The advances of allergen component detection in IgE-mediated food allergy / 中华预防医学杂志

There are many types in food allergy, and the most common is mediated by IgE. Currently, the diagnosis of food allergy mainly relied on skin prick test and serum specific IgE of allergen extract, which can not identify cross-sensitization. Component-resolved diagnosis (CRD) can identify the major allergen components and cross-components of food allergens, which plays an important role in dietary guidance, prognosis monitoring and diagnosis of special types of IgE-mediated food allergy. This article enumerates clinical characteristics of the IgE-mediated common food allergies, such as milk, egg and seafood allergy, and special type of food allergy, such as cat pork syndrome, oral allergy syndrome, α-gal syndrome and food-dependent exercise-induced anaphylaxis, summarizes the advances of CRD in these types of IgE-mediated food allergy, in order to provide an evidence for the diagnosis, treatment and prevention of IgE-mediated food allergy.

Phytochemical interventions for post-traumatic stress disorder: A cluster co-occurrence network analysis using CiteSpace / 中西医结合学报

OBJECTIVE@#This study investigated trends in the study of phytochemical treatment of post-traumatic stress disorder (PTSD).@*METHODS@#The Web of Science database (2007-2022) was searched using the search terms "phytochemicals" and "PTSD," and relevant literature was compiled. Network clustering co-occurrence analysis and qualitative narrative review were conducted.@*RESULTS@#Three hundred and one articles were included in the analysis of published research, which has surged since 2015 with nearly half of all relevant articles coming from North America. The category is dominated by neuroscience and neurology, with two journals, Addictive Behaviors and Drug and Alcohol Dependence, publishing the greatest number of papers on these topics. Most studies focused on psychedelic intervention for PTSD. Three timelines show an "ebb and flow" phenomenon between "substance use/marijuana abuse" and "psychedelic medicine/medicinal cannabis." Other phytochemicals account for a small proportion of the research and focus on topics like neurosteroid turnover, serotonin levels, and brain-derived neurotrophic factor expression.@*CONCLUSION@#Research on phytochemicals and PTSD is unevenly distributed across countries/regions, disciplines, and journals. Since 2015, the research paradigm shifted to constitute the mainstream of psychedelic research thus far, leading to the exploration of botanical active ingredients and molecular mechanisms. Other studies focus on anti-oxidative stress and anti-inflammation. Please cite this article as: Gao B, Qu YC, Cai MY, Zhang YY, Lu HT, Li HX, Tang YX, Shen H. Phytochemical interventions for post-traumatic stress disorder: A cluster co-occurrence network analysis using CiteSpace. J Integr Med. 2023; 21(4):385-396.

Clinical Application of Zanubrutinib in B-Cell Lymphoma --Review / 中国实验血液学杂志

Zanubrutinib is a highly selective second-generation BTK inhibitor developed in China and first approved by the U.S. Food and Drug Administration (FDA) as a novel antineoplastic drug. In recent years, with the birth of molecularly targeted drugs, the treatment of B-cell lymphoma have entered the era of targeted therapy, and immunotherapy has been widely accepted. Especially in some relapsed and refractory lymphomas, zanubrutinib has shown deep and sustained remissions and a favorable safety, which lays a foundation for precision therapy. In this review the clinical application and new progress for zanubrutinib in B-cell lymphoma was summarized briefly.

Application of argatroban in patients receiving extracorporeal membrane oxygenation support: a case-control study / 中华危重病急救医学

