Diagnosis and treatment of incomplete Kawasaki disease in children / 中国当代儿科杂志

Kawasaki disease (KD) is a febrile disease mainly observed in children aged <5 years, with medium- and small-vessel vasculitis as the main lesion. Although KD has been reported for more than 50 years and great progress has been made in the etiology and pathology of KD in recent years, there is still a lack of specific indicators for the early diagnosis of KD, especially with more difficulties in the diagnosis of incomplete Kawasaki disease (IKD). At present, there are no clear diagnostic criteria for IKD, which leads to the failure of the timely identification and standardized treatment of IKD in clinical practice and even induce the development of coronary artery lesion. This article reviews the concept, epidemiological features, diagnosis, treatment, and follow-up management of IKD, in order to deepen the understanding of IKD among clinical workers and help to improve the clinical diagnosis and treatment of KD in China.

Research on quality difference of standard decoction of raw and fried Paeoniae Radix Alba based on fingerprint and multicomponent determination / 中国中药杂志

The extract rates, multicomponent content and fingerprint were determined in this study to investigate the quality diffe-rence between standard decoction of raw Paeoniae Radix Alba and fried Paeoniae Radix Alba. UPLC fingerprint was established for 17 batches of standard decoction of raw and fried Paeoniae Radix Alba, and the contents of gallic acid, catechin, albiflorin, paeoniflorin and benzoyl paeoniflorin were determined. The peak areas of standard decoction were analyzed by the independent t-test and orthogonal partial least squares discriminant analysis. There was no significant difference in extract rates between the standard decoction of raw and fried Paeoniae Radix Alba. After fried processing, the content of albiflorin increased by 0.26%, while the contents of gallic acid, catechin, paeoniflorin and benzoyl paeoniflorin decreased by 13.04%, 27.97%, 10.30% and 18.79% respectively. There were 14 common peaks in the fingerprint of standard decoction of raw Paeoniae Radix Alba, and 16 common peaks in the fried Paeoniae Radix Alba. Peak 1 and peak 3 were new ones after processing, among which the peak 3 was 5-hydroxymethylfurfural. The results showed that peak 1, peak 3, peak 11 and peak 15 were the key compounds to distinguish standard decoction of raw and fried Paeoniae Radix Alba. In conclusion, this method is stable and can be used for the study of quantity transfer and quality control in the preparation process of standard decoction, granules and other dosage forms for raw and fried Paeoniae Radix Alba, providing reference for the identification of raw and fried Paeoniae Radix Alba and related preparations.

Therapeutic application of skin stretch closure device for treatment of limbs skin wound defects in children / 中国骨伤

OBJECTIVE@#To analyze the clinical application value of adjustable skin retractor in large area of limb wound defect in children.@*METHODS@#From January 2017 to January 2019, 11 children including 9 males and 2 females, aged 4 to 12 (8.3±2.7) years old with severe lower extremity wound defects were treated with adjustable skin stretch and closure device, all of them were unilateral lower extremity large area wound defects, including 4 cases of limb skin defect caused by traffic accident, 3 cases of failure to close after osteofasciotomy and decompression, 3 cases of plate exposure after internal fixation of lower extremity fracture and 1 case of ischemic necrosis after debridement and suturing of skin avulsion. The width of the wound was (5.6±1.2) cm and the length was (7.0±1.6) cm. VSD negative pressure drainage and expanded suture were used in all the patients. Four of them had been treated with free skin graft and two had been treated with local flap transfer. The graft or flap operation failed, and the effect of the early treatment was not good.@*RESULTS@#After 5 to 14 (10.5±2.6) days of continuous traction, the wound was closed and no skin grafting or flap repair was performed. No complications such as poor blood supply, skin infection and necrosis, peripheral sensory disturbance occurred. All 11 patients were followed up for 3 to 18 (8.9±3.8) months. The wound edge skin was linear healing with slight scar.@*CONCLUSION@#It is in accordance with Wolff's law and the concept of natural tissue reconstruction to treat large-scale limb wound defects in children with adjustable skin stretch and closure device, which provides an effective method for the treatment of limb skin and soft tissue defects in children.

