Application effectiveness of PDCA in emergency blood management / 中国输血杂志

【Objective】 To explore the effectiveness of PDCA (Plan-Do-Check-Act Cycle Management) in clinical emergency blood management. 【Methods】 The data of emergency blood-using cases from January 2021 to June 2022 in each clinical department of our hospital were collected to observe the blood matching time, blood retrieving time, and emergency bloodusing rate. They were divided into PDCA experimental group (Experimental group, July to December 2021, n=287), pre-PDCA experimental group (Control group 1, January to June 2021, n=516) and post-PDCA experimental cessation group (Control group 2, January to June 2022, n=277). Subgroup analysis was performed according to different departments, which were Internal Medicine Department, Surgery Depatment, and ICU. The situation of non-emergency blood use occupying emergency lanes in the pre-implementation period was continuously improved using PDCA, and the differences in blood matching time, blood retrieving time, and emergency blood-using rate among the three groups were compared and analyzed by Kruskal-Wallis test and chi-square test. 【Results】 The blood matching time and blood retrieving time (M, min) in the experimental group, control group 1 and control group 2 were 19.00 vs 45.50 vs 23.00 and 22.00 vs 44.00 vs 25.00, respectively (P< 0.05), and were 19.00 vs 47.00 vs 24.00 and 23.00 vs 56.00 vs 30. 50 in Internal Medicine Department, 18.00 vs 57.50 vs 14.00 and 32.00 vs 41.00 vs 24.00 in Surgery Department, 20.00 vs 42.00 vs 23.00 and 16.50 vs 34.00 vs 12.50 in ICU (P<0.05). The rate of emergency blood use in the experimental group, control group 1, and control group 2 were 6.9%(287/4 141) vs 11.0%(516/4 689) vs 6.8%(277/4 089), respectively (P< 0.05), and were 6.3%(175/2 769) vs 11.8% (297/2 512) vs 6.7% (186/2 789) in Internal Medicine Department, 5.9%(24/405) vs 3.6 %(44/1 213) vs 7.4% (37/501) in Surgery Department, and 9.1% (88/967) vs 18% (175/973) vs 6.8%(54/799) in ICU (P<0.05). 【Conclusion】 The adoption of PDCA in Blood Transfusion Department can effectively shorten the blood matching time and blood retrieving time for clinical emergencies and improve the success rate of emergency blood transfusion.

Age-related change in mitochondrial DNA copy number and its correlation with intrinsic capacity and body composition / 中华老年医学杂志

Objective:To investigate the correlation of peripheral blood relative mitochondrial DNA copy number(mtDNAcn)with intrinsic capacity and body composition, and to identify potential biomarkers for healthy aging.Methods:Clinical data of 416 patients admitted to our hospital from September 2019 to June 2021 were consecutively collected.MtDNA was extracted from peripheral blood of these subjects, and mtDNAcn was determined by a real-time fluoresence quantitative reverse transcription-polymerase chain reaction(qRT-PCR). Intrinsic capacity assessment included 5 aspects that were exercise[Morse Fall Scale(MFS), Physiological Frailty Phenotype(PFP), Sarcopenia Questionnaire(SARC-CALF), Short Physical Performance Battery(SPPB), Time Up and Go Test(TUG)]; vitality[Mini Nutritional Assessment(MNA), Multidimensional Prognostic Index(MPI)]; cognition[Mini-Mental State Examination(MMSE)scale]; psychology[Geriatric Depression Scale(GDS), Self-rating Anxiety Scale(SAS)]; sensory capacities[Cumulative Illness Rating Scale-the Comorbidity Index(CIRS-CI)]. To assess body composition, dual-energy X-ray absorptiometry was used to measure body fat, including trunk fat, total body fat, fat in the abdominal region, fat in the buttock region, and then to calculate fat index(FMI)and limb skeletal muscle mass index(ASMI).Results:Spearman correlation analysis showed that mtDNAcn had a negatively correlation with age( r=-0.176, P<0.05). After adjustment for gender and body mass index, partial correlation analysis showed mtDNAcn were still negatively correlated with age( r=-0.144, P<0.05). Furthermore, mtDNAcn was significantly correlated with 4 m gait speed, the scores of SARC-CalF, MFS, MNA, MMSE, MPI and its sub-scale's Activities of Daily Living(ADL)and Short Portable Mental Status Questionnaire(SPMSQ)( r=0.171, -0.207, -0.163, 0.221, 0.184, -0.210, 0.241, -0.269, all P<0.05). After adjustment for age, gender and body mass index, partial correlation analysis showed mtDNAcn still had a significant correlation with gait speed, the scores of MFS, MNA, MPI and SPMSQ( r=0.170, -0.170, 0.148, -0.242, -0.188, all P<0.05). In addition, the Spearman correlation analysis showed that mtDNAcn was positively correlated with FMI, trunk fat, total body fat, abdominal fat and fat in the buttock region( r=0.168, 0.143, 0.175, 0.116, 0.199, all P<0.05). However, after adjustment for age and gender, mtDNAcn was only correlated with FMI, total body fat, fat in the buttock region( r=0.126, 0.131, 0.127, all P<0.05). On the other hand, multiple linear regression analysis showed that mtDNAcn was significantly correlated with age, gait speed, FMI, total body fat, fat in the buttock region, the scores of MFS, PFP, MNA and MPI( β=-0.191, 0.156, 0.126, 0.131, 0.125, -0.119, -0.145, 0.151, -0.171, all P<0.05). Conclusions:MtDNAcn is correlated with physical function, frailty, nutrition, falling, cognition and body composition, and may be considered as a biomarker for the evaluation of the locomotion and vitality of human intrinsic capacity.

