The incidence and risk factors of early hyperglycemia in extremely preterm infants / 中国新生儿科杂志

Objective:To study the incidence and risk factors of early hyperglycemia in extremely preterm infants (EPIs).Methods:From January 2018 to December 2021, EPIs with gestational age (GA) <28 w born in our hospital and admitted to the neonatal department were retrospectively studied. According to the occurrence of early hyperglycemia (within 1 w after birth), the infants were assigned into hyperglycemia group and non-hyperglycemia group. Univariate and logistic regression were used to analyze the risk factors of early hyperglycemia in EPIs.Results:A total of 218 cases of EPIs were enrolled, including 70 (32.1%) in the hyperglycemia group and 148 (67.9%) in the non-hyperglycemia group. The incidence of early hyperglycemia in EPIs with GA<25 w was 10/20 and 11/16 in EPIs with birth weight (BW) ≤700 g. The GA and BW of the hyperglycemia group were significantly lower than the non-hyperglycemia group ( P<0.05). More infants in the hyperglycemia group had 1-min and 5-min Apgar≤7 than the non-hyperglycemia group ( P<0.05). Logistic regression analysis showed that increased BW ( OR=0.995, 95% CI 0.993~0.997, P<0.05) was a protective factor for early hyperglycemia in EPIs, while male gender ( OR=2.512,95% CI 1.232~5.123, P<0.05), vasoactive drug use during the first week of life ( OR=2.687, 95% CI 1.126~6.414, P<0.05), maternal hypertension during pregnancy ( OR=14.735, 95% CI 1.578~137.585, P<0.05) were risk factors for early hyperglycaemia in EPIs. Conclusions:Early hyperglycemia are common among EPIs. Low BW, male gender, vasoactive drug use during the first week of life and maternal hypertension during pregnancy may increase the risk of early hyperglycemia.

Discovery of miRNA and target signal molecules involved in inhibition of chlorogenic acid on N-acetyl-p-aminophenol-induced hepatotoxicity based on microRNA array / 中国中药杂志

This study aims to observe the effect of chlorogenic acid(CGA) on microRNA(miRNA) in the process of protecting against N-acetyl-p-aminophenol(APAP)-induced liver injury. Eighteen C57BL/6 mice were randomly assigned into a normal group, a model group(APAP, 300 mg·kg~(-1)), and a CGA(40 mg·kg~(-1)) group. Hepatotoxicity of mice was induced by intragastric administration of APAP(300 mg·kg~(-1)). The mice in the CGA group were administrated with CGA(40 mg·kg~(-1)) by gavage 1 h after APAP administration. The mice were sacrificed 6 h after APAP administration, and plasma and liver tissue samples were collected for the determination of serum alanine/aspartate aminotransferase(ALT/AST) level and observation of liver histopathology, respectively. MiRNA array combined with real-time PCR was employed to discover important miRNAs. The target genes of miRNAs were predicted via miRWalk and TargetScan 7.2, verified by real-time PCR, and then subjected to functional annotation and signaling pathway enrichment. The results showed that CGA administration lowered the serum ALT/AST level elevated by APAP and alleviate the liver injury. Nine potential miRNAs were screened out from the microarray. The expression of miR-2137 and miR-451a in the liver tissue was verified by real-time PCR. The expression of miR-2137 and miR-451a was significantly up-regulated after APAP administration, and such up-regulated expression was significantly down-regulated after CGA administration, consistent with the array results. The target genes of miR-2137 and miR-451a were predicted and verified. Eleven target genes were involved in the process of CGA protecting against APAP-induced liver injury. Gene Ontology(GO) annotation and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment with DAVID and R language showed that the 11 target genes were enriched in Rho protein-related signal transduction, vascular patterning-related biological processes, binding to transcription factors, and Rho guanyl-nucleotide exchange factor activity. The results indicated that miR-2137 and miR-451a played an important role in the inhibition of CGA on APAP-induced hepatotoxicity.

