Research progress of cell death in radiation protection and radiosensitization / 中国辐射卫生

@#The rapid advances in technology and medicine have greatly facilitated the application of ionizing radiation. Clinically, radiotherapy is one of the major treatments for malignant tumors. However, besides killing tumor cells, ionizing radiation inevitably leads to radiation damage and even death of normal cells. How ionizing radiation causes cell death and the forms of cell death have always been important research topics in this field. Recently, several forms of cell death induced by irradiation have been discovered. Apart from apoptosis, pyroptosis, necroptosis, ferroptosis, autophagic cell death, and methuosis have gradually become research hotspots, and provide new targets for the development of radioprotective drugs and radiosensitizers. In this review, we summarize various forms of ionizing radiation-induced cell death and related molecular mechanisms. We also introduce the latest progress in radiation protection and radiosensitization based on these cell death mechanisms. This review will provide a reference for the research and development of radioprotective drugs and radiosensitizers in the future.

Current situation and influencing factors of humanistic care needs of maternal family members in maternal intensive care unit / 中国实用护理杂志

Objective:To investigate the current situation and influencing factors of humanistic care needs of family members of pregnant women in maternal intensive care unit, and to explore the relationship between humanistic care needs of family members of pregnant women in maternal intensive care unit, relocation stress level and perceived social support ability, so as to provide a basis for clinical nursing staff to implement targeted humanistic care for family members of pregnant women in maternal intensive care unit.Methods:From July to December 2022, 267 family members of pregnant women who were observed in the Maternal Intensive Care Unit of Maternity Hospital Affiliated to Nanjing Medical University/Nanjing Maternal and Child Health Hospital were selected as the research objects by the convenient sampling method. The general information questionnaire, Humanistic Care Needs Scale for Family Members of Pregnant Women in the Obstetric Intensive Care Unit, Family Relocation Stress Scale for Intensive Care Unit Patients and Perceived Social Support Scale were used to carry out a cross sectional investigation.Results:The scores of humanistic care needs, relocation stress scale and perceived social support scale were (175.32 ± 16.04), (35.12 ± 8.11), (57.30 ± 15.43) points, respectively. The length of maternal intensive care unit stay ( B=1.301, P<0.05), the family′s role changed for the first time ( B=2.328, P<0.05), the delivery mode doesn′t match the family′s expectations ( B=-2.407, P<0.05), maternal admission to maternal intensive care unit due to childbirth complications ( B=3.228, P<0.05), relocation stress level of intensive care unit patients′ family members ( B=0.891, P<0.05), and family members′ perceived social support ability ( B=0.461, P<0.05) were the influencing factors of humanistic care needs of maternal family members in maternal intensive care unit factors, which explained 83.2% of the total variation. Conclusions:The humanistic care needs of family members of pregnant women in maternal intensive care unit are at a high level. Medical staff should pay more attention to the family members of pregnant women who stay in maternal intensive care unit for a long time, undergo role change for the first time, have unexpected delivery mode and stay in maternal intensive care unit due to childbirth complications, so as to provide them with more comprehensive humanistic care and establish multiple support system, in order to improve the level of humanistic care for the family members of maternal intensive care unit.

Application of Targeted Coronary Angiography in the Diagnosis of Sudden Cardiac Death / 法医学杂志

OBJECTIVES@#To diagnose coronary artery stenosis by using the postmortem computed tomography angiography (PMCTA), and to explore the diagnostic value of PMCTA in sudden cardiac death.@*METHODS@#Six death cases were selected, and the contrast medium iohexol was injected under high pressure through femoral artery approach with 5F pigtail catheter to obtain coronary image data and then the data was analyzed. The results of targeted coronary imaging and coronary artery calcium score (CaS) were compared with the results of conventional autopsy and histopathological examination.@*RESULTS@#The autopsy and histopathological examination of cases with coronary artery stenosis obtained similar results in targeted coronary angiography, with a diagnostic concordance rate of 83.3%. Targeted coronary angiography could effectively show coronary artery diseases, and the CaS was consistent with the results of conventional autopsy and histopathological examination.@*CONCLUSIONS@#Targeted coronary angiography can be used as an effective auxiliary method for conventional autopsy in cases of sudden cardiac death.

