Predictive value of deep learning-based coronary artery calcification score for coronary artery disease in type 2 diabetes mellitus / 中华放射学杂志

Objective:To explore the predictive value of deep learning (DL)-based coronary artery calcification score (CACS) for obstructive coronary artery disease (CAD) and noncalcified plaque/mixed plaque in type 2 diabetes mellitus (T2DM).Methods:Forty hundred and twenty-four consecutive T2DM patients who accepted CACS scan and coronary CT angiography (CCTA) from December 2012 to December 2019 were included retrospectively, with clinical risk factors and plaque features collected. Plaque composition was classified as calcified, non-calcified or mixed plaque. Obstructive CAD was defined as maximum diameter stenosis≥50%. CACS was calculated with a fully automated method based on DL. Univariate and multivariate logistic regressions were applied to select statistically significant factors and the odds ratios(ORs) were measured. Receiver operating characteristic (ROC) curve was evaluated to assess the predictive performance.Results:Increased CACS was associated with a significantly higher odds of obstructive CAD in CCTA (adjusted ORs were 2.22, 6.18 and 16.98 for CACS=1-99, 100-299, 300-999 vs. CACS=0, and P values were 0.009,<0.001,<0.001 respectively). The area under ROC curve (AUC) of CACS to predict obstructive CAD was 0.764. Compared with 0, increased CACS was associated with increased risk of non-calcified/mixed plaque (adjusted ORs were 2.75, 4.76, 5.29 for CACS=1-99, 100-299, 300-999 respectively and P values were 0.001,<0.001,<0.001 respectively). The AUC of CACS to predict non-calcified/mixed plaque was 0.688. It took 1.17 min to perform automated measurement of CACS based on DL in total, which was significantly less than manual measurement of 1.73 min ( P<0.001). Conclusion:DL-based CACS can predict obstructive CAD and non-calcified plaque/mixed plaque in T2DM, which is economical and efficient, and has important value for clinical diagnosis and treatment.

Identification and expression analysis of MADS-box gene family in Docynia delavayi (Franch.) Schneid / 生物工程学报

MADS-box gene family is a significant transcription factor family that plays a crucial role in regulating plant growth, development, signal transduction, and other processes. In order to study the characteristics of MADS-box gene family in Docynia delavayi (Franch.) Schneid. and its expression during different stages of seed germination, this study used seedlings at different stages of germination as materials and screened MADS-box transcription factors from the transcriptome database of D. delavayi using bioinformatics methods based on transcriptome sequencing. The physical and chemical properties, protein conservative motifs, phylogenetic evolution, and expression patterns of the MADS-box transcription factors were analyzed. Quantitative real-time PCR (qRT-PCR) was used to verify the expression of MADS-box gene family members during different stages of seed germination in D. delavayi. The results showed that 81 genes of MADS-box gene family were identified from the transcriptome data of D. delavayi, with the molecular weight distribution ranged of 6 211.34-173 512.77 Da and the theoretical isoelectric point ranged from 5.21 to 10.97. Phylogenetic analysis showed that the 81 genes could be divided into 15 subgroups, among which DdMADS27, DdMADS42, DdMADS45, DdMADS46, DdMADS53, DdMADS61, DdMADS76, DdMADS77 and DdMADS79 might be involved in the regulation of ovule development in D. delavayi. The combination of the transcriptome data and the qRT-PCR analysis results of D. delavayi seeds indicated that DdMADS25 and DdMADS42 might be involved in the regulation of seed development, and that DdMADS37 and DdMADS38 might have negative regulation effects on seed dormancy. Previous studies have reported that the MIKC* subgroup is mainly involved in regulating flower organ development. For the first time, we found that the transcription factors of the MIKC* subgroup exhibited a high expression level at the early stage of seed germination, so we speculated that the MIKC* subgroup played a regulatory role in the process of seed germination. To verify the accuracy of this speculation, we selected DdMADS60 and DdMADS75 from the MIKC* subgroup for qRT-PCR experiments, and the experimental results were consistent with the expression trend of transcriptome sequencing. This study provides a reference for further research on the biological function of D. delavayi MADS-box gene family from the perspective of molecular evolution.

