The effect of medial calcar screws on the treatment of Neer type Ⅲ proximal humeral fracture with Multiloc intramedullary nailing / 中华创伤骨科杂志

Objective:To investigate the effect of the use of medial calcar screws on the treatment of Neer type Ⅲ proximal humeral fracture with Multiloc intramedullary nailing.Methods:A retrospective study was conducted to analyze the data of 36 patients with Near type Ⅲ fracture of the proximal humerus who had received Multiloc intramedullary nailing at Department of Upper Limbs, Sichuan Orthopedic Hospital from January 2016 to December 2021. There were 6 males and 30 females with an age of (63.9±5.3) years. They were divided into 2 groups according to whether medial calcar screws had been used or not. There were 17 cases in the group without medial calcar screws and 19 cases in the group with medial calcar screws. The 2 groups were compared in terms of flexion and lifting, external rotation, internal rotation and back touch, visual analogue scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score for shoulder function (Constant score), neck shaft angle, and incidence of complications at the last follow-up.Results:There were no statistically significant significances in the preoperative general data between the 2 groups, indicating comparability between the groups ( P>0.05). The 36 patients were followed up for 13.5(12.0,19.8) months after surgery. The flexion and lifting, external rotation, internal rotation and back touch, VAS, ASES score, Constant score, neck shaft angle at the last follow-up in the group without medial calcar screws were, respectively, 134.1°±8.4°, 32.1°±5.3°, 14.0 (13.0, 15.5) , 0.0 (0.0, 1.0), 78.2±5.2, 78.0±5.8, and 137.6°±8.1°, insignificantly different from those in the group with medial calcar screws [134.7°±6.1°, 35.0(30.0, 35.0)°, 14.0(13.0, 15.0), 1.0 (0.0, 1.0), 78.2±5.4, 76.7±4.5, and 136.9°±6.4°] ( P>0.05). Postoperative complications occurred in 6 patients in each group, showing no statistically significant difference between the 2 groups ( P=1.000). Conclusion:The use of medial calcar screws has no significant impact on the postoperative shoulder function and incidence of complications in the treatment of Neer type Ⅲ fractures of the proximal humerus with Multiloc intramedullary nailing.

Advances in genetic etiology of isolated growth hormone deficiency / 国际儿科学杂志

Isolated growth hormone deficiency(IGHD)is a growth disorder characterized by short stature.The etiology and pathogenesis of IGHD are still not fully understood.IGHD can be caused by congenital(heredity and/or malformations)or acquired(tumors, physical trauma, inflammation, brain infections, or radiation therapy)factors.The most common genes in its genetic etiology are the growth hormone 1(GH1)and growth hormone-releasing hormone receptor(GHRHR). In rare cases, IGHD may be caused by mutations in transcription factors such as HESX1, SOX3, OTX2, POU1F1, etc.The disease phenotype of IGHD patients is highly variable.Correct diagnosis and early treatment are crucial for the long-term prognosis of IGHD patients.This review mainly discusses advance of IGHD gene mutation and disease phenotype.

On standards of and approaches to "Golden Course" construction of medical English writing in the era of big data / 中华医学教育探索杂志

In order to cultivate talents who fuel and lead medical innovation, it is critical to implement medical English writing "Golden Course" in the substantial development of English teaching in medical universities. Based on the guidelines issued by the Ministry of Education, this paper proposes five principles in the construction of medical English writing "Golden Course", suggests the integration of big data technology, and explores approaches to construct "Golden Course" in terms of teaching objectives, curriculum design, models of instruction, curriculum evaluation and teaching staff.

Behavioral problems of children with congenital adrenal hyperplasia and their influencing factors / 中华实用儿科临床杂志

