Analysis of treatment outcomes of elderly pulmonary tuberculosis aged 65 and above in Chongqing from 2015 to 2020 / 中国热带医学

@#Abstract: Objective　To analyze the treatment outcomes of elderly patients with pulmonary tuberculosis in Chongqing, so as to provide reference for the prevention and control strategies of the epidemic of elderly pulmonary tuberculosis. Methods　The data of tuberculosis cases aged ≥65 years in Chongqing from 2015 to 2020 were collected from the National Health Insurance Information Project Disease Prevention and Control Information system. Descriptive statistical methods were used to analyze the data. Results The registration rates of elderly active pulmonary tuberculosis patients and etiological positive patients were 110.95/10-5and 32.25/10-5 in 2015 and 84.06/10-5 and 57.29/10-5 in 2020. The annual decline rate of active tuberculosis registration was 5.40%, and the annual increase rate of pathogenic-positive tuberculosis registration was 12.18%. The registration rates of active tuberculosis patients and etiological positive patients in the whole population were 70.75/10-5 and 17.63/10-5 in 2015 and 50.34/10-5 and 29.14/10-5 in 2020. The annual decline rate of active tuberculosis registration was 6.58%, and the annual increase rate of pathogenic-positive tuberculosis registration was 10.57%. From 2015 to 2020, a total of 25 931 cases of elderly pulmonary tuberculosis were registered, of which 21 374 (82.43%) cases were successfully treated and 4 010 (15.80%) cases had unfavorable outcomes. The proportion of cured and death patients showed an increasing trend year by year (χ2trend=313.853, 100.502, P<0.01). From 2015 to 2020, the average annual successful treatment rate of elderly pulmonary tuberculosis in the whole city was 82.43%, with the lowest rate in southeast Chongqing (74.23%), followed by urban areas (81.99%). The success rate of elderly pulmonary tuberculosis treatment in the whole city, west Chongqing, northeast Chongqing and southeast Chongqing showed a downward trend year by year (χ2trend=230.199, 35.278, 108.076, 112.130, all P<0.01), with annual decline rates of 2.77%, 2.26%, 3.0% and 4.12%, respectively. Among the registered elderly patients, female, 65-<75 years old, Han nationality, newly diagnosed, no complications, and negative for etiology (χ2=15.234, 255.910, 146.842, 179.998, 25.575, 131.170, P<0.01) had higher success treatment rates. Conclusions The prevalence of pulmonary tuberculosis in the elderly population in Chongqing City is declining, but the positive registration rate of etiology is increasing annually, and the success rate of treatment is decreasing. Therefore, it is necessary to strengthen the systematic management, publicity and education of elderly patients (especially those in southeast Chongqing, male, positive patients and severe patients) to effectively control the epidemic of tuberculosis in the elderly.

Research progress of optical motion capture technology in shoulder biomechanics / 中国骨伤

The shoulder joint is the most flexible joint in the body with the largest range of motion, and the movement pattern is more complex. Accurate capture of three-dimensional motion data of the shoulder joint is crucial for biomechanical evaluation. Optical motion capture systems offer a non-invasive and radiation-free method to capture shoulder joint motion data during complex movements, enabling further biomechanical analysis of the shoulder joint. This review provides a comprehensive overview of optical motion capture technology in the context of shoulder joint movement, including measurement principles, data processing methods to reduce artifacts from skin and soft tissues, factors influencing measurement results, and applications in shoulder joint disorders.

