Pars plana vitrectomy combined with inverted internal limiting membrane flap technique for treating macular hole retinal detachment in high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the clinical efficacy of pars plana vitrectomy(PPV)combined with inverted internal limiting membrane flap technique in the treatment of macular hole retinal detachment(MHRD)in high myopia.METHODS: A retrospective clinical study was conducted. A total of 63 patients(64 eyes)with high myopia and MHRD who treated at our hospital from October 2017 to October 2021 were selected as research subjects. They were divided into two groups according to different surgery, with 34 cases(35 eyes)who received PPV combined with inverted internal limiting membrane flap technique in group A, and 29 cases(29 eyes)received PPV combined with internal limiting membrane peeling in group B. The patients were followed up for 6mo. The two groups were compared in terms of the hole closure rate, the reduction rate of retinal detachment and best corrected visual acuity(BCVA)before operation and at 1wk, 1, 3 and 6mo after operation, and the postoperative complications were recorded.RESULTS: The hole closure rate within 6mo after operation was significantly higher in group A than in group B(P<0.05), but there was no statistically significant difference in the reduction rate of retinal detachment(P>0.05). The BCVA of the two groups was significantly improved over time after operation(P<0.05). There was no statistically significant difference in BCVA between the two groups before operation and at 1wk, 1, 3 and 6mo after operation(P>0.05). Complications were observed in the two groups, but there was no statistically significant difference in the incidence of complications between the two groups(P<0.05).CONCLUSION: PPV combined with inverted internal limiting membrane flap technique is safe and effective in the treatment of MHRD in high myopia, which can effectively improve the patients' BCVA and the hole closure rate without influence on intraocular pressure.

Diagnostic value of myocardial blood flow quantitative imaging with CZT SPECT in patients with high-risk coronary artery disease / 中华核医学与分子影像杂志

Objective:To investigate the diagnostic value of myocardial blood flow quantitative imaging with cadmium zinc telluride (CZT) SPECT in patients with high-risk coronary artery disease (CAD).Methods:A total of 148 patients (82 males, 66 females, age: (63.8±8.2) years) who successfully completed CZT SPECT dynamic acquisition and routine SPECT myocardial perfusion imaging (MPI) in TEDA International Cardiovascular Hospital from November 2018 to October 2020 were analyzed retrospectively. According to the results of coronary angiography (CAG), patients were divided into two groups: high-risk CAD group and low-to-medium-risk CAD group. At the case level, quantitative parameters (stress myocardial blood flow (sMBF), rest myocardial blood flow (rMBF) and myocardial flow reserve (MFR)), semi-quantitative parameters (summed stress score (SSS), summed rest score (SRS), summed difference score (SDS) and transient ischemic dilation (TID)) and left ventricular function parameters of two groups were compared. Diagnostic accuracy was evaluated by ROC curve analysis. At the vascular level, the correlation between the degree of coronary artery stenosis and some parameters was analyzed. Mann-Whitney U test, logistic regression, Spearman rank correlation analysis and DeLong test were used for statistical analysis. Results:Case level analysis showed that MFR and sMBF in high-risk CAD group were significantly lower than those in low-to-medium-risk CAD group (1.36(0.87, 1.64) vs 2.74(2.30, 3.33), 1.06(0.69, 1.48) vs 2.50(1.73, 2.95) ml·g -1·min -1; U values: 628.0 and 853.5, both P<0.001). MFR and SDS were independent predictors of high-risk CAD patients (odds ratio ( OR)=0.251(95% CI: 0.136-0.464), P<0.001; OR=1.188(95% CI: 1.026-1.375), P=0.021), and MFR was more capable of predicting high-risk CAD. MFR and sMBF had the highest accuracy in diagnosing high-risk CAD (AUCs: 0.885 and 0.844). Differences of AUCs between MFR and other parameters were statistically significant ( z values: 1.99-6.77, all P<0.05), and the best diagnostic cut-off value was ≤1.83 (sensitivity: 85.90%; specificity: 85.71%). Vascular level analysis showed that MFR and sMBF( R2 values: 0.39 and 0.35, both P<0.001) were negatively correlated with the degree of coronary stenosis, while SSS, SRS and SDS ( R2 values: 0.22, 0.12 and 0.14, all P<0.001) were positively correlated with the degree of coronary stenosis. Conclusion:Compared with conventional SPECT MPI, CZT SPECT myocardial blood flow quantitative imaging has better diagnostic efficacy and clinical value in patients with high-risk CAD.

A comparison between CT-guided fine-needle aspiration biopsy with core-needle biopsy for pancreatic lesions / 中华肝胆外科杂志