Objective:To investigate the behavioral problems of children with congenital adrenal hyperplasia (CAH), and to explore the influencing factors, thus providing evidence for their prevention and interventions.Methods:A case-control study was carried out.A total of 25 children with CAH who were aged 4-16 and regularly followed up in the Outpatient Department of the Second Xiangya Hospital, Central South University from June 1, 2017 to March 31, 2019 were enrolled in the study group, and 50 age-and gender-matched healthy children in Hunan Province were selected as the healthy control group.The parents of the selected subjects were investigated with the Achenbach Child Behavior Checklist (CBCL) to evaluate children′s behavior problems.SPSS 22.0 software was applied to statistical analysis.Results:(1) The scores of externalizing behaviors, aggressive factors and behavior problems in 4-to 5-year-old male children in the CAH group were significantly higher than those in the healthy control group [(12.440±8.353) scores vs.(5.060±5.230) scores, (9.670±6.481) scores vs.(4.110±4.157) scores, (22.110±13.062) scores vs.(12.890±9.405) scores] ( t=2.829, 2.711, 2.109, respectively, all P<0.05). There was no significant difference in the scores of other behavior problems and influencing factors between the CAH group and the healthy control group (all P>0.05). (2) The influencing factor of behavioral problems was progesterone ( β=0.567). Testoste-rone not only was the influencing factor of externalizing and internalizing behaviors ( β=0.582, 0.497, respectively), but also affected the behavior of physical complaints, violation of discipline and social withdrawal ( β=0.735, 0.531 and 0.492, respectively). The factor influencing the schizoid behavior was the initial treatment age ( β=0.402). Conclusions:Four- to 5-year-old male children with CAH have behavioral problems, among which aggression and externalizing behaviors are more common.The increase of testosterone may cause the problems of internalizing and externalizing behaviors in children with CAH, and has a great impact on physical complaints, social withdrawal, and discipline violation.The increase of progesterone may lead to the behavior problems of the children.The older the initial treatment age, the more serious the schizoid behavior problem may be.

Analysis of clinical phenotype and genotype in patients with 21-hydroxylase deficiency in Hunan / 中华实用儿科临床杂志

Objective:To investigate the clinical characteristic, gene mutations and genotype-phenotype correlation of 21-hydroxylase deficiency (21-OHD) in Hunan.Methods:A total of 48 patients with 21-OHD who were admitted to the Department of Pediatrics, the Second Xiangya Hospital, Central South University from March 2016 to March 2017 were collected.According to the clinical manifestations and biochemical characteristics of the patients, they were divided into salt wasting (SW) and simple virilizing (SV). Sanger sequencing combined with multiplex ligation-dependent probe amplification(MLPA) were used to detect the mutations of CYP21A2 gene.The patients were divided into 3 groups according to their mutations severity: severe mutation group, moderate mutation group and unknown mutation group.Then, the correlation between genotype and phenotype was analyzed. Results:(1) Forty-eight 21-OHD patients included 28 SW cases and 20 SV cases, and the first visiting age of SW was younger than that of SV, and the difference was statistically significant ( U=44.5, P<0.05). The SW cases had high incidence rate of adrenal crisis and the SV patients were liable to advanced bone age and precocious puberty.(2) Forty-four patients were detected abnormal gene mutation and the positive rate of genetic diagnosis was 91.7%.Fourteen mutation types including I2G, Del, I173N, R357W, R484fs(c.1451_1452delGGinsC, c.1450dupC), R483fs, G111Vfs*21, Q319X, c.292+ 1G>A, c.377C>G, E6Cluster, p.H393Q and m. 1647C>T, were found in 88 alleles.The most frequent mutations were I2G(36.4%), I173N(20.4%), and Del(22.7%). p.H393Q and m. 1647C>T were 2 novel mutations.I2G (47.3%) and Del (27.3%) were the most frequent mutations in SW cases, and I173N (48.5%) was the most frequent mutation in SV cases.(3) Severe mutation was in 29 patients, including 26 SW, and moderate mutation was in 13 patients, including 12 SW.The percentage of SW in severe mutation group was 89.7% and SV in moderate mutation was 92.3%. Conclusions:I2G, I173N and Del were the frequent mutations of 21-OHD in Hunan, and the total percen-tage was 79.5%.Genotype of 21-OHD has strong correlation with clinical phenotype, which can effectively predict SW by severe mutation and predict SV by moderate mutation.

