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Platelets are reprogrammed by cancer via a process called education, which favors cancer development. The transcriptional profile of tumor-educated platelets (TEPs) is skewed and therefore practicable for cancer detection. This intercontinental, hospital-based, diagnostic study included 761 treatment-naïve inpatients with histologically confirmed adnexal masses and 167 healthy controls from nine medical centers (China, n = 3; Netherlands, n = 5; Poland, n = 1) between September 2016 and May 2019. The main outcomes were the performance of TEPs and their combination with CA125 in two Chinese (VC1 and VC2) and the European (VC3) validation cohorts collectively and independently. Exploratory outcome was the value of TEPs in public pan-cancer platelet transcriptome datasets. The AUCs for TEPs in the combined validation cohort, VC1, VC2, and VC3 were 0.918 (95% CI 0.889-0.948), 0.923 (0.855-0.990), 0.918 (0.872-0.963), and 0.887 (0.813-0.960), respectively. Combination of TEPs and CA125 demonstrated an AUC of 0.922 (0.889-0.955) in the combined validation cohort; 0.955 (0.912-0.997) in VC1; 0.939 (0.901-0.977) in VC2; 0.917 (0.824-1.000) in VC3. For subgroup analysis, TEPs exhibited an AUC of 0.858, 0.859, and 0.920 to detect early-stage, borderline, non-epithelial diseases and 0.899 to discriminate ovarian cancer from endometriosis. TEPs had robustness, compatibility, and universality for preoperative diagnosis of ovarian cancer since it withstood validations in populations of different ethnicities, heterogeneous histological subtypes, and early-stage ovarian cancer. However, these observations warrant prospective validations in a larger population before clinical utilities.
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Humans , Female , Blood Platelets/pathology , Biomarkers, Tumor/genetics , Ovarian Neoplasms/pathology , ChinaABSTRACT
Objective:To assess the ultrasonographic features and potential diseases of fetal abnormal sylvian fissure(SF), and to explore the value of whole-genome sequencing (WGS) in prenatal detection.Methods:A total of 28 fetuses with a sonographic diagnosis of abnormal SF in Shenzhen Maternal and Child Health Hospital Affiliated to Southern Medical University between October 2018 and October 2020 were prospectively included. The fetal brain was evaluated by neuroultrasound and intrauterine MRI in detail. Amniotic fluid/cord blood obtained by amniocentesis or tissue samples from umbilical cord after birth were collected for WGS. Pregnancy outcomes and postnatal MRI were recorded, and neurodevelopment of live-born infants was followed up for more than 24 months after delivery.Results:During the study period, 28 fetuses with abnormal SF were identified, with a gestational age of 21.3-30.0 (24.8±2.0) weeks. Abnormal SF presented in MCD ( n=15, 53.6%), chromosomal anomalies ( n=3, 10.7%) or single-gene genetic syndromes ( n=3, 10.7%) with the affected fetuses showing developmental delay, hydrocephalus or leukomalacia ( n=4, 14.2%), corpus callosal agenesis with large interhemispheric cysts ( n=1, 3.6%), benign subarachnoid space enlargement with arachnoid cysts ( n=1, 3.6%), and multiple malformations ( n=1, 3.6%). Among the 15 cases with MCD, the most common pathology was lissencephaly/pachygyria, followed by schizencephaly, severe microcephaly, hemimegalencephaly with paraventricular heterotopia, and polymicrogyria. Abnormal SF presented bilaterally in 23 fetuses and unilaterally in 5. All cases were categorized into six types depending on SF morphology in the transthalamic section: no plateau-like or a small insula, linear type, irregular corrugated SF, Z-shaped, and cyst occupying type. In addition to abnormal SF, associated anomalies or mild variations were identified in all fetuses. There were 17 cases underwent intrauterine MRI, and 13 cases underwent postnatal MRI examination.And 25 pregnancies were terminated; 3 were born alive, and 2 had typical syndromic changes with poor neurodevelopmental prognosis. A related pathogenic genetic variant was detected in 57.1% (16/28) fetus, and the incidence of single nucleotide variants(SNVs) was 42.9% (12/28), among which de novo SNVs accounted for 91.7% (11/12). Conclusions:Fetal abnormal SF could be classified based on the ultrasonographic features of transthalamic section. Fetal abnormal SF may indicate MCD, some chromosomal abnormalities or single-gene genetic syndromes that may lead to poor neurodevelopmental outcomes, and may be affected by extra-cortical factors. It is suggested to carry out targeted prenatal genetic diagnosis for fetuses with abnormal SF.
