Hemostasis Using Prothrombin Complex Concentrate in Patients Undergoing Cardiac Surgery: Systematic Review with Meta-Analysis

ABSTRACT Objective: The purpose of present study was to comprehensively explore the efficacy and safety of prothrombin complex concentrate (PCC) to treat massive bleeding in patients undergoing cardiac surgery. Methods: PubMed®, Embase, and Cochrane Library databases were searched for studies investigating PCC administration during cardiac surgery published before September 10, 2022. Mean difference (MD) with 95% confidence interval (CI) was applied to analyze continuous data, and dichotomous data were analyzed as risk ratio (RR) with 95% CI. Results: Twelve studies were included in the meta-analysis. Compared with other non-PCC treatment regimens, PCC was not associated with elevated mortality (RR=1.18, 95% CI=0.86-1.60, P=0.30, I2=0%), shorter hospital stay (MD=-2.17 days; 95% CI=-5.62-1.28, P=0.22, I2=91%), reduced total thoracic drainage (MD=-67.94 ml, 95% CI=-239.52-103.65, P=0.44, I2=91%), thromboembolic events (RR=1.10, 95% CI=0.74-1.65, P=0.63, I2=39%), increase in atrial fibrillation events (RR=0.73, 95% CI=0.52-1.05, P=0.24, I2=29%), and myocardial infarction (RR=1.10, 95% CI=0.80-1.51, P=0.57, I2=81%). However, PCC use was associated with reduced intensive care unit length of stay (MD=-0.81 days, 95% CI=-1.48- -0.13, P=0.02, I2=0%), bleeding (MD=-248.67 ml, 95% CI=-465.36- -31.97, P=0.02, I2=84%), and intra-aortic balloon pump/extracorporeal membrane oxygenation (RR=0.65, 95% CI=0.42-0.996, P=0.05, I2=0%) when compared with non-PCC treatment regimens. Conclusion: The use of PCC in cardiac surgery did not correlate with mortality, length of hospital stay, thoracic drainage, atrial fibrillation, myocardial infarction, and thromboembolic events. However, PCC significantly improved postoperative intensive care unit length of stay, bleeding, and intra-aortic balloon pump/ extracorporeal membrane oxygenation outcomes in patients undergoing cardiac surgery.

Progress on diagnosis and treatment of latent tuberculosis infection / 浙江大学学报·医学版

One fourth of the global population has been infected with Mycobacterium tuberculosis, and about 5%-10% of the infected individuals with latent tuberculosis infection (LTBI) will convert to active tuberculosis (ATB). Correct diagnosis and treatment of LTBI are important in ending the tuberculosis epidemic. Current methods for diagnosing LTBI, such as tuberculin skin test (TST) and interferon-γ release assay (IGRA), have limitations. Some novel biomarkers, such as transcriptome derived host genes in peripheral blood cells, will help to distinguish LTBI from ATB. More emphasis should be placed on surveillance in high-risk groups, including patients with HIV infection, those using biological agents, organ transplant recipients and those in close contact with ATB patients. For those with LTBI, treatment should be based on the risk of progression to ATB and the potential benefit. Prophylactic LTBI regimens include isoniazid monotherapy for 6 or 9 months, rifampicin monotherapy for 4 months, weekly rifapentine plus isoniazid for 3 months (3HP regimen) and daily rifampicin plus isoniazid for 3 months (3HR regimen). The success of the one month rifapentine plus isoniazid daily regimen (1HP regimen) suggests the feasibility of an ultra-short treatment strategy although its efficacy needs further assessment. Prophylactic treatment of LTBI in close contact with MDR-TB patients is another challenge, and the regimens include new anti-tuberculosis drugs such as bedaquiline, delamanid, fluoroquinolone and their combinations, which should be carefully evaluated. This article summarizes the current status of diagnosis and treatment of LTBI and its future development direction.

