[Association of body fat ratio with precocious puberty in girls].

OBJECTIVE: To study the association of body fat ratio with precocious puberty in girls. Previous studies have shown that body mass index (BMI) is associated with the girls' age of puberty but have not revealed the association of body fat ratio with age of puberty. METHODS: Based on the consensus on the diagnosis and treatment of central precocious puberty (CPP), 128 children with precocious puberty who were admitted to the hospital from July to August, 2017, were divided into a CPP group with 87 children and a peripheral precocious puberty (PPP) group with 41 children. A total of 51 girls without any puberty development signs were enrolled as the control group. Dual-energy X-ray absorptiometry was used to measure the body fat ratios of upper limbs, legs, trunk, android area, gynoid area, and the whole body. The association between body fat ratios and precocious puberty was analyzed with reference to age, BMI, BMI-Z score, bone age, ovarian volume, and hormone levels. RESULTS: Compared with the control group, the CPP and PPP groups had significantly higher body fat ratios of upper limbs, legs, trunk, android area, gynoid area, and the whole body, legs/whole body fat ratio, and (upper limbs+legs)/trunk fat ratio (P<0.05), while there were no significant differences in the above body fat ratios and fat distribution indicators between the CPP and PPP groups (P>0.05). For the girls with precocious puberty, the high body fat ratio group had significantly higher luteinizing hormone (LH) base value, luteinizing hormone releasing hormone (LHRH)-stimulated LH peak value, and LH/follicle-stimulating hormone peak value than the low body fat ratio group (P<0.05). Compared with the control group, both the high body fat ratio and low body fat ratio groups had a significantly higher LH base value (P<0.05). CONCLUSIONS: The increase in body fat may be a factor inducing precocious puberty in girls, but further studies are needed to determine the mechanism.

Subpollens delivery of Platanus acerifolia pollen allergen Pla a3 and nucleic acid into lungs and cells.

Pollen allergy is a very serious seasonal respiratory disease. However, there has been a lack of understanding how pollen allergens enter the body and act on cells. This study focused on the release, transport and characteristic of Pla a3 allergen of the Platanus acerifolia pollen. Pla a3 protein was purified by prokaryotic expression system for preparation of polyclonal antibody. The distribution and release of Pla a3 protein in pollen were observed by immunohistochemistry. Mice were immunized with purified Pla a3 protein and SPPs, respectively. The pathological examination of mouse lung tissue proved that SPPs, as a fine particle in the range of 0.1-1µm, can enter the deep part of the lung directly through the respiratory tract and led to inflammation. Furthermore, DAPI staining confirmed a certain amount of nucleic acids in SPPs. After incubation with SPPs for 6 h, the Pla a3 mRNA could be detected in A549 cells by PCR. This suggests that nucleic acid wrapped in SPPs could be delivered into A549 cells. These results could provide a new clue and experimental data accumulation for further study on the mechanism of pollen sensitization.

Mechanical sensitivity analysis and optimization of a large-aperture KDP frequency converter for higher SHG efficiency.

The effective energy density at the target of inertial confinement fusion facility is subject to the problem of the low efficiency of second harmonic generation of large-aperture KDP frequency converters over a long time. To overcome this problem, we propose the optomechanical analysis method to correlate the mechanical factors with its critical physical performance in theory. Further, combined with experiments and simulations, the mechanical sensitivity of the frequency converter is completely explained from the microscopic and macroscopic perspectives. Finally, we introduce a moment-dominated clamping scheme that is expected to greatly improve the online service performance of the converter.

Effect of athletic fatigue damage and the associated bone targeted remodeling in the rat ulna.

BACKGROUND: Fatigue damage of the long bones is prevalent in running athletes and military recruits due to vigorous mid- and long-term physical activity. The current study attempted to know the features of bony athletic fatigue damage and to explore the mechanism of fatigue damage repair through bone targeted remodeling process. METHODS: Right ulnae of the Wistar rats were fatigue loaded on an INSTRON 5865 to construct the athletic fatigue damage model, and several time points (i.e. experimental days: 0, 7, 13 and 19) were selected to simulate physiological status, preliminary, mid-term and perennial stage during continuous high-intensive training, respectively. The multi-level responses of rat ulnae under the athletic fatigue loading, including cellular protein expression, micro damage or micro-crack and macro mechanical properties, were tested and statistically analyzed. RESULTS: Wistar rats, subjected to the athletic fatigue loading protocol, experienced a decrease of ulna fatigue mechanical properties and an active bone resorption of the loaded ulnae in the early stage, whereafter, a hyperactive bone formation and significant improvements of ulnae fatigue mechanical properties were detected. However, a deterioration of quasi-static mechanical properties in the subsequent period implied limitations of bone remodeling to maintain the bearing capacity of bone during long-term strenuous exercise. CONCLUSIONS: In summary, after athletic fatigue loading, bone targeted remodeling is activated and proceeds to repair fatigue damage, but only to a certain extent.

