Muscular tissue desaturation and pneumonia in patients receiving lung cancer surgery: a cohort study / 中华医学杂志(英文版)

BACKGROUND@#Post-operative pneumonia (POP) is a common complication of lung cancer surgery, and muscular tissue oxygenation is a root cause of post-operative complications. However, the association between muscular tissue desaturation and POP in patients receiving lung cancer surgery has not been specifically studied. This study aimed to investigate the potential use of intra-operative muscular tissue desaturation as a predictor of POP in patients undergoing lung cancer surgery.@*METHODS@#This cohort study enrolled patients (≥55 years) who had undergone lobectomy with one-lung ventilation. Muscular tissue oxygen saturation (SmtO 2 ) was monitored in the forearm (over the brachioradialis muscle) and upper thigh (over the quadriceps) using a tissue oximeter. The minimum SmtO 2 was the lowest intra-operative measurement at any time point. Muscular tissue desaturation was defined as a minimum baseline SmtO 2 of <80% for >15 s. The area under or above the threshold was the product of the magnitude and time of desaturation. The primary outcome was the association between intra-operative muscular tissue desaturation and POP within seven post-operative days using multivariable logistic regression. The secondary outcome was the correlation between SmtO 2 in the forearm and that in the thigh.@*RESULTS@#We enrolled 174 patients. The overall incidence of muscular desaturation (defined as SmtO 2 < 80% in the forearm at baseline) was approximately 47.1% (82/174). The patients with muscular desaturation had a higher incidence of pneumonia than those without desaturation (28.0% [23/82] vs. 12.0% [11/92]; P  = 0.008). The multivariable analysis revealed that muscular desaturation was associated with an increased risk of pneumonia (odds ratio: 2.995, 95% confidence interval: 1.080-8.310, P  = 0.035) after adjusting for age, American Society of Anesthesiologists status, Assess Respiratory Risk in Surgical Patients in Catalonia score, smoking, use of peripheral nerve block, propofol, and study center.@*CONCLUSION@#Muscular tissue desaturation, defined as a baseline SmtO 2 < 80% in the forearm, may be associated with an increased risk of POP.@*TRIAL REGISTRATION@#No. ChiCTR-ROC-17012627.

Analysis of blood lipid levels and its influencing factors in male residents around an uranium mine / 中华放射医学与防护杂志

Objective:To analyze the serum lipid levels, and its influencing factors, of male residents around an uranium mine in order to provide a scientific basis for health risk assessment for such residents.Methods:With such a mine as the center, the surveyed subjects were divided into four groups as within 5, 10, 15 and 20 km of this mine, respectively. These male residents living around the mine were randomly selected as subjects. A health questionnaire survey was conducted among the subjects. The indicator such as height, weight and blood pressure were measured by means of the standard method. Peripheral venous blood was extracted from the subjects, and their venous blood glucose and serum lipid were detected. The levels of serum lipid and detectable rates of abnormal serum lipid were analyzed by using univariate analysis, and multivariate logistic regression analysis was used to analyze the influencing factors of dyslipidemia.Results:A total of 867 males at age 40 to 69 was included in the vicinity of the mine. The mean levels ( ± s) of TC, TG, LDL-C, and HDL-C were (5.46±1.11), (1.92±1.64), (3.19±1.02), and (1.39±0.43) mmol/L, respectively. 384 subjects with dyslipidemia were totally detected in the residents, and the detection rate was 44.29% (384/867). Of the residents with dyslipidemia, the majority was abnormal in two lipid related indexes (45.57%, 175/384). Univariate analysis result showed that there was statistically significant difference in TG level in different distance groups ( F=3.34, P<0.05). There were statistically significant differences in the abnormal detection rates of TG and HDL-C in subjects in different distance groups ( χ2=9.52, 10.18, P<0.05). The detection rates of dyslipidemia were significantly different in the groups of BMI, blood pressure and blood glucose ( χ2=45.91, 32.31, 11.42, P<0.05). Multivariate logistic regression analysis showed that excluding marital status and degree of education, the BMI, blood pressure and blood glucose all had an impact on dyslipidemia. The residents with overweight ( OR=2.08, 95% CI: 1.52-2.86) and obeseness ( OR=2.88, 95% CI: 1.58-5.24) had a higher risk for dyslipidemia than those with normal weight. The risks for dyslipidemia in the residents with hypertension ( OR=1.94, 95% CI: 1.45-2.60) and hyperglycemia ( OR= 2.17, 95% CI: 1.27-3.69) were higher than those with normal blood pressure and blood glucose, respectively. Conclusions:The detection rate of dyslipidemia is higher in male residents around the mine. The BMI, alcohol consumption, blood pressure, blood glucose and distance from the mine are influencing dyslipidemia and other relevant indexes. Overweight is an independent risk factor for dyslipidemia and its components. The distances from uranium mine has no significant effect on the dyslipidemia of male residents.

