Determination of 10 organophosphorus flame retardants in drinking water by On-line SPE-UPLC-MS/MS / 公共卫生与预防医学

Objective To establish a method for the determination of 10 organophosphorus flame retardants in drinking water by on-line solid phase extraction coupled with high performance liquid chromatography-tandem mass spectrometry (On-line SPE-UPLC-MS/MS). Methods After adding the internal standard, the water sample was filtered by Millipore filtration, and then concentrated and detected by Online SPE-UPLC-MS/MS. Samples were concentrated by C8 SPE column and separated by C18 column with acetonitrile-water-formic acid as the mobile phases gradient elution，and were detected by multiple reaction monitoring (MRM) acquisition under anion mode. Results The 10 organophosphorus flame retardants all displayed good linear relationships within a certain range of concentrations, with the correlation coefficients being more than 0.990. The method detection limits were 0.60-5.50 ng/L, and the spiked recoveries of low, medium and high concentrations were 64%-106% , 83%-104% and 85%-99%, respectively. Conclusion The method is simple, sensitive, rapid, accurate and reliable, so it is applicable for the determination of 10 organophosphorus flame retardants in drinking water.

Clinical comprehensive evaluation for Chinese patent medicine based on evidence-based medicine and pharma- coeconomic model / 中国药房

OBJECTIVE To conduct a c omprehensive clinical evaluation method of Chinese patent medicine ，and to provide reference for rational clinical drug use. METHODS Taking the top 10 Chinese patent medicine injections for promoting blood circulation and removing stasis in Shandong province from 2016 to 2020 collected by the National Rational Drug Use Monitoring Network as an example ，the method combining health technology assessment with objective judgement analysis is used to construct the comprehensive evaluation index system ；based on evidence-based medical evidence and pharmacoeconomic model ，the safety ， effectiveness and economy of the drug were evaluated comprehensively ，and the scores were quantified. RESULTS & CONCLUSIONS The final scores of the 10 kinds of Chinese patent medicine injections were between 26 and 37 scores. Safflower yellow for injection scored the highest score in the treatment of cerebral infarction and angina pectoris of coronary heart disease ， while Ginkgo diterpene lactone meglumine injection and Shuxuening injection had the highest scores in the treatment of coronary heart disease. The clinical comprehensive evaluation method of Chinese patent medicine based on evidence-based medical evidence and pharmacoeconomic model can clarify the comprehensive value of Chinese patent medicine in clinic ，promote rational drug use in clinic ，and provide basis for the next adjustment of medical insurance catalogue and essential medicine catalogue ，decision-making of centralized procurement of related drugs.

Determination of eight volatile halogenated hydrocarbons in drinking water by headspace thermal desorption⁃gas mass spectrometry / 上海预防医学

ObjectiveTo establish a method for the determination of 8 volatile halogenated hydrocarbons in drinking water， including vinyl chloride， trichloroethylene， tetrachloroethylene， tetrachloromethane， chloroform， dichlorobromomethane， dichlorodibromomethane， and tribromomethane by headspace thermal desorption-gas mass spectrometry. MethodsThe water sample was kept in the headspace bottle at 60 ℃ for 40 min， and the volatile matter was transferred to the cold trap，subjected to thermal desorption， then analyzed by gas chromatography-mass spectrometry. ResultsThe linear ranges were 0.2‒20.0 μg·L-1 for vinyl chloride， 0.1‒20.0 μg·L-1 for chloroform， 0.02‒20.00 μg·L-1 for tetrachloromethane， 0.2‒20.0 μg·L-1 for trichloroethylene， 0.3‒20.0 μg·L-1 for dichlorobromomethane， 0.1‒20.0 μg·L-1 for tetrachloroethylene， 0.4‒20.0 μg·L-1 for dichlorodibromomethane， and 1.0‒20.0 μg·L-1 for tribromomethane. All the correlation coefficients were more than 0.997. The respective quantitative limits were 0.162， 0.073， 0.016， 0.184， 0.270， 0.071， 0.356 and 0.813 μg·L-1， and the respective recoveries were 98.0%‒101.0%， 102.0%‒110.0%， 99.2%‒101.0%， 95.5%‒96.2%， 96.0%‒102.0%， 100.0%‒102.0%， 99.0%‒105.0%， and 94.0%‒103.0%. ConclusionThe method is simple， sensitive， rapid， accurate and reliable， so it is applicable for the determination of 8 kinds of volatile halogenated hydrocarbons in drinking water.

