Epidemiology and clinical characteristics of scrub typhus based on 680 unexplained fever patients in Hainan / 中国热带医学

@#Abstract: Objective　To analyze the epidemiological characteristics of scrub typhus in 680 patients with unexplained fever in Hainan Island and provide guidance for local scrub typhus prevention and control. Methods　Blood samples from patients with clinically diagnosed unexplained fever in the First Affiliated Hospital of Hainan Medical University, Second Affiliated Hospital of Hainan Medical University, Haikou Municipal People's Hospital and Central South University Xiangya Medical College Affiliated Hospital, People's Hospital of Qiongzhong Li Miao Autonomous County were collected between 2018 and 2021, then samples were tested for Orientia tsutsugamushi specific IgM, IgG antibodies and Orientia tsutsugamushi 56kD-specific antigen genes using colloidal gold immunochromatography and PCR methods. The clinical and epidemiological information of the samples were also collected. Epidemiological analysis was carried out on the obtained sample information and test results. Results　A total of 680 samples from patients with clinically unknown fever were collected. The positive rates of scrub typhus IgM antibody, IgG antibody, PCR were 23.97% (163/680), 36.62% (249/680), 20.88% (142/680), respectively, and eschar or rash was observed in 12.06% (82/680) of all patients. According to the diagnostic criteria, 223 patients were finally diagnosed with scrub typhus. Among them, there were 111 males (49.78%) and 109 females (48.88%); the average age was (53.14±15.12) years old, and the 40-<60 years old was the main incidence group (98 cases, accounting for 43.95%). The ethnicity of the patient with scrub typhus was mainly Han ethnicity (136 cases, accounting for 60.99%). Farmers were the main morbidity group (93 cases, 41.70%). The patient with scrub typhus distributed throughout the island except for Sanya and Wuzhishan, with Haikou and Qiongzhong show the highest number of cases. The number of cases in autumn was the highest (114 cases, 51.12%). The clinical manifestations of infected patients were mainly non-specific symptoms and signs, 36.77% of patients developed skin-specific ulcers or eschars, which were mainly distributed in the shoulder and neck, armpits, elbow fossa, chest and abdomen, back, buttocks, groin, scrotum and other joints and skin folds of the upper and lower limbs. Conclusions　Hainan Island is the foci of scrub typhus and the epidemic time has obvious seasonality. Its prevention should focus on rural areas in autumn, and its clinical features are mainly high fever and eschar or ulceration.

Risk factors of preoperative hypoxemia in geriatric patients with hip fracture / 中华创伤杂志

Objective:To investigate the risk factors for preoperative hypoxemia in geriatric patients with hip fracture.Methods:A case-control study was used to analyze the clinical data of 99 geriatric patients with hip fracture admitted to Zhongda Hospital affiliated to Southeast University between November 2020 and August 2021. There were 29 males and 70 females, aged 67-96 years [(82.6±6.2)years]. The patients were divided into hypoxemia group ( n=51) and non-hypoxemia group ( n=48) using partial arterial partial pressure of oxygen (PaO 2)<80 mmHg while breathing room air at emergency as the reference standard. The two groups were compared in terms of sex, age, fracture types, body mass index (BMI), American Society of Anesthesiologists (ASA) classification, pulmonary diseases diagnosed by preoperative chest CT [atelectasis, pleural effusion, chronic obstructive pulmonary disease (COPD)], time from injury to visit, New York Heart Association (NYHA) classification, Barthel index, KATZ index, modified Medicine Research Council (mMRC) dyspnea scale, numeric rating scale (NRS), smoking, drinking, comorbidities (hypertension, diabetes mellitus, Parkinson′s disease, Alzheimer′s disease, cerebral infarction, coronary atherosclerotic heart disease), body temperature, blood routine test at first examination (erythrocyte count, leukocyte count, C-reactive protein, hemoglobin), biochemistry (serum albumin, blood glucose, blood creatinine, blood urea nitrogen), electrolyte (serum potassium, serum sodium), and other related examinations [D-dimer, brain natriuretic peptide (BNP), lactic acid]. Univariate analysis was performed to the correlation of those indicators with preoperative hypoxemia. Multivariate Logistic regression analysis was used to identify the independent risk factors for preoperative hypoxemia in geriatric patients with hip fracture. Results:Differences in sex, age, fracture types, BMI, pulmonary diseases diagnosed by preoperative chest CT, time from injury to visit, Barthel index, KATZ index, NRS, smoking, drinking, comorbidities, body temperature, first laboratory results of erythrocyte count, biochemistry, electrolyte and other related examinations were not statistically significant between the two groups (all P>0.05). The two groups showed statistical differences in ASA classification, NYHA classification, mMRC dyspnea scale, leukocyte count at first examination, C-reaction protein and hemoglobin (all P<0.05). Univariate analysis indicated that ASA classification, NYHA classification, mMRC dyspnea scale, leukocyte count at first examination and C-reaction protein were correlated with the occurrence of preoperative hypoxemia in geriatric patients with hip fracture (all P<0.05). Multivariate Logistic regressions analysis indicated that higher mMRC dyspnea scale ( OR=2.30, 95% CI 1.10-4.81, P<0.05), higher leukocyte count at first examination ( OR=1.24, 95% CI 1.05-1.45, P<0.05), higher level of C-reaction protein ( OR=1.02, 95% CI 1.01-1.03, P<0.05) and higher level of hemoglobin ( OR=1.04, 95% CI 1.01-1.07, P<0.05) were significantly correlated with the occurrence of preoperative hypoxemia in geriatric patients with hip fracture. Conclusion:Higher mMRC dyspnea scale, higher leukocyte count, higher level of C-reaction protein and higher level of hemoglobin are independent risk factors for preoperative hypoxemia in geriatric patients with hip fracture.

