Research progress of circadian rhythm and circadian clock gene regulation in the development of myopia / 国际眼科杂志(Guoji Yanke Zazhi)

With the development of society, the incidence of myopia and the population of myopia has increased year by year, which has become a major public health problem. Therefore, the research on the pathogenesis and prevention and control measures of myopia is imminent. In recent years, the role of the biological clock in the development of myopia has gradually attracted scholars interest. Now the author starts from the impact of the biological clock on the axial length, retina and choroid in the development of myopia. In order to provide new ideas for the study of prevention and control measures and the pathogenesis of myopia, a brief review is made from the perspective of contemporary society and disrupted body clock.

New model of PIRADS and adjusted prostatespecific antigen density of peripheral zone improves the detection rate of initial prostate biopsy: a diagnostic study / 亚洲男科学杂志(英文版)

This study explored a new model of Prostate Imaging Reporting and Data System (PIRADS) and adjusted prostate-specific antigen density of peripheral zone (aPSADPZ) for predicting the occurrence of prostate cancer (PCa) and clinically significant prostate cancer (csPCa). The demographic and clinical characteristics of 853 patients were recorded. Prostate-specific antigen (PSA), PSA density (PSAD), PSAD of peripheral zone (PSADPZ), aPSADPZ, and peripheral zone volume ratio (PZ-ratio) were calculated and subjected to receiver operating characteristic (ROC) curve analysis. The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve (AUC). The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves. The AUCs of PSA, PSAD, PSADPZ, aPSADPZ, and PZ-ratio were 0.669, 0.762, 0.659, 0.812, and 0.748 for PCa diagnosis, while 0.713, 0.788, 0.694, 0.828, and 0.735 for csPCa diagnosis, respectively. All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa. The new model significantly improved the diagnostic accuracy of PCa (0.945 vs 0.830, P < 0.01) and csPCa (0.937 vs 0.845, P < 0.01) compared with the base model. In addition, the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold. This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators. Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies.

Study on risk factors of abnormal pulmonary function among dust-exposed workers and prediction model / 中华劳动卫生职业病杂志

Objective: To explore the influencing factors of abnormal pulmonary function in dust-exposed workers and establish the risk prediction model of abnormal pulmonary function. Methods: In April 2021, a total of 4255 dust exposed workers from 47 enterprises in 2020 were included in the study. logistic regression was used to analyze the influencing factors of abnormal pulmonary function in dust-exposed workers, and the corresponding nomogram prediction model was established. The model was evaluated by ROC curve, Calibrationpolt and decision analysis curve. Results: logistic regression analysis showed that age (OR=1.03, 95%CI=1.02~1.05, P<0.001) , physical examination type (OR=4.52, 95%CI=1.69~12.10, P=0.003) , dust type (Comparison with coal dust, Cement dust, OR=3.45, 95%CI=1.45~8.18, P=0.005, Silica dust (OR=2.25, 95%CI=1.01~5.03, P=0.049) , blood pressure (OR=1.63, 95%CI=1.22~2.18, P=0.001) , creatinine (OR=0.08, 95%CI=0.05~0.12, P<0.001) , daily exposure time (OR=1.06, 95%CI=1.10~1.12, P=0.034) and total dust concentration (OR=1.29, 95%CI=1.08~1.54, P=0.005) were the influencing factors of abnormal pulmonary function. The area under the ROC curve of risk prediction nomogram model was 0.764. The results of decision analysis curve showed that the nomogram model had reference value in the prevention and intervention of abnormal pulmonary function when the threshold probability exceeded 0.05. Conclusion: The accuracy ofthe nomogram model constructed by logistic regression werewell in predicting the risk of abnormal lung function of dust-exposed workers.

Influencing factors of preoperative pulmonary function in elderly patients undergoing rotator cuff surgery / 北京大学学报(医学版)

