A pair of new isoflavonoid enantiomers from Dalbergia benthamii Prain / 药学学报

Thirteen isoflavones were separated and purified from an ethanol extract of the rhizome of Dalbergia benthamii Prain by using silica gel, Sephadex LH-20, recrystallization et al. Their structures were identified by physicochemical properties and spectral analysis such as MS, 1D/2D-NMR as dalbergibenthamin (1), butesuperin A (2), xanthocercin A (3), butesuperin B (4), di-O-methylalpinum isoflavone (5), 2′-deoxgisoaunculutin (6), robustone (7), 4′-hydroxy-5,7-dimethoxy-6-(3-methyl-2-butenyl)-isoflavone (8), formononetin (9), 6″-O-rhamnosyldaidzin (10), 3′,4′-di-O-methylene-5-hydroxy-7-methoxy-6-isopentenyl isoflavone (11), derrubone dimethyl enter (12), and derrubone (13). Compound 1 is a pair of new isoflavonoid enantiomers, compound 12 is a new natural product and compounds 1-7 and 10-13 were obtained from D. benthamii Prain for the first time. In vitro cytotoxic activities of the compounds were explored by MTS testing with HL-60, A-549, SMMC-7721, MCF-7 and SW480 cell lines. Results show that compound 8 significantly inhibited cellular proliferation. The IC50 of compound 8 in A-549 and SW480 cells was 16.68 ± 0.19 and 15.21 ± 0.60 μmol·L-1.

Correlation between the anatomical morphology of palatal rugae and sex / Correlación entre la morfología anatómica de las rugas palatinas y el sexo

SUMMARY: To investigate the correlation between the anatomical morphology of palatal rugae and sex. The study sample consisted of 120 students studying from Shanxi Medical University, of which 60 were females and 60 were males. The digital model of the palatal rugae was obtained by the 3 Shape TRIOS intraoral scanner. And the shapes of palatal rugae were recorded. Association between palatal rugae shape and sex were tested using Chi-square analysis. And logistic regression analysis (LRA) was carried out to calculate the accuracy of gender prediction using rugae shapes. There was a statistically significant difference between males and females in terms of the distribution of wavy and circular palate rugae. The use of logistic regression analysis obtained a sex predictive value of 65 % when all the rugae shapes were analyzed. Digital images of the palatal rugae morphology contribute to more accurate and convenient for data collection and transformation. It was found that rugae patterns can moderately identify the sex of the specific population when multivariate statistics such as LRA is applied. The palatal rugae morphology can be utilized as an assistant measure for sex identification.

RESUMEN: Investigar la correlación entre la morfología anatómica de las rugas palatinas y el sexo. En la muestra de este estudio se incluyeron 120 estudiantes de la Universidad Médica de Shanxi, (60 mujeres y 60 hombres). El modelo digital de las rugas palatinas se obtuvo mediante escáner intraoral 3 Shape TRIOS, y se registraron las formas de las rugas palatinas. La asociación entre la forma de las rugas palatinas y el sexo se evaluó mediante un análisis de Chi-cuadrado; para calcular la precisión de la predicción de sexo se llevó a cabo un análisis de regresión logística (ARL) Se observó una diferencia estadísticamente significativa entre hombres y mujeres en términos de la distribución de las rugas palatinas onduladas y circulares. El uso de análisis de regresión logística obtuvo un valor predictivo de sexo del 65 % cuando se analizaron todas las formas de las rugas. Las imágenes digitales de la morfología de las rugas palatinas contribuyen a una recopilación de datos más precisa. En este análisis se determinó que los patrones de rugas pueden identificar relativamente el sexo de una población específica, cuando se aplican estadísticas multivariadas como ARL. La morfología de las rugas palatinas se puede utilizar como medida de ayuda para la identificación de sexo.

Morphology changes of maxillary molar distalization by clear aligner therapy / Cambios de la morfología en la distalización de molares maxilares mediante terapia con alineadores transparentes

SUMMARY: To evaluate the skeletal, dento-alveolar and soft tissue morphology changes after maxillary molar distalization by clear aligner therapy and identify the significant efficacy of molar distalization,18 patients in conformity with the inclusion criteria were selected. Pre- and post-treatment Cone Beam Computed Tomography (CBCT) were examined to measure the angular and linear parameters. All subjects were completed non-extraction clear aligner treatment by distalizing molars. A paired-t test and independent-samples t-test were performed to observe the difference between before and after treatment and the difference between the first molar and second molar respectively. P-values <0.05 were considered statistically significant. Predicted movement rate was calculated by the formula: (actual movement(mm)/planned movement(mm)) x100%. Most variables of pre- and post-treatment showed no statistical difference(P<0.05), excepting SNA angle (P<0.05) and Upper lip/E-line linear (P<0.01) due to incisor retraction. The first and second molar revealed a translation movement without significant tipping and vertical movement. Clear aligners provided a high predictability (83.44 %) of distalization the maxillary first molar, and 85.14 % of the maxillary second molar. Clear aligners can effectively achieve distal displacement of molars.