Analysis of the current situation and influencing factors of the post-discharge coping difficulties in women with hypertensive disorders of pregnancy / 中华护理杂志

Objective To describe the status of the post-discharge coping difficulties in women with hypertensive disorders of pregnancy(HDP),and to explore its influencing factors.Methods A total of 280 women with HDP from a tertiary A maternity hospital in Nanjing City were investigated with the general information questionnaire,the post-discharge coping difficulty scale-new mother form,the readiness for hospital discharge study-new mother form,the family APGAR index.The factors influencing post-discharge coping difficulties in women with HDP were analyzed using univariate analysis and multiple linear regression.Results 238 valid questionnaires were collected,with a response rate of 85.0%.The score of the post-discharge coping difficulties in women with HDP was 5.07±1.69,which is at a middle level.The results of multiple linear regression analysis showed that parity,primary caregiver during the postpartum period,HDP type,readiness for hospital discharge,family APGAR index were influencing factors of post-discharge coping difficulties in women with HDP(P＜0.05).Conclusion Post-discharge coping difficulties in women with HDP remains to be further improved,and it is affected by many factors.Medical staff should pay more attention to post-discharge coping difficulties of such parturients,formulate targeted continuation care programs according to relevant influencing factors,comprehensively improve their coping ability,and reduce their coping difficulties after discharge.

Neural mechanism for modulation of auditory response of the striatum by locomotion / 南方医科大学学报

OBJECTIVE@#To explore whether the characteristic responses to sound stimulations of the auditory neurons in the striatum is regulated in different behavioral states.@*METHODS@#The auditory neurons in the striatum of awake C57BL/6J mice were selected for this study. We recorded the auditory response of the striatum to noises over a long period of time by building a synchronous in vivo electrophysiological and locomotion recording system and using glass microelectrode attachment recording. By analyzing the running speed of the mice, the behavioral states of the mice were divided into the quiet state and the active state, and the spontaneous activity and evoked responses of the auditory neurons in the striatum were analyzed in these two states.@*RESULTS@#Compared with those recorded in the quiet state, the spontaneous activity of the auditory neurons in the striatum of the mice increased significantly (37.06±12.02 vs 18.51±10.91, P < 0.001) while the auditory response of the neurons decreased significantly (noise intensity=60 dB, 3.45±2.99 vs 3.04±2.76, P < 0.001) in the active state.@*CONCLUSION@#Locomotion has a significant inhibitory effect on the auditory response of the striatum, which may importantly contribute to the decline of sound information recognition ability in the active state.

Impact of bicuspid aortic valve or tricuspid aortic valve on hemodynamics and left ventricular reverse remodeling in patients after transcatheter aortic valve replacement / 中华心血管病杂志

