Craniofacial anatomical Characteristics of patients with catathrenia / 中华口腔医学杂志

Objective: To analyze whether the upper airway of patients with catathrenia has obstructive manifestations using nasal resistance, craniofacial, and upper airway imaging methods, which could benefit the exploration of the etiology and treatment options. Methods: From August 2012 to September 2019, a total of 57 patients with catathrenia in the Department of Orthodontics at Peking University Hospital of Stomatology were included in the study, including 22 males and 35 females, aged (31.1±10.9) years, with a body mass index of (21.7±2.7) kg/m2. All the patients were diagnosed by full-night polysomnography at the Sleep Division, Peking University People's Hospital, of which 10 patients were combined with obstructive sleep apnea hypopnea syndrome (OSAHS). The median groaning index of patients was 4.8 (1.8, 13.0) events/h. Nasal resistance and cone-beam CT were conducted on the patients, and measurements were performed on the craniofacial structures, upper airway, and surrounding soft tissues, compared with non-snoring normal occlusion individuals' references published by the same research team (144 college students recruited at Peking University and 100 non-snoring young adults with normal occlusion recruited at six universities in Beijing). Results: The total nasal resistance of patients with catathrenia was (0.26±0.08) Pa·cm-3·s-1. The patients had overall well-developed mandibular hard tissues. However, the patients were found with increased FH/BaN (steep anterior cranial base plane), increased MP/FH (forward rotation of the mandible); increased U1/NA and L1/MP (proclined upper and lower incisors). The sagittal diameter of the velopharynx [(19.2±4.5) mm] was significantly larger than the normal reference (t=8.44, P<0.001), while the sagittal diameter at the hypopharynx [(17.4±6.4) mm] was statistically smaller than the normal reference (t=-2.79, P=0.006). Catarhrenia patients combined with OSAHS presented longer soft palate, tongue, and lower hyoid bone than those with primary catathrenia. Conclusions: In patients with catathrenia, the overall craniofacial characteristics are well-developed skeletal structures, lower nasal resistance, proclined upper and lower incisors, wide upper sagittal development of the upper airway and narrow hypopharynx. Groaning sounds might be related to the narrowing of the hypopharynx during sleep.

A cohort study of infant development and health in Tianjin / 中国学校卫生

Objective@#To investigate the current situation of obesity and related metabolic abnormalities among preschool children, so as to provide theoretical support for future intervention.@*Methods@#A cohort of 3 952 children, born in Tianjin and enrolled in the kindergarten from September 2017 to October 2018, were selected to conduct a baseline survey and a three-year follow-up (questionnaire survey, physical examination and laboratory testing). At the same time, a two-way cohort study was conducted to retrospectively collect maternal prenatal examination, delivery and regular physical examination information of children from birth to preschool age from Tianjin Maternal and Child Health Information System.@*Results@#A total of 3 935, 3 654 and 2 739 children completed the follow up in the primary, middle and senior classes of kindergarten respectively. The height and weight of pre-school children increased with age, while the percentage of body fat decreased with age ( β-trend =-0.74, P <0.01). During three-year follow up, height, weight and body mass index of boys were higher than girls (P<0.05), while the percentage of body fat was lower than girls (primary class: 17.5%,18.5%; middle class: 16.4%,17.2%; senior class: 16.1%,17.1%, P <0.05). The detection rate of overweight (including obesity) and obesity increased with age( χ 2 trend were 15.51,38.72, P <0.05). The total detection rate of obesity increased from 5.4% at the baseline level to 9.6%. Laboratory test results showed that the detection rates of fasting blood glucose of boys were higher than that of girls in primary class, but blood lipid abnormalities were in the opposite (glucose: 7.7%, 4.8 %; lipid: 23.8% , 27.7%)( χ 2=12.01, 6.63, P <0.05).@*Conclusion@#The study has established a large growth cohort starting from the early embryonic stage, which will help to establish the strategies to promote children s health and prevent obesity and chronic diseases from multidimensional perspectives.

