Endogenous FGF21 attenuates blood-brain barrier disruption in penumbra after delayed recanalization in MCAO rats through FGFR1/PI3K/Akt pathway / 中南大学学报(医学版)

OBJECTIVES@#Restoration of blood circulation within "time window" is the principal treating goal for treating acute ischemic stroke. Previous studies revealed that delayed recanalization might cause serious ischemia/reperfusion injury. However, plenty of evidences showed delayed recanalization improved neurological outcomes in acute ischemic stroke. This study aims to explore the role of delayed recanalization on blood-brain barrier (BBB) in the penumbra (surrounding ischemic core) and neurological outcomes after middle cerebral artery occlusion (MCAO).@*METHODS@#Recanalization was performed on the 3rd day after MCAO. BBB disruption was tested by Western blotting, Evans blue dye, and immunofluorescence staining. Infarct volume and neurological outcomes were evaluated on the 7th day after MCAO. The expression of fibroblast growth factor 21 (FGF21), fibroblast growth factor receptor 1 (FGFR1), phosphatidylinositol-3-kinase (PI3K), and serine/threonine kinase (Akt) in the penumbra were observed by immunofluorescence staining and/or Western blotting.@*RESULTS@#The extraversion of Evans blue, IgG, and albumin increased surrounding ischemic core after MCAO, but significantly decreased after recanalization. The expression of Claudin-5, Occludin, and zona occludens 1 (ZO-1) decreased surrounding ischemic core after MCAO, but significantly increased after recanalization. Infarct volume reduced and neurological outcomes improved following recanalization (on the 7th day after MCAO). The expressions of Claudin-5, Occludin, and ZO-1 decreased surrounding ischemic core following MCAO, which were up-regulated corresponding to the increases of FGF21, p-FGFR1, PI3K, and p-Akt after recanalization. Intra-cerebroventricular injection of FGFR1 inhibitor SU5402 down-regulated the expression of PI3K, p-Akt, Occludin, Claudin-5, and ZO-1 in the penumbra, which weakened the beneficial effects of recanalization on neurological outcomes after MCAO.@*CONCLUSIONS@#Delayed recanalization on the 3rd day after MCAO increases endogenous FGF21 in the penumbra and activates FGFR1/PI3K/Akt pathway, which attenuates BBB disruption in the penumbra and improves neurobehavior in MCAO rats.

Research progress on the relationship between air pollution and gestational diabetes / 中华预防医学杂志

Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications and has serious implications for the health of mothers and their offspring. In recent years, studies have confirmed that air pollution is one of the main risk factors for diabetes, and there is increasing evidence that air pollution exposure is closely related to the occurrence of gestational diabetes. However, current studies on the association between air pollutant exposure and the incidence of gestational diabetes are inconsistent, and the window period of pollutant exposure is still unclear. Limited mechanistic studies suggest that airborne particulate matter and gaseous pollutants may affect GDM through multiple mechanisms, including inflammation, oxidative stress, disruption of adipokine secretion, and imbalance of intestinal flora. This review summarizes the relationship between air pollutant exposure and the incidence of GDM in recent years, as well as the possible molecular mechanism of the occurrence and development of GDM caused by air pollutants, in order to provide scientific basis for preventing pollutant exposure, reducing the risk of GDM, improving maternal and fetal outcomes and improving the quality of the birth population.

Renal oncocytoma misdiagnosed as renal cell carcinoma: report of two cases and literature review / 中国基层医药

Objective:To investigate the clinical, imaging, and pathological characteristics of renal oncocytoma, and to improve the understanding, diagnosis, and treatment of renal oncocytoma.Methods:The imaging and pathological data of two patients misdiagnosed with renal cell carcinoma in the 970 Hospital of PLA Joint Logistics Support Force from January to March 2021 were retrospectively analyzed. The relevant literature was reviewed and discussed.Results:The tumors were located in the left kidney of two patients, with diameters of 2.7 cm and 3.2 cm respectively. The patients underwent retroperitoneal laparoscopic removal of partial left kidney and retroperitoneal laparoscopic removal of the whole left kidney separately. The pathological results confirmed the diagnosis of renal oncocytoma.Conclusion:Renal oncocytoma is a rare benign renal cell tumor which is difficult to be diagnosed before surgery. Contrast-enhanced CT can provide evidence for the identification of renal oncocytoma. Its final diagnosis depends on pathological results.

