Clinical effects of island posterior femoral composite tissue flaps in the repair of sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter / 中华烧伤杂志

Objective: To explore the clinical effects of island posterior femoral composite tissue flaps in the repair of sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter. Methods: The retrospective observational study was conducted. From December 2018 to December 2021, 23 patients with sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter who met the inclusion criteria were admitted to Ganzhou People's Hospital, including 16 males and 7 females, aged 45 to 86 years. The size of pressure ulcers in ischial tuberosity ranged from 1.5 cm×1.0 cm to 8.0 cm×5.0 cm, and the size of pressure ulcers in greater trochanter ranged from 4.0 cm×3.0 cm to 20.0 cm×10.0 cm before debridement. After treatment of underlying diseases, debridement and vacuum sealing drainage for 5 to 14 days were performed. All the wounds were repaired by island posterior femoral composite tissue flaps, with area of 4.5 cm×3.0 cm-24.0 cm×12.0 cm, pedicle width of 3-5 cm, pedicle length of 5-8 cm, and rotation radius of 30-40 cm. Most of the donor site wounds were sutured directly, and only 4 donor site wounds were repaired by intermediate thickness skin graft from the contralateral thigh. The survival of composite tissue flaps, wound healing of the donor and recipient sites and the complications were observed. The recurrence of pressure ulcers, and the appearance and texture of flaps were observed during follow-up. Results: A total of 32 wounds in 23 patients were repaired by island posterior femoral composite tissue flaps (including 3 fascio subcutaneous flaps, 24 fascial flaps+fascio subcutaneous flaps, 2 fascial flaps+fascial dermal flaps, 2 fascial flaps+fascio subcutaneous flaps+femoral biceps flaps, and one fascial flap+fascio subcutaneous flap+gracilis muscle flap). Among them, 31 composite tissue flaps survived well, and a small portion of necrosis occurred in one fascial flap+fascio subcutaneous flap post surgery. The survival rate of composite tissue flap post surgery was 96.9% (31/32). Twenty-nine wounds in the recipient sites were healed, and 2 wounds were torn at the flap pedicle due to improper postural changes, and healed one week after bedside debridement. One wound was partially necrotic due to the flap bruising, and healed 10 days after re-debridement. Thirty-one wounds in the donor sites (including 4 skin graft areas) were healed, and one wound in the donor site was torn due to improper handling at discharge, and healed 15 days after re-debridement and suture. The complication rate was 12.5% (4/32), mainly the incision dehiscence of the flap pedicle and the donor sites (3 wounds), followed by venous congestion at the distal end of flap (one wound). During the follow-up of 3 to 24 months, the pressure ulcers did not recur and the flaps had good appearance and soft texture. Conclusions: The island posterior femoral composite tissue flaps has good blood circulation, large rotation radius, and sufficient tissue volume. It has a high survival rate, good wound healing, low skin grafting rate in the donor site, few postoperative complications, and good long-term effect in the repair of sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter.

Progress in research of etiology of childhood obesity based on interaction between genes and environment / 中华流行病学杂志

Childhood obesity is a global public health problem, which can not only endangers children's health, but also might be an important cause of chronic diseases in adulthood. In recent years, with the in-depth development of precision medicine research, more and more research evidences have shown that there are interactions between environmental factors, such as early intrauterine environment, children's diet, physical activity and children's gene factor on the incidence of childhood obesity, which can result in or inhibit the incidence and development of childhood obesity. This paper summarizes the progress in research in this field to reveal the effects and potential mechanisms of genetic factors and environmental factors on the incidence of childhood obesity in order to provide reference for the precise prevention and control of childhood obesity under different genetic backgrounds.

A multiomics comparative study on the intervention of fecal microbiota transplants of Fengshining on rheumatoid arthritis / 药学学报