Characteristic profiles of biofilm, enterotoxins and virulence of Staphylococcus aureus isolates from dairy cows in Xinjiang Province, China

As an important zoonotic pathogen, Staphylococcus aureus has led to serious mastitis and endometritis in infected dairy cows. In this study, a total of 164 strains of S. aureus were isolated from dairy cows in Xinjiang Province, China, and subjected to assays to determine drug susceptibility and biofilm (BF) formation ability. Enterotoxin-related genes were detected, and the transcription levels of genes related to BF formation were determined by using reverse transcription-quantitative polymerase chain reaction. Moreover, the pathogenicity of isolates with different BF formation abilities was determined by measuring their hemolysis activity, half lethal dose (LD₅₀) and organ bacterial load. The results showed that 86.0% of S. aureus isolates could form BF. Among them, 42.1% of the strains had weak BF formation ability, and most strains with a strong BF formation ability were ica gene carriers. The S. aureus isolates displayed multidrug resistance and their drug resistance was positively correlated with their BF formation ability. Moreover, 96.3% of the S. aureus isolates carried enterotoxin genes. Among them, the detection rates of the novel enterotoxin genes were higher than those of conventional enterotoxin genes. Furthermore, isolates with a strong BF formation ability had higher LD50 but lower hemolysis ability and organ bacterial load than those of the isolates with weak or no BF ability. However, isolates without BF ability produced more severe pathological changes than those of isolates with strong BF formation ability. These findings suggest that higher BF ability and presence of novel enterotoxin genes are important characteristics of S. aureus isolates from dairy cows in Xinjiang Province, China, and such isolates may pose potential threats to food safety.

The impact evaluation of a community-based intervention supporting type 2 diabetes mellitus patients in their self-management of the disease / 中华预防医学杂志

Objective@#To evaluate the effect of a community-based intervention supporting type 2 diabetes mellitus patients in their self-management of the disease.@*Methods@#This research was a randomized controlled trial conducted in communities in Fangshan District, Beijing, China. Adult patients with type 2 diabetes from 17 communities in 4 sub-district of Fangshan District were randomly assigned to either the intervention or control group. Participants in the intervention group participated in a three-month group-based diabetes self-management intervention service. Data were collected both in intervention and control group at baseline and after the intervention to evaluate the effect of the intervention. A questionnaire survey was completed by all participants to collect their demographic information, diabetes related health behaviors and skills. A physical examination and lab testing including height, weight, blood pressure, and waist circumference as well as HbA1c, fasting blood glucose, lipid profile were conducted before and after the intervention.@*Results@#A total of 500 valid questionnaires were received, including 259 in the intervention group and 241 in the control group. Patients in the intervention group who learned how to conduct the self-monitoring of blood glucose increased from 56.76% (n=147) to 87.26% (n=226) after the intervention, higher than that of control group (63.07%, n=152) (P<0.001). 69.50% (n=180) patients in intervention group had blood glucose monitor at home, which was 60.62% (n=157) prior to the intervention and higher than that of control group (57.68%, n=139) (P=0.004). After the intervention, 3.09% (n=8) patients in intervention group ceased to take medicine by themselves, which was 16.22% (n=42) before the intervention, while the control group was 8.30% (n=20) after the intervention (P=0.009). Patients in the intervention group made significant improvements in implementing self monitoring on blood glucose (SMBG), which was increased from one day per week to 2 days per week, and foot self-examination, which increased from 2 days per week to 7 days per week. The body weight of patients in the intervention group reduced 1.62 kg on average after the intervention, while it increased 0.88 kg in the control group. Similar improvement was found in waist circumstance between the intervention and control group (-0.83 cm vs -0.16 m). There was a significant reduction on body weight and waist circumstance in the intervention group (P<0.05).@*Conclusion@#The group activities focusing on people with type 2 diabetes resulted in improvement in their lifestyle and self management behaviors, as well as their body weight and waist circumstance.

Analysis on influencing factors for acute gastroenteritis outbreaks caused by norovirus in Beijing, 2014-2018 / 中华流行病学杂志

