A systematic review of mouse model construction for sarcopenia / 中国组织工程研究

BACKGROUND:Sarcopenia is a progressive,generalized skeletal muscle disease that is closely related to the occurrence of osteoarthritis,fractures,limb disability and death in the elderly.Establishing animal models of sarcopenia is essential to understand the pathophysiology of sarcopenia and to identify effective treatment strategies. OBJECTIVE:To review the evaluation criteria of mouse models of sarcopenia and the modeling methods of mouse models of sarcopenia,and to analyze and compare the advantages and disadvantages of various modeling methods,in order to provide reference for the research and diagnosis and treatment of sarcopenia. METHODS:"Sarcopenia,skeletal muscle aging,mouse model,animal model"in Chinese and English were used as Chinese and English search terms,respectively.The search formula was"(sarcopenia OR skeletal muscle aging)AND(mouse model OR animal model)."CNKI,WanFang and PubMed were searched for related articles published from January 2010 and October 2022.A total of 59 articles were finally included for analysis. RESULTS AND CONCLUSION:There is a faster modeling time in SAMP8 mice and the type of muscle atrophy is consistent with that of patients with sarcopenia.Therefore,it is an ideal model.Although the surgical method can successfully induce muscle atrophy,it requires precise surgical operation,which is difficult and time-consuming.Hindlimb suspension modeling in mice is similar to that of the elderly and can be regarded as an effective model of senile sarcopenia.Although reagent injection molding is simple to perform,both the dose and number of days of administration of reagents are not clear and need to be further investigated.Transgenic mouse models are less commonly used and their model stability needs further study.The search for a mouse model with low cost,short time consumption and high simulation of human sarcopenia is still a future research direction.

Role of Ferroptosis in Bone Homeostasis and Traditional Chinese Medicine Intervention： A Review / 中国实验方剂学杂志

Osteoporosis （OP） is a systemic metabolic bone disease characterized by bone microstructure degeneration and bone mass loss， which has a high prevalence and disability rate. Effective prevention and treatment of OP is a major difficulty in the medical community. The nature of OP is that multiple pathological factors lead to the imbalance of human bone homeostasis maintained by osteoblasts and osteoclasts. Ferroptosis is a non-apoptotic cell death pathway， and its fundamental cause is cell damage caused by iron accumulation and lipid peroxidation. Studies have shown that ferroptosis is involved in and affects the occurrence and development of OP， which leads to OP by mediating the imbalance of bone homeostasis. Ferroptosis is an adjustable form of programmed cell death. The intervention of ferroptosis can regulate the damage degree and death process of osteoblasts and osteoclasts， which is beneficial to maintain bone homeostasis， slow down the development process of OP， improve the clinical symptoms of patients， reduce the risk of disability， and improve their quality of life. However， there are few studies on ferroptosis in OP. Traditional Chinese medicine （TCM） is a medical treasure with unique characteristics and great application value in China. It has been widely used in China and has a long history. It has the multi-target and multi-pathway advantages in the treatment of OP， with high safety， few toxic and side effects， and low treatment cost， and has a significant effect in clinical application. The intervention of TCM in ferroptosis to regulate bone homeostasis may be a new direction for the prevention and treatment of OP in the future. This article summarized the regulatory mechanisms related to ferroptosis， discussed the role of ferroptosis in bone homeostasis， and reviewed the current status and progress of active ingredients in TCM compounds and monomers in the regulation of OP through ferroptosis， so as to provide a theoretical basis for the participation of TCM in the prevention and treatment of OP in the future.

Death-Related Factors in Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease Treated by Sequential Mechanical Ventilation / 中国医学科学院学报

