Early Outcomes of Minimally Invasive Right Anterior Thoracotomy vs. Median Full Sternotomy in Isolated Aortic Valve Replacement: A Propensity Score Analysis

ABSTRACT Introduction: This study aimed to compare the early postoperative outcomes of right anterior thoracotomy minimally invasive aortic valve replacement (RAT-MIAVR) surgery with those of median full sternotomy aortic valve replacement (MFS-AVR) approach with the goal of identifying potential benefits or drawbacks of each technique. Methods: This retrospective, observational, cohort study included 476 patients who underwent RAT-MIAVR or MFS-AVR in our hospital from January 2015 to January 2023. Of these, 107 patients (22.5%) underwent RAT-MIAVR, and 369 patients (77.5%) underwent MFS-AVR. Propensity score matching was used to minimize selection bias, resulting in 95 patients per group for analysis. Results: After propensity matching, two groups were comparable in preoperative characteristics. RAT-MIAVR group showed longer cardiopulmonary bypass time (130.24 ± 31.15 vs. 117.75 ± 36.29 minutes, P=0.012), aortic cross-clamping time (76.44 ± 18.00 vs. 68.49 ± 19.64 minutes, P=0.004), and longer operative time than MFS-AVR group (358.47 ± 67.11 minutes vs. 322.42 ± 63.84 minutes, P=0.000). RAT-MIAVR was associated with decreased hospitalization time after surgery, lower postoperative blood loss and drainage fluid, a reduced incidence of mediastinitis, increased left ventricular ejection fraction, and lower pacemaker use compared to MFS-AVR. However, there was no significant difference in the incidence of major complications and in-hospital mortality between the two groups. Conclusion: RAT-MIAVR is a feasible and safe alternative procedure to MFS-AVR, with comparable in-hospital mortality and early follow-up. This minimally invasive approach may be a suitable option for patients requiring isolated aortic valve replacement.

Diagnostic value of nasal nitric oxide for children with primary ciliary dyskinesia / 中华儿科杂志

Objective: To evaluate the value of nasal nitric oxide (nNO) measurement as a diagnostic tool for Chinese patients with primary ciliary dyskinesia (PCD). Methods: This study is a retrospective study. The patients were recruited from those who were admitted to the respiratory Department of Respiratory Medicine, Children's Hospital of Fudan University from March 2018 to September 2022. Children with PCD were included as the PCD group, and children with situs inversus or ambiguus, cystic fibrosis (CF), bronchiectasis, chronic suppurative lung disease and asthma were included as the PCD symptom-similar group. Children who visited the Department of Child health Care and urology in the same hospital from December 2022 to January 2023 were selected as nNO normal control group. nNO was measured during plateau exhalation against resistance in three groups. Mann-Whitney U test was used to analyze the nNO data. The receiver operating characteristic of nNO value for the diagnosis of PCD was plotted and, the area under the curve and Youden index was calculated to find the best cut-off value. Results: nNO was measured in 40 patients with PCD group, 75 PCD symptom-similar group (including 23 cases of situs inversus or ambiguus, 8 cases of CF, 26 cases of bronchiectasis or chronic suppurative lung disease, 18 cases of asthma), and 55 nNO normal controls group. The age of the three groups was respectively 9.7 (6.7,13.4), 9.3 (7.0,13.0) and 9.9 (7.3,13.0) years old. nNO values were significantly lower in children with PCD than in PCD symptom-similar group and nNO normal controls (12 (9,19) vs. 182 (121,222), 209 (165,261) nl/min, U=143.00, 2.00, both P<0.001). In the PCD symptom-similar group, situs inversus or ambiguus, CF, bronchiectasis or chronic suppurative lung disease and asthma were significantly higher than children with PCD (185 (123,218), 97 (52, 132), 154 (31, 202), 266 (202,414) vs. 12 (9,19) nl/min,U=1.00, 9.00, 133.00, 0, all P<0.001). A cut-off value of 84 nl/min could provide the best sensitivity (0.98) and specificity (0.92) with an area under the curve of 0.97 (95%CI 0.95-1.00, P<0.001). Conclusions: nNO value can draw a distinction between patients with PCD and others. A cut-off value of 84 nl/min is recommended for children with PCD.

