Mid-term clinical outcome of arthroscopic surgery on early knee osteoarthritis in middle-old aged patients / 中国骨伤

OBJECTIVE@#To compare the mid-term clinical effect of arthroscopic surgery versus conservative treatment on the middle aged early knee osteoarthritis (EKOA) patients, with the hope to provide clinical evidence for their individual therapy.@*METHODS@#A total of 145 middle aged EKOA patients(182 knees) who received arthroscopic surgery or conservative treatment from January 2015 to December 2016 were retrospectively enrolled, including 35 males and 110 females, aged from 47 to 79 years old with an average of (57.6±6.9) years old, and the duration of disease ranged from 6 to 48 months with an average of(14.6±8.9) months. According to treatment method, patients were divided into arthroscopic surgery group (47 patients, 58 knees) and conservative treatment group(98 patients, 124 knees). Before treatment, patients presented with symptoms of knee joint, such as pain, swelling, locking, limited flexion and extension, and weakness, as well as abnormal findings in knee X-ray (without or suspicious joint space narrow, and a few of osteophyte formation) or in knee MRI (injury or degeneration of articular cartilage or meniscus, loose body in the joint cavity and synovial hyperemia edema, etc). Related data were collected, including duration of knee symptoms, presence of meniscus injury, loose body in the joint cavity or mechanical symptoms such as locking, and visual analogue scale (VAS) and Lysholm knee function score before treatment and at the latest follow-up. Statistical analysis was performed to compare the differences in VAS or Lyshilm score before or after treatment between the low groups and within each group.@*RESULTS@#Patients in the two groups were followed up from 60 to 76 months. In the arthroscopic surgery group, the incision healing was good and no surgical complications occurred. There were no significant differences in age, gender, BMI and follow-up time between the two groups(P>0.05). Before treatment, compared with conservative group, duration of symptoms in the arthroscopic group was longer (P<0.001), comorbidity rates of meniscus injury (P<0.001), free body (P=0.001) and mechanical symptoms (P<0.001) were higher, VAS (P<0.001) and Lysholm score (P<0.001) were worse. At the final follow-up, VAS and Lysholm score in either the conservative group or the arthroscopic group were significantly better than before treatment (P<0.05), while no significant differences between the two groups were found. The VAS was (1.5±1.2) scores in the arthroscopic group and (1.6±1.0)scores in the conservative group(P=0.549), and the Lysholm score was (84.9±12.5) scores in the arthroscopic group and (84.2±9.9) scores in the conservative group (P=0.676).@*CONCLUSION@#Both arthroscopic surgery and conservative treatment have satisfactory intermediate clinical effect middle- aged patients with EKOA, without statistically differences. However, most of the patients before surgery in the arthroscopic treatment group had mechanical locking symptoms caused by meniscus injury or loose body. Therefore, for the middle-aged EKOA patients with mechanical locking symptoms or without obtaining satisfactory outcome after conservative treatment, arthroscopic surgery may be considered.

HIV-1 Transmission among Injecting Drug Users is Principally Derived from Local Circulating Strains in Guangxi, China / 生物医学与环境科学（英文）

OBJECTIVE@#The mode of human immunodeficiency virus (HIV) transmission via injection drug use (IDU) still exists, and the recent shift in IDU-related transmission of HIV infection is largely unknown. The purpose of this study was to analyze the spatiotemporal sources and dynamics of HIV-1 transmission through IDU in Guangxi.@*METHODS@#We performed a molecular epidemiological investigation of infections across Guangxi from 2009 to 2019. Phylogenetic and Bayesian time-geographic analyses of HIV-1 sequences were performed to confirm the characteristics of transmission between IDUs in combination with epidemiological data.@*RESULTS@#Among the 535 subjects, CRF08_BC (57.4%), CRF01_AE (28.4%), and CRF07_BC (10.7%) were the top 3 HIV strains; 72.6% of infections were linked to other provinces in the transmission network; 93.6% of sequence-transmitted strains were locally endemic, with the rest coming from other provinces, predominantly Guangdong and Yunnan; 92.1% of the HIV transmission among people who inject drugs tended to be transmitted between HIV-positive IDUs.@*CONCLUSION@#HIV recombinants were high diversity, and circulating local strains were the transmission sources among IDUs in Guangxi. However, there were still cases of IDUs linked to other provinces. Coverage of traditional prevention strategies should be expanded, and inter-provincial collaboration between Guangxi, Yunnan, and Guangdong provinces should be strengthened.

Structure Design and Finite Element Analysis on Patch in Intraventricular Tunnel / 医用生物力学

ObjectiveT o explore the influence of patch shape for intraventricular tunnel (IVT) construction on biomechanical performance of the double outlet right ventricle after correction. Methods Based on the idealized IVT model, a two-dimensional IVT patch was designed. Six groups of patch models with the rhombic long-to-short axis ratio of 1∶0.625, 1∶0.3, 1∶0.2, 1∶0.15, 1∶0.125, 1∶0.1 were established according to the difference between the long and short axis of the rhombus patch in the turning part, and finite element analysis method was used to numerically simulate the process of stitching, holding and propping up the patch into a three-dimensional (3D) IVT model. Results The maximum stresses on suture line of 6 patch models were mainly concentrated at acute-angle corners of the rhombus. As rhombic long-to-short axis ratio of the patch increased, the maximum stress of the IVT suture line first decreased and then increased, and the volume showed an increasing trend. The pressure difference between two ends of the tunnel first decreased and then increased. The patch with the long-to-short axis ratio of 1∶0.15 had a uniform surface stress distribution, and the maximum stress on the suture line was the smallest. Meanwhile the right ventricular volume was less encroached on, and the pressure difference at both ends of the tunnel was small. Conclusions The IVT shape can influence stresses of suture line, the right ventricle volume and the pressure difference of IVT with non-monotonic variations. The suture effect of the patch with the long-to-short axis ratio of 1∶0.15 is relatively better among the constructed models.

