Drug resistance and genomic characteristics of a strain of O139 Vibrio cholerae isolated from human bloodstream infection / 中华预防医学杂志

Objective: To analyze the drug resistance and genomic characteristics of a strain of serogroup O139 Vibrio cholerae producing cholera toxin isolated from the bloodstream of a person with bacteremia. Methods: The broth dilution method and automatic drug sensitivity analyzer were used to determine the antibiotic sensitivity of the strain. The complete genome sequence of the strain was obtained by using second-generation gene sequencing and nanopore sequencing. BLAST software was used for comparison and analysis with CARD, Resfinder, ISfinder, VFDB, and other databases. The drug-resistant genes, insertion sequences and virulence genes carried by the strain were identified. MEGA 5.1 software was used to construct a genetic phylogenetic tree based on the core genomic single nucleotide polymorphisms. Results: V. cholerae SH400, as the toxigenic strain, carried multiple virulence-related genes and four virulence islands. The strain was resistant to streptomycin, tetracycline and cotrimoxazole, carrying corresponding drug-resistant genes. The strain also carried IncA/C plasmid with the size of 172914 bp and contained 10 drug-resistant genes. Combined with the genomic evolutionary relationship, this study found that the drug-resistant genes and drug-resistant plasmids carried among strains showed certain aggregation. The traditional ST type of strain SH400 was ST69, and the cgMLST type was a new type highly similar to cgST-252. Conclusion: This strain of serogroup O139 V. cholerae carries the ctxAB gene, multiple drug-resistant genes and IncA/C plasmid, and there are multiple drug-resistant islands.

Treatment and prevention of frontal sinusitis after cerebral frontal sinus surgery / 中国医师进修杂志

Objective:To study the cause of frontal sinusitis and the prevention methods after opened frontal sinus in the trans-frontal approach surgery.Methods:Retrospectively analyze 18 cases of frontal sinusitis secondary to the trans-frontal approach surgery in Sanbo Brain Hospital, Capital Medical University from January 2016 to December 2020. The main symptoms include headache, stuffy nose, skin redness and skin abscess in frontal. The mean history was 3.2 years, all the patients were performed surgical treatment, including 5 patients undergone trans-nasal trans-sphenoid sinus operation, 14 patients undergone debridement surgery following the original surgical approach. The cause of frontal sinusitis were analyzed statistically.Results:All the patients were totally cured post operation, the standard included no frontal sinus inflammation symptoms, no imaging characters of frontal sinusitis.Conclusions:Proper management of opened frontal sinus in trans-frontal approach is very important for preventing the frontal sinusitis. Completely remove the frontal sinus mucosa, avoid using bone wax, chemical glue stuffing, which can effectively prevent the frontal sinusitis.

Craniopharyngioma and anterior central space of brain base / 中国医师进修杂志

Objective:To analyze the surgical (anatomical) approach of craniopharyngioma based on the concept of anterior central space of brain base.Methods:The clinical data of MRI images of 10 cases of craniopharyngioma who treated in Sanbo Brain Hospital, Capital Medical University from January 2021 to December 2021 were analyzed retrospectively. The brain cisterns involved in the growth of craniopharyngioma were analyzed from the perspective of anterior central space of brain base. Meanwhile, the surgical approach and the basis of selection were discussed.Results:Among all the surgical approaches that can reach the anterior central space of the brain base, the fronto-basal interhemispheric approach was the best.Conclusions:The concept of anterior central space of the brain base is a new observation and interpretation of the anatomy of the brain base from a new perspective, and then create a new concept of brain base surgery. As a new method to analyze the surgical anatomy of this area, its inclusion has important clinical significance.

The surgical method and curative effect of resection of craniopharyngioma through sub-frontal longitudinal fissure duramater-keyhole approach / 中国医师进修杂志

Objective:To investigate the surgical method and curative effect of resection of craniopharyngioma through sub-frontal longitudinal fissure duramater-keyhole approach.Methods:The clinical data, imaging data of 179 patients with craniopharyngioma treated by sub-frontal longitudinal fissure duramater-keyhole approach from January 2017 to January 2021 in Sanbo Brain Hospital Capital Medical University were studied retrospectively.Results:Through this approach, total resection in 175 cases (97.77%), near total resection in 2 cases (1.12%), partial resection in 2 cases (1.12%); drilling of the tuberculum sellae in 31 cases (17.32%); the pituitary stalk was reserved in166 cases (92.74%), preserved in 13cases (7.26%); papillary craniopharyngioma in 27 cases (15.08%), ameloblastic craniopharyngioma in 152cases (84.92%); postoperative visual acuity improved in 65 cases (36.31%), not improved in 53 cases (29.61%), decreased in 6 cases (3.35%); electrolyte disorder in 101 cases (56.42%), polydipsia and polyuria in 65cases (36.31%), cerebrospinal fluid rhinorrhea in 3 cases (1.68%), hydrocephalus in 6 cases (3.35%). Postoperative hematoma in 2 (1.12%) cases and cerebral infarction in 6 cases (3.35%), intracranial infection in 8 cases (4.47%), postoperative disturbance of consciousness in 4 cases (2.23%) and death in 3cases (1.68%).Conclusions:Sub-frontallongitudinal fissure duramater-keyhole approach is an effective combination of minimally invasive and delicate surgery principle. It is a safe and effective method for the treatment of craniopharyngioma.

