Correlation analysis of bone mineral density, hemoglobin and serum albumin in healthy population / 中华健康管理学杂志

Objective:To use quantitative computed tomography (QCT) technology to measure the bone mineral density of the spine of the Chinese healthy population, and to explore its correlation with hemoglobin and serum albumin.Methods:The data in this study came from the China Health Quantitative CT Big Data Project (China Biobank). The spine bone density was measured by using QCT Pro Image Analysis System and all cooperating centers used the European spine phantom (NO.145) for quality control. Total of 50 053 healthy persons who met the criteria for entry were selected as the research subjects. The subjects were divided into 7 groups according to age. The general data, spine bone density, serum albumin, hemoglobin of the subjects were collected. The single-factor analysis of variance, Pearson correlation analysis and multi-classification logistic regression model were applied to analyze the correlation between bone density and hemoglobin and serum albumin.Results:The bone mineral density of healthy people decreased with age ( P<0.05), and there were significant differences in hemoglobin, serum albumin and body mass index (BMI) among different age groups (all P<0.05). Linear correlation analysis showed that there were positive correlation between bone mineral density and hemoglobin in healthy males in different age groups ( r=0.086, 0.101, 0.076, 0.090, 0.072, 0.123, 0.100, all P<0.01). There were negative correlation between bone mineral density and hemoglobin in certain age groups in women (40-49 years group: r=-0.027; 70-79 yearsgroup: r=-0.077; both P<0.05). And corelation were found between bone mineral density and serum levels of albumin in certain age groups of healthy subjects (among men, 30-39 years group: r=-0.048; 40-49 years group, r=-0.027; 70-79 years group, r=-0.051; among women, 30-39 years group: r=-0.044; 40-49 years group, r=-0.042; 50-59 years group, r=-0.086; 70-79 years group, r=-0.070; all P<0.05). After adjusting for age and BMI, the multi-category logistic regression analysis showed that the hemoglobin level was protective factor of normal bone density ( OR=1.022, 95% CI:1.017-1.027) and decreased bone density ( OR=1.012, 95% CI:1.007-1.016) in healthy males, and the serum albumin was risk factor for normal bone density ( OR=0.926, 95% CI:0.905-0.948) and decreased bone density ( OR=1.006, 95% CI:0.951-1.011) in healthy women. Conclusion:There is a correlation between bone mineral density and hemoglobin and serum albumin in Chinese healthy population. Hemoglobin is a protective factor for bone mineral density in men, and serum albumin is a risk factor for bone mineral densityin women.

Reference value of lumbar spine bone mineral density and regional differences based on quantitative CT examination in healthy adult female in China / 中华健康管理学杂志

Objective:To establish the normal reference value of lumbar bone mineral density (BMD) under quantitative CT (QCT) in Chinese healthy adult females and to explore the regional differences.Methods:Total of 35 431 healthy women who met the inclusion criteria of Chinese health quantitative CT big data program were selected in this study. The BMD of the central plane of L 1 and L 2 vertebrae was measured by Mindways′s QCT system, and the mean value was taken. One-way analysis of variance was used to compare the BMD differences of lumbar vertebrae in women of different ages and regions. The subjects were grouped by an age interval of 10 years, and the level of BMD in different regions of the same age group were compaired. Results:The peak BMD of Chinese healthy adult women appeared in the age group of 20-29 years (Northeast China(183.01±24.58) mg/cm 3, North China (188.93±24.80) mg/cm 3, East China (187.54±27.71) mg/cm 3, South China (186.22±33.72) mg/cm 3, Central China (176.33±24.91) mg/cm 3, Southwest China(182.25±28.00) mg/cm 3), and then it decreased with age. The level of BMD in different regions decreased with the age. Before the age of 70 years, BMD in Central and Southwest China was always at a low level((176.23±24.91) to (90.38±28.12) mg/cm 3, 182.25±28.00 to (88.55±25.68) mg/cm 3), lower than those in Northeast China ((183.01±24.58) to (99.69±27.85) mg/cm 3), North China ((188.93±24.80) to (95.89±26.12) mg/cm 3), East China ((187.54±27.71) to (95.65±27.86) mg/cm 3). After 70 years of age, BMD tended to be the same in different regions ( P>0.05). The BMD values in Central China and Southwest China were similar in the age group of 40-60 years ( P>0.05). The BMD values in the health adult femles in the age group of 60 years in different regions of Chinawere all lower than those of bone mass abnormality (all P<0.05). The detection rate of osteoporosis in females over 50 years was the highest in Southwest China (25.65%) and it was the lowest in North China (17.30%). Conclusions:This study establishes reference values of BMD under QCT in healthy Chinese women, which can be used as a reference basis for identifying women with low BMD who are at risk of osteoporosis. The BMD value is the lowest in Southwest China and the highest in South China.

Normal reference and regional variation of spinal bone mineral density under the quantitative CT in Chinese male population / 中华健康管理学杂志

Objective:To investigate the normal reference values of spinal bone mineral density measured by quantitative computed tomography (QCT) and the differences of bone mineral density (BMD) in different regions of in Chinese adult males.Methods:Men who underwent low-dose CT lung scan for cancer screening in regions of Northeast, North, East, South, Central and Southwest of China from January 2018 to December 2019 were selected. And the lumbar vertebrae BMD values in the male subjects were measured by the QCT system (Mindways Software, Inc.). The mean BMD values and their decline rates were calculated at an age interval of 10 years, and the prevalence of osteoporosis was calculated according to the American College of Radiology spine QCT osteoporosis diagnostic criteria.Results:A total of 50 682 males with a mean age of (50.22±12.79) years (ranged 20 to 98 years) were included in this study. The peak BMD of (173.11±28.56) mg/cm 3 in the healthy Chinese adult male population appeared in the age group of 20 to 29 years and then declined with age. Before the age of 70 years, the BMD was relatively higher in males in South China, and it was lower in Central China and Southwest China, and it was intermediate in Northeast, North and East of China, with statistically significant differences. There was no significant differences in BMD in the males in the two age groups of 70 to 79 years and 80 and older among the regions in China. The overall decline rate of spinal BMD in Chinese males under QCT was about 46.92% over the lifetime, and it declined obviouslyin the 40-49 age group. The overall prevalence of osteoporosis in Chinese male population aged 50 years and above was approximately 11.42%, with the highest prevalence in Southwest China and Central China (14.72% and 13.87%, respectively) and the lowest in North China and South China (8.53% and 7.71%, respectively). Conclusions:A reference of lumbar spine BMD values for healthy males in China based on QCT is established. BMD values were highest in South China and Lowest in Central China.

Baseline characteristics of the Chinese health quantitative CT big data program in 2018—2019 / 中华健康管理学杂志

Objective:To describe the baseline characteristics of the subjects enrolled in the China Quantitative CT (QCT) big data program in 2018—2019.Methods:Based on baseline data from the Chinese health big data project from January 2018 to December 2019 from the eligible enrolled population, measurements of bone mineral density (BMD) and visceral adipose tissue (VAT) were performed using Mindways′ QCT Pro Model 4 system. The baseline data of age, gender, regional distribution, height, weight, abdominal circumference, blood pressure, blood routine and blood biochemical tests were analyzed. And the single factor analysis of variance (ANOVA) was used to check the age related trend of BMD and VAT in both genders.Results:After screening the inclusion exclusion criteria and outliers of the main indicators, 86 113 people were enrolled in the project. The enrollment rate was 92.47%, including 35 431 (41.1%) women and 50 682 (58.9%) men, and the ratio of men to women was 1.43. The mean age was (50.3±12.7) years in all the subjects, and it was (50.2±12.8) years and (50.4±12.5) years in men and women, respectively, and there was no statistical difference between the two genders ( P>0.05). Total of 43 833 people were enrolled in east China, it was the largest group by region (50.90%), it was followed by central China (16 434 people, 19.08%), and the number of people enrolled in Northeast China was the lowest (2 914 people, 3.38%). The rate of completing of health information indicators related to the main outcome of the study were all above 70%, and there were significant differences between men and women (all P<0.05). The mean BMD was (139.33±46.76) mg/cm 3 in women, (135.90±36.48) mg/cm 3 in men, which showed a decreasing trend with age in both gender (both P<0.001); the mean intra-abdominal fat area was (116.39±56.23) cm 2 in women, (191.67±77.07) cm 2 in men, and there was an increasing trend with age in both men and women (both P<0.001). Conclusions:There are gender differences in BMD and VAT measured by QCT with different age tendency, and there are gender differences in health information index. Regional factors should also be taken into account for regional differences in the inclusion of data.

