Design and performance evaluation of a firefighting protective suit with an incorporated liquid-cooled system.

A liquid-cooled garment with active cooling function can make up for deficiency of the human thermoregulatory system and passive thermal insulation of the firefighting protective suit. Fabrics treated at different inlet temperatures and pipeline intervals were applied in multilayered liquid-cooled fabric assemblies (LCFAs). The heat absorbed by the skin and the second-degree burn time were evaluated by the stored energy test under low heat radiation. Results indicated that the thermal protective performance of the LCFAs was significantly improved, with the second-degree burn time increasing more than 50% on average. There was a strong negative correlation between the thermal protective performance and cooling effect under different pipeline intervals, while the negative correlation was weak for different inlet temperatures. The results gained from this study may provide valuable insight for design of the inlet temperature and pipeline interval of a liquid-cooled system in the firefighting protective suit.

Application of CT pulmonary angiography in acute pulmonary embolism and right heart function / 中国康复理论与实践

ObjectiveTo explore the application value of CT pulmonary angiography (CTPA) in assessing the severity of acute pulmonary embolism (APE) and right heart function in rehabilitation patients. MethodsFrom January, 2013 to January, 2020, 133 inpatients (94 positive and 39 negative) who underwent CTPA examination in Beijing Bo'ai Hospital were involved. Positive patients were further divided into mild, moderate and severe groups based on the pulmonary artery obstruction index (PAOI). The clinical parameters and right heart function indicators were compared. Spearman correlation analysis was used to analyze the correlation between PAOI, and clinical parameters and right heart function indicators, and Logistic regression analysis was used to predict the risk factors of APE. ResultsThere was significant difference in lower extremity venous thrombosis, D-dimer, oxygen partial pressure, PAOI and left process of interventricular septum among four groups (H ≥ 12.350, P < 0.01). PAOI was moderately positively correlated with D-dimer (r = 0.443, P < 0.001) and left process of interventricular septum (r = 0.520, P < 0.001), and was weakly positively correlated with lower extremity venous thrombosis (r = 0.399, P < 0.001), left pulmonary artery diameter (r = 0.213, P = 0.014) and inferior vena cava regurgitation (r = 0.229, P = 0.008). Lower extremity venous thrombosis (OR = 7.708, P < 0.001) and left process of interventricular septum (OR = 3.641, P = 0.008) were independent risk factors for the onset of APE. The combination of the two indicators was effective for diagnosis of APE, and AUC was 0.795 (95% CI 0.715 to 0.874). ConclusionCTPA may be applied to evaluate the severity of APE and right heart function in rehabilitation patients.

Effect and mechanism of safranal in a mouse model of sepsis-related liver injury induced by lipopolysaccharide / 临床肝胆病杂志

‍ ObjectiveTo investigate the protective effect of safranal against sepsis-related liver injury （SRLI） induced by lipopolysaccharide （LPS） in mice and its mechanism. MethodsA total of 32 experimental male C57BL/6 mice were divided into control group， single drug group， model group， and treatment group using the simple random method， with 8 mice in each group. The mice in the single drug group and the treatment group were intraperitoneally injected with safranal （60 mg/kg） for 7 days of pretreatment， and the mice in the model group and the treatment group were intraperitoneally injected with LPS （10 mg/kg） to induce acute liver injury. The activities of serum alanine aminotransferase （ALT） and aspartate aminotransferase （AST） were measured； HE staining was used to observe liver tissue sections； immunohistochemistry was used to analyze the expression of the downstream protein heme oxygenase-1 （HO-1） in the signal pathway； TUNEL was used to analyze the apoptosis of hepatocytes； Western blot was used to measure the expression of total proteins （nuclear factor erythroid 2-related factor 2 ［Nrf-2］ and HO-1） in liver tissue. The human liver cell line L02 was pretreated with safranal （100 μmol/L）， followed by induction of acute hepatocellular injury with LPS （100 ng/mL）， and DCFH-DA fluorescent labeling was used to detect reactive oxygen species （ROS）. ResultsAfter safranal pretreatment， the treatment group had significantly lower levels of ALT and AST than the model group （both P<0.001）， with a relatively intact pseudolobular structure and a smaller necrotic area in the liver. Compared with the model group， the treatment group had significant increases in the expression levels of Nrf2 and HO-1 in liver tissue after safranal+LPS treatment （both P<0.001）， and immunohistochemistry showed that safranal pretreatment increased the number of HO-1-positive cells. In the cell model of LPS-induced acute liver injury， the treatment group had a significant reduction in the production of ROS compared with the model group. ConclusionSafranal can exert a protective effect against SRLI induced by LPS in mice through the Nrf2/HO-1 pathway.

