Effect of Pulsatilla Saponin A on Proliferation and Apoptosis of Burkitt Lymphoma Cells Based on JAK2/STAT3 Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo investigate the effect of pulsatilla saponin A （PSA） on proliferation and apoptosis of human Burkitt lymphoma （BL） cell line Raji cells and expression of related pathway proteins. MethodWith Raji cells as the research object， the cell proliferation was detected by cell counting kit-8 （CCK-8） method， and the half-maximal inhibitory concentration （IC50） values of 24 h， 48 h and 72 h were calculated to be 19.77， 18.31， 16.70 μmol·L-1， respectively. In subsequent related experiments， 0， 8， 16， 32 μmol·L-1 PSA were selected according to the IC50 value of Raji cells treated with PAS for 72 h. After 0， 8， 16， 32 μmol·L-1 PSA acted on Raji cells for 24， 48， 72 h， the optical density values of cell growth curve were detected by CCK-8 method. The zymogen activities of cysteine aspartate-specific protease （Caspase）-3， Caspase-8 and Caspase-9 in Raji cells treated with 0， 8， 16 and 32 μmol·L-1 PSA for 24 h were measured by Caspase-3， Caspase-8 and Caspase-9 colorimetric assay kit. The apoptosis rate and cell cycle of Raji cells treated with different concentrations of PSA after 24 h were detected by flow cytometry. The expression of B-cell lymphoma 2 （Bcl-2）， Bcl-2-associated X protein （Bax）， cleaved poly（ADP-ribose） polymerase （cleaved PARP）， cleaved cysteinyl aspartate-specific protease-3 （cleaved Caspase-3） apoptosis related protein and Janus kinase 2 （JAK2）， signal transducer and activator of transcription 3 （STAT3）， phosphorylated-JAK2 （p-JAK2）， and phosphorylated- STAT3 （p-STAT3） pathway proteins in Raji cells after 24 h of treatment with 0， 8， 16 and 32 μmol·L-1 PSA were tested by Western blot. ResultCompared with control group， decreased cell survival rate， inhibited cell proliferation， activated zymogens of Caspase-3， Caspase-8 and Caspase-9 （P<0.01）， increased apoptosis （P<0.05， P<0.01）， and enhanced cell cycle arrest in Gap phase 2 （G2） were observed in 8， 16 and 32 μmol·L-1 PSA groups（P<0.05， P<0.01）. Compared with control group， cells treated with 8， 16 and 32 μmol·L-1 PSA had lower expression of Bcl-2， p-JAK2， p-STAT3 proteins （P<0.05， P<0.01）， and higher expression of Bax， cleaved PARP and cleaved Caspase-3 protein （P<0.01）， while no significant change was found in the expression of JAK2 and STAT3 proteins. ConclusionPSA could inhibit proliferation and induce apoptosis of Raji cells， and its potential mechanism might be related to the regulation of JAK2/STAT3 signaling pathway.

Effect of Mitochondrial Function on Cell Senescence and Anti-ging Effect of Traditional Chinese Medicine and Moxibustion： A Review / 中国实验方剂学杂志

Since ancient times， delaying aging， health， and longevity have been the universal wish of people. Nowadays， China gives top strategic priority to the development of people's health. How to maintain a healthy life and slow down the aging of the human body is a problem worthy of our attention. Human aging can be shown as cell senescence from the microscopic level. Cell senescence is a process in which cell proliferation and differentiation and physiological function gradually decline. It is a normal physiological function responsible for the removal of damaged cells and is the regeneration and recovery of tissues after injury or acute stress. Aging is an irresistible natural law. Although it is inevitable， it is possible to delay aging. Energy metabolism is an important basis of cell function， in which cells use nutrients such as sugar and fat to produce adenosine triphosphate （ATP）. Mitochondria serve as the cell's power stations， where sugars， fats， and amino acids are eventually oxidized to release energy. Mitochondrial function decreases with age. Changes in mitochondrial dynamics， reactive oxygen species content， autophagy， and metabolites can cause dysfunction of electron transport chain and oxidative phosphorylation， and induce mitochondrial dysfunction. Mitochondrial dysfunction is one of the internal causes of many aging-related diseases， such as neurodegenerative diseases， Alzheimer′s disease， and atherosclerosis. Chinese medicine with few side effects and rich ingredients and health care moxibustion with safety and efficacy have been widely applied to the field of anti-aging. This study reviewed the effect of mitochondrial function on cell senescence， and retrieved， analyzed， and summarized research papers on the mechanism of traditional Chinese medicine （TCM） and moxibustion in delaying aging by affecting mitochondrial function， which is expected to provide new insights for further research in this field.

