Progress of research on application of chondroitin sulfate in osteogenic repair materials / 口腔医学

@#Chondroitin sulfate is an important component of extracellular matrix (ECM) in animal and human body. In recent years, chondroitin sulfate has been proven to have potential efficacy in biomedical application and has been widely used in bone regeneration and osteogenesis, especially in craniofacial reconstruction and dental medicine. Research shows that chondroitin sulfate derivatives and chondroitin sulfate composite scaffolds have great potential in promoting osteogenesis and biomineralization. However, due to the variety of chondroitin sulfate and various application forms, study on its mechanism of osteogenic repair is still insufficient. In this paper, biological characteristics, bone regeneration and osteogenesis of chondroitin sulfate, its application in different biomaterial design and future prospect are discussed.

Trifecta achievement in patients undergoing partial nephrectomy: a systematic review and meta-analysis of predictive factors

ABSTRACT Purpose The predictors of trifecta achievement in partial nephrectomy (PN) were poorly inquired and remained a controversial area of discovery. To evaluate predictive factors of trifecta achievement in patients undergoing PN. Materials and Methods A systematic literature search was performed to identify relevant articles. Only studies focusing on postoperative trifecta achievement and exploring its predictor with multivariable analyses were included. The trifecta achievement was defined as negative surgical margins, warm ischemia time <25 minutes, and no complications. Merged odds ratio (OR) and 95% confidence interval (CI) were used to evaluate the predictive effect. Results Thirteen studies with 7066 patients meeting the inclusion criteria were included. The rate of trifecta achievement ranged from 43.3% to 78.6%. Merged results showed that preoperative eGFR (OR: 1.01, 95% CI: 1.00, 1.02, P=0.02), operative time (OR: 0.99, 95% CI: 0.99, 1.00, P=0.02), estimated blood loss (OR: 1.00, 95% CI: 1.00, 1.00, P <0.001), tumor size (OR: 0.70, 95% CI: 0.58, 0.84, P <0.001), medium (OR: 0.39, 95% CI: 0.18, 0.84, P=0.02) and high PADUA score (OR: 0.23, 95% CI: 0.08, 0.64, P=0.005) were independently associated with trifecta achievement. A publication bias was identified for tumor size. Sensitivity analysis confirmed the stability of result for tumor size. Conclusions Larger tumor size, medium and high PADUA score are associated with decreased probability of trifecta achievement. After verifying by further high-quality studies, these variables can be incorporated into tools to predict probability of trifecta achievement during clinical practice.

UGT1A1 gene polymorphisms in patients with Gilbert syndrome and Crigler-Najjar syndrome type Ⅱ / 临床肝胆病杂志

Objective To investigate the differences in UGT1A1 gene mutation sites, haplotypes, and diplotypes between patients with Gilbert syndrome (GS) and those with Crigler-Najjar syndrome type Ⅱ (CN-2). Methods A retrospective analysis was performed for the clinical data of 138 patients with GS or CN-2 who attended Beijing YouAn Hospital, Capital Medical University, from January 1, 2010 to December 31, 2019, with 109 patients in the GS group and 29 patients in the CN-2 group, and the differences in mutation sites were analyzed between the two phenotypes. The Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. SNPStats software was used to perform linkage disequilibrium (LD) and haplotype analyses of mutation sites. Strong LD was defined as both | D ′| and r 2 > 0.8, and moderate LD was defined as | D ′| > 0.8 and r 2 > 0.4. Results UGT1A1 gene detection was performed for all patients, and mutations mainly included -3279T > G mutation (104 patients, 75.36%) and -3152G > A mutation (82 patients, 59.42%) in the upstream promoter PBREM region, a promoter TATA box TA insertion mutation (88 patients, 63.77%), and c.211G > A mutation in Exon 1 of the coding region (66 patients, 47.83%). Compared with the CN-2 group, the GS group had a significantly higher proportion of PBREM region -3279T > G mutation (82.57% vs 48.28%, χ 2 =14.508, P A mutation (68.81% vs 24.14%, χ 2 =18.955, P (TA) 7 mutation (72.48% vs 31.03%, χ 2 =17.027, P 0.8, r 2 > 0.8) between (TA) 6 > (TA) 7 and -3152G > A and moderate LD (| D ′| > 0.8, r 2 > 0.4) between (TA) 6 > (TA) 7 and -3279T > G, between -3152G > A and -3279T > G, between (TA) 6 > (TA) 7 and c.211G > A, and between -3279T > G and c.211G > A. Haplotype frequency analysis showed that compared with the CN-2 group, the GS group had a significantly higher frequency of haplotype -3279G—-3152A—(TA) 7 (45.72% vs 17.24%, χ 2 =7.833, P =0.005) and significantly lower frequencies of c.1456G (4.10% vs 16.48%, χ 2 =4.873, P =0.027) and c.211A—c.1456G (1.86% vs 24.90%, χ 2 =15.210, P < 0.001). The diplotype analysis showed that diplotypes consisting of haplotype c.1456G or c.211A—c.1456G were associated with a higher level of total bilirubin (TBil). Conclusion There are differences in common mutation sites and major haplotypes of the UGT1A1 gene between patients with GS and those with CN-2, and the common diplotypes of CN-2 correspond to a higher level of TBil.

