Animal model-based simulation training for three emergent and urgent operations of penetrating thoracic injuries / 中华创伤杂志(英文版)

PURPOSE@#To develop animal models of penetrating thoracic injuries and to observe the effects of the animal model-based training on improving the trainees' performance for emergent and urgent thoracic surgeries.@*METHODS@#With a homemade machine, animal models of lung injuries and penetrating heart injuries were produced in porcine and used for training of chest tube drainage, urgent sternotomy, and emergent thoracotomy. Coefficient of variation of abbreviated injury scale and blood loss was calculated to judge the reproducibility of animal models. Five operation teams from basic-level hospitals (group A) and five operation teams from level III hospitals (group B) were included to be trained and tested. Testing standards for the operations were established after thorough literature review, and expert questionnaires were employed to evaluate the scientificity and feasibility of the testing standards. Tests were carried out after the training. Pre- and post-training performances were compared. Post-training survey using 7-point Likert scale was taken to evaluate the feelings of the trainees to these training approaches.@*RESULTS@#Animal models of the three kinds of penetrating chest injuries were successfully established and the coefficient of variation of abbreviated injury scale and blood loss were all less than 25%. After literature review, testing standards were established, and expert questionnaire results showed that the scientific score was 7.30 ± 1.49, and the feasibility score was 7.50 ± 0.89. Post-training performance was significantly higher in both group A and group B than pre-training performance. Post-training survey showed that all the trainees felt confident in applying the operations and were generally agreed that the training procedure were very helpful in improving operation skills for thoracic penetrating injury.@*CONCLUSIONS@#Animal model-based simulation training established in the current study could improve the trainees' performance for emergent and urgent thoracic surgeries, especially of the surgical teams from basic-level hospitals.

Expression of SEC61G in Oral Squamous Cell Carcinoma and Its Prognostic Value / 肿瘤防治研究

Objective To analyze the expression of SEC61G in oral squamous cell carcinoma (OSCC) tissues and cell lines and determine its correlations with the clinicopathological features and prognosis of patients with OSCC. Methods The expression of SEC61G in OSCC tissues and its diagnostic and prognostic value were detected in the TCGA database. The expression levels of SEC61G in paraffin-embedded OSCC tissues and adjacent normal tissue specimens of 64 patients with OSCC were detected by immunohistochemistry. The correlation of SEC61G expression in OSCC tissues with the clinicopathological features was analyzed. Kaplan-Meier survival curve analysis showed that the expression of SEC61G correlated with the overall survival time of patients with OSCC. Cox regression analysis was used to analyze prognostic influence factors. Results The expression of SEC61G in OSCC tissues was significantly higher than that in para-carcinoma tissues (P < 0.05), consistent with the results of the TCGA database analysis, and its expression was closely related to N stage and clinical stage (P < 0.05). The overall survival of patients with OSCC in the group with low SEC61G expression was significantly higher than that in the high SEC61G expression group (P < 0.05). N stage and SEC61G expression were the prognostic influence factors for patients with OSCC (P < 0.05). SEC61G expression was an independent predictor of the prognosis of patients with OSCC (P < 0.05, AUC=0.923). Conclusion SEC61G is highly expressed in OSCC tissues and associated with N stage and clinical stage. Its high expression is associated with poor prognosis of patients. It may be a diagnostic biomarker for OSCC.

Application Value and Research Progress of Human Microbiome in Sexual Assault Cases / 法医学杂志

In recent years, sexual assault cases have been on the rise, seriously infringing the legitimate rights and interests of women and children, causing widespread concern in society. DNA evidence has become the key evidence to prove the facts in sexual assault cases, but lack of DNA evidence or only DNA evidence in some sexual assault cases leads to unclear facts and insufficient evidence. With the emergence of high-throughput sequencing technology and the development of bioinformatics and artificial intelligence, new progress has been made in the study of human microbiome. Researchers have begun to use human microbiome for difficult sexual assault cases indentification. This paper reviews the characteristics of human microbiome, and its application value in the inferences of the body fluid stain origin, the sexual assault method, the crime time, etc. In addition, the challenges faced by the application of the human microbiome in practical case handling, the solutions and future development potential are analyzed and prospected.

