Effects of different acupuncture schemes on neurotransmitters and related inflammatory factors in rats with post-stroke depression / 中国康复理论与实践

ObjectiveTo investigate the effects of different acupuncture schemes on behaviors, neurotransmitters and inflammation-related factors in post-stroke depressed (PSD) rats. MethodsA total of 72 healthy male Sprague-Dawley rats were randomly divided into normal group, model group, drug control group, scalp acupuncture group, abdominal acupuncture group and combined acupuncture group, 12 rats in each group. The PSD model was prepared using a combination of middle cerebral artery occlusion and chronic unpredictable mild stimulation (CUMS) for the model and each intervention groups. The drug control group was administered fluoxetine, the scalp acupuncture group accepted acupuncture at Baihui (DU 20) and Yintang (EX-HN3), while the abdominal acupuncture group at Zhongwan (RN 12) and Guanyuan (RN 4), the combined acupuncture group at all the four acupoints, for 21 days. They were assessed with Longa neurological function score, body mass, open-field test and sugar-water preference test on the 0 (before modeling), the seventh (before CUMS), the 14th (before treatment) and the 35th day (after treatment). The levels of 5-hydroxytryptamine (5-HT), dopamine (DA), norepinephrine (NE), interferon-γ (INF-γ), tumor necrosis factor⁃α (TNF⁃α) and macrophage migration inhibitory factor (MIF) in the serum were determined with ELISA on the 35th day. Results The neurological function score was lower in the drug control group and the combined acupuncture group thanin the model group (P < 0.01) on the 35th day; while the body mass was higher in the drug control group, the abdominal acupuncture group and the combined acupuncture group than in the model group (P < 0.01); and the number of horizontal span frames, the number of uprightness and the sugar water consumption were higher in the drug control group, the scalp acupuncture group, the abdominal acupuncture group and the combined acupuncture group than in the model group (P < 0.05). There was no significant difference among the four intervention groups (P > 0.05). The levels of 5-HT, DA and NE were higher in the four intervention groups than in the model group (P < 0.01), and the levels of IFN-γ, TNF⁃α and MIF were lower (P < 0.01). 5-HT level was higher in the combined acupuncture group than in the scalp acupuncture group and the abdominal acupuncture group, and the levels of IFN-γ, TNF⁃α and MIF were lower (P < 0.01); the levels of DA and NE was higher in the combined acupuncture group than in the abdominal acupuncture group (P < 0.01). ConclusionThe combination of scalp acupuncture and abdominal acupuncture can improve behavior, neurotransmitters and inflammatory factors of PSD rats, like fluoxetine. Scalp or abdominal acupuncture alone is still effecive, and can be used secondarily.

A novel robotic-assistant flexible ureteroscopy system: initial results from the in vitro study and the in vivo experience / 中华泌尿外科杂志

Objective:Objectives The aim of the study is to evaluate the mechanical performance, safety and efficacy of the novel robotic-assistant flexible ureteroscopy system (Ra-fURS) under in vitro and in vivo environments.Methods:Combing with commercial flexible ureteroscopes, the novel Ra-fURS was used for the in vitro test and animal model operation in October 2020. The study included three sections. ①Basic mechanical performance assessment: including endoscope motion control (dual deflection, axial rotation and forward/backward distance), reaction time and fiber regulation. ②Simulated surgery in ex-vivo 3D-printing renal collecting system model: including completion rate and time of calyxes exploration, directional movement and laser fragmentation [gypsum models (0.5×0.5×0.5 cm) were used to stimulate kidney stones]. ③Intrarenal surgeries in animal models (two 5-month female Yorkshire white pigs). In total, 32 surgeries was performed (8 surgeons × 2 pigs × 2 kidneys/pig). In vivo assessments were carried out including: ①consuming time for Ra-fURS installation and offloading; ②completion rate and time of calyxes exploration; ③comfort score (ranging from 0-10) as compared to the manual f-URS, which was corresponding to each Ra-fURS surgery. In simulated surgery and animal surgery sections, 8 surgeons were enrolled in the study (group A 4 without flexible ureteroscopy experience; group B: 4 highly experienced), and results were compared between two groups.Results:Under the Ra-fURS control, the flexible ureteroscope movement in three degrees of freedom (forward / backward: + 11 to -11 cm, axial rotation + 225°to -225°; active duel-flection: + 270°to -270°, as well as the laser fiber regulation + 2.5 to -2.5 cm). In simulated surgery tests, both groups achieved 100% completion rate of calyxes exploration, and there were no statistical differences in the time of the calyxes exploration between group A and group B (116.0±8.0)s vs.(110.3±15.4)s( P>0.05). Time-consumption for laser fragmentation of group B was shorter than that of group A (525.8±58.5)s vs. (780.5±141.2)s( P<0.01). In animal surgery, the installation time of Ra-fURS gradually shortened within the first 7 cases was(234.0±43.0)s, and became comparable in the later 8-32 cases was(149.3±8.0)s. The average uninstall time was (43.9 ±5.9)s and was relatively stable. There were 51 renal calyxes in two pigs. It was higher for the completion rate of calyxes exploration in group B than in group A [(95.5±9.1)% vs. (59.1±9.1)%, P<0.05], and the exploration time was also statistically variant between the two groups group A and group B[(274.8±34.6)s vs.(127.3±18.2)s, P<0.05]. For all the operators, the comfort scores were favorable to the Ra-fURS as compared to the manual f-URS (8.9±0.3 vs. 5.9±1.1, P<0.05). Conclusions:This preliminary study demonstrated that the novel Ra-fURS was capable of controlling flexible ureteroscope to perform retrograde intrarenal surgery and fragmenting stones with laser. Besides, other features, including easy installation, stable performance and comfortable manipulating environment, made it easy to use in clinical application.