Comparison of the predictive value of anthropometric indicators for the risk of benign prostatic hyperplasia in southern China / 亚洲男科学杂志(英文版)

This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia (BPH). Males over 50 years of age who underwent health examinations at the Health Management Center of the Second Xiangya Hospital, Central South University (Changsha, China) from June to December 2020 were enrolled in this study. The characteristic data were collected, including basic anthropometric indices, lipid parameters, six anthropometric indicators, prostate-specific antigen, and total prostate volume. The odds ratios (ORs) with 95% confidence intervals (95% CIs) for all anthropometric parameters and BPH were calculated using binary logistic regression. To assess the diagnostic capability of each indicator for BPH and identify the appropriate cutoff values, receiver operating characteristic (ROC) curves and the related areas under the curves (AUCs) were utilized. All six indicators had diagnostic value for BPH (all P ≤ 0.001). The visceral adiposity index (VAI; AUC: 0.797, 95% CI: 0.759-0.834) had the highest AUC and therefore the highest diagnostic value. This was followed by the cardiometabolic index (CMI; AUC: 0.792, 95% CI: 0.753-0.831), lipid accumulation product (LAP; AUC: 0.766, 95% CI: 0.723-0.809), waist-to-hip ratio (WHR; AUC: 0.660, 95% CI: 0.609-0.712), waist-to-height ratio (WHtR; AUC: 0.639, 95% CI: 0.587-0.691), and body mass index (BMI; AUC: 0.592, 95% CI: 0.540-0.643). The sensitivity of CMI was the highest (92.1%), and WHtR had the highest specificity of 94.1%. CMI consistently showed the highest OR in the binary logistic regression analysis. BMI, WHtR, WHR, VAI, CMI, and LAP all influence the occurrence of BPH in middle-aged and older men (all P ≤ 0.001), and CMI is the best predictor of BPH.

An Epidemiologic Survey and Violent Behavior Analysis of Antisocial Personality Disorder in Young Men in Chengdu / 法医学杂志

OBJECTIVES@#To investigate the epidemiological characteristics of antisocial personality disorder (ASPD) in young men in Chengdu and explore the characteristics and risks of violence.@*METHODS@#Stratified random sampling was used to conduct a self-assessment questionnaire survey in 4 108 males aged from 18 to 34 in Chengdu, including general demographic characteristics, structured clinical interview for the diagnostic and statistical manual of mental disorders-Ⅳ axis Ⅱ disorders (SCID-Ⅱ) personality disorder screen questionnaire, violence questionnaire, psychosis screening questionnaire (PSQ), Alcohol Use Disorders Identification Test (AUDIT) and drug use. χ2 test, univariate and multivariate logistic regression were used for analysis and odds ratio (OR) was calculated.@*RESULTS@#The positive rate of ASPD was 5.91%, which was associated with young age, unmarried, unemployment state, low educational level, violent behavior, psychotic symptoms, alcohol and drug use (P<0.05). Young men with ASPD also had a risk (P<0.05) of violence (OR was 8.51), multiple violence (OR was 16.57), injury (OR was 6.68), intentional violence (OR was 11.41), etc., the risk decreased after controlling for psychotic symptoms and substance abuse, but was still statistically significant.@*CONCLUSIONS@#The risk of violence, severe violence and intentional violence in young men in Chengdu is high, and psychotic symptoms and substance abuse increase the risk of ASPD violence and relate characteristics.

The fat attenuation index around coronary artery measurement on coronary calcium score images and coronary CT angiography images: a comparison study / 中华放射学杂志

Objective:To investigate the difference in the peri-coronary fat attenuation index (FAI) between using coronary calcium score (CCS) images and coronary CT angiography (CCTA) images, and to explore the feasibility and befitting threshold of FAI measured on CCS images.Methods:The clinical and imaging data of patients who underwent CCTA examination from August 2019 to August 2020 were retrospectively analyzed in the First Affiliated Hospital of Soochow University. According to the inclusion and exclusion criteria, there were 122 cases in non-calcified plaque group (144 coronary arteries) and 97 cases in none-plaque group (186 coronary arteries). The coronary arteries were delineated both on CCS and CCTA images with Perivascular Fat Analysis Tool; the regions of interest of peri-coronary adipose tissue were generated automatically after setting the threshold of fat tissue. Then the FAI value was calculated. The thresholds were set in four levels (-190--30, -185--25, -180--20 and -175--15 HU) for CCS images and one level (-190--30 HU) for CCTA images. The intra-class correlation coefficient (ICC) was used to evaluate the consistency of the measurements of FAI values on CCS and CCTA images between the two physicians. Paired t test was used to compare the differences of FAI values between CCS and CCTA images, and Pearson correlation coefficient was used to evaluate the correlation between CCS-FAI and CCTA-FAI. Results:(1) FAI values measured on CCS and CCTA images by 2 physicians showed good consistency; (2) At the threshold of -185--25 HU, there was no significant difference in FAI values between the CCS and CCTA images for non-calcified plaque group [(-84.15±5.99)HU vs. (-83.83±5.98)HU, t=0.79, P=0.429], as well as for the none-plaque group [(-83.41±5.75)HU vs.(-83.84±6.25)HU, t=-1.08, P=0.280]; (3) There were significant differences on FAI values between the CCS images and CCTA images at the threshold of -190--30、-180--20 and -175--15 HU (all P<0.05); (4) There were moderate correlations on FAI values between the CCS images and CCTA images under different thresholds both in non-calcified plaque group and none-plaque group. Conclusion:It is feasible to measure FAI on CCS images, and the befitting threshold is -185--25 HU.

