Application value of new assistive technology in keratopathy-associated cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

Keratopathy-associated cataract, that is, on the basis of corneal disease, and later the development of lens opacity, seriously damage visual quality. In order to avoid corneal transplantation for some patients, partial visual quality can be restored. A comprehensive and accurate evaluation of the effect of corneal opacity on visual function is of great improtance for determining cataract surgery alone. Due to the opacity of the cornea, the operation is very difficult and challenging. Therefore, it is of clinical value to develop and use new assistive technologies, including capsule staining, endoillumination, pupil dialation technology, femtosecond laser assisted technology, etc., avoiding problems such as limited visibility and decreased light flow caused by corneal opacity and facilitating cataract surgery. This article reviews progress of assistive technologies for keratopathy-associated cataract, hoping to guide clinical application.

Moxibustion improves experimental colitis in rats with Crohn's disease by regulating bile acid enterohepatic circulation and intestinal farnesoid X receptor / 中西医结合学报

OBJECTIVE@#This study was conducted to explore the mechanism of intestinal inflammation and barrier repair in Crohn's disease (CD) regulated by moxibustion through bile acid (BA) enterohepatic circulation and intestinal farnesoid X receptor (FXR).@*METHODS@#Sprague-Dawley rats were randomly divided into control group, CD model group, mild moxibustion group and herb-partitioned moxibustion group. CD model rats induced by 2,4,6-trinitrobenzene sulfonic acid were treated with mild moxibustion or herb-partitioned moxibustion at Tianshu (ST25) and Qihai (CV6). The changes in CD symptoms were rated according to the disease activity index score, the serum and colon tissues of rats were collected, and the pathological changes in colon tissues were observed via histopathology. Western blot, immunohistochemistry (IHC) and immunofluorescence were used to evaluate the improvement of moxibustion on intestinal inflammation and mucosal barrier in CD by the BA-FXR pathway.@*RESULTS@#Mild moxibustion and herb-partitioned moxibustion improved the symptoms of CD, inhibited inflammation and repaired mucosal damage to the colon in CD rats. Meanwhile, moxibustion could improve the abnormal expression of BA in the colon, liver and serum, downregulate the expression of interferon-γ and upregulate the expression of FXR mRNA, and inhibit Toll-like receptor 4 (TLR4) and myeloid differentiation factor 88 (MyD88) mRNA. The IHC results showed that moxibustion could upregulate the expression of FXR and mucin2 and inhibit TLR4 expression. Western blot showed that moxibustion inhibited the protein expression of TLR4 and MyD88 and upregulated the expression of FXR. Immunofluorescence image analysis showed that moxibustion increased the colocalization sites and intensity of FXR with TLR4 or nuclear factor-κB p65. In particular, herb-partitioned moxibustion has more advantages in improving BA and upregulating FXR and TLR4 in the colon.@*CONCLUSION@#Mild moxibustion and herb-partitioned moxibustion can improve CD by regulating the enterohepatic circulation stability of BA, activating colonic FXR, regulating the TLR4/MyD88 pathway, inhibiting intestinal inflammation and repairing the intestinal mucosal barrier. Herb-partitioned moxibustion seems to have more advantages in regulating BA enterohepatic circulation and FXR activation. Please cite this article as: Shen JC, Qi Q, Han D, Lu Y, Huang R, Zhu Y, Zhang LS, Qin XD, Zhang F, Wu HG, Liu HR. Moxibustion improves experimental colitis in rats with Crohn's disease by regulating bile acid enterohepatic circulation and intestinal farnesoid X receptor. J Integr Med. 2023; 21(2): 194-204.

Effects of patent ductus arteriosus on bronchopulmonary dysplasia in very low birth weight preterm infants / 中国新生儿科杂志

Objective:To study the effects of patent ductus arteriosus (PDA) on bronchopulmonary dysplasia (BPD) in very low birth weight preterm infants (VLBWIs).Methods:From January 2018 to December 2020,VLBWIs hospitalized in NICU of our hospital were retrospectively analyzed.They were assigned into BPD group and non-BPD group according to whether BPD occurred. Clinical data including the severity of BPD , the diameter and duration of PDA and ibuprofen usage were analyzed. The predictive values of PDA diameter and duration for BPD were calculated using area under curve (AUC) of receiver operating characteristic curve (ROC) analysis.Results:A total of 173 VLBWIs were enrolled, including 42 in the BPD group and 131 in the non-BPD group. The incidence of hemodynamically significant PDA (hsPDA) in the BPD group was significantly higher than the non-BPD group (45.2% vs. 22.1%, P=0.001).hsPDA ( OR=2.806, 95% CI 1.307-5.745, P=0.005), PDA diameter ≥1.5 mm ( OR=7.003, 95% CI 1.323-48.884, P<0.001) and PDA duration >1 w ( OR=7.754, 95% CI 1.203-49.989, P=0.031) were all risk factors for BPD.As for the severity of BPD, hsPDA, PDA diameter ≥1.5 mm, PDA duration >1 w and FiO 2max >30% within 72 h after birth were risk factors for grade Ⅱ~Ⅲ BPD. The incidence of ibuprofen usage was significantly higher in grade Ⅱ~Ⅲ BPD group. If the diameter of PDA was 1.25 mm, the AUC was 0.806 (95% CI 0.706-0.906, P<0.001), sensitivity 82.6% and specificity 68.7% for grade Ⅱ~Ⅲ BPD. If the PDA duration was 10.5 d, the AUC was 0.821 (95% CI 0.718-0.925, P<0.001), sensitivity 65.2% and specificity 91.3%. Conclusions:hsPDA, larger PDA diameter and longer PDA duration are risk factors for the occurrence and severity of BPD in VLBWIs.

