Impact of autonomic nerve function on motor function in patients with post-stroke depression / 中国康复理论与实践

ObjectiveTo explore the impact of autonomic nerve function on motor function in patients with post-stroke depression (PSD) from the perspective of regional homogeneity (ReHo). MethodsFrom January to December, 2020, a total of 60 inpatients and outpatients with cerebral infarction in the Affiliated Brain Hospital of Nanjing Medical University were divided into control group (n = 30) and PSD group (n = 30). Two groups were assessed using Fugl-Meyer Assessment (FMA), modified Barthel Index (MBI) and Hamilton Depression Scale (HAMD). Heart rate variability (HRV) was measured. Ten patients in each group were selected randomly to undergo resting state functional magnetic resonance imaging (rs-fMRI) to calculate ReHo. ResultsAll HRV indices were lower in PSD group than in the control group (|t| > 2.092, P < 0.05). In PSD group, FMA and MBI scores showed positive correlations with 24-hour standard deviation of normal-to-normal R-R intervals (SDNN), the root mean square of successive differences between normal heartbeats over 24 hours (RMSSD), the percentage of differences between adjacent normal R-R intervals over 24 hours that were greater than 50 ms (PNN50), total power (TP), very low frequency power (VLF) and low frequency power (LF) (r > 0.394, P < 0.05), and showed negative correlations with HAMD scores (|r| > 0.919, P < 0.001). HAMD scores in PSD group were negatively correlated with SDNN, RMSSD, PNN50, TP and VLF (|r| > 0.769, P < 0.001). Compared with the control group, the ReHo increased in PSD group in the right rectus gyrus (142 voxels, t = 6.575), the left medial and paracingulate gyri (204 voxels, t = 4.925) (GRF correction, P-Voxel < 0.005，P-Cluster < 0.05); and reduced in the right cerebellum (191 voxels, t = -6.487), the left middle temporal gyrus (140 voxels, t = -5.516), and the left precentral gyrus (119 voxels, t = -4.764) (GRF correction, P-Voxel < 0.005，P-Cluster < 0.05) in PSD group. ConclusionAutonomic nerve function is related to motor dysfunction in patients with PSD. The modulation of emotional, cognitive and motor brain regions by the autonomic nervous system may play a role in influencing the motor function in patients with PSD.

Effectiveness of finger reconstruction using nail flap anastomosing nerve branch of the first toe nail bed / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of finger reconstruction using nail flap anastomosing the nerve branch of the first toe nail bed.@*METHODS@#Between January 2016 and December 2022, 18 patients (18 fingers) with thumb or finger nail bed defects were admitted. There were 12 males and 6 females, with an average age of 32 years (range, 19-42 years). Four cases were finger tip tissue damage caused by machine compression, and 4 cases were distal tissue necrosis after finger replantation. There were 9 cases of thumb injury, 3 cases of index finger injury, 5 cases of middle finger injury, and 1 case of ring finger injury. There were 11 cases of distal nail damage and 7 cases of distal nail root (including nail root) damage. The time from injury to admission was 1-5 hours, with an average of 2 hours. After debridement and anti-infection treatment for 5-7 days, the wounds in size of 1 cm×1 cm to 4 cm×3 cm were reconstructed by using nail flaps anastomosing the nerve branches of the first toe nail bed. The size of the nail flaps ranged from 1.5 cm×1.5 cm to 4.5 cm×3.5 cm. The donor sites were repaired with the flaps in 16 cases and skin graft in 2 cases.@*RESULTS@#All nail flaps, flaps, and skin grafts survived after operation and the wounds healed by first intention. All patients were followed up 6-12 months (mean, 10 months). The nails of 18 cases were all grown, in which 16 cases had smooth nails with satisfactory appearances, 1 case had uneven nails, and 1 case had obvious scar hyperplasia around the suture opening. At 6 months after operation, the two-point discrimination of the skin flap was 4-8 mm (mean, 6 mm). Meanwhile, the skin grafts and flaps at the donor sites regained protective sensation, good abrasion resistance, and had no negative effect upon walking and wearing shoes.@*CONCLUSION@#The application of a nail flap that anastomoses the nerve branch of the first toe nail bed for finger reconstruction has minimal damage and can achieve good nail bed repair results.