Advances in the study of optimum chest compression point for adult cardiopulmonary resuscitation / 中华危重病急救医学

Chest compressions are a key component of cardiopulmonary resuscitation (CPR). The determination of the optimal compression point (OCP) in adult CPR is an indispensable critical factor for high quality chest compressions (CCs). At present, the OCP for adult CPR is still controversial, which still needs further research and discussion. To provide theoretical reference for determining the OCP, this paper reviews the research progress of the OCP of adult CPR from the development process of compression point and hemodynamic mechanism, so as to improve the quality of CCs and the outcome of cardiac arrest (CA) patients.

Advances in heterologous expression, structural elucidation and molecular modification of pullulanase / 生物工程学报

Starch is composed of glucose units linked by α-1, 4-glucoside bond and α-1, 6-glucoside bond. It is the main component of foods and the primary raw material for starch processing industry. Pullulanase can effectively hydrolyze the α-1, 6-glucoside bond in starch molecules. Combined with other starch processing enzymes, it can effectively improve the starch utilization rate. Therefore, it has been widely used in the starch processing industry. This paper summarized the screening of pullulanase-producing strain and its encoding genes. In addition, the effects of expression elements and fermentation conditions on the production of pullulanase were summarized. Moreover, the progress in crystal structure elucidation and molecular modification of pullulanase was discussed. Lastly, future perspectives on pullulanase research were proposed.

Research progress on mitochondrial dynamics and age-related diseases / 中华老年医学杂志

Mitochondrial dynamics regulates mitochondrial morphology and functions.Imbalance in mitochondrial dynamics with aging leads to mitochondrial dysfunction, accelerates the aging process and is closely related to the occurrence and progression of age-related diseases.However, the specifics of the relationship between aging and altered mitochondrial dynamics are still not fully understood.Here, we review the link between mitochondrial dynamics and aging, and discuss mechanisms underlying age-related diseases associated with altered mitochondrial dynamics, aiming to identify novel therapeutic targets and strategies for the management of age-related diseases.

A case of congenital myopathy caused by the SPEG gene mutation / 中华实用儿科临床杂志

Clinical data of a child with congenital myopathy caused by the SPEG gene mutation diagnosed in the Children′s Hospital of Nanjing Medical University in March 2020 were retrospectively analyzed, and the relevant literature was reviewed.A 13-year-old female child with lagged motor development since childhood, weakness of both lower extremities for 10 years, and slow progression of disease.Physical examinations showed gait swinging, mild hypertrophy of gastrocnemius, positive Gower sign, grade Ⅴ distal muscle strength of both lower extremities, and grade Ⅳ proximal muscle strength.The electromyography showed myogenic damage changes.Her 11-year-old sister presented similar symptoms of muscle weakness.Gene sequencing revealed compound heterozygous mutations in the SPEG gene, with the newly reported mutation sites at c. 3715+ 4C>T and c. 3588delC, which had not been reported at home and abroad.This study for the first time reported a case of congenital myopathy caused by the SPEG gene mutation in China, which differed from previous cases accompanied cardiomyopathy.This case report expanded the mutation spectrum of the SPEG gene.

