Statistical process control methods for quality inspection of blood component samples: a case study / 中国输血杂志

【Objective】 To explore the analytical methods for detecting data in the process of quality inspection of blood component samples. 【Methods】 The quality inspection data of blood component samples from 2018 to 2022 in our center were collected. Based on the principles of statistical process control, control charts were created using Minitab software to analyze key test items. 【Results】 The P control chart was used to analyze the pass rate of platelet content and revealed one out-of-control point. The normality test was performed on plasma protein content to analyze the causes of data fluctuations for further improvement. The mean and range control chart was utilized for hematocrit measurement, with abnormal data trends detected. Further analysis of the normality test and process capability analysis was conducted, resulting in a Cpk value of 0.67. 【Conclusion】 By applying statistical process control methods, the study employed P control charts to analyze count data in the quality inspection of blood component samples, conducted normality tests for measurement data, and utilized mean and range control charts to identify abnormal data trends. For data conforming to a normal distribution, the process capability index (Cpk) was calculated to explore effective monitoring methods for ensuring stability in the blood supply process.

Pharmacodynamic evaluation of Polygonum capitatum nanofiber functional dressing / 中国药房

OBJECTIVE To evaluate the efficacy of the functional dressing of Polygonum capitatum nanofibers （P-PVP-PCL）. METHODS P-PVP-PCL were prepared by electrospinning technology， and the microstructure of P-PVP-PCL was observed. The antibacterial activity and antioxidant activity of P-PVP-PCL and its effects on the survival rate， adhesion and migration rate of mouse fibroblast L929 cells were investigated. The effects of medical gauze dressing， blank nanofiber dressing （PVP-PCL） and P- PVP-PCL on the healing rate of the wound were investigated by establishing the back skin wound model of rats. The pathological changes of the wound tissue and collagen fiber deposition were observed， as well as the number of platelet endothelial cell adhesion molecule-1 （CD31） positive blood vessels and the expression of transforming growth factor-β （TGF-β） protein in wound tissue. RESULTS P-PVP-PCL had a smooth surface and a double-layer structure at the cross-section. The inhibition rates of P-PVP-PCL against Staphylococcus aureus and Escherichia coli were （98.88±0.66）% and （94.75±1.41）% ， respectively. The antioxidant activity of P-PVP-PCL was （83.69±1.56）%， and the cell activity of the P-PVP-PCL group was significantly higher than those of the control group and PVP-PCL group （P＜0.05）. Compared with medical gauze dressings， P-PVP-PCL was more conducive to L929 cell adhesion； at 48 hours， the cell scratches in this group had basically healed. Compared with the medical gauze dressing group， the wound healing rates of the PVP-PCL group and the P-PVP-PCL group were significantly increased （P＜0.05）. On the 14th day of intervention， the wounds in the P-PVP-PCL group had basically healed， there was no dermal necrosis in the wound tissue， and the collagen fibers were arranged relatively neatly and the density was relatively uniform. The number of CD31 positive blood vessels and the expression of TGF-β protein showed a downward trend compared with the 7th day of intervention， and the number of CD31 positive blood vessels was significantly lower than those of the medical gauze dressing group and PVP-PCL group （P＜0.05）， but the protein expression of TGF- β was significantly higher than those of the medical gauze dressing group and the PVP-PCL group （P＜0.05）. CONCLUSIONS P-PVP-PCL has good antibacterial and antioxidant activity in E-mail：444096585@qq.com vitro， and can promote the proliferation， adhesion and migration of L929 cells. It can promote wound healing of rats in vivo.

Construction and validation of a prognostic model for colon cancer based on inflammatory response-related genes / 肿瘤研究与临床