The effect of Brucella outer membrane protein L16, L19 on the expression of immune regulatory factors in THP-1 cells / 中华地方病学杂志

Objective:To investigate the effect of recombinant lipoproteins of Brucella outer membrane protein 16, 19 (L16 and L19) on the expression of immune regulatory factors in human monocytic leukemia cell line (THP-1 cells). Methods:THP-1 cells activated with phorbol ester (PMA) were used as an in vitro experimental cell model, and a group design was used to co-culture L16, L19 and THP-1 cells (L16 stimulated group, L19 stimulated group), respectively. THP-1 cells activated with PMA were used as the control group. When co-cultured for 4 hours, immunofluorescence staining (IFS) and Western blotting were used to detect whether L16 and L19 entered the cells, respectively; when co-cultured for 12, 24 hours, real-time fluorescent quantitative PCR was used to measure the mRNA expression levels of interferon regulatory factor 1 (IRF-1) and trans activator protein of major histocompatibility complex class Ⅱ (CⅡTA); Western blotting was used to detect the protein expression levels of T cell immunoglobulin mucin-3 (Tim-3) and γ interferon receptor 1 (IFNGR1). Results:When co-cultured for 4 hours, L16 and L19 were observed entering THP-1 cells in the L16 stimulated group and L19 stimulated group, respectively. When co-cultured for 12 hours, the expression level of IRF-1 mRNA in the L16 stimulated group (0.16 ± 0.15) was significantly lower than that in the control group (1.00 ± 0.00, P < 0.05). When co-cultured for 24 hours, the expression level of CⅡTA mRNA in the L16 stimulated group (0.17 ± 0.10) was significantly lower than that in the control group (1.00 ± 0.00, P < 0.05). When co-cultured for 12 and 24 hours, there were no statistically significant differences in the expression levels of IRF-1 and CⅡTA mRNA between the L19 stimulated group and the control group ( P > 0.05). Western blotting results showed that there were statistically significant differences in the expression levels of INFGR1 and Tim-3 protein among the control group, L16 stimulated group, and L19 stimulated group after co-cultured for 12 and 24 hours ( F = 50.92, 6.80, 148.73, 156.57, P < 0.05). Among them, when co-cultured for 12 hours, the expression level of INFGR1 protein in the L16 and L19 stimulated groups were significantly lower than that in the control group, and the L19 stimulated group was higher than the L16 stimulated group ( P < 0.05), and the expression level of Tim-3 protein in the L19 stimulation group was higher than that in the control group ( P < 0.05). When co-cultured for 24 hours, the expression level of INFGR1 protein in the L16 and L19 stimulated groups were lower than that in the control group, and the L19 stimulated group was higher than that in the L16 stimulated group ( P < 0.05); and the expression level of Tim-3 protein in the L16 stimulated group was higher than that in the control group and L19 stimulated group ( P < 0.05). Conclusions:Brucella L16 can downregulate the expression levels of IRF-1 and CⅡTA mRNA in THP-1 cells. Both L16 and L19 can downregulate IFNGR1 and upregulate Tim-3 protein expression levels.

Morphological index of fetal cerebral ventricular development: a diagnostic ultrasound study / Índice morfológico del desarrollo ventricular cerebral fetal: un estudio ecográfico diagnóstico

SUMMARY: To establish an unprovable diagnostic indicative index reference for ultrasound examination of the fetal cerebral ventricles, based on the morphological characteristics throughout fetal nervous system development. Key ultrasonic morphological indicators of fetal ventricular development, which includes frontal horn width (FHW), occipital horn width (OHW), width of 3rd ventricle, cavity of septum pellucidum (CSP), width and length of 4th ventricle and thalamo-occipital distance (TOD) had been measured and analyzed collectively. All data of the indicators was collected on singleton pregnant woman between 16-39 weeks of gestational age (GA), between November 2017 and June 2021 at the Second Hospital of Dalian Medical University. A total of 235 pregnant women were enrolled in the cross section study; another 36 pregnant women voluntarily joined a timeline-tracking follow-up study (cohort study) under the same examining criteria. A decrease of FHW and OHW of the lateral ventricles was observed as GA increased; while dimensional values of TOD, 3rd ventricle, CSP, as well as 4th ventricle increased with GA. Most of these indicators showed an enhanced variation tendency within a certain period of GA. Moreover, values of FHW and TOD showed asymmetry of the two hemispheres within the whole GA. Our findings revealed the morphological regularity of fetal ventricular development, which would instructively enhance the relative clinical ultrasound diagnosis; moreover, TOD also showed regularly changes as GA increased, suggesting that TOD should be considered as an additional routine ultrasonic indicator for fetal ventricular development.