Application value of intravenous anesthesia combined with ultrasound-guided nerve block in patients with intestinal cancer / 中国医学装备

Objective:To investigate the application value of intravenous anesthesia combined with ultrasound-guided nerve block in patients with intestinal cancer.Methods:A total of 200 patients who prepared to undergo laparoscopic radical resection of intestinal cancer under general anesthesia in Beijing Yanhua Hospital between January 2017 and January 2022 were selected as the study subjects.They were divide into study group and control group according to inter-group matching principle,with 100 cases in each group.Control group adopted single intravenous anesthesia,and study group adopted intravenous anesthesia combined with ultrasound-guided nerve block.The heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SpO2)before anesthesia(T0),after anesthesia(T1),when skin incision(T2)and when completed surgery(T3),and the visual analogue scale(VAS)values,the time of the first exhausting,the time of postoperative hospital stay,the occurrence of adverse reaction at the 6th h(T4)and 12th h(T5)after surgery between two groups were compared.The drive pressure(DP)values at five time points included 5min(t1)after endotracheal intubation,5min(t2)after establishing pneumoperitoneum,5min(t3)and 60min(t4)after implementing the position with lower head and higher foot,and 5min(t5)after restoring horizontal position of pneumoperitoneum exhaust were recorded.And then,the concentrations of serum tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),angiotensin(AngⅡ)and cortisol(Cor)before and 24h after surgery were respectively measured.Results:The results of one-way ANOVA indicated that there were no statistically significant differences in HR,MAP and SpO2 between the two groups at T0,T1,T2 and T3(P>0.05),respectively.The dosage of Propofol within unit time of study group was significantly lower than that of control group(t=8.305,P<0.05),and the time of the first exhausting and the time of hospital stay of study group were significantly shorter than those of control group(t=7.978,t=9.141,P<0.05),respectively.The VAS scores of study group were significantly lower than that of control group at T4 and T5(t=10.033,t=9.071,P<0.05),and the incidence of adverse reaction of study group was significantly lower than that of control group(x2=13.78,P<0.05),respectively.The results of one-way ANOVA showed that there were statistically significant differences in DP values between the two groups at different times(F=595.765,F=448.108,P<0.05),and the DP values of two groups at t2,t3,t4 and t5 were significantly higher than that at t1(10.59±1.52)(F=595.765,P<0.05).The DP values at t2,t3 and t4 of study group were significantly higher than those of control group(t2=17.69±2.12,t3=20.16±2.06,t4=20.06±2.0)(t=9.650,t=14.339,t=0.738,P<0.05),respectively.The differences of the serum AngⅡ,Cor,TNF-α and IL-6 levels between two groups were not statistically significant before surgery(P>0.05).The serum AngⅡ,Cor,TNF-α and IL-6 levels of the two groups of patients after surgery were significantly higher than them before surgery.At 24 hours after surgery,the serum AngⅡ,Cor and TNF-α and IL-6 levels of study group of patients were significantly lower than them of control group(t=2.601,t=3.790,t=5.779,t=6.154,P<0.05),respectively.Conclusion:The application of intravenous anesthesia combined with ultrasound-guided nerve block in patients who undergo laparoscopic radical resection of intestinal cancer can effectively maintain intraoperative hemodynamic stability,and reduce the amount of anesthetic,and shorten the times of the first exhausting and hospital stay,and reduce postoperative pain,stress and inflammation reaction,and improve respiratory function.

Intraoperative fluoroscopy on femoral tunnel placement in the treatment of professional snow sports athletes with anterior cruciate ligament injury / 中华创伤杂志

