A case report of mitochondrial enoyl-CoA hydratase short chain 1 deficiency caused by enoyl-CoA hydratase short chain 1 gene mutation / 中华神经科杂志

Objective:To summarize the clinical features and gene mutation characteristics of a child with mitochondrial enoyl-CoA hydratase short chain 1 deficiency (ECHS1D) caused by enoyl-CoA hydratase short chain 1 ( ECHS1) gene mutation. Methods:The clinical characteristics and genetic test results of a child with ECHS1D who visited the Department of Neurology of Xuzhou Children′s Hospital in January 2021 were retrospectively analyzed, and the clinical features of the disease were also reviewed by searching relevant domestic and foreign literature.Results:The child was a 6 months and 4 days old male, with acute onset, the main clinical manifestation being limb movement disorder after admission. The child had slow motor development, his head was still upright and cannot turn over, the child also cannot sit alone, follow up and make a laugh, and the muscle tension of limbs was increased. The child′s blood lactate was increased to 6.2 mmol/L, which suggested metabolic acidosis, and magnetic resonance imaging (MRI) of the head showed abnormal signals in the basal ganglia on both sides, abnormal enhancement of the meninges of the left cerebral hemisphere. Whole exome sequencing revealed that the child had compound heterozygous mutations in ECHS1 gene, c.563C>T (p.A188V) and c.5C>T (p.A2V), respectively. The child′s father carried c.563C>T mutation, the mother carried c.5C>T mutation, all of which were missense mutations. Conclusions:ECHS1 gene mainly has missense mutations, most of which are compound heterozygous mutations, and a few are homozygous mutations. The ECHS1D caused by ECHS1 gene mutation often affects infants and young children. MRI suggests abnormal signals in the basal ganglia; for cases with the above clinical manifestations and abnormal signals in the basal ganglia on MRI, genetic testing should be considered to confirm the diagnosis.

Correlation of tumor budding with KRAS,NRAS,BRAF gene mutation and MSI status in colorectal adenocarcinoma and their clinical significance / 临床与实验病理学杂志

Purpose To explore the clinicopathological re-lationship between tumor budding and KRAS,NRAS,BRAF gene mutations and MSI status in colorectal adenocarcinoma and their clinical significance.Methods The clinical data of 237 cases of colorectal adenocarcinoma were collected to interpret tumor budding.RT-PCR was used to detect the gene mutations of KRAS,NRAS,BRAF in 229 cases and to analyze the corre-lation between tumor budding and gene mutations.MSI was de-tected by PCR and its relationship with tumor budding was ana-lyzed.Results Of the 237 patients,147 showed low-to medi-um-grade tumor budding and 90 showed high-grade tumor bud-ding.Tumor budding was associated with tumor size,vascular involvement,perineural invasion,tumor differentiation,lymph node metastasis,tumor nodule formation,tumor recurrence and TNM staging(P＜0.05),while it was not associated with age,sex and location.Single factor logistic regression analysis showed that tumor budding was associated with the risk of lymph node metastasis(P＜0.05),while multivariate logistic regres-sion analysis showed that tumor budding was an independent pre-dictor of lymph node metastasis in colorectal adenocarcinoma(P＜0.05).Of the 229 cases,the mutation rate of KRAS,NRAS and BRAF was 42.4％,2.6％and 3.1％,respectively.A-mong KRAS,NRAS and BRAF mutation cases,the proportion of high-grade tumor budding was 56.7％,33.3％and 14.3％,respectively.Tumor budding was associated with mutations in the Kras 12 and Kras 13 codons,as well as KRAS total muta-tions(P＜0.05).However,tumor budding had no relationship with NRAS and BRAF.In the high-grade budding tumors,KRAS mutations were mainly KRAS codons 12 and 13.Among the cases with KRAS mutation,the disease-free survival time and total survival time of the cases with high-grade tumor bud-ding were significantly shorter(P＜0.05).Of the 237 patients,the rate of MSI-H was 6.8％and only 2 out of 16 MSI-H pa-tients had high-grade tumor budding.There was a negative cor-relation between tumor budding and MSI status(r=-0.143,P＜0.05).Conclusion Tumor budding is related to the muta-tions in the Kras 12 and Kras 13 codons,as well as total KRAS mutations and MSI status.Tumor budding is also related to the prognosis of patients with colorectal adenocarcinoma,which can provide a reference for their outcome judgment.