Discussion on automated external defibrillator configuration optimization strategy of rapidly developing city: a case study of Bao'an, Shenzhen / 中华危重病急救医学

Objective:To explore the automated external defibrillator (AED) configuration optimization strategy in line with the characteristics of the rapidly developing cities by analyzing the actual coverage of AED in Bao'an District based on the real world data of out-of-hospital cardiac arrest (OHCA) in Bao'an District, Shenzhen City.Methods:The data of cardiac arrest database registered in Bao'an District of Shenzhen City from March 1, 2019 to February 29, 2020 were included in a retrospective observational study. The AED coverage of public and non-public areas was analyzed by calculating the minimum distance between the occurrence place of each OHCA event and the nearest AED. The minimum distance ≤100 m was set as AED coverage, and the minimum distance > 100 m was set as non-AED coverage. It was assumed that one AED was configured for each OHCA hotspot area, then the AED coverage changes were analyzed. Based on the actual situation that the AED in schools, governments, sports venues, subways, tourist attractions and parks of public areas in Bao'an District could not be obtained at any time within 24 hours, it was assumed that all AED in the public areas could be obtained at any time within 24 hours, the impact of AED available at any time on AED coverage was analyzed.Results:A total of 525 cases of OHCA were enrolled. The highest incidence of OHCA was found in residential and industrial areas [54.5% (286/525) and 14.3% (75/525), respectively]. There were 252 AED in Bao'an District, Shenzhen, and 115 OHCA events occurred within the coverage area of AED. Even if all AED met the ideal state that could be obtained at any time within 24 hours, the coverage rate was only 21.9% (115/525). The AED coverage rate of the public areas and non-public areas was 31.6% (37/117) and 19.1% (78/408) respectively, with uneven distribution, and the AED coverage rate of non-public areas was low. Assuming that the residential community and industrial zone with more than 2 OHCA cases were respectively equipped with one AED, the coverage rate of AED in the non-public areas increased from 19.1% (78/408) to 28.2% (115/408), basically meeting the requirement that AED could be obtained at any time when OHCA events occurred. Some AED in the public areas of Bao'an District were not available at any time within 24 hours. If the ideal state that all AED in the public area could be obtained at any time within 24 hours could be achieved, the AED coverage rate of all regions increased from 16.8% (88/525) to 21.9% (115/525), the AED coverage rate of the public areas increased from 29.1% (34/117) to 31.6% (37/117), the AED coverage rate of the non-public areas increased from 13.2% (54/408) to 19.1% (78/408).Conclusions:AED configuration in Bao'an District was unevenly distributed, and the coverage rate of AED in non-public areas was low. The allocation strategy for AED in fast-growing cities like Shenzhen should be as follows: on the premise of ensuring AED availability for 24 hours, priority should be given to covering the number of AED in the non-public areas including residential communities and industrial zones; AED is available in the public areas for 24 hours.

Influence of Tuina plus oxiracetam on serum inflammatory factors and oxidative stress in mild vascular dementia patients / 针灸推拿医学（英文版）

Objective: To observe the clinical efficacy of Tuina (Chinese therapeutic massage) plus oxiracetam in treating mild vascular dementia (VD) and seek its underlying mechanism. Methods: Ninety-six patients with mild VD were randomized into an observation group and a control group, with 47 cases in the observation group and 49 cases in the control group. The control group received oral oxiracetam capsules for treatment, and the observation group was given additional Tuina treatment. Before and after treatment, the mini-mental state examination (MMSE) was adopted to assess the patient's cognitive function; the activities of daily living (ADL) scale was used to evaluate their ability to conduct daily activities; changes in the serum inflammatory factors and oxidative stress indicators were also detected. Results: After treatment, the serum content of malondialdehyde (MDA) decreased in both groups (P<0.05) and was lower in the observation group than in the control group (P<0.05); the serum contents of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) increased in both groups (P<0.05) and were higher in the observation group than in the control group (P<0.05); the serum contents of interleukin (IL)-1, tumor necrosis factor (TNF)-α, IL-6, and IL-8 declined in both groups (P<0.05) and were lower in the observation group than in the control group (P<0.05). After the intervention, the levels of systolic velocity (Vs) and mean velocity (Vm) of the middle cerebral artery elevated, and the pulsatility index (PI) dropped in patients in the two groups, showing significant intra-group differences (P<0.05); the levels of Vs and Vm in the observation group were higher than those in the control group, and the PI was lower in the observation group than in the control group, showing significant between-group differences (P<0.05). The MMSE and ADL scores increased in both groups after the intervention (P<0.05) and were higher in the observation group than in the control group (P<0.05). Conclusion: In the treatment of mild VD, Tuina plus oxiracetam can improve the cerebral blood supply, ADL, and cognitive function; the mechanism may be associated with the reduction of oxidative stress damages and inflammatory reactions.