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Objective To study the effect of dexmedetomidine (DEX), an α2- adrenoceptor agonist, on the pain-related anxiety-like and depression-like behaviour induced by complete Freund' s adjuvant (CFA) injection and its possible regulatory mechanism. Methods Thirty-six ICR female mice were randomly divided into normal saline (NS) group, CFA group and DEX + CFA group, n = 12 for each group. Chronic inflammatory pain model was established by subcutaneous injection of 10 μl CFA into the right hind limb of mice. DEX + CFA group mice were injected intraperitoneally with 0.025 mg/kg DEX 30 minutes before nociceptive behavior test, and once a day for 7 days. Von-frey fiber was used to evaluate the threshold of mechanical pain in mice, n = 12 for each group. The anxiety-like behavior of mice were detected by open field test, n = 12 for each group. Sucrose preference, tail suspension test and forced swimming test were used to detected the depression-like behavior of mice, n = 12 for each group. The expression of adrenergic receptor β2 (ADRB2), Brain-derived neurotrophic factor (BDNF), tyrosine kinase B receptor (TrkB), and glutamate receptors 1 (GluR1) and GluR2 were detected by Western blotting, n = 8 for each group. Immunohistochemical staining was used to detect the expression of recombinant doublecortin(DCX), which is a marker of newborn neurons in the hippocampus, n = 4 for each group. Results Compared with the NS group, the mechanical threshold of mice on the 1st, 3rd and 7th day after CFA injection decreased significantly (P 0.05). Compared with the NS group, the time spent in the inner ares (P<0.01), number of entering the central grid area (P<0.01) and distance travelled in the inner area (P<0.01) of CFA group mice reduced significantly, while the time (P<0.01), numbers (P < 0.05) and distance (P < 0.05) of DEX + CFA group mice entering the central grid area enhanced significantly. The result of depression-like behavior tests showed that the sucrose preference percentage (P < 0.05) reduced significantly in CFA group when compared with NS group, and the immobility time increased significantly in tail suspension test (P<0.01) and forced swimming test (P< 0.001) in CFA mice when compared with NS group, while DEX intervention could significantly increase the sucrose preference scores (P<0.05) and decreased the immobility time in tail suspension test (P<0.05) and forced swimming test (P<0.05). The result of Western blotting showed that compared with the NS group, the levels of ADRB2 (P<0.0010), BDNF (P < 0.001), TrkB (P < 0.01), GluR1 (P < 0.001) and GluR2 (P < 0.001) in the hippocampus of CFA group were significantly decreased, while DEX intervention could significantly increase the expression of ADRB2 (P<0.05), BDNF (P < 0.001), TrkB (P < 0.001), GluR1 (P < 0.001) and GluR2 (P < 0.001). Immunohistochemical result showed that compared with the NS group, the average absorbance (AA) of DCX decreased significantly in hippocampus of CFA group (P<0.05), but increased significantly in DEX+CFA group (P < 0.05). Conclusion Dexmedetomidine may promote hippocampal neurogenesis through upregulated the expression of BDNF-TrkB, thus improving CFA-induced anxiety-like and depression-like behaviors in mice.