Correlation between pneumoperitoneum pressure, level of blood uric acid and postoperative cognitive function in elderly patients undergoing laparoscopic cholecystectomy / 中国医师进修杂志

Objective:To study the correlation between pneumoperitoneum pressure, level of blood uric acid (UA) and postoperative cognitive function in elderly patients undergoing laparoscopic cholecystectomy (LC).Methods:One hundred and one patients from December 2018 to December 2019 in Wuhu First People′s Hospital of Anhui Province were selected. According to average value of intraoperative pneumoperitoneum pressure, the patients were divided into low pressure group (intraoperative pneumoperitoneum pressure<11.2 mmHg, 1 mmHg = 0.133 kPa; 50 cases) and standard pressure group (intraoperative pneumoperitoneum pressure ≥ 11.2 mmHg, 51 cases). According to preoperative average level of preoperative blood UA, the patients were divided into low-level UA group (UA<324.1 mmol/L, 50 cases) and high-level UA group (UA≥324.1 mmol/L, 51 cases). The cognitive function 24 h after surgery was assessed by mini-mental state examination (MMSE) scale and Loewenstein occupational therapy cognitive assessment (LOTCA) scale. The correlation between pneumoperitoneum pressure, level of blood UA and cognitive function was analyzed by Pearson correlation analysis.Results:There were no statistical differences in recovery time of spontaneous breathing, recovery time and extubation time between standard pressure group and low pressure group ( P>0.05); the recovery time of orientation in low pressure group was significantly shorter than that in standard pressure group: (12.54 ± 2.41) min vs. (14.65 ± 2.88) min, the postoperative MMSE score and LOTCA score were significantly higher than those in standard pressure group: (25.12 ± 2.03) scores vs. (20.84 ± 2.42) scores and (96.24 ± 6.54) scores vs. (85.15 ± 5.12) scores, and there were statistical differences ( P<0.01). The postoperative MMSE score and LOTCA score in high-level UA group were significantly higher than those in low-level UA group: (24.76 ± 2.53) scores vs. (21.12 ± 2.06) scores and (94.86 ± 6.18) scores vs. (86.34 ± 5.27) scores, and there were statistical differences ( P<0.01). The Pearson correlation analysis result showed that pneumoperitoneum pressure was negative correlation with MMSE score and LOTCA score ( r = -0.544 and - 0.615, P<0.01); while UA level was positive correlation with MMSE score and LOTCA score ( r = 0.433 and 0.405, P<0.01). Conclusions:The carbon dioxide pneumoperitoneum pressure and UA level are related to postoperative cognitive function in elderly LC patients. The postoperative cognitive function is relatively better in patients with lower intraoperative pneumoperitoneum pressure and higher preoperative UA level.

Application of bacterial culture, polymerase chain reaction and serum antibody detection in the diagnosis of pertussis in children / 中华实用儿科临床杂志

Objective:To evaluate the auxiliary diagnosis value of bacterial culture, polymerase chain reaction (PCR) and serum anti-pertussis toxin immunoglobulin G (AntiPT-IgG) level detection in suspected pertussis.Methods:A total of 110 suspected cases of pertussis treated in the Department of Pediatrics of Wuhu No.1 People′s Hospital from June 2018 to May 2019 were recruited for the study.The nasopharyngeal swabs of all cases were collected for Bordetella pertussis culture and specific nucleic acid PCR detection.Serum samples of 78 cases were collected for the detection of AntiPT-IgG level by enzyme linked immunosorbent assays.Results:The positive rates of bacterial culture group and PCR group were 21.8% and 30.0%, respectively, with no statistically significant difference ( χ2=1.198, P>0.05). The culture positive rate of cases with the duration of cough<2 weeks was 32.1%, which was signi-ficantly higher than that of cases with the duration of cough about 2-4 weeks (14.3%) or >4 weeks (9.1%) ( χ2=6.522, P<0.05). The PCR positive rate of cases with the duration of cough <2 weeks was 39.6%, which was also significantly higher than that of cases with the duration of cough about 2-4 weeks (25.7%) or > 4 weeks (13.6%) ( χ2=6.126, P<0.05). The mean value for serum AntiPT-IgG level of 78 cases was (75.727±78.454) IU/mL, the median AntiPT-IgG levels of cases with the duration of cough<2 weeks and about 2-4 weeks were 5.909 IU/mL and 20.948 IU/mL, respectively, and the positive rates were 14.7% and 38.1%, respectively.The AntiPT-IgG level of cases with the duration of cough> 4 weeks and that at convalescent stage were (79.281±68.254) IU/mL and (107.242±75.750) IU/mL, and the positive rates were 39.1% and 57.1%, respectively. Conclusions:In the vaccine era, the results of pathogenic and serological tests should be combined to assist the clinical diagnosis of pertussis.The positive rate of bacterial culture and specific nucleic acid pathogen detection in children with cough duration less than 2 weeks is high, and the serological diagnosis is more effective after the duration of cough is over 4 weeks.

