Value of soluble fms-like tyrosine kinase 1 for predicting acute pancreatitis severity: a systematic review and meta-analysis

SUMMARY OBJECTIVE: The objective of this study was to explore the relationship between serum soluble fms-like tyrosine kinase 1 and the severity of acute pancreatitis and its diagnostic utility. METHODS: This study was carried out by searching Chinese and English literature from the establishment of the database to July 9, 2023, systematically, and assessing the quality and heterogeneity of the articles included. RESULTS: Thirteen studies with a total of 986 patients were included. Patients with severe acute pancreatitis showed higher levels of soluble fms-like tyrosine kinase 1 compared with mild acute pancreatitis [weighted mean difference=76.64 pg/mL, 95% confidence interval (95%CI 50.39-102.89, p<0.001)]. Soluble fms-like tyrosine kinase 1 predicted pooled sensitivity, specificity, and area under the curve were 79%, 74%, and 0.85 for severe acute pancreatitis, with some heterogeneity (I2>50% or p<0.05). In the subgroup analysis, cutoff >150 pg/mL was found to be a heterogeneous factor. CONCLUSION: Soluble fms-like tyrosine kinase 1 is a reliable tool for identifying acute pancreatitis severity, but only as a screening tool.

Yoga for emotional control in children with adhd / Yoga no controle emocional em crianças com tdah / Yoga para el control emocional en niños con tdah

ABSTRACT Introduction: Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders, with several negative social and behavioral consequences. Yoga shows appropriate efficacy in different conditions but is poorly explored during childhood. Objective: Analyze the efficacy of yoga in regulating emotions and symptoms in children with ADHD. Methods: This experimental study followed up on a control group of 30 children with ADHD. They were randomly allocated group into control (N=15) and experimental (N=15) through the block randomization method. Participants completed the emotion regulation and Conner scale (CBRS) before, after, and 60 days after yoga exercise (20 sessions twice a week). Results: After 8 weeks of training, participants' emotion regulation and ADHD symptoms improved significantly. The improvement in emotion regulation and ADHD symptoms was maintained at follow-up. Conclusion: Yoga training proved to be an easy and inexpensive method to improve the mental and physical condition of children with ADHD. Level of evidence II; Therapeutic studies - investigating treatment outcomes.

RESUMO Introdução: O transtorno de déficit de atenção com hiperatividade (TDAH) é conhecido como um dos transtornos infantis mais comuns, com várias consequências sociais e comportamentais negativas. A ioga demonstra eficácia apropriada em diferentes condições, porém é pouco explorada durante a infância. Objetivo: Analisar a eficácia da ioga na regulação das emoções e sintomas de crianças com TDAH. Métodos: Este estudo experimental efetuou o acompanhamento em um grupo-controle realizado em 30 crianças com TDAH. Foram alocados, aleatoriamente, grupo em controle (N=15) e experimental (N=15) através do método de aleatorização em bloco. Os participantes completaram a regulação emocional e a escala de Conner (CBRS) antes, depois e 60 dias após o exercício de yoga (20 sessões duas vezes por semana). Resultados: Após 8 semanas de treinamento, a regulação das emoções dos participantes e os sintomas de TDAH melhoraram significativamente. A melhoria da regulação das emoções e dos sintomas de TDAH foi mantida no acompanhamento. Conclusão: O treinamento em ioga demonstrou-se um método fácil e econômico para melhorar a condição mental e física das crianças com TDAH. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: El trastorno por déficit de atención e hiperactividad (TDAH) es conocido como uno de los trastornos más comunes de la infancia, con varias consecuencias sociales y conductuales negativas. El yoga muestra una eficacia adecuada en diferentes condiciones, sin embargo, está poco explorado durante la infancia. Objetivo: Analizar la eficacia del yoga en la regulación de las emociones y los síntomas en niños con TDAH. Métodos: Este estudio experimental hizo un seguimiento de un grupo de control de 30 niños con TDAH. Se asignaron aleatoriamente grupos de control (N=15) y experimentales (N=15) mediante el método de aleatorización por bloques. Los participantes completaron la escala de regulación de la emoción y de Conner (CBRS) antes, después y 60 días después del ejercicio de yoga (20 sesiones dos veces por semana). Resultados: Tras 8 semanas de entrenamiento, la regulación de las emociones y los síntomas del TDAH de los participantes mejoraron significativamente. La mejora en la regulación de las emociones y los síntomas del TDAH se mantuvieron durante el seguimiento. Conclusión: El entrenamiento de yoga demostró ser un método fácil y barato para mejorar la condición mental y física de los niños con TDAH. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Elevated Levels of Naturally-Occurring Autoantibodies Against the Extracellular Domain of p75NTR Aggravate the Pathology of Alzheimer's Disease / 神经科学通报·英文版