Correlation analysis between different nutritional status and age at first spermatorrhea of boys aged 11 to 18 in Ningxia in 2019 / 中国学校卫生

Objective@#To explore the correlation between obesity and first ejaculation in boys aged 11-18 years old in Ningxia in 2019, and to provide the theoretical reference for puberty development among obese boys.@*Methods@#Using the method of stratified random cluster sampling, 5 240 boys aged 11- 18 were selected from Yinchuan, Zhongwei, Wuzhong and Guyuan in Ningxia Hui Autonomous Region. Height, weight, and first ejaculation were obtained.Body mass index (BMI) was calculated to determine nutritional status, and the χ 2 test was used to compare the differences between groups of nutritional status; the probability unit regression method was used to calculater the soth percentile age at ejaculation, and the U test was applied to compare the differences in age at ejaculation between groups.@*Results@#The rates of overweight and obesity among boys aged 11 to 18 years in Ningxia Hui Autonomous Region in 2019 were 15.5% and 8.8%. The detection rate of overweight and obesity among urban boys was 17.8% and 10.5% and the detection rate of overweight and obesity among rural boys was 12.9% and 6.9%,respectively. The 50 th percentile age at half ejaculation among urban boys aged 11 to 18 years was 14.94 years; the 50 th percentile age at ejaculation among rural boys was 15.33 years( P <0.01). The 50 th percentile age at ejaculation was 15.61, 15.10, 15.05 and 15.05 years for boys in the wasted, normal weight, overweight and obese groups, respectively.@*Conclusion@#Nutritional status was not associated with age at first ejaculation in the present study,but warrants farther investigation.

Clinical Analysis of Oxaliplatin-related Thrombocytopenia in Patients with Digestive System Malignancy / 肿瘤防治研究

Objective To investigate the changing trend and correlation of platelet count and spleen diameter in patients with digestive system malignancy receiving oxaliplatin-based chemotherapy. Methods We retrospectively analyzed clinical data of 72 patients with digestive system cancer, recorded and analyzed platelet count and spleen diameter during and after oxaliplatin-based chemotherapy. Results The incidence of thrombocytopenia in all patients was 65.3%. The median time of thrombocytopenia after the beginning of chemotherapy was 2.53±0.49 months, and the median cumulative dose of oxaliplatin was 520±35.81 mg/m2; the median time of lowest platelet count after the beginning of chemotherapy was 4.03±0.49 months, and the median cumulative dose of oxaliplatin was 780±36.32 mg/m2. Splenomegaly occurred in 52(72.2%) patients during the follow-up. The median increase rate was (18.82±0.01)%. The median time of splenomegaly after the beginning of chemotherapy was 2.15±0.19 months, the median time for the largest spleen diameter was 4.68±2.89 months; after the end of chemotherapy, the median time for spleen contraction was 3.28±0.44 months, and the median time for spleen recovery was 8.80±1.05 months. Conclusion Oxaliplatin-based chemotherapy can cause thrombocytopenia and splenomegaly, and it is difficult to recover to baseline for a long time after the end of chemotherapy. The increase of spleen diameter was positively correlated with splenomegaly and thrombocytosis.

Characteristics of skin microbiota in an atopic dermatitis-like mouse model induced by 2,4-dinitrochlorobenzene / 中华皮肤科杂志

Objective:To investigate characteristics and changes of skin microbiota in atopic dermatitis-like mouse models induced by different concentrations of 2,4-dinitrochlorobenzene (DNCB) .Methods:Totally, 30 male specific-pathogen-free BALB/c mice were randomly divided into 3 groups by using a random number table: negative control group topically treated with 200 μl of mixture of acetone and olive oil at a volume ratio of 3∶1 on the back twice a week for 6 consecutive weeks; high-and low-concentration DNCB groups both topically treated with 200 μl of 1% DNCB on the first and third day at the first week, followed by topical application of 200 μl of 0.5% and 0.1% DNCB, respectively, twice a week for 5 weeks from the second week. Twenty-four hours after the last treatment, the severity of skin lesions was evaluated, and the transepidermal water loss and stratum corneum hydration were measured. After the experiment, the mice were sacrificed, and skin tissues were resected from the back of the mice for histopathological examination. Full-thickness skin tissue samples were obtained from the back of 3 mice in each group. Illumina Miseq PE300 high-throughput sequencing was performed to sequence the V3-V4 variable region of 16S rRNA gene of skin microbiota on the back of the mice, and the composition and structure of the skin microbiota and changes in the relative abundance of different genera were analyzed. One-way analysis of variance was used to analyze differences in indices among the 3 groups, and the Games-Howell method was used for multiple comparisons.Results:The severity scores of skin lesions were significantly higher in the high-and low-concentration DNCB groups (9.83 ± 2.45 points, 2.71 ± 0.56 points, respectively) than in the negative control group (0.51 ± 0.12 points, t=-7.19,-2.85, respectively, both P < 0.05) . Compared with the negative control group, the high-and low-concentration DNCB groups showed significantly increased transepidermal water loss ( t=-7.72,-2.68, respectively, both P < 0.05) , but significantly decreased stratum corneum hydration ( t=6.77, 5.99, respectively, both P < 0.05) ; the transepidermal water loss was significantly higher in the high-concentration DNCB group than in the low-concentration DNCB group ( t=2.76, P < 0.05) , while no significant difference in the stratum corneum hydration was observed between the high-and low-concentration DNCB groups ( P > 0.05) . There was a significant difference in the relative abundance of Corynebacterium among the 3 groups ( F=249.85, P < 0.001) , which was highest in the high-concentration DNCB group. No significant differences in the observed species and Chao1 index of the skin samples were observed among the 3 groups (both P > 0.05) , and the Shannon index was significantly lower in the high-concentration DNCB group than in the low-concentration DNCB group and negative control group ( t=6.96,-6.37, respectively, both P < 0.05) . Conclusion:DNCB could induce atopic dermatitis-like dermatitis in mice, and the severity of skin lesions and degree of barrier function impairment were related to the concentration of DNCB; the species diversity of skin microbiota markedly decreased in the high-concentration DNCB group, indicating that high-concentration DNCB modeling has more advantages in studying microbiological changes associated with atopic dermatitis.