Influence of the coronavirus disease 2019 pandemic on maternal breastfeeding for very low birth weight infants / 中国当代儿科杂志

OBJECTIVES@#To investigate the changes in the rate and volume of mother's own milk (MOM) feeding for very low birth weight infants (VLBWIs) hospitalized during the prevention and control of the coronavirus disease 2019 (COVID-19) pandemic.@*METHODS@#A retrospective analysis was performed on the medical data of the VLBWIs with a gestational age of <32 weeks who were born and admitted to the Neonatal Intensive Care Unit of Nanjing Maternal and Child Health Hospital from January 2019 to December 2020. The changes in the rate and volume of MOM feeding for VLBWIs during hospitalization were examined.@*RESULTS@#A total of 301 VLBWIs were enrolled. According to the timing of COVID-19 outbreak, these infants were divided into a pre-CIVID-19 group with 205 VLBWIs and a post-COVID-19 group with 96 VLBWIs. Compared with the pre-CIVID-19 group, the post-COVID-19 group had a significantly lower rate of MOM feeding within 28 days after birth and during hospitalization (P<0.05), a significantly lower volume of MOM feeding within 0-7 days, 0-14 days, and 0-28 days after birth (P<0.05), and significantly higher incidence rates of moderate-to-severe bronchopulmonary dysplasia and feeding intolerance (P<0.05).@*CONCLUSIONS@#The COVID-19 pandemic has a significant impact on MOM feeding for VLBWIs, and there are significant reductions in the rate and volume of MOM feeding for VLBWIs within 28 days after birth, as well as a significant reduction in the rate of MOM feeding during hospitalization.

Research progresses in transcutaneous vagus nerve stimulation / 上海交通大学学报（医学版）

The vagus nerve is involved in the regulation of human inflammation, mood and pain. Stimulation of the vagus nerve has assured therapeutic effects on intractable epilepsy and refractory depression. On the surface of the human body, the ear is the only area in which vagal afferent fibers distribute. According to the "bottom-up" mechanism of the signal processing, the central nervous system can be modulated by stimulating the peripheral nerve. Therefore, stimulation of the vagus nerve can regulate the activities of brain stem, thalamus, cerebral cortex and other related areas to produce therapeutic effects. Transcutaneous vagus nerve stimulation is a safe, low-cost, non-invasive physical therapy modified from vagus nerve stimulation. This review focuses on the regulation of organ function by transcutaneous vagus nerve stimulation and its application to diseases treatment.

Application of energy cost in evaluating energy expenditure in multi-ball practice with table tennis players / 中国应用生理学杂志

OBJECTIVE@#To investigate the feasibility of applying the measure of energy cost, utilized widely in cyclic sports, in table tennis multi-ball practice.@*METHODS@#Eleven collegiate table tennis players volunteered (18±1 yrs, 177±2 cm, 71±3 kg, approximately 10 yrs' training experience) to participate in one graded exercise test on treadmill, and two step tests (forehand and backhand, 3 min × 6, 35～85 stroke/min). A portable spirometric system and heart rate monitor were utilized for the three trials. Earlobe blood samples were collected and analyzed prior to and post the test. Energy cost was calculated for one stroke at each stroke frequency.@*RESULTS@#The energy cost of loop drive multi-ball practice was decreased with increased stroke frequency (P＜0.05). The energy cost of forehand loop drive was higher than backhand, with the difference significant at 35, 45, 55, 65, and 85 stroke·min (P＜0.05). The function between energy cost and frequency were y=166.4x (R=0.9731), and y=33.21x (R=0.8423), respectively, where y was energy cost, and x was stroke frequency.@*CONCLUSION@#The measure of energy cost utilized in cyclic sports could be applied to evaluate the energy expenditure in table tennis multi-ball practice of single technique, and indicate the stroke efficiency of table tennis muti-ball practice with different stroke frequencies.