Objective:To compare the safety and clinical value of percutaneous computed tomography (CT)-guided fine-needle aspiration biopsy (CT-FNA) with CT-guided core-needle biopsy (CT-CNB) in diagnosis of pancreatic lesions.Methods:We retrospectively analyzed the clinical data of patients with pancreatic lesions who underwent percutaneous CT-guided biopsy from January 2017 to January 2022 at the First Affiliated Hospital of Zhengzhou University. A total of 454 patients (251 men, 203 women) were enrolled in this study with age of (60.5±11.6) years old. They were divided into the CT-FNA group ( n=300) and the CT-CNB group ( n=154) according to the biopsy method. The one-time diagnosis rate, accuracy, sensitivity, false negative rate and incidence rate of complications of the two groups were compared. Results:The one-time diagnosis rate and accuracy rate in the CT-CNB group were slightly higher than those in the CT-FNA group, but the differences were not statistically significant [92.2%(142/154) vs. 86.0%(258/300), χ 2=3.74, P=0.053; 97.4%(150/154) vs. 92.0%(276/300), χ 2=0.16, P=0.690]. Compared with the CT-FNA group, the CT-CNB group had a higher sensitivity and a lower false negative rate, and the differences were statistically significant [97.2%(138/142) vs. 91.5%(260/284), χ 2=4.89, P=0.036; 2.8%(4/142) vs. 8.5%(24/284), χ 2=4.89, P=0.036]. Common complications in the two groups were pain, hematoma and pancreatitis, and there was no statistically significant difference in the incidences of complication [9.0%(27/300) vs. 9.1%(14/154), χ 2<0.01, P=0.975]. Conclusions:Both CT-FNA and CT-CNB were safe for diagnosis of pancreatic lesions, with high diagnostic yields and with similar safety and accuracy. When compared with CT-FNA, CT-CNB has a higher sensitivity and a lower false negative rate.

On the post competency evaluation system of general practitioners based on Delphi method / 中华医学教育探索杂志

Objective:To build a system for evaluation on post competency of general practitioners.Methods:From April to October 2020, the Delphi method was used to consult on the importance of 4 first-level indicators and 48 second-level indicators for evaluation on post competency of general practitioners. Excel 2016 and SPSS 22.0 was used for data entry and statistical analysis.Results:There were 16 consulting experts, and the positive coefficients of the two rounds were 100% and 75%, respectively. The overall authority coefficient Cr of experts was 0.85. For the first-level indicators, the mean values of the importance of the two rounds were 8.07-9.00 and 8.67-9.00, and the coefficient of variation were 0-0.16 and 0-0.09, respectively. For the second-level indicators, the mean values of the importance of the two rounds were 6.79-9.00 and 8.17-9.00, and the coefficient of variation were 0-0.38 and 0-0.16, respectively. All the coordination coefficient tests were statistically significant ( P<0.001). Finally, the evaluation system was established including 4 first-level indicators and 32 second-level indicators. Conclusion:The constructed post competency evaluation system for general practitioners has a relatively high coordination and credibility, which can provide a reference for the post competency evaluation of general practitioners.

Role and mechanism of Vγ4 T cells in impaired wound healing of rapamycin-induced full-thickness skin defects in mice / 中华烧伤杂志

