Association between paediatric eye injuries, later academic success and social performance.

Aim: To investigate an association between eye injury and later academic and social performance. Materials: A retrospective longitudinal study of taking measurements multiple times was conducted including all severe eye injuries admitted during 2011-2017 at the main regional clinic to investigate changes in academic success and social inclusion before and after an injury. Parents/caregivers were surveyed asking questions on academic performance, and community/social involvement. In 2023 data on employment status were obtained. Kappa (ĸ) and non-parametric Wilcox-on signed-rank test for multiple comparisons were used. For association of employment status and post-injury visual acuity Fisher score was tested. Results: The total sample for assessing social inclusion and academic success was 36 and 25 children, respectively. In the following academic year ĸ agreements decreased from 0.88 (p<0.001) comparing pre-injury with a one-year post to 0.5106 (p<.0001) in the second year and 0.4750 (p=0.003) in the third, suggesting a deteriorating trend. A comparison of academic success before injury to two and three years after injury showed the trend significantly worsening with time (p=0.005, and 0.003, respectively). No association between an eye injury and social inclusion, as well as between employment and final visual acuity was noticed. Conclusion: Our findings suggest no association between social inclusion, employment, and eye trauma, while in later years academic success may be more impacted by the eye injury. Due to eye injury unpredictability in childhood age, both an informed and supportive climate environment at home and school is essential to minimize deleterious responses to eye trauma.

GC-MS-based untargeted plasma metabolomics identifies a 2-biomarker panel for possible diagnosis of precancerous cervical intraepithelial neoplasia stages from cervical cancer.

Cervical cancer (CC) remains a major health concern globally, much of the brunt of which is experienced by the low- and middle-income countries where screening in terms of cytology and DNA genotyping for the high-risk oncogenic subtypes of the human papilloma virus (hr-HPV) is either inadequate or performed rather late. In this study, we aimed to determine biomarkers or panels of biomarkers that are capable of diagnosing the precancerous cervical intraepithelial neoplasia (CIN) stages from healthy and CC patients via untargeted gas chromatography-mass spectrometry-based metabolomics. Various cross-comparisons were conducted from which differential metabolites were identified. The underlying metabolic pathways based on the differential metabolites identified from the various cross-comparisons mainly related to amino acids biosynthesis and metabolism and steroid hormone biosynthesis. From all cross-comparisons, two common metabolites namely, 2-methyl-1-propylamine (also known as isobutylamine) and estrone were found to possess excellent to good diagnostic abilities, especially in distinguishing the early stages of CIN (CIN I, CIN II) from healthy women and CC patients. These findings have clinical significance in the sense that, once validated the 2-biomarker panel could be adopted in clinical practice for early diagnosis of CIN and invasive carcinoma. This would therefore inform the choice of treatment to be initiated by the clinician.

Cultivating High-Performance Flexible All-in-One Supercapacitors With 3D Network Through Continuous Biosynthesis.

Flexible supercapacitors can potentially power next-generation flexible electronics. However, the mechanical and electrochemical stability of flexible supercapacitors under different flexible conditions is limited by the weak bonding between adjacent layers, posing a significant hindrance to their practical applicability. Herein, based on the uninterrupted 3D network during the growth of bacterial cellulose (BC), a flexible all-in-one supercapacitor is cultivated through a continuous biosynthesis process. This strategy ensures the continuity of the 3D network of BC throughout the material, thereby forming a continuous electrode-separator-electrode structure. Benefitting from this bioinspired structure, the all-in-one supercapacitor not only achieves a high areal capacitance (3.79 F cm-2) of electrodes but also demonstrates the integration of high tensile strength (2.15 MPa), high shear strength (more than 54.6 kPa), and high bending resistance, indicating a novel pathway toward high-performance flexible power sources.

