Two conserved histidines (His490 and His621) on the E2 glycoprotein of hepatitis C virus are critical for CD81-mediated cell entry.

Hepatitis C virus (HCV) entry is a sequential and multi-step process that includes receptor interactions followed by pH-dependent membrane fusion. Specific and conserved histidine residues on the viral envelope proteins are involved in most pH-induced virus entries. In the case of HCV, some conserved histidines on the E1 and E2 proteins have been investigated in HCV pseudotype particle (HCVpp) systems. However, the roles of these histidines in cell-culture-derived HCV particle (HCVcc) systems remain unclear due to the different aspects of the viral life cycle emphasized by the two systems. In this study, the role of two conserved histidines (His490 and His621, located in domains II and III of E2, respectively) in HCV infection was evaluated in the context of JFH-1-based HCVcc using alanine substitutions. The infectivity of the H490A mutant decreased in spite of comparable initial RNA replication, protein expression and assembly efficiency as WT virus. The H621A mutant did not affect viral protein expression, but exhibited no obvious infectivity; there were fewer core proteins in the culture supernatant compared with WT virus, indicating the partially deficient virus assembly. The HCV receptor CD81-binding ability of the two mutant E2s was assessed further using enzyme immunoassays. The CD81-binding activity of H490A-E2 was reduced, and H621A-E2 was unable to bind to CD81. These data revealed the crucial role played by His490 and His621 in HCV infection, particularly during CD81 binding in cell entry. These results also contributed to the mechanical identification of the histidines involved in pH-dependent HCV entry.

Reliable finite frequency filter design for networked control systems with sensor faults.

This paper is concerned with the reliable finite frequency filter design for networked control systems (NCSs) subject to quantization and data missing. Taking into account quantization, possible data missing and sensor stuck faults, NCSs are modeled in the framework of discrete time-delay switched systems, and the finite frequency l(2) gain is adopted for the filter design of discrete time-delay switched systems, which is converted into a set of linear matrix inequality (LMI) conditions. By the virtues of the derived conditions, a procedure of reliable filter synthesis is presented. Further, the filter gains are characterized in terms of solutions to a convex optimization problem which can be solved by using the semi-definite programme method. Finally, an example is given to illustrate the effectiveness of the proposed method.

A study on reducing nonfunctional distractors of multiple-choice questions in medical examination / 中华医学教育探索杂志

Objective:To discuss the possibility of modifying nonfunctional distractors to improve the quality of multiple-choice questions in medical examination through analyzing the changes in the difficulty and discrimination of items and the selection rate of modified distractors.Methods:Thirty-two multiple-choice questions involving nonfunctional distractors from a medical examination were studied. According to the item-writing guidelines, experts modified nonfunctional distractors based on actual measurements. We analyzed the changes in the difficulty and discrimination of items and the selection rate of modified distractors before and after item modification using the paired Wilcoxon test, and investigated the correlation of item difficulty and discrimination before and after item modification by Spearman's rank correlation analysis.Results:Six questions were modified due to technical factors, and 26 questions were modified due to weak interference in knowledge content. Before and after nonfunctional distractor modification, the difficulty values of the questions were 0.676 (0.558, 0.893) and 0.637 (0.531, 0.839), respectively; the discrimination values (point-biserial correlation) were 0.261 (0.150, 0.316) and 0.262 (0.138, 0.358), respectively; and the discrimination index values were 0.215 (0.113, 0.352) and 0.259 (0.138, 0.346), respectively. There were significant differences in the difficulty and discrimination index of items before and after modification. The difficulty and discrimination of items before and after modification were both significantly correlated. The selection rates of modified distractors were 0.009 (0.003, 0.015) and 0.044 (0.021, 0.092) before and after modification, respectively, which were significantly different.Conclusions:Nonfunctional distractors in this study were mainly caused by reasons in the contents of the test questions, less in technical defects. Through the analysis and modification of nonfunctional distractors, the selection rate of nonfunctional distractors can be effectively increased, and item difficulty and discrimination can be improved.