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Objective:To assess the significance of counting the number of caudal vertebral ossification centers (OCN) below fetal terminal conus medullaris in the screening for closed spina bifida and tethered cord syndrome (TCS).Methods:The OCN was counted in 961 normal fetuses(normal group) between 17 and 41 gestational weeks and in 140 fetuses with closed spina bifida or tethered cord syndrome(abnormal group) from Jan.2013 to Dec.2020 in Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Women and Children′s Hospital, School of Medicine, Xiamen University and Maternity and Child Health Care of Guangxi Zhuang Autonomous Region. The OCN was counted in the dorsal mid-sagittal section of fetal caudal spine.The reliability and agreement test were evaluated by intraclass correlation coefficients in another 50 normal fetuses. The OCN was compared between two groups. ROC curve and the cut-off value were constructed and calculated.Results:In normal group, the N increased with the growing of gestational age.In the subgroup of 17-20 weeks, the OCN ranged from 5 to 7 in most fetuses. In the others subgroups, the OCN was equal to or greater than 6 in 99.9% cases and more than 6 in 97.1% cases. In abnormal group, OCN was less than 7 in 93.0% fetuses and less than 6 in 82.8% cases. There were statistical differences between the two groups except for the subgroup of 17-20 gestational weeks( P<0.05). With the cut-off value of 6.5, the specificity and sensitivity were 93.0% and 94.3% respectively for predicting the presence of closed spinal dysraphism or TCS. Conclusions:OCN is a simple way to evaluate the position of conus medullaris and to screen for the skin-covered spine dysraphism or TSC. OCN is more than 6 in most normal fetuses. Further evaluation of spine is required in fetuses with N less than or equal to 6.
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Objective:To observe the morphological changes of the sylvian fissure on the transthalamic section of fetal brain at 20-32 weeks, and grade the fetal sylvian fissure development by means of a simple scoring system and explore its clinical feasibility.Methods:From September 2018 to June 2020, 487 normal single fetuses of 20-32 weeks were examined in Shenzhen Maternal and Child Health Hospital Affiliated to Southern Medical University. The sylvian fissure maturation was analyzed on the transthalamic section of fetal brain at 20-32 weeks and was graded from 0 to 5: un-visualized (grade 0), shallow arc (grade 1), obtuse-angled platform (grade 2), right-angled platform (grade 3), acute-angled platform (grade 4), and closed operculum (grade 5). The pregnancy outcomes and gestational age were recorded.Statistical analysis was performed by SPSS 20.0 software using box plot, Mann-Whitney U test, Weighted Kappa coefficient. Results:Left sylvian fissuer grades were obtained in 280 fetuses and right sylvian fissure grades were obtained in 247 fetuses. The fetal sylvian fissure maturation at 20-32 weeks was graded from 0 to 5, which increased with advancing gestation. Grade 0 only appeared in 3 fetuses at 20 weeks, and 99.4% fetuses at 20 weeks had grade ≥1. Grade 1 appeared in 20-22 weeks, grade 2 in 20-25 weeks, grade 3 in 22-26 weeks, grade 4 in 25-32 weeks, and grade 5 in 27-32 weeks. Box-plot and Mann-Whitney U test showed that gestational week distribution of sylvian fissure at all grades was symmetric on both sides ( P>0.05). The Weighted Kappa coefficients were 0.857(95% CI=0.750-0.957) and 0.939 (95% CI=0.859-1.000), respectively, with strong consistency regarding inter- and intra-observer agreements. Conclusions:Fetal sylvian fissure maturation at 20-32 weeks can be evaluated by means of a simple scoring system with symmetrical grading of both sides.
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Objective To investigate the alteration of mood and hippocampal microglia morphology in a mouse model of chronic inflammatory pain induced by complete Freund' s adjuvant (CFA). Methods Thirty-two male ICR mice were randomly divided into two groups, including normal saline control group (NS) and CFA model group (CFA). The pain model was established by right hindpaw intraplantar CFA injection. The change of mechanical pain threshold after CFA injection was measured by von Frey fiber needle, the locomotor activity and anxiety-like behavior were determined by open field test (OFT), the depression-like behavior was determined by sucrose preference test (SPT) and forced swimming test (FST). The expression of microglia marker ionized calcium binding adaptor molecule-1 (IBA-1) in the hippocampus was determined by immunohistochemistry and its morphological change was analyzed by Sholl analysis. Results Compared with the NS group, the mechanical pain threshold of CFA group decreased significantly (P<0.01). The behavior result showed that the CFA group showed remarkably reduced time in the inner area (P<0.01) compared with the NS group in the open field test; In the sucrose preference test, the percentage of sucrose preference (P<0.01) of CFA mice decreased significantly compared with the NS mice, while the immobility time of CFA mice (P<0.01) increased significantly in the forced swimming test compared with the NS mice. The immunohistochemistry showed that the number of microglia in the dentate gyrus (DG) of CFA mice increased significantly compared with the NS mice. The Sholl analysis result showed that compared with the NS mice, the number of intersections of microglia in hippocampal DG decreased significantly in CFA mice. Conclusion Our finding indicates that the negative emotions in CFA-induced chronic inflammatory pain may be related to the morphological changes of hippocampal microglia in the mice.