Effect of acupuncture combined with medical training therapy for the patients with functional ankle instability / 国际中医中药杂志

Objective:To observe the clinical effect of acupuncture combined with Medical Training Therapy (MTT) for Functional ankle instability (FAI).Methods:A total of 72 patients, who met the inclusion criteria of FAI, from January 2018 to June 2019, were selected and randomly divided them into 4 groups: Combination group (CG), MTT group (MTT), Acupuncture group (ACU) and Control group (Ctrl). Intervention of groups were that MTT and Acupuncture were used in CG, MTT and acupuncture are used separately in MTT and ACU groups. Patients of Ctrl Group were on the waiting list. All four groups were treated for 8 weeks. The Cumberland Ankle Instability Tool (CAIT), Foot And Ankle Ability Measure (FAAM) and American Orthopedic Foot and Ankle Society (AOFAS) were assessed for the ankle function evaluation.Results:After treatment, the CAIT (23.17 ± 5.22, 21.17 ± 6.85, 21.88 ± 4.24 vs. 20.10 ± 6.31, F=34.737), FAAM-ADL (96.52 ± 3.61, 94.39 ± 5.56, 95.04 ± 4.03 vs. 92.66 ± 10.18, F=39.244), FAAM-Sport (72.38 ± 8.10, 70.71 ± 9.57, 71.82 ± 10.0 vs. 57.98 ± 15.27, F=42.187) and AOFAS (89.16 ± 3.02, 85.82 ± 5.33, 86.08 ± 4.00 vs. 77.08 ± 8.90, F=37.629) in CG Group, MTT Group, ACU Group were significantly higher than those in the Ctrl Group ( P<0.01). Conclusion:Acupuncture combined with MTT treatment can increase the stability and improve the ankle function, which is superior to acupuncture alone and MTT alone.

SNP Panel Analysis of Ancestry Inference in East Asian Populations / 法医学杂志

Objective To develop an SNP Panel for East Asian population, which has a high individual identification rate and the capability of ancestry analysis. Methods The 55 SNP Panel by Professor KIDD of Yale University and the 128 SNP Panel by Professor SELDIN of Davis School of California University, 170 SNP Panel in total was used as the basis and its test data in the East Asian population was collected. The genetic parameters of SNP loci were calculated and combined with the results of heatmap analysis to screen SNP loci suitable for East Asian population. Some Tibetan and Han samples were tested. The possibility of using the SNP loci in ancestry inference was analyzed by means of STRUCTURE analysis, principal component analysis and heatmap analysis. Results A Panel with 45 SNPs （45 SNP Panel） was screened out, and the average genetic parameters of each SNP were better than 170 SNP Panel, with the same ancestry analysis and inference ability. Conclusion In terms of ancestry inference information, the 45 SNP Panel can completely replace the 170 SNP Panel and achieve the same ancestry analysis and inference ability. In genetic parameters, 45 SNP Panel is better than 170 SNP Panel in the East Asian population, which shows its important potential forensic application value.

Drug-Resistant Mycobacterium tuberculosis Isolates from New and Previously Treated TB Patients in China, 2017-2019

Abstract INTRODUCTION: Mycobacterium tuberculosis (MTB) is a causative agent of tuberculosis (TB) that causes death worldwide. METHODS: MTB was subjected to phenotypic drug-susceptibility tests (DST), and drug-resistant genes were sequenced. RESULTS: Previously treated patients were more likely to have positive smear results and exhibit drug resistance. New patients were more likely to be mono SM-resistant and less likely to be INH- and RIF-resistant. The most common mutations were katG (S315T), rpoB (S450L), rpsL (K43R), and embB (M306V). CONCLUSIONS: The proportion of mono-SM-resistant TB among new patients was higher.

Different anchorages can affect the position of maxillary third molars in extraction treatment / 中国组织工程研究

BACKGROUND: In orthodontic treatment, different anchorage controls will make different effects on the maxillary third molar. Whether this can affect the normal eruption of maxillary third molar remains unclear. OBJECTIVE: To explore the effect of Physiologic Anchorage Spee-Wire System (PASS) treatment on impacted maxillary third molars, and to provide reference for clinical application. METHODS: Thirty patients with maxillary third molars were treated with PASS and 30 patients were treated with McLaughlin, Bennett, and Trevisi (MBT). All patients chose the plan of extracting four first premolars. The angles and distances were measured before and after treatment and statistical analysis was performed. The study was in accordance with the ethical requirements of the Fifth Affiliated Hospital of Xinjiang Medical University. All participants and their guardians signed the informed consents. RESULTS AND CONCLUSION: (1) In the PASS group, the ∠UM3-HP, ∠UM2-HP and U-ES were significantly increased (P=0.00), and the UM3-OP was significantly decreased (P=0.00), indicating that the maxillary second molar and third molar became more upright, and larger eruption space contributed to eruption. (2) Compared with the PASS group, the obliquity of the maxillary third molar in the MBT group showed significant change, while the vertical eruption rate in the PASS group was relatively larger. (3) These results imply that both PASS and MBT can improve the eruption angle and space of the third molar, and make it easier to erupt in orthodontic treatment of extraction of the first premolar.