Objective:To evaluate the safety and efficacy of argatroban applied as alternative anticoagulant in critical illness patients underwent extracorporeal membrane oxygenation (ECMO) with contraindications of unfractionated heparin (UFH), and to further explore the effective dose of argatroban.Methods:From July 1, 2013 to February 28, 2022, there were 14 patients who admitted in the respiratory intensive care unit (RICU) of Beijing Chao-Yang Hospital received ECMO and used argatroban for anticoagulation (argatroban group). Two of them received argatroban as the initial anticoagulant. The remaining 12 patients used UFH at first, and then switched to argatroban. UFH group included 28 patients who received UFH for anticoagulation after matching the demographic characteristics. Primary endpoint was the prevalence of ECMO-related thrombotic events. Secondary endpoints included the type of thrombotic events, prevalence of ECMO-related major bleeding events, bleeding sites, ICU mortality, mortality during ECMO, liver and kidney function, thrombelastogram, blood transfusion, dosage of argatroban, the dynamic changes of coagulation variables 4 days before and 7 days after argatroban treatment.Results:In argatroban group, there were 8 patients received veno-venous ECMO (VV-ECMO), 2 patients with veno-arterial ECMO (VA-ECMO), and 4 patients with veno-arterio-venous ECMO (VAV-ECMO). In UFH group, VV-ECMO was applied in 23 patients, VA-ECMO and VAV ECMO was established in 3 patients and 2 patients, respectively. In endpoint events, the incidence of ECMO related thrombotic events in argatroban group was slightly higher than that in UFH group (28.6% vs. 21.4%). The ECMO running time in argatroban group was slightly longer than that in UFH group [days: 16 (7, 21) vs. 13 (8, 17)]. The incidence of ECMO-related bleeding events (28.6% vs. 32.1%) and mortality during ECMO (35.7% vs. 46.4%) in argatroban group were slightly lower than those in UFH group. However, the differences were not statistically significant (all P < 0.05). The platelet transfusion in argatroban group was significantly higher than that in UFH group [U: 7.7 (0, 10.0) vs. 0.8 (0, 1.0)]. The coagulation reaction time (R value) in thrombelastography in argatroban group was significantly longer than that in UFH group [minutes: 9.3 (7.2, 10.8) vs. 8.8 (6.3, 9.7)]. The maximum width value [MA value, mm: 48.4 (40.7, 57.9) vs. 52.6 (45.4, 61.5)] and blood clot generation rate [α-Angle (deg): 54.1 (45.4, 62.0) vs. 57.9 (50.2, 69.0)] in the argatroban group were significantly lower than those in the UFH group (all P < 0.05). The activated partial thromboplastin time (APTT) was prolonged after changing from UFH to argatroban in the argatroban group [seconds: 63.5 (58.4, 70.6) vs. 56.7 (53.1, 60.9)]. The PLT level showed a decreasing trend during UFH anticoagulation therapy, and gradually increased after changing to argatroban. D-dimer level was 19.1 (7.0, 28.7) mg/L after switching to argatroban, and then no longer showed an increasing trend. The level of fibrinogen (FIB) showed a decreasing trend during the anticoagulant therapy of UFH (the lowest was 23.6 g/L), and fluctuated between 16.8 and 26.2 g/L after changing to argatroban. The median initial dose of argatroban was 0.049 (0.029, 0.103) μg·kg -1·min -1, which the highest dose was in VV-ECMO patients of [0.092 (0.049, 0.165) μg·kg -1·min -1]. The initial dose of VAV-ECMO was the lowest [0.026 (0.013, 0.041) μg·kg -1·min -1], but without significant difference ( P > 0.05). The maintenance dose of argatroban was 0.033 (0.014, 0.090) μg·kg -1·min -1, VV-ECMO patients was significantly higher than those in VA-ECMO and VAV-ECMO patients [μg·kg -1·min -1: 0.102 (0.059, 0.127) vs. 0.036 (0.026, 0.060), 0.013 (0.004, 0.022), both P < 0.05]. Conclusion:Argatroban appears to be a feasible, effective and safety alternative anticoagulant for patients with contraindications to UFH who undergoing ECMO support.

