Analysis on urinary iodine level of school-age children aged 8 - 10 in Shaanxi Province from 2017 to 2020 / 中华地方病学杂志

Objective:To learn about the iodine nutrition level of school-age children aged 8 - 10 in Shaanxi Province.Methods:From 2017 to 2020, in counties (cities, districts) under the jurisdiction of Shaanxi Province, one township (street) was selected from five directions: East, West, South, North and Middle, one primary school was selected from each township (street), and 42 non-boarding school-age children aged 8 - 10 (age balanced, half male and half female) were selected from each primary school. Random urine samples of children were collected once, and urinary iodine was detected by arsenic-cerium catalytic spectrophotometry.Results:A total of 91 766 children's urine samples were tested from 2017 to 2020, and the median urinary iodine was 221.7 μg/L. Urinary iodine < 100 μg/L accounted for 10.4% (9 554/91 766), 100 - < 200 μg/L accounted for 32.3% (29 602/91 766), 200 - < 300 μg/L accounted for 30.6% (28 065/91 766), and ≥300 μg/L accounted for 26.7% (24 545/91 766). The median of children's urinary iodine in each year was 228.5, 218.0, 211.7, and 230.1 μg/L, respectively, the difference between years was statistically significant ( H = 278.66, P < 0.001). Conclusion:From 2017 to 2020, the iodine nutrition of school-age children aged 8 - 10 in Shaanxi Province is generally in an ultra-suitable state.

A multivariate analysis of acute severe cholangitis and the establishment and evaluation of a risk prediction scoring model / 临床肝胆病杂志

Objective To investigate the independent risk factors for acute severe cholangitis and related protective factors, and to construct a risk prediction scoring model for acute severe cholangitis. Methods A retrospective analysis was performed for the clinical data of 381 patients with acute cholangitis who were admitted to Department of Hepatobiliary Surgery, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, from January 2016 to July 2021, among whom there were 273 patients with non-severe cholangitis and 108 patients with severe cholangitis. Univariate and multivariate logistic regression analyses were used to screen out the independent risk factors for acute severe cholangitis and related protective factors, and then a logistic regression model was established. The receiver operating characteristic (ROC) curve was used to evaluate the discriminatory ability of the model, the calibration curve was used to evaluate the prediction accuracy of the model, and decision curve analysis (DCA) was used to evaluate the clinical value of the model. Moreover, the enhanced Bootstrap method was used to perform internal validation of the model and evaluate the performance of the model in internal validation. The model was visualized by the construction of Web calculator, nomogram, and scoring system. The two-independent-samples t test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups. Results The univariate and multivariate logistic regression analyses showed that total bilirubin (TBil) (odds ratio [ OR ]=1.014, 95% confidence interval [ CI ]: 1.009-1.020, P < 0.001), percentage of neutrophils ( OR =1.128, 95% CI : 1.088-1.175, P < 0.001), and age ( OR =1.053, 95% CI : 1.027-1.082, P < 0.001) were independent risk factors, and albumin (Alb) ( OR =0.871, 95% CI : 0.817-0.924, P < 0.001) was a protective factor. The above independent risk factors and protective factor were included in the logistic regression analysis for model fitting, and the predictive model obtained had an area under the ROC curve (AUC) of 0.925 (95% CI : 0.897-0.952), with a specificity of 0.817 and a sensitivity of 0.935 at the optimal cut-off value of 0.245. The calibration curve showed that the predicted probability of the model was approximately equal to the actual probability, with a Brier value of 0.098, and the decision curve analysis showed that the model had a higher net income within the threshold probability interval of 0.1-0.9. Internal validation showed an AUC internal validation of 0.915 and a Brier value internal verification of 0.106. Conclusion TBil, percentage of neutrophils, and age are independent risk factors for acute severe cholangitis, while Alb is a protective factor. The established risk prediction scoring model has good discriminatory ability, calibration, and clinical value and can identify patients with acute severe cholangitis at an early stage, which provides a reference for subsequent diagnosis and treatment.