Objective: To compare the impact of bicuspid aortic valve (BAV) or tricuspid aortic valve (TAV) on hemodynamics and left ventricular reverse remodeling after transcatheter aortic valve replacement (TAVR). Methods: We retrospectively analyzed the clinical data of patients who underwent TAVR in our hospital from January 2019 to March 2021. Patients were divided into BAV group and TAV group according to aortic contrast-enhanced CT. Each patient was followed up by N-terminal pro B-type natriuretic peptide (NT-proBNP) and echocardiography at four time points, namely before TAVR, 24 hours, 1 month and 6 months after TAVR. Echocardiographic data, including mean pressure gradient (MPG), aortic valve area (AVA), left ventricular ejection fraction (LVEF), left ventricle mass (LVM) and LV mass index (LVMi) were evaluated. Results: A total of 41 patients were included. The age was (75.0±8.6) years, and male patients accounted for 53.7%. There were 19 BAV patients and 22 TAV patients in this cohort. All patients undergoing TAVR using a self-expandable prosthesis Venus-A valve. MPG was (54.16±21.22) mmHg(1 mmHg=0.133 kPa) before TAVR, (21.11±9.04) mmHg at 24 hours after TAVR, (18.84±7.37) mmHg at 1 month after TAVR, (17.68±6.04) mmHg at 6 months after TAVR in BAV group. LVEF was (50.42±13.30)% before TAVR, (53.84±10.59)% at 24 hours after TAVR, (55.68±8.71)% at 1 month after TAVR and (57.42±7.78)% at 6 months after TAVR in BAV group. MPG and LVEF substantially improved at each time point after operation, and the difference was statistically significant (all P<0.05) in BAV group. MPG in TAV group improved at each time point after operation, and the difference was statistically significant (all P<0.05). LVMi was (164.13±49.53), (156.37±39.11), (146.65±38.84) and (134.13±39.83) g/m2 at the 4 time points and the value was significantly reduced at 1 and 6 months post TAVR compared to preoperative level(both P<0.05). LVEF in the TAV group remained unchanged at 24 hours after operation, but it was improved at 1 month and 6 months after operation, and the difference was statistically significant (all P<0.05). LVMi in TAV group substantially improved at each time point after operation, and the difference was statistically significant (all P<0.05). NT-proBNP in both two groups improved after operation, at 1 month and 6 months after operation, and the difference was statistically significant (all P<0.05). MPG in TAV group improved better than in BAV group during the postoperative follow-up (24 hours after TAVR: (11.68±5.09) mmHg vs. (21.11±9.04) mmHg, P<0.001, 1 month after TAVR: (10.82±3.71) mmHg vs. (18.84±7.37) mmHg, P<0.001, 6 months after TAVR: (12.36±4.42) mmHg vs. (17.68±6.04) mmHg, P=0.003). There was no significant difference in NT-proBNP between BAV group and TAV group at each time point after operation (all P>0.05). There was no significant difference in paravalvular regurgitation and second prosthesis implantation between the two groups (all P>0.05). Conclusions: AS patients with BAV or TAV experience hemodynamic improvement and obvious left ventricular reverse remodeling after TAVR, and the therapeutic effects of TAVR are similar between BAV and TAV AS patients in the short-term post TAVR.

Neoseq for neonatal screening of fatty acid oxidation disorders / 中华围产医学杂志

Objective:To explore the value of Neoseq in screening and diagnosis of neonatal fatty acid oxidation disorders (FAOD).Methods:A retrospective case-control study was conducted on 163 500 live births in Changzhou city from April 2015 to April 2021. The following two models were adopted for FAOD screening and diagnosis. (1) Traditional mode: Heel blood samples were obtained from all subjects for initial screening using tandem mass spectrum (TMS), followed by next-generation sequencing (NGS) and other differential diagnostic testings for those with positive results. (2) Neoseq: Neoseq was performed on the true positive, negative and false positive cases according to the traditional mode screening results. The detection rate, additional discovery, reporting period, and other parameters of the two models for FAOD were described and compared.Results:(1) Detection and diagnosis of FAOD: A total of 18 confirmed cases of FAOD were detected through the traditional model, with an incidence of 1/9 083 in Changzhou city. The positive rate was 0.55% (907/163 500) for initial TMS and 0.04% (73/163 500) for the second. The positive predictive value was 2.0%(18/907), with a false positive rate of 98%(889/907) in the initial screening. (2) The results of Neoseq: ①Pathogenic mutations were detected in 16 of the 18 confirmed cases, and the coincidence rate of mutation sites between the two methods was 16/18. The other two confirmed cases were missed diagnosed by Neoseq, including one β-ketothiolase deficiency with only one detected pathogenic mutation and one medium-chain acyl-CoA dehydrogenase deficiency without any detected pathogenic mutation. ②No pathogenic mutations were detected in the 57 false-positive cases by Neoseq. ③Among the 100 negative cases in initial screening, DUOX2 heterozygous mutation, and MTTL1 hemizygous mutation were detected in one case each. ④The median period of results reporting was 43.5 d (28-104 d) for the traditional mode and 12 d (10-15 d) for the Neoseq mode. Conclusions:Neoseq has a high detection rate for FAOD. Combined with TMS screening, Neoseq reduces the false-positive rate of biochemical screening, rapidly identifies genetic causes by shortening the results waiting time and covers diseases that couldn't be detected by traditional biochemical methods.

