The selective serotonin reuptake inhibitors, sertraline and paroxetine, improve islet beta-cell mass and function in vitro.

AIMS: To investigate the effects of the selective serotonin reuptake inhibitors (SSRIs) sertraline and paroxetine at therapeutically relevant concentrations on beta-cell mass and function. METHODS: Viability was quantified in mouse insulinoma (MIN6) beta cells and mouse islets after 48-h exposure to sertraline (1-10 µM) or paroxetine (0.01-1 µM) using the Trypan blue exclusion test. The effects of therapeutic concentrations of these SSRIs on insulin secretion were determined by static incubation and perifusion experiments, while islet apoptosis was investigated by Caspase-Glo 3/7 assay, TUNEL staining and quantitative PCR analysis. Finally, proliferation of MIN6 and mouse islet beta cells was assessed by bromodeoxyuridine (BrdU) enzyme-linked immunosorbent assay and immunofluorescence. RESULTS: Sertraline (0.1-1 µM) and paroxetine (0.01-0.1 µM) were well tolerated by MIN6 beta cells and islets, whereas 10 µM sertraline and 1 µM paroxetine were cytotoxic. Exposure to 1 µM sertraline and 0.1 µM paroxetine significantly potentiated glucose-stimulated insulin secretion from mouse and human islets. Moreover, they showed protective effects against cytokine- and palmitate-induced apoptosis of islets, they downregulated cytokine-induced Stat1 and Traf1 mRNA expression, and they significantly increased proliferation of mouse beta cells. CONCLUSIONS: Our data demonstrate that sertraline and paroxetine act directly on beta cells to enhance glucose-stimulated insulin secretion and stimulate beta-cell mass expansion by increasing proliferation and decreasing apoptosis. These drugs are therefore likely to be appropriate for treating depression in people with type 2 diabetes.

Recent remediation strategies for flame retardancy via nanoparticles.

This review article delves into the application of nanoparticles (NPs) in fire prevention, aiming to elucidate their specific contribution within the broader context of various fire prevention methods. While acknowledging established approaches such as fire safety principles, fire suppression systems, fire alarm systems, and the use of fire-retardant chemicals and safety equipment, this review focuses on the distinctive properties of NPs. The findings underscore the remarkable potential of NPs in controlling and mitigating fire propagation within both architectural structures and vehicles. Specifically, the primary emphasis lies in the impact of NPs on reducing oxygen levels, as assessed through the limiting oxygen index , a subject explored by various researchers. Furthermore, this review delves into the examination of combustion reduction rates facilitated by NPs, utilizing assessments of ignition time, heat release rate (HRR), and flammability tests (UL-94) on plastic materials. Beyond these aspects, the review evaluates the multifaceted role of NPs in achieving weight reduction and establishing fire-retardant properties. Additionally, it discusses the reduction of smoke, a significant contributor to environmental pollution and health risks. Among the nanoparticles investigated in this study, SiO2, MgAl, and nano hydrotalcite have demonstrated the best results in weight reduction, smoke reduction, and HRR, respectively. Meanwhile, Al2O3 has been identified as one of the least effective treated nanoparticles. Collectively, these findings significantly contribute to improving safety measures and reducing fire risks across a range of industries.

Biosynthesis of selenium nanoparticles using cell-free extract of Xenorhabdus cabanillasii GU480990 and their potential mosquito larvicidal properties against yellow fever mosquito Aedes aegypti.

Nanomaterials are successful due to their numerous applications in various domains such as cancer treatment, environmental applications, drug and gene delivery. Selenium is a metalloid element with broad biological activities and low toxicity especially at the nanoscale. Several studies have shown that nanoparticles synthesized from microbial and plant extracts are effective against important pests and pathogens. This study describes the bio fabrication of selenium nanoparticles using cell free extract of Xenorhabdus cabanillasii (XC-SeNPs) and assessed their mosquito larvicidal properties. Crystallographic structure and size of XC-SeNPs were determined with UV-a spectrophotometer, Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction analysis (XRD), Energy-dispersive X-ray spectroscopy (EDAX), Zeta potential and Transmission electron microscopy (TEM). The significant surface plasmon resonance at 275 nm indicated the synthesis of XC-SeNPs from the pure cell-free extract of X. cabanillasii. The XRD result exhibits the crystalline nature of XC-SeNPs. The Zeta potential analysis confirmed that the surface charge of XC-SeNPs was -24.17 mV. TEM analysis revealed that synthesized XC-SeNPs were monodispersed, spherically shaped, and sized about 80-200 nm range. In addition, the larvicidal potentials of the bio-fabricated XC-SeNPs were assessed against the 4th-instar Ae. aegypti. XC-SeNPs displayed a dose-dependent larvicidal effect; the larval mortality was 13.3 % at the minimum evaluated concentration and increased to 72 % at higher dose treatments. The LC50 and LC90 concentration of XC-SeNPs against mosquito larvae were 79.4 and 722.4 ppm, respectively.