Detection of varicella-zoster virus in different specimens from patients with acute herpes zoster / 中华皮肤科杂志

Objective:To investigate positive rates of varicella-zoster virus (VZV) DNA in blood and saliva samples, as well as in swab samples from lesions and clothes in contact with lesions in patients with acute herpes zoster, and to explore their clinical significance.Methods:Patients with confirmed herpes zoster were collected from Department of Dermatology, Shenzhen Hospital, Southern Medical University from April 2019 to August 2020. Fluorescence-based quantitative PCR was performed to detect VZV DNA in blood and saliva samples, lesion and cloth swab samples from the patients before and after antiviral treatment. Chi-square test was used to compare the positive rate of VZV DNA in saliva samples between patients with herpes zoster on the head, face and neck and those without involvement of the head, face or neck, and changes in the positive rate of VZV DNA in different specimens were analyzed before and after treatment.Results:A total of 86 patients with herpes zoster were collected, including 26 males and 60 females aged 52.65 ± 14.83 years, with a disease duration being 5.23 ± 2.10 days. The positive rate of VZV DNA in the saliva samples was significantly higher in the 24 patients with herpes zoster on the head, face and neck (41.67%, 10/24) than in the 62 patients without involvement of the head, face or neck (12.90%, 8/62; χ2 = 7.63, P < 0.05) . Both pre- and post-treatment blood samples were collected from 37 patients, saliva samples from 35, lesion swab samples from 28, and cloth swab samples from 27. Before the treatment, the positive rates of VZV DNA in the blood, saliva, lesion and cloth swab samples were 86.49% (32/37) , 22.86% (8/35) , 92.86% (26/28) and 88.89% (24/27) respectively, which decreased to 51.35%, 8.57%, 89.29% and 85.18%, respectively, after 6.82 ± 2.23 days of treatment. The positive rate of VZV DNA significantly differed before and after treatment only in the blood samples ( χ2 = 9.60, P = 0.003) , while showed no significant difference in the other specimens (all P > 0.05) . Conclusion:The positive rate of VZV DNA in the saliva samples was significantly higher in the patients with acute herpes zoster on the head, face and neck than in those without involvement of the head, face or neck, and that in the cloth swab samples was relatively high before and after antiviral treatment.

Application of next-generation sequencing in detection of BRCA1/2 and homologous recombination repair pathway multi-genes germline mutation and correlation analysis / 中华预防医学杂志

Objective: To investigate the germline mutation status of related genes in breast cancer patients and high-risk individuals by next-generation sequencing. To analyze the correlations between homologous recombination repair (HR) pathway gene mutation status and clinicopathological characteristics of breast cancer patients. To supplement the database of breast cancer related gene mutations in Chinese population. Methods: This study is a cross-sectional study. From October 2020 to September 2021, whole blood samples were collected from 350 breast cancer patients and 49 high-risk individuals, admitted to Peking University People's Hospital and accepted genetic testing voluntarily. Germline mutations in 32 breast cancer related genes were detected by NGS. The clinicopathological characteristics, including age at the onset, family history, unilateral/bilateral tumor, Luminal typing (Luminal A subtype, Luminal B subtype, HER2-enriched subtype and triple negative breast cancer), tumor size and metastasis, were analyzed, and the correlations between HR pathway gene mutation status and clinicopathological characteristics were analyzed by Chi-squared test and Fisher's exact probability test. Results: Among 350 breast cancer patients, 64 (18.3%) cases carried gene pathogenic mutations (including pathogenic and likely pathogenic mutations), including 47 (13.4%) in BRCA1/2, 16 (4.6%) in non-BRCA1/2 genes, 1 (0.3%) in BRCA2 and FANCL. Among 49 high-risk individuals, 7 (14.3%) cases carried gene pathogenic mutations, including 6 (12.3%) in BRCA1/2 and 1 (2%) in ATM genes. BRCA1/2 pathogenic mutations were associated with age at the onset (18%, 8.7%, χ²=6.346, P=0.012), and the BRCA1/2 pathogenic mutation frequency was higher in patients diagnosed at age ≤45 years. HR pathway gene mutations (including pathogenic, likely pathogenic and uncertain significance mutations) were correlated with unilateral/bilateral tumor (49.5%, 68.4%, χ²=4.841, P=0.028) and Luminal typing (45.7%, 62.2%, 32%, 60%, χ²=12.004, P=0.007), and the HR mutation frequencies were higher in patients with bilateral tumor, Luminal B breast cancer and triple negative breast cancer (TNBC). Conclusion: The BRCA1/2 pathogenic mutation frequency in high-risk individuals is similar to that in breast cancer patients, and BRCA1/2 testing is helpful to guide breast cancer screening and prevention in high-risk individuals. Patients with early onset breast cancer, bilateral breast cancer, Luminal B breast cancer and TNBC have higher mutation frequencies of HR pathway genes, and HR pathway genes testing should be conducted as soon as possible to provide laboratory evidence for diagnosis, treatment, prognosis and risk evaluation of breast cancer.