Step treatment of Kashin-Beck disease arthritis of the knee / 中华地方病学杂志

Kashin-Beck disease (KBD) is a disabling osteoarthropathy of unknown cause, which occurs most frequently in children and adolescents and affects many regions in China. In adults KBD patients, the degeneration of weight-bearing joints is the most serious, especially the knee joint. Up to now, there are still a large number of adult patients with KBD arthritis of the knee, and they have not been systematically and effectively treated. The main manifestations are knee joint pain, thickening, deformation and restricted movement. In severe cases, it can lead to knee joint varus, valgus, flexion contracture, and rotational deformity, which seriously affects the quality of life and work ability of the patients. Early diagnosis of KBD arthritis of the knee is difficult and there is no effective treatment, so it needs to be differentiated from knee osteoarthritis (OA). KBD and OA have common pathological characteristics. According to the "Consensus of Four-stepladder Program of Knee 0steoarthritis" (2018), OA treatment is divided into four levels: basic treatment, drug treatment, restorative treatment and reconstruction treatment. In this paper, the treatment of KBD arthritis of adult knee joint is summarized, which is also divided into four steps. It is necessary to make stepwise treatments according to the severity of KBD arthritis of the knee and the differences of patient's own condition, so that the limited medical resources can be efficiently used. At the same time, this paper also systematically summarizes the epidemiological characteristics, pathological features and diagnostic criteria of KBD arthritis of the knee, aiming to provide effective reference and guidance for the treatment of KBD arthritis of the knee.

A comparative study on the clinical effects of hip arthroplasty through direct anterior approach in lateral decubitus in the treatment of hip osteoarthritis caused by Kaschin-Beck disease and congenital acetabular dysplasia / 中华地方病学杂志

Objective:To compare the clinical effects of hip arthroplasty through direct anterior approach (DAA) in lateral decubitus in the treatment of hip osteoarthritis caused by Kaschin-Beck disease and congenital acetabular dysplasia.Methods:The prospective study method was used to select the patients who needed hip arthroplasty in the Fourth Department of Orthopedics, the Second Affiliated Hospital of Harbin Medical University from January 2015 to December 2019. All of them were operated with lateral decubitus DAA. According to the inclusion criteria, they were divided into Kacshin-Beck disease hip osteoarthritis group (group A) and congenital acetabular dysplasia hip osteoarthritis group (group B). Hip Harris score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, visual analogue scale (VAS) score were conducted, and hip abduction angle and flexion angle were measured before surgery, 3, 14 days and 1, 3, and 12 months after surgery.Results:Nineteen and twenty-two patients were included in group A and group B, respectively. All patients successfully completed the surgery. There was no significant difference in Harris score between the two groups before surgery, 3, 14 days, and 1, 12 months after surgery ( P > 0.05). There were no significant differences in WOMAC score, VAS score, hip abduction angle and hip flexion angle between the two groups before surgery and each time point after surgery ( P > 0.05). In the same group, there were significant differences in Harris score, WOMAC score, VAS score, hip abduction angle and hip flexion angle at different time points ( P < 0.001). All postoperative indicators were significantly improved compared with those before surgery. Conclusions:There is no significant difference in the clinical effects of hip arthroplasty through lateral decubitus DAA in the treatment of hip osteoarthritis caused by Kaschin-Beck disease and congenital acetabular dysplasia. This surgical method has good therapeutic effect on both types of hip osteoarthritis.

