Pharmacological action and clinical evaluation of difelikefalin, a new drug for the treatment of uremic pruritus / 中国基层医药

Uremic pruritus is one of the skin complications that perplex patients with end-stage renal disease undergoing hemodialysis or peritoneal dialysis. Because the specific pathogenesis is not clear, there is no unified treatment plan in the world. In August 2021, the US Food and Drug Administration approved the use of difelikefalin (under the trade name Korsuva) for the treatment of moderate to severe pruritus associated with chronic kidney disease in adult patients undergoing hemodialysis. Studies have shown that difelikefalin can remarkably reduce the intensity of pruritus and improve sleep and pruritus-related quality of life. The recommended dose of difelikefalin is 0.5 μg/kg, and difelikefalin is well tolerated and has high safety. This paper reviews the pharmacological effects, pharmacokinetics, clinical efficacy and safety of difelikefalin.

Qualitative and quantitative analysis of contrast-enhanced ultrasound images for assessing the correlation between the stability of newly formed vessels in the carotid plaque and the occurrence of ischemic stroke / 中国基层医药

Objective:To evaluate the stability of newly formed blood vessels in the carotid plaque using qualitative and quantitative analysis of contrast-enhanced ultrasound images and to investigate its correction with the occurrence of ischemic stroke.Methods:A total of 100 patients with carotid artery plaques diagnosed by routine ultrasound who received treatment between August 2017 and December 2019 in Haiyan People's Hospital, China were included in this study. They were divided into an ischemic stroke group ( n = 60) and a non-ischemic stroke group ( n = 40) according to the occurrence of stroke. Two groups of patients underwent contrast-enhanced ultrasound examination of the carotid artery. The correlation between the stability of the newly formed vessels in the carotid plaque and the occurrence of ischemic stroke was quantitatively analyzed. Results:Contrast-enhanced ultrasound results revealed low or medium intensity of echoes. The proportion of patients exhibiting grade 3-4 intensity of echoes in the ischemic stroke group was significantly higher than that in the non-ischemic stroke group ( P < 0.05). Time to peak in the ischemic stroke group was significantly shorter than that in the non-ischemic stroke group [(25.46 ± 3.25) seconds vs. (32.77 ± 4.28) seconds, t = 3.783, P = 0.000]. In the ischemic stroke group, peak intensity [(59.62 ± 10.18) dB vs. (47.53 ± 14.36) dB, t = 3.263, P = 0.000] and the area under the receiver operating characteristic curve [(2 365.37 ± 346.03) cm 2vs. (1 695.42 ± 525.44) cm 2, t = 4.981, P = 0.000] were significantly higher than those in the non-ischemic stroke group (both P < 0.05). Conclusion:Contrast-enhanced ultrasound visual scoring combined with quantitative ultrasonography technology can be used to assess the stability and possible development process of carotid plaques, which provide practical and reliable evidence for selecting a rational opportunity for clinical treatment of ischemic cerebrovascular disease and developing a reasonable treatment plan.

Effects of non-steroidal anti-inflammatory drugs administered at different time points on mesenteric traction syndrome following open radical gastrectomy in elderly patients / 中华老年医学杂志