Mortality trend of chronic respiratory diseases in China, 1990-2019 / 中华流行病学杂志

Objective: To analyze mortality and its trend of chronic respiratory diseases (CRD) in China from 1990 to 2019. Methods: Based on the provincial results of China from the 2019 Global Burden of Disease (GBD) study, the average annual percent change (AAPC) of standardized mortality rates of different CRDs were analyzed by using Joinpoint 4.8.0.1, and the age-standardized mortality rate of CRD was calculated by using the GBD 2019 world standard population. Based on the comparative risk assessment theory of GBD, the attributable deaths due to 12 CRD risk factors were estimated, including smoking, indoor air pollution, occupational gas exposure, particulates and smog exposure, environmental particulate pollution, low temperature, passive smoking, ozone pollution, occupational exposure to silica, occupational asthma, high body mass index, high temperature and occupational exposure to asbestos. Results: From 1990 to 2019, the number of deaths and standardized mortality of chronic obstructive pulmonary disease (COPD) showed a downward trend (P<0.001). The number of COPD deaths decreased from 1 244 000 (912 000 - 1 395 000) in 1990 to 1 037 000 (889 000 - 1 266 000) in 2019. AAPC=-0.9% (95%CI: -1.5% - -0.3%), P<0.001; The standardized mortality rate decreased from 217.9/100 000 (163.3/100 000 - 242.0/100 000) in 1990 to 65.2/100 000 (55.5/100 000 - 80.1/100 000) in 2019. AAPC= -4.2% (95%CI:-5.2% - -3.2%), P<0.001. The number of deaths from asthma decreased from 40 000 (30 000 - 58 000) in 1990 to 25 000 (20 000 - 31 000) in 2019. AAPC=-2.0% (95%CI: -2.6% - -1.4%), P<0.001; The standardized mortality rate of asthma decreased from 6.4/100 000 (4.7/100 000 - 9.5/100 000) in 1990 to 1.5/100 000 (1.2/100 000 - 1.9/100 000) in 2019. AAPC=-5.1% (95%CI: -5.8% - -4.4%), P<0.001. The number of pneumoconiosis deaths decreased from 11 000 (8 000 - 14 000) in 1990 to 10 000 (8 000 - 14 000) in 2019, AAPC=-0.2%(95%CI:-0.4% - 0.1%), P=0.200; The standardized mortality rate of pneumoconiosis decreased from 1.4/100 000 (1.0/100 000 - 1.7/100 000) in 1990 to 0.5/100 000 (0.4/100 000 - 0.7/100 000) in 2019. AAPC=-3.1% (95%CI: -3.4% - -2.8%), P<0.001. The number of deaths from pulmonary interstitial diseases and pulmonary sarcoidosis increased from 3 000 (3 000 - 6 000) in 1990 to 8 000 (6 000 - 10 000) in 2019, AAPC=3.5% (95%CI: 2.7% - 4.2%), P<0.001; The corresponding standardized mortality rate changed little from 1990 to 2019, and AAPC was not statistically significant.The age-standardized mortality rates of different CRDs were higher in men than those in women. In 1990 and 2019, the mortality rates of COPD, asthma, pneumoconiosis and interstitial pulmonary disease and pulmonary sarcoidosis increased with age. In 2019, the population attributable fractions (PAFs) for smoking, environmental particulate pollution, occupational gas exposure, particulate and smog exposure, low temperature exposure and passive smoking were 71.1% (68.0% - 74.3%), 24.7% (20.1% - 30.0%), 19.3% (13.0% - 25.4%), 15.7% (13.6% - 18.3%) and 8.8% (4.5% - 13.1%) respectively in men, and the PAFs for environmental particulate pollution, smoking, low temperature exposure, occupational gas exposure, particulate and smog exposure, and passive smoking were 24.1% (19.6% - 29.3%), 21.9% (18.7% - 25.2%), 16.4% (14.0% - 19.2%), 15.6% (10.2% - 21.1%) and 14.7% (7.9% - 21.3%) respectively in women. Conclusions: During 1990-2019, the overall death level of CRD decreased significantly in China, but it is still at high level in the world. Active prevention and control measures should be taken to reduce the death level caused by CRD.

DYNC2H1 gene mutation analysis and prenatal diagnosis in two pedigrees affected with short rib-polydactyly syndrome type Ⅲ / 中华围产医学杂志