Effects of Electroacupuncture on Metabolic Changes in Motor Cortex and Striatum of 6-Hydroxydopamine-Induced Parkinsonian Rats / 中国结合医学杂志

OBJECTIVE@#To explore the possible underlying mechanism by investigating the effect of electroacupuncture (EA) treatment on the primary motor cortex and striatum in a unilateral 6-hydroxydopamine (6-OHDA) induced rat Parkinson's disease (PD) model.@*METHODS@#Male Sprague-Dawley rats were randomly divided into sham group (n=16), model group (n=14), and EA group (n=14). EA stimulation at Dazhui (GV 14) and Baihui (GV20) was applied to PD rats in the EA group for 4 weeks. Behavioral tests were conducted to evaluate the effectiveness of EA treatment. Metabolites were detected by 7.0 T proton nuclear magnetic resonance.@*RESULTS@#Following 4 weeks of EA treatment in PD model rats, the abnormal behavioral impairment induced by 6-OHDA was alleviated. In monitoring changes in metabolic activity, ratios of myoinositol/creatine (Cr) and N-acetyl aspartate (NAA)/Cr in the primary motor cortex were significantly lower at the injected side than the non-injected side in PD rats (P=0.024 and 0.020). The ratios of glutamate + glutamine (Glx)/Cr and NAA/Cr in the striatum were higher and lower, respectively, at the injected side than the non-injected side (P=0.046 and 0.008). EA treatment restored the balance of metabolic activity in the primary motor cortex and striatum. In addition, the taurine/Cr ratio and Glx/Cr ratio were elevated in the striatum of PD model rats compared to sham-lesioned rats (P=0.026 and 0.000). EA treatment alleviated the excessive glutamatergic transmission by down-regulating the striatal Glx/Cr ratio (P=0.001). The Glx/Cr ratio was negatively correlated with floor plane spontaneous locomotion in PD rats (P=0.027 and P=0.0007).@*CONCLUSIONS@#EA treatment is able to normalize the metabolic balance in the primary motor cortex and striatum of PD rats, which may contribute to its therapeutic effect on motor deficits. The striatal Glx/Cr ratio may serve as a potential indicator of PD and a therapeutic target of EA treatment.

Enteral nutrition support reduces toxicity of chemotherapy in patients with advanced or metastatic esophageal cancer / 北京大学学报(医学版)

OBJECTIVE@#To assess the impact of enteral nutrition support on response and toxicity of the first-line chemotherapy in those patients with advanced or metastatic esophageal cancer.@*METHODS@#We collected the clinical data of 118 patients with unresectable advanced or metastatic esophageal cancer who received the first-line chemotherapy in our center from July 2014 to December 2016. All these 118 esophageal cancer patients were then divided into two groups: the nutrition group (received enteral nutrition support in addition to chemotherapy) and the control group (received chemotherapy only). Differences were analyzed before and after chemotherapy in each of the nutritional indicators including Karnofsky performance status (KPS), weight, body mass index (BMI), hemoglobin (Hb), number of lymphocytes (Lymph), total protein (TP), albumin (Alb), triglycerides (TG), total cholesterol (TC) in both groups. And differences of the efficacy and toxicities of the first-line chemotherapy between the two groups were also analyzed.@*RESULTS@#(1) Weight, BMI and Hb were all significantly decreased after chemotherapy in the control group (P<0.001), while there was no significant change of weight and BMI in the nutrition group, just with Hb decrease only. However, there was no significant change of all the other nutrition indicators after chemotherapy in both groups. (2) Compared with the control group, the nutrition group had significantly lower incidence of grade 3 to 4 hematologic toxicities after chemotherapy (15.4% vs. 42.1%, P=0.004). In addition, the incidence of grade 3 to 4 nonhematologic toxicities after chemotherapy was also lower in the nutrition group but without statistical significance (0 vs. 9.2%, P=0.123). Logistic regression model was then used for multivariate analysis to identify the factors that affected the toxicity of chemotherapy in these patients, and the results showed that nutrition therapy was an independent influencing factor of grade 3 or higher hematological toxicity after chemotherapy in the patients with esophageal cancer (P=0.008, RR=6.048, 95%CI: 1.589-23.027). (3) The response rate of chemotherapy between the control group and the nutrition group had not significant difference.@*CONCLUSION@#Enteral nutrition support in addition to chemotherapy could improve nutrition status and reduce toxicity of chemotherapy in advanced or metastatic esophageal cancer patients.

