A Prediction Model for Human Immunodeficiency Virus Infection and Mother-to-Child Transmission Based on the Expression Levels of Selenoprotein Genes / 中国医学科学院学报

Objective To study the expression of selenoprotein genes in human immunodeficiency virus(HIV)infection and its mother-to-child transmission,so as to provide a theoretical basis for the prevention,diagnosis,and treatment of acquired immunodeficiency syndrome.Methods The dataset GSE4124 was downloaded from the Gene Expression Omnibus(GEO).Two groups of HIV-positive mothers(n=25)and HIV-negative mothers(n=20)were designed.HIV-positive mothers included a subset of transmitter(TR)mothers(n=11)and non-transmitter(NTR)mothers(n=14).Then,t-test was carried out to compare the expression levels of selenoprotein genes between the four groups(HIV-positive vs. HIV-negative,NTR vs. HIV-negative,TR vs. HIV-negative,TR vs. NTR).Univariate and multivariate Logistic regression were adopted to analyze the effects of differentially expressed genes on HIV infection and mother-to-child transmission.R software was used to establish a nomogram prediction model and evaluate the model performance.Results Compared with the HIV-negative group,HIV-positive,NTR,and TR groups had 8,5 and 8 down-regulated selenoprotein genes,respectively.Compared with the NTR group,the TR group had 4 down-regulated selenoprotein genes.Univariate Logistic regression analysis showed that abnormally high expression of GPX1,GPX3,GPX4,TXNRD1,TXNRD3,and SEPHS2 affected HIV infection and had no effect on mother-to-child transmission.The multivariate Logistic regression analysis showed that the abnormally high expression of TXNRD3(OR=0.032,95%CI=0.002-0.607,P=0.022)was positively correlated with HIV infection.As for the nomogram prediction model,the area under the receiver-operating characteristic curve for 1-year survival of HIV-infected patients was 0.840(95%CI=0.690-1.000),and that for 3-year survival of HIV-infected patients was 0.870(95%CI=0.730-1.000).Conclusions Multiple selenoprotein genes with down-regulated expression levels were involved in the regulation of HIV infection and mother-to-child transmission.The abnormal high expression of TXNRD3 was positively correlated with HIV infection.The findings provide new ideas for the prevention,diagnosis,and treatment of acquired immunodeficiency syndrome.

Acupuncture for glaucoma-induced optic atrophy: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of acupuncture for glaucoma-induced optic atrophy.@*METHODS@#A total of 70 patients (89 affected eyes) with glaucoma-induced optic atrophy were randomized into an observation group and a control group, 35 cases in each group. The control group was given basic western medicine treatment. In the observation group, on the basis of the treatment in the control group, acupuncture was applied at main acupoints i.e. Baihui (GV 20), Shangjingming (Extra), Chengqi (ST 1), Fengchi (GB 20), Zusanli (ST 36), combined with supplementary acupoints based on syndrome differentiation, once every three days, twice a week. The treatment for 3 months was required in both groups. Before treatment, after treatment and in follow-up of 6 months after treatment, the best corrected visual acuity (BCVA), intraocular pressure (IOP), indexes of visual field (visual field index [VFI], mean deviation [MD], pattern standard deviation [PSD]) and mean thickness of retinal nerve fiber layer (RNFL) were observed in the two groups.@*RESULTS@#Compared before treatment, BCVA was decreased after treatment and in follow-up in the control group (P<0.05); in the follow-up, BCVA in the observation group was higher than that in the control group (P<0.05). On each time point before and after treatment, there was no significant difference within or between the two groups (P>0.05). After treatment and in the follow-up, the mean thickness of RNFL was larger than the control group (P<0.05).@*CONCLUSION@#On the basis of the basic western medicine treatment, acupuncture can delay the decline of vision and the thinning of retinal nerve fiber layer in patients with glaucoma-induced optic atrophy.

Damage Control Surgery for Severe Abdominal Sepsis With Free Skin Graft Transplantation: A Case Report.