Objective:To screen the differentially expressed genes (DEG) related to inflammatory response associated with the prognosis of colon cancer based on the bioinformatics approach, and to construct and validate a prognostic model for colon cancer.Methods:RNA sequencing and clinical data of 472 colon cancer patients and normal colon tissues of 41 healthy people were retrieved from the Cancer Genome Atlas (TCGA) database. Gene expression related to prognosis of colon cancer and clinical data were retrieved from the International Cancer Genome Consortium (ICGC) database. The retrieval time was all from the establishment of library to November 2022. A total of 200 genes associated with inflammatory response obtained from the Gene Set Enrichment Analysis (GSEA) database were compared with the RNA sequencing gene dataset of colon cancer and normal colon tissues obtained from the TCGA database, and then DEG associated with inflammatory response were obtained. The prognosis-related DEG in the TCGA database were analyzed by using Cox proportional risk model, and the inflammatory response-related DEG were intersected with the prognosis-related DEG to obtain the prognosis-related inflammatory response-related DEG. The prognostic model of colon cancer was constructed by using LASSO Cox regression. Risk scores were calculated, and colon cancer patients in the TCGA database were divided into two groups of low risk (< the median value) and high risk (≥the median value) according to the median value of risk scores. Principal component analysis (PCA) was performed on patients in both groups, and survival analysis was performed by using Kaplan-Meier method. The efficacy of risk score in predicting the overall survival (OS) of colon cancer patients in the TCGA database was analyzed based on the R software timeROC program package. Clinical data from the ICGC database were applied to externally validate the constructed prognostic model, and patients with colon cancer in the ICGC database were classified into high and low risk groups based on the median risk score of patients with colon cancer in the TCGA database. By using R software, single-sample gene set enrichment analysis (ssGESA), immunophenotyping difference analysis, immune microenvironment correlation analysis, and immune checkpoint gene difference analysis of immune cells and immune function were performed for prognosis-related inflammation response-related DEG in the TCGA database.Results:A total of 60 inflammatory response-related DEG and 12 prognosis-related DEG were obtained; and 6 prognosis-related inflammatory response-related DEG (CCL24, GP1BA, SLC4A4, SRI, SPHK1, TIMP1) were obtained by taking the intersection set. LASSO Cox regression analysis showed that a prognostic model for colon cancer was constructed based on 6 prognosis-related inflammatory response-related DEG, and the risk score was calculated as = -0.113×CCL24+0.568×GP1BA+ (-0.375)×SLC4A4+(-0.051)×SRI+0.287×SPHK1+0.345×TIMP1. PCA results showed that patients with colon cancer could be better classified into 2 clusters. The OS in the high-risk group was worse than that in the low-risk group in the TCGA database ( P < 0.001); the area of the curve (AUC) of the prognostic risk score for predicting the OS rates of 1-year, 3-year, 5-year was 0.701, 0.685, and 0.675, respectively. The OS of the low-risk group was better than that of the high-risk group in the ICGC database; AUC of the prognostic risk score for predicting the OS rates of 1-year, 2-year, 3-year was 0.760, 0.788, and 0.743, respectively. ssGSEA analysis showed that the level of immune cell infiltration in the high-risk group in the TCGA database was high, especially the scores of activated dendritic cells, macrophages, neutrophils, plasmacytoid dendritic cells, T helper cells, and follicular helper T cells in the high-risk group were higher than those in the low-risk group, while the score of helper T cells 2 (Th2) in the high-risk group was lower compared with that in the low-risk group (all P < 0.05); in terms of immune function, the high-risk group had higher scores of antigen-presenting cell (APC) co-inhibition, APC co-stimulation, immune checkpoint, human leukocyte antigen (HLA), promotion of inflammation, parainflammation, T-cell stimulation, type Ⅰ interferon (IFN) response, and type ⅡIFN response scores compared with those in the low-risk group (all P < 0.05). The results of immunophenotyping analysis showed that IFN-γ-dominant type (C2) had the highest inflammatory response score, and the differences were statistically significant when compared with trauma healing type (C1) and inflammatory response type (C3), respectively (all P < 0.05). Immune microenvironment stromal cells and immune cells were all positively correlated with prognostic risk scores ( r values were 0.35 and 0.21, respectively, both P < 0.01). The results of immune checkpoint difference analysis showed there was a statistically significant difference in programmed-death receptor ligand 1 (PD-L1) expression level between high-risk group and low-risk group ( P = 0.002), and PD-L1 expression level was positively correlated with prognostic risk score ( r = 0.23, P < 0.01). Conclusions:Inflammatory response-related genes may play an important role in tumor immunity of colon cancer and can be used in the prognostic analysis and immunotherapy of colon cancer patients.

Changes of thyroid hormone level in type 1 diabetic children complicated with ketoacidosis / 中华全科医师杂志

