Postoperative infection after anterior cruciate ligament reconstruction caused by Finegoldia magna: a case report / 中华骨科杂志

One case of knee infection after anterior cruciate ligament reconstruction caused by the gram-positive anaerobic bacterium Finegoldia magna was reported. The patient was admitted to hospital due to fever and knee joint swelling and pain after anterior cruciate ligament reconstruction. Through medical history, physical examination, imaging examination and next-generation sequencing, it was confirmed that the infection was caused by Finegoldia magna. Through literature review, 37 literatures on infectious diseases caused by Finegoldia magna was retrieved and analyzed, and the identification points of anaerobic bacteria, the application of second-generation sequencing technology and the treatment status of infection after anterior cruciate ligament reconstruction were reviewed. The incidence of infection after arthroscopic anterior cruciate ligament reconstruction is low, while anaerobic infection is even more rare and difficult to culture. The next-generation sequencing can be used to assist the diagnosis. On the basis of giving priority to the preservation of the reconstructed ligament, the combined use of arthroscopic debridement, irrigation and sensitive antibiotics is the main treatment method.

Innovation and practice of endoscope-assisted nipple-sparing mastectomy combined with immediate subpectoral implant breast reconstruction without gas and mesh through small skin incisions / 中华内分泌外科杂志

Objective:To examine the feasibility and safety of endoscopic subcutaneous mastectomy and immediate reconstruction via a small skin incision approach without gas and mesh for early breast carcinomas.Methods:We analyzed 7 patients diagnosed with breast cancer who underwent an endoscopic subcutaneous mastectomy and immediate reconstruction from Jun. to Nov. 2021 using a gasless and meshless small skin incision approach at the Department of Thyroid and Breast Surgery, the First Affiliated Hospital of USTC. Mean age was 44.9 (29-63) years. Clinical stage, postoperative complications and other data of patients were collected. Patients were required to fill in BREAST-Q scale anonymously before and during postoperative follow-up. The difference was considered significant for P < 0.05. Results:The tumors were all unilateral and solitary lesions, with a mean diameter of 1.74 (0-5) cm. The average distance of mass from the nipple on imaging was 2.11cm (range 0 to 4) . Postoperative pathological clinical stage,1 patient was in Tis, 3 patients were in stage I, 2 patients were in stage II and a pathological complete response was achieved in one patient (ypT0pN0cM0 CR) . The mean operative time was 245.3 (195-316) min, the mean intraoperative bleeding volume was 37.1ml, the mean postoperative hospital stay was 5.1 d, and the median follow-up time was 8.8 (6-11.2) months. All the 7 patients had incision healing at the first stage, and no complications such as infection, incision complications, capsular contracture, nipple-areola complex or skin flap necrosis, removal or displacement of breast implant occurred. No local recurrence or metastasis was detected during the follow-up period. Compared with preoperative, the scores of postoperative psychosocial status, chest wall status were lower ( P<0.05) , but still ideal, while breast satisfaction and sexual satisfaction scores were not significantly different from preoperative baseline ( P>0.05) . Conclusion:This study indicates that endoscope-assisted breast reconstruction with gasless and meshless is a safe and feasible surgical intervention method for early breast cancer, with good cosmetic effects, and can be promoted as a new type of breast reconstruction.

The role of repair of Lafosse I subscapularis lesions in anterosuperior rotator cuff reconstruction / 中华骨科杂志

