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Objective:To investigate the effects of marathon exercise on knee cartilage volume and T2 relaxation time (T2 value) based on MRI.Methods:From December 2018 to December 2021, 25 healthy volunteers without long-distance running habits and 32 non-professional marathon runners with long-term long-distance running were recruited to undergo knee MRI 3D water-selective excitation (three dimensional water-selective excitation, 3D-WATS) and T2 mapping imaging were performed, and the cartilage volumes in 5 knee areas and T2 values in 42 subareas were extracted for analysis. To compare the cartilage volume and its ratio to body surface area of knee joint of healthy volunteers and non-professional marathon runners, the T2 value of cartilage in each subregion, and the correlation between marathon exercise intensity and the volume and T2 value of cartilage in different regions.Results:Compared with healthy volunteers, there was no significant difference in cartilage volume or the ratio of body surface area to body volume of non-professional marathon runners ( P>0.05). There were significant differences between healthy volunteers and non-professional marathon runners in cartilage T2 values of the median layer of medial condyle of femur (47.61±5.65 ms and 44.29±6.10 ms) and the deep layer of medial condyle of femur (36.82±9.05 ms and 31.67±7.59 ms), deep precondylar area of medial femur (38.37±4.68 ms and 34.09±4.19 ms), shallow area of medial condylar area of femur (52.17±11.11 ms and 45.51±7.76 ms), middle layer of medial condylar area of femur (49.09±5.08 ms and 45.63±5.04 ms), medial layer of anterior condylar region of lateral femur (45.69±4.68 ms and 42.57±5.77 ms), superficial layer of posterior condylar region of lateral femur (55.42±18.41 ms and 47.99±8.39 ms), deep layer of anterior tibial medial plateau (33.40±7.76 ms and 29.03±5.69 ms), deep layer of posterior tibial medial plateau (31.28±5.02 ms and 27.92±5.99 ms), deep layer of patellofemoral surface (35.65±6.99 ms and 32.30±5.28 ms), respectively ( P<0.05). In non-professional marathon runners, the medial tibial plateau cartilage volume was negatively correlated with step frequency ( r=-0.371, P=0.035), the lateral femoral condylar cartilage volume was negatively correlated with step frequency ( r=-0.365, P=0.043), and the lateral tibial plateau cartilage volume was negatively correlated with step frequency ( r=-0.550, P=0.001). The T2 value of the medial layer cartilage in the anterior tibial medial plateau region was negatively correlated with body weight ( r=-0.277, P=0.039) and body mass index ( r=-0.290, P=0.030). The T2 value of the superficial layer of patellofemoral surface was negatively correlated with the amount of running in 3 months ( r=-0.457, P=0.010). The superficial T2 value in the posterior lateral plateau of the tibia was negatively correlated with stride length ( r=-0.437, P=0.014), and the medial layer cartilage T2 value in the anterior condylar area of the lateral femur was negatively correlated with stride frequency ( r=-0.380, P=0.035). Conclusion:Marathon exercise had little effect on the knee cartilage volume, but had a certain effect on the cartilage T2 value, resulting in changes in cartilage structure. The higher the step frequency, the smaller the cartilage volume. The greater the body weight or body mass index, the greater the amount of running in 3 months, and the greater the stride length, the lower the cartilage T2 value.
