Performance Evaluation of Automated Magnetic Beads Extraction Method for Extraction of Serum Fat-soluble Vitamins by LC-MS/MS Detection / 现代检验医学杂志

Objective To evaluate the performance of the automated magnetic beads extraction method for extraction of serum fat-soluble vitamins by liquid chromatography-tandem mass spectrometry(LC-MS/MS).Methods A total of 120 clinical residual serum samples were collected automated magnetic beads extraction method was applied to extract serum fat-soluble vitamins A,D2,D3,E and K.The linearity,limit of quantification,precision,accuracy,carryover and matrix effect of fat-soluble vitamins A,D2,D3,E and K were detected by LC-MS/MS.The consistency of the method and conventional extraction method was compared.Results The linear correlation coefficients for extracting fat-soluble vitamins A,D2,D3,E and K by automated magnetic beads extraction method were all greater than 0.99,and the quantitative limits for these five fat-soluble vitamins were 5,0.25,0.25,125 and 0.025 ng/ml.The intra-batch precision and inter-batch precision were 0.66%～4.83%and 0.15%～3.70%,respectively,and the average spike recovery rate was 87.05%～111.11%.The matrix effect was 95.43%～99.07%,and the difference between the mean value of the cyclic injection results of high-low value samples and the mean value of the cyclic injection results of low-low value samples was less than 3s of the mean value of the cyclic injection results of low-low value samples.The statistical analysis showed that the correlation between the results of the automated magnetic beads extraction method and the conventional extraction method was good(r＞0.99),and there was no significant bias in the detection results of the two methods.Conclusion The automated magnetic beads extraction method for extraction of fat-soluble vitamins had good detection performance,which may be expected to improve sample flux and analysis efficiency.

Analysis of clinical characteristics of 33 cases of tuberculosis complicated by tumor necrosis factor-α inhibi-tor in autoimmune diseases / 实用医学杂志

Objective To investigate the clinical characteristics,treatment and prognosis of tuberculosis in patients with autoimmune diseases after tumor necrosis factor-αinhibitors.Methods Clinical data of 33 patients with TB after biologics(tumor necrosis factor-α inhibitors)treated in Guangzhou Chest Hospital from January 2019 to March 2023 were collected,including 25 males and 8 females,with a median age of 32 years.The clinical symptoms,laboratory results,imaging and tracheoscopic features,pathological features,treatment and outcome were analyzed retrospectively.Results The common clinical manifestations were cough(26/33),sputum(23/33)and fever(17/33).The most common cases were pulmonary tuberculosis(32/33),bronchial tuberculosis(15/33),mediastinum and hilar lymph node tuberculosis(11/33).Bilateral lung spread of tuberculosis(21/33),intrapulmonary spread of tuberculosis(bronchus,mediastinal hilar lymph nodes,pleura)(19/33),extrapulmonary tuberculosis(18/33),pulmonary tuberculosis with intrapulmonary or extrapulmonary tuberculosis(26/33).Blood CD4+T lymphocyte test was normal(23/33),and blood IGRA test was positive(27/33).Pulmonary imaging miliary nodules(8/33).The histopathology of the lymph nodes showed atypical granulomatous nodules.The duration of anti-tuberculosis treatment is 8-32 months.1 case of death.Conclusion Patients with autoimmune diseases complicated with tuberculosis after the application of tumor necrosis fact-α inhibitor are more likely to have double lung lesions,which are easy to spread to lung tissues and multiple organs of the body,and have decreased immune function.Most of them need to extend the treatment course,and the prognosis is generally good after comprehensive treatment.

Establishment and evaluation of HPLC-MS/MS method in determining serum H2S / 中国医学装备

