Development and Implementation of a Simple and Rapid Extraction-Free Saliva SARS-CoV-2 RT-LAMP Workflow for Workplace Surveillance

Effective management of the COVID-19 pandemic requires widespread and frequent testing of the population for SARS-CoV-2 infection. Saliva has emerged as an attractive alternative to nasopharyngeal samples for surveillance testing as it does not require specialized personnel or materials for its collection and can be easily provided by the patient. We have developed a simple, fast, and sensitive saliva-based testing workflow that requires minimal sample treatment and equipment. After sample inactivation, RNA is quickly released and stabilized in an optimized buffer, followed by reverse transcription loop-mediated isothermal amplification (RT-LAMP) and detection of positive samples using a colorimetric and/or fluorescent readout. The workflow was optimized using 1,670 negative samples collected from 172 different individuals over the course of 6 months. Each sample was spiked with 50 copies/L of inactivated SARS-CoV-2 virus to monitor the efficiency of viral detection. Using pre-defined clinical samples, the test was determined to be 100% specific and 97% sensitive, with a limit of detection comparable to commercially available RT-qPCR-based diagnostics. The method was successfully implemented in a CLIA laboratory setting for workplace surveillance and reporting. From April 2021-February 2022, more than 30,000 self-collected samples from 755 individuals were tested and 85 employees tested positive mainly during December and January, consistent with high infections rates in Massachusetts and nationwide. The rapid identification and isolation of infected individuals with trace viral loads before symptom onset minimized viral spread in the workplace.

Profiling RT-LAMP tolerance of sequence variation for SARS-CoV-2 RNA detection

The ongoing SARS-CoV-2 pandemic has necessitated a dramatic increase in our ability to conduct molecular diagnostic tests, as accurate detection of the virus is critical in preventing its spread. However, SARS-CoV-2 variants continue to emerge, with each new variant potentially affecting widely-used nucleic acid amplification diagnostic tests. RT-LAMP has emerged as a quick, inexpensive diagnostic alternative to RT-qPCR, but has not been studied as thoroughly. Here we interrogate the effect of SARS-CoV-2 sequence mutations on RT-LAMP amplification, creating 572 single point mutation "variants" covering every position of the LAMP primers in 3 SARS-CoV-2 assays and analyzing their effects with over 4,500 RT-LAMP reactions. Remarkably, we observed only minimal effects on amplification speed and no effect on detection sensitivity, highlighting RT-LAMP as an extremely robust technique for viral RNA detection. Additionally, we describe the use of molecular beacons to sensitively identify variant RNA sequences. Together these data add to the growing body of knowledge on the utility of RT-LAMP and increase its potential to further our ability to conduct molecular diagnostic tests outside of the traditional clinical laboratory environment.

Improving RT-LAMP Detection of SARS-CoV-2 RNA through Primer Set Selection and Combination

Reverse transcription loop-mediated isothermal amplification (RT-LAMP) has emerged as a viable molecular diagnostic method to expand the breadth and reach of nucleic acid testing, particularly for SARS-CoV-2 detection and surveillance. While rapidly growing in prominence, RT-LAMP remains a relatively new method compared to the standard RT-qPCR, and contribution to our body of knowledge on designing LAMP primer sets and assays can have significant impact on its utility and adoption. Here we evaluate 18 LAMP primer sets for SARS-CoV-2, comparing speed and sensitivity with different LAMP formulations and conditions across more than 5,000 RT-LAMP reactions and identifying several primer sets with similar high sensitivity for different SARS-CoV-2 gene targets. Significantly we observe a consistent sensitivity enhancement by combining primer sets for different targets, confirming and building on earlier work to create a simple, general approach to building better and more sensitive RT-LAMP assays.

Qualitative research of initial motivation of undergraduate nursing students participating in aged nursing voluntary service in aged care facility / 中国实用护理杂志