Effects of Sevoflurane and Propofol on Neurological Recovery of Traumatic Brain Injury Patients in the Early Postoperative Stage: A Retrospective Cohort Study / 中国医学科学杂志(英文版)

Objective To investigate the effects of propofol and sevoflurane on neurological recovery of traumatic brain injury (TBI) patients in the early postoperative stage.Methods We retrospectively analyzed the clinical data of TBI patients who underwent craniotomy or decompressive craniectomy. Generalized additive mixed model (GAMM) was used to analyze effects of propofol and sevoflurane on Glasgow Coma Scale (GCS) on postoperative days 1, 3, and 7. Multivariate regression analysis was used to analyze effects of the two anesthetics on Glasgow Outcome Scale (GOS) at discharge.Results A total of 340 TBI patients were enrolled in this study. There were 110 TBI patients who underwent craniotomy including 75 in the propofol group and 35 in the sevoflurane group, and 134 patients who underwent decompressive craniectomy including 63 in the propofol group and 71 in the sevoflurane group. It showed no significant difference in GCS at admission between the propofol and the sevoflurane groups among craniotomy patients (β = 0.75, 95%CI: -0.55 to 2.05, P = 0.260). However, elevation in GCS from baseline was 1.73 points (95%CI: -2.81 to -0.66, P = 0.002) less in the sevoflurane group than that in the propofol group on postoperative day 1, 2.03 points (95%CI: -3.14 to -0.91, P < 0.001) less on day 3, and 1.31 points (95%CI: -2.43 to -0.19, P = 0.022) less on day 7. The risk of unfavorable GOS (GOS 1, 2, and 3) at discharge was higher in the sevoflurane group (OR = 4.93, 95%CI: 1.05 to 23.03, P = 0.043). No significant difference was observed among two-group decompressive craniectomy patients in GCS and GOS.Conclusions Compared to propofol, sevoflurane was associated with worse neurological recovery during the hospital stay in TBI patients undergoing craniotomy. This difference was not detected in TBI patients undergoing decompressive craniectomy.

Audit to assess the quality of 916 prosthetic prescriptions of removable partial dentures / 华西口腔医学杂志

OBJECTIVES@#The objectives of this study were to assess the quality of prosthetic prescriptions of removable partial dentures (RPDs) and to analyze the current situation of the communication and information delivery between clinicians and technicians.@*METHODS@#All RPD prosthetic prescriptions received by a major dental laboratory in 4 weeks were involved in a quality audit, and the prescriptions were divided into three groups in accordance with the grades of clients. The filling of prosthetic prescriptions was recorded. The items in the prescriptions for audit included the general information of the patient, the general information of the clinician, the design diagram information, other detailed information, and the return date. The prescriptions were categorized into four levels on the basis of their quality by two quality inspectors who have been working for more than 10 years.@*RESULTS@#A total of 916 prescriptions were collected and assessed. The names in the general information of the patient and the clinician were filled out best, both at the rate of 97.6% (n=894). The return date was filled out worst, only at the rate of 6.4% (n=59). Of those prescriptions, 86.8% (n=795) exhibited inadequate design diagram information. The results of the quality assessment demonstrated that 74.2% of prescriptions were assessed as noncompliant ones and failed to meet the acceptable clinical quality standard.@*CONCLUSIONS@#At present, the overall quality of RPD prosthetic prescriptions is poor. The responsibilities of clinicians and technicians are unclear, and the communication between them is not ideal.

Research on the clinical diagnostic value of joint test of RBP, CYSC, and urinary ALB/Cr in early diabetes nephropathy / 中华内分泌外科杂志

Objective:To investigate the clinical diagnostic value of joint test of retinol-binding protein (RBP), cystatin C (CYSC) and urinary (albumin/creatinine ratio, ALB/Cr) ALB/Cr in early diabetes nephropathy.Methods:Data of 50 early diabetic nephropathy patients (EDN group) from Jan. 2020 to Jun. 2021 in our hospital, another 50 pure type 2 diabetic patients (T2DM group), and 50 healthy subjects (control group) were compared and analysed. RBP, CYSC and urinary ALB/Cr were tested for the 3 groups. Then the clinical diagnostic value between single index test and joint test for the early diabetes nephropathy were compared.Results:Group EDN had higher RBP, CYSC and urinary ALB/Cr [ (114.66±0.56) mg/L, (2.64±0.33) mg/L, (351.81±15.48) ] mg/g than group T2DM [ (83.58±0.83) mg/L, (1.41±0.29) mg/L, (113.65±12.55) mg/g] and control group[ (38.61±0.66) mg/L, (0.53±0.26) mg/L, (16.36±5.61) mg/g]. The difference was statistically significant ( P<0.05). The specificity and sensitivity of early diabetes nephropathy were 95.38% and 96.21%, both higher than single index test. Conclusion:The combined detection of serum RBP, CYSC and urine ALB/Cr has certain reference value for the clinical diagnosis of early diabetic nephropathy.

