The relationship between insulin resistance and risk of long-term mortality in people without diabetes: a 30-year follow-up of the Daqing Diabetes Study / 中华内科杂志

Objective:To determine whether insulin resistance is associated with all-cause mortality in subjects without diabetes.Methods:A total of 505 participants without diabetes, 198 with normal glucose tolerance (NGT) and 307 with impaired glucose tolerance (IGT), were recruited from the Daqing Diabetes Study. The participants were followed up for 30 years. They were stratified into three groups (tertiles) according to baseline homeostasis model assessment of insulin resistance(HOMA-IR) levels, as the HOMA-IR 0, the HOMA-IR 1 and the HOMA-IR 2 groups, to assess the predictive effect of insulin resistance on risk of all-cause mortality.Results:During the 30-year follow-up, 52, 56 and 78 participants died across the three HOMA-IR groups, respectively. The corresponding mortality per 1 000 person-years (95 %CI) were 12.12 (9.56-15.01), 13.10 (10.46-16.03) and 19.91 (16.73-23.15), respectively. Participants in the HOMA-IR 2 group had a significantly higher risk of death than those in the HOMA-IR 0 group after adjustment of age, sex and smoking status ( HR=1.97,95 %CI 1.38-2.81, P<0.001). Cox analyses showed that a one standard deviation increase in HOMA-IR was associated with a 22% increase in the mortality after adjustment of potential confounders ( HR=1.22, 95 %CI 1.08-1.39, P=0.002). Conclusions:Insulin resistance is associated with increased risk of all-cause death in Chinese people without diabetes, suggesting that improving insulin resistance could be beneficial for people without diabetic in reducing risk of long-term all-cause mortality.

Epidemiological and etiological characteristics of dengue fever in Hangzhou in 2018 / 中华微生物学和免疫学杂志

Objective:To analyze the epidemiological and etiological characteristics of dengue fever in Hangzhou in 2018.Methods:RT-PCR was used to detect the nucleic acids and analyze the serotypes of dengue viruses (DENV) in serum samples collected from dengue fever cases. Phylogenetic trees based on the E gene sequences of DENV isolated from the serum samples were then constructed and analyzed. Epidemiological characteristics of these dengue fever cases were analyzed. Results:A total of 80 cases of dengue fever were detected in Hangzhou in 2018 with 55 imported cases and 25 indigenous cases (24 caused by DENV-1 and one by DENV-3). These indigenous cases mainly occurred during late July to early October with people above 50 years old accounting for 68%. Phylogenetic analysis showed that DENV-1 strains isolated from the indigenous cases in Yuhang, Jianggan-Shangcheng and Qiantang districts all belonged to genotype Ⅰ, and were respectively closely related to the strains from Indonesia in 2015, Myanmar in 2017, Ningbo in 2018 and Hangzhou imported cases from Thailand in 2018. The indigenous DENV-3 strain belonged to genotype Ⅲ, and shared 99.5% homology with the Singapore strain in 2013.Conclusions:Imported cases accounted for a large fraction of the dengue fever cases in Hangzhou, which brought a high risk to indigenous outbreak. Due to multiple imported cases, the current epidemic presented a characteristic of multiple small-scale outbreaks.

Skin diseases in the Da Qing Diabetes Study: a cross-sectional study / 中华医学杂志(英文版)

