Structural characteristics of lower respiratory tract microflora in patients with pneumoconiosis / 中华劳动卫生职业病杂志

Objective: To explore the composition of bacteria in lower respiratory tract of patients with pneumoconiosis and dust exposure, and to compare and analyze the difference and correlation between them. Methods: From May 2020 to January 2021, a prospective multicenter cross-sectional study was conducted to select patients with pneumoconiosis who underwent bronchoalveolar lavage treatment at the Respiratory and Critical Care Medical Department of the 920th Hospital of the Joint Support Force and the Respiratory Department of Tongren Hospital in Kunming, as well as the population of dust recipients. A total of 24 patients with pneumoconiosis (pneumoconiosis group) were included, and 16 dust exposed individuals (dust exposed group) were used as controls. Two groups of patients' alveolar lavage fluid were collected. The 16SrRNA gene V3-V4 sequencing technology and bioinformatics analysis platform were used to measure and analyze the differences in microbial structure composition and associations between bacterial communities. Results: Compared with the dust exposed group, the top 5 bacterial phyla in the alveolar lavage fluid level of patients with pneumoconiosis were the same, followed by Proteobacteria, Firmicutes, Bacteroidetes, Fusobacteria, and Actinobacteria. Compared with the dust exposure group, the pneumoconiosis group patients belong to the top 5 genera of horizontal flora abundance, which are different. The dust exposure group is respectively: Pseudomonas, Proctor, Streptococcus, Achromobacter, and Neisseria. The pneumoconiosis group is respectively: Pseudomonas, Achromobacter, Streptococcus, Ralstonia, and Proctor. The Alpha diversity analysis results showed that compared with the dust exposed group, the level of bacterial diversity in the pneumoconiosis group was difference (P<0.05), and there was no statistically significant difference in bacterial evenness (P>0.05) ; Beta diversity showed differences in microbial community structure between the two groups (P<0.05 ). Single factor microbial association network analysis showed that there was a high correlation between Firmicutes and Bacteroidetes in the pneumoconiosis and dust exposed groups and other species, showing a positive correlation; The correlation between Proteobacteria and other species is high, showing a negative correlation. Conclusion: The structure and relative abundance of bacteria in lower respiratory tract were different between patients with pneumoconiosis and dust exposure, and the diversity of bacteria in lower respiratory tract increased in patients with pneumoconiosis, which may be related to disease status.

Physical activity among senior primary school students on weekends in Beijing / 中国学校卫生

Objective@#To analyze the duration and influencing factors of moderate and vigorous physical activity(MVPA) on weekends for primary school students in grades 4 to 6 in Beijing, and to provide a reference for formulating health education and promotion measures.@*Methods@#Multi stage stratified cluster sampling method was used to randomly select 2 515 students from grades 4-6 in 14 primary schools in Beijing, and a self administered questionnaire was used to record MVPA on weekend, social demographic characteristics, other related health behaviors and knowledge. Multivariate Logistic regression analysis was used to explore the influencing factors of MVPA on weekends.@*Results@#The prevalence of insufficient MVPA on weekends in Beijing was 63.54 %, and the prevalence was higher among girls (69.92%) than boys (57.81%) ( χ 2=39.65, P <0.01). Multiple Logistic regression analysis revealed that girls ( OR =1.74), living in rural areas ( OR =1.41), participants attending general schools ( OR = 1.34 ), from divorced family ( OR =1.46), and short sleep duration ( OR =1.50) were more likely to fail to meet the MVPA recommendations( P <0.05).@*Conclusion@#It is quite common that no sufficient weekend MVPA among senior primary school students, among them, the outer suburbs and schools with relatively weak teaching resources are the key places that need attention, and girls are the key groups that need attention.

Are There Any Clinical and Radiographic Differences Between Quadriceps-sparing and Mini-medial Parapatellar Approaches in Total Knee Arthroplasty After a Minimum 5 Years of Follow-up? / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Although the early clinical outcomes of total knee arthroplasty (TKA) using minimally invasive surgery techniques have been widely described, data on the mid- to long-term outcomes are limited. We designed a retrospective study to compare the two most common TKA techniques - The modified quadriceps-sparing (m-QS) approach and the mini-medial parapatellar (MMP) approach - In terms of the clinical and radiographic parameters, over a minimum follow-up period of 5 years.</p><p><b>METHODS</b>The m-QS approach was used in 31 knees and the MMP approach, in 36 knees. Knees in both groups were compared for component position and alignment, knee alignment, length of the skin incision, range of motion, Visual Analog Scale score, muscle torques, Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis Index, and number of complications.</p><p><b>RESULTS</b>There were no major intergroup differences in any of the clinical and radiographic outcomes assessed at the final follow-up examination.</p><p><b>CONCLUSIONS</b>On the basis of numbers studied, the m-QS group, which requires more technique, showed equivalent results with the MMP group in the postoperative 5 years. Preservation of the extensor mechanism in the m-QS approach could not ensure any improvement in the clinical outcomes during the mid-term follow-up duration.</p>