Objective:To explore the initial motivation of nursing students to engage in voluntary service for the aged, and to provide scientific basis for the formulation of strategies and measures of voluntary service for the aged.Methods:Totally 25 nursing students volunteers who regularly participated in the volunteer service for the aged in Changsha First Welfare Home were selected by objective sampling method for semi-structured in-depth interviews, and the data were analyzed by Colaizzi phenomenological 7-step analysis method.Results:Four themes of nursing students' initial motivation to participate in voluntary service for the aged were extracted: self-interest motivation, altruistic motivation, affinity motivation and achievement motivation. Among them, self-interest motivation included two sub-themes: enriching college life and life experience, improving one's own ability and gaining professional experience; altruistic motivation included two sub-themes: accompanying and helping the elderly and eliminating loneliness of the elderly; affinity motivation included two sub-themes: establishing emotional sustenance and making up for the lack of emotion; achievement motivation included two sub-themes: facing challenges bravely, acquiring a sense of achievement, serving society and others, and realizing one's own value.Conclusion:Nursing students have a clear initial motivation to participate in the voluntary service for the aged of the aged care facilities, and schools can strengthen the relevant education for students to participate in voluntary service in the training of nursing talents. The voluntary service for the aged can formulate corresponding development strategies and incentives according to the initial motivation of nursing students, so that promote the expansion and stability of the voluntary service for the aged team, and promote the development and improvement of voluntary service for the aged.

Development of Multiplexed RT-LAMP for Detection of SARS-CoV-2 and Influenza Viral RNA

The ongoing COVID-19 pandemic has demonstrated the utility of widespread molecular testing for surveillance and diagnostic detection of SARS-CoV-2. Reverse-transcription loop-mediated isothermal amplification (RT-LAMP) has enabled testing outside of the standard clinical laboratory PCR infrastructure, with simple and rapid tests supplementing the existing, standard methods. However, current LAMP tests have detected single targets and required separate reactions for controls or multiple targets. As flu season arrives in the Northern Hemisphere the ability to screen for multiple viral targets will be increasingly important, and the ability to include internal control assays in the RT-LAMP test allows for decreased resource use and increased throughput. Here we describe a multiplexing approach to RT-LAMP with four targets (SARS-CoV-2, Influenza A, Influenza B, and internal control human RNA) in a single reaction using real-time and endpoint fluorescence detection. This increase to the functionality of RT-LAMP will, we hope, enable even broader adoption of this power molecular testing approach to aid in the global fight against this continuing public health threat.

Rapid Molecular Detection of SARS-CoV-2 (COVID-19) Virus RNA Using Colorimetric LAMP

The ability to detect an infectious agent in a widespread epidemic is crucial to the success of quarantine efforts in addition to sensitive and accurate screening of potential cases of infection from patients in a clinical setting. Enabling testing outside of sophisticated laboratories broadens the scope of control and surveillance efforts, but also requires robust and simple methods that can be used without expensive instrumentation. Here we report a method to identify SARS-CoV-2 (COVID-19) virus RNA from purified RNA or cell lysis using loop-mediated isothermal amplification (LAMP) using a visual, colorimetric detection. This test was additionally verified using RNA samples purified from respiratory swabs collected from COVID-19 patients in Wuhan, China with equivalent performance to a commercial RT-qPCR test while requiring only heating and visual inspection. This simple and sensitive method provides an opportunity to facilitate virus detection in the field without a requirement for complex diagnostic infrastructure.

Analysis of proliferative lesions of haematopoietic and lymphoid tissue in the female productive tract / 中华妇产科杂志

Objective To study the clinicopathologic features,diagnosis and differential diagnosis of tumors of haematopoietic and lymphoid tissue in the female productive tract. Methods Eleven cases of myeloid sarcoma and leukemia, 9 of non Hodgkin lymphoma(NHL),13 of cervical lymphoma-like lesions were selected from Peking University People′s Hospital from January 2006 to August 2017. According to WHO classification of tumors of haematopoietic and lymphoid tissues(2008)and updated classification(2016),the cases were studied by microscopy,immunohistochemistry and in situ hybridization.Results In 20 cases of tumors of haematopoietic and lymphoid tissue,the mean and median age was 48.5 and 56 years old(range:16-77 years old).In cases of lymphoma-like lesion of uterine cervix,the mean and median age was 45.9 and 48 years old(range:23-62 years old).The patients with neoplasm present as fever,fatigue, hypogastralgia, colporrhagia and mass etc. Eight cases had history of acute myeloid leukemia, and 3 had myeloid leukemia while pregnancy. One case of chronic lymphocytic leukaemia/small lymphocytic lymphoma(CLL/SLL)had history of ovary small cell carcinoma and high grade serous carcinoma resected with chemotherapy.One case of diffuse large B cell lymphoma(DLBCL)had history of renal transplantation. Lactic dehydrogenase(LDH)was elevated in 9 cases(9/18).The cases of lymphoma-like lesion present as contact bleeding in most cases and all located in cervix. Four cases of neoplasm located in vulva, 1 in vagina,4 in cervix, 4 in uterine corpus, 8 in ovary and 2 in placenta.Clinical staging of NHL: 4 case was stageⅠ,1 case of stageⅢ,and 4 cases of stageⅣ.Pathological morphology:9 cases were myeloid sarcoma, 2 cases were placenta invaded by myeloid leukemia. Six cases were DLBCL, and 1 case was CLL/SLL, 1 case was mucosa associated lymphoid tissuse lymphoma(MALToma), and 1 case was anaplastic large cell lymphoma. Resected mass, chemotherapy was performed in tumors of haematopoietic and lymphoid tissue. Five cases of myeloid sarcoma and 2 of NHL died. In 13 cases of lymphoma-like lesion of uterine cervix, the general condition was good as following up. Conclusions The clinical history, pathological morphology and immunohistochemistry are very important for diagnosing tumors of haematopoietic and lymphoid tissue in the female productive tract.Resection with chemotherapy is recommended in treatment. The prognosis of lymphoma-like lesion of uterine cervix is good,and should be differentiated from lymphoma.

