Intermediate dose enoxaparin in hospitalized patients with moderate-severe COVID-19: a pilot phase II single-arm study, INHIXACOVID19.

BACKGROUND: Randomized clinical trials in non-critically ill COVID-19 patients showed that therapeutic-dose heparin increased survival with reduced organ support as compared with usual-care thromboprophylaxis, albeit with increased bleeding risk. The purpose of the study is to assess the safety of intermediate dose enoxaparin in hospitalized patients with moderate to severe COVID-19. METHODS: A phase II single-arm interventional prospective study including patients receiving intermediate dose enoxaparin once daily according to body weight: 60 mg for 45-60 kg, 80 mg for 61-100 kg or 100 mg for > 100 kg for 14 days, with dose adjustment according to anti-factor Xa activity (target range: 0.4-0.6 UI/ml); an observational cohort (OC) included patients receiving enoxaparin 40 mg day for comparison. Follow-up was 90 days. Primary outcome was major bleeding within 30 and 90 days after treatment onset. Secondary outcome was the composite of all-cause 30 and 90-day mortality rates, disease severity at the end of treatment, intensive care unit (ICU) admission and length of ICU stay, length of hospitalization. All outcomes were adjudicated by an independent committee and analyzed before and after propensity score matching (PSm). RESULTS: Major bleeding was similar in IC (1/98 1.02%) and in the OC (none), with only one event observed in a patient receiving concomitantly anti-platelet therapy. The composite outcome was observed in 53/98 patients (54%) in the IC and 132/203 (65%) patients in the OC (p = 0.07) before PSm, while it was observed in 50/90 patients (55.6%) in the IC and in 56/90 patients (62.2%) in the OC after PSm (p = 0.45). Length of hospitalization was lower in the IC than in OC [median 13 (IQR 8-16) vs 14 (11-21) days, p = 0.001], however it lost statistical significance after PSm (p = 0.08). At 30 days, two patients had venous thrombosis and two pulmonary embolism in the OC. Time to first negative RT-PCR were similar in the two groups. CONCLUSIONS: Weight adjusted intermediate dose heparin with anti-FXa monitoring is safe with potential positive impact on clinical course in COVID-19 non-critically ill patients. TRIAL REGISTRATION: The study INHIXACOVID19 was registred on ClinicalTrials.gov with the trial registration number (TRN) NCT04427098 on 11/06/2020.

[Application of cortical bone trajectory screw and sacral alar screw internal fixation for surgical treatment of lumbar adjacent segment degeneration].

Objective: To explore the application of cortical bone trajectory screw (CBTS) and sacral alar screw (SAS) internal fixation in the treatment of lumbar adjacent segment degeneration (ASD) and evaluate its clinical effect. Methods: Data of 24 patients who were diagnosed with ASD and treated by CBTS or SAS in Beijing Chaoyang Hospital were retrospectively reviewed. There were 14 males and 10 females with a mean age of (67.9±8.2) years. The patients were followed-up for (2.6±0.4) years. Perioperative parameters including operation time, intraoperative blood loss and postoperative time on the ground were counted. All patients were followed-up for at least 2 years. Visual analogue scale (VAS) and the Oswestry disability index (ODI) were compared between pre-operation and at the last follow-up. The internal fixation-related complications, pseudarthrosis and adjacent re-degeneration were evaluated in the follow-up. Results: There were 14 proximal ASD patients, 8 distal ASD patients, 1 both ends ASD patient and 1 ASD patient in between the fusion surgeries. Bone mineral density (BMD) T score of the adjacent vertebrae was -1.98±0.91 on average. The ASD patients were re-operated with CBTS and SAS internal fixation technique. A small incision was made in the revision surgery and the original fixation was not completely cut open and removed. The mean operation time was (125±36) min, mean blood loss was (85±33) ml. The postoperative ambulation time was (3.1±1.9) days, and the hospitalization time was (9.0±2.6) days. Before the operation, the average VAS (back pain) score was 5.2±1.0, the average of VAS (leg pain) score was 6.8±1.9 and ODI was 56.6%±12.8%. VAS score was reduced to 1.4±0.6 (waist pain) and 0.9±0.4 (leg pain). ODI was improved to 13.8%±6.3%. All the difference between preoperative and the last follow-up was statically significant (all P<0.01). No internal fixation failure, pseudarthrosis and adjacent re-degeneration were observed in the final follow-up. Conclusion: The application of CBTS and SAS internal fixation techniques in the surgical treatment of lumbar ASD has the advantages of less trauma, faster postoperative recovery, reliable internal fixation, and fewer complications, especially in patients with low bone mineral density.