Epidemiological characteristics of new pneumoconiosis in Zigong City in 2018 - 2022 / 公共卫生与预防医学

Objective To understand the epidemiological characteristics of new occupational pneumoconiosis in Zigong City from 2018 to 2022, and to provide the basis for further prevention and treatment of local pneumoconiosis. Methods The information of newly diagnosed and reported cases of pneumoconiosis in Zigong City from 2018 to 2022 was collected through the occupational disease and occupational health information monitoring system, and the characteristics of the distribution of pneumoconiosis in three regions, the composition of diseases and the length of service of exposure to dust were analyzed. Results From 2018 to 2022, the top 3 newly diagnosed pneumoconiosis diseases in Zigong City were silicosis, coal workers' pneumoconiosis and asbestosis. Silicosis cases were mainly distributed in small and medium-sized employers, accounting for 81.41%. Coal workers' pneumoconiosis was mainly distributed in large and medium-sized employers, accounting for 97.24%. Asbestosis mainly distributed in large scale employers, accounting for 96.36%. There was significant difference in dust handling age of different scale employers (H=11.453, P<0.05). The median ages of silicosis, coal workers' pneumoconiosis and other pneumoconiosis were 47.0 years, 52.0 years and 48.2 years, respectively. The median age of dust handling was 3.3 years, 22.0 years and 23.2 years, respectively. The age of onset of coal workers' pneumoconiosis was higher than that of silicosis and other pneumoconiosis (H=72.547, P<0.05), and the age of dust exposure of silicosis was shorter than that of coal workers' pneumoconiosis and other pneumoconiosis (H=10.453, P<0.05). Conclusion The current situation of pneumoconiosis in Zigong City is still severe, with obvious clustering in disease types and industries. Prevention and treatment of pneumoconiosis in key industries should be further strengthened to protect the health rights and interests of workers.

Analysis of cases of reinfection of past SARS-CoV-2 patients in Pudong New Area of Shanghai / 上海预防医学

ObjectiveTo identify the rate， population characteristics， and vaccination history of repeat infections among previously infected people in the current epidemic based on the rate of repeat infection and population characteristics of different mutant strains at different times in Pudong New Area of Shanghai， and to provide reference for the prevention and control strategies of novel coronavirus repeat infections. MethodsA total of 9 250 investigated subjects were randomly selected from the new cases of asymptomatic infection and confirmed cases reported by Pudong New Area from March to May 2022. The investigation mainly focused on demographic characteristics， nucleic acid or antigen test results， and symptoms after infection. The repeat infection rates among different populations were compared， and logistic regression was used to analyze the impact of gender， age， and vaccination status on repeat infections. ResultsThe survey sample of 9 250 people had a response rate of 81.85%. There were 4 043 males （53.40%） and 3 528 females （46.60%）， with a median age of 34 years old （P25， P75： 7， 61）. The overall vaccine uptake rate was 59.44% （4 500/7 571）. In December of 2022， there were 563 cases of repeat infection， with an infection rate of 7.44%. The lowest rate of repeat infection was seen in the 3‒ year-old group （2.86%） and the highest rate in the 30‒ year-old group （12.42%）， with significant differences between different age groups. The repeated infection rate for those who had completed their vaccinations was significantly lower （6.57%） compared to those who had not （7.11%）. The age groups of 3‒ years， 70‒79 years， as well as individuals who completed full vaccination and received booster shots were protective factors against repeat infections. ConclusionThe overall rate of reinfection among the infected in Shanghai during the spring of 2022 was low in the outbreak of the Omicron variant， and the rate of reinfection in the 3‒ year-old group was significantly lower than in other age groups. Completing the full course of vaccination significantly reduces the risk of reinfection. Although the reinfection rate is high in individuals who received booster shots， it remains a mitigating factor compared to those who do not receive the vaccine. It is recommended to continue monitoring reinfections in key populations and further strengthen immunization efforts.

Metabolic engineering of Escherichia coli for high-level production of violaxanthin.

BACKGROUND: Xanthophylls are a large class of carotenoids that are found in a variety of organisms and play particularly important roles in the light-harvesting and photoprotection processes of plants and algae. Violaxanthin is an important plant-derived xanthophyll with wide potential applications in medicines, foods, and cosmetics because of its antioxidant activity and bright yellow color. To date, however, violaxanthins have not been produced using metabolically engineered microbes on a commercial scale. Metabolic engineering for microbial production of violaxanthin is hindered by inefficient synthesis pathway in the heterologous host. We systematically optimized the carotenoid chassis and improved the functional expression of key enzymes of violaxanthin biosynthesis in Escherichia coli. RESULTS: Co-overexpression of crtY (encoding lycopene ß-cyclase), crtZ (encoding ß-carotene 3-hydroxylase), and ZEP (encoding zeaxanthin epoxidase) had a notable impact on their functions, resulting in the accumulation of intermediate products, specifically lycopene and ß-carotene. A chassis strