Efficacy of polyetheretherketone rod hybrid surgery in preventing proximal junctional failure after adult spinal deformity surgery / 中华外科杂志

Objective: To investigate the clinical outcome and preventive effect of polyetheretherketone(PEEK) rod hybrid surgery on proximal junction failure(PJF) after long-segment fusion of adult spinal deformity. Methods: A retrospective study was conducted to analyze patients with degenerative scoliosis/kyphosis who underwent long-segment decompression and fusion surgery at Department of Orthopedics, Peking University First Hospital from January 2017 to December 2021. A total of 75 patients were included in the study, including 14 males and 61 females, aged (67.2±6.8)years (range:55 to 84 years). According to the operation method chosen by the patients, the patients were divided into PEEK rod hybrid group (20 cases) and traditional titanium rod group (55 cases). The general information of the patients was collected, and the coronal and sagittal parameters of the spine were measured before operation, at 1 month after operation, and at the last follow-up. The clinical effect of surgery was judged by the visual analogue scale (VAS) and Oswestry disability index (ODI). Whether proximal junctional kyphosis (PJK) and PJF occurred during the follow-up and the time of occurrence were recorded. Comparisons between groups were performed using independent sample t test, Mann-Whitney U test, χ2 test and Fisher's exact probability method. The data before and after surgery in the same group were compared using the paired sample t test and the Wilcoxon test. Results: There were no significant differences in age, gender, body mass index, bone mineral density, distal instrumented vertebrae, surgical segments, osteotomy method, operation time, and intraoperative bleeding between the two groups (all P>0.05). The follow-up time of the PEEK rod group was shorter(M(IQR)16.5(4.8) vs. 25.0(12.0),Z=-4.230,t<0.01). There were no significant differences in coronal, sagittal parameters, VAS, and ODI between the two groups before operation (all P>0.05). Postoperative coronal Cobb angle, pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, sagittal vertical axis (SVA), VAS, and ODI were significantly improved in both groups(all P<0.05). At the last follow-up, the SVA of the PEEK rod hybrid group was(3.74±2.40)cm, which was significantly lower than that of the titanium rod group (6.28±4.06)cm (t'=-3.318, P=0.002). At the last follow-up, the ODI of the PEEK rod hybrid group was 30.7±6.1, significantly better than the titanium rod group 39.3±17.2. PJK occurred in 2 patients (10.0%) in the PEEK rod hybrid group, and no PJF phenomenon was observed. In the titanium rod group, 18 patients (32.7%) developed PJK, and 11 patients (20.0%) developed PJF. There was a statistically significant difference in the incidence of PJF between the PEEK rod hybrid group and the titanium rod group (P=0.031). Conclusions: PEEK rod hybrid surgery can achieve good clinical results in the treatment of adult spinal deformities. Compared with traditional titanium rod surgery, it can significantly reduce the incidence of postoperative PJF and improve the clinical function of patients.

Herbal-moxa plaster for diarrhea type irritable bowel syndrome of spleen and kidney yang deficiency: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between herbal-moxa plaster and moxa-box moxibustion for diarrhea type irritable bowel syndrome (IBS-D) of spleen and kidney yang deficiency.@*METHODS@#Eighty patients with IBS-D of spleen and kidney yang deficiency were randomly divided into a herbal-moxa plaster group and a moxa-box moxibustion group, 40 cases in each group. The patients in the two groups were treated with conventional acupuncture at Baihui (GV 20), Yintang (GV 24+), Zhongwan (CV 12) and bilateral Tianshu (ST 25), Yinlingquan (SP 9), and Taixi (KI 3), etc. In addition, the patients in the herbal-moxa plaster group were treated with herbal-moxa plaster (Wenyang Fuzheng ointment, composed of prepared monkshood, prepared evodia rutaecarpa, dried ginger, cinnamon, etc.) at Shenque (CV 8), Guanyuan (CV 4), Zhongwan (CV 12) and bilateral Tianshu (ST 25), Shenshu (BL 23) and Shangjuxu (ST 37); the patients in the moxa-box moxibustion group were treated with moxa-box moxibustion at the same acupoints as the herbal-moxa plaster group. The acupuncture-moxibustion treatment was provided once every other day for 4 weeks (14 treatments). Before and after treatment, the scores of clinical symptom of TCM, irritable bowel syndrome (IBS) symptom severity scale (IBS-SSS) and IBS quality of life scale (IBS-QOL) were compared between the two groups, and the clinical efficacy was evaluated.@*RESULTS@#Compared with those before treatment, each item scores and total scores of clinical symptom of TCM, and IBS-SSS scores in the two groups were reduced after treatment (P<0.05). The abdominal bloating score, stool frequency score and total score of clinical symptom of TCM as well as IBS-SSS score in the herbal-moxa plaster group were lower than those in the moxa-box moxibustion group (P<0.05). Compared with those before treatment, the IBS-QOL scores in the two groups were increased after treatment (P<0.05), and the IBS-QOL score in the herbal-moxa plaster group was higher than that in the moxa-box moxibustion group (P<0.05). The total effective rate was 92.5% (37/40) in the herbal-moxa plaster group, which was higher than 85.0% (34/40) in the moxa-box moxibustion group (P<0.05).@*CONCLUSION@#On the basis of conventional acupuncture treatment, herbal-moxa plaster could effectively improve the clinical symptoms and quality of life in IBS-D patients of spleen and kidney yang deficiency, and its efficacy is superior to that of moxa-box moxibustion.