Objective@#To analyze the influencing factors of acute gastroenteritis outbreaks caused by norovirus in Beijing from 2014 to 2018.@*Methods@#Data of acute gastroenteritis events caused by norovirus in Beijing from April 2014 to March 2018 were collected. Unconditional logistic regression model was conducted to identify the risk factors of the outbreaks.@*Results@#A total of 765 acute gastroenteritis epidemics caused by norovirus were reported in Beijing, in which 85.88% (657/765) were cluster events and 14.12% (108/765) were outbreaks. Among the outbreaks, 70.37% (76/108) were reported in 2017; 84.26% (91/108) were reported in winter and spring; 88.89% (96/108) were reported in kindergartens, primary or secondary schools; 81.48% (88/108) were through person-to-person transmission; 93.52% (101/108) were caused by norovirus GⅡ infection. The risk of outbreaks in suburban and out suburb area were 1.84 times (95%CI: 1.13-3.02) and 3.78 times (95%CI: 1.62-8.82) as high as that in urban area, respectively. The risks of outbreaks in primary, secondary schools and other institutions were 6.26 times (95%CI: 3.53-11.10), 14.98 times (95%CI: 6.23-36.01) and 8.71 times (95%CI: 3.07-24.71) as high as that in kindergartens, respectively. The risk of outbreak in which patients having lower hospital visiting rate than the median rate of all events was 2.29 times than that in the context of having higher hospital visiting rate (95%CI:1.42-3.68). The risk of foodborne outbreak was 14.55 times as high as that transmitted through person-to-person (95%CI: 3.15-67.07).@*Conclusion@#Measures such as strengthening the prevention and control of norovirus outbreaks in suburbs, primary schools, secondary schools and other institutions, promoting patients to visit the hospital actively, improving the management of foodborne events and kitchen workers should be taken to reduce the incidence of acute gastroenteritis outbreaks caused by norovirus.

Establishment of the classified evaluation system on the levels of influenza epidemics through a synthetic index method, in Beijing / 中华流行病学杂志

Objective To establish a classified evaluation system for recognizing the levels of influenza epidemics and to explore the new reporting system on influenza epidemics.Methods The following 3 indicators,including 1) the number of influenza-like illness,2) positive rate of detection on influenza virus nucleic acids,and 3) the number of influenza outbreaks were chosen to calculate the synthetic index and to classify the grades of evaluation.Results 209 weeks during 2013-2017 were classified into 5 grades:Grade 1 were 110 weeks (52.63％),Grade 2 were 47 weeks (22.49％),Grade 3 were 44 weeks (21.05％),Grade 4 were 8 weeks (3.83％),and Grade 5 were 0 week.Conclusion This classified evaluation system provided simple,comprehensive and comparable reference indicators and used for the evaluation on influenza epidemics,also providing suggestions for influenza prevention and control accordingly.

Study on Quality Standard for Siwei Jiangmei Tablets / 中国药房

OBJECTIVE:To establish the quality standard for Siwei jiangmei tablets. METHODS:TLC method was used for the qualitative identification of Salvia miltiorrhiza,Artemisiae Scopariae Herba and Taraxaci Herba. HPLC method was adopted for the content determination of chlorogenic acid. The determination was performed on Agilents TC-C18column with mobile phase consisted of acetonitrile-3% acetic acid(10:90,V/V)at the flow rate of 1.0 mL/min. The detection wavelength was set at 327 nm,and column temperature was 25 ℃. The sample size was 10 μL. RESULTS:TLC spots of S. miltiorrhiza, Artemisiae Scopariae Herba and Taraxaci Herba were clear and well-separated without interference from negative control. The linear range of chlorogenic acid was 0.26-0.79 μg for(r=0.999 9). The limits of quantitation and detection were 0.26,0.12 μg, respectively. RSDs of precision,stability and reproducibility tests were lower than 1.0%. The recoveries were 96.11%-101.96%(RSD=1.98%,n=9). CONCLUSIONS:Established standard can be used for quality control of Siwei jiangmei tablets.

Effects of migration on glucose metabolism of the population / 中华内分泌代谢杂志

Most migrations occur movement from less developed regions to developed areas ( most of which involve people migrating from South Asia to Europe) . Migrants had a higher risk of diabetes in the migratory population than that in the locals, earlier of illness, more severe insulin resistance, and more likely failure of pancreaticβcell function, which lead to increased complications such as macrovasular and microvascular diseases. These differences may be related to the genetic, epigenetic, lifestyle, as well as the social security of the migrant population.