Comparison of safety and effectiveness of active migration technique and in situ lithotripsy technique in the treatment of 1-2 cm upper ureteral calculi by flexible ure-teroscopy / 北京大学学报(医学版)

OBJECTIVE@#To compare the safety and effectiveness of active migration technique and in situ lithotripsy technique in the treatment of 1-2 cm upper ureteral calculi by retrograde flexible ureteroscopy.@*METHODS@#A total of 90 patients with 1-2 cm upper ureteral calculi treated in the urology department of Beijing Friendship Hospital from August 2018 to August 2020 were selected as the subjects. The patients were divided into two groups using random number table: 45 patients in group A were treated with in situ lithotripsy and 45 patients in group B were treated with active migration technique. The active migration technique was to reposition the stones in the renal calyces convenient for lithotripsy with the help of body position change, water flow scouring, laser impact or basket displacement, and then conduct laser lithotripsy and stone extraction. The data of the patients before and after operation were collected and statistically analyzed.@*RESULTS@#The age of the patients in group A was (51.6±14.1) years, including 34 males and 11 females. The stone diameter was (1.48±0.24) cm, and the stone density was (897.8±175.9) Hu. The stones were located on the left in 26 cases and on the right in 19 cases. There were 8 cases with no hydronephrosis, 20 cases with grade Ⅰ hydronephrosis, 11 cases with grade Ⅱ hydronephrosis, and 6 cases with grade Ⅲ hydronephrosis. The age of the patients in group B was (51.8±13.7) years, including 30 males and 15 females. The stone diameter was (1.52±0.22) cm, and the stone density was (964.6±214.2) Hu. The stones were located on the left in 22 cases and on the right in 23 cases. There were 10 cases with no hydronephrosis, 23 cases with grade Ⅰ hydronephrosis, 8 cases with grade Ⅱ hydronephrosis, and 4 cases with grade Ⅲ hydronephrosis. There was no significant diffe-rence in general parameters and stone indexes between the two groups. The operation time of group A was (67.1±16.9) min and the lithotripsy time was (38.0±13.2) min. The operation time of group B was (72.2±14.8) min and the lithotripsy time was (40.6±12.6) min. There was no significant difference between the two groups. Four weeks after operation, the stone-free rate in group A was 86.7%, and in group B was 97.8%. There was no significant difference between the two groups. In terms of complications, 25 cases of hematuria, 16 cases of pain, 10 cases of bladder spasm and 4 cases of mild fever occurred in group A. There were 22 cases of hematuria, 13 cases of pain, 12 cases of bladder spasm and 2 cases of mild fever in group B. There was no significant difference between the two groups.@*CONCLUSION@#Active migration technique is safe and effective in the treatment of 1-2 cm upper ureteral calculi.

Relaxation effects on fatigue and physical fitness in badminton athletes / Efeitos do relaxamento na fadiga e aptidão física em atletas de badminton / Efectos de la relajación sobre la fatiga y la aptitud física en atletas de bádminton

