Head and Face Protection of the Health Care Workers in the Operating Room of Peking Union Medical College Hospital during the Corona Virus Disease-19 Pandemic / 中国医学科学院学报

Objective To investigate the understanding of the head and face protection of the health care workers in operating room of Peking Union Medical College Hospital during the corona virus disease-19(COVID-19) pandemic.Methods The knowledge of head and face protection of health care workers in the operating room was evaluated based on the non-registered questionnaires for protection measures collected on-line.Results The survey was conducted in two phases.In the first phase(COVID-19 outbreak),153 questionnaires were collected.In the second phase(when Beijing lowered the emergency response to level 3 and normalized the epidemic prevention and control),101 questionnaires were collected.The results showed that 98% of health care workers had used any form of protective devices during the pandemic and anesthesiologists had the highest usage rate(93.0%)of ear-loop face mask with eye shield.During the pandemic,health care workers mainly used goggles(71.2%)for protection to diagnose and treat the patients with fever and ear-loop face mask with eye shield(56.2%)for protection to diagnose and treat the non-fever patients.In the first-and second-phase survey,43% and 68% of health care workers still used protection,and they mainly used face shield(50.0% and 56.5%)and ear-loop face mask with eye shield(56.1% and 68.1%).Conclusions During the pandemic,more than 90% of the health care workers in the operating room of Peking Union Medical College Hospital were aware of head and face protection.Different healthcare workers in the operating room had different choices of head and face protection,and more than 40% of them would still keep such protection during the normalized stage of pandemic prevention and control.

Inductive effect of solamargine on the apoptosis of human esophageal cancer KYSE150 cells and its action mechanism / 医学研究生学报

Objective Solamargine (SM), with its anti-inflammatory and anti-tumor effects, inhibits the proliferation and promotes the apoptosis of various tumor cells. This study was to investigate the effects of SM on the proliferation and apoptosis of human esophageal cancer KYSE150 cells and its action mechanism. Methods We treated KYSE150 cells with SM at the concentrations of 0 (the blank control group), 2, 4, 6 and 8 μmol/L for 24 hours. Then, we observed the morphological changes of the cells under the inverted microscope, detected their proliferation and apoptosis by MTT assay and flow cytometry respectively, and determined the expressions of the classical NF-κB signaling pathway-related proteins NF-κB, p-NF-κB, IKKα, IKKβ, IkBα and p-IkBα) and apoptosis-related proteins Bax, caspase-3, cleaved caspase-3 and Bcl-2 in different groups of the cells by Western blot. Results Compared with the blank control, the inhibition rate of the proliferation of the KYSE150 cells in the 2, 4, 6 and 8 μmol/L SM groups was increased significantly in a concentration-dependent manner (0 vs [15.03 ± 0.15]%, [47.94 ± 1.74]%, [68.72 ± 0.47]% and [77.51 ± 1.70]%, P<0.05), and so was the apoptosis rate ([8.17 ± 0.51]% vs [14.50 ± 0.73]%, [18.57 ± 2.08]%, [65.10 ± 10.88]% and [81.55 ± 5.48]%, P<0.05). The expression of the apoptosis-related protein Bax in the SM treated cells was up-regulated, those of Bcl-2, IKKα, IKKβ and p-IkBα down-regulated, and the activity of caspase-3 and cleaved caspase-3 promoted, all in a concentration-dependent manner, with statistically significant differences between the blank control and the 4, 6 and 8 μmol/L SM groups (P<0.05). Statistically significant differences were also found in the expressions of NF-κB, p-NF-κB and IkBα between the blank control and the 6 and 8 μmol/L SM groups (P<0.05). Conclusion Solamargine can significantly inhibit the proliferation and promote the apoptosis of KYSE150 cells, probably by suppressing the classical NF-κB signaling pathway.