BACKGROUND: Acute abdomen represents a great surgical challenge. Damage control surgery has been a better approach in acute abdominal emergencies to reduce the risk of mortality compared with primary definitive surgery. CASE PRESENTATION: A 52-year-old man presented with nonspecific abdominal pain for 2 days. Physical examination and computed tomography scan suggested abdominal viscera perforation and acute diffuse peritonitis. Segmental resections and sigmoidostomy were performed, the abdomen was temporarily closed with a 3-liter infusion bag and maintained for 72 hours. Small intestinal ischemic necrosis was found, partial resection of small intestine was performed later, and abdomen was still closed with the 3-liter infusion bag and maintained for 10 days. One month later, intermediate split thickness self-free skin graft transplantation was performed. Abdomen was closed 6 months later. CONCLUSIONS: Damage control surgery with free skin graft transplantation can be successfully applied in severe abdominal infection in patients with an open abdomen. The study was in compliance with the Helsinki Congress and the Declaration of Istanbul. CORE TIP: Damage control surgery has been a better approach in acute abdominal emergencies to reduce the risk of mortality compared with definitive surgery. Although laparostomy is a useful treatment of abdominal sepsis, successful management with free skin graft transplantation after laparostomy has rarely been reported in stercoral perforation. We report a patient with severe abdominal sepsis treated with damage control surgery with free skin graft transplantation. The patient was discharged with good recovery.

The pulmonary pharmacokinetics and anti-inflammatory effect of anemoside B4 after intratracheal and intravenous administration / 药学学报

Anemoside B4 (B4), a main triterpenoid saponin from a traditional Chinese medicine plant, Pulsatilla chinensis, is a novel anti-inflammatory agent for protection from acute lung injury. We investigated the pulmonary availability and anti-inflammatory efficacy of B4 after intratracheal and intravenous dosing with a view to evaluating the suitability of inhalation delivery. All animal studies were performed under the guidelines approved by the Animal Care and Use Committee of Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences (Approval No: SLXD-20181113046). In vitro evaluation of the aerodynamic characteristics and droplet size distribution showed that the aerosols generated by a commercially available nebulizer were well deposited in the respiratory tract. Following intratracheal administration, B4 underwent pulmonary absorption into the bloodstream, rendering an absolute bioavailability of 103%. Compared to intravenous delivery, intratracheal administration dramatically increased the drug availability in lung tissue of rats by more than 1 000-fold, leading to improved and prolonged concentrations of B4 in lung tissue up to 48 h. In addition, the intratracheal administration of B4 resulted in dose-dependent and prolonged anti-inflammatory efficacy in a lipopolysaccharide (LPS)-induced lung injury model in mice. The present results demonstrate that inhalation delivery of B4 is a promising approach to treat pulmonary inflammation with once-daily dosing.

Spatio-temporal trend of female breast cancer mortality in Shandong Province from 1970 to 2013 / 中华预防医学杂志

The mortality of female breast cancer in Shandong Province has increased since the 1970. The differential decomposition analysis found that the slight decline in the crude mortality of breast cancer among women was entirely due to non-demographic factors during the 1970-1990, and the significant increase in the crude mortality was due to a combination of demographic and non-demographic factors since the 1990. The contribution rate of demographic factor has gradually increased from 53.5% in 2004-2005 to 59.5% in 2011-2013, while that of non-demographic factor has decreased from 46.5% to 40.5%. The women aged 45-64 years old were the major population of female breast cancer deaths, accounting for 40%-60% of total breast cancer deaths in different times, and then the mortality in female aged 55-64 years old increased rapidly, with increases of 52.12%, 115.19% and 29.01% in 2011-2013 over the 1970-1974, 1990-1992 and 2004-2005, respectively (Z=-7.342,P<0.001). Compared with 1970-1974, the age-standardized mortality rate of rural women increased by 41.86% in 2011-2013 (Z=-17.933, P<0.001), and that of urban women increased by 18.62% in 2011-2013 (Z=-25.642, P<0.001). The age-standardized mortality rate of breast cancer in urban women was higher than that in rural women in different times (all P<0.05). The spatial scan analysis found that eastern Shandong Province was found to be a sustained high-risk area for death, and other high-risk areas were transferred from north to southwest of Shandong between 1970 and 2013.