Effect of jejunal feeding tube placement on complications after laparoscopic radical surgery in patients with incomplete pyloric obstruction by gastric antrum cancer / 中华胃肠外科杂志

Objective: To assess the effect of jejunal feeding tube placement on early complications of laparoscopic radical gastrectomy in patients with incomplete pyloric obstruction by gastric cancer. Methods: This was a retrospective cohort study. Perioperative clinical data of 151 patients with gastric antrum cancer complicated by incomplete pyloric obstruction who had undergone laparoscopic distal radical gastrectomy from May 2020 to May 2022 in the First Affiliated Hospital of Nanchang University were collected. Intraoperative jejunal feeding tubes had been inserted in 69 patients (nutrition tube group) and not in the remaining 82 patients (conventional group). There were no statistically significant differences in baseline characteristics between the two groups (all P>0.05). The operating time, intraoperative bleeding, time to first intake of solid food, time to passing first flatus, time to drainage tube removal, and postoperative hospital stay, and early postoperative complications (occurded within 30 days after surgery) were compared between the two groups. Results: Patients in both groups completed the surgery successfully and there were no deaths in the perioperative period. The operative time was longer in the nutritional tube group than in the conventional group [(209.2±4.7) minutes vs. (188.5±5.7) minutes, t=2.737, P=0.007], whereas the time to first postoperative intake of food [(2.7±0.1) days vs. (4.1±0.4) days, t=3.535, P<0.001], time to passing first flatus [(2.3±0.1) days vs. (2.8±0.1) days, t=3.999, P<0.001], time to drainage tube removal [(6.3±0.2) days vs. (6.9±0.2) days, t=2.123, P=0.035], and postoperative hospital stay [(7.8±0.2) days vs. (9.7±0.5) days, t=3.282, P=0.001] were shorter in the nutritional tube group than in the conventional group. There was no significant difference between the two groups in intraoperative bleeding [(101.1±9.0) mL vs. (111.4±8.7) mL, t=0.826, P=0.410]. The overall incidence of short-term postoperative complications was 16.6% (25/151). Postoperative complications did not differ significantly between the two groups (all P>0.05). Conclusion: It is safe and feasible to insert a jejunal feeding tube in patients with incomplete outlet obstruction by gastric antrum cancer during laparoscopic radical gastrectomy. Such tubes confer some advantages in postoperative recovery.

Effect of moxibustion on skin lesions and immune inflammatory response in psoriasis mice / 中国针灸

OBJECTIVE@#To observe the effect of moxibustion on skin lesions and immune inflammatory response in psoriasis mice, and to explore the possible mechanism of moxibustion for psoriasis.@*METHODS@#A total of 32 male BALB/c mice were randomly divided into a normal group, a model group, a moxibustion group and a medication group, 8 mice in each group. Psoriasis model was induced by applying 5% imiquimod cream on the back for 7 days in the model group, the moxibustion group and the medication group. At the same time of model establishment, the moxibustion group was treated with suspension moxibustion on skin lesions on the back, 20 min each time, once a day; the medication group was treated with 1 mg/kg methotrexate tablet solution by gavage, once a day. Both groups were intervened for 7 days. The daily changes of skin lesions were observed, and the psoriasis area and severity index (PASI) score was evaluated; the histopathological changes of skin lesions were observed by HE staining; the positive expression of proliferating cell nuclear antigen (PCNA) and T lymphocyte surface marker CD3 were detected by immunohistochemistry; the expression level of serum interleukin (IL) -17A was detected by ELISA, and the relative expressions of tumor necrosis factor-α (TNF-α), IL-1β and IL-6 mRNA in skin lesions were detected by real-time PCR.@*RESULTS@#The increased and hypertrophy scale, dry skin, red and swollen epidermis and obvious infiltration were observed in the model group, and each score and total score of PASI were higher than those in the normal group (P<0.01). The scale score, infiltration score, and total score of PASI in the moxibustion group were lower than those in the model group (P<0.01); the infiltration score and total score of PASI in the medication group were lower than those in the model group (P<0.01, P<0.05). The inflammatory cell infiltration in the model group was obvious, and the thickness of epidermal layer was increased compared with that in the normal group (P<0.01); the inflammatory cell infiltration and Munro micro abscess were decreased in the moxibustion group and the medication group, and the thickness of epidermal layer was decreased compared with that in the model group (P<0.01). Compared with the normal group, the positive cell number of PCNA and T was increased (P<0.01), and the body mass was decreased, and the spleen index was increased (P<0.01), and the expression of serum IL-17A and the relative expression of TNF-α, IL-1β and IL-6 mRNA in the skin lesions was increased in the model group (P<0.01). Compared with the model group, the positive cell number of PCNA and T was reduced (P<0.01), and the spleen index and the relative expression of TNF-α, IL-1β and IL-6 mRNA were reduced (P<0.01) in the moxibustion group and the medication group; the body mass of mice in the moxibustion group was higher than that in the model group (P<0.01); the content of serum IL-17A in the medication group was lower than that in the model group (P<0.01); the relative expression of TNF-α, IL-1β mRNA in the moxibustion group was higher than that in the medication group (P<0.01).@*CONCLUSION@#Moxibustion could effectively improve the scale and infiltration of skin lesions in psoriasis mice. Its mechanism may be related to inhibiting inflammatory response and regulating immunity.