Qualitative research on thematic interviews and factual records of Kampo medicine based on grounded theory / 国际中医中药杂志

Through literature search and screening, with qualitative research methods and the guidance of the three-level coding framework of grounded theory, literature about interview and factual records with Kampo medicine as theme was analyzed to explore concern areas and key points of Kampo medicine. The included literature mainly showed the modern development prospect of Kampo medicine from the fields of the revival background, laws and regulations, clinical work, education and teaching, scientific research, Kampo medicine industry, periodicals and books, representatives, symbolic events, organization and communication of Kampo medicine. Among them, half or more of the literature involved specific aspects such as clinical diagnosis and treatment methods of Kampo medicine, international communication, drug dosage forms and marketing, scientific research institutions and clinical research, and university education. At the same time, the specific aspects of events, legislation, organizations, periodicals, books and representatives mentioned in the literature provided important indexes for the comparative study of traditional medicine between China and Japan. In the future, the above fields and aspects can be set as starting points and main framework to further obtain and research relevant interviews and documentary literature, so as to promote the communication and development of traditional medicine at home and abroad.

Analysis of Antioxidant Lipids in Five Species of Dietary Seaweeds by Liquid Chromatography/Mass Spectrometry.

Seaweeds are a good source of bioactive lipids and are known for their nutritional benefits, making them a valuable food source. Despite their dietary significance and nutritional importance, there are limited reports on comprehensive lipidome analysis of lipids with antioxidant properties. Therefore, this study aimed to compare the lipid profiles of five commonly consumed Japanese dietary seaweeds using non-targeted liquid chromatography/mass spectrometry (LC/MS). A total, of 304 molecular species from four major lipid classes were detected and characterized by MS/MS analysis. Multivariate statistical analysis revealed distinct lipid molecular compositions in kombu and sea mustard compared to hijiki, mozuku, and laver seaweeds. Kombu has been shown to contain large amounts of antioxidants, such as polyunsaturated fatty acids (PUFAs), and a high health promotion index compared to other seaweeds. Hierarchical cluster correlations indicated the predominance of glycerophospholipids (GPs) and glycerolipids (GLs) in sea mustard and kombu. As a result, dietary seaweeds have great potential as antioxidants and health-promoting foods for human consumption due to their high levels of PUFA-rich GPs and GLs. Unsaturated triacylglycerols are predominant in hijiki, whereas other health-beneficial lipids, such as monogalactosyldiacylglycerol and sulfoquinovosyl diacylglycerols, are predominant in sea mustard. This study provides a detailed characterization of lipids and their comparative fingerprints in seaweeds, demonstrating the potential use of dietary seaweeds in biotechnological and industrial applications involving the development of functional food products.

A long-term clinical report of a modified unilateral cutaneous ureterostomy in bladder cancer patients receiving radical cystectomy / 中华泌尿外科杂志