The study aims to investigate the mechanism of Fengshining fecal microbiota transplants in the intervention of rheumatoid arthritis by ultra-performance liquid chromatography-quadrupole/electrostatic field obitrap high-resolution mass spectrometry (UHPLC-Q-Exactive Orbitrap-MS). All animal welfare and experimental procedures followed the regulations of the Medical Ethics Committee of Shanxi University of Chinese medicine. The rats were randomly divided into normal group, model group, fecal microbiota transplantation group and Tripterygium wilfordii polyglycoside group, and the collagen induced arthritis (CIA) was established. The changes of body weight and metatarpodal lesions of rats were evaluated. The serum of rats in each group was analyzed by liquid chromatography-mass spectrometry and metagenomic technology for differential metabolites and microflora. The protein expression levels of Toll-like receptors (TLR4), myeloid differentiation factor 88 (MyD88) and nuclear factor of kappa B (NF-κB p65) were detected by Western blot. A total of 13 different metabolites, including arachidonic acid, docosahexaenoic acid, 13S-hydroxyoctadecanodienoic acid and L-phenylalanine were screened from serum. Three metabolic pathways, including phenylalanine, tyrosine and tryptophan biosynthesis, phenylalanine metabolism and arachidonic acid metabolism were identified through pathway enrichment. Metagenomic analysis showed that the abundance of g_Bacteroides, g_Prevotella and p_Actinobacteria in CIA group was higher. The abundance of c_Clostridia, g_Akkermansia and s_Akkermansia_muciniphila in fecal microbiota transplantation group is higher. The hierarchical cluster heat map showed that Akkermansia was negatively correlated with L-phenylalanine; while positively correlated with docosahexaenoic acid. Prevotella was positively correlated with L-phenylalanine. Fecal microbiota transplantation group could significantly inhibit the expression of TLR4, MyD88 and p65 proteins in the synovium of rats (P < 0.01). The anti-rheumatoid arthritis effects of fecal microbiota transplantation group is closely related to the intervention of the metabolism of phenylalanine and arachidonic acid, through Akkermansia, Prevotella and other microorganisms, inhibition the TLR4/MyD88/NF-κB pathway.

Analysis of risk factors for death within 1 year after hip fracture surgery in the elderly / 中华创伤杂志

Objective:To explore the risk factors for death within 1 year after hip fracture surgery in the elderly.Methods:A case control study was made on the clinical data of 551 elderly patients with hip fracture treated in Second Affiliated Hospital of Soochow University from January 2019 to December 2020, including 182 males and 369 females; aged 65-100 years [80(73,86)years]. Joint replacement, cannulated screw fixation or proximal femoral nail fixation were performed. The patients were divided into survival group ( n=494) and death group ( n=57) based on the death within 1 year after surgery recorded at postoperative telephone follow-up. The gender, age, hypertension, diabetes, cardiovascular diseases, chronic respiratory diseases, neurological diseases, chronic renal failure, anemia on admission, fracture types, American anesthesiologist Association (ASA) classification, operative methods, preoperative waiting time, duration of operation and perioperative blood transfusion were recorded in two groups. Univariate Cox regression was used to analyze the correlation between the above indexes and death within 1 year after surgery. All indexes with P<0.2 in the univariate analysis were included in multivariate Cox regression analysis to clarify the independent risk factors for death within 1 year after surgery. Results:Univariate Cox regression analysis showed that death within 1 year after surgery correlated with gender, age chronic respiratory diseases, chronic renal failure and anemia on admission (all P<0.01), but not with hypertension, diabetes, cardiovascular diseases, neurological diseases, fracture types, ASA classification, operative methods, preoperative waiting time, duration of operation or perioperative blood transfusion (all P>0.05). Multivariate Cox regression analysis showed that male ( HR=2.08, 95% CI 1.20, 3.61, P<0.01), age ≥ 80 years ( HR=2.22, 95% CI 1.15, 4.28, P<0.05), chronic respiratory diseases ( HR=2.54, 95% CI 1.19, 5.40, P<0.05), chronic renal failure ( HR=4.57, 95% CI 1.27, 16.44, P<0.05), anemia on admission ( HR=2.82, 95% CI 1.38, 5.76, P<0.01) were significantly associated with death within 1 year after surgery. Conclusion:Male age≥ 80 years, chronic respiratory disease, chronic renal failure and anemia on admission are independent risk factors for death within 1 year after hip fracture surgery in the elderly.

Research and Prospect of Visual Event-Related Potential in Traumatic Brain Injury and Visual Function Evaluation / 法医学杂志

Visual event-related potential (ERP) is an electrophysiological technique that objectively reflects the cognitive processing of stimulus from the perspective of detecting and recording neural electrophysiology responses using different paradigms of visual stimuli. Its endogenous components are closely related to advanced psychological activities. This article introduces the characteristics of main endogenous components including visual mismatch negativity (vMMN), N200 and P300, reviews the research progress of visual ERP in the sequelae of brain injury and objective evaluation of visual function, and prospects the application prospect of visual ERP in the field of forensic medicine.