Quantitative computed tomography-derived abdominal visceral adipose tissue and cardiometabolic risk in a large-scale population / 中华健康管理学杂志

Objective:To investigate the relationship between abdominal visceral adipose tissue (VAT) and cardiometabolic risk (CMR) through quantitative computed tomography (QCT).Methods:The present study included 76226 participants. Abdominal fat areas were measured using the QCT Pro Model 4 system. Cardiometabolic indices were collected, including systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, triglyceride, and low-density and high-density lipoprotein cholesterols CMR score was the sum of abnormal blood pressure, fasting glucose, triglyceride, and high-density lipoprotein cholesterol. Restricted cubic spline and ordered logistic regression models were applied.Results:The mean age was 50±13 years and the percentage of men was 58.8%. The level of VAT area was higher in men than in women (191.7±77.1 cm 2 vs 116.4±56.2 cm 2, P<0.0001 for all). After adjustment for age, the cardiometabolic indices except high-density lipoprotein cholesterol increased with increasing VAT area. When VAT area was 300 cm 2, age-adjusted odds ratios and 95% confidence intervals of a CMR score ≥ 1 were 14.61 (13.31, 16.04) for men and 5.46 (4.06, 7.36) for women, and the age-adjusted probability of a CMR score ≥ 3 was 31.7% for men and 31.3% for women. Conclusions:QCT-derived VAT is closely related to CMR. The findings suggest that measurement of visceral fat is recommended for the management of abdominal obesity in subjects who agree to undergo lung cancer screening via low-dose CT without additional radiation exposure.

Clinical observation of double mini locking plate in the treatment of olecranon fracture / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of double mini-locking plates in the treatment of ulna olecranon fractures.@*METHODS@#From March 2017 to May 2020, 19 patients with olecranon fractures were treated with double mini locking plates, including 12 males and 7 females, aged from 20 to 75 years old with an average of (40.50±7.62) years old;10 patients had the injuries on the left side and 9 patients on the right side. All the 19 patients were fresh closed fractures without ulnar coronoid process fracture, elbow dislocation and other injuries. The fracture healing time and complications were recorded, and the clinical efficacy was evaluated by Mayo elbow performance score (MEPS) before operation and 12 months after operation.@*RESULTS@#All the 19 patientswas followed up, and the duration ranged from 12 to 17 months with an average of (13.51±3.17) months. Postoperative follow-up showed all fractures healed. Fracture healing time ranged from 2 to 6 months, with an average of(3.77±1.24) months. There was no internal fixation fracture, screw loosening, infection, internal fixation irritation, heterotopic ossification, elbow stiffness and other complications occurred. The MEPS score of affected elbow at 12 months after operation was 91.26±3.87, which was significantly different from that before operation 56.18±9.56 (@*CONCLUSION@#It is a reliable fixation method to treat olecranon fracture with double mini locking plate. The incision lengh is small and the fracture fixation is reliable. Elbow joint function exercise can be performed early after operation. Postoperative internal fixation has less skin irritation and satisfactory elbow joint function recovery.