Analysis of surgical strategy of percutaneous endoscopic lumbar discectomy in young and middle-aged double-segment patients with lumbar disc herniation / 北京大学学报(医学版)

OBJECTIVE@#To investigate clinical efficacy and safety of single and double segmental percutaneous lumbar discectomy for young and middle-aged patients with double-segment disc herniation.@*METHODS@#Retrospective analysis was undertaken for 32 young and middle-aged patients with percutaneous endoscopic lumbar discectomy (PELD) in the treatment of double-segment lumbar disc herniation from January 2015 to October 2018 in Peking University First Hospital. In the study, 18 cases were treated with single-segment treatment and 14 cases with double-segment treatment. Visual analogue score (VAS) and oswestry disability index (ODI) assessment were used to compare clinical symptom outcomes before surgery, 3 months after surgery and at the last follow-up. Macnab criteria were used to assess the patients' overall satisfaction after surgery. Imaging parameters included lumbar lordosis, intervertebral height at each segment and endplate angle of lesion segment on the X-ray. And Michigan State University(MSU) rating and Pfirrmann scoring system were used to evaluate the grade of disc herniation and disc degeneration respectively on magnetic resonance imaging (MRI). The perioperative parameters included the surgeon, anesthesia method, operation time, postoperative hospital stay, postoperative bracing time and perioperative complications.@*RESULTS@#The mean follow-up time was (26.78±10.64) months. There was no significant difference in the follow-up time and baseline information between the two groups(P > 0.05). ODI scores 3 months post-operatively and at the last follow-up were lower in the double segment (P < 0.05). The ODI improvement was also more significant in the double-segment group at the last follow-up (P < 0.05). There was no significant difference in radiographic parameters at baseline (P>0.05). MSU scale for the primary segment was significantly lowered after both operations (P < 0.05). MSU scale for secondary segment was significantly lowered in double segment group but not in single segment group. Other imaging parameters were similar between the two groups (P > 0.05). The operation time of the single-segment group was significantly shorter than that of the double-segment group(P < 0.001). No perioperative complications were found in either group, but three patients underwent secondary lumbar surgery during the postoperative follow-up period in the single-segment group.@*CONCLUSION@#For young and middle-aged patients with double-segment disc herniation, this study suggests double-segment PELD may be more advantageous than single-segment PELD in terms of asuring clinical efficacy without increasing perioperative risks.

Surveillance of cockroach population and evaluation of control effects in households from 2017 to 2019 in Jiading District of Shanghai / 上海预防医学

Objective To learn the population and infestation rates of cockroaches from 2017 to 2019 in Jiading District of Shanghai, to evaluate the effect of cockroach termination in household, and to provide information for cockroach control. Methods Cockroaches were controlled by dinotefuran baits and clean-up in households.Sticky trap and visual method were employed for density monitoring in farmers markets, supermarkets, hotels, restaurants, hospitals, and residential areas.Visual method was used in households before and after using the insecticide. Results Sticky trap result showed the room infestation rate was 3.24%, mean adhesion rate was 3.29%, the density was 0.06 per board, and the density peak appeared in May.Rate of invasion and density decreased year by year.Blattella germanica was the dominant species, counting for 71.88%.The density, and rate of infestation, as determined by sticky trap method, were the highest in the farmers markets, followed by hospitals and residential areas.Determined by visual method, room infestation rate was 1.16%, and the infestation rate was 4.44%.The peak appeared in January.Infestation rate of the farmers markets was the highest, followed by hospitals and residential areas.By visual method, the room infestation rate was 59.01%, and 48.45% for nymphs.The room infestation and ootheca rates were 54.04% and 17.39%.The rate decreased more than 80% in 30 days after use of the insecticide. Conclusion Infestation rate of cockroach remains at low level in Jiading District.The effect of bait combined with environmental cleaning is remarkable.Future work should strengthen monitoring and control in farmers markets, hospitals and residential areas.