Objective:To explore the clinical outcomes of intraoperative fluoroscopy on femoral tunnel placement in treating professional snow sports athletes with anterior cruciate ligament (ACL) injury.Methods:A retrospective case series study was used to analyze the clinical data of 13 professional snow sports athletes with ACL injury treated in the National Institute of Sports Medicine, General Administration of Sport of China from January 2016 to January 2019. There were 5 males and 8 females, aged 16-27 years [(18.5±3.0)years]. Intraoperative lateral fluoroscopy combined with quadrant method was performed for the accurate femoral tunnel placement in single-bundle ACL reconstruction by using autologous hamstring tendon in all patients. KT1000 side-to-side difference (KT1000-ssd), pivot shift test, International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Marx activity scale and maximum extension and flexion resistance ratio of the involved and uninvolved knee were compared before operation (or before injury) and at 3, 6, 12 and 24 months after operation. Whether returning to the field, time taken in returning to the field and re-injury were recorded at each follow-up visit. ACL graft signal intensity ratio (SIR) in MRI of the involved knee was evaluated at postoperative 24 months.Results:All patients were followed up for 24-33 months [(25.8±2.7)months]. There were 7 patients with KT1000-ssd degree I, 5 with degree II and 1 with degree III before operation, compared to 12 patients with KT1000-ssd degree 0 and 1 with degree I at 3 and 6 months after operation and 13 patients with KT1000-ssd degree 0 at 12 and 24 months after operation. The pivot shift test was grade I in 8 patients and grade II in 5 before operation, compared to 11 patients with degree 0 and 2 with degree I at 3 months after operation and 12 patients with degree 0 and 1 with degree I at 6, 12 and 24 months after operation. IKDC subjective score was (68.0±4.3)points, (84.7±7.9)points, (94.6±3.3)points and (96.5±1.8)points at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, IKDC subjective score was significantly improved compared to the preoperative (48.3±25.0)points (all P<0.01). The Lysholm score was (63.4±6.6)points, (80.1±6.5)points, (93.8±4.6)points and (96.5±2.4)points at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the Lysholm score was significantly improved compared to the preoperative (47.5±29.4)points (all P<0.01). The Marx activity scale was (7.4±0.5)points, (13.8±0.7)points, (14.6±0.8)points and (15.0±0.7)points at postoperative 3, 6, 12 and 24 months, respectively, significantly lower than (16.0±0.0)points before the injury (all P<0.01). The maximum extension resistance ratio of the involved and uninvolved knee was 0.60±0.10, 0.85±0.08, 0.91±0.06 and 0.97±0.04 at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the maximum extension resistance ratio of the involved and uninvolved knee was significantly increased compared to the preoperative 0.57±0.18 (all P<0.01).The maximum flexion resistance ratios of involved and uninvolved knee were 0.64±0.09, 0.82±0.06, 0.89±0.04 and 0.94±0.06 at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the maximum flexion resistance ratio of the involved and uninvolved knee was significantly increased compared to the preoperative 0.60±0.12 (all P<0.01). Thirteen athletes returned to the field within 12 months after operation with the time taken in returning to the field ranging from 5-12 months [(8.7±1.9)months]. There was no ACL re-injury at postoperative 24 months. The ACL graft SIR in MRI of the involved knee was 1.80±0.20 at postoperative 24 months. Conclusion:Intraoperative fluoroscopy on femoral tunnel placement in the treatment of professional snow sports athletes with ACL injury can significantly improve the knee joint stability, subjective function, sports performance and muscle strength within 6 months, and can help them return to the field within 12 months, and accelerates graft healing.

Structural design of an ankle multi-dimensional rehabilitation training device / 中国康复理论与实践

@#Objective To design a novel ankle rehabilitation trainer to meet the rehabilitation needs of multiple motion after ankle injury.Methods Based on the model of ankle motion, combined with the mechanical design and the rehabilitation techniques, a trainer was designed using SolidWorks software, including rotational plane and dynamic mechanism design, allowing a multi-dimensional motion.Results The trainer completed the motion of plantar-flexion/dorsiflexion, inversion/eversion, and adduction/abduction of ankle, to carry out uniaxial or multidimensional motor rehabilitation.Conclusion The mechanical structure of the rehabilitation trainer is simple, meeting the needs of ankle rehabilitation training program, which can be used to relieve ankle joint motor dysfunction.

Detection of Minimal Residual Disease in Acute Myeloid Leukemia by Multi-color Flow Cytometry / 中国实验血液学杂志

OBJECTIVE@#To establish 10-color fluorescent antibody combination panels for the detection of minimal residual disease (MRD) of acute myeloid leukemia (AML) in our laboratory and discuss the value of clinical application.@*METHODS@#According to the antigen expression characteristics of leukemia cells of incipient AML patients, MRD in bone marrow were detected by multiparameter flow cytometry, and the test results were compared with both bone marrow cell morphology and PCR results, then 10-color fluorescent antibody combination panels in our lab for MRD detection was determined.@*RESULTS@#The immunophenotypic characteristics of 392 incipient patients with AML in the First Affiliated Hospital of Zhengzhou University were analyzed, among them 357 (91.07%) cases showed abnormal immunophenotypes, which mainly included cross-lineage expression, cross-stage expression, deficiency of antigen expression or abnormal antigen intensity and other abnormal expression. The 10-color fluorescent antibody combination panels established according to abnormal immunophenotypic characteristics of leukemia cells were applied for detecting MRD in 156 patients with AML, the positive rate (43.6%) was higher than 26.8% of morphology, and the results were highly consistent with PCR detection results (96.49%), moreover, the recurrence rate of MRD positive patients (86.96%) was significantly higher than 5.75% of MRD negative patients. Therefore, this method could truly reflect the load of leukemia cells and prompt change of disease condition.@*CONCLUSION@#Multiparameter flow cytometry can detect various abnormal immunophenotypes of AML. The 10-color fluorescent antibody combination panels in our lab based on the characteristics of antigens expression in leukemia cells can well detect MRD of leukemia cells, so as to predict relapse and provide basis for clinical treatment.