RESUMEN: Se seleccionaron 18 pacientes, de acuerdo con los criterios de inclusión, para evaluar los cambios en la morfología esquelética, dentoalveolar y de los tejidos blandos después de la distalización de los molares maxilares, mediante la terapia con alineadores transparentes e así identificar la significativa eficacia de la distalización de los molares. Se examinó a través de tomografía computarizada de haz cónico (CBCT) antes y después del tratamiento para medir los parámetros angulares y lineales. Todos los sujetos completaron el tratamiento con alineadores transparentes sin extracción mediante la distalización de los molares. Se realizó una prueba t pareada y una prueba t de muestras independientes para observar la diferencia entre antes y después del tratamiento y la diferencia entre el primer molar y el segundo molar, respectivamente. Los valores de p<0,05 se consideraron estadísticamente significativos. La tasa de movimiento prevista se calculó mediante la fórmula: (movimiento real (mm)/movimiento planificado (mm)) x 100 %. La mayoría de las variables de pre y postratamiento no mostraron diferencia estadística (P<0,05), excepto el ángulo SNA (P<0,05) y el labio superior/línea E lineal (P<0,01) debido a la retracción del incisivo. El primer y segundo molar revelaron un movimiento de traslación sin inclinación significativa y movimiento vertical. Los alineadores transparentes proporcionaron una alta previsibilidad (83,44 %) de la distalización del primer molar superior y del 85,14 % del segundo molar superior. Los alineadores transparentes pueden lograr efectivamente el desplazamiento distal de los molares.

Regulatory role of non-coding RNA in the pathogenesis of uveitis and future perspectives / 中华实验眼科杂志

Non-coding RNA (ncRNA) is a type of RNA that has multiple biological functions but is not translated into proteins.Uveitis, a common blindness-causing disease, is susceptible to relapse and difficult to treat, but its pathogenesis is not completely elucidated.Recent studies have shown that ncRNA plays an important role in the pathogenesis of human uveitis and rabbit experimental autoimmune uveitis.ncRNAs participate in the pathogenesis of uveitis by regulating important signaling pathways related to immunity, the immune response of T lymphocytes or antigen-presenting cells, and the secretion of inflammatory factors, so targeting some ncRNAs is of certain value for the treatment of uveitis.The single nucleotide polymorphisms and copy number variation of ncRNA are highly correlated with the genetic susceptibility of uveitis.Therefore, ncRNA may become a biomarker for the diagnosis and prognosis of uveitis and targeting ncRNA may become a new treatment strategy in uveitis.The regulatory roles of microRNA and long non-coding RNA in the pathogenesis of uveitis were reviewed in this article.

Investigation on the IGF-1 and lipid level in term small for gestational age infants within 24 hours postnatally / 中国新生儿科杂志

Objective:To study the insulin-like growth factors-1 (IGF-1) and lipid level of term small for gestational age (SGA) infants within 24 hours postnatally and to explore the correlation between IGF-1 and blood lipids.Methods:A prospective study was conducted on singleton term SGA and appropriate for gestational age infant (AGA) who were delivered and admitted to the neonatal ward of Guangdong Women and Children Hospital within 24 hours after birth from May 2020 to January 2021, and the infants were divided into SGA and AGA groups to compare the differences in IGF-1 and lipid levels within 24 hours after birth and to analyze the correlation between IGF-1 and lipids.Results:A total of 95 cases in the SGA group and 84 cases in the AGA group were included in the study. The proportion of infants with IGF-1 <25 ng/ml was significantly higher in SGA group (87.4%) than in the AGA group (52.4%). It was also found that the proportion of infants with IGF-1 <25 ng/ml in SGA was significantly higher than that in AGA within different gender composition groups, early-term and full-term births groups. The triglyceride (TG) level was higher in the SGA group than that in the AGA group, but the high-density lipoprotein cholesterol (HDL-C) level was lower than that in the AGA group ( P<0.05). IGF-1 level within 24 hours postnatally in SGA and AGA was positively correlated with HDL-C levels ( P<0.01) and negatively correlated with TG ( P<0.01), and HDL-C level was a predictor of IGF-1. Conclusions:Compared with term AGA, SGA term infants showed insufficient IGF-1 and HDL-C secretion and high TG within 24 hours after birth. Nutritional support for SGA should be given promptly after birth to avoid hypoglycemia and to stimulate IGF-1 secretion.