Long-term effects and mechanisms of paternal environment on glucose and lipid metabolism in offspring / 中国糖尿病杂志

The developmental origins of health and disease(DOHaD)suggests that a poor maternal developmental environment during pregnancy can significantly increase the risk of chronic metabolic diseases such as obesity,diabetes mellitus(DM),and cardiovascular disease in offspring during adulthood.The adverse environmental factors of the father's generation influence the glucose and lipid metabolism of the offspring.The environmental factors exposed by the father before fertilization,such as over nutrition,obesity,diabetes caused cross generation reprogramming in offspring,and develop glucose and lipid metabolism disorders,which can last for one or more generations.Currently,paternal origin of health and disease(POHaD)has received widespread attention and has important scientific value and social significance.This article reviews the research progress on the impact of parental nutritional environment on offspring glucose metabolism.

Association between parents′ participation in accompanying picture book reading and preschool children′s emotional regulation ability / 中国儿童保健杂志

【Objective】 To analyze the association between preschool children′s emotional regulation ability and parents′ participation in accompanying picture book reading, in order to provide theoretical reference for improving children′s emotional regulation abilility. 【Methods】 From September to November 2022, preschool children aged 3 - 6 years from Guangfeng County, Yukan County, Wannian County, Yanshan County and Wuyuan County were selected by random cluster stratified sampling method. Mann-Whitney U test or Kruskal-Wallis H test were used to analyze the correlation of different levels of children′s emotional control ability with different demographic characteristics as well as parents′ participation in children′s picture book reading. Multivariate Logistic regression model was used to analyze the correlation between parents′ involvement in picture book reading and children′s emotional control ability. 【Results】 Finally 848 valid questionnaires were collected.The average age of children was (4.33±0.95)years old,with 432 boys and 416 girls. Multivariate Logistic regression analysis showed that the temperament control ability(>P75) of preschool children was positively correlated with mother being the main accompanying caregiver (OR=4.17, 95%CI: 2.13 - 8.17), and negatively correlated with father being the main accompanying caregiver (OR=0.38, 95%CI: 0.21 - 0.70) or both parents being the main accompanying caregivers (OR=0.14, 95%CI: 0.07 - 0.28)(P<0.05). The social confidence (father as the main caregiver OR=3.53, 95%CI:1.62 - 7.66; mother as the main caregiver OR=3.52, 95%CI: 1.66 - 7.45) and anxiety control abilities(father as the main caregiver OR=4.32, 95%CI: 1.85 - 10.09; mother as the main caregiver OR=3.39, 95%CI: 1.49 - 7.73) of preschool children were positively correlated with the type of accompanying caregiver(P<0.05). Additionally, the anxiety control ability (>P75) of preschool children was negatively correlated with father′s accompanying frequency (sometimes OR=0.09, 95%CI: 0.03 - 0.28; often OR=0.19, 95%CI: 0.06 - 0.60) and mother′s accompanying duration (<1h/d OR=0.33, 95%CI: 0.12 - 0.91) (P<0.05). 【Conclusions】 The frequency and duration of accompanying reading by father or mother are correlated with the emotional regulation ability of preschool children. Parents can moderately participate in picture book reading to promote the development of preschool children′s emotional control ability.

Effect of intense pulsed light on hair removal in pediatric auricular reconstruction using tissue expander / 中华医学美学美容杂志

Objective:To investigate the safety and efficiency of depilation with intense pulsed light (IPL) in congenital microtia patients during different phase of reconstruction treatment sessions.Methods:The hairy skin was treated with the M22TM system (Lumenis, German) using a filter of 695-1 200 mm. A three pluses mode of the radiant setting with a pulse width of 3.5 ms, a delay of 60 ms, and an energy density of 16-18 mJ/cm 2 was applied in the expanded patients. Depilation efficacy was evaluated as follows: excellent (hair density reduction >75%), good (50%-75%), fair (25%-50%), and poor (<25%). The depilation effect was compared between different phases. And the adverse effect was observed. Results:A total of 131 cases were included. There was no difference of the hair density reduction between patients with different expander volume after same IPL depilation treatments [15 (13-19) vs. 16 (15-19) root/cm 2, Wilcoxon rank analysis]. The hair density reduction in the expansion group was lower than the non-expansion group after two IPL depilation treatments [15 (13-19) vs. 17 (15-21) root/cm 2, P<0.05, Wilcoxon rank analysis]. The depilation efficacy was highly related with the numbers of IPL depilation treatments the patients received [Kendall′ stat b=0.74 (95% CI: 0.71-0.77), P<0.05]. There were 3 cases of folliculitis, 2 cases of blisters occurred in this study, and no expander exposure and cartilage absorption were observed. Conclusions:Hair removal with IPL is a safe and effective photo-epilation method during all stages of ear reconstruction using tissue expander. The volume of the expander does not significantly affect the hair removal efficiency. Depilation in the expansion phase is more efficient than that in the non-expansion phase, and the ideal result of " hair-free" or " less hairy" reconstructed ears can be achieved in 5 treatments, with suboptimal results in 3 treatments.