miR-139-5p protects septic mice with acute lung injury by inhibiting Toll-like receptor 4/Myeloid differentiation factor 88/Nuclear factor-&mac_kgr; B signaling pathway

OBJECTIVES: To investigate the role of miR-139-5p and the TLR4/MyD88/NF-κB signaling pathway in acute lung injury in septic mice. METHOD: A total of 140 healthy male SPF C57BL/6 mice were divided into seven groups, i.e., Normal, Control, NC, miR-139-5p mimic, miR-139-5p inhibitor, TAK-242, and miR-139-5p inhibitor+TAK-242 groups. The levels of miR-139-5p, proteins related to the TLR4/MyD88/NF-κB signaling pathway (TLR4, MyD88, and p-NF-κB p50), and MPO, SOD, GSH, and MDA in lung tissue were measured. The lung tissue wet-to-dry mass ratio (W/D), arterial oxygen partial pressure (PaO2), and carbon dioxide partial pressure (PaCO2) were measured. RESULTS: A web-based bioinformatic tool predicted that MyD88 was a target of miR-139-5p, which was verified by a dual luciferase reporter assay. Compared with those in the Normal group, the levels of miR-139-5p, PaO2, SOD, and GSH were significantly lower, while those of TLR4, MyD88, p-NF-κB p50, W/D, PaCO2, IL-1β, TNF-α, IL-6, MPO, and MDA were higher in all other groups. Moreover, compared with their levels in the Control group, these indicators exhibited contrasting results in the miR-139-5p mimic and TAK-242 groups, but were similar in the miR-139-5p inhibitor group. In the miR-139-5p inhibitor+TAK-242 group, acute lung injury, aggravated by miR-139-5p inhibitor, was partially rescued by TAK-242. CONCLUSION: miR-139-5p inhibits the TLR4/MyD88/NF-κB signaling pathway to alleviate acute lung injury in septic mice.

Application of polymeric porcelain color-masking cast posts in the aesthetic repair of anterior teeth: a case report / 华西口腔医学杂志

Many patients with large-area tooth defect need cast post-core crown restoration. However, the color defect of the cast post-core will affect the final restorative result, especially that of the anterior teeth. A new technology of color masking by applying CERAMAGE polymeric porcelain to the cast metal post-core surface improves the color of a full-ceramic restoration of anterior teeth and may provide a new alternative for the aesthetic repair of anterior teeth with a large area of defective tooth.

Survival analysis of HIV/AIDS patients with antiretroviral therapy among drug users in Yili Prefecture from 2005 to 2019 / 预防医学

Objective@#To understand the survival status and influencing factors of HIV/AIDS patients with highly active antiretroviral therapy ( HAART ) among drug users in Yili Prefecture, Xinjiang from 2005 to 2019, so as to provide references for reducing AIDS mortality. @*Methods @#The demographic information, clinical stage, baseline CD4+T lymphocyte ( CD4 ) level and treatment status of HIV/AIDS patients with HAART in Yili Prefecture from 2005 to 2019 were collected through AIDS Antiretroviral Therapy Information System. The survival rate was calculated by the life table method. The influencing factors for survival time were analyzed by Cox proportional hazard regression model.@*Results@#Totally 1 935 patients were recruited, the median age receiving HAART was 37 years old and the median CD4 counts was 293/μL. The cumulative survival rates at 1, 5, 7 and 10 years were 97%, 78%, 73%, and 66%, respectively. The multivariate Cox proportional hazards regression analysis showed that the patients with body mass index of 18.5-<28.0 kg/m2 ( HR: 0.391-0.656, 95%CI: 0.234-0.958 ), baseline CD4>200/μL ( HR: 0.354-0.667, 95%CI: 0.232-0.841 ) , or missed medication in the last 7 days ( HR=0.009, 95%CI: 0.001-0.061 ) had lower risk of death; the patients with WHO clinical stage of Ⅱ-Ⅳ ( HR: 1.479-2.311, 95%CI: 1.004-3.288 ) or treatment delay ≥1 years ( HR: 1.287-1.388, 95%CI: 1.029-1.826 ) had higher risk of death. @*Conclusions@#The 5-year cumulative survival rate of HIV/AIDS patients with HAART in Yili Prefecture is 78%. Body mass index, baseline CD4 level, WHO clinical stage, treatment delay and missed medication in last 7 days were the influencing factors for survival time.

