Normative wideband absorbance measures in children: a cross-sectional study / 中华耳鼻咽喉头颈外科杂志

Objective: This study was to investigate the main characteristics and related factors of wideband absorbance (WBA) in children with normal hearing and to obtain age-specific reference range of WBA. Methods: 384 children between 0-12 years old (615 ears) who visited the Beijing Children's Hospital, Capital Medical University from October 2019 to February 2021 were enrolled, including 230 males (376 ears) and 154 females (239 ears), with totally 306 left ears and 309 right ears. Wideband tympanometry (WBT) was performed and normative WBA data were analyzed by SPSS 24.0 statistical software. Repeated measures and multivariate analysis of variance were applied to the data from 16 points at 1/3-octave frequencies (226, 324, 408, 500, 667, 841, 1 000, 1 297, 1 682, 2 000, 2 670, 3 364, 4 000, 5 339, 6 727 and 8 000 Hz) to evaluate the effects of frequency, age, external auditory canal pressures, gender and ear on WBA. Results: According to the WBT frequency-absorbance curve, the subjects were divided into seven groups: 1-month old group, 2-month old group, 3-month old group, 4-5 month old group, 6-24 month old group,>2-6 year old group and>6-12 year old group. The WBA of normal-hearing children underwent a series of developmental changes with age at both ambient pressure and tympanometric peak pressures. WBA results for 1-month group and 2-month old group exhibited a multipeaked pattern, with the peaks occurring around 2 000 and 4 897 Hz, and a notch around 3 886 Hz. WBA results for 3-month group and 4-5 month old group exhibited a single broad-peaked pattern, with the peak occurring between 2 000-4 757 Hz. The WBA of 1-month old group to 4-5 month old group decreased gradually at low frequency (226-408 Hz) and 6 727 Hz, and increased at middle to high frequency (2 670-4 000 Hz). The WBA of 6-24 month old group were significantly lower than that of 2-month old group to 4-5 month old group at all frequencies except 3 364 and 4 000 Hz. WBA results for 6-24 month old group,>2-6 year old group and>6-12 year old group exhibited a single-peaked pattern, and the peak frequency of WBA moved to the lower frequency successively. From 6-24 month old group to>6-12 year old group, the WBA gradually increased at low to middle frequencies (667-2 670 Hz) and 8 000 Hz, and decreased at middle to high frequencies (3 364-5 339 Hz). Among the 16 frequencies of all age groups, the difference between WBA under ambient pressure and tympanometric peak pressure were -0.09-0.06, and 43.75%-81.25% frequency points had statistically significant difference, which was mainly manifested in that WBA under ambient pressure were lower than that under tympanometric peak pressure at 226-1 682 Hz. There was no significant ear effect on all of the age groups. Similarly, there was no significant gender effect except for 3-month old group and 4-5 month old group. Conclusions: The WBA of normal-hearing children measured at ambient pressure and tympanometric peak pressure varied across the frequencies with age from 1 month to 12 years old, and different frequencies followed different change patterns (increase vs. decrease) in WBA. There was also significant external auditory canal pressures effect on all of the age groups. The establishment of age-specific reference range of WBA for 0-12 years old normal-hearing children in this study would be useful for clinical practice of determining normative data regarding WBT.

Effect of septic shock rapid response group on compliance with hour-1 bundle therapy strategy / 中华急诊医学杂志