Combination of AAV-delivered tumor suppressor PTEN with anti-PD-1 loaded depot gel for enhanced antitumor immunity

Recent clinical studies have shown that mutation of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) gene in cancer cells may be associated with immunosuppressive tumor microenvironment (TME) and poor response to immune checkpoint blockade (ICB) therapy. Therefore, efficiently restoring PTEN gene expression in cancer cells is critical to improving the responding rate to ICB therapy. Here, we screened an adeno-associated virus (AAV) capsid for efficient PTEN gene delivery into B16F10 tumor cells. We demonstrated that intratumorally injected AAV6-PTEN successfully restored the tumor cell PTEN gene expression and effectively inhibited tumor progression by inducing tumor cell immunogenic cell death (ICD) and increasing immune cell infiltration. Moreover, we developed an anti-PD-1 loaded phospholipid-based phase separation gel (PPSG), which formed an in situ depot and sustainably release anti-PD-1 drugs within 42 days in vivo. In order to effectively inhibit the recurrence of melanoma, we further applied a triple therapy based on AAV6-PTEN, PPSG@anti-PD-1 and CpG, and showed that this triple therapy strategy enhanced the synergistic antitumor immune effect and also induced robust immune memory, which completely rejected tumor recurrence. We anticipate that this triple therapy could be used as a new tumor combination therapy with stronger immune activation capacity and tumor inhibition efficacy.

Expert opinions on operation rules of Morita therapy outpatient service / 中国心理卫生杂志

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.

Advances in COVID-19 vaccine development and clinical application / 中国药理学通报

Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) has spread to more than 220 countries, including China. With the deepening of research on the viral molecular structure and pathogenesis of SARS-COV-2, various prevention strategies and treatment plans for coronavirus disease 2019 (COVID-19) are being actively explored. Pharmaceutical companies and scientific research institutions in many countries or regions are also actively engaged in the research and development of COVID-19 vaccines. More than 300 COVID-19 vaccine candidates are currently under study globally, and more than 10 have entered phase III clinical trials or are authorized for emergency use. Five COVID-19 vaccines have been approved for use in China, including three inactivated vaccines, one type 5 adenovirus vector vaccine and one recombinant protein vaccine (from CHO cell). The COVID-19 vaccines developed by Oxford University/Astrazeneca and Johnson & Johnson are adenovirus vector vaccines. Emergency licensing of mRNA vaccines developed by Pfizer and BioNTech, and mRNA vaccines developed by Moderna also offer potential prospects for COVID-19 prevention and control. This article reviews the development and clinical application of COVID-19 vaccines.

Progress in the study of iodine nutrition evaluation indicators during pregnancy / 中华地方病学杂志

Iodine, as the main raw material for the synthesis of thyroid hormones in the body, exhibits a U-shaped curve relationship with thyroid function. Both iodine deficiency and excess may cause thyroid dysfunction and damage human health. China was once one of the countries where iodine deficiency were widely prevalent in the world. Since the implementation of universal salt iodization in 1995, the iodine nutritional status in China has been greatly improved, and the goal of eliminating iodine deficiency disorders has been basically achieved. However, there is still a state of inadequate iodine nutrition among susceptible populations (pregnant women, breastfeeding mothers and infants). Pregnancy is a special physiological stage for women, and in order to meet the iodine needs of themselves and their fetuses, the iodine requirement of pregnant women increases by about 50% compared to non-pregnant women. WHO/UNICEF/ICCIDD suggest using urinary iodine concentration (UIC) to evaluate iodine nutritional status during pregnancy, with UIC of 150 - < 250 μg/L is considered suitable for iodine nutrition, but the best method for evaluating iodine nutrition status during pregnancy is still controversial. With the improvement of socio-economic level and people's health awareness, especially during special stages such as pregnancy, people pay more attention to individual iodine status. Therefore, the investigation of reliable indicators for evaluating iodine nutrition during pregnancy has gained increasing significance.