Objective:To observe the effect of Lafosse I subscapularis lesion repair on the reconstruction of anterosuperior rotator cufftear.Methods:A retrospective analysis was performed on patients who underwent surgical treatment of the supraspinatus torn combined with Lafosse I subscapularis lesion from January 2016 to October 2017. It was divided into two groups according to the subscapularis lesion was repaired or not. There were 16 cases in non-repaired group, 7 males and 9 females, aged from 48 to 75 years (average, 59.3 years). In this group, supraspinatus repair and subscapularis debridement with no repair were done. There were 13 cases in repaired group, 5 males and 8 females, aged from 45 to 72 years (average, 57.2 years). In this group, both supraspinatus and subscapularis were repaired. MRI was performed at last follow-up. The pain analogue scale (VAS), American Shoulder & Elbow Surgeons (ASES) score, Constant-Murley score and range of motion (ROM) were recorded at the last follow-up. Patients' satisfaction was recorded.Results:Twenty-nine patients had been followed up. Patients in non-repaired group were followed up 15.9±3.9 months (range 10-22 months), and patients in repaired group were followed up 16.9±3.4 months (range 10-21 months). At the last follow-up, VAS, ASES score, and Constant-Murley score of non-repaired group were 1.1±1.1, 88.4±4.0 and 85.9±3.2 respectively. VAS, ASES score, and Constant-Murley score of repaired group were 0.9±1.1, 89.6±2.9 and 87.5±2.6 respectively. VAS ( t=0.342, P=0.735), ASES score ( t=-0.941, P=0.355) and Constant-Murley score ( t=-1.392, P=0.175) showed no significant difference between non-repaired group and repaired group. At the last follow-up, forward flexion of affected shoulder in non-repaired group was 150.3°±17.3°, external rotation was 41.6°±16.0°, and internal rotation was L 2 level; Forward flexion in repaired group was 148.1°±16.3°, external rotation was 43.9°±9.2°, and internal rotation was L 1 level, which were improved significantly compared with those pre-operation. Forward flexion, external rotation, and internal rotation showed no statistically significant difference between non-repaired group and repaired group. 3 patients were found to have rotator cuff re-tear by MR examination. The re-tear rate was 10.34% (3/29). There were 2 cases in non-repaired group and 1 case in repaired group. At the last follow-up, the ASES score of re-tear patients was 85.3±3.1, which was better than preoperative 41.0±5.2 ( t=12.74, P<0.001). Forward flexion 131.67°±5.8° was better than preoperative 81.7°±11.5° ( t=6.708, P<0.001). One re-tear patient (in non-repaired group) received reoperation and got pain relief. The satisfaction of non-repaired group and repaired group were 93.7% and 92.3%, respectively. Conclusion:For type I subscapularis lesion combined with supraspinatus injury, wheter type I subscapularis lesion was repaired or notdidn't affect the repair effect of the anterosuperior rotator cuff tear in short-term follow-up.

Nutrition risk screening and nutrition support treatment in elderly patients with hip fracturein the perioperative period / 中华骨科杂志

With the aging of the Chinese society and the population, the incidence of hip fractures in the elderly is increasing significantly. Elderly patients have various basic diseases and decreased organ compensatory capacity, which increase the risks related to surgery and anesthesia, increase the incidence of postoperative complications and mortality, and affect the recovery process of patients. Malnutrition is one of the main causes of hip fractures in elderly patients, and it is also a major factor predicting the prognosis of patients. Elderly patients with hip fractures are considered at high risk of malnutrition. Malnutrition can lead to adverse clinical outcomes, such as increased mortality and complications, prolonged hospital stays, and increased hospital costs. Elderly patients with hip fracture should be routinely screened for nutritional risk. Those with malnutrition or nutritional risk, should be given nutritional support treatment. And conduct assessments and optimizations of nutritional support treatmentby observing the prognosis indicators such as complication rate, mortality, and rehabilitation status. At present, orthopedic surgeons who are the main body of elderly hip fracture treatment do not pay enough attention to the nutritional status of patients. Many elderly hip fracture patients undergo surgery while their malnutrition status has not improved. Therefore, it is important to improve their prognosis that strengthen the perioperative nutritional management of elderly patients with hip fracture. Domestic research on the nutritional status of elderly hip fracture patients started late. Many medical institutions have not carried out routine nutritional screening and active nutritional support treatment for elderly hip fracture patients, and there is also a lack of relevant clinical research and data statistics in the nutritional support and treatment of elderly patients with hip fractures. This article describes the current research status of nutritional risk screening and nutritional support treatment for elderly patients with hip fracture at home and abroad. However, due to differences in ethnicity, lifestyle, religious culture, and eating habits in various regions, foreign research data may not be suitable for domestic patients. Therefore, this article provides a reference for the research on perioperative nutritional screening and nutritional treatment of elderly hip fracture patients, and establishes a nutritional management plan suitable for elderly hip fracture patients in China.