Phenomenological study of the effects of traumatic birth events on compassion fatigue among midwives / 中国实用护理杂志

Objective:To provide theoretical reference for the construction of effective prevention and control strategies. The study deeply investigates the impact of traumatic birth events on compassion fatigue and inner feelings of midwives.Methods:Fifteen midwives from five tertiary hospitals in Guangzhou were interviewed in depth by semi-structured interview method from April to June 2021. Colaizzi analysis and Nvivo12 plus software were used to analyze and integrate the data and extract themes.Results:Three main themes were extracted, including the characteristics of traumatic birth events (high incidence, sudden and dangerous, preventable and controllable); exacerbating compassion fatigue (reducing compassion satisfaction levels; exacerbating burnout; and aggravating traumatic stress responses); and exploring effective coping strategies (time required for adjustment, seeking stress release).Conclusions:As a strong stressor, traumatic birth events aggravate the symptoms of compassion fatigue in midwives. Managers should pay attention to the occupational exposure of traumatic childbirth events, actively guide midwives to make psychological adjustments. In addition, managers can increase social support and strengthen the ideological and political education of midwives, so that they have good stress tolerance and excellent professional psychological quality.

Effect of Zuoguiwan on Wnt/β-catenin Signaling Pathway in Ovariectomized Osteoporosis Model Rats / 中国实验方剂学杂志

Objective:To observe the effect of Zuoguiwan on bone metabolism and Wnt/<italic>β</italic>-catenin signaling pathway in ovariectomized osteoporotic rats model， and to explore the molecular biological mechanism of Zuoguiwan in the prevention and treatment of osteoporosis. Method:The rat model of postmenopausal osteoporosis was established by bilateral ovariectomy， 60 female SD rats were randomly divided into sham operation group， model group， positive group （estradiol valerate tablet 0.05 mg·kg^-1·d^-1） and low， middle and high dose groups of Zuoguiwan （5.5，11，22 g·kg^-1·d^-1）.After successful establishment of the model in the 13^th week， intragastric administration （<italic>ig</italic>） was given once a day for a total of 12 weeks. After administration， the histomorphological changes of femur in rats were observed by hematoxylin-eosin （HE） staining， the bone mineral density （BMD） and bone mineral content（BMC） of femur were measured by dual energy X-ray apparatus， and the biomechanical properties of bone were measured by MTS Acumen3 biomechanical testing system. The contents of bone alkaline phosphatase （BALP）， bone glaprotein（BGP），estradiol （E₂） ，and tartrate-resistant acid phosphatase （TRAP）， type Ⅰ procollagen N-terminal propeptide （PINP） in serum were detected by enzyme-linked immunosorbent assay （ELISA）. Western blot was used to detect the protein level of Wnt2，<italic>β</italic>-catenin，low density lipoprotein related receptor protein 5 （LRP5） and the phosphorylation level of glycogen synthase kinase-3<italic>β</italic>（GSK-3<italic>β</italic>） in rat tibia. Result:Compared with sham operation group， the maximum load and stiffness of BMD，BMC， in the model group decreased significantly（<italic>P</italic><0.01）， the contents of E₂ and PINP in serum decreased significantly（<italic>P</italic><0.01）， the content of BALP，BGP，TRAP increased significantly（<italic>P</italic><0.01）， the expression levels of Wnt2，p-GSK-3<italic>β </italic>Ser9，LRP5 and <italic>β</italic>-catenin protein in bone tissue decreased significantly（<italic>P</italic><0.01）， the trabecula of femur became thinner and thinner， the number of bone trabeculae decreased. Compared with model group， the maximum load and stiffness of BMD，BMC， in estradiol group and Zuoguiwan group were significantly increased （<italic>P</italic><0.05，<italic>P</italic><0.01）， the contents of serum E₂ and PINP were significantly increased （<italic>P</italic><0.05，<italic>P</italic><0.01）， the content of BALP，BGP，TRAP was significantly decreased （<italic>P</italic><0.01）， and the expression level of Wnt2，p-GSK-3<italic>β</italic> Ser9，LRP5， <italic>β</italic>-catenin protein in bone tissue was significantly increased （<italic>P</italic><0.05，<italic>P</italic><0.01） ， the trabeculae of femur became thicker， the number increased， the structure was basically clear. Conclusion:Zuoguiwan has a certain preventive and therapeutic effect on osteoporosis in ovariectomized rats， and its mechanism may be related to increasing the level of estrogen， activating Wnt/<italic>β</italic>-catenin signaling pathway， up-regulating the expression of Wnt2 and LRP5 protein， inhibiting the activity of GSK-3<italic>β</italic>， reducing the degradation of <italic>β</italic>-catenin， coordinating the dynamic coupling balance between bone formation and bone resorption， correcting the disorder of bone metabolism and improving bone morphology.