ABSTRACT Introduction: Badminton is characterized by a high amount of exercise and high intensity of work. Muscle pain and discomfort often occur throughout the game, so some relaxation training is necessary. Objective: Study the effect of relaxation training on recovery from sports fatigue and fitness recovery during badminton. Methods: Badminton training was conducted three times a week. The duration of the exercises of the experimental and control group students was the same. The experimental group adopted the relaxation training form, including stretching, aerobic, and other relaxation actions. The duration of relaxation training was 15 minutes, while the control group continued to use the traditional relaxation method. Results: Lactate in the experimental group showed a continuous downward trend, from 2.09 to 1.93 and then to 1.62; heart rate increased from 84.73 to 85.48, then decreased to 81.57, and finally increased to 85.62. The optimization effect was greater than in the control group. In the experimental group, the speed and strength of the athletes improved considerably. Conclusion: Relaxation training can improve athletes' fatigue, promoting body development and improving strength and speed in physical fitness. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O Badminton tem como características uma alta quantidade de exercícios e uma elevada intensidade de trabalho. A dor muscular e o desconforto ocorrem frequentemente durante todo o jogo, portanto, algum treinamento de relaxamento é necessário. Objetivo: Estudar o efeito do treinamento de relaxamento sobre a recuperação da fadiga esportiva e a recuperação da aptidão física durante a prática de badminton. Métodos: O treinamento no badminton foi realizado três vezes por semana. A duração dos exercícios dos alunos do grupo experimental e do grupo de controle foi a mesma. O grupo experimental adotou a forma de treinamento de relaxamento, incluindo alongamento, aeróbico e outras ações de relaxamento. A duração do treinamento de relaxamento foi de 15 minutos, enquanto o grupo de controle continuou a usar o método tradicional de relaxamento. Resultados: O ácido láctico no grupo experimental apresentou uma tendência contínua de queda, de 2,09 para 1,93 e depois para 1,62; a frequência cardíaca aumentou de 84,73 para 85,48, e em seguida diminuiu para 81,57, e finalmente aumentou para 85,62. O efeito de otimização foi superior ao do grupo de controle. No grupo experimental, a velocidade e a força dos atletas melhoraram consideravelmente. Conclusão: O treinamento de relaxamento pode melhorar a fadiga dos atletas, promovendo o desenvolvimento do corpo e melhorando a força e velocidade na preparação física. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El bádminton tiene como características una gran cantidad de ejercicio y una elevada intensidad de trabajo. A menudo se producen dolores y molestias musculares a lo largo del partido, por lo que es necesario realizar algún entrenamiento de relajación. Objetivo: Estudiar el efecto del entrenamiento de relajación en la recuperación de la fatiga deportiva y la recuperación de la forma física durante el bádminton. Métodos: El entrenamiento en bádminton se realizó tres veces por semana. La duración de los ejercicios de los alumnos del grupo experimental y del grupo de control fue la misma. El grupo experimental adoptó la forma de entrenamiento de relajación que incluía estiramientos, ejercicios aeróbicos y otras acciones de relajación. La duración del entrenamiento de relajación fue de 15 minutos, mientras que el grupo de control siguió utilizando el método de relajación tradicional. Resultados: El ácido láctico en el grupo experimental mostró una tendencia descendente continua, de 2,09 a 1,93 y luego a 1,62; la frecuencia cardíaca aumentó de 84,73 a 85,48, luego descendió a 81,57 y finalmente aumentó a 85,62. El efecto de optimización fue mayor que en el grupo de control. En el grupo experimental, la velocidad y la fuerza de los atletas mejoraron considerablemente. Conclusión: El entrenamiento de relajación puede mejorar la fatiga de los atletas, favoreciendo el desarrollo corporal y mejorando la fuerza y la velocidad en el acondicionamiento físico. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Relaxation training effects on the muscular and technical level of athletes / Efeitos do treinamento de relaxamento a nível muscular e técnico dos atletas / Efectos del entrenamiento de relajación en el nivel muscular y técnico de los deportistas

ABSTRACT Introduction The current teaching of athletes focuses mainly on gaining their skills, often neglecting the beneficial impacts of relaxation on the overall physical quality of its students. Therefore, clarifying the relationship between muscle relaxation training and athletic performance is important. Objective Explore the effect of relaxation training on running athletes' technical and muscular levels. Methods A comparative experiment was conducted on 40 male and female runners, randomly divided into two groups. Before training, the athletes in the experimental group received relaxation training through the breath regulation method, muscle relaxation method, and independent training method, with 60 minutes in each session, for 6 months. Results Based on the assumption that there was no significant difference in the initial physical indices, the athletes in the experimental group performed better in 100m, 200m, and 300m than those in the control group, and the difference between the two groups was significant (P < 0.05). Conclusion Adequate relaxation training positively affects athletes' muscular endurance and technical level. Therefore, an adequate increase in relaxation training is shown to be conducive in improving the overall physical quality and competitive level of athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O ensino atual dos atletas foca-se principalmente no ganho de suas habilidades, negligenciando muitas vezes os impactos benéficos do relaxamento na qualidade física geral de seus alunos. Portanto, é de grande importância esclarecer a relação entre o treinamento de relaxamento muscular e o desempenho atlético. Objetivo Explorar o efeito do treinamento de relaxamento sobre o nível técnico e muscular dos atletas de corrida. Métodos Uma experiência comparativa foi realizada em 40 corredores masculinos e femininos, divididos aleatoriamente em dois grupos. Antes do treinamento, os atletas do grupo experimental receberam treinamento de relaxamento através do método de regulação da respiração, método de relaxamento muscular e método de treinamento independente, com um total de 60 minutos de duração em cada sessão, por 6 meses. Resultados Partindo da premissa de que não houve diferença significativa nos índices físicos iniciais, os atletas do grupo experimental tiveram melhor desempenho em 100m, 200m e 300m do que os do grupo controle, e a diferença entre os dois grupos foi significativa (P < 0,05). Conclusão O treinamento de relaxamento adequado tem um efeito positivo sobre a resistência muscular e o nível técnico dos atletas. Portanto, o aumento adequado do treinamento de relaxamento mostra-se propício na melhoria da qualidade física geral e no nível competitivo dos atletas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La enseñanza actual de los deportistas se centra principalmente en la ganancia de sus habilidades, descuidando muchas veces los impactos beneficiosos de la relajación en la calidad física general de sus alumnos. Por lo tanto, es de gran importancia aclarar la relación entre el entrenamiento de relajación muscular y el rendimiento deportivo. Objetivo Explorar el efecto del entrenamiento de relajación en el nivel técnico y muscular de los atletas que corren. Métodos Se realizó un experimento comparativo con 40 corredores masculinos y femeninos, divididos aleatoriamente en dos grupos. Antes del entrenamiento, los atletas del grupo experimental recibieron un entrenamiento de relajación mediante el método de regulación de la respiración, el método de relajación muscular y el método de entrenamiento independiente, con una duración total de 60 minutos en cada sesión, durante 6 meses. Resultados Partiendo de la base de que no había diferencias significativas en los índices físicos iniciales, los atletas del grupo experimental obtuvieron mejores resultados en 100m, 200m y 300m que los del grupo de control, y la diferencia entre los dos grupos fue significativa (P < 0,05). Conclusión Un entrenamiento de relajación adecuado tiene un efecto positivo en la resistencia muscular y el nivel técnico de los atletas. Por lo tanto, el aumento adecuado del entrenamiento de relajación se muestra propicio para mejorar la calidad física general y el nivel competitivo de los deportistas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