The formula and medication rules of Chinese patent medicines for jaundice based on data mining / 国际中医中药杂志

Objective:To analyze the formula and medication rules based on the Chinese patent medicines database for treating jaundice, so as to provide reference for the treatment of jaundice.Methods:By using descriptive statistics and data mining methods to analyze the current condition of Chinese patent medicines treating jaundice, Chinese medicines that are frequently appeared and the Chinese medicine paris as well as the combination of mediicnes, and then by using complex network clustering and topology parameter analysis to screen the potential formulations and core Chinese medicines.Results:Seventy-nine Chinese patent medicines with the function of heat-clearing and detoxification were obtained, heat-clearing and removing dampness, and removing jaundice. A total of 233 Chinese medicines are involved, and the most frequently used are Artemisiae Scopariae Herba, Glycyrrhizae Radix et Rhizoma, Bupleuri Radix, Gardeniae Fructus, Scutellariae Radix, etc. The Chinese medicine pairs with high association rule support were Scutellariae Radix- Artemisiae Scopariae Herba, Gardeniae Fructus- Artemisiae Scopariae Herba, Glycyrrhizae Radix et Rhizoma- Artemisiae Scopariae Herba, etc. Based on the compatibility network, four clusters with close connection were obtained, including 23 Chinese medicines. According to the degree and closeness index, the core nodes of Artemisiae Scopariae Herba, Bovis Calculus, Carthami Flos, Glycyrrhizae Radix et Rhizoma, Aucklandiae Radix, Cyperi Rhizoma, Rhei Radix et Rhizoma, Bupleuri Radix, Salviae Miltiorrhizae Radix et Rhizoma were obtained. Conclusion:The combination of herbs and formula for treating icterus conforms to the TCM theory and clinical practice, which could provide reference for the treatment of icterus with TCM and related Chinese patent medicine research.

Review on role of NLRP3 inflammasome in pathogenesis of silicosis / 环境与职业医学

Silicosis is one of the most common forms of pneumoconiosis globally. Workers who engage in mining, construction, ceramics, and many other industries have a high risk of developing silicosis. Chronic and repeated inhalation of free silica (SiO2) dust (<5 μm) during working can lead to inflammatory reactions, resulting in interstitial lung disease characterized by extensive nodular fibrosis in both lungs. Once silicosis occurs, it will develop progressively even when the workers are removed from the silica dust environment. The pathogenesis of silicosis is complex, especially the role of nod-like receptor family protein 3 (NLRP3) inflammasome in the pathogenesis and progression of silicosis remains to be further studied. NLRP3 inflammasome, a multi-protein complex composed of NLRP3, apoptosis-associated speck-like protein, and cysteinyl aspartate specific proteinase 1 is involved in oxidative stress, inflammatory response, apoptosis, and pyroptosis, and has become one of the hot spots in silicosis research. This review summarized the structure, function, and activation mechanism of NLRP3 inflammasome. Furthermore, the cellular and molecular mechanisms of NLRP3 in mediating oxidative stress, inflammatory response, apoptosis, and pyroptosis in the progression of silicosis were reviewed. Finally, the potential therapeutic drugs for silicosis based on NLRP3-associated mechanisms were outlined. More attention should be paid to the role of NLRP3 inflammasome in the pathogenesis and progression of silicosis in the future, which will provide new ideas for the prevention and treatment of silicosis.

Changes in the vessel densities of macular and optic nerve head and their relationships with axial length in pathological myopia / 中华眼底病杂志

Objective:To observe the changes of vessel densities (VD) in the macula and optic disc and its correlation with axial length (AL) in pathological myopia (PM).Methods:A retrospective clinical study. A total of 171 eyes from 171 patients admitted to Department of Ophthalmology of Jinshan Hospital of Fudan University from June 2019 to December 2019 were included in this study. Among them, there were 72 males and 99 females; age was 35.0±10.8 years old. The patients were divided into PM group, high myopia (HM) group and non-HM group, 51 cases with 51 eyes, 70 cases with 70 eyes, and 50 cases with 50 eyes, respectively. Optical coherence tomography angiography was used to scan the macular and optic disc areas of all the examined eyes in the range of 6 mm×6 mm. According to the early treatment of diabetic retinopathy study, the 6 mm macular and optic disc scan range was centered on the macular fovea and optic disc, respectively, then divided into two concentric circles with diameters of 1 mm of central area, an annulus between 1-3 mm circles of paracentral area. The paracentral area was divided into superior, inferior, nasal, temporal four quadrants by 2 radiation lines. The VD of superficial capillary plexus (SCP), deep capillary plexus (DCP), outer retina, and choriocapillaris layer were calculated in the central, superior, inferior, nasal, and temporal areas, respectively. The VD of PM, HM and non-HM groups were compared. The variance analysis was used to compare the VD among the three groups; Pearson’s correlation was used to assess the correlation between VD and AL.Results:The perifoveal VD of the SCP, outer retina and choriocapillaris layers were all lower in the PM than those of HM and non-HM group, and the differences were statistically significant ( P<0.05). The VD of DCP macular central was higher in the PM than in the HM group, and the difference was statistically significant ( P=0.020). In the optic disc, the VD were lower in the PM group than in the non-HM group except for the area of DCP superior, inferior, temporal, outer retinal center, and the differences were statistically significant ( P<0.05). The results of correlation analysis showed that the VD in the DCP macular central, ONH superior and the choriocapillaris ONH central were not correlated with AL ( P=0.647, 0.688, 0.146), and the other VDs were negatively correlated with AL ( P<0.05). Conclusion:Compared with HM and non-HM groups, the majority of VDs in macular and ONH are lower in participants with PM.

