mTORC1 signaling pathway regulates tooth repair / 国际口腔科学杂志·英文版

Tooth germ injury can lead to abnormal tooth development and even tooth loss, affecting various aspects of the stomatognathic system including form, function, and appearance. However, the research about tooth germ injury model on cellular and molecule mechanism of tooth germ repair is still very limited. Therefore, it is of great importance for the prevention and treatment of tooth germ injury to study the important mechanism of tooth germ repair by a tooth germ injury model. Here, we constructed a Tg(dlx2b:Dendra2-NTR) transgenic line that labeled tooth germ specifically. Taking advantage of the NTR/Mtz system, the dlx2b+ tooth germ cells were depleted by Mtz effectively. The process of tooth germ repair was evaluated by antibody staining, in situ hybridization, EdU staining and alizarin red staining. The severely injured tooth germ was repaired in several days after Mtz treatment was stopped. In the early stage of tooth germ repair, the expression of phosphorylated 4E-BP1 was increased, indicating that mTORC1 is activated. Inhibition of mTORC1 signaling in vitro or knockdown of mTORC1 signaling in vivo could inhibit the repair of injured tooth germ. Normally, mouse incisors were repaired after damage, but inhibition/promotion of mTORC1 signaling inhibited/promoted this repair progress. Overall, we are the first to construct a stable and repeatable repair model of severe tooth germ injury, and our results reveal that mTORC1 signaling plays a crucial role during tooth germ repair, providing a potential target for clinical treatment of tooth germ injury.

The beginnings and evolution of a pancreatic surgeon: a technical morphological analysis in first 5 years / 中华外科杂志

Objective: To explore the development of the pancreatic surgeon technique in a high-volume center. Methods: A total of 284 cases receiving pancreatic surgery by a single surgeon from June 2015 to December 2020 were retrospectively included in this study. The clinical characteristics and perioperative medical history were extracted from the medical record system of Zhongshan Hospital,Fudan University. Among these patients,there were 140 males and 144 females with an age (M (IQR)) of 61.0 (16.8) years(range: 15 to 85 years). The "back-to-back" pancreatic- jejunal anastomosis procedure was used to anastomose the end of the pancreas stump and the jejunal wall. Thirty days after discharge,the patients were followed by outpatient follow-up or telephone interviews. The difference between categorical variables was analyzed by the Chi-square test or the CMH chi-square test. The statistical differences for the quantitative data were analyzed using one-way analysis of variance or Kruskal-Wallis H test and further analyzed using the LSD test or the Nemenyi test,respectively. Results: Intraoperative blood loss in pancreaticoduodenectomy between 2015 and 2020 were 300,100(100),100(100),100(0),100(200) and 150 (200) ml,respectively. Intraoperative blood loss in distal pancreatectomy was 250 (375),100 (50),50 (65), 50 (80),50 (50),and 50 (100) ml,respectively. Intraoperative blood loss did not show statistical differences in the same operative procedure between each year. The operative time for pancreaticoduodenectomy was respectively 4.5,5.0(2.0),5.5(0.8),5.0(1.3),5.0(3.3) and 5.0(1.0) hours in each year from 2015 to 2020,no statistical differences were found between each group. The operating time of the distal pancreatectomy was 3.8 (0.9),3.0 (1.5),3.0 (1.8),2.0 (1.1),2.0 (1.5) and 3.0(2.0) hours in each year,the operating time was obviously shorter in 2018 compared to 2015 (P=0.026) and 2020 (P=0.041). The median hospital stay in 2020 for distal pancreatectomy was 3 days shorter than that in 2019. The overall incidence of postoperative pancreatic fistula gradually decreased,with a incident rate of 50.0%,36.8%,31.0%,25.9%,21.1% and 14.8% in each year. During this period,in a total of 3,6,4,2,0 and 20 cases received laparoscopic operations in each year. The incidence of clinically relevant pancreatic fistula (grade B and C) gradually decreased,the incident rates were 0,4.8%,7.1%,3.4%,4.3% and 1.4%,respectively. Two cases had postoperative abdominal bleeding and received unscheduled reoperation. The overall rate of unscheduled reoperation was 0.7%. A patient died within 30 days after the operation and the overall perioperative mortality was 0.4%. Conclusion: The surgical training of a high-volume center can ensure a high starting point in the initial stage and steady progress of pancreatic surgeons,to ensure the safety of pancreatic surgery.