Clinical analysis of 14 cases of head and neck carcinosarcoma / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the clinicopathological characteristics, treatment and prognosis of head and neck carcinosarcoma. Methods: The clinical data of 14 patients with head and neck carcinosarcoma treated in the First Affiliated Hospital of Zhengzhou University from January 2010 to May 2020 were retrospectively analyzed, including 11 males and 3 females, with age range from 30 to 72 years old. Clinicopathological characteristics, treatments and follow-up results of patients were evaluated. Kaplan-Meier method was used to estimate the cumulative survival rate. Results: Histopathological examination showed the co-existence of malignant epithelial and mesenchymal components in all cases. Immunohistochemical staining of 13 cases showed cytokeratin and epithelial membrane antigens were positively expressed in the epithelial areas, whereas vimentin was positive in the malignant mesenchymal tissue area. Among 14 cases, 5 cases were treated with surgery, 3 cases with surgery and radiotherapy, and 6 cases with surgery, radiotherapy and chemotherapy. The follow-up time was 2-81 months, with a median follow-up time of 22.5 months. Except for one patient who was lost to follow-up in 21 months after treatment, among the remaining 13 patients, 4 patients had recurrence, 8 patients died, and 5 patients had a tumor-free survival. The Kaplan-Meier analysis showed that the 1, 3, and 5-year cumulative survival rates of 14 patients with head and neck carcinosarcoma were 64.3%, 57.1%, and 42.9%, respectively. Conclusions: Carcinosarcoma of the head and neck is rare in clinic, histopathological and immunohistochemical examinations are important basis for diagnosis, and surgery is a preferred treatment. Carcinosarcoma of the head and neck has a poor prognosis, and patients should be followed up for a long time.

Evaluation of nursing effect of enhanced recovery after surgery model in elderly patients with hip fracture / 中华创伤杂志

Objectives:To investigate the nursing effect of perioperative enhanced recovery after surgery（ERAS）management model in elderly patients with hip fracture.Methods:A retrospective case-control study was conducted to analyze the clinical data of 94 elderly patients with hip fracture admitted to Second Affiliated Hospital of Soochow University from July 2017 to June 2018，including 24 males and 70 females aged 76-98 years［（83.7±5.4）years］. There were 54 patients with intertrochanteric fracture and 40 patients with femoral neck fracture. Surgical method was proximal femoral nail antirotation（PFNA）fixation or artificial hip arthroplasty. A total of 44 patients were managed by ERAS（enhanced recovery group）and 50 patients by traditional nursing（traditional rehabilitation group）. The off-bed time was compared between the two groups from aspects of different fracture sites，bone mineral density and causes of injury. The visual analogue scale（VAS）was tested preoperatively and at postoperative days 1，3 and 7. The complications were recorded at postoperative 1 month. The activity of daily living（ADL）score was assessed preoperatively and at postoperative 1 week，1 month and 3 months. The Harris hip score was assessed at postoperative 1 week，1 month，3 months and at the last follow-up. The length of hospital stay and death at postoperative 3 months and at the last follow-up were recorded.Results:All patients were followed up for 12-24 months［（17.7±6.2）months］. In enhanced recovery group，the off-bed time of patients with different fracture sites（femoral neck，femoral intertrochanter），bone mineral density（>-2.5 SD，≤-2.5 SD）and causes of injury（falls，traffic accidents and others）were markedly shortened as compared with traditional rehabilitation group（ P<0.01）. There was no significant difference in VAS between the two groups before operation（ P>0.05）. However，the VAS in enhanced recovery group was（3.4±0.9）points，（2.7±0.5）points，（1.7±0.6）points at postoperative days 1，3 and 7，significantly lower than that in traditional rehabilitation group［（4.3±1.1）points，（3.5±0.5）points，（2.7±0.9）points］（ P<0.01）. One month after operation，the incidence of pulmonary infection was 0% in enhanced recovery group and 28%（14/50）in traditional rehabilitation group（ P<0.01）. While there showed no significant differences in incidences of cardiovascular system，nervous system，urinary tract infection，lower limb deep vein thrombosis，impaired liver and kidney function，anemia，electrolyte disorder or hypoalbuminemia between the two groups（ P>0.05）. There was no significant difference in preoperative ADL score between the two groups（ P>0.05）. The ADL score in enhanced recovery group was（37.0±6.6）points，（70.1±8.4）points，（86.2±9.3）points at postoperative 1 week，1 month and 3 months，significantly higher than that in traditional rehabilitation group［（26.5±10.4）points，（50.1±11.4）points，（70.7±9.0）points］（ P<0.01）. The Harris hip score in enhanced recovery group was（80.9±8.6）points at postoperative 1 month，significantly higher than that in traditional rehabilitation group［（71.1±9.2）points］（ P<0.01）. There were no significant differences in Harris hip score between the two groups at postoperative 1 week，3 months and at the last follow-up（ P>0.05）. The length of hospital stay was（4.7±2.4）days in enhanced recovery group，significantly shorter than（7.8±3.9）days in traditional rehabilitation group（ P<0.01）. The enhanced recovery group showed no death within 3 months after operation and 2 deaths［5%（2/44）］at the last follow-up，while the traditional rehabilitation group revealed 4 deaths［8%（4/50）］within 3 months after operation. There was no significant difference in the mortality between the two groups until the last follow-up（ P>0.05）. Conclusion:For elderly patients with hip fracture，perioperative ERAS management model can effectively shorten periods in bed，relieve postoperative pain，reduce incidence of postoperative pulmonary infection，accelerate recovery of hip function，improve quality of life，shorten length of hospitalization and promote early recovery.