Exploring the treatment of sepsis-associated acute lung injury with Liangge Powder via ERK1/2 and PI3K/AKT pathways: based on network pharmacology and whole animal experimentation / 中华劳动卫生职业病杂志

Objective: To investigate the therapeutic effect and mechanism of Liangge Powder against sepsis-induced acute lung injury (ALI) . Methods: From April to December 2021, the key components of Liangge Powder and its targets against sepsis-induced ALI were analyzed by network pharmacology, and to enrich for relevant signaling pathways. A total of 90 male Sprague-Dawley rats were randomly assigned to sham-operated group, sepsis-induced ALI model group (model group), Liangge Powder low, medium and high dose group, ten rats in the sham-operated group and 20 rats in each of the remaining four groups. Sepsis-induced ALI model was established by cecal ligation and puncture. Sham-operated group: gavage with 2 ml saline and no surgical treatment. Model group: surgery was performed and 2 ml saline was gavaged. Liangge Powder low, medium and high dose groups: surgery and gavage of Liangge Powder 3.9, 7.8 and 15.6 g/kg, respectively. To measure the wet/dry mass ratio of rats lung tissue and evaluate the permeability of alveolar capillary barrier. Lung tissue were stained with hematoxylin and eosin for histomorphological analysis. The levels of tumor necrosis factor-alpha (TNF-α), interleukin (IL) -6 and IL-1β in bronchoalveolar lavage fluid (BALF) were measured by enzyme-linked immunosorbent assay. The relative protein expression levels of p-phosphatidylinositol 3-kinase (PI3K), p-protein kinase B (AKT), and p-ertracellular regulated protein kinases (ERK) were detected via Western blot analysis. Results: Network pharmacology analysis indicated that 177 active compounds of Liangge Powder were selected. A total of 88 potential targets of Liangge Powder on sepsis-induced ALI were identified. 354 GO terms of Liangge Powder on sepsis-induced ALI and 108 pathways were identified using GO and KEGG analysis. PI3K/AKT signaling pathway was recognized to play an important role for Liangge Powder against sepsis-induced ALI. Compared with the sham-operated group, the lung tissue wet/dry weight ratio of rats in the model group (6.35±0.95) was increased (P<0.001). HE staining showed the destruction of normal structure of lung tissue. The levels of IL-6 [ (392.36±66.83) pg/ml], IL-1β [ (137.11±26.83) pg/ml] and TNF-α [ (238.34±59.36) pg/ml] were increased in the BALF (P<0.001, =0.001, <0.001), and the expression levels of p-PI3K, p-AKT and p-ERK1/2 proteins (1.04±0.15, 0.51±0.04, 2.31±0.41) were increased in lung tissue (P=0.002, 0.003, 0.005). The lung histopathological changes were reduced in each dose group of Liangge Powder compared with the model group. Compared with the model group, the wet/dry weight ratio of lung tissue (4.29±1.26) was reduced in the Liangge Powder medium dose group (P=0.019). TNF-α level [ (147.85±39.05) pg/ml] was reduced (P=0.022), and the relative protein expression levels of p-PI3K (0.37±0.18) and p-ERK1/2 (1.36±0.07) were reduced (P=0.008, 0.017). The wet/dry weight ratio of lung tissue (4.16±0.66) was reduced in the high-dose group (P=0.003). Levels of IL-6, IL-1β and TNF-α[ (187.98±53.28) pg/ml, (92.45±25.39) pg/ml, (129.77±55.94) pg/ml] were reduced (P=0.001, 0.027, 0.018), and relative protein expression levels of p-PI3K, p-AKT and p-ERK1/2 (0.65±0.05, 0.31±0.08, 1.30±0.12) were reduced (P=0.013, 0.018, 0.015) . Conclusion: Liangge Powder has therapeutic effects in rats with sepsis-induced ALI, and the mechanism may be related to the inhibition of ERK1/2 and PI3K/AKT pathway activation in lung tissue.

