Investigation of leprosy survivors in Fengxian District， Shanghai / 上海预防医学

Objective:To understand the current living and health status of leprosy survivors in Fengxian District， Shanghai， and to provide scientific evidence for improving their quality of life. Methods:In January 2018-June 2020， professionally trained CDC staff performed a household investigation on 41 patients with leprosy （case group） and 82 non-leprosy persons （control group） every year. Living and health status， and routine laboratory examinations such as blood pressure， blood glucose， and blood lipids were monitored. Results:Majority of the patients with leprosy had low educational level （68.29% being primary school） and were mostly farmers （51.22%）.The patients had abnormal residual Ⅱ level 5 （12.20%） and mostly were tb-like （TT） （53.66%）. Moreover， some patients were not incapacitated （46.34%）， had no family financial difficulties （29.27%）， did not acquire the national subsistence allowance policy （58.54%）， and asked for "regular physical examination" （68.29%）.Compared to the 82 control persons， the patients with leprosy had significantly different body mass index （BMI） and blood pressure （P<0.05）. Conclusion:Living and health status of leprosy survivors in Fengxian District remains to be further improved. The China Disabled Persons’ Federation （CDF）， Red Cross， civil affairs， and health administration need to further strengthen the cooperation.

Preparation and Evaluation of the Serum Quality Control Material of β2-Microglobulin / 现代检验医学杂志

Objective To prepare quality control material of β2-microglobulin (β2 MG),then evaluate the quality of it.Methods The quality control material of β2-MG was prepared with pooled serum from patients.Then according to Guidance on Evaluating the Homogeneity and Stability of Samples Used for Proficiency Testing and ISO Guide 35,the homogeneity and stability of it was evaluated.Results According to the result of homogeneity test,there was no statistically significant difference between within groups and between-groups (F=0.699,2.091,all P＞0.05) for 2 levels of quality control materi al.What was more,the stability test showed that it could stabilize for at least 5 days at 25 ℃ (t=-1.76,-2.64,all P＞ 0.05),28 days at 4 ℃ (t=-1.86,-2.44,all P＞0.05),4 months at-20 ℃ (t=0.26,-2.68,allP＞0.05),and 1 yearat -80℃ (t=-0.96,0.01,all P＞0.05).Conclusion Quality control material of β2-MG has simple preparation.The homogeneity and stability of it meets the standard requirements.

Pharmaceutical care for nutrition support therapy in large area burn patients / 中国药学杂志

OBJECTIVE: To explore the keypoints and methods of pharmaceutical care provided by clinical pharmacists in nutritional support for patients with severe burn. METHODS: Through summarizing the pharmaceutical care process in nutrition support therapy in large area burn patients, the contents of pharmaceutical care including the requirements for thermal energy and nutrients, choice of drugs, nutrition support pathway, complication prevention, application of other special nutrients and so on were described. RESULTS: Through pharmaceutical care, the nutritional support regimen was adjusted, which improved the safety and effectiveness of drug treatment and laid the foundation for related treatments for patients with severe burn. CONCLUSION: Nutritional support is one of the important measures in the treatment of severe burn patients. Pharmaceutical care can improve the standardization and effectiveness of nutritional support treatment. At the same time, the value of clinical pharmacists can be reflected through collaborative service with doctors and nurses.

Treatment of sternoclavicular joint dislocation with sternoclavicular hook plate fixation / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the technique and therapeutic effect of sternoclavicular hook plate fixation in treating sternoclavicular joint (SCJ) dislocation.</p><p><b>METHODS</b>From January 2010 to March 2014,6 patients with SCJ dislocation were treated with sternoclavicular hook plate fixation in our hospital. Among the 6 patients, 5 patients were male and 1 patient was female, and the average age was 34 years, ranging from 26 to 48 years. The course of the disease ranged from 3 to 20 days. All the SCJ dislocations were caused by external injury and accompanied with the symptoms of swelling pain and obvious shoulder joint activity restricted in affected side. All SCJ dislocations were anterior dislocation by the diagnosis of X-ray and CT scan. The postoperative curative effect was evaluated according to Rockwood score.</p><p><b>RESULTS</b>All the patients' operative incision were healed well and in good appearance. X-ray showed that the dislocated SCJ was well reduced and the plate was on right position. All the 6 patients were followed up for 4 to 18 months, with an average of 12 months. The results were evaluated according to Rockwood score, 4 got excellent results, 1 good and 1 fair. No fixation loosening, redislocation or side injury such as vessel, nerve or pleura injury were found.</p><p><b>CONCLUSION</b>With sternoclavicular hook plate fixation, SCJ dislocation could be reduced while keeping its amphiarthrodial function and the completeness of the cartilage surface. Sternoclavicular hook plate fixation has advantages of safety and stabilization in fixation, and patients can begin function exercises earlier.</p>