Mediating effect of anxiety on relationship between mobile phone addiction and locus of control in college students / 中华行为医学与脑科学杂志

Objective@#To explore the relationship among mobile phone addiction, locus of control and anxiety in college students.@*Methods@#Using Mobile Phone Addiction Index (MPAI), Internality, Powerful Others, and Chance Scale (IPC), Self-Rating Anxiety Scale (SAS), 826 college students were surveyed and the data were analyzed by SPSS17.0 and Amos24.0.@*Results@#73.6% college students had mobile phone dependence. College students being addicted to mobile phone got higher scores on chance(20.17±6.65), powerful others(18.74±7.45) and anxiety(45.95±10.41)than non-cellphone dependent students (chance(17.09±6.67), powerful others(15.03±7.65)and anxiety(40.44±8.29)). There were significant differences(all P<0.01). The scores on mobile phone addiction were positively related to chance, powerful others and anxiety (r=0.289, r=0.261, r=0.267, P<0.01). Anxiety played a partial mediating role between chance and mobile phone addiction and the mediating effect was 26.6%.@*Conclusion@#Chance can directly predict mobile phone addiction or indirectly predict cell phone addiction through anxiety.

Efficacy of Yinxing-Tongzhi dripping pills combined with clopidogrel in the secondary prevention of non cardiac cerebral infarction / 国际中医中药杂志

Objective To investigate the clinical efficacy ofYinxing-Tongzhi dripping pills combined with clopidogrel in the secondary prevention of non cardiac acute cerebral infarction (ACI).Methods A total of 117 patients met the inclusion criteria in our hospital were divided into the control group (58 cases) and observation group (59 cases). The control group was orally clopidogrel 75 mg/d in prevention of ACI recurrence, and the observation group addedYinxing-Tongzhi dripping pills based on the treatment of control group, each time 50 mg tid. Both groups were fellowed-up 1 year. The color Doppler ultrasound was used for determination of carotid artery interior and medial thickness (IMT), maximum thickness of the common carotid artery, internal carotid artery, external carotid artery plaques for evaluation. The carotid plaque score was introduced into evaluation of crouse plaque; blood rheometer was used for testing of whole blood viscosity (BV) and plasma viscosity (PV); automatic biochemical analyzer was used for testinghigh sensitive protein (hs-CRP), D-dimer and homocysteine (HCY). The patient's infertility response was recorded during the medication,and adverse drug reactions of the two groups were compared.Results The reductions on IMT (0.18 ± 0.07vs. 0.12 ± 0.04,t=5.679)mm and carotid plaque score (1.25 ± 0.31vs. 1.04 ± 0.26,t=5.009) of the observation group after follow-up were significantly higher than the control group (P<0.05). The reductions on low shear BV (0.73 ± 0.19vs. 0.51 ± 0.16,t=6.769) mPa?s and PV (0.37 ± 0.09vs. 0.22 ± 0.05,t=11.117) mPa?s of the observation group after follow-up were significantly higher than the control group (P<0.05). The reductons on hs-CRP (3.67 ± 0.88vs. 2.65 ± 0.75,t=6.742) mg/L, D-dimer (107.6 ± 23.8vs. 89.3 ± 18.7,t=4.629) g/L、Hcy (15.1 ± 2.9vs. 11.7 ± 2.6,t=6.679) mol/L of the observation group were significantly higher than the control group (P<0.05). The observation group with incidences of transient ischemic attack (8.5%vs. 19.0%), ACI recurrence (0vs. 8.6%), cerebrovascular death (0vs. 1.7%) were significantly lowerer than the control group. The ACI recurrences of the two groups with statistically significant difference (P=0.027).Conclusions Based on orally clopidogrel in secondary prevention of ACI,Yinxing-Tongzhi dripping pills combined can reduce blood viscosity, inhibit atherosclerotic plaque growth, reduce ACI recurrence, and with no increase of adverse reactions.