Objective:To investigate the effects of the non-steroidal anti-inflammatory drugs Parecoxib and Flurbiprofen administered at different time points on mesenteric traction syndrome(MTS).Methods:This was a prospective, randomized, controlled clinical trial.One hundred elderly patients scheduled for open radical gastrectomy under general anesthesia were randomly allocated to four groups: the control group, the P-Pre-MT group, the F-Pre-MT group, and the F-Post-MT group(n=25, each group). Parecoxib 40 mg and Flurbiprofen 50 mg were intravenously administered 30 min and 5 min before skin incision in the P-Pre-MTS group and the F-Pre-MTS group, respectively.Flurbiprofen 50 mg was infused at the moment of MTS in the F-Post-MTS group while the control group was intravenously injected with saline.Anesthesia induction and maintenance were performed with plasma target-controlled infusion of Propofol and Remifentanil.After the incision of the peritoneum.The incidence of MTS, the duration of hypotension, and the use of norepinephrine during MTS were recorded.Systolic blood pressure(SBP), heart rate(HR), and effect-site concentration of Remifentanil were monitored at MT(T 0), 10 min(T 10), 20 min(T 20), 30 min(T 30), 45 min(T 45), and 60 min(T 60)after MT in patients with MTS. Results:MTS was observed in 19 of 22 patients(86%), 19 of 23 patients(83%), 0 of 24 patients(0%)and 20 of 23 patients(87%)in the control, P-Pre-MT, F-Pre-MT and F-Post-MT groups, respectively.The incidence of MTS in the F-Pre-MT group was lower than that in the control group( χ2=35.313, P=0.000). The duration of hypotension and the use of norepinephrine in patients with MTS were less in the F-Post-MT group than in the control group( P=0.007 and 0.015). SBP and HR at different time points after MT had significant differences in patients with MTS in the control group( F=47.425 and 26.318, P=0.000 and 0.000), but did not differ in the F-Pre-MT group( F=2.140 and 1.013, P=0.066 and 0.413). SBP and the effect-site concentration of Remifentanil were lower and HR was higher in the control group than in the F-Pre-MT group at T 10and T 20after MT( P=0.000), and SBP was higher and HR was lower in the F-Post-MT group than in the control group C at T 20after MT( P=0.002 and 0.002). Conclusions:Flurbiprofen not only can prevent the occurrence of MTS, maintain blood pressure stability and heart rate after MT, but also can reduce the duration of hypotension and the amplitude of heart rate increase when MTS occurs in elderly patients undergoing open radical gastrectomy.Parecoxib has no effect on MTS.

Effects of emergency medical service on prognosis of ischemic stroke patients treated with intravenous thrombolysis / 浙江大学学报·医学版

OBJECTIVE@#To investigate the effect of emergency medical service (EMS) on the prognosis of ischemic stroke patients treated with intravenous thrombolysis.@*METHODS@#Clinical data of 2123 ischemic stroke patients treated with intravenous thrombolysis in 70 hospitals in Zhejiang province were retrospectively analyzed. There were 808 patients sent to the hospital by ambulance (EMS group) and 1315 patients by other transportations (non-EMS group). Good outcome was defined as modified Rankin Scale (mRS) ≤ 2 at 3-month. The onset to needle time (ONT), onset to door time (ODT), door to needle time (DNT) and outcome were compared between EMS group and non-EMS group. Binary logistic regression was used to explore the influencing factors for the outcome at 3-month.@*RESULTS@#Compared with the non-EMS group, patients in the EMS group were older, with higher baseline National Institute of Health Sroke Scale (NIHSS) score, and had a higher proportion of atrial fibrillation (all 0.05). Binary logistic regression showed that EMS was not independently associated with good outcome (=0.856, 95%:0.664-1.103, >0.05).@*CONCLUSIONS@#EMS had not improve the outcome of patients receiving intravenous thrombolysis in Zhejiang province.

Advanced treatment time improves outcomes of patients with ischemic stroke undergoing reperfusion therapy / 浙江大学学报·医学版