Protective Mechanism of Banxia Houputang on Lipopolysaccharide-induced Neuroinflammatory Injury / 中国实验方剂学杂志

ObjectiveTo study the inhibitory effect of Banxia Houputang （BHT） on lipopolysaccharide （LPS）-induced inflammation of microglia （BV2） cells and the neuroprotective effect on human neuroblastoma （SH-SY5Y） cells. MethodAfter the neuroinflammatory model was constructed by LPS inducing BV2 cells， model group （LPS 100 µg·L-1）， administration groups （LPS+1 g·L-1 BHT， LPS+2 g·L-1 BHT， LPS+5 g·L-1 BHT， LPS+10 g·L-1 BHT）， and blank group were given DEME medium at the same volume. In addition， neuronal apoptosis model was established by co-culture of LPS-induced BV2 cell inflammation medium and SH-SY5Y cells （LPS-DMEM） and was administrated according to the above grouping. Cell viability was detected by Cell Counting Kit-8 （CCK-8） assay. The content of nitric oxide （NO） and that of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and interleukin-6 （IL-6） were determined by Griess aasay and enzyme-linked immunosorbent assay （ELISA）， respectively. The mRNA levels of TNF-α， IL-1β， interleukin-4 （IL-4）， nitric oxide synthase （iNOS）， and interleukin-10 （IL-10） were measured by real-time polymerase chain reaction （Real-rime PCR）. Western blot was used to detect the expression levels of signal transducer and activator of transcription 3 （STAT3）， Janus kinase 2 （JAK2） and nuclear factor kappa-B （NF-κB p65）， protein kinase B （Akt）， inhibitor of nuclear factor κB α （IκBα）， B-cell lymphoma-2 （Bcl-2）， and Bcl-2 associated X protein （Bax）. ResultCompared with blank group， LPS increased the NO release， levels of TNF-α， IL-1β， IL-6， and iNOS and protein expression of Akt， NF-κB p65， IκBα， JAK2 and STAT3， decreased the content of IL-4 and IL-10 in BV2 cells， and induced apoptosis of co-cultured SH-SY5Y cells （P<0.01）. Compared with model group， BHT reduced the content of NO， TNF-α， IL-1β， and iNOS （P<0.01） and protein expression of Akt， NF-κB p65， IκBα， JAK2 and STAT3 （P<0.01）， elevated the content of IL-4 and IL-10 （P<0.01）， and inhibited the apoptosis of SH-SY5Y cells induced by LPS-DMEM （P<0.01）. ConclusionThis experiment reveals that BHT inhibited LPS-induced inflammation in BV2 cells by regulating Akt/NF-κB/JAK2/STAT3 signaling pathway and showed neuroprotective effects on SH-SY5Y cells.

Ubiquitin-conjugating enzyme UBE2Q2 participates in HUWE1-mediated protection on renal tubulointerstitial fibrosis / 生理学报

The ubiquitin-proteasome system plays an important role in protein degradation. The process of ubiquitination requires ubiquitin activating enzyme E1, ubiquitin-conjugating enzyme E2, and ubiquitin ligase E3 to complete the coordination. Our previous studies have shown that HUWE1 (HECT, UBA and WWE domain containing 1), as an E3 ubiquitin ligase, can degrade epidermal growth factor receptor (EGFR) to inhibit renal tubulointerstitial fibrosis. However, E2 ubiquitin-conjugating enzymes binding to HUWE1 are still unclear. The aim of the present study was to identify E2 ubiquitin-conjugating enzymes of HUWE1. Real-time PCR was used to identify E2 ubiquitin-conjugating enzyme that may interact with HUWE1. The expression of E2 ubiquitin-conjugating enzyme was detected in kidney of unilateral ureteral obstruction (UUO) mice and HK-2 cells treated with transforming growth factor-β (TGF-β). The results showed that the expressions of E2 ubiquitin-conjugating enzyme UBE2Q2 were significantly down-regulated at both RNA and protein levels in UUO kidneys. The expression of UBE2Q2 was also down-regulated in HK-2 cells stimulated with TGF-β, which was consistent with the change in the expression of HUWE1. These findings indicated that UBE2Q2 expression was synergistic with HUWE1 in the injured kidney. Co-immunoprecipitation (Co-IP) experiments showed that HUWE1 interacted with UBE2Q2 in HK-2 cells. The co-localization of UBE2Q2 and HUWE1 was confirmed by cell immunofluorescence staining. After knocking down UBE2Q2 by siRNA, ubiquitin binding to HUWE1 and EGFR was decreased. In sum, our results demonstrated that UBE2Q2, ubiquitin-conjugating enzyme, works with HUWE1 to mediate ubiquitination and degradation of target protein in kidney.

