Analysis of the clinical characteristics and therapeutic effect of refractory juvenile dermatomyositis to tofacitinib / 中华儿科杂志

Objective: To elucidate the clinical features of patients with refractory juvenile dermatomyositis (JDM), and to explore the efficacy and safety of tofacitinib in the treatment of refractory JDM. Methods: A total of 75 JDM patients admitted to the Department of Rheumatology and Immunology in Shenzhen Children's Hospital from January 2012 to January 2021 were retrospectively analyzed, and to analyze the clinical manifestations, efficacy and safety of tofacitinib in the treatment of refractory JDM. Patients were divided into refractory group with using of glucocorticoids in combination with two or more anti-rheumatic drugs for treatment, and the presence of disease activity or steroid dependence after a one-year follow-up. The non-refractory group is defined as clinical symptoms disappeared, laboratory indicators were normal, and clinical remission was achieved after initial treatment, and the clinical manifestations and laboratory indexes of the two groups were compared. The Mann-Whitney U test, Fisher's precision probability test was used for intergroup comparison. Binary Logistic multivariate regression analysis was used to identify risk factors for refractory JDM. Results: Among the 75 children with JDM, 41 were males and 34 were females with a age of onset of 5.3 (2.3, 7.8) years. The refractory group consisted of 27 cases with a age of onset of 4.4 (1.5, 6.8) years, while the non-refractory group consisted of 48 cases with a age of onset of 5.9 (2.5, 8.0) years. Compared with 48 cases in the non-refractory group, the proportion of interstitial lesions and calcinosis in the refractory group was higher than that in the non-refractory group (6 cases (22%) vs. 2 cases (4%), 8 cases (30%) vs. 4 cases (8%), both P<0.05). Binary Logistic regression analysis showed that observation group were more likely to be associated with to interstitial lung disease (OR=6.57, 95%CI 1.22-35.31, P=0.028) and calcinosis (OR=4.63, 95%CI 1.24-17.25, P=0.022). Among the 27 patients in the refractory group, 22 cases were treated with tofacitinib, after treatment with tofacitinib, 15 of 19 cases (86%) children with rashes showed improvement, and 6 cases (27%) with myositis evaluation table score less than 48 score both were improved, 3 of 6 cases (27%) had calcinosis were relieved, and 2 cases (9%) had glucocorticoid-dependence children were successfully weaned off. During the tofacitinib treatment, there was no increase in recurrent infection, blood lipids, liver enzymes, and creatinine were all normal in the 22 cases. Conclusions: Children with JDM with calcinosis and interstitial lung disease are more likely to develop refractory JDM. Tofacitinib is safe and effective for refractory JDM.

Simultaneous determination of eleven volatile components in Cinnamomi Oleum by GC-MS / 中国中药杂志

A gas chromatography-triple quadrupole mass spectrometry(GC-MS) method was established for the simultaneous determination of eleven volatile components in Cinnamomi Oleum and the chemical pattern recognition was utilized to evaluate the quality of essential oil obtained from Cinnamomi Fructus medicinal materials in various habitats. The Cinnamomi Fructus medicinal materials were treated by water distillation, analyzed using GC-MS, and detected by selective ion monitoring(SIM), and the internal standards were used for quantification. The content results of Cinnamomi Oleum from various batches were analyzed by hierarchical clustering analysis(HCA), principal component analysis(PCA), and orthogonal partial least squares-discriminant analysis(OPLS-DA) for the statistic analysis. Eleven components showed good linear relationships within their respective concentration ranges(R~2>0.999 7), with average recoveries of 92.41%-102.1% and RSD of 1.2%-3.2%(n=6). The samples were classified into three categories by HCA and PCA, and 2-nonanone was screened as a marker of variability between batches in combination with OPLS-DA. This method is specific, sensitive, simple, and accurate, and the screened components can be utilized as a basis for the quality control of Cinnamomi Oleum.