Clinical outcomes of severe calcified lesions after carotid artery stenting / 中华普通外科杂志

Objective:To evaluate the safety and efficacy of carotid artery stenting (CAS) in the treatment of non-circumferential severe calcification using the distal embolic protection device.Methods:Clinical data of patients with severe calcification lesions in cervical carotid artery treated by CAS from Jan 2018 to Dec 2020 at our center was analyzed retrospectively.Results:226 consecutively admitted patients of cervical carotid artery stenosis and non-circumferential severe calcification (CR>270°) underwent CAS using the distal embolic protection device. The technical success rate was 90.26%. No death or myocardial infarction occurred during the perioperative period. Two patients had ipsilateral hemiparesis ischemic stroke during post-dilatation. The incidence of perioperative bradycardia/hypotension was 25.34%. Patients were followed up for 6-36 months, with median follow-up period of 17.3 months. The incidence of mild or moderate in-stent restenosis (<70%) was 16.59%, and the incidence of severe in-stent restenosis or occlusion (>70%) was 3.22%.Conclusions:For carotid artery stenosis with non-circumferential severe calcification in high risk for CEA patients, carotid artery stenting is safe and effective with the aggressive pre-dilation strategies, strict stent selections and implantation standards. The incidence of perioperative death, myocardial infarction or ipsilateral hemiparesis ischemic stroke was low. The patency rate of the carotid stent in the calcification lesion is satisfactory during the mid-term follow-up.

Short term result of COOK-ZFEN custom-made endovascular stent graft system for the treatment of short-neck abdominal aortic aneurysm / 中华普通外科杂志

Objective:To evaluate the safety and efficacy of a Zenith fenestrated aortic stent-graft (ZFEN) system in the treatment of short-necked aneurysms.Methods:The clinical data of 5 patients receiving F-EVAR in Zhongshan Hospital, Fudan University from Mar 2018 to Sep 2019 according to the standards of short-necked abdominal aortic aneurysm and COOK ZFEN custom stent were retrospectively analyzed.Results:Patients' average age was (69±11) years old. The time of stent customization was 4-6 weeks. The average maximum diameter of AAA was (60.8±14.0) mm. The average proximal neck diameter was (26.0±2.6) mm and the average length anchoring zone was (6.4±2.2) mm. The rate of technical success was 100%. There was no intraoperative loss of visceral vessels and stent displacement. The meane follow-up time was 6.8 months. The perioperative mortality was 0, and there were no other major complications. There were 3 patients with simple type Ⅱ endoleak and 1 patient with type Ⅲ endoleak. The endoleaks disappeared in 4 patients during follow-up of 3-12 months. 1 patient suffered with type Ⅱ and type Ⅲ endoleak, and the visceral vessels and branching stents were patent in all patients.Conclusion:The short term result of COOK ZFEN stent-graft system was safe and feasible for the treatment of short-necked AAA.

Clinical effect analysis of intraocular pressure intervention in patients with NAION / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To observe the improvement of ocular hemodynamics before and after intraocular pressure(IOP)intervention in patients with non-arteritic anterior ischemic optic neuropathy(NAION).<p>METHODS: Retrospective case series. Totally 92 patients(92 eyes)with NAION were admitted to the Department of Ophthalmology, Xi'an Fourth Hospital from July 2012 to September 2018. Forty-six patients received only basic treatment without IOP lowering treatment as the conventional treatment group. The other 46 patients were treated with brinzolamide eye drops combined with brimonidine eye drops to lower IOP on the basis of conventional treatment, as the IOP intervention group. Before and after treatment, the blood flow rate of the ophthalmic artery and central retinal artery were measured by color Doppler ultrasound. The IOP, best corrected visual acuity(BCVA), mean visual field defect(MD), retinal nerve fiber layer thickness(RNFLT), ophthalmic artery and central retinal artery peak systolic blood velocity(PSV), end-diastolic blood velocity(EDV), pulse index(PI)and resistance index(RI)were compared.<p>RESULTS: Before treatment, there were no significant differences in IOP, BCVA(LogMAR), MD, RNFLT, PSV, EDV, PI and RI between the two groups(<i>P</i>>0.05). After 14d of treatment, IOP, BCVA(LogMAR), MD and RNFLT of the two groups were significantly improved compared with those before treatment(<i>P</i><0.05), and the improvement effect of IOP intervention group was better, and the difference between the two groups was statistically significant(<i>P</i><0.05). The PSV, EDV, PI of ophthalmic artery and central retinal artery in the two groups were increased compared with those before treatment, and RI was decreased compared with before treatment; and the changes of PSV, EDV, RI, PI of ophthalmic artery and PSV, EDV, RI of central retinal artery in the IOP intervention group were more significant than those in the conventional treatment group(<i>P</i><0.05). <p>CONCLUSION: IOP intervention can significantly improve the ocular hemodynamic indexes and improve the visual acuity of patients with NAION.

