Changes of cytokines after cardiopulmonary bypass in children with congenital heart disease / 中国小儿急救医学

Objective:To study the changes of cytokines after cardiopulmonary bypass(CPB)in children with congenital heart disease.Methods:A total of 124 children with congenital heart disease underwent CPB surgery at Shanghai Children′s Medical Center from June 2020 to October 2021 with cytokine detection were enrolled.Twelve kinds of cytokines, white blood cell count(WBC)and neutrophil-to-lymphocyte ratio(NLR), C-reactive protein(CRP)and procalcitonin were detected before and 24 hours after operation.All patients were divided into CPB<120 min group ( n=102)and CPB≥120 min group ( n=22)acoording to CPB time, and were divided into systemic inflammatory response syndrome (SIRS) group, compensatory anti-inflammatory response syndrome (CARS) group and control group according to the changes of cytokines.The changes of cytokines, anti-inflammatory factors and pro-inflammatory factors before and after CPB and the correlation with CPB time were analyzed. Results:There were 65 boys and 59 girls with a body weight of(10.69±8.18)kg and a median age of 317(141, 975)d.After CPB, WBC(×10 9/L)(13.47 vs.8.6), NLR(4.93 vs.0.55), and CRP(mg/L)(81.35 vs.0.8) were significantly higher than those before operation( P<0.001). IL-6(pg/mL)(135.69 vs.6.86), IL-8(pg/mL)(33.33 vs.14.95), and IL-10(pg/mL)(6.05 vs.2.44)were significantly higher than those before operation( P<0.001). Compared with CPB<120 min group, IL-6(pg/mL)(211.88 vs.119.47), IL-8(pg/mL)(71.67 vs. 25.39), and IL-10(pg/mL)(7.69 vs. 4.92)in CPB≥120 min group significantly increased( P<0.001). CRP was negatively correlated with CPB time( r=-0.204, P=0.025), while IL-6( r=0.254, P=0.005), IL-8( r=0.358, P=0.001), IL-10( r=0.198, P=0.03) were positively correlated with CPB time.Twelve children(9.7%)had obvious SIRS, and four cases(3.2%)had early CARS.The mortality of CARS group was significantly higher than that of SIRS group and the control group( P=0.011). Conclusion:Il-6 , IL-8, and IL-10 are significantly increased after CPB in children with congenital heart disease.With the increase of CPB time, IL-6 and IL-8 increase significantly, and the correlation between IL-8 and CPB time is the strongest.Although the proportion of children with early postoperative CARS is small, the mortality is high, which indicates clinical surveillance and treatment need to be strengthened for anti-inflammatory response.

Clinical observation of diaphragm plication after pediatric congenital heart disease surgery / 中国小儿急救医学

Objective:To analyze the risk factors of performing diaphragm plication(DPL) after congenital heart disease(CHD) surgery as well as the timing and clinical efficacy.Methods:Data regarding children underwent open heart surgery at Shanghai Children′s Medical Center from January 2017 to December 2019 were reviewed.According to whether DPL was performed after CHD operation or not, the children were divided into DPL group and non-diaphragm plication(NDPL)group.Clinical data including age, surgery, cardiopulmonary bypass(CPB)temperature and time of two groups were compared, meanwhile the risk factors of DPL surgery were analyzed.Based on the median of 8 days between open heart surgery and DPL, children in DPL group were divided into early surgery group(less than 8 days), and delayed operation group(no less than 8 days). The parameters of comparison included ventilator using time, hospital stay time, hospitalization expenditure, postoperative infection to evaluate the timing of DPL and effect.Results:There were 10 309 children after CHD, including 95 in DPL group and 10 214 in NDPL group.In DPL group, there were 52 males(54.7%) and 43 females(45.3%), with age 147(52, 318) d, weight(5.5±4.1) kg, height(56.8±25.6) cm, CPB time(136.8±93.4) min and aortic occlusion time(62.5±50.2) min.Compared with NDPL group, DPL group had younger age, shorter height, lighter weight, higher incidence of preoperative special treatment, higher proportion of reoperation, lower CPB temperature, longer CPB time and longer aortic occlusion time.There were significant differences between two groups( P<0.05). Multivariate Logistic regression analysis showed that younger operative age( OR=0.998, 95% CI 0.998~0.999, P<0.001), staging operation( OR=72.977, 95% CI 39.096~136.211, P<0.001), long CPB time( OR=1.006, 95% CI 1.002~1.011, P=0.008), and pulmonary venoplasty( OR=4.219, 95% CI 2.132~8.350, P<0.001) were independent risk factors for DPL after CHD.Early surgery group had lower postoperative infection rate(43.59% vs. 88.38%, P=0.007), shorter ventilator duration[168.0(99.5, 280.5) h vs.309.9(166.2, 644.5) h, P=0.029], shorter hospital stay duration[27.00(20.75, 35.00)d vs.37.00(28.00, 53.00)d, P<0.001], and lower hospitalization cost[158.36(128.99, 203.11) thousand yuan vs.232.95(174.54, 316.47) thousand yuan, P<0.001] than delayed operation group. Conclusion:Younger age, staging operation, long CPB time, and pulmonary venoplasty are independent risk factors for DPL due to diaphragmatic paralysis after pediatric CHD surgery.Early surgical intervention is beneficial for the recovery of children.

