Association of SLC6A4 gene c.*670T>G polymorphism with the risk for asthma and peripheral blood cytological characteristics among ethnic Zhuang Chinese population / 中华医学遗传学杂志

OBJECTIVE@#To assess the association of SLC6A4 gene c.*670T>G polymorphism with the risk for asthma and peripheral blood cytological characteristics among ethnic Zhuang Chinese from Guangxi, China.@*METHODS@#From May 2017 to March 2020, 258 patients diagnosed with asthma and 244 healthy controls were recruited from the Affiliated Hospital of Youjiang Minzhu Medical College and the People's Hospital of Hechi. Genotypes of the c.*670T>G polymorphism were determined by Sanger sequencing. Flow cytometry was used in combination with an electrical impedance method for the counting and classification of peripheral blood cells.@*RESULTS@#Compared with the T allele, the G allele of the c.*670T>G polymorphism was associated with the risk for asthma in the population (OR = 1.54, 95%CI = 1.15-2.06; P = 0.004). Compared with the GT and TT genotypes, homozygous GG genotype also comprised a risk factor (OR = 1.66, 95%CI = 1.16-2.38; P = 0.005). Stratification of the risk factors showed that the homozygous GG genotype has increased the risk of asthma in males and urban residents (P < 0.01). The erythrocyte, hemoglobin and platelet counts of the asthma group were significantly higher than the control group (P < 0.001). The GG, GT and TT genotypes have respectively accounted for 82.35%, 17.65% and 0% of the samples with platelets exceeding the normal value. The overall platelet level of GG genotype was higher than GT+TT genotype (P < 0.05). The significant association was verified by the false positive report probability, and at a prior probability level of 0.1, G vs. T false positive probability was 0.071, and GG vs. GT+TT false positive probability was 0.153.@*CONCLUSION@#The GG genotype of the c.*670T>G polymorphism is associated with the risk for asthma among ethnic Zhuang Chinese from northwest Guangxi. Above finding has also enriched the genotypic data and peripheral blood phenotype for this polymorphism.

Neuroanatomical Localization of Rapid Eye Movement Sleep Behavior Disorder in Human Brain Using Lesion Network Mapping

Objective@#To localize the neuroanatomical substrate of rapid eye movement sleep behavior disorder (RBD) and to investigate the neuroanatomical locational relationship between RBD and α-synucleinopathy neurodegenerative diseases. @*Materials and Methods@#Using a systematic PubMed search, we identified 19 patients with lesions in different brain regions that caused RBD. First, lesion network mapping was applied to confirm whether the lesion locations causing RBD corresponded to a common brain network. Second, the literature-based RBD lesion network map was validated using neuroimaging findings and locations of brain pathologies at post-mortem in patients with idiopathic RBD (iRBD) who were identified by independent systematic literature search using PubMed. Finally, we assessed the locational relationship between the sites of pathological alterations at the preclinical stage in α-synucleinopathy neurodegenerative diseases and the brain network for RBD. @*Results@#The lesion network mapping showed lesions causing RBD to be localized to a common brain network defined by connectivity to the pons (including the locus coeruleus, dorsal raphe nucleus, central superior nucleus, and ventrolateral periaqueductal gray), regardless of the lesion location. The positive regions in the pons were replicated by the neuroimaging findings in an independent group of patients with iRBD and it coincided with the reported pathological alterations at postmortem in patients with iRBD. Furthermore, all brain pathological sites at preclinical stages (Braak stages 1–2) in Parkinson’s disease (PD) and at brainstem Lewy body disease in dementia with Lewy bodies (DLB) were involved in the brain network identified for RBD. @*Conclusion@#The brain network defined by connectivity to positive pons regions might be the regulatory network loop inducing RBD in humans. In addition, our results suggested that the underlying cause of high phenoconversion rate from iRBD to neurodegenerative α-synucleinopathy might be pathological changes in the preclinical stage of α-synucleinopathy located at the regulatory network loop of RBD.

