Secular trends of asthma mortality in China and the United States from 1990 to 2019 / 中华医学杂志(英文版)

BACKGROUND@#Asthma imposes a large healthcare burden in China and the United States (US). However, the trends of asthma mortality and the relative risk factors have not been comparatively analyzed between the countries. The aim of this study was to compare the mortality and risk factors between China and the US.@*METHODS@#The deaths, and mortality rates of asthma in China and the US during 1990-2019 were obtained from the Global Burden of Disease Study 2019. The age-period-cohort model was used to estimate these mortality rates based on a log-linear scale with additive age, period, and cohort effects. The population attributable fractions of risk factors for asthma were estimated.@*RESULTS@#In 1990-2019, the asthma mortality rate was higher in China than in the US. The crude and age-standardized asthma mortality rates trended downward in both China and the US from 1990 to 2019. The decline in mortality was more obvious in China. Mortality gap between the two countries was narrowing. A sex difference in asthma mortality was observed with higher mortality in males in China and females in the US. The age effects showed that mortality increased with age in adults older than 20 years, particularly in the elderly. Downward trends were generally observed in the period and cohort rate ratios in both countries, with China experiencing a more obvious decrease. Smoking and high body mass index (BMI) were the leading risk factors for asthma mortality in China and the US, respectively. Mortality attributable to occupational asthmagens and smoking decreased the most in China and the US, respectively.@*CONCLUSIONS@#In 1990-2019, the asthma mortality rate was higher in China than in the US; however, the mortality gap has narrowed. Mortality increased with age in adults. The improvements in asthma death risk with period and birth cohort were more obvious in China than in the US. Smoking, high BMI, and aging are major health problems associated with asthma control. The role of occupational asthmagens in asthma mortality underscores the importance of management and prevention of occupational asthma.

Clinical application of Flow-through bridge anterolateral thigh flap in repair of complex calf soft tissue defects / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of Flow-through bridge anterolateral thigh flap transplantation in the treatment of complex calf soft tissue defects.@*METHODS@#The clinical data of the patients with complicated calf soft tissue defects, who were treated with Flow-through bridge anterolateral thigh flap (study group, 23 cases) or bridge anterolateral thigh flap (control group, 23 cases) between January 2008 and January 2022, were retrospectively analyzed. All complex calf soft tissue defects in the two groups were caused by trauma or osteomyelitis, and there was only one major blood vessel in the calf or no blood vessel anastomosed with the grafted skin flap. There was no significant difference between the two groups in general data such as gender, age, etiology, size of leg soft tissue defect, and time from injury to operation ( P>0.05). The lower extremity functional scale (LEFS) was used to evaluate the sufferred lower extremity function of the both groups after operation, and the peripheral blood circulation score of the healthy side was evaluated according to the Chinese Medical Association Hand Surgery Society's functional evaluation standard for replantation of amputated limbs. Weber's quantitative method was used to detect static 2-point discrimination (S2PD) to evaluate peripheral sensation of the healthy side, and the popliteal artery flow velocity, toenail capillary filling time, foot temperature, toe blood oxygen saturation of the healthy side, and the incidence of complications were compared between the two groups.@*RESULTS@#No vascular or nerve injury occurred during operation. All flaps survived, and 1 case of partial flap necrosis occurred in both groups, which healed after free skin grafting. All patients were followed up 6 months to 8 years, with a median time of 26 months. The function of the sufferred limb of the two groups recovered satisfactorily, the blood supply of the flap was good, the texture was soft, and the appearance was fair. The incision in the donor site healed well with a linear scar, and the color of the skin graft area was similar. Only a rectangular scar could be seen in the skin donor area where have a satisfactory appearance. The blood supply of the distal limb of the healthy limb was good, and there was no obvious abnormality in color and skin temperature, and the blood supply of the limb was normal during activity. The popliteal artery flow velocity in the study group was significantly faster than that in the control group at 1 month after the pedicle was cut, and the foot temperature, toe blood oxygen saturation, S2PD, toenail capillary filling time, and peripheral blood circulation score were significantly better than those in the control group ( P<0.05). There were 8 cases of cold feet and 2 cases of numbness on the healthy side in the control group, while only 3 cases of cold feet occurred in the study group. The incidence of complications in the study group (13.04%) was significantly lower than that in the control group (43.47%) ( χ 2=3.860, P=0.049). There was no significant difference in LEFS score between the two groups at 6 months after operation ( P>0.05).@*CONCLUSION@#Flow-through bridge anterolateral thigh flap can reduce postoperative complications of healthy feet and reduce the impact of surgery on blood supply and sensation of healthy feet. It is an effective method for repairing complex calf soft tissue defects.

