Challenges, Attitudes and Skills of Occupational Therapists towards Pre-Driving Assessments Practices in Malaysia (Cabaran, Sikap Dan Kemahiran Ahli Terapi Cara Kerja Terhadap Amalan Penilaian Pra-Pemanduan Di Malaysia) / Jurnal Sains Kesihatan Malaysia

@#A pre-driving assessment usually involves standardised and non-standardised tests to examine the skills for safe driving of people with disabilities. However, it is still unknown to what extent the pre-driving assessments are being practised among occupational therapists in Malaysia. Therefore, this study aims to investigate the association of challenges, attitudes, and skills of occupational therapists towards practising driving rehabilitation and explore the most used predriving assessment. A cross-sectional study had been conducted from July to September 2020. The convenient sampling method was used to recruit experienced occupational therapists in driving rehabilitation. A total of 53 therapists had completed an online survey. According to the results, the bivariate correlation between skills and challenges was positive and strong (rѕ = 0.680, p < 0.05). A multivariate analysis of variance (MANOVA) indicated that workplace variables had a significant effect on the combined dependent variables of challenges, attitudes, and skills, F(3,49) = 4.521 p = 0.007, partial Ƞ² = 0.217. This study found that the most used standardised assessment was the range of motion (n = 39, 73.6 %) and the right and left discrimination (n = 40, 75.5 %). The findings of this study identified that occupational therapists challenges and attitudes are significantly associated with the skills to practice driving rehabilitation. Malaysian occupational therapists working in the government sector reported better skills than those working in the private sector. Furthermore, numerous types of pre-driving assessments were used and vary from setting to setting. This study hopes to benefit occupational therapists and related rehabilitation practitioners towards a holistic understanding of Malaysia's driving rehabilitation practices.

Immunogenicity and safety of a severe acute respiratory syndrome coronavirus 2 inactivated vaccine in healthy adults: randomized, double-blind, and placebo-controlled phase 1 and phase 2 clinical trials / 中华医学杂志(英文版)

BACKGROUND@#The significant morbidity and mortality resulted from the infection of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) call for urgent development of effective and safe vaccines. We report the immunogenicity and safety of an inactivated SARS-CoV-2 vaccine, KCONVAC, in healthy adults.@*METHODS@#Phase 1 and phase 2 randomized, double-blind, and placebo-controlled trials of KCONVAC were conducted in healthy Chinese adults aged 18 to 59 years. The participants in the phase 1 trial were randomized to receive two doses, one each on Days 0 and 14, of either KCONVAC (5 or 10 μg/dose) or placebo. The participants in the phase 2 trial were randomized to receive either KCONVAC (at 5 or 10 μg/dose) or placebo on Days 0 and 14 (0/14 regimen) or Days 0 and 28 (0/28 regimen). In the phase 1 trial, the primary safety endpoint was the proportion of participants experiencing adverse reactions/events within 28 days following the administration of each dose. In the phase 2 trial, the primary immunogenicity endpoints were neutralization antibody seroconversion and titer and anti-receptor-binding domain immunoglobulin G seroconversion at 28 days after the second dose.@*RESULTS@#In the phase 1 trial, 60 participants were enrolled and received at least one dose of 5-μg vaccine (n = 24), 10-μg vaccine (n = 24), or placebo (n = 12). In the phase 2 trial, 500 participants were enrolled and received at least one dose of 5-μg vaccine (n = 100 for 0/14 or 0/28 regimens), 10-μg vaccine (n = 100 for each regimen), or placebo (n = 50 for each regimen). In the phase 1 trial, 13 (54%), 11 (46%), and seven (7/12) participants reported at least one adverse event (AE) after receiving 5-, 10-μg vaccine, or placebo, respectively. In the phase 2 trial, 16 (16%), 19 (19%), and nine (18%) 0/14-regimen participants reported at least one AE after receiving 5-, 10-μg vaccine, or placebo, respectively. Similar AE incidences were observed in the three 0/28-regimen treatment groups. No AEs with an intensity of grade 3+ were reported, expect for one vaccine-unrelated serious AE (foot fracture) reported in the phase 1 trial. KCONVAC induced significant antibody responses; 0/28 regimen showed a higher immune responses than that did 0/14 regimen after receiving two vaccine doses.@*CONCLUSIONS@#Both doses of KCONVAC are well tolerated and able to induce robust immune responses in healthy adults. These results support testing 5-μg vaccine in the 0/28 regimen in an upcoming phase 3 efficacy trial.@*TRIAL REGISTRATION@#http://www.chictr.org.cn/index.aspx (No. ChiCTR2000038804, http://www.chictr.org.cn/showproj.aspx?proj=62350; No. ChiCTR2000039462, http://www.chictr.org.cn/showproj.aspx?proj=63353).

