Relationship between blood uric acid levels and body composition in patients with polycystic ovary syndrome / 中华妇产科杂志

Objective: To analyze the difference in blood uric acid levels between patients with polycystic ovary syndrome (PCOS) and healthy women of childbearing age, and to investigate the correlation between body composition and blood uric acid levels. Methods: A total of 153 eligible childbearing age patients with PCOS treated at Tianjin Medical University General Hospital from January 2018 to March 2022 were selected, and 153 healthy women with normal menstruation were selected as the control group. Fasting blood uric acid levels were measured by venous blood test, and body composition was measured by a body composition analyzer. Group comparisons were made to analyze the correlation between body composition and blood uric acid levels. Results: The incidence of hyperuricemia was higher in patients with PCOS than that in the control group [30.1% (46/153) vs 2.0% (3/153)], with a statistically significant difference (χ2=44.429, P<0.001). Blood uric acid level was also significantly higher in patients with PCOS than that in the control group [(371±98) vs (265±67) μmol/L; t=11.170, P<0.001]. Among PCOS patients, there were statistically significant differences in weight, body mass index (BMI), body fat mass, skeletal muscle mass, percent body fat, lean body weight, fat mass/lean body weight, percent skeletal muscle, and visceral fat level between the hyperuricemia group and the normal blood uric acid group (all P<0.001), but no significant difference was observed in waist-hip ratio (P=0.348). The following body composition indicators: weight, BMI, waist-hip ratio, body fat mass, skeletal muscle mass, percent body fat, visceral fat level, lean body weight, and fat mass/lean body weight in all subjects, the PCOS patients and the control group, were positively correlated with blood uric acid levels (all P<0.01). The blood uric acid level in PCOS obese patients was higher than that in non-obese PCOS patients, and the difference was statistically significant [(425±83) vs (336±91) μmol/L; t=6.133, P<0.001]. The blood uric acid level in central obesity PCOS patients was also higher than that in non-central obesity PCOS patients [(385±95) vs (299±79) μmol/L], the difference was statistically significant (t=4.261, P<0.001). The blood uric acid level in normal-weight obese PCOS patients was higher than that in normal-weight non-obese PCOS patients [(333±73) vs (277±54) μmol/L], and the difference was statistically significant (t=2.848, P=0.006). Blood uric acid levels in normal-weight [(315±74) vs (255±67) μmol/L], overweight [(362±102) vs (276±57) μmol/L], and obese PCOS patients [(425±83) vs (303±74) μmol/L] were all higher than those in the corresponding control groups, with statistically significant differences (all P<0.001). Conclusions: PCOS patients have a higher incidence of hyperuricemia than healthy women of childbearing age. Blood uric acid levels are closely correlated with body composition indicators, such as weight, BMI, waist-hip ratio, body fat mass, skeletal muscle mass, percent body fat, and visceral fat level. Body composition analysis of women with PCOS could help identify potentially obese people more accurately and carry out individualized treatment, thereby reducing the risk of metabolic abnormalities.

Standardized diagnosis and treatment of spinal infectious diseases / 中华骨科杂志

Infectious diseases of spine (IDS) refer to a series of infectious diseases in different parts of the spine (vertebral body, intervertebral disc, appendix of vertebra, spinal canal, and adjacent paravertebral tissues) caused by various pathogenic microorganisms, accounting for about 2%~7% of systemic musculoskeletal system infections. According to the classic classification IDS can be divided into two types: specific infection and non-specific infection. IDS often has an insidious onset, atypical clinical manifestations, and less-specific imaging and laboratory tests, which causes great difficulties for the accurate diagnosis and treatment, often leading to missed diagnosis, misdiagnosis, and even mistreatment. Problems such as disordered clinical diagnosis and treatment procedures, diverse treatment methods, and non-standard medication and course of treatment still affect the prognosis of IDS. This article reviews the current research progress of the diagnosis and treatment process of IDS, in order to further standardize the diagnosis and treatment process of IDS.