Balloon dilatation combined with pneumatic and ultrasound lithotripsy in the treatment of unilateral renal stones by percutaneous nephrolithotomy / 上海交通大学学报（医学版）

Objective: To investigate the application effect of balloon dilatation and percutaneous nephrolithotomy (PCNL) combined with pneumatic and ultrasound lithotripsy on the clinical treatment of unilateral kidney stones. Methods: Ninety-four patients with unilateral kidney stones who accepted PCNL in the Department of Urology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine from June 2017 to July 2019, were retrospectively analyzed and divided into group A and group B. Among them, 68 patients (group A) were subjected to balloon dilatation combined with pneumatic and ultrasound lithotripsy, while 26 patients (group B) underwent fascia dilatation combined with holmium laser lithotripsy. The clinical effects of two kinds of lithotripsy on the treatment of unilateral kidney stones were compared. Results: The operation time was shorter in group A than that in group B [(107.82±10.87) min vs (115.41±10.68) min, P=0.003]. The increase rate of postoperative white blood cell (WBC) was lower in group A than that in group B (4.41% vs 23.08%, P=0.018). The fever ( ≥ 38.5 ℃ ) rate was lower in group A than that in group B (4.41% vs 23.08%, P=0.018). There were no significant differences in hemoglobin reduction, WBC count, hospital stay, stone-free rate, blood transfusion rate and perforation rate of collection system between the two groups (all P>0.05). Conclusion: Balloon dilatation combined with pneumatic and ultrasound lithotripsy in treatment of unilateral renal stones by PCNL can shorten the operation time, and reduce the increase rate of postoperative WBC and fever rate, which is worthy of being promoted in the clinical treatment of patients with unilateral kidney stones.

Genetic Structure Analysis of Y Chromosome STR and SNP in Population of Changshu / 法医学杂志

Objective To provide a theoretical basis for building a Y chromosome database in specific regions by analyzing the pedigree specific core haplogroup and region specific genetic structure in Changshu. Methods One thousand seven hundred and two samples from unrelated Han male individuals in Changshu were collected. Then 27 Y-STR were genotyped through YfilerTM Plus PCR Amplification Kit, Y-SNP haplogroup of each sample was speculated using Y-Predictor software and some samples were verified by amplification refractory mutation system-polymerase chain reaction （ARMS-PCR）. Results A total of 1 556 haplotypes were found on the 27 Y-STR genetic markers of the 1 702 samples. The haplotype diversity （HD） value was 0.999 827. DYS385 （0.933） had the highest gene diversity （GD） value while DYS438 （0.409） had the lowest. By the Y-Predictor software, all samples were confirmed to be from 162 sub-haplogroups of C, D, N, O, Q and R. Samples were randomly selected to verify the prediction results by the software and the prediction accuracy of Y-Predictor software was as high as 95.74%. Conclusion This study found that 27 Y-STR genetic markers have relatively high polymorphisms in the Changshu population, and have good forensic individual identification and paternity testing ability.