Objective:To investigate the changes of thyroid hormone level in children with type 1 diabetic mellitus (T1DM) complicated with ketoacidosis.Methods:Sixty-seven children with acute T1DM and ketoacidosis admitted in Department of Endocrinology, Shanxi Children′s Hospital from December 2017 to December 2020 were enrolled as acidosis group; and 44 T1DM children without ketoacidosis at admission served as control group. According to blood gas analysis, in acidosis patients there were 22 cases in mild group (pH<7.3), 16 cases in moderate group (pH<7.2) and 29 cases in severe group (pH<7.1). Serum levels of triiodothyronine (T 3), thyroxine (T 4), free T 3(FT 3), free T 4(FT 4), thyroid stimulating hormone (TSH) were measured in all patients at admission and recovery, retrospectively. Patients in the acidosis group at acute stage were treated with balanced fluid infusion, insulin infusion and eritone. Results:The serum levels of T 3 [0.48(0.19, 0.67)nmol/L vs. 0.97(0.74, 1.18)nmol/L, Z=-5.97, P<0.001], T 4 [(49.99±26.06) nmol/L vs. (73.48±23.32)nmol/L, t=4.68, P<0.001], FT 3 [1.80(1.24, 2.51) pmol/L vs. 3.31(2.56, 3.98) pmol/L, Z=-6.15, P<0.001], FT 4 [9.74 (7.21, 12.85)pmol/L vs. 14.54 (11.29, 16.75)pmol/L, Z=-5.23, P<0.001] and TSH [0.86(0.31, 1.81) mIU/L vs. 1.92(1.01, 3.56)mIU/L, Z=-4.19, P<0.001] in acidosis group at acute stage were significantly lower than those in the control group. In acidosis group at recovery stage serum levels of T 3 [1.58 (1.25, 1.86)nmol/L], T 4 [(92.52±27.03) nmol/L], FT 3 [5.03(4.15, 5.78) pmol/L], FT 4 [15.94 (14.40, 18.38)pmol/L], and TSH [2.21(1.58, 3.16)mIU/L] were significantly higher than those at acute stage ( Z=-6.96, t=-11.34, Z=-7.00, Z=-6.39, Z=-5.28,all P<0.001). There was an decreasing trend of T 3 and FT 3 levels from mild group [0.60 (0.47, 0.78)nmol/L, 2.20(1.47, 2.89) pmol/L], moderate group [0.36(0.18, 0.64)nmol/L, 1.90(1.11, 2.31)pmol/L] to severe acidosis group [0.35(0.16, 0.54) nmol/L, 1.48(1.08, 1.89)pmol/L](T 3: Z=-3.44, P=0.001; Z=-3.97, P<0.001; Z=-5.63, P<0.001;FT 3: Z=-3.44, P=0.001; Z=-4.13, P<0.001; Z=-5.86, P<0.001). Compared to control group serum T 4 and FT 4 levels in moderate group [(47.34±29.89)nmol/L and 9.75(5.74,12.29)pmol/L] and severe group [(44.08±22.27)nmol/L and 8.82 (6.40, 9.89)pmol/L] were significantly decreased (T 4: t=3.66, t=5.01,all P<0.001; FT 4: Z=-3.40, P=0.001; Z=-5.73, P<0.001). The TSH level in severe acidosis group [0.63 (0.27, 1.33)mIU/L] was lower than that in the control group ( Z=-4.23, P<0.001). At the recovery stage the serum levels of T 3 [1.69 (1.22, 1.87)nmol/L,1.68 (1.24, 1.84)nmol/L,1.55(1.25, 1.86) nmol/L], FT 3 [5.27 (4.37, 5.76)pmol/L,4.32(4.17, 5.73)pmol/L,5.04(3.81, 5.79)pmol/L], T 4 [(87.41±18.40)nmol/L,(90.02±30.41)nmol/L,(97.34±30.10)nmol/L] and FT 4 [16.05(14.23, 17.71) pmol/L,15.26(14.40, 16.11)pmol/L,16.88(13.98, 18.89) pmol/L] in the mild, moderate and severe acidosis groups were higher than those in the control group (T 3: Z=-4.55, Z=-3.87, Z=-4.93,all P<0.001;FT 3: Z=-4.72, Z=-3.72, Z=-4.52,all P<0.001;T 4: t=-2.01, P=0.047; t=-2.15, P=0.034; t=-3.88, P<0.001;FT 4: Z=-2.21, P=0.027; Z=-0.84, P=0.399; Z=-2.67, P=0.008); while there was no significant difference in TSH levels [2.28(1.88, 3.16)mIU/L, 2.19(1.26, 3.57) mIU/L, 2.18(1.36, 3.09) mIU/L] between mild, moderate, severe acidosis groups and the control group (all P>0.05). Conclusions:Thyroid function in T1DM children complicated with ketoacidosis is decreased significantly with the aggravation of acidosis. After correction of ketoacidosis, the level of thyroid function can basically return to normal.

Mental health status of middle school students from single parent families in urban area of Lishui City / 中国学校卫生

Objective@#To investigate mental health status and associated factors among middle school students from single parent families in urban Lishui, and to provide reference for mental health education for adolescents from single parent families.@*Methods@#In the urban area of Lishui City, a total of 160 middle school students from single parent families in four middle schools were selected by stratified random sampling, among 160 middle school students from two parent families were selected matched for class, gender, age and family background, and Mental Health Diagnostic Test Scale (MHT) was used for testing.@*Results@#In terms of allergy tendency, physical symptoms, phobic tendency and total anxiety detection, middle school students from single parent families were higher than those from two parent families, and the differences were statistically significant ( χ 2=5.70, 5.34, 6.84, 4.30, P <0.05). Among the 160 middle school students from single parent families, the detection rate of girls in learning anxiety, anxiety towards others, self blame tendency, allergic tendency, physical symptoms, terror tendency, impulsive tendency and total anxiety were higher than that of boys, and the differences were statistically significant. ( χ 2=12.26, 4.61, 7.34, 14.96, 20.53, 10.05, 16.19 , 9.39, P <0.05). Multivariate Logistic regression analysis showed that gender was positively associated with mental health of middle school students in singleparent families ( OR=4.25, 95%CI=1.87-7.02, P <0.05).@*Conclusion@#There are a higher prevalence of psychological problems among middle school students from single parent families in Lishui city, especially among girls, which warrents further psychosocial services including mental health education.

Application of artificial intelligence in the target delineation of radiotherapy / 国际肿瘤学杂志

Artificial intelligence is the use of computer algorithms to copy or simulate human behavior, giving machines human-like ability. With the rapid development of radiotherapy technology, artificial intelligence has great potential value in all stages of radiotherapy. Image segmentation is the premise of target delineation using artificial intelligence. The commonly used methods in clinic mainly include automatic segmentation based on deep learning and atlas library. The technology of artificial intelligence in organs at risk delineation is relatively mature, which can significantly shorten the delineation time and improve the efficiency. The delineation of tumor targets has achieved some success, the accuracy still needs to be further improved. Artificial intelligence technology makes the target delineation more and more efficient, and the consistency and repeatability have been significantly improved. It is expected to provide more accurate and individualized treatment for patients.