Increased early activation of CD56dimCD16dim/- natural killer cells in immunological non-responders correlates with CD4+ T-cell recovery / 中华医学杂志(英文版)

BACKGROUND@#Natural killer (NK) cells play a critical role in suppressing human immunodeficiency virus-1 (HIV-1) infection, but knowledge on whether and how NK cells affect immune reconstitution in HIV-1-infected individuals who receive antiretroviral therapy (ART) is limited.@*METHODS@#We performed a case-control study with 35 healthy individuals and 66 HIV-1-infected patients including 32 immunological non-responders (INRs) with poor CD4+ T-cell recovery (500 cells/μL after 4 years of ART). NK cell phenotype, receptor repertoire, and early activation in INRs and IRs were investigated by flow cytometry.@*RESULTS@#A significantly higher proportion of CD56dimCD16dim/- NK cells was observed in INRs than IRs before ART and after 4 years of ART. The number of CD56dimCD16dim/- NK cells was inversely correlated with CD4+ T-cell counts in INRs before ART (r = -0.344, P = 0.050). The more CD69-expressing NK cells there were, the lower the CD4+ T-cell counts and ΔCD4, and these correlations were observed in INRs after ART (r = -0.416, P = 0.019; r = -0.509, P = 0.003, respectively). Additionally, CD69-expressing CD56dimCD16dim/- NK cells were more abundant in INRs than those in IRs (P  = 0.018) after ART, both of which had an inverse association trend towards significance with CD4+ T-cell counts. The expression of the activating receptors NKG2C, NKG2D, and NKp46 on CD56dimCD16dim/- NK cell subsets were higher in IRs than that in INRs after 4 years of ART (all P < 0.01). Strong inverse correlations were observed between CD69 expression and NKG2C, NKG2A-NKG2C+, NKG2D, and NKp46 expression on CD56dimCD16dim/- NK cells in INRs after ART (NKG2C: r = -0.491, P = 0.004; NKG2A-NKG2C+: r = -0.434, P = 0.013; NKG2D: r = -0.405, P = 0.021; NKp46: r = -0.457, P = 0.008, respectively).@*CONCLUSIONS@#INRs had a larger number of CD56dimCD16dim/- NK cells characterized by higher activation levels than did IRs after ART. The increase in the CD56dimCD16dim/- NK cell subset may play an adverse role in immune reconstitution. Further functional studies of CD56dimCD16dim/- NK cells in INRs are urgently needed to inform targeted interventions to optimize immune recovery.

Deubiquitinases as pivotal regulators of T cell functions / 医学前沿

T cells efficiently respond to foreign antigens to mediate immune responses against infections but are tolerant to self-tissues. Defect in T cell activation is associated with severe immune deficiencies, whereas aberrant T cell activation contributes to the pathogenesis of diverse autoimmune and inflammatory diseases. An emerging mechanism that regulates T cell activation and tolerance is ubiquitination, a reversible process of protein modification that is counter-regulated by ubiquitinating enzymes and deubiquitinases (DUBs). DUBs are isopeptidases that cleave polyubiquitin chains and remove ubiquitin from target proteins, thereby controlling the magnitude and duration of ubiquitin signaling. It is now well recognized that DUBs are crucial regulators of T cell responses and serve as potential therapeutic targets for manipulating immune responses in the treatment of immunological disorders and cancer. This review will discuss the recent progresses regarding the functions of DUBs in T cells.

