Whole genomic features analysis of coxsackievirus B3 strains isolated in Tianjin / 中国热带医学

@#Abstract: Objective　To genotype and analyze whole genomic features of Coxsackievirus B3 (CVB3) isolated in Tianjin, to improve evolution information of CVB3 virus in Tianjin, and to provide basis for surveillance and early warning of related diseases. Methods　Viral RNA was extracted from five CVB3 strains isolated in Tianjin, whole genome sequence of the virus was amplified by RT-PCR and sequenced by next-generation sequencing method, and phylogenetic and recombinant analysis were carried out. Results　The open reading frame 1(ORF) of the five CVB3 strains contained 6 555 nucleotides and encoded 2 185 amino acids, and ORF2 was composed of sequences encoding 68 amino acids. The nucleotide sequence similarity ranged from 78.3%-100%, and the amino acid sequence similarity ranged from 95.7%-100%. Compared with the CVB3 prototype strain, the nucleotide sequence similarity of the five viruses was between 78.2%-79.1%, and the similarity of amino acid sequences was 94.9%-95.3%. All five viruses exhibited a T151A mutation on the VP2 protein. Additionally, the encephalitis isolate showed a K158E mutation on the VP2 protein, while one of the sewage isolates had a C234T mutation in 5' noncoding region. The five strains belonged to two different genotypes, among which the encephalitis isolate in 2016 belonged to the D genotype, while the sewage isolates in 2021 belonged to the E genotype. This is also the first report of E genotype CVB3 in northern China. The CVB3 strain may have recombinant events in non-structural protein regions, in which encephalitis isolate may recombine with a Coxsackievirus B5 (CVB5) strain, while sewage isolates may have recombinant events with a strain of ECHO virus 18 (E18). Conclusions　The CVB3 isolates in Tianjin belong to D and E genotypes, and recombination events may exist in non-structural protein region of the viral genome. The results of CVB3 virus genome analysis in sewage suggests presence of CVB3 infection in the population of Tianjin, and its epidemic dominant genotype may have changed.

A case of stage Ⅲ pneumoconiosis with large shadow by burr-like changes misdiagnosed as lung cancer / 中华劳动卫生职业病杂志

Pneumoconiosis is characterized by chronic lung inflammation and fibrosis, and inflammation can promote pulmonary fibrosis, which in turn leads to pneumoconiosis. When a large shadow with a long diameter of not less than 2 cm and a short diameter of not less than 1 cm appears in the lung, it can be classified as stage Ⅲ pneumoconiosis. This paper reports a case of stage Ⅲ pneumoconiosis with a large shadow in the upper right lung accompanied by burr-like changes misdiagnosed as lung cancer by CT examination.When the large shadow lesions in patients with pneumoconiosis and lung cancer are difficult to distinguish on CT, an additional MRI examination, particularly T(2)W imaging sequence is useful sequence for identifying the two.

Efficacy of polyetheretherketone rod hybrid surgery in preventing proximal junctional failure after adult spinal deformity surgery / 中华外科杂志

Objective: To investigate the clinical outcome and preventive effect of polyetheretherketone(PEEK) rod hybrid surgery on proximal junction failure(PJF) after long-segment fusion of adult spinal deformity. Methods: A retrospective study was conducted to analyze patients with degenerative scoliosis/kyphosis who underwent long-segment decompression and fusion surgery at Department of Orthopedics, Peking University First Hospital from January 2017 to December 2021. A total of 75 patients were included in the study, including 14 males and 61 females, aged (67.2±6.8)years (range:55 to 84 years). According to the operation method chosen by the patients, the patients were divided into PEEK rod hybrid group (20 cases) and traditional titanium rod group (55 cases). The general information of the patients was collected, and the coronal and sagittal parameters of the spine were measured before operation, at 1 month after operation, and at the last follow-up. The clinical effect of surgery was judged by the visual analogue scale (VAS) and Oswestry disability index (ODI). Whether proximal junctional kyphosis (PJK) and PJF occurred during the follow-up and the time of occurrence were recorded. Comparisons between groups were performed using independent sample t test, Mann-Whitney U test, χ2 test and Fisher's exact probability method. The data before and after surgery in the same group were compared using the paired sample t test and the Wilcoxon test. Results: There were no significant differences in age, gender, body mass index, bone mineral density, distal instrumented vertebrae, surgical segments, osteotomy method, operation time, and intraoperative bleeding between the two groups (all P>0.05). The follow-up time of the PEEK rod group was shorter(M(IQR)16.5(4.8) vs. 25.0(12.0),Z=-4.230,t<0.01). There were no significant differences in coronal, sagittal parameters, VAS, and ODI between the two groups before operation (all P>0.05). Postoperative coronal Cobb angle, pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, sagittal vertical axis (SVA), VAS, and ODI were significantly improved in both groups(all P<0.05). At the last follow-up, the SVA of the PEEK rod hybrid group was(3.74±2.40)cm, which was significantly lower than that of the titanium rod group (6.28±4.06)cm (t'=-3.318, P=0.002). At the last follow-up, the ODI of the PEEK rod hybrid group was 30.7±6.1, significantly better than the titanium rod group 39.3±17.2. PJK occurred in 2 patients (10.0%) in the PEEK rod hybrid group, and no PJF phenomenon was observed. In the titanium rod group, 18 patients (32.7%) developed PJK, and 11 patients (20.0%) developed PJF. There was a statistically significant difference in the incidence of PJF between the PEEK rod hybrid group and the titanium rod group (P=0.031). Conclusions: PEEK rod hybrid surgery can achieve good clinical results in the treatment of adult spinal deformities. Compared with traditional titanium rod surgery, it can significantly reduce the incidence of postoperative PJF and improve the clinical function of patients.