Apigenin inhibits liver fibrosis through PDK1/AKT signaling pathway in mice / 中国药理学通报

Aim To evaluate the therapeutic effect of apigenin on liver fibrosis in mice anrl the pharmacologi¬cal mechanism.Methods Carbon tetrachloride ( CC14) -induced liver fibrosis mouse model was estab¬lished.The mice were divided into six groups of con¬trol, model, silibinin(55 mg • kg 1 • d 1 ) , apigenin in high dosage (60 mg • kg 1 • d 1 ) , apigenin in mid¬dle dosage( 30 mg • kg 1 • d 1 ) and apigenin in low dosage( 15 mg • kg 1 • d 1 ).The general life status, body weight and liver coefficient of the mice in every group were recorded.HE staining, Masson staining, immunohistochemistry and Western blot were used to e- valuate the effect of apigenin on the pathological chan¬ges, the markers related to epithelial-mesenchymal transition and signaling pathways of liver tissues.Re¬sults In CCI4-induced liver fibrosis mice, middle and high-dosage of apigenin could improve the general life status, increase body weight, decrease liver coeffi¬ cient, and significantly improve liver lesions.Middle and high-dosage of apigenin significantly increased the expression of the epithelial marker protein E-cadherin and significantly decreased the expression of the mes¬enchymal marker protein Vimentin in liver tissues of mice with the disease.The further results showed that middle and high-dosage apigenin could significantly in¬hibit the expression of phosphorvlated PDK1 and phos- phorvlated AKT protein in liver tissues of model mice.Conclusions Apigenin can inhibit EMT by inhibiting PDK1/AKT signaling pathway, which plays an anti-fi- brosis role.The apigenin has the potential to be further developed as a drug to protect the liver and treat liver fibrosis.

Role of intestinal stem cells in prevention of radiation-induced intestinal injury / 中华放射医学与防护杂志

At present, there is no effective treatment method of radiation-induced intestinal injury. Clinically, only symptomatic remission therapy can be used. Intestinal stem cells (ISCs) have strong renewal ability, which is an important part of intestinal structure regeneration. To promote the recovery of the number and function of ISCs has been a research hotspot in the treatment of radiation gastrointestinal syndrome. This article introduces the important role of ISCs in the protection of radiation-induced intestinal injury and its clinical application significance from the classification and regulatory mechanism of ISCs, and drugs that regulate the damage, apoptosis and repair of stem cells, so as to provide reference for the future research on the role of intestinal stem cells in radiation protection.

Efficacy of Shugan Lidan Decoction in Treating Acute Calculous Cholecystitis and Analysis of Its Mechanism Based on Network Pharmacology / 中国实验方剂学杂志

