Clinical efficacy of free deep inferior epigastric artery perforator flap in repair of large wounds in upper limb / 中华显微外科杂志

Objective:To summarise the clinical efficacy of free deep inferior epigastric artery perforator flap (DIEPF) in repairing large wounds in upper limb.Methods:From June 2016 to March 2022, free DIEPF repair surgery were performed for 9 cases with large defects in elbow, forearm and wrist in the Department of Hand Surgery, Xuzhou Renci Hospital. The patients were 3 males and 6 females at 36-65(average 50) years old. The sizes of defect ranged from 6.0 cm×7.0 cm to 25.0 cm×33.0 cm. Seven defects combined with radius-ulnar fracture, 4 with wrist fracture, 4 with metacarpal fracture and 1 with humerus fracture. All defects had various degrees of injuries of tendon, blood vessel and nerve. A total of 10 flaps were harvested, and the size of flaps were 7.0 cm×8.0 cm-12.0 cm×35.0 cm. Vessels in 7 flaps of 6 patients were anastomosed with unilateral vascular pedicles and 3 with bilateral vascular pedicles. End-to-end arterial anastomosis was performed on 1 flap, and the other 9 flaps of 8 patients had end-to-side arterial anastomoses. End-to-end vein anastomoses were performed on all flaps. Umbilical reconstruction was performed at the abdominal donor site for 3 patients, and all donor site wounds were closed in stage I surgery. Scheduled outpatient and WeChat follow-up were made after surgery.Results:Nine flaps in 8 patients survived successfully. Partial skin necrosis occurred in 1 flap and repaired by skin grafting. Follow-up lasted for 6 to 60 months(12 months in average). At the last follow-up, the colour of the flaps was found being similar to the surrounding skin with mildly bloated and soft in texture. Sensation of the flaps recovered to S 2 in 5 patients, and not detected in 4 cases. Conclusion:The free DIEPF has a relatively constant perforator and the flap can be used for repairing a large area of defect. The donor site wound can be closed in Ⅰ stage surgery. Free DIEPF is suitable for repair of large upper limb wounds.

Dihydromyricetin mediates epithelial mesenchymal transformation and regulates the proliferation and apoptosis of esophageal squamous cell carcinoma cells / 中华肿瘤杂志

Objective: To study the effects of dihydromyricetin (DMY) on the proliferation, apoptosis and epithelial mesenchymal transition (EMT) of esophageal squamous cell carcinoma (ESCC) cell KYSE150 and KYSE410. Methods: KYSE150 and KYSE410 cells were treated with different concentrations of DMY (0, 25, 50, 100, 150, 200 μmol/L) for 24 hours. The median inhibition concentration (IC50) values of KYSE150 and KYSE410 were detected by cell counting kit-8 (CCK-8) method. Then 0.5‰ dimethyl sulfoxide (DMSO) was used as control group, dihydromyricetin (DMY), dihydromyricetin and transforming growth factor-β1 (DMY+ TGF-β1), transforming growth factor-β1 (TGF-β1) were used as experimental group. Cell proliferation and apoptosis rates were measured by clonal formation and flow cytometry. Transwell invasion and wound healing assay were used to detect cell invasion and migration. The protein expression levels of Caspase-3, Caspase-9, Bcl-2, Bax, Smad2/3, phosphorylation-Smad2/3 (p-Smad2/3) and Vimentin were detected by western blot. Results: The IC50 values of DMY on KYSE410 and KYSE150 cells were 100.51 and 101.27 μmol/L. The clone formation numbers of KYSE150 and KYSE410 in DMY group [(0.53±0.03) and (0.31±0.03)] were lower than those in DMSO group [(1.00±0.10) and (1.00±0.05), P<0.05]. The apoptosis rates of KYSE150 and KYSE410 cells in DMY group [(1.84±0.22)% and (2.80±0.07)%] were higher than those in DMSO group [(1.00±0.18)% and (1.00±0.07)%, P<0.05]. The invasion numbers of KYSE150 and KYSE410 cells in DMY group [(0.42±0.03) and (0.29±0.05)] were lower than those in DMSO group [(1.00±0.08) and (1.00±0.05), P<0.05]. The migration rates of KYSE150 and KYSE410 cells in DMY group [(0.65±0.14)% and (0.40±0.17)%] were lower than those in DMSO group [(1.00±0.10)% and (1.00±0.08)%, P<0.05]. The clone formation numbers of KYSE150 and KYSE410 in TGF-β1 group [(1.01±0.08) and (0.99±0.25)] were higher than those in DMY+ TGF-β1 group [(0.73±0.10) and (0.58±0.05), P<0.05]. The apoptosis rates of KYSE150 and KYSE410 cells in TGF-β1 group [(0.81±0.14)% and (1.18±0.10)%] were lower than those in DMY+ TGF-β1 group [(1.38±0.22)% and (1.85±0.04)%, P<0.05]. The invasion numbers of KYSE150 and KYSE410 cells in TGF-β1 group [(1.19±0.11) and (1.39±0.11)] were higher than those in DMY+ TGF-β1 group [(0.93±0.09) and (0.93±0.05), P<0.05]. The migration rates of KYSE150 and KYSE410 cells in TGF-β1 group [(1.87±0.19)% and (1.32±0.04)%] were higher than those in DMY+ TGF-β1 group [(0.86±0.16)% and (0.77±0.12)%, P<0.05]. The protein expression levels of Bax, Caspase-3 and Caspase-9 in KYSE150 and KYSE410 cells in DMY group were higher than those in DMSO group, while the protein expression level of Bcl-2 was lower than that in DMSO group (P<0.05). The protein expression levels of p-Smad2/3, Smad2/3 and Vimentin in KYSE150 and KYSE410 cells in DMY group were lower than those in DMSO group (P<0.05). The protein expression levels of Bax, Caspase-3 and Caspase-9 in KYSE150 and KYSE410 cells in TGF-β1 group were lower than those in DMY+ TGF-β1 group, and the protein expression level of Bcl-2 was higher than that in DMY+ TGF-β1 group (P<0.05). The protein expression levels of Bax, Caspase-3 and Caspase-9 in KYSE150 and KYSE410 cells in DMY+ TGF-β1 group were lower than those in DMY group, and the protein expression level of Bcl-2 was higher than that in DMY group (P<0.05). The protein expression levels of p-Smad2/3, Smad2/3 and Vimentin in KYSE150 and KYSE410 cells in TGF-β1 group were higher than those in DMY+ TGF-β1 group (P<0.05). Conclusion: DMY can inhibit the proliferation and EMT of ESCC mediated by TGF-β1 and promote cell apoptosis.