Clinical efficacy of short-term halo-pelvic traction combined with surgery in the treatment of severe spinal deformities / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the clinical efficacy of short-term halo-pelvic traction (HPT) combined with surgery in the treatment of severe spinal deformities.@*METHODS@#In the study, 24 patients diagnosed as severe spinal deformity accepted the treatment of one-stage short-term HPT and two-stage surgery from January 2015 to May 2018 in our orthopedics department. 24 cases (9 males and 15 females) were retrospectively reviewed. The average age of the cohort was (28.8±10.0) years (12－48 years). The height, scoliosis angle, kyphosis angle, the height difference of shoulders, the height difference of crista iliaca, C7PL-CSVL and the perpendicular distance of S1 and the convex point of the patients were assessed at pre-traction, post-traction and post-surgery. The paired t test was used to analyze the difference among pre-traction, post-traction and post-surgery.@*RESULTS@#The average traction time of 24 cases was (2.5±1.1) weeks (1－5 weeks). The height of pre-traction and post-traction were (141.7±11.2) cm (116-167 cm) and (154.1±9.5) cm (136－176 cm) respectively, showing significant difference (P < 0.05), and the increased height was (12.4±4.6) cm (4－20 cm). The average scoliosis angle before traction was 104.9°±35.0°(25°－158°), and it was significantly decreased in post-traction[64.8°±21.0°(19°－92°)] and post-surgery[39.3°±17.0° (10°-70°)] (P < 0.05). The traction's coronal correction rate was 37.2%±10.9% (11.9%－51.2%) and the total coronal correction rate was 61.9%±12.6%(26.9%-79.0%). The average kyphosis angle before traction was 106.9°±29.2°(54°－163°), and it was significantly decreased in post-traction [63.1°±17.1°(32°－92°)] and post-surgery [39.0°±16.8°(10°－68°)](P < 0.05). The traction's sagittal correction rate was 40.0%±10.7%(16.7%－55.5%) and the total sagittal correction rate was 64.3%±10.7%(49.0%－87.5%). The average C7PL-CSVL before traction was (3.2±2.8) cm, and it was significantly decreased in post-traction [(2.5±2.5) cm] (P < 0.05). The perpendicular distance of S1 and the convex point before traction was (10.5±4.8) cm, and it was significantly decreased in post-traction[(8.4±3.5) cm] (P < 0.05).@*CONCLUSION@#The one-stage short-term HPT combined with two-stage surgery is a safe and effective procedure for severe spinal deformities. The clinical efficacy is satisfactory and the complication is relatively less.

Subcellular localization of GTPase of immunity-associated protein 2 / 北京大学学报(医学版)

OBJECTIVE@#To analyze the subcellular localization of GTPase of immunity-associated protein 2 (GIMAP2) for the further functional study.@*METHODS@#In the study, we first obtained the protein sequences of GTPase of immunity-associated protein 2 (GIMAP2) from National Center for Biotechnology Information (NCBI) database, and then performed a prediction analysis of its transmembrane structure, nuclear localization signal (NLS), nuclear export signal (NES) and subcellular localization through bioinformatics online tools. GIMAP2 gene amplified by PCR was inserted into the expression vector pQCXIP-mCherry-N1 and positive clones were selected by ampicillin resistance. After using methods to extract and purify, the sequenced recombinant plasmid pQCXIP-GIMAP2-mCherry, together with the retroviral packaging plasmids VSVG and Gag/pol, was transferred into HEK293FT cells by liposomes for virus packaging. The virus supernatant was collected 48 h after transfection and directly infected the human breast cancer cell line MDA-MB-436. Immunofluorescence staining was constructed to detect the localization of endogenous and exogenous GIMAP2 in MDA-MB-436 cells. Meanwhile, green fluorescent chemical dyes were used to label mitochondria, endoplasmic reticulum, and lipid droplets in living MDA-MB-436 cells stably expressing the GIMAP2-mCherry fusion protein. Images for the three dye-labeled organelles and GIMAP2-mCherry fusion protein were captured by super-resolution microscope N-SIM.@*RESULTS@#Bioinformatics analysis data showed that GIMAP2 protein composed of 337 amino acids might contain two transmembrane helix (TM) structures at the carboxyl terminus, of which TMs were estimated to contain 40-41 expected amino acids, followed by the residual protein structures toward the cytoplasmic side. NES was located at the 279-281 amino acids of the carboxyl terminus whereas NLS was not found. GIMAP2 might locate in the lumen of the endoplasmic reticulum. Sequencing results indicated that the expression vector pQCXIP-GIMAP2-mCherry was successfully constructed. Fluorescent staining confirmed that GIMAP2-mCherry fusion protein, co-localized well with endogenous GIMAP2, expressed successfully in the endoplasmic reticulum and on the surface of lipid droplets in MDA-MB-436 cells.@*CONCLUSION@#GIMAP2 localizes in the endoplasmic reticulum and on the surface of LDs, suggesting potential involvement of GIMAP2 in lipid metabolism.

Analysis of the management measures and effects in prevention and control of COVID-19 in outpatient service of a general hospital / 医学研究生学报

To preliminarily analyze the prevention and control of COVID-19, a general hospital outpatient service took six management measures, including setting up a leading group, building rules and regulations, infection control and supervision, special training, humanized service, public opinion propaganda. After nearly two months, the rates of both body temperature monitoring and epidemiological history screening are 100%, the medical staff infection rate is zero, and no cross infection between the patients due to adopting outpatient service comprehensive management measures which had strong organization and leadership, effective targeted training, effective control of all links in epidemic prevention and control work. During the fight against COVID-19, outpatient management played an important role in hospital management. The above approaches provide valuable experience for preventing the spread of infectious diseases effectively and winning the biological weapon wars in the future.