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Objective:To examine the reliability and validity of tolerance of mental pain scale (TMPS-10) in college students.Methods:A total of 2 171 college students were recruited in this study from November to December 2021.Sample 1( n=1 085) was tested for item analysis and exploratory factor analysis from November to December 2021.Sample 2 ( n=1 086) was tested for confirmatory factor analysis, convergence validity, and criterion validity analysis.Ninety-nine cases were randomly selected from sample 2 for retest intraclass correlation efficient (ICC) 30 days later.The questionnaire of suicide attitude (QSA), Beck depression inventory version 2 (BDI-Ⅱ), self-rating anxiety scale (SAS), and Chinese perceived stress scale (CPSS) were used to examine criterion validity of TMPS-10.The SPSS 25.0 and AMOS 21.0 softwares were used for statistical analysis. Results:The exploratory factor analysis extracted two common factors, which explained 72.33% of the total variance contribution rate.The confirmatory factor analysis showed a good model fit ( χ2/ df=7.85, AGFI=0.92, GFI=0.95, TLI=0.96, CFI=0.97, IFI=0.97, RMSEA=0.08). The combined reliability (CR) of the Chinese version of TMPS-10 and its two factors were 0.96, 0.93 and 0.89, and the average variances extracted (AVE) were 0.72, 0.73 and 0.63.The total score of TMPS-10 was positively correlated with the two dimensions of QSA (knowledge of the nature of suicide behavior and attitude to euthanasia) ( r=0.40, 0.09, both P<0.01), while was negatively correlated with the other two dimensions of QSA (attitude to suicide and attitude to suicide family members), and the total scores of BDI-Ⅱ, SAS, and CPSS ( r=-0.30, -0.34, -0.30, -0.45, -0.46, all P<0.01). The Cronbach α coefficients of the Chinese version of TMPS-10 and its two factors were 0.82, 0.89 and 0.93, and the spilt-half reliabilities were 0.85, 0.89 and 0.89.The ICC of the Chinese version of TMPS-10 and its two factors after 30 days were 0.77, 0.87 and 0.86. Conclusion:The Chinese version of TMPS-10 has good reliability and validity among college students, and it can effectively evaluate students' endurance of psychological pain.
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The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.
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Pediatric neurogenic bladder (PNB) is defined as dysfunction of the detrusor and/or urethral sphincter due to myelodysplasia or spinal cord injury, manifesting as impaired urination or defecation, which seriously affects the patients’ quality of life. The main indication for sacral neuromodulation (SNM) is overactive bladder syndrome, which presents as refractory urinary frequency and urgency, urgency incontinence and non-obstructive urinary retention. Age more than 16 years are also recommended for this technique. Previous studies have revealed that SNM could significantly improve the outcome of refractory bladder bowel dysfunction. This paper reviews the advances of the application of SNM in the treatment of pediatric neurogenic bladder so as to provide reference for pediatricians.
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Objective:To assess the application effect of "internet + mobile medicine" on the process management of standardized residency training of obstetrics and gynecology.Methods:A total of 43 teachers including 14 administrators and 29 instructors who were not directly responsible for management, and 41 residents who participated in the standardized training in our base were enrolled as research objects. The data of process management were sorted by internet technology, and combined with personal wishes and casting lots, the residents were divided into two groups: the control group ( n=21) adopted traditional way while the observation group ( n=20) used mobile medicine for process management. By conducting multi-dimensional questionnaire and data comparison, we analyzed the evaluation of teachers and residents, the scores of different stage of residents, and the satisfaction of cervical cancer postoperative patients to medical care under different process management mode. SPSS 22.0 software was used for t test and chi-square test. Results:The application of "internet + mobile medicine" in standardized residency training obtained positive evaluation both by teachers and residents, and the ratio of considering "necessary" to reform the traditional residency training management mode in residents [95.1%(39/41)] and administrators [92.9%(13/14)] were both higher than that in instructors [62.1%(18/29)]. And 78.6%(11/14) of the administrators believed that cloud data management took less time. After 6 months of process management by different modes, the clinical diagnosis and treatment ability and skill operation ability scores of observation group were higher than those of control group [(93.6±5.6) vs. (89.4±5.7); (89.6±8.8) vs. (84.0±8.7)]. The "overall medical satisfaction rate" of cervical cancer patients was relatively high in both groups [100%(30/30) vs. 93.3%(28/30)], and the "very satisfied rate" of patients in the mobile medical group was higher than that in the traditional group [86.7%(26/30) vs. 63.3%(19/30)].Conclusion:The application of "internet + mobile medicine" is conducive to strengthening the process management and optimizing the quality of standardized residency training management of obstetrics and gynecology.