[Analysis of 15 cases of toxic encephalopathy caused by acute benzene poisoning].

In this paper, the MRI manifestations of 15 patients with benzene toxic encephalopathy were analyzed, and the lesion location, shape, scope and signal were observed. The clinical manifestations of 15 patients were mainly central nervous system damage, and the MRI manifestations were characteristic, with a wide range of lesions, and the shapes were "sunflower-like", "flame-like", "bracket-like" and "butterfly-like", and the MRI signal was sheet-like long T(1), long T(2), fluid attenuated inversion recovery (FLAIR) sequence and diffusion weighted imaging (DWI) high signal, apparent diffusion coeffecient (ADC) map low, equal or high signals. When the patient's diagnosis is unclear, MRI examination may provide clinical basis for diagnosis.

Interaction between sodium dodecylsulfate (SDS) and pluronic L61 in aqueous medium: assessment of the nature and morphology of the formed mixed aggregates by NMR, EPR, SANS and FF-TEM measurements.

The interaction of copolymer L61 i.e., (EO)2(PO)32(EO)2 (where EO and PO are ethylene and propylene oxides, respectively) with surfactant SDS (sodium dodecylsulfate) in relation to their self-aggregation, dynamics and microstructures has been physicochemically studied in detail employing the Nuclear Magnetic Resonance (NMR), Electron Paramagnetic Resonance (EPR), Small-Angle Neutron Scattering (SANS), and Freeze-Fracture Transmission Electron Microscopy (FF-TEM) methods. The NMR self-diffusion study indicated a synergistic interaction between SDS and L61 forming L61-SDS mixed complex aggregates, and deuterium (2H) NMR pointed out the nonspherical nature of these aggregates with increasing [L61]. EPR spectral analysis of the motional parameters of 5-doxyl steraric acid (5-DSA) as a spin probe provided information on the microviscosity of the local environment of the L61-SDS complex aggregates. SANS probed the geometrical aspects of the SDS-L61 assemblies as a function of both [L61] and [SDS]. Progressive evolution of the mixed-aggregate geometries from globular to prolate ellipsoids with axial ratios ranging from 2 to 10 with increasing [L61] was found. Such morphological changes were further corroborated with the results of 2H NMR and FF-TEM measurements. The strategy of the measurements, and data analysis for a concerted conclusion have been presented.

[Clinical application of sacral alar screw fixation in surgical treatment of lumbosacral degenerative disease].

Objective: To verify the safety and feasibility of sacral alar screw fixation and fusion surgery in lumbosacral area. Methods: The clinical and radiological data of patients receiving L5/S1 single-level cortical bone trajectory screw combined with sacral alar screw decompression fixation and fusion in Beijing Chaoyang Hospital due to lumbar spinal stenosis from January 2019 to January 2020 were retrospectively analyzed. The clinical data included operation duration, intraoperative blood loss, postoperative drainage, pain and function scores during follow-up. The radiological data included preoperative and postoperative follow-up X-rays and three-dimensional reconstruction of lumbar spine CT. The fusion status and complication of internal fixation, such as screw loosening and fixation failure were evaluated by the radiological examination. Results: According to the inclusion and exclusion criteria, a total of 16 patients (7 males and 9 females) were included, with an average age of (69.6±5.2) years. The patients were followed-up for (16.2±1.7) months. The average operation duration was (144±21) min, the intraoperative blood loss was (103±20) ml, and the postoperative drainage was (80±34) ml. The patient's low back pain visual analogue scale (VAS) score was 6.8±1.0 before surgery, and it was improved to 0.9±0.7 at the last follow-up; leg pain VAS score was 6.1±0.9 before the operation and it improved to 0.9±0.7 at the last follow-up; Oswestry disability index (ODI) function score was 66.2%±8.0% before the surgery and it decreased to 26.6%±7.2% at the last follow-up. No neurological complications, surgical site infection, screw loosening, internal fixation failure or cage displacement were observed during the follow-up. The fusion rate was 68.8% (11/16) at 6 months post operation. Conclusion: It is safe, feasible and effective to apply cortical screws combined with sacral alar screws in short-segment decompression, fixation and fusion surgery on the lumbosacral region to treat lumbosacral spinal stenosis.

