Tripterine promotes pyroptosis of liver cancer cells by regulating ATF4/caspase-3/GSDME signaling pathway / 中国药理学通报

Aim To explore the new mechanism of triptolide (TRI) inhibiting the progression of hepatocellular carcinoma (HCC) . Methods Different concentrations (0, 0 . 5, 2, and 8 jjunol • L~) of TRI were administered to act on liver cancer cells, and then the cell phenotypes and possible mechanisms were explored using experimental methods such as CCK-8, cell cloning, Transwell, and protein immunoblotting; siRNA was used to interfere with the target gene GSDME and its role was determined. Finally, the mechanism of TRI inhibiting the growth of HCC cells in vivo was validated using a transplanted tumor model. Results TRI could inhibit the proliferation, cloning, and invasion of HCC cells, and promote cell apoptosis. Immunoblotting results showed that the expression of GSDME was significantly upregulated in HepG2 or He-pal-6 hepatocellular carcinoma after TRI treatment, while the expression of cleaved caspase-3 and PARP also significantly increased. Knocking out GSDME could partially reverse TRI-induced cell apoptosis. At the same time, cells knocked down by GSDME had stronger cloning and migration abilities, and the apoptosis rate was reduced compared to the TRI treatment group alone. In vivo experiments showed that TRI inhibited HCC tumor growth, and the TRI + siGSDME group had a faster tumor growth rate than the TRI treatment group alone did. In addition, after TRI stimulation, p-eIF2a and ATF4 in HepG2 and Hepal-6 cells significantly increased. The immunofluorescence results showed a dose-dependent increase in the number of ATF4 positive cells in HepG2 and Hepal-6 cells after TRI stimulation. Conclusion The inhibitory effect of TRI on the growth and invasion of liver cancer cells may be related to its regulation of the ATF4/caspase-3/GSDME signaling pathway and promotion of liver cancer cell apoptosis.

Research progress in ferroptosis pathways and ubiquitination modification of ferroptosis-related molecules / 中国药理学通报

Ferroptosis is an iron-dependent cell death caused by phospholipid peroxidation damage of polyunsaturated fatty acids on cell membranes and involves several pathways, including the iron homeostasis regulatory pathway, the cystine glutamate reverse transporter (system Xc) pathway and the voltage-dependent anion channel (VDAC) pathway. Ferroptosis is involved in the development of several diseases (e. g. myocardial infarction, stroke, cancer and degenerative diseases). The ubiquitination is an important post-translational modification of various protein molecules in the organism. Studies have shown that regulating the ubiquitination of ferroptosis pathway-related molecules can control cellular ferroptosis. Targeting the ubiquitination of ferroptosis pathway-related molecules can effectively promote or inhibit ferroptosis, which is expected to be a new strategy for the treatment of cancer or cardiovascular diseases. In this paper we review the progress of the ferroptosis pathways and the ubiquitination modification of ferroptosis-related molecules.

Realationship between personality impulsivity and aggressivity in adolescents： the effecting path of sibling relationships / 四川精神卫生

BackgroundIn China， the structure shift from just one-child family to both one-child and more-than-one-child families is happening. Exploring how the sibling relationships effect between adolescent personality impulsivity and aggressivity is of great significance for promoting adolescent mental health as well as maintaining social harmony and stability. ObjectiveTo investigate the effecting path of sibling relationships between personality impulsivity and aggressivity in adolescents， so as to provide references for the prevention of violent and aggressive behavior in adolescents. MethodsFrom February to April， 2023， a total of 1 200 students with sibling relationships from 12 primary and secondary schools in a county of Sichuan province were included by random sampling. Barratt Impulsivity Scale （BIS-11）， Chinese Version of Buss & Perry Aggression Questionnaire （AQ-CV）， and Sibling Relationship Questionnaire （SRQ） were used for cross-sectional investigation. Pearson Correlation Analysis was used to analyze the correlation between the scores of these scales. Bootstrap method was used to test the effecting path of sibling relationships between personality impulsivity and aggressivity. ResultsThe total score of BIS-11 was positively correlated with that of AQ-CV as well as the scores of conflict and competition dimensions in SRQ （r=0.485、0.276、0.280，P<0.01）， while negatively correlated with the score of warmth/intimacy dimension in SRQ （r=-0.383， P<0.01）. The total score of AQ-CV was positively correlated with the scores of conflict and competition dimensions in SRQ （r=0.387， 0.340， P<0.01）， while negatively correlated with the score of warmth/intimacy dimension in SRQ （r=-0.304， P<0.01）. Within SRQ， negative correlations could be observed between the score of warmth/intimacy and scores of conflict and competition （r=-0.307， -0.375， P<0.01）， whereas positive correlation could be observed between the score of conflict and that of competition （r=0.267， P<0.01）. The total effect of personality impulsivity level on aggressivity level in adolescent was 0.480 （P<0.01）. Sibling relationships played a mediating role between personality impulsivity and aggressivity in adolescents. Meanwhile， the indirect effect values of warmth/intimacy， conflict and competition were 0.054， 0.075 and 0.062， with the effect values accounting for 11.21%， 15.70% and 12.93%， respectively. ConclusionThe personality impulsivity of adolescents can directly affect their aggressivity， and sibling relationships may act as an important channel connecting personality impulsivity and aggressivity. ［Funded by 2023 Project of the Psychology and Behavioral Science Research Center of the Deyang Federation of Social Sciences （number， XLYXW2023305）］