Establishment of the classified evaluation system on the levels of influenza epidemics through a synthetic index method, in Beijing / 中华流行病学杂志

Objective To establish a classified evaluation system for recognizing the levels of influenza epidemics and to explore the new reporting system on influenza epidemics.Methods The following 3 indicators,including 1) the number of influenza-like illness,2) positive rate of detection on influenza virus nucleic acids,and 3) the number of influenza outbreaks were chosen to calculate the synthetic index and to classify the grades of evaluation.Results 209 weeks during 2013-2017 were classified into 5 grades:Grade 1 were 110 weeks (52.63％),Grade 2 were 47 weeks (22.49％),Grade 3 were 44 weeks (21.05％),Grade 4 were 8 weeks (3.83％),and Grade 5 were 0 week.Conclusion This classified evaluation system provided simple,comprehensive and comparable reference indicators and used for the evaluation on influenza epidemics,also providing suggestions for influenza prevention and control accordingly.

Infection characteristics of patients in acute gastroenteritis outbreaks caused by noroviruses / 中华实验和临床病毒学杂志

Objective@#To analyze the infection characteristics of patients in acute gastroenteritis outbreaks caused by noroviruses.@*Methods@#Between April 2014 and March 2016, the clinical data and samples were collected from the patients in acute gastroenteritis outbreaks caused by noroviruses in Beijing. Noroviruses were detected and genotyped using real time RT-PCR, and the infection characteristics of norovirus gastroenteritis were analyzed using the descriptive epidemiological method.@*Results@#A total of 1743 clinical diagnosed cases of norovirus gastroenteritis were collected, and children under 12 years old accounted for 77.68% (1354/1743). The detection rate of noroviruses was 73.98% (509/688). The detection rates of noroviruses in fecal, swab and vomitus samples were gradually decreased (χ2=67.798, P<0.001). Among these clinical diagnosed cases, vomiting was the most common symptom (93.98%), followed by abdominal pain (40.34%), diarrhea (30.35%) and fever (27.94%). The most common symptom of patients under 6 years old was vomiting(98.14%), whereas diarrhea was most common among over 18 years old patients (68.12%). With the increase of age of the patients, the incidence of vomiting was gradually decreased (χ2=100.913, P<0.001), whereas the incidence of diarrhea was gradually increased (χ2=261.164, P<0.001). There was no statistical difference in vomiting, diarrhea and abdominal pain symptoms between patients infected with genogroup Ⅰ and Ⅱ noroviruses, and patients infected with genogroup Ⅱ (34.49%, 149/432) had the higher incidence rate of fever than that of genogroup Ⅰ (18.18%, 14/77) (χ2=7.985, P<0.01).@*Conclusions@#Noroviruses mainly infected children under 12 years old in acute gastroentertis outbreaks. The most common symptom of patients with acute gastroenteritis caused by noroviruses was vomiting, and the incidences of vomiting and diarrhea were significantly correlated with age of the patients. Patients infected with genogroup Ⅱ had the higher incidence rate of fever than genogroup Ⅰ infection.

Expressions and roles of long non-coding RNA UCA1 in tumors / 国际肿瘤学杂志

Urothelial carcinoma associated antigen 1(UCA1)is a highly bladder cancer-specific long non-coding RNA(lncRNA),and it does not have the function of encoding protein. UCA1 differentially expre-sses in various fetal tissues,but its expression is turned off in most adult tissues. It reactivates during tumori-genesis. Researches indicate that UCA1 may regulate cell proliferation,apoptosis,metastasis and chemoresis-tance of tumors,such as bladder cancer,breast cancer and hepatocellular cancer.

Effect of long non-coding RNA UCA1 on invasion and metastasis of pancreatic cancer cell lines / 基础医学与临床

Objective To explore the expression of urothelial carcinoma-associated 1 ( UCA1 ) in pancreatic cancer cell lines and its influence on the invasion and metastasis of the pancreatic cancer cells .Methods The expression of UCA1 in pancreatic cancer tissues and paired adjacent normal tissues ( 11 cases ) and 5 pancreatic cancer cell lines was analyzed by real-time PCR.The level of UCA1 in BxPC-3 was knocked down by small interfering RNA . The ability of invasion and migration in vitro of transfected BxPC-3 was detected by Transwell invasion assay and wound healing assay .The protein levels of MMP-2 and MMP-9 were measured by Western blot experiment .Results The expression level of UCA1 in pancreatic cancer tissues was higher than that in paired adjacent normal tissues , and UCA1 differentially expressed in 5 pancreatic cancer cell lines .Down-regulation of UCA1 by siRNA suppressed the expression of MMP-2 and MMP-9 in BxPC3, and dramatically impaired the ability of invasion and migration of BxPC-3.Conclusions UCA1 is over-expressed in pancreatic cancer , and down-regulation of UCA1 attenuates the capacity of invasion and metastasis in vitro of BxPC-3 by decreasing MMP-2 and MMP-9.