Thyroid Hormone Reference Intervals among Healthy Individuals In Lanzhou, China

Background@#The common reference intervals (RIs) for thyroid hormones currently used in China are provided by equipment manufacturers. This study aimed to establish thyroid hormone RIs in the population of Lanzhou, a city in the subplateau region of northwest China, and compare them with previous reports and manufacturer-provided values. @*Methods@#In total, 3,123 individuals (1,680 men, 1,443 women) from Lanzhou, an iodine-adequate area of China, perceived as healthy were selected. The Abbott Architect analyzer was used to determine the serum concentration of thyroid hormones. The 95% RI was estimated using the 2.5th and 97.5th percentiles as the lower and upper reference limits, respectively. @*Results@#The serum levels of thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), antithyroglobulin (ATG) antibody, and antithyroid peroxidase (ATPO) antibody levels were significantly correlated with sex (P0.05). The established RIs of TSH, ATG, and ATPO in this study differed between sexes (P<0.05). The thyroid hormone RIs established herein were inconsistent with the manufacturer-provided values. @*Conclusion@#The RIs of thyroid hormones in the healthy population of Lanzhou were inconsistent with those in the manufacturer’s manual. Validated sex-specific values are required for diagnosing thyroid diseases.

Effect and influence factors of cardiopulmonary resuscitation in children with congenital heart disease in pediatric intensive care unit / 中华儿科杂志

Objective: To investigate the prognostic factors of children with congenital heart disease (CHD) who had undergone cardiopulmonary resuscitation (CPR) in pediatric intensive care unit (PICU) in China. Methods: From November 2017 to October 2018, this retrospective multi-center study was conducted in 11 hospitals in China. It contained data from 281 cases who had undergone CPR and all of the subjects were divided into CHD group and non-CHD group. The general condition, duration of CPR, epinephrine doses during resuscitation, recovery of spontaneous circulation (ROSC), discharge survival rate and pediatric cerebral performance category in viable children at discharge were compared. According to whether malignant arrhythmia is the direct cause of cardiopulmonary arrest or not, children in CHD and non-CHD groups were divided into 2 subgroups: arrhythmia and non-arrhythmia, and the ROSC and survival rate to discharge were compared. Data in both groups were analyzed by t-test, chi-square analysis or ANOVA, and logistic regression were used to analyze the prognostic factors for ROSC and survival to discharge after cardiac arrest (CA). Results: The incidence of CA in PICU was 3.2% (372/11 588), and the implementation rate of CPR was 75.5% (281/372). There were 144 males and 137 females with median age of 32.8 (5.6, 42.7) months in all 281 CPA cases who received CPR. CHD group had 56 cases while non-CHD had 225 cases, with the percentage of 19.9% (56/281) and 80.1% (225/281) respectively. The proportion of female in CHD group was 60.7% (34/56) which was higher than that in non-CHD group (45.8%, 103/225) (χ2=4.00, P=0.045). There were no differences in ROSC and rate of survival to discharge between the two groups (P>0.05). The ROSC rate of children with arthythmid in CHD group was 70.0% (28/40), higher than 6/16 for non-arrhythmic children (χ2=5.06, P=0.024). At discharge, the pediatric cerebral performance category scores (1-3 scores) of CHD and non-CHD child were 50.9% (26/51) and 44.9% (92/205) respectively. Logistic regression analysis indicated that the independent prognostic factors of ROSC and survival to discharge in children with CHD were CPR duration (odds ratio (OR)=0.95, 0.97; 95%CI: 0.92~0.97, 0.95~0.99; both P<0.05) and epinephrine dosage (OR=0.87 and 0.79, 95%CI: 0.76-1.00 and 0.69-0.89, respectively; both P<0.05). Conclusions: There is no difference between CHD and non-CHD children in ROSC and survival rate of survival to discharge was low. The epinephrine dosage and the duration of CPR are related to the ROSC and survival to discharge of children with CHD.

