Application status and prospect of Indocyanine green in radical prostatectomy / 国际外科学杂志

Prostate cancer is a common malignant tumor in male genitourinary system, and radical prostatectomy is one of the important methods to treat prostate cancer. Indocyanine green is a non-radioactive, water-soluble compound, which can help identify anatomical structures and visualize blood vessels through near-infrared fluorescence. The role and injection techniques of Indocyanine green in radical prostatectomy in sentinel lymph node identification, pelvic lymph node dissection and neurovascular bundle preservation are reviewed, so as to provide a reference for improving the surgical effect, reducing the difficulty of surgery, and prolonging the survival period of patients, and evaluate the potential research field of this technology in the future.

Application of case-based learning based on the clinical case library of stomatology in standardized residency training for comprehensive stomatology / 中华医学教育探索杂志

Objective:To investigate the application effect of case-based learning (CBL) based on the clinical case library of stomatology in standardized residency training for comprehensive stomatology.Methods:A total of 52 residents in Department of Stomatology, Chongqing Medical University, were given CBL teaching based on the clinical case library of comprehensive stomatology, and a questionnaire survey was performed to evaluate the teaching effect. Theoretical and skill assessments were performed before and after CBL teaching, and a comparative analysis was performed. SPSS 19.0 software was used for the t-test. Results:The questionnaire survey showed that CBL teaching based on the clinical case library of stomatology effectively improved the ability of independent learning [92.31% (48/52)], the interest in learning [88.46% (46/52)], and the ability for case diagnosis and the accuracy of investigation and judgment [94.23% (49/52)]. This method helped with the mastery and understanding of the theoretical knowledge in stomatology [96.15% (50/52)] and improved the abilities for expression and communication [84.62% (44/52)] and the ability to find and solve problems [94.23% (49/52)]. It also helped to stimulate the interest in scientific research and teaching [82.69% (43/52)] and create an active classroom atmosphere [82.69% (43/52)]. Among these residents, 94.23% (49/52) liked CBL teaching, and 88.64% (46/52) thought the setting of the case library was reasonable. After the application of CBL teaching, there were significant increases in theoretical score [from (66.74±4.25) points to (81.44±7.16) points] and skill examination score [from (64.00±3.14) points to (81.96±7.50) points].Conclusions:CBL teaching based on the case library of stomatology has a good teaching effect in the standardized residency training for comprehensive stomatology and can not only improve the theoretical and skill assessments of residents, but also improve their learning interest and clinical thinking ability.

Epidemiological and clinical characteristics of 49 children with severe hemorrhagic fever with renal syndrome / 中国小儿急救医学

Objective:To understand the epidemiological and clinical characteristics of children with severe and critical hemorrhagic fever with renal syndrome(HFRS), and to accumulate experience in the diagnosis and treatment of severe and critical HFRS in children.Methods:A retrospective analysis method was used to collect the clinical data of 49 children diagnosed with HFRS, who were admitted to the Department of Infectious Diseases, Children′s Hospital Affiliated to Xi′an Jiaotong University from January 2019 to December 2021 and classified as severe or critical group.The epidemiological data, characteristics, clinical manifestations, laboratory examinations, diagnosis and treatment outcomes of the children were analyzed.Results:Among the 49 children with severe HFRS, the ratio of male∶female was 3.45∶1(38∶11), the median age was 10 years and 8 months old, and the highest proportion was 6-12 years old.The peak incidence was in November and December(75.51%).Most of them lived in rural areas, with a total of 39 cases(79.59%).All patients had fever onset, gastrointestinal symptoms(vomiting, abdominal pain, diarrhea, 81.63%)and hyperemia of skin and mucous membranes(77.55%)were common, but typical headache, backache pain and orbital pain(three pains)only accounted for 15 cases(30.6%).Laboratory test results: the white blood cells in routine blood increased in 42 cases(85.71%), while the platelets decreased in 47 cases(95.91%).The procalcitonin was increased in 48 cases(97.95%).The alanine aminotransferase was elevated in 49 cases(100%), while the albumin of 38 cases(77.55%)were lower than 30 g/L.The urea nitrogen increased in 34 cases(69.38%), and the creatinine increased in 47 cases(95.91%).The creatine kinase isozyme was elevated in 41 cases(83.67%).Forty-nine children had different degrees of electrolyte imbalance, among which low sodium(91.83%)and low calcium(85.71%)were the most common.The urine protein was positive in 47 cases(95.91%), and the urine red blood cell was positive in 38 cases(77.55%).Ultrasonography of the urinary system revealed abnormalities in the kidneys and surrounding kidneys in 43 cases(91.48%).Twenty-eight(58.33%)patients had abnormal electrocardiogram.All the 49 patients were clinically cured.Conclusion:Severe HFRS is mainly in rural male children aged 6-12 years, mainly with fever and gastrointestinal symptoms, lack of typical three pain symptoms.When white blood cell count and procalcitonin significantly increased, platelet count significantly decreased, liver and kidney function impaired and electrolyte imbalance, severe cases should be highly suspected.Early identification of critically ill children and active treatment are critical to their prognosis.