Efficacy of Yinxing-Tongzhi dripping pills combined with clopidogrel in the secondary prevention of non cardiac cerebral infarction / 国际中医中药杂志

Objective To investigate the clinical efficacy ofYinxing-Tongzhi dripping pills combined with clopidogrel in the secondary prevention of non cardiac acute cerebral infarction (ACI).Methods A total of 117 patients met the inclusion criteria in our hospital were divided into the control group (58 cases) and observation group (59 cases). The control group was orally clopidogrel 75 mg/d in prevention of ACI recurrence, and the observation group addedYinxing-Tongzhi dripping pills based on the treatment of control group, each time 50 mg tid. Both groups were fellowed-up 1 year. The color Doppler ultrasound was used for determination of carotid artery interior and medial thickness (IMT), maximum thickness of the common carotid artery, internal carotid artery, external carotid artery plaques for evaluation. The carotid plaque score was introduced into evaluation of crouse plaque; blood rheometer was used for testing of whole blood viscosity (BV) and plasma viscosity (PV); automatic biochemical analyzer was used for testinghigh sensitive protein (hs-CRP), D-dimer and homocysteine (HCY). The patient's infertility response was recorded during the medication,and adverse drug reactions of the two groups were compared.Results The reductions on IMT (0.18 ± 0.07vs. 0.12 ± 0.04,t=5.679)mm and carotid plaque score (1.25 ± 0.31vs. 1.04 ± 0.26,t=5.009) of the observation group after follow-up were significantly higher than the control group (P<0.05). The reductions on low shear BV (0.73 ± 0.19vs. 0.51 ± 0.16,t=6.769) mPa?s and PV (0.37 ± 0.09vs. 0.22 ± 0.05,t=11.117) mPa?s of the observation group after follow-up were significantly higher than the control group (P<0.05). The reductons on hs-CRP (3.67 ± 0.88vs. 2.65 ± 0.75,t=6.742) mg/L, D-dimer (107.6 ± 23.8vs. 89.3 ± 18.7,t=4.629) g/L、Hcy (15.1 ± 2.9vs. 11.7 ± 2.6,t=6.679) mol/L of the observation group were significantly higher than the control group (P<0.05). The observation group with incidences of transient ischemic attack (8.5%vs. 19.0%), ACI recurrence (0vs. 8.6%), cerebrovascular death (0vs. 1.7%) were significantly lowerer than the control group. The ACI recurrences of the two groups with statistically significant difference (P=0.027).Conclusions Based on orally clopidogrel in secondary prevention of ACI,Yinxing-Tongzhi dripping pills combined can reduce blood viscosity, inhibit atherosclerotic plaque growth, reduce ACI recurrence, and with no increase of adverse reactions.

Bipolar Disorder Associated microRNA, miR-1908-5p, Regulates the Expression of Genes Functioning in Neuronal Glutamatergic Synapses

Bipolar disorder (BD), characterized by recurrent mood swings between depression and mania, is a highly heritable and devastating mental illness with poorly defined pathophysiology. Recent genome-wide molecular genetic studies have identified several protein-coding genes and microRNAs (miRNAs) significantly associated with BD. Notably, some of the proteins expressed from BD-associated genes function in neuronal synapses, suggesting that abnormalities in synaptic function could be one of the key pathogenic mechanisms of BD. In contrast, however, the role of BD-associated miRNAs in disease pathogenesis remains largely unknown, mainly because of a lack of understanding about their target mRNAs and pathways in neurons. To address this problem, in this study, we focused on a recently identified BD-associated but uncharacterized miRNA, miR-1908-5p. We identified and validated its novel target genes including DLGAP4, GRIN1, STX1A, CLSTN1 and GRM4, which all function in neuronal glutamatergic synapses. Moreover, bioinformatic analyses of human brain expression profiles revealed that the expression levels of miR-1908-5p and its synaptic target genes show an inverse-correlation in many brain regions. In our preliminary experiments, the expression of miR-1908-5p was increased after chronic treatment with valproate but not lithium in control human neural progenitor cells. In contrast, it was decreased by valproate in neural progenitor cells derived from dermal fibroblasts of a BD subject. Together, our results provide new insights into the potential role of miR-1908-5p in the pathogenesis of BD and also propose a hypothesis that neuronal synapses could be a key converging pathway of some BD-associated protein-coding genes and miRNAs.