The effects of activating the reticulospinal tract on anticipatory postural adjustments in fine motor movements of the upper extremities / 中华物理医学与康复杂志

Objective:To observe any dependence of anticipatory postural adjustment (APA) on the difficulty of fine upper limb tasks and to document any effect of reticulospinal tract (RST) facilitation on APAs during such tasks.Methods:The study′s bivariate mixed design involved 4 different tasks and 3 different priming states. Thirteen healthy, male, right-handed subjects were recruited. They were asked to complete the 4 tasks of reaching, grasping a cup, pinching a card using the thumb or using the little finger, respectively for 10 times 1 in response to two different starting cues delivered through an earphone. Half of the trials with each task were initiated with 114dB white noise to startle and activate the reticulospinal tract (RST), while the others were activated with 80dB beeps as a control. Electromyographic signals were recorded from the bilateral sternocleidomastoid (SCM), lower trapezius (LT), latissimus dorsi (LD), lumbar erector spinae and right anterior deltoid muscles and also from the right flexor and extensor carpi radialis muscles (ECR/FCR). In the subsequent processing the electromyographic time domain and frequency domain indicators were converted into a pre-motor reaction time, a time to muscle peak contraction, an activation latency, and APA or compensatory postural adjustment (CPA) amplitude of the tested muscles. These were compared among the different tasks and stimuli. In addition, the 114dB test tasks were classified as two different priming status as SCM + and SCM - according to whether the sternocleidomastoid muscle (SCM) was activated in advance. Results:After RST activation the pre-motor reaction time and the time to peak contraction of all of the muscles were significantly shortened in all of the tasks. The deltoid muscle reaction times in the SCM + , SCM - and control states were (106.89±43.78)ms, (136.78±48.74)ms and (168.60±73.17)ms, respectively, and those differences are significant. The APA amplitudes of the contralateral LT and ipsilateral LD were significantly greater than normal, but the timing of muscle activation onset and the APA/CPA amplitudes of the ECR/FCR were not affected. The latency in the anticipatory muscle activation of the ECR in the little finger grip task was significantly shorter than that in reaching. Conclusions:The extensor carpi radialis show task-specific early activation in fine tasks of the upper limbs with different difficulties. RST activation can lead to early starting of expected actions, accelerate muscle contraction and increase APA amplitude of some trunk muscles, but it has no significant effect on APA/CPA amplitudes in the forearm muscles.

Investigation on prevalence of Schistosoma japonicum infections in wild mice in Shitai County, Anhui Province, 2018 / 中国血吸虫病防治杂志

Objective To investigate the prevalence of Schistosoma japonicum infection in wild mice in Shitai County, Anhui Province, so as to provide insights into precise control of the source of S. japonicum infections. Methods Wild mice were captured using the trapping method for three successive nights at snail-infested settings from Jitan Village of Jitan Township, and Shiquan Village and Xibai Village of Dingxiang Township, Shitai County, Anhui Province in June and October, 2018. All trapped wild mice were sacrificed and liver and mesenteric vein specimens were collected for detection of S. japonicum eggs using microscopy, while the fecal samples in mouse intestines were collected for identification of S. japonicum infections using Kato-Katz technique. In addition, the population density of trapped wild mice was estimated and the prevalence of S. japonicum infection was calculated in trapped wild mice. Results A total of 376 wild mice were trapped from three villages in Shitai County. The population density of trapped wild mice was 9.1% (376/4 124), and the prevalence of S. japonicum infection was 24.2% (91/376) in trapped wild mice. The highest prevalence of S. japonicum infection was detected in Shiquan Village of Dingxiang Township (30.1%), and the lowest prevalence was seen in Xibai Village of Dingxiang Township; however, there was no significant difference in the prevalence of S. japonicum infection in trapped wild mice among three villages (χ2= 4.111, P > 0.05). In addition, there was no significant difference in the prevalence of S. japonicum infection in wild mice captured between on June (26.8%, 34/127) and October (22.9%, 57/249) (χ2 = 0.690, P = 0.406). The trapped wild mice included 6 species, including Rattus norvegicus, Niviventer niviventer, R. losea, Apodemus agrarius, Mus musculus and N. coning, and the two highest prevalence of S. japonicum infection was detected in R. losea (34.9%, 22/63) and R. norvegicus (31.2%, 44/141). Conclusions The prevalence of S. japonicum infections is high in wild mice in Shitai County, and there is a natural focus of schistosomiasis transmission in Shitai County.