Correlation analysis between hospice care attitude and death depression in undergraduate nursing students / 中国实用护理杂志

Objective:To explore the association between attitudes toward care of the dying and death depression in undergraduate nursing students.Methods:With stratified sampling, 380 undergraduate nursing students in Guangdong Medical University from June to September 2020 were investigated by using a self-designed questionnaire, Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B-C) and Chinese version of Death Depression Scale-Revised (CCDS-R). Pearson correlation analysis was used to analyze the correlation between hospice care attitude and death depression of nursing undergraduates.Results:The score of FATCOD-B-C of 380 nursing undergraduates was (104.92 ± 7.92) points. The highest average score of dimensions of attitude toward the necessity of family support was (4.02 ± 0.38) points, and the lowest average score of dimensions of attitude toward communication with the dying person was (2.95 ± 0.42) points. The score of CCDS-R was (54.58 ± 12.52) points. The highest average score of dimensions of other death was (3.48 ± 0.80) points, and the lowest average score of dimensions of existential vacuum was (1.78 ± 0.69) points. Pearson analysis revealed that attitudes toward care of the dying had a negative association with death depression ( r=-0.34, P<0.05). Conclusions:Attitudes toward care of the dying of undergraduate nursing students is in a higher level and it has close association with death depression. It is recommended to reduce the death depression level of undergraduate nursing students through hospice care training and carrying out death education, so as to improve the positive attitudes of caring for dying patients.

Risk factors for cryptogenic stroke in patients with patent foramen ovale / 国际脑血管病杂志

Objective:To investigate the potential risk factors for cryptogenic stroke (CS) in patients with patent foramen ovale (PFO).Methods:Patients underwent PFO closure in the Department of Cardiovascular Surgery, the Second Hospital of Hebei Medical University from June 2018 to December 2021 were enrolled retrospectively. Transesophageal echocardiography was used to evaluate the morphological characteristics of foramen ovale and right-to-left shunt (RLS). Multivariate logistic regression analysis was used to determine the independent risk factors for CS in patients with PFO. Results:A total of 203 patients with PFO were enrolled. Their age was 41.9±14.3, and 116 patients (57.1%) were male. There were 102 patients in CS group and 101 patients in non-stroke group. The age, body mass index, systolic blood pressure and diastolic blood pressure, and the constituent ratios of male, hypertension, diabetes, hyperlipidemia and smoking of the CS group were significant higher than those of the non-stroke group (all P<0.05). The PFO channel of the CS group was longer, wider and more combined with resting RLS (all P<0.05). Multivariate logistic regression analysis showed that systolic blood pressure (odds ratio [ OR] 1.065, 95% confidence interval [ CI] 1.022-1.111; P=0.003), PFO length ( OR 1.124, 95% CI 1.004-1.258; P=0.043) and resting RLS ( OR 5.449, 95% CI 2.283-13.004; P<0.001) were the independent risk factors for CS in patients with PFO. Conclusion:Systolic blood pressure, PFO length and the presence of resting RLS are the independent risk factors for CS in patients with PFO.