Compared study of the diffuse calcified distribution on X-ray mammography between benign and malignant breast lesions / 实用放射学杂志

Objective To discuss the clinical significance of the diffuse calcified distribution in diagnosis of benign and malignant breast lesions .Methods 379 patients with different benign and malignant breast lesions confirmed by surgery underwent digital X‐ray mammography .The morphology ,distribution ,number ,diameter ,concentration and density of calcification in lesions ,the maximum range of the calcified area and other accompanied manifestations in benign and malignant breast lesions were analyzed .Results As for the morphology of calcification ,tiny polymorphic calcification was found in 58 .5% of malignant lesions ,meanwhile ,dot‐like one was found in 49 .3% of benign lesions .Fine linear calcification or branched linear one occurred in malignant lesions ,however ,round one occurred in benign lesions .As for the calcification distribution ,regional distribution was found in 43 .9% of malignant lesions , meanwhile the clustered distribution was found in 58 .4% of benign lesions .And all lobar or segmental distribution was seen in malig‐nant lesions .As for the calcification diameter ,the calcification with the diameter less than 0 .5 mm occurred in 71 .6% of malignant lesions ,however ,that with diameter more than 1 .0 cm occurred in 69 .3% of benign lesions .As for the concentration of calcification , lesions with calcification more than 25 were 71 .8% of malignant ones ,whereas those with calcification of 15-25 were 58 .4% of be‐nign ones .As for calcified density ,uneven calcification occurred in 94 .2% of malignant lesions ;however the even one occurred in 63 .4% of benign lesions .The maximum diameter of calcification ranged from 40 mm to 80 mm was found in 59 .0% of malignant lesions , whereas that ranged from 0 mm to 40 mm was in 77 .2% of benign lesions .Conclusion Statistical differences have been found in the morphology ,distribution ,diameter ,concentration ,density and maximum diameter of calcification between the breast benign and ma‐lignant lesions .

Relationships between androgen receptor expression and clinicopathological features and prognosis of early-onset breast cancer in Xinjiang / 国际肿瘤学杂志

Objective To study the relationships between androgen receptor (AR)expression and the clinicopathological features and prognosis of young patients (age≤35 years)with early-onset breast cancer in Xinjiang.Methods One hundred and forty-five young patients (age≤35 years)with invasive breast cancer who underwent surgery in Affiliated Cancer Hospital of of Xinjiang Medical University from January 201 0 to December 201 2 were collected.The expressions of AR in 1 45 patiens with early-onset breast cancer were detec-ted by immunohistochemical method.The relationships between AR expression and the clinicopathological fea-tures and prognosis of patients with early-onset breast cancer were retrospective analysed.Results The posi-tive rate of AR expression of patients with early-onset breast cancer in Xinjiang was 69.0% (1 00 /1 45).Single factor analysis showed that AR expression was related with neurovascular invasion (χ2 =5.309,P =0.021 ) and lymph node metastasis (χ2 =6.073,P =0.01 4),but it was not related with ethnicity (χ2 =0.097,P =0.755),age (χ2 =0.045,P =0.831 ),feeding history (χ2 =0.066,P =0.797),family history of cancer (P =0.556),histological grade (P =0.469),tumor size (χ2 =1 .006,P =0.605)and clinical stage (χ2 =4.381 ,P =0.223).The median follow-up time was 47 months.There was no significant difference between AR expression and disease-free survival of patients with early-onset breast cancer (χ2 =1 .972,P =0.1 60). Conclusion Early-onset breast cancer patients with AR positive are more likely to appear lymph node metasta-sis and neurovascular invasion than the patients with AR negative,which has certain guidance means for the treatment of early-onset breast cancer with lymph node metastasis positive.

