Germline PRKACA amplification-associated primary pigmented nodular adrenocortical disease: a case report and literature review

SUMMARY Primary pigmented nodular adrenocortical disease (PPNAD) is a rare adrenocorticotropin hormone (ACTH)-independent Cushing's syndrome (CS). Pediatric patients with PPNAD typically have unusual skin lesions and slow growth with unknown causes. We present a case of a female Chinese patient with PPNAD caused by the germline PRKACA gene copy number gain of chromosome 19. The patient initially presented with kidney stones, short stature, and obesity. After further testing, it was discovered that the patient had diabetes, mild hypertension, low bone mass, a low ACTH level, and hypercortisolemia, and neither the low-dose or high-dose dexamethasone suppression test was able to inhibit hematuric cortisol, which paradoxically increased. PPNAD was pathologically diagnosed after unilateral adrenalectomy. Chromosome microarrays and whole exon sequencing analyses of the peripheral blood, as well as testing of sectioned adrenal tissue, showed a rise in the copy number of the duplication-containing PRKACA gene on chromosome 19p13.13p13.12, a de novo but not heritable gene defect that causes disease. The clinical signs and symptoms supported the diagnosis of Carney complex (CNC). One significant mechanism of CNC pathogenesis may be the rise in germline PRKACA copy number of chromosome 19. When assessing PPNAD patients for CNC, the possibility of PRKACA gene amplification should be considered. The effect of PRKACA gene amplification on the clinical manifestations of CNC needs to be confirmed by more cases.

Demand and influencing factors of non-occupational post-exposure prophylaxis for AIDS among men who have sex with men in Wuhan / 中国热带医学

@#Abstract: Objective　To investigate the drug demand and related influencing factors of AIDS non-occupational post-exposure prophylaxis (nPEP) among men who have sex with men (MSM) in Wuhan, and to provide a scientific basis for the development of subsequent intervention policies for MSM. Methods　With the assistance of social organizations in Wuhan, MSM was recruited by the snowball method to carry out an online questionnaire survey to collect information on demographics, AIDS-related knowledge, high-risk behaviors, and the need for nPEP medication. The χ2 test and unconditional Logistic regression were used to analyze the related factors of the demand for nPEP medication. Results　A total of 308 valid subjects were included in this study, with predominantly 18-29 years old (78.57%, 242/308). The self-reported sexual orientation was mainly homosexuality (82.47%, 254/308), and the awareness rate of AIDS knowledge was high (89.29%, 275/308). Among the survey respondents, 35.06% (108/308) did not know the situation of HIV infection among MSM population in Wuhan; 55.19% (170/308) had two or more same-sex sexual partners in the last six months; 90.91% (280/308) had heard of nPEP before participating in this survey. After passing nPEP and informing the protective effect of nPEP, 59.42% (183/308) of them needed nPEP. After HIV exposure, 73.38% (226/308) were willing to spend money to buy nPEP drugs, and 88.64% (273/308) were willing to take nPEP drugs because of the known side effects. Logistic regression analysis showed that in the last six months, the needs for taking nPEP medication in those who had 2 or more same-sex sexual partners (OR=2.121, 95%CI: 1.329-3.386) and who had received peer education (OR=1.740, 95%CI: 1.088-2.781) were higher than those of those who had a same-sex sexual partner in the last six months and who had not received peer education. Conclusions　The MSM population in Wuhan has a great demand for nPEP drugs, and peer education is an important way to carry out nPEP publicity and promotion. At the same time, we should continue to strengthen warning publicity and education and behavioral intervention to reduce MSM risky sexual behaviors and reduce new HIV infections.

Maxent modeling for predicting the global potential distribution of talaromycosis marneffei / 中国热带医学

@#Abstract: Objective　To predict the potential distribution of talaromycosis marneffei (TSM) and analyze its driving factors, so as to provide evidence for the surveillance and prevention of this disease. Methods　The data of all laboratory-confirmed, non-duplicating TSM published in the English and Chinese literature from the first case in January 1964 to December 2018 was collected. A Maxent ecology model using environmental variables, Rhizomys distribution and HIV/AIDS epidemic was developed to forecast ecological niche of TSM worldwide, as well as identify the driving factors. Results　A total of 705 articles (477 in Chinese and 228 in English) were obtained during the study period. After excluding imported cases, a total of 100 foci information were included in the model. The area under the receiver operating characteristic (ROC) curve (AUC) of the model was 0.997 for the training set and 0.991 for the test set. Maxent model revealed that Rhizomys distribution, mean temperature of warmest quarter, precipitation of wettest month, HIV/AIDS epidemic and mean temperature of driest quarter were the top 5 important variables affecting TSM distribution. In addition to identifying traditional TSM endemic areas (South of the Yangtze River in China, Southeast Asian, North and Northeast India), other potential endemic areas were also identified, including parts of the North of the Yangtze River, Central America, West Coast of Africa, East Coast of South America, the Korean Peninsula and Japan. Conclusion　Our finding has discovered hidden high-risk areas and provided insights about driving factors of TSM distribution, which will help inform surveillance strategies and improve the effectiveness of public health interventions against TM infections.