Effect of Nrf2/HO-1 signaling pathway in intestinal protection by Sishen Pills against ulcerative colitis in mice / 中国中药杂志

The present study aimed to explore the effect of nuclear factor erythroid 2 related factor 2(Nrf2)/heme oxygenase-1(HO-1) signaling pathway in intestinal protection by Sishen Pills against ulcerative colitis(UC). After the UC model was induced by 3% dextran sodium sulfate(DSS), experimental animals were randomly divided into control group, model group, salazosulfapyridine(SASP) group, and low-and high-dose Sishen Pills groups. Drug intervention(ig) was performed for seven consecutive days during modeling. On the 7 th day, the mice were euthanized. The body weight and colon length were recorded, and the histopathological changes of the colon were observed by HE staining. Serum interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), total antioxidant capacity(T-AOC), malondialdehyde(MDA), and reactive oxygen species(ROS) were detected by ELISA. The protein and mRNA expression of Nrf2, HO-1, and NADPH quinine oxidoreductase-1(NQO-1) was determined by Western blot and reverse transcription-polymerase chain reaction(RT-PCR). Compared with the normal group, the model group exhibited reduced body weight, colon length, and T-AOC, increased IL-6, TNF-α, MDA, and ROS, and diminished protein and mRNA expression of Nrf2, HO-1, and NQO-1 in the colon tissues. Compared with the model group, the SASP group and high-dose Sishen Pills group showed elevated body weight, colon length, and T-AOC, lowered IL-6, TNF-α, MDA, and ROS levels, and increased protein and mRNA expression of Nrf2, HO-1, and NQO-1 in the colon tissues. As assessed by HE staining, Sishen Pills could improve the pathological changes of the colon. The findings suggested that Sishen Pills could protect the colon against UC induced by 3% DSS. The specific mechanism of action may be related to the anti-inflammatory and anti-oxidative stress effects by the activation of the Nrf2/HO-1 signaling pathway.

Pathogenesis effect of serum chromium on oral cancer based on propensity score matching / 中华疾病控制杂志

Objective To evaluate the effect of serum chromium on oral cancer after adjusting the covarite between groups based on propensity score matching (PSM). Methods We performed a case-control study in 395 cases of newly diagnosed primary oral cancer from the First Affiliated Hospital of Fujian Medical University and 1 240 controls from the same community from January 2010 to February 2018. Using the PSM to select 309 controls randomly which were matched with the cases by 1 ∶1 matching. Conditional Logistic regression model was used to explore the association between chromium and oral cancer. Results The level of serum chromium was 178.91 (121.83-284.19) μg/L in the case group, which was lower than 324.27 (264.82-397.69) μg/L in control group, the difference was statistically significant (P＜0.001). Dose-response analysis showed that the risk of oral cancer gradually decreased with the increase of serum chromium, which presented a negative correlation. There was a negative correlation between serum chromium level and the risk for oral cancer by conditional Logistic regression,the aOR of serum chromium in the Q2, Q3 and Q4 compared with the Q1 were 0.14 (0.08-0.26), 0.15 (0.08-0.28) and 0.10 (0.05-0.20),with significant trend (Ptrend＜0.001). Stratified analysis showed the negative correlation between serum chromium and oral cancer by smoking, drinking tea, not drinking alcohol status and fish, fruits and green vegetables intake frequencies. Conclusions The high level of serum chromium is a protective factor for the incidence of oral cancer, and the higher of serum chromium, the lower risk of developing oral cancer.

Endemic situation of schistosomiasis in national surveillance sites of Anhui Province from 2015 to 2018 / 中国血吸虫病防治杂志

Objective To analyze the endemic situation of schistosomiasis in national surveillance sites of Anhui Province from 2015 to 2018, so as to provide scientific evidence for schistosomiasis control and prevention in Anhui Province. Methods According to the National Schistosomiasis Surveillance Programme (2014 version), a total of 51 national schistosomiasis surveillance sites were assigned in Anhui Province in 2015, and Schistosoma japonicum infections in humans and livestock and snail distribution were monitored from 2015 to 2018. Results A total of 89 638 local residents and 42 609 mobile populations received serological screening of schistosomiasis in 51 national surveillance sites of Anhui Province from 2015 to 2018, and the sero-prevalence of S. japonicum infections was 1.41% to 3.69% in local residents and 0.84% to 2.13% in mobile populations, respectively. There were 5 egg-positive local residents and 1 egg-positive mobile populations detected in 2015, with occupations of farmers and fishermen. There were 6 405 livestock detected for S. japonicum infections, and no egg-positives were identified. Among an area of 12 661 hm2 surveyed in the national schistosomiasis surveillance sites of Anhui Province from 2015 to 2018, the areas of snail habitats were 2 461.27 to 2 628.96 hm2, andthemeandensityoflivingsnailswas 0.3757 to 0.4330 snails/0.1 m2, with no S. japonicum infections identified in snails. Conclusions The endemic situation of schistosomiasis is at a low level in Anhui Province; however, the risk of schistosomiasis transmission remains in local regions of the province. The construction of the surveillance-responsesystemshouldbereinforcedtoconsolidatetheachievementsofschistosomiasis control in Anhui Province.

