Clinical application and development of robot assisted surgery in orthopedic trauma / 中华创伤骨科杂志

With the development of intelligent manufacturing technology, robot-assisted surgery has been widely acknowledged and increasingly conducted in spine and joint orthopaedics. The appearance of TiRobot, a universal type orthopedic robot, marked expansion of robot-assisted surgery into orthopedic trauma, providing minimally invasive, intelligent, and precise protocols for fixation of pelvic and acetabular fractures, hip fractures, hand and foot fractures, and other fractures. Recently, fracture reduction robots have started an era of intelligent involvement of robots in the reduction of pelvic fractures, expanding the application of orthopedic robots from the fixation procedures to the reduction ones. In addition, robot-assisted rehabilitation exercises after fracture surgery are actively explored. Consequently, robots can be expected to get involved in every step in reduction, fixation and rehabilitation of fractures. This paper introduces the present application of robots in fracture treatment and discusses future potential development of orthopaedic robots.

Bibliometrics and visualized analysis of research hotspots and current status in clinical management of osteoporotic fractures / 中华内分泌代谢杂志

Objective:Based on Web of Science database, this study aimed to explore the current status, research hotspots and development trends of countries regarding clinical management of osteoporotic fractures using bibliometrics and visualized analysis.Methods:We collected literatures in the field of clinical management of osteoporotic fractures included in Web of Science database, and applied bibliometrics to analyze the publication dates, countries, institutions, journals, authors, highly cited literatures and research hotspots. Visualization was drawn by VOSviewer software.Results:Analysis of the 2 508 articles revealed 3 types of data. (1) The analysis of basic information of the literature showed that: ①The country with the largest number of publications was the United States, which published 672 articles, followed by the United Kingdom and Canada, and China ranked fourth; ②The top three authors in the number of publications were Kanis JA, Cooper C and McCloskey EV respectively; ③The institution with the highest number of publications was the University of Sheffield, UK, followed by the University of Southampton, UK and the University of Toronto, Canada. (2) Network visualization of highly cited literatures showed that 118 highly cited literatures were mainly divided into 5 clusters, which were related to osteoporotic fracture diagnosis, treatment, medication adherence, management consensus and strategies of preventing refracture. (3) Temporal overlay visualization of research hotspots showed that early research mainly focused on traditional therapeutic drugs, and current research hotspots were mainly molecular targeted drugs, trabecular bone score and fracture liaison services.Conclusion:This study shows that the research activity of clinical management of osteoporotic fractures is increasing worldwide, and there is still a huge gap between China and Europe or the United States. Current research hotspots and development trends mainly focus on molecular targeted drugs, osteoporotic fracture treatment concepts, emerging fracture risk assessment tools, and fracture prevention and management models.

Spatial lifecourse epidemiology in chronic non-communicable disease research / 中华流行病学杂志

In recent years, the research focus on determinants of chronic non-communicable diseases has shifted from non-spatial factors (e.g., lifestyle behaviors) to spatial factors (e.g., natural and built environments). As the intersection of lifecourse epidemiology and spatial epidemiology, spatial lifecourse epidemiology is a research area in the field of health geography. It combines advanced spatial technologies, including geographic information systems, surveying, remote sensing, location-based services and artificial intelligence, to accurately retrace, measure, and simulate individuals' exposures across the life course (i.e., exposome); and adopts lifecourse models, including the accumulation of risk model and critical/sensitive period models, to investigate the impact of individuals' exposures in the past on their health status at different stages of life. This paper introduces the theories, main analysis approaches and focus of spatial lifecourse epidemiology in the research of chronic non-communicable diseases for the purpose of better understanding and applications of spatial lifecourse epidemiology in the research of determinants of chronic non-communicable diseases, providing important reference for future research, facilitating the development of health geography to eventually achieve precise health management over the lifecourse.

