HbA1c comparison and diagnostic efficacy analysis of multi center different glycosylated hemoglobin detection systems / 中华预防医学杂志

Objective: Compare and analyze the results of the domestic Lanyi AH600 glycated hemoglobin analyzer and other different detection systems to understand the comparability of the detection results of different detectors, and establish the best cut point of Lanyi AH600 determination of haemoglobin A1c (HbA1c) in the diagnosis of diabetes. Methods: Multi center cohort study was adopted. The clinical laboratory departments of 18 medical institutions independently collected test samples from their respective hospitals from March to April 2022, and independently completed comparative analysis of the evaluated instrument (Lanyi AH600) and the reference instrument HbA1c. The reference instruments include four different brands of glycosylated hemoglobin meters, including Arkray, Bio-Rad, DOSOH, and Huizhong. Scatter plot was used to calculate the correlation between the results of different detection systems, and the regression equation was calculated. The consistency analysis between the results of different detection systems was evaluated by Bland Altman method. Consistency judgment principles: (1) When the 95% limits of agreement (95% LoA) of the measurement difference was within 0.4% HbA1c and the measurement score was≥80 points, the comparison consistency was good; (2) When the measurement difference of 95% LoA exceeded 0.4% HbA1c, and the measurement score was≥80 points, the comparison consistency was relatively good; (3) The measurement score was less than 80 points, the comparison consistency was poor. The difference between the results of different detection systems was tested by paired sample T test or Wilcoxon paired sign rank sum test; The best cut-off point of diabetes was analyzed by receiver operating characteristic curve (ROC). Results: The correlation coefficient R2 of results between Lanyi AH600 and the reference instrument in 16 hospitals is≥0.99; The Bland Altman consistency analysis showed that the difference of 95% LoA in Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180) was -0.486%-0.325%, and the measurement score was 94.6 points (473/500); The difference of 95% LoA in the Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant II) was -0.727%-0.612%, and the measurement score was 89.8 points; The difference of 95% LoA in the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT) was -0.231%-0.461%, and the measurement score was 96.6 points; The difference of 95% LoA in the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT) was -0.469%-0.479%, and the measurement score was 91.9 points. The other 14 hospitals, Lanyi AH600, were compared with 4 reference instrument brands, the difference of 95% LoA was less than 0.4% HbA1c, and the scores were all greater than 95 points. The results of paired sample T test or Wilcoxon paired sign rank sum test showed that there was no statistically significant difference between Lanyi AH600 and the reference instrument Arkray HA8180 (Z=1.665,P=0.096), with no statistical difference. The mean difference between the measured values of the two instruments was 0.004%. The comparison data of Lanyi AH600 and the reference instrument of all other institutions had significant differences (all P<0.001), however, it was necessary to consider whether it was within the clinical acceptable range in combination with the results of the Bland-Altman consistency analysis. The ROC curve of HbA1c detected by Lanyi AH600 in 985 patients with diabetes and 3 423 patients with non-diabetes was analyzed, the area under curve (AUC) was 0.877, the standard error was 0.007, and the 95% confidence interval 95%CI was (0.864, 0.891), which was statistically significant (P<0.001). The maximum value of Youden index was 0.634, and the corresponding HbA1c cut point was 6.235%. The sensitivity and specificity of diabetes diagnosis were 76.2% and 87.2%, respectively. Conclusion: Among the hospitals and instruments currently included in this study, among these four hospitals included Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180), Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant Ⅱ), the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT), and the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT), the comparison between Lanyi AH600 and the reference instruments showed relatively good consistency, while the other 14 hospitals involved four different brands of reference instruments: Arkray, Bio-Rad, DOSOH, and Huizhong, Lanyi AH600 had good consistency with its comparison. The best cut point of the domestic Lanyi AH600 for detecting HbA1c in the diagnosis of diabetes is 6.235%.

Research progress of optic disc tilt in high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

With the prevalence of myopia in Asia, the prevalence of high myopia is gradually increasing, and high myopia has undoubtedly become a public health problem in Asia and even around the globe. As a relatively common pathological change in the eyes of patients with high myopia, optic disc tilt may also become a risk factor for diseases such as glaucoma and macular degeneration, thereby increasing the risk of visual impairment. However, the mechanism of optic disc tilt in high myopia and the role of optic disc tilt in the aggravation of high myopia complications still needs to be further explored. Therefore, this article collects and organizes relevant literatures on optic disc tilt, and makes a comprehensive discussion on the mechanism of optic disc shape changing caused by high myopia and the impact on various complications, so as to provide a certain basis for clinical diagnosis and treatment of high myopia and its complications.