OBJECTIVE@#To analyze the preoperative pulmonary function in rotator cuff injury patients and the possible influencing factors.@*METHODS@#All the rotator cuff surgery patients who underwent pre-operative pulmonary function examination in Peking University Third Hospital from Jan. 2020 to Jun. 2020 were retrospectively reviewed. Their perioperative medical records and main parameters of pulmonary function were collected from database management system, and their gender, age, body mass index (BMI), smoking history, time from injury, visual analogue scale (VAS) and other factors impacting on preoperative pulmonary function were studied.@*RESULTS@#Twenty-nine patients with rotator cuff injury were included, among whom 1 patient was reported to have restrictive ventilation dysfunction and 2 patients to have obstructive ventilation dysfunction. All the three patients denied the history of respiratory diseases, and had no respiratory symptoms. In all enrolled patients, the mean forced expiratory volume in one second (FEV1)/ forced vital capacity (FVC) was 79.2%±5.9%, and the mean VAS pain score was 3.66±1.26. In addition, the dynamic pulmonary functions (FVC, FEV1) were reduced in more than half of the elderly, and the total lung capacity (TLC) was lower than the estimated value in 2/3 of the elderly. There were significant differences in three main indexes of pulmonary functions between genders, and the percentage of the estimated TLC between normal BMI group (18 kg/m2 < BMI < 24 kg/m2) and overweight/obesity group (BMI≥24 kg/m2) was significantly different. Based on the injury time longer than 1 year or not, the results indicated that FVC and TLC were significantly different between the two groups.@*CONCLUSION@#In addition to gender and age, time from injury and severity of pain, as well as overweight/obesity, may influence pulmonary function outcomes in the elderly rotator cuff patients. Targeted intervention can be carried out on these factors before surgery. Preoperative lung function test can be used as one of the basic evaluation indexes for respiratory training and rehabilitation of patients.

Management algorithm for septic arthritis after anterior cruciate ligament reconstruction / 北京大学学报(医学版)

OBJECTIVE@#To summarize the experience in the diagnosis and management of septic arthritis after anterior cruciate ligament reconstruction.@*METHODS@#A retrospective review was conducted of all the arthroscopic anterior cruciate ligament reconstructions performed at Department of Sports Medicine, Peking University Third Hospital between January 2001 and December 2020. In the study, 65 of 27 867 patients experienced postoperative septic arthritis. The incidence, presentation, laboratory results, treatment, and outcome of all the infected patients were analyzed. The experiences of diagnosis and management of septic arthritis after anterior cruciate ligament reconstruction were summarized.@*RESULTS@#A total of 27 867 anterior cruciate ligament reconstructions were performed at our department between January 2001 and December 2020. In the study, 65 (0.23%) patients were identified with postoperative septic arthritis. The most common symptoms of the infected patients were fever (38.7±0.5) ℃, knee swelling, pain, and restricted motion. The mean peripheral white blood cell count (WBC) was (9.2±2.6)×109/L (range 4.2×109/L-19.4×109/L), with (72.5±6.3) % (range 54.9%-85.1%) polymorphonuclear neutrophils (N). The mean erythrocyte sedimentation rate (ESR) was (59.9±24.1) mm/h (range 9-108 mm/h), C-reactive protein (CRP) was (10.9±5.7) mg/dL (range 1.2-30.8 mg/dL), and fibrinogen (FIB) level was (7.0±1.6) g/L (range 3.7-10.8 g/L). All of the laboratory results were statistically higher in the infection group compared with the normal postoperative group (P＜0.001). The synovial white blood cell count (SWBC) of aspirated knee joint fluid was (45.0±29.8)×109/L (range 7.1×109-76.5×109/L). Polymorphonuclear cell percentage (PMNC) was (90.27±7.86) % (range 60%-97%). In the study, 45 patients (69.2%) had positive aspirate cultures. Microbiology showed coagulase-negative Staphylococcus (CNS) and Staphylococcus aureus (SA) were the most common bacterium (34 cases and 7 cases, individually). There were 26 methicillin-resistant Staphylococcus. Both conservative (16 patients) and operative (49 patients) treatments were effective, but conservative group had a longer recovery time (5.6 d vs. 1.6 d, P=0.042).@*CONCLUSION@#Septic arthritis after arthroscopic anterior cruciate ligament reconstruction is a rare but potentially devastating complication. The correct diagnosis relies on synovial fluid analysis and bacterial culture. Our proposed treatment protocol is arthroscopic debridement and antibiotic therapy as quickly as possible.

Microbes as a production host to produce natural activecompounds from mushrooms: biosynthetic pathway elucidationand metabolic engineering / 中国天然药物

Mushrooms are abundant in bioactive natural compounds. Due to strict growth conditions and long fermentation-time, microbe as a production host is an alternative and sustainable approach for the production of natural compounds. This review focuses on the biosynthetic pathways of mushroom originated natural compounds and microbes as the production host for the production of the above natural compounds.

