[Clinical Study of Peripherally Inserted Central Catheter-Related Thrombosis and Its Influence on the Blood Flow Status of the Inserted Veins in Cancer Patients].

Objective: To investigate the clinical features of peripherally inserted central catheter (PICC)-related thrombosis (PICCRT) within 2 weeks after PICC placement in cancer patients and its dynamic influence on the blood flow status of veins inserted with catheter, and to provide support for implementing thrombosis prevention and control measures. Methods: Between May 2019 and July 2020, patients who had solid tumors and who had PICC were prospectively enrolled at West China Hospital, Sichuan University. Scheduled color Doppler imaging was performed to examine the status of PICCRT formation at 8 points of time, with the first one conducted one day before the insertion of PICC and the other 7 completed within 2 weeks after the insertion of PICC. Then, based on whether patients had PICCRT, the patients were divided into two groups, a non-PICCRT group and a PICCRT group. The PICCRT group was further divided into two subgroups, an asymptomatic PICCRT group and a symptomatic PICCRT group, according to whether the patients had thrombosis-related symptoms and signs. Comparisons were made to study the incidence of PICCRT and the vascular diameter and the blood flow velocity in the veins inserted with catheters at different points of time in the patients of different groups. Results: Among 173 cancer patients in the cohort, 126 (72.8%) developed PICCRT, all of which occurred within 1 week after PICC insertion. There were 95 cases of asymptomatic PICCRT and 31 cases of symptomatic PICCRT. Before and after PICC insertion, the vascular diameter of both the asymptomatic and symptomatic PICCRT groups was significantly smaller than that of the non-PICCRT group and the blood flow velocity was significantly slower than that of the non-PICCRT group, with the difference continuing to increase with the prolongation of catheter indwelling time. Conclusion: Inserting catheters in veins with bigger vascular diameter and faster blood flow velocity may help reduce the incidence of PICCRT. The first week post catheter insertion is the key intervention period for the prevention of PICCRT.

Clinical observation on wrist-ankle acupuncture for shoulder-hand syndrome phaseⅠafter stroke / 中国针灸

OBJECTIVE@#To compare the clinical efficacy between wrist-ankle acupuncture and conventional acupuncture on shoulder-hand syndrome (SHS) phaseⅠafter stroke.@*METHODS@#A total of 64 patients with SHS phaseⅠafter stroke were randomized into a wrist-ankle acupuncture group and a conventional acupuncture group, 32 cases in each group. On the basis treatment of internal medicine and conventional rehabilitation, wrist-ankle acupuncture was applied at upper 4 area, upper 5 area and upper 6 area on the affected side in the wrist-ankle acupuncture group, while acupuncture was applied at Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), etc. on the affected side in the conventional acupuncture group. The treatment was given 30 min each time, once a day, 5 days a week for 3 weeks in both groups. Before and after treatment, the visual analogue scale (VAS) score, degree of hand swelling, shoulder-hand syndrome scale (SHSS) score, Fugl-Meyer assessment for upper extremity (FMA-UE) score and modified Barthel index (MBI) score were observed, and the clinical therapeutic effect was evaluated in both groups.@*RESULTS@#After treatment, the VAS scores, degree of hand swelling and SHSS scores were decreased (P<0.05), and the FMA-UE scores and MBI scores were increased (P<0.05) compared before treatment in both groups; in the wrist-ankle acupuncture group, the VAS score, degree of hand swelling and SHSS score were lower (P<0.05), and the FMA-UE score and MBI score were higher (P<0.05) than those in the conventional acupuncture group. The total effective rate was 96.9% (31/32) in the wrist-ankle acupuncture group, which was superior to 90.6% (29/32) in the conventional acupuncture group (P<0.05).@*CONCLUSION@#Wrist-ankle acupuncture can effectively relieve pain and hand swelling, improve motor function of upper extremity and self-care ability of daily life in patients with shoulder-hand syndrome phaseⅠafter stroke, the therapeutic effect is superior to conventional acupuncture.