T lymphocyte subsets combined with inflammatory indicators for auxiliary diagnosis and prognosis evaluation of sepsis / 中华预防医学杂志

Objective: To explore the application value of T lymphocyte subsets combined with procalcitonin (PCT), C-reactive protein (CRP), neutrophil to lymphocyte ratio (NLR) and white blood cell count (WBC) in the auxiliary diagnosis and prognosis evaluation of sepsis. Methods: In a retrospective study, seventy-two patients with sepsis diagnosed and treated in Tianjin First Central Hospital from June 2018 to April 2021 were selected as the research objects, and included in the sepsis group were 46 males and 26 females, aged 68 (57.3, 80.3) years. In addition, 111 patients with local infection admitted to hospital during the same period were included in the local infection group, including 62 males and 49 females, aged 68 (51, 77) years. Sepsis patients were divided into survival group (43 cases) and death group (29 cases) according to the 28-day outcome. CD3+, CD4+, CD8+, CD4+/CD8+ ratio were detected by flow cytometry within 24 h after admission, PCT was detected by ELISA, CRP was detected by immunoturbidimetry, blood routine examination, blood lactic acid (Lac) and oxygen partial pressure (PO2) were detected by instrumental method. Multivariate Logistic regression analysis was used to evaluate the correlation between each indicator and sepsis, and receiver operating characteristic curve (ROC) was drawn to evaluate the diagnostic value of each indicator for sepsis. Multivariate Logistic regression analysis and Kaplan Meier survival analysis were used to evaluate the prognostic value of each index for patients with sepsis. Results: Peripheral blood CD3+, CD4+, CD8+, CD4+/CD8+ ratio and PLT in sepsis group were significantly lower than those in local infection group(Z=-8.184,P<0.001;Z=-7.210,P<0.001;Z=-5.936,P<0.001;Z=-2.700,P=0.007;Z=-6.381,P<0.001); PCT, CRP, NLR and Lac levels were significantly higher than those in local infection group(Z=-8.262,P<0.001;Z=-3.094,P=0.002;Z=-9.004,P<0.001;Z=-4.770,P<0.001). Multivariate Logistic regression model showed that PCT, NLR, CD3+, CD8+, CD4+/CD8+ were independent risk factors for sepsis. According to ROC curve analysis, AUC of sepsis patients diagnosed by each indicator were 0.862, 0.894, 0.858, 0.760 and 0.618, respectively. The cut-off values were 3.075 ng/ml, 10.715, 44.935×109/L, 27.463×109/L and 0.750, respectively. The NLR sensitivity was 80.6%, and the CD3+ specificity was 94.6%. The AUC of combined detection of PCT and NLR was 0.947, sensitivity was 87.5% and specificity was 91.9%. The combined detection AUC of PCT, NLR, CD3+, CD4+/CD8+ was 0.958, the sensitivity and specificity were 90.3% and 91.0% respectively(P<0.001). PCT and Lac in death group were significantly higher than those in survival group(Z=-2.302,P=0.021;Z=-3.095,P=0.002);Peripheral blood CD4+/CD8+ levels were significantly lower than those in survival group(Z=-3.691,P<0.001),Multivariate Logistic regression model showed that CD4+/CD8+ ratio was an independent risk factor for 28 d mortality in patients with sepsis (P<0.001). The ROC curve showed that the AUC was 0.758, and the Youden index reached the maximum when the cut-off value was 1.27, the sensitivity and specificity were 79.3% and 60.5%, respectively. Compared with patients with CD4+/CD8+ ≥1.27, 28-day mortality was significantly increased in patients with CD4+/CD8+<1.27 (P=0.032). Conclusion: The combined detection of PCT, NLR, CD3+ and CD4+/CD8+ can improve the auxiliary diagnostic efficiency of sepsis, and the ratio of CD4+/CD8+ in peripheral blood may have certain predictive value for the prognosis of sepsis.

