoral scanner to establish digital models. The ultrasonic jaw motion tracking device was used to obtain simulated jaw movements on the articulator, which was repeated for three times. The digital models and data of jaw movements were merged in one coordination with the aid of bite forks. The jaw position of repositioning splint was determined by adjusting data of jaw movements, each of which was used to determine three vertical jaw positions 4 mm, 5 mm, and 6 mm with the horizontal jaw position of protrusion 2 mm. The virtual articulators with differently adjusted jaw movements were applied in designing repositioning splints, and the final repositioning splints and virtual jaw relationships were exported in STL format. Then the repositioning splints were fabricated with additive manufacturing technique and tried in plaster casts on the mechanical articulator, which were scanned and the jaw relationships on the mechanical articulator were exported later. The virtual jaw relationships and scanned jaw relationships were registered according to lower models and displacement of upper models was calculated. Ball markers were fit to acquire the coordinates of centers and absolute difference values of centers along three coordinating axes X, Y, and Z were calculated. One-way analysis of variance was conducted using SPSS 18.0 software to compare deviations of the three different vertical jaw relationships in two-side test and the significance level was 0.05.@*RESULTS@#With the aid of multi-source data fusion and individualized jaw motion, the clinical workflow of determining jaw position of repositioning splint was preliminarily established. The designed jaw position was realized on the right and the condyle was more inferior than the designed position on the left. Both displacement of the upper models and absolute difference values of centers showed no significant differences (P>0.05) in different vertical jaw dimensions. The displacement of the upper models was (0.25±0.04) mm. The absolute difference values of centers along the three coordinating axes X, Y, and Z were respectively (0.08±0.01) mm, (0.30±0.02) mm, and (0.21±0.04) mm.@*CONCLUSION@#A novel method of determining the jaw position of repositioning splint with the aid of digital technique is established. It is proved to be feasible by try-in after multi-data fusion, computer-aided design and computer-aided manufacturing. As is shown in vitro, it is accurate to apply this method in adjusting jaw position. Further clinical trial will be designed to evaluate its clinical effect.

Application of positive end-expiratory pressure of pulmonary protective ventilation strategy in laparoscopic surgery in overweight patients / 中国医师杂志

Objective:To investigate the effect of end-expiratory positive pressure of pulmonary protective ventilation strategy in overweight patients undergoing laparoscopic surgery.Methods:Forty overweight patients, 24 kg/m 2≤BMI<28 kg/m 2, aged 20-65yr, of American Society of Anesthesiologists (ASA) physical status Ⅰ or Ⅱ, scheduled for elective laparoscopic surgery to radical resection of rectal cancer under general anesthesia, were randomly divided into 2 groups ( n=20 each) using a random number table: positive end-expiratory pressure (PEEP) group (group P), control group (group C). The rest of the settings in mechanical ventilation were the same in both groups, tidal volume (Vt)=6 ml/kg, initial respiration frequency (RR)=15 bpm, oxygen inhalation 100%, inspiratory expiratory time ratio ( I∶E)=1∶2. The concentration of oxygen inhalation was 50% and respiration frequency was adjusted to maintain P ETCO 2 35-45 mmHg after endotracheal intubation. The heart rate (HR), mean arterial pressure (MAP), tidal volume (Vt), airway peak pressure (Ppeak), airway pressure platform (Pplat) were recor-ded, and the lung dynamic compliance (Cdyn) was calculated; arterial oxygen partial pressure (PaO 2) and partial pressure of carbon dioxide in arterial blood (PaCO 2) were measured by gas analyzer; oxygenation index (OI) was calculated at the time of before induction of anesthesia (T 0) , 5 min after endotracheal intubation (T 1), 5 min after laparoscopic pneumoperitoneum (T 2), 60 min after laparoscopic pneumoperitoneum (T 3), and suturing the skin (T 4). The postoperative pulmonary complications were observed 3 days after surgery. Results:There was no significant difference between the two groups in patients characteristics and operative indicators ( P>0.05). Compared with T 0, the mean arterial blood pressure of the two groups decreased at T 3 and T 4, and there was no significant difference in heart rate at each time ( P>0.05). There was no significant difference in hemodynamic parameters between the two groups ( P>0.05). Compared with T 1, VT increased at T 2 in group P and T 3 in group C, while there was no significant difference in VT between the two groups ( P>0.05); compared with T 1, Ppeak and Pplat increased at T 2 and T 3 in both groups, while there was no significant difference between the two groups ( P>0.05); compared with T 1, Cdyn of the two groups decreased at T 2 and T 3 ( P<0.05), and cdyn of the P group at each time were higher than that of the group C ( P<0.05). Compared with T 1, PaO 2 and OI decreased and PaCO 2 increased at T 2, T 3 and T 4 in the two groups ( P<0.05). PaO 2 and OI at T 3 and T 4 in the P group were higher than those in the C group ( P<0.05). There was no significant difference in PaCO 2 between the two groups ( P>0.05). There was no significant difference in the incidence of pulmonary complications between the two groups ( P>0.05). Conclusions:Positive end-expiratory pressure of protective ventilation strategy from the induction period of general anesthesia can effectively improve dynamic lung cdyniance, improve oxygenation and promote pulmonary function recovery in overweight patients undergoing laparoscopic surgery.