Berberine prevents primary peritoneal adhesion and adhesion reformation by directly inhibiting TIMP-1

Peritoneal adhesions are fibrous tissues that tether organs to one another or to the peritoneal wall and represent the major cause of postsurgical morbidity. Enterolysis at repeat surgeries induces adhesion reformation that is more difficult to prevent than primary adhesion. Here we studied the preventive effects of different approaches of berberine treatment for primary adhesion, and its effects on adhesion reformation compared to Interceed. We found the primary adhesion was remarkably prevented by berberine through intraperitoneal injection 30 min before abrasive surgery (pre-berberine) or direct addition into injured cecum immediately after the surgery (inter-berberine). Rats with adhesion reformation had a more deteriorative collagen accumulation and tissue injury in abrasive sites than rats with primary adhesion. The dysregulated TIMP-1/MMP balance was observed in patients after surgery, as well as adhesion tissues from primary adhesion or adhesion reformation rats. Inter-berberine treatment had a better effect for adhesion reformation prevention than Interceed. Berberine promoted the activation of MMP-3 and MMP-8 by directly blocking TIMP-1 activation core, which was reversed by TIMP-1 overexpression in fibroblasts. In conclusion, this study suggests berberine as a reasonable approach for preventing primary adhesion formation and adhesion reformation.

Clinical features of children with severe adenovirus pneumonia and hemophagocytic syndrome: an analysis of 30 cases / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of children with severe adenovirus pneumonia (SAP) and hemophagocytic syndrome (HPS).@*METHODS@#A retrospective analysis was performed from the chart review data of 30 children with SAP and HPS who were admitted from January 2014 to June 2019. According to the prognosis, the children were divided into a good prognosis group (n=18) and a poor prognosis group (n=12).@*RESULTS@#Among the 30 children with SAP and HPS, the ratio of male to female was 2:1. The median age of onset was 1 year and 3 months (range 3 months to 5 years), and the mean course of fever was 19±7 d. Of the 30 children, 28 (93%) experienced disease onset in January to June. High-throughput gene detection of serum pathogens showed that 16 (53%) children were positive for human adenovirus type 7 (HAdV-7), and the other 14 (47%) children were positive for HAdV antigen based on immunofluorescence assay for throat swab, with unknown type. Of all 30 children, 29 (97%) had respiratory complications, 24 (80%) had cardiovascular complications, 16 (53%) had gastrointestinal complications, and 9 (30%) had toxic encephalopathy. Eighteen children (60%) improved or recovered and 12 (40%) did not recover (3 died). Compared with the good prognosis group, the poor prognosis group had a significantly longer course from onset to diagnosis of HPS (P<0.05), significantly higher levels of fibrinogen and tumor necrosis factor-α (P<0.05), and a significantly lower level of interferon-γ (P<0.05). The mean follow-up time was 6±2 months; 11 (41%) children recovered, 1 (4%) experienced recurrence of HPS, and 15 (56%) had the sequela of post-infectious bronchiolitis obliterans (PIBO).@*CONCLUSIONS@#HPS may be observed in children with SAP, and PIBO is the most common sequela of SAP.

Clinical study of Yiqi-Jiedu decoction combined with mesalazine sustained release granules for the patients with ulcerative colitis / 国际中医中药杂志

Objective To evaluate the effect of Yiqi-Jiedu decoction combined with mesalazine sustained release granules for the patients with ulcerative colitis (UC).Methods A total of 93 UC patients who met the inclusion criteria were divided into control group (46 cases) and study group (47 cases) according to the random number table method.The control group was treated with mesalazine sustained release granules orally.The treatment group added Yiqi-Jiedu decoction on the basis of the control group.Both groups were treated for 2 months.The level of plasma thromboxane B2 (TXB2),6-keto-prostaglandin F1α (6-Keto-PGF1α) and serum CRP,IL-1 and TNF-α were measured by ELISA,and the clinical effect was evaluated.Results The total effective rate was 95.7％ (45/47) in the treatment group and 78.3％ (36/46) in the control group.There was significant difference between the two groups (x2=6.323,P=0.012).After treatment,the plasma TXB2 level in the treatment group was significantly lower than that in the control group (601.14 ± 13.31 pg/ml vs.780.33 ± 16.54 pg/ml;t=57.619,P＜0.01),and the plasma 6-Keto-PGFlα level was significantly higher than that in the control group (84.04 ± 1 1.39 pg/ml vs.69.48 ± 10.21 pg/ml;t=6.487,P＜0.01).After treatment,the level of CRP,IL-1 and TNF-α in the treatment group was significantly lower than those in the control group (t=15.457,7.006 and 17.434,respectively,all Ps＜0.01).Conclusions The Yiqi-diedu decoction combined with mesalazine sustained release granules can reduce the level of serum inflammatory cytokines in UC patients,reduce the level of plasma TXB2,and increase the level of plasma 6-Keto-PGF 1 α,so as to improve the clinical effectiveness.