Laboratory testing strategies for human immunodeficiency virus (HIV) in blood donors / 细胞与分子免疫学杂志

Objective To propose the blood detection strategies for human immunodeficiency virus (HIV) among blood donors, and provide reference for the detection, early diagnosis and transmission blocking of HIV. Methods A total of 117 987 blood samples from blood donors were screened using the third- and fourth-generation ELISA HIV detection reagents. Western blot analysis was used to verify the reactive results of the third-generation reagent alone, or both the third-generation and fourth-generation reagents. HIV nucleic acid test was carried out for those with negative test results of the third- and fourth-generation reagents. For those with positive results of the fourth-generation reagent only, nucleic acid test followed by a confirmatory test by Western blot analysis was carried out. Results 117 987 blood samples from blood donors were tested by different reagents. Among them, 55 were tested positive by both the third- and fourth-generation HIV detection reagents at the same time, accounting for 0.047% and 54 cases were confirmed HIV-positive by Western blot analysis, and 1 case was indeterminate, then turned positive during follow-up testing. 26 cases were positive by the third-generation reagent test alone, among which 24 cases were negative and 2 were indeterminate by Western blot analysis. The band types were p24 and gp160 respectively detected by Western blot analysis, and were confirmed to be HIV negative in follow-up testing. 31 cases were positive by the fourth-generation HIV reagent alone, among which 29 were negative by nucleic acid test, and 2 were positive according to the nucleic acid test.Western blot analysis was used to verify that the two cases were negative. However, after 2~4 weeks, the results turned positive when the blood sample was retested by Western blot analysis during the follow-up of these two cases. All the specimens that were tested negative by both the third- and fourth-generation HIV reagents were validated negative by HIV nucleic acid test. Conclusion A combined strategy with both third- and fourth-generation HIV detection reagents can play a complementary role in blood screening among blood donors. The application of complementary tests, such as nucleic acid test and Western blot analysis, can further improve the safety of blood supply, thus contributing to the early diagnosis, prevention, transmission and treatment of blood donors potentially infected by HIV.

Research on the construction of structural equation model of factors affecting the long-term care needs of the disabled elderly in elderly care institutions / 中国实用护理杂志

Objective:To explore the mechanism of factors affecting the long-term care needs of disabled elderly in elderly care institutions, and provide basis for taking targeted nursing intervention.Methods:From July to November 2018, convenience sampling method was used to conduct cross-sectional survey of the current situation and influencing factors of long-term care needs of 508 disabled elderly people in 10 elderly care institutions in Baoding City by general information questionnaire, Barthel index, the Long-term Care Needs of the Disabled Elderly in elderly care institutions, the Questionnaire on the Factors Affecting the Long-term Care Needs of the Disabled Elderly in elderly care institutions. SPSS 21.0 was used for correlation analysis and multiple regression analysis, and AMOS 24.0 was used for model fitting, path and mediation effect analysis.Results:The score of long-term care needs of the disabled elderly in elderly care institution was (105.04 ± 21.68) points; the scores of intra-personal, interpersonal, and extra-personal factors were (16.93 ± 5.20) points, (10.51 ± 3.39) points, (19.80 ± 6.24) points, respectively. Intra-individual factors, interpersonal factors, extra-individual factors and care needs were all positively correlated ( r values were 0.222-0.645, P<0.05). Intra-individual, inter-personal and extra-individual factors could directly affect the long-term care needs of the disabled elderly ( β=0.455, 0.527, 0.403); intra-individual and inter-personal factors had independent mediating effects and chain mediating effects between extra-individual factors and the long-term care needs of the disabled elderly, and the effects were significant, with effect value of 0.078, 0.095 and 0.023, accounting for 15.15%, 18.45% and 4.47% of the total effect, respectively. Conclusions:Each influencing factor has a strong ability to predict and explain the long-term care needs of the disabled elderly, and nursing staff could meet the care needs of the disabled elderly according to different influencing factors.

Effects of preoperative dezocine patient-controlled analgesia pump on stress response and cognitive function in elderly patients with lower extremity fractures / 中国临床药理学与治疗学

AIM: To explore the effects of preoperative application of dezocine patient-controlled analgesia pump on stress response and cognitive function in elderly patients with lower extremity fractures. METHODS: A total of 80 elderly patients with lower extremity fractures who were treated from November 2018 to June 2020 were selected and randomly divided into a control group and a study group, 40 cases in each. The control group was not given a patient-controlled analgesia pump before anesthesia, and the study group was given intravenous analgesia with a dezocine patient-controlled analgesia pump before surgery. The postoperative stress response, cognitive function and safety were compared between the two groups.RESULTS: There were no significant differences in cognitive function MMSE score, stress response index (cortisol, epinephrine) levels, and inflammatory factors (IL-6, TNF-α) levels between the two groups before intervention (P>0.05). Compared with the indexes after operation, the MMSE scores of the study group at 12 h, 24 h and 3 days after operation were higher than those in the control group (P<0.05); The levels of cortisol, epinephrine, IL-6 and TNF-α in the study group were lower than those in the control group at 12 h and 24 h after operation (P<0.05); At the same time, the incidences of respiratory depression, urinary retention and nausea and vomiting in the study group were significantly lower than those in the control group (P<0.05).CONCLUSION: Preoperative application of dezocine patient-controlled analgesia pump in elderly patients with lower extremity fracture can significantly reduce postoperative stress response, reduce inflammatory response, and improve postoperative cognitive function, which is worthy of clinical application.

The influence of sporadic cases of COVID-19 on the work of Transfusion Department and its countermeasures / 中国输血杂志

【Objective】 To analyze the impact of sporadic cases of COVID-19 on the work of Transfusion Department, so as to explore the countermeasures. 【Methods】 The admission of inpatient departments, the reception of outpatient(including emergency) departments, the workload of transfusion department(including blood typing, unexpected antibody screening and cross matching), and the consumption of blood components in the Xijing Hospital between October and November in 2021, during COVID-19 outbreak, were collected. All the above data was statistically compared to the data in same period in 2018, before the COVID-19 outbreak. 【Results】 Due to the COVID-19 epidemic, there was a significant decrease in number of inpatients(280±157.1 vs 340.4±110.2), outpatient(including emergency)(8 359±3 615 vs 10 151±3 225), the workload of blood typing(272.0±132.4 vs 341.6±110.4), unexpected antibody screening(78.26±42.22 vs 98.51±43.53) and crossmatch(237.2±99 vs 475.7±155.6), as well as the consumption(U) of all blood components(457.9±50.32 vs 579.4±62.51) in the Xijing Hospital(P<0.05). In detail, the epidemic had the most direct impact on the number of inpatients and outpatients, which shrank continuously on the 2nd day after official announcement of the new COVID-1 cases. While the workload of blood typing, unexpected antibody screening and crossmatch decreased slightly, with a lag, usually on the 2nd, 3rd and 5th day after official announcement. The decrease of the usage of red blood cells and plasma began from the 7th day after the new epidemic to the 6th day after the end of the epidemic. However, the usage platelets and cryoprecipitate coagulation factors decreased from the 8th and 10th day after the new epidemic to the 2nd and 6th day after the end of the epidemic, respectively. 【Conclusion】 The daily work of Blood Transfusion Department has been seriously affected by sporadic COVID-19 epidemic. The working mode, staff structure and inventory ratio of blood components should be adjusted and optimized instantly to maintain the normal conduct of medical treatments in hospitals and ensure the safety of patients.

Clinical application of laparoscopic sentinel lymph node mapping in early staged cervical cancer / 中华妇产科杂志

Objective:To investigate the application of sentinel lymph node biopsy (SLNB) in early-staged cervical cancer by laparoscopy.Methods:It was a prospective, single-arm, single-center clinical study. Seventy-eight cases of cervical cancer patients were collected from July 2015 to December 2018 at the Fourth Hospital of Hebei Medical University. All the patients were injected with tracer into the disease-free block of cervical tissue after anesthesia by the same surgeon who learned sentinel lymph node (SLN) mapping technique in Memorial Sloan-Kettering Cancer Center, and underwent SLN mapping followed by complete pelvic lymphadenectomy. Moreover, all the dissected lymph nodes were stained with hematoxylin eosin staining (HE) pathological examination. Besides, the negative SLN on hematoxylin-eosin staining were detected by immunohistochemistry cytokeratin staining micro-metastasis. To analyze the distribution, detection rate, false negative rate the sensitivity and negative predictive value of the SLN in early-staged cervical cancer by laparoscopy, and explore the value of SLN mapping in predicting the lymph nodes metastasis in early-staged cervical cancer.Results:The overall detection rate of SLN in cervical cancer was 99% (77/78), bilateral detection rate was 87% (68/78). The average of 12.4 lymph node (LN) and 3.6 SLN were dissected for each patients each side. SLN of cervical cancer were mainly distributed in the obturator space (61.5%, 343/558), followed by external iliac (23.5%, 131/558), common iliac (7.3%, 41/558), para-uterine (3.8%, 21/558), internal iliac (2.2%, 12/558), para abdominal aorta (1.1%, 6/558), and anterior sacral lymphatic drainage area (0.7%, 4/558). Fourteen cases of LN metastasis were found among all 78 cases. There were a total of 38 positive LN, including 26 SLN metastasis and 12 none sentinel LN metastasis. Through immunohistochemical staining and pathological ultra-staging, 1 SLN was found to be isolated tumor cells (ITC), and 5 SLNs were found to be micro-metastases (MIC), accounting for 23% (6/26) of positive SLN. SLN mapping with pathological ultra-staging improved the prediction of LN metastasis in cervical cancer (2/14). Metastatic SLN mainly distributed in the obturator space (65%, 17/26), peri-uterine region (12%, 3/26), common iliac region (15%, 4/26), and external iliac region (8%, 2/26). The consistency of the diagnosis of lymph node metastasis by SLN biopsy and postoperative retroperitoneal lymph node metastasis showed that the Kappa value was 1.000 ( P<0.001), indicated that the metastasis status of SLN and retroperitoneal lymph node were completely consistent. The sensitivity, specificity, accuracy, false-negative rate, and negative predictive value of SLN biopsy in the diagnosis of lymph node metastasis were 100%, 100%, 100%, 0, and 100%, respectively. Conclusions:SLN in early-staged cervical cancer patients were mainly distributed in the obturator and external iliac space, pathalogical ultra-staging of SLN could improve the prediction of LN metastasis. Intraoperative SLN mapping is safe, feasible and could predict the state of retroperitoneal LN metastasis in early-staged cervical cancer. SLNB may replace systemic pelvic lymphadenectomy.