Molecular epidemiology of Listeria monocytogenes isolated from ready-to-eat food in 2017 in China / 中华预防医学杂志

To analyze the molecular characteristics of strains from ready-to eat food in China. A total of 239 strains isolated from ready-to-eat food in 2017, all strains underwent whole-genome sequencing (WGS) , and comparisons uncovered population structure derived from lineages, clonal complex, serogroups, antimicrobial susceptibility and virulence, which were inferred in silico from the WGS data. Core genome multilocus sequence typing was used to subtype isolates. All strains were categorized into three different lineages, lineage Ⅱ was the predominant types in food, and IIa was the main serogroups. CC8, CC101 and CC87 were the first three prevalent CCs among 23 detected CCs, accounting for 49.4%. Only 4.6% (11 isolates) of tested strains harbored antibiotic resistance genes, which were mostly trimethoprim genes (7 isolates, 2.9%). All strains were positive for LIPI-1, and only a part of strains harbored LIPI-3 and LIPI-4, accounting for 13.8% (33 isolates) and 14.2% (34 isolates), respectively. ST619 carried both LIPI-3 and LIPI-4. 51.5% (123 isolates) of strains carried SSI-1, and all CC121 strains harbored SSI-2. Different lineages, serogroups and CCs can be separated obviously through cgMLST analysis, and 24 sublineages were highly concordant with CCs. Ⅱa was the main serogroups in ready-to-eat food isolates in China; CC8, CC101 and CC87 were the prevalent CCs, and CC87 isolates was hypervirulent isolates, cgMLST method can be adopted for prospective foodborne disease surveillance and outbreaks detection.

Impacts of menu information quality and nutrition information quality on technology acceptance characteristics and behaviors toward fast food restaurants' kiosk

BACKGROUND/OBJECTIVES: With the advances in technologies, self-service kiosks at foodservice operations are becoming a new way of service provision. This study examined the relationships among the menu information quality, nutrition information quality, technology acceptance characteristics, and customer behavioral intention toward the kiosks in fast food restaurants.SUBJECTS/METHODS: A survey with a self-administered method was distributed online and offline. The sample consisted of customers who had used the kiosks at fast food restaurants in the last six months prior to the survey. The study hypotheses were tested by applying structural equation modeling.RESULTS: Structural equation modeling revealed the positive impacts of menu information quality and nutrition information quality, technology acceptance characteristics, and behavioral intention toward kiosks at fast food restaurants. On the other hand, one hypothesis (Hypothesis 4) on the impact of nutrition information quality on the perceived usefulness was rejected.CONCLUSION: The study is the first to investigate nutrition and menu information at foodservice kiosks and relate them to technology acceptance. The study is very timely and adequate in the time of the 4th industrial revolution. The critical importance of the presentation of nutrition information and menu information at the kiosks at fast food restaurants was verified. The academic and industrial implications of the study findings were discussed.