Predictive effect of psychological stress in early puberty on subsequent anxiety and depression / 中国学校卫生

Objective@#Longitudinal data were used in this study to examine the predictive effects of psychological stress in early puberty on subsequent anxiety and depression symptoms.@*Methods@#Objects from a puberty cohort of 998 children from 4 primary schools in Chongqing were included. Psychological stress was measured during their early puberty, and anxiety and depression were followed up after 4 years. Multiple linear regression was used to analyze the influence of psychological stress on anxiety and depression level in their middle puberty.@*Results@#The average score of psychological stress during early puberty was (34.79±24.78), and scores of anxiety and depression were (11.20±10.89) and (12.06±6.69), respectively, with detection rates of 14.03% and 15.63%. Girls had higher anxiety and depression scores than boys(F=51.58,5.48，P<0.05). The depression scores of children with different parents’ educational levelsand perceived parental relationship were different(F=6.74, 7.38, 10.49, P<0.05). The results of multiple linear regression showed that girls(β=4.38), higher psychological stress(β=0.13), older age (β=0.89) were risk factors for higher anxiety level. Children with higher psychological stress(β=0.05), older age(β=0.57), perceived worse parents’ relationship(β=1.19), lower maternal education (β=-1.00) had higher depression scores(P<0.05).@*Conclusion@#The psychological stress level, and age during early puberty had a positive predictive effect on anxiety and depression after 4 years. Simultaneously, girls were more prone to anxiety, and poor parental relationship and low maternal literacy were risk factors for children’s depression.

Association between incidence of fatal intracerebral hemorrhagic stroke and fine particulate air pollution

OBJECTIVE@#Few studies investigating associations between fine particulate air pollution and hemorrhagic stroke have considered subtypes. Additionally, less is known about the modification of such association by factors measured at the individual level. We aimed to investigate the risk of fatal intracerebral hemorrhage (ICH) incidence in case of PM (particles ≤ 2.5 μm in aerodynamic diameter) exposure.@*METHODS@#Data on incidence of fatal ICH from 1 June 2012 to 31 May 2014 were extracted from the acute stroke mortality database in Shanghai Municipal Center for Disease Control and Prevention (SCDC). We used the time-stratified case-crossover approach to assess the association between daily concentrations of PM and fatal ICH incidence in Shanghai, China.@*RESULTS@#A total of 5286 fatal ICH cases occurred during our study period. The averaged concentration of PM was 77.45 μg/m. The incidence of fatal ICH was significantly associated with PM concentration. Substantial differences were observed among subjects with diabetes compared with those without; following the increase of PM in lag2, the OR (95% CI) for subjects with diabetes was 1.26 (1.09-1.46) versus 1.05 (0.98-1.12) for those without. We did not find evidence of effect modification by hypertension and cigarette smoking.@*CONCLUSIONS@#Fatal ICH incidence was associated with PM exposure. Our results also suggested that diabetes may increase the risk for ICH incidence in relation to PM.

Suspension method of double-ring breast fascia flap in treatment of sagging breast / 中华医学美学美容杂志

Objective To study the suspension method of double ring breast fascia flap in the treatment of sagging breast.Methods By double-ring skin full-thickness resection,suspension method of breast fascia flap was used in the treatment of sagging breast.The pedicle in the upper half of the breast fascia flap was vertically pulled down and then sutured in the lower quadrant of the breast and the pectoralis major.The sagging breast tissue was left and breast shape rebuilt.Results In the 50 patients their incision healed in phase 1.No skin necrosis and fat liquefaction occured.Nipple and areola had no blood barrier and disordered.Within 3 to 24 months visiting,incisions were without obvious scar.There was no sagging breast and breast shapes were satisfied.Conclusions This method reduces postoperative complications.It can restore the perfect breast shape and it is an ideal surgical method for sagging breast.