CERKL attenuates blue light-induced oxidative stress in human retinal pigment epithelial cells by activating the SIRT1/E2F1 axis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate whether ceramide kinase-like protein(CERKL)alleviates oxidative stress injury of retinal pigment epithelial(RPE)cells induced by blue light via activating the silent information regulator 1(SIRT1)/E2F transcription factor 1(E2F1)axis. METHODS:Cultured human retinal pigment epithelial-19(ARPE-19)cells were irradiated with blue light to observe the morphological changes, and the expression of CERKL was detected by PCR and Western blot. ARPE-19 cells were transfected with siRNA-CERKL and pcDNA3.1-CERKL respectively. After exposure to blue light, cell viability was determined by MTT assay, apoptosis was detected by TUNEL assay, content of oxidative stress markers and the expression of SIRT1/E2F1 axis was analyzed. Then siRNA-SIRT1 was transfected into ARPE-19 cells, and the oxidative stress damage of ARPE-19 cells under blue light irradiation was detected again.RESULTS:ARPE-19 cells gradually contracted into spheres and appeared vacuoles after exposure to blue light. Blue light irradiation led to the increase of CERKL expression level(P<0.05), meanwhile, the rate of cell viability was decreased(P<0.05), the rate of the apoptosis was increased(P<0.05), contents of reactive oxygen species, malondialdehyde and 8-hydroxydeoxyguanosine were increased(P<0.05). Silence of CERKL aggravated this phenomenon, while up-regulation of CERKL could alleviate this change(P<0.05). Up-regulation of CERKL also activated the expression of SIRT1 and promoted the deacetylation of E2F1(P<0.05). Silencing SIRT1 could reverse the alleviating effect of up-regulating CERKL on oxidative stress injury of ARPE-19 cells induced by blue light(P<0.05). CONCLUSION: CERKL can reduce oxidative stress damage of ARPE-19 cells induced by blue light via activating SIRT1 expression and promoting the deacetylation of E2F1.

Problem and solution for tuberculosis prevention and control in schools / 中国学校卫生

Abstract@#Tuberculosis (TB) prevention and control in schools is always the key area of TB control work. The paper reviews the TB epidemic change trend and characteristic in students, and analyzes existing problems in current TB control work in schools, including incompletely implemented routine precaution measurements in schools, inaccurate occupational information for TB patients, absence of evidence from TB laboratory in diagnosis and tracing infectious source, lack of timeliness and standardization in close contact screening, low coverage of preventive therapy, and lack of capacity for tackling public sentiment. Specific suggestions were proposed for every institute involved in TB control work in schools to solve these problems.

Effect of Huanglian Jiedutang on Learning and Memory Ability and Cholinergic System in AD Rats Induced by Aβ1-42 / 中国实验方剂学杂志

Objective:To investigate the effects of Huanglian Jiedutang on learning and memory ability and the cholinergic system in Alzheimer's disease（AD） rats induced by amyloid <italic>β</italic>-protein（A<italic>β</italic>）_1-42. Method:Sixty male SD rats were divided into normal group， model group， huperzine A group （2.1×10^-5 g·kg^-1）， high-， medium- and low dose of Huanglian Jiedutang groups （6，3，1.5 g·kg^-1）. AD rat model was replicated by hippocampal injection of A<italic>β</italic>_1-42. After 4 weeks of treatment， Morris water maze test was performed. Hematoxylineosin （HE） staining was used to observe the pathological changes of rat hippocampus. Sampling blood from abdominal aorta was taken. Acetylcholine （ACh）， acetylcholinesterase （AchE） and choline acetyltransferase （ChAT） in serum and hippocampus were detected by enzyme-linked immunosorbent assay （ELISA）. The expression of hippocampal <italic>α</italic>7 nicotinic acetylcholine receptor （<italic>α</italic>7nAChR） protein was detected by Western blot. The expression of hippocampal <italic>α</italic>7nAChR mRNA was detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. Result:Compared with the normal group， there were obvious pathological changes in the model group，such as neuron necrosis in the cerebral cortex，pyramidal cell or granular cell necrosis in the hippocampus，disorder of arrangement and inflammatory cell infiltration，prolonged escape latency，decreased escape platform times，decreased residence time in the effective area and swimming path in the effective area （<italic>P<</italic>0.05，<italic>P<</italic>0.01）. The contents of <italic>α</italic>7nAChR mRNA，ACh，AchE，ChAT，<italic>α</italic>7nAChR in the hippocampus decreased （<italic>P<</italic>0.01）. Compared with the model group，the escape latency of the middle dose group was shorter （<italic>P<</italic>0.05）， the escape platform times，the swimming path in the effective area and the residence time in the effective area increased （<italic>P<</italic>0.05，<italic>P<</italic>0.01）， the contents of serum ACh，ChAT， hippocampal AchE，ChAT and <italic>α</italic>7nAChR increased （<italic>P<</italic>0.05，）. The expression of hippocampal <italic>α</italic>7nAChR protein significantly increased （<italic>P<</italic>0.01）， the residence time of effective area in high dose group was prolonged （<italic>P<</italic>0.01）， the times of escape platform increased，and the contents of serum ACh，ChAT and hippocampal ACh，AchE，<italic>α</italic>7nAChR protein and <italic>α</italic>7nAChR mRNA increased （<italic>P<</italic>0.05）. Conclusion:Huanglian Jiedutang can significantly improve the learning and memory ability of AD rats induced by A<italic>β</italic>_1-42，and its mechanism may be related to the improvement of cholinergic system damage and enhancement of cholinergic system function induced by A<italic>β</italic>_1-42.

