An outbreak and control of dengue fever in Yong'an City， Fujian Province / 上海预防医学

Objective To investigate a local outbreak of dengue fever in 2019 in a city village in Yong'an City， determine its characteristics， and evaluate the effect of countermeasures. Methods Epidemic characteristics of the outbreak were analyzed by descriptive analysis， and the effect of countermeasures was evaluated using the number of new cases and the change in mosquito vector density. Results The density of mosquito vectors in the core areas of the epidemic areas was gradually reduced by implementing multiple countermeasures. The Braitu index decreased below the threshold of dengue fever transmission. After the longest incubation period of the last case， there was no further case of dengue fever. The outbreak ended on 28th November. Conclusion This is a local outbreak of dengue fever. Comprehensive measures should be implemented to control the epidemic by principally eliminating adult mosquitoes and clearing mosquito breeding grounds， be supplemented by isolation and treatment of cases.

History and present situation of seromuscular flap anastomosis in proximal gastrectomy / 中华胃肠外科杂志

With the increasing detection rate of early upper gastric cancer and adenocarcinoma of esophagogastric junction, the safety of proximal gastrectomy with clear indications has been verified, and function-preserving proximal gastrectomy has been widely used. However, proximal gastrectomy destructs the normal anatomical structure of esophagogastric junction, resulting in severe postoperative gastroesophageal reflux symptoms and seriously affecting the quality of life. Among various anti-reflux surgery methods, reconstruction of "cardiac valve" has always been the focus of relevant scholars because its similarity with the mechanism of normal anti-reflux. After years of development, evolution and optimization, the designed seromuscular flap anastomosis includes tunnel muscle flap anastomosis, Hatafuku valvuloplasty, single muscle flap anastomosis and double muscle flap anastomosis. The double muscle flap anastomosis has become a research hotspot because it shows good anti-reflux effect in clinical application. This paper reviews the history, research status and hot issues of seromuscular flap anastomosis of esophageal remnant stomach at home and abroad.

Epidemiological characteristics of COVID-19 epidemic in Ejina banner, Inner Mongolia Autonomous Region, October 2021 / 中华流行病学杂志

Objective: To understand the epidemiological characteristics of COVID-19 epidemic in Ejina banner, Inner Mongolia, in October 2021 and provide evidence for the improvement of COVID-19 prevention and control. Methods: The information about the time, area and population distributions of COVID-19 cases in Ejina before November 13, 2021 and the gene sequencing result of the isolates were collected for a statistical descriptive analysis. Results: The first COVID-19 case in Ejina occurred on 7 October, 2021. A total of 164 COVID-19 cases were reported from October 19 to November 12. Most cases were distributed in 6 communities in Darahub (156 cases, 95.12%). The result of full gene sequencing of the isolates indicted that the pathogen was Delta variant (B.1.617.2). The male to female ratio of the cases was 1.3∶1. The age of cases ranged from 1 to 85 years, and the cases aged 20-59 years accounted for 78.66%. The main clinical symptoms were sore throat (91 cases, 91.92%), cough (49 cases, 49.49%) and fever (23 cases, 23.23%). Most cases were ordinary ones (81 cases, 49.39%) and mild ones (68 cases, 41.46%). The cases were mainly detected at the isolation points (84 cases, 51.22%) and through population based nucleic acid testing (62 cases, 37.80%). The basic reproduction number (R0) of COVID-19 was 5.3, the average incubation period was 3.9 days. The local government rapidly started Ⅳ level emergency response and conducted 10 rounds of nucleic acid tests. The transferring of travelers reduced the risk for the further spread of COVID-19 in Ejina. Conclusions: The epidemic of COVID-19 in Ejina characterized by strong transmission, short incubation period, herd susceptibility and case clustering. Delta variant (B.1.617.2) was the pathogen, which might be imported from Zeke port. Comprehensive prevention and control measures, such as closed-loop management and vaccination, should be continued. The successful transferring of the patients and travelers provided evidence for the effective and precise prevention and control of COVID-19 in a routine manner.