Application and research advances of intracorporeal anastomosis in laparoscopic surgery for colon cancer / 中华消化外科杂志

Laparoscopic surgery has been accepted as an optimal treatment for colon cancer. Digestive tract reconstruction may be performed using extracorporeal anastomosis or intracor-poreal anastomosis after radical colectomy of colon cancer. More and more studies have compared both procedures, but the selection of optimal method of digestive tract reconstruction is still controversial. The authors conduct a systematic review on the application and research advances of intracorporeal anastomosis in laparoscopic surgery for colon cancer, investigate the technical skills of intracorporeal anastomosis and its clinical outcomes, so as to provide valid information for its clinical application.

Effects of allyl isothiocyanate on the expression, function, and its mechanism of ABCA1 and ABCG1 in pulmonary of COPD rats.

BACKGROUND AND AIMS: Allyl isothiocyanate(AITC) has been shown to play an important role in the improved symptoms of chronic obstructive pulmonary disease(COPD) and the inhibition of inflammation, but the role in COPD lipid metabolism disorder and the molecular mechanism remains unclear. We aimed to explore whether and how AITC affects COPD by regulating lipid metabolism and inflammatory response. METHODS: The COPD rat model was established by cigarette smoke exposure. Cigarette smoke extract stimulated 16HBE cells to induce a cell model. The effect of AITC treatment was detected by lung function test, H&E staining, Oil red O staining, immunohistochemistry, ELISA, CCK-8, HPLC, fluorescence efflux test, siRNA, RT-PCR, and Western blotting. Biological analysis was performed to analyze the results. Graphpad Prism 8.0 software was used for statistical analysis. RESULTS: AITC can improve lung function and pathological injury in COPD rats. The levels of IL-1 ß and TNF- α in the AITC treatment group were significantly lower than those in the model group(P < 0.05), and the lipid metabolism was also improved (P < 0.05). AITC reverses CSE-induced down-regulation of LXR α, ABCA1, and ABCG1 expression and function in a time-and concentration-dependent manner (P < 0.05). AITC regulates the cholesterol metabolism disorder induced by CSE in NR8383 cells and attenuates macrophage inflammation (P < 0.05). In addition, after silencing LXR α with siRNA, the effect of AITC was also inhibited. CONCLUSION: These results suggest that AITC improves COPD by promoting RCT process and reducing inflammatory response via activating LXR pathways.

GC-MS-Based Serum Metabolomic Investigations on the Ameliorative Effects of Polysaccharide from Turpiniae folium in Hyperlipidemia Rats.

Hyperlipidemia, a typical metabolic disorder syndrome, can cause various cardiovascular diseases. The polysaccharides were found to have enormous potential in the therapy of hyperlipidemia. This study was aimed at evaluating the ameliorative effects of polysaccharide from Turpiniae folium (TFP) in rats with hyperlipidemia. A serum metabolomic method based on gas chromatography-mass spectrometry (GC-MS) was used to explore the detailed mechanism of TFP in rats with hyperlipidemia. The oxidative stress indicators, biochemical indexes, and inflammatory factors in serum and histopathological changes in the liver were also evaluated after 10-week oral administration of TFP in rats with high-fat diet-induced hyperlipidemia. TFP significantly relieved oxidative stress, inflammation, and liver histopathology and reduced blood lipid levels. Multivariate statistical approaches such as principal component analysis and orthogonal projection to latent structure square-discriminant analysis revealed clear separations of metabolic profiles among the control, HFD, and HFD+TFP groups, indicating a moderating effect of TFP on the metabolic disorders in rats with hyperlipidemia. Seven metabolites in serum, involved in glycine, serine, and threonine metabolism and aminoacyl-tRNA biosynthesis, were selected as potential biomarkers in rats with hyperlipidemia and regulated by TFP administration. It was concluded that TFP had remarkable potential for treating hyperlipidemia. These findings provided evidence for further understanding of the mechanism of action of TFP on hyperlipidemia.