Research Advances on Clinical Application of Umbilical Cord Blood Transplantation in the Treatment of Hematological Diseases--Review / 中国实验血液学杂志

Abstract　　Umbilical cord blood (UCB) is an alternative source of hematopoietic stem cells (HSCs) for patients who were lack of HLA match related or unrelated donors. Compared with bone marrow and mobilized peripheral blood, UCB has the advantages of easy availability, safety for donors, and low requirement for HLA match between donors and recipients. However, the cell amount in UCB is relatively less, which was associated with increased graft failure, delayed hematologic recovery, immune reconstitution, and higher transplant related mortality after UCB transplantation (UCBT). Double-unit UCB is a straightforward method to augment cell amount in UCB. Compared with single-unit UCBT, double-unit CBT associated with less risk of primary disease relapse and increased incidence rate of graft-versus-host disease (GVHD), but the hematologic recovery and overall survival of recipients were no significantly difference between single and double-unit UCBT. Novel strategies for UCB expansion significantly increased the cell amount in UCB, single-unit expanded UCBT not only increased the sources of UCB, but also decreased the high cost of double-unit UCB. ATG can decrease the risk of graft failure and GVHD rate, but the role of ATG in UCBT is still controversial. Herein, the recent clinical advances on UCBT in the treatment of hematologic diseases are systematically reviewed.

Initial experience with ablation of the innervation surrounding sinus and atrioventricular nodes to treat paroxysmal bradyarrhythmia / 中华医学杂志(英文版)

BACKGROUND@#The symptomatic bradyarrhythmia is Class I indication for pacing therapy which is not a radical cure. The present study aimed to assess the feasibility and to present the initial results of the restricted ablation of the parasympathetic innervation surrounding sinus and atrioventricular (AV) nodes for treating patients with bradyarrhythmia.@*METHODS@#A total of 13 patients with cardiogenic syncope were included from May 2008 to June 2015. Under the guidance of fluoroscopy and /or three-dimensional geometry by 64-slice spiral computed tomography, atrial activation sequence in sinus rhythm was mapped. Chamber geometry was reconstructed manually or automatically using the Niobe II magnetic navigation system integrated with the CARTO-remote magnetic technology (RMT) system. Cardioneuroablation was targeted at the high-amplitude fractionated electrograms surrounding the regions of His bundle and the site with the earliest activation in sinus rhythm. Areas surrounding the sinus node, AV node, and the phrenic nerve were avoided.@*RESULTS@#Thirteen patients completed the studies. Ablation was successfully performed in 12 patients and failed in one. The high-frequency potential was recorded in atrial electrograms surrounding the sinus or AV nodes in all the patients and disappeared in 15 s after radiofrequency applications. The vagal reaction was observed before the improvement of the sinus and AV node function. No complications occurred during the procedures. Patients were followed up for a mean of 13.0 ± 5.9 months. During the follow up ten patients remained free of symptoms, and two patients had a permanent cardiac pacemaker implanted due to spontaneous recurrence of syncope. The heart rate of post-ablation was higher than pre-ablation (69.0 ± 11.0 vs. 49.0 ± 10.0 beats/min, t = 4.56, P = 0.008). The sinus node recovery time, Wenckebach block point, and atrium-His bundle interval were significantly shorter after ablation (1386.0 ± 165.0 vs. 921.0 ± 64.0 ms, t = 7.45, P = 0.002; 590.0 ± 96.0 vs. 464.0 ± 39.0 ms, t = 2.38, P = 0.023; 106.0 ± 5.0 vs. 90.0 ± 12.0 ms, t = 9.80, P = 0.013 before and after ablation procedure, respectively).@*CONCLUSIONS@#Ablation of sinoatrial and AV nodal peripheral fibrillar myocardium electrical activity might provide a new treatment to ameliorate paroxysmal sinus node dysfunction, high degree AV block, and vagal-mediated syncope.