Analysis of the iodine nutrition level of children aged 8 - 10 and pregnant women in Shaanxi Province in 2019 / 中华地方病学杂志

Objective:This study aims to provide scientific evidence for prevention and treatment of iodine deficiency disorders through monitoring the iodine nutrition status of children and pregnant women in Shaanxi Province.Methods:Totally 110 counties (cities, districts) in Shaanxi Province in 2019 were surveyed. Each of the counties (cities, districts) was further divided into five sampled regions along five different geographic directions: east, west, south, north and middle. From each region, one town was selected and then one primary school was selected from each town. Finally, there were a total of 42 non-boarding students aged 8 - 10 years old (age and gender balanced) selected from each school, who would be tested household salt iodine's level and urinary iodine's level. Also, we did the same test for 21 pregnant women who were selected from each town randomly. Additionally, we examined the children's thyroid by B-scan ultrasonograph in 39 counties (cities, districts).Results:A total of 23 101 salt and urine samples were collected from children aged 8 - 10 years old, the average of salt iodine content of the children' family was (24.07 ± 3.71) mg/kg; the consumption rate of qualified iodized salt was 97.55% (22 536/23 101); the median urinary iodine was 211.68 μg/L; and the thyroid goiter rate (TGR) was 1.50% (123/8 191). A total of 11 555 salt and urine samples from pregnant women were collected, the salt iodine content was (24.05 ± 3.66) mg/kg; and the consumption rate of qualified iodized salt was 97.57% (11 274/11 555); the median urinary iodine was 182.74 μg/L.Conclusions:In 2019, the iodine nutrition of children in Shaanxi Province is in the super appropriate level, and the iodine nutrition of pregnant women is appropriate. The iodine content of edible salt can be adjusted. It is suggested that pregnant women should be supplied special iodized salt.

Analysis of iodine nutrition levels of children and pregnant women in Shaanxi Province in 2018 / 中华地方病学杂志

Objective:To master the iodine nutrition status of children and pregnant women after adjustment of salt iodization content in Shaanxi Province, and provide scientific basis for preventing and treating iodine deficiency disorders.Methods:In 2018, 107 counties (cities, districts) in Shaanxi Province were divided into three districts in Guanzhong, northern Shaanxi and southern Shaanxi for studying iodine nutrition based on terrain distribution. Among them, each monitoring county (city, district) was further divided into 5 sampling areas according to east, west, south, north, and middle locations. One township (street) was selected in each location, and forty-two 8 - 10 years old non-boarding children (age and sex balanced) and 21 pregnant women were selected in each township (street), edible salt samples and random urine samples were collected for salt iodine, urinary iodine testing, and goiter of children was examined.Results:A total of 34 264 edible salt samples from 8 - 10 years old children and pregnant women were collected, the median salt iodine was 23.80 mg/kg, and the qualified iodized salt consumption rate was 96.98% (33 229/34 264). The median salt iodine and the qualified iodized salt consumption rate were statistically significantly different among the three regions in Guanzhong, northern Shaanxi, and southern Shaanxi ( H = 26.471, χ 2 = 32.371, P < 0.05). A total of 22 895 urine samples were collected from children, with a median urinary iodine of 218.00 μg/L, which was at an ultra-suitable level of iodine nutrition; and 11 369 urine samples from pregnant women were collected, with a median urinary iodine of 181.03 μg/L, which was at an appropriate level of iodine nutrition. The median urinary iodine of pregnant women in Guanzhong, northern Shaanxi, and southern Shaanxi was 186.39, 177.52, and 176.00 μg/L, respectively. A total of 22 895 children aged 8 to 10 years old were examined, the goiter rate was 1.35% (309/22 895), and there was no significant difference between different regions (χ 2 = 3.395, P > 0.05). Conclusions:Shaanxi Province has reached the standard for elimination of persistent iodine deficiency, children's iodine nutrition is at a ultra-suitable level, and pregnant women is at an appropriate level.