Status quo of and challenges for research on rust disease in medicinal plants / 中国中药杂志

Medicinal plants are beneficial to human health. However,most of the major producing regions of medicinal plants suffer from rust disease,which threatens the yield and quality of Chinese medicinal materials,thus causes huge economic loss,and hinders the sustainable development of the Chinese medicine industry. By the end of 2020,rust disease had been reported in medicinal plants of 76 species and 33 families. In the 76 species,79 rust pathogens were detected. The majority of these pathogens belonged to Puccinia( 33,39. 24%),Coleosporium( 14,15. 19%),and Aecidium( 11,13. 92%). Of these 79 rust pathogens,10 were autoecious and 13 were heteroecious. Through literature research,this study reviewed the symptoms,pathogen species,severity and distribution,prevalence and occurrence conditions,and control measures of rust disease in medicinal plants,and thereby summarized the research status of rust disease in medicinal plants and the gap with other plants,which is expected to serve as a reference for further research on rust disease in medicinal plants.

Analysis of visual acuity and visual quality after regional refracted multifocal IOL implantation and aspherical unifocal IOL implantation / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To contrast the visual acuity and visual quality after implantation of regional refraction multifocal IOL and aspheric unifocal IOL.<p>METHODS: The study enrolled 82 cases(96 eyes)of age-related cataract patients, underwent phacoemulsification surgery in our hospital. According to the intraoperative intraocular lens implantation type, they were divided into two groups: the observation group(46 cases, 53 eyes, implanted with Oculentis MF30 regional refractive multifocal IOL)and the control group(36 cases, 43 eyes, implanted with ADAPT AO aspherical unifocal IOL). The total visual acuity and visual quality 3mo after operation were compared between the two groups. <p>RESULTS: Three months after surgery, compared with the control group, the observation group had significantly improved near and middle vision, significantly increased contrast sensitivity, significantly increased modulation transfer function cutoff frequency, Strehl ratio, objective scatter index and OQAS values, significantly decreased VF-12-CN score(38.16±4.05 <i>vs</i> 45.72±4.69), and significantly increased desorption rate score(11.38±1.04 <i>vs</i> 9.23±0.87)and surgical satisfaction score(3.57±0.36 <i>vs</i> 3.32±0.31)(<i>P</i><0.05). Age >65 years old, illiteracy, uncorrected distant visual acuity of good eye ≥0.1(LogMAR), implantation of aspheric unifocal IOL are the influencing factors of the quality of life of cataract patients. <p>CONCLUSION: Compared with aspheric unifocal IOL, Oculentis regional refraction multifocal IOL can provide good overall vision in the short term after operation, and the contrast sensitivity, visual quality, quality of life, glasses removal rate and satisfaction are significantly improved.

Dynamic histopathological changes of thyroid nodule after microwave ablation and its clinical significance / 第二军医大学学报

Objective: To investigate the changes of tissue structure in the ablation area after microwave ablation of thyroid nodules and to identify the appropriate time for pathological evaluation of the ablation area. Methods: From January 2017 to December 2018, a total of 69 core-needle biopsy tissue samples from the ablation area of thyroid nodules in 60 patients were investigated histologically using H-E and immunohistochemical staining. The samples were taken after microwave ablation at different stages and from different areas. Cellular morphology and tissue structure as well as thyroid transcription factor 1 (TTF1) in the tissues from the central zone and marginal zone of ablation area were observed immediately, 1 month, 3 months, 6 months and 12 months after microwave ablation. Results: Successful biopsies were achieved in 69, 12, 19, 25 and 13 ablation areas immediately, 1 month, 3 months, 6 months and 12 months after microwave ablation. There was no necrosis but only coagulated degeneration in both the central zone and marginal zone of the 69 (100.00%) ablation areas immediately after microwave ablation. At 1 month after microwave ablation, 9 (75.00%) samples of central zone and 9 (75.00%) samples of marginal zone showed complete necrosis. At 3 months, 16 (84.21%) samples of central zone and 15 (78.95%) samples of marginal zone showed complete necrosis. At 6 and 12 months, all (100.00%) samples of central zone and marginal zone became necrotic completely. Conclusion: The histopathologic feature of thyroid nodules after microwave ablation varies with time. There is only coagulated degeneration in the freshly ablated thyroid tissue, and no necrosis is found. Necrosis occurs and progresses to the whole ablation area in all patients. It suggests that the reliable therapeutic effect of microwave ablation on thyroid nodules is due to complete necrocytosis. Necrosis occurs in all the ablation area at 6 months after microwave ablation, indicating the 6th month is an appropriate time for pathological evaluation of the ablation area.

