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The perception of motion is an important function of vision. Neural wiring diagrams for extracting directional information have been obtained by connectome reconstruction. Direction selectivity in Drosophila is thought to originate in T4/T5 neurons through integrating inputs with different temporal filtering properties. Through genetic screening based on synaptic distribution, we isolated a new type of TmY neuron, termed TmY-ds, that form reciprocal synaptic connections with T4/T5 neurons. Its neurites responded to grating motion along the four cardinal directions and showed a variety of direction selectivity. Intriguingly, its direction selectivity originated from temporal filtering neurons rather than T4/T5. Genetic silencing and activation experiments showed that TmY-ds neurons are functionally upstream of T4/T5. Our results suggest that direction selectivity is generated in a tripartite circuit formed among these three neurons-temporal filtering, TmY-ds, and T4/T5 neurons, in which TmY-ds plays a role in the enhancement of direction selectivity in T4/T5 neurons.
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Animals , Neurites , Drosophila , Neurons , ConnectomeABSTRACT
OBJECTIVE To explore the pharmaceutical service model in multidisciplinary diagnosis and treatment （MDT） of rare diseases in children. METHODS Clinical pharmacists of West China Second University Hospital （hereinafter referred to as “our hospital”） participated in the process of MDT of children’s rare diseases. Clinical pharmacists took part in the entire diagnosis and treatment process of children and established the MDT pharmaceutical service model of children’s rare diseases by formulating drug treatment plans based on evidence-based practice， improving the accessibility of drugs， pharmaceutical monitoring and drug treatment management. RESULTS From January 2021 to April 2022， clinical pharmacists of our hospital had participated in a total of 39 cases of rare diseases MDT in children， including 21 hospitalized children with rare diseases and 18 outpatient com children with rare diseases， involving a total of 23 rare diseases. Clinical pharmacists completed 45 pharmaceutical zhanglingli@scu.edu.cn rounds and 26 pharmaceutical consultations for rare diseases inpatients， 25 outpatients’ MDT and 5 pharmaceutical outpatient service for outpatients with rare diseases， 38 medication educations for inpatients and outpatients with rare diseases and 25 follow-up services for out-of-hospital patients. There were 24 cases （61.54%） of off-label drug use， involving 13 rare diseases and 16 therapeutic drugs， among which off-label drug use registration of 11 drugs had been completed or was in progress. The temporary purchase evaluations of 3 drugs had been completed； 268 cases of medical insurance drug and high-value drug prescription had been reviewed. CONCLUSIONS Our hospital have primarily established a loop pharmaceutical service model of MDT for children with rare diseases， which covers inpatients and outpatients. The model improves the availability and standardization of clinical application of therapeutic drugs， and diagnosis and treatment level for children with rare diseases in our hospital.
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Objectives To explore the associations between higher antibiotic use rates (AURs) and adverse outcomes in very-low-birthweight (VLBW) infants without culture-proven sepsis or necrotizing enterocolitis (NEC) in a multicenter of China. Methods A prospective cohort study was performed on VLBW infants admitted to 24 neonatal intensive care units from January 1, 2018, to December 31, 2018. AUR was calculated as calendar days of antibiotic therapy divided by total hospital days. The composite primary outcome was defned as mortality or severe morbidity, including any of the following: severe neurologic injury, bronchopulmonary dysplasia (BPD), and stage 3 or higher retinopathy of prematurity. Results A total of 1,034 VLBW infants who received antibiotics without culture-proven sepsis or NEC were included in this study. The overall AUR of eligible VLBW infants was 55%, and the AUR of each eligible VLBW infant ranged from 3 to 100%, with a median of 56% (IQR 33%, 86%). After generalized propensity score and logistic regression analysis of 4 groups of VLBW infants with diferent AUR range, infants in the higher quartile AUR, (Q3, 0.57~0.86) and (Q4, 0.87~1.00), had higher odds of composite primary outcome (adjusted OR: 1.81; 95% CI: 1.23–2.67; adjusted OR 2.37; 95% CI: 1.59–3.54, respectively) and BPD (adjusted OR: 3.09; 95% CI: 1.52–6.57; adjusted OR 3.17; 95% CI: 1.56–6.57, respectively) than those in the lowest AUR (Q1). Conclusions Antibiotic overexposure in VLBW infants without culture-proven sepsis or NEC was associated with increased risk of composite primary outcome and BPD. Rational empirical antibiotic use in VLBW infants is urgently needed in China.