Objective To analyze the death-related factors of elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) treated by sequential mechanical ventilation,so as to provide evidence for clinical practice. Methods The clinical data of 1204 elderly patients (≥60 years old) with AECOPD treated by sequential mechanical ventilation from June 2015 to June 2021 were retrospectively analyzed.The probability and influencing factors of death were analyzed. Results Among the 1204 elderly patients with AECOPD treated by sequential mechanical ventilation,167 (13.87%) died.Multivariate analysis showed that plasma procalcitonin ≥0.5 μg/L (OR=2.762, 95%CI=1.920-3.972, P<0.001),daily invasive ventilation time ≥12 h (OR=2.202, 95%CI=1.487-3.262,P<0.001),multi-drug resistant bacterial infection (OR=1.790,95%CI=1.237-2.591,P=0.002),oxygenation index<39.90 kPa (OR=2.447,95%CI=1.625-3.685,P<0.001),glycosylated hemoglobin >6% (OR=2.288,95%CI=1.509-3.470,P<0.001),and acute physiology and chronic health evaluation Ⅱ score ≥25 points (OR=2.126,95%CI=1.432-3.156,P<0.001) were independent risk factors for death in patients with AECOPD treated by sequential mechanical ventilation.Oral care>twice/d (OR=0.676,95%CI=0.457-1.000,P=0.048) and sputum excretion>twice/d (OR=0.492, 95%CI=0.311-0.776, P=0.002) were independent protective factors for death in elderly patients with AECOPD treated by sequential mechanical ventilation. Conclusions The outcomes of sequential mechanical ventilation in the treatment of elderly patients with AECOPD are affected by a variety of factors.To reduce the mortality,we put forward the following measures:attaching great importance to severe patients,restoring oxygenation function,shortening unnecessary invasive ventilation time,controlling blood glucose,preventing multidrug resistant bacterial infection,oral care twice a day,and sputum excretion twice a day.

Surgical strategy and clinical outcomes of reoperative aortic root replacement after prior aortic valve replacement / 中国胸心血管外科临床杂志

@#Objective    To summarize the surgical strategy of reoperative aortic root replacement after prior aortic valve replacement (AVR), and analyze the early and mid-term outcomes. Methods    From April 2013 to January 2020, 75 patients with prior AVR underwent reoperative aortic root replacement in Fuwai Hospital. There were 54 males and 21 females with a mean age of 56.4±12.7 years. An emergent operation was performed in 14 patients and an elective operation in 61 patients. The indications were aortic root aneurysm in 38 patients, aortic dissection involving aortic root in 30 patients, root false aneurysm in 2 patients, prosthesis valve endocarditis with root abscess in 2 patients, and Behçet's disease with root destruction in 3 patients. The survival and freedom from aortic events during the follow-up were evaluated with the Kaplan-Meier survival curve and the log-rank test. Results    The operative procedures included prosthesis-sparing root replacement in 45 patients, Bentall procedure in 26 patients, and Cabrol procedure in 4 patients. Operative mortality was 1.3% (1/75). A composite of adverse events occurred in 5 patients, including operative death (n=1), stroke (n=1), and acute renal injury necessitating hemodialysis (n=3). The follow-up was available for all 74 survivors, with the mean follow-up time of 0.5-92.0 (30.3±25.0) months. Four late deaths occurred during the follow-up. The survival rate at 1 year, 3 years and 6 years was 97.2%, 91.4% and 84.4%, respectively. Aortic events developed in 2 patients. The rate of freedom from aortic events at 1 year, 3 years, and 6 years was 98.7%, 95.0% and 87.7%, respectively. There was no difference in rate of survival or freedom from aortic events between the elective patients and the emergent patients. Conclusion    Reoperative aortic root replacement after prior AVR can be performed to treat the root pathologies after AVR, with acceptable early and mid-term outcomes.

Analysis of success rate of organoid construction of nasopharyngeal carcinoma by first-day suspension method / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the efficacy of the first-day suspension method for improving the success rate of construction of nasopharyngeal carcinoma-patient derived organoids (NPC-PDO). Methods: The tumor samples of 14 nasopharyngeal carcinoma(NPC) patients, i.e.,13 males and 1 female, with a mean age of 43.0±12.0 years old, were collected from the Affiliated Tumor Hospital of Guangxi Medical University and the First Affiliated Hospital of Guangxi Medical University from January 2022 to July 2022. The tumor samples of 3 patients were digested into single cell suspension and divided into 2 groups, for comparing the efficacy of NPC-PDO construction by the direct inoculation method and the first-day suspension method. The remaining 11 patients were randomized to receive either the direct inoculation method or the first-day suspension method for NPC-PDO construction. The diameter and the number of spheres of NPC-PDO constructed by the two methods were compared by optical microscope; the 3D cell viability detection kit was used to compare the cell viability; the survival rates were compared by trypan blue staining; the success rates of the two construction methods were compared; the number of cases which could be successfully passaged for more than 5 generations and were consistent with the original tissue by pathological examination was counted; and the dynamic changes of cells in suspension overnight were observed by live cell workstation. The independent sample t-test was applied to compare the measurement data of the two groups, and the chi-square test was used to compare the classification data. Results: Compared with the direct inoculation, the diameter and the number of spheres of NPC-PDO constructed by the first-day suspension method were increased, with a higher cell activity, and the success rate of construction was obviously improved (80.0% vs 16.7%, χ2=4.41, P<0.05). In the suspension state, some of the cells aggregated and increased their ability to proliferate. Conclusion: The first-day suspension method can improve the success rate of NPC-PDO construction, especially for those whose original tumor sample size is small.