Identify Candidate Genes in the Interaction between Abdominal Aortic Aneurysm and Type 2 Diabetes Mellitus by Using Biomedical Discovery Support System / 中国医学科学杂志(英文版)

Objective To explore the candidate genes that play significant roles in the interconnection between abdominal aortic aneurysm (AAA) and type 2 diabetes mellitus (DM). Methods We used the Biomedical Discovery Support System (BITOLA) to screen out the candidate intermediate molecular (CIM) "Gene or Gene Product" that are related to AAA and DM. The dataset of GSE13760, GSE7084, GSE57691, GSE47472 were used to analyze the differentially expressed genes (DEGs) of AAA and DM compared to the healthy status. We used the online tool of Venny 2.1 assisted by manual checking to identify the overlapped DEGs with the CIMs. The Human eFP Browser was applied to examine the tissue specific expression levels of the detected genes in order to recognize strong expressed genes in both human artery and pancreatic tissue. Results There were 86 CIMs suggested by the closed BITOLA system. Among all the DEGs of AAA and DM, 8 genes in GSE7084 (ISG20, ITGAX, DSTN, CCL5, CCR5, AGTR1, CD19, CD44) and 2 genes in GSE13760 (PSMD12, FAS) were found to be overlapped with the 86 CIMs. By manual checking and comparing with tissue-specific gene data through Human eFP Browser, the gene PSMD12 (proteasome 26S subunit, non-ATPase 12) was recognized to be strongly expressed in both the aorta and pancreatic tissue. Conclusion We proposed a hypothesis through text mining that PSMD12 might be involved or potentially involved in the interconnection between AAA and DM, which may provide a new clue for studies on novel therapeutic strategies for the two diseases.

Excimer laser combined with drug coated balloon in the treatment of arteriosclerosis obliterans of lower extremities / 中华普通外科杂志

Objective:To evaluate the efficacy and safety of excimer laser ablation (ELA) combined with drug-eluting balloon angioplasty in the treatment of arteriosclerosis obliterans of lower extremities.Methods:The clinical data of 17 patients who received ELA from May to Dec 2017 was retrospectively analyzed, including 12-month primary patency rate, technical success rate, surgical success rate, stent implantation rate, target vessel reintervention rate and major adverse events.Results:The length of lesions was (23.3±8.9) cm. The success rate of technique and operation was 100%.All cases were treated with combined DCB. Five cases underwent stent placement, and the patency rate at 12 months was 82.4%. The recurrence rate of target lesion was 5.9%.Conclusion:ELA combined with DCBA is safe and feasible in the treatment of lower extremity arterial occlusive disease.

A Method Based on the Complex Network for Mining the System Biological Information of Scutellaria Barbata D. Don / 世界科学技术-中医药现代化

Scutellaria barbata D. Don is widely used in TCM clinical practice, so it is important to delve the information of its system biology. In this paper, we integrate its natural compounds and genomics information. The Herb-Prince complex networks algorithm is used to delve potential associated genes, gene families and KEGG signal pathways for Scutellaria barbata D. Don, and the information is verified by literature. The top 100 genes, 4 gene families and 10 KEGG signaling pathways were found. The related results are highly consistent with the clinical and pharmacological studies of Scutellaria barbata D. Don, which provide decision support for researchers to study pharmacological activities of Scutellaria barbata D. Don at the molecular level.

Hydrogen suppresses the inflammatory response of rat abdominal aorta after percutaneous transluminal angiography / 中华普通外科杂志

Objective To investigate the effect of hydrogen on the inflammatory response of abdominal aorta after atherosclerotic percutaneous transluminal angiography (PTA) in rats.Methods 40 established model of atherosclerosis Wistar rats were divided into 2 groups,one week before PTA to be injected intraperitoneally with hydrogen-saturated saline (experimental group) and normal saline (control group).The vascular structures were observed by HE.Interleukin-1 β (IL-1β) and tumor necrosis factor-α (TNF-α) were detected by ELISA.Plasma interleukin-6 (IL-6) was measured.Results The intima/ media ratio of aorta in experimental group and control group were 0.111 ± 0.015 and 0.173 ± 0.028 respectively,t =4.728,P ＜ 0.01;the IL-1β concentrations were (83 ± 27) ng/L and (163 ± 48) ng/L,respectively,t =5.081,P ＜ 0.01;the TNF-α concentrations were (107 ± 39)ng/L and (353 ± 54)ng/L,respectively,t =9.832,P ＜ 0.01.The degree of hyperplasia and expression of inflammatory factor were lower in experimental group than in the control group.Also,the plasma IL-6 was lower.Conclusion Hydrogen can inhibit the expression of inflammatory factors such as IL-1β3,TNF-α,IL-6 after PTA of abdominal aorta in rats,thereby inhibiting intimal hyperplasia.