Clinical effects of Kirschner wire with hole transverse fixation combined with titanium cable purse string suture for the treatment of refractory fracture of patellar comminuted fracture / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effects of Kirschner wire with hole transverse fixation combined with titanium cable purse string suture in treating refractory fracture of patellar comminuted fracture.</p><p><b>METHODS</b>From January 2014 to January 2016, 17 comminuted fracture treated by Kirschner wire with hole transverse fixation combined with titanium cable purse string suture were retrospectively analyzed, including 10 males and 7 females aged from 28 to 67 years old with an average of (48.7±3.2) years old. According to AO/OTA fracture classification, all fractures were type 34-C3.2. Operative time, blood loss, intervals of the first functional exercise postoperatively and complications were observed. Meanwhile, function recovery was evaluated by Böstman scoring at 10 months after operation.</p><p><b>RESULTS</b>All patients were followed up with an average of(14.6±2.1) months ranged from 10 to 24 months. All incisions healed at stage I. Clinical fracture healing time ranged from 11.7 to 16.5 weeks with an average of (12.7±1.7) weeks; operative time ranged from 67 to 95 min with an average of (71.4±11.5) min; blood loss ranged from 41 to 72 ml with an average of (57.0±7.5) ml; the first time of functional exercise ranged from 2 to 5 d with an average of (2.2±1.7) d. No complications including Kirschner pin stabbing the skin, loose or slippery of Kirschner pin, bursitis with pain brought by tip of Kirschner pin, wire escaped and broken occurred. Postoperative Böstman score at 10 months were 28.15±1.74, 12 patients got excellent results, 4 well and 1 lose.</p><p><b>CONCLUSIONS</b>Kirschner wire with hole transverse fixation combined with titanium cable purse string suture in treating refractory fracture of patellar comminuted fracture has advantages of simple operation, good anatomical reduction, stable fixation and less complications, which is worth popularizing.</p>

Identifying a Safe Range of Stimulation Current for Intraoperative Neuromonitoring of the Recurrent Laryngeal Nerve: Results from a Canine Model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) has been widely applied during thyroid surgery. However, the safe range of stimulation intensity for IONM remains undetermined.</p><p><b>METHODS</b>Total thyroidectomies were performed on twenty dogs, and their RLNs were stimulated with a current of 5-20 mA (step-wise in 5 mA increments) for 1 min. The evoked electromyography (EMG) of vocal muscles before and after supramaximal stimulation were recorded and compared. Acute microstructural morphological changes in the RLNs were observed immediately postoperatively under an electron microscope.</p><p><b>RESULTS</b>The average stimulating threshold for RLNs stimulated with 15 mA and 20 mA showed no significant changes compared to the unstimulated RLNs (15 mA group: 0.320 ± 0.123 mA vs. 0.315 ± 0.097 mA, P = 0.847; 20 mA group: 0.305 ± 0.101 mA vs. 0.300 ± 0.103 mA, P = 0.758). Similar outcomes were shown in average evoked EMG amplitude (15 mA group: 1,026 ± 268 μV vs. 1,021 ± 273 μV, P = 0.834; 20 mA group: 1,162 ± 275 μV vs. 1,200 ± 258 μV, P = 0.148). However, obvious acute microstructural morphological changes were observed in the nerves that were stimulated with 20 mA.</p><p><b>CONCLUSIONS</b>A stimulation intensity less than 15 mA might be safe for IONM of the RLN.</p>

Investigation on operation timing of limb fractures combined with severe craniocerebral trauma in children / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the best choice of operation opportunity and operation plan for limb fractures combined with severe craniocerebral trauma in children.</p><p><b>METHODS</b>From January 2005 to July 2012,36 patients with limb fractures and severe craniocerebral trauma were received,including 24 males and 12 females aged from 1 to 13 years old (mean, 6.1 +/- 3.0). The time from injury to hospital was (18.0 +/- 15.0) h. Glasgow coma score were less than 8 with an average of 6.4 +/- 1.3. AIS-ISS score were 25.9 +/- 8.1. Thirteen patients were open fracture, 23 were closed fracture. Patients were divided into immediate operation group (21 patients) received fracture fixation with 24 h, the average time was (15.0 +/- 7.4) h, and delayed operation group (15 patients) received fracture fixation after 24 h, the average time was (165.4 +/- 114.6) h. All patients were treated by open reduction, and 33 cases by internal fixation, 3 cases were external fixation. Operative time, blood loss, fracture healing time and brain trauma,physical trauma, postoperative rehabilitation situation were observed and evaluated.</p><p><b>RESULTS</b>All patients were healed at stage I ,and no dead, aggravating of coma, disorders of breathing and circulation occurred during operation. Operative time,blood loss,healing time in immediate operation group was (44.5 +/- 25.3) min, (47.1 +/- 36.5) ml, (2.7 +/- 0.5) months, respectively; while in delayed operation group was (87.0 +/- 40.0) min, (112.7 +/- 67.5) ml, (3.8 +/- 1.2) months,respectively; and there were obvious differences between two groups. There was no siginificant meaning in Glasgow coma score and Fugl-Meyer motor function between immediate operation group (4.7 +/- 0.6, 97.9 +/- 2.7) and delayed operation group (4.7 +/- 0.5, 97.7 +/- 3.9) (t = 0.23, P > 0.05; t = 0.11, P > 0.05).</p><p><b>CONCLUSION</b>The condition of limb fractures combined with severe craniocerebral trauma in children is seriously, comfortable surgical opportunity should according to particular case, and immediate operation can performed on the condition of stabled vital signs.</p>