[A long-term follow up study of cervical spondylotic myelopathy using diffusion tensor imaging].

Objective: To analyze the correlation between the parameters of diffusion tensor imaging (DTI) and the clinical function scores before and 5 years after anterior cervical discectomy and fusion (ACDF) by measuring the DTI signal of the maximum compression level (MCL) of the cervical spinal cord in patients with cervical spondylotic myelopathy (CSM). Methods: A prospective study was conducted and clinical data of 37 patients with CSM treated by ACDF in Beijing Chaoyang Hospital from February 2014 to February 2020 were analyzed. The MCL was studied with diffusion tensor imaging (DTI) of MRI. The changes of diffusion indexes (fractional anisotropy (FA)), and clinical function score including Modified Japanese Orthopedic Association (mJOA), neck disability index (NDI) and visual analog scale (VAS) of pain were compared among each follow-up point. The FA value and clinical function score were collected and the data was analyzed to determine whether the high signal intensity could be observed in T2-weighted imaging (T2WI) at each follow-up point. The changes of preoperative and postoperative data were compared, and the correlation between FA value and other two clinical function score were analyzed at each follow-up point. Results: There were 14 males and 23 females with a mean age of (55±10) years in this study. All patients received the surgery and the medullary symptoms improved significantly postoperatively. After 3 months, the mJOA and FA value were improved by 2.62±1.41 and 0.14±0.11 on average, respectively (both P<0.05); and there were significant differences in these two indexes between each follow-up point in two years after the operation (all P<0.05). At the MCL, there were strong correlations between the FA value and mJOA score pre-and postoperatively (rs=0.770, 0.729, both P<0.01). There was no significant correlation between mJOA, NDI and VAS (both P>0.05). Conclusions: The DTI sensitively reflects the improvement of spinal cord function and can be used as an important tool to predict and evaluate the state of spinal cord dysfunction in patients with CSM.

[Consumption of sugar-sweetened beverages and artificially sweetened beverages and risk of cardiovascular disease: a meta-analysis].

Objective: Using Meta-analysis to evaluate the relation of sugar-sweetened beverages (SSBs) intakes and artificially sweetened beverages (ASBs) intakes with risk of incident cardiovascular disease. Methods: "Sugar-sweetened beverages"(SSBs),"artificially sweetened beverages"(ASBs),"coronary heart disease"(CHD),"stroke","cardiovascular disease"(CVD), and related terms (both in English and in Chinese) were searched in Pubmed, EMBASE, Web of Science, Cochrane library, ProQuest, China National Knowledge Infrastructure (CNKI), Wanfang databases, and VIP Chinese Science and Technology Journal. Besides, it searched for additional references in websites including Clinical Tirals.gov and International Clinical Trials Registry Platform. The time was up to May 31st 2020. Stata 13 software was used to calculate pooled RR, perform heterogeneity test, and assess publication bias. Results: A total of 14 articles were included from the 40 804 articles retrieved, including 12 articles from European and American countries and 2 articles from Asian countries. The baseline mean age of the participants ranged from 52 to 69 years, and the mean follow-up time was from 6 to 26 years. Meta-analysis showed that compared with those in the lowest group, the RR (95%CI) for those in the highest group of SSBs consumption was 1.11 (1.04-1.08) for CHD, 1.10 (1.01-1.19) for stroke, and 1.09 (0.96-1.24) for CVD events. The corresponding RR (95%CI) comparing extreme groups of ASBs consumption was 1.10 (0.98-1.23) for CHD, 1.19 (1.09-1.29) for stroke, and 1.32 (1.15-1.52) for CVD events. Further analysis for subtypes of stroke showed that compared with the lowest group, the RR (95%CI) for those in the highest groups of SSBs consumption was 1.10 (0.99-1.22) for ischemic stroke and 0.86 (0.71-1.04) for hemorrhagic stroke. The corresponding RR (95%CI) comparing extreme consumption of ASBs was 1.23 (1.04-1.46) for ischemic stroke and 1.33 (1.03-1.72) for hemorrhagic stroke. Conclusion: Higher consumption of SSBs or ASBs may lead to increased risk of incident CHD and stroke (particularly ischemic stroke).