Objective:To investigate the molecular genetic etiology of two fetuses with short rib-polydactyly syndrome type Ⅲ (SRPS Ⅲ).Methods:Next-generation sequencing (NGS) was used to detect 226 known genes related to inherited skeletal dysplasia in two fetuses with SRPS Ⅲ diagnosed in the First Affiliated Hospital of Zhengzhou University in August 2015 and June 2020. Suspect pathological variants were verified in the pedigree members using Sanger sequencing. The prenatal genetic diagnosis of the high-risk fetus in pedigree one was conducted to identify the confirmed pathogenic variation.Results:The homozygous mutation of DYNC2H1 gene c.5881A>G(p.Lys1961Glu) was identified in the proband in pedigree one, and the parents were the carriers. The proband in pedigree two carried compound heterozygous mutations in the DYNC2H1 gene with c.10606C>T(p.Arg3536*) inherited from the father and c.8954T>G(p.Val2985Gly) from the mother. Autosomal recessive inheritance was confirmed in both pedigrees. Mutations of c.5881A>G(p.Lys1961Glu) and c.8954T>G(p.Val2985Gly) in the DYNC2H1 gene were likely pathogenic variants and had not been reported before. The prenatal diagnosis did not identify the DYNC2H1 gene c.5881A>G(p.Lys1961Glu) mutation in the fetus (Ⅱ-7) in pedigree one, which was confirmed by the umbilical cord blood sample after birth. Conclusion:DYNC2H1 gene mutation underlies the fetal skeletal dysplasia in the two pedigrees.

Arthroscopic, histological and imaging studies of rare abnormal insertion points in the anterior root of the medial meniscus / 中华骨科杂志

Objective:To investigate the characteristics of an abnormal attachment point of the anterior horn of the medial meniscus (AHMM) by methods of arthroscopy, radiological imaging, and pathology.Methods:A total of seven cases of a rare abnormal attachment (anteromedial meniscofemoral ligament, AML) connecting the AHMM and anterior cruciate ligament (ACL) were identified in the more than six thousand arthroscopic procedures from January 2018 to April 2021. During the procedures, subtotal meniscal resection or meniscal repair was performed in all cases. Tissue removed intraoperatively was used for pathologic examination. For this study, the preoperative MRI films of these patients were retrospectively examined.Results:Finally, seven cases with diagnosed meniscal tears were included in this study, including 4 males and 3 females with a mean age of 37.85±7.70 years (range, 27-50 years). The AML, which extends outward and upward and is anterior to the ACL, begins at the AHMM and ends anterior to the femoral attachment of the ACL. The histological staining showed that the AML was a bundle of collagen fibers, whereas the ACL was a bundle of dense fibrous collagen. The AML could be clearly identified in the proton-weighted image of sagittal MRI preoperatively and showed a low signaling similar to the signal intensity of the ACL. AML was easily identified on sagittal MRI but not on axial and coronal MRI. In three patients who underwent bilateral MRI, the AML structure was found in both knees.Conclusion:The incidence of rare anatomic variation between the AHMM and the lateral condyle of the femur is 0.1%, usually occurring in both knees simultaneously. In cases with this variation, there is no bony attachment in the AHMM connected to the ACL via the AML. After transection of the AML, the annular fibrous structure and mechanical properties of the meniscus are damaged, as consequently the AML should be carefully protected in clinical practice.

Early clinical effect of new autologous semitendinosus ribbon-like graft in reconstruction of anterior cruciate ligament tear / 中华创伤杂志

Objective:To investigate the early curative effect of the new autologous semitendinosus ribbon-like graft in reconstruction of anterior cruciate ligament (ACL) tear.Methods:A retrospective cohort study was conducted to analyze the clinical data of 65 patients with knee ACL tear admitted to Zhengzhou Orthopedics Hospital from June 2019 to January 2021, including 52 males and 13 females, aged 16-50 years [(30.5±8.4)years]. According to the reconstruction method and graft selection, the patients were divided into ribbon-like reconstruction group ( n=31) and circular bundle reconstruction group ( n=34). All patients underwent anatomical ACL reconstruction using the new autologous semitendinosus ribbon-like graft in ribbon-like reconstruction group and the traditional circular bundle graft in circular bundle reconstruction group. The operation time, morphological difference in ACL graft immediately after surgery with original ACL, Lysholm score before and at 3 months after surgery, Lachman test and axial shift test immediately and at 3 months after surgery, and intraoperative and postoperative complications were compared between the two groups. Results:All patients were followed up for 3-15 months [(6.0±3.1)months]. The operation time was (61.6±6.7)minutes in ribbon-like reconstruction group and was (48.0±6.3)minutes in circular bundle reconstruction group ( P<0.01). Under arthroscopic observation, the original ACL was ribbon-shaped in the joint, the graft in ribbon-like reconstruction group was also ribbon-like structure, the graft in circular bundle reconstruction group was bundle structure. Therefore, the grafts in ribbon-like reconstruction group better simulated the ribbon-like structure of the original ACL than those in circular bundle reconstruction group. The ribbon-like graft mimiced the natural twisting of the ACL when the knee was bent. Lysholm score was (82.8±5.2)points in ribbon-like reconstruction group at 3 months after surgery, significantly higher than (47.5±8.7)points before surgery ( P<0.01). Lysholm score was (79.9±7.5)points in circular bundle reconstruction group at 3 months after surgery, significantly higher than (44.2±9.4)points before surgery ( P<0.01). There were no significant differences in Lysholm score between the two groups before and at 3 months after surgery (all P>0.05). Lachman and axial shift tests were negative in both groups immediately and at 3 months after surgery. The ribbon-like reconstruction group showed breakage or wear of Kirschner wires in 4 patients and hollow drill deformation in 1 intraoperatively. The circular bundle reconstruction group showed wear of Kirschner wires in 2 patients intraoperativley. There was no significant difference in intraoperative complications between the two groups ( P>0.05). One patient experienced tibial incision infection in ribbon-like reconstruction group at 3 months after surgery. All wounds were healed at stage I with no incision infection in circular bundle reconstruction group. No patients had ligament failure or function limitation. There was no significant difference in postoperative complications between the two groups ( P>0.05). Conclusions:The clinical effect of new autogenous semitendinosus ribbon-like graft in ACL reconstruction is comparable to that of traditional circular bundle graft. However, arthroscopic observation reveals that the parenchymal part of the ribbon-like graft is ribbon-shaped, which better simulates the physiological morphology of the original ACL. The natural distortion of the simulated ACL during knee bend may better simulate the physiological function of the original ACL.