Analysis of adverse events of transport in critical patients with extracorporeal membrane oxygenation / 中国实用护理杂志

Objective:To discuss how to avoid the occurrence of adverse events and provides basis for improving the extracorporeal membrane oxygenation (ECMO) transport safety management to formulate the corresponding preventive measures through analyzing the causes and characteristics of adverse events in transport of ECMO.Methods:By using a self-designed ECMO transport observation table to collect data, with a retrospective study of adverse events in patients with ECMO transport in ECMO center of Beijing Chaoyang Hospital from January 2013 to June 2017, carrying out classification and analysis according to the causes of adverse events and the potential risks of the patients, thus put forward the feasible preventive measures.Results:There were 53 cases of ECMO transport in study period, with 18 cases (33.96%) of adverse events, among which the incidence of adverse events in inner-hospital transport was 34.21% (13/38) and that in inter-hospital transport was 33.33% (5/15). There was no patient died in ECMO transport. In the adverse events of ECMO transport, the main causes were related to transport staff, transport equipment and patient, which accounting for 1/3 of each. Among them, the most prominent was 4 cases (22.22%) of equipment lacking and 3 cases of battery and power supply (16.67%). In classification according to the risk degree of patients, 6 cases (33.33%) of third grade risk were found.Conclusions:It is safe and feasible to carry out ECMO transport in inner-hospital transport and inter-hospital transport based on ECMO transport team and transport process of this hospital. However the unexpected events of high risk or crisis of life is inevitable in ECMO transport. Through standardized training for ECMO team, with full assessment before transport, by the use of ECMO checklist and strict implementation of various transport processes and specifications, the incidence of adverse events in ECMO transport may be reduced.

Clinical features and prognosis of lymphoma patients with monoclonal immunoglobulin / 白血病·淋巴瘤

Objective:To analyze the clinical features and prognosis of lymphoma patients with monoclonal immunoglobulin (McIg).Methods:The data of 14 patients who were pathologically diagnosed as lymphoma and with McIg in the First Affiliated Hospital of Fujian Medical University from January 2014 to January 2019 were retrospective analyzed. At the same time, 40 lymphoma patients without McIg were sellected as controls. The patients'age, gender, international prognostic index (IPI) score, B symptoms, tumor cell source and Ki-67 index were analyzed by prognostic single factor analysis. Kaplan-Meier method was used for survival analysis, and the overall survival (OS) and progression-free survival (PFS) were compared between the two groups.Results:Among 14 lymphoma patients with McIg, 6 were males and 8 were females. The median age of onset was 63 years (42-78 years). There were 13 cases of clinical stage Ⅲ-Ⅳ, and 12 cases of extranodal disease. The most common type was IgM-κ. The results of univariate analysis showed that IPI score≥3 points and elevated D-dimer level were related to poor prognosis (both P < 0.05). At the end of follow-up, the median OS time of lymphoma patients with McIg had not reached, the 2-year OS rate was 64.3%, and the median PFS time was 16 months; the median OS time of lymphoma patients without McIg had not reached, the 2-year OS rate was 90.8%, and the median PFS time was 37 months; the difference of OS between the two groups was statistically significant ( P = 0.040). Conclusions:Most lymphoma patients with McIg have extranodal involvement, the clinical stage is more inclined to stage Ⅲ-Ⅳ, IPI score ≥3 points and elevated D-dimer level are poor prognostic factors. The secretion of McIg is an important factor for the poor prognosis of patients with lymphoma.

Effect of receptor tyrosine phosphatase D on the characteristics of breast cancer stem cells / 临床与实验病理学杂志