Objective:To explore the clinical efficacy of Shugan Lidan decoction（SLD） combined with laparoscopic cholecystectomy on acute calculous cholecystitis（ACC），and explore its mechanism based on network pharmacology. Method:In a retrospective analysis， 121 patients with ACC were divided into laparoscopic cholecystectomy+SLD group （observation group， 68 cases） and laparoscopic cholecystectomy group（control group，53 cases）. The postoperative recovery of the patients （time to first exhaust，time to temperature recovery，antibiotic use time and hospitalization time），serum inflammatory factor levels ［white blood cell count（WBC），C-reactive protein（CRP），interleukin-6（IL-6）］，immune index levels［claster of differentiation（CD）3⁺，CD4⁺/CD8⁺，immunoglobulin M（IgM）］ and safety were compared between these two groups. The TCMSP，BATMAN-TCM and TCMIP databases were used to collect all chemical components and targets of SLD. GeneCard and OMIM databases were combined to search ACC-related targets，and then the intersection ones of SLD-related targets and ACC-related targets were extracted to obtain the potential action targets of SLD for treatment of ACC. The STRING database platform was used to establish and analyze the protein-protein interaction （PPI） network，and Bioconductor software package was used for Kyoto encyclopedia of genes and genomes（KEGG） pathway enrichment of the targets. Result:The time to first exhaust，antibiotic use time and hospitalization time of observation group were shorter than those of control group，and the differences were statistically significant（<italic>P</italic><0.05）. After treatment，the postoperative WBC，CRP，IL-6，CD4⁺/CD8⁺ and IgM in the two groups of patients were lower than those before treatment，and the postoperative CD3⁺ was higher than that before treatment，with statistically significant differences（<italic>P</italic><0.05）. The postoperative WBC，CRP，IL-6，CD4⁺/CD8⁺ and IgM in the observation group were lower than those in control group，and the CD3⁺ was higher than that of control group，with statistically significant differences（<italic>P</italic><0.05）. There was no statistical difference in adverse reactions between the two groups. Totally 159 components in SLD were screened，which acted synergistically on key targets such as IL-6，vascular endothelial growth factor A（VEGFA），insulin（INS），and epidermal growth factor receptor（EGFR），and participated in the regulation of HIF-1 signaling pathway，EGFR tyrosine kinase inhibitor resistance and PI3K-Akt signaling pathway in the treatment of ACC. Conclusion:SLD may regulate HIF-1 pathway and other signaling pathways by acting on IL-6，VEGFA，INS，EGFR and other targets，thereby reducing postoperative inflammatory factors，improving immune function，and promoting postoperative recovery in patients with ACC.

Toll-like Receptor Agonists in Radiation Protection / 中国医学科学院学报

Ionizing radiation causes the massive apoptosis of human tissue cells,leading to dysfunction of the gastrointestinal tract and hematopoietic system.Thus,high-efficiency,low-toxicity radiation protection drugs are urgently needed.Toll-like receptor agonists have been developed based on the anti-apoptotic mechanism of tumor cells in recent years,which exert their radioprotective effects by activating downstream pathways,mainly nuclear factor-κB.Here we elucidate several agonists of Toll-like receptors involved in radiation protection,with an attempt to inform the research and development of new radiation protection agents.

Improvement program on pretreatment of acid decalcified tissue in hematoxylin-eosin staining / 华西口腔医学杂志

OBJECTIVE@#To explore the treatment conditions of acid decalcified specimens and improve the poor quality of sections and unclear structure of hematoxylin-eosin (HE) staining caused by the change in pH in tooth and hard tissue after acid decalcification.@*METHODS@#A total of 20 cases of oral pathological specimens that contain hard tissues were decalcified and treated with routine treatment, concentrated ammonia water immersion treatment, and saturated lithium carbonate solution immersion treatment. The quality and HE staining effects of hard tissue sections treated with different methods were compared.@*RESULTS@#Compared with routine treatment, lithium carbonate saturated solution treatment showed complete sections. Hematoxylin is strongly stained, the nucleus is clear, and the cytoplasm is bright.@*CONCLUSIONS@#Soaking acid decalcified specimens in lithium carbonate saturated solution before embedding in dehydration can neutralize the acidic environment of the tissue. The quality of sections and HE staining effect are improved and are suitable for the pretreatment of acid decalcified tissue samples of oral pathology.

Survey on pathogens of co-infection of influenza virus pneumonia among adults in Beijing from 2015 to 2018 / 国际药学研究杂志

Objective: To analyze the co-infection of influenza virus infection pneumonia in Beijing from 2015 to 2018, so as to provide reference for the selection of clinical antibiotics and antiviral drugs. Methods: The 114 influenza virus positive samples were screened out from the influenza virus infected pneumonia samples collected from 23 hospitals in Beijing from January 2015 to December 2018, of which 77 were severe pneumonia. Co-infection of 12 viruses and 11 bacteria in the respiratory tract was detected by fluorescence quantitative PCR. Results: Of the 114 patients with influenza pneumonia, only 22 cases(19.3%)with influenza virus infection were detected, of which 18 cases(15.8%)were infected with influenza A virus and 4 cases(3.5%)were infected with influenza B virus. A total of 92 cases(80.7%)of influenza virus mixed with other pathogens, including 47 cases(51.1%)co-infected with one pathogen, 45 cases(48.9%)co-infected with multiple pathogens Among the cases, influenza A virus and influenza B virus co-infected the most(8.5%); 42 cases(89.4%)were co-infected with bacteria, of which the highest infection rate was methicillin-resistant Staphylococcus aureus, followed by pneumonia Streptococcus and Pseudomonas aeruginosa. Conclusion: More than 80% of patients with severe viral pneumonia of influenza have co-infection of influenza virus and bacteria. The bacterial pathogens co-infected with influenza virus and bacteria in Beijing area from 2015 to 2018 are methicillin-resistant Staphylococcus aureus> Streptococcus pneumoniae> Verdigris Pseudomonas, among which methicillin-resistant Staphylococcus aureus is the most common bacteria co-infected with influenza virus in Beijing in recent years. The results of this study provide a reliable basis for clinical treatment drug screening.