The inhibition effects of allicin on TGF-β1 induced epithelial⁃mesenchymal transition of human cholangiocarcinoma cell and its mechanism / 医学研究生学报

Objective　The metastasis mechanism of cholangiocarcinoma is complex, which may be related to epithelial-mesenchymal transition(EMT). This study focused on investigating the inhibition effects of allicin on TGF-β1 induced epithelium mesenchymal transition of human cholangiocarcinoma cells and its related mechanism, and providing theoretical basis for the application of allicin in the treatment of cholangiocarcinoma.　Methods　MTT assay were used to detect the inhibition effects of different concentrations of allicin on the human cholangiocarcinoma RBE cell proliferation, and the drug concentration of allicin was determined by IC50 of 24 h. The RBE cells were cultured and divided into control group, allicin group(130.7μmol/L), TGF-β1 group(10ng/mL) and allicin+ TGF-β1 group(130.7μmol/L+10ng/mL). Wound scratch and transwell invasion assay were performed to detect the migration and invasion ability of RBE cells after 24 hours. Western blots were applied to detect expression of EMT-related proteins (E-Cadherin, N-Cadherin, Vimentin, Snail) and NF-κB signaling pathways.　Results　The migration rates in allicin group and allicin+ TGF-β1 group were both decreased compared with that in the control group ( 9.25% ± 0.36% vs 28.19 %±0.66%, P<0.05) and TGF⁃β1 group(13.91%±0.75% vs 49.22%±0.27%, P<0.05). The invasion rates in allicin group and allicin+ TGF-β1 group were also decreased compared with that in the control group (6.59%±0.06% vs 33.48%±0.04%, P<0.05) and TGF⁃β1 group(9.4%± 0.05% vs 40.21%±0.12%, P<0.05). Compared with the control group, E-Cadherin expression was significantly increased, and N-Cadherin, Vimentin, Snail, NF-κB and p-NF-κB expression were significantly decreased in the allicin group (P<0.05). Compared with TGF-β1 group, E-Cadherin expression was significantly up-regulated, and N-Cadherin, Vimentin, Snail, NF-κB and p-NF-κB expression were significantly down-regulated in the allicin+ TGF-β1 group (P<0.05)．　Conclusion　These results indicate that allicin can inhibit the EMT induced by TGF-β1 on the human cholangiocarcinoma cell by blocking NF-κB signaling pathway, which may have potential value to be the drug candidate for the treatment of human cholangiocarcinoma in future.

Retrospective Analysis of 16 Cases Receiving Cardiopulmonary Resuscitation in the Operating Room among 127 053 Anesthetics Undergoing Non-cardiac Surgeries / 中国医学科学院学报

Objective To identify the high-risk factors of cardiac arrest during non-cardiac surgery and to provide experience for the effective cardiopulmonary resuscitation (CPR). Method The baseline data,co-morbidities,causes of cardiac arrest,treatment responsees,and survivals of 16 patients undergoing CPR among 127 053 patients receiving non-cardiac surgeries in our center from January 2013 to December 2016 were retrospectively analyzed. Results The main causes of intraoperative CPR included the co-existing cardiovascular diseases,massive intraoperative blood loss/high-risk surgical procedures,and allergy-related factors. Nine patients survived after immediate CPR in the operating room,with a 30-day survival rate of 77.8%. Conclusions Intraoperative cardiac arrest is a rare but potentially catastrophic event during non-cardiac surgeries. The success rate of CPR decreases in elderly patients undergoing high-risk emergency surgeries,especially when massive blood loss occurs during the surgery.

Adding Ondansetron in Morphine Intravenous Analgesia Pump for Prevention of Postoperative Nausea and Vomiting in Women / 中国医学科学院学报