Comparison of clinical effects of total spondylectomy with different procedures in treating lumbar metastatic tumor / 中国骨伤

<p><b>OBJECTIVE</b>To compare the therapeutic effects of debris spondylectomy, piecemeal spondylectomy, total en bloc spomdylectomy in treating lumbar metastatic tumors.</p><p><b>METHODS</b>The clinical data of 20 patients with lumbar metastatic tumors treated from January 2008 to October 2013 were retrospectively reviewed. There were 8 males and 12 females, aged from 35 to 65 years old with an average of (49.50 ± 9.97) years. All patients had single solitary metastases. Four cases were in L1,5 cases in L2,4 cases in L3,4 cases in L4, and 3 cases in L5. According to the type of Tomita, type II had in 4 cases, type III in 6 cases, type IV in 6 cases, type V in 4 cases. Tokuhashi score was 12.50 ± 1.97. All patients complained with back or leg pain, VAS score was 8.13 ± 0.85. Among patients, 7 cases were treated with debris spondylectomy (group A), 7 cases with piecemeal spondylectomy (group B), 6 cases with total en bloc spondylectomy (group C). Statistical analysis was used to compare the three groups with respect to surgical trauma (including operative time, transoperative bleeding, and intraoperative blood transfusion), clinical symptoms (by VAS score at 1 week after operation), surgical procedures conditions (by AP and lateral X-rays), and long-term results (by recurrence and death information).</p><p><b>RESULTS</b>All patients were followed up from 6 to 36 months with an average of (16.50 ± 7.88) months. Operative time for debris spondylectomy was (6.14 ± 0.68) h, intraoperative bleeding was (3 457.14 ± 399.40) ml, and intraoperative blood transfusion was (2 771.43 ± 423.14) ml. Operative time for piece-meal spondylectomy was (4.93 ± 0.61) h, intraoperative bleeding was (1 942.86 ± 378.51) ml, and intraoperative blood transfusion was (1 500.00 ± 336.65) ml. Operative time for total en bloc spondylectomy was(4.17 ± 0.67) h, intraoperative bleeding was (1 341.67 ± 361.13) ml, and intraoperative blood transfusion was (916.67 ± 321.66) ml. There was significant differences in operative time, intraoperative blood loss, and intraoperative blood transfusion between three groups (P < 0.05). In terms of these factors, total en bloc spondylectomy had the best outcome followed by piecemeal spondylectomy. All pains had released, VAS score decreased obviously at 1 week after operation (P < 0.05), and there was no significant differences between three groups (P > 0.05). Surgical effects were well with these methods according to the evaluation of AP and lateral X-rays . At final follow-up, group A had 4 recurrences (2 with breast cancer, 1 with prostate cancer,and 1 with thyroid cancer) and 3 deaths (2 with lung cancer and 1 with thyroid cancer); group B had 2 recurrences (1 with breast cancer and 1 with prostate cancer) and 3 deaths (1 with lung cancer, 1 with breast cancer and 1 with kidney cancer);group C had no recurrences and 2 deaths for lung cancer. There was significant differences in recurrence and death between three groups (P < 0.05). In terms of these factors, total en bloc spondylectomy had the best outcome in three methods.</p><p><b>CONCLUSION</b>Three kinds of operation method can relieve pain, improve nerve function, increase the spinal stability, control the local lesions, improve the patient's quality of life in treating lumbar metastatic tumors, but total en bloc spendylectomy, respect to operative time, transoperative bleeding, intraoperative blood transfusion, tumor recurrence and death is clearly superior to other two methods.</p>