Effects on extravascular lung water of lung protective ventilation strategy applied on piglets with acute respiratory distress syndrome induced by paraquat / 中华劳动卫生职业病杂志

Objective: To study the effects on extravascular lung water of lung protective ventilation strategy applying on piglets with acute respiratory distress syndrome (ARDS) induced by paraquat (PQ) under pulse indicating continuous cardiac output (PiCCO) monitoring. Methods: The piglets models with ARDS induced by PQ were established in June 2020 and all of them were received mechanical ventilation and divided into three groups according to tidal volume (V(T)) : small V(T) group (6 ml/kg) , middle V(T) group (10 ml/kg) and large V(T) group (15 ml/kg) , there were 5 piglets in each group. The positive end expiratory pressure (PEEP) were all setup on 10 cmH(2)O. The indexes such as arterial blood gas analysis, oxygenation index (OI) , extravascular lung water index (ELWI) and pulmonary vascular permeability index (PVPI) were monitored at time of before the model was established (baseline) , time of the model was established (t(0)) and 2 h (t(2)) , 4 h (t(4)) , 6 h (t(6)) after mechanical ventilation. Lung tissue were punctured at time of baseline, t(0) and t(6) to be stained by Hematoxylin-eosin (HE) staining and pulmonary pathology were observed under light microscopy. Results: The heart rate (HR) , mean arterial pressure (MAP) and partial pressure of carbon dioxide (PaCO(2)) of all groups were higher than the base value while the pH values, partial pressure of oxygen (PaO(2)) and OI were lower than the base value when the models were established (P<0.05) . After mechanical ventilation, the HR and MAP values of all groups at t(2), t(4) and t(6) were lower than t(0) while the PaCO(2) of t(4) and t(6) were all higher than t(0), the differences were statistically significant (P<0.05) . The PaO(2) and OI of all groups showed a trend of rising at first and then decreasing after mechanical ventilation. The MAP, PaO(2), PaCO(2) and OI of the middle V(T) group and large V(T) group were apparently lower than that of the small V(T) group at t(2), t(4) and t(6) (P<0.05) . The ELWI and PVPI at t(0) of all groups were higher than that of baseline (P<0.05) . The ELWI of the small V(T) group at t(6) were lower than t(0) of the same group and t(6) of the middle V(T) group and large V(T) group (P<0.05) . HE staining showed congestion and edema of alveolar tissue, swelling of capillaries, exudation of red blood cells and widening of alveolar septum in piglets after successful modeling. And further widening of alveolar septum and rupture of alveolar septum could be seen in the lung tissues of each group at t(6), and the injury was the slightest in the small V(T) group. Conclusion: The lung protective ventilation strategy can alleviate the extravascular lung water and ARDS induced by PQ and improve oxygenation.

Effects of AG3340 on the migration and invasion of human retinal pigment epithelial cells induced by high glucose / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect and mechanism of matrix metalloproteinase(MMPs)inhibitor AG3340 on the migration and invasion ability of retinal pigment epithelial cells-19(ARPE-19)cultured in high glucose(CHG). METHODS: ARPE-19 cells cultured in vitro were divided into four groups: Control group, the glucose at the concentration of 5.6mmol/L in DMEM/F12 medium; HG group, the glucose at the concentration of 30mmol/L was cultured with DMEM/F12 medium; HG+AG3340 group, the cells were pretreated with AG3340 for 12h, and then cultured in DMEM/F12 medium containing 30mmol/L glucose; The mannitol(MA)group, cultured with DMEM/F12 medium of 5.6mmol/L glucose and 24.4mmol/L mannitol, which used as hypertonic control group. The migration ability of cells was detected by wound healing assay, the invasion ability of cells was detected by Transwell assay, and the relative expression levels of MMP-9, MMP-2, fibronectin and collagen Ⅳ were detected by Western blot.RESULTS: The results of wound healing assay showed that compared with the Control group, the cell migration rate of scratching after 24h and 48h in the HG group was significantly increased(all P<0.001).After pretreated by AG3340, the cell migration rate was significantly lower than that in the HG group(all P<0.01).Transwell assay showed that compared with the Control group, the number of cell invasion in the HG group was significantly higher than that in the Control group(all P<0.001). After pretreated by AG3340, the number of cell invasion was decreased than the HG group(all P<0.01). Western blot results showed that compared with the Control group, the relative expression levels of MMP-9 and MMP-2 of the cells in the HG group were increased, and the relative expression levels of Fibronectin and Collagen Ⅳ were decreased(all P<0.001). Compared with the HG group, the relative expression levels of MMP-9 and MMP-2 protein in AG3340 pretreatment group were decreased, and the relative expression levels of Fibronectin and Collagen Ⅳ were increased(all P<0.05). CONCLUSION: High glucose induced ARPE-19 cells with enhanced migration and invasion ability, and AG3340 partially reversed this effect, which was related to the inhibition of MMP-9 and MMP-2 expression and the stability of extra-cellular matrix components.