RESUMEN: El objetivo del estudio fue establecer un índice de referencia indicativo diagnóstico no demostrable para el examen ecográfico de los ventrículos cerebrales fetales, basado en las características morfológicas a lo largo del desarrollo del sistema nervioso fetal. Indicadores morfológicos ultrasónicos clave del desarrollo ventricular fetal, que incluyen el ancho del cuerno frontal (FHW), el ancho del cuerno occipital (OHW), el ancho del tercer ventrículo, la cavidad del septo pelúcido (CSP), el ancho y el largo del cuarto ventrículo y la distancia tálamo-occipital (TOD) fueron medidos y analizados conjuntamente. Todos los datos de los indicadores se recopilaron en mujeres embarazadas de un solo feto entre 16 y 39 semanas de edad gestacional (EG), entre noviembre de 2017 y junio de 2021 en el Segundo Hospital de la Universidad Médica de Dalian. Un total de 235 mujeres embarazadas se inscribieron en el estudio transversal; otras 36 mujeres embarazadas se unieron voluntariamente a un estudio de seguimiento de línea de tiempo (estudio de cohorte) bajo los mismos criterios de examen. Se observó una disminución de FHW y OHW de los ventrículos laterales a medida que aumentaba la GA; mientras que los valores dimensionales de TOD, tercer ventrículo, CSP y cuarto ventrículo aumentaron con GA. La mayoría de estos indicadores mostraron una tendencia de variación mejorada dentro de un cierto período de GA. Además, los valores de FHW y TOD mostraron asimetría de los dos hemisferios dentro de toda la AG. Nuestros hallazgos revelaron la regularidad morfológica del desarrollo ventricular fetal, lo que mejoraría de manera instructiva el diagnóstico clínico de ultrasonido relativo; además, TOD también mostró cambios regulares a medida que aumentaba la GA, lo que sugiere que TOD debe considerarse como un indicador ultrasónico de rutina adicional para el desarrollo ventricular fetal.

Herbal Textual Research on Ephedrae Herba in Famous Classical Formulas / 中国实验方剂学杂志

Ephedrae Herba is a commonly used medicine for dispersing wind and cold， which has a long medicinal history. By referring to the herbal literature， medical books and prescription books， this paper intends to carry out herbal textual research on the name， origin， medicinal part， producing area， harvesting and processing methods of Ephedrae Herba in famous classical formulas， in order to provide the basis for the development of relevant famous classical formulas. According to textual research， the main base of ancient Ephedrae Herba was Ephedra sinica. The medicinal part is the herbaceous stems of Ephedrae Herba. Before the Northern and Southern dynasties， the origin of the records was Jindi and Hedong， which is now Shanxi province. In the Northern and Southern dynasties and later generations， the producing area expanded， and now it is mainly distributed in Hebei， Shanxi， Shaanxi， Inner Mongolia， Gansu， Liaoning and other places， among which Inner Mongolia is the main producing area. The harvesting and processing methods in the past dynasties are to harvest the stems in autumn， dry them in the shade or air to 70%-80% dry， and then dry them in the sun. The processing methods in the past dynasties mainly include removing the knots， wine-fried， honey-fried， processing with vinegar and so on， at present， only honey-fried is still in use. Based on the research results， it is suggested that Ephedrae Herba in famous classical formulas should be selected the dry herbaceous stems of E. sinica. If the processing requirements are not indicated， it is suggested to use raw products of Ephedrae Herba.