Objective:To investigate the effect of septic shock rapid response team (SSRRT) on the compliance and prognosis of hour-1 bundle therapy strategy in emergency department patients with septic shock.Methods:This study was conducted on emergency patients with septic shock who were admitted to Huai’an First Hospital Affiliated to Nanjing Medical University from January 2020 to December 2021. The inclusion criteria were emergency patients with septic shock who met the international guideline for surviving sepsis campaigns (Sepsis 3.0). Exclusion criteria: age<18 years, pregnant patients, patients transferred from another hospital who had received fluid resuscitation and/or vasoactive drugs, patients requiring emergency surgery, patients with emergency detention time<1 h, patients who refused to place central venous catheterization or had contraindications for catheterization, and patients who refused to give informed consent. SSRRT was established in January 2021. According to the establishment of SSRRT, patients were divided into the pre-SSRRT intervention group and the post-SSRRT intervention group. The general clinical data of the enrolled patients were collected, including vital signs, lactate, fluid resuscitation volume, maximum vasoactive drug pumping rate at the diagnosis of septic shock, implementation of hour-1 bundle therapy strategies, and ICU and 28-day mortality. Statistical software SPSS 25.0 was used. Pearson chi-squared test was used to compare categorical variables between groups, and Mann-Whitney U test was used to compare continuous variables between groups.Results:A total of 289 emergency patients met the inclusion criteria, 115 patients were excluded, and 174 patients were eventually included, including 83 patients in the pre-SSRRT group and 91 patients in the post-SSRRT group. Compared with the pre-SSRRT group, the proportion of lactate monitoring (54.2% vs. 100.0%, P<0.001), blood culture (27.7% vs. 93.4%, P<0.001), antibiotics (57.8% vs. 97.8%, P<0.001), fluid resuscitation volume ≥ 30 mL/kg (4.8% vs. 34.1%, P<0.001), and mean arterial pressure ≥ 65 mmHg (49.4% vs. 68.1%, P<0.001) were significantly increased. There was no significant difference in ICU mortality (50.6% vs. 37.4%, P=0.079) or 28-day mortality (53.0% vs. 38.5%, P=0.054) between the two groups. Conclusions:SSRRT can significantly improve the compliance of hour-1 bundle therapy strategy implementation in patients with emergency septic shock, and has a trend of decreasing mortality.

Effects of overweight/obesity and type 2 diabetes mellitus on leptin and visfatin levels / 预防医学

Objective@#To investigate the effects of the link between overweight/obesity and type 2 diabetes mellitus (T2DM) on leptin and visfatin levels.@*Methods@#Males without T2DM and male patients with T2DM hospitalized in Lishui Municipal Central Hospital from January to June, 2017 were enrolled. Subjects' age and medical history of diseases were collected. The height and body weight were measured, and the body mass index (BMI) was estimated. The leptin and visfatin levels were determined, and compared between patients with and without T2DM, and between patients with and without overweight/obesity. The effect of the link between overweight/obesity and T2DM on leptin and visfatin levels was examined using a generalized linear regression model.@*Results@#There were 66 patients with T2DM, with a mean age of (49.70±9.45) years and a mean diabetes duration of (4.99±4.46) years, and there were 64 patients without T2DM, with a mean age of (43.89±0.20) years. The leptin [ (3.17±0.36) vs. (3.03±0.30) ng/mL; t=2.387, P=0.018] and visfatin levels [ (29.14±3.16) vs. (21.81±3.32) ng/mL; t=12.900, P<0.001] were significantly greater in T2DM patients than in patients without T2DM. The leptin level was significantly greater in patients with overweight/obesity than in those without overweight/obesity [ (3.27±0.32) vs. (2.92±0.26) ng/mL; t=6.634, P<0.001], and the visfatin level was significantly lower in patients with overweight/obesity than in those without overweight/obesity [(24.38±5.14) vs. (26.71±4.36) ng/mL; t=2.780, P=0.006]. Generalized linear regression analysis showed interacting effects of overweight/obesity and T2DM on leptin (β=0.286, P=0.003) and visfatin levels (β=2.709, P=0.008).@*Conclusion@#The interaction between overweight/obesity and T2DM affects leptin and visfatin levels.

Arthroscopic classification and management for the popliteal hiatus of the lateral meniscus tears / 北京大学学报(医学版)