The correlation of age-related mitochondrial respiratory function of peripheral blood mononuclear cells with grip strength and appendicular skeletal muscle mass / 中华老年医学杂志

Objective:To investigate the correlation of mitochondrial respiration function and oxidative phosphorylation of peripheral blood mononuclear cells(PBMCs)with grip strength and muscle mass in the elderly, and to identify potential biomarkers for the diagnosis of sarcopenia.Methods:A total of 65 patients admitted to our hospital from June 2019 to August 2020 were enrolled in this study.PBMCs were extracted from subjects.Mitochondrial oxidative respiration function was assessed via the Seahorse XF24 analyzer.Grip strength was measured using a hydraulic dynamometer, and appendicular skeletal muscle mass(ASM)was estimated by dual-energy X-ray absorptiometry(DXA). Multivariate analysis was conducted by using partial correlation analysis and multiple linear regression, in order to evaluate the correlation of mitochondrial oxidative respiration function with grip strength and ASM.Results:After adjustment for gender and body mass index(BMI), partial correlation analysis showed that grip strength and ASM had a negative correlation with age( r=-0.537 and -0.390, both P<0.001); and basal respiration, maximal respiration, ATP production and spare respiratory capacity of mitochondria in PBMCs were negatively correlated with age( r=-0.558, -0.614, -0.526 and -0.582, all P<0.001), whereas grip strength and ASM were positively correlated with basal respiration, maximal respiration, ATP production, spare respiratory capacity and proton leak of mitochondria in PBMCs(grip strength: r=0.414, 0.451, 0.362, 0.420 and 0.425, P=0.002, 0.001, 0.008, 0.002 and 0.002; ASM: r=0.319, 0.368, 0.299, 0.352 and 0.279, P=0.019, 0.006, 0.028, 0.009 and 0.041). Multiple linear regression analysis showed that grip strength and ASM were positively correlated with basal respiration, maximal respiration, ATP production, spare respiratory capacity and proton leak of mitochondria in PBMCs(grip: β=0.503, 0.548, 0.452, 0.519 and 0.532, t=3.248, 3.604, 2.774, 3.301 and 3.350, P=0.002, 0.001, 0.008, 0.002 and 0.002; ASM: β=0.302, 0.355, 0.289, 0.346 and 0.271, t=2.427, 2.856, 2.263, 2.716 and 2.091, P=0.019, 0.006, 0.028, 0.009 and 0.041). Age was negatively correlated with basal respiration, maximal respiration, ATP production and spare respiratory capacity of mitochondria in PBMCs( β=-0.581, -0.654, -0.558 and -0.640, t=-4.285, -5.157, -3.938 and -4.863, all P<0.001). Multiple linear regression analysis showed that ASM and grip strength had no significant correlation with basal respiration, maximal respiration, ATP production, spare respiratory capacity or proton leak of mitochondria in PBMCs. Conclusions:Age-related mitochondrial oxidative respiration in PBMCs can reflect changes in muscle strength and muscle mass and, combined with grip strength and ASM, may be considered as a biomarker for the evaluation of sarcopenia in the elderly.

Pim-1 Protects Retinal Ganglion Cells by Enhancing Their Regenerative Ability Following Optic Nerve Crush