Comparative Study of the Genetic Diversity, Antimicrobial Resistance, and Pathogenicity of / 生物医学与环境科学（英文）

Objective@#This study was performed to compare the genetic diversity, virulence, and antimicrobial resistance of @*Methods@#A total of 38 clinical strains and 19 strains from healthy individuals were isolated from the samples collected in Ma'anshan City, Anhui Province. Their taxonomy was investigated using concatenated @*Results@#The 57 @*Conclusions@#The taxonomy, virulence properties, and antibiotic resistance of

Correlation between the polymorphism of erythrocyte membrane blood group glycoprotein A (GPA) related gene GYPA and clonorchis sinensis infection / 中国输血杂志

【Objective】 To analyze the polymorphism of erythrocyte membrane blood group glycoprotein A (GPA) related gene GYPA in high and low endemic population for clonidia sinensis infection, aimed at investigating the correlation between erythrocyte transmembrane glycoproteins and clonorchis sinensis infection. 【Methods】 From Dec 2019 to Jun 2020, anticoagulant blood samples were randomly collected in WuMing district (n=700) and GuiGang district (n=500 ) of Nanning city, and the IgG antibody to clonorchis sinensis in plasma was detected, and the DNA of leukocyte was extracted. The full-length exon and partial intron of GYPA gene were sequenced, mutations were characterized by gene cloning, and the risk of infection was calculated by chi-square test. 【Results】 The yield rate of IgG antibody was 62.7% (439/700) in WuMing district and 3.4% (17/500) in GuiGang district(P<0.05). The insertion of base C at the 54th position of intron-2 in GYPA gene caused the reading frame shift. The mutation was presented in 23.9% (105/439) and 17.6% (3/17) of the population with clonorchis sinensis exposure in WuMing and GuiGang area, respectively, while 49.4% (129/261) and 54.7% (264/483) in the negative population, respectively (P<0.05). 【Conclusion】 The infection rate of clonorchis sinensis in WuMing district was higher than that in GuiGang district. The mutation rate of reading frame shift caused by the insertion of base C at the 54th position of GYPA intron-2 was much lower in the positive population of clonorchis sinensis infection than the negative population, suggesting that the mutation is a protective gene in the negative population of clonorchis sinensis infection. It is necessary to study the mechanism of clonorchis sinensis infection and the mutation point of this gene in order to facilitate the early diagnosis of disease, blood transfusion management, treatment and prevention.

Association between body composition and blood pressure by quantitative CT in a Shanghai population / 中华健康管理学杂志

Objective:To explore the association between body composition and blood pressure by quantitative CT (QCT) in a Shanghai population.Methods:A total of 1 307 participants undergoing low-dose CT lung cancer screening and body composition measurem ents using QCT in our hospital from May to December 2018 were retrospectively enrolled. Body composition, including the abdominal soft tissue area (ASTA), visceral adipose area (VAA), and subcutaneous adipose area (SAA) at the central slice of L2, was measured using QCT. To explore the correlations among body composition and systolic blood pressure, diastolic blood pressure, and hypertension, Pearson’s correlation, multivariate linear regression, and multivariate logistic regression analysis were used. The cut-off value for predicting hypertension was analyzed using the ROC curve.Results:Pearson’s correlation analysis showed that ASTA was negatively correlated with systolic blood pressure and diastolic blood pressure ( r=-0.237- -0.102, P<0.05), while VAA and SAA were positively correlated with systolic blood pressure and diastolic blood pressure (VAA: r=0.359-0.486, SAA: r= 0.088-0.365, P<0.05 ). After adjusting for age, sex, body mass index, and waist circumference, multivariate regression analysis showed that VAA was significantly associated with systolic blood pressure (β= 0.142, P= 0.002), diastolic blood pressure (β= 0.245, P<0.001), and hypertension ( OR=1.005, 95% CI: 1.001-1.008, P=0.01), while ASTA or SAA was not significantly associated with systolic blood pressure, diastolic blood pressure, and hypertension. ROC curve analysis indicated that the cut-off values of VAA at the central slice of L2 for predicting hypertension in males and females were 201.89 cm 2 and 136.01 cm 2, respectively. Conclusion:Visceral adiposity was found to be closely related to hypertension. For hypertension management, early screening and strengthening of prevention and management methods are needed for people with abnormally increased visceral adiposity.