Clinical Observation of Suanzaoren Tang Combined with Fluoxetine in Treatment of Depression of Liver Stagnation and Blood Deficiency Accompanied by Insomnia / 中国实验方剂学杂志

Objective:To observe the clinical therapeutic effect of Suanzaoren Tang combined with fluoxetine in the treatment of patients with depression of liver stagnation and blood deficiency accompanied by insomnia. Method:The patients with depression of liver stagnation and blood deficiency accompanied by insomnia （120 cases） were randomly divided into an observation group and a control group， with 60 cases in each group. The patients in the observation group received Suanzaoren Tang combined with fluoxetine， and those in the control group received fluoxetine. The course of treatment was eight weeks. The clinical efficacy was evaluated with Hamilton Depression Rating Scale （HAMD）， Pittsburgh Sleep Quality Index（PSQI）， and Activities of Daily Living （ADL） score. Enzyme-linked immunosorbent assay （ELISA） was used to determine the plasma levels of 5-hydroxytryptamine （5-HT）， norepinephrine （NE），brain-derived neurotrophic factor （BDNF）， glial cell-derived neurotrophic factor （GDNF）， neuron-specific enolase （NSE）， and S100<italic>β</italic>. Result:After eight weeks of treatment， the scores of HAMD and PSQI were reduced（<italic>P</italic><0.01）， while the scores of ADL were elevated（<italic>P</italic><0.01），and the levels of 5-HT， NE， GDNF and BDNF were up-regulated （<italic>P</italic><0.01） in the plasma of patients in the observation group as compared with those before treatment. After treatment， compared with the control group， the observation group showed increased total effective rate（<italic>P</italic><0.01）， decreased scores of HAMD and PSQI （<italic>P</italic><0.01）， elevated score of ADL（<italic>P</italic><0.01）， up-regulated levels of 5-HT， NE， GDNF and BDNF in plasma， and declining NSE and S100<italic>β</italic>（<italic>P</italic><0.01）. Conclusion:Suanzaoren Tang combined with fluoxetine is superior to fluoxetine alone in treating the depression of liver stagnation and blood deficiency accompanied by insomnia. Its therapeutic effect is achieved by increasing the release of monoamine neurotransmitters and promoting the secretion of BDNF and GDNF in the brain.

Effect of Sinisan on BDNF/TrkB， 5-HT/5-HT1AR， and HPA axis in Depression Model Rats / 中国实验方剂学杂志

Objective:To observe the effect of Sinisan on the brain-derived neurotrophic factor （BDNF）/tyrosine kinase receptor B （TrKB）， 5-hydroxytryptamine （5-HT）/5-HT1A receptor （5-HT1AR）， and hypothalamus-pituitary-adrenal （HPA） axis in depressed rats， and explore the antidepressant mechanism of Sinisan based on BDNF/TrKB， 5-HT/5-HT1AR， and HPA axis. Method:A total of 120 male Wistar rats were randomly divided into a normal group， a model group， a fluoxetine （0.01 g·kg^-1） group， and low- （1.25 g·kg^-1）， medium- （2.5 g·kg^-1）， and high-dose （5 g·kg^-1） Sinisan groups， with 20 rats in each group. The depression model was induced by isolation combined with chronic unpredictable mild stimulation（CUMS） in rats except for those in the normal group for 21 days. Rats were then treated correspondingly once a day for 21 days by gavage. Those in the normal group and the model group received an equal volume of normal saline. During the intervention， the model rats were stimulated continuously. The depressive state of CUMS model rats was evaluated by sucrose preference test and open field test. Enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of corticotropin-releasing hormone （CRH）， adrenocorticotropic hormone （ACTH）， and corticosterone （CORT） in the plasma and BDNF and 5-HT levels in the hippocampal homogenate. The mRNA expression of hippocampal TrKB， 5-HT1AR， glucocorticoid receptor （GR）， and mineralocorticoid receptor （MR） was detected by real-time fluorescence-based quantitative polymerase chain reaction （Real-time PCR）. The protein expression of hippocampal TrKB， 5-HT1AR， GR， and MR was detected by Western blot. The histomorphological changes of the hippocampus were observed by hematoxylin-eosin （HE） staining. Result:Compared with the normal group， the model group showed decreased sucrose preference rate （<italic>P</italic><0.01）， reduced horizontal and vertical scores in the open field test （<italic>P</italic><0.01）， increased plasma content of CRH， ACTH， and CORT （<italic>P</italic><0.01）， declining content of BDNF and 5-HT in the hippocampus （<italic>P</italic><0.01）， dwindled mRNA and protein expression levels of TrKB， 5-HT1AR， and GR （<italic>P</italic><0.01）， elevated mRNA and protein expression of MR （<italic>P</italic><0.01）， and damaged hippocampal neurons revealed by HE staining. Compared with the model group， the groups with drug intervention showed increased sucrose preference rate （<italic>P</italic><0.01） and horizontal and vertical scores in the open field test （<italic>P</italic><0.05， <italic>P</italic><0.01）， decreased content of plasma CRH， ACTH， and CORT （<italic>P</italic><0.05， <italic>P</italic><0.01）， elevated content of hippocampal BDNF and 5-HT （<italic>P</italic><0.05， <italic>P</italic><0.01）， elevated mRNA and protein expression levels of hippocampal TrKB， 5-HT1AR， and GR （<italic>P</italic><0.05， <italic>P</italic><0.01）， reduced mRNA and protein expression levels of hippocampal MR （<italic>P</italic><0.05， <italic>P</italic><0.01）， and recovered hippocampal neurons as revealed by HE staining. Conclusion:Sinisan can exert a significant antidepressant effect by increasing hippocampal BDNF and 5-HT content， up-regulating TrKB， 5-HT1AR， and GR mRNA and protein expression， down-regulating MR mRNA and protein expression， inhibiting HPA axis hypertrophy， and enhancing the regeneration and repair of hippocampal neurons.