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OBJECTIVE@#To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province.@*METHODS@#The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017.@*RESULTS@#The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01).@*CONCLUSIONS@#Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.
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Humans , Infant , Infant, Newborn , Anti-Bacterial Agents , Birth Weight , Infant, Extremely Low Birth Weight , Intensive Care Units, Neonatal , Surveys and QuestionnairesABSTRACT
Objective:To investigate the therapeutic mechanism of high-frequency repetitive transcranial magnetic stimulation (rTMS) in treating mild amnestic cognitive impairment (aMCI).Methods:Twenty-five patients with aMCI were randomly divided into an observation group of 13 and a control group of 12. The observation group was given 10-Hz rTMS over the left dorsolateral prefrontal cortex at 80% of the motor threshold-400 pulses a day, 5 times a week for 4 consecutive weeks. The control group received sham stimulation on the same schedule. Before and after the experiment, both groups were evaluated using the Montreal cognitive assessment (MoCA) and received fMRI scans.Results:After the intervention, the average MoCA score of the observation group had improved significantly more compared with that of the control group and compared with before the intervention. According to the fMRI results, regional homogeneity in the right middle frontal gyrus of the observation group had increased significantly, while that of the control group both there and in the left precuneus had decreased significantly.Conclusions:High-frequency rTMS can effectively improve the cognitive function of patients with aMCI and synchronize neuron activity in cognition-related brain regions.
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Stroke would result in upper-limb dysfunction. Robot-assisted upper limb rehabilitation is applied in the rehabilitation training after stroke, mainly for intensive and repetitive specific task-oriented training to improve muscle strength and promote the isolated movement of upper limbs for the hemiplegics. However, it can do less for spasm and activities of daily living. It may be more effective combining with other therapies. Although the robots have the advantages of no fatigue, quantification, individualization and objective evaluation, there are also some disadvantages, such as incomplete training, inability to correct compensatory action and lack of empathy, etc. There is still a lack of high quality clinical research of large samples about robot-assisted upper limb rehabilitation, and frequency and time of the treatment is unclear.
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Objective:To observe the efficacy of compound wrist-hand orthosis-assisted training on wrist-hand dysfunction in patients with convalescent stroke. Methods:From June, 2018 to December, 2019, 34 stroke patients in our hospital were randomly divided into control group (n = 17) and experimental group (n = 17). Both groups received basic treatment and routine occupational therapy, while the experimental group wore a compound wrist-hand orthosis during and after the daily occupational therapy. The occupational therapy was carried out 30 minutes a time, twice a day for 14 days, and the non-training time orthosis wearing was carried out cumulative five hours a day for 14 days. Before and after treatment, the Brunnstrom stage (upper limb and hand) and Fugl-Meyer Assessment (FMA) (wrist and hand) were used to assess the motor function of the upper limbs and hands, while the modified Ashworth Scale (MAS) and modified Barthel Index (MBI) were separately used to assess the wrist tension and activities of daily living. Results:Two cases dropped out in the control group. There was no significant difference in Brunnstrom stage, FMA score, MAS score, and MBI score between two groups before treatment (P > 0.05). After treatment, the scores of FMA and MBI significantly improved in both groups (|Z| > 3.420, P < 0.01), and the improvement was higher in the experimental group than in the control group (Z = -2.895, t = 4.331, P < 0.01); while, no significant difference was found in Brunnstrom stages and MAS score in both groups (P > 0.05). Conclusion:The compound wrist-hand orthosis-assisted therapy could improve the wrist-hand motor function and activities of daily living in patients with convalescent stroke.