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Lung cancer tops the disease list in the world due to the high incidence and mortality, and about 85% of lung cancer cases is non-small cell lung cancer (NSCLC). Most NSCLC patients are in the advanced stage at the time of diagnosis, with a low 5-year survival. Traditional Chinese medicine (TCM) plays a role in the comprehensive treatment of malignant tumors. Oral Chinese patent medicines, as an important part of TCM, have the advantages of stable preparations, mild taste, simple package, and accurate effective ingredients, which are different from decoctions. They have been widely used in the adjuvant treatment of NSCLC. In clinical practice, the combination of oral Chinese patent medicines with chemotherapy, targeted therapy, or radiotherapy, as well as the application of the oral Chinese patent medicines alone, can increase efficiency, reduce toxicity, prolong the survival time of patients, and improve the quality of life. The mechanisms of oral Chinese patent medicines in the treatment of NSCLC mainly include inhibiting the proliferation, invasion, and metastasis of lung cancer cells, promoting the apoptosis of lung cancer cells, inhibiting tumor neovascularization, reversing multidrug resistance, and regulating the immune functions, which reflects the multi-pathway and multi-target manner of TCM. The oral Chinese patent medicines commonly used in the clinical treatment of NSCLC include Jinfukang oral liquid, Shenyi capsules, Pingxiao capsules, Xiao'aiping tablets, Kanglaite capsules, compound Cantharis capsules, Huisheng oral liquid, Yangzheng Xiaoji capsules, Xihuang pills, Zilongjin tablets, and Cinobufagin capsules. There are many clinical and basic studies about the treatment of NSCLC with these medicines, while a systematic review remains to be carried out. Therefore, we systematically reviewed the mechanisms and clinical application of commonly used oral Chinese patent medicines in the adjuvant treatment of NSCLC, aiming to provide reference for follow-up research and clinical treatment.
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Objective:To investigate the expression of serum circular RNA PUM1 (circPUM1) and microRNA-760 (miR-760) in patients with polycystic ovary syndrome (PCOS) , and their correlation with BMI and biochemical indexes.Methods:A total of 118 patients with PCOS who were diagnosed and treated in Zhengzhou Central Hospital Affiliated to Zhengzhou University from Feb. 2019 to Feb. 2022 were regarded as as the research subjects (PCOS group) . Another 120 women who underwent physical examination in our hospital were regarded as the control group. Real-time quantitative PCR (RT-qPCR) was performed to detect the expression levels of circPUM1 and miR-760 in serum, and to measure serum glucose and lipid metabolism indicators and sex hormone indicators; Pearson method was performed to analyze the correlation between the expression levels of circPUM1 and miR-760, and the correlation between circPUM1 and miR-760 and each index.Results:The expression level of BMI, FBG, FINS, HOMA-IR, TG, estradiol, LH, prolactin and circPUM1 was (23.81±2.85) kg/m 2, (4.87±0.73) ] mmol/L, (8.51±2.18) mIU/L, 1.85±0.69, (1.58±0.57) mmol/L, (182.34±30.47) pmol/L, (7.43±2.05) mIU/ml, (323.45±60.25) mIU/L and 1.05±0.21, while they were (25.24±2.36) kg/m 2, (5.35±0.65) mmol/L, (14.43±4.36) mIU/L, 3.21±1.05, (1.93±0.60) mmol/L, (193.75±38.42) pmol/L, (10.42±2.60) mIU/mL, (372.31±75.44) mIU/L and 1.83±0.45. The expression level of miR-760 was 1.01±0.23 in the control group, while it was 0.77±0.16 in PCOS group. Correlation analysis showed that serum circPUM1 in PCOS patients was negatively correlated with miR-760 ( r=-677, P<0.001) , and serum circPUM1 in PCOS patients was positively correlated with FBG, FINS, HOMA-IR, and TG ( P<0.05) , while was no greatly correlated with other indicators ( P>0.05) , and miR-760 was negatively correlated with FBG, FINS, HOMA-IR, and TG ( P<0.05) , while was no greatly correlated with other indicators ( P>0.05) . Conclusion:The expression level of circPUM1 in serum of patients with PCOS is increased, and the expression level of miR-760 is decreased, which is correlated with glucose and lipid metabolism indicators and can be used to predict the occurrence of metabolic diseases in PCOS patients.
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Traumatic cerebrospinal fluid leakage commonly presents in traumatic brain injury patients, and it may lead to complications such as meningitis, ventriculitis, brain abscess, subdural hematoma or tension pneumocephalus. When misdiagnosed or inappropriately treated, traumatic cerebrospinal fluid leakage may result in severe complications and may be life-threatening. Some traumatic cerebrospinal fluid leakage has concealed manifestations and is prone to misdiagnosis. Due to different sites and mechanisms of trauma and degree of cerebrospinal fluid leak, treatments for traumatic cerebrospinal fluid leakage varies greatly. Hence, the Craniocerebral Trauma Professional Group of Neurosurgery Branch of Chinese Medical Association and the Neurological Injury Professional Group of Trauma Branch of Chinese Medical Association organized relevant experts to formulate the " Chinese expert consensus on the diagnosis and treatment of traumatic cerebrospinal fluid leakage in adults ( version 2023)" based on existing clinical evidence and experience. The consensus consisted of 16 recommendations, covering the leakage diagnosis, localization, treatments, and intracranial infection prevention, so as to standardize the diagnosis and treatment of traumatic cerebrospinal fluid leakage and improve the overall prognosis of the patients.