Inhibitory effect of GALNT2 gene knockdown on apoptosis of human retinal vascular endothelial cells in high glucose culture and its mechanism / 中华实验眼科杂志

Objective:To investigate the effect of polypeptide N-acetylgalactosaminaminyltransferase 2 (GALNT2) on the proliferation and apoptosis of human retinal vascular endothelial cells (HRCECs) cultured in high glucose and its possible mechanism.Methods:The small hairpin RNA (shRNA) targeting GALNT2 gene was constructed to interfere with the lentiviral vector and infect HRCECs.HRCECs were divided into blank control group, model group, NC-shGALNT2 group and shGALNT2 group, which were cultured in medium containing 5.5 mmol/L glucose, 25 mmol/L glucose, shGALNT2 negative control virus 25 mmol/L glucose and shGALNT2 knockdown virus 25 mmol/L glucose for 24 hours, respectively.The relative expression of GALNT2 mRNA in the four groups was detected by real-time fluorescence quantitative PCR.The relative expression levels of GALNT2, epidermal growth factor (EGF), EGF receptor (EGFR) and phosphorylated EGFR (p-EGFR) were detected by Western blot.The proliferative values of HRCECs were detected by cell counting kit-8 method.The apoptosis rate of different groups was detected by flow cytometry. Results:The relative expression levels of GALNT2 mRNA and protein were significantly higher in model group than in blank control group, and were significantly lower in shGALNT2 group than in blank control group (all at P<0.05). The cell proliferation value was significantly lower in model group than in blank control group, and was significantly higher in shGALNT2 than in model group and NC-shGALNT2 group (all at P<0.05). The apoptosis rates of blank control group, model group, NC-shGALNT2 group and shGALNT2 group were (4.73±0.26)%, (8.66±0.25)%, (9.26±1.12)% and (5.47±0.18)%, respectively, with a significant overall difference ( F=342.921, P<0.001). The apoptosis rate was significantly higher in model group than in blank control group, and was significantly lower in shGALNT2 group than in model group and NC-shGALNT2 group (all at P<0.05). The relative expression level of EGFR protein was significantly higher and the relative expression level of p-EGFR protein was significantly lower in model group than in blank control group (all at P<0.05). The relative expression of p-EGFR protein was significantly higher in shGALNT2 group than in model group (all at P<0.05). Conclusions:Knocking down GALNT2 can improve the proliferative ability of HRCECs under high glucose culture and reduce apoptosis, which may be related to the activation of EGFR signaling pathway.

Analysis of clinical features of convulsion in rotavirus enteritis and the risk factors for multiple convulsion / 中国医师进修杂志

Objective:To analyze the clinical features of convulsion in rotavirus enteritis and the risk factors of multiple convulsion.Methods:The clinical data of children with rotavirus enteritis complicated with convulsion admitted to Xi'an Children's Hospital from January 2018 to March 2021 were retrospectively analyzed. According to whether there was fever during convulsion, they were divided into febrile seizure (FS) group and afebrile seizure (AFS) group.Results:A total of 274 children with rotavirus enteritis accompanied by convulsion were enrolled. The male to female ratio was 2.26∶1 in the FS group, while the male to female ratio was 1∶1.1 in the AFS group. The median number of vomiting in the AFS group was higher than that in the FS group: 4(2, 6) times per day vs. 2(1, 5) times per day, P<0.01. One convulsion was dominant in the FS group (80.68%), and more than two convulsions in the AFS group (62.90%). In the FS group, 60.23% of convulsions occurred on the first day of the course of disease, while in the AFS group,79.57% of convulsions mainly occurred on the second and third day of the course of disease. There was no statistical difference in duration of convulsion and overall course of disease between the two groups ( P>0.05). The median of hypersensitive C-reactive protein (CRP) and procalcitonin (PCT) in FS group were higher than those in AFS group: 5.52(1.45, 15.50) mg/L vs. 0.98(0.50, 3.17) mg/L, 0.17(0.07, 0.46) μg/L vs. 0.06(0.05, 0.15) μg/L. The median of alanine aminotransferase (ALT), aspartate aminotransferase (AST), uric acid (UA) and creatine kinase isoenzyme(CK-MB) in the AFS group were higher than those in the FS group: 28.00(21.00, 34.25) U/L vs. 25.00(19.00, 31.00) U/L, 53.00(45.00, 62.00) U/L vs. 50.00(40.00, 58.00) U/L, 390.00(296.00, 474.25) μmol/L vs. 331.00(250.00, 399.75) μmol/L, 67.00(49.75, 94.25) U/L vs. 59.50(37.25, 78.75) U/L, the differences were statistically significant ( P<0.05). The median age and the median of UA levels in ≥3 convulsions group were higher than those in ≤2 convulsions group: 21(18, 26) months vs. 18(15, 21) months, 411.00(296.50, 496.50) μmol/L vs. 364.00(278.00, 440.50) μmol/L, while the median of serum Na +, the mean value of serum Cl - in the ≥3 convulsions group were lower than those in the ≤2 convulsions group: 135.50(133.75, 137.25) mmol/L vs. 136.60(134.50, 138.20) mmol/L, (103.76 ± 3.26) mmol/L vs. (105.08 ± 4.26) mmol/L, the differences were statistically significant ( P<0.05). The age ≥18 months in children with rotavirus enteritis and convulsion ( OR = 3.359, P = 0.002, 95% CI 1.544 - 7.307) and the serum Cl - < 104.8 mmol/L ( OR = 2.17, P = 0.019, 95% CI 1.138 - 4.138) had an increased risk of convulsions ≥3 times during the course of rotavirus enteritis. Conclusions:Rotavirus enteritis FS mostly occurred on the first day of the course of disease, most of them had convulsion once, hs-CRP and PCT were relatively high. In AFS, convulsions were more than 2 times, and occurred on the 2nd and 3rd day of the course of disease. ALT, AST and UA were relatively high. Children with age ≥18 months and serum Cl - < 104.8 mmol/L had an increased risk of convulsions ≥3 times during the course of the disease.