[Recurrent anorexia and pigmentation of skin for more than two months in an infant].

A 2-month-old boy presented with adrenal insufficiency, impaired liver function, hypertriglyceridemia, significantly elevated creatine kinase and electrolyte disturbance. Microarray comparative genomic hybridization (aCGH) analysis test showed a pathogenic 8.7 Mb deletion in the short arm of chromosome X (Xp21.3 - p21.1) and confirmed the diagnosis of complex glycerol kinase deficiency (cGKD). He was treated with hydrocortisone, coenzyme Q10 and L-carnitine and was subsequently followed up for 4 years. His serum cortisol levels returned to normal one week later after treatment, but the serum creatine kinase, triglyceride and aminotransferase levels were progressively increased along with mental retardation and decreased muscular strength. cGKD is also named as Xp21 contiguous gene syndrome. The clinical manifestations of this disease include hypertriglyceridemia, congenital adrenal hypoplasia (AHC), Duchenne muscular dystrophy, and mental retardation. This case highlights the necessity to screen the serum triglyceride and creatine kinase levels in infants with suspected adrenal insufficiency.

Recurrent Abnormal Clones in Myelodysplastic Syndrome Marrow Originate from Cells at a Pluripotent Stem Level and Maintain Their Early Differentiation Potency.

OBJECTIVE: The present study aimed to investigate the origins and differentiation potencies of 4 common malignant clonal cell types (+8, 5q-/-5, 20q-/-20, 7q-/-7) in myelodysplastic syndrome (MDS) and to investigate whether the trisomy of chromosome 8 occurs subsequently to other chromosomal abnormalities. METHODS: The present study analyzed a total of 46 cases of chromosomal abnormalities in MDS patients. The magnetic activated cell sorting technique (MACS) was used to sort the CD34(+)CD38(-) (pluripotent hematopoietic stem cells) and CD34(+)CD38(+) cells (committed progenitor cells) from the bone marrow mononuclear cells (BMNCs) of these patients; the sorted cells were then individually smeared. Meanwhile, cytospins were prepared from the remaining CD34(-) BMNCs after cell sorting. The clonal cell proportions in these three types of smears were detected by fluorescence in situ hybridization (FISH). Cases in which +8 was associated with another abnormality (2 cases each in combination with abnormalities in chromosomes 7, 5, and 20) were dually hybridized with the cep8 probe and another corresponding probe. RESULTS: (1) for abnormalities of +8, 5q-/-5, 20q-/-20 or chromosome 7 involvements, clonal cells above the baseline level were detected in the pluripotent stem cell level. (2) The average clonal cell proportion in the committed progenitor cells of the 46 cases increased to 75.3% from 57.3% at the level of stem cell (p < 0.001). The groups with +8 and chromosome 5 abnormalities showed a statistically significant increase in clonal cells at the progenitor cell stage. At the individual level, 33 of 46 cases showed significant increases in clonal cells at the progenitor cell stage relative to the stem cell stage, whereas the clonal cell proportion in the CD34(-) BMNCs generally did not increase relative to the committed progenitor cell population. (3) The dual hybridization analysis showed that if +8 and another abnormality were present in the same abnormal clone according to G-banding, +8 always coexisted with the other chromosomal abnormality at the single cell level; there were no situations in which +8 occurred later than the other chromosomal abnormality. CONCLUSION: It seems that the all malignant MDS clones originated at the pluripotent hematopoietic stem cell stage and that the proliferation and differentiation potencies were retained partly in these clonal cells. The present study failed to confirm that the trisomy 8 occurred subsequently to the other abnormalities, but some in vitro or transplant experiments maybe prove the succession of clonal origination.

Bone formation in rabbit cancellous bone explant culture model is enhanced by mechanical load.

