Analysis on Current Status of Knowledge, Attitude, Practice of COVID -19 in College Students and Their Influencing Factors / 中国医学伦理学

In order to understand the current status of the knowledge, attitude and practice (KAP) about prevention and control of COVID -19 in college students, and to provide theoretical basis for prevention and control work in college campus. This study investigated the KAP of COVID -19 of 1 847 college students in Shaanxi province by questionnaire using the convenience sampling method. Chisquare test and multivariate logistic regression analysis were used to analyze the influencing factors for the KAP of COVID -19. The results demonstrated that 48.3% of the students had a higher knowledge level of COVID -19, 11.7% had a fear attitude and 39.6% had good protective practices. Logistic regression results showed that female and urban household college students had higher cognitive level of COVID -19. The college students with anxiety state were more likely to have fear attitude. Students of female, urban household, anxiety, higher cognition and fear attitude showed better protective practices. The above results indicated that the knowledge level of COVID -19 in college students are not enough, and the attitude and protective practices need to be further improved. Therefore, relevant departments should follow the rules of KAP, carry out targeted propaganda and education on COVID -19 for college students, to improve their ability to cope with public health emergencies.

Predictive value of Pv-aCO 2/Ca-vO 2 combined blood lactate concentration for primary peritonitis-related septic shock in children / 中华危重病急救医学

Objective:To investigate the prognostic value of the ratio of veno-arterial carbon dioxide partial pressure difference to arterio-venous oxygen content difference (Pv-aCO 2/Ca-vO 2) in children with primary peritonitis-related septic shock. Methods:A retrospective study was conducted. Sixty-three children with primary peritonitis-related septic shock admitted to department of intensive care unit of the Children's Hospital Affiliated to Xi'an Jiaotong University from December 2016 to December 2021 were enrolled. The 28-day all-cause mortality was the primary endpoint event. The children were divided into survival group and death group according to the prognosis. The baseline data, blood gas analysis, blood routine, coagulation, inflammatory status, critical score and other related clinical data of the two groups were statistics. The factors affecting the prognosis were analyzed by binary Logistic regression, and the predictability of risk factors were tested by the receiver operator characteristic curve (ROC curve). The risk factors were stratified according to the cut-off, Kaplan-Meier survival curve analysis compared the prognostic differences between the groups.Results:A total of 63 children were enrolled, including 30 males and 33 females, the average age (5.6±4.0) years old, 16 cases died in 28 days, with mortality was 25.4%. There were no significant differences in gender, age, body weight and pathogen distribution between the two groups. The proportion of mechanical ventilation, surgical intervention, vasoactive drug application, and procalcitonin, C-reactive protein, activated partial thromboplastin time, serum lactate (Lac), Pv-aCO 2/Ca-vO 2, pediatric sequential organ failure assessment, pediatric risk of mortality Ⅲ in the death group were higher than those in the survival group. Platelet count, fibrinogen, mean arterial pressure were lower than those in the survival group, and the differences were statistically significant. Binary Logistic regression analysis showed that Lac and Pv-aCO 2/Ca-vO 2 were independent risk factors affecting the prognosis of children [odds ratio ( OR) and 95% confidence interval (95% CI) were 2.01 (1.15-3.21), 2.37 (1.41-3.22), respectively, both P < 0.01]. ROC curve analysis showed that the area under curve (AUC) of Lac, Pv-aCO 2/Ca-vO 2 and their combination were 0.745, 0.876 and 0.923, the sensitivity were 75%, 85% and 88%, and the specificity were 71%, 87% and 91%, respectively. Risk factors were stratified according to cut-off, and Kaplan-Meier survival curve analysis showed that the 28-day cumulative probability of survival of Lac ≥ 4 mmol/L group was lower than that in Lac < 4 mmol/L group [64.29% (18/28) vs. 82.86% (29/35), P < 0.05]. Pv-aCO 2/Ca-vO 2 ≥ 1.6 group 28-day cumulative probability of survival was less than Pv-aCO 2/Ca-vO 2 < 1.6 group [62.07% (18/29) vs. 85.29% (29/34), P < 0.01]. After a hierarchical combination of the two sets of indicator variables, the 28-day cumulative probability of survival of Pv-aCO 2/Ca-vO 2 ≥ 1.6 and Lac ≥ 4 mmol/L group significantly lower than that of the other three groups (Log-rank test, χ2 = 7.910, P = 0.017). Conclusion:Pv-aCO 2/Ca-vO 2 combined with Lac has a good predictive value for the prognosis of children with peritonitis-related septic shock.