Adverse effect of mirror artifact across trachea on microwave ablation of thyroid nodules / 第二军医大学学报

Objective To study the adverse effect of mirror artifacts generated from the specular reflection of trachea wall on microwave ablation (MWA) treatment of thyroid nodules and the causes. Methods Perioperative ultrasound imaging data of 304 patients who received MWA of thyroid nodules in Shanghai International Medical Center from Jan. 2018 to Oct. 2018 were systemically studied. The occurrence rate, sources, acoustic characteristics of the mirror artifacts and the adverse effects of mirror artifacts on MWA were summarized. The factors contributing to specular reflection of trachea were analyzed. Results A total of 169 cases (55.59%) presented tracheal mirror reflection artifacts in this study. The sources of mirror artifacts included thyroid nodules (20 cases, 11.83%), injection needle (133 cases, 78.70%), ablation electrode (16 cases, 9.47%), hydro-dissection zone (137 cases, 81.07%), and remote ablated area of thyroid nodule (8 cases, 4.73%). We also found that 88.17% (149/169) of mirror artifacts were during the MWA operative period. Conclusion Mirror artifacts generated from the specular reflection of trachea wall are commonly seen in the perioperative period of thyroid nodule MWA. Lesion close to the trachea, flattened tracheal wall, and flat interface linearity larger than the real source dimension are the important causes of mirror artifacts. Direct compression on the tracheal wall caused by thyroid nodules, ablated areas and hydro-dissection zone are the main causes of flattened tracheal wall.

Determinants of prognosis in Talaromyces marneffei infections with respiratory system lesions / 中华医学杂志(英文版)

Background@#Little study has investigated the differences between Talatomyces marneffei (T. marneffei) respiratory infection and tuberculosis and the prognostic factors of such infection. This study investigated the characteristics and prognostic factors of T. marneffei infections with respiratory lesions and the causes of misdiagnosis.@*Methods@#Clinical characteristics and prognoses of patients with T. marneffei infections with respiratory system lesion were investigated. T. marneffei diagnosis followed isolation from clinical specimens using standard culture, cytology, and histopathology. Survival curves were estimated by using Kaplan-Meier analysis, with log-rank test to compare differences in survival rates between groups. Univariate and multivariate Cox regression analyses were also performed to assess significant differences in clinical characteristics of overall survival.@*Results@#Of 126 patients diagnosed with T. marneffei infections, 63 (50.0%) had T. marneffei respiratory system infections; 38.1% (24/63) were misdiagnosed as having tuberculosis. Human immunodeficiency virus (HIV) infection, CD4/CD8 < 0.5, percentage of CD4+ T cells <42.8%, and length of time from onset to confirmation of diagnosis >105 days were potential risk factors for poor prognoses. Length of time from onset to confirmation of diagnosis persisted as an independent predictor of all-cause mortality in multivariate analysis (odds ratio: 0.083, 95.0% confidence interval: 0.021–0.326, P < 0.001). However, the size of the lung lesions, dyspnea, thoracalgia, mediastinal lymphadenopathy, and pleural effusion did not significantly predict overall survival. There was no significant difference in prognosis according to the type of treatment.@*Conclusions@#T. marneffei infections involving the respiratory system are common. The critical determinants of prognosis are HIV infection, CD4/CD8, percentage of CD4+ T cells, type of treatment, and the time range from onset to confirmation of diagnosis. Rapid and accurate diagnosis is crucial for improving prognosis.

Determinants of prognosis in Talaromyces marneffei infections with respiratory system lesions / 中华医学杂志(英文版)