Effects of FasL inhibitors on corneal apoptosis and Treg after corneal transplantation in rats / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To explore the effect of intravitreal injection FasL inhibitors on corneal apoptosis, Fas, FasL expression, Treg numbers in blood and lymph nodes and rejection index in rats after corneal transplantation.METHODS:A total of 24 SD rats(24 eyes)who received penetrating keratoplasty were randomly divided into two groups: PBS group received intravitreal injection of PBS(12 rats, 12 eyes)and FasL inhibitor group(12 rats, 12 eyes). Rejection index was recorded every week and blood samples and lymph node were collected at 1, 3 and 5wk after surgery to analyze the proportions of Treg. Corneal tissue was collected for detecting the expression of Fas and FasL and number of apoptosis.RESULTS: The expression of Fas, FasL in FasL inhibitor group decreased significantly compared with the PBS group(all P<0.05); Corneal cell apoptosis significantly decreased in FasL inhibitor group, and it was the lowest at 5wk after surgery; Treg numbers in blood and lymph nodes significantly increased in FasL inhibitor group at 3wk after surgery(all P<0.05); rejection index of corneal transplantation in the FasL inhibitor group was significantly lower than that of PBS group(all P<0.05).CONCLUSION:Intravitreal injection of FasL inhibitors after corneal transplantation could reduce the apoptosis in all layers of cornea, increase the number of Tregs in blood and lymph nodes, and alleviate rejection.

Pharmacodynamics of human interferon α1b against severe acute respiratory syndrome coronavirus 2 Omicron strain in vitro / 中国生物制品学杂志

@#Objective To evaluate the pharmacodynamics of human interferon(IFN)α1b against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)Omicron strain in vitro.Methods Total four drugs human IFNα1b bulk,human IFNα1b eye drops,human IFNα1b spray and Remdesivir were detected for cytotoxicity by CCK-8 assay.The inhibitory effect of human IFNα1b on SARS-CoV-2 Omicron strains(BA.5/BA.2/BA.1)was determined by qPCR.Results Human IFNα1b bulk of the maximum concentration(1 × 107IU/mL)and Remdesivir of the maximum concentration(150 μmol/L)did not achieve half cytotoxicity to Vero cells;The median cytotoxicity concentrations(CC_(50))of human IFNα1b eye drops and human IFNα1b sprays were 29 958 and 37 550 IU/mL,respectively,showing toxicity to Vero cells.The median effective concentrations(EC_(50))of human IFNα1b against virus strains BA.1,BA.2 and BA.5 after incubation for 2 h in advance were 9.30,13.38 and 12.33 IU/mL and those of Remdesivir were 0.314 7,0.291 0 and0.300 3 μmol/L.When incubation with virus simultaneously,the EC_(50)of human IFNα1b to BA.1,BA.2 and BA.5 were19.68,10.91 and 18.84 IU/mL and those of the control drug Remdesivir were 0.320 5,0.274 4 and 0.304 1 μmol/L,respectively.Conclusion At the cell level in vitro,human IFNα1b of very low activity showed a good inhibitory effect on SARS-CoV-2 Omicron strain,which was expected to be a clinical specific drug for the treatment of SARS-CoV-2 Omicron strain infection.

The evaluation of IgG4 and IgG expression in cutaneous Rosai-Dorfman disease

Abstract Objective The authors investigated the expression of IgG4 and IgG in cutaneous Rosai-Dorfman Disease (CRDD) to further improve the understanding of this disease. Methods The authors retrospectively reviewed the clinicopathological features of 23 CRDD patients. The authors diagnosed CRDD by the presence of emperipolesis and immunohistochemical (IHC) staining of histiocytes consisting of S-100(+)/CD68(+)/CD1a(-) cells. The expressions of IgG and IgG4 in cutaneous specimens were assessed by IHC (EnVision) and quantitatively calculated by a medical image analysis system. Results All 23 patients, including 14 males and 9 females, were confirmed to have CRDD. Their ages ranged from 17 to 68 years (mean 47.91 ± 14.16). The most frequently affected skin regions were the face, followed by the trunk, ears, neck, limbs, and genitals. In 16 of these cases, the disease presented as a single lesion. IHC staining of sections showed that IgG was positive (≥ 10 cells/High-Power Field [HPF]) in 22 cases, while IgG4 was positive (≥ 10 cells/HPF) in 18 cases. Moreover, the IgG4/IgG proportion ranged from 1.7% to 85.7% (mean 29.50 ± 24.67%, median 18.4%) in the 18 cases. Study limitations In the majority of studies, as well as in the current study, the design. RDD is a rare disease, so the sample size is small. In the next studies to come, the authors will expand the sample for multi-center verification and in-depth study. Conclusion The positive rates of IgG4 and IgG and the IgG4/IgG ratio assessed through IHC staining may be important in understanding the pathogenesis of CRDD.