The National Life Science Competition for College Students assists fostering life science talents in colleges and universities / 生物工程学报

The National Life Science Competition for College Students has been held for five times, which has become the largest and most influential life science competition in China. The competition is designed to follow principles of "interest-driven, scientific exploration, process evaluation and ability improvement". The holding of the competition has effectively improved the training quality of life science talents in colleges and universities. This paper summarized the development, organization and management of the competition as well as the organizational characteristics of the competition. It may serve as a guidance for colleges and universities to organize students to participate in the competition, and improve the fostering of talents in the field of life sciences in colleges and universities nationwide.

Knowledge Domain and Emerging Trends of Chinese Medicine in Management of Pediatric Asthma: A Scientometric Study / 中国结合医学杂志

OBJECTIVE@#To analyze the intellectual landscape and emerging research trends of Chinese medicine (CM) in the management of pediatric asthma through a scientometric study.@*METHODS@#Publications related to CM in the management of pediatric asthma were retrieved from the Web of Science Core Collection using relevant keywords. A scientometric study was performed using CiteSpace and VOSviewer.@*RESULTS@#A total of 1,673 original articles and reviews from 1991 to 2019 were included in the analysis. The amount of annual publications had a gradual increase with time. USA was the major contributor both in country and institution analyses. Based on the co-citation, the published journals were grouped into 4 clusters. Keyword analysis indicated that the main hotspots were: (1) comprehensive management; (2) risk factors, mechanism, and prevalence; (3) prevention and treatment; (4) inflammation; and (5) environmental research. Lastly, we predicted that three emerging trends were quality of life promotion, immune response, and combination therapy.@*CONCLUSIONS@#CM research in the management of pediatric asthma will maintain the current trend of steady growth. This scientometric analysis may help scientists to identify the areas of interests and future directions in the field.

Expression of Toll-like receptor 8 in diffuse large B-cell lymphoma and its clinical significance / 白血病·淋巴瘤

Objective:To investigate the expression of Toll-like receptor 8 (TLR8) in diffuse large B-cell lymphoma (DLBCL) and its correlation with clinicopathological characteristics and prognosis of patients.Methods:The data in the Oncomine database was used to analyze the difference of TLR8 mRNA expression between DLBCL tumor tissues and normal lymphocytes, and the result was verified in two independent subsets GSE 25638 and GSE 32018 of the NCBI-GEO database. The OSDLBCL online survival analysis tool was used to analyze the correlation of TLR8 mRNA relative expression level with overall survival (OS) and progression-free survival (PFS) of DLBCL patients. Gene ontology bioprocess (GO_BP) enrichment analysis was performed by using GSEA software. The correlation of TLR8 mRNA expression with tumor immune cell infiltration degree and immune checkpoint-related molecule expression was analyzed by TIMER online tool website. A total of 53 DLBCL patients who underwent lymph node biopsy in Yancheng No. 1 People's Hospital from June 2020 to June 2021 were selected. Immunohistochemistry was used to detect the expression of TLR8 protein, and its relationship with the clinicopathological characteristics of patients was analyzed.Results:The analysis result of data from Oncomine and GEO databases showed that the relative expression levels of TLR8 mRNA in tumor tissues of patients with DLBCL or activated B cell-like DLCBL were higher than those in normal lymphocytes (all P < 0.001). The results of OSDLBCL online survival analysis indicated that the OS ( P = 0.020) and PFS ( P = 0.004) in DLBCL patients with high TLR8 mRNA expression were worse than those in patients with low TLR8 mRNA expression. The level of TLR8 was related to the abnormal function of immune response, cytokine metabolism and DNA damage monitoring; the result of TIMER online analysis showed that the expression level of TLR8 mRNA was positively related to the degree of neutrophil infiltration ( r = 0.78, P < 0.001) and the expression of immunosuppressive molecules [HAVCR2 ( r = 0.85, P < 0.001), LAG3 ( r = 0.63, P < 0.001), CD274 ( r = 0.77, P < 0.001), TIGIT ( r = 0.32, P = 0.037), and C10ORF54 ( r = 0.34, P = 0.029)]. Among 53 DLBCL patients, 29 patients (54.7%) had low expression of TLR8 protein and 24 patients (45.3%) had high expression of TLR8 protein. There were statistical differences in the expressions of TLR8 protein in DLBCL patients with different serum lactate dehydrogenase and β 2-microglobulin levels (both P < 0.05). Conclusions:TLR8 is highly expressed in DLBCL patients, and TLR8 may be a prognostic marker of DLBCL.