Regulation effects of electroacupuncture at "Sanyinjiao" (SP 6) on bladder function in rats with overactive bladder after cystostomy / 中国针灸

<p><b>OBJECTIVE</b>To observe the effects of electroacupuncture (EA) at "Sanyinjiao" (SP 6) on urodynamics indices in rats with overactive bladder (OAB) after cystostomy, and to explore its regulation mechanism on bladder function.</p><p><b>METHODS</b>Forty-eight Sprague-Dawley female rats which received cystostomy were randomly divided into a blank group (group A), a blank Sanyinjiao group (group B), a blank non-acupoint group (group C), a model group (group D), a model Sanyinjiao group (group E) and a model non-acupoint group (group F), 8 rats in each one. The model of OAB was established with 1% acetic acid solution perfused into the bladder in the group D, group E and group F. No treatment was given to the group A and group D. Acupuncture was applied at bilateral "Sanyinjiao" (SP 6) in the group B and group E, followed by EA after the arrival of qi. Acupuncture was applied at bilateral non-acupoint in the group C and group F, followed by EA with continuous wave, 2 Hz of frequency for 30 min. The treatment was given for continuous 5 urination cycles. The BL-420 E+ biological function experiment system was used to measure and record the changes of indices of bladder pressure and urodynamics.</p><p><b>RESULTS</b>Compared with the group A, the bladder capacity and urine output in the group B were significantly increased (both P<0.05), and the urination rate was increased in the group C (P<0.05); the differences of each index between group C and group B were not statistically significant (all P>0.05). Compared with the group D, the capacity pressure, bladder capacity, detrusor pressure, urinary output and urination rate in the group E were all increased (all P<0.05). Compared with the group F, the capacity pressure and detrusor pressure in the group E were increased (both P<0.05).</p><p><b>CONCLUSION</b>The EA at "Sanyinjiao" (SP 6) could significantly improve urine function in rats with OAB after cystostomy, but its regulation effect on urination is not obvious in rats with non-OAB.</p>

Effects of class I( phosphatidylinositol-3-kinases inhibitor on gastric cancer cell xenografts in nude mice / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of recombinant adenovirus (phosphatidylinositol-3-kinases(PI3K)(I()-RNAi-AD which blocks the class I( PI3K signaling pathway on gastric carcinoma cells xenografts in nude mice.</p><p><b>METHODS</b>Subcutaneous tumor models of nude mice were established with SGC7901 cells and randomly divided into PI3K(I()-RNAi-AD group, NC-RNAi-GFP-AD group and control group. The tumor size and the inhibitory rate of tumor growth on days 3, 6, and 9 after cell transplantation were measured. The expression of TNF-α, COX2, P53, PCNA, E-cadherin and nm23/DNPK in tumor tissues were detected by immunohistochemistry.</p><p><b>RESULTS</b>Tumor growth was significantly inhibited in the PI3K(I()-RNAi-AD group(14.2%, 21.0%, and 28.1%) on days 3, 6, 9 compared with NC-RNAi-GFP-AD group(1.3%, 1.9%, and 2.0%, all P<0.05). The expressions of TNF-α, P53, E-cadherin and nm23/DNPK were up-regulated, and the expressions of COX2 and PCNA were down-regulated in the PI3K(I()-RNAi-AD group by immunohistochemical staining(all P<0.05).</p><p><b>CONCLUSIONS</b>PI3K(I()-RNAi-AD can inhibit the growth of SGC7901 cell transplantation tumor in vivo in nude mice by inhibiting cell growth, reducing the capacity of tumor invasion and inhibiting tumor angiogenesis.</p>