Therapeutic effect of atomized inhalation of Budesonide for chronic cough after Mycoplasma pneumoniae infection in children / 中华实用儿科临床杂志

Objective To investigate the therapeutic effect of Budesonide inhalation for the children with chronic cough after Mycoplasma pneumoniae infection and its influence on the improvement of sleep quality.Methods One hundred children with chronic cough after Mycoplasma pneumoniae infection treated at Shsnghai Tongji Hospital(Tongji Hospital Affiliated to Tongji University) were selected from June to December 2016,and they were randornly divided into the Budesonide group and the Azithromycin group.The Budesonide group received the Budesonide inhalation,the atomized inhalation 1 mg each time,2 times a day,for 3 consecutive days,and 3 days later,they received ato-mization treatment once a day,for a total of 7 days.The patients in the Azithromycin group were given oral the Azithromycin treatment 10 mg/(kg · d) for 3 days.The efficacy and sleep scores of 2 groups were compared during the period.Results The cure rate of cough in the Budesonide group[8.0％ (4/50 cases),32.0％ (16/50 cases),38.0％ (19/50 cases)]was higher than those in the Azithromycin group[0 (0/50 cases),4.0％ (2/50 cases),6.0％ (3/50 cases)] during 3,7,14 days,and the differences were all statistically significant (x2 =4.167,13.279,14.918,all P ＜0.05).The improvement rates of cough in the Budesonide group [28.0％ (14/50 cases),28.0％ (14/50 cases),26.0％ (13/50 cases)]were higher than those in the Azithromycin group[10.0％ (5/50 cases),10.0％ (5/50 cases),8.0％ (4/50 cases)] in treatment 3,7,14 days,and the differences were all statistically significant (x2 =5.263,5.263,5.741,all P ＜ 0.05).Nighttime sleep scores returned to normal ratio and improvement rates during 3,7,14 days in the Budesonide group [8.0％ (4/50 cases),32.0％ (16/50 cases),42.0％ (21/50 cases);30.0％ (15/50 cases),30.0％ (15/50 cases),30.0％ (15/50 cases)],which were significantly higher than those in the Azithromycin group [0(0/50 cases),4.0％ (2/50 caes),6.0％ (3/50 cases);12.0％ (6/50 cases),12.0％ (6/50 cases),10.0％ (5/50 cases)],and the differences were all statistically significant (all P ＜ 0.05).Conclusions The inhalation of Budesonide can effectively treat chronic cough in children with Mycoplasma pneumoniae infection in children,and significantly improve the quality of sleep.Chronic cough after Mycoplasma pneumoniae infection may be related to airway hyperresponsiveness due to nonspecific inflammation.Inhaled corticosteroids should be selected rather than anti infective therapy.

Effect of modified electroconvulsive treatment on oxidative stress parameters in patients with bipolar disorder / 上海交通大学学报（医学版）

Objective · To investigate the effect of modified electroconvulsive therapy (MECT) on oxidative stress parameters in patients with bipolar disorder. Methods · Forty-three patients with bipolar disorder (case group) were enrolled that received MECT intervention for 6 weeks, and 49 healthy volunteers (control group) were recruited. Chinese versions of the 17 items Hamilton Depression Rating Scale (HAMD-17), Young Mania Rating Scale (YMRS) and Clinical Global Impression-Severity Scale (CGI-S) were used to assess the efficacy and side effects at baseline and after 6 weeks of treatment. The plasma levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) were measured at baseline and after 6 weeks of treatment to assess the level of oxidative stress. Results · The serum MDA and GSH-Px levels of the case group were higher while the serum SOD levels of the case group was lower than that of the control group, and there was no significant difference in the serum CAT levels between two groups at baseline. MDA levels were higher in manic states than in depressed states, and they were positively correlated with the CGI-S scores. After MECT treatment, the CGI-S scores of patients decreased significantly, and the plasma MDA levels decreased significantly in manic and depressive states, but there was no change in other oxidative stress parameters. Conclusion · There was oxidative stress damage in patients with bipolar disorder, and the severity of the disease varied with the degree of damage. MECT improved the symptoms of the disease and decreased the level of plasma MDA, while there was no effect on the anti-oxidation index.