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Based on the open data of China Health and Nutrition Survey (CHNS), 249 children, adolescents and 249 heads of families who completed two rounds of surveys in 2011 and 2015 were selected in this study. According to the fast food consumption of children and adolescents, they were divided into fast food consumption group and non-fast food consumption group. Logistic regression model was used to analyze the relationship between children and adolescents watching Food TV advertising and fast food consumption. After adjusting relevant factors, the results showed that children and adolescents requiring their parents to buy food in TV advertisements (OR=3.122, P=0.001), parents buying food for their children in TV advertisements (OR=4.717, P=0.036), children and adolescents buying food in TV advertisements themselves (OR=3.728, P=0.041), children and adolescents' preference for food in TV advertisements (OR=2.946, P=0.044) and the frequency of children and adolescents reported by their parents asking their parents to buy food in TV advertisements (OR=3.113, P=0.002) were associated with children and adolescents' fast food consumption.
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Adolescent , Child , Humans , Advertising , China , Fast Foods/analysis , Nutrition Surveys , TelevisionABSTRACT
As food preferences and eating habits form early in life, the development of healthy eating habits in early childhood is a way to prevent diet-related diseases. The dietary pattern approach examines the effect of an overall diet on health outcomes, instead of individual foods or nutrients, thereby presenting a comprehensive evaluation of children's dietary intake. This article reviews the current literature to summarize the main methods for assessing dietary patterns and explore relationships between children's dietary patterns and obesity, puberty onset, cardiovascular diseases, and neurodevelopment. The purpose of this review is to provide evidence-based support for reducing the risk of diet-related diseases in children and recommendations for future research directions.
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Child , Child, Preschool , Humans , Diet , Eating , Feeding Behavior , Food Preferences , Obesity/prevention & controlABSTRACT
@#AIM:To investigate the efficacy of 99Tcm-octreotide orbital imaging combined with magnetic resonance imaging(MRI)in stage diagnosis of thyroid associated ophthalmopathy(TAO). <p>METHODS: Retrospective analysis of clinical data of 35 surgically treated TAO patients admitted to hospital from June 2017 to June 2018. 99Tcm-octreotide orbital imaging and MRI were performed, and the pathological observation and stages were performed. The result of pathological staging was statistically analyzed. The imaging findings and results of 99Tcm-octreotide orbital imaging combined with MRI were observed. The efficacy of 99Tcm-octreotide orbital imaging, MRI, 99Tcm-octreotide orbital imaging combined with MRI in the stage diagnosis of TAO was analyzed. <p>RESULTS: Totally 58 eyes with TAO in 35 patients with pathological stages were 49 eyes in the active phases and 9 eyes and inactive phases. 99Tcm-octreotide orbital imaging and MRI diagnosis of TAO severity staging have typical imaging findings, and the sensitivity, specificity, accuracy of 99Tcm-octreotide orbital imaging combined with MRI in the diagnosis of active TAO was higher than that of 99Tcm-octreotide orbital imaging and MRI alone. The ROC results showed that the AUC of the active phase of 99Tcm-octreotide orbital imaging combined with MRI diagnosis was 0.893, which was higher than that of 99Tcm-octreotide orbital imaging or MRI alone. <p>CONCLUSION:It is recommended to use 99Tcm-octreotide orbital imaging and MRI imaging in combination with TAO stage diagnosis. The imaging findings are typical, and the combined application has higher diagnostic efficiency.
