Application of double mediastinal drainage tubes in elderly patients with intrathoracic anastomotic leak after thoracoscopic Ivor-Lewis surgery / 中华老年医学杂志

Objective:To investigate the clinical significance of intraoperative prepositioning of dual mediastinal drains in elderly patients developing anastomotic leakage(AL)after a total endoscopic Ivor-Lewis procedure.Methods:This retrospective case-control study analyzed the clinical data of 500 elderly patients who underwent total endoscopic Ivor-Lewis surgery for esophageal or cardia cancer from January 2020 to December 2022.In the control group, one mediastinal drainage tube was placed intraoperatively, while in the study group, two mediastinal drainage tubes were placed.Both groups had a chest tube placed conventionally.The study compared the incidence of anastomotic leak(AL)at 1 month postoperatively, inflammatory indexes in patients with AL, grading of AL, rate of nasal fistula placement, incision infection, anastomotic stenosis, and incidence of hoarseness.Additionally, it compared ICU occupancy, ventilator use, and ICU length of stay between the two groups.Results:The analysis included clinical data from 455 elderly patients.Among the patients who developed AL, the study group had significantly lower peak body temperature[(39.58±1.03)℃ vs.(38.05±0.56)℃, t=4.298, P<0.05], white blood cell count[(18.63±3.35)×10 9/L vs.(14.28±2.78)×10 9/L, t=3.450, P<0.05], and C-reactive protein(CRP)levels[(154.66±41.64)mg/L vs.(122.19±31.29)mg/L, t=2.131, P<0.05]. The study group also had a significantly lower grading of AL and rate of nasal fistula placement(82.4% vs.30.0%, P<0.05). In terms of ICU indicators, the study group had a significantly lower ICU admission rate(64.7% vs.10.0%, P<0.05), shorter period of ventilator use[(6.47±8.15)days vs.(0.90±2.23)days, t=2.62, P<0.05], and shorter ICU stay[(11.70±8.89)days vs.(4.70±6.27)days, t=2.184, P<0.05]. Conclusions:Double mediastinal drainage tubes, have been found to significantly alleviate inflammation, decrease the rate of nasal fistula placement and ICU admission, and shorten the length of ICU stay in elderly patients.Therefore, they are considered safe and deserving of clinical promotion.

The Effects of Huqi Zhengxiao Formula （槲芪癥消方） on the Survival Rate and Quality of Life of Patients of Stage Ⅲ Hepatitis B-Associated Primary Liver Cancer with Syndrome of Healthy Qi Deficiency， Toxic Stasis Accumulation After Transcatheter Arterial Chemoembolisation Treatment / 中医杂志

ObjectiveTo observe the effects of Huqi Zhengxiao Formula （槲芪癥消方） on the survival rate and quality of life of patients with stage Ⅲ hepatitis B-associated primary liver cancer （PLC） with syndrome of healthy qi deficiency and toxic stasis accumulation after transcatheter arterial chemoembolisation （TACE） treatment. MethodsOne hundred and twenty-six patients with stage Ⅲ hepatitis B-associated PLC who were identified as syndrome of healthy qi deficiency and toxic stasis accumulation after TACE treatment were selected， and were randomly assigned to 63 cases each of the treatment group and the control group in a ratio of 1∶1 by using the random number table method； the control group was given symptomatic supportive treatments with western internal medicine， and the treatment group was given the addition of Huqi Zhengxiao Formula on the basis of the control group. All patients were treated for a period of 48 weeks， and were followed up at weeks 4， 8， 12， 24， 36， and 48 of the treatment process. The primary effectiveness index was the 1-year survival rate， and the secondary effectiveness index was the Karnofsky score and the traditional Chinese medicine （TCM） syndrome score. Survival analysis was performed using the Kaplan-meier method， and Log-rank test was used to compare the differences between the survival curves of each group. ResultsSix withdrawals in the treatment group and seven withdrawals in the control group， and finally 57 patients in the test group and 56 patients in the control group were included in the statistical analysis. The 1-year survival rate of patients in the treatment group was 56.1% （32/57）， which was higher than that of 33.9% （19/56） in the control group （P = 0.033）. The mean survival time was （275.30±15.50） days in the treatment group， higher than （227.16±17.11） days in the control group （P = 0.039）. Thirty-two patients in the treatment group and 19 patients in the control group completed the Karnofsky score and TCM symptom score at each time point. At weeks 4， 8， 12 and 36， the difference in the Karnofsky score between the two groups was not statistically significant （P＞0.05）； at weeks 24 and 48， the Karnofsky score in the treatment group was higher than that in the control group at the same time point （P＜0.05）； analysis of variance of repeated measurements found that the downward trend of the Karnofsky score in the treatment group was slower than that in the control group （F = 4.47， P = 0.037）. The difference between the TCM symptom scores of the two groups at each follow-up observation point was not statistically significant （P＞0.05）； there was a tendency for the TCM symptom scores of the two groups to increase， but the ANOVA of repeated measurements found that the difference between the two groups was not statistically significant either （F = 0.31， P = 0.58）. Concusion The oral administration of Huqi Zhengxiao Formula can improve the survival rate， prolong the survival time， and improve the quality of life of patients with stage Ⅲ hepatitis B-associated PLC with syndrome of healthy qi deficiency and toxic stasis accumulations after TACE treatment.