Postpartum pyomyoma: two cases report and literature review / 中华围产医学杂志

Objective:To investigate the clinical characteristics of postpartum pyomyoma.Methods:Clinical data of two patients with postpartum pyomyoma admitted to the Department of Obstetrics and Gynecology, Peking University First Hospital, between 2019 and 2020, were collected. Another 16 postpartum pyomyoma reported in China and foreign areas from 2000 to 2020 were reviewed.Results:Apart from three patients without reported gravidity and parity, 12 out of the remaining 15 patients were primiparous. The median maximum diameter of uterine fibroids in pregnancy was 10 cm (6-25 cm). Of the 18 patients, 12 had a history of intrauterine manipulation, 10 had anemia or severe postpartum hemorrhage, and four had other infections. All patients manifested as fever at first, and most were accompanied by abdominal pain. The onset time of 14 cases was within postpartum two weeks. CT, MRI, and ultrasound detection rate in diagnosing postpartum pyomyoma was 11/13, 3/6, and 1/8, respectively. Pus culture had the highest positive rate, with Escherichia coli as the most common pathogen. No death was reported, but 14 patients developed severe complications, including sepsis, septic shock, disseminated intravascular coagulation, rupture of pyomyoma, peritonitis, and incision infection. As failing in anti-infection medication, all patients received surgical treatment, which controlled infections. Three patients were conceived two years after the operation (16 months to two years). Conclusions:Pyomyoma should be considered once postpartum fever develops in patients complicated by uterine fibroids ≥10 cm in diameter during pregnancy, especially those with anemia, infection, or a history of intrauterine manipulation. Surgical treatment should be performed once pyomyoma is diagnosed.

A new diphenyl butanedione from Astragalus membranaceus of northern Shanxi / 药学学报

Seven compounds were isolated from Astragalus membranaceus of northern shaanxi by silica gel and Sephadex LH-20 column chromatographies. Their chemical structures were identified on the basis of their physical and chemical properties. These compounds were elucidated as astragaloside IV (1), formononetin (2), calycosin (3), 1-(4-hydroxyphenyl)-4-(2,4-hydroxyphenyl)-2-hydroxy-1,4-but anedione (4), (E)-4-methylcinnamic acid (5), quercetin (6), and uridine (7). Compound 4 is a new compound and compound 5 was isolated from the plants of Astragalus Linn. for the first time. The results of in vitro antitumor activity assay showed that compound 4 could inhibit the proliferation of A549 with IC50 values of 11.41 μmol·L-1.

Research advances on current situation and management strategies of re-fractures after osteoporotic fractures / 中华骨科杂志

The incidence of osteoporosis and its resulting osteoporotic fractures is increasing year by year. More and more scholars pay attention to the fact that the 2 years after osteoporotic fractures is a high-risk period for re-fractures and the key window period for secondary fracture prevention. Osteoporotic fractures are important risk factors for re-fractures, and many other factors, such as the time interval after fracture and fracture site, affect the occurrence of re-fractures. Therefore, traditional fracture risk assessment tools are not suitable for the re-fracture risk assessment, while preliminary reports of emerging re-fracture risk assessment tools have been available. In recent years, with the worldwide promotion of fracture liaison service (FLS), the comprehensive management strategies have effectively improved the diagnosis rate, treatment rate and drug compliance of patients with osteoporotic fractures, while reducing the risk of re-fractures. However, there are a variety of FLS projects with different models around the world, clinicians in some countries and regions have insufficient understanding and attention to the absence of management after osteoporotic fractures, and the risk of re-fractures is still imminent. Therefore, this article systematically elaborated the latest status of re-fractures after osteoporotic fractures, risk factors affecting re-fractures and new re-fracture risk assessment tools. The prevention and management strategies of re-fractures are summarized from three aspects: the standardized anti-osteoporosis drug therapy, the multidisciplinary FLS, as well as the early and personalized rehabilitation therapy, in order to provide references for clinical management of osteoporotic fractures in China.

Comparison of the efficacy of femoral stable interlocking intramedullary nail and proximal femoral nail anti-rotation in the treatment of anterograde intertrochanteric fractures / 中华骨科杂志