Provirus integration site Moloney murine leukemia virus (Pim-1) is a proto-oncogene reported to be associated with cell proliferation, differentiation and survival. This study was to explore the neuroprotective role of Pim-1 in a rat model subjected to optic nerve crush (ONC), and discuss its related molecules in improving the intrinsic regeneration ability of retinal ganglion cells (RGCs). Immunofluorescence staining showed that AAV2- Pim-1 infected 71% RGCs and some amacrine cells in the retina. Real-time PCR and Western blotting showed that retina infection with AAV2- Pim-1 up-regulated the Pim-1 mRNA and protein expressions compared with AAV2-GFP group. Hematoxylin-Eosin (HE) staining, γ-synuclein immunohistochemistry, Cholera toxin B (CTB) tracing and TUNEL showed that RGCs transduction with AAV2-Pim-1 prior to ONC promoted the survival of damaged RGCs and decreased cell apoptosis. RITC anterograde labeling showed that Pim-1 overexpression increased axon regeneration and promoted the recovery of visual function by pupillary light reflex and flash visual evoked potential. Western blotting showed that Pim- 1 overexpression up-regulated the expression of Stat3, p-Stat3, Akt1, p-Akt1, Akt2 and p-Akt2, as well as βIII-tubulin, GAP-43 and 4E-BP1, and downregulated the expression of SOCS1 and SOCS3, Cleaved caspase 3, Bad and Bax. These results demonstrate that Pim-1 exerted a neuroprotective effect by promoting nerve regeneration and functional recovery of RGCs. In addition, it enhanced the intrinsic regeneration capacity of RGCs after ONC by activating Stat3, Akt1 and Akt2 pathways, and inhibiting the mitochondrial apoptosis pathways. These findings suggest that Pim-1 may prove to be a potential therapeutic target for the clinical treatment of optic nerve injury.

A modified gentamicin protection assay for detecting invasive phenotype of Salmonella enterica serovar Enteritidis / 生物工程学报

Salmonella enterica serovar Enteritidis (SE) is one of the most important zoonotic pathogens that cause enteritis and systemic infection in animals and human. Understanding invasive capacities of SE isolates is of vital importance to elucidate pathogenesis of Salmonella infection. To improve the throughput capacity and repeatability of classical gentamicin protection assay (GPA), a modified PGA was developed by taking high-throughput advantage of 96-well cell plates and multichannel pipettes. In addition, drop plate technique rather than spread plate method was applied in the modified GPA protocol for bacterial enumeration. The modified GPA protocol was evaluated by phenotyping intracellular replication of a high virulent and a low virulent SE isolates, JL228 and LN248, in a phagocytic cell line RAW264.7. The protocol was then applied in invasive phenotype determination of 16 SE strains to non-phagocytes (HT-29) and the intracellular replication of 43 SE strains to phagocytes (RAW264.7). Significant lower intra-group and inter-group coefficient of variations of the modified GPA was observed, implying good repeatability and reproducibility over traditional protocol. Further, replication phenotypes were also correlated with those from direct observation by confocal microscopy. Collectively, the improved GPA protocol had advantages of high throughput capacity, good repeatability and reliability, it was also noticed that the protocol also represented a fast and labor-saving alternative scheme for the invasive phenotype determination of Salmonella Enteritidis, and providing reliable phenotype profiles for Salmonella-host interplay interpretation.

Characteristics of optical coherence tomography of lamellar hole-associated epiretinal proliferation / 中华眼底病杂志

Objective@#To observe the OCT characteristics of lamellar hole-associated epiretinal proliferation (LHEP).@*Methods@#A retrospective case analysis. A total of 128 patients (133 eyes) with lamellar macular hole (LMH) and 202 patients (212 eyes) with full-thickness macular hole (FTMH) diagnosed by the examinations of spectral-domain OCT (SD-OCT) in Department of Ophthalmology, The Third People's Hospital of Chengdu from January 2013 to December 2016 were included in this study. Among 133 eyes with LMH, there were 53 eyes (39.8%) with LHEP and 80 eyes (60.2%) without LHEP. Among 212 eyes with FTMH, there were 12 eyes (5.7%) with LHEP and 200 eyes (94.3%) without LHEP. The mean age of LMH with or without LHEP patients were 70.88±10.98, 64.76±13.60 years old, respectively. The difference of mean age between LMH with or without LHEP patients was statistically significant (U=1521.5, P=0.006). The inner diameter, median diameter and base thickness of the LMH, the height, base diameter and minimum diameter of FTMH were measured by SD-OCT. The traction index (THI) and the macular hole index (MHI) were calculated. An independent sample t-test or rank-sum test was used to compare the inner diameter, median diameter, and base thickness of the LMH in patients with or without LHEP, and χ2 test was used to compare the injury rate of ellipsoid zone.@*Results@#Of the LMH patients with or without LHEP, the inner diameter were 611.15±209.83 and 521.70±198.05 μm, the median diameter were 961.22±571.09 and 497.01±172.30 μm, the base thickness were 99.83±38.69 and 154.12±43.17 μm. The differences of the inner diameter, median diameter and the base thickness between LMH patients with or without LHEP were statistically significant (t=2.490, 5.747, -7.395; P=0.014, 0.000, 0.000). Among the 53 eyes with LHEP, There were 50 eyes (94.34%) were injured in ellipsoid zone among 53 eyes with LHEP, while 17 eyes (21.25%) were injured in ellipsoid zone among 80 eyes without LHEP. The injury rate of ellipsoid zone between LMH patients with or without LHEP was statistically significant (χ2=68.126, P=0.000). In 12 eyes of FTMH with LHEP, there were 10 eyes with THI <1.0 and MHI<0.5.@*Conclusion@#Compared with the LMH without LHEP, the LMH with LHEP has larger inner diameter and median diameter, thinner base and higher injury rate of ellipsoid zone.