Application and challenge of neoadjuvant immunotherapy on perioperative treatment for locally advanced gastric cancer / 国际外科学杂志

The application of immunotherapy in advanced gastric cancer has become a research hotspot. At the same time, the combination of immunotherapy and neoadjuvant therapy is expected to further achieve tumor downstage, pathological remission, increase the proportion of R0 resection, which enhance the overall therapeutic effect of locally advanced gastric cancer (LAGC). Whether neoadjuvant immunotherapy affects perioperative complications, adverse events, tumor pathological responses, and long-term survival in LAGC is still in the initial stage of clinical exploration, which depends on large-scale prospective phase III clinical studies to demonstrate its clinical value. Meanwhile, the application of new innovative drugs and comprehensive perioperative treatment, screening high-specific biomarkers for therapeutic prediction, and weighing the selection of neoadjuvant cycle and interval of treatment-operation time are helpful to optimize and standardize the rational application of neoadjuvant immunotherapy, and ultimately bring benefits to patients.

Functional study of Zinc in regulating M1 polarization of tumor associated macrophages during radical resection of lung cancer / 中华胸心血管外科杂志

Objective:To explore the molecular mechanism of zinc donor regulating macrophage polarization, and to explore the correlation between serum zinc content and the clinical index during radical resection of lung cancer.Methods:One hundred and thirty-two patients who undergoing radical resection of lung cancer were enrolled in this study. The serum zinc content was detected by atomic absorption spectrophotometry before operation. The patients were allocated into high-Zn group and low-Zn group. The blood samples of the included subjects were collected before operation (before), immediately after operation (POP1) and 6 hours after operation (POP2), and the plasma high-sensitivity C-reactive protein (hs-CRP) and catalase were detected. The correlation between serum zinc content and clinical features were analyzed. Metrological statistics was performed by using t test or Mann- Whitney test, and counting statistics was performed by χ2 test. Results:The POP1-hs-CRP[(1.69±0.66)mg/L vs. (1.99±0.43)mg/L, POP2-hs-CRP[(3.51±1.01)mg/L vs. (4.59±0.78)mg/L] and other indicators of high-Zn group were significantly lower than those of low-Zn group.Conclusion:There is a negative correlation between serum zinc content and the inflammation during radical resection of lung cancer, suggesting that appropriate zinc supplementation has a protective effect on radical resection of lung cancer patients.

Relationship between symmetry of lower limb function and gait symmetry in patients with incomplete spinal cord injury / 中国康复理论与实践

ObjectiveTo observe the characteristics of gait symmetry and its influencing factors in patients with incomplete spinal cord injury (ISCI). MethodsFrom May, 2018 to November, 2021, 34 patients with ISCI in Beijing Bo'ai Hospital were divided into symmetrical injury of lower limb (SI) group and asymmetrical injury of lower limb (ASI) group according to the lower extremities motor score (LEMS). Three dimensional motion acquisition system and plantar pressure acquisition system were used for gait test. The symmetry indexes of step length, stance time and swing time were caculated. ResultsThe symmetry indexes of step length, stance time and swing time were significant lower in SI group than in ASI group (|t| > 2.619, P < 0.01). Stance time and swing time significantly correlated to the difference of bilateral LEMS in ASI group (r > 0.468, P < 0.01). Discriminant analysis showed that gait parameter equations were different for patients with different symmetry of lower limb injuries. ConclusionThe symmetry of lower limb motor function impacts gait symmetry for patients with ISCI, especially the difference value of bilateral total LEMS. Gait parameters can be used to determine the symmetry of lower limb injury in patients with ISCI.

