Composite Sophora Colon-Soluble Capsule Ameliorates DSS-Induced Ulcerative Colitis in Mice via Gut Microbiota-Derived Butyric Acid and NCR+ ILC3 / 中国结合医学杂志

OBJECTIVE@#To investigate the effects of composite Sophora colon-soluble Capsule (CSCC) on gut microbiota-mediated short-chain fatty acids (SCFAs) production and downstream group 3 innate lymphoid cells (ILC3s) of dextran sulfate sodium (DSS)-induced ulcerative colitis (UC) mice model.@*METHODS@#The main components of CSCC were analyzed by hybrid ultra-high-performance liquid chromatography ion mobility spectromety quadrupole time-of-flight mass spectrometry (UHPLC-IM-QTOF/MS). Twenty-four male BALB/c mice were randomly divided into 4 groups (n=6) by using a computer algorithm-generated random digital, including control, DSS model, mesalazine, and CSCC groups. A DSS-induced colitis mice model was established to determine the effects of CSCC by recording colonic weight, colonic length, index of colonic weight, and histological colonic score. The variations in ILC3s were assessed by immunofluorescence and flow cytometry. The results of gut microbiota and SCFAs were acquired by 16s rDNA and gas chromatography-mass spectrometry (GC-MS) analysis. The expression levels of NCR+ ILC3-, CCR6+ Nkp46- (Lti) ILC3-, and ILCreg-specific markers were detected by enzyme-linked immunosorbent assay, and real-time quantitative polymerase chain reaction and Western blot, respectively.@*RESULTS@#The main components of CSCC were matrine, ammothamnine, Sophora flavescens neoalcohol J, and Sophora oxytol U. After 7 days of treatment, CSCC significantly alleviated colitis by promoting the reproduction of intestinal probiotics manifested as upregulation of the abundance of Bacteroidetes species and specifically the Bacteroidales_S24-7 genus (P<0.05). Among the SCFAs, the content of butyric acid increased the most after CSCC treatment. Meanwhile, compared with the model group, Lti ILC3s and its biomarkers were significantly downregulated and NCR+ ILC3s were significantly elevated in the CSCC group (P<0.01). Further experiments revealed that ILC3s were differentiated from Lti ILC3s to NCR+ ILC3s, resulting in interleukin-22 production which regulates gut epithelial barrier function.@*CONCLUSION@#CSCC may exert a therapeutic effect on UC by improving the gut microbiota, promoting metabolite butyric acid production, and managing the ratio between NCR+ ILC3s and Lti ILC3s.

Correlation between biomarker EHD3 and immune cell infiltration in gastric cancer / 西安交通大学学报(医学版)

【Objective】 To investigate the prognostic role of EHD3 and its association with immune cell infiltration in gastric cancer. 【Methods】 In this study, EHD3 expression was analyzed using RNA sequencing data from Cancer Genome Atlas (TCGA). Differential analysis, functional enrichment, immune infiltration, immune checkpoint exploration, and clinical baseline data analysis were performed. Independent prognostic factors were identified using univariate and multivariate Cox regression analysis; a column diagram model was developed and evaluated using C-index and calibration diagrams. 【Results】 EHD3 was significantly upregulated in STAD and functional enrichment analysis showed that EHD3 expression was associated with immune response, with most immune cells and immune checkpoints positively correlated with their expression. Cox regression showed that EHD3 was an independent prognostic factor in STAD patients (HR=2.112, 95% CI: 1.340-3.327, P=0.001). 【Conclusion】 EHD3 is considered to be a novel prognostic biomarker for STAD patients, and this study provides a potential therapeutic target for STAD treatment.

A multicenter prospective randomized controlled study on the timing of laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for grade Ⅱ-Ⅲ acute cholecystitis / 中华肝胆外科杂志

