Molecular characteristics of the hemagglutinin 1 and neuraminidase genes of influenza B viruses isolated in Yancheng city from 2015 to 2017 / 中华疾病控制杂志

Objective To analyze the genetic characteristics of the hemagglutinin （HA) and neuraminidase （NA) genes of influenza B viruses isolated in Yancheng City from 2015 to 2017. Methods The throat swab specimens of influenza-like illness( ILI) from sentinel surveillance hospital and outbreak sites were collected and sent to Yancheng CDC for virus nucleic acids and virus isolation testing. After validation with serological tests, eighteen strains of influenza B virus isolates were selected to amplify their HA1 and NA genes through RT-PCR assay. Their molecular characteristics of the obtained viral HA1 and NA gene sequences were analyzed using bioinformation software from three aspects, including nucleic acid level, amino acid level and molecular evolution level. Results Basically, the clustering relationships and the branche patterns between HA1 and NA genes from the 18 Yancheng influenza B virus strains were similar. The Yamagata lineage strains in 2015 were distributed in the Yamagata Clade 3 branch, belonging to Phuket/3073 strains. The Victoria lineage strains in 2016-2017 were distributed in the Victoria Clade 1A branch, belonging to Brisbane/60 strains. D196N substitution was detected on HA1 protein in all of Yamagata lineage strains at 190-helix epitope; Amino acid substitutions of victoria lineage strains involved two antigenic epitopes, 117 and 129 sites of 120-loop epitope and 197 and 199 sites of 190-helix epitope. No Intra-lineage or inter-lineage rearrangements occurred in Yancheng strains. Eighteen influenza B strains had no mutations in catalytic residues and drug resistant sites of NA genes. Conclusion The Yamagata strains well matched with vaccine strain B/Phuket/3073/2013. The HA1 and NA genes of victoria lineage strains circulated in Yancheng City during 2016 to 2017 are changing gradually. The accumulation of these mutations will result in antigenic drift of victoria lineage strains and increase the mismatch of the IFV field stains with the available vaccine strains, which may reduce the protective effect of flu vaccine.

Application of hypobaric ropivacaine spinal anesthesia and nerve block anesthesia in hip surgery ofelderly patients / 中国组织工程研究

BACKGROUND: The rational choice of anesthesia for the elderly patients with hip surgery not only ensures the smooth operation, but also significantly reduces the incidence of postoperative complications. OBJECTIVE: To compare the clinical anesthetic effects between combined lumbar plexus-sciatic nerve block and hypobaric ropivacaine spinal anesthesia in hip joint surgery of elderly patients. METHODS: Forty patients who were scheduled for hip joint surgery, at the age of 65-99 years old, American Society of Anesthesiologists grades II-III, were enrolled and randomly allocated to two groups: nerve block (n=20) and spinal anesthesia (n=20). In nerve block group, combined lumber plexus-sciatic nerve block was performed directed by a nerve stimulator under the guidance of ultrasound. In spinal anesthesia group, patients received single-dose hypobaric ropivacaine spinal anesthesia at L3-4interspace. Hemodynamic changes, anesthetic effects and perioperative adverse effects were recorded in both groups before and after anesthesia. RESULTS AND CONCLUSION: (1) The patients' heart rate and mean artery pressure in each group did not change significantly before and after anesthesia in the nerve block and spinal anesthesia groups (P > 0.05). (2) The onset time of anesthesia in spinal anesthesia group was significantly faster than that in nerve block group (P < 0.01). Hypobaric ropivacaine spinal anesthesia had a better analgesic effect during the surgery, which did not need extra intravenous anesthetics. The duration of motor and sense block was significantly longer in nerve block group than in spinal anesthesia group (P < 0.01). However, five patients in spinal anesthesia group needed extra intravenous anesthetics to finish the surgery. (3) No side effects were found in both nerve block and spinal anesthesia groups. (4) These indicated that compared to combined lumbar plexus-sciatic nerve block, hypobaric ropivacaine spinal anesthesia can provide a better analgesic effect during the hip joint surgery with stable hemodynamics. Moreover, hypobaric ropivacaine spinal anesthesia dose not increase the incidence of complications and has very good clinical application prospects.

Management of duodenal trauma / 中华创伤杂志(英文版)

Duodenal trauma is uncommon but nowadays seen more and more frequently due to the increased automobile accidents and violent events. The management of duodenal trauma can be complicated, especially when massive injury to the pancreatic-duodenal-biliary complex occurs simultaneously. Even the patients receive surgeries in time, multiple postoperative complications and high mortality are common. To know and manage duodenal trauma better, we searched the recent related literature in PubMed by the keywords of duodenal trauma, therapy, diagnosis and abdomen. It shows that because the diagnosis and management are complicated and the mortality is high, duodenal trauma should be treated in time and tactfully. And application of new technology can help improve the management. In this review, we discussed the incidence, diagnosis, management, and complications as well as mortality of duodenal trauma.