Diagnostic values of integrated evidence chain, Roussel Uclaf Causality Assessment Method, and Structured Expert Opinion Process method for drug-induced liver injury / 临床肝胆病杂志

Objective To investigate the clinical applicability and different characteristics of three commonly used diagnostic methods for drug-induced liver injury from the two aspects of liver injury induced by Western medicine and liver injury induced by traditional Chinese medicine. Methods A prospective cohort study was performed for 289 hospitalized patients with acute drug-induced liver injury who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2015 to December 2020 and did not receive integrated traditional Chinese and Western medicine therapy, among whom 187 patients had herb-induced liver injury and 102 had Western medicine-induced liver injury. The 289 patients were diagnosed by the integrated evidence chain (IEC), Roussel Uclaf Causality Assessment Method (RUCAM), and the Structured Expert Opinion Process (SEOP) method, and related data at acute onset were collected, including general information, latency period, detailed medication, and laboratory markers such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase, alkaline phosphatase, and total bilirubin. A statistical analysis was performed to investigate the consistency between IEC, RUCAM, and SEOP in the diagnosis of Western medicine-induced liver injury and herb-induced liver injury and their own applicability. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data; the chi-square was used for comparison of categorical data. Results The hepatocellular type was the main type of clinical liver injury in both Western medicine-induced liver injury and herb-induced liver injury, accounting for 81.4% and 74.3%, respectively, and laboratory examination showed higher levels of ALT and AST. Western medicine-induced liver injury cases were diagnosed by IEC, RUCAM, and SEOP, with a clinical diagnosis rate of 65.7%, 100%, and 63.7%, respectively, and the constituent ratio of Western medicine-induced liver injury was 23.2%, 35.3%, and 22.5%, respectively. Herb-induced liver injury cases were diagnosed by these three methods, with a clinical diagnosis rate of 47.6%, 100%, and 29.9%, respectively, and the constituent ratio of herb-induced liver injury was 30.8%, 64.7%, and 19.4%, respectively. The consistency test of the three diagnostic methods showed that in the diagnosis of Western medicine-induced liver injury cases, there was good consistency between IEC and SEOP (Kappa=0.785, P 0.05) and between RUCAM and SEOP (Kappa=0.117, P > 0.05); in the diagnosis of herb-induced liver injury cases, there was poor consistency between RUCAM and SEOP (Kappa=0.066, P > 0.05), while there was good consistency between RUCAM and IEC (Kappa=0.026, P < 0.05) and between IEC and SEOP (Kappa=0.437, P < 0.05). Conclusion The IEC method shows good applicability for both Western medicine-induced liver injury and herb-induced liver injury, and there is good consistency between IEC and SEOP in the diagnosis of Western medicine-induced liver injury cases, while there is a relatively low level of consistency between IEC and SEOP in the diagnosis of herb-induced liver injury. There is poor consistency between RUCAM and the other two methods. In the clinical diagnosis of Western medicine-induced liver injury, IEC, RUCAM, and SEOP should be used in combination to accurately judge the causal relationship between drugs and liver injury.

Formation of the Looming-evoked Innate Defensive Response during Postnatal Development in Mice / 神经科学通报·英文版

Environmental threats often trigger innate defensive responses in mammals. However, the gradual development of functional properties of these responses during the postnatal development stage remains unclear. Here, we report that looming stimulation in mice evoked flight behavior commencing at P14-16 and had fully developed by P20-24. The visual-evoked innate defensive response was not significantly altered by sensory deprivation at an early postnatal stage. Furthermore, the percentages of wide-field and horizontal cells in the superior colliculus were notably elevated at P20-24. Our findings define a developmental time window for the formation of the visual innate defense response during the early postnatal period and provide important insight into the underlying mechanism.