Effect of acupoint stimulation on the quality of recovery in patients with radical thyroidectomy under the concept of enhanced recovery after surgery: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of acupoint stimulation on the quality of recovery in patients with radical thyroidectomy under the concept of enhanced recovery after surgery (ERAS).@*METHODS@#A total of 62 patients with radical thyroidectomy were randomized into an observation group and a control group, 31 cases in each one. In both of the two groups, general anesthesia with tracheal intubation was applied, the same anesthesia induction and maintenance medication were given. In the observation group, auricular point pressing with magnetic beads was adopted at bilateral shenmen (TF) and transcutaneous electrical acupoint stimulation (dilatational wave, 2 Hz/100 Hz in frequency, 6 to 12 mA) was performed at bilateral Hegu (LI 4) and Neiguan (PC 6) from 30 min before anesthesia induction to the end of the anesthesia. In the control group, medical adhesive plaster was pasted at bilateral shenmen (TF) and the electrodes were plastered at bilateral Hegu (LI 4) and Neiguan (PC 6) with no corresponding stimulation. In both of the two groups, visual analogue scale for anxiety (VAS-A) score was observed to evaluate the anxiety severity before anesthesia induction; the total intraoperative dosages of sufentanil, remifentanil and propofol were recorded; the numerical rating scale (NRS) score was used to assess the pain severity of instant time (T0) and 30 min (T1) of entering post-anesthesia recovery room (PACU), motor and static mode at 2 h (T2), 6 h (T3), 12 h (T4), 24 h (T5) after surgery; time of first anal exhaust, time of getting out of bed after surgery, total hospitalization time and the incidences of postoperative nausea and vomiting were observed; the quality of recovery was assessed by the 40-item quality of recovery score (QoR-40).@*RESULTS@#The VAS-A score and the total intraoperative dosage of remifentanil in the observation group were reduced compared with the control group (0.05). The time of first anal exhaust and getting out of bed after surgery in the observation group were advanced than those in the control group (0.05). Compared with the control group, the QoR-40 score was increased in the observation group (<0.05).@*CONCLUSION@#Acupoint stimulation can improve the preoperative anxiety in patients with radical thyroidectomy, reduce the intraoperative anesthetic dosage and postoperative pain, advance the time of anal exhaust and getting out of bed, improve the quality of postoperative recovery and enhance the recovery process.

Perceptions of a night float system for intern doctors in an internal medicine program: an Asian perspective / 한국의학교육

Long duty hours have been associated with significant medical errors, adverse events, and physician “burn-out”. An innovative night float (NF) system has been implemented in our internal medicine program to reduce the negative effects of long duty hours associated with conventional full-call systems. However, concerns remain if this would result in inadequate training for interns. We developed a structured questionnaire to assess junior doctors’ perceptions of the NF system compared to full calls, in areas of patient safety, medical training, and well-being. Ninety-seven (71%) of the 137 doctors polled responded. Ninety-one (94%) felt the NF system was superior to the full call system. A strong majority felt NF was beneficial for patient safety compared to full call (94% vs. 2%, p<0.001). The NF system was also perceived to reduce medical errors (94% vs. 2%, p<0.001) and reduce physician “burn-out” (95% vs. 5%, p<0.001). Beyond being a practical solution to duty-hour limitations, there was a significant perceived benefit of the NF system compared to the full call in terms of overall satisfaction, patient safety, reducing medical errors and physician “burn-out”.

Perceptions of a night float system for intern doctors in an internal medicine program: an Asian perspective / 한국의학교육

Long duty hours have been associated with significant medical errors, adverse events, and physician “burn-out”. An innovative night float (NF) system has been implemented in our internal medicine program to reduce the negative effects of long duty hours associated with conventional full-call systems. However, concerns remain if this would result in inadequate training for interns. We developed a structured questionnaire to assess junior doctors’ perceptions of the NF system compared to full calls, in areas of patient safety, medical training, and well-being. Ninety-seven (71%) of the 137 doctors polled responded. Ninety-one (94%) felt the NF system was superior to the full call system. A strong majority felt NF was beneficial for patient safety compared to full call (94% vs. 2%, p<0.001). The NF system was also perceived to reduce medical errors (94% vs. 2%, p<0.001) and reduce physician “burn-out” (95% vs. 5%, p<0.001). Beyond being a practical solution to duty-hour limitations, there was a significant perceived benefit of the NF system compared to the full call in terms of overall satisfaction, patient safety, reducing medical errors and physician “burn-out”.

Prognostic value of right pulmonary artery distensibility in dogs with pulmonary hypertension

The right pulmonary artery distensibility (RPAD) index has been used in dogs with pulmonary hypertension (PH) caused by heartworm infection, myxomatous mitral valve disease, or patent ductus arteriosus. We hypothesized that this index correlates with the tricuspid regurgitation pressure gradient (TRPG) assessed by echocardiography and could predict survival in dogs with PH secondary to various causes. To assess this hypothesis, the medical records of 200 client-owned dogs at a referral institution were retrospectively reviewed. The RPAD index and the ratios of acceleration time to peak pulmonary artery flow (AT) and to the ejection time of pulmonary artery flow (ET) were recorded for each dog. The owners were contacted for follow-up assessments. The findings indicated that the RPAD index was correlated with the TRPG (R2 = 0. 362, p < 0.001). The survival time was significantly shorter in dogs with an RPAD index ≤ 21% that were followed up for 3 months and in dogs with an RPAD index ≤ 24% that were followed up for 1 year. Thus, the RPAD index was correlated with the TRPG and could predict the clinical outcome in dogs with PH caused by various diseases. This index could be used to evaluate the severity of PH in dogs without tricuspid regurgitation.