Salvage of vascular graft infections via vacuum sealing drainage and rectus femoris muscle flap transposition: A case report.

BACKGROUND: The management of vascular graft infections continues to be a significant challenge in a clinical situation. The aim of this report is to illustrate the novel vacuum sealing drainage (VSD) technique and rectus femoris muscle flap transposition for vascular graft infections, and to evaluate the prospective of future testing of this surgical procedure. CASE SUMMARY: We report the case of a 32-year-old male patient, who presented a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure. Using the VSD and muscle flap trans-position, the groin wound and vascular graft infection were finally treated successfully. CONCLUSION: Our case report highlights that VSD technique and rectus femoris muscle flap transposition could be considered in patients presenting with a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure, especially in consideration of treatable conditions.

Primary Closure Versus T-Tube Drainage Following Laparoscopic Common Bile Duct Exploration in Patients With Previous Biliary Surgery.

Laparoscopic common bile duct exploration (LCBDE) has been recently introduced for management of CBD stone in patients with previous biliary surgery history. The aim of this study was to evaluate the safety and effectiveness of primary closure in patients with previous biliary surgery history compared to T-tube drainage. Eighty patients with previous biliary surgery history including laparoscopic cholecystectomy, open cholecystectomy, or open common bile duct exploration were enrolled in the retrospective study. The patients were divided into 2 groups according to the methods of choledochotomy closure. Group A: patients with primary closure after LCBDE (n = 51); group B: patients with T-tube drainage after LCBDE (n = 29). Group A exhibited a shorter postoperative hospital stay and lower hospitalization expenses compared to group B. There was no significant difference in conversion rate to open surgery, operating time, intraoperative blood loss, bile leakage rate, overall complication rate, and stone recurrence rate between the 2 groups. Biliary stricture was not observed in the 2 groups during the follow-up period. Primary closure following LCBDE is safe and effective for the management of CBD stones in patients with previous biliary surgery history.

Surgical Treatment and Rehabilitation for Hoffa Fracture Nonunion: Two Case Reports and a Literature Review.

BACKGROUND: A coronal fracture of the distal femoral condyle, known as a Hoffa fracture, seldom occurs and is easy to misdiagnose. Surgery treatment, including open anatomic reduction and internal fixation, is the primary method of treatment. However, cases involving nonunion are extremely rare. CASE PRESENTATION: We reported two cases in a 56-year-old female who visited our outpatient clinic with complaints of locking sensation, swelling, and pain, and a 64-year-old male patient who need additional care after having undergone surgery for a distal femur fracture. They presented with nonunion ofa Hoffa fracture (Letenneur type II), and these cases of nonunion were resolved surgically with debridement, two cannulated lag screws, a lateral extra-articular buttress plate, and the liberal use of autologous bone grafts. After surgery, the two patients were allowed to bear partial weight and perform exercises. They were allowed to walk with full weight-bearing after 3 months. No early complications, such as infection and loss of reduction, were noted after the revision surgery. At the one-year follow-up, both patients had excellent function and reported minimal pain, with a Lysholm score of 94. CONCLUSIONS: Our case reports highlight the importance of the liberal use of autologous bone grafts, which allow stable reconstruction of the affected femoral condyle, thereby restoring joint congruence. A lateral extra-articular buttress plate in combination with two cannulated lag screws is recommended for nonunion in Hoffa fracture patients, and they need to be closely followed up to detect complications promptly, especially those related to nonunion.