Application of special acupoints for chronic gastritis in ancient literature of acupuncture and moxibustion / 中国针灸

The application of special acupoints for different primary symptoms of chronic gastritis in ancient literature of acupuncture and moxibustion was analyzed and summarized. With keywords, electronic and manual retrieval of ancient literature being performed to establish a database, the association rules were performed with SPSS Modeler 18. As a result, ① among all the 2243 items included, 109 items mentioned special acupoints (excluding those only mentioned crossing acupoint). The frequency of special acupoints was 2554 (71.7%), and the special acupoints on the spleen meridian, the stomach meridian, the conception vessel were frequently used. The frequency of five- point was highest, followed by front- points. ② The special acupoints for four main primary symptoms of chronic gastritis, "stomachache" "vomiting and regurgitation" "belching and acid regurgitation" and "epigastric fullness", included Zusanli (ST 36), Neiguan (PC 6), Zhongwan (CV 12), Gongsun (SP 4), Taibai (SP 3). In addition, the back- points were also selected to treat the primary symptoms other than "epigastric fullness". Zhangmen (LR 13) was added to treat "belching and acid regurgitation". The combination of Neiguan (PC 6) and Gongsun (SP 4) showed the strongest correlation; due to different primary symptoms, the combination had different emphasis.

Detection of viral pathogens and allergens in infants and young children at high risk of asthma during a wheezing episode / 中国当代儿科杂志

OBJECTIVE@#To investigate the viral etiology and allergen distribution in infants and young children at high risk of asthma during a wheezing episode.@*METHODS@#A total of 135 infants and young children at high risk of asthma were enrolled who were admitted due to asthmatic bronchitis or asthmatic bronchopneumonia between April 2016 and August 2017. Fluorescent probe PCR was used to measure influenza A (Flu A), respiratory syncytium virus (RSV), adenovirus (ADV), parainfluenza virus (PinF), human rhinovirus (HRV), human partial lung virus (hMPV) and human bocavirus (HBoV) in nasopharyngeal aspirates. ImmunoCAP was used to measure inhaled allergens, food allergens, and total IgE concentration.@*RESULTS@#Among the 135 patients, the overall virus detection rate of nasopharyngeal aspirates was 49.6%, and HRV had the highest detection rate of 25.2%, followed by HBoV (9.6%), RSV (8.1%), PinF (5.9%), Flu-A (3.7%), ADV (1.5%) and hMPV (0.7%). The 1-3 years group had a significantly higher detection rate of HRV than the <1 year group (P<0.05). The positive rate of allergen screening was 59.3%, with 44% for inhaled allergens and 89% for food allergens. Among the inhaled allergens, dust mites had the highest positive rate of 77%, followed by mould (37%), pollen (26%) and animal dander (9%). Among the food allergens, egg white had a positive rate of 73% and milk had a positive rate of 68%. The <1 year group had a significantly higher positive rate of inhaled allergens than the 1-3 years group (P<0.05). The 1-3 years age group had a significantly higher level of T-IgE than the <1 year group (P<0.05). The positive virus group had a significantly higher positive rate of inhaled allergens than the non-virus group (P<0.05). The children with the second wheezing episode had significantly higher positive rates of inhaled allergens and food allergens and level of T-IgE than those with the first wheezing episode (P<0.05). The children with the second wheezing episode also had significantly higher positive rates of dust mites and mould than those with the first wheezing episode (P<0.05).@*CONCLUSIONS@#Early HRV infection and inhaled allergen sensitization are closely associated with the development of wheezing in infants and young children at high risk of asthma.

Effect of Zilongjin Tablets on immune function of patients with lung cancer after operation / 中草药

Objective: To explore the regulatory effect of Zilongjin Tablet on immune function of postoperative patients with lung cancer from humoral immunity and cellular immunity, and to seek an effective method for comprehensive treatment of lung cancer. Methods: Sixty patients with lung cancer after operation were divided into two groups according to the digital random table, 30 in the control group and 30 in the treatment group. The control group was given routine supportive treatment after operation. The treatment group was given Zilongjin Tablets (4 tablets, 3 times/d) with routine supportive treatment on day 3 after operation. The indexes of immunoglobulin (IgA, IgG, IgM), T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+), and NK cells were compared between the two groups. Results: On day 2 after operation, IgA, IgG, IgM, CD3+, CD4+, CD4+/CD8+ in the two groups decreased compared with those before operation, and the difference was statistically significant (P 0.05). On day 14 after operation, the levels of IgA, IgG, IgM, CD3+, CD4+, CD4+/CD8+, NK in the two groups increased, the NK of the control group and the IgA, IgG, IgM, CD3+, CD4+, CD4+/CD8+ of the treatment group were significant differences compared with the 2nd day after operation (P < 0.05). Moreover, there were significant differences in IgA, IgG, CD4+, CD4+/CD8+, NK between the two groups on day 14 after operation (P < 0.05). Conclusion: Patients with lung cancer have immunosuppressive status in the early postoperative period. Zilongjin Tablets can improve the postoperative humoral immunity and cellular immunity of patients with lung cancer, promote the recovery of immune function and enhance their anti-tumor ability.