Application value of metagenomic next generation sequencing in the diagnosis of non-tuberculous spinal infection / 中华骨科杂志

Objective:To investigate the application value of metagenomic next generation sequencing (mNGS) in the diagnosis of spinal infectious diseases except tuberculosis and non-tuberculous mycobacterium infection.Methods:According to the inclusion and exclusion criteria, the clinical data of 171 patients with suspected non-tuberculous infectious diseases of spine from January 2019 to November 2020 were analyzed retrospectively. All patients underwent puncture biopsy of spine or surgery to obtain tissue specimens, then tissue biopsy were measured, and Foci purulent blood or lavage fluid was obtained for routine bacterial and mNGS. The differences of reporting time, sensitivity (positive rate) and specificity (true negative rate) were compared between the two methods. The pathogenic microorganism spectrum of spinal infection was analyzed. The effects of specimen collection method, preoperative antibiotic use and specimen type on the detection of pathogenic microorganisms were analyzed.Results:According to the diagnostic criteria of non-tuberculous infectious diseases of the spine, there were 136 cases of infection, among which 111 cases had specific pathogenic microorganism. The average reporting time of traditional culture and mNGS were 81.67+15.52 h and 36.33+11.92 h. There were 43 positive cases and 5 false positive cases in traditional culture, the sensitivity was 31.62%, and the specificity was 85.71%; There were 76 positive cases and 19 false positive cases in mNGS, the sensitivity was 55.88%, and the specificity was 45.71%. There were significant statistical differences in the sensitivity, specificity and reporting time for detection of pathogenic microorganisms by mNGS. The top 3 pathogens of non-specific infection were Staphylococcus aureus and Staphylococcus, Escherichia coli and Streptococcus. Eleven patients with non-tuberculous specific infection were confirmed, including 2 positive cases with traditional culture, 11 positive cases with mNGS. A higher detection rate for rare specific infections were expressed in mNGS. Logistic regression analysis indicated that the standard antibiotic use 4 weeks before surgery and specimen acquisition methods had significant effects on the traditional culture results, while the specimen acquisition methods had no statistically significant effects on the mNGS.Conclusion:Metagenomic next generation sequencing has a higher sensitivity to the detection of pathogenic microorganisms in the diagnosis of non-tuberculous spinal infectious diseases, especially for the detection of rare pathogenic microorganisms, which has a high diagnostic value.

Progress of clinical nutrition support management and corresponding data analysis in a tertiary (A) children's hospital in Shanghai in the past ten years / 中华临床营养杂志

Objective:To analyze the paradigm and changes of enteral nutrition support for hospitalized children in Shanghai Children's Medical Center affiliated to School of Medicine of Shanghai, Jiao Tong University in last ten years, so as to provide guidance for nutritionists and dietitians on the application and management of enteral nutrition.Method:Relevant data were collected and analyzed from 2011 to 2020 in the Clinical Nutrition Department of Shanghai Children's Medical Center, including the implementation status of parenteral and enteral nutrition as well as the types and distribution of different enteral nutrition formulas and diet.Results:The Clinical Nutrition Department of our hospital provided seventy-five types of diet for hospitalized children. The utilization of ordinary diets and specialized diets has been stable at about 76,000 cases per year. In the past decade, twenty-one ordinary formulas and special formulas were provided every year by the Clinical Nutrition Department in our hospital and the utilization has been stable at 46,000 cases per year. The total consumption of ordinary formulas and the proportion of ordinary formulas users showed a descending trend. The proportion of specialized formulas users among discharged patients remained at 10%, with an upward trend in the proportion of high-calorie formulas and extensively-hydrolyzed formulas.Conclusions:The enteral nutrition formulas and inpatient diets are important components of nutritional treatment. The evolution of its clinical application to some extent reflects the changes of disease spectrum and the development of clinical disciplines. In short, the dietitians play a significant role in the nutrition support team.

Performance of point-of-care testing for cervical cancer screening / 中华预防医学杂志

Objective: To evaluate the performance of point-of-care testing for cervical cancer and precancerous lesions screening. Methods: In September 2020, 197 and 273 women were selected by using simple random sampling method from "self-sampling" cohort and "physician-sampling" cohort established in Xiangyuan county, Shanxi Province, China, respectively. Cervical exfoliated cells were collected by women themselves or gynecologists. All samples were detected by POCT and women with positive result were directly referred for colposcopy. Subsequently, all the samples were detected by careHPV and PCR test. Colposcopy and punch biopsy were performed for women with POCT negative but careHPV or PCR test positive at another visit. Using histopathological diagnosis as the gold standard, we calculated sensitivity, specificity and drew the receiver operating characteristic (ROC) curves. The accuracy of POCT was analyzed and compared to that of careHPV and conventional PCR test in cervical cancer and precancerous lesions screening. Results: The median (Q1 , Q3) age of 470 women was 51 (45, 57) years old. Based on self-sampling, the sensitivity and specificity of POCT for CIN2+ were 100.00% (95%CI: 56.56%-100.00%) and 28.95% (95%CI: 22.97%-35.76%), respectively. Compared with POCT, POCT HPV16/18 test had similar sensitivity and higher specificity of 89.47% (95%CI: 84.30%-93.08%). Self-sampling POCT HPV16/18 test had an AUC of 0.947 (95%CI:0.910-0.985), which was higher than that of careHPV and PCR test. Physician-sampling POCT test had 100.00% sensitivity (95%CI: 64.57%-100.00%) and 55.85% specificity (95%CI: 49.83%-61.70%) for detecting CIN2+. POCT HPV16/18 test had lower sensitivity (71.43%, 95%CI: 35.90%-91.76%) and higher specificity (92.45%, 95%CI: 88.63%-95.06%). POCT HPV16/18 test generally showed similar AUC on both self-collected samples and clinician-collected samples (0.947 vs 0.819, P=0.217). Conclusion: POCT HPV16/18 test is an effective method with relatively high sensitivity and specificity for cervical cancer screening.