Application of modified Kamikawa anastomosis in digestive tract reconstruction after proximal gastrectomy / 中华胃肠外科杂志

Objective: Traditional Kamikawa anastomosis in digestive tract reconstruction after proximal gastrectomy can greatly decrease the anastomosis-related complications and reduce the incidence of reflux esophagitis, but its complexity limits the wide application. To decrease the complexity of Kamikawa anastomosis, the surgical team of Changzhi People's Hospital of Shanxi Changzhi Medical College improved this technique by using novel notion and reduced surgical procedures. This study aims to evaluate the efficacy and safety of modified Kamikawa anastomosis in digestive tract reconstruction after proximal gastrectomy. Methods: A descriptive cohort study was carried out. Case enrollment criteria: (1) upper gastric carcinoma or esophagogastric junction carcinoma without distant metastasis was confirmed by preoperative gastroscopic biopsy and imaging examination; (2) tumor diameter was less than 4 cm; (3) preoperative clinical staging was cT1-3N1M0. Exclusion criteria: (1) patients received preoperative neoadjuvant chemotherapy; (2) patients had severe heart or lung disease, or poor nutritional status so that they could not tolerate surgery. Clinical data of 25 patients with upper gastric carcinoma or esophagogastric junction carcinoma who underwent modified Kamikawa anastomosis in digestive tract reconstruction in Heji Hospital (8 cases) and Changzhi People's Hospital (17 cases) from April 2019 to December 2020 were retrospectively collected. Of 25 patients, 21 were male and 4 were female, with mean age of 63.0 (49 to 78) years; 3 underwent open surgery and 22 underwent laparoscopic surgery. The modified Kamikawa anastomosis was as follows: (1) the novel notion of total mesangial resection of the esophagogastric junction was applied to facilitate the thorough removal of lymph nodes and facilitate hand-sewn anastomosis and embedding; (2) the diameter of the anastomotic stoma was selected according to the diameter of the esophageal stump, between 2.5 and 3.5 cm, to reduce the occurrence of anastomotic stenosis; (3) an ultrasonic scalpel was used to incise the esophageal stump, which could not only prevent bleeding of the esophageal stump, but also closely seal the esophageal mucosa, muscle layer and serosa to prevent esophageal mucosa retraction; (4) barbed suture was used to suture the remnant stomach fundus and esophagus to fix the stomach fundus in order to reduce the cumbersome and difficult intermittent sutures in a small space; (5) two barbed sutures were used to continuously suture the front and back walls of the anastomosis and complete the suture and fixation of the muscle flap. Relevant indicators of surgical safety, postoperative complications (using the Clavien-Dindo classification), esophageal reflux symptoms and the occurrence of esophagitis (using Los Angeles classification) were analyzed. The gastroesophageal reflux disease (GERD) score, gastroscopy, multi-position digestive tract radiography during postoperative follow-up were used to evaluate the residual gastric motility and anti-reflux efficacy. Results: Modified Kamikawa anastomosis in digestive tract reconstruction after proximal gastrectomy was successfully performed in 25 patients. The surgical time was (5.8±1.8) hours, the intraoperative blood loss was (89.2±11.8) ml, and the average hospital stay was (13.8±2.9) days. Three cases (12.0%) developed postoperative anastomotic stenosis as Clavien-Dindo grade III and were healed after endoscopic dilation treatment. Postoperative upper gastrointestinal radiography showed 1 case (4.0%) with reflux symptoms as Clavien-Dindo grade I. Gastroscopy showed no signs of reflux esophagitis, and its Los Angeles classification was A grade. No anastomotic bleeding, local infection and death were found in all the patients. At postoperative 6-month of follow-up, GERD score showed no significant difference compared to pre-operation (2.7±0.6 vs. 2.4±1.0, t=-1.495, P=0.148). Conclusion: Modified Kamikawa anastomosis in digestive tract reconstruction after proximal gastrectomy is safe and feasible with good anti-reflux efficacy.