Iodine status and characteristics of Korean adolescents and their parents based on urinary iodine concentration: a nationwide cross-sectional study

PURPOSE: Iodine is a major component of thyroid hormones. Both deficiency and excess of iodine are major risk factors for thyroid disease, making it important to accurately assess iodine level in the human body. Urinary iodine concentration (UIC) is a commonly used measure of iodine status. However, there is little research on iodine status and related characteristics in Korean adolescents. METHODS: Using data from the sixth Korea National Health and Nutrition Examination Survey (KNHANES VI) for the years 2013–2015, we analyzed UIC and thyroid function test results in adolescents aged 10–18 years and their parents. We also investigated the influence of socioeconomic factors and family history of thyroid disease on iodine status. RESULTS: Mean UIC in Korean adolescents was 963.5±55.7 μg/L. Among evaluated subjects, 6.6%±1.0%, 29.8%±1.7%, and 63.9%±1.9% had low (UIC<100 μg/L), adequate (UIC: 100–299.9 μg/L), and excess (UIC≥300 μg/L) iodine concentrations, respectively. Based on regional trends, the incidence of iodine deficiency exceeded 10% in several regions, even though there was a dominance of regions with excess iodine. Parental UIC, female sex, average monthly income, and expenditure were all found to affect the iodine status of Korean adolescents. CONCLUSIONS: Although regional differences exist, the iodine status in Korean adolescents is mainly affected by the eating habits of their families and socioeconomic factors. Therefore, monitoring of iodine status is necessary in this population.

Exercise induced Right Ventricular Fibrosis is Associated with Myocardial Damage and Inflammation

BACKGROUND AND OBJECTIVES@#Intense exercise (IE) induced myocardial fibrosis (MF) showed contradictory findings in human studies, making the relationship between IE and the development of MF unclear. This study aims to demonstrate exercise induced MF is associated with cardiac damage, and inflammation is essential to the development of exercise induced MF.@*METHODS@#Sprague-Dawley rats were submitted to daily 60-minutes treadmill exercise sessions at vigorous or moderate intensity, with 8-, 12-, and 16-week durations; time-matched sedentary rats served as controls. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum cardiac troponin I (cTnI) concentration. After completion of the exercise protocol rats were euthanized. Biventricular morphology, ultrastructure, and collagen deposition were then examined. Protein expression of interleukin (IL)-1β and monocyte chemotactic protein (MCP)-1 was evaluated in both ventricles.@*RESULTS@#After IE, right but not left ventricle (LV) MF occurred. Serum cTnI levels increased and right ventricular damage was observed at the ultrastructure level in rats that were subjected to long-term IE. Leukocyte infiltration into the right ventricle (RV) rather than LV was observed after long-term IE. Long-term IE also increased protein expression of pro-inflammation factors including IL-1β and MCP-1 in the RV.@*CONCLUSIONS@#Right ventricular damage induced by long-term IE is pathological and the following inflammatory response is essential to the development of exercise induced MF.

Exercise induced Right Ventricular Fibrosis is Associated with Myocardial Damage and Inflammation

BACKGROUND AND OBJECTIVES: Intense exercise (IE) induced myocardial fibrosis (MF) showed contradictory findings in human studies, making the relationship between IE and the development of MF unclear. This study aims to demonstrate exercise induced MF is associated with cardiac damage, and inflammation is essential to the development of exercise induced MF. METHODS: Sprague-Dawley rats were submitted to daily 60-minutes treadmill exercise sessions at vigorous or moderate intensity, with 8-, 12-, and 16-week durations; time-matched sedentary rats served as controls. Enzyme-linked immunosorbent assay (ELISA) was used to measure serum cardiac troponin I (cTnI) concentration. After completion of the exercise protocol rats were euthanized. Biventricular morphology, ultrastructure, and collagen deposition were then examined. Protein expression of interleukin (IL)-1β and monocyte chemotactic protein (MCP)-1 was evaluated in both ventricles. RESULTS: After IE, right but not left ventricle (LV) MF occurred. Serum cTnI levels increased and right ventricular damage was observed at the ultrastructure level in rats that were subjected to long-term IE. Leukocyte infiltration into the right ventricle (RV) rather than LV was observed after long-term IE. Long-term IE also increased protein expression of pro-inflammation factors including IL-1β and MCP-1 in the RV. CONCLUSIONS: Right ventricular damage induced by long-term IE is pathological and the following inflammatory response is essential to the development of exercise induced MF.