Effect of knee isokinetic training on mild to moderate muscle spasticity of the lower limbs in stroke patients / 中国脑血管病杂志

Objective To observe the effect of knee isometric training on mild to moderate lower limb muscle spasticity in stroke patients.Methods A total of 130 stroke hemiplegia patients were prospectively included in this study.They were admitted to Xiangcheng People's Hospital of Suzhou City between August 2021 and December 2023 and numbered according to the order of collection.The patients were then randomly assigned to either the control group or the isokinetic group using a random number table.Each group consisted of 65 cases.Both groups underwent conventional rehabilitation training(5 days a week,40 minutes per day),with the isokinetic group receiving additional isokinetic muscle training(5 days a week,20 minutes per day)on top of the conventional rehabilitation training.The treatment period lasted for 6 weeks.The surface electromyographic signals of the rectus femoris muscle on the affected side were analyzed for their root-mean-square(RMS),integral electromyographic(iEMG)values,the modified Ashworth scale(MAS)scores,knee flexors and extensors peak torque and its ratio,the Fugl-Meyer assessment scale-lower extremity(FMA-LE)scores,and the 10 m walk test were used before and after the treatments to compare the surface electromyography of rectus femoris,the degree of muscle spasticity and exercise capacity of the lower extremities of the two groups.Results Prior to treatment,there were no statistically significant differences between the two groups in terms of the RMS of the rectus femoris muscle,iEMG values,MAS scores,peak torque of the flexor and extensor muscles and their ratio,FMA-LE score,and step speed(all P＞0.05).RMS of the rectus femoris muscle,iEMG values,MAS scores,peak torque of the knee flexors and extensors and their ratios,FMA-LE scores,and step speed improved in control group after treatment compared to before treatment([12.3±2.2]μV vs.[15.5± 2.9]μV,[24.8±2.3]μV·s vs.[29.2±3.1]μV·s,[1.34±0.15]points vs.[1.56± 0.25]points,[20.8±3.4]N·m vs.[12.3±2.5]N·m,[34.5±2.3]N·m vs.[26.3±3.6]N·m,0.60±0.16 vs.0.47±0.14,[26.1±2.9]points vs.[21.3±2.4]points,[0.61±0.14]m/s vs.[0.46±0.15]m/s;all P＜0.05).Rectus femoris muscle RMS,iEMG values,MAS scores,peak torque of the flexor and extensor muscles and their ratio,FMA-LE scores and step speed after treatment in the isokinetic group were(10.9±1.8)μV,(22.4±2.1)μV·s,(1.25±0.18)points,(28.7±3.0)N·m,(41.5±2.8)N·m,0.69±0.18,(29.0±2.3)points,(0.69±0.18)m/s,compared with pretreatment(respectively[15.4±2.2]μV,[29.6±3.0]μV·s,[1.58±0.34]points,[12.6± 2.3]N·m,[26.1±3.1]N·m,0.48±0.17,[21.5±2.1]points,[0.48±0.17]m/s)and control group after treatment,the differences were statistically significant(all P＜0.05).Before treatment,the differences in rectus femoris muscle RMS and iEMG values between patients with mild spasticity and patients with moderate spasticity in the isokinetic group and the corresponding patients with mild spasticity and moderate spasticity within the control group were not statistically significant(all P＞0.05).After treatment,the rectus femoris muscle RMS and iEMG values in patients with mild spasticity within the isokinetic group([10.2±1.0]μV and[20.2±2.0]μV·s,respectively)were statistically different from those before treatment([14.1±2.3]μV and[28.1±3.2]μV·s,respectively)and those after treatment in patients with mild spasticity within the control group([11.4±1.7]μV and[23.6±2.5]μV·s respectively;all P＜0.05);the rectus femoris muscle RMS and iEMG values in patients with moderate spasticity within the isokinetic group improved compared with the pre-treatment period([11.8±1.5]μV vs.[16.9±2.6)μV,and[24.9±2.2]μV·s vs.[31.3±3.8]μV·s,respectively;both P＜0.05),and with the control group after treatment(RMS and iEMG values of[13.2±2.5]μV and[26.1± 2.7]μV·s,respectively),the difference in RMS was statistically significant(P＜0.01),and the difference in iEMG values was not statistically significant(P＞0.05).Conclusion Isokinetic muscle training has a positive effect on improving mild-to-moderate muscle spasticity of the lower limb knee extension,and the effect is more significant the lighter the degree of spasticity.