Imaging features of intraductal pancreatic neuroendocrine tumor / 中华消化外科杂志

Objective:To explore the imaging features of intraductal pancreatic neuro-endocrine tumor (PNET).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 17 patients with intraductal PNET who were admitted to the First Affiliated Hospital of Naval Medical University (Changhai Hospital of Shanghai) from January 2013 to October 2020 were collected. There were 7 males and 10 females, aged (47±13)years. Preoperative contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) of the pancreas was performed on patients. Observation indicators: (1) imaging features of intraductal PNET, including ① imaging features of CT and ② imaging features of MRI; (2) treatment and histopathological examination of intraductal PNET. Measurement data with normal distribution were described as Mean± SD and count data were described as absolute numbers. Results:(1) Imaging features of intraductal PNET. ① Imaging features of CT: 17 patients underwent preoperative contrast-enhanced CT of pancreas. There were 9 cases with tumor located in the head of the pancreas, 5 cases with tumor located in the neck of the pancreas and 3 cases with tumor located in the body and tail of the pancreas. The tumor diameter of the 17 patients was (8.7±2.5)mm, with a range of 5.2?15.5 mm. The tumor shape was round-like in the 17 patients. All the 17 patients showed isodensity on plain CT and markedly enhancement in arterial, venous and portal phases on enhanced CT. The degree of enhancement of tumor was higher than surrounding normal pancreatic parenchyma. All tumors of 17 patients were located at the truncation of main pancreatic duct (MPD) dilation, showing abrupt change in caliber of MPD without the "beak sign". The diameter of dilated MPD was (11.4±5.3)mm, with a range of 4.5?22.5 mm. Other imaging manifestations of the 17 patients included 11 cases with pancreatic parenchymal atrophy, 1 case with retention cyst, 1 case with choledochal dilation, 1 case with calcification, and all cases without cystic degeneration or hemorrhage. ② Imaging features of MRI: preoperative contrast-enhanced MRI was performed in 14 patients. Five cases showed slightly low signal but 9 cases showed unclear on T1-weighted imaging. Five cases showed low signal, 2 cases showed slightly high signal but 7 cases showed unclear on T2-weighted imaging. Of the 14 patients, 9 cases showed diffusion limited on diffusion weighted imaging and 5 cases showed unlimited diffusion. Nine cases showed marked enhancement in tumor higher than in normal pancreatic parenchyma, but 5 cases were unclear on contrast-enhanced MRI. (2) Treatment and histopathological exmination of intraductal PNET: all the 17 patients underwent surgical treatment, including 9 cases with pancreaticoduodenectomy, 4 cases with distal pancreatectomy and splenectomy, 4 cases with pancreatic segmentectomy. Postoperative histopatho-logical examination results showed 10 cases of G1 and 7 cases of G2, including 1 case of G2 with lymph node metastasis, 1 case of G2 with lymph node and liver metastasis. The pathological gross showed that the tumor body was mainly located in the pancreatic duct and blocked the pancreatic duct, with upstream pancreatic dilation. There were pancreatic acinar atrophy and fibrous tissue hyperplasia. The tumor was grayish-yellow or brownish red, solid, medium in texture and well-defined with the surrounding tissues. Microscopically, the tumor of 17 patients was mainly located in the pancreaic duct and invaded into surrounding pancreatic parenchyma. The cells of tumor were polygonal with a central nucleus, but the mitosis was rare. The cytoplasm was eosinophilic or hyaline. The tumor stroma was mainly collagen fiber with abundant capillary network.Conclusions:The imaging features of intraductal PNET are small size, marked enhancement on contrast-enhanced CT and MRI. The tumor obstructs the MPD with distal MPD dilation and pancreatic parenchyma atrophy.

Imaging features of undifferentiated pancreatic carcinoma with osteoclast-like giant cells / 中华胰腺病杂志

Objective:To investigate the imaging features of undifferentiated pancreatic carcinoma (UCOGCP) with osteoclast-like giant cells.Methods:CT and MRI data of 4 pathologically diagnosed UCOGCP patients admitted in the First Affiliated Hospital of Naval Medical University from December 2014 to January 2019 were retrospectively analyzed. The tumor location, major length, shape, border, density or signal, capsule, calcification, hemorrhage, cystic degeneration, degree of enhancement, as well as the presence or absence of pancreatic duct dilatation, pancreatic parenchymal atrophy, peripheral vascular invasion, lymph node and organ metastasis were recorded.Results:Of 4 UCOGCP patients, 1 case had the mass located in head of pancreas, 2 cases in body of pancreas , and 1 in tail of pancreas. The length of tumor ranged from 3.3 cm to 13.0 cm, and the average was 8.8 cm.3 cases were round-like, and 1 was irregular; 2 tumors were well defined with capsules, 2 with unclear border. 4 cases showed solid-cystic masses, 3 of which had cystic separation. 4 cases showed heterogeneous low density on unenhanced CT, and 1 case had spotted calcification. The solid component of the mass was mild enhanced on enhanced CT, and partial solid component of the mass showed obvious enhancement in 2 cases. 2 cases showed mixed low signal on T 1WI, 1 of which had small patchy high signal indicating hemorrhage. 2 cases showed mixed high signal on T 2WI, and high signal on DWI. 2 cases had major pancreatic duct dilation. 1 case had pancreatic parenchyma atrophy. 1 case had descending duodenum invasion. 3 cases had peripheral vascular invasion, including portal vein, splenic artery, and splenic vein. 1 case had tumor thrombosis in the portal vein and splenic vein. 1 case was associated with pancreatogenous portal hypertension. Conclusions:The imaging features of UCOGCP showed a large solid-cystic mass with hemorrhage and calcification. The solid component of the mass was mild enhanced and the partially solid component was obviously enhanced. The combination of its imaging characteristics and clinical data can improve the accuracy of diagnosis.

Optimization of polysaccharide extraction from Hippocampus by deep neural network and Box-Behnken design-response surface methodology / 中国中药杂志

In this paper, the extraction rate of crude polysaccharides and the yield of polysaccharides from Hippocampus served as test indicators. The comprehensive evaluation indicators were assigned by the R language combined with the entropy weight method. The Box-Behnken design-response surface methodology(BBD-RSM) and the deep neural network(DNN) were employed to screen the optimal parameters for the polysaccharide extraction from Hippocampus. These two modeling methods were compared and verified experimentally for the process optimization. This study provides a reference for the industrialization of effective component extraction from Chinese medicinals and achieves the effective combination of modern technology and traditional Chinese medicine.