Herbal Textual Research on Schizonepetae Herba in Famous Classical Formulas / 中国实验方剂学杂志

In this paper， the name， classification， origin and other aspects of Schizonepetae Herba in the famous classical formulas were researched by referring to the related herbal literature， medical books and prescription books in the past dynasties. The results showed that Schizonepetae Herba first appeared in Shennong Bencaojing （《神农本草经》） as Jiasu， while Jingjie first appeared in Wupu Bencao （《吴普本草》）， and the name of Jingjie was mainly used as the rectification of name in later generations. The name of Jiasu is mostly derived from its smell， and the name of Jingjie is mostly derived from its pronunciation. Schizonepeta tenuifolia has been highly praised in the past as a original material， and its genuine producing area is Jiangsu， Hebei and other places， medicinal part is whole herb with spike. In modern times， the quality of Schizonepetae Herba is best described as having thin stems， green spike， and aroma. In clinical application， the raw products of Schizonepetae Herba is mainly used， and the carbonisata is mainly used for hemostasis. Famous classical formulas of Huaihuasan and Danggui Yinzi are all made of Schizonepetae Spica， so it is recommended to use the dried panicle of S. tenuifolia. In Liangxue Dihuangtang， Schizonepetae Herba Carbonisata is used， therefore， it is suggested to adopt the processing method of Schizonepetae Herba Carbonisata in the 2020 edition of Chinese Pharmacopoeia.

Chronic hypoperfusion due to intracranial large artery stenosis is not associated with cerebral β-amyloid deposition and brain atrophy / 中华医学杂志(英文版)

BACKGROUND@#Insufficient cerebral perfusion is suggested to play a role in the development of Alzheimer disease (AD). However, there is a lack of direct evidence indicating whether hypoperfusion causes or aggravates AD pathology. We investigated the effect of chronic cerebral hypoperfusion on AD-related pathology in humans.@*METHODS@#We enrolled a group of cognitively normal patients (median age: 64 years) with unilateral chronic cerebral hypoperfusion. Regions of interest with the most pronounced hypoperfusion changes were chosen in the hypoperfused region and were then mirrored in the contralateral hemisphere to create a control region with normal perfusion. 11C-Pittsburgh compound-positron emission tomography standard uptake ratios and brain atrophy indices were calculated from the computed tomography images of each patient.@*RESULTS@#The median age of the 10 participants, consisting of 4 males and 6 females, was 64 years (47-76 years). We found that there were no differences in standard uptake ratios of the cortex (volume of interest [VOI]: P = 0.721, region of interest [ROI]: P = 0.241) and grey/white ratio (VOI: P = 0.333, ROI: P = 0.445) and brain atrophy indices (Bicaudate, Bifrontal, Evans, Cella, Cella media, and Ventricular index, P > 0.05) between the hypoperfused regions and contralateral normally perfused regions in patients with unilateral chronic cerebral hypoperfusion.@*CONCLUSION@#Our findings suggest that chronic hypoperfusion due to large vessel stenosis may not directly induce cerebral β-amyloid deposition and neurodegeneration in humans.

Relationship between clopidogrel responsiveness and CYP2C19 genotype by thromboelastography in patients with coronary heart disease after PCI / 中国输血杂志

【Objective】 To explore the relationship between clopidogrel responsiveness and CYP2C19 gene polymorphism by thromboelastography(TEG) after PCI in patients with coronary heart disease, and its guiding significance for the use of clopidogrel after PCI. 【Methods】 A total of 246 patients who underwent PCI surgery in our hospital from June 2018 to May 2021 and routinely took clopidogrel maintenance treatment after the operation were selected.The platelet inhibition rate of the patients was detected by TEG to obtain their response to clopidogrel.The CYP2C19 genotype was detected, and the relationship between the patient′s responsiveness to clopidogrel and the CYP2C19 genotype was analyzed. 【Results】 The CYP2C19 genotypes in 246 patients were fast metabolizer (n=95), intermediate metabolizer (n=104) and slow metabolizer (n=47), with the mean ADP inhibition rate(%) at 46.27±21.41, 40.99±25.53 and 24.77±21.68, respectively.They were divided into clopidogrel resistant group (n=98) and clopidogrel normal response group (n=148). The three groups of patients with different CYP2C19 genotypes had no statistically significant differences in gender composition, age and platelet count (P>0.05), while significant differences in hypertension, diabetes and hyperlipidemia(P0.05), but they were all lower than those with slow metabolism patients (both P0.5). Statistically significant difference was noticed in the low responsiveness to clopidogrel by different CYP2C19 genotypes (P<0.05). The drug responsiveness of clopidogrel measured by TEG had strong correlation with the patient′s CYP2C19 genotype.When the ADP inhibition rate was the best cut-off value (27.10%), the sensitivity and specificity of CYP2C19 genotype being diagnosed as the slow metabolite type, was 73.37% and 70.21%, respectively. 【Conclusion】 The response of clopidogrel after PCI in patients with coronary heart disease is associated with CYP2C19 genotype polymorphism.The use of TEG to detect the ADP inhibition rate of patients has strong predictive effect on CYP2C19 genotype and has guiding significance on antiplatelet therapy in patients with coronary heart disease after PCI.