The relationship between anti epidemic mentality and post traumatic stress disorder in medical college students during the COVID-19 pandemic / 中国学校卫生

Objective@#To explore the relationship between an anti epidemic mentality and post traumatic stress disorder (PTSD) among college students during the corona virus disease 2019 (COVID-19) pandemic, and to provide a scientific basis for the prevention of PTSD when college students experience sudden crisis events in the future.@*Methods@#An online questionnaire survey was conducted among 9 399 undergraduates from Shanxi Medical University using the Posttraumatic Stress Disorder Checklist Civilian Version (PCL-C) and the public anti epidemic psychology self examination scale.@*Results@#During the COVID-19 pandemic, the total PCL-C scores of college students were (22.74±7.78), and the positive rate of PTSD symptoms was 5.3%. The detection rates of symptom recurrence, avoidance/numbness symptoms and increased alertness symptoms were 27.0%, 16.6% and 8.6 %, respectively. The average score of avoidance/numbness symptoms in the three symptom groups was (9.21±3.39), the two items with the highest scores were repeated recall of traumatic events (1.57±0.71) and impaired concentration (1.47±0.71). Females scored higher than males on the increased alertness dimension(6.82±2.61，6.67±2.72) ( t = -6.49 ， P <0.05). In respect to PCL-C total scores and the scores of each dimension, rural areas were associated with higher scores than urban areas, and non medical students scored higher than medical students, while the scores of those who grew up with siblings were higher than only children ( P <0.05). There was a significant positive correlation between an anti epidemic mentality and total PTSD scores ( r =0.51, P <0.01). Multiple regression analysis showed that the place of origin, choice of college major, and antiepidemic mentality were predictors of PTSD symptoms ( P <0.01).@*Conclusion@#Anti epidemic mentality is associated with the occurrence of PTSD among college students.

Periplaneta americana extract promotes intestinal mucosa repair of ulcerative colitis in rat

Abstract Purpose: To investigate the mechanism of Periplaneta americana extract promoting intestinal mucosal repair of OXZ-induced colitis in rat. Methods: All experiments used an equal number of male and female SD rats (n=48). We injected OXZ into the colon to induce UC rat model. To determine the optimal concentration of P. Americana's extract (PA-40), it was classified into low (L), medium (M), and high (H) doses. After OXZ treatment, each drug was administered by enema for 7 consecutive days. Rats were divided into the following 6 groups: (1) Saline treatment group (NC), (2) OXZ treatment UC model group (MC), (3) OXZ + budesonide group (BUN), (4) OXZ + PA-40 L group, (5) OXZ + PA-40 M group, (6) OXZ + PA-40 H group. Disease activity index (DAI) scores, colon length, histopathological score, serum cytokine level (IL-4, IL-10, iNOS, tNOS), and amount of MPO, EGF, IL-13 in colonic mucosa were measured. Results: PA treatment had a significant healing effect on the OXZ-colitis model and significantly reduced the lesioned area, especially in the PA-40H groups. PA treatment did not alter the expression of IL-10 and MPO level, but increased EGF (epidermal growth factor) and decrease IL-13 in the colonic tissue. PA inhibited the rise of NOSs (nitric oxide synthase) and decreased the serum IL-4 level. Conclusions: The data suggest that Periplaneta americana extract may be a potential compound for the treatment of colonic lesions. The mechanism may be related to inhibiting the secretion of IL-13 and promoting the formation of EGF.

