Incidence of congenital cleft lip and cleft palate in Shanxi province and its trend from 2010 to 2020 / 中华全科医师杂志

Objective:To analyze the incidence of congenital cleft lip and cleft palate in Shanxi province and its trend from 2010 to 2020.Methods:The clinical data of perinatal infants from 2010 to 2020 were collected from Shanxi Provincial Hospital Monitoring System, and the distribution, prenatal diagnosis, the incidence of cleft lip, cleft palate, and the trend were analyzed.Results:From 2010 to 2020, among 843 457 prenatal infants in Shanxi province, there were 1 264 cases of cleft lip and/or cleft palate with an overall incidence rate of 1 4.99/10 4. Among them 199 cases were cleft palate (15.74%) with an incidence rate of 2.36/10 4; 358 cases were cleft lip (28.33%) with an incidence rate of 4.24/10 4; 707 cases were cleft lip with cleft palate (55.93%) with an incidence rate of 8.38/10 4. The overall incidence of cleft lip and/or cleft palate was significantly decreased from 2010 to 2020 ( χ2=104.04, P<0.001). The incidence of cleft lip in rural area was higher than that in urban areas (19.13/10 4vs. 11.50/10 4, χ2=81.29, P<0.001); the incidence in male infants was higher than that in female infants (16.41/10 4vs. 13.41/10 4, χ2=90.59, P<0.001). There were significant differences in the incidence of cleft lip and cleft palate among different maternal ages ( χ2=58.40, P<0.001); the incidence in maternal age<20 years (21.66/10 4) and 20-<25 years (21.06/10 4) was higher than that of other groups. The proportion of prenatal diagnosis of total cleft lip was 27.85% (352/1 264), which showed an increasing trend ( χ2=6.96, P=0.008). Conclusion:From 2010 to 2020, the incidence of congenital cleft lip and palate in Shanxi province shows a decreasing trend, while the prenatal diagnosis rate shows an increasing trend.

TGR5 deficiency activates antitumor immunity in non-small cell lung cancer via restraining M2 macrophage polarization

The bile acid-responsive G-protein-coupled receptor TGR5 is expressed in monocytes and macrophages, and plays a critical role in regulating inflammatory response. Our previous work has shown its role in promoting the progression of non-small cell lung cancer (NSCLC), yet the mechanism remains unclear. Here, using Tgr5-knockout mice, we show that TGR5 is required for M2 polarization of tumor-associated macrophages (TAMs) and suppresses antitumor immunity in NSCLC via involving TAMs-mediated CD8+ T cell suppression. Mechanistically, we demonstrate that TGR5 promotes TAMs into protumorigenic M2-like phenotypes via activating cAMP-STAT3/STAT6 signaling. Induction of cAMP production restores M2-like phenotypes in TGR5-deficient macrophages. In NSCLC tissues from human patients, the expression of TGR5 is associated with the infiltration of TAMs. The co-expression of TGR5 and high TAMs infiltration are associated with the prognosis and overall survival of NSCLC patients. Together, this study provides molecular mechanisms for the protumor function of TGR5 in NSCLC, highlighting its potential as a target for TAMs-centric immunotherapy in NSCLC.

Study of the uniformity between MRI and 18F-FDG PET/CT in detection of spinal metastatic tumor / 实用放射学杂志

Objective To compare the uniformity between spine MRI and 18F-FDG PET/CT in detection of spinal metastatic tumor, and to analyze the reasons for the discrepancy between them.Methods Data of 42 malignant tumor patients underwent spine MRI and 18F-FDG PET/CT were analyzed retrospectively.And the two tests were underwent within 30 days.The author censused and analyzed the number of centrums with metastatic tumor detected by spine MRI and 18F-FDG PET/CT,and supposed that 18F-FDG PET/CT was gold standard,to evaluate the sensitivity and specificity of spine MRI.The inconsistent between two tests was analysed.Results The study included 509 centrums of 42 patients.123 positive centrums (24.2%) were detected on spine MRI,and 114 positive centrums (22.4%) on 18F-FDG PET/CT(P=0.22>0.05).The uniformity between two tests was good (Kappa=0.76).Supposing that 18F-FDG PET/CT was gold standard,the sensitivity,specificity,positive predictive value, negative predictive value,false negative rate and false positive rate of spine MRI was 85.1%(97/114),93.4%(369/395),85.1%(97/114),93.4% (369/395),14.9%(17/114) and 6.6%(26/395) respectively.43 centrums of 14 patients were diagnosed inconsistently by spine MRI and 18F-FDG PET/CT.The main reasons for the inconformity were as following: types of primary tumors, insensitivity of spine MRI for diffuse scattered spinal metastatic tumors, the existence of misdiagnosis on spine MRI, misdiagnosis of spine MRI for metastatic lesions located in the vertebral appendix and paramedian vertebral body,misdiagnosis of 18F-FDG PET/CT for metastatic lesions located in the sacral centrum, existence of false positive on 18F-FDG PET/CT and so on.Conclusion The uniformity between spine MRI and 18F-FDG PET/CT is good.The inconformity still existes in some cases.Carefully comparative analysis of them contributes to find metastatic lesions.