Treatment of acromioclavicular joint dislocation with double Endobutton internal fixation assisted by orthopaedic robot / 中华骨科杂志

Objective:To investigate the early clinical effects of orthopedic surgery robot-assisted double Endobutton titanium plate internal fixation in the treatment of fresh acromioclavicular joint dislocation.Methods:Thirty-nine patients with fresh acromioclavicular joint dislocation were included from January 2020 to January 2022. A total of 19 patients were treated with double Endobutton suspension internal fixation assisted by the domestic third-generation orthopaedic surgical robot (TiRobot ? 2.0) Dimensity system. There were Rockwood type III in 11 cases, type IV in 8 cases. Twenty cases were treated with conventional incision double Endobutton internal fixation, with Rockwood type III in 13 cases, type V in 7 cases. The operation duration, blood loss volume, incision length and hospitalization time were compared between the two groups. The following CT parameters of acromioclavicular joint at 2 days and 1 year after operation, distance between distal inferior cortex of clavicle and subacromial cortex, distance between upper and lower endobuttons, horizontal distance between anterior edge of distal clavicle and anterior edge of acromion and diameter of coracoid process and diameter of clavicular tunnel were measured. The visual analogue score (VAS), Constant-Murley shoulder function score and shoulder abduction activity were also evaluated before and at 12 months after operation. Results:The follow-up duration was 10.8±2.4 months in the robot group and 11.5±3.1 months in the routine group. The VAS score of the robot group decreased from 5.3±2.1 to 0.3±0.2 at 12 months after operation ( t=10.46, P=0.014). The Constant-Murley score increased from 55.6±6.4 to 92.0±4.2. The range of shoulder abduction increased from 42.2°±5.4° to 172.6°±6.1° ( t=17.24, P<0.001). The operation duation of the robot group was 74.4±6.6 min, which was longer than that of the conventional group 61.7±7.2 min ( t=5.43, P=0.037). There was no significant difference in VAS score, Constant-Murley score, shoulder abduction activity or CT measurement between the two groups ( P>0.05). During the follow-up, two cases in the robot group had cortical osteolysis on the supraclavicular surface, one case in the conventional group had loss of reduction, one case in the supraclavicular cortical osteolysis, and 4 cases in the cortical defect on the side of the coracoid process tunnel. Conclusion:Orthopedic robot-assisted and conventional incision with double Endobutton titanium plate internal fixation in treating fresh acromioclavicular joint dislocation can achieve satisfied early clinical effects. Accurate establishment of clavicle and coracoid bone tunnel assisted by robot can overcome the defects of bone tunnel deviation in conventional incision operation and can prevent reduction and bone loss. However, robot-assisted and conventional incision Endobutton internal fixation could enlarge bone tunnel.

Transform routine medical accelerators to achieve Flash-RT and physical performance measurements / 中华放射肿瘤学杂志

Objective:To investigate the feasibility of transforming conventional medical accelerator to achieve ultra-high dose rate required to achieve Flash radiotherapy (Flash-RT), and to understand the physical properties of the Flash-RT beam.Methods:By transforming the Varian 23CX medical accelerator, the radiation average dose rate at the isocenter was not less than 40 Gy/s. The relevant physical measurement scheme was designed to accurately measure the actual radiation dose rate of different source skin distance (SSD) conditions, the percent depth dose (PDD) curve and the off-axis dose distribution of the beam.Results:The average dose rate of 9 MeV electron beam after the transformation was measured using the HD-V2 type film, the average dose rate of 3 s was 97.9 Gy/s, and the average dose rate of 6 s was 99.27 Gy/s. When the SSD was 100 cm, 80 cm and 60 cm, the average dose rate of 9 MeV electron beam after the transformation was 99.3 Gy/s, 168 Gy/s and 297.5 Gy/s, respectively. After the transformation, the R100 of the 9 MeV beam was 2.2 cm underwater, R50 was 3.87 cm underwater, the electron range Rp was 4.58 cm, and the maximum possible energy Ep,0 on the phantom surface was 9.28 MeV. These parameters were slightly higher than those of the conventional 9 MeV beam, manifested with slight increase in the surface dose and widening high dose flat area. The overall deposit dose distribution exhibited the highest central axis and the increase in dose declines from the axis distance. Under the condition that the field size was 20 cm×20 cm and the SSD was 100 cm, the FWHM of the vertical and horizontal off-axis dose distribution curves were 16.6 cm and 16.4 cm, respectively. Conclusion:By transforming conventional medical accelerator, the average dose rate of the beam at the isocycle meets the requirement of Flash-RT, and the average dose rate under the condition of 60 cm SSD is much higher than the requirement of at least 40 Gy/s for Flash-RT.