Particular characteristics of physical fitness in the training of dancers / Características particulares de aptidão física no treinamento de dançarinos / Características particulares de la aptitud física en el entrenamiento de bailarines

ABSTRACT Introduction: Chinese sports dance has occupied a prominent place worldwide due to its rapid development and the exchange between countries has gradually increased, requiring studies on the improvement in the training of these athletes. Objective: Study the particular characteristics of physical fitness and its insertion methods in the training of sport dancers. Methods: The author used the method of literature data, questionnaire survey and mathematical statistics to take the students specializing in sports dance in the School of Physical Education as research volunteers, performing a series of fitness index tests to check the most relevant characteristics to the fitness of their training. Results: The body shape training and special strength training, including special flexibility training is organized according to the demand standards. As for the physical training specific to dancers, the basic ballet training reaches 32 exercises, the strength training of the costal muscles, waist and abdomen 32 exercises, and the flexibility of the groin and legs 25 exercises, the latter being the key quality content for athletes. Conclusion: In-depth investigations and research are constantly being conducted into the content of special fitness training for students specializing in sports dance, and the factors influencing the particular fitness training have the potential to most effectively promote the development of sports dance. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A dança esportiva chinesa tem ocupado um lugar de destaque mundial pelo seu rápido desenvolvimento e o intercâmbio entre países tem aumentado gradualmente, exigindo estudos sobre o aprimoramento no treino desses atletas. Objetivo: Estudar as características particulares de aptidão física e os seus métodos de inserção no treinamento dos dançarinos esportivos. Métodos: O autor utilizou o método de dados da literatura, levantamento de questionários e estatísticas matemáticas para levar os estudantes especializados em dança esportiva na Escola de Educação Física como voluntários de pesquisa, realizando uma série de testes de índice de aptidão física para verificar as características mais relevantes à aptidão física de seu treinamento. Resultados: O treinamento de forma corporal e o treinamento de força especial, incluindo o treinamento de flexibilidade especial e organizado conforme os padrões de exigência. Quanto ao treinamento físico específico aos dançarinos, o treinamento básico do balé atinge 32 exercícios, o treinamento de força da musculatura costal, cintura e abdômen 32 exercícios, e a flexibilidade da virilha e pernas 25 exercícios, sendo estes últimos o conteúdo chave de qualidade aos atletas. Conclusão: Investigações e pesquisas aprofundadas estão em constante atualização sobre o conteúdo do treinamento especial de aptidão física para estudantes especializados em dança esportiva e os fatores que influenciam o treinamento particular de aptidão física tem o potencial de promoverem de forma mais eficaz o desenvolvimento da dança esportiva. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

Resumen Introducción: La danza deportiva china ha ocupado un lugar destacado en todo el mundo por su rápido desarrollo y el intercambio entre países ha aumentado gradualmente, lo que exige estudios sobre la mejora en la formación de estos atletas. Objetivo: Estudiar las características particulares de la aptitud física y sus métodos de inserción en el entrenamiento de los bailarines deportivos. Métodos: El autor utilizó el método de datos bibliográficos, encuesta por cuestionario y estadística matemática para tomar a los alumnos especializados en danza deportiva de la Escuela de Educación Física como voluntarios de la investigación, realizando una serie de pruebas de índice de aptitud física para comprobar las características más relevantes para la aptitud de su entrenamiento. Resultados: El entrenamiento de la forma del cuerpo y el entrenamiento especial de la fuerza, incluido el entrenamiento especial de la flexibilidad, se organizan de acuerdo con las normas de la demanda. En cuanto a la formación física específica de los bailarines, el entrenamiento básico de ballet alcanza los 32 ejercicios, el entrenamiento de la fuerza de los músculos costales, la cintura y el abdomen 32 ejercicios, y la flexibilidad de la ingle y las piernas 25 ejercicios, siendo este último el contenido de calidad clave para los atletas. Conclusión: Se están actualizando constantemente las investigaciones y los estudios sobre el contenido de la preparación física especial para los estudiantes que se especializan en la danza deportiva y los factores que influyen en la preparación física particular tienen el potencial de promover el desarrollo de la danza deportiva con mayor eficacia. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Lower Body Perfusion Reduces the Morbidity of Postoperative Acute Kidney Injury in Type A Dissection: A Propensity-Matched Analysis