[Change of cervical sagittal alignment after the treatment of growing rods to the early-onset scoliosis].

Objective: To determine the impact of growing rods (GR) technique on cervical alignment in early-onset scoliosis (EOS) through the change of cervical alignment parameters after the GR surgery. Methods: Total of 24 consecutive EOS patients treated in Beijing Chao-Yang Hospital from 2009 to 2018 were retrospectively reviewed (17 males and 7 females). Cervical lordosis, T(1) slope and C(2-7) sagittal vertical axis (C(2-7)SVA), thoracic/lumbar Cobb angle, thoracic kyphosis (TK), global kyphosis Cobb angle, SVA were included in radiographic data in the full spinal standing X-ray before and post operation and at the last follow-up. Based on clinical data, including the upper instrumented vertebra (UIV), proximal junctional kyphosis (PJK) and the number of GR, patients were divided into different groups for statistical analysis. Logistic regression analysis was used to find the independent risk factors of the abnormality of C(2-7)SVA. Results: All patients received at least one time of distraction operation, the mean follow-up was (35±14) months. The C(2-7) Cobb angle increased from 17°±11° to 18°±9° and T(1) slope changed from 28°±13° to 28°±11° and C(2-7)SVA changed from (17±11) mm to (16±10) mm after the operation, but no significant differences were found in those indexes before and after the operation (t=-1.15, 0.14, 0.55, all P>0.05). At the last follow-up after GR technique, the C(2-7) Cobb angle, T(1) slope angle and C(2-7)SVA significantly increased when compared with those before the operation (t=-7.60, -4.08, -2.46, all P<0.05). The △C(2-7) Cobb angle and △T(1) slope angle PJK group was both more significant than those in non-PJK group (t=3.50, 3.25, both P<0.05); while there was no significant difference in the △C(2-7) Cobb angle and △T(1) slope angle when the choice of UIV and the number of GD were taken into account (t=-1.02, -1.61, -0.67, 0.31, all P>0.05). The occurrence of PJK was identified as an independent risk factor for the abnormality of C(2-7)SVA during the GR surgery with logistic regression analysis(OR=11.57, 95%CI: 1.49-91.54, P<0.05). Conclusions: When used for EOS to correct deformity, GR surgery will increase the cervical lordosis and T(1) slope angle of EOS patients. More attention should be paid to the cervical sagittal alignment and cervical sagittal imbalance in EOS patients with PJK.

[Effect of posterior lumbar fusion on the degeneration of adjacent segments using cortical bone trajectory screw fixation].

Objective: To compare the degenerative changes of adjacent segments after posterior lumbar fusion surgery using cortical bone trajectory (CBT) screws and pedicle screws (PS) in lumbar spinal degenerative disease. Methods: According to certain inclusion and exclusion criteria, prospective non-randomized study on cases of the single-segment lumbar spinal fusion surgery using cortical bone trajectory screws fixation and pedicle screws fixation in Beijing Chao-Yang Hospital from January 2015 to February 2016 was performed. The intervertebral space height (ISH), foramen height (FH), foramen width (FW), cephalad adjacent segment (CAS) and intervertebral disc degeneration grades at MRI scans were measured before surgery and during follow-up. Clinical symptoms were evaluated by Oswestry Dysfunction Index (ODI) score and pain visual analogue scale (VAS) before and during the follow-up. Radiologic adjacent segment degeneration (R-ASD) and symptomatic adjacent segment disease (S-ASD) patients were diagnosed during the follow-up. Paired sample t test was performed when data were compared before surgery and during follow-up. Results: A total of 69 patients were included in the study, 33 in the CBT group (male/female, 15/18), with an average age of (65±11) years, and 36 in the PS group (male/female, 17/19), with an average age of (64±10) years. The follow-up time was no less than 36 months. At the last follow-up, the ISH of the adjacent segments in the CBT group were not statistically different from that before surgery; the ISH of the adjacent segments in the PS group were significantly reduced compared with that before surgery (t=6.78, P<0.05). The loss of ISH, FH, and FW in the adjacent segments in the CBT group were smaller than those in the PS group, and the differences were statistically significant. During follow-up, 4 cases (12.1%) of R-ASD and no S-ASD were found in the CBT group, while 12 cases (33.3%) of R-ASD appeared in the PS group, which was significantly higher than that in the CBT group (χ(2)=4.35, P=0.04). According to MRI, the adjacent discs of PS group had significantly more severe degeneration at the last follow-up than the CBT group (Z=-2.14, P=0.03). Conclusions: Compared with the PS fixation fusion, the CBT screw fixation can effectively reduce the occurrence of adjacent segment degeneration.