Biocompatibility evaluation of collagen suture and collagen biofilm / 国际生物医学工程杂志

Objective:To evaluate the biocompatibility of collagen suture (CS) and collagen biofilm (CB) preliminarily.Methods:The pyrogenic contaminants test was used to analyze the pyrogen in CS and CB. The skin stimulation and intradermal stimulation tests were used to evaluate the stimulation effects of CS and CB to the skin. The hemolytic test was used to evaluate the hemolytic effect of CS and CB. The muscle implantation experiment was used to evaluate the stimulation and toxicity of CS and CB.Results:The results of pyrogenic contaminants test show that the temperature increment of rabbits in each group is lower than 0.6 ℃, and the total temperature increment is lower than 1.4 ℃ indicating that the two materials meet the requirements of pyrogenic examination and the pyrogenic contaminants test is qualified. The results of skin stimulation test and intradermal stimulation test of collagen suture and collagen biofilms were negative indicating that the two materials have no skin irritation. The hemolysis rates of collagen suture and collagen biofilm were 2.943% and 4.127% respectively (all P<0.05) indicating that the two materials will not cause hemolysis. The muscle was tolerated well and the tissue response was not serious after two biomaterials were embedded, which was reduced over time gradually. Conclusions:Both the collagen suture and collagen biofilm have good biocompatibility.

Investigation of AIDS cognition and testing willingness among freshmen in Fengtai District, Beijing / 中国学校卫生

Objective@#To examine college students awareness of AIDS (acquired immunodeficiency syndrome) and HIV (human immunodeficiency virus), as well as their willingness to undergo testing, and to provide guidance for further education targeted towards AIDS prevention.@*Methods@#The respondents were selected from two companies of military training camps in 4 universities in Fengtai District of Beijing using cluster sampling, and a questionnaire was used to obtain relevant information among 1 248 college freshmen. The content of the questionnaire included basic information about the students, awareness of AIDS, and willingness to undergo testing.@*Results@#A total of 87.18% students were familiar with AIDS related knowledge, and 62.98% students intended to have HIV tests in the future. Willingness to be tested for HIV was higher among not local students (67.39%) than among local students(55.65%)(χ 2=17.32, P<0.05). The willingness to get HIV testing was higher among students who had an understanding of AIDS (65.26%) than among those who lacked an awareness(47.50%)(χ 2=18.87, P<0.05). In terms of the willingness to be tested for HIV, the main concerns focused on personal privacy (23.24%) and the cost (18.59%). Multivariate regression analysis showed that improving students awareness of five of the items related to a basic knowledge of AIDS may increase their willingness to get HIV testing(P<0.05). Most students indicated a preference to get HIV testing at a hospital (68.51%) or at the Centers for Disease Control and Prevention(42.79%).@*Conclusion@#The willingness to get HIV testing can be increased by launching an AIDS health education program that targets weak knowledge points with respect to AIDS awareness.

Effect of general anesthesia guided by electroencephalography monitoring on postoperative delirium in elderly patients with non-acute fragile brain function / 中华麻醉学杂志

