[The predictive value of warning scores for intensive care unit admission in coronavirus disease 2019 patients].

To evaluate the predictive value of early warning scores for intensive care unit (ICU) admission in patients with coronavirus disease 2019 (COVID-19). For COVID-19 patients who were admitted to Shijiazhuang People's Hospital from January 2021 to February 2021, national early warning score (NEWS), national early warning score 2 (NEWS2), rapid emergency medicine score (REMS), quick sepsis-related organ failure (qSOFA), altered consciousness, blood urea nitrogen, respiratory rate, blood pressure, and age-65 (CURB-65) were used to evaluate the inpatient condition and the predictive value for ICU admission. A total of 368 patients were included, and 32 patients (8.7%) were transferred to the ICU. The median age was 49.0 (34.0,61.0) years. The scores of NEWS, NEWS2, REMS, and CURB-65 were 1 (0, 2), 1 (0, 2), 4 (2, 6) and 0 (0, 1), respectively. The receiver operating characteristic (ROC) cure (AUC) was used to evaluate the predictive value in detecting patients who are at risk of being transferred to the ICU. Area under the ROC AUC of NEWS was 0.756, sensitivity 65.6%, and specificity 71.3%. ROC AUC of NEWS2 was 0.732, sensitivity 62.5%, and specificity 61.3%. ROC AUC of REMS was 0.787, sensitivity 84.4%, and specificity 64.6%. ROC AUC of CURB-65 was 0.814, sensitivity 81.3%, and specificity 76.8%. The predictive value of NEWS and NEWS2 combined with age were significantly improved. The ROC AUC of NEWS combined with age was 0.885, sensitivity 85.1%, and specificity 75.0%. The ROC AUC of NEWS2 combined with age was 0.883, sensitivity 84.2%, and specificity 75.0%. NEWS and NEWS2 combined with age can be used as a predictive tool for whether COVID-19 patients will be admitted to the ICU.

[Clinical outcome of open reduction and internal fixation with digastric trochanteric flip osteotomy for acetabular posterior wall fracture with hip dislocation].

Objective: To evaluate the clinical outcome of open reduction and internal fixation via digastric trochanteric flip osteotomy for acetabular posterior wall fracture with hip dislocation. Methods: From January 2014 to December 2016 a total of 39 patients who suffered posterior wall acetabular fracture and hip dislocation and treated in Beijing Jishuitan Hospital were included in this retrospective study. All the patients were divided into two groups according to surgery type. There were 22 cases in osteotomy group who underwent digastric trochanteric flip osteotomy (DTFO) via Kocher-Langenbeck (K-L) approach, while 17 cases in control group who only received surgery via (K-L) approach. The Matta scale was used to evaluate fracture reduction, while functional recovery scale (FRS) and Euro-Quality of 5 Dimension (EQ-5D) were applied to measure the clinical effect. Results: The baseline characteristics were similar for both groups and the mean follow-up period was (48±11) months. All the surgeries were performed successfully. The blood loss (t=1.52, P=0.12), bed days (t=1.22, P=0.25), complication rate (χ²=2.02, P=0.16) and operation time (t=1.31, P=0.23) showed no significant difference between the 2 groups (P>0.05). The fracture reduction (χ²=0.05, P=0.81) were similar between the 2 groups but the excellent rate were higher in osteotomy group. According to evaluation scales the FRS score and EQ-5D index favored osteotomy group(85±13 vs 80±15 and 0.86±0.12 vs 0.80±0.17, respectively, t=2.87, 3.47, both P<0.05). Conclusion: K-L approach with DTFO can provide clearier surgical field which is convenient for procedure, and compared to K-L approach the clinical effect is more satisfactory.

A haplotype variant of Hu sheep follicle-stimulating hormone receptor promoter region decreases transcriptional activity.

In sheep, increased expression of the follicle-stimulating hormone receptor (FSHR) in the ovary is a common feature of ewes that carry the prolific allele. In this study, we demonstrated that polymorphisms in the core promoter of the FSHR gene are associated with the reproductive performance of Hu sheep and are involved in the transcriptional activity of FSHR. An approximately 1.5-kb region of the 5' flanking sequence of the Hu sheep FSHR gene was isolated and characterized, and its core promoter was located in the 5' regulatory region, from nucleotides -580 to -342. Four variants (c.-518T>C, c.-466C>T, c.-414A>G and c.-365C>T) were detected in this region, and six genotypes and three haplotypes were found in the Hu sheep population (n = 245). An association analysis revealed that these polymorphisms are associated with the litter size of Hu ewes. Furthermore, a luciferase assay showed that the T-C-A-C- and C-T-G-T-type core promoters have higher transcriptional activity than does the T-C-G-C type. Notably, the putative binding site for the transcription factor Yin Yang 1 (YY1) was present at the A allele of nucleotide -414, but YY1 can significantly increase the transcriptional activity of the FSHR core promoter, which contains three different haplotypes. Taken together, our results establish that these variants might be involved in regulating the transcriptional activity of FSHR and litter size in Hu ewes and may provide a novel candidate marker for marker-assisted selection in sheep breeding.

[Deltoid ligament augmentation and repairing in ankle fracture associated with deltoid ligament injury and syndesmosis diastasis].