Effects of Bisphenol A and Its Substitute, Bisphenol F, on the Gut Microbiota in Mice / 生物医学与环境科学（英文）

OBJECTIVE@#The aim of this study was to assess the impact of bisphenol A (BPA) and its substitute, bisphenol F (BPF), on the colonic fecal community structure and function of mice.@*METHODS@#We exposed 6-8-week-old male C57BL/6 mice to 5 mg/(kg∙day) and 50 μg/(kg∙day) of BPA or BPF for 14 days. Fecal samples from the colon were analyzed using 16S rRNA sequencing.@*RESULTS@#Gut microbiome community richness and diversity, species composition, and function were significantly altered in mice exposed to BPA or BPF. This change was characterized by elevated levels of Ruminococcaceae UCG-010 and Oscillibacter and decreased levels of Prevotella 9 and Streptococcus. Additionally, pathways related to carbohydrate and amino acid metabolism showed substantial enrichment.@*CONCLUSION@#Mice exposed to different BP analogs exhibited distinct gut bacterial community richness, composition, and related metabolic pathways. Considering the essential role of gut bacteria in maintaining intestinal homeostasis, our study highlights the intestinal toxicity of BPs in vertebrates.

Correlation between progesterone receptor G1978T polymorphism and endometrial cancer / 中国临床药理学与治疗学

To explore the relationship between progesterone receptor (PGR) gene G1978T polymorphism and endometrial carcinoma. METHODS: After searching PubMed, EMBASE, Wan-fang and CNKI databases for literatures on PGR G1978T genotyping of endometrial cancer patients, the data were extracted and odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using STATA15. The whole blood samples of endometrial carcinoma cases (EC group) and normal women (control group) were collected. Allelic-specific primers matching G1978T wild type G allele and mutant type T allele were designed with 3' terminal phosphorothioate modification, and the two-directional primer extension was performed using Exo + polymerase to genotype PGR gene G1978T polymorphism and Sanger sequencing was used to verify the genotype. RESULTS: PGR gene G1978T mutation was marginally associated with endometrial carcinoma risk (ORper allele =1.10, 95%CI=0.98-1.24, P= 0.072). At the same time, only 1 normal blood samples were found with PGR gene G1978T mutation, and the differences in genotypes and allele frequency between the case group and the control group were not statistically significantP>0.05. CONCLUSION: The G1978T polymorphism of the PGR gene maybe not be associated with the risk of endometrial carcinoma.

The application of transcervical non-inflatable endoscopic posterior inferior sternocleidomastoid approach in thyroid surgery / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the clinical efficacy and safety of transcervical non-inflatable endoscopic thyroidectomy through the posterior inferior sternocleidomastoid approach. Methods:From December 2022 to May 2023, the clinical data of 35 patients with papillary thyroid carcinoma treated by transcervical non-inflatable endoscopic surgery via posterior inferior sternocleidomastoid approach were retrospectively analyzed. There were 14 males and 21 females, with an average age of 44.7 years. The operation time, bleeding volume, postoperative recovery, complications and follow-up were recorded. Results:All 35 patients successfully completed the surgery, with an average operation time of 4 hours and 7 minutes, an average bleeding volume of 14 ml, and an average postoperative hospital stay of 3.5 days. There were no serious complications and no obvious neck discomfort during postoperative follow-up. Conclusion:Transcervical non-inflatable endoscopic thyroidectomy via posterior inferior sternocleidomastoid approach is safe and effective, with fast postoperative recovery,high appearance satisfaction and good neck comfort.