Current status of research on standardized management of specimens after radical gastrectomy for gastric cancer / 中华胃肠外科杂志

The quality control and standardization of procedures in radical gastrectomy for gastric cancer, especially the standardized processing of specimens after radical gastrectomy for gastric cancer, is very important. It is not only the basis of accurate pathological staging, but also the evidence of surgical quality and the original data of clinical research, which plays a pivotal role. The examination and classification of lymph nodes, specimens processing records, and data uploading and archiving after radical gastrectomy for gastric cancer are indispensable. It is necessary for surgeons to participate in the processing of surgical specimens. This article will combine the current research status and progress at home and abroad to review the standardized processing of specimens after radical gastrectomy for gastric cancer.

Analysis of the positive conversion rate of negative spouse and survival analysis on HIV sero－discordant couples / 中华疾病控制杂志

@#Objective To analyze the positive conversion rate of negative spouse and the survival analysis on HIV sero－discordant couples． Methods Data were collected from the case report database of the integrated AIDS prevention and control data and information system． HIV sero－discordant couples diagnosed between September 1，1997 and September 1，2018 were recruited into the cohort． The participants were divided into three groups as untreated subgroup，routine treatment subgroup and early treatment subgroup according to the situation when they started HIV treatment． The positive conversion rate of negative spouse and the survival were compared among the three subgroups． Ｒesults 598 HIV sero－discordant couples were recruited and the overall survival time of the three subgroups were 258. 92，4 987．17 and 862．25 person－year． The rate of positive conversion were 6. 18/100，0. 48/100 and 0. 23/100 person－year． Multivariate Cox regression model showed that the hazard ratio of routine treatment subgroup ( HＲ = 0. 052，95% CI: 0. 037－0. 074) and early treatment subgroup ( HＲ=0. 011，95% CI: 0. 003－0. 035) were lower than untreated subgroup． The risk of death of women was lower than that of men( HＲ=0. 667，95% CI: 0. 472－0. 944) ; the older the age，the higher the risk of death ( HＲ=1. 041，95% CI: 1. 026－1. 056) ; and the risk of death of the unemployed is higher than that of farmers ( HＲ=1. 571，95% CI: 1. 037－2. 381) ． Conclusion Targeted interventions methods and early antiviral therapy should be taken urgently for sero－discordant couples．

Demand for non-occupational post-exposure prophylaxis services for HIV and associated factors among men who have sex with men in Liuzhou, Guangxi / 中华疾病控制杂志

Objective To analyze the demand for non-occupational post-exposure prophylaxis (nPEP) services and related influencing factors among men who have sex with men (MSM) in Liuzhou City, Guangxi Province. Methods MSM was recruited in Liuzhou City, Guangxi Province. Face-to-face survey was used to collect demographic information, knowledge about AIDS, history of high-risk behavior, knowledge and demand for nPEP services. 2 test was used to analyze the differences of demand for nPEP services among MSM with different characteristics and different high-risk behaviors. Log-binomial regression model was used to analyze the influencing factors of demand for nPEP services. Prevalence ratio and 95% confidence interval were calculated. Results 31.1% of MSM population had heard of nPEP service, and 61.6% of them needed the service after being informed of nPEP about its protective effect. 58.6% of MSM would spend money to buy nPEP service after high-risk behavior. Logistic regression analysis showed that the education level was university degree or above (PR=2.743, 95% CI: 1.996-3.450), the perception of the local MSM AIDS epidemic was not serious or unknown (PR=0.211, 95% CI: 0.112-0.294), and the number of temporary sexual partners in half a year was 2 or more (PR=3.642, 95% CI: 2.223-4.842), these subjects above were influencing factors of nPEP service demanded for respondents. Conclusions MSM population in Liuzhou area of Guangxi have a certain need for nPEP service. We should implement nPEP service as soon as possible in accordance with local conditions, and strengthen the corresponding propaganda to reduce the harm of AIDS to MSM population.