Study on the related factors of antiviral treatment in previously reported hepatitis C patients based on the Andersen model / 中华肝脏病杂志

Objective: To understand the basic characteristics of previously reported patients with hepatitis C and analyze the related factors affecting their antiviral treatment. Methods: A convenient sampling method was adopted. Patients who had been previously diagnosed with hepatitis C in the Wenshan Prefecture of Yunnan Province and Xuzhou City of Jiangsu Province were contacted by telephone for an interview study. The Andersen health service utilization behavior model and related literature were used to design the research framework for antiviral treatment in previously reported hepatitis C patients. A step-by-step multivariate regression analysis was used in previously reported hepatitis C patients treated with antiviral therapy. Results: A total of 483 hepatitis C patients, aged 51.73 ± 12.06 years, were investigated. The proportion of male, agricultural occupants who were registered permanent residents, farmers and migrant workers was 65.24%, 67.49%, and 58.18%, respectively. Han ethnicity (70.81%), married (77.02%), and junior high school and below educational level (82.61%) were the main ones. Multivariate logistic regression analysis results showed that married patients with hepatitis C (OR = 3.19, 95% CI: 1.93-5.25, compared with unmarried, divorced, and widowed patients) with high school education or above (OR = 2.54, 95% CI: 1.54-4.20, compared with patients with junior high school education or below) were more likely to receive antiviral treatment in the predisposition module. Patients with severe self-perceived hepatitis C in the need factor module (compared with patients with mild self-perceived disease, OR = 3.36, 95% CI: 2.09-5.40) were more likely to receive treatment. In the competency module, the family's per capita monthly income was more than 1,000 yuan (compared with patients with per capita monthly income below 1,000 yuan, OR = 1.59, 95% CI: 1.02-2.47), and the patients had a high level of awareness of hepatitis C knowledge (compared with patients with a low level of knowledge, OR = 1.54, 95% CI: 1.01-2.35), and the family members who knew the patient's infection status (compared with patients with an unknown infection status, OR = 4.59, 95% CI: 2.24-9.39) were more likely to receive antiviral treatment. Conclusion: Different income, educational, and marital statuses are related to antiviral treatment behavior in hepatitis C patients. Family support of hepatitis C patients receiving hepatitis C-related knowledge and their families knowing the infection status is more important in promoting the antiviral treatment of patients, suggesting that in the future, we should further strengthen the hepatitis C knowledge of hepatitis C patients, especially the family support of hepatitis C patients' families in treatment.

Analysis of the regular monitoring of occupational hazards in Guangdong Province in 2022 / 中国职业医学

Objective To analyze the overall situation of regular monitoring of occupational hazards in enterprises in Guangdong Province in 2022. Methods Analysis and quality sampling from enterprises were conducted on the occupational hazard regular monitoring reports submitted by various occupational health institutions through the Guangdong Province Occupational Health Quality Control Platform for the year 2022. Results In 2022, a total of 40 129 enterprises in Guangdong Province conducted regular monitoring of occupational hazards, accounting for 5.9%. More than 4.85 million workers were enrolled, of which more than 1.99 million workers were exposed to occupational hazards, with an incidence of 41.1%. The incidence of exposure to chemicals, dust, and noise were 18.2%, 11.9%, and 23.5%, respectively. The incidence of exceeding national standard for chemical substances, dust and noise in enterprises were 2.7%, 3.3%, and 42.7%, respectively. The incidence of exceeding national standard for all occupational hazards increased with the scale of enterprises from micro, small, medium to large enterprises (29.1% vs 46.7% vs 61.3% vs 65.4%, all P<0.05). The top three key industries, with more enterprises exceeding national standard, were metal furniture manufacturing, wooden furniture manufacturing, and other metal daily necessities manufacturing. The concentration of 97 chemical hazardous agents such as silica dust and benzene in work site exceeded the national standard, but less than 1.0% chemical hazardous agents exceeded national standard in most of the chemical-exposed work site. The incidence of noise exceeding national standard was 45.4%, while the incidence of silica dust exceeding national standard was 17.3%. Conclusion The percentage of regular monitoring of occupational hazards in enterprises in Guangdong Province is relatively low. The main occupational hazard that exceeds the national standard was noise, indicating the need for special attention on noise protection in workplace.