Efficacy of arthroscopically-assisted modified outside-in technique for posterior cruciate ligament reconstruction / 中华创伤杂志

Objective:To compare the clinical outcome between arthroscopically-assisted modified outside-in technique and inside-out technique for reconstruction of posterior cruciate ligament (PCL).Methods:A retrospective cohort study was conducted to analyze the clinical data of 53 patients with PCL rupture treated at Zhengzhou Orthopaedics Hospital from September 2015 to March 2019. There were 36 males and 17 females, at age of 21-58 years [(37.2±12.5)years]. There were 29 patients with right knee injury and 24 patients with left knee injury. All patients underwent minimally invasive arthroscopically- assisted PCL reconstruction, including the femoral tunnel established using the modified outside-in technique in 22 patients (outside-in group) and the inside-out technique with 120° of knee flexion in 31 patients (inside-out group). The two groups were compared in terms of operation time, length of femoral tunnel intraoperatively, angle between femoral tunnel and intra-articular graft at postoperative 3 days, and posterior drawer test (PDT), International Knee Documentation Committee (IKDC) score, Lysholm knee score, knee range of motion (ROM), knee extension muscle strength at the last follow-up. The complications were recorded after operation.Results:All patients were followed up for 15-38 months [(21.4±8.7) months]. There were no significant differences between the two groups in operation time and last follow-up evaluation of PDT, IKDC score, Lysholm knee score and knee ROM (all P>0.05). The length of femoral tunnel in outside-in group [(38.6±2.9)mm] was longer than that in inside-out group [(32.4±2.5)mm] ( P<0.05). The angle between femoral tunnel and intra-articular graft in outside-in group [(147.5±3.1)°] was larger than that in inside-out group [(136.4±2.6)°] ( P<0.01). The knee extension muscle strength of all patients reached grade V at the last follow-up. There were 2 patients with 5° flexion limitation in outside-in group, comparable to 3 patients with 5° flexion limitation and 1 patient with 10° flexion limitation in inside-out group ( P>0.05). No incision infection, implant loosening or injury of the extension apparatus of the knee occurred after operation. Conclusions:In treating PCL rupture, both arthroscopically-assisted modified outside-in technique and inside-out technique can achieve satisfied stability and functional recovery. However, the length and angle of femoral tunnel is more controllable when using the the modified outside-in technique.

Association between exposure to artificial light at night and the occurrence of menarche in Han girls / 中国学校卫生

Objective@#To analyze the association between the occurrence of menarche and the exposure to artificial light at night (ALAN) in female Han nationality girls aged 9-18 in China, so as to provide a reference for the research on the disturbance mechanism of ALAN on puberty, as well as provide a scientific evidence for controlling ALAN and making public sanitary policy.@*Methods@#A total of 74 483 Han girls aged 9-18 with complete records of menarche, height, and weight were included in the 2014 Chinese National Surveys on Students Constitution and Health. Pearson correlation was used to explore the correlation between the incidence of menarche and the exposure to artificial light at night in 11-year-old Han girls, and the third quantiles of the area covered by outdoor night lights (0.16, 0.60) and the third quantiles of the average night light intensity [0.97, 5.91 nw/(sr ·cm) 2] were used respectively to divide the study subjects into 3 groups, and the multifactor Logistic regression model was used to analyze the effect of artificial light at night exposure on menarche.@*Results@#In 2014, the median age of menarche of Chinese Han girls was 12.18 years old, and the incidence of menarche in the 11-year-old group was 26.31%. After controlling for body mass index, local population and the logarithmic values of per capita GDP, the incidence of menarche of 11-year-old Han girls was positively correlated with the local outdoor average night light coverage area ratio and the night average light intensity logarithmic adjustment value( r =0.29, 0.30, P <0.05).The higher the local outdoor night light coverage area ratio ( OR =1.28, 1.52) and the average night light intensity ( OR =1.47, 1.58), the higher the incidence of menarche in 11-year-old Han girls( P <0.05).@*Conclusion@#There is a positive correlation between artificial light at night exposure and the menarche rate of 11-year-old Han girls. Research on artificial light at night exposure may provide scientific evidence on puberty onset and its effects on population health.