A 4-year follow-up study on sexual orientation, sexual behavior and AIDS related knowledge of undergraduate students in a medical university / 中华疾病控制杂志

Objective To explore the characteristics of medical sexual orientation, sexual behavior and acquired immunodeficiency syndrome(AIDS) related knowledge changing with grade. Methods A group of 876 undergraduate students of 2015 in a medical university were selected to conduct an anonymous survey once a year and a total of four times using self-compiled questionnaires on AIDS-related knowledge, sexual orientation and behavior of college students. Descriptive epidemiological methods were adopted for statistical description. Results The distribution of sexual orientation among medical students with different survey batches was statistically significant ( 2=26.223, P=0.036). The proportion of openly gay people in the total number of homosexuals showed an increasing trend ( 2trend=4.150, P=0.042). Follow-up study of Chinese medicine students on AIDS related knowledge of the overall rate of increased ( 2trend=23.462, P<0.001). The incidence of general sexual behavior and male homosexual sex among medical students in the past six months showed an increasing trend with grade growth ( 2trend=4.450, P=0.035; 2trend=6.738，P=0.009). At the second and third follow-ups, the proportion of men who used condoms occasionally and never used condoms increased, and the difference was statistically significant ( 2=7.935, P=0.047). Conclusions Due to the weak awareness of medical sexual safety protection, the school should continue to strengthen the AIDS publicity and prevention education of medical students in all grades, and improve the school sexual health education mechanism.

Seroepidemiological survey of hepatitis B virus infection among people under 60 years old in Ma’anshan City, 2017 / 中华疾病控制杂志

Objective To understand the current epidemic and immunity status of hepatitis B virus in Ma’anshan City, and to compare the prevention and control effect after the adjustment of hepatitis B vaccine immunization strategy. Methods Multi-stage random sampling method was used to select 10 investigation points in the whole city, a random sample of 3 460 people under 60 years old was included according to urban and rural stratification. questionnaires and blood were collected from the subjects, and domestic enzyme linked immunosorbent assay (ELISA) was used for hepatitis B immunoglobulins detection. Results The total positive rate of hepatitis B virus surface antigen (HBsAg), hepatitis B virus surface antibody (HBsAb) and Hepatitis B virus (HBV) infection was 3.32%, 51.21% and 29.16% respectively. The positive rate of HBsAb in urban area was higher than that in rural area ( 2=28.204, P<0.001). The positive rate of HBsAb was significantly different between the medical and nursing staff and other occupational groups ( 2=22.772, P<0.001). The difference of HBsAb positive rate before and after HepB vaccine content adjustment was statistically significant ( 2=90.331, P<0.001). The rate of HepB decreased with age ( 2trend=1 984.342, P<0.001). Conclusions Since HepB was incorporated into the immunization program, hepatitis B prevention and control in school-age children has achieved remarkable results. More attention should be paid on the low positive rate of HBsAb in students and the low immunization rate of HepB in adults.

Risk of Active Pulmonary Tuberculosis among Patients with Coal Workers'Pneumoconiosis: A Case-control Study in China / 生物医学与环境科学（英文）

The aim of this study was to estimate the association between occupational, environmental, behavioral risk factors, and active pulmonary tuberculosis (PTB) among coal workers' pneumoconiosis (CWP) patients. A matched case-control study was conducted in 86 CWP patients with active PTB and 86 CWP controls without TB. A standardized questionnaire was used for risk factors assessment. Conditioned logistic regression analysis was used to identify associations between the risk factors and active PTB among CWP patients. The results showed that the stage of CWP, poor workplace ventilation, family history of TB, and exposure to TB were independent risk factors for active PTB in patients with CWP with which recommendations for improving work environments, and for case finding activities in patients with CWP could be made.