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Damage to skin, muscle, bone and nerve tissues can result in various degrees of damage to the body, leading to organ dysfunction even life-threatening. To restore the structure and function of the damaged tissues, various immune cells and histocytes have successively participated in the tissue repair process. As the terminally differentiated white blood cells, neutrophils can remove necrotic tissue, debris and pathogens via phagocytosis and release of antimicrobial peptides after tissue injury to provide conditions for subsequent tissue repair process. However, enhanced neutrophils recruitment as well as excessive inflammatory response may also aggravate tissue damage. In recent years, more and more evidences indicate that neutrophils display plasticity and heterogeneity and that play critical roles in the initiation of tissue repair, promotion of angiogenesis, regulation of cell proliferation and so on. Herein, the authors review the recruitment, phenotype and function, role and outcome of neutrophils during tissue repair so as to provide references for future studies.
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Objective:To study the treatment efficacy and safety in using needle-grasper assisted single-port laparoscopic hepaticojejunostomy to treat choledochal cysts in children.Methods:The data of 41 patients with choledochal cysts treated at the Department of Pediatric Surgery, the First Affiliated Hospital of Xiamen University and the Second Hospital of Hebei Medical University from January 2018 to December 2021 were reviewed. There were 8 males and 33 females, aged (2.5±1.9) years. These patients were divided into the needle-grasper assisted single-port laparoscopic hepaticojejunostomy group (needle-grasper group, n=21) and the single-port laparoscopic hepaticojejunostomy group (control group, n=20). Operation time, intestinal function recovery time, gastric tube retention time, abdominal drain indwelling time, postoperative hospital stay, and perioperative complications were compared between the two groups. Results:All 21 children in the needle-grasper group underwent successful surgery without any need to convert to conventional laparoscopic or open surgery. The operation time (156.4±21.2) min was significantly shorter than the control group (218.3±28.6) min ( t=2.95, P=0.017). There were no significant differences in intestinal function recovery time, gastric tube retention time, abdominal drain indwelling time, postoperative hospital stay and perioperative complications between the two groups (all P>0.05). Parents were very satisfied with the cosmetic effect of the invisible scar after surgery. Conclusion:Needle-grasper assisted single-port laparoscopic hepaticojejunostomy was safe, reliable and the operation time was shorter than using a single-port to achieve minimally invasive and scarless surgery.
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Objective To investigate the specificity and targeting abilities of FITC-CSPLNTRFC peptide FITC-BCSP1 optical molecular probe on breast cancer cells Bcap-37. Methods Probe FITC-BCSP1 and negative control probe FITC-svBCSP1 were prepared by solid phase synthesis. MTT assay was used to determine the toxicity of the two probes on breast cancer cells Bcap-37. The specificity of the binding of FITC-BCSP1 probe to Bcap-37 cells was identified by flow cytometry and fluorescent inversed microscopy. The specificity and targeting abilities of FITC-BCSP1 probe for transplantation tumor in Bcap-37 cells tumor-bearing nude mice model were tested by optical molecular imager. Results The purity of the synthesized probe was more than 98%, identified by mass spectrometry and high performance liquid chromatography. FITC-BCSP1 and FITC-svBCSP1 probes had no effect on proliferation and activity of Bcap-37 cells at the concentrations of 50-300 mol/L (IR%≤30%). FCM results showed that the percentage of FITC-BCSP1-labeled cells in Bcap-37 cells was significantly higher than that in other cells (all P < 0.001), and the percentage of FITC-BCSP1-labeled Bcap-37 cells was significantly higher than that of the control group (P < 0.001). It was observed under inverted fluorescence microscope that there were a large number of fluorescent cells in FITC-BCSP1-labeled Bcap-37 cells, with a positive rate of 100%, while the positive rate of FITC-svBCSP1 group was only 1%. In vivo assay with Bcap-37 cells tumor-bearing nude mice model showed that FITC-BCSP1 probe could be specifically enriched in the transplantation tumor tissue. Conclusion The optical molecular probe FITC-BCSP1 has good specificity and targeting abilities on breast cancer cells and can be used in the early diagnosis of breast cancer.