Design and application of an anti-pull device for medical drainage tube / 中华危重病急救医学

The management of drainage tube is an important part of nursing work. Patient restraint and tube fixation cannot effectively prevent unplanned extubation (UEX) when the tube is accidentally pulled by violence. The nursing innovation team of Henan Provincial People's Hospital designed a medical drainage tube anti-pull device in order to change the existing technology of preventing drainage tube disconnecting by means of restraint and fixation, and to interfere with the basic cause of drainage tube disconnection, and obtained the national utility model patent (patent number: ZL 2020 2 2843025.1). The design of sleeve and clasp is that when the drainage tube is pulled by accidental violence, the friction fastener clamps the drainage tube mechanically to achieve the purpose of braking the drainage tube and prevent the drainage tube from coming out. Card sleeve ring fracture design can be applied to drainage tubes of different diameters, and the buzzer device at the instant of the snap ring into the card set warning medical staff to the occurrence of risk events, so that the nurse can come in the first place for effective treatment, which is a fuse for surgical drainage tubes and is to timely and effectively prevent UEX.

Lymphedema and retroperitoneal fibrosis / 中华风湿病学杂志

Objective:To improve the understanding of the relationship between lymphedema and retroperitoneal fibrosis (RPF).Methods:Four cases with lymphedema and RPF in Beijing Shijitan Hospital Capital Medical University were reported. The diagnosis and treatment were analyzed and discussed.Results:All four patients had lymphedema onset and imaging showed suspicious RPF. One case of non-Hodgkin's lymphoma was confirmed by lymph node biopsy. The malignant lesions were excluded in the other two cases by pathology or positron emission tomography (PET)/computerized tomography (CT). They were proved to be idiopathic retroperitoneal fibrosis after treatment with glucocorticoid combined immunosuppressive agents. Another case was systemic amyloidosis mimicking retroperitoneal fibrosis.Conclusion:Lymphatic involvement in RPF is relatively rare, and the possibility of RPF should be considered when patients develop lymphedema. Even if the initial diagnosis is RPF, we should be wary of tumors or other diseases. Imaging examination should be performed, and tissue biopsy should be used if necessary, so as to facilitate early diagnosis and treatment and improve the prognosis of patients.

Recent developments on PET radiotracers for TSPO and their applications in neuroimaging

The 18 kDa translocator protein (TSPO), previously known as the peripheral benzodiazepine receptor, is predominately localized to the outer mitochondrial membrane in steroidogenic cells. Brain TSPO expression is relatively low under physiological conditions, but is upregulated in response to glial cell activation. As the primary index of neuroinflammation, TSPO is implicated in the pathogenesis and progression of numerous neuropsychiatric disorders and neurodegenerative diseases, including Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), Parkinson's disease (PD), multiple sclerosis (MS), major depressive disorder (MDD) and obsessive compulsive disorder (OCD). In this context, numerous TSPO-targeted positron emission tomography (PET) tracers have been developed. Among them, several radioligands have advanced to clinical research studies. In this review, we will overview the recent development of TSPO PET tracers, focusing on the radioligand design, radioisotope labeling, pharmacokinetics, and PET imaging evaluation. Additionally, we will consider current limitations, as well as translational potential for future application of TSPO radiopharmaceuticals. This review aims to not only present the challenges in current TSPO PET imaging, but to also provide a new perspective on TSPO targeted PET tracer discovery efforts. Addressing these challenges will facilitate the translation of TSPO in clinical studies of neuroinflammation associated with central nervous system diseases.

Advances in the management of psoriatic arthritis / 中国临床药理学与治疗学

Psoriatic arthritis (PsA), which affects musculoskeletal structures, skin and nails, is a chronic inflammatory disease. The treatment of PsA has changed tremendously over the past decade owing to the improvement in early diagnosis and treatment strategies. TNF-α blockers, including adalimumab, etanercept, golimumab and infliximab, are representatives of a revolution in the treatment of PsA. Certolizumab (a new anti-TNF agent) and ustekinumab (a fully human monoclonal antibody against IL-12 and IL-23) are approved for the treatment of active PsA. In recent years, multiple small molecule drugs targeting Janus kinase/signal transducers and activators of transcription signaling pathway have been developed and applied to treat PsA in clinic. Developing better targeted drugs is an important research direction for the treatment of psA in the future.