Quantitative computed tomography analysis for stratifying the severity of Coronavirus Disease 2019 / 药物分析学报

To examine the feasibility of using a computer tool for stratifying the severity of Coronavirus Disease 2019 (COVID-19) based on computed tomography (CT) images. We retrospectively examined 44 confirmed COVID-19 cases. All cases were evaluated separately by radiologists (visually) and through an in-house computer software. The degree of lesions was visually scored by the radiologist, as follows, for each of the 5 lung lobes:0, no lesion present;1,<1/3 involvement;2,>1/3 and<2/3 involvement;and 3,>2/3 involvement. Lesion density was assessed based on the proportion of ground-glass opacity (GGO), consolidation and fibrosis of the lesions. The parameters obtained using the computer tool included lung volume (mL), lesion volume (mL), lesion percentage (％), and mean lesion density (HU) of the whole lung, right lung, left lung, and each lobe. The scores obtained by the radiologists and quantitative results generated by the computer software were tested for correlation. A Chi-square test was used to test the consistency of radiologist- and computer-derived lesion percentage in the right/left lung, upper/lower lobe, and each of the 5 lobes. The results showed a strong to moderate correlation between lesion percentage scores obtained by radiologists and the computer software (r ranged from 0.7679 to 0.8373, P < 0.05), and a moderate correlation between the proportion of GGO and mean lesion density (r=-0.5894, P<0.05), and proportion of consolidation and mean lesion density (r=0.6282, P<0.05). Computer-aided quantification showed a statistical significant higher lesion percentage for lower lobes than that assessed by the radiologists (x2 = 8.160, P = 0.004). Our experiments demonstrated that the computer tool could reliably and accurately assess the severity and distribution of pneumonia on CT scans.

A comparative study of patent foramen ovale and white matter lesions in migraine without aura / 西安交通大学学报(医学版)

Objective To explore the effect of patent foramen ovale(PFO)on white matter lesions(WMLs) in migraine without aura(MwoA).Methods Thirty-five patients with MwoA were examined by contrast transcranial Doppler(cTCD)and magnetic resonance imaging(MRI).According to the results of PFO and MRI Flair data,the patients' age,sex and headache characteristics were matched,and the WMLs were compared between the PFO positive group and negative group.Results Seven cases of WMLs were recruited in PFO positive group(19 cases)and the WMLs were distributed in the frontal lobe and/or the parietal lobe.The score ranged from 1 to 7 points.Five cases of WMLs were enrolled in PFO negative group(16 cases)and the WMLs also were distributed in the frontal lobe and/or the parietal lobe.The score ranged from 1 to 3 points.There was no significant difference in WMLs between the groups(P＞ 0.05).Conclusion White matter lesions in migraine without aura are distributed in the frontal lobe and the parietal lobe,and these findings do not support a relationship between PFO and WMLs.

Laparoscopic feature and its relationship with clinical manifestations in infertile women with endometriosis / 实用医学杂志

Objective To investigate the laparoscopic feature and its relationship with clinical manifesta-tions in infertile patients with endometriosis. Methods From Jan.2013 to Jan.2017,infertile patients who received hysteroscopy and hysteroscopy combination surgery in Ganzhou People′s Hospital were enrolled in this ret-rospective study.The basic clinical data and the distribution of endometriotic lesions were recorded and analyzed in patients with endometriosis simultaneously. Analysis was performed about the clinical manifestations and the rAFS stage of the patients. Results 204 patients are totally enrolled in the study. Among them,120 patients(58.8%) had endometriosis. The presence of menorrhea,dyspareunia,tenesmus,chronic pelvic pain,hypermenorrhea, adnexal mass,restricted uterine mobility,tenderness of adnexa,and tenderness nodules of posterior vaginal fornix are clinically statistically significant.In addition,the presence of ovarian endometrioma is also a significant clinical factor that is close related with the rAFS stage of infertile patients with endometriosis. Moreover,uterosacral liga-ment,rectovaginal septum,vagina and bowel were more common infiltrated in stage Ⅲ and stage Ⅳ endometrio-sis. Conclusions For infertile patients,detailed case history,overall bimanual examination and trans-vaginal ultrasound examination are very important to help diagnosis endometriosis preoperatively and provide evidence for the selection of individualized treatment strategies.