Modified Wenjingtang Affects Caspase-8， MMP-9， N-cadherin and E-cadherin in Local Microenvironment of EM Rats with Kidney Deficiency and Blood Stasis / 中国实验方剂学杂志

Objective:To investigate the therapeutic effect and mechanism of modified Wenjingtang on endometriosis （EM） rats with kidney deficiency and blood stasis. Method:Healthy non-pregnant female Sprague-Dawley （SD） rats of SPF grade were randomly divided into the blank group and experimental group. After being modeled via soaking in ice water and subcutaneous injection of epinephrine hydrochloride， the ones in the experimental group were further divided into the sham operation group and EM model group， with the former only undergoing laparotomy and the latter further receiving autologous endometrial transplant for triggering EM. The successfully modeled rats with EM due to kidney deficiency and blood stasis were randomized into the positive drug （danazol， 63 mg·kg^-1） group and low- （5 g·kg^-1）， medium- （10 g·kg^-1）， and high-dose （20 g·kg^-1） modified Wenjingtang groups. The corresponding drugs were administered by gavage， once per day， for four weeks. Then the ectopic and eutopic endometrial tissues were stained with hematoxylin-eosin （HE） to observe the histopathological changes. The protein and mRNA expression levels of cysteinyl aspartate-specific proteinase-8 （Caspase-8）， matrix metalloproteinase-9 （MMP-9）， N-cadherin， and E-cadherin were detected by immunohistochemistry （IHC）， Western blotting， and real-time polymerase chain reaction （Real-time PCR）， respectively. Result:The IHC and Western blot revealed that the protein expression levels of MMP-9 and N-cadherin in eutopic and ectopic endometrial tissues of the model group were significantly increased as compared with those in the sham operation group （<italic>P</italic><0.01）， while the levels of Caspase-8 and E-cadherin was significantly decreased （<italic>P</italic><0.01）. Compared with the model group， the danazol and low-， medium-， and high-dose modified Wenjingtang groups exhibited obviously down-regulated MMP-9 and N-cadherin protein expression in eutopic and ectopic endometrial tissues （<italic>P</italic><0.05，<italic>P</italic><0.01）， but up-regulated Caspase-8 and E-cadherin （<italic>P</italic><0.05， <italic>P</italic><0.01）. Real-time PCR uncovered that the mRNA expression levels of MMP-9 and N-cadherin in eutopic and ectopic endometrial tissues of the model group were significantly elevated as compared with those in the sham operation group （<italic>P</italic><0.01）， whereas the levels of Caspase-8 and E-cadherin significantly declined （<italic>P</italic><0.01）. The comparison with the eutopic endometrial tissue in the model group showed that the mRNA expression levels of MMP-9 and N-cadherin in the danazol group and high- and medium-dose modified Wenjingtang groups were significantly down-regulated， while those of Caspase-8 and E-cadherin were significantly up-regulated （<italic>P</italic><0.05，<italic>P</italic><0.01）. Conclusion:Modified Wenjingtang alleviates the immunosuppression and blocks the angiogenesis in EM rats with kidney deficiency and blood stasis syndrome by regulating the expression of such cytokines as Caspase-8， MMP-9， N-cadherin， and E-cadherin， thus exerting the therapeutic effect against EM. The above-mentioned micro-indicators are potential markers reflecting the disease （EM）， syndrome （kidney deficiency and blood stasis）， and pathological mechanisms （immunosuppression and angiogenesis）.

Effect of Modifide Wenjingtang on JAK2/STAT3 Signal Pathway and Downstream Factors Protein Expression in Endometriosis Rats / 中国实验方剂学杂志