Animal experimental study of biodegradable magnesium alloy stapler for gastrointestinal anastomosis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the safety and feasibility of biodegradable magnesium alloy stapler based on the result of animal experimental study for gastrointestinal anastomosis.</p><p><b>METHODS</b>Sixteen beagle dogs were equally and randomly divided into experimental (magnesium alloy) group and control (titanium alloy) group. A gastrojejunal and a colonic anastomosis were performed in each beagle dog. The anastomosis time, postoperative complications, body weight, blasting pressure of anastomosis and serum glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, creatinine, blood urea nitrogen, and serum magnesium were compared between the two groups. The healing of anastomosis and degradation of magnesium alloy were observed. The histopathological features of heart, liver, spleen and kidney were examined in the two groups.</p><p><b>RESULTS</b>There were no significant differences in anastomosis time, body weight, postoperative complications, anastomotic bursting pressure between the two groups. The anastomosis was healed well, and no dramatic inflammatory cell infiltration was observed. Magnesium alloy could be degraded completely in the animal body within 90 days. There were no significant differences in serum glutamic pyruvic transaminase, glutamic oxaloacetic transaminase, creatinine, blood urea nitrogen and serum magnesium between the two groups. Histopathological examination showed that the degradation of magnesium alloy did not harm the important organs (liver, kidney, heart, brain and spleen).</p><p><b>CONCLUSIONS</b>Magnesium alloy stapler is safe and feasible for gastrointestinal anastomosis in beagle dogs. The degradation of magnesium alloy does not harm the healing of anastomosis and other important organs. Magnesium alloy stapler may be a candidate of biodegradable and safe material of stapler for gastrointestinal anastomosis in human.</p>

Preparation and antimicrobial effect of aromatic, natural and bacteriostatic foot wash with skin care / 中国中药杂志

To prepare the aromatic, natural and bacteriostatic foot wash with skin care and research the inhibition effect on the different bacteria and pathogenic fungus which cause dermatophytosis. It was prepared by using Sophoraflavescens and Dictamnus dasycarpus as materials with the addition of Aloe extract, essential oil, surfactant, etc. The antifungal and antibacterial activity was researched by the levitation liquid quantitative method. The foot wash smelled faintly scent. The use of this product can produce a rich foam. The inhibitory rate were all more than 90%. The preparation process of the foot wash was simple. It has obviously bacteriostatic and fungistatic effect.

Short-term efficacy comparison of complete mesocolic excision and traditional colon cancer resection / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the short-term efficacy of complete mesocolic excision (CME).</p><p><b>METHODS</b>Clinical data of 62 cases of colon cancer (I-III phase) with radical resection including CME surgery group of 31 cases and traditional surgery group of 31 cases from January 2011 to October 2011 in Peking University People's Hospital were retrospective analyzed.</p><p><b>RESULTS</b>The number of removed lymph node in CME and traditional resection group was 22.5±1.8 and 17.6±1.3 respectively (P<0.05) and the positive rate of lymph node in mesentery root was 9.7% (3/31) in CME surgery group. Operative blood loss was (123.5±17.6) ml and (143.5±15.3) ml in CME and traditional resection group without significant difference (P>0.05). Except for more abdominal drainage volume of 3 days post-operation in CME group (P<0.05), the postoperative recovery indicators of postoperative drainage tube removed time, exhaust time, eating time, and the socioeconomic effects indicators of postoperative hospitalization, hospitalization costs were not significantly different between two groups (all P>0.05). Postoperative intestinal obstruction occurred in 3 cases and 4 cases, lymph fistula in 2 cases and 0 case, wound dehiscence in 1 case and 1 case in CME group and traditional resection group respectively. Postoperative complication rate was not significantly different (19.4% vs. 16.1%, P>0.05).</p><p><b>CONCLUSION</b>Compared with traditional radical surgery, CME sweeps lymph nodes more thoroughly, including lymph nodes of mesocolic roots, and does not affect postoperative recovery and increase the risk of postoperative complications.</p>