OBJECTIVE@#To bring forward an arthroscopic classification of the popliteal hiatus of the lateral meniscus (PHLM) tears and to assess the effects of arthroscopic all-inside repair with suture hook in management of such injuries.@*METHODS@#This study involved 146 patients who underwent arthroscopic operation because of PHLM tears from April 2014 to October 2017, eliminating the patients who had discoid lateral meniscus. There were 81 males and 65 females, with 54 left knees and 92 right knees. The average ages were (34.7±3.7) years. Among the selected participants, there were 107 patients with anterior cruciate ligament (ACL) injuries, 39 patients with medial collateral ligament (MCL) injuries, and 48 patients with medial meniscus tears. The average preoperative Lysholm and International Knee Documentation Committee (IKDC) scores were 57.7±9.2 and 54.1±8.9, respectively. The arthroscopic classification was based on the extent and degree of PHLM tears and using the arthroscopic all-inside repair with suture hook for such injuries. For the patients associated with ACL injuries, the ipsilateral autograft hamstring tendons use as the reconstruction graft for single bundle ACL reconstructions. The suture anchors were used for treatment of MCL Ⅲ injuries, and the arthroscopic all-inside repair for medial meniscus tears.@*RESULTS@#A total of 146 PHLM tears in 146 patients were divided into type Ⅰ (tears not involved in popliteus tendon incisura; n=86, 58.9%), type Ⅱ (tears involved in popliteomeniscal fascicles; n=36, 24.7%), and type Ⅲ (tears involved in popliteus tendon incisura; n=24, 16.4%). For type Ⅰ, there were three subtypes, including type Ⅰa: longitudinal tear (n=53, 61.6%), type Ⅰb: horizontal tear (n=27, 31.4%), and type Ⅰc: radial tear (n=6, 7.0%). For type Ⅱ, there were also three subtypes, including type Ⅱa: anterosuperior popliteomeniscal fascicle tear (n=5, 13.9%), type Ⅱb: posterosuperior popliteomeniscal fascicle tear (n=20, 55.6%), and type Ⅱc: both tears (n=11, 30.6%). For type Ⅲ, there were two subtypes, including type Ⅲa: horizontal tear (n=9, 37.5%), type Ⅲb: radial tear (n=15, 62.5%). In the follow-up for an average of 15.3±2.6 months, all the patients had done well with significantly improved Lysholm (84.6±14.3) and IKDC (83.2±12.8) scores at the end of the last follow-up relative to preoperative scores (P > 0.01).@*CONCLUSION@#We propose that it is possible to classify lateral meniscus tears at the popliteal hiatus region for three types, which can summarize the injury characteristics of this area. The arthroscopic all-inside repair with suture hook for the PHLM tears can avoid stitching to popliteal tendon or narrowing popliteal hiatus and have satisfactory clinical results.

Effect of baicalin on renal fibrosis in rats with diabetic nephropathy by TGF-β1 / 医学研究生学报

ObjectiveDiabetic nephropathy (DN) is a pathological process involving the kidney that develops from Diabetes Mellitus (DM). The onset is hidden and difficult to reverse. Baicalin is an important flavonoid compound in Scutellaria Baicalensis. It has the functions of clearing heat and detoxifying, anti-inflammatory and anti-oxidant. In recent years, the role of baicalin in lowering blood glucose and lipids and improving metabolic syndrome has received widespread attention. Therefore, we observed the protective effect of baicalin on the kidneys of DN rats and explored its possible regulatory mechanism.MethodsForty-five male SD rats were randomly divided into a normal control group, a DN model group, and a baicalin-treated group, with 15 rats in each group. The normal group was routinely bred, and the DN model was established in the model group and the baicalin treatment group, and the corresponding preparations were given gavage treatment. After a fixed time point, rat body weight, fasting blood glucose (FBG), blood urea nitrogen (BUN), and serum creatinine (Scr) levels were measured, and the histopathological changes of the kidneys in each group were observed. TGF-β1 and α- SMA protein expression was measured by Western blot.ResultsCompared with the DN group, the FBG, BUN, Scr and 24h urine output of the baicalin treatment group were significantly decreased, and the body weight did not change significantly. Histopathological observation showed that compared with DN group, the pathological damage, glycogen deposition and fibrosis of the rats in the baicalin treatment group were significantly improved. Compared with the DN group, the results of Western blot showed that the expression of TGF-β1 and α-SMA protein in the baicalin treatment group were significantly decreased (P<0.05).ConclusionBaicalin can delay the progression of DN and improve renal fibrosis, and its mechanism may be closely related to the inhibition of α-SMA expression by baicalin by low regulation of TGF-β1.

The status quo of targeted therapy in bladder cancer / 医学研究生学报

Bladder cancer is the most common malignant tumor of the urinary system. Prognosis of advanced or metastatic bladder urothelial carcinoma is usually poor. More than half of the patients cannot receive standard, first-line cisplatin-based chemotherapy due to renal dysfunction, cachexia or other complications. As targeted drugs shine in cancer treatment, targeted therapy for bladder cancer has also entered clinical research. This article reviews the targeted therapies include human epithelial growth factor family, vascular endothelial growth factor and receptor, fibroblast growth factor receptor, phosphoinositide 3-kinase-AKT-mammalian target of rapamycin.