Objective: To investigate the role and mechanism of Vγ4 T cells in impaired wound healing of rapamycin-induced full-thickness skin defects in mice. Methods: The experimental research methods were applied. Eighty-six C57BL/6J male mice (hereinafter briefly referred to as wild-type mice) aged 8-12 weeks were selected for the following experiments. Vγ4 T cells were isolated from axillary lymph nodes of five wild-type mice for the following experiments. Intraperitoneal injection of rapamycin for 42 mice was performed to establish rapamycin-treated mice model for the following experiments. Eighteen wild-type mice were divided into normal control group without any treatment, trauma only group, and trauma+CC chemokine ligand 20 (CCL20) inhibitor group according to the random number table (the same grouping method below), with 6 mice in each group. The full-thickness skin defect wound was made on the back of mice in the latter two groups (the same wound model below), and mice in trauma+CCL20 inhibitor group were continuously injected subcutaneously with CCL20 inhibitor at the wound edge for 3 days after injury. Another 6 rapamycin-treated mice were used to establish wound model as rapamycin+trauma group. On post injury day (PID) 3, the epidermal cells of the skin tissue around the wound of each trauma mice were extracted by enzyme digestion, and the percentage of Vγ4 T cells in the epidermal cells was detected by flow cytometry. In normal control group, the epidermal cells of the normal skin tissue in the back of mice were taken at the appropriate time point for detection as above. Five wild-type mice were used to establish wound models. On PID 3, the epidermal cells were extracted from the skin tissue around the wound. The cell populations were divided into Vγ4 T cells, Vγ3 T cells, and γδ negative cells by fluorescence-activated cell sorter, which were set as Vγ4 T cell group, Vγ3 T cell group, and γδ negative cell group (with cells in each group being mixed with B16 mouse melanoma cells), respectively. B16 mouse melanoma cells were used as melanoma cell control group. The expression of interleukin-22 (IL-22) mRNA in cells of each group was detected by real-time fluorescence quantitative reverse transcription polymerase chain reaction (RT-PCR), with the number of samples being 6. Thirty rapamycin-treated mice were used to establish wound models, which were divided into Vγ4 T cell only group and Vγ4 T cell+IL-22 inhibitor group performed with corresponding injections and rapamycin control group injected with phosphate buffer solution (PBS) immediately after injury, with 10 mice in each group. Another 10 wild-type mice were taken to establish wound models and injected with PBS as wild-type control group. Mice in each group were injected continuously for 6 days. The percentage of wound area of mice in the four groups was calculated on PID 1, 2, 3, 4, 5, and 6 after injection on the same day. Six wild-type mice and 6 rapamycin-treated mice were taken respectively to establish wound models as wild-type group and rapamycin group. On PID 3, the mRNA and protein expressions of IL-22 and CCL20 in the peri-wound epidermis tissue of mice in the two groups were detected by real-time fluorescence quantitative RT-PCR and Western blotting, respectively. The Vγ4 T cells were divided into normal control group without any treatment and rapamycin-treated rapamycin group. After being cultured for 24 hours, the mRNA and protein expressions of IL-22 of cells in the two groups were detected by real-time fluorescence quantitative RT-PCR and Western blotting, respectively, with the number of samples being 6. Data were statistically analyzed with independent sample t test, analysis of variance for repeated measurement, one-way analysis of variance, Bonferroni method, Kruskal-Wallis H test, and Wilcoxon rank sum test. Results: The percentage of Vγ4 T cells in the epidermal cells of the skin tissue around the wound of mice in trauma only group on PID 3 was 0.66% (0.52%, 0.81%), which was significantly higher than 0.09% (0.04%, 0.14%) in the epidermal cells of the normal skin tissue of mice in normal control group (Z=4.31, P<0.01). The percentages of Vγ4 T cells in the epidermal cells of the skin tissue around the wound of mice in rapamycin+trauma group and trauma+CCL20 inhibitor group on PID 3 were 0.25% (0.16%, 0.37%) and 0.24% (0.17%, 0.35%), respectively, which were significantly lower than that in trauma only group (with Z values of 2.27 and 2.25, respectively, P<0.05). The mRNA expression level of IL-22 of cells in Vγ4 T cell group was significantly higher than that in Vγ3 T cell group, γδ negative cell group, and melanoma cell control group (with Z values of 2.96, 2.45, and 3.41, respectively, P<0.05 or P<0.01). Compared with that in wild-type control group, the percentage of wound area of mice in rapamycin control group increased significantly on PID 1-6 (P<0.01), the percentage of wound area of mice in Vγ4 T cell+IL-22 inhibitor group increased significantly on PID 1 and PID 3-6 (P<0.05 or P<0.01). Compared with that in rapamycin control group, the percentage of wound area of mice in Vγ4 T cell only group decreased significantly on PID 1-6 (P<0.05 or P<0.01). Compared with that in Vγ4 T cell only group, the percentage of wound area of mice in Vγ4 T cell+IL-22 inhibitor group increased significantly on PID 3-6 (P<0.05 or P<0.01). On PID 3, compared with those in wild-type group, the expression levels of IL-22 protein and mRNA (with t values of -7.82 and -5.04, respectively, P<0.01) and CCL20 protein and mRNA (with t values of -7.12 and -5.73, respectively, P<0.01) were decreased significantly in the peri-wound epidermis tissue of mice in rapamycin group. After being cultured for 24 hours, the expression levels of IL-22 protein and mRNA in Vγ4 T cells in rapamycin group were significantly lower than those in normal control group (with t values of -7.75 and -6.04, respectively, P<0.01). Conclusions: In mice with full-thickness skin defects, rapamycin may impair the CCL20 chemotactic system by inhibiting the expression of CCL20, leading to a decrease in the recruitment of Vγ4 T cells to the epidermis, and at the same time inhibit the secretion of IL-22 by Vγ4 T cells, thereby slowing the wound healing rate.

Quantitative evaluation of global left ventricular myocardial work in patients with hepatitis B cirrhosis by pressure-strain loop / 中华肝脏病杂志

Objective: To quantitatively evaluate myocardial work in patients with hepatitis B cirrhosis by using left ventricular pressure-strain loop. Methods: 70 cases with hepatitis B cirrhosis who were hospitalized in Henan Provincial People's Hospital from March to December 2020 were selected as the study group. Patients were divided into three subgroups according to the Child-Pugh score of liver cirrhosis (Child-Pugh class A, B, and C groups: 25, 25, and 20 patients, respectively). At the same time, 25 healthy volunteers were included as the control group. Global longitudinal strain (GLS), global myocardial work index (GWI), global work efficiency (GWE), global constructive work (GCW), and global wasted work (GWW) were obtained by applying pressure-strain loops. The differences were analyzed and compared among the four groups parameters. Results: Compared with the control group, the Child-Pugh class A group had decreased GLS, while Child-Pugh class B and C had decreased GLS, GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Compared with Child-Pugh class A group, Child-Pugh class B group had decreased GLS, GWE, and increased GWW, while Child-Pugh class C group had decreased GLS,GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Compared with Child-Pugh class B group, Child-Pugh class C group had decreased GLS, GWI, GWE, GCW, and increased GWW, and the differences were statistically significant (P<0.05). Conclusion: The pressure-strain loop can detect early myocardial dysfunction, and has a certain value in the diagnosis, treatment and prognosis evaluation of myocardial function changes in patients with hepatitis B cirrhosis.

The effect of miR-485-5p on cisplatin resistance of colon cancer cells / 中华老年医学杂志