Analysis on signs and diagnostic value of transabdominal ultrasound of pregnant women with placenta accreta / 中国基层医药

Objective:To investigate the signs and diagnostic value of transabdominal ultrasound of pregnant women with placenta accreta.Methods:The clinical data of 140 pregnant women with placenta previa who received regular prenatal examination between August 2015 and August 2019 in Lishui City People's Hospital were retrospectively analyzed. Clinical and pathological results were used as the gold standard for clinical diagnosis of placenta accreta. The sensitivity, specificity and accuracy of transabdominal ultrasound in the diagnosis of placenta accreta were evaluated. The included 140 women were divided into observation (75 women with placenta previa complicated by placenta accreta) and control (65 women with placenta previa not complicated by placenta accreta) groups. The difference in ultrasonic signs was compared between the two groups.Results:The sensitivity, specificity and accuracy of transabdominal ultrasound in the diagnosis of placenta accreta were 93.33% (70/75), 93.84% (61/65) and 93.57% (131/140), respectively. The incidences of placental thickening, disappearance of retroplacental space, uneven echo in placenta, abundant blood vessels at the interface between uterine serosa and bladder, and focal or extensive intraplacental blood flow in the observation group were 92.00% (69/75), 52.00% (39/75), 82.66% (62/75), 60.00% (45/75) and 50.66% (38/75), respectively, which were significantly higher than those in the control group [32.30% (21/65), 29.23% (19/65), 30.76% (20/65), 35.38% (23/65), 27.69% (18/65), χ2 = 54.041, 7.439, 38.650, 8.446 and 7.658, all P < 0.05]. The score of ultrasonic sign in the observation group was significantly higher than that in the control group ( Z = 10.656, P < 0.05). Conclusion:Transabdominal ultrasound examination can provide information to help screen placenta accreta in patients with placenta previa. Transabdominal ultrasound is of great significance for clinical diagnosis of placenta accreta.

Effect of early ambulation time in lower limbs muscle strength in patients with total knee arthroplasty / 中国实用护理杂志

Objective:To investigate the effect of early ambulation time on lower limbs muscle strength and fear of falling in patients with total knee arthroplasty, so as to provide basis for promoting the postoperative rehabilitation of patients undergoing total knee arthroplasty.Methods:A total of 210 patients after unilateral total knee replacement from July 2018 to December 2019 in the Second Affiliated Hospital of Soochow University were included and assigned to experimental group 1, experimental group 2 and experimental group 3 by random digits table method, each group contained 70 cases, and the patients began ambulation at 16, 20, 24 hours after knee replacement, respectively. The peak torque (PT) of knee joints flexors and extensor as well as hamstrings quadriceps ratio (H/Q) were compared among three groups at 1 week, 1 month and 3 months after knee replacement. The fall efficiency was evaluted by Modified Fall Efficacy Scale (MFES), the fear of falling rate was conducted by single item method.Results:After 1 month of knee replacement, the PT of knee joints flexor and extensor and H/Q were (18.73±5.49) N·m, (37.56±7.76) N·m, (48.08±9.19)% and (18.44±5.27) N·m, (37.04±7.07) N·m, (47.49±9.30)% in the experimental group 1 and experimental group 2, which were higher than those in the experimental group 3(16.38±2.85) N·m, (33.75±6.75) N·m, (43.48±7.17)%, the differences were statically significant ( t values were 2.316-3.057, P<0.05). After 1 week of knee replacement, the fear of falling rate were 72.3%(47/65) and MFES scores were (3.14±0.58) points in the experimental group 1, 53.7%(36/67), (3.81±0.65) points and 50.8%(32/63), (3.87±0.74) points in the experimental group 2 and experimental group 3, the fear of falling rate significantly increased and MFES scores significantly decreased in the experimental group 1 compared to the experimental group 2 and experimental group 3, the differences were statistically significant ( χ2 values were 5.780, 4.878, t values were 6.221, 6.129, P<0.05). Conclusions:Twenty hours after knee replacement is the best time for ambulation, which can shortern the time for lower limbs muscle strength recovery and reduce the risk of fear of falling.