Resistance training improves functional sympatholysis in persons with primary hypertension / 中华物理医学与康复杂志

Objective:To explore the effect of twelve weeks of resistance training on the functional sympatholysis of the skeletal muscles in persons with primary hypertension.Methods:Thirty untreated adult men with stage 1 essential hypertension (SBP/DBP: 140-159/90-99mmHg) formed a hypertension group, while thirty healthy counterparts (SBP/DBP: 90-120/60-80mmHg) served as a control group. Both groups underwent 12 weeks of progressive resistance training, 3 times a week. Before and after the intervention, any changes in forearm haemodynamics at rest were measured, along with handgrip after activation of the sympathetic nerve using a cold pressor test (CPT). The sympathetic vasoconstriction response was represented by the rate of change in brachial vascular conductance (%FVC) induced by the CPT, and the ability to suppress sympathetic vasoconstrictor responses using muscle contractions (functional sympatholysis) was quantified as the difference in sympathetic vasoconstrictor response between the handgrip test and at rest (△%FVC).Results:There were no significant differences between the two groups in their average △%FVCs before the intervention. After the intervention, significant increases were observed in both groups, but there was still no significant difference between the two groups′ average △%FVCs.Conclusion:Twelve weeks of resistance training can improve the functional sympatholysis of adult men with essential hypertension. Their elevated blood pressure does not impair functional sympatholysis.

Analysis of chloroplast genome and its characteristics of medicinal plant Sophora flavescens / 药学学报

In order to explore the chloroplast genome characteristics of Sophora flavescens and the phylogenetic relationship of the genus, this study used high-throughput sequencing technology to sequence and functionally annotate the chloroplast genome of Sophora flavescens. The results showed that the full length 154 165 bp of Sophora flavescens chloroplast genome showed a typical four-stage structure. The chloroplast genome contains 123 genes, including 77 protein-coding genes, 38 tRNA genes and 8 rRNA genes. Sequence analysis revealed 104 SSR loci, most of which consisted of A and T. In addition, the chloroplast genome codon preference is weak, and the coding region is biased towards the use of A and T bases. A comparative analysis of two different regions of Sophora flavescens chloroplast genome revealed four differential genes. Based on the maximum likelihood method (ML) for phylogenetic analysis of Sophora flavescens and 16 other leguminous, it was found that the relationship between Sophora flavescens and the genus Sophora alopecuroides is the closest. This study provides an important theoretical basis for the genetic variation, breeding and phylogenetic analysis of Sophora flavescens, and has certain reference value.

Exosome-derived galectin-9 may be a novel predictor of rejection and prognosis after liver transplantation / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Acute cellular rejection (ACR) remains a major concern after liver transplantation. Predicting and monitoring acute rejection by non-invasive methods are very important for guiding the use of immunosuppressive drugs. Many studies have shown that exosomes and their contents are potential biomarkers for various liver diseases. Here, we identify and validate the role of exosomes and galectin-9 in ACR after liver transplantation. Exosomes were isolated from three sets of paired patients, with and without ACR, and the proteins within the exosomes were isolated and identified. Candidate proteins were then validated using a tissue microarray containing resected liver samples from 73 ACR and 63 non-rejection patients. Finally, protein expression and clinical manifestations were included in Kaplan-Meier survival and Cox regression analyses. Circulating exosomes were isolated from ACR and non-rejection patients and characterized using transmission electron microscopy and western blotting for CD63/CD81. Western blotting experiments revealed higher levels of galectin-9 protein in circulating exosomes from ACR recipients. Immunohistochemical analysis of the tissue microarray showed that the expression of galectin-9 in resected liver was significantly higher in the ACR group than in the non-rejection group (P<0.05). Higher levels of galectin-9 expression in resected livers were associated with poorer prognosis (P<0.05). Exosome-derived galectin-9 may be a novel predictor of rejection and prognosis after liver transplantation.