Characteristics of optical coherence tomography of lamellar hole-associated epiretinal proliferation / 中华眼底病杂志

Objective To observe the OCT characteristics of lamellar hole-associated epiretinal proliferation (LHEP).Methods A retrospective case analysis.A total of 128 patients (133 eyes) with lamellar macular hole (LMH) and 202 patients (212 eyes) with full-thickness macular hole (FTMH) diagnosed by the examinations of spectral-domain OCT (SD-OCT) in Department of Ophthalmology,The Third People's Hospital of Chengdu from January 2013 to December 2016 were included in this study.Among 133 eyes with LMH,there were 53 eyes (39.8％) with LHEP and 80 eyes (60.2％) without LHEP.Among 212 eyes with FTMH,there were 12 eyes (5.7％) with LHEP and 200 eyes (94.3％) without LHEP.The mean age of LMH with or without LHEP patients were 70.88± 10.98,64.76± 13.60 years old,respectively.The difference of mean age between LMH with or without LHEP patients was statistically significant (U=1521.5,P=0.006).The inner diameter,median diameter and base thickness of the LMH,the height,base diameter and minimum diameter of FTMH were measured by SD-OCT.The traction index (THI) and the macular hole index (MHI) were calculated.An independent sample t-test or rank-sum test was used to compare the inner diameter,median diameter,and base thickness of the LMH in patients with or without LHEP,and x2 test was used to compare the injury rate of ellipsoid zone.Results Of the LMH patients with or without LHEP,the inner diameter were 611.15 ± 209.83 and 521.70± 198.05 μm,the median diameter were 961.22 ± 571.09 and 497.01 ± 172.30 μm,the base thickness were 99.83 ± 38.69 and 154.12± 43.17 μm.The differences of the inner diameter,median diameter and the base thickness between LMH patients with or without LHEP were statistically significant (t=2.490,5.747,-7.395;P=0.014,0.000,0.000).Among the 53 eyes with LHEP,There were 50 eyes (94.34％) were injured in ellipsoid zone among 53 eyes with LHEP,while 17 eyes (21.25％) were injured in ellipsoid zone among 80 eyes without LHEP.The injury rate of ellipsoid zone between LMH patients with or without LHEP was statistically significant (x2=68.126,P=0.000).In 12 eyes of FTMH with LHEP,there were 10 eyes with THI＜ 1.0 and MHI＜0.5.Conclusion Compared with the LMH without LHEP,the LMH with LHEP has larger inner diameter and median diameter,thinner base and higher injury rate of ellipsoid zone.

Clinical analysis of third-line combination therapy with S-1 plus apatinib for advanced colorectal cancer / 中国肿瘤临床

Objective: To investigate the efficacy and toxicity of apatinib combined with S1 as a third-line therapy for advanced colorectal cancer. Methods: Forty-four patients with adavanced colorectal cancer from Tongji Hospital Cancer Center were enrolled from April 2016 to August 2018. The median follow-up period was 8 months. Data related to efficacy and adverse effects were recorded. Results: The median progression-free survival (PFS) time was 3.93 months (95%CI: 2.72-5.15 months), and the median overall survival (OS) time was 7.77 months (95%CI: 5.36-10.18 months). Patients with left hemicolon cancer and rectal cancer group had a longer PFS than patients with right hemicolon cancer group (4.94 months vs . 3.89 months, P=0.024); the OS for left hemicolon cancer and rectal cancer was 12.5 months, the OS for right hemicolon cancer was 7.4 months, P=0.080; gender, previous bevacizumab use and liver metastasis had no statistically significant effect on PFS and OS; the PFS was 4.48 months and 1.10 month, in the patients with ECOG 0-1 and ECOG 2; the OS was 9.67 months and 2.90 month, in these two groups respectively. The major adverse effects of the combination therapy were fatigue (52.3%), hypertension (45%), hand-foot syndrome (22.7%), leukopenia (15.9%), and neutropenia (15.9%), thrombocytopenia (22.7%), elevated transaminase levels (13.6%), diarrhea (15.9%). Conclusions: The results suggest that the combination of apatinib and S-1 is safe and effective as a third-line treatment for advanced colorectal cancer.