Relationship between neuropeptide Y gene polymorphism and schizophrenia / 上海交通大学学报（医学版）

Objective·To explore the association between neuropeptide Y (NPY) gene polymorphism and schizophrenia in Chinese Han population. Methods·Four single nucleotide polymorphism (SNP) loci (rs16148, rs1859290, rs16147, and rs16478 in NPY gene) were selected and genotyped by TaqMan genotyping assay in a case-control study with 678 schizophrenia cases (case group) and 685 healthy controls (control group). The allele, genotype and haplotype frequencies distribution of the SNPs between the groups were compared with SHEsis online software. Results·The distribution of genotype frequency of locus rs16478 showed a nominal statistically difference between the adult-onset schizophrenia (AOS group) and control group (χ2=6.66, P=0.036, P correction=0.144). Under recessive inherited model, the distribution of CC genotype frequency of locus rs1859290 showed statistically difference between the male schizophrenia cases and control group (P=0.012, OR=0.97, 95％CI 0.94-0.99, P correction=0.048). The distribution of haplotype CCTA (consisted of rs16148, rs1859290, rs16147, and rs16478) frequency showed statistically difference between the male AOS group and control group (8.1％ vs 13.2％, OR=0.57, P=0.010, P correction=0.040). Conclusion·The polymorphisms in NPY gene may be associated with schizophrenia in Chinese Han population.

Effect of modified electroconvulsive treatment on oxidative stress parameters in patients with bipolar disorder / 上海交通大学学报（医学版）

Objective · To investigate the effect of modified electroconvulsive therapy (MECT) on oxidative stress parameters in patients with bipolar disorder. Methods · Forty-three patients with bipolar disorder (case group) were enrolled that received MECT intervention for 6 weeks, and 49 healthy volunteers (control group) were recruited. Chinese versions of the 17 items Hamilton Depression Rating Scale (HAMD-17), Young Mania Rating Scale (YMRS) and Clinical Global Impression-Severity Scale (CGI-S) were used to assess the efficacy and side effects at baseline and after 6 weeks of treatment. The plasma levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) were measured at baseline and after 6 weeks of treatment to assess the level of oxidative stress. Results · The serum MDA and GSH-Px levels of the case group were higher while the serum SOD levels of the case group was lower than that of the control group, and there was no significant difference in the serum CAT levels between two groups at baseline. MDA levels were higher in manic states than in depressed states, and they were positively correlated with the CGI-S scores. After MECT treatment, the CGI-S scores of patients decreased significantly, and the plasma MDA levels decreased significantly in manic and depressive states, but there was no change in other oxidative stress parameters. Conclusion · There was oxidative stress damage in patients with bipolar disorder, and the severity of the disease varied with the degree of damage. MECT improved the symptoms of the disease and decreased the level of plasma MDA, while there was no effect on the anti-oxidation index.

Research progress of targeting PD-1/PD-L1 in immunotherapy for non-small-cell lung cancer / 肿瘤研究与临床

Lung cancer is the leading cause of cancer-related death in the world.PD-1 is a member of the CD28 family expressed on the surface of a variety of immune cells.PD-L1, one of PD-1 ligands, plays a pivotal role in the ability of tumor cells to evade the host immune system.A recent study showed that signaling via mutant EGFR in lung tumor cells upregulates directly tumor PD-L1 expression.In this review, the clinical significance of the PD-1/PD-L1 pathway in immunotherapy for non-small-cell lung cancer (NSCLC) and the relevance to targeted therapy were summarized.

Determination of Content and Entrapment Efficiency of VEC-5 Liposomes by HPLC / 中国药师

Objective:To establish an HPLC method for the determination of content and entrapment efficiency of HIV-1 virus in-fection factor Vif inhibitor VEC-5 liposomes. Methods:VEC-5 liposomes were prepared by a method of freeze-drying and reconstruc-tion. The separation of free drug from the liposomes was achieved by ultracentrifugation, and an HPLC method was used to determine the content and entrapment efficiency of VEC-5 liposomes. Results:The linear range of VEC-5 was 20-100 μg·ml-1(r=0. 999 0). The average recovery was 100. 25% and RSD was 0. 93%(n=9). The content of three batches of VEC-5 liposomes was 98. 63%, 100. 43% and 102. 65%, respectively within the range of 90%-110%, and the entrapment efficiency was 94. 89%, 93. 68% and 94. 56%, respectively, which was above 90%. Conclusion:The method is accurate and reliable, which can be used to determine the content and entrapment efficiency of VEC-5 liposomes.