BACKGROUND@#The prevalence of skin diseases and diabetes mellitus (DM) are prominent around the world. The current scope of knowledge regarding the prevalence of skin diseases and comorbidities with type 2 DM (T2DM) is limited, leading to limited recognition of the correlations between skin diseases and T2DM.@*METHODS@#We collected 383 subjects from the Da Qing Diabetes Study during the period from July 9th to September 1st, 2016. The subjects were categorized into three groups: Normal glucose tolerance (NGT), impaired glucose tolerance (IGT), and T2DM. The prevalence and clinical characteristics of skin diseases were recorded and investigated.@*RESULTS@#In this cross-sectional study, 383 individuals with ages ranging from 53 to 89-year-old were recruited. The overall prevalence of skin diseases was 93.5%, and 75.7% of individuals had two or more kinds of skin diseases. Additionally, there were 47 kinds of comorbid skin diseases in patients with T2DM, of which eight kinds of skin diseases had a prevalence >10%. The prevalence of skin diseases in NGT, IGT, and T2DM groups were 93.3%, 91.5%, and 96.6%, respectively; stratified analysis by categories showed a statistically significant difference in "disturbances of pigmentation" and "neurological and psychogenic dermatoses". The duration of T2DM also significantly associated with the prevalence of "disturbances of pigmentation" and "neurological and psychogenic dermatoses". Subsequently, the prevalence of "disturbances of pigmentation" was higher in males than females in NGT (P < 0.01) and T2DM (P < 0.01) groups. In addition, the difference in the prevalence of "disturbances of pigmentation" was also significant in NGT and T2DM groups (P < 0.01).@*CONCLUSIONS@#There was a high prevalence of skin diseases in the Da Qing Diabetes Study. To address the skin diseases in the Da Qing Diabetes Study, increased awareness and intervention measures should be implemented.

Tumor microenvironments self-activated nanoscale metal-organic frameworks for ferroptosis based cancer chemodynamic/photothermal/chemo therapy

Ferroptosis, as a newly discovered cell death form, has become an attractive target for precision cancer therapy. Several ferroptosis therapy strategies based on nanotechnology have been reported by either increasing intracellular iron levels or by inhibition of glutathione (GSH)-dependent lipid hydroperoxidase glutathione peroxidase 4 (GPX4). However, the strategy by simultaneous iron delivery and GPX4 inhibition has rarely been reported. Herein, novel tumor microenvironments (TME)-activated metal-organic frameworks involving Fe & Cu ions bridged by disulfide bonds with PEGylation (FCSP MOFs) were developed, which would be degraded specifically under the redox TME, simultaneously achieving GSH-depletion induced GPX4 inactivation and releasing Fe ions to produce ROS

Neuroprotective mechanism of autophagy in bradykinin postconditioning after cardiac arrest in rats / 中华危重病急救医学

Objective:To explore the protective effects of bradykinin postconditioning on cardiopulmonary resuscitation (CPR) rats, and to assess the underlying mechanisms.Methods:Forty-eight adult male Sprague-Dawley (SD) rats were randomly divided into four groups according to random number table: Sham operation group, cardiac arrest (CA) group, bradykinin treatment (BK) group, and AMP-activated protein kinase (AMPK) inhibitor Compound C+ bradykinin treatment (CP+BK) group, finally, 8 rats in each group were taken for follow-up experiment. CA was induced by asphyxia. Rats in the Sham group received arteriovenous catheterization, endotracheal intubation, and mechanical ventilation, without CA. Compound C (250 μg/kg) was intraperitoneally injected in CP+BK group 30 minutes before CA, and the same volume of dimethyl sulfoxide (DMSO) was given in the remaining groups. Bradykinin (150 μg/kg) was intraperitoneally injected in BK group and CP+BK group 48 hours after restoration of spontaneous circulation (ROSC), and same volume of saline was given in the remaining groups. The neural function of rats in each group was evaluated with neurological deficit score (NDS) 72 hours after ROSC. Microtubule-associated protein light chain 3 (LC3) and p62 expressions were detected by immunohistochemistry, autophagosomes were observed by transmission electron microscopy, and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling method (TUNEL) assay was used to assess apoptosis.Results:Compared with the Sham group, the NDS was decreased (60.75±5.80 vs. 80.00±0.00, P < 0.01), the expression levels of LC3 and p62 elevated [LC3 ( A value): 1.04±0.64 vs. 0.40±0.14, p62 ( A value): 2.75±0.57 vs. 0.36±0.12, both P < 0.05], the number of autophagosomes and apoptotic cells increased in the CA group [(39.00±8.00)% vs. (3.87±1.90)%, P < 0.05]. Compared with the CA group, the NDS (67.75±6.32 vs. 60.75±5.80, P < 0.05), the expression of LC3 ( A value: 1.60±0.34 vs. 1.04±0.64, P < 0.05), and the number of autophagosomes increased in the BK group, while the expression of p62 and the rate of apoptotic cells reduced [p62 ( A value): 1.51±0.32 vs. 2.75±0.57, apoptotic cells rate: (23.03±1.91)% vs. (39.00±8.00)%, both P < 0.05]. Compared with the BK group, the NDS (59.00±8.19 vs. 67.75±6.32, P < 0.05), the expression of LC3 ( A value: 0.62±0.41 vs. 1.60±0.34, P < 0.05) and the number of autophagosomes declined in the CP+BK group, while the expression of p62 and the rate of apoptotic cells elevated [p62 ( A value): 3.50±0.47 vs. 1.51±0.32, apoptotic cells rate: (44.53±10.15)% vs. (23.03±1.91)%, both P < 0.05]. Conclusion:Bradykinin postconditioning played a neuroprotective role in CPR rats by activating autophagy and reducing apoptosis.