Cone-beam computed tomography digital for measuring the inclination angle to the long axis of healthy maxillary anterior teeth and morphologically characterizing their labial bone plates / 华西口腔医学杂志

OBJECTIVE@#We aim to determine the thickness of the labial plate, the distance between the cement-enamel junction (CEJ) and alveolar crest, and the inclination angle of the long axis of healthy maxillary anterior teeth by using cone- beam computed tomography (CBCT).@*METHODS@#A total of 345 CBCT volumes obtained by Newtom VGI® CBCT were analyzed by using the NNT software. The digital measurements of the labial bone plate thickness at level 4 mm below the CEJ, the midpoint of tooth root and the radiological tooth apex, the distance between the CEJ and alveolar crest, and the angle between the long axis of the teeth and the long axis of alveolar process were obtained from the mid-sagittal planes of maxillary incisors and canines. Plate thickness 4 mm below the CEJ was measured, and values below ≥1 mm were recorded.@*RESULTS@#In the central incisor, 1) the angle between the long axis of the teeth and alveolar bone was 15.2°±6.2°, the distance between the CEJ and alveolar crest was (1.5±1.0) mm, labial bone plate thick-ness at 4 mm below the CEJ was (0.8±0.4) mm, the midpoint of tooth root was (0.6±0.4) mm, and the radiological tooth apex was (1.3±0.7) mm; in the lateral incisor, 16.2°±8.8°, (1.6±1.0) mm, (0.7±0.5) mm, (0.4±0.6) mm, and (1.1±0.7) mm, respectively; and in the canine, 19.0°±6.2°, (1.8±1.0) mm, (0.9±0.6) mm, (0.4±0.6) mm, and (1.2±0.7) mm, respectively. 2) The frequencies of plate thickness ≥1 mm were 28.3%, 25.8%, and 42.7% in the central incisor, lateral incisor, and canine, respectively. 3) The distance between the CEJ and alveolar crest was positively correlated with age. The correlation coefficients was 0.42 (P<0.01) in the central incisor, 0.50 (P<0.01) in the lateral incisor, and 0.62 (P<0.01) in the canine.@*CONCLUSIONS@#The thickness of labial bone plate is thin, the distance from CEJ to alveolar crest increases with age, and the long axis of the teeth is more inclined than the long axis of alveolar process. Knowledge of these special morphological characteristics can improve the safety and result for many dental procedures.

Research progress in ventilator-associated events and prevention / 中国感染控制杂志

Healthcare-associated pneumonia (HAP) is a key factor affecting the clinical prognosis of critically ill patients undergoing long-term mechanical ventilation.In the past, ventilator-associated pneumonia (VAP) was an important mean of monitoring complications of ventilator-associated infection, but it is highly controversial because of its high subjectivity, low specificity and poor sensitivity.Therefore, the definition of ventilator-associated event (VAE) was proposed by Centers for Disease Control and Prevention of USA in 2013, the monitoring definition adopts objective and quantitative criteria, which can better predict the clinical outcomes of patients.This paper summarizes the research progress of VAE in recent years, and provides some new ideas for better prevention and control of VAE.

Preparation of fisetin solid dispersions / 中成药

AIM To prepare fisetin solid dispersions.METHODS Melting method and solvent method were used for the preparation of solid dispersions,respectively.With carrier type,drug-carrier ratio and stirring time as influencing factors,accumulative dissolution rate as an evaluation index,the preparation was optimized by orthogonal test on the basis of single factor experiment.The interaction between drug and carrier was investigated by Fourier transform infrared spectroscopy (FTIR),and the drug existing state was analyzed by differential scanning calorimetry (DSC).RESULTS Solvent method was more suitable for the preparation of solid dispersions.The optimal conditions were determined to be PVPK-30 as a carrier,1 ∶ 12 for drug-carrier ratio,and 30 min for stirring time,the accumulative dissolution rate reached 90.87％ within 20 min.There might be a hydrogen bond association between PVPK-30 and fisetin previously existing in amorphous or molecular state.CONCLUSION The dissolution rate of fisetin can be obviously increased after being prepared into solid dispersions.

Research on medical device technology archives and its management method / 医疗卫生装备

Objective To implement institutionalized and standardized medical device technology archives management to facilitate its application. Methods The medical device technology archives and its management requirements were introduced, and the problems in its application were analyzed, then some countermeasures were put forward accordingly. Results The management rules and regulations had to be established for medical device technology archives, and considerations should be taken on its collection, arrangement, archiving, keeping, secrecy, lending, statistics and destroying. Conclusion Medical device technology archives management has to be standardized to facilitate its application.