BACKGROUND@#Little study has investigated the differences between Talatomyces marneffei (T. marneffei) respiratory infection and tuberculosis and the prognostic factors of such infection. This study investigated the characteristics and prognostic factors of T. marneffei infections with respiratory lesions and the causes of misdiagnosis.@*METHODS@#Clinical characteristics and prognoses of patients with T. marneffei infections with respiratory system lesion were investigated. T. marneffei diagnosis followed isolation from clinical specimens using standard culture, cytology, and histopathology. Survival curves were estimated by using Kaplan-Meier analysis, with log-rank test to compare differences in survival rates between groups. Univariate and multivariate Cox regression analyses were also performed to assess significant differences in clinical characteristics of overall survival.@*RESULTS@#Of 126 patients diagnosed with T. marneffei infections, 63 (50.0%) had T. marneffei respiratory system infections; 38.1% (24/63) were misdiagnosed as having tuberculosis. Human immunodeficiency virus (HIV) infection, CD4/CD8 105 days were potential risk factors for poor prognoses. Length of time from onset to confirmation of diagnosis persisted as an independent predictor of all-cause mortality in multivariate analysis (odds ratio: 0.083, 95.0% confidence interval: 0.021-0.326, P < 0.001). However, the size of the lung lesions, dyspnea, thoracalgia, mediastinal lymphadenopathy, and pleural effusion did not significantly predict overall survival. There was no significant difference in prognosis according to the type of treatment.@*CONCLUSIONS@#T. marneffei infections involving the respiratory system are common. The critical determinants of prognosis are HIV infection, CD4/CD8, percentage of CD4 T cells, type of treatment, and the time range from onset to confirmation of diagnosis. Rapid and accurate diagnosis is crucial for improving prognosis.

Heterotopic ossification after arthroscopy for hip impingement syndrome / 中华医学杂志(英文版)

BACKGROUND@#Heterotopic ossification (HO) is a known complication of hip arthroscopy. We investigated incidence of HO after hip arthroscopy and determined whether revision for HO improved outcome.@*METHODS@#A retrospective study was conducted on 242 patients (140 men and 102 women, mean age: 36.2 ± 9.5 years) who underwent hip arthroscopy for femoroacetabular impingement (FAI) between January 2016 and January 2018. The average follow-up period was 22.88 ± 11.74 months (range: 11-34 months). Thirteen (5.37%) cases of HO (six men and seven women, five left hips and eight right hips; mean age: 37.5 ± 4.7 years) were observed. Among them, four cases with HO with obvious pain symptoms and persistent non-remission underwent revision surgery to remove HO. Monthly follow-up was conducted. Visual analog scale (VAS), modified Harris Hip Score (mHHS), and non-Arthritis Hip Score (NAHS) were evaluated and compared between HO and non-HO patients. Independent sample t test, Mann-Whitney U test and the Chi-square test were used for inter-group comparisons. HO degree was evaluated using Brooker classification. Symptoms and function were evaluated before and after revision.@*RESULTS@#A total of 242 patients were involved in this study. Thirteen cases (5.4%) had imaging evidence of HO. Nine (9/13) were classified as Brooker stage I, three (3/13) Brooker stage II, and one (1/13) Brooker stage III. HO was detected by ultrasonography as early as 3 weeks after operation. After primary surgery, the mHHS of the HO group and non-HO group increased by 13.00 (8.50, 25.50) and 24.00 (14.00, 34.50) points (Z = -1.80, P = 0.08), NAHS increased by 18.00 (9.50, 31.50) and 26.00 (13.50, 36.00) points (Z = -1.34, P = 0.18), and VAS decreased by 3.00 (2.00, 4.00) and 4.00 (3.00, 4.50) points (Z = -1.55, P = 0.12). Average follow-up time after revision was 9.00 ± 2.94 months; mHHS increased by 34.75 points (t = -55.23, P < 0.01) and NAHS by 28.75 points (t = -6.03, P < 0.01), and VAS decreased by 4 points (t = 9.80, P < 0.01). HO and non-HO patients were similar for demographic and surgical data, and clinical and functional scores.@*CONCLUSION@#HO incidence after arthroscopic treatment of FAI is similar to that found in previous studies. Most HO have no effect on clinical symptoms. Patients who undergo revision HO resection show improvement in pain and joint function.

Application of ultrasound-guided hip joint drug injection in the postoperative rehabilitation of arthroscopie repair of acetabular labral tears / 北京大学学报(医学版)