Current status and research progress of POCT-based detection technology for 2019-nCoV / 中华检验医学杂志

In view of the significant changes in the prevention and control of COVID-19 at home and abroad, "external prevention of importation and internal prevention of rebound" has become the focus of prevention and control of the epidemic in China. Due to the limitation of testing sites, equipment and reaction time, traditional detection methods cannot meet the needs of real-time and rapid detection of 2019-nCoV. Point-of-care testing (POCT) is rapid, portable and flexible. It plays an increasingly important role in the rapid detection and screening of 2019-nCoV. Here, we review the current status and research progress of POCT for 2019-nCoV in terms of antigens, specific antibodies and nucleic acids, in order to provide reference for epidemic prevention and control and clinical management.

Target and dose design of 125I seed brachytherapy for treatment of pediatric borderline tumor in head neck region / 中华放射医学与防护杂志

Objective:To summarize and evaluate the target and dose design of 125I seed brachytherapy treatment plan of pediatric borderline tumor in head neck region. Methods:Eleven patients underwent definitive 125I brachytherapy or combined with surgery in Peking University Hospital of Stomatology from January 2010 to December 2018 were retrospective analyzed. The target region was set by extending the tumor gross region by 0.5 to 1.0 cm. The prescription dose and activity ranged from 80 to 120 Gy and 18.5 MBq, respectively. The treatments were performed according to the plan under general anesthesia. Response and toxic reaction were recorded during follow-up. The preoperative and postoperative dosimetric results were compared; and the local control rate, objective response rate, complete response rate and acute toxic reaction rate were calculated. Results:There was no statistically significant difference between preoperative and postoperative dosimetric results ( P>0.05). The follow-up time ranged from 33 to 131 months, with a median of 48 months. The local control rate, objective response rate, complete response rate and acute toxic reaction rate were 100%, 100%, 71.4% and 81.8%, respectively. Conclusions:Under well-designed target and dose, 125I brachytherapy for treatment of pediatric borderline tumor in head neck region would bring ideal therapeutic and toxic outcomes, and could be regarded as a feasible therapy.

Kang-Ai Injection Inhibits Gastric Cancer Cells Proliferation through IL-6/STAT3 Pathway / 中国结合医学杂志

OBJECTIVE@#To explore the mechanisms underlying the proliferative inhibition of Chinese herbal medicine Kang-Ai injection (KAI) in gastric cancer cells.@*METHODS@#Gastric cancer cell lines MGC803 and BGC823 were treated by 0, 0.3%, 1%, 3% and 10% KAI for 24, 48 and 72 h, respectively. The cell proliferation was evaluated by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) assay. The apoptosis and cell cycle were evaluated by flow cytometry. Interleukin (IL)-6 mRNA and protein expression levels were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and enzyme-linked immune sorbent assay (ELISA), respectively. The protein expression levels of cyclin A, cyclin E, cyclin B1, cyclin D1, p21, retinoblastoma (RB), protein kinase B (AKT), extracellular regulated protein kinases (ERK), signal transducer and activator of transcription (STAT) 1 and STAT3 were detected by Western blot.@*RESULTS@#KAI inhibited the proliferation of MGC803 and BGC823 gastric cancer cells in dose- and time-dependent manner. After treated with KAI for 48 h, the proportion of G1 phase was increased, expression level of cyclin D1 and phosphorylation-RB were down-regulated, whereas the expression of p21 was up-regulated (all P<0.01). Furthermore, 48-h treatment with KAI decreased the phosphorylation level of STAT3, inhibited the mRNA and protein expressions of IL-6 (all P<0.01). IL-6 at dose of 10 ng/mL significantly attenuated the proliferative effect of both 3% and 10% KAI, and recovered KAI-inhibited STAT3 phosphorylation and cyclin D1 expression level (all P<0.01).@*CONCLUSION@#KAI exerted an anti-proliferative function by inhibiting IL-6/STAT3 signaling pathway followed by the induction of G1 phase arrest in gastric cancer cells.