Optimization of Water Extraction Technology of Taohe Chengqi Decoction by Response Surface Methodology Combined with Information Entropy Theory / 中国药房

OBJECTIVE： To optimize the water extraction technology of classic formula Taohe chengqi decoction. METHODS： Based on single factor test， combined with response surface methodology and information entropy theory， the soaking time， solid-liquid ratio and extraction time were investigated. Using the contents of rhein， amygdalin， cinnamaldehyde and glycyrrhizic acid in Taohe chengqi decoction as indexes， information entropy theory was used to assign weight coefficients to each evaluation index and calculate the comprehensive score. Through Design-Expert 10 software， the interactions of each factor were analyzed. Water extraction technology was optimized， and validation test was also performed. RESULTS： According to information entropy theory， the weight coefficients of rhein， amygdalin， glycyrrhizic acid and cinnamaldehyde were located at 0.097 6， 0.363 2， 0.173 5 and 0.365 7. The results of interaction analysis showed that the material-liquid ratio had a greater impact on the comprehensive score. The optimal water extraction technology of Taohe chengqi decoction were determined as that soaking time was 60 min； the ratio of material to liquid was 1 ∶ 10 （g/mL）； total extraction time was 130 min （extracting for 3 times， lasting for 65， 33， 32 min each time）. The results of verification test showed that RSD of content of each index component and the comprehensive score was less than 3％. CONCLUSIONS： The optimal water extraction technology is proved to be stable and feasible， which can provide the basis for the further development and utilization of Taohe chengqi decoction.

Comparison of the Extraction Effects of Two Methods on the Total Volatile Oil from Citrus aurantium and Cyperus rotundus in Qizhi Weitong Granule / 中国药房

OBJECTIVE： To compare the extraction effects of steam distillation method （SD） and extraction-azeotropic distillation coupling technology （WER） on the volatile oil from Citrus aurantium and Cyperus rotundus， so as to determine the suitable extraction method and improve the extraction technology of volatile components in Qizhi weitong granule. METHODS： SD and WER were used to extract the total volatile oil from C. aurantium and C. rotundus. t-test was conducted for the yield of volatile oil extracted by the two methods. GC-MS method was used to analyze the volatile oil， and the main components were determined. The relative content of main components was determined compared by area normalization method. GC-MS conditions included that Agilent HP-5 capillary column （30 m×0.25 mm ， 0.25 μm）， inlet temperature of 250 ℃， nitrogen as carrier gas， flow rate of 1 mL/min， split ratio of 20 ∶ 1， sample size of 2 μL， temperature programmed， electron bombardment， electron bombardment energy of 70 eV， scanning range of m/z 50-500. RESULTS： The appearance of volatile oil extracted by WER was more clear， with better product phase than that by SD. The average yield of volatile oil extracted by WER method were significantly higher than SD method （1.78％ vs. 1.48％， P＜0.01）. The volatile oil extracted by WER method and SD method contained 39 and 38 components， involving 38 common components. Among them， D-limonene， acetophenone， ketoenone and α-ketone were the main components of the total volatile oil from C. aurantium and C. rotundus， and the sum of the 4 main components was about 73.40％ （WER method） and 68.46％ （SD method） of the total components.  CONCLUSIONS： Compared with SD method， WER method for extracting volatile oil from C.aurantium and C. rotundus is better in product， phase higher in yield and higher in content of active volatiles， and is more suitable for the extraction of volatile components in Qizhi weitong granule.

Optimization of the Extraction Technology of Volatile Oil from Schizonepeta tenuifolia and Forsythia suspensa / 中国药房