Objective:To evaluate the effect of femoral stable interlocking intramedullary nail (FSIIN) and proximal femoral nail anti-rotation (PFNA) in the treatment of anterograde intertrochanteric fractures.Methods:From June 2015 to December 2020, 68 cases with surgically treated of femoral intertrochanteric fractures were included. Among them, there were 37 cases (17 males and 20 females) in proximal femoral nail antirotation (PFNA) group, and the age ranged from 48 to 78 years (62.9±7.1 years); 18 cases were on the left and 19 cases on the right; AO/OTA classification: 16 cases of A1 type and 21 cases of A2 type. And there were 31 cases (18 males and 13 females) in FSIIN group without distal locking, the age ranged from 47 to 84 years (62.4±8.6 years); 15 cases were on the left and 16 cases on the right; AO/OTA classification: 11 cases of A1 type and 20 cases of A2 type. Fracture fixation time, incision length and number, intraoperative blood loss, fracture healing time, visual analogue scale (VAS) and Harris scores at the last follow-up were compared between the two fixation methods.Results:Both groups were followed up, and the follow-up time was 15.3±3.9 months in the FSIIN group and 15.7±3.9 months in the PFNA group, and the difference was not statistically significant ( t=0.42, P=0.675). In FSIIN group, the fracture fixation time was 26.6±11.5 min, the total incision length was 7.6±1.8 cm, the intraoperative blood loss was 107.6±42.8 ml and the fracture healing time was 10.1±1.3 weeks. In PFNA group, the fracture fixation time was 40.3±10.8 min, the total incision length was 12.2±1.8 cm, the intraoperative blood loss was 209.4±52.0 ml and the fracture healing time was 16.3±1.6 weeks. In FSIIN group, the fracture fixation time ( t=3.46, P<0.001), total incision length ( t=2.39, P=0.020), intraoperative blood loss ( t=3.16, P<0.001), fracture healing time ( t=2.80, P<0.001) were all less than those in PFNA group, and the difference was statistically significant. The VAS score of FSIIN group was 1.4±0.5 points, and that of PFNA group was 1.6±0.6 points, and the difference was not statistically significant ( t=0.68, P=0.503). The Harris score was 84.5±2.2 in FSIIN group and 83.3±2.5 in PFNA group, and the difference was not statistically significant ( t=0.63, P=0.530). At the last follow-up, 29 patients in the FSIIN group were very satisfied with the operation, and 2 patients were satisfied with the operation, with a satisfaction rate of 100%. In PFNA group, 30 patients were very satisfied with the operation, 7 patients were satisfied with the operation, and the satisfaction rate was 100%. Conclusion:Compared with PFNA, micro-invasive and micro-stress shielding methodes of FSIIN in the fixation of anterograde intertrochanteric fractures is more minimally invasive, simple, time-saving, less bleeding, less risk, less pain, minimal stress shilding and enhanced recovery after surgery. The effect of treatment is similar in FSIIN and PFNA group.

Characteristic of 8p11 Myeloproliferative Syndrome with Rare Phenotype / 中国实验血液学杂志

OBJECTIVE@#To deeply understand the clinical manifestation, laboratory examination characteristics, diagnosis and treatment of an eight p11 myeloproliferative syndrome (EMS) with rare phenotypes.@*METHODS@#The clinical and laboratory characteristics and the process of allogeneic hematopoietic stem cell transplantation (allo-HSCT) were summarized in 1 rare EMS case involving T/B/myeloid cells. Meanwhile, 2 similar cases in the previous literature were also discussed.@*RESULTS@#The bone marrow examination indicated that the patient with B-cell acute lymphocytic leukemia. The lymph node biopsy showed that the patient was T lymphoblastic/myeloid lymphoma. The 8p11 abnormality was found by the examination of bone marrow chromosomes. The RT-PCR examination showed that the BCR-ABL fused gene was negtive. The FGFR1 breakage was found by using the FISH with FGFR1 probe in lymph node. The Mutation of FMNL3, NBPF1 and RUNX1 genes was found by using the whole exome sequencing. The patient received allo-HSCT under CR2. By the follow-up till to September 2019, the patient survived without the above-mentioned disease.@*CONCLUSION@#EMS manifest as neoplasms involving T-lineage, B-lineage, and myeloid-lineage simultaneously is extremely rare. Although the FGFR1 gene-targeted therapy can be conducted, allo-HSCT should be actively considered.