Objective:To establish a determination method of high performance liquid chromatography-tandem mass spectrometry(HPLC-MS/MS)for serum hydrogen sulfide(H2S),so as to determine serum H2S.Methods:This study collected serum samples of 30 patients who admitted to Beijing Jishuitan Hospital affiliated to Capital Medical University from April 2023 to May 2023,and they were divided into osteoporosis group and control group according to whether existed osteoporosis,with 15 cases in each group.HPLC-MS/MS and enzyme-linked immunosorbent assay were used respectively to determine serum H2S.And then,the precision,accuracy and correlation between the two methods were evaluated.Results:HPLC-MS/MS can fast detect the content of serum H2S through detecting methylene blue in the serum,which analysis time was only 1.5 minutes,and its specificity was higher.The relative standard deviation(RSD)value of quality control plasma was 8.77%,and that of quality control plasma with the standard and pure water with standard were respectively 4.58% and 8.23%.The precisions of them met the requirement of detection(less than 20%).The recovery was 103.5% through used the above data,and the accuracy accorded with the requirements of quantitative detection(recovery was 103.5%).Conclusion:HPLC-MS/MS method is rapid and accurate in detecting H2S,which can accurately detect the content of serum H2S.This method has a series of advantages include fast,high throughput,high sensitivity and favorable stability,which contributes to conduct basic research of the content of serum H2S in the cellular pathways of human.

Application effect analysis of a horizontal endoscope storage cabinet in storage of flexible endoscopes / 中国内镜杂志

Objective To explore the influence of different storage methods on flexible endoscope.Methods 500 compliant soft endoscopes in the endoscopy center of our hospital from January 2019 to January 2020 were selected as research objects.The endoscopes of the observation group were placed horizontally in the storage cabinet,while those of the control group were placed vertically in the storage cabinet.The effects of the two storage methods on bacterial colony number,quality qualified rate and quality of soft endoscopes were compared.Results The study found that the number of bacterial colonies in the flexible endoscope in the 2 h storage of the observation group was(10.27±2.22)cfu/piece and the control group was(13.18±1.33)cfu/piece,and the difference was not statistically significant(P>0.05);The number of bacterial colonies in the flexible endoscope in the 72 h of the observation group was(14.75±2.00)cfu/piece,and the control group was(223.28±17.07)cfu/piece,and the difference was statistically significant(P<0.05).The observed cost of consumables and labor were obliviously lower than those of the control group,there was statistical significance(P<0.05).Conclusion The flexible endoscope is placed horizontally in the designated storage cabinet,which can eliminate the daily morning pre-cleaning within 72 h,and will not increase the damage rate of endoscope.It is a clinically recommended storage method for endoscopes.

Effectiveness of rhomboid intercostal and sub-serratus plane block in improving early recovery quality after thoracoscopic radical surgery for lung cancer / 中国现代医生

@#Objective Verify the improvement effect of rhomboid intercostal and sub-serratus plane block on the quality of early postoperative recovery in patients undergoing thoracoscopic radical resection of lung cancer;Comparison of the differences in the effect of regional block at different timing on improving the quality of early postoperative recovery.Methods A total of 75 patients,aged 18 to 75 years,with ASA gradeⅠ-Ⅱ,who were scheduled to undergo thoracoscopic radical resection of lung cancer from January 2022 to January 2023 were selected.Randomly divided into three groups:blank control group(Group C),preoperative block group(PR group),and postoperative block group(PO group).The PR group and the PO group received ultrasound guided rhomboid intercostal and sub-serratus plane block in the preoperative anesthesia preparation room and postoperative anesthesia recovery room,respectively,with a dosage of 0.375％ropivacaine 30ml.Evaluate the postoperative recovery quality of patients at 24 and 48 hours using the postoperative recovery quality rating scale(QoR-40)scoring scale.Record numeric rating scale(NRS)pain scores in resting and active states at 0.5h,1h,2h,4h,8h,12h,24h,and 48h after surgery.Record the consumption of opioid drugs during and after surgery,the effective number of postoperative patient-controlled intravenous analgesia(PCIA)compressions,and the incidence of nausea and vomiting.Results Compared with Group C,the consumption of opioids during surgery in the PR group was significantly reduced.The QoR-40 score at 24 hours after surgery was significantly higher in the PR and PO groups.Significant reduction in NRS scores between 1-8 hours of rest and 1-12 hours of activity after surgery,and the effective times of PCIA compressions and opioid consumption were significantly reduced(P<0.05).Compared with the PR group,the PO group consumed more opioids during surgery and had a higher NRS score at 0.5 hours after surgery(P<0.05).There was no significant difference in postoperative QoR-40 scores,PCIA effective compressions,and opioid consumption;There was no statistically significant difference in the incidence of postoperative nausea and vomiting among the three groups.Conclusion Rhomboid intercostal and sub-serratus plane block can improve the early recovery quality of patients undergoing thoracoscopic radical resection of lung cancer,reduce the postoperative pain level of patients,and reduce the amount of opioids used in perioperative period,and its effectiveness has nothing to do with the blocking time.