Objective To evaluate the application of adding ondansetron in morphine intravenous analgesia pump for prevention of postoperative nausea and vomiting(PONV)in women. Methods Data of surgical female inpatients who received general anesthesia and postoperative intravenous analgesia with morphine in our center from January 1st,2013 to December 31st,2014 were retrospectively analyzed. Based on whether ondansetron was added,patients were divided into the observation group(n=834) and the control group(n=856). Outcome variables including morphine consumption,visual analogue scale(VAS) score,nausea score,and total times of vomiting within 48 hours after surgery were collected and compared. Results Age(t=0.432,P=0.665),morphine consumption during the first post-operative day(t=0.599,P=0.548) and during the second post-operative day(t=0.236,P=0.813),maximum VAS score of postoperative pain during movement during the first post-operative day [3(2,4) vs. 3(2,5);Z=1.850,P=0.064] and at rest during the second post-operative day [0(0,1) vs. 0(0,1);Z=1.511,P=0.131] were not significantly different between two groups. While the maximum VAS score of postoperative pain at rest during the first post-operative day [0(0,2) vs.0(0,2);Z=2.435,P=0.015] and during movement during the second post-operative day [3(1,3)vs.3(2,4);Z=3.445,P=0.001] were significantly different between two groups. The maximum score of postoperative nausea(χ=9.810,P=0.020) and cumulative frequency of postoperative vomiting(Z=3.726,P=0.002)in the observation group were significantly lower than those in the control group during the first post-operative day;however,there was no significant difference during the second post-operative day(χ=5.017,P=0.170;Z=0.000,P=1.000). Logistic regression analysis showed that adding ondansetron in morphine intravenous analgesia pump was an independent influencing factor of reduced postoperative nausea. The probability of nausea during the first post-operative day was 0.781 time(P=0.015)of that in the control group and 0.736 time(P=0.030)during the second post-operative day. Conclusion Adding ondansetron in morphine intravenous analgesia pump may reduce PONV in women.

Application of endoscopic retrograde cholangiopancreatography after Roux-en-Y reconstruction / 中国内镜杂志

Objective To evaluate the feasibility and safety of endoscopic retrograde cholangiopancreatography (ERCP) after Roux-en-Y reconstruction. Methods 22 cases underwent ERCP after Roux-en-Y reconstruction from January 2015 to January 2017 were collected, the operating time, success rate of endoscopy and treatment, related complications were analyzed. Results ERCP was performed in 22 cases about Roux-en-Y reconstruction of digestive tract, the mean insertion and cannulation time was 74.1 and 22.5 minutes; the overall success rate was 81.8% (18/22) and 77.2% (17/22), and no major complications occurred. Conclusions ERCP can be used as a safe and effective method for the diagnosis and treatment on the Roux-en-Y reconstruction of digestive tract.

Research status on prevention and treatment of traditional Chinese medicine on focal segmental glomerulosclerosis / 中草药

Focal segmental glomerulosclerosis (FSGS) is a common glomerular disease, and nephrotic syndrome is the main clinical manifestation. The prognosis of the kidney is mainly related to proteinuria severity, renal function, and drug response. The use of chemical drugs such as hormones and immunosuppressants is not effective in the treatment of some FSGS patients, and the side effects are obvious. In recent years, with the in-depth research on the treatment of FSGS by traditional Chinese medicine and the proof of clinical efficacy, traditional Chinese medicine has great advantages in delaying glomerular sclerosis and reducing the side effects of chemical drugs. The present situation of Chinese medicine treatment in FSGS is reviewed in this paper.

Design and Application of Intelligent and Meticulous Nursing Scheduling Management System / 医学信息学杂志

The paper designs intelligent and meticulous nursing scheduling management system,introduces the system modules including basic information of personnel,scheduling of departments,attendance management,statistical analysis,etc.,and indicates that this system can be applied to reasonably allocate nursing resources and improve the management level of the nursing department.