Fetal bovine serum inhibits hepatitis C virus attachment to host cells.

Fetal bovine serum (FBS), used normally as a basic cell culture supplement, inhibits influenza virus growth. However, the role of FBS in the regulation of hepatitis C virus (HCV) infection has not been studied extensively and remains largely unclear. We adopted the established cell-cultured HCV (HCVcc) isolated from the JFH-1 strain and two sets of solutions (cDMEM7.4 and cDMEM6.8; RHMNB6.8 and RHMN6.8) to investigate the effect of FBS on HCV infection. Our data indicate that FBS blocks HCV infection in a dose-dependent manner. The infectivity of HCV diluted in the RHMNB solution was more susceptible to the addition of FBS than that diluted in the cDMEM solution. In addition, FBS-mediated blocking of HCV infection occurred at the step of virus attachment to the target cells, suggesting that FBS contains factors that interfere with the early steps in HCV infection.

The Arg719 residue at the C-terminal end of the stem region in hepatitis C virus JFH-1 E2 glycoprotein promotes viral infection.

Hepatitis C virus (HCV) envelope glycoprotein E2 is involved in virus assembly and initial entry into host cells. The tertiary organization of the E2 ectodomain is mainly composed of domains I-III, followed by the stem (ST) region and transmembrane (TM) domain. The ST region is critical for reorganizing the envelope glycoproteins during the membrane fusion process. While this region is relatively flexible, the physicochemical properties of its amino acid residues are conserved. Whether and how this physicochemical conservation is required for HCV infection is still unclear. The last residue of the E2 ST region evolved to be either an arginine or lysine among different HCV strains, suggesting that the residues confer different functions during HCV infection. To address this possibility, we constructed an R719K point mutant in the JFH-1 strain (genotype 2a) in the context of the cell-culture derived HCV (HCVcc) system. Compared with wild-type (wt) HCV, the R719K mutant exhibited decreased growth, and its extracellular and intracellular infectivity were also significantly decreased at 48 and 72 h post-electroporation. Correspondingly, less RNA and HCV core protein was observed in the supernatant for the R719K mutant, as well as less efficient RNA replication and protein expression. These findings indicate that the 719th residue of arginine on E2 is critical to promote HCV replication and infection. The data provide new clues for the biochemical function of E2, which is required for efficient HCV assembly and infection.

A preliminary study on the relationship between the length of A2 type objective test questions and the degree of difficulty and discriminative power in medical examination / 中华医学教育探索杂志

Objective In a large-scale clinical medical examination, A2 type best multiple-choice test questions to the same knowledge were used respectively in simple and complex form, to compare the difficulty and discrimination indices of the two forms of test questions and provide evidence to the improve-ment of clinical medical examination. Method In a large-scale clinical medical examination more than 4000 candidates participated, and 20 questions to different knowledge points were randomly selected and used in the examination respectively in simple and complex A2 type best multiple-choice test questions. The difficulty and discrimination indices of the two forms of test questions were compared. Results The average difficulty coefficient of the 20 simple test questions (65.5 words per question in average) is 0.6829, and the average discriminative powers are 0.2675 and 0.2579 respectively using identification index method and point biserial correlation method. The average difficulty coefficient of the 20 complex test ques-tions (135.5 words per question in average) is 0.7095, and the average discriminative powers are 0.3065 and 0.2967 respectively using identification index method and point biserial correlation method. Conclusion To the same knowledge points, the average difficulty of complex A2 type best multiple-choice test questions is slightly lower than the simple ones, while the average discriminative power is increased in the complex questions. The complex A2 type test questions are of higher quality and more in line with the requirements of the medical entrance examination, medical education and examination reform.