Fungal periprosthetic joint infection: Rare but challenging problem / 中华创伤杂志(英文版)

Periprosthetic joint infection (PJI) is the most difficult complication following total joint arthroplasty. Most of the etiological strains, accounting for over 98% of PJI, are bacterial species, with Staphylococcusaureus and Coagulase-negative staphylococci present in between 50% and 60% of all PJIs. Fungi, though rare, can also cause PJI in 1%-2% of cases and can be challenging to manage. The management of this uncommon but complex condition is challenging due to the absence of a consistent algorithm. Diagnosis of fungal PJI is difficult as isolation of the organisms by traditional culture may take a long time, and some of the culture-negative PJI can be caused by fungal organisms. In recent years, the introduction of next-generation sequencing has provided opportunity for isolation of the infective organisms in culture-negative PJI cases. The suggested treatment is based on consensus and includes operative and non-operative measures. Two-stage revision surgery is the most reliable surgical option for chronic PJI caused by fungi. Pharmacological therapy with antifungal agents is required for a long period of time with antibiotics and included to cover superinfections with bacterial species. The aim of this review article is to report the most up-to-date information on the diagnosis and treatment of fungal PJI with the intention of providing clear guidance to clinicians, researchers and surgeons.

Mechanism of polyphyllin Ⅰ targeting EGFR to affect proliferation and apoptosis of human breast cancer cells / 中国中药杂志

This study aims to investigate the molecular mechanism of polyphyllin Ⅰ(PPⅠ) inhibiting proliferation of human breast cancer cells. Human breast cancer BT474 and MDA-MB-436 cells were treated with different concentrations of PPⅠ, and then the effect of PPⅠ on cell proliferation was detected by MTT assay, trypan blue dye exclusion assay, real-time cell analysis, and clone forming assay, respectively. The apoptosis was detected by Annexin V-FITC/PI staining and then analyzed by flow cytometry. The change of mitochondrial membrane potential was detected by flow cytometry after fluorescent probe JC-1 staining. Western blot was used to detect protein expression and phosphorylation. Molecular docking was performed to detect the binding between PPⅠ and EGFR. The affinity between PPⅠ and EGFR was determined by drug affinity responsive target stability assay. The results indicated that PPⅠ inhibited the proliferation and colony formation of BT474 and MDA-MB-436 cells in a time-and concentration-dependent manner. The PPⅠ treatment group showed significantly increased apoptosis rate and significantly decreased mitochondrial membrane potential. PPⅠ down-regulated the expression of pro-caspase-3 protein, promoted the cleavage of PARP, and significantly reduced the phosphorylation levels of EGFR, Akt, and ERK. Molecular docking showed that PPⅠ bound to the extracellular domain of EGFR and formed hydrogen bond with Gln366 residue. Drug affinity responsive target stability assay confirmed that PPⅠ significantly prevented pronase from hydrolyzing EGFR, indicating that PPⅠ and EGFR have a direct binding effect. In conclusion, PPⅠ inhibited the proliferation and induced apoptosis of breast cancer cells by targeting EGFR to block its downstream signaling pathway. This study lays a foundation for the further development of PPⅠ-targeted drugs against breast cancer.

Research progress in molecular mechanism of bone homeostasis imbalance due to bone infection / 中华创伤杂志

Bone infection is an osteal disorder with bone damage resulting from infection of bone marrow，cortex，periosteum and surrounding tissues，characterized by a high incidence and severe symptoms. The treatment is often complicated and prolonged. Regardless of the method used，the goal is to reduce bone defect caused by infection，control infection，rebuild impaired tissues，and promote bone healing，so as to restore bone homeostasis. Starting from bone homeostasis，the authors review the research progress in the commonly used drugs and molecular mechanisms that affect bone formation-related pathways caused by bone infection，activate bone resorption-related mechanisms，and regulate bone homeostasis，in order to provide a theoretical basis for reducing bone defect caused by bone infection and promoting bone healing.