Long-term effects of metabolically healthy obesity on the risks of diabetes, cardiovascular disease events and its mortality over 23 years in the China Daqing diabetes prevention study / 中华内分泌代谢杂志

Objective:To investigate the long-term effects of metabolically healthy obesity on the risks of type 2 diabetes, cardiovascular disease events, and its mortality over a 23-year follow-up.Methods:Based on the results of an oral glucose tolerance test, there were 519 participants with normal glucose tolerance and 630 with newly diagnosed type 2 diabetes enrolled in 1986 and then given to assess the long-term clinical outcomes during the 23-year follow-up in Daqing. Metabolically healthy obesity was defined as the overweight and obese individuals with no metabolic abnormalities (diabetes, hypertension, hyperlipidemia). Finally, we identified 682 participants (350 with normal glucose tolerance and 332 with newly diagnosed diabetes). They were divided into five groups: 211 individuals with metabolically healthy normal weight (MHNW group), 58 with metabolically healthy overweight and obesity (MHO group), 81, 109, 223 were metabolically unhealthy overweight and obesity with hypertension (MUHO group), type 2 diabetes (MUDO group), hypertension and diabetes (MUHDO group). Incidences of type 2 diabetes, morbidity and mortality of cardiovascular disease were compared among these groups.Results:Over 23 years, instead of the morbidity and mortality of cardiovascular disease, the incidence of type 2 diabetes in MHO group was two times higher than in MHNW group ( 24.1%, 12.5/1 000 person years vs 10.9%, 5.2/1 000 person years, P=0.01), with an age, sex, and smoking history-adjusted hazard ratio ( HR) of 2.42 (95% CI 1.24-4.74, P=0.01). The morbidity and mortality of cardiovascular disease in the groups of overweight and obesity with metabolically unhealthy were higher than in MHNW group, and increased across the subjects with MUHO, MUDO, MUHDO ( P<0.05). Conclusion:Compared with metabolically healthy normal weight participants, the metabolically healthy obese group was at increased risk of type 2 diabetes but not cardiovascular disease events and its mortality. On the contrary, the overweight and obese groups with metabolic abnormalities had significant higher incidence of type 2 diabetes, morbidity and mortality of cardiovascular diseases.

Loss of GRB2 associated binding protein 1 in arteriosclerosis obliterans promotes host autophagy / 中华医学杂志(英文版)