New progress in the treatment for gastrointestinal stromal tumors / 医学研究生学报

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors. Surgery remains to be the primary treatment for patients with localized GISTs, but there are still many patients suffering from tumor metastasis and recurrence after surgery. Imatinib adjuvant therapy plays an important role in the prevention and treatment of tumor metastasis and recurrence, but there are still many controversies in terms of dosage and time of administration. For initial unresectable GISTs with large volume, neoadjuvant therapy may considered to be an option. Sunitinib and regorafenib have played an important role in the second and the third line treatments. BLU-285 has brought hope to patients with mutation of PDGFRA D842. The emerging immunotherapy is still in the exploration stage of gastrointestinal stromal tumors in recent years. This article reviews the research progress of surgical treatment, neoadjuvant therapy, postoperative adjuvant therapy and other treatments for GISTs.

Clinical results of arthroscopic anterior cruciate ligament reconstruction with short femoral tunnel / 中国骨伤

OBJECTIVE@#To evaluate the clinical outcome of arthroscopic reconstruction of anterior cruciate ligament (ACL) with short femoral tunnel.@*METHODS@#From May 2013 to June 2017, 128 patients with anterior cruciate ligament reconstruction were performed with Transportal technique. Among them, 32 cases had short femoral tunnel were included, including 13 males and 19 females, aged 25.8 (17 to 43) years old, with a mean history of (4.5±1.1) months. The tibial tunnels were drilled in the middle of the footprint of the ACL, and femoral tunnels were drilled by transportal technique. Grafts were fixed with Endobutton at the femoral side and with interference screw at the tibial side. The changes of symptoms and signs were observed and the anterior tibial displacement was measured. The function of knee joint was evaluated by Lysholm score and Tegner score.@*RESULTS@#All patients were followed up for over 2 years. At the latest follow-up, 30 patients were negative and 2 patients were positive in knee shift test; 28 patients were negative in Lachman sign, 4 patients were positive in degree I; 30 patients were negative in anterior drawer test, 1 patient was positive in degree I and 1 patient was positive in degree II. The anterior displacement of the tibia increased by (2.6±1.8) mm compared with the healthy side, which was significantly different from that before operation (=19.77, <0.05). Lysholm score of 82.2±6.1 was significantly higher than that before operation (=17.33, =0.001). According to Lysholm score evaluation, 15 cases got an excellent result, 10 were good, 7 were fair, and no bad results, with a significant difference compared with that before operation (=-7.151, <0.05). Tegner motor function score of (7.4±0.6) was significantly different from that before operation (=9.11, =0.000 5). After operation, the knee joint movement ability of the patients improved significantly. Twelve patients could participate in antagonistic sports and 15 patients could participate in non-antagonistic sports. Fifteen patients were very satisfied with the curative effect, 13 patients were satisfied with the curative effect.@*CONCLUSIONS@#The incidence of short femoral tunnel in anterior cruciate ligament reconstruction with transportal technique is 25%. At present, the clinical effect of patients with short tunnel is acceptable. However, due to the lack of comparative study, the effect of short tunnel on the curative effect is still unclear.

Analysis of Phenotype and L12R Mutation in Signal Peptide and 3' Non-translation Region c11814-insAA Mutation of F7 Gene in a Family with Hereditary Coagulation Factor VII Deficiency / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To examine one young female patient with hereditary FVII deficiency and her family members, to observe the gene mutation and clinical phenotype, and to investigate the molecular mechanism of the dysfunction.</p><p><b>METHODS</b>Prothrombin time (PT), activated partial thromoploastin time (APTT), fibrinogen (Fg) and FVII activity (FVII:C) and FVII antigen (FVII:Ag) were tested. The gene mutations were sought by DNA sequencing for all of the exons and flanks, 5' and 3' non-translation region of F7 gene. To confirm the role of the found gene mutation, the reverse sequence were determined with Chromas software. To infer the influence of the mutation on the synthesis and function of FVII protein, the FVII protein molecule model containing the found mutation was constructed and the function prediction was performed by the signal peptide prediction database.</p><p><b>RESULTS</b>Compared with the normal population, the proband's PT value was significantly prolonged, and the ratio % FVII:C and that of FVII:Ag were significantly decreased by 1.1% and 0.9%, respectively. The PT, APTT, FVII:C and FVII:Ag of the proband's parents were both normal. Heterozygous 556th nucleotide mutations T/G were found in the proband's and his father's exon lA of F7 gene, with codon CTG turning into CGG, corresponding leucine (L) into arginine (R), i.e Leu12Arg. Function prediction showed that L12R mutations affected the segmentation of different parts of the signal peptide and its corresponding function, which could result in the decline in the mature protein synthesis and its activity obviously. In addition, a spontaneous 3' untranslated region c11814-insAA heterozygous mutation was detected in the proband's F7 gene, while her parents didn't possess this mutation.</p><p><b>CONCLUSION</b>A new hererozygous mutation (L12R) located in signal peptide of F7 gene is the primary molecular basis of the case with hereditary FVII deficiency. At the same time, the proband's spontaneous 3' non-translation region c11814-insAA mutation may lead to the further reduetion of the FVII synthesis.</p>