MicroRNA-320d Inhibits Epithelial Mesenchymal Transition Function in Endometrial Carcinoma JEC Cells by PBX3 / 中山大学学报(医学科学版)

[Objective]To investigate the inhibitory effect and mechanism of the microRNA-320d(miR-320d)on epithelial mesenchymal transition in endometrial carcinoma JEC cells.[Methods]JEC endometrial carcinoma cell lines were transfected with miR-320d mimics or negative control mimic,respectively,as M320d or NCM group. Control group was established with untreated JEC endometrial carcinoma cells. miR-320d content in each group was detected by RT-PCR method. Transwell assay was used to detect the migration and invasion ability of the 3 groups. Western-blot assay was used to detect the expressions ofα-Catenin,E-cad-herin,Vimentin and PBX3 protein in 3 groups. Antagonistic effect of PBX3 overexpression on miR-320d inhibition of EMT was detect-ed by western blot assay. The relationship between miR-320d and PBX3 was detected by dual luciferase assay.[Results]The expres-sion level of miR-320d in M320d group was significantly up-regulated,and the expression level of miR-320d was 808.25 ± 15.58 times higher than that of control group(P<0.05). The number of migrating cells in M320d group was 29.56 ± 0.59,which was signif-icantly lower than that of control group at 94.48 ± 1.02(P < 0.05). The number of invasive cells in M320d group was 7.33 ± 0.84, which was significantly lower than that of group control 86.28 ± 3.51(P < 0.05). Compared with control group ,the expression of α-Catenin and E-cadherin protein was significantly increased ,the expression of Vimentin protein was significantly decreased ,and the expression of PBX3 protein was significantly decreased. After PBX3 overexpression,the expression ofα-Catenin and E-cadherin protein were significantly decreased,the expression of Vimentin protein were significantly increased. Dual luciferase assay showed that PBX3 is a downstream target gene of miR-320d(P<0.05).[Conclusion]miR-320d may inhibit the expression of EMT related protein through the downstream target gene PBX3 and inhibit the epithelial mesenchymal transition function of endometrial carcinoma JEC cells.

The effect of using optimizing procedures of CT enhancement scanning and CT angiography examinations on shortens the checkup time and improves patients' satisfaction degree / 中国实用护理杂志

Objective To analyze the causes of time consumption in CT enhancement scanning (CTES) and CT angiography (CTA) examinations in order to optimize the procedures, and help to save time and medical costs for patients. Methods A total of 2328 outpatients and 1402 inpatients to take CTES and CTA examinations were randomly selected as the normal control group, and another 2085 outpatients and 793 inpatients who underwent the optimized procedures were randomly selected as the experimental group. The problems of time consumption and patients'satisfaction degree were analyzed. Results The major causes for time consumption in CTES and CTA examinations included taking wrong contrast medicine, forgetting to take contrast medicine, having no auxiliary examination results, waiting in the wrong line, and opening the cap of contrast medicine. The time spent for checkup for inpatients and outpatients in the control and experimental groups was (119.8±15.6) minutes and (31.5±8.6 ) minutes vs (55.2 ± 10.6) minutes and (8.4 ±2.1) minutes. The satisfaction degree of inpatients and outpatients in the control and experimental groups were 90.16%(1264/1402) and 88.66%(2064/2328) vs 98.49%(781/793) and 97.94%(2042/2085). The experimental group spent shorter time and had higher satisfaction degree than those in the control group, and the differences were statistical significantly, tinpatient=34.96, P<0.01, toutpatient=12.03, P<0.01;χ2inpatient=55.20, P<0.01,χ2outpatient=146.27, P<0.01. Conclusions After the procedures of CTES and CTA examinations are optimized, the checkup time is significantly shortened, and patients' satisfaction degree is remarkably improved.

A Clinical Study on Imbalance of Th17/Treg in Patients with Ovarian Endometriosis / 中山大学学报(医学科学版)