Expressions of EphA2 in esophageal squamous cell carcinoma tissues and serums of 2 different ;nations in Xinjiang and its clinicopathological significance / 中国癌症杂志

Background and purpose:The incidence of esophageal cancer of Kazakh race is higher than that of Han people. EphA2, as a member of Eph protein family, is related to a variety of malignant tumors. This study used immunohistochemical method and enzyme-linked immunoassay to detect EphA2 in tissues and serums of Kazakh and Han patients. Therefore to analyze the expression differences of EphA2 in esophageal squamous cell carcinoma (ESCC) tissues and serum of Kazakh and Han patients in Xinjiang, and the relationship with pathological features. Methods:The expression of EphA2 protein was detected by immunohistochemistry method in 100 cases of ESCC tissues and adjacent normal esophageal tissues;Then was tested by ELISA in those cases’ serum and 60 healthy persons. Results:The positive expression rate of EphA2 protein in ESCC and corresponding adjacent tissues were 72.0%, 28.0% in Kazakh, and 62.0%, 26.0% in Han people, respectively, and the differences were statistically significant (P=0.000) in the 2 nations. EphA2 protein levels in serum of ESCC and healthy persons, and Kazakh were (58.36±12.60) and (29.39±7.34) pg/mL, Han Chinese were (58.79±13.29) and (29.39±7.34) pg/mL respectively, there were statistical signiifcance (P=0.000). In ESCC of Kazakh and Han people, EphA2 protein expression had relationship with lymph node metastasis, TNM stage and tumor depth of invasion (P0.05). Conclusion:The high expression of EphA2 protein may contribute to the occurrence, invasion and metastasis of Kazakh and Han ESCC patients. EphA2 protein expression in tissues and serum of patients with ESCC may be related to the primary tumor invasion, lymph node metastasis and TNM stage. The expression of EphA2 protein in peripheral blood of patients with esophageal cancer in Kazakh may be related to depth the of invasion.

The treatment effect of mifepristone for decidual residue after drug abortion / 中国基层医药

Objective To analyze the treatment effect of mifepristone on decidual residue after drug abortion.Methods 48 cases with decidual residue of drug induced abortion were selected as the study subjects.They were randomly divided into the observation group and the control group,24 cases in each group.Patients in the control group were given conventional medicine on decidual residue of abortion surgery of curettage of the uterus,the observation group received mifepristone treatment.The therapeutic effect,incidence rate of infection,negative emotions and other variations were compared between the two groups.Results The time of ceasing vagina bleeding,intrauterine echo Doppler abnormalities disappeared and cure rate had no significant differences between the two groups (P ＞ 0.05).The incidence rate of infection in observation group was lower than the control group(P ＜ 0.05).The pain score,depression score,anxiety scores in observation group were significantly lower than those of the control group (P ＜ 0.05).Conclusion Mifepristone in treatment of decidual residue of drug induced abortion can reduce the risk of infections,relieve patients' negative emotions.

Paraspinal approach versus conventional approach in pedicle screw fixation of thoracolumbar fractures / 中华创伤杂志

Objective To estimate the effect of pedicle screw fixation of thoracolumbar fractures via paraspinal approach and compare it with the conventional posterior midline approach.Methods Forty-two cases of thoracolumbar monosegmental fractures subjected to single posterior pedicle screw fixation and reduction from December 2008 to May 2010 were included in the study.Among the patients,19 cases were operated through paraspinal muscular-sparing approach (paraspinal approach group) and 23 cases through posterior midline surgical approach (conventional approach group).Surgical incision length,operation time,intraoperative blood loss,postoperative drainage volume,postoperative hospital stay,pre-and post-operative VAS and other perioperative indices as well as fracture reduction outcome were compared between the two groups.Oswestry disability index (ODI) was assessed after operation.Results There were no statistical differences between the two groups in aspects of surgical incision length,operation time,postoperative hospital stay,height restoration of fractured vertebra (P ＞ 0.05),but intraoperative blood loss (148.5 ± 26.5) ml,postoperative draining loss (72.9 ± 17.3) ml,postoperative VAS (1.1 ± 0.3) points and ODI (13.4 ± 2.7) points in paraspinal approach group showed statistical differences from those in conventional approach group (P ＜ 0.05).Conclusion Paraspinal muscle-sparing approach is characterized by minor trauma,less bleeding,slight pain and quick recovery as compared with conventional posterior midline approach and hence may be the preferred choice for the treatment of thoracolumbar fracture without spinal canal decompression.