Biological function of exosomes secreted by heat-stroke hepatocytes and induced liver damage / 解放军医学杂志

Objective To explore the biological function of exosomes secrected by heat-stroke hepatocytes and its effect on liver injury. Methods Exosomes were isolated from donor HepG2 hepatocytes and control hepatocytes by ultra-high-speed centrifugation. The morphology of exosomes was observed by transmission electron microscopy, the diameter of distribution was detected by nano-tracking technology and the expression of characteristic surface markers CD9, CD63 and CD81 were examined by Western blotting. The isobaric tags for relative and absolute quantification methods were applied to analyze the difference in protein composition between the control and HS hepatocyte derived exosomes. Biological information analysis on the differential protein set was performed by the Kyoto Encyclopedia of Genes and Genomes pathway analysis. Recipient hepatocytes were stimulated with sterilized PBS, control hepatocyte exosomes or HS exosomes (10 μg for 24 h), or directly exposed to HS or pretreated with exosome production inhibitor GW4869 2 h before HS. Supernatant alanine aminotransferase (ALT)/aspartate aminotransferase (AST)/lactic dehydrogenase (LDH) levels tested for evaluation of the hepatocyte damage. C57/BL6 mice were injected with sterilized PBS, control hepatocyte exosomes or HS exosomes (40 μg/per mice) through the tail vein, or treated with HS or intraperitoneally injected with GW4869 2 h before HS and sacrificed 9 h thereafter. Plasma ALT/AST/LDH level was examined to assess liver tissue damage. Results The microparticles secreted by hepatocytes are round or elliptical structures with a double-layer membrane coating, with a diameter ranging from 90–150 nm and highly expressed CD9, CD63 and CD81, suggesting the consistence to exosomes. The number of exosomes released by HS hepatocytes was significantly elevated than that in the control group [(8.46±1.38)×109/ml vs. (0.66±0.16)×109/ml, t=5.605, P=0.005]. HS significantly altered the protein expression profile of hepatocyte exosomes, and the enriched proteins were involved in necroptosis, PI3K-Akt signaling, antigen processing and presentation, apoptosis and NOD-like receptor signaling pathways. The supernatant level of ALT/AST/LDH of the recipients' hepatocytes in the HS exosomes-treated group was significantly increased, whereas that in the HS+GW4869 pretreatment group was significantly lower than that in the HS group. The serum ALT/AST/LDH level of the HS exosomes infusion group was significantly enhanced, and that of the pre-HS GW4869 treatment group was significantly reduced than that of the HS group. Conclusion HS may induce the release of exosomes from hepatocytes, which may lead to the changes in the protein profile of exosomes and affect the induction of acute liver injury.

A technique to design the framework of removable partial denture by multi-stage expert system / 华西口腔医学杂志

This study aims to apply a new expert system to design removable partial denture (RPD) framework. The RPD design is completed in three steps, namely, "selecting missing teeth", "selecting abutment condition", and "selecting personalized clasp". The system can help auxiliary dentists develop personalized treatment plans to reduce their clinical workload. It can also generate a dental preparation guideline for clinical preparation, which can prevent tooth preparation mistakes. By generating the standard electronic drawings of the framework design, the system can reduce the inconvenience caused by manual drawing, thereby facilitating dentist-technician communication and reducing the rate of remade.

Clinicopathologic study of adenosarcoma with sarcomatous overgrowth of the uterine / 临床与实验病理学杂志

Purpose To investigate the clinicopathologic characteristtics, immunophenotype and differential diagnosis of uterine adenosarcoma with sarcomatous overgrowth. Metheds The clinicopathological data of 4 cases of uterine adenosarcoma with sarcomatous overgrowth were collected, the histopathologic and immunohistochemical features were investigated, and the rele-vant literatures were also reviewed. Results All of tumors were arised from the endometrium with complains of postmenopausal vaginal bleeding or prolonged menstrual period. There is a poly-poid nodular in the uterine cavity with a pedicle or no pedicel, or rough endometrium. On the cut surface, the tumor was fish-like without distinct from the surrounding tissue. Light microsco-py show the tumors were composed of benign glands and malignant mesenchymal components, the sarcomatouscomponents ac-counted for over 25％. In 4 cases, 2 cases had heterologous com-ponent of rhabdomyosarcoma. The component of sarcomatous were positive for vimentin and CD10. The heterologous component of rhabdomyosarcoma were positive for desmin, MyoDl, and Myogenin.3 cases were died at in 5, 10, and 19 months after operation, 1 patient was disease free survival for 3 months. Conclusion Uterine adenosarcoma with sarcomatous overgrowth has a bad prognosis.

