Investigation on the chronic disease management of hypertension in county-level medical institutions in China / 中华医院管理杂志

Objective:To investigate the development of hypertension specialty and chronic disease management of county-level hospitals in China, for reference in improving the standardized chronic disease management level of hypertension in the counties.Methods:From September to November 2020, a questionnaire survey on 597 county-level hospitals in 24 provinces was conducted on a voluntary basis. The survey covered such areas as the setup of hypertension specialty, team building of professionals and the management regulations of chronic hypertension of the hospital. The survey data were analyzed by descriptive statistics.Results:Among the 597 county-level hospitals, 54(13.5%) hospitals had independent hypertension departments, 147(24.6%) had hypertension clinics, and 143(24.0%) hospitals had hypertension beds. 431(72.2%) hospitals had hypertension diagnosis and treatment process in outpatient clinics, 454(76.0%) hospitals had hypertension diagnosis and treatment process in wards, and 535(89.6%) hospitals had graded diagnosis and treatment process of hypertension. 473(79.2%) hospitals had established county medical alliance as the lead unit, including 167 compact medical alliances. 97.7% of the hospitals were equipped with basic hypertension risk stratification screening items, and 63.8% could carry out primary screening of secondary hypertension.Conclusions:The pattern of chronic diseases management of hypertension in county-level medical institutions has basically taken shape, but there is still room for improvement. In the future, we should focus on the construction of professional teams of hypertension, the standardized management of diagnosis and treatment of hypertension, and a smoother path of tiered medical service, so as to increase the health management level of hypertension in China.

Expert recommendations for diabetes with or without COVID-19 management in communities / 中华内分泌代谢杂志

Since December 2019, the outbreak of coronavirus disease 2019 (COVID-19) has occurred in China. Higher risk of COVID-19 infection and worse prognosis were observed among patients with diabetes. There are rigorous challenges existing in terms of diabetes prevention and glycemic control in primary medical care during period of COVID-19. Here, expert recommendations were presented by Chinese diabetologists, healthcare providers, and public health administrators to improve the ability of primary health facilities and provide standardized basic public health and medical services throughout the country. The main contents include basic requirements for management, workflow of health management, referral, treatment, as well as the long-term follow-up.

Expert recommendations for diabetes with or without COVID-19 management in communities / 中华内分泌代谢杂志

Since December 2019, the outbreak of coronavirus disease 2019 (COVID-19) has occurred in China. Higher risk of COVID-19 infection and worse prognosis were observed among patients with diabetes. There are rigorous challenges existing in terms of diabetes prevention and glycemic control in primary medical care during period of COVID-19. Here, expert recommendations were developed by Chinese diabetologists, healthcare providers, and public health administrators to improve the ability of primary health facilities and provide standardized basic public health and medical services throughout country. The main contents include basic requirements for management, workflow of health management, referral, treatment, and long-term follow-up.

Tag single nucleotide polymorphism rs1532624 located in cholesteryl ester transfer protein gene is associated with atherosclerosis cerebral ischemia

Objective: To investigate the relationship between polymorphisms of rs1532624 and rs289741 loci in cholesteryl ester transfer protein (CETP) genes and atherosclerotic cerebral infarction (ACI). Methods: The CETP gene rs1532624 and rs289741 in 95 patients with ACI and 177 healthy subjects were genotyped by MassARRAY mass spectrometry. Each locus genotype and allele frequency distributions were compared. Results: The difference of allele frequency distribution between the rs1532624 (χ

Tag single nucleotide polymorphism rs1532624 located in cholesteryl ester transfer protein gene is associated with atherosclerosis cerebral ischemia

Objective:To investigate the relationship between polymorphisms of rs1532624 and rs289741 loci in cholesteryl ester transfer protein (CETP) genes and atherosclerotic cerebral infarction (ACI).Methods:The CETP gene rs1532624 and rs289741 in 95 patients with ACI and 177 healthy subjects were genotyped by MassARRAY mass spectrometry. Each locus genotype and allele frequency distributions were compared.Results:The difference of allele frequency distribution between the rs1532624 (χConclusion:ACI have a positive correlation with rs1532624 polymorphism, and AA genotype may be susceptible factors of ACI.