History and Pharmacological Mechanism of Gastric Acid-suppressive Drugs

Gastric acid-related disorders are commonly encountered in clinical practice. Acetylcholine, gastrin, and histamine are physiological agonists that stimulate acid secretion from parietal cells. Histamine plays a decisive role in the transformation of parietal cells into acid-secreting forms. The H+, K+- ATPase proton pump, which represents the final step of acid secretion, translocates from cytoplasmic tubulovesicles to secretory canaliculi upon parietal cell stimulation and facilitates exchange of intracellular H+ with extracellular K+ in a 1:1 ratio. Histamine-2 receptor antagonists and proton pump inhibitors (PPIs) are widely used in clinical practice, and potassium-competitive acid blockers (P-CABs) have gained attention in recent times. P-CABs address the unmet needs of patients who receive conventional PPIs and have broadened the spectrum of drug choices; however, further research is warranted to confirm long-term safety of these drugs. Comprehensive understanding of the mechanisms of actions, characteristics, advantages and disadvantages, and the adverse effect profile is essential for appropriate prescription of gastric acid-suppressive drugs. In this review, we provide a developing history and outline the pharmacological mechanisms underlying various gastric acid-suppressive drugs used in clinical settings.

Diagnostic value of 18F-PSMA-1007 PET/CT in seminal vesicle invasion of prostate cancer / 中华核医学与分子影像杂志

Objective:To evaluate the diagnostic value of the 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT in seminal vesicle invasion (SVI) of prostate cancer. Methods:Clinical and pathological materials of 88 patients (age: 51-84 years) who underwent radical prostatectomy (RP) between May 2019 and December 2021 in the First Affiliated Hospital of Xi′an Jiaotong University were analyzed retrospectively. All patients underwent 18F-PSMA-1007 PET/CT examination for primary staging before surgery. The diagnostic efficiency of 18F-PSMA-1007 PET/CT in SVI was obtained using postoperative pathological results as the " gold standard" and ROC curve was drawn. Furthermore, univariate and multivariate logistic regression analyses were used to screen the influencing factors for 18F-PSMA-1007 PET/CT prediction of SVI. Results:The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 18F-PSMA-1007 PET/CT in diagnosing SVI were 79.55%(70/88), 72.73%(16/22), 81.82%(54/66), 57.14%(16/28) and 90.00%(54/60), respectively. The ROC AUC was 0.77. Results of univariate logistic regression showed that total prostate specific antigen (tPSA), primary SUV max, Gleason score, International Society of Urological Pathology (ISUP) grade group were associated with 18F-PSMA-1007 PET/CT prediction of SVI. Results of multivariate logistic regression showed that Gleason score (odds ratio ( OR)=2.04, 95% CI: 1.19-3.50, P=0.009) was a predictor of SVI in prostate cancer. Conclusion:18F-PSMA-1007 PET/CT has certain diagnostic value in SVI of prostate cancer, and combining with Gleason score can improve the diagnostic efficiency.

The characteristics of nutritional intake and bone metabolism in preterm infants with very low birth weight and small gestational age / 中国新生儿科杂志

Objective:To study the differences in nutritional intake and bone metabolism between small gestational age infant (SGA) and appropriate gestational age infant (AGA) in very low birth weight (VLBW) preterm infants.Methods:From January 2015 to January 2020, infants admitted to the neonatal intensive care unit of our hospital immediately after birth and survived more than 4 weeks were retrospectively studied. The infants with GA<32 weeks, BW<1 500 g and small for gestational age were assigned into SGA group. Each SGA group infants were paired with an AGA infants The perinatal history was reviewed. Serum total calcium, blood phosphorus, blood magnesium, alkaline phosphatase and other nutritional intake indicators in the blood biochemistry were examined at 1 w, 2 w and 4 w after birth. SPSS 22.0 statistical software was used to analyze the relationship between nutritional intake and bone metabolism indexes.Results:A total of 80 cases were included in SGA group and AGA group, respectively. No significant difference existed in the incidence of hypophosphatemia within 2w after birth between the two groups ( P>0.05). SGA group had significantly lower incidence of hypophosphatemia at 4w than AGA group [36.3% (29/80 ) vs. 56.3% (45/80)]( P<0.05). SGA group showed significantly higher proportion of ALP>500 U/L cases than AGA group at 2 w and 4 w [16.3% (13/80) vs. 1.3% (1/80), 21.3% (17/80) vs. 2.5% (2/80)]( P<0.05). The two groups had similar serum magnesium level ( P>0.05). SGA group had higher incidence of delayed milk feeding [67.5% (54/80) vs. 26.2% (21/80)], longer parenteral nutrition duration [(49.4±14.4)d vs. (40.5±18.2)d] and slower increase of calorie intake and enteral nutrition than AGA group ( P<0.05). Conclusions:Among VLBW preterm infants, SGA infants have worse nutritional intake than AGA and are more vulnerable to abnormal bone metabolism.