Expression and clinical significance of laboratory of genetics and physiology 2, retinoic acid inducible gene I and melanoma differentiation associated gene 5 in children with hand, foot and mouth disease / 中国小儿急救医学

Objective:To detect the expression levels of laboratory of genetics and physiology 2 (LGP2), retinoic acid inducible gene I (RIG-I) and melanoma differentiation associated gene 5 (MDA5) in children with hand, foot and mouth disease (HFMD), and to explore their possible clinical significance in HFMD.Methods:Fifty children with HFMD, who visited Second Affiliated Hospital of Xi′an Jiao Tong University, Xi ′an Children′s Hospital and Xi ′an Central Hospital from May 2020 to May 2021, were selected as the research subjects, and 20 children with physical examination at the same age during the same period were selected as the control group.Children with HFMD were divided into enterovirus 71 (EV-A71) type and coxsackievirus A6 (CV-A6) type according to the results of pathogen detection, and then divided into mild group and severe group according to the severity of the disease.The relative mRNA expression levels of LGP2, RIG-I and MDA5 in each group, and the correlation among the three proteins were compared and analyzed.Results:Among 50 cases of HFMD, 26 cases were EV-A71 type (16 cases were mild and 10 cases were severe) and 24 cases were CV-A6 type (17 cases were mild and 7 cases were severe). There was no significant difference in age and sex between HFMD group and control group ( P>0.05). The relative expression levels of LGP2 mRNA in EV-A71 and CV-A6 HFMD cases were 2.37(1.78, 3.25)% and 1.88 (1.35, 3.13)%, lower than that in control group [2.97(2.61, 3.55)%]. Only the difference between CV-A6 HFMD children and control group was statistically significant ( Z=-2.310, P=0.021). The relative expression levels of RIG-I mRNA in EV-A71 and CV-A6 HFMD cases were 9.95 (7.79, 14.62)% and 9.78(7.04, 15.83)%, lower than that in control group [18.47(13.00, 21.07)%]. The differences were all statistically significant ( P<0.05). The relative expression levels of MDA5 mRNA in EV-A71 and CV-A6 HFMD cases were 4.41(2.82, 5.99)% and 3.98 (2.18, 7.41)%, lower than that in control group [5.10(3.52, 7.71)%], but the differences were not statistically significant.There were no significant differences in the relative expression levels of the three indicators between the mild and severe groups of children with EV-A71 or CV-A6 HFMD.The expression levels of LGP2, RIG-I and MDA5 mRNA were highly correlated( P<0.001). Conclusion:The relative expression levels of LGP2, RIG-I and MDA5 mRNA in children with HFMD are decreased in different degrees than those in normal children.And there is a correlation among them.