Relationship between impairment and magnetic resonance imaging finding in patients with traumatic cervical spinal cord injury after surgery / 中国康复理论与实践

ObjectiveTo explore the application of Brain and Spinal Injury Center (BASIC) score in evaluation of traumatic cervical spinal cord injury. MethodsFrom January, 2015 to December, 2021, 175 patients with traumatic cervical spinal cord injury in Beijing Bo'ai Hospital were analyzed. Gender, age, cause of injury, injury mechanism and American Spinal Injury Association Impairment Scale (AIS) grade were collected. The sagittal and axial T2 weighted imaging (T2WI) of the patients were evaluated with BASIC score, single/multi-segment injury, and with/without intramedullary hemorrhage. According to the injury mechanism, the patients were divided into two groups: with fracture/fracture dislocation (n = 92) and without fracture and dislocation (n = 83). The baseline demographic indicators and T2WI evaluation indicators were compared between the two groups, and the relationship between AIS grade and BASIC score, intramedullary hemorrhage, single/multi-segment injury were investigated. ResultsThere were significant differences in gender, age and AIS grade, BASIC score, and the rates of inntramedullary hemorrhage and single segment injury of T2WI between two groups (t = -10.276, χ2 > 8.703, P < 0.01); however, no difference was found in the cause of injury (P > 0.05). The AIS grade was significantly correlated with the BASIC score (r = 0.790, P < 0.001). There was significant difference in AIS grade between intramedullary hemorrhage or not, and single/multi-segment injury (χ2 > 5.516, P < 0.05). ConclusionThe BASIC score of T2WI is a predictor of the severity of spinal cord injury after traumatic cervical spinal cord injury, and is different with the injury mechanisms.

Comparative analysis of the management practice of including designated retail pharmacies in the outpatient pooling of basic medical insurance / 中国卫生政策研究

Objective:To summarize and analyze the practice of the local practice on covering drugstore bills by pooled funds of basic medical insurance,and provide a reference for improving relevant policies.Methods:The medical insurance policies from various provinces,municipalities,autonomous regions,and coordination areas were systematically retrieved.ROST CM6 software was applied to analyze the high-frequency words and semantic network of the policy text,and combined with the interview and field investigation resultss,the key dimensions of the policy practice were identified and summarized.Then the regional differences,existing problems,and their causes were analyzed to put forward policy recommendations.Result:The selection of pharmacies covered in the payment system with outpatient expenses reimbursed by the pooled fund,the formulation of drug reimbursement list,the design of benefit plans,the management of drug prices and payments,and the supervision of hospital outflow prescriptions were five key dimensions of policy practice.There were significant differences in practice among different regions,and the problems mainly included the overall arrangement of covering pharmacies in the payment system,the mechanism of drug prices in pharmacies,and the coordination with other medical insurance policies.Conclusion:To improve the convenience of buying drugs for the insured,it is necessary to make full use of the advantages of pharmacies to meet the demand for outpatient medicine,promote the transparency of drug prices in pharmacies,coordinate the relevant medical insurance policies,strengthen the collaborative management between the healthcare security administration and relevant departments such as the health commission and the medical products administration,analyze and evaluate the potential effects of policy measures,and adjust policy measures promptly according to local conditions.

Research progress of receptor ，pathway and pharmacological effect of 3-iodothyronine / 中国药房

3-iodothyronamine（T1AM）is an endog enous derivative of thyroid hormone. It can also be used as exogenous drug. It can play pharmacological effects such as reducing cardiac output and coronary flow ，slowing heart rate ，promoting lipolysis ， reducing basic metabolism and improving learning and memory ability. Its regulatory effect on metabolism is similar to that of thyroxine，but regulatory effect on heart and thermogenic function is opposite to that of thyroxine. As a new chemical messenger ， T1AM can exert different pharmacological effects through a variety of receptors and signal pathways. This review summarizes the research progress of various pharmacological effects and mechanisms of exogenous T 1AM，in order to provide new therapeutic drugs of cardiovascular ，metabolic diseases and nervous system diseases.