The value of prenatally quantitative sonography in diagnosing clubfoot / 中华超声影像学杂志

Objective To investigate the value of prenatally quantitative sonography in diagnosing clubfoot.Methods By routine sonography totally 32 feet diagnosed doubtfully with clubfoot were chosen as case group,and 414 normal feet between 16 and 38 weeks'gestation were enrolled in control group stochastically.The length of foot(FL)and width of the foot(FW)in both group were measured,and then the length-to-width ratio(FL、FW)was calculated.On the basis of the research of Glotzbecker,the angle that the long-axis of the foot made with the long-axis of the lower leg was measured and classified into mild, moderate,severe degree in control group.The length and width of the foot and the length-to-width ratio in both groups were compared.After birth,the fetuses of case group were followed up and Dimeglio score was recorded.The FL、FW and the angle that the long-axis of the foot made with the long-axis of the lower leg were subjected to the correlation analysis with Dimeglio score,respectively.Results Twenty-six of the 32 feet with prenatal diagnosis had a clubfoot documented at birth(false positive equals to 18.8%).According to Glotzbecker's classification,13,13 and 5 of 32 feet respectively were classified as mild,moderate,severe degree.The FL and FL、FW in case group were smaller than those in the other group(FL:Z=-2.10,P <0.05;FL、FW:Z=-8.46,P <0.001),and the foot width was wider(Z=-2.06,P <0.05).Significant negative correlation was identified between the FL、FW and the Dimeglio score(r =-0.600,P <0.01) and significant positive correlation was identified between the angle that the long-axis of the foot made with the long-axis of the lower leg and the Dimeglio score(r=0.764,P <0.01).Conclusions The angle that the long-axis of the foot made with the long-axis of the lower leg,FL,FW and FL、FW can provide more information for prenatally sonography in diagnosing clubfoot without more section of the examination.

Expression and clinical significance of TAP in lung cancer patients / 实用医学杂志

Objective To investigate the expression and clinical significance of tumor abnormal protein (TAP)in patients with lung cancer.Methods Plasma TAP concentration was measured by enzyme-linked immu-nosorbent assay(ELISA)in 93 patients with lung cancer and 100 healthy subjects.Results The plasma TAP con-centration[(187.71 ± 82.295)μm2]in lung cancer group was significantly higher than that in the healthy control group[(67.836 ± 28.642)μm2,t=13.991,P<0.05).The sensitivity of TAP in lung cancer group was 83.87%. Conclusions TAP can improve the early diagnosis rate of lung cancer patients,which is important for early diag-nosis and early treatment. TAP detection is suitable for lung cancer screening in healthy people and people with high risks.

Comparative analysis of distribution and drug resistance of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in elderly and young and middle-aged patients / 新乡医学院学报

Objective To explore the distribution and drug resistance of extended-spectrum beta-lactamase (ESBLs)producing Klebsiella pneumoniae in elderly and young and middle-aged patients,and provide reference for rational use of antibiotics for clinicians.Methods Specimens of elderly (≥ 60 years old) and young and middle-aged (18-59 years old) patients who with various clinical infection in Shengjing Hospital of China Medical University from January 2016 to December 2016 were collected as the research object.ESBLs-producing Klebsiella pneumoniae was isolated from 125 patients (60 elderly patients and 65 young and middle-aged patients).The preliminary screening and phenotypic confirmatory test of ESBLs were carried according to the method which was recommended by American Clinical and Laboratory Standards Institute.The drug resistance of ESBLs-producing Klebsiella pneumoniae was analysed and the resuh of the two groups were compared.Results The specimens of ESBLs-producing Klebsiella pneumoniae strains of elderly patients were mainly from urine (36.67％),sputum (33.33％) and whole blood (11.67％);the specimens of young and middle-aged patients were also mainly from urine (24.62％),sputum(24.62％) and whole blood (15.38％).There was statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the specimens secretions between the elderly patients and the young and middle-aged patients(P ＜0.05).There was no statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the specimens of urine,sputum,whole blood,bile,pus,drain,cerebrospinal fluid,ascitic fluid and catheter between the elderly patients and the young and middle-aged patients (P ＞ 0.05).ESBLs-producing Klebsiella pneumoniae strains of elderly patients were mainly isolated from department of respiration (20.00％,12/60) and department of urinary surgery (18.33％,11/60);the ESBLs-producing Klebsiella pneumoniae strains of young and middle-aged patients were mainly isolated from department of intensive care (16.92％,11/65) and department of neurosurgery (16.92％,11/65).There was statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the department of respiration and obstetrics and gynecology between elderly patients and young and middle-aged patients(P ＜ 0.05);there was no statistical significance in the distribution of ESBLs producing Klebsiella pneumoniae in the department of urinary surgery,general surgery,intensive care,neurosurgery,rheumatoid immunology,invasive technology,oncology,digestion,infection,kidney,orthopaedics,rehabilitation,hematology,neurology and other department between elderly patients and young and middle-aged patients(P ＞ 0.05).The drug resistance rates of ESBLs-producing Klebsiella pneumoniae to beta-lactam antibiotic in elderly and young and middle-aged patients were more than 90.00％;the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to carbapenems were nearly 0.00％ in elderly and young and middle-aged patients.There was significant difference in the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to ceftazidime and gentamicin between elderly patients and young and middle-aged patients(P ＜ 0.05);there was no significant difference in the drug resistance rate of ESBLs-producing Klebsiella pneumoniae to another antibiotic between elderly patients and young and middle-aged patients (P ＞ 0.05).Conclusion Both elderly and the young and middle-aged patients can be infected with ESBLs-producing Klebsiella pneumoniae.There was no significant difference in the distribution of ESBLs-producing Klebsiella pneumoniae in most clinical departments (except respiratory and obstetrics and gynecology).The most effective antimicrobial drugs at present for the treatment of ESBLs-producing Klebsiella pneumoniae was carbapenems.There is no significant difference in the drug resistance rates of ESBLs-producing Klebsiella pneumoniae to common antibiotics between elderly patients and young and middle-aged patients.Clinicians should rationally use antibiotics according to the results of susceptibility tests.