LFK-SLT30 semiconductor laser combined with polidocanol for the treatment of varicose veins of the lower extremities / 中华普通外科杂志

Objective To explore the clinical efficacy and satety of LFK-SLT30 semiconductor laser combined with polidocanol for the treatment of varicose veins of the lower extremities.Methods The clinical data of 105 patients treated by traditional surgery (surgery group) and 113 patients with endovascular laser treatment (EVLT) combined with polidocanol (combination group) were retrospectively analyzed from Apr 2013 to Apr 2015.Results The operative time [(50 ± 12) min vs.(70 ±10)min] and blood loss [(19 ± 6)ml vs.(41 ± 8)ml] between combination group and surgery group were significantly different (P ＜ 0.05).The rate of complications in surgery group was significantly higher than that in the combination group[15.2％ (16/105)vs.6.3％ (7/113),x2 =4.717,P =0.030].The overall 1',2' and 3 year follow-up rate was 85.3％ (186/218),76.6％ (167/218),and 60.6％ (132/218).The average follow up was (20 ± 13)months.No significant difference existed in the rate of recurrence [0 vs.3.5％(4/113),x2 =3.786,P=0.123] between the two groups.Conclusions EVLT combined with foam sclerotherapy is as effective as surgery,while resulting in less complications,less invasive,safer and more effective for the treatment of varicose veins of the lower extremities.

Testicular histology does not affect the clinical outcomes of ICSI in men with non-obstructive azoospermia / 中华男科学杂志

Objective@#To investigate whether testicular histology influences the clinical outcomes of intracytoplasmic sperm injection (ICSI) in men with non-obstructive azoospermia (NOA).@*METHODS@#We retrospectively analyzed the clinical data about 73 cases of NOA undergoing ICSI, including 105 ICSI cycles and 79 embryo transfer cycles. The infertility of the patients was attributed to male factors only or both male and female tube factors and the females' age was ≤38 years. Based on testicular histology, we divided the ICSI cycles into three groups: hypospermatogenesis (HS, n = 72), maturation arrest (MA, n = 21) and Sertoli cells only (SCO, n = 12). We recorded and analyzed the age of both the males and females, infertility duration, base follicle-stimulating hormone (FSH) level, dose and days of gonadotropin (Gn) administration, estradiol (E2) and progesterone (P) levels on the day of human chorionic gonadotropin (hCG) administration, endometrial thickness, number of metaphase II (MII) oocytes, and rates of fertilization, transferrable embryos, high-quality embryos, clinical pregnancy, and abortion.@*RESULTS@#The rates of fertilization, failed fertilization, transferrable embryos, and high-quality embryos, and the average number of transferred embryos were 67.03% (553/825), 9.52% (10/105), 85.66% (472/551), 35.03% (193/551), and 2.10, respectively, resulting in 44 pregnancies (55.70%) and 42 live births (53.16%), with no birth defects. No statistically significant differences were observed among the HS, MA and SCO groups in the mean age of the men and women, infertility duration, base FSH level, Gn dose, Gn days, E2 and P levels on the hCG day, endometrial thickness, or number of MII oocytes, nor in the rates of fertilization (68.51% vs 64.39% vs 61.45%), transferrable embryos (85.05% vs 90.48% vs 83.05%), or high-quality embryos (33.09% vs 41.67% vs 38.98%). The rates of clinical pregnancy and embryo implantation were higher in the HS (60.00% and 37.61%) and SCO (62.50% and 50.00%) than in the MA group (37.50% and 21.21%), but with no statistically significant differences (P >0.05).@*CONCLUSIONS@#Once testicular sperm is retrieved, desirable clinical outcomes can be achieved in ICSI for NOA patients, which is not affected by testicular histopathology.