Objective:To explore the long-term efficacy of a modified unilateral cutaneous ureterostomy in bladder cancer patients receiving radical cystectomy.Methods:The medical data of 104 bladder cancer patients who underwent ureterostomy in our hospital from Janurary 2013 to December 2020 were retrospectively analyzed. The patients were divided into unilateral and bilateral group. The unilateral group contained 66 cases, with 53 males and 13 females, average age (71.8±9.8) years, body mass index (BMI)(23.3±3.2)kg/m 2. The bilateral group contained 38 cases, with 33 males and 5 females, average age (75.1±10.8) years; BMI (22.7±3.0)kg/m 2. There was no significant difference in the above characteristics between the two groups ( P>0.05). The pathology, survival status, long-term complications between the two groups were compared. Quality of life was assessed during follow-up using the European Core Questionnaire for Quality of Life in Cancer Patients (EORTC QLQ-C30). Results:The unilateral group contained 46(69.7%) muscle invasive bladder cancer (MIBC) cases, 15 (22.7%) cases with lymph node metastasis, 7 (10.6%) cases with distant metastasis. The bilateral group contained 24(63.2%) muscle invasive bladder cancer(MIBC) cases, 6 (15.8%) cases with lymph node metastasis, 2 (5.3%) cases with distant metastasis. There was no significant difference in disease specific survival between the two groups ( P>0.05). During the follow-up, the incidence of overall complication rate in the unilateral group was significantly lower than that in the bilateral group [43.9% (29/66) vs. 63.2% (24/38), P<0.001]. The incidence of pyelonephritis in unilateral group was significantly lower than that in the bilateral group [16.6%(11/66) vs. 42.1%(16/38), P=0.006]. There was no statistical significance in terms of quality of life before operation in the two groups. After operation, both physical function score[(54.9±7.1) vs.(49.2±6.7)] and emotional function score [(63.1±6.4) vs.(59.9±6.7)] in unilateral group were higher than that in bilateral group ( P<0.05). Conclusions:The modified unilateral cutaneous ureterostomy could achieve relatively low complication rate, and improve the quality of life to some extent compared with bilateral ureterostomy.

Comparative analysis of epidemiological trends of COVID-19 in Shanghai and New York City / 上海预防医学

ObjectiveTo assess the effects of countermeasures against coronavirus disease 2019 （COVID-19） in Shanghai from March to May 2022 in comparison with epidemiological trend of COVID-19 in New York City. MethodsDaily confirmed cases， asymptomatic SARS-CoV-2 carriers， and daily deaths were obtained in the Shanghai Municipal Health Commission and the Center for Disease Control and Prevention （CDC） of the United States. Descriptive study was conducted by using these data. ResultsFrom March 1 to May 17， the number of daily asymptomatic SARS-CoV-2 infections in Shanghai was up to 58 times as large as that of daily confirmed cases； however， the number of daily confirmed cases in Shanghai was generally less than that in New York in the same time period. At the peak of the COVID-19 epidemic， the growth of daily attack rate in Shanghai was significantly lower than that in New York （P<0.05）. Moreover， the number of daily death was evidently less than that in New York. In addition， the vaccination rate in the elderly （aged ≥60 years） in Shanghai was evidently lower than that in New York （aged ≥65 years）. ConclusionThe COVID-19 epidemics in Shanghai from March to May 2022 and in New York after December 2021 were both caused by the Omicron variant. Compared with the Delta variant， the Omicron variant has stronger replication ability and infectivity， resulting in challenges to the containment of the epidemic in metropolis such as Shanghai and New York City. The epidemic in New York City remained crucial due to absence of effective countermeasures， while that in Shanghai has been effectively contained with strict countermeasures. The prevention and control strategies may be adjusted along with the continual evolution of SARS-CoV-2 and increasing trend of imported COVID-19 cases.

Analysis on the development of health informatization during the " 14th Five-Year Plan" in China / 中华医院管理杂志