Genetic analysis of 21 cases of methylmalonic acidemia / 中华医学遗传学杂志

OBJECTIVE@#To carry out genetic analysis for 21 patients with methylmalonic acidemia (MMA) and provide genetic counseling for their families.@*METHODS@#Next generation sequencing (panel) was used to detect the pathogenic variants underlying the disease.@*RESULTS@#In total 29 variant sites of MMUT, MMAA, MMUT were identified in the 21 patients, with common variants including c.323G>A (10%), c.917C>T (10%), c.984delC (10%) of MMUT gene, and c.609G>A (45%), c.80A>G (10%) , c.567dupT (10%) of MMACHC gene. Among these, c.2000A>G of MMUT, c.298G>T of MMACHC and c.734-7A>G of MMAA gene were unreported previously.@*CONCLUSION@#Genetic testing for MMA patients can clarify the cause of the disease and provide a basis for the clinical diagnosis. Discovery of novel variants has enriched the mutational spectrum of MMA.

Post-radiation neutrophil-to-lymphocyte ratio is a prognostic marker in patients with localized pancreatic adenocarcinoma treated with anti-PD-1 antibody and stereotactic body radiation therapy

Purpose@#To investigate the role of pre- and post-stereotactic body radiation therapy (SBRT) neutrophil-to-lymphocyte ratio (NLR) in patients with localized pancreatic cancer treated with anti-PD-1 (programmed cell death protein-1) antibody and SBRT. @*Materials and Methods@#This was a retrospective review of 68 patients with borderline resectable or locally advanced pancreatic cancer treated with anti-PD-1 antibody and SBRT after multi-agent chemotherapy. Immunotherapy was administered with 5-fraction SBRT in the neoadjuvant, concurrent, or adjuvant/maintenance setting. Clinical outcomes included overall survival (OS), local progression-free survival, distant metastasis-free survival, and progression-free survival. Median pre- and post-SBRT peripheral blood markers were compared with the Mann-Whitney U test. Univariate and multivariable analyses (UVA and MVA) were performed to identify variables associated with clinical outcomes. Linear regression was performed to determine correlations between variables and peripheral blood markers. @*Results@#A total of 68 patients were included in the study. The percent change between median pre- and post-SBRT absolute lymphocyte count (ALC), absolute neutrophil count, and NLR were -36.0% (p < 0.001), -5.6% (p = 0.190), and +35.7% (p = 0.003), respectively. Median OS after SBRT was 22.4 months. On UVA, pre-SBRT CA19-9 (hazard ratio [HR] = 1.001; 95% confidence interval [CI], 1.000–1.001; p = 0.031), post-SBRT ALC (HR = 0.33; 95% CI, 0.11–0.91; p = 0.031), and post-SBRT NLR (HR = 1.13; 95% CI, 1.04–1.22; p = 0.009) were associated with OS. On MVA, induction chemotherapy duration (HR = 0.75; 95% CI, 0.57–0.99; p = 0.048) and post-SBRT NLR (HR = 1.14; 95% CI, 1.04–1.23; p = 0.002) predicted for OS. Patients with post-SBRT NLR ≥3.2 had a median OS of 15.6 months versus 27.6 months in patients with post-SBRT NLR <3.2 (p = 0.009). On MVA linear regression, log10CTV had a negative correlation with post-SBRT ALC (regression coefficient = -0.314; 95% CI, -0.626 to -0.003; p = 0.048). @*Conclusion@#Elevated NLR after SBRT is primarily due to depletion of lymphocytes and associated with worse survival outcomes in localized pancreatic cancer treated with anti-PD-1 antibody. Larger CTVs were associated with decreased post-SBRT ALC.

Comparison of the thickness of macular ganglion cell inner plexiform layer in patients with a history of laser photocoagulation versus intravitreal injection of ranibizumab for retinopathy of prematurity / 中华眼底病杂志

Objective:To compare the thickness of the macular ganglion cell inner plexiform layer (mGCIPL) in patients with a history of laser photocoagulation (LP) versus intravitreal injection of ranibizumab (IVR) for retinopathy of prematurity (ROP).Methods:A retrospective clinical study. From June 2020 to January 2021, 70 eyes of 35 children with a history of surgery for ROP in Shenzhen Eye Hospital were included in the study. Among them, 18 males had 36 eyes, and 17 females had 34 eyes. The average age was 5.54±1.04 years. There were 18 patients (36 eyes) in LP group and 17 patients (34 eyes) in IVR group. There was no significant difference in age ( t=-1.956), sexual composition ratio ( χ2=0.030), birth gestational age ( t=-1.316) and birth weight ( t=-1.060) between the two groups ( P=0.059, 0.862, 0.197, 0.297). All the eyes underwent the examination of optical coherence tomography (OCT). An elliptical region of 14.13 mm 2 centered on macular fovea was scanned according to the macular cube 512×128 model of the Cirrus HD-OCT 5000. The software was used to automatically divide macular fovea into six sectors (superior, inferior, temporal-superior, temporal-inferior, nasal-superior and nasal-inferior) and the average and minimum thickness of mGCIPL. t test was used to compared mGCIPL thickness between two groups using independent samples. Pearson correlation analysis was used to evaluate the correlation between mGCIPL thickness and age, birth gestational age, birth weight. Results:Patients in IVR group had significantly decreased mGCIPL thickness than that in LP group in the six sectors (superior, inferior, temporal-superior, temporal-inferior, nasal-superior and nasal-inferior) and the average and minimum ( t=6.484, 6.719, 7.682, 7.697, 5.151, 5.008, 7.148, 6.581; P<0.05). The thickness of mGCIPL was not significantly correlated with age, birth gestational age, birth weight ( P>0.05). Conclusion:The thickness of mGCIPL in patients with IVR treatment history is thinner than that in LP treatment.