Role of Recursive Partitioning Analysis and Graded Prognostic Assessment on Identifying Non-Small Cell Lung Cancer Patients with Brain Metastases Who May Benefit from Postradiation Systemic Therapy / 中华医学杂志(英文版)

<p><b>Background</b>The role of postradiation systemic therapy in non-small cell lung cancer (NSCLC) patients with brain metastasis (BM) was controversial. Thus, we explored the role of Radiation Therapy Oncology Group recursive partitioning analysis (RTOG-RPA) and graded prognostic assessment (GPA) in identifying population who may benefit from postradiation systemic therapy.</p><p><b>Methods</b>The clinical data of NSCLC patients with documented BM from August 2007 to April 2015 of two hospitals were studied retrospectively. Cox regression was used for multivariate analysis. Survival of patients with or without postradiation systemic therapy was compared in subgroups stratified according to RTOG-RPA or GPA.</p><p><b>Results</b>Of 216 included patients, 67.1% received stereotactic radiosurgery (SRS), 24.1% received whole-brain radiation therapy (WBRT), and 8.8% received both. After radiotherapy, systemic therapy was administered in 58.3% of patients. Multivariate analysis found that postradiation systemic therapy (yes vs. no) (hazard ratio [HR] = 0.361, 95% confidence interval [CI] = 0.202-0.648, P = 0.001), radiation technique (SRS vs. WBRT) (HR = 0.462, 95% CI = 0.238-0.849, P = 0.022), extracranial metastasis (yes vs. no) (HR = 3.970, 95% CI = 1.757-8.970, P = 0.001), and Karnofsky performance status (<70 vs. ≥70) (HR = 5.338, 95% CI = 2.829-10.072, P < 0.001) were independent factors for survival. Further analysis found that subsequent tyrosine kinase inhibitor (TKI) therapy could significantly reduce the risk of mortality of patients in RTOG-RPA Class II (HR = 0.411, 95% CI = 0.183-0.923, P = 0.031) or with a GPA score of 1.5-2.5 (HR = 0.420, 95% CI = 0.182-0.968, P = 0.042). However, none of the subgroups stratified according to RTOG-RPA or GPA benefited from the additional conventional chemotherapy.</p><p><b>Conclusion</b>RTOG-RPA and GPA may be useful to identify beneficial populations in NSCLC patients with BM if TKIs were chosen as postradiation systemic therapy.</p>

Study on distribution status of Oncomelania hupensis, the intermediate host of Schistosoma japonicum in Jiangxi Province Ⅱ Spatial-temporal distribution of snail-infested environments / 中国血吸虫病防治杂志

To grasp the status of Oncomelania hupensis snail-infested environments in schistosomiasis endemic areas of Jiangxi Province, and establish the spatial database of snail-infested environments with the administrative village as the unit.The spatial and temporal distributions of the historical snail environments, existing snail environments, and suspicious snail-infested environments were analyzed by the historical data review and field investigations.The distribution of snail-infested environments in Jiangxi Province included two popular types of lakeshore and hills. The O. hupensis snail-infested environments were mainly concentrated in the Poyang Lake area, which accounting for 66.97% of the total snail-infested areas. The potential snail-infested environment area was 204 745.48 hm2, among which the potential snail-infested environment areas in the lakeshore and hills were 146 548.58 hm2 and 58 196.90 hm2, accounting for 71.58% and 28.42%, respectively. The real existing snail area was 83 234.50 hm2, among which the real existing snail areas in the lakeshore and hills were 80 890.81 hm2 and 2 343.69 hm2, accounting for 97.18% and 2.82%, respectively. The compressed snail area was 114 253.30 hm2 with a compression rate of 57.85%, of which the compression rates in the lakeshore and hills were 46.51% and 94.97%, respectively. In the four types of snail-infested environments, the areas of Type I, Type II, Type III and Type IV accounted for 55.77%, 25.75%, 13.91% and 4.57% of the total area, respectively.The spatial database of O. hupensis snail-infested environments is established comprehensively and systematically, that will be conducive to tracking and performing the dynamic updates of the data of snails, so as to provide an important technical support for investigation and monitoring in the future.

Oral health related life quality assessment of young children before and after dental treatment under general anesthesia / 实用口腔医学杂志

Objective:To assess the effects of dental treatment under general anesthesia on the life quality of children and their families.Methods:59 children aged 3 to 6-year-old were included.Parents were required to complete the early childhood oral health impact scales(ECOHIS) before and 1 month after dental treatment under general anesthesia.The questionnaire includes child impact section(CIS) and family impact section(FIS).Data were analyzed using SPSS version 19.0.Results:55 out of the 59 parents completed the qustionnaire.After treatment the total ECOHIS scores decreased by 51％ (P ＜ 0.001),overall child impact section scores decreased by 50％ (P ＜0.001),and family impact section scores decreased by 53％ (P ＜0.001),revealing a large effect size(ES) for the child(1.4) and family (4.0) sections of the ECOHIS.Conclusion:Dental treatment under general anesthesia for uncooperative young children with extensive dental problems can improve the quality of life of both children and their families.