Toxic effect of Brucella outer membrane protein 16 on osteoblasts / 中华地方病学杂志

Objective:This study is designed to investigate the toxicity of lipoprotein (L16) and non-lipoprotein (U16) of Brucella outer membrane protein (OMP) 16 on osteoblasts. Methods:Recombinant L16 and U16 proteins were prepared by using prokaryotic expression system of Escherichia coli ( E. coli) BL21 (DE3) and purified by Ni column. Using group design, mouse osteoblasts (MC3T3 cells) were co-incubated with L16 and U16, respectively. Brucella lipopolysaccharide (LPS) stimulus was used as the positive control, and cells without any stimulation were used as the negative control. Incubation time was 24 h. The activity of co-incubated MC3T3 cells were detected by CCK-8; the supernatant of cultured cells was collected and the release rate of lactate dehydrogenase (LDH) in the supernatant was detected by bioluminescence, and the virulence of L16 and U16 on MC3T3 cells was evaluated. Annexin Ⅴ-PE/7-AAD double staining flow cytometry was further used to analyze the apoptosis rate of MC3T3 cells, and the activation level of apoptosis executive protein Caspase-3 was detected by Western blotting (WB). Results:The activity of MC3T3 cells in L16 group [(56.16±1.63)%] was significantly lower than that in U16 and LPS groups [(97.02±1.44)%, (98.64±0.90)%, P < 0.01], the LDH release rate [(84.64±0.96)%] was significantly higher than that in U16 and LPS groups [(34.82±3.41)%, (26.75±1.95)%, P < 0.01]. Annexin Ⅴ-PE/7-AAD double staining results showed that the apoptosis rate was (46.45±2.19)% in L16 group, while the remaining groups were all less than 1%. WB results showed that activated Caspase-3 (cleaved-Caspase-3) existed in L16 stimulated cells, but not in U16 stimulated cells and LPS control cells. Conclusion:L16 can induce the apoptosis of osteoblasts and inhibit the proliferation of osteoblasts, but U16 has no obvious effect indicating that Brucella L16 with complete lipid structure is necessary for virulence effect.

Barriers to implement early mobilization by nursing in adult ICUs:A systematic review and summary analysis / 中国实用护理杂志

Objective:To systematically review the barriers encountered by nursing staff in the implementation of early activities in adult ICU units.Methods:A systematic search was conducted on CNKI, Wanfang Database, VIP Database, China Biomedical Database, PumMed, Web of Science, Cochrane Library and EMBASE for the research on the obstacles of early activity nursing implementation in adult ICU from the establishment of the database to July 2020, and the final integrated analysis of the included literature was carried out.Results:A total of 26 articles were included, and 59 obstacles in 5 categories were integrated, including 6 kinds of technical level, 13 kinds of organizational culture level, 7 kinds of personnel level, 4 kinds of structural level, and 29 kinds of 6 sub categories of patients level. The most frequent obstacles were unstable condition of patients, sedation or continuous deep sedation, low staffing level, disturbance of consciousness of patients, insufficient equipment related to early activities, and low willingness or compliance of patients to participate.Conclusion:The nursing staff are facing with many obstacles in guiding and assisting ICU adult patients to carry out early activities. It is necessary to formulate modified policies aiming at changeable factors in order to promote the application of early activities in adult ICU units.

Pharmacologically targeting molecular motor promotes mitochondrial fission for anti-cancer

Mitochondrial shape rapidly changes by dynamic balance of fusion and fission to adjust to constantly changing energy demands of cancer cells. Mitochondrial dynamics balance is exactly regulated by molecular motor consisted of myosin and actin cytoskeleton proteins. Thus, targeting myosin-actin molecular motor is considered as a promising strategy for anti-cancer. In this study, we performed a proof-of-concept study with a natural-derived small-molecule J13 to test the feasibility of anti-cancer therapeutics

Treatment of chronic internal carotid artery occlusion and its effect on cognitive function / 国际脑血管病杂志

The brain tissue of patients with chronic internal carotid artery occlusion is in a state of hypoperfusion for a long time, which often presents as asymptomatic cognitive impairment. Even with the best medical treatment, patients with chronic internal carotid artery occlusion still have a higher risk of stroke and cognitive impairment. Recent studies have shown that recanalization can reduce the incidence of stroke in patients with chronic internal carotid artery occlusion, but whether it can improve the cognitive function remains controversial. This article reviews the treatment of chronic internal carotid artery occlusion and its effect on cognitive function.