Analysis of risk factors of nosocomial death in patients with cardiogenic shock / 中华急诊医学杂志

Objective:To investigate the risk factors of death in patients with cardiogenic shock (CS) in the Intensive Care Unit (ICU).Methods:This retrospective cohort study was conducted to collect the clinical data on critically ill patients from a number of hospitals in the United States released by the eICU Collaborative Research Database v2.0 (eICU-CRD v2.0) as of May 2018. The patients diagnosed with CS were selected and categorized into the survival and death groups according to the death in the hospital. The age, sex, and body mass index (BMI) of the enrolled patients were recorded, along with the acute physiology and chronic health evaluation Ⅳ (APACHE Ⅳ) score, simplified acute physiology score Ⅱ (SAPS Ⅱ), ethnicity, ICU type, clinical complications, diagnosis at admission, hemodynamic parameters, important treatments, and clinical outcomes. A propensity score was used to match age, BMI, and APACHE Ⅳ score, and SAPS Ⅱ. Multivariate Logistic regression analysis was performed to analyze the risk factors influencing ICU and hospital mortality, and the receiver operator characteristic (ROC) curve was used to evaluate its clinical utility.Results:In total, 33 998 in-hospital patients were included, among whom 27 596 patients survived and 6 402 died (18.83%), and 6 301 pairs were matched in preference. After matching, there were statistically significant differences between the two groups in the incidence of acute renal failure (29.33% vs. 31.82%), duration of mechanical ventilation [(6.05 ± 5.77) d vs (4.97 ± 5.11) d], length of ICU stay [(101.35 ± 154.59) h vs (110.15 ± 175.58) h] and length of hospital stay[ (12.73 ± 10.53) d vs (9.53 ± 10.35) d, P<0.01]. Multivariable logistic regression analysis revealed that age, BMI, APACHE Ⅳ score, SAPS Ⅱ, partial complications (except pacemaker implantation), diagnosis at admission (cardiac arrest, acute myocardial infarction, heart failure, respiratory system diseases, and digestive tract bleeding), and some treatments (noninvasive mechanical ventilation, blood purification, coronary artery bypass graft surgery, and vascular active drug application) were risk factors for hospital mortality in patients with CS ( P<0.05). Implantation of a ventricular assist device (VAD) was a protective measure against in-hospital death in patients with CS [hazard ratio ( HR)=0.49; 95% confidence interval (95% CI): 0.24-0.98; P=0.045). Multivariate ROC curve analysis revealed that the model could better predict ICU mortality [the area under the curve (AUC) =0.80 (95% CI: 0.784-0.816)] and hospital mortality [AUC=0.779 (95% CI, 0.765-0.793)] ( P <0.01). Conclusions:For patients with CS in ICU, age, BMI, APACHE Ⅳ score, SAPS Ⅱ, partial complications, diagnosis at admission (cardiac arrest, acute myocardial infarction, heart failure, respiratory system diseases and digestive tract bleeding), and some treatments (noninvasive mechanical ventilation, blood purification, CABG surgery, vascular active drug application) are independent risk factors for death. Implantation of a VAD can reduce the hospital mortality rate of patients with CS. The ROC curve of the related factors revealed that the model can better predict the clinical outcomes.

Thinking and practice on establishing a high-quality university education system of laboratory medicine / 中华检验医学杂志

It is an urgent need for the development of medical and health undertakings in the new era to build a high-quality university education system and cultivate high-quality personnel for laboratory medicine. In the process of building a national first-class specialty, the medical laboratory technology specialty of Southern Medical University adheres to the concept of high-quality university education and improves the training level of laboratory medicine personnel through the teaching reform practice of constructing the whole-process moral education system, systematical training mode, internationalized teaching team, and intelligent teaching technology. In this paper, we analyzed the connotation and construction experience of a high-quality university education system of laboratory medicine, in order to increase the exchange and communication between different colleges and universities, and make contributions to the national strategic goal of building a powerful country in education before 2035.