A polysaccharide purified from Radix Adenophorae promotes cell activation and pro-inflammatory cytokine production in murine RAW264.7 macrophages / 中国天然药物

Radix Adenophorae, a traditional Chinese medicine, has been reported to have a variety of biological functions. In the present study, a polysaccharide component, Radix Adenophorae Polysaccharide (RAPS), was purified from Radix Adenophorae by decoloring with ADS-7 macroporous adsorption resin, DEAE-52 cellulose ion-exchange chromatography, and Sephacryl S-300HR gel chromatography, with the purity of 98.3% and a molecular weight of 1.8 × 10(4) Da. The cell viability assay and microscopic examination revealed that RAPS promoted the proliferation and activation of macrophages. At 400 μg·mL(-1), RAPS stimulated RAW264.7 cell proliferation by 1.91-fold compared with the control. Meanwhile, RAPS significantly increased the secretion of pro-inflammatory cytokines (TNF-α and IL-6) in a dose-dependent manner in the supernatant of RAW264.7 cell culture as determined by ELISA. At 400 μg·mL(-1), the production of TNF-iα was 20.8-fold higher than that of the control. Simultaneously, the production of nitric oxide (NO) and the expression of inducible nitric oxide synthase (iNOS) were increased in RAW264.7 cells incubated with RAPS, as measured by Griess assay and Western blot analysis. The NO production of cells treated with RAPS (400 μg·mL(-1)) reached 15.8 μmol·L(-1), which was 30.4-fold higher than that of the control (0.53 μmol·L(-1)). These data suggested that RAPS may enhance the immune function and protect against exogenous pathogens by activating macrophages.

Identification of gene mutation and prenatal diagnosis in a family with X-linked ichthyosis / 中国当代儿科杂志

X-linked ichthyosis (XLI) is a metabolic disease with steroid sulfatase deficiency and often occurs at birth or shortly after birth. The encoding gene of steroid sulfatase, STS, is located on the short arm of the X chromosome, and STS deletion or mutation can lead to the development of this disease. This study collected the data on the clinical phenotype from a family, and the proband, a boy aged 11 years with full-term vaginal delivery, had dry and rough skin and black-brown scaly patches, mainly in the abdomen and extensor aspect of extremities. Peripheral blood samples were collected from each family member and DNA was extracted. Multiplex ligation-dependent probe amplification (MLPA) was used to measure the copy number of STS on the X chromosome. Whole-genome microarray was used to determine the size of the segment with microdeletion in the X chromosome. MLPA was then used for prenatal diagnosis for the mother of the proband. The results revealed that the proband and another two male patients had hemizygotes in STS deletion. Gene microarray identified a rare deletion with a size of 1.6 Mb at Xp22.31 (chrX: 6,516,735-8,131,442). Two female family members were found to be carriers. Prenatal diagnosis showed that the fetus carried by the proband's mother was a carrier of this microdeletion. This study showed STS gene deletion in this family of XLI, which causes the unique skin lesions of XLI. MLPA is a convenient and reliable technique for the molecular and prenatal diagnosis of XLI.

Involvement of heat shock protein 27 in the susceptibility of KT human breast cancer cells to UVC and interferon lethality.

Revealing the key molecules regulating the stress-response pathways in human cells is an intriguing problem. Chaperones, such as glucose-regulated protein 78 (GRP78) and heat shock protein 27 (HSP27), are important molecules for protecting the viability of human cells; however, it remains to be further clarified whether the molecules differentially modulate cellular responses to various types of stressors, such as DNA-damaging ultraviolet ray C (principally 254-nm wavelength, UVC) and cytocidal cytokine interferons. In the present study, the human breast cancer cell lines KT and MCF-7 were examined for GRP78 and HSP27 expression following exposure to UVC and human interferon-ß (HuIFN-ß). The KT cells demonstrated a higher sensitivity to both UVC and HuIFN-ß lethality than MCF-7 cells. The cellular expression levels of GRP78 in KT cells, assessed by western blot analysis, were approximately 2-fold higher than that in MCF-7 cells, while the expression of HSP27 in the KT cells was 20% of the expression in the MCF-7 cells. Decreased resistance to UVC lethality was observed in GRP78 siRNA-transfected KT cells. In addition, HSP27 cDNA transfection of KT cells resulted in an increased resistance to UVC lethality. The cDNA-transfected KT cells showed an increased viability against HuIFN-ß, compared with that of empty vector-transfected cells. By contrast, KT cells pretreated with HuIFN-ß and irradiated with UVC demonstrated an increased resistance to UVC lethality, in association with increased levels of HSP27 expression. Thus, HSP27 may control the survival response pathways to both UVC and HuIFN-ß in the human cells examined.