BACKGROUND: When studying and designing an artificial bone in vitro with similar features and functionality of natural bone by tissue engineering technology, the culturing environment, especially the mechanical environment is supposed to be an important factor, because a suitable mechanical environment in vitro may improve the adaptability of the planted-in tissue engineering bone in the body. Unfortunately, up to now, the relationship between mechanical stimuli and natural bone growth has not yet been precisely determined, and it is so imperative for a prior study on effect of mechanical loading on growth of the natural bone cultured in vitro. METHODS: Under sterile conditions, explant models of rabbit cancellous bone with 3 mm in thickness and 8 mm in diameter were prepared and cultured in a dynamic loading and circulating perfusion bioreactor system. By Micro-CT scanning, a 3D model for finite element (FEM) analysis was achieved. According to the results of FEM analysis and physiological load bearing capacity of the natural bone, these models were firstly subjected to mechanical load with 1Hz frequency causing average apparent strain of 1000 µÎµ, 2000 µÎµ, 3000 µÎµ and 4000 µÎµ respectively for 30 min every day, activities of alkaline phosphatase (AKP) were detected on the 5th and the 14th loading day and on the 14th and the 21st day, mechanical properties, tissue mineral density (TMD) of the bone explant models were investigated and Von-kossa staining and fluorescence double labeling assays were conducted to evaluate whether there were fresh osteoid in the bone explant models. In addition, Western blot, Elisa and Real-time PCR were employed to analyze expression of Collagen-I (COL-1), bone morphogenetic protein-2 (BMP-2) and osteoprotegerin (OPG) protein and RNA. RESULTS: The explant models of rabbit cancellous bone prepared under sterile conditions grew well in the bioreactor system. With the increasing culturing time and load levels, bone explant models in groups with 1000 µÎµ and 2000 µÎµ average apparent strain experienced improving mechanical properties and TMD (P<0.05), and results of Von-kossa staining and fluorescence double labeling also showed apparent fresh osteoid formation. Under the same loading conditions, a up-regulations in protein and RNA of COL-1, BMP-2 and OPG were detected, especially, relative genes notably expressed after 21 days. CONCLUSION: Our study demonstrated that mechanical load could improve function and activity of osteoblasts in explant models of cancellous bone. Through regulations of COL-1, OPG and BMP-2 secreted by osteoblasts, the mechanical load could improve the tissue structural density and stiffness due to formation of fresh osteoid.

Duodenum-preserving pancreatic head resection vs. pancreatoduodenectomy for benign lesions and low-grade malignancies of the pancreatic head.

BACKGROUND/AIMS: To compare the postoperative results of duodenum-preserving pancreatic head resection (DPPHR) techniques with those of conventional pancreatoduodenectomy (PD). METHODOLOGY: We retrospectively reviewed the records of 58 patients who underwent DPPHR or PD at Jinhua central hospital between May 1998 and May 2011. RESULTS: Eighteen patients underwent DPPHR (Group 1) and 40 conventional PD (Group 2). They were followed up for more than 6 months. Operation time in Group 1 was longer (290±18 min vs 269±14 min, p=0.001). Estimated blood loss in Group 1 was more (633±88 mL vs. 495±131 mL, p=0.003). Intraoperative transfusion in Group 1 was more (533±88 mL vs. 335±218 mL, p=0,001). However, postoperative transfusion was Iess (141±162 mL vs. 440±193 mL, p=0.000). Group 1 had a lower short-term complication rate (16.67% vs. 50.0%, p=0.0 16) and long-term complication rate (11.11% vs. 45.0%, p=0.012). Hospital mortality of both groups were 0. CONCLUSIONS: DPPHR for benign or premalignant lesions is a difficult procedure, but with a lower complication rate than conventional PD. Preserving the entire duodenum and a normal biliary tree allows better short-term and long-term results. DPPHR will be suitable for only a small group of patients and should be performed by experienced surgeons.

Live poultry markets beyond health risks: Understanding consumer preferences for live poultry in South China.