The Short-term and Mid-term Outcomes of Elderly Patients With Valvular Heart Disease Undergoing Valve Replacement With Biological or Mechanical Prostheses / 中国循环杂志

Objectives: To compare the short-term and mid-term outcomes of elderly patients (>60 years old) with valvular heart disease (VHD) underwent bioprosthetic or mechanical valve replacement. Methods: Between January 2007 and December 2010, 559 elderly patients underwent valve replacement in Fuwai Hospital, clinical data of these patients were analyzed retrospectively (319 cases with bioprostheses vs 240 cases with mechanical prostheses). After matching, data from 192 cases in each group were compared. Results: The mortality within 30 postoperative days were similar (2.1% in both groups). All-cause death during follow up was also similar between the two groups (13.6% vs 13.7%, P=0.98). There was no statistically significant difference on the hospital readmission rate between the two groups (25.5% vs 35.9%, P=0.17). No significant difference was found on thromboembolic and hemorrhagic events free survival between the two groups (144 cases vs 138 cases, P=0.78). Conclusions: Short-term and mid-term survival and readmission rate are similar for the elderly VHD patients receiving bioprosthetic or mechanical valve replacement.

Prevention of abdominal adhesions in rats by rhynchophylline through inhibition of Smad singnaling pathway / 药学学报

Postoperative intra-abdominal adhesion is one of the most common complications in the postoperative period. Current remedies are very ineffective to prevent the pathological outcomes except steroid hormones. Rhynchophylline is deemed as a pharmacologically active component from traditional Oriental medicine Uncaria rhynchophylla (Miq.) Jacks. (Rubiaceae). This study was designed to investigate the preventative effect of rhynchophylline on the abdominal adhesions in rats. Rhynchophylline relieved the experimental abdominal adhesion and decreased the levels of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the blood serum in a dose-dependent manner. The levels of transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF) were reduced significantly in the peritoneal fluid. The potential mechanism of the activity is related to inhibition of the TGF-β1/Smad signaling pathway.

Do stress fractures induce hypertrophy of the grafted fibula? A report of three cases received free vascularized fibular graft treatment for tibial defects / 中华创伤杂志(英文版)

The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons. Free vascularized fibular grafting (FVFG) is considered to be a reliable reconstructive procedure. Stress fractures are a common complication following this surgery, and hypertrophy is the main physiological change of the grafted fibula. The exact mechanism of hypertrophy is not completely known. To the best of our knowledge, no studies have examined the possible relationship between stress fractures and hypertrophy. We herein report three cases of patients underwent FVFG. Two of them developed stress fractures and significant hypertrophy, while the remaining patient developed neither stress fractures nor significant hypertrophy. This phenomenon indicates that a relationship may exist between stress fractures and hypertrophy of the grafted fibula, specifically, that the presence of a stress fracture may initiate the process of hypertrophy.

Is the European System for Cardiac Operative Risk Evaluation useful in Chinese patients undergoing heart valve surgery? / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The European System for Cardiac Operative Risk Evaluation (EuroSCORE) is one of the most widely used risk models for the predicting mortality after cardiac surgery. The aim of this study was to validate the EuroSCORE model for predicting operative mortality in heart valve surgery on a Chinese multicenter database and comparing the performance of EuroSCORE with our new risk stratification system, the Sino System for Coronary Operative Risk Evaluation (SinoSCORE).</p><p><b>METHODS</b>Data from patients undergoing heart valve surgery between January 2007 and December 2008 were retrospectively collected, from 43 hospitals in China. The EuroSCORE and the SinoSCORE were calculated for each patient. Mortality was defined as any in-hospital death. Area under the receiver operating characteristics curve (AUC) was used to study the discriminatory abilities of the models. The Hosmer-Lemeshow (H-L) goodness-of-fit test was used to study the calibration of the predictive models.</p><p><b>RESULTS</b>A total of 15 367 patients were analyzed. For the entire cohort, the observed mortality was 2.34%, the predicted mortality was 3.71% (additive), 3.19% (logistic) and 3.66% (SinoSCORE). AUC was 0.747 for SinoSCORE, 0.699 additive and 0.696 for logistic EuroSCORE. Calibration of SinoSCORE and additive EuroSCORE was good (H-L: P = 0.250 and P = 0.051, respectively), but the logistic EuroSCORE model had a poor calibration (H-L: P < 0.05). The discriminatory ability and calibration of the SinoSCORE were good in low- and high-risk patients. However, the discriminatory ability of the EuroSCORE model was poor in all risk deciles.</p><p><b>CONCLUSIONS</b>The EuroSCORE does not accurately predict mortality in Chinese patients with heart valve surgery, and the SinoSCORE is superior to the EuroSCORE at predicting in-hospital mortality in Chinese heart valve surgery patients.</p>