BACKGROUND@#Arteriosclerosis obliterans (ASO) is a major cause of adult limb loss worldwide. Autophagy of vascular endothelial cell (VEC) contributes to the ASO progression. However, the molecular mechanism that controls VEC autophagy remains unclear. In this study, we aimed to explore the role of the GRB2 associated binding protein 1 (GAB1) in regulating VEC autophagy.@*METHODS@#In vivo and in vitro studies were applied to determine the loss of adapt protein GAB1 in association with ASO progression. Histological GAB1 expression was measured in sclerotic vascular intima and normal vascular intima. Gain- and loss-of-function of GAB1 were applied in VEC to determine the effect and potential downstream signaling of GAB1.@*RESULTS@#The autophagy repressor p62 was significantly downregulated in ASO intima as compared to that in healthy donor (0.80 vs. 0.20, t = 6.43, P < 0.05). The expression level of GAB1 mRNA (1.00 vs. 0.24, t = 7.41, P < 0.05) and protein (0.72 vs. 0.21, t = 5.97, P < 0.05) was significantly decreased in ASO group as compared with the control group. Loss of GAB1 led to a remarkable decrease in LC3II (1.19 vs. 0.68, t = 5.99, P < 0.05), whereas overexpression of GAB1 significantly led to a decrease in LC3II level (0.41 vs. 0.93, t = 7.12, P < 0.05). Phosphorylation levels of JNK and p38 were significantly associated with gain- and loss-of-function of GAB1 protein.@*CONCLUSION@#Loss of GAB1 promotes VEC autophagy which is associated with ASO. GAB1 and its downstream signaling might be potential therapeutic targets for ASO treatment.

Genetic evolution of influenza B virus hemagglutinin (HA) and neuraminidase (NA) genes in Hangzhou between 2014 and 2019 / 中华微生物学和免疫学杂志

Objective:To analyze the prevalence of influenza B virus in Hangzhou between 2014 and 2019, and the variation in hemagglutinin (HA) and neuraminidase (NA) genes.Methods:Viruses were isolated from throat swabs collected from 10 481 patients with influenza-like illness in Hangzhou from October 2014 to September 2019. The subtypes of influenza viruses were identified by real-time RT-PCR. HA and NA genes of some influenza B virus strains were amplified with specific primers and then analyzed with gene sequencing and phylogenetic analysis.Results:Influenza B virus had circulated in Hangzhou every year since 2014 and caused a much higher morbidity in people aged 5-14 years. The Victoria lineage of influenza B virus circulating in Hangzhou between 2014 and 2019 belonged to the V1A clade, while the Yamagata lineage belonged to the Y3 clade. Homology analysis showed that 124 strains shared 94.67%-100.00% homology in HA gene sequences and 128 strains shared 97.13%-100.00% homology in NA gene sequences. Influenza B virus possessed several mutations in the antigenic sites of HA and NA.Conclusions:Influenza B virus played a critical role in the influenza epidemics in Hangzhou. During 2014 to 2019, genetic mutations in the antigenic sites of HA and NA and reassortant strains were detected, and there was a mismatch between epidemic and vaccine strains. However, no drug-resistant virus was found.

Characteristics of clinical bacteria and H3N2 influenza virus co-infection and variations in viral hemagglutinin cleavage site / 中华微生物学和免疫学杂志

Objective:To investigate the characteristics of clinical bacteria and H3N2 influenza A virus coinfection and variations in the hemagglutinin (HA) cleavage site of H3N2 among influenza-like cases.Methods:A total of 12 250 samples were collected from influenza-like cases for real-time PCR detection of H3N2 influenza virus from January 2013 to December 2018. To analyze the characteristics of co-infection, some H3N2-positive samples were selected and analyzed by real-time PCR to detect Staphylococcus aureus, Streptococcus pneumoniae and haemophilus influenzae type B. HA genes of H3N2 isolates were amplified by RT-PCR and sequenced. A phylogenetic tree was constructed based on HA gene sequences. Amino acid variations in cleavage sites were analyzed. Results:H3N2 influenza viruses had been detected every year since 2013, causing 44.69% influenza-positive cases. There were 295 randomly selected H3N2-positive samples, of which 29.2% had clinical bacterial infection. The HA cleavage sites of 210 H3N2 isolates were sequenced and 68 had variations, including 63 carrying K342R (PEKQTR to PERQTR) single-amino acid site variation. The co-infection rate was 31.25% (45/144) in unmutated samples and 23.53% (16/68) in mutated samples (χ 2=1.34, P>0.05). The H3N2 influenza viruses circulating in Hangzhou mainly belonged to two evolutionary clusters of 3c.3a and 3c.2a, and the viruses with K342R mutation at the cleavage site belonged to the evolutionary cluster of 3c.3a. Conclusions:H3N2 influenza virus played an important role in the epidemic of influenza virus in Hangzhou. There were some bacterial co-infections in influenza-positive cases. Cleavage site variations showed regional epidemic characteristics, but had no significant correlation with bacterial co-infection.