ABSTRACT Introduction: Lower body perfusion (LBP) is a technique used to provide blood perfusion to distal organs and spinal cord during circulatory arrest. However, the effect of LBP on the prognosis of aortic arch surgery, especially on postoperative renal function, remains unclear. Methods: A total of 304 patients with acute type A aortic dissection who underwent total aortic arch replacement combined with frozen elephant trunk implantation between May 2016 and December 2021 were retrospectively analyzed. The patients were divided into LBP group (group L, n=85) and non-LBP group (group NL, n=219). Routine lower body circulatory arrest was applied during operation in group NL, and antegrade LBP combined was applied during operation in group L. Perioperative data were recorded. Propensity score matching was used for statistical analysis. Results: After propensity score matching, 85 pairs of patients were successfully matched. Two groups significantly differed in circulatory arrest time (six minutes vs. 30 minutes, P=0.000), cross-clamping time (101 minutes vs. 92 minutes, P=0.010), minimum nasopharyngeal temperature (29.4ºC vs. 27.2ºC, P=0.000), and highest lactate value during cardiopulmonary bypass (2.3 μmol/L vs. 4.1 μmol/L, P=0.000). Considering the postoperative indicators, the drainage volume (450 mL vs. 775 mL, P=0.000) and the incidence of level I acute kidney injury (23.5% vs. 32%, P=0.046) in group L was lower than those in group NL. Conclusion: LBP resulted as a safe and feasible approach in aortic arch surgery, as it could significantly shorten the circulatory arrest time, which might reduce the incidence of postoperative level I acute kidney injury.

The mechanism of BRCC3/NLRP3 in promoting the transformation of endometriosis to endometriosis-associated ovarian carcinoma / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：探讨NOD样受体蛋白3（NLRP3）炎症小体的活化在子宫内膜异位症（EMT）进展为EMT相关性卵巢癌（EAOC）过程中的作用及其机制。方法：选取2018年4月至2019年6月上海市长宁区幼保健院收治的EAOC、EMT、正常子宫内膜（CON组）组织标本各15例及患者的临床资料，利用免疫组织化学染色法、WB法检测EAOC、EMT和CON组织中NLRP3、caspase-1和IL-1β及含BRCA1/BRCA2的复杂亚基3（BRCC3）的表达水平。构建过表达BRCC3质粒和si-NLRP3质粒并转染EMT细胞CRL-7566，通过WB法检测转染后细胞中BRCC3蛋白的表达水平，利用MTT法、流式细胞术及Transwell实验分别检测转染后细胞增殖、凋亡、迁移与侵袭能力的变化。对过表达BRCC3组细胞进行干扰NLRP3实验，通过WB法检测干扰后BRCC3和NLRP3蛋白的表达水平，检测干扰后细胞增殖、凋亡、迁移与侵袭能力的变化。结果：EAOC和EMT组织中NLRP3、caspase-1、IL-1β和BRCC3的表达水平较CON组均呈明显升高（均P<0.01），且EAOC组织中NLRP3与BRCC3的表达呈正相关（r=0.65，P<0.01）。在CRL-7566细胞中过表达BRCC3显著促进细胞的增殖、迁移和侵袭并抑制细胞凋亡（均P<0.01），敲减NLRP3则抑制CRL-7566细胞的上述表型（均P<0.01），过表达BRCC3增强NLRP3的表达水平（P<0.01），而干扰BRCC3则抑制NLRP3表达（P<0.01）；干扰NLRP3可以部分逆转BRCC3对细胞凋亡的抑制作用（P<0.01）、对细胞迁移（P<0.05）和侵袭（P<0.01）的促进作用。结论：EAOC和EMT组织中NLRP3和BRCC3均呈高表达，过表达BRCC3可促进CRL-7566细胞的增殖、迁移和侵袭并抑制细胞凋亡，与EMT向EAOC转化有关，BRCC3/NLRP3是潜在的EAOC炎癌转化预测标志物及治疗靶点。

Research progress of traditional Chinese medicine in the prevention and treatment of COVID-19 / 中国热带医学