Objective:To analyze the health development plans of the provinces in China during the " 14th Five-Year Plan" , and explore the key tasks, similarities and differences of health informatization construction in each province.Methods:Using the website of local people′s government and the official website of the provincial Health Commission, 27 copies of health development plans of various provinces during the " 14th Five-Year Plan" period were retrieved and collected from February 16 to June 5, 2022. The relevant statements of health information in the plan were extracted, content analysis was used to reveal the structural characteristics of the policy in the form of word frequency statistics, and discourse analysis was used to study the policy content.Results:The health information policies of 27 provinces during the " 14th Five-Year Plan" period could be summarized as 10 major themes, such as accelerating the construction of hierarchical diagnosis and treatment system, promoting the high-quality development of public hospitals, and deepening the reform of medical security system. The health information policy in the eastern, central and western regions was relatively clear, and there were certain differences in the construction points according to their own characteristics.Conclusions:During the " 14th Five-Year Plan" period, the policies of each province around the field of health information are well defined, and the core structure and content are similar. The distribution of key points in the eastern region is relatively balanced; the construction of health information in the central region is more prioritized and prominent; the construction of health information in the western region is focused on complementing the weak links and weaknesses.

Development and Validation of a Random Forest Diagnostic Model of Acute Myocardial Infarction Based on Ferroptosis-Related Genes in Circulating Endothelial Cells.

The high incidence and mortality of acute myocardial infarction (MI) drastically threaten human life and health. In the past few decades, the rise of reperfusion therapy has significantly reduced the mortality rate, but the MI diagnosis is still by means of the identification of myocardial injury markers without highly specific biomarkers of microcirculation disorders. Ferroptosis is a novel reported type of programmed cell death, which plays an important role in cancer development. Maintaining iron homeostasis in cells is essential for heart function, and its role in the pathological process of ischemic organ damages remains unclear. Being quickly detected through blood tests, circulating endothelial cells (CECs) have the potential for early judgment of early microcirculation disorders. In order to explore the role of ferroptosis-related genes in the early diagnosis of acute MI, we relied on two data sets from the GEO database to first detect eight ferroptosis-related genes differentially expressed in CECs between the MI and healthy groups in this study. After comparing different supervised learning algorithms, we constructed a random forest diagnosis model for acute MI based on these ferroptosis-related genes with a compelling diagnostic performance in both the validation (AUC = 0.8550) and test set (AUC = 0.7308), respectively. These results suggest that the ferroptosis-related genes might play an important role in the early stage of MI and have the potential as specific diagnostic biomarkers for MI.

Characterizing cellular and molecular variabilities of peripheral immune cells in healthy inactivated SARS-CoV-2 vaccine recipients by single-cell RNA sequencing

We systematically investigated the transcriptomes of the peripheral immune cells from 6 inactivated vaccine, BBIBP-CorV recipients at 4 pivotal time points using single-cell RNA-seq technique. First, the significant variation of the canonical immune-responsive signals of both humoral and cellular immunity, as well as other possible symptom-driver signals were evaluated in the specific cell types. Second, we described and compared the common and distinct variation trends across COVID-19 vaccination, disease progression, and flu vaccination to achieve in-depth understandings of the manifestation of immune response in peripheral blood under different stimuli. Third, the expanded T cell and B cell clones were correlated to the specific phenotypes which allowed us to characterize the antigen-specific ones much easier in the future. At last, other than the coagulopathy, the immunogenicity of megakaryocytes in vaccination were highlighted in this study. In brief, our study provided a rich data resource and the related methodology to explore the details of the classical immunity scenarios.

A Novel Polymeric Nanohybrid Antimicrobial Engineered by Antimicrobial Peptide MccJ25 and Chitosan Nanoparticles Exerts Strong Antibacterial and Anti-Inflammatory Activities.