Pancreaticogastrostomy for the treatment of pancreatojejunostomy stricture after pancreaticoduodenectomy:A report of 3 cases / 中国实用外科杂志

OBJECTIVE: To investigate the clinical value of pancreaticogastrostomy(PG) in the treatment ofpancreatojejunostomy stricture(PJS) after pancreaticoduodenectomy(PD).METHODS: The clinical data of 3 patients withPJS who failed the endoscopic treatment underwent PG followed by resection of pancreatojejunostomy(PJ) from May2010 to December 2017 in Department of General Surgery,Xinhua Hospital,Shanghai Jiaotong University School ofMedicine were analyzed retrospectively. After the pancreatointestinal anastomosis was explored and resected, thedigestive tract of the remnant pancreas was reconstructed by using the single-layer bundle pancreaticogastric mucosaanastomosis. The intraoperative and postoperative conditions were observed.RESULTS: The median time of presentationwas 72,37 and 21 months. Three cases of operation were completed successfully. The operation time was 137, 210, 120 min,and blood loss was 210, 350, 180 m L. No pancreatic fistula,surgical bleeding and other serve complicationoccurred postoperatively. All the 3 patients experienced resolution of symptoms without recurrent acute pancreatitis afterPG during the follow-up of 23, 58 and 15 months.CONCLUSION: PG especially duct-to-mucosa PG followed byresection of PJ could be used in the PJS patients who failed the endoscopic treatment.

Whole Genome Sequence Determination and Analysis of Strain CGMCC 12426 / 中国医学科学院学报

Objective To describe the microbiological characteristics of ()CGMCC 12426 and determine and analyze its complete genome sequences.Methods strain CGMCC 12426 genomic DNA sequencing was performed on a single molecule real-time sequencing(SMRT)platform and the annotation was completed in the NCBI Prokaryotic Genomic Annotation Pipeline(pGAP).Results The complete genomic sequences of the released CGMCC 12426 consisted of a 4 138 265-bp circular chromosome and a 74 165-bp plasmid,which resulted in the prediction of 4581 genes including 4222 coding sequences,87 tRNAs,and 30 rRNAs(which included 5S rRNA,16S rRNA,and 23S rRNA).Conclusion The genome sequencing provided a basis for further investigations on the genetic background of and on the metabolic and regulatory mechanisms.

Correlation study on Tibetan medicine Pterocephalus hookeri of bitter taste receptors based on molecular docking technology / 中国中药杂志

In order to study the interaction between Pterocephalus hookeri and bitter taste receptors,three-dimensional structural models of bitter taste receptors TAS2 R16,TAS2 R14 and TAS2 R13 were established by homology modeling in this paper. Maestro software was used for docking the chemical constituents of P. hookeri with bitter taste receptors. The results showed that 25 chemical components of P. hookeri can regulate three bitter taste receptors. And these components were mainly iridoid glycosides and phenolic acids.This research focused on the comprehensive application of homology modeling and molecular docking technology to explore the interaction between bitter chemical constituents of P. hookeri and bitter taste receptors. This study provided assistance in revealing pharmacodynamic basis of bitter Tibetan medicine at molecular level. It also provided new ideas and methods for the study of Tibetan medicine.