Comparison of curative effect between percutaneous compression plate and cannulated compression screw in the treatment of displaced femoral neck fractures in young and middle-aged patients / 中国骨伤

OBJECTIVE@#To compare the efficacy of percutaneous compression plate and cannulated compression screw in the treatment of displaced femoral neck fractures in young and middle-aged patients.@*METHODS@#From January 2015 to July 2020, 68 young and middle-aged patients with displaced femoral neck fracture were retrospectively analyzed. Among them, 31 cases were fixed by percutaneous compression plate (PCCP), and 37 cases were fixed by cannulated compression screw (CCS). General data such as gender, age, cause of injury, comorbidities, fracture classification and cause of injury of two groups were collected. The operation time, intraoperative blood loss, hospital stay, full weight bearing time, fracture healing time, visual analogue scale(VAS), Harris hip score and complications were compared between two groups.@*RESULTS@#Patients in both groups were followed up for more than 2 years. There were no significant differences in operation time, intraoperative blood loss, fracture reduction quality, hospital stay and VAS between two groups. The fracture healing time in PCCP group was significantly shorter than that in CCS group (t=-4.404, P=0.000). The complete weight bearing time of PCCP group was significantly shorter than that of CCS group (t=-9.011, P=0.000). Harris score of hip joint in PCCP group was better than that in CCS group 2 years after operation (P=0.002). Complications occurred in 3 cases (9.68%) in PCCP group, while 11 cases (29.72%) in CCS group, with a statistically significant difference (P=0.042).@*CONCLUSION@#Both PCCP and CCS can be used for the treatment of displaced femoral neck fractures in young and middle-aged people. Compared with CCS, PCCP fixation can achieve shorter fracture healing time and create conditions for early full weight bearing. PCCP results in higher hip score and lower complications.

Clinical features of acute macular neuroretinopathy induced by Omicron / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the clinical features of acute macular neuroretinopathy(AMN)induced by Omicron.METHODS: A retrospective study. A total of 9 patients(18 eyes)diagnosed with AMN from December 2022 to January 2023 in the Hospital of Chengdu University of Traditional Chinese Medicine were included. Patients underwent spectral-domain optical coherence tomography(SD-OCT), fundus fluorescein angiography(FFA), fundus photography, autofluorescence(AF), infrared reflectance(IR), optical coherence tomography angiography(OCTA)and multicolor, etc. Furthermore, they were followed up for 1～3mo and observed the prognosis.RESULTS: The initial symptom of the Omicron-induced AMN was the sudden onset of central/paracentral scotoma in the eyes with or without impaired vision and metamorphopsia, and the scotoma could persist for at least 3mo. The image features of AMN are as follows. First, the SD-OCT examination showed the rupture of outer retinal layers, scattered hyperreflective lesions, and atrophy of outer retinal layers. In severe cases, hyperreflective lesions were seen in the inner nuclear layer(INL)or with microcystic cavities under the retinal pigment epithelium(RPE). Second, the OCTA examination demonstrated the decreased blood flow density of the deep capillary plexus(DCP)of the macula. Third, the IR examination showed the weak reflection of lesion areas. Fourth, the fundus photography demonstrated the localized brown wedge-shaped lesion.CONCLUSIONS: The Omicron-induced AMN is mostly found in young females, and the characteristic manifestation of fundus is damage to the outer retinal layers. The extent of fundus lesions is related to the systemic inflammatory response and ocular microcirculatory changes after infection. The multimodal fundus image examination and a history of Omicron infection are helpful to diagnose the Omicron-induced AMN.

Design and application of flipped classroom combined with micro-lectures in the teaching of pediatric infectious diseases / 中华医学教育探索杂志

Objective:To investigate the application effect of flipped classroom combined with micro-lectures in the teaching of pediatric infectious diseases.Methods:A total of 199 five-year students in the class of 2019 from Department of Pediatrics of Chongqing Medical University were divided into 14 groups. Each group selected a micro-lecture theme targeting the key and difficult points of the course and produced an original micro-lecture video through flipped classroom, which was then uploaded to Chaoxing platform for evaluation by teachers and students. At the end of the course, a questionnaire survey was performed to investigate the teaching effect, and final examination score and department examination score during internship were compared between the students in the class of 2019 and those in the class of 2018. SPSS 22.0 was used to perform the t-test, the Wilcoxon rank-sum test, the chi-square test, and the Fisher's exact test. Results:A total of 14 flipped micro-lecture works were completed by the students. The questionnaire survey showed that 98.47% (193/196) of the students thought that this model was helpful to master the key and difficult points; 93.88% (184/196) of the students thought that the flipped micro-lecture works had better originality and quality than reading reports and literature reviews in the past; 94.90% (186/196) of the students were more willing to accept the mode of flipped classroom combined with micro-lectures. Compared with the students in the class of 2018, the students in the class of 2019 had significantly higher final examination score (79.32±7.53 vs. 76.06±12.01, P<0.001), theoretical score of department examination (88.68±4.87 vs. 87.15±4.09, P<0.001), and operation score of department examination (84.93±7.56 vs. 82.08±9.10, P<0.001). Conclusion:Flipped classroom combined with micro-lectures can effectively solve the key and difficult points in the teaching of pediatric infectious diseases, and it can also stimulate the interest in independent learning and help to improve learning performance among students. Therefore, it holds promise for clinical application.