Prediction on postoperative visual acuity of cataract patients by objective quality analysis system / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To assess the accuracy of optical quality analysis system Ⅱ(OQAS Ⅱ)in predicting postoperative visual acuity of cataract patients.<p>METHODS: Prospective study, patients underwent cataract surgery in Daping Hospital from June 2019 to November 2019 were recruited. According to predicted visual acuity 100%(PVA100%)and best corrected visual acuity(BCVA), patients were dichotomized into group A(PVA100% worse than BCVA, 145 eyes)and group B(PVA100% equal to or better than BCVA, 114 eyes). Visual acuity improvement was compared between the two groups 1mo after surgery.<p>RESULTS: In group A, visual acuity of 112 eyes(77.2%)improved at least 2 lines. While in group B, 93 eyes(81.6%)improved at least 2 lines. There was no significant difference in visual acuity improvement ratio between the two groups(<i>P</i>=0.394). The average BCVA improvement of group A was 0.3(0.2, 0.4)LogMAR, and that of group B was 0.4(0.2, 0.5)LogMAR, revealed statistically significant differences(<i>P</i>=0.001). No significant correlation was found between preoperative PVA100% and postoperative BCVA in both of the two groups(<i>P</i>=0.888,0.304). In patients combined with preoperative ocular comorbidity, 17 eyes(94.4%)in group A and 26 eyes(65.0%)in group B improved at least 2 lines with significant difference between the two groups(<i>P</i>=0.041). BCVA improved 0.3(0.2, 0.4)LogMAR in group A and 0.3(0.1, 0.5)LogMAR in group B, there was no significant difference between the two groups(<i>P</i>=0.597).<p>CONCLUSION: The binary classification method based on the value of preoperative PVA100% and BCVA failed to accurately predict who shall benefit more from cataract surgery. In patients diagnosed with preoperative ocular comorbidity, BCVA is likely to be significantly improved if preoperative PVA100% were worse than BCVA. More data are needed to determine the clinical value of PVA100%.

Clinical observation of hot-wet compression with Xiaohua ointment for acne mastitis in mass stage / 中国医师杂志

Objective:To observe the clinical effects of hot-wet compression with Xiaohua ointment for acne mastitis in mass stage and its impacts on humoral immune function and inflammation.Methods:85 cases of patients with acne mastitis in mass stage treated in our hospital from January 2018 to January 2019 were selected as the research objects and randomly divided into control group (42 cases) and observation group (43 cases). The control group taken Tuoli xiaodu powder and external use of purple detumescence cream, and the observation group received hot-wet compression with Xiaohua ointment additionally. All treated for 30 days. The clinical efficacy, symptom scores, breast mass size, humoral immune indexes, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were compared, and the adverse reactions were recorded.Results:After treatment, the humoral immune indexes of the two groups had no significant change ( P>0.05), but the pain score, breast tumor size, mass score, CRP and ESR were significantly decreased than those before treatment ( P<0.05); compared with the control group, the pain score, breast tumor size and mass score in the observation group were significantly lower than those in the control group ( P<0.05). The total effective rate of the observation group was 83.7%, which was significantly higher than 59.5% of the control group ( P<0.05). There were no obvious adverse reactions in both groups. Conclusions:Hot-wet compression with Xiaohua ointment is effective and safe for patients with acne mastitis in mass stage, and could improve their inflammation.

Relationship between metabolic disorder in polycystic ovary syndrome and zinc α 2 glycoprotein / 中国基层医药

Objective:To explore the changes of serum zinc-2 glycoprotein (ZAG) levels in patients with polycystic ovary syndrome (PCOS) with metabolic indicators, and to seek the correlation between metabolic disorders and ZAG in patients with PCOS, so as to provide a basis for the diagnosis and treatment of metabolic disorders in patients with PCOS.Methods:A total of 200 Han PCOS patients admitted to Shenzhen Hospital of Guangzhou University of Traditional Chinese Medicine (Futian) from January 2017 to June 2018 were selected as the observation group, and divided into the group A (BMI ≥ 25kg/m 2) and the group B (BMI <25kg/m 2) according to body mass index(BMI). Meanwhile, 100 healthy Han women who came to the hospital for physical examination during this period were selected as the control group.ZAG, fasting blood glucose (FPG), fasting insulin (FINS), triglyceride (TG), total cholesterol (TC), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were measured, and the differences among the three groups were compared.After weight control, group A reviewed the above indicators and compared the differences of these indicators before and after weight control. Results:In group A, the FPG, FINS, HOMA-IR, TC, TG, HDL, LDL and ZAG were (5.92±0.51)mmol/L, (19.94±3.15)mIU/L, (5.29±1.19), (5.59±0.49)mmol/L, (2.03±0.35)mmol/L, (0.72±0.21)mmol/L, (3.05±0.43)mmol/L, (35.80±8.12)ng/mL, respectively, which in group B were (5.38±0.62)mmol/L, (15.67±4.59)mIU/L, (3.84±1.45), (4.61±0.65)mmol/L, (1.49±0.35)mmol/L, (1.24±0.40)mmol/L, (2.61±0.40)mmol/L, (45.22±10.27)ng/mL, respectively, which in the control group were (4.77±0.53)mmol/L, (11.66±3.23)mIU/L, (2.52±0.95), (4.59±0.53)mmol/L, (1.39±0.26)mmol/L, (1.40±0.31)mmol/L, (2.50±0.35)mmol/L, (59.15±8.90)ng/mL, respectively, and the differences were statistically significant between group A and group B, between group A and control group, and between group B and control group( F=36.81, 41.04, 44.05, 33.65, 38.61, 39.25, 18.45, 56.88, all P<0.01). After weight control, the FPG, FINS, HOMA-IR, TC, TG, HDL, LDL and ZAG in group A were (5.27±0.54)mmol/L, (15.67±3.16)mIU/L, (3.72±1.06), (4.98±0.45)mmol/L, (1.62±0.30)mmol/L, (1.03±0.25)mmol/L, (2.82±0.43)mmol/L, (43.59±8.20)ng/mL, respectively, and the differences were statistically significant in group A before and after weight control ( t=15.26, 15.67, 17.70, 11.04, 17.61, -9.61, 22.83, -13.79, all P<0.01). The serum ZAG was positively correlated with HDL ( r=0.628, P<0.01), and negatively correlated with BMI ( r=-0.685, P<0.01), HOMA-IR ( r=-0.729, P<0.01), and TC ( r=-0.579, P<0.01). Conclusion:ZAG value is reducedin PCOS patients, with lower level in obesity group, and is positively correlated with HDL, negatively correlated with BMI, HOMA-IR, TC.The metabolism in patients with PCOS can be reflected by ZAG, which has a certain value in diagnosis and treatment of PCOS patients with metabolic disorder, and provides theory basis for further study of the metabolic disorder of PCOS.