The relationship between red blood cell distribution width and metabolic syndrome in patients with impaired glucose tolerance / 中国医师杂志

Objective:To evaluate the relationship between red blood cell distribution width (RDW) and metabolic syndrome (MS) in patients with impaired glucose tolerance (IGT).Methods:A total of 415 patients with abnormal glucose tolerance were screened by oral glucose tolerance test in Changsha Traditional Chinese Medicine Hospital (Changsha Eighth Hospital) from October 2015 to September 2019. General data were collected and blood routine and biochemical indexes were detected. There were 193 cases in the observation group and 222 cases in the control group. The RDW and other clinical indicators were compared between the two groups, the correlation between RDW and other indicators was analyzed, and the risk factors of metabolic syndrome were analyzed.Results:⑴ The RDW, systolic blood pressure (SBP), diastolic blood pressure (DBP), height (Ht), weight (Wt), waist circumferenc (Wc), triglyceride (TG), cholesterol (CHOL), low density lipoprotein (LDL), creatinine (Cr), uric acid (UA), alanine aminotransferase (ALT), high sensitive C-reactive protein (hs-CRP), body mass index (BMI) of the observation group were significantly higher than those of the control group, while the high density lipoprotein (HDL) was significantly lower than that of the control group, with statistically significant difference ( P<0.05); ⑵ correlation analysis showed that RDW was positively correlated with SBP, DBP, Ht, Wt, Wc, TG, CHOL, Cr, UA, ALT, hs-CRP, BMI, and negatively correlated with HDL ( P<0.05); ⑶ binary logistic regression analysis showed that RDW, Wt, Wc, CHOL, HDL, LDL and hs-CRP were independent risk factors for MS in patients with impaired glucose tolerance. Conclusions:The increase of RDW is a predictor of metabolic syndrome in people with abnormal glucose tolerance, which may provide some reference value for the prevention and treatment of metabolic syndrome.

Survey on the testing accuracy of HBV serological markers among grassroots medical institutions in the demonstration areas of infectious diseases / 中华临床感染病杂志

Objective:To evaluate the detection accuracy of hepatitis B virus (HBV) serological markers among grassroots medical institutions in the demonstration areas of infectious diseases.Methods:A fixed sampling method was used among the followed-up hepatitis B cohort in general population of six infectious disease demonstration areas nationwide. Blood samples of chosen objects were collected, in which HBsAg and anti-HBs were tested by grassroots medical institutions and were also parallely tested by the third-party platform. The test results were compared between the two groups. Statistical analyses were conducted by SAS 9.4 software.Results:A total of 5 756 and 5 263 samples of HBsAg and anti-HBs were successfully tested, respectively. Comparing the results of HBsAg and anti-HBs from grassroots medical institutions with the results from the third platform, the agreement of HBsAg and anti-HBs was 97.13% and 77.33%, respectively. The Kappa value was 0.56 (95% CI 0.50-0.62) for HBsAg and 0.54 (95% CI 0.52-0.56) for anti-HBs, respectively; and the McNemar tests indicated the difference between the results (all P<0.01). There were also significant differences in agreement of testing results with the third platformin among different regions ( P<0.05 or <0.01). The Kappa values indicated that Jiangsu province and Guangdong province had high accordance rates of HBsAg (0.87 and 0.81, respectively), and Gansu province and Guangdong province had high accordance rates of anti-HBs (Both were 0.74). Regarding the results from the third platform as the standard, the sensitivity of HBsAg testing in grassroots medical institutions was moderate (40.51%) and the specificity was well (99.96%). The sensitivity of anti-HBs testing was substantial (73.18%) and the specificity was well (84.31%). Guangdong province (Youden index: 0.69) and Jiangsu province (Youden index: 0.80) had high identification ability for HBsAg, and for indicator of anti-HBs, Gansu province (Youden index: 0.78) and Guangdong province (Youden index: 0.76) had high identification ability. Conclusion:There are certain differences in results of HBV serological markers tests between the grassroots medical institutions in the demonstration areas of infectious diseases and the third platform. Current testing strategies in grassroots medical institutions are suitable for identifying people without hepatitis B infection, while it is necessary to pay attention to the situation of potential false negative error.