Advances of programmed death ligand 1 and its inhibitor in non-small cell lung cancer / 国际肿瘤学杂志

Programmed death-ligand 1 (PD-L1 ),which is highly expressed in NSCLC,can be divided into two categories:membrane PD-L1 and soluble PD-L1 .PD-L1 participates in tumor immune escape through combining with its receptor.PD-L1 immune checkpoint inhibitors have entered the phase Ⅰ studies and showed a good application prospect.It is also found that the sensitivity of PD-L1 immune checkpoint inhibitors is strongly associated with the expression of PD-L1 in tumor.Therefore,PD-L1 can be used as a biomarker to pre-dict its curative effect.

Advance in Relationship between Tau Protein and Alzheimer's Disease (review) / 中国康复理论与实践

Alzheimer's disease is a common neurodegenerative disease. One of the main pathology is neurofibrillary tangles in neurons, in which principal component is the phosphorylation of tau protein. Previous studies focused on senile plaques and Aβlevels. Recent studies indicated that the development of tau protein closely associated with Alzheimer's disease, especially the abnormal phosphorylation. This pa-per reviewed the relationship between tau protein phosphorylation and Alzheimer's disease based on the perspective of protein kinases and phosphatases.

Seroepidemiology and genetic characterization of hepatitis E virus in western Yunnan Province

Objective: To investigate the seroepidemiology and genetic characterization of hepatitis E virus (HEV) in western Yunnan Province. Methods: Questionnaire survey was conducted among 1638 residents in western Yunnan Province using stratified sampling method. Enzyme-linked immunosorbent assay was used to detect serum anti-HEV IgG and IgM. HEV RNA was extracted from patients with serum anti-HEV IgM positive. The open reading flame 2 (ORF2) of HEV that was amplified by nested RT-PCR was sequenced and compared with standard HEV genotypes 1-4. Results: Serum anti-HEV positive was found in 13.92% (228/1638) residents. The HEV infection rate in males was significantly higher than that in females with a ratio of 1.47 (. P<0.01). 20-30 and 30-40 years old young men showed the highest incidence, 20.57% and 20.78%, respectively. While 10-20 and 20-30 years old young women exhibited the highest infection rate, 11.85% and 15.60%, respectively. According to occupation, the highest HEV infection rate was observed in farmers (20.35%) and migrants (16.50%). We isolated 10 individual HEV isolates from 31 patients with serum anti-HEV IgM positive. Homology analysis and phylogenetic analysis indicated that these 10 HEV isolates belonged to HEV genotype 4 with the homology of 78.65%-94.71%. Conclusions: The HEV infection rate is high in western Yunnan Province. HEV genotype 4 is the leading cause of HEV infection and young farmers and migrants are the main infected population.

Seroepidemiology and genetic characterization of hepatitis E virus in western Yunnan Province

OBJECTIVE@#To investigate the seroepidemiology and genetic characterization of hepatitis E virus (HEV) in western Yunnan Province.@*METHODS@#Questionnaire survey was conducted among 1638 residents in western Yunnan Province using stratified sampling method. Enzyme-linked immunosorbent assay was used to detect serum anti-HEV IgG and IgM. HEV RNA was extracted from patients with serum anti-HEV IgM positive. The open reading flame 2 (ORF2) of HEV that was amplified by nested RT-PCR was sequenced and compared with standard HEV genotypes 1-4.@*RESULTS@#Serum anti-HEV positive was found in 13.92% (228/1638) residents. The HEV infection rate in males was significantly higher than that in females with a ratio of 1.47 (P<0.01). 20-30 and 30-40 years old young men showed the highest incidence, 20.57% and 20.78%, respectively. While 10-20 and 20-30 years old young women exhibited the highest infection rate, 11.85% and 15.60%, respectively. According to occupation, the highest HEV infection rate was observed in farmers (20.35%) and migrants (16.50%). We isolated 10 individual HEV isolates from 31 patients with serum anti-HEV IgM positive. Homology analysis and phylogenetic analysis indicated that these 10 HEV isolates belonged to HEV genotype 4 with the homology of 78.65%-94.71%.@*CONCLUSIONS@#The HEV infection rate is high in western Yunnan Province. HEV genotype 4 is the leading cause of HEV infection and young farmers and migrants are the main infected population.