Systemic Therapy after Radiotherapy Significantly Reduces the Risk of Mortality of Patients with 1-3 Brain Metastases: A Retrospective Study of 250 Patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>For patients with a brain metastasis (BM), systemic therapy is usually administered after the completion of radiotherapy, especially in cases of multiple BMs. However, the role of systemic therapy in patients with a limited number of BMs is not clear. Therefore, we conducted a retrospective study to explore this question.</p><p><b>METHODS</b>Consecutive patients with a pathologically confirmed malignancy and 1-3 intracranial lesions that had been documented within the last decade were selected from the databases of three hospitals in China.</p><p><b>RESULTS</b>A total of 250 patients were enrolled; of them, 135 received radiotherapy alone and 115 received radiotherapy plus systemic therapy. In patients receiving whole-brain radiation therapy (WBRT) as radiotherapy, 28 received WBRT alone and 35 patients received WBRT plus systemic therapy. Of the patients treated with stereotactic radiosurgery (SRS), 107 received SRS alone and 80 received SRS plus systemic therapy. Multivariate analysis revealed that systemic therapy significantly reduced the risk of mortality compared with radiotherapy alone (hazard ratio [HR] = 0.294, 95% confidence interval [CI] = 0.158-0.548). Further, when the analysis was conducted in subgroups of WBRT (HR = 0.230, 95% CI = 0.081-0.653) or SRS (HR = 0.305, 95% CI = 0.127-0.731), systemic therapy still showed the ability to reduce the risk of mortality in patients with BMs.</p><p><b>CONCLUSION</b>Systemic therapy after either SRS or WBRT radiotherapy may significantly reduce the risk of mortality of patients with 1-3 BMs.</p>

Effects of recombinant hemoglobin on balance of oxygen supply and demand in coronary heart disease rats / 中华危重病急救医学

Objective To discuss the influence of two recombinant hemoglobin (rHb1.1 and rHb2.0) and human serum albumin (HSA) on oxygen supply and demand balance in rat with coronary heart disease (CHD). Methods Male Wistar rats were randomly divided into normal control group, CHD model group, HSA treatment group, rHb1.1 treatment group and rHb2.0 treatment group, 20 rats in each group. Rat model of CHD was established by high fat diet combined with pituitrin injection. The mean arterial pressure (MAP) decreased to 40 mmHg (1 mmHg = 0.133 kPa) after femoral arterial blood was drawn from the femoral arteries, and the rats were resuscitated with 13.4% HSA, rHb1.1 and rHb2.0, respectively, at the rate of 60 mL·kg-1·h-1 (20 mL/kg). The changes of electrocardiogram (ECG) ST-segment were calculated before model reproduction and at 12 hours after the last time injection of pituitrin. MAP, heart rate (HR), superior mesenteric artery blood flow (QSMA) and arterial blood gas analysis were recorded at 0, 30, 60, 90 and 120 minutes after the administration. The blood was collected after 12-hour fasting, and serum total cholesterol (TC) and triglyceride (TG) were determined by enzymatic method. The pathological changes in cardiac tissue were observed with light microscope. Results Compared with the normal control group, the changes of ECG ST-segment and TC, TG of model group were significantly increased. Compared with the model group, rHb can significantly reduce the value of ST segment changes, and HSA has no such effect; rHb short-term infusion has no significant effect on blood lipids, but can reduce myocardial pathological changes. Compared with the normal control group, the MAP of the model group decreased significantly, the HR was increased, the QSMA was slowed down, the pH value, the residual alkali (BE), the arterial carbon dioxide partial pressure (PaCO2) and HCO3- were decreased significantly. MAP in rHb1.1 group and rHb2.0 group were significantly higher than those in HSA group. Values of MAP were significantly higher in rHb2.0 group than those in rHb1.1 group at 90 minutes and 120 minutes (mmHg: 80.9±3.3 vs. 69.4±4.9, 79.2±4.0 vs. 69.1±3.7, both P < 0.05). The HR of HSA, rHb1.1 and rHb2.0 decreased to normal in 30 minutes after administration, significantly lower than those in the model group (bpm: 534±46, 518±28, 526±37 vs. 609±52, all P < 0.05). In the rHb2.0 group, the QSMA increased significantly at 60, 90 and 120 minutes compared with the model group (qv·mL-1·min-1: 5.6±0.4 vs. 3.9±0.6, 6.2±0.6 vs. 4.1±0.4, 6.9±0.7 vs. 4.0±0.3, all P < 0.05), but there was no significant difference between the HSA group and the rHb1.1 group. The pH, BE, PaCO2 did not return to the normal level after administration of HSA; pH, PaCO2 and HCO3- in the rHb1.1 group returned to normal level at 60 minutes after administration, and BE returned to normal level at 90 minutes after administration. Each index in rHb2.0 group can restore to normal levels 30 minutes ahead of. Conclusion Recombinant hemoglobin can significantly improve the oxygen supply and demand balance of rats with CHD model, can quickly and effectively correct the hypoxic state of blood metabolic acidosis, and rHb2.0 has better effect than rHb1.1.