Maze Ⅳ in the treatment of heart valve disease with persistent atrial fibrillation in elderly patients: A cohort study / 中国胸心血管外科临床杂志

@#Objective    To investigate the clinical effect of Maze Ⅳ in the treatment of elderly patients with valvular heart disease and persistent atrial fibrillation (AF). Methods    We retrospectively analyzed the clinical data of 78 elderly patients with cardiac valve disease combined with persistent AF in our hospital from 2017 to 2018. The patients were allocated to two groups including a trial group (n=37) and a control group (n=41). There were 21 males and 16 females aged 61 to 74 (65.2±2.5) years in the trial group. There were 23 males and 18 females aged 62 to 76 (64.8±3.3) years in the control group. The clinical effects of the two groups were compared. Results    There was no statistical difference in baseline data between the two groups (P>0.05). The aortic occlusion time, extracorporeal circulation time, and operation time of the trial group were longer than those of the control group with statistical differences (P<0.05). There was no statistical difference in postoperative ventilator assistance time, complication rate, mortality, ICU retention time, perioperative drainage, red blood cell transfusion volume, or length of hospital stay between the two groups (P>0.05). At the time of discharge, postoperaive 1-month, 3-month, 6-month, and 12-month, the maintenance rates of sinus rhythm in the control group were statistically different from those of the trial group (P<0.05). Compared with the control group, left atrial diameter, left ventricular end diastolic diameter and the decrease of pulmonary artery systolic blood pressure were statistically different (P<0.05). Conclusion    Maze Ⅳ is safe and effective in the treatment of elderly patients with valvular heart disease and persistent AF, which is conducive to the recovery and maintenance of sinus rhythm, and is beneficial to the remodeling of the left atrium and left ventricle and the reduction of pulmonary systolic blood pressure with improvement of life quality of the patients.

Association of Polygenic Risk Score with Age at Onset and Cerebrospinal Fluid Biomarkers of Alzheimer's Disease in a Chinese Cohort / 神经科学通报·英文版

To evaluate whether the polygenic profile modifies the development of sporadic Alzheimer's disease (sAD) and pathological biomarkers in cerebrospinal fluid (CSF), 462 sAD patients and 463 age-matched cognitively normal (CN) controls were genotyped for 35 single-nucleotide polymorphisms (SNPs) that are significantly associated with sAD. Then, the alleles found to be associated with sAD were used to build polygenic risk score (PRS) models to represent the genetic risk. Receiver operating characteristic (ROC) analyses and the Cox proportional hazards model were used to evaluate the predictive value of PRS for the sAD risk and age at onset. We measured the CSF levels of Aβ42, Aβ42/Aβ40, total tau (T-tau), and phosphorylated tau (P-tau) in a subgroup (60 sAD and 200 CN participants), and analyzed their relationships with the PRSs. We found that 14 SNPs, including SNPs in the APOE, BIN1, CD33, EPHA1, SORL1, and TOMM40 genes, were associated with sAD risk in our cohort. The PRS models built with these SNPs showed potential for discriminating sAD patients from CN controls, and were able to predict the incidence rate of sAD and age at onset. Furthermore, the PRSs were correlated with the CSF levels of Aβ42, Aβ42/Aβ40, T-tau, and P-tau. Our study suggests that PRS models hold promise for assessing the genetic risk and development of AD. As genetic risk profiles vary among populations, large-scale genome-wide sequencing studies are urgently needed to identify the genetic risk loci of sAD in Chinese populations to build accurate PRS models for clinical practice.