Chimeric bone flap pedicled with superficial palmar branch of radial artery in reconstruction of fingers with composite tissue defect / 中华显微外科杂志

Objective:To investigate the clinical effect of free chimeric bone flap pedicled with superficial palmar branch of radial artery in reconstruction of partial finger with composite tissue defect.Methods:From July, 2018 to January, 2020, 9 cases of compound tissue defect of fingers were reconstructed by free transfer of chimeric bone flap pedicled with superficial palmar branch of radial artery. The wrist transverse striated flap and distal radius bone flap pedicled with superficial palmar branch of radial artery were harvested in operations. The size of flap were 2.0 cm × 4.0 cm -3.0 cm × 6.5 cm, and the length of bone flaps were 1.5-2.5 cm. All patients entered monthly follow-up by clinic visit in 6 months after the surgery, and thereafter by WeChat interviews.Results:All of the 9 chimeric bone flaps survived well. The average healing time of bone flap was 1.7 months, and the average length of reconstructed finger was 2.4(1.8-3.0) cm; The appearance of the affected fingers restored well, the scars of the donor sites were mild, and average of the TPD of the flaps was 6.6(5.3-8.6) mm at 6 months after the surgery. The function of the affected finger was evaluated according to the Trial Standard of the Upper Limb Function Evaluation proposed by the Hand Surgery Society of the Chinese Medical Association: excellent in 7 cases, good in 1 case and medium in 1 case.Conclusion:Free chimeric bone flap pedicled with superficial palmar branch of radial artery can be used in reconstruction of the soft tissue and bone defects of fingers at the same time. It restores the functional length of fingers, improves the function and appearance of fingers, with less damage to the donor site. It is a simple method for reconstruction of finger defects.

Development and validation of an individualized nomogram for early prediction of the duration of SARS-CoV-2 shedding in COVID-19 patients with non-severe disease / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

With the number of cases of coronavirus disease-2019 (COVID-19) increasing rapidly, the World Health Organization (WHO) has recommended that patients with mild or moderate symptoms could be released from quarantine without nucleic acid retesting, and self-isolate in the community. This may pose a potential virus transmission risk. We aimed to develop a nomogram to predict the duration of viral shedding for individual COVID-19 patients. This retrospective multicentric study enrolled 135 patients as a training cohort and 102 patients as a validation cohort. Significant factors associated with the duration of viral shedding were identified by multivariate Cox modeling in the training cohort and combined to develop a nomogram to predict the probability of viral shedding at 9, 13, 17, and 21 d after admission. The nomogram was validated in the validation cohort and evaluated by concordance index (C-index), area under the curve (AUC), and calibration curve. A higher absolute lymphocyte count (

Epidemiological investigation on a cluster epidemic of COVID-19 in a collective workplace in Tianjin / 中华流行病学杂志

