Preliminary study of preoperative MRI measurement of hamstring tendon cross-sectional area to predict graft diameter during anterior cruciate ligament reconstruction / 中华放射学杂志

Objective:To investigate the value of preoperative MRI measurements of hamstring (semitendinosus+gracilis) tendon cross-sectional area in predicting intraoperative graft diameter for anterior cruciate ligament reconstruction (ACLR).Methods:A total of 265 preoperative MRI were retrospectively collected in the Third Affiliated Hospital of Southern Medical University from January 2013 to August 2020 for patients who underwent single-bundle ACLR of hamstring tendon. Patients were divided into a graft diameter≥8 mm group (129 patients) and a graft diameter<8 mm group (136 patients) according to intraoperative graft diameter. The cross-sectional areas of the semitendinosus and gracilis tendons were measured at the largest level of the femoral condyle on preoperative MRI cross-sectional images, and the two were summed to obtain the cross-sectional area of the hamstring tendon. The independent samples t-test was used to compare the differences in the cross-sectional area of each tendon between the graft diameter≥8 mm group and the graft diameter<8 mm group. The Spearman correlation analysis was used to assess the correlation between tendon cross-sectional area and intraoperative graft diameter. Multi-factor logistic regression analysis was used to screen the influence of tendon cross-sectional area on intraoperative graft diameter. The effectiveness of intraoperative graft diameter≥8 mm was assessed by plotting the receiver operating characteristic curves. Results:Intraoperative measurement of graft diameter was 7.5 (7.5, 8.0) mm. The cross-sectional area of the popliteal tendon was (21.4±4.6) mm 2 in the graft diameter≥8 mm group and (15.6±3.7) mm 2 in the graft diameter<8 mm group. Statistically significant differences were found in the cross-sectional areas of the semitendinosus, soleus and hamstring tendons between the graft diameter≥8 mm group and graft diameter<8 mm group ( t=-10.26, -10.29, -11.47, P<0.001). Intraoperative graft diameter was positively correlated with the cross-sectional area of the semitendinosus, gracilis, and hamstring, with correlation coefficients of 0.57 ( P<0.001), 0.58 ( P<0.001), and 0.62 ( P<0.001), respectively. Multi-factor logistic regression showed that popliteal tendon cross-sectional area was a predictor of intraoperative graft diameter (OR=1.45, 95%CI 1.32-1.59, P<0.001). The area under the curve for popliteal tendon cross-sectional area to predict intraoperative graft diameter≥8 mm was 0.838 (95%CI 0.792-0.885), with a critical value of 20.0 mm 2, a sensitivity of 0.581, and a specificity of 0.941. Conclusion:The measurement of the cross-sectional area of the hamstring muscle on preoperative MRI can predict the diameter of the autologous hamstring graft of ACLR.

Gut-liver axis： Intestinal microbial homeostasis and hepatocellular carcinoma / 临床肝胆病杂志

Intestinal microbiota plays an important role in maintaining liver metabolic homeostasis and affects the development and progression of hepatocellular carcinoma by participating in bile acid metabolism. Gut-liver axis plays an important role in the pathogenesis of liver diseases， and it might be one of the effective methods to prevent the progression of hepatocellular carcinoma by correcting intestinal ecological imbalance to restore normal bile acid level. This article summarizes the mechanism of bile acid receptor affecting hepatocellular carcinoma and the latest therapeutic targets， in order to provide a reference for the early prevention and treatment of hepatocellular carcinoma.

Analysis on Changes of Aquaporin and Intestinal Flora in a Rat Model with Spleen-Yin Deficiency Syndrome / 中国实验方剂学杂志