An Easily Compatible Eye-tracking System for Freely-moving Small Animals / 神经科学通报·英文版

Measuring eye movement is a fundamental approach in cognitive science as it provides a variety of insightful parameters that reflect brain states such as visual attention and emotions. Combining eye-tracking with multimodal neural recordings or manipulation techniques is beneficial for understanding the neural substrates of cognitive function. Many commercially-available and custom-built systems have been widely applied to awake, head-fixed small animals. However, the existing eye-tracking systems used in freely-moving animals are still limited in terms of their compatibility with other devices and of the algorithm used to detect eye movements. Here, we report a novel system that integrates a general-purpose, easily compatible eye-tracking hardware with a robust eye feature-detection algorithm. With ultra-light hardware and a detachable design, the system allows for more implants to be added to the animal's exposed head and has a precise synchronization module to coordinate with other neural implants. Moreover, we systematically compared the performance of existing commonly-used pupil-detection approaches, and demonstrated that the proposed adaptive pupil feature-detection algorithm allows the analysis of more complex and dynamic eye-tracking data in free-moving animals. Synchronized eye-tracking and electroencephalogram recordings, as well as algorithm validation under five noise conditions, suggested that our system is flexibly adaptable and can be combined with a wide range of neural manipulation and recording technologies.

MouseVenue3D: A Markerless Three-Dimension Behavioral Tracking System for Matching Two-Photon Brain Imaging in Free-Moving Mice / 神经科学通报·英文版

Understanding the connection between brain and behavior in animals requires precise monitoring of their behaviors in three-dimensional (3-D) space. However, there is no available three-dimensional behavior capture system that focuses on rodents. Here, we present MouseVenue3D, an automated and low-cost system for the efficient capture of 3-D skeleton trajectories in markerless rodents. We improved the most time-consuming step in 3-D behavior capturing by developing an automatic calibration module. Then, we validated this process in behavior recognition tasks, and showed that 3-D behavioral data achieved higher accuracy than 2-D data. Subsequently, MouseVenue3D was combined with fast high-resolution miniature two-photon microscopy for synchronous neural recording and behavioral tracking in the freely-moving mouse. Finally, we successfully decoded spontaneous neuronal activity from the 3-D behavior of mice. Our findings reveal that subtle, spontaneous behavior modules are strongly correlated with spontaneous neuronal activity patterns.

Optimization strategy of anaesthesia for laparoscopic gynecological surgery: anterior quadratus lumborum block at supra-arcuate ligament combined with general anesthesia / 中华麻醉学杂志

Objective:To evaluate the optimization efficacy of anterior quadratus lumborum block at supra-arcuate ligament (SA-AQLB) combined with general anesthesia for laparoscopic gynecological surgery.Methods:Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 28-64 yr, weighing 52-78 kg, with height of 154-166 cm, scheduled for elective laparoscopic gynecological surgery, were divided into general anesthesia group (group G, n=40) and SA-AQLB combined with general anesthesia group (group SG, n=40) using a random number table method.In group SG, bilateral SA-AQLB was performed under ultrasound guidance before anesthesia induction, and 0.4% ropivacaine 25 ml plus dexamethasone 5 mg was injected into both sides.Combined intravenous-inhalational anesthesia was applied in both groups.Patient-controlled intravenous analgesia (PCIA) with sufentanil 2 μg/kg (in 150 ml of normal saline) was performed after surgery.The PCIA pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval and background infusion at 2 ml/h.Visual analogue scale (VAS) scores for abdomen, pelvis and shoulder pain were recorded at 1, 6, 12, 24 and 48 h after operation.Flurbiprofen was used for rescue analgesia when VAS score >4.The occurrence of intraoperative cardiovascular events and amount of sufentanil used during operation were recorded.The time to first pressing the analgesia pump, effective pressing times of PCA, requirement for rescue analgesia and consumption of sufentanil after operation were recorded.The extubation time, time to first flatus after operation, first ambulation time, length of hospital stay and development of postoperative adverse reactions such as nausea and vomiting, urinary retention and respiratory depression within 48 h after operation were recorded. Results:Compared with group G, the incidence of intraoperative hypertension and tachycardia was significantly decreased, the incidence of intraoperative hypotension and bradycardia was increased, the intraoperative consumption of sufentanil was reduced, the extubation time was shortened, the time to first pressing the analgesia pump was prolonged, the effective pressing times of PCA, requirement for rescue analgesia and postoperative consumption of sufentanil were reduced, the time to first flatus, first ambulation time and length of hospital stay were shortened, VAS scores for abdomen, pelvis and shoulder pain were decreased at each time point after operation, and the incidence of nausea and vomiting, urinary retention and respiratory depression after operation was decreased in group SG ( P<0.01). Conclusions:Compared with general anesthesia, the combination of SA-AQLB and general anesthesia can reduce the opioid consumption, inhibit intraoperative stress responses and postoperative hyperalgesia and promote early postoperative recovery when used for the patients undergoing laparoscopic gynecological surgery.

