Safety and efficacy analysis of hepatic artery infusion chemotherapy combined with immune targeted therapy for single CNLC Ⅰb hepatocellular carcinoma / 中华肝胆外科杂志

Objective:To investigate the safety and efficacy of FOLFOX (5-fluorouracil + calcium folinate + oxaliplatin) hepatic arterial infusion chemotherapy (FOLFOX-HAIC) combined with immune and targeted therapy as triple combination therapy for patients with single China Liver Cancer Staging (CNLC) Ⅰb hepatocellular carcinoma.Methods:A total of 20 patients with single CNLC Ⅰb hepatocellular carcinoma who received FOLFOX-HAIC combined with immune and targeted therapy as triple combination therapy in the First Affiliated Hospital of Guangxi Medical University from October 2021 to August 2022 were included. The clinical data of all patients was retrospectively analyzed. There were 18 males and 2 females, with the age of (55.1±9.9) years. Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and Modified Response Evaluation Criteria in Solid Tumors (mRECIST) were used to evaluate the efficacy of FOLFOX-HAIC combined with immune and targeted therapy, and the clinical safety of triple combination therapy was evaluated by common terminology criteria for adverse events 4.0.Results:According to RECIST 1.1, objective response rate of 20 patients was 70.0% (14/20) and disease control rate was 100.0% (20/20) after 2 cycles of treatment (one cycle of FOLFOX-HAIC plus programmed death-1 antibody). According to mRECIST, objective response rate was 90.0% (18/20) and the disease control rate was 100.0% (20/20) after 2 cycles of treatment. Following the treatment, 12 patients (60.0%) received liver tumor resection, and all of them achieved R 0 resection, 2 patients (10.0%) received radiotherapy, 3 patients (15.0%) stopped drug treatment for surgery, 2 patients (10.0%) refused surgery, and 1 patient (5.0%) died of multiple organ failure caused by immune hepatitis. According to pathological results, 3 patients (25.0%, 3/12) achieved pathological complete response, and 4 patients (33.3%, 4/12) achieved major pathological response. In the safety evaluation, the overall incidence of adverse events was 100.0% (20/20). Seven patients (35.0%) had grade 3 adverse events and 1 patient (5.0%) died of multiple organ failure due to immune hepatitis (grade 5). Grade 1-3 adverse events could be relieved after symptomatic treatment. Conclusion:The triple combination therapy of FOLFOX-HAIC combined with immune and targeted therapy is safe and has high objective response rate and disease control rate, which could be a new strategy for the neoadjuvant treatment of hepatocellular carcinoma.

Recent research on the epidemiology and preventive strategies of neonatal group B Streptococcus infection in the latest decade / 中国当代儿科杂志

Currently, the main strategy for preventing neonatal group B Streptococcus (GBS) infection is prenatal screening combined with intrapartum antibiotic prophylaxis, which has effectively reduced the incidence of neonatal GBS early-onset disease. However, the burden of GBS infection is still significant. The intrapartum antibiotic prophylaxis strategy has limitations such as inducing antibiotic resistance and inability to effectively prevent GBS late-onset disease. It is crucial to develop and evaluate other prevention strategies, while paying close attention to assessing penicillin allergy in pregnant women and how to prevent GBS infection in neonates with negative maternal GBS screening. In recent years, there has been some progress in GBS vaccines and related immunological research, and the use of specific vaccines is expected to significantly reduce GBS infection in neonates.

Paying attention to the epidemic of group A Streptococcus infections in multiple European and American countries / 中国当代儿科杂志

At the end of 2022, the World Health Organization reported an increase in group A Streptococcus (GAS) infections, such as scarlet fever, in multiple countries. The outbreak primarily affected children under 10 years old, and the number of deaths was higher than anticipated, causing international concern. This paper reviews the current state of the GAS disease outbreak, its causes, and response measures. The authors aim to draw attention from clinical workers in China and increase their awareness and vigilance regarding this epidemic. Healthcare workers should be aware of the potential epidemiological changes in infectious diseases that may arise after the optimization of control measures for coronavirus disease 2019 to ensure children's health.