Effects of HOTAIR on epithelial mesenchymal transition in HaCaT cells / 中华医学美学美容杂志

Objective:To verify that hypoxia induces epithelial mesenchymal transition in HaCaT cells, and to observe the effect of LncRNA HOTAIR on epithelial mesenchymal transition in HaCaT cells.Methods:From Jan. 2018 to Dec. 2018 in Chinese Academy of Medical Science, HaCaT cells were divided into four groups: group A cultured under normoxia, group B cultured under hypoxia, group C transfected with sh-control cultured under hypoxia, and group D transfected with sh-LncRNA HOTAIR cultured under hypoxia. After 36 hours of culturing, the expression of E-cadherin and vimentin were detected using qPCR and Western blot. The migration of HaCaT cells was evaluated by Transwell assay.Results:The relative quantity of E-cadherin mRNA in the four groups were 3.076±0.271, 1.000±0.089, 1.024±0.222, and 2.595±0.085, while vimentin mRNAs were 1.002±0.183, 4.170±0.279, 4.111±0.477, and 2.412±0.134, respectively. In addition, the Transwll invasion assay showed that numbers of cell migration in the four groups were 32.70±3.93, 125.40±6.26, 120.10±6.79, and 58.24±7.06, respectively.Conclusions:The study suggests that hypoxia promotes epithelial mesenchymal transition in keratinocytes. Furthermore, downregulation of HOTAIR is noted to inhibit epithelial mesenchymal transition of keratinocytes under hypoxia condition.

Solitaire FR with intracranial support catheter for mechanical thrombectomy in patients with progressive cerebral venous sinus thrombosis / 国际脑血管病杂志

Objective:To investigate the safety and effectiveness of Solitaire FR with intracranial support catheter for mechanical thrombectomy (SWIM) in the treatment of cerebral venous sinus thrombosis (CVST).Methods:Patients with progressive CVST treated with SWIM technology in the Neurology Department, Zhongshan Hospital of Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine from June 2019 to March 2022 (including 4 patients with intracranial hemorrhage) were retrospectively included. The venous sinus recanalization after procedure and during follow-up was observed. The modified Rankin Scale (mRS) was used to evaluate the outcome at 3 months after procedure.Results:A total of 9 patients with progressive CVST were treated with SWIM technology, including 6 males with a median age of 37.0 years (range, 15-78). Immediately post-procedural angiography showed complete recanalization of the venous sinuses in 6 cases and partial recanalization in 3 cases. At 3 months after procedure, the mRS score showed that 3 cases was 0, 3 cases was 1, 2 cases was 2, and 1 case was 4.Conclusion:SWIM technology may be a safe and effective method in the treatment of progressive CVST.

Effect of health education based on symptom management model for patients with colorectal cancer undergoing preventive enterostomy / 中国实用护理杂志

Objective:To construct a symptom management model for colorectal cancer patients with preventive colostomy and evaluate the effect of health education strategy.Methods:A randomized controlled trial was used to facilitate the sampling of 92 patients with colorectal cancer receiving preventive colostomy at Jinhua Central Hospital from July 2020 to August 2022, they were randomly divided into control group ( n = 46) and test group ( n = 46). The control group was given routine health education, the experimental group was given symptom management model health education strategy, compare the disease symptom perception level, self-care behavior execution intention score, and quality of life score of two groups at admission, discharge, and one month after discharge using the Disease Perception Questionnaire, Self Care Behavior Intention Questionnaire for Enterostomy Patients, and Quality of Life Questionnaire for enterostomy patients. Results:The 43 patients in the control group and 44 patients in the test group completed the study.At discharge and one month after discharge, the scores of the patients in the control group were 50.95 ± 4.13 and 46.05 ± 2.87, respectively, compared with those in the trial group 48.72 ± 2.75 and 41.42 ± 2.39, respectively, the difference was significant ( t = 2.97, 8.12, both P<0.05). At discharge and 1 month after discharge, the scores of self-care behavior of the control group were 64.72 ± 3.47 and 68.13 ± 3.51, respectively, compared with those of the trial group 74.21 ± 4.55 and 79.89 ± 3.72, respectively, the differences were significant ( t = - 10.80, -15.20, both P<0.05). One month after discharge, the scores of physical, mental and mental health in the control group were 3.46 ± 1.09, 4.09 ± 1.19 and 4.72 ± 1.04, respectively, compared with those in the test group 5.07 ± 1.21, 6.27 ± 1.34 and 5.54 ± 1.16, respectively, the differences were significant ( t = - 6.47, - 8.03, - 3.52, all P<0.05). Conclusions:The health education strategy of symptom management mode reduces the level of disease perception, promotes the intention of self-care behavior, and improves the quality of life.

Epidemic status of drinking water type endemic arsenic poisoning in Inner Mongolia Autonomous Region / 中华地方病学杂志