Purpose To investigate the effect of protein tyrosine phosphatase receptor type D (PTPRD) on the characteristics of breast cancer stem cells. Method PTPRD expression in breast cancer cell line MDA-MB231 was down-regulated by small interference RNAs (siRNAs). Self-renewal ability of breast cancer stem cells (BCSCs) was detected by mammosphere formation assay. The holocolony forming ability was detected by colony formation assay. The proportion of CD44+/CD24- BCSCs was detected by flow cytometry. The ability of tumorigenesis of breast cancer cells in mice was sdudied with mouse tumorigenesis test. Separation of CD44+/CD24- stem cell population and non-stem cell population was isolated by immunomagnetic beads. Expression of PTPRD in stem cell and non-stem cell population was detected by Western blot and immunofluorescent. Results Down-regulation of PTPRD promoted the expression of stem cell markers ALDH1 and OCT-4. The expression of PTPRD in breast cancer stem cells was lower than than in non-stem cells (P<0.05). After PTPRD was down-regulated, the number of mammosphere (147±3.51) was significantly higher than that of the control group (106±12.5) (P<0.05), the proportion of holoclone [(35.9±3.4) ％] was significantly higher than that of the control group [(11.2±5.3) ％] (P<0.05), the proportion of CD44+/CD24- cells[(2.88±1.2) ％]was significantly higher than that of the control group [(0.6±0.4) ％], the in vivo tumorigenicity was significantly enhanced in nude mice (P<0.05). Conclusion The expression of PTPRD is lower in BCSCs. PTPRD may inhibit the self-renewal ability of breast cancer stem cells.

Comparison of intravascular ultrasound and venography in the intraoperative evaluation of iliac vein compression syndrome / 中华普通外科杂志

Objective@#To compare intravascular ultrasound (IVUS) with venography in the intraoperative evaluation of iliac vein compression syndrome (IVCS).@*Methods@#From Sep 2017 to Mar 2018, consecutive patients with suspicious iliac vein compression, underwent both venography and IVUS. The results were compared between IVUS and venography.@*Results@#40 patients with 48 limbs were enrolled. Venography underestimated both the diameter and area stenosis compared with IVUS (39.63%±15.48% vs. 64.97%±16.42%, P<0.001; 51.83%±18.23% vs. 59.19%±14.17%, P=0.021, respectively). The eccentricity detected by venography was lower than IVUS (0.69±0.17 vs. 0.93±0.17, P<0.001). Taking IVUS as gold standard, the sensitivity and the specificity of venography for detecting a ≥50% stenosis was 18.92% and 81.82%, and the intertechnique agreement was extremely low between venography and IVUS (κ=0.004).@*Conclusion@#Compared with IVUS, venography underestimated the degree of stenosis in IVCS. The sensitivity of venography in detecting a significant stenosis was very low.

Comparison of intravascular ultrasound and venography in the intraoperative evaluation of iliac vein compression syndrome / 中华普通外科杂志

Objective To compare intravascular ultrasound (IVUS) with venography in the intraoperative evaluation of iliac vein compression syndrome (IVCS).Methods From Sep 2017 to Mar 2018,consecutive patients with suspicious iliac vein compression,underwent both venography and IVUS.The results were compared between IVUS and venography.Results 40 patients with 48 limbs were enrolled.Venography underestimated both the diameter and area stenosis compared with IVUS (39.63％ ± 15.48％ vs.64.97％ ±16.42％,P＜0.001;51.83％ ±18.23％ vs.59.19％ ±14.17％,P=0.021,respectively).The eccentricity detected by venography was lower than IVUS (0.69 ±0.17 vs.0.93 ±0.17,P ＜0.001).Taking IVUS as gold standard,the sensitivity and the specificity of venography for detecting a ≥50％ stenosis was 18.92％ and 81.82％,and the intertechnique agreement was extremely low between venography and IVUS (κ =0.004).Conclusion Compared with IVUS,venography underestimated the degree of stenosis in IVCS.The sensitivity of venography in detecting a significant stenosis was very low.