Preliminary evidence for the presence of multiple forms of cell death in diabetes cardiomyopathy

Diabetic mellitus (DM) is a common degenerative chronic metabolic disease often accompanied by severe cardiovascular complications (DCCs) as major causes of death in diabetic patients with diabetic cardiomyopathy (DCM) as the most common DCC. The metabolic disturbance in DCM generates the conditions/substrates and inducers/triggers and activates the signaling molecules and death executioners leading to cardiomyocyte death which accelerates the development of DCM and the degeneration of DCM to heart failure. Various forms of programmed active cell death including apoptosis, pyroptosis, autophagic cell death, autosis, necroptosis, ferroptosis and entosis have been identified and characterized in many types of cardiac disease. Evidence has also been obtained for the presence of multiple forms of cell death in DCM. Most importantly, published animal experiments have demonstrated that suppression of cardiomyocyte death of any forms yields tremendous protective effects on DCM. Herein, we provide the most updated data on the subject of cell death in DCM, critical analysis of published results focusing on the pathophysiological roles of cell death, and pertinent perspectives of future studies.

Input-output efficiency analysis for children′s diagnosis and treatment service at 27 community health service centers in China / 中华医院管理杂志

Objective:To provide strategic suggestions for optimizing children′s diagnosis and treatment services in the communities, by means of analyzing the overall efficiency of children′s diagnosis and treatment services in the sample community health service centers, and learning the current input and output of children′s diagnosis and treatment resources.Methods:In April 2020, a total of 27 community health service centers in 14 cities were selected by random sampling. Data such as the number of medical visits by children aged 0 to 18 years and the area of pediatric diagnosis and treatment departments in the sample centers in 2019 were collected by self-filling questionnaires. Excel was used for data sorting. Data envelopment analysis(DEA) was used for data processing. The data processing tool was DEAP 2.1.Results:The average comprehensive efficiency, the average technical efficiency and the average scale efficiency of the 27 sample community health service centers were 0.445, 0.865 and 0.494 respectively. There were five DEA efficient centers, 4 DEA weak inefficiency centers and 18 inefficient centers. Six out of 18 DEA inefficient centers had redundant input of healthcare professionals capable pediatrics; 12 centers were short of children visits, and 15 were short of visits by children aged 0-6 years.The centers where DEA was inefficient were concentrated in the central region, the suburbs and " centers with independent pediatric clinics but without pediatric wards" .Conclusions:The comprehensive efficiency of children′s diagnosis and treatment services in the sample community health service centers is relatively low. Currently, the sample community health service centers are faced with such problems as small and insufficient input of children′s diagnosis and treatment resources in the community, unbalanced development of children′s diagnosis and treatment services in the region among others. It is suggested that on the basis of making full use of the existing resources to create the maximum output value, we should consider appropriately expanding the scale of resource input to improve the efficiency of children′s diagnosis and treatment services at the primary level and further give play to the value of the " gatekeepers" at the primary level in children′s diagnosis and treatment.

Clinical research progress of PET imaging in tumor hypoxia / 中华核医学与分子影像杂志

Hypoxia is a common phenomenon of solid tumor, which is closely related to the malignant proliferation, tumor progression, radiotherapy and chemotherapy resistance, treatment failure, and poor prognosis. At present, many researches focus on the application of medical imaging and nuclear medicine methods in detecting the hypoxic areas of tumors. This article focuses on the detection of hypoxia microenvironment and the application of PET tracers in tumor hypoxia imaging.

Free carnitine levels in peripheral blood of healthy pregnant women in third trimester and their relationship with maternal and fetal cardiac function and structure / 中华围产医学杂志

Objective:To investigate the levels of periphreal blood free carnitine and amino acids in healthy pregnant women in the third trimester and their association with maternal, fetal, and neonatal cardiac function and structure.Methods:This prospective descriptive study included healthy singleton pregnancies who underwent routine obstetric examination and delivered in two district maternal and child health hospitals (one in the urban and one in the suburb an area) in Beijing from June 2017 to February 2018. All recruiters had serology Down's syndrome screening test at (18±1) gestational weeks. Besides measurement of amino acids and free carnitine levels in whole blood and urine samples by liquid chromatography-tandem mass spectrometry, all cases underwent maternal and fetal echocardiography at (35±1) weeks of gestation. And neonatal echocardiography was performed after delivery to assess the heart function and structure. Antenatal factors were also collected, including maternal education background, age at first marriage and conception, gravidity, and folic acid supplement in early pregnancy. Statistical analysis was performed using t-test, ANOVA, Chi-square test, Pearson correlation coefficient, and Kappa test. Results:A total of 493 mother-neonate dyads were enrolled in this study. Blood free carnitine levels in the healthy pregnant women in the third trimester ranged from 5.09 to 59.17 μmol/L (reference value: 10.00-50.00 μmol/L) with an average value of (13.03±3.87) μmol/L. None was found with structural abnormalities by cardiac ultrasound, showing an average left ventricular end diastolic diameter (LVEDD) and end systolic diameter (LVESD) of (45.70±3.08) mm and (29.17±3.12) mm, respectively, and left ventricular ejection fraction (LVEF) of all cases were over 55%. No cardiac malformation was detected by the third-trimester fetal echocardiography. The average birth weight of the 493 newborns was (3 340±313) g. Those whose birth weight <2 500 g and >4 000 g were accounted for 1.0% (5 cases) and 3.0% (15 cases) with the average maternal blood free carnitine level of (13.25±2.17) μmol/L (10.46-19.21 μmol/L) and (12.64±2.50) μmol/L (8.78-17.73 μmol/L) ( t=0.42, P>0.05). The average LVEDD and LVESD of the 493 newborns were (17.21±1.27) mm and (11.03±1.30) mm, respectively. For the 64 newborns (13.0%) whose LVEF<60%, the maternal blood free carnitine level was (12.93±2.78) μmol/L (7.34-22.13 μmol/L), showing no statistical difference ( t=-0.29, P>0.05) with those 59 neonates (12.0%) whose LVEF over 75% and maternal carnitine level of (13.09±3.24) μmol/L (8.66-27.49 μmol/L). All cases were divided into four groups based on the quartiles of maternal blood free carnitine level and no significant difference in maternal or neonatal LVEDD or LVEF was observed among these groups (all P>0.05). Conclusions:Blood free carnitine concentration in healthy pregnant women in the third trimester is at the lower limit of normal range, and no significant effect on maternal cardiac function and fetal cardiac structure is seen. However, the effect of low maternal carnitine level in the third trimester on children's myocardial function and whether carnitine should be supplemented in the third trimester are worthy of further investigation with larger sample size.