ObjectiveTo investigate the effects of spleen-Yin deficiency on gastrointestinal absorption， water metabolism and intestinal flora in rats with spleen-Yin deficiency syndrome. MethodA rat model of spleen-Yin deficiency syndrome was established by using the composite factors， including irregular meat and vegetable diet， weight-bearing fatigue swimming and gavage with warm-heat injury-Yin drugs. The changes of body weight， food intake， water intake and duration of swimming in the blank and model groups were observed. Hematoxylin-eosin（HE） staining was used to observe the histopathological damage of the stomach and colon. Urinary excretion rate of D-xylose was determined by phloroglucinol method. The content of gastrin（GAS） in serum was determined by enzyme-linked immunosorbent assay（ELISA）. The relative expression levels of vasoactive intestinal peptide（VIP）， aquaporin 3（AQP3） and AQP4 in gastric tissues were detected by Western blot. The relative mRNA expression levels of VIP， AQP3 and AQP4 in gastric tissues were detected by Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）， and the changes of intestinal flora were analyzed by 16S rDNA sequencing. ResultCompared with the blank group， the results of general physical signs showed that the body weight and food intake of rats in the model group were significantly decreased， the water intake was significantly increased（P<0.05， P<0.01）， and the duration of swimming was significantly decreased（P<0.01）. Pathological examination results showed that in the mucosa of gastric tissues of rats in the model group appeared to be misaligned， the mucosa of colonic tissues could be seen to be obviously thinned or mutilated， and the epithelial cells appeared to be necrotic or even exfoliated. Compared with the blank group， the urinary D-xylose excretion rate of rats in the model group was significantly decreased（P<0.01）， and the serum GAS content was significantly decreased（P<0.05）. Compared with the blank group， Western blot results showed that the relative expression level of VIP protein in gastric tissues of rats in the model group was significantly decreased， while the relative expression levels of AQP4 and AQP3 proteins were significantly increased（P<0.01）. Compared with the blank group， Real-time PCR results showed that the relative expression level of VIP mRNA in gastric tissues of rats in the model group was significantly decreased（P<0.01）， and the relative mRNA expression levels of AQP3 and AQP4 were significantly increased（P<0.05， P<0.01）. Compared with the blank group， the results of intestinal flora analysis showed that the number of operational taxonomic units（OTUs） and α-diversity increased and β-diversity decreased significantly in the model group， the abundance of Porphyromonadaceae was increased significantly， and the abundance of Oscillibacter_ruminantium was decreased significantly（P<0.05）. Spearman correlation analysis showed that Porphyromonadaceae was significantly positively correlated with AQP4 protein level， while Oscillibacter_ruminantium was significantly positively correlated with VIP protein level， and negatively correlated with AQP3 and AQP4 protein levels（P<0.05）. Linear discriminant analysis effect size（LEfSe） analysis results showed that there were significant differences in a variety of intestinal bacteria between groups， and the intestinal bacteria of the model group were significantly enriched in the phylum/order/family/genus of Elusimicrobia， Betaproteobacteria， Burkholderiales， Sutterellaceae and Parasutterella（P<0.05）. ConclusionSpleen-Yin deficiency syndrome can weaken the digestion and absorption capacity of gastrointestinal tract， and cause the disturbance of water metabolism and intestinal flora. AQP4， AQP3 and VIP protein levels of gastric mucosa are closely related to Porphyromonadaceae and Oscillibacter_ruminantium. And AQP4， AQP3 and VIP may be involved in the regulation of intestinal flora in order to affect the physiological function of spleen governing transportation and transformation.

A case report of prostate mucinous adenocarcinoma / 中华泌尿外科杂志

Mucinous adenocarcinoma of the prostate is a rare pathological type of prostate cancer. We reported one case. The patient went to see a doctor because of intermittent hematuria. He was diagnosed as prostate adenocarcinoma before operation. He underwent laparoscopic radical prostatectomy. Postoperative pathological examination showed mucinous adenocarcinoma of the prostate. The patient was followed up for six months. Imaging showed no signs of recurrence and metastasis with normal tPSA.

mRNA Expression of Aquaporins in Human Luteinized Granulosa Cells from Different Diameter Follicles / 中山大学学报(医学科学版)

ObjectiveTo investigate the mRNA expression levels of various aquaporins （AQPs） in luteinized granulosa cells from follicles of different diameters. MethodsFrom March 25， 2022 to September 23， 2022 in our reproductive medicine center， 48 women undergoing in-vitro fertilization （IVF） were enrolled and divided into the antagonist group and the agonist group according to the ovarian stimulation protocol. Follicular fluid samples were collected on the day of oocyte pick-up and granulosa cells were extracted from follicles of different diameters： small （<13 mm）， medium （13~18 mm） and large （≥18 mm）. After RNA quantification， 22 cases （66 samples） were included for analysis and mRNA expression levels of AQPs were compared among the three follicle groups. ResultsThe mRNA expression of aquaporin 2 （AQP2） in luteinized granulosa cells increased with the increase of follicle diameter （linear trend P = 0.004） and the difference was statistically significant between two groups of large and small follicles （P = 0.017）. Statistical difference was found in the antagonist group （P = 0.049 6）， but not in the agonist group （P = 0.108）. ConclusionThe mRNA level of AQP2 in luteinized granulosa cells increases with the increase of follicle diameter and its expression is related to the ovarian stimulation protocol， suggesting that AQP2 may play a role in follicle growth and follicular fluid formation， and its mRNA expression level may be regulated by follicle stimulating hormone （FSH） and luteinizing hormone （LH）.