Early-onset pharyngeal airway collapse in infants: a retrospective single-center study.

BACKGROUND: Early-onset pharyngeal airway collapse (PAC) in infants, which presents with onset within 6-months old is relatively rare. This disease has not been given enough attention in clinic. The aim of this study was to explore the clinical features, endoscopic findings and outcomes of early-onset PAC in infants. METHODS: The children of PAC with onset within 6-months old were included. A retrospective study was conducted. RESULTS: (1) Total 26 cases were included. The age of onset was neonatal period in 20 cases, 1 to 3-months old in 5 cases, and 4 to 6-months old in 1 case. (2) The main clinical manifestations were noisy breathing (26/26), suprasternal retraction (18/26), snoring (14/26) and hypoxic episode (13/26). (3) Based on the endoscopic findings, collapse at the retropalatal level was most common (24/26). (4) Twelve cases underwent pharyngolaryngeal CT examination, which revealed abnormal findings in 7 cases. (5) Fifteen cases were accompanied with the other airway malformations. (6) In the group with comorbidities of cerebral impairment or craniofacial abnormalities, 1 case was lost to follow up, 4 cases died, and 10 cases survived, in which 9 cases had neurodevelopmental disorders. In the group without comorbidities, 2 cases were lost to follow up, 9 cases survived, in which 1 case had neurodevelopmental disorders. The incidence of poor prognosis including death and neurodevelopmental disorders was significantly higher in the group with comorbidities than that without comorbidities (P<0.01). (7) An symptomatic improvement of PAC was found in the majority of the survived cases (18/19) with age. CONCLUSIONS: Early-onset PAC in infants usually exhibits varying degrees of relief with age, whereas the cases with comorbidities had a poor prognosis.

Papermaking wastewater treatment coupled to 2,3-butanediol production by engineered psychrotrophic Raoultella terrigena.

The simultaneous bioremediation and bioconversion of papermaking wastewater by psychrotrophic microorganisms holds great promise for developing sustainable environments and economies in cold regions. Here, the psychrotrophic bacterium Raoultella terrigena HC6 presented high endoglucanase (26.3 U/mL), xylosidase (732 U/mL), and laccase (8.07 U/mL) activities for lignocellulose deconstruction at 15 °C. mRNA monitoring and phenotypic variation analyses confirmed that cold-inducible cold shock protein A (CspA) facilitated the expression of the cel208, xynB68, and lac432 genes to increase the enzyme activities in strain HC6. Furthermore, the cspA gene-overexpressing mutant (strain HC6-cspA) was deployed in actual papermaking wastewater and achieved 44.3%, 34.1%, 18.4%, 80.2% and 100% removal rates for cellulose, hemicellulose, lignin, COD, and NO3--N at 15 °C. Simultaneously, 2,3-butanediol (2,3-BD) was produced from the effluent with a titer of 2.98 g/L and productivity of 0.154 g/L/h. This study reveals an association between the cold regulon and lignocellulolytic enzymes and provides a promising candidate for simultaneous papermaking wastewater treatment and 2,3-BD production.

Characteristics of blood uric acid level and its correlation with metabolic indexes in obese adolescentsu / 公共卫生与预防医学

Objective To explore the characteristics of blood uric acid levels and its correlation with calcium and phosphorus levels, and glucose and lipid metabolism in obese adolescents in weight-loss training camps. Methods In this study, 357 obese adolescents aged 12-18 were selected as the research subjects, and 135 normal-weight adolescents were selected as the controls. The body shape and blood uric acid characteristics of the subjects were measured and analyzed. Further, 59 subjects were selected from the obese adolescents for blood calcium, blood phosphorus and glucose and lipid metabolism index tests to analyze the correlation between blood uric acid level and calcium, phosphorus, and glucose and lipid metabolism indicators. Results The average blood uric acid level of obese adolescents was (527.12±122.94)μmol/L, (566.58±122.51)μmol/L for boys, and (468.35±97.79)μmol/L for girls. The blood uric acid level of the obesity group was significantly higher than that of the control group (P<0.001 for boys, P<0.05 for girls), and it was higher in boys than in girls (P<0.01). Obese adolescents with high uric acid accounted for 73.39%. The HOMA-IR of obese adolescents was 5.79±3.04. The blood uric acid level was significantly correlated with blood calcium, total cholesterol, and low-density lipoprotein cholesterol (P<0.05). Gender and low-density lipoprotein cholesterol were the main influencing factors of blood uric acid (P<0.05). Conclusion Obese adolescents have high blood uric acid levels, low calcium and high phosphorus in the body, and a higher incidence of insulin resistance. There exists a positive correlation between the blood uric acid level and the body's calcium and phosphorus metabolism and glucose and lipid metabolism in obese adolescents. Clinical monitoring of lipid metabolism indicators such as low-density lipoprotein has certain reference value for the prevention and treatment of hyperuricemia.