Determination of thallium and its soluble compounds in workplace air by inductively coupled plasma mass spectrometry / 中国职业医学

Objective To establish a method for the determination of thallium and its soluble compounds in workplace air using microporous filter membrane sampling and inductively coupled plasma mass spectrometry (ICP-MS). Methods Thallium and its soluble compounds in workplace air were collected using microporous filter membranes, digested with nitric acid, quantified using lutetium internal standard method, and detected by ICP-MS. Results The linear range of thallium was 0.00 to 600.00 μg/L, with the correlation coefficient of 1.000. The detection limit was 0.08 μg/L, and the lower limit of quantification was 0.26 μg/L. The minimum detection concentration and minimum quantitation concentration of thallium of 75.00 L workplace air were 1.0×10-5 and 3.0×10-5 mg/m3, respectively. The minimum detection concentration and minimum quantitation concentration of thallium of 480.00 L workplace air was 2.0×10-6 and 5.0×10-6 mg/m3, respectively. The recovery rate of spiking was 100.82%-103.44%, and the relative standard deviation within- and between-batches was 1.50%-3.32% and 1.32%-3.11%, respectively. The sample could be stored at room temperature for at least 14 days. Conclusion This method can be used for the detection of thallium and its soluble compounds in workplace air.

Determination of two isomers of tetrachloroethane by solvent desorption-gas chromatography in workplace air / 中国职业医学

Objective: To establish a solvent desorption-gas chromatography method for the determination of 1,1,2,2-tetrachloroethane and 1,1,1,2-tetrachloroethane in workplace air. Methods: The 1,1,2,2-tetrachloroethane and 1,1,1,2-tetrachloroethane in workplace air were collected using activated carbon tubes, desorbed with carbon disulfide, and separated and detected by gas chromatography. The quantifications were based on standard curves. Results: The linear ranges of 1,1,2,2-tetrachloroethane and 1,1,1,2-tetrachloroethane were 0.98-395.50 and 0.87-395.50 mg/L, respectively, with the correlation coefficient of 0.999 95. The detection limits were 0.29 and 0.26 mg/L, respectively. The average of desorption efficiency was 92.04%-104.67%. The within- and between-run relative standard deviations were 1.42%-2.09% and 1.63%-6.09%, respectively. The sampling efficiency was more than 98.00%. The samples could be stored at room temperature for at least 14 days. Conclusion: This method can be used in detection of 1,1,2,2-tetrachloroethane and 1,1,1,2-tetrachloroethane in workplace air.

Relationship between postoperative delirium and preoperative frailty in elderly patients undergoing spinal surgery / 中华麻醉学杂志

Objective:To evaluate the relationship between postoperative delirium(POD) and preoperative frailty in elderly patients undergoing spinal surgery.Methods:Two hundred and twenty patients of both sexes, aged ≥65 yr, of American Society of Anesthesiologists Physical Status classification Ⅱ-Ⅳ, undergoing elective posterior lumbar decompression, bone grafting and internal fixation under general anesthesia, were selected. Frailty was measured using the FRAIL (fatigue, resistance, ambulation, illness, and loss of weight) scale on 1 day before surgery. POD was assessed twice a day within 3 days by Confusion Assessment Method. Patients were divided into POD group and non-POD group according to whether POD occurred within 3 days after surgery. Multivariate logistic regression analysis was used to identify the risk factors for POD in elderly patients undergoing spinal surgery, and the value of preoperative frailty in predicting POD was analyzed using the receiver operating characteristic curve.Results:A total of 190 patients were finally enrolled, among which 55 patients presented with frailty before surgery, and the incidence was 29.0%. Forty-six patients developed POD, and the incidence was 24.2%. Multivariate logistic regression analysis showed that aging ( OR=1.15, 95% confidence interval [ CI] 1.03-1.29, P=0.017), preoperative frailty ( OR=2.35, 95% CI 1.24-4.43, P=0.009), increase in surgical segments ( OR=4.14, 95% CI 1.71-10.05, P=0.002) and increase in postoperative 24-h pain VAS score ( OR=1.38, 95% CI 1.07-1.78, P=0.013) were independent risk factors for POD in elderly patients undergoing spinal surgery. The area under receiver operating characteristic curve of preoperative frailty in predicting POD was 0.702 (95% CI 0.608-0.796, P<0.001). Conclusions:Preoperative frailty is an independent risk factor for POD in elderly patients undergoing spinal surgery. Preoperative frailty can predict the occurrence of POD in elderly patients undergoing spinal surgery to some extent.