Serum-free media for articular chondrocytes in vitro expansion / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In vitro chondrocyte expansion is a major challenge in cell-based therapy for human articular cartilage repair. Classical culture conditions usually use animal serum as a medium supplement, which raises a number of undesirable questions. In the present study, two kinds of defined, serum-free media were developed to expand chondrocytes in monolayer culture for the purpose of cartilage tissue engineering.</p><p><b>METHODS</b>Bovine chondrocytes were expanded in serum-free media supplemented with fibroblast growth factor-2 and platelet-derived growth factor or fibroblast growth factor-2 and insulin-like growth factor. Expansion culture in a conventional 10% fetal bovine serum (FBS) medium served as control. Fibronectin coating was used to help cell adhesion in serum-free medium. Next, in vitro three-dimensional pellet culture was used to evaluate the chondrocyte capacity. Cell pellets were expanded in different media to re-express the differentiated phenotype (re-differentiation) and to form cartilaginous tissue. The pellets were assessed by glycosaminoglycans contents, collagen II, collagen I and collagen X immunohistological staining.</p><p><b>RESULTS</b>Chondrocytes cultured in serum-free media showed no proliferation difference than cells grown with 10% FBS medium. In addition, chondrocytes expanded in both serum-free media expressed more differentiated phenotypes at the end of monolayer culture, as indicated by higher gene expression ratios of collagen type II to collagen type I. Pellets derived from chondrocytes cultured in both serum-free media displayed comparable chondrogenic capacities to pellets from cells expanded in 10% FBS medium.</p><p><b>CONCLUSION</b>These findings provide alternative culture approaches for chondrocytes in vitro expansion, which may benefit the clinical use of autologous chondrocytes implantation.</p>

Anatomical study of the anterolateral and posteromedial bundles of the posterior cruciate ligament for double-bundle reconstruction using the quadruple bone-tunnel technique / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Several techniques have been described for posterior cruciate ligament (PCL) reconstruction. However, double-bundle PCL reconstruction using the quadruple bone-tunnel technique has been seldom reported. The current study investigated this technique, focusing on the anatomy of the femoral and tibial insertions of the anterolateral (AL) and posteromedial (PM) bundles of the PCL.</p><p><b>METHODS</b>Twenty-two fresh, healthy adult cadaveric knees were dissected and measured. The PCL was divided into the AL bundle and PM bundle at the insertion footprint. The insertion footprints of the AL and PM bundles, their location, size, and the clock positions were measured and described.</p><p><b>RESULTS</b>On the femur, the clock position of the footprint of the AL bundle was 11:21 ± 0:23 (left) or 0:39 ± 0:23 (right), and the PM bundle was 9:50 ± 0:18 (left) or 2:10 ± 0:18 (right), with the knee flexed at 90 degrees. The distances from the center of the femoral insertions of the AL and PM bundles to the anterior cartilage margins of the medial femoral condyle were (7.79 ± 1.22) mm and (8.36 ± 1.63) mm, respectively. On the tibia, the vertical distances from the center of the tibial insertions of the AL and PM bundles to the tibial articular surface were (3.25 ± 1.20) mm and (6.91 ± 1.57) mm, respectively.</p><p><b>CONCLUSIONS</b>These results have led to a better definition of the anatomy of the AL and PM bundle footprint of the PCL. The technique of double-bundle PCL reconstruction using quadruple bone-tunnel is feasible. Application of these data during PCL reconstruction using the quadruple bone-tunnel technique may help optimize knee stability.</p>