The physical development and associated factors of ninth grade students in China / 中华疾病控制杂志

Objective To analyse the status and related factors of physical development of ninth grade students in China,so as to provide reference and scientific basis for the development of adolescent’ physical health promotion programs.Methods Multiple linear regression and binomial Logistic regression models were used to analyse the data from 7 840 ninth grade students in the 2016 China Education Panel Survey.Results There were differences in the distribution of height and weight between urban and rural and between boys and girls.From the age of 14 to 16,boys were taller and heavier than girls(height cm：171.69±6.95 vs 161.54±5.58, weight kg：60.43±13.19 vs 53.21±11.69), and urban students were taller and heavier than rural students(height cm：167.93±8.16 vs 165.80±7.94；weight kg：58.18±13.16 vs 55.94±12.78). The rate of physical fitness of boys was lower than that of girls(51.8% vs 87.8%), and that of urban boys was lower than that of rural boys(45.7% vs 58.9%), and that of urban girls was higher than that of rural girls(92.0% vs 84.6%). The average age of first spermatorrhea was 13.62±1.23 years for boys and 12.87±1.07 years for girls. Sexual development of urban students appeared earlier than rural students. Multivariate linear regression analysis showed that height and weight were related to bring single-child and sleep time. Height was also related to parents’height, nationality, family economic level and exercise time, weight was also related to parents’ weight (all P<0.05). Binomial Logistic regression analysis showed that physical fitness level was related to gender, nationality, nutritional status, weight, high calorie intake, exercise time, etc (all P<0.05). Correlative factors of male first spermatorrhea were nationality, urban residence, singleton , sleep time, physical fitness level, while female menarche was related to exercise time, lunch spot and nutritional status (all P<0.05). Conclusions Comprehensive efforts and cooperation are needed to promote the normal development and physical health of the students.

Trends and risk factors of overweight and obesity among Chinese middle school students / 中华疾病控制杂志

Objective To investigate the trends and risk factors of overweight and obesity in Chinese middle school students. Methods Data from the China Education Panel Survey conducted in 2014, 2015 and 2016 were used (8 616, 8 762, 7 614; age range 11-18 years old). Overweight and obesity were defined according to Chinese sex-age-specific body mass index (BMI) cutoffs. Relationships between risk factors and BMI, overweight and obesity were tested, using linear regression and logistic regression models. Results The overall prevalence of overweight and obesity in 2016 was 15.3% (17.9% in boys, 12.6% in girls). From 2014 to 2016, the prevalence of overweight and obesity was increasing steadily. After adjusting for age and sex in 2016, being only-child, self-perceived being overweight or obese, or living in urban area were associated with higher BMI (β(SE)=0.23(0.10), β(SE)=2.83(0.14), β(SE)=0.23(0.11), respectively). Self-perceived being overweight or obese was associated with overweight and obesity (OR=4.20, 95% CI: 2.97-5.40). Conclusions Overweight and obesity rates among Chinese middle school students increased steadily from 2014 to 2016. Efforts should be made on childhood obesity prevention and control, especially target at those being only-child, living in urban areas.