Objective: To evaluate the outcome of the deep component augmentation and superficial component repairing and syndesmosis screw fixation in treating ankle fracture associated with deltoid ligament injury and syndesmosis diastasis. Methods: From January 2014 to December 2017, 16 patients with ankle fracture combined with deltoid ligament injury and syndesmosis diastasis were treated with the deep component augmentation and superficial component repairing in Beijing Jishuitan Hospital.Of the patients, 13 were males and 3 were females, with an average age of (38±10) years (21-57 years). Nine cases were athletic injuries, 4 cases were daily-life injuries and 3 cases were traffic injuries.According to the Weber classification, 6 cases were type B, 10 cases were type C. According to the Lauge-Hansen classification, 6 cases were supination external rotation Ⅳ injury, 9 cases were pronation external rotation Ⅳ injury, 1 case was pronation abduction Ⅲ injury.The surgical treatment method was rigid fixation of the lateral malleolus and deep deltoid ligament augamentation instead of syndesmosis screw fixation.The effect of the surgical method was observed. Results: The average follow up was (24±12) months (6-40 months). The mean degree of dorsiflexion was 17.8°±6.8° (5°-30°), with 3.8°±6.0° (0°-15°) less than that in normal side, the mean degree of plantar flexion was 46.9°±7.9°, with 1.9°±3.9° (0°-10°) less than that in normal side.The mean Philips and Schwartz score was 96.8±5.1 (82-100), the American Orthopaedic Foot and Ankle Society (AOFAS) Score was 97.4±4.6 (84-100). Conclusion: In the treatment of ankle fracture associated with deltoid ligament injury and syndesmosis diastasis, the deep component augmentation and superficial component repairing and proper rehabilitation can benefit the functional recovery.

[Clinical value of diffusion tensor imaging parameter value in evaluating the prognosis of spinal cord injury in acute cervical spinal cord injury].

Objective: To evaluate the clinical application value of diffusion tensor imaging (DTI) parameter in evaluating the prognosis of spinal cord injury in acute cervical spinal cord injury. Method: From October 2012 to December 2015, a total of 23 patients with acute cervical spinal cord injury were examined by routine MRI-T2WI high signal DTI examination, according to the American Spinal Injury Association (ASIA) damage standard. One month later according to the functional outcome of the spinal cord, all patients were divided into non improvement group (group A) 4 cases (2 cases of ASIA-A, 2 cases of grade B) and improvement group (group B) 19 cases (13 cases of ASIA-C, 5 cases of grade D, 1 case of grade B), 15 cases of healthy volunteers as the normal group (group C ). The FA value, ADC and axial eigen value[λ∥=λ1], radial eigen value[λ⊥=(λ2+ λ3)/2]of before and after the treatment in group A and group B were compared by paired t test respectively. Single factor analysis of variance (ANOVA) was used to analyze the differences of DTI among the group A, group B and group C, and LSD test was used to compare the differences among the groups.Before and after treatment, the DTI measurement area was consistent.Changes of nerve fiber bundles in group A and group B before and after treatment were displayed in DTT. Results: After the treatment , the FA value of group A decreased , ADC value and λ⊥ value increased than that of before treatment(t=3.037, -4.183, -4.805, all P<0.05), λ∥ value increased(t=-1.160, P>0.05). After the treatment , the FA value and ADC value of group B increased , λ⊥ value decreased than that of before treatment(t=-3.344, -3.642, 4.694, all P<0.05), λ∥ value increased(t=-0.596, P>0.05). After treatment, there were statistical differences in FA values, λ⊥ value , ADC values and λ∥ values among three groups (F=71.958, 70.432, 75.902, 22.521, all P<0.01). Conclusion: The changes of FA value, λ⊥ value are the two most sensitive indicators of acute cervical spinal cord injury of spinal cord function prognosis.It suggests the poor prognosis of spinal cord function when FA value decreases and λ⊥ value continues to increase.DTT can visually display subtle changes in the nerve fiber bundle.

Pyrosequencing analysis of the gyrB gene to differentiate bacteria responsible for diarrheal diseases.

Pathogens causing acute diarrhea include a large variety of species from Enterobacteriaceae and Vibrionaceae. A method based on pyrosequencing was used here to differentiate bacteria commonly associated with diarrhea in China; the method is targeted to a partial amplicon of the gyrB gene, which encodes the B subunit of DNA gyrase. Twenty-eight specific polymorphic positions were identified from sequence alignment of a large sequence dataset and targeted using 17 sequencing primers. Of 95 isolates tested, belonging to 13 species within 7 genera, most could be identified to the species level; O157 type could be differentiated from other E. coli types; Salmonella enterica subsp. enterica could be identified at the serotype level; the genus Shigella, except for S. boydii and S. dysenteriae, could also be identified. All these isolates were also subjected to conventional sequencing of a relatively long ( approximately1.2 kb) region of gyrB DNA; these results confirmed those with pyrosequencing. Twenty-two fecal samples were surveyed, the results of which were concordant with culture-based bacterial identification, and the pathogen detection limit with simulated stool specimens was 10(4) CFU/ml. DNA from different pathogens was also mixed to simulate a case of multibacterial infection, and the generated signals correlated well with the mix ratio. In summary, the gyrB-based pyrosequencing approach proved to have significant reliability and discriminatory power for enteropathogenic bacterial identification and provided a fast and effective method for clinical diagnosis.

[Phylogenetic relationships and evolution of yeast-like symbionts of the small brown planthoppers based on partial 18S rDNA sequences].

The yeast-like symbionts are isolated and purified from the small brown planthoppers collected from five areas in China. The 18S rDNA sequences of them are determined. Combined with the sequences of other fungi, we have constructed a comprehensive phylogenetic tree. The results suggested that the taxonomic positions of the YLS are in the class Pyrenomycetes in the subphylum Ascomycotina and the YLS have the closest relationship with H. chrysospermus. The YLS of different areas in China and Japan may belong to different geographical populations of one species. We could also draw a conclusion that there are independent acquisitions of various symbionts in differentiated hosts.