Comparison of thromboelastography and routine coagulation tests for evaluation of blood coagulation function in patients / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the correlation and consistency between thromboelastography(TEG) and routine coagulation tests, and to evaluate the value of the two methods in determining the blood coagulation of patients.</p><p><b>METHODS</b>The TEG, routine coagulation tests and platelet counts of 182 patients from the Intensive Care Unit(ICU) and Department of Gastroenterology in our hospital from January to September 2014 were performed and analyzed retrospectively for their correlation, Kappa identity test analysis and chi-square test, and the diagnostic sensitivity and specificity of both methods in the patients with bleeding were evaluated.</p><p><b>RESULTS</b>The TEG R time and PT, R time and APTT showed a linear dependence (P<0.01). The relationship between the TEG K value, α-Angle, MA and Fibrinogen showed a linear dependence (P<0.001). And the relationship between the TEG K value, α-Angle, MA and the platelet count were in a linear dependent way (P<0.001). The Kappa values of the TEG R time with PT and APTT were 0.038 (P>0.05) and 0.061 (P>0.05), respectively. The chi-square test values of the TEG R time with PT and APTT were 35.309 (P<0.001) and 15.848 (P<0.001), respectively. The Fibrinogen and the TEG K value, α-Angle, MA value had statistical significance (P<0.001), with a Kappa value of 0.323, 0.288 and 0.427, respectively. The chi-square test values between Fibrinogen and the TEG K value, α-Angle, MA value were not statistically significant, with X2=1.091 (P=0.296), X2=1.361 (P=0.243), X2=0.108 (P=0.742). The Kappa values of the platelet count and the TEG K value, α-Angle, MA value were 0.379, 0.208 and 0.352, respectively, which were also statistically significant difference (P<0.001). The chi-square test values between the platelet count and the TEG K value, α-Angle, MA value showed a statistically significant difference (P<0.001), with X2=37.5, X2=37.23, X2=26.630. The diagnostic sensitivity of the two methods for the patients with bleeding was less than 50%.</p><p><b>CONCLUSION</b>There was a significant correlation between some TEG parameters and routine coagulation tests, but the consistency is weak. Moreover, the diagnostic sensitivity of two methods in the patients with bleeding is low. It was concluded that the TEG cannot replace the conventional coagulation tests, and the preferable method remains uncertain which could reflect the risk of bleeding.</p>

Prophylactic antibiotics: a necessity in totally percutaneous thoracic endovascular aortic repair? / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the benefit of prophylactic antibiotics (PA) in totally percutaneous aortic endovascular repair (PEVAR) in the catheterization laboratory for reducing stent-graft infection and postimplantation syndrome (PIS).</p><p><b>METHODS</b>The clinical data were analyzed of patients undergoing thoracic endovascular aortic repairs. The patients were divided into non-PA group and PA group according to the use of prophylactic antibiotics before PEVAR. The diagnosis of infection was made by two senior physicians with reference to Hospital Acquired Infection Diagnostic Criteria Assessment released by the Ministry of Health of China.</p><p><b>RESULTS</b>The 95 enrolled patients included 35 with PA and 60 without PA group, who were comparable for baseline characteristics. Infection-related deaths occurred in 1 case in non-PA group and retrograde Stanford type A dissection and death occurred in 1 case in PA group (1.67% vs 2.85%, P=1.00). The PA and non-PA groups showed no significant difference in the incidence of postoperative infection (5% vs 2.86%, P=1.000), hospital stay (9.30±7.21 vs 10.06±5.69, P=0.094), infection-related mortality (1.67% vs 0%, P=1.00), or postoperative fever (70.90% vs 91.43%, P=0.20). The body temperature showed significant variations at different time points after procedure (F=19.831, P<0.001) irrelevant to the use of prophylactic antibiotics (F=0.978, P=0.326).</p><p><b>CONCLUSION</b>The current data do not support the benefit of PA in reducing postoperative infection and PIS in patients undergoing PEVAR, but the patients without PA may have worse clinical outcomes in the event of postoperative infections.</p>