Objective To investigate and analysis the epidemiological characteristics of a cluster epidemic of COIVD-19 in a collective workplace in Tianjin, evduate the prevention and control measures based on limited evidence and experience in early period of COVID-19 epidemic. Methods Descriptive research method was used to describe the distribution and other epidemiological characteristics of the cluster cases of COVID-19. Results Since the onset of the first index case on January 15, ten confirmed COVID-19 cases had occurred in the workplace, and the epidemic had spread from the workplace to 4 families, infecting 7 family members. The median age of 17 cases was 55 (19-79) years. All the 10 employee cases were males, and in 7 family cases, 3 were males and 4 were females. Of the employee cases, 8 worked in CW workshop and 2 worked in administrative office building. The median exposure-onset interval of all the cases was 4 (0-12) days, and the median exposure-onset interval was 4.5 days in the employee cases and 4 days in the family cases. The median onset-medical care seeking interval was 4 days in the non-isolated cases, 2.5 days in the cases with home isolation after onset, and 0.5 day in the cases with home isolation before onset. Conclusion The clustering of COVID-19 cases was observed in this workplace in Tianjin, which affected 4 families. In the early stage of the epidemic, accurate and rapid blocking and control measures can completely prevent the large-scale spread of COVID-19.

Expression analysis of Foxa2 gene in NIPBL+/- deficient mice with cardiac atrial septal defect / 医学研究生学报

ObjectiveThe occurrence of atrial septal defect in Cornelia DE Lange syndrome are rarely reported in previous studies. The objective of this study is to investigate the relationship between the formation of atrial septal defect and Foxa2 gene expression in NIPBL+/- mouse model through the analysis of the expression of Foxa2 gene in heart tissue. MethodsThe NIPBL+/- mice were used as the experimental group, and wild-type NIPBL+/+ mice were used as the normal group. There were six mice in each group. The weights of the mice at 1, 2, 3, and 4 weeks were measured and recorded. Mouse heart tissues were collected at 4 weeks, and the expression of Foxa2 gene and protein were determined by real-time fluorescence quantitative PCR (Qrt-PCR) and Western blot. Pathological sections and HE staining were carried out to observe the effect of NIPBL gene defect on the development and changes of the mouse heart, as well as the anatomical structure of the atrial septum of the heart. ResultsThe weight of mice in the experimental group was significantly lower than that of the normal group (P<0.05) at all four time points. Foxa2 gene expression and protein expression in heart tissues of the experimental group were statistically lower than those of the normal group (P<0.05). Abnormal defect was observed in the atrial septum of the heart pathological sections of the NIPBL deficient mice. ConclusionThe decreased expression of Foxa2 gene in the heart tissue of NIPBL+/- deficient mice may be a factor inducing growth retardation and weight loss in mice. The abnormal defect in the atrial septum of nipbl-deficient mice might be associated with the down-regulation of Foxa2 gene expression in cardiomyocytes.

Genetic Polymorphism and Forensic Application of 47 Autosomal InDel Loci in 5 Chinese Ethnic Groups / 法医学杂志

Objective To investigate the population genetic data of 47 autosomal insertion/deletion （InDel） polymorphism genetic markers involved in AGCU InDel 50 kit in Guangdong Han, Guangxi Zhuang, Guangxi Yao, Guangxi Jing, and Guangxi Mulam, and to evaluate their application in forensic DNA identification. Methods Multiplex amplification of the 768 unrelated individuals from the 5 ethnic groups mentioned above was performed with the AGCU InDel 50 kit. Genotyping was carried out by 3500xL gene analyzer, population genetic parameters were gathered and polymorphism analysis was performed. Results No linkage disequilibrium was found among 47 autosomal InDel loci in the 5 ethnic groups. The distribution of genotype frequency of 47 autosomal InDel loci confirmed to the Hardy-Weinberg equilibrium in Guangdong Han and Guangxi Zhuang. Except for rs139934789, the other 46 loci confirmed to the Hardy-Weinberg equilibrium in Guangxi Yao, Guangxi Jing, and Guangxi Mulam. The results of genetic variation analysis among the populations showed that 1.12% of genetic variation was caused by ethnic group differences. The cumulative discrimination power of 47 autosomal InDel loci for the 5 ethnic groups were all above 0.999 999 999 999 999. The cumulative probability of exclusion for each ethnic group was less than 0.999 9. The two Y-InDels were identified in all male individuals and were absent in all female individuals. Conclusion Except for rs139934789, the other 46 InDel loci have a relatively good genetic polymorphism in the 5 Chinese ethnic groups, and can be used for forensic individual identification and as effective supplements for paternity testing.

Expression and significance of Shh and Wnt5a genes in Cornelia de Lange syndrome / 中国当代儿科杂志

OBJECTIVE@#To study the expression of Shh and Wnt5a genes in the limb buds of NIPBL fetal rats and the association of these two genes with Cornelia de Lange syndrome (CdLS).@*METHODS@#A total of 72 NIPBL fetal rats were divided into an experimental group and a control group, with 36 rats in each group. The limb buds were collected from 12 fetal rats each on embryonic days 10, 11 and 12 (E10, E11 and E12) respectively. Real-time PCR and Western blot were used to measure the mRNA and protein expression of Shh and Wnt5a.@*RESULTS@#The mRNA and protein expression of Shh and Wnt5a was detected in the limb buds on E10, E11 and E12, and the experimental group had significantly lower expression than the control group (P<0.01). The mRNA and protein expression of Shh and Wnt5a in limb buds was at a low level on E10, followed by an increase on E11 and a reduction on E12, and the expression on E12 was still lower than that on E10 (P<0.01).@*CONCLUSIONS@#The mRNA and protein expression of Shh and Wnt5a are consistent. The pathogenesis of CdLS may be associated with the low mRNA and protein expression of Shh and Wnt5a inhibited by the low expression of NIPBL gene.