@#Abstract: The coronavirus disease 2019 (COVID-19) has become a global public health problem due to its highly contagious nature. This article aims to discuss the current situation of traditional Chinese medicine in the prevention and treatment of COVID-19, and to provide a basis for traditional Chinese medicine research and scientific and standardized treatment of COVID-19.In this article, the etiology, pathogenesis, treatment plan and research progress were summarized, analyzed and concluded by retrieving and reviewing the literature and clinical reports related to the prevention and treatment of COVID-19 with traditional Chinese medicine. Traditional Chinese medicine has obvious effects in the prevention and treatment of COVID-19, improvement of clinical symptoms, and control of disease progression, which had the unique advantages of mild curative efficacy and safety. It has important practical significance in relieving patients' early symptoms and reducing the incidence of progression from mild to severe, and had great potential for development in the treatment of COVID-19. The traditional Chinese medicine intervention and the formulation of diagnosis and treatment plans for the COVID-19 need to be continuously optimized and improved. Scientific and rational application of traditional Chinese medicine to prevent and treat COVID-19, optimization diagnosis and treatment programs, and in-depth exploration of pharmacological mechanisms, especially the provide reference for early intervention of new coronavirus pneumonia by traditional Chinese medicine, the control of disease progression in the middle stage, and improve prognosis in the late stage with Western medicine.

Treatment efficacy of MUC1-DC vaccine in breast cancer MCF-7 cell xenografts in nude mice evaluated by monitoring tumor growth with optical molecular imaging / 中国肿瘤生物治疗杂志

@#[摘 要] 目的：评价黏蛋白1（mucin 1，MUC1）基因转染的DC疫苗治疗乳腺癌MCF-7细胞裸鼠移植瘤的效果及其可能的机制。方法：采用GFP慢病毒转染MCF-7细胞获得GFP-MCF-7细胞，皮下种植于BALB/c裸鼠，成瘤后随机分为3组。各组裸鼠首先尾静脉注射体外活化的CIK细胞（1×108个/只），治疗组于皮下注射MUC1基因转染的MUC1-DC（MUC1-DC组）或DC（DC组）（0.2 ml，1×107个/只），对照组（Control组）注射等体积生理盐水，每天治疗1次，连续5 d；采用小动物活体光学成像系统在开始治疗前及治疗后第35天观察移植瘤荧光成像，分析荧光强度和荧光面积；并采用免疫组化法检测瘤组织中Caspase 3的表达、TUNEL法检测细胞凋亡率。结果：GFP-MCF-7接种后7 d，成瘤率100%；光学分子成像法监测结果显示，治疗前MUC1-DC组、DC组和Control组之间体内移植瘤荧光信号强度无明显差异（P>0.05）；第35天，MUC1-DC组的荧光信号强度明显低于Control组（P<0.05）；DC与Control、MUC1-DC与DC组间均无显著性差异（均为P>0.05），但MUC1-DC比DC组荧光信号更低；治疗前MUC1-DC组、DC组和Control组之间体内移植瘤荧光信号分布面积无显著差异（P>0.05）；第35天，Control组荧光信号呈多处散在分布，MUC1-DC组和DC组的荧光信号面积均明显低于Control组（均为P<0.01），MUC1-DC组的荧光信号面积低于DC组，但无显著差异（P>0.05）；Control组Caspase 3表达最少，DC组次之，MUC1-DC组呈高表达Caspase 3，3组间差异均有统计学意义（均为P<0.05）；3组细胞凋亡率分别为：Control组（4.11±2.61）%、DC组（9.63±2.27）%、MUC1-DC组（25.30±8.24）%，3组间差异均有统计学意义（均P<0.05）。结论： MUC1-DC疫苗比单纯DC免疫治疗人乳腺癌荷瘤小鼠能够更有效地抑制肿瘤的生长和扩散，发挥了更好的促进肿瘤细胞凋亡的作用。

Advance in Flexible Variable Stiffness Actuator of Rehabilitation Robot (review) / 中国康复理论与实践

Flexible variable stiffness actuator is divided into four categories including elastic element, pneumatic element, electric-magnetic element and intelligent material. It is gradually applied in rehabilitation robot. It could adapt the change of patient's impedance in the upper and lower limb rehabilitation robots, ensure the safety of the wearer in the exoskeleton, and improve the biomimetics in the prosthesis. Variable stiffness driving mechanism for rehabilitation robot still has some disadvantages. It is proposed to have compact structure, low power consumption, good stiffness characteristics, high response rate and progressive output torque curve, etc.