OBJECTIVE@#To explore the clinical application of ultrasound-guided hip joint drug injection in the postoperative rehabilitation of arthroscopie repair of acetabular labral tears.@*METHODS@#This research retrospectively analyzed a total of 38 hips from 36 patients (2 of them were bilateral) whose imaging examination showed acetabular labral well healed but the rehabilitating training was limited due to hip pain after arthroscopie repair of acetabular labral tears in our hospital between June 2015 and May 2017. All the patients underwent ultrasound-guided hip joint drug injection treatment. Through comparing the pain and the function of hip before and after drug injection, the clinical application values of ultrasound-guided hip joint drug injection in the postoperative rehabilitation of arthroscopie repair of acetabular labral tears were explored. The degree of hip pain was assessed by visual analogue score (VAS), which were scored before and after the injection. The hip function was assessed by the hip range of activity. The SPSS 21.0 statistical software was used for the data analysis. The effective rate of hip injection was calculated, which was defined as: ("excellent" + "good")/total number of cases×100%. The degree of hip pain was assessed by VAS, which was divided into 0 to 10 points with 0 for no pain and 10 for unbearable severe pain. The function of hip was assessed by the hip range of activity. The therapeutic effect of "excellent" meant no pain or occasional slight pain in the hip, along with Patrick test was negative and hip joint was not limited; the therapeutic effect of "good" meant that the pain was significantly reduced, and the hip's activity was slightly restricted. "No effect" meant that the pain of hip was not relieved, and the Patrick test was positive.@*RESULTS@#The VAS score of the patient before drug injection was 5.46±1.46, and the VAS score was 2.01±0.53 after drug injection 4 weeks later. The score of the latter was significantly lower than that of the former, and the difference was statistically significant (P<0.05). The hip joint activity after ultrasound-guided hip joint drug injection was significantly improved. The therapeutic effective rate was 84.2%.@*CONCLUSION@#For patients with hip pain and limitations after arthroscopie repair of acetabular labral tears, ultrasound-guided drug injection can effectively reduce hip pain, improve hip activity, and promote hip functional reconstruction.

Association Between the Circumferential Pulmonary Veins Scar and Atrial Fibrillation Recurrence in Patients Undergoing Catheter Ablation of Atrial Fibrillation / 中国循环杂志

Objectives: This study aims to analyze the relationship between late gadolinium enhancement cardiac magnetic resonance imaging (LGE-cMRI) detected scar formation of circumferential pulmonary vein and recurrence rate after catheter ablation in patients with atrial fibrillation, and to compare the efficacy of the single-step cryoballoon ablation with the point-by-point radiofrequency current ablation. Methods: A total of 56 patients with nonvalvular atrial fibrillation who underwent catheter ablation from July 2014 to December 2016 in Fujian Provincial Hospital were enrolled in this study. Among them, 27 patients underwent radiofrequency ablation (RFA), and 29 cases underwent cryoballoon ablation (CBA). Scar formation of circumferential pulmonary vein was detected by LGE-cMRI in all patients at 3 months after ablation. All patients were monitored by telephone or outpatient follow-up (patients complaint, ECG or 24-hour Holter, etc.) at 6 months post ablation. Recurrent atrial tachyarrhythmias were defined as ≥ 30 seconds AF, atrial flutter, or atrial tachycardia. Results: AF recurrence was defined in 13 (23.21%) patients. The ratio of scar formation in circumferential pulmonary vein was significantly lower in recurrence patients than that in the non-recurrent patients ([63.23±5.86]% vs [79.95±7.47]%, P<0.001). The ratio of scar formation in each pulmonary vein of 56 patients was as follows: (76.80±11.60)% in the left superior pulmonary vein, (78.90±10.64)% in the left inferior pulmonary vein, (83.35±9.44)% in the right superior pulmonary vein (P<0.05 vs the left superior pulmonary vein), which was significantly lower in the right inferior pulmonary vein (66.13±13.44)% than above veins (all P<0.05). The ratio of scar formation of all four pulmonary vein was significantly lower in recurrence patients than in the non-recurrent patients, especially in left superior pulmonary vein ([61.19±4.89]% vs [81.52±8.43]%) and the right lower pulmonary vein ([52.47±7.62] % vs [70.26±12.03]%), both P<0.001.Univariate analysis showed that the recurrence rate , the total ratio of scar formation in circumferential pulmonary vein and the ratio of scar formation in recurrence patients were similar between the CBA group and the RFA group. Conclusions: Lower circumferential pulmonary vein scar is associated with higher recurrence rate post catheter ablation in atrial fibrillation patients. The scar formation ratio is low in the right inferior pulmonary vein and the left superior pulmonary vein. The circumferential pulmonary veins scar after cryoablation and radiofrequency catheter ablation is equivalent, indicating the pulmonary vein isolation efficacy of the two procedual methods is comparable.