Research on antitumor effects of small molecule inhibitors of deubiquitinases: new progress and new ideas / 药学学报

The abnormality of ubiquitin proteasome pathway is an important factor leading to the imbalance of protein homeostasis. In this process, the deubiquitinase responsible for removing the ubiquitin chain of protein substrate is very important. Its abnormal activity or expression can cause the functional changes of key oncogenic/tumor suppressor proteins, which directly or indirectly lead to the occurrence, development and malignant evolution of tumors. Based on this, the discovery and research of small molecule inhibitors targeting deubiquitinases have become a hot field of anti-tumor candidate drugs. This review will focus on the regulatory effect and mechanism of ubiquitin proteasome pathway, especially deubiquitinase on tumor, introduce the application of deubiquitinase small molecule inhibitors in tumor treatment, and discuss the research status and latest progress of small molecule inhibitors, so as to provide ideas for the research of new anti-tumor strategies based on deubiquitinase.

Novel compound heterozygous SCN9A variations causing congenital insensitivity to pain in a patient / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a child featuring congenital insensitivity to pain (CIP).@*METHODS@#Targeted capture and next generation sequencing (NGS) was carried out for the proband. Suspected pathogenic variants were confirmed by Sanger sequencing of the proband and his parents.@*RESULTS@#The proband was found to harbor compound heterozygous variants of SCN9A gene, namely c.1598delA (p.N533Ifs*31) and c.295_296delCGinsAT (p.R99I), which were respectively inherited from his father and mother. Both variants were predicted to be pathogenic, and neither was reported previously.@*CONCLUSION@#The compound heterozygous variants of the SCN9A gene probably underlay the CIP in this child. Above finding has enabled genetic counseling for this family.

Air Temperature Affects the Hospital Admission for Cardiovascular Diseases among Rural Residents in Dingxi City / 中国医学科学院学报

Objective To explore the effect of air temperature on the hospitalization of rural residents with cardiovascular diseases and its lag effect in Dingxi city. Methods The meteorological data and air pollution data of Dingxi city from 2018 to 2019,as well as the daily hospitalization data of rural residents due to cardiovascular diseases,were collected.The distributed lag non-linear models were employed to analyze the relationship between daily mean air temperature and the number of inpatients with cardiovascular diseases.Meanwhile,stratified analysis was carried out according to gender,age,and disease. Results There was a non-linear relationship between air temperature and the number of hospitalized rural residents with cardiovascular diseases in Dingxi city.The exposure-response curve approximated a bell shape.The curves for different cardiovascular diseases appeared similar shapes,with different temperature thresholds.Low temperature(-7 ℃) and moderately low temperature(0 ℃) exhibited a cumulative lag effect on the number of patients hospitalized with cardiovascular diseases.With a cumulative lag of 7 days at -7 ℃ and 14 days at 0 ℃,the RR values peaked,which were 1.121(95% CI=1.002-1.255) and 1.198(95% CI=1.123-1.278),respectively.With a cumulative lag of 14 days at 0 ℃,the RR values were 1.034(95% CI=1.003-1.077) and 1.039(95% CI=1.004-1.066) for the number of hospitalized patients with ischemic heart disease and heart rhythm disorders,respectively.The cumulative lag effects of moderately high temperature(17 ℃) and high temperature(21 ℃) on ischemic heart disease,heart rhythm disorders,and cerebrovascular disease all peaked on that day.Specifically,the RR values at 17 ℃ and 21 ℃ were 1.148(95% CI=1.092-1.206) and 1.176(95% CI=1.096-1.261) for ischemic heart disease,1.071(95% CI=1.001-1.147) and 1.112(95% CI=1.011-1.223) for heart rhythm disorders,and 1.084(95% CI=1.025-1.145) and 1.094(95% CI=1.013-1.182) for cerebrovascular disease,respectively.There was no cumulative lag effect of air temperature on the number of hospitalized patients with heart failure.In addition,stratified analysis showed that low temperature(-7 ℃) and moderately low temperature(0 ℃) affected the number of hospitalized female patients with cardiovascular diseases,and only moderately low temperature(0 ℃) affected males.The cumulative lag effect of high temperature on females was higher than that on males.Air temperature exhibited a stronger impact on female patients than on male patients. Additionally,the population aged<65 years old was more sensitive to low temperature and high temperature than that aged ≥65 years old. Conclusions Air temperature changes increase the hospitalization risk of rural residents with cardiovascular diseases in Dingxi city,which presents a lag effect.The effects of air temperature on patients hospitalized due to cardiovascular diseases varied among different etiologies,genders,and ages.It is necessary to emphasize on the impact of temperature changes on health in residents,especially for key populations such as females,people aged<65 years old,and those with ischemic heart disease.