A survey on iodine nutrition status of children aged 8 - 10 and pregnant women in Chongqing in 2018 / 中华地方病学杂志

Objective:To learn about the iodine nutrition status of children aged 8 - 10 and pregnant women in Chongqing.Methods:From March to November 2018, according to the requirements of the "Technical Plan for Iodine Deficiency Disorders Monitoring in Chongqing in 2018", in all 39 counties (districts) of the city, each county (district) was divided into 5 sampling areas according to the orientation of east, west, south, north and middle. One township/street was selected from each area, one primary school was selected from each township/street, and 40 non-boarding students aged 8 - 10 (age balanced, half male and half female) were selected from each primary school. At the same time, 20 pregnant women (balanced in early, middle and late pregnancy) were selected from each township/street. Household edible salt and random urine samples from children and pregnant women were collected to detect the contents of salt iodine and urinary iodine. Children from 13 counties (districts) were selected for thyroid examination, and the goiter rate of children was calculated.Results:Totally 7 973 and 3 927 household edible salt samples from children and pregnant women were tested, respectively. The median salt iodine was 26.20 mg/kg, the coverage rates of iodized salt were 99.07% (7 899/7 973) and 99.57% (3 910/3 927), the consumption rates of qualified iodized salt were 93.72% (7 472/7 973) and 95.03% (3 732/3 927), respectively. Totally 7 973 and 3 927 urine samples from children and pregnant women were tested, respectively. The medians urinary iodine were 228.60 and 186.30 μg/L, respectively. Among the 39 monitored counties (districts), there were no county (district) with iodine deficiency in children, and 4 counties (districts) had iodine deficiency in pregnant women. A total of 2 656 children were examined, and the goiter rate was 1.73% (46/2 656).Conclusions:In 2018, children aged 8 - 10 in Chongqing are generally at the appropriate level of iodine, and the goiter rate conforms to the national standard (< 5%). Pregnant women are generally at the appropriate level of iodine, however, pregnant women in some counties (districts) are at risk of iodine deficiency.

Effects of CaMKII phosphorylation on myocardial ischemia-reperfusion injury in rats / 中华急诊医学杂志

Objective:To explore the effects of calcium/calmodulin dependent protein kinase II (CaMKII) on myocardial ischemia-reperfusion injury in vitro, and apoptosis and autophagy of myocardial cells in isolated rats.Methods:Seventy female SD rats (250-280 g) with normal electrocardiogram were selected to establish the myocardial IR injury model by Langendorff perfusion system. These SD rats were randomly divided into five groups (n=14): cardiac ischemia reperfusion group (IR group), CaMKII phosphorylation activator group (IR+ isoproterenol group), CaMKII phosphorylation inhibitor analogue group (IR+KN92 group), CaMKII phosphorylation inhibitor group (IR+KN93 group), and control group. After reperfusion, the left ventricular function and myocardial morphology were measured to assess the myocardial injury, and TUNEL was performed to assess the apoptosis index. Western blot was used to determine the phosphorylation levels of CaMKII and PLN (p-CaMKII/CaMKII and p-PLN/PLN), and the expression levels of apoptosis-related proteins Bax, Bcl-2, cleaved caspase-3, and autophagy marker proteins LC3II/LC3I, Beclin-1 and P62.Results:Compared with the control group, the left ventricular function of the IR group was decreased, morphological arrangement of myocardial fibers was disordered, and the apoptosis index was increased. The levels of p-CaMKII/CaMKII, p-PLN/PLN, cleaved caspase-3, Bax/Bcl-2, LC3II/LC3I, and Beclin-1 were increased significantly, while the level of P62 was decreased significantly, and apoptosis and autophagy were increased significantly (all P<0.05). Compared with the IR group, the myocardial damage of rats in the IR+KN93 group was significantly improved, the apoptosis index was decreased, and the expression of p-CaMKII/CaMKII, p-PLN/PLN, Cleaved Caspase-3, Bax/Bcl-2, LC3II/LC3I and Beclin-1 were significantly decreased and the level of p62 was remarkable increased, and apoptosis and autophagy decreased significantly (all P< 0.05). Compared with the IR group, the left ventricular function was further decreased in the IR+ isoproterenol group, while the levels of apoptosis and autophagy were further increased ( P < 0.05), while there was no significant difference in myocardial indexes between the IR+ KN92 group and the IR group ( P > 0.05). Conclusions:Inhibition of CaMKII phosphorylation attenuates isolated myocardial ischemia-reperfusion injury by reducing apoptosis and autophagy.