Safety and efficacy of China-made sildenafil citrate in the treatment of erectile dysfunction / 中华男科学杂志

Objective@#To evaluate the safety, efficacy and tolerability of China-made sildenafil citrate (Jinge) in the treatment of ED.@*METHODS@#We conducted a multi-center, randomized, double-blind and placebo-controlled clinical trial among 222 ED patients in five urological or andrological clinics of China. The patients were randomly assigned to receive sildenafil citrate (SC, n = 111) or placebo (n = 111) for 8 weeks. We obtained and analyzed the demographic and clinical characteristics of the patients, the scores of International Index of Erectile Function (IIEF), the success rate of sexual intercourse, and the incidence of adverse events.@*RESULTS@#No statistically significant differences were found between the patients of the SC and those of the placebo group in the mean age (［47.2±11.32］ yr vs ［46.67±13.08］ yr, P>0.05), psychological etiology (27.93% vs 23.42%, P>0.05), organic etiology (21.62% vs 29.73%, P>0.05) or mixed etiology (50.45% vs 46.85%, P>0.05), nor in height, weight, nationality, or history of smoking, drinking or allergy. Compared with the placebo controls, the SC-treated patients showed significant increases in the excellence rate of effectiveness (29.91% vs 78.90%, P<0.01), success rate of sexual intercourse (29.16% vs 63.87%, P<0.01), and total effectiveness rate (34.58% vs 77.98%, P<0.01). The effectiveness rates on organic, psychogenic and mixed types ED were remarkably higher in the SC group (64.52%, 83.33%, and 82.14%) than in the placebo control (46.15%, 21.21%, and 25.00%) (P<0.01). Mild or temporary adverse events were observed in 32 cases in the SC group as compared with 13 in the placebo control.@*CONCLUSIONS@#China-made sildenafil citrate is an effective, safe and well-tolerated drug for ED of different etiologies in the Chinese population.

Endovascular management versus open surgery for subclavian steal syndrome / 中华普通外科杂志

Objective To evaluate the therapeutic effects and safety of open surgery vs.endovascular procedures for subclavian steal syndrome (SSS).Methods A retrospective analysis was made on 112 patients from July 2005 to July 2014 including 72 undergoing endovascular therapy and 40 cases treated by open bypass surgery.Results There were not difference between endovascular therapy group and surgical group in technical success rate (95.8％ vs.100％,P =0.239),postoperative subclavian artery diameter [(8.3 ± 1.6) mm vs.(8.1 ± 0.7) mm,P =0.374],postoperative suffering/contralateral systolic pressure ratio [(0.95 ±0.12) vs.(0.96 ±0.15),P =0.518].Nor there were the differences in mortality [0(0％) vs.3 (7.5％),P =0.018],postoperative renal dysfunction [2 (2.8％) vs.5 (12.5％),P =0.042],wound inffections [1 (1.4％) vs.4 (10％),P=0.034],duration of operation [(1.5 ±0.32) h vs.(2.7±0.51) h,P=0.027],days in hospital [(5.7±3) dvs.(9.3±3) d,P=0.013].After 1,3,5 years postoperative follow-up the two groups were not significantly different in patency rates,subclavian artery diameter,suffering/contralateral systolic pressure ratio (all P ＞ 0.05).Conclusion For subclavian artery steal syndrome,endovascular treatment is safe,effective and minimally invasive.

Analysis of Clinical Features and Prognosis in 31 Patients with Primary Myelofibrosis / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical and laboratorial features of primary myelofibrosis (PMF) patients treated in our hospital, to analyze the risk factors influancing survival, and to compare several prognostic scoring systems.</p><p><b>METHODS</b>parameters about clinical and laboratorial features were taken from medical documents at diagnosis, univariate analysis was conducted by Kaplan-Meier method, the survival data were compared with Log-rank test, and a COX model was used for multivariate analyses.</p><p><b>RESULTS</b>In our center the anemia and JAK2V617F mutation were more common, while the abnormal karyotype was less common, the constitutional symptoms, splenomegaly, Hb level < 100 g/L and LDH are adverse factors for survival in univariate analysis. Constitutional symptoms and Plt count < 100 × 10(9)/L are adverse factors of survival according to multivariate analysis.</p><p><b>CONCLUSION</b>The anemia is more frequent in Chinese patients. Constitutional symptoms and Plt count < 100 × 10(9)/L are independent risk factors for survival. LILLI, modified IPSS, modified DIPSS are suitable to our data.</p>