Textual research on the name and reality of edible and medicinal Zisu / 药学实践与服务

Objective To make a textual research on Zisu about the name, origin, morphology and efficacy, a dual-purpose medicinal and edible plant, in order to make the original clear and provide reference basis for clinical application. Methods Textual research was carried out from the aspects of synonym, distribution, morphology, efficacy, toxicity and side effects of the plants. Results Zisu，Baisu and Su in the herbal medicine of past dynasties belong to the Ren category, which are species or varieties of Perilla frutescens（L.）Britt. Zisu has purple leaves, and its stems, leaves and seeds are used as medicine to mainly lower Qi. While Baisu has green leaves, which could cure wind cold. Conclusion There are significant differences in botanical morphology and pharmacological efficacy between Zisu and Baisu, which should be distinguished and used separately. Zisu is a dual-purpose traditional Chinese medicine with a long application history. Baisu is not suitable for edible consumption.

PIRO concept is used to analyze the characteristics of different types of hepatitis B-related acute-on-chronic liver failure / 实用医学杂志

Acute-on-chronic liver failure(ACLF)is generally accepted as a clinical syndrome characterized by an acute hepatic insult and rapid deterioration of liver function in patients with pre-existing chronic liver disease in combination with multi-organ failure with high short-term mortality.Because of the differences in etiology and inducement,there are different definitions and diagnostic criteria of ACLF in the East and West.Attempting to cover all ACLF diagnosed,WGO defined ACLF into three categories in 2014:patients with CLD but no cirrhosis(type A),compensated cirrhosis(type B),and decompensated cirrhosis(type C).However,different types of ACLF have different pathophysiology,which leads to obvious differences in predisposition,injury,response,organ failure and mortality among different types of ACLF.The concept of PIRO,which is similar to that used in determining outcomes of sepsis,is contribute to comprehensively understand different types of HBV-ACLF,improve management.Therefore,it is of great significance to improve the survival rate of ACLF.

The synergistic antitumor effect of pyrotinib in combination with 5-fluorouracil on HER2 positive breast cancer cells and its underlying mechanism / 肿瘤

Objective:To investigate the synergistic antitumor effect of pyrotinib in combination with 5-fluorouracil(5-Fu)on human epidermal growth factor receptor 2(HER2)positive breast cancer cells and its underlying molecular mechanism. Methods:HER2 positive breast cancer cells were screened by Western blotting.HER2 positive SKBR-3 and BT474 cells were treated with pyrotinib and 5-Fu individually or in combination for the following experiments.MTT assay was used to assess the effect of different drugs on the proliferation of the treated cells,and the combination index(CI)values were calculated using Combidrug software.Colony formation assay was used to evaluate the effect of different drugs on the colony-forming ability of the treated cells.FCM assay was used to analyze the effect of different drugs on the apoptosis rate and cell cycle of the treated cells.Western blotting was used to examine the effect of different drugs on the expression levels of proteins in the proliferation-and apoptosis-related signaling pathways.SKBR-3-cell-based tumor xenograft model was established using BALB/c nude mice.After treatment with pyrotinib and 5-Fu individually or in combination,the growth profiles of the xenograft tumors were recorded and the expression levels of proteins in the proliferation-and apoptosis-related signaling pathways were examined in the tumor tissues. Results:HER2 positive breast cancer cell lines SKBR-3 and BT474 were selected for further experiments after screening.The proliferation SKBR-3 and BT474 cells could be inhibited after treatment with pyrotinib and 5-Fu individually or in combination(all P＜0.05).Compared with pyrotinib or 5-Fu single drug treatment,pyrotinib in combination with 5-Fu had higher inhibition rate on the proliferation of SKBR-3 and BT474 cells with a Cl value of＜1,indicating the synergistic effect of pyrotinib and 5-Fu.In addition,in contrast to pyrotinib or 5-Fu single drug treatment,there was a further decrease in the number of colonies formed,increase in apoptosis rate,and increase in the percentage of G0/G,cells in SKBR-3 and BT474 cells after treatment with pyrotinib in combination with 5-Fu(all P＜0.01).Animal experiment results showed that the growth rate of xenograft tumors in mice treated with pyrotinib in combination with 5-Fu was significantly slower than that of the single-drug treated mice(P＜0.05).Western blotting analysis showed that the expression levels of HER2,HER4,AKT and phosphorylated ERK were significantly decreased after treatment with pyrotinib in combination with 5-Fu both in vitro and in vivo(all P＜0.01),indicative of the blockage of proliferation-related signaling pathways.Meanwhile,analysis of the apoptosis-related proteins revealed a decrease in the expression levels of caspase 3,poly ADP-ribose polymerase(PARP),and Bcl-2(all P＜0.01),while an increase in the expression levels of cleaved-caspase 3,cleaved-PARP,and p21(all P＜0.01). Conclusion:Pyrotinib and 5-Fu had synergistical antitumor effect on HER2 positive breast cancer cells,and the underlying mechanism may be related to the blockage of proliferation-associated signaling pathways and the induction of apoptosis and cell cycle arrest.