Objective:To investigate the effect of miR-485-5p on cisplatin resistance of colon cancer cells through the PI3K/Akt-PAK1 signaling pathway.Methods:The LoVo/DDP cell lines were constructedand divided into an NC group(without transfection treatment), an miR-485-5p mimics group(transfected with miR-485-5p mimics), an miR-485-5p inhibitors group(transfected with miR-485-5p inhibitors), an IPA-3 group(intervention with IPA-3)and an miR-485-5p mimics+ IPA-3 group(transfection with miR-485-5p mimics andinterventionwith IPA-3), with all given 0, 3, and 5 μmol/L cisplatin treatment.Results:Among the 20 patients, the proportion of negative miR-485-5p detection was 85.0%(17/20), and the proportion of positive detection was 15.0%(3/20); the proportion of negative PAK1 detection was 20.0%(4/20), and the proportion of positive detection was 80.0%(16/20). The expression of miR-485-5p in colon cancer tissue was significantly lower than that in adjacent tissues( P<0.05); the expression of miR-485-5p in the human colon cancer cell lines LoVo, SW620, HCT116, and SW480 was all lower than in normal intestinal mucosal cells( P<0.05); the expression of miR-485-5p in LoVo/DDP was significantly lower than inLoVo( P<0.001). Under the action of 3 μmol/L and 5 μmol/L cisplatin, LoVo/DDP had highercell viability but a lower apoptosis rate than LoVo( P<0.001). The cell survival rate in the miR-485-5p mimics group was significantly lower than that in the miR-485-5p inhibitors group( P<0.001). Compared with the NC mimics group, overexpression of miR-485-5p significantly down-regulated luciferase activity of the wild-type PAK1 reporter gene( P<0.001); P-PI3k, P-Akt and PAK1levels in the miR-485-5p mimics group were significantly lower than in the miR-485-5p inhibitors group( P<0.001); the cell survival rate in the miR-485-5p mimics group, the IPA-3 group and the miR-485-5p mimics+ IPA-3 group was significantly lower than in the NC group( P<0.001)and the cell survival rate in the miR-485-5p mimics+ IPA-3 group was significantly lower than in the miR-485-5p mimics group( P<0.001). Conclusions:Up-regulation of miR-485-5p reverses colon cancer cisplatin resistance through the PI3K/Akt-PAK1signaling pathway, suggesting that overexpression of miR-485-5p or inhibition of the PI3K/Akt-PAK1signaling pathway enhances the therapeutic efficacy of cisplatin in colon cancer.

Primary study of motion correction effect on myocardial blood flow quantitative imaging with CZT SPECT / 中华核医学与分子影像杂志

Objective:To investigate the effect of motion correction (MC) on the calculated values of myocardial blood flow (MBF) and myocardial flow reserve (MFR) based on cadmium-zinc-telluride SPECT (CZT SPECT) images.Methods:Twenty-eight consecutive patients (10 males, 18 females, age: (60.75±11.62) years) with suspected or known coronary artery disease who underwent myocardial perfusion imaging (MPI) with dynamic CZT SPECT between June 2019 and August 2019 in TEDA International Cardiovascular Hospital were retrospectively analyzed. The MBF and MFR during rest imaging and stress imaging were quantitatively analyzed. Corridor 4DM software was used to calculate the stress MBF (sMBF) and MFR of the coronary artery branches and left ventricular (LV) before and after MC. The paired t test and Pearson correlation were used for data analysis. Results:The sMBF and MFR of LV before MC were (0.82±0.49) ml·min -1·g -1 and 1.69±0.68 respectively. After MC the two parameters increased to (1.05±0.64) ml·min -1·g -1 and 2.12±0.77 respectively ( t values: -4.87, -6.01, both P<0.001). The sMBF and MFR in left anterior descending (LAD), left circumflex (LCX), right coronary artery (RCA) and LV before MC were correlated with those after MC ( r values: 0.69-0.96, all P<0.001). If MFR <2.0 was used as the reference of impaired MFR, data before MC showed 19 patients (67.9%, 19/28) had impaired MFR, while 13 patients (46.4%, 13/28) had impaired MFR based on MFR values after MC. Conclusion:For MPI quantitative imaging with CZT SPECT, the calculated values of sMBF and MFR after MC is higher than those before MC, suggesting that MC is helpful to reduce the false positive results which may be caused by the " creep" effect of the heart.

Sweroside Effectively Protects Against Ischemia/Reperfusion Injury by Regulating Excitation-contraction Coupling / 中国实验方剂学杂志

ObjectiveTo explore the effect of sweroside on the protection of cardiac systolic/diastolic function during ischemia/reperfusion （I/R） injury. MethodTwenty-four healthy male SD rats were randomly divided into control group， model group， 10 μmol·L-1 sweroside group and 1 μmol·L-1 digoxin group. The I/R injury was modeled by Langendorff and ligation of the left anterior descending coronary artery. The infarct size in each group was measured by 2，3，5-triphenyltetrazolium chloride （TTC） staining and hemodynamic parameters such as left ventricular diastolic pressure （LVDP）， left ventricular end-diastolic pressure （LVEDP）， left ventricular end-systolic pressure （LVESP）， maximum rate of rising of left ventricular pressure （+dp/dtmax） and maximum rate of decreasing of left ventricular pressure （-dp/dtmax） of rat isolated heart were detected by Powerlab. In addition， neonatal rat cardiomyocytes （NRCMs） were isolated and randomly divided into control group， model group， 1 μmol·L-1 sweroside group and 10 μmol·L-1 sweroside group. Hypoxia/reoxygenation （H/R） injury model was established. Cardiac systolic function and calcium transients were examined by multi-functional cell imaging analyzer and laser confocal microscope. Furthermore， real-time polymerase chain reaction（Real-time PCR） was used to verify the mRNA expression of excitation-contraction coupling genes such as L-type calcium channel （Cacnb2）， cytochrome c oxidase subunit 6A2 （Cox6a2）， troponin （Tnnc1， Tnni3， Tnnt2）， actin （Actc1）， and myosin （Myh6， Myl2， Myl4） according to the results of previous transcriptome sequencing and literature investigation. Differentially expressed genes were subjected to cluster analysis. ResultCompared with the conditions in the control group， increased cardiac infarction size （P<0.01） and LVEDP （P<0.01） and decreased LVDP （P<0.01） and LVESP （P<0.05） were observed in the model group， with +dp/dtmax of increasing trend while -dp/dtmax decreasing. Moreover， the cell viability， heart rate and contraction amplitude of NRCMs was reduced （P<0.01）， while the contraction duration， time to peak and relaxation time was elevated （P<0.01） in the model group. Interestingly， sweroside could reverse these indicators （P<0.05）. In addition， the expression of Cacnb2， Cox6a2， Tnnc1， Tnni3， Tnnt2， Actc1， and Myh6， Myl2， and Myl4 was down-regulated in the model group （P<0.05， P<0.01）， but sweroside could up-regulate the expression of the above genes （P<0.05）. ConclusionSweroside effectively regulated Ca2+ level in NRCMs， enhanced cardiac systolic function， and protected against H/R injury by regulating excitation-contraction coupling.