Comparison of adjacent segment degeneration following single-segment minimally invasive and open transforaminal lumbar interbody fusion / 中华骨科杂志

Objective@#To compare the incidence of adjacent segment degeneration (ASDeg) and clinical outcomes of minimally invasive versus traditional transforaminal lumbar interbody fusion (TLIF) in the treatment of L 4,5 single-segment lumbar spinal stenosis (LSS) and explore the risk factors of ASDeg.@*Methods@#All of 115 patients with LSS who were treated by the same group of doctors from 2009 to 2013, with a minimum follow-up of 5 years. Thirty-eight patients underwent minimally invasive trans-foraminal lumbar interbody fusion (MIS-TLIF) and 77 patients underwent traditional TLIF. Standing radiographs at the preopera-tive period and the final follow-up were assessed. Radiological parameters included lumbar lordosis (LL), fused segment angle (FSA), disc height (DH) and range of motion (ROM). Babu classification was used to identify facet joint violation (FJV) in patients at 5-year follow-up. Clinical outcomes were assessed according to visual analog scale (VAS) score, Japanese Orthopaedic Associa-tion (JOA) score and Oswestry Disability Index (ODI). Student's t-test, Chi-square test, and non-parametric test were used as the main statistical methods.@*Results@#The mean age of MIS-TLIF group was 58.2±8.8 years, and that of TLIF group was 54.7±11.2 years, and there was no significant difference between the two groups. The mean follow-up time was 64.5±3.8 months in the MIS-TLIF group and 63.9±3.3 months in the TLIF group, and there was no significant difference between the two groups. There were 17 cases of degenerative spondylolisthesis in MIS-TLIF group (44.7%) and 35 cases of degenerative spondylolisthesis in TLIF group (45.5%), and there was no significant difference between the two groups. There was no significant difference in DH and ROM of L3,4, L4,5, L5S1 between the two groups before operation. There was no significant difference in VAS, JOA and ODI scores between the two groups before operation. The VAS, JOA and ODI scores were significantly improved at the last follow-up compared with those before operation. After 5-year follow-up, 56 cases (48.7%) had ASDeg. The incidence of ASDeg was 31.6% in MIS-TLIF group and 57.1% in TLIF group, and there was statistical differences between the two groups (χ2=6.656, P <0.01). Among them, 32 cases only had upper segment ASDeg (6 cases in MIS-TLIF group, 26 cases in TLIF group), 19 cases only had lower segment ASDeg (6 cases in MIS-TLIF group, 13 cases in TLIF group), and 5 cases had both upper and lower ASDeg (5 cases in the TLIF group). The DH of adjacent segments decreased after operation, but the loss of DH in MIS-TLIF group was smaller than that in TLIF group, including L3,4 segments (-4.9%±6.4% vs-8.7%±7.2%, t=-2.761, P <0.01), L5S1 segment (-4.7%±9.8% vs-10.5%±11.7%, t=-2.623, P <0.01). The ROM of adjacent segments increased in both groups, but the increase of ROM in MIS-TLIF group was smaller than that in TLIF group, including L 3,4 segments (1.1°±1.8° vs 2.3°±2.5°, t=-3.122, P <0.01), L5S1 segment (0.9°± 1.9 ° vs 1.8°±1.9 °, t=-2.353, P <0.01). The incidence of FJV was 54.2% in patients with ASDeg in MIS-TLIF group and 47.7% in patients with ASDeg in TLIF group. Chi-square analysis showed that FJV was related to ASDeg in both groups (χ2=3.869, P < 0.05).@*Conclusion@#Both of the two surgical methods have good clinical effects on L 4,5 single-segment LSS. The incidence of AS-Deg after MIS-TLIF is lower than that of TLIF. FJV is a risk factor for ASDeg.

Anatomy and clinical significance of hilar plate / 中国实用外科杂志

The concept of hepatic hilar plate was first proposed by Couinaud in 1957. After more than 60 years of exploration and clinical practice, the related techniques of hepatic hilar plate exposure, including lowering hepatic hilar plate technique, extra-glissonean pedicle approach technique,have been used in hepatic vascular inflow occlussion of open and laparoscopic anatomical hepatectomy, resection of hepatic hilar complex tumors, management of hepatolithiasis and traumatic benign stricture of high bile duct. Hilar plate detachment and glissonean pedicle approach technique are more and more widely used, which have become a compulsory course for hepatobiliary surgeons to reduce the difficulty of perihilar surgery and increase the safety of liver surgery.

Comparison of adjacent segment degeneration following single?segment minimally invasive and open transforaminal lumbar interbody fusion / 中华骨科杂志