Objective:To study the optimal timing of laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGBD) for grade Ⅱ-Ⅲ acute cholecystitis.Methods:A multicenter, single blind and randomized controlled study was conducted at Shanghai Fifth People's Hospital Affiliated to Fudan University, Shanghai Pudong Hospital, and Shanghai Minhang District Central Hospital from October 2018 to September 2021. Patients who underwent LC after PTGBD were divided 1∶1 into the early group and the late group. LC was performed 4-6 weeks after PTGBD in the early group and 7-8 weeks after PTGBD in the late group. Gender, age, AC grade, complications after PTGBD, body mass index, complications before LC, operation time of LC, intraoperative bleeding, total treatment cost, conversion rate to open surgery and complications after LC were compared between the two groups. The 36-Item Short Form Health Survey (SF-36) before and after LC was also compared.Results:Of 248 patients who were eligible for the study, there were 52 males and 196 females, with ages ranging from 18 to 89 years, and mean ±s.d. of (52.5 ± 20.2) years. There were 126 patients in the early group and 122 patients in the late group. There were no significant differences in gender, age, AC grade, body mass index and complications before LC between the two groups (all P>0.05). The preoperative score of SF-36 in the early group was significantly better than that in late group, and the complications of PTGBD in the late group were significantly higher than the early group (both P<0.05). The operation time and total treatment cost of the early group were significantly less than those of the late group (37.2±12.8 min vs. 48.5±19.7 min, 20 856±2 136 yuan vs. 2 2207±2 049 yuan) (both P<0.05). The intraoperative bleeding volume of LC in the early group was [ M( Q1, Q3)] 40 (40, 60) ml and the late group was [ M( Q1, Q3)] 35 (25, 40) ml. The difference was also significant ( P<0.05). There was no significant differences in the conversion rates to open surgery, complications and SF-36 scores after LC between the two groups (all P>0.05). Conclusion:LC should be performed 4-6 weeks after PTGBD for grade Ⅱ-Ⅲ acute cholecystitis. Although the amount of intraoperative bleeding was higher, the operation time was shorter, the burden on patients was reduced and there was more rapid recovery.

A study of the effectiveness of nucleos(t)ide analogues in the treatment of HBeAg- positive chronic hepatitis B with normal alanine aminotransferase and high level of HBV DNA / 中华肝脏病杂志

Objective: To investigate the effectiveness of nucleos(t)ide analogues in the treatment of HBeAg-positive chronic hepatitis B with normal alanine aminotransferase and high level of HBV DNA. Methods: Treatment-naïve chronic hepatitis B patients who were followed up at the Center of Infectious Diseases, West China Hospital of Sichuan University from January 2019 to January 2020 were selected as subjects. Demographic characteristics, the results of laboratory examination before treatment and one year after treatment were retrospectively collected. Patients were divided into tenofovir dipivoxil (TDF) and propofol fumurate tenofovir (TAF) treatment group according to different types of medication. The changes of serum HBV DNA level, HBeAg serological conversion and HBsAg quantitative level were analyzed and compared between the two groups. Results: A total of 38 cases were enrolled. Among them, there were 16 and 22 cases in the TDF and TAF group, respectively. There was no statistically significant difference in demographic characteristics, baseline HBV DNA levels and HBsAg quantitative levels between the two groups. Virological response was achieved in 60.5% (23/38) of patients after one year of antiviral therapy. Serum HBV DNA levels below the lower limit of detection [68.2% (15/22) vs. 50.0% (8/16), P=0.258] and higher HBeAg seroconversion rate [18.2%] (4/22) vs. 6.3% (1/16), P=0.374] was obtained in TAF than TDF group; however, there was no statistically significant differences between the two. Serum HBsAg quantitative level was significantly reduced with TDF and TAF treatment. In addition, alanine aminotransferase elevation was reduced in TAF than TDF treated group. Multivariate logistic regression analysis showed that patient age was an independent predictor of a virological response to antiviral therapy. Conclusion: HBeAg-positive CHB patients with normal alanine aminotransferase, and high HBV DNA level can obtain better curative effect after TDF and TAF treatment.

Clinical value of routine contrast esophagram in the diagnosis of anastomotic leakage for three-incision esophagectomy with cervical anastomosis / 中华外科杂志

Objective: To examine the clinical value of routine contrast esophagram (RCE) for the diagnosis of anastomotic leakage (AL) after three-incision esophagectomy with cervical anastomosis. Methods: Clinical data of 1 022 patients with esophageal cancer who underwent McKeown three-incision esophagectomy with cervical anastomosis from January 2015 to December 2019 at Department of Minimally Invasive Esophageal Surgery, Tianjin Medical University Cancer Hospital and Institute were analyzed retrospectively. There were 876 males and 146 females, aging(M(IQR)) 48(16) years (range: 36 to 84 years). There were 253 patients (24.8%) with neoadjuvant therapy, and 817 patients (79.9%) with minimally invasive esophagectomy. According to the diagnosis and treatment habits of the attending surgeons, 333 patients were included in the RCE group, and RCE was performed on the 7th day postoperative, while 689 patients were included in the non-RCE group, and RCE was performed when the patients had suspicious symptoms. Taking clinical symptoms, RCE, CT, endoscopy and other methods as reference to the diagnosis of AL, the sensitivity and specificity were used to analyze and evaluate the efficacy of RCE for the diagnosis of AL. The data were compared by U test or χ² test between groups. Results: The incidence rate of AL after three-incision esophagectomy was 7.34% (75/1 022), including 30 cases in the RCE group and 45 cases in the non-RCE group (9.0%(30/333) vs. 6.5%(45/689), χ²=2.027, P=0.155). The diagnostic time of AL was 9(5) days postoperative (range: 4 to 30 days). Among them, 23 cases showed cervical leakages, 50 cases showed intro-thoracic leakages, and 2 cases both cervical and intro-thoracic leakages. The diagnostic time of patients with intro-thoracic leakages was longer than that of cervical leakages (10(4) days vs. 6(3) days, Z=-2.517, P=0.012). Among the 333 patients in the RCE group, 16 cases of RCE indicated leakages including 11 cases of true positive and 5 cases determined to be false positive, while 317 cases indicated no abnormalities including 19 cases developed leakages. The sensitivity and specificity of RCE to detect AL were 36.7%(11/30) and 98.3%(298/333), respectively. The Youden-index was 0.35, and the diagnostic accuracy was 92.8%(309/333). The positive and negative predictive value were 11/16 and 94.0%(298/317), respectively. Conclusions: Routine contrast esophagram after three-incision esophagectomy with cervical anastomosis has low sensitivity and high specificity in the diagnosis of AL. The diagnostic time of AL is the 9th day after surgery. It is necessary to prolong the observation time clinically, and combine RCE with CT, endoscopy and other inspection methods for diagnosis.