Role of inflammation and apoptosis in right ventricular dysfunction induced by injurious mechanical ventilation in rats / 中华危重病急救医学

Objective:To investigate whether myocardial inflammation and apoptosis are involved in right ventricular dysfunction (RVD) induced by injurious mechanical ventilation with high tidal volume (VT) in rats.Methods:Total 30 adult male SD rats were randomly divided into the control group (CON group), the low VT ventilation group (LVT group) and the injurious mechanical ventilation group (HVT group), with 10 rats in each group. The CON group was maintained spontaneous breathing, the LVT group and HVT group were ventilated with different VT 6 mL/kg and 20 mL/kg for 4 hours, respectively. The right jugular vein and the left carotid artery were catheterized and connected with the PowerLab biological signal acquisition and analysis system to record heart rate (HR), mean arterial pressure (MAP), right ventricular systolic pressure (RVSP), the maximum rate of rising of right ventricular pressure (+dp/dt max). Echocardiography was performed to measure left ventricular end-diastolic diameter (LVEDd), right ventricular end-diastolic diameter (RVEDd), tricuspid annulus plane systolic migration (TAPSE) and myocardial performance index (MPI). The rats were sacrified by cervical dislocation. Specimens of right ventricle tissues were taken for hematoxylin-eosin (HE) staining, and morphological changes of right ventricle tissues were observed under light microscope. Real time reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting were used to detect the mRNA and protein expressions of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), caspase-3, apoptosis-related proteins Bax and Bcl-2.Results:HR, MAP, +dp/dt max gradually decreased, while RVSP gradually increased in different group with the increase of VT ventilation. There was no significant difference between the CON group and LVT group. However, there was a statistically significant difference with respect to these index in HVT group as compared to CON group and LVT group [HR (bpm): 397.6±5.7 vs. 433.0±4.8, 441.6±7.8; MAP (mmHg, 1 mmHg≈0.133 kPa): 102.0±2.4 vs. 108.5±2.2, 110.6±2.1; +dp/dt max (mmHg/s): 2 357.65±62.80 vs. 2 661.27±55.62, 2 679.43±75.13; RVSP (mmHg): 28.8±1.0 vs. 22.6±10.8, 21.9±0.4; all P < 0.05]. Echocardiography findings showed that RVEDd/LVEDd and MPI gradually increased, TAPSE gradually decreased in different group with the increase of VT ventilation. There was no significant difference between the LVT group and CON group. However, there was a statistically significant difference with respect to these indexes in HVT group as compared to the CON group and LVT group [RVEDd/LVEDd: 0.36±0.02 vs. 0.26±0.01, 0.23±0.02; MPI: 1.23±0.03 vs. 0.84±0.04, 0.86±0.03; TAPSE (mm): 1.65±0.03 vs. 1.88±0.02, 1.91±0.04; all P < 0.05]. Histopathological observation of the right ventricle tissue showed that myocardial cells of the rats in the CON group were orderly arranged and uniformed in size. In the LVT group, there was a small amount of inflammatory cell infiltration in the myocardial interstitium, while in the HVT group, the myocardial cell arrangement was obviously disordered, the structure was obviously damaged, and more inflammatory cell infiltration was found. RT-PCR and Western blotting analysis showed that the mRNA and protein expressions of IL-6, TNF-α, caspase-3 and Bax in HVT group were significantly higher than those in the LVT group and CON group [mRNA expression (2 -ΔΔCt): IL-6 were 1.97±0.07 vs. 1.09±0.02, 1.02±0.03, TNF-α were 1.69±0.10 vs. 1.10±0.03, 1.05±0.04, caspase-3 were 1.82±0.09 vs. 1.08±0.02, 1.06±0.03, Bax were 2.19±0.14 vs. 1.07±0.03, 1.04±0.03; protein expression (gray value): IL-6 were 0.64±0.02 vs. 0.38±0.03, 0.31±0.04, TNF-α were 0.50±0.04 vs. 0.16±0.01, 0.15±0.01, caspase-3 were 0.58±0.02 vs. 0.29±0.01, 0.25±0.02, Bax were 0.50±0.03 vs. 0.21±0.01, 0.26±0.02; all P < 0.05], and the mRNA and protein expressions of Bcl-2 in the HVT group were lower than those in the LVT group and CON group [mRNA expression (2 -ΔΔCt): 1.23±0.05 vs. 1.43±0.05, 1.50±0.08; protein expression (gray value): 0.42±0.02 vs. 0.62±0.03, 0.65±0.03, all P < 0.05]. Conclusion:Myocardial inflammation and apoptosis may be involved in RVD induced by injurious mechanical ventilation.