Sinonasal mammary analogue secretory carcinoma: a clinicopathological analysis of 2 cases / 临床与实验病理学杂志

Purpose To investigate the clinicopathological features of sinonasal primary secretory carcinoma (SC) and its diagnosis, differential diagnosis. Methods Two cases of sin-nasal SC were analyzed by light microscopy with immunohisto-chemical staining (EnVision) for CK, vimentin, S-100 protein, SOX10, PAS, DPAS, Mamaglobin, Calponin, DOG1, p63 and molecular detection of ETV6 gene break. Results Morphologically, SC revealed varying proportions of solid, tubular, acinar, microcystic, tubular growth patterns. All SC cases were cytological low grade with uniform cells, small-to medium-sizes nuclei, occasional small nucleoli, and abundant pink, bubbly cytoplasm. Mitotic figures were rarely encountered. Tumor cells secreted eosinophilic, colloid-like secretions that were PAS positive. There were no DPAS positive zymogen granules in cyto-plasm. This tumor cells were CK, vimentin, S-100, SOX10, PAS positive and Mamaglobin, Calponin and p63 negative. The ETV6 gene rearrangement was confirmed in all cases by fluorescence in situ hybridization (FISH). After excision, all two patients were survival without tumor recurrence for 41 months and53 months. Conclusion Sinonasal primary SC is a low grade malignant tumor. The histological features of SC are overlap with other salivary gland tumors. Immunohistochemical analysis and FISH are useful for the diagnosis and differential diagnosis.

Chinese Pediatric Reference Intervals for Serum Cortisol on IMMULITE 2000

Clinical interpretation of the test results for cortisol based on continuous reference intervals with appropriate partitions improves pediatric diagnosis; however, these values are available only for Caucasians. To develop the pediatric reference intervals for Chinese population, we examined the serum cortisol levels in 1,143 healthy Chinese children aged 4–18 years (566 boys and 577 girls), using an IMMULITE 2000 Immunoassay System (Siemens Healthcare GmbH). Phlebotomy was performed at 7–9 a.m. for 284 boys and 287 girls and at 1–3 p.m. for the others. They were divided into four age groups according to the Clinical and Laboratory Standards Institute guideline EP28-A3c, with the last group further stratified according to sampling time. Separate reference intervals of 49.6–323.7, 70.9–395.3, and 90.1–448.7 nmol/L were established for children aged 4–8, 9–12, and 13–15 years, respectively. Further, reference intervals of 118.2–464.7 and 71.4–446.7 nmol/L were established for morning and afternoon cortisol levels, respectively, in children aged 16–18 years. Further studies are necessary to transfer and validate these reference intervals in other analytical systems and pediatric populations, and to allow for broader applications.

Analysis on current situation and the stakeholder's attitude of PBM pilot in China :A case in Wuhu city of Anhui province / 中国卫生政策研究

Objective:To understand the present situation, operation mode, stakeholder's attitude, preliminary results and problems in Pharmacy Benefit Management (PBM) from pilot areas in China, and put forward corresponding suggestions. Methods :In this paper, we carried out an analysis of introduced PBM model after reviewing the existing literature, conducting interviews with key person in the pilot areas and process observation. Moreover, we combined all of the methods and techniques with quantitative analysis in order to find promising results. Results :We constructed a PBM model based on the information provided by the analysis mainly carried out in the piloting community health service centers. After launching the model, the number of drugs increased, the number of outpatients doubled, and the program was widely praised by the patients who joined it. To a certain extent, with the introduction of PBM model, patients with chronic diseases returned to the grassroots level and promoted the development of basic public health services. On the contrast, stakeholders showed different attitudes towards the program, and this inconsistency greatly affected its development through many factors. PBM promoted the management of chronic diseases and tiered care system in pilot areas, but some problems are still there. Conclusions :To a certain limit, PBM can improve the accessibility of drugs in primary health service centers and promote the management of chronic disease and separation of clinics from pharmacies. With the gradual elimination of drug-supporting medical system and the deepening of health insurance reform, PBM may play its positive role in improving service quality and controlling medical expenses. However, its long-term effect requires more follow-up studies,

