Progress in extension lag after knee surgery / 中华骨科杂志

Most literature defines knee extension lag as the failure of the knee joint to achieve the passive extension angle, and some literature defines the inability of the knee to complete the last 15° extension as knee extension lag. Extension lag is one of the common complications after knee surgery, which seriously affects the postoperative knee joint function of patients. Disuse atrophy due to prolonged postoperative bed rest, arthrogenic muscle inhibition due to pain and (or) swelling, direct injury to the knee extensor mechanism during surgery and nerve dysfunction of the quadriceps muscle can all contribute to extension lag. While rehabilitation exercises, physical therapy and medication can significantly improve the patient's symptoms, extension lag due to the knee extension device injury requires surgery if necessary to regain normal knee function. As surgical techniques continue to be refined and rehabilitation interventions advance, the prevention of extension lag and the minimization of angle of knee extension lag need to be given adequate attention by patients, physicians, and researchers. This article reviews clinical studies related to extension lag after knee surgery, focusing on etiology, treatment, prevention and prognosis, with the aim of providing a basis and guidance for the current clinical management.

Efficacy comparison of early and late open reduction and internal fixation for severe rib fracture combined with respiratory failure / 中华创伤杂志

Objective:To investigate the effect of timing of rib internal fixation on early curative effect of patients with severe rib fracture complicated with respiratory failure.Methods:A retrospective cohort study was conducted on clinical data of 33 patients with multiple rib fracture complicated with respiratory failure admitted to 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xiamen University Medical College) from January 2018 to October 2019.There were 26 males and 7 females; aged 60-87 years [(67.9±6.7)years]. The time interval from injury to open reduction and internal fixation was within 3 days in 16 patients (early operation group) and over 3 days in 17 patients (later operation group). The number of fixed ribs, operation time, duration of mechanical ventilation, length of ICU stay, chest tube indwelling time and lenghth of hospital stay were compared in the two groups. The numeric rating scale (NRS) pain score was assessed at postoperative 1, 3 and 7 days. Postoperative complications were detected as well.Results:All patients were followed up for 8-24 months [(16.5±4.3)months]. Number of fixed ribs was not statistically different between the two groups ( P>0.05). The operation time, duration of mechanical ventilation, length of ICU stay, chest tube indwelling time and length of hospital stay in early operation group [(67.3±11.2)minutes, (103.9±28.2)hours, (5.2±1.9)days, (6.4±2.8)days, (12.5±3.5)days] were shorter than those in late operation group [(108.4±18.4)minutes, (160.8±89.3)hours, (10.1±2.3)days, (9.5±2.2)days, (18.0±4.5)days] ( P<0.05 or 0.01). The NRS score was (6.6±0.6)points, (3.3±0.6)points and (2.7±0.8)points in early operation group at postoperative 1, 3 and 7 days, significantly lower than those in late operation group [(7.4±1.1)points, (4.9±1.1)points, (3.9±0.7)points] ( P<0.05 or 0.01). The total complication rate was 25.0%(4/16) in early operation group, lower than 70.6%(12/17) in late operation group ( P<0.05). Conclusion:For severe rib fracture complicated with respiratory failure, early open reduction and internal fixation can effectively reduce operation time, duration of mechanical ventilation, lenghth of ICU stay, chest tube indwelling time and lenghth of hospital stay, early relieve pain and decrease complications rate when compared with late operation.

Efficacy comparison of extracorporeal membrane oxygenation and ventilation therapy in the treatment of severe blast lung injury / 中华创伤杂志

Objective:To compare the clinical efficacy of extracorporeal membrane oxygenation (ECMO) and ventilation therapy in the treatment of severe blast lung injury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 37 patients with severe blast lung injury admitted to 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from January 2000 to December 2021, including 23 males and 14 females; aged 26-50 years [(36.3±11.1)years]. The chest abbreviated injury score (AIS) was 3-5 points. In all, 16 patients were treated with ECMO from January 2017 to December 2021 (ECMO group) and 21 with ventilator from January 2000 to December 2016 (ventilator group). Blood gas analysis indexes [arterial pH, partial pressure of carbon dioxide (PaCO 2), partial pressure of oxygen (PaO 2), blood lactate (Lac)] and hemodynamics indexes [central venous pressure (CVP), cardiac output index (CI), pulmonary arterial systolic pressure (PASP), pulmonary capillary wedge pressure (PAWP)] were compared in the two groups at 30 minutes before treatment and at 2, 4, 6 hours after treatment. The mechanical ventilation time, ICU length of stay, acute physiology and chronic health evaluation II (APACHE II) score and mortality were measured at 7 days after treatment. Results:All patients were followed up for 24-48 months [(33.6±8.2)months]. The blood gas analysis and hemodynamic indexes were significantly improved in the two groups at 2, 4, 6 hours after treatment when compared with those at 30 minutes before treatment (all P<0.05), and the improvements were still statistically significant in ECMO group at 4, 6 hours after treatment when compared with those at 2 hours after treatment (all P<0.05), while not in ventilator group (all P>0.05). There was no significant difference in blood gas analysis indexes or hemodynamic indexes between the two groups at 30 minutes before treatment (all P>0.05). After treatment for 2, 4, 6 hours, blood gas analysis indexes and hemodynamic indexes in ECMO group were statistically different from those in ventilator group (all P<0.05). After treatment for 7 days, the mechanical ventilation time, ICU length of stay, APACHE II score and mortality were (3.2±1.2)days, (5.4±1.3)days, (14.1±3.3)points and 12.5% (2/16) in ECMO group, significantly different from (5.1±1.6)days, (7.6±1.6)days, (10.2±2.6)days and 28.6% (6/21) in ventilator group (all P<0.05). Conclusion:For severe blast lung injury, ECMO can attain rapid and continuous improvement of refractory hypoxemia and dyspnea, shorten the duration of mechanical ventilation and ICU length of stay and reduce the mortality rate when compared with ventilator therapy.