The extracellular domain (p75ECD) of p75 neurotrophin receptor (p75NTR) antagonizes Aβ neurotoxicity and promotes Aβ clearance in Alzheimer's disease (AD). The impaired shedding of p75ECD is a key pathological process in AD, but its regulatory mechanism is largely unknown. This study was designed to investigate the presence and alterations of naturally-occurring autoantibodies against p75ECD (p75ECD-NAbs) in AD patients and their effects on AD pathology. We found that the cerebrospinal fluid (CSF) level of p75ECD-NAbs was increased in AD, and negatively associated with the CSF levels of p75ECD. Transgenic AD mice actively immunized with p75ECD showed a lower level of p75ECD and more severe AD pathology in the brain, as well as worse cognitive functions than the control groups, which were immunized with Re-p75ECD (the reverse sequence of p75ECD) and phosphate-buffered saline, respectively. These findings demonstrate the impact of p75ECD-NAbs on p75NTR/p75ECD imbalance, providing a novel insight into the role of autoimmunity and p75NTR in AD.

Clinical Efficacy of Gandouling Decoction in Improving Hepatic Function with Phlegm and Blood Stasis Type Wilson' s Disease / 中国实验方剂学杂志

Objective::To observe the clinical efficacy of Gandouling decoction on hepatic function of patients with phlegm and blood stasis type Wilson's disease. Method::From January 2015 to December 2017, totally 72 cases of phlegm and blood stasis type Wilson's disease admitted to Encephalopathy Center in the First Affiliated Hospital of Anhui University of Chinese Medicine were randomly divided into treatment group and control group, with 36 cases in each group. Patients in both groups were injected with sodium dimercaptopropane sulfonate for routine treatment. At the same time, patients in control group received Hugan Tablets, and patients in treatment group received Gandouling decoction for a total of 6 treatment courses. Before and after treatment, traditional Chinese medicine(TCM)syndrome effective rate, serum enzyme index [alanine aminotransferase(ALT), aspartate aminotransferase (AST), alkaline phosphatase(AKP)], bilirubin metabolism index [total bilirubin(TBIL)], liver fibrosis index [laminin(LN), hyaluronic acid(HA), collagen type IV(CⅣ), procollagen type Ⅲ peptide(PⅢP)]and blood coagulation index [fibrinogen (FBG), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) ]were observed. Result::TCM syndrome effective rates of treatment group and control group were 86.11%(31/36) and 63.98%(23/36) respectively, with a significant difference between two groups (P<0.05). ALT, AST, AKP, TBIL decreased in two groups after treatment (P<0.01), and the effects of ALT, AST, AKP, TBIL in treatment group were significantly better than those in control group (P<0.01), liver fibrosis index decreased in both groups after treatment (P<0.01), and the effect in treatment group was significantly better than that in control group (P<0.01). Blood coagulation indexes were improved to different degrees in both groups (P<0.05, P<0.01), and there were significant differences between treatment group and control group in decreasing PT, APTT, TT levels (P<0.05, P<0.01) and increasing FBG level (P<0.01). Conclusion::Gandouling decoction can significantly improve hepatic function of patients with phlegm and blood stasis type Wilson's disease, which is manifested in improving serum enzymes and bilirubin indexes, reversing liver fibrosis, promoting clotting factors and reducing bleeding tendency, in order to delay the progress of the disease and improve the life quality of patients.