Analysis of factors affecting intraoperative blood loss in patients with spinal tumors undergoing preoperative selective arterial embolization / 肿瘤研究与临床

Objective:To investigate the related factors affecting intraoperative blood loss in patients with spinal tumors undergoing preoperative selective arterial embolization.Methods:The clinical data of 90 patients with spinal tumors who underwent preoperative selective arterial embolization in the Affiliated Hospital of Jining Medical College and the Second Affiliated Hospital of Shanxi Medical University from January 2017 to December 2020 were retrospectively analyzed. The influencing factors of intraoperative bleeding were analyzed by using multiple linear regression.Results:There were statistically significant differences in intraoperative blood loss of spinal tumor patients undergoing preoperative selective arterial embolization with different blood supply abundance and the number of tumors involving vertebral body (all P < 0.05). There were no significant differences in age, gender, body mass index, interval after embolization, operation time, pathological type, tumor site, embolization degree, the number of embolized vessels, preoperative Frankel grade among different groups (all P > 0.05). Multiple linear regression analysis showed that the number of tumors involving vertebral body and tumor blood supply abundance were factors affecting intraoperative blood loss, and vertebra number and tumor blood supply were positively correlated with intraoperative blood loss (all P < 0.05). Conclusion:For patients with spinal tumors undergoing preoperative selective arterial embolization, the number of tumors involving vertebral body and the abundance of the tumor blood supply are factors affecting the amount of intraoperative bleeding.

Efficacy comparison of circular external fixator and intramedullary nail in treating segmental tibial fractures / 中华创伤杂志

Objective:To compare the clinical effect of circular external fixator and intramedullary nail in treatment of tibial segmental fractures.Methods:A retrospective case control study was performed on clinical data of 43 patients with segmental tibial fractures treated from January 2006 to December 2012 in Tianjin Hospital. There were 31 males and 12 females with age range of 20-60 years［（35.9±9.6）years］. All fractures were classified as type 42C2 using the AO/OTA classification. A total of 21 patients treated with circular external fixator（circular fixator group）and 22 patients were treated with intramedullary nail（intramedullary nail group）. The condition of vascular and neural injuries，methods of fracture reduction，time of full weight bearing，bone healing time and infection rate were compared between the two groups. The proximal tibial medial angle，proximal tibial posterior angle，IOWA knee and ankle joint score，range of motion of flexion of keen joint and range of motion of plantar flexion and dorsal flexion of ankle joint were compared between the two groups at the last follow-up.Results:All patients were followed up for 12- 48 months［（19.6±2.1）months］. There were no vascular and neural injuries or other severe complications in both groups. All 21 patients in circular fixator group underwent closed reduction but 3 patients in intramellary nail group were treated by open reduction. The time of full weight bearing was（12.9±2.8）days and in circular fixator group and（75.1±8.0）days in intramedullary nail group（ P<0.05），with bone healing time for（7.0±1.0）months and（8.2±1.4）months，respectively（ P<0.05）. There was no deep infection in both groups. In circular fixator group and intramedullary nail group，the proximal tibial medial angle was（86.7±1.5）° and（93.5±1.7）°（ P<0.05），while the proximal tibial posterior angle was（82.1±1.8）°and（75.1±2.7）°（ P<0.05）. No significant differences were found between the two groups at the last follow-up concerning IOWA knee and joint score，range of motion of flexion of keen joint and range of motion of plantar flexion of ankle joint（ P>0.05）. The range of motion of dorsal flexion of ankle joint in intramedullary nail group was（30.9±3.0）°，better than（21.2±2.2）° in circular fixator group（ P<0.05）. Conclusion:For segmental tibial fractures，cirlular external fixation is superior to intromedullary nail in aspects of completely close reduction，early full weight bearing and early bone healing and alignment.

Clinical significance of changes in peripheral white blood cell count after total joint arthroplasty / 中华创伤骨科杂志