Silybin alleviates hepatic lipid accumulation in methionine-choline deficient diet-induced nonalcoholic fatty liver disease in mice via peroxisome proliferator-activated receptor α / 中国天然药物

Nonalcoholic fatty liver disease (NAFLD) is regarded as the most common liver disease with no approved therapeutic drug currently. Silymarin, an extract from the seeds of Silybum marianum, has been used for centuries for the treatment of various liver diseases. Although the hepatoprotective effect of silybin against NAFLD is widely accepted, the underlying mechanism and therapeutic target remain unclear. In this study, NAFLD mice caused by methionine-choline deficient (MCD) diet were orally administrated with silybin to explore the possible mechanism and target. To clarify the contribution of peroxisome proliferator-activated receptor α (PPARα), PPARα antagonist GW6471 was co-administrated with silybin to NAFLD mice. Since silybin was proven as a PPARα partial agonist, the combined effect of silybin with PPARα agonist, fenofibrate, was then evaluated in NAFLD mice. Serum and liver samples were collected to analyze the pharmacological efficacy and expression of PPARα and its targets. As expected, silybin significantly protected mice from MCD-induced NAFLD. Furthermore, silybin reduced lipid accumulation via activating PPARα, inducing the expression of liver cytosolic fatty acid-binding protein, carnitine palmitoyltransferase (Cpt)-1a, Cpt-2, medium chain acyl-CoA dehydrogenase and stearoyl-CoA desaturase-1, and suppressing fatty acid synthase and acetyl-CoA carboxylase α. GW6471 abolished the effect of silybin on PPARα signal and hepatoprotective effect against NAFLD. Moreover, as a partial agonist for PPARα, silybin impaired the powerful lipid-lowering effect of fenofibrate when used together. Taken together, silybin protected mice against NAFLD via activating PPARα to diminish lipid accumulation and it is not suggested to simultaneously take silybin and classical PPARα agonists for NAFLD therapy.

Molecular identification and efficacy analysis of herbs at Orussey Herbal Market, Phnom Penh, Cambodia / 中国中药杂志

Cambodia is rich in medicinal plant resources. One hundred and thirty-three medicinal material samples, including the hole herb, root, stem/branch, leaf, flower, fruit, seed, and resin, were collected from the Orussey Herbal Market in Phnom Penh, Cambodia, and then authenticated by ITS and psbA-trnH. A total of 46 samples were identified based on ITS sequences, belonging to 24 families, 40 genera, and 42 species. A total of 100 samples were identified by psbA-trnH sequences to belong to 42 families, 77 genera, and 84 species. A total of 103 samples were identified by two DNA barcodes. According to the morphological characteristics of the medicinal materials, 120 samples classified into 50 species, 86 genera, and 86 families were identified, and the majority of them were from Zingiberaceae, Fabaceae, and Acanthaceae. Such samples have been commonly used in traditional Cambodian medicine, Ayurvedic medicine, Unani medicine, traditional Chinese medicine, and ethnomedicine, but different medical systems focus on different functional aspects of the same medicinal material. The results of this study have demonstrated that DNA barcoding has a significant advantage in identifying herbal products, and this study has provided basic data for understanding the traditional medicinal materials used in Cambodia.

Identification and characterization of DIR gene family in Schisandra chinensis / 中国中药杂志

Dirigent(DIR) proteins are involved in the biosynthesis of lignin, lignans, and gossypol in plants and respond to biotic and abiotic stresses. Based on the full-length transcriptome of Schisandra chinensis, bioinformatics methods were used to preliminarily identify the DIR gene family and analyze the physico-chemical properties, subcellular localization, conserved motifs, phylogeny, and expression patterns of the proteins. The results showed that a total of 34 DIR genes were screened and the encoded proteins were 156-387 aa. The physico-chemical properties of the proteins were different and the secondary structure was mainly random coil. Half of the DIR proteins were located in chloroplast, while the others in extracellular region, endoplasmic reticulum, cytoplasm, etc. Phylogenetic analysis of DIR proteins from S. chinensis and the other 8 species such as Arabidopsis thaliana, Oryza sativa, and Glycine max demonstrated that all DIR proteins were clustered into 5 subfamilies and that DIR proteins from S. chinensis were in 4 subfamilies. DIR-a subfamily has the unique structure of 8 β-sheets, as verified by multiple sequence alignment. Finally, through the analysis of the transcriptome of S. chinensis fruit at different development stages, the expression pattern of DIR was clarified. Combined with the accumulation of lignans in fruits at different stages, DIR might be related to the synthesis of lignans in S. chinensis. This study lays a theoretical basis for exploring the biological functions of DIR genes and elucidating the biosynthesis pathway of lignans in S. chinensis.