Association of Polygenic Risk Score with Age at Onset and Cerebrospinal Fluid Biomarkers of Alzheimer's Disease in a Chinese Cohort / 神经科学通报·英文版

To evaluate whether the polygenic profile modifies the development of sporadic Alzheimer's disease (sAD) and pathological biomarkers in cerebrospinal fluid (CSF), 462 sAD patients and 463 age-matched cognitively normal (CN) controls were genotyped for 35 single-nucleotide polymorphisms (SNPs) that are significantly associated with sAD. Then, the alleles found to be associated with sAD were used to build polygenic risk score (PRS) models to represent the genetic risk. Receiver operating characteristic (ROC) analyses and the Cox proportional hazards model were used to evaluate the predictive value of PRS for the sAD risk and age at onset. We measured the CSF levels of Aβ42, Aβ42/Aβ40, total tau (T-tau), and phosphorylated tau (P-tau) in a subgroup (60 sAD and 200 CN participants), and analyzed their relationships with the PRSs. We found that 14 SNPs, including SNPs in the APOE, BIN1, CD33, EPHA1, SORL1, and TOMM40 genes, were associated with sAD risk in our cohort. The PRS models built with these SNPs showed potential for discriminating sAD patients from CN controls, and were able to predict the incidence rate of sAD and age at onset. Furthermore, the PRSs were correlated with the CSF levels of Aβ42, Aβ42/Aβ40, T-tau, and P-tau. Our study suggests that PRS models hold promise for assessing the genetic risk and development of AD. As genetic risk profiles vary among populations, large-scale genome-wide sequencing studies are urgently needed to identify the genetic risk loci of sAD in Chinese populations to build accurate PRS models for clinical practice.

Research progress on ophthalmologic optogenetics / 中华实验眼科杂志

Optogenetics is a genetic technique that applies illumination with certain wavelength to modulate the biological activity of cells or subcellular components accurately.This technique is friendly to researchers of ophthalmology due to characteristics of the eyes including transparency, accessibility and comparative independence.Optogenetics can be used in retinal neurons, such as retinal ganglion cells (RGCs), even extended to vascular endothelial cells, immune cells and other ocular cells or cell substructures, which can further our understanding of ocular physiology and provide potential, therapeutic approaches for neurodegenerative diseases, vascular diseases, inflammation and other eye-related diseases.Improvement in effectiveness, safety and comfort is pivotal for this technique to expand application in ophthalmology and for its function to reach the physiology state of nomal eyes.In this review, a comprehensive analysis of optogenetics progress in ophthalmology was performed.Challenges in imaging including light sensitivity, spatial resolution and temporal resolution, and problems in expression involving local and systemic safety, specificity and persistence were reviewed.

Imbalance of γδT17/γδTreg cells in the pathogenesis of allergic asthma induced by ovalbumin

We aimed to explore the imbalance between the T helper 17 γδT cells (γδT17) and the regulatory γδT cells (γδTreg) in asthmatic mice. Male Balb/c mice were randomly divided into the normal control group and the asthmatic model group. The asthmatic model group mice were intraperitoneally injected with the mixture of ovalbumin (OVA)/Al(OH)3 and then activated by exposure of the animals to OVA atomization. Airway hyperresponsiveness (AHR) was determined by a non-invasive lung function machine. Hematoxylin and eosin and Alcian blue-periodic acid Schiff staining were done for histopathological analysis. Interleukin (IL)-17 and IL-35 levels in bronchoalveolar lavage fluid were detected by ELISA. The percentage of IL-17+ γδT cells and Foxp3+ γδT cells in spleen cells suspension were detected and the transcription levels of RORγt and Foxp3 in the lung tissue were determined. Compared with the normal control, the severity of airway inflammation and AHR were higher in the asthmatic mice. Furthermore, mice in the asthmatic group displayed significant increases of IL-17+ γδT cells, expression of IL-17A, and RORγt, whereas control mice displayed marked decreases of Foxp3+ γδT cells, expression of IL-35, and transcription factor Foxp3. In addition, the mRNA expression of RORγt was positively correlated with the percentage of IL-17+γδT cells, and the mRNA level of Foxp3 was positively correlated with the percentage of Foxp3+ γδT cells. The imbalance of γδT17/γδTreg in the asthmatic mice may contribute to the pathogenesis of OVA-induced asthma.