Predictive value of SYNTAX-Ⅱ score on prognosis of patients with chronic total occlusion undergoing percutaneous coronary intervention / 中华心血管病杂志

Objective: To investigate the predictive value of SYNTAX-Ⅱ score on long term prognosis of patients diagnosed with chronic total occlusion (CTO) and received percutaneous coronary intervention (PCI). Methods: Patients undergoing CTO-PCI in Fuwai hospital from January 2010 to December 2013 were enrolled in this retrospective analysis. The SYNTAX-Ⅱ score of the patients was calculated. According to SYNTAX-Ⅱ score tertiles, patients were stratified as follows: SYNTAX-Ⅱ≤20, 20<SYNTAX-Ⅱ≤27, SYNTAX-Ⅱ>27. Primary endpoint was major adverse cardiac events (MACCE), including all-cause death, myocardial infarction, stroke and any revascularization. Secondary endpoints included stent thrombosis, heart failure and target lesion failure (TLF). Patients were followed up by outpatient visit or telephone call at 1 month, 6 months and 1 year after PCI, and annually up to 5 years. Multivariate Cox regression model was used to analyze the independent risk factors of all-cause death in patients undergoing CTO-PCI. The predictive value of SYNTAX score with SYNTAX-Ⅱ score for all-cause death was evaluated by the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Results: A total of 2 391 patients with CTO and received PCI were enrolled in this study. The mean age was (57.0±10.5) years, 1 994 (83.40%) patients were male. There were 802 patients in lower tertile group (SYNTAX-Ⅱ≤20), 798 patients in intermediate group (20<SYNTAX-Ⅱ≤27) and 791 patients in upper tertile group (SYNTAX-Ⅱ>27). At the end of 5-year follow-up, the loss to follow-up rate of the three groups was 9.10%(73/802), 10.78%(86/798)and 8.85%(70/791), respectively. The rate of all-cause mortality (1.78% (13/729) vs. 3.65% (26/712) vs. 9.02% (65/721), P<0.001), cardiac death (1.37% (10/729) vs. 2.11% (15/712) vs. 4.85% (35/721), P<0.001), target vessel myocardial infarctions (4.25% (31/729) vs. 4.49% (32/712) vs. 7.07% (51/721), P=0.03), probable stent thrombosis (1.51% (11/729) vs. 2.81% (20/712) vs. 3.61% (26/721), P=0.04) and heart failure (1.78% (13/729) vs. 1.97% (14/712) vs. 5.41% (39/721), P<0.001) increased in proportion to increasing SYNTAX-Ⅱ score (all P<0.05). Multivariable Cox regression analysis indicated that female (HR=2.05, 95%CI 1.12-3.73, P=0.01), left ventricular ejection fraction (HR=0.97, 95%CI 0.95-1.00, P=0.05) and SYNTAX-Ⅱ score (HR=1.07, 95%CI 1.02-1.11,P=0.01) were independent predictors for all-cause mortality in patients undergoing CTO-PCI. The predicted value of the SYNTAX-Ⅱ score for all-cause death was significantly higher than the SYNTAX score (AUC 0.71 vs. 0.60, P=0.003). Conclusion: For CTO patients who underwent percutaneous coronary intervention, SYNTAX-Ⅱ score is an independent predictor for 5-year all-cause death, and SYNTAX-Ⅱ serves as an important predictor for all-cause death in these patients.