Correlation between interleukin-18 promoter -607C/A polymorphism and susceptibility to ischemic stroke

Single nucleotide polymorphisms in the promoter region of interleukin-18 (IL-18), an inflammatory cytokine, have been linked to susceptibility to many diseases, including cancer and immune dysfunction. Here, we explored the potential association between the IL-18 -607C/A (rs1946518) promoter region polymorphism and susceptibility to ischemic stroke (IS). This locus was amplified from peripheral blood samples of 386 IS patients (cases) and 364 healthy individuals (controls) by the polymerase chain reaction with sequence-specific primers. Significant differences were observed by the χ2 test in the -607C/A (rs1946518) genotype and allele frequencies between cases and controls (P < 0.05). Furthermore, after excluding for age, gender, smoking status, and hypertension, logistic regression indicated that IS susceptibility of -607C carriers increased 1.6 times (OR = 1.601, 95%CI = 1.148-2.233, P = 0.006) compared to -607A carriers. Additionally, similar increases in IS risk were noted for male patients or patients less than 65 years old. In conclusion, IL-18 -607C/A (rs1946518) promoter polymorphism is associated with IS susceptibility, and the C allele may confer increased IS risk.

Surgical treatment of thoracic ossification of ligamentum flavum and therapeutic effects analysis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the surgical treatment of thoracic ossification of the ligamentum flavum (TOLF) and analysis of the therapeutic effects.</p><p><b>METHODS</b>Six patients with thoracic ossification of the ligamentum flavum were retrospectively studied from October 2006 to October 2009. All of the patients in this group were treated by en bloc hemi-articular process laminectomy. There were 4 males and 2 females, ranging in age from 45 to 66 years, averaged 55.2 years. The evaluate factors including the preoperative and postoperative JOA scores,and the function of the urinary bladder were analyzed.</p><p><b>RESULTS</b>All the 6 patients were followed after operation. The mean followed-up duration was 10.5 months, ranging from 2 to 18 months. According to JOA evaluation criteria, 4 patients got an excellent result, 1 good and 1 bad. The one patient with bad result had spinal cord compressed for too long time, and the T2-weight MRI showed nonreversible degeneration of spinal cord and combined with schizophrenia. The clinical symptoms improved with varying degrees.</p><p><b>CONCLUSION</b>The en bloc hemi-articular process laminectomy is an effective method for ossification of the thoracic ligamentum flavum. A thorough decompression and real-time protection of the spinal cord is the key to the success of surgery.</p>

Clinicopathological analysis of 250 patients with early-stage gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the factors associated with early diagnosis of gastric cancer.</p><p><b>METHODS</b>Clinical data were retrospectively analyzed for 250 patients with early-stage gastric cancer (EGC) from 2005 to 2008, during which the concept of intra-epithelial neoplasia (IN) was adopted in our department.</p><p><b>RESULTS</b>On preoperative endoscopic biopsy with pathological exam, there were 15 cases suspicious for cancer, 90 with high-grade IN (HGIN), and 15 gastric cancer. Postoperative pathological exam of the surgical specimen showed infiltrating early-stage cancer in 224 patients, of which 5 (2.2%) were type I (all were Tsm), 190 (84.8%) were type II including Tm in 82 and Tsm in 108 patients, 29 were type III (5 Tm and 24 Tsm). Twenty-six patients had non-infiltrating lesions (Tis). There were 184 (73.6%) well-differentiated tumors, including 26 Tis, 58 Tm, and 100 Tsm. Lymphatic metastasis was identified in 21 patients, of which 2 (2.3%) were Tm (all were poorly-differentiated) and 19 (13.9%) were Tsm. Lymphadenopathy was present in 15 (7.9%) cases in type II, and in 6 (20.7%) in type III. Of the 90 cases with a preoperative diagnosis of HGIN, 24 were found to be Tis, 29 were Tm, and 37 were Tsm on postoperative pathological assessment.</p><p><b>CONCLUSIONS</b>Well-differentiation is the main histological type in EGC. The adoption of the concept of IN is associated with improved detection of EGC, which warrants further investigation.</p>

Expression, purification, and crystallization of a novel galactose mutarotase from Thermoanaerobacter tengcongensis / 中国医学科学院学报