Objective:To study whether early leukocytosis after total joint arthroplasty (TJA) requires further workup to exclude infection by observing changes in peripheral blood white blood cell (WBC) count after TJA.Methods:This study included the 294 patients (infection-free group) who had undergone primary hip or knee TJA from June 2019 to June 2020 but reported no periprosthetic joint infection (PJI) within one month after surgery and the 31 patients (infection group) who had undergone the same TJA but reported infection within one month after surgery from May 2012 to June 2020 at Department of Joint Surgery, The First Affiliated Hospital to Xinjiang Medical University. Peripheral blood WBC counts were measured and recorded before surgery and 1 to 5 days after surgery. Differences were compared between time points and multiple linear regression analysis was used to screen the factors associated with early postoperative leukocytosis. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of WBC for early PJI.Results:The peripheral WBC level in the infection-free group showed a trend of increasing at first and then decreasing. It reached the peak on day 2 after surgery, increasing by 8.08×10 9/L±2.33×10 9/L compared to pre-surgery, and then began to decrease to a level slightly higher than the preoperative value on day 5 after surgery. The changes in WBC count in the first 2 days after surgery ranged from 6.24×10 9/L to 26.32×10 9/L. The incidence of leukocytosis in the first 5 days after surgery was 95.6% (281/294). The factors associated with postoperative leukocytosis included preoperative WBC count and bilateral surgery. For every increase of 1.00×10 9/L in preoperative WBC count, the postoperative WBC value increased by an average of 0.98×10 9/L [ β=0.984, 95% confidence interval (95% CI): 0.821-1.148, P<0.001]. The postoperative WBC count in the patients undergoing bilateral surgery increased by an average of 1.03×10 9/L compared with that in the patients undergoing unilateral surgery ( β=1.026, 95% CI: 0.565-1.486, P<0.001). The area under the curve (AUC) for prediction of early PJI by absolute WBC count difference (the absolute difference between the maximum postoperative WBC value and the baseline) was 0.655 (95% CI: 0.546-0.764, P<0.05), providing a threshold of 7.96×10 9/L, a sensitivity of 57.5% and a specificity of 74.2%. Conclusions:Leukocytosis is a common phenomenon after TJA, indicating a normal physiological response to surgery. The preoperative WBC count is a predictor for postoperative leukocytosis. In the absence of abnormal clinical symptoms or signs, there is no need for further workup to check infection if the postoperative WBC does not deviate from its changing range and trend.

Efficacy of high-flow nasal cannula versus nasal continuous positive airway pressure in the treatment of respiratory distress syndrome in neonates: a Meta analysis / 中国当代儿科杂志

OBJECTIVE@#To systematically evaluate the efficacy and safety of high-flow nasal cannula (HFNC) therapy versus nasal continuous positive airway pressure (nCPAP) in the treatment of respiratory distress syndrome (RDS) in neonates.@*METHODS@#PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine disc, Wanfang Database, CNKI, and Weipu Database were searched for the randomized controlled trials (RCTs) of HFNC versus nCPAP in the treatment of neonatal RDS published up to April 1, 2020. RevMan5.3 software was used to perform a Meta analysis of the eligible RCTs.@*RESULTS@#A total of 12 RCTs were included, with 2 861 neonates in total, among whom 2 698 neonates (94.30%) had a gestational age of ≥28 weeks and 163 (5.70%) had a gestational age of 0.05). For primary respiratory support and post-extubation respiratory support, the HFNC group had a significantly lower incidence rate of nasal injury than the nCPAP group (P0.05).@*CONCLUSIONS@#Based on the current clinical evidence, HFNC has a higher failure rate than nCPAP when used as primary respiratory support for neonates with RDS, and therefore it is not recommended to use HFNC as the primary respiratory support for neonates with RDS. In RDS neonates with a gestational age of ≥28 weeks, HFNC can be used as post-extubation respiratory support in the weaning phase.

Short-term therapeutic outcomes of robotic-assisted laparoscopic radical prostatectomy for oligometastatic prostate cancer: a propensity score matching study / 中华医学杂志(英文版)