Study on the NDM-1 carbapenemases producing Acinetobacter baylyi / 中华检验医学杂志

Objective:To investigate the drug resistance genes carried on a carbapenem-resistant Acinetobacter spp. isolate. Methods:A retrospective study was conducted on one strain of carbapenem-resistant Acinetobacter spp, which was clinically isolated in July 2016. The strain was identified by Vitek2-compact and further confirmed by PCR detection of bla OXA-51-like, 16S-23S rRNA intergenic space sequencing and partial rpoB gene sequence analysis. Carbapenemase (NDM, KPC, VIM, IMP, SIM, SPM, GIM, OXA-23-like, OXA-24-like, OXA-58-like), 16S rRNA methylase gene (armA, rmtA, rmtB), Beta-lactamases (TEM, SHV, CTX-M, VEB, PER) and class 1 integron were amplified and detected by PCR, and plasmids were analyzed using Southern hybridization. Results:The Acinetobacter baylyi isolate showed the positive for bla NDM-1 only, and negative for the other genes. Plasmid analysis and Southern bybridization result revealed that the bla NDM-1 gene was located on unconjugatable plasmid (54 000-60 000 bp). Conclusions:Attention should be paid to the occurrence of carbapenem-resistant non-baumannii Acinetobacter spp. and the transmission mechanism of drug resistant genes.

Genetic Diversity, Antimicrobial Resistance, and Virulence Genes of Isolates from Clinical Patients, Tap Water Systems, and Food / 生物医学与环境科学（英文）

Objective@#This study aimed to evaluate the genetic diversity, virulence, and antimicrobial resistance of isolates from clinical patients, tap water systems, and food.@*Methods@#Ninety isolates were obtained from Ma'anshan, Anhui province, China, and subjected to multi-locus sequence typing (MLST) with six housekeeping genes. Their taxonomy was investigated using concatenated sequences, while their resistance to 12 antibiotics was evaluated. Ten putative virulence factors and several resistance genes were identified by PCR and sequencing.@*Results@#The 90 isolates were divided into 84 sequence types, 80 of which were novel, indicating high genetic diversity. The isolates were classified into eight different species. PCR assays identified virulence genes in the isolates, with the enterotoxin and hemolysin genes , , , and found in 47 (52.2%), 13 (14.4%), 22 (24.4%), and 12 (13.3%) of the isolates, respectively. The majority of the isolates (≥ 90%) were susceptible to aztreonam, imipenem, cefepime, chloramphenicol, gentamicin, tetracycline, and ciprofloxacin. However, several resistance genes were detected in the isolates, as well as a new variant.@*Conclusions@#Sequence type, virulence properties, and antibiotic resistance vary in isolates from clinical patients, tap water systems, and food.

Study on Ranunculaceae herbal decoction pieces using X-ray diffraction / 中国中药杂志

The powder X-ray diffraction(PXRD) technique was used to investigate fourteen kinds of Ranunculaceae herbal decoction pieces(RHDP) recorded in Chinese Pharmacopoeia and to explore a novel PXRD quality control method for RHDP. The results indicated that only three RHDP-Paeoniae Radix Alba, Paeoniae Radix Rubra, and Moutan Cortex, contained calcium oxalate monodydrate(COM), whereas no COM existed in other eleven kinds of RHDP. The difference in PXRD for Paeoniae Radix Alba and Paeoniae Radix Rubra from different growing areas were investigated. The quantitative analysis method for COM was discussed by considering the water-boiling manufacturing process of herbal decoction pieces. The water-boiling experiments revealed that the PXRD peaks from COM crystals in RHDP were enhanced significantly after boiling. Paeoniae Radix Alba, Paeoniae Radix Rubra, Moutan Cortex, Aconiti Lateralis Radix Praeparata, Aconiti Radix, Aconiti Kusnezoffii Radix, and Anemone Raddeanae Rhizoma exhibited a similar series of broader peaks in the 2θ region of 15° to 35°, whose origins were discussed on the basis of chemical constituents RHDP reported by other researchers. These diffraction broader peaks most likely originated from periodic orientation of benzene ring in organic molecular crystals of aconitine-and paeonolum-based alkaloids and glycosides chemical constituents, subsequently, possibly from some other organic constituents. The PXRD technique can be used to rapidly identify Cimicifuga heracleifolia with an amorphous dispersion peak and C. dahurica with a sharp-peak feature. Climatidis Radix et Rhizoma exhibited a series of sharp PXRD peaks. The PXRD method can provide a valuable quality control method for RHDP.