Objective:To investigate the therapeutic effect and mechanism of modified Wenjingtang on endometriosis （EM） rats with kidney deficiency and blood stasis. Method:The 10 from 105 SPF female healthy SD rats were randomly selected as the blank group. The rest constructed the rat model of kidney deficiency and blood stasis by compound factorial method. After the model was successfully established， 10 rats were randomly selected as the sham operation group， with only laparotomy and no intima suture， and the remaining rats were established with EM kidney deficiency and blood stasis type by autologous intimal transplantation. Fifty rats which were randomly selected from 56 successful rats were treated with the modified Wenjingtang （5，10，20 g·kg^-1） and danazol group（63 mg·kg^-1）， 1 time daily ， for 4 weeks. The endometrial tissues of each group were stained with hematoxylin eosin （HE） to observe the histopathology. The levels of inflammatory factors interleukin-10 （IL-10） and interleukin-17 （IL-17） in serum supernatant were detected by enzyme linked immunosorbent assay （ELISA）. Measuring the length（D₁），width （D₂） and height （D₃） of the heterotopic foci in each group before and after treatment. Then calculating the volume of them. The expression of tyrosine kinase 2（JAK2），transcription factor 3 （STAT3），phosphorylation transcription factor 3 （p-STAT3）， vascular endothelial growth factor （VEGF）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>） and thrombospondin-1 （TSP-1） were detected by immunohistochemistry （IHC）. The expression of VEGF，TNF-<italic>α</italic> and TSP-1 was detected by Western blot. Result:Microscopic pathological observation showed that the endometrial glandular cells of the blank group were arranged in order， and the glandular and stromal cells grew well， compared with the blank group， the endometrial structure of the model group was complete， showing a cavity like or annular closed structure， with cyst formation， and the epithelium was cubic or columnar epithelium， most of the epithelial cells had secretion， the stroma was dense， and the matrix showed a little fibrosis There were a few glands and inflammatory cell infiltration. Compared with the blank group， the content of IL-10 in serum of model group was significantly decreased （<italic>P</italic><0.01）， and the content of IL-17 was significantly increased （<italic>P</italic><0.01）， the protein expression of JAK2， STAT3，p-STAT3， VEGF， TNF-<italic>α</italic> in endometrial tissue of model group was significantly increased （<italic>P</italic><0.05）， and the expression of TSP-1 protein was significantly decreased （<italic>P</italic><0.05）. Compared with the model group， the serum IL-10 content of rats in modified Wenjingtang treatment group increased significantly （<italic>P</italic><0.01）， the IL-17 content decreased significantly <italic>（P</italic><0.01）， and the volume of ectopic foci decreased significantly （<italic>P</italic><0.01）. While the level of JAK2，STAT3，p-STAT3，TNF-<italic>α</italic>，VEGF protein in intimal tissue of modified Wenjingtang high and middle dose group decreased significantly （<italic>P</italic><0.05） and the level of TSP-1 protein increased significantly （<italic>P</italic><0.05）. Conclusion:Modified Wenjingtang can inhibit the invasion of ectopic foci in EM rats with kidney deficiency and blood stasis， the mechanism may be related to the intervention of immune barrier and block angiogenesis function mediated by JAK2/STAT3 signaling pathway activation.

Preliminary development and manufacturing of radioactive sewage purification device / 中国职业医学

OBJECTIVE: To develop a radioactive sewage purification device that can effectively filter the nuclides in low-level nuclide-contaminated wastewater. METHODS: The radioactive sewage purification device was composed of lifting pump, stack filter, multi-medium filter, security filter, tubular ultrafiltration membrane, high-pressure pump and reverse osmotic membrane. The combined process of adsorption-ultrafiltration-reverse osmosis was used to separate radioactive elements from wastewater by reverse osmosis membrane separation system. Through two-stage multi-medium filter circulation system circulation treatment, radioactive sewage was purified. The flow rate of water treatment is 20 L/min. The filtration efficiency and purification efficiency of the device were tested by filtration experiments on elements containing radionuclide and purification experiments on radionuclide.RESULTS: The filtration efficiency on iodine, potassium, strontium and cesium, that are the common elements in radioactive sewage samples were 97.88%, 98.38%, 99.99% and 99.80%, respectively. The single purification efficiency of radionuclide ~(40)K in low-level radioactive sewage was over 90.00%. CONCLUSION: The device has high filtering efficiency for common elements such as iodine, potassium, strontium and cesium in sewage and high removal rate of radioactive activity for sewage containing ~(40)K. It can be further optimized and transformed into a suitable radioactive sewage water purifier.