Analysis of the monitor results of Marmota sibirica plague foci from 2004 to 2008 / 中国地方病学杂志

Objective To master of the characteristics of development and variation in plague natural foci of Marmota sibirica, and to analyze the plague monitoring results from 2004 to 2008. Methods From May to September every year, we monitored plague in Manzhouli, Chenbaerhuqi, Xinbaerhuzuoqi, Xinbaerhuyouqi,Ewenkeqi and Yakeshi city. The monitored area was 20 000 - 40 000 hm2 in every county. The density of Marmota,ground squirrel and moonlighting rats was surveyed by path method, one-day bow-clip method and a clamp was placed every five meters, respectively. The classification and identification of ectoparasite fleas were done by using low power lens. The fleas in the ground squirrel hole were collected by flannel rubber stick, then classified and identified. According to National Standard of Plague Diagnostic Criteria(GB 15991-1995), the collected rats and fleas were detected by isolation and cultured Yersinia pestis, the serums of collected rats were tested by indirect hemagglutination test. Results In five years, the density of Marmota and ground squirrel was 0.010/hm2 and 0.602/hm2, respectively. The capture rate of moonlighting rats was 2.69％ (258/9600). The flea infection rate of Marmota was 17.54％(10/57) and the fleas index was 2.54. The fleas infection rate of ground squirrel was 28.40％(213/750) and the fleas index was 1.01. Flea infection rat of ground squirrel hole was 5.60％(46/822) and the fleas index was 0.17. The total number of various hosts of Yersinia pestis detected was 1351, the groups number of the variety of cultured fleas was 127, and the pathogen test results were negative. The number of serum tested was 1064, positive number was 43, and the detection rate was 4.04％(43/1064). The highest positive titer was 1 : 1280. Other than 2006, the remaining four years were found positive for blood clotting material; positive serum was found in a total of three regions, they were Manzhouli, Xinbaerhuzuoqi, and Xinbaerhuyouqi; and 30, 12 and 1 copies of hemagglutination-positive sera were detected. Conclusions The epidemic of plague natural foci of Marmota sibirica is in a active state, and gradually expands the scope. We must continue to strengthen the inspection of the bacteria, bearing in mind the replacement of the region's main host, make every effort to prevent and control of human plague.

Analysis of sensitivity and specificity of sputum cytology screening for lung cancer with different positive criteria / 中华预防医学杂志