The application of multiplex fluorescent PCR in the diagnosis of clinical bloodstream infection / 中华检验医学杂志

Objective To observe the application of multiple fluorescent PCR (Polymerase Chain Reaction) in the diagnosis and clinical detection of bloodstream infection. Methods 256 blood cultures were collected by the Laboratory Department of Yinzhou People′s Hospital from January 2018 to May 2018, and were detected by multiplex fluorescent PCR. The results of the PCR were compared with the traditional blood culture bacteria identification instrument (traditional blood culture method). The number of positive and negative samples and the number of corresponding samples of the two methods were counted. Then, they analyzed the specificity and sensitivity of multiplex fluorescence PCR in the diagnosis of bloodstream flow infections. Results A total of 18 pathogenic microbes are detected through blood culture and PCR. Multiple fluorescent PCR detects 142 positive samples and 114 negative samples. Among them, 132 samples also show positive through blood culture, and 111 samples show negative. The consistency rate between multiple PCR and traditional blood cultures is 91.8％ (235/256). The negative prediction rate of PCR is 97.4％ (111/114), sensitivity rate 97.8％ (132/135), specificity rate 91.7％ (111/121). 10 samples show positive through multiple fluorescence PCR but negative for blood culture, 3 samples show positive through blood culture but negative for PCR. Besides, there are 3 types of pathogens that exceed the detection range of PCR. Conclusions Multiplex PCR method can detect 17 pathogens in blood culture specimens of patients, which can not only optimize the traditional blood culture process, but also greatly shorten the reporting time and improve the detection rate of blood culture methods. Especially for patients treated with antibiotics, it can reduce missed detection and improve the diagnostic rate of bloodstream infections.

Network Meta-analysis on the efficacy and safety of surgical resection and thermal ablations for hepatocellular carcinoma in China / 中华肝胆外科杂志

Objective@#To compare the efficacy and safety of surgical resection and thermal ablations in patients with hepatocellular carcinoma in China using a network Meta-analysis.@*Methods@#References related to eligible randomized controlled studies (RCTs) were searched from China Biology Medicine, China National Knowledge Infrastructure(CNKI), PubMed, Embase and Cochrane Library from 1st January 2010 to 1st December 2017, and were selected according to the criteria. The 1-year, 3-year, and 5-year survival rates and incidence of serious complications were compared among surgical resection (SR), radiofrequency ablation (RFA), and microwave ablation(MWA) by network Meta-analysis based frequency and Bayesian methods.@*Results@#A total of 24 RCTs were included in this study. The results of surface under the cumulative ranking probabilities (SUCRA) showed that when all RCTs were included, the frequency model supported MWA had the highest 5-year overall survival rate (66.1%), while the Bayesian model supported SR had the highest 5-year overall survival rate (64.7%). When the tumor diameter of hepatocellular carcinoma was less than 5 cm and the liver function was Child-Pugh A/B, the frequency and Bayesian model both supported SR had the highest 5-year overall survival rate (89.1% and 88.3%, respectively). When all RCTs or RCTs were included with the tumor diameter less than 5 cm and liver function was Child-Pugh A/B, both the frequency and the Bayesian model supported RFA had the best safety (serious complications rate) (16.4%, 18.7%, 12.6 and 12.8%, respectively).@*Conclusion@#SR should be the first choice for early and small hepatocellular carcinoma, while RFA and MWA have their own indications.

Application of a Self-management Mobile Platform in Rehabilitation of Chronic Obstructive Pulmonary Disease / 中国康复理论与实践