The Connotation,Current Situation and Policy Direction of China's Government Health Investment from the Perspec-tive of National Governance / 中国卫生经济

Health finance is an important part of the public financial system.Based on literature review and field survey,it analyzes how to further understand the relationship between financial health input policy and national governance under the perspective of national governance,and explores the current situation of financial health input in China,the problems existing in the current input policy and the methods to improve it,so as to provide references for relevant departments to improve China's government health invest-ment policy.

Application of prone position in severe ARDS caused by pneumocystis jirovecii pneumonia after kidney transplantation / 器官移植

Objective To investigate the improvement of oxygenation after the treatment of prone position in patients with severe acute respiratory distress syndrome (ARDS) caused by pneumocystis jirovecii pneumonia (PJP) after kidney transplantation. Methods Clinical data of 5 cases of moderate and severe ARDS caused by PJP after kidney transplantation were analyzed retrospectively, and clinical characteristics, treatment regimen and prognosis were summarized. Results Clinical manifestations of 5 patients were fever, dry cough, chest tightness, shortness ofbreath,sweating and fatigue, and body temperature fluctuated between 38 ℃ and 39 ℃, percutaneous arterial oxygen saturation(SpO2) was gradually decreased, and respiratory distress symptoms were worsened. Pulmonary CT scan showed diffuse ground-glass shadow. After transfer to intensive care unit (ICU), immunosuppressive drugs were terminated, and all patients were given with compound sulfamethoxazole, caspofungin, low-dose glucocorticoids against pneumocystis jirovecii (PJ), oxygen therapy and other symptomatic supportive treatments. Four patients diagnosed with severe ARDS upon admission to ICU were treated in a prone position. One patient with moderate ARDS was not kept in a prone position. At 1 d after treatment in a prone position, partial pressure of arterial oxygen (PaO2) and oxygenation index were increased, whereas alveolar-arterial oxygen difference (A-aDO2) was decreased compared with before treatment (allP<0.05). Compared with 1 d after treatment, SpO2, PaO2 and oxygenation index were all increased, while A-aDO2 was decreased at 4 d after treatment (all P<0.05). Box diagram showed that oxygenation index showed an overall upward trend after prone-position treatment, whereas A-aDO2 showed an overall downward trend. The length of ICU stay of 5 patients was 14 (8, 29) d. All patients in a prone position did not develop complications, such as skin pressure sore, tube detachment and tube displacement, etc. Among 5 patients, 4 patients were mitigated, and 1 patient died of septic shock and multiple organ failure. Conclusions For both conscious and intubated patients, a prone position may significantly improve oxygenation and prognosis of patients with severe ARDS caused by PJP after kidney transplantation. Early diagnosis and accurate and standardized treatment play a pivotal role in enhancing cure rate.

Study of the clinical significance of ETAR mRNA expression in high-grade serous ovarian cancer and the inhibitory effect of ETAR derived fusion polypeptide on cancer progression / 中华妇产科杂志