Adult-onset Still's disease successfully treated with Chinese herbal medicine: A case report with 15-month follow-up / 中西医结合学报

Adult-onset Still's disease (AOSD) is a rare but clinically well-known, polygenic, and systemic autoinflammatory disease, which is characterized by spiking fever, evanescent skin rash, arthralgia, and sore throat. The application of non-steroidal anti-inflammatory drugs and glucocorticoids, which are first-line therapies of AOSD, is limited due to their side effects such as liver injury or disorder of blood glucose. Therefore, patients who suffer from systemic diseases in China prefer to seek help from Chinese herbal medicine (CHM), which is an important part of complementary and alternative medicine. In this case, we report a 28-year-old male badminton coach presenting with a 15-day history of fever and skin rash, accompanied by sore throat, fatigue, myalgia and chills. Additionally, hepatosplenomegaly, multiple lymphadenopathies, aminotransferase abnormality, and elevated inflammatory factor levels were observed during hospitalization. Infectious diseases, solid tumors, hematological diseases, and common autoimmune diseases were excluded. Not benefitting from antibiotic therapy, the patient was finally diagnosed with AOSD, after a careful examination, then showed rapid remission after a six-week treatment with CHM granules based on Xiaochaihu Decoction and Yinqiao Powder. After stopping the treatment, there was no relapse within a 15-month follow-up period. To the best of our knowledge, this is the first well-documented case of this successful treatment. The present case report suggests that CHM is a reliable choice for complementary and alternative therapy for AOSD, but confirming the utility of CHM for AOSD requires further support from prospective studies.

Significance of Detecting Serum Complement C3 and C4 in Patients with Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To investigate the significance of detecting serum complement C3 and C4 in patients with multiple myeloma (MM) and to explore its correlation with myeloma bone disease (MBD).@*METHODS@#The levels of serum complement C3 and C4 in 69 MM patients and 30 healthy people were examined by scatter nephelometry. The bone density of L1-4 vertebral body, bilateral femoral neck and bilateral hip joints were measured by dual energy bone density meter (DXA).@*RESULTS@#The levels of serum complement C3 and C4 in MM patients significantly increased in comparison with that in healthy people (P＜0.01). The patients in advanced clinical stage exhibited a higher levels of C3 and C4 than those in stable stage (P＜0.01). In addition, the patients with grade C of MBD had a higher levels of serum complement C3 and C4 than those in patients with grade A and B of MBD (P＜0.01). The levels of serum complement C3 and C4 in MM patients negatively correlated with bone density in L1-4 vertebral body, bilateral femoral necks and hip joints. The correlation coefficients were r=-0.938, r=-0.659, r=-0.745, r=-0.748, r=-0.596 in complement C3 and r=-0.908, r=-0.623, r=-0.710, r=-0.714, r=-0.595 in complement C4, respectively.@*CONCLUSION@#The levels of complement C3 and C4 positively correlate with the severity of bone disease and bone density in MM patients, which suggests that complement C3 and C4 plays important roles in the development of MBD. The levels of serum C3 and C4 may be the sensitive biomarkers of MBD.