Objective:To investigate the epidemic scope and intensity of drinking water type endemic arsenic poisoning in Inner Mongolia Autonomous Region, as well as the prevalence and influencing factors, in order to provide scientific basis for precise formulation of prevention and control measures.Methods:A sampling survey was conducted on residents' drinking water in all villages and counties in Inner Mongolia Autonomous Region, water samples were selected according to different water supply methods (engineering water supply, physical and chemical water purification, and decentralized water supply), and the arsenic content was detected by atomic fluorescence method. The "Diagnosis of Endemic Arsenicosis" (WS/T 211-2015) was used for diagnosis of arsenic poisoning among all permanent residents who were exposing to or had been exposed to excessively high arsenic water, in order to search all the arsenic poisoning patients. Analyze the distribution of water arsenic in the historical disease areas and high arsenic villages and newly discovered high arsenic villages, and explore the prevalence and influencing factors of arsenic poisoning.Results:There were a total of 1 186 historical disease areas and high arsenic villages in Inner Mongolia Autonomous Region, mainly distributed in 28 banner counties of 8 league cities such as Bayannur, Hohhot and Baotou, with a regional distribution trend of more in the west and less in the east. At present, the water improvement rate in the historical disease areas and high arsenic villages was 98.23% (1 165/1 186), and the qualified rate of arsenic content in the water was 99.83% (1 184/1 186). The arsenic content in the water of historical disease areas and high arsenic villages ranged from 0.000 to 0.093 mg/L. Four newly discovered villages with arsenic exceeding standards had been found, and their arsenic content ranged from 0.074 to 0.142 mg/L. A total of 2 249 patients with arsenic poisoning were detected in the confirmed disease area/high arsenic villages, and the detection rate was 1.67% (2 249/134 645). The number of patients in Bayannur City was the largest with the most severe disease, accounting for 82.70% (1 860/2 249). Patients aged 60 and above accounted for 61.41% of the total cases (1 381/2 249), which was higher than other age groups (χ 2 = 840.52, P < 0.001). The detection rate of arsenic poisoning was higher in males than in females (χ 2 = 132.38, P < 0.001). There are statistically significant differences in the detection rate and severity distribution of arsenic poisoning patients among different water arsenic content groups(χ 2 = 1 557.85, 1 741.05, P < 0.001). Conclusions:After years of prevention and control work, the arsenic content in most historical disease areas and high arsenic villages in Inner Mongolia Autonomous Region is currently qualified, and some areas have water arsenic exceeding standards or newly discovered villages with arsenic exceeding standards. At the same time, there are still a large number of arsenic poisoning patients in Inner Mongolia Autonomous Region. In the future, the prevention and control of endemic arsenic poisoning in Inner Mongolia Autonomous Region cannot be relaxed, and it is necessary to strengthen water quality monitoring and improve water quality in newly discovered villages with arsenic exceeding standards to prevent the occurrence of new cases.

A nomogram model predicting futile recanalization in patients with acute anterior circulation large vessel occlusion after endovascular mechanical thrombectomy / 中华神经医学杂志

Objective:To investigate the risk factors for futile recanalization in patients with acute anterior circulation large vessel occlusion after endovascular mechanical thrombectomy (EMT), and establish a nomogram model predicting futile recanalization in these patients.Methods:One hundred and eighty-eight patients with acute anterior circulation large vessel occlusion after EMT were enrolled from Department of Neurology, Zhongshan Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine from January 2018 to December 2021. Patients were divided into futile recanalization group and effective recanalization group according to whether futile recanalization occurred; futile recanalization was defined as successful recanalization showed by immediate postoperative DSA (modified thrombolysis in cerebral infarction [mTICI] ≥2b), but poor functional outcome (modified Rankin Scale [mRS] scores>2 90 d after surgery). The clinical data were compared between futile recanalization group and effective recanalization group. Multivariate Logistic regression analysis was used to screen the risk factors for futile recanalization. R software was used to establish a nomogram model for futile recanalization. C-index was used to evaluate the differentiation of the model, and correction curve was used to evaluate the accuracy of the line graph model prediction. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficiency of the nomogram model.Results:Ninety-two patients had futile recanalization. Compared with the effective recanalization group, futile recanalization group had significantly older age, significantly higher hemoglobin A1c on admission, significantly longer time from puncture to vascular recanalization, significantly higher proportions of patients with hypertension history and poor collateral circulation, and significantly different severities of stroke and white matter hyperintensities (WMHs) and distribution of occlusive sites ( P<0.05). Multivariate Logistic regression analysis showed that age, history of hypertension, time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke were independent risk factors for futile recanalization after EMT in patients with acute anterior circulation large vessel occlusion ( P<0.05). A nomogram model of futile recanalization was established according to the above 6 factors, with C-index of 0.862 ( 95%CI: 0.809-0.914); the calibration curve of the model was highly coordinated to the ideal model curve; area under the ROC curve of futile recanalization was 0.862 ( 95%CI: 0.809-0.914, P<0.001). Conclusions:Acute anterior circulation large vessel occlusion patients with older age, history of hypertension, longer time from puncture to vascular recanalization, poor collateral circulation, severe WMHs, and moderate-severe stroke trend to have futile recanalization after EMT. This nomogram can predict futile recanalization after EMT.