Maternal liver damage induced by cadmium exposure in pregnant mice through hypoxia inducible factor-1α-mediated upregulation in DRP1 / 环境与职业医学

Background Mitochondrial dynamin-related protein 1 (DRP1) regulates mitochondrial division and plays an important role in maintaining hepatocyte function. However, the role of DRP1 in cadmium exposure-induced maternal liver damage in pregnant mice remains unclear. Objective To investigate the role and mechanism of DRP1 in maternal liver damage induced by cadmium exposure during pregnancy. Methods This study consisted of animal experiments and cell experiments. (1) Animal experiments. Mice at 14 days of gestation were randomly divided into three groups: a control group, a low-dose cadmium group (LCd group: 2.5 mg·kg−1), and a high-dose cadmium group (HCd group: 5 mg·kg−1). The pregnant mice were intraperitoneally injected with cadmium chloride (CdCl2) for 6 and 24 h in the next morning. The weights of pregnant mice, uterus, maternal liver, and fetal mice were recorded after sacrifice. Serum and liver of pregnant mice were collected, the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum were detected, and liver tissues were stained with HE to observe changes in liver function and liver tissue structure. The expressions of oxidative phosphorylation-related proteins, hypoxia inducible factor-1α (HIF-1α) and DRP1 proteins in liver of pregnant mice were detected by Western blotting. (2) Cell experiments. AML12 cells were treated with CdCl2 (10 μmol·L−1) for 0, 2, 6, 12, and 24 h. The expressions of oxidative phosphorylation-related proteins, DRP1, and hypoxia inducible factor-1α (HIF-1α) proteins were detected. AML12 cells were pretreated with DRP1 inhibitor Mdivi-1 for 1 h and then CdCl2 (10 μmol·L−1) for 12 h to detect the expression of oxidative phosphorylation-related proteins and DRP1 protein. AML12 cells were treated with Hif-1α siRNA for 48 h and CdCl2 (10 μmol·L−1) for 6 h to detect the expression of HIF-1α and DRP1 proteins. Results The results of animal experiments showed that cadmium exposure in pregnant mice had no effects on maternal liver weight and liver coefficient. However, the histomorphological changes and necrosis in hepatocytes were observed. Compared with the control group, the serum ALT and AST levels of pregnant mice in the LCd group were significantly increased after 6 h (P＜0.05), and the levels in the HCd group were significantly increased after 6 and 24 h (P＜0.05). Cadmium exposure during pregnancy significantly up-regulated HIF-1α and DRP1 expressions and down-regulated the expressions of oxidative phosphorylation-related proteins in maternal livers. In vitro cell experiments showed that the expressions of oxidative phosphorylation-related proteins was significantly decreased and HIF-1α and DRP1 protein expressions were significantly increased in the AML12 cells treated with CdCl2 for 6 h. Mdivi-1 pretreatment significantly antagonized the inhibitory effect of cadmium on the expressions of oxidative phosphorylation-related proteins in AML12 cells, while Hif-1α siRNA pretreatment significantly antagonized the up-regulative effect of cadmium on DRP1 expression in AML12 cells. Conclusion Cadmium exposure in pregnant mice may up-regulate DRP1 expression by activating HIF-1α signaling, then inhibit oxidative phosphorylation level of hepatic cells, and ultimately lead to maternal liver damage.

CD301b+ macrophage: the new booster for activating bone regeneration in periodontitis treatment / 国际口腔科学杂志·英文版

Periodontal bone regeneration is a major challenge in the treatment of periodontitis. Currently the main obstacle is the difficulty of restoring the regenerative vitality of periodontal osteoblast lineages suppressed by inflammation, via conventional treatment. CD301b+ macrophages were recently identified as a subpopulation that is characteristic of a regenerative environment, but their role in periodontal bone repair has not been reported. The current study indicates that CD301b+ macrophages may be a constituent component of periodontal bone repair, and that they are devoted to bone formation in the resolving phase of periodontitis. Transcriptome sequencing suggested that CD301b+ macrophages could positively regulate osteogenesis-related processes. In vitro, CD301b+ macrophages could be induced by interleukin 4 (IL-4) unless proinflammatory cytokines such as interleukin 1β (IL-1β) and tumor necrosis factor α (TNF-α) were present. Mechanistically, CD301b+ macrophages promoted osteoblast differentiation via insulin-like growth factor 1 (IGF-1)/thymoma viral proto-oncogene 1 (Akt)/mammalian target of rapamycin (mTOR) signaling. An osteogenic inducible nano-capsule (OINC) consisting of a gold nanocage loaded with IL-4 as the "core" and mouse neutrophil membrane as the "shell" was designed. When injected into periodontal tissue, OINCs first absorbed proinflammatory cytokines in inflamed periodontal tissue, then released IL-4 controlled by far-red irradiation. These events collectively promoted CD301b+ macrophage enrichment, which further boosted periodontal bone regeneration. The current study highlights the osteoinductive role of CD301b+ macrophages, and suggests a CD301b+ macrophage-targeted induction strategy based on biomimetic nano-capsules for improved therapeutic efficacy, which may also provide a potential therapeutic target and strategy for other inflammatory bone diseases.

Clinical treatment guideline for pulmonary blast injury (version 2023) / 中华创伤杂志

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.