Live poultry markets (LPMs) are veterinary and public health risks because of potential for zoonotic spillover of pathogens from diseased animals to humans. To control these health risks, veterinary and public health authorities in Asia, including China, have closed or restricted LPMs. In south China, however, LPM closure has been opposed or rendered infeasible by consumers who prefer to purchase live poultry. Previous scholarship has suggested this preference is due to cultural values of freshness. In this study, we present results from detailed interviews with shoppers in south China, including those who prefer live poultry and those who prefer pre-slaughtered poultry. We argue that broader concerns about food safety and quality, rather than freshness alone, drive the demand for LPMs. Live poultry provide sensory information that enable shoppers to evaluate safety and quality in ways that are not possible with pre-slaughtered, refrigerated meat. Based on these findings, we suggest that hygienic interventions into LPMs should recognize that not only freshness, but also trust, must be constructed and maintained in any intervention.

Study on the immune enhancement of different immunoadjuvants used in the pentavalent vaccine for turbots.

In this study, we investigated the immune enhancing effects of different adjuvants used in a pentavalent vaccine for turbots. The pentavalent vaccine consisted of inactive bacterial cells from five common pathogenic strains (Vibrio anguillarum, Vibrio scophtalmi, Edwardsiella tarda, Vibrio harveyi and Vibrio alginolyticus) and the adjuvants were astragalus polysaccharides (APS), propolis, and the Freund's complete adjuvant (FCA). Turbots were immunized with the pentavalent vaccine alone or with one of the adjuvants, and the immune efficiency was evaluated by measuring the activities of lysozyme (LSZ) and superoxide dismutase (SOD), and serum antibody titers. Fish were also challenged with the pathogens after immunization and the relative percent survival (RPS) was assessed. Our results showed that APS, propolis, and FCA had significant immune-enhancing effects on turbots as shown by the higher titers of antibodies against the pathogens, increased LSZ and SOD activities, and enhanced RPS after challenge with pathogens. Among the three adjuvants, FCA had the most significant immune synergistic effects with the vaccine, and APS and propolis had lower and similar immune synergies.

Selective separation of magnolol using molecularly imprinted membranes.

Molecularly imprinted membranes (MIMs) for selective separation of magnolol were prepared by thermal polymerization using magnolol as the template, ethylene glycol dimethacrylate (EGDMA) as the cross-linker, 2,2-azobisisobutyronitrile (AIBN) as the initiator, organic solvent as the porogen, methacrylamide (MAM) and acrylic acid (AA) as the functional monomers and cellulose acetate as the agglutinant. Commercial filter paper was used as the supporting material. The effects of different porogens and the ratio of functional monomers on the binding and recognition capacity of MIMs were investigated, and the morphology of the membranes was examined by scanning electron microscopy (SEM). The results showed that the MIMs have the highest selectivity to magnolol when the ratio of MAM/AA was 1:4 and tetrahydrofuran (THF) with dimethyl sulfoxide (DMSO) was used as the porogen. The morphology of the imprinted membranes after template extracting is much rougher with big cavities than that of the non-imprinted membranes (NIMs) and the imprinted membranes before template extracting. The MIMs can selectively separate the magnolol.

A narrative review on vaccination rate and factors associated with the willingness to receive pneumococcal vaccine in Chinese adult population.

The 23-valent pneumococcal polysaccharide vaccine (PPSV-23) is the only approved vaccine for pneumococcal diseases in elderly Chinese population. Though regional studies explored the PPSV-23 vaccination coverage rates and influencing factors in China, a large-scale, nation-wide epidemiological surveillance studies to understand the different factors impeding pneumococcal vaccination rate are required. Hence, this review summarized PPSV-23 coverage rate, analyzed and identified vaccination influencing factors among elderly population across China by exploring articles published in CNKI, Wanfang and PubMed databases. Pneumococcal vaccination coverage rate was found to be low at around 1.23%~42.10% in China. Co-morbidities, knowledge, attitude, perception toward pneumonia and PPSV-23, education level, socio-economic disparities, health education and local policies were some of the factors associated with vaccination willingness among elderly Chinese population. Interventions or policies like government funding, subsidies, inclusion of PPSV-23 in medical insurance, or systematic encouragement from HCPs as key strategies should be implemented to encourage vaccination.

Removal of autologous activated CD4-positive T lymphocytes also results in increased colony-forming units in patients with low and intermediate-1 risk myelodysplastic syndromes.