Determination of dimethyl sulfate in workplace air by pre-column derivatization-high performance liquid chromatography / 中国职业医学

@#Abstract: Objective - - To establish a pre column derivatization high performance liquid chromatography method for detecting Methods dimethyl sulfate (DMS) in workplace air. DMS in workplace air was collected with mercaptopyridine impregnated （ silicone tube. The derivative of DMS and mercaptopyridine was eluted by mobile phase phase A: water, phase B: acetonitrile, ∶ the volume ratio was 40 60) , and separated with a C18 column, then detected with diode array detector and quantitated by a Results - standard curve. The linear range of DMS was 0.17 40.00 mg/L, with the correlation coefficient of 0.999 95. The detection limit and the lower limit of quantitation were 0.05 and 0.17 mg/L respectively. The minimum detection concentration and minimum quantitation concentration were 0.02 and 0.04 mg/m³, respectively (air sample volume of 4.5 L, 1.0 mL sample - - - solution). The average desorption efficiency was 98.40% 102.00%. The within run and between run relative standard deviations - - were 0.61% 3.92% and 1.71% 6.00%, respectively. The samples could be stored at room temperature for at least 14 days. Conclusion This method can be used to detect DMS in workplace air.

Effect of general anesthesia guided by electroencephalography monitoring on postoperative delirium in elderly patients with non-acute fragile brain function / 中华麻醉学杂志

Objective:To evaluate the effect of general anesthesia guided by electroencephalography (EEG) monitoring on postoperative delirium (POD) in elderly patients with non-acute fragile brain function.Methods:Sixty patients of both sexes with non-acute fragile brain function, aged 65-85 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with body mass index of 18-30 kg/m 2, undergoing hip replacement, were divided into 2 groups ( n=30 each) by a random number table method: conventional general anesthesia group (group C) and general anesthesia guided by EEG monitoring group (group E). Anesthesia was maintained by intravenous infusion of propofol 50-150 μg·kg -1·min -1 and remifentanil 0.05-0.30 μg·kg -1·min -1 and intermittent intravenous boluses of rocuronium.In group E, the dose of anesthetic was reduced when the EEG burst-suppression ratio≥10% for more than 1 min or anesthesia index (AI) <40.If the situation mentioned above still existed after 1 min, the dose of anesthetic was continued to be reduced or norepinephrine was injected intravenously.In group C, the amount of intraoperative anesthesia was adjusted according to the changes in hemodynamics.Norepinephrine 4-10 μg or dopamine 1 mg was given intravenously in the light of the patients′ heart rates when intraoperative hypotension occurred.At 10 min after anesthesia induction, immediately after skin incision, immediately at the end of surgery and at 1 h after surgery, blood samples were obtained from the artery and jugular venous bulb for blood gas analysis and for calculation of jugular bulb blood oxygen content (CjvO 2), artery-jugular bulb blood oxygen content difference (Ca-jvO 2), cerebral oxygen uptake rate (CERO 2) and jugular-arterial blood lactate concentration difference (Djv-aLac). The emergence time, amounts of intraoperative anesthetics, use of noradrenaline, cumulative time of EEG burst inhibition and duration of AI<40 were recorded.The development of POD was assessed within 5 days after surgery by the confusion assessment method for the intensive care unit and the duration was recorded. Results:Compared with group C, recovery time, cumulative time of EEG burst inhibition and duration of AI<40 were significantly shortened, the intraoperative consumption of propofol and remifentanil was decreased, the requirement for intraoperative noradrenaline was increased, CjvO 2 was increased, Ca-jvO 2 and CERO 2 were decreased immediately at the end of surgery and at 1 h after surgery, the incidence of POD within 5 days after surgery was decreased, and POD duration was shortened in group E ( P<0.05). Conclusion:General anesthesia guided by EEG monitoring can reduce the development of POD in elderly patients with non-acute fragile brain function.