Clinical outcomes of minimally invasive transforaminal lumbar interbody fusion for lumbar degenerative disease at more than 5 years follow-up:a review of 832 patients / 中华骨科杂志

Objective To observe the mid-and long-term clinical efficacy of minimally invasive transforaminal lumbar interbody fusion for the treatment of single-segment lumbar degenerative diseases. Methods Retrospective analysis of the clin-ical data of 832 patients with lumbar degenerative disease treated with single-segment MIS-TLIF surgery from 2007 to 2013, 443 males and 389 females; aged 23-82 years, mean 56.4±18.7 years old. All cases were divided into revision surgery group, severe lumbar spinal stenosis group, moderate to severe lumbar spondylolisthesis group and general case groups (as a control) for comparative analysis. Efficacy evaluation indicators include Oswestry disability index (ODI), visual analog scale (VAS), in-tervertebral fusion rate, and complications. Results All patients were followed up for 62 to 93 months, with an average of 79.2±18.6 months. One month after operation, the VAS score of low back pain in the severe spinal stenosis group 2.9±0.5 and the moderate to severe spondylolisthesis group 3.8±1.1 were both significantly higher than the general case group 1.6±0.6, and the difference was statistically significant. The VAS score of leg pain was high in the moderate to severe slip group 2.6 ± 0.7, but the difference was not statistically significant. The ODI value was significantly higher in the moderate to severe spoiler group 28.8±6.9％ than in the general case group 22.1±6.4％. In the 2 years after the operation, the vas of lower back pain was divided into 2.4 ± 0.9, compared with the general case group 1.7 ± 0.5, and the difference was statistically significant; the ODI group of severe spinal stenosis and moderate-severe spondylolisthesis were 17.9％± 3.4％ and 19.4％± 4.9％, respectively, which was higher than the general case group 11.3％±3.3％, and the difference was statistically significant. In the last follow-up, the VAS scores 2.3±0.8 and 2.6±1.1 of the severe vertebral canal stenosis group and the moderate-severe spondylolisthesis group were respectively higher than that of the general case group 1.6±0.7, and the difference was statistically significant; the ODI group of severe vertebral canal stenosis and moderate-severe spondylolisthesis were 18.3％±11.1％ and 19.6％±12.1, high-er than the general case group 11.8％± 9.7％, the difference was statistically significant. The incidence of mid- and long-term complications (intervertebral non-fusion, adjacent segment disease) was not statistically significant among the four groups. Con-clusion MIS-TLIF treatment of lumbar degenerative diseases can obtain good medium and long-term clinically effect. For complex diseases such as revision, severe degeneration and moderate to severe spondylolisthesis, MIS-TLIF did not increase the incidence of medium and long-term complications.

Effects of the Helicobacter pylori Virulence Factor CagA and Ammonium Ion on Mucins in AGS Cells

PURPOSE: To investigate the effects of Helicobacter pylori (H. pylori)-CagA and the urease metabolite NH₄⁺ on mucin expression in AGS cells. MATERIALS AND METHODS: AGS cells were transfected with CagA and/or treated with different concentrations of NH₄⁺CL. Mucin gene and protein expression was assessed by qPCR and immunofluorescence assays, respectively. RESULTS: CagA significantly upregulated MUC5AC, MUC2, and MUC5B expression in AGS cells, but did not affect E-cadherin and MUC6 expression. MUC5AC, MUC6, and MUC2 expression in AGS cells increased with increasing NH₄⁺ concentrations until reaching a peak level at 15 mM. MUC5B mRNA expression in AGS cells (NH₄⁺ concentration of 15 mM) was significantly higher than that at 0, 5, and 10 mM NH₄⁺. No changes in E-cadherin expression in AGS cells treated with NH₄⁺ were noted, except at 20 mM. The expression of MUC5AC, MUC2, and MUC6 mRNA in CagA-transfected AGS cells at an NH₄⁺ concentration of 15 mM was significantly NH₄⁺ concentration, and was significantly higher compared to that in untreated cells. No significant change in the expression of E-cadherin mRNA in CagA-transfected AGS cells was observed. Immunofluorescence assays confirmed the observed changes. CONCLUSION: H. pylori may affect the expression of MUC5AC, MUC2, MUC5B, and MUC6 in AGS cells via CagA and/or NH₄⁺, but not E-cadherin.