Autologous activated CD4(+) T lymphocytes (CD4(+) /CCR5(+) double-positive cells) that derived from BMNCs of patients with low and intermediate-1 risk myelodysplastic syndrome were depleted or added to in vitro cultures. The BMNCs depleted of CD4(+) /CCR5(+) T cells exhibited significantly increased numbers of colony-forming units (CFUs). Conversely, the bone marrow mononuclear cells cultures with a fourfold augmentation of CD4(+) /CCR5(+) T lymphocytes exhibited no colonies in cultures in vitro. The apoptotic index (AI) of colony cells was decreased compared with that of preculture counterparts. After depletion of CD4(+) /CCR5(+) in vitro cultures, the clonal cells increased in patients with chromosome 5q- or 20q- abnormalities but remained unchanged in patients with trisomy 8. In addition, after removal of CD4(+) /CCR5(+) T cells, the number of CFUs was increased in those patients with a higher number of BM Th1 (CD4(+) / IFN-γ(+) ) cells, hypocellularity, or bearing the DR15 allele. We concluded that the selective removal of autologous activated CD4(+) T cells can increase the generation of CFUs. However, whether the increased CFUs consisted of cells derived from residual normal hemopoiesis or clonal hemopoiesis remains unknown.

Identification of hub genes and transcription factors involved in periodontitis on the basis of multiple microarray analysis.

OBJECTIVES: To identify the differentially expressed genes (DEGs) during the pathogenesis of periodontitis by bioinformatics analysis. METHODS: GEO2R was used to screen DEGs in GSE10334 and GSE16134. Then, the overlapped DEGs were used for further analysis. g:Profiler was used to perform Gene Ontology analysis and pathway analysis for upregulated and downregulated DEGs. The STRING database was used to construct the protein-protein interaction (PPI) network, which was further visua-lized and analyzed by Cytoscape software. Hub genes and key modules were identified by cytoHubba and MCODE plug-ins, respectively. Finally, transcription factors were predicted via iRegulon plug-in. RESULTS: A total of 196 DEGs were identified, including 139 upregulated and 57 downregulated DEGs. Functional enrichment analysis showed that the upregulated DEGs were mainly enriched in immune-related pathways including immune system, viral protein interaction with cytokine and cytokine receptor, cytokine-cytokine receptor interaction, leukocyte transendothelial migration, and chemokine receptors bind chemokines. On the contrary, the downregulated DEGs were mainly related to the formation of the cornified envelope and keratinization. The identified hub genes in the PPI network were CXCL8, CXCL1, CXCR4, SEL, CD19, and IKZF1. The top three modules were involved in chemokine response, B cell receptor signaling pathway, and interleukin response, respectively. iRegulon analysis revealed that IRF4 scored the highest. CONCLUSIONS: The pathogenesis of periodontitis was closely associated with the expression levels of the identified hub genes including CXCL8, CXCL1, CXCR4, SELL, CD19, and IKZF1. IRF4, the predicted transcription factor, might serve as a dominant upstream regulator.

Novologue Therapy Requires Heat Shock Protein 70 and Thioredoxin-Interacting Protein to Improve Mitochondrial Bioenergetics and Decrease Mitophagy in Diabetic Sensory Neurons.

Diabetic peripheral neuropathy (DPN) is a complication of diabetes whose pathophysiology is linked to altered mitochondrial bioenergetics (mtBE). KU-596 is a small molecule neurotherapeutic that reverses symptoms of DPN, improves sensory neuron mtBE, and decreases the pro-oxidant protein, thioredoxin-interacting protein (Txnip) in a heat shock protein 70 (Hsp70)-dependent manner. However, the mechanism by which KU-596 improves mtBE and the role of Txnip in drug efficacy remains unknown. Mitophagy is a quality-control mechanism that selectively targets damaged mitochondria for degradation. The goal of this study was to determine if KU-596 therapy improved DPN, mtBE, and mitophagy in an Hsp70- and Txnip-dependent manner. Mito-QC (MQC) mice express a mitochondrially targeted mCherry-GFP fusion protein that enables visualizing mitophagy. Diabetic MQC, MQC × Hsp70 knockout (KO), and MQC × Txnip KO mice developed sensory and nerve conduction dysfunctions consistent with the onset of DPN. KU-596 therapy improved these measures, and this was dependent on Hsp70 but not Txnip. In MQC mice, diabetes decreased mtBE and increased mitophagy and KU-596 treatment reversed these effects. In contrast, KU-596 was unable to improve mtBE and decrease mitophagy in MQC × Hsp70 and MQC × Txnip KO mice. These data suggest that Txnip is not necessary for the development of the sensory symptoms and mitochondrial dysfunction induced by diabetes. KU-596 therapy may improve mitochondrial tolerance to diabetic stress to decrease mitophagic clearance in an Hsp70- and Txnip-dependent manner.