BACKGROUND@#The role of local treatment in oligometastatic prostate cancer (PCa) is gaining interest with the oligometastases hypothesis proposed and the improvement of various surgical methods and techniques. This study aimed to compare the short-term therapeutic outcomes of robotic-assisted laparoscopic radical prostatectomy (RALP) for oligometastatic prostate cancer (OPC) vs. localized PCa using propensity score matching.@*METHODS@#Totally 508 consecutive patients underwent RALP as a first-line treatment. The patients were divided into two groups according to oligometastatic state: the OPC group (n = 41) or the localized PCa group (n = 467). Oligometastatic disease was defined as the presence of two or fewer suspicious lesions. The association between the oligometastatic state and therapeutic outcomes of RALP was evaluated, including biochemical recurrence (BCR) and overall survival (OS). A Cox proportional hazards model was used to assess the possible risk factors for BCR.@*RESULTS@#Totally 41 pairs of patients were matched. The median operative time, the median blood loss, the overall positive surgical margin rate, the median post-operative hospital stays, and the post-operative urinary continence recovery rate between the two groups showed no statistical significance. The 4-year BCR survival rates of the OPC group and localized PCa group were 56.7% and 60.8%, respectively, without a significant difference (P = 0.804). The 5-year OS rates were 96.3% and 100%, respectively (P = 0.326). Additionally, the results of Cox regression showed that oligometastatic state was not an independent risk factor for BCR (P = 0.682).@*CONCLUSIONS@#Our findings supported the safety and effectiveness of RALP in OPC. Additionally, oligometastatic state and sites did not have an adverse effect on BCR independently.

An analysis of global research on SARS-CoV-2 / 生物医学工程学杂志

The SARS-CoV-2 has been spread to 26 countries around the world since its outbreak. By February 16, 2020, more than 68 000 people had been diagnosed with COVID-19. Researchers from all over the world have carried out timely studies on this public health emergency and produced a number of scientific publications. This review aims to re-analyze and summarize the current research findings in a timely manner to guide scholars in relevant fields to further SARS-CoV-2 research and assist healthcare professionals in their work and decision-making. The SARS-CoV-2 related terms were selected in both English and Chinese and were searched in several major databases, including Pubmed, Web of Science, CNKI, Wanfang, and VIP databases. The reference list of each search result was screened for relevance, which was further supplemented to the search results. The included studies were categorized by topics with key characteristics extracted, re-analyzed, and summarized. A total of 301 articles were finally included with 136 in Chinese and 165 in English. The number of publications has rapidly increased since mid-January, 2020, and a peak day was 6th February on which 50 articles were published. The top three countries publishing articles were China, the United States and the United Kingdom. The and its specialty journals have published the most articles, with contribution also from journals such as ( ), ( ), and . All articles were categorized into epidemiology, clinical diagnosis and treatment, basic research, pregnant women and children, mental health, epidemic prevention & control, and others. The literatures related to SARS-CoV-2 are emerging rapidly. It is necessary to sort out and summarize the research topic in time, which has a good reference value for staff in different positions. At the same time, it is necessary to strengthen the judgment of the quality of literatures.

Correlation between EOS level and hormone therapy effect and prognosis of patients with AECOPD / 中国基层医药

Objective:To investigate the correlation between EOS level and hormone therapy effect and prognosis of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:From January 2016 to June 2018, 120 patients with AECOPD were selected in the Fifth People's Hospital of Datong.According to EOS levels, all patients were divided into two groups, including EOS ≥2% group(56 cases) and EOS<2% group(64 cases). The general clinical data and treatment related indicators of patients with different EOS levels were compared, and the clinical value of EOS level in predicting the risk of severe AECOPD recurrence and death of patients were evaluated.Results:The levels of WBC, N%, NLR and CRP of the EOS≥2% group were significantly lower than those of the EOS<2% group[(6.89±1.16)×10 9/L, (69.08±12.79)%, (3.54±1.16), (5.30±1.18)mg/L vs.(8.45±1.85)×10 9/L, (76.42±16.58)%, (6.08±1.42), (7.43±1.77)mg/L]( t=5.27, 4.81, 4.65, 2.58, all P<0.05). The used time of antibiotics of the EOS≥2% group was significantly shorter than that of the EOS<2% group[8.0(6.0, 10.0)d vs.9.0(7.0, 11.0)d]( U=2.46, P<0.05). The time of hormone therapy and hospitalization time of the EOS≥2% group were significantly shorter than those of the EOS<2% group[9.0(7.0, 11.0)d, 10.0(9.0, 12.0)d vs.11.0(7.0, 13.0)d, 12.0(10.0, 13.0)d]( U=2.79, 2.56, all P<0.05). The proportion of CAT score decreased ≥2 points at 7d after treatment of the EOS≥2% group was significantly higher than that of the EOS<2% group[86.84% vs.68.18%](χ 2=2.84, P<0.05). Logistic regression analysis showed that EOS≥2% was the independent risk factor for severe AECOPD recurrence and death( OR=2.84, 95% CI: 1.49~5.03, P<0.05). There was no relationship between EOS level and death risk ( P>0.05). Conclusion:Serum EOS level can independently predict the clinical effect of hormone therapy and prognosis in patients with AECOPD, and clinicians can make more reasonable clinical treatment plan accordingly.