Extracellular vesicles of pathogenic microorganisms: friend or foe? / 中华检验医学杂志

Extracellular vesicles (EV) are lipid bilayer vesicles with a diameter of 30-1000 nm secreted by cells or microorganisms, which are abundant in proteins, nucleic acids, lipids and other biological information molecules. Therefore, EV can be used as a carrier, transferring materials between cells. At present, in infectious diseases, EV derived from pathogenic microorganisms could be considered as a double-edged sword, which means it can not only play a negative role in the host′s infection immunity, bacteria′s pathogenicity and antibiotic resistance transmission, but also manifest the advantages in clinical diagnosis and treatment.

Evaluation of the performance of systems for whole blood C-reactive protein detection: a multi-center study / 中华检验医学杂志

Objective:To explore the performance of the commonly used whole blood C-reactive protein (CRP) detection systems and give related recommendation on the performance requirements of detection systems.Methods:A total of 7 540 venous blood samples from 26 maternal, child and children′s hospitals were collected to conduct this multi-center study on the analytical performance of 5 commonly used whole blood CRP detection systems from March to April in 2019. The blank check, carryover, repeatability, intermediate precision, linearity, sample stability, influence of hematocrit/triglyceride/bilirubin, comparison with SIEMENS specific protein analyzer and trueness were evaluated. The 5 systems included BC-5390CRP autohematology analyzer, AstepPLUS specific protein analyzer, Ottoman-1000 Automated Specific Protein POCT Workstation, i-CHROMA Immunofluorometer equipment Reader and Orion QuikRead go detecting instrument. The 5 systems were labeled as a, b, c, d and e randomly.Results:Within the 5 systems, all values of blank check were less than 1.00 mg/L, the carryovers were lower than 1.00%. The repeatability of different ranges of CRP concentrations including 3.00-10.00, 10.00-30.00 and>30.00 mg/L were less than 10.00%, 6.00% and 5.00%, respectively, and the intermediate precision was less than 10.00%. The linearity correlation coefficients of the 5 systems were all above 0.975, while the slope was within 0.950-1.050. Whole blood samples were stable within 72 hours both at room temperature (18-25 ℃) and refrigerated temperature (2-8 ℃). The CRP results were rarely influenced by high triglyceride or bilirubin, except for the immmunoturbidimetric test based on microparticles coated with anti-human CRP F(ab) 2 fragments. When triglyceride was less than 15.46 mmol/L, the deviation of CRP was less than 10.00%. When bilirubin was less than 345.47 μmol/L, the deviation of CRP was less than 10.00%. CRP was more susceptible to Hct on the systems without Hct correction. The deviation of CRP between different Hct dilution concentration and 40% dilution concentration can reach as high as 67.48%. The correlation coefficients ( r) of 5 systems were all more than 0.975 in the range of 0-300.00 mg/L compared with Siemens specific protein analyzer. All systems passed the trueness verification using the samples with specified values of 12.89 and 30.60 mg/L. Conclusion:The performance of 5 systems can basically meet the clinical needs, but it is suggested that the whole blood CRP detection system without automatic Hct correction should be modified manually.

Prognostic factors of surgical therapy for abdominal aortic aneurysm in the area of Tibet plateau / 中华普通外科杂志

Objective:To analyze the feasibility of surgical therapy and the risk factors affecting prognosis for patients with abdominal aortic aneurysms in Tibetan plateau.Methods:Data of 48 abdominal aortic aneurysm cases were retrospectively analyzed at our hospital from Jun 2013 to Dec 2017.Results:Five cases received conservative treatment for suspected rupture of abdominal aortic aneurysm and all died. Eight cases left hospital without treatment, among them 5 cases died for rupture of abdominal aortic aneurysm.Thirty-five patients had abdominal aortic aneurysm resection and artificial vascular reconstruction. Successful rate was 100%. Perioperative complications developed in 5.7% patients; blood transfusion rate was 11.4%, there were non-perioperative death. Single-factor regression analysis showed that chronic altitude erythrocytosis as an independent risk factor with poor surgical prognosis ( P<0.05). Conclusion:Even in Tibet plateau, traditional surgery is a safe and effective method for treating abdominal aortic aneurysms. Chronic altitude erythrocytosis is an independent risk factor for poor surgical prognosis.