Primary ovarian squamous cell carcinoma: clinicopathological features and prognostic analysis of fifteen cases / 中华病理学杂志

Objective: To assess the clinical features and treatment outcomes in patients with primary ovarian squamous cell carcinoma (POSCC). Methods: Fifteen patients with primary ovarian squamous cell carcinoma diagnosed from January 2009 to December 2018 in Cancer Hospital of the University of Chinese Academy of Sciences were collected. The expression of p16, hMLH1, hMSH2, hMSH6 and PMS2 in POSCC was detected by immunohistochemistry, and the status of high-risk human papillomavirus (HPV) by RNAscope test. Results: Squamous cell carcinoma with different degrees of differentiation was found in 15 cases, including three cases with high differentiation and 12 cases with medium to low differentiation. There were four cases with in situ squamous cell carcinoma, four cases with teratoma, one case with endometrial carcinoma/atypical hyperplasia, and one case with endometriosis. p16 was expressed in five cases (5/15), indicating coexisting high-risk HPV infection. There was no high-risk HPV infection in the remaining 10 cases, and p16 staining was negative. There was no deficient mismatch repair protein in all cases. The overall survival time (P=0.038) and progression free survival (P=0.045) of patients with high-risk HPV infection were longer than those without HPV infection. Conclusions: POSCC is more commonly noted in postmenopausal women and often occurs unilaterally. Elevated serological indexes CA125 and SCC are the most common finding. Morphologically, the tumors show variable degrees of differentiation, but the current data suggest that the degree of differentiation cannot be used as an independent prognostic index. High-risk HPV infection may be associated with the occurrence of POSCC, and that the prognosis of POSCC patients with HPV infection is better than that of patients without infection.

Occult hepatitis C virus infection in volunteer blood donors in Shaanxi province / 中国输血杂志

【Objective】 To investigate the prevalence of occult hepatitis C virus infection (OCI) in Shaanxi blood donors and characterize the occult hepatitis C virus in this cohort. 【Methods】 Between July and September of 2019, 112, 117, 46, and 75 blood samples were obtained from eligible donors, alanine aminotransferase (ALT) elevated donors(ALT>50 U/L), hepatitis B virus surface antigen (HBsAg) positive donors, and anti-hepatitis C virus (anti-HCV) positive donors, respectively. Peripheral blood lymphocytes (PBMCs) were isolated from all the samples. HCV 5′UTR was amplified from total RNA of PBMCs using reverse transcription nested PCR (RT-Nested PCR) to detect the infection status of OCI in blood donors. HCV RNA core/E2 region was amplified from HCV RNA positive samples with RT-Nested PCR to determine HCV genotypes and subtypes via sequencing. 【Results】 Two (2.67%, 2/75) cases of OCI were identified in anti-HCV positive samples, 1(0.85%, 1/117) case of OCI was identified in abnormal ALT samples, and all OCI were genotyped as 1b. OCI was not found in HBsAg positive and eligible blood donors. 【Conclusions】 Our findings suggest that OCI does exist among Shaanxi blood donors and that ALT may be useful in diagnosing OCI.