Related issues in platelet-rich plasma-loaded antibiotics combined with Masquelet technique for treatment of infectious bone defect / 中华创伤杂志

Infectious bone defect is a serious complication after high-energy trauma, osteomyelitis and infection of implants. It has become one of the most difficult diseases in orthopedics. The formation of biofilm is an important factor of infectious bone defect. With the wide application and success of platelet-rich plasma (PRP) in orthopedics and other fields, PRP can be used as a new biomaterial to load antibiotics and become a new treatment method for infectious diseases, including infectious bone defects. The authors discuss the characteristics of PRP-loaded antibiotics combined with Masquelet technique in treatment of infectious bone defect from the aspects of advantages, operation points, indications and operation methods, so as to provide references for treatment of infectious bone defect in clinic.

Application of WeChat platform combined with the flipped classroom in the teaching of fever clinic resident doctors / 中华医学教育探索杂志

Objective:To explore the role of WeChat platform combined with flipped classroom in improving the working ability of resident doctors in the fever clinic.Methods:A total of 118 resident doctors who rotated in the fever clinic of department of emergency medicine were selected as the study subjects, and they were randomized into experimental group and control group, with 59 people in each group. The experimental group used WeChat platform and flipped classroom teaching, and the control group used traditional teaching. The results of theory assessment, operation performance and questionnaire survey were compared between the two groups. SPSS 26.0 statistical software was used for t test and chi-square test. Results:There was no significant difference in theoretical test scores between the experimental group and the control group ( P>0.05). The experimental group scored (91.61±3.01) points and the control group scored (84.52±4.02) points in operational assessment, with significant differences ( t=-10.85, P<0.05). The results of the satisfaction survey showed that there was no significant difference in teaching time distribution between the two groups, and the experimental group was better than the control group in any other aspects. Conclusion:The use of WeChat platform combined with flipped classroom during the COVID-19 epidemic can improve the level of operational skills of the resident doctors to wear or take off the protective clothing and collect nasopharyngeal swabs, help residents to avoid the infections, and improve the level of daily diagnosis and treatment of fever clinic.

Mechanism of Chuanxiong Rhizoma-Paeoniae Radix Rubra drug pair on intervention of cerebral ischemia based on network pharmacology-molecular docking / 中国中药杂志

Cerebral ischemia is one of the most common diseases in China, and the drug pair of Chuanxiong Rhizoma and Paeoniae Radix Rubra can intervene in cerebral ischemia to reduce the inflammatory response of cerebral ischemia and apoptosis. To reveal the intervention mechanism of Chuanxiong Rhizoma-Paeoniae Radix Rubra drug pair on cerebral ischemia systematically, computer network pharmacology technology was used in this paper to predict the target and signaling pathway of the drug pair on the intervention of cerebral ischemia, and then the molecular docking technology was used to further analyze the mechanism of the intervention. The target results were then verified by the rat cerebral ischemia model. The target network results showed that the active compounds of Chuanxiong Rhizoma-Paeoniae Radix Rubra for cerebral ischemic disease contained 30 compounds, 38 targets and 9 pathways. The main compounds included phenolic acids in Chuanxiong Rhizoma and monoterpene glycosides in Paeoniae Radix Rubra. The key targets involved mitogen-activated protein kinase 1(MAPK1), steroid receptor coactivator(SRC), epidermal growth factor receptor(EGFR), mitogen-activated protein kinase 14(MAPK14), caspase-3(CASP3), caspase-7(CASP7), estrogen receptor 1(ESR1), and mitogen-activated protein kinase 8(MAPK8), etc. The target gene functions were biased towards protein kinase activity, protein autophosphorylation, peptidyl-serine phosphorylation and protein serine/threonine kinase activity, etc. The important KEGG pathways involved Ras signaling pathway, ErbB signaling pathway and VEGF signaling pathway. Molecular docking results showed that catechin, oxypaeoniflorin, albiflorin, paeoniflorin and benzoylpaeoniflorin had strong binding ability with MAPK1, SRC, EGFR, MAPK14 and CASP7. MCAO rat experimental results showed that Chuanxiong Rhizoma-Paeoniae Radix Rubra significantly improved the cerebral ischemia injury and interstitial edema, and significantly reduced the activation of caspase-7 and the phosphorylation of ERK1/2. The Chuanxiong Rhizoma-Paeoniae Radix Rubra drug pair alleviated cerebral ischemia injury through a network model of multi-phenotype intervention by promoting cell proliferation and differentiation, reducing inflammatory factor expression, protecting nerve cells from death and figh-ting against neuronal cell apoptosis, with its action signaling pathway most related to Ras signaling pathway, ErbB signaling pathway and VEGF signaling pathway. This study provides the basis for clinical intervention of Chuanxiong Rhizoma-Paeoniae Radix Rubra drug pair on cerebral ischemia, and also provides ideas for the modernization of drug pairs.