Analysis of pathogenic bacteria of urinary tract infection in patients with mental disorders of different genders / 四川精神卫生

ObjectiveTo analyze the gender differences in the pathogen distribution and drug susceptibility of bacteria causing urinary tract infection among psychiatric inpatients in a hospital in Guangzhou， and to provide a basis for clinical diagnosis and rational use of drugs in treatment. MethodsClinical data of 326 psychiatric patients complicating urinary tract infection in a hospital in Guangzhou from 2019 to 2020 were retrospectively analyzed， including 126 males and 200 females. Data including gender， age， identification results of urinary tract pathogens from urine samples and drug susceptibility results were collected. The differences in bacterial distribution and drug resistance rate of urinary tract infection pathogens in patients of different genders were analyzed. ResultsA total of 326 strains of urinary tract infection bacteria were isolated， including 103 strains （31.60%） of multi-drug resistant bacteria. Male and female urinary tract infection in patients with multi-drug resistant bacteria were detected 52 strains （41.27%） and 51 strains （25.50%）， the detection rate of multi-drug resistant bacteria in female patients was significantly higher than that in male patients， with statistical difference （χ2=8.895， P<0.01）. In terms of bacterial distribution， the composition ratio of Escherichia coli in female patients was higher than that in male patients （χ2=14.794）， while the composition ratio of Acinetobacter baumannii and Pseudomonas aeruginosa was lower than that in male patients （χ2=13.665， 4.054）， with statistical difference （P<0.05 or 0.01）. The drug susceptibility results showed that Escherichia coli isolated from female patients were less resistant to various antibiotics such as ampicillin/sulbactam， aztreonam， cefepime， ceftazidime， levofloxacin， imipenem and meropenem than those from male patients （χ2=5.028~17.680， P<0.05 or 0.01）. ConclusionThe prevalence rate and bacterial distribution of psychiatric patients complicating urinary tract infection differ between patients of different genders， furthermore， the rate of drug resistance for Escherichia coli is lower in female patients than that in male patients.

Analysis of surgical strategy of percutaneous endoscopic lumbar discectomy in young and middle-aged double-segment patients with lumbar disc herniation / 北京大学学报(医学版)