Effects of porcine urinary bladder matrix on motility and polarization of bone marrow-derived macrophages in mice / 中华烧伤杂志

Objective: To explore the effects of porcine urinary bladder matrix (UBM) on the motility and polarization of bone marrow-derived macrophages in mice, so as to provide evidence for the rational selection of stent in clinical wound repair. Methods: The method of experimental research was used. The microstructure of porcine UBM and absorbable dressing was observed under scanning electron microscope. Polyacrylamide gel electrophoresis was used to observe the protein distribution of the two stent extracts. The primary macrophages were induced from bone marrow-derived cells isolated from six 6-8-week-old male C57BL/6J mice (mouse age, sex, and strain, the same below) and identified. Three batches of macrophages were divided into porcine UBM extract group and absorbable dressing extract group. The cells in each group were cultured with Dulbecco's modified Eagle medium/F12 medium containing the corresponding extracts. The cell migration rate was detected and calculated on 1, 3, and 7 d after scratching by scratch test. The number of migrated cells at 12 and 24 h of culture was detected by Transwell experiment. The percentages of CD206 and CD86 positive cells at 24 h of culture was detected by flow cytometer. The numbers of sample in the above cell experiments were all 3. An incision was prepared on the left and right back of twelve mice, respectively. The left incision of each mouse was included in porcine UBM group and the right incision was included in absorbable dressing group, and the corresponding stents were implanted into the incisions respectively. On post operation day (POD) 7 and 14, the number of inflammatory cells infiltrated in the stent was detected by hematoxylin-eosin staining; the number of F4/80, transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF), and matrix metalloprotein-9 (MMP-9) positive cells and type Ⅰ collagen deposition in stents were observed by immunohistochemistry; the percentages of F4/80, CD86, and CD206 positive cells were observed by immunofluorescence staining. The numbers of sample in the above animal experiments were all 6. Data were statistically analyzed with analysis of variance for factorial design, analysis of variance for repeated measurement, and independent sample t test. Results: Porcine UBM has a dense basement membrane structure on one side and porous propria containing a fibrous structures on the other. Both sides of the absorbable dressing had three-dimensional porous structure. In the molecular weight range of (50-70)×103, multiple non-type Ⅰ collagen bands appeared in the lanes of porcine UBM extract, while no obvious bands appeared in the lanes of absorbable dressing extract. It had been identified that mouse bone marrow-derived cells had been successfully induced into macrophages. The cell migration rates in porcine UBM extract group were significantly higher than those in absorbable dressing extract group on 1, 3, and 7 d after scratching (with t values of 15.31, 19.76, and 20.58, respectively, P<0.05). The numbers of migrated cells in porcine UBM extract group were significantly more than those in absorbable dressing extract group at 12 and 24 h of culture (with t values of 12.20 and 33.26, respectively, P<0.05). At 24 h of culture, the percentage of CD86 positive cells in porcine UBM extract group ((1.27±0.19)%) was significantly lower than (7.34±0.14)% in absorbable dressing extract group (t=17.03, P<0.05);the percentage of CD206 positive cells in porcine UBM extract group was (73.4±0.7)%, significantly higher than (32.2±0.5)% in absorbable dressing extract group (t=119.10, P<0.05). On POD 7 and 14, the numbers of inflammatory cells infiltrated in the stents in porcine UBM group was significantly more than those in absorbable dressing group (with t values of 6.58 and 10.70, respectively, P<0.05). On POD 7 and 14, the numbers of F4/80, TGF-β1, VEGF, and MMP-9 positive cells in the stents in porcine UBM group were significantly more than those in absorbable dressing group (with t values of 46.11, 40.69, 13.90, 14.15, 19.79, 32.93, 12.16, and 13.21, respectively, P<0.05); type Ⅰ collagen deposition in the stents in porcine UBM group was more pronounced than that in absorbable dressing group; the percentages of CD206 positive cells in the stents in porcine UBM group were significantly higher than those in absorbable dressing group (with t values of 5.05 and 4.13, respectively, P<0.05), while the percentages of CD86 positive cells were significantly lower than those in absorbable dressing group (with t values of 20.90 and 19.64, respectively, P<0.05), and more M2-type macrophages were seen in the stents in porcine UBM group and more M1-type macrophages were seen in the stents in absorbable dressing group. Conclusions: Porcine UBM can enhance macrophage motility, induce M2 polarization and paracrine function, create a microenvironment containing growth factors such as TGF-β1 and MMP-9 tissue remodeling molecules, and promote tissue regeneration and extracellular matrix remodeling in mice.