Efficacy comparison of standardized incision and conventional incision for reduction and internal fixation of multiple rib fracture / 中华创伤杂志

Objective:To compare the efficacy of standardized incision and conventional incision for reduction and internal fixation of multiple rib fracture.Methods:A retrospective cohort study was conducted to analyze the clinical data of 192 patients with multiple rib fracture treated in 909th Hospital of Joint Logistics Support Force (Affiliated Dongnan Hospital of Xianmen University Medical College) from January 2020 to January 2022. There were 101 males and 91 females; aged 32-94 years [(51.5±16.6)years]. The patients underwent open reduction and internal fixation with nickel-titanium shape memory alloy embracer via standard incision such as anterior axillary longitudinal incision (standard incision group, n=96) or conventional incision such as posterolateral incision (conventional incision group, n=96). The incision length, operation time, intraoperative blood loss, number of fixed fractures, indwelling time of closed thoracic drainage tube, postoperative thoracic drainage volume, postoperative spontaneous ambulation time and length of hospital stay were compared in the two groups. The visual analogue scale (VAS) was used to evaluate pain at 1 month after operation. Postoperative complications were recorded. Results:All patients were followed up for 1-16 months [4.0(3.0, 10.5)months]. The operation time, intraoperative blood loss, indwelling time of closed thoracic drainage tube, postoperative thoracic drainage volume, postoperative spontaneous ambulation time, length of hospital stay and VAS at postoperative 1 month in standard incision group [(12.1±1.6)cm, (51.4±13.0)minutes, (191.5±16.8)ml, (2.8±0.6)days, (568.9±109.0)ml, (4.1±0.7)days, (11.4±1.7)days, (2.5±0.7)points] were better than those in conventional incision group [(13.7±1.9)cm, (62.0±8.8)minutes, (248.9±65.4)ml, (4.8±1.1)days, (655.9±121.9)ml, (5.2±0.9)days, (15.3± 1.7)days, (3.5±0.7)points] ( P<0.05 or 0.01). There was no statistical difference in the number of fixed fractures between standard incision group and conventional incision group (5.1±0.8 vs. 5.4±0.9) ( P>0.05). In standard incision group, there were 3 patients with poor wound healing, 5 with pulmonary infection, 3 with atelectasis and 3 with small pleural effusion. In conventional incision group, there were 11 patients with poor wound healing, 9 with pulmonary infection, 7 with atelectasis and 7 with small pleural effusion. The incidence of postoperative complications was 14.6% (14/96) in standard incision group and 35.4% (34/96) in conventional incision group ( P<0.01). Conclusion:For multiple rib fracture, standard incision is superior to conventional incision reduction in shortening the incision length, operation time, indwelling time of drainage tube, postoperative spontaneous ambulation time and length of hospital stay, reducing the intraoperative blood loss and postoperative thoracic drainage volume, alleviating the pain and reducing the postoperative complications.

Mechanism of hepatic fibrosis associated with Echinococcus: a review / 中国血吸虫病防治杂志

Echinococcosis is a zoonotic parasitic disease caused by Echinococcus infections, and this disorder may cause fibrosis of multiple vital organs, which may further progress into cirrhosis. Early-stage hepatic fibrosis is reversible, and unraveling the mechanisms underlying hepatic fibrosis induced by Echinococcus infections is of great significance for the prevention and treatment of early-stage hepatic fibrosis. Recently, the studies pertaining to hepatic fibrosis associated with Echinococcus infections focus on cytokines and immune cells. This review summarizes the advances in the mechanisms underlying host immune cells- and cytokines-mediated hepatic fibrosis in humans or mice following Echinococcus infections.