Current status and suggestions of home pharmacy services under the background of aging / 药学实践杂志

Objective To explore how to further improve the quality of home pharmacy services under the background of aging. Methods The development history of home pharmacy service in our country in recent years was summarized, and the current status and limitations of home-based pharmacy service were analyzed. Results Our country's home-based pharmacy service has gradually matured and standardized from the early stage of independent exploration in various regions, but its quality improvement is still restricted by multiple bottlenecks. It is recommended to increase the popularity of pharmacy services, broaden the promotion channels for rational drug use, and optimize the allocation of pharmacists. etc. to be improved. Conclusion It is of great significance to improve the quality of home-based pharmacy services for home-based patients in the community, and it requires the joint efforts of multiple parties to improve it.

Influence of vitamin D deficiency on fibrosis-4 index and disease severity in patients with nonalcoholic steatohepatitis / 临床肝胆病杂志

Objective To investigate the influence of vitamin D deficiency on nonalcoholic steatohepatitis (NASH). Methods The patients with NASH who were hospitalized in Department of Infectious Diseases, The First Hospital of Changsha, from January 2020 to October 2021 were enrolled, and according to the serum level of 1, 25(OH) 2 D 3 , they were divided into group A with 1, 25(OH) 2 D 3 deficiency ( 30 ng/mL). The three groups were compared in terms of the serum levels of 1, 25(OH) 2 D 3 , alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), total cholesterol (TC), triglyceride (TG), interleukin-18 (IL-18), and interleukin-37 (IL-37) and liver pathological grade, and fibrosis-4 (FIB-4) index was calculated. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups. A Pearson correlation analysis was also performed. Results A total of 120 NASH patients were enrolled, with 40 patients in each group. Compared with group A, groups B and C had significant increases in the levels of 1, 25(OH) 2 D 3 and IL-37 and significant reductions in FIB-4 index and the levels of ALT, AST, TBil, TC, TG, and IL-18 (all P < 0.05). Compared with group B, group C had significant increases in the levels of 1, 25(OH) 2 D 3 and IL-37 and significant reductions in FIB-4 index and the levels of ALT, AST, TC, TG, and IL-18 (all P < 0.05). The correlation analysis showed that 1, 25(OH) 2 D 3 was negatively correlated with ALT ( r =-0.84, P < 0.001), AST ( r =-0.77, P < 0.001), TBil ( r =-0.32, P < 0.001), TC ( r =-0.45, P < 0.001), TG ( r =-0.42, P < 0.001), IL-18 ( r =-0.40, P < 0.001), and FIB-4 index ( r =-0.62, P < 0.001), and it was positively correlated with IL-37 ( r =0.59, P < 0.001). Compared with group A, groups B and C had significant reductions in the proportion of patients with severe steatosis ( χ 2 =51.46, P < 0.001), bridging fibrosis and early liver cirrhosis ( χ 2 =36.59, P < 0.001), or bridging necrosis and large-scale necrosis ( χ 2 =37.28, P < 0.001). Light microscopy showed that group A had extensive ballooning degeneration of hepatocytes, a large number of lipid droplets (mainly macrovesicular lipid droplets), disordered arrangement of the liver plate, lymphocyte infiltration, and focal bridging fibrosis; group B mainly had spotted focal necrosis, periportal fibrosis, lipid droplets with various sizes, a small amount of neutrophil infiltration, and ballooning degeneration of some hepatocytes; group C had ballooning degeneration of a small number of hepatocytes, focal perisinusoidal fibrosis, a small number of lesions with spotted focal necrosis, and a small number of lipid droplets in the cytoplasm of hepatocytes. Conclusion The degree of liver injury and fibrosis increases with the reduction in vitamin D level, and vitamin D measurement helps to evaluate the progression of NASH.

Effect analysis of trajectory screw technique in fragility fracture of pelvic ring / 中国骨伤