Effectiveness of anti-pressure protective mask for medical personnel fighting against coronavirus disease 2019 / 第二军医大学学报

Objective To evaluate the effectiveness of anti-pressure protective mask for medical personnel fighting against the coronavirus disease 2019 (COVID-19). Methods Convenience sampling method was used to select 120 military frontline anti-epidemic medical personnel supporting Wuhan medical team from Jan. 26 to Feb. 24, 2020, and they were evenly divided into blank group, control group and observation group. The blank group did not use anti-pressure dressings, the control group wore face protection equipments after using hydrocolloid dressings, and the observation group wore face protection equipments after using anti-pressure protective mask. At the end of the intervention, the facial comfort, facial pressure injuries, and adverse effects were compared between the three groups. Results At the end of the intervention, the facial comfort score was 6.00 (6.00, 7.00) in the blank group, 5.00 (4.00, 5.00) in the control group, and 1.00 (0.50, 2.00) in the observation group, with significant differences found among the three groups (H=97.392, P<0.001). According to the further inference of the rank mean, the blank group had the largest facial comfort rank mean (96.68), while the observation group had the smallest facial comfort rank mean (20.88). At the end of the intervention, three cases (7.5%, 3/40) in the blank group had no facial injury, 28 cases (70.0%, 28/40) had facial pressure injury at stage 1, and nine cases (22.5%, 9/40) at stage 2; 27 cases (67.5%, 27/40) in the control group had no facial injury and 13 cases (32.5%, 13/40) had facial pressure injury at stage 1; 37 cases (92.5%, 37/40) in the observation group had no facial injury and three cases (7.5%, 3/40) had facial pressure injury at stage 1. There was significant difference in the incidence of facial pressure injuries among the three groups (χ2=71.863, P<0.001). The observation group had the lowest facial pressure injury rate among the three groups. There was no skin allergic reaction in the three groups and none of them was infected with COVID-19. Conclusion Anti-pressure protective mask can effectively reduce the incidence of facial pressure injuries and improve the facial comfort when wearing facial protective equipment, and it can be used for protecting frontline anti-epidemic medical personnel.

Difference Analysis of Volatile Components in Roots ，Stems and Leaves of Gaultheria yunnane nsis by GC-MS / 中国药房

OBJECTIVE：To compare the volatile components extracted from the roots ，stems and leaves of Gaultheria yunnanensis. METHODS ：Steam distillation method was used to extract the volatile oils from roots ，stems and leaves of G. yunnanensis. Chemical constituents were analyzed by GC-MS. NIST 2011 standard mass spectral library was adopted to select the chromatographic peak with a matching degree higher than 80，and combined with relevant literatures for identification. Relative percentages of chemical constituents were calculated by peak area normalization. RESULTS ：Totally 95 chromatographic peaks were detected in valatile oil from the roots of G. yunnanensis and 54 chemical constituents were identified ，accounting for 82.35％ of the total content of root volatile components. The constituents with relatively high content were methyl salicylate （20.30％）， n-hexadecanoic acid （19.86％），（Z，Z）-9，12-octadecadienoic acid （9.26％），phenanthrene（4.37％）and so on. Totally 69 chromatographic peaks were detected in volatile oil from the stems and leaves of G. yunnanensis and 46 chemical constituents were identified，accounting for 97.10％ of the total content of volatile components in stems and leaves. The constituents with relatively high content were methyl salicylate （86.72％），n-hexadecanoic acid （2.60％），（Z，Z，Z）-9，12，15-octadecatrienoic acid （1.25％） and so on. Both of them contained 16 common constituents such as alkenes esters ，acids and so on. CONCLUSIONS：The chemical constituents of volatile oils extracted from the roots ， stems and leaves of G. yunnanensis are mainly esters and acids. The components are similar to each other ，but the contents of acids in the roots and esters in the leaves and stems are higher.