A meta-analysis of the safety of simultaneous versus staged resection for synchronous liver metastasis from colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety of simultaneous and staged resection for synchronous liver metastasis from colorectal cancer.</p><p><b>METHODS</b>PubMed/Medline, ISI Web of Knowledge, Springer link, ebscohost, Elsevier Wiley Interscience, Google Scholar were searched for case-control studies concerning simultaneous versus staged resection of synchronous liver metastasis from colorectal cancer between January 1989 and March 2009. A meta-analysis was performed to analyze the morbidity and perioperative mortality.</p><p><b>RESULTS</b>Seven case-control studies, with a total of 1390 patients of liver metastasis from colorectal cancer undergone curative hepatic resection, were reviewed. There were 495 simultaneous and 895 staged resections. Perioperative mortality was 1.1% in the staged resection group and 2.4% in the the simultaneous group, the difference was statistically significant[Peto OR 3.39, 95% CI 1.29-8.93, P=0.01]. No significant difference was found in morbidity between two groups[OR(random)0.88, 95% CI 0.51-1.51, P=0.64].</p><p><b>CONCLUSION</b>Selective staged resection is safe for synchronous liver metastasis from colorectal cancer.</p>

Analysis of apoptosis-related gene expression in different serum level of insulin-like growth factor-1 in mice breast cancer tissue / 中华外科杂志

<p><b>OBJECTIVE</b>A stable primary breast cancer model in liver-specific insulin-like growth factor 1 (IGF-1) deficient (LID) mice and control mice was established. To screen apoptosis related genes expression in different serum IGF-1 levels by gene chip and flow cytometry.</p><p><b>METHODS</b>The LID mice and control mice were used. Induction of breast cancer was achieved by using the 7,12-dimethylbenz(a) anthracene. Ginsenoside Rg3 was used to interfering therapy treatment. The incidence of breast cancer in every group was compared, and expression of apoptosis associated genes was detected by gene chip and flow cytometry.</p><p><b>RESULTS</b>The incidence of tumor in none ginsenoside Rg3 injected control mice was 66.7%. The incidence of tumor in ginsenoside Rg3 injected LID mice was 12.0% which was significantly lower than any other group (P < 0.05). The apoptosis percentage in none ginsenoside Rg3 injected control mice was (2.7 +/- 0.7)%. The apoptosis percentage in ginsenoside Rg3 injected LID mice was (14.0 +/- 1.7)%. The results of gene chip indicated that in contrast to LID mice, LTA, LTB, TNF-alpha, TRAIL, TRANCE, BLK, BOK, CASP8, TRAF5, and APAF1 genes were down-regulated, and LTBR, TRAF4 genes were up-regulated in the breast cancer tissues of control mice. Application of ginsenoside Rg3 therapy could change the expression of these genes.</p><p><b>CONCLUSIONS</b>Circulating IGF-1 levels play a role in the onset and development of breast cancer. Degrade serum IGF-1 level is able to promote apoptosis by affecting the expression of a series of apoptosis related genes consequently inhibit the growth of breast cancer. There was a synergistic effect with the application of ginsenoside Rg3.</p>

Portal venous and enteric drainage in simultaneous pancreas kidney transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the initial experience of simultaneous pancreas kidney transplantation (SPK) with portal venous and enteric drainage.</p><p><b>METHODS</b>Between Jane 2001 and Jane 2003, SPK were performed in 5 patients. Systemic venous-enteric drainage (SED) was used in the first 2 patients and portal venous-enteric drainage (PED) in the last 3 cases. All patient were immunosuppressed with quadruple therapy, which included anti-CD25 mAb (Zenapax/Simulect) induction therapy, FK506, mycophenolate mofetil (MMF), and prednisone baseline therapy. The complications were analyzed.</p><p><b>RESULTS</b>Serum glucose and renal function of the 5 cases were normal and no further insulin was needed within 7 days post-operation. No technique complications such as duodenal fistula and thrombosis were observed, One episode of acute rejection of kidney allograft occurred in one patient with SED, and resolved with a bolus corticosteroids. One case with SED and one with PED were died of sepsis and FK506 toxicity 4 weeks after transplantation. The death occurred with functioning pancreas graft. No latter complications were observed in the 3 survived patients with excellent graft functions.</p><p><b>CONCLUSIONS</b>Both methods of SED and PED can be performed successfully and with no latter complications. But with its potential physiologic and immunologic advantages, PED might be a standard procedure for SPK.</p>

Clinical Analysis of 48 Children with Phenylketonuria / 实用儿科临床杂志

20 mg/L again.Children without treatment regulared exam for phe concentration level in blood and test for physical and mental capability development.Results Forty-eight children with PKU were diagnosed in 355 615 newborns who were collected from June 1999 to April 2005.The incidence rate of PKU was 1/7408,carriers with PKU gene was 1/48.There was no significant difference in physical and mental condition compared with that of normal children.Conclusions The treatment results for children with PKU is significant.It has good social and economic value.It is one of the important measures for reducing infant defect and improving population quality.