<p><b>OBJECTIVE</b>To purify a novel galactose mutarotase (TTE1925) from Thermoanaerobacter tengcongensis for crystallization and X-ray diffraction.</p><p><b>METHODS</b>The tte 1925 gene was subcloned into the prokaryotic expression vector pGEX-6P-1 and overexpression was obtained in the E.coli BL21 (DE3) through transformation of the right recombinant plasmid that had been verified by colony PCR and sequencing. Soluble fusion protein with glutathione S-transferase tag expressed highly by the induction of isopropyl beta-D-thiogalactoside and was purified in a three-step procedure, which included Glutathione Sepharose 4B affinity, ion chromatography (Resource Q 6 mL), and gel filtration chromatography (10/300 superdex 200).</p><p><b>RESULT</b>The purity of the purified protein was over 99% and a large amount of claval crystals whose X-ray diffraction reached 1.9 A were obtained.</p><p><b>CONCLUSIONS</b>We successfully prepared TTE1925 with high purity and obtained crystals for X-ray diffraction. These work paved the way for the further research on the 3-D structure of TTE1925 and its biological mechanism.</p>

Effect of Tongdatang Serial Recipe on antipsychotic drug-induced galactorrhea-amenorrhea syndrome / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the clinical effect of self-formulated Tongdatang serial recipe (TDT) in treating antipsychotic drug-induced galactorrhea-amenorrhea syndrome (GAS).</p><p><b>METHODS</b>One hundred female schizophrenic patients with antipsychotic drug-induced GAS were selected and equally assigned to the treatment group and the control group at random. Both received antipsychotic drug-therapy, but combined with TDT and placebo respectively. The efficacy was evaluated by determining prolactin level before, 4 and 8 weeks after treatment.</p><p><b>RESULTS</b>The treatment course was completed in 96% of patients. Therapeutic efficacy on the 49 patients of the treatment group was cured in 31 (63.3%), markedly effective in 11 (22.4%), effective in 4 (8.2%) and ineffective in 3 (6.1%), with total effective rate of 93.9%, while in 47 patients of the control group, the corresponding cases (%) was 0, 3 (6.4%) , 7 (14.9%) and 37 (78.7%), respectively, with the total effective rate of 21.3%. Prolactin levels in the two groups were insignificantly different before treatment, it reduced in the treatment group after treatment (P < 0.01), and the decrement in the treatment group was more significant than that in the control group (P < 0.05).</p><p><b>CONCLUSION</b>Satisfactory effect could achieved by using TDT for treatment of antipsychotic drug-induced GAS.</p>

Inter-observer variations of digital radiograph pulmonary nodule marking by using computer toolkit / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To assess inter-observer variations of pulmonary nodule marking in routine clinical chest digital radiograph (DR) softcopy reading by using a lung nodule computer toolkit.</p><p><b>METHODS</b>A total of 601 chest posterior-anterior DR images were randomly selected from routine outpatient screening in Peking Union Medical College Hospital. Two chest radiologists with experience more than ten years were first asked to read the images and mark all suspicious nodules independently by using computer toolkit IQQA-Chest, and to indicate the likelihood for each nodule detected. They were also asked to draw the boundary of the identified nodule manually on an enlarged region of interest, which was instantly analyzed by IQQA-Chest. Two sets of diagnostic reports, including the marked nodules, likelihood, manually drawn boundaries, quantitative measurements, and radiologists' names, were automatically generated and stored by the computer system. One week later, the two radiologists read the same images together by using the same computer toolkit without referring to their previous reading results. Marking procedure was the same except that consensus was reached for each suspicious region. Statistical analysis tools provided in the IQQA-Chest were used to compare all the three sets of reading results.</p><p><b>RESULTS</b>In the independent readings, Reader 1 detected 409 nodules with a mean diameter of 12.4 mm in 241 patients, and Reader 2 detected 401 nodules with a mean diameter of 12.6 mm in 253 patients. In the consensus reading, a total of 352 nodules with a mean diameter of 12.4 mm were detected in 220 patients. Totally, 42.3% of Reader 1's and 45.1% of Reader 2's marks were confirmed by the consensus reading. About 40% of each reader's marks agreed with the other. There were only 130 (14.4%) out of the total 904 unique nodules were confirmed by both readers and the consensus reading. Moreover, 5.6% (51/904) of the marked regions were rated identical likelihood in all three readings. Statistical analysis showed significant differences between Readers 1 and 2, and between consensus and Reader 2 in determining the likelihood of the marks (P < 0.01), but not between consensus and Reader 1. No significant difference in terms of size was observed in nodule segmentation between either two of the three readings.</p><p><b>CONCLUSION</b>Large variations in nodule marking and nodule-likelihood determination but not in nodule size were observed between experts as well as between single-person reading and consensus reading.</p>