Family History as a Risk Factor for Iron Deficiency Anemia among Korean Adolescents: Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES) / 임상소아혈액종양

BACKGROUND: Iron deficiency anemia (IDA) is a disease prevalent throughout the world. However, there is limited information regarding whether familial factors are associated with the risk of adolescent IDA. METHODS: This study evaluated the association between adolescent IDA and family history of IDA using data from the fifth Korea National Health Nutrition Survey (2010–2012). Data from 10-18-year-old children who underwent laboratory testing were analyzed. RESULTS: The overall prevalence of IDA was 3.1% (95% confidence interval [CI]: 2.4−4.1%), with prevalence of 0.5% among boys (95% CI: 0.2−1.3%) and 6.2% among girls (95% CI: 4.6−8.3%). The prevalence of IDA was associated with female sex (odds ratio [OR]: 13.43, 95% CI: 4.92−36.65; P < 0.001) and a family history of IDA (OR: 3.12, 95% CI: 1.11−8.76; P=0.03). Other risk factors for IDA were receiving social welfare support (OR: 3.31, 95% CI: 1.45−7.56; P=0.031), low maternal education (OR: 3.12, 95% CI: 1.39−6.99; P=0.006), receiving charitable food support (OR: 2.27: 95% CI: 0.9−5.44; P=0.04), poor body-image (OR: 2.14, 95% CI: 1.16−3.93; P=0.026), and weight-loss efforts (OR: 2.42, 95% CI: 1.27−4.61; P=0.01). Nutritional supplementation protected against IDA (OR: 0.40, 95% CI: 0.19−0.82; P=0.007), although adolescents with awareness of nutritional labels had a high IDA prevalence (OR: 8.06, 95% CI: 1.71−38.05; P < 0.001). CONCLUSION: A family history of IDA was an independent risk factor for IDA. Further studies are needed to determine whether family-level educational interventions can reduce the risk of adolescent IDA.

Analysis of pediatric adverse drug reactions reported to regional pharmacovigilance center of a single university hospital

PURPOSE: Adverse drug reactions (ADRs) are a recurring problem among pediatric patients, and the incidence is increasing. However, there have been only a few studies on the clinical presentation of pediatric ADRs in Korea. This study investigated the clinical presentation of ADRs and the causative drugs in pediatric patients from a single university hospital. METHODS: We retrospectively collected the data on pediatric ADRs as reported to the Regional Pharmacovigilance Center in Dong-A University Hospital between March 2013 and July 2016. We analyzed clinical presentations associated with the events. To determinate causality, we evaluated each ADR according to the Naranjo probability scale, the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) criteria and the Korean ADR algorithm. RESULTS: A total of 365 ADR cases were reported. Sixty-eight patients (26.5%) responded to 2 or more drugs. Antibiotics (43.3%) were the most common causative drugs, of whom the third generation cephalosphorins caused most ADRs. The most common clinical presentations were gastrointestinal manifestations (36.6%). A total of 312 ADRs were reported in 257 patients based on both the Naranjo probability scale and the Korean ADR algorithm. In addition, 323 ADRs were reported in 257 patients based on the WHO-UMC criteria. CONCLUSION: Various drugs are related to ADRs in pediatric patients. Further efforts to improve ADR-reporting systems and to increase awareness of ADRs in pediatric patients are needed.