Epidemiological characteristics of varicella outbreaks in the Republic of Korea, 2016–2020

Objectives@#We described the trends and epidemiological characteristics of varicella outbreaks from 2016 to 2020 in the Republic of Korea. @*Methods@#We investigated variables such as the outbreak setting, age of patients, vaccination status, and lesion count. The collected data were analyzed with the Cochrane-Armitage trend test and Kruskal-Wallis test. These statistical tests were performed using R ver. 4.0.3. @*Results@#The number of varicella outbreaks increased from 2016 to 2018; however, after a slight decrease in the number of outbreaks in 2019, the number fell sharply in 2020. The median size of outbreaks decreased from 8 to 9 cases during 2016−2019 to 6 cases in 2020. The median duration of outbreaks was 18 days during 2016−2017, 28 days in 2018, 29 days in 2019, and 15 days in 2020. Varicella outbreaks occurred most frequently in elementary schools, and vaccination coverage of patients increased from 89.4% in 2016 to 97.2% in 2019. The median age of patients with outbreak-related varicella decreased from 8 years in 2016 to 6 years in 2020. @*Conclusion@#Significant changes were observed in the age of patients with outbreak-related varicella. Ongoing monitoring of varicella outbreaks should be conducted. Further research will be needed to measure the disease burden of varicella and enable evidence-based policy decisions.

A Study on the Difference of Psychosocial Characteristics and Quality of Life according to the Type of Functional Gastrointestinal Disorder / 정신신체의학

Objectives@#：The purpose of this study is to compare the psychosocial characteristics of patients diagnosed with functional gastrointestinal disorder (FGID) by classifying them into irritable bowel syndrome (IBS), functional dyspepsia (FD), functional constipation (FC), functional heartburn (FH) groups, and overlap group (two or more functional diseases) and to examine the factors associated with the quality of life (QoL) of patients with FGID. @*Methods@#：A total of 144 patients who were diagnosed with FGID were selected as the subjects. The demographical factors were investigated; Korean-Beck Depression Inventory-II (K-BDI-II), Korean-Beck Anxiety Inventory (K-BAI), Korean version of Childhood Trauma Questionnaire (K-CTQ), Multi-dimensional Scale of Perceived Social Support (MSPSS), Korean Version of Connor-Davidson Resilience Scale (K-CD-RISC), and World Health Organization Quality of Life Assessment Instrument Brief Form (WHOQOL-BREF) were used to evaluate the psychosocial factors. @*Results@#：TThe overlap group had a significantly higher K-BDI-II score (F=11.09, p<0.001) and K-BAI score (F=8.93, p<0.001) compared to other groups. In childhood trauma, the IBS patients had a difference in emotional neglect (F=2.54, p=0.04) than the FD patients. The QoL of FGID patients had a negative correlation with depression (r=-0.196, p<0.01), anxiety (r=-0.235, p<0.01), and childhood trauma (r=-0.222, p<0.01), and a positive correlation with social support (r=0.512, p<0.01) and resilience (r=0.581, p<0.01). @*Conclusions@#：Overlap group had a higher level of depression and anxiety, and the IBS patient group had a higher level of emotional neglect than the FD patient group in terms of childhood trauma.

Regulatory effect of mild moxibustion on P2X3 receptors in spinal cord, anterior cingulate cortex and thalamic ventral posterolateral nucleus of rats with IBS visceral hyperalgesia / 针灸推拿医学（英文版）

Objective: To observe the therapeutic effect of mild moxibustion on irritable bowel syndrome (IBS) visceral hyperalgesiamodel rats and its regulatory effect on P2X3 receptors in the spinal cord, anterior cingutate cortex (ACC) and thalamic ventral posterolateral nucleus (VPL). Methods: Thirty 8-day-old newborn rats were randomly divided into a normal group (n=6) and a modeling group (n=24) according to the completely random number table method. Rats in the normal group were bred routinely, and those in the modeling group were subjected to preparing IBS chronic visceral hyperalgesia model using colorectal distention (CRD) in stimulation method. Rats successfully modelled were re-divided into a model group, a mild moxibustion group, a P2X3 receptor antagonist group, and a normal saline group according to the completely random number table method with 6 rats in each group. Rats in each group received corresponding interventions from the 37-day old, once a day for 7 consecutive days. Immunohistochemistry and Western blot assays were used to detect P2X3 protein expressions in the spinal cord, ACC and VPL of rats. Results: Under different intensities of CRD stimulation, the abdominal withdrawal reflex (AWR) scores of the model group were significantly increased versus the normal group (all P<0.05); the AWR scores of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). The P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the model group were significantly increased versus the normal group (all P<0.01); the P2X3 protein expressions in rat spinal cord, ACC and VPL tissues of the mild moxibustion group and the P2X3 receptor antagonist group were significantly reduced versus the model group (all P<0.01). Conclusion: Mild moxibustion can inhibit the P2X3 receptor expressions in the spinal cord, ACC, and VPL tissues of IBS visceral hyperalgesia model rats, which may be the mechanism of mild moxibustion in relieving the central sensitization of rats with IBS visceral hyperalgesia.