Representations of object animacy and real-world size in the ventral visual pathway / 生理学报

How the brain perceives objects and classifies perceived objects is one of the important goals of visual cognitive neuroscience. Previous research has shown that when we see objects, the brain's ventral visual pathway recognizes and classifies them, leading to different ways of interacting with them. In this paper, we summarize the latest research progress of the ventral visual pathway related to the visual classification of objects. From the perspective of the neural representation of objects and its underlying mechanisms in the visual cortex, we summarize the current research status of the two important organizational dimensions of object animacy and real-world size, provide new insights, and point out the direction of further research.

Structure Design and Finite Element Analysis on Patch in Intraventricular Tunnel / 医用生物力学

ObjectiveT o explore the influence of patch shape for intraventricular tunnel (IVT) construction on biomechanical performance of the double outlet right ventricle after correction. Methods Based on the idealized IVT model, a two-dimensional IVT patch was designed. Six groups of patch models with the rhombic long-to-short axis ratio of 1∶0.625, 1∶0.3, 1∶0.2, 1∶0.15, 1∶0.125, 1∶0.1 were established according to the difference between the long and short axis of the rhombus patch in the turning part, and finite element analysis method was used to numerically simulate the process of stitching, holding and propping up the patch into a three-dimensional (3D) IVT model. Results The maximum stresses on suture line of 6 patch models were mainly concentrated at acute-angle corners of the rhombus. As rhombic long-to-short axis ratio of the patch increased, the maximum stress of the IVT suture line first decreased and then increased, and the volume showed an increasing trend. The pressure difference between two ends of the tunnel first decreased and then increased. The patch with the long-to-short axis ratio of 1∶0.15 had a uniform surface stress distribution, and the maximum stress on the suture line was the smallest. Meanwhile the right ventricular volume was less encroached on, and the pressure difference at both ends of the tunnel was small. Conclusions The IVT shape can influence stresses of suture line, the right ventricle volume and the pressure difference of IVT with non-monotonic variations. The suture effect of the patch with the long-to-short axis ratio of 1∶0.15 is relatively better among the constructed models.

Effects of exposure to low-dose ionizing radiation on changing platelets: a prospective cohort study

BACKGROUND@#Numerous studies have concentrated on high-dose radiation exposed accidentally or through therapy, and few involve low-dose occupational exposure, to investigate the correlation between low-dose ionizing radiation and changing hematological parameters among medical workers.@*METHODS@#Using a prospective cohort study design, we collected health examination reports and personal dose monitoring data from medical workers and used Poisson regression and restricted cubic spline models to assess the correlation between changing hematological parameters and cumulative radiation dose and determine the dose-response relationship.@*RESULTS@#We observed that changing platelet of 1265 medical workers followed up was statistically different among the cumulative dose groups (P = 0.010). Although the linear trend tested was not statistically significant (P@*CONCLUSION@#We concluded that although the exposure dose was below the limit, medical workers exposed to low-dose ionizing radiation for a short period of time might have increased first and then decreased platelets, and there was a dose-response relationship between the cumulative radiation dose and platelets changing.

Variant analysis of SEC23B gene in 4 families with congenital dyserythropoietic anemia / 中华医学遗传学杂志

OBJECTIVE@#To identify the pathogenic variants of 4 patients with hemolytic anemia of unknown cause.@*METHODS@#Peripheral blood samples of the patients and their family members were collected to extract DNA. The coding region and splice region in all exons of gene of erythrocyte related diseases were analyzed by using target sequence capture and high-throughput sequencing technology. Suspected pathogenic variants were verified by PCR combined Sanger sequencing technology.@*RESULTS@#Each of the probands was detected two compound heterozygous variants, and CDA II was diagnosed. Six variants were detected in the 4 probands, four variants were reported and the other two were first reported.@*CONCLUSION@#By high-throughput sequencing, gene variant of CDA II be analyzed fast and accurately. It is an effective supplement to convenional diagnostic methods. Furthermore, the novel variant sites have enriched the variant database of the SEC23B gene.