Sporadic adult Burkitt lymphoma confirmed by ascites test: report of one case and review of literature / 白血病·淋巴瘤

Objective:To improve the understanding of sporadic adult Burkitt lymphoma.Methods:The clinical data of a patient with sporadic adult Burkitt lymphoma who was admitted to the Affiliated Hospital of Chengde Medical College in August 2019 were retrospectively analyzed, and the relevant literature was reviewed.Results:The patient visited the clinic mainly for abdominal pain and abdominal distension, and the disease progressed rapidly. The early pathological examination of an ileocecal mass showed B-cell lymphoma, which was treated with R-CHOP regimen chemotherapy, and the mass disappeared immediately. The patient's symptoms were slightly improved, but the ascites was not significantly improved. The diagnosis of Burkitt lymphoma was confirmed by ascites test, and the treatment was adjusted to R-EPOCH regimen. The patient's condition was stable before the submission of this paper.Conclusion:Burkitt lymphoma is a highly aggressive malignancy, and cytological detection of serosal effusion is of important reference value in the diagnosis of Burkitt lymphoma.

Clinical study of Bushen-Jianpi-Huoxue Decoction combined with western medicine in the treatment of diabetes mellitus with osteoporosis / 国际中医中药杂志

Objective:To explore the clinical application of Bushen-Jianpi-Huoxue Decoction combined with western medicine in the treatment of diabetes mellitus with osteoporosis. Methods:A total of 180 patients with diabetes mellitus complicated with osteoporosis in Pudong Hospital from November 2017 to June 2019 who met the inclusion criteria were divided into two groups according to the random number table method, with 90 patients in each group. The control group was treated with conventional western medicine, the study group was treated with Bushen-Jianpi-Huoxue Decoction on the basis of the control group, and both groups were treated for 3 months. The TCM symptom scores were performed before and after treatment. Fasting blood glucose (FPG) and serum calcium levels were determined by a fully automated biochemical analyzer, HbAlc levels were determined by glycosylated hemoglobin analyzer, and TNF-α, monocyte chemoattractant protein-1 (MCP-1), and insulin-like growth factor-1 (IGF-1) and Chemerin levels were determined by a double-antibody sandwich ELISA. Bone mineral density (BMD) was measured by dual-energy X-ray apparatus and clinical efficacy was evaluated. Results:The total effective rate of the study group was 95.6% (86/90), and that of the control group was 76.7% (69/90), where the difference between the two groups was statistically significant ( χ2=13.425, P<0.01). After treatment, the main symptom, secondary symptom and total score of the study group were significantly lower than those in the control group ( t=20.851, 15.365, 27.339, respectively, all Ps<0.01). After treatment, FPG and HbAlc in the study group were significantly lower than those in the control group ( t=5.287, 10.304, P<0.01), BMD and serum calcium were significantly higher than those in the control group ( t=3.644, 3.964, P<0.01). After treatment, the levels of serum TNF-α (6.30 ± 2.05 pg/m vs. 10.43 ± 3.26 pg/m, t=10.174), MCP-1 (324.38 ± 20.05 pg/ml vs. 411.14 ± 27.67 pg/ml, t=24.087), Chemerin (57.74 ± 8.35 ng/ml vs. 63.34 ± 10.64 ng/ml, t=3.928) in the study group were significantly lower than those in the control group ( P<0.01); IGF-1 (167.79 ± 11.31 μg/L vs. 142.21 ± 9.34 μg/L, t=16.544) were significantly higher than that of the control group ( P<0.01). Conclusions:Bushen-Jianpi-Huoxue Decoction combined with conventional western medicine therapy can improve the blood glucose level and BMD of patients with diabetes mellitus complicated with osteoporosis, and improve the clinical effect.

Spatial characteristics analysis of hand, foot and mouth disease in Pudong New Area of Shanghai, 2015-2018 / 公共卫生与预防医学

Objective To understand the spatial epidemic characteristics of hand-foot-mouth disease in Pudong New Area of Shanghai from 2015 to 2018, and to provide reference for prevention and control. Methods SPSS 21.0 software was used for statistical analysis of the reported incidence of hand-foot-mouth disease, ArcGIS 10.2 software was used to make geographic distribution map, and OpenGeoDa software was used to make spatial autocorrelation analysis. Results The global Moran's I autocorrelation coefficient of the reported incidence rate of hand-foot-mouth disease in various streets and towns in Pudong New Area of Shanghai was 0.38, which was statistically significant (P=0.001). Local spatial autocorrelation analysis found that 5 streets were in high-high area. Conclusion The geographical distribution of reported incidence of hand-foot-mouth disease in various streets and towns of Pudong New Area in Shanghai was spatially aggregated, and the reported incidence decreased from north to south.