Combining endometrium sampling device and SurePath preparation to screen for endometrial carcinoma: a validation study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The aim of this study was to compare specimen adequacy of SAP-1 provided for cytology with that of dilation and curettage (D & C) or hysteroscopy for histology, and evaluate the accuracy of combining endometrium sampling by SAP-1 and liquid-based cytology using SurePath preparation for screening endometrial carcinoma and its precursor.</p><p><b>METHODS</b>Endometrial specimens from women (n = 1514) with risk factors were obtained using an SAP-1 device for cytological analysis; histological samples were obtained from 375 of these women who underwent D & C or hysteroscopy. Cytological specimens were prepared to liquid-based smear using SurePath technology and stained by Papanicolaou. Histological samples were processed in routine pathology and stained by hematoxylin and eosin.</p><p><b>RESULTS</b>Adequate specimens for cytology were obtained from 1458/1541 patients (96.3%), while adequate samples for pathology were obtained from 285/375 patients (76%). However, for postmenopausal women, 1006 of 1045 cytology (86.3%) were adequate, 153 of 238 histology (64.3%) were adequate, it was easier to collect cytological specimens than histological specimens (P < 0.05). The accuracy of endometrial cytology for detecting endometrial carcinoma and its precursor was 92.4% (sensitivity, 73%; specificity, 95.8%; positive predictive value, 75%; and negative predictive value, 95.3%).</p><p><b>CONCLUSIONS</b>Endometrial cytology using SAP-1 sampling and SurePath preparation may be a reliable approach for screening patients with endometrial carcinoma and its precursor.</p>

Preparation of low immunogenic porcine dermal scaffold and evaluation of its cytocompatibility / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the changes in the structure and cytocompatibility of porcine acellular dermal matrix, which was prepared with dermal reticular layer, treated with matrix metalloproteinase 7 (MMP-7), genipin, and vacuum freeze-drying.</p><p><b>METHODS</b>Fifty-four pieces of porcine dermal reticular layer, prepared with lateral abdominal skin were obtained from healthy large Yorkshire pig with mechanical method under sanitary condition, each 10.0 mm×5.0 mm in size and 0.5 - 0.6 mm in thickness. They were divided into normal control group (A(1), without treatment, n = 6), decellularization group (B, decellularized, n = 12), decellularization + MMP-7 group (C, treated with MMP-7 after decellularization, n = 12), decellularization + MMP-7 + genipin group (D, treated with MMP-7 and genipin after decellularization, n = 12), and decellularization + MMP-7 + genipin + vacuum freeze-drying group (E, treated with MMP-7, genipin, and vacuum freeze-drying after decellularization, n = 12) according to the random number table. Meanwhile, 6 pieces of human acellular dermal matrix, with the same size and thickness as listed above, were taken as control group (A(2), without treatment) in the cytocompatibility tests. HE staining and scanning electron microscope were used to detect the cell number and the change in tissue structure in dermal scaffold in groups A(1) and B-E. Immunohistochemical staining was used to determine residual vimentin, laminin and collagen IV in groups A(1), B, and C. Cytotoxicity tests were employed to test the cytotoxicity of the leaching solutions of groups B-E. Human fibroblasts were seeded on the surface of dermal scaffold in groups A(2) and B-E. The proliferation of fibroblasts were determined on post culture day (PCD) 3, 7, and 14, and the content of IL-6 and IL-8 in the supernatant were determined on PCD 3 and 7 with enzyme-linked immunosorbent assay. Data were processed with two-way analysis of variance and LSD- t test.</p><p><b>RESULTS</b>Granular structure with hair follicle in pale yellow color was observed in group A(1). Small amount of hair, epithelial root sheath, nuclei, cell debris-like structure, vimentin, laminin, and collagen IV were observed in group B but not in group C, D, or E, which had been treated with MMP-7. The toughness of dermal scaffold was stronger in groups D, E than in groups B and C as observed in gross condition observation. The collagen fibers of dermal scaffold in groups C-E maintained their structural integrity with similar arrange as that of group A(1). The interspaces among collagen fibers in groups C-E were all increased, while those of groups C and D were similar but larger than that in group B; the interspace in group E was the largest. Groups B-E scored level 0 or 1 in the cytotoxicity test. Fibroblasts could proliferate on the surface of dermal scaffold in groups A(2) and B-E. Furthermore, with the extension of culture time, fibroblasts gradually became to be stratified to form multiple layers, and they proliferated toward the dermis. High density of fibroblasts was observed on the surface in groups D and E and in the deep layer in groups A(2) and C. On PCD 7, the contents of IL-6 [(132 ± 14), (104 ± 9), (122 ± 14), (120 ± 12), (128 ± 17) pg/mL] and IL-8 [(135 ± 18), (102 ± 17), (127 ± 18), (134 ± 23), (141 ± 24) pg/mL] in the supernatant in groups A(2) and B-E were significantly higher than those on PCD 3 [(55 ± 13), (34 ± 8), (48 ± 8), (50 ± 13), (49 ± 12) pg/mL] and [(93 ± 19), (63 ± 11), (82 ± 15), (82 ± 16), (89 ± 16) pg/mL], with F values respectively 98.869, 184.038, 125.531, 93.237, 87.265 and 15.694, 23.451, 22.801, 19.607, 18.808, P values below 0.05. The differences among groups A(2) and B-E in the levels of IL-6 and IL-8 at each time point were statistically significant (with F values respectively 2.809, 3.301 and 3.757, 3.266, P values below 0.05). The differences among groups A(2), C, D, and E in amount of IL-6 and IL-8 at each time point were not statistically significant (with t values respectively 0.058 - 1.905 and 0.034 - 1.295, P values above 0.05), but they were all higher than those in group B (with t values respectively 3.707 - 5.612 and 2.785 - 4.079, P values below 0.05).</p><p><b>CONCLUSIONS</b>The low immunogenic porcine dermal scaffold treated with MMP-7, genipin, and vacuum freeze-drying after decellularization, has good cytocompatibility. The growth of only a few fibroblasts in the dermal scaffold may be correlated with genipin, which increases tissue toughness.</p>