Correlation of single nucleotide polymorphisms of X-ray repair cross complementing group 1 gene to hereditary susceptibility of colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the correlation of single nucleotide polymorphisms (SNP) of XRCC1 gene to hereditary susceptibility of colorectal cancer.</p><p><b>METHODS</b>XRCC1 genotypes in 124 colorectal cancer patients and 214 matched healthy people as control were analyzed by SnaP Shot SNP-typing technique. Five different inheritance models including codominant, dominant, recessive, overdominant and log-additive were analyzed using logistic regression model. The haplotype distribution was estimated with phase and its correlation with the risk of colorectal cancer was evaluated.</p><p><b>RESULTS</b>The frequencies of mutant 25487G-A, 25489C-T and 1799782C-T alleles were 0.20, 0.11, 0.32 respectively in the patients, and 0.23, 0.13, 0.34 in the controls. There was no significant correlation of polymophisms of XRCC1 gene to the risk of colorectal cancer in 5 different inheritance models (P>0.05). GCT, GCC, ACC and GTC were the most common haplotypes and the odds ratios were 1, 1.35, 0.90 and 0.84 respectively. There was no significant difference of distribution between 2 groups in haplotypes.</p><p><b>CONCLUSION</b>Polymorphisms of XRCC1 gene, including rs25487, rs25489, rs1799782, are not associated with to the risk of colorectal cancer.</p>

Influence of age on median lethal burn area of burn patients / 中华烧伤杂志

<p><b>OBJECTIVE</b>To discuss the influence of age on the LA50 (the burn area lethal to 50% of patients) of burn patients.</p><p><b>METHODS</b>(1) Twenty-three thousand and seventy-three burn patients hospitalized in our center from December 1958 to December 2004 were enrolled, and they were divided into 25 age groups. LA50 values of total and full-thickness burn areas of patients in each age group were computed with probit regression method with Probit analysis of SPSS 11.0. (2) Those age groups with similar LA50 values were merged into one age group; thus 4 new age groups were formed. LA50 and its 95% confidence interval (CI) of total and full-thickness burn areas of patients in each age group were computed respectively. (3) All the patients were divided into group A (admitted from 1 December 1958 to 31 December 1983) and group B (admitted from 1 January 1984 to 31 December 2004) according to the admission time. LA50 and its 95% CI of total and full-thickness burn areas of patients in each age group of groups A and B were computed respectively.</p><p><b>RESULTS</b>(1) LA50 values of total and full-thickness burn areas of patients among the 25 age groups were low in age groups younger than or equal to 5 years, which increased in age groups older than 5 years, distinctly higher in age groups older than 15 years, and they became lower in age groups older than 60 years. (2) LA50 values of total and full-thickness burn areas of patients in the 4 merged age groups were lowest in age groups older than 60 years (50.90% TBSA) and younger than or equal to 5 years (35.81% TBSA), and highest in age group older than 15 years and younger than or equal to 60 years (89.38% and 59.22% TBSA). There were statistically significant differences in LA50 of total and full-thickness burn areas of patients among 4 merged age groups [with 95% CI values of LA50 of total burn areas of patients in age groups ranging from young to old respectively (56.87 to 64.69)%, (64.46 to 74.36)%, (85.89 to 93.37)%, (44.55 to 60.73)% TBSA; with 95% CI values of LA50 of full-thickness burn areas of patients in age groups from young to old respectively (32.67 to 39.69)%, (40.86 to 50.41)%, (55.27 to 63.85)%, (32.46 to 54.86)% TBSA]. (3) LA50 values of total and full-thickness burn areas of patients in group B (98.94% and 73.23% TBSA) were significantly higher than those in group A (69.61% and 39.79% TBSA). There were differences in LA50 values of patients among different age groups in both group A and group B. The variation trend of LA50 values of patients among the 4 age groups in groups A and B was almost the same. Except for LA50 of total burn areas of patients in age group older than 5 years and younger than or equal to 15 years and LA50 of full-thickness burn areas of patients in age group older than 60 years, there were statistically significant differences in the LA50 of total and full-thickness burn areas of the other patients between group A and group B [with 95% CI of LA50 of total burn areas of patients of younger than or equal to 5 years, older than 15 years and younger than or equal to 60 years, and older than 60 years respectively (48.38 to 56.07)% and (68.68 to 81.35)% TBSA, (75.91 to 84.89)% and (97.09 to 110.45)% TBSA, (30.08 to 45.08)% and (60.67 to 102.69)% TBSA; with 95% CI of LA50 of full-thickness burn areas of patients of younger than or equal to 5 years, older than 5 years and younger than or equal to 15 years, older than 15 years and younger than or equal to 60 years respectively (27.48 to 34.69)% and (42.09 to 54.03)% TBSA, (34.78 to 46.43)% and (49.62 to 69.47)% TBSA, (43.98 to 51.77)% and (66.43 to 77.99)% TBSA].</p><p><b>CONCLUSIONS</b>Age is one of the important factors that influence the LA50 of burn patients. LA50 in different age groups increases with the development of medical technology; however, the influence of age on LA50 is not visibly changed by the advance of treatment.</p>