OBJECTIVE@#To assess the clinical efficacy of minimally invasive technology with trajectory screw fixation for fragility fractures of pelvic(FFP).@*METHODS@#A retrospective case control study was performed to analyze the clinical data of 35 patients with FFP who were treated and followed up between January 2016 and December 2019. There were 12 males and 23 females, aged from 65 to 99 years with an average of(75.4±7.8) years old. There were 13 cases of type Ⅱb, 7 cases of type Ⅱc, 8 cases of type Ⅲa, 2 cases of type Ⅲb, 2 cases of type Ⅲc, 1 case of type Ⅳb, and 2 cases of type Ⅳc according to Rommens FFP comprehensive classification. All patients received the treatment of minimally invasive technology with trajectory screws fixation. According to the different methods of anterior pelvic ring fixation, FFP patients were divided into two groups:12 cases were fixed with the pedicle screw rod system in the anterior pelvic subcutaneous internal fixator (INFIX) group;23 cases were fixed with hollow screws of the pubic symphysis, superior ramus of pubis or acetabular anterior column in the screw group. The operation time, intraoperative blood loss, intraoperative fluoroscopy times, length of hospital stay, cost of internal fixation, pre- and post-operative visual analogue scale(VAS) were compared between the two groups. The fracture reduction quality was evaluated according to the Matta criteria, and the clinical function was evaluated by the Majeed functional scoring system respectively.@*RESULTS@#All patients were followed up for 12 to 39(16.5±5.4) months after surgery. There was no statistically significant difference in the operation time, intraoperative blood loss, intraoperative fluoroscopy time, and length of hospital stay between the two groups(P>0.05). As for the cost of internal fixation, the cost of internal fixation in the screw group [2 914 (2 914, 4 371) yuan] was significantly lower than that of the INFIX group [6 205 (6 205, 6 205) yuan] (P<0.05). No significant difference was observed in the incidence of postoperative complications between the two groups (P>0.05). There was no significant difference in VAS assessment at admission, 1 week, and 3 months after surgery between the two groups(P>0.05). However, the VAS assessment at 1 week and 3 months after surgery of the two groups were significantly better than those at admission(P<0.05). There was no significant difference in the quality of fracture reduction after the operation and the efficacy evaluation at the last follow-up between the two groups(P>0.05).@*CONCLUSION@#For the treatment of fragility fractures, minimally invasive technology with trajectory screw fixation can achieve good clinical efficacy. It has the advantages of being relatively minimally invasive, less bleeding, relieving the pain. It deserves clinical application.

Serum inflammation index and synovial fluid analysis in the diagnosis of periprosthetic joint infection in patients with rheumatoid arthritis / 中华骨科杂志

Objective:To investigate the threshold of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), synovial fluid white blood-cell count (WBC) and polymorphonuclear cells (PMN) proportion in the diagnosis of periprosthetic joint infection (PJI) in patients with rheumatoid arthritis (RA).Methods:The clinical data of 246 patients with RA and osteoarthritis (OA) who had previously undergone total knee and hip arthroplasty from January 2006 to December 2019 was retrospectively analyzed. The patients were divided into four groups according to the disease type and whether PJI occurred, namely 46 patients in the RA-PJI group, 64 patients in the RA-non-PJI group, 72 patients in the OA-PJI group, and 64 patients in the OA-non-PJI group. The receiver operating characteristics (ROC) curve was used to determine the optimum cut-off values of CRP, ESR, synovial fluid WBC and PMN proportion for diagnosing the RA-PJI and OA-PJI. The optimal cut-off values of serum and synovial fluid indexes were evaluated for the diagnostic efficacy of RA-PJI by comparing the area under curve (AUC) of each index. Further, the values were applied for joint test analysis.Results:For PJI prediction, the results of serological and synovial fluid indexes were different between RA-PJI group and OA-PJI group. The results of ROC curve analysis showed that the optimal cut-off values of each detection index were as follows. The optimal cut-off value of CRP for diagnosing RA-PJI was 14.4 mg/L, ESR was 39 mm/1 h, synovial fluid WBC was 3 654×10 6 /L, and PMN proportion was 0.659. The optimal cut-off value for diagnosing OA-PJI were 8.16 mg/L, 31 mm/1 h, 2 452×10 6 /L, and 0.625, respectively. In the RA-PJI group, the difference between the AUC of each detection index and AUC=0.5 was statistically significant ( P<0.05). Among them, the specificity of synovial fluid WBC was 92.3%, AUC was 0.879 (95% CI: 0.776, 0.982) with 87.8% positive predictive value and 10.21 positive likelihood ratio. These values were higher than those of CRP, ESR, and PMN proportion. The results of joint test analysis for the diagnosis of RA-PJI were as follows. The specificity of the series test was 100%, and the sensitivity of the parallel test was 100%; the specificity of the joint index diagnostic test was 100%, AUC was 0.926 (95% CI: 0.848, 1.000), the difference between AUC and AUC=0.5 was statistically significant ( P<0.05). Conclusion:The optimum cut-off values of CRP, ESR, synovial fluid WBC and PMN proportion for the diagnosis of PJI in patients with RA are all higher than those of patients with OA. Their optimal cut-off values can be used as important auxiliary indexes for a clear diagnosis of PJI in patients with RA. Compared with other indexes, the synovial fluid WBC has strong predicting power and lower misdiagnosis rate, which could be the best detection index for identifying PJI in patients with RA. The joint test could improve the sensitivity or specificity of PJI diagnosis in patients with RA. The combination with multiple detection indexes could provide a reference for the early and accurate diagnosis of PJI in patients with RA.