Spatiotemporal distribution of Oncomelania hupensis snail habitats in Anhui Province / 中国血吸虫病防治杂志

Objective To investigate the spatiotemporal distribution of Oncomelania hupensis snails and infected snails in the endemic areas of schistosomiasis in Anhui Province. Methods Based on the snail survey data in Anhui Province in 2016, the distribution of snails and infected snails were analyzed, and the spatial distribution of snails and spatial cluster patterns of infected snails were investigated in snail habitats in Anhui Province from 1950 to 2016. Results A total of 22 757 snail habitats and 5 004 infected snail habitats were identified in Anhui Province from 1950 to 2016, which appeared single-peak and double-peak patterns, with an inflection point seen in 1970. There were 141 000 hm2 historically accumulative snail habitats, 88.08% of which were firstly identified from 1950 to 1979, and totally 114 500 hm2 snail habitats were eradicated, 77.17% of which were eradicated from 1970 to 1999. There were 4 830 snail habitats identified until 2016, in which 1 051 were once detected with infected snails. In addition, 78.12% of current snail habitats had been present for over 40 years, and infected snails had been eliminated in 65.75% of the infected snail habitats within 10 years. There was a spatial autocorrelation of the living snail density in current snail habitats in Anhui Province (Moran’s I = 0.196, Z = 139.63, P < 0.001), and local hotspot analysis showed spatial clusters of living snails density in snail habitats, with high-value clusters in south of the Yangtze River and low-value clusters in north of the Yangtze River. The 21 high-value clusters of living snail density with statistical significance were distributed along the Yangtze River basin and its branches. Spatiotemporal scan analysis revealed spatiotemporal clusters of infected snails in 4 current snail habitats. Conclusions The current snail habitats have been present for a long period of time, and snails are difficult to be eliminated by chemical treatment alone, which requires the combination of environment improvements. There are spatial clusters of living snail density in current snail habitats in Anhui Province. The epidemic factors and risk of human and animal infections still remain in some clusters of historical infected snail habitats revealed by spatiotemporal scan analysis, which should be consid- ered as the key target areas for snail control in Anhui Province.

Application of infrared camera technique in investigation of wild animals as infectious source of schistosomiasis / 中国血吸虫病防治杂志

Objective To investigate the species and activities of wild animals infected with schistosome in hilly and mountain areas by using an infrared camera technique, so as to provide the evidence for the surveillance of schistosomiasis in these areas. Methods Six infrared cameras were selected and placed in 6 environments of the risk monitoring points of schistosomiasis in Shitai County in Anhui Province. The species and activities of the wild animals in the 6 environments were observed through the photographs and videos taken by the cameras. Results Through 5 day’s monitoring, 3 wild mammals, such as voles, hares and wild boars, were found in 4 monitoring environments, of which voles were found at 2 environments with snails, and hares, wild boars and voles were found in 2 environments adjacent to environments with snails respectively. The monitoring showed that the vole activity was most frequent in the monitored environment. Conclusion The use of infrared camera technique has a good effect in the investigation of wild animal infectious source of schistosomiasis, and it is also suitable for the monitoring work in other types of environments.

Finite element analysis of bending and standing manipulation in the treatment of lumbosacral joint disorder / 中国骨伤