Objective: To investigate the clinical significance of endothelin A receptor (ETAR) expression in high-grade serous ovarian carcinoma (HGSOC). To design ETAR carboxyl terminal (ETAR-C) amino acids derived polypeptide and to study the inhibitory effect on ovarian epithelial carcinoma cells in vitro. Methods: (1) A total of 126 patients who received surgical treatment and were diagnosed with HGSOC by postoperative pathological examination in Central Hospital of Xuzhou from January 1, 2007 to December 31, 2017 were selected. All patients had completed clinicopathological data and follow-up data. Cancer tissue samples were collected and ETAR mRNA expression in HGSOC tissues was detected by reverse transcript-PCR. The clinical significance was analyzed. (2) ETAR-C fusion polypeptide was designed based on the sequence of carboxyl terminal amino acids of ETAR, expressed and purified in vitro. The effects of ETAR-C fusion polypeptide on migration and invasion ability of ovarian cancer SKOV3 and CAOV3 cells were detected by scratch test and invasion test, respectively. The effect of ETAR-C fusion polypeptide on chemosensitivity of cisplatin-resistant ovarian cancer SKOV3/cDDP and CAOV3/cDDP cells was determined by methyl thiazolyl tetrazolium (MTT) colorimetric assay. The effect of ETAR-C fusion polypeptide on β-arrestin-1 expression in ovarian cancer SKOV3 and CAOV3 cells was detected by western blot. Results: (1) The relative expression level of ETAR mRNA in HGSOC tissues was 18.6±5.1. Patients with HGSOC were divided into high ETAR mRNA expression (n=76) and low ETAR mRNA expression (n=50) with 61.7% as cut-off value analyzed by X-Tile software. High expression of ETAR mRNA was significantly correlated with abdominal water volume, platinum drug resistance, and cancer antigen 125 (CA125) value in HGSOC patients (all P<0.05), but was not related to the age of patients with HGSOC and the size of postoperative residual lesions (all P>0.05). The 5-year progression free survival rates were 18.4% and 28.0%, and the 5-year overall survival rates were 38.2% and 52.0% in HGSOC patients with high and low ETAR mRNA expression respectively, there were statistically significant differences (P=0.046, P=0.034). (2) The results of scratch test and invasion test showed that the scratch healing rate and cell invasion rate of SKOV3 or CAOV3 cells treated with endothelin-1 (ET-1) and ET-1+ETAR-C were respectively compared, and the differences were statistically significant (all P<0.05). MTT assay showed that the inhibition rates of ETAR-C fusion polypeptide treated in SKOV3/cDDP and CAOV3/cDDP cells were significantly higher than those of control cells after the addition of 4, 6, 8, 10, 12, and 24 μg/ml cisplatin (all P<0.05). Western blot analysis showed that the relative expression levels of β-arrestin-1 in SKOV3 or CAOV3 cells treated with ET-1 and ET-1+ETAR-C were 1.85±0.09 and 1.13±0.09 (SKOV3 cells), 2.14±0.15 and 1.66±0.12 (CAOV3 cells), respectively. The differences were statistically significant (all P<0.05). Conclusions: The prognosis of HGSOC patients with high expression of ETAR mRNA is significantly worse than those with low expression of ETAR mRNA. ETAR might be a new target for HGSOC treatment. The ETAR-C fusion polypeptide that interferes with the interaction of ETAR and β-arrestin-1 has good inhibitory effect on ovarian cancer cells in vitro, and might have clinical application potential.

Applications of activity-based protein profiling and affinity-based protein profiling in pharmacology and toxicology research / 中国药理学与毒理学杂志

Activity-based protein profiling(ABPP)and affinity-based protein profiling(AfBPP)are reliable chemical proteomics techniques that exhibit significant advantages in identifying the direct acting targets of small molecule drugs and toxicants,which can help researchers understand the pharmaco-logical and toxicological mechanisms of active small molecules.This paper introduces ABPP and AfBPP technologies and summarizes the applications of this technique in drug off-target effect and target iden-tification of toxicants in recent years,such as drug off-target effect of crenolanib,BIA 10-2474,orlistat and target identification of VX,fenitrothion,acrolein.It is hoped that this review will give readers a better idea of ABPP/AfBPP and offer a line of thinking for researchers in the fields of pharmacology,toxicology and chemical biology.

Meta-analysis of risk factors for rheumatoid arthritis complicated with interstitial pulmonary disease / 中华风湿病学杂志