Application and reflection of laboratory-based monitoring in early warning of infectious diseases / 中华预防医学杂志

Despite the fact that our cognition towards infectious disease prevention, the advanced technology and the economic status of the whole society has made a great progress in the last decade, the outbreak of COVID-19 pneumonia has again enabled the public to acquire more about super-challenges of infectious diseases, epidemics and the relevant preventive measurements. In order to identify the epidemic signals in early stage or even before the onset of epidemic, the data research and utilization of a series of factors related to the occurrence and transmission of infectious diseases have played a significant role in research of prevention and control during the whole period of surveillance and early warning. Laboratory-based monitoring for the etiology has always been an important part of infectious disease warning system due to pathogens as the direct cause of such diseases. China has initially established a laboratory-based monitoring and early warning system for bacterial infectious diseases based on the Chinese Pathogen Identification Network with an aim to identify pathogens, outbreaks and sources. This network has played an essential role in early detection, tracking and precise prevention and control of bacterial infectious diseases, such as plague, cholera, and epidemic cerebrospinal meningitis. This issue focuses on the function of laboratory-based monitoring during the period of early warning, prevention, and control of bacterial infectious diseases, and conducted a wide range of researches based on the analysis of the epidemic and outbreak isolates, together with field epidemiological studies and normal monitoring systems. All of these could illustrate the effect of laboratory surveillance in the infectious disease risk assessment and epidemic investigation. At the same time, we have put forward our review and expectation of scenarios about laboratory-based monitoring and early warning technologies to provide innovative thoughts for promoting a leapfrog development of infectious disease monitoring and early warning system in China.

Comparative Study of the Genetic Diversity, Antimicrobial Resistance, and Pathogenicity of / 生物医学与环境科学（英文）

Objective@#This study was performed to compare the genetic diversity, virulence, and antimicrobial resistance of @*Methods@#A total of 38 clinical strains and 19 strains from healthy individuals were isolated from the samples collected in Ma'anshan City, Anhui Province. Their taxonomy was investigated using concatenated @*Results@#The 57 @*Conclusions@#The taxonomy, virulence properties, and antibiotic resistance of

Free carnitine levels in peripheral blood of healthy pregnant women in third trimester and their relationship with maternal and fetal cardiac function and structure / 中华围产医学杂志

Objective:To investigate the levels of periphreal blood free carnitine and amino acids in healthy pregnant women in the third trimester and their association with maternal, fetal, and neonatal cardiac function and structure.Methods:This prospective descriptive study included healthy singleton pregnancies who underwent routine obstetric examination and delivered in two district maternal and child health hospitals (one in the urban and one in the suburb an area) in Beijing from June 2017 to February 2018. All recruiters had serology Down's syndrome screening test at (18±1) gestational weeks. Besides measurement of amino acids and free carnitine levels in whole blood and urine samples by liquid chromatography-tandem mass spectrometry, all cases underwent maternal and fetal echocardiography at (35±1) weeks of gestation. And neonatal echocardiography was performed after delivery to assess the heart function and structure. Antenatal factors were also collected, including maternal education background, age at first marriage and conception, gravidity, and folic acid supplement in early pregnancy. Statistical analysis was performed using t-test, ANOVA, Chi-square test, Pearson correlation coefficient, and Kappa test. Results:A total of 493 mother-neonate dyads were enrolled in this study. Blood free carnitine levels in the healthy pregnant women in the third trimester ranged from 5.09 to 59.17 μmol/L (reference value: 10.00-50.00 μmol/L) with an average value of (13.03±3.87) μmol/L. None was found with structural abnormalities by cardiac ultrasound, showing an average left ventricular end diastolic diameter (LVEDD) and end systolic diameter (LVESD) of (45.70±3.08) mm and (29.17±3.12) mm, respectively, and left ventricular ejection fraction (LVEF) of all cases were over 55%. No cardiac malformation was detected by the third-trimester fetal echocardiography. The average birth weight of the 493 newborns was (3 340±313) g. Those whose birth weight <2 500 g and >4 000 g were accounted for 1.0% (5 cases) and 3.0% (15 cases) with the average maternal blood free carnitine level of (13.25±2.17) μmol/L (10.46-19.21 μmol/L) and (12.64±2.50) μmol/L (8.78-17.73 μmol/L) ( t=0.42, P>0.05). The average LVEDD and LVESD of the 493 newborns were (17.21±1.27) mm and (11.03±1.30) mm, respectively. For the 64 newborns (13.0%) whose LVEF<60%, the maternal blood free carnitine level was (12.93±2.78) μmol/L (7.34-22.13 μmol/L), showing no statistical difference ( t=-0.29, P>0.05) with those 59 neonates (12.0%) whose LVEF over 75% and maternal carnitine level of (13.09±3.24) μmol/L (8.66-27.49 μmol/L). All cases were divided into four groups based on the quartiles of maternal blood free carnitine level and no significant difference in maternal or neonatal LVEDD or LVEF was observed among these groups (all P>0.05). Conclusions:Blood free carnitine concentration in healthy pregnant women in the third trimester is at the lower limit of normal range, and no significant effect on maternal cardiac function and fetal cardiac structure is seen. However, the effect of low maternal carnitine level in the third trimester on children's myocardial function and whether carnitine should be supplemented in the third trimester are worthy of further investigation with larger sample size.