OBJECTIVE@#To analyze the displacement, stress and mechanism of lumbosacral joint disorder patients after bending and standing manipulation in the finite element model.@*METHODS@#A three-dimensional finite element model of a patient with lumbosacral joint disorder was established. The finite element analysis method was used to observe and analyze the three loading conditions of the model:axial, 34 degree inclined upward and vertical upward.@*RESULTS@#In the lumbosacral joint disorder model, the L₅ vertebral body was concentrated in the middle of the lower endplate, the intervertebral disc was concentrated in the center of the intervertebral disc, and the stress of S₁ and related structures were concentrated in the anterior and posterior edges of the vertebral body. After simulated manipulation, stress mainly concentrated in the anterior, posterior and central circular areas of L₅ vertebral upper endplate. The posterior structures of vertebral body concentrated in the ventral part of pedicle, isthmus and dorsal part of lamina. The stress of intervertebral disc dispersed in the posterior edge of vertebral body. Displacement results:In the lumbosacral joint disorder model, the left transverse process, the upper and lower articular process and the left part of spinous process were significantly displaced to the left, and the intervertebral disc was protruded forward. After simulated manipulation, the lower notch of L₅ vertebral body moved forward and upward; the area of intervertebral foramen increased; the inferior articular process of L₅ vertebral body moved forward; the superior articular process of sacrum moved forward and downward; the distance of articular process joints increased; and the displacement of sacrum concentrated on the posterior edge of vertebral body and the median sacral crest.@*CONCLUSIONS@#Successful lumbosacral joint modeling can be carried out by finite element analysis, and the mechanism of bending and erecting manipulation is clear, which is effective and safe for the treatment of lumbosacral joint disorders.

Application of a novel porous tantalum implant in rabbit anterior lumbar spine fusion model: in vitro and in vivo experiments / 中华医学杂志(英文版)

BACKGROUND@#Some porous materials have been developed to enhance biologic fusion of the implants to bone in spine fusion surgeries. However, there are several inherent limitations. In this study, a novel biomedical porous tantalum was applied to in vitro and in vivo experiments to test its biocompatibility and osteocompatibility.@*METHODS@#Bone marrow-derived mesenchymal stem cells (BMSCs) were cultured on porous tantalum implant. Scanning electron microscope (SEM) and Cell Counting Kit-8 assay were used to evaluate the cell toxicity and biocompatibility. Twenty-four rabbits were performed discectomy only (control group), discectomy with autologous bone implanted (autograft group), and discectomy with porous tantalum implanted (tantalum group) at 3 levels: L3-L4, L4-L5, and L5-L6 in random order. All the 24 rabbits were randomly sacrificed at the different post-operative times (2, 4, 6, and 12 months; n = 6 at each time point). Histologic examination and micro-computed tomography scans were done to evaluate the fusion process. Comparison of fusion index scores between groups was analyzed using one-way analysis of variance. Other comparisons of numerical variables between groups were made by Student t test.@*RESULTS@#All rabbits survived and recovered without any symptoms of nerve injury. Radiographic fusion index scores at 12 months post-operatively between autograft and tantalum groups showed no significant difference (2.89 ± 0.32 vs. 2.83 ± 0.38, F = 244.60, P = 0.709). Cell Counting Kit-8 assay showed no significant difference of absorbance values between the leaching liquor group and control group (1.25 ± 0.06 vs. 1.23 ± 0.04, t = -0.644, P = 0.545), which indicated the BMSC proliferation without toxicity. SEM images showed that these cells had irregular shapes with long spindles adhered to the surface of tantalum implant. No implant degradation, wear debris, or osteolysis was observed. Histologic results showed solid fusion in the porous tantalum and autologous bone implanted intervertebral spaces.@*CONCLUSION@#This novel porous tantalum implant showed a good biocompatibility and osteocompatibility, which could be a valid biomaterial for interbody fusion cages.

Investigation of Oncomelania hupensis snails in Anhui Province in 2016 / 中国血吸虫病防治杂志