Changes in maternal age and its influences on maternal and neonatal complications under the two-child policy / 中华围产医学杂志

Objective To explore the changes in gravida's age and its influences on maternal and neonatal complications under China's two-child policy.Methods This study retrospectively analyzed the clinical data such as adverse gestational complications and fetal condition of 42 771 gravidas delivering at Changzhou Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University from July 2013 to December 2017.According to their age at delivery,they were divided into three groups:the younger maternal age group (1 140 cases,＜20 years),the advanced maternal age group (4 307 cases,≥ 35 years) and the median maternal age group (37 324 cases,≥ 20 and ＜35 years).Chi-square test was used to compare the differences among groups.Cochran-Armitage test was used for trend analysis.The risks of various complications in younger and advanced maternal age groups were analyzed by binary logistic regression analysis.Results (1) The proportion of advanced maternal age pregnancies tended to rise gradually year by year (Z=-9.909,P＜0.001).However,the figure of younger gravidas remained low and presented a downward trend (Z=10.685,P＜0.001).(2) The incidence of pregnant complications in the younger,advanced and the median maternal age groups were 52.8％ (602/1 140),72.3％ (3 116/4 307) and 56.5％ (21 091/37 324),respectively.Compared with the median maternal age group,the advanced maternal age group was at greater risks of premature delivery [9.0％ (3 343/37 324) vs 11.6％ (499/4 307),x2=124.233,P＜0.001],fetal growth restriction (FGR) [0.6％ (218/37 324) vs 1.2％ (50/4 307),x2=20.087,P＜0.001],postpartum hemorrhage [5.7％ (2 120/37 324) vs 7.8％ (336/4 307),x2=31.299,P＜0.05],hypertensive disorders in pregnancy(HDP) [4.2％ (1 561/37 324) vs 8.7％ (376/4 307),x2=180.013,P＜0.001],gestational diabetes mellitus (GDM) [7.6％ (2 845/37 324) vs 15.1％ (650/4 307),x2=280.126,P＜0.001]and placenta previa [1.7％ (621/37 324) vs 3.8％ (165/4 307),x2=97.904,P＜0.001],and the younger maternal age group was at greater risks of HDP [4.2％ (1 561/37 324) vs 5.9％ (67/1 140),x2=4.234,P=0.040],fetal distress [3.5％ (1 325/37 324) vs 5.1％ (58/1 140),x2=7.546,P=0.006],premature delivery [9.0％ (3 343/37 324) vs 15.0％ (171/1 140),22=48.668,P＜0.001] and FGR [0.6％ (218/37 324) vs 1.1％ (12/1 140),x2=4.086,P=0.043].(3) Gestational complications in the younger maternal age group were mainly related to the fetuses such as premature rupture of membranes (PROM) and premature delivery,while the advanced maternal age group had a higher incidence of maternal complications,especially GDM and HDP.(4) Most of the gravidas of advanced maternal age with HDP developed severe preeclampsia (47.9％,180/376),while mild preeclampsia was dominant in the median maternal aged HDP women (45.4％,708/1 561).(5) The advanced maternal age group had higher risk of stillbirth,premature delivery,FGR,placenta previa,GDM,HDP and postpartum hemorrhage [OR(95％CI):1.91 (1.29-2.84),1.33 (1.21-1.46),1.66 (1.21-2.28),2.56 (2.15-3.04),2.39 (2.19-2.61),2.36 (2.11-2.65),1.46 (1.31-1.62);all P＜0.05],but lower risks of fetal distress and PROM [OR(95％CI):0.79 (0.65-0.95) and 0.88 (0.81-0.96);both P＜0.05].The younger maternal age group had a higher risk of premature delivery [OR(95％CI):1.97 (1.61-2.40);P＜0.001],but significant lower risks of PROM and GDM [OR(95％CI):0.77 (0.62-0.95) and 0.05 (0.02-0.16);both P＜0.05].Conclusions Maternal age is closely related to the adverse outcomes of pregnancy.Two-child policy in China will bring about changes in maternal age and composition of pregnant complications.