Immunoregulatory Effect of Chaihu Jia Longgu Mulitang Modified with Bupleuri Radix on Hippocampal NLRP3 Pathway in Depressed Rats / 中国实验方剂学杂志

Objective:To investigate the effect and mechanism of Chaihu Jia Longgu Mulitang （CJLM） on hippocampal NOD-like receptor protein 3 （NLRP3）inflammasome pathway in rats with depression. Method:Sixty male SD rats were randomly divided into a normal group，a model group， a MCC950 （1 mg·kg^-1） group， and high- （13 g·kg^-1）， medium- （6.5 g·kg^-1）， and low-dose （3.25 g·kg^-1） Chaihu Jia Longgu Mulitang groups， with 10 rats in each group．The depression model was induced by isolation combined with chronic unpredictable mild stimulation（CUMS） in rats except for those in the normal group. Rats were treated correspondingly for 21 days by intraperitoneal injection in the MCC950 group and gavage in other groups. The normal group and the model group received an equal volume of normal saline. The depression-like behaviors of rats were observed by sucrose preference test （SPT） and novelty-suppressed feeding test. Enzyme-linked immunosorbent assay （ELISA） was used to determine the levels of interleukin-1<italic>β </italic>（IL-1<italic>β</italic>） and IL-18 in the hippocampus of depressed rats. Western blot was used to detect the protein levels of NLRP3， apoptosis-associated speck-like protein containing a C-terminal caspase recruitment domain （ASC）， and Caspase-1. Result:Compared with the normal group， the model group showed decreased sucrose preference rate （<italic>P</italic><0.01）， prolonged novelty-suppressed feeding time （<italic>P</italic><0.01）， enhanced protein expression of NLRP3，ASC， and caspase-1<italic> </italic>（<italic>P</italic><0.05， <italic>P</italic><0.01）， and elevated expression of IL-1<italic>β</italic> and IL-18 （<italic>P</italic><0.01）. Conclusion:CJLM can alleviate depression-like behaviors in CUMS-induced model rats， and the underlying mechanism is related to the inhibition of the NLRP3 inflammasome pathway．

Action Mechanisms of Zhongjing's Antidepressant Prescriptions： A Review / 中国实验方剂学杂志

Depression is a threat to human health due to high incidence， recurrence， and disability rates. At present， the complex etiology and pathogenesis of depression are still unclear， and such hypotheses as monoamine neurotransmitters and their receptor abnormality， hyperactivity of hypothalamic-pituitary-adrenal （HPA） axis， inflammation， and neuron damage and remodeling have been put forward. Anti-depressants developed based on the pathogenesis have a certain effect， but there also exist some problems like low cure rate， poor compliance， relapse after discontinuation， and obvious side effects. According to Zhongjing's theory， depression falls into the categories of depression syndrome， visceral agitation， insomnia， and lily disease， and it is mainly located in the liver， involving the spleen， heart， and kidney. The pathogenesis mainly lies in qi stagnation and zang-fu organ dysfunction. Attention should be focused on regulating qi and relieving depression. Zhongjing's antidepressant prescriptions have exhibited good clinical efficacy in the treatment of depression， reflecting the multi-pathway action advantages of Chinese herbs. Based on the pathogenesis of depression and domestic and foreign literature on the intervention of depression with Zhongjing's prescriptions available in the past 20 years， this paper summarized the mechanisms of Zhongjing's prescriptions against depression from the experimental and clinical research aspects， in order to provide reference for clinical treatment of depression with Zhongjing's prescriptions.

Infection and strain analysis of superficial fungi in 498 cases in Shiyan area / 公共卫生与预防医学

Objective To understand the clinical characteristics, susceptibility factors, and the composition and distribution of pathogenic fungi in Shiyan area. Methods From January 2018 to December 2018, at the outpatient department of Taihe Hospital, a total of 498 patients with superficial mycosis were confirmed by clinical features and microbial identification. Clinical data was collected and statistical analysis of these patients was carried out. Results Among 498 patients, the top three diseases were 123 cases of tinea corporis (24.70%), 110 cases of onychomycosis (22.09%), and 54 cases of body ringworm (10.84%). The top three pathogenic fungi were Trichophyton rubrum (232 strains, 46.59%), Trichophyton interdigitale (71 strains, 14.26%) and Candida albicans (41 strains, 8.23%). There were some differences in the incidence of patients of different genders, ages, and jobs. Conclusion Tinea cruris was the main superficial mycosis in Shiyan area and Trichophyton rubrum was the main pathogen of superficial mycosis. The epidemic trend is similar to that in most regions of the country, but it has its own characteristics.