Analysis of long-term survival outcomes and late radiation toxicity of 132 nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy / 中华放射肿瘤学杂志

Objective:To retrospectively analyze the long-term survival (10-15 years) and late toxicity of nasopharyngeal carcinoma (NPC) patients after intensity-modulated radiotherapy (IMRT), aiming to provide reference for the optimal treatment of NPC.Methods:132 patients with NPC who were treated with IMRT in Sichuan Cancer Hospital from 2003 to 2009 were recruited. Among them, 3 patients were classified as stage Ⅰ, 22 cases of grade Ⅱ, 61 cases of grade Ⅲ, 43 cases of Ⅳ A and 3 cases of Ⅳ B, respectively. The median dose was 73.37Gy (66 to 85Gy), divided into 33 times. Twenty patients received radiotherapy alone, 112 cases of concurrent radiochemotherapy. The survival rate was calculated by Kaplan-Meier method and log- rank test. Univariate prognostic analysis was performed. Cox model was used to conduct multivariate prognostic analysis. The late radiation toxicity was evaluated by RTOG/EORTC criteria. Results:The median follow-up duration was 128 months (range, 3 to 191 months). The 10-and 15-year local control rates of NPC patients were 86.0% and 79.9%. The disease-free survival rates were 72.5% and 63.2%, and the overall survival (OS) rates were 65.2% and 57.1%. The local recurrence rate was 12.1%, and the distant metastasis rate was 16.7%. A total of 53 patients died, of whom 15 patients died of local recurrence, 20 patients died of distant metastasis and 18 patients died of other diseases (pneumonia, intracranial hemorrhage and accident, etc.). The 10-and 15-year non-tumor-related mortality rates were 11.3% and 13.6%. Univariate analysis showed that age, smoking habit, lactate dehydrogenase (LDH), T stage and clinical stage were the independent prognostic factors of OS in NPC patients. Multivariate analysis demonstrated that LDH, T stage and synchronous chemotherapy were the prognostic factors of OS in NPC patients. The incidence of gradeⅠ-Ⅱ late radiation injury (hearing impairment, dysphagia, dental caries and xerostomia) was 90.4%, and 8.5% for grade Ⅲ-Ⅳ late radiation injury (skin fibrosis, hearing impairment and radiation brain injury).Conclusions:The 10-and 15-year OS of NPC patients treated with IMRT is relatively high. With the prolongation of survival, the non-tumor-related mortality rate is increased. Distant metastasis is the main cause of treatment failure. The main late injuries include grade Ⅰ/Ⅱ hearing impairment, dysphagia, dental caries and xerostomia.

Tetrahydroxystilbene glucoside protects against sodium azide-induced mitochondrial dysfunction in human neuroblastoma cells / 中草药·英文版

Objective: Mitochondrial dysfunction is evident in the early stage of Alzheimer's disease (AD). Therefore development of drugs that protect mitochondrial function is a promising strategy for AD. The present work was to investigate the effects of 2, 3, 5, 4′-Tetrahydroxystilbene-2-O-β-d-glucosides (TSG) on a mitochondrial dysfunction cell model induced by sodium azide and elucidate the underlying mechanisms. Methods: Mitochondrial membrane potential (MMP) was detected by a fluorescence method. Cellular adenosine triphosphate (ATP) level was measured using a firefly luciferase-based kit. Reactive oxygen species (ROS) was detected using dichlorofluorescin diacetate (DCFH-DA). The expression levels of Bcl-2 and Bax were measured by Western blotting assay. Flow cytometry was utilized to measure apoptosis. Results: Pretreatment of TSG (25–200 μmol/L) for 24 h significantly elevated MMP and ATP content, reduced ROS level and Bax/Bcl-2 ratio, and inhibited apoptosis in SH-SY5Y cells exposed to sodium azide. Conclusion: These results suggest that TSG protects SH-SY5Y cells against sodium azide-induced mitochondrial dysfunction and apoptosis. These findings are helpful to understand the protective effect of TSG on mitochondria, which are involved in the early stage of AD.

Anesthesia methods for patients undergoing orthopeadic surgery in the epidemic period of COVID-19 / 中华创伤骨科杂志