Genetic evolution of influenza A (H3N2) virus in Hangzhou between 2012 and 2017 / 中华微生物学和免疫学杂志

Objective To analyze the prevalence of influenza A (H3N2) virus in Hangzhou be-tween 2012 and 2017 and to investigate the genetic variations in hemagglutinin ( HA) and neuraminidase ( NA) . -ethods Throat swab samples were collected for viral isolation from 12185 patients with suspected influenza in Hangzhou area from January 2012 to December 2017. Influenza virus subtypes were identified by real-time RT-PCR. HA and NA genes of some isolated Influenza A (H3N2) viruses were amplified with spe-cific primers and then analyzed by sequencing and phylogenetic analysis. Results Influenza A (H3N2) virus was the predominant subtype circulating in Hangzhou during 2012 to 2017. It caused high morbidity in elderly people (Z=81. 039, P<0. 05). Most of the isolated influenza A (H3N2) viruses belonged to the phylogenetic clades of 3C. 3a and 3C. 2a. These viruses shared a homology of 96. 7％-100％ in nucleotide sequences of both HA and NA genes, but possessed several HA and NA mutations in antigenic sites. Con-clusions Influenza A (H3N2) virus was an important pathogen causing influenza epidemics in Hangzhou during 2012 to 2017. HA and NA genes showed many mutations in antigenic sites. No drug resistant virus was reported.

Clinical progress of wound management in venous leg ulcers / 中华全科医师杂志

Venous leg ulcer (VLU) is a disease of venous hypertension leading to open skin lesions of lower extremities, which is the terminal stage of chronic venous insufficiency. Considering the high prevalence and recurrence rate, VLU restrain daily activities, impair mental health and even contribute to social isolation of patients. Currently, surgery and compression therapy are wildly used to relieve symptoms and eliminate the etiological factors, however, ulcers remain unhealed even after these treatments in many cases. In this article, we review the clinical progress of treatment for VLU, including the debridement, antibiotics, ulcer dressing, negative pressure wound therapy and skin graft, to provide reference on the therapeutic strategy for different ulcer conditions.

Translation, revision and assessment of reliability and validity of the Assessment of Interprofessional Team Collaboration Scale / 中国实用护理杂志

0bjective To translate and revise the Assessment of Interprofessional Team Collaboration Scale (AITCS) into Chinese, then to evaluate the reliability and validity of the Chinese version of AITCS. Methods The Chinese version of AITCS was translated from the original one, back-translated and adjusted for cultural adaptation. The reliability and validity were tested among 288 nurses, 81 physicians, 25 respiratory therapists, 10 physical therapists and 3 nutritionists from a tertiary hospital in Hangzhou using convenience sampling. Results The average of scale-level content validity index was 0.98, unanimity of scale-level content validity index was 0.84 and item-level content validity index was 0.89-1.00. Exploratory factor analysis extracted three common factors,which explained 61.427% of the total variance,and each item had high factor loading quality (>0.4). The correlations coefficients between each dimension score and the total score ranged from 0.801 to 0.898 (P<0.05),and the correlations coefficients between each dimension score ranged from 0.607 to 0.698 (P<0.05). The Cronbach α of AITCS was 0.909, split-half reliability was 0.835 and test-retest reliability was 0.763. Conclusion The Chinese version of the AITCS has been proved to be reliable and valid. It is a valuable tool for evaluating interprofessional team collaboration among the health professional providers in mainland China.