Attachment process of capsular and intraocular lens and its effect on visual quality after cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

@#The adhesion of capsule and intraocular lens(IOL)is a common phenomenon after cataract surgery. At present, there are increasing researches on the adhesion between the capsule and IOL at home and abroad. In this paper, we will review the adhesion process between the capsule and IOL, morphology, related factors that affect the adhesion, and its influence on the visual quality.

Clinical value of left ventricular strain analysis by cardiovascular magnetic resonance in patients with coronary chronic total occlusion / 中华心血管病杂志

Objective: To explore the clinical value of quantitatively assessment of left ventricular strain in patients with coronary chronic total occlusion (CTO) by cardiac magnetic resonance imaging (CMR)-feature tracking (CMR-FT) technique. Methods: In this retrospective and observation study, patients with single CTO, who underwent CMR examination in Beijing Anzhen Hospital from November 2014 to January 2019, were selected as case group (CTO group), and those without cardiovascular diseases defined by echocardiography, electrocardiogram (ECG) and clinical history and with normal CMR results were selected as healthy control group (control group). General clinical data including age, gender, discharge diagnosis, and the examination results of echocardiography and ECG were obtained from the electronic medical record system. Two-dimensional CMR-FT was applied to measure left ventricle (LV) global peak radial, circumferential, and longitudinal strains (GPRS, GPCS and GPLS, respectively), and the regional myocardial strain in the target vessel area of CTO was analyzed. Grayscale thresholds of 5 standard deviations (SDs) were used to quantify late gadolinium enhancement (LGE). Patients with CTOs were divided into infract size>10% group and infarct size≤10% group, and left ventricular ejection fraction (LVEF)≥50% group and LVEF<50% group, respectively. The differences between various groups were compared. Results: There were 52 patients in CTO group (34 males, age (54.1±11.7) years, body mass index (BMI) (26.2±2.5)kg/m2) and 30 patients in control group (14 males, age(51.6±12.3)years, BMI (25.6±3.3)kg/m2). There was no significant difference in age, gender, and BMI between the two groups (all P>0.05). LVEF, GPRS, GPCS and GPLS were significantly lower in CTO group than in control group (all P<0.05), left ventricular volume (LVEDV) was similar between the two groups (P>0.05). Among the patients with CTO, there were 26 patients with infarct size>10% and 26 patients with infarct size≤10%. GPRS, GPCS and GPLS were significantly lower (all P<0.05), while LVEF and LVEDV were similar in CTO patients with infarct size≤10% as compared to control group (both P>0.05). LVEF, GPRS, GPCS and GPLS were significantly lower (all P<0.05), while LVEDV was similar in CTO patients with infarct size>10% (P>0.05) as compared to control group. GPRS and GPCS were significantly lower (both P<0.05), while LVEF, LVEDV and GPLS were similar in CTO patients with infarct size>10% as compared to infarct size≤10% group. There were 40 subjects in LVEF≥50% group and 12 subjects in LVEF<50% group. Compared with the control group, GPCS and GPLS of CTO patients were significantly lower in LVEF≥50% group and LVEF<50% group (all P<0.01), LVEF and LVEDV was similar in CTO patients with LVEF≥50% (both P>0.05), but LVEF was lower and LVEDV was larger in LVEF<50% group (both P<0.05). The GPRS, GPCS, GPLS and LVEF of CTO patients in LVEF ≥ 50% group were higher than those in LVEF<50% group (all P<0.0l), and the myocardial infarction size was smaller than that in LVEF reduced group (P<0.0l), but there was no significant difference in LVEDV between the two groups (P=0.07). In the CTO group, there were 21 patients with left anterior descending artery (LAD) occlusion and 126 segments supplied by the target vessels. The peak radial strain (PRS), circumferential strain (PCS) and longitudinal strain (PLS) in the blood supply area were lower than those in the control group (all P<0 01). In 7 patients with left circumflex artery (LCX) occlusion, the number of myocardial segments supplied by the target vessels was 35, and the PRS, PCS and PLS in the target vessel supply area were lower than those in the control group (all P<0 05). In 24 patients with right coronary artery (RCA) occlusion, the number of myocardial segments supplied by the target vessels was 120, and the PRS, PCS and PLS in the target vessel supply area were lower than those in the control group (all P<0.01). Among the 126 segments in 21 patients with LAD CTO, 91 (72.2%) segments had infarct size≤25%, 17 (13.5%) segments had infarct size between 26%-50%, 11 segments (8.7%) had infarct size between 51%-75%, and 7 (5.6%) segments had infarct size between 76%-100%. Among the 35 segments in 7 patients with LCX CTO, 31 (88.6%) segments had infarct size≤25%, and 4 (11.4%) segments had infarct size between 26%-75%. Among the 120 segments in 24 patients with RCA CTO, 96 (80.0%) segments had infarct size≤25%, 11 (9.2%) segments had infarct size between 26%-50%, 8 (6.7%) segments had infarct size between 51%-75%, and 5 segments (4.2%) had infarct size between 76%-100%. Conclusions: In this study with single CTO, although the LVEF is preserved in the majority of the patients, the left ventricular global and regional strain values are significantly decreased. The larger the infarct size, the greater the impact on radial and circumferential motion, reflecting the early impairment of left ventricular function in these patients.