Challenges and Prospects of Medical Device Containing Adaptive Algorithms to Supervision / 中国医疗器械杂志

With the market development and demand change, the use of adaptive algorithms in medical devices has become a possible trend. However, some uncertainties in the adaptive algorithm itself will bring challenges to the existing current supervisory work model. This article focuses on the ademptions of US agencies on artificial intelligence device supervision, and discusses the problems that existing pilot policies may encounter when facing devices with adaptive algorithms. In this way, we will provide relevant suggestions and look forward to discussing with scholars.

Core Architecture and Clinical Application of Orthopedic Robot Based on Human-like Thinking / 中国医疗器械杂志

Intelligent and precision medical treatment is the future development trend of surgical operations. We proposed a core architecture of orthopedic robots with human-like thinking based on the growing demand for orthopedic robots and disadvantages of current robots, it consists of brain, eyes and hands three modules according to functions. The architecture design is extremely in line with the doctor's logic so that the work process of the orthopedic robot is similar to the process of traditional surgery which is mainly done by the doctor's brain-eye-hand coordination. It realizes the digitization of the doctor's thinking, the immediacy and visualization of surgical information and the accuracy of surgical operation process. The clinical application proved that the orthopedic robot has the advantages of higher accuracy, less radiation and shorter operation time, which can be further promoted clinically.

Diagnosis and treatment for acute phase of suppurative meningoencephalitis / 中华神经科杂志

Suppurative meningoencephalitis is the kind of intracranial infectious disease which exhibits comparatively more severe clinical manifestations, more expensive diagnostic and treatment costs and poorer prognosis. Early diagnosis and effective treatment are essential for better improvement of disease prognosis. Clear identification of intrinsic and extrinsic factors causing the acute phase of suppurative meningoencephalitis, as well as its epidemiological and pathogenic characteristics, clinical manifestations and classifications, imaging features and laboratory tests explanations, may contribute greatly to the diagnostic correctness and treatment efficacy, thus promoting diagnostics and medical treatment of this disease which remains ultimately critical to patients′ prognosis.

Learning from the past: the history of human monkeypox and the atypical multi-country outbreak in 2022 / 中国当代儿科杂志

In 2022, the outbreak of human monkeypox (HMPX) occurred in many non-endemic countries. World Health Organization (WHO) assesses that this outbreak is "atypical". The history of monkeypox and HMPX must be reviewed to clearly recognize the "typical" outbreaks to fully understand this comment. Therefore, this paper reviews the epidemiological history of monkeypox, especially HMPX, and discusses and analyzes the atypical manifestations and the possible causes of the present outbreak based on the recent views of WHO, other organizations/institutions, and experts. The text describes the thought-provoking history of the interaction between the monkeypox virus and the human being in the past 64 years, and provides various information and views on the outbreak of HMPX, which is helpful to understand risk assessment and the potential impact of this outbreak on clinical and public health in future.