Characteristics and associated factors of visual and motor integration in children with developmental dyslexia and attention deficit hyperactivity disorder / 中国学校卫生

Objective@#To investigate the characteristics of visual motor integration in children with developmental dyslexia and ADHD, and to provide a reference for the diagnosis and treatment of these children.@*Methods@#During July to November of 2020，students from grade 3 to grade 5 of 7 primary schools in Xinjiang were selected by using random cluster sampling method. A total of 56 dyslexia group (group DD), attention deficit hyperactivity disorder group (group ADHD), comorbidity group and normal control group were selected and compared the differences of their visual motor integration ability and related factors ability. Multiple linear regression analysis was used to explore the predictive effects of related factors on visual motor integration ability.@*Results@#The scores of visual integration ability and visual perception in comorbidity group (95.05±14.01, 12.71±7.40) were lower than those in DD group (104.77±17.19，23.04±11.48), ADHD group (104.00±14.11，25.70±10.74) and normal control group (129.80±12.91, 44.05±16.56) ( F/Z =58.24,110.49, P <0.05). The visual working memory score of the comorbidity group ( 73.64 ±5.36) was lower than the normal control group (78.96±4.68) ( P <0.05)，and there was no significant difference between the DD group (74.48±7.06) and the ADHD group (75.98±7.36) ( P >0.05). The results of multiple regression showed that visual perception, age, IQ and visual working memory were associated with visual and motor integration ability of dyslexia children with ADHD ( R 2=0.32，0.17，0.11， 0.04 ， P <0.05).@*Conclusion@#Visual motor integration and visual perception among children with DD combined ADHD are more severely impaired than those with ADHD and DD alone. Visual perception, age, IQ and visual working memory could help predict the development of visual and motor integration ability in children with DD combined ADHD.

Role of DNAJB6 gene in the regeneration of liver resection and partial liver transplantation / 中华器官移植杂志

Objective:To explore the role and molecular mechanism of DNAJB6 in liver regeneration during partial liver transplantation(PLT).Methods:Dark agouti(DA, donor)and Lewis(recipient)rats were prepared for liver regeneration model of PLT.Rats were divided into before perfusion, after split liver perfusion, after portal vein opening, before abdominal closure and Day 3/7 after surgery groups(n=6 each)for timepoints of PLT.C57 mice were performed for residual liver regeneration model of partial hepatectomy and divided into control, Day 1/2/3/4/5 groups(n=6 each)for timepoints of hepatectomy.Gene Expression Omnibus liver regeneration data were utilized for locating DNAJB6 in liver regeneration.DNAJB6 low-expression human hepatocytes were constructed by DNAJB6-Si transfection.The relationship between DNAJB6 and liver regeneration was examined by Western blot detection of cell proliferation markers PCNA and CCK8 cell proliferation experiments.And the possible molecular mechanism of DNAJB6 regulating liver regeneration in PLT was studied by Western blot detection of nuclear protein and protein in cell proliferation signal pathway.Results:The result of residual liver regeneration of partial hepatectomy showed that DNAJ family genes were differentially expressed on regenerated liver gene chip and DNAJB6 was lowly expressed on regenerated liver gene chip.Meanwhile, DNAJB6 was lowly expressed in regenerated liver tissues of PLT and partial liver resection.After silencing DNAJB6 by transfecting DNAJB6-Si, the cellular expression level of PCNA and proliferation rate increased.However, nuclear extraction failed to detect the nuclear/plasma changes of β-catenin and the level of Wnt4 protein had no obvious change.Although the activation levels of p38 and JNK2 downstream of Ras/MAPK showed no change, there was a higher activation level of ERK.Conclusions:In regenerating liver tissue, hepatocytes may suppress the Ras/MEK/ERK signaling pathway by lowering the expression level of DNAJB6 to promote liver regeneration.

Effect of 1 064-nm Q-switched Nd:YAG laser on cell viability, protease activity and structures of Malassezia furfur / 中华皮肤科杂志