Study on intervention effect of Astragali Radix-Curcumae Rhizoma on growth and metastasis of colon cancer in orthotopic transplantation mice model of colon cancer / 中国中药杂志

Astragali Radix-Curcumae Rhizoma is a classic drug pair mainly used for the treatment of digestive tract-related inflammation and tumors, but the ratio is not fixed in clinical practice. In order to study whether the anti-tumor effect of the drug pair is diffe-rent under different ratios, orthotopic transplantation model of colon cancer was established in mice. Then the principal component analysis(PCA) and cluster analysis(CA) were used to explore the effect of different ratios of the drug pair on the tumor growth and metastasis, and select the optimal ratio of Astragali Radix-Curcumae Rhizoma for anti-colon cancer effect. After administration for 15 days, the body weight of colon cancer mice with the tumor removed, the tumor volume and the number of liver metastases were mea-sured; the pathological changes of tumor tissue and liver tissue were observed by HE staining. At the same time, Western blot method was used to detect the protein expression level of tumor growth-related indicators in tumor tissue(Ki67, HBP1, AFP) and tumor metastasis-related indicators in liver tissue(β-catenin, E-cadherin, vimentin, p53) of the tumor-bearing mice. Subsequently, PCA and CA were used to select the optimal ratio of Astragali Radix-Curcumae Rhizoma for anti-colon cancer effect. The experimental results showed that different ratios of Astragali Radix-Curcumae Rhizoma inhibited tumor growth and metastasis to varying degrees. The ratio at 1∶1 of Astragali Radix-Curcumae Rhizoma had the best inhibitory effect on tumor growth, and the 2∶1 ratio group had the best effect on inhibiting liver metastasis and improving weighed loss. Astragali Radix-Curcumae Rhizoma significantly up-regulated the protein expression of HBP1 in tumor tissue of colon cancer mice, and significantly down-regulated the protein expression of Ki67 and AFP in tumor tissue; meanwhile, Astragali Radix-Curcumae Rhizoma significantly up-regulated the protein expression of E-cadherin in liver tissue of colon cancer mice, and significantly reduced the protein expression of β-catenin, vimentin and p53 in liver tissue. PCA results showed that the first three groups in the Astragali Radix-Curcumae Rhizoma compatibility group that were closer to the sham operation group were in the order of 2∶1, 1∶1 and 3∶2, among which the center distance of the 2∶1 group was the shortest from the sham operation group, indicating that the ratio 2∶1 of Astragali Radix-Curcumae Rhizoma had the best intervention effect on colon cancer in mice, consistent with the commonly used clinical proportion. CA results showed that 11 groups of colon cancer mice were classified into 3 categories: Astragali Radix-Curcumae Rhizoma compatibility group, sham operation group and model group, which was consistent with the theory. The results of this study provide a basis for more effective clinical application of Astragali Radix-Curcumae Rhizoma in the treatment of colon cancer, and provide new ideas for the development of classic drug pairs.

Effect of Astragali Radix-Curcumae Rhizoma on SDF-1/CXCR4/NF-κB Signaling Pathway of Orthotopic Transplantation Model of Colon Cancer in Mice / 中国实验方剂学杂志