Correlation of the single nucleotide polymorphism rs662 of PON1 with the risk of male infertility / 中华男科学杂志

<p><b>Objective</b>To investigate the correlation between the single nucleotide polymorphism (SNP) rs662 of the paraoxonase 1 gene (PON1) and the risk of male infertility.</p><p><b>METHODS</b>This case-control study included 403 male idiopathic infertility patients aged 29.00 ± 4.48 years in the case group and 329 normal fertile men aged 28.28 ± 4.08 years as healthy controls. We obtained DNA from the peripheral venous blood of the subjects, genotyped the SNP rs662 of PON1 by Sequenom MassArray, and analyzed the association between different genotypes of PON1 rs662 and male infertility using the logistic regression model.</p><p><b>RESULTS</b>Compared with the normal controls, the infertility patients showed a significantly increased level of follicle-stimulating hormone (FSH) (［16.30 ± 17.76］ vs ［4.72 ± 2.51］ U/L, P < 0.01) but a decreased percentage of progressively motile sperm (PMS) (［7.40 ± 14.17］ % vs ［41.93 ± 9.06］ %, P < 0.01) and sperm concentration (［2.74 ± 3.64］ vs ［75.83 ± 63.66］ ×10⁶/ml, P < 0.01). Statistically significant differences were not found in the other parameters between the two groups of subjects, nor in the correlation of male infertility with the heterozygous genotype GA versus the wild homozygous genotype GG (OR = 0.98, 95% CI: 0.63－1.53, P = 0.923) or the homozygous genotype AA versus the wild homozygous genotype GG (OR = 0.87, 95% CI: 0.56－1.34, P = 0.525).</p><p><b>CONCLUSIONS</b>The SNP rs662 of PON1 was not correlated with male infertility, which, however, needs to be confirmed by further studies with larger samples from a larger area.</p>

Analysis of Factors Influencing Prognosis of 87 Adults with Ph Chromosome Negative ALL / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the factors influencing total complete remission (CR), recurrence, disease-free survival (DFS) rate and overall survival (OS) rate in adults with Philadelphia (Ph) chromosome negative acute lymphoblastic leukemia (ALL) and the effect of subsequent allogeneic hematopoietic stem cell transplantation (allo-HSCT) on prognosis.</p><p><b>METHODS</b>The clinical data of 87 adult patients with Ph negative ALL were retrospectively analyzed, the CHOP regimen plus L-asparaginase (L-Asp) was used for the induction therapy, and the CHOP+ modified Hyper-CVAD or methotrexate was set up as the consolidation chemotherapy regimen. After consolidation chemotherapy for 3-6 courses, 45 patients (51.72%) received allo-HSCT , and 42 patients (48.28%) continually received the maintained consolidation chemotherapy. The average follow up time of the surviving patients was 40.13 (3-60 months).</p><p><b>RESULTS</b>Out of 87 patients with PhALL one patient died (1.15%). In 86 patients who could be evaluated, 68 cases (79.67%) reached CR at the end of 1 course, 80 cases obtained CR (93.02%). Multivariate regression analysis showed that the enlargement of lever, spleen and lymphomode, WBC count≥ 100×10/L were affecting factors for total CR (P<0.05). Among 80 cases with CR, 27 cases (33.75%) relapsed, 5 years' overall survival (OS) rate and disease-free survival (DFS) rate were 47.50% and 45.00% respectively. Multivariate regression analysis yet showed that the induction chemotherapy without L-Asp, presence of CNS leukemia at diagnosis, absence of allo-HSCT and no CR after indution chemotherapy for 4 weeks were affecting factors for relapse and poor prognosis of patients (P<0.05). According to 4 prognostic factors such as presence of CNS leukemia or no, WBC count≥100×10/L or no, induction chemotherapy with L-Asp or no and CR after induction chemotherapy for 4 weeks or no, 86 patients were divided into low-risk group (without poor prognostic factor), middle-risk group (with 1 poor prognostic factor), high-risk group (with 2-4 poor prognostic factors). Statistical results showed that allo-HSCT treatment in low-risk group had no significant effect on OS and DFS (P>0.05). The rate of OS and DFS in middle and high-risk group were significantly higher than those of patients without allo-HSCT treatment (P<0.05).</p><p><b>CONCLUSION</b>Patients with central nervous system leukemia, high white blood cell count (≥100×10/L), induction chemotherapy without L-Asp, no CR after 4 weeks of chemotherapy and absence of allo-HSCT treatment are the factors influencing the prognosis of adult patients with Ph negative ALL, so the patients with those poor prognostic factors should take active treatment of allo-HSCT.</p>