Multi-factor analysis of sellar floor dural suture, bone reconstruction and pedicled nasoseptal flap in skull base reconstruction / 西安交通大学学报(医学版)

【Objective】 To evaluate the efficacy and weight of sellar floor repair techniques such as different dura suture, bone reconstruction, and pedicled nasoseptal flap (PNSF) on the skull base reconstruction of medium and high flow cerebrospinal fluid leakage during endonasal endoscopic pituitary adenoma surgery. 【Methods】 We collected the data of Grade 2-3 cerebrospinal fluid leakage (Kelly grade) during endonasal endoscopic pituitary adenoma resection in our hospital from January 2015 to April 2021. Multiple reconstruction techniques such as dura suture, bone reconstruction and PNSF, and related factors such as age, sex, body mass index (BMI), diabetes, tumor size and diameter of diaphragmatic defect were recorded and introduced to multivariate regression to analyze the effects of the above factors on the duration of postoperative cerebrospinal fluid rhinorrhea and bed rest time, with a special focus on the weight priority of dura suture, bone reconstruction, and PNSF. 【Results】 A total of 281 patients were included, with the average age of (47±12.6) years, males accounting for 52.6%. There were 93 cases of PNSF, 268 cases of bone reconstruction, 109 cases of dura anchor suture, 50 cases of patch suture, and 122 cases without suture. The results of multivariate analysis indicated that the application of PNSF, bone reconstruction, and dura suture significantly reduced postoperative rhinorrhea time [reduced by 18.524, 35.876, and 16.983/19.791 (anchor suture/patch suture) hours, respectively; all PPNSF>bone reconstruction [Standard β=0.211/0.207 (anchor suture/patch suture)>0.200>0.165]. The weight of reducing bed time was bone reconstruction >dura suture > PNSF [Standard β=0.239>0.206/0.210 (anchor suture/patch suture) >0.164]. After stabilizing the learning curve in 25-30 cases, the average time for bone reconstruction was (3.9±0.4) minutes. After stabilizing learning curve in 30-40 cases, the dura suture technique took an average of (3.7±0.3) minutes per stitch, (3.7±1.0) stitches per case, and (13.6±2.7) minutes of total time consumption per case. 【Conclusion】 Dural anchoring and patching suture can both effectively shorten the duration of cerebrospinal fluid rhinorrhea and bed rest time. Bone reconstruction significantly improves the stability of reconstruction, especially in prompting patients’ early disengagement of bed rest. Moreover, the learning curves of the above two methods are economical and reasonable, and their weight is close to or even exceeds that of PNSF. Therefore, they can be an effective supplement or even substitute for PNSF.

Establishment of the data capture and management platform for case-control study on precocious puberty based on REDCap system / 西安交通大学学报(医学版)

【Objective】 To conduct a case-control study on precocious puberty as an example to introduce the establishment and design of the electronic Data capture and management platform using Research Electronic data Capture (REDCap) system and support the development of clinical research. 【Methods】 Based on the clinical REDCap system, the case-control research project of precocious puberty was created, the case report forms were designed, the user rights were set, and the data quality control rules were formulated. 【Results】 We established the electronic data capture and management platform for our research, which had 15 case report forms, to collect the data of the participants, including sociodemographic information, time for rest and activities, diet, exposure to environmental internal-secretion interfering-substances, physical examination and biochemical indicators. We conducted project management by setting up features such as user permissions and workgroups, and added data quality verification rules to control data quality. The data could be exported in various file formats for analysis and sharing. 【Conclusion】 The application of REDCap to establish the data capture and management platform of precocious puberty case-control study has promoted the efficient implementation of clinical research, which can be further popularized and applied to clinical researches in other fields.