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OBJECTIVE@#To evaluate the regulation of VEGF-Notch signaling pathway on proliferation and apoptosis of mesenchymal stem cells (MSC) in the patients with aplastic anemia (AA).@*METHODS@#The bone marrow specimens of AA patients were collected for isolation and identification of BM MSC. Westen blot was used to detect the expression of VEGF-Notch signaling pathway-related proteins (VEGF, VEGFR, Notch 1, Jagged 1, Delta-like 1 and Hes1). The VEGF (100 ng/ml) and DAPT (γ-secretase inhibitor, 10 μmol/L) were respectively added into MSC culture system in oder to activate and inhibit the signaling transduction of VEGF-Notch in BM MSC. The proliferation, apoptosis and cell cycle of MSC in AA patients were detected by CCK8 assay and flow cyfometry. The adipogenic differentiation of BM MSC was detected by oil red O staining.@*RESULTS@#The VEGF-Notch signaling pathway was significantly inhibited in AA BM tissues and AA MSC (P＜0.05) detected by Western blot. The intervention of VEGF and DAPT significantly activated and inhibited VEGF-Notch signaling in AA MSC, respectively. CCK8 assay showed that VEGF intervention significantly promoted the proliferation of MSC in AA patients (P＜0.05). Flow cytometry showed that VEGF significantly inhibited apoptosis of MSCs by blocking S phase cells (P＜0.05).@*CONCLUSION@#The activation of VEGF-Notch can restore the proliferation function of MSC in AA patients.
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Humans , Anemia, Aplastic , Apoptosis , Bone Marrow , Cell Proliferation , Mesenchymal Stem Cells , Signal Transduction , Vascular Endothelial Growth Factor AABSTRACT
Objective To disscus the applicability of three surveillance methods for Aedes albopictus in dengue risk indication. Methods Larval and adult mosquito surveillance were conducted in two villages of Guangzhou by using three vector monitoring methods. Meteorological data and dengue cases were obtained in the same period. Results The population dynamics of larvae and adult mosquitoes were affected by temperature and their overall trend was consistent, but there were differences between the abundance of larvae and adult mosquitoes. From December to February the next year, Breteau index(BI) ranged from 5.66 to 24.53 with a risk of level 1 to 3 for dengue fever, while the mosquito and oviposition positive index(MOI) and adult-mosquito density index(ADI) were 0 to 4.00 and 0 to 1 per man-hour, respectively, indicating no risk for dengue fever. In March, compared with BI which indicated a risk of level 3, MOI were 2.13 and 3.77, respectively, representing for no risk. ADI were 4 to 6 per man-hour, indicating a risk of level 1 and level 2, respectively. After April, the dengue risk level reflected by each indicator became to be consistent. Conclusions The risk of dengue fever indicated by BI is always higher than or equal to the risk indicated by the other two. Compared with BI, MOI and ADI are more sensitively in reflecting the activity of Ae. albopictus.
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To explore species diversity of Hypocreaceae, collections from Guangdong, Hubei, and Tibet of China were examined and two new species and a new Chinese record were discovered. Morphological characteristics and DNA sequence analyses of the ITS, LSU, EF-1α, and RPB2 regions support their placements in Hypocreaceae and the establishments of the new species. Hypomyces hubeiensis sp. nov. is characterized by occurrence on fruitbody of Agaricus sp., concentric rings formed on MEA medium, verticillium-like conidiophores, subulate phialides, rod-shaped to narrowly ellipsoidal conidia, and absence of chlamydospores. Trichoderma subiculoides sp. nov. is distinguished by effuse to confluent rudimentary stromata lacking of a well-developed flank and not changing color in KOH, subcylindrical asci containing eight ascospores that disarticulate into 16 dimorphic part-ascospores, verticillium-like conidiophores, subcylindrical phialides, and subellipsoidal to rod-shaped conidia. Morphological distinctions between the new species and their close relatives are discussed. Hypomyces orthosporus is found for the first time from China.