Infection caused by antibiotic-resistant microorganisms (ARMs) has been declared a global threat to public health. Polymeric nanoparticles (PNPs) formed by antimicrobial peptides (AMPs) and synthetic PNPs against ARM infections are emerging. PNPs are also considered to be a promising natural biological preservative that prevents microbial spoilage through food processing and preservation. We engineered CNMs, a novel nanocomposite antibacterial agent based on chitosan nanoparticles and AMP microcin J25. In this study, we aimed to evaluate the comprehensive antimicrobial activity, potential antimicrobial mechanism, and anti-inflammatory activity of CNMs. We demonstrated that CNMs harbor excellent bactericidal activity against clinical foodborne pathogens and ARMs. CNMs caused fast mortality against different growth phases of tetracycline (Tet)-resistant enterotoxigenic E. coli (ETEC) and significantly killed Tet-resistant ETEC in food biological environments. Mechanistically, CNMs have the ability to bind lipopolysaccharides (LPS), neutralize endotoxin, and promote diaphragm permeability by damaging the cell membrane. CNMs did not cause mouse RAW264.7 cell cytotoxicity. Notably, CNMs significantly reduced the cytotoxicity of RAW264.7 macrophages induced by LPS. The LPS-induced inflammatory response was significantly ameliorated by CNMs by reducing the levels of nitric oxide and proinflammatory cytokines, including tumor necrosis factor α, interleukin (IL)-6, IL-8, IL-1ß, Toll-like receptor 4, and nuclear factor κB (NF-κB), in LPS-challenged RAW264.7 macrophages. CNMs downregulated the NF-κB and mitogen-activated protein kinase signaling pathways, thereby inhibiting inflammatory responses upon LPS stimulation. Taken together, CNMs could be applied as effective antimicrobial/anti-inflammatory agents with lower cytotoxicity in food, medicine, and agriculture to prevent bacterial contamination and infection, respectively.

Analysis of thyroid iodine uptake rate and 99Tc m imaging in the treatment of Graves hyperthyroidism with 131I / 中国医师杂志

Objective:To investigate the relationship between thyroid iodine uptake rate, 99Tc m imaging and treatment of Graves' hyperthyroidism with 131I. Methods:132 patients with Graves' hyperthyroidism were analyzed retrospectively. According to the difference of thyroid 24-hour iodine uptake rate, they were divided into group A (≤50%), group B (50%-80%) and group C (≥80%). According to the trend of iodine uptake rate curve, they were divided into peak advance group (6 h/24 h iodine uptake rate ratio >1) and non-peak advance group (6 h/24 h iodine uptake rate ratio≤1). Thyroid 99Tc m imaging was divided into three groups according to quality, including group 1 (≤30 g), group 2 (30-60 g) and group 3 (≥60 g). The therapeutic effects of 131I in different types of patients were compared. Results:132 patients were followed up for 6 months after the first 131I treatment. The total effective rate, total cure rate and uncured rate were 88.6%(117/132), 78.0%(103/132), 22.0%(29/132), respectively. The serum thyroxine levels of patients with different 24-h iodine uptake rates in the three groups after treatment were significantly lower than those before treatment ( P<0.05). The lower the 24-h iodine uptake rate of thyroid, the more significantly the serum total triiodothyronine (TT3), total triiodothyronine (TT4), free triiodothyronine (FT3) and free thyroxine (FT4) levels decreased after treatment, the more obvious the increase of thyroid stimulating hormone (TSH), and the more obvious the treatment effect ( P<0.05). The cure rate (13/29, 44.8%) in the peak advance group was significantly lower than that in the non peak advance group (90/103, 87.4%), with statistically significant difference (χ 2=23.899, P<0.001). There was significant difference in the cure rate among the three groups with different thyroid 99Tc m imaging quality (χ 2=15.502, P<0.001). Conclusions:With the increase of thyroid mass, the higher the 24-h iodine intake rate, the more obvious the peak shift, the lower the cure rate, the higher the non-healing rate, and the lower the incidence of hypothyroidism.

Phosphorylation regulates cullin-based ubiquitination in tumorigenesis

Cullin-RING ligases (CRLs) recognize and interact with substrates for ubiquitination and degradation, and can be targeted for disease treatment when the abnormal expression of substrates involves pathologic processes. Phosphorylation, either of substrates or receptors of CRLs, can alter their interaction. Phosphorylation-dependent ubiquitination and proteasome degradation influence various cellular processes and can contribute to the occurrence of various diseases, most often tumorigenesis. These processes have the potential to be used for tumor intervention through the regulation of the activities of related kinases, along with the regulation of the stability of specific oncoproteins and tumor suppressors. This review describes the mechanisms and biological functions of crosstalk between phosphorylation and ubiquitination, and most importantly its influence on tumorigenesis, to provide new directions and strategies for tumor therapy.