Comparison between high-frequency irreversible electroporation and irreversible electroporation ablation of small swine liver: follow-up of DCE-MRI and pathological observations / 中华医学杂志(英文版)

BACKGROUND@#High-frequency irreversible electroporation (H-FIRE) is a novel, next-generation nanoknife technology with the advantage of relieving irreversible electroporation (IRE)-induced muscle contractions. However, the difference between IRE and H-FIRE with distinct ablation parameters was not clearly defined. This study aimed to compare the efficacy of the two treatments in vivo.@*METHODS@#Ten Bama miniature swine were divided into two group: five in the 1-day group and five in the 7-day group. The efficacy of IRE and H-FIRE ablation was compared by volume transfer constant (Krans), rate constant (Kep) and extravascular extracellular volume fraction (Ve) value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), size of the ablation zone, and histologic analysis. Each animal underwent the IRE and H-FIRE. Temperatures of the electrodes were measured during ablation. DCE-MRI images were obtained 1, 4, and 7 days after ablation in the 7-day group. All animals in the two groups were euthanized 1 day or 7 days after ablation, and subsequently, IRE and H-FIRE treated liver tissues were collected for histological examination. Student's t test or Mann-Whitney U test was applied for comparing any two groups. One-way analysis of variance (ANOVA) test and Welch's ANOVA test followed by Holm-Sidak's multiple comparisons test, one-way ANOVA with repeated measures followed by Bonferroni test, or Kruskal-Wallis H test followed by Dunn's multiple comparison test was used for multiple group comparisons and post hoc analyses. Pearson correlation coefficient test was conducted to analyze the relationship between two variables.@*RESULTS@#Higher Ve was seen in IRE zone than in H-FIRE zone (0.14 ± 0.02 vs. 0.08 ± 0.05, t = 2.408, P = 0.043) on day 4, but no significant difference was seen in Ktrans or Kep between IRE and H-FIRE zones at all time points (all P > 0.05). For IRE zone, the greatest Ktrans was seen on day 7, which was significantly higher than that on day 1 (P = 0.033). The ablation zone size of H-FIRE was significantly larger than IRE 1 day (4.74 ± 0.88 cm2vs. 3.20 ± 0.77 cm2, t = 3.241, P = 0.009) and 4 days (2.22 ± 0.83 cm2vs. 1.30 ± 0.50 cm2, t = 2.343, P = 0.041) after treatment. Apoptotic index (0.05 ± 0.02 vs. 0.73 ± 0.06 vs. 0.68 ± 0.07, F = 241.300, P  0.05). Electrode temperature variations were not significantly different between the two zones (18.00 ± 3.77°C vs. 16.20 ± 7.45°C, t = 0.682, P = 0.504). The Ktrans value (r = 0.940, P = 0.017) and the Kep value (r = 0.895, P = 0.040) of the H-FIRE zone were positively correlated with the number of hepatocytes in the ablation zone.@*CONCLUSIONS@#H-FIRE showed a comparable ablation effect to IRE. DCE-MRI has the potential to monitor the changes of H-FIRE ablation zone.

Risk factors for diabetic retinopathy in patients with type 1 diabetes mellitus / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To explore the risk factors for diabetic retinopathy(DR)in patients with type 1 diabetes mellitus(T1DM).<p>METHODS: A total of 204 patients with T1DM in recent 10a were enrolled. The patients were divided into DR group(<i>n</i>=71)and non-DR group(<i>n</i>=133). The clinical information was collected and relevant biochemical indices were detected. Univariate and multivariate Logistic regression were used to assess the relationship between potential risk factors and DR/proliferative diabetic retinopathy(PDR). The value of risk factors in predicting DR/PDR was evaluated by drawing receiver operating characteristic curve(ROC).<p>RESULTS: The age of onset, longer duration of diabetes, HbA1c, hypertension, hyperlipidemia, diabetic nephropathy(DN), diabetic peripheral neuropathy(DPN)were related to DR(<i>P</i><0.05)in patients with T1DM. Longer duration of diabetes, body mass index(BMI), systolic blood pressure(SBP), hyperlipidemia, DN, DPN were related to PDR. Logistic regression analysis indicated that longer duration of diabetes(<i>OR</i>=1.130, <i>P</i><0.001)and HbA1c(<i>OR</i>=2.734, <i>P</i><0.001)were risk factors of DR. Longer duration of diabetes(<i>OR</i>=1.144, <i>P</i>=0.005)and DN(<i>OR</i>=6.500, <i>P</i>=0.001)were risk factors of PDR. The results of ROC curve analysis showed that the area under the curve(AUC)of the disease course and HbA1c predicting the occurrence of DR were 0.720 and 0.727, respectively. The cutoff values were 15.1a and 8.2%, respectively. The sensitivity was 50.7% and 76.1%, and the specificity was 86.5% and 59.4%, respectively. The AUC for predicting PDR was 0.713, the best cutoff value was 18.5a, the sensitivity was 73.9%, and the specificity was 60.4%.<p>CONCLUSION: Retinopathy is associated with age of onset in patients with T1DM. Duration of disease and hyperglycemia are the major influencing factor for DR. HbA1c is associated with DR. DN is associated with PDR occurrence.