Study on Impedance of Implantable Cardiac Pacemaker in Unipolar/Bipolar Pacing Mode by in Vitro Experiment / 中国医疗器械杂志

The unipolar/bipolar pacing mode of pacemaker is related to its circuit impedance, which affects the battery life. In this study, the in vitro experiment scheme of pacemaker circuit impedance test was constructed. The human blood environment was simulated by NaCl solution, and the experimental environment temperature was controlled by water bath. The results of in vitro experiments showed that under the experimental conditions similar to clinical human parameters, the difference between the circuit impedance of bipolar mode and unipolar mode is 120~200 Ω. The results of the in vitro experiment confirmed that the circuit impedance of bipolar circuit was larger than that of unipolar mode, which was found in clinical practice. The results of this study have reference value to the optimization of pacing mode and the reduction of pacemaker power consumption.

Bioinformatics Analysis on Key Genes and Immune Infiltration of Osteosarcoma / 中国医学科学院学报

Objective To screen the potential key genes of osteosarcoma by bioinformatics methods and analyze their immune infiltration patterns. Methods The gene expression profiles GSE16088 and GSE12865 associated with osteosarcoma were obtained from the Gene Expression Omnibus(GEO),and the differentially expressed genes(DEGs)related to osteosarcoma were screened by bioinformatics tools.Gene Ontology(GO)annotation,Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment,and analysis of immune cell infiltration were then carried out for the DEGs.The potential Hub genes of osteosarcoma were identified by protein-protein interaction network,and the expression of Hub genes in osteosarcoma and normal tissue samples was verified via the Cancer Genome Atlas(TCGA). Results A total of 108 DEGs were screened out.GO annotation and KEGG pathway enrichment revealed that the DEGs were mainly involved in integrin binding,extracellular matrix (ECM) structural components,ECM receptor interactions,and phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt)signaling pathway.Macrophages were the predominant infiltrating immune cells in osteosarcoma.Secreted phosphoprotein 1(SPP1),matrix metallopeptidase 2(MMP2),lysyl oxidase(LOX),collagen type V alpha(II)chain(COL5A2),and melanoma cell adhesion molecule(MCAM)presented differential expression between osteosarcoma and normal tissue samples(all P<0.05). Conclusions SPP1,MMP2,LOX,COL5A2,and MCAM are all up-regulated in osteosarcoma,which may serve as potential biomarkers of osteosarcoma.Macrophages are the key infiltrating immune cells in osteosarcoma,which may provide new perspectives for the treatment of osteosarcoma.

Development of a Recombinase-aided Amplification Combined With Lateral Flow Dipstick Assay for the Rapid Detection of the African Swine Fever Virus / 生物医学与环境科学（英文）

OBJECTIVE@#To establish a sensitive, simple and rapid detection method for African swine fever virus (ASFV) B646L gene.@*METHODS@#A recombinase-aided amplification-lateral flow dipstick (RAA-LFD) assay was developed in this study. Recombinase-aided amplification (RAA) is used to amplify template DNA, and lateral flow dipstick (LFD) is used to interpret the results after the amplification is completed. The lower limits of detection and specificity of the RAA assay were verified using recombinant plasmid and pathogenic nucleic acid. In addition, 30 clinical samples were tested to evaluate the performance of the RAA assay.@*RESULTS@#The RAA-LFD assay was completed within 15 min at 37 °C, including 10 min for nucleic acid amplification and 5 minutes for LFD reading results. The detection limit of this assay was found to be 200 copies per reaction. And there was no cross-reactivity with other swine viruses.@*CONCLUSION@#A highly sensitive, specific, and simple RAA-LFD method was developed for the rapid detection of the ASFV.