Study on the protective effect of quercetin on age-related macular degeneration in mice based on Nrf2/Keap1/ARE pathway / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the protective effect and mechanism of quercetin on age-related macular degeneration in mice through Nrf2/Keap1/ARE pathway. <p>METHODS: Kunming mice were used as research objects, which were divided into control group, model group and quercetin group. Fundus examination was showed whether yellow-white like glassy sputum substances appeared in the fundus of each group of mice; OCT was used to examine the retinal thickness of each group of mice; HE staining was used to observe the changes of retinal morphology in each group of mice; FFA was observed the fundus vascular integrity of each group of mice. The activities of SOD, GSH-Px, CAT and the contents of ROS and MDA in serum were detected by ELISA; Western blot was used to detect the expression of Nrf2/Keap1/ARE related proteins in the retina of each group. <p>RESULTS: Quercetin can reduce the yellow and white glassy wart substance in the fundus of mice and increase the thickness of the retina(<i>P</i><0.05), and the points of retinal vascular leakage is significantly reduced. Compared with the model group, the a-wave amplitude and b-wave amplitude of the quercetin group were significantly higher than those of the model group(<i>P</i><0.01); Quercetin can make the retinal structure of mice clearer, necrosis and shed part of the outer nuclear layer, and reduce the content of ROS and MDA in mouse serum(all <i>P</i><0.05), and increase the activities of SOD, GSH-Px, and CAT(all <i>P</i><0.05). Compared with the model group, the expression of Nrf2 protein in the retinal cytoplasm of mice in the quercetin group was up-regulated(<i>P</i><0.05), and the expression of Nrf2 protein in the nucleus was down-regulated(<i>P</i><0.05), GCL protein expression was down-regulated(<i>P</i><0.05).<p>CONCLUSION: Quercetin improved the oxidative stress state after retinal photodamage through the Nrf2/Keap1/ARE pathway, protected the retinal function, and protected against age-related macular degeneration.

Comparison of predictive values between different risk assessment scales for deep vein thrombosis in patients with pelvic or acetabular fracture / 中华创伤骨科杂志

Objective:To compare the predictive values between 4 risk assessment scales for deep venous thrombosis (DVT) in patients with pelvic or acetabular fracture.Methods:The clinical data of 235 patients with pelvic or acetabular fracture were retrospectively analyzed who had been admitted to Xi'an Honghui Hospital from July 2014 to July 2018. They were 168 males and 67 females, aged from 18 to 90 years (average, 43.5 years). They were divided into a DVT group and a DVT-free group according to the results of vein ultrasongraphy. The RAPT, Caprini, Wells, and Autar scales were used respectively to assess the risk of DVT in the patients. The 2 groups were compared in terms of the scores of the 4 scales. After the receiver operating characteristic curve (ROC) was drawn and the area under the ROC curve (AUC) was calculated, the predictive values of the 4 scales were evaluated for lower limb DVT in the patients with pelvic or acetabular fracture.Results:Of the 235 patients, 104 (44.3%) had DVT. There was no statistically significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). The DVT group scored significantly higher in RAPT, Wells and Autar scales than the DVT-free group( P<0.05). The AUCs for the RAPT, Caprini, Wells, and Autar scales were respectively 0.84±0.02, 0.65±0.05, 0.81±0.02 and 0.72±0.03, showing significant differences ( F=1.254, P=0.031). The AUCs for RAPT and Wells scales were significantly higher than those for Caprini and Autar scales, and the AUS for Autar scale was significant higher than that for Caprini ( P<0.05). The sensibilities for RAPT, Caprini, Wells and Autar scales were respectively 94.0%, 65.0%, 90.6% and 84.0% while the specificities for them 62.1%, 51.8%, 67.2% and 32.5%. Conclusion:Although all the 4 scales have a certain predictive value for the DVT risk in patients with pelvic or acetabular fracture, RAPT and Wells scales are more valuable.

Risk factors of atrial fibrillation complicated with left atrial thrombosis / 中国基层医药