Construction of gut microbial culture banks: advances, methods and perspectives / 生物工程学报

Recently, the gut microbiota-based live biotherapeutics (LBPs) development, the interaction between gut microbial species and the host, and the mining of new antimicrobial peptides, enzymes and metabolic pathway have received increasing attention. Culturing gut microbial species is therefore of great importance. This review systemically compared the construction advances of gut microbial culture banks and also analyzed the differences of methods used by research groups to give insight into the construction and enrichment of gut microbial resources. Presently, the gut microbial culture banks have included more than 1 000 bacterial species, belonging to 12 phyla, 22 classes, 39 orders, 96 families, and 358 genera. Among these, Firmicutes, Proteobacteria, Bacteroidota, and Actinomycetota exhibited the greatest diversities at the species level. The sequencing data showed that there are more than 2 000 species inhibited in the human gut. Therefore, the cultured gut microbial species are far from saturation. In terms of the construction method, the stool samples were pre-treated with ethanol or directly spread and cultured in the non-selective nutritional rich medium (represented by Gifu anaerobic medium) to obtain single colony. Then single colony was further purified. Generally, a simplified isolation and culture method is sufficient to obtain the most common and important intestinal bacterial species, such as Bifidobacteria-Lactobacillus, Akkermansia muciniphila, Faecalibacterium prausnitzii, Prevotella and S24-7 family strains. Finally, microbial resources with great diversities at the strain level are required for further functional research and product development. Samples covering hosts with distinct physiological status, diets or regions are necessary.

Efficacy of echocardiography-guided alone versus fluoroscopy-guided percutaneous closure of atrial septal defect: A systematic review and meta-analysis / 中国胸心血管外科临床杂志

@#Objective     To systematically evaluate the safety and efficacy of percutaneous closure of atrial septal defect (ASD) guided by echocardiography alone versus fluoroscopy. Methods     The databases of PubMed, The Cochrane Library, EMbase, VIP, Wanfang Data and CNKI from January 2000 to October 2021 were searched by computer for relevant research literature. Two reviewers independently screened the literature, extracted the data and evaluated the quality according to the inclusion and exclusion criteria. Meta-analysis was performed using RevMan 5.4 software. Results     A total of 19 cohort studies and 1 randomized controlled study were collected, including 2 825 patients. The Newcastle-Ottawa Scale score for cohort studies was≥7 points. Meta-analysis showed that there was no statistical difference in the operative success rate (RR=1.01, 95%CI 1.00 to 1.02, P=0.17), incidence of occluder displacement/shedding (RR=0.77, 95%CI 0.26 to 2.27, P=0.63), incidence of arrhythmia (RR=0.50, 95%CI 0.21 to 1.14, P=0.10), incidence of pericardial effusion (RR=0.98, 95%CI 0.32 to 2.98, P=0.97), operative time (MD=–0.23, 95%CI –7.56 to 7.10, P=0.95) or cost (SMD=–0.39, 95%CI –1.09 to 0.30, P=0.27) between the two groups. The echocardiography group reduced the incidence of total postoperative complications (RR=0.42, 95%CI 0.30 to 0.60, P<0.001) and residual shunt (RR=0.70, 95%CI 0.50 to 0.98, P=0.04), and shortened length of hospital stay (MD=–0.43, 95%CI –0.77 to 0.09, P=0.01). Conclusion     Compared with traditional fluoroscopy-guided percutaneous closure of ASD, echocardiography guidance alone is equivalent in terms of operative success rate, major postoperative complications, operative time and total cost, but it reduces the incidence of total postoperative complications and residual shunt, and has a shorter length of hospital stay.

Causal Relationship Between Acromegaly and Colon Cancer: A Two-sample Mendelian Randomization Study / 肿瘤防治研究

Objective To determine the causal relationship between acromegaly and colon cancer by using two-sample Mendelian randomization. Methods Genetic loci closely related to acromegaly in the whole genome-wide association study (GWAS) were selected as tool variables, and the genetic data of colon cancer from different GWASs were analyzed by two-sample Mendelian randomization (MR).The inverse variance weighting method (IVW) of the random effect model was used for analysis, and MR-weighted median and MR-Egger methods were used to supplement the analysis. Results were presented as OR values. Results Four SNPs closely related to acromegaly were obtained as tool variables, and the multiplicity test of tool variables showed that P=0.59.Three methods were used to estimate causal effects.The IVW analysis were OR=1.00(0.99-1.001) and P=0.42;the MR-Egger analysis results were OR=1.00(0.99-1.001) and P=0.42;and the Weighted median analysis results were OR=1.00(1.00-1.001) and P=0.03.The sensitivity test showed that the confidence interval of the tool variable SNP passed through 0, indicating the robustness of the MR results. Conclusion Acromegaly is not an independent risk factor for colon cancer.