Objective:To evaluate the effect of general anesthesia guided by electroencephalography (EEG) monitoring on postoperative delirium (POD) in elderly patients with non-acute fragile brain function.Methods:Sixty patients of both sexes with non-acute fragile brain function, aged 65-85 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, with body mass index of 18-30 kg/m 2, undergoing hip replacement, were divided into 2 groups ( n=30 each) by a random number table method: conventional general anesthesia group (group C) and general anesthesia guided by EEG monitoring group (group E). Anesthesia was maintained by intravenous infusion of propofol 50-150 μg·kg -1·min -1 and remifentanil 0.05-0.30 μg·kg -1·min -1 and intermittent intravenous boluses of rocuronium.In group E, the dose of anesthetic was reduced when the EEG burst-suppression ratio≥10% for more than 1 min or anesthesia index (AI) <40.If the situation mentioned above still existed after 1 min, the dose of anesthetic was continued to be reduced or norepinephrine was injected intravenously.In group C, the amount of intraoperative anesthesia was adjusted according to the changes in hemodynamics.Norepinephrine 4-10 μg or dopamine 1 mg was given intravenously in the light of the patients′ heart rates when intraoperative hypotension occurred.At 10 min after anesthesia induction, immediately after skin incision, immediately at the end of surgery and at 1 h after surgery, blood samples were obtained from the artery and jugular venous bulb for blood gas analysis and for calculation of jugular bulb blood oxygen content (CjvO 2), artery-jugular bulb blood oxygen content difference (Ca-jvO 2), cerebral oxygen uptake rate (CERO 2) and jugular-arterial blood lactate concentration difference (Djv-aLac). The emergence time, amounts of intraoperative anesthetics, use of noradrenaline, cumulative time of EEG burst inhibition and duration of AI<40 were recorded.The development of POD was assessed within 5 days after surgery by the confusion assessment method for the intensive care unit and the duration was recorded. Results:Compared with group C, recovery time, cumulative time of EEG burst inhibition and duration of AI<40 were significantly shortened, the intraoperative consumption of propofol and remifentanil was decreased, the requirement for intraoperative noradrenaline was increased, CjvO 2 was increased, Ca-jvO 2 and CERO 2 were decreased immediately at the end of surgery and at 1 h after surgery, the incidence of POD within 5 days after surgery was decreased, and POD duration was shortened in group E ( P<0.05). Conclusion:General anesthesia guided by EEG monitoring can reduce the development of POD in elderly patients with non-acute fragile brain function.

Blood biochemical indicators, IgM and IgG antibodies in 56 confirmed and suspected COVID-19 cases / 上海预防医学

Objective To provide reliable indicators for effective prevention and control of COVID-19, we examined the biochemical indicators as well as anti-SARS-CoV-2 IgM and IgG antibodies in confirmed and suspected COVID-19 patients. Methods A total of 56 confirmed and suspected COVID-19 cases quarantined during January-March, 2020 in Gansu Provincial People′s Hospital and People′s Hospital of Xigu District, Gansu Province were included.Based on the results of nucleic acid testing and CT scan finding, they were divided into three groups: positive in both nucleic acid testing and CT scan finding; positive in nucleic acid testing but negative in CT scan finding; negative in both nucleic acid testing and CT scan finding.COVID-19 viral nucleic acid was detected and chest CT scan was performed.The following biochemical indicators were examined: total protein, albumin, total bilirubin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, γ-glutamyltranspeptidase, creatine kinase and lactate dehydrogenase.SPSS 22.0 statistical software was used to analyze the differences in the biochemical indicators among these three groups, as well as the temporal trend of IgM and IgG antibodies at different points of time. Results There were significant differences in the mean values of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and lactate dehydrogenase between these three groups (P < 0.05), whereas no significant difference in the mean value of total protein and albumin (P>0.05).ROC curve indicated that aspartate aminotransferase had the largest maximum area under the curve (AUC, 0.834), whereas alanine aminotransferase had the highest sensitivity (1.0) and total bilirubin had the highest specificity (0.927).Thus, aspartate transaminase provided the best prediction for the diagnosis of COVID-19, with sensitivity of 0.786, specificity of 0.854, and the maximum AUC of 0.834.In 12 of 16 confirmed COVID-19 patients tested IgG positive after 10 days of diagnosis, and 10 of 10 confirmed COVID-19 patients tested IgG positive after 14 days of diagnosis. Conclusion Aspartate aminotransferase may be the most useful indicator in the diagnosis of COVID-19.