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Objective To understand the epidemiological and molecular characteristics of a norovirus-borne outbreak caused by GⅡ.4 Sydney 2012 in a university of Guangzhou to provide evidence for the prevention and control strategy on norovirus-caused epidemics.Methods A self-designed questionnaire was used to collect clinical information from the patients as well as other data related to the epidemic.Pathogen detections were performed through anal swab specimens from the patients,kitchen workers and samples from the environment.Positive samples were further sequenced for phylogenetic analysis.A case-control study was employed to identify the risk factors related to this outbreak.Results A total of 226 cases of norovirus-borne infection were identified between September 17 and 21,2017,including 223 students,with an attack rate of 0.73％ (223/30 711),and 3 kitchen workers.Students staying in the A dormitory area had the highest attack rate (1.73％,164/9 459).No clustering was found in different colleges or classes.Results from the case-control study revealed that people who ate at the canteen in A dormitory area during September 18 to 20 was at risk for the onset of illness (OR=10.75,95％CI:5.56-20.79).The highest risk was related to the dinner on September 18.Another significant risk factor (OR=3.65,95％ CI:1.92-6.94) was close personal contact in the same room of the dorm.The 3 norovirus infected kitchen workers were all from the canteen in A dormitory area where the positive rate of norovirus identified in kitchen workers was 26.67％ (12/45).Positive samples were sequenced and sub-typed with results showing that the GⅡ.4 Sydney 2012 variant and the nucleotide sequences of cases and kitchen workers were 100％ identical.Conclusions The outbreak was caused by norovirus GⅡ.4 Sydney 2012 variant at campus.Similar outbreaks had been seen since 2013,with the routes of transmission most likely due to food-borne or personal contact.
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Objective To understand the epidemiological and molecular characteristics of a norovirus-borne outbreak caused by GⅡ.4 Sydney 2012 in a university of Guangzhou to provide evidence for the prevention and control strategy on norovirus-caused epidemics.Methods A self-designed questionnaire was used to collect clinical information from the patients as well as other data related to the epidemic.Pathogen detections were performed through anal swab specimens from the patients,kitchen workers and samples from the environment.Positive samples were further sequenced for phylogenetic analysis.A case-control study was employed to identify the risk factors related to this outbreak.Results A total of 226 cases of norovirus-borne infection were identified between September 17 and 21,2017,including 223 students,with an attack rate of 0.73％ (223/30 711),and 3 kitchen workers.Students staying in the A dormitory area had the highest attack rate (1.73％,164/9 459).No clustering was found in different colleges or classes.Results from the case-control study revealed that people who ate at the canteen in A dormitory area during September 18 to 20 was at risk for the onset of illness (OR=10.75,95％CI:5.56-20.79).The highest risk was related to the dinner on September 18.Another significant risk factor (OR=3.65,95％ CI:1.92-6.94) was close personal contact in the same room of the dorm.The 3 norovirus infected kitchen workers were all from the canteen in A dormitory area where the positive rate of norovirus identified in kitchen workers was 26.67％ (12/45).Positive samples were sequenced and sub-typed with results showing that the GⅡ.4 Sydney 2012 variant and the nucleotide sequences of cases and kitchen workers were 100％ identical.Conclusions The outbreak was caused by norovirus GⅡ.4 Sydney 2012 variant at campus.Similar outbreaks had been seen since 2013,with the routes of transmission most likely due to food-borne or personal contact.
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@#Objective To apply the surface electromyography (sEMG) in the evaluation of hand motor function for patients with hemiplegia after stroke. Methods From January to August, 2018, 43 hemiplegic patients with hand dysfunction after stroke were selected. All the patients received comprehensive rehabilitation for four weeks. Their root mean square (RMS) and integrated electromyography (iEMG) of wrist flexor (WF), wrist extensor (WE), extensor digitorum (ED) and abductor pollicis brevis (APB) were measured before and after treatment, while they were assessed with Fugl-Meyer Assessment (FMA) and Brunnstrom's stages for the affected hand. Results The FMA score and Brunnstrom's stages, as well as the RMS and iEMG of WF, WE, ED and APB increased after treatment (Z > 2.496, t > 5.361, P < 0.05). The FMA score positively correlated with the RMS and iEMG of WF, WE, ED and APB (r = 0.423-0.732, P < 0.05). The Brunnstrom's stages positively correlated with the RMS of WE, ED and ABP (r = 0.343-0.467, P < 0.05) and the iEMG of WF, WE and ABP (r = 0.223-0.328, P < 0.05). Multiple linear stepwise regression drew the RMS of ED and iEMG of WE as the related factors for FMA (t > 4.243, P < 0.001), and RMS of ED as the related factors for Brunnstrom's stages (t = 4.707, P < 0.001). Conclusions EMG is an effective tool to evaluate the motor function of hand for stroke patient as an objective and quantitative assessment, especially those of WE and ED.