Prospective cohort study of pre-pregnancy sugar-sweetened beverage consumption and risk of gestational diabetes mellitus / 环境与职业医学

Background There is a lack of research evidence on the association between sugar-sweetened beverage (SSB) consumption and gestational diabetes mellitus (GDM) in China. Objective To explore the association between frequency of SSB consumption before pregnancy and risk of GDM in pregnant women in Shaanxi Province, and to provide a scientific basis for targeted interventions to control maternal blood glucose. Methods The recruitment to the China Birth Cohort study started in October 2020. Pregnant women at 6-16 weeks who had their first prenatal examination at five hospitals in Shaanxi Province were recruited. A maternal health questionnaire was used to collect basic information about pregnant women. A semi-quantitative food frequency questionnaire was used to collect the consumption of carbonated beverages, fruit and vegetable juice beverages, coffee beverages, and milk tea beverages in one year before pregnancy, which were summed to obtain the SSB consumption. Pregnant women were divided into three groups according to SSB consumption, namely <1 serving·week−1, 1-4 servings·week−1, and ≥5 servings·week−1. GDM was confirmed by oral glucose tolerance test (OGTT) between 24-28 weeks of gestation. A binary logistic regression model was applied to explore the association between SSB consumption and risk of GDM. Multiple linear regression was applied to investigate the associations between SSB consumption (per 1-serving·d−1 increase) and OGTT fasting plasma glucose, 1-hour glucose, and 2-hour glucose. Results A total of 3811 pregnant women were finally enrolled in this study, of which 752 developed GDM, with an incidence rate of 19.7%. The incidence rates of GDM in pregnant women with SSB consumption frequency of <1 serving·week−1, 1-4 servings·week−1, and ≥5 servings·week−1 were 18.0%, 21.1%, and 26.8%, respectively. After adjusting for maternal age, pre-pregnancy body mass index (BMI), education, number of children born, family history of diabetes, smoking, alcohol consumption, physical activity level, and total energy intake, the risk of GDM increased by 26% (OR=1.26, 95%CI: 1.05, 1.50) in the 1-4 servings·week−1 group and by 76% (OR=1.76, 95%CI: 1.31, 2.38) in the ≥5 servings·week−1 group compared to the <1 serving·week−1 SSB consumption group, respectively. Further stratified analysis revealed no interaction effect (Pinteraction>0.05) between SSB consumption and maternal age, pre-pregnancy BMI, or first labor or not. For each additional SSB consumption per day, the risk of GDM increased by 94% (OR=1.94, 95%CI: 1.37, 2.75); and the maternal OGTT 1-hour glucose and 2-hour glucose increased by 0.33 mmol·L−1 and 0.18 mmol·L−1, respectively (P<0.05), and no significant increase in fasting plasma glucose was found (P>0.05). Conclusion Higher SSB consumption before pregnancy increases the risk of GDM in pregnant women.

Influence of tutor responsibility system combined with CBL teaching method on the operating skills and teaching quality of hematology residents / 中华医学教育探索杂志

Objective:To explore the teaching effect of standardized training physicians in department of hematology through the tutor responsibility system combined with case-based learning (CBL teaching method), and to provide new ideas for the formulation of the teaching plan of standardized training physicians in the future.Methods:A total of 52 residents trained in the Department of Hematology, The First Affiliated Hospital of Army Medical University from January to December 2017 were selected in the study. And they were randomly divided into observation group and control group, with 26 cases in each group. The control group received the CBL teaching method, and the observation group received the tutor responsibility system combined with the CBL teaching method, both of which were taught for 3 years. Our hospital's self-made assessment form was used to assess the operating skills, theoretical knowledge and teaching quality of the two groups' residents before and after 3 years of teaching. SPSS 24.0 was used for t test and chi-square test. Results:After 3 years of teaching, the scores of bone marrow aspiration, bone marrow biopsy, lumbar puncture, and intrathecal injection, the basic theories of specialists, standardized diagnosis and treatment of common diseases, analysis of difficult cases, and rescue scores of critically ill patients, the scores of medical knowledge, clinical thinking, professional ethics, doctor-patient communication, theoretical connection with practice of both groups were all increased than before teaching ( P<0.05), and the above scores of the observation group were higher than those of the control group, with statistical differences ( P<0.05). Conclusion:The tutor responsibility system combined with CBL teaching method is conducive to improving the training effect and teaching quality of hematology.