Bilateral middle pontine brachium and cerebral peduncula infarction: a case report / 中华神经科杂志

Bilateral middle pontine brachium and cerebral peduncula infarction is an extremely rare posterior circulation infarction.This article analyzed a patient with bilateral middle pontine brachium and cerebral peduncula infarction, reviewed the literature, and determined the cause through detailed medical history and imaging examinations.

Clinical study on the treatment of anorexia in children by Tui Na therapy combined with self-made Jianpi-Tiaogan Decoction / 国际中医中药杂志

Objective:To evaluate the efficacy of Tui Na therapy combined with self-made Jianpi-Tiaogan Decoction in the treatment of anorexia in children. Methods:A total of 92 patients with pediatric anorexia in our hospital from January 2018 to June 2019 who met the inclusion criteria were divided into 2 groups by random number table method, with 46 patients in each group. The control group was treated with the Tui Na therapy mainly by manipulating on the abdomen and pushing the spleen, and the treatment group was given the self-made Jianpi-Tiaogan Decoction on the basis of the treatment of the control group. Both groups were treated for 4 weeks. The TCM syndrome scores were performed, serum Leptin and Ghrelin levels were measures by enzyme linked immunosorbent assay, serum neuropeptide Y (NPY) was measured by radioimmunoassay, contents of blood zinc and salivary amylase ptyalase were measured by flame atomic absorption spectrometry and Western blot, and D-xylose absorption test was carried out respectively before and after treatment. And the clinical efficacy was evaluated. Results:The total effective rate was 91.3% (42/46) in the treatment group and 73.9% (34/46) in the control group. The difference between the two groups was statistically significant ( χ2=4.821, P=0.028). After treatment, the scores of anorexia, antifeedance, irritability, agitation, hiccup and belching, fullness of chest and flank, thin shape, sleep difficulty and total score in the treatment group were significantly lower than those in the control group ( t values were 6.782, 7.524, 9.100, 5.643, 4.796, 6.066, 4.069, 3.197, 5.073, respectively, all Ps<0.01). After treatment, the serum NPY (133.7 ± 12.4 ng/L vs. 105.6 ± 10.8 ng/L, t=11.589) and Ghrelin (329.6 ± 26.1 ng/L vs. 275.4 ± 25.0 ng/L, t=12.211) levels in the treatment group were significantly higher than those in the control group ( P<0.01), but Leptin (21.7 ± 4.0 g/L vs. 25.2 ± 4.3 g/L, t=4.042) was significantly lower than that of the control group ( P<0.01). After treatment, blood zinc (9.9 ± 2.5 mol/L vs. 8.7 ± 2.3 mol/L, t=2.396), salivary amylase ptyalase content (23.5 ± 4.2 U/L vs. 17.9 ± 3.6 U/L, t=6.866), D-xylose absorption test (0.9 ± 0.4 ng/L vs. 0.7 ± 0.3 ng/L, t=2.713) were significantly higher than those in the control group ( P<0.05 or P<0.01). Conclusions:Tui Na therapy combined with self-made Jianpi-Tiaogan Decoction can improve TCM syndromes of children, regulate the levels of NPY, Leptin and Ghrelin, and improve clinical efficacy.

MiR-665 Promotes the Biological Behavior of Small Cell Lung Cancer by Targeting LLGL1 / 中国肺癌杂志

BACKGROUND@#MicroRNAs (miRNAs) are non-coding small molecule RNAs that are widely found in eukaryotic organisms, although some miRNAs have been found in tumors, the expression and effects of miR-665 on small cell lung cancer (SCLC) are unclear. The aim of this study was to analyze the effects of miR-665 on proliferation, cycle, invasion and migration of SCLC cells, and to explore the role of miR-665 in SCLC and its working mechanism.@*METHODS@#The expression of miR-665 in SCLC tissues and adjacent normal tissues was detected by qRT-PCR. TargetScan predicted potential target genes for miR-665 and validated with dual luciferase reporter assays, qRT-PCR and Western blot. CCK8 assay, flow cytometry, Transwell and wound healing assay to detect the effects of miR-665 and LLGL1 on proliferation, invasion, migration and S-phase fraction of SCLC cell line NCI-H446, NCI-H1688. A nude mouse xenograft model of SCLC was constructed and the effect of miR-665 on tumor growth in mice was observed.@*RESULTS@#The expression of miR-665 in SCLC tissues was significantly higher than that in non-tumor normal tissues. MiR-665 could target 3'-UTR of LLGL1 and inhibit its expression. Compared with non-tumor normal tissues, the expression of LLGL1 was significantly lower in SCLC tissues. Inhibition of miR-665 expression could inhibit proliferation, S-phase fraction, invasion and migration ability of SCLC NCL-H446 cells, and interference LLGL1 expression could reverse this inhibition effect. Up-regulation of miR-665 expression could promoted proliferation, S-phase fraction, invasion and migration ability of SCLC NCI-H1688 cells, but this promotion effect was also reversed by overexpression of LLGL1. In a nude mouse xenograft model of SCLC, inhibition of miR-665 expression could up-regulate LLGL1 protein expression and inhibit tumor growth, while up-regulation of miR-665 expression could produce opposite results.@*CONCLUSIONS@#The expression of miR-665 is closely related to SCLC. miR-665 can promote the biological behavior of SCLC cells by inhibiting the expression of target gene LLGL1, and miR-665 play a role in tumor-promoting genes in SCLC.