Effect of augmented renal clearance on plasma concentration of vancomycin and treatment outcome in children with methicillin-resistant Staphylococcus aureus infection / 中国当代儿科杂志

OBJECTIVE@#To investigate the effect of augmented renal clearance (ARC) on plasma concentration of vancomycin, bacteriological outcome, and clinical outcome in children with methicillin-resistant Staphylococcus aureus (MRSA) infection treated by vancomycin.@*METHODS@#A retrospective analysis was performed for the clinical data of 60 critically ill children who were treated with vancomycin due to MRSA infection from January 2013 to July 2017 and underwent plasma concentration monitoring. According to estimated glomerular filtration rate, these children were divided into an ARC group with 19 children and a normal renal function group with 41 children. The two groups were compared in terms of the use of vancomycin, plasma concentration of vancomycin, and treatment outcome.@*RESULTS@#The children in the ARC group had an age of 1-12 years, and the ARC group had significantly higher body weight and body surface area than the normal renal function group (P0.05), but the ARC group had significantly longer length of stay in the pediatric intensive care unit (PICU) and length of hospital stay than the normal renal function group (P<0.05).@*CONCLUSIONS@#ARC can significantly reduce the trough concentration of vancomycin and prolong the length of PICU stay and the length of hospital stay in children with MRSA infection. Idividualized medication should be administered to children with ARC.

Incidence and Risk of Peripheral Neuropathy Caused by Intravenous and Subcutaneous Injection of Bortezomib / 中国实验血液学杂志

OBJECTIVE@#To compare the effects of intravenous and subcutaneous injection of bortezomib on incidence and relative risk of peripheral neuropathy in patients with multiple myeloma(MM).@*METHODS@#The electronic database of PubMed, Embase, Cochrance library, CNKI and related meeting records were searched by computers. The data were derived all from a matched randomized controlled studies. The incidence, relative risk(RR) and 95% confidence interval of peripheral neuropathy caused by intravenous and subcustaneous injections were calculated by the statistical methods.@*RESULTS@#Four RCT studies were selected for meta-analysis, with a total of 911 patients (479 cases and 432 cases in the subcutaneous injection and intravenous injection groups, respectively). The incidence of peripheral neuropathy in the intravenous injection group was 41.4% (95% CI=0.137-0.692, P=0.003), and the incidence of >2 grade of peripheral neuropathy was 15.6% (95% CI=0.005-0.308, P=0.043). The corresponding incidence rates of the subcutaneous injection group were 16% (95% CI=0.021-0.299, P=0.024) and 3.4% (95% CI=-0.011-0.080, P=0.141) respectively. Compared with the intravenous injection group, the RR of peripheral neuropathy and the relative risk of peripheral neuropathy above grade 2 were 0.525, 95% CI=0.297-0.928 (P=0.027) and 0.376, 95% CI=0.196-0.722 (P=0.003) respectively.@*CONCLUSION@#Subcutaneous injection of bortezomib at therapeutic doses significantly reduces the incidence of peripheral neuropathy compared with intravenous injection.

Association between vasoactive-inotropic score and prognosis in children with septic shock / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the association between vasoactive-inotropic score (VIS) and prognosis in children with septic shock.</p><p><b>METHODS</b>A total of 117 children with decompensated septic shock who received the treatment with vasoactive agents were enrolled. According to their prognosis, they were divided into death group with 41 children and survival group with 76 children. With the maximum VIS within the first 24 hours (24hVIS max) as the cut-off value (29.5), the children were divided into low VIS group with 78 children and high VIS group with 39 children. The 24hVIS max and the mean VIS within the first 24 hours (24hVIS mean) were calculated for all children. A receiver operating characteristic (ROC) curve analysis was performed for the association between VIS and the prognosis of septic shock.</p><p><b>RESULTS</b>Compared with the survival group, the death group had significantly higher 24hVIS max, 24hVIS mean, PRISM III score, and level of lactate before the use of vasoactive agents and after 24 hours of use (P<0.05). 24hVIS max, 24hVIS mean, PRISM III score, level of lactate before the use of vasoactive agents and after 24 hours of use, and 24-hour pH had a certain value in predicting the prognosis of septic shock, but 24hVIS max had the largest area under the ROC curve. Compared with the low VIS group, the high VIS group had significantly higher number of deaths, PRISM III score, and level of lactate before treatment and after 24 hours of treatment (P<0.05).</p><p><b>CONCLUSIONS</b>VIS is associated with the mortality of children with septic shock, and the severity and mortality of patients increase with the increase in VIS.</p>