Objective To investigate the status of Oncomelania hupensis snails in Anhui Province in 2016, so as to provide the evidence for formulating the 13th Five-Year Plans for Schistosomiasis Control. Methods In 2016, a snail survey was conducted in Anhui Province according to the National Programme of the Oncomelania Snail Survey, covering all snail habitats or historical snail habitats and suspected environments of snail breeding, and the results of the survey were analyzed. Results In 2016, 22 848 environments were surveyed, and no schistosome-infected snails were found. There were 17 927 historical snail habitats in whole province, among which, the environments without changes, changed partly and changed completely accounted for 71.2%, 19.3% and 9.5%, respectively. The area of historical snail habitats was 1.410 billion m2. There were 4 830 environments with snail habitats covering an area of 0.265 billion m2 in 38 counties of 7 cities, including newly emerging area of 1 287.65 hm2 and reemerging area of 1 375.32 hm2. The density of living snails was 0.392 0 snails/0.1 m2, and the rate of frame with living snails was 12.93%. The type of marshland and lake regions, and the type of hilly and mountainous regions accounted for 22.4% and 77.6% of number of snail habitats, and accounted for 86.7% and 13.3% of areas of snail habitats, respectively. Among the different types of vegetation in snail habitats, grass was superior owe to accounting for 82.2% of the number of snail habitats, 57.3% of the area with snail habitats, and the highest density of living snails (0.413 9 snails/0.1 m2). Among the different types of environments in snail habitats, the ditch was superior owe to accounting for 56.8% of the number of snail habitats, the highest density of living snails (0.570 3 snails/0.1m2) and the highest rate of frame with living snails (18.57%), and the beach was superior owe to accounting for 87.8% of the area with snail habitats. In Anhui Province, the first year of snails and schistosome-infected snails being found was 1950 and 1952, respectively, and the latest year of schistosome-infected snails being found was 2012. The map showed that the most environments with snail habitats were distributed along the Yangtze River in Anhui Province. Conclusion For the first time, the investigation has built the database and map of snail spatial distribution, which truly reflect the historic and current status of snail distribution in Anhui Province and can provide the evidence for formulating the 13th Five-Year Plans for Schistosomiasis Control and improving the schistosomiasis prevention and control work in the future.

Investigation of Oncomelania hupensis snails in Anhui Province in 2016 / 中国血吸虫病防治杂志

Objective To investigate the status of Oncomelania hupensis snails in Anhui Province in 2016, so as to provide the evidence for formulating the 13th Five-Year Plans for Schistosomiasis Control. Methods In 2016, a snail survey was conducted in Anhui Province according to the National Programme of the Oncomelania Snail Survey, covering all snail habitats or historical snail habitats and suspected environments of snail breeding, and the results of the survey were analyzed. Results In 2016, 22 848 environments were surveyed, and no schistosome-infected snails were found. There were 17 927 historical snail habitats in whole province, among which, the environments without changes, changed partly and changed completely accounted for 71.2%, 19.3% and 9.5%, respectively. The area of historical snail habitats was 1.410 billion m2. There were 4 830 environments with snail habitats covering an area of 0.265 billion m2 in 38 counties of 7 cities, including newly emerging area of 1 287.65 hm2 and reemerging area of 1 375.32 hm2. The density of living snails was 0.392 0 snails/0.1 m2, and the rate of frame with living snails was 12.93%. The type of marshland and lake regions, and the type of hilly and mountainous regions accounted for 22.4% and 77.6% of number of snail habitats, and accounted for 86.7% and 13.3% of areas of snail habitats, respectively. Among the different types of vegetation in snail habitats, grass was superior owe to accounting for 82.2% of the number of snail habitats, 57.3% of the area with snail habitats, and the highest density of living snails (0.413 9 snails/0.1 m2). Among the different types of environments in snail habitats, the ditch was superior owe to accounting for 56.8% of the number of snail habitats, the highest density of living snails (0.570 3 snails/0.1m2) and the highest rate of frame with living snails (18.57%), and the beach was superior owe to accounting for 87.8% of the area with snail habitats. In Anhui Province, the first year of snails and schistosome-infected snails being found was 1950 and 1952, respectively, and the latest year of schistosome-infected snails being found was 2012. The map showed that the most environments with snail habitats were distributed along the Yangtze River in Anhui Province. Conclusion For the first time, the investigation has built the database and map of snail spatial distribution, which truly reflect the historic and current status of snail distribution in Anhui Province and can provide the evidence for formulating the 13th Five-Year Plans for Schistosomiasis Control and improving the schistosomiasis prevention and control work in the future.