Association of non-thyroidal illness syndrome with interleukin-6 and interleukin-10 in critically ill children with sepsis / 中国当代儿科杂志

OBJECTIVE@#To study the incidence rate of non-thyroidal illness syndrome (NTIS) in critically ill children with or without sepsis and the association of NTIS with interleukin-6 (IL-6) and interleukin-10 (IL-10).@*METHODS@#A retrospective analysis was performed on the medical data of 97 children with sepsis (sepsis group) and 80 non-sepsis children with bacterial infection (non-sepsis group). The correlations of IL-6 and IL-10 with the thyroid function parameters triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) were analyzed.@*RESULTS@#There were no significant differences in age and sex between the sepsis and non-sepsis groups (P>0.05). Compared with the non-sepsis group, the sepsis group had a significantly higher Sequential Organ Failure Assessment score, a significantly longer length of hospital stay, and a significantly higher rate of use of ventilator (P0.05), but the pooled analysis of the two groups showed that IL-6 level was negatively correlated with T3 and T4 levels (P<0.001).@*CONCLUSIONS@#Children with sepsis have a higher incidence rate of NTIS than those without sepsis. The high level of IL-6 may be associated with the development of NTIS.

Role of hepatic lymphangiogenesis in the progression of liver fibrosis / 临床肝胆病杂志

Liver fibrosis can progress to liver cirrhosis and end-stage liver disease, which may lead to poor prognosis. In addition to pathological angiogenesis and hepatic sinusoid remodeling, hepatic lymphangiogenesis also plays an important role in the progression of liver fibrosis. This article briefly describes lymphatic vessel markers and their expression in the liver, introduces the role of lymphangiogenesis in liver fibrosis, and reviews the role of liver macrophages (Kupffer cells) and lymphatic endothelial cells in lymphangiogenesis. It is pointed out lymphangiogenesis may become a potential target for the intervention of liver fibrosis, which plays an important role in the early treatment and reversal of liver fibrosis and the prevention of liver cirrhosis and end-stage liver disease.

Changes in intestinal microbiota and phenotypes of immune cells in mice with atherosclerosis and arthritis / 中华微生物学和免疫学杂志

Objective To investigate the changes in intestinal microbiota and immune cells in mice with atherosclerosis and arthritis. Methods Two groups were set up with 8-week-old ApoE knockout (ApoE-/ -) and C57BL/ 6 mice. All mice were fed with high fat diet. The severity of atherosclerosis was evaluated through analyzing the level of serum lipid by ELISA and arteriosclerotic plaques by oil red O stai-ning. K/ BxN serum was intraperitoneally injected into ApoE-/ - and C57BL/ 6 mice at 17 to 26 weeks of age until 26 weeks to induce arthritis. The development of arthritis in mice was evaluated with vernier caliper-measured ankle width and clinical score. Total DNA was extracted from fecal samples of mice to amplify the 16S V4 region by PCR, and then sequencing analysis was performed on Illumina HiSeq PE250. Splenocytes and bone marrow cells were isolated and stained by antibodies to analyze the changes in immune cell distribu-tion by flow cytometry. Results The levels of low density lipoprotein cholesterol (LDL-C) and total choles-terol (TCHO) in serum and the atherosclerotic plaques in aorta were significantly increased in ApoE-/ - mice than in C57BL/ 6 mice, suggesting that the symptoms of atherosclerosis in ApoE-/ - mice were more severe than those in C57BL/ 6 mice. Ankle width measurements and clinical scores of arthritis showed that the ApoE-/ - mice had less severe ankle swelling than the C57BL/ 6 mice. Moreover, the ApoE-/ - mice had de-creased intestinal microbiota diversity, especially in the number of Verrucomicrobiae. Flow cytometry analy-sis showed that CD3+T and CD19+B cells were down-regulated, while CD11b+ macrophages were up-regula-ted in splenocytes and bone marrow cells of the ApoE-/ - mice. Conclusions Immune cell distribution was changed in the ApoE-/ - mice with atherosclerosis and arthritis. Compared with the C57BL/ 6 mice, the ApoE-/ - mice had decreased intestinal microbiota diversity and altered bacterial composition. Moreover, the abundance of Akkermansia, a potential biomarker of healthy intestinal environment, in the ApoE-/ - mice was also decreased. It was suggested that the changes in intestinal microbiota might be involved in the pathogene-sis of atherosclerosis complicated by arthritis.