Inference on Injury Mechanism of Ankle Fracture by Lauge-Hansen Classification / 法医学杂志

OBJECTIVES@#To explore the injury mechanism of ankle fracture inferred by the Lauge-Hansen classification with the application of medical imageology and its application value in forensic medicine.@*METHODS@#A total of 32 ankle fracture cases with known injury mechanism were collected from January 2013 to May 2018, which were identified in Yongkang Public Security Bureau, Zhejiang Province. The Lauge-Hansen classification of ankle fracture was performed by three forensic experts based on the data of X-ray and CT image. Fisher's exact test and Kappa consistency analysis were performed by SPSS 20.0 statistical software to compare the results of the Lauge-Hansen classification with the injury mechanism of ankle fracture obtained through the criminal evidence.@*RESULTS@#In 32 cases, 84.4% （27/32） ankle fractures were classified according to the Lauge-Hansen classification based on medical imaging. The mechanism of ankle fracture identified by the Lauge-Hansen classification was consistent with that obtained through the criminal evidence.@*CONCLUSIONS@#Based on medical imaging, the Lauge-Hansen classification can be well applied to infer the injury mechanism of ankle fracture in part cases, and provide objective evidence for the crime scene reconstruction of criminal cases.

Effects of the relationship between bone cement and endplate on the vertebral height loss after percutaneous vertebroplasty / 复旦学报（医学版）

Objective To investigate the effects of the relationship between bone cement polymethyl methacrylate (PMMA) and endplate on the vertebral height loss after percutaneous vertebroplasty (PVP).Methods A retrospective analysis of 84 female patients with single segment osteoportic vertebral compression fracture who had undergone PVP between Jun.,2013 and May,2016 was conducted.According to the X-ray radiographs and CT scans,all subjects were divided into the doPMMA-endplate-contact group (40 cases,average age 76.88 years) and the non-PMMA-endplatecontact group (44 cases,average age 77.96 years).The volume of bone cement,operation time,fractured vertebral height restoration rate,3-month postoperative vertebral height loss rate,changes in local sagitta view Cobb angle and bone cement leakage rate were respectively recorded and compared.Results There were no significant difference in age,body mass index,the levels of serum calcium and phosphorus,bone mineral density and preoperative vertebral body compression rate between the two groups (P＞0.05).Postoperative vertebral height loss rate and changes in local sagitta view Cobb angle in the do-PMMA-endplate-contact group were significantly less than the non-PMMA-endplate-contact group (P＜0.05).However,there was no significant difference in bone cement leakage rate between the two groups (P＞0.05).Conclusions Making bone cement contact with endplate would reduce the height loss of cemented vertebrae without increasing the rate of cement leakage.

Comparison of the therapeutic effects between penetrating resin and fluoride on early enamel caries / 天津医药

Objective To investigate the therapeutic effects of penetrating resin and fluoride on early enamel caries. Methods Sixty intact bovine incisors were immersed in demineralized solution for 24 hours to make bovine incisor enamel caries.The specimens were divided into four groups(n=15 for each group)according to the treatment methods:control group (CON)-immersion in artificial saliva, DF group-immersion in 0.05% fluoride solution daily, WF group-2% fluoride gel weekly and IC group-resin infiltration.After processing for four and eighe weeks,the microhardness of the surface of each group was measured.After the treatment for four weeks,the depth of penetration and the microhardness of the samples were measured. After 8-week treatment, all samples were reintroduced into the demineralized solution for 24 hours and the microhardness of the samples was measured again.Results Results of microhardness assessment showed that there were no significant differences in baseline values(after white spots)between four groups(P>0.05).After treatment for four weeks the microhardness value reached the peak in IC group. After treatment for eight weeks the microhardness values reached the peak in DF group and WF group.The values of microhardness were significantly higher at different time points in IC group than those of other groups(P<0.05).After 4-week treatment,the percentages of penetration depth were significantly higher in DF,WF and IC groups than those of control group(P<0.01).The penetration depth was significantly higher in IC group than that of DF group and WF group (P<0.05). There was no significant difference in the penetration depth between DF group and WF group(P>0.05).Conclusion For the early enamel caries penetration resin,the penetration percentage is significantly higher than the fluoride treatment.