Preoperative intravitreal Ranibizumab with panretinal photocoagulation followed by conventional trabeculectomy without drainage device for neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the efficacy and safety of preoperative intravitreal injection of ranibizumab(IVR)and panretinal photocoagulation(PRP)combined with conventional trabeculectomy without drainage device in patients with neovascular glaucoma(NVG).<p>METHODS: The charts of 27 patients(27 eyes)who presented with NVG in our hospital between August 2015 and November 2018 were reviewed. All eyes were treated using the standard protocol of IVR accompanied by PRP, followed by conventional trabeculectomy without drainage device. The main outcomes were intraocular pressure(IOP)control, change in best-corrected visual acuity(BCVA), and surgical complications.<p>RESULTS: The postoperative follow-up periods for all patients were at least 18(mean 21.7±4.3)mo. The IOP significantly decreased from 45.7±5.1 mmHg(baseline)to 18.4±3.6 mmHg(last visit), and BCVA(LogMAR)improved from 2.42±0.68(baseline)to 1.77±0.93(last visit). The success rate was higher in eyes with peripheral anterior synechiae(PAS)≤50% than in those with PAS >50% after 3mo postoperatively. The main surgical complications were hyphema(11.1%)and hypotony with a shallow anterior chamber(14.8%)during the early postoperative stage, along with encapsulated bleb(37.0%)during the mid-late postoperative stage. Serious intraoperative or postoperative complications were not observed.<p>CONCLUSION: IVR and PRP combined with conventional trabeculectomy without drainage device is a safe and effective way in NVG treatment, especially for eyes with PAS ≤50%. Preoperative IVR and PRP appear to improve the success rate.

Safety-II and Resilience Engineering in a Nutshell: An Introductory Guide to Their Concepts and Methods

Background@#Traditional safety concept, which is called Safety-I, and its relevant methods and models have much contributed toward enhancing the safety of industrial systems. However, they have proved insufficient to be applied to complex socio-technical systems. As an alternative, Safety-II and resilience engineering have emerged and gained much attention for the last two decades. However, it seems that safety professionals have still difficulty understanding their fundamental concepts and methods. Accordingly, it is necessary to offer an introductory guide to them that helps safety professionals grasp them correctly in consideration of their current practices. @*Methods@#This article firstly explains the limitations of Safety-I and how Safety-II can resolve them from the four points of view. Next, the core concepts of resilience engineering and Functional Resonance Analysis Method are described. @*Results@#Workers' performance adjustment and performance variability due to it should be the basis for understanding human-related accidents in socio-technical systems. It should be acknowledged that successful and failed work performance have the same causes. However, they are not well considered in the traditional safety concept; in contrast, Safety-II and resilience engineering have conceptual bases and practical approaches to reflect them systematically. @*Conclusion@#It is necessary to move from a find-and-fix and reactive approach to a proactive approach to safety management. Safety-II and resilience engineering give a set of useful concepts and methods for proactive safety management. However, if necessary, Safety-I methods need to be properly used for situations where they can still be useful as well.

Trends in recent waterborne and foodborne disease outbreaks in South Korea, 2015–2019

Objectives@#This study analyzed trends in foodborne and waterborne diseases in South Korea between 2015 and 2019. @*Methods@#The data consisted of information on outbreaks of waterborne and foodborne infectious diseases reported through the Korea Centers for Disease Control and Prevention(KCDC) system. We analyzed the trends and epidemiological aspects of outbreaks by month, place of occurrence, and causative pathogens in this observational study. @*Results@#The number of outbreaks has steadily increased over the last 5 years, but the number of cases per outbreak has followed a decreasing trend. Incidence at daycare centers and preschools has been steadily increasing over consecutive years. @*Conclusion@#The steady number of patients and decreasing number of cases per outbreak,even as the number of outbreaks has been increasing, suggest that the KCDC’s professional management system is operating effectively. It is necessary to continue improving the objectivity and efficiency of the management system and to carefully examine the increasing number of outbreaks in smaller-scale group catering facilities, such as daycare centers and preschools. Outbreaks can be prevented by closely examining those caused by unidentified pathogens and group outbreaks caused by other diseases, identifying problems, and supplementing the management system.