Effects of Zhongfeng capsule on autophagy related proteins expressions of brain tissue in rats with cerebral ischemia/reperfusion injury / 中国应用生理学杂志

Objective: To investigate the effects of Zhongfeng capsule on the autophagy-related proteins expression in rats with cerebral ischemia/reperfusion injury (CI/ RI), and to explore its neural protection mechanisms of the decoction. Methods: Rat middle cerebral artery ischemia/reperfusion injury model (ischemia for 2 h, reperfusion for 24 h) was prepared by the improved line plug method. Sixty male SD rats were randomly divided into sham operation group, model group, butylphthalide group(0.054 g/kg), Zhongfeng capsule high-dose groups (1.08 g/kg), Zhongfeng capsule middle-dose groups (0.54 g/kg), Zhongfeng capsule low-dose groups (0.27 g/kg), with 10 rats in each group. Rats were treated with Zhongfeng capsule by gavage once a day for 10 days. The rats were sacrificed and the brain tissue was obtained after the experiment in each group. Score neurological deficit was evaluated after 24 h of the last intervention in rat of each group. The pathological changes of brain tissue were observed by HE staining. The serum levels of estradiol (E2) and follicle stimulating hormone (FSH) were determined by ELISA. The expressions of key genes and proteins of PI3K/Akt/Beclin1 signaling pathway in brain tissue were detected by qRT-PCR and Western blot respectively. Results: Compared with the sham operation group, the body weight and protein expressions of p-PI3k and p-Akt in brain tissue of rats were decreased significantly in the model group, while the brain index, neurological deficit score, gene and protein expressions of Beclin1 and LC3 were increased markedly in the model group(P＜0.05 or P＜0.01). In the model group, nerve cells of brain tissue were loosely packed, interstitial edema, triangular in shape, nuclear pyknosis and dark-blue staining were observed. Compared with the model group, the body weight of rats was increased obviously, the neurological deficit score was decreased significantly and the pathological injury of brain tissue was alleviated evidently in high-dose of Zhongfeng capsule group (P＜0.05). The brain index, the gene and protein expressions of Beclin1 and LC3 were decreased apparently in Zhongfeng capsule treatment groups(P＜0.05 or P＜0.01), while the expressions of p-PI3k and p-Akt in brain tissue were increased evidently in Zhongfeng capsule treatment groups(P＜0.05 or P＜0.01). Conclusion: Zhongfeng capsule can inhibit autophagy and improve brain neurons lesion of CIRI rats, the mechanism may be related to regulate the expression of Beclin1 and LC3 in PI3K/Akt/Beclin1 signaling pathway.

Prevention of vasovagal response by applied muscle tension at different time points during blood donation / 中国输血杂志

【Objective】 To explore the role and value of applied muscle tension (AMT) in preventing vasovagal nerve reaction (VVR) in blood donors. 【Methods】 A total of 2 992 people, susceptible to suffer VVR from May 2020 to may 2022, were randomly divided into control group (1406 cases) and observation group (1 586 cases). The control group was not given AMT intervention, while the observation group received AMT intervention at different periods during blood donation. The changes of systolic blood pressure, diastolic blood pressure, heart rate and psychological state of anxiety (self-rating anxiety scale, SAS) of blood donors were monitored in the two groups at each period to compare the occurrence of VVR. 【Results】 There were no statistically significant differences in blood pressure and heart rate between the two groups before blood donation (P>0.05). The parameters were relatively stable in observation group during and after donation, but significantly different from that of the controls(P>0.05). SAS score was similar in two groups before blood donation(P>0.05), while decreased in observation group during and after donation in comparison with the controls(P<0.05). The incidence of VVR in the observation group was 3.09%, which was significantly lower than that in the control group (7.97%)(P<0.05). The incidence of VVR was 2.18% after AMT exercise during blood donation. 【Conclusion】 AMT intervention in different periods of blood donation can significantly reduce the occurrence of VVR.