Levels of serum VEGF and NO in patients with early diabetic retinopathy and its application value / 国际生物医学工程杂志

Objective:To detect the levels of vascular endothelial growth factor (VEGF) and nitric oxide (NO) in the serum of patients with early diabetic retinopathy (DR) and to explore their value in the treatment of DR.Methods:Fifty-nine patients with type 2 diabetes mellitus from March 2019 to June 2020 in the Yulin Second Hospital were collected and divided into the non-diabetic retinopathy (NDR) group (32 cases) and background stage diabetic retinopathy (BDR) group (27 cases) according to the DR grading criteria, and 29 healthy subjects were enrolled in the healthy control (HC) group. Serum VEGF levels were measured by a double antibody sandwich enzyme-linked immunosorbent assay (ELISA), and serum NO levels were measured by the nitrate reductase method (one-step method). Pearson analysis was used to correlate serum VEGF with NO levels in each group, and a logistic regression model was used to analyze the risk factors for DR.Results:Compared with the HC group, the differences in serum VEGF and NO levels of patients in the BDR group were statistically significant (all P < 0.05). The serum VEGF and NO levels were positively correlated in all groups (all P < 0.01). Duration of diabetes, smoking, glycated hemoglobin A1c (HbA1c), serum VEGF, and NO levels were high risk factors for DR. Conclusions:Serum VEGF and NO levels may be potential pathological mechanisms for the development of microvascular complications in patients with type 2 diabetes, and the interaction may induce or accelerate the progression of DR. This study is expected to provide a new idea of complementary or combined treatment in the treatment of DR.

Research progress concerning prevention and treatment of tension blisters after fracture / 中华创伤骨科杂志

This paper reviews the research progress concerning the prevention and treatment of tension blisters after fracture. There are 8 preventive measures to reduce the incidence of fracture tension blisters, such as correct identification of the high risk factors for fracture blister, immobilization and fixation, and elevation of the affected limb. There are 4 treatments: blister aspiration, deroofment, leaving the blister intact, and negative pressure wound therapy. This review is to provide useful reference for those who need construction of clinical protocls for prevention and treatment of fracture tension blisters.

Ionomic and metabolic responses of wheat seedlings to PEG-6000-simulated drought stress under two phosphorus levels.