Ventricular Arrhythmia during Tracheal Intubation and Extubation under General Anesthesia Possibly Induced by Amisulpride: A Case Report

We are presenting the first documented case of amisulpride related ventricular arrhythmia during tracheal intubation and extubation under general anesthesia in an 48 year-old female with psychiatric history of chronic schizophrenia who was treated with amisulpride. This case suggests the threshold of perioperative arrhythmia is possibly decreased in patients with long-term antipsychotic medication. So, the potential risk of antipsychotics-induced perioperative arrhythmia should be evaluated, as well as heart rhythm monitoring, prophylactic use of antiarrhythmic drugs, and preoperative adjustment of antipsychotics should be considered.

The application of intravenous lidocaine in general anesthesia of patients with gastrointestinal tumors / 中国医师杂志

Lidocaine is often used for local anaesthesia and nerve block.Intravenous lidocaine can reduce intracranial pressure and exert brain protection in neurosurgery.With the continuously deepening clinical research and application of lidocaine,the effects of lidocaine on analgesia,anti-inflammatory,organ protection and promotion of postoperative recovery in general anesthesia are also gradually attracting attention.The patients with digestive tract tumors are mostly middle-aged and elderly.Because of long-term malnutrition and hemorrhage of tumors,the patients suffer from hypoproteinemia,emaciation,anemia,systemic organ failure,poor tolerance to surgery and anesthesia,intraoperative and postoperative prone to hemodynamic instability,poor oxygenation,delirium,cognitive dysfunction,pain and so on.This article reviews the application of intravenous lidocaine in general anesthesia of patients with gastrointestinal tumors,aiming to optimize the intraoperative management and improve the prognosis of patients.

Effect of matrix metalloproteinase-26 on human glioma angiogenesis / 临床与实验病理学杂志

To investigate the effect of MMP-26 on human glioma angiogenesis and the possible mechanism.Methods The MMP-26 plasmid and empty plasmid pcDNA3.1 were stably transfected into U251 cells to establish a nude mice xenograft model,and then an in vitro human tumor tissue-based three-dimensional angiagenic model.Tissue disks were visually assessed over time to determine the percentage of wells that developed an angiogenic response(I％) and the density and length of neovessel growth were graded at intervals using a semiquantitative visual growth-rating scheme (angiogenic index,AI,0-16scale) in groups of MMP-26 transfected U251 cells (U251-MMP-26),pcDNA3.1 vector-transfected U251 cells (U251-pcDNA3.1) and non-transfected U251 cells (U251).RT-PCR and immunohistochemistry were used to detect the expression of mRNA and protein of MMP-26 and VEGF in groups of U251-MMP-26,U251-pcDNA3.1 and U251.Immunohistochemical localization of CD31 was determined in the endothelial tubes invading the fibrin-thrombin clot matrix.Results Immunohistochemical endothelial cell markers CD31 was positive in the vascular tubes invading the fibrin-thrombin clot matrix,confirming their endothelial origin.The angiogenesis results showed that difference of length of micro capillaries,density of branches,and the area occupied between U251-MMP-26 groups and control groups were significant.The percentage of tumor implants that developed invasion (I％) and the angiogenic index AI in U251-MMP-26 group on day 14 were higher than those of U251-pcDNA3.1 group and U251 group (P ＜ 0.05).The trends of I％ and AI in 14 days were significant compared with those in control groups.The expression of mRNA and protein of MMP-26and VEGF in U251-MMP-26 group was significantly higher in U251-MMP-26 group than those in U251-pcDNA3.1 group and U251 group(P ＜0.01).Conclusion The effect of MMP-26 on promoting glioma angiogenesis may be related to the increased expression of VEGF,which can be used as targets for anti-tumor therapy.