Perioperative management strategies for surgical patients during the COVID-19 outbreak / 中华消化外科杂志

At present, the prevention and control situation of epidemics of Corona Virus Disease 2019 (COVID-19) is still serious, medical institutions should provide quality and safe routine medical services while doing their best in the prevention and control of this disease. The purpose of this article is to suggest a way to give quality and safe medical services to patients who need surgical treatment, especially to those who need emergency surgical treatment, with strict classified managements and standard precaution during perioperative period. With those suggestions, we may reduce the incidence of nosocomial infection and contribute to the prevention and control of COVID-19.

Detection of nitroaromatics based on aggregation induced emission of barbituric acid derivatives.

Barbituric acid derivatives with typical aggregation induced emission (AIE) are reported. Their emission wavelengths varied with water fraction of their solution. UV-visible absorption spectroscopy and theoretical calculations revealed the intramolecular charge transfer (ICT) possibility from donor to acceptor and the mechanism was confirmed as a restriction of intramolecular motion (RIM). The AIE properties were affected by the different substituents on barbituric acid. When the molecular volume increased, the AIE effect decreased. Fluorescent quenching mechanism was applied to detect nitroaromatic explosives. For 2,4,6-trinitrophenol (PA), one of the derivatives 5-(4-diphenylamino styrene)-1,3-diphenyl-barbituric acid in THF/H2O mixture (1:9, v/v), showed amplified fluorescence quenching with a maximum Stern-Volmer quenching constant of 4.1 × 104 M-1. The solid phase paper test based on 5-(4-diphenylamino styrene)-1,3-diphenyl-barbituric acid also showed a superior sensitivity toward PA both in vapor and solution.

The exploration of aerobic power and energy expenditure of Chinese rugby players / 中国应用生理学杂志

OBJECTIVE@#To explore aerobic power and energy expenditure of high level rugby players in China, which provide experimental basis for accurate training and nutritional strategy in match-play.@*METHODS@#Eighteen master rugby players were selected as research subjects. The parameters such as VOmax, lactic aicd threshold (LT) and modify conconi test were measured respectively. The differences of energy were compared between the forward and the defender. The data were analyzed by independent sample t test.@*RESULTS@#The VOmax(42.05±3.69 ml/min ·kg) of rugby players was poorer. The VOmax of the forward was 38.83±3.52 (ml/min ·kg), and that of the defender was 47.31±3.17 (ml/min ·kg),and there was significant difference between the forwards and the defenders (P＜0.05). The LT of the defenders was obviously higher than that of the forwards. Modifier conconi test had a high correlation (r = 0.772) with VOmax. The average energy consumption in the first half of the game was about(276.94±18.08)kcals, the second half was(225.58±22.86)kcals, and the second half was less than the first half (P＜0.05).@*CONCLUSION@#The aerobic power is different between the forwards and the defenders. The power of aerobic of Chinese players is weaker than that of the foreign rugby players.

Correlation between patulous Eustachian tube with habitual nasal extraction and acquired middle ear cholesteatoma / 中华耳鼻咽喉头颈外科杂志

Objective@#By comparing the clinical characteristics of patulous Eustachian tube with habitual nasal extraction and those of non-Eustachian tube abnormalities, we aimed to investigate the relationship between patulous Eustachian tube and acquired cholesteatoma of middle ear.@*Methods@#A total of 218 patients in Affiliated Hospital of Qingdao University from November 2011 to November 2016 who underwent surgical treatment and with complete data of acquired cholesteatoma of middle ear were enrolled. The patients were divided into two groups: patulous Eustachian tube with habitual nasal extraction and non-Patulous Eustachian tube. Their ages of onset , sides, characteristics of acoustic immitance, clinical manifestations, prognosis and complications were compared. The statistical analysis was carried out with SPSS 19.0 software.@*Results@#Among the 218 cases of acquired cholesteatoma of the middle ear, 22 cases were diagnosed as patulous Eustachian tube with habitual nasal extraction [with average age of (35.7±7.5) years]; 196 cases were diagnosed as non-patulous Eustachian tube [with average age of (47.8±20.1) years]. The average age of the patulous Eustachian tube with habitual nasal extraction was significantly lower than that of the non-patulous Eustachian tube group (t=4.25, P<0.01). Ratio of bilateral middle ear cholesteatoma in patulous Eustachian tube [68.2%(15/22)] was significantly higher than that of the non-patulous Eustachian tube group [18.9%(37/196)] (χ2=26.47, P<0.01).@*Conclusions@#Some acquired cholesteatoma patients are associated with the patulous Eustachian tube with habitual nasal extraction. The patients have a lower age, and are susceptible for bilateral middle ear cholesteatoma.