OBJECTIVE@#To investigate the effect of treatment time on the outcome of patients with ischemic stroke undergoing reperfusion therapy.@*METHODS@#The clinical data of 3229 ischemic stroke patients who received intravenous thrombolysis with or without arterial thrombolysis from 71 hospitals in Zhejiang province from June 2017 to September 2018 were retrospectively reviewed. The good outcome was defined as modified Rankin Scale (mRS) ≤ 2. Binary logistic regression analysis was used to investigate the association of door to needle time (DNT), or door to reperfusion time (DRT) with the outcomes in patients treated by intravenous thrombolysis or bridging arterial thrombolysis, respectively.@*RESULTS@#Binary logistic regression showed that DNT (=0.994, 95%:0.991-0.997, <0.01) or DRT (=0.989, 95%:0.983-0.995, <0.01) were independently associated with good outcomes, respectively. Every hour decreases in DNT resulted in a 4.7%increased probability of functional independence (mRS 0-2) in patients treated by intravenous thrombolysis; Every hour decreases in DRT was associated with a 11.4%increased probability of functional independence in patients treated by intravenous thrombolysis with arterial thrombolysis.@*CONCLUSIONS@#Good outcomes are associated with lower DNT in ischemic stroke patients treated by intravenous thrombolysis or lower DRT in patients treated by intravenous thrombolysis bridging arterial thrombolysis.

Association of atrial fibrillation with hemorrhagic transformation after intravenous thrombolysis in patients with ischemic stroke / 浙江大学学报·医学版

OBJECTIVE@#To investigate the association of atrial fibrillation (AF) with hemorrhagic transformation (HT) in patients with ischemic stroke treated by intravenous thrombolysis.@*METHODS@#Clinical data of 3272 patients treated by intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and December 2018 were retrospectively reviewed. Intracranial HT was defined as intracranial hemorrhage suggested by imaging examination 24 hours after intravenous thrombolysis. Patients were dichotomized into HT group (=533) and non-HT group (=2739). The association of AF and HT was analyzed by univariate analysis and binary logistic regression.@*RESULTS@#Compared with the non-HT group, the HT group were older, had longer onset to needle time (ONT), higher baseline National Institute of Health Stroke Scale (NIHSS) score, higher baseline glucose level, and higher AF rate (<0.05 or <0.01). Binary logistic regression analysis revealed that AF was independently associated with HT (=2.527, 95%:2.030-3.146, <0.01).@*CONCLUSIONS@#AF is independently associated with the occurrence of HT in ischemic stroke patients treated with intravenous thrombolysis.

Analysis of intravenous thrombolysis time and prognosis in patients with in-hospital stroke / 浙江大学学报·医学版

OBJECTIVE@#To compare the time delay between in-hospital stroke and out-of-hospital stroke patients, and to explore the influence factors for the prognosis of in-hospital stroke patients treated by intravenous thrombolysis.@*METHODS@#Clinical data of 3050 patients with ischemic stroke who received intravenous thrombolysis in 71 hospitals in Zhejiang province from June 2017 to September 2018 were analyzed. Differences of time delay including door to imaging time (DIT), imaging to needle time (INT) and door to needle time (DNT) between in-hospital stroke (=101) and out-of-hospital stroke (=2949) were observed. The influencing factors for the outcome at 3 month after intravenous thrombolysis in patients with in-hospital stroke were analyzed using binary logistic regression analysis.@*RESULTS@#Patients with in-hospital stroke had longer DIT[53.5 (32.0-79.8) min vs. 20.0 (14.0-28.0) min, <0.01], longer IDT[47.5(27.3-64.0)min vs. 36.0(24.0-53.0)min, <0.01], and longer DNT[99.0 (70.5-140.5) min vs. 55.0 (41.0-74.0) min, <0.01], compared with patients with out-of-hospital stroke; patients in comprehensive stroke center had longer DIT[59.5(44.5-83.3) min vs. 37.5(16.5-63.5) min, <0.01], longer DNT[110.0(77.0-145.0) min vs. 88.0 (53.8-124.3) min, <0.05], but shorter INT[36.5(23.8-60.3)min vs. 53.5 (34.3-64.8) min, <0.05], compared with patients in primary stroke center. Age (=0.934, 95% 0.882-0.989, <0.05) and baseline National Institute of Health Stroke Scale score (=0.912, 95% 0.855-0.973, <0.01) were independent risk factors for prognosis of in-hospital stroke patients.@*CONCLUSIONS@#In-hospital stroke had longer DIT and DNT than out-of-hospital stroke, which suggests that a more smooth thrombolysis process of in-hospital stroke should be established.