The relationship between air pollutants and mortality in Huairou District / 预防医学

Objective@#To evaluate the relationship between air pollutants and mortality of residents in Huairou District, Beijing, providing a basis for the formulation of air pollution control measures. @*Methods @#The data of daily deaths, meteorological factors and air pollutants in Huairou District from 2014 to 2018 were collected from Beijing Disease Prevention Monitoring Information Integration and Analysis System, Huairou Meteorological Bureau and Environmental Monitoring Station. The generalized additive models were used to analyze the relationship between the average daily concentration of air pollutants and the daily deaths.@*Results@#The medians of daily average concentrations of SO2, NO2, CO, O3, PM10 and PM2.5 were 5.00 μg/m3, 24.00 μg/m3, 0.71 mg/m3, 77.27 μg/m3, 64.25 μg/m3 and 44.13 μg/m3, respectively. Except for O3, the daily average concentrations of SO2, NO2, CO, PM10 and PM2.5 showed decreasing trends from 2014 to 2018. An increase of 10 μg/m3 of NO2 resulted in an elevation of 1.69% ( 95%CI: 0.31%-3.08% ) , 3.31% ( 95%CI: 1.24%-5.42% ) and 3.31% ( 95%CI: 0.51%-6.19% ) for non-accidental death in the whole population, females and people under 65 years old, respectively, with a delay of 2 days (lag2). For every 10 μg/m3 increase in the daily average concentrations of CO and PM2.5, the risk of non-accidental death among people under 65 years old at lag2 increased by 0.08% ( 95%CI: 0.01%-0.14% ) and 0.88% ( 95%CI: 0.12%-1.64% ) , respectively. For every 10 μg/m3 increase in daily average concentration of O3, there was 0.69% ( 95%CI: 0.02%-1.36% ) increase in daily male non-accidental death risk at lag4. The results of the multi-pollutant model showed that after adjusting the effects of the other two air pollutants, NO2, CO and PM2.5 had no statistically significant effects on the daily non-accidental deaths of people under 65 years old at lag2 ( P>0.05 ) . @*Conclusion@# The ambient NO2, CO, O3 and PM2.5 pollution increase daily non-accidental deaths, which shows a lag effect．

Preliminary study on the risk of macrosomia using Bayesian discriminant analysis based on prenatal records / 中华疾病控制杂志

Objective To explore the clinical effect of Bayesian discriminant analysis in predicting the risk of macrosomia. Methods 169 fetal macrosomia and 169 non-macrosomia were enrolled in a 1:1 matched case-control study. Conditional Logistic regression was used to select the discriminant indexes,and the discriminant indexes were put into the Bayesian discriminant model to obtain the Bayesian discriminant function. The discriminant function was the retrospectively examined and externally tested. Results The results of conditional Logistic regression model indicated that mother's height, early pregnancy body mass index (BMI), gestational diabetes, gestational weeks, the height of uterine and abdominal circumference were associated with the birth of fetal macrosomia. The Bayesian discriminant function were established: Fetal macrosomia:y1=-27.802+8.420×Mother＇s height+8.719×early pregnancy BMI+10.485×gestational weeks+3.375×gestational diabetes+2.862×height of uterine and abdominal circumference; Non-macrosomia y2=-17.477+7.161×Mother＇s height+7.217×early pregnancy BMI+7.862×gestational weeks+2.036×gestational diabetes-0.085×height of uterine and abdominal circumference. Wilks′ Lambda λ=0.489, P<0.001, the Bayesian discriminant function was statistically significant. The internal and external conformity rates of the Bayesian discriminant model were all more than 80%. Conclutions The birth of fetal macrosomia is related to many factors. The Bayesian discriminant model in the present study is valuable to discriminate macrosomia and provide an objective reference for more accurate identification of macrosomia in the future.

Analysis on potential factors of small for gestational age of Zhuang ethnicity in Wuming District of Nanning / 中华疾病控制杂志

Objective To understand the prevalence of small for gestational age (SGA) in Zhuang population, and to analyze the potential factors of SGA. Methods A total of 3 839 live births in the Wuming District People’s Hospital and Wuming Maternal and Child Health Hospital from January 2016 to January 2018 were recruited. Random Forest, 2 test and Logistic regression model were used for statistical analyses. Results The incidence of SGA was 9.6% (368/3 839), and it was 6.9% (142/2 049) and 12.6% (226/1 790) for male and female infants respectively. Random Forest method showed that second-trimester intrauterine growth restriction’s importance score was the highest, but gestational week’s was the lowest. Also, seven important variables were selected by this method. Unconditional logistic regression analysis showed that parity <2, the height of mothers <1.55 m, insufficient gestational weight gain, second-trimester intrauterine growth restriction were risk factors for SGA, but pre-pregnancy BMI ≥18.5 kg/m2 and male infants were protective factors. Conclusions The incidence of SGA is slightly higher, among the Zhuang population in Guangxi. SGA is affected by many factors. Therefore, it is necessary to evaluate the status of intrauterine growth and adopt comprehensive measures to control and reduce the incidence of SGA.