Objective:To investigate the predictive value of plasma platelet microparticle (PMP) levels on left atrial thrombosis of patients with non-valvular atrial fibrillation.Methods:From January 2014 to December 2018, 500 patients with non-valvular atrial fibrillation in Shaoxing People's Hospital were selected and divided into thrombus group (62 cases) and non-thrombotic group (438 cases) according to the presence or absence of left atrial wall thrombosis.The plasma PMP levels were determined by flow cytometry.The serum high-sensitivity C-reactive protein (hs-CRP), D-dimer (D-D), fibrinogen (Fg) and von Willebrand factor (vWF) levels were measured.The left ventricular ejection fraction (LVEF), left atrial diameter (LAD), left ventricular end-systolic volume (ESV) and left ventricular end-diastolic volume (EDV) were measured by echocardiography.Results:The PMP[(4.81±0.64)×10 5/mL], hs-CRP[(2.02±0.37)mg/L], D-D[(1.34±0.16)mg/L], Fg[(4.38±0.69)g/L] and vWF[(145.31±14.62)ng/mL] in the thrombus group were higher than those in the non-thrombosis group[(3.67±0.58)×10 5/mL, (1.51±0.24)mg/L, (1.08±0.12)mg/L, (3.46±0.71)g/L, (122.16±12.31)ng/mL]( t=14.296, 14.487, 15.257, 9.582, 13.523, all P<0.05). The LAD in the thrombus group[(59.02±9.74)mm] was higher than that in the non-thrombosis group[(61.23±9.53)mm]( t=4.085, P<0.05). Univariate logistic regression analysis showed that stroke ( OR=2.624, 95% CI: 1.012-1.067, P=0.011), persistent atrial fibrillation ( OR=3.426, 95% CI: 2.014-5.691, P<0.001), CHA2DS2-VASc score ( OR=1.702, 95% CI: 1.357-2.002, P<0.001), PMP ( OR=1.562, 95% CI: 1.124-1.968, P<0.001), hs-CRP ( OR=1.486, 95% CI: 1.077-2.043, P=0.013), DD ( OR=1.765, 95% CI: 1.126-2.031, P<0.001), Fg ( OR=1.637, 95% CI: 1.077-2.043, P<0.001), vWF ( OR=1.812, 95% CI: 1.242-2.238, P<0.001) and LAD ( OR=1.094, 95% CI: 1.043-1.152, P<0.001) were the influencing factors of thrombosis ( P<0.05). Multivariate logistic regression analysis showed that persistent atrial fibrillation ( OR=3.361, 95% CI: 1.658-6.543, P<0.001), CHA2DS2-VASc score ( OR=1.721, 95% CI: 1.242-2.065, P=0.002) and PMP ( OR=1.173, 95% CI: 1.086-3.981, P=0.016) were independent influencing factors for thrombosis.The areas under the ROC curve of CHA2DS2-VASc score, PMP and CHA2DS2-VASc score combined with PMP in diagnosis of thrombosis were 0.783 (95% CI: 0.780-0.786, P<0.001), 0.744 (95% CI: 0.741-0.747, P<0.001), 0.853 (95% CI: 0.850-0.858, P<0.001). Conclusion:PMP is an independent influencing factor for left atrial thrombosis in non-valvular atrial fibrillation, which can assist the CHA2DS2-VASc score to improve the predictive value in left atrial thrombosis of non-valvular atrial fibrillation.

Advances of immunotherapy in refractory thyroid carcinoma / 中华内分泌外科杂志

In recent years, the incidence of thyroid cancer has increased significantly and it has become the most common malignant tumor of the endocrine system. Despite the favorable prognosis of most thyroid cancers, a small fraction of differentiated thyroid carcinomas and almost all anaplastic thyroid carcinomas grouped together as "refractory thyroid carcinoma (RTC) " , remain resistant to standard treatment options, including early surgery and radioactive 131I treatment. It is unclear what treatment is best for cases of RTC. Tumor immunotherapy is an emerging treatment after surgery, radiotherapy, chemotherapy and targeted therapy. Immunotherapy has shown great potential in various malignant tumors and may provide a new choice for the treatment of RTC.

Purification of Periploca forrestii total flavonoids and assay for the in vitro inhibitory activity on xanthine oxidase / 国际药学研究杂志

Objective: To extract and purify total flavonoids from Periploca forrestii Schltr.(P. forrestii),and test the in vitro inhibitory activity of the total flavonoids and two flvaonoidal compounds in P. forrestii,so as to provide a reference for studies on the related medicinal substances in P. forrestii. Methods: Total flavonoids were extracted from P. forrestii and then purified by the column chromatography on macroporous resin and polyamide columns. The content of total flavonoids was determined according to the Lambert-Beer’s law. The in vitro xanthine oxidase(XOD)inhibitory ac- tivity was assayed for total flavonoids and the two flavonoidal compounds by the ultraviolet spectrophotometry. Results The purified total flavonoids had a content of more than 95%. The total flavonoids and two flavonoidal compounds all showed an inhibitory effect on XOD in vitro,with the inhibitory rate enhanced with increasing concentration. The IC50 of the total flavonoids as well as the two flavonoidal compounds,quercetin-3-O-α-L-pyranoside(QP)and quercetin-7-O-β- D-glucopyranoside(QG)were 608.9,221.2 and 261.2 μg/ml,respectively. Conclusion: The total flavonoids as well as the two flvaonoidal compounds QP and QG in P. forrestii all showed the in vitro inhibitory activity on XOD.