OBJECTIVE： To establish the method for content determination of volatile oil of Schizonepeta tenuifolia and Forsythia suspensa， and to optimize the extraction technology of the volatile oil. METHODS： The contents of β-pinene and pulegone were determined by GC method. The determination was performed on Hp-5 capillary column. The detector was hydrogen flame ion detector with programmed temperature. The sample size was 0.5 μL， the split ratio was 70 ∶ 1， the carrier gas was nitrogen， the inlet temperature was 250 ℃， the detector temperature was 280 ℃， the air flow rate was 390 mL/min， the hydrogen flow rate was 36 mL/min， the tail flow rate was 15 mL/min， and the nitrogen flow rate was 1 mL/min. Based on single factor test， orthogonal test combined with information entropy method were used to optimize the extraction technology of S. tenuifolia and F. suspensa using soaking time， extraction time， material-liquid ratio and forsythia grain size as factors， with the extraction amount of volatile oil， the content of β-pinene and pulegone and their comprehensive score as indexes.  RESULTS： The linear range of β-pinene and pulegone 1.575-7.875（r＝0.999 9） and 1.892-9.46 μg（r＝0.999 7）， respectively. The limits of quantitation were 0.10 and 0.25 μg； the limits of detection were 0.03 and 0.08 μg； RSDs of precision， stability and reproducibility tests were less than 2％ （n＝6）； the recoveries were 97.77％-100.01％ （RSD＝0.93％，n＝9） and 96.47％-99.00％（RSD＝0.89％， n＝9）. The optimal extraction technology was soaking 2 h， extracting for 6 h， 10-fold water （mL/g）， half a clove of granularity. Under this condition， the extraction amount of volatile oil， the contents of β-pinene and pulegone were 3.6 mL， 1 450.4 mg， 127.6 mg， respectively. RSD were 1.62％， 0.20％， 1.42％. CONCLUSIONS： Established method is simple， accurate and reproducible， and the optimal extraction technology is stable and feasible.

Comprehensive management of pregnancy in women with congenital heart disease / 中国实用妇科与产科杂志

There are an increasing number of women with CHD seeking to bear children,and once pregnant,the risk of heart and maternal and fetal complications increases,and heart function is furhter damaged.The risk depends on the type of congenital heart disease,degree of hemodynamic impairment,and potential complications.Strengthening the comprehensive management of such patients,conducting careful individual and multidisciplinary risk assessment,and formulating detailed plans for follow-up during pregnancy,delivery and postpartum treatment can reduce the risk and improve perinatal outcomes,which has important significance for reducing maternal mortality.

Electroacupuncture inhibited inflammation mediated by activated microglia in rats with spinal cord injury / 国际中医中药杂志

Objective To observe the effect of electroacupuncture on inflammation mediated by activated microglia after spinal cord injury to explore the mechanism of electroacupuncture inhibiting inflammation and treating spinal cord injury. Methods Thirty-six SD rats were randomly divided into sham group, model group and electroacupuncture group. The sham group was undergone laminectomy while model group and electroacupuncture group with NYU spinal cord impactor for the spinal cord injury model was established. Three days after administration, tissues were gathered for Nissl staining, Elisa, immunofluorescence and qPCR. Results Compared with the model group, the expression of IL-1β (21.37 ± 0.86 vs. 31.21 ± 0.86), IL-18 (16.76 ± 0.63 vs. 23.39 ± 0.97), IL-1β mRNA (3.37 ± 0.86 vs. 5.21 ± 0.75) and IL-18 mRNA (2.76 ± 0.63 vs. 4.39 ± 0.97) in the electroacupuncture group significantly decreased (P<0.05), while the number of IBA-1/ED-1 double positive cells (7.50 ± 1.18 vs. 12.83 ± 1.84) in the electroacupuncture group significantly reduced (P<0.05). Conclusions Electroacupuncture can promote neurons to rehabilitate with a mechanism that electroacupuncture inhibits inflammation mediated by activated microglia after spinal cord injury.

Effect of the proactive percutaneous catheter drainage strategy in the treatment of acute pancreatitis with infected necrosis / 局解手术学杂志