Short-term clinical outcome of single level degenerative lumbar diseases treated by minimally invasive surgery oblique lumbar interbody fusion / 中华骨科杂志

Objective To investigate the short-term clinical outcome of one-level degenerative diseases for a single surgeon during his initial phase of performing a minimally invasive surgery oblique lumbar interbody fusion (OLIF) on the basis of perioperative parameters and follow-up data.Methods A prospective analysis of 49 consecutive patients that underwent a OLIF between November 2014 and March 2016 by corresponding author was performed.Only those patients that were single level,index surgeries were included.Every patient had a diagnosis of degenerative lumbar diseases including lumbar spondylolisthesis (25 cases),discogenic low back pain (14 cases) or segmental instability (10 cases).Patients underwent an indirect decompression and fusion using an expandable tubular retractor and single intervertebral cage with bilateral percutaneous pedicle screw fixation.49 patients were divided into the A group (the first 24 patients) and the B group (25 patients after the initial 24 patients).The following data were compared between the two groups:surgical time for Skin-Skin (minutes),estimated blood loss (ml),radiograph exposure time (seconds),the clinical and radiographic results,and intra-/postoperative complications.All intraoperative parameters only included the measurement and findings related with the OLIF procedure.The short-term clinical outcome of single level degenerative lumbar diseases treated by OLIF was assessed on the basis of follow-up data.The learning curve was measured using a logarithmic curve-fit regression analysis.Results Average operative time was significantly longer in the A group 47.1±10.6 min compared with the B group 37.2± 10.0 min.In comparison with the B group,the A group had significantly more X-ray exposure time (25.3±6.1 s versus 17.1±6.9 s).The operative and X-ray exposure time gradually decreased as the series progressed,and an asymptote was reached after about 20 cases.There was no statistically significant difference in intraoperative blood loss between the A group (28.1± 18.2) ml and the B group 24.4± 10.9 ml.The most observed complication was donor site pain (11 cases,45.8％),followed by thigh numbness/pain (5 cases,20.8％) and psoas/quadriceps weakness (2cases,8.3％),paralytic ileus (one case,4.2％) and sympathetic nerve injury (one case,4.2％) in the A group.Donor site pain occurred in four patients (16.0％),thigh numbness/ pain in three patients (12.0％),psoas/quadrieeps weakness in one patient (4.0％) and sympathetic nerve injury in one patient (4.0％) in the B group.All complications were transient and resolved within 3 months.The incidence of complications excluding donor site pain in the early period (A group) and the later period (B group) was 37.5％ and 20.0％,respectively,although there were no significant differences in perioperative complications between both groups.Forty nine patients were followed up for more than 1 year,and the average follow-up period was 18.5±3.9 months.The back pain VAS and ODI scores decreased respectively from 6.4±2.3 before surgery to 1.5±0.9 in final follow-up and from 37.1 ±9.4 before surgery to 11.8±3.9 in the last follow-up time.Total fusion rate was 89.8％ (44/49 cases)in final follow-up.Radiographic evaluation showed similar bony fusion in the A group (22 of 24 cases) with the B group (22 of 25 cases) in the last follow-up time.Conclusion Single level degenerative lumbar diseases can safely and effectively be treated by using OLIF with a good short-term clinical outcome.The procedure presents a learning curve to the practicing spine surgeon with regards to operative time,X-ray exposure time and intra-/postoperative complications.Intraoperative parameters improved with understanding the minimally invasive technique.Close attention to details can minimize complications that may be associated with the learning curve.

Prevention of wrong absorption of pancreatic pseudocyst using guided transmural drainage under endoscopic ultrasonography / 中国内镜杂志

Objective To discuss how to preven wrong absorption of pancreatic pseudocyst using guided transmural drainage under endoscopic ultrasonography.Methods Retrospectively analyzed the clinical data of patients with pancreatic pseudocysts underwent operations of Endoscopic ultrasonography guided transmural drainage.Results 16 cases of pancreatic pseudocysts were finished with guided transmural drainage under endoscopic ultrasonography using needling to place bypass grafting with successful rate 100.0% of guided transmural drainage by needling. After needling, 2 cased happened regurgitation which led to wrongly absorbed, rate of occurrence is 12.5%. Generally, pancreatic pseudocysts of 16 cases disappeared completely with cure rate 100.0%. From above, stents were pulled out by endoscope in 3 cases while stents were removed voluntarily in another 13 cases.Conclusion Dorsal elevated position, detailed operation and esophageal annular tubes can effectively prevent wrong absorption of guided transmural drainage under endoscopic ultrasonography of pancreatic pseudocysts.