<p><b>OBJECTIVE</b>To discuss the effect of different positive criteria on the sensitivity and specificity of sputum cytology screening for lung cancer among Yunnan tin miners.</p><p><b>METHODS</b>9223 Yunnan tin miners who received at least one annual sputum cytology screening for lung cancer during the period between 1992 and 1999 were recruited in the study. At time of enrollment, all participants were aged over 40 years old, had at least 10 years of employment as an underground miner and(or) smelter, and had not been diagnosed with malignancy. In our study, a true positive was categorized as having at least one prior positive sputum screening and a diagnosis of lung cancer, while a true negative, by our definition, signified negative sputum examinations and no diagnosis of lung cancer during the follow up time. Based on different positive criteria, sensitivity and specificity of sputum cytology were computed and receiver operating characteristic (ROC) curve analysis was conducted. Z statistic was used to test the differences of the area under ROC based on Hanley and McNeil method.</p><p><b>RESULTS</b>By the end of following up on December 31, 2001, a total 500 lung cancer cases were diagnosed among 9223 participants: most were squamous cell carcinoma (55.8% (222/398)) and central lung cancers (68.5% (316/461)). 150 lung cancer cases had a previous positive sputum screening result. When positive criteria were taken as grave atypical metaplasia, moderate atypical metaplasia and slight atypical metaplasia, the corresponding sensitivities were 30.0% (150/500), 36.4% (182/500), 53.0% (265/500) respectively; while the corresponding specificities were 98.9% (8628/8723), 95.1% (8611/8723), 77.9% (7033/8723) respectively. The areas under ROC curve according to different positive criterias were 0.645 (95%CI: 0.635 - 0.654), 0.657 (95%CI: 0.668 - 0.667), 0.655 (95%CI: 0.645 - 0.664) respectively. There were no significant differences found in the comparisons between grave and moderate atypical metaplasia, grave and slight atypical metaplasia, moderate and slight atypical metaplasia(Z statistics were 0.780, 0.645, 0.209 respectively, all P values > 0.05).</p><p><b>CONCLUSION</b>While the standard of positive criteria for diagnosis of lung cancer decreased, the sensitivity of sputum cytology screening increased and the specificity decreased. Since there were no significant differences of accuracy for different positive criteria.</p>

Left ventricular reconstruction with no-patch technique: early and late clinical outcomes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Few studies have evaluated late clinical outcome of no-patch technique in patients with large left ventricular aneurysms. The objectives of this study were to evaluate a no-patch surgical technique to reconstruct the left ventricle in patients with left ventricular aneurysm and to assess early and late clinical outcomes.</p><p><b>METHODS</b>In 1995, we began using a no-patch technique in patients with dyskinetic left ventricular aneurysms. A total of 145 patients underwent left ventricular reconstruction with this technique and were followed up for (59 ± 29) months (range, 1 - 127 months). Risk factors for early mortality were analyzed by bivariate analyses. Cox's proportional hazards model was used to calculate risk factors for all-cause mortality and hospital readmission. Kaplan-Meier methodology was used to analyze late survival.</p><p><b>RESULTS</b>One week after operation, left ventricular end-diastolic diameter had decreased from (61 ± 8) mm to (55 ± 8) mm, and geometry of the left ventricle was restored to a more normal conical shape. Early mortality was 3% and late mortality 11%. Over a 5-year follow-up period, hospital readmission was 28%. One-, 5-, and 10-year survival estimates were 95% (95% confidence interval (CI) 91% - 99%), 86% (95%CI 78% - 94%), and 74% (95%CI 60% - 88%). Readmission-free survival at 1 and 5 years after operation was 87% (95%CI 81% - 93%) and 60% (95%CI 50% - 70%), respectively.</p><p><b>CONCLUSION</b>The no-patch technique for left ventricular reconstruction is an effective and simple procedure that can achieve satisfactory early and late clinical outcomes in patients with left ventricular aneurysms.</p>