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BACKGROUND@#The incidence of uterine cesarean scar defect (niche) is high, and some patients require surgery. Single-port laparoscopy can reduce post-operative pain, and provide better cosmetic effects. This study was performed to evaluate the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scar defect (niche) in women after cesarean section.@*METHODS@#This study included 74 patients who were diagnosed with uterine cesarean niche at the Shanghai First Maternity and Infant Hospital from January 2013 to June 2015. Thirty-seven patients underwent single-port laparoscopy-assisted vaginal surgery as the case group, and the remaining patients underwent vaginal repair surgery as the control group. We collected data from the inpatient and follow-up medical records. The clinical characteristics of these two groups were compared. The odds ratios and 95% confidential intervals were calculated for each variable by univariate and multivariate analyses.@*RESULTS@#Patients who underwent single-port laparoscopy-assisted vaginal repair had a significantly longer operation time (2.3 [2.0-2.7] vs. 2.0 [1.6-2.3] h, P = 0.015), shorter gas passage time (1.2 [1.0-1.5] vs. 1.7 [1.0-2.0] days, P = 0.012), shorter hospital stay (3.1 [3.0-4.0] vs. 4.5 [4.0-6.0] days, P = 0.019), and fewer complications (0 vs. 4 cases). Univariate analysis showed that depth of the niche (P = 0.021) the mild adhesiolysis score (P = 0.035) and moderate adhesiolysis score (P = 0.013) were associated with the bladder injury. Multivariate analysis showed that the moderate adhesiolysis score (P = 0.029; 95% confidence interval, 1.318-3.526) was the strongest independent predictor of bladder injury.@*CONCLUSION@#This study confirmed the safety and superiority of single-port laparoscopy-assisted vaginal repair of uterine cesarean scars.
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Objective@#To examine the association of pre-pregnancy body mass and weight gain during pregnancy with macrosomia. @*Methods@#From January 2015 to December 2015, a total of 20 477 pregnant women were recruited by probabilistic proportional scale sampling with simple randomization in Sichuan, Yunnan and Guizhou Provinces. Basic information of pregnant women, weight gain during pregnancy and weight of newborn were collected. A multiple logistic regression model was used to assess the association between the pre-pregnancy body mass and gestational weight gain indicators with macrosomia. @*Results@#20 321 mother-infant were included in the final analysis. 20 321 pregnant women were (30.09±4.10) years old and delivered at (39.20±1.29) weeks, among which 12 341 (60.73%) cases were cesarean delivery. The birth weight of 20 321 infants were (3 292.26±431.67) grams, and 970 (4.77%) were macrosomia. The multiple logistic regression model showed that after adjusting for the age of women, compared to the normal weight group in the pre-pregnancy, the overweight and obesity group elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.69−2.35) and 4.05 (95%CI: 3.05−5.39), respectively. After adjusting for the age, the pre-pregnancy BMI, delivery weeks, delivery mode and infant′s gender, compared to the weight-gain appropriate group, higher weight gain rate in the mid-pregnancy and excessive total gestational weight gain elevated the risk of macrosomia, with OR (95%CI) about 1.99 (95%CI: 1.66−2.39) and 1.80 (95%CI: 1.55−2.08), respectively. @*Conclusion@#The overweight before pregnancy, obesity before pregnancy, the rate of weight gain in the second trimester and the high total weight gain during pregnancy could increase the risk of macrosomia.
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Indoleamine 2,3-dioxygenase 1 (IDO1) is a key enzyme in the human tryptophan metabolism pathway, which can mediate tumor immune response. An IDO1 inhibitor would be a potential cancer immunotherapy drug. Based on the recently reported crystal of an IDO1 protein-inhibitor complex (PDBID: 6AZV), the structure of reported inhibitor, and by analyzing the interaction mode between the inhibitor and IDO1, new inhibitor molecules were designed and synthesized. All structures were confirmed by spectral data. Preliminary activity studies showed that compounds containing an azabiphenyl tetrazole structure (B1 and B2) and biphenyl compounds containing a sulfonamide structure (D1, D2 and D3) had excellent inhibitory activity of IDO1 at the enzyme and cell level, and were comparable or even better than the control drug INCB24360.