Progress of epidermal growth factor in breast milk / 国际儿科学杂志

Breastfeeding plays a crucial role in the early and even later health of offspring.Epidermal growth factor(EGF)in breast milk is one of growth factor family members, which can regulate energy balance and is closely related to the growth and development of infants.In recent years, researchers at home and abroad have paid close attention to the research of EGF in breast milk.The paper summarizes the basic situation of EGF, and the content, the influencing factors, the main functions of EGF in breast milk and the risk relationship between EGF in breast milk and diseases, in order to point out the direction for further research of EGF in breast milk.

Clinical phenotypes and genetic features of epilepsy children with MBD5 gene variants / 中华儿科杂志

Objective: To summarize the phenotypes of epilepsy in patients with MBD5 gene variants. Methods: A total of 9 epileptic patients, who were treated in the Department of Pediatrics, Peking University First Hospital from July 2016 to September 2021 and detected with MBD5 gene pathogenic variants, were enrolled. The features of clinical manifestations, electroencephalogram (EEG), and neuroimaging were analyzed retrospectively. Results: Among 9 patients, 6 were male and 3 were female. Age at seizure onset ranged from 5 to 89 months. Multiple seizure types were observed, including generalized tonic clonic seizures (GTCS) in 7 patients, myoclonic seizures in 5 patients, focal seizures in 5 patients, atypical absence seizures in 3 patients, atonic seizures in 2 patients, myoclonus absence seizures in 1 patient, epileptic spasms in 1 patient, and tonic seizures in 1 patient. There were 8 patients with multiple seizure types, 2 patients with sensitivity to fever and 5 patients with clustering of seizures. Two patients had a history of status epilepticus. All patients had developmental delay before seizure onset. Nine patients had obvious language delay, and 6 patients had autism-like manifestations. Five patients had slow background activity in EEG. Interictal EEG showed abnormal discharges in 9 patients. Brain magnetic resonance imaging (MRI) was normal in all patients. A total of 9 epileptic patients carried MBD5 gene variants, all of them were de novo variants. There were MBD5 gene overall heterozygous deletion in 1 patient, large fragment deletions including MBD5 gene in 3 patients and single nucleotide variations (c.300C>A/p.C100X, c.1775delA/p.N592Tfs*29, c.1759C>T/p.Q587X, c.150_151del/p.Lys51Asnfs*6, c.113+1G>C) in 5 patients. The age at last follow-up ranged from 2 years and 9 months to 11 years and 11 months. At the last follow-up, 2 patients were seizure-free for more than 11 months to 4 years 6 months, 7 patients still had seizures. Conclusions: The initial seizure onset in patients with MBD5 gene variants usually occurs in infancy. Most patients have multiple seizure types. The seizures may be fever sensitive and clustered. Developmental delays, language impairments, and autistic behaviors are common. MBD5 gene variants include single nucleotide variations and fragment deletions. Epilepsy associated with MBD5 gene variants is usually refractory.