Effect of different working time on the prognosis of ischemic stroke patients undergoing intravenous thrombolysis / 浙江大学学报·医学版

OBJECTIVE@#To investigate the effect of working time on the prognosis of patients with ischemic stroke undergoing intravenous thrombolysis.@*METHODS@#Clinical data of 3050 patients with ischemic stroke received intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and September 2018 were retrospective analyzed. Whole day of Saturday and Sunday were defined as weekend; whole day of Monday to Friday were defined as weekdays; Monday to Friday 8:00-17:00 were defined as daytime of weekdays; Monday to Friday 17:01-07:59 on next day were defined as nights of weekdays; unconventional working time were defined as weekend and nights of weekdays. Good outcome was defined as mRS 0-2 at 3 months. Univariate analyses of baseline and prognostic variables in group of weekend and weekdays, nights of weekdays and daytime of weekdays, unconventional working time and daytime of weekdays were performed. Binary logistic regression was used to investigate whether weekend, nights of weekdays and unconventional working time were independent predicting factors of outcome after intravenous thrombolysis, respectively.@*RESULTS@#There was no difference in 7-day mortality, 3-month mortality and good outcome at 3-month between weekend group and weekdays group, nights of weekdays group and daytime of weekdays group, unconventional working time group and daytime of weekdays group (all >0.05). Binary logistic regression results showed that weekends, nights of weekdays and unconventional working time were not independent predicting factors for outcome after intravenous thrombolysis (all >0.05).@*CONCLUSIONS@#The working time has not affected the outcomes of patients with ischemic stroke undergoing intravenous thrombolysis in studied hospitals of Zhejiang province.

Cilastatin protects against imipenem-induced nephrotoxicity inhibition of renal organic anion transporters (OATs)

Imipenem is a carbapenem antibiotic. However, Imipenem could not be marketed owing to its instability and nephrotoxicity until cilastatin, an inhibitor of renal dehydropeptidase-I (DHP-I), was developed. In present study, the potential roles of renal organic anion transporters (OATs) in alleviating the nephrotoxicity of imipenem by cilastatin were investigated and in rabbits. Our results indicated that imipenem and cilastatin were substrates of hOAT1 and hOAT3. Cilastatin inhibited hOAT1/3-mediated transport of imipenem with IC values comparable to the clinical concentration, suggesting the potential to cause a clinical drug-drug interaction (DDI). Moreover, imipenem exhibited hOAT1/3-dependent cytotoxicity, which was alleviated by cilastatin and probenecid. Furthermore, cilastatin and probenecid ameliorated imipenem-induced rabbit acute kidney injury, and reduced the renal secretion of imipenem. Cilastatin and probenecid inhibited intracellular accumulation of imipenem and sequentially decreased the nephrocyte toxicity in rabbit primary proximal tubule cells. Renal OATs, besides DHP-I, was also the target of interaction between imipenem and cilastatin, and contributed to the nephrotoxicity of imipenem. This therefore gives in part the explanation about the mechanism by which cilastatin protected against imipenem-induced nephrotoxicity. Thus, OATs can potentially be used as a therapeutic target to avoid the renal adverse reaction of imipenem in clinic.

Identification of differentially expressed genes between lung adenocarcinoma and squamous cell carcinoma using transcriber signature analysis / 南方医科大学学报