OBJECTIVE@#To investigate clinical efficacy and safety of single and double segmental percutaneous lumbar discectomy for young and middle-aged patients with double-segment disc herniation.@*METHODS@#Retrospective analysis was undertaken for 32 young and middle-aged patients with percutaneous endoscopic lumbar discectomy (PELD) in the treatment of double-segment lumbar disc herniation from January 2015 to October 2018 in Peking University First Hospital. In the study, 18 cases were treated with single-segment treatment and 14 cases with double-segment treatment. Visual analogue score (VAS) and oswestry disability index (ODI) assessment were used to compare clinical symptom outcomes before surgery, 3 months after surgery and at the last follow-up. Macnab criteria were used to assess the patients' overall satisfaction after surgery. Imaging parameters included lumbar lordosis, intervertebral height at each segment and endplate angle of lesion segment on the X-ray. And Michigan State University(MSU) rating and Pfirrmann scoring system were used to evaluate the grade of disc herniation and disc degeneration respectively on magnetic resonance imaging (MRI). The perioperative parameters included the surgeon, anesthesia method, operation time, postoperative hospital stay, postoperative bracing time and perioperative complications.@*RESULTS@#The mean follow-up time was (26.78±10.64) months. There was no significant difference in the follow-up time and baseline information between the two groups(P > 0.05). ODI scores 3 months post-operatively and at the last follow-up were lower in the double segment (P < 0.05). The ODI improvement was also more significant in the double-segment group at the last follow-up (P < 0.05). There was no significant difference in radiographic parameters at baseline (P>0.05). MSU scale for the primary segment was significantly lowered after both operations (P < 0.05). MSU scale for secondary segment was significantly lowered in double segment group but not in single segment group. Other imaging parameters were similar between the two groups (P > 0.05). The operation time of the single-segment group was significantly shorter than that of the double-segment group(P < 0.001). No perioperative complications were found in either group, but three patients underwent secondary lumbar surgery during the postoperative follow-up period in the single-segment group.@*CONCLUSION@#For young and middle-aged patients with double-segment disc herniation, this study suggests double-segment PELD may be more advantageous than single-segment PELD in terms of asuring clinical efficacy without increasing perioperative risks.

Pathogenic mechanisms of Anaplasma phagocytophilum / 中华微生物学和免疫学杂志

Anaplasma phagocytophilum ( A. phagocytophilum) is tick-borne obligate pathogen that parasitizes rodents, ruminants, deer, horses and human. Ticks can transmit A. phagocytophilum to human resulting in a disease called anaplasmosis. With the increase in outdoor activities, the chances of exposing to ticks increase in human and the probability of suffering from anaplasmosis increases correspondingly. Most patients can recover from anaplasmosis after doxycycline therapy, but immunocompromised patients are at risk of seizure, renal failure and even death. A comprehensive understanding of A. phagocytophilum pathogenic mechanisms can provide new therapeutic strategies for the treatment of critically ill patients. Therefore, this review first gave examples of pathogenesis-related proteins of A. phagocytophilum, and then summarized the current research status of the pathogenic mechanism of this pathogen from three aspects of interference with cytoskeletal remodeling, inhibition of host cell apoptosis and dysfunction of the innate immune response, and proposed main issues to be addressed.

Effects of parental feeding practices on children s anemia in plateau area / 中国学校卫生

Objective@#To investigate the effects of parental feeding practices on anemia in children aged 0-6 years in the minority area of the plateau, and to provide evidence for anemia intervention.@*Methods@#A total of 1 726 children aged 0-6 years in 4 counties of Gannan Tibetan Autonomous Prefecture were selected by stratified random cluster sampling to measure hemoglobin level. Parental feeding practices were evaluated.@*Results@#The anemia prevalence rate among children aged 0-6 years was 50.3%. The prevalence of anemia was higher in those with younger age, Tibetan ethnic, rural residence, low parents education level and family income(χ2=156.95，899.51，148.17，8.18，16.36，11.03，P<0.05). Parentl awareness rates on feeding knowledge were 10.0%-53.7%. The report rates of distraction and force-feeding were 51.4% and 36.1%, respectively. Logistic regression analysis showed that parents incorrect feeding knowledge and compulsive feeding behaviors were positively associated with anemia in children(P<0.05).@*Conclusion@#Improvement of parents health literacy and feeding behavior is an important intervention to reduce anemia in children aged 0-6 years.

Prognostic Factors and Predictive Value of MRD before Consolidation Therapy in Middle-risk Newly Diagnosed Young and Middle-aged Patients with AML / 中国实验血液学杂志