Construction and practice of medical alliance referral system based on blockchain / 中华医院管理杂志

Hierarchical diagnosis and treatment system is an important measure to rationally allocate medical resources and promote the homogenization of basic medical services. The medical alliance is an important service mode and service system of hierarchical diagnosis and treatment, whose role is to perfect the up-down linkage and meet the patient′s medical needs. Informatization construction is an important starting point to promote the services of the medical alliance. In order to solve the problem of connectivity, the medical alliance needs to establish a regional referral platform and realize the integrated service of all medical institutions. Renji Hospital, Shanghai Jiaotong University School of Medicine, has built a blockchain based referral system for hierarchical diagnosis and treatment, incorporating the S2B2C mode concept, and using the traceability, tamper proof and distributed accounting features of blockchain technology, realized independent storage of data in hospitals, realized real-time information sharing and interconnection, and provided a feasible solution for medical alliance management.

Research progress on the application of time-restricted eating in adult obesity and related metabolic diseases / 中华预防医学杂志

The soaring prevalence of obesity and its complications presents a significant health care burden, and there is currently a lack of effective and sustainable treatment methods. Time-restricted eating (TRE) is a specific intermittent fasting (IF) protocol involving consistent fasting and eating periods within a 24-hour cycle. Time-restricted eating can restore robust circadian rhythms and improve metabolic health, providing an emerging dietary strategy for the prevention and treatment of obesity and related metabolic diseases. Previous TRE trials laid the groundwork, and indicate a need for further clinical research including large-scale controlled trials to determine TRE efficacy and the mechanisms by which it may affect humans.

Toxic effects of lipoglycans of different genotypes of Mycobacterium tuberculosis on macrophages / 中华微生物学和免疫学杂志

Objective:To detect the inflammatory reaction of macrophages induced by lipoglycans of different genotypes of Mycobacterium tuberculosis ( Mtb) in vitro and to analyze the differences in lipoglycan virulence. Methods:Lipoglycans were extracted from Mtb of Beijing, T1 and MANU2 genotypes and H37Rv by Triton X-114 liquid phase method and the crude extracts of lipoglycans was used to stimulate RAW264.7 macrophages. Changes in cytokine and receptor expression and cell apoptosis were detected 24 h after stimulation. The virulence of lipoglycans from different genotypes of Mtb was analyzed and compared. One-way analysis of variance and Tukey′s multiple comparisons test were used to compare the differences in various indexes between groups. Results:The expression of IL-10 at mRNA level induced by lipoglycans from Mtb of Beijing, T1 and MANU2 genotypes and H37Rv was (0.94±0.24), (1.86±0.24), (1.90±0.24) and (2.55±0.75) times that of the control group. Moreover, IL-10 mRNA expression induced by lipoglycans from Mtb of Beijing genotype was significantly lower than that of H37Rv group ( P<0.05). After stimulating RAW264.7 cells with the crude extracts of lipoglycans, the proportions of living cells in H37Rv, Beijing genotype, T1 genotype and MANU2 genotype groups were (72.75±2.25)%, (60.99±0.13)%, (80.66±0.40)% and (79.06±1.19)%, and the total cell apoptosis ratios was (10.42±0.23)%, (8.30±0.03)%, (9.24±0.79)% and (8.04±0.48)%, respectively. The proportion of living cells in Beijing genotype group was the lowest ( P<0.05), and the proportions of living cells in T1 and MANU2 genotype groups were higher than that in H37Rv group ( P<0.05). There was no significant difference in cell apoptosis ratio among the groups ( P>0.05). Lipoglycan-induced cell death was increased in Beijing genotype group, and the lipoglycan from Beijing genotype Mtb was more virulent than those from Mtb of T1 and MANU2 genotypes. Conclusions:Lipoglycan from Mtb of Beijing genotype could induce a higher level of cell death in vitro. It was an antigen component with stronger virulence than those from Mtb of T1 and MANU2 genotypes.