Effect of influencing factors on stability of Guanxinning Injection / 中草药

Objective: To identify the influencing factors (light, temperature, etc) of Guanxinning Injection (GXNI) in the storage and transportation process, and lay the foundation for the storage and transportation of GXNI. Methods: Taking the content of sodium danshensu, protocatechuic aldehyde, ferulic acid, rosmarinic acid, and salvianolic acid B as quantitative indicators, combined with the common peak similarity analysis, principal component analysis, and relative content comparison in the fingerprint to evaluate the effect of different influencing factors on the main chemical composition of GXNI. Results: After low temperature treatment, the content of four compounds, such as senkyunolide I and senkyunolide H, were increased, the content of five compounds, such as vanillic acid and vanillin aldehyde, were reduced, the content of 13 compounds, such as protocatechuic aldehyde and ferulic acid, showed no significant changes. Under the freezing-thawing conditions, the content of four compounds, such as 5-hydroxymethylfurfural, were increased, the content of seven compounds, such as vanillin acid and chlorogenic acid, was reduced, the content of 11 compounds, such as sodium danshensu and ferulic acid, showed no significant changes. Under high temperature, the content of seven compounds, such as sodium danshensu and protocatechuic aldehyde, were increased, the content of 11 compounds, such as ferulic acid and rosmarinic acid, were reduced, the content of four compounds, such as chlorogenic acid and caffeic acid, showed no significant changes. Under strong light conditions, the content of two compounds, such as senkyunolide H, were increased, the content of 16 compounds, such as ferulic acid and salvianolic acid B, were reduced, the content of four compounds, such as sodium danshensu and protocatechuic aldehyde, showed no significant changes. Conclusion: High temperature and strong light will affect the components of GXNI, and some compounds will also be affected under freezing-thawing conditions. Thus, the GXNI should be stored under low temperature, but higher than 0 ℃.

Relationship between modified Frailty Index and development of delirium after artificial joint re-placement in elderly patients / 中华麻醉学杂志

Objective To evaluate the relationship between modified Frailty Index(mFI)and de-velopment of delirium after artificial joint replacement in elderly patients.Methods Elderly patients(aged≥60 yr)who scheduled for elective hip or knee replacement,were enrolled.Preoperative frailty was assessed using the mFI scale.All the patients received surgery under combined spinal-epidural anesthesia.Primary outcome was the incidence of delirium within 5 days after operation,and delirium was assessed by Confusion Assessment Method or Confusion Assessment Method-Intensive Care Unit.The patients were di-vided into delirium group and non-delirium group according to whether delirium occurred or not.Results A total of 620 patients were included in the study,the mFI was 0.09(0.18),and the incidence of delirium within 5 days after surgery was 8.5％.The results of multivariate logistic regression analyses showed that in-crease in age(OR 1.068,95％CI 1.018-1.120,P＝0.007),higher postoperative consumption of mor-phine(OR 1.089,95％CI 1.051-1.128,P＜0.01)and higher mFI(OR 2.465,95％CI 1.636-3.714,P＜0.01)were the independent risk factors for postoperative delirium.Conclusion Higher mFI is the independent risk factor for delirium after artificial joint replacement in elderly patients.

Monitoring and analysis of gross α and gross β levels in drinking water sources in Guangdong province / 中华放射医学与防护杂志

Objective@#To investigate the distribution of gross α and gross β radioactive levels in drinking raw water from different regions of Guangdong province, and to establish the radioactive level base line value in raw water.@*Methods@#The samples from 191 drinking water sources in use in Guangdong province were collected in rainy season and dry season, respectively, and determined and analyzed under the standard examination method for drinking water-radiological parameters (GB/T 5750.13-2006). The levels of gross α and gross β radioactivity were evaluated under the standard for drinking water quality (GB 5749-2006).@*Results@#A total of 377 raw water samples were taken, including 189 samples in rainy season and 188 samples in dry season, in which 186 samples were matched between rainy season and dry season. In dry season, the gross α levels ranged from 0.008 Bq/L to 0.582 Bq/L, averaged at (0.034±0.060) Bq/L, while the gross β levels ranged from 0.014 Bq/L to 0.637 Bq/L, averaged at (0.108±0.091) Bq/L. In rainy season, the gross α levels ranged from 0.008 Bq/L to 0.402 Bq/L, averaged at (0.045±0.064) Bq/L, while the gross β levels ranged from 0.014 Bq/Lto 0.848 Bq/L, averaged at (0.125±0.128) Bq/L. The gross α and gross β radioactivity levels of other samples were much lower than the guidance values in the national radioactivity standards on drinking water radioactivity, except for a sample from Shanwei area. The gross α and gross β radioactivity levels in the rainy season were higher than in the dry water season, and the gross α radioactivity levels in the rainy season were significantly higher than in the dry water season. There were significant differences in gross α and gross β radioactivity levels in rainy(Frainy season=1.819, 2.709, P<0.05) and dry season (Fdry season=1.985, 8.461, P<0.05)in different water systems, and the levels of gross α and gross β radioactivity in the rivers in western Guangdong were the highest. The gross α and gross β radioactivity levels of groundwater in rainy season were higher than in river water and lake water, and the gross α and gross β radioactivity levels in river water were higher than in lake and reservoir water, with the statistically significant differences(Ftotal α=39.323, Ftotal β=25.911, P<0.05), the gross α and gross β radioactivity levels in dry season were higher than in river water and lake water, with the statistically significant difference(Ftotal α=11.520, Ftotal β=28.435, P<0.05). The highest radioactivity levels is in groundwater, followed by river water, and the lowest is in lake and reservoir water.@*Conclusions@#The natural radioactivity background levels in drinking raw water in Guangdong province is lower than the limit value on drinking water stipulated by our country. The radioactivity levels in raw water in western Guangdong is significantly higher than in other water systems, and the radioactivity level in river water is also significantly higher than in lake and reservoir water.