[Association between self-rated health and risk of cardiovascular disease among middle-aged and elderly Chinese].

Objective: To analyze the association between the self-rated health (SRH) status and risk of cardiovascular disease (CVD) among the middle-aged and eldly Chinese. Methods: Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which enrolled 21 133 participants by using the probability proportional to size (PPS) sampling from 150 counties/districts of 28 provinces in China from 2011 to 2012. A total of 11 701 participants were included in the study. Basic information and SRH were obtained in the baseline survey via questionnaires. Information of CVD was self-reported during the follow-up. Cox proportional hazards modeling was used to analyze the association between the baseline SRH and risk of CVD. Subgroup analyses were performed by age, sex and body mass index (BMI), and their interactions with SRH for risk of CVD were examined by using the likelihood ratio test. A sensitivity analysis was conducted to test the robustness of the association. Results: Participants were (57.9±9.7) years old, and men accounted for 48.1% (5 626). SRH was reported as the excellent, very good, good, fair and poor among 4.2% (n=487), 13.5% (n=1 583), 33.6% (n=3 932), 35.4% (n=4 147) and 13.3% (n=1 552), respectively. During 42 104 person-years of followed up, 590 cases of CVD were identified. Cox regression analyses showed that compared with the excellent/very good SRH, the HR (95%CI) of CVD risk for the good, fair and poor SRH was 1.36 (1.02-1.80), 1.66 (1.26-2.19) and 1.89 (1.38-2.59), respectively. Subgroup analyses showed that compared with the excellent/very good SRH, HR (95%CI) of CVD risk for poor SRH in the group of 45-59 years old, equal to or over 75 years old, men, women and normal BMI were 2.00 (1.32-3.04), 3.87 (1.04-14.46), 1.76 (1.07-2.91), 1.92 (1.27-2.91) and 2.30 (1.42-3.72), respectively. There were no interactions between age, sex, BMI and SRH (P>0.05). Conclusion: SRH is associated with risk of CVD among middle-aged and elderly Chinese. The CVD risk for good, fair and poor SRH is higher than that for excellent/very good SRH.

[The application of energy adjustment models in nutritional epidemiology].

The energy adjustment models in nutritional epidemiological studies could substantially reduce the confounding effect of total energy intake from the intake of dietary components, and it could explore the real relationship between the intake of dietary component and research outcomes. Four energy adjustment models were introduced in this article, including the standard multivariate model, multivariate nutrient residual model, energy partition model, and multivariate nutrient density model. The four energy adjustment models were applied to analyze the association between the intake of saturated fatty acids and the risk of all-cause mortality based on the data of the US National Health and Nutrition Examination Survey. The consistent results of different energy adjustment models could indicate that the four models could better control the confounding effect of total energy intake.

[Research progress of relationship between vitamin K and type 2 diabetes].

Objective: To systematically review research on the association between vitamin K and type 2 diabetes and diabetes-related biomarkers in humans, and evaluate the role of vitamin K in the prevention of type 2 diabetes. Methods: "Vitamin K", "type 2 diabetes" and related terms were searched in PubMed, EMBASE, China National Knowledge Infrastructure (CNKI) and Wanfang Med Online up to November 2018. Results: A total of 1 Chinese and 12 English articles were included. Among 6 observational studies, 5 of them showed that higher dietary vitamin K intake and plasma vitamin K level were associated with the decrease of the risk of type 2 diabetes. Among 6 clinical intervention studies, 5 of them indicated that the supplementation of vitamin K(1) or K2 could have positive influence on insulin metabolism. One Mendelian randomization study showed higher circulation vitamin K level might reduce the risk of type 2 diabetes. Conclusion: Vitamin K plays an important role in the prevention and control of type 2 diabetes, which may be related to the improvement of insulin metabolism and blood glucose level.

Microstructural visual pathway abnormalities in patients with primary glaucoma: 3 T diffusion kurtosis imaging study.