Domain specific roles of child neglect on the latent profiles of security in children / 中华行为医学与脑科学杂志

Objective:To explore the latent categories of child security and analyze domain-specific roles of child neglect on security among children aged 10-13 years.Methods:From October to December 2019, the security questionnaire (SQ), child neglect scale (CNS) and Buss-Perry aggression questionnaire (BPAQ) were used to investigate 577 children aged 10-13 years. Mplus 7.0 software was used for latent profile analysis (LPA) to explore the latent categories of child security. SPSS 22.0 software was used for multinomial Logistic regression to examine the effects of different domains of child neglect on the child security categories.Results:(1) Child security was divided into three categories named "medium-slightly low-security subgroup (48.9%)" , "high-security subgroup (31.8%)" , and "inability control subgroup (19.3%)" (entropy = 0.90, Lo-Mendell-Rubin likelihood, and Bootstrapped likelihood ratio test, all P<0.01). (2) Child security(35.06±6.08, 51.49±4.99, 69.67±6.13, F=1 378.09, P<0.01), neglect(71.09±20.58, 59.96±12.90, 50.76±9.27, F=74.50, P<0.01), and aggression(54.31±15.23, 46.44±12.46, 34.19±12.61, F=90.95, P<0.01) were significantly different among the "medium-slightly low-security subgroup" , "high-security subgroup" , and "inability control subgroup" . (3)Compared with "high-security subgroup" , the proportion of children with poor parental relationship and low paternal education level were higher in the other two subgroups(all P<0.05), while the proportion of children in the fifth grade were lower(all P<0.05). (4)In " inability control subgroup" , safe neglect had no impact on security( B=0.01, OR=1.02, 95% CI=0.91-1.13, P>0.05), while physical neglect ( B=0.13, OR=1.14, 95% CI=1.01-1.28), affection neglect( B=0.14, OR=1.15, 95% CI=1.07-1.23), and communication neglect( B=0.15, OR=1.16, 95% CI=1.03-1.30) predicted the "inability control subgroup" (all P<0.05). Only communication neglect predicted the "medium-slightly low-security subgroup" ( B=0.16, OR=1.17, 95% CI=1.07-1.28, P<0.01). Conclusion:Security is heterogenous with three latent categories among Children aged 10-13 years. Child neglect plays domain-specific roles in different child security categories.

Reflections on Chinese residents' calcium intake and human health / 中华预防医学杂志

Calcium plays an important role in various physiological activities of the human body, and long-term insufficient or excessive intake of calcium will have a negative impact on the body's health. Existing data show that insufficient dietary calcium intake is closely related to bone health, but the non-bone effects are not clear. Increasing dietary calcium and supplementing calcium (with or without vitamin D) have a certain beneficial effect on the bone mineral density and its peak of adolescents and can delay the bone loss of the elderly, but it can't improve the height and bone mineral density of adults and fracture in the elderly. This article introduces the physiological functions of calcium, dietary sources, human intake, and methods for formulating recommended amounts, and summarizes the relationship between calcium and health effects. It also recommends that when formulating the reference intake of dietary calcium for Chinese residents, more consideration should be given to the data and information of the Chinese population, combined with the characteristics of Chinese residents' genetics, absorption and metabolism.

Analysis of influence factors for short-term recurrence of retroperitoneal liposarcoma after complete resection / 中华外科杂志

Objective: To examine the influence factors of short-term recurrence after complete surgical resection of retroperitoneal liposarcoma. Methods: The clinicopathological data of retroperitoneal liposarcoma at Department of General Surgery, the First Medical Center, People's Liberation Army General Hospital from January 2000 to January 2020 were retrospectively analyzed. There were 60 males and 31 females, aged (52.1±9.9) years (range: 30 to 84 years). Tumor recurrence within 12 months after complete resection was defined as short-term recurrence, and tumor recurrence more than 12 months was defined as non-short-term recurrence. The t test, rank-sum test, χ2 test and Fisher exact test were conducted for inter-group comparison. Logistic regression analysis was used to analyze the independent influence factors for the short-term recurrence of retroperitoneal liposarcoma after complete resection. The Kaplan-Meier curve was used to calculate the recurrence-free survival, and the Log-rank test was adopted for the comparison between the groups. Results: The univariate analysis results showed that irregular tumor morphology, multiple pathological subtypes, pathological scores>3, and multiple primary tumors are influence factors for short-term recurrence after complete resection of retroperitoneal liposarcoma (χ2: 4.422 to 7.773, all P<0.05). Regression analysis of the above risk factors showed that multiple primary tumors was the independent risk factor (OR=2.918, 95%CI: 1.127 to 7.556, P=0.027). In the short-term recurrence group, Kaplan-Meier curve analysis showed that patients with multiple primary tumors had a shorter median recurrence time than patients with unifocal tumor (6 months vs. 9 months, P=0.028). Conclusions: Multiple primary tumor is an independent risk factor for short-term recurrence after complete resection of retroperitoneal liposarcoma. It suggests that the frequency of follow-up after surgery should be increased for such patients.