Target delineation and dosimetry analysis of 125I interstitial brachytherapy for recurrent adenoid cystic carcinoma in the parotid gland / 中华放射医学与防护杂志

Objective:To analyze the target design and dosimetric parameters of patients with recurrent adenoid cystic carcinoma (ACC) in the parotid gland who were treated with 125I interstitial brachytherapy alone. Methods:A retrospective analysis was conducted for 25 patients with recurrent adenoid cystic carcinoma in parotid gland who were histopathologically diagnosed between January 2015 and October 2019. These patients were treated with 125I interstitial brachytherapy alone, with prescribed doses of 100-120 Gy. The target volume was designed according to the pathological characteristics of ACC and recurrence sites. The pre- and post-operation dosimetric parameters (i.e., local control rates) were calculated using the treatment planning system. Results:In this study, the local recurrence sites included the superficial lobe (10/25) and deep lobe (7/25) of the parotid gland primarily and the skull base region (four patients) and mastoid posterior region (four patients) secondarily. The number of 125I seeds ranged from 16 to 111, with a median number of 59. The activity of radioactive particles was 18.5-25.9 MBq. The 3- and 5-year local control rates were 81.5% and 61.5%, respectively. No significant differences were found between pre- and post-operative dosimetric parameters such as D90, V100, and V150. There was no significant difference in local control rates among the four different recurrence sites. Conclusions:125I interstitial brachytherapy is proven to be an effective approach in the treatment of recurrent adenoid cystic carcinoma in the parotid gland. Satisfying local control rates can be achieved through target delineation performed according to recurrence sites and perineural invasion characteristics of ACC.

Debridement effectiveness of infected bone tissue of chronic hematogenous osteomyelitis in the lower extremities under the guidance of 99mTc-MDP SPECT/CT fused images / 中华创伤杂志

Objective:To explore the debridement effectiveness of infected bone tissue of chronic hematogenous osteomyelitis in the lower extremities under the guidance of 99mTc-MDP SPECT/CT fused images. Methods:A retrospective case series analysis was conducted on 21 patients with chronic hematogenous osteomyelitis in the lower extremities treated at Southwest Hospital of Army Medical University from May 2017 to June 2020. There were 8 males and 13 females, with the age range of 10-62 years [23(18, 37)years]. The tibial infections were found in 16 patients, and femoral infections in 5 patients. The duration of bone infection was 4-480 months [120(42, 228)months]. According to the Cierny-Mader anatomico-physiological system, 4 patients were classified as type I, 14 as type III, 3 as type IV; 18 patients were classified as type A and 3 as type B. Intraoperative debridement of infected bone tissue was operated at stage I on the region of interest (ROI) where the isocontour(ISO) value was between 30%-40%, using the preoperative 99mTc-MDP SPECT/CT fused images as the reference. The stage II bone defect reconstruction was based on autologous and / or allogeneic bone. To observe the frequency of operations regarding bone infection control in stage I. The preoperative white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), intraoperative bacterial culture and pathological examination were compared at stages I and II. The skin redness and swellings, pain, sinus tract in the infected limbs, and ossification of grafted bones in the original bone defect part were observed at stage II. The accuracy rate between ISO value in the region of interest (ROI) and set ISO figure was checked. The difference of longitudinal length of the bone debridement area in ROI area with the actual bone debridement area was observed under the coronal position. Results:All patients were followed up for 6-36 months [11(9, 29)months] after stage II operation. All of the 21 patients had undergone operations of infection control with an average number of 1.04 times in stage I. 1 patient's intraoperative frozen section indicated that neutrophils were>5/HP. The bone graft at stage II had been completed after another debridement. Comparison of preoperative inflammatory markers at stages I and II: the WBC was decreased from (5.9±1.6)×10 9/L to (5.4±1.5)×10 9/L ( P>0.05), the ESR decreased from 9(5, 26)mm/h to 4(2, 10)mm/h ( P<0.05), and the CRP decreased from 2.8(2.3, 7.7)mg/L to 2.3(1.4, 3.0)mg/L ( P>0.05). The results of bacterial culture of tissue at stage I were positive in 12 patients and negative in 9 patients. The pathological examination indicated neutrophils and lymphocyte infiltration. The results of bacterial culture of tissue at stage II were all negative. A modicum of plasmacyte and lymphocyte infiltration and the neutrophils (<5 per/Hp) had been found in the intraoperative frozen section and pathological examination. No redness, swelling or sinus tract was found in the skin after stage II surgery and ossification of grafted bone was good. The accuracy rate between ISO value in the ROI and set ISO figure was 90.5%. The comparison between longitudinal debridement scope of ROI [(86.8±31.1)mm] and actual bone tissue debridement scope [(86.0±31.3)mm] at stage I showed no significant difference ( P>0.05). Conclusions:99mTc-MDP SPECT/CT fused images can be used as an effective means to define the debridement scope of infected bone tissue preoperatively. The method can not only avoid excessive debridement, but also improve the cure rate of hematogenous osteomyelitis in the lower extremities.