Efficacy comparison of bundle suture and Krackow suture in the treatment of acute closed Achilles tendon rupture / 中华创伤杂志

Objective:To compare the clinical efficacy of bundle suture and Krackow suture in the treatment of acute closed Achilles tendon rupture.Methods:A retrospective cohort study was used to analyze the clinical data of 58 patients with acute closed Achilles tendon rupture admitted to Tongji Hospital of Tongji University from August 2014 to August 2021, including 53 males and 5 females, aged 27-55 years [(39.6±7.1)years]. The patients were treated with open repair and were assigned to bundle suture group ( n=30) and Krackow suture group ( n=28). The incision length and operative time were compared between the two groups. The healing of the Achilles tendon was observed. The difference in circumference between the affected and healthy side of the calf, ratio of width to anterior-posterior diameter at the cross-sectional area of Achilles tendon rupture, and ratio of scar tissue to tendinous fibrous tissue at the cross-sectional area of Achilles tendon rupture were measured at 12 months after surgery. At the same time, the complete Achilles tendon rupture score (ATRS) and American Foot and Ankle Surgery Society (AOFAS) ankle-hindfoot score were performed. The occurrence of complications was observed at follow-up. Results:All patients were followed up for 12-28 months [(17.9±4.2)months]. The incision length and operative time in bundle suture group [6.0(4.5, 9.0)cm, 77.5(60.0, 95.0)minutes] were significantly shorter or longer than those in Krackow suture group [8.0(7.0, 11.0)cm, 68.5(55.0, 86.0)minutes] (all P<0.01). After 3 months, healing of the Achilles tendon was obtained in both groups. After 12 months, the difference in circumference between the affected and healthy side of the calf was (2.0±0.9)cm in bundle suture group and was (1.9±0.9)cm in Krackow suture group ( P>0.05); the ratio of width to anterior-posterior diameter at the cross-sectional area of Achilles tendon rupture was 1.42±0.20 in bundle suture group, significantly greater than 1.27±0.16 in Krackow suture group ( P<0.01); the ratio of scar tissue to tendinous fibrous tissue at the cross-sectional area of Achilles tendon rupture was 8.6%(6.0%, 24.0%) in bundle suture group, significantly lower than 11.9%(9.0%, 33.0%) in Krackow suture group ( P<0.01); the ATRS and AOFAS ankle-hindfoot score were 91.5(80.0, 99.0)points and 93.0(82.0, 100)points in bundle suture group, similar to 89.0(75.0, 99.0)points and 91.5(77.0, 99.0)points in Krackow suture group (all P>0.05). During the follow-up period, the occurrence of complications were not significantly different between bundle suture group [no deep infection, early Achilles tendon rerupture in 2 patients (7%) ] and Krackow suture group [deep infection in 1 patient (4%), early Achilles tendon rerupture in 1 patient (4%)] (all P>0.05). Conclusions:Both bundle suture and Krackow suture can achieve satisfactory clinical efficacy in the treatment of acute closed Achilles tendon rupture. However, the bundle suture is more conducive to restoring normal anatomical shape of the Achilles tendon and reducing scar formation at the end of the Achilles tendon rupture.

Hepatotoxic mechanism of diclofenac sodium on broiler chicken revealed by iTRAQ-based proteomics analysis

Background@#At the therapeutic doses, diclofenac sodium (DFS) has few toxic side effects on mammals. On the other hand, DFS exhibits potent toxicity against birds and the mechanisms remain ambiguous. @*Objectives@#This paper was designed to probe the toxicity of DFS exposure on the hepatic proteome of broiler chickens. @*Methods@#Twenty 30-day-old broiler chickens were randomized evenly into two groups (n = 10).DFS was administered orally at 10 mg/kg body weight in group A, while the chickens in group B were perfused with saline as a control. Histopathological observations, serum biochemical examinations, and quantitative real-time polymerase chain reaction were performed to assess the liver injury induced by DFS. Proteomics analysis of the liver samples was conducted using isobaric tags for relative and absolute quantification (iTRAQ) technology. @*Results@#Ultimately, 201 differentially expressed proteins (DEPs) were obtained, of which 47 were up regulated, and 154 were down regulated. The Gene Ontology classification and Kyoto Encyclopedia of Genes and Genomes pathway analysis were conducted to screen target DEPs associated with DFS hepatotoxicity. The regulatory relationships between DEPs and signaling pathways were embodied via a protein-protein interaction network. The results showed that the DEPs enriched in multiple pathways, which might be related to the hepatotoxicity of DFS, were “protein processing in endoplasmic reticulum,” “retinol metabolism,” and “glycine, serine, and threonine metabolism.” @*Conclusions@#The hepatotoxicity of DFS on broiler chickens might be achieved by inducing the apoptosis of hepatocytes and affecting the metabolism of retinol and purine. The present study could provide molecular insights into the hepatotoxicity of DFS on broiler chickens.