Objective:To investigate the effect of 1 064-nm Q-switched Nd:YAG laser at different energy settings on cell viability, protease activity and structures of Malassezia furfur. Methods:Cultured standard strains of Malassezia furfur were divided into several groups to be irradiated with 1 064-nm Q-switched Nd:YAG laser at different energies of 0 (control group) , 500, 600, 700, 800 and 900 mJ, respectively. Then, fungal suspensions in the above groups were inoculated onto the Leeming & Notman medium separately. After 7-day culture, the diameter and number of colonies were measured to evaluate the fungal cell viability, the protease activity was measured by using the whole-milk plate medium, and the ultrastructure of Malassezia furfur in each group was observed by transmission electron microscopy. One-way analysis of variance was used for comparisons among multiple groups, least significant difference- t test for multiple comparisons, and Pearson correlation analysis for analyzing correlations of laser energy with colony diameter, number and protease activity. Results:The colony diameter and number both significantly differed among the control group, 500-, 600-, 700-, 800- and 900-mJ groups (colony diameter: 4.05 ± 0.69, 3.76 ± 0.51, 3.28 ± 0.41, 3.09 ± 0.72, 2.54 ± 0.64 and 2.43 ± 0.41 mm, respectively; colony number: 4 787 ± 597, 4 287 ± 761, 1 879 ± 275, 1 082 ± 248 and 209 ± 42, 72 ± 31 colony-forming units, respectively; F = 14.83, 231.85, respectively, both P < 0.05) , and were significantly decreased in the 600-, 700-, 800- and 900-mJ groups compared with the control group (all P < 0.05) . The laser energy was negatively correlated with the colony diameter and number ( r = -0.67, -0.91, respectively, both P < 0.05) . The protease activity significantly differed among the control group, 500-, 700- and 900-mJ groups ( F = 346.60, P < 0.05) , and was significantly lower in the 700- and 900-mJ groups than in the control group (both P < 0.05) . There was a negative correlation between the laser energy and protease activity ( r = -0.94, P < 0.05) . Transmission electron microscopy showed intact fungal structures in the control group, relatively intact fungal structures in the 500-mJ group, and obviously damaged fungal structures in the 600- to 900-mJ groups, and the greater the laser energy, the more severely the fungal structures were damaged. Conclusion:The 1 064-nm Q-switched Nd:YAG laser could affect the cell viability of and protease activity in Malassezia furfur, and damage its structures.

Clinical guideline on first aid for blast injury of the chest (2022 edition) / 中华创伤杂志

Blast injury of the chest injury is the most common wound in modern war trauma and terrorist attacks, and is also the most fatal type of whole body explosion injury. Most patients with severe blast injury of the chest die in the early stage before hospitalization or during transportation, so first aid is critically important. At present, there exist widespread problems such as non-standard treatment and large difference in curative effect, while there lacks clinical treatment standards for blast injury of the chest. According to the principles of scientificity, practicality and advancement, the Trauma Society of Chinese Medical Association has formulated the guidance of classification, pre-hospital first aid, in-hospital treatment and major injury management strategies for blast injury of the chest, aiming to provide reference for clinical diagnosis and treatment.

Causes of ABO forward and reverse grouping discrepancy: 75 cases / 中国输血杂志

【Objective】 To analyze the causes and solutions of ABO forward and reverse grouping discrepancy, and to ensure the safety of blood transfusion in clinical. 【Methods】 Samples from 75 patients with discrepancy between forward and reverse grouping in December 2019 and March 2022 were tested and analyzed in combination with saline method(forward and reverse grouping), direct antiglobulin test, antibody screening, antibody identification, increasing plasma volume, incubation enhancement test at 4℃, absorption-eluation test and molecular biological tests. 【Results】 Causes for abnormal reverse typing were as follows : weak antibody in 11 cases(14.67%), unexpected antibody in 19 cases(25.33%), inverted albumin and globulin ratios in 9 cases(12.00%), increased white blood cells in 3 cases(4.00%), inadequate anticoagulation in 3 cases(4.00%), bone marrow transplantation in 2 cases(2.67%), multiple myeloma in 4 cases(5.33%), acute gastrointestinal bleeding in 3 cases(4.00%). Causes for abnormal forward typing were as follows: self-coagulating in 1 case(1.33%), acute leukemia in 7cases(9.34%), post-transplantation in 1 case(1.33%). Causes for abnormal forward/reverse typing: acute leukemia in 1 case(1.33%), condensin syndrome in 1 case(1.33%), autoimmune hemolytic anemia in 6 cases(8.00%), subtype in 4 cases(5.33%). Results of genotying in 7 cases were as follows: B(A) 04 for 1 case, B(A)02 2 cases, AB3 1case, A1 2 cases, and 1case with new genotype. 【Conclusion】 For patients with forward and reverse typing discrepancy for ABO blood group, several studying methods, such as clinical/serological tests inquiring, absorption-eluation tests and molecular biological tests, should be combined to ensure blood transfusion safety.