Advances in JAK2 inhibitors for treatment of myeloproliferative neoplasms / 药学学报

Myeloproliferative neoplasms (MPNs) result from clonal expansion of haematopoietic stem cells and are characterized by abnormal proliferation of myeloid lineage cells in the bone marrow. Sustained activation of JAK-STAT signaling pathway due to JAK2 phosphorylation is an important cause of MPNs, and mutation of JAK2 kinase can keep it in a state of continuous phosphorylation. The most typical mutation in JAK2 is a site mutation of V617F in the pseudokinase domain. The JAK2V617F-activating mutation is highly prevalent in MPNs, with frequencies estimated at approximately 95% in polycythaemia vera (PV) and 50% in primary myelofibrosis (PMF) and essential thrombocytosis (ET) patients. It is now clear that JAK2 is an important target for treatment of MPNs. Inhibiting aberrant activation of the JAK2-STAT signaling pathway has become a popular trend in research for effective treatment of MPNs. This review summarizes the research progress in developing JAK2 inhibitors for treatment of MPNs in recent years, including the new discoveries of the biological functions of JAK2, the relationship between JAK2 and MPN, and the status of development of JAK2 small molecule inhibitors.

Recent advances in microglial activation for treatment of chronic neuropathic pain / 药学学报

As the primary innate immune cells in the central nervous system, microglia can be activated by external noxious stimulus and in turn interact with astroglia and neurons to induce neuroinflammation and facilitate the transmission of pain signals. This response can help the central nervous system adapt to the changes of the internal environment induced by noxious stimulus, leading to the long-term sensitivity of peripheral and central pain nerve conduction pathways and chronic neuropathic pain. Numerous researches found that activation of microglia participated in the occurrence and maintenance of chronic neuropathic pain, and inhibition of microglial activation in the spinal cord or the brain had analgesic effect in animal experiments. Due to the fact that molecular and cellular mechanisms between the activation of microglia and pain remittence are unclear, there are many difficulties in designing of new drugs selectively targeting to the activation of microglia for treatment of chronic neuropathic pain. We review here the research articles on microglia and chronic neuropathic pain, sorting out the relationship between microglia and chronic neuropathic pain, and provide new ideas for the development of new drugs targeting to microglia for the treatment of chronic neuropathic pain.

Value of serum gamma-glutamyl transpeptidase combined with direct bilirubin in the diagnosis of biliary atresia in infants / 中国当代儿科杂志

OBJECTIVE@#To study the value of serum gamma-glutamyl transpeptidase (GGT) combined with direct bilirubin (DB) in the diagnosis of biliary atresia.@*METHODS@#A total of 667 infants with cholestasis who were hospitalized and treated from July 2010 to December 2018 were enrolled as subjects. According to the results of intraoperative cholangiography and follow-up, they were divided into biliary atresia group with 234 infants and cholestasis group with 433 infants. The two groups were compared in terms of age of onset, sex, and serum levels of total bilirubin (TB), DB, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bile acid (TBA), and GGT. A receiver operating characteristic (ROC) curve analysis was performed for indices with statistical significance, and the area under the ROC curve (AUC) and the optimal cut-off value for diagnosis were calculated.@*RESULTS@#The biliary atresia group had a significantly younger age of onset than the cholestasis group (P0.05), while the biliary atresia group had significantly higher serum levels of TB, DB, TBA, and GGT than the cholestasis group (P<0.05). GGT combined with DB had the highest AUC of 0.892 (95% confidence interval: 0.868-0.916) in the diagnosis of biliary atresia. At the optimal cut-off values of 324.0 U/L for GGT and 115.1 μmmol/L for DB, GGT combined with DB had a sensitivity of 79.8% and a specificity of 83.2% in the diagnosis of biliary atresia.@*CONCLUSIONS@#GGT combined with DB has high sensitivity and specificity in the diagnosis of biliary atresia and can be used as an effective indicator for diagnosis of biliary atresia in infants.