Anterior corpectomy combined with intervertebral decompression and fusion for multilevel cervical spondylotic myelopathy / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical outcomes of anterior corpectomy combined with anterior intervertebral decompression and fusion for multilevel cervical spondylotic myelopathy.</p><p><b>METHODS</b>The clinical data of 28 patients with multilevel cervical spondylotic myelopathy who underwent surgery from October 2012 to June 2014 were retrospectively analyzed. There were 18 males and 10 females, aged from 45 to 77 years old with an average of (60.11±9.37) years. Three levels were involved in 27 cases, while four levels were involved in 1 case. The preoperative JOA score was 8.89±1.87; the fusion segments angles was (4.87±4.56)°; and the cervical curvature was (11.68±1.25)°. Anterior hybrid decompression and fusion were performed in 28 patients. The fusion segments angles and the cervical curvature were assessed by X-rays at 1, 12 months after operation, respectively. JOA score was used to evaluate the clinical effect.</p><p><b>RESULTS</b>The operative time was 163 min on average (ranged from 120 to 205 min), and intraoperative bleeding was 198 ml on average(ranged from 100 to 300 ml). Hoarseness occurred in 1 case and got recovery at 3 weeks after operation and choke cough occurred in 1 case, and got improvement at 1 week after operation. All the patients were regularly followed for 12-24 months with an average of(18.46±3.20) months. Graft bone obtained fusion at 12 months after operation and the position of internal fixation was good. The fusion segments angles, the cervical curvature and JOA scores were significantly improved at 1, 12 months after operation(<0.05). The improvement rate of JOA score was(46.46±20.26)% at 12 months after operation, 12 cases got excellent results, 14 good and 2 fair.</p><p><b>CONCLUSIONS</b>Anterior corpectomy combined with anterior intervertebral decompression and fusion is safe and effective and can get satisfactory effects for multilevel cervical spondylotic myelopathy.</p>

Expression of MMP and TIMP in the Development of Exercise-induced Cardiac Damage and Fibrosis / 中国运动医学杂志

Objective To determine the expression of matrix metalloproteinase-1 (MMP-1) and its inhibitor in the development of exercise-induced atrial fibrosis.Methods Totally 48 eight-week-old male adult sprague-dawley rats were randomly divided into a control(C) group and a highly intensive exercise(H) group,each of 24.Group C was fed normally,while group H took one hour treadmill running with the gradient of 10°and speed of 28 m/min every weekday,lasting 5 weeks.The mRNA and protein expression of MMP-1 and matrix metalloproteinase tissue inhibitor-1 (TIMP-1) were detected using the real-time PCR and Western blotting.Results The MMP-1 expression of group H increased significantly after 8 weeks' training,compared to the control group.However,there was no significant difference in MMP-1 expression between group C and H after 12 or 16 weeks of training.The MMP-1 mRNA expression decreased with the extending of exercise,and that of group H after 16 weeks' training was significantly lower than 8 weeks' (P＜0.05).The TIMP-1 expression had an increasing trend without significance after 8-week exercise.After 12 and 16-week exercise,the mRNA and protein expression of TIMP-1 increased significantly(P＜0.01 and P＜0.05).The TIMP-1 mRNA and protein expression increased gradually with the extension of exercise,and the TIMP-1 mRNA expression of group H after 16 weeks of training was significantly higher than that after 8 weeks(P＜0.01).The ratio of MMP-1/TIMP-1 mRNA and protein increased at first and decreased afterwards.The ratio of MMP-1/TIMP-1 of group H after 16 weeks of exercise was significantly lower than group C at the same time point,and group H after 8 weeks' Conclusion After a long-term high-intensity exercise,the MMP-1 expression of atrial first increases and then decreases,while the TIMP-1 expression increases gradually.Moreover,such exercise can induce disbalance between MMP-1 and TIMP-1,maybe due to the molecular pathological mechanism of exercise-induced atrial damage and fibrosis.

Effects of jejunal interposition and Roux-en-Y surgery after total gastrectomy / 局解手术学杂志

Objective To investigate and compare the effects of jejunal interposition and Roux-en-Y surgery after total gastrectomy. Methods The clinical data of 41 patients with gastric cancer who underwent total gastrectomy in our hospital from June 2013 to June 2016 were retrospectively analyzed.According to the different ways of reconstruction of digestive tract,the patients were divided into observation group and control group.Patients of the observation group were with jejunal interposition surgery,while patients of the control group were trea-ted with Roux-en-Y surgery,and the effects of the two groups were compared and analyzed.Results There was no significant difference be-tween the two groups in the time of reconstruction,length of hospital stay and the incidence of complications(P>0.05).One year after sur-gery,incidence of complications,albumin,total health score,fatigue score,and disgust score of the observation group were significantly better than those of the control group with statistically significant difference(P<0.05).There was no significant difference between the two groups in survival rate,hemoglobin,total protein,weight changes(P>0.05).Conclusion For patients with total gastrectomy,jejunal interposition and Roux-en-Y surgery had similar effect.But in terms of the long-term effect,jejunal interposition can reduce complications and improve lev-el of nutrition and quality of life.