Anti-rheumatoid arthritis potential of diterpenoid fraction derived from Rhododendron molle fruits / 中国天然药物

Rhododendron molle G. Don is first recorded in Shengnong's Herbal Classic, and its fruits, which are termed as Liuzhouzi, are often used to treat rheumatoid arthritis in Chinese folk. During our ongoing investigation to develop a safer and potential new arthritis therapy, a process for the preparation of diterpenoid fraction from Rhododendron mollefruits was established. In order to evaluate the main components and the anti-rheumatoid arthritis effect of the diterpenoid fraction, phytochemical and pharmacological experiments were used. As the result, the main components of diterpenoid fraction were identified as rhodojaponin III (1), rhodojaponin VI (2), 2-O-methylrhodojaponin (3), and 5'-β-D-glucopyranosy-loxyjasmonic acid (4). These four components constitute greater than 95% of diterpenoid fraction using area normalization method of HPLC-ELSD. The results of CIA rat experiment showed that high dose of diterpenoid fraction (0.6 mg·kg

Predictive diagnostic value of serum 25-hydroxyvitamin D3 in eosinophilic chronic rhinosinusitis with nasal polyps / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the value of 25-hydroxyvitamin D3 (25-(OH)D3) with other clinical parameters in the prediction and diagnosis of eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP). Methods: Eligible chronic rhinosinusitis with nasal polyps (CRSwNP) patients and healthy subjects in the Affiliated Hospital of Guizhou Medical University from January to April of 2021 were included for this study. The age, gender, past history and other basic characteristics of all subjects were recorded. The CRSwNP patients were classified into ECRSwNP and non-eosinophilic chronic rhinosinusitis with nasal polyps (nECRSwNP) endotypes by the percentage of tissue eosinophils. Serum 25-(OH)D3 levels measurements were performed in all subjects. Paranasal sinus CT scans, blood eosinophil counts, and determination of total immunoglobulin E (total IgE), Th1/Th2 plasma cytokines and nasal nitric oxide (nNO) levels were performed before surgery. Logistic regression analysis was used to evaluate the related factors of ECRSwNP. Receiver operating characteristic (ROC) curves was used to evaluate the predictive potential of the clinical parameters. Results: One hundred and twenty-seven CRSwNP patients and 40 healthy subjects were recruited, including 74 males and 93 females of the patients, with the age of (38.73±13.05) years. In patients with ECRSwNP, serum 25-(OH)D3 levels were significantly lower than those in nECRSwNP patients ((26.14±4.58) ng/ml vs (35.71±7.86) ng/ml, t=-8.564, P<0.01). The prevalence of asthma, prevalence of allergic rhinitis, peripheral blood eosinophil counts, total IgE levels, nNO levels and CT scores ratio for ethmoid sinus and maxillary sinus (E/M ratio) of ECRSwNP patients were significantly higher than those in nECRSwNP patients (all P<0.05). However, there was no significant difference in Th1/Th2 cytokines levels between the histological types of CRSwNP (all P>0.05). Among the predictive indicators, 25-(OH)D3 had the highest predictive value, with ROC area under curve (AUC) value of 0.882. The best cut-off point of 28.5 ng/ml for 25-(OH)D3 demonstrated a sensitivity of 0.871 and a specificity of 0.762 for ECRSwNP. Conclusion: Measurement of serum 25-(OH)D3 level may be used as an effective method to distinguish between ECRSwNP and nECRSwNP.

Clinical effects of two different enteral nutritional emulsions in elderly patients with severe pneumonia / 中华老年医学杂志

Objective:To compare the clinical effects of two enteral nutritional emulsions, TP-HE and TPF, in elderly patients with severe pneumonia.Methods:This was a randomized study with contemporaneous controls.A total of 56 elderly patients over 65 years old who met the diagnostic criteria for severe pneumonia and were receiving insulin were enrolled.They were randomly divided into the observation group(n=28, enteral TPF-HE at a uniform rate through a nasogastric tube)and the control group(n=28 cases, enteral TPF at a uniform rate through a nasogastric tube). The total daily energy supply was calculates based on the ideal weights of patients.Prealbumin(PA), serum albumin(ALB), body mass index(BMI)and hemoglobin(Hb)were continuously measured at 1, 2, 3, 4, 5, 6 and 7 days after treatment.The effects of the enteral nutritional emulsions in elderly patients with severe pneumonia were analyzed by using repeated measures analysis of variance in a general linear model.Results:There was no significant difference in PA(244.5±55.1)mg/L vs.(237.8±40.4)mg/L, ALB(37.6±5.6)mg/L vs.(38.3±5.5)mg/L, BMI(21.9±0.2)kg/m 2vs.(22.4±0.2)kg/m 2)or Hb(104.4±26.8)mg/L vs.(103.6±25.6)mg/L between the TP-HE group and the TPF group before admission( P>0.05). The energy received from the enteral nutritional emulsions was not significantly different between the TP-HE group and the TPF group(79.8±4.8)kcal/d vs.(79.3±6.6)kcal/d( P>0.05). PA and serum ALB levels had significant differences between the TP-HE group and the TPF group at 1, 2, 3, 4, 5, 6 and 7 days after treatment( P<0.01 or 0.05). Increases in PA and serum ALB levels varied at certain time points between the TP-HE group and the TPF group.Hb levels had no significant difference at 1 and 2 days( P>0.05), but were significantly different at other time points between the two groups( P<0.01). There was no significant difference in BMI between the two groups( F=1.709, P>0.05). Conclusions:Both of the enteral nutrition emulsions can improve PA, ALB and Hb levels, with TP-HE offering more significant effects on PA, ALB and Hb levels.There is no difference in BMI at any time point whether patients receive TP-HE or TPF.