Relationship between modified Frailty Index and development of delirium after artificial joint replacement in elderly patients / 中华麻醉学杂志

Objective@#To evaluate the relationship between modified Frailty Index (mFI) and development of delirium after artificial joint replacement in elderly patients.@*Methods@#Elderly patients (aged ≥60 yr) who scheduled for elective hip or knee replacement, were enrolled.Preoperative frailty was assessed using the mFI scale.All the patients received surgery under combined spinal-epidural anesthesia.Primary outcome was the incidence of delirium within 5 days after operation, and delirium was assessed by Confusion Assessment Method or Confusion Assessment Method-Intensive Care Unit.The patients were divided into delirium group and non-delirium group according to whether delirium occurred or not.@*Results@#A total of 620 patients were included in the study, the mFI was 0.09 (0.18), and the incidence of delirium within 5 days after surgery was 8.5%.The results of multivariate logistic regression analyses showed that increase in age (OR 1.068, 95% CI 1.018-1.120, P=0.007), higher postoperative consumption of morphine (OR 1.089, 95% CI 1.051-1.128, P<0.01) and higher mFI (OR 2.465, 95% CI 1.636-3.714, P<0.01) were the independent risk factors for postoperative delirium.@*Conclusion@#Higher mFI is the independent risk factor for delirium after artificial joint replacement in elderly patients.

Survey of nuclear medicine practice in Guangdong in 2016 / 中华放射医学与防护杂志

Objective To survey the basic situation of diagnosis and treatment in clinical nuclear medicine across Guangdong province,evaluate the risks of exposure to the radiation workers and public and explore the countermeasures to control radiation exposre.Methods A survey team was set up to survey,by filling questionnaires,the basic information on nuclear medicine practices for workers,equipment,radionuclide,frequency and dose to workers and radiation protection measures.Results A total of 71 nuclear medicine institutions was involved in the survey with 733 radiation workers in 2016 in Guangdong.The average annual effective dose to nuclear medicine workers was (0.55±0.66) mSv per year.The total pieces of nuclear medical equipment was up to 189 in 2016 including 59 SPECT/CT scanners (5 SPECT),28 PET/CT scanners and 54 thyroid scanners.Total activity of 1.15× 10s MBq in radiopharmaceuticals was used in 325 903 examinations and treatments with the number of frequency of 2.97 examinations per 1 000 population.Concluions There have been a rapid progress in practice of nuclear medicine over the past 20 years in Guangdong province with departments of nuclear medicine set up in 18 of 21 cities.Compared with 1998,the activity in radiopharmaceuticals used has increased by 414％ in 2016 and the number of frequency of examination and treatment has increased by 111％.The rapid expansion of nuclear medicine practice has also caused potential risks of radiation to the public and environment.

In Silico Molecular Docking Study of Repensine and Bentysrepinine against HBV DNA Polymerase / 中草药·英文版

Bentysrepinine (Y101), a derivative of repensine, is a novel di-peptide structure isolated from Dichondra repens. In vitro and in vivo tests exhibited that bentysrepinine markedly inhibited DNA-HBV and cccDNA activities. The binding mode of Y101 and repensine with DNA polymerase was driven by hydrophobic interactions. This might provide novel recognition of inhibitory effect of Y101 against HBV, though its inhibition mechanism needs to be validated by bio-assay at cellular level and of polymerase activity. Preliminary docking study suggested that Y101 might be able to inhibit HIV inverse transcriptase, also have the potential to interact with DNA polymerase and HCV NS5B polymerase.

Functional analysis of the receptor Dectin-1 on dendritic cells from a patient with recurrent vulvovaginal candidiasis / 中华皮肤科杂志