Objective:To compare the anesthesia methods for patients undergoing orthopaedic surgery between the epidemic period of COVID-19 in 2020 and the same period in 2019.Methods:A retrospective study was conducted of the patients who had undergone orthopedic surgery at The Trauma Emergency Center, The Third Hospital of Hebei Medical University in the epidemic period of COVID-19 from 20 January through 1 March in 2020 and from 4 February through 14 March in 2019 (the same lunar period). Their anesthesia methods were analyzed.The patients in the 2 periods were divided into a group of ≥65 years old and a group of <65 years old.The anesthesia methods and anesthetic operation time were compared between the total cohorts and 2 age groups in the 2 periods.Results:A total of 285 orthopedic operations were completed in the epidemic period in 2020, a decrease by 63.7% than the 784 operations in the same period in 2019; the proportion of elderly fracture patients ≥65 years old in 2020 [29.5%(84/285)] was significantly higher than that [18.1%(142/784)] in 2019. The proportion of non-airway management anesthesia in the epidemic period in 2020 [56.5% (161/285)] was significantly higher than that in the same period in 2019 [38.3%(300/784)]; there was a significant difference in the proportion of non-airway management anesthesia for elderly patients ≥65 years old between the 2 periods [41.6%(59/142) versus 71.4%(60/84)] ( P<0.05). The proportions of intraspinal anesthesia[36.5% (104/285)] and intravenous/+peripheral nerve block anesthesia[4.9%(14/285)] in 2020 were significantly higher than those in 2019 [25.5%(200/784) and 0.3%(2/784)] ( P<0.05); the proportion of laryngeal mask/+peripheral nerve block anesthesia in 2020 [27.7%(79/285)] was significantly lower than that in 2019 [48.9% (383/784)] ( P<0.05). In the group of ≥65 years old, the proportions of intraspinal anesthesia [48.8% (41/84)] and intravenous/+peripheral nerve block anesthesia [10.7%(9/84)]in 2020 were significantly higher than those in 2019 [29.6%(42/142) and 0] ( P<0.05), but the proportion of laryngeal mask/+peripheral nerve block anesthesia in 2020 [21.4% (18/84)] was significantly lower than that in 2019 [47.9%(68/142)] ( P<0.05). Compared with the operation time for intraspinal anesthesia (6.2 min ± 0.4 min) and for intubation/+block anesthesia (7.4 min ± 0.4 min) in 2019, the operation time in 2020 (12.6 min ± 0.4 min and 13.2 min ± 0.3 min, respectively) was significantly increased ( P< 0.05). Conclusions:The anesthesia methods for patients undergoing orthopaedic surgery in the epidemic period in 2020 were featured by non-airway management like peripheral nerve block anesthesia, intraspinal anesthesia, and laryngeal mask/+peripheral nerve block anesthesia because they might have helped to reduce the postoperative complications in respiratory system.The anesthetic operation time in the epidemic period in 2020 was increased than in the same period in 2019.

Determination of lithium and its compounds in workplace air by inductively coupled plasma mass spectrometry / 中国职业医学

OBJECTIVE: To establish a method for testing lithium and its compounds in workplace air by inductively coupled plasma mass spectrometry(ICP-MS). METHODS: Lithium and its compounds in workplace air were collected by microporous filtration membrane. After elution with nitric acid solution in volume fraction of 1.0%, the samples were determined by ICP-MS. RESULTS: The linearity range of lithium mass concentration was 10.00-500.00 μg/L, and the correlation coefficient was 0.999 8. The detection limit was 0.03 g/L and the lower limit of quantitation was 0.10 μg/L. The minimum detection concentration and the minimum quantitative concentration of lithium were 4.0 and 10.0 ng/m~3 respectively. The recovery rate of standard addition was 96.18%-100.91%.The within-run and the between-run relative standard deviation were 1.17%-2.17% and 0.89%-1.54% respectively. Lithium and its compound samples could be stored at room temperature for at least 28 days. CONCLUSION: The method could be used for detection of lithium and its compounds in workplace air.

Construction of hidden curriculum in the academic experience inheritance of distinguished TCM veteran doctors / 中国针灸

To discuss the advantages and necessity of hidden curriculum construction in the academic experience inheritance of distinguished TCM veteran doctors by analyzing the characteristics of the hidden curriculum and the academic experience inheritance of distinguished TCM veteran doctors, and put forward viewpoints and pathways of promoting academic experience inheritance of distinguished TCM veteran doctors through the construction of hidden curriculum，such as optimal design of teaching environment，reasonable planning of teaching content and development of teaching information model，to effectively improve student cultivation quality and achieve the TCM talent cultivation goal which clinical diagnosis and treatment skills and clinical innovation ability are the core.

Clinical and genetic characteristics of a young child with combined pituitary hormone deficiency type I caused by POU1F1 gene variation / 中国当代儿科杂志

This paper reports the clinical and genetic characteristics of a case of combined pituitary hormone deficiency type I (CPHD1) caused by POU domain, class 1, transcription factor 1 (POU1F1) gene variation. A 2 years and 3 months old girl mainly presented with short stature, special facial features of prominent forehead, enophthalmos, and short mandible, loose skin, central hypothyroidism, complete growth hormone deficiency, and anterior pituitary hypoplasia. Gene analysis identified a novel heterozygous mutation, c.889C>T (p.R297W), in POU1F1 gene, and this locus of her parents was wild-type. This mutation was analyzed as a possible pathogenic variant according to the guidelines of the American College of Medical Genetics and Genomics, which has not been previously reported in the literature and conforms to the autosomal dominant inheritance. This child was diagnosed with CPHD1. Her height increased by 19.8 cm and showed a catch-up growth trend after one year of combined treatment with growth hormone and euthyrox. This study enriches the mutation spectrum of POU1F1 gene and has important significance for the diagnosis and classification of combined pituitary hormone deficiency.