OBJECTIVE@#To analyze the differentially expressed genes (DEGs) between lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC) with bioinformatics analysis and search for potential biomarkers for clinical diagnosis of nonsmall cell lung cancer (NSCLC).@*METHODS@#The gene expression profiling datasets of LUAD and LUSC were acquired. The transcriptome differences between LUAD and LUSC were identified using R language processing and t-test analysis. The differential expressions of the genes were shown by Venn diagram. The DEGs identified by GEO2R were analyzed with DAVID and Ingenuity Pathway Analysis (IPA) to identify the signaling pathways and biomarkers that could be used for differential diagnosis of LUAD and LUSC. The TCGA data and the biomarker expression data from clinical lung cancer samples were used to verify the differential expressions of the Osteoarthritis pathway and LXR/RXR between LUAD and LUSC. We further examined the differential expressions of miR-181 and its two target genes, and , in 23 clinical specimens of lung squamous cell carcinoma and the paired adjacent tissues.@*RESULTS@#GEO data analysis identified 851 DEGs (including 276 up-regulated and 575 down-regulated genes) in LUAD and 885 DEGs (including 406 up-regulated and 479 down-regulated genes) in LUSC. DAVID and IPA analysis revealed that leukocyte migration and inflammatory responses were more abundant in LUAD than in LUSC. Osteoarthritis pathway was inhibited in LUAD and activated in LUSC. IPA analysis showed that transcription factors (GATA4, RELA, YBX1, TP63 and MBD2), cytokines (WNT5A and IL1A) and microRNAs (miR-34a, miR-181b and miR-15a) differed significantly between LUAD and LUSC. miR-34a with IL-1A, miR-15a with YBX1, and miR-181b with WNT5A and MBD2 could serve as the paired microRNA and mRNA targets for differential diagnosis of NSCLC subtypes. Analysis of the clinical samples showed an increased expression of miR-181b-5p and the down-regulation of WNT5A, which could be used as molecular markers for the diagnosis of LUSC.@*CONCLUSIONS@#Through transcriptome analysis, we identified candidate genes, paired microRNAs and pathways for differentiating LUAD and LUSC, and they can provide novel differential diagnosis and therapeutic strategies for LUAD and LUSC.

monitoring of the structural change of microemulsions in simulated gastrointestinal conditions by SAXS and FRET

Microemulsions are promising drug delivery systems for the oral administration of poorly water-soluble drugs. However, the evolution of microemulsions in the gastrointestinal tract is still poorly characterized, especially the structural change of microemulsions under the effect of lipase and mucus. To better understand the fate of microemulsions in the gastrointestinal tract, we applied small-angle X-ray scattering (SAXS) and fluorescence resonance energy transfer (FRET) to monitor the structural change of microemulsions under the effect of lipolysis and mucus. First, the effect of lipolysis on microemulsions was studied by SAXS, which found the generation of liquid crystalline phases. Meanwhile, FRET spectra indicated micelles with smaller particle sizes were generated during lipolysis, which could be affected by CaCl, bile salts and lecithin. Then, the effect of mucus on the structural change of lipolysed microemulsions was studied. The results of SAXS and FRET indicated that the liquid crystalline phases disappeared, and more micelles were generated. In summary, we studied the structural change of microemulsions in simulated gastrointestinal conditions by SAXS and FRET, and successfully monitored the appearance and disappearance of the liquid crystalline phases and micelles.

Grassroots health demonstration base construction for full-coverage promotion practice and achievement at the county level, based on the experiences in Haiyan County Emergency Base / 中华医学科研管理杂志

Objective To expand the influence and promotion effect of the grassroots health demonstration base of appropriate technology at county level,explore the practice model for full coverage.Methods Four consortium and eight units in the county were engaged into the whole process,the whole cycle,synchronous implementation;the promotion practices were divided into different stages with different focuses based on priority setting;Stratified training,classified promotion strategies were involved to carry out the appropriate technology for all 11 items covered.Results The technical promotion training,technical promotion applications were completed with full coverage in the county,gained high satisfaction from both medical staff and public.Enhanced the technology radiation ability,also the base's annual development was increasing year by year.Conclusions The base construction full coverage promotion experiences can be shared and learned by other areas which aims for the promotion of fit health techniques.

