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1.
Asian Journal of Andrology ; (6): 240-248, 2021.
Article in English | WPRIM | ID: wpr-879765

ABSTRACT

Spermatogonial stem cells (SSCs) have great applications in both reproductive and regenerative medicine. Primates including monkeys are very similar to humans with regard to physiology and pathology. Nevertheless, little is known about the isolation, the characteristics, and the culture of primate SSCs. This study was designed to identify, isolate, and culture monkey SSCs. Immunocytochemistry was used to identify markers for monkey SSCs. Glial cell line-derived neurotrophic factor family receptor alpha-1 (GFRA1)-enriched spermatogonia were isolated from monkeys, namely Macaca fascicularis (M. fascicularis), by two-step enzymatic digestion and magnetic-activated cell sorting, and they were cultured on precoated plates in the conditioned medium. Reverse transcription-polymerase chain reaction (RT-PCR), immunocytochemistry, and RNA sequencing were used to compare phenotype and transcriptomes in GFRA1-enriched spermatogonia between 0 day and 14 days of culture, and xenotransplantation was performed to evaluate the function of GFRA1-enriched spermatogonia. SSCs shared some phenotypes with rodent and human SSCs. GFRA1-enriched spermatogonia with high purity and viability were isolated from M. fascicularis testes. The freshly isolated cells expressed numerous markers for rodent SSCs, and they were cultured for 14 days. The expression of numerous SSC markers was maintained during the cultivation of GFRA1-enriched spermatogonia. RNA sequencing reflected a 97.3% similarity in global gene profiles between 0 day and 14 days of culture. The xenotransplantation assay indicated that the GFRA1-enriched spermatogonia formed colonies and proliferated in vivo in the recipient c-Kit

2.
Cancer Research and Clinic ; (6): 9-13, 2021.
Article in Chinese | WPRIM | ID: wpr-886011

ABSTRACT

Objective:To investigate the progression pattern of acquired resistance to osimertinib and the treatment method as well as the therapeutic effect of salvage therapy in advanced lung cancer patients with epidermal growth factor receptor (EGFR) sensitive mutation or T790M mutation after the treatment of tyrosine-kinase inhibitor (TKI).Methods:The data of 145 patients with advanced lung cancer treated with osimertinib in Jiangsu Cancer Hospital between April 2017 (the approval time of osimertinib in China) and May 2019 were collected. At the last follow-up (December 2019), a total of 87 (60.0%) patients had acquired resistance to osimertinib, 61 (70.1%) of whom received salvage treatment; for patients with dramatic progression after resistance, chemotherapy was mainly given in the salvage therapy; for patients with gradual or local progression after resistance, the continuing targeted drug therapy and the local therapy were given. Imaging evaluation and Kaplan-Meier method were used to analyze the progression pattern of acquired resistance to osimertinib and the survival status, and to compare the salvage treatment results among subgroups.Results:The median follow-up time of 61 patients receiving salvage therapy was 11 months (4-32 months), among which 58 (95.1%) patients again had resistance to osimertinib, and 24 (39.3%) patients died of lung cancer. The median progression-free survival (PFS) time and overall survival (OS) time for the whole cohort was 2.5 months (95% CI 2.1-3.0 months) and 19.0 months (95% CI 13.7-26.3 months), respectively. The 1-year and 2-year OS rate was 72.1% and 41.7%, respectively. Among 61 patients receiving salvage therapy, 8 (13.1%) , 30 (49.2%) and 23 (37.7%) cases had dramatic progression, gradual progression and local progression, respectively; when given timely and proper salvage treatment, there were no statistically differences in PFS and OS of the patients in the above three subgroups (all P>0.05). There were no statistically differences in PFS and OS between patients receiving local therapy (24 cases) and patients not receiving local therapy (37 cases) after the progression occurred (all P>0.05). Among 58 patients with resistance to osimertinib again after the salvage therapy, 6 patients with gradual or local progression had more than 6-mouth PFS after the salvage therapy. Conclusions:Dramatic, gradual and local progression are the main patterns in patients with acquired resistance to osimertinib. The therapeutic efficacy of salvage therapy still shows some disappointing results.