Clinical features and imaging diagnosis of colonic stenosis in infants / 天津医药

Objective To explore clinical features and imaging diagnosis of colonic stenosis in infants. Methods Seven patients with congenital and acquired colonic stenosis proved by surgery were included in this study. The clinical features, erect abdominal plain radiograph and barium enema were analyzed. Results Of the 7 patients, 4 were congenital colonic stenosis with progressive abdominal distention and vomiting. The erect abdominal plain radiograph showed that intestinal inflation in 3 patients, low-set mechanical intestinal obstruction in 1 patient. In the remaining 3 patients who underwent ileostomy after neonatal necrotizing enterocolitis (NEC). Barium enema showed colonic stenosis in 5 patients and 2 were missed diagnosed who underwent contrast examination in the small intestine, and which showed stenosis in ascending colon near the ileocecus. Seven patients were all proved by surgery. The stenosis sites were located in sigmoid colon in 2 cases, in descending colon in 2 cases, in ascending colon in 2 cases and in transverse colon in 1 case. In 4 cases of congenital colonic stenosis, 2 cases underwent surgical staging, 1 case was followed up for half a year, showing normal defecation and well development, the other 1 case was lost visit after hospital discharge. The other 2 cases received end-to-end ileum and colon anastomosis, the abdominal distension was relieved in outpatient review, showing well-developed. Three cases with NEC and secondary colonic stenosis underwent staged surgery. Two patients were followed up in outpatient 2 weeks after operation. They were followed up for half a year, showing normal defecation and well-developed. The other 1 case was lost visit after hospital discharge. Conclusion Clinical features of colonic stenosis are very different and depend on the stenosis degree. NEC is the main cause of acquired colonic stenosis and it can be diagnosed by barium enema.

Construction of innovation ability training system for postgraduates of health service management in higher medical colleges and universities / 中华医学教育探索杂志

Targeting the common fact that colleges and universities of traditional Chinese medicine neglect management post practice,are lack of cutting-edge,cross-disciplinary and methodological courses,fail to reflect the traditional Chinese medicine's singularity and update courses slowly during the process of cultivating their graduate students,Heilongjiang University of Chinese Medicine innovates its culture system of graduate student in related major.It is also devoted to developing problem-based learning,introducing bitutor system,reforming course system,which may hopefully improve their graduate students' innovative thoughts and abilities,strengthen their innovative knowledge theory system to finally discover an appropriate reform model for the culture system which can be perfectly replicable.

Nine-hole Peg Test and Ten-meter Walk Test for Evaluating Functional Loss in Chinese Charcot-Marie-Tooth Disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The 9-hole peg test (9-HPT) and 10-meter walk test (10-MWT) are commonly used to test finger motor function and walking ability. The aim of this present study was to investigate the efficacy of these tests for evaluating functional loss in Chinese Charcot-Marie-Tooth (CMT) disease.</p><p><b>METHODS</b>Thirty-four Chinese CMT patients (CMT group) from August 2015 to December 2016 were evaluated with 9-HPT, 10-MWT, CMT disease examination score, overall neuropathy limitation scale (ONLS), functional disability score, and Berg Balance Scale (BBS). Thirty-five age- and gender-matched healthy controls (control group) were also included in the study. Student's nonpaired or paired t-test were performed to compare data between two independent or related groups, respectively. The Pearson test was used to examine the correlations between recorded parameters.</p><p><b>RESULTS</b>The mean 9-HPT completion time in the dominant hand of CMT patients was significantly slower than that in the healthy controls (29.60 ± 11.89 s vs. 19.58 ± 3.45 s; t = -4.728, P < 0.001). Women with CMT completed the 9-HPT significantly faster than men with CMT (dominant hand: 24.74 ± 7.93 s vs. 33.01 ± 13.14 s, t = 2.097, P = 0.044). The gait speed of the average self-selected velocity and the average fast-velocity assessed using 10-MWT for CMT patients were significantly slower than those in the control group (1.03 ± 0.18 m/s vs. 1.44 ± 0.17 m/s, t = 9.333, P < 0.001; 1.31 ± 0.30 m/s vs. 1.91 ± 0.25 m/s, t = 8.853, P < 0.001, respectively). There was no difference in gait speed between men and women. Both 9-HPT and 10-MWT were significantly correlated with the ONLS, functional disability score, and BBS (P < 0.05 for all).</p><p><b>CONCLUSION</b>The 9-HPT and 10-MWT might be useful for functional assessment in Chinese patients with CMT.</p>

Analysis on excessive heavy metal problem of Chinese materia medica exports to EU from perspective of UK ban / 中草药

The EU is a key export market of Chinese materia medica (CMM). Following "The Traditional Herbal Medicinal Products Directive" (2004/24/EC) of EU, the UK enacted the restriction law on the sales of traditional herbs, which made the sales of CMM more difficult in the EU market. The prime reason is that the production or registration of CMM is difficult to meet the standards of the EU relevant technical regulations. In particular, the excess of heavy metals in CMM becomes a very serious problem which has not only influenced its quality and reputation but also has hindered the CMM to the world. By means of analyzing the relevant directives and standards of heavy metals in herbal management of EU, we analyze the impact of the UK ban on CMM exports in depth, and propose the countermeasures of CMM companies, so we can accelerate the internationalization of CMM.