Biomechanical simulation and verification of astronaut extravehicular activities / 医用生物力学

Objective The present biomechanical model built for extravehicular activities (EVA) of astronaut is lack of human anatomy features, and still there isn’t a reasonable verification method. This study is aimed at solving the problems above and providing references for the further application of EVA simulation. Methods Based on a typical extravehicular activity, an inverse kinematical and dynamical upper limb model with muscle forces was built to conduct simulation calculation. Both the kinematical and dynamical results were verified through OpenGL animation sequence driven by kinematical calculation results and verification experiment with a real model, respectively. Results The animation built for kinematical verification proved that the calculation results were correct. The relative error of two muscle forces between dynamic verification and simulation was 14.54% and 0.91%, respectively. Conclusions A reasonable upper limb model of astronaut is established in this study. The simulation results are credible and the verification Results showed that this feasible method could supports the further research on EVA simulation and verification.

Retrospective analysis of 100 patients managed by extracorporeal membrane oxygenation / 中华外科杂志

<p><b>OBJECTIVE</b>To describe the experience with extracorporeal membrane oxygenation (ECMO) for cardiorespiratory support of 100 patients.</p><p><b>METHODS</b>Retrospective analysis of the medical files of 100 patients submitted to the implant of extracorporeal membrane oxygenation system for cardiorespiratory assistance of acute and refractory cardiogenic shock from December 2004 to September 2008. There were 67 males and 33 females, age ranged from 5 d to 76 years with a mean of (28+/-26) years, body mass ranged from 3.8 to 100.0 kg with a mean of (42+/-30) kg. The inter-surface of the ECMO equipment system was completely coated by heparin-coating technique. All patients were applied veno-artery ECMO and activated clotting time was maintained between 120 and 180 s and heparin usage dose was 5 to 20 Uxkg(-1)xh(-1). Mean blood flow was 40 to 220 mlxkg(-1)min(-1) during ECMO assistant period.</p><p><b>RESULTS</b>The shortest ECMO time was 12 to 504 h with a mean of (119+/-80) h. Sixty-one patients (61.0%) weaned off successfully from ECMO, 55 of them (90.2%) were discharged and 6 died of post-operative complications. Thirty-nine patients could not weaned off from ECMO. Total survival discharge rate was 55.0%. Mean aortic pressure before ECMO in survived patients was significantly higher than that of dead patients (P=0.038). Lactic acid concentration of artery blood before ECMO in survived patients was significantly lower than that of dead patients (P=0.005).</p><p><b>CONCLUSIONS</b>ECMO is an effective mechanical assistant therapy method for cardiac and pulmonary failure after cardiac surgery. Earlier usage of ECMO for heart lung failure patient and avoiding the main organs from un-recovery trauma are key success.</p>

Effect of (CAG) n polymorphism of androgen receptor gene on hormonal male contraception / 中华男科学杂志

<p><b>OBJECTIVE</b>To study (CAG) n polymorphism of the androgen receptor (AR) gene in responders and non-responders of male volunteers who received testosterone undecanoate intramuscular injection for contraception and to explore the effect of the polymorphism on hormonal male contraception.</p><p><b>METHODS</b>Twenty-nine non-responders and 34 responders were enrolled in this study as a test and a control group respectively. The numbers of CAG sequence repeats were determined by PCR and DNA sequencing, and the effect of (CAG) n polymorphism on hormonal male contraception was analyzed.</p><p><b>RESULTS</b>The means of CAG repeats of the test and the control group were 23.62 and 22.97, with no significant difference in between (P > 0.05). The short CAG repeats (n < or = 22) constituted 51.7% in the test group and 50% in the control, while the long ones (n > 22) accounted for 48.3% and 50% , respectively. The short and the long group had a similar distribution. No association was found between CAG repeats and sperm concentration. With FSH > 0.2 IU/L, the probability of azoospermia in the long CAG repeat group was 1.5 times that of the short one.</p><p><b>CONCLUSION</b>CAG repeats in the AR gene presented polymorphism in the subjects, with no significant difference between the responders and non-responders. Further investigation has yet to be performed into the relationship of hormonal male contraception with CAG repeats or other factors.</p>