Analysis of the effect of sequential high-flow nasal canula oxygen therapy in post-extubation mechanically ventilated patients in intensive care unit / 中华危重病急救医学

Objective:To observe the application effect of high-flow nasal canula oxygen therapy (HFNC) after extubation in patients with mechanical ventilation (MV) in the intensive care unit (ICU).Methods:A prospective study was conducted. From January 2018 to June 2020, 163 MV patients admitted to Yijishan Hospital of Wannan Medical College were enrolled, and they were divided into HFNC group (82 cases) and traditional oxygen therapy group (81 cases) according to the oxygen therapy model. The patients included in the study were given conventional treatment according to their condition. In the HFNC group, oxygen was inhaled by a nasal high-flow humidification therapy instrument. The gas flow was gradually increased from 35 L/min to 60 L/min according to the patient's tolerance, and the temperature was set at 34-37 ℃. The fraction of inspiration oxygen (FiO 2) was set according to the patient's pulse oxygen saturation (SpO 2) and SpO 2 was maintained at 0.95-0.98. A disposable oxygen mask or nasal cannula was used to inhale oxygen in the traditional oxygen therapy group, and the oxygen flow was 5-8 L/min, maintaining the patient's SpO 2 at 0.95-0.98. The differences in MV duration before extubation, total MV duration, intubation time, reintubation time, extubation failure rate, ICU mortality, ICU stay, and in-hospital stay were compared between the two groups, and weaning failure were analyzed. Results:There was no significant differences in MV duration before extubation (days: 4.33±3.83 vs. 4.15±3.03), tracheal intubation duration (days: 4.34±1.87 vs. 4.20±3.35), ICU mortality [4.9% (4/82) vs. 3.7% (3/81)] and in-hospital stay [days: 28.93 (15.00, 32.00) vs. 27.69 (15.00, 38.00)] between HFNC group and traditional oxygen therapy group (all P > 0.05). The total MV duration in the HFNC group (days: 4.48±2.43 vs. 5.67±3.84) and ICU stay [days: 6.57 (4.00, 7.00) vs. 7.74 (5.00, 9.00)] were significantly shorter than those in the traditional oxygen therapy group, the reintubation duration of the HFNC group was significantly longer than that of the traditional oxygen therapy group (hours: 35.75±10.15 vs. 19.92±13.12), and the weaning failure rate was significantly lower than that of the traditional oxygen therapy group [4.9% (4/82) vs. 16.0% (13/81), all P < 0.05]. Among the reasons for weaning failure traditional oxygen therapy group had lower ability of airway secretion clearance than that of the HFNC group [8.64% (7/81) vs. 0% (0/82), P < 0.05], there was no statistically differences in the morbidity of heart failure, respiratory muscle weakness, hypoxemia, and change of consciousness between the two groups. Conclusion:For MV patients in the ICU, the sequential application of HFNC after extubation can reduce the rate of weaning failure and the incidence of adverse events, shorten the length of ICU stay.

Analysis of clinical effects of iliolumbar fixation in treating U-shaped sacral fractures / 中国骨伤

OBJECTIVE@#To evaluate the efficacy of iliolumbar fixation in the treatment of U-shaped sacral fractures.@*METHODS@#A retrospective study was conducted on the 14 complex U-shaped sacral fractures which had been treated from January 2014 to December 2019, involved 10 males and 4 females, aged 24 to 48 (35.4±6.5) years. Fracture healing time, nerve function, clinical function and complications were observed in the patients.@*RESULTS@#All patients were followed up for 9 to 16(26.0±5.9) months. The complete weight-bearing time for bone healing was(12.4±2.0) weeks. One case of surgical incision infection occurred after operation, and one case of sacrum nailspenetrated to the outer plate of sacrum. No complications such as pressure ulcers, loosening or rupture of internal fixation occurred. According to Gibbons scoring, the neurological function recovered from preoperative 2.9±0.9 to postoperative 2.1±1.1, there were statistically significant differences between preoperative and postoperative (@*CONCLUSION@#Sacral lumbar fixation is an effective method for the treatment of U-shaped sacrum fractures. It has the advantages of strong internal fixation and satisfactory functional recovery.