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Bladder cancer (BC) is a common malignant tumor of the urinary system. Common white light cystoscopy is the most important method in the diagnosis and treatment of BC, but its ability to identify small tumors and residual tumors at surgical sites is limited, so it is urgent to develop new diagnosis and treatment techniques. With the rise of the concept of precision medicine, a group of targeted molecules that can specifically bind to BC at the cellular and molecular levels have been discovered in recent years, and the molecular image and targeted therapy based on them can significantly improve the diagnosis and treatment efficiency of BC, with a great potential for clinical application. Based on the latest progress and the research work of our research group, this paper comprehensively analyzes and systematically summarizes the application of targeted molecular carriers in the diagnosis and treatment of BC.
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【Objective】 To evaluate the effect of Arntl on T cell development and T cell-mediated anti-viral immunity. 【Methods】 ArntlF/FCD4cre+(KO) in mice was constructed to delete Arntl gene specifically in T cells. We examined the percentage and number of T cell subsets in the thymus and spleen by flow cytometry (FCM). At day 8 after lymphocytic choriomeningitis virus (LCMV) infection, the proportions of T cell subsets, virus-specific CD8+ T cells and IFN-γ secreting T cells were analyzed. The viral load in the spleen was measured using qPCR. Naive CD4+ T cells (CD4+CD25-CD44-CD62L+) were sorted by flow cytometry to perform T helper cell differentiation in vitro. 【Results】 The percentage and number of T cells in the thymus and spleen of KO mice showed no significant change compared with those in the control group (ArntlF/FCD4cre- mice, WT) (P>0.05). Acute LCMV infection did not cause observable changes in effector T cell proportion in the spleen of KO mice compared to that in WT mice (P>0.05), but KO mice showed a higher proportion of IFN-γ secreting T cells (P<0.05) and better virus clearance (P<0.05). In addition, naive CD4+ T cells from KO mice were more prone to differentiate into Th1 cells in vitro (P<0.05). 【Conclusion】 Arntl deletion in T cells does not affect T cell development, but enhances their ability to defend against viral infection by promoting Th1 cell differentiation and response.
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Objective:To explore the teaching effect of individualized teaching based on problem-based learning (PBL) that applied in gynecology practice teaching under the background of conflicts between postgraduate examination preparation and clinical internship for medical undergraduates.Methods:A total of 157 medical students of the five-year program who started gynecology internship and meanwhile prepared for the postgraduate entrance examination in 2018 were enrolled in the study and divided into two groups randomly. One group received traditional teaching (control group), and the other group received individualized teaching mode based on PBL (observation group). After the internship, the two groups of students were assessed for their theoretical and clinical skills, and the students' evaluation of the teaching effect was acquired through a questionnaire survey. SPSS 22.0 was used to perform chi-square test.Results:The students in observation group had statistically significant higher scores in theory and skill tests than those in the control group ( P<0.001). The evaluation of boosting their enthusiasm for internship, advancing self-learning ability, conducing to improving learning methods in the future, and enhancing clinical skills and thinking ability in the observation group was significantly better than that in the control group ( P<0.05). Conclusion:The individualized teaching model based on PBL could efficiently alleviate the conflicts between internship and postgraduate entrance examination preparation and improve the effect of gynecology practice teaching.