Effect of Kinesio Taping on Chronic Nonspecific Low Back Pain: A Meta-analysis / 中国康复理论与实践

Objective:To evaluate the effect of Kinesio taping on chronic nonspecific low back pain (CNLBP). Methods:The Cochrane Library, PubMed, Web of Science, CNKI, CBM, VIP, and Wanfang Data were searched for the randomized controlled trials (RCT) about the effect of Kinesio taping on CNLBP from establishment to January, 2019. The included studies were evaluated according to the method recommended by the Cochrane Collaboration. RevMan 5.3 software was used to analyze the extracted data. Results:Finally, nine RCTs involving 545 patients were included. Meta-analysis showed that the effect of Kinesio taping was significantly different in the improvement of pain compared with the non-stimulated group (MD = -0.76, 95%CI: -1.43 to -0.08, P = 0.03), the difference might be significant compared with the sham stimulation group (MD = -1.10, 95%CI: -2.22 to 0.02, P = 0.05); For improving dysfunction, the Oswestry Disability Index (ODI) scores were better in the Kinesio taping group than in the non-stimulation group (MD = -6.02, 95%CI: -8.63 to -3.41, P < 0.001) and the sham stimulation group (MD = -4.11, 95%CI: -5.82 to -2.41, P < 0.001), however, their was no significant difference in Roland Morris Disability Questionnaire (RMDQ) score between the Kinesio taping group and the non-stimulated group (MD = 0.69, 95%CI: -2.35 to 3.74, P = 0.66), and between the Kinesio taping group and the sham stimulation group (MD = -0.17, 95%CI: -1.43 to 1.08, P = 0.78). Conclusion:For the patients with CNLBP, the intervention of Kinesio taping could alleviate pain and improve function.

Occupational exposure limits of methyl t-butyl ether in workplace air / 中国职业医学

OBJECTIVE: To establish the occupational exposure limits for methyl t-butyl ether(MTBE) in the air of workplace in China. METHODS: According to the GBZ/T 210.1-2008 Guide for Establishing Occupational Health Standards--Part 1: Occupational Exposure Limits for Airborne Chemicals in the Workplace, we collected and analyzed data on physical and chemical properties, toxicology, occupational epidemiology and foreign occupational exposure limits related to MTBE by literature search. A total of 180 occupational workers exposed to MTBE were selected as exposure group, and 155 workers and administrative logistics personnel without exposure to MTBE were selected as the control group. Occupational hygiene investigation and occupational physical examination were carried out. We deduced the occupational exposure limits for MTBE in workplace air in China by combining literature data. RESULTS: The time-weighted average(TWA) of MTBE in the workplace air developed by the United States of America and Britain is 180.00 mg/m~3. The short-term exposure limit(STEL) of MTBE in the workplace air developed by Australia and New Zealand is 270.00 mg/m~3. The concentration of TWA(C_(TWA)) of MTBE in the exposure group was less than 0.08-4.90 mg/m~3. The concentration of short term exposure was less than 0.10-14.28 mg/m~3, and the C_(TWA) was less than 0.02-83.66 mg/m~3, in parts of workplaces. There was no statistically significant difference on the self-conscious discomfort and the abnormality in physical examination between these two groups(P>0.05). CONCLUSION: It's recommended that the permissible concentration-TWA of MTBE should be set at 180.00 mg/m~3, and the permissible concentration-STEL should be set at 270.00 mg/m~3 in China.