Prevalence and influencing factors of thyroid nodules in children aged 8-10 years old in Suzhou / 公共卫生与预防医学

Objective To investigate the prevalence and influencing factors of thyroid nodules in children aged 8-10 years in Suzhou , and to provide a scientific basis for the rational prevention and treatment of iodine deficiency disorders (IDD). Methods PPS sampling method was used in this study. Questionnaire survey, physical examination and thyroid B-ultrasound examination were conducted on students aged 8-10 years. Salt samples and urine samples were collected for laboratory detection of the salt iodine and urinary iodine. Univariate and multivariate logistic regression models were used to analyze the risk factors related to thyroid nodules. Results A total of 2 048 children aged 8-10 years were included in the present survey, and the prevalence of thyroid nodules was 23.34% (478/2 048). The prevalence of nodules in boys was 20.98% (218/1 039), and the prevalence of nodules in girls was 25.77% (260/1 009). Multivariate analysis showed that gender (OR=1.338, P=0.006), height (OR=1.993, P=0.001), frequency of iodine-rich food intake (OR=0.862, P=0.048) and nutritional supplements (OR=1.469, P=0.008) were correlated with the prevalence of thyroid nodules. Conclusion The prevalence rate of thyroid nodules in children aged 8-10 years old in Suzhou is 23.34%. Female gender, higher height, regular intake of iodine-rich foods and dietary supplements are statistically associated with the prevalence of thyroid nodules, which may be risk factors for the prevalence of thyroid nodules , but further research is needed to confirm.

Enhanced recovery after surgery in transurethral surgery for benign prostatic hyperplasia / 亚洲男科学杂志(英文版)

Enhanced recovery after surgery (ERAS) measures have not been systematically applied in transurethral surgery for benign prostatic hyperplasia (BPH). This study was performed on patients with BPH who required surgical intervention. From July 2019 to June 2020, the ERAS program was applied to 248 patients, and the conventional program was applied to 238 patients. After 1 year of follow-up, the differences between the ERAS group and the conventional group were evaluated. The ERAS group had a shorter time of urinary catheterization compared with the conventional group (mean ± standard deviation [s.d.]: 1.0 ± 0.4 days vs 2.7 ± 0.8 days, P < 0.01), and the pain (mean ± s.d.) was significantly reduced through postoperative hospitalization days (PODs) 0-2 (POD 0: 1.7 ± 0.8 vs 2.4 ± 1.0, P < 0.01; POD 1: 1.6 ± 0.9 vs 3.5 ± 1.3, P < 0.01; POD 2: 1.2 ± 0.7 vs 3.0 ± 1.3, P < 0.01). No statistically significant difference was found in the rate of postoperative complications, such as postoperative bleeding (P = 0.79), urinary retention (P = 0.40), fever (P = 0.55), and readmission (P = 0.71). The hospitalization cost of the ERAS group was similar to that of the conventional group (mean ± s.d.: 16 927.8 ± 5808.1 Chinese Yuan [CNY] vs 17 044.1 ± 5830.7 CNY, P =0.85). The International Prostate Symptom Scores (IPSS) and quality of life (QoL) scores in the two groups were also similar when compared at 1 month, 3 months, 6 months, and 12 months after discharge. The ERAS program we conducted was safe, repeatable, and efficient. In conclusion, patients undergoing the ERAS program experienced less postoperative stress than those undergoing the conventional program.

Changes of ganglion cell complex and retinal nerve fiber layer thickness in different degrees of myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the changes in retinal nerve fiber layer(RNFL)and macular ganglion cell complex(GCC)measured by spectral domain optical coherence tomography(SD-OCT)in non-glaucoma subjects with low, moderate, and high myopia.METHODS: A total of 400 subjects(400 eyes)with myopia who attended our hospital from December 2019 to November 2022 were selected to participate in this study, and the subjects were divided into the following groups according to their degree of myopia: low myopia group(142 cases, 142 eyes, 35.5%), moderate myopia group(139 cases, 139 eyes, 34.8%)and high myopia group(119 cases, 119 eyes, 29.8%). RNFL thickness profiles were measured, including mean, superior, inferior, nasal, and temporal RNFL thickness. GCC parameters were measured, including mean, superior, superior temporal, inferior, inferior temporal, superior nasal, and inferior nasal. Correlation between RNFL thickness measured by OCT, mean GCC parameters, and axial length was evaluated.RESULTS: The mean RNFL thickness above, below and nasal side was significantly higher in the low and moderate myopia groups and the temporal RNFL thickness was significantly lower than the high myopia group(all P&#x003C;0.05); the mean GCC thickness above, above temporal, below, below temporal, above nasal, below nasal and mean GCC thickness were significantly higher in the low and moderate myopia groups than in the high myopia group(all P&#x003C;0.05); In the moderate myopia group, the mean RNFL and GCC thickness were both negatively correlated with axial length(r=-0.387, -0.309, all P&#x003C;0.05). In the high myopia group, both RNFL and GCC thickness means were negatively correlated with eye axis length(r=-0.499, -0.503, all P&#x003C;0.01).CONCLUSION:RNFL and GCC thicknesses tend to be thinner in subjects with high myopia than in subjects with low and moderate myopia.