Application of two health risk assessment models in the occupational health risk assessment of chemicals in different industries / 预防医学

Objective To explore the applicability of Singapore semi-quantitative risk assessment mode and Romania risk assessment model in occupational health risk assessment. Methods We employed two risk assessment models to evaluate the risk of key positions in papermaking factories, electroplating factories, and chemical factories. Then we compared the results with occupational exposure limits, classification of occupational hazards and literature reports. Results The results of Singapore model showed that the total risk ratio was 0.40 ±0.16. The risk levels of papermaking factories, electroplating factories, and chemical factories were low-medium, negligible-low and low-very high, respectively. The risk ratio of three industries were 0.42±0.04, 0.31±0.10 and 0.62±0.15. The results of Romania model showed that the total risk ratio was 0.43 ±0.11. The risk levels of papermaking factories, electroplating factories, and chemical factories were respectively low-high, minimal-low and low-very high. The risk ratio of three industries was 0.46±0.13, 0.38±0.08 and 0.52±0.11, respectively. The risk levels of electroplating factories were higher than papermaking factories and chemical factories (P<0.05) . There was no significant difference between risk levels of papermaking factories and chemical factories (P>0.05) . There was significant difference between the occupational health risk levels assessed by the two models (P >0.05) . Conclusion These findings suggest that Singapore semi-quantitative risk assessment model and Romania risk assessment model both can be applied for the occupational health risk assessment of different workplaces, such as papermaking factories,electroplating factories, and chemical factories. The risk assessment results of the two methods are basically identical.

A study on application of semi-quantitative risk assessment models in furniture industry / 预防医学

Objective To explore the suitable risk assessment model for printing industry, we evaluated the risk of furniture industry using models provided by Singapore Ministry of Manpower (MOM) . Methods According to the occupational-disease-prevention laws and regulations, we improved the MOM and increased the risk assessment of physical agents. Then, we evaluate the risk of furniture industry using the improved MOM. Results The range of wood dust was 1.9-8.9mg/m3, and the percent of pass was 50%. The range of formaldehyde, benzene, methylbenzene and dimethylbenzene was 0.24-0.36 mg/m3, <0.6mg/m3, 3.8-6.7mg/m3 and 6.1-16.1mg/m3 respectively, and their percent of pass was 100%. Furthermore, the noise intensity was 80.8 dB (A), which was under the occupational exposure limit. The risk level of wood dust, formaldehyde, benzene and noise was high, while the risk level of methylbenzene and dimethylbenzene was moderate. Conclusion The improved semi-quantitative risk assessment was appropriate for furniture industry, but its applicability in industrial enterprise needs to be studied further.

Influence of different CO2 pneumoperitoneum pressure on intestinal mucosal injury and intestinal function recovery in patients undergoing laparoscopic radical gastrectomy / 中国现代普通外科进展

Objective:To evaluate the influence of different CO2 pneumoperitoneum pressure on intestinal mucosal injury and intestinal function recovery in patients undergoing laparoscopic radical gastrectomy.Methods:A total of 120 patients undergoing laparoscopic radical gastrectomy were randomly divided into group A,B and C.Each group included 40 patients.CO2 pneumoperitoneum pressure ingroup A,B and C were 8～10 mmHg,11～13 mmHg and 14～16 mmHg,respectively.The degree of intestinal mucosa damage,plasma D-lactate(2,24 and 48 hours after the treat-ment),intestinal function recovery and complication ration were compared between the three groups.Results:Damage degree of intestinal mucosa after operation in A,B and C groups were 0～1,1～2 and 2～3 respectively.There was significant change in intestinal mucosa injury after operation in both B and C groups.The level of D-lactic acid in group C (2,24 and 48 hours after the treat-ment) were significantly higher those in group A and group B (P＜0.05).The bowel sounds appeared time,exhaust time and intake time in group C were significantly longer than group A and group B (P＜0.05).The incidence of complications were not significantly difference during the three groups.Conclusion:The high pressure of CO2 pneumoperitoneum will cause intestinal mucosa damaged,and not conducive to the patients' intestinal rehabilitation.We suggest that the CO2 pneumoperitoneum pressure should be as low as possible under clear visualization during operation.