Investigation of the cognition and behavior on drug safety in Beijing middle school students / 北京大学学报(医学版)

Objective:To understand the cognition and behavior of drug safety in Beijing middle school students and provide advice for relevant education.Methods:A cross-sectional survey using paper questionnaires was carried out on the student body of nine Beijing middle schools.Multi-stage proportionate stratified cluster sampling was adopted to enroll participants.In addition to demographic questions,the questionnaire included 17 questions assessing the cognition and behavior of safe drug use,prioritizing questions that aligned with the health education guideline for primary and secondary school students from Chinese Ministry of Education.Descriptive statistical methods were applied using the SAS 9.2 software.Results:Of the 4 220 students investigated,2 097(49.7％) were males and 2 123(50.3％) were females.The average age was (14.3 ± 1.7) years.2 030(48.1％) students were from downtown areas,1 511(35.8％) were from urban-rural linking areas and 679(16.1％) were from rural areas.Half (51.5％) of the respondents were junior high school students,and the others were from senior high schools (34.2％) and vocational high schools (14.3％).Most of the students (89.6％) lived off campus.The awareness rate of drug safety knowledge was 74.4％,the median score of drug safety behavior was 4 points (full score was 5 points) and there was a statistically positive correlation between the two (Spearman's correlation coefficient was 0.156,P ＜0.001).Both the awareness rates and the drug safety behavior scores were statistically different among the students in different regions,different school types and different residence types (P ＜ 0.001).Multiple factors analysis demonstrated the correlation between the cognition degrees of both drug safety knowledge,behavior and the above factors.Of all the students,80.4％ agreed that any drug could have adverse drug reactions;40.5％ were aware that antibiotics couldn't kill viruses;as many as 49.6％ mistook aspirin as antibiotic;97.4％ would read drug instructions before taking them;Only 42.4％ put expired drugs into special recycling bins;49.8％ would deviate from the suggested dosage and frequency of their medication when they were sick with common diseases.Conclusion:Overall,the cognition of drug safety in Beijing middle school students is good,but problems still exist in medication adherence,the management of expired drugs and the antibiotics cognition,which need to be fixed through specific,pointed way of education.And more efforts should be made to improve the cognition in rural regions,vocational high schools and on campus students.

Influence of high fat diet on insulin resistance and expression of liver insulin receptor substrate 1 and 2 in Tibet minipigs / 中国实验动物学报

Objective To explore the effects of high fat diet on insulin resistance ( IR) and the expression of liver insulin receptor substrate ( IRS) 1 and 2 in Tibet minipigs. Methods Ten Tibet minipigs were randomly divided into 2 groups, normal control (Ctr, n=5) group was fed with normal diet, and IR model (n=5) group fed with high fat/choles-terol diet for 12 weeks. After the establishment of pig models for 12 weeks, the body weight and body length were measured and body mass index ( BMI) was calculated, and the changes of total cholesterol ( TC) , low density lipoprotein ( LDL?C) , high density lipoprotein ( HDL?C) , triglyceride ( TG) , free fatty acids ( FFA) , fasting blood glucose ( FBG) , fasting insu?lin ( insulin) and homeostasis model assessment?insulin resistance ( HOMA?IR) were detected. Glucose tolerance test was performed, the area under the curve of glucose tolerance ( AUC) was also calculated, and the expressions of IRS?1 and IRS?2 gene and protein in liver tissue were detected. The lipid deposition, liver glycogen and pathological changes were ex?amined by pathology using oil?red O, PAS and HE staining, respectively. Results Compared with the control group, the body weight, BMI index, TC, LDL?C, HDL?C, FFA, FBG, insulin and HOMA?IR were significantly increased ( P <0. 05, P<0. 01). Intravenous glucose tolerance test showed that the curve of blood glucose and insulin levels were slowed down, while AUCglucose and AUCinsulin were significantly increased (P<0. 05, P<0. 01). Lipid deposition and liver glyco?gen were increased, and partial hepatocyte swelling, part of the nuclei disappeared or were pushed to one end, occasionally scattered infiltration of lymphocytes in the liver tissue. Furthermore, the expressions of IRS?1 and IRS?2 mRNA and protein were significantly decreased (P<0. 05, P<0. 01). Conclusions High fat diet can induce insulin resistance in Tibet minipigs. The decreased IRS?1 and IRS?2 expression in the liver may be one of the molecular mechanisms involved in the effects of high fat diet on insulin sensitivity in Tibet minipigs.

Effects of different dietary calcium levels on the bone metabolism in growing WHBE rabbits via OPG-RANK?RANKL systems / 中国实验动物学报