Repair of complex soft tissue defect in calf by ALTF with a cross-limb bridged "Y" shape vascular anastomosis: a report of 33 cases / 中华显微外科杂志

Objective:To explore the clinical effect of ALTF transfer with cross-limb bridged "Y" shape vascular anastomosis in repair of complex soft tissue defects in calf.Methods:From August 2010 to September 2020, 33 patients(23 males and 10 females) with complex traumatic soft tissue defects in calf were treated. Preoperative angiography and intraoperative exploration confirmed that there was only 1 main vessel remained in the affected calf or the wound surface and the vessel could not be anastomosed with the vascular pedicle of the ALTF. The size of flap were 16 cm × 8 cm to 25 cm × 18 cm. Two patients received bilobed ALTFs. A "Y" shape anastomosis between the artery of ALTF vascular pedicle and the posterior tibial artery of the contralateral lower limbs was made in all 33 patients to establish the blood supply to the transferred free ALTF. The "Y" shape cross-limb bridged blood vessels at the proximal end of the vascular pedicle artery of the flap were embedded at both ends of the cut-off superior ankle posterior tibial artery of the contralateral lower limb. The vein of the flap was anastomosed with the saphenous vein that associates with the posterior tibial artery. The surface of the suspended blood vessel "bridge" was wrapped with a free skin craft, and the lower limbs were fixed in a straight and parallel position with an external fixation frame. The perfused area of the flap was directly sutured or covered with a free skin craft. The vascular bridge was kept for 3 to 6 weeks before being separated. Outpatient follow-up after discharge.Results:All the patients were entered the postoperative follow-up was 13 months to 7 years, in an average of 25 months. Among the 33 flaps, 31 survived completely, except 1 had necrosis and the other 1 had partial necrosis at the distal end of the flap. The flaps received good blood supply, hence with soft texture and satisfactory appearance. Doppler or DSA was performed after the surgery on the posterior tibial artery of the healthy limb, and the vascular pulsation and patency were found normal. Donor sites for the free skin graft healed well.Conclusion:The ALTF transfer with cross-limb bridged "Y" vascular anastomosis is one of the effective techniques and it was employed in the repair of complex defects of calf soft tissue. It solved the tissue that there was only 1 main vessel or even without a suitable vessel could be anastomosed with the pedicle of the flap.

Progress on the phenotype of human corneal stromal cells / 中华实验眼科杂志

Human corneal stromal cells (HCSCs), a type of resting neural crest mesenchymal cell, are highly specialized transparent tissues responsible for the secretion of stroma and play an important role in maintaining the transparency of the cornea and the normal visual function of human eye.Normally, corneal stromal cells are quiescent, flat and dendritic.After the cornea is stimulated by trauma, the corneal stromal cells will be activated, and the activated human corneal keratocytes (HCK) will turn to a repair phenotype, undergo apoptosis or transform to corneal fibroblast phenotype and myofibroblast phenotype.The phenotype transformation of HCSCs is closely related to the formation of scar tissue and the reduction of ocular transparency caused by the repair process of human corneal injury.In this article, three phenotypes, phenotypic markers, phenotype transformation and in vitro transformation mechanisms of HCSCs were reviewed, and it was found that corneal fibrosis could be inhibited by interfering with the transformation process of HCK to fibrotic phenotype and TGF-β/Smad signaling pathways.Therefore, in-depth study of the molecular mechanism of phenotypic transformation of HCSCs and the regulatory mechanism of intervention in corneal scarring formation is helpful for prevention and treatment of corneal fibrosis and postoperative corneal opacity in patients.

Literature study on herbal medicine of Borneol / 国际中医中药杂志

As a collective noun of incense and medicine, fragrant medicine has long been integrated into Chinese culture. It is not only a symbol of the cultural exchange between China and foreign countries in the middle ancient times, but also plays a very important role in medicine and other fields. Among them, Borneol can not only be used for medicinal purposes, but also for incense and fumigation, as well as food, tea, wine and other applications. This paper intends to sort out the medicinal properties, effects and other applications of Borneol recorded in ancient books of traditional Chinese herbs in the past dynasties, focusing on summarizing its medicinal properties, meridians, effects, compatibility and application characteristics. In addition, modern pharmacological action was included as a supplement, in order to provide reference for the clinical use of Borneol in medicinal aspects.