Value of lactulose hydrogen breath test combined with radionuclide imaging in the diagnosis of small intestinal bacterial overgrowth / 中华核医学与分子影像杂志

Objective To compare the tracing effects of radionuclide and barium sulfate on lactulose hydrogen breath test (LHBT), and to explore the value of LHBT combined with radionuclide imaging in the diagnosis of small intestinal bacterial overgrowth (SIBO) in patients with irritable bowel syndrome (IBS).Methods From November 2010 to November 2012, 89 patients (47 males, 42 females;mean age (45.7±12.9) years) with IBS and 13 healthy volunteers (9 males, 4 females;mean age (43.3±8.6) years) were enrolled in this prospective study.All the subjects underwent LHBT combined with radionuclide imaging.Recording the time when the increment of H2 value >0.005‰ and the OCTT of the radionuclide.Four healthy volunteers also underwent LHBT combined with barium sulfate 1 week after radionuclide imaging.The location of barium sulfate was recorded when H2 value increment >0.020‰.Patients with SIBO received rifaximin treatment, and the effect was observed.χ2 test, Pearson correlation analysis and Wilcoxon rank sum test were used to analyze the data.Results (1)In LHBT combined with barium sulfate test, barium sulfate was found still stagnating in small intestine by abdominal X-ray when H2 value increment >0.020‰ in 4 healthy volunteers, and barium sulfate didn′t reach the colon in delayed imaging in 1 patient.(2) The rates of SIBO detected by LHBT in IBS patients and healthy volunteers were significantly different (43.8%(39/89) vs 5/13;χ2=0.133, P=0.716), and those detected by LHBT combined with radionuclide imaging were also significantly different (39.3%(35/89) vs 1/13;χ2=4.970, P=0.026).(3)The time of H2 value increased >0.005‰ correlated well with OCTT in 13 healthy volunteers ((73±31) and (50±19) min;r=0.871, P<0.001) and 54 IBS patients without SIBO ((83±34) and (66±28) min;r=0.735, P<0.001), but there was no correlation in 35 IBS patients with SIBO ((36±30) and (75±30) min;r=0.304, P=0.076).(4)A total of 34 SIBO-positive patients received a rifaximin treatment, with a significant improvement in the frequency of abdominal pain and abdominal distension after the treatment according to Rome Ⅲ diagnostic criteria: 5(4, 6) vs 4(3, 5), 4(1, 6) vs 0(0, 4)(z values:-4.842 and-5.388, both P<0.001).Conclusion LHBT alone is not a valid test for SIBO, and LHBT combined with radionuclide imaging is a good candidate for SIBO diagnosis.

Correlation among electrocardiogram indexes,myocardial enzyme peak and short term cardiac function in patients with anterior STEMI / 心血管康复医学杂志

Objective:To explore the correlation among ECG indexes,myocardial enzyme peak and short term cardi-ac function in patients with acute anterior ST elevation myocardial infarction (STEMI).Methods:A total of 150 pa-tients with acute anterior STEMI were selected from our hospital.According to left ventricular ejection fraction af-ter three months (3m LVEF),they were divided into cardiac dysfunction group (n=78,LVEF<50%)and normal cardiac function group (n= 72,LVEF≥ 50%).Following indexes were compared between two groups,including sum of ST elevation extent (ΣST),R wave (ΣR),Q wave (ΣQ),maximum value of ST elevation (STm)and Q wave (Qm)etc.on infarct related leads,and peak value of creatine kinase (CKm),CK isoenzyme (CK-MBm)and cardiac troponin T (cTnTm)etc.Results:Compared with normal cardiac function group,there were significant rise in ΣST,ΣQ,STm,Qm,CKm,CK-MBm,cTnTm,left ventricular end-diastolic diameter (LVEDd),3mLVEDd and significant reduction in ΣR and LVEF,3mLVEF in cardiac dysfunction group,P <0.05 or <0.01;Spearman correlation analysis indicated that ΣST,ΣQ,STm,Qm,CKm,CK-MBm and cTnTm were positively correlated with 3m LVEDd (r =0.18~0.63,P <0.05 or <0.01),and inversely correlated with 3m LVEF (r =-0.88~-0.42, P <0.01 all).ΣR was inversely correlated with LVEDd and 3m LVEDd (r =-0.46、-0.51,P <0.01 both),and positively correlated with LVEF and 3m LVEF (r =0.81,0.71,P <0.01 both).Conclusion:In patients with ante-rior STEMI,the higher ST elevation,the higher Q wave,the lower R wave,the higher myocardial enzyme peak is, the poorer short term cardiac function is.

Protection of Occupational Exposure for Contract Workers in Supply Center of Military Hospital / 中华医院感染学杂志

OBJECTIVE To probe current status on protection of occupational exposure for contract workers in supply center of military hospital,therefore to put forward rational suggestion and measure.METHODS Current status among contract workers in supply center of military hospital were investigated by questionnaire with conversation.RESULTS The investigation showed that contract workers in supply center of military hospital had poor recognition on protection of occupational exposure,with higher prevalence of occupational exposure(95%),and short of effective protection against occupational exposure,and without correct and efficient measures once occupational exposure occurred.CONCLUSIONS It is essential to enhance education on occupational exposure protection,establish strict,systemic and periodic training,thus to strengthen self-protection on occupational exposure,therefore to reduce the occurrence of inhospital infection.

Different Kinds of Cleaning Methods for Moderately Contaminated Instruments in Hospital Supply Center:Investigation on Results / 中华医院感染学杂志

OBJECTIVE To seek for an effective,rapid,economic,safety and practical cleaning method,so as to ensure the high quality of sterilization in hospital supply center.METHODS Six hundred moderately contaminated recyclable instruments were divided into three groups randomly,conventional group,experimental group A and experimental group B(two hundred sorts each).The instruments in experimental group A were put into warmed water(40 ℃) for ten minutes first,and that in experimental group B were put into multi-enzyme solution for five minutes first,and then all the instruments in three groups were put into automatic sprinkling cleaning machine to accomplish the cleaning process automatically.After cleaning process,cleaning degree of the instruments and remained blood residues were compared in three groups.RESULTS The cleaning quality in the groups A and B was significantly higher than that of the conventional group,both P