3.
Chinese Journal of Urology ; (12): 97-103, 2021.
Article in Chinese | WPRIM | ID: wpr-884966

ABSTRACT

Objective:To analyze the prognostic factors of robot-assisted radical cystectomy (RARC).Methods:The clinical data of 224 patients underwent RARC from December 2014 to December 2018 in Nanjing Drum Hospital were reviewed. There were 193 males and 31 females, aged 36-92 years, with mean of 68 years. There were 7 patients(3.1%)undergoing neoadjuvant chemotherapy, the ASA scores of 125 patients (55.8%) were more than 2, and the mean body mass index was 23.4(15.4-35.5)kg/m 2. All patients were treated with RARC, with 72(32.1%) patients undergoing intraoperative blood transfusion. Kaplan-Meier method was used to analyze recurrence-free survival rate (RFS), cancer-specific survival rate (CSS) and overall survival rate (OS). Cox multivariate risk ratio model was used to evaluate the correlation between survival outcome and perioperative and pathological factors in patients treated with RARC. Results:For pathological status, there were 82 of ≤T 1, 64 of T 2, 57 of T 3 and 21 of T 4. Of all the patients, 49(21.9%) had lymph node metastasis, 12(5.4%) had positive surgical margin, 82(36.6%) had lymphovascular invasion(LVI), and 41(18.3%) underwent adjuvant chemotherapy. Follow-up time was between 11-60 months, and the median follow-up time was 24 months. The 5-year cumulative OS, RFS and CSS were 57.15%, 48.84% and 59.60%, respectively. Univariate Cox regression analysis showed that T stage( HR=5.764, 95% CI 1.926-17.249, P=0.002; HR=4.086, 95% CI 1.611-10.364, P=0.003; HR=9.391, 95% CI 2.118-41.637, P=0.003), N stage( HR=6.446, 95% CI 3.438-12.087, P<0.001; HR=5.661, 95% CI 3.086-10.385, P<0.001; HR=5.980, 95% CI 2.982-11.992, P<0.001), LVI( HR=3.319, 95% CI 2.008-5.486, P<0.001; HR=2.894, 95% CI 1.782-4.701, P<0.001; HR=3.471, 95% CI 2.017-5.974, P<0.001), American Society of Anesthesia (ASA)score( HR=2.888, 95% CI 1.619-5.150, P<0.001; HR=1.765, 95% CI 1.060-2.940, P=0.029; HR=2.612, 95% CI 1.424-4.792, P=0.002), body mass index( HR=0.886, 95% CI 0.819-0.957, P=0.002; HR=0.885, 95% CI 0.819-0.955, P=0.002; HR=0.862, 95% CI 0.792-0.938, P=0.001), age( HR=1.580, 95% CI 1.250-1.997, P<0.001; HR=1.362, 95% CI 1.088-1.705, P=0.007; HR=1.530, 95% CI 1.190-1.968, P=0.001) and intraoperative blood transfusion( HR=1.899, 95% CI 1.160-3.108, P=0.011; HR=2.218, 95% CI 1.371-3.587, P=0.001; HR=2.227, 95% CI 1.312-3.782, P=0.003) were significantly related to survival outcome. Multivariate Cox regression analysis showed that T stage( HR=4.506, 95% CI 1.433-14.175, P=0.01; HR=3.159, 95% CI 1.180-8.454, P=0.022; HR=7.810, 95% CI 1.674-36.444, P=0.009), N stage( HR=6.096, 95% CI 2.981-12.467, P<0.001; HR=5.368, 95% CI 2.683-10.740, P<0.001; HR=5.539, 95% CI 2.497-12.288, P<0.001) and ASA score( HR=6.180, 95% CI 2.371-16.110, P<0.001; HR=2.702, 95% CI 1.175-6.215, P=0.019; HR=6.471, 95% CI 2.290-18.286, P<0.001) were independent predictors of RFS, CSS and OS, and adjuvant chemotherapy( R=0.434, 95% CI 0.202-0.930, P=0.032) could only predict OS. Conclusion:T stage, N stage and ASA were main independent predictors of postoperative survival outcomes, and adjuvant chemotherapy was independent predictor of OS.

4.
Chinese Journal of Geriatrics ; (12): 364-369, 2021.
Article in Chinese | WPRIM | ID: wpr-884896

ABSTRACT

Objective:To investigate the nutritional status of elderly inpatients in China, and to assess its relationship with clinical outcomes.Methods:A prospective, multicenter, parallel investigation was organized and conducted by the Chinese Medical Association's Group of Geriatric Nutrition Support.Patients aged ≥65 years from 30 major hospitals of 14 cities in China were evaluated by the Nutritional Risk Screening 2002(NRS2002)and the Mini-Nutritional Assessment-Short Form(MNA-SF), in order to understand the nutritional status and nutritional risk of elderly inpatients in China.The indicators of clinical outcomes were summarized, and the correlation between nutritional status and clinical outcomes was analyzed.Results:A total of 10 184 elderly patients who met the inclusion criteria were enrolled in this study, aged 65-112(74.81±7.01)years, with a body mass index(BMI)of 17.80-35.50(23.32±3.83)kg/m 2.Grip strength of the dominant hand was(16.95±18.42)kg, upper arm circumference was(25.68±3.70)cm, and calf circumference was(32.07±3.89)cm.BMI, grip strength, upper arm circumference and calf circumference decreased significantly with age( F=13.74, 97.47, 28.31 and 88.68, all P<0.001). NRS2002 was conducted on 10 182 patients.Of them, 10.14%(895/10 182)suffered malnutrition(BMI≤18.5 kg/m 2), and 46.42%(4 726/10 182)were at nutritional risk(NRS2002 score≥3). Nutrition deficiency and nutritional risk showed upward trends with age( F=43.41 and 177.05, both P<0.001). A total of 9 755 patients(95.79%, 9 755/10 182)completed the MNA-SF.Of them, 14.67%(1 431/9 755)had malnutrition, 35.04%(3 418/9 755)were at risk of malnutrition, and 50.29%(4 906/9 755)had normal nutritional status.The incidence of malnutrition and the risk of malnutrition significantly increased with age( F=172.79, 12.10 and 152.42, all P<0.05). Nutritional risk(NRS2002 score≥3)was related to age, BMI, mortality, infectious complications, length of hospital stay and total hospital cost(all P<0.05). Conclusions:The incidence of malnutrition and the risk of malnutrition are high in elderly inpatients in China.Nutritional risk is an influencing factor for adverse clinical outcomes.