Investigation on job burnout and depression status of surgical residents / 国际外科学杂志

Objective:To investigate the current situation of job burnout and depression among surgical residents, with a view to reduding or alleviating the burnout and depression of surgical residents.Methods:The job burnout scale and depression scale were used to investigate the burnout and depression of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2016 to January 2019, there were 108 males and 29 females, aged (26.57±1.77) years, and the age ranged from 23 to 28 years. The distribution differences of the incidence of job burnout and depression in gender, time status and the correlation between the three dimensions of job burnout and depression were analyzed. The measurement data were expressed as mean±standard deviation ( Mean± SD). Counting data were expressed as percentage(%). The differences in the distribution of job burnout and depression in gender, time and status were analyzed by chi-square test. Pearson correlation analysis was used to analyze the correlation among the three dimensions of job burnout and depression. Results:Of the 137 surgical residents, 10 (7.3%) had severe job burnout requiring intervention . In the emotional exhaustion dimension, 67 (48.9%) had mild burnout, 53 (38.7%) had moderate burnout, and 17 (12.4%) had severe burnout. In the cynicism dimension, 86 (62.8%) had mild burnout, 37 (27.0%) had moderate burnout, and 14 (10.2%) had severe burnout. In the reduced personal accomplishment dimension, 64(46.7%) had mild burnout, 43(31.4%) had moderate burnout, 30(21.9%) had severe burnout. The results of the depression survey showed that 27 (19.7%) of the 137 surgical residents were depressed. There were no statistically significant differences in the incidence of job burnout in gender, time and status( P>0.05). There were no statistically significant differences in the incidence of depression in gender and status( P>0.05). The incidence of depression was higher among 1-year residents (14, 35.0%) than among 2-year (8, 15.7%) and 3-year(5, 10.9%) residents ( P<0.01). Depression is associated with emotional exhaustion, cynicism and reduced sense of achievement ( r=0.248, r=0.301, r=0.201, respectively, P<0.05). Conclusions:The job burnout and depression of surgical residents are not optimistic. There were differences in the time distribution of depression incidence, among which the incidence of depression is higher among the residents in the first year. The occurrence of depression is positively correlated with three dimensions of job burnout.

Research on satisfaction degree of surgical resident in standardized training / 国际外科学杂志

Objective:To investigate the satisfaction degree of surgical resident in standardized training and to explore the existing problems and influencing factors. It provides references for improving the system and quality of standardized training.Methods:The Self-designed Satisfaction scale was used to investigate the satisfaction degree of 137 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2015 to June 2018. There were 108 males (78.8%) and 29 females (21.2%). The mean age was (26.78±1.83) years. The measurement data of normal distribution were expressed as mean ± standard deviation. Counting data was expressed by frequency and constituent ratio. The differences between groups were analyzed by t test and one-way anova.Results:The overall satisfaction score of the surgical residents to the standardized training was 3.71±0.83, among which the residents scored the highest on the working condition (4.12±0.67), while the training effect (3.53±0.85) was the last in all dimensions. The overall satisfaction of third-year residents was lower than that of first-year and second-year residents, and the differences were statistically significant ( F=3.27, P=0.04). The scores of first-year residents in standardized management was higher than that of second-year and third-year residents, and the difference was statistically significant ( F=3.30, P=0.04). The scores of professional degree postgraduate in overall satisfaction, standardized management and research training were higher than those of enrolled resident, and the differences were statistically significant ( P<0.05). The score in enrolled resident (3.78±0.85) was higher than that of professional degree postgraduate (3.44±0.63)in the dimension of salary, and the difference was statistically significant ( P=0.02). Conclusion:Surgical residents expressed satisfaction with the general condition of standardized training, training condition, research training, training effect and postgraduate salary were still need be strengthen.

Study of surgical residents′ stressors and job burnout / 国际外科学杂志

Objective@#To investigate the current situation of stressors and job burnout among surgical residents and to explore the influencing factors, so as to provide evidences for reducing stress and relieving job burnout.@*Methods@#The stressor scale and job burnout scale were used to investigate the stress and burnout of 145 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital, Capital Medical University from September 2016 to June 2019, to understand the existence of stress and job burnout in surgical residents, and analyze the linear correlation between each dimension of stressors and each dimension of burnout. There were 132 males and 13 females, who were (26.62±1.45) years old, ranged from 22 to 30 years. SPSS19.0 software was used for statistical analysis. The measurement data of normal distribution were expressed as Mean±SD Counting data were expressed by frequency and constituent ratio. Pearson correlation analysis was used to analyze the linear correlation between each dimension of stressors and each dimension of job burnout.@*Results@#The total score of surgical resident stress was 2.51±0.57. The scores of social factors and workload were higher in each dimension 3.02±0.58 and 3.00±0.62, respectively. The burnout survey showed that 7 residents (4.8%) had severe burnout. In the dimension of emotional exhaustion, there were 14 residents with severe burnout. In the dimension of cynicism, there were 21 residents (14.5%) had severe burnout. In the dimension of reduced personal accomplishment, there were 19 residents (13.1%) of mild burnout and 17 residents (11.7%) of severe burnout. Further analysis of the linear correlation between each dimension of stressors and each dimension of burnout showed that most of them were positively linear correlated. In particular, emotional exhaustion and workload (r=0.411, P<0.05), reduced personal accomplishment and social factors (r=0.429, P<0.05) had a relatively large correlation coefficient.@*Conclusions@#The stress and burnout of surgical residents were at a high level. In order to reduce the stress and relieve the burnout, it is necessary to strengthen the residents′ self-management and improve the social support system.