Risk factor distribution features and trends of young adults with first acute coronary syndrome / 中华心血管病杂志

Objective: To observe the characteristics and trends during the last 11 years of risk factors of young adults with first acute coronary syndrome (ACS). Methods: It was a cross-sectional study. We included young adults (18 to 44 years old) hospitalized for acute coronary syndrome in Beijing Anzhen Hospital for a first time from January 2007 to December 2017. Acute coronary syndromes include ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina (UA). The general information, medical history and laboratory test were recorded. Risk factors of ACS were smoking, dyslipidemia, overweight/obesity, hypertension and diabetes. Results: Data from 7 106 patients were analyzed, mean age was (39.8±4.2) years old and 6 593(92.8%)were men, including 2 254 (31.7%) STEMI, 704 (9.9%) NSTEMI and 4 148 (58.4%) UA. Most patients were male (6 593(92.8%)). Dyslipidemia (85.8%(6 094/7 106)), overweight/obesity (82.3%(5 850/7 106)), and smoking (63.9%(4 545/7 106)) were most prevalent. 98.3% (6 885/7 106) patients had at least 1 risk factor. The prevalence of hypertension, diabetes and overweight/obesity increased from 2007 to 2017. Rates of hypertension increased from 37.1%(111/299) to 48.1%(498/1 035) (Ptrend<0.01), diabetes from 12.0%(36/299) to 19.4%(201/1 035) (Ptrend<0.01), overweight/obesity from 74.2%(222/299) to 83.9%(868/1 035) (Ptrend<0.05), respectively. Conclusions: Dyslipidemia, overweight/obesity and smoking are most prevalent risk factors in young adults with a first ACS and most patients have at least 1 risk factor for ACS. Rates of hypertension, diabetes and overweight/obesity progressively increases over time in this patient cohort.

Comparative analysis of the treatment of partial anomalous pulmonary vein connection by double-patch method or Warden Technique / 中华胸心血管外科杂志

Objective:To compare the surgical and long-term follow-up results of partial anomalous pulmonary vein connection treated by double-patch method or Warden Technique.Methods:There were 33 cases of right pulmonary vein connected with the superior vena cava from May 2010 to May 2019 in our center treated by double-patch method or Warden technique. 21 cases were treated by double-patch method and 12 cases by Warden technique. Echocardiography and electrocardiogram were followed up regularly to observe the occurrence of arrhythmia, superior vena cava stenosis and pulmonary vein stenosis postoperatively.Results:All patients were discharged uneventfully, and were followed up for 1~8 years. In double-patch group, 2 cases with arrhythmia, 1 of whom was junctional arrhythmia which was automatically converted to sinus rhythm 1 day after surgery. The other had an early second degree atrioventricular block after surgery, and sinus rhythm was restored 3 days later with temporary pacemaker. 1 case had superior vena cava stenosis by echocardiography(PD 8 mmHg). No arrhythmia was found in long-term follow-up in Warden group. 2 cases had superior vena cava stenosis by echocardiography(PD 6 mmHg). Right pulmonary vein stenosis(PD 8 mmHg) was found in 1 case by echocardiography, no obvious aggravation was found in long-term follow-up.Conclusion:The double-patch method and Warden Technique are both safe and effective in the treatment of partial anomalous pulmonary venous connection.

Research progress of mitochondrial Lon protease and its related diseases / 上海交通大学学报（医学版）

Lon protease (LON) is a highly conserved ATP-dependent serine protease, which is responsible for the decomposition and elimination of abnormal proteins. As an important executor of intracellular environment stability, LON can degrade misfolded and damaged proteins together with proteasome to ensure the high quality of proteins in vivo, especially in the maintenance of mitochondrial function. At the same time, the physiological function of LON also has an important effect on cell survival under various stresses. Recent studies have shown that the abnormal expression or activity of LON is involved in the occurrence and development of many diseases such as neurodegenerative diseases, diabetes mellitus, myocardial ischemia, cerebral ischemia and tumors. This review focuses on the structure and the function of LON, the relationship between abnormal expression and diseases, and the research progress of LON activity intervention, in order to provide ideas for clinical diagnosis and treatment of related diseases.

Identification of a novel DGUOK variant in a Chinese family affected with mitochondrial DNA depletion syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the molecular etiology for a Chinese family with mitochondrial DNA depletion syndrome.@*METHODS@#Genomic DNA was extracted from peripheral blood samples of the patient and her parents.Targeted capture and next-generation sequencing was carried out to detect potential variants. Suspected variant was validated by Sanger sequencing.@*RESULTS@#A novel homozygous frameshift variant c.505_508delTATC was identified in the patient, for which both his mother and father were carriers.@*CONCLUSION@#The frameshift variant c.505_508delTATC probably underlies the mitochondrial DNA depletion syndrome in this patient. The result also enriched the variant spectrum of DGUOK gene.