Expression levels and mechanism of microRNA-34a and Notch1 signaling pathway in hippocampi of temporal lobe epilepsy rats / 中华实用儿科临床杂志

Objective To explore the expression levels of microRNA(miR)-34a in hippocampus of temporal lobe epilepsy rats and the effect of miR-34a on its target signaling pathway Notch1.Methods Rats were divided randomly into experiment group (n=40) and control group (n=40) by adopting random number table method.The status epilepticus model and the temporal lobe epilepsy model were induced by using lithium-pilocarpine for experiment group.The control group rats received an injection of an equal amount of 9 g/L saline as instead of pilocarpine.Racine grading was performed at 24 hours,day 3,day 7,day 15,and 1 month after modeling to evaluate the behavior.Real-time fluorescent quantitative polymerase chain reaction was used to test the mRNA expressions of miR-34a and Notch1.Western blot was performed to explore the protein expression of Notch1.Results The expression levels of miR-34a at post-status epilepticus in 24 hours,day 3,day 7,day 15 were 2.55±0.29,2.11±0.17,1.68±0.49 and 1.84±0.42,respectively,which showed statistically significant difference compared with the control group (1.00±0.00) (t=-1.55,-1.11,-0.68,-0.84,all P<0.05).The expression levels of Notch1 mRNA at post-status epilepticus in 24 hours,day 3,day 7,day 15,1 month were 1.44±0.31,1.27±0.13,1.52±0.28,0.91±0.33,and 0.80±0.09 respectively.There were significant differences at 24 hours,day 7 in Notch1 mRNA expression (t=-0.44,-0.52,all P<0.05) compared with the control group(1.00±0.00).The expression level of Notch1 mRNA on day 15 was significantly lower than 24 hours and day 7 (t=-0.54,-0.62,all P<0.05),and the expression in 1 month was significantly lower than in 24 hours,or day 3 and day 7 (t=-0.64,-0.46,-0.72,all P<0.05).The expression levels of Notch1 protein at post-status epilepticus 24 hours,day 3,day 7,day 15,1 month were 0.78±0.09,0.57±0.13,0.55±0.16,0.42±0.13,and 0.33±0.09,respectively.There was significantly up-regulated at 24 hours of Notch1 protein expression compared with control group (0.51±0.15)(t=-0.20,P<0.05);and the expression level at day 15 were significantly lower than 24 hours (t=-0.26,P<0.05),while the expression in 1 month was significantly lower than in 24 hours and on day 3 (t=-0.36,-0.24,all P<0.05).Conclusion miR-34a is significantly up-regulated in the post-status epilepticus rat hippocampus,and it may contribute to temporal lobe epilepsy by activating Notch1 signaling pathway.

Fabrication of Nitrogen-doped Carbon Nanoparticles and Application in Detection of Free Chlorine / 分析化学

Nitrogen-doped carbon nanoparticles (N-CNPs) with a fluorescence quantum yield of 15.1％ were prepared from sucrose and urea in oleic acid medium by a one-pot solvothermal method.A new approach for quick,sensitive,and selective determination of free chlorine in water was developed based on fluorescence quenching of N-CNPs.There existed a good linear correlation between the fluorescence quenching and the concentration of ClO-in the range of 0.05-25.00 μmol/L.The limit of detection (LOD,S/N =3) was estimated to be 23 nmol/L.This method can be applied to the determination of free chlorine in real water samples.