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Objective:To investigate the effects of circ_0000285/miR-127/VAMP2 axis on proliferation and invasion of ovarian cancer (OC) cells.Methods:Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of circ_0000285, miR-127 and VAMP2 in tissue with OC and normal tissue respectively, and the correlation circ_0000285/miR-127/VAMP2 was analyzed by correlation analysis. Dual luciferase reporter assay was used to verify the targeting relationship between miR-127 and circ_0000285/VAMP2. Cell proliferation and invasion were subsequently detected by MTT and Transwell assay.Results:Compared with the paracancerous tissue, the expression of miR-127 was significantly decreased, while the expression of circ_0000285 and VAMP2 was increased in OC tissue. miR-127 was negatively correlated with circ_0000285 and VAMP2 ( r=-0.534 8, P<0.000 1; r=-0.376 6, P<0.000 1) . Compared with proliferative activity at 24 h, 48 h, 72 h (0.47±0.03) (0.79±0.05) (1.16±0.09) and invasion (100.00±12.33) in si-NC group, knocking down of circ_0000285 inhibited the proliferation (0.28±0.02) (0.51±0.04) (0.78±0.06) and invasion (49.22±5.08) of OC cells (all P<0.05) . Overexpression of miR-127 could also restrain proliferation, invasion of OC cells, but this effect can be partly saved by circ_0000285. The regulation circ_0000285 on OC may be realized through miR-127/VAMP2. Conclusions:circ_0000285 participates in the progression of ovarian cancer via regulating miR-127/VAMP2 axis. Down-regulating the expression of circ_0000285 inhibits the proliferation and invasion of ovarian cancer cells, circ_0000285 is expected to play a role in the targeted therapies of OC.
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Traumatic rib fractures are the most common injury in thoracic trauma. Previously,the patients with traumatic rib fractures were mostly treated non-surgically,of which 50%,especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities,being unable to retain a full-time job. In the past two decades,thanks to the development of internal fixation material technology,the surgical treatment of rib fractures has achieved good outcomes. However,there are still some problems in clinical treatment,including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans,and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore,the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association,in conjunction with national multidisciplinary experts,formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures(2021)following the principle of evidence-based medicine,scientific nature and practicality. This expert consensus puts forward some clear,applicable,and graded recommendations from aspects of preoperative imaging evaluation,surgical indications,timing of surgery,surgical methods,rib fracture sites for surgical fixation,internal fixation methods and material selections,treatment of combined injuries in rib fractures,in order to provide references for surgical treatment of traumatic rib fractures.
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Objective:Bioinformatics method was used to screen out prognostic model constructed by the tumor microenvironment (TME)- related genes of adrenocortical carcinoma (ACC), and the prognostic model was verified to provide clinical guidances and related biomarkers for the diagnosis and treatment of ACC.Methods:Transcriptome and clinicopathological data of 79 ACC patients were collected from the Cancer Genome Atlas (TCGA) database. ESTIMATE algorithm was used to calculate immune score, stromal score (both reflect TME) and ESTIMATE score; VennDiagram was used to select differentially expressed genes among immune score, high and low stromal score groups (grouped by median value); Gene Ontology (GO) database and Kyoto Encyclopedia of Genes and Genome (KEGG) database were used to perform functional enrichment analysis on selected genes and to explore the potential function and pathway of genes. Univariate Cox analysis, lasso regression analysis and multivariate Cox analysis were used to screen out genes related to ACC TME and to establish risk score (RS) model for ACC patients. The receiver operating characteristic (ROC) curve was used to evaluate the prognostic value of RS. The data sets GSE33371 and GSE19750 of Gene Expression Omnibus (GEO) were used as external validation sets to validate the prognostic model. The data of 79 ACC patients were extracted from the TCGA database, and the clinicopathological factors and the RS of the established prognostic model were included in the Cox regression analysis to obtain the prognostic factors of ACC patients.Results:According to the immune score and stromal score, 1 205 differentially expressed genes from intersection of both scores were screened out by using VennDiagram, including 833 up-regulated genes and 372 down-regulated genes. After continuing the regression analysis and screening of differentially expressed genes, the ACC prognostic model containing 9 TME-related genes (GREB1, POU4F1, HIC1, HOXC9, CACNB2, RAB27B, ZIC2, C3, CYP2D6) was finally constructed, that was, RS = GREB1×0.223 6+POU4F1×0.671 7+HIC1×0.167 5+HOXC9×0.211 3+CACNB2×0.156 0+RAB27B×0.956 5+ZIC2×0.582 7+C3×(-0.003 1)+CYP2D6×0.819 3. The area under the curve (AUC) of ROC for the 1, 3, and 5-year overall survival of 79 ACC patients predicted by the model in the TCGA database was 0.876, 0.919, 0.917, respectively. In the GEO validation set, the AUC of the 1, 3, and 5-year overall survival for 45 ACC patients predicted by the model was 0.689, 0.704, and 0.708, respectively, indicating that the model had a high prediction accuracy for survival results of ACC patients. Cox regression analysis on the data of 79 ACC patients in the TCGA database showed that the TME-related gene prognostic model RS was an independent factor influencing the prognosis of ACC patients ( HR = 1.011, 95% CI 1.005-1.016, P < 0.01). Conclusions:The established ACC TME-related gene prognostic model can be used to predict the prognosis of ACC patients. The model including 9 genes may become a new target for studying the pathogenesis and immunotherapy of ACC, and it is worthy of further research.