Morinda citrifolia (Noni) Juice Suppresses A549 Human Lung Cancer Cells via Inhibiting AKT/Nuclear Factor-κ B Signaling Pathway / 中国结合医学杂志

OBJECTIVE@#To study the mechanism of the anti-tumor effect of Morinda citrifolia (noni).@*METHODS@#The influences of noni juice on cell proliferation, apoptosis, invasion, migration and the activity of AKT/nuclear factor- κ B (NF- κ B) signaling pathway in A549 human lung cancer cells were detected by MTT, cell counting kit-8, colony formation, Annexin V/PI double labeling, transwell, scratch test and immunoblotting assay, respectively. A549 cells were inoculated into the right axilla of nude mice, followed by noni juice treatment. The body weight of the nude mice was weighed, and the tumor volume and weight were measured. Cell proliferation and expression of apoptosis-related proteins were measured by immunohistochemistry, and the activity of NF- κ B signaling pathway was measured by immunoblotting.@*RESULTS@#The in vitro studies showed that noni juice inhibited the A549 cells proliferation, migration and invasion. Noni juice also promoted cells apoptosis in A549 cells. Immunoblotting assay showed that the phosphorylation level of AKT, p50, and STAT3 proteins was inhibited to different extents after noni juice treatment. The in vivo studies showed that noni juice effectively suppressed tumor formation of A549 cells in nude mice. Noni juice treatment inhibited the expression of Ki67, PCNA, and Bcl-2 protein in the tumor; while promoted the expression of caspase-3 protein. Additionally, we also found that noni juice treatment could restrain the activity of AKT/NF- κ B signaling pathway in the tumor tissue.@*CONCLUSION@#Noni juice inhibited the proliferation of A549 lung cancer cells, induced apoptosis, and inhibited cell invasion and migration via regulating AKT/NF- κ B signaling pathway.

Analysis on tissue-related biomarkers in patients with acute aortic dissection / 中华心血管病杂志

Objective: To explore the clinical implication of tissue-related biomarkers in patients with acute aortic dissection (AAD). Methods: It was a cross-sectional study. Ten Stanford Type A AAD patients, who were diagnosed and surgically treated in the Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, from December 2018 to August 2019, were selected as the case group. Meanwhile, 10 patients with atherosclerotic heart disease, who underwent coronary artery bypass grafting (CABG), were selected as control group. The ascending aorta tissue specimens from patients of the two groups were collected during the operation. Four-dimensional non-standard quantitative proteomics technology (4D-LFQ) was used to detect the protein profile of ascending aorta tissue specimens of the two groups and to screen out differentially expressed proteins and analyze their biological functions. Precise quantification of the selected target proteins was achieved by parallel response monitoring (PRM). Results: A total of 3 985 proteins were identified by 4D-LFQ technology, among which 3 350 proteins could be quantified. There were 39 proteins were significantly upregulated and 47 proteins were significantly downregulated in AAD group. The results of biological function analysis showed that most of the differentially expressed proteins were located in the extracellular, and their functions were mainly involved in cell migration and proliferation, inflammatory cell activation, cell contraction, and muscle organ development. The 15 selected proteins underwent precise quantification by PRM, and the results showed that integrin α-Ⅱb (ITGA2B), integrin α-M (ITGAM), integrin β-2 (ITGB2), integrin β-3 (ITGB3) were significantly upregulated in the ascending aorta tissue of AAD patients. Conclusion: ITGA2B, ITGAM, ITGB2, and ITGB3 are highly expressed in aortic tissues of patients with AAD, which may be used as biomarkers for the diagnosis of AAD patients.

Analysis of the SARS-CoV-2 specific antibodies and immune function of COVID-19 patients one year after discharge / 中国胸心血管外科临床杂志

@#Objective    To summarize the results of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibody, total antibody and cellular immune function of COVID-19 convalescent patients one year after discharge, and to analyze the correlation between the SARS-CoV-2 antibody and the indexes of immune function. Methods    A total of 41 confirmed COVID-19 patients discharged from Chengdu Public Health Clinical Medical Center from January to April 2020 and followed up one year after discharge were included in the study as the research group, including 18 males and 23 females with an average age of 47.83±12.95 years. The results of SARS-CoV-2 IgG, total antibody and immune function indexes one year after discharge were collected in order to discuss the correlation of SARS-CoV-2 and cellular immune function. A total of 40 healthy employees of the hospital vaccinated against COVID-19 were randomly selected as the vaccine group, including 10 males and 30 females with an average age of 43.90±6.86 years. The SARS-CoV-2 antibodies between the two groups were compared. Results    CD8+T cell count was higher and CD4+T/CD8+T was lower in male patients than those in female patients (all P<0.05). The IgG and total antibodies in patients with re-detectable positive RNA test were both higher than those in patients without re-detectable positive RNA test, but the differences were not statistically significant (P=0.158, 0.060). The positive rate of SARS-CoV-2 IgG in the research group was 80.5% (33/41). SARS-CoV-2 IgG was positively correlated with total antibody (P<0.001). There was a positive correlation between CD4+T cell count and SARS-CoV-2 IgG (r=0.455, P=0.003). The positive rate of SARS-CoV-2 IgG, SARS-CoV-2 IgG amount and total antibody amount in the research group were significantly higher than those in the vaccine group (all P<0.001). Conclusion    SARS-CoV-2 IgG of most COVID-19 patients one year after discharge is positive, and their SARS-CoV-2 total antibody is significantly higher than people vaccinated against COVID-19, which suggests that patients infected with SARS-CoV-2 can obtain lasting protection, but the protection may be gradually weaken over time. The degree of antibody attenuation in patients with re-detectable positive RNA test may be weaker. In the convalescence stage, the dynamics of SARS-CoV-2 IgG may be closely related to cellular immune function.