Objective To compare the incidence of adjacent segment degeneration (ASDeg) and clinical outcomes of minimally invasive versus traditional transforaminal lumbar interbody fusion (TLIF) in the treatment of L 4,5 single?segment lumbar spinal stenosis (LSS) and explore the risk factors of ASDeg. Methods All of 115 patients with LSS who were treated by the same group of doctors from 2009 to 2013, with a minimum follow?up of 5 years. Thirty?eight patients underwent minimally invasive trans?foraminal lumbar interbody fusion (MIS?TLIF) and 77 patients underwent traditional TLIF. Standing radiographs at the preopera?tive period and the final follow?up were assessed. Radiological parameters included lumbar lordosis (LL), fused segment angle (FSA), disc height (DH) and range of motion (ROM). Babu classification was used to identify facet joint violation (FJV) in patients at 5?year follow?up. Clinical outcomes were assessed according to visual analog scale (VAS) score, Japanese Orthopaedic Associa?tion (JOA) score and Oswestry Disability Index (ODI). Student's t?test, Chi?square test, and non?parametric test were used as the main statistical methods. Results The mean age of MIS?TLIF group was 58.2±8.8 years, and that of TLIF group was 54.7±11.2 years, and there was no significant difference between the two groups. The mean follow?up time was 64.5±3.8 months in the MIS?TLIF group and 63.9±3.3 months in the TLIF group, and there was no significant difference between the two groups. There were 17 cases of degenerative spondylolisthesis in MIS?TLIF group (44.7%) and 35 cases of degenerative spondylolisthesis in TLIF group (45.5%), and there was no significant difference between the two groups. There was no significant difference in DH and ROM of L 3,4, L 4,5, L5S1 between the two groups before operation. There was no significant difference in VAS, JOA and ODI scores between the two groups before operation. The VAS, JOA and ODI scores were significantly improved at the last follow?up compared with those before operation. After 5?year follow?up, 56 cases (48.7%) had ASDeg. The incidence of ASDeg was 31.6% in MIS?TLIF group and 57.1% in TLIF group, and there was statistical differences between the two groups (χ2=6.656,P<0.01). Among them, 32 cases only had upper segment ASDeg (6 cases in MIS?TLIF group, 26 cases in TLIF group), 19 cases only had lower segment ASDeg (6 cases in MIS?TLIF group, 13 cases in TLIF group), and 5 cases had both upper and lower ASDeg (5 cases in the TLIF group). The DH of adjacent segments decreased after operation, but the loss of DH in MIS?TLIF group was smaller than that in TLIF group, including L 3,4 segments (-4.9%±6.4% vs-8.7%±7.2%, t=-2.761, P<0.01), L5S1 segment (-4.7%±9.8% vs-10.5%± 11.7%, t=-2.623, P<0.01). The ROM of adjacent segments increased in both groups, but the increase of ROM in MIS?TLIF group was smaller than that in TLIF group, including L 3,4 segments (1.1°± 1.8°vs 2.3°± 2.5°, t=-3.122, P<0.01), L5S1 segment (0.9°± 1.9°vs 1.8°±1.9°, t=-2.353, P<0.01). The incidence of FJV was 54.2% in patients with ASDeg in MIS?TLIF group and 47.7% in patients with ASDeg in TLIF group. Chi?square analysis showed that FJV was related to ASDeg in both groups (χ2=3.869,P <0.05). Conclusion Both of the two surgical methods have good clinical effects on L 4,5 single?segment LSS. The incidence of AS?Deg after MIS?TLIF is lower than that of TLIF. FJV is a risk factor for ASDeg.

Relationship of lymph node metastasis rate with prognosis of esophageal squamous cell carcinoma after radical resection and postoperative adjuvant chemotherapy / 中华消化外科杂志