Analysis of medication regularity and pharmacodynamic characteristics of traditional Chinese medicine treatment in 444 severe cases of COVID-19 / 中国中药杂志

The coronavirus disease 2019(COVID-19) is developing rapidly and posing great threat to public health. There is no effective intervention for the severe patients, and their prognosis is poor. It is worth noting that in the fight against COVID-19, China has always put equal emphasis on both Chinese and Western medicine. Traditional Chinese medicine has played an important role in the whole process. It is of great significance to discuss the rules and characteristics of the prescription of traditional Chinese medicine in the treatment of COVID-19. In this study, information was collected from 444 severe COVID-19 patients who were admitted to a hospital designated to treat patients with severe COVID-19 in Wuhan before March 20, 2020. We collected traditional Chinese medicine prescriptions for patients with severe COVID-19, referred to Chinese Pharmacopoeia to standardize the names of traditional Chinese medicine, and extract the property, flavor and channel tropism of traditional Chinese medicines to analyze the rules of the prescriptions. IBM SPSS Modeler 18.0 software was used to conduct correlation analysis of traditional Chinese medicine. Effective traditional Chinese medicines against COVID-19 was identified by the TCMATCOV platform. In the end, 1 532 effective prescriptions were included. Among them, the high-frequency drugs are Poria, Astragali Radix, Pogostemonis Herba, Armeniacae Semen Amarum, Atractylodis Macrocephalae Rhizoma, Pinelliae Rhizoma, Glycyrrhizae Radix et Rhizoma, Magnoliae Officinalis Cortex, Ephedrae Herba, Cinna-momi Ramulus. Most of the drugs have the following functions: resolving dampness, replenishing deficiency, resolving phlegm, cough, and asthma. The core combinations are Pogostemonis Herba-Poria, Astragali Radix-Pogostemonis Herba-Poria, Amomi Fructus-Poria, Amomi Fructus-Pogostemonis Herba, Amomi Fructus-Astragali Radix. The majority of the medicines are with cold and warm properties, and the proportions are 41.03% and 38.46%, respectively. The medicinal flavors are mainly concentrated in sweet and bitter, and the proportions are 34.71% and 30.58%, respectively. The meridian of the drug is more into the lung, stomach and spleen, with lung accounting for 22.87%. From the analysis of high-frequency drugs to the core combinations, one can see that the main treatment principle for severe COVID-19 is to remove internal and external dampness, protect the spleen and stomach, remove evil energy, and support righteousness. TCMATCOV platform was used to calculate the network disturbances of the high-frequency drugs. It was found that the traditional Chinese medicine with a high disturbance score accounted for a high proportion of the classic anti-COVID-19 prescriptions used by clinicians. Among them, the drugs with top scores are Ephedrae Herba, Citri Reticulatae Pericarpium, Eupatorii Herba, Platycodonis Radix, Cinnamomi Ramulus, Astragali Radix, Magnoliae Officinalis Cortex, Atractylodis Macrocephalae Rhizoma, Pogostemonis Herba, Scutellariae Radix. After a further exploration of the action targets, it was showed that disease-specific factor TNF was the target of the above ten drugs, and traditional Chinese medicine can exert anti-inflammatory and immune-modulating effects.

Mechanism of Modified Erchentang on Expression of CXCL8-CXCR1/2 Axle Genes in Lung Tissue of Rats with Chronic Obstructive Pulmonary Disease / 中国实验方剂学杂志

Objective:To observe the effect of modified Erchentang on the expression of CXC chemokine ligand (CXCL) 8-CXC chemotaxis factor receptor (CXCR) 1/2 genes in the lung tissue of rats with chronic obstructive pulmonary disease (COPD), in order to explore the anti-inflammatory molecular mechanism of Erchentang on COPD. Method:Forty SD rats were randomly divided into normal group, model group, Jizhi syrup group and modified Erchentang group. COPD models in rats were prepared by cigarette smoke and dripping lipopolysaccharide (LPS) in the trachea. After modeling, normal and model groups were intragastrically given normal saline solution, Jizhi syrup group was given Jizhi syrup（10 g·kg-1），and modified Erchentang group was given intragastrically corresponding herbal drugs (10 g·kg-1) for 14 days. The levels of chemokines CXCL1, CXCL8 were detected by enzyme-linked immunosorbent assay in rat bronchoalveolar lavage fluid (BALF). The mRNA expressions of CXCL8, CXCR1 and CXCR2 were detected by quantitative real time PCR (Real-time PCR). Western blot was used to detect the levels of CXCL8, CXCR1 and CXCR2 protein, the pathological changes of lung tissues were observed by hematoxylin-eosin(HE) staining,and immunohistochemistry (IHC) method was used to detect the expressions of CXCL8, CXCR1 and CXCR2 protein in the lung tissue of all the groups. Result:The levels of chemokines CXCL1, CXCL8 in rats BALF were increased significantly (P<0.01), the expressions of CXCL8，CXCR1 and CXCR2 mRNA and protein were increased significantly (P<0.05, P<0.01) in model group compared with normal group. Compared with model group, the expressions of CXCL8, CXCR1 and CXCR2 mRNA and protein were decreased significantly (P<0.05), and the levels of chemokines CXCL1, CXCL8 in rats BALF were decreased significantly (P<0.01) in modified Erchentang. Conclusion:Modified Erchentang has an anti-inflammatory effect on COPD. The mechanism may be related to inhibiting the expressions of CXCL8, CXCR1, CXCR2 mRNA and protein, and reducing the release of chemokines CXCL1, CXCL8.