Correlation between hemolysis degree and antibody IgG subtypes contained in infant serum and erythrocyte eluates / 中国输血杂志

【Objective】 To analyze the effects of IgG subtypes(IgG 1 and IgG3) of antibodies contained in infant serum and erythrocyte eluates on hemolytic disease of the newborn(HDN), so as to provide reference for its early clinical diagnosis and treatment. 【Methods】 49 newborns with HDN in our hospital from June 2019 to March 2020 were detected for three hemolytic tests(direct antiglobulin test, elution test and indirect antiglobulin test), as well as the components of IgG1 and IgG3 in eluates. The correlation analysis was conducted by combining birth hours (physiological jaundice) and hemolytic degrees (total bilirubin, indirect bilirubin, and hemoglobin). 【Results】 In the 44 cases of IgG1 and IgG3 subtype detection of infant RBC eluates, regression equations could be established between total bilirubin, indirect bilirubin and birth hours, and between hemoglobin and elution test, and linear regression relationships were found (P<0.05). In the 28 cases of IgG1 and IgG3 subtype detection of infant serum, regression equations could be established between total bilirubin, indirect bilirubin, birth time and IgG3 subtype, and between hemoglobin and IgG1 subtype (P<0.05), and linear regression relationships were found (all P<0.05). Three infants, presenting IgG1 and IgG2 subtypes(+ ) and three hemolysis tests(-), were all second pregnancy, constituted by Rh-HDN of 2 case and other-system-HDN 1. 【Conclusion】 The degree of HDN is directly related to IgG1 and IgG3 antibodies in infant blood plasma. In addition to the total bilirubin and indirect bilirubin, the changes of IgG3 antibodies in infant plasma and IgG1 antibody in anemic infants should be monitored. If IgG1 and IgG3 antibodies are yielded even with all negative ABO-HDN hemolysis tests, non-ABO-HDN should be considered in time to achieve accurate diagnosis and treatment.

Investigation of modulating effect of Qingfei Paidu Decoction on host metabolism and gut microbiome in rats / 中国中药杂志

This study is to explore the effect of Qingfei Paidu Decoction(QPD) on the host metabolism and gut microbiome of rats with metabolomics and 16 S rDNA sequencing. Based on 16 S rDNA sequencing of gut microbiome and metabolomics(GC-MS and LC-MS/MS), we systematically studied the serum metabolites profile and gut microbiota composition of rats treated with QPD for continued 5 days by oral gavage. A total of 23 and 43 differential metabolites were identified based on QPD with GC-MS and LC-MS/MS, respectively. The involved metabolic pathways of these differential metabolites included glycerophospholipid metabolism, linoleic acid metabolism, TCA cycle and pyruvate metabolism. Meanwhile, we found that QPD significantly regulated the composition of gut microbiota in rats, such as enriched Romboutsia, Turicibacter, and Clostridium_sensu_stricto_1, and decreased norank_f_Lachnospiraceae. Our current study indicated that short-term intervention of QPD could significantly regulate the host metabolism and gut microbiota composition of rats dose-dependently, suggesting that the clinical efficacy of QPD may be related with the regulation on host metabolism and gut microbiome.

Drug resistance and pathogenic spectrum of patients coinfected with nontuberculous mycobacteria and human-immunodeficiency virus in Chengdu, China / 中华医学杂志(英文版)