Objective To compare the Dectin-1 signal transduction pathway and its function on dendritic cells between a female patient with recurrent vulvovaginal candidiasis (RVVC) and a healthy woman,and to explore the possible mechanism for VVC recurrence in this patient.Methods Venous blood samples were collected from a female patient with RVVC and a healthy woman.Then,monocytes were isolated from the blood samples,and were induced to differentiate into dendritic cells (DCs) in vitro.The obtained DCs were divided into three groups to be cultured alone,cocultured with Candida albicans or the combination of Candida albicans and anti-Dectin-1 antibodies for different durations.Flow cytometry was performed to determine the expression levels of CD83,CD86 and CD80 on DCs to evaluate the maturity of DCs,Western blot analysis to measure the protein expressions of Dectin-1,Syk and CARD9 in DCs,and enzyme-linked immunosorbent assay (ELISA) to determine the levels of interleukin (IL)-23,tumor necrosis factor α (TNF-α) and IL-12 in the culture supernatant of DCs.Results After co-culture with Candida albicans for 24 hours,the expressions of CD83,CD86 and CD80 were significantly inhibited on the patient-derived DCs compared with the controlderived DCs.Western blot analysis showed no significant differences in the expression of Dectin-1 between the controland patient-derived DCs,but a decrease in the expressions of phosphorylated-Syk and CARD9 in the patient-derived DCs compared with the control-derived DCs after 2-hour coculture with Candida albicans.After co-culture with Candida albicans for 6 hours,the levels of IL-23,TNF-α and IL-12 were lower in the culture supernatant of patient-derived DCs than in that of control-derived DCs.Furthermore,the anti-Dectin antibody showed no inhibitory effects on the activation of the Syk-dependent signal transduction pathway in or the secretion of the above cytokines by the patient-derived DCs.Conclusion The Dectin-1 signal transduction pathway was abnormal in DCs from the patient with RVVC,which may decelerate the maturation of DCs,inhibit the secretion of IL-23,TNF-o and IL-12 by them,and finally result in a defect in natural mucosal immunity against Candida infection in the host.

Cutaneous and subcutaneous coinfection by Lichtheimia corymbifera and Candida parapsilosis: a case report / 中华皮肤科杂志

To report a case of cutaneous and subcutaneous coinfection caused by Lichtheimia corymbifera and Candida parapsilosis.A 67-year-old female peasant consulted about proliferative granuloma developing on her left forearm after topical application of a Chinese herbal drug and splint fixation for the treatment of suspected fracture of the wrist.Direct microscopic examination showed gram positive budding yeast cells in lesion secretions.Pathological study with periodic acid-Schiff (PAS) and gormori methenamine silver (GMS) staining revealed broad non-separate hyphae in the corneum and dermis.Fungal culture of lesional tissue at 35℃ grew both mould and yeast.The mould was identified as Lichtheimia corymbifera based on morphological findings and sequences of the internal transcribed space (ITS) 1-4 regions.Thermal tolerance study revealed that the isolate grew fast at 37℃ but slowly at 40℃.Under a scanning electron microscope,the acrogenous sporangia were pear-shaped with conical sporangiophores originating from the top of stolon,which were among but not opposite to the rhizoids.The yeast was identified as Candida parapsilosis by Chromagar test and D1/D2 region sequencing.As antimicrobial susceptibility test indicated,the Lichtheimia corymbifera isolate was most sensitive to terbinafine and itraconazole.The proteolytic activity of Lichtheimia corymbifera was higher than that of Candida parapsilosis.The granuloma completely subsided after surgical resection and 6-week treatment with oral itraconazole 200 mg twice a day.No recurrence was observed during a 4-year follow-up.

Absidia corymbifera induces apoptosis of human umbilical vein endothelial cells in vitro / 中华微生物学和免疫学杂志

Objective To analyze the influence of Absidia corymbifera on cell activity of human umbilical vein endothelial cells (HUVEC) as well as the related mechanism. Methods Time course analy sis of the influence of A. corymbifera on cell viability of HUVEC was determined by cell counting after Trypan blue staining. Apoptosis of HUVEC induced by A. corymbifera was observed under fluorescence microscope after treatment with apoptosis detection kit. Time course analysis of HUVEC apoptosis induced by A. corymbifera was detected by flow cytometry quantitatively. Effect of caspase-3 inhibitor on A. corymbifera associated apoptosis was also evaluated at the same time. Activation of caspase-3 inside HUVEC was detected by Western blot. Results A. corymbifera inhibited cell viability of HUVEC in a time-dependent manner by Trypan blue staining. After 12 hours' co-culture, A. corymbifera began to show suppression on cell viability (P =0. 001 ). Fluorescence microscope observation revealed A. corymbifera induced apoptosis of HUVEC instead of necrosis. Flow cytometry analysis showed A. corymbifera induced apoptosis of HUVEC in a time-dependent manner. A. corymbifera began to show obvious effect on apoptosis after 12 h co-culture (P =0.0036). Moreover, A. corymbifera-associated apoptosis was almost abrogated completely by caspase-3 inhibitor. Western blot analysis demonstrated that A. corymbifera triggered the activation of caspase-3 inside HUVEC in a timedependent fashion. Conclusion A. corymbifera induces apoptosis of HUVEC in vitro. Such apoptotic signal is transmitted through caspase cascade reaction.