Anterior cervical discectomy and fusion to treat cervical spondylosis with sympathetic symptoms / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinical effectiveness of polytheretherketone (PEEK) cages assisted anterior cervical discetomy and fusion (ACDF) to treat cervical spondylosis with sympathetic symptoms.@*METHODS@#Retrospective analysis was undertaken for 39 patients who were diagnosed as cervical spondylosis with sympathetic symptoms and underwent ACDF with PEEK cages. Radiographs obtained before surgery, after surgery, and at the final follow-up were assessed for quality of fusion. The following criteria were used for assessing radiographic success of fusion: (1) endplate obliterated with no lucent lines; (2) obliteration of disc space by bony trabeculae; (3) less than 2°of intervertebral motion or 2 mm of motion between the spinous processes at the operated segment on flexion-extension lateral radiographs. The sympathetic symptoms including vertigo, headache, tinnitus, nausea and vomiting, heart throb, hypomnesia and gastroenterological discomfort were scored by 20-point system preoperatively, 2 months postoperatively and at the final follow-up. The recovery rate and clinical satisfaction rate were also evaluated. Surgical complications were also assessed.@*RESULTS@#They were followed up for at least one year. The mean follow-up was 15.6 months. Radiographs of the cervical spine at the last follow-up revealed a solid fusion with no signs of a pseudoarthrosis in 36 cases. In two patients delayed union and bony fusion were achieved at the end of 9 and 11 months. Pseudoarthosis was found in 1 case but the patient had no symptoms. The score of sympathetic symptoms before surgery, 2 months after surgery and at the final follow-up were 8.4±1.0,2.2±0.3,and 2.4±0.3, respectively. There were 22 excellent cases, 15 good cases, 1 fair case and 1 bad case in terms of RR. Good to excellent results were attained in 95% of theses patients. The sympathetic symptoms improved in all the patients and the score was significantly improved after surgery. There was one patient who had cerebral spinal fluid leakage but he recovered one week after surgery. Two patients felt a mild swallowing discomfort, but it disappeared within one month after surgery. Subcutaneous hematoma occurred in one patient due to obstructed drainage. It was cleared two days after surgery.@*CONCLUSION@#Cervical spondylosis patients with sympathetic symptoms may be managed successfully with ACDF using PEEK cages. Successful clinical results regarding symptom improvement and general satisfaction with the surgical procedure depend not only on obtaining successful decompression and radiographic fusion but also on patient selection.

Evaluation of cytotoxicity of stearoyl gemcitabine-loaded PLGA nanoparticles to Lewis lung cancer cells / 中国免疫学杂志

Objective:To investigate the anti-proliferation effect of 4-(N)-stearoyl gemcitabine-loaded poly(lactic-co-glycolic) acid nanoparticles(GemC18-PLGA-NPs) on Lewis lung cancer cells(LLC) in vitro.Methods: Lewis cells were incubated with GemC18-PLGA-NPs,free GemC18,gemcitabine HCl(GemHCl) or GemC18-free blank nanoparticles(PLGA-NPs) respectively and cell viability was determined using an MTT assay after 24,48 or 72 h of incubation.The apoptosis rate after 48 and 72 h of incubation were measured by flow cytometry.Results:GemC18-PLGA-NPs,GemC18,and GemHCl all significantly inhibited the growth of LLC cells, and the survival rate of GemHCl group was lowest,GemC18-PLGA-NPs group had the highest survival rate.The cell survival rate of GemC18-PLGA-NPs after 72 h was significantly higher than that of GemHCl (P<0.05) at the concentration of 1 μmol/L,indicating that it had a significant drug release effect.PLGA-NPs group produced trifle inhibition on the Lewis cells without correlation to time or concentration.Conclusion:GemC18-PLGA-NPs have significant anti-proliferation effect on mouse Lewis lung cancer cells in vitro.

Epidemiological analysis of 440 cases of respiratory adenovirus infections in children from the Suzhou area between 2006 and 2015 / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the epidemiological characteristics of respiratory adenovirus (ADV) infections in children from the Suzhou area, China.</p><p><b>METHODS</b>The clinical data of ADV-positive children out of 35 529 children with respiratory tract infections who were hospitalized in the Children's Hospital of Soochow University between January 2006 and December 2015 were retrospectively studied.</p><p><b>RESULTS</b>Of the 35 529 children with respiratory tract infections, 440 (1.24%) were ADV-positive. There was no significant difference in the rate of ADV infections between boys and girls (1.18% vs 1.34%). The ADV infection rates of children at the age of <1 year old, 1-3 years old, 3-7 years old and 7-14 years old were 0.39% (71/18 002), 1.12% (103/9 191), 3.14% (201/6 398), and 3.35%( 65/1 938) respectively and the rate increased with age (P<0.01). The ADV infection rates in spring [1.85%(60/8 658)] and summer [2.20%(189/8 606)] were significantly higher than in autumn [0.30%(27/8 952)] and winter [0.69%(64/9 313)] (P<0.01).</p><p><b>CONCLUSIONS</b>The ADV infection rate is increased with age in the children from the Suzhou area, but it is not associated with gender. ADV infections are more common in spring and summer.</p>