BACKGROUND: Wheat (Triticum aestivum L.) is a major food crop worldwide. Low soil phosphorus content and drought are the main constraints on wheat production in Xinjiang, China. METHODS: In this study, the ionic and metabolic responses of one wheat variety ("Xindong20") to drought stress simulated by using polyethylene glycol 6000 (PEG-6000) were investigated under low phosphorus (LP) and conventional phosphorus (CP) conditions by analysing wheat mineral elements and metabolites. Besides, due to xanthohumol was the metabolite with the most significant difference in expression detected in "Xindong 20", two wheat variety "Xindong20 and Xindong 23" were selected to conduct the germination test simultaneously, to further verify the function of xanthohumol in wheat growth. Xanthohumol was mixed with PEG solution (20%) to prepare PEG solutions with different concentrations (0%, 0.1%, 0.5%, and 1%) of xanthohumol. Then wheat grains were soaked in the solutions for 20 hours, followed by a germination test. After 7 days, the indicators including shoot length, max root length, and root number were determined to identify whether the metabolite was beneficial to improve the drought tolerance of wheat. RESULTS: The results showed that the root density and volume of wheat in LP treatment were higher than those in CP treatment. The roots underwent programmed cell death both in LP and CP treatments under PEG-6000-simulated drought stress, however, the DNA degradation in root cells in LP treatment was lower than that in CP treatment after rehydration for 3 d. Before drought stress, the malondialdehyde (MDA) content in shoot and the peroxidase (POD) activity in root in LP treatment were significantly higher than those in CP treatment, while the soluble sugar content and chlorophyll content in LP treatment were significantly lower than those in CP treatment. During drought stress, the POD activity maintained at a high level and the soluble sugar content gradually increased in LP treatment. After rehydration, the MDA content still maintained at a high level in LP treatment, the superoxide dismutase (SOD) activity increased, and the contents of soluble sugar and chlorophyll were significantly higher than those in CP treatment. The analysis of mineral elements and metabolites showed that the wheat in CP treatment was more sensitive to drought stress than that in LP treatment. Besides, the effect of drought stress was greater on shoot than on root in CP treatment, while it was opposite in LP treatment. The effect of drought stress on sugar metabolism gradually increased. Germination assays showed that 0.1% exogenous xanthohumol addition could significantly increase the shoot length of the two wheat varieties under drought stress. CONCLUSION: Appropriate low phosphorus supply could increase antioxidant enzyme activity in wheat, and enhance sugar metabolism to regulate osmotic balance, as well as the accumulation of various organic acids to maintain the intracellular ion homeostasis. Therefore, compared to the conventional phosphorus supply level, appropriate low phosphorus supply can significantly improve the drought tolerance of wheat. Additionally, addition of 0.1% exogenous xanthohumol, an important differential expressed metabolite in drought-stressed wheat, could effectively promote wheat shoot growth under drought stress.

Mechanics Analysis on Novel Micro-Movement Elastic Implant of Distal Tibiofibular Syndesmosis in Dorsiflexion Position / 医用生物力学

Objective To study mechanical properties of the novel micro-movement elastic implant of distal tibiofibular syndesmosis in dorsiflexion position.Methods A combination of simulation and experiment was used. The normal ankle dorsiflexion model, the bone nail repaired model and the micro-movement elastic implant repaired model were established by using Mimics and CT data. Besides, ANSYS Workbench was used for finite element analysis. Mechanical experiments on lower limb specimens were conducted on Instron E10000 mechanical test instrument, and five sets of experimental data were measured and analyzed.Results Mechanical properties of the micro-movement elastic implant repaired model were closer to those of the normal ankle dorsiflexion model, but stress of the micro-movement elastic implant repaired mode was greater than that of the bone nail repaired model. The results of two-sample heteroscedasticity t test indicated that there was no significant difference in resistance torque between the micro-movement elastic implant repaired model and the normal ankle dorsiflexion model.Conclusions For dorsiflexion position, repairing mechanical properties of the novel micro-movement elastic implant are much better than those of the bone nail, and there is still room for optimizing the micro-movement elastic implant.

Characteristics of exploratory behavior in high risk autism spectrum disorder infants / 中华实用儿科临床杂志