Study on DNA methylation in HEB cells exposed to PM(2.5) by application of methylation chip technology / 中华劳动卫生职业病杂志

Objective: To screen the differential methylation sites, genes and pathways of air pollution fine particles (PM(2.5)) on human bronchial epithelial (HBE) cells by methylation chip and bioinformation technology, so as to provide scientific basis for further study of the toxicological mechanism of PM(2.5) on HBE cells. Methods: In August 2020, HBE cells were infected with 10 μg/ml and 50 μg/ml PM(2.5) aqueous solution for 24 h, namely PM(2.5) 10 μg/ml exposure group (low dose group) and PM(2.5) 50 μg/ml exposure group (high dose group) ; uninfected HBE cells were used as control group. The DNA fragments were hybridized with the chip, the chip scanned and read the data, analyzed the data, screened the differential methylation sites, carried out GO analysis and KEGG analysis of the differential methylation sites, and analyzed the interaction relationship of the overall differential methylation sites by functional epigenetic modules (FEMs). Results: Compared with the control group, 127 differential methylation sites were screened in the low-dose group, including 89 genes, including 55 sites with increased methylation level and 72 sites with decreased methylation level. The differential methylation sites were mainly concentrated in the Body region and UTR region. Compared with the control group, 238 differential methylation sites were screened in the high-dose group, including 168 genes, of which 127 sites had increased methylation level and 111 sites had decreased methylation level. The differential heterotopic sites were mainly concentrated in the Body region and UTR region. Through FEMs analysis, 8 genes with the most interaction were screened, of which 6 genes had significant changes in methylation level. MALT1 gene related to apoptosis was found in the heterotopic site of methylation difference in low-dose group; PIK3CA and ARID1A genes related to carcinogenesis were found in the heterotopic sites of methylation difference in high-dose group; TNF genes related to tumor inhibition were found in the results of FEMs analysis. Conclusion: After PM(2.5) exposure to HBE cells, the DNA methylation level is significantly changed, and genes related to apoptosis and carcinogenesis are screened out, suggesting that the carcinogenic mutagenic effect of PM(2.5) may be related to DNA methylation.

The status of knowledge of sudden cardiac death prevention among general practitioners / 中华全科医师杂志

Objective:To survey the knowledge levels of sudden cardiac death (SCD) prevention among general practitioners (GPs) in Henan province.Methods:From October to November 2019, a questionnaire survey on the knowledge of SCD prevention and treatment was conducted among GP residents participating in the standardized training and assistant GPs taking final examination after training in Henan province. The questionnaire included three dimensions of SCD knowledge: prevention, early diagnosis and first aid. The factors influencing the knowledge levels on SCD prevention were analyzed.Results:A total of 546 questionnaires were distributed and 519 responders (95.1%) completed the questionnaire, including 176 GP residencies and 343 assistant GPs. The age of the respondents was 22-44 (27.91±2.84) years, 234 (45.1%) were males and 285 were females. The overall correct rate of SCD prevention and treatment was (61.46±12.39) %, and the correct rates of prevention, early diagnosis and first aid knowledge were (65.22±17.88)%, (56.58±20.20)% and (62.57±14.60)%, respectively. The overall correct rate and the correct rates of SCD prevention and treatment knowledge among GP residents were higher than those among assistant GPs ( t=10.55, 9.20, 8.62, 3.42, P<0.001); the overall correct rates and the correct rates of SCD first aid knowledge of female GPs were higher than those of males ( t=2.26, 2.13, P=0.025, 0.033); the overall correct rate and the correct rates of each dimensions in age group ≥28 years were higher than those in age group <28 years ( t=4.21, 3.37, 3.20, 2.00, P<0.05). The multivariate logistic regression analysis showed that compared to GP residents,the assistant GPs was the factor influencing the lower levels of the overall knowledge ( OR=0.24, 95 %CI:0.16-0.38, P<0.001), knowledge of prevention ( OR=0.19, 95 %CI:0.10-0.32, P<0.001) and knowledge of early diagnosis ( OR=0.35, 95 %CI: 0.23-0.52, P<0.001);compared to male responders,the females had significantly higher pass rate in SCD first aid knowledge ( OR=1.56, 95 %CI:1.07-2.28, P=0.020). Conclusions:The SCD knowledge levels of the prevention, early diagnosis, and emergency treatment are less satisfactory among GPs in Henan province; it is necessity for targeted training on the weak points of SCD knowledge for GPs.

Tumescent anesthesia combined with skin and soft tissue expansion for the repair of 41 cases of congenital giant melanocytic nevi / 中华皮肤科杂志

Objective:To investigate the efficacy of tumescent anesthesia combined with skin and soft tissue expansion for the repair of congenital giant melanocytic nevi.Methods:From July 2015 to December 2019, 41 patients with congenital giant melanocytic nevi, including 24 males and 17 females aged 7 - 45 years, were collected from the Department of Dermatology, Xijing Hospital, the Fourth Military Medical University. Skin lesions ranged from 5 cm × 12 cm to 12 cm × 18 cm in size, and were located on the scalp in 13 cases, on the face in 18 cases, as well as on the trunk in 10 cases. Before surgery, the composition of tumescent solution was adjusted according to the body weight, operation duration, skin lesion area, etc., and the total dose and peak plasma concentration of lidocaine should be below 35 mg/kg and 4 mg/L respectively. All the patients received tissue expander placement and second-stage flap transfer under tumescent anesthesia.Results:During surgery, satisfactory effect of tumescent anesthesia was achieved in all the 41 patients, the pain score assessed by a numerical rating scale was 1.82 ± 0.54. In addition, the surgical field and dissection levels were clear with little bleeding and no related complications. Follow-up of 3 - 36 months showed that the skin flaps matched the surrounding skin tissues well, with relatively concealed incision lines and soft flat scars.Conclusion:For the treatment of congenital giant melanocytic nevi, tumescent anesthesia is effective and safe, which combined with skin and soft tissue expansion can effectively reduce the incidence of postoperative complications, and this strategy is worthy of clinical promotion.