A nomogram for predicting lymph node metastasis in early gastric cancer / 中华胃肠外科杂志

Objective: To explore the independent risk factors of lymph node metastasis (LNM) in early gastric cancer, and to use nomogram to construct a prediction model for above LNM. Methods: A retrospective cohort study was conducted. Inclusion criteria: (1) primary early gastric cancer as stage pT1 confirmed by postoperative pathology; (2) complete clinicopathological data. Exclusion criteria: (1) patients with advanced gastric cancer, stump gastric cancer or history of gastrectomy; (2) early gastric cancer patients confirmed by pathology after neoadjuvant chemotherapy; (3) other types of gastric tumors, such as lymphoma, neuroendocrine tumor, stromal tumor, etc.; (4) primary tumors of other organs with gastric metastasis. According to the above criteria, 1633 patients with early gastric cancer who underwent radical gastrectomy at the Department of General Surgery of the Chinese PLA General Hospital First Medical Center from December 2005 to December 2020 were enrolled as training set, meanwhile 239 patients with early gastric cancer who underwent gastrectomy at the Department of General Surgery of the Chinese PLA General Hospital Fourth Medical Center from December 2015 to December 2020 were enrolled as external validation set. Risk factors of LNM in early gastric cancer were identified by using univariate and multivariate logistic regression analyses. A nomogram prediction model was established with significant factors screened by multivariate analysis. Area under the receiver operating characteristic curve (AUC) was used for assessing the predictive value of the model. Calibration curve was drawn for external validation. Results: Among 1633 patients in training set, the mean number of retrieved lymph nodes was 20 (13-28), and 209 patients (12.8%) had lymph node metastasis. Univariate analysis showed that gender, resection range, tumor location, tumor morphology, lymph node clearance, vascular invasion, lymphatic cancer thrombus, tumor length, tumor differentiation, microscopic presence of signet ring cells and depth of tumor invasion were associated with LNM (all P<0.05). Multivariate analysis revealed that females, tumor morphology as ulcer type, vascular invasion, lymphatic cancer thrombus, tumor length≥3 cm, deeper invasion of mucosa, and poor differentiation were independent risk factors for LNM in early gastric cancers (all P<0.05). Receiver operating characteristic curve indicated that AUC of training set was 0.818 (95%CI: 0.790-0.847) and AUC of external validation set was 0.765 (95%CI: 0.688-0.843). The calibration curve showed that the LNM probability predicted by nomogram was consistent with the actual situation (C-index: 0.818 in training set and 0.765 in external validation set). Conclusions: Females, tumor morphology as ulcer type, vascular invasion, lymphatic cancer thrombus, tumor length≥3 cm, deeper invasion of mucosa and poor differentiation are independent risk factors for LNM of early gastric cancer. The establishment of a nomogram prediction model for LNM in early gastric cancer has great diagnostic value and can provide reference for treatment selection.

Changes of bone mineral density in distal femur and proximal tibia in patients with spinal cord injury / 中国康复理论与实践

ObjectiveTo investigate the changes of bone mineral density of distal femur and proximal tibia in patients with spinal cord injury. MethodsNine inpatients with spinal cord injury in Beijing Bo'ai Hospital for rehabilitation from November, 2018 to January, 2021 were recruited. The bone mineral density of distal femur, proximal tibia, total hip and femoral neck at admission and six months after admission was measured. ResultsCompared with the results of admission, the bone mineral density of distal femur, proximal tibia, total hip and femoral neck decreased significantly six months after admission (∣Z∣ > 2.265, P < 0.01). The percentage of decreased bone mineral density in the femoral neck was inversely correlated with the lower extremity movement score at the second measurement (r = -0.515, P = 0.035). ConclusionWithin one year after the onset of spinal cord injury, the bone mineral density of distal femur and proximal tibia decreases.