OBJECTIVE@#To explore the prognostic factors of young and middle-aged patients with acute myeloid leukemia (AML) and the predictive value of minimal residual disease (MRD) before consolidation therapy.@*METHODS@#The clinical data of 262 middle-risk young and middle-aged patients with AML treated in our hospital from January 2010 to December 2018 were selected retrospectively. All the patients were reached morphological leukemia-free state (MLFS) after induction chemotherapy, the overall and subgroup clinical data of the selected patients were analyzed. Cox regression model was used to evaluate the independent prognostic factors of middle-risk newly diagnosed young and middle-aged patients.@*RESULTS@#Among the patients less than 40 years old treated by consolidation therapy with PR-CT and allo-HSCT regimens, the 5-year cumulative leukemia-free survival(LFS) rates were 40.92% and 63.51%（P=0.01）respectively, while those over 40 years old were 23.61% and 49.14%（P=0.00）, respectively. The 5-year cumulative LFS rates of the patients treated by chemotherapy and achieved early remission and late remission were 63.51% and 41.33% （P=0.01）, respectively. The 5-year cumulative overall survival(OS) rates of the patients treated by PR-CT and allo-HSCT regimens were 23.65% and 69.32% (P=0.00), respectively, and the 5-year cumulative LFS rates were 26.44% and 52.30% (P=0.01). Among the patients treated by PR-CT consolidation treatment, the MRD-negative and MRD-positive cases were 74 and 60 cases, respectively. The 5-year cumulative incidence of relapse rate in the MRD-negative subgroup was significantly lower than those in the MRD-positive subgroup (P<0.05), the 5-year LFS rate and OS rate of the patients in MRD-negative subgroup were significantly higher than those in MRD-positive subgroup (P<0.05). For the patients treated by allo-HSCT consolidation treatment, the MRD-negative and MRD-positive cases were 66 and 62 cases, respectively. The 5-year cumulative incidence of relapse rate of the patients in MRD-negative subgroup was significantly lower than those in MRD-positive subgroup（P<0.05）, and the 5-year LFS and OS rates of the patients in MRD-negative subgroup were significantly higher than those in MRD-positive subgroup (P<0.05). The univariate analysis results showed that age, chromosome karyotype, MRD status after reaching MLFS, and consolidation treatment regime were all related to the prognosis of patients (P<0.05). The multivariate analysis results showed that age, MRD status after reaching MLFS, and consolidation therapy were the independent factors affecting the cumulative OS rate of the patients (P<0.05). Chromosome karyotype was an independent factor affecting the cumulative LFS rate of the patients (P<0.05). MRD status and consolidation treatment plan after reaching MLFS were the independent factors affecting the cumulative recurrence rate of the patients (P<0.05).@*CONCLUSION@#The OS rate of middle-risk young and middle-aged patients with newly diagnosed AML is independently related to age, MRD status after MLFS and consolidation therapy, while chromosome karyotype is independently related to cumulative LFS, and allo-HSCT consolidation therapy is recommended for middle-risk young and middle-aged AML patients after induction chemotherapy for MLFS, especially for those less than 40 years old and MRD positive before consolidation therapy.

Comparative study on effect of electroacupuncture at lower -sea point of stomach and -sea matching front- points for gastroparesis / 中国针灸

OBJECTIVE@#To explore the efficacy difference of electroacupuncture at lower -sea point and -sea matching front- points for the treatment of gastroparesis.@*METHODS@#A total of 63 patients with gastroparesis were randomly divided into a lower point group (group A, 32 cases, 2 cases dropped off) and a matching points group (group B, 31 cases, 1 case dropped off). The group A was treated with electroacupuncture at Zusanli (ST 36), and the group B was treated with electroacupuncture at Zusanli (ST 36) and Zhongwan (CV 12). Both groups were treated with continuous wave (2 Hz in frequency) for 30 min, once a day, 5 times a week for 3 weeks. The gastroparesis cardinal symptom index (GCSI) score, gastric half-emptying time (T) and the 180 min gastric residual rate of the two groups before and after treatment were observed, and the clinical effective rate was compared.@*RESULTS@#After treatment, the total GCSI scores, T and the 180 min gastric residual rates in both groups were lower than those before treatment (<0.01), and the 180 min gastric residual rate and T in the group A were lower than those in the group B (<0.05). The total effective rate was 93.3% (28/30) in the group A, which was superior to 70.0% (21/30) in the group B (<0.05).@*CONCLUSION@#Electroacupuncture at lower -sea point and -sea matching front- points can both be used to treat gastroparesis, but electroacupuncture at Zusanli (ST 36) has a better effect. The acupoints of Zusanli (ST 36) and Zhongwan (CV 12) may have antagonistic effects.

Effect of Home-based Rehabilitation on Congenital Muscular Torticollis / 中国康复理论与实践

Objective:To explore the effect of home-based rehabilitation on children with congenital muscular torticollis (CMT). Methods:From January, 2016 to January, 2018, 60 children with CMT were randomly divided in to control group (n = 30) and observation group (n = 30). Both groups received comprehensive physical therapy; the observation group received home-based rehabilitation in addition. Three months after treatment, the sternocleidomastoid thickness, severity classification of CMT, and clinic effect were compared. Results:After treatment, the sternocleidomastoid thickness decreased in both groups (t > 9.862, P < 0.001), and was better in the observation group than in the control group (t = 5.468, P < 0.001); the severity classification of CMT decreased in both groups (|Z| > 5.857, P < 0.001), and was better in the observation group than in the control group (Z = -2.226, P < 0.05), as well as the clinical effect (U = 2359, P = 0.018). Conclusion:Home-based rehabilitation combined with comprehensive physical therapy is superior to comprehensive physical therapy only.