Atrial fibrillation in critically ill patients who received prolonged mechanical ventilation: a nationwide inpatient report

Background/Aims@#To evaluate temporal trends of atrial fibrillation (AF) prevalence in critically ill patients who received prolonged mechanical ventilation (MV) in the United States. @*Methods@#We used the 2008 to 2014 National Inpatient Sample to compute the weighted prevalence of AF among hospitalized adult patients on prolonged MV. We used multivariable-adjusted models to evaluate the association of AF with clinical factors, in-hospital mortality, hospitalization cost, and length of stay (LOS). @*Results@#We identified 2,578,165 patients who received prolonged MV (21.27% of AF patients). The prevalence of AF increased from 14.63% in 2008 to 24.43% in 2014 (p for trend < 0.0001). Amongst different phenotypes of critically ill patients, the prevalence of AF increased in patients with severe sepsis, asthma exacerbation, congestive heart failure exacerbation, acute stroke, and cardiac arrest. Older age, male sex, white race, medicare access, higher income, urban teaching hospital setting, and Western region were associated with a higher prevalence of AF. AF in critical illness was a risk factor for in-hospital death (odds ratio, 1.13; 95% confidence interval, 1.11 to 1.15), but in-hospital mortality in critically ill patients with AF decreased from 11.6% to 8.3%. AF was linked to prolonged LOS (2%, p < 0.0001) and high hospitalization cost (4%, p < 0.0001). LOS (–1%, p < 0.0001) and hospitalization cost (–4%, p < 0.0001) decreased yearly. @*Conclusions@#The prevalence of comorbid AF is increasing, particularly in older patients. AF may lead to poorer prognosis, and high-quality intensive care is imperative for this population.

Mechanisms for Nogo-B mediating mitochondrial reactive oxygen species generation during vascular remodeling in mice / 中华老年医学杂志

Objective:To investigate the role of Nogo-B in mitochondrial reactive oxygen species(m-ROS)production and vascular remodeling in vascular smooth muscle cells(VSMCs), and to further clarify the molecular mechanism for Nogo-B in m-ROS production via regulating ATP synthase expression.Methods:A mouse model of vascular remodeling was established.The expression of Nogo-B in mouse smooth muscle cells was detected.Forty mice were divided into the AAV-NC+ control, AAV-NC+ angiotensin Ⅱ(AngⅡ), AAV-Nogo-B+ control and AAV-Nogo-B+ AngⅡ groups(n=10 for each group). VSMCs cultured in vitro were divided into the control group and the Nogo-B overexpression group(Ad-Nogo-B). The expression of Nogo-B in VSMCs in vitro stimulated with AngⅡ was detected.Through experiments conducted in vivo, Nogo-B was overexpressed in VSMCs, then VSMCs were stimulated with AngⅡ, and m-ROS production, tissue fibrosis and mitochondrial function were examined.The regulatory effects of Nogo-B on m-ROS production were explored.Molecular mechanisms for NoGO-B in vascular remodeling via regulating ATP synthase/m-ROS production were examined. Results:Compared with the control group, the expression of Nogo-B was decreased in VSMCs treated with AngⅡ(0.36±0.13 vs.1.00±0.13, t=8.44, P<0.05). The production of m-ROS, fibrosis and mitochondrial dysfunction were increased in VSMCs during vascular remodeling( P<0.05), while overexpression of Nogo-B significantly reduced m-ROS production, fibrosis and mitochondrial dysfunction( P<0.05). ATP synthase expression in VSMCs was positively regulated by Nogo-B.ATP synthase expression was higher in the AAV-Nogo-B+ AngⅡ group than in the AAV-NC+ AngⅡ group(0.86±0.14 vs.0.49±0.17, t=-3.97, P<0.05). The production of m-ROS was reduced by Nogo-B and was lower in the AAV-Nogo-B+ AngⅡ group than in the AAV-NC+ AngⅡ group(1.28±0.34 vs.3.26±0.57, t=7.18, P<0.05). Meanwhile, the ability of Nogo-B to mitigate the deleterious effects of oxidative stress in VSMCs could be offset by oligomycin. Conclusions:Nogo-B participates in vascular remodeling by regulating ATP synthase-mediated m-ROS production.

Preliminary construction of health literacy monitoring questionnaire for general practitioners / 中华全科医师杂志

Objective:To develop a monitoring tool for evaluating health literacy level of general practitioners.Methods:The health literacy monitoring questionnaire for general practitioners was preliminarily developed by referring to the National Residents′ Health Literacy Monitoring Questionnaire. The Delphi method was used to conduct two rounds of consultation among 15 experts to improve the questionnaire.Results:The effective response rates of the two rounds of expert consultation were 100.0%, the expert authority coefficients of the two rounds of consultation were 0.87 and 0.86, the mean scores of the two rounds of expert questions were 3.93 -5.00 and 4.47-5.00. The variance coefficients of the two rounds of expert scores were 0-0.32 and 0-0.20, and the Kendall harmony coefficients of the two rounds of expert scores were 0.167 and 0.102, respectively (all P<0.05). Finally, the basic theory literacy dimension (including 8 chronic disease prevention items, 5 maternal and child health items and 5 infectious disease prevention items), and the basic skill literacy dimension (including 6 safety and first aid items, 8 health information items), and the healthy lifestyle and behavior dimension (7 items, including regular physical examination, exercise, diet and so on) were established. A total of 39 items and 3 dimensions were used to monitor the health literacy level of general practitioners. Conclusion:The monitoring tool of health literacy level for general practitioners based on Delphi method has been preliminarily constructed, which can be used to evaluate the health literacy level of general practitioners.

Effect of laparoscopic transvesical radical prostatectomy on sexual function and urinary control / 中华泌尿外科杂志

Urinary incontinence and sexual dysfunction are common complications after prostatectomy. The clinical data of 12 patients with low-risk localized prostate cancer treated in Shanghai Jiao Tong University Affiliated 6th People’s Hospital from November 2017 to November 2018 were analyzed retrospectively. All patients underwent transvesical laparoscopic radical prostatectomy. The recovery of urinary control and erectile function was satisfactory, with few complications and definite tumor control effect.