Predictors for partial suppression of spermatogenesis of hormonal male contraception / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To analyze factors influencing the efficacy of hormonal suppression of spermatogenesis for male contraception.</p><p><b>METHODS</b>A nested case-control study was conducted, involving 43 subjects, who did not achieve azoospermia or severe oligozoospermia when given monthly injections of 500 mg testosterone undecanoate (TU), defined as partial suppressors compared with 855 subjects who had suppressed spermatogenesis (complete suppressors). Sperm density, serum testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) concentrations at the baseline and the suppression phase were compared between partial and complete suppressors. Polymorphisms of androgen receptor (AR) and three single nucleotide variants and their haplotypes of FSH receptor (FSHR) genes determined by polymerase chain reaction (PCR) and DNA sequencing technique were compared between 29 partial and 34 complete suppressors.</p><p><b>RESULTS</b>Baseline serum LH level was higher and serum LH as well as FSH level during the suppression phase was less suppressed in partial suppressors. Additionally, in a logistic regression analysis larger testis volume, higher serum FSH concentrations alone, or interaction of serum LH, FSH, testosterone and sperm concentrations were associated with degree of suppression. The distribution of polymorphisms of AR or FSH receptor genes did not differ between partial and complete suppressors. In cases with incomplete FSH suppression (FSH 0.2 IU/L), the chances of reaching azoospermia were 1.5 times higher in the subjects with more than 22 CAG triplet repeats.</p><p><b>CONCLUSION</b>Partial suppression of spermatogenesis induced by 500 mg TU monthly injections is weakly influenced by hormonal and clinical features but not polymorphism in AR and FSHR genes.</p>

Effects of androgen on lipoprotein and the cardiovascular system / 中华男科学杂志

The effects of androgen on lipid and the cardiovascular system are very important. The relationship between androgen and lipoprotein is rather complicated and influenced by many factors. The effects of endogenous androgen on the metabolism of lipoprotein vary with age, environment, nutrition and gender, while the effects of exogenous androgen on lipoprotein vary with different androgen preparations, administration methods and diseases to be treated. Androgen can impact the metabolism of lipoprotein, vascular endothelium, macrophage, vascular smooth muscle, angiotasis, blood coagulation, platelet and so on. The effects of polymorphism of the androgen receptor gene CAG on the cardiovascular system are important and yet somehow controversial and have to be further investigated.

Cloning of the Phosphatidylserine Synthase Gene and Its Secretive Expression in Bacillus subtilis / 中国生物工程杂志

The gene encoding the phosphatidylserine synthase in Escherichia coli K12 Sgal-(ExPASy P23830) was amplified by PCR. After DNA sequence analysis, it was inserted into the inducible expressive shuttle vector pBES of Bacillus subtilis, which was constructed in the lab, and the recombinant plasmid pBES-pss was transformed into competent cells of the Bacillus subtilis strain DB104. The positive transformant DB104 (pBES-pss) was grown on Bacillus subtilis common fermentation medium, which contained 30?g/ml kanamycin. After 2 hours cultivation, sucrose was added and increased to the final concentration of 2% for induction and this phosphatidylserine synthase was secreted into the medium. The result of SDS-PAGE showed that the molecular weight of the protein was 52kDa and the result of enzyme coupling colorimetric method showed that the enzyme activity was 1.50U/ml. The recombinant Bacillus subtilis has increased the yield of phosphatidylserine synthase which will be used for industrial biosynthesis of phosphatidylserine.

Analysis of the mechanisms of rabbit's brainstem hemorrhage complicated with irritable changes in the alvine mucous membrane.

AIM: To explore the dynamic changes in the pressure of the lateral ventricle during acute brainstem hemorrhage and the changes of neural discharge of vagus nerve under the load of intracranial hypertension, so as to analyze their effects on the congestive degree of intestinal mucous membrane and the morphologic changes of intestinal mucous membrane. METHODS: An operation was made to open the skull to obtain an acute brainstem hemorrhage animal model. Microcirculatory microscope photography device and video recording system were used to determine the changes continuously in the caliber of jejunal mesenteric artery during brainstem hemorrhage and the changes with time in the congestion of jejunal mucosal villi. We used HE stain morphology to analyze the changes of duodenal mucosal villi. A recording electrode was used to calculate and measure the electric discharge activities of cervical vagus nerve. RESULTS: (1) We observed that the pressure of lateral cerebral ventricle increased transiently during acute brainstem hemorrhage; (2) The caliber of the jejunal mesenteric artery increased during brainstem hemorrhage. Analysis of red color coordinate values indicated transient increase in the congestion of jejunal mucous membrane during acute brainstem hemorrhage; (3) Through the analysis of the pathologic slice, we found enlarged blood vessels, stagnant blood, and transudatory red blood cells in the duodenal submucous layer; (4) Electric discharge of vagus nerve increased and sporadic hemorrhage spots occurred in duodenal mucous and submucous layer, when the lateral ventricle was under pressure. CONCLUSION: Brainstem hemorrhage could cause intracranial hypertension, which would increase the neural discharge of vagus nerve and cause the transient congestion of jejunal mucous membrane. It could cause hyperemia and diffused hemorrhage in the duodenal submucous layer 48 h after brainstem hemorrhage.