Diagnosis and treatment of 21-hydroxylase deficiency with testicular adrenal rest tumors:a report of three cases and literature review / 中华内科杂志

Objective:To provide insight into the diagnosis for clinicians, the clinical characteristics, diagnosis and treatment history of 3 patients with 21-hydroxylase deficiency (21-OHD) and testicular adrenal rest tumors (TART) were analyzed.Methods:The clinical, laboratory and imaging data of 3 male patients with 21-OHD and TART, confirmed with CYP21 gene sequencing, from May 2010 to May 2021 in the First Medical Center of Chinese PLA General Hospital were analyzed retrospectively. The treatment strategy and clinical outcome were followed up.Results:All the 3 patients were first diagnosed with bilateral adrenal mass at the age of 27-42 years old. They were 145-162 cm tall. The levels of progesterone, 17-hydroxyprogesterone, and adrenocorticotropic hormone (ACTH) of the 3 patients were relatively high, and that of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) of the 3 patients were low. Testosterone level of 1 patient was significantly elevated, and that of the other 2 patients was below the lower limit of normal range. Testicular ultrasound showed heterogeneous hyperechoic masses in both testes. CT of the adrenal glands showed bilateral adrenal enlargement with mass. All 3 patients were treated with dexamethasone. After 4-96 months of follow-up, 17-hydroxyprogesterone level was kept above the median normal level. One of the patients got married and had a baby after treatment. The sizes of adrenal hyperplasia and testicular masses reduced to various degrees with the change of the testicular masses being proportional to that of adrenal hyperplasia.Conclusions:Patients with 21-OHD are prone to have TART, leading to the impaired testicular function. Early glucocorticold therapy is beneficial to the reduction of TART and restoration of testicular function.

Risk factors for postoperative nausea and vomiting in patients undergoing thoracic surgery / 中华麻醉学杂志

Objective:To identify the risk factors for postoperative nausea and vomiting (PONV) in the patients undergoing thoracic surgery.Methods:The medical records of patients of either sex, aged 18-80 yr, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, underwent elective thoracic surgery from January 2018 to January 2020, were collected retrospectively.The age, gender, educational background, American Society of Anesthesiologists physical status, motion sickness, history of smoking, history of drinking, history of heart disease, history of hypertension, history of diabetes, preoperative blood routine, liver function, parameters of electrolytes; operation method, type of operation, operation time, intraoperative nerve block, consumption of dexamethasone before anesthesia induction and intraoperative sufentanil and dexmedetomidine, use of postoperative patient-controlled intravenous analgesia (PCIA), and postoperative rescue opioid analgesics and antiemetics were recorded.The patients were divided into PONV group and non-PONV group depending on the occurrence of nausea and vomiting within 24 h after operation.PONV group was further divided into nausea group (PON group) and vomiting group (POV group) according to whether vomiting occurred.Logistic regression analysis was used to identify the risk factors for PONV.Results:A total of 3 791 patients were enrolled in this study, with 144 cases in PONV group and 3 647 cases in non-PONV group.The incidence of PONV was 3.80%.There were 38 patients in POV group, and the incidence was 26.4%.The results of logistic regression analysis showed that motion sickness, female, pulmonary wedge resection, postoperative PCIA and increased use of postoperative rescue opioid analgesics were risk factors for PONV in the patients undergoing thoracic surgery, intraoperative use of dexmedetomidine was a protective factor for PONV; motion sickness, female and history of hypertension were risk factors for postoperative vomiting in the patients at risk for PONV ( P<0.05). Conclusions:Motion sickness, female, pulmonary wedge resection, postoperative PCIA, and increased use of postoperative rescue opioid analgesics are risk factors and intraoperative use of dexmedetomidine is a protective factor for PONV in the patients undergoing thoracic surgery; motion sickness, female and history of hypertension are risk factors for postoperative vomiting in the patients at risk for PONV.