Discussion on the intraoperative bleeding control strategies in total laparoscopic complex splenectomy / 中华肝胆外科杂志

Objective:To investigate the control strategies of intraoperative bleeding in total laparoscopic complex splenectomy.Methods:The clinical data of 11 patients who underwent total laparoscopic complex splenectomy from May 2016 to October 2021 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed, including 3 males and 8 females, aged (43.5±16.3) years. Splenectomy was performed in 8 cirrhotic patients with portal hypertension and 3 patients with hematologic diseases. Intraoperative bleeding was controlled by priority splenic artery blocking, bleeding prevention strategies of perisplenic and splenic pedicle dissociation. The operative time, intraoperative blood loss, postoperative exhaust time, postoperative drainage tube removal time and postoperative complications were analyzed.Results:All 11 patients underwent total laparoscopic complex splenectomy successfully. The operative time of 11 patients was (242.8±43.6) min, and the intraoperative blood loss was 180(50-1 480) ml. The postoperative exhaust time was (3.9±0.8) d, the removal time of abdominal drainage tube was (6.4±0.8) d, and the postoperative hospitalization time was (13.1±3.9) d. The 11 patients had no postoperative complications such as hemorrhage, pancreatic fistula, gastric fistula, colon injury, infection, etc. One patient had splenic vein thrombosis, 2 patients had mild pancreatitis, and 4 patients had moderate ascites.Conclusion:Intraoperative bleeding could be controlled by priority splenic artery blocking, bleeding prevention strategies of perisplenic and splenic pedicle dissociation, which is one of the important guarantees for the success of total laparoscopic complicated splenectomy.

Expression and clinical significance of vitamin D receptor in children with hand, foot and mouth disease / 中国小儿急救医学

Objective:To detect the expression level of vitamin D receptor(VDR) in children with hand, foot, and mouth disease(HFMD), and explore its potential value in the diagnosis and treatment of children with HFMD.Methods:A total of 82 children with HFMD hospitalized in the Second Affiliated Hospital of Xi′an Jiaotong University and Xi′an Children′s Hospital from May 2017 to May 2019 were selected as the case group.At the same time, 42 healthy children who underwent physical examination in the Child Health Department during the same period were randomly selected as the control group.Peripheral blood of two groups of children was extracted to detect and compare the expression levels of VDR mRNA in mononuclear cells, and the correlation between the expression level of VDR and HFMD and the correlation with various clinical characteristics were analyzed.Results:The relative expression of VDR in children with EV71 HFMD was 2.03%±0.38%, which was lower than that in children of control group(3.11%±1.29%), and the difference was statistically significant( t=-3.586, P=0.001). However, the relative expression of VDR in children with CA16 HFMD was 3.69%±1.79%, which was higher than that in children of control group, and the difference was not statistically significant( t=1.043, P=0.305). Among children with EV71 HFMD, the relative expression level of VDR was significantly different between the mild group and the severe group(2.18%±0.44% vs. 1.84%±0.17%, t=2.199, P= 0.041). There was no statistical difference regarding the relative expression level of VDR between mild and severe CA16 HFMD(4.16%±1.73% vs. 2.93%±1.73%, t=1.587, P=0.129). Conclusion:Compared with healthy children, the expression level of VDR is significantly lower in children with EV71 HFMD, and may be related to the severity of EV71 HFMD.

Association of single nucleotide polymorphisms in the vitamin D receptor gene with the clinical outcome of influenza in children / 中国小儿急救医学

Objective:To investigate the association of single nucleotide polymorphisms(SNPs)in the vitamin D receptor(VDR)gene with influenza susceptibility and severity of disease in children.Methods:Peripheral venous blood was collected from 172 children with influenza A (study group) and 88 healthy children (healthy control group) admitted to Xi ′an Children′s Hospital and Xi ′an Central Hospital from February 2019 to February 2021.Serum 25-hydroxyvitamin D(25-OH-D) level was detected by using 25-OH-D kit.The study group was divided into three groups according to clinical syndrome: mild group, severe group, and critical group.Four candidate loci in the VDR gene(ApaI, TaqI, FokI, and BSMI)were selected, and polymorphisms in the VDR gene of each group were determined by polymerase chain reaction restriction fragment length polymorphism and analyzed in relation to children with influenza.Results:Compared with the healthy control group[(109.65±4.35) nmol/L], the serum 25-OH-D levels in the study groups were lower[(73.55±2.46)nmol/L in the mild group, (45.59±4.62) nmol/L in the severe group, and (33.65±3.87) nmol/L in the critical group]( P<0.05); Genotypes AA, Aa and allele A of the ApaI locus(51.74%, 22.67%, and 63.08%, respectively)and genotypes FF, Ff and allele F of the FokI locus(41.86%, 34.88%, and 59.30%, respectively)accounted for a significantly higher proportion of cases in the study group than those in healthy control group(11.36%, 14.77%, 18.75%, 10.23%, 13.64%, and 17.05%, respectively)( P<0.05). The proportion of allele A at the ApaI locus and genotypes AA and Aa in severe group(63.70%, 43.84%, and 28.76%) were significantly higher than those in mild group(47.37%, 35.09%, and 24.56%)( P<0.05); The proportion of allele A and genotype AA and at the ApaI locus in critical group(92.86%, 88.10%, and 49.52%) were significantly higher than those in severe group( P<0.05). Serum 25-OH-D<50 nmol/L( OR=5.087, 95% CI 3.114-5.648), ApaI site genotypes AA ( OR=4.011, 95% CI 1.217-18.624)and Aa( OR=3.839, 95% CI 2.483-1.456), FokI site genotypes FF( OR=4.112, 95% CI 3.215-20.775)and Ff( OR=4.591, 95% CI 0.032-10.936)were risk factors for the onset of influenza in children. Conclusion:Serum 25-OH-D deficiency is associated with childhood influenza, and VDR gene genotype AA and Aa of ApaI locus, and FokI site genotype FF, Ff may increase the risk of childhood influenza susceptibility, and allele A of ApaI locus and genotypes AA and Aa are associated with the severity of influenza.