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To investigate the clinical efficacy of antibiotic impregnated beads on the tibial chronic osteomyelitis, so as to search for a more applicable method for the treatment. Through comparative analysis, we divided 72 patients with chronic tibial osteomyelitis who received treatment in hospital between January 2016 and December 2016 randomly into two groups: Control group [n=36] and the experiment group [n=36]. Patients in the control group underwent closed lavage plus drainage for treatment, while those in the experiment group received the antibiotic impregnated beads. After treatment, we compared the times of treatment, average length of stay in hospital and the efficacy between two groups, and data were analyzed using SPSS 15.0 software. In the control group, average length of stay in hospital was [[3.3 +/- 0.9] months, average time of surgery was [2.9 +/- 1.8] times, cure rate was 25.0% and elimination rate of bacteria was 88.0%; in the experiment group, average length of stay in hospital was [[2.2 +/- 1.3] months, average time of surgery was [2.4 +/- 1.0] times, cure rate was 47.2%, and elimination rate of bacteria was 93.8%. Differences in the average length of stay in hospital, the cure rate and elimination rate of bacteria between two groups showed statistical significance [p<0.05]. For tibial chronic osteomyelitis, antibiotic impregnated bead implantation can reduce the chance of secondary infection after operation and shorten the hospitalization time, showing a more promising effect than the closed lavage and drainage, and this method is worthy of being promoted in clinical practice
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Objective To explore the effects of both pre-gestational BMI and gestational weight gain (GWG) on the birth weight of neonates.Methods A total of 5 395 pregnant women were selected from the Southwest areas of China (Sichuan/Yunnan/Guizhou) and were divided into groups as pre-gestational underweight,normal weight,overweight and obesity,according to the WHO Recommendation on BMI Classification.Guidelines on Pregnancy weight were adopted from the Institute of Medicine to confirm the accuracy of GWG.Multinomial logistic regression model was used to assess the associations between pregestational BMI and GWG,on the birth weight of the neonates.Results After adjusting for related confounders,low pre-gestational BMI appeared as a risk factor for SGA (OR=1.91,95％CI:1.47-2.50),and was also associated with the decreased risk of LGA (OR=0.55,95％CI:0.47-0.66).Inadequate GWG was both associated with the increased risk of delivering SGA (OR=1.57,95％CI:1.21-2.03) and the decreased risk of LGA (OR=0.48,95％CI:0.41-0.57).Pre-gestational overweight/obesity (OR=1.85,95％CI:1.58-2.17) and excessive GWG (OR=1.87,95％CI:1.67-2.11) were both positively associated with the risks on LGA.Data from the stratified analysis indicated that inadequate GWG was positively associated with the risk of SGA among underweight or normal weight women (all P＜0.05),but not with those overweight/obese women.Conclusions Pre-gestational BMI and GWG were important influencing factors on the birth weight of neonates.Health education programs for pregnant women should be intensified and gestational weight gain should also be reasonably under control.
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Objective To explore the effects of both pre-gestational BMI and gestational weight gain (GWG) on the birth weight of neonates.Methods A total of 5 395 pregnant women were selected from the Southwest areas of China (Sichuan/Yunnan/Guizhou) and were divided into groups as pre-gestational underweight,normal weight,overweight and obesity,according to the WHO Recommendation on BMI Classification.Guidelines on Pregnancy weight were adopted from the Institute of Medicine to confirm the accuracy of GWG.Multinomial logistic regression model was used to assess the associations between pregestational BMI and GWG,on the birth weight of the neonates.Results After adjusting for related confounders,low pre-gestational BMI appeared as a risk factor for SGA (OR=1.91,95％CI:1.47-2.50),and was also associated with the decreased risk of LGA (OR=0.55,95％CI:0.47-0.66).Inadequate GWG was both associated with the increased risk of delivering SGA (OR=1.57,95％CI:1.21-2.03) and the decreased risk of LGA (OR=0.48,95％CI:0.41-0.57).Pre-gestational overweight/obesity (OR=1.85,95％CI:1.58-2.17) and excessive GWG (OR=1.87,95％CI:1.67-2.11) were both positively associated with the risks on LGA.Data from the stratified analysis indicated that inadequate GWG was positively associated with the risk of SGA among underweight or normal weight women (all P＜0.05),but not with those overweight/obese women.Conclusions Pre-gestational BMI and GWG were important influencing factors on the birth weight of neonates.Health education programs for pregnant women should be intensified and gestational weight gain should also be reasonably under control.