Value of common clinical indices and noninvasive liver fibrosis scores in the diagnosis of advanced liver fibrosis in hepatic-type Wilson’s disease in China / 临床肝胆病杂志

ObjectiveTo investigate the association of common clinical indices and noninvasive liver fibrosis scores with hepatic-type Wilson’s disease (WD) in Chinese patients and their ability to identify advanced liver fibrosis. MethodsA retrospective analysis was performed for the clinical data of 236 Chinese patients with WD who were diagnosed and treated in Beijing YouAn Hospital and China-Japan Friendship Hospital from May 1996 to April 2020. A total of 26 patients with hepatic-type WD who underwent liver pathological examination and had complete clinical data were enrolled; the METAVIR score was used to determine liver fibrosis stage, and the patients were divided into advanced liver fibrosis (F3 and F4 stages) group and non-advanced liver fibrosis (F0, F1, and F2 stages) groups. Three noninvasive liver fibrosis scores ［Sheth index, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) index］ were calculated for both groups, and the above indices and related clinical indices were compared between the two groups. The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the Fisher’s exact test was used for comparison of categorical data between two groups. The Spearman rank correlation test was used for further analysis of indices with statistical significance, and the clinical indices and scoring criteria correlated with liver fibrosis degree were screened out; the receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was calculated. ResultsMost of the patients in this study developed the disease in childhood and adolescence, and among these patients, 10 (38.5%) had positive K-F ring and 17 (65%) were in the stage of advanced liver fibrosis. There were significant differences between the advanced liver fibrosis group and the non-advanced liver fibrosis group in white blood cell count (WBC) (Z=-2.102, P=0.036), hemoglobin (Hb) (t=-2.860, P=0009), platelet count (PLT) (t=-4.053, P＜0.001), direct bilirubin (DBil) (Z=-2.130, P=0.033), albumin (Alb) (t=-2.875, P=0.008), and Sheth index (Z=-3.369, P=0.001). WBC, Hb, PLT, and Alb were negatively correlated with liver fibrosis degree in WD patients (r=-0.587, -0.610, -0.656, and -0.411, all P＜0.05), and DBil and Sheth index were positively correlated with liver fibrosis degree (r=0.486 and 0.711, both P＜0.05). The ROC curve analysis showed that WBC, DBil, Sheth index, Hb, PLT, and Alb had an AUC of ＞0.7, among which Sheth index had the largest AUC of 0.908, with a sensitivity of 70.6%, a specificity of 100.0%, a positive predictive value of 100.0%, and a negative predictive value of 64.3%. ConclusionSheth index has a better diagnostic efficiency than the other clinical indices alone and can well identify advanced liver fibrosis in Chinese patients with hepatic-type WD.

Clinical characteristics of Brucella epididym-orchitis / 中华地方病学杂志

Objective:To understand the clinical characteristics of Brucella epididym-orchitis (BEO). Methods:The clinical data of married male patients with brucellosis in acute stage admitted to Hulunbuir People's Hospital from September 2017 to October 2019 were collected and divided into BEO group and non-BEO group, with 46 and 50 cases, respectively. The clinical manifestations, laboratory examination and treatment effect were analyzed and evaluated.Results:The frequency of lower abdominal pain, erectile dysfunction and premature ejaculation in BEO group were higher than those in non-BEO group [26.1% (12/46) vs 8.0% (4/50), 89.1% (41/46) vs 12.0% (6/50), and 28.3% (13/46) vs 6.0% (3/50), χ 2 = 5.643, 57.037, 8.548, P < 0.05]. In laboratory examination, the incidence of increased leukocyte (WBC) count in BEO group was significantly higher than that in non-BEO group [23.9% (11/46) vs 8.0% (4/50), χ 2 = 4.602, P < 0.05]. In terms of sperm function, the incidence of decreased sperm dens (DENS) in BEO group was significantly higher than that in non-BEO group [21.7% (10/46) vs 2.0% (1/50), χ 2 = 9.201, P < 0.05]. After 2 - 7 d of treatment, the pain and/or tenderness of scrotum were relieved in all patients with BEO. After 3 - 5 d of treatment, the symptoms of BEO patients with lower abdominal pain and dysuria were relieved. After 12 weeks of treatment, 97.8% (45/46) of BEO patients had normal scrotal and testicular ultrasonography; 95.1% (39/41) of BEO patients had normal erectile function, 76.9% (10/13) of BEO patients had no premature ejaculation, and DENS returned to normal in 80.0% (8/10) of patients with DENS decreased. Five cases' sperm motility (PRNPPER) returned to normal of 6 patients with PRNPPER decreased. Conclusion:BEO patients have the clinical characteristics of lower abdominal pain, erectile dysfunction, premature ejaculation and spermatogenic dysfunction, and the overall prognosis is good after treatment.