Service competence evaluation of 99 smoking cessation clinics in Zhejiang Province / 预防医学

Objective@#To evaluate the service competence of 99 smoking cessation clinics in Zhejiang Province, so as to provide reference for the improvement. @*Methods@#The questionnaire, prepared by Tobacco Control Office of Chinese Center for Disease Control and Prevention, was used to investigate all the smoking cessation clinics in Zhejiang Province, to score the basic and developmental indicators, and to assess the qualified rates ( basic indicators >50 points and total scores >60 points ). @*Results@#There were 99 smoking cessation clinics, with 52 in secondary hospitals and 47 in tertiary hospitals. The overall assessment scored from 11 to 96 points, with an average of ( 53.99±16.56 ) points. The smoking cessation clinics in secondary and tertiary hospitals scored ( 53.92±15.88 ) points and ( 54.06±17.45 ) points. The scores of basic and developmental indicators were ( 45.66±12.16 ) points and ( 8.33±5.39 ) points, with the scoring rates of 65.23% and 27.77%. The overall assessment of 43 smoking cessation clinics were qualified and the rate was 43.43%, which was 44.23% in secondary hospitals and 42.55% in tertiary hospitals. @*Conclusion@#The qualified rate of smoking cessation clinics in Zhejiang Province was 43.43%, which was similar between second hospitals and tertiary hospitals.

Visual acuity in preschool children of Yangpu District in Shanghai / 上海预防医学

Objective To investigate the visual acuity condition of preschool children in Yangpu District of Shanghai, providing the basis for formulation of corresponding intervention measures for myopia. Methods The inspection equipment was the international standard logarithmic E-word visual acuity chart, and the Canon RK-F1 automatic computer optometry instrument.By using cross-sectional study and random cluster sampling method, a total of 1 415 preschool children in 5 kindergartens in Yangpu District were selected according to their ages and genders, and their visual acuity and refractive parameters were examined with the result being statistically analyzed. Results In preschool children of Yangpu District, their envisage rate was 80.4%, myopia rate 16.7% and hyperopia rate 2.9%.There was no significant difference in the incidence rate of envisage, myopia and hyperopia between different age groups (χ2=3.419, P=0.755) and different genders (χ2=2.433, P=0.296).The rate of poor vision for preschool children in Yangpu was 10.5%.There was a statistically significant difference in the rate of poor vision between different age groups (χ2=9.637, P=0.022) and different genders (χ2=4.191, P=0.041). Conclusion The visual acuity rate and myopia rate in preschool children are not optimistic and need further screening and early intervention.

Visual acuity in preschool children of Yangpu District in Shanghai / 上海预防医学

Objective To investigate the visual acuity condition of preschool children in Yangpu District of Shanghai, providing the basis for formulation of corresponding intervention measures for myopia. Methods The inspection equipment was the international standard logarithmic E-word visual acuity chart, and the Canon RK-F1 automatic computer optometry instrument.By using cross-sectional study and random cluster sampling method, a total of 1 415 preschool children in 5 kindergartens in Yangpu District were selected according to their ages and genders, and their visual acuity and refractive parameters were examined with the result being statistically analyzed. Results In preschool children of Yangpu District, their envisage rate was 80.4%, myopia rate 16.7% and hyperopia rate 2.9%.There was no significant difference in the incidence rate of envisage, myopia and hyperopia between different age groups (χ2=3.419, P=0.755) and different genders (χ2=2.433, P=0.296).The rate of poor vision for preschool children in Yangpu was 10.5%.There was a statistically significant difference in the rate of poor vision between different age groups (χ2=9.637, P=0.022) and different genders (χ2=4.191, P=0.041). Conclusion The visual acuity rate and myopia rate in preschool children are not optimistic and need further screening and early intervention.