Proliferation and apoptosis property of mesenchymal stem cells derived from peripheral blood under the culture conditions of hypoxia and serum deprivation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The proliferation and apoptosis property of mesenchymal stem cells derived from peripheral blood (PB-MSCs) were investigated under hypoxia and serum deprivation conditions in vitro so as to evaluate the feasibility for autologous PB-MSCs applications in cartilage repair.</p><p><b>METHODS</b>MSCs were mobilized into peripheral blood by granulocyte colony stimulating factor (G-CSF) and AMD3100. The blood samples were collected from central ear artery of rabbits. Adhered cells were obtained by erythrocyte lysis buffer and identified as MSCs by adherence to plastic, spindle shaped morphology, specific surface markers, differentiation abilities into osteoblasts, adipocytes and chondroblasts in vitro under appropriate conditions. MSCs were cultured in four groups at different oxygen tension (20% O2 and 2% O2), with or without 10% fetal bovine serum (FBS) conditions: 20% O2 and 10% FBS complete medium (normal medium, N), 20% O2 and serum deprivation medium (D), 2% O2 and 10% FBS complete medium (hypoxia, H), 2% O2 and serum deprivation (HD). Cell proliferation was determined by CCK-8 assay. Apoptosis was detected by Annexin V/PI and terminal deoxynucleotide transferase dUTP nick end labeling (TUNEL) staining.</p><p><b>RESULTS</b>Spindle-shaped adherent cells were effectively mobilized from peripheral blood by a combined administration of G-CSF plus AMD3100. These cells showed typical fibroblast-like phenotype similar to MSCs from bone marrow (BM-MSCs), and expressed a high level of typical MSCs markers CD29 and CD44, but lacked in the expression of hematopoietic markers CD45 and major histocompatibility complex Class II (MHC II). They could also differentiate into osteoblasts, adipocytes and chondroblasts in vitro under appropriate conditions. No significant morphological differences were found among the four groups. It was found that hypoxia could enhance proliferation of PB-MSCs regardless of serum concentration, but serum deprivation inhibited proliferation at the later stage of culture. Apart from that, hypoxia or serum deprivation could promote the apoptosis of PB-MSCs after 48 hours; the effect was stronger when these two conditions combined together. Furthermore, the effect of serum deprivation on apoptosis was stronger compared with that of hypoxia.</p><p><b>CONCLUSIONS</b>PB-MSCs possess similar phenotypes as BM-MSCs. Their differentiation and proliferation abilities make them a new source of seed cells for ischemia-related cell therapy and tissue engineering in the field of the articular cartilage repair.</p>

An anatomical and histological study of human meniscal horn bony insertions and peri-meniscal attachments as a basis for meniscal transplantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Allograft meniscal transplantation is an increasingly popular treatment option for the symptomatic young patients with meniscus deficiency. However, many questions still surround it. In this research, we studied the anatomical location and histological structure of human meniscal horn bony insertions and to observe the anatomical morphology and histomorphology of peri-meniscal attachments based on meniscal allograft transplantation.</p><p><b>METHODS</b>Twenty-two fresh-frozen adult cadaver knees were dissected. The locations of meniscal anterior and posterior horn bony insertions to tibia were measured. The anatomical morphology of peri-meniscal attachments was observed and the histological structure of meniscal horn bony insertions and peri-meniscal attachment were studied by HE staining.</p><p><b>RESULTS</b>The anterior horn bony insertion of medial meniscus was (9.19 +/- 1.83) mm inferior to the corresponding anterior border of tibial plateau, and (7.81 +/- 2.25) mm lateral to the axial line of the medial intercondylar eminence. The posterior horn bony insertion of medial meniscus was in the posterior intercondylar fossa of tibia, located between the anterior fibers of the posterior cruciate ligament (PCL) tibial insertion and anterior border of the tibial posterior intercondylar fossa, and was (5.05 +/- 1.18) mm lateral to the axial line of the medial intercondylar eminence. The distance between anterior and posterior horn bony insertions of the lateral meniscus was (13.68 +/- 2.19) mm. Anterior horn bony insertion of the lateral meniscus was (3.99 +/- 1.27) mm medial to the axial line of the lateral intercondylar eminence, and the posterior horn bony insertion of the lateral meniscus was (5.80 +/- 1.36) mm medial to the axial line of the lateral intercondylar eminence. Except for the meniscal horn bony insertions, which is the typical enthesis, we call the attachment of the other parts of menisci as 'peri-meniscal attachment'. The morphological and histological study showed that the main peri-meniscal attachment was the meniscotibial ligament, through which the meniscus attached to the tibia with enthesis structure, and there was only loose connective tissue between menisci and capsule.</p><p><b>CONCLUSIONS</b>In meniscal allograft transplantation, the traditional meniscal size-matching method which take medial and lateral intercondylar eminences as references is not as accurate as expected. Attention should be taken to locate both anterior and posterior horn tunnels of medial meniscal allograft inferior to the tibia plateau, and to locate anterior and posterior horn tunnels of lateral meniscus close enough (mean 13.68 mm). The best way to reconstruct the peri-meniscal attachment is to suture the allograft to the preserved outer remnant of the original meniscus.</p>