Design and Implementation of Rehabilitation Equipment Monitoring System Based on Web / 中国康复理论与实践

Objective:To design a web-based monitoring system for rehabilitation equipment in order to solve the problems of inadequate monitoring system for existing rehabilitation equipment and poor communication between doctors and patients. Methods:The system was composed of device communication layer, server layer and user access layer, which was implemented by B/S architecture. Rehabilitation equipment was connected with intelligent gateway through wireless communication module. HTTP protocol and socket communication technology were used to realize remote communication between rehabilitation equipment and platform server. The server layer mainly used MVC design pattern and J2EE technology, adopted the current popular Web framework SSM (Spring + Spring MVC + MyBatis) design, MySQL database was responsible for data storage. User access layer was designed with HTML5+JSP+Bootstrap+HighCharts+CSS+JavaScript+Ajax and other technologies. Results:By deploying the public network of the project, the remote monitoring experiment of the equipment was carried out. The upload of status information and the download of page control instructions could be responded in a short time interval. Considering the factors such as network delay, the design met the requirements. Conclusion:This system is simple to operate and efficient to transmiss data between platform and equipment. It can provide convenient service support for medical staff, patients and equipment administrators.

A Novel Four-Degree-of-Freedom Upper Limb Rehabilitation Robot / 中国康复理论与实践

Objective:A novel four-degree-of-freedom upper limb rehabilitation robot was designed to overcome the shortcomings of the structure of the most of serial robots. Methods:The shoulder and elbow joint drive system and the information detection system were placed in the base. The synchronous belt drive system and the spiral bevel gear transmission system were designed to transmit power from the base to the shoulder and elbow joint of the arm. The cubic polynomial trajectory planning method based on the joint space was selected to accomplish the trajectory planning of the recovery movements of taking objects and drawing quadrilaterals, and the single-degree-of-freedom motion control experiment and multi-degree-of-freedom trajectory planning experiment were designed to verify the rationality and feasibility of the design. Results:Each joint of the rehabilitation robot reached the designed range of motion at the designed speed, and well completed the planned rehabilitation training movements. Conclusion:This robot can effectively reduce the volume and mass of the mechanical arm, overcome the influence of motor noise and radiation on patients' rehabilitation training, and assist patients to complete a variety of rehabilitation exercises.

Research of a Wearable Lower Extremity Assisted Exoskeleton Robot System / 中国康复理论与实践

Objective:To propose a new type of lightweight wearable lower extremity exoskeleton assisted robot system, and explore the feasibility of walking and posture change rehabilitation training for patients with gait disorder and with paraplegia under T4 spinal cord injury (exclusion of lower extremity muscle spasm and obvious pain). Methods:The active and passive hybrid wearable lower extremity exoskeleton assisted robot structure of the hip joint with two-motor active drive and the knee joint passive four-link simulating the instantaneous movement of the human body was designed. Based on modular control, the STM32F767IGT6 and peripheral circuits, attitude acquisition, power supply and crutches module control system were proposed. The exoskeleton robot was worn by a normal person to perform the experiment of leveling, slope and posture transformation and analyze hip/knee /ankle joint angles during exercise, and compare the myoelectric signals of the lateral femoral and medial femoral muscles. Results:The wearer could realize the sitting-standing posture change and the flat/slope walking only based on the exoskeleton robot system, and the hip/knee/ankle angles were basically consistent with the normal walking and the electromyographic signals of the lateral femoral, medial femoral muscle significantly decreased when the robot was worn while walking. Conclusion:The active-passive hybrid lower exoskeleton assisted robot system can still achieve the rehabilitation of walking and posture change while reducing the weight. This verified the feasibility of the assisted robot system with the active dual-motor of the hip joint and the passive four-link structure of the knee joint to help the patients with paraplegia and gait disorder to walk and recover.

Bacteriology of peritonsillar abscess: the changing trend and predisposing factors / Bacteriologia do abscesso peritonsilar: tendência de mudança e fatores predisponentes

Abstract Introduction: Peritonsillar abscess is the most common deep neck infection. The infectious microorganism may be different according to clinical factors. Objective: To identify the major causative pathogen of peritonsillar abscess and investigate the relationship between the causative pathogen, host clinical factors, and hospitalization duration. Methods: This retrospective study included 415 hospitalized patients diagnosed with peritonsillar abscess who were admitted to a tertiary medical center from June 1990 to June 2013. We collected data by chart review and analyzed variables such as demographic characteristics, underlying systemic disease, smoking, alcoholism, betel nut chewing, bacteriology, and hospitalization duration. Results: A total of 168 patients had positive results for pathogen isolation. Streptococcus viridans (28.57%) and Klebsiella pneumoniae (23.21%) were the most common microorganisms identified through pus culturing. The isolation rate of anaerobes increased to 49.35% in the recent 6 years (p = 0.048). Common anaerobes were Prevotella and Fusobacterium spp. The identification of K. pneumoniae increased among elderly patients (age > 65 years) with an odds ratio (OR) of 2.76 (p = 0.03), and decreased in the hot season (mean temperature > 26 °C) (OR = 0.49, p = 0.04). No specific microorganism was associated with prolonged hospital stay. Conclusion: The most common pathogen identified through pus culturing was S. viridans, followed by K. pneumoniae. The identification of anaerobes was shown to increase in recent years. The antibiotics initially selected should be effective against both aerobes and anaerobes. Bacterial identification may be associated with host clinical factors and environmental factors.