A Neural Network Model Based on Enhanced CT for Distinguishing ISUP Grade of Clear Cell Renal Cell Carcinoma / 肿瘤防治研究

Objective To establish a neural network model based on enhanced CT for distinguishing ISUP grade of clear cell renal cell carcinoma (ccRCC). Methods We collected 131 cases of ccRCC, with 92 cases of low ISUP grade and 39 cases of high ISUP grade. Patients were divided into training set and validation set according to 5:5 stratified sampling. The enhanced CT images of each ccRCC patient were evaluated by the radiologist. Recursive feature elimination (RFE) was used to reduce the dimension of patients' general features and enhanced CT features, which was used for neural network modeling and validation. Results Patients' general features and enhanced CT features were verified by RFE method and then reduced to 14 features. The top 5 features were growth pattern, necrosis, enlargement of lymph nodes, tumor size and capsule. The AUC of the neural network model based on these 5 features in training set was 0.8844 (95%CI: 0.8062-0.9626), sensitivity was 89.47% and specificity was 82.61%; and those in validation set were 0.7924 (95%CI: 0.6567-0.9280), 75.00% and 86.96%, respectively. Conclusion The neural network model of ccRCC ISUP grade based on enhanced CT has relatively high diagnostic efficiency.

Lunch supply in public primary school canteens in Zhejiang Province / 中国学校卫生

Objective@#To investigate lunch supply of public primary school canteens in Zhejiang Province, and to provide a basis for the scientific guidance of school lunch.@*Methods@#During May to Jun. and Sept. to Oct. in 2019, lunch food supply was weighed and recorded and the number of diners in 44 public primary school canteens were summarized. Each investigation lasted for one week.@*Results@#Food was mainly based on the taste of the students (40.91%) in the school canteen. About 45.45% of the schools referred to the Nutrition Guidelines of School Meals for students meals when making recipes in the school canteen. The supplies of cereals, vegetables, fruits, livestock and poultry meat, fish and shrimp, eggs, milk, soybean nuts, vegetable oil and salt were 109.05, 118.01, 0, 63.96, 9.25, 11.31, 0, 10.68, 10.47, 2.54 g. The supply of vegetable oil was basically the same as the recommended amount ( P >0.05). The supplies of energy, protein, calcium, iron, zinc, vitamin A, vitamin B 1, vitamin B 2, vitamin C, dietary fiber were 820.84 kcal, 32.79 g, 164.18 mg, 7.84 mg, 4.71 mg, 23.07 μgRAE, 0.41 mg, 0.35 mg, 20.47 mg, 2.34 g, 37.56% of energy from fat and 48.47% of energy from carbohydrate. The supply of vitamin B 1 was basically the same as the recommended amount ( P >0.05). There were no significant differences in all kinds of food and nutrients between urban and rural primary schools ( P >0.05).@*Conclusion@#Lunch supply is not optimistic in public primary school canteens in Zhejiang Province, with unreasonable structure and fails to agree with current nutritional recommendations. It is suggested that the scientific guidance of students meals should be carried out according to the survey results combined with the characteristics of local diet.

Novel MSX1 variants identified in families with nonsyndromic oligodontia / 国际口腔科学杂志·英文版

The goal of this study was to identify MSX1 gene variants in multiple Chinese families with nonsyndromic oligodontia and analyse the functional influence of these variants. Whole-exome sequencing (WES) and Sanger sequencing were performed to identify the causal gene variants in five families with nonsyndromic oligodontia, and a series of bioinformatics databases were used for variant confirmation and functional prediction. Phenotypic characterization of the members of these families was described, and an in vitro analysis was performed for functional evaluation. Five novel MSX1 heterozygous variants were identified: three missense variants [c.662A>C (p.Q221P), c.670C>T (p.R224C), and c.809C>T (p.S270L)], one nonsense variant [c.364G>T (p.G122*)], and one frameshift variant [c.277delG (p.A93Rfs*67)]. Preliminary in vitro studies demonstrated that the subcellular localization of MSX1 was abnormal with the p.Q221P, p.R224C, p.G122*, and p.A93Rfs*67 variants compared to the wild type. Three variants (p.Q221P, p.G122*, and p.A93Rfs*67) were classified as pathogenic or likely pathogenic, while p.S270L and p.R224C were of uncertain significance in the current data. Moreover, we summarized and analysed the MSX1-related tooth agenesis positions and found that the type and variant locus were not related to the severity of tooth loss. Our results expand the variant spectrum of nonsyndromic oligodontia and provide valuable information for genetic counselling.

Perirectal fascial anatomy and pelvic autonomic nerve preservation during the transanal total mesorectal excision / 中华胃肠外科杂志

The difficulty of transanal total mesorectal excision (TME) is to find the correct dissection plane of perirectal space. As a complex new surgical procedure, the fascial anatomic landmarks of transanal approach operation are more likely to be ignored. It is often found that dissection plane is false after the secondary injury occurs during the operation, which results in the damage of pelvic autonomic nerves. Meanwhile, the mesorectum is easily damaged if the dissection plane is too close to the rectum. Thus, the safety of oncologic outcomes could be limited by difficulty achieving adequate TME quality. The promotion and development of the theory of perirectal fascial anatomy provides a new thought for researchers to design a precise approach for transanal endoscopic surgery. Transanal total mesorectal excision based on fascial anatomy offers a solution to identify the transanal anatomic landmarks precisely and achieves pelvic autonomic nerve preservation. In this paper, the authors focus on the surgical experience of transanal total mesorectal excision based on the theory of perirectal fascial anatomy, and discuss the feature of perirectal fascial anatomy dissection and technique of pelvic autonomic nerve preservation during transanal approach operation.