The investigation on the acute, severe hepatitis of unknown origin in children / 中国当代儿科杂志

In April 2022, the United Kingdom notified the World Health Organization (WHO) of an unexpected increase of acute hepatitis of unknown origin in children. Subsequent investigations have found more than 400 cases in more than 20 countries and regions around the world. Although the potential role of adenovirus type 41 in the pathogenesis of these cases is one hypothesis, but it is probably not the only pathogenic factor, and other infectious and non-infectious causes cannot be completely ruled out. For hepatitis caused by non-hepatitis A, B, C, D and E viruses, there is a lack of systematic monitoring and research, and many unknowns still exist. According to the current etiology speculation and epidemiological characteristics of adenovirus in China, cases of acute hepatitis with unknown origin may be found in China in the future. There is also a risk of imported cases. This article systematically sorts out the reports and studies on child acute hepatitis of unknown origin, hoping to attract the attention of pediatric clinicians in China, raise awareness and vigilance, and calmly prepare for possible abnormal situations.

Clinical and molecular characteristics of Streptococcus pneumoniae-associated hemophagocytic lymphohistiocytosis in children / 中华儿科杂志

Objective: To summarize the clinical features of Streptococcus pneumoniae-associated hemophagocytic syndrome (SP-HLH), and the serotypes and drug-resistant characteristics of the isolated strains. Methods: There were 15 children with SP-HLH admitted to the Pediatric Intensive Care Unit (PICU) of Beijing Children's Hospital, Capital Medical University from January 2013 to December 2020 were included in this study. Clinical data including children's general characteristics, clinical features, laboratory examinations, treatments, prognosis and the outcomes of follow-up by May 2021 were analyzed retrospectively. The serotypes and drug resistance of the isolated strains were identified. All children were divided into the clinical improvement group and the death group. Mann-Whitney U test, Fisher's exact test were used to compare the data of the two groups. Results: Among the 15 children with SP-HLH, 8 were males and 7 were females. The age of these children was 1.0 (1.0, 2.5) years. Regarding the primary infection, there were 9 cases of severe pneumonia, 3 cases of meningitis and 3 cases of blood stream infection. None of these children had received pneumoniae conjugate vaccine (PCV) and all of them were admitted to the PICU. Respiratory failure was observed in 10 patients, acute renal injury in 5, and hemolytic uremic syndrome in 3 patients. All children received glucocorticoids and high-dose intravenous immunogloblin (IVIG) in addition to anti-infective treatment. Eight of the children were cured while the other 7 died. The neutrophil count in the death group was lower than that in the clinical improvement group ((5.0 (1.7, 9.3) × 109 vs. 5.2 (3.4, 10.5) ×109/L, Z =-2.43, P<0.015), and the length of hospital stay and days of PICU stay in the death group were both shorter than those in the improvement group statistically (3 (1, 11) vs. 39 (34, 48) d, 2 (1, 4) vs. 19 (12, 31) d, Z=-3.25, -3.24, both P=0.001). Ten serotypes of Streptococcus pneumoniae were identified, including 4 strains of 19F, 3 of 19A, 1 of 23F, 1 of 15A and 1 of 14, among which 9 strains (9/10) were covered by PCV13. All strains were resistant to erythromycin yet sensitive to vancomycin and linezolid. Conclusions: SP-HLH is more common in children under the age of 3, with a high mortality rate. The death cases have lower neutrophil count and rapid disease progression. The comprehensive treatment is anti-infective combined with glucocorticoids and high-dose IVIG. The predominant serotypes are 19F and 19A and all isolated strains were susceptible to vancomycin and linezolid.

Relationships among psychological stress, achievement motivation and psychological capital in college students / 中国学校卫生