Systematic Review of Drug-induced Acute Kidney Injury in Chinese Population / 中国药房

OBJECTIVE：To study clinical situation and influential factors for prognosis of drug-i nduced acute kidney injury （DIAKI）in Chinese population ，and to provide reference for early detection ，early intervention and prognosis improvement of DIAKI. METHODS ：Retrieved from PubMed ，Embase，Cochrane Library ，CNKI，Wanfang database and VIP ，clinical studies related to DIAKI were collected during the inception to Apr. 16th，2020. After the data extraction and quality evaluation of included studies，the results were analyzed descriptively ，and Meta-analysis was carried out by Rev Man 5.3 software. RESULTS ：A total of 29 studies were included ，including 1 870 patients. The results showed that DIAKI accounted for 32.2％（877/2 721）of the patients developed AKI in the same period. Antibacterial drugs were the main cause of DIAKI ，accounting for 47.5％（773/1 629）. The top five drugs by case number were classified as aminoglycoside antibiotics ，diuretics or dehydrating agents ，cephalosporin antibiotics，non-steroidal anti-inflammatory drugs and traditional Chinese medicine. The pathological type of DIAKI was mainly acute interstitial nephritis ，accounting for 51.9％（70/135）. The mortality of DIAKI patients was 14.4％（240/1 677）. A total of 70.4％（1 176/1 670）of patients had renal recovery. Compared with conservative treatment ，the mortality of patients receiving dialysis treatment was significantly lower [OR ＝0.30，95％CI（0.10，0.91），P＝0.003]. Compared with patients without anemia ， patients with anemia had a significantly delayed renal recovery [OR ＝0.25，95％CI（0.09，0.65），P＝0.004]. Lower levels of retinol binding protein was significantly related to rapid renal recovery [MD ＝－15.84，95％CI（－22.34，－9.34），P＜0.01]. CONCLUSIONS：Clinicians need to continuously strengthen antibiotic management and use drugs that induce AKI with caution. For patients with DIAKI ，receiving dialysis treatment as soon as possible may help reduce mortality. Timely correction of the basic anemia status of patients with DIAKI will help patients withrapid renal recovery ，and lower retinol binding protein levels may be a potential biomarker for predicting patients ’rapidrenal recovery.

Status analysis of quality control of high-risk medical equipment in Zhejiang province / 中华医院管理杂志

Objective:To master the quality control status of high-risk medical equipment of medical institutions in Zhejiang province, and to put forward improvement measures to promote the quality control level of high-risk medical equipment.Methods:All the tertiary public hospitals, second-class public hospitals and private hospitals in Zhejiang were investigated. A questionnaire survey was conducted on the quantity, quality control methods and quality control specifications of high-risk medical equipment used by the medical institutions. Excel was used for data collation and descriptive statistical analysis of the questionnaire.Results:The quality control methods of high-risk medical equipment in 96 medical institutions in Zhejiang had different tendencies. The tertiary public hospitals tended to conduct quality control on their own, and the second-class public hospitals and private hospitals tended to choose third-party testing institutions for quality control. In addition, there were irregularities in quality control of some medical institutions. 16% of the quality control equipment in self-control mode was not traceable, and 2% of the third-party testing organizations had no relevant qualifications.Conclusions:Medical institutions in Zhejiang generally have a strong awareness of quality control of high-risk medical equipment. But there are some unsolved problems remained in quality control. In the future, we should continue to improve the quality control level of high-risk medical equipment based on medical measurement, as well as to focus on the improvement of the technical ability of medical equipment management departments, the traceability of quality inspection equipment, and the supervision and spot check of third-party testing institutions.