Objective:A meta-analysis was conducted to investigate the risk factors of interstitial lung disease in patients with RA to provide a reliable reference for clinical practice.Methods:Publications of the China Knowledge Network, Vipshop, Wanfang, China Biomedical Literature Database, EMbase, PubMed, and Cochrane Library databases were searched to obtain literature on cohort studies and case-control studies for risk factors for RA complicated with interstitial lung disease from the time of database creation until December 31, 2022. Literature screening, information extraction, and final quality evaluation were performed independently by two investigators. The extracted data were analyzed using RevMan 5.3 software.Results:A total of 31 studies with a total of 26 747 patients were included in this study, of which 4 799 patients(17.94%) were patients with RA complicated with interstitial lung disease. A total of 12 risk factors were obtained included: advanced age [ OR (95% CI) =1.07(1.04, 1.09), P<0.001], high age at onset [ OR (95% CI) =2.11(1.17, 3.82), P=0.010], male [ OR (95% CI) =1.95(1.34, 2.84), P<0.001], long duration of disease [ OR (95% CI) =1.10(1.08, 1.13), P<0.001], smoking [ OR (95% CI) =2.47(1.57, 4.04), P<0.001], high disease activity [ OR (95% CI) =(1.21, 2.54), P=0.003), cough [ OR (95% CI) =6.10 (2.40, 15.52), P<0.001], decreased pulmonary carbon monoxide diffusing capacity [ OR (95% CI) =0.93(0.89, 0.96), P<0.001], and high titer anti-CCP antibody [ OR (95% CI) =1.14(1.03, 1.26), P=0.010], high titer RF [ OR (95% CI) =2.37(1.70, 3.29), P<0.001], high level of immunoglobulin A [ OR (95% CI) =1.26 (1.09, 1.46), P=0.002] and high level of glycoprotein antigen 125 [ OR (95% CI) =3.66 (1.81, 7.41), P<0.001]. Conclusion:The existing evidence have shown that advanced age, high age at onset, male, long disease duration, smoking, high disease activity, cough, decreased pulmonary carbon monoxide diffusing capacity, high titer anti-CCP antibody and RF, high level of immunoglobulin A and high level of glycoprotein antigen 125 are the main risk factors for interstitial lung disease in patients with rheumatoid arthritis. However, the evidence of Raynaud's phenomenon and tumor marker CA153 as risk factors for RA complicated with interstitial lung disease is not strong, and further high-quality prospective cohort studies are needed.

High cut-off membranes in patients requiring renal replacement therapy: a systematic review and meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Whether high cut-off (HCO) membranes are more effective than high-flux (HF) membranes in patients requiring renal replacement therapy (RRT) remains controversial. The aim of this systematic review was to investigate the efficacy of HCO membranes regarding the clearance of inflammation-related mediators, β2-microglobulin and urea; albumin loss; and all-cause mortality in patients requiring RRT.@*METHODS@#We searched all relevant studies on PubMed, Embase, Web of Science, the Cochrane Library, and China National Knowledge Infrastructure, with no language or publication year restrictions. Two reviewers independently selected studies and extracted data using a prespecified extraction instrument. Only randomized controlled trials (RCTs) were included. Summary estimates of standardized mean differences (SMDs) or weighted mean differences (WMDs) and risk ratios (RRs) were obtained by fixed-effects or random-effects models. Sensitivity analyses and subgroup analyses were performed to determine the source of heterogeneity.@*RESULTS@#Nineteen RCTs involving 710 participants were included in this systematic review. Compared with HF membranes, HCO membranes were more effective in reducing the plasma level of interleukin-6 (IL-6) (SMD -0.25, 95% confidence interval (CI) -0.48 to -0.01, P   =  0.04, I2  = 63.8%); however, no difference was observed in the clearance of tumor necrosis factor-α (TNF-α) (SMD 0.03, 95% CI -0.27 to 0.33, P  = 0.84, I2  = 4.3%), IL-10 (SMD 0.22, 95% CI -0.12 to 0.55, P  = 0.21, I2  = 0.0%), or urea (WMD -0.27, 95% CI -2.77 to 2.23, P  = 0.83, I2  = 19.6%). In addition, a more significant reduction ratio of β 2 -microglobulin (WMD 14.8, 95% CI 3.78 to 25.82, P  = 0.01, I2  = 88.3%) and a more obvious loss of albumin (WMD -0.25, 95% CI -0.35 to -0.16, P  < 0.01, I2  = 40.8%) could be observed with the treatment of HCO membranes. For all-cause mortality, there was no difference between the two groups (risk ratio [RR] 1.10, 95% CI 0.87 to 1.40, P  = 0.43, I2  = 0.0%).@*CONCLUSIONS@#Compared with HF membranes, HCO membranes might have additional benefits on the clearance of IL-6 and β 2-microglobulin but not on TNF-α, IL-10, and urea. Albumin loss is more serious with the treatment of HCO membranes. There was no difference in all-cause mortality between HCO and HF membranes. Further larger high-quality RCTs are needed to strengthen the effects of HCO membranes.