Research status of scientific research ability of professional surgical postgraduates under the standardized training mode of residents / 国际外科学杂志

Objective@#To explore the status quo and countermeasures of the scientific research ability of professional surgical postgraduates under the standardized training mode of residents.@*Methods@#Fifty-five students in Beijing Friendship Hospital, Capital Medical University during September 2015 to December 2017 were enrolled in the present study. Questionnaire was used to collection the data in order to evaluate the current research abilities and provide feedbacks for the adoption of improvement measures of research skill. The results of the survey were entered into the computer using EpiData 3.0 software, and descriptive analysis of the data were performed using Excel 2010 and SPSS 20.0 to calculate the percentage of each indicator.@*Results@#The results showed that 38(69.1%) graduate students were able to assist the instructor in basic research work, and 17(30.9%) graduate students showed low enthusiasm for independent design and writing of the paper. In addition, 23(41.8%) graduate students hoped to improve their research capabilities and added more training courses. 10(18.2%) students hoped to strengthen the training of the clinical subject tutors, and thought that the communication and contact with the tutor was not enough.@*Conclusions@#The professional postgraduates overvalue clinical practice and undervalued scientific research. This article introduces ways of strengthening the cultivation of scientific research awareness, optimizing curriculum system, playing the core role of mentors, establishing incentive system and scientific research platform to enhance scientific research capacity.

Research status of scientific research ability of professional surgical postgraduates under the standardized training mode of residents / 国际外科学杂志

Objective To explore the status quo and countermeasures of the scientific research ability of professional surgical postgraduates under the standardized training mode of residents.Methods Fifty-five students in Beijing Friendship Hospital,Capital Medical University during September 2015 to December 2017 were enrolled in the present study.Questionnaire was used to collection the data in order to evaluate the current research abilities and provide feedbacks for the adoption of improvement measures of research skill.The results of the survey were entered into the computer using EpiData 3.0 software,and descriptive analysis of the data were performed using Excel 2010 and SPSS 20.0 to calculate the percentage of each indicator.Results The results showed that 38(69.1％) graduate students were able to assist the instructor in basic research work,and 17 (30.9％) graduate students showed low enthusiasm for independent design and writing of the paper.In addition,23 (41.8％) graduate students hoped to improve their research capabilities and added more training courses.10 (18.2％) students hoped to strengthen the training of the clinical subject tutors,and thought that the communication and contact with the tutor was not enough.Conclusions The professional postgraduates overvalue clinical practice and undervalued scientific research.This article introduces ways of strengthening the cultivation of scientific research awareness,optimizing curriculum system,playing the core role of mentors,establishing incentive system and scientific research platform to enhance scientific research capacity.

Study of surgical residents' stressors and job burnout / 国际外科学杂志

Objective To investigate the current situation of stressors and job burnout among surgical residents and to explore the influencing factors,so as to provide evidences for reducing stress and relieving job burnout.Methods The stressor scale and job burnout scale were used to investigate the stress and burnout of 145 residents who attended the standardized training of surgical residents in Beijing Friendship Hospital,Capital Medical University from September 2016 to June 2019,to understand the existence of stress and job burnout in surgical residents,and analyze the linear correlation between each dimension of stressors and each dimension of burnout.There were 132 males and 13 females,who were (26.62 ± 1.45) years old,ranged from 22 to 30 years.SPSS 19.0 software was used for statistical analysis.The measurement data of normal distribution were expressed as Mean ± SD Counting data were expressed by frequency and constituent ratio.Pearson correlation analysis was used to analyze the linear correlation between each dimension of stressors and each dimension of job burnout.Results The total score of surgical resident stress was 2.51 ±0.57.The scores of social factors and workload were higher in each dimension 3.02 ± 0.58 and 3.00 ± 0.62,respectively.The burnout survey showed that 7 residents (4.8％) had severe burnout.In the dimension of emotional exhaustion,there were 14 residents with severe burnout.In the dimension of cynicism,there were 21 residents (14.5％) had severe burnout.In the dimension of reduced personal accomplishment,there were 19 residents (13.1％) of mild burnout and 17 residents (11.7％) of severe burnout.Further analysis of the linear correlation between each dimension of stressors and each dimension of burnout showed that most of them were positively linear correlated.In particular,emotional exhaustion and workload (r =0.411,P ＜ 0.05),reduced personal accomplishment and social factors (r =0.429,P ＜ 0.05) had a relatively large correlation coefficient.Conclusions The stress and burnout of surgical residents were at a high level.In order to reduce the stress and relieve the burnout,it is necessary to strengthen the residents' self-management and improve the social support system.

Predictive value of serum uric acid on new-onset cholelithiasis (a report of 97 469 cases) / 中华消化外科杂志