Diagnostic values of different diagnostic criteria of 18F-DCFPyL PET/CT for primary prostate cancer / 中华核医学与分子影像杂志

Objective:To compare the diagnostic values of different diagnostic criteria of prostate specific membrane antigen (PSMA) PET/CT for primary prostate cancer (PCa).Methods:From May 2019 to May 2021, 2-(3-(1-carboxy-5-((6- 18F-fluoro-pyridine-3-carbonyl)-amino)-pentyl)-ureido)-pentanedioic acid ( 18F-DCFPyL) PET/CT images of 78 patients (age: (68.5±1.4) years) with clinically suspected PCa in Shanxi Bethune Hospital were retrospectively collected and blind diagnosed by the three criteria of SUV max, PSMA reporting and data system (PSMA-RADS) score and molecular imaging PSMA (miPSMA) score. The diagnostic efficacy for PCa, the correlation between the diagnostic results and disease risk, and the consistency of the diagnostic results of the three criteria were compared. Delong test, Spearman rank correlation analysis, and intra-class correlation coefficient (ICC) were used to analyze data. Results:The sensitivities of SUV max, PSMA-RADS score and miPSMA score for PCa were all 93.75%(60/64) and the specificities were 12/14, 10/14 and 12/14 respectively; AUCs of the three criteria were 0.951, 0.862 and 0.951, with no significant difference between SUV max and miPSMA score ( z=0.00, P=1.000), while there were significant differences between PSMA-RADS score and SUV max or miPSMA score ( z values: 2.71, 2.93, P values: 0.007, 0.030). There were positive correlations between the diagnostic results of the three criteria and the disease risk (International Society of Urological Pathology (ISUP) grading: rs values: 0.66, 0.62, 0.63, all P<0.001; D′Amico grouping: rs values: 0.67, 0.64, 0.67, all P<0.001). The diagnostic results of the three criteria were highly consistent (ICC=0.941, 95% CI: 0.903-0.967). Conclusion:The SUV max and miPSMA score have higher diagnostic efficiency and correlation of disease risk, which are more suitable for clinical application.

Clinical study of Liangxue-Xiaofeng Decoction combined with acitretin A capsule in the treatment of psoriasis vulgaris / 国际中医中药杂志

Objective:To evaluate the efficacy of Liangxue-Xiaofeng Decoction combined with acitretin A capsule in the treatment of psoriasis vulgaris. Methods:A total of 80 patients with psoriasis vulgaris from March 2015 to June 2019 in our hospital, who met the inclusion criteria, were divided into two groups according to the random number table method, 40 patients in each group. The control group was given acitretin A capsules on the basis of conventional western medicine treatment, and the study group was given Liangxue-Xiaofeng Decoction on the basis of the control group. Both groups were treated for 2 months and followed up for 6 months. The skin lesion area and Psoriasis Area and Severity Index (PASI) scores were performed before and after treatment. The levels of IL-8, IL-6 and TNF-α were detected by real time PCR amplification, and the levels of histone acetyltransferase (HATs) and histone deacetylase (HDACs) by ELISA. The adverse reactions and recurrence during the follow-up period were recorded and the clinical efficacywas evaluated. Results:The total effective rate of the study group was 82.5% (33/40) and that of the control group was 62.5% (25/40). The difference between the two groups was statistically significant ( χ2=4.012, P=0.045). After treatment, the PASI score of the study group was significantly lower than that of the control group ( t=7.921, P<0.01), and the serum levels of IL-8, IL-6 and TNF-α were significantly lower than those in the control group ( t=12.749, 13.933, 10.856, all Ps<0.01); the activity of HATs [(35.03 ± 3.79) g/L vs. (29.26 ± 2.41) g/L, t=8.125] of the study group was significantly higher than that of the control group ( P<0.01), and HDACs activity [(31.00 ± 2.71) g/L vs. (37.55 ± 3.08) g/L, t=10.098] of the study group was significantly lower than that of the control group ( P<0.01). Conclusions:Acitretin A capsule combined with Liangxue-Xiaofeng Decoction can reduce the level of inflammatory cytokines in patients with psoriasis vulgaris, and prevent the disease progression. The mechanism may be related to the regulation of homeostasis balance in acetylation.