Predictors for Massive Blood Loss During Posterior Correction of Congenital Scoliosis in Pre-school Children:A Retrospective Observation / 中国医学科学院学报

Objective To investigate the predictors for massive blood loss during posterior correction of congenital scoliosis in pre-school children. Methods Totally 124 children under six years of age,who received posterior correction of congenital scoliosis,were divided into two groups according to the ratio of intraoperative blood loss (BL) and estimated blood volume (EBV). Massive blood loss was defined as BL/EBV>0.15,and minor or moderate blood loss as BL/EBV≤0.15. All the records,including demographics,intraoperative fluids,pre- or postoperative laboratory parameters,and the length of hospital stay,were compared between these two groups. Results There were 57 children in the moderate or minor blood loss group and 67 children in the massive blood loss group. When compared with moderate or minor blood loss group,children in massive blood loss group had significantly lower body weight,shorter body height,longer anesthesia period,and more autologous or allogeneic transfusion (P<0.05). Binary Logistic regression analysis showed that body weight lower than 15 kg was the independent predictor for massive blood loss (OR=0.435,95% CI=0.197-0.962). Conclusions The incidence of massive blood loss is about 54% in children under six years of age who have received posterior correction of congenital scoliosis. The body weight of lower than 15 kg is an independent predictor for massive blood loss during the surgery.

Evaluation of risk factors for arytenoid dislocation after endotracheal intubation: a retrospective case-control study / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the risk factors for postoperative arytenoid dislocation.</p><p><b>METHODS</b>From September 2003 to August 2013, the records of 16 patients with a history of postoperative arytenoid dislocation were reviewed. Patients matched in terms of date and type of procedures were chosen as the controls (n=16). Recorded data for all patients were demographics, smoking status, alcoholic status, preoperative physical status, airway evaluation, intubation procedures, preoperative laboratory test results, anesthetic consumption and intensive care unit stay. For arytenoid dislocation cases, we further analyzed the incidences of the left and right arytenoid dislocation, and the outcomes of surgical repair and conservative treatment. Categorical variables were presented as frequencies and percentages, and were compared using the chi-squared test. Continuous variables were expressed as means±SD and compared using the Student's unpaired t-test. To determine the predictors of arytenoid dislocation, a logistic regression model was used for multivariate analysis.</p><p><b>RESULTS</b>Sixteen patients with postoperative arytenoid dislocation were enrolled, with a median age of 52 years. Most postoperative arytenoid dislocation patients (15/16, 93.75%) received surgical repair, except one patient who recovered after conservative treatment. None of the postoperative arytenoid dislocation patients were smokers. Red blood cell (P=0.044) and hemoglobin (P=0.031) levels were significantly lower among arytenoid dislocation cases compared with the controls.</p><p><b>CONCLUSIONS</b>Non-smoking and anemic patients may be susceptible to postoperative arytenoid dislocation. However, neither of them was independent risk factor for postoperative arytenoid dislocation.</p>

Influence of insertion torque on biomechanical characteristics at implant-bone interface / 医用生物力学

Objective To evaluate the influence of different insertion torque values on stress and strain distributions at implant-bone interface. Methods The three-dimensional finite element model of the whole mandible with dental implants for immediate loading was created by CT scanning and self-developed USIS (universal surgical integration system) software. The insertion torque values of dental implants were supposed to be 0、15、25 N•cm3, respectively. The values of Von Mises stress and strain at implant-bone interface were calculated with ANSYS software, when the dental implants were loaded with vertical and buccolingual force at a 45°oblique angle of 150 N. Results When the dental implants under the three insertion torques were loaded with the vertical force, the maximum Von Mises stress was 33.6, 56.4, 69.6 MPa and the maximum strain was 5 157, 8 645, 15 630 με, respectively, while loaded with the buccolingual force, the maximum Von Mises stress was 95.3, 100.6, 108.3 MPa and the maximum strain was 17 110, 18 690, 21 380 με, respectively. Conclusions With the increased torque value of dental implants, the stress and strain at the implant-bone interface were both increased, but the increase was much slower under buccolingual loading than that under vertical loading.

Anesthetic management of a patient with Freeman-Sheldon syndrome: case report and literature review / 中华医学杂志(英文版)

The Freeman-Sheldon syndrome (FSS) is a rare congenital syndrome, characterized with myopathy and dysplasia. The musculoskeletal and soft-tissue manifestations often require orthopedic and plastic surgery. We reported a case of 8-year-old girl with FSS operated on for scoliosis.