Correlation analysis of chronic obstructive pulmonary disease with inositol 1, 4, 5-trisphosphate 3-kinase C and phospholipase c-like 1 gene polymorphisms in elderly population / 中华老年医学杂志

Objective:To investigate the correlations of stable chronic obstructive pulmonary disease(COPD)with inositol 1, 4, 5-trisphosphate 3-kinase C(ITPKC)and phospholipase C-like 1 protein(PLCL1)single nucleotide polymorphisms(SNPs)in the Han elderly population in Ningxia.Methods:A case-control study was conducted.A total of 250 elderly patients with stable COPD were enrolled and divided into the COPD-related pulmonary hypertension(PH)group(n=103)and the COPD non-PH group(n=147). During the same period, 127 healthy elderly Han subjects were included as the control group.The ITPKC gene SNPs and the PLCL1 gene SNP were detected, and differences in alleles and genotype frequencies were compared between the groups.Results:The allele and genotype frequency distributions of rs2288450 and rs9789480 showed statistical differences between the COPD group and the control group(χ 2=6.09, 5.18, 30.14 and 32.89, P=0.048, 0.020, <0.001, <0.001). There was no difference in the allele and genotype frequency distributions of the ITPKC gene SNPs rs2290692 and rs17713068 between the control group and the COPD group(all P>0.05). The allele and genotype frequency distributions of rs9789480 showed differences between the COPD non-PH group and the COPD-PH group(χ 2=94.50 and 72.76, both P<0.001). There was no significant difference in the allele and genotype frequency distributions of rs2290692, rs17713068, rs2288450 between the COPD-PH group and the COPD non-PH group(all P>0.05). Conclusions:The ITPKC gene SNP rs2288450 CA and AA genotypes and A allele can reduce the incidence of COPD and may be a protective factor for COPD in the elderly.The PLCL1 gene SNP rs9789480 CA and AA genotypes and A allele can reduce the incidence of COPD and COPD-PH and may be a protective factor for COPD and COPD-PH in the elderly.

Monitoring report of Keshan disease in Chongqing City in 2019 / 中华地方病学杂志

Objective:To master the current status and trend of Keshan disease in Chongqing City, and to provide scientific basis for prevention and treatment of Keshan disease in the future.Methods:In 2019, case search was carried out in 9 Keshan disease areas (counties) in Wanzhou District, Fuling District, Changshou District, Liangping District, Dianjiang County, Fengdu County, Zhong County, and Shizhu County of Chongqing City; five Keshan disease areas (counties) including Wanzhou District, Fuling District, Kaizhou District, Dianjiang County, Kaizhou District and Zhong County were selected as the monitoring sites to carry out key monitoring. Questionnaire survey, clinical examination, and electrocardiogram (ECG) were carried out on monitored subjects. The suspected cases of Keshan disease were examined by cardiac ultrasonography or posterior anterior chest X-ray.Results:A total of 25 728 cases were searched in 471 medical institutions, among which 240 suspected cases of Keshan disease were found, and 2 cases of chronic Keshan disease were confirmed. A total of 4 043 permanent residents were monitored in 5 key monitoring sites, and 813 abnormal ECG were detected, with an abnormal rate of 20.11%. Cardiac ultrasonography was performed in 40 cases, of which 19 (47.50%) cases had decreased cardiac function, 16 cases (40.00%) had thickened ventricular septal, and 11 cases (27.50%) had enlarged heart. In 56 cases of chest X-ray examination, mild, moderate and severe enlargement of heart were 9 (16.07%), 5 (8.93%) and 3 (5.36%), respectively. No case of various types of Keshan disease had been found in cardiac ultrasonography and X-ray examations.Conclusions:Chongqing City is in a stable and low incidence of Keshan disease, but some cases of chronic Keshan disease have been detected. We should continue to carry out the disease monitoring in the future.

Clinical effect of two fixation methods by anterolateral approach in the treatment of Rüedi-Allg?wer Ⅱ Pilon fracture / 中国医师进修杂志