Research progress on insulin like growth factor-1 and infectious diseases / 中国小儿急救医学

Insulin like growth factor-1(IGF-1) has been found to be a cell proliferation regulator that promotes cell differentiation and proliferation.In recent years, IGF-1 has been found to play an important role in infectious diseases, participating in the occurrence and development of a variety of infectious diseases.This review briefly summarized the research progress on IGF-1 in infectious diseases, providing new ideas for the application of IGF-1 in clinical diagnosis and treatment of infectious diseases.

Clinical characteristics and misdiagnosis analysis of infectious mononucleosis in children / 中国医师进修杂志

Objective:To summarize the clinical characteristics, causes of misdiagnosis and preventive measures of infectious mononucleosis (IM) in children, and to improve the ability of clinicians in early diagnosis of IM in children.Methods:The clinical data of 468 children with IM in Xi′an Children′s Hospital from January 2018 to December 2021 were retrospectively analyzed, including general situation, disease onset, diagnosis and misdiagnosis.Results:Among the 468 children, 33 cases were clinically diagnosed and 435 cases were a definitely diagnosed; 281 males (60.04%) and 187 females (39.96%); the incidence rate was highest in preschool children (43.80%, 205/468) and in autumn (33.12%, 155/468). The first symptoms were fever (52.99%, 248/468), eyelid edema (15.38%,72/468) and neck mass (14.96%, 70/468). The fever rate was 90.38% (423/468), and the median time of first fever appearance was on the first (first, second) day of disease course, and the median duration of fever was 6 (4, 8) d. The median time of first visit was on the third (first, fifth) day of disease course, and the time of diagnosis was on the seventh (fifth, ninth) day of disease course. Blood routine examination showed that the proportion of white blood cell count increased was 51.92% (243/468), the proportion of lymphocytes increased was 61.75% (289/468), and the proportion of abnormal lymphocytes increased (≥10%) in peripheral blood was 58.97% (276/468). The lymphocyte subsets of 364 children were detected, the rate of helper T lymphocytes (Th cells) decreased was 80.22% (292/364), the rate of suppressor T lymphocytes (Ts cells) increased was 99.45% (362/364), the value and decreased rate of Th cells/Ts cells were 0.24 (0.16, 0.40) and 100.00% (364/364), rate of B lymphocytes decreased was 93.96% (342/364), rates of natural killer cells decreased and increased were 35.16% (128/364) and 0.55% (2/364). The misdiagnosis rate was 55.13% (258/468), and the misdiagnosis time was on the fifth (fourth, seventh) day of disease course. Among the 258 misdiagnosed children, 105 cases (40.70%) were misdiagnosed as upper respiratory tract infection, 65 cases (25.19%) as acute suppurative tonsillitis, 27 cases (10.47%) as acute cervical lymphadenitis or neck mass.Conclusions:Due to the complex and diverse clinical manifestations of IM in children, it is easy to be misdiagnosed in the early stage of the disease. So, it is necessary for clinicians to master the clinical characteristics of IM in children, constantly improve the level of diagnosis and treatment, and reduce the misdiagnosis rate.

Application of task-driven teaching method combined with Sandwich teaching method in standardized residency training of oral general practitioners / 中华医学教育探索杂志