Biological characteristics of coxsackievirus A6 clinical isolates / 中华微生物学和免疫学杂志

Objective To analyze the biological characteristics of clinical isolates of coxsackievir-us A6 (CVA6), a pathogen of hand,foot and mouth disease (HFMD), and to provide reference for vaccine development. Methods CVA6 strains were isolated from 21 stool and throat swab specimens of patients with HFMD in Yunnan Province and then identified. Their growth characteristics, plaque morphology and virulence to suckling mice were analyzed. Results Five CVA6 strains, named CVA6-129, CVA6-113, CVA6-57, CVA6-94 and CVA6-162, were isolated and all belonged to D3 subtype. Only the CVA6-129 strain could proliferate rapidly in Vero and KMB17 cells and the proliferation peaked 30 h after inoculation. The infectious titer of the CVA6-129 strain was 7. 54 lgCCID50 (50％ cell culture infective dose) / ml in KMB17 cells. Different morphologies of plaques were formed by the CVA6-129 strain in Vero and KMB17 cells at the same time points, which were small and round with clear edges in Vero cells, and large and irregular with blurry edges in KMB17 cells. Suckling mice were susceptible to CVA6 via intramuscular and intraperito-neal injection. The most common symptoms in infected suckling mice were reduced mobility, hind limb pa-ralysis and quadriplegia. CVA6 infection could result in death in severe cases. Conclusions This study isolated five CVA6 strains from a number of clinical samples of suspected HFMD cases, of which the CVA6-129 strain showed potential as a vaccine candidate.

Changes in blood coagulation in middle-aged and elderly patients with fresh vertebral compression fractures / 中华创伤骨科杂志

Objective To explore the short-term effects of fresh vertebral compression fracture on blood coagulation in middle-aged and elderly osteoporotic patients.Methods A retrospective analysis was conducted of the 140 middle-aged and elderly patients (70 ones with fresh vertebral compression fracture and 70 ones with degenerative spinal disease) who had been treated at Department of Orthopaedics,The First Affiliated Hospital to Peking University between January 2016 and December 2018.Collected were their baseline parameters including age,gender and American Society of Anesthesiologists (ASA) scores,preoperative blood parameters including coagulation indicators [D-Dimer,fibrinogen degradation product (FDP),prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (FIB),international normalized ratio (INR) and thrombin time (TT)] and platelets indicators,and fracture parameters including number of fractured vertebrae and duration of fracture.The 2 patients groups were divided into 5 age groups:4 age groups for each 10 between 50 and 90 years and one age group for ＞ 90 years.The values of D-Dimer and FDP were compared between the 2 patient groups in each corresponding age group.The proportions of patients with D-Dimer negative and correlations between coagulation parameters and platelets before and after age adjustment were statistically analyzed.Results There were no statistically significant differences in the baseline parameters between the 2 patient groups(P ＞ 0.05).The mean onset time for the fracture group was 6.7 days.The values of D-Dimer,FDP,PT,INR,TT and FIB in the fracture group were significantly higher than those in the degenerative disease group(P ＜0.001).After the D-Dimer threshold adjusted by age,75.71％ (53/70) of the patients in the fracture group were negative while 98.57％ (69/70) of those in the degenerative disease group were negative.Meanwhile,the values of D-Dimer and FDP showed a significant correlation (P ＜ 0.001) with a Pearson correlation coefficient of 0.932.Compared with the degenerative disease group,the values of D-Dimer and FIDP in the fracture group increased significantly in the age groups from 61 to 90 years(P ＜0.001).Conclusions Fresh vertebral compression fractures may have a significant effect on the blood coagulation in osteoporotic patients.It is therefore presumed that the middle-aged and elderly patients with fresh vertebral compression fracture may face a higher risk of deep vein thrombosis than those with degenerative spinal disease.