Associations between screen time, physical activity, and depressive symptoms during the 2019 coronavirus disease (COVID-19) outbreak among Chinese college students

BACKGROUND@#The 2019 novel coronavirus disease (COVID-19) emerges in China, which spreads rapidly and becomes a public health emergency of international concern. Chinese government has promptly taken quarantine measures to block the transmission of the COVID-19, which may cause deleterious consequences on everyone's behaviors and psychological health. Few studies have examined the associations between behavioral and mental health in different endemic areas. This study aimed to describe screen time (ST), physical activity (PA), and depressive symptoms, as well as their associations among Chinese college students according to different epidemic areas.@*METHODS@#The study design is cross-sectional using online survey, from 4 to 12 February 2020, 14,789 college students accomplished this online study, participants who did not complete the questionnaire were excluded, and finally this study included 11,787 college students from China.@*RESULTS@#The average age of participants was 20.51 ± 1.88 years. 57.1% of the college students were male. In total, 25.9% of college students reported depression symptoms. ST > 4 h/day was positively correlated with depressive symptoms (β = 0.48, 95%CI 0.37-0.59). COVID-19ST > 1 h/day was positively correlated with depressive symptoms (β = 0.54, 95%CI 0.43-0.65), compared with COVID-19ST ≤ 0.5 h/day. Compared with PA ≥ 3 day/week, PA < 3 day/week was positively associated with depression symptoms (β = 0.01, 95%CI 0.008-0.012). Compared with low ST and high PA, there was an interaction association between high ST and low PA on depression (β = 0.31, 95%CI 0.26-0.36). Compared with low COVID-19ST and high PA, there was an interaction association between high COVID-19ST and low PA on depression (β = 0.37, 95%CI 0.32-0.43). There were also current residence areas differences.@*CONCLUSIONS@#Our findings identified that high ST or low PA was positively associated with depressive symptoms independently, and there was also an interactive effect between ST and PA on depressive symptoms.

Construction of an in vivo diffusion model of Treponema pallidum in New Zealand rabbits / 中华皮肤科杂志

Objective:To establish an in vivo diffusion model of Treponema pallidum (Tp) in New Zealand rabbits. Methods:A standard strain of Tp (Nichols strain) was recovered in the testes of New Zealand rabbits, and isolated and passaged continuously. The suspensions of the second-passage Tp were collected and inoculated onto the dorsal skin of New Zealand rabbits. After 21-day infection, the New Zealand rabbits were anesthetized and sacrificed, blood samples were collected, and skin tissues at the infection site as well as liver, spleen, testes and lymph nodes were aseptically resected. Real-time fluorescence-based quantitative PCR was performed to detect the spread of Tp in different tissues and organs.Results:On day 21 after infection with Tp, skin lesions such as indurations and ulcers were seen at all inoculated sites of New Zealand rabbits. Pathological examination showed a lot of inflammatory cells in the infected lesions, mainly including plasma cells, macrophages and lymphocytes. Real-time fluorescence-based quantitative PCR revealed a large number of Tp in tissues and organs, such as liver, spleen and testes.Conclusion:After inoculation with Tp in the dorsal skin of New Zealand rabbits, Tp could spread to the liver, spleen, testes and other tissues and organs through blood and lymph nodes, and the in vivo diffusion model of Tp strains in New Zealand rabbits was successfully constructed.

Clinical features of Kawasaki disease shock syndrome and analysis of interleukin-6 expression levels / 中国小儿急救医学

Objective:Kawasaki disease shock syndrome(KDSS) is a serious complication of Kawasaki disease(KD). The main manifestations are low blood pressure and decreased blood perfusion at the acute stage of onset, which is life-threatening.The purpose of this study was to provide early intervention and reduce the complications and mortality of this disease by analyzing clinical features and expression level of interleukin-6(IL-6)of children with KDSS.Methods:In this study, a total of 25 children with KDSS in Nanjing Children′s Hospital were collected, and their clinical characteristics, relevant laboratory indicators and IL-6 expression levels were analyzed by retrospective case-control study.Results:Compared with ordinary KD children, KDSS children were more common in older children, with prolonged fever, severe skin rash, high inflammatory indicators, and more likely to be associated with coronary dilatation.The level of IL-6 in children with KDSS in the acute phase was significantly higher than that in children with KD[(28.5±39.2) ng/mL vs.(226.8±102.9) ng/mL, P<0.05], while the level of IL-6 in children with KDSS in the convalescent period was significantly lower than that in the acute phase of KDSS[(226.8±102.9) ng/mL vs.(5.6±1.7)ng/mL, P<0.05], and the difference was statistically significant. Conclusion:The systemic inflammatory response of KDSS is more obvious, IL-6 plays an important role in it, and the therapeutic effect of IL-6 blocker in KD and its complications needs further study.