Objective@#This study explored the relationships among psychological stress, achievement motivation and psychological capital in college students to provide a reference for improving the level of psychological capital in college students.@*Methods@#A multi stage stratified cluster sampling method was used to select 9 940 college students from ten universities in Anhui Province. The achievement motivation scale (AMS), psychological stress scale (SRQ-20) and psychological capital scale (PPQ) were applied. The moderating effect of the questionnaire was analyzed with χ 2 tests, Spearman rank correlation and stratified regression.@*Results@#Statistical differences were found in psychological stress according to major, whether students leader, family economic status and whether students had left behind experience ( χ 2=15.50, 10.25, 28.61, 25.55, P <0.05). The rank correlation results indicated that psychological stress was negatively correlated with the pursuit of success ( r =-0.27) and four dimensions of self efficacy,optimism,hope and resilence in psychological capital ( r =-0.43, -0.41,-0.36,-0.45)( P <0.05), and was positively correlated with the avoidance of failure ( r =0.25, P <0.05). The stratified regression model indicated that psychological stress in the dimensions of college students achievement motivation (pursuit of success: β =0.02, Δ R 2=0.01, P <0.01; failure avoidance: β = 0.03 , Δ R 2=0.01, P <0.01) played a moderating role in the relationship between psychological capital and psychological capital.@*Conclusion@#Being female, senior students, low household economic status, and left behind experience are associated with more psychological stress among college students. Psychological stress is correlated with achievement motivation and psychological capital, and has a moderating effect on the relationship between achievement motivation and psychological capital.

Development and Clinical Application of Portable Electronic Endoscope / 中国医疗器械杂志

Electronic endoscope is one of the crucial tools for minimally invasive diagnosis and treatment. Along with the continuous development of clinical applications, conventional electronic endoscope has not been able to meet all the clinical requirements. In recent years, with the rapid development of the material, sensor and electronic technologies, electronic endoscope has attracted many researchers and companies' attention. Nowadays, because of being suitable for some special mobile medical scenes like field operations, natural calamities and hospital first aids, various portable electronic endoscopes have been developed and applied in clinic. The present study aims to give a review on portable electronic endoscopes development and clinical applications.

Research advances in the treatment strategies for severe pertussis in children / 中国当代儿科杂志

At present, effective antibiotics and comprehensive symptomatic/supportive treatment as early as possible are mainly used for the treatment of severe pertussis in clinical practice. However, some children with severe pertussis have unsatisfactory response to commonly used drugs and treatment measures in the intensive care unit and thus have a high risk of death. Studies have shown that certain treatment measures given in the early stage, such as exchange transfusion, may help reduce deaths, but there is still a lack of uniform implementation norms. How to determine the treatment regimen for severe pertussis and improve treatment ability remains a difficult issue in clinical practice. This article reviews the advances in the treatment of severe pertussis, in order to provide a reference for clinical treatment and research.

Treatment of displaced intra-articular calcaneal fractures with cannulated screws and plates: A metaanalysis of 15 randomized controlled trials / 中国组织工程研究

OBJECTIVE: Displaced intra-articular calcaneal fractures are the most common type of calcaneal fracture. Cannulated screw fixation and plate fixation are commonly used methods. However, the differences in therapeutic effectiveness between cannulated screw fixation and plate fixation are still unclear. Thus, this study compared the effect of percutaneous cannulated screw fixation and plate fixation in the treatment of intra-articular calcaneal fractures. METHODS: The authors searched for randomized controlled trials on displaced intra-articular calcaneal fractures fixated with cannulated screws or plates in the following electronic databases: PubMed, Cochrane Library, Embase, Web of Science, and CNKI. The retrieval time limit was from the establishment of the database to December 2019. The retrieved literatures were screened according to inclusion and exclusion criteria. Quality evaluation was performed to extract effective data. Meta-analysis was conducted using RevMan 5.3 software. RESULTS: Fifteen randomized controlled studies were included with 1 438 patients with calcaneal fractures. The risk bias evaluation of the included literature showed that the overall quality of literature was above average. Meta-analysis results show that (1) plate fixation group was better than cannulated screw fixation group in terms of Bohler’s angle (MD=0.69, 95%CI:0.27-1.10, P=0.001) and Gissane’s angle (MD=0.95, 95%CI:0.16-1.74, P=0.02) (P < 0.05). (2) Compared with plate fixation, cannulated screw fixation showed a significant reduction in the operation time (MD=-23.92, 95%CI:-25.40 to-22.44, P < 0.000 01) and postoperative complications (OR=0.28, 95%CI:0.19-0.41, P < 0.000 01) (P < 0.05). (3) There was no statistically significant difference between the cannulated screw fixation group and the plate fixation group in terms of calcaneal height (MD=0.43, 95%CI:-0.17-1.03, P=0.16) and AOFAS score (MD=0.61, 95%CI:-0.35-1.58, P=0.21). CONCLUSION: Above data concluded that Bohler’s and Gissane’s angles in the plate fixation group are better than those in the cannulated screw fixation group, while the cannulated screw fixation technology has the advantages of short operation time and low complication rate.