Impact of non-pharmacological interventions on COVID-19 boosting vaccine prioritization and vaccine-induced herd immunity: a population-stratified modelling study

BackgroundWhile the COVID-19 pandemic seemed far from the end, the booster vaccine project was proposed to further reduce the transmission risk and infections. However, handful studies have focused on questions that with limited vaccine capacity ether boosting high-risk workers first or prioritizing susceptible normal individuals is optimal, and vaccinating how many people can lead us to the goal of herd immunity. In this study we aimed to explore the conclusions of such two problems with consideration of non-pharmacological interventions including mandatory quarantine for international entrants, keeping social distance and wearing masks. MethodsBy implementing the corresponding proportion of individuals who remain infectious after four lengths of quarantine strategies to the novel population-stratified model, we quantified the impact of such measures on optimizing vaccine prioritization between high-risk workers and normal populations. Furthermore, by setting the hypothetical COVID-19 transmission severity (reproduction number, R0) to the level of the most contagious COVID-19 variant (B.1.617.2, delta variant, R0 = 5.0), we separately estimated the threshold vaccine coverage of five countries (China, United States, India, South Africa and Brazil) to reach herd immunity, with and without the consideration of interventions including wearings masks and keeping social distance. At last, the sensitive analysis of essential parameter settings was performed to examine the robustness of conclusions. ResultsFor Chinese scenarios considered with moderate hypothetical transmission rate (R0 = 1.15-1.8), prioritizing high-risk workers the booster dose reached lower cumulative infections and deaths if at least 7-days of quarantine for international travelers is maintained, and the required screening time to remain such vaccinating strategy as optimal increased from 7-days to 21-days with the transmission severity. Although simply maintaining at least 7-days quarantine can lead to over 69.12% reduction in total infections, the improvement of longer quarantine strategies was becoming minimum and the least one was 2.28% between the 21 and the 28-days of quarantine. Besides, without the vaccination program, the impact of such measures on transmission control dropped significantly when R0 exceeded 1.5 and reached its minimal level when R0 equal to 2.5. On the other hand, when we combat the delta variant, the threshold vaccine coverage of total population to reach herd immunity lay within 74%-89% (corresponding to the vaccine efficiency from 70% to 50%), and such range decreased to 71%-84% if interventions including wearing mask and keeping social distance were implemented. Furthermore, Results of other countries with 85% vaccine efficiency were estimated at 79%, 91%, 94% and 96% for South Africa, Brazil, India and United States respectively. ConclusionsNon-pharmacological interventions can substantially affect booster vaccination prioritization and the threshold condition to reach herd immunity. To combat the delta variant, restrictions need to be integrated with mass vaccination so that can reduce the transmission to the minimum level, and the 21-days might be the suggested maximum quarantine duration according to the cost-effectiveness. Besides, by implementing interventions, the requirement to reach herd immunity can be lower in all countries. Lastly, the following surveillance after vaccination can help ensure the real-time proportion of vaccinated individuals with sufficient protection.

Smartwatch Facilitated Remote Health Care for Patients Undergoing Transcatheter Aortic Valve Replacement Amid COVID-19 Pandemic

BACKGROUNDThe novel coronavirus disease-2019 (COVID-19 Pandemic) has brought difficulties to the management of patients undergoing transcatheter aortic valve replacement (TAVR). OBJECTIVESThis prospective, observational cohort study sought to evaluate the feasibility of a novel, virtual, and remote health care strategy for TAVR patients with smart wearable devices. METHODSA total of 100 consecutive severe aortic stenosis patients who underwent elective transfemoral TAVR were enrolled and each received a HUAWEI smartwatch at least one day before TAVR. Vital signs were continuously tracked and recorded. Single lead electrocardiogram (ECG) was recorded periodically after TAVR. A designated heart team member was to provide remote data-assisted health care to address the medical demand. RESULTSThirty-eight cardiac events were reported in 34 patients after discharge, with most of the events (76.0%) were detected and confirmed by the smartwatch. Six patients were advised and readmitted to the hospital for arrhythmia events, among whom, four received pacemaker implantations. The remaining 28 (82.4%) patients received telemedicine monitoring instead of face-to-face clinical visits, and three of them received new medication treatment under a doctors online guidance of doctors. New-onset LBBB was found in 48 patients with transient and recovered spontaneously in 30 patients, while new-onset atrial fibrillation in 4 patients. There were no significant differences in the average weekly heart rates, the ratio of abnormal or low oxygen saturation when compared with the baseline. The average daily steps increased over time significantly (baseline, 870{+/-}1353 steps; first week, 1986{+/-}2406 steps; second week, 2707{+/-}2716 steps; third week, 3059{+/-}3036 steps; fourth week, 3678{+/-}3485 steps, p < 0.001). CONCLUSIONSSmartwatch can facilitate remote health care for patients undergoing TAVR during COVID-19 and enables a novel remote follow-up strategy. The majority of cardiac clinical events that occurred within 30-day follow-up were detected by the smartwatch, mainly due to the record of conduction abnormality. (SMART Watch Facilitated Early Discharge in Patients undergoing Transcatheter Aortic Valve Replacement, NCT04454177).