The application and insight of single-stage posterior total en bloc spondylectomy treatment on L 5 vertebrae spine tumors / 中华骨科杂志

Objective:To investigate the feasibility and technical points of single posterior total spine resection for L 5 vertebrae tumors, evaluate the effectiveness and safety of the technique, and propose a comprehensive treatment model for L 5 tumors on this basis. Methods:A retrospective analysis was performed on the data of 13 patients with L 5 vertebrae tumor who were treated by total en bloc spondylectomy (TES) through single-stage posterior approach from January 2014 to September 2021, including 4 males and 9 females. The age range was 21-65 years, with an average age of 33.85±14.24 years. Imaging examination showed isolated tumors of L 5 vertebrae without other metastases. All patients were treated with a single posterior L 5 vertebrae tumor TES by adjusting the curvature of lumbar lordosis, and the lumbar nerve root was fully dissociated. The vertebra with tumor was removed entirely and lumbar stability reconstruction via a pedicle screw system. Various parameters, including operative time, blood loss, complications, preoperative and postoperative spine sagittal parameters, Japanese Orthopaedic Association scores (JOAs), tumor control and outcome, were listed and analyzed. Results:Preoperative pathological diagnosis of 13 patients was mainly primary bone tumor including giant cell tumor in 7 cases, and invasive hemangioma, epithelioid hemangioma, aneurysmal bone cyst, chordoma, plasma cell myeloma and bone metastasis of breast cancer in 1 case. The mean operative time was 333.23±99.48 min (range 175-480 min), and the mean intraoperative blood loss was 1 407.69±676.49 ml (range 300-2 800 ml). There were no serious perioperative complications during the perioperative period. The mean follow-up was 54.92±19.29 months (range 28-84 months). JOAs improved from 13.85±3.86 points before operation to 24.31±2.16 points at 6 months after operation, and the difference was statistically significant ( t=8.19, P<0.001). Postoperative delayed wound healing occurred in 2 case. 2 patients showed numbness of the left lower limb, and 1 patient had slightly reduced plantar flexion movement. Conclusion:Single posterior TES is a good surgical method for the treatment of isolated L 5 vertebrae tumors. Although this technique is difficult, it can reduce surgical wounds and postoperative complications and good functional and oncology prognosis can be achieved.

Validation of compound C19 as a glutaminase C inhibitor / 药学学报

The mitochondrial enzyme glutaminase C (GAC) is highly expressed in a variety of cancer cells, resulting in increased glutamine metabolism and cancer development. Therefore, GAC has become a potential target for anti-tumor drug development. However, current GAC inhibitors shared similar structural characteristics, few new scaffolds were reported. By conducting a prokaryotic Escherichia coli expression system, human GAC protein of high-purity was obtained through lysozyme digestion combined with ultrasound dissociation, and cobalt magnetic beads purification, Moreover, we performed studies to validate interaction between small molecules and GAC protein through thermal shift assay, drug affinity responsive target stability assay, protein crosslinking and GAC enzyme activity detection. Meanwhile, a comprehensive small molecule-protein interaction confirmation and systematic pharmacodynamic study in vitro were carried out on compound C19, which was a reported GAC inhibitor screened from the Enamine database. Results showed that C19 directly bind to GAC protein, disturbed GAC tetramers formation, and inhibited its enzyme catalytic activity. By interfering GAC function, C19 dose-dependently suppressed GAC-mediated glutamine metabolism, reduced glutamate in cancer cells, and thus alleviated A549 and NCI-H1299 non-small cell lung cancer cell growth. Together, C19 was identified as a lead compound, providing a new strategy for the structural design of drugs targeting GAC.