Objective:To explore the possible mechanism of Astragali Radix-Curcumae Rhizoma （AC） in inhibiting tumor growth in the orthotopic transplantation model of colon cancer in mice. Method:The molecular docking technology was used to predict the intermolecular interaction between the main active components of AC and the pathway target proteins， such as stromal cell-derived factor-1 （SDF-1）， C-X-C motif chemokine receptor 4 （CXCR4）， and nuclear factor kappa-B p65 （NF-<italic>κ</italic>B p65）. The orthotopic transplantation model of CT26.WT colon cancer was established in mice for <italic>in vivo</italic> experimental verification. Sixty BALB/c male mice were randomly divided into a sham operation group， a model group， a 5-fluorouracil （5-Fu， 30 mg·kg^-1） group，and low- （0.32 g·kg^-1）， medium- （0.64 g·kg^-1）， and high-dose （1.28 g·kg^-1） AC groups， with 10 mice in each group. The sham operation group and the model group received normal saline by gavage. The corresponding drugs were administered by gavage in the 5-Fu group and by intraperitoneal injection in the AC groups. After intervention for 15 days， the tumor <italic>in situ</italic> was completely stripped， and the colon tissues 5-6 cm in length adjacent to the tumor were taken. The tumor volume was measured and calculated. The pathological changes of tumor tissues and colon tissues were observed by Hematoxylin-Eosin （HE） staining. Western blot was used to detect the protein expression of SDF-1， CXCR4， p-NF-<italic>κ</italic>B p65 in colon tissues. Western blot and Real-time quantitative polymerase chain reaction （Real-time PCR） were used to detect SDF-1， CXCR4， NF-<italic>κ</italic>B p65， Cyclin D₁， oncogene c-Myc protein and mRNA expression in tumor tissues. Result:Compared with the model group， 5-Fu and AC groups showed reduced tumor volumes <italic>in situ</italic> （<italic>P</italic><0.05， <italic>P</italic><0.01）， with the tumor inhibition rate in the 5-Fu group as high as （61.38±2.34）%. The tumor-inhibiting effect was optimal in the medium-dose AC group， with the tumor inhibition rate of （43.43±3.71）%. Compared with the model group， 5-Fu and AC groups showed relieved pathological changes of tumor and colon tissues. Specifically， AC down-regulated the protein expression levels of SDF-1， CXCR4， and p-NF-<italic>κ</italic>B p65 in colon tissues （<italic>P</italic><0.01）， and down-regulated the protein and mRNA expression levels of SDF-1， CXCR4， NF-<italic>κ</italic>B p65， Cyclin D₁， and c-Myc in tumor tissues （<italic>P</italic><0.05， <italic>P</italic><0.01）. Conclusion:AC can inhibit the growth of orthotopic transplantation tumor of colon cancer， and its intervention mechanism may be related to the regulation of related protein and mRNA expression in the SDF-1/CXCR4/NF-<italic>κ</italic>B signaling pathway.

Paris saponin VII, a direct activator of AMPK, induces autophagy and exhibits therapeutic potential in non-small-cell lung cancer / 中国天然药物

Paris saponin VII (PSVII), a bioactive constituent extracted from Trillium tschonoskii Maxim., is cytotoxic to several cancer types. This study was designed to explore whether PSVII prevents non-small-cell lung cancer (NSCLC) proliferation and to investigate its molecular target. AMP-activated protein kinase (AMPK) has been implicated in the activation of autophagy in distinct tissues. In cultured human NSCLC cell lines, PSVII induces autophagy by activating AMPK and inhibiting mTOR signaling. Furthermore, PSVII-induced autophagy activation was reversed by the AMPK inhibitor compound C. Computational docking analysis showed that PSVII directly interacted with the allosteric drug and metabolite site of AMPK to stabilize its activation. Microscale thermophoresis assay and drug affinity responsive target stability assay further confirmed the high affinity between PSVII and AMPK. In summary, PSVII acts as a direct AMPK activator to induce cell autophagy, which inhibits the growth of NSCLC cells. In the future, PSVII therapy should be applied to treat patients with NSCLC.

Clinical efficacy of vacuum sealing drainage combined with topical oxygen therapy for traumatic wounds / 中华创伤杂志

Objective:To study the clinical efficacy of vacuum sealing drainage (VSD) plus topical oxygen therapy for traumatic wounds.Methods:A retrospective case-control study was conducted to analyze the clinical data of 60 patients with traumatic wounds admitted to Daping Hospital of Army Medical University from July 2016 to June 2019, including 34 males and 26 females, aged 22-72 years[(42.2±12.8)years]. There were 48 patients with wound sites in lower extremities, 9 in upper extremities, 3 in back. The area of the wounds was 30-156 cm 2[(76.9±25.1)cm 2]. A total of 20 patients were treated with regular dressing (Group A), 20 patients were treated with VSD plus irrigation of saline (Group B), and 20 patients were treated with vacuum sealing drainage plus irrigation of saline loaded with oxygen (Group C). Bacteria clearance rate, granulation tissue coverage rate and partial pressure of oxygen of the exudate in wounds were compared among the three groups. Foam dry rate and blockage rate of drainage tube were compared between Group B and Group C. Wound healing time, dressing change time and hospitalization day were compared among the three groups. Results:Bacterial clearance rate of wounds in Group B [(78.3±7.0)%] and Group C [(85.3±9.7)%] was higher than that in Group A [(58.5±11.1)%] (both P<0.05), while Group C was higher than that in Group B ( P<0.05). Granulation tissue coverage rate of wounds in Group B [(71.5±9.9)%] and Group C [(86.0±9.2)%] was higher than that in Group A [(49.1±14.7)%] (both P<0.05), while Group C was higher than that in Group B ( P<0.05). Partial pressure of oxygen of the exudate in wounds in Group B [(49.5±10.1)%] and Group C [(80.9±12.1)%] was higher than that in Group A[(49.4±11.2) %] (both P<0.05), while Group C was higher than that in Group B ( P<0.05). The foam dry rate [9.5 (5.0, 13.8)%] and drainage tube blockage rate [0.6 (0, 1.7)%] in Group C showed no significant difference with that [9.0 (5.0, 10.0)%, 0.6 (0, 1.2)%] in Group B ( P>0.05). Wounds healing time in Groups A, B, C were (36.5±4.8)days, (25.9±3.9)days, (25.5±4.2)days, respectively; dressing change times in Groups A, B, C were 23.0 (20.3, 27.8)times, 8.0 (6.0, 9.0)times, 7.5 (5.3, 9.0)times, respectively; hospitalization day in Groups A, B, C were 23.5 (19.0, 27.8)d, 17.0 (15.3, 19.0)d, 17.0 (16.0, 18.8)d, respectively. These outcomes in Group B and Group C showed significant differences compared to Group A ( P<0.05), while there were no significant differences between Group B and Group C ( P>0.05). Conclusions:VSD plus topical oxygen therapy can facilitate wound healing and reduce dressing change frequency for traumatic wounds compared to traditional methods. The technique can also improve bacterial clearance rate and granulation tissue coverage rate of wounds compared to VSD plus irrigation of saline, but the difference of wounds healing time is similar.