Research Status of Traditional Chinese Medicine in Treating Gastric Cancer and Precancerous Lesion of Gastric Cancer by Regulating Autophagy / 中国实验方剂学杂志

Gastric cancer is one of the most common malignant tumors in the digestive system， and precancerous lesion of gastric cancer （PLGC） represents a long-term stage in the process of malignant development of normal gastric mucosa into gastric cancer. Gastric cancer and precancerous lesions are difficult to cure clinically， leaving poor prognosis and a serious negative impact on the quality of daily life of patients. In recent years， studies on cell autophagy have been at the forefront of the natural life science. Regulating autophagy to treat precancerous lesions and prevent gastric cancer has become nowadays a hot topic. Autophagy is a process in which cells enclose some redundant or damaged cytoplasm， proteins and organelles to form autophagosomes， and bind to lysosomes to degrade the contents. Autophagy has bidirectional effect on different cells and different stages of the same cell. Autophagy at a lower level can kill cancer cells， while autophagy can promote the growth and proliferation of cancer cells under stress conditions such as hypoxia， hunger and infection， or when autophagy clears damaged proteins in cells and organelle function is abnormal. Traditional Chinese medicine（TCM）， which has low toxicity and easy acceptance by patients， has a positive effect on the treatment of gastric cancer and PLGC. At present， studies on the prevention and treatment of gastric cancer and PLGC by TCM have been carried out in depth with cell autophagy as the breakthrough point. More and more research results have confirmed that TCM can regulate the autophagy process of gastric cancer cells and play an anti-tumor role by interfering with various autophagy related genes， signal pathways and organelles. This paper summarizes the studies on the regulation of cell autophagy by TCM in the treatment of gastric cancer and precancerous lesions， so as to provide references for future studies on the regulation of autophagy by TCM.

Correlation between internal damage due to seven emotions in traditional Chinese medicine and pathogenesis of breast cancer from perspective of psychological stress / 中国中药杂志

Breast cancer is a major chronic disease threatening women's health. It has topped the global cancers as the diagnosed cases outnumbered lung cancer patients in 2020. Internal damage due to the seven emotions is an important cause of breast cancer and the disorders of hypothalamic-pituitary-adrenal(HPA) axis and endocrine system and the abnormal immune defense mechanism in response to psychological stress all affect the occurrence and development of breast cancer. It is noteworthy that the theory of seven emotions in traditional Chinese medicine and the psychological stress theory of modern medicine have something in common in some aspects. Therefore, this study explored the correlation between internal damage due to the seven emotions and psychological stress and analyzed the molecular biological mechanisms of psychological stress influencing breast cancer from the perspective of modern medicine, which is helpful to reasonably prevent breast cancer and other related tumors and improve the prognosis of breast cancer patients through emotion regulation.

Changes in forms of Indigo Naturalis slices in ancient and modern times: a systematic study on quality of purified Indigo Naturalis and crude Indigo Naturalis / 中国中药杂志

Indigo Naturalis has a long history of medicinal use with particularity and complexity in its processing. Before the Ming dynasty,Indigo Naturalis was extracted from the top layer of zymotic fluid,called " purified Indigo Naturalis". In modern processing,the precipitate " crude Indigo Naturalis" is dried to produce Indigo Naturalis after impurity removal. The form of Indigo Naturalis slices has undergone significant changes in ancient and modern times. In view of this,the quality comparison between crude Indigo Naturalis and purified Indigo Naturalis was conducted in this study with modern analytical techniques. Firstly,chemical composition was analyzed with UPLC-Q-TOF-MS,and the chemical composition of scent with HS-SPME/GC-MS/MS. The content of indigo,indirubin,total ash,and water-soluble extract was determined as well as the inorganic composition in crude Indigo Naturalis and purified Indigo Naturalis. Then,their microscopic morphology was observed and the surface element composition was investigated. Finally,the antipyretic activities of crude Indigo Naturalis and purified Indigo Naturalis were compared in the fever rat model induced by lipopolysaccharide and 2,4-dinitrophenol. The results demonstrated that the purified Indigo Naturalis had a faster and more lasting antipyretic effect,while the crude Indigo Naturalis had almost no antipyretic effect. This study is of great significance to the research on processing technology of Indigo Naturalis and provides reference for the formulation of its quality standards,production specifications and calibration procedures.