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Hepatic fibrosis is an important pathological process in the development of liver cirrhosis and liver cancer from chronic liver damage. So far there is no effective chemical drug in clinic for treatment of hepatic fibrosis. Therefore, the research in anti-hepatic fibrosis drugs is a hot topic. For drugs currently under research and development, most of the mechanisms of action are related to inhibition of factors that could cause or deteriorate liver fibrosis, including activation and proliferation of hepatic stellate cells, inflammation, oxidative stress and production of extracellular matrix, et al. In this review, we briefly analyze targets and drugs related to the mechanisms mentioned above in order to provide a reference to the future research and development of anti-hepatic fibrosis drugs.
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Objective To investigate the precision and clinical practicability of anchor point locating under the guidance of augmented reality (AR) navigation for anterior cruciate ligament (ACL) reconstruction.Methods A cube model was made by 3D print which contained some concentric circles of different diameters to be the target.Fifty orthopedists were chosen and numbered from 1 to 50 to locate with AR guidance.Finally,the results of precision and score of satisfaction were analyzed.Results The location precision guided by AR in different diameter concentric circle were 74％ (0.25 cm),78％ (0.5 cm),83％ (0.75 cm),86％ (1.0 cm),89％ (1.25 cm),96％ (1.5 cm) respectively.The average satisfaction score of the orthopedists' was (8.7 ± 1.3).Conclusion Anchor point locating under the guidance of AR navigation is a feasible and effect method for clinical ACL reconstruction,which can observe the relations of the anchor point and the adjacent structure in real time.
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Objective To investigate the method and effect of arthroscopic repair of recurrent anterior shoulder dislocation caused by anterior and inferior labrum complete defect.Methods Retrospective analyzed the clinical data of 23 patients with anterior and inferior la-brum complete defect who were admitted into hospital from June 2014 to October 2016 and recieved arthroscopic repair opreation with gleno-humeral ligament combined with articular capsule.Intraoperative arthroscopy was used to suture the lower glenohumeral ligament and articular capsule at the missing part of the glenoid labrum.The Rowe score,ASES score and UCLA score were compared before and after operation. Results There was no postoperative complications such as dislocation or infection occurred.All the 23 cases were followed up for 12~42 months,with an average of(19.6 ±3.4)months.The average lost angle of shoulder external rotation was(17.3 ±3.9)°.And the postopera-tive Rowe score,ASES score and UCLA score were significantly better than those before operation.Conclusion Arthroscopic repair opreation with glenohumeral ligament combined with articular capsule can effectively restore the stability of front shoulder joint,and it can be a good method for the treatment of recurrent anterior shoulder dislocation caused by anterior and inferior labrum complete defect.
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Objective To explore the clinical effect of arthroscopic repair without traction for non-osseous Bankart injury.Methods From January 2009 to January 2015,the clinical data of 182 cases underwent arthroscopic Bankart repair for anterior shoulder instability in our hospital were analyzed retrospectively.They were aged from 18 to 39 years old,mean age was(26.5 ± 9.3) years.The course of disease was from 1 to 10 years,mean duration was(3.2 ±2.6) years.Recurrent dislocation was 6 to 62 times,with average of (24.2 ± 17.3) times.All cases were performed arthroscopic repair without traction.Rowes scores and UCLA scores were used for evaluation.Results All of 182 cases were followed up from 6 to 18 months,an average of (12.5 ± 6.7) months.Of the 182 patients,12 cases with postoperative limited 20°external rotation could not attend confrontational training and the other 170 cases had no adverse effect.The average loss of shoulder joint extorsion activity angle were (10.5 ± 4.1) °.Postoperative UCLA score (89 ± 3.5) was more than preoperative (25 ± 6.2),the differences were significant (P ＜ 0.05).Postoperative Rowes score (28.7 ± 2.2) were more than preoperative (7.3 ± 1.6),the differences were significant (P ＜ 0.05).Conclusion Curative effect of arthroscopic repair without traction for non-osseous Bankart injury caused by training is satifactory,which can provide brachial plexus,blood vessel and other tissues during surgery from traction,and be helpful to the popularization and application in basic-level hospitals.
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The paper introduces the design and implementation of residents online medical examination report query system based on cloud platform,including the system architecture,process,data structure,security and necessary controls,etc.This system makes it able for the residents to check their medical examination reports and corresponding video pictures whenever and wherever possible on the Internet.