Research progress in exosomes in tissue fibrosis / 中国药理学与毒理学杂志

Exosomes are extracellular nanovesicles secreted by a variety of cell types such as cardiomyocyte, hepatocytes, and stem cells. They carry specific sets of mRNA, microRNA, and proteins, which play a role in intercellular communication in almost each physiological and pathological process. Exosomes, which are released after tissue cell injury, can initiate repair/regeneration responses by triggering inflammation and active fibroblast, and finally lead to tissue fibrosis. However, exosomes released by stem cells can retard tissue fibrosis by enhancing cell survival and reducing apoptosis. In this paper, we reviewed the research progress in the relationship between exosomes and tissue fibrosis.

Comparison of clinical effects between anterior cervical Zero-incision fusion system and traditional nail plate system in the treatment of cervical spondylotic myelopathy / 中国骨伤

<p><b>OBJECTIVE</b>To compare the short-term efficacy of anterior cervical discectomy and fusion(ACDF) with traditional nail plate system and Zero-profile device in the treatment of cervical spondylotic myelopathy(CSM).</p><p><b>METHODS</b>The clinical data of 45 patients with CSM treated from July 2014 to August 2015 was retrospectively analyzed. There were 23 males and 22 females with an average age of 53.7 years old(range, 32 to 71 years old). The course of disease was 5 months to 2 years. All the patients were treated with ACDF with 24 cases by traditional nail plate system fixation(group A) and 21 cases by Zero-P system fixation(group B). Operation time and intraoperative bleeding were compared between two groups. Neurological function and cervical pain were evaluated by Japanese Orthopaedic Association scores (JOA) and visual analogue scale (VAS), respectively. Cervical curvature(Cobb angle) change and intervertebral fusion were evaluated by X-rays and CT. And associated complications were analyzed in two groups.</p><p><b>RESULTS</b>All the patients were followed up for 12 to 16 months with an average of 14 months. Operation time of group A and B was(87.6±23.2) min and (62.7±17.3) min respectively, and the difference was significant between two groups; and intraoperative bleeding was (80.2±36.8) ml and (78.4±29.6) ml respectively, and the difference was not significant. At final follow-up, JOA and VAS of all patients were obvious improved, but there was no significant difference between two groups. Preoperative Cobb angle in group A and B was (8.7±4.3) ° and (8.6±4.2) ° respectively, and the difference was significant. The Cobb angle at final follow-up was (14.5±6.4) ° and (17.4±8.6) ° respectively, and the difference between two groups was significant. The incidence of dysphagia in group A and B were 29.17% and 9.52% respectively, and there was significant difference between two groups. All intervertebral spaces got fusion at final follow-up. No tracheo-asophageal injury and recurrent laryngeal nerve damage or other complications were found. No fusional migration, subsidence, loosening, breakage, etc. were found.</p><p><b>CONCLUSIONS</b>The clinical comparison of Zero-P interbody fixation system and cervical plate internal fixation for the treatment of cervical spondylosis was quite fair, but Zero-P showed a better therapeutic effect with improvement of life quality.</p>

A Comparative Study on Effects of Exercise Intensity and Duration on Left and Right Ventricular / 中国运动医学杂志