Early outcomes of 203 neonates with low birth weight undergoing cardiac surgery and analysis of death causes / 中国胸心血管外科临床杂志

@#Objective To analyze the early outcomes of 203 neonates with low birth weight (<2 500 g) undergoing cardiac surgery, and to analyze the causes of death during hospitalization. Methods From June 2003 to June 2017, medical records of 203 neonates with low birth weight undergoing congenital heart surgery in Guangdong General Hospital were reviewed retrospectively. There were 124 males and 79 females, including 151 premature infants. The average birth weight was 1 719±515 g, the average age at operation was 32.7±20.2 d and the average weight at operation was 1 994±486 g. The causes of death during hospitalization (including neonates given up on treatments) were analyzed. Results Totally 103 patients had pneumonia, 98 patients needed mechanical ventilation to support breathing and 26 patients needed emergency operation before operation. All patients undergoing congenital heart surgery were treated with general anesthesia with tracheal intubation, including 107 patients under non cardiopulmonary bypass (CPB) and 96 patients under CPB with a mean CPB time of 96.5±71.7 min and a mean aorta cross-clamp time of 51.8±45.5 min. The average postoperative mechanical ventilation time was 9.1±21.5 d and the average postoperative length of stay was 26.7±19.3 d. The major postoperative complications included pneumonia, anemia, atelectasis, septicemia, intrapleural hemorrhage, diaphragm paralysis and cardiac dysfunction. Twenty-nine patients died during hospitalization and the overall mortality rate was 14.3%. Four patients died in the operation room, 14 patients died 72 hours after operation and 2 patients were given up. The main causes of hospitalized death were low cardiac output syndrome, severe infection, disseminated intravascular coagulation disorder, acute renal failure and pulmonary hypertension crisis. Conclusion Overall, early cardiac surgery for low birth weight neonates is safe and effective. The difficulty of the cardiac surgery is the key to the prognosis. Strengthening perioperative management can improve the quality of operation and reduce the risk of mortality and morbidity during hospitalization.

Clinical Research on Alzheimer's Disease: Progress and Perspectives / 神经科学通报·英文版

Alzheimer's disease (AD), the most common type of dementia, is becoming a major challenge for global health and social care. However, the current understanding of AD pathogenesis is limited, and no early diagnosis and disease-modifying therapy are currently available. During the past year, significant progress has been made in clinical research on the diagnosis, prevention, and treatment of AD. In this review, we summarize the latest achievements, including diagnostic biomarkers, polygenic hazard score, amyloid and tau PET imaging, clinical trials targeting amyloid-beta (Aβ), tau, and neurotransmitters, early intervention, and primary prevention and systemic intervention approaches, and provide novel perspectives for further efforts to understand and cure the disease.

Genetic evolution of HA and NA genes of H9N2 influenza viruses isolated in regions of Hunan Province, China, in 2015 / 生物工程学报

The high prevalence of influenza A virus is identified in Hunan Province because of the high density of poultry farms. To survey the variations of H9N2 subtype avian influenza virus in Hunan province, we analyzed HA and NA genes of 10 virus strains isolated from different areas of Hunan Province. All these strains belong to the Eurasian lineage, Y280-like sub-lineage. The cleavage sites in their HA genes were all RSSR↓GLT, corresponding to the feature of low pathogenic AIV. All strains had an L (Leu) at the site 234 in the HA genes, indicating the ability of binding with the SAα-2,6 receptor. NA gene stalk deletions at aa 63-65 were also detected from all the isolates, indicating a possibility of increased virus replication in mammals. Our findings suggest that more attention should be paid to the surveillance of H9N2 influenza virus and its direction of reassortment.