Microbial community structure and transformation of indoles in soaking and fermentation of Indigo Naturalis / 中国中药杂志

The soaking and fermentation of Baphicacanthus cusia( Nees),the important intermediate link of Indigo Naturalis processing,facilitates the synthesis of indigo and indirubin precursors and the dissolution of endogenous enzymes and other effective components,while the role of microorganisms in the fermentation is ignored. The present study investigated the changes of microbial community structure in Indigo Naturalis processing based on 16 S amplicon sequencing and bioinformatics. Meanwhile,the contents of indigo,indirubin,isatin,tryptanthrin,indole glycoside,etc. were determined to explore the correlation between the microorganisms and the alterations of the main components. As demonstrated by the results,the microbial diversity decreased gradually with the fermentation,which bottomed out after the addition of lime. Proteobacteria,Bacteroidetes,and Firmicutes were the main dominant communities in the fermentation. The relative abundance of Proteobacteria declined gradually with the prolongation of fermentation time,and to the lowest level after the addition of lime. The relative abundance of Firmicutes increased,and that of Bacteroidetes decreased first and then increased. The contents of effective substances in Indigo Naturalis also showed different variation tendencies. As fermentation went on,indole glycoside decreased gradually; indigo first increased and then decreased; indirubin and isatin first decreased and then increased; tryptanthrin gradually increased. Those changes were presumedly related to the roles of microorganisms in the synthesis of different components. This study preliminarily clarified the important role of microorganisms in the soaking and fermentation and provided a scientific basis for the control of Indigo Naturalis processing and the preparation of high-quality Indigo Naturalis.

Clinical application of backtracking full-thickness continuous everting suturing in primary closure of common bile duct after laparoscopic bile duct exploration / 中华肝胆外科杂志

Objective:To analyze the results in clinical application of backtracking full-thickness continuous everting suturing in primary closure of common bile duct after laparoscopic bile duct exploration.Methods:From February 2014 to November 2018 at the Affiliated Changzhou No.2 People’s Hospital of Nanjing Medical University, 82 patients with cholecystolithiasis and choledocholithiasis entered into this study. There were 45 males and 37 females, with an average age of 62.7 years. These patients underwent primary closure of common bile duct after laparoscopic bile duct exploration using backtracking full-thickness continuous everting suturing to close the incisions in common bile ducts. Clinical data on surgery, postoperative complications and follow-up were collected and analyzed retrospectively.Results:Primary closure of common bile duct was successfully carried out in all patients. The operation time ranged from 45 to 150 min (average 68.5 min). Intraoperative blood loss ranged from 5 to 150ml (average 18.4 ml). Postoperative bile leakage occurred in 2 patients (2.4%). There were no intra-abdominal or biliary bleeding, severe cholangitis, liver function derangement, abdominal infection or residual stones. Of 77 patients who were followed up (follow-up rate of 93.9%), the follow-up time ranged from 9 to 50 months (median 14 months). On follow-up, 2 patients (2.4%) developed recurrence of choledocholithiasis and 1 patient (1.2%) was diagnosed to have intrahepatic bile duct stones. There were no patients with bile duct stenosis or acute cholangitis.Conclusion:Primary closure of common bile duct with backtracking full-thickness continuous everting suturing has the advantage of reducing postoperative bile leakage in patients after laparoscopic bile duct exploration. The long-term effects of this technique still need further clinical studies.

Three-dimensional imaging reconstruction of pancreatic head based on embryological fusion plane of the pancreas / 中华肝胆外科杂志