Examination characteristics and therapeutic approach on integrated traditional Chinese and western medicine for treatment of infants with gastric volvulus and gastroesophageal reflux-induced pneumonia / 中国中西医结合急救杂志

Objective To observe the influences on prognoses and airway acid and base levels while using anti-inflammatory and anti-reflux therapies combined with "Hezhong Fuzheng massage" for treatment of infants with gastric volvulus (GV) and gastroesophageal reflux (GER)-induced pneumonia in order to provide evidence for clinical diagnosis and treatment of such infant disease. Methods Sixty infants 1-6 months old admitted to the Department of Integrated Traditional Chinese and Western Medicine of Wuhan Children's Hospital from January 2013 to December 2015 were diagnosed as pneumonia combined with GV and GER by the chest radiograph and radiography of upper gastrointestinal tract (UGT) with iodine, and according to difference in diagnostic methods, they were divided into an observation 1 group (30 cases) and an observation 2 group (30 cases). In observation 1 group, 24-hour pH value in upper digestive tract especially the distal esophagus was dynamically monitored, while in observation 2 group, 24-hour multichannel intraluminal impedance (MII) combined with pH monitoring of esophagus was carried out. Furthermore, two control groups were set up, each 30 cases; after radiography of the UGT with iodine, the control 1 group was diagnosed as GV and GER without pneumonia and control 2 group was diagnosed as only simple GV. Treatment of infant pneumonia was carried out in accordance with the guidelines for the management of community-acquired pneumonia in children; the treatment of GV and GER included postural, dietary, prokinetic and Hezhong Fuzheng massage [acupoint selection and massage was undertaken in 5 steps: push from the palmar crease to Banmen (rectilinear pushing manipulation) 300 times, push abdominal Yin and Yang (finger-pushing massage) 200 times, palpate the abdomen (clockwise) 100 times, poking of Tianshu 100 times, poke alternately bilateral Zusanli 100 times. Once-daily massage, (15±2) minutes each time, for consecutive 7 days]. The results of pH monitoring of the distal esophagus in observation 1 group was recorded; All GER data concerning pH monitoring of observation 2 group and the results of esophagus multi-channel intra-luminal impedance combined with pH monitoring in control group were compared. After 7 days of continuous treatment, the clinical efficacy of pneumonia and GV, hospitalization time, prognosis and the changes of sputum pH before and after treatment in the two observation groups were compared. Results In two observation groups, the main type of 60 cases with GV was organoaxial volvulus, accounting for 91.67% (55 cases), and more than 60% patients exhibited sputum pH <7.0. The distal esophagus 24-hour pH dynamic monitoring in observation 1 group showed that there were 26 cases with acid reflux (86.67%), 4 cases with GER negative (13.33%), the proportion of pH < 4 in GER negative patients was significantly lower than that in moderate acid reflux patients [3.35% (0.77% - 8.08%) vs. 26.23% (15.19% - 42.87%), P < 0.05], the number of long reflux (> 5 minutes) in GER negative patients was significantly reduced than that in mild acid reflux patients [times: 2 (0-5) vs. 7 (2-15), P < 0.05], the longest time of reflux in GER negative patients was significantly shorter than that in either mild or moderate acid reflux patients [minutes: 5.9 (2.5-10.0) vs. 19.2 (5.9-51.0), 41.6 (16.9-121.0), both P < 0.05]. The 24-hour MII-pH monitoring of esophagus in observation 2 group showed that there were 30 cases with pathological reflux, mainly mild acid reflux accounting for 90%, in which the percentage of proximal reflux events was 46.07% in the total reflux events. The numbers of acid reflux and proximal reflux in the observation 2 group were significantly higher than those in the control 1 and 2 groups [1 305 (37.72%) vs. 795 (25.69%) and 136 (18.89%), 1 594 (46.07%) vs. 687 (22.20%) and 154 (21.39%), both P < 0.05]; there were no significant differences in total effective rate (100% vs. 100%, P > 0.05) and hospitalization time (days: 7.58±1.09 vs. 7.67±1.12, P > 0.05) between the two observation groups. Conclusions For the diagnosis of infant pneumonia combined with GV and GER, the first selection of chest radiograph and radiography of the UGT with iodine can identify the severity of pneumonia, whether it is complicated with GV and its classification, and whether GER exists at the same time. The estimation of 24-hour pH dynamic monitoring of the acid reflux in the upper digestive tract especially the distal esophagus is consistent with that of the 24-hour MII-PH monitoring of esophagus. Moreover, 24-hour MII-PH monitoring of esophagus can also identify non-acid reflux, resulting in the GER diagnosis more accurate. Since the proximal reflux ratio of infants with GV combined with GER and pneumonia is relatively high and easy to cause cough and aspiration. attention should be paid on early diagnosis and timely intervention to such patients. The sputum acidity test can reflect the airway acid-base level and its manipulation is simple, so by that the real time disease situation can be estimated, and aspiration of sputum also can help the treatment. The therapeutic schedule formulated by our group can elevate the therapeutic effect, improve the airway acid-base environment and benefit prognosis.