Resumo Introdução: O Abscesso Peritonsilar é a infecção cervical profunda mais comum. O microrganismo infeccioso pode ser diferente de acordo com os fatores clínicos. Objetivo: Identificar o principal agente causador do abscesso peritonsilar e investigar a relação entre o patógeno causador, os fatores clínicos do hospedeiro e a duração da hospitalização. Método: Este estudo retrospectivo incluiu 415 pacientes hospitalizados diagnosticados com abscesso peritonsilar que foram internados em um centro médico terciário de junho de 1990 a junho de 2013. Coletamos dados através da análise dos arquivos médicos dos pacientes e analisamos variáveis como características demográficas, doença sistêmica subjacente, tabagismo, alcoolismo, hábito de mascar noz de betel, bacteriologia e duração da hospitalização. Resultados: Um total de 168 pacientes apresentaram resultados positivos para isolamento de patógenos. Streptococcus viridans (28,57%) e Klebsiella pneumoniae (23,21%) foram os microrganismos mais comuns identificados pela cultura da secreção. A taxa de isolamento de anaeróbios aumentou para 49,35% nos últimos 6 anos (p = 0,048). Os anaeróbios comuns foram Prevotella e Fusobacterium spp. A identificação de K. pneumoniae aumentou em pacientes idosos (idade > 65 anos) com razão de chances (Odds Ratio - OR) de 2,76 (p = 0,03) e diminuiu na estação do calor (temperatura média > 26 °C) (OR = 0,49, p = 0,04). Nenhum microrganismo específico foi associado à hospitalização prolongada. Conclusão: O patógeno mais comumente identificado através da cultura de secreção foi S. viridans, seguido por K. pneumoniae. A identificação de anaeróbios mostrou ter aumentado nos últimos anos. Os antibióticos selecionados inicialmente devem ser efetivos contra aeróbios e anaeróbios. A identificação bacteriana pode estar associada a fatores clínicos e fatores ambientais do hospedeiro.

Thoracolaparoscopic versus open approach for thoracic esophageal squamous cell carcinoma: A case control study / 中国胸心血管外科临床杂志

@#Objective    To evaluate the security and outcomes of thoracolaparoscopic esophagectomy (TLE) versus open approach (OA) for thoracic esophageal squamous cell carcinoma. Methods    From June 2014 to June 2015, 125 patients with thoracic esophageal squamous cell carcinoma underwent esophagectomy through McKeown approach, including TLE (a TLE group, 107 patients, 77 males and 30 females) and OA (an OA group, 18 patients, 13 males and 5 females). The data of operation and postoperative complications of the two groups were analyzed retrospectively. Results    There was no statistical difference in the duration of operation and ICU stay and resected lymph nodes around laryngeal recurrent nerve between the TLE group and the OA group (333.58±72.84 min vs. 369.17±91.24 min, P=0.067; 2.84±1.44 d vs. 6.44±13.46 d, P=0.272; 4.71±3.87 vs. 3.89±3.97, P=0.408) . There was a statistical difference in blood loss, total resected lymph nodes and resected lymph nodes groups between TLE group and OA group (222.62±139.77 ml vs. 427.78±276.65, P=0.006; 19.62±9.61 vs. 14.61±8.07, P=0.038; 3.70±0.99 vs. 3.11±1.13, P=0.024). The rate of postoperative complications was 32.7% in the TLE group and 38.9% in the OA group (P=0.608). There was a statistical difference (P=0.011) in incidence of pulmonary infection (2.8% in the TLE group and 16.7% in the OA group). Incidences of complications, such as anastomotic leakage, cardiac complications, left-side hydrothorax, right-side pneumothorax, voice hoarse and incision infection, showed no statistical difference between two groups. Conclusion    For patients with thoracic esophageal squamous cell carcinoma, TLE possesses advantages of more harvested lymph nodes, less blood loss and less pulmonary infection comparing with open approach, and is complied with the principles of security and oncological radicality of surgery.