The role of nuclear receptor transcription factor NR2F6 in tumor / 生物工程学报

Nuclear receptor subfamily 2, group F, member 6 (NR2F6) is a member of orphan nuclear receptors, which is expressed in major tissues and organs of the human body, and plays an important role in the regulation of various biological functions and gene expressions. Recent studies have shown that the expression of NR2F6 was up-regulated in a variety of malignant tumors and showed significant correlations with cancer progression. These findings triggered the widespread interest in understanding the relationship between NR2F6 and cancer development and progression. In addition, the latest studies have underscored that NR2F6 was involved in enhancing antitumor immune responses that could serve as a potential target for immune regulation. This review summarizes the biological functions of NR2F6 and its role in tumors, with the aim to provide new insights into effective cancer therapies.

Long-term prognosis of patients with hepatitis C virus-related hepatocellular carcinoma receiving direct-acting antiviral: A Meta-analysis / 临床肝胆病杂志

ObjectiveTo systematically evaluate the difference in recurrence-free survival rate, hepatocellular carcinoma (HCC) recurrence rate, all-cause mortality rate, and liver-related mortality rate between hepatitis C-related HCC patients receiving oral direct-acting antiviral (DAA) and those receiving non-DAA (NDAA) treatment regimen. MethodsCNKI, Wanfang Data, VIP, CBM, PubMed, Embase, and Cochrane Library were searched for Cohort studies of DAA in the treatment of hepatitis C-related HCC patients published before December 2020, and quality assessment and meta-analysis were performed. ResultsA total of 10 cohort studies were included in this study, with 3108 patients in total. The meta-analysis showed that compared with NDAA regimen, DAA treatment significantly increased recurrence-free survival rate (risk ratio ［RR］=1.38, 95% confidence interval ［CI］: 1.10-1.72, P=0.005) and significantly reduced HCC recurrence rate (RR=0.52, 95%CI: 0.42-0.63, P＜0.000 01), all-cause mortality rate (RR=0.42, 95%CI: 0.32-0.55, P＜0.000 01), and liver-related mortality rate (RR=0.37, 95%CI: 0.18-0.76, P=0.007) in hepatitis C-related HCC patients. ConclusionDAA treatment is beneficial and safe for hepatitis C-related HCC patients.

Development and validation on death risk model of Stanford type A aortic dissection based on Cox regression / 中华危重病急救医学

Objective:To construct the prediction model of death risk of Stanford type A aortic dissection (AAD) based on Cox proportional risk regression model.Methods:AAD patients who were diagnosed and received surgical treatment admitted to the department of cardiothoracic surgery of Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from January 1st, 2019 to April 30th, 2020 were enrolled. The general situation, clinical manifestations, pre-hospital data, laboratory examination and imaging examination results of the patients were collected. The observation period was up to the death of the patients or ended on April 30th, 2021. They were divided into the model group and the verification group according to the ratio of 7∶3. Lasso method was used to screen prognostic variables from the data of the modeling group, and multivariate Cox regression analysis was included to construct the AAD death risk prediction model, which was displayed by nomogram. The receiver operator characteristic curve (ROC curve) was used to evaluate the discrimination of the model, the calibration curve to evaluate the accuracy of the model, and the clinical decision curve (DCA) to evaluate the effectiveness of the model.Results:A totel of 454 patients with AAD were finally included, and the mortality was 19.4% (88/454). Lasso regression analysis was used to screen out 10 variables from the data of 317 patients in the model group, and the prediction model of death risk was constructed: 0.511×abdominal pain+1.061×syncope+0.428×lower limb pain/numbness-0.365×emergency admission-1.933×direct admission-1.493×diagnosis before referral+0.662×preoperative systolic blood pressure (SBP) < 100 mmHg (1 mmHg = 0.133 kPa)+0.632×hypersensitivity cardiac troponin I (hs-cTnI) > 34.2 ng/L+1.402×De Bakey type+0.641× pulmonary infection+1.472×postoperative delirium. The area under the ROC curve (AUC) and 95% confidence interval (95% CI) of the AAD death risk prediction model were 0.873 (0.817-0.928), and that of the verification group was 0.828 (0.740-0.916). DCA showed that the net benefit value of the model was higher. The calibration curve showed that there was a good correlation between the actual observation results and the model prediction results. Conclusion:The AAD death risk prediction model based on abdominal pain, syncope, lower limb pain/numbness, mode of admission, diagnosis before referral, preoperative SBP < 100 mmHg, hs-cTnI > 34.2 ng/L, De Bakey type , pulmonary infection, and postoperative delirium can effectively help clinicians identify patients at high risk for AAD, evaluate their postoperative survival and timely adjust treatment strategies.