Objective:To explore the application effect of task-driven teaching method combined with Sandwich teaching method in the standardized residency training of oral general practitioners.Methods:A total of 40 trainees of the standardized residency training of the Teaching and Research Section of Oral General Practice in Chongqing Medical University were randomly divided into experimental group and control group. The experimental group ( n=20) adopted task-driven teaching method combined Sandwich teaching method, and the control group ( n=20) adopted the traditional teaching method. The theory assessment, skills assessment and the teaching satisfaction questionnaire survey were conducted to evaluate the teaching effects. SPSS 19.0 software was used for t-test. Results:The theoretical test scores of the experimental group were significantly higher than those of the control group [(85.85±25.61) points vs. (74.35±10.53) points], and the difference between the two groups was statistically significant ( t=8.56, P < 0.001). The skill test scores of the experimental group were significantly higher than those of the control group [(86.50±18.20) points vs. (73.40±16.57) points], and the difference was statistically significant ( t=9.94, P<0.001). The results of the teaching satisfaction questionnaire showed that the experimental group had significantly higher scores than control group in such seven aspects as improving students autonomous learning ability and interest in learning, teamwork and interpersonal relationships, diagnostic ability of cases and the accuracy, doctor-patient expression and communication ability, ability to find and solve problems, stimulating interest in scientific research and teaching, mastering and understanding the oral theoretical knowledge and so on ( t=10.40, 10.40, 9.95, 5.43, 7.66, 8.08, 9.60, respectively, all P<0.001). Task-driven teaching combined with Sandwich teaching method stimulated the learning interest of trainees and improved their comprehensive ability. Conclusion:Task-driven teaching combined with Sandwich teaching method has greatly improved the teaching effect of standardized residency training of oral general practitioners.

Anti-hepatoma Effect of Active Ingredients of Chinese Medicine via Wnt/β-catenin Signaling Pathway： A Review / 中国实验方剂学杂志

Hepatoma is one of the most common malignant tumors of digestive system worldwide， and a main factor leading to cancer-related deaths. Its incidence is increasing year by year， posing a serious threat to human health. Currently， hepatoma is mainly treated by surgical resection， liver transplantation， radiation and drugs， but there are certain adverse reactions and problems of high recurrence rate and low survival rate. Chinese medicine has unique advantages in improving the comprehensive curative effect of hepatoma and reducing adverse reactions. With a variety of active ingredients， Chinese medicine can induce hepatoma cell apoptosis， inhibit the proliferation， migration and reverse multidrug resistance through multiple targets， thus exerting anti-hepatoma effect. It has become an important means for the prevention and treatment of hepatoma as well as a rich resource for anti-hepatoma drug research and development. Wnt/β-catenin signaling pathway， one of the most classical pathways in cancer， is involved in tumor cell proliferation， cell cycle， migration， invasion and tumor angiogenesis. Recently， many studies have reported that the active ingredients of Chinese medicine can play an anti-hepatoma role through this pathway. Therefore， this paper summarized the domestic and foreign literature in recent years， analyzed the relationship between wnt/β-catenin signaling pathway and the specific mechanism of hepatoma occurrence and development， and combed the literature on the effect of flavonoids， terpenoids， alkaloids， polysaccharides and other active ingredients of Chinese medicine on inducing hepatoma cell apoptosis， regulating cell cycle and inhibiting the invasion and metastasis through Wnt/β-catenin signaling pathway. In addition， the paper summarized the research progress of relevant active ingredients of Chinese medicine against hepatoma， to explore their specific mechanism against hepatoma through Wnt/β-catenin signaling pathway， so as to provide theoretical reference for further development of anti-hepatoma drugs.

Coptidis Rhizoma Crude Polysaccharide and Berberine Synergistically Restore Intestinal Mucosal Barrier Damage in Ulcerative Colitis / 中国实验方剂学杂志

ObjectiveTo investigate the synergistic effect of Coptidis Rhizoma crude polysaccharide （CCP） and berberine （BBR） in treating ulcerative colitis （UC） model mice. MethodThirty male BALB/c mice were randomized into five groups. Except the 6 mice in the normal group， the rest were given 5% dextran sodium sulfate in their daily drinking water to establish the UC model. After modeling， the mice were administrated with corresponding agents by gavage once daily for 4 days： BBR （100 mg·kg-1） group， BBR （100 mg·kg-1） + low-dose （22.8 mg·kg-1） CCP group， BBR （100 mg·kg-1） + high-dose （45.6 mg·kg-1） CCP group. The mice in the model group and normal group were administrated with the same volume of normal saline. At the end of the experiment， the mice were sacrificed for the collection of colon， and the expression of tight junction proteins zonula occluden-1 （ZO-1）， Claudin-1， and Occludin in colon tissue was detected by Western blot. With the normal group as the control， the disease activity index （DAI） score， colon length， colon histomorphology， and expression levels of tight junction proteins in other groups were evaluated. ResultCompared with the normal group， the modeling down-regulated the protein levels of ZO-1， Claudin-1， and Occludin （P<0.01）. Compared with the model group， BBR did not significantly change the protein level of Claudin-1 and up-regulated those of ZO-1 and occludin （P<0.01）. The expression levels of Claudin-1， ZO-1， and Occludin were up-regulated in BBR + CCP groups （P<0.01）. The expression levels of tight junction proteins in BBR + CCP groups were significantly higher than those in the BBR group （P<0.05）. ConclusionThe administration of CCP combined with BBR can effectively ameliorate intestinal mucosal barrier damage in the mice with UC.