Effect of immune enhanced enteral nutrition on immune function in postoperative patients with gastric cancer:a Meta-analysis / 肿瘤研究与临床

Objective To evaluate the effect of immune enhanced enteral nutrition on immune function in postoperative patients with gastric cancer by using meta-analysis. Methods The databases of PubMed, the Cochrane Library, CNKI, CBM, VIP and Wanfang Data were used to search randomized controlled trials (RCT) about the effect of immune enhanced enteral nutrition and conventional enteral nutrition on immune function in postoperative patients with gastric cancer. The retrieval time span was from inception to Sept 1, 2016. The studies were screened according to the inclusion and exclusion criteria, the data were extracted and the quality was evaluated by 2 reviewers independently. Besides, the meta-analysis was conducted by using RevMan 5.3 software. Results Meta-analysis included 5 RCT, 216 cases in total. The results showed that the immune parameters of immune enhanced enteral nutrition such as IgA (MD=0.18, 95 % CI 0.09-0.27, P0.05). Regarding to cellular factor, the IL-6 level of immune enhanced enteral nutrition was lower than conventional enteral nutrition after 9 days of gastric surgery (MD=-77.40, 95 %CI-112.25 - -42.55, P 0.05). Conclusion Immune enhanced enteral nutrition for postoperative patients with gastric cancer can improve and enhance the immune function under stress, and reduce the excessive inflammatory reaction, which is more conducive to the safety of patients with gastric cancer.

Comprehensive correction of secondary unilateral cleft lip nasal deformity using autologous cartilage and supported by septum cartilage / 中华医学美学美容杂志

Objective To study the surgical method of comprehensive correction of secondary unilateral cleft lip nasal deformity using autologous cartilage and supported by septum cartilage and its outcomes.Methods Our surgery adopted an open approach,fully revealed the deformed alar cartilage and deviated nasal septum cartilage.Part of the nasal septum was removed and made it into various cartilage grafts to repair and reconstruct the columella,nasal tip,nasal alar and nasal dorsal by implanted in the corresponding positions.Results 18 patients with congenital unilateral cleft lip nasal deformity underwent the corrective and reconstructive surgery.The postoperative follow-up was 6-12 months,showing that the malformed nasal appearance came back to normal without obvious scar.The 18 patients did not have associated complications.Conclusions The surgery with a supplementary septal graft achieves good effect,the overall appearance of the malformed nose gets obvious changes,and therefore patients and their families are satisfied with the postoperative nasal shape.

Relationship between TDAG8 and endogenous neuron-protective mechanism against oxygen-glucose deprivation and restoration-induced apoptosis in rat neurons / 中华麻醉学杂志

Objective To investigate the relationship between T?cell death?associated gene 8 ( TD?AG8) and endogenous neuron?protective mechanism against oxygen?glucose deprivation and restoration ( OGD∕R)?induced apoptosis in rat neurons. Methods The primary cortical neurons obtained from fetal rats were seeded in 6?well plates at a density of 1×105 cells∕ml and divided into 5 groups using a random number table: control group ( group C, n=24 ) , group OGD∕R ( n=48 ) , TDAG8 agonist BTB09089 group (group BTB, n=24), TDAG8?siRNA group ( group siRNA, n=24), and blank vehicle group ( group V, n=24) . The medium was replaced with glucose?and serum?free Locke′s buffer, and the neu?rons were exposed to 95% N2?5% CO2 in an air?tight incubator at 37℃ for 60 min followed by routine cul?ture to establish the model of OGD∕R. In BTB, siRNA and V groups, 20 μmol∕L TDAG8 agonist BTB09089, 200 pmol∕L TDAG8?siRNA, and 6 μl∕200 μl transfection reagent were added, respectively, at 24 h before oxygen?glucose restoration. At 6 h of oxygen?glucose restoration, the neuronal viability and a?mount of lactic dehydrogenase ( LDH) released were measured, and the expression of TDAG8 and caspase?3 mRNA in neurons was detected by fluorescent quantitative real?time polymerase chain reaction. In group OGD∕R, the expression of TDAG8 and caspase?3 was measured by Western blot at 0, 3, 6, 12 and 24 h of oxygen?glucose restoration. In C, OGD∕R, BTB, siRNA and V groups, the expression of TDAG8, caspase?3 and p?Akt was detected at 6 h of oxygen?glucose restoration. Results In group OGD∕R, the ex?pression of TDAG8 was gradually up?regulated after oxygen?glucose restoration, and the expression of caspase?3 peaked at 6 h of oxygen?glucose restoration. Compared with group C, the neuronal viability was significantly decreased, the amount of LDH released was significantly increased, and the expression of TD?AG8 and caspase?3 protein and mRNA and p?Akt was significantly up?regulated in OGD∕R, V and siRNA groups ( P0?05) . Conclusion TDAG8 is partially involved in the endogenous neuron?protective mechanism against OGD∕R?induced apoptosis in rat neurons, which may be related to activation of Akt signaling pathway.