Changes of molecular markers of prothrombotic c state in plasma and puerarin for treatment of acute pancreatitis / 中国综合临床

ObjectiveTo study changes of molecular markers of prothrombotic state:Platelet granule membrane protein ( GMP-140 ),Von Willebrand factor ( vWF:Ag),thrombomodulin (TM),Two-D dimer ( DD),antithrombin Ⅲ ( AT- Ⅲ ) in plasma and puerarin for treatment functions of acute pancreatitis (AP).MethodsIn 78 patients with AP [ severe acute pancreatitis (SAP):26 cases,mild acute pancreatitis (MAP):52 cases ],using a random number table,the patients were given puerarin treated base (n =40) and conventional treated base group (n =38 ).The two groups were given fast,continuous gastrointestinal decompression,correction of electrolyte and acid-base balance disorders,vein support,antisecretory drugs,antibiotics inhibit pancreatic secretion and inhibition of trypsin activity of drug treatment.Puerarin group:Puerarin injection 0.5 g in 5％glucose injection intravenous infusion of 500 ml,1 time a day.GMP-140 vWF:Ag,TM,DD were measured by the methods of analysis of enzyme-linked immunosorbent assay and AT-Ⅲ was measured by the methods of analysis of chromogenic substrate method preformed in all patients,plasma amylase and uric amylase were determined by the method of somogyi and after the treatment.And 22 healthy people were selected as normal controls ( NC,Group C,n =22).ResultsCompared with the Group C and MAP,the plasma GMP-140 [ ( 86.26 ± 15.28 )ng/Lvs (32.56 ± 18.17) ng/L and (58.68 ± 15.86)ng/L],vWF[(236.22 ±31.78)％vs (95.12 ±31.68)％ and (126.68 ± 17.06)％ ],TM [(65.70 ± 12.27) μg/L vs (4.26 ±0.92) μg/L and (9.80 ± 6.98) μg,/L],DD [ (0.87 ±0.04) mg/L vs (0.36 ±0.06) mg/L and (0.56 ±0.05) mg/L] were significantly elevated,however the AT-Ⅲ [ (56.13 ± 15.78) U/ml vs (98.76 ±22.68) U/ml and (80.38 ± 18.29)U/ml )was significantly decreased SAP ( P ＜ 0.01 ).There were significant differences on the levels of GMP-140 [ (31.52 ± 15.81 ) ng/L vs (59.62 ± 13.73 ) ng/L,t =- 23.283 ],vWF [ ( 93.32 ± 28.62) ％ vs ( 128.81 ±16.23)％,t=-28.205,P＜0.01 ],TM[ (4.36 ± 0.82) μg,/L vs (11.23 ± 7.62)μg/L,t =-43.419,P ＜0.001],DD[ (0.32 ±0.05) mg/L vs (0.68 ±0.04) mg/L,t =- 15.642,P ＜0.001],AT-Ⅲ ((97.68 ±21.69) U/ml vs (76.86 ± 17.92) U/m,t =14.967,P ＜ 0.01 ) between puerarin treated base group and conventional treated base group.Comparing with treated base,the group given puerarin obviously shortened the increased of plasma [ ( 81.26 ± 17.12) U/L vs ( 119.63 ± 51.87 ) U/L,t =- 7.618,P ＜ 0.001 ],uric amylase [ (416.37 ± 116.50) U/L vs (576.32 ± 126.58) U/L,t =- 36.659,P ＜ 0.001 ],the time of abdominal pain relief and therapy to spend [ ( 2.18 ± 0.76 ) d vs ( 5.26 ± 0.58 ) d,t =- 13.619,P ＜ 0.001 ].Conclusion The molecular markers of prothrombotic state:GMP-140,vWF:Ag,TM,DD,AT- Ⅲ might all play key roles in the development of AP.Puerarin can improve the pancreatic microcirculation and adjust molecular markers of prothrombotic state,and had certain treatment functions with AP.