Genetic variation and pathogenicity analysis of highly pathogenic porcine reproductive and respiratory syndrome virus strain TJ in the course of attenuation / 病毒学报

To develop an attenuated vaccine against the highly pathogenic porcine reproductive and respiratory syndrome (HP-PRRS) virus, the HP-PRRS virus strain TJ was attenuated by serial passages and plaque cloned every 5 to 10 passages in Marc-145 cells. Genetic variation and pathogenicity of HP-PRRSV strain TJ in the course of attenuation were analyzed. The results showed that the strain TJ sustained various sequence changes during the course of attenuation. Fifty-eight amino acids changes and a new continuous 120 amino acids deletion after the discontinuous 30 amino acids deletion (sites 481 and 533-561) occurred in strain TJ passages 140, and the position of 120 amino acids deletion was between 628 to 747 according to VR-2332. Animal test showed that the pathogenicity of strain TJ passages 20 was attenuated obviously, so we presume that genetic variation in nonstructural protein nsp2-nsp5, nsp7 and structural protein GP5 during the attenuation provides the molecular bases for the observed attenuated phenotype.

Clinical application of a self-developed bone collector in dental implantation / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To introduce a self-developed bone collector designed by the authors and evaluate its effect in clinical application.</p><p><b>METHODS</b>A self-developed bone collector was used in 38 patients who underwent the dental implant operation from May 2008 to October 2009. During the operation the bone particles were harvested, which was used for the reconstruction of the bone defects around the implant simultaneously. The defects were fenestrate in 29 regions and triangle in 23 regions on buccal or lingual side of the dental implants.</p><p><b>RESULTS</b>All cases had no surgical wound infection and dehiscence 7 - 10 days after operation. Three to six months after implantation, the X-ray showed that all the dental implants had perfect osseointergration and the alveolar bone were successfully augmented.</p><p><b>CONCLUSIONS</b>Bone debris harvested by self-developed bone collector could repair small peri-implant bone defects, which is simple to use in clinic.</p>

Isolation, identification and genetic analysis of an H1N1 subtype isolate of swine influenza virus / 病毒学报

In 2006, a swine influenza virus (SIV) isolate was isolated from 30 nasal swabs samples collected from pigs with clinical syndromes of swine influenza in a pig farm of Liaoning Province. The virus isolate was studied and identified by the growth in 9-11 days old chicken embryo, hemagglutination (HA) assay, hemagglutination inhibition (HI) assay, reverse transcription-polymerase chain reaction assays (RT-PCR) for its genetic subtype, whole gene sequence analysis and animal trial for its virulence. The virus isolate demonstrated the hemagglutination activity. Result of HI test against H1 subtype of SIV was positive, however, the results were negative when the HI studies were conducted using SIV H3 subtype virus and Newcastle Disease Virus (NDV). Eight gene segments of the virus isolate were amplified by RT-PCR. Phylogenetic analysis of the gene sequence of the virus isolate by using DNAstar software program revealed that the isolate have the H1 HA gene, by comparing to the sequences of H1-H16 in the GenBank. Furthermore, sequencing results also demonstrated that the virus isolate's NA gene belongs to N1 subtype. Therefore, the subtype of the SIV isolate is H1N1. The results of sequence analysis indicated that the genome of the SIV-H1N1 LN strain includes 8 fragments, among which only M protein gene is not swine originated. All other 7 fragments have close relationship with the domestic standard swine H1N1 strains. Results suggested that the SIV isolate LN strain might be created by a possible triple reassortants among the classic swine influenza virus, human influenza-like virus, and avian influenza-like virus. Piglets were inoculated with the SIV LN strain virus preparations and the virus caused the typical clinical symptoms of swine influenza in the inoculated piglets. This study, the isolation, identification and genetic analysis of the SIV LN strain provided useful information and basic data for the further investigation of epidemic principles and patterns of swine influenza virus in China.