Objective:To construct a three-dimensional imaging model of the pancreatic head based on the embryological fusion plane, and to provide morphological parameters of the pancreatic head for future developments of basic and clinical researches on the pancreas.Methods:Histologic cross-sections of the pancreatic head with its adjacent structures were made from healthy cadavers. Immunohistochemical analysis of pancreatic polypeptide antibody was then performed to verify the existence and location of the embryological fusion plane reported previously. The histologically positioning method of the embryological fusion plane was then applied to the corresponding sections on computed tomography (CT). Based on the results of the above work, volunteers from the Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University were then used as research objects. A three-dimensional visualization reconstruction software was used to perform CT image-based structures to include the abdominal pancreas, dorsal pancreas head, and embryo fusion surface. Three-dimensional reconstruction of the pancreatic head, and morphological measurements of the relevant structures of the pancreatic head were then made.Results:Immunohistochemical analysis verified the existence and the position of the embryological fusion plane. The histologically positioning method was then successfully applied to the CT sections. The three-dimensional imaging model of the pancreatic head containing the embryological fusion plane, dorsal segment and ventral segment of head were built based on CT images. A total of 35 volunteers were included, including 19 males and 16 females, aged (48.26±8.26) years, and with a BMI of (22.29±1.78) kg/m 2. The morphological results showed that the volume of the pancreatic head, dorsal pancreas and abdominal pancreas were (32.80±8.15) cm 3, (22.21±6.94) cm 3, (10.59±3.87) cm 3, and the area of the embryo fusion surface was (12.46±3.20) cm 2. All volunteers were then grouped according to gender. Statistical analysis showed that there were no significant differences in the total pancreatic head volume, dorsal pancreatic head volume, abdominal pancreatic volume, and embryo fusion area among the groups ( P>0.05). Conclusions:It was feasible and practical to build a three-dimensional imaging model of the pancreatic head based on the embryological fusion plane by using a 3D computer system. This model and its morphological parameters could provide a new tool for research on pancreas.

Comparison of different treatment regiments in resistant Kawasaki disease / 中华风湿病学杂志

Objective:To investigate the different effects of different treatment regimens in resistant Kawasaki disease (KD) and to provide evidence for clinical treatment.Methods:Forty-nine inpatient children with resistant KD from July 2017 to June 2019 in Children's Hospital of Nanjing Medical University were enrolled into this study. Treatment and follow-up were still in progress. Rank sum test and χ2/Fisher test were used for statisic. Results:The incidence of resistance in infliximab group was significantly lower than that of intravenous immunoglobulin (IVIG) retreated group ( P<0.05). Sixteen cases were treated with 5 mg/kg infliximab (IFX), and 33 cases received methylprednisolone and an additional dose of IVIG. Nine cases who were resistant to IVIG and methylprednisolone were treated with IFX, 6 patients responded to IFX, 3 of them were treated with cyclosporine. Coronary artery changes were followed up. Coronary artery lesions (CALs) were improved in the IFX group, CALs occurred in 12(36%) patients received IVIG and methylprednisolone, 4 of them were improved( χ2=0.633 , P=0.426). Patients were followed up for 3-24 months, the incidence of CALs persistence was statistically significantly different between the two groups (0 vs 24%, P=0.021]. Conclusion:IFX might be an effective and tolerable treatment for resistant KD.

Accurate positioning and analysis on health function of high frequency anti-fatigue herbal medicines / 中国中药杂志

Fatigue is a widespread and complex physiological phenomenon. Chronic fatigue can lead to cardiovascular dysfunction, mental disorders and other serious pathological reactions. Therefore, how to relieve fatigue accurately and effectively is an important proposition to implement the concept of "Healthy China" in the new era. As an important part of Chinese medicine health industry, Chinese medicine health food has been developing rapidly in recent years. At present, there are 1 157 kinds of anti-fatigue health food on the market in China, most of which are single Chinese medicine and its compound. However, their functions are generally labeled as "anti-fatigue", and their function positioning is too extensive and unclear. With the deepened understanding of fatigue classification and its physiological and pathological basis, it is urgent to be combined with the progress of modern chemical and pharmacological stu-dies to differentiate and precisely position the anti-fatigue health effects of traditional Chinese medicine. For this purpose, the classifications of fatigue were summarized in this paper, and the mechanism of fatigue was explained from the aspects of energy metabolism, accumulation of metabolites, oxidative stress, inflammation, hypothalamus pituitary adrenal axis and so on. We selected 10 traditional Chinese medicines which are most frequently used in health food, analyzed their anti-fatigue effect mechanisms, and summarized the best types of anti-fatigue food, so as to promote the scientific development of anti-fatigue health food industry, expand the market application scope of anti-fatigue health food, better respond to the construction of a healthy China and serve for people's health.