Identification of metabolites of Zhali Nusi Prescription in rat plasma, bile, urine and feces after oral administration / 中国中药杂志

This study was designed to determine the metabolites of Zhali Nusi Prescription(ZLNSP) in rats. The ultra-high performance liquid chromatography-LTQ Orbitrap mass spectrometric(UHPLC-LTQ-Orbitrap-MS) and mass defect filter techniques were applied to analyze the metabolites of ZLNSP in rat plasma, bile, urine and feces. The biological samples were analyzed by ACQUITY UPLC BEH T_3 column(2.1 mm×100 mm,1.7 μm), with 0.1% formic acid water(A)-acetonitrile(B) as mobile phase, and the biological samples were analyzed in negative ion mode by electrospray ionization mass spectrometry(ESI-MS). An analytical method for biological samples of rats was established, and 8 prototype components and 36 metabolites were identified. The results showed that the metabolic pathways of the main components of ZLNSP in rats included methylation, glucuronidation, sulfation and so on. It provi-ded information for the therapeutic effect of ZLNSP in vivo.

Relationship between peripheral neuropathy and vitamin D in elderly patients with type 2 diabetes / 中华老年医学杂志

Objective@#To investigate the levels of vitamin D and the correlation between DPN and vitamin D in elderly patients with diabetic peripheral neuropathy(DPN).@*Methods@#A total of 849 patients aged 60 years and over admitted into endocrinology department from June 2016 to September 2017 were enrolled in this retrospective case-control study.According to DPN diagnostic criteria, patients were divided into the non-DPN group(n=542)and the DPN group(n=307). The 25(OH)-vitamin D[25(OH)D]level and blood biochemical parameters were determined and compared between the two groups.The risk factors for DPN were analyzed using logistic regression analysis and plotting receiver operating characteristic(ROC)curves.@*Results@#The mean of serum 25(OH)D level in the 849 patients was 43.9±19.4 nmol/L.Serum 25(OH)D level was lower in the DPN patients than in the non-DPN patients[(40.9±20.4)nmol/L vs.(45.7±18.6)nmol/L, P<0.05]. The incidence of 25(OH)D deficiency was higher in the DPN group than in the non-DPN group(72.3% or 222/307 vs. 64.6% or 350/542, P<0.05). Binary logistic regression analysis indicated that 25(OH)D was a protective factor for DPN(OR=0.980, 95% CI: 0.964~0.995, P<0.05)and the disease duration was a risk factor for DPN(OR=1.048, 95% CI: 1.027~1.070, P<0.001). ROC analysis indicated that the diagnostic cut-off value of serum 25(OH)D for predicting DPN was 37.5nmol/L, with a Youden index of 0.17, sensitivity of 0.65 and specificity of 0.52.@*Conclusions@#The 25(OH)D level is much lower in diabetic patients, especially in DPN patients.Higher 25(OH)VD level might be a protective factor for DPN, and vitamin D might be one of potential biomarkers for DPN in diabetic patients.

Relationship between peripheral neuropathy and vitamin D in elderly patients with type 2 diabetes / 中华老年医学杂志

Objective To investigate the levels of vitamin D and the correlation between DPN and vitamin D in elderly patients with diabetic peripheral neuropathy(DPN).Methods A total of 849 patients aged 60 years and over admitted into endocrinology department from June 2016 to September 2017 were enrolled in this retrospective case-control study.According to DPN diagnostic criteria,patients were divided into the non-DPN group(n=542)and the DPN group(n=307).The 25 (OH)-vitamin D[25(OH)D]level and blood biochemical parameters were determined and compared between the two groups.The risk factors for DPN were analyzed using logistic regression analysis and plotting receiver operating characteristic(ROC)curves.Results The mean of serum 25(OH)D level in the 849 patients was 43.9± 19.4 nmol/L.Serum 25(OH)D level was lower in the DPN patients than in the non-DPN patients [(40.9 ± 20.4) nmol/L vs.(45.7 ± 18.6) nmol/L,P ＜ 0.05].The incidence of 25(OH)D deficiency was higher in the DPN group than in the non-DPN group(72.3％ or 222/307 vs.64.6％ or 350/542,P＜0.05).Binary logistic regression analysis indicated that 25(OH) D was a protective factor for DPN(OR =0.980,95％ CI:0.964～0.995,P ＜0.05)and the disease duration was a risk factor for DPN(OR =1.048,95％ CI:1.027～1.070,P＜0.001).ROC analysis indicated that the diagnostic cut-off value of serum 25(OH)D for predicting DPN was 37.5nmol/L,with a Youden index of 0.17,sensitivity of 0.65 and specificity of 0.52.Conclusions The 25 (OH)D level is much lower in diabetic patients,especially in DPN patients.Higher 25(OH)VD level might be a protective factor for DPN,and vitamin D might be one of potential biomarkers for DPN in diabetic patients.