Working memory span training improves working memory capacity / 中华行为医学与脑科学杂志

Objective:To explore whether working memory span training can expand working memory capacity.Methods:A randomized controlled trial design was adopted and a total of 60 healthy college students were recruited and randomly divided into training group ( n=30, receiving adaptive training of spatial breadth task) and control group ( n=30, receiving non-adaptive training of low difficulty spatial breadth task). The cognitive behavior and event-related potential (ERP) data of all subjects when completing the change awareness task were collected before and after training.The SPSS 22.0 statistical software was used for data analysis. The differences between the training group and the control group before and after training were compared by repeated measurement analysis of variance. Results:Repeated measurement ANOVA showed that there were significant time and group interactions at the levels of cognitive behavior(K score, F=5.352, P=0.025) and ERP (CDA, F=4.644, P=0.037) levels. Further post test found that compared with pre-training (pre-test), the K-score ((0.51±0.93), (1.61±1.07), F=26.81, P<0.001) and CDA ((-1.49±1.07)μV, (-2.03±0.94)μV, F=4.731, P=0.041) of the training group increased significantly after training (post-test), and there was no significant difference in K-score and CDA of the control group before and after training (boh P>0.05). Conclusion:Working memory span task can be used as an effective training paradigm to improve working memory capacity.

Outcome of extracorporeal membrane pulmonary oxygenation after congenital heart diseases in pediatric: experience from single center / 中国小儿急救医学

Objective:To review the clinical prognosis and causes of death in children with extracorporeal membrane pulmonary(ECMO) assistance after congenital heart disease(CHD) operation in our center, so as to improve the survival rate of ECMO.Methods:All clinical data of 105 children with VA-ECMO assisted after CHD operation who were admitted to the Department of Cardiothoracic Surgery at Shanghai Children′s Medical Center from January 2017 to December 2019 were collected, and the clinical characteristics and causes of death were retrospectively analyzed.Results:The age of 105 children with ECMO was 110(38, 341)days, the weight was 5.30(3.75, 8.45)kg, and the risk adjustment for congenital heart surgery score was 3(2-3)points.There were no statistically significant differences in gender, age, weight, height, risk adjustment for congenital heart surgery score, the number of ECMO installed in the operating room, the number of ECMO installed after cardiopulmonary resuscitation and ECMO duration between the surviving group ( n=51) and the death group ( n=54)( P>0.05). While there was a significant difference in utilization of continuous renal replacement therapy[7.8% (4/51) vs.38.9% (21/54), P<0.001]. The death mainly occurred within one week after evacuating ECMO(83.3%, 45/54). ECMO installation was most in children aged 1 month to 1 year old(52.4%, 55/105), and the survival rate showed a rise over three years(2017 to 2019), increased from 31.6% (6/19) to 65.0% (13/20). Children with 3 to 5 kg were the most affected (39.0%, 41/105) when ECMO was installed, and the survival rate from 2017 to 2019 increased from 28.6%(4/14) to 75.0%(9/12). The main cause of death was heart failure(48.1%, 26/54), followed by bleeding(18.5%, 10/54)and pulmonary hypertension(13.0%, 7/54). Conclusion:With the progress of surgical technology and cardiopulmonary bypass, and the improvement of postoperative management, the mortality of children with CHD in our hospital after ECMO has decreased year by year during the last three years.However, the mortality of children requiring continuous renal replacement therapy assistance during ECMO is higher.Therefore, it is still necessary to strengthen the maintenance of each organ function during ECMO.