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Transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) has been reported to be effective for local control of different-sized hepatocellular carcinomas. However, it is unclear if these benefits could also be applicable to different-sized liver metastases from gastrointestinal cancers. The aim of this study was to evaluate the outcomes of TACE combined with RFA for liver metastases from gastrointestinal cancers. In this study, we retrospectively analyzed clinical data of 19 consecutive patients who had a total of 26 liver metastatic lesions from gastrointestinal cancers and underwent RFA followed by first-time TACE treatment. The tumor recurrence, overall survival rate and procedure-related complications were evaluated. Moreover, patients' demographics and tumor characteristics were analyzed to determine their impact on the outcomes. The technical success of TACE plus RFA was achieved with 2 major procedure-related complications found. The mean follow-up was 21.3 months. The total 1-, 2-, and 3-year survival rate was 89.4%, 52.6%, and 35.1%, respectively. It was found that the tumor size and the ratio of enhancement area were significant factors that influenced the overall survival. In conclusion, patients with gastrointestinal cancer-derived liver metastatic lesions of smaller size and larger enhancement area are considered appropriate candidates for TACE plus RFA.
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Objective TolearnthehealthstatusofemptynesterswithdiabetesinthemountainssouthwestofZhejiangand toexploretheinfluencingfactors.Methods Usingthemethodofstratified-random-clustersampling,78emptynesters with diabetes and 1 56 non -empty nesters with diabetes who come from five streets and 1 0 towns of 30 community (or village)were selected and investigated by questionnaire and physical examination were conducted.Univariate analysis were conducted to compare the differences about lifestyle,biochemical indicators and health status between the two groups and multivariateunconditionallogisticregressionanalysiswereconductedtoanalyzetheinfluencingfactors.Results The prevalence of hypertension of empty nest group was 70.51%,and the prevalence of hypertension of non-empty nest group was 58.97%.Fasting blood glucose level of empty nest group was 9.39 ±5.73 mmol/L,higher than that of the non-empty nest group(P<0.05 ).There was significant difference between the two groups in other indicators,such as drinking rate,high -salt diet rate,obesity rate,triglyceride levels,regular exercise rate,vegetables/fruits ≥4 days/week proportion,fish/meat≥4 days/week,awareness of their own blood pressure and blood sugar awareness (P<0.05).After adjustment for age,the obesity rate,abnormal rate of triglycerides,fish/meat(≥4 days/week)intake,regular exercise rate,blood pressure and blood sugar awareness rate were lower among non-empty nesters with diabetes,and overweight rate,systolic blood pressure abnormal rate,fasting glucose ratio,alcohol and high salt diet were higher in empty nest group patientswithdiabetes.Conclusion Emptynesterswithdiabeteshavearelativelyhighproportionoflackofexercise, inadequate nutrition intake,alcohol consumption,high-salt diet and lack of health knowledge and other unhealthy factors. The community health services and individual guidance for the empty nesters should be strengthened to improve the health status of empty nesters with diabetes.
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Transarterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) has been reported to be effective for local control of different-sized hepatocellular carcinomas. However, it is unclear if these benefits could also be applicable to different-sized liver metastases from gastrointestinal cancers. The aim of this study was to evaluate the outcomes of TACE combined with RFA for liver metastases from gastrointestinal cancers. In this study, we retrospectively analyzed clinical data of 19 consecutive patients who had a total of 26 liver metastatic lesions from gastrointestinal cancers and underwent RFA followed by first-time TACE treatment. The tumor recurrence, overall survival rate and procedure-related complications were evaluated. Moreover, patients' demographics and tumor characteristics were analyzed to determine their impact on the outcomes. The technical success of TACE plus RFA was achieved with 2 major procedure-related complications found. The mean follow-up was 21.3 months. The total 1-, 2-, and 3-year survival rate was 89.4%, 52.6%, and 35.1%, respectively. It was found that the tumor size and the ratio of enhancement area were significant factors that influenced the overall survival. In conclusion, patients with gastrointestinal cancer-derived liver metastatic lesions of smaller size and larger enhancement area are considered appropriate candidates for TACE plus RFA.