Arsenic Trioxide Combining Leflunomide Activates Nrf2-ARE-HO-1 Signaling Pathway and Protects Heart Xenografts / 中国结合医学杂志

OBJECTIVE@#To investigate the molecular mechanisms underlying the effects of arsenic trioxide (As@*METHODS@#Transplantation of LVG hamster hearts to Lewis rats was performed by anastomosis of vessels in the neck using end-to-end anastomosis with a non-suture cuff technique. Four groups of recipient rats (n=6 in each) were treated with normal saline (control), As@*RESULTS@#Expression of Nrf2-ARE-HO-1 signaling pathway was upregulated in heart xenografts in rats treated with As@*CONCLUSION@#Combination treatment with As

Study on Mechanism and Validation of Effect of Astragali Radix in Treatment of Parkinson's Disease by Network Pharmacology / 中国实验方剂学杂志

Objective:To analyze the mechanism of Astragali Radix in the treatment of Parkinson's disease by network pharmacology and PC-12 extracellular model. Method:Traditional Chinese medicines systems pharmacology platform （TCMSP） and CD-HIT databases were used to screen out active components and targets of Astragali Radix， GENECARDS and Online Mendelian Inheritance in Man （OMIM） databases were used to screen out targets relating to Parkinson's disease and draw component-target network， STRING database was used to build the protein-protein interaction network， Bioconductor Cluster Profiler was applied in Gene Ontology （GO） enrichment analysis， and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis. PC-12 cells were pretreated with water extract of Astragali Radix， and Western blot was used to assess the expression of phosphorylation extracellular regulatory protein kinase 1/2（p-ERK1/2）， ERK1/2， B cell lymphoma -2 （Bcl-2） associated X protein （Bax）， Bcl-2， cysteine aspartic acid protease -3 （Caspase-3） and cleaved-Caspase3 （c-Caspase-3）. The levels of interleukin-6 （IL-6）， IL-10 and tumor necrosis factor-α（TNF-α） were determined by enzyme-linked immunosorbent assay （ELISA） interleukin-6 （IL-6）， IL-10， tumor necrosis factor-α（TNF-α）. Result:Network pharmacology showed that 14 compounds in Astragali Radix， including emodin and quercetin， played a role through multi-target and multi-channel synergy， involving ERK signal pathway， Bax， Bcl-2， Caspase-3， IL-6， IL-10， TNF-α and other target proteins. Western blot showed that the expressions of Bax， p-ERK1/2， c-Caspase-3 and Bcl-2 in Astragali Radix Extract group decreased， while the expressions of Bcl-2 in Astragali Radix Extract group was significantly higher than that in model group （P<0.05）. There were statistical differences between the two groups. ELISA showed that Astragali Radix water extract could reduce the expressions of IL-6， TNF-α， but increase the expression of IL-10， with statistical differences from the model group （P<0.05）. Conclusion:This study shows that Astragali Radix can affect the expressions of these proteins， and verify the results of network pharmacology， so as to provide a basis for further study of Astragali Radix in the treatment of Parkinson's disease.

Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Predicting Prognosis of Surgically Resectable Urinary Cancers: Systematic Review and Meta-Analysis / 中国医学科学杂志(英文版)

Objective Accumulated evidence has suggested that there is a close association between preoperative neutrophil-to-lymphocyte ratio (NLR) and prognosis of various malignant tumors. However, the relationship between NLR and surgically resectable urinary cancers remains contradictory. Therefore, we performed this systematic review and meta-analysis to explore whether preoperative NLR could predict the prognosis of surgically resectable urinary cancers. Methods After searching the Embase, PubMed/MEDLINE and Cochrane databases and screening the articles, we finally included 25 studies involving 15950 patients. Hazard ratios (s) and their 95% confidence intervals (s) were extracted to assess the association between preoperative NLR and the overall survival (OS) and cancer-specific survival (CSS) of surgically resectable urinary cancers. Results The pooled results revealed that an elevated preoperative NLR could predict a worse OS (=1.40, 95%: 1.26-1.54, <0.001) and CSS (=1.43, 95%: 1.27-1.59, <0.001) in urinary cancers. In addition, our analyses also suggested that high preoperative NLR was associated with worse prognosis in renal cell carcinoma (OS: =2.06, 95%: 1.54-2.76, =0.131; CSS: =2.46, 95%: 1.46-4.16, =0.178), upper tract urothelial carcinoma (OS: =1.91, 95%: 1.50-2.42, =0.616; CSS: =1.84, 95%: 1.41-2.39, =0.001), bladder cancer (OS: =1.09, 95%: 1.02-1.17, <0.001; CSS: =1.05, 95%: 1.01-1.09, =0.163) and prostate cancer (OS: =1.69, 95%: 1.19-2.41, =0.714). Regardless of the participants' race or the cutoff value of the preoperative NLR, the results remained valid. Conclusion Elevated preoperative NLR could predict a worse prognosis in surgically resectable urinary cancers, namely, renal cell carcinoma, bladder cancer, prostate cancer and upper tract urothelial carcinoma.