Changes in blood coagulation in middle-aged and elderly patients with fresh vertebral compression fractures / 中华创伤骨科杂志

Objective@#To explore the short-term effects of fresh vertebral compression fracture on blood coagulation in middle-aged and elderly osteoporotic patients.@*Methods@#A retrospective analysis was conducted of the 140 middle-aged and elderly patients (70 ones with fresh vertebral compression fracture and 70 ones with degenerative spinal disease) who had been treated at Department of Orthopaedics, The First Affiliated Hospital to Peking University between January 2016 and December 2018. Collected were their baseline parameters including age, gender and American Society of Anesthesiologists (ASA) scores, preoperative blood parameters including coagulation indicators [D-Dimer, fibrinogen degradation product (FDP), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), international normalized ratio (INR) and thrombin time (TT)] and platelets indicators, and fracture parameters including number of fractured vertebrae and duration of fracture. The 2 patients groups were divided into 5 age groups: 4 age groups for each 10 between 50 and 90 years and one age group for >90 years. The values of D-Dimer and FDP were compared between the 2 patient groups in each corresponding age group. The proportions of patients with D-Dimer negative and correlations between coagulation parameters and platelets before and after age adjustment were statistically analyzed.@*Results@#There were no statistically significant differences in the baseline parameters between the 2 patient groups(P>0.05). The mean onset time for the fracture group was 6.7 days. The values of D-Dimer, FDP, PT, INR, TT and FIB in the fracture group were significantly higher than those in the degenerative disease group(P<0.001). After the D-Dimer threshold adjusted by age, 75.71%(53/70) of the patients in the fracture group were negative while 98.57%(69/70) of those in the degenerative disease group were negative. Meanwhile, the values of D-Dimer and FDP showed a significant correlation (P<0.001) with a Pearson correlation coefficient of 0.932. Compared with the degenerative disease group, the values of D-Dimer and FDP in the fracture group increased significantly in the age groups from 61 to 90 years(P< 0.001).@*Conclusions@#Fresh vertebral compression fractures may have a significant effect on the blood coagulation in osteoporotic patients. It is therefore presumed that the middle-aged and elderly patients with fresh vertebral compression fracture may face a higher risk of deep vein thrombosis than those with degenerative spinal disease.

Ezrin enhancer knockout inhibits the proliferation and migration of human esophageal carcinoma Eca-109 cells / 中国肿瘤生物治疗杂志

@#Objective: To investigate the effects of ezrin enhancer knockout on ezrin gene expression, cell proliferation and migration of human esophageal carcinoma Eca-109 cells. @*@#Methods: The CRISPR/Cas9 recombinant plasmids targeting upstream/downstream of human ezrin enhancer were co-transfected into human esophageal carcinoma Eca-109 cells, and the cell line Eca-C2 with ezrin enhancer knockout was screened by purinomycin. Then the expression levels of ezrin mRNAand protein in Eca-C2 cells were detected by Real-time quantitative PCR (qPCR) and Western blotting, respectively; The expression levels of MAPK-pathway-related proteins were detected by protein array technology; and the effects of ezrin enhancer knockout on the proliferation and migration of Eca-C2 cells were analyzed by WST-1 method and wound-healing assay, respectively. @*@# Results:The human esophageal carcinoma cell line Eca-C2 with stable ezrin enhancer knockout was established successfully. Compared with control cells, the mRNA and protein expressions of ezrin in Eca-C2 cells were significantly reduced (all P<0.05).Among the 17 detected MAPK pathway related proteins in Eca-C2 cells, 9 proteins (AKT, CREB, GSK3b, MKK6, mTOR, P38, P53, P70S6K and RSK1) were down-regulated, and the cell proliferation and migration were significantly inhibited (all P<0.05).@*@# Conclusion: ezrin enhancer knockout can significantly inhibit the cell proliferation and migration of human esophageal carcinoma Eca-109 cells.

Lymph node dissection for Siewert Ⅱ esophagogastric junction adenocarcinoma: a retrospective study of three surgical procedures / 中华胸心血管外科杂志