Clinical and neuroimaging features and survival time of atypical teratomatoid / rhabdoid tumors of the central nervous system / 中国综合临床

Objective:To investigate the clinical and neuroimaging features of atypical teratoid/rhabdoid tumors (AT/RT) of the central nervous system and the survival prognosis in different locations.Methods:The clinical data of 27 patients with AT/RT confirmed by biopsy or postoperative pathology in Sanbo Brain Hospital of Capital Medical University from October 2012 to September 2020 were collected, including 17 males and 10 females, aged (7.6±10.0) years, ranging from 0.2 to 39.0 years old.The clinical features and the results of the first preoperative imaging examination were retrospectively analyzed.The patients were divided into supratentorial, infratentorial and trans supratentorial and infratentorial groups according to the location.The survival time of the three groups was compared by Kaplan-Meier survival curve.Results:All patients presented with headache, including 12 cases with vomiting.There were 12 cases of supratentorial, 10 cases of infratentorial and 5 cases of supratentorial and infratentorial.There were 20 cases of cystic degeneration, 7 cases of calcification, 6 cases of hemorrhage and 13 cases of peritumoral edema.The median survival time of patients with infratentorial AT/RT was longer than that of patients with supratentorial and transtentorial AT/RT (χ 2=7.353, P=0.025). Conclusion:Central nervous system AT/RT is easy to occur in young children, and the survival time of AT/RT patients is longer.

Five-year clinical outcomes of patients with in-stent chronic total occlusion undergoing percutaneous coronary intervention / 中华心血管病杂志

Objective: To evaluate the safety and long-term clinical efficacy of percutaneous coronary intervention (PCI) in patients with in-stent chronic total occlusion (IS-CTO) lesions. Metheds: This is a retrospective analysis. Patients with IS-CTO who underwent PCI in Fuwai hospital from January 2010 to December 2013 were enrolled. A total of 212 patients who met the inclusion criteria were included in the IS-CTO group, 212 matched patients with primary CTO lesions were included in the de novo CTO group. The incidence of complications and the success rate of PCI were compared between the two groups. Successful PCI was defined as successfully implantation of stent(s) at target CTO lesions. The primary endpoint was defined as a composite event of cardiac death and myocardial infarction (MI). Secondary endpoints including PCI success, all-cause death, cardiac death, MI, target vessel related MI, revascularization, target vessel revascularization, heart failure for rehospitalization. The patients were followed up for 5 years after PCI. Results: A total of 424 cases were included. The mean age was (57.8±10.5) years, there were 364 males in this cohort. The left ventricular ejection fraction was significantly lower ((58.7±9.2)% vs. (61.0±7.7)%, P=0.01) and the SYNTAX scores was significantly higher (19.4±8.3 vs. 15.3±10.0, P<0.01) in IS-CTO group than that in de novo CTO group. The proportion of patients with target CTO lesions in left anterior descending artery was significantly higher (42.9% (50/212) vs. 23.6% (91/212), P<0.01) in IS-CTO group than that in de novo CTO group. The rate of successful PCI (71.7% (152/212) vs. 69.8% (148/212), P=0.70) and complication (40.6% (86/212) vs. 36.3% (77/212), P=0.37) was similar between the two groups. The incidence of primary endpoint at 5 years was significantly higher in IS-CTO group (10.8% (23/212) vs. 4.7% (10/212), P=0.02), which was driven by higher incidence of MI (9.0% (19/212) vs. 4.2% (9/212), P=0.05). There were a trend of higher secondary endpoints in IS-CTO group (all P>0.05). Conclusion: The safety and effectiveness of PCI are acceptable in patients with IS-CTO, but the risk of long-term cardiac death and MI is higher among patients with IS-CTO as compared to patients with primary CTO lesions.