Development of policies for prevention and treatment of common diseases among school-age children and adolescents in China / 中国学校卫生

Abstract@#The health of children and adolescents is not only related to the growth and wellbeing of individuals, but also to the construction and development of countries. This study reviewed policies that were issued by the central government since the founding of New China which focused on the prevention and treatment of common diseases among school-age children and adolescents. The results revealed that, since the founding of New China, policies for the prevention and control of common diseases among school-age children and adolescents increased in number, and they began to focus on specific rather than general health problems. A gradual emphasis was placed on the specific implementation of prevention and control measures, rather than on guiding principles. Increasingly more attention has been paid to the prevention and treatment of common diseases among school-age children and adolescents.

Research status and challenges in the prognosis of primary biliary cholangitis after liver transplantation / 临床肝胆病杂志

Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease with unknown etiology, and patients with poor response to ursodeoxycholic acid and obeticholic acid may eventually progress to liver cirrhosis and even liver failure. Liver transplantation is the only effective treatment method for PBC at present. This article elaborates on liver transplantation, survival time after liver transplantation, complications, recurrence of PBC after liver transplantation, and prospects and challenges of liver transplantation in patients with PBC, so as to provide a reference for clinical outcome and treatment after liver transplantation for PBC.

Construction and evaluation of a predictive model for esophageal stenosis after endoscopic submucosal dissection of early esophageal cancer and precancerous lesions / 中华消化内镜杂志

Objective:To investigate the risk factors of esophageal stenosis after endoscopic submucosal dissection (ESD) of early esophageal cancer and precancerous lesions, and to construct and assess a predictive model for esophageal stenosis.Methods:Data of 421 patients with early esophageal cancer or precancerous lesions who underwent ESD and were confirmed by pathology in the First Affiliated Hospital of Zhengzhou University between January 2015 and April 2020 were retrospectively analyzed.Eighty-nine cases developed postoperative esophageal stenosis (stenosis group) and 332 cases did not (non-stenosis group). Risk factors of esophageal stenosis were investigated by univariate and multivariate logistic regression analysis. Independent risk factors were used as predictors to construct a nomogram model by using the lasso algorithm.The accuracy of the model was evaluated by the consistency index (C-index) and the calibration curve. Bootstrap was applied to internal verification to avoid over-fitting of the model.Results:Univariate analysis showed that postoperative pathology, depth of infiltration, median long and short diameters of the specimen, circumferential resection range, and muscularis propria injury were related to postoperative esophageal stenosis( P<0.05). Further multivariate logistic regression analysis showed that the resection range≥1/2 of the circumference (VS <1/2 circumference: P<0.01, OR=48.453, 95% CI: 11.288-207.983), muscularis propria injury( P<0.01, OR=4.671, 95% CI: 2.283-9.557)and longitudinal length≥50 mm (VS <50 mm: P=0.008, OR=2.741, 95% CI: 1.299-5.785) were independent risk factors for esophageal stenosis after ESD. The nomogram model was constructed through the lasso algorithm by taking the longitudinal length, circumferential resection range, and muscularis propria injury as the predictive factors. The C-index of the nomogram was 0.934 (95% CI: 0.909-0.959)and was 0.931 after 100 times of Bootstrap internal sampling, which meant the prediction probability of the model in the calibration curve was in good agreement with the actual observation probability. Conclusion:Circumferential resection range ≥1/2, muscularis propria injury, and longitudinal length≥50 mm are independent risk factors for post-ESD esophageal stenosis. The nomogram model constructed by the above three indicators as predictors shows an ideal prediction effect on esophageal stenosis after ESD for early esophageal cancer and precancerous lesions, which is helpful to establish a standard plan for early intervention in patients at high risk of stenosis after ESD.

Application of extracorporeal membrane oxygenation in critically ill pregnant women / 中华危重病急救医学

Objective:To investigate the safety and effectiveness of extracorporeal membrane oxygenation (ECMO) in emergency treatment of critically ill pregnant women.Methods:Clinical data of 8 pregnant women with severe cardiopulmonary dysfunction during the perinatal period treated by ECMO in the department of intensive care unit (ICU) of Nanjing Drum Tower Hospital, the Affiliated Hospital to Nanjing University Medical School from September 2017 to November 2020 were retrospectively analyzed. Results:For the 8 pregnant women, the mean age was (32.5±6.3) years old. Body weight was (73.5±8.1) kg. Gestational age was (31.0±4.4) weeks. Acute physiology and chronic health evaluationⅡ (APACHEⅡ) score was 13.0±6.6, and sequential organ failure assessment (SOFA) score was 8.3±3.8. Among them, 5 pregnant women suffered from severe pneumonia and were treated with veno-venous ECMO (VV-ECMO). Another 3 pregnant women with heart failure underwent veno-arterial ECMO (VA-ECMO). The initial ECMO flow rate was set to 2.0-3.0 L/min. Then the highest flow rate was (3.1±0.6) L/min, and the average ECMO running time was (174±36) hours. The length of ICU stay was (16.0±5.4) days. Six pregnant women (5 with severe pneumonia and 1 with peripartum cardiomyopathy) successfully evacuated from ECMO and survived. Two pregnant women with pulmonary hypertension showed poor prognosis. In total, seven babies survived. Two of them were delivered after ECMO evacution, and one underwent emergency cesarean section with ECMO support. In another case, the fetus could not be delivered due to under-gestational weeks. During this period, there were no serious bleeding complications. One pregnant woman developed heparin-induced thrombocytopenia and thrombosis (HITT), then she received another anticoagulant treatment. One pregnant woman got sequential anticoagulation therapy for 3 months on account of thrombosis in the puncture vessel.Conclusions:ECMO has played an active role in the rescue of critically ill pregnant women. For those with reversible severe cardiopulmonary dysfunction, it is necessary to evaluate the application of ECMO as early as possible to improve the survival rate of mothers and infants.