Recent advances in LncRNAs and chronic kidney disease / 药学学报

Long non-coding RNAs (LncRNAs), defined as transcripts which are hundreds of nucleotides with little or non-protein coding potential. Recently, LncRNAs have caught much more attentions, instead of considering as noises of genome transcripts, and indeed they have been found to play important roles associated with some biological processes, such as tumorigenesis, immunology dysfunction, metabolism adjustment, and so on. The incidence of chronic kidney disease (CKD) in different regions of the world is about 10% to 15%, with high growth rate and high unawareness, including the diabetic nephropathy, membranous nephropathy, etc. Previous publications also suggest that LncRNAs have a close relationship with the kidneys, and it may become new therapeutic targets or new biomarkers to diagnose diseases. In this review, we will summarize LncRNAs' functions with chronic kidney diseases, and discuss the prospects of the clinical applications of LncRNAs in the treatment of CKD treatment.

Effects of OASIS iris expander in phacoemulsification surgery of cataract with small pupil / 眼科新进展

Objective To assess the outcomes of OASIS iris expander in phacoemulsification surgery of cataract with small pupil.Methods A prospective case-control study was conducted in 22 microcoria cataract patients (22 eyes).And they were randomly divided into group A and B,in which the pupils of group A were dilated by tearing instruments in 13 eyes,and the pupils of group B were dilated using OASIS iris expander in 9 eyes.All patient underwent phacoemulsification with 3.2 mm clear corneal incision and were followed up at postoperative 1 week,1 month,3 months and 6 months.Finally,the best corrected visual acuity (BCVA),intraocular pressure (IOP),corneal endothelial cell counts,pupil size before and after surgery were recorded and analyzed by an independent sample t test.Results All procedures were completed successfully by the same skilled doctor.Intraocular lenses were implanted in capsule completely,and no complications occurred.At 6 months after operation,patients'BCVA in group A (0.41 ± 0.30) and group B (0.77 ± 0.23) was significantly higher than that in group A (0.17 ±0.14) and group B (0.16 ±0.14) before operation,but there was no statistical difference between the two groups (all P ＞0.05);whereas there was no significant change in the IOP of group A and B at 6 months after operation (1 kPa =7.5 mmHg) and before operation [(14.22 ±6.00) mmHg vs.(15.70 ± 5.70) mmHg)] (all P ＞ 0.05).Moreover,corneal endothelial cell counts in group A [(1486 ±718) cells · mm-2] and B [(1246 ±516)cells · mm-2] were significantly smaller than those before operation [(2498 ±564)cells · mm-2 vs.[(2424 ± 640) cells · mm-2],with no significant difference (P=0.091).The postoperative diameter of the pupil in group A [(4.00 ±0.88) mm] and group B [(4.70 ± 1.57) mm] after operation was larger than that in group A [(2.30 ±0.35)mm] and group B [(1.94 ±0.50)mm] before operation,and there was no statistical difference between the two groups (all P ＞0.05).Conclusions OASIS iris expander can help to dilate and hold pupils and does not affect the postoperative visual acuity and intraocular pressure in mlcrocoria cataract phacoemulsification.The postoperative pupils become larger,and it is necessary to pay attention to protect corneal endothelial cell during usage of OASIS iris expander.

Correlation between wavefront aberrations and myopia progression in school-age myopia / 眼科新进展

Objective To investigate the correlation of wavefront aberration and myopic development in school-age children.Methods Together 150 school-age children (300 eyes) in Beijing city were collected and underwent cycloplegic refractometry for detect the refraction status and Allegretto wavefront aberrometry for the measurement of wavefront aberration for 1-year follow up.Results Totally 132 children were successfully followed up and only 120 children were included in this study.The average increased diopter was (0.74 ± 0.55) D.It was found that the development of myopia was correlated with age,myopic duration and the baseline diopter (all P ＜ 0.01),and the wavefront aberration was correlated with age (P ＜ 0.05).There were significant difference in the third order RMS value and C7 (coma) between the myopic children with rapid progress and slow progress.C12 (spherical aberration) was significantly correlated with the change of diopter (P ＜ 0.05).Conclusion Both third order RMS and C7 (coma) may be the major contributors for myopia progress in school-age children,and the increased diopter may polarize the spherical aberration toward minus values.