Mutation and Clinical Feature of IL-7R in Adult Patients with Acute Lymphoblastic Leukemia / 中国实验血液学杂志

OBJECTIVE@#To investigate the IL-7R gene mutation and clinical features of adult patients with acute lymphoblastic leukemia (ALL).@*METHODS@#One hundred sixty-four cases of newly treated adults with ALL from May 2016 to December 2018 were selected. Targeted and specific next-generation sequencing technology was used to detected a total of 16 types of Ph-like ALL mutations, which include IL-7R mutation, and the cilinical features, rate, types and sites of IL-7R were analyzed.@*RESULTS@#IL-7R mutation was determined in 10 cases of 164 adult patients with ALL and the total mutation frequency was 13 times (6.1%). Out of 10 cases 5 cases were male (50%), 5 cases were female (50%). 6 cases of B-ALL ( 60% ) and 4 cases of T-ALL (40%). The mutation site of all cases was located at exon 6, among which 6 cases had replacement mutations, 3 cases had deletion mutations and 4 cases had insertion mutations. In addition, 1 triple and 1 double mutation of IL-7R were found. Besides, six mutation sites were newly identified, including: c.720_724del, c.723_726del, c.721_722insAGTG, c.727_728insTAACGGCCCCCTGCT, c.727_728insATGCAGGGAGCGAA and c.728_729insAAGTGTCA.@*CONCLUSION@#Six novel mutation sites and a poor manifestation of IL-7R have been explored in this research. Thus more samples are required to study the effects of IL-7R mutation on ALL treatment.

Difference in intestinal absorption of Wuzhuyu decoction between normal and migraine model rats / 中国中药杂志

To compare the intestinal absorption of Wuzhuyu decoction(WZYD) between normal rats and migraine model rats, and investigate the optimized WZYD from aspect of absorption. The rat single pass intestinal perfusion test(SPIP) was adopted for optimized sample and un-optimized sample in normal and migraine model rats induced by nitroglycerin and reserpine. The contents of 8 ingredients were determined by high performance liquid chromatography(HPLC), and 4 absorption parameters for each ingredient were calculated and compared: unit area absorption(Mper area), absorption rate constant(Ka), apparent coefficient(Papp) and relative absorption rate(RA). The results showed that there was a great difference between normal rats and model rats in the intestinal absorption of the same WZYD. As compared with normal rats, the absorption parameters of most ingredients in optimized sample were increased in migraine model rats induced by nitroglycerin; Similar phenomena were also found in migraine model rats induced by reserpine. However, the absorption parameters of most ingredients were decreased in un-optimized sample. Therefore, pathological model rats shall be used for effective ingredient recognition based on the correlation between intestinal absorption spectra and pharmacological effects. As compared with the un-optimized samples, the absorption of effective ingredients was faster, easier and more adequate in the optimized samples, revealing their mechanism on better efficacy from the aspect of absorption.

Effect of dexmedetomidine on liver and kidney function in patients undergoing spinal surgery / 临床麻醉学杂志

Objective To observe the effect of dexmedetomidine on liver and kidney function in patients undergoing spinal surgery.Methods Sixty patients (31 males and 29 females,aged 49-78 years)of BMI 19-30 kg/m2and ASA physical status Ⅰ-Ⅲ who underwent surgery for posterior lum-bar interbodyfusion under general anesthesia from December 2016 to May 2017 in our hospital were selected as the research object.Patients were randomly divided into dexmedetomidine group (group D)and control group (group C)(n=30 each).In group D,DEX was infused over 10 min with the loading dose 0.5-1.0 μg/kg and followed by 0.2-0.5 μg·kg-1·h-1as a maintenance dose.Group C received the same volume of saline.The blood samples were obtained from the patient at 30 min be-fore anesthesia induction (T0),the end of the operation (T1)and 2 days after operation (T2)for re-cording monitoring index and determination of the levels of plasma CysC,Cr,UREA,ALT and AST.The dosages of remifentanil and propofol,hospital stay and the adverse reactions after the sur-gery (such as postoperative hypotension or cardio-cerebral vascular events)were compared between the two groups.Results Compared with T0,the levels of ALT,AST,Cr and UREA in the two groups were significantly reduced at T1(P<0.05),the levels of ALT,UREA of two groups and the levels of AST of group D were significantly reduced at T2(P<0.05).The levels of ALT,AST,U-REA at T1,T2and the levels of Cr at T1in group D were significantly lower than group C (P<0.05).Compared with group C,the urine volume of group D increased significantly (P<0.05),and there was a significant decrease in the dosage of remifentanil and propofol in group D (P<0.05). There was no significant difference in the incidence of adverse reactions and hospitalization time be-tween the two groups.Conclusion Spinal surgery patients during general anesthesia using dexme-detomidine,significantly reduce the amount of intraoperative anesthetic,protect liver and kidney function and increase the safety during anesthesia.