Investigation on prevention knowledge level of brucellosis among permanent residents in the agricultural area of Hulunbuir City, Inner Mongolia Autonomous Region / 中华地方病学杂志

Objective:To understand the prevention knowledge of brucellosis among permanent residents in the agricultural area of Hulunbuir City, Inner Mongolia Autonomous Region, and to provide a scientific basis for formulating brucellosis prevention strategies and measures.Methods:From May to December 2018, Daur Autonomous Banner of Morin Dawa and Arun Banner in the agricultural area of Hulunbuir City were selected as the survey sites. Three townships were selected from each banner, and one administrative village from each township was selected as the survey village. The permanent residents aged ≥14 who had lived in the survey village for at least one year were selected as the survey subjects. Serum was separated by the examiner and the rose-bengal plate agglutination test (RBPT) was conducted. The positive sera were further tested by tube agglutination test (SAT).Questionnaires were conducted by investigators in the form of face-to-face case interview, including general demographic information, family information, brucellosis prevention knowledge awareness status, epidemiological contact history, prevention status, general behavior, etc., to calculate the awareness rate of brucellosis prevention knowledge.Results:A total of 880 sera were isolated, of which 185 were positive for RBPT. Further examination of SAT showed that the positive rate of SAT was 17.27% (152/880). The overall awareness rate of brucellosis prevention knowledge was 46.73% (16 450/35 200). The awareness rates of males and females were 47.82% (8 473/17 720) and 45.64% (7 977/17 480), respectively. The 21 - 40 years old group had the highest awareness rate [60.94% (3 705/6 080)]. The awareness rates of primary school and below, junior high school, senior high school and above were 45.96% (11 969/26 040), 48.79% (3 962/8 120) and 49.90% (519/1 040), respectively. The awareness rate of people with livestock raising behavior in the year before the survey was 47.35% (8 011/16 920), while the awareness rate of people without such behavior was 46.17% (8 439/18 280).Conclusions:The overall awareness rate of brucellosis prevention knowledge among permanent residents in the agricultural area of Hulunbuir City is low. It is necessary to strengthen the training of relevant knowledge and strengthen the publicity and education of people with low awareness rate.

Inhibitory Effect of Sangsuyin on Airway Inflammation in Asthmatic Rats by Regulating TLR4 Pathway / 中国实验方剂学杂志

Objective:To investigate the inhibitory effect of Sangsuyin on airway inflammation in asthmatic rats by regulating the Toll-like receptor 4 （TLR4） pathway. Method:Forty-eight SD rats were randomly divided into a normal group （<italic>n</italic>=8） and an experimental group （<italic>n</italic>=40）. Asthma model was induced in the rats of the experimental group which were further divided into the following five groups according to a random number table： a model group， a dexamethasone group （0.005 g·kg^-1），and low- （2.1 g·kg^-1）， medium- （4.2 g·kg^-1）， and high-dose （8.4 g·kg^-1） Sangsuyin groups. The drugs were all dissolved in normal saline at 0.01 L·kg^-1. The rats in the model group and the normal group received normal saline （<italic>ig</italic>） at 0.01 L·kg^-1. The drug treatment was carried out once per day， for a total of 7 days. The grades of allergic reactions were compared among the groups after intervention. The levels of interleukin-1<italic>β</italic> （IL-1<italic>β</italic>），tumor necrosis factor-<italic>α</italic>（TNF-<italic>α</italic>）， and interferon-<italic>γ</italic>（IFN-<italic>γ</italic>） in serum and bronchoalveolar lavage fluid （BALF） were detected by enzyme-linked immunosorbent assay （ELISA）. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of lung tissues，and the inflammatory cell infiltration scores of lung tissues were compared. The mRNA expression of TLR4 and nuclear factor-<italic>κ</italic>B （NF-<italic>κ</italic>B） was detected by quantitative real-time fluorescence-based reverse-transcription polymerase chain reaction （Real-time PCR）. The expression of TLR4，NF-<italic>κ</italic>B， and the level of phosphorylated NF-<italic>κ</italic>B （p-NF-<italic>κ</italic>B） were detected by Western blot. Result:The success rate of modeling was 95.00%. Compared with the normal group， the model group showed a higher grade of allergic reaction and more severe pathological changes of lung tissues，and the groups with drug intervention exhibited relieved conditions. The levels of IL-1<italic>β</italic> and TNF-<italic>α</italic> in the serum and BALF were higher in the model group than in the normal group，and lower in the groups with drug intervention than in the model group （<italic>P</italic><0.01）. The level of IFN-<italic>γ</italic> in the serum and BALF was lower in the model group than in the normal group，and higher in the groups with drug intervention than in the model group （<italic>P</italic><0.05，<italic>P</italic><0.01）. The inflammatory cell infiltration score，mRNA and protein expression of TLR4 and NF-<italic>κ</italic>B，and the mRNA level of p-NF-<italic>κ</italic>B were higher in the model group than in the normal group，and lower in the groups with drug intervention than in the model group （<italic>P</italic><0.01）. Conclusion:Sangsuyin could inhibit allergic reactions，lung tissue lesions， and airway inflammation in asthmatic rats. It is speculated that this effect is achieved by inhibiting the TLR4 pathway，down-regulating the mRNA and protein expression of TLR4 and NF-<italic>κ</italic>B，and reducing the level of p-NF-<italic>κ</italic>B.angsuyin can inhibit allergic reaction，lung tissue lesions and airway inflammation in asthmatic rats. It is speculated that this effect is achieved by inhibiting TLR4 pathway，down regulating the mRNA and protein expression of TLR4，NF-<italic>κ</italic>B，and reducing the levels of p-NF-<italic>κ</italic>B.