Experimental study on the prevention of bone loss by deferoxamine in type 1 diabetic mice with osteoporosis / 中华内分泌代谢杂志

Objective To observe the effect of a hypoxia mimicking agent deferoxamine (DFO) on the mineral density,volume,architecture,strength,and metabolism of the bones in type 1 diabetic mice withosteoporosis.Methods Type 1 diabetic mice model was established by intraperitoneal injections of streptozotocin.The mice were divided into control (normal mice),diabetes mellitus,and DFO groups.Micro-CT was used to analyze the bone mineral density,volume,architecture,and strength of the trabecule in the distal part of femurs.Three point bending test was carried out to evaluate the bone strength.Hematoxylin and eosin (HE) staining was performed to observe the alteration in the number of osteoblasts.Real-time PCR was used to detect the mRNA expressions of Runt-related gene 2 (Runx-2),osteoclacin,and tartrate resistant acid phosphatase (TRAP) in tibias.Western blot was used to detect the protein expressions of Hypoxia-inducible factor-1α(HIF-1α) and vascular endothelial growth factor (VEGF) in tibias.Results There was a decrease in mineral density,volume,strength of bones as well as deteriorated trabecular microarchitecture in diabetic mice as compared to control mice,which were partially improved by DFO treatment.Moreover,DFO treatment increased the number of osteoblasts and mRNA expression levels of Runx-2,osteoclacin,TRAP,as well as protein expression levels of HIF-1 α and VEGF(P＜0.05).Conclusion Bone loss could be partially prevented by DFO treatment in type 1 diabetic osteoporosis mice,which might be ascribed to increased bone formation via stimulating hypoxia inducible factor singnaling pathway.

Clinical analysis of severe acute pancreatitis complicated with acute acalculous cholecystitis:a 39 cases report / 中国实用外科杂志

OBJECTIVE: To summarize the clinical characteristics of severe acute pancreatitis(SAP)complicated withacute acalculous cholecystitis(AAC).METHODS: The clinical data of 141 SAP patients admitted in the First Affiliated Hospital of Harbin Medical University from September 2012 to August 2017 were analyzed retrospectively. Among them,39 SAP patients were complicated with AAC. The clinical characteristics and key points of diagnosis and treatment ofSAP complicated with AAC were analyzed and compared with the basic data and treatment of patients without AAC.RESULTS: The incidence of SAP complicated with AAC was 27.7%(39/141). Compared with the non-AAC group,theAAC group had statistically significant differences in age [(48.8±12.5)years vs.(41.4±10.9)years], Balthazar CTSIscore [(6.8±1.3)vs.(5.7±1.3)],diabetes mellitus(35.9% vs. 18.6%), fasting time [(16.9±9.5)h vs.(12.2±7.6)h],incidence of ARDS(74.3% vs. 54.9%)and ARF(43.6% vs. 23.5%),and length of hospital stay [(33.7±19.6)d vs.(21.9±12.9)d](P<0.05). In the AAC group,8 patients underwent conservative treatment. 31 patients underwent invasivetreatment for severe gallbladder inflammation,among them 20 patients received PTGD and their condition improved. Themortality rates of patients in the AAC group were also higher than that in the non-AAC group(20.5% vs. 8.8%),butthere was no statistical significance(P=0.106).CONCLUSION: The AAC is one of the common complications in the latecourses of SAP. Early diagnosis and individualized treatment are crucial to improve the curative effects. For the patients,the early use of PTGD is a safe and effectivetreatment method,which is worthy of promotion.