The safety and efficacy of Firesorb bioresorbable scaffold in first-in-man study for coronary artery disease: the four-year outcomes / 中华心血管病杂志

Objective: To evaluate the 4-year clinical outcomes of patients following Firesorb bioresorbable scaffold (BRS) implantation. Methods: The study reported the 4-year follow-up results of the FUTURE I study. FUTURE I was a prospective, single-center, open-label, first-in-man study which evaluated the feasibility, preliminary safety, and efficacy of Firesorb stent in the treatment of coronary artery stenosis. A total of 45 patients with single de novo lesions in native coronary arteries ,who hospitalized in Fuwai Hospital from January to March 2016 were enrolled. After successfully stent implantation these patients were randomized in a 2∶1 ratio into cohort 1 (n=30) or cohort 2 (n=15). The patients in cohort 1 underwent angiographic, IVUS or OCT examination at 6 months and 2 years; and cohort 2 underwent angiographic, IVUS or OCT at 1 and 3 years. All patients underwent clinical follow-up at 1, 6 months and 1 year and annually thereafter up to 5 years. The primary endpoint was target lesion failure (TLF, including cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization). Secondary endpoints included patient-oriented composite endpoint (PoCE, defined as composite of all death, all miocardial infarction, or any revascularization). Results: A total of 45 patients were enrolled and implanted with Firesorb BRS, including 35 males (77.8%), and the age was (54.4±9.3) years. At 4 years, 10 patients in cohort 1 were reexamined by coronary angiography and OCT examination. Among them, 2 patients' stents were completely degraded and absorbed. Compared with the OCT images of the other 8 patients in cohort 2 at 3 years, the degree of stent degradation was increased, and no stent adherence was found. The 4-year clinical follow-up rate was 100%. In 4-year clinical following up, 2 patients suffered PoCE (4.4%): 1 patient underwent non-target vessel revascularization the day after index procedure and target vessel revascularization (Non-target lesion revascularization) at 2-year imaging follow-up; the other patient underwent target lesion revascularization during imaging follow-up at 4 years but not due to ischemic driven. There was no scaffold thrombosis or TLF events through 4 years. Conclusions: Four years after the implantation, complete degradation and absorption of the Firsorb stent are evidenced in some patients. Firesorb stent is feasible and effective in the treatment of patients with non-complex coronary lesions.

Tobramycin promotes fracture healing by upregulating expressions of ALP and RUNX2 proteins through activating Wnt/β-catenin pathway / 中国骨伤

OBJECTIVE@#To explore effect of tobramycin (TOB) on healing of femoral fractures in rats.@*METHODS@#Totally 32 male sprague-dawley (SD) rats were selected and randomly divided into sham group (group A), fracture group (group B), fracture with TOB group (group C) and fracture + TOB + IWR-1 group (group D), 8 rats in each group. Close femoral fracture model in rats were established in group B, C and D, group A was sham operation without otherwise process. Group D was intraperitoneal injected 100 μl (8 μM) of Wnt pathway inhibitor IWR-1-endo (IWR-1) before molding at 1 day. At 1 day after molding, 100 μl (100 μM) of TOB was intraperitoneally injected into group C and D at once a day for 7 days. At 7 weeks after modling, fracture healing of group B, C and D were observed by X-ray, Western blotting was appilied to detect alkaline phosphatase(ALP) and Runt related transcription factor 2 (RUNX2) and β-catenin of Wnt passway.@*RESULTS@#X-ray results showed fracture line disappeared, callus formation and fracture healing well in group C compared with begning of molding; while a little fracture line, callus formation and fracture malunion in group B and d could be seen. Western blotting results showed ALP, RUNX2 and expression of β-catenin in group B, C and D were higher than that of group A (@*CONCLUSION@#Tobramycin could promote osteoblast differentiation and fracture healing by stimulating Wnt / β-catenin signaling pathway, up regulating expression of ALP and RUNX2.

Physical Activity and Functional Rehabilitation for Aging People Based on ICF: A Scoping Review / 中国康复理论与实践

Objective:To review the categories of physical activities and rehabilitation exercise for aging people based on the theory and method of the International Classification of Functioning, Disability, and Health (ICF). Methods:From the framework and coding of ICF, physical activities, rehabilitation exercise and functional improvement for the aging people were reviewed. Results:There were three typical physical activities: physical fitness, skills and sports, mainly including regular exercises, cognitive amusements, leisure sports activities, recreational sports activities, rehabilitation exercises, etc. Physical activities promoted the functioning of the aging people, including mental function (b1), pain and sensory dysfunction (b2), cardiovascular, blood, the function of the immune system and respiratory system (b4), digestion, metabolism and function of the endocrine system (b5), nerve musculoskeletal function related to movement (b7), the function of skin and related structures (b8), activity (d4), and community, social and civic life (d9), etc., especially body mass index, cardiovascular, physical fitness (muscular strength and endurance, aerobic endurance), balance, flexibility, upper and lower extremities strength, sleep, metabolic capability, cognitive function and anti-aging ability. There were more gains at individual levels, including promotion of subjective happiness, quality of life, reducing depression, risk of sarcopenia, dementia and falling, etc. The environmental and personal factors related to activity and participation in physical activities included the products and technologies (e1), natural environment and man-made changes to the environment (e3), support and interpersonal relationships (e3), attitude, service system and policy (e5), such as urban environment, building environment, street pavement behavior, weather, caregivers, accompany of family and friends, etc. Conclusion:The physical activities and rehabilitation exercise the aged joined include physical fitness activities, skills activities, and sports activities. The physical activities had effects on the rehabilitation of the aged including the function of the body(mental function, pain and sensory dysfunction, cardiovascular, blood, the function of the immune system and respiratory system, digestion, metabolism, and function of the endocrine system, nerve musculoskeletal function related to movement, the function of skin and related structures) and the participation in activities (activities, community, society and civic life). The function of the body works for the health of the aged to promote physical health, mental health, functional health, social adjustment and social well-being.