Objective To investigate the effect of the proactive percutaneous catheter drainage(PCD)strategy in the treatment of acute pancreatitis(AP)complicated with necrotic infection.Methods A total of 70 patients with AP complicated with necrotic infection and trea-ted by PCD from January 2016 to November 2017 were prospectively enrolled.The patients were randomly divided into the routine group(n=35)and the modified group(n =35)according to the random number table method.The same indication and principle were performed performed during the first time PCD in both of the two groups.However,the subsequent treatment strategy was different between the two groups.The routine group was given a maximum of 1 adjustment of the drainage tube position or another catheterization.If the drainage effect was still poor,the necrosectomy would be taken through laparoscope,nephroscope or laparotomy directly.While the modified group was given frequent and early drain revision and upsizing of drains in case of lack of clinical improvement.The general data,the total number of PCD pro-cedures,the maximal final drain size,the duration between the first two times of PCD,the total drainage duration,the number of patients need for necrosectomy,the length of hospital stay after drainage,the number of patients need for new ICU admission,the number of patients need for readmission,complications and mortality were compared between the 2 groups.Results The total number of PCD procedures and the maxi-mal final drain size of the modified group was significantly higher than that of the routine group(P<0.05 or P<0.01).The duration be-tween the first two times of PCD in the modified group was significantly shorter than of the routine group(P<0.01).The ratio of patients need for necrosectomy and suffered new-onset multiple organ failure significantly decreased in the modified group,and the difference was sta-tistically significant(P<0.05).There was no significant difference between the two groups in total days of drainage,length of hospital stay after drainage,number of patients need for new ICU admission,number of patients need for readmission,complications and mortality.Conclu-sion The proactive PCD strategy of frequent and early drain revision and upsizing of drains for patients with acute infected necrotizing pan -creatitis when lack of clinical improvement can reduce the proportion of recurrent multiple organ failure and the need for necrosectomy,and it does not increase the risk of related complications.

Hypothesis and prospects of disturbed gut microbiota in major depressive disorder / 中国实验动物学报

Major depressive disorder ( MDD) is one of the severe mental illness caused by genetic and environ-mental interactions. There are several hypotheses that sought to account for this disorder. However, none of them is widely recognized. Gut microbiome, the largest and most direct external environment for human body, is considered as a new focus in the research of MDD. Based on the new development, we will summarize the following aspects of MDD in this article:(1) How the gut microbiome shapes the brain neurochemistry and behaviors through microbiota?gut?brain axis?(2) Associ?ation between disturbances of gut microbiome and MDD;(3) The potential pathogenesis of gut microbiome in the onset of MDD;(4) The prospects of developing new diagnosis and treatment for MDD by targeting microbiota?gut?brain axis.

Induced pluripotent stem cells differentiate into intestinal organoids in three-dimensional niche in vitro / 中国组织工程研究

BACKGROUND: Induced pluripotent stem cells (iPSCs) are a special type of cells with self-renewal and multi-differentiation potential, which can differentiate into intestinal organoids under certain conditions. OBJECTIVE: To explore whether iPSCs can differentiate into intestinal organoids under specific conditions in vitro.METHODS: iPSCs from B6J mice were recovered and cultured for 3 days until clone units covered about 80％ of the culture dish, and then the cells were cultured in the medium containing Activin A for 3 days until the deterministic endoderm formed. Further, the culture medium was replaced by the medium with fibroblast growth factor 4 and Wnt3A for 4 days to differentiate into the spheroids with CDX2+. After that, spheroids were collected and mixed with Matrigel,and then the mixture was dropped into the 4-well plate and cultured with Rspondin1, Noggin, epidermal growth factor, B27 and other growth factors to differentiate into intestinal organoids. Cell morphology was observed, FoxA2 and Sox17 expresson in the deterministic endoderm was detected, and CDX2, Sox9, CGA, MMP7 were measured.RESULTS AND CONCLUSION: iPSCs were cultured with Activin A for 3 days with higher cell fusion, initial differentiation and FoxA2/Sox17 expression (P < 0.05) than those of non-induced iPSCs. Spheroids began to appear at the 3rd day after culture with fibroblast growth factor 4 and WNT3A, and formed a lot at the 4th day. And CDX2 expression in spheroids was significantly increased compared with that in the deterministic endoderm (P < 0.05). Organoids gradually formed after 3 days culture, which contained all cell types of intestinal organoids, and expressions of specific markers, Sox9, CGA, MMP7, were significantly higher than those in spheroids (P < 0.05). To conclude, iPSCs can be induced to differentiate into intestinal organoids in three-dimensional niche in vitro.