Mitomycin C combined with anterograde lacrimal drainage tube implantation for the treatment of upper lacrimal duct obstruction / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the application effect of mitomycin C in lacrimal duct obstruction during anterograde lacrimal drainage tube implantation. <p>METHODS:Totally 78 cases of lacrimal duct obstruction(82 eyes)were randomly divided into the observation group(39 cases, 42 eyes)and the control group(39 cases, 40 eyes), and the control group was treated with lacrimal drainage tube implantation. The observation group was based on this combined mitomycin C treatment and compared the effect of two groups. <p>RESULTS: The total effective rate of the observation group was 81%, which was significantly higher than that of the control group(62%), and the difference between the two groups was statistically significant(<i>P</i><0.05). The eye surface change score(26.25±1.67)and tear SP content(256.32±10.07pg/mL)were lower than that of the control group after treatment. The tear film rupture time(8.85±0.89s)was shorter than that of the control group(9.58±0.92s), and the two groups were statistically significant(<i>P</i><0.05). <p>CONCLUSION: Mitomycin C can improve the efficacy of anterograde lacrimal drainage tube implantation for the treatment of lacrimal duct obstruction and improve prognosis.

Analysis of pathogen characteristics in children with acute respiratory tract infection / 中华实验和临床病毒学杂志

Objective@#To determine the epidemic characteristics of respiratory viruses, mycoplasma pneumonia(MP) and chlamydia pneumoniae(CP) in outpatients and hospitalized children with acute respiratory tract infections(ARI), to lay a foundation for the prevention and control of ARI.@*Methods@#From 2011 to 2013, children with ARI, including outpatients and inpatients, were involved in this study. One nasopharyngeal aspirate or throat swab specimen was collected from each patient.Real time PCRs were performed to detect common respiratory tract viruses, MP and CP.@*Results@#At least one pathogen was identified in each of 610 out of 908 patients and the overall positive rate was 67.2%. The positive rate in inpatient(76.7%)was higher than that in outpatient(43.0%) (χ2=94.79, P<0.001). Simultaneous detection of two or more viruses was found in 206 cases.Co-infection was more frequent in inpatients than in outpatients(29.0% VS 6.6%, P<0.001). Significant differences of the detection rate were observed in RSV, PIV, HRV, Flu, human bocavirus (hBoV), adenovirus (AdV), saffold virus(SAFV), MP and CP between the inpatient and outpatient group. Respiratory syncytial virus(RSV)(34.5%) was the most prevalent virus detected among hospitalized children, followed by MP(15.0%)and human rhinovirus(HRV)(14.6%). Whereas adenovirus(AdV) (15.2%)was the most frequently identified virus in the outpatient group, followed by influenza virus(Flu)(11.7%))and PIV(7.8%). Except for RSV and Flu, co-infection of the other pathogens was more frequent than its mono-infection in inpatients. Significant differences of the AdV co-infection rate were observed between the inpatient and outpatient group(χ2=18.90, P<0.001). Compared with mono-infection, co-infection has no significant effect on the clinical presentation.@*Conclusions@#The detection rate of respiratory pathogens was higher in inpatients than in outpatients with ARI, and co-infections were more popular in children hospitalized, it may show that co-infection had some correlation with disease severity.

Differentiating the morphology of infective larvae between two human hook-worms / 中国血吸虫病防治杂志

The morphological differentiation of the infective larvae between human Ancylostoma duodenale and Necator ameri-canus is of great significance for the epidemiological survey of hookworm diseases and human parasitology teaching.Understand-ing of features of the oral spear and transverse lines on the tunica vaginalis is able to accurately differentiate the infective larvae between these two human hookworms.