Objective The study was carried out to investigate the effects of different dietary Ca levels on bone metabolism, based on the osteoprotegerin ( OPG)-receptor activator of NF?κB ligand ( RANKL)?receptor activator of NF?κB ( RANK) system in growing WHBE rabbits. Methods Twenty one weaned male WHBE rabbits at the age of 42 days were divided into 3 groups (I, II and III) according to dietary Ca levels (0. 95%, 1. 10%, and 1. 30%, respectively) for a 42?d feeding trial. The above three diets had similar phosphor (P) (about 0. 64 g/kg), digestible energy (9. 50 MJ/kg), crude protein (about 19. 70%) and crude fibre (13. 57%) contents. When the feeding trial finished, the serum in?dices of bone metabolism (Ca, PTH and BALP) were detected, and the OPG?RANK?RANKL system in bone tissue was analyzed by real?time fluorescence quantitative PCR assay and immunohistochemistry, respectively. At last, the relationships between bone metabolism and dietary Ca were evaluated according to RANKL/OPG ratio. Results All the contents of serum Ca, PTH and BALP had no significant differences in the groups I, II and III (P>0. 05). Both the RANKL mR?NA and RANKL/OPG mRNA ratio were lowest in the group II and had significant differences with group I and III ( P<0. 05). Dietary Ca levels had significant effects on the protein expression of OPG?RANK?RANKL in bone tissues (P<0. 01). The positive index of OPG in the groups II and III was significantly higher than that in the group I(P<0. 01), while the positive index of RANK in the group II was lower than those of the group I and III(P<0. 01). The protein ex?pression positive index ratio of RANKL to OPG was also lowest in the group II, showing a significant difference with group I(P<0. 01). Furthermore, both the gene transcription ratio of RANKL to OPG and the protein expression positive index ratio of RANKL to OPG had significant correlations (with quadratic curve) to the dietary Ca levels (R2 =0. 4068, 0. 8433;P<0. 05,P<0. 001). Conclusions In summary, the bone metabolism of WHBE rabbits during growing periods has sig?nificant correlation with dietary Ca levels. An optimal bone metabolism status can be obtain at 1. 10% dietary Ca level as demonstrated in this study.

MRI findings of cerebral schistosomiasis in acute stage:establishment of ex-perimental model of acute cerebral schistosomiasis with rabbits / 中国血吸虫病防治杂志

Objective To establish an experimental model of acute cerebral schistosomiasis japonica and explore the MRI manifestations of acute cerebral schistosomiasis. Methods Rabbits were divided into 3 groups with 10 rabbits in each group. The rabbits in the experimental group were directly injected with suspension fluid of Schistosoma japonicum eggs(0.9 mg,1 ml) by the cranial drilling method,those in the negative control group were given saline(1 ml)by the same method above-men-tioned,and those in the blank control group were not given any treatment. Antibiotic was given to the first two groups after the op-eration. The clinical manifestations of the 3 groups were observed,and the magnetic resonance imaging(MRI)was performed in 30 days post-operation,and then the brain tissues were taken for pathological examinations. Results All the rabbits in the ex-perimental group exhibited inappetence,various neurological symptoms including hemiplegia,and weight loss after the opera-tion;while those in the negative control group showed inappetence in 3 days after the operation,and 1 week later,the symptom disappeared;there were no adverse reactions in the blank control group. MRI of the experimental group showed nodular or patchy enhancement on T1WI enhancement,brain edema,abnormal ventricular dilatation,and needle augmentation. SWI dis-played hypointense in the abnormal enhanced nodules and flaky hypointense on the operation brain. In the negative control group,2 rabbits showed abnormal enhancement of the needle canal,and 1 showed mild dilatation of the ventricle. The blank control group showed normal manifestations. The pathological examinations showed abnormal appearances in 10 rabbits of the ex-perimental group,including 6 with S. japonicum egg granuloma nodules,nonspecific granuloma nodules coexisted with perivas-cular inflammation;no granuloma nodules were found in the negative control group,but 2 rabbits showed vascular inflamma-tion;the blank control group showed the normal brain tissue. Conclusions An experimental model of acute cerebral schistoso-miasis is successfully established in rabbits by intracranial injection of schistosome eggs. The MRI examination combined with the clinical manifestations can improve the accuracy of early diagnosis of cerebral schistosomiasis.

Prevalence, Characteristics of Ear Deformity and Treatment Tendency for Auricular Hematoma in Elite Wrestlers / 대한스포츠의학회지

Wrestlers has frequently injured on his ear by friction or hitting. If the ear injury like hematoma did not treat appropriately, it should be deform to disfigured outer shape. We analyzed the incidence and characteristics of ear deformity with elite wrestlers. We took the photo with elite 58 male wrestlers' ears. We surveyed the carrier of elite player, duration of training time, ear injury history, treatment history and satisfactory scale of his ear shape. The characteristics of ear shape were classified by Yotuyanagi classification. 44 wrestlers has deformity of his ear in elite wrestlers (76%, 44/58). Right side ear deformity is 50 cases, bilaterally involvement is one case. Microtia was 11 (24%), ear protrusion was 15 (33%) cases. Yotuyanagi type IB was 13 (29%) cases that deformity extending from helix to antihelix. Type IIA was 12 (27%) cases that deformity with a substantial change with good structural integrity in outline of the ear. Acute ear injury was treated with simple icing (33 cases, 56%), aspiration and compression (6 cases, 10%). 34 wrestlers (77%) dissatisfied his own ear shape. 10% of acute ear injuries treat appropriately in domestic elite male wrestlers. 76% of the wrestlers has an ear deformity and dissatisfaction.