Risk factors for diabetic retinopathy in patients with type 1 diabetes mellitus / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To explore the risk factors for diabetic retinopathy(DR)in patients with type 1 diabetes mellitus(T1DM).<p>METHODS: A total of 204 patients with T1DM in recent 10a were enrolled. The patients were divided into DR group(<i>n</i>=71)and non-DR group(<i>n</i>=133). The clinical information was collected and relevant biochemical indices were detected. Univariate and multivariate Logistic regression were used to assess the relationship between potential risk factors and DR/proliferative diabetic retinopathy(PDR). The value of risk factors in predicting DR/PDR was evaluated by drawing receiver operating characteristic curve(ROC).<p>RESULTS: The age of onset, longer duration of diabetes, HbA1c, hypertension, hyperlipidemia, diabetic nephropathy(DN), diabetic peripheral neuropathy(DPN)were related to DR(<i>P</i><0.05)in patients with T1DM. Longer duration of diabetes, body mass index(BMI), systolic blood pressure(SBP), hyperlipidemia, DN, DPN were related to PDR. Logistic regression analysis indicated that longer duration of diabetes(<i>OR</i>=1.130, <i>P</i><0.001)and HbA1c(<i>OR</i>=2.734, <i>P</i><0.001)were risk factors of DR. Longer duration of diabetes(<i>OR</i>=1.144, <i>P</i>=0.005)and DN(<i>OR</i>=6.500, <i>P</i>=0.001)were risk factors of PDR. The results of ROC curve analysis showed that the area under the curve(AUC)of the disease course and HbA1c predicting the occurrence of DR were 0.720 and 0.727, respectively. The cutoff values were 15.1a and 8.2%, respectively. The sensitivity was 50.7% and 76.1%, and the specificity was 86.5% and 59.4%, respectively. The AUC for predicting PDR was 0.713, the best cutoff value was 18.5a, the sensitivity was 73.9%, and the specificity was 60.4%.<p>CONCLUSION: Retinopathy is associated with age of onset in patients with T1DM. Duration of disease and hyperglycemia are the major influencing factor for DR. HbA1c is associated with DR. DN is associated with PDR occurrence.

Influenza surveillance among children in Songjiang District of Shanghai, 2014-2018 / 上海预防医学

Objective To investigate the epidemiological characteristics of influenza in Songjiang District, Shanghai during 2014-2018, and to provide scientific evidence for the prevention of influenza. Methods We collected the data including influenza-like illness(ILI)report, etiological examination and influenza outbreak in Songjiang, and further characterized the epidemic of influenza using descriptive statistics. Results Data from the sentinel hospital-based surveillance system showed two peaks of influenza incidence in winter and summer in Songjiang, in which the winter peak was more significant. The largest proportion of ILI was the age group 0-4 years(57.90%). The proportion of being positive for influenza nucleic acid was 18.44%. All principal types of influenza were prevalent in Songjiang with a certain pattern of alternative circulation, in which influenza B virus accounted for 41.18% among all the types, followed by seasonal H3(36.95%)and H1N1(21.98%). A total of 650 influenza strains were isolated. The total proportion of isolation was 67.08%, which fluctuated by year with a peak of 79.37% in 2016. Of all the 27 outbreaks of influenza, 88.89% of them were identified in primary and middle schools and 70.37% occurred in December. Conclusion Different subtypes of influenza viruses were prevalent alternatively in Songjiang during 2014-2018. The etiological results and influenza outbreaks are generally in consistent with ILI report. It warrants necessary prevention in primary and middle schools in epidemic seasons of influenza.

Prediction of hub genes of Alzheimer’s disease using a protein interaction network and functional enrichment analysis

Alzheimer disease (AD) is a chronic, progressive brain disorder that slowly destroys affected individuals’ memory and reasoning faculties, and consequently, their ability to perform the simplest tasks. This study investigated the hub genes of AD. Proteins interact with other proteins and non-protein molecules, and these interactions play an important role in understanding protein function. Computational methods are useful for understanding biological problems, in particular, network analyses of protein-protein interactions. Through a protein network analysis, we identified the following top 10 hub genes associated with AD: PTGER3, C3AR1, NPY, ADCY2, CXCL12, CCR5, MTNR1A, CNR2, GRM2, and CXCL8. Through gene enrichment, it was identified that most gene functions could be classified as integral to the plasma membrane, G-protein coupled receptor activity, and cell communication under gene ontology, as well as involvement in signal transduction pathways. Based on the convergent functional genomics ranking, the prioritized genes were NPY, CXCL12, CCR5, and CNR2.