Objective The surgical approaches and extent of lymph node dissection for Siewert type Ⅱ adenocarcinoma of the esophagogastric junction(AEG) are controversial.The present study was aimed to investigate the application of right thansthoracic Ivor-Lewis(IL),left transthoracic(LTT),and left thoracoabdominal(LTA) approach in Siewert type Ⅱ AEG.Methods The data of 196 patients with Siewert type Ⅱ AEG received surgical resection in our cancer center between January 2014 and April 2016 was retrospectively analyzed.Finally,136 patients met the inclusion criteria were enrolled in the study and divided into the IL(47 cases),LTT(51 cases),and LTA group(38 cases).Clinical and short-term treatment effects were compared among the three groups.Results The patients with weight loss,diabetes,and heart disease increased in the LTT group (P =0.054,P =0.075,and P =0.063,respectively).Operation time was significantly longest in the IL group (P =0.000),but the amount of bleeding and tumor size did not significantly differ among the three groups (P =0.176 and P =0.228,respectively).The IL group had the significantly longest proximal surgical margin (P =0.000) and most number of total (P =0.000) and thoracic lymph nodes(P =0.000) dissected.Both the IL and LTA groups had more abdominal lymph nodes dissected than the LTT group(P =0.000).In general,the IL and LTT group had the highest dissection rates of every station of thoracic (P ＜ 0.05) and lower mediastinal lymph nodes (P ＜ 0.05),respectively.The dissection rate of the paracardial,left gastric artery,and gastric lesser curvature lymph nodes did not differ significantly among the three groups(P ＞ 0.05),but the dissection rate of the hepatic artery,splenic artery,and celiac trunk lymph nodes was significantly highest in the IL group (P ＜0.05).Postoperative hospital stay,perioperative complications,and mortality did not differ significantly among the three groups(P ＞ 0.05).Conclusion Compared with the traditional left transthoracic approach,the Ivor-Lewis approach did not increase the perioperative mortality and complication rates in Siewert type Ⅱ AEG,but obtained satisfactory length of the proximal surgical margin,and was better than left transthoracic approach in thoracic and abdominal lymph node dissection.However,the advantages of Ivor-Lewis procedure requires further follow-up and validation through prospective randomized controlled trials.

Anterior cervical discectomy and fusion to treat cervical spondylosis with sympathetic symptoms / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinical effectiveness of polytheretherketone (PEEK) cages assisted anterior cervical discetomy and fusion (ACDF) to treat cervical spondylosis with sympathetic symptoms.@*METHODS@#Retrospective analysis was undertaken for 39 patients who were diagnosed as cervical spondylosis with sympathetic symptoms and underwent ACDF with PEEK cages. Radiographs obtained before surgery, after surgery, and at the final follow-up were assessed for quality of fusion. The following criteria were used for assessing radiographic success of fusion: (1) endplate obliterated with no lucent lines; (2) obliteration of disc space by bony trabeculae; (3) less than 2°of intervertebral motion or 2 mm of motion between the spinous processes at the operated segment on flexion-extension lateral radiographs. The sympathetic symptoms including vertigo, headache, tinnitus, nausea and vomiting, heart throb, hypomnesia and gastroenterological discomfort were scored by 20-point system preoperatively, 2 months postoperatively and at the final follow-up. The recovery rate and clinical satisfaction rate were also evaluated. Surgical complications were also assessed.@*RESULTS@#They were followed up for at least one year. The mean follow-up was 15.6 months. Radiographs of the cervical spine at the last follow-up revealed a solid fusion with no signs of a pseudoarthrosis in 36 cases. In two patients delayed union and bony fusion were achieved at the end of 9 and 11 months. Pseudoarthosis was found in 1 case but the patient had no symptoms. The score of sympathetic symptoms before surgery, 2 months after surgery and at the final follow-up were 8.4±1.0,2.2±0.3,and 2.4±0.3, respectively. There were 22 excellent cases, 15 good cases, 1 fair case and 1 bad case in terms of RR. Good to excellent results were attained in 95% of theses patients. The sympathetic symptoms improved in all the patients and the score was significantly improved after surgery. There was one patient who had cerebral spinal fluid leakage but he recovered one week after surgery. Two patients felt a mild swallowing discomfort, but it disappeared within one month after surgery. Subcutaneous hematoma occurred in one patient due to obstructed drainage. It was cleared two days after surgery.@*CONCLUSION@#Cervical spondylosis patients with sympathetic symptoms may be managed successfully with ACDF using PEEK cages. Successful clinical results regarding symptom improvement and general satisfaction with the surgical procedure depend not only on obtaining successful decompression and radiographic fusion but also on patient selection.