Design and implementation for portable ultrasound-aided breast cancer screening system / 生物医学工程学杂志

Early screening is an important means to reduce breast cancer mortality. In order to solve the problem of low breast cancer screening rates caused by limited medical resources in remote and impoverished areas, this paper designs a breast cancer screening system aided with portable ultrasound Clarius. The system automatically segments the tumor area of the B-ultrasound image on the mobile terminal and uses the ultrasound radio frequency data on the cloud server to automatically classify the benign and malignant tumors. Experimental results in this study show that the accuracy of breast tumor segmentation reaches 98%, and the accuracy of benign and malignant classification reaches 82%, and the system is accurate and reliable. The system is easy to set up and operate, which is convenient for patients in remote and poor areas to carry out early breast cancer screening. It is beneficial to objectively diagnose disease, and it is the first time for the domestic breast cancer auxiliary screening system on the mobile terminal.

A preliminary study of double guidewire technique combined with pancreatic duct stenting in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis / 中华消化内镜杂志

To study the preventive effects of double guidewire technique combined with pancreatic duct stenting in preventing post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP). Patients receiving ERCP were divided into the treatment group and the control group by random number table. In the treatment group, double guidewire technique combined with pancreatic duct stenting was applied. In the control group, selective biliary intubation was applied in the conventional way. The intubation time, PEP, hyperamylasemia and bleeding incidence were analyzed between the two groups. A total of 80 patients were enrolled in this study from January 2016 to December 2018. There were 40 cases in the treatment group and 39 cases in the control group. In the treatment group, the mean intubation time was 384±102 seconds. No PEP or bleeding during and after the operation occurred, but hyperamylasemia occurred in 2 cases. In the control group, the mean intubation time was 427±115 seconds. Hyperamylasemia occurred in 6 cases, PEP occurred in 3 cases, and 1 case of intraoperative bleeding happened in the control group. The incidence of PEP [0 VS 7.7%(3/39)]and hyperamylasemia [5.0% (2/40)VS 15.4%(6/39)] were lower in the treatment group (both P<0.05). Double guidewire technique combined with pancreatic duct stenting can successfully perform selective bile duct intubation and effectively prevent PEP.

Analysis of the effect of arthroscopic high-strength non-absorbable sutures on fresh avulsion fractures of the tibial ACL / 国际外科学杂志

Objective:To explore the efficacy of small incision open reduction and internal fixation and arthroscopic high strength non-absorbable suture in the treatment of tibial avulsion fracture of anterior cruciate ligament (ACL).Methods:The clinical data of 72 patients with ACL tibial avulsion fracture treated in Shantou Central Hospital from April 2018 to April 2020 were analyzed retrospectively. The patients were randomly divided into control group ( n=36) and experimental group ( n=36). The control group was treated with small incision open reduction and internal fixation and the experimental group was treated with high intensity non-absorbable suture under arthroscopy. The general data, surgical indexes and postoperative adverse reactions of the two groups were compared, and the knee joint function indexes of the two groups before and after treatment were compared and evaluated by random walking model. The counting data were expressed by percentage, the comparison between groups was expressed by chi-square test, the measurement data was expressed by mean ±standard deviation, the independent t-test was used for inter-group comparison, and the paired t-test was used for intra-group comparison. Results:There was no significant difference in general information, intraoperative blood loss, preoperative Lysholm score, IKDC score, Tegner score, knee mobility, and bilateral tibial displacement distance between the two groups of patients ( P>0.05). In the experimental group, the operation time, hospitalization time, the first postoperative time to move to the ground, bone healing time, and the total incidence of adverse reactions were (68.41±7.65) min, (11.93±3.24) d, (6.37±1.85) d, (23.65± 2.28) weeks, 2.78% (1/36), the control group were (55.37±8.62) min, (13.45±2.96) d, (8.16±2.08) d, (25.79±2.46) weeks, 22.22% (8/36), the difference between the two groups was statistically significant ( P<0.05). The Lysholm score, IKDC score, Tegner score, range of motion of the knee joint, and the difference of bilateral tibial displacement distance after treatment in the experimental group were (85.27±5.28) points, (85.43±1.74) points, and (6.65±1.41) points, respectively. (108.45±5.79)°, (1.12±0.65) mm, the control group was (79.73±4.69) points, (80.37±1.59) points, (5.72±1.31) points, (97.58±5.42)°, (2.24±0.72) mm, the difference between the two groups was statistically significant ( P<0.05). Random walking model evaluation the improvement of knee joint function in the experimental group was significantly better than that in the control group. Conclusion:Arthroscopic treatment of ACL tibial avulsion fracture with high-intensity non-absorbable suture can significantly improve the knee joint function of patients with rapid recovery and high safety, so it has a broad prospect of clinical application.