Clinical features and genetic screening of hereditary hemorrhagic telangiectasia / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze clinical features of 4 families with hereditary hemorrhagic telangiectasia (HHT) and potential mutations of ENG, ACVRL1 and SMAD4 genes.</p><p><b>METHODS</b>Four unrelated HHT patients and their affected family members were analyzed. All exons and flanking regions of ENG, ACVRL1 and SMAD4 genes were analyzed with PCR and direct sequencing and multiplex ligation-dependent probe amplification (MLPA) methods.</p><p><b>RESULTS</b>Eleven patients from the 4 families were enrolled in this study. Two ENG and 1 ACVRL1 mutations were identified, among which an ENG mutation (c.207G>A; p.L69L) and an ACVRL1 mutation (c.817C>T; p.L273L) have been previously reported. In addition, a novel ENG mutation (c.1004A>T; p.Q335L) has been found in 3 different families. Similar mutations were not detected in 200 healthy individuals. No mutations of ENG, ACVRL1 and SMAD4 were found in the fourth family.</p><p><b>CONCLUSION</b>A novel mutation c.1004A>T (p. Q335L) of ENG has been identified in patients with HHT. And there is significant phenotypic variability and genetic heterogeneity with the disease.</p>

Analysis of monitoring results of coal-burning borne endemic fluorosis in Shanxi province in 2010 / 中国地方病学杂志

ObjectiveTo investigate the current situation of coal-burning borne endemic fluorosis in the infected area,the usage of defluoridation stove and the formation of related behavior; to evaluate the control effect,so as to provide a theoretical basis for superiors' policy-making.MethodsNine villages in three counties of Ankang city and Hanzhong city Shanxi province were monitored in 2010.Choose five disease infected villages with oven changed in the three monitoring counties,and 10 families were randomly selected in each of the nine monitoring points and every chosen village,and a survey on the stove using and related behavior changes was carried out.By using Dean method,the dental fluorosis of every child aged 8 - 12 in the monitoring villages was examined.Meanwhile 10 copies of urine samples were randomly collected in each age group in the above-mentioned villages.The content of fluoride in urine was determined by F-ion selective electrode(WS/T 30-1996) and evaluated according to “The Normal Concentration of Urinary Fluoride of Population” (WS/T 256-2005).Twenty men over 25years old in the monitoring counties were randomly selected in each age group to be examined skeletal fluorosis by X-rays,and diagnosis was based on “The Endemic Skeletal Fluorosis Standard”(WS 192-2007).ResultsThe proper utilization rate and the qualified households of iron stoves and improved stoves,the correct drying rate and the correct storage rate of peppers and coms were all low.The washing rate of corns and peppers before eating was higher than 95％.Of the 350 children being examined of dental fluorosis in the 9 monitoring villages,the detection rate of dental fluorosis was 59.71％ (209/350).A total of 871 adults over the age of 25 were examined,and the detection rate of skeletal fluorosis was 17.22％ (150/871).A total of 350 copies of children urine samples were tested and the fluoride content were between 0.07 - 2.02 mg/L,the geometric mean value of fluoride content was 0.66 mg/L.ConclusionsThe coal-burning borne endemic fluorosis in Shanxi is in a growth phase,many defluoridation stoves are out of order,and the formation of healthy behaviors is low.To strengthen the disease surveillance,health education and management of defluoridation stoves are keys to prevent coal-burning borne endemic fluorosis in the future.