Pneumocystis jirovecii pneumonia induced by low-dose methotrexate in a patient with chronic urticaria

Abstract Methotrexate has immunosuppressive effects and is administered for refractory chronic urticaria. We present a case of Pneumocystis jirovecii pneumonia in a patient with refractory chronic urticaria managed by low-dose weekly methotrexate treatment (total cumulative dose 195mg). Our study highlights the importance of providing prompt diagnosis and treatment of Pneumocystis jirovecii pneumonia in patients with chronic urticaria under methotrexate therapy.

Metabonomic analysis of Hugan Tablets on CCl4-induced acute hepatic injury in rats based on 1 H-NMR / 中国药理学通报

Aim To identify the potential biomarkers associated with carbon tetrachloride(CCl 4 )-induced a-cute hepatic injury in rats and explore the therapeutic effect of Hugan Tablets(HGT). Methods The model was established by intraperitoneal injection of CCl4 in oil(1 : 1,V/ V)with a dosage of 1 mL·kg - 1 body weight to rats once. The levels of aspartate aminotrans-ferase(AST),alanine aminotransferase(ALT),alka-line phosphatase (ALP ) and lactate dehydrogenase (LDH)in serum of rats were determined. Moreover,a proton nuclear magnetic resonance (1 H-NMR)based metabonomic approach in combination with multivariate data analysis was applied to demonstrate CCl4-induced acute hepatic injury metabolic perturbations in rat urine and feces and identify the corresponding metabolic bio-markers. The intervention effect of HGT was evaluated based on the changes of metabolic phenotype and po-tential biomarkers related to acute hepatic injury. Re-sults The levels of AST,ALT,ALP and LDH in ser-um of rats with acute hepatic injury were significantly reduced by administration of HGT,respectively. The disturbed metabolic state associated with CCl4-induced acute hepatic injury in rat urine and feces could be re-stored by HGT. Meanwhile,five potential biomarkers (2-oxoglutarate,citrate,creatinine,trimethylamine N-oxide,hippurate)in rat urine and three potential bio-markers(butyrate,glucose,uracil)in rat feces related to acute hepatic injury were reversed by administration of HGT,respectively. Conclusion HGT exerts pro-tective effects against CCl4-induced acute hepatic inju-ry in rats,which is probably mediated by regulation of tricarboxylic acid cycle and gut microbiota metabolism.

Biological Effects of Chlamydiaphage phiCPG1 Capsid Protein Vp1 on Chlamydia Trachomatis In Vitro and In Vivo / 华中科技大学学报（医学）（英德文版）

The researches on chlamydia in recent years show that chlamydia bacteriophage may be a potential and effective means to solve the clinical infection of chlamydia trachomatis (Ct).We investigated the biological effect of chlamydiaphage phiCPG1 capsid protein Vp1 on Ct both in McCoy cells and genital tract of mice.Different concentrations of Vp1 were co-incubated with Ct E serotype strain in McCoy cells.Female BALB/c mice were used to establish Ct E strain-induced urogenital infection model.They were randomly divided into five groups and given different treatments on the fifth day after Ct inoculation.Animals in groups 1 and 2 were given 30 μL different concentrations of Vp1 in the genital tract respectively,those in group 3 were intramuscularly injected with 30 μL Vp1,those in the infected group did not receive any intervention,and those in the control group received 30 μL PBS in the genital tract.The vaginal discharge was collected to identify the live chlamydia by cell culture and gene fragment by real time PCR different days after infection.Inhibition rate of 100 μg/mL and 50 μg/mL Vpl proteins against Ct E strain in the McCoy cell cultures was 91％ and 79％ respectively,The number of intracellular Ct inclusion in the McCoy cells co-cultured with vaginal discharge of group 1 and group 2 was less than in the infected group,and that in group 1 was less than in group 2,on the 7th day after Ct inoculation.Real-time PCR showed that chlamydia concentration of the vaginal discharge in group 2 was lower than in the infected group,and that in group 1 was lower than in group 2 on the 10th day.It was suggested that Vp1 capsid proteins had inhibitory effect on the proliferation of Ct serovar E strain in cell culture and mouse genital tract.