Research Progress of Periploca forrestii Schltr / 中国药学杂志

Periploca forrestii, a traditional medicine commonly used by Miao people, is one of the "three treasures of Miao medicine", which mainly contains various components such as cardiac glycosides, flavonoids, ceramides, terpenoids, phenylpropanoid and volatile oils. It has significant pharmacological effects including cardiotonic, anti-inflammatory, antioxidant, pain-suppressing, and antibacterial activities, and is used to treat rheumatoid arthritis, bruises, stomach pain, dyspepsia, amenorrhea, and dysentery. Relevant domestic and abroad literatures were summarized, and a comprehensive review of the chemical constituents, pharmacological effects, clinical application, quality control and spectrum-effect relationship of Periploca forrestii was conducted, to provide evidences for further investigation of Periploca forrestii Schltr.

Protective Effect of Zengye Decoction () on Submandibular Glands in Nonobese Diabetic Mice / 中国结合医学杂志

OBJECTIVE@#To investigate the protective effect of Zengye Decoction (, ZYD) on the submandibular glands (SMGs) in nonobese diabetic (NOD) mice.@*METHODS@#Twenty-seven female NOD mice were randomly equally divided into 3 groups: the model group, the hydroxychloroquine (HCQ) group, and the ZYD group. Nine C57/B6 mice served as the normal group. After 1-week acclimation, the HCQ and ZYD groups were intragastrically administered with HCQ and ZYD, respectively, and the normal and model groups were administered with normal saline. Changes in the salivary flow rate were observed. Mice from all 4 groups were sacrificed at the age of 20 weeks. The serum and SMGs were collected. Serum cytokines gamma-interferon (IFN-γ), interleukin-10 (IL-10) were detected by enzyme-linked immunosorbent assay. Histological changes in the submandibular glands were examined by hematoxylin and eosin staining. The mRNA expression of IFN-γ, IL-10 and vasoactive intestinal peptide (VIP) in the submandibular glands were measured by real-time polymerase chain reaction.@*RESULTS@#Compared with the model group, the salivary flow of the ZYD group significantly increased (P<0.05), the extent of the histological changes was ameliorated (P<0.05), and the Th1/Th2 cytokine imbalance was remedied (P<0.05). In the ZYD-treated mice, the VIP mRNA was up-regulated (P<0.05).@*CONCLUSIONS@#ZYD is beneficial in protecting structure and function of SMGs in NOD mice. The mechanism may be associated with the correction of the Th1/Th2 cytokine imbalance, and with the prevention of a progressive decline of the VIP level.

Determination of Eight Kinds of Elements in Cuttings by Logging Special Laser-induced Breakdown Spectrometer / 分析化学

It is one of the necessary work in oil and gas exploration and development to record the logging of different depth cuttings.In this study, a laser induced breakdown spectrometer ( LIBS-Trace) developed by our research group was used for the lithology logging in the field of oil and gas exploration and development.A total of 60 samples from a drilling site in the Southwest China were divided into training set and test set, and then element quantitative analysis model of eight elements of Si, Al, Ca, K, Mg, Mn, Ti and Fe was established based on support vector machine regression ( SVR).The results showed that the mean percentage prediction errors (MPE) predicted by this method were Si 5.68%, Al 7.22%, Ca 7.45%, K 9.76%, Mg 8.79%, Mn 11.9%, Ti 11.4% and Fe 10.4%, which met the requirements of logging work.In addition, according to the logging process and demand, the instrument hardware and software were modified, and the quantitative model integrated in the instrument was optimiZed.The results showed that the algorithm model combined with the instrument could quickly complete the quantitative analysis of rock debris samples, and exhibited potential application value and broad application prospect in oil and gas exploration and development.