AIM: To evaluate microstructural visual pathway damage in patients with primary glaucoma (PG) by using 3 T diffusion kurtosis imaging (DKI). MATERIALS AND METHODS: The study was approved by the ethics committee, and all participants provided written informed consent. Ten patients with PG were examined. Twenty healthy individuals served as control subjects. DKI was performed with a GE Silent 3 T magnetic resonance imaging (MRI) unit. Mean diffusivity (MD), fractional anisotropy (FA), and mean kurtosis (MK) maps were automatically created. Mean MK, MD, and FA values were calculated for each part of the visual pathway. RESULTS: No abnormalities in the shape and signal intensity were observed along the entire visual pathway in patients and the control group on the conventional MRI. Higher MD, and lower MK and FA were observed in the optic nerves (ON), lateral geniculate nucleus (LGN), optic radiations (OR), and visual cortex (VCx) of PG patients, as compared with control subjects. A significantly higher MD was observed in the ON (p<0.01), and significantly lower FA was observed in OR (p<0.05). Additionally, significantly lower MK was observed in the ON, LGN, and VCx, except for OR (p<0.01). Changes of DKI parameters in the ON were the most distinct. CONCLUSION: Glaucoma is a complex neurological disease that affects the entire visual pathway. MK derived from DKI would be a better biomarkers than FA and MD in detecting microstructural damage.

Genome-wide association study confirms that the chromosome Z harbours a region responsible for rumplessness in Hongshan chickens.

Rumplessness in Hongshan chickens has been reported as a novel sex-linked characteristic. Re-sequencing data suggest that a pseudogene on the Z chromosome, LOC431648, is affiliated with this phenotype. In this study, we chose 23 rumpless and 25 normal Hongshan chickens to localize the potential variation by means of a genome-wide association study using a high density microarray. A region on the Z chromosome was found to be closely associated with rumplessness in Hongshan chickens. The region, located in gene LINGO2, was approximately 3 Mb away from pseudogene LOC431648. The function of this gene has not yet been studied in birds. Differential expression of the candidate genes in the tail feather follicles was not detected by q-PCR, which suggests that the rumplessness trait could be attributed to other genetic mechanisms.

[Assessment of biomechanical properties of paraspinal muscles in adolescent idiopathic scoliosis].

Objective: To assess the bio-mechanical properties of paraspinal muscles in adolescent idiopathic scoliosis (AIS). Methods: The MyotonPro® device and shear wave elasticity imaging(SWEI) technique were applied to detect the paraspinal muscle tone (F), stiffness (S), relaxation time (R), Deborah number (C) and elasticity (D) of paravertebral muscles on the concave side and convex side of scoliosis curvature at several points: apex of the curve (a), upper (b) and lower (c) limits of the curve in 23 cases of AIS treated from October to December 2017 in Beijing Chaoyang Hospital.Cobb angle of the main curve was measured on the standing anteroposterior whole spine radiograph.Pearson correlation analysis was applied to detect the relation between the bio-mechanical properties and Cobb angle of the main curve. Results: A total of 23 AIS patients [3 males and 20 females, mean age was (15±4) years] were assessed in this study.The mean Cobb angle was (66±33) degrees.The MyotonPro® data showed that the muscle tone on the concave side were all significantly greater than those on the convex side [a: (18.9±2.2) Hz vs (17.4±1.6) Hz, t=4.435, P<0.05; b: (18.2±2.0) Hz vs (16.7±1.7) Hz, t=4.183, P<0.05; c: (18.0±2.3) Hz vs (16.8±1.7) Hz, t=4.520, P<0.05]. The muscle stiffness on the concave side were all significantly greater than those on the convex side at the three points (t=1.974, 2.048, 1.749, all P<0.05). The relaxation time were all longer on the convex side (t=-3.422, -2.713, -2.380, all P<0.05). The Deborah number were greater on the convex side at a and b points (t=-2.939, -2.466, both P<0.05). No significant difference in elasticity was found between the muscles of the two sides.The SWEI results also indicated that the elasticity of the paraspinal muscles of the two sides were similar.The Pearson correlation analysis showed that stiffness on the concave side was moderate positively correlated with Cobb angle of the main curve (r=0.582, P<0.05). Deborah number on the two sides and relaxation time on the concave were moderate negatively correlated with Cobb angle of the main curve (r=-0.632, -0.432, -0.611, all P<0.05). Conclusions: The bio-mechanical properties of paraspinal muscles in AIS are different significantly between the concave and convex side and affected by the severity of scoliosis.