Advances in study on exosomes and their applications in kidney diseases / 中南大学学报(医学版)

Exosomes are in a size of 30-100 nm vesicles released by various cells, with a double-layered lipid membrane containing DNA, RNA, and protein. In the past, exosomes were considered to be molecular waste, and recently exosomes have been shown to be involved in many pathophysiological processes, including intercellular communication, immune response, nerve repair, and tumorigenesis. Exosomes are present in numerous body fluids, and urinary exosomes have been shown to be biomarkers of a variety of kidney diseases.

Titanium cable binding plate combined with proximal femoral nail antirotation for recurrent fractures after treatment of unstable intertrochanteric fractures / 中华创伤杂志

Objective:To investigate the clinical effect of titanium cable binding plate combined with lengthened proximal femoral nail antirotation (PFNA) for fixation of recurrent fracture after treatment of unstable intertrochanteric fractures.Methods:A retrospective case series study was conducted for analyzing the clinical data of 17 patients with recurrent fracture of unstable intertrochanteric fractures admitted to Southwest Hospital of Army Medical University from January 2010 to January 2018. There were 7 males and 10 females, aged from 65 to 94 years [(75.7±13.2)years]. The patients were treated using titanium cable binding plate combined with PFNA. Anti-osteoporosis therapy was applied as well. X-ray images were performed at postoperative 3 days, 3, 6 and 12 months. The healing and complications of the patients were recorded. The Harris hip score, visual analogue score (VAS), physical health score (PCS), mental health score (MCS) and 36-item short form health survey questionnaire (SF-36) were evaluated before operation and at postoperative 6 and 12 months.Results:All patients were followed up for 12-18 months [(15.3±2.8)months]. Bone healing was achieved in all patients, and the postoperative bone healing time was 3-6 months [(3.6±1.1)months]. One patient developed lumbosacral pressure sores and recovered after dressing change. Two patients developed drooping pneumonia, which was completely relieved after symptomatic treatment including nebulized inhalation of antibiotics and sputum aspiration. At postoperative 6 and 12 months, Harris hip score was (76.5±5.2)points and (85.5±5.7)points, significantly higher than (32.8±5.1)points before operation ( P<0.05); VAS was (3.3±0.5)points and (1.2±0.7)points, significantly lower than (8.5±0.7)points before operation ( P<0.05); PCS was (44.2±4.9)points and (56.9±5.8)points, significantly higher than (29.3±4.7)points before operation ( P<0.05); MCS was (47.9±6.8)points and (58.4±7.9)points, significantly higher than (39.7±5.9) points before operation ( P<0.05); SF-36 was (493.9±85.7)points and (603.4±76.8)points, significantly higher than (415.9±88.2)points before operation ( P<0.05). Conclusions:Titanium cable binding plate combined with lengthening PFNA can provide stability of fracture end, promote fracture healing, reduce complications, relieve pain and improve patients' quality of life for recurrence of unstable intertrochanteric fracture.

Application of CBL teaching based on digital orthopedic technology in clinical teaching of kyphosis / 中华医学教育探索杂志

Objective:To explore the feasibility and superiority of applying digital orthopedic technology of virtual human reconstruction and 3D printing to CBL teaching of kyphosis for clinical postgraduates.Methods:Thirty postgraduates of professional degree participated in the standardized training of resident doctors in our department were randomized into the experimental group (New CBL teaching mode group) and the control group (traditional teaching mode group) with 15 students in each group, and the two groups were taught differently (the teaching content was two typical cases of kyphosis). Among them, the experimental group adopted the new CBL teaching mode, and successively conducted small class theory teaching, model explanation, group discussion, preoperative design, surgery observation and specific questions and answers, etc. The control group only used the traditional method to teach theory in a large class. The teaching effect of the two groups was evaluated in t test by SPSS 25.0.Results:For the teaching of patients with ankylosing spondylitis and kyphosis, scores of the satisfaction with class interest, mastery of theoretical knowledge and understanding of operation plan in the experimental group were (9.4±0.2), (91.1±3.8), and (91.5±3.5) respectively, and those in the control group were (8.2±0.4), (82.1±3.5) and (83.1±4.7) respectively, with statistical significance ( P<0.05). Conclusion:In the teaching of kyphosis, the CBL teaching mode based on digital orthopedic technology is superior to the traditional teaching mode, which is conducive to improving clinical skills for students.