A new treatment for early postoperative infections of prosthetic joint: intermittent irrigation with povidone iodine / 中华骨科杂志

Objective:To investigate the clinical effects of intermittent irrigation with povidone iodine for early postoperative infections of prosthetic joint.Methods:From September 2014 to September 2017, a total of 6 patients with early postoperative infections of prosthetic joint were analyzed retrospectively. They underwent one of three types of orthopedic surgery, namely femoral head replacement (FHR), total hip arthroplasty (THA) or total knee arthroplasty (TKA). These patients were treated with intermittent irrigation at the bedside instead of debridement. After extensive disinfection, the presence of pus and sinuses communicating with the prosthesis were detected with vascular forceps. Then, the specimens were taken for bacterial culture. Under the protection of the forceps, a needle was entered the joint cavity. Povidone iodine solution (50 g/L, 10 ml) was injected into the joint for irrigation. The intervention was repeated once every day. When the wound was fresh, no pus was observed with negative bacterial cultures for more than twice. The irrigation operation was stopped followed by dressing change until the wound heals. During the follow-up, six patients were observed for systemic and local infections, including body temperature, swelling, tenderness, fluctuations, exudation and sinus. At 1, 3, 6, 12 and 24 months after discharge, the routine blood tests, erythrocyte sedimentation rate, C-reactive protein, liver and kidney function were tested. X-rays of the affected joints were examined to record the signs of infection such as prosthesis subsidence, loosening, osteolysis, and periosteal reaction. Harris/KSS joint function score and visual analogue score (VAS) were used to evaluate the hip or knee joint function. The iatrogenic injuries and complications were also recorded.Results:The follow-up duration was 42.1±13.4 months (24-60 months). Each case has been irrigated for 12.7±5.7 times (6-18 times). At the last follow-up, all patients achieved satisfied incision healing. No swelling, exudation, systemic and local infection was observed without signs of infection such as osteolysis, loosening of prosthesis and periosteal reaction in radiographs. The VAS scores at 1, 3, 6, 12, 24 months after discharge were all lower than those at the preoperative (4.67±0.82) ( F=24.79, P<0.001). The Harris scores of the 5 hip patients at 1, 3, 6, 12, 24 months after discharge were 70.00±8.92, 76.40±7.23, 81.40±6.07, 82.80±4.87 and 83.20±5.07, respectively. No statistical difference was found between them ( P>0.05). However, they were all higher than the preoperative Harris score (22.40±12.74) ( F=43.74, P<0.001). In a patient with TKA, the knee function was significantly improved after discharge. Before surgery and 1, 3, 6, 12, 24 months after discharge, the KSS scores were 50, 75, 80, 88, 90 and 90 respectively. No iatrogenic injuries, serious complications such as deep vein thrombosis, pulmonary embolism, severe liver/kidney damage or deaths were observed. Conclusion:When debridement is contraindicated or refused by patients, intermittent irrigation with povidone iodine may be a treatment method for patients with early postoperative infections of prosthetic joint.

Sequence analysis of enterovirus 71 3′UTR and construction of a recombinant cDNA infectious clone / 中华实验和临床病毒学杂志

Objective@#To sequence the 3′UTR of enterovirus 71 strains, investigate its foundation and impact in virulence by constructing a 3′UTR-replaced recombinant cDNA infectious clone.@*Methods@#Viral RNA of EV-A71 isolated viruses were extracted, and the nucleotide analysis was performed after sequencing. The 3′UTR of a full-length infectious clone of SDLY107 strain was replaced by its corresponding part of SDLY1 strain, and then the recombinant virus was constructed and identified.@*Results@#The nine isolated strains were classified into sub-genotype C4a of enterovirus (EV)-A71 by analysis, and nucleotide sequence homology for 3′UTR were 94%-100%. 3′UTR of EV-A71 strains may be associated with its pathogenicity. Identification of the rescued virus by sequencing and indirect immunofluorescence confirmed the successful construction of infectious recombinant virus.@*Conclusions@#Sequence analysis indicated that the 3′UTR may be involved in the pathogenicity of EV-A71. The recombinant virus SDLY107(1-3′UTR) was rescued successfully. Our study may provide evidence for further research on the influence of 3′UTR on the virulence of enterovirus 71.