Physical Activity and Functional Rehabilitation for Children and Youth Based on ICF-CY: A Systematic Review / 中国康复理论与实践

Objective:To systematically review and develop the categories in the fields of recreational physical activities and rehabilitation exercise for the children and youth with disabilities based on the theory and method of International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY). Methods:The literatures about physical activities and rehabilitation exercise for children and youth with disabilities were retrieved with subject retrieval method, from the database of CNKl, Wanfang Data, PubMed and Web of Science, until December 31st, 2020. The authors, countries, published time, published journals, research objectives, object of the study and their ages, data collection tool, and the key findings were extracted. Results:A total of 1920 literatures were returned, and 26 of them were enrolled, which were published in eleven countries, and mainly from the journals of medicine, public health, exercise and rehabilitation for people with disabilities, and mainly published after 2010. The researches mainly used questionnaire survey, experimentation and measurement methods. There were three typical recreational physical activities: physical fitness activities, skills activities and sports activities, mainly including physical activities in daily life, recreational and leisure activities, sports activities, school physical education courses and rehabilitation training, etc. According to the framework of ICF-CY, physical activities might promote functional recovery for children and youth with disabilities, in b body functions, including bl mental function; b2 sensory function and pain; b4 cardiovascular, blood, the function of the immune system and respiratory system; b5 digestion, metabolism and function of the endocrine system; and b7 nerve musculoskeletal function related to movement; and d activities and participation, including d2 the general tasks and requirements; d4 activity; d5 self-care; d6 family life; d7 interpersonal communication and interpersonal relationship; d8 main area of life and d9 community, social and civic life. The evidences showed benefits of improvement in the fields of gross motor function, muscle strength, balance coordination, walking, running, dexterity and functioning of hand, cardio-respiratory fitness, body composition, and pain relief. Further more, there were gains at improvement of the quality of life, well-being, social support and self-efficacy, taking an active part in all kinds of leisure activities and physical activity, increasing the range of activities, etc. The environmental and personal factors might affect the participation and performance in physical activities for children and youth, including e1 products and technologies, e2 natural environment and man-made changes to the environment, e3 support and interpersonal relationships, e4 attitude, e5 service system and policy, including physical and built environment, assistive technology, activity facilities, transportation, physical accessibility and availability of community leisure and recreational activities, athletic ability, orientation of family activities, family environment, etc. Conclusion:The physical activities may promote the recovery of body function, and activities and participation for children and youth with disabilities. The environmental and personal factors may affect the participation and performance in physical activities.

Effect of Placing Drainage or Not on Rapid Rehabilitation after Primary Total Knee Arthroplasty / 中国康复理论与实践

Objective:To explore the effect of placing drainage or not on rapid rehabilitation after total knee arthroplasty (TKA). Methods:From January, 2018 to September, 2020, 80 patients with knee osteoarthritis who underwent primary TKA in our hospital were analyzed retrospectively, and they were divided into groups A and B, with 40 cases in each group. Drainage was placed routinely in group A and not in group B. The postoperative serum inflammatory factors, postoperative pain score, postoperative complication rate, postoperative time out of bed, hospital stay, knee function score, range of motion of knee and World Health Organization Quality Of Life-abbreviated version score (WHOQOL-BREF) were compared between two groups. Results:There was no significant difference in the levels of C-reactive protein between two groups on the 1st to 3rd day after operation (t < 0.410, P > 0.05). There was no significant difference in Visual Analogue Score between two groups from 12 h to 48 h after operation (t < 0.300, P > 0.05). The incidences of postoperative complications were 5.0% in group A and 2.5% in group B, with no significant difference between two groups (χ2 = 0.346, P > 0.05). The time of getting out of bed and hospital stay was significantly shorter in group B than in group A (t > 4.863, P < 0.001). The scores of knee joint function, range of motion of knee and WHOQOL-BREF significantly increased after operation in both groups (t > 6.099, P < 0.001), however, there was no significant difference between two groups (P > 0.05). Conclusion:Placement or non-placement of drainage after primary TKA does not affect postoperative complications, knee joint function and quality of life of patients with knee osteoarthritis, however, non-placement of drainage can promote postoperative recovery and discharge.