Research of hyperoxia-inducedlung injury related signaling pathways / 医学研究生学报

Mammals exposured to high volume fractional oxygen (hyperoxygen) are prone to go under oxidative stress, and activating inflammatory cells in the lung produce cytotoxic reactive oxygen species directly or indirectly, activate complex signaling pathways and epigenetic factors, causing lung epithelial cells and endothelial cell damage and death. In the hyperoxia-induced lung injury-related signaling pathways, the current research includes MAPK pathway, P13K/Akt pathway, TGF-β related pathway, NF-κB pathway, Wnt pathway, Rho/Rock pathway, Notch pathway, Shh pathway, AngⅡ-P22phox-ROS pathway, Src pathway and so on. This review summarizes the research of these signaling pathways in hyperoxia-induced lung injury.

A new hope for treating the aseptic loosening after jointarthroplasty-mesenchymal stem cells / 医学研究生学报

Aseptic loosening is one of the most commonly seen longterm complications after joint arthroplasty. Previous stud-ies have shown that prosthetic wear is one of the major causes of chronic inflammation in tissues surrounding the prosthesis,and that macrophage is the key factor responsible for the interaction between prostheses-derived wear particles and the host. Wear particles acti-vate macrophages and secretion of inflammatory mediators stimulate osteoclastic bone resorption,resulting in reduction of bone mass a-round the prosthesis. However,the balance of bone turnover depends not only on osteoclast-mediated bone resorption but also on osteo-blast-mediated bone formation,both of which are in close cooperation. Osteoblasts are mainly derived from mesenchymal stem cells. A growing body of research shows that wear particles can significantly inhibit the differentiation of mesenchymal stem cell into osteoblasts and subsequent bone formation. However,some characteristics of mesenchymal stem cells enable them one of the main candidates for the treatment of aseptic loosening. We reviewed the current research advances on the aseptic loosening post arthroplasty using mesen-chymal stem cells as target.

Value of conventional magnetic resonance imaging combined with magnetic resonance cholangiopancreatography for the diagnosis of portal cholangiocarcinoma / 新乡医学院学报

Objective To investigate the value of conventional magnetic resonance imaging(MRI) combined with magnetic resonance cholangiopancreatography(MRCP) for the diagnosis of portal cholangiocarcinoma (HCCA).Methods Fortysix patients with HCCA in Chaoyang Central Hospital from September 2014 to February 2016 were selected as the research subjects.The characteristics of conventional MRI and MRCP of HCCA were retrospectively analyzed.Results Among the 46 patients with HCCA,33 cases showed portal nodules or irregular lumps blurred with the adjacent tissues,13 cases showed no obvious lump.Among the 33 cases,there were 4 cases of left hepatic duct involvement,7 cases of right hepatic duct involvement,18 cases of the left and right hepatic duct confluence involvement and 4 cases of common hepatic duct involvement.The irregular lumps or portal nodules in coronal Fiesta showed equal signal and slightly higher signal in T2WI.The liver acquisition with volume acceleration (LAVA) scan of 33 cases of portal nodules or irregular lumps showed that 24 cases had no significant enhancement in arterial phase and significant enhancement in delayed phase;and 9 cases had slight enhancement in arterial phase and non significant intensification in delayed phase.The LAVA scan of the 13 cases without obvious lumps showed the thickening of the vascular wall in arterial phase,vascular stenosis,slight enhancement in arterial phase and the significant enhancement in delayed phase.The MRCP examination of 46 cases showed moderate or severe dilatation with "soft rattan like"changes in intrahepatic bile ducts.The rupture of the dilated bile duct in porta hepatis position was found in 33 cases of portal nodules or irregular lumps,and 13 cases showed " empty" or "rat tail-like" stenosis of hepatic portal.The accuracy rates of localization and qualitative diagnosis of conventional MRI in the 46 patients were 80.43％ (37/46) and 82.61％ (38/46),respectively;and those of conventional MRI combined with MRCP were 100.00％ (46/46) and 95.65％ (44/46),respectively.The accuracy rate of localization and qualitative diagnosis of HCCA by MRI combined with MRCP was significantly higher than that by conventional MRI(x2 =8.762,4.039;P ＜ 0.05).Conclusion MRI combined with MRCP has a high diagnostic value for HCCA.