The effect of oral nutrition supplementation on the nutritional status of children with primary acute lymphoblastic leukemia during chemotherapy / 中华临床营养杂志

Objective:This study aims to survey the changes of the nutritional status of the children with primary acute lymphoblastic leukemia (ALL) using L-asparaginase (L-Asp) and evaluate the effect of Oral nutritional supplements (ONS) added high protein and medium-chain triglyceride (MCT)(FSMP) improving their nutritional status and clinical outcome.Methods:121 ALL patients receiving the L-Asp chemotherapy were randomized administered conventional low-fat formula (control group, 63 cases) and high protein and MCT FSMP (intervention group, 58 cases). We recorded the one-week diet and performed dietary analysis. The changes of body weight and albumin were recorded on admission and discharge, and the body composition was determined, the nutritional status, number of hospitalization days, and medical costs were assessed.Results:ALL patients had lower intake than the guideline′s recommended value during chemotherapy. The control group was significantly lower in calorie intake and nutrients intake than the intervention group. Weight changes during chemotherapy were positivelycorrelated with calorie intake ( P=0.009), protein intake( P=0.014), and carbohydrate intake( P=0.003). Conclusions:ALL children have different degrees of weight loss and protein level decline during chemotherapy, and their nutritional status was closely related to nutritional intake.ONS is an important nutritional therapy. The appropriate addition of high protein and MCT FSMP can alleviate the loss of thin body weight and the decline of albumin in ALL children.

Case-control study on cortical bone trajectory screw and pedicle screw internal fixation for the treatment of senile patients with lumbar tuberculosis / 中国骨伤

OBJECTIVE@#To compare clinical effect of cortical bone trajectory (CBT) screw and pedicle screw (PS) internal fixation in treating senile patients with lumbar tuberculosis.@*METHODS@#From January 2014 to January 2017, 42 senile patients with lumbar tuberculosis were divided into CBT group and PS group, 21 patients in each group. In CBT group, there were 12 males and 9 females, aged from 64 to 81 years old with an average of (72.52±9.25) years old, T value of bone mineral density was (-2.69±0.17) g / cm, posterior CBT screw internal fixation and anterior debridement, interbody fusion with bone grafting was performed. In PS group, there were 11 males and 10 females, aged from 63 to 85 years old with an average of (71.42±9.81) years old, T value of bone mineral density was (-2.70±0.21) g / cm, PS internal fixation and anterior debridement, interbody fusion with bone grafting were performed. Length of posterior incision, intraoperative bleeding volume, operation time, time of bone graft fusion and complications between two groups were compared. Level of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), segment kyphotic Cobb angle before and after operation were compared, VAS score was used to evaluate pain releasing, JOA score was applied to evaluate clinical effect.@*RESULTS@#All patients were followed up from 12 to 21 months with an average of (15.00±3.57) months. No reoccurrence of lumbar tuberculosis and screw loosing occurred. There were statistical difference in length of incision, intraoperative bleeding volume, operation time between two groups (0.05). There were no statistical differences in complications, time of bone graft fusion and segment kyphotic Cobb angle at 1 week after operation between two groups (>0.05). There was difference in Cobb angle at 12 months after operation (0.05), but VAS score at 3 months after operation were improved after operation between two groups (<0.05).For JOA score, there were no difference between two groups before operation, 3 and 12 months after operation, and JOA score at 3 and 12 months after operation were improved than that of before operation between two groups (<0.05).@*CONCLUSION@#Both of CBT screw internal fixation and PS screw internal fixation could achieve satisfying results for the treatment of elderly patients with lumbar tuberculosis. PSinternal fixation has a long fixation but great trauma. However, CBT screw internal fixation only needs to fix adjacent segments of the lesion to reduce the fixation range, which has advantages of less trauma and strong screw holding force.