Lipopolysaccharide potentiates dopaminergic neuronal dysfunction in α-synuclein transgenic mice / 药学学报

Parkinson's disease (PD) is the most prevalent neurodegenerative disorder, with several risk factors contributing to the onset, such as aging, genetics, oxidative stress and neuroinflammation. There are several PD animals that mimics different risk factor. α-Synuclein mutation mice and systemic lipopolysaccharide (LPS) injection mice are two kinds of most common animal models that replicate genetic mutation and neuroinflammation, respectively. However, in these two animal models, the pathogenesis occurred after a long period of stimulation. In the present study, four-month-old α-synucleintransgenic mice (A53T) were intraperitoneally injected with LPS once a week for continuous 8 weeks to simulate the inflammatory response. The behavioral results showed that the time of mice staying on the rod and the performance score were markedly decreased, indicating motor dysfunction. Dopaminergic neuronal function also decreased. It was noted that the movement dysfunction and pathological changes were aggravated in LPS plus α-synuclein challenged mice compared with LPS or α-synuclein stimulated alone, suggesting that the double attack had synergistic effects. Mechanistic study demonstrated that LPS and α-synuclein combined challenge led to obvious neuroinflammatory response and apoptosis, which might contribute to motor and dopaminergic neuronal dysfunction. In addition, differential proteomic study showed that the expression of CD99L2 and COX7RP significantly increased in the midbrain of LPS plus α-synuclein challenged mice, which were closely related to inflammation and apoptosis, and might be involved in the pathogenesis of PD. In conclusion, the present study demonstrated that LPS could potentiate dopaminergic neuronal function in α-synuclein transgenic mice, which might be an ideal method to develop PD animal model.

The effect of modified pericardial devascularization on esophageal gastric varices of liver ;cirrhosis with portal hypertension / 中国医师进修杂志

Objective To explor the operative method of modified pericardial devascularization and compare the effects of modified pericardial devascularization and traditional pericardial devascularization on esophageal gastric varices of liver cirrhosis with portal hypertension. Methods The clinical data of 35 patients receiving modified pericardial devascularization (MED group) and 35 patients receiving traditional pericardial devascularization (ED group) were retrospectively analyzed . Results The operating time in MED group was significantly lower than that in ED group:(182 ± 30)min vs.(220 ± 30) min, P0.05). Conclusions The operating time, blood loss and early complication rate in modified pericardial devascularization is better than traditional pericardial devascularization. There is no significant difference in long-term efficacy between two methods.

Curative effect of soft silicone dressing combined with calcium alginate dressing in treating skin graft donor sites of burned patients / 第二军医大学学报

Objective To observe the curative effect of soft silicone dressing combined with calcium alginate dressing for treatment of skin graft donor sites of burned patients. Methods A total of 80 burned patients were randomly divided into treatment group (n=39) and control group (n=41). In the treatment group the donor sites were covered with calcium alginate dressing (Sorbalgon) inside and soft silicone dressing (Mepilex) outside, and the donor sites in the control group were covered with chlorhexidine gauze inside and multilayer sterile gauze outside. The wound healing, pain improvement and scar formation were evaluated in the two groups. Results The wound healing rates at post-operative 7, 10 and 12 d in the treatment group were significantly higher than those in the control group (treatment group:[51. 31±7. 09]%, [78. 77±8. 80]% and[96. 44±3. 24]%; control group:[45. 85±5. 54]%, [73. 63±7. 73]% and[93. 12±4. 08]%; P<0. 01). The wound healing time of the treatment group was significantly shorter than that of the control group ([10. 95±1. 41] d vs[11. 93±1. 44] d, P<0. 01). Visual analogue scale (VAS) scores at post-operative 1, 3, 7 and 10 d in the treatment group were significantly lower than those in the control group (treatment group:5. 36±1. 21, 4. 29±1. 25, 4. 00±0. 46 and 1. 00±0. 45; control group:7. 34±1. 34, 5. 89±1. 39, 4. 50±0. 74 and 1. 35±0. 52; P<0. 01). The Vancouver scar scale (VSS) scores at post-operative 1, 3, 6 and 12 month in the treatment group were also significantly lower than those in the control group (treatment group:3. 82±1. 47, 6. 00±1. 61, 3. 77±2. 28 and 2. 59±1. 39; control group:5. 80±1. 68, 7. 80±1. 65, 5. 24±1. 67 and 4. 05±1. 41; P<0. 01). Conclusion Soft silicone dressing combined with calcium alginate dressing in treatment of the skin graft donor sites can greatly improve the wound healing rate, shorten the wound healing time, relieve pain in dressing change and improve the wound healing quality, and it may serve as an effective method for protecting the donor sites.