Adenine: an important drug scaffold for the design of antiviral agents

Adenine derivatives, in particular the scaffold bearing the acyclic nucleoside phosphonates (ANPS), possess significant antiviral and cytostatic activity. Till now, several effective adenine derivatives have been marketed for the treatment of HIV, HBV, CMV and other virus-infected diseases. These compounds are represented by tenofovir (PMPA), a medicine for both HIV and HBV, and adefovir as an anti-HBV agent. More than this, other analogs, such as GS9148, GS9131, and GS7340, are also well-known anti-viral agents that have been progressed to the clinical studies for their excellent activity. In general, the structures of these compounds include an adenine nucleobase linked to a phosphonate side chain. Considerable structural modifications on the scaffold itself and the peripheral sections were made. The structure-activity relationships (SARs) of this skeleton will provide valuable clues to identify more effective adenine derivatives as antiviral drugs. Here, we systematically summarized the SARs of the adenine derivatives, and gave important information for further optimizing this template.

Application of auricle skin degloving technique in correction surgery of prominent ears / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of helix and antihelix skin degloving technique in correction surgery of prominent ears.</p><p><b>METHODS</b>Twenty-three cases of prominent ears were corrected by helix and antihelix skin degloving technique. The clinical results were observed.</p><p><b>RESULTS</b>All the prominent ears were corrected with natural appearance and good symmetry results. The distance from the helix to the skull was decreased obviously (P<0.05). Cranial ear angle, the angle of helix and ear boat were significantly reduced (P<0.05). No complications such as infection, hematoma, skin flap necrosis and deformity recurrence occurred.</p><p><b>CONCLUSIONS</b>The auricle skin degloving technique has advantages of exact suture position, good shape, no obvious cartilage hurt and simple operation procedure.</p>

Determination of Chlorinated Persistent Organic Pollutants in Infant Hair by Gas Chromatography_High Resolution Mass Spectrometry / 分析化学

Infant hair is a good medium to assess the cumulative exposure level of infant in the mother ' s body. Chlorinated persistent organic pollutants were ubiquitous and with the highest volume concentration in the human body. In this experiment, 20 infant hairs were collected from Beijing. The sample was overnight incubated in HCl, extracted with the mixture of hexane and dichloromethane, and cleaned up by a cartridge filled with alumina and acidified silica. The final eluate was concentrated, and 16 kinds of typical chlorinated persistent organic pollutants were detected with gas chromatography_high resolution mass spectrometry ( HRGC_MS). The results showed that the detection limit of the target compounds in sample was 1. 00-2. 50 μg/kg, the recovery of surrogate in all samples was more than 67 . 6%, and the range of recoveries for target compounds in spiked sample was 62. 5%-92. 3%. The positive rate is 100% for hexachlorobenzene,β_HCH and p, pˊ_DDE, 85% for γ_HCH, 50% for PCB28, and 40% for PCB52. The concentrations of Hexachlorobenzene, HCHs, DDTs and PCBs were 5. 48-8. 40 μg/kg, 3. 86-27. 1 μg/kg, 1. 16-18. 3 μg/kg and 2. 20-22. 1 μg/kg, respectively. The average concentrations were 7. 84 μg/kg for hexachlorobenzene, 6. 93 μg/kg for HCHs, 5. 53 μg/kg for DDTs, and 3. 44 μg/kg for PCBs. The method and the analysis results can be used to evaluate the accumulation level and cumulative exposure level of 16 target compounds for fetal in motherˊs body.