Gene variation analysis and prenatal diagnosis for 54 families with oculocutaneous albinism / 中华围产医学杂志

Objective:To investigate the pathogenic gene locus and prenatal genetic diagnosis of 54 families with oculocutaneous albinism (OCA).Methods:This retrospective study enrolled 54 OCA probands and their families from Gansu Province Maternal and Child Health Care Hospital from May 2014 to May 2020. TYR gene variation screening was performed on the probands by Sanger sequencing. Those with negative results were analyzed by high-throughput sequencing, and further verification was performed on their parents by Sanger sequencing. Among the 54 families, 15 ml amniotic fluid were collected from 16 women at 18-21 gestational weeks in their subsequent pregnancy. Sanger sequencing combined with short tandem repeats sequence for linkage analysis were performed for genetic analysis. All data were analyzed using descriptive statistical analysis. Results:Out of the 54 OCA probands, 48 were diagnosed as OCA1, five were OCA2 and one was OCA4 based on the Sanger sequencing and high-throughput sequencing detection. A total of 26 different variation sites were involved in the 48 OCA1 probands, including 15 missense mutations, five nonsense mutations, three splicing mutations, and three frame-shift mutations, among which, c.929insC (29%, 28/96) was the most frequent mutation, followed by c.896G>A (11%, 11/96), c.832C>T (8%, 8/96) and c.703T>C (5%, 5/96). The diagnosis was confirmed in all 16 fetuses in the 16 families that underwent prenatal diagnosis. Five of them were affected and their mothers chose to terminate the pregnancies, the other 11 pregnancies continued to delivery, including seven heterozygous carriers and four fetuses without the same pathogenic allele as the proband. Maternal contamination was excluded in all prenatal samples using short tandem repeat for linkage analysis. All 11 children were in good health during telephone follow-up one month after birth. Postnatal validations were consistent with the prenatal tests.Conclusions:Genetic diagnosis could accurately identify various types of OCA and help to provide prenatal diagnosis and fertility consultation for subsequent pregnancies.

Application of digital surgical techniques in radioactive 125I seed implantation for brachytherapy of deep head and neck tumors / 中华放射医学与防护杂志

Objective:To explore and evaluate the accuracy, conformity, and clinical application value of digital surgical techniques in guiding 125I seed implantation in the brachytherapy of deep head and neck tumors. Methods:Twelve patients with deep head and neck tumors who received brachytherapy of radioactive 125I seed implantation were selected for the study.The locations of the implantation needles and seeds were designed based on CT images before the operation.A digital positioning model was built according to the treatment plan to accurately import the planned locations of implantation needles into the surgical navigation system.Meanwhile, an individualized puncture guidance template was designed and printed according to the patients′ facial profiles as well as the locations and directions of the implantation needles.During the operation, the template was put in place under the guidance of the navigation system and meanwhile, the implantation needle puncture and radioactive seed implantation were conducted under the joint guidance of the visual needle path and real-time implantation needle locations in the navigation system and template guidance holes.The locations of the implantation needle and the seeds were validated by CT scan and the dose distribution in target areas was calculated.Adverse reactions such as hematoma, pain, infection, nonunion of puncture sites, and tumor cell implantation were observed during and after the operation. Results:All 12 patients successfully received implantation needle puncture and radioactive seed implantation under the guidance of the digital surgical techniques, achieving excellent effects of real-time visualization guidance.Meanwhile, the locations and number of the implantation needles and seeds were consistent with the treatment plan and were distributed evenly.Furthermore, according to postoperative verification, D90 ranged from 83.7 Gy to 131.0 Gy, with an average of 107.5 Gy; V100 was 89.6%-99.3%, with an average of 94.6%, and V150 ranged from 40.2% to 58.9%, averaging 47.8%.No serious adverse reactions were observed during and after the operation. Conclusions:With digital surgical techniques, the surgical navigation system and 3D-printed individualized puncture guidance template jointly guided the implantation needle puncture and 125I seed implantation, improving the accuracy and conformity of the brachytherapy.Therefore, they have clinical application value in head and neck brachytherapy, especially in deep areas with complex anatomical structures.