Complete mesocolic excision versus traditional radical resection in colon cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the short-term efficacy and safety between complete mesocolic excision (CME) and traditional radical resection in colon cancer.</p><p><b>METHODS</b>Between January 2008 and August 2011, 92 patients undergoing elective open surgery for colon were included in the study. CME was performed in 54 patients in the period from November 2009 to August 2011. The other 38 patients underwent traditional radical resection from January 2008 to October 2009. Short-term outcomes were compared between the patients of two different time periods.</p><p><b>RESULTS</b>Lymph nodes retrieved in the CME group (22.2 ± 8.0) were significant more than that in the control group (18.6 ± 4.7)(P<0.05). In patients with stage III cancer, CME group was associated with higher lymph node counts (23.8 ± 7.6 vs. 16.7 ± 3.6, P<0.01), however, there were no significant differences for those with stage I and stage II cancer (P>0.05). The number of positive lymph nodes and metastatic lymph node ratio (LNR) for stage III patients in two groups were not significantly different (P>0.05). There were no differences in operation time, time to first bowel movement, hospital stay, and postoperative complications between the two groups (P>0.05). However, intraoperative blood loss in the CME group was significantly reduced (median, 100 vs. 115 ml, P<0.05).</p><p><b>CONCLUSIONS</b>CME can achieve en-bloc resection of the tumor and mesocolon, and have optimal lymph nodes harvest. Despite wider resection extent with CME technique, the surgical risk and postoperative complications are not increased and the short-term efficacy is good.</p>

Learning curve of complete mesocolic excision for colon cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the learning curve of complete mesocolic excision(CME) for colon cancer.</p><p><b>METHODS</b>Clinical data of 75 cases in whom CME was performed by a group of surgeons in the Department of Gastrointestinal Surgery, Peking University People's Hospital from November 2009 to June 2011 were reviewed. The patients were divided into three groups(groups A, B, C, 25 cases in each group) by operative chronologic sequence.</p><p><b>RESULTS</b>There were no significant differences in age, sex, preoperative staging, cancer location, operation history of abdomen, ASA among the three groups(P>0.05). The operative time in group A was (205.4 ± 53.2) min and decreased to (180.4 ± 29.7) min in group B and (169.8 ± 41.3) min in group C (P<0.05). The postoperative hospital stay decreased from (17.8 ± 10.9) d in group A to(12.9 ± 4.1) d in group B and(11.0 ± 3.5) d in group C(P<0.05). The postoperative complication rate decreased from 32%(8/25) in group A and 36%(9/25) to 8%(2/25) in group C. The specimen quality was superior in group C compared to group A (WEST grade C above were 20 and 11 respectively, P<0.05). There were no significant differences in intraoperative bleeding, time to first flatus, postoperative fasting time, number of retrieved lymph nodes among the three groups(P>0.05).</p><p><b>CONCLUSION</b>From the learning curve of CME, surgeons can learn CME skill after performing 25 cases.</p>

Feasibility of complete mesocolic excision in elderly patients with colon cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the short-term outcomes and safety of complete mesocolic excision (CME) in elderly patients with colon cancer.</p><p><b>METHODS</b>The clinical pathological factors of 71 patients with colon cancer undergoing CME procedure by the same group of surgeons were analyzed retrospectively from November 2009 to February 2012. The elderly group(≥70 years) and the non-elderly group(<70 years) were compared regarding short-term outcomes and safety.</p><p><b>RESULTS</b>Similar extent of resection could be achieved in the elderly and non-elderly groups in terms of area of mesentery[(13 049±4332) vs. (13 163±4725) mm2, P=0.916], distance between the tumor and the high ligation site[(95±22) vs. (98±20) mm, P=0.516], distance between normal bowel and high ligation site [(130±25) vs. (128±25) mm, P=0.731], the length of colon [(262±60) vs. (245±49) mm, P=0.212], and lymph nodes retrieved(22.0±6.4 vs. 24.8±9.9, P=0.168). The mean operative time, intraoperative blood loss, postoperative complications, time to first flatus, time to first bowel movement, drainage removal time, diet resumption, drainage volume in three days after surgery, and hospital deaths showed no statistical significances(all P>0.05), while hospital stay and expenses of the elderly group were significantly increased(both P<0.01).</p><p><b>CONCLUSION</b>Elderly patients undergoing elective CME operation can achieve similar operative extent and lymph nodes harvest, and the surgical risk is not increased.</p>