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Genital size is a crucial index for the assessment of male sexual development, as abnormal penile or testicular size may be the earliest visible clinical manifestation of some diseases. However, there is a lack of data regarding penile and testicular size measurements for Chinese boys at all stages of childhood and puberty. This cross-sectional study aimed to develop appropriate growth curves and charts for male external genitalia among children and adolescents aged 0-17 years in Chongqing, China. A total of 2974 boys were enrolled in the present study. Penile length was measured using a rigid ruler, penile diameter was measured using a pachymeter, and testicular volume was determined using a Prader orchidometer. Age-specific percentile curves for penile length, penile diameter, and testicular volume were drawn using the generalized additive models for location, scale, and shape. Very similar growth curves were found for both penile length and penile diameter. Both of them gradually rose to 10 years of age and then sharply increased from 11 to 15 years of age. However, testicular volume changed little before the age of 10 years. This study contributes to the literature covering age-specific growth curve and charts about male external genitalia in Chinese children and adolescents. These age-related values are valuable in evaluating the growth and development status of male external genitalia and could be helpful in diagnosing genital disorders.
Subject(s)
Adolescent , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Male , Asian People , Body Height , Body Mass Index , China/epidemiology , Cross-Sectional Studies , Genitalia, Male/growth & development , Penis/growth & development , Reference Values , Sexual Maturation , Testis/growth & developmentABSTRACT
Background@#Technical aspects of the correct placement of medial support locking screws in the locking plate for proximal humerus fractures remain incompletely understood. This study was to evaluate the clinical relationship between the number of medial support screws and the maintenance of fracture reduction after locked plating of proximal humerus fractures.@*Methods@#We retrospectively evaluated 181 patients who had been surgically treated for proximal humeral fractures (PHFs) with a locking plate between September 2007 and June 2013. All cases were then subdivided into one of four groups as follows: 75 patients in the medial cortical support (MCS) group, 26 patients in the medial multiscrew support (MMSS) group, 29 patients in the medial single screw support (MSSS) group, and 51 patients in the no medial support (NMS) group. Clinical and radiographic evaluations included the Constant-Murley score (CM), visual analogue scale (VAS), complications, and revision surgeries. The neck-shaft angle (NSA) was measured in a true anteroposterior radiograph immediately postoperation and at final follow-up. One-way analysis of variance or Kruskal-Wallis test was used for statistical analysis of measurement data, and Chi-square test or Fisher's exact test was used for categorical data.@*Results@#The mean postoperative NSAs were 133.46° ± 6.01°, 132.39° ± 7.77°, 135.17° ± 10.15°, and 132.41° ± 7.16° in the MCS, MMSS, MSSS, and NMS groups, respectively, and no significant differences were found (F = 1.02, P = 0.387). In the final follow-up, the NSAs were 132.79° ± 6.02°, 130.19° ± 9.25°, 131.28° ± 12.85°, and 127.35° ± 8.50° in the MCS, MMSS, MSSS, and NMS groups, respectively (F = 4.40, P = 0.008). There were marked differences in the NSA at the final follow-up between the MCS and NMS groups (P = 0.004). The median (interquartile range [IQR]) NSA losses were 0.0° (0.0-1.0)°, 1.3° (0.0-3.1)°, 1.5° (1.0-5.2)°, and 4.0° (1.2-7.1)° in the MCS, MMSS, MSSS, and NMS groups, respectively (H = 60.66, P < 0.001). There were marked differences in NSA loss between the MCS and the other three groups (MCS vs. MMSS, Z = 3.16, P = 0.002; MCS vs. MSSS, Z = 4.78, P < 0.001; and MCS vs. NMS, Z = 7.34, P < 0.001). There was also significantly less NSA loss observed in the MMSS group compared to the NMS group (Z = -3.16, P = 0.002). However, there were no significant differences between the MMSS and MSSS groups (Z = -1.65, P = 0.225) or the MSSS and NMS groups (Z = -1.21, P = 0.099). The average CM scores were 81.35 ± 9.79, 78.04 ± 8.97, 72.76 ± 10.98, and 67.33 ± 12.31 points in the MCS, MMSS, MSSS, and