Research progress of myeloproliferative neoplasms / 中国实验血液学杂志

The classic BCR-ABL negative myeloproliferative neoplasm (MPN) comprise polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). These three disorders are characterized by stem cell-derived clonal myeloproliferation and presence of somatic mutations. The WHO diagnostic criteria for the classic BCR-ABL negative MPN has been revised in the 2008 edition by incorporating new information about their molecular pathogenesis. Robust prognostic system for PMF has already done, and those for PV and ET are under discussion. Treatment with novel drugs is promising, and allo-stem cell transplantation (allo-ASCT) is the only curative treatment for myelofibrosis, however, the patient selection and management before transplant have been discussed for a long time.

Correlation between neglect and behaviour problems of rural children aged 3-6 years in Urumqi / 中国学校卫生

Objective@#To understand the situation of neglect and behavior problems of children aged 3-6 years in rural areas of Urumqi, Xinjiang, and to provide basis and reference for the prevention and treatment of child neglect.@*Methods@#Stratified random cluster sampling was performed to select 1 326 children aged 3-6 years from 6 kindergartens in rural Urumqi. The “Chinese Rural Child Aged 3-6 Years Neglect Evaluation Norm” and “Conners Parent Symptom Questionnaire” were used.@*Results@#The total neglect rate of rural children was 51.89%, and the rate of behavioral problems was 23.37%. Each dimensional score of neglect among children with behavioral problems was higher than those without behavior preblems, and the difference was statistically significant (t=2.77，4.05，2.95，2.44，3.01，2.71，P<0.05). Emotional neglect was correlated with all factors in behavioral preblems, except phychosomation fact (r=0.18，0.80，0.15，0.14，0.19，P<0.05). Neglect in educational was correlated with all factors in behavioral factors except anxiety and hyperactivity (r=0.06，0.05，0.62，0.08，P<0.05).@*Conclusion@#Neglect of children aged 3-6 years in rural areas of Urumqi is more prominent and behavioral problems are more common, which should be paid more attention by relevant departments and parents.

Management of arterial reocclusion after endovascular treatment for diabetic feet / 中华普通外科杂志

Objective To investigate the causes of arterial reocclusion in diabetic feet patients after endovascular treatment and its remedial measures.Methods From January 2009 to October 2013,clinical data of 371 arterial reocclusion of diabetic feet patients after endovascular treatment in Tianjin First Central Hospital were reviewed retrospectively.We summarized the causes of reocclusion,treatment methods and the short term results.Results According to the Trans-Alantic Inter-Society Consensus (TASC) Ⅱ grading standards,the first time when the endovascular treatment started there were 37 cases of grade A,85 cases of grade B,143 cases of grade C,106 cases of grade D.Arterial re-occlusion developed from one day to 36 months,averaging at (21 ± 8) months.Causes of re-occlusion included intimal hyperplasia in 263 cases (70.9％),thrombosis in 65 cases (17.5％),dissection in 19 cases (5.1％),stent fracture in 17 cases (4.6％),vascular rupture in 7 cases (1.9％).Remedial therapy adopted for arterial reocclusion was repeated endovascular treatment in 327 cases (88.1％),arterial bypass surgery in 23 cases (6.2％),conservative treatment in 13 cases (3.5％),amputation (cut toe) in 4 cases (1.1％),4 cases (1.1％) died perioperatively.275 cases were followed up for 1 to 36 months,the average was (13 ± 8) months.patency rate was 82.9％,71.3％ and 63.0％ at 6 months,1 year and 2 years.Amputation rate was 1.1％,1.8％ and 2.5％ at 6 months,1 year and 2 years.Conclusions Intimal hyperplasia is to blame for arterial reocclusion after endovascular treatment of diabetic foot.In this case most patients still can benefit from second time endovascular treatment,with a satisfactory short term patency rate.