Evaluation of left ventricular diastolic function by strain rate parameters in patients with coronary artery disease without regional wall motion abnormalities / 中华超声影像学杂志

Objective:To investigate the value of early diastolic strain rate (e′SR) and peak value of early diastolic velocity (E) to e′SR (E/e′SR) in predicting the severity of coronary lesions in patients with coronary artery disease (CAD) without regional wall motion abnormalities (RWMA) and with preserved left ventricular ejection fraction (LVEF).Methods:A selection of 70 patients with CAD without RWMA and with preserved LVEF (>50%) admitted to Zhengzhou University People′s Hospital from October 2020 to March 2021 were collected and divided into two groups according to the Gensini score method: low group with a score<34 and high group with a score≥34. Another 30 healthy volunteers with matching gender and age at the same period were selected as the control group. Cardiac structural parameters left atrium diameter (LAD), left ventricular end diastolic diameter (LVEDd), left ventricular end systolic diameter (LVEDs), interventricular septum diastolic diameter (IVST), left atrial volume (LAV), E, peak value of late diastolic velocity (A) of mitral inflow, peak value of early diatolic tissue Doppler velocity of septal and lateral walls of mitral annulus and LVEF were routinely measured. Left atrial volume index (LAVI), mean of peak value of early diatolic tissue Doppler velocity of septal and lateral walls of mitral annulus (e′), E/e′were calculated. Speckle tracking imaging (STI) technique was used to collect systolic left ventricular global longitudinal strain (GLS) and e′SR, E/e′SR was calculated. The differences in each parameter among the three groups were compared. The ROC curve was used to obtain the best cut-off values of e′SR and E/e′SR for predicting the severity of coronary lesions in CAD patients, respectively, and the corresponding sensitivity and specificity were obtained, respectively.Results:Compared with the control group, LAV and LAVI were increased in the high group (all P<0.05). Compared with the control and the low group, e′ was decreased and E/e′ was increased in the high group (all P<0.05). Compared with the control group, e′SR and GLS were decreased and E/e′SR were increased in the high and low groups (all P<0.05). Compared with the low group, e′SR and GLS were decreased and E/e′SR was increased in the high group (all P<0.05). ROC curve analysis showed that the maximum area of E/e′SR under the curve was 0.717. When the Youden index was maximum, its best cut-off value was 0.75 m, and corresponding sensitivity and specificity were 60.0% and 85.7%, respectively. The maximum area under the e′SR curve was 0.785. When the Youden index was maximum, its best cut-off value was 1.12 s -1, and the corresponding sensitivity and specificity were 85.7% and 68.6%, respectively. Conclusions:For CAD patients without significant RWMA and with preserved LVEF, left ventricular diastolic and systolic function may be impaired to varying degrees, manifesting as decreased e′SR, increased E/e′SR, decreased GLS. The parameters of diastolic strain rate are a reliable basis for early detection of impaired diastolic function in CAD patients, and have certain clinical significance for predicting the severity of coronary lesions.

A follow-up study on the effects of different blood pressure control levels on left ventricular myocardial mechanics / 中华超声影像学杂志

Objective:To evaluate the effects of different blood pressure control levels on left ventricular myocardial mechanics in patients with primary elderly hypertension by using two-dimensional speckle tracking imaging (2D-STI).Methods:A total of 315 elderly patients with essential hypertension diagnosed in Bethune Hospital Affiliated to Shanxi Medical University from January to June 2017 were collected and randomly divided into standard antihypertensive group and intensive antihypertensive group. The patients who were receiving antihypertensive drugs were treated with antihypertensive drugs more or less, and the patients who had not yet been treated started antihypertensive drugs therapy. The blood pressure was adjusted to the target value within 3 months (blood pressure in standard antihypertensive group was controlled at 130-150/<90 mmHg, intensive antihypertensive group was controlled at 110-130/<80 mmHg). All patients were followed up for 24 months. After 24 months of antihypertensive drugs treatment, 26 cases of lost follow-up, substandard blood pressure or poor image quality were excluded, and 289 patients were included, standard antihypertensive group ( n=148), intensive antihypertensive group ( n=141) . During the same period, 71 age-matched people without essential hypertension were selected as control group. Comprehensive echocardiography were performed in all subjects at baseline and 24 months. The longitudinal strain of the inner, middle and outer layers (GLS-endo, GLS-mid, GLS-epi) of the whole left ventricle were obtained by two-dimensional speckle tracking technique. The routine echocardiographic and left ventricular strain parameters were compared at baseline and 24 months. Results:①At baseline, the end-diastolic thickness of interventricular septum (IVSD), the end-diastolic thickness of left ventricular posterior wall (LVPWD), the end-diastolic diameter of left ventricle (LVEDD), the left ventricular mass index (LVMI), the relative wall thickness (RWT) and the ratio of early diastolic mitral flow velocity to early diastolic mitral annulus velocity(E/e′) in two antihypertensive groups were higher than those in the control group, and the levels of GLS-endo, GLS-mid and GLS-epi were lower than those in the control group(all P<0.05). There were no significant differences in routine echocardiographic parameters and strain parameters between standard antihypertensive group and intensive antihypertensive group (all P>0.05). ②After 24 months of antihypertensive drugs treatment, LVEDD and E/e′ in standard antihypertensive group and IVSD, LVPWD, LVEDD, LVMI, RWT, E/e′in intensive antihypertensive group were lower than those at baseline, and IVSD, LVMI and RWT in intensive antihypertensive group were lower than those in standard antihypertensive group (all P<0.05). ③After 24 months of antihypertensive drugs treatment, GLS-endo, GLS-mid and GLS-epi in two antihypertensive groups were higher than those at baseline, and GLS-endo, GLS-mid, GLS-epi in intensive antihypertensive group were higher than those in standard antihypertensive group(all P<0.05). Conclusions:①The left ventricular myocardial mechanics is damaged and the systolic function is decreased in elderly patients with essential hypertension; ②The myocardial mechanics is significantly improved after antihypertensive treatment, with more improvement in intensive antihypertensive treatment patients.