Awareness and associated factors of tobacco hazards among middle school personnel in Shanghai / 中国学校卫生

Objective@#To understand current situation of the awareness of tobacco hazards among middle school personnel in Shanghai and to explore its influencing factors,and to provide reference for making targeted measures to control tobacco hazards in schools.@*Methods@#A total of 30 middle schools in Shanghai were selected by stratified cluster sampling method. The questionnaires were used to investigate the smoking prevalence and tobacco hazard awareness of 3 007 faculty members.@*Results@#The total smoking rate of school personnel in Shanghai was 8.25%; the complete correct rate on the harm of smoking and second-hand smoke was only 19.72% and 23.74%, respectively. The correct awareness rate of harm caused by tobacco, such as stroke, osteoporosis and heart disease, was less than 50%. Gender, education level, smoking behavior and tobacco control training were related with tobacco hazards perception level.@*Conclusion@#The smoking rate among middle school personnel in Shanghai has been generally improved, but the faculty and staff have an unbalanced understanding of tobacco hazards. The school's tobacco control education should be targeted. Smoking, men and personnel with relatively low education levels are the key groups in school tobacco control education.

Effect of percentage of enteral nutrition in the total energy and nutrition support for patients with traumatic brain injury / 肠外与肠内营养

Objective: This study was conducted to determine the proper percentage of EN in the total energy and nutrition support for critically ill patients with traumatic brain injury (TBIs). Methods: 94 cases were randomly divided into 3 groups according to the percentage of EN in the total energy: 100％ EN group in which patients received 100％ calories from EN; 75％ EN group in which patients received 75％ calories from EN, 25％ from PN; 50％ EN group in which patients received 50％ calories fromm EN, 50％ from PN. At baseline and follow-up on day 4, 7, 10, nutrition parameters, complete blood count and electrolytes as well as metabolic parameters including tests of liver and renal function were measured. Complications during treatment were recorded and the prognosis was finally judged. Results: Total protein and albumin were significantly higher in the 50％ EN and 75％ EN group on day 7 than in TEN group (P＜ 0. 05). There was significance difference found in complications between 75％EN and 50％EN group. A reduction in the length of stay in the hospital and expenses in the ICU for 10 days in the 75％ EN group (P ＜ 0. 05) was also observed. Conclusion: 75％ calories from EN in the total energy and nutrition support appeared to have great impact on management of critically ill patients with traumatic brain injury.

Development and clinical applications of therapeutic contact lenses / 国际眼科杂志(Guoji Yanke Zazhi)

Therapeutic contact lenses, a great invention on optometry, have been widely used on clinical therapy of ocular surface diseases due to its specialty on material and structure. As a result, relevant researches and development should be focused on the optimization of its material making it more adaptable for clinical therapy. In this review, we discuss the progress in developing material of therapeutic contact lenses and mainly illustrate its mechanism and clinical application together with its complications and potential improvements.

Relationship between postoperative cognitive dysfunction and inflammatory response of patients with non-acute fragile brain function / 中华麻醉学杂志

Objective To evaluate the relationship between postoperative cognitive dysfunction and inflammatory responses of patients with non-acute fragile brain function. Methods Sixty American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients of both sexes, aged 65-83 yr, weighing 52-85 kg, scheduled for elective lumbar spinal internal fixation under general anesthesia, were divided into 2 groups (n=30 each) using a random number table method: brain function normal control group (group C) and non-acute fragile brain function group ( group F) . The blood samples were obtained from the peripheral vein at 30 min before anesthesia induction, at the end of operation and at 2 days after operation to determine the concentrations of tumor necrosis factor-alpha ( TNF-α) , interleukin-6 ( IL-6) , IL-10 and C-reactive pro-tein by enzyme-linked immunosorbent assay. Confusion assessment method was used to assess the develop-ment of delirium at 2 days after operation. Mini Mental State Examination was used to assess the develop-ment of postoperative cognitive dysfunction at 7 days after operation. Results Compared with the baseline at 30 min before anesthesia induction, the concentrations of TNF-α, IL-6 and C-reactive protein in plasma were significantly increased at 2 days after operation in two groups ( P<0. 05) . Compared with group C, the concentrations of TNF-α and IL-6 in plasma and incidence of postoperative delirium were significantly in-creased at 2 days after operation in group F ( P<0. 05) . Conclusion The mechanism of delirium occurred after surgery may be related to inflammatory responses of patients with non-acute fragile brain function.