5.
Chinese Journal of Orthopaedics ; (12): 386-397, 2021.
Article in Chinese | WPRIM | ID: wpr-884723

ABSTRACT

Due to good mechanical properties and biocompatibility, tissue engineering scaffolds have become the vital method for repairing and regenerating articular cartilage defects. With the continuous development of tissue engineering technology, many scaffolds preparation and formation methods have been developed and tested in the past decade, however, the preparation of ideal regenerative scaffolds remain controversial. As load-bearing tissue inside the body joints, the matrix structure and cell composition of articular cartilage are hierarchical, and there are several smooth natural gradients from the cartilage surface to the subchondral bone layer, including cell phenotype and number, specific growth factors, matrix composition, fiber arrangement, mechanical properties, nutrient and oxygen consumption. Therefore, in the design of regenerative scaffolds, it is necessary to achieve these gradients to regenerate articular cartilage in situ. In recent studies, many new biomimetic gradient scaffolds have been used to simulate the natural gradient of articular cartilage. These scaffolds show different mechanical, physicochemical or biological gradients in the structure, and have achieved good repair effects. The related articles on tissue engineering for the treatment of articular cartilage defects were retrieved by searching databases with key wordsarticular cartilage injury, cartilage repair and gradient scaffolds. In this work,the structural, biochemical, biomechanical and nutrient metabolism gradients of natural articular cartilage were studied and summarized firstly. Then, the latest design and construction of articular cartilage gradient scaffolds were classified. Besides that, the material composition (such as hydrogels, nanomaterials, etc.) and the preparation process (such as electrospinning, 3D printing, etc.) of grandient scaffolds were further enhanced. Finally, the prospect and challenge of biomimetic gradient scaffolds in cartilage engineering are discussed, which provides a theoretical basis for the successful application of gradient scaffolds in clinical transformation.

6.
Chinese Journal of Orthopaedics ; (12): 195-200, 2021.
Article in Chinese | WPRIM | ID: wpr-884698

ABSTRACT

Traumatic fracture accounts for about 50% of the total of traffic accidents. The incidence of fracture in postmenopausal women is significantly higher than that in men. About 5%-10% of patients with bone fracture will suffer from complications such as delayed union or nonunion, which seriously affects the recovery of patients after operation and increases the economic burden of families and society, however, the specific regulatory mechanism has not been fully defined. Immune cells play an important regulatory role in fracture healing, and innate immune response is the first to initiate and participate in fracture healing. Macrophages are innate immune cells which widely exist in various tissues of the body. They play a complex and precise regulatory role in fracture healing by participating in inflammatory response, osteogenic and osteoclast differentiation, mineralization and angiogenesis. Nevertheless, macrophages can be polarized into different subsets and perform different or even opposite functions under different immune microenvironments. At present, it is believed that there are three main polarization states of macrophages: non-activated M0 macrophages, classically activated M1 macrophages and selectively activated M2 macrophage. It has been shown that each subset was positively involved in the regulation process of fracture healing at different stages. Herein, in this paper, the role of different subsets of macrophages in different stages of fracture healing and the related experimental studies are reviewed, helpfully to clarify the immunological mechanism of fracture in-depth and provide new strategies for the research on the immunological intervention of fractures targeting macrophages.

7.
Chinese Journal of Orthopaedics ; (12): 137-140, 2021.
Article in Chinese | WPRIM | ID: wpr-884697

ABSTRACT

Tibial plateau fracture is a common acute trauma of the knee joint. At present, there are many studies on its classification and treatment, and minimally invasive treatment has become a research hotspot and mainstream direction of tibial plateau fracture. We summarized the clinical results of minimally invasive treatment of more than 300 cases of tibial plateau fractures, and proposed the concept of core weight-bearing area on tibial plateau, that is, the core weight-bearing area of the tibial plateau of the knee joint under normal motion statuswhile walking and moderate-intensity running. We performed thinsection CT scanning of the knee joint in a male volunteer for three-dimension finite element modeling.The results showed that during the walking state (the load was twice that of gravity), the core weight-bearing area of the medial and lateral plateaus was 389 mm 2 and 363 mm 2, accounting for 33.2% and 42.9% of tibial plateau, respectively;during the moderate-intensity running state (the load was four times that of gravity), the core weight-bearing area of the medial and lateral plateaus was 418 mm 2 and 406 mm 2, accounting for 35.6% and 48.0%of tibial plateau, respectively. Accordingly, tibial plateau fractures are supposed to be divided into core weight-bearing fracture and non-core weight-bearing fracture, and there are significant differences in the treatment ofthese twokinds of fractures: reduction is more demanding for core weight-bearing fracture,and the fracture involves the core area closely, the anatomical reduction is sought; for non-core weight-bearing area, the reduction requirements can be appropriately low demanded, and even in some cases , for example simple avulsion fracture, marginal fracture, some tibial plateau Hoffa fractures,can be treated conservatively. In summary, during clinical diagnosis and treatmentpractice, orthopedic surgeons should take the core weight-bearing area fracture as the core of diagnosis and treatment, strictly evaluate the extent of fracture involvement, select targeted internal fixation materials, and target to promote more accurate, minimally invasive, and individualized treatment of tibial plateau fractures.