Protective effect of Sarcandra glabra on radiation-induced parotid injury in rats / 中华放射医学与防护杂志

Objective@#To study the changes of inflammatory response and apoptosis in parotid gland tissues of rats after X-ray irradiation, and to explore the protective effect and possible mechanism of Sarcandra glabra on radiation-induced parotid injury in rats.@*Methods@#A total of 120 male rats were randomly divided into 5 groups(24 for each): control group, single irradiation group, radiation combined with a high(26.8 g·kg-1·d-1), moderate(13.4 g·kg-1·d-1) and low(6.7 g·kg-1·d-1) dosage of Sarcandra glabra group. The parotid gland of rats in the irradiation group received 15 Gy X-ray. Rats in each group were anesthetized with 2% pentobarbital sodium (0.16 ml/100 g) at 10, 40 and 70 d after irradiation and blood was collected from abdominal aorta. ROS levels in blood serum of each group were detected on the 10th, 40th and 70th days after irradiation. After parotid gland tissue was taken, the pathological changes and ultrastructural changes were observed by hematoxylin-eosin (HE) staining and transmission electron microscopy, respectively. The expression level of TNF-α in parotid gland tissue was detected by immunohistochemistry, and apoptosis of parotid cells was detected by TUNEL assay.@*Results@#The content of ROS and the expression of TNF-α protein in the single irradiation group were simultaneously increased compared with the control group (t=-24.723, -35.013, -19.515, P<0.05; t=-13.563, 43.519, -15.249, P<0.05), while they were reduced by Sarcandra glabra in a dosage dependent manner, especially in the high dosage group of Sarcandra glabra (t=5.295, 8.138, 6.545, P<0.05; t=10.093, -7.868, 10.539, P<0.05). In the control group, the parotid gland tissue structure was intact, without congestion, exudation, edema, etc. For the single irradiation group, the parotid gland tissue became hyperemia, edema and inflammatory cell infiltration at 10 d after irradiation followed by fibrosis at 40 d after irradiation. These pathological alterations in the parotid gland tissue were significantly recovered when the rats were treated with Sarcandra glabra before irradiation, and the tissue damage was negatively correlated with drug dosage. TUNEL assay showed that the apoptosis rate of parotid gland cells in the single irradiation groups was higher than that in the control group (t=-4.639, -3.979, P<0.05).@*Conclusions@#Sarcandra glabra protects parotid gland from radiation damage by scavenging radiation-induced ROS and declining inflammatory response, and thus it may be applied as a potential protective agent for radiation injury.

A comparative analysis of the Chinese and English descriptions of typical pertussis manifestations and recommendations for the diagnosis of pertussis-like or pertussis syndrome / 中国当代儿科杂志

The Chinese and English names of pertussis or whooping cough show the important clinical features of the disease in terms of its course and cough characteristics respectively. In the clinical description of typical pertussis, the meanings of the Chinese and English words are not completely consistent, such as spastic cough versus paroxysmal cough, spasmodic stage/phase versus paroxysmal stage/phase, and "back-hook" versus whoop, and some descriptions in English are not seen in Chinese. This article aims to provide more comprehensive information for the understanding of pertussis by comparing the descriptions of typical clinical manifestations of pertussis in Chinese and English literatures and to put forward suggestions for the diagnosis of pertussis syndrome based on typical clinical manifestations.