Objective:To investigate the clinical effect of primary debridement combined with external fixation and secondary sequential internal fixation in the treatment of Rüedi-Allg?wer Ⅱ Pilon fracture.Methods:The clinical data of 36 patients with Rüedi-Allg?wer Ⅱ Pilon fracture from January 2017 to December 2019 in the People′s Hospital of Quzhou City, Zhejiang Province were retrospectively analyzed. Among them, 16 patients were treated with primary debridement with calcaneal traction and secondary internal fixation (internal fixation group), and 20 patients were treated with primary debridement combined with external fixation and secondary sequential internal fixation (combined fixation group). The operative time, intraoperative blood loss, postoperative drainage volume, time of full weight bearing, fracture healing time, American Society of Foot and Ankle Surgery (AOFAS) posterior ankle foot function score, visual analogue score (VAS), reduction quality (Burwell-Charnley score) and incidence of complication were compared between 2 groups.Results:The patients were followed up for 6 to 18 (10.7 ± 2.8) months. The time of full weight bearing and fracture healing time in combined fixation group were significantly shorter than those in internal fixation group: (7.2 ± 1.9) weeks vs. (9.4 ± 2.1) weeks and (3.4 ± 0.8) months vs. (4.1 ± 1.2) months, and there were statistical differences ( P<0.05 or <0.01); there were no statistical differences in operative time, intraoperative blood loss and postoperative drainage volume between 2 groups ( P>0.05). There was no statistical difference in AOFAS posterior ankle foot function score 1 month after surgery between 2 groups ( P>0.05); the AOFAS posterior ankle foot function score 3 and 6 month after surgery in combined fixation group was significantly higher than that in internal fixation group: (86.4 ± 1.7) scores vs. (75.7 ± 1.2) scores and (93.6 ± 2.2) scores vs. (82.1 ± 1.9) scores, and there was statistical difference ( P<0.05). There was no statistical difference in VAS between 2 groups ( P>0.05). There were no statistical differences in rate of reduction satisfaction and incidence of complication between 2 groups ( P>0.05). Conclusions:The primary debridement combined with external fixation and secondary sequential internal fixation for the treatment of Rüedi-Allg?wer Ⅱ Pilon fracture is conducive to the rapid recovery, which is worthy of extensive clinical promotion.

Effect of E54 mutation of human secreted phospholipase A2 GIIE on substrate selectivity / 生物工程学报

Human secreted phospholipase A2 GIIE (hGIIE) is involved in inflammation and lipid metabolism due to its ability of hydrolyzing phospholipids. To reveal the mechanism of substrate head-group selectivity, we analyzed the effect of mutation of hGIIE on its activity and selectivity. hGIIE structural analysis showed that E54 might be related to its substrate head-group selectivity. According to the sequence alignment, E54 was mutated to alanine, phenylalanine, and lysine. Mutated genes were cloned and expressed in Pichia pastoris X33, and the enzymes with mutations were purified with 90% purity by ion exchange and molecular size exclusion chromatography. The enzymatic activities were determined by isothermal microthermal titration method. The Km of mutant E54K towards 1,2-dihexyl phosphate glycerol decreased by 0.39-fold compared with that of wild type hGIIE (WT), and the Km of E54F towards 1,2-dihexanoyl-sn-glycero-3-phosphocholine increased by 1.93-fold than that of WT. The affinity of mutant proteins with phospholipid substrate was significantly changed, indicating that E54 plays an important role in the substrate head-group selectivity of hGIIE.

Vascularised medial femoral condylar osteochondral chimeric tissue flap for repairing a complex tissue defect in metatarsal head: A case report / 中华显微外科杂志

In February, 2019, a patient with a defect of open dorsal cartilage and bone in the first metatarsal head, including the defects of soft tissue, tendon and joint capsule, was treated in our department. After multiple debridement, the vascularised medial femoral condyle osteochondral chimeric tissue flap was transferred to repair the composite tissue defect in the metatarsal head at the second stage. After 18 months of follow-up, the patient felt no pain in the foot and walking, and there was no sign of lameness and discomfort at donor sites. The postoperative functional recovery was satisfactory.

Heat-sensitive moxibustion combined with western medication for low back pain of osteoporosis with kidney- / 中国针灸

OBJECTIVE@#To compare the clinical therapeutic effect between heat-sensitive moxibustion combined with western medication and simple western medication for low back pain of osteoporosis with kidney-@*METHODS@#A total of 60 patients with osteoporosis were randomized into an observation group (32 cases, 2 cases dropped off) and a control group (32 cases, 3 cases dropped off). In the control group, alendronate sodium tablet and calcium carbonate and vitamin D@*RESULTS@#The VAS scores, ODI scores and TCM clinical symptom scores after treatment were reduced in the two groups (@*CONCLUSION@#Heat-sensitive moxibustion combined with western medication could relieve low back pain, improve BMD in patients of osteoporosis with kidney-

Identification and characterization of murine adipose tissue-derived somatic stem cells of Shenque (CV8) acupoint / 中华医学杂志(英文版)