Corilagin inhibits SARS-CoV-2 replication by targeting viral RNA-dependent RNA polymerase

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become one major threat to human population health. The RNA-dependent RNA polymerase (RdRp) presents an ideal target of antivirals, whereas nucleoside analogs inhibitor is hindered by the proofreading activity of coronavirus. Herein, we report that corilagin (RAI-S-37) as a non-nucleoside inhibitor of SARS-CoV-2 RdRp, binds directly to RdRp, effectively inhibits the polymerase activity in both cell-free and cell-based assays, fully resists the proofreading activity and potently inhibits SARS-CoV-2 infection with a low 50% effective concentration (EC

Clinical characteristics of Brucella Melitensis type 1 and type 3 in Hulunbuir of Inner Mongolia Autonomous Region / 中华地方病学杂志

Objective:To investigate the clinical characteristics of patients infected with Brucella Melitensis ( B. Melitensis) type 1 and type 3 in Hulunbuir, Inner Mongolia Autonomous Region. Methods:A retrospective analysis method was used to collect clinical medical records of patients with brucellosis admitted to Hulunbuir People's Hospital from June 2013 to August 2017, and 71 patients with brucellosis positive in blood culture and identified by polymerase chain reaction (PCR) and AMOS-PCR were selected as the study subjects. According to the identification results, they were divided into B. Melitensis type 1 and type 3 groups. General information, epidemiological characteristics, clinical characteristics, laboratory examinations, complications and efficacy of the two groups were compared. Results:Among 71 patients with brucellosis, 22 cases were B. Melitensis type 1, including 16 males and 6 females, aged (39.91 ± 16.04) years old; 49 cases were B. Melitensis type 3, including 34 males and 15 females, aged (40.67 ± 18.72) years old. There were no significant differences in gender composition and age between the two groups (χ 2 = 0.081, t = 0.166, P > 0.05). There were 10 cases(45.5%) of B. Melitensis type 1 patients living in agricultural areas, 10 cases (45.5%) in pastoral areas, and 2 cases (9.1%) in cities; there were 40 cases (81.6%) of B. Melitensis type 3 patients living in agricultural areas, 7 cases (14.3%) in pastoral areas and 2 cases (4.1%) in cities, and the difference between regions was statistically significant (χ 2 = 9.276, P < 0.05). Testicular swelling and pain symptoms [22.7% (5/22), 6.1% (3/49)] in B. Melitensis type 1 and type 3 patients were compared, the difference was statistically significant (χ 2 = 4.187, P < 0.05); other clinical features were compared, the differences were not statistically significant ( P > 0.05). There were no significant differences in white blood cell count (WBC) and platelet count (PLT) decreased, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased between the two groups ( P > 0.05). The number of complications in B. Melitensis type 1 and type 3 patients were 12 cases (54.5%) and 14 cases (28.6%), respectively, and the difference between the two groups was statistically significant (χ 2 = 4.413, P < 0.05). Ten cases (45.5%) of B. Melitensis type 1 patients were cured, 12 cases (54.5%) were improved, 34 cases (69.4%) of B. Melitensis type 3 patients were cured, 15 cases (30.6%) were improved, and there were no invalid or relapsed patients in both groups, the difference in curative effect between the two groups was statistically significant (χ 2 = 3.690, P < 0.05). Conclusions:In Hulunbuir, Inner Mongolia Autonomous Region, there are differences in the living areas of B. Melitensis type 1 and type 3 patients. The B. Melitensis type 1 patients are prone to testicular swelling and pain and brucellosis complications.