Objective:To design a mobile health platform with the features of continuity, interactivity and involvement, which is suitable for patients with chronic obstructive pulmonary disease (COPD); and to test the effect of this platform which is expected to prolong the effect of pulmonary rehabilitation for patients with COPD. Methods:From March to June, 2016, 67 patients with COPD from department of respiration in our hospital were enrolled. They were divided into control group (n = 33) and intervention group (n = 34). The control group received the routine self-management intervention and the intervention group received the mobile health platform to carry out the dynamic, continuous and targeted pulmonary rehabilitation therapy and self-management intervention. They were assessed with forced expiratory volume in one second (FEV1%), COPD Assessment Test (CAT), modified Medical Research Council Dyspnea Scale (mMRC) and Self-management Scale. Results:No statistical differences was found on all the indexes between two groups before intervention (t < 0.945, χ2 = 2.044, P > 0.05). One month after intervention, the score of CAT decreased (t = 4.921, P < 0.001), and was lower in the intervention group than in the control group (t = 3.508, P = 0.001); the score of mMRC improved (χ2 = 7.937, P < 0.05), but no difference was found between two groups (χ2 =1.018, P > 0.05); the score of Self-management Scale significantly increased (t = -5.650, P < 0.001), and was significantly higher in the intervention group than in the control group (t = 4.812, P < 0.001). Conclusion:The continuous, interactive and participatory mobile health platform designed in this study could effectively improve the quality of life and self-management ability of COPD patients, and prolong the effect of pulmonary rehabilitation.

Study on the clinical benefits of endoscopy combined with contrast fistulography in the diagnosis and treatment of chronic wound with sinus tract adjacent to body cavity / 中华烧伤杂志

Objective@#To explore the advantages of endoscopy combined with contrast fistulography in the clinical diagnosis and treatment of chronic wound with sinus tract adjacent to body cavity.@*Methods@#Thirty-two patients (14 males and 18 females, aged 17 to 87 years) of chronic wounds with sinus tracts adjacent to body cavity, who underwent endoscopy combined with contrast fistulography (CT or magnetic resonance imaging) for the diagnosis and treatment in the Outpatient Department of Wound Healing Center of our hospital from October 2017 to March 2019, were enrolled in the study. Their diagnosis and treatment results were retrospectively analyzed. The following data were calculated. (1) The incidence rates of sinus wound involving body cavity or fistula. (2) The detection rates of sinus wound involving body cavity detected by routine examination and by endoscopy combined with contrast fistulography. (3) The detection rate of pathological features at deep part of wound by routine examination and by endoscopy combined with contrast fistulography. (4) The proportion of patients who benefited from routine examination and from endoscopy combined with contrast fistulography. Data were processed with paired chi-square test and Fisher′s exact probability test.@*Results@#(1) The incidence rate of sinus wound involving body cavity was 43.75% (14/32); the incidence rate of fistula was 0. (2) The detection rate of sinus wound involving body cavity detected by endoscopy combined with contrast fistulography was 43.75% (14/32), which was obviously higher than that by routine examination [12.50% (4/32), χ2=32.0, P<0.01]. (3) The detection rate of pathological features at deep part of wound by endoscopy combined with contrast fistulography was 37.50% (12/32), which was obviously higher than that by routine examination (0, P<0.01). (4) The proportion of patients who benefited from endoscopy combined with contrast fistulography was 71.43% (20/28), which was obviously higher than that from routine examination [12.50% (4/32), χ2=21.6, P<0.01].@*Conclusions@#Compared with routine examination, endoscopy combined with contrast fistulography is more accurate in detecting chronic wound with sinus tract adjacent to body cavity. The diagnosis and treatment of chronic wound with sinus tract adjacent to the body cavity can benefit from this joint examination.

Diagnosis and treatment standard for treatment with endoscopy technique in chronic wounds with sinus tract (trial version) / 中华烧伤杂志

The " exploration of treatment technology of chronic wound with sinus tract supported by endoscope and related auxiliary methods" study had been conducted by Wound Healing Center of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. The feasibility and effectiveness of this technique have been confirmed, and good clinic results have been achieved. In order to further promote the new technology and its related research, the theoretical knowledge and technical experience accumulated in the early stage are summarized as diagnosis and treatment standard for treatment with endoscopy technique in chronic wounds with sinus tract, including four parts: the applicable subjects, the diagnosis and treatment procedures and classification criteria, the healing criteria, and the risk assessment and prevention measures. The purpose of this standard is to facilitate the application of standardized endoscopy technique, to make the most of its technological advantages, prevent risks, and provide a reference for the official version of the diagnosis and treatment standard.