Changes in serum insulin-like growth factor-1 and insulin-like growth factor-binding protein-3, and their significance in children with left-to-right shunt congenital heart disease associated with heart failure / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate changes in serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor-binding protein-3 (IGFBP-3) and their significance in children with left-to-right shunt congenital heart disease (CHD) associated with heart failure (HF).</p><p><b>METHODS</b>Twenty healthy children (control group), 20 children with HF, without basic heart disease (HF group), 20 children with left-to-right shunt CHD, without HF (CHD group), and 30 children with left-to-right shunt CHD associated with HF (CHD+HF group) were included in the study. These groups were compared in terms of serum IGF-1 and IGFBP-3 levels. According to the New York Heart Association (NYHA) Functional Classification, the CHD+HF group was further divided into NYHA-II, NYHA-III and NYHA-IV subgroups and the subgroups were compared in terms of serum IGF-1, IGFBP-3, and cardiac troponin I (cTnI) levels. The correlation of serum IGF-1 and IGFBP-3 levels with serum cTnI level in the CHD+HF group was analyzed.</p><p><b>RESULTS</b>The CHD group showed decreased serum IGF-1 and IGFBP-3 levels compared with the control group (P<0.01). The CHD+HF group showed a significantly decreased serum IGF-1 level compared with the control group (P<0.01) and CHD group (P<0.05). The HF group had significantly increased serum IGF-1 and IGFBP-3 levels compared with other groups (P<0.01). The NYHA-II subgroup had the highest serum IGF-1 level and the NYHA-IV subgroup had the lowest serum IGF-1 level (P<0.01). In the CHD+HF group, serum IGF-1 and IGFBP-3 levels were negatively correlated with serum cTnI level (r=-0.692, P<0.05; r=-0.530, P<0.05).</p><p><b>CONCLUSIONS</b>Serum IGF-1 level can be used as an objective condition evaluation indicator for CHD, and low serum IGF-1 level is a risk factor for HF. This also provides a clinical basis for treatment of HF using exogenous IGF-1.</p>

Clinical features and prognostic factors in children with dilated cardiomyopathy / 中华实用儿科临床杂志

Objective To discuss the clinical features and prognostic factors in the children with dilated cardiomyopathy(DCM).Methods The clinical data of 45 cases of DCM,including 27 boys and 18 girls,from May 2007 to Nov.2011 in Wuhan Children's Hospital were analyzed by retrospective medical record survey methods.The average age of onset was(19.20 ± 18.98) months.Eight cases (17.8％) were of cardiac function grade Ⅰ-lⅡ,and 37 cases (82.2％) were of cardiac function grade Ⅲ-Ⅳ.The patients whose left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS) increased by 10％-15％ compared with those before treatment were defined as improved group,and the patient's LVEF and LVFS levels declined persistently or those of dead cases were defined as worsened group.There were 34 cases assigned as the improved group,8 cases as the worsened group,and 5 out of 8 cases were dead.The age,occurrence of abnormal Q waves,cardiac function,LVEF and LVFS in the 2 groups were analyzed.Results The cardiac troponin,creatine kinase,creatine kinase isoenzyme in the cardiac function grade Ⅲ-Ⅳgroup were significantly higher than those in the cardiac function grade Ⅰ-Ⅱ group (all P ＜ 0.01).There were 11 patients who had abnormal Q waves by electrocardiogram when they were diagnosed.The LVEF and LVFS levels in the cardiac function grade Ⅰ-Ⅱ group were significantly higher than those in the cardiac function grade Ⅲ-Ⅳ group (all P ＜ 0.05).There were statistically significant differences in age on diagnosed,proportion of newly diagnosed cases age ≤ 1 year old,occurrence of abnormal Q waves,cardiac function in grade Ⅲ-Ⅳ,LVEF and LVFS levels between the improved group and the worsened group (all P ＜ 0.05).Conclusions Most of the children with DCM were diagnosed more when they were ≤ 1 year old,mostly with cardiac function grade Ⅲ-Ⅳ.The occurrence of abnormal Q waves,cardiac function grade,LVEF and LVFS levels could be used as important prognostic indicators for DCM.