Effect of therapeutic postural placement on postural control and balance in stroke patients with hemiplegia / 中国康复理论与实践

ObjectiveTo explore the effect of therapeutic postural placement on postural control and balance in stroke patients with hemiplegia. MethodsFrom January, 2020 to June, 2022, 60 stroke patients in Cangzhou Hospital of Integrated TCM-WM•Hebei were randomly divided into control group (n = 30) and observation group (n = 30). Both groups accepted routine rehabilitation, while the observation group accepted therapeutic postural placement based on the concept of Bobath additionally. Fugl-Meyer Assessment-Lower Extremity (FMA-LE), Berg Balance Scale (BBS), Postural Assessment Scale for Stroke Patient (PASS) and Pro-kin balance instrument were used to evaluate the postural control and balance function before and four weeks after treatment, while the area of ellipse and length of motion with eyes open and closed were recorded, respectively. ResultsAfter treatment, the scores of FMA-LE, PASS and BBS significantly increased (|t| > 3.856, P < 0.001), and the area of ellipse and length of motion with eyes open and closed decreased in both groups (|t| > 4.083, P < 0.001); all the indexes were better in the observation group than in the control group (|t| > 2.261, P < 0.05). ConclusionThe therapeutic postural placement could effectively improve the postural control ability and balance function in stroke patients.

Laparoscopic limited anatomical hepatectomy for hepatocellular carcinoma within the right anterior section: a propensity score matched study / 中华肝胆外科杂志

Objective:To study the efficacy of laparoscopic limited anatomical hepatectomy (LLAH) for hepatocellular carcinoma (HCC) within the right anterior section.Methods:The clinical data of 144 patients with HCC confined in the right anterior section undergoing hepatectomy at the First Affiliated Hospital of Army Medical University from January 2015 to December 2022 were retrospectively analyzed, including 122 males and 22 females, aged (54.5±9.7) years. Patients were divided into LLAH ( n=27), laparoscopic anatomical hepatectomy (LAH, n=69), and laparoscopic non-anatomical hepatectomy (LNAH, n=48). Propensity score matching was used to compare the operative time, postoperative hospital stay, postoperative complications, serum total bilirubin and albumin, and the prognostic indicators such as tumor-free survival (DFS) rate and cumulative survival rate between the groups. Results:After propensity score matching, there were 26 cases each in LLAH and LNAH group. There was no significant difference in operative time, intraoperative blood loss and postoperative hospital stay between LLAH group and LNAH group (all P<0.05). The total bilirubin and albumin in LLAH on the third day after operation were [ M( Q1, Q3)] 24.1(20.9, 29.1) μmol/L and (35.8±2.9) g/L, better than those in LNAH group 39.3(33.2, 57.0) μmol/L and (33.9±2.5) g/L, respectively. The 1- and 3-year DFS rates in LLAH group were 92.3% and 57.7%, higher than those in LNAH group (80.8% and 19.2%) (all P<0.05). After propensity score matching, there were 25 patients each in LLAH and LAH group. The operative time, postoperative hospital stay and postoperative complications of LLAH group were lower than those of LAH group, and the liver function parameters of LLAH group was also better than those of LAH group (all P<0.05). There was no significant difference in DSF rate between the two groups LLAH group and LAH group ( χ2=0.10, P=0.800). Conclusions:The perioperative outcome of LLAH for HCC within the right anterior section are similar to that of LNAH and better than that of LAH. The DFS of LLAH were better than that of LNAH and similar to that of LAH.

Whole-Brain Direct Inputs to and Axonal Projections from Excitatory and Inhibitory Neurons in the Mouse Primary Auditory Area / 神经科学通报·英文版

Neurons in the primary auditory area (AUDp) innervate multiple brain regions with long-range projections while receiving informative inputs for diverse functions. However, the brain-wide connections of these neurons have not been comprehensively investigated. Here, we simultaneously applied virus-based anterograde and retrograde tracing, labeled the connections of excitatory and inhibitory neurons in the mouse AUDp, and acquired whole-brain information using a dual-channel fluorescence micro-optical sectioning tomography system. Quantified results showed that the two types of neurons received inputs with similar patterns but sent heterogeneous projections to downstream regions. In the isocortex, functionally different areas consistently sent feedback-dominated projections to these neurons, with concomitant laterally-dominated projections from the sensory and limbic cortices to inhibitory neurons. In subcortical regions, the dorsal and medial parts of the non-lemniscal auditory thalamus (AT) were reciprocally connected to the AUDp, while the ventral part contained the most fibers of passage from the excitatory neurons and barely sent projections back, indicating the regional heterogeneity of the AUDp-AT circuit. Our results reveal details of the whole-brain network and provide new insights for further physiological and functional studies of the AUDp.

Changes of thyroid hormone level in type 1 diabetic children complicated with ketoacidosis / 中华全科医师杂志