Understanding the Clinical Features of Coronavirus Disease 2019 From the Perspective of Aging: A Systematic Review and Meta-Analysis.

Problems: An outbreak of novel coronavirus (2019-nCov) infection is now widespread in multiple countries. Compared with adult patients, elderly patients have not received enough attention. The aim of the meta-analysis was to assess the clinical characteristics of elder patients with COVID-19. Methods: A deep literature search was performed in the databases through August 21, 2020. Risk ratio (OR) and 95% confidence intervals (CIs) were pooled using analysis models. Results: Three studies including 2046 infected patients were precisely evaluated, and the results show that the elderly group has a higher risk of hypertension, diabetes, and cardiovascular disease than the younger patients. Their total white blood cells are higher than that of the younger patients, and their lymphocytes are relatively reduced compared with the younger patients. Conclusion: We comprehensively assessed the clinical characteristics of patients of different ages with COVID-19 and found that elder patients had a high risk of chronic cardiovascular and metabolism comorbidities. The characteristic clinical manifestations and laboratory examinations of elderly patients support their excessive inflammation and weak immune defenses against 2019-nCoV. All these findings provide important information for understanding the general clinical characterization of the aging immune defense against the virus and enhancing the public awareness of the prevention and treatment of elder patients in the COVID-19 pandemic.

Identification of four linear B-cell epitopes on the SARS-CoV-2 spike protein able to elicit neutralizing antibodies

SARS-CoV-2 unprecedentedly threatens the public health at worldwide level. There is an urgent need to develop an effective vaccine within a highly accelerated time. Here, we present the most comprehensive S-protein-based linear B-cell epitope candidate list by combining epitopes predicted by eight widely-used immune-informatics methods with the epitopes curated from literature published between Feb 6, 2020 and July 10, 2020. We find four top prioritized linear B-cell epitopes in the hotspot regions of S protein can specifically bind with serum antibodies from horse, mouse, and monkey inoculated with different SARS-CoV-2 vaccine candidates or a patient recovering from COVID-19. The four linear B-cell epitopes can induce neutralizing antibodies against both pseudo and live SARS-CoV-2 virus in immunized wild-type BALB/c mice. This study suggests that the four linear B-cell epitopes are potentially important candidates for serological assay or vaccine development.

Visualization of cardiovascular development, physiology and disease at the single-cell level: Opportunities and future challenges.

Single-cell RNA sequencing (scRNA-seq), a method of transcriptome sequencing at the single-cell level, has recently emerged as a revolutionary technology in the field of biomedical research. Compared to conventional gene expression profiling in bulk, scRNA-seq resolves biological differences among individual cells and enables the identification of rare cell populations that are easily overlooked. This review introduces the method of scRNA-seq, summarizes its applications in the field of cardiovascular disease research, and discusses existing limitations and prospects for future applications.

Clinical significance of microcalcification in patients with thyroid micropapillary carcinoma / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the clinical significance of microcalcification under high resolution ultrasonography in predicting thyroid micropapillary carcinoma(PTMC) and cervical lymph node metastasis. METHODS The clinical data of 388 patients with papi l lar y thyroid microcarcinoma were analyzed retrospectively in Beijing Tongren Hospital from Jan 2013 to Jun 2017, which included patients' clinical ultrasonographic features and pathological results in this study. Pearson correlation analysis and data fitting modeling were used to analyze the microcalcification, the maximum diameter of the tumor and the cervical lymph node metastasis in the central region. RESULTS The incidence of microcalcification in PTMC patients was closely related to the maximal diameter of the tumor. The tumor diameter of PTMC was related to the lymph node metastasis rate in the central region of the neck, and it was not found that microcalcification was associated with lymph node metastasis in the central region of the neck. CONCLUSION The weight of microcalcification in the diagnosis of PTMC is related to the maximum diameter of the nodule. Furthermore, patients with thyroid nodules having a tumor diameter of less than 1 cm, with the larger diameter of tumor nodules, the greater the risk of PTMC, the more recommended fine needle biopsy.