Drug resistence and NA gene characteristics of influenza virus A/H1N1(pdm09) studied in Shanghai during 2018-2019 / 上海预防医学

Objective A/H1N1(pdm09) viruses were the dominant strains in Shanghai during 2018-2019 influenza surveillance year.This study is to provide a scientific reference for clinical drug use by investigating the susceptibility of A/H1N1(pdm09) viruses to neuraminidase inhibitors(NAIs). Methods Sixty strains of A/H1N1(pdm09) viruses were randomly selected for testing the susceptibility and drug resistance to Oseltamivir and Zanamivir by means of neutaminidase inhibition and neuraminidase (NA) gene sequencing. Results The 60 epidemic strains all proved to be susceptible to Oseltamivir and Zanamivir and the susceptibility was not observed to be decreased or remarkably decreased.In genetic sequencing, NA was not observed to present amino acid mutation at the key sites and auxiliary sites in catalytic activity, which confirmed the results of the phototypic detection of neuraminidase inhibition. Conclusion The subtype influenza viruses A/H1N1(pdm09) circulating in Shanghai during 2018-2019 surveillance year are still sensitive to NAIs, which provides a scientific reference for clinical use of drugs.However, we monitored only a number of strains and think that the work monitoring antiviral susceptibility should be continued with the wide use of the drugs.

Effect of thoracic paravertebral block on intraoperative hypotension in patients undergoing thoracoscopic lung surgery under general anesthesia / 中华麻醉学杂志

The data of patients of both sexes, aged ≥ 18 yr, of American Society of Anesthesiologists physical statusⅠ-Ⅲ, underwent thoracoscopic lung surgery under general anesthesia from January 2017 to December 2017, were retrospectively collected.The patients were divided into 2 groups according to whether they received thoracic paravertebral block (PVB) before operation: general anesthesia group (group G) and thoracic PVB combined with general anesthesia group (GP group). T 3/T 4 and T 6/T 7 double point thoracic PVB was performed under ultrasound guidance before anesthesia induction in GP group.Anesthesia was induced with sufentanil, propofol/etomidate and cisatracurium and maintained with propofol, remifentanil, cisatracurium and dexmedetomidine during operation.According to whether sufentanil was added before skin incision, patients received thoracic PVB combined with general anesthesia were divided into 2 subgroups: increment of sufentanil group and non-increment of sufentanil group, and a 1∶1 propensity score matching was performed in two groups.The usage of vasopressor drugs, amount of opioids consumed, volume of fluid infused, urine volume, blood loss and operation time were recorded.Compared with group G, the intraoperative urine volume, volume of fluid infused, and requirement for vasopressor drugs after skin incision were increased, and the intraoperative consumption of remifentanil was reduced in group GP ( P<0.05). Before matching, compared with non-increment of sufentanil group, the consumption of sufentanil at induction, intraoperative blood loss, volume of fluid infused and urine volume were significantly increased, and the operation time was prolonged in increment of sufentanil group ( P<0.05). After matching, compared with non-increment of sufentanil group, the requirement for vasopressor drugs was significantly increased in increment of sufentanil group ( P<0.05). In conclusion, thoracic PVB can increase the incidence of intraoperative hypotension in the patients undergoing thoracoscopic lung surgery under general anesthesia, and the reason may be related to the thoracic PVB-induced direct inhibition of sympathetic nerves and to opioids usage.

Prediction of hub genes of Alzheimer’s disease using a protein interaction network and functional enrichment analysis

Alzheimer disease (AD) is a chronic, progressive brain disorder that slowly destroys affected individuals’ memory and reasoning faculties, and consequently, their ability to perform the simplest tasks. This study investigated the hub genes of AD. Proteins interact with other proteins and non-protein molecules, and these interactions play an important role in understanding protein function. Computational methods are useful for understanding biological problems, in particular, network analyses of protein-protein interactions. Through a protein network analysis, we identified the following top 10 hub genes associated with AD: PTGER3, C3AR1, NPY, ADCY2, CXCL12, CCR5, MTNR1A, CNR2, GRM2, and CXCL8. Through gene enrichment, it was identified that most gene functions could be classified as integral to the plasma membrane, G-protein coupled receptor activity, and cell communication under gene ontology, as well as involvement in signal transduction pathways. Based on the convergent functional genomics ranking, the prioritized genes were NPY, CXCL12, CCR5, and CNR2.