Pregnancy Outcomes Following Transvaginal Cerclage for Cervical Insufficiency: Results From a Single-center Retrospective Study / 华中科技大学学报（医学）（英德文版）

To study maternal and perinatal outcomes after cervical cerclage in both singleton and twin pregnancies,we retrospectively reviewed women undergoing cervical cerclage for cervical insufficiency at Tongji Hospital,Wuhan,China from January 1,2010 to July 31,2015 to evaluate primary and secondary outcomes for subgroups with cervical length (CL) ≤15,＞15 to ＜25,and ≥25 mm.Of 166 patients who underwent cervical cerclage,after exclusion of patients with missed abortion and continuing pregnancy,141 patients (121 singleton and 20 twin pregnancies) were included in the analysis.Mean gestational age at birth was 34.22 and 28.27 weeks for singleton and twin pregnancies,respectively.There were 17 (14.05％) and 13 (33.33％) neonatal deaths in singleton and twin pregnancies,respectively.Mean age (31.60-±4.62 vs.31.22±4.63 years,P=0.39) and gestational weeks at cerclage (18.50-±4.62 vs.19.31±4.99,P=0.47) were similar for both groups.Mean gestational weeks at delivery (34.22±5.77 vs.28.27±6.17,P＜0.001) and the suture to delivery interval (15.72±7.15 vs.8.96±6.70,P＜0.001) were significantly longer in the singleton group.These variables indicate a linear negative correlation with the degree of CL shortening,with better outcomes in patients with CL ≥25 mm who underwent cerclage,both in singleton and twin pregnancies.No difference in mode of delivery existed between the singleton group and twin group.Our results indicate a high risk of preterm delivery in both groups,especially in the twin group.Patients with a history of preterm labor and CL ＞25 mm in the current pregnancy,possibly in a twin pregnancy,could benefit from elective cervical cerclage;however,cervical cerclage was inadvisable for twin pregnancies with a CL ＞15 and ＜25 mm.Our data emphasize the importance of re-evaluating the efficacy of cervical cerclage for twin pregnancies in well-designed clinical trials.

Correlation of severe neonatal hyperbilirubinemia and hearing damage / 上海交通大学学报（医学版）

Objective · To investigate the risk factors of hearing damage in child patients with severe neonatal hyperbilirubinemia (NHB) and follow up their prognosis. Methods · Clinical data of 106 newborns with severe NHB in neonatal ward of Shanghai Children's Medical Center from June 2015 to June 2016 were retrospectively analyzed. According to total serum bilirubin (TSB) level, they were divided into three groups, severe NHB group (342.0 μmol/L<TSB peak <427.5 μmol/L), very severe NHB group (TSB peak range 427.5-513.0 μmol/L), and fatal NHB group (TSB peak >513.0 μmol/L). Automatic auditory brainstem response (AABR) was used to evaluate the hearing ability of children in hospital, while those who got abnormal results would undergo diagnostic test of auditory brainstem response (ABR) when 3 months old. Auditory behavioral response of all 106 child patients at 3 and 6 months old were followed up. Results · There were totally 106 cases in three groups, among which 33 cases (33/106, 31.13%) got abnormal results at hearing screening in hospital, 22 cases (22/86, 25.58%) in severe NHB group, 9 cases (9/16, 56.25%) in very severe NHB group, and 2 cases (2/4, 50.00%) in fatal NHB group. The difference between groups was statistically significant (all P<0.05). All 33 patients not passing AABR in hospital came to undergo diagnostic test of ABR through regular education by a specially assigned person when 3 months old. Two children were diagnosed mild hearing damage. One of them was considered being caused by tympanitis. All children had good situation of auditory behavioral response at 3 and 6 months old in follow-up. Conclusion · Severe NHB is one of the high risk factors of hearing damage in neonates. The morbidity of hearing damage was higher with the increase of TSB level. The hearing damage caused by severe NHB might be reversible. It also suggested that the follow-up plan should be improved. The hearing damage caused by severe NHB might have no obvious effect on children in daily life, but long term follow-up of these children is still needed.