Discussion about risk and management of Chinese patent medicine with double identity / 中国中药杂志

Chinese patent medicine with double identity was a special phenomenon, and many preparations not only were prescription drugs but also over the counter ( OTC) drugs, which brought a lot of trouble. Based on statistics of list of OTC medicines of CFDA, related varieties, route of administration and functions of these drugs were searched. The causes of insufficient were analyzed and the potential risk was investigated. To ensure the safety of drug usage for the patient, risk management system should be set up by improving the technical requirements for registration, improving the drug labels and manuals, playing the role of pharmacists in pharmacy services and raising awareness of doctor and patient for these drugs.

Role of removing stasis and reducing heat formula in clearance of proximal ureteral calculi after ureteroscopic Ho:YAG laser lithotripsy: a prospective randomized study / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To prospectively evaluate the efficacy of Removing Stasis and Reducing Heat Formula in accelerating calculus clearance and improving lower urinary tract symptoms of patients with proximal ureteral calculi after ureteroscopic Ho:YAG laser lithotripsy.</p><p><b>METHODS</b>A total of 138 patients with proximal ureteral calculi underwent ureteroscopic Ho:YAG laser lithotripsy by a single endocrinologist. Stone size varied from 10 to 15 mm. After operation, the patients were randomly divided into three groups: the control group (group A), tamsulosin group (group B), and Removing Stasis and Reducing Heat Formula group (group C). The treatment lasted for 4 weeks or until stone clearance. The primary and secondary outcomes of the three groups at follow-up were assessed.</p><p><b>RESULTS</b>Of the 131 patients available for follow-up, 44 cases were in the group A, 45 in the group B, and 42 in the group C, respectively. The stone free rate at 2 weeks in the groups B and C were significantly higher than that in the group A (95.56%, 97.62% vs. 79.55%; all P<0.05). The ureteral colic rate and mean time of fragment expulsion were significantly reduced in the groups B (4.44% and 7.86±4.99 days) and C (2.43% and 6.76±4.37 days) compared with the group A (22.73% and 11.54±9.89 days, all P<0.05). On the day of double-J ureteric stent removal, the group C differed significantly from the group A in the total International Prostate Symptom Score, irritative subscore, obstructive subscore, and quality of life score (all P<0.05).</p><p><b>CONCLUSION</b>Removing Stasis and Reducing Heat Formula in the medical expulsive therapy might be an effective modality for patients with calculus in the proximal uretera after ureteroscopic Ho:YAG laser lithotripsy.</p>

Inhibition of fatty acid synthase supresses osteosarcoma cell invasion and migration.

Background : Fatty acid synthase (FASN) is overexpressed in a variety of human cancers, and may be involved in cancer metastasis. Hence, the strategies targeted on FASN may have therapeutic potential for treating cancer metastasis. Objectives : The aim of this study is to investigate the correlation of FASN expression with metastasis in human osteosarcoma. Materials and Methods : Human osteosarcoma cell lines U2-OS and osteosarcoma biopsy specimens were employed in this study. The expression of FASN protein in osteosarcoma specimens was detected by IHC (immunohistochemistry) and the relationship with metastasis was analyzed. We performed the cerulenin, an inhibitor of FASN, to inhibit FASN expression in U2-OS cells. Western blot and RT-PCR were performed to investigate the expression of FASN in U2-OS cells. Cells mobility was detected by wound healing and Transwell assays. Results : Results showed that the FASN expression level in the cases with pulmonary metastases was significantly higher than in those without metastasis. In vitro, the invasion and migration of U2-OS cells were suppressed by inhibiting FASN. Our findings suggested that FASN may be involved in osteosarcoma metastasis