Plastic and reconstruction surgery for non-healing wound after posterior spinal surgery / 北京大学学报(医学版)

OBJECTIVE@#To investigate the clinical significance of different plastic surgeries in the treatment of poor healing wound after posterior spinal internal fixation.@*METHODS@#In this study, 16 patients with poor incision healing after posterior spinal internal fixation were retrospectively included, and dif-ferent plastic surgery treatment plans were determined according to the wound characteristics and defect condition. The measures included debridement, vacuum sealing drainage (VSD), and different tissue flaps according to the location and extent of the defect.@*RESULTS@#A total of 16 patients meeting the criteria were included, of whom 3 were treated with debridement combined with VSD and wound suture directly, 6 were treated with debridement combined with Z-flap for wound repair, 1 was treated with bilateral sacrospinous muscle flap for dural defect repair combined with Z-flap for skin wound repair, 1 was treated with lectus dorsi flap for wound repair, 3 were treated with the fourth lumbar artery perforator flap for wound repair. The wound was repaired with local rotating flap in 1 case and gluteus maximus musculocutaneous flap in 1 case. Among the 16 patients, 7 cases were positive for wound culture, including 3 cases of Staphylococcus aureus, 1 case of Pseudomonas aeruginosa, 1 case of Staphylococcus epidermidis, 1 case of Escherichia coli, 1 case of Klebsiella pneumoniae, and the other 9 cases were negative. After surgery, there were 7 patients with different degrees of poor wound healing, including 3 patients undergoing dressing change, 2 patients undergoing secondary debridement and suture, 1 patient undergoing free scalp skin graft, and 1 patient undergoing local effusion suction treatment. All the above 7 patients were discharged from hospital after improvement, and the remaining 9 patients had good first-stage wound hea-ling after surgery. None of the 16 patients underwent internal fixation.@*CONCLUSION@#Multiple factors could lead to poor wound healing after posterior spinal internal fixation. Early intervention, thorough debridement, removal of necrotic/infected tissue, and selection of suitable skin flap for effective wound fil-ling and covering were important means to ensure wound healing after spinal surgery and reduce removal of internal fixation.

Efect of Surgical or Spontaneous Pregnancy Reduction of One Twin after In Vitro Fertilization-Embryo Transfer on Clinical Outcomes / 实用妇产科杂志

Objective:To investigate the effect of early selective reduction of twin pregnancies or spontaneous reduction on the improvement of clinical outcome in IVF-ET treatment.Methods:The clinical data of 6535 cycles(6535 cases)of single or twin pregnancy obtained from fresh and frozen-thawed embryo transfer(FET)of IVF or ICSI-ET in the Department of Reproductive Medicine,Women and Children's Hospital Affiliated to Xiamen Univer-sity from November 2011 to December2021 were analyzed retrospectively,The propensity score matching(PSM)method(1∶4)was used to include the study subjects.The surgical reduction group and the spontaneous single-ton group were included in 128 cycles and 510 cycles,respectively.The spontaneous reduction group and the ini-tial singleton group were included in 511 cycles and 2038 cycles,respectively.The pregnancy outcomes of each groups were compared.Results:After PSM,the number of transferred embryos in the surgical and spontaneous reduction group was higher than that in the initial singleton group.The gestational week of delivery was earlier than that of the initial singleton group,and the birth weight of the newborn was lower than that in the initial single-ton group.The rate of premature delivery and low birth weight was higher than that in the initial singleton group,and the difference was statistically significant(P＜0.05).The incidence of pregnancy complications(postpartum hemorrhage,gestational diabetes,hypertensive disorders of pregnancy)and the rate of cesarean section were not significantly different(P＞0.05).The abortion rate and neonatal birth defect rate were missing after adjusting the PSM model.According to the calculation before adjustment,the early abortion rate of the surgical reduction group and the spontaneous reduction group were significantly lower than that in the initial singleton group(P＜0.05),and the late abortion rate of the spontaneous reduction group was lower than that in the initial singleton group,the difference was statistically significant(P＜0.05).There was no significant difference in the neonatal birth defect rate between the surgical/spontaneous reduction group and the initial singleton group(P＞0.05).Conclusions:Patients with multiple pregnancies caused by assisted reproductive technology(ART)may have a relatively poor prognosis in the perinatal period even if the effect of early pregnancy reduction surgery or spontaneous reduction is limited.Reducing the number of embryos transferred cannot completely reverse the pregnancy outcome.Limiting the number of embryos transferred is the fundamental solution to the adverse outcomes of ART assisted pregnancy.