Effects of left ventricular reconstruction on magnetic resonance imaging derived left ventricular wall stress and contractive function in patients with postinfarction ventricular aneurysm / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the effects of left ventricular reconstruction on left ventricular wall stress and function in patients with postinfarction left ventricular aneurysm.</p><p><b>METHODS</b>During January 2005 to June 2006, 16 patients [15 male, (56.6 +/- 8.8) years] with postinfarction ventricular aneurysm received left ventricular reconstruction operation on CPB (5 linear repair, 6 endoventricular purse-string suture, 5 endoventricular patch repair) and CABG was also performed in 15 patients. MRI examination was made before and 3 months post operation by Siemens Magnetom Avanto 1.5T MR with routine cine-MRI in combination with late-delayed enhancement sequence. Left ventricular geometric parameters and segmental thickening were obtained with accessory image analysis software. Non-invasive blood pressure was acquired in order to compute ventricular wall stress. The revascularized and unrevascularized segments were defined by comparing the post operation revascularization of the blood-supply coronary artery with preoperative results.</p><p><b>RESULTS</b>A total of 192 segments including 74 unrevascularized segments were analyzed. Segmental thickening were significantly increased while wall stress were significantly reduced in both unrevascularized and revascularized segments 3 months post operation compared to preoperative values (all P < 0.05). The increase of wall thickening was positively correlated with the reduction of wall stress in these segments.</p><p><b>CONCLUSION</b>Left ventricular reconstruction plus CABG is associated with reduced left ventricular wall stress and increased myocardial contractive function in patients with postinfarction left ventricular aneurysm.</p>

Experimental study of directional differentiation of bone mesenchymal stem cells (BMSCs) to osteoblasts guided by serum containing cistanche deserticola / 中国骨伤

<p><b>OBJECTIVE</b>To study directional differentiation of BMSCs guided by Desert living Cistanche (Herba Cistanches) which invigorates the kidney.</p><p><b>METHODS</b>Primary BMSCs were obtained by whole bone marrow culture and subcultured to the fourth generation by trypsin digestion, and than inoculated into two six-well plates at 5 x 10(6) cells per milliliter, all the plates were divided into three groups as blank group, Dexamethasone (DXM) group and Herba Cistanches group, three wells in each group, medium were changed at day 2. The blank group were changed with L-DMEM containing 10% FBS. The DXM group were changed with medium containing 10 mmol/L beta-sodium glycerophosphate, 0.1 micromol/L DXM and 50 mg/L vitamin C. The Herba Cistanches group were changed with medium containing 10% blood serum containing Herba Cistanches and L-DMEM. One of the six-well plates was stained by alkaline phosphatase (AKP) at the tenth day,the other one was stained by alizarin Bordeaux at the twentieth day.</p><p><b>RESULTS</b>At the tenth day DXM group and Herba Cistanches group were ALKP stained positive; from the 12th day,white calcium nodus could be seen at the surface of the wells; which alizarin stained positive by the twentyth day.</p><p><b>CONCLUSION</b>The medium containing Herba Cistanches can guide BMSCs to differentiate into osteoblast, which promises a favorable prospect for the treatment of osteoporosis and bone fracture disunion.</p>

Early diagnosis of lingual thyroglossal duct cyst in newborns: analysis of 10 cases previously misdiagnosed as laryngomalacia / 中华儿科杂志

<p><b>OBJECTIVE</b>To distinguish lingual thyroglossal duct cyst (LTDC) from laryngomalacia in newborn infants.</p><p><b>METHODS</b>Data of 10 newborn infants with laryngeal stridor and dyspnea, admitted to the department of neonatology in our hospital during December, 2004 to August, 2007, who were finally diagnosed with LTDC though previously diagnosed as congenital laryngeal stridor in other hospitals, were summarized and analyzed.</p><p><b>RESULTS</b>Inspiratory stridor with chest wall retractions was cardinal symptom of newborn with LTDC. A slightly gray and round cyst with smooth surface at the base of the tongue was found with laryngoscopy. On computed tomography examination of larynx, a well-circumscribed lesion with low intensity was detected at the base of the tongue protruding into the air passage. Pathological examination demonstrated that the cyst wall was composed of tabular and columnar epithelium.</p><p><b>CONCLUSIONS</b>LTDC is a common disease in newborns, which is similar to laryngomalacia. For neonates suspected of LTDC, laryngoscopic examination should be performed first, while laryngeal CT scan is an important diagnostic basis. Cyst puncture can ameliorate the symptoms of the patients, while surgical removal is the method of radical cure.</p>