Research progress of long non-coding RNA in tumor epithelial-mesenchymal transition / 国际肿瘤学杂志

Long non-coding RNA (lncRNA)is a kind of RNA molecule which is longer than 200 nucleotides and has no capacity of coding proteins.Accumulating evidences have indicated that several lncRNAs,such as HOTAIR,MALAT-1 ,H1 9 and BANCR may promote tumor metastasis by inducing epitheli-al-mesenchymal transition.

The role of matrix metalioproteinase-9 and high sensitive C-reactive protein in type 2 diabetes mellitus combined with coronary heart disease / 中国医师进修杂志

Objective To investigate the effect of matrix metalloproteinas-9 (MMP-9) and high sensitive C-reactive protein (hs-CRP) in type 2 diabetes mellitus (T2DM) combined with coronary heart disease(CHD). Methods Thirty-one patients with T2DM combined with CHD(T2DM combined with CHD group) ,50 patients with CHD (CHD group) and 30 healthy volunteers (control group) were studied. Serum MMP-9 was measured by ELISA, and serum hs-CRP was measured by scattering immunoturbidimetric assay. Results The level of MMP-9 in T2DM combined with CHD group (409.62 μg/L) was significantly higher than that in CHD group (263.40 μg/L) and control group [(196.15 ±44.89) μg/L] (P < 0.05).The level of hs-CRP in T2DM combined with CHD group (17.20 mg/L) was significantly higher than that in CHD group (4.57 mg/L) and control group [(1.52±0.78) mg/L] (P <0.01). MMP-9 wa significantly related with hs-CRP in T2DM combined with C HD group (r = 0.482,P < 0.01). Conclusion The serum M MP-9 and hs-CRP levels are closely associated with the occurrence and development of diabetes related coronary atherosclerosis.

Assay of growth hormone receptor gene mutations in children with idiopathic short stature / 中华内分泌代谢杂志

A homozygous A to G transition (AGT to GGT) in codon 16 of growth hormone receptor (GHR) gene was found in one patient with idiopathic short stature(ISS), resulting in an amino acid change(Ser16Gly). This may be a novel GHR gene mutation; and another novel Arg43Gln GHR gene polymorphism was found in Chinese people.

Insulin resistance in patients with advanced prostate cancer who received surgical castration / 中国医师进修杂志

Objective To investigate the role of insulin resistance in patients with prostate cancer who received surgical castration. Methods Sixty-seven patients with advanced prostate cancer who received with surgical castration were divided into obesity group [30 cases, BMI (26.85±1.22) kg/m2] and non-obesity group[37 cases, BMI(22.72±1.28) kg/m2]. The fasting blood glucose (FBG) and the fasting serum insulin, while evaluated the insulin resistance index(IRI) were determined before treatment, 6 months after treatment and 12 months after treatment. Results The levels of fasting serum insulin were significantly higher 6 months[(23.21±5.78 )mU/L] and 12 months [(24.34±5.37) mU/L] after treatment than that be-fore treatment[(20.01±4.82) mU/L] in obesity group, but 12 months after treatment [(22.19±6.14) mU/L ]was higher than that before treatment [(17.36±6.01) mU/L] in non-obesity group (P<0.01). The IRI were significantly higher 6 months (2.94±0.79) and 12 months (3.10±0.73) after treatment than that be-fore treatment (2.53±0.64) in obesity group, but 12 months after treatment (2.79±0.75) was higher than that before treatmeat(2.17±0.73) in non-obesity group(P<0.01). Conclusion The current data suggests that the patients with prostate cancer who received surgical castration is at risk for developing insulin resistance, thus leading to increasing risk of cardiovascular disease and type 2 diabetes mellitus.