Incidence of late-onset sepsis in very low birth weight and extremely low birth weight infants and risk factors for late-onset sepsis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the incidence of late-onset sepsis (LOS) in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU) and the risk factors for LOS.</p><p><b>METHODS</b>A retrospective analysis was performed for the clinical data of all VLBW and ELBW infants who were hospitalized in the NICU between January 2011 and December 2013. According to the presence or absence of LOS, these infants were divided into LOS group and non-LOS group. The incidence and mortality rates of LOS, common pathogenic bacteria, and risk factors for LOS were analyzed.</p><p><b>RESULTS</b>Of the 226 VLBW and ELBW infants, 117 (51.8%) developed LOS, among whom 45 had a confirmed diagnosis of LOS and 72 had a clinical diagnosis of LOS. The LOS group had a significantly higher mortality rate than the non-LOS group [13.7% (16/117) vs 4.6% (5/109); P<0.05]. Bacterial culture found 51 strains of pathogenic bacteria, among which 32 (63%) were Gram-negative bacteria, 16 (31%) were Gram-positive bacteria, and 3 (6%) were fungi. The multivariate logistic regression analysis showed that gestational age, small for gestational age (SGA), duration of parenteral nutrition, peripherally inserted central catheter (PICC) placement, and mechanical ventilation were independent risk factors for LOS in VLBW and ELBW infants (OR=0.84, 1.59, 1.34, 3.11, and 4.55 respectively; P<0.05).</p><p><b>CONCLUSIONS</b>LOS has high incidence and mortality rates in VLBW and ELBW infants. Common pathogenic bacteria of LOS are Gram-negative bacteria. Low gestational age, long duration of parenteral nutrition, SGA, PICC placement, and mechanical ventilation may increase the risk of LOS in VLBW and ELBW infants.</p>

Role of emergency and staged hepatectomy in peritoneal metastasis associated with spontaneous rupture of resectable hepatocellular carcinoma patients / 中华肝胆外科杂志

Objective To evaluate the role of emergency and staged hepatectomy in peritoneal metastasis associated with ruptured hemorrhage of resectable hepatocellular carcinoma (HCC) patients,and investigate the impact of surgery timing-selecting on peritoneal metastasis of postoperative HCC patients.Methods A retrospective analysis was conduct on the pooled data from 38 HCC patients with spontaneously ruptured hemorrhage treated in our hospital from August 2011 to January 2016.These patients were divided into emergency group who underwent hepatectomy within 24 hours at admission,and staged group who underwent the procedure one week after admission.Perioperative events,overall survival (OS) and disease-freesurvival (DFS) rates,incidence of recurrent and metastatic disease were compared between the two groups.Results The perioperative blood loss and transfusion were much more in emergency group than staged group (both P ＜ 0.05).Nevertheless,the incidence of postoperative mortality was not significantly different (6.0％ vs 0％,P ＞ 0.05).The median survival was 22.5 months in emergency group versus 14.2 months in staged group.The 6-month,1-year,3-year OS rates in emergency group were 88.2％,82.4％ and 30.3％ respectively,and 6-month,1-year,3-year DFS rates were 81.3％,54.7％ and 27.3％.The 1-year OS and 6-month DFS rates were higher than those of staged group (both P ＜ 0.05).The incidence of peritoneal metastasis in staged group was higher than that in emergency group,but it was not significantly different (38.1％ vs 29.4％,P ＞ 0.05).Univariate and multivariate analysis indicated that tumor diameter ≥ 10 cm and AFP ＞ 10 000 μg/L were the risk factors for peritoneal metastasis after hepatectomy for HCC patients with spontaneously ruptured hemorrhage.Conclusions Emergency hepatectomy would warrant a better short-term prognosis compared with staged hepatectomy for the HCC patients with spontaneously ruptured hemorrhage.Staged hepatectomy would not raise the possibility of postoperative peritoneal metastasis.The predictors of tumor diameter ≥ 10 cm and AFP ＞ 10 000 μg/L were risk factors for peritoneal metastasis after hepatectomy for spontaneously ruptured HCC patients.