Efficacy comparison between operation and non-operation treatment for hip fractures patients complicated with pulmonary embolism / 中华创伤杂志

Objective@#To investigate efficacy of operation and non-operation treatment for hip fractures patients complicated with pulmonary embolism.@*Methods@#A retrospective case control study was conducted to analyze the clinical data of 18 hip fracture patients complicated with pulmonary embolism admitted to Dongyang People's Hospital from May 2017 to January 2019. There were 11 males and seven females, aged 59 to 96 years[(80.0±9.3)years]. There were 10 patients with intertrochanteric fractures, one with femoral subtrochanteric fracture and seven with femoral neck fractures. After diagnosis of pulmonary embolism, the patients were given anticoagulant therapy with low molecular weight heparin for at least one week. The re-examination showed that pulmonary embolism absorption improved and D-dimer did not increase. Eleven patients chose surgical treatment (operation group) with intramedullary nail internal fixation or artificial hip replacement. Seven patients chose non-surgical treatment (non-operation group) with skin traction. The Harris score of hip function was compared between the two groups. Visual analogue scale (VAS) was used to evaluate hip joint pain. At the last follow-up, fracture healing, prognosis of pulmonary embolism and mortality within 3 months were recorded.@*Results@#All the patients were followed up for 3-22 months [(11.2±6.0)months]. At last follow-up, the Harris score was (92.1±2.2)points in the operation group and (28.8±18.8)points in the non-operation group (P<0.01); the VAS was 0 point (0-1 point) in the operation group and 3 points (1-3 points) in the non-operation group (P<0.01). At the last follow-up in the operation group, five patients obtained fracture healing after internal fixation, and among the six patients receiving artificial joint replacement, five patients recovered well except for one deceased patient. At the last follow-up, pulmonary embolism was absorbed and no recurrence of pulmonary embolism was found. None of the patients died within 3 months in operation group, while 14% of the patients (1/7) in the non-operation group died within 3 months.@*Conclusions@#For hip fracture patients complicated with pulmonary embolism, compared with non-operation treatment, operation treatment is more beneficial to restore hip function and relieve pain, with lower mortality rate within 3 months. Operation treatment is feasible for patients who showed improved absorption of pulmonary embolism and no secondary increase of D-dimer after one to two weeks of full anticoagulation treatment before operation.

Efficacy comparison between operation and non-operation treatment for hip fractures patients complicated with pulmonary embolism / 中华创伤杂志

Objective To investigate efficacy of operation and non-operation treatment for hip fractures patients complicated with pulmonary embolism.Methods A retrospective case control study was conducted to analyze the clinical data of 18 hip fracture patients complicated with pulmonary embolism admitted to Dongyang People's Hospital from May 2017 to January 2019.There were 11 males and seven females,aged 59 to 96 years[(80.0 ± 9.3)years].There were 10 patients with intertrochanteric fractures,one with femoral subtrochanteric fracture and seven with femoral neck fractures.After diagnosis of pulmonary embolism,the patients were given anticoagulant therapy with low molecular weight heparin for at least one week.The re-examination showed that pulmonary embolism absorption improved and D-dimer did not increase.Eleven patients chose surgical treatment (operation group) with intramedullary nail internal fixation or artificial hip replacement.Seven patients chose non-surgical treatment (non-operation group) with skin traction.The Harris score of hip function was compared between the two groups.Visual analogue scale (VAS) was used to evaluate hip joint pain.At the last follow-up,fracture healing,prognosis of pulmonary embolism and mortality within 3 months were recorded.Results All the patients were followed up for 3-22 months [(11.2 ± 6.0) months].At last follow-up,the Harris score was (92.1 ± 2.2) points in the operation group and (28.8 ± 18.8) points in the non-operation group (P＜0.01);the VAS was 0 point (0-1 point) in the operation group and 3 points (1-3 points) in the non-operation group (P ＜ 0.01).At the last follow-up in the operation group,five patients obtained fracture healing after internal fixation,and among the six patients receiving artificial joint replacement,five patients recovered well except for one deceased patient.At the last follow-up,pulmonary embolism was absorbed and no recurrence of pulmonary embolism was found.None of the patients died within 3 months in operation group,while 14％ of the patients (1/7) in the non-operation group died within 3 months.Conclusions For hip fracture patients complicated with pulmonary embolism,compared with non-operation treatment,operation treatment is more beneficial to restore hip function and relieve pain,with lower mortality rate within 3 months.Operation treatment is feasible for patients who showed improved absorption of pulmonary embolism and no secondary increase of D-dimer after one to two weeks of full anticoagulation treatment before operation.

Study on Sulfated Modification and Anti-psoriasis Activity of Polysaccharide from Dictamnus dasycarpus / 中国药房