BACKGROUND@#Shenque (CV8) acupoint is located on the navel and has been therapeutically used for more than 2000 years in Traditional Chinese Medicine (TCM). However, clinical research on the underlying therapeutic molecular mechanisms of the CV8 acupoint lags far behind. This study aimed to study the mechanisms of umbilical acupoint therapy by using stem cells.@*METHODS@#The morphological characteristics of CV8 acupoint were detected under a stereomicroscope using hematoxylin and eosin (H&E) staining. Oil Red, Masson, and immunohistochemical staining on multi-layered slices were used to identify the type of cells at the CV8 acupoint. Cell proliferation was measured by a cell counting kit-8 (CCK-8) method. Flow cytometry and immunohistochemistry were used for cell identification. Induced differentiation was used to compare the differentiation of cells derived from CV8 acupoint and non-acupoint somatic stem cells into other cell types, such as osteogenic, adipogenic, and neural stem cell-like cells.@*RESULTS@#Morphological observations showed that adipose tissues at the linea alba of the CV8 acupoint in mice had a mass-like distribution. Immunohistochemical staining confirmed the distribution of stem cell antigen-1 (Sca-1) positive cells in the multi-layered slices of CV8 acupoint tissues. Cells isolated from adipose tissues at the CV8 acupoint exhibited high expression of Sca-1 and CD44 and low expression of CD31 and CD34, and these cells possessed osteogenic, adipogenic, and neurogenic stem cell-like cell differentiation ability. The cell proliferation (day 4: 0.5138 ± 0.0111 vs. 0.4107 ± 0.0180, t = 8.447, P = 0.0011; day 5: 0.6890 ± 0.0070 vs. 0.5520 ± 0.0118, t = 17.310, P 100 μm: 2.6000 ± 0.5477 vs. 0.8000 ± 0.8367, t = 4.025, P = 0.0038) were significantly enhanced in somatic stem cells derived from the CV8 acupoint compared to somatic stem cells from the groin non-acupoint. However, cells possessed significantly weaker osteogenicity ([2.697 ± 0.627]% vs. [7.254 ± 0.958]%, t = 6.893, P = 0.0023) in the CV8 acupoint group.@*CONCLUSIONS@#Our study showed that CV8 acupoint was rich with adipose tissues that contained abundant somatic stem cells. The biological examination of somatic stem cells derived from the CV8 acupoint provided novel insights for future research on the mechanisms of umbilical therapy.

The Expression of CD40/CD40L in MM Patients and Its Significance to the Prognosis of MM Patients / 中国实验血液学杂志

OBJECTIVE@#To explore the expression of CD40/CD40L in multiple myeloma(MM) patients and its influence on prognosis.@*METHODS@#Thirty patients with MM treated in Cangzhou People's Hospital from May 2016 to June 2017 were selected and divided into MM group, then 30 healthy people with a physical examination in our hospital at the same time were selected as the normal group. The serum CD40/CD40L levels of the patients in the two groups was detected by flow cytometry, and its correlation with the lymphocyte population, pathological grade and prognostic significance of MM patients was anaysis.@*RESULTS@#The expression of CD40 in serum of the patients in MM group was significantly higher than those in normal group (P0.05). The levels of CD40 and CD40L in the patients before and after chemotherapy showed no difference(P>0.05). The levels of Ts and NK cells in the patients of MM group were lower than those in normal group (P0.05). The CD40 level was correlated with the serum total B lymphocyte level of the patients in MM group (r=0.877, P=0.005). There was a correlation with CD40L and Th cells in the serum of MM patients (r=-0.783, P=0.035). The expression of serum CD40 in the patients at phase III-IV was higher than those of the patients at phase I-II, the levels of serum CD40L in MM patients at different periods showed no significant difference(P>0.05). The survival rate of MM patients with high CD40 expression was lower than that of MM patients with low CD40 expression (χ@*CONCLUSION@#The increasing of CD40 level in MM patients is related to the pathological grade of the patients. Chemotherapy can reduce the level of CD40. The increasing of CD40 is an important factor for the poor prognosis of MM patients. CD40L level is not meaningful for MM treatment and prognosis.