Analysis of immune suppression in patients with systemic lupus erythematosus complicated by herpes zoster virus infection / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the changes in cellular immune function and the safety of physical therapy in patients with systemic lupus erythematosus (SLE) complicated by herpes zoster (HZ) virus infection. Methods A retrospective analysis was conducted among 10 SLE pateints with HZ virus infection, with 30 SLE patients without HZ infection as the control group. The results of routine laboratory tests and T lymphocyte subset counts (before and during infection and after cure of infection) were compared between the two groups.</p><p><b>RESULTS</b>The proportion of patients with significantly increased absolute neutrophil count and white blood cell count before HZ infection, and those with decreased lymphocyte percentage and elevated C-reactive protein during infection differed significantly between the two groups (P<0.05). Before HZ infection, the proportions of patients with increased CD3%, decreased CD16CD56%, abnormal 4/8 ratio (P<0.01) and those with increased CD8% and CD8count and decreased CD16CD56count differed significantly between the two groups (P<0.05). During HZ infection, the proportion of patients with increased CD3% and CD8% and decreased CD4% and 4/8 ratio count (P<0.05) and those with decreased CD16CD56% and increased CD8count differed significantly between the two groups (P<0.01). After cure of HZ infection, the proportion of patients with decreased CD16CD56% was significantly different between the two groups (P<0.01). The treatment time of HZ infection averaged 5∓1.3 days with a cure rate of 100% postherpetic neuralgia occurred in none of the patients after the treatment.</p><p><b>CONCLUSION</b>Patients with SLE complicated by HZ infection are in an immunosuppressive state, suggesting the need of monitoring T lymphocyte subsets in SLE treatment. The combined use of antiviral drugs and physical therapy can be safe and effective for treatment of SLE complicated by HZ infection.</p>

Nerve growth factor for the treatment of spinocerebellar ataxia type 3: an open-label study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Spinocerebellar ataxia type 3 (SCA3) is the most common subtype of SCA worldwide, and runs a slowly progressive and unremitting disease course. There is currently no curable treatment available. Growing evidence has suggested that nerve growth factor (NGF) may have therapeutic effects in neurodegenerative diseases, and possibly also in SCA3. The objective of this study was to test the efficacy of NGF in SCA3 patients.</p><p><b>METHODS</b>We performed an open-label prospective study in genetically confirmed adult (>18 years old) SCA3 patients. NGF was administered by intramuscular injection (18 μg once daily) for 28 days consecutively. All the patients were evaluated at baseline and 2 and 4 weeks after treatment using the Chinese version of the scale for assessment and rating of ataxia (SARA).</p><p><b>RESULTS</b>Twenty-one SCA3 patients (10 men and 11 women, mean age 39.14 ± 7.81 years, mean disease duration 4.14 ± 1.90 years, mean CAG repeats number 77.57 ± 2.27) were enrolled. After 28 days of NGF treatment, the mean total SARA score decreased significantly from a baseline of 8.48 ± 2.40 to 6.30 ± 1.87 (P < 0.001). Subsections SARA scores also showed significant improvements in stance (P = 0.003), speech (P = 0.023), finger chase (P = 0.015), fast alternating hand movements (P = 0.009), and heel-shin slide (P = 0.001).</p><p><b>CONCLUSIONS</b>Our preliminary data suggest that NGF may be effective in treating patients with SCA3.</p>

Research of determination methods of fluorouracil injection / 中国药学杂志

OBJECTIVE: To confirm the best content determination method of fluorouracil injection. METHODS: The contents of 95 batches of fluorouracil injection were determined by UV spectrophotometry absorption coefficient method and high performance liquid chromatography (HPLC), respectively. Through investigation of method recoveries, the reasons for difference in the content determination results were further analyzed. RESULTS: The HPLC determination results were slightly higher than those of the UV method (P<0.05), The intervonversion of double alcohol type structure and double ketone type structure of fluorouracil might lead to the lower recovery and determination results of UV method. CONCLUSION: The HPLC method is more accurate and reliable than UV method qualitatively and quantitatively.