Background@#Human-immunodeficiency virus (HIV) infection is increasing worldwide and nontuberculous mycobacteria (NTM) is an established microbiologic cause of pulmonary disease, lymphadenitis, and disseminated disease in cases of advanced immune suppression. Data on patients coinfected with HIV and NTM are limited. Thus, this study aimed to analyze the clinical characteristics, drug resistance, and pathogen spectrum of patients coinfected with both HIV and NTM in the Chengdu area of China.@*Methods@#Data of 59 patients coinfected with both HIV and NTM collected from the Public Health Clinical Center of Chengdu, between January 2014 and December 2018, were analyzed. NTM drug sensitivity testing was performed using the microporous plate ratio method. Data were analyzed using SPSS 19.0, and the change in drug resistance rate was analyzed using the chi-square (χ2) test.@*Results@#Seven species/complex of NTM were identified from patients coinfected with HIV and NTM in this study, with Mycobacterium avium–intracellulare complex (52.5%) and M. kansasii (27.1%) as the predominant species. Male patients were more affected 50/59 (84.7%); the mean age of the 59 cases was 45 years. The clinical characteristics mainly included anemia (86.4%), cough and expectoration (79.7%). The baseline CD4 count was <50 cells/μL (84.7%). Patients were mainly in advanced acquired immunodeficiency syndrome (AIDS) stage. Chest imaging mainly showed patchy shadows (42.4%) and nodules (32.2%), with various degrees of AIDS-defining diseases. The drug resistance of NTM was severe, and the rate of isoniazid resistance (100.0%) was the highest, followed by rifampicin (94.9%), streptomycin (94.9%), ofloxacin (93.2%), and others. Ethambutol (52.5%) and clarithromycin (33.9%) were relatively low. No significant difference was found in the drug resistance rate of NTM strain against nine antituberculosis drugs in 5 years (P > 0.05).@*Conclusions@#The immune level of patients coinfected with HIV and NTM is low in advanced AIDS stage; more male are affected in patients who are mainly infected with MAC and M. kansasii and with serious drug resistance. The drug resistance rate of ethambutol and clarithromycin is relatively low.

Drug resistance and pathogenic spectrum of patients coinfected with nontuberculous mycobacteria and human-immunodeficiency virus in Chengdu, China / 中华医学杂志(英文版)

BACKGROUND@#Human-immunodeficiency virus (HIV) infection is increasing worldwide and nontuberculous mycobacteria (NTM) is an established microbiologic cause of pulmonary disease, lymphadenitis, and disseminated disease in cases of advanced immune suppression. Data on patients coinfected with HIV and NTM are limited. Thus, this study aimed to analyze the clinical characteristics, drug resistance, and pathogen spectrum of patients coinfected with both HIV and NTM in the Chengdu area of China.@*METHODS@#Data of 59 patients coinfected with both HIV and NTM collected from the Public Health Clinical Center of Chengdu, between January 2014 and December 2018, were analyzed. NTM drug sensitivity testing was performed using the microporous plate ratio method. Data were analyzed using SPSS 19.0, and the change in drug resistance rate was analyzed using the chi-square (χ) test.@*RESULTS@#Seven species/complex of NTM were identified from patients coinfected with HIV and NTM in this study, with Mycobacterium avium-intracellulare complex (52.5%) and M. kansasii (27.1%) as the predominant species. Male patients were more affected 50/59 (84.7%); the mean age of the 59 cases was 45 years. The clinical characteristics mainly included anemia (86.4%), cough and expectoration (79.7%). The baseline CD4 count was 0.05).@*CONCLUSIONS@#The immune level of patients coinfected with HIV and NTM is low in advanced AIDS stage; more male are affected in patients who are mainly infected with MAC and M. kansasii and with serious drug resistance. The drug resistance rate of ethambutol and clarithromycin is relatively low.

Correlation of secondary thoracotomy with risk of thrombosis during perioperative period following thoracic trauma / 中华创伤杂志

Objective To investigate the effect of perioperative secondary thoracotomy on the risk of thrombosis in patients with thoracic trauma.Methods A retrospective case control study was conducted on the clinical data of 175 patients with thoracic trauma who underwent thoracotomy from January 2000 to December 2016.According to whether the patients underwent secondary thoracotomy,they were divided into secondary thoracotomy group (36 cases) and the control group (139 cases).In the secondary thoracotomy group,there were 25 males and 11 females,with age of (65.4 ± 5.5) years and thoracic abbreviated injury score (AIS) of (3.8 ±0.6) points.In the control group,there were 98 males and 41 females,with the age of (64.6 ±5.3)years and thoracic AIS of (3.7 ±0.8)points.The ICU stay,thoracic drainage,bed rest time,and the incidence of thrombosis in two groups were compared,and the levels of endothelin (ET-1),D-dimer aggregation and platelet were measured.Logistic regression analysis was used to analyze the impact of secondary thoracotomy on the risk of thrombosis.Results Compared with the control group,patients in the secondary thoracotomy group had longer ICU stay [(4.2 ± 1.4) d ∶(1.8± 1.0)d](P＜0.01),more thoracic drainage [(1 550 ±250)ml ∶ (635 ± 184)ml] (P＜0.01),and longer bed rest time [(5.4 ± 1.6) days ∶ (1.5 ± 0.9) days] (P ＜ 0.01).There were significant differences in levels of ET-1 and D-dimer aggregation between two groups (P＜0.01).There was significant difference in platelet count after 5 days (P ＜ 0.01).Twelve cases of deep venous thrombosis (33％) occurred in the secondary thoracotomy group,of which six cases died of thrombus related complications.Eight cases (5.7％) of deep venous thrombosis occurred in the control group,all of which recovered (P ＜ 0.05).In multivariate analysis,ET-1 (OR =7.46,95％ CI 4.53-11.06,P ＜ 0.05),D-dimer aggregation (OR =4.28,95％ CI 2.65-8.37,P ＜ 0.05),and platelet count (OR =1.13,95 ％ CI 0.56-1.98,P ＜ 0.05) were independent risk factors for thrombosis events.Conclusions Perioperative secondary thoracotomy increases the risk of thrombotic events.ICU hospitalization,thoracic drainage,and bed time are associated with thrombosis events.ET-1,D-dimer aggregation,and platelet count are independent risk factors for thrombosis events.