The Incubation Period of Severe Acute Respiratory Syndrome Coronavirus 2:A Systematic Review

While the novel coronavirus continues to spread worldwide, the reported incubation period has varied between studies and is imprecise due to limited data. A literature search with certain selection criteria was conducted on May 30, 2020. In total, sixty-four articles were included, and 854 individual-level data were extracted from 30 studies for pooled analysis. Of these studies, 72% of them reported a median or mean incubation period of 4-7 days, while our estimated median was 4.9 days (95% confidence interval [CI]: 4.6-5.2). However, the inclusion of 81 asymptomatic and presymptomatic patients, as well as 31 cases with incubation periods exceeding 14 days, led to our estimation of 97.5 th percentile with 19.3 days (95% CI: 17.4-21.4), beyond the currently suggested 14-day quarantine period. Therefore, we appeal to prolong the quarantine duration, especially for areas that have insufficient testing resources, to protect susceptible populations from being infected. Article Summary LineThis article reviewed the COVID-19 studies involving incubation period and provided pooled estimation based on available data from these studies.The result showed that our estimated median incubation period is consistent with the estimates of formal studies but the 97.5 percentile is larger than ever on account of including a number of asymptomatic and presymptomatic patients.These finds suggested that we should properly prolong the isolation or quarantine period in order to identify more patients with longer incubation period and those without any symptoms.

Controlling nutritional status (CONUT) score is a predictive marker for patients with traumatic brain injury.

OBJECT: We designed this study to evaluate whether controlling nutritional status (CONUT) score was valuable in predicting outcome of patients with traumatic brain injury (TBI). METHODS: Clinical and laboratory data of patients admitted with TBI in our hospital between January 2015 and January 2018 was retrospectively collected. We divided patients into two groups according to in-hospital and 90-day outcome respectively and compared baseline characteristics of two groups. Multivariate analyses were conducted to evaluate whether CONUT score was associated with outcome of included patients. Receiver operating characteristics (ROC) curves were drawn to compare the predictive value of CONUT score and constructed models. RESULTS: A total of 365 patients were included in our study. Multivariate logistic regression analyses showed that CONUT score was independently associated with in-hospital mortality (OR = 1.244, 95% CI: 1.099-1.408, p = 0.001) and 90-day outcome (OR = 1.441, 95% CI: 1.193-1.741, p < 0.001). ROC curve showed that area under the ROC curve (AUC) of CONUT score for predicting in-hospital mortality and 90-day outcome were 0.790 (95% CI: 0.745-0.836, p < 0.001) and 0.839 (95% CI: 0.792-0.886, p < 0.001), respectively. CONCLUSION: CONUT score is independently associated with in-hospital mortality and 90-day outcome of patients with TBI.

The application values of the relative length of lesion in differential diagnosis of extrahepatic infiltrating cholangiocarcinoma and cholangitis / 中华放射学杂志

Objective:To evaluate the diagnostic value of relative lesion length in differentiating extrahepatic bile duct infiltrating cholangiocarcinoma with inflammation.Methods:From October 2014 to February 2018, 24 cases of infiltrating extrahepatic cholangiocarcinomas confirmed operatively and pathologically and 23 cases of extrahepatic bile duct inflammation confirmed clinically from the Third People′s Hospital of Datong City were respectively enrolled in this study. Upper abdomen MR and/or CT image data of all patients were respectively reviewed. The extrahepatic duct wall was defined as wall thickening with obvious enhancement. The length of the lesion was measured. L lesion/L duct was referred as the ratio of the lengths of lesion to extrahepatic bile duct (common hepatic duct+common bile duct)was calculated. The difference in the average values of L lesion/L ductbetween the cholangiocarcinomas group and inflammation group was analyzed with t test, and the differential diagnostic efficacy of L lesion/L ductratio was analyzed with receiver operating characteristic curve (ROC) test. Results:Significant difference was found in the length of lesion between the extrahepatic cholangiocarcinoma group [(22.01±1.86) mm] and the cholangitis group [(47.36±2.81) mm] ( P<0.01). The average ratio of L lesion/L ductwere 0.26±0.02 for the cholangiocarcinomas group and 0.54±0.03 for the inflammation group, respectively ( P<0.01). The area under the ROC curve of L lesion/L duct in diagnosis of the infiltrating extrahepatic cholangiocarcinomas was 0.92. With <0.40 as cut-off point, the diagnostic sensitivity and specificity were 87.5% and 82.6%, respectively. Conclusion:The L lesion/L ductmight be taken as an important diagnostic sign in differentiation between infiltrating extrahepatic cholangiocarcinomas and extrahepatic bile duct inflammation.