Corrigendum: A Matrine Derivative M54 Suppresses Osteoclastogenesis and Prevents Ovariectomy-Induced Bone Loss by Targeting Ribosomal Protein S5.

[This corrects the article DOI: 10.3389/fphar.2018.00022.].

Experimental and clinical characteristics in myelodysplastic syndrome patients with or without HLA-DR15 allele.

We studied the effects of the presence of the HLA-DR15 allele on the experimental and clinical features of myelodysplastic syndrome (MDS) by assessing the clinical data of 136 patients with MDS. We observed that the frequency of HLA-DR15 expression in MDS patients (38.7%) was significantly higher than that in the healthy controls (p < 0.01). We noted the following observations with regard to disease progression: None of the 46 HLA-DR15 positive patients with international prognostic scoring system (IPSS) scores or=1.5 and the presence of >or=5% blasts in the bone marrow in the DR15-positive patients were lower than the corresponding findings in the DR15-negative patients. In addition, we also recorded the following observations with regard to bone marrow (BM) failure: The bicytopenia/pancytopenia ratio in the DR15-positive patients was higher than that in the DR15-negative patients (92.4 vs. 78.3%; p = 0.029). The peripheral-neutrophil count and the platelet count in the DR15-positive patients were lower than those in the DR15-negative patients (p = 0.028 and p = 0.011, respectively). Moreover, hypocellularity was more easily detectable in the DR15-positive patients (26.4 vs. 16.9%). In addition, the BM CD4+ lymphocyte count and the CD4/CD8 ratio in the DR15-positive patients were higher than the corresponding values in the DR15-negative patients (p < 0.05 for both). However, there were no significant differences between the polarization of T-helper (T(h)) and T-cytotoxic (T(c)) cells and the cytokine levels in these two patient groups. We concluded that the presence of the HLA-DR15 allele is indicative of a genetic susceptibility to MDS and, the presence of the HLA-DR15 allele showed less association with disease progression and greater association with BM failure.

Preoperative assessment of hilar cholangiocarcinoma: combination of cholangiography and CT angiography.

BACKGROUND: Hilar cholangiocarcinoma is one of the most difficult carcinomas to manage because of the location of the main tumor at the hepatic hilus and the complex anatomy of the biliary, arterial, and portal systems. To plan an operation, it is important to acquire accurate information about the relationship between hilar cholangiocarcinoma and adjacent vessels. This study aimed to evaluate the clinical value of cholangiography combined with spiral CT three-dimensional (3D) angiography for a preoperative assessment of hilar cholangiocarcinoma. METHODS: From March 2007 to August 2009, cholangiography was performed in 13 patients with hilar cholangiocarcinoma. Meanwhile, contrast-enhanced abdominal scanning was performed using 16-slice spiral CT, and the 3D images of the hepatic artery and portal vein were acquired. The level and range of invasion of the hepatic artery, the portal vein, and the bile duct, the preoperative Bismuth classification, and T-staging were recorded and compared with those after surgical exploration. RESULTS: The hepatic artery and portal vein were reconstructed successfully in all these patients. Percutaneous transhepatic cholangiography was performed in 9 patients, endoscopic retrograde cholangiopancreatography in 1, and magnetic resonance cholangiopancreatography in 3. The CT angiography records of invasion of the hepatic artery were consistent with the results of explorations in these patients. The data from 5 of the 13 patients were consistent with those on invasion of the portal vein. The results of the Bismuth classification and the T-staging system were consistent with those of surgical exploration in 12 of the 13 patients. Seven of 8 patients who were estimated to be suitable for operation based on images were curatively treated and 5 who were judged to be unsuitable for curative operation by cholangiography and CT angiography were confirmed intraoperatively and underwent palliative procedures. CONCLUSIONS: Cholangiography combined with multi-slice spiral 3D CT angiography can satisfactorily delineate the local invasion of hilar cholangiocarcinoma and accurately evaluate the resectability. This approach, therefore, contributes to the planning of safe operation.