Effect of glucosamine sulfate, chondroitin sulfate and diacetarine on renal function in adult patients with Kashin-Beck disease / 中华地方病学杂志

Objective:To investigate the effects of glucosamine sulfate, chondroitin sulfate and diacetarine on urinary renal function indexes UREA, creatinine (CREA), urinary microprotein(mALB) and N-acetyl-β-D-glucosidase (NAG) in adult patients with Kashin-Beck disease.Methods:According to the criteria of "Diagnosis of Kashin-Beck Disease" (WS/T 207-2010), adult patients with degrees Ⅰ and Ⅱ Kashin-Beck disease in Heilongjiang Province were selected in 2019. They were randomly divided into three treatment groups according to age, gender, disease classification and other condition by clinical randomized controlled trial, group A (glucosamine sulfate group), group B (chondroitin sulfate group) and group C (diacetarine group). Fasting mid-morning urine was collected at 0, 90 and 180 days of treatment. The levels of UREA, CREA, mALB and NAG were measured using an automatic biochemical analyzer. And the abnormal rates of the above indexes were analyzed.Results:At 0 day of treatment, there were 118, 99 and 116 people in the 3 groups, respectively; after 90 days of treatment, 115, 93 and 106 people remained in the 3 groups; after 180 days of treatment, 95, 80 and 93 people remained in the 3 groups. The results showed that there was no significant difference in the levels of UREA, CREA, NAG and mALB among the 3 groups at 0 and 180 days of treatment ( H = 0.055, 0.923, 0.276, 1.125, 1.635, 3.873, 1.045, 4.135, P > 0.05). After 90 days of treatment, there was no significant difference in CREA level among the 3 groups ( H = 1.719, P > 0.05), the levels of UREA and NAG in group C were higher than those in group B ( P < 0.05), and the level of mALB in group B was higher than that in group C ( P < 0.05). The comparison results of all indexes before and after treatment showed that after 90 days of treatment, the levels of mALB in the 3 groups were lower than those of 0 day ( Z = - 2.858, - 3.217, - 2.124, P < 0.05), the levels of NAG were higher than those of 0 day ( Z = - 3.700, - 2.222, - 4.672, P < 0.05); and the level of UREA in group C was higher than that of 0 day ( Z = - 2.393, P < 0.05). After 180 days of treatment, the levels of CREA in the 3 groups were higher than those of 0 day ( Z = - 5.853, - 6.984, - 6.255, P < 0.05), and the levels of mALB in the 3 groups were lower than those of 0 day ( Z = - 3.785, - 2.624, - 3.427, P < 0.05). The abnormal rates of CREA in the 3 groups after 180 days of treatment were higher than those of 0 and 90 days (χ 2 = 39.499, 37.707, 71.534, 57.959, 58.160, 55.129, P < 0.05). There was no significant difference in the abnormal rate of CREA between 0 day and 90 days of treatment (χ 2 = 0.004, 2.068, 0.053, P > 0.05). The abnormal rates of NAG in groups A and C after 90 days of treatment were higher than those of 0 day (χ 2 = 8.999, 11.227, P < 0.05). The abnormal rates of NAG in group C after 180 days of treatment was higher than that of 0 day (χ 2 = 5.006, P < 0.05). There was no significant difference in the abnormal rate of NAG between group A and group C after 90 days and 180 days of treatment (χ 2 = 1.976, 1.413, P > 0.05). The abnormal rates of mALB in groups A and B after 90 days and 180 days of treatment were lower than those of 0 day (χ 2 = 6.461, 8.881, 7.563, 4.999, P < 0.05), and there was no significant difference between 90 days of treatment and 180 days of treatment (χ 2 = 0.638, 0.013, P > 0.05). Conclusions:The effects of glucosamine sulfate, compound chondroitin sulfate and diacetarine on renal function of the patients are not significantly different after 180 days of medication, but the three drugs all have certain effects on CREA and NAG. Follow-up work should be done during drug treatment to closely monitor the changes of the two indicators.