[The relationship between smoking and hyperuricemia in Chinese residents].

Objective: To explore the relationship between smoking and hyperuricemia in Chinese residents. Methods: Based on data from the China Health and Nutrition Survey (CHNS), residents with blood samples provided in the 2009 round (including information of socio-demographic factors, lifestyle behaviors, medical history, and laboratory examinations etc.) were selected as the participants in the current analysis. Unconditional logistic regression models were utilized to compute the ORs and corresponding 95%CIs for assessing the relationship between smoking and hyperuricemia. Results: Among the 8 785 subjects, 1 435 had hyperuricemia with a prevalence rate of 16.3%, consisting of 886 men and 549 women with prevalence rates of 21.6% (886/4 110) and 11.7% (549/4 675) , respectively. Compared with never smokers, the adjusted OR (95%CI) for hyperuricemia was 0.83 (0.70-0.98) among current smokers, 0.77 (0.63-0.94) among current smokers with 20-39 years of smoking, and 0.79 (0.65-0.97) among current smokers with 11-20 cigarettes per day. When stratified by gender and compared with non-smoker, the adjusted OR (95%CI) for hyperuricemia among current smokers compared with never smokers was 0.83 (0.70-0.98) among men, while no significant association was found in female current smokers (OR=0.73, 95%CI: 0.42-1.26, P=0.260). Conclusion: In Chinese residents, there is an inverse association between smoking and hyperuricemia prevalence, and this association may be related to duration and intensity of smoking among current smokers. The findings need to be validated in large prospective cohort studies.

Vesicle to micelle transition in the ternary mixture of L121/SDS/D2O: NMR, EPR and SANS studies.

Subtle changes in the microstructure and dynamics of the triblock copolymer L121, (ethylene oxide)5 (propylene oxide)68 (ethylene oxide)5i.e., E5P68E5, and sodium dodecylsulfate (SDS) system in aqueous medium were investigated using high-resolution nuclear magnetic resonance (NMR), electron paramagnetic resonance (EPR) and small-angle neutron scattering (SANS) methods. NMR self-diffusion measurements helped us to understand the nature of binding of SDS with L121, and the formation of their mixed aggregates. These results showed that even at low [SDS] (∼2 mM), the addition of L121 stabilized the dynamics of SDS. Furthermore, the increase in [SDS] resulted in progressive changes in the diffusion behavior of both SDS and L121. 13C chemical shift analysis revealed that preferential binding of L121 occurred on the SDS micelle surface. Deuterium (2H) NMR spin-relaxation data evidenced that the formed mixed aggregates were non-spherical in terms of relaxation rate changes, and slowed the dynamics. The rotational correlation times of mixed aggregates were estimated from EPR analysis. A SANS study indicated the presence of uni- and multi-lamellar vesicles of L121 at low [SDS]. The vesicles transformed to mixed L121-SDS micelles in the presence of a higher [SDS]. This was supported by the measurements of 2H NMR spin-relaxation and EPR rotational correlation times.

[Biomechanical effects on adjacent segments of different growing-rod fixation in early onset scoliosis].

Objective: To analyse the biomechanical effects on adjacent segments of different growing-rod (GR) fixation in early onset scoliosis through a finite element analysis method. Methods: A severe early-onset scoliosis patient was selected and the pre-operation and post-GR-operation (Upper instrumented levels: T(4), T(5). Lower instrumented levels: L(3), L(4)) whole spine 3-dimentional CT scan data were collected to build the finite models. Based on the different models, biomechanical differences on adjacent segments were analysed. Results: The stress on the adjacent structures decreased after the GR surgery compared with the pre-operation. Compared with the single GR, stress on T(3) vertebrae decreased by 6.2%, stress on T(3/4) disc decreased by 6.7%, stress on T(3/4) ligament decreased by 27.7%, stress on T(6) vertebrae decreased by 16.9%, stress on T(5/6) disc decreased by 1.2%, stress on T(5/6) ligament decreased by 40.4%, stress on L(2) vertebrae decreased by 32.6%, stress on L(2/3) disc decreased by 30%, stress on L(2/3) ligament decreased by 15.6%, stress on L(5) vertebrae decreased by 1.2%, stress on L(4/5) disc decreased by 15.7%, stress on L(4/5) ligament decreased by 100.0% in dual GR structure. The application of hook (s) on the upper instrumented vertebrae (s) decreased the stress on the cranial adjacent segment. Stress on T(3) vertebrae decreased by 2.8% and 2.2%, stress on T(3/4) disc decreased by 2.4% and 1.5%, stress on T(3/4) ligament decreased by 3.6% and 5.7% in single GR and dual GR models separately when the hook (s) were utilized. In the meanwhile, the stress on the adjacent segment was more concentrated in the single GR model. Conclusion: Dual-rod growing-rod and the application of hook (s) on the upper instrumented vertebrae could reduce the stress on the adjacent segments more effectively in patients with early onset scoliosis.