Characteristics of COVID-19 clusters in Lishui / 预防医学

Objective@#To analyze the epidemiological characteristics of coronavirus disease 2019 ( COVID-19 ) clusters in Lishui, so as to provide basis for the prevention and control of COVID-19 clusters.@*Methods@#The data of COVID-19 clusters in Lishui from January 23 to March 29, 2020 were collected through China Disease Control and Prevention Information System-Public Health Emergency Information System, and analyzed time, space, scale, source of infection, exposure and transmission route by descriptive epidemiological method. @*Results@#There were 31 cases in 8 clusters ( about 4 cases per cluster ), with no death. The report time was bimodal, peaked first from January 20 to February 10 with 4 clusters imported from domestic and peaked second from March 1 to 29 with 4 clusters imported from overseas. Qingtian County reported 4 clusters, Liandu District, Yunhe County, Qingyuan County and Jingning County each reported 1 cluster. Thirteen cases were restaurant employees, accounting for 41.94%. The cases were mainly occurred in the condition that exposed in the same family ( 6 clusters ), in the same dinner and car ( 1 clusters ), and in the same party ( 1 clusters ). The exposure modes that caused more cases infected were through the same family (9 cases) and through the same dinner and car ( 6 cases ). There were 3 clusters with first-generation cases, 3 clusters with second-generation cases and 2 clusters with third-generation cases. The recurrence rate of the 8 clusters ranged from 1.49% to 7.69%, with a median of 3.47%. @*Conclusions@#The COVID-19 clusters in Lishui imported from domestic in the early stage and later from overseas. Most cases were reported from Qingtian County, were engaged in catering business, and exposed by living with families.

New perspectives on traumatic bone infections / 中华创伤杂志(英文版)

In this paper, we review the results of previous studies and summarize the effects of various factors on the regulation of bone metabolism in traumatic bone infections. Infection-related bone destruction incorporates pathogens and iatrogenic factors in the process of bone resorption dominated by the skeletal and immune systems. The development of bone immunology has established a bridge of communication between the skeletal system and the immune system. Exploring the effects of pathogens, skeletal systems, immune systems, and antibacterials on bone repair in infectious conditions can help improve the treatment of these diseases.

Clinical study of movable external fixation for elbow tuberculosis / 中国骨伤

OBJECTIVE@#To compare clinical effect of movable external fixation and fusion fixation for the treatment of elbow tuberculosis.@*METHODS@#From October 2013 to June 2019, 52 patients with elbow tuberculosis treated with standard antituberculosis therapy were divided into movable external fixation group and fusion fixation group according to treatment methods. In group A, there were 25 patients, including 11 males and 14 females, aged from 24 to 75 years old with an average of (42.81± 9.01) years old; the courses of diseases ranged from 2 to 9 months with an average of (3.96±1.45) months. In group B, there were 27 patients, including 15 males and 12 females, aged from 23 to 77 years old with an averageof (44.08±7.44) years old; the courses of diseases ranged from 2 to 7 months with an average of (3.88±1.67) months. All patients were performed focus debridement. Intraoperative blood loss, operative time were compared between two groups. VAS score before operation, 2 weeks and 12 months after operation were applied to evaluate pain relieve;Mayo elbow performance score (MEPS) before operation, 1 and 12 months after operation were used to evaluate clinical effect;changes of erythrocyte sedimentation rate (ESR) and Creactive protein, CRP) before operation, 3 weeks after antituberculosis therapy, 1 week and 6 months after operation were compared between two groups.@*RESULTS@#All patients were followed up from 12 to 20 months with an average of (13.50±4.85) months. No mixed infection and recurrence of tuberculosis occurred. There were no statistical differences in intraoperative blood loss and operative time(@*CONCLUSION@#For elbow tuberculosis, movable external fixation and fusion fixation have equal effect in operative time, amount of bleeding and control of tuberculosis infection indicator. Movable external fixation need earlier functional exercise, not conducive to pain relief at early stage, which may be better than fusion fixation, it is worth clinical promoting.