8.
Article in Chinese | WPRIM | ID: wpr-884583

ABSTRACT

The training program of radiation therapists in the United States has been established early, and the mode of training, qualification and continuing education are relatively complete. Literature review was conducted at home and abroad and United States Department of Labor, American Registry of Radiologic Technologists, American Society of Radiologic Technologists as well as Joint Review Committee on Education in Radiologic Technology websites were reviewed. The training mode, qualification, work content, continuing education and employment situation of American radiotherapists were analyzed, aiming to provide some reference and enlightenment for the establishment of a new model for the training of professional radiologists suitable for the national conditions of China Mainland.

9.
Article in Chinese | WPRIM | ID: wpr-884483

ABSTRACT

Objective:To understand the monitoring levels of individual dose to radiation workers in Jiangsu province from 2011 to 2018, and to analyze their changing trends.Methods:Through National Individual Dose Registry, the data on the monitoring result of occupational external exposure of radiation workers in our province was collected, and statistical analysis was performed.Results:A total of 176 134 radiation workers in Jiangsu province were collected from 2011 to 2018. The annual collective effective dose was 58 man·Sv and the average annual effective dose was 0.35 mSv. The average annual effective doses to medical radiation workers for interventional radiology and nuclear medicine were both 0.41 mSv, with significantly higher NRE ratios than others ( χ2=219.1, P<0.05). By 2018, the numbers of monitored workers were 25 714 for medical radiation, accounting for 81%, with an average annual effective dose of 0.24 mSv, and 6 169 for industrial radiation, accounting for 19%, with an average annual effective dose of 0.18 mSv. Conclusions:The average annual effective dose to radiation workers in Jiangsu province is in consistency with the relevant national standards. The dose values for radiation workers in interventional and nuclear medicine are relatively high. The protection measures in their workplace should be improved. Meanwhile oversight of radiation protection should be enhanced for individual radiation workers in Jiangsu province.

10.
Article in Chinese | WPRIM | ID: wpr-884305

ABSTRACT

Objective:To discuss the characteristics of ultrasound diagnosis of optic disc capillary hemangioma.Methods:The study analyzed retrospectively 7 cases of optic disc capillary hemangioma diagnosed in the Beijing Tongren Hospital from 2015 to 2018. The size, morphology, internal echo, and secondary changes of the lesion were analyzed during ultrasound examination.Color Doppler flow imaging was used to check the blood flow in the lesion.Results:Pre-optic disc occupying lesions could be detected in the ultrasound images of the 7 cases. Lesion size: average base diameters (5.39±1.90)mm×(4.79±1.28)mm, average height (3.61±1.37)mm. Lesion morphology: 5 cases were round, and 2 cases were irregular. Echo within the lesion: 3 cases had medium echo inside the lesion, and 4 cases had high echo inside the lesion. Internal echo characteristics: 5 cases had uniform echo, and 2 cases had uneven echo. Secondary changes: 6 cases had secondary retinal detachment and vitreous opacity, and 1 cases was accompanied by retinal hemangioma in other parts. In all cases, blood flow signals could be detected inside the space-occupying lesions, which were in the form of branches, stripes or spots, and the blood flow spectrum showed a parallel spectrum of arteries and veins.Conclusions:Ultrasound examination of optic disc capillary hemangioma has certain characteristics, which can provide a valuable follow-up basis for clinical diagnosis.

11.
Article in Chinese | WPRIM | ID: wpr-884229

ABSTRACT

Objective:To evaluate the clinical efficacy of minimally invasive treatment of Fraser type Ⅱ floating knee by homeopathic reduction.Methods:From November 2016 to July 2018, 7 patients with Fraser type Ⅱ floating knee were treated by homeopathic reduction and minimally invasive surgery at Trauma Emergency Center, The Third Hospital of Hebei Medical University. They were 5 males and 2 females, aged from 30 to 82 years (average, 52 years). They all suffered from tibial plateau fracture complicated with floating knee, with 5 cases of Fraser type ⅡA (tibial plateau fracture complicated with femoral shaft fracture) and 2 cases of Fraser type ⅡC (tibial plateau fracture complicated with femoral condyle fracture). The femoral and tibial plateau fractures were reduced with a bidirectional traction reduction device, followed by minimally invasive implantation of internal fixators. The operation time, length of a single incision, blood loss and fluoroscopic frequency were recorded. The anteroposterior and lateral X-ray films of the lower limb were taken and fracture healing time was recorded during follow-up. The function of knee joint was evaluated by Hospital for Special Surgery (HSS) scoring system at the last follow-up.Results:For the 7 patients, operation time averaged 87.2 min, length of a single incision 2.8 cm, blood loss 471 mL, and fluoroscopy frequency 37 times. The postoperative X-ray films showed fine alignment and force line and smooth articular surface in all patients. All the incisions healed by grade A. The follow-up time for 7 patients ranged from 12 to 21 months (average, 15.6 months). All the fractures healed after an average time of 12.8 weeks. The HSS scores at the last follow-up showed that 6 cases were excellent and one was good.Conclusion:The fractures of the femur side and of the tibia side can be treated separately by closed reduction and internal fixation using a homeopathic bidirectional traction reduction device so as to obtain better knee joint function.