Investigation of P300 evoked by Stroop Color Word Task in children with emotional neglect / 四川精神卫生

ObjectiveTo investigate the P300 evoked by Stroop Color Word Task in children with emotional neglect, and to explore their implication for inhibition control. MethodsA cluster sampling was conducted for the first grade students of a middle school in Sanmenxia City, Henan Province. The students from 3 classes were assessed by standard Raven reasoning test and Child Neglect Scale (CNS), and a total of 147 eligible students were screened out. Children were divided into the emotional neglect group (n=40) and the control group (n=40) according to the 27% before and after the score of CNS emotional neglect factor. Both groups completed the Stroop Color word task, and EEG data were collected to compare the response time, accuracy, amplitude and latency of P300 between the two groups. ResultsThe CNS total score and the scores of safety neglect, communication neglect, physical neglect and emotional neglect factors in the emotional neglect group were significantly higher than those in control group (t=15.003, 4.301, 11.495, 4.803, 23.957, P<0.01). The average reaction time in the incongruent task of emotional neglect group was significantly longer than that in the control group [(879.02±101.52) ms vs. (756.93±113.91) ms, t=5.061, P<0.01]. Under incongruent task, the average amplitude of P300 in emotional neglect group was lower than that of the control group [(3.97±1.12) μV vs. (8.71±1.24) μV, t=-17.976, P<0.01]. The average latency of P300 of emotional neglect group was longer than that of the control group [(361.81±39.69) ms vs. (301.35±33.67) ms, t=7.346, P<0.01]. ConclusionUnder incongruent task, children with emotional neglect had longer response time, longer latency and lower amplitude of P300， which suggested that children with affective neglect may have inhibition and control disorder.

Observational analysis of changes in thyroid function after acute traumatic and infectious abdominal surgery / 国际外科学杂志

Objective:To investigate the thyroid function changes and clinical significance after acute traumatic and infectious abdominal surgery.Methods:The clinical data of patients admitted to the intensive care unit (ICU) for acute traumatic and infectious abdominal surgery during the period from January 1, 2012 to December 31, 2021 in the First Medical Center of People′s Liberation Army General Hospital were retrospectively analyzed using retrospective case-control study. Eligible cases were obtained according to the inclusion and exclusion criteria, and an observation group was set ( n=65). According to the factors such as gender, age, body mass index, and surgical site (organ), a 1∶1 propensity score matching method was used to match the same number of non-traumatic non-infectious abdominal surgery patients admitted in the same time interval, and they were set as the control group ( n=65). The preoperative white blood cells, neutrophils, interleukin -6, c-reactive protein, and procalcitonin were collected, and the thyroid function index for the first time after operation was calculated. The incidence of postoperative thyroid dysfunction was calculated. The thyroid function changes of patients with thyroid dysfunction after exogenous thyroid hormone replacement therapy and the effects on complications and mortality within 30 days were observed. Measurement data of normal distribution were expressed as mean standard deviation( ± s), and t-test was used for comparison between groups. Enumeration data were compared between groups using chi-square test. Results:In the observation group, there were 50 patients with thyroid dysfunction (76.9%). After a 1∶1 match, the baseline of the observation group and the control group was level and comparable. The preoperative inflammatory indexes such as leukocyte, neutrophil ratio, interleukin -6, C-reactive protein and procalcitonin in the observation group were (23.7±5.7)×10 12/L, 0.86±0.13, (66.7±16.3) ng/L, (365.8±77.9) mg/L and (17.9±3.5) μg/L, respectively. Those in the control group were (12.3±2.7)×10 12/L, 0.71±0.04, (8.5±4.7) ng/L, (14.3±6.5) mg/L and (1.3±0.6) μg/L, respectively. The elevations in the observation group were different from those in the control group( P<0.05). In the first postoperative thyroid function test, T3 and FT3 in the observation group were (1.07±0.54) nmol/L and (2.23±1.02) pmol/L, respectively, and those in the control group were (1.61±0.34) nmol/L and (4.36±1.25) pmol/L, respectively. These values in the observation group were significantly lower than those in the control group( P<0.05). On the 10th day after surgery, T3 and FT3 levels in the exogenous thyroid supplementation group rapidly increased and gradually returned to the normal level. In addition, the total hospitalization time of patients in the observation group was significantly shortened, and the incidence and mortality of postoperative complications were reduced. The results in the observation group were (13.47±4.66) d, 17.6% and 11.8%, respectively. The corresponding results in the control group were (16.33±5.18) d, 36.4% and 21.2%, respectively. The difference between the two groups was statistically significant( P<0.05). Conclusion:The incidence of thyroid dysfunction after acute traumatic and infectious abdominal surgery is high, and exogenous thyroxine supplementation can improve the outcome of patients.