Three dimension finite element analysis of anisotropic mandible with dental implants effect on implant-bone interface / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To establish anisotropic mandible model with dental implants and to investigate the effect of anisotropy material on stress and strain distribution of implant-bone interface.</p><p><b>METHODS</b>Three-dimensional finite element models of whole mandible with anisotropic and equivalent isotropic material were created by CT scanning and universal surgical integration system (USIS) software developed by the authors. Two ITI threaded implants were implanted in the posterior teeth area. The values of principal stress and principal strain on the bone around dental implants were calculated in two different finite element models with buccolingual load.</p><p><b>RESULTS</b>In the anisotropic mandible model, nearly all values of the principal stress and principal strain on cortical and cancellous bone increased compared with the equivalent isotropy model, 2.1%-74.1% for principal stress and 4.7%-57.3% for principal strain, but 10. 3%-71.4% for principal stress and 19.5%-63.4% for principal strain on cancellous bone.</p><p><b>CONCLUSIONS</b>In the three-dimensional finite element analysis, anisotropic mandible model with dental implants has an apparent effect on the stress and strains of the implant-bone interface. Anisotropic mechanical properties of mandible should be emphasized in biomechanical study.</p>

Changes of interleukin-6 and related factors as well as gastric intramucosal pH during colorectal and orthopaedic surgical procedures / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the changes of perioperative serum levels of interleukin-6 (IL-6), C-reactive protein (CRP), and cortisol, as well as gastric intramucosal pH (pHi) and plasma lactate, aiming to compare systemic changes and tissue perfusion during colorectal and orthopaedic surgical procedures.</p><p><b>METHODS</b>Twenty patients were randomly assigned to two groups, 10 cases of operation on vertebral canal, 10 cases of colorectal radical operation. Venous blood was drawn at 1 day before operation, 2, 4, and 6 hours following skin incision, and 1 day after operation, in order to measure serum IL-6, CRP, and cortisol. pHi and plasma lactate were also measured at the same time points.</p><p><b>RESULTS</b>Serum concentrations of IL-6 and cortisol increased gradually following operation, reaching the peak value at 6 hours from the beginning of operation. CRP was not detectable until the first day after operation. Peak concentration of IL-6 had positive relationship with CRP. These variables changed more significantly in colorectal group than that in orthopaedic group (P < 0.05). pHi decreased gradually, reaching the lowest level at 4 hours from the beginning of operation, and to more extent in colorectal group than that in orthopaedic group (P < 0.05).</p><p><b>CONCLUSION</b>IL-6 may reflect tissue damage more sensitively than CRP. Colorectal surgery might induce systemic disorder to more extent, in terms of immuno-endocrinal aspect as well as tissue perfusion, reflected with pHi.</p>

Obstructive site of the upper airway in patients with obstructive sleep apnea hypopnea syndrome: analysis of dynamic MRI / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the obstructive site and the dynamic change of the upper airway in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) during sleep and wakefulness.</p><p><b>METHODS</b>After being deprived of sleeping for 20 hours, sequential midline sagittal images of the upper airway were obtained in 21 patients during sleep and wakefulness with dynamic MRI. The obstructive state was studied according to hypopnea (< 10 s) and apnea (> or = 10 s). The length of obstruction site was measured and the dynamic characteristics of obstruction was observed. Statistical analysis was performed with paired t-test.</p><p><b>RESULTS</b>The obstruction at the level of the palatopharynx in patients with hypopnea during wakefulness was similar to that in patients with apnea during sleep. The maximal length [(6.61 +/- 1.23) cm], the minimal length [(0.95 +/- 0.22) cm] and maximal length difference [(5.66 +/- 1.27) cm] related to apnea during sleep were longer than those correlated with hypopnea [(2.99 +/- 0.51) cm, (0.72 +/- 0.23) cm, (2.27 +/- 0.67) cm, respectively] in wakefulness. (P < 0.01).</p><p><b>CONCLUSIONS</b>The obstruction of upper airway during sleep is dynamic and multilevel in patients with OSAHS. To a certain degree, hypopnea during wakefulness can give a clue to the obstructive state during sleep.</p>