Mental Health, Quality of Life and Well-being of Recreational Physical Activity for Adults Using ICF: A Systematic Review / 中国康复理论与实践

Objective:To systematically review and develop the categories in the fields of recreational physical activities and rehabilitation exercise for adults based on the concept and method of the International Classification of Functioning, Disability and Health (ICF). Method:The literatures about recreational or leisure time physical activities and mental health for adults were retrieved with subject retrieval method, from the database of PubMed, Web of Science, CNKI and Wanfang Data, until June 30, 2021. The effects of leisure physical activities on mental health, quality of life and well-being of adults were extracted. Results:A total of 1856 literatures were returned, and 24 out of them were enrolled, which were published mainly from the journals of medicine, public health, exercise and rehabilitation. The researches mainly used questionnaire survey, interview and measurement methods. The types of physical activities involved were leisure time physical activities, leisure time recreational activities, non-leisure time physical activities and non-leisure time recreational activities. According to the framework of ICF, the effects of leisure time physical activities and recreational physical activities on mental health of adults were mainly reflected in body functions, including bl mental function, b152 emotion function, b140 attention function, b144 memory function, b163 basic cognition function, b126 temperament and personality function, b134 sleep function, b130 energy and drive function, b122 overall psychology and society function, b180 self-experience and time experience function, b139 other general mental functions specified and not specified; and activities and participation, including d6 family life, d7 interpersonal communication and interpersonal relationship, d8 main area of life, and d9 community, social and civic life; in terms of burnout, depression, anxiety, perceived stress, risk of depression, attention fatigue, life vigor, self-esteem, positive and negative emotions, mental disorders, insomnia, subjective well-being, life satisfaction and quality of life, etc. Leisure time physical activities and recreational physical activities might improve health-related quality of life and well-being. Some environmental and personal factors might affect the participation and performance in leisure time and recreational physical activities for the adult, including e3 support and interpersonal relationships, e4 attitude, e5 service system and policy, in terms of workload, positive emotion, social support, emotional support, etc. Conclusion:Adults can benefit from leisure time physical activities and recreational physical activities for promoting mental health, quality of life and well-being. These activities are beneficial to emotion, cognition, sleep, happiness, satisfaction and quality of life, etc. It is critical for rehabilitation to integrate leisure time and recreational physical activities into health care, recreation and relaxation, physical and mental health. And it is effective to expand mental health care to improve quality of life and well-being and achieve the United Nations 2030 Sustainable Development Goal 3: Good Healthy and Well-being.

Effect of Participation Physical Activity on Health, Quality of Life and Well-being for Elderly Adults: a Systematic Review / 中国康复理论与实践

Objective:To establish the framework of physical activity and rehabilitation for the elderly, and systematically review the health and rehabilitation effects of physical activity for the elderly, based on the relevant important documents of World Health Organization (WHO). Methods:The literatures about physical activities and health, quality of life for the older adults were retrieved with subject retrieval method, from the database of CNKI, Wanfang Data, PubMed and Web of Science, EBSCO, Google Scholar until June 30, 2021. This paper reviewed the rehabilitation effects of physical activities on health, quality of life and well-being of older adults through extracting the literature content. Results:There were five typical physical activities: aerobic activity, muscle and bone development activities, improving balance activities and comprehensive activities. The effect of the elderly participating in physical activities on health and rehabilitation was mainly reflected in the improvement of physical and mental health, social adaptation and activity behavior and nutrition. Health and rehabilitation impacts were mainly reflected in increased healthy life expectancy, improved quality of life and well-being. In terms of improving physical health, it can promote physical fitness, chronic diseases and physical function for the aging people. In terms of improving mental health, cognitive function, mood, personality traits and sleep can be promoted. The elderly participating in physical activities was mainly influenced by both personal and environmental factors. Conclusion:Participation in all physical activity by older adults provides health benefits, promoting healthy ageing, improving physical and mental health, facilitating social adjustment and activity behaviors and nutrition and then increasing healthy lifespan, quality of life and well-being. Physical activity is a health-related service, so scientific and reasonable physical activity of the elderly should be enhanced. It is necessary to combine physical activity with rehabilitation services to promote the health, function, well-being and quality of life of the elderly.