Investigation and analysis of radiation doses to CT examinees in 11 medical institutions in Shijiazhuang, China / 中国辐射卫生

Objective To investigate radiation doses to examinees undergoing computed tomography (CT) scanning of different body parts (the head, chest, and abdomen) in medical institutions of Shijiazhuang, China, and to provide a reference for optimizing radiation protection for examinees in medical institutions. Methods March 2021 to March 2022, eleven medical institutions of radiation monitoring in Shijiazhuang were surveyed for the basic information, scanning parameters, and dosimetric data of a total of 930 adults and children who received CT examinations. The dosimetric data of the subjects were analyzed and compared with the domestic and international diagnostic reference levels and the results of other cities in China. Results In the above hospitals, the CTDIvol(P50) of CT subjects in children's group were 17.42-50.45 mGy, 2.13-14.01 mGy and 3.58-28.20 mGy, respectively. DLP(P50) ranges from 228.87 to 966.97 mGy·cm, 33.20 to 296.03 mGy·cm, and 74.90 to 926.53 mGy·cm, respectively. In the adult group, the CTDIvol(P50) in the head, chest and abdomen of CT subjects were 37.28-54.05 mGy, 6.43-14.99 mGy and 8.28-18.75 mGy, respectively. DLP(P50) ranges from 372.81 to 630.56 mGy·cm, from 219.77 to 467.93 mGy·cm, and from 313.86 to 689.87 mGy·cm, respectively. The distribution of radiation doses in different-grade hospitals varied greatly. The abdomen dose of the children's hospital was higher than other hospitals. Especially the primary hospitals were significantly higher than the recommended diagnostic reference level (DRL). Conclusion In some secondary and primary hospitals, the setting of CT scanning parameters was simplified, not specific to the subjects’ age and body types. They should strictly comply with the principal of optimizing radiation protection to strengthen radiation dose optimization and supervision, reducing the radiation dose of examinees in future examinations .

Impact of low whole grain intake on the burden and trend of colorectal cancer among Chinese residents aged 70 and above from 1990 to 2019：Based on GBD data / 公共卫生与预防医学

Objective To analyze the impact of low whole grain intake on the burden and trend of colorectal cancer in China, and to explore health management strategies for high-risk populations. Methods Using the 2019 Global Burden of Disease Study (GBD 2019) data, the Joinpoint regression model was used to analyze the mortality rate and disability adjusted life years (DALYs) of colorectal cancer in China caused by low whole grain intake from 1990 to 2019. Results The number of colorectal cancer deaths, mortality and DALYs of residents over 70 years old caused by low whole grain intake in China increased from 4 615, 12.06/105 and 187.66/100 000 in 1990 to 21 094 , 19.54/100 000 and 291.02/100 000 in 2019. The trend analysis found that the total crude mortality rate of colorectal cancer in Chinese residents over 70 years old caused by low whole grain intake increased by 2.03% year by year, with men increasing by 2.61% year by year, and women increasing by 1.24% year by year (all P<0.001). From 1990 to 2019, the disease burden of colorectal cancer in China was higher than that of countries with middle, low-middle, and low SDI, but lower than the global average, and high and middle-high SDI countries or regions. The growth rate in China was higher than the above regions (China 1.86% vs. global -0.25%, high SDI -0.88%, middle-high SDI -0.09%, middle SDI 1.53%, low-middle SDI 1.12%, and low SDI 0.63%). Conclusion Based on the current situation and trend of colorectal cancer disease burden of residents over 70 years of age in the world and China, precise health management of unhealthy lifestyles of high-risk populations will help to achieve the goals of healthy aging and healthy China 2030.