Status and Unmet Needs of Family Rehabilitation for Children with Disabilities / 中国康复理论与实践

@#Objective To investigate the current status of family rehabilitation for children with disability and the unmet needs of habilitation/rehabilitation for their parents. Methods Family Rehabilitation Needs Survey Questionnaire was used to investigate 186 families of the children with disability from 5 rehabilitation institutions in 4 provinces. Results Most families accepted family rehabilitation, including family support, developed rehabilitation scheme, telephone counseling, real-time guidance and appointment for family rehabilitation. Most families would spent 1-2 hours a day for the family rehabilitation, and prefer the rehabilitation of gross motion. However, the rehabilitation agencies played less importance on supports of family rehabilitation. Conclusion The family rehabilitation supports needs to be improved in specification of rehabilitation process, developing rehabilitation scheme and quality control.

Status and Unmet Needs of Family Rehabilitation for Children with Disabilities / 中国康复理论与实践

Objective To investigate the current status of family rehabilitation for children with disability and the unmet needs of habili-tation/rehabilitation for their parents. Methods Family Rehabilitation Needs Survey Questionnaire was used to investigate 186 families of the children with disability from 5 rehabilitation institutions in 4 provinces. Results Most families accepted family rehabilitation, including family support, developed rehabilitation scheme, telephone counseling, real-time guidance and appointment for family rehabilitation. Most families would spent 1-2 hours a day for the family rehabilitation, and prefer the rehabilitation of gross motion. However, the rehabilitation agencies played less importance on supports of family rehabilitation. Conclusion The family rehabilitation supports needs to be improved in specification of rehabilitation process, developing rehabilitation scheme and quality control.

Study on canceration law of gastric mucosal dysplasia based on syndromes of Chinese medicine / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the syndrome evolution law of Chinese medicine (CM) in the patients with gastric mucosal dysplasia.</p><p><b>METHODS</b>Three hundred and twenty four gastric mucosal dysplasia patients with deficiency and excess correlation syndromes were enrolled by a multi-center collaboration for two years' clinical follow-up to detect the levels of tumor supplied group of factors (TSGF) and carcino-embryonic antigen (CEA).</p><p><b>RESULTS</b>Among the 324 cases, 29 cases turned cancer in the two years, and the canceration rate was 9.0%. The three syndromes with higher canceration rate were the damp-heat accumulating Wei syndrome concurring or combining with asthenia-cold in Pi and Wei syndrome for 16.7%; stagnation in Wei collaterals syndrome concurring or combining with asthenia of both qi and yin syndrome for 13.2%; stagnation of Gan and Wei qi syndrome concurring or combining with asthenia-cold in Pi and Wei syndrome for 8.0%, respectively. Among the three syndromes, the highest level of TSGF occurred in the former two syndromes. In the half year before carcinogenesis, the syndromes of the patients took on deficiency and excess concurrent syndromes, and the deficiency syndromes involving the qi and blood deficiency syndrome and the Shen deficiency syndrome accounting for 48.0%.</p><p><b>CONCLUSIONS</b>Gastric mucosal dyspalsia canceration syndromes took on the polymorphism of excess and deficiency concurrent syndromes and had the characteristics of deficiency syndromes involving qi and blood deficiency syndrome and Shen-yin-yang deficiency syndrome.</p>