Anti-inflammatory and analgesic activities of ethanol extract of Toddalia asiatica / 中成药

AIM To study the anti-inflammatory and analgesic activities of ethanol extract of Toddalia asiatica Lamn.and the mechanism.METHODS Both inflammatory rat model induced by carrageenan and pain model induced by formalin were applied to investigating the analgesic effect of extract of Toddalia asiatica Lam.ELISA kit was used to detect the contents of β-EP,5-HT and PGE2 in serum of carrageenan-treated rats,contents of TNF-αand IL-1β in skin tissue of inflammatory rats,and content of LTB4 in serum of formalin-treated rats;immunohistochemical method was used to observe the SP and FOS protein expressions in rat spinal cord.RESULTS The ethanol extract of Toddalia asiatica Lam.could significantly reduce the rate of toe swelling.In the formalin test,the ethanol extract of Toddalia asiatica Lam.reduced not only the total licking time,but also the content of PGE2,especially in the high dose group.And lowered serum 5-HT contents were observed in all the three dose groups,but a much better performance was found in both the high and low dose groups,and the high dose group's capability in increasing serum β-EP content was also noticed.TNF-α and IL-1β contents in skin tissue were reduced in various dose groups.Middle and high dose groups inhibited FOS protein expression.And the content of LTB4 in serum was obviously decreased in the high dose group.CONCLUSION The anti-inflammatory and analgesic activities of ethanol extract of Toddalia asiatica Lam.may associate with its power in increasing β-EP in serum,decreasing PGE2,5-HT,LTB4 contents,reducing TNF-α,IL-1β contents in skin tissue,and lowering SP and FOS protein expressions in spinal cord.

Prognostic value of first documented rhythms in patients with in-hospital cardiac arrest / 中华急诊医学杂志

Objective To evaluate the prognostic value of the first documented rhythm in patients with in-hospital cardiac arrest.Methods The clinical data of 62 in-hospital cardiac arrest patients collected from May 2011 to April 2016 were reviewed.Multiple regression analysis was performed for determination of the factors relevant to ROSC.The patients were divided into defibrillative rhythm group [ventricular fibrillation (VF) /ventricular tachycardia (VT)] and non-defibrillative rhythm group [pulseless electrical activity (PEA) /asystole] according to the first documented rhythm after cardiac arrest.The differences in rate of restoration of spontaneous circulation,number of survival at hospital discharge and those discharged with favorable neurological outcome were compared between groups.Results Logistic regression analysis showed that non-defibrillative rhythm was related to low rate of ROSC.Rate of ROSC (x2 =6.90,P =0.01),number of survival at hospital discharge (x2 =10.49,P =0.00) and those discharged with favorable neurological outcome (x2 =14.70,P =0.00) were higher in the defibrillative rhythm group,while there was no difference in outcomes between the VF and VT groups.There was no difference in consequence found between the PEA and asystole groups.Conclusion Rate of restoration of spontaneous circulation,number of survival at hospital discharge and those discharged with favorable neurological consequence were higher with defibrillative initial rhythm.

Diffusion tensor imaging of brain white matter in rats with ischemia reperfusion injury and its behavioral changes / 中华急诊医学杂志

Objective To investigate the changes of diffusion tensor imaging (DTI) in the cerebral white matter of rats with ischemia-reperfusion injury.Methods Adult SD rats were randomly divided into two groups,sham operation group and model group.The model of ischemia reperfusion injury was made by the Koizumi suture method to occlude the middle cerebral artery.Application of Zea-Longa score was carried out to determine the establishment of modeling,and the modified neurological severity score (mNSS) was used to evaluate the neurological deficit of rats.The Rotarod test instrument was used to observe the motor function of rats by using Rotarod fatigue balance signs,and the DTI sequence scanning observation of brain white matter nerve fiber damage was determined by using Brook 7.0T small animal magnetic resonance imaging system.Track Vis software was used to analyze the distribution of cerebral white matter nerve fibers,and the relative number of nerve fibers in the areas of ROI (region of interest,ROI),sensorimotor areas and striatum were calculated.Results The results showed varying degrees of neurological impairment in rats 2 h after cerebral ischemia reperfusion injury,and the Zea-Longa score and the mNSS score were gradually reduced at the 1 d,7 d and 14 d after ischemia reperfusion injury.The time of rats retaining on the rotating rod was shortened at the 7 d and 14 d after ischemia reperfusion injury.At the ischemic lateral,nerve fibers decreased significantly,and the number of sensory nerve fiber connections in the sensorimotor areas to striatum was reduced.Nissl staining showed that the cytoplasm of neurons in the sensorimotor cortex and striatum of the ischemic lateral were disappeared and the Nissl bodies were decreased.Conclusions The nerve fibers of sensory motor cortex connecting to striatum were damaged by ischemia reperfusion injury.