Protective role of brain CYP2J in diverse Parkinson disease animal models / 中国药理学与毒理学杂志

OBJECTIVE CYP2 family including CYP2C and CYP2J is the predominant arachidonic acid (AA) epoxygenase, and the epoxidation of AA produces four regioisomeric cis-epoxyeicosatrienoic acids (5,6-, 8,9-, 11,12-, and 14,15-EET). Human CYP2J2 is one of the main CYP isoforms expressed in brain, but CYP2C8 was present at a low level. The aim of this study is to investigate the roles of brain CYP2J in Parkinson disease. METHODS Rats received the right-unilaterally injection with concentrated LV-CYP2J3 or LV-EGFP in the substantia nigra (SN) at 3 d before LPS or 6-OHDA treatment. The animals were tested for rotational behavior with the dopaminergic agonist apomorphine dissolved in sterile saline at 14 and 21 d after LPS injection. The influence of CYP2J-dependent derivative, 14,15-EET, on the genes related with oxidative stress was assayed in SH-SY5Y cells. RESULTS CYP2J overexpression or 14,15-EET treatment significantly increased the levels of SOD1, CAT, GPX1, NRF2 and KEAP1 in neurons. TLR4- MyD88 signaling pathway was involved the down- regulation of CYP2J by LPS. The binding of p-CREB with the promoter of CYP2J was inhibited by the LPS treatment. The loss of dopami?nergic neurons in the right SN induced by LPS or 6- OHDA was significantly decreased by CYP2J3 transfection at 21 d after LPS injection. Compared with LPS or 6-OHDA group, the number of the rotation of rats was decreased by 42.6% and 60.7% by CYP2J3 transfection at 14 d after LPS or 6-OHDA injection;meanwhile, the rotation number was decreased by 12.7% and 21.3% at 21 d. The accumulation of alpha synuclein induced by LPS was significantly decreased by CYP2J3 transfection. The mRNA levels of SOD1, CAT, GPX1, NRF2 and KEAP1 in SN were decreased by LPS, which was attenuated by the injection of LV-CYP2J3. CONCLUSION Brain CYP2J can play a protective role in the damage of the inflammation and oxidative stress to the dopaminergic neurons. Brain CYP2J- dependent derivatives from AA may have therapeutic effects in Parkinson disease via the up- regulation of the antioxidant system in neurons.

Clinical Application Value of Chitinase-3-like Protein 1 in Patients with Different Liver Diseases / 现代检验医学杂志

Objctive To explore the clinical value of Chitinase-3-like protein 1(CHI3L1)in patients with chronic hepatitis B (CHB),liver cirrhosis and liver cancer.Methods 96 clinically diagnosed patients in Department of Infectious Diseases Hos-pital of Anhui Provincial Hospital from Jan 2016 to Feb 2017(28CHB,44livercirrhosis,24liver cancer,15healthy controls) were analyzed.The serum level of CHI3L1 was measured by enzyme-linked immunosorbentassay(ELISA).The Golgi pro-tein(GP73)was tested by double-antibody sandwich immunochromatographic assay.The Alpha-fetoprotein(AFP)was tested by means of chemical luminescence.Results There were significant differences between the groups of chronic hepati-tis B(CHB),liver cirrhosis,liver cancer and healthy controls on the CHI3L1 level(χ2=70.249,P<0.001).The CHI3L1 level of the liver cirrhosis group and the liver cancer group increased significantly compared with that of the healthy controls (P<0.001).The GP73 levels of these groups were significantly different(χ2=44.963,P<0.001).The GP73 levels of the CHB group,the liver cirrhosis group and the liver cancer group all increased significantly compared with that of the healthy controls(P<0.05).The AFP levels of these groups were significantly different(χ2=57.606,P<0.001).The AFP level of the liver cancer group increased significantly compared with that of the CHB group,the liver cirrhosis group and the healthy controls(P<0.001).Based on the receiver operating characteristic(ROC)curve of CHI3L1,GP73 and AFP in the CHB group and the liver cirrhosisgroup,the Area Under roc Curve(AUC)of CHI3L1 was 0.953(95%CI:0.902~1.000),the sensitivity was 88.6%,and the specificity was 92.9%,which was higher than GP73 and AFP.Based on the ROC curve of CHI3L1,GP73 and AFP in the liver cirrhosis group and the liver cancer group,the AUC of AFP was 0.930(95% CI:0.871~0.989),the sensitivity was 75.0%,and the specificity was 97.7%,which was higher than CHI3L1 and GP73.The corre-lation between the CHI3L1,GP73 and AFP in CHB,liver cirrhosis and liver cancer groups were analyzed.There was a posi-tive correlation between AFP and GP73(rs=0.491,P<0.001),a positive correlation between AFP and CHI3L1(rs=0.452,P<0.001),a positive correlation between GP73 and CHI3L1(rs=0.554,P<0.001).Conclusion CHI3L1 is good at diagnosis of liver cirrhosism,better than GP73 and AFP.And AFP could be more beneficial in patients with liver cancer, better than CHI3L1 and GP73.