12.
Article in Chinese | WPRIM | ID: wpr-884226

ABSTRACT

Objective:To investigate the associations of articular depression depth (ADD) and tibial plateau widening (TPW) by pre-operative CT measurement with incidence of lateral meniscal tear in patients with Schatzker type Ⅱ tibial plateau fracture.Methods:Included in this retrospective study were 131 patients who had been admitted to Emergency Center of Trauma, The Third Hospital Affiliated to Hebei Medical University from January 2016 to January 2020 for Schatzker type Ⅱtibial plateau fractures. They were 88 males and 51 females, aged from 18 to 60 years (average, 41.5 years), with 74 right and 57 left sides injured. All patients were treated with closed reduction and internal fixation assisted by bidirectional traction. Arthroscopy was used to detect the status of lateral meniscus immediately after closed reduction and internal fixation of the fracture fragments. Furthermore, patients were divided into 2 groups according to the integrity of lateral meniscus: meniscal tear group ( n=70) and tear-free group ( n=61). The 2 groups were compared in terms of age, gender, body mass index(BMI), injury side, time interval from injury to surgery, TPW and ADD. The receiver operating curve (ROC) was drafted to calculate the cut-off values of TPW and ADD in complication of lateral meniscal tear in patients with Schatzker type Ⅱ tibial plateau fracture. Results:The overall incidence of lateral meniscal tear in this cohort was 53.4% (70/131). There was no statistically significant difference in terms of age, gender, injury side, BMI or time interval from injury to surgery between the 2 groups ( P>0.05); TPW and ADD were significantly higher in the meniscal tear group than in the tear-free group ( P<0.05). To predict lateral meniscal tear in patients with Schatzker type Ⅱtibial plateau fracture, the area under ROC was 0.656 (95% CI: 0.562 to 0.750, P=0.002) for TPW and 0.709 (95% CI: 0.619 to 0.800, P<0.001) for ADD, respectively; the cut-off values of TPW and ADD were 4.3 mm and 6.1 mm. Conclusion:TPW and ADD may be effective predictors for prediction of lateral meniscal tear in patients with Schatzker type Ⅱ tibial plateau fracture.

13.
Article in Chinese | WPRIM | ID: wpr-884207

ABSTRACT

Objective:To explore the risk factors and the treatment outcomes of rifampicin-resistant tuberculosis (RR-TB) in Guizhou Province.Methods:The clinical data of 16 548 pulmonary tuberculosis patients with drug sensitivity test results registered in the Tuberculosis Information Management System in China from designated tuberculosis hospitals of 88 counties (cities, districts) in Guizhou Province from January 2014 to December 2018 were collected. The gender, age, occupation, ethnicity, patient registration classification, molecular biology or Lowenstein-Jenden (L-J) solid culture results of positive sputum culture patients, and treatment outcomes were retrospectively analyzed. Cohen′s kappa coefficient was used to analyze the consistency between molecular biology and L-J solid culture in detecting rifampin resistance. Chi-square test and non-conditional logistic regression model were used to analyze the risk factors of mono-rifampicin resistance tuberculosis and multidrug-resistant tuberculosis (MDR-TB) and the factors affecting treatment outcomes.The measurement data were compared by chi-square test or Fisher exact test. Results:The detection rate of RR-TB in the newly diagnosed cases was 6.79%(807/11 883), and that in the retreated cases was 30.01%(1 400/4 665). The drug sensitivity tests of 184 sputum culture positive RR-TB samples were performed by both L-J solid culture and molecular biology, and the rifampicin resistance detection rates were 20.65%(38/184) and 16.85%(31/184), respectively. The consistency between two methods was good ( kappa=0.697, 95% confidence interval ( CI) 0.564-0.830, P<0.01). Multivariate logistic regression analysis showed that patients aged 20 to 39 years old (odds ratio ( OR)=1.679, 95% CI 1.134-2.487) and aged 40 to 60 years old ( OR=1.526, 95% CI 1.019-2.283) were the high risk groups for MDR-TB. Treatment failure ( OR=27.753, 95% CI 22.455-34.300; OR=2.982, 95% CI 1.544-5.760, respectively), relapse and return ( OR=5.381, 95% CI 4.563-6.346; OR=3.897, 95% CI 2.901-5.234, respectively) were both high risk factors for MDR-TB and mono-rifampicin resistance tuberculosis. The treatment rate of RR-TB patients was 39.96% (396/991) from 2014 to 2016. Among 396 treatment cases, 138(34.85%) were cured and 16(4.04%) died. The patients aged>60 years old had lower cure rate (12.68%(9/71) vs 39.69%(129/325)) and higher death rate (11.27%(8/71) vs 2.46%(8/325)) than those aged ≤60 years. The differences were both statistically significant ( χ2=18.732, P<0.01; Fisher′s exact test, P=0.003). Conclusions:The RR-TB patients in Guizhou Province are mainly re-treated. Young and middle-age (20-60 years old) and treatment history are risk factors for RR-TB. The patients over 60 years old have a low cure rate and a high mortality rate. It is suggested to strengthen the screening, treatment and management of RR-TB to reduce the spread of tuberculosis.