In silico cloning, expression and bioinformatics analysis of NtODB from common tobacco / 生物工程学报

It has been reported that ODB genes play an important role in homologous recombination-directed DNA repair, suggesting their potential applications in plant breeding. To analyze the expression characteristics of tobacco NtODB gene, the cDNA sequence of NtODB was obtained using in silico cloning technique. The physicochemical properties, signal peptide, and advanced structures of the predicted protein were analyzed using bioinformatics tools. The results showed that the NtODB gene has a 579-bp open reading frame which encodes a protein with 192 amino acid residues. The protein NtODB is predicted to be alkaline and hydrophilic. Real-time quantitative PCR showed that NtODB was constitutively expressed in different tissues. Subcellular localization showed that NtODB was mainly expressed in cell membrane and chloroplast. These results may help us to better understand and elucidate the roles of ODB genes in the homologous recombination-directed DNA repair.

Reduced Firing of Nucleus Accumbens Parvalbumin Interneurons Impairs Risk Avoidance in DISC1 Transgenic Mice / 神经科学通报·英文版

A strong animal survival instinct is to approach objects and situations that are of benefit and to avoid risk. In humans, a large proportion of mental disorders are accompanied by impairments in risk avoidance. One of the most important genes involved in mental disorders is disrupted-in-schizophrenia-1 (DISC1), and animal models in which this gene has some level of dysfunction show emotion-related impairments. However, it is not known whether DISC1 mouse models have an impairment in avoiding potential risks. In the present study, we used DISC1-N terminal truncation (DISC1-N

Antiviral effect of entecavir in chronic hepatitis B patients with rtA181V/T mutation / 临床肝胆病杂志

ObjectiveTo investigate the clinical effect of entecavir (ETV) rescue treatment in chronic hepatitis B (CHB) patients at the onset of rtA181V/T mutation. MethodsA total of 174 CHB patients who were treated in the outpatient and inpatient departments of The Affiliated Hospital of Xuzhou Medical University from January 2012 to January 2017 and underwent the detection of drug-resistance mutations of the genes in the reverse transcription (RT) polymerase region were enrolled, among whom there were 72 previously untreated patients and 102 treatment-experienced patients with virological breakthrough or poor response. The association between the previous medication history of nucleos(t)ide analogues and the mutation pattern (including rtA181V/T) was evaluated in the treatment-experienced CHB patients. A total of 155 patients were enrolled, among whom 72 patients had no drug-resistance mutations, 45 had rtA181V/T mutation, and 38 had rtA181V/T+rtN236T mutation. The three groups were compared in terms of virologic response and biochemical parameters at baseline and at weeks 24 and 48 of ETV rescue treatment. The t-test was used for comparison of normally distributed continuous data between two groups, and a one-way analysis of variance was used for comparison between multiple groups; the Kruskal-Wallis H test was used for comparison between multiple groups. The chi-square test was used for comparison of categorical data between two groups. A logistic regression analysis was used to screen out the influencing factors for poor prognosis. ResultsA analysis of the previous medication history of NAs and the mutation patterns for all patients suggested that the patients with the medication history of multiple NAs tended to have multisite mutations and multi-drug resistance (χ2=4295, P＜0.05). The level of HBV DNA at the time of virological breakthrough was lower than that at the time of initial administration of NAs in the rtA181V/T mutation group ［(6.22±1.48) log10 IU/ml vs (7.08±1.59) log10 IU/ml, t=3.098, P=0.002］ and the rtA181V/T+rtN236T mutation group ［(5.94±1.45) log10 IU/ml vs (6.94±1.61) log10 IU/ml，t=2.850, P=0.004］. At week 48 of ETV rescue treatment, there were no significant differences between the three groups in HBV DNA negative conversion rate (83.3% vs 82.2% vs 81.6%, P＞0.05) and HBeAg negative conversion rate (22.2% vs 17.8% vs 21.1%, P＞0.05), and there were also no significant differences in alanine aminotransferase normalization rate (77.1% vs 85.2% vs 83.3%, P＞0.05), aspartate aminotransferase normalization rate (80.4% vs 75.9% vs 76.0%, P＞0.05), and total bilirubin normalization rate (80.8% vs 79.3% vs 78.1%, P＞0.05). HBV DNA level at the beginning of ETV treatment was the risk factor for the treatment outcome of 48-week antiviral therapy (odds ratio = 1.655, 95% confidence interval: 1.128-2.428, P=0.01). ConclusionETV has a good antiviral effect in treatment-experienced CHB patients with rtA181 drug-resistance mutation, and HBV DNA level at the initiation of ETV treatment can predict the outcome of 48-week ETV rescue treatment.