Influencing factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer / 中华消化外科杂志

Objective:To investigate the influencing factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer.Methods:The retrospective case-control study was conducted. The clinicopathological data of 104 patients with pancreatic head cancer who underwent radical resection in Fudan University Shanghai Cancer Center from May 2014 to May 2015 were collected. There were 62 males and 42 females, aged (61±10)years. Patients underwent carative pancreaticoduodenectomy. Observation indicators: (1) surgical situations; (2) follow-up; (3) influencing factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer. Follow-up was conducted using telephone interview to detect recurrence of patients up to postoperative 1 year. Measurement data with normal distribution were represented as Mean±SD. Count data were described as absolutes numbers, and comparison between groups was analyzed using the chi-square test. Multivariate analysis was analyzed using the Logistic regression model. Results:(1) Surgical situations: 104 patients underwent curative pancreaticoduodenec-tomy successfully. The volume of intraoperative blood loss was (474±280)mL and the number of lymph node dissection was 21±10. (2) Follow-up: 104 patients received postoperative follow-up, 44 of whom had early recurrence. Of the 44 patients with early recurrence, 42 cases had intraperitoneal recurrence including 23 cases with liver metastasis, 7 cases with metastasis in surgical site, 7 cases with retroperitoneal lymph node metastasis, 5 cases with omentum metastasis, 2 cases had extraperitoneal recurrence including 1 case with pleural metastasis and 1 case with pulmonary metastasis. (3) Influencing factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer: results of univariate analysis showed levels of preoperative CA19-9, levels of postoperative CA19-9, the number of lymph node dissection were related factors for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer ( χ2=5.833, 9.276, 4.261, P<0.05). Results of multivariate analysis showed that postoperative CA19-9 >37 U/mL was an independent risk factor for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer ( odd ratio=3.599,95% confidence interval as 1.551-8.347, P<0.05). Conclusion:Postoperative CA19-9>37 U/mL is an independent risk factor for early recurrence after curative pancreaticoduodenectomy of pancreatic head cancer.

A sufentanil-based rapid cardiac anesthesia regimen in children undergoing percutaneous minimally-invasive intraoperative device closure of ventricular septal defect

Abstract Objective: To assess the effectiveness and safety of fast-track cardiac anesthesia using the short-acting opioid sufentanil in children undergoing intraoperative device closure of ventricular septal defect (VSD). Methods: This retrospective clinical study included 65 children who underwent intraoperative device closure of VSD between January 2017 and June 2017. Patients were diagnosed with isolated perimembranous VSD by transthoracic echocardiography. Then, they were divided into two groups, group F (n=30), whose patients were given sufentanil-based fast-track cardiac anesthesia, and group C (n=35), whose patients were given conventional cardiac anesthesia. Perioperative clinical data were analyzed. Results: No significant differences were found between the preoperative clinical parameters and intraoperative hemodynamic indices between the two groups. In group C, compared with group F, the postoperative duration of mechanical ventilation, the length of stay in the intensive care unit, the length of hospital stay, and the hospital costs were significantly increased. Conclusion: In this retrospective study at a single center, sufentanil-based fast-track cardiac anesthesia was shown to be a safe and effective technique for minimally-invasive intraoperative device closure of VSD in children, which was performed with reduced in-hospital costs.

Comparative study between surgical repair of atrial septal defect via median sternotomy, right submammary thoracotomy, and right vertical infra-axillary thoracotomy

Abstract Objective: To compare the results of surgical repair via median sternotomy, right submammary thoracotomy, and right vertical infra-axillary thoracotomy for atrial septal defect (ASD). Methods: This is a retrospective analysis of the relative perioperative and postoperative data of 136 patients who underwent surgical repair for ASD with the abovementioned three different treatments in our hospital from June 2014 to December 2017. Results: The results of the surgeries were all satisfactory in the three groups. No statistically significant difference was found in operative time, duration of cardiopulmonary bypass, blood transfusion amount, postoperative mechanical ventilation time, duration of intensive care unit, length of hospital stay, and hospital costs. However, the median sternotomy group had the longest incision. Meanwhile, there was no significant difference in postoperative complications. Conclusion: All three types of surgical incisions can be safely and effectively used to repair ASD. The treatments via right submammary thoracotomy and right vertical infra-axillary thoracotomy have advantages over the treatment via median sternotomy in cosmetic results and should be the recommended options.