A new lignan from Gleditsiae spina / 药学学报

The chemical constituents from ethyl acetate extract of Gleditsiae spina were isolated and purified by various chromatographic methods such as MCI gel CHP-20, ODS, Sephadex LH-20, silica gel and semi-preparative HPLC. Seven lignans were isolated and identified by spectroscopic data analyses as (7R,8S,7'E,7''S,8''R)-buddlenol P (1), (+)-syringaresinol (2), (+)-isolariciresinol (3), (7S,8R)-cedrusin (4), (7S,8R)-4,9,9'-trihydroxy-3,3'-dimethoxy-7,8-dihydrobenzofuran-1'-propylneolignan (5), 3',4-O-dimethylcedrusin (6), balanophonin (7). Among them, compound 1 is a new lignan, compounds 2-7 are isolated from the Gleditsia L. for the first time. MTT method was used to investigate the effect of compounds 2-7 on LPS-induced injury of NRK-52e cells. As a result, compounds 2, 3 and 7 exhibit protective effects against LPS-induced damage to NRK-52e cells.

Prognostic Value of CD123 in Acute Myeloid Leukemia Patients with Intermediate Risk in Normal Karyotype / 中国实验血液学杂志

OBJECTIVE@#To investigate the expression of CD123 in patients with acute myeloid leukemia (AML) and its relationship between clinical features, concomitant fusion gene or gene mutation, efficacy and prognosis.@*METHODS@#365 patients with newly diagnosed AML (except M3) treated in the First Affiliated Hospital of Zhengzhou University were enrolled and retrospective analysis, and multi-parameter flow cytometry was performed to detect the expression of CD123 in myeloid leukemia cell population. CD123≥20% was defined as positive. Clinical features, concomitant fusion gene or gene mutation, efficacy and prognosis of CD123@*RESULTS@#The positive rate of CD123 in 365 newly diagnosed AML patients was 38.9%. Compared with the CD123@*CONCLUSION@#CD123 positive indicates that AML patients have higher tumor burden and are more difficult to reach remission. It is an independent risk factor for OS and EFS in patients with normal karyotype and intermediate risk, which is important to evaluate the prognosis of patients with AML without specific prognostic marker.

Molecular mechanism of polygonatum sibiricum polysaccharide in the prevention and treatment of postmenopausal osteoporosis / 中国组织工程研究

BACKGROUND: Previous studies have found that polygonatum sibiricum polysaccharide (PSP) exhibits anti-osteoporosis effect, but its therapeutic effect in ovariectomized osteoporotic rats and the molecular mechanisms are poorly understood. OBJECTIVE: To investigate the effect of administration of PSP on the bone microstructure, bone mineral density as well as osteoblast- and osteoclast-related gene expression in rats. METHODS: Twenty-five infertile female Sprague-Dawley rats aged 3 months were randomly allotted into five groups (n=5 per group): sham operation (same volume normal saline), model, zoledronate (0.2 mg/kg?d), high-dose PSP (800 mg/kg?d) and medium-dose PSP (400 mg/kg?d) groups. All rats were subjected to ovariectomy except sham operation group. The administration was intragastrically given every 2 days beginning at 7 days after modeling and lasted 12 weeks. Then, the rats were sacrificed, and the uterus was weighed. The bilateral tibias were removed, one side for histomorphometric analysis by micro-CT, and the other one for RNA detection by qualified PCR. RESULTS AND CONCLUSION: Compared with the sham operation group, the rat body mass in the model group was significantly increased and the weight of uterus was significantly decreased (P < 0.05). Compared with the model group, zoledronate and high-dose PSP could significantly alleviate the excessive increase in body mass (P < 0.05). The bone mineral density in the model group was decreased by 63% compared with the sham operation group (P < 0.01), Compared with the model group, after 12-week high-dose PSP and zoledronate administration, the bone mineral density was increased by 44% and 38%, respectively (P < 0.01); the trabecular bone volume fraction and trabecular number rose significantly(P<0.05),while the trabecular separation decreased significantly(P<0.05).In vivo,PSP could significantly promote the expression levels of osteoblast-related genes (alkaline phosphatase, RUNX2, Col1a1 and osteocalcin), and significantly inhibit the expression levels of osteoblast-related genes (ACP5 and CTSK) (P < 0.05). These results imply that high-dose PSP can reduce bone loss and decrease of bone mineral density, improve the destruction of bone microstructure, as well as promote osteoblast-related genes but inhibit osteoclast-related gene mRNA expression in the ovariectomized rats.