Epidemiological characteristics of respiratory syncytial virus in hospitalized children with acute lower respiratory tract infection in Chongqing, China, from 2013 to 2018: an analysis of 2 066 cases / 中国当代儿科杂志

OBJECTIVE@#To study the detection rate, epidemic pattern, and clinical features of respiratory syncytial virus (RSV) in hospitalized children with acute lower respiratory infection (ALRI).@*METHODS@#Nasopharyngeal aspirates were collected from children with ALRI, aged < 2 years, who were hospitalized in Children's Hospital of Chongqing Medical University from June 2013 to May 2018. Multiplex PCR was used to detect 16 common respiratory viruses. The epidemiological characteristics of RSV were analyzed.@*RESULTS@#A total of 2 066 hospitalized children with ALRI were enrolled. Among the children, 1 595 (77.20%) tested positive for virus and 826 (39.98%) tested positive for RSV [410(49.6%) positive for RSV-A, 414 (50.1%) positive for RSV-B, and 2 (0.2%) positive for both RSV-A and RSV-B]. RSV-B was the main subtype detected in 2013-2014 and 2016-2017, while RSV-A was the main subtype in 2014-2015 and 2017-2018, and these two subtypes were prevalent in 2015-2016. The highest detection rate of RSV was noted in winter. RSV + human rhinovirus was the most common combination of viruses and was detected in 123 children. These children were more likely to develop wheezing than those with single RSV detected (@*CONCLUSIONS@#In Chongqing in 2013-2018, RSV-A and RSV-B not only can predominate alternately, but also can co-circulate during a season. RSV is the major viral pathogen of hospitalized children with ALRI and can cause severe lower respiratory tract infection. There are no differences in clinical manifestations between children with RSV-A infection and those with RSV-B infection, but boys are more susceptible to RSV-A infection.

Study on mechanism of enhancing antioxidant activity in fermented Ziziphi Spinosae Semen with Poria cocos / 中国中药杂志

In this study, the antioxidant property changes in fermented Ziziphi Spinosae Semen(FZSS) with Poria cocos were analyzed by DPPH, ABTS and FRAP methods. Then the content determination of active ingredients and ~1H nuclear magnetic resonance(~1H-NMR) spectroscopy were also used to investigate the mechanism of FZSS with P. cocos in enhancing the antioxidant activity. The results showed that the content of active ingredients such as total phenols, total saponins and total polysaccharides were significantly increased during the fermentation time. The results of ~1H-NMR metabonomics showed that the contents of amino acids such as leucine, lysine, valine and alanine, nitrogen compounds such as creatine, creatinine, and betaine, and secondary metabolites, for instance, jujuboside A and spinosin were higher after fermentation, and above components showed positive correlation with antioxidant capacity in Pearson correlation analysis. Therefore, it was inferred that the enhancement of antioxidant activity of FZSS may be the result of the joint action of various chemical components. This study preliminarily clarified the mechanism of FZSS in enhancing the antioxidant activity, and provided new research ideas for the product development and utilization of FZSS.

Influence of the surgery concept of rapid rehabilitation on the postoperative rehabilitation, immune function and nutritional status of patients with colorectal cancer undergoing laparoscopic radical surgery / 中国基层医药

Objective:To explore the effect of the surgery concept of rapid rehabilitation on the postoperative rehabilitation, immune function and nutritional status of patients with colorectal cancer undergoing laparoscopic radical surgery.Methods:From June 2017 to June 2019, 106 patients with colorectal cancer underwent laparoscopic radical surgery in the Affiliated Hospital of Shaoxing University of Arts and Sciences were divided into the observation group and the control group according to the random digital table method, with 53 cases in each group.The observation group adopted the surgery concept of rapid rehabilitation, while the control group adopted the surgery concept of conventional rehabilitation.The amount of intraoperative bleeding, postoperative complications and operation time were compared between the two groups.The recovery of gastrointestinal function, the changes of immune function and nutritional indicators were compared between the two groups.Results:There were no statistically significant differences in the amount of bleeding and operation time between the two groups(all P>0.05). The incidence of postoperative complications in the observation group was 5.66%(3/53), which was lower than 24.53%(13/53) in the control group(χ 2=7.361, P<0.05). The time of first anal exhaust[(2.14±0.32)d] and first eating[(1.85±0.42)d]in the observation group were shorter than those in the control group[(3.62±0.61)d and (2.79±0.36)d]( t=15.642, 12.371, all P<0.05). Three days after operation, the CD 3+ [(50.82±2.31)%], CD 4+ [(34.01±2.19)%]and CD 4+/CD 8+ (1.03±0.08) in the observation group were higher than those in the control group[(46.30±2.68)%, (30.26±2.05)% and (0.81±0.12)]( t=9.300, 9.101, 11.105, all P<0.05). The serum transferrin[(1.97±0.14)g/L]and prealbumin[(0.23±0.03)g/L] in the observation group were higher than those in the control group[(1.72±0.15)g/L and (0.18±0.03)g/L]( t=8.870, 8.580, all P<0.05). Conclusion:The surgery concept of rapid rehabilitation can promote the postoperative rehabilitation of patients with colorectal cancer, improve the immune function and nutritional status of patients, and has less complications.