Objective:To compare the differences in exploratory behaviors between infants with high-risk autism spectrum disorder (HR-ASD) and normal development (TD) infants, and to explore the relationship between exploratory behaviors and the severity of ASD symptoms.Methods:A total of 31 infants aged 6-23 months with HR-ASD in the Pediatric Clinic, the Affiliated Brain Hospital of Nanjing Medical University from January 2019 to August 2020 were retrospectively recruited in the HR-ASD group, and 37 TD infants aged from 6 to 23 months in Nanjing were selected as the TD group.The development level of the 2 groups was evaluated by Gesell development scale, and the depth and breadth of exploratory behaviors were measured in free play.Autism Diagnostic Observation Schedule (ADOS) was used to evaluate the severity of ASD symptoms in HR-ASD group.Differences in exploratory behaviors between the 2 groups were analyzed by the independent sample t-test and Chi- square test. Pearson′ s correlation analysis was performed to explore the correlation between exploratory behaviors and symptom severity in HR-ASD group.Binary Logistic regression analysis was used to explore the discrimination efficiency of sexual behavior in the 2 groups. Results:Compared with TD group, the depth and breadth of exploratory behaviors in HR-ASD group were significantly lower (55.06±25.73 vs.132.78±44.69, 4.42±2.20 vs.8.78±3.28)( t=-8.95, -6.53, all P<0.01), and atypical exploratory behavior and avoidance withdrawal behavior were significantly worse [18 cases(58.06%) vs.6 cases(16.22%), 10 cases(32.26%) vs.3 cases(8.11%)]( χ2=15.30, 6.36, all P<0.05). Significant differences in the frequency and duration of object exploration, environmental exploration and social exploration were detected between HR-ASD group and TD group (3 vs. 0 vs. 0, 45 vs. 0 vs. 0)(all P<0.01). Pearson correlation analysis showed that, the frequency of object exploratory behavior was positively correlated with the dimension of ADOS in HR-AD group ( r=0.40, P<0.05); while the duration of object exploratory behavior, the complexity of object explo-ratory behavior and the depth of exploratory behavior were negatively correlated with CARS score ( r=-0.45, -0.47, -0.42, all P<0.05). The depth of exploratory behavior was negatively correlated with the stereotyped dimension of ADOS ( r=-0.40, P<0.05). Binary Logistic regression analysis showed that the depth of exploratory behavior had a discrimination effect ( P<0.01). Conclusions:The characteristics of exploratory behaviors in HR-ASD infants are abnormal, especially the distinguishing effect on the depth of exploratory behaviors, which can be used as a candidate behavioral index for early screening of ASD.

Novel cross-locking intramedullary nails for olecranon: a finite element analysis and specimen experiments / 中华创伤骨科杂志

Objective:To determine the mechanical properties of our self-designed novel cross-locking intramedullary nails and the impact of number of conical locking nails on the fixation through a finite element analysis and specimen experiments.Methods:Mimics 19.0 and SolidWorks 2014 were used to create transverse fracture models of the olecranon which were subjected to fixation with respectively K-wire tension band (KTB) and our self-designed novel cross-locking intramedullary nails (NIN). The strengths of KTB and NIN fixation were analyzed by Ansys. Fifteen human ulna specimens were used to construct a transverse fracture model of the olecranon; an Instron E10000 mechanical testing machine was used to determine mechanical properties in fixation respectively with KTB, one NIN (NIN-1) and 3 NINs (NIN-3).Results:In the finite element analysis, in simulation of the forearm flexed at 45° under a 100 N load, the deformation of the fracture surface of the olecranon in fixation with KTB, NIN-1 and NIN-3 was respectively 0.131 mm, 0.123 mm and 0.121 mm. In the specimen experiments, in simulation of the forearm flexed at 45°, the maximum failure loads for fixation with KTB, NIN-1 and NIN-3 were (313.38±27.68) N, (528.56±53.58) N and (871.04±94.95) N, respectively, showing significant differences among the 3 groups ( P<0.05). The maximum failure load for NIN-3 fixation was significantly greater than that for KTB or NIN-1 fixation, and the maximum failure load for NIN-1 fixation was significantly greater than that for KTB fixation ( P<0.05). Conclusions:Compared with KTB fixation, NIN fixation is more convenient in operation and has better mechanical properties. NIN-3 fixation has the best mechanical properties.

Management of autoimmune hepatitis during prepregnancey-pregnancy-postpartum / 临床肝胆病杂志

Autoimmune hepatitis (AIH) is a chronic progressive inflammatory disease of the liver caused by the attack of liver cells by the autoimmune system, with the features of positive serum autoantibodies, high IgG, and/or γ-globulinemia. Current studies on pregnancy in patients with AIH mainly focus on labor complications, and there is still a lack of systematic recommendations for the evaluation, treatment, and management of diseases in the progestational stage, during pregnancy, and after delivery. Although immunity is suppressed during pregnancy, poor disease control within one year before pregnancy and spontaneous drug withdrawal during pregnancy can significantly increase adverse pregnancy outcomes. Therefore, this article describes how to implement multidisciplinary collaboration and management of the whole cycle of pregnancy, so as to improve maternal and fetal safety.