Treatments for prolonged disorder of consciousness in recent five years: a visualized analysis / 中国康复理论与实践

ObjectiveTo investigate the current landscape and hotspots on researches about treatment of prolonged disorder of consciousness (pDOC) in the recent five years, and forecast the trends. MethodsLiterature about treatment of pDOC was retrieved from the Web of Science Core Collection database, from January 1st, 2019, to June 7th, 2023. The data were analyzed with CiteSpace 5.8.R3 to create knowledge maps for authors, countries, institutions, keywords, references, co-cited authors and co-cited literature. ResultsA total of 411 articles were included. Aurore Thibaut was the most influential author, Belgium was the most influential country, and Harvard Medical School was the institution with the most publications. The researches focused on neuromodulation, prognostic assessment and care, and management of swallowing function. The neuromodulation techniques mainly included transcranial direct current stimulation, repetitive transcranial magnetic stimulation, deep brain stimulation and transcutaneous auricular vague nerve stimulation. In the coming years, the researches trended to explore neuromodulation and mechanisms of consciousness recovery, and the main neuromodulation techniques might be deep brain stimulation and transcutaneous auricular vague nerve stimulation. ConclusionThe researches about treatment of pDOC are increasing, mainly focusing on neuromodulation, prognostic evaluation, nursing care, and training for swallowing function. More researches would focus on neuromodulation and mechanisms for restoring consciousness.

Exploration on standardized management of ethical review of organ donation after citizen’s death / 器官移植

Objective To explore the standardized management mode of the Ethics Committee for organ donation after citizen’s death in hospitals. Methods The situations of ethical review before and after the standardized adjustment of the Ethics Committee of human organ donation in the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. Baseline data of donors before and after standardized adjustment of the Ethics Committee of human organ donation were compared. The influence of standardized adjustment of the Ethics Committee on the attendance rate of committee members and duration of ethical review were analyzed. Results No significant differences were observed in donors' ethical review data, such as gender, age and death determination, before and after standardized adjustment of Ethics Committee structure (all P>0.05). Significant difference was noted regarding the cause of death in ethical review (P<0.05). Univariate analysis showed that there were significant differences in the impact of Ethics Committee standardization adjustment and cause of death on the attendance rate of committee members (both P<0.05). Multivariate analysis revealed that gender, cause of death and standardized adjustment of the Ethics Committee were the influencing factors of the attendance rate of committee members, and the attendance rate of committee members after standardized adjustment was higher than that before adjustment (P<0.05). Univariate analysis showed that there were statistically significant differences in the effects of Ethics Committee standardized adjustment, attendance rate of committee members and cause of death on the duration of ethical review (all P<0.05). Multivariate analysis indicated that standardized adjustment of the ethics committee was the influencing factor of the duration of ethical review, and the duration of ethics review after standardized adjustment was shorter than that before adjustment (P<0.05). Conclusions Appropriate arrangement of the total number of ethics committee members and standardizing the review process may improve the efficiency of ethical review. Scientific evaluation mechanism for ethical committee members should be established by dynamically adjusting the ethical committee members, clarifying the responsibilities and tasks of members and secretaries, aiming to further improve standardized management level of ethical review for organ donation after citizen’s death.

Selection criteria of community mentors for postgraduates in general practice / 中华全科医师杂志

Objective:To establish selection criteria of community mentors for postgraduates in general medicine.Methods:A subject index system of selection criteria of community tutors for general practice postgraduates was drafted and refined based on literature retrieving and in-depth interviews during January to December 2020. Twenty experts in general practice related fields were invited for two rounds of Delphi consultation. Analytic hierarchy process was used to calculate index weight coefficient and consistency test; and the developed selection criteria were evaluated.Results:Through the in-depth interviews with 11 general practice faculty and 11 general practice postgraduates, the following five first-level thematic frameworks were refined: (1) the professional qualities; (2) the basic qualities; (3) the clinical ability; (4) the teaching ability; (5) the scientific research ability. After two rounds of Delphi expert consultation, the selection criteria of community tutors for postgraduates in general practice were finally constructed, including 5 first-level indicators (professional quality, basic quality, medical practice ability, teaching and guidance ability, academic research ability) and 28 second-level indicators. The positive coefficients of experts were 85% and 100%; the expert authority coefficients were 0.825 and 0.860; and the expert opinion coordination coefficients were 0.486 and 0.515, respectively (all P<0.05). the weight coefficients of the five first-level indicators were 0.345, 0.210, 0.138, 0.210 and 0.097, respectively. Conclusion:The criteria and index system on the selection of community mentors for general practice postgraduates has been successfully developed in the study.