Epidemiological characteristics and genetic evolution of human bocavirus infection in hospitalized children with severe acute respiratory infection in Hangzhou / 中华临床感染病杂志

Objective To study the epidemiological characteristics and genetic evolution of human bocavirus ( HBoV ) infection in hospitalized children with severe acute respiratory infection ( SARI ) in Hangzhou.Methods A total of 1388 clinical specimens were collected from children with SARI admitted in Affiliated Children' s Hospital, Zhejiang University School of Medicine from January 2011 to December 2014.HBoV1-4 and other respiratory pathogens were identified by fluorescent real -time polymerase chain reaction (fRT-PCR).The VP1 gene in HBoV1 positive samples was amplified and sequenced for genetic analysis with Clustal X and MEGA 6.0.Chi-square test and Fisher exact probability were used to analyze the data.Results Eighty five HBoV positive samples were detected from 1388 samples (6.12％), among which 83 (97.65％) were HBoV1 positive and 2 (2.35％) were HBoV2 positive.The positive rates of HBoV in males and females were 6.54％and 5.35％(χ2 =0.780, P>0.05).The posititve detection rate of HBoV in all age groups was statistically significant (χ2 =47.446,P <0.01).The detection rate in children aged 6 months-1 year was highest (12.84％), in children aged >3 years was lowest (1.64％), in children aged ≤6 months and aged 1-3 years was 3.04％ and 3.33％, respectively.The detection rate of HBoV in summer was the highest (14.97％), followed by that in autumn (7.14％), spring (3.19％) and winter (1.97％) (χ2 =58.807, P<0.01).The detection rates of HBoV in 2011 to 2014 were 7.39％, 7.31％, 5.58％ and 4.72％ (χ2 =3.447, P >0.05 ).The co-infection rate with other respiratory pathogens was 62.35％.The main pathogens were human rhinovirus (33.96％), parainfluenza virus (28.30％) and respiratory syncytial virus (20.75％).The incidence of anhelation and wheezing in HBoV positive group was higher than that in HBoV negative group (χ2 =15.161 and 13.914, P <0.01). Sequence analysis of VP 1 gene showed that 44 isolates belonged to the same branch ( clade 1 ) as Swedish strain ST2, and 2 isolates HZ12-S32 and HZ12-S199 belonged to a separated branch.Conclusion HBoV is an important causative agent of hospitalized children with SARI in Hangzhou area and has high co -infection with other respiratory pathogens.Most of the strains belong to the same clade as the Swedish strain ST 2, and two strains of HZ12-S32 and HZ12-S199 are identified in a separated clade.

KTP laser combined with drainage tube implantation for lacrimal duct obstruction patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the influence and safety of KTP laser combined with drainage tube implantation for lacrimal duct obstruction patients.<p>METHODS: Totally 200 patients(200 eyes)randomly selected from June 2012 to September 2015 in our hospital was diagnosed with lacrimal duct obstruction and treated with KTP laser combined drainage tube implantation. The ocular surface condition, including tear break-up time, fern-like crystals, dry eye symptoms questionnaire, lissamine green staining, corneal fluorescein staining, were assessed before and 1mo after surgery.<p>RESULTS: At 1mo after surgery, the tear secretion increased significantly. After extubation, tear secretion decreased significantly compared to the preoperative(<i>P</i><0.05). The results of the questionnaire showed that the symptoms improved significantly after surgery. There were no significant differences between tear break-up time, fern-like crystals and conjunctival goblet cells before and after surgery, or after extubation.<p>CONCLUSION: KTP laser combined with drainage tube implantation can improve the symptoms and quality of life for lacrimal duct obstruction patients.