Utility of endovascular simulation to improve technical performance and stimulate interest of medical students in vascular surgery / 基础医学与临床

Objective To determine whether endovascular simulation training in medical students may increase technical proficiency,enhance interest in vascular surgery. Methods We recruited 30 medical students from Pe-king Union Medical College prospectively. We gave these students an eight-week course with a structured curricu-lum comprised of weekly simulator sessions and theoretical lessons. A test of iliac artery balloon dilatation was con-ducted in pre-and post-course. Performance was assessed. Demographics and subjective survey data,including in-terest in vascular surgery were obtained pre-and post-course from the students too. Results Parameters measured on the standardized global endovascular rating scale,including angiography skills,wire handling and interventional criteria as well as simulator-generated metrics such as fluoroscopy time and volume of contrast used significantly im-proved from pre-to post-course values for the medical students(P<0.05) All the students agreed or strongly agreed that the simulation course increased their interest in vascular surgery. Conclusions A simulation-based endovascu-lar course improves technical performance with interest in vascular surgery training of medical students. The simula-tor is quite potential in the medical students training.

Micro-dissection testicular sperm extraction for non-obstructive azoospermia patients with the history of secondary testicular injury / 中华男科学杂志

<p><b>Objective</b>To investigate the value of micro- dissection testicular sperm extraction (micro-TESE) in the treatment of non-obstructive azoospermia (NOA) in patients with the history of secondary testicular injury.</p><p><b>METHODS</b>Totally, 121 NOA patients with the history of secondary testicular injury underwent micro-TESE in our hospital from September 2014 to December 2017. We analyzed the correlation of the sperm retrieval rate with the causes of testicular injury and compared the outcomes of the ICSI cycles with the sperm retrieved from the NOA males by micro-TESE (the micro-TESE group) and those with the sperm ejaculated from severe oligospermia patients (sperm concentration <1×10⁶/ml, the ejaculate group). Comparisons were also made between the two groups in the female age, two-pronucleus (2PN) fertilization rate, transferrable embryos on day 3 (D3), D3 high- quality embryos, D14 blood HCG positive rate, embryo implantation rate, and clinical pregnancy rate.</p><p><b>RESULTS</b>Testicular sperm were successfully retrieved by micro-TESE in 86.0% of the patients (104/121), of whom 98.4% had the history of orchitis, 75.5% had been treated surgically for cryptorchidism, and 63.6% had received chemo- or radiotherapy. No statistically significant differences were observed between the micro-TESE and ejaculate groups in the 2PN fertilization rate (59.4% vs 69.3%, P > 0.05), D14 blood HCG positive rate (44.6% vs 57.9%, P > 0.05), embryo implantation rate (31.8 %% vs 32.6%, P > 0.05) and clinical pregnancy rate (41.5% vs 48.7%, P > 0.05). However, the rate D3 transferrable embryos was significantly lower in the micro-TESE than in the ejaculate group (40.5% vs 52.2%,P < 0.05), and so was that of D3 high-quality embryos (32.5% vs 42.1%, P < 0.05).</p><p><b>CONCLUSIONS</b>Micro-TESE can be applied as the first choice for NOA patients with the history of secondary testicular injury, but more effective strategies are to be explored for the improvement of ICSI outcomes with the sperm retrieved by micro- TESE.</p>

Direct sampling introduction and atomic fluorescence spectrometry for determination of selenium content in mice liver and urine / 中华地方病学杂志

Objective Through determination of selenium content in liver and urine of selenium-induced mice, direct sampling atomic fluorescence spectrometry was established to provide a more accurate and convenient determination method for detection of selenium-related biological samples. Methods Selenium in the sample was released by the electrically heated quartz tube,the selenium in the atomic state was captured by the quartz tube,and the selenium released by the heating quartz tube was carried by the argon-hydrogen mixed gas into the argon-argon flame atomic fluorescence detector for determination; standard curve was established based on selenium content and fluorescence area, and then the content of selenium in the sample was calculated. Results The detection limit of selenium in samples by direct sampling atomic fluorescence spectrometry was 0.28 μg/kg, the correlation coefficient of standard curve was 0.999 3, and the relative standard deviation range was 1.82% - 4.19%. The adding standard recovery of the liver in mice was 87.30%- 100.20%; meanwhile the adding standard recovery of the urine in mice was 93.10% - 96.60%. Conclusions Direct sampling atomic fluorescence method is simple and easy to operate, accuracy and precision are better, the linear range is wide. The samples need not be processed by complex pretreatment,such as acid,etc.,elements loss is avoided and efficiency of detection is improved.The method can be used in a variety of samples for rapid detection of trace selenium.