14.
Journal of Chinese Physician ; (12): 658-662, 2021.
Article in Chinese | WPRIM | ID: wpr-884102

ABSTRACT

Objective:To analyze the cause of poor distance visual acuity after refractive rotationally asymmetric multifocal intraocular lens (IOL) implantation in cataract patients.Methods:The data were collected from patients who underwent cataract phacoemulsification combined with intraocular lens (refractive rotationally asymmetric multifocal intraocular lens, SBL-3) implantation at Beijing Aier Intech Eye Hospital from December 2016 to December 2018, and followed up for six months after operation. Standard logarithmic visual acuity chart was used to record uncorrected distance visual acuity, best corrected distance visual acuity, intermediate visual acuity, and near visual acuity. Defocus curve was drawn. The corneal topography, postoperative visual quality and intraocular lens centered or not were checked by Itrace.Results:Total 95 eyes of 70 patients were implemented by cataract phacoemulsification combined with regional refractive intraocular lens operation. Among them, uncorrected distance visual acuity of 16 eyes of 16 patients, were less than or equal to 0.6. The distance power zone of the intraocular lens of 7 patients were placed in the area of high corneal refractive power. Because of measurement error, reserved error, etc, the power of IOL in 7 patients had deviations. Farsightedness and dizziness occurred in 2 patients. The visual discomfort symptoms disappeared and vision improved through intraocular lens positioning.Conclusions:The poor quality of distance visual acuity is mainly caused by the coincidence of the distance power zone with the corneal high-refractive region, the deviation of the power of the intraocular lens, and the intraocular lens center shift. If the cornea has a high refractive area, the distance power zone should avoid to be placed in the same area. The intraocular lens should be reserved between 0-+ 0.25 D. Two-step surgery is recommended. It′s also recommended to make sure the lens is centered during the operation by lens reflection method.

15.
Journal of Chinese Physician ; (12): 338-342, 2021.
Article in Chinese | WPRIM | ID: wpr-884052

ABSTRACT

Objective:To analyze the incidence and risk factors of non-acute symptomatic portal vein thrombosis (PVT) after endoscopic gastric variceal injection (GVI) in the treatment of liver cirrhosis with gastric variceal bleeding (GVB).Methods:66 patients with GVB who were treated with GVI for the first time from July 2017 to October 2019 in Minhang Hospital Affiliated to Fudan University were retrospectively analyzed. The data of gender, age, preoperative Child-Pugh grade, preoperative platelet count, preoperative plasma D-dimer concentration, preoperative splenic length, preoperative portal vein velocity, preoperative splenic vein velocity, preoperative portal vein diameter, preoperative splenic vein diameter, treatment times, total number of injection points, total dose of sclerosing agent and tissue adhesive agent were collected. The patients were divided into PVT group and non-PVT group according to the occurrence of non-acute symptomatic PVT within one year after GVI. Univariate analysis was performed first, and then the factors with P<0.2 were included in the binary logistic regression model to screen the risk factors of PVT after GVI. Results:There were 25 cases (37.88%) in PVT group and 41 cases (62.12%) in non-PVT group. There were significant differences in D-dimer concentration, spleen length, Child-Pugh grade and total dose of sclerosing agent between the two groups ( P<0.05). The D-dimer concentration ( OR=2.319, 95% CI:1.359-3.956), spleen length ( OR=1.044, 95% CI:1.007-1.081) and total dose of sclerosing agent ( OR=1.075, 95% CI:1.004-1.152) were independent risk factors for PVT ( P<0.05). Conclusions:Preoperative D-dimer concentration, spleen length and total dose of sclerosing agent can predict the risk of PVT after GVI. In order to reduce the risk of PVT after GVI, the dose of sclerosing agent should be reduced as much as possible.

16.
Chinese Journal of Endemiology ; (12): 211-214, 2021.
Article in Chinese | WPRIM | ID: wpr-883695

ABSTRACT

Objective:To explore the relationship between dental fluorosis and serum chemical elements in children after water modification.Methods:Using the method of stratified sampling, according to the monitoring data of the Xi'an Center for Disease Control and Prevention in the past 20 years, the drinking-water-borne fluorosis areas in Xi'an City were changed according to the water-improvement period of 1-, 5-, 10- and ≥15 years, and 2 villages in each layer were selected as the survey sites. Each survey site selected school-age children aged 7 to 13 years old as the survey subjects to detect the prevalence of dental fluorosis; and blood samples were collected to detect 14 chemical elements contents in the serum [calcium (Ca), iron (Fe), magnesium (Mg), copper (Cu), zinc (Zn), iodine (I), selenium (Se), lead (Pb), arsenic (As), cadmium (Cd), chromium (Cr), fluorine (F), mercury (Hg), nickel (Ni)]. The differences of chemical element contents in children with different water improvement years and different dental fluorosis conditions were analyzed.Results:The prevalence of dental fluorosis of children were 51.40% (55/107), 16.92% (11/65), 16.67% (17/102) and 5.08% (6/118) in the villages with different water improvement period, the difference was statistically significant (χ 2 = 74.444, P < 0.05). Serum levels of Ca, Fe, Mg, Cu, Zn, I, Se, Pb, As, Cr, F and Ni in children of different water improvement period were compared, the difference were statistically significant ( P < 0.05). Levels of Fe, Zn and Ni in dental fluorosis patients were lower than those in normal children ( P < 0.05), and the serum fluoride level was higher than that of normal children ( P < 0.05). There were no significant differences in the contents of other chemical elements levels between children with dental fluorosis and normal children ( P > 0.05). Conclusions:The detection rate of dental fluorosis in children in ward villages whose water has been improved for more than 15 years is the lowest, and the detection rate of children with dental fluorosis can be reduced by improving water to reduce fluoride. Children in the drinking-water-borne fluorosis areas are deficient in some trace element.