Preliminary investigation on the influencing factors and health impacts of hookworm infection in South Mountain area of Zhejiang Province / 中华地方病学杂志

Objective To understand the demographic characteristics and clinical features of hookworm infectors in high infection area in South Mountain area of Zhejiang Province,and to find the risk factors of infection,so as to provide the evidence for formulating prevention and control measures.Methods In 2018,according to the soil-borne nematode monitoring results of the previous year in Zhejiang Province,three villages with relatively more hookworm infections were selected from Qingtian County in South Mountain area of Zhejiang Province,and more than 10 cases of hookworm infection were selected from each survey site.A face to face questionnaire survey was conducted by all investigators using a questionnaire designed by the Center for Infectious Disease Control and Prevention,Zhejiang Provincial Center for Disease Control and Prevention,and information on the general condition,past diagnosis history,clinical symptoms and risk factors of infection of infected persons were collected.The stool samples were collected and tested for infection by modified Kato-Katz method to evaluate the drug deworming effect in the previous year.Results A total of 33 cases of hookworm infection were investigated,including 18 males and 15 females;the age ranged from 33-85 years old,mainly concentrated in 60-79 years old,a total of 23 cases (69.7％).Ten cases (30.3％) had been diagnosed with hookworm disease;19 cases (57.6％) had similar symptoms of hooky dermatitis;and 12 cases (36.4％) had gastrointestinal symptoms in the past three years.There were 31 cases (93.9％) worked in the field for more than one month each year,18 cases (54.5％) used fresh manure directly at home,6 cases (18.2％) were used to working barefoot in the field,and 30 cases (90.9％) used to wearing slippers in the field.A total of 32 eligible stool samples were examined,and 4 case (12.5％) were still positive for hookworm eggs.Conclusions Among the infectors,fertilizing with fresh stool,working barefoot or wearing slippers in the field may serve as the risk factors.There is a certain failure proportion to eliminate the infection status when adopting only one round anthelminthic treatment.For prevention and control hookworm infections,comprehensive intervention measures including infection source management,harmless treatment of stools,individual behavior intervention and environment improvement are suggested.

Anatomic basis and clinical application of perforator flap thinning of posterior tibial artery / 中华显微外科杂志

Objective To explore the anatomic basis of the thinning of the free posterior tibial artery perforator flaps and the clinical effect of repairing wound on hand or foot due to trauma.Methods From November,2016 to December,2017,10 cases of lower extremity cadaver specimens perfused with red ralex were dissected,which were perfused through the amputated femoral artery.Five of them were left and the rest were right.All cases were males.The number,diameter,branches and distribution of the perforator was observed.From September,2012 to September,2017,there were 13 cases of clinical application,which were 5 cases of hand wound and 8 cases of foot wound.The size of the wound was 3.0 cm × 2.0 cm to 6.0 cm × 4.0 cm,and the flap area was 3.5 cm × 2.2 cm to 6.5 cm × 4.5 cm.The repairing procedure was suitable for the wound associated with tendon,bone,joint capsule exposure.Results The number of posterior tibial artery perforating branches that more than 0.50 mm in diameter was 4 to 6,and the mean diameter was (0.87±0.26) mm.The perforating branch penetrated into the fat layer and was divided into 3 layers of vascular network:deep fat vascular network,superficial fat vascular network and subdermal vascular network.The perforating branch was located according to the positional relationship from deep to shallow,and vessel diameter become smaller step by step.The perforating branch trunk gave off branches to the deep vascular network,and the superficial vascular network had the same origin or shared with the deep blood vessels.The subdermal vascular network issued from the superficial vascular network or directly from the perforating branch trunk.There was no or few communicating branch between the deep vascular network and superficial ones,besides the vessel pedicle.So trimming deep fat layer will not affect the blood supply of superficial vascular network and neither will affect the flap blood supply.Most of the deep fat tissue was trimmed in 13 cases.The superficial and subdermal fat vascular network was preserved,and the same to the trunk and branches of the pedicle.All the flaps survived.Of which,1 appeared arterial crisis on the 2nd day after operation,and relieved by the local injection of papaverine.There was 1 case of venous crisis on the 3rd day,and improved by stitches,local release of congestion.Followed-up time was ranged from 2 to 12 months.All flaps were soft with good blood supply and good appearance,and did not need a second thinning surgery.Flaps restored the protective feeling 6 months later.Conclusion The microdissection of perforator flap of posterior tibial artery provides a theoretical basis for the perforator flap thinning,and the thinning of perforator flap is a good method to repair the appearance and function of the wound after foot and hand injuries.