Related factors of three-vessel disease in patients with stable coronary artery disease / 中华全科医师杂志

Objective:To analyze the risk factors of three-vessel disease (TVD) in patients with stable coronary artery disease (SCAD).Methods:The clinical data of 447 patients with SCAD diagnosed in Zhongshan Hospital from May 2019 to April 2020 were retrospectively analyzed, including 108 cases with the single-vessel disease (SVD), 136 cases with the two-vessel disease, and 203 cases with three-vessel disease. The general data and hematological indexes were compared between patients with SVD and those with TVD; the related factors for TVD in SCAD patients were analyzed with univariate and multivariate logistic regression.Results:There were 244 males (78.5%) and 67 females (21.5%) with a median age of 57 years (64, 69). Univariate analysis showed that there were significant differences in diabetes history ( χ2=7.75, P=0.005), uric acid ( Z=-2.10, P=0.036), glycosylated hemoglobin ( Z=-2.77, P=0.006) and high density lipoprotein cholesterol (HDL-C) ( Z=-2.99, P=0.003) levels between SVD and TVD groups. Multivariate analysis showed that the high level of blood uric acid ( OR=1.01, 95% CI: 1.00-1.01, P<0.05) and the low level of HDL-C ( OR=3.29, 95% CI:1.23-8.85, P<0.05) were related risk factors of TVD. Conclusion:High blood uric acid level and low HDL-C level are related factors for TVD in patients with SCAD.

Early thrombotic risks and prophylactic anticoagulation after liver transplantation / 中华器官移植杂志

In early stage after liver transplantation(LT), coagulation function of recipients stays in a fragile balance. Affected by a variety of complex mechanisms, blood is usually hypercoagulable. An imbalance between coagulation factors and physiological anticoagulants, elevated level of vWF, an occurrence of fibrinolysis inhibition and dosing of immunosuppressive agents cause a hypercoagulable state in an early stage after LT. Blood hypercoagulability may lead to such thrombotic complications as hepatic artery, portal vein and deep vein thromboses. Some studies have demonstrated that postoperative prophylactic anticoagulation has some effect in reducing the risks of early postoperative thrombosis. However, there is still a great lack of high-quality evidence. This review summarized the latest researches on early coagulation dysfunction, thrombosis and preventive anticoagulation after LT.

Effects of 21-hydroxylase deficiency on male fertility / 中华内分泌代谢杂志

Congenital adrenal hyperplasia(CAH) is a group of autosomal recessive disorders caused by deficiency of specific enzymes in the adrenocortical hormone synthesis pathway, resulting in impaired corticosteroid synthesis. 21-hydroxylase deficiency is the most common type of CAH, and the disorder can lead to impaired fertility in patients. Most current studies have focused on fertility problems in female CAH patients. The most common causes of impaired fertility in men with 21-OHD include testicular adrenal rest tumors(TART), low gonadotropin secretion, and inappropriate glucocorticoid therapy. This article reviews the causes of impaired fertility and its treatment in male patients with 21-OHD, with the aim of providing guidance for improving the fertility of male patients with 21-OHD.

Efficacy of vitamin D adjuvant therapy for prevention of spontaneous bacterial peritonitis in patients with decompensated cirrhosis of hepatitis B / 中华临床感染病杂志

Objective:To evaluate the efficacy of vitamin D supplementation for prevention of spontaneous bacterial peritonitis (SBP) in patients with decompensated liver cirrhosis of hepatitis B.Methods:A total of 172 patients with decompensated cirrhosis of hepatitis B admitted in Jinhua Hospital affiliated to Zhejiang University School of Medicine from January to December 2021 were randomly divided into two groups with 86 cases in each group. Patients in both groups received conventional antiviral and symptomatic treatment; while patients in the intervention group received additinal oral vitamin D drops (800 IU/d) for 6 months. After 6 months of treatment, the incidence of SBP and the serum biochemical indexes were compared between two groups. SPSS 21.0 statistical software was used for data analysis.Results:After 6 months of treatment, the incidence of SBP in the intervention group(5.81%, 5/86) was significantly lower than that in control group(30.23%, 26/86)( χ2=19.210, P<0.01). The serum 25-(OH)D level in intervention group was significantly higher than that in the control group ( t=13.425, P=0.018), while the levels of CRP, PCT and IL-6 in intervention group were significantly lower than those in control group ( t=17.312, 10.353 and 12.218, P<0.01 or <0.05). Conclusion:Vitamin D adjuvant therapy can increase serum 25-(OH)D level, decrease serum CRP, PCT and IL-6 levels, and effectively reduce the incidence of SBP in patients with decompensated cirrhosis of hepatitis B.