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Objective:To investigate the teaching mode of laparoscopic surgery skills for medical interns and its effect.Method:s New interns were randomly divided into experimental group and control group. The experimental group received the laparoscopic surgery skill training by learning Pick and Place (PP), Scrip Shear (SS), Suture and Knot tying (SK) and Tissue Isolation (TI), and they also received additional training of basic surgery skills before the training of laparoscopic surgery skills, while the control group did not receive the pre-training. Examines and questionnaires were conducted after the training.Result:s There were no significant differences in laparoscopic skills between the two groups at the beginning of the training, but they all had obvious improvement after training ( P<0.01). Compared with the control group, the experimental group did better in PP and SK ( P<0.01), but no differences in SS and TI. The satisfaction rate of training model and skill improvement was 95% and 85% in the experimental group and control group. Conclusion:Short-term program of laparoscopic surgery skill training could effectively improve intern's laparoscopic surgery skills, and the master of basic surgery skills is conducive to the learning of laparoscopic surgery skills.
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Skull defect is commonly seen after traumatic brain injury and is often caused by decompressive craniectomy. Despite from pressure induced deformation or translocation, traumatic skull defect can also lead to multiple pathological influences to the brain, including cerebral blood flow or metabolism reduction, cerebrospinal fluid circulation disturbance, contralateral hematoma or effusion, and cerebral electrical activity changes. Cranioplasty can improve cerebral perfusion and metabolism as well as to support the rectification of cerebrospinal fluid circulation. Currently, early cranioplasty has been well accepted by neurosurgeons for the treatment of skull defect after decompressive surgery for traumatic brain injury, but the exact time point is still under debate and requires further clinical evidence. Therefore, the authors review the research progress of timing and material choices for cranioplasty of patients with skull defect after traumatic current researches, so as to provide possible inspiration for clinical practice.
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Objective:To investigate the property and the combination effect of the peptide specifically binding to human medullary breast cancer Bcap-37 cells by using phage display in vivo and to provide molecular targeting probe for early diagnosis of breast cancer.Methods:The human medullary breast carcinoma Bcap-37 cells tumor-bearing nude mice model was prepared and three rounds in vivo were performed by using Ph.D.-C7CTM phage display peptide library. The distribution of screened phages in tumors and normal tissues was detected by using immunohistochemistry. The affinity of monoclonal phage to Bcap-37 cells was identified by using enzyme linked immunosorbent assay (ELISA). The positive monoclonal phage DNA was taken and sequenced, and the sequence with high repetition rate was selected to synthesize peptide by using chemical methods. Optical molecular probe was prepared and fluorescence molecular imaging was used to test its specificity and targeting ability for breast transplantation tumor of tumor-bearing nude mice in vivo.Results:The recovery rate of phage in the third round screening in vivo was 107.2 times than that in the first round. Immunohistochemical results showed that the phages binding to the tumor tissues were increased successively with the increasing screening rounds in vivo. The number of phages binding to tumor tissues was more than that binding to normal tissues (lung, skeletal muscle, liver and kidney). The absorbancy ( A) value of section scanning image in the tumor tissues was higher than that in the normal tissues, and the difference was statistically significant different ( P < 0.05). ELISA results showed that 22 phages (affinity≥2) among the 50 randomly selected monoclonal phage were positive. After DNA sequencing analysis of the positive monoclonal phage, 4 repeat amino acid sequences were obtained. The fluorescein isothiocyanate-labelled (FITC)-CSPLNTRFC with the highest repetition rate was synthesized for FITC-CSPLNTRFC peptide. Bcap-37 cells tumor-bearing nude mice model assay in vivo showed that FITC-CSPLNTRFC peptide could significantly enriched in the breast xenograft tissues. Conclusion:CSPLNTRFC peptide specifically binding to human medullary breast cancer Bcap-37 cells can be screened out successfully by using phage display in vivo, which will be helpful to vitro studies on the early diagnosis of breast cancer.