ADC and relative ADC in differential diagnosis of lymphoma and metastasis in cervical lymph nodes / 中国医学影像技术

Objective To investigate the value of MR apparent diffusion coefficient (ADC) and relative apparent diffusion coefficient (rADC) in differential diagnosis of lymphoma and metastasis in cervical lymph nodes.Methods Totally 69 patients with lymphoma (lymphoma group) and 66 patients with cervical lymph nodes metastasis (metastasis group) underwent MR examination.ADC values of lymph nodes and the right masseter muscle were measured,and rADC values were calculated.The consistency between two observers was evaluated.The differences of ADC value and rADC value were compared between the two groups.The efficacy of ADC value and rADC value in differential diagnosis of lymphoma and metastasis in cervical lymph nodes was analyzed with ROC curve.Results The consistency between two observers was excellent (all ICC＞0.9).Both ADC and rADC values of lymphoma group were significantly lower than those of metastasis group (all P＜0.05).Taken ADC and rADC values as 0.702 × 10-3 mm2/s and 0.584,the sensitivity and specificity was 98.48 ％ and 89.39 ％,76.81 ％ and 84.06 ％,respectively.Conclusion ADC and rADC values are useful in discriminating lymphoma from metastatic lymph nodes.

The prognosis of ocular inflammation index after pterygium surgery based on Oculus Keratograph(R) 5M and Visual analogue scale / 中华实验眼科杂志

Objective To investigate the characteristics of ocular surface inflammation index after pterygium excision by using Oculus Keratograph(R) 5M and Visual analogue scale and evaluated the effectiveness of antiinflammatory treatment.Methods A prospective case control study was performed.Eighteen patients (6 males and 12 females) who suffered from primary pterygium were recruited in Zhongshan Ophthalmic Center from June to September 2016.All patients were treated with monocular pterygium excision combined with amniotic membrane transplantation.Anti-inflammatory treatment was given after surgery,and the ocular inflammation index was evaluated at preoperative and 1st,3rd,7th,10th,30th and 60th day postoperative.The temporal conjunctival hyperemia index (TCHI) was assessed by Oculus Keratograph(R) 5M with a red eye index analysis software.Ocular symptom scores (OSS) and visual analogue scale (VAS) were used to analyze the subjective symptoms of the patients.Fluorescein staining was used to detect the epithelization of corneal and scleral wound.The best corrected visual acuity (BCVA),intraocular pressure and complications were evaluated in this study.This study was approved by the Medical Ethics Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University (2016KYPJ024).All patients signed informed consent for clinical research.Results No drug-related ocular and systemic adverse events were found during the follow-up.Corneal epithelial defect was recovered on 10th day,and conjunctival epithelization was observed in sclera exposed area on 30th day.The BCVA on the 60th day was 0.12±0.17,which was significantly lower than 0.34±0.36 preoperatively (t =3.401,P =0.003).Compared with those before surgery,OSS and VAS were significantly increased on 1 st day (OSS:Z =-4.255,P =0.000;VAS:Z =-5.256,P =0.000).The OSS on 7th day was not significantly different from that before surgery (Z=-0.958,P=0.372).VAS decreased to baseline on 30th day.The OSS on 60th day after surgery was significantly lower than that before surgery (Z =-2.397,P =0.037).TCHI was higher than 1.2 preoperatively,and increased to the highest on 1 st day after surgery,with significant difference between them (t=-6.620,P=0.000).The TCHI decreased to baseline on 7th day,no significant difference were obtained when compared with preoperative TCHI (t =-1.050,P =0.310),and TCHI on 60th day after surgery was lower than that before surgery,with significant difference between them (t =2.758,P =0.020).Conclusions The subjective symptoms combined with conjunctival hyperemia can be more accurate assessment of ocular surface inflammation in the perioperative period of pterygium surgery,which can be used as an evaluation index to assess the effectiveness of anti-inflammatory treatment.