Study of the plasma thrombomodulin and von Willebrand factor determination in the diagnosis and treatment of acute ischemic colitis / 中国医师进修杂志

ObjectiveTo study the changes of the plasma thrombomodulin(TM) and von Willebrand factor (vWF) levels and their clinical significance associated with the extent and severity of acute ischemie colitis.MethodsThe plasma TM and vWF levels were determined by enzyme linked immunosorbent assay in 46 patients with acute ischemic colitis (acute ischemic colitis group),42 patients with ulcerative colitis (ulcerative colitis group) and 40 healthy subjects (control group).ResultsThe plasma TM was (49.6 ±2.3) μg/L,and vWF was(198.8 ±8.9)％ in acute ischemic colitis group.The plasma TM was (38.2 ± 3.8) μ g/L,and vWF was ( 162.6 ± 7.6)％ in ulcerative colitis group.The plasma TM was (23.8 ±2.3) μg/L,and vWF was ( 116.7 ± 6.2)％ in control group.The plasma TM and vWF levels in acute ischemic colitis group were higher than those in ulcerative colitis group and control group (P ＜ 0.05 or ＜ 0.01 ).The plasma TM and vWF levels in ulcerative colitis group were higher than those in control group (P＜ 0.05).The plasma TM levels[(49.9 ± 0.3 ) μg/L] and vWF [(210.6 ± 8.2 ) ％] in all colon disease were higher than those in partial colon disease (P ＜ 0.05 ).ConclusionThe changes of plasma TM and vWF levels can be used as one of the indicators for assessment of the development and the prognosis of acute ischemic colitis.

Study on the correlation and clinical significance between ultrasound elastography and the distribution of myofibroblast in breast tumor / 中华超声影像学杂志

Objective To investigate the correlation and clinical diagnosis significance between ultrasound elastography and the distribution of myofibroblast in breast tumor.To assess the value of ultrasonic elastography and myofibroblast in the diagnosis of breast cancers.MethodsThree-hundred and fifteen patients recruited from May 2009 to November 2010 were divided into benign group and malignant group according to postoperative pathological diagnosis results considered as gold standard.The clinical value of the score of ultrasonic elastography was evaluated.The expression levels of CD34 and α-SMA protein in breast tissues were examined by immunohistochemistry.ResultsThe difference was statistically significant for the expression level of CD34 and α-SMA between malignant breast tumor patients compared with benign ( P ＜0.05).The expression level of CD34 was lower,but α-SMA was higher in the patients of breast cancer compared with benign tumor.However,the expression level of CD34 and α-SMA was just the opposite in the patients of benign tumor.The expression level of CD34 was the negative correlation with the elastography score ( P ＜0.05) in the breast tumor,but α SMA just the opposite situation.Conclusions The score of ultrasound elastography can represent MFS distribution characteristics in breast tumors in the result that α-SMA +/CD34- can determine the existence of myofibroblast.

Simple peritoneal lavage combined with venous-venous hemofiltration for severe acute pancreatitis / 中华胰腺病杂志

Objective To investigate the effectiveness of simple peritoneal lavage combined with venous-venous hemofiltration therapy for severe acute pancreatitis (SAP). Methods Needles were inserted into abdominal cavity and tee was connected, then normal saline was administrated and discharged, followed by lidocaine, dexamethasone and antibiotics once daily until bloody peritoneal drainage became clear. At the same time venous-venous hemofiltration was used. Results 61 SAP patients were randomly divided into peritoneal lavage + hemofiltration group (treatment group, n =31) and control group (n = 31). The time to abdominal pain relief, abdominal distention relief, nausea and vomiting disappearance, peritoneal irritation disappearance was (1.5 ±0.3)d,(2.7 ±0.3)d, (1.9 ±0.3)d, (1.5 ±0.2)d, and the time to cure was (11.0 ±2.0)d in the treatment group, which was significantly shorter than that in the control group [(3.9 ± 0. 3) d, (4.5 ±0.6)d, (3.7 ±0.2)d, (5.3 ±0.4)d, (18.0 ±2.5)d, P＜0.05]. At the 1st day of treatment, serum ALT,AST was significantly lower than that in the control group; at the 3rd day of treatment, the serum and urine amylase and serum levels of TNF-α, IL-6 and IL-8 level were significantly lower, but the serum level of IL-10,HCO3-was significantly higher than that in the control group (P ＜ 0.05 or ＜ 0. 01); at the 5th day of treatment, the serum Bun and Cr level were significantly lower than those in the control group (P ＜ 0. 05).Conclusions Simple peritoneal lavage combined with venous-venous hemofiltration therapy can effectively eliminate the inflammatory factors, which is more rational and effective for the treatment of severe acute pancreatitis.