Objective:To investigate the changes of thyroid hormone level in children with type 1 diabetic mellitus (T1DM) complicated with ketoacidosis.Methods:Sixty-seven children with acute T1DM and ketoacidosis admitted in Department of Endocrinology, Shanxi Children′s Hospital from December 2017 to December 2020 were enrolled as acidosis group; and 44 T1DM children without ketoacidosis at admission served as control group. According to blood gas analysis, in acidosis patients there were 22 cases in mild group (pH<7.3), 16 cases in moderate group (pH<7.2) and 29 cases in severe group (pH<7.1). Serum levels of triiodothyronine (T 3), thyroxine (T 4), free T 3(FT 3), free T 4(FT 4), thyroid stimulating hormone (TSH) were measured in all patients at admission and recovery, retrospectively. Patients in the acidosis group at acute stage were treated with balanced fluid infusion, insulin infusion and eritone. Results:The serum levels of T 3 [0.48(0.19, 0.67)nmol/L vs. 0.97(0.74, 1.18)nmol/L, Z=-5.97, P<0.001], T 4 [(49.99±26.06) nmol/L vs. (73.48±23.32)nmol/L, t=4.68, P<0.001], FT 3 [1.80(1.24, 2.51) pmol/L vs. 3.31(2.56, 3.98) pmol/L, Z=-6.15, P<0.001], FT 4 [9.74 (7.21, 12.85)pmol/L vs. 14.54 (11.29, 16.75)pmol/L, Z=-5.23, P<0.001] and TSH [0.86(0.31, 1.81) mIU/L vs. 1.92(1.01, 3.56)mIU/L, Z=-4.19, P<0.001] in acidosis group at acute stage were significantly lower than those in the control group. In acidosis group at recovery stage serum levels of T 3 [1.58 (1.25, 1.86)nmol/L], T 4 [(92.52±27.03) nmol/L], FT 3 [5.03(4.15, 5.78) pmol/L], FT 4 [15.94 (14.40, 18.38)pmol/L], and TSH [2.21(1.58, 3.16)mIU/L] were significantly higher than those at acute stage ( Z=-6.96, t=-11.34, Z=-7.00, Z=-6.39, Z=-5.28,all P<0.001). There was an decreasing trend of T 3 and FT 3 levels from mild group [0.60 (0.47, 0.78)nmol/L, 2.20(1.47, 2.89) pmol/L], moderate group [0.36(0.18, 0.64)nmol/L, 1.90(1.11, 2.31)pmol/L] to severe acidosis group [0.35(0.16, 0.54) nmol/L, 1.48(1.08, 1.89)pmol/L](T 3: Z=-3.44, P=0.001; Z=-3.97, P<0.001; Z=-5.63, P<0.001;FT 3: Z=-3.44, P=0.001; Z=-4.13, P<0.001; Z=-5.86, P<0.001). Compared to control group serum T 4 and FT 4 levels in moderate group [(47.34±29.89)nmol/L and 9.75(5.74,12.29)pmol/L] and severe group [(44.08±22.27)nmol/L and 8.82 (6.40, 9.89)pmol/L] were significantly decreased (T 4: t=3.66, t=5.01,all P<0.001; FT 4: Z=-3.40, P=0.001; Z=-5.73, P<0.001). The TSH level in severe acidosis group [0.63 (0.27, 1.33)mIU/L] was lower than that in the control group ( Z=-4.23, P<0.001). At the recovery stage the serum levels of T 3 [1.69 (1.22, 1.87)nmol/L,1.68 (1.24, 1.84)nmol/L,1.55(1.25, 1.86) nmol/L], FT 3 [5.27 (4.37, 5.76)pmol/L,4.32(4.17, 5.73)pmol/L,5.04(3.81, 5.79)pmol/L], T 4 [(87.41±18.40)nmol/L,(90.02±30.41)nmol/L,(97.34±30.10)nmol/L] and FT 4 [16.05(14.23, 17.71) pmol/L,15.26(14.40, 16.11)pmol/L,16.88(13.98, 18.89) pmol/L] in the mild, moderate and severe acidosis groups were higher than those in the control group (T 3: Z=-4.55, Z=-3.87, Z=-4.93,all P<0.001;FT 3: Z=-4.72, Z=-3.72, Z=-4.52,all P<0.001;T 4: t=-2.01, P=0.047; t=-2.15, P=0.034; t=-3.88, P<0.001;FT 4: Z=-2.21, P=0.027; Z=-0.84, P=0.399; Z=-2.67, P=0.008); while there was no significant difference in TSH levels [2.28(1.88, 3.16)mIU/L, 2.19(1.26, 3.57) mIU/L, 2.18(1.36, 3.09) mIU/L] between mild, moderate, severe acidosis groups and the control group (all P>0.05). Conclusions:Thyroid function in T1DM children complicated with ketoacidosis is decreased significantly with the aggravation of acidosis. After correction of ketoacidosis, the level of thyroid function can basically return to normal.

Expert consensus on lung transplantation nursing (version 2022) / 中国胸心血管外科临床杂志

@#In order to promote the development of lung transplantation nursing in China, and to provide patients with comprehensive, safe, scientific and standardized surgical nursing, thoracic surgery experts and nursing experts from medical institutions qualified for lung transplantation were convened for extensive consultation. This consensus was developed in accordance with the principles of evidence-based medicine and based on the published best evidence in Chinese and English. This consensus aims to solve the potential problems in nursing cooperation in lung transplantation surgery to the greatest extent, and provide a scientific and standardized nursing cooperation plan for lung transplantation surgeries.