Impact of Bundle Branch Block on Long-term Prognosis in Patients With Acute Coronary Syndrome After Percutaneous Coronary Intervention / 中国循环杂志

Objective: To explore the impact of bundle branch block (BBB) on acute coronary syndrome (ACS) prognosis in patients after percutaneous coronary intervention (PCI). Methods: A total of 6 429 ACS patients received PCI in our hospital from 2013-01 to 2013-12 were enrolled. According to BBB diagnosis at discharge, the patients were divided into 2 groups: BBB group, n=159 and Non-BBB group, n=6 270. The incidences of 2-year major adverse cardio and cerebral-vascular events (MACCE) including all-cause death, cardiac death, myocardial infarction, revascularization, in-stent thrombosis and stroke were compared between 2 groups; relationship between existing BBB and clinical outcomes was assessed. Results: Compared with Non-BBB group, BBB group had the elder age (62.97±11.37) years vs (58.26±10.36) years, lower BMI (25.31±3.02) vs (25.89±3.20), decreased glomerular filtration rate (86.89±16.15)ml/min vs (91.05±15.53)ml/min and LVEF (59.27±9.86)% vs (62.37±7.36) %, all P<0.05; other baseline condition, angiographic and interventional features were similar between 2 groups, all P>0.05. During 2-year follow-up period, compared with Non-BBB group, BBB group showed the higher incidences of cardiac death (2.5% vs 0.7%) and in-stent thrombosis (3.1% vs 0.8%), both P<0.05; other incidences of MACCE were similar between 2 groups, all P>0.05. With adjusted propensity score matching, 2-year incidence of MACCE was similar between 2 groups, P>0.05; 2-year incidences of MACCE in BBB group including LBBB and RBBB were similar to Non-BBB group, P>0.05. Cox regression analysis revealed that BBB was not related to ACS prognosis after PCI. Conclusion: BBB was not an independent risk factor for long-term MACCE occurrence in ACS patients after PCI.

Impact and clinical outcome of intra-aortic balloon pump use during percutaneous coronary intervention / 中华心血管病杂志

Objective@#To observe the impact and clinical outcome of intra-aortic balloon pump(IABP) use in patients underwent percutaneous coronary intervention (PCI).@*Methods@#From January 2013 to December 2013, 10 724 consecutive patients undergoing PCI were enrolled.After 2 years′ follow-up, the incidence of major adverse cardiovascular and cerebrovascular events such as death, myocardial infarction, stent thrombosis, revascularization, recurrent stroke were recorded, propensity score was used to match baseline data, and the clinical outcomes in patients with IABP and non-IABP were compared.@*Results@#The overall use of IABP was 1.3%(143/10 724), clinical and angiographic risks were significantly higher in IABP group than non-IABP group.The rate of cardiac shock was significantly higher (9.8%(14/143) vs. 0.2%(16/10 581), P<0.01) and left ventricular ejection fraction was significantly lower (54.3%±11.0% vs. 62.9%±7.2%, P<0.01) in the IABP group than in the non-IABP group.Patients in IABP group had a significantly higher rate of left main or triple-vessel disease (P<0.01), and their SYNTAX score, target lesion number, stent number were also significantly higher compared with non-IABP patients (all P<0.01). During the 2-year follow-up, all-cause mortality was significantly higher in IABP group than in non-IABP group (10.5%(15/142) vs. 1.1%(116/10 581), P<0.001). Multivariable analyses indicated that IABP was associated with increased mortality (HR=3.51, 95%CI 1.71-7.17, P=0.001). However, after propensity score matched analyses (137 pairs), IABP use was no longer an independent predictor of all-cause mortality (HR=2.09, 95%CI 0.72-6.13, P=0.177).@*Conclusions@#In this single large center of coronary heart disease in China, the IABP usage was about 1.3%.Propensity score matched analyses showed that during the 2 years′ follow-up, adverse effect including similar long-term mortality is similar between PCI patients with or without IABP after adjusting for confounders.