Comparison of percutaneous transverse fixation of a Kirschner wire with miniplate placement for treatment of a fifth metacarpal shaft fracture / 中国组织工程研究

BACKGROUND:Fractures of the fifth metacarpal shaft are common in the clinic,and surgical treatment is mostly performed with open reduction plate fixation,but postoperatively,most patients require removal of the internal fixation and require secondary hospitalization.Transcutaneous fixation with a Kirschner wire has many advantages,such as less trauma,small incision,and no need for reoperation. OBJECTIVE:To comparatively analyze the clinical efficacy of percutaneous fixation of a Kirschner wire with miniplate placement in the transverse plane for treatment of the fifth metacarpal shaft fracture. METHODS:A total of 60 patients who underwent surgery for the fifth metacarpal shaft fracture at Binzhou Medical University Hospital between May 2018 and May 2020 were retrospectively analyzed and divided into two groups according to the operation method.30 patients in the plate group were treated with open reduction miniplate internal fixation;30 patients in the Kirschner wire group were treated with closed reduction and percutaneous fixation with a Kirschner wire(of which 5 patients were treated with mini-incision incision assisted fixation).The length of hospital stay,operation time,incision healing grade,incision length,intraoperative blood loss,intraoperative fluoroscopy number,and postoperative complications were compared between the two groups.The fracture healing time,grip strength,and the motion range of the fifth metacarpophalangeal joint were recorded in the two groups,and the functional outcomes of the fingers were evaluated by the total active movement method. RESULTS AND CONCLUSION:(1)Patients in both groups were followed up for 13-18 months.The differences in hospital stay,operation time,and incision healing grade between the two groups were not statistically significant(P>0.05).(2)The amount of intraoperative blood loss and incision length in the Kirschner wire group were less than those in the plate group(P<0.05).The number of intraoperative fluoroscopies in the plate group was less than that in the Kirschner wire group(P<0.05).There was no significant difference in the fracture healing time between the two groups(P>0.05).(3)At the last follow-up,the efficacy was evaluated according to the total active movement method.The excellent and good rate was 87%in the Kirschner wire group and 90%in the plate group,with no significant difference.There were no significant differences between the two groups in the motion range and grip strength of the fifth metacarpophalangeal joint at the last follow-up(P>0.05).(4)Pin tract infection occurred in one case after Kirschner wire placement,which improved after giving iodophor to enhance the dressing change.There was 1 case of pin tail irritating skin symptoms,which resolved after the removal of the Kirschner wires.There were 12 patients in the plate group who were hospitalized after 12 months for personal reasons for plate removal,and all in the Kirschner wire group were removed on an outpatient basis.In the plate group,three patients developed sensory numbness of the skin on the dorsal side of the distal fifth metacarpal and the dorsal side of the little finger,which resolved gradually with oral administration of mecobalamin after surgery.There were no instances of nonunion and refracture with internal fixation in either group.(5)Our results showed that both of these surgical procedures achieved good results in the treatment of fifth metacarpal shaft fracture with excellent functional recovery of the fingers,but the transverse fixation with percutaneous Kirschner wire has many advantages,such as less trauma,small incision,low cost,and convenient removal of internal fixation.

Study on geriatric nursing competency of undergraduate nursing interns of four nursing schools in Beijing / 中华医学教育探索杂志

Objective:To investigate the geriatric nursing competency of undergraduate nursing interns in four schools of nursing in Beijing as well as the influencing factors, and to provide a reference for perfecting the geriatric nursing education system in colleges and universities.Methods:From October to November 2022, a cross-sectional survey was performed on 223 undergraduate nursing interns selected by convenience sampling from four schools of nursing in Beijing, with the use of a general information questionnaire and the Gerontological Nursing Competence instrument. A general linear regression model was established to explore the factors influencing the geriatric nursing competency of nursing interns.Results:The mean total score for gerontological nursing competency was (3.19±0.40). In all dimensions, the mean score was highest for "Providing a safe living environment for older persons" (3.40±0.47) and lowest for "Understanding the sexual needs of older persons" (2.78±0.73). The thought about whether gerontological nursing contents were enough and the level of motivation to study gerontological nursing courses were the factors affecting nursing interns' gerontological nursing competency ( P<0.05). Conclusions:The overall gerontological nursing competency of the nursing interns was at a medium level, with uneven competencies in different dimensions. Nursing schools should strengthen gerontological nursing course building and stimulate students' learning motivation to improve their gerontological nursing competency.