Correlation of the CTD structural domain of hepatitis B virus core protein with the encapsulation effect of indocyanine green / 生物工程学报

Hepatitis B virus core protein (HBc) has become a hot spot in drug carrier protein research due to its natural particle self-assembly ability and ease of modification. The truncation of the C-terminal polyarginine domain (CTD, aa 151-183) of HBc does not affect the self-assembly of the particles. However, it does affect the internal and external charges of the particles, which may subsequently affect drug encapsulation. Thus, the truncated C-terminal polyarginine domain (CTD) of HBc and the inserted RGD peptide were selected to construct and express three HBc variants (RH) encapsulated with ICG (RH/ICG) with different C-terminal lengths to compare the stability and drug activity of their nanoformulations. RH160/ICG was found to have a great advantages in encapsulation efficiency and biological imaging. Compared with other HBc variants, RH160/ICG significantly improved encapsulation efficiency, up to 32.77%±1.23%. Cytotoxicity and hemolysis assays further demonstrated the good biocompatibility of RH160/ICG. Cell uptake and in vivo imaging experiments in mice showed that RH160/ICG could efficiently deliver ICG in tumor cells and tumor sites with good imaging effect. This research provides a new direction for further expanding the diagnosis and treatment application of ICG and development of HBc-based nanoparticle drug carrier platform.

Anterior and posterior auricular approach for ear cartilage harvesting rhinoplasty: a comparative study / 中华医学美学美容杂志

Objective:To compare the pros and cons of harvesting ear cartilage through anterior and posterior auricular approaches during rhinoplasty.Methods:From January 2017 to December 2018, 63 patients with otochondral rhinoplasty in our hospital were enrolled in this study, 60 were female and 3 were male; the average age was 31.6 years (range, 18 to 43) . They were randomly divided into anterior auricular approach group with 32 cases (64 sides) and posterior auricular approach group with 31 cases (62 sides). Surgical duration, complications and postoperative scar of the two methods were analyzed.Results:The average time for harvesting the ear cartilage through posterior auricular approach and anterior auricular approach was (20.8±1.7) min and (12.6±1.1) min, respectively ( P<0.01). The overall complication rate was 15.6% for posterior auricular approach group and 4.8% for anterior auricular approach group. The wound healed well in both groups, and there was no significant difference in postoperative scar between the two groups during an average 13 months follow-up period. Conclusions:While both the anterior and the posterior auricular approaches present with similar inconspicuous scarring, the use of anterior auricular approach alone to harvest ear cartilage during rhinoplasty provides both the surgeons and the patients with easier access, shorter surgical duration, and fewer complications. Hence, we believe that the anterior auricular approach possesses greater advantages than the posterior auricular approach.

Classification system and surgical design of developmental breast asymmetry / 中华医学美学美容杂志

Objective:To explore the classification and treatment strategies of developmental breast asymmetry (DBA).Methods:A retrospective study was conducted in adult female patients with developmental breast asymmetry deformity who underwent surgery between January 2005 to June 2019 in the Plastic Surgery Department of Peking Union Medical College Hospital. According to different clinical manifestations, DBA was divided into three types which adopted to different surgical strategies. Postoperative complications and patient satisfaction were evaluated.Results:A total of 203 patients were included in the study; 42.36% (86 cases) were type Ⅰ, 31.03% (63 cases) were type Ⅱ and 26.60% (54 cases) were type Ⅲ. The number of follow-up patients accounted for 79.3% (161/203). The mean follow-up time was 9 months. There were one case of poor healing of the axillary incision in latissimus dorsi muscle flap, two cases of seroma, five cases of Baker grade Ⅰ capsule contracture, two cases of Baker grade Ⅱ capsule contracture and one cases of small nodules in autologous fat breast augmentation. With regard to patient satisfaction, 80.1% (129 cases) felt satisfied with the aesthetic results, 15% (24 cases) felt good, 3.7%. (6 cases) felt average and 1.2% (2 cases) felt unsatisfied.Conclusions:This study shows that the clinical manifestations of DBA are varied, and our classification method is an effective and useful tool to guide the surgical treatment. Individualized surgical design is essential for aesthetical results.

LncRNA HOTAIR involves in upregulation of HIF-1α in HaCat cells under low oxygen condition / 中华医学美学美容杂志

Objective:To observe the effect of LncRNA HOTAIR on the expression of HIF-1α in HaCat cell under low oxygen condition, and to explore the role of LncRNA HOTAIR in the pathogenesis and development of keloid.Methods:From Jan. 2018 to Dec. 2018 in Chinese Academy of Medical Science, recombinant plasmids were designed and constructed by specific shRNA-HOTAIR. After transfected HaCat cells with sh-LncRNA HOTAIR, RT-PCR was used to detect the expression level of HOTAIR. HaCat cells were cultured in different conditions and divided into four groups: group A cultured under normoxia condition, the other three groups cultured under hypoxia condition. Group C was transfected with sh-control before hypoxic culture, while group D were transfected with sh-LncRNA HOTAIR. After 24 hours′ culture, dual luciferase reporter gene assay was used to verify the relationship of LncRNA HOTAIR and HIF-1α. Expression of HIF-1α in four groups of HaCat cells were determined by Western blot analysis.Results:Recombinant plasmids of shRNA-HOTAIR were successfully constructed, and the HOTAIR expression was significantly decreased. The relative luciferase activity was 0.94±0.30 in group A, 20.39±1.15 in group B, 18.09±0.80 in group C and 3.04±1.15 in group D. The relative luciferase activity of group B was higher than those of group A ( t=29.03, P<0.05), and the difference was statistically significant ( P<0.05). According to the results of Western blotting, group B (1.19±0.07) and group D (1.15±0.06) had higher expression of HIF-1α than group A (0.56±0.29) and group C (0.37±0.38). Down-regulation of HOTAIR significantly inhibited the protein level of HIF-1α. Conclusions:LncRNA HOTAIR plays a positive role in upregulation of HIF-1α in HaCat cells under hypoxia condition. Thus LncRNA HOTAIR may take part in the pathogenesis and development of keloid through HIF-1α pathway.