Protective effect of Sarcandra glabra on radiation-induced parotid injury in rats / 中华放射医学与防护杂志

Objective To study the changes of inflammatory response and apoptosis in parotid gland tissues of rats after X-ray irradiation,and to explore the protective effect and possible mechanism of Sarcandra glabra on radiation-induced parotid injury in rats.Methods A total of 120 male rats were randomly divided into 5 groups (24 for each):control group,single irradiation group,radiation combined withahigh (26.8g· kg-1 · d-1),moderate (13.4g· kg-1 ·d-1) and low (6.7g· kg-1 · d-1) dosage of Sarcandra glabra group.The parotid gland of rats in the irradiation group received 15 Gy X-ray.Rats in each group were anesthetized with 2％ pentobarbital sodium (0.16 ml/100 g) at 10,40 and 70 d after irradiation and blood was collected from abdominal aorta.ROS levels in blood serum of each group were detected on the 10th,40th and 70th days after irradiation.After parotid gland tissue was taken,the pathological changes and ultrastructural changes were observed by hematoxylin-eosin (HE) staining and transmission electron microscopy,respectively.The expression level of TNF-α in parotid gland tissue was detected by immunohistochemistry,and apoptosis of parotid cells was detected by TUNEL assay.Results The content of ROS and the expression of TNF-α protein in the single irradiation group were simultaneously increased compared with the control group (t =-24.723,-35.013,-19.515,P＜ 0.05;t =-13.563,43.519,-15.249,P＜ 0.05),while they were reduced by Sarcandra glabra in a dosage dependent manner,especially in the high dosage group of Sarcandra glabra (t =5.295,8.138,6.545,P＜0.05;t =10.093,-7.868,10.539,P＜0.05).In the control group,the parotid gland tissue structure was intact,without congestion,exudation,edema,etc.For the single irradiation group,the parotid gland tissue became hyperemia,edema and inflammatory cell infiltration at 10 d after irradiation followed by fibrosis at 40 d after irradiation.These pathological alterations in the parotid gland tissue were significantly recovered when the rats were treated with Sarcandra glabra before irradiation,and the tissue damage was negatively correlated with drug dosage.TUNEL assay showed that the apoptosis rate of parotid gland cells in the single irradiation groups was higher than that in the control group (t=-4.639,-3.979,P＜0.05).Conclusions Sarcandra glabra protects parotid gland from radiation damage by scavenging radiation-induced ROS and declining inflammatory response,and thus it may be applied as a potential protective agent for radiation injury.

Logistic regression analysis of death risk factors of patients with severe and critical coronavirus disease 2019 and their predictive value / 中华危重病急救医学

Objective:To analyze the risk factors of death in patients with severe and critical coronavirus disease 2019 (COVID-19) and their predictive value.Methods:Using the clinical and epidemiological database of Yangtze River Shipping General Hospital in Wuhan, the clinical and epidemiological data of 105 patients with severe and critical COVID-19 from January to March in 2020 were collected. Multivariate unconditional Logistic regression method was used to analyze the death risk factors of patients during hospitalization. The receiver operating characteristic (ROC) curve was drawn according to the multivariate analysis results to construct a death prediction model; the prediction value of the model was analyzed.Results:The 105 patients with severe and critical COVID-19 were enrolled with 66 males (62.9%) and 39 females (37.1%). The age was (58.2±14.4) years old. Forty-two patients died in hospital and 63 survived. Among the dead patients, 69.0% (29/42) were male, and 78.6% (33/42) were over 60 years old. Compared with survival patients, the non-survival patients were older (years old: 59.2±12.5 vs. 51.2±11.4), and had more comorbidities, including coronary heart disease, hypertension, myocardial damage and thrombocytopenia (coronary heart disease: 33.3% vs. 11.1%, hypertension: 28.6% vs. 9.5%, myocardial damage: 73.8% vs. 11.1%, thrombocytopenia: 61.9% vs. 14.3%), and received more mechanical ventilation (92.9% vs. 44.4%), with significant differences (all P < 0.01). The variables of gender, age, basic diseases, mechanical ventilation and complications were included in the unconditional Logistic regression analysis, which showed that gender [odds ratio ( OR) = 2.852, 95% confidence interval (95% CI) was 0.122-66.694], age ( OR = 3.257, 95% CI was 0.466-18.584), coronary heart disease ( OR = 7.337, 95% CI was 0.227-87.021), hypertension ( OR = 5.517, 95% CI was 0.258-65.024) and concurrent myocardial damage ( OR = 7.322, 95% CI was 0.278-95.020) and thrombocytopenia ( OR = 3.968, 95% CI was 0.325-35.549) were independent risk factors for death in patients with severe and critical COVID-19 during hospitalization. According to the risk factors, the death prediction model was constructed and ROC curve was analyzed, which showed that the area under ROC curve (AUC) of death prediction model for predicting the mortality of patients with severe and critical COVID-19 during hospitalization was 0.804, the sensitivity was 83.8%, and the specificity was 82.3%. Conclusions:Various risk factors are associated with the death of severe or critical COVID-19 patients, such as gender, age, basic diseases and complications. The death prediction model is constructed by gender, age, basic diseases with coronary heart disease and hypertension, concurrent myocardial damage and thrombocytopenia, which has certain predictive value for the death of patients with severe or critical COVID-19.