Treatment and prognosis of 76 patients with gallbladder cancer: a single-center retrospective study / 中华肝胆外科杂志

Objective To investigate effective treatment modalities and the related factors influencing prognosis of patients with gallbladder cancer.Methods The clinical data of 76 gallbladder carcinoma patients admitted to the Department of General Surgery,PLA Nanjing General Hospital from January 2005 to October 2015 were analyzed retrospectively.Follow-up was carried out via telephone or outpatient service until January 2016.Cox regression and Kaplan-Meier models were performed for survival analysis.Results 69 patients were treated with surgery and/or postoperative adjuvant chemotherapy.The remaining 7 patients with liver or distant metastases who did not undergo surgery received chemotherapy.24 patients died from cancer relapse,37 patients died from disease progression after giving up treatment,and 7 patients were lost to follow-up.The remaining 8 patients were still alive at the time of follow-up.The depth of cancer invasion (HR =2.736),the type surgical procedure (HR =2.207),and adjuvant chemotherapy (HR =0.603) were significant impact factors of survival for GBC patients.Adjuvant chemotherapy was a protective factor.The average survival in the chemotherapy-naive group was (10.6 ± 1.9) months,the single chemotherapy group (18.5 ± 2.8) months,and the combined chemotherapy group (26.9 ± 6.4) months.There were no significant differences among these groups.Conclusions The depth of cancer invasion,types of surgical procedure particularly radical cholecystectomy,and adjuvant chemotherapy were significant factors of survival in patients with GBC.Radical cholecystectomy combined with arterial and intravenous chemotherapy using gemcitabine and oxaliplatin showed benefits in survival in GBC patients.

The strategies on reducing ventilator-associated pneumonia incidence in ICU / 中国基层医药

Objective To understand the incidence trend of ventilator -associated pneumonia(VAP)in ICU and to evaluate the effects of the interventions on the incidence of VAP,so as to provide scientific evidences for the prevention of VAP.Methods A study of 149 patients with VAP occurred in the 3 710 patients of ICU before and after intervention during 7 /2010 -12 /2014 in Wujin People's Hospital,Changzhou city was conducted.It was divided into two stages:baseline survey and stem expectations,VAP interventions included:training and education,chlorhexidine oral care and maintain appropriate endotracheal tube cuff pressure,elevated head of bed to up to 30°and improved hand hygiene.Hospital infection control professionals collected the number of patients,basic information,length of hospital stay,days of receiving mechanical ventilation and the VAP incidence data in ICU.And then change of the VAP incidence of the intervention before and after the intervention was compared and evaluation of the effect of combined intervention measures.Results Prospective data from 3 710 patients hospitalized in ICU were collected for an aggregate of 14 831 days,the utilization rate of ventilator was 55.2%.The occurrence of VAP was 149 cases.The average rate of VAP was 18.2 cases per 1 000 ventilator -day.VAP was associated with a crude mortality of 7.56%and with increased ICU LOS of 13.2d.As the results of the interventions,the rate of VAP was decreased from 52.38 /1 000 during 7 /2010 -6 /2011 to 5.71 /1 000 during 1 /2014 -12 /2014.Conclusion The rate of VAP in the inves-tigated ICU has led to a decreased incidence of VAP under the comprehensive interventions.

Prevention and control of postoperative anastomotic leak after colorectal anastomosis / 中华胃肠外科杂志

Anastomotic leak is a major complication after colorectal resection. Risk factors for anastomotic leak include patient and disease related factors, preoperative factors(e.g. use of neoadjuvant chemoradiation and mechanical bowel preparation), intraoperative factors(e.g. anastomotic techniques, performing of water injection test, preventive colostomy, and surgical procedures, etc; postoperative factors, such as postoperative medication use, etc. Early diagnosis of anastomotic fistula is crucial, which can be made by combining laboratory examination with imaging examination or take the prediction and diagnosis model as reference. Once diagnosed, anastomotic leak should be managed immediately according to individual status and severity of disease. As for intraperitoneal anastomosis, no matter whether the bowel lack of blood supply or not, original anastomosis should be removed and terminal loop ileumstomy should be created. As for extraperitoneal anastomosis(mainly low rectal anastomosis), adequate drainage and terminal loop ileumstomy can be considered when anastomosis is slightly cracked or invisible due to adhesion. When anastomosis is severely cracked or blood supply is too limited, however, we must disconnect the original anastomotic and create a proximal colostomy.