Clinical analysis of full-repair strategy under small incision for closed Lauge-Hansen pronation-external rotation type Ⅳ ankle fracture / 中国修复重建外科杂志

Objective: To investigate the safety, feasibility, and efficacy of full repair strategy under small incision in the treatment of closed Lauge-Hansen pronation-external rotation type Ⅳ ankle fracture. Methods: The clinical data of 57 patients with closed Lauge-Hansen pronation-external rotation type Ⅳ ankle fracture treated by full repair strategy (fracture, ligament, and cartilage repair) under small incision between January 2012 and January 2017 were retrospectively analyzed. There were 31 males and 26 females, with an average age of 41.1 years (range, 21-65 years). The causes of injury included traffic accident injury in 33 cases and falling injury in 24 cases. All of them were closed fractures, including 20 cases of medial malleolus fracture, 37 cases of complete medial malleolus but deep and shallow rupture of deltoid ligament. The average time from injury to admission was 9.6 hours (range, 3-34 hours). The quality of reduction of distal tibial articular surface (based on Ketz-Sanders standard), the reduction of tibiofibular syndesmosis (the anterior and posterior distances of distal tibiofibular syndesmosis and the lateral ankle twist angle measured by CT scan at 10 mm above the ankle joint line), and the fracture healing were evaluated. The medial clear space (MCS), tibiofibular clear space (TFCS), and distal fibular tip to lateral process of talus (DFTL) were measured on the X-ray films of ankle points. Before and after operation, the pain and functional improvement of ankle joint were evaluated by visual analogue scale (VAS) score and American Orthopedic Foot and Ankle Association (AOFAS) score, and the activities of ankle dorsiflexion and plantar flexion were measured. Results: Three cases with osteochondral lesions of the talus were found during operation and all were treated with microfracture techniques. Tournament paralysis occurred in 2 cases after anesthesia. The surgical incisions healed by first intention in all patients. All the 57 patients were followed up 24-84 months, with an average of 38.6 months. All patients achieved bone healing without bone nonunion and malunion at 12 months after operation. The reduction quality of distal tibial articular surface was excellent in 56 cases and good in 1 case at 3 months after operation, the excellent and good rate was 100%. There was no significant difference in the MCS, TFCS, DFTL, anterior distance of distal tibiofibular syndesmosis, posterior distance of distal tibiofibular syndesmosis, and lateral ankle twist angle between the affected and healthy sides at 12 months after operation ( P>0.05). At last follow-up, the VAS score, AOFAS score, ankle dorsiflexion and plantar flexion activities of the affected side were significantly improved when compared with preoperative ones ( P0.05). Conclusion: Full-repair strategy under small incisions for the treatment of Lauge-Hansen pronation-external rotation type Ⅳ ankle fracture is effective and safe. It can not only reduce wound complications, but also improve the quality of joint reduction of the ankle joint and distal tibiofibular syndesmosis. Full repair of ligaments and cartilage can improve the internal fixation strength and joint stability of the ankle joint.

Risk assessment of schistosomiasis transmission in Chuxiong City of Yunnan Province / 中国血吸虫病防治杂志

Objective To evaluate the potential risk of schistosomiasis transmission so as to provide the evidence for formulating the control strategy. Methods Two villages were selected as the investigated sites in Chuxiong City and the risk of schistosomiasis transmission was evaluated by reviewing the data of schistosomiasis epidemic situation and prevention and control work, and carrying out the field survey for Oncomelania hupensis snail status, wild faeces, and schistosome infection of the population from 2015 to 2017. Results There was 1.49 hm2 area of snail habitats, with an average density of 0.54 snails/0.1 m2. The occurrence rate of frames with snails was 5.41%. No schistosome-infected snails were found. The positive rate of schistosomiasis serological tests of the residents was 3.36%, but the stool examination positive cases were not found. A total of 58 wild faeces samples were collected but no schistosome infested cases were found. The risk levels of schistosomiasis transmission in both villages were Grade III. Conclusions Although Chuxiong City has been in a low risk state of schistosomiasis transmission, the density of snails is still high, and there is a risk of infection source importation. In the future, the infection source control and snail control should be strengthened.

Risk assessment of schistosomiasis transmission in Chuxiong City of Yunnan Province / 中国血吸虫病防治杂志

Objective To evaluate the potential risk of schistosomiasis transmission so as to provide the evidence for formulating the control strategy. Methods Two villages were selected as the investigated sites in Chuxiong City and the risk of schistosomiasis transmission was evaluated by reviewing the data of schistosomiasis epidemic situation and prevention and control work, and carrying out the field survey for Oncomelania hupensis snail status, wild faeces, and schistosome infection of the population from 2015 to 2017. Results There was 1.49 hm2 area of snail habitats, with an average density of 0.54 snails/0.1 m2. The occurrence rate of frames with snails was 5.41%. No schistosome-infected snails were found. The positive rate of schistosomiasis serological tests of the residents was 3.36%, but the stool examination positive cases were not found. A total of 58 wild faeces samples were collected but no schistosome infested cases were found. The risk levels of schistosomiasis transmission in both villages were Grade III. Conclusions Although Chuxiong City has been in a low risk state of schistosomiasis transmission, the density of snails is still high, and there is a risk of infection source importation. In the future, the infection source control and snail control should be strengthened.