Expression of Na+-H+ exchanger 1 in human gastric carcinoma tissue and its clinical significance / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To determine the expression of Na+/H+ exchanger 1(NHE1) in human gastric carcinoma tissue and to investigate the association between NHE1 expression and clinicopathological characteristics.</p><p><b>METHODS</b>The expressions of NHE1 mRNA and protein were detected in both gastric carcinoma tissue (n=60) and adjacent gastric mucosa tissue (n=30) by reverse transcription polymerase chain reaction (RT-PCR) and Western blot. The association between the expression and the clinicopathological characteristics was analyzed.</p><p><b>RESULTS</b>The relative expression levels of NHE1 mRNA and protein in gastric carcinoma tissue were 0.786+/-0.291 and 1.442+/-0.175, which were significantly higher than those in adjacent gastric mucosa tissue (0.369+/-0.052 and 0.348+/-0.029) (P<0.01). The expression of NHE1 mRNA was positively correlated with NHE1 protein in the gastric carcinoma tissue (r=0.264, P<0.05). The expressions of NHE1 mRNA and protein were associated with the depth of invasion, lymph node metastasis, and TNM staging (P<0.05). However, no statistical difference was found in age, gender, and tumor differentiation (P>0.05).</p><p><b>CONCLUSION</b>The expression levels of NHE1 mRNA and protein are significantly up-regulated in gastric carcinoma tissue, which may be involved in the development of gastric carcinoma.</p>

Effect of the amount of portal blood stasis removal on endotoxemia and liver function after liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the influence of the amount of portal blood stasis removal on endotoxemia and liver function after liver transplantation.</p><p><b>METHODS</b>Forty-seven patients who received liver transplantation from February 2006 to November 2007 were divided into 2 groups according to the amount of portal blood stasis removal during operation: group A (n = 26) 50 ml and group B (n = 21) 200 ml of portal blood stasis removal respectively. The levels of plasma endotoxin, D-lactate, tumor necrosis factor-alpha, interleukin-6, liver function and blood coagulation were examined and analyzed.</p><p><b>RESULTS</b>Under the condition of no significant difference in sex, age, primary liver diseases and Child-pugh's classification, cold ischemic time, total operation and anhepatic time, operation methods, volume of blood loss and transfusion, and all preoperative observations. Most of observations showed the restoration of the patients in group B was better than that in group A. The plasma levels of endotoxin, D-lactate, tumor necrosis factor-alpha, interleukin-6, alanine aminotransferase, aspartate aminotransferase, prothrombin time and activated partial thromboplastin time in group B were significantly lower than those in group A (P < 0.05). The level of plasma prealbumin in group B was significantly higher than that in group A (P < 0.05).</p><p><b>CONCLUSIONS</b>The removal of 200 ml portal blood stasis leads to a better results than that of 50 ml, and it can help alleviate endotoxemia and facilitate the restoration of the liver function after liver transplantation.</p>

Design and Functional Investigation of a Novel Anti-coagulative Fusion Protein by Hirudin With a Recognizing Sequence of FXa / 中国生物工程杂志

Hirudin (HV) is known as the most potent and specific inhibitor of thrombin. Although hirudin has many advantages , it has the bleeding side effect and this is the great shortage of hiudin for clinical application. In order to alleviate bleeding side effect of hirudin, fusion protein, named as FHV (fusion hirudin linked with FXa recognition peptide) was designed. The fusion protein gene ( fhv) was cloned into plasmid pPIC9K. FHV engineered Pichia pastoris containing high copies was chosen for fermentation and purification at 30 L fermentor scale, finally, FHV with purity of above 97% was obtained. To investigate the function of FHV in vivo, mouse tail thrombosis model was used. In the mice thrombus tail model induced by carrageenan, FHV decreased the length of tail thrombus significantly, similar to that of HV control, and had no obvious effects on the TT, PT and APTT. In conclusion, FHV is constructed and expressed in yeast. FHV fusion proteins is obtained by fermentation and purification. FHV has antithrombotic effects not influencing IT, PT and APTT after administration immediately in animal models. Therefore, FHV is a promising anticoagulant and antithrombotic drug.