Improved marking and characterizing of pulmonary nodules on digital radiographs using a computer-aided diagnosis system / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate and reduce inter-observer variations in the detection and characterization of pulmonary nod-ules on digital radiograph (DR) chest images.</p><p><b>METHODS</b>Two hundreds and thirty-two new posterior-anterior DR chest images were collected from out-patient screening patients. Consensus was reached by two experienced radiologists on the marking, rating, and segmentation of small actionable nodules ranged from 5 to 15 mm in diameter using a computer-aided diagnosis (CAD) system. Both their own nodule findings and the computer's automatic nodule detection results were analyzed to make the consensus. Nodules identified together with corresponding likelihood rating and segmentation results were referred as "Gold Standard". Two un-experienced radiologists were asked to first mark and characterize suspicious nodules independently, then were allowed to consult the computer nodule detection results and change their decisions.</p><p><b>RESULTS</b>Large inter-observer variations in pulmonary nodule identification and characterization on DR chest images were observed between un-experienced radiologists. Un-experienced radiologists could greatly benefit from the CAD system, including substantial decrease of inter-observer variation and improvement of nodule detection rates. Moreover, radiologists with different levels of skillfulness could achieve similar high level performance after using the CAD system.</p><p><b>CONCLUSION</b>The CAD system shows a high potential for providing a valuable assistance to the examination of DR chest images.</p>

Foreign metallic pellet in the heart / 中华创伤杂志(英文版)

Foreign bodies in the heart are a rare but serious form of cardiac injury. The objects usually are sharp pointed. Such as acupuncture needles, sewing needles, coat hangers, fragments of Kirschner wires, pins, etc.(1) We report a patient with a metallic pellet lodged in the heart, which was accurately diagnosed and successfully removed.

The relationship between postoperative complication and pathological features of 324 patients with neuronal intestinal malformations / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the morphological features of different types of neuronal intestinal malformations (NIM) and their postoperative complications.</p><p><b>METHODS</b>The data of morphological and clinical features of 324 cases with NIM were analyzed retrospectively.</p><p><b>RESULTS</b>In all 324 patients, 210 cases were Hirschsprung's disease (HD), 38 intestinal neuronal dysplasia (IND), 45 mixed HD/IND, 8 hypoganglionosis, 22 combined HD/hypoganglionosis and 1 immaturity of ganglion cells. The percentages of normal neuron in bowel of different NIM were 88.1%, 24.4%, 18.4%, 4/8, 27.7% and 0/1 in HD, HD/IND, IND, hypoganglionosis, HD/hypoganglionosis and immaturity of ganglion cells respectively. There were totally 46 cases complicated with recurrent postoperative enterocolitis (EC). Incidence of recurrent postoperative EC in HD patients was 6.7% while in IND/HD and IND patients was 35.6% and 28.9%, respectively. Incidences of EC in cases with the residual IND margins and with the normal margins were 38.2% and 8.7%, respectively. Incidence of EC in cases with transanal endorectal pull-through procedure and with transabdominal procedure was 18.0% and 8.3%, respectively. Nine cases underwent another procedure because of severe persistent constipation or EC after operation, including 4 cases HD/IND, 1 case IND, 3 cases HD and 1 case HD/hypoganglionosis.</p><p><b>CONCLUSIONS</b>Neuron distribution is inconsistent with pathology of NIM. Postoperative EC are rare in the patients only with isolated HD. Furthermore, margins with residual IND and transanal endorectal pull-through procedure are risk factors to recurrent EC. However, the extension of excision about IND is uncertain and need further study.</p>