Effect of thoracic paravertebral block combined with general anesthesia on postoperative brain injury in elderly patients undergoing thoracoscopic radical resection of lung cancer / 中华麻醉学杂志

Objective:To evaluate the effect of thoracic paravertebral block (TPVB) combined with general anesthesia on the postoperative brain injury in elderly patients undergoing thoracoscopic radical resection of lung cancer.Methods:A total of 100 patients of either sex, aged ≥65 yr, with body mass index of 20-24 kg/m 2, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective thoracoscopic radical resection of lung cancer, were divided into 2 groups ( n=50 each) by using a random number table method: general anesthesia group (G group) and TPVB combined with general anesthesia group (TG group). TPVB was performed before induction of anesthesia in group TG.Anesthesia was induced with IV midazolam, etomidate, rocuronium and sufentanil and maintained with infusion of propofol and remifentanil and intermittent IV boluses of cis-atracurium.Patient-controlled intravenous analgesia (PCIA) was used for postoperative analgesia after surgery.Venous blood samples were taken at 5 min after entering the operating room and 24 and 72 h after surgery to determine the concentrations of S100β, neuron-specific enolase, Tau protein, β amyloid and interleukin-6 in plasma.The cognitive function was assessed by using the Mini Mental State Examination Scale and Montreal Cognitive Assessment Scale at 1 day before surgery and 24 and 72 h after surgery, and cognitive dysfunction was recorded.The quality of night sleep was assessed using Numerical Rating Scale at 1 day before surgery, on the day of surgery and on day 3 after surgery.The occurrence of nausea and vomiting within 72 h after operation, perioperative consumption of sufentanil, effective pressing times of PCA within 24 h after operation and requirement for postoperative rescue analgesia were recorded. Results:No postoperative nausea and vomiting was found and no patients required rescue analgesia in either group.Compared with group G, the concentrations of S100β, neuron-specific enolase and interleukin-6 in plasma, Montreal Cognitive Assessment scale score, and incidence of cognitive dysfunction were significantly decreased at 24 h after surgery, sleep quality score was increased, and the perioperative sufentanil consumption and effective pressing times of PCA were reduced ( P<0.05), and no significant change was found in plasma Tau protein and β amyloid concentrations in group TG ( P>0.05). Conclusions:TPVB combined with general anesthesia is helpful in reducing postoperative brain injury in elderly patients undergoing thoracoscopic radical resection of lung cancer.

Primary renal mesenchymal chondrosarcoma: a case report / 中华泌尿外科杂志

Renal mesenchymal chondrosarcoma is a rare malignant soft tissue tumor. This paper reports a patient who was admitted to hospital because of left renal tumor, and underwent robot-assisted laparoscopic partial nephrectomy. The patient was diagnosed as left renal mesenchymal chondrosarcoma by pathological and genetic examination after operation. There was no local recurrence and metastasis six months after operation.

Quantitative evaluation of the influence of posterior malleolus fracture and fixation on the rotational stability of the ankle / 中华骨科杂志

Objective:To analyze the correlation between the posterior malleolus fracture and fixation and the rotational stability of the ankle and to explore the surgical indications for posterior malleolus fracture aiming to provide the theories for the diagnosis and treatment of disorder.Methods:Twenty fresh frozen cadaver specimens were selected. Further, the extent of the tibial insertion of the posterior inferior tibiofibular ligament (PITFL) and inferior transverse tibiofibular ligament (ITTFL) complex was dissected and measured. Based on the tibial insertion of the ligament complex, the model for the supination-external rotation degree 3 ankle fracture with a posterior malleolar fragment and syndesmosis diastasis was created. Moreover, the area threshold of the posterior tibial insertion of posterior malleolus fracture was biomechanically assessed. The difference of the antirotating ability of the ankle-stiffness between simple posterior malleolus fixation and simple syndesmotic fixation was analyzed statistically.Results:The PITFL and ITTFL were presented in all specimens with relatively broad in PITFL tibial insertion. The PITFL was attached to the posterolateral tibia. The distance between the highest point of the tibial insertion and the articular line was 45.2±5.6 mm, while the ITTFL was attached to the posterior distal tibia. The distance between the highest point of the tibial insertion and the articular line was 5.5±1.0 mm. The width of the tibial insertion of the PITFL and ITTFL complex decreased as the distance from the joint line increased. Biomechanical analysis showed that the threshold of posterior area of posterior malleolus fracture was 1/4S. The stiffnesses of posterior malleolus fixation and syndesmosis stabilization were 0.264±0.080 N·m/° and 0.164 ± 0.061 N·m/°, respectively. The percentage of stiffness restored by posterior ankle fixation was 60.9%±10.2%, which was greater than that by syndesmosis stabilization 37.5%±7.9% ( t=17.09, P<0.001) . Conclusion:The surgical technique for posterior malleolus fracture should consider restoration of the axial and rotational stability of the ankle simultaneously. Posterior malleolus fracture fixation is recommended when the syndesmosis is unstable with the area ratio of posterior tibial insertion of posterior malleolus fracture greater than or equal to 1/4. Syndesmotic fixation is proposed to restore and maintain the rotational stability of the ankle when the syndesmosis is unstable with the area ratio less than 1/4. Regardless of the area ratio, the surgical indications for stable syndesmosis depend on the impact of the posterior malleolus fracture on the axial stability of tibiotalar joint, on the involved articular surface area and on the displacement degree of posterior malleolus fragment.