Primary Amebic Meningoencephalitis: A Case Report

Primary amebic encephalitis (PAM) is a devastating central nervous system infection caused by Naegleria fowleri, a free-living amoeba, which can survive in soil and warm fresh water. Here, a 43-year-old healthy male was exposed to warm freshwater 5 days before the symptom onset. He rapidly developed severe cerebral edema before the diagnosis of PAM and was treated with intravenous conventional amphotericin B while died of terminal cerebral hernia finally. Comparing the patients with PAM who has similar clinical symptoms to those with other common types of meningoencephalitis, this infection is probably curable if treated early and aggressively. PAM should be considered in the differential diagnosis of purulent meningoencephalitis, especially in patients with recent freshwater-related activities during the hot season.

Analysis of correlation between childhood abuse and adolescent psychological capital / 中国学校卫生

Objective@#To understand current situation and relations of childhood abuse and psychological capital, providing scientific basis for adolescent mental health promotion.@*Methods@#Stratified cluster sampling method was used to select 1 894 students from junior high schools and senior high schools in Harbin. Questionnaire survey was conducted by using Childhood Trauma QuestionnaireShort Form (CTQ-SF) and Positive Psychological Capital (PPQ).@*Results@#The total rate of childhood abuse among adolescents in the region was 98.3%. In addition to emotional abuse, scores of other dimensions of childhood abuse were higher for boys than for girls(P<0.01). Childhood abuse in rural area was higher than those in urban area except physical abuse(P<0.05). High psychological capital was observed among participants with boys higher in selfefficacy and resilience than that of girls(P<0.05). Psychological capital in urban students was higher than rural students(P<0.05). Except for the negative correlation between sexual abuse and resilience, all other dimensions of childhood abuse were negatively correlated with four dimensions of psychological capital. Stepwise regression analysis showed that emotional abuse, emotional neglect and physical neglect was negatively correlated with all dimensions of psychological capital(P<0.01); Sexual abuse showed negative association with selfefficacy and optimism(P<0.01).@*Conclusion@#Childhood abuse is closely related to psychological capital among adolescents in Harbin, suggesting exposure to childhood abuse might confer detrimental effects on psychological capital development.

Salivary protease spectrum biomarkers of oral cancer / 国际口腔科学杂志·英文版

Proteases are important molecules that are involved in many physiological and pathological processes of the human body, such as growth, apoptosis and metastasis cancer cells. They are potential targets in cancer diagnosis and biotherapy. In this study, we analyzed the salivary protease spectrum of patients with oral squamous cell carcinoma (OSCC), oral benign masses and chronic periodontitis, as well as that of health, using human protease array kits, enzyme-linked immunosorbent assay, western blot and immunofluorescence. The salivary protease spectrum was found to be associated with oral diseases. For example, the saliva of patients with OSCC contained increased numbers of proteases than those of other oral diseases and health. The levels of matrix metalloproteinase (MMP)-1, MMP-2, MMP-10, MMP-12, A disintegrin and metalloprotease (ADAM)9, A disintegrin and metalloprotease with thrombospondin type 13 motifs (ADAMST13), cathepsin V and kallikrein 5 in the saliva of patients with OSCC were significantly increased compared with those of other groups. Taking MMP-1, cathepsin V, kallikrein 5 and ADAM9 as biomarkers of OSCC, cutoff values were199, 11.34, 9.29 and 202.55 pg·mL, respectively. From the area under the curve, sensitivity and specificity, the combination of cathepsin V/kallikrein5/ADAM9 was an optimal biomarker for diagnosing OSCC. Thus, analysis of the salivary protease spectrum may be an innovative and cost-efficient approach to evaluating the health status of the oral cavity. Specifically, increases in cathepsin V, kallikrein 5 and ADAM9 may be useful biomarkers in the screening and diagnosis of OSCC.