Correlation of severe neonatal hyperbilirubinemia and hearing damage / 上海交通大学学报（医学版）

Objective · To investigate the risk factors of hearing damage in child patients with severe neonatal hyperbilirubinemia (NHB) and follow up their prognosis. Methods · Clinical data of 106 newborns with severe NHB in neonatal ward of Shanghai Children's Medical Center from June 2015 to June 2016 were retrospectively analyzed. According to total serum bilirubin (TSB) level, they were divided into three groups, severe NHB group (342.0 μmol/L<TSB peak <427.5 μmol/L), very severe NHB group (TSB peak range 427.5-513.0 μmol/L), and fatal NHB group (TSB peak >513.0 μmol/L). Automatic auditory brainstem response (AABR) was used to evaluate the hearing ability of children in hospital, while those who got abnormal results would undergo diagnostic test of auditory brainstem response (ABR) when 3 months old. Auditory behavioral response of all 106 child patients at 3 and 6 months old were followed up. Results · There were totally 106 cases in three groups, among which 33 cases (33/106, 31.13%) got abnormal results at hearing screening in hospital, 22 cases (22/86, 25.58%) in severe NHB group, 9 cases (9/16, 56.25%) in very severe NHB group, and 2 cases (2/4, 50.00%) in fatal NHB group. The difference between groups was statistically significant (all P<0.05). All 33 patients not passing AABR in hospital came to undergo diagnostic test of ABR through regular education by a specially assigned person when 3 months old. Two children were diagnosed mild hearing damage. One of them was considered being caused by tympanitis. All children had good situation of auditory behavioral response at 3 and 6 months old in follow-up. Conclusion · Severe NHB is one of the high risk factors of hearing damage in neonates. The morbidity of hearing damage was higher with the increase of TSB level. The hearing damage caused by severe NHB might be reversible. It also suggested that the follow-up plan should be improved. The hearing damage caused by severe NHB might have no obvious effect on children in daily life, but long term follow-up of these children is still needed.

Finite element analysis of rapid canine retraction through reducing resistance and distraction

Objective: The aims of this study were to compare different surgical approaches to rapid canine retraction by designing and selecting the most effective method of reducing resistance by a three-dimensional finite element analysis. Material and Methods: Three-dimensional finite element models of different approaches to rapid canine retraction by reducing resistance and distraction were established, including maxillary teeth, periodontal ligament, and alveolar. The models were designed to dissect the periodontal ligament, root, and alveolar separately. A 1.5 N force vector was loaded bilaterally to the center of the crown between first molar and canine, to retract the canine distally. The value of total deformation was used to assess the initial displacement of the canine and molar at the beginning of force loading. Stress intensity and force distribution were analyzed and evaluated by Ansys 13.0 through comparison of equivalent (von Mises) stress and maximum shear stress. Results: The maximum value of total deformation with the three kinds of models occurred in the distal part of the canine crown and gradually reduced from the crown to the apex of the canine; compared with the canines in model 3 and model 1, the canine in model 2 had the maximum value of displacement, up to 1.9812 mm. The lowest equivalent (von Mises) stress and the lowest maximum shear stress were concentrated mainly on the distal side of the canine root in model 2. The distribution of equivalent (von Mises) stress and maximum shear stress on the PDL of the canine in the three models was highly concentrated on the distal edge of the canine cervix. . Conclusions: Removal of the bone in the pathway of canine retraction results in low stress intensity for canine movement. Periodontal distraction aided by surgical undermining of the interseptal bone would reduce resistance and effectively accelerate the speed of canine retraction. .