[Objective]To investigate the disturbance between Th17 and Treg cell balance in ovarian endometriosis patients.[Methods]Case-control study comparing 40 women with histo-pathologically confirmed ovarian endometriosis and with 40 control infertility women without visible endometriosis foci ,pelvic inflammations who were subjected to laparoscopic surgery during the same period. Peripheral blood,peritoneal fluid,ovarian ectopic endometrial tissue and eutopic endometrial tissue of ovarian endometriosis patients and controls were collected during surgery. T lymphocytes subpopulations in peripheral blood were analyzed by flow cytometry using specific monoclonal antibodies recognizing CD4+,CD25+and CD127-markers and CD3+,CD8-and IL-17A+markers. Then, IL-17,IL-22,IL-10and TGF-βconcentration in the serum and peritoneal fluid was determined using enzyme linked immunosorbent assay(ELISA). Also,Q-PCR was performed to verify Foxp3 mRNA and ROR-γt mRNA expression differences in eutopic and ectopic endometrial tissue.[Results]1.The percentage of CD4+CD25+CD127-Treg cells was significantly decreased in the peripheral blood ofwomen with ovarian endometriosis compared with control women. On the other hand ,the proportion of CD3+CD8-IL-17A+Th17 cells was significantly increased in the peripheral blood of women with endometriosis compared with control wom en. 2. Comparing with the controls ,the concentration of IL-17 and IL-22 was significantly higher in the serum of women with ovarian endometriosis ,and the levels of IL-10 and TGF-β were significantly lower in the serum of women with endometriosis. On the contrast ,in the peritoneal fluid of women with ovarian endometriosis ,the concentration of IL-17 and IL-22 were lower ,and the concentration of IL-10 and TGF-β were significantly higher than the controls. 3.Foxp3 mRNA expression level was significantly elevated in ectopic endometrial tissue of patients with ovarian endometriosis compared with eutopic endometrial tissue ,while the ROR-γt mRNA expression level of ectopic endometrial tissue was significantly decreased than eutopic endometrial tissue.[Conclusion]The present study verifies the imbalance of Th17/Treg in peripheral blood ,peritoneal fluid and endometrial tissue in ovarian endometriosis patients ,which implies the immune dysregulation and the disturbance of immunity homeostasis in the establishment and progression of endometriosis.

Cytogenetic and molecular characterization of a patient with partial 6q trisomy and 1q monosomy / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze a girl with moderate mental retardation and speech and language disorders with cytogenetics technique and next-generation sequencing (NGS).</p><p><b>METHODS</b>G-banding chromosome analysis was used to ascertain the karyotype of the child and her parents, and NGS was used for determining the size and origin of the abnormal chromosome fragment. Mate-pair and PCR were used to determine its parental origin.</p><p><b>RESULTS</b>The karyotype of the child was determined to be 46,XX,add(1)(q44)dn, while her parents were both normal. NGS revealed that the child has harbored a partial trisomy of 6q24.3-q27, and the breakpoint was mapped to at 6q24.3q27. In addition, a 2.5 Mb microdeletion at 1q44 was found in the patient.</p><p><b>CONCLUSION</b>No recognizable phenotype was associated with 1q44 deletion. The abnormal phenotypes presented by the child may be attributed to the 6q24.3-q27 triplication. Compared with conventional cytogenetic analysis, NGS has a much higher resolution and great accuracy.</p>

Different implant fixation repairs femoral neck combined with ipsilateral subtrochanteric fractures：comparisons of biomechanical properties / 中国组织工程研究

BACKGROUND:Choosing internal fixator implants with good strength and stiffness is the key to repair femoral neck combined with ipsilateral subtrochanteric fractures. OBJECTIVE:To compare the biomechanical properties of different implant fixation for femoral neck combined with ipsilateral subtrochanteric fractures. METHODS:Totaly 24 adult antiseptic cadaver specimens were used to produce fracture models with femoral neck fracture combined with 5 cm of ipsilateral subtrochanteri medical cortical defect, and were divided into femoral proximal locking plate group, lengthening proximal femur anti-rotation intramedulary nail group and lengthening proximal femoral nail group according to the random number table method. The results of axial compression test, torsion test and axial compression failure rest in three groups were compared. RESULTS AND CONCLUSION: The axial compressive stiffness and failure load in lengthening proximal femur anti-rotation intramedulary nail group were significantly greater than those in femoral proximal locking plate group and lengthening proximal femoral nail group, and those in lengthening proximal femoral nail group were significantly greater than those in femoral proximal locking plate group (P 0.05). These results demonstrate that to a certain extent, compared with the femoral proximal locking plate and lengthening lengthening proximal femoral nail, lengthening proximal femur anti-rotation intramedulary nail fixation for repair of femoral neck combined with ipsilateral subtrochanteric fractures has more biomechanical advantages.