Association between maternal psychological status and fetal hemodynamic circulation in late pregnancy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The prevalence reported of maternal depression from the first to the third trimester was 7.4%, 12.8%, 12.0% respectively, which implies that around one-tenth of pregnant women suffer from psychological disorder during the whole pregnancy. It is assumed that during pregnancy the maternal-fetal circulation unit is also affected by maternal psychological status. The aim of this study is to explore the association between maternal psychological status and fetal dynamic blood flow circulation during pregnancy.</p><p><b>METHODS</b>We recruited 102 singleton low risk pregnant women between 30 to 33 gestational weeks. The Symptom Checklist-90 (SCL-90) was used to assess maternal psychological status. Ultrasound Doppler was used to measure blood flow changes in maternal-fetal circulation. Pulsatility index (PI) value was measured in umbilical artery (UA), fetal middle cerebral artery (MCA) and maternal uterine arteries (UTA). Peak systolic velocity (PSV) was measured in MCA and velocity was measured in umbilical vein (UV). Statistical analysis was performed with standard nonparametric Mann-Whitney U tests. Two-tailed P values <0.05 were considered statistical significance.</p><p><b>RESULTS</b>Of the 102 pregnant women, 12 patients show high levels of poor mental health. Women with poor mental health have higher umbilical artery PI values than good mental health patients (P = 0.020). A higher MCA PI value is found in poor mental health patients but this does not reach statistical significance (P = 0.053). Women with hostility show lower placental scores (P = 0.030). Women with somatization demonstrate higher values in UA PI, MCA PI and MCA PSV (P = 0.049, 0.030 and 0.035 respectively). A higher MCA PSV value is also found in phobic anxiety patients (P = 0.046).</p><p><b>CONCLUSIONS</b>Poor mental health during pregnancy is found to have an adverse effect on maternal-fetal circulation. Umbilical artery and fetal cerebral circulation are more sensitive and affected by maternal psychological disorder.</p>

Reliability and accuracy of three-dimensional digital fusion anatomy in the preoperative evaluation of intracranial tumors / 中华显微外科杂志

Objective To evaluate the reliability and accuracy of three-dimensional digital fusion anatomy in the preoperative evaluation and therapeutic strategy choice of intracranial tumors.Methods MRI scan,including regular MRI,MRA,MRV and DTI,were performed in 87 case.Then tumor themselves as well as tumor-associated structures were reconstructed and fused through iPlan 2.6 software.Based on the reconstructed images,therapeutic strategy were established,preoperative and intraoperative imags were compared.Results The digital reconstruction were successfully finished in all cases.Meanwhile,digital images,originally radiological images and actual images matched well.No approach-associated complication were met in our series.Among tumors in the convexity,the relationship of the reflux veins and the tumors were divided into three types:anterior(12 cases),posterior(19 cases) and overriding(3 cases).All of the relationships were seen in the preoperative fusion image,and the veins were all effectively protected during operation.The tumor-associated arteries could be pushed or wraped by the tumors,and the three-dimensional fusion image could provided their virtually aberrant pathway as well as their relationship with tumor.During microsurgical managment of tumors in the deep brain parenchyma,safe approach were found with the help of comprehensive understanding of the tumors and their adjacent structures.Conclusion Three-dimensional digital fusion anatomy can vividly and accurately display full rang of information about the tumor,and facilitate tumor treatment safely.