Objective To explore the predictive value of serum uric acid on new-onset cholelithiasis.Methods The retrospective cohort study was conducted.The data of 97 469 subjects who participated health examination at the Kailuan General Hospital Affiliated to the North China University of Science and Technology,Kailuan Linxi Hospital,Kailuan Zhaogezhuang Hospital,Kailuan Tangjiazhuang Hospital,Kailuan Fan'gezhuang Hospital,Kailuan Lyujiatuo Hospital,Kailuan Jinggezhuang Hospital,Kailuan Linnancang Hospital,Kailuan Qianjiaying Hospital,Kailuan Majiagou Hospital and Kailuan Branch Hospital from June 2006 to December 2015 were collected.Epidemiological investigation,anthropometric parameters and biochemical indicators were collected.All the subjects were allocated into 4 groups according to squartiles of serum uric acid:24 140 with serum uric acid ＜232 μmol/L in the Q1 group,24 473 with 232 μmol/L≤ serum uric acid ＜282 μmol/L in the Q2 group,24 382 with 282 μmol/L≤ serum uric acid ＜338 μmol/L in the Q3 group and 24 474 with serum uric acid ≥ 338 μmol/L in the Q4 group.Observation indicators:(1) comparisons of clinical characteristics among the 4 groups;(2) incidence of cholelithiasis in the 4 groups;(3) effects of serum uric acid on the new-onset cholelithiasis:① the dose-response relationship between serum uric acid and the risk of cholelithiasis,② comparisons of the fitting degree of serum uric acid on the cholelithiasis model,③ effects of different serum uric acid levels on incidence of cholelithiasis after stratification by sex,④ serum uric acid of different gender on the boxplots,⑤ effects of different serum uric acid levels on the incidence of cholelithiasis after stratification by age.Measurement data with normal distribution were expressed as (x)±s,and comparisons among groups were analyzed using the one-way ANOVA.Measurement data with skewed distribution is expressed by M (Q),and comparisons among groups were analyzed using the nonparametric Krustal-willis test.Count data were represented by percentage,and comparisons among groups were analyzed using chi-square test.The incidences of cholethiasis in 4 groups of different serum uric acid were calculated by person-year incidence.Restrictive cubic spline regression was used to calculate the dose-response relation between the continuous variable and the risks of new-onset cholelithiasis and 95％ confidence interval (CI).COX regression model was used to analyze the hazard ratio (HR) and 95％ CI of different serum uric acid levels on new-onset cholelithiasis.Likelihood ratio test and akaike information criterion (AIC) were used to calculate the fitting degree of serum uric acid on new-onset cholelithiasis model.Boxplots were used to describe serum uric acid in different genders.Results (1) comparisons of clinical characteristics among the 4 groups:sex (male),age,body mass index (BMI),systolic pressure,diastolic pressure,fasting plasma glucose (FPG),total cholesterol (TC),triglyceride (TG),high sensitive C-reactive protein,diabetes,hypertension,smoking,drinking and physical exercise were 15 162,(50± 11) years,(24±3)kg/m2,(123±21)mmHg (1 mmHg=0.133 kPa),(82± 12)mmHg,(5.6±2.0) mmol/L,(4.8±1.2) mmol/L,1.14 mmol/L (range,0.81-1.63 mmol/L),0.70 mmol/L (range,0.23-2.23 mmol/L),2 537,9 415,4575,2380,2 649 in the Q1 group,19 079,(51±12) years,(25±3)kg/m2,(130±21)mmHg,(83±12) mmHg,(5.5 ± 1.7) mmol/L,(4.9 ± 1.2) mmol/L,1.20 mmol/L (range,0.86-1.76 mmol/L),0.71 mmol/L (range,0.28-1.98 mmol/L),2 287,10 124,6 918,3 649,3 288 in the Q2 group,21 132,(52±13)years,(25±3)kg/m2,(132±21)mmHg,(84±12)mmHg,(5.5±1.6)mmol/L,(5.0±1.2) mmol/L,1.29 mmol/L (range,0.91-1.94 mmol/L),0.80 mmol/L (range,0.30-2.06 mmol/L),2 027,10 755,8 259,4 730,3 958 in the Q3 group,22 651,(53± 14) years,(26± 3) kg/m2,(134± 21) mmHg,(85±12)mmHg,(5.4±1.5)mmol/L,(5.1±1.2)mmol/L,1.54 mmol/L (range,1.05-2.35 mmol/L),1.02 mmol/L (range,0.43-2.50 mmol/L),1 981,12 082,9 562,6 209,4 758 in the Q4 group,respectively,with statistically significant differences among the 4 groups (x2 =7 624.63,F=279.93,961.91,330.84,271.40,38.25,353.18,H =3 406.30,912.23,x2 =108.15,590.49,2567.07,2 209.21,760.15,P＜0.05).(2)Incidence of cholelithiasis in the 4 groups:97 469 participants were followed up for 592 922 person-year,4 270 participants had new-onset cholelithiasis,with a total person-year incidence of 7.20 thousand person / year.The person-year incidence were respectively 6.34 (971/153 205 * 1 000),6.91 (1 034/149 686 * 1 000),7.44 (1 090/146 549 * 1 000),8.19 (1 175/143 482 * 1 000) thousand person / year in Q1,Q2,Q3 and Q4 group.(3) Effects of serum uric acid on the new-onset cholelithiasis.① The dose-response relationship between serum uric acid and the risk of cholelithiasis:restricted cubic spline regression showed a linear relationship between continuous serum uric acid,logarithmic transformated serum uric acid and the risk of cholelithiasis (x2 =11.74,8.01,P＜0.05).② Comparisons of the fitting degree of serum uric acid on the cholelithiasis model:adjusted for sex,age,BMI,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,risks of new-onset cholelithiasis increased in Q3 and Q4 groups compared with Q1 group (HR=1.10,1.12,95％CI:1.01-1.20,1.03-1.23,P＜0.05).The-2Log L and AIC value of multivariate model,serum uric acid+multivariate model were 92 532.39,92 550.39 and 92 525.35,92 549.35,respectively,with a statistically significant difference (x2=7.04,P ＜ 0.05).③ Effects of different serum uric acid levels on incidence of cholelithiasis after stratification by sex:in female participants,adjusted for age,BMI,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,risk of new-onset cholelithiasis in Q1 group was not statistically significant different from that in Q2,Q3,Q4 group (HR=1.06,1.15,1.09,95％CI:0.88-1.28,0.93-1.34,0.91-1.31,P＞0.05).In male participants,adjusted for age,BMI,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,risks of new-onset cholelithiasis in Q2,Q3 and Q4 groups were increased compared with Q1 group (HR=1.17,1.24,1.30,95％CI:1.06-1.30,1.12-1.37,1.18-1.44,P＜0.05).④ Serum uric acid of different gender on the boxplots:in female participants,the level of serum uric acid was (249 ± 61) μmol/L,(235±50)μmol/L,(231±56) μmol/L,(250±66) μmol/L,(266±75) μmol/L,(281±81) μmol/L,(298±76) μmol/L,(379±86)μmol/L respectively in the group of 18-27 years old,28-37 years old,38-47 years old,48-57 years old,58-67 years old,68-77 years old,78-87 years old,88-97 years old after stratified by 10 years old.In male participants,the level of serum uric acid was respectively (310±76)μmol/L,(298 ±75) μmol/L,(298±74) μmol/L,(294±74) μmol/L,(302±78) μmol/L,(311 ±80) μmol/L,(322±80) μmol/Land (330±75)μmol/L after participants stratified by 10 years old.⑤ Effects of different serum uric acid levels on the incidence of cholelithiasis after stratification by age:in participants with age ≤ 60 years old,adjusted for sex,BMI,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,risk of new-onset cholelithiasis in the Q2 and Q3 groups were not increased compared with Q1 group (HR=1.05,1.10,95％CI:0.94-1.17,0.99-1.23,P＞0.05),however,risk of new-onset cholelithiasis was increased in the Q4 group (HR =1.15,95％CI:1.02-1.28,P＜0.05).In participants with age ＞ 60 years old,adjusted for sex,BMI,TC,TG,diabetes,hypertension,smoking,drinking and physical exercise,risk of new-onset cholelithiasis in the Q2 groups was not increased compared with Q1 group (HR=1.16,95％CI:0.99-1.36,P＞0.05),however,risks of new-onset cholelithiasis were increased in the Q3 and Q4 groups (HR =1.19,1.21,95％CI:1.02-1.40,1.04-1.41,P＜ 0.05).Conclusion Elevated serum uric acid is an independent risk factor for the new-onset cholelithiasis.