Effect of mild hypothermia combined with hydrogen-rich saline on cerebral injury after cardiac arrest and resuscitation in rats / 中华麻醉学杂志

Objective To evaluate the effect of mild hypothermia combined with hydrogen-rich saline on cerebral injury after cardiac arrest and resuscitation in rats.Methods Healthy male Sprague-Dawley rats,aged 7-8 weeks,weighing 280-320 g,were divided into 5 groups (n=33 each) using a random number table method:sham operation group (group S),cardiac arrest and resuscitation group (group CAR),hydrogen-rich saline group (group H2),mild hypothermia group (group MH),and mild hypothermia plus hydrogen-rich saline group (group MH+H2).Cardiac arrest was induced with transoesophageal cardiac pacing followed by cardiopulmonary resuscitation to establish the cerebral injury model.Hydrogen-rich saline 5 ml/kg was intraperitoneally injected immediately after return of spontaneous circulation (ROSC) in H2 and MH+H2 groups,while the equal volume of normal saline was given instead in the other groups.The body temperature of rats was cooled down to 32-34℃ within 15 min starting from the time point immediately after ROSC and maintained for 4 h in MH and MH+H2 groups.Fifteen rats were selected at 24 h after ROSC to assess the neurological function score (NDS).Eighteen rats in each group were sacrificed at 24 h after ROSC,and brains were removed for microscopic examination of the pathological changes in hippocampal CA1 region after hematoxylin and eosin staining and for determination of pyramidal cell count and expression of glucose-regulated protein 78 (GRP78),C/EBP-homologous protein (CHOP),caspase-12,caspase-3,Bcl-2 and Bax in hippocampal CA1 region (by Western blot).Results Compared with group S,the NDS was significantly decreased,the pyramidal cell count was reduced,the expression of GRP78,CHOP,caspase-12,caspase-3 and Bax was up-regulated,and the expression of Bcl-2 was down-regulated in the other four groups (P＜0.05).Compared with group CA-R,the NDS and pyramidal cell count were significantly increased,the expression of GRP78 and Bcl-2 was up-regulated,and the expression of CHOP,caspase-12,caspase-3 and Bax was down-regulated in H2,MH and MH+H2 groups (P＜0.05).Compared with group H2 or group MH,the NDS and pyramidal cell count were significantly increased,the expression of caspase-3 and Bax was down-regulated,the expression of Bcl-2 was up-regulated (P＜0.05),and no significant change was found in the expression of GRP78,CHOP and caspase-12 in group MH+H2 (P＞ 0.05).Conclusion Combination of mild hypothermia and hydrogen-rich saline offers enhanced efficacy in reducing cerebral injury after cardiac arrest and resuscitation over mild hypothermia or hydrogen-rich saline alone in rats.

Validity of the size-specific dose estimate derived from the water equivalent diameter value of the center slice of the scan range in the head CT examination / 中华放射学杂志

Objective To explore the validity of the size-specific dose estimate (SSDE) derived from the water-equivalent diameter (Dw)value of the slice located in the middle of the scan range in the head CT examination. Methods A total of 197 patients underwent head CT nonenhanced scan were enrolled in this retrospective study. The Dw, size-dependent conversion factor (f), normalized volume CT dose index (CTDIvol) and SSDE values of all slices were calculated. Two sets of SSDE, SSDEgroand SSDEcenbased on the Dwvalues slice by slice (Dw-gro) and the Dwvalues of the slices in the middle of the scan range (Dw-cen), were obtained across all patients. Pearson correlation analysis and linear regression analysis were performed for Dw-grovs Dw-cen, Spearman correlation analysis and linear regression analysis for SSDEgrovs SSDEcen, SSDE vs Dw, CTDIvolvs Dw. With the reference of SSDEgrovalue, mean absolute relative difference (MARD) of SSDEcen values were calculated to assess its accuracy and the correlated factors of MARD was analyzed with multivariate linear stepwise regression analysis. Results The minimal Dwvalue close to the roof of the skull corresponded to the maximal value of f and SSDE, which was the minimal value of CTDIvol. The significant positive correlation was showed between Dw-grovs Dw-cen, SSDEgrovs SSDEcen, SSDE vs Dw, CTDIvolvs Dw(r=0.947, 0.931, 0.416, 0.626;P＜0.05). The values of Dw,groand Dw-cenwere (16.94±0.69) and (18.50±0.62) cm respectively. The values of SSDEgroand SSDEcenwere [54.10 (52.29, 56.39)] mGy and [53.77 (51.85, 55.25)] mGy respectively. An approximation of SSDEcenvalues with an average of 1.62% of the gross MARD was found to match the reference value. Multivariate linear stepwise regression analysis indicated that MARD had negative correlation with Dw(β=–1.319,P＜0.05), positive correlation with CTDIvol(β=0.202,P＜0.05), and f was not included in the multivariate regression equation. Conclusion SSDEcenbased on the Dwvalue of the slice located at the center of the scan range yields small MARD value and can represent a reliable SSDE estimation in the head CT examination.