Objective To investigate the relationship of lymph node metastasis rate (LNR) with prognosis of esophageal squamous cell carcinoma after radical resection and postoperative adjuvant chemotherapy.Methods The retrospective case-control study was conducted.The clinicopathological data of 121 patients who underwent radical resection of esophageal squamous cell carcinoma in the Peking University Cancer Hospital from January 2012 to September 2016 were collected.There were 105 males and 16 females,aged from 42 to 76 years,with a median age of 58 years.All patients underwent radical resection of esophageal cancer with at least two-field lymph nodes dissection.Some patients underwent corresponding chemotherapy and radiotherapy.The thoracic and abdominal lymph nodes were grouped according to the 7th edition standard of Americau Joint Committee on Cancer (AJCC).The lymph nodes dissected were labeled in groups,and all the lymph nodes were examined by pathology test.Observation indicators:(1) follow-up;(2) effects of LNR on prognosis of patients in different AJCC N staging;(3) relationship between LNR and postoperative adjuvant chemotherapy.Follow-up was conducted by outpatient examination,telephone interview and hospital statistical office to detect postoperative survival of patients up to February 2017.The disease-free survival time was from surgery date to date of confirmation of tumor recurrence,and the overall survival time was from surgery date to death of the patient or the last follow-up date.Measurement data with skewed distribution were expressed by M (range).The Kaplan-Meier method was used to calculate the survival rate and draw the survival curve.The Log-rank test was used for survival analysis.Results (1) Follow-up:121 patients were followed up for 3.0-94.2 months,with a median follow-up time of 27.1 months.During the follow-up,98 of 121 patients had tumor recurrence and metastasis (including 64 deaths),22 had no metastasis,and 1 had unknown tumor metastasis.The mean overall survival time of patients was 30.8 months.The 1-,3-,5-year disease-free survival rates were 47.1％,20.3％,and 5.9％,respectively.The 1-,3-,5-year overall survival rates were 93.1％,48.7％,and 35.3％,respectively.(2) Effects of LNR on prognosis of patients in different AJCC N staging:of 121 patients,46 were in N0 stage,42 were in N1 stage,28 were in N2 stage,and 5 were in N3 stage.Of 42 patients in N1 stage,35 with 0 ＜ LNR ≤ 0.15 had a disease-free survival time of 12.2 months (range,1.2-82.3 months),and 7 with LNR ＞ 0.15 had a disease-free survival time of 6.9 months (range,2.1-23.1 months);the difference between the two groups was statistically significant (x2 =3.888,P＜0.05).Of the 28 patients in N2 stage,12 with 0 ＜ LNR ≤ 0.15 had a disease-free survival time of 8.5 months (range,1.2-38.8 months),and 16 with LNR ＞ 0.15 had a disease-free survival time of 4.4 months (range,1.0-52.7 months);the difference was not statistically significant (x2 =0.007,P＞0.05).Forty-six patients in N0 stage were detected no lymph node metastasis,and only 5 cases were in N3 stage,with no analysis.(3) Relationship between LNR and postoperative adjuvant chemotherapy:of the 121 patients,56 underwent postoperative adjuvant chemotherapy,which was mainly constituted by pactitaxel,platinum,and 5-fluorouracilbased regimens,58 didn't undergo postoperative adjuvant chemotherapy,and 7 had unknown data of postoperative adjuvant chemotherapy.Of 121 patients,46 had LNR =0,47 had 0 ＜ LNR ≤ 0.15,28 had LNR ＞ 0.15.Of the 46 patients with LNR =0,17 who underwent postoperative adjuvant chemotherapy had a disease-free survival time of 8.1 months (range,3.9-66.7 months) and a overall survival time of 34.0 months (range,4.7-76.0 months);29 who didn't undergo postoperative adjuvant chemotherapy had a disease-free survival time of 18.8 months (range,1.6-53.2 months),and a overall survival time of 48.6 months (range,8.3-94.2 months);there was no significant difference in the disease-free survival time and overall survival time between the two groups (x2=0.311,0.858,P＞0.05).Of the 47 patients with 0 ＜ LNR ≤ 0.15,27 who underwent postoperative adjuvant chemotherapy had a disease-free survival time of 13.3 months (range,5.0-82.3 months),and a overall survival time of 53.1 months (range,5.7-82.3 months);20 without postoperative adjuvant chemotherapy had a disease-free survival time of 8.4 months (range,1.2-39.2 months),and a overall survival time of 26.5 months (range,5.9-52.6 months).There were significant differences in the disease-free survival time and overall survival time between the two groups (x2 =10.322,4.971,P＜0.05).Of the 28 patients with LNR ＞ 0.15 (7 had unknown data of postoperative adjuvant chemotherapy),12 who underwent adjuvant chemotherapy had a diseasefree survival time of 10.3 months (range,2.9-52.7 months),and a overall survival time of 29.5 months (range,11.2-58.5 months);9 without postoperative adjuvant chemotherapy had a disease-free survival time of 2.9 months (range,1.4-35.7 months),and a overall survival time of 14.5 months (range,3.0-62.3 months);there was a significant difference in the disease-free survival time between the two groups (x2 =6.687,P＜0.05),and no significant difference in the overall survival time between the two groups (x2=2.938,P＞ 0.05).Conclusions LNR can be used as a supplementation of AJCC N staging system.In patients with 0＜ LNR ≤ 0.15,postoperative adjuvant chemotherapy can improve disease-free survival time and overall survival time.