MiR-222 inhibition alleviates Staphylococcal Enterotoxin B-induced inflammatory acute lung injury by targeting Foxo3

Acute lung injury (ALI) is a common acute and severe disease in clinical practice. Staphylococcal EnterotoxinB (SEB) is a superantigen that can cause inflammatory ALI. MiR-222 has been demonstrated to be upregulatedin SEB-induced inflammatory ALI, but its exact roles and functions remain ill-defined. In this study, SEBexposure led to inflammatory ALI and high expression of miR-222 in model mice and lung infiltratingmononuclear cells, but the inflammatory response and high expression of miR-222 were restored in miR-222-/-mice. Moreover, we investigated the roles of miR-222 in vitro and observed that the concentrations ofinflammatory cytokines and the expression of miR-222 were all elevated in SEB-activated splenocytes andmiR-222 inhibition reversed the effects. Foxo3 was confirmed as a direct target of miR-222. Interestingly, SEBexposure led to a decrease of Foxo3 expression, and Foxo3 knockdown partially reversed the promotion ofFoxo3 and the inhibition of inflammatory cytokines induced by miR-222 inhibitor in SEB-activated splenocytes. Our data indicated that miR-222 inhibition could alleviate SEB-induced inflammatory ALI by directlytargeting Foxo3, shedding light on the potential therapeutic of miR-222 for SEB-induced inflammation in thelung.

Aberrant expression of calcitonin gene-related peptide and its correlation with prognosis in severe childhood pneumonia

OBJECTIVES: The purpose of this study was to evaluate the relationship between the serum levels of calcitonin gene-related peptide (CGRP) and the prognosis of pediatric patients with severe pneumonia. METHODS: Children diagnosed with severe pneumonia (n=76) were stratified into the survival (n=58) and non-survival groups (n=18) according to their 28-day survival status and into the non-risk (n=51), risk (n=17) and high-risk (n=8) categories based on the pediatric critical illness score (PCIS). Demographic data and laboratory results were collected. Serum CGRP levels were determined by enzyme-linked immunosorbent assay (ELISA). A receiver operating characteristic (ROC) curve was generated to determine the cutoff score for high CGRP levels. RESULTS: Serum CGRP levels were significantly higher in the survival group than in the non-survival group and were significantly higher in the non-risk group than in the risk and high-risk groups. The ROC curve for the prognostic potential of CGRP yielded a significant area under the curve (AUC) value with considerable sensitivity and specificity. CONCLUSION: Our findings show that CGRP downregulation might be a diagnostic marker that predicts the prognosis and survival of children with severe pneumonia.

Effect of Gymnastics Exercise on Sensory Integration Disorder in Children Aged Three to Six Years / 中国康复理论与实践

Objective:To explore the effect of gymnastic exercise on sensory integration disorder (SID) in children aged three to six years. Methods:From March to June 2018, 27 children aged three to six years with SID were recruited from Chengdu U-Beller International Children Education Center (Pidu Campus), and were randomly divided into control group (n = 13) and experimental group (n = 14). The experimental group accepted gymnastic exercise, 60 minutes a time, three times a week, for 16 weeks. The control group received no intervention. They were assessed with Assessment Scale for Children Sensory Integration Development, for vestibular dysfunction, tactile defense and proprioception dysfunction. Results:After intervention, the SID improvement was better in the experimental group than in the control group (χ2 > 6.639, P < 0.05), several children with mild disorder returned to normal level, and several with severe disorder returned to mild level. There was no difference in the scores of vestibular dysfunction, tactile defense and proprioception dysfunction before and after intervention in the control group (P > 0.05), and the scores significantly improved in the experimental group (|t| > 7.015, P < 0.01), and was higher in the experimental group than in the control group after intervention (t > 2.193, P < 0.01). Conclusion:Gymnastic exercise can improve vestibular dysfunction, tactile defense and proprioception dysfunction for children with SID aged three to six years.