Practice and experience of offering MOOC of anatomy / 基础医学与临床

Massive open online courses(MOOCs)have a major influence on modern higher education."Anatomy and clinics"course was offered on Chinese University MOOC from November,2015.The course already has run 4 ver-sions,with over 60 000 registrants.This paper analyzed the data of 4 versions and results of questionnaire survey, suggests that offering MOOC of anatomy plays a role in continuing professional and interprofessional medical educa-tion.Combining MOOC to traditional anatomy teaching is also suggested.

Separation and Identification of Microplastics in Digestive System of Bivalves / 分析化学

As a new type of pollutants,microplastics (small pieces of plastic with the longest dimension less than 5 mm) are bringing wide concerns by policy makers and researchers. The impact of microplastics on marine life is closely related to human health. Bivalves, as filter feeding creatures, can easily ingest microplastics in their feeding process. The microplastics in these bivalves can easily enter the human body through the food chain. In this study,a bivalve sample pretreatment method was established for separating the microplastics in their digestive system. Qualitative and quantitative analysis of microplastics was carried out by micro-Fourier transformed infrared spectroscope (μ-FT-IR) and Stereo microscope. By comparing the digestion systems of using 10% KOH and 30% H2O2, respectively, it was found that the digestion system using 10% KOH had better digestion efficiency. The recoveries of polypropylene (PP),polyethylene (PE), polystyrene (PS) and polyvinyl chloride (PVC) ranged from 96.7% to 98.6%, with RSD of less than 3.2%. Therefore, 10% KOH was used to digest organic tissue for separating the microplastics from the bivalves'digestive system. With this digestion system,the microplastics in Chlamys farreri from local markets and Mytilus galloprovincialis from both local markets and wild environments in Qingdao were separated and analyzed. The results showed that microplastics were found in over 80% of the individuals purchased from the market and 40% in the collected wild individuals. The average abundance of microplastics in Chlamys farreri purchased from different markets varied from 5.2 to 19.4 items/individual and 3.2-7.1 items/g, while in Mytilus galloprovincialis, the numbers varied from 1.9 to 9.6 items/individual and 2.0-12.8 items/g. Farmed mussels contained more microplastics (average 1. 9 items/individual, 3. 17 items/g) than wild mussels (average 0.53 items/individual, 2.0 items/g). There were various colors of microplastics. The detected microplastics came from three shapes: fibers, fragments and granules. Fibrous microplastics, being the most dominant ones,accounted for 84.11%. The average size of fibrous microplastics(0.66±0.70 mm) was larger than that of the other two shapes of microplastics. The number of microplastics decreased with increasing microplastic sizes. Microplastics of less than 500 μm coming from different markets were in the range of 26% to 84%. There was great spatial difference in the size of microplastics. The polymer composition of the microplastic was identified by μ-FT-IR. And it was found that the most common polymer component sin the samples were cellophane(CP),followed by polypropylene(PP). In the farmed mussels,PP was the most abundant component. The results showed that the abundance and types of microplastics in cultured or wild bivalves were closely related to their growing environment.

Current Status of Antithrombotic Strategy for Elderly Patients With Atrial Fibrillation and Acute Coronary Syndrome After Stent Implantation in Beijing Area / 中国循环杂志

Objective: To investigate the current status of antithrombotic strategy for elderly patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) after stent implantation in Beijing area and to study the safety and efficacy of different therapeutic strategy. Methods: A total of 467 relevant patients were enrolled by re-travelling electronic medical records from 12 hospitals in Beijing area. The patients' mean age was (78.70±3.32) years and they were divided into 2 groups by antithrombotic therapy condition: Triple therapy group, n=17 (3.64％), Double therapy group, n=450 (96.36％). The incidence of major adverse cardiac and cerebral events (MACCE) including all-caused death, non-fatal myocardial infarction, stent thrombosis, target vessel revascularization (TVR), stoke and bleeding was compared between Triple therapy group and Double therapy group.Results: The medication in Double therapy group included aspirin+ticagrelor, aspirin+clopidogrel, clopidogrel+warfarin and cilostazol+clopidogrel; in Triple therapy group was aspirin+clopidogrel+warfarin. Patient with HAS-BLED score≥3 was defined as high risk of bleeding and they were all treated by double therapy; HAS-BLED<3 was defined as low risk of bleeding, only 5.03％ patients were treated by triple therapy. 3 patients in Triple therapy group and 33 in Double therapy group suffered from gastrointestinal bleeding, P=0.338; 6 patients in Triple therapy group and 128 in Double therapy group had MACCE, P=0.589; 3 and 80 patients died in Triple therapy group and Double therapy group, P=0.766. Conclusion: Triple therapy was rarely used in elderly AF and ACS patients after stent implantation, double therapy was the main strategy; the incidence of MACCE and mortality were similar between triple and double therapies; patients with triple therapy had the higher incidence of gastrointestinal bleeding.