Objective To examine the effects of exercise intensity and duration on the structure,function and fibrosis of the left and right ventricular,and to discuss the potential mechanism in these processes.Methods Forty-eight male Sprague-Dawley rats were randomly divided into a sedentary(Sed)group,a moderate exercise(ME)group and an intensive exercise(IE) group,each of 16.Rats in Sed group were not given any training,while those in ME group and IE group run on treadmill at the speed of 15.2 m/min with the slope gradient of 5° and 28 m/min with the slope gradient of 10 degree 1 hour per day,5 days per week.Eight and 16 weeks after the training,we recorded the body weight and measure end-diastolic diameter,end-diastolic wall thickness,and ejection fraction of both ventriculars using the ultrasonic testing.All rats were then sacrificed after blood sampling.Elisa was used to measure serum cTnI concentration,and sirius red staining was applied to evaluate collagen volume fraction of both ventriculars.Results Eight or sixteen weeks after the training,the average bi-ventricular end-diastolic diameter of ME and IE rats was bigger than Sed group.There were no differences in end-diastolic diameter of both ventricular between ME group and IE group after sixteen-week training,but the left ventricular end-diastolic diameter of IE group was greater than ME group.As exercise intensive increased and time accumulated,the end-diastolic wall thickness of both ventriculars increased but without statistical significance.At sixteen-week intervention,the bi-ventricular ejection fraction of IE rats was significantly lower than Sed and ME groups,while there was a decreasing trend eight weeks earlier without significant differences.After 8 or 16 weeks of training,the serum cTnI was significantly higher in IE rats than Sed group or ME group,but there was no significant differences between ME group and Sed group.After 16 weeks' exercises,the average bi-ventricular collagen volume fraction of ME or IE group was greater than that after 8 weeks' exercises.The average collagen volume fraction of the right ventricular was greater than Sed group at the same time points,and after sixteenweek training the right ventricular collagen volume fraction in IE group was significantly greater than ME group.However,there were no significant differences in the measurement of the left side among different groups.The serum cTnI was negatively correlated with the left and right ventricular systolic function(r=-0.327,P=0.029 and r=-0.582,P=0.000).Moreover,it was positively correlated with the right ventricular collagen volume fraction moderately,but had no correlation with the left ventricular collagen volume fraction.Conclusion(1)Sixteen-week moderate and intensive exercise result in left ventricular dilation,and the dilation increases with the increase of the exercise intensity.Only 8 weeks' exercise at the same intensity can lead to right ventricular dilation,but exercise intensity has little influence on the right ventricular dilation.(2)Long-term moderate or intensive endurance exercises may cause bi-ventricular hypertrophy potentially.The left ventricular hypertrophy and dilation may not be synchronous with hypertrophy followed by dilation,while the right ventricular hypertrophy and dilation is synchronous.(3)The temporary decrease in bi-ventricular systolic function after intensive endurance exercise may be caused by ventricular injury,with more serious injury in the right ventricular than in the left.Moderate exercises don't cause ventricular injury,thus there is little or no influence on ejection fraction.(4) Long-term (8 or 16 weeks)moderate or intensive endurance exercises can increase the right ventricular collagen volume fraction,which may indicate cardiac fibrosis following right ventricular injury but not in the left ventricular.The bi-ventricular collagen volume fraction at sixteenth week in ME and IE rats are greater than corresponding rats at eighth week.It may result from the hypertrophy of bi-ventricular cardiomyocyte after 8-week training,followed by increase in the extracellular matrix but not cardiac fibrosis.

Effects of procyanidins on cell apoptosis and the release of cytochrome C in human trabecular meshwork cells under oxidative stress / 眼科新进展

Objective To investigate the effect of procyanidins (PC) on cell apoptosis and cytochrome C releasing in human trabecular meshwork cells (HTMC) under oxidative stress induced by H2 O2.Methods HTMC were cultured and then divided randomly into 5 groups.Normal cultured HTMC served as normal group without treatment,and normal cultured HTMC in control group were treated with 500 μrnol · L-1 H2O2 for 1 h,as well as normal cells in treatment groups were treated with 500 imol · L-1 H2 O2 for 1 h combined with different concentrations of PC (0.02 g · L-1,0.05 g · L-1,0.10 g · L-1).Then flow cytometry and Western blot were applied to detect the cell apoptosis rate and the release of cytochrome C (CytC) respectively.Results Compared with the normal group,the apoptotic rates of the control group and the PC treatment groups were significantly increased,and the difference was statistically significant (all P ＜ 0.01).Compared with the control group,the apoptotic rates of the 3 PC treatment groups were decreased,and the differences were statistically significant (all P ＜ 0.01).Moreover,the apoptotic rate in 0.02 g · L-1,0.05 g · L-1,0.10 g · L-1 PC treatment groups was decreased as PC concentration increased,and the differences were statistically significant (all P ＜ 0.01).Furthermore,compared with the normal group,the release of cytochrome C in the control group,0.02 g · L-1 and 0.05 g · L-1 PC treatment group enhanced,and the differences were statistically significant (all P ＜ 0.01),but there was no significant difference between 0.01 g · L-1 PC treatment group and the normal group (P ＞ 0.05).Compared with the control group,the release of cytochrome C in the 3 PC treatment group was attenuated with significant differences (all P ＜0.01).Meanwhile,the release of cytochrome C was decreased in the 3 PC treatment groups with a concentration-dependent manner,and the pairwise differences were statistically significant (all P ＜ 0.01).Conclusion Exogenous PC can decrease the apoptotic rate of HTMC under oxidative stress and reduce the release of cytochrome C,as well as it also has an antioxidant effect in a certain concentration-dependent manner.