Surgical approach and curative effect analysis of craniopharyngioma resection through cockscomb approach / 中国综合临床

Objective:To explore the surgical method and clinical effect of craniopharyngioma resection through the cockscomb approach.Methods:A retrospective case-control study was conducted from December 2010 to May 2018.The clinical data, imaging data and follow-up data of 101 patients with craniopharyngioma confirmed by pathology by pathology after resection of the frontal floor longitudinal fissure through the crow′s comb approach were performed in Department of Neurosurgery, Sanbo Brain Hospital Capital Medical University.The total tumor resection rate, mortality and complications were analyzed by statistical methods.Results:Through this approach, the total resection rate of tumor was 90.1%(91/101), and the mortality was 1.9%(2/101). The most common postoperative complications were disturbance of sodium metabolism (54.5%(55/101)).Conclusion:Sub-frontal longitudinal fissure crista galli approach can safely and thoroughly remove the tumor and avoid the injury of the hypothalamus and its surrounding tissues as far as possible.

Genetic Diversity, Antimicrobial Resistance, and Virulence Genes of Isolates from Clinical Patients, Tap Water Systems, and Food / 生物医学与环境科学（英文）

Objective@#This study aimed to evaluate the genetic diversity, virulence, and antimicrobial resistance of isolates from clinical patients, tap water systems, and food.@*Methods@#Ninety isolates were obtained from Ma'anshan, Anhui province, China, and subjected to multi-locus sequence typing (MLST) with six housekeeping genes. Their taxonomy was investigated using concatenated sequences, while their resistance to 12 antibiotics was evaluated. Ten putative virulence factors and several resistance genes were identified by PCR and sequencing.@*Results@#The 90 isolates were divided into 84 sequence types, 80 of which were novel, indicating high genetic diversity. The isolates were classified into eight different species. PCR assays identified virulence genes in the isolates, with the enterotoxin and hemolysin genes , , , and found in 47 (52.2%), 13 (14.4%), 22 (24.4%), and 12 (13.3%) of the isolates, respectively. The majority of the isolates (≥ 90%) were susceptible to aztreonam, imipenem, cefepime, chloramphenicol, gentamicin, tetracycline, and ciprofloxacin. However, several resistance genes were detected in the isolates, as well as a new variant.@*Conclusions@#Sequence type, virulence properties, and antibiotic resistance vary in isolates from clinical patients, tap water systems, and food.

Impacts of smoking status on the clinical outcomes of coronary non-target lesions in patients with coronary heart disease: a single-center angiographic study / 中华医学杂志(英文版)

BACKGROUND@#Coronary atherosclerotic plaque could go through rapid progression and induce adverse cardiac events. This study aimed to evaluate the impacts of smoking status on clinical outcomes of coronary non-target lesions.@*METHODS@#Consecutive patients with coronary heart disease who underwent two serial coronary angiographies were included. All coronary non-target lesions were recorded at first coronary angiography and analyzed using quantitative coronary angiography at both procedures. Patients were grouped into non-smokers, quitters, and smokers according to their smoking status. Clinical outcomes including rapid lesion progression, lesion re-vascularization, and myocardial infarction were recorded at second coronary angiography. Multivariable Cox regression analysis was used to investigate the association between smoking status and clinical outcomes.@*RESULTS@#A total of 1255 patients and 1670 lesions were included. Smokers were younger and more likely to be male compared with non-smokers. Increase in percent diameter stenosis was significantly lower (2.7 [0.6, 7.1] % vs. 3.5 [0.9, 8.9]%) and 3.4 [1.1, 7.7]%, P = 0.020) in quitters than those in smokers and non-smokers. Quitters tended to have a decreased incidence of rapid lesions progression (15.8% [76/482] vs. 21.6% [74/342] and 20.6% [89/431], P = 0.062), lesion re-vascularization (13.1% [63/482] vs. 15.5% [53/432] and 15.5% [67/431], P = 0.448), lesion-related myocardial infarction (0.8% [4/482] vs. 2.6% [9/342] and 1.4% [6/431], P = 0.110) and all-cause myocardial infarction (1.9% [9/482] vs. 4.1% [14/342] and 2.3% [10/431], P = 0.128) compared with smokers and non-smokers. In multivariable analysis, smoking status was not an independent predictor for rapid lesion progression, lesion re-vascularization, and lesion-related myocardial infarction except that a higher risk of all-cause myocardial infarction was observed in smokers than non-smokers (hazards ratio: 3.00, 95% confidence interval: 1.04-8.62, P = 0.042).@*CONCLUSION@#Smoking cessation mitigates the increase in percent diameter stenosis of coronary non-target lesions, meanwhile, smokers are associated with increased risk for all-cause myocardial infarction compared with non-smokers.