Transforming bacterial disease surveillance and investigation using whole-genome sequence to probe the trace / 医学前沿

Two decades have passed since the first bacterial whole-genome sequencing, which provides new opportunity for microbial genome. Consequently, considerable genetic diversity encoded by bacterial genomes and among the strains in the same species has been revealed. In recent years, genome sequencing techniques and bioinformatics have developed rapidly, which has resulted in transformation and expedited the application of strategy and methodology for bacterial genome comparison used in dissection of infectious disease epidemics. Bacterial whole-genome sequencing and bioinformatic computing allow genotyping to satisfy the requirements of epidemiological study in disease control. In this review, we outline the significance and summarize the roles of bacterial genome sequencing in the context of bacterial disease control and prevention.We discuss the applications of bacterial genome sequencing in outbreak detection, source tracing, transmission mode discovery, and new epidemic clone identification. Wide applications of genome sequencing and data sharing in infectious disease surveillance networks will considerably promote outbreak detection and early warning to prevent the dissemination of bacterial diseases.

Landscape of emerging and re-emerging infectious diseases in China: impact of ecology, climate, and behavior / 医学前沿

For the past several decades, the infectious disease profile in China has been shifting with rapid developments in social and economic aspects, environment, quality of food, water, housing, and public health infrastructure. Notably, 5 notifiable infectious diseases have been almost eradicated, and the incidence of 18 additional notifiable infectious diseases has been significantly reduced. Unexpectedly, the incidence of over 10 notifiable infectious diseases, including HIV, brucellosis, syphilis, and dengue fever, has been increasing. Nevertheless, frequent infectious disease outbreaks/events have been reported almost every year, and imported infectious diseases have increased since 2015. New pathogens and over 100 new genotypes or serotypes of known pathogens have been identified. Some infectious diseases seem to be exacerbated by various factors, including rapid urbanization, large numbers of migrant workers, changes in climate, ecology, and policies, such as returning farmland to forests. This review summarizes the current experiences and lessons from China in managing emerging and re-emerging infectious diseases, especially the effects of ecology, climate, and behavior, which should have merits in helping other countries to control and prevent infectious diseases.

Comparison of SSDE values based on effective diameter and water equivalent diameter in head CT examination of adult patients / 中华放射医学与防护杂志

Objective@#To compare and quantify the differences in size-specific dose estimates (SSDE) obtained by effective diameter and water-equivalent diameter from the central slice of the scan range in head CT examination.@*Methods@#A total of 111 consecutive adult patients who underwent head CT examination were enrolled in this study. All of CTDIvol values in the dose report were documented. The dataset was assigned into group A and group B, based on the individual size-dependent conversion factors (f) of effective diameter (deff) and water-equivalent diameter (dw) at the central slice multiplied by normalized volume computed tomography dose index (CTDIvol ) respectively. Body size, f and SSDE were calculated. With SSDEgross served as the reference level, the performance of SSDEdeff and SSDEdw was evaluated.@*Results@#Statistically significant differences were found in body size (t=47.587, P<0.05) and f(z=-9.242, P<0.05) between group A and group B. Statistically significant difference also existed in SSDE (t=-46.687, P<0.05), (56.20±2.66) and (53.49±2.48) mGy for group A and group B respectively. Strongly positive correlation was shown in body size (r=0.873, R2 =0.761) and SSDE (r=0.974, R2 =0.949) between group A and group B(all P<0.05). Positive correlation was also found between SSDEdeff and SSDEgross(r=0.900, R2 =0.809), SSDEdw and SSDEgross (r=0.904, R2 =0.817, all P<0.05). Mean absolute difference was 2.34 and 0.78 mGy, for SSDEdeff vs. SSDEgross and SSDEdw vs. SSDEgross respectively; mean absolute relative difference was 4.38%, 1.40%; root mean square difference was 1.17 mGy (2.17%), 1.06 mGy (1.91%). Interquartile range and full range of SSDEdeff and SSDEdw were 3.22 vs. 2.39 mGy, 13.65 vs. 12.48mGy, respectively. A less degree of variation was observed in SSDEdw than that in SSDEdeff.@*Conclusions@#SSDEdw values based on the water-equivalent diameter at the central slice of the scan range got better agreement with those derived from all slices, which could serve as a simpler and more valid indicator to represent the average value of size-specific dose estimates of the whole scan range in head CT examination.