Clinical features of Enterococcus faecium meningitis in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To summarize the clinical features of Enterococcus faecium meningitis in children.</p><p><b>METHODS</b>The clinical data of nine children with Enterococcus faecium meningitis were analyzed.</p><p><b>RESULTS</b>In all the nine children, Enterococcus faecium was isolated from blood, cerebrospinal fluid, or peripherally inserted central catheters; 6 (67%) patients were neonates, 2 (22%) patients were younger than 6 months, and 1 (11%) patient was three years and four months of age. In those patients, 56% had high-risk factors before onset, which included intestinal infection, resettlement of drainage tube after surgery for hydrocephalus, skull fracture, perinatal maternal infection history, and catheter-related infection. The main symptoms were fever and poor response. In those patients, 22% had seizures; no child had meningeal irritation sign or disturbance of consciousness. The white blood cell count and level of C-reactive protein were normal or increased; the nucleated cell count in cerebrospinal fluid was normal or mildly elevated; the protein level was substantially elevated; the glucose level was decreased. The drug sensitivity test showed that bacteria were all sensitive to vancomycin and the vancomycin treatment was effective. Only one child had the complication of hydrocephalus.</p><p><b>CONCLUSIONS</b>Enterococcus faecium meningitis occurs mainly in neonates and infants. The patients have atypical clinical features. A high proportion of patients with Enterococcus faecium meningitis have high-risk factors. Enterococcus faecium is sensitive to vancomycin.</p>

Mechanical properties and cytocompatibility of a new-type nano-bionic anti-adhesion hernia mesh / 中国组织工程研究

BACKGROUND:A new-type nano-bionic anti-adhesion hernia mesh was developed in our previous research.OBJECTIVE:To investigate the mechanical properties and cytocompatibility of the new-type nano-bionic anti-adhesion hernia mesh.METHODS:The tensile strength of the compound hernia mesh was detected using a textile detector.Mouse fibroblasts (L929) were cultured with the compound hernia mesh,and cell structures on the mesh surface were observed under electron microscope at 1,3,5 days after culture.In addition,L929 cells were co-cultured with compound hernia mesh,polypropylene patch,and polyester patch,respectively.Cells cultured alone were used as negative controls.After 1,3,5 days of culture,MTS array was used to detect cell proliferation and evaluate cytotoxicity;after 3 days of culture,western blot was used to detect the content of type Ⅰ and Ⅲ collagens.RESULTS AND CONCLUSION:The average tensile strength of the compound hernia mesh was 31.2 N The number of fibroblasts on the nanofibrous layer of the compound hernia mesh increased as long as cultured.The cells spread along the nanofibers and pseudopodia extended from the cells formed polygon and fusiform structures,with a good cross-linking with the mesh.A complete cell layer covered all pores of the nanofibers at 5 days.The cytotoxicity of the nanofibrous layer of the compound hernia mesh was graded 0,and the cytotoxicity was graded 1 of polypropylene and polyester patches.All the three kinds of patches fulfilled the implantation requirements,and the compound hernia mesh had better biological properties.No significant differences were found among groups in the contents of type Ⅰ and Ⅲ collagens at 3 days of culture.To conclude,the new-type nano-bionic anti-adhesion hernia mesh has good mechanical properties and cytocompatibility.

Closed-cell stents for cervical internal carotid artery pseudo-occlusion and its effects on vessel remodeling / 中华普通外科杂志

Objective To evaluate the closed-cell stents in the treatment of carotid pseudo-occlusion.Methods From Jan 2014 to Dec 2017,clinical data of 34 patients undergoing carotid artery recanalization with closed-cell stents for pseudo-occlusion were analyzed retrospectively.Results The technical success rate was 97.1％ (33/34) and the intracranial blood supply improved in 91.2％ patients (31/34).The 30-day perioperative ipsilateral symptomatic ischemic stroke rate was 2.9％ (1/34).All the patients were discharged with no peri-operative hyperperfusion syndrome,myocardial infarction.The average follow-up time was 15.2 ±7.6 months.The incidence of carotid artery restenosis was 17.6％.There was no stroke-related mortality.Ultrasound or CTA found luminal dilatation of the distal internal carotid artery.The diameter increased from (2.5 ±0.5) mm to (4.1 ±0.6) mm after intervention (P ＜0.001).Conclusion Closed-cell stents for carotid artery pseudo-occlusion is safe and effective,decreasing cerebral stroke and carotid occlusion.