Comparison of the effects of methylprednisolone and dexamethasone individually combined with tropisetron on the prevention of postoperative nausea and vomiting of high risk in patients with thyroid surgery / 中国医师杂志

Objective To compare the effects of methylprednisolone and dexamethasone individually combined with tropisetron on the prevention of postoperative nausea and vomiting (PONV) of high risk in patients with thyroid surgery.Methods One hundred and sixty patients of high risk of postoperative nausea and vomiting scheduled for radical operation of thyroid with general anesthesia were randomly divided into four groups with 40 cases each.Four groups of the patients were intravenously injected methylprednisolone 40 mg plus tropisetron 5 mg at the end of the operations (group MT),dexamethasone 7.5 mg before anesthesia induction,and tropisetron 5 mg at the end of the operations (group DT),tropisetron 5 mg at the end of the operations (group T),and normal saline (group C).Incidence and severity of nausea,vomiting and adverse reactions were recorded during 24 hours after end of the operations.Results Compared to group DT,the incidences of PONV during the 0 ～ 2 h and 2 ～ 6 h,and the visual analogue scale (VAS) of PONV at 2 h after the operations in group MT were significantly lower (P ＜ 0.05).Compared to group C,the incidences of PONV and VAS score during the 0 ～ 24 h after the operations in group MT and group DT were significantly lower (P ＜0.05),the incidences of PONV during the 2 ～6 h and 6 ～ 12 h after the operations,and VAS score of PONV at 6 h and 12 h after the operations in group T were significantly lower (P ＜0.05).Compared to group C,incidences of headache in group MT and group DT were significantly lower (P ＜ 0.05),and incidence of swim in group T was also significantly lower (P ＜ 0.05).Incidence of adverse reactions in group MT and group DT were no significant difference.Conclusions Preventive effect of methylprednisolone combined with tropisetron for PONV in high-risk patients within 6 hours after thyroid surgery was significantly better than that of dexamethasone combined with tropisetron.

Comparison of Clinical Application of Ultrasound Localization Method and Palpation Method on Radial Artery Puncture and Catheterization in Patients with Septic Shock / 中国医科大学学报

Objective To compare the application of two different radial artery puncture and cannulation methods in septic shock patients. Meth-ods A total of 80 septic shock patients who need emergency operation were enrolled in this study. The shock index was>1.0. The patients were randomly divided into two groups:ultrasound group(group U)and palpation group(group A),with 40 cases in each group. For the patients in group U,Sonosite S-Nerve ultrasound in the wrist was used to determine the location of the radial artery puncture. For the patients in group A ,pal-pation method was used to determine the location of the radial artery puncture. The heart rate,blood pressure,first puncture success rate,total suc-cess rate,number of punctures,puncture time and complication rate of the two groups were monitored. Results The success rate of first puncture and total success rate of group U were higher than those of group A ,the number of puncture was less than that of group A ,the puncture time was shorter than that of group A,and the incidence of complications was lower than that of group A(P<0.05). Conclusion The application of ultra-sound for radial artery puncture and catheterization in septic shock patients is accurate ,and with higher first success puncture rate and total success rate,less number of puncture,shorter puncture time,and lower incidence of complications compared with palpation method.

Application of locking plate in elderly patients with proximal humeral fractures / 中国医师进修杂志

Objective To explore the clinical curative effect of locking plate in elderly patients with proximal humeral fractures. Methods Seventy elderly patients with proximal humeral fractures were selected, and all patients were treated with surgical treatment. Among them, application of locking plate was in 35 cases (locking plate group), and application of ordinary steel plate was in 35 cases (ordinary steel plate group). The operation time, intraoperative blood loss, fracture healing time and curative effect between 2 groups were compared. Results The operation time, intraoperative blood loss and fracture healing time in locking plate group were significantly lower than those in ordinary steel plate group: (61.3 ± 5.6) min vs. (78.3 ± 4.2) min, (190.5 ± 11.5) ml vs. (268.5 ± 21.2) ml and (12.6 ± 1.8) weeks vs. (16.5 ± 1.5) weeks, the excellent and good rate was significantly higher than that in ordinary steel plate group: 94.29% (33/35) vs. 74.98% (26/35), and there were statistical differences (P<0.05). Conclusions The curative effect of locking plate in elderly patients with proximal humeral fractures is accurate. Locking plate can be fixed firmly, and it is conducive to early recovery after surgery.