Application of comfort care for dental out-patients / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To explore and apply the nursing methods of comfort care for dental out-patients.</p><p><b>METHODS</b>Control group included 103 dental out-patients who were first treated in General Dentistry Department of West China Hospital of Stomatology from June to August 2008. Experimental group included 105 dental out-patients who were first treated in the same hospital from September to November 2008. Conventional nursing methods were used for control group, and comfort care nursing methods were used for experimental group. The patients' degree of satisfaction with nursing and oral health knowledge rate after first treatment and nursing were investigated.</p><p><b>RESULTS</b>The patients' degree of satisfaction with nursing of the control and experimental groups were 72.816% and 98.095%, and the patients' oral health knowledge rate of the two groups were 57.282% and 93.333%. Both of the investigating results had obvious difference.</p><p><b>CONCLUSION</b>Comfort care for dental out-patients can improve patients' degree of satisfaction with nursing and increase patients' oral health knowledge rate. Simultaneously, comfort care can improve the specialized quality of dental nurses and would advantage to build a harmonious relationship between nurses and patients.</p>

Clinical effects of Fu Fang Ya Tong Ding on gingivitis and pericoronitis / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effects of Fu Fang Ya Tong Ding on treatment of gingivitis and pericoronitis.</p><p><b>METHODS</b>120 clinical patients with gingivitis or pericoronitis were randomly divided into 3 groups (40 patients in each group). After routine rinse treatment for all patients, patients in the test group were treated with Fu Fang Ya Tong Ding, patients in the positive group were treated with iodine glycerol, while that time patients in the negative group received no treatment anymore. Ten minutes after treatment, visual analogue scale (VAS) was used to record the severity of pain for each patient. 3 days and 7 days later, pain and inflammation degree were also recorded by pain three-degree scoring method and index of gingivitis. The total treatment effects were evaluated under a comprehensive clinical treatment standard.</p><p><b>RESULTS</b>10 minutes after treatment, 40.0% of patients in the test group had almost no pain, while no obvious reduction of pain was found in the control group. 3 days, 7 days after the treatment, 92.5%, 95.0% of patients in the test group had no pain, and 55.0%, 90.0% of patients in the positive group had no pain. In the negative group, there were 47.5% of patients which pain was still remained in 7 days. 7 days after treatment, gingival index in the test group reduced by 25.0% and 42.8% compared with the positive and negative groups (P<0.05). 3 days after treatment, 62.5%, 45.0% and 30.0% patients separately in the test, positive and negative groups manifested good effects under the comprehensive clinical treatment standard; after 7 days, 97.5%, 92.5% and 77.5% patients in the 3 groups manifested good effect. The group using Fu Fang Ya Tong Ding had better effects than groups using iodine glycerol or only applying routine rinsing treatment group (P<0.05).</p><p><b>CONCLUSION</b>Fu Fang Ya Tong Ding can treat gingivitis and pericoronitis through significantly reducing inflammation and pain.</p>

Construction of recombinant adenovirus co-expression vector carrying the human transforming growth factor-beta1 and vascular endothelial growth factor genes and its effect on anterior cruciate ligament fibroblasts / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Remodeling of the anterior cruciate ligament (ACL) graft usually takes longer than expected. Gene therapy offers a radical different approach to remodeling of the graft. In this study, the internal ribosome entry site (IRES) sequence was used to construct a new recombinant adenovirus which permits co-expression of transforming growth factor-beta1 (TGFbeta1) and vascular endothelial growth factor 165 (VEGF165) genes (named Ad-VEGF165-IRES-TGFbeta1). We investigated the effects of the new adenovirus on the migration of and matrix synthesis by ACL fibroblasts.</p><p><b>METHODS</b>Adenoviral vector containing TGFbeta1 and VEGF165 genes was constructed. ACL fibroblasts were obtained from New Zealand white rabbits. After ACL fibroblasts were exposed to Ad-VEGF165-IRES-TGFbeta1, the expression of VEGF165 and TGFbeta1 proteins were assessed by enzyme-linked immunosorbent assay (ELISA) and Western blotting analysis. Bioassay of VEGF165 and TGFbeta1 proteins were assessed by Western blotting analysis. Proliferation and migration of ACL fibroblasts were assessed by in vitro wound closure assay. Gene expression of collagen type I, collagen type III, and fibronectin mRNA among matrix markers were assessed by real-time PCR.</p><p><b>RESULTS</b>The results showed the successful construction of a recombinant co-expression adenovirus vector containing TGFbeta1 and VEGF165 genes. Co-expression of TGFbeta1 and VEGF165 can induce relatively rapid and continuous proliferation of ACL fibroblasts and high gene expression of collagen type I, collagen type III, and fibronectin mRNA among matrix markers.</p><p><b>CONCLUSION</b>Co-expression of TGFbeta1 and VEGF165 genes has more powerful and efficient effects on the migration of and matrix synthesis by ACL fibroblasts.</p>