Effect of dexmedetomidine on proliferation, migration and invasion of human gastric cancer SGC-7901 cells / 临床麻醉学杂志

Objective To observe different behavior of proliferation,migration and invasion of SGC-7901 cells when exposured to dexrnedetomidine of different concentrations.Methods Human gastric cancer cells SGC-7901 were inoculated on culture plate for 24 h,then were randomly divided into 5 groups:control group (group C),dexmedetomidine 312.5μg/ml group (group D1),dexme detomidine 625μg/ml group (group D2),dexmedetomidine 1 250 μg/ml group (group D3),dexmedetomidine 2 500 μg/ml group (group D4).Each group was medicated and incubated for 48 h,then the cell proliferation,migration and invasion immediately were detected by CCK-8 and Transwell.Results SGC-7901 cell viability of groups D1,D2,D3 和 D4 had no significant difference compared with that of group C.The invasion ability and migration ability of SGC-7901 cells in groups D1,D2,D3 and D4 were significantly higher than those in group C (P ＜ 0.05 or P ＜ 0.01).Conclusion Dexmedetomidine can promote migration and invasion of SGC-7901 cells.

Effect of continuous incision infusion different concentration of ropivacaine for postoperative analgesia after radical mastectomy / 临床麻醉学杂志

Objective To observe the effect of continuous incision infusion different concentra-tion of ropivacaine for postoperative analgesia after radical mastectomy.Methods One hundred pa-tients under radical mastectomy,aged 40-70 years,ASA Ⅰ or Ⅱ,were randomly divided into four groups (n =25 each):0.2% (group R1),0.3% (group R2),0.4% (group R3)ropivacaine incision continued infiltration group and patient-controlled intravenous analgesia (group PCIA)as control group.VAS pain scores,sedation Ramsay score and side effects were recorded at each time point in rest and turning over 90°,2 h (T1 ),4 h (T2 ),8 h (T3 ),12 h (T4 ),24 h (T5 ),48 h (T6 )after the operation.Results VAS scores in group R1 at T1-T6 in rest and turn over 90°were significantly high-er than that of group PCIA (P <0.05).There were no significant differences among the group PCIA, group R2 and group R3.Sedation score in PCIA group was significantly higher than that in the other three groups (P <0.05),and the adverse reactions,such as nausea and vomiting,in group PCIA (2 cases)were more serious than that in the other groups (0 cases ).There were no significant differences among the other groups.Conclusion Ropivacaine plays an effective role in infiltration an-algesia when its concentration reaches 0.3% subcutaneous after radical mastectomy.

Influences of different mechanical ventilation modes on ventilator-induced diaphragm dysfunction / 实用医学杂志

Objective To investigate the influences of different mechanical ventilation modes on ventilator?induced diaphragm dysfunction (VIDD). Methods The patients received invasive mechanical ventilation in our ICU after lower abdomen surgery were enrolled into 3 groups according to different ventilation modes. The data of the 3 groups were analyzed. According to the offline results, patients were divided into two groups, the success of weaning as the dependent variable, the clinical indicators with statistical significance as the independent variable, the Logistic regression analysis was performed to analyze the ventilator weaning. Results The mechanical ventilation time, 48 h reintubation rate and the length of ICU stay in the A/C mode group were significantly higher than those in the SIMV mode group and the PSV mode group. The weaning success rate in the A/C mode group was significantly lower than that in the SIMV mode group and the PSV mode group, with significant difference (P<0.05). Weaning success group and weaning failure group had significant differences in the proportion of three ventilation modes (P < 0.05). With weaning as dependent variable, APACHE Ⅱ score, ALB and ventilation mode as independent variables, logistic regression analysis was performed using the enter method. APACHE Ⅱ and ventilation mode were independent influencing factors for weaning. Conclusion Compared with the A/C mode, the SIMV mode and the PSV mode have less influence on VIDD and high weaning success rate in the mechanical ventilation process of patients post?lower abdomen surgery. No significant difference was found between the SIMV mode and the PSV mode in their influence on weaning.