Application of 3D printing technology combined with CPBL teaching mode in postgraduate teaching of spinal surgery specialty / 中华医学教育探索杂志

Objective:To explore the application of 3D printing technology combined with CPBL teaching mode in the teaching of master's degree in spine surgery.Methods:42 postgraduates in our department were randomly divided into two groups: experimental group (21) and control group (21). The experimental group used 3D printing technology combined with CPBL teaching mode as teaching techniques. Before class, the teacher would select some typical cases and design related problems. During class, 3D models were used to guide students to think and solve related problems; The control group used traditional teaching mode. Students in the two groups were compared for the theoretical knowledge and operational techniques they have mastered, and the students' satisfaction and recognition towards different teaching modes were obtained through questionnaire survey. Independent sample t-test was performed using SPSS 25.0.Results:The scores of the theoretical knowledge, operational techniques, teaching satisfaction and recognition of postgraduates were (84.7±3.4), (87.1±3.7), (9.7±0.3), (9.3±0.4) in the experimental group, and (79.7±3.3), (80.4 ± 4.0), (8.4±0.7) and (8.3±0.6) in the control group. The difference between the two groups was statistically significant ( P<0.05). Conclusion:The new teaching mode of combining 3D printing technology with CPBL teaching mode is better than the traditional teaching mode, which is worth further promotion and application.

Effect of sakubatril/valsartan on left ventricular systolic dyssynchrony in young patients with dilated cardiomyopathy / 中国医师进修杂志

Objective:To investigate the effect of sakubatril/valsartan on left ventricular systolic dyssynchrony in young patients with dilated cardiomyopathy (DCM).Methods:Forty-nine patients with left ventricular systolic asynchronism DCM from July 2017 to July 2018 in Guangdong Medical University Affiliated Hospital were randomly divided into two groups. The experimental group was treated with sakubatra valsartan and the control group was treated with lotensin for 12 months. Left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVESd) and ejection fraction (EF) were measured by two-dimensional color Doppler echocardiography. The left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), ejection fraction (EF) and systolic dyssynchrony index (SDI) of 16 segments were measured by three-dimensional color Doppler ultrasound. Plasma NT-proBNP was tested before and after treatment.Results:After treated for 12 months, three-dimensional color Doppler ultrasonography showed the LVEDV in the experimental group decreased significantly: (180.5 ± 42.7) ml vs. (160.5 ± 45.6) ml, P<0.05. The left ventricular systolic asynchronism (SDI) of 16 segments in the experimental group significantly improved, and the value of left ventricular SDI significantly decreased compared with that of the control group: (8.2 ± 3.6)% vs. (10.8 ± 4.1)%, P<0.05. Plasma NT-proBNP decreased more significantly in the experimental group compared with that in the control group: (105.54 ± 13.25) ng/L vs. (137.27 ± 14.36) ng/L, P<0.05. Conclusions:Sakubatril/valsartan can effectively improve left ventricular systolic dyssynchrony in young patients with dilated cardiomyopathy.

Prognostic Value of Morphology and Hans Classification in Diffuse Large B Cell Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the prognostic value of morphology and Hans classification in diffuse large B cell lymphoma（DLBCL）.</p><p><b>METHODS</b>Clinical data of 249 patients diagnosed with DLBCL in our hospital and Hangzhou Xixi hospital during Jan 2006 to Dec 2016 were analyzed retrospectively. These patients were classified into 3 groups: immunoblastic variant（IB） group, centroblastic variant（CB） group and others group according to the cell morphology. And DLBCL was also divided into GCB（germinal center B-cell-like）or non-GCB（non-germinal center B-cell-like） group by analyzing the expression of CD10, BCL6 and MUM1 (GCB: CD10 ,BCL6,MUM1/CD10,BCL6,MUM1；non-GCB：CD10,BCL6,MUM1/CD10,BCL6,MUM1).</p><p><b>RESULTS</b>The univariate analysis displayed that the age，LDH level，IPI，IB，non-GCB，B-symptoms and rituximab all could influence the OS and EFS, the CR rate of CB subtype patients was significantly higher than that of the patients with IB subtype （68.3% vs 38.9%)(P=0.02）. IB subtype was the in dependent prognostic factor for both EFS and OS in the whole study. In multivariate analysis, IPI and IB were the independent prognostic factors for OS and EFS. IB subtype was also an independent prognostic factor in EFS and OS with or without rituximab. The expression of BCL2 and BCL6 was related with prognosis in R-CHOP, but not in CHOP treated patients. Other markers (CD5, CD10, IRF4/MUM1, HLA-DR and Ki-67 proliferation index) were not of the significant prognostic value for DLBCL. When accepted rituximab, the GCB and non-GCB were not different significantly for prognosis. However, the non-GCB group showed a poor prognosis without using rituximab （EFS P=0.020；OS P=0.020）. Multivariate Cox models showed that OS and EFS were not significantly different between GCB and non-GCB group, however, the IB subtype had a very significantly poor prognosis in OS and EFS (P=0.001, P=0.002). When the analysis was restricted to DLBCL with CB morphology only, no prognostic value was observed in Hans classification.</p><p><b>CONCLUSION</b>The subtype of immunoblast is a major risk factor in patients treated with CHOP or R-CHOP. There is a significant association between the Hans classification and the morphologic subclassification. Results of this study have supplemented the data for the prognostic factor of DLBCL and demonstrated that the cytomorphologic diagnosis can be reproducible.</p>