Cynomorium songaricum improves sperm count and motility and serum testosterone level and promotes proliferation of undifferentiated spermatogonia in oligoasthenospermia rats / 中华男科学杂志

<p><b>Objective</b>To investigate the effects of cynomorium songaricum (CS) decoction on the testis weight, serum testosterone level, and sperm parameters of rats with oligoasthenospermia (OAS), explore its action mechanism of improving the proliferation of undifferentiated spermatogonial cells, and provide some experimental and theoretical evidence for the development of new Chinese drugs for OAS.</p><p><b>METHODS</b>Thirty 8-week-old male SD rats were randomly divided into five groups of equal number: blank control, model control, high-dose CS, medium-dose CS, and low-dose CS. OAS models were established by intraperitoneal injection of cyclophosphamide and, a month later, treated intragastrically with normal saline or CS at 2, 1, and 0.5 g per kg of the body weight per day, all for 4 weeks. Then, the testes of the animals were harvested to obtain the testicular weight, sperm concentration and motility, and the level of serum testosterone (T), detect the expressions of the transcription factor 1 (Oct4), Thy-1 cell surface antigen (Thy1), promyelocytic leukemia zinc finger (PLZF), KIT proto-oncogene receptor tyrosine kinase (C-kit) and glial cell-derived neurotrophic factor (GDNF) in the testis tissue of the rats in the low-dose CS group by real-time PCR.</p><p><b>RESULTS</b>The testis weights in the blank control, model control, high-dose CS, medium-dose CS, and low-dose CS groups were (1.52±0.06), (1.55±0.06), (1.43±0.30), (1.35±0.40) and (1.34±0.04) g, respectively, not significantly different in the blank and model controls from those in the CS groups (P>0.05). The visual field sperm count per 10 HP was significantly increased in the high-, medium-, and low-dose CS groups (202±20, 196±5 and 216±25) as compared with the blank and model controls (200±15 and 134±30) (P<0.05). The mRNA expressions of the Oct4, Thy1, PLZF and GDNF genes were remarkably higher in the low-dose CS group than in the controls (P<0.05), but that of the C-kit gene showed no significant difference from the latter (P>0.05). The visual field sperm motility per 10 HP was markedly increased in the blank control (［52.1±5.5］%), model control (［38.1±2.5］%), high-dose CS (［59.1±9.5］%), medium-dose CS (［58.7±9.5］%), and low-dose CS (［49.6±1.0］%) groups, and so was the level of serum testosterone (［190±87.5］, ［82.5±25.8］, ［229±75.6］, ［331±86.7］ and ［185±82.4］ mmol/L), both remarkably higher in the CS groups than in the model controls (P<0.05) but with no statistically significant difference between the CS groups and the blank controls (P>0.05).</p><p><b>CONCLUSIONS</b>CS can significantly improve sperm concentration, sperm motility and serum T level in OAS rats, probably by inducing the expression of GDNF in the rat Sertoli cells, promoting the proliferation of undifferentiated spermatogonial cells, and enhancing spermatogenesis.</p>

Prostate-specific Antigen Density Variation Rate as a Potential Guideline Parameter for Second Prostate Cancer Detection Biopsy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The diagnostic value of current prostate-specific antigen (PSA) tests is challenged by the poor detection rate of prostate cancer (PCa) in repeat prostate biopsy. In this study, we proposed a novel PSA-related parameter named PSA density variation rate (PSADVR) and designed a clinical trial to evaluate its potential diagnostic value for detecting PCa on a second prostate biopsy.</p><p><b>METHODS</b>Data from 184 males who underwent second ultrasound-guided prostate biopsy 6 months after the first biopsy were included in the study. The subjects were divided into PCa and non-PCa groups according to the second biopsy pathological results. Prostate volume, PSA density (PSAD), free-total PSA ratio, and PSADVR were calculated according to corresponding formulas at the second biopsy. These parameters were compared using t-test or Mann-Whitney U-test between PCa and non-PCa groups, and receiver operating characteristic analysis were used to evaluate their predictability on PCa detection.</p><p><b>RESULTS</b>PCa was detected in 24 patients on the second biopsy. Mean values of PSA, PSAD, and PSADVR were greater in the PCa group than in the non-PCa group (8.39 μg/L vs. 7.16 μg/L, 0.20 vs. 0.16, 14.15% vs. -1.36%, respectively). PSADVR had the largest area under the curve, with 0.667 sensitivity and 0.824 specificity when the cutoff was 10%. The PCa detection rate was significantly greater in subjects with PSADVR >10% than PSADVR ≤10% (28.6% vs. 6.5%, P< 0.001). In addition, PSADVR was the only parameter in this study that showed a significant correlation with mid-to-high-risk PCa (r = 0.63, P = 0.03).</p><p><b>CONCLUSIONS</b>Our results demonstrated that PSADVR improved the PCa detection rate on second biopsies, especially for mid-to-high-risk cancers requiring prompt treatment.</p>