Comparison of different minimally invasive internal fixation in the treatment of pelvic anterior ring fracture / 中国骨伤

OBJECTIVE@#To compare the clinical efficacy of three minimally invasive methods of anterior column screw, plate and screw rod system in the treatment of anterior pelvic ring fracture.@*METHODS@#From December 2015 to September 2018, 77 patients with pelvic anterior ring fracture were treated and followed up, including 45 males and 32 females, aged 19 to 73 years. According to AO / OTA classification, there were 26 cases of type B1, 20 cases of type B2, 17 cases of type B3 and 14 cases of type C. According to the different internal fixation methods, they were divided into three groups:anterior column screw group(35 cases), plate group(20 cases), and screw rod system group(22 cases). The operation time, intraoperative fluoroscopy times, blood loss, fracture reduction quality, complications and curative effect of the three groups were compared.@*RESULTS@#All 77 patients were followed up for 12 to 33 (16.5±5.7) months. The operation time, intraoperative blood loss and incision length of anterior column screw group were significantly shorter than those of plate group and screw rod system group, and intraoperative fluoroscopy times of plate group were significantly less than those of anterior column screw group and screw rod system group (@*CONCLUSION@#Minimally invasive internal fixation with anterior column screw, plate and screw rod system can obtain good clinical effect, but anterior column screw fixation has less trauma and lower incidence of surgicalcomplications.

Application of laboratory diagnostic technologies for SARS-CoV-2: current progress and prospect / 南方医科大学学报

Since the outbreak of COVID-19 pandemic, the detection capability has been improving and the detection techniques have been evolving with innovations. qRT- PCR and mNGS, which represent the current mainstay diagnostic technologies, play key roles in disease diagnosis and monitoring of virus variation. The detection technologies based on serum and plasma IgM and IgG antibodies are important for auxiliary diagnosis. RT-LAMP is highly specific for a diagnostic purpose. Digital PCR could quantitatively detect nucleic acid and SHERLOCK has a higher sensitivity. These techniques all have great potential for future development and application for pathogen detection. In this review the authors summarize the basic rationales, technical characteristics and the current application of the SARS-CoV-2 detection techniques.

Effect of Buyang Huanwu Tang on Synaptic Structural Plasticity After Cerebral Ischemia-reperfusion in Rats / 中国实验方剂学杂志

<b>Objective::To investigate the mechanism of Buyang Huanwu Tang (BYHWT) in improving synaptic structural plasticity after cerebral ischemia-reperfusion in rats. <b>Method::Middle cerebral artery occlusion and reperfusion model was established. SD rats were randomly divided into sham-operated group, model group, BYHWT group, BYHWT+ Gap26(connexin43 inhibitor)groups. BYHWT was given twice a day(16 g·kg^-1), Gap26 was intraperitoneally injected once a day since the third day after surgery (25 g·kg^-1). Brain was taken out at the 7^th day. The changes of neuronal synaptic and gap junction ultrastructure were observed by transmission electron microscopy. Synaptophysin (SYN) and growth-associated protein-43 (GAP-43) protein expression were detected by Western blot and immunofluorescence. <b>Result::The structure of synapses was integrated, and the gap junctions were clear in sham-operated group. In the hippocampus of model group, the structure was destroyed, and the gap junctions disappeared. Compared with the sham-operated group, model group up-regulated the expressions of SYN and GAP-43 (<italic>P</italic><0.05, <italic>P</italic><0.01). In the hippocampus of BYHWT group, the structure was close to the normal. Furthermore, BYHWT up-regulated the expressions of SYN and GAP-43 (<italic>P</italic><0.05, <italic>P</italic><0.01). However, after the combined administration with Cx43 inhibitor (Gap26), the damage of synaptic structural decreased, only a small number of gap junctions with the structural integrity can be seen, and the effect of BYHWT on SYN and GAP-43 was inhibited (<italic>P</italic><0.05, <italic>P</italic><0.01). <b>Conclusion::BYHWT could improve the hippocampal synaptic structural plasticity obviously after the CIRI. The mechanism may be related to the increase of the expression of Cx43 and the promotion of the intervention of SYN and GAP-43.

Value of sTREM-1 in serum and bronchoalveolar lavage fluid, APACHE II score, and SOFA score in evaluating the conditions and prognosis of children with severe pneumonia / 中国当代儿科杂志

OBJECTIVE@#To study the significance of the level of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) in serum and bronchoalveolar lavage fluid (BALF), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score in evaluating the conditions and prognosis of children with severe pneumonia.@*METHODS@#A total of 76 children with severe pneumonia who were admitted from August 2017 to October 2019 were enrolled as the severe pneumonia group. According to the treatment outcome, they were divided into a non-response group with 34 children and a response group with 42 children. Ninety-four children with common pneumonia who were admitted during the same period of time were enrolled as the common pneumonia group. One hundred healthy children who underwent physical examination in the outpatient service during the same period of time were enrolled as the control group. The serum level of sTREM-1, APACHE II score, and SOFA score were measured for each group, and the level of sTREM-1 in BALF was measured for children with severe pneumonia. The correlation of the above indices with the severity and prognosis of severe pneumonia in children was analyzed.@*RESULTS@#The severe pneumonia group had significantly higher serum sTREM-1 level, APACHEII score, and SOFA score than the common pneumonia group and the control group (P0.05).@*CONCLUSIONS@#The level of sTREM-1 in serum and BALF and SOFA score can be used to evaluate the severity and prognosis of severe pneumonia in children.