Accuracy of SPECT/CT fusion imaging in differential diagnosis of benign and malignant spinal lesions / 中国基层医药

Objective@#To analyze and discuss the clinical value of single photon emission computed tomography(SPECT)/CT fusion imaging in differentiating benign and malignant spinal lesions.@*Methods@#From January 2017 to January 2018, 70 cases with benign and malignant spinal lesions in Shanxida Hospital were studied.SPECT/CT fusion imaging and SPECT examination were used to compare the diagnosis results between the two groups.@*Results@#After SPECT diagnosis, a total of 98 bone metastatic lesions were detected, including 10 false positive lesions, 60 benign lesions and 28 false negative lesions.After SPECT/CT fusion imaging, there were 100 lesions, including 4 false positive lesions, 59 benign lesions and 37 false negative lesions.In this study, a total of 145 lesions were found in 70 patients with benign and malignant spinal lesions, including 95 benign lesions and 50 malignant lesions.The specificity, sensitivity and accuracy of SPECT/CT fusion imaging [95.79%(91/95), 92.00%(46/50), 93.79%(136/145)] were higher than those of the control group [82.11%(78/95), 64.00%(32/50), and 82.76%(120/145)], the differences were statistically significant(χ2=9.048, 11.422, 9.578, all P<0.05).@*Conclusion@#In the diagnosis of benign and malignant spinal diseases, SPECT/CT fusion imaging can accurately distinguish benign and malignant lesions, and clearly reflect the development of the disease, which lay a solid foundation for good treatment in the future.

Accuracy of SPECT/CT fusion imaging in differential diagnosis of benign and malignant spinal lesions / 中国基层医药

Objective To analyze and discuss the clinical value of single photon emission computed tomography(SPECT)/CT fusion imaging in differentiating benign and malignant spinal lesions.Methods From January 2017 to January 2018,70 cases with benign and malignant spinal lesions in Shanxida Hospital were studied.SPECT/CT fusion imaging and SPECT examination were used to compare the diagnosis results between the two groups.Results After SPECT diagnosis,a total of 98 bone metastatic lesions were detected,including 10 false positive lesions,60 benign lesions and 28 false negative lesions.After SPECT/CT fusion imaging,there were 100 lesions,including 4 false positive lesions,59 benign lesions and 37 false negative lesions.In this study,a total of 145 lesions were found in 70 patients with benign and malignant spinal lesions,including 95 benign lesions and 50 malignant lesions.The specificity,sensitivity and accuracy of SPECT/CT fusion imaging [95.79％ (91/95),92.00％ (46/50),93.79％ (136/145)] were higher than those of the control group [82.11％ (78/95),64.00％ (32/50),and 82.76％ (120/145)],the differences were statistically significant (x2 =9.048,11.422,9.578,all P ＜0.05).Conclusion In the diagnosis of benign and malignant spinal diseases,SPECT/CT fusion imaging can accurately distinguish benign and malignant lesions,and clearly reflect the development of the disease,which lay a solid foundation for good treatment in the future.

Clinical observation of elephantiasis myogenic cream for treatment of chronic refractory skin ulcer / 国际中医中药杂志

Objective To explore clinical efficacy of elephantiasis myogenic cream for treatment of chronic refractory skin ulcer. Methods A total of 91 chronic refractory skin ulcer patients were randomized into the treatment group (n=46) and the control group (n=45) by random number table method. Patients of control group were treated with conventional debridement, while the treatment group were treated with elephantiasis myogenic cream. The two groups were treated for 4 weeks. Clinical curative effect was evaluated after treatment. The pain score at the times of debridement and ulcer wound healing time of the two groups were compared. The FGF-2, VEGF and fiber connection (Fn) of wound secretion of the two groups before and after treatment were compared. Results Total effective rate of treatment group was 87.0％ (40/46), which was significantly higher than the control group 66.7％ (30/45), and the difference was statistically significant (χ2=5.275, P=0.022). The pain score at the time of 2 w and 4 w after treatment in the treatment group were significantly lower than those in the control group (t value were 10.456, 12.266, all Ps<0.01). After treatment, ulcer wound healing time in the treatment group were significantly lower than those in the control group (t=2.911, P=0.002). After treatment, the FGF-2 (7.72 ± 0.58 ng/ml vs. 6.37 ± 0.50 ng/ml, t=11.881), VEGF (24.85 ± 5.63 ng/ml vs. 18.75 ± 4.51 ng/ml, t=5.697) and Fn (4.15 ± 0.42 ng/ml vs. 3.47 ± 0.38 ng/ml, t=8.093) of wound secretion in the treatment group were significantly higher than those in the control group (P<0.05).There were no serious adverse reaction of the two groups during treatment. Conclusions The elephantiasis myogenic cream for treatment of chronic refractory skin ulcer has a good efficacy and low adverse reactions, can relieve patients' pain, improve the wound heal, reduce heal times.