17.
Article in Chinese | WPRIM | ID: wpr-883659

ABSTRACT

Objective:To evaluate the effect of different water-improving methods on dental fluorosis of children aged 8 to 12 in drinking-water-borne fluorosis areas in Xi'an City, and provide basis for making fine prevention and control measures.Methods:In 2018, 50 drinking-water-borne fluorosis villages in Xi'an City with water improvement time from 2011 to 2013 were selected as survey sites. The condition and the way of water improvement were surveyed, water fluoride content was determined and the prevalence of dental fluorosis in children aged 8 to 12 was examined, and the rates of dental fluorosis were compared before and after the water improvement in the 50 villages.Results:The water-improving projects were in normal operation in 50 villages. The medians of water fluoride content were 0.31, 0.88 and 1.14 mg/L in villages with municipal water supply, low fluorine well and defluoridation treatment water supply (the villages of different water-improvement methods were 12, 24 and 14, respectively), the differences were statistically significant ( H = 75.54, P < 0.01). The qualification rates of water fluoride in villages with different water-improvement methods were 100.00% (12/12), 79.17% (19/24) and 57.14% (8/14), and the difference was statistically significant (χ 2 = 6.95, P < 0.05). The detection rate of dental fluorosis was 43.17% (218/505) in the 11 villages with excessive water fluoride content, and the detection rate was 20.77% (331/1 594) in the 39 villages with qualified water fluoride content, the difference was statistically significant (χ 2 = 99.66, P < 0.01). After water improvement, the total detection rate of dental fluorosis (26.16%, 549/2 099) in the 50 villages was lower than that before water improvement (41.66%, 959/2 302), the difference was statistically significant (χ 2 = 117.17, P < 0.01). The detection rates of dental fluorosis were reduced after the water improvement in villages with municipal water supply and low fluorine well, the differences were statistically significant (χ 2 = 74.37, 69.36, P < 0.01). The detection rate was declined after water improvement in villages with defluoridation treatment water supply, but the difference was not significant (χ 2 = 0.78, P > 0.05). There was a statistically significant difference in the detection rate of dental fluorosis among children in villages with different water-improvement methods (χ 2 = 72.79, P < 0.01). The detection rate of dental fluorosis in villages with defluoridation treatment water supply [39.53% (200/506)] was higher than that in villages with municipal water supply [17.97% (133/740)] and low fluorine well [25.32% (216/853)], the differences were statistically significant ( P < 0.017); the detection rate of dental fluorosis in villages with municipal water supply was lower than that in villages with low fluorine well ( P < 0.017). Conclusions:The dental fluorosis of children's has been effectively controlled in the villages after water improvement in Xi'an City. The fluoride content in the water and the detection rate of dental fluorosis in children in some endemic areas are still high. It is necessary to further improve the water quality or consolidate the improvement effect as soon as possible.

18.
Article in Chinese | WPRIM | ID: wpr-883420

ABSTRACT

Objective:To investigate the relationship between heart rate, blood pressure and autonomic nerve function in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) after uvulopalatopharyngoplasty (UPPP).Methods:One hundred patients with OSAHS who underwent UPPP in Wuhan Central Hospital Tongji Medical College, Huazhong University of Science and Technology from July 2018 to July 2019 were selected. According to the disease grade of apnea hypopnea index (AHI), 38 cases were divided into mild group (AHI 5 to 15 times/h) and 62 cases were divided into severe group (AHI>16 times/h). The preoperative and postoperative polysomnography and 24 h dynamic electrocardiogram records was used to monitor the patient′s data, and the quality of sleep was compared before and after treatment in patients with sleep apnea, including: apnea and AHI, the longest apnea time (LAT), the lowest oxygen saturation (L SaO 2) and ratio of time with blood oxygen saturation lower than 90% to total sleep time (TSPO 2 90%); patient′s heart rate, including: maximum heart rate, minimum heart rate and average heart rate; heart rate variability (HRV) and related indexes of patients, including: all sinus RR interval (SDNN), RR interval mean standard deviation (SDANN), root mean square (RMSSD) of adjacent RR interval difference, the percentage of adjacent NN>50 ms in total sinus interval difference (PNN50%) and HRV triangle index; autonomic nerve function of patients, including: high frequency band (HF, 0.05 to 0.15 Hz), low frequency band (LF, 0.01 to 0.05 Hz) and LF/HF; patients′blood pressure, including: systolic and diastolic blood pressure. Results:Compared with those before treatment, AHI, LAT, TSPO 2 90%, SDNN, SDANN, RMSSD, PNN50% and HRV trigonometric index were decreased in mild group and severe group after treatment, L SaO 2 was increased, and there were statistical differences ( P<0.05). Compared with those of mild group, AHI, LAT, TSPO 2 90%, SDNN, SDANN, RMSSD, PNN50% and HRV trigonometric index were increased in severe group before treatment, LSaO 2 was decreased, and there were statistical differences ( P<0.05). In the mild group before treatment, mild group after treatment, severe group before treatment and severe group after treatment, the highest heart rates were (127.22 ± 21.87), (72.26 ± 6.15), (143.71 ± 22.09) and (75.03 ± 8.21) beats/min, the lowest heart rates were (50.18 ± 5.21), (61.27 ± 7.10), (42.18 ± 5.13) and (59.67 ± 6.77) beats/min, and the average heart rates were (71.95 ± 8.36), (62.37 ± 6.28), (85.72 ± 11.04) and (64.30 ± 5.89) times/min. After treatment, the maximum heart rate and average heart rate of mild group and severe group were lower than those before treatment, the lowest heart rate was higher than that before treatment, and there were statistical differences ( P<0.05). In the mild group before treatment, mild group after treatment, severe group before treatment and severe group after treatment, the LF were (1107.61 ± 151.69), (768.42 ± 135.18), (1 307.57 ± 182.30), (770.41 ± 160.25) ms 2, HF were (781.81 ± 91.46), (457.24 ± 72.13), (835.03 ± 152.75), (450.44 ± 94.10) ms 2, LF/HF were 1.76 ± 0.25, 1.35 ± 0.14, 1.98 ± 0.32, 1.38 ± 0.11. After treatment, LF, HF and LF/HF in mild group and severe group were lower than those before treatment ( P<0.05); before treatment, LF, HF and LF/HF rate in severe group were higher than those in mild group ( P<0.05). In the mild group before and after treatment, mild group before and after treatment, the systolic blood pressure were (125.01 ± 15.23), (103.22 ± 17.93), (146.13 ± 21.60), (111.25 ± 23.63) mmHg (1 mmHg = 0.133 kPa), and the diastolic blood pressure were (82.27 ± 11.49), (66.13 ± 10.27), (93.52 ± 16.06), (69.10 ± 14.39) mmHg. After treatment, systolic and diastolic blood pressure in mild group and severe group were lower than those before treatment, and there were statistical differences ( P<0.05); systolic and diastolic blood pressure in severe group were higher than that in mild group before treatment, and there were statistical differences ( P<0.05). LF/HF was positively correlated with AHI, mean heart rate, systolic and diastolic blood pressure ( P<0.05), and negatively with HRV triangle index ( P<0.05). Conclusions:Symptoms of OSAHS patients recover gradually after UPPP, and the recovery of autonomic nerve function is correlated with AHI, heart rate and blood pressure.