Emergence of vaccine-derived poliovirus type 2 after using monovalent type 2 oral poliovirus vaccine in an outbreak response, Philippines

Objective@#In response to an outbreak of circulating vaccine-derived poliovirus (cVDPV) type 2 in the Philippines in 2019–2020, several rounds of supplementary immunization activities using the monovalent type 2 oral poliovirus vaccine (OPV) were conducted for the first time in the Western Pacific Region. After use of the monovalent vaccine, the emergence of vaccine-derived poliovirus unrelated to the outbreak virus was detected in healthy children and environmental samples. This report describes the detection of this poliovirus in the Philippines after use of the monovalent type 2 OPV for outbreak response.@*Methods@#We describe the emergence of vaccine-derived poliovirus unrelated to the outbreak detected after supplementary immunization activities using the monovalent type 2 OPV. This analysis included virus characterization, phylogenetic analyses and epidemiological investigations.@*Results@#Three environmental samples and samples from six healthy children tested positive for the emergent vaccine-derived poliovirus. All isolates differed from the Sabin type 2 reference strain by 6–13 nucleotide changes, and all were detected in the National Capital Region and Region 4, which had conducted supplementary immunization activities.@*Discussion@#Since the 2016 removal of type 2 strains from the OPV, vaccine-derived poliovirus outbreaks have occurred in communities that are immunologically naive to poliovirus type 2 and in areas with recent use of monovalent OPV. To prevent the emergence and further spread of cVDPV type 2, several interventions could be implemented including optimizing outbreak responses by using the monovalent type 2 OPV, accelerating the availability of the novel type 2 OPV, strengthening routine immunization using inactivated polio vaccine and eventually replacing OPV with inactivated poliovirus vaccine for routine immunization.

Study on quality standard of compound Yuhong suppository / 药学实践杂志

Objective To establish the quality standard of compound Yuhong suppository. Methods Angelica dahurica, colophony and Sophora flavescens Alt. were identified by thin layer chromatography（TLC）method. The contents of sulfadiazine and dyclonine hydrochloride were determined by HPLC with diode array detection method. The mobile phase was methanol-0.02 mol/L potassium dihydrogen phosphate (adjusted to pH 3.3 with phosphoric acid) for gradient elution. The detection wavelength was 280 nm for sulfadiazine and dyclonine hydrochloride. Results The three Chinese traditional medicines were identified by TLC with clear spots. The linear ranges of sulfadiazine and dyclonine hydrochloride were good in 12.40-99.20 μg/ml (r=0.999 9) and 2.56-20.48 μg/ml (r=0.999 9). The average recovery was (99.21±0.43) % (n=9) and (99.54±0.68) % (n=9). Conclusion This method is accurate, sensitive, and reproducible. It can be used as a standard method for the quality control of compound Yuhong suppository.

Clinical application of autologous nanofat combined with pearl fat transplantation in comprehensive improvementof lacrimal groove depression / 中华医学美学美容杂志

Objective:To evaluate the clinical effect of autologous nanofat combined with pearl fat transplantation in comprehensive improvement of lacrimal groove depression.Methods:Seventy-eight patients (age ranges from 28 to 56 years, with average 38 years) who desired for lacrimal groove improvement were involved in this study from Jan. 2019 to Jun. 2020 in the Department of Plastic Surgery in Peking Union Medical College Hospital. Primary fat tissue was obtained and purified by liposuction. Nanofat and pearl fat were prepared and injected into lacrimal groove area in different layers and multiple points evenly to ameliorate depression. Visual analogue scoring (VAS) was used for evaluating injection pain. Dark eye circles, faint lines on lower eyelid, color spots and lacrimal groove depression between pre-operation pictures and post-operation pictures of 1 year follow-up were evaluated by patients＇ satisfaction scores.Results:All 78 patients revealed mild swelling and disappeared in 3 to 4 days. Injection areas were stable in 3 months. All patients appeared no complications such as infection, hematoma, fat liquefaction, local induration and so on. Among 78 patients, 2 patients showed ecchymosis after surgery which disappeared in 10 days, and 1 patient showed uneven appearance which disappeared after timely treatment. After 1 year of follow-up, the average satisfaction score of improvement was 8.9±0.5, which showed satisfied post-operative effect.Conclusions:Autologous nanofat combined with pearl fat transplantation has high feasibility, short operation time, which could achieve good effect of facial rejuvenation with high patients＇ satisfaction. In this case, this technique is worthy of clinical promotion.