Clinical significance of expression of enhancer of zeste homolog 2 and 53 in cervical squamous cell carcinoma and intraepithelial neoplasia / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression and clinical significance of enhancer of zeste homolog 2 (EZH2) and p53 proteins in cervical squamous cell carcinoma (SCC) and cervical intraepithelial neoplasia (CIN).</p><p><b>METHODS</b>The expression and distribution of EZH2 and p53 were determined with reference to clinicopathological features and patient survival. 168 cervical SCC, 19 CINII, 35 CINIII patients and 30 normal control cases were collected for immunohistochemical analysis.</p><p><b>RESULTS</b>The expression of EZH2 in the normal cervix, CIN and SCC was 6.7% (2/30), 37.0% (20/54) and 75.6% (127/168), respectively, with a significant difference between them (P < 0.05). The expression of p53 was 3.3% (1/30), 20.4% (11/54) and 39.3% (66/168), respectively, also (P < 0.05). In the 168 SCC cases, the positive rate of EZH2 in the cases with lymph node metastasis was 82.9%, and that of p53 was 45.7%; the positive rate of EZH2/p53 protein expression in the cases with negative lymph nodes was 70.4%, and that of p53 was 34.7%, with a significant difference between the two subgroups (P < 0.05). Among the 143 followed-up SCC patients, the EZH2(+) p53(+) cases had a progression-free survival of (51.3 ± 3.8) months, that of EZH2(+) or p53(+) cases was (66.1 ± 2.0) months, and that of EZH2(-) p53(-) cases was (71.3 ± 1.9) months, with a very significant difference among the three subgroups (P < 0.001). The overall survival times of EZH2(-) p53(-), EZH2(+) or p53(+), and EZH(2+) p53(+) cases were (72.9 ± 1.1), (68.6 ± 1.8), and (57.4 ± 3.4) months, respectively, with a significant difference among the three subgroups (P < 0.001). The multivariate analysis showed that EZH2 expression, lymph node metastasis and tumor staging were independent prognostic factors.</p><p><b>CONCLUSIONS</b>Both EZH2 and p53 proteins may play important roles in the occurrence and development of cervical squamous cell carcinoma. There is a close relationship between the expression of both EZH2 and p53 proteins and the prognosis of SCC patients.</p>

Evaluation of the cerebral venous variations in infants with susceptibility weighted imaging MR imaging / 实用放射学杂志

Objective To describe the anatomical variants of infants’internal cerebral veins and their tributaries with MR suscep-tibility weighted imaging,and to evaluate the capability in the visualization of cerebral deep veins.Methods 80 healthy infants were enrolled in this study.All the brain images were obtained by a 3D gradient-echo sequence (Enhanced T2 ? weighted angiography-ES-WAN)on a 3.0T MR,which were reconstructed with minimal intensity projection.The septal vein,thalamostriate vein,internal cerebral vein and anterior caudate nucleus veins were evaluated.4 types (ⅠA,ⅠB,ⅡA,ⅡB)were classified based on their rela-tionship with the septal vein-internal cerebral vein junction and interventricular foramen,and 3 types (Ⅰ,Ⅱ,Ⅲ)based on the drainage patterns of the anterior caudate nucleus veins.Results The septal vein,thalamostriate vein and internal cerebral vein could be clearly and continuously visualized in 100% infants,and the visualization rate of the anterior caudate nucleus veins was 88.1%. TypeⅠA and TypeⅠ were most common in the two classification patterns.Conclusion Infants’internal cerebral veins and their tributaries are able to be clearly shown with the minimal intensity projection in susceptibility weighted imaging,which is a good method to evaluate the cerebral deep veins in infants.

Clinical efficacy of single-incision and conventional three-port laparoscopic appendectomy: a Meta analysis / 中华消化外科杂志