Case-control study on shoulder pain caused by hook palte for the treatment of acromioclavicular joint dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To explore causes of shoulder pain and propose prevention measures in treating acromioclavicular joint dislocation.</p><p><b>METHODS</b>From January 2005 to January 2013, 86 patients with acromioclavicular joint dislocation (Tossy III) were treated with hook plate fixation, and were divided into two groups. Bsaed on recovery of shoulder function mostly, the patients who suffered from rest pain, motion pain were named as shoulder pain group, while the patients without pain were named as painless group. In shoulder pain group, there were 21 cases including 15 males and and 6 females ranging the age from 22 to 62 years old with an average of (40.6±11.2) years old. There were 8 cases were on the left side and 13 cases were on the right side. In painless group, there were 65 cases including 36 males and and 29 females ranging the age from 19 to 65 years old with an average of (40.0±11.3) years old. There were 33 cases were on the left side and 32 cases were on the right side. The time from injury to operation ranged from 3 h to 8 d with an average of 34.6 h. Shoulder function of all patients were normal before injuried. Postoperative pain, activity of daily living (ADL), range of motion, deltoid muscle strength were compared. Anteflexion,rear protraction, abduction and upthrow of shoulder joint were also compared. Postoperative complications between two groups were observed and compared.</p><p><b>RESULTS</b>All patients were followed up from 12 to 48 months with an average of 18.5 months. Constant-Murley score were used to evaluate clinical efficacy at the least following up, and 13 cases got an excellent results, 5 moderate, 2 good and 1 poor in shoulder pain group ; while 61 cases were obtained excellent results, 3 moderate and 1 good in painless group. There were significantly differences between two groups in Constant-Murley score and activity of shoulder joint (P<0.05). In shoulder pain group, 3 cases were disconnected, 1 case occurred stress fracture, 9 cases were subacromial impingement syndrome, 5 cases occurred subluxation, 1 case occurred plate breakage and 11 cases were acromioclavicular arthritis.</p><p><b>CONCLUSION</b>Chosing individual clavicular hook plate, fulfilling anatomic reset, paying attention to the repair of articular capsule ligament, and reducing hook and bone antagonism between stress is the key point of preventing and decreasing postoperative shoulder pain.</p>

Protective effect of dexmedetomidine on mechanically ventilated patients with pulmonary contusion / 中国中西医结合急救杂志

Objective To approach the protective effect of dexmedetomidine on mechanically ventilated patients with pulmonary contusion. Methods A prospective randomly controlled trial was conducted. 70 mechanically ventilated patients with pulmonary contusion from January 2010 to December 2012 in the Critical Care Medicine of Foshan Hospital of Traditional Chinese Medicine were divided into a control group and a therapy group by the difference in number odd or even,with 35 patients in each group. Based on the same principles of comprehensive treatment,the control group used midazolam,and the therapy group used dexmedetomidine for sedation. The measured parameters included oxygenation index(PaO2/FiO2),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6), and extra-vacular lung water index(EVLWI)for both groups on the1st and 5th day. The incidence of delirium,the time of mechanical ventilation,and the incidence of hypotension were observed in both groups. Results Compared with those on the 1st day,TNF-α,IL-6 and EVLWI on the 5th day were decreased significantly in both groups〔the control group TNF-α(ng/L):1.29±0.38 vs. 2.21±0.37,IL-6(ng/L):97.97±28.77 vs. 131.03±41.52,EVLWI (mL/kg):8.25±2.03 vs. 11.96±3.36;the therapy group TNF-α:1.06±0.33 vs. 2.32±0.37,IL-6:82.07±23.35 vs. 134.98±64.25, EVLWI(mL/kg):6.74±1.33 vs. 11.23±2.78, all P0.05). Conclusion Dexmedetomidine has protective effect on mechanically ventilated patients with pulmonary contusion, and it is an relatively ideal sedative drug for these patients.

Up-regulation of B-cell lymphoma 6 expression suppresses apoptosis of rat liver cells / 第二军医大学学报

Objective To clone the gene of B-cell lymphoma 6 (Bcl6), construct a green fluorescent expression vector carrying rat Bcl6 gene, and to evaluate its roles in rat liver cells. Methods Total liver RNA was isolated from rat liver samples and cDNA was synthesized by reverse transcription; the coding sequence of Bcl6 gene was obtained by nested PCR. PEGFP-Bcl6 fusion expression vector was constructed by recombination technique and confirmed by sequencing. Then the recombinant vectors were transfected into rat liver cell line BRL-3A by lipofectamine; the expression levels of Bcl6 mRNA and protein were determined by real-time PCR and Western blotting analysis, respectively. Finally, the apoptosis of BRL-3A cells transfected with recombinant vector was analyzed by flow cytometry and cell proliferation was examined by MTT assay. Results The recombinant vector pEGFP-Bcl6 was successfully constructed as determined by PCR and sequencing, and was effectively delivered to BRL-3A cells by transient transfection as confirmed by PCR and Western blotting analysis. Result of flow cytometry proved that Bcl6 up-regulation suppressed apoptosis of rat liver cells and MTT assay found that Bcl6 up-regulation promoted proliferation of liver cells. Conclusion We have successfully cloned rat Bcl6 gene and constructed its green fluorescent expression vector. Our results initially prove that Bcl6 may inhibit cell apoptosis and promote cell proliferation in rat liver cells.