Clinicopathologic analysis of 38 male breast cancers / 中国实用外科杂志

OBJECTIVE: To analyze the clinicopathologic characteristics and molecular subtype in male breast cancer(MBC). METHODS: The clinical features, histological features and molecular subtype of 38 cases of male breast cancers admitted from January 2013 to March 2019 in Clinical Pathology Diagnostic Center of Ningbo were analyzed retrospectively. RESULTS: Thirty-eight patients were diagnosed with MBC, accounting for 0.83% of all the breast cancer in the same term. The median age was 68.5(range from 24 to 88). Tumor were located in left side in 20 cases, right side in 18 cases. Twenty-nine cases were diagnosed as invasive ductal carcinoma, two cases of secretory breast cancer, one case of invasive solid papillary carcinoma, two cases of intraductal papillary carcinoma with microinvasive, and four cases of encapsulated papillary carcinoma(two of them with microinvasive). Sixteen patients had lymphatic metastasis when the tumor was diagnosed. Imunohistochemically, ER was positive in 36 cases, while PR was positive in 35 cases.Eighteen cases were Luminal A type, while sixteen were Luminal B type and two cases were basal-like subtype.CONCLUSION: MBC is a rare malignant neoplasm, and most patients are diagnosed older and at advanced clinical stage,what is more, there is more possibility of second non-breast primary cancer. All suggesting that early diagnosis,treatment and more intensive surveillance are important. MBC needs further study.

Clinical application of the disposable vasographic interventional therapy kit in vasoseminal vesiculography / 中华男科学杂志

Objective@#To investigate the success rate and safety of percutaneous vasoseminal vesiculography with the disposable vasographic interventional therapy kit (VITK).@*METHODS@#This study included ninety-six 19－65 (mean 43) years old male patients with infertility, hematospermia, seminal vesicle cyst, ejaculatory duct cyst, ejaculatory dysfunction, or vas deferens injury, with disease courses varying from 1 month to 7 years. With an open, multi-centered, single-group, self-controlled design and using the disposable VITK, we treated the patients by percutaneous vasoseminal vesiculography via injection of contrast medium into the vas deferens cavity under local anesthesia.@*RESULTS@#Percutaneous vasoseminal vesiculography was successfully performed in 92 (97.87%) of the patients, which revealed abnormal seminal ducts in 51 cases (54.3%). Among the 28 infertile patients, 3 were found with bilateral and 5 with unilateral vas deferens obstruction. Vesiculitis was detected in 36 (81.8%) of the 44 hematospermia patients and bilateral vas deferens abnormality in 5 (38.5%) of the 13 patients with ejaculatory dysfunction. Transectional damage was observed in 2 patients with vas deferens injury induced by bilateral inguinal hernia repair. Three cases of seminal vesicle cyst and 4 cases of ejaculatory cyst were definitely diagnosed by vasoseminal vesiculography.@*CONCLUSIONS@#The disposable vasographic interventional therapy kit, with the advantages of simple operation and high safety, deserves a wide clinical application in vasoseminal vesiculography.

Cloning of Oryza sativa N-glycanase gene (OsPNGase A) and its expression in Pichia pastoris / 生物工程学报

N-glycanase is a class of deglycosylation enzymes, widely used in the study of N-glycosylation modification of glycoprotein. In this study, an N-glycanase gene (OsPNGase A, XM_015775832) with high GC content (69.48%) was cloned from rice and then the yeast secretory expression vector pPICZ(α)A-OsPNGase A was constructed for the purpose of transformation to Pichia pastoris. After induction in Pichia pastoris SMD1168H, the target protein was purified by DEAE Sepharose and HisTrap HP chromatography, with a yield of 12.3 mg OsPNGase A from 1 L fermentation medium, showing a specific activity of 258 U/mg. SDS-PAGE revealed that the purified OsPNGase A was a single band and showed consistentcy with the expected molecular weight. OsPNGase A could act on transferrin recombinantly expressed in rice, avidin recombinantly expressed in corn and horseradish peroxidase. Furthermore, OsPNGase A showed higher activity than commercial PNGase F towards avidin. OsPNGase A displayed the highest digestion activity at pH 6.0 and 40 °C, and was also active in the neutral and alkaline environment. Despite the fact that OsPNGase A was inhibited by reducing agents and surfactants, it still maintained partial enzymatic activity in 100 mmol/L β-ME or DTT. Therefore, the successful expression of rice OsPNGase A provides a new tool for the study of plant glycoproteins and the establishment of yeast secretion expression system lays the foundation for the preparation of PNGase A.