Beh?et's disease complicated with tendinopathy: report of 2 cases with literature review / 中华风湿病学杂志

Objective:To explore the possible related factors of Beh?et's disease complicated with tendinitis, in order to better understand the etiology and development mechanism so to guide clinical diagnosis and treatment.Methods:The clinical data of patients with Beh?et's disease complicated with tendonitis treated at Department of Rheumatology and Immunology of Lanzhou University Second Hospital from October 2018 to September 2019 were retrospectively reviewed and related literature were reviewed.Results:Two patients were diagnosed as Beh?et's disease. Foot pain occurred during the treatment. Ultrasound showed tendonitis, and the corresponding treatment relieved the symptoms.Conclusion:Tendons may be involved and presents as a chronic change in patients with Beh?et's disease. In patients with rheumatic diseases, attention should be paid to the correlation between the disease and tendonitis. Aggressive treatment can prevent adverse consequences.

Effects of different anesthesia methods on postoperative analgesia, short-term cognitive function and deep venous thrombosis in patients undergoing hip replacement / 中国基层医药

Objective:To compare the effects of different anesthesia methods on postoperative analgesia, short-term cognitive function and deep venous thrombosis(DVT) in patients undergoing hip replacement.Methods:From March 2017 to March 2019, 96 patients with hip replacement were divided into group A (48 cases) and group B (48 cases) according to the random digital table method.Epidural anesthesia was used in group A, and general anesthesia was used in group B. The perioperative conditions, anesthesia effect, visual analogue scale (VAS) at postoperative 3, 12 and 24 hours, postoperative cognitive dysfunction (POCD) and DVT at postoperative 1, 3 and 7 days were compared between the two groups.Results:The operation time, intraoperative bleeding volume and time to get out of bed between the two groups had no statistically significant differences (all P>0.05). The recovery time[(14.98±2.31)min]and extubation time[(17.35±3.54) min]of group A were faster than those of group B[(19.13±3.42)min and (22.18±2.87)min]( t=6.967, 7.343, all P<0.05). The VAS scores of group B at postoperative 3 h[(3.27±0.73)points], postoperative 12 h[(2.45±0.38)points]and postoperative 24 h[(1.98±0.45)points]were higher than those of group A[(2.34±0.56)points, (1.65±0.43)points and (1.07±0.31)points]( t=7.003, 9.659, 11.538, all P<0.05). The incidences of POCD in group A at postoperative 3d(10.42%) and 7d(2.08%) were lower than those in group B (33.33% and 14.58%) (χ 2=7.357, 3.909, all P<0.05). The incidences of DVT in group A at postoperative 3d(4.17%) and 7d(8.33%) were lower than those in group B (20.83% and 29.17%) (χ 2=7.357, 3.909, all P<0.05). Conclusion:Epidural anesthesia is superior to general anesthesia in hip replacement.Postoperative analgesia is superior to general anesthesia, and can reduce the occurrence of short-term POCD and DVT, which is worthy of clinical reference.