Effects of Malassezia isolates on cytokines production associated with melanogenesis by keratinocytes / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the co-culture of keratinocytes with Malassezia isolates which cause the pityriasis versicolor with different color and to analyze the changes of cytokines associated with melanogenesis.</p><p><b>METHODS</b>The effects of Malassezia species with different proportions on the growth rate of keratinocytes was assessed with 5 g/L methyl thiazolyl tetrazolium (MTT). Co-culture of keratinocytes and Malassezia species were performed with isolates from hyer- and hypo-pigmentation areas of pityriasis versicolor. The supernatants were collected at different time points, and the changes of basic fibroblast growth factor (b-FGF), endothelin-1 (ET-1), nerve growth factor-beta (NGF-beta), interleukin-1alpha (IL-1alpha), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), stem cell factor (SCF) were recorded. Three control groups were established accordingly.</p><p><b>RESULTS</b>When the ratio between keratinocytes and Malassezia species was lower than 1: 10, the growth rate of keratinocytes was not affected by Malassezia (P > 0.05). When the ratio was increased above 1:20, the growth rate of keratinocytes was significantly inhibited by Malassezia (P < 0.01). The secretions of IL-1alpha, IL-6, TNF-alpha, and ET-1 was significantly increased after the co-culture of keratinocytes and Malassezia (P < 0.01), while those of b-FGF, NGF-beta, and SCF had no significant changes (P > 0.05). Compared with the isolates from the hypo-pigmentation area, ET-1 induced by isolate from hyperpigmentation area significantly increased (P < 0.01).</p><p><b>CONCLUSION</b>When Malassezia isolates are co-cultured with keratinocytes, the secretions of cytokines associated with melanogenesis may differ from each other. ET-1 may play certain role in the hyper-pigmentation of pityriasis versicolor.</p>

Direct Detection of Pathogenic Fungi in Superficial Fungal Infections Based on Polymerase Chain Reaction / 中华皮肤科杂志

Objective To develop a rapid and reliable polymerase chain reaction (PCR) procedure to detect the pathogenic fungi in clinical specimens. Methods Skin, nail and hair samples were taken from patients suspected of being infected with superficial mycosis. Pathogens were detected by PCR based on the ITS1 primer, and the results were compared with those from microscopic examination and culture. Results One hundred and twelve patients were recruited in this study. For PCR, microscopic examination and culture the sensitivities were 80.7%, 96.5% and 70.2%, the specificities were 100%, 89.1% and 100%, the positive predictive values were 100%, 90.2% and 100%, and the negative predictive values were 83.3%, 96.1% and 76.4%, respectively. The PCR process could be completed within 24 h. Conclusions PCR assay has good specificity and accuracy, while fungal culture takes 2 weeks to get the results. PCR is helpful for making rapid clinical diagnosis, which leads to the appropriate treatment of superficial fungal infection.

Genotyping of Clinical Isolates of Malassezia from Patients with Tinea Versicolor by PCR-RFLP / 中华皮肤科杂志

Objectives To develop a rapid genotyping method of clinical isolates of Malassezia from patients with tinea versicolor by PCR-RFLP,and to evaluate reliability of the approach as compared with biochemical classification.Methods Tween assimilation test and catalase reaction were carried out to identify 74 isolates of Malassezia species from patients with tinea versicolor and 7 Malassezia reference strains.The sequence of 28S rDNA of Malassezia species was amplified by PCR,and then the product was analyzed by RFLP with Eco88I,Bsp143Ⅱ and BshNⅠ,respectively.Results M.restricta,M.obtusa and M.pachydermatis were successfully identified by three restriction endonucleases.M.restricta was found to be more diverse from the other 6 species in genetic homology.By comparison with PCR-RFLP technique,a possible mistake was discovered with biochemical method.Conclusion PCR-RFLP is a promising molecular biological technique,which could rapidly and correctly classify Malassezia species.

Experimental Study on the Pathogenicity of Cladosporium carrionii in Mice / 中华皮肤科杂志

Objective To develop a murine model of chromomycosis by using Cladosporium carrioni and explore the pathogenicity of Cladosporium carrio nii in mice. Methods The suspension of Cladosporium carrioni was inoculated to two groups of mice, the immunocompetent mice and the immunosuppressed mice, b y intraperitoneal route using 1 ml inoculum containing 108 conidia/mL. All mice were sacrificed 30 days after inoculation, and then macroscopic examination, his topathology and fungal culture were performed. Results The morbidity in both g roups was 100% according to the dark brown hyphae and sclerotic bodies found in histopathologic examination and fungal culture. Macroscopic examination found th at the adhesion among the internal organs in immunocompetent mice was more sever e than that in immunosuppressed mice. Histopathologic sections showed that necro sis and inflammatory infiltration in immunocompetent mice were more obvious than those in immunosuppressed mice. Conclusions The virulence of Cladosporium car rionii strains is strong enough to construct experimental murine model of chromo mycosis, and animal passage of the strains is unnecessary. This murine model cou ld be used to study the pathogenesis of chromomycosis.