Evaluation of jaws-only intensity-modulated radiation therapy for nasopharyngeal carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the feasibility and efficiency of jaws-only intensity-modulated radiation therapy (JO-IMRT) in treatment of nasopharyngeal carcinoma (NPC) using direct aperture optimization (DAO) technique and the independent jaws of linear accelerator.</p><p><b>METHODS</b>Both JO-IMRT and MLC-IMRT were planed in 10 NPC cases. The differences in the target coverage and dose uniformity, as well as the total monitor units and delivery times of the two IMRT plans were compared.</p><p><b>RESULTS</b>All the tested plans met the clinical requirement of the designed simplified IMRT (sIMRT). The conformal index (CI) of JO-IMRT and MLC-IMRT were 0.941±0.015 and 0.981±0.013, respectively (P<0.001), showing a minor superiority of MLC-IMRT. While controlling the total segment numbers to approach the limitation of sIMRT, the two therapies showed a total MU of 474.3 and 419.6 (P<0.05) with delivery times of 8.0 and 7.5 min (P<0.01), respectively. The efficiency of JO-IMRT was slightly lower than that of MLC-IMRT.</p><p><b>CONCLUSION</b>JO-IMRT can meet the sIMRT requirement in NPC treatment, and is feasible as an alternative treatment modality for the centers not equipped with MLC in their accelerators.</p>

Inhibitory effects of recombinant adenovirus carrying human endostatin gene on the growth of human pancreatic carcinoma xenograft in nude mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the inhibitory effect of recombinant adenovirus carrying human endostatin gene (Ad-endo) on the growth of human pancreatic carcinoma xenograft in nude mice.</p><p><b>METHODS</b>The expression of endostatin in human pancreatic carcinoma Capan-2 cells was examined by RT-PCR after infection with Ad-endo. The supernatants of Capan-2 cells were collected after 48 h of infection with Ad-endo as the conditioned medium for human umbilical vein endothelial cells (HUVECs), whose proliferation in vitro was assayed. Capan-2 cell xenografts were established to determine the antitumoral effects of Ad-endo in vivo. The intratumoral microvessel density (MVD) was evaluated using CD31 staining.</p><p><b>RESULTS</b>The expression of endostatin gene was detected by PT-PCR in infected Capan-2 cells. The conditioned medium from Ad-endo-infected cells significantly inhibited HUVEC proliferation (P<0.05). Ad-endo significantly suppressed the growth of Capan-2 tumor xenografts in nude mice (P<0.05), and the MVD decreased significantly in the treated tumor (P<0.05) as compared with that in the control group.</p><p><b>CONCLUSION</b>Adenovirus carrying human endostatin gene produces inhibitory effects on the growth of human pancreatic carcinoma tumors in nude mice.</p>

Therapeutic effects of traditional Chinese medicine on nontraumatic necrosis of femoral head in different stages / 解放军医学杂志

Objective To investigate the clinical therapeutic effects of traditional Chinese medicine on different stages of nontraumatic necrosis of femoral head.Methods The clinical data were retrospectively analyzed of 359 patients(239 males and 120 females,aged 16-69 years,averaged 40.6) suffering from nontraumatic necrosis of femoral head,admitted to our hospital from Aug.2001 to Aug.2008,and treated with traditional Chinese medicine.The patients were divided into five stages(0,1,2,3,and 4) according to Huang Changlin's and Ficat's clinical diagnostic criteria.The age,gender and disease course of patients in different stages were of comparability.All the patients were treated with traditional Chinese medicine for 3-6 months and followed up for 1-2 years,and the final therapeutic effects were evaluated by the comprehensive evaluation criteria.Results The clinical cure rates in patients of stages 0,1,2,3 and 4 were 44.9%,36.1%,30.5%,0% and 0%,and the effective rates were 97.8%,80.6%,75.6%,63.6% and 50.0%,respectively.The total cure rate was 25.3%,and the total effective rate was 76.3%.The therapeutic effect in patients of stage 0 was better than those of stages 1 and 2(P0.05).Conclusions The therapeutic effect of traditional Chinese medicine is remarkable on the patients with nontraumatic necrosis of femoral head in stages 0,1 and 2,but not in stages 3 or 4.Traditional Chinese medicine may increase the cure rate of early stage patients,and improve the symptoms of advanced stage patients.