[Retrospectively analysis on 95 postpartum hemorrhage women treated with obstetrics and gynecology in intensive care unit].

Objective: To review the clinical aspects and pathogenesis of postpartum hemorrhage (PPH) and investigate the optimal protocols for intervention. Methods: From February 2009 to December 2015, data of normal labour and casearean birth women admitted to intensive care unit (ICU) in our hospital because of hematobilia were selected. 95 patients were divided into three groups (e. g ≥500-1 000 ml, ≥1 000-1 500 ml, ≥1 500-2 500 ml and ≥2 500 ml group) according to the bleeding volume. A retrospective analysis was performed to study the pathogenesis of PPH, organ function, surgical intervention and clinical prognosis on hemorrhage. Results: The data comprised 20 504 women over the 6-year period. 95 (0.463%) of which resulted in PPH and were admitted to ICU. 9 of these patients with PPH unsurvived. The value of creatinine and urea nitrogen, the score of APACHE Ⅱ and the possibility of multiple organ dysfunction syndromethe (MODS) increased with the amount of bleeding (P<0.05). For patients with PPH caused by injury of birth canal and/or placenta factors, there was significant difference among three groups on amount of bleeding (P<0.05). For patients with surgical intervention such as vaginal packing, interventional treatment and exploratory laparotomy conducted in 6 hours, the volume of transfusion was(759±114) ml. The volume of transfusion was (2 000±829) ml and (4 999±1 699) ml in 6 to 12 hours intervention group and in greater than 12 hours intervention group, respectively. The volume of transfusion significant increased over intervention time. There was a statistically significant difference in all groups (P<0.05). Conclusions: Classified treatment should be conducted according the classification on the amount of bleeding. Patients with severe PPH and/or tendency of organ failure should be admitted to ICU. Measures for maintenance of the function of organs are necessary, while appropriate surgical intervention is also needed based on the cooperation between ICU and obstetrical department, and the cure rate could be improved.

Characterization and comparison of transgenic Artemisia annua GYR and wild-type NON-GYR plants in an environmental release trial.

The anti-malarial drug, artemisinin, is quite expensive as a result of its slow content in Artemisia annua. Recent investigations have suggested that genetic engineering of A. annua is a promising approach to improve the yield of artemisinin. In this study, the transgenic A. annua strain GYR, which has high artemisinin content, was evaluated in an environmental release trial. First, GYR plants were compared with the wild-type variety NON-GYR, with regard to phenotypic characters (plant height, crown width, stem diameter, germination rate, leaf dry weight, 1000-seed weight, leave shape). Second, stress resistance in the two varieties (salt, drought, herbicide, and cold resistance) was evaluated under different experimental conditions. Finally, gene flow was estimated. The results indicated that there were significant differences in several agronomic traits (plant height, stem diameter, and leave dry weight) between the transgenic GYR and NON-GYR plants. Salt stress in transgenic and control plants was similar, except under high NaCl concentrations (1.6%, w/w). Leaf water, proline, and MDA content (increased significantly) were significantly different. Transgenic A. annua GYR plants did not grow better than NON-GYR plants with respect to drought and herbicide resistance. The two varieties maintained vitality through the winter. Third, gene flow was studied in an environmental risk trial for transgenic GYR. The maximum gene flow frequency was 2.5%, while the maximum gene flow distance was 24.4 m; gene flow was not detected at 29.2 m at any direction. Our findings may provide an opportunity for risk assessment in future commercialization of transgenic A. annua varieties.