Discussion on the Application of Supercritical Carbon Dioxide Technology for Sterilization of Medical Devices / 中国医疗器械杂志

Traditional medical device sterilization processes are mature, but there are constraints when using on medical devices by new materials. With increasing environmental concerns, using of ethylene oxide sterilization has been limited by global environmental protection administrations. Exploring new sterilization methods for medical devices is urgently needed. This paper reviews the supercritical carbon dioxide sterilization technology by arranging the exploratory work of industry researchers. In the paper, we introduce the theory of supercritical carbon dioxide sterilization technology, microbial inactivation ability, material influence research and sterilization equipment. Then we discuss the concerns and possibilities of the technology applied to the medical device industry basing on the good manufacturing practices.

Effect of double-leaf perforator free flap posterolateral calf peroneal artery on reconstruction of oropharyngeal anatomy after ablation of advanced oropharyngeal carcinoma / 南方医科大学学报

OBJECTIVE@#To evaluate the effect of using free double- leaf perforator flap posterolateral calf peroneal artery in anatomical reconstruction of the oropharyngeal structure after ablation of advanced oropharyngeal carcinoma.@*METHODS@#Twenty-six patients with oropharyngeal defects after ablation of oropharyngeal malignancies were recruited, including 12 with carcinoma in the tongue base, 5 in the latenral pharyngeal wall and 9 in the soft palate. Between July, 2016 and July, 2018, the patients underwent surgeries for reconstruction of the oropharyngeal defects using flaps. The areas of tissue defects repaired by double-leaf perforator flaps ranged from 40.5 to 72.5 cm. Reconstruction was performed for oropharyngeal defects in the soft palate, pterygopalate, parapharyngeal, pterygo- mandibular, and tongue base tissues. The patients' outcomes including mouth opening, functions of deglutition, linguistic function, restoration of palatopharyngeal anatomical structure and postoperative survival were evaluated, and their quality of life was assessed using FACT-H&N scale (Chinese Edition).@*RESULTS@#All the 26 patients with transplantation of the free flaps survived. Six months after the operation, the oropharyngeal function and anatomical structure of the patients were basically restored. The questionnaire survey showed that the patients' physical, social/family, emotional and functional conditions, the total score of the core scale, items scores for the head and neck, and the total score of the scale all improved significantly after the operation compared with those before the operation ( < 0.05).@*CONCLUSIONS@#The free peroneal artery bilobate perforator flap in the posterolateral crus, which seldom has anatomical variations of the blood vessels, allows flexible design and contains rich tissue volume to facilitate defect repair with different approaches and ranges. The application of this flap, which is an ideal perforator flap for reconstruction of the oropharyngeal structure and function, can improve the quality of life of patients following operations for advanced oropharyngeal cancer.