Impact of Different Hospitals on Reperfusion Time in Acute ST-segment Elevation Myocardial Infarction Patients from Regional Cooperative Chest Pain Center / 中国循环杂志

Objective:To investigate the impact of different hospitals on reperfusion time in acute ST-segment elevation myocardial infarction (STEMI) patients from regional cooperative chest pain center (CPC).Methods:A total of 364 STEMI patients received percutaneous coronary intervention (PCI) at 18 months before and after CPC establishment were enrolled.Based on hospital levels,the patients were divided into 2 groups:Initial PCI hospital group,n=197 and Initial non-PCI hospital group,n=167.According to hospital visiting time,Initial PCI hospital group was further divided into 2 subgroups as Green channel subgroup,n=91 and CPC subgroup,n=106;Initial non-PCI hospital group was further divided into 2 subgroups as Routine referral subgroup,n=71 and CPC referral subgroup,n=96.Total ischemia time,from onset to first medical contact (S-FMC) time,from S-FMC to balloon dilatation (FMC2B) time,from hospital visit to balloon dilatation (D2B) time were compared among relevant patients;the impact factors for total ischemia time were studied by multivariate regression analysis.Results:Compared with Routine referral subgroup,the following parameters were shortened in CPC referral subgroup:total ischemia time 325 (236,1185) min vs 367 (214,1340) min,P＜0.05;FMC2B time 115 (82,227) min vs 149 (94,483) min,P＜0.05;D2B time 69 (35,195) min vs 105 (55,260) min,P＜0.05.Compared with CPC referral subgroup,the following parameters were further shortened in Initial PCI hospital group:total ischemia time 283 (168,873) min vs 325 (236,1185) min,P＜0.05;FMC2B time 78 (45,265) min vs 115 (82,227) min,P＜0.05.Multivariate linear regression analysis presented that high school or above education (β=-0.117,P=0.047),arrived PCI hospital within 60 min of onset (β=-0.243,P=0.000)and using initial PCI hospital (β=-0.175,P=0.000) were the independent impact factors for total ischemia time in STEMI patients.Conclusion:Regional cooperative CPC may shorten FMC2B time by patients' referral;visiting PCI hospital within 60 min of onset was the best way to reduce total isehemia time in STEMI patients.

Impact of Different Hospitals on Reperfusion Time in Acute ST-segment Elevation Myocardial Infarction Patients from Regional Cooperative Chest Pain Center / 中国循环杂志

Objective:To investigate the impact of different hospitals on reperfusion time in acute ST-segment elevation myocardial infarction (STEMI) patients from regional cooperative chest pain center (CPC).Methods:A total of 364 STEMI patients received percutaneous coronary intervention (PCI) at 18 months before and after CPC establishment were enrolled.Based on hospital levels,the patients were divided into 2 groups:Initial PCI hospital group,n=197 and Initial non-PCI hospital group,n=167.According to hospital visiting time,Initial PCI hospital group was further divided into 2 subgroups as Green channel subgroup,n=91 and CPC subgroup,n=106;Initial non-PCI hospital group was further divided into 2 subgroups as Routine referral subgroup,n=71 and CPC referral subgroup,n=96.Total ischemia time,from onset to first medical contact (S-FMC) time,from S-FMC to balloon dilatation (FMC2B) time,from hospital visit to balloon dilatation (D2B) time were compared among relevant patients;the impact factors for total ischemia time were studied by multivariate regression analysis.Results:Compared with Routine referral subgroup,the following parameters were shortened in CPC referral subgroup:total ischemia time 325 (236,1185) min vs 367 (214,1340) min,P＜0.05;FMC2B time 115 (82,227) min vs 149 (94,483) min,P＜0.05;D2B time 69 (35,195) min vs 105 (55,260) min,P＜0.05.Compared with CPC referral subgroup,the following parameters were further shortened in Initial PCI hospital group:total ischemia time 283 (168,873) min vs 325 (236,1185) min,P＜0.05;FMC2B time 78 (45,265) min vs 115 (82,227) min,P＜0.05.Multivariate linear regression analysis presented that high school or above education (β=-0.117,P=0.047),arrived PCI hospital within 60 min of onset (β=-0.243,P=0.000)and using initial PCI hospital (β=-0.175,P=0.000) were the independent impact factors for total ischemia time in STEMI patients.Conclusion:Regional cooperative CPC may shorten FMC2B time by patients' referral;visiting PCI hospital within 60 min of onset was the best way to reduce total isehemia time in STEMI patients.