Detection rate and enhanced effects of different iodine concentration of contrast agent for patients with liver cirrhosis of different time phase hepatocarcinoma in 64-MDCT / 局解手术学杂志

Objective To compare the clinical diagnosis effect of high and common iodine concentration of contrast agent to patients with liver cirrhosis hepatocarcinoma in 64-MDCT.Methods Ninety patients who diagnosed with cirrhosis and hepatoma by biopsy in our hospital from January 2015 to December 2016 were randomly divided into observation group(n =45) and control group(n =45).The observation group and the control group separately accepted 350 mgI/mL and 300 mgI/mL Lohexol enhancement.The CT values of different enhanced parts,detection rate of lesions and the incidence of adverse reactions were chosen as clinical diagnosis indexes.Results The CT value of liver parenchyma,aorta and portal vein in observation group were particularly or very particularly higher than those of control group (P ＜ 0.05).145 and 110 lesions were respectively detected in observation group and control group.It showed higher diagnostic sensitivity of observation group in three phases (P ＜ 0.05) and good safety in 64-MDCT.Conclusion High concentration iodine contrast agent can remarkably improve the detection CT value and detection rate of liver cancer patients with liver cirrhosis in 64-MDCT,with less adverse reactions.

MicroRNA-375 Suppresses the Tumor Aggressive Phenotypes of Clear Cell Renal Cell Carcinomas through Regulating YWHAZ / 中华医学杂志(英文版)

Background@#MicroRNAs (miRNAs) are key regulators during tumor initiation and progression. MicroRNA-375 (MiR-375) has been proven to play a tumor-suppressive role in various types of human malignancies; however, its biological role in clear cell renal cell carcinoma (ccRCC) remains unclear. The purpose of this study was to explore the biologic role as well as the underlying mechanism of miR-375 in ccRCC progression.@*Methods@#Quantitative polymerase chain reaction (qPCR) was applied to test the expression of miR-375 in tissues and cell lines by t-test. Functional experiments were used to investigate the biological role of miR-375 utilizing a gain-of-function strategy. The target of miR-375 was investigated by bioinformatic analysis and further verified by luciferase reporter assay, qPCR, Western blotting, and functional experiments in vitro.@*Results@#Our study demonstrated that miR-375 was significantly downregulated in ccRCC tissues (cancer vs. normal, 0.804 ± 0.079 vs. 1.784 ± 0.200, t = 5.531 P < 0.0001) and cell lines, and loss of miR-375 expression significantly associated with advanced Fuhrman nuclear grades (Grade III and IV vs. Grade I and II, 1.000 ± 0.099 vs. 1.731 ± 0.189, t = 3.262 P = 0.003). Functional studies demonstrated that miR-375 suppressed ccRCC cell proliferation, migration, and invasion (all P < 0.05 in both 786-O and A498 cell lines). Multiple miRNA target prediction algorithms indicated the well-studied oncogene YWHAZ as a direct target of miR-375, which was further confirmed by the luciferase reporter assay, qPCR, and Western blotting. Moreover, restoration of YWHAZ could rescue the antiproliferation effect of miR-375.@*Conclusions@#The data provide the solid evidence that miR-375 plays a tumor-suppressive role in ccRCC progression, partially through regulating YWHAZ. This study expands the antitumor profile of miR-375, and supports its role as a potential therapeutic target in ccRCC treatment.