The mechanism of Shuyu capsules in treating premenstrual dysphoric disorder caused by liver qi depression based on microdialysis technology from the aspect of Glu-GABA metabolic pathway / 国际中医中药杂志

Objective:To explore the mechanism of premenstrual dysphoric disorder (PMDD) caused by liver-qi depression from the aspect of Glu-GABA metabolic pathways.Methods:Thirty-six rats with similar open field scores and regular estrus cycles were divided into blank group, model group, fluoxetine group, Shuyu capsule group, saikosaponin group and inhibitor group according to the random number table method, with 6 rats in each group. Stereotactic hippocampus surgery was performed during the first estrous cycle reception period after the estrus cycle was determined. In the non-receiving period of the third and fourth estrus cycles, the restraint model was constructed, and from the first day of the modeling, rats of the fluoxetine group were given fluoxetine capsules 2.67 mg/kg, while rats of the Shuyu capsule group and saikosaponin group were given Shuyu capsules 0.408 g/kg and saikosaponin 0.72 mg/kg once a day for 5 consecutive days. Rats in the inhibitor group were injected with 20 μl L-malic acid with 5 mmol/L concentration, which is an inhibitor of glutamate decarboxylase (GAD), in the hippocampus on the last day of modeling. After the administration, weighed the rats and carried out open field experiments. During the second and fivth estrus cycles of rats, the extracellular fluid of the hippocampus was collected by microdialysis technology, and the content of Glu and GABA in the dialysate was detected by HPLC-FLD. Results:After 5 days of administration, compared with the model group, the body weight of rats in the Shuyu capsule group, the inhibitor group and the fluoxetine group increased ( P<0.05), and the total score of the open field experiment decreased ( P<0.05); compared with the model group, during the receiving period of the five estrus cycle, the Glu level of the Shuyu capsule group and the inhibitor group decreased ( P<0.05); In the non-receiving period of the fifth estrus cycle, the Shuyu capsule group, Glu level of the fluoxetine group and the saikosaponin group increased, GABA level of Shuyu capsule group, inhibitor group and fluoxetine group decreased ( P<0.05), Glu/GABA level of Shuyu capsule group, fluoxetine group and inhibitor group (1.49 ± 0.13, 1.32 ± 0.33, 3.92 ± 0.79 vs. 0.35 ± 0.48) was higher than that of the model group ( P<0.05). Conclusion:The therapeutic mechanism of Shuyu capsule in the treatment of PMDD caused by liver Qi depression rats may be ascribed to inhibiting GAD from Glu-GABA metabolic pathway.

Satisfaction degree and related factors of community health services among residents in Zhejiang province / 中华全科医师杂志

Objective:To analyze the satisfaction degree and related factors of community health services among residents in Zhejiang province.Methods:A service satisfaction survey was conducted during July to October 2019; using purpose sampling method three community health service centers were selected as survey sites in Hangzhou, Jiaxing, and Lishui cities, representing high, medium, and low economic development levels in Zhejiang province. The short-form Patient Satisfaction Questionnaire (PSQ-18) was used in the survey. SPSS 19.0 was adapted for data analysis, and multivariate logistic regression was applied use of analyze the affecting factors of satisfaction.Results:A total of 464 questionnaires were distributed, and 429 valid ones were returned with a response rate of 92.46%. Among them, 112 were from Hangzhou, 159 from Jiaxing, and 158 from Lishui. The overall satisfaction score of community health services was (4.22±0.59), and the satisfaction rate was 85.8%(368/429).Among the three cities, the overall satisfaction score in Lishui was the highest (4.28±0.51) with a satisfaction rate of 88.7% (140/158). The satisfaction scores of service quality, doctors' interpersonal communication ability, doctor-patient communication level, economic efficiency of service, timeliness of service, and accessability of service were (3.99±0.57), (4.10±0.77), (4.27±0.56), (3.54±0.84), (4.13±0.68) and (3.88±0.55); the satisfaction rates of those items were 59.6%(256/429), 79.4%(340/429), 86.3%(370/429), 43.6%(187/429), 78.9%(338/429)and 50.3%(216/429), respectively. Multivariate logistic regression analysis indicated that the quality of service, doctors' interpersonal communication ability, doctor-patient communication level and accessability of service were the affecting factors of the residents' satisfaction to community health services ( OR=3.734, 2.928, 7.732, 4.275; P<0.05). Conclusion:The residents of Zhejiang province have a high overall satisfaction with community health services. The quality of service, doctors' interpersonal communication ability, doctor-patient communication level and accessability of service are the affecting factors of the overall satisfaction degree.