Da Vinci robot-assisted filling with pedicled omental flap for breast reconstruction / 局解手术学杂志

Objective To explore the effect of pedicled omental flap with Da Vinci surgical system for breast reconstruction,so as to facilitate the application of robot-assisted surgery in the breast reconstruction after breast cancer(BC) surgery.Methods A luminal BC patient,administrated in March 2017,received Da Vinci robot-assisted filling with pedicled omental flap after extensive lumpectomy and sentinel lymph node biopsy.Blood supply,wound healing,cosmetic outcome,complications and satisfaction of the patient were evaluated.Results The wound healed well,with no obvious scar.The reconstructed breast had desirable volume and looked symmetrical against the other side.The cosmetic outcome was excellent and the patient was satisfied with the surgery.No recurrence or metastasis was found during the twomonth post-operational follow-up.Conclusion Da Vinci robot-assisted breast reconstruction with pedicled omental flap has the advantages of clear vision,precise movement and flexible machinery joint.Breast conservation and autologous reconstruction with this technique substantially improves the psychological and social well-being of the patient.

Clinical comparison of percutaneous transluminal angioplasty and surgical resection for Cimino-Brescia arteriovenous fistula stenosis in hemodialysis patients / 医学研究生学报

Objeetive As to the high incidence of arteriovenous fistula(AVF) stenosis,surgical operation will result in the exhaustion of vascular resources in patients,while percutaneous transluminal angioplasty(PTA) can maintain vascular resources for ostomy.However,there is still no clear definition between the choices of PTA and surgical resection.The aim of this study was to compare the efficacy of PTA and surgical resection followed by reconstruction for the treatment of arteriovenous fistula stenosis in order to find appropriate treatment.Methods Retrospective analysis had been done on 46 hemodialysis patients with arteriovenous fistula stenosis in Nanjing BenQ hospital from January 2015 to March 2017,which included 22 cases treated with PTA (PTA group) and 24 cases treated with surgical operation (operation group).Comparison was made in general clinical situation,patency rate at six months after surgery,over patency time and adverse reactions to surgery between the two groups.Results The number of stenoses in PTA group was bigger than that in operation group and the difference was of statistic significance (2.78±1.43 vs 1.67±0.71,P＜0.05).There was no significant difference in patency rate between the two groups (P =0.828).There were 57 venous stenoses in PTA group,among which 12 stenoses were anastomotic (21.05％) with 79.3％ average stenosis degree and 43 stenoses were at venous outflow tract of fistula (75.44％) with 84.26 average stenosis degree.In PTA group,3 patients had hematoma brachial puncture position and recovered by self-absorption without special treatment.In operation group,1 patient had mild blood oozing and recovered after treatment;4 patients recovered gradually from mild swelling on the back of the hand of the operation side.No difference was found in adverse reactions between two groups (P＞0.05).Conclusion PTA treatment is preferred for multiple stenoses(n ≥ 3),which ensures better preservation of vascular resources at a comparable patency rate.

Functional analysis of a novel SCN5A mutation G1712C identified in Brugada syndrome / 南方医科大学学报

<p><b>OBJECTIVE</b>To elucidate the molecular and electrophysiological mechanisms of Brugada syndrome through functional analysis of a novel SCN5A gene mutation G1712C.</p><p><b>METHODS</b>A recombinant plasmid pRc<CMV-hH1 containing the mutant human cardiac sodium channel α subunit (hH1) cDNA was constructed using in vitro PCR-based site-directed mutagenesis technique. LipofectamineTM 3000 was used to transfect the plasmid DNA into HEK293 cell line to induce stable expression of Nachannel β1-subunit, and the positive colonies were selected by screening with G418.The standard liposome method was used to transiently transfect HEK293 cells with either the wild-type or mutant Nachannel subunits (hH1 and mhH1, respectively), and the macroscopic Nacurrents were recorded using whole-cell patch-clamp technique. Data acquisition and analysis, generation of voltage commands and curve fitting were accomplished with EPC-10, PatchMaster and IGOR Pro 6.0.</p><p><b>RESULTS</b>An HEK293 cell line that stably expressed Nachannel β1-subunit was successfully established. After transient transfection with the WT subunit, large Nacurrents were recorded from the stable β1-cell line. Transient transfection with the G1712C subunit, however, did not elicit a Nacurrent in the cells.</p><p><b>CONCLUSION</b>Compared with normal Nachannel, the wild-type channel exhibits a similar sodium current. The characteristic kinetics of sodium channel of WT-hH1 was identical to that in normal cardiac muscle cell, and the missense mutation (G1712C) in the P-loop region of the domain IV may have caused the failure of sodium channel expression.</p>