Effects of miR-122a on blood-spinal cordbarrier after spinal cord ischemia-reperfusion injury in rats / 中国药理学通报

Aim To investigate the effects of miR-122a on blood-spinal cord barrier after spinal cord ischemia-reperfusion injury in rats.Methods Thirty-six SD rats were randomly divided into three groups:group of sham(S group),group of control(C group)and group of miR-122a antagomir(M group).Rats in S group were subjected to exposure of aorta arch but without occlusion.Spinal ischemia-reperfusion injury was induced by clamping the aorta arch for 14 min in C group and M group.Rats in M group and C group were intrathecally injected with miR-122a antagomir or antagomir control daily for three times after injury.The miR-122a expression in injured spinal cord tissue was detected by real-time PCR.The occludin expression in injured spinal cord tissue was detected by Western blot.The permeability of blood-spinal cord barrier was examined using evans blue as a vascular tracer.The neurological motor function was evaluated by Basso Beattie Bresnahan score.Results Compared with S group,the expression of miR-122a was increased,the expression of occludin was decreased,the permeability of blood-spinal cord barrier was increased,and neurological motor function score was decreased significantly in C group(P<0.05).Compared with C group,the expression of miR-122a was decreased,the expression of occludin was increased,the permeability of blood-spinal cord barrier was decreased,and neurological motor function score was increased significantly in M group(P<0.05).Conclusion miR-122a can regulate the expression of occludin and change the permeability of blood-spinal cord barrier.

Diversity and distribution of the threatened medicinal vascular plants in Lancang / 中国中药杂志

The rich diversity in medicinal plants provides an important material basic for the development of Traditional Chinese medicine in China. It is important to explore the present situation of medicinal plants within special regions in order to provide scientific instructions for their sustainable protection and exploitation and utilization. In this study, we carried out the field survey according to the guideline of national survey of Chinese material medica resources and the guideline of plant species diversity survey and estimation at county level with the line transect method. With the field surveyed data, we explored the diversity and distribution of the threatened medicinal vascular plants in Lancang. We found that there were 33 species of the threatened medicinal vascular plants in this county. These species were from 23 genera and 17 families, and were composed of one critical endangered, 10 endangered and 22 vulnerable species. They were widely distributed across the whole county and were most concentrated in the town of Nuozhadu, Fazhanhe, Nuofu and Zhutang, which were located in the southeastern, southwestern and western of Lancang, respectively. We also found that the plant species richness followed a unimodal pattern along elevation. In addition, we found that the areas of Nuozhadu Nature Reserve in Lancang only covered six threatened medicinal vascular plants, while most of the regions with high species richness were not well protected. Therefore, we proposed to make more efforts to improve the protection measurements in order to better protect and utilize the medicinal plants in Lancang.

The application of lung protective ventilation strategy in laparoscopic surgery of obese patients / 中国医师杂志

With the ventilator associated lung injury (VALI) atracting more and more attention,lung protective ventilation strategy (LPVS) has gradually been applied to clinical practice.Obese patients are at higher risk in VALI for laparoscopic surgery,mechanical ventilation induced atelectasis is an important reason for low oxygen in intraoperative and postoperativen procedure.In laparoscopic surgery,high abdominal pressure causes the elevation of diaphragm,and increases airway pressure.The excessive pressure increases the amount of alveolar dead space and airway pressure,reduces lung compliance,and increases the possibility of barotrauma and colotrauma.In addition,carbon dioxide pnenmoperitoneum indces hypercapnia.Both of them influence the recovery of postoperative lung function.To optimize intraoperative management and improve the prognosis of patients with general anesthesia,the application of LPVS attracts more attention,including small tidal volume,positive end-expiratory pressure,and recruitment maneuvers,etc.However,LVPS may also cause lung injury.This article is a review on the application of LPVS in laparoscopic surgery of obese patients.

An analysis on metabolic indices among diabetic patients in different seasons / 预防医学

Objective To analysis the metabolic index among diabetic patients in community in summer and winter,and to provide evidence for disease management.Methods During June and December,119 diabetic patients were seleted from communities living for more than a year by the method of stratified cluster sampling.The metabolic indexes were compared usingpaired t test ,and the rate of biochemical indicators were analyzed by McNemar 's test between two seasons .Results The values of HbA1c,GLU and HDL -C were higher in winter than in summer (P <0.01).The mean values of TC in summer and winter were the same.The detection values of triglyceride and low density lipoprotein were lower in winter than in summer,but the difference was not statistically significant (P >0.05 ).The control rate of HbA1c was 56.36% in summer,and the control rate was 44.54% in winter,the difference was statistically significant (P <0.05).In summer, the control rate was 59.66%,higher than 45.38% in winter,and the difference was statistically significant (P <0.05). The control rate of blood pressure was better than that in winter,while triglyceride and low density lipoprotein control was better than that in summer,but which was not statistically significant (P >0.05).Conclusion The metabolic index of diabetic patients in Zhoushan urban community was significantly affected by seasonal changes.Most indexes were better in summer than that in winter,which suggested that the intervention of diabetics should be enhanced in winter.