Expression of Cripto-1 in esophageal carcinoma and its relationship with epithelial-mesenchymal transformation / 解放军医学杂志

Objective To investigate the expression of Cripto-1 in esophageal carcinoma and its relationship with epithelialmesenchymal transformation (EMT). Methods RT-PCR and Western blotting were used to examine the expression levels of Cripto-1 in carcinoma, paraneoplastic and normal esophageal mucosa tissue of 41 patients with esophageal carcinoma. The protein expressions of Cripto-1 and EMT markers such as N-cadherin, Vimentin and E-cadherin were detected by immunohistochemistry, and the clinical pathologic parameters were simultaneously analyzed. The correlation between Cripto-1 and the expression of N-cadherin, Vimentin and E-cadherin were also analyzed. Results The expression levels of Cripto-1 mRNA and protein were significantly higher in esophageal carcinoma (0.35±0.08 and 0.62±0.06) than in paraneoplastic (0.22±0.04 and 0.45±0.07) and normal esophageal mucosa tissue (0.13±0.03 and 0.33±0.05, P<0.05). Immunohistochemistry revealed that the positive expression rates of Cripto-1, N-cadherin, Vimentin and E-cadherin protein in esophageal carcinoma were 53.7%, 51.2%, 61.0% and 36.6% respectively. The expression of Cripto-1 showed a positive correlation with N-cadherin (r=0.463, P<0.05) and Vimentin (r=0.460, P<0.05), while a negative correlation with E-cadherin (r=-0.310, P<0.05) was found. The expression of Cripto-1 also showed a significant correlation with lymph node metastasis, distant metastasis and clinical stage (P<0.05). Conclusion The expression of Cripto-1 is closely related to the carcinogenesis and development of esophageal carcinoma, and may promote the invasion and metastasis of esophageal carcinoma by regulation of EMT.

Impacts of establishment of chest pain center on the door-to-balloon time and the short-term outcome after primary percutaneous coronary intervention of patients with ST segment elevated myocardial infarction / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the impact of the establishment of chest pain center (CPC) model based on the pre-hospital real-time tele-12-lead electrocardiogram on the door-to-balloon (D-to-B) time and short-term outcome after primary percutaneous coronary intervention (PPCI) of patients with ST-segment elevated myocardial infarction (STEMI).</p><p><b>METHODS</b>A regular CPC was established with pre-hospital transmitted real-time 12-lead electrocardiogram system for pre-hospital diagnosis of STEMI and enabled the STEMI patients to bypass the emergency room and directly treated in the catheter lab to shorten the D-to-B time. The mean D-to-B time, the short-term outcome and medical costs were compared in PPCI patients before (93 cases, group A) and after (149 cases, group B) the establishment of CPC.</p><p><b>RESULTS</b>After the establishment of CPC, the annual mean D-to-B time was significantly shortened [(127 ± 79) min in group A vs.(72 ± 23 )min in group B, P < 0.01], the shortest monthly mean D-to-B time was remarkably reduced in group B than in group A [(56 ± 11) min vs. (73 ± 14) min, P < 0.01]. The annual ratio of D-to-B below 90 minutes was significantly increased from 62.4% (58/93) in group A to 91.9% (137/149) in group B (P < 0.05) . The in-hospital mortality rate tended to be lower and the incidence of heart failure during hospitalization was significantly reduced in group B compared with group A [3.4% (5/149) vs. 6.5% (6/93), P > 0.05; 14.1% (21/149) vs. 24.7% (23/93), P < 0.05]. The length of hospital stay was slightly shortened from (8.98 ± 4.89) days to (7.79 ± 5.43) days (P > 0.05). Corrected mean medical cost went down by 9.4% (P < 0.05).</p><p><b>CONCLUSION</b>The establishment of CPC may significantly shorten the D-to-B time, improve the short-term outcome and reduce the hospitalization cost for PPCI patients with STEMI.</p>