NMS groups, respectively (F = 18.68, P < 0.001). The rates of excellent and good CM scores were 86.67%, 80.77%, 65.52%, and 43.14% in the MCS, MMSS, MSSS, and NMS groups, respectively (χ = 29.25, P < 0.001). The median (IQR) VAS scores were 1 (0-2), 1 (0-2), 2 (1-3), and 3 (1-5) points in the MCS, MMSS, MSSS, and NMS groups, respectively (H = 27.80, P < 0.001). Functional recovery was markedly better and VAS values were lower in the MCS and MMSS groups (for CM scores: MCS vs. MSSS, P < 0.001; MCS vs. NMS, P < 0.001; MMSS vs. MSSS, P = 0.031; and MMSS vs. NMS, P < 0.001 and for VAS values: MCS vs. MSSS, Z = 3.31, P = 0.001; MCS vs. NMS, Z = 4.64, P < 0.001; MMSS vs. MSSS, Z = -2.09, P = 0.037; and MMSS vs. NMS, Z = -3.16, P = 0.003).@*Conclusions@#Medial support screws might help enhance mechanical stability and maintain fracture reduction when used to treat PHFs with medial metaphyseal comminution or malreduction.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Bone Plates , Bone Screws , Fracture Fixation, Internal , Methods , Humerus , Retrospective Studies , Shoulder Fractures , General Surgery , Treatment OutcomeABSTRACT
Objective To study the antiviral effect of Jin Qiao Tablets on influenza A H1N1 virus in vivo. Methods The mouse pneumonia model was established by nasal inhalation of 15 LD50 of influenza virus. After prophylactic or therapeutic medication for 5 d,mouse lung tissue was taken out and weighed. Viral load in lung tissue was measured by polymerse chain reaction(PCR),and the level of γ-interferon(γ-IFN)in rat serum and lung was detected by double antibody sandwich enzyme-linked immunosorbent assay (ELISA)for evaluating the effect of Jin Qiao Tablets on lung index, viral load and γ-IFN in rats. After prophylactic or therapeutic medication for 7 d,morbidity and mortality within 14 d of mice with pneumonia induced by nasal inhalation of 3 LD50 were observed to evaluate the action of Jin Qiao Tablets for protecting against death and prolonging life span. Results Jin Qiao Tablets markedly decreased the increased lung index,promoted the death-protection rate and life-prolongation rate, decreased viral load, raised the level of γ-IFN in mice (P < 0.05 or P < 0.01). Experimental results in vivo showed that Jin Qiao Tablets had better anti-influenza virus activity than Yinqiao Jiedu Tablets and Lianhua Qingwen Capsules, and the effect of Jin Qiao Tablets was equivalent to that of Tamiflu. The prophylactic effect of Jin Qiao Tablets was stronger than the therapeutic effect, but there was no significant difference between them. Conclusion Jin Qiao Tablets have obvious effect against influenza A H1N1 virus in vivo.
ABSTRACT
Objective To design a novel double-leaf proximal humeral locking plate for fixing greater and lesser tuberosities in complex proximal humeral fractures, and evaluate its fixing stability by biomechanical tests. Methods Twelve fresh-frozen humerus specimens with intact rotator cuff were randomly divided into two groups (Group A and Group B) to establish the same greater and lesser tuberosities fracture models. Specimens in Group A were fixed with the double-leaf proximal humeral locking plate, while specimens in Group B were fixed with the proximal humeral internal locking system (PHILOS) and tension band suture, and a 3.5-mm cannulated screw was added to stabilize the lesser tuberosity. The tensile test on subscapularis, infraspinatus and teres, supraspinatus as well as the load-to-failure test on greater and lesser tuberosities were performed on specimens in two groups. Results For subscapularis tensile tests, displacements under 150 N tensile stretch and after fatigue test in Group A were both significantly smaller than those in Group B (P0.05). For supraspinatus tensile tests, there were no statistical differences between Group A and B in displacements under 90 N tensile stretch and after fatigue test (P>0.05). For load-to-failure tests on lesser tuberosity, the failure load in Group A was significantly greater than that in Group B (P0.05). Conclusions Compared with the ordinary tension band suture plus cannulated screw for fixing lesser tuberosity, the novel double-leaf proximal humeral locking plate shows more obvious biomechanical stability, with the advantage of simultaneously fixing greater and lesser tuberosities. The research findings provide a new choice for the clinical treatment of complex proximal humeral fractures.