Mild hypothermia combined with mitochondrial division inhibitor alleviates mitochondrial damage after global cerebral ischemia-reperfusion / 临床麻醉学杂志

Objective To investigate the effect of mild hypothermia combined with mitochondrial divison inhibitor 1 in mitochondrial after cerebral ischemia-reperfusion (IR).Methods Fourty male healthy Sprague-Dawley (SD) rats, weighing 280-320 g, were randomly divided into 5 groups (n=8 each): group Sham, group IR, hypothermia group (group H), Mdivi-1 group (group M) and hypothermia+Mdivi-1 group (group HM).Animal models of global cerebral IR were established by transoesophageal cardiac pacing inducing cardiac arrest followed by cardiopulmonary resuscitation (ischemia 4 min and reperfusion 6 h).The group Sham was similarly treated to group IR except the cardiac arrest and cardiopulmonary resuscitation.In groups H and HM, the core temperature was cooled down to 32-34℃ within 15 min starting from the beginning of reperfusion, and maintained for 6 h.In the other groups, the core temperature was maintained at the normal temperature.In groups M and HM, the animals were given Mdivi-1 (1.2 mg/kg) intravenously at the beginning of the reperfusion and the other groups were given the same Volume of dimethylsnlfone (DMSO).After 6 h of reperfusion, the rats were sacrificed, and bilateral hippocampi were immediately removed for determination the protein level of dynamin-related proten 1 (Drp1) and cytochrome C (Cyt-C) expression by Western blot and obsevation of the mitochondrial structure of pyramidal cell in hippocampal CA1 under electronic microscope.Results Compared with group Sham, the expression of Drp1 and Cyt-C was up-regulated in groups IR, H, M and HM (P＜0.05).Compared with group IR, the expression of Drp1 and Cyt-C was down-regulated in groups H, M and HM (P＜0.05).Compared with groups H and M, the expression of Drp1 and Cyt-C was down-regulated in group HM (P＜0.05).There was no significant difference in the expression of Drp1 and Cyt-C between groups H and M.The mitochondria were rod-shaped with clear and sound structure in group Sham, while mitochondria showed various degree of fission, swollen structures, matrix deposit, vacuoles formation and cristae collapse in other groups.The changes of group HM were relatively slight.Conclusion Mild hypothermia combined with mitochondrial divison inhibitor 1 alleviate mitochondrial damage after global cerebral IR of rats.The combined effect is better than that of any individual application.

Effect of hydrogen sulfide on hippocampal endoplasmic reticulum stress during global cerebral ischemia-reperfusion in rats / 中华麻醉学杂志

Objective To evaluate the effect of hydrogen sulfide on hippocampal endoplasmic reticulum stress during global cerebral ischemia-reperfusion (I/R) in rats.Methods Seventy-two pathogen-free healthy male Sprague-Dawley rats,weighing 280-320 g,aged 8-10 weeks,were divided into 3 groups (n=24 each) using a random number table:sham operation group (group Sham),global cerebral I/R group (group I/R) and global cerebral I/R plus sodium hydrosulfide group (group I/R+NaHS).Cardiac arrest was induced with transoesophageal cardiac pacing followed by cardiopulmonary resuscitation to establish the global cerebral I/R model.Immediately after recovery of spontaneous circulation,sodium hydrosulfide 2.5 mg/kg was intraperitoneally injected in group I/R+NaHS,and normal saline 5 ml/kg was given in group I/R.The hippocampi were immediately removed at 24 h of reperfusion for determination of the expression of glucose-regulated protein 78 (GRP78),C/EBP-homologous protein (CHOP) and caspase-12 in hippocampal tissues (by Western blot).At 1,3 and 7 days of reperfusion,the hippocampal tissues were obtained and stained with haematoxylin and eosin for examination of the pathological changes in hippocampal CA1 region (under a light microscope) and for determination of apoptosis in hippocampal cells (using TUNEL staining),and the apoptosis rate was calculated.Results Compared with group Sham,the apoptosis rate of hippocampal tissues at 1,3 and 7 days of reperfusion in group I/R and at 3 and 7 days of reperfusion in group I/R+NaHS were significantly increased,and the expression of GRP78,CHOP and caspase-12 in hippocampal tissues was significantly up-regulated in I/R and I/R+NaHS groups (P＜0.05).Compared with group I/R,the apoptosis rate of hippocampal tissues was significantly decreased,and the expression of GRP78,CHOP and caspase-12 was down-regulated at 1,3 and 7 days of reperfusion (P＜0.05),and the pathological changes were significantly attenuated in group I/R+NaHS.Conclusion The mechanism by which hydrogen sulfide reduces apoptosis in hippocampal cells is related to inhibition of endoplasmic reticulum stress during global cerebral I/R in rats.