Efficacy analysis of pectoralis major muscle flap transplantation for sternal infection after cardiac surgery / 中华胸心血管外科杂志

To investigate the therapeutic effect of pectoralis major muscle flap transplantation in thoracotomy patients with sternal infection. Methods From January 2014 to December 2017, the treatment group of 39 patients with thoracic bone infection after cardiac surgery was used pectoralis major muscle flap to close the wound, while 26 patients were treated by debridement and vacuum sealing drainagea at the same time as the control group. The hospitalization time, hospital costs, number of operations, satisfaction survey, and relapse rate were compared between the those. Results Compared with the control group, the treatment group has the benefit of shorter hospitalization time [(18. 1 ± 3. 8)days vs. (36. 7 ± 11. 4) days], less hospital costs [(19429 ±4088)yuan vs. (33495 ±10712)yuan], less number of operations [(1. 1 ±0. 3)times vs. (2. 4 ±0. 8)times], higher level of satisfaction(56. 4％ vs. 30. 8％), lower relapse rate(5. 1％ vs. 26. 9％), the differences are statistically significant(all P <0. 05). Conclusion Thoracic reconstruction with pectoralis major muscle flap is an effective treatment for sternal infection in postcardiac surgery.

Effects of Treg cells on treatment of chronic brucellosis patients / 中华地方病学杂志

Objective To investigate the percentage of regulatory T cells (Treg) in peripheral blood lymphocytes of patients with chronic brucellosis and the percentage change before and after treatment of different regimens,and to analyze the influence of Treg cell-induced immunosuppression on the therapeutic effect of chronic stage brucellosis.Methods Using case-control study,35 patients with chronic brucellosis who were hospitalized in Heilongjiang General Hospital of Agriculture Bureau [28 males,7 females,aged (45.37 ± 20.16) years old] were selected as case group.According to the treatment regimen,they were divided into standard treatment group (15 cases) and immune enhancer group (20 cases),the treatment was 20 d;30 cases of in-hospital health examinations were selected [16 males and 14 females,aged (35.53 ± 11.38) years old] as control group.Peripheral blood sample of the subject was collected before and after the treatment,the Treg cells as a percentage in peripheral blood lymphocytes were detected by flow cytometry.And the percentage change of Treg cells of brucellosis patients who underwent different treatment regimens was analyzed.Results Before treatment,the percentage of Treg cells in peripheral blood lymphocytes of the control group,the standard therapy and the immune enhancer groups [(1.69 ± 0.38)％,(3.12 ± 0.86)％,(3.05 ± 1.07)％] was significantly different (F =25.89,P ＜ 0.05);compared with the control group,the percentage of Treg cells in the peripheral blood lymphocytes of the standard treatment group and the immune enhancer group increased (P ＜ 0.05);there was no significant difference between the standard treatment group and the immune enhancer group (P ＞ 0.05).After treatment,the percentage of Treg cells in peripheral blood lymphocytes of the control group,the standard therapy and the immune enhancer groups [(1.69 ± 0.38)％,(3.06 ± 0.76)％,(2.85 ± 0.89)％] was significantly different (F =30.84,P ＜ 0.05);compared with the control group,the percentage of Treg cells in the peripheral blood lymphocytes of the standard treatment group and the immune enhancer group increased (P ＜ 0.05);there was no significant difference between the standard treatment group and the immune enhancer group (P ＞ 0.05),and compared with the same group before the treatment,respectively,the differences were not statistically significant (P ＞ 0.05).Conclusions The percentages of Treg cells in peripheral blood lymphocytes of the chronic brucellosis patient are not significantly changed before and after different treatment regimens.It suggests that the immunesuppression induced by Treg cells may be one of the reasons why the host organism cannot effectively remove residual Brucella in the body,which leads to chronic infection.