Values of high-frequency ultrasound, elastography and ultrasound contrast in diagnosis of thyroid solid nodules / 医疗卫生装备

Objective To investigate the diagnostic criteria of thyroid solid nodules by high-frequency ultrasound,elastography and ultrasound contrast.Methods Totally 87 patients with thyroid solid nodules underwent high-frequency ultrasound,elastography and ultrasound contrast before surgery,distinguishing benign from malignant lesions was executed based on pathological results,and according to the pathological character the image features by the three measures were compared.There were 40 patients divided into a control group going through the examination by high-frequency ultrasound,and 47 ones into an observation group with the examinations by the three measures.Pathological results were used as gold standard,and the two groups were compared on diagnostic sensitivity.Results High-frequency ultrasound showed significant differences of benign and malignant nodules in equal echo,very low echo,irregular peripheral halo,rates of clear nodule boundary and aspect ratio higher than as well as microcalcification (x2--4.603,17.394,5.833,14.832,10.107 and 27.392,and all Pvalues were less than 0.05).There were 85％ benign nodules gained grade Ⅰ and Ⅱ elastography images,81.82％malignant nodules had grade Ⅲ and ⅣV elastography images,and there were significant differences between benign and malignant nodules (x2=53.42,P=0.00).Ultrasound contrast found annular enhancement in most of benign nodules (x2=39.16,P＜0.01) while uneven enhancement in most of malignant nodules (x2=40.28,P＜0.01),and the nodule ranges increasedsignificantly after contrast (t=2.19,P＜0.05).The observation group had the sensitivity being 82.86％,which was statisticallyhigher than 59.38％ in the control group (x2=4.537,P--0.033).Conclusion High-frequency ultrasound,elastography and ultrasound contrast all show the manifestations of thyroid solid nodules,and the comprehensive application of the above three measures contributes to determining the nature of the nodules.

Values of high-frequency ultrasound, elastography and ultrasound contrast in diagnosis of thyroid solid nodules / 医疗卫生装备

Objective To investigate the diagnostic criteria of thyroid solid nodules by high-frequency ultrasound,elastography and ultrasound contrast.Methods Totally 87 patients with thyroid solid nodules underwent high-frequency ultrasound,elastography and ultrasound contrast before surgery,distinguishing benign from malignant lesions was executed based on pathological results,and according to the pathological character the image features by the three measures were compared.There were 40 patients divided into a control group going through the examination by high-frequency ultrasound,and 47 ones into an observation group with the examinations by the three measures.Pathological results were used as gold standard,and the two groups were compared on diagnostic sensitivity.Results High-frequency ultrasound showed significant differences of benign and malignant nodules in equal echo,very low echo,irregular peripheral halo,rates of clear nodule boundary and aspect ratio higher than as well as microcalcification (x2--4.603,17.394,5.833,14.832,10.107 and 27.392,and all Pvalues were less than 0.05).There were 85％ benign nodules gained grade Ⅰ and Ⅱ elastography images,81.82％malignant nodules had grade Ⅲ and ⅣV elastography images,and there were significant differences between benign and malignant nodules (x2=53.42,P=0.00).Ultrasound contrast found annular enhancement in most of benign nodules (x2=39.16,P＜0.01) while uneven enhancement in most of malignant nodules (x2=40.28,P＜0.01),and the nodule ranges increasedsignificantly after contrast (t=2.19,P＜0.05).The observation group had the sensitivity being 82.86％,which was statisticallyhigher than 59.38％ in the control group (x2=4.537,P--0.033).Conclusion High-frequency ultrasound,elastography and ultrasound contrast all show the manifestations of thyroid solid nodules,and the comprehensive application of the above three measures contributes to determining the nature of the nodules.