Early result of in-situ fenestration with self-designed puncture system to preserve left subclavian artery in TEVAR / 中华普通外科杂志

Objective To evaluate a self-designed in-situ fenestration system to preserve left subclavian artery during thoracic endovascular aortic repair (TEVAR).Methods From June 2016 to May 2017,aortic dilatation disease patients with insufficient proximal landing zone were treated by the selfdesigned in situ fenestration system to preserve the left subclavian artery during TEVAR.The patients were regularly followed-up with CTA.Results Totally 12 patients with an average age of 65 ± 11 years were enrolled.Among them,6 patients had thoracic aortic aneurysm and the other 6 suffered from aortic dissection.The mean operating time was 145 ± 36 minutes.The perioperative procedure success rate was 100％.One patient had intraoperative type Ⅰ endoleak,1 patient had type Ⅱ endoleak.One patient had suffered from stroke and 1 patient had mild paraplegia post-operatively.All patients were followed-up for a mean time of 6.5 ± 3.0 months.The type Ⅰ endoleak in 1 patient disappeared,type Ⅱ endoleak remained in one.There was no death during perioperative and in follow up period.Conclusions This self-designed in-situ fenestration system effectively and quickly restores the blood flow of the left subclavian artery during TEVAR.

Investigation on Degree of Recognition about the Protection of Traditional Knowledge of Chinese Medicine among Shaanxi University of Chinese Medicine Students / 中国医学伦理学

Objective:To study the degree of recognition about the protection of traditional knowledge of Chi-nese medicine and its influencing factors among Shaanxi University of Chinese Medicine students and provide scien-tific evidence for improving relevant policies.Methods: 1,162 college students were chosen by stratified cluster sampling from Shaanxi University of Chinese Medicine and questionnaires were surveyed among them.Rank sum test and multiple linear regression model were used to explore the related factors on degree of recognition about the protection of traditional knowledge of Chinese medicine.Results: The overall cognition-scoring rate was 36.55％,and subscales in descending order by scoring rate were loss of traditional knowledge of Chinese medicine,international and domestic related protection systems.There were significant differences in scores between age groups,majors,grades,place of origin,family monthly income per capita,parents'educational background,moti-vation of applying for medical school,and whether they had taken the protection of traditional knowledge of Chinese medicine courses(P<0.05).Conclusion:The overall cognition-scoring rate among Shaanxi University of Chi-nese Medicine students was generally low.In order to motivate students to protect traditional knowledge of Chinese medicine and promote a healthy development of Chinese medicine,measures from national institution and school education should be conducted.

Study on the Attitude towards the Protection of Traditional Knowledge of Chinese Medicine among Students in a University of Traditional Chinese Medicine in Shaanxi Province / 中国医学伦理学

Objective:To investigate and analyze the attitude and its influencing factors of traditional knowledge of Chinese medicine among students in a Traditional Chinese Medicine ( TCM) college in Shaanxi Province, and provide scientific evidence for improving the relevant institution and policies. Method:A stratified cluster sampling method was used to conduct a questionnaire survey of 1,162 students in a TCM college in Shaanxi Province. Rank sum test and multiple linear regression model were used to explore the factors affecting the attitude of students. Result:The score of attitudes towards TCM protection was(43. 09 ± 6. 50), while specialty, parental education, family members' attitudes towards TCM, evaluation of courses in TCM, had taken related courses or not, clinical practice or internship experience of TCM, and the score of correlative knowledge were the influencing factors of attitudes ( P<0 . 05 ) . Conclusion:Students of this school had a relatively positive attitude towards the protection of traditional knowledge of Chinese medicine. In order to cultivate the fresh troop for the development of TCM, it is suggested that the system of TCM courses and textbooks should be reformed so as to improve students' enthusiasm for protecting traditional knowledge of Chinese medicine and establishing a special institution.