Local administration of calcitonin gene-related peptide promotes early healing after rotator cuff injury in mice / 中国组织工程研究

BACKGROUND: Repair of tendon interface is a difficulty in orthopedics and sports medicine, and the formation of new bone is conducive to its healing. Calcitonin gene-related peptide (CGRP) plays a critical role in tissue homeostasis and repair, but its effect on the bone-tendon interface repair is unknown. OBJECTIVE: To investigate the effect of CGRP on the expression of osteocalcin and to evaluate the effect of CGRP on the early healing of rotator cuff injury in a mouse model. METHODS: A mouse model of supraspinatus insertion-humerus injury was created. All model mice were then randomized into two groups, and given the injection of 5 nmol/kg CGRP (experimental group) or same volume of normal saline (control group) through the glenohumeral joint immediately after operation, thrice weekly, for 2 weeks. The mice were sacrificed at postoperative 4 and 6 weeks to remove the rotator cuff samples for hematoxylin-eosin staining and biomechanical test. The mRNA and protein expression levels of osteocalcin were surveyed by qRT-PCR, immunohistochemistry, and western blot assay. RESULTS AND CONCLUSION: At postoperative 4 and 6 weeks, the mRNA and protein expression of osteocalcin in the experimental group were significantly higher than those in the control group (P < 0.05). Compared with the control group, there were more fibrocartilages in the experimental group at 4 weeks postoperatively, and more new bone formation in the experimental group at 6 weeks postoperatively. At 4 weeks postoperatively, failure load in the experimental group increased slightly, but it was not significantly different from that in the control group (P > 0.05); at 6 weeks postoperatively, failure load in the experimental group was significantly higher than that in the control group (P<0.05). To conclude, local injection of CGRP can up-regulate the expression of osteocalcin and the formation of new bone at the injury site, which can enhance early healing the injured rotator cuff.

Influence of acute high altitude exposure and short-term acclimation on platelet-associated parameters in healthy young man / 解放军医学杂志

Objective To explore the effect of high altitude exposure and short-term acclimation on the platelet-associated parameters by studying the changes of platelet-associated parameters in healthy young man.Methods Four hundred and sixtytwo young men were recruited from Chengdu (the elevation of 500m) during Jun.2012 to Aug.2013 according to the inclusion and exclusion criteria,of which 193 had been living in Chengdu (plain group),and 269 flew from Chengdu to Lhasa (3700m) in 2 hours,and then 147 of them were exposed in the high altitude for 1 day (acute high altitude exposure group),and another 122 for 7 days (short-term acclimation group).The demographic data were collected and the blood routine and platelet-associated parameters were measured of all the participants,and then the information collected were compared between the 3 groups.Results Compared to the plain group,the platelet count (PLT),platelet distribution width (PDW) and plateletcrit (PCT) reduced and the mean platelet volume (MPV) increased significantly (P＜0.05) in the acute high altitude exposure group;while all the indexes in short-term acclimation group returned to approach the levels in the plain group,but statistical differences still existed in PLT,PDW and PCT (P＜0.05).The platelet activating factor (PAF) and epinephrine (Epi) decreased markedly in acute high altitude exposure group than in plain group (P＜0.05);while in short-term acclimation group,the PAF returned to approach the level in plain group,and the Epi was further down (P＜0.05).In addition,no marked difference of 5-HT level was observed in the 3 groups (P＞0.05).Pearson correlation analysis indicated that high altitude-induced reduction of oxygen saturation (SpO2) was positively related to the changes of PLT.Conclusions Acute high altitude exposure may reduce PLT,PDW and PCT levels,but elevate MPV and enhance the platelet activity.The reduction of SpO2 might be associated with the changes of PLT,PDW and PCT.Platelet-associated parameters may be recovered to normal with a compensatory effect after short-term acclimation.