Analysis on voluntary blood donation and associated factors in men who have sex with men in 3 cities in China / 中华流行病学杂志

Objective To assess the prevalence of blood donation and associated factors in men who have sex with men (MSM) in China.Methods Our observational study was conducted between January and August,2017 in 3 cities:Guangzhou,Shenzhen and Wuxi.Eligible participants were MSM (≥ 18 years old) who had either ≥2 male sex partners or unprotected anal sex with casual partners,or had been diagnosed with STI in the past 6 months.A self-completed tablet-based questionnaire was used to collect the information about MSM's socio-demographic characteristics,sexual behaviors and blood donation history.Results A total of 603 MSM were enrolled in our study,including 302 in Guangzhou,152 in Shenzhen and 149 in Wuxi,with a mean age of 27.9 years (SD=7.8).Overall,29.2％ (176/603) of the MSM reported a history of blood donation,and 33.1％ (100/302) in Guangzhou,27.6％ (42/152) in Shenzhen and 22.8％ (34/149) in Wuxi,the differences were not significant (x2=6.421,P=0.093).Multivariate logistic regression analysis indicated that MSM had ever tested for HIV for ≥2 times in the past 12 months (vs.MSM tested for HIV one time,aOR=1.49,95％CI:1.08-2.19) or who had ever used gay dating app (vs.MSM who not used gay dating app,aOR=2.13,95％CI:1.12-4.44) were more likely to donate blood.Conclusions Blood donation was common in MSM in China.Health education about blood donation in MSM should be strengthened to ensure the blood safety.

A Rare Missense Variant in Telomerase Reverse Transcriptase is Associated with Idiopathic Pulmonary Fibrosis in a Chinese Han Family / 中华医学杂志(英文版)

<p><b>Background</b>Idiopathic pulmonary fibrosis (IPF) is an age-related and progressive interstitial lung disease. Up to 20% of cases of IPF cluster in families, genetic factors contribute significantly to the pathogenesis of the disease. This study aimed to explore the association between rare genetic variants and IPF in Chinese Han families.</p><p><b>Methods</b>A Han family, comprising three IPF patients and five unaffected their first-degree relatives, and 100 ethnically matched control individuals from North China were enrolled in this study. Peripheral blood was collected, and genomic DNA was extracted. To elucidate if rare genetic variants are associated with the familial IPF, we performed whole-exome sequencing of affected members from a Chinese Han IPF family. Candidate rare variants were then confirmed by Sanger sequencing.</p><p><b>Results</b>We identified a potentially damaging rare variant-a heterozygous mutation c.2146G>A in exon 6 of the gene encoding for telomerase reverse transcriptase (TERT), which results in an amino acid substitution (p.Ala716Thr). We confirmed the missense mutation by Sanger sequencing in all the affected family members but did not detect this mutation in 100 ethnically matched healthy controls. Patients carried this mutation were characterized by the frequently acute exacerbation of IPF phenotype, with poor prognosis. The mean time to death was 2.8 years after diagnosis.</p><p><b>Conclusion</b>Using next-generation sequencing technology in familial IPF patients, we identified the heterozygous rare variant in TERT gene, and strengthened the importance of genetic variants in telomere-related pathogenesis in Chinese IPF patients.</p>

Three-dimensional printing technique combined with computer-assisted navigation in treatment of complex maxillofacial fracture / 中华整形外科杂志

From November 2015 to January 2016, two patients with multiple maxillofacial fractures were chosen to undergo CT scanning and maxillofacial three-dimensional (3D) imaging reconstruction. The data were input to 3D printer in order to yield rapid prototyping model with the same size of patients′ maxillofacial regions. Simulated fracture surgery and reconstruction of the Ti-palate were performed on the models. The operations were conducted with the guidance of navigation system. The consistency of simulated model and real fractures was compared. The results show the complex maxillofacial fracture could make the operation more accurate and shorten the operation time. Moreover, the facial features and masticatory function of both patients were improved. The 3D printing technique combined with computer-assisted navigation could be applied to complex maxillofacial fractures surgery, in order to improve the surgical accuracy and achieve effective reconstruction.