Efficacy observation of sindillizumab combined with apatinib in treatment of elderly patients with advanced recurrent and metastatic esophageal squamous cell carcinoma / 肿瘤研究与临床

Objective:To investigate the efficacy and safety of sindilizumab combined with apatinib in the treatment of elderly patients with advanced recurrent and metastatic esophageal squamous cell carcinoma.Methods:A total of 74 elderly patients with recurrent and metastatic esophageal squamous cell carcinoma who were admitted to Xuancheng City Central Hospital from March 2019 to August 2020 were selected, and they were divided into study group and control group by random number table method, with 37 cases in each group. The control group was treated with apatinib mesylate, and the study group was treated with sindilizumab combined with apatinib mesylate. All patients were treated for 2 cycles and followed up for 1 year. The efficacy, peripheral blood tumor marker levels, adverse reactions and survival were compared between the two groups.Results:The objective response rate and clinical control rate in the study group were higher than those in the control group [35.1% (13/37) vs. 13.5% (5/37), 67.6% (25/37) vs. 43.2% (16/37)], and the differences were statistically significant ( χ2 = 4.70, P = 0.030; χ2 = 4.43, P = 0.035). After treatment, the levels of carcinoembryonic antigen (CEA), squamous cell carcinoma-associated antigen (SCC-Ag) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) in the two groups were all lower than those before treatment (all P < 0.05); the levels of CEA, SCC-Ag and CYFRA21-1 in the study group were lower than those in the control group (all P < 0.05). There were no differences in the incidence rates of fatigue, proteinuria, bone marrow suppression, and hand-foot syndrome between the two groups (all P > 0.05). After 1 year of follow-up, 20 patients in the study group survived, and the 1-year overall survival (OS) rate was 54.1%; 10 patients in the control group survived, and the 1-year OS rate was 28.6%; the difference in OS between the two groups was statistically significant ( χ2 = 4.06, P = 0.044). Conclusions:Sintilimab combined with apatinib has a good efficacy in the treatment of elderly patients with advanced recurrent and metastatic esophageal squamous cell carcinoma. This regimen can reduce the levels of tumor markers, improve the short-term survival rate of patients, and has good safety.

Characteristics of lapsed apheresis donors from 2016 to 2020, Zhejiang Blood Center / 中国输血杂志

【Objective】 To understand the structural characteristics of lapsed apheresis donors in our blood center and provide guidance for further improving recruitment and retention strategies by retrospectively analyzing the characteristics of lapsed apheresis donors in our center in recent years. 【Methods】 The apheresis donation and lapsed apheresis donors in Zhejiang Blood Center from 2016 to 2020 were statistically analyzed, and the general information of lapsed donors, including gender, blood type, age, education level and occupation composition, were compared and analyzed. The lapse of novel and long-term donors with different frequency were retrospectively analyzed. The SPSS 19.0 statistical software package was used for data analysis. 【Results】 In 2020, the total lapse of apheresis donors decreased by 16.6% as compared with 2016(P<0.05). The lapse rate of donors with blood groups A, B, O and AB was 1∶1∶1∶1, higher in female donors(59.0%) than males(50.0%), and dominated by age group of 18-35(66.3%). With the increase of age, the lapse rate decreased. Donors lapsed were mainly with college or above educational background(60.8%), with high proportion in students and the staff. In 2020, the lapse of novel apheresis donors decreased by 34.1% as compared with 2016, but the average lapse rate of novel apheresis donors was still as high as 70.5%. The average lapse rate of blood donors with different frequency was 52.5%, and the lapse rate decreased significantly with the increase of apheresis donation frequency. The average lapse rate of novel blood donors with whole blood donation experience was lower than those without (56.1% vs 82.9%). 【Conclusion】 Multiple measures for recruitment and retention have effectively reduced the lapse of apheresis donors. However, apheresis donors who are 18-35 years old, with college degree or above, students and staff were the main groups from lapsing. In addition, low-frequency and novel apheresis donors without whole blood donation experience were more likely to be lapsing. Targeted and personalized blood donation services should be further provided, and the management of " full cycle of blood donation" should be strengthened to reduce the lapsing, so as to retain more blood donors.