The effect of maternal high sucrose exposure on bone mineral density and serum bone metabolism markers in adult offspring / 中华内分泌代谢杂志

Objective@#To study the impact on bone mineral density, serum bone metabolism markers, and the expression of osteoprotegerin (OPG) and receptor activator of NF-κB ligand (RANKL) in the adult offspring exposed to maternal high sucrose diet during gestation.@*Methods@#The pregnant Sprague-Dawley (SD) rats were randomly divided into two groups: high sucrose diet group (HS group) rats were given 20% sucrose solution and standard rat food, normal diet group (ND group) rats were provided with fresh tap water and standard rat food. The serum concentrations of alkaline phosphatase (ALP), osteocalcin, tartrate resistant acid phosphatase-5b (TRACP-5b), OPG, and RANKL were measured by the enzyme linked immunosorbent assay (ELISA). The lumbar vertebrae were attained and prepared for micro-computed tomography (Micro-CT) scanning. Compared the expression of OPG and RANKL mRNA in the adult lumbar vertebrae were determined by realtime quantitative PCR.@*Results@#The maternal blood glucose levels and insulin levels were higher in the HS group(P<0.05). The body weight gain during pregnancy and fetal body weight were heavier in the HS group(P<0.05). In HS group that compared to ND group, the serum concentrations of ALP and OPG were decreased, while TRACP-5b and RANKL were increased, and the ratio of OPG/RANKL were significantly increased(P<0.05). Compared to ND group, the bone mineral density, the bone volume per tissue volume, trabecular thickness, the trabecular number were decreased in HS group(P<0.05). The trabecular separation was increased in HS group compared to ND group(P<0.05). The expression of OPG mRNA in the offspring lumbar vertebrae was significantly down-regulated. Conversely, the expression of RANKL mRNA was significantly up-regulated.@*Conclusion@#Maternal high sucrose diet during gestational periods may affect the bone mineral density, serum bone metabolism markers, and the expression of OPG and RANKL in adult offspring.

Experimental study on the prevention of bone loss by deferoxamine in type 1 diabetic mice with osteoporosis / 中华内分泌代谢杂志

Objective To observe the effect of a hypoxia mimicking agent deferoxamine (DFO) on the mineral density,volume,architecture,strength,and metabolism of the bones in type 1 diabetic mice withosteoporosis.Methods Type 1 diabetic mice model was established by intraperitoneal injections of streptozotocin.The mice were divided into control (normal mice),diabetes mellitus,and DFO groups.Micro-CT was used to analyze the bone mineral density,volume,architecture,and strength of the trabecule in the distal part of femurs.Three point bending test was carried out to evaluate the bone strength.Hematoxylin and eosin (HE) staining was performed to observe the alteration in the number of osteoblasts.Real-time PCR was used to detect the mRNA expressions of Runt-related gene 2 (Runx-2),osteoclacin,and tartrate resistant acid phosphatase (TRAP) in tibias.Western blot was used to detect the protein expressions of Hypoxia-inducible factor-1α(HIF-1α) and vascular endothelial growth factor (VEGF) in tibias.Results There was a decrease in mineral density,volume,strength of bones as well as deteriorated trabecular microarchitecture in diabetic mice as compared to control mice,which were partially improved by DFO treatment.Moreover,DFO treatment increased the number of osteoblasts and mRNA expression levels of Runx-2,osteoclacin,TRAP,as well as protein expression levels of HIF-1 α and VEGF(P＜0.05).Conclusion Bone loss could be partially prevented by DFO treatment in type 1 diabetic osteoporosis mice,which might be ascribed to increased bone formation via stimulating hypoxia inducible factor singnaling pathway.

Effect of relatively closed environment dispensing new mode on insoluble particles in pharmaceuticals / 中国感染控制杂志

Objective To study the effect of relatively closed environment dispensing mode on insoluble particles in pharmaceuticals.Methods The numbers of insoluble particles in conventional manual dispensing mode and relatively closed environment dispensing mode in lass Ⅰ and class Ⅲ environment were detected, effect of different dispensing modes on the number of insoluble particles in pharmaceuticals was compared.Results When adopting manual dispensing, the numbers of 1-10 μm insoluble particulates in different groups in class Ⅰ environment were less than those in class Ⅲ environment respectively, differences were all statistically significant (all P＜0.05). When adopting a new mode of dispensing in relatively closed environment, there was no significant difference in the numbers of 1-15 μm insoluble particulates in different groups between class Ⅰ and class Ⅲ environment respectively (all P＞0.05). The numbers of 1-20 μm and 1-15 μm insoluble particles in different groups were less than those in manual dispensing when the new mode of dispensing were adopted in class Ⅲ and class Ⅰenvironment respectively, differences were all statistically significant (all P＜0.05). The numbers of 1-15 μm insoluble particles in different groups in manual dispensing in class Ⅰ environment were more than those in class Ⅲ environment respectively, difference were all statistically significant (all P＜0.05).Conclusion The relatively closed environment dispensing mode can effectively reduce environmental particulates entering intravenous infusion system during dispensing process.