Influence of Air Pollution on Hospital Admissions in Adult Asthma in Northeast China / 中华医学杂志(英文版)

<p><b>Background</b>Asthma is a common chronic respiratory disease and is related to air pollution exposure. However, only a few studies have concentrated on the association between air pollution and adult asthma. Moreover, the results of these studies are controversial. Therefore, the present study aimed to analyze the influence of various pollutants on hospitalization due to asthma in adults.</p><p><b>Methods</b>A total of 1019 unrelated hospitalized adult asthma patients from Northeast China were recruited from 2014 to 2016. Daily average concentrations of air pollutants (particulate matter <2.5 μm [PM], particulate matter <10 μm [PM], sulfur dioxide [SO], nitrogen dioxide [NO], and carbon monoxide [CO]) were obtained from the China National Environmental Monitoring Centre website from 2014 to 2016. Cox logistic regression analysis was used to analyze the relationship between air pollutants and hospital admissions in adult asthma.</p><p><b>Results</b>The maximum odds ratio (OR) value for most air pollutants occurred on lag day 1. Lag day 1 was chosen as the exposure period, and 8 days before onset was chosen as the control period. Three pollutants (PM, CO, and SO) were entered into the regression equation, and the corresponding OR (95% confidence interval) was 0.995 (0.991-0.999), 3.107 (1.607-6.010), and 0.979 (0.968-0.990), respectively.</p><p><b>Conclusions</b>A positive association between hospital admissions and the daily average concentration of CO was observed. CO is likely to be a risk factor for hospital admissions in adults with asthma.</p>

Management of bone defects in total knee arthroplasty / 中国组织工程研究

BACKGROUND: Bone defects are one of the most important challenges that surgeons have to manage in total knee arthroplasty. The reasonable treatment method can guarantee the effect of the repair operation. OBJECTIVE: To review the relevant literatures concerning bone defects treated by primary total knee arthroplasty and revision total knee arthroplasty, and to analyze the optimal managements for different types of bone defects. METHODS: Relevant literatures were identified in China National Knowledge Infrastructure, Wanfang data, Vip, PubMed, Medline, and Web of Science. The key words were "total knee arthroplasty, total knee replacement, revision total knee arthroplasty, bone loss, bone defect, bone deficiency, management". The included studies were analyzed and summarized. RESULTS AND CONCLUSION: (1) Sixty-two studies regarding total knee arthroplasty for bone defects were included, without recognized standards on the type of bone defects. AORI is the most widely used classification for bone defects. (2) Pre-operated detailed evaluation including laboratory and radiographic examination, and accurate diagnosis are the key to success. (3) Management of bone defect was similar in tibia and femur, but there is still no standard classification and management of patellar bone defect. (4) Using stem fixation whenever a femoral or tibial component is revised can improve clinical outcome. (5) Through detailed evaluation, accurate diagnose and appropriate classification of bone defect, selection, according to the characteristics of different strategies, the age of the patient and the needs of life, can get a good clinical result.

Stiffness of the lower extremities during landing / 中国组织工程研究

BACKGROUND: Downhill running has been found to cause a significant change in the stiffness of the support leg, thus affecting the magnitude and speed of the center of pressure travel. If the stiffness cannot effectively adjust the impact of exercise, sport performance will be weakened and even induce sport injuries. OBJECTIVE: To understand the stiffness to be as the mechanical parameters of human movement, and to assess the mechanisms underlying musculoskeletal system regulating stiffness. METHODS: Medline and CNKI databases were retrieved for relevant articles using the keywords of "landing, spring-mass model, stiffness, human body movement" in English and Chinese, respectively. The stiffness model, stiffness assessment, as well as the role of stiffness during human movement and its influencing factors were reviewed, thereby revealing the significance of stiffness during human movement. RESULTS AND CONCLUSION: When the human body interacts with the ground, the visual information is different, and the neuromuscular system generates coordinated control to arrange appropriate muscle activity of the lower extremities, such as stiffness regulation. The movement settings, working condition, and individual factors all make effects on the stiffness during human movement, and the stiffness efficacy can be controlled by changing the dynamic and kinematic parameters during movement. Appropriate adjustment of the stiffness can promote the human movement performance, and avoid or reduce sport injuries. Running and jumping are the indispensable movements, and taking off is the key step during jumping action, and the stiffness control during taking off action combined with sports skills can improve the sport performance. These results indicate that the vertical stiffness and leg stiffness will be changed with the human actions, accompanied with changes in the stiffness of hip, knee, and ankle joints. In addition, the spring-mass model is helpful for understanding the movement performance and preventing exercise injuries.