Alectinib (CH5424802) antagonizes ABCB1- and ABCG2-mediated multidrug resistance in vitro, in vivo and ex vivo

Alectinib, an inhibitor of anaplastic lymphoma kinase (ALK), was approved by the Food and Drug Administration (FDA) for the treatment of patients with ALK-positive non-small cell lung cancer (NSCLC). Here we investigated the reversal effect of alectinib on multidrug resistance (MDR) induced by ATP-binding cassette (ABC) transporters, which is the primary cause of chemotherapy failure. We provide the first evidence that alectinib increases the sensitivity of ABCB1- and ABCG2-overexpressing cells to chemotherapeutic agents in vitro and in vivo. Mechanistically, alectinib increased the intracellular accumulation of ABCB1/ABCG2 substrates such as doxorubicin (DOX) and Rhodamine 123 (Rho 123) by inhibiting the efflux function of the transporters in ABCB1- or ABCG2-overexpressing cells but not in their parental sensitive cells. Furthermore, alectinib stimulated ATPase activity and competed with substrates of ABCB1 or ABCG2 and competed with [125I] iodoarylazidoprazosin (IAAP) photolabeling bound to ABCB1 or ABCG2 but neither altered the expression and localization of ABCB1 or ABCG2 nor the phosphorylation levels of AKT and ERK. Alectinib also enhanced the cytotoxicity of DOX and the intracellular accumulation of Rho 123 in ABCB1-overexpressing primary leukemia cells. These findings suggest that alectinib combined with traditional chemotherapy may be beneficial to patients with ABCB1- or ABCG2-mediated MDR.

Advances in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy / 国际脑血管病杂志

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary cerebral small vessel disease.NOTCH3 missense mutation causes its coded cysteine occurring odd change and then affects the conformation and function of protein of NOTCH3.The abnormal NOTCH3 protein has vascular smooth muscle toxicity and finally deposits in the cerebral small blood vessels and causes the disease.Usually,CADASIL can be suspected by its typical clinical manifestations and neuroimaging findings.Its diagnosis needs genetic testing or skin biopsy to find the outer granular osmiophilic deposits of small vascular smooth muscle cells or immunohistochemical NOTCH3-ECD staining positive.For nearly two decades,the studies on genetics,pathogenesis,clinical manifestations,and diagnostic techniques of CADASIL have made great progress,however,many important questions have not been fully clarified and have new discoveries,such as the NOTCH3 gene mutation pattern and loci,and the relationship between gene phenotype and clinical phenotype,optimization of diagnosis process,depth study of pathogenic mechanism,exploration of new discoveries,new therapeutic targets and concepts.This article reviews the genetic characteristics,pathogenesis,and clinical diagnosis and treatment technology of CADASIL.

[Comparison of three-dimensional position on cone beam computed tomography of temporomandibular joint osteoarthrosis].

OBJECTIVE: This study investigates the effect of temporomandibular joint osteoarthritis (TMJOA) on different stages of condylar three-dimensional position and provides a theoretical basis for clinical application. METHODS: The cone beam computed tomography (CBCT) images of 108 TMJOA patients were analyzed and divided into four stages based on the stage standard of osteoarthrosis X-ray performance proposed by Xuchen Ma in 2005. A total of 28 defect-free temporomandibular joint disorders were used as the control group. Differences in condylar position and condylar axis horizontal angle were evaluated and compared. RESULTS: No significant differences were found in terms of sagittal relationship, but condylar axis horizontal angle showed a significant difference (F = 3.872, P = 0.005). The horizontal angle values of stage 1 in the TMJOA group were lower than those in stages 2 and 3 (P = 0.027, P = 0.000), whereas the horizontal angle values of stage 2 and control groups were lower than those of stage 3 group (P = 0.004, P = 0.047). CONCLUSION: Condylar horizontal angle differed in each stage of TMJOA, but no significant difference between the parasagittal positions of the condyles was observed in each stage.