Objective To compare the efficacy and safety of single-incision and conventional three-port laparoscopic appendectomy.Methods According to the Cochrane systematic review methods,literatures on the comparison of the effects of single-incision laparoscopic appendectomy (SILA) and conventional three-port laparoscopic appendectomy (CTLA) were searched for in the PubMed,EMBASE,the Cochrane Controlled Trials Register,CNKI,CBM and VIP database.Data including the operation time,pain visual analogue scales scores,duration of postoperative hospital stay,incidence of postoperative complications,mean time of hospital stay and cost between the SILA and CTLA were compared by 2 reviewers.RevMan 4.2 software was used for Meta analysis,and the heterogeneity of the study was analyzed using the 12 test.Categorical variables were presented by odds ratio and 95％ confidence interval (95％ CI),and continuous variables were presented by weighted mean difference (WMD) and 95％C1.Results Eight randomized controlled trials including 1 444 patients were selected.All the patients were subdivided into the adults group (760 patients) and the children group (684 patients).A total of 721 patients received SILA (SILA group) and 723 received CTLA (CTLA group).The operation time of patients who received SILA in the adults group and the children group were significantly longer than those who received CTLA (WMD =4.40,7.39,95％ CI:2.14-6.66,2.16-12.61,P ＜0.05).There were no significant difference in the pain visual analogue scales scores,incidence of postoperative complications and duration of hospital stay between patients who received SILA and CTLA in the adults group and the children group (WMD =-0.34,95 ％ CI:-1.02-0.33,OR=0.97,95％CI:0.64-1.47; WMD=-0.19,95％CI:-1.14-0.76,P＞0.05).The cost of patients who received SILA was significantly higher than those who received CTLA in the children group (WMD =0.87,95 ％ CI:0.26-1.48,P ＜ 0.05).Conclusions There is no obvious advantages of SILA in perioperative and postoperative outcomes when compared with CTLA.Therefore,SILA is only a possible alternative to CTLA other than the preferred method.

Changes of intracellular cholesterol metabolism in neuroendocrine differentiation of prostate cancer and their significance / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the roles of intracellular cholesterol metabolism in neuroendocrine (NE) differentiation of prostate cancer based on an androgen-independent prostate cancer NE cell model induced by androgen deprivation.</p><p><b>METHODS</b>LNCaP cells were cultured in androgen-depleted medium, and NE phenotypes were identified by observing the changes in cell morphology, molecular markers (SgIII, NSE and CgA) and cell proliferation. The expression and distribution of cholesterol and Sg III were determined by immunofluorescence staining. The expressions of the key genes LDL-R, SREBP-1 and SREBP-2 involved in cholesterol synthesis and uptake were detected by semi-quantitative RT-PCR.</p><p><b>RESULTS</b>The LNCaP cells showed shrinking bodies and extending axons after androgen deprivation, and all the molecular markers, such as Sg III, NSE and CgA, significantly increased in a time-dependent manner, while the cell proliferation was obviously inhibited (P < 0.05). The cholesterol distribution in the LNCaP cells after NE differentiation presented remarkable aggregation at the axon terminals. However, there were no significant differences in the expression of cholesterol between the two types of cells, nor in the changes of the expressions of key genes LDL-R, SREBP-1 and SREBP-2 involved in cholesterol synthesis and uptake (P > 0.05).</p><p><b>CONCLUSION</b>Transient androgen depletion could successfully induce NE differentiation of LNCaP cells, and the intracellular cholesterol could re-distribute into axon terminals to enhance the formation of neurosecretory granules.</p>

Progress of adipokines in the treatment of type 2 diabetes by the Roux-en-Y bariatric surgery / 国际外科学杂志

The adipokines is a class of active substances secreted by adipose tissue,with the function of regulating the body glucose balance and others.Some experiments prove Roux-en-Y gastric bypass postoperative plasma levels of adipokines will change that play an important role in improving islet function in the treatment of type 2 diabetes mellitus.Here,the author will make a review about the adipokines role in pathways and postoperative level changes,etc,in order to further explore the mechanism of the surgical treatment of diabetes.