19.
Article in Chinese | WPRIM | ID: wpr-882208

ABSTRACT

Objective:To investigate the current situation of suicidal self-injurious behavior in teenagers and analyze its influencing factors. Methods:From January to November 2020, a stratified sampling method was used to investigate 707 teenagers in Guangdong. The “questionnaire of health-related behaviors of Chinese teenagers” compiled by the Chinese Center for Disease Control and Prevention was used anonymously to investigate the current situation of suicidal self-injurious behavior of the teenagers. The chi-square test was used for univariate analysis, and logistic regression was used for multivariate analysis. Results:The incidence rate of suicidal self-injurious behavior was 14.57% (103/707). It was 13.31% (45/338) in males, 15.72% (58/369) in females, 13.83% (48/347) in junior high school students and 15.28% (55/360) in senior high school students. There was no statistical significance in the incidence of suicidal self-injurious behavior of teenagers between different genders, different learning stages, smoking or not, asexual behavior or not, gambling or not, and fighting or not (all P>0.05). The incidence of suicidal self-injurious behaviors in teenagers from single parent family, drunkenness, runaway, loneliness, under great study pressure, lovelorn, and mobile phone addiction was significantly higher (χ2=13.809, 10.852, 14.279, 11.451, 12.893, 22.905, 19.473, respectively. All P<0.001). Logistic regression analysis showed that the following were main risk factors affecting the incidence of suicidal self-injurious behavior in teenagers: single parent family (OR=3.826, 95%CI: 1.402-7.501), drunkenness (OR=3.903, 95%CI: 1.512-7.368), runaway (OR=3.447, 95%CI: 1.669-7.715), loneliness (OR=3.613, 95%CI: 1.504-7.697), great study pressure (OR=3.712, 95%CI: 1.387-7.604), lovelorn(OR=4.125, 95%CI: 1.516-8.117) and mobile phone addiction(OR=4.027, 95%CI: 1.499-7.984 (all P<0.001). Conclusion:The incidence of suicidal self-injurious behavior in teenagers is not low in Guangdong, and targeted measures should be developed to screen and intervene based on the influencing factors.

20.
Acta Pharmaceutica Sinica ; (12): 1727-1738, 2021.
Article in Chinese | WPRIM | ID: wpr-881568

ABSTRACT

In the research and development of new drugs, it is very important to investigate the in vitro metabolism of candidate drugs. Traditional models such as liver microsomes have many limitations, while the in vitro model of recombinant human drug metabolizing enzymes is considered as an important and useful approach because of its convenient access, stable activity and low cost. In this study, six major human UDP-glucuronosyltransferases (UGTs) genes (UGT1A1, 1A3, 1A4, 1A6, 1A9 and 2B7) were cloned from human liver cDNA and heterologously expressed in Saccharomyces cerevisiae and baculovirus-infected insect cell. UGT1A1, 1A3, 1A6 and 1A9 were successfully expressed in yeast and showed glucuronidation activity against a variety of different structural types of substrates, but their activities were low. All six UGTs were successfully expressed and exhibited significantly improved glucuronidation activity when Trichopolusia ni cells BTI-TN5B1-4 (High Five) were used as the host. The recombinant human UGTs expressed in insect cells can catalyze the glucuronidation of their specific substrates, and the glucuronidation products were synthesized at milligram-scale with yields of 13%-66% for the first time, of which the structures were identified via MS, 1H NMR, and 13C NMR spectroscopic analysis. Above all, the recombinant human UGTs yeast and insect cell expression systems constructed in this study can be used for in vitro metabolism evaluation in the early stage of new drugs research and development, and also provide a new tool for the synthesis of glucuronide metabolites.

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