Analysis of Factors Associated with Death in Maintenance Hemodialysis Patients: A Multicenter Study in China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Patients on hemodialysis have a high-mortality risk. This study analyzed factors associated with death in patients on maintenance hemodialysis (MHD). While some studies used baseline data of MHD patients, this study used the most recent data obtained from patients just prior to either a primary endpoint or the end of the study period to find the characteristics of patients preceding death.</p><p><b>METHODS</b>Participants were selected from 16 blood purification centers in China from January 2012 to December 2014. Patients' data were collected retrospectively. Based on survival status, the participants were divided into two groups: survival group and the death group. Logistic regression analysis was performed to determine factors associated with all-cause mortality.</p><p><b>RESULTS</b>In total, 4104 patients (57.58% male, median age 59 years) were included. Compared with the survival group, the death group had more men and more patients with diabetic nephropathy (DN) and hypertensive nephropathy. The patients preceding death also had lower levels of diastolic blood pressure, hemoglobin, serum albumin, serum calcium, serum phosphate, Kt/V, and higher age. Multivariate analysis revealed that male sex (odd ratio [OR]: 1.437, 95% confidence interval [CI]: 1.094-1.886), age (OR: 1.046, 95% CI: 1.036-1.057), and presence of DN (OR: 1.837, 95% CI: 1.322-2.552) were the risk factors associated with mortality. High serum calcium (OR: 0.585, 95% CI: 0.346-0.989), hemoglobin (OR: 0.974, 95% CI: 0.967-0.981), albumin (OR: 0.939, 95% CI: 0.915-0.963) levels, and dialysis with noncuffed catheter (OR: 0.165, 95% CI: 0.070-0.386) were protective factors based on a multivariate analysis.</p><p><b>CONCLUSIONS</b>Hemodialysis patients preceding death had lower hemoglobin, albumin, and serum calcium levels. Multivariate analysis showed that male sex, age, DN, low hemoglobin, low albumin, and low serum calcium were associated with death in hemodialysis patients.</p>

An evaluation of coordination relationships during earthquake emergency rescue using entropy theory / Uma avaliação das relações de coordenação durante operações de resgate após terremoto utilizando a teoria da entropia / Relación de coordinación en rescates de emergencia tras terremotos, usandola teoría de la entropía

Emergency rescue after an earthquake is complex work which requires the participation of relief and social organizations. Studying earthquake emergency coordination efficiency can not only help rescue organizations to define their own rescue missions, but also strengthens inter-organizational communication and collaboration tasks, improves the efficiency of emergency rescue, and reduces loss. In this paper, collaborative entropy is introduced to study earthquake emergency rescue operations. To study the emergency rescue coordination relationship, collaborative matrices and collaborative entropy functions are established between emergency relief work and relief organizations, and the collaborative efficiency of the emergency rescue elements is determined based on this entropy function. Finally, the Lushan earthquake is used as an example to evaluate earthquake emergency rescue coordination efficiency.

O resgate de emergência após terremoto é um trabalho complexo que exige a participação das organizações sociais e de ajuda. O estudo da eficiência da coordenação do resgate emergencial não apenas ajuda as organizações a definirem suas próprias missões de resgate, como também fortalece a comunicação entre as organizações e as tarefas de colaboração, além de melhorar a eficiência do trabalho de resgate e reduzir as perdas. O artigo usa a entropia colaborativa como base para estudar o trabalho de resgate emergencial após terremoto. Para estudar a relação de coordenação do resgate emergencial, são estabelecidas matrizes colaborativas e funções entrópicas colaborativas entre a ajuda de emergência e as organizações de ajuda; a eficiência colaborativa dos elementos de resgate emergencial é determinada com base nessa função de entropia. Finalmente, o terremoto de Lushan no sudoeste da China é usado como exemplo para avaliar a eficiência da coordenação do resgate emergencial após terremoto.

El rescate de emergencia tras un terremoto es un trabajo complejo que requiere la participación de organizaciones sociales y especializadas en socorro. Estudiar la eficiencia en la coordinación de emergencia tras un terremoto, no sólo ayuda a las organizaciones destinadas al rescate en la definición de sus propias misiones de rescate, sino que también fortalece la comunicación interorganizacional y las tareas de colaboración, mejorando la eficiencia en el rescate de emergencia y reduciendo pérdidas. En este trabajo, se introduce la entropía colaborativa para estudiar las operaciones de rescate tras un terremoto; con el fin analizar la relación de coordinación en los rescates de emergencia, estudiar la relación de coordinación en los mismos, donde se establecen matrices colaborativas y funciones de entropía colaborativas entre el trabajo de las organizaciones de socorro y sociales, y donde la eficiencia colaborativa de los elementos de rescate está determinante basada en esta función de entropía. Finalmente, el terremoto de Lushan se usa como ejemplo para evaluar la eficiencia en la coordinación de un rescate de emergencia tras un terremoto.