Expression of high mobility group box chromosomal protein 1 in mice with lupus nephritis / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To determine the role of the novel proinflammatory cytokine high mobility group box chromosomal protein 1 (HMGB-1) in the pathogenesis of lupus nephritis.</p><p><b>METHODS</b>Serum levels of anti-dsDNA antibodies were determined by enzyme linked immunosorbent assay (ELISA). Renal morphologic features were examined by light microscopy, electron microscopy, and immunohistologic analyses. The mRNA expression of HMGB-1 and monocyte chemoattractant protein-1 (MCP-1) was detected by RT-PCR.</p><p><b>RESULT</b>MRL/lpr mice demonstrated characteristic alterations of serum immune parameters, with progressively increased anti-dsDNA antibodies with age, compared with age-matched C57BL/6J mice. MRL/lpr mice showed progressive development of renal damage, starting at 12 weeks of age and reached the peak at 20 weeks. The observed lesions included the presence of enlarged hypercellular glomeruli, with increased numbers of both resident cells and infiltrating leukocytes. Higher expression of HMGB-1 mRNA was found in MRL/lpr mice than what in C57BL/6J mice. Expression of HMGB-1 was positively correlated with that of MCP-1 mRNA.</p><p><b>CONCLUSION</b>The results demonstrate that the higher expression of HMGB-1 may contribute to the pathogenesis of lupus nephritis.</p>

Immunosuppressive function of histone deacetylases inhibitors: Recent progress / 第二军医大学学报

Histone deacetylases inhibitors (HDACIs) are a group of compound regulating gene expression at transcriptional level. HDACIs can induce protein hyperacetylation and subsequently lead to chromatin remodeling, cell-cycle arrest, cell differentiation and apoptosis, and transcriptional activation and repression. HDACIs demonstrate promising antitumor activity and are presently tested in clinical studies for solid and hematologic malignancies. Cumulating evidence in animal models of immune disorders also suggests immunosuppressive properties of HDACIs, which provides us with new ideas for treating immune disorders and rejection after transplantation. This paper reviews the recent progress of immunosuppressive function induced by HDACIs from the following aspects: immune diseases, T lymphocytes, inflammatory cytokines and dendritic cells.