OBJECTIVE： To conduct sulfated modification of polysaccharide from Dictamnus dasycarpus （DDP-Ⅲ）， and to compare structure characteristics and anti-psoriasis activity of DDP-Ⅲ before and after sulfated modification. METHODS： DDP-Ⅲ was separated and purified with DEAE-52 anion exchange cellulose column and Sephadex G-100 column. After derived with 1-phenyl-3-methyl-5-pyrazolone， HPLC was used to determine the composition of its monosaccharide. SDDP-Ⅲ was synthesized using esterification reagent （anhydrous pyridine+chlorosulfonic acid） to modify DDP-Ⅲ. The degree of sulfate substitution was determined by barium chloride-gelatin turbidimetric method. The structures were compared by IR， Raman spectrum and SEM before and after modification. The male ICR mice were randomly divided into normal group， model group， positive group （tripterygium glycosides， 20 mg/kg） and DDP-Ⅲ/SDDP-Ⅲ low-dose， medium-dose and high-dose groups （56， 112， 224 mg/kg）. Except that normal group was given vaseline for external use， and other groups were given Imiquimod cream for external use to induce psoriasis model. At the same time， administration groups were given relevant medicine intragastrically 0.4 mL， and both normal group and model group were given constant volume of water intragastrically， once a day， for consecutive 14 d. Two hours after last medication， the serum contents of IL-17 and IL-23 were determined by ELISA. The skin scales near the tail were observed by HE staining， and the number of scales with granular layer was recorded. RESULTS： DDP-Ⅲ was composed of mannose， rhamnose， glucuronic acid， galacturonic acid and glucose. The degree of sulfate substitution was 0.65 for SDDP-Ⅲ. IR and Raman spectrum showed that the characteristic absorption peaks of sulfate radical group appeared near 1 255 cm－1 and 823 cm－1， 1 240 cm－1 and 815 cm－1 for SDDP-Ⅲ， except for same characteristic absorption peak as DDP-Ⅲ. SEM analysis showed that DDP-Ⅲ was flaky， smooth and tightly arranged； SDDP-Ⅲ was massive or granular with porous structure and loose arrangement. Animal experiment showed that compared with normal group， the epidermis of skin lesion was significantly thickened and the granular layer was significantly reduced； serum contents of IL-17 and IL-23 were increased significantly， while the number of scales with granular layer was decreased significantly （P＜0.05 or P＜0.01）. Compared with model group， above symptoms of administration groups were improved to different extent， and serum contents of IL-17 and IL-23 in positive group， DDP-Ⅲ high-dose groups， SDDP-Ⅲ medium-dose and high-dose groups were decreased significantly； the number of scales with granular layer was increased significantly， and above indexes of SDDP-Ⅲ medium-dose and high-dose groups were significantly better than corresponding DDP-Ⅲ group （P＜0.05 or P＜0.01）. CONCLUSIONS： DDP-Ⅲ contains five monosaccharide components such as mannose， etc. Both DDP-Ⅲ and SDDP-Ⅲ possess anti- psoriasis effects， and SDDP-Ⅲ exhibits stronger anti-psoriasis effect than DDP-Ⅲ. Its mechanism may be associated with inhibiting IL-23/IL-17 signaling pathway.

Efficacy evaluation of“radiotherapy assistant”application on lung cancer patients / 预防医学

Objective @#To explore the effects of“radiotherapy assistant”application on lung cancer patients who receive radiotherapy.@*Methods @#A total of 120 patients with lung cancer who received radiotherapy in Hangzhou Cancer Hospital from March to September 2017 were recruited and randomly divided into a control group and an experimental group. The patients in the control group received the routine health education,while the ones in the experimental group performed the“radiotherapy assistant”application focused on interactive guidance. Before and after the intervention,the scores of treatment-nursing compliance and self-management efficacy between the two groups were compared. @*Results @#After the intervention,the compliance scores of radiotherapy treatment,health behaviors,regular review,moderate exercise,medication and diets in the experimental group were 2.77±0.43,2.67±0.51,2.68±0.50,2.45±0.75,2.77±0.43 and 2.65±0.55;the ones in the control group were 2.62±0.49,2.42±0.59,2.55±0.50,2.37±0.64,2.67±0.48 and 2.37±0.69. The scores of the six items of compliance in the two groups were all improved compared to the ones before the intervention,but the interaction between the groups and intervention time was not statistically significant（P>0.05）. The scores of positive attitude,self-decompression,self-decision and total self- management efficacy in the experimental group were 52.48±7.69,10.51±3.31,36.88±6.15 and 97.62±12.87,respectively;the ones in the control group were 37.38±10.44,5.70±1.51,27.58±9.41,and 92.17±11.19. The scores of the two groups were all improved compared to the ones before the intervention,and the ranges of the scores improved in the experimental group were wider than those in the control group.@*Conclusion @#The“radiotherapy assistant”application can significantly improve the self-management efficacy of patients who receive the lung cancer radiotherapy,but its effect on the improvement of treatment compliance requires long-term intervention to verify.

Risk factors of mortality in peritoneal dialysis patients / 中国综合临床

Objective To explore the risk factors affecting the death of peritoneal dialysis patients.Methods The clinical data of 275 patients with peritoneal dialysis who place a peritoneal catheter in the Department of Nephrology, First Affiliated Hospital of Guangxi Medical University and had regular peritoneal dialysis for more than 3 months from January 1,2005 to December 31,2015 were retrospectively analyzed.Sixty patients died in the observation group, and 215 patients who continued regular peritoneal dialysis were in the control group.Univariate analysis and two?class logistic regression analysis were used to analyze risk factors for death.Results The composition ratio of the primary disease to diabetic nephropathy in the death group and the control group was 15.0%(9／60) and 5.6%(12／215),respectively,the average age of patients entering peritoneal dialysis was ( 50.6 ± 14.3) years old and ( 45.7 ± 13.2) years old, respectively(t＝－2.518),glomerular filtration rates were 6.0(4.5,9.4) and 5.1(4.2,6.6),respectively, blood potassium is (4.2±0.7) mmol／L and (4.5±0.7) mmol／L,respectively,serum creatinine was 721.0 (585.0,891.3) μmol／L and 847 (723.3,1 033.3) μmol／L,respectively,there were significant differences between the two groups ( t＝2.14, all P＜0.05).Logistic regression analysis indicated that the primary disease was diabetic nephropathy,and the age of admission to peritoneal dialysis,glomerular filtration rate, blood uric acid are risk factors for death in peritoneal dialysis patients.Conclusion Diabetic nephropathy, age,glomerular filtration rate,and blood uric acid level are independent risk factors for death in peritoneal dialysis patients.