Clinical Efficacy of Shashen Maidongtang Plus Total Glucosides of Paeony Capsule in Treatment of Primary Sjogren's Syndrome with Based on Theory of Fluid Metabolism / 中国实验方剂学杂志

Objective:To investigate the clinical efficacy of Shashen Maidongtang plus total glucosides of paeony capsule on primary Sjogren's syndrome (pSS) based on the theory of fluid metabolism. Method:In this study, 84 patients of Qi-Yin deficiency type pSS admitted in Zhengzhou Chinese Medicine Hospital from January 2018 to January 2019 were divided into observation group (42 cases) and control group (42 cases) on the basis of random number table. The control group was orally given total glucosides of paeony capsule and iguratimod tablet, while the observation group was orally given Shashen Maidongtang combined with glucosides of paeony capsule. After 3 months of continuous treatment to all subjects, the clinical efficacy was evaluated, and side effects were recorded. Before and after the treatment, the saliva flow rate and basal tear secretion Schirmer I test (SIt) value were measured, European League Against Rheumatism Sjogren's syndrome patient reported index and Sjogren's syndrome disease activity index (ESSPRI and ESSDAI) were scored, the erythrocyte sedimentation rate (ESR) was determined by Westergren, and the levels of serum rheumatoid factor (RF) and immunoglobulin (Ig) G were tested by immunoturbidimetry and rate scattering turbidimetry, respectively. Result:The overall effective rate of the observation group was 90.48% (38/42), which was much higher than 69.05% (29/42) of the control group (χ2=5.974，P<0.05). After treatment, the saliva flow rates and SIt values of both groups got significantly increased compared with those before the treatment (P<0.05), but the saliva flow and SIt of the observation group were significantly better than those of the control group over the same period after treatment (P<0.05). After treatment, both groups had a great decrease in ESSPRI and ESSDAI scores compared with those before the treatment (P<0.05), and the above scores of the observation group were dramatically lower than those of the control group over the same period (P<0.05). After treatment, ESR, serum RF, and IgG levels of both groups were significantly lower than those before the treatment (P<0.05), and the observation group showed higher levels of ESR, serum RF and IgG than the control group over the same period after treatment (P<0.05). Side effects were few and mild in both groups. Conclusion:In treating patients of Qi-Yin deficiency type pSS, Shashen Maidongtang plus total glucosides of paeony capsule was proven to be effective generally. It could significantly inhibit excessive inflammation and hyperhumoral immunity in patients, and control their disease activity. This may be related to the effect of Shashen Maidong decoction and its decomposed recipes in correcting body fluid infusion and metabolic disorder in patients of Qi-Yin deficiency type pSS.

The exploration on clinical value of MRI fat quantification in patients with thyroid associated ophthalmopathy / 中华内分泌代谢杂志

Objective:To quantify the fat of extraocular muscle in TAO patients with MRI fat-water separation technique.Methods:66 patients (129 eyes) with TAO were included in this study from November 2017 to July 2019. The age, gender, course of disease, disease activity and severity were collected. Fat fraction(FF) of the heaviest inflamed extraocular muscle was used as FFmax, the average FF of each orbital was recorded as FFmean. FF differences between groups of severity and activity were compared, the correlation between FF and clinical characteristics was also analyzed. Meanwhile, the changes of FF in follow-up patients before and after treatment were compared.Results:FFmean and FFmax of mild group were higher than moderate-to-severe as well as sight-threatening group. In male patients, active group′s FFmean and FFmax were lower. FF was different in groups which based on disease course ( P<0.05). Spearman correlation analysis showed a positive correlation between FF and disease course. Besides, there was a negative correlation between FF, disease activity, and disease severity ( P < 0.05). FF increased after treatment(FFmean: 34.03%±6.75% vs 32.26%±6.06%, P=0.040; FFmax: 33.43%±9.44% vs 29.04%±8.45%, P=0.006). Conclusion:MRI fat fraction can quickly and objectively quantify the fat of extraocular muscle, providing a new reference index for TAO′s disease evaluation.