Clinicopathological significance of aberrant methylation of the fragile histidine triad gene in patients with hepatocellular carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the aberrant methylation of fragile histidine triad (FHIT) gene and to explore possible relationship between the aberrant methylation of FHIT and clinicopathological features in hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>The hypermethylation of FHIT was detected by the methylation specific PCR (MSP) method in 45 patients with HCC (tumoral and nontumoral tissue), 14 cases of normal livers and 4 HCC cell lines (SK-Hep-1, Hep-G2, Hep-3B and Huh7). The correlation of FHIT methylation and clinicopathological features was analyzed.</p><p><b>RESULTS</b>The frequencies of hypermethylation of FHIT in tumoral and nontumoral tissue, normal liver and cell lines were 71.1%, 64.4%, 14.3% and 75.0%, respectively. A significant relation between hypermethylation of FHIT and poor survival was present (P = 0.0430).</p><p><b>CONCLUSIONS</b>Hypermethylation of FHIT is a frequent and early event in HCC, it might relate to a poor prognosis for patients with HCC.</p>

The clinical analysis of free patellar implantation in repairing the defect of the knee of giant cell tumors / 中华外科杂志

<p><b>OBJECTIVE</b>To analysis the clinical effects of free patellar implantation in treating the defect of the knee joint after the excision of giant cell tumor in the distal femur and the proximal tibia.</p><p><b>METHODS</b>If the giant cell tumor in the distal femur and the proximal tibia invaded the articular surface, we resected the condyle of femur or tibia including the tumor, dissociated the patella and placed it in the condyle horizontally to repair the articular surface. The cruciate ligament was reserved in all the patients. The condyle of femur or tibia was replaced by the anterior surface or the articular surface of the patella respectively. The implanted patella was fixed by the screw to the contralateral condyle, and the remaining defect was filled by autogenous cancellous illium.</p><p><b>RESULTS</b>Nine patients were followed up 3 to 121 months, the average was 65 months. None of them recurred or metastated. The excellent and good rate of the functional evaluation of knee joints was 88.9%.</p><p><b>CONCLUSION</b>After resecting the condyle of femur or tibia including the tumors which invade the articular surface, we find that free patellar implantation is a suitable way to repair the defect of the knee.</p>

Arthroscopic anterior cruciate ligament reconstruction: a comparison between bone-patellar tendon-bone autograft and two-strand hamstring tendon autograft / 中华创伤杂志

Objective To evaluate arthroscopic reconstruction of a torn anterior cruciate ligament with either a central-third bone-patellar tendon-bone autograft or a two-strand semitendinosus-gracilis autograft and compare the results of clinical testing, satisfaction and functional status. Methods A retrospective study was done on 49 cases undergoing reconstruction with an ipsilateral central-third bone-patellar tendon-bone autograft and 54 treated with an ipsilateral two-strand semitendinosus-gracilis autograft. Patients were followed up for an average of 31.6 months (24-48 months). At the time of final follow-up, patients in each group were evaluated by Lysholm knee score, International Knee Documentation Committee (IKDC) rating scale and KT-1000 arthrometer for ACL ligament stability. Results No statistical difference was found between the groups in regard of the Lysholm knee score, overall IKDC score or KT-1000 arthrometrical measurements that stand for patient satisfaction, knee function and objective stability, respectively. The patellar tendon procedure group had a significantly higher knee pain rate than the hamstring group (37% versus 11%). Conclusions The bone-patellar tendon-bone autograft and the two-strand semitendinosus-gracilis autograft can attain comparable results for anterior cruciate ligament reconstruction in regard to patient satisfaction, knee stability and knee function in the medium-term follow-up. However, reconstruction of anatomic attachment sites, firm initial fixation and a structured postoperative rehabilitation program may have more influence on clinical outcomes and knee stability.