Causes of early death in children after congenital heart surgery / 中国小儿急救医学

Objective:To explore the causes of death after congenital heart surgery, which may be benefit for improving postoperative outcome of children with congenital heart disease (CHD).Methods:All cases of in-hospital mortality from 2013 to 2018 were collected to analyze the epidemiological characteristics of mortality and causes of death.Results:The mortality showed a downtrend over the past 6 years, from 2.2% in 2013 to 1.2% in 2018.Of all the cases, 72.0% children died under the age of one year old.The death mainly occurred within one week postoperatively (254, 73.2%), especially during the first (101, 29.1%) and the second (51, 14.7%) days.The main cause of death was residual or remained anatomy issues (103, 29.7%), followed by arrhythmia (66, 19.0%) and pulmonary hypertension (57, 16.4%). The incidence of heart failure ( P=0.048) and pulmonary hypertension( P<0.001) in children with functional single ventricle was higher than that in biventricular patients. Conclusion:With the progress of surgical technology and cardiopulmonary bypass, and the improvement of postoperative management, early death after the open-heart surgery for CHD decreased year by year.Postoperative residual or remained anatomy issues was the main cause of death, and the management of it should be strengthened in clinic, especially in children under one year old.

Effect of tea polyphenols in bone tissue cells and its application progress in tissue engineering / 国际生物医学工程杂志

Bone tissue plays an important role in maintaining physical activity and health. The study of the biological functions of bone tissue cells and their application in tissue engineering is of great significance for clinical prevention and treatment of orthopedic-related diseases. Tea polyphenols are the main components of tea, with natural antioxidant, scavenging free radical activity and anti-inflammatory effects. Research results indicated that tea polyphenols can promote the bone remodeling process mainly by enhancing the formation of osteoblasts and reducing the occurrence of osteoclasts. In addition, tea polyphenols can also be used as surface modification molecules of artificial bone materials and are widely used in the field of bone tissue engineering. In this paper, the regulatory effects of tea polyphenols in bone tissue cells and its application in tissue engineering were reviewed, and related research contents were summarized and prospected, in order to provide reference and theoretical basis for subsequent research work.

Hemodynamic Characteristics of Pulmonary Arterial Hypertension Related to Congenital Heart Disease / 医用生物力学

Objective Hemodynamic disorder of the pulmonary artery (PA) is the main cause of pulmonary arterial hypertension related to congenital heart disease (PAH-CHD). To study the hemodynamic characteristics of PA, so as to understand biomechanical factors in the occurrence and development of PAH-CHD. Methods Clinical and imaging data were collected in five PAH-CHD patients and five matched controls (Non-PAH) to reconstruct subject-specific three-dimensional (3D) PA models. Computational fluid dynamics (CFD) was performed to compare the hemodynamic difference of flow patterns, wall shear stress (WSS) and normalized energy loss (E·) in the two groups. Results Hemodynamics-related parameters showed that the velocity and WSS were higher in the left and right PA branches of PAH-CHD patients, with significantly lower WSS in the main PA. The E· significantly increased in PAH-CHD patients and positively correlated with normalized PA diameter and inflow. Conclusions Compared with Non-PAH subjects, PAH-CHD patients have obviously higher velocity and WSS in PA branches, lower WSS in main PA and greater E·, indicating these hemodynamic parameters are related with the PAH-CHD, which can be used as potential biomechanical factors for the clinical evaluation of PAH-CHD.

Research Progress on Computational Hemodynamics of Pulmonary Hypertension / 医用生物力学

Pulmonary hypertension (PH) is a devastating disease caused by different etiology and characterized by the progressive elevation of pulmonary vascular resistance and pulmonary artery pressure. As a new method that applied to clinical studies, computational fluid dynamics (CFD) gradually becomes a powerful tool for in-depth understanding of the disease progression. It can noninvasively obtain the patient-specific hemodynamic parameters at any point of the vessel and present them through the visualization technology. In this paper, an overall review of CFD with the focus on PH, including the numerical simulation method, boundary conditions, blood characteristics and relevant hemodynamic parameters was presented.