Relationship between different skin incisions and the injury of the infrapatellar branch of the saphenous nerve during anterior cruciate ligament reconstruction / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>After anterior cruciate ligament (ACL) reconstruction, some patients suffered from sensory disturbance around the surgical incision of the leg. This research was aimed to investigate the relationship between the different skin incisions and the injury of the infrapatellar branch of the saphenous nerve (IPBSN) post ACL reconstruction.</p><p><b>METHODS</b>ACL reconstructions were performed with quadruple hamstring tendon for 60 patients. Sensory disturbance around the skin incision was followed up at an average of 14.5 +/- 4.7 months post operation. Among the 60 patients, vertical incision for 35 patients and oblique incision for 25 patients were used for graft taking during ACL reconstruction. The lengths of the incisions were measured. The patients were asked to mark the sensory disturbance zone at follow up time, and then the marked area was measured. The IPBSN of 15 cadaver knees were anatomized. The distance between the IPBSN and the upper edge of the pes anserinus tendon at the middle point of the incision was measured. Independent-samples t-test, chi-square and Mann-Whitney tests were used for statistical analyses.</p><p><b>RESULTS</b>The patients' age (P = 0.329), the follow-up time (P = 0.681), and the incision length (P = 0.732) between the two groups had no significant difference. Twenty-three patients (65.7%) in the vertical incision group had IPBSN injury compared with 6 patients (24.0%) in oblique incision group (P = 0.002). The average sensory disturbance area in vertical incision group ((48.0 +/- 75.3) cm(2)) was significantly larger (P = 0.004) than that in the oblique group ((8.4 +/- 19.4) cm(2)). The anatomy measurement showed the average distance between IPBSN and the upper edge of the pes anserinus tendon was 0.6 cm at the incision.</p><p><b>CONCLUSIONS</b>Oblique incision with less risk of damage for IPBSN may be better for graft harvesting in ACL reconstruction. As the IPBSN is so near and parallel to the hamstring tendons, damage to the IPBSN is one of the potential complications for graft harvesting, regardless of the incision used. That's why even in the oblique incision group, 24% patients also had sensory disturbance complication.</p>

Biomechanical study of four-bundle semitendinosus tendon autograft used for anterior cruciate ligament reconstruction in rabbits model / 中华外科杂志

<p><b>OBJECTIVE</b>To observe the biomechanical change of the remodeling process of a four bundles model using semitendinosus tendon for the reconstruction of anterior cruciate ligament (ACL) in rabbits, and to explore the possibility of using braiding technique for improving the outcome for reconstruction of ACL.</p><p><b>METHODS</b>Two techniques were employed for the ACL reconstruction, one group with the implant of parallel bundles and the other with the braided bundles. Specimen were collected at 26 and 52 weeks after surgery respectively for biomechanical test. Gross morphology was also observed.</p><p><b>RESULTS</b>The group with the implant of the braided bundles showed a more fused rate. The biomechanical test showed that the strength of the reconstructed ACL with the unbraided bundles was 35.87% of the controlled normal ACL, while the braided bundles reached 67.20%. The strength of the graft of the 26 and 52 weeks with the braided bundles were significantly higher than that of the unbraided group, while the stiffness of the 52 weeks graft of the braided group was significantly higher than that of the unbraided group also.</p><p><b>CONCLUSIONS</b>Braiding each bundle to become a single implant for reconstruction of ACL might have better outcome since it will decrease the movement between each bundles and improve the biomechanical properties.</p>