Study on the dilemma of the administration of Essential Medicines System and legal protection / 中国卫生政策研究

The implementation of the essential medicine system in China faces problems including the lack of compelling force of the existing law,Lack of legal authority on the essential medicine list,the unreasonable selection mechanism of medicines,the appearance of problems about the medicine procurement mechanism legalization process, lack of legal use mechanism,the unreasonable financial compensation mechanism,and the lack of effective supervisory regulation mechanism. Therefore,it is recommended that when formulating the basic medical and health law, the es-sential medicine system should be constructed under the ethical and framed stimulation from a macro and scientific point of view. It is also suggested that the legal status of the national essential medicine list should be defined,scientifically selecting the essential medicines, improving the essential medicine bidding procurement system, using the essential medicines under the appropriate law,determining the reasonable compensation mechanism and improving the essential medicines regulation mechanism.

Risk factors of oxygen saturation decrease during intrahospital transportation of intensive care unit patients in emergency department / 中华护理杂志

Objective To explore risk factors of oxygen saturation (SpO2) decrease during intrahospital transporta-tion (IHT) of intensive care unit (ICU) patients in emergency department,and provide theoretical basis for prevent-ing oxygen saturation decrease during intrahospital transportation. Methods A cross-sectional study design was adopted,from April to May,2017,we investigated 182 ICU patients who required IHT in an emergency department in a tertiary hospital in Shanxi Province by using self-designed Evaluation Form of Intrahospital Transportation for ICU Patients in Emergency Room. We divided patients into two groups based on whether their SpO2 decreased or not. Risk factors of SpO2 decrease were identified by univariate and multivariate Logistic regression analysis. Results Among 182 patients,117 had SpO2 decrease,and the rate of SpO2 decrease was 64.3%. Patient's age,MEWS score, disease type,escort personnel,and oxygen supply device were risk factors of SpO2 decrease. Conclusion SpO2 de-crease is the result of combination of multiple risk factors during IHT. We ought to enhance training of escort person-nel,assess patient's condition and SpO2 level accurately and make plan before transportation,choose qualified oxygen supply device to ensure patients can have effective oxygen supply during IHT,which prevent SpO2 decrease during IHT.

Rapid Determination of 17 Chemicals Illegally Added into Anti-rheumatic TCM Patches by UPLC-MS/MS / 中国药房

OBJECTIVE:To establish a rapid determination method for 9 kinds of glucocorticoid and 8 kinds of non-steroidal anti-inflammatory drugs illegally added into anti-rheumatic TCM patches. METHODS:UPLC-MS/MS method was adopted. The samples were separated on Acquity UPLC? BEN C18 column with methanol-water(90:10,V/V)as mobile phase at flow rate 0.4 mL/min. The column temperature was set at 30℃,and sample size was 1μL. The ionization mode was electrospray ion source(ESI):spray needle voltage of 5500 V,ion source spray GS1,GS2 pressure of 50,50 psi,ion source temperature of 500 ℃,scanning range of m/z 50-500. The multiple reaction monitoring(MRM)combined with information-dependent acquisition (IDA) and en-hanced product ion scanning(EPI)was used to rapid qualitative analysis. RESULTS:The detection limits for 17 kinds of chemical components were not more than 0.400 μg/mL. RSDs for precision,repeatability,stability tests were not more than 4.93%,7.69%, 9.57%,respectively. Diclofenac sodium was detected in the sample. CONCLUSIONS:The method is selective and sensitive. It is suitable for qualitative analysis of chemicals illegally added into anti-rheumatism TCM patches.

Clinical Significance of Peripheral blood EB Virus Detection in NK/T Cell Lymphoma Patients / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the clinical significance of peripheral blood EB virus detection in NK/T cell lymphoma patients.</p><p><b>METHODS</b>The positive rate of EB virus and EBV-DNA in 85 cases of NK/T cell lymphoma was assayed; the correlation of positive rate of EB virus with clinical staging, short-term and long-term prognosis was analyzed.</p><p><b>RESULTS</b>The positive rate of EB virus in NK/T cell lymphoma was high (80.00%). The EBV-DNA copy number in peripheral blood leukocytes was higher than that in peripheral plasma (P<0.05), but there was no significant difference in EBV-DNA level between peripheral leukocytes and serum (P>0.05). The I-II stages ratio of patients in EBVgroup was significantly lower than that in EBVgroup. The CR rate and ORR in EBVgroup was significantly lower than those in EBVgroup, the 3 year OS rate and 3 year DFR in EBVgroup also was significantly lower than those in EBVgroup.</p><p><b>CONCLUSION</b>The detection of periphera blood EBV may be used as an reference indicator for anxiliary diagnosis of NK/T cell lymphoma and evaluation of prognosis for patients, thus possessing a certain value for clinical application.</p>