Design of customized hip stem prosthesis with standard cross-section shape / 医用生物力学

Objective To introduce the structure of the self-developed design for customized hip stem prothesis and decribe its standard cross-section shape. Methods The proximal femur model was reconstructed based on a patient’s CT image with DICOM format. The rectangle borders on cross-section of the matching area of the hip stem prosthesis were created, and the cross-section contour lines in rectangle borders were formed preliminarily by using simple lines. Based on the proximal femur model, the hip stem prosthesis was verified, and made modification to match the corresponding femoral cavity of the patient through adjusting design parameters. Results The cross-section of the customized hip stem prosthesis was of standard shapes, which was convenient for the quick design of this kind of individualized prosthesis with a simple design course. The parametric design program greatly reduced the workload when designing individualized hip stem prosthesis. Conclusions The design of customized hip stem prosthesis with standard cross-section shape could help to increase the success rate of artificial hip replacement surgeries, promote the application of customized hip stem prosthesis in clinic, and further improve the life quality of patients.

Design principle and method of customized hip stem prosthesis based on X-ray films / 医用生物力学

Objective To introduce the design principles and functional modules of a self-programmed software system for designing customized hip stem prosthesis based on X-ray films. Methods Some femoral anatomical feature points (e.g. the peak of trochanter minor, the center of femoral head, trochanteric fossa), two planned points on osteotomy line (a boundary point at the side of trochanter major and the lowest point on the osteotomy line), and some key location points for designing (e.g. the hip stem far-end location point, the highest point of neck shaft connecting section) were extracted from X-ray films by using image processing methods to predict the patient’s proximal femoral cavities. The customized hip stem prosthesis was designed by inputting the design parameters (e.g. the neck-shaft angle, anteversion angle, thickness of reserved cancellous bone, radiuses of the cross-section in matching area of the prosthesis, height of transition area of the prosthesis). Two-dimensional cross-section verification on matching area of the customized hip stem prosthesis and three-dimensional overall verification were conducted. Results According to the verification results, the design parameters were adjusted to regenerate point cloud data of the hip stem prosthesis model, which could make the designed hip stem prosthesis match the patient’s femoral cavity and finally meet the requirements for the customized purpose. Conclusions The program system introduced in this paper can be used to design customized hip stem prostheses for patients. With the much shorter design cycle and relatively lower cost, this program system can promote the application of customized hip stem prosthesis in clinic and further prove the life quality of patients.

Perioperative aortic dissection rupture after endovascular stent graft placement for treatment of type B dissection / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The perioperative aortic dissection (AD) rupture is a severe event after endovascular stent graft placement for treatment of type B AD. However, this life-threatening complication has not undergone systematic investigation. The aim of the study is to discuss the reasons of AD rupture after the procedure.</p><p><b>METHODS</b>The medical record data of 563 Stanford type B AD patients who received thoracic endovascular repair from 2004 to December 2011 at our institution were collected and analyzed. Double entry and consistency checking were performed with Epidata software.</p><p><b>RESULTS</b>Twelve patients died during the perioperation after thoracic endovascular repair, with an incidence of 2.1%, 66.6% were caused by aortic rupture and half of the aortic rupture deaths were caused by retrograde type A AD. In our study, 74% of the non-rupture surviving patients had the free-flow bare spring proximal stent implanted, compared with 100% of the aortic rupture patients (74% vs. 100%, P = 0.213). The aortic rupture patients are more likely to have ascending aortic diameters = 4 cm (62.5% vs. 9.0%, P = 0.032), involvement the aortic arch concavity (62% vs. 27%, P = 0.041) and have had multiple stents placed (P = 0.039).</p><p><b>CONCLUSIONS</b>Thoracic AD endovascular repair is a safe and effective treatment option for AD with relative low in-hospital mortality. AD rupture may be more common in arch stent-graft patients with an ascending aortic diameter = 4 cm and with severe dissection that needs multi-stent placement. Attention should be paid to a proximal bare spring stent that has a higher probability of inducing an AD rupture. Post balloon dilation should be performed with serious caution, particularly for the migration during dilation.</p>