Graft heaIing and functionaI recovery after anterior cruciate Iigament reconstruction:a case study of rehabiIitation training / 中国组织工程研究

BACKGROUND: Anterior cruciate ligament (ACL) injury directly impacts the individual's lower limb function. It is very important for althelets whether rehabilitation training after ACL reconstruction is reasonable, effective and can restore the normal function of the knee joint.OBJECTIVE: To explore the effect of rehabilitation training on graft healing and knee joint function recovery after ACL reconstruction. METHODS: An elite rugby player was enrolled and subjected to phased rehabilitation training after ACL reconstruction. MRI examination was done before and after rehabilitation training. Then, the following indicators were tested, including joint flexion of knee, leg circumference degrees, isokinetic muscle strength of the lower limb, feedback test, the test of YBT, the Balance Error Scoring System, feedforward test, static balance test on one foot, dynamic balance test on the feet, Lysholm knee score, anaerobic work of the upper extremity, torso strength, to analyze the graft healing, body shape, the knee joint function and physical quality improvement after ACL reconstruction. RESULTS AND CONCLUSION: After 10 months of phased rehabilitation training, the graft healed well; the knee flexion degree was back to normal; knee joint swelling basically eliminated; the muscle strength of the extensor flexor of the knee joint was back to over 95% of the normal level; the function of the injured knee joint was good and returned to a higher level; the Lysholm knee score was 85 points; the anaerobic work of the upper limbs and trunk strength reached to 120% of the normal level; and the quality of the body was greatly improved. To conclude, a great improvement in graft healing, knee joint function, recovery of muscle strength and physical qualities has been achieved in athletes who receive rehabilitation training after ACL reconstruction.

Ultrasound-guided steel needle cross projection in percutaneous nephroscopy localization / 中国内镜杂志

Objective To evaluate the application value of ultrasound-guided steel needle cross projection in percutaneous nephroscopy localization for clinical treatment. Methods From July 2015 to July 2017, we selected 307 cases of percutaneous nephrolithotomy with ultrasonic stereoscopic precision positioning, stones are antipyroid stones, renal calculi multiple kidney stones, ESWL treatment failure, isolated kidney stones, renal pelvis and ureteral junction (UPJ) obstruction with stones, open stone surgery recurrence, upper ureteral stones and so on. Refer to preoperative CT and KUB+IVP to determine the puncture angle and the puncture of the calyx. Then, in the ultrasonic stereo precise positioning to select the first mark line and the second mark line, two-line intersection for the final puncture point, this point with the first mark point connection with the vertical axis of the kidney.Finally, at the end of the puncture point in the ultrasonic stereo precise probe under the guidance of the probe to adjust the target angle of the calyx puncture. Results Of the 307 patients, 281 were 1 ~ 2 successful punctures, 21 were 3 ~ 5 times. The total success rate was 98.4% (302/307). 5 cases of small incision were separated to the kidney weeks under the guidance of the fingers.1 case of bleeding after 2 days (by selective renal artery embolization to stop bleeding).The net rate of calculi was 95.8% (294/307) and 13 residual stones were less than 0.5 cm. Conclusions The application of ultrasonic stereoscopic accurate positioning in percutaneous nephroscopy is safe and effective, and the localization method is refined and easy to be promoted.