Analysis on the Genotype of 5018 Cases of Thalassemia in Hunan Area / 中国实验血液学杂志

OBJECTIVE@#To investigate the type and distritution of thalassemia gene mutaitons in Hunan area, so as to provide evidence for prenatal screening, diagnosis and reduction of birth defects.@*METHODS@#A total of 5018 cases from Maternal and Children Health Hospital of Hunan from June 2017 to Dec 2018 were undergone thalassemia gene mutation analysis. The reverse dot blot hydridization was used to detect 6 kinds of genotypes of α-thalassemia and 17 kinds of point mutations of β-thalassemia, and the detected data were analyzed statistically.@*RESULTS@#889 cases (55.9%) of α-thalassemia carriers were found, including 385 cases of silent α-thalassemia, 488 cases of α-thalassemia trait, 16 cases of Hb H disease. --/αα was the most common genotype in α thalassemia. 664 cases (41.7%) were diagnosed as β-thalassemia carriers, heterozygotes accounted for 99.8% (663/664), IVS-Ⅱ-654, CD41-42M and CD17M were the main genotypes, and compound heterozygote accounted for 0.2% (1/664). 38 cases were diagnosed as α-thalassemia combined β-thalassemia.@*CONCLUSION@#The constituent ratio of thalassemia gene mutations in Hunan has regional characteristics, --/αα is the most common genotype in α-thalassemia carrier. IVS-Ⅱ-654, CD41-42 and CD17 are common ones in β-thalassemia. The frequency of α-thalassemia combined with β-thalassemia is high.

Double locking mini-plates for fixation of comminuted fracture of the first metacarpal base / 中华创伤骨科杂志

Objective To investigate the clinical efficacy of double locking mini-plates for fixation of the comminuted fracture of the first metacarpal base.Methods Twenty-four patients with the comminuted fracture of the first metacarpal base were treated by double locking mini-plates in our hospital from January 2013 to January 2016.They were 17 males and 7 females,from 27 to 65 years of age (average,33.5 years).By the Green classification,6 cases were type Ⅰ,13 cases type Ⅱ and 5 cases type Ⅲ.All the fractures were closed.The average time from injury to surgery was 2.3 days (from 8 hours to 7 days).After open reduction via the palmar-radial incision,the fracture was fixated with 2 mini-plates,one locking T-plate on the radial side and one straight locking plate on the dorsal side.Fracture healing time,pain and finger function were followed up postoperatively.Visual analogue scale (VAS) was used to evaluate the pain at 12 months and scoring for digital total range of motion to assess the function of the affected finger at the final follow-up.Results The 24 patients obtained follow-up for 8 to 28 months (average,18 months).All the Fractures healed after 9 to 12 weeks (average,10.5 weeks).The VAS scores at 12 months ranged from 0 to 3 (average,1.5).The function of the affected finger at the final follow-up was excellent in 20 cases and good in 4,giving an excellent to good rate of 100％.Two patients complained of pain after frequent motion of the finger.No complications like skin problems,dislocation of the first metacarpal base,implant failure,necrosis or irritation of the soft tissue were observed during follow-up.No angulation or rotational deformity occurred after fracture union.Conclusion Fixation with double locking mini-plates can effectively treat comminuted fractures of the first metacarpal base,because it can provide rigid stabilization which promotes early functional exercise of the finger,and prevents joint stiffness as well.

An Experimental Study Observing the Transient Expansion of Right Heart During Contrast-enhanced Echocardiography Post Bolus Injection of SonoVueTM / 中国循环杂志

Objectives: To observe the phenomenon of transient expansion of right heart during contrast-enhanced ultrasound (CEUS) by SonoVue?ultrasound contrast agent (UCA) in Chinese experimental mini-pig , and to explore the possible causes of this phenomenon. Methods: 24 healthy Chinese experimental mini-pigs were randomly divided into 3 groups according to the dose of injected contrast agent: 2 ml group (n=8), 1 ml group (n=8) and 0.5 ml group (n=8). Cardiac structure and function at baseline and during contrast procedure were determined by contrast-enhanced echocardiography. Pigs in each group received bolus contrast agent injection followed by 5ml saline flush with baseline concentration, 2, 4 and 6-fold serial dilutions, respectively. When the right heart enlargement appeared, stop the injection and next injection followed after the right heart returned its original size. The study protocols discontinued at the time when the right heart enlargement did not appear post injection. Results: In 2 ml group, the number of right heart enlargement with different injection concentrations was 7, 6, 4, 3, respectively; in 1 ml group, the number of right heart enlargement with different injection concentrations was 6, 5, 3, 1; in 0.5 ml group, the number of right heart enlargement with different injection concentrations was 5, 5, 2, and 0, respectively. Incidence of right heart enlargement decreased in proportion with lower contrast agent amount, and lower contrast concentration(P<0.001). The right heart enlargement phenomenon occurred at about (26±15) s after the injection and lasted for about (47±21) s. Conclusions:Transient expansion of right heart phenomenon is common by bolus injection of contrast agent during CEUS in the Chinese mini-pigs, which may be related to the injected concentration and dosage of the contrast agent, as well as the injection mode and animal species.