Determination of diacetyl in workplace air by high performance liquid chromatography using 4-nitro-o-phenylenediamine as precolumn derivatization / 环境与职业医学

Background Diacetyl (DC) is widely used in the food flavoring industry and excessive occupational exposure to DC can cause serious respiratory diseases. However, there is no corresponding national standard method for the determination of DC in the air of workplace. Objective To establish a method for the determination of DC in workplace air by high performance liquid chromatography using 4-nitro-o-phenylenediamine (NPDA) as precolumn derivatization. Methods DC in the air of workplace was collected by solution absorption method. This experiment used NPDA as the derivatization reagent. By adjusting acidity of solution and optimizing concentration ration of DC/NPDA, derivatization temperature, and time, a method for the determination of DC in workplace air was proposed, and its performance indexes such as linearity, detection limit, and lower limit of quantification were obtained. Sampling efficiency was evaluated by relative comparison method, and sample stability was evaluated by sample preservation test. Accuracy and precision of the method were evaluated by standard addition recovery test with blank samples, and an interference test was carried out by adding standard samples. The established method was applied to actual samples to evaluate its adaptability. Results A combination of 60 °C for 2 h was selected for derivatization because a higher derivatization reaction temperature and a longer reaction time associated with a higher derivatization efficiency. The solution was separated by SB-C18 column (250 mm×4.6 mm, 5 μm) at 30 ℃, using a mixture of methanol and water (v/v, 65%/35%) as mobile phase with an elution flow rate of 1.0 mL·min−1, and was detected with a variable wavelength detector (λmax=257 nm) by qualitative analysis based on retention time and quantitative analysis based on external standard method. In terms of the proposed method, the linear range of detection was from 5 μg·L−1 to 2000 μg·L−1, with a correlation coefficient of 0.9999, and a detection limit of 1.3 μg·L−1, the quantitative detection of the lower limit was 4.3 μg·L−1, with a sampling volume V0 of 3.0 L, the minimum detection concentration was 4.3 μg·m−3, and the minimum quantitative concentration was 14.3 μg·m−3. The recovery rate was 99.1%-100.8%, the intra-batch precision was 0.5%-3.0%, and the inter-batch precision was 1.2%-2.0%. The average sampling efficiency of this method was 94.5%, and the sample could be stored at 4 °C for at least 14 d. The coexisting components in the air of the workplace did not interfere with the determination of DC. The DC content in the air of a flavor workplace was 5.86-8.85 mg·m−3. Conclusion A determination method for DC in workplace air by high performance liquid chromatography using NPDA as precolumn derivatization after being collected by 1.0% phosphoric acid absorbent is proposed and has the advantages of simple operation, high sensitivity, and good accuracy. With no DC loss and degradation, the method may satisfy the request for DC determination in the air of workplace.

The construction and thinking of the online open course of Knowledge and Skills of Health Education for the Army / 中华医学教育探索杂志

Military vocational education has become one of the strategies to strengthen the military in the new era. The army urgently needs to build a number of featured online courses of military vocational education. Therefore, taking the course "Knowledge and Skills of Health Education for the Army" as an example, this paper discusses the overall construction objectives, construction ideas, teaching content, curriculum and test question bank construction of the course. In addition, this paper analyzes and summarizes the problems existing in the teaching organization, implementation, and preliminary application, so as to provide ideas and construction strategies for the construction of online open courses in other military vocational education.