Risk factors of postoperative complication after total gastrectomy in advanced gastric cancer patients receiving neoadjuvant chemotherapy / 中华胃肠外科杂志

Objective: At present, there are few studies focusing on the factors short-term complications after total gastrectomy in patients with advanced gastric cancer receiving neoadjuvant chemotherapy (NACT). The purpose of this study is to provide a reference for clinical prevention of complications in these patients. Methods: A retrospective case-control study was conducted. Case inclusion criteria: (1) clinical stage II-III gastric cancer diagnosed by preoperative gastroscopy, pathology, abdominal CT, EUS or PET-CT; (2) evaluated suitable for NACT by MDT discussion; (3) no previous history of other malignant tumors and no concurrent tumor; (4) undergoing total gastrectomy+ D2 lymphadenectomy after NACT. Exclusion criteria: (1) age <18 or >80 years old; (2) severe concurrent diseases, and ASA classification>grade III; (3) stump gastric cancer or history of gastric surgery; (4) incomplete clinicopathological data. According to the above criteria, clinicopathological data of 140 advanced gastric cancer patients who underwent total gastrectomy after NACT in Chinese PLA General Hospital between June 2012 and June 2019 were collected, including 109 males and 31 females with mean age of (56.9±11.4) years and body mass indey (BMI) of (23.3±3.1) kg/m(2). Logistic analysis was used to analyze the relationship between postoperative complication and clinicopathological data. Factors in univariate analysis with P<0.05 were included in the multivariate analysis. Results: Postoperative complications (Clavien-Dindo classification ≥ II) occurred in 35 cases (25.0%) and severe complications (Clavien-Dindo classification ≥ IIIa) occurred in 4 cases (2.9%), including 1 case of esophago-jejunal anastomotic leakage, 1 case of vena cava thrombosis, 1 case of pleural effusion, 1 case of septic shock during perioperative days resulting in death. Univariate analysis showed that BMI (P=0.011), cycle of NACT (P=0.027), tumor diameter (P=0.021), and vascular invasion (P=0.033) were associated with postoperative complication within 30 days, while open/laparoscopic total gastrectomy were not associated with postoperative complication (P=0.926). Multivariate analysis revealed that BMI ≥ 25 kg/m(2) (OR=3.294, 95% CI: 1.343-8.079, P=0.009) and < 4 cycles of NACT (OR=2.922, 95% CI: 1.217-7.016, P=0.016) were independent risk factors for postoperative complication. The 3-year overall survival rates of patients with or without complication were 54.4% and 64.0%, respectively (P=0.395), and 3-year disease-free survival rates were 47.4% and 52.9%, respectively (P=0.587). Conclusions: Higher BMI and fewer cycles of NACT are independent risk factors of postoperative complication in advanced gastric cancer patients undergoing total gastrectomy after NACT. No obvious association is found between postoperative complication and surgical approaches.

Anatomy research on Denonvilliers fascia and its significance in nerve-preservation rectal cancer surgery / 中华胃肠外科杂志

Urinary and sexual dysfunctions due to intraoperative pelvic autonomic nerve injury have become the most common complications of rectal cancer surgery, seriously affecting postoperative quality of life. How to protect the nerve and urogenital function while ensuring radical resection for rectal cancer has become the focus of research. We previously carried out a series of systematic studies on Denonvilliers fascia, an important anatomical structure closely related to protection of pelvic autonomic nerve, and demonstrated the importance of Denonvilliers fascia in preservation of intraoperative pelvic autonomic nerve and protection of postoperative urogenital function from aspects of anatomy, physiology, tissue, operation practice and so on. Meanwhile, based on the interim results of our multicenter randomized controlled study, we confirmed that total mesorectal excision with preservation of Denonvilliers fascia (innovative TME, iTME) could effectively reduce the incidence of postoperative urinary and sexual dysfunctions in male patients with mid-low rectal cancer, without sacrificing oncologic outcome. In this article, combined with our research results, we review the literature on anatomy research progress of Denonvilliers fascia to demonstrate the significance and research prospect of Denonvilliers fascia in the pelvic autonomic nerve preservation surgery for rectal cancer.