Comparison of two approaches for the treatment of distal radius fractures / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the effective operative approach for the treatment of distal radius fractures.</p><p><b>METHODS</b>From March 2003 to April 2010,107 patients with distal radius fractures suffered internal fixation with locking compression plate (LCP). There were 48 males and 59 females with an average age of 51.27 years (ranged, 23 to 79). Of them, with directed volar approach was in 55 cases and Henry approach was in 52 cases. Surgical feature, fractured exposure time, operative time, median nerve complication, repair rate of the musculus pronator quadratus were compared between the two groups. Gartland-Werley wrist score (GW score), range of motion of wrist joint, grasp force and imageology score were observed in two groups at the first year after operation.</p><p><b>RESULTS</b>The average fractured exposure time in directed volar approach group and Henry approach group was (21.18 +/- 1.69) min and (12.56 +/- 1.35) min,operative time was (89.90 +/- 4.86) min and (61.58 +/- 4.37) min, postoperative median nerve irritation rate was 34.55% and 5.77%, and repair rate of the musculus pronator quadratus was 52.73% and 100%,respectively;there was statistical difference between two groups (P < 0.01). At the one-year after operation, GW score was 3.25 +/- 2.29,and with rate of excellent and good of 90.91% in directed volar approach group;in Henry approach group that was 2.92 +/- 2.13 and 92.31%, respectively; there was no statistical difference between two groups (P > 0.05). There was no statistical difference in range of motion of wrist joint, grasp force and imageology score between two groups (P > 0.05).</p><p><b>CONCLUSION</b>Henry approach can obtain the same operative result compared with directed volar approach in treating distal radius fractures. Henry approach has advantage of simple anatomy,easy operation,better repair rate of the the musculus pronator quadratus and lower postoperative median nerve complication,which should be used preferentially to treat distal radius fractures.</p>

A free-breathing non-contrast-enhanced pulmonary magnetic resonance angiography at 3 Tesla / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The breathhold contrast-enhanced three-dimensional magnetic resonance angiography (MRA) using T1-weighted gradient-echo imaging sequence is the standard technique for MRA of the thorax. However, this technique is not desirable for certain patients with respiratory insufficiency, serious renal impairment, or allergy to contrast agents. The objective of this study was to optimize and evaluate a non-contrast-enhanced free-breathing pulmonary MRA protocol at 3 Tesla.</p><p><b>METHODS</b>The time-of-flight protocol was based on a two-dimensional T1-weighted turbo field echo sequence with slice-selective inversion recovery and magnetization transfer preparation together with respiratory navigator gating, cardiac gating, and parallel imaging. Optimal values for time of inversion delay, flip angle and slice thickness were experimentally determined and used for all subjects.</p><p><b>RESULTS</b>Excellent pulmonary MRA images, in which the 7th order branches of pulmonary arteries could be reliably identified, were obtained in the 12 free-breathing healthy volunteers. TI of approximately 300 ms provides the best suppression of background thoracic and cardiac muscles and effective inflow enhancement. With increasing flip angle, the pulmonary vessels gradually brightened and exhibited optimal contrast at 20 degrees-30 degrees. The 2 mm slice thickness and 0.5 mm slice overlap is suitable for visualization of the peripheral pulmonary vessel.</p><p><b>CONCLUSIONS</b>The MRA protocol at 3 Tesla may have clinical significance for pulmonary vascular imaging in patients who are not available for contrast-enhanced 3D MRA and CT angiography examination or are unable to sustain a long breath-hold.</p>

Abnormal expression of beta-catenin and E-cadherin in Her2-positive breast cancer and its implications / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the relationship between positive expression of Her2 and abnormal expressions of beta-catenin and E-cadherin and its implications.</p><p><b>METHODS</b>Immunohistochemistry was used to detect the expressions of Her2, beta-catenin and E-cadherin in 147 samples of human breast carcinoma. The expressions of beta-catenin and E-cadherin were also detected in 19 tissues adjacent to the carcinoma and 17 benign breast lesions as controls.</p><p><b>RESULTS</b>In breast carcinoma, positive Her2 expression was associated with lymph node metastasis, advanced clinical stage and negative expression of ER and PR (P<0.05). Abnormal beta-catenin expression was associated with positive lymph node status and high histological grade (P<0.01). Abnormality of E-cadherin expression was related to lymph node metastasis and advanced clinical stage (P<0.05). Abnormal beta-catenin expression was directly correlated with abnormal E-cadherin expression (P<0.01). Her2 positivity showed a direct correlation to abnormal beta-catenin expression (P<0.01), and they cooperated in promoting axillary lymph node metastasis in human breast carcinoma (P<0.01).</p><p><b>CONCLUSION</b>A direct correlation between positive Her2 expression and abnormal beta-catenin expression exists in human breast carcinoma, and positive Her2 expression may have functional interactions with abnormal activation of Wnt/beta-catenin signaling pathway.</p>