Changes of mitochondria in human placenta in intrauterine growth restriction / 临床儿科杂志

Objective To explore the mechanism of intrauterine growth restriction (IUGR) via observing the change of mitochondria in IUGR placenta. Methods Placenta samples were collected from 30 singleton pregnancies at the time of elec-tive caesarean section. Fifteen of them were appropriate for gestational age and 15 were IUGR. Mitochondrial morphology was observed by transmission electron microscopy, DNA copies were analyzed by real-time quantitative PCR and membrane potential was assayed by lfow cytometry. Results Signiifcant morphological changes of placental mitochondria were observed under transmission electron microscopy in IUGR, mitochondrial DNA copies in IUGR placenta were signiifcantly increased (P<0.01) and membrane potential decreased dramatically (P<0.01). Conclusions It is suggest that impaired mitochondrial function in IUGR may involve in IUGR pathogenesis.

Genetic variability in adapter proteins with APPL1/2 is associated with the risk of coronary artery disease in type 2 diabetes mellitus in Chinese Han population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Adaptor proteins containing PH domain, PTB domain, and leucine zipper motif 1 and 2 (APPL1/2) play a key role in cell proliferation in many tissues. APPL1 or APPL2 as an adaptor for adiponectin receptors mediates the signaling pathway of adiponectin which acts as an anti-atherosclerotic adipokine. This study aimed to investigate whether genetic variations in the APPL1/2 genes affect the risk of coronary artery disease (CAD) in Chinese patients with type 2 diabetes mellitus (T2DM).</p><p><b>METHODS</b>Seven haplotype-tagging single nucleotide polymorphisms (tag-SNPs) were selected from CHB HapMap database (Phase II) and total 203 CAD-positive cases and 106 CAD-negative controls with T2DM were genotyped for the 7 tag-SNPs by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay.</p><p><b>RESULTS</b>The minor allele G of rs4640525 at APPL1 locus was protective from CAD in patients with T2DM, with the carriers of genotype CC at higher risk of CAD compared with non-carriers (OR = 2.830, 95%CI 1.285 - 6.230, P = 0.010; OR' = 4.992, 95%CI = 1.758 - 14.173, P' = 0.003, after adjustment for the other known CAD risk factors); the homozygotes of AA at rs11112412 in APPL2 gene had higher risk of CAD compared with those of GG (adjusted OR' = 5.697, 95%CI 1.006 - 32.257, P' = 0.049).</p><p><b>CONCLUSION</b>Genetic variation(s) in APPL1/2 may be associated with CAD risk in T2DM in Chinese population.</p>

Overexpression of resistin affect 3T3-L1 adipocyte lipid metabolism / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the effect of resistin overexpression on 3T3-L1 adipocyte lipid and glucose metabolism.</p><p><b>METHODS</b>Expression vector for rat resistin gene was constructed and transfected into 3T3-L1 adipocytes. Cell differentiation and lipid accumulation was determined by Oil Red O staining. Differentiation marker genes (pref-1, C/EBPalpha, FAS) and glucose transporter 4 (GLUT4) gene mRNA expressions were evaluated by reverse transcription-PCR (RT-PCR). Triglyceride (TG) and free fatty acids (FFAs) in adipocytes were measured by colorimetric kit.</p><p><b>RESULTS</b>(1) In resistin-overexpressed adipocytes, the lipid droplets presented at the second day which was earlier than the control cells. (2) The expression of C/EBPalpha and FAS genes in resistin-overexpressed adipocytes were up-regulated and the pref-1 was down-regulated compared with that of the control cells. (3) In resistin-overexpressed adipocytes, cellular TG and FFAs levels were significantly increased (P<0.05). (4) There was no difference in the expression of GLUT4 gene between 3T3-L1 adipocytes and resistin-overexpressed adipocytes (P> 0.05).</p><p><b>CONCLUSION</b>Overexpression of resistin can affect 3T3-L1 adipocyte lipid metabolism and thereby result in obesity and insulin resistance, but have no effect on GLUT4 gene expression.</p>