Study on the outcome differences of the payment policy"fix out of pocket"under the back-ground of separation between revenue and expenditure / 中国卫生政策研究

Objective:This study aimed to evaluate the impacts of the separation between revenue and expendi-ture on the outcome of the payment policy"fix out of pocket". Methods: Using descriptive analysis, difference in difference(DID) model based on data from Wanning county where the new policy has been carried out,Ledong coun-ty where has not,including claim data and hospital utilization data from Nov 2010 to Oct 2014. We also supplemen-ted and interpreted the results of quantitative analysis combined with qualitative data from the interview recording ma-terial;Results:As for the two most common hospitalized diseases(hypertension and pneumonia),the number of in-patient visits in primary medical institutions didn't change respectively. From DID model, the policy only increased out of pocket(OOP) in Wanning by 11% and 28% and decreased average medical expense in Qionghai by 66% and 67% respectively. Conclusion:The separation between revenue and expenditure make the"fix out of pocket"pay-ment policy have better performance on the control of medical expense.

Contralateral C7 Nerve Root Transfer for Function Recovery in Adults: A Meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Root avulsion to all 5 roots of the brachial plexus is a common presentation and keeps a major reconstructive challenge. The contralateral C7 (CC7) nerve transfer has been used in treating brachial plexus avulsion injury (BPAI) since 1986. However, the effectiveness of the procedure remains a subject of controversy. The aim of this meta-analysis was to study surgical outcomes regarding motor and sensory recovery after CC7 nerve transfer.</p><p><b>METHODS</b>Chinese or English (i.e., "contralateral c-7", "contralateral c7", "c7 nerve root", and "seventh cervical nerve root") keywords were used for a literature search for articles related to CC7 nerve transfer in several databases (i.e., PubMed, Cochrane, Embase, CNKI, CQVIP, and Wanfang Data). Clinical research articles were screened, and animal studies as well as duplicate publications were excluded. Muscle strength and sensory recovery were considered to be effective only when the scores on the United Kingdom Medical Research Council scale were equal to or higher than M3 and S3, respectively.</p><p><b>RESULTS</b>The overall ipsilateral recipient nerve recovery rates were as follows: the efficiency rate for muscle strength recovery after CC7 nerve transfer was 0.57 (95% confidence interval [CI]: 0.48-0.66) and for sensory recovery was 0.52 (95% CI: 0.46-0.58). When the recipient nerve was the median nerve, the efficiency rate for muscle strength recovery was 0.50 (95% CI: 0.39-0.61) and for sensory was 0.56 (95% CI: 0.50-0.63). When the recipient nerve was the musculocutaneous nerve and the radial nerve, the efficiency rate for muscle strength recovery was 0.74 (95% CI: 0.65-0.82) and 0.50 (95% CI: 0.31-0.70), respectively.</p><p><b>CONCLUSIONS</b>Transfer of CC7 nerves to musculocutaneous nerves leads to the best results. CC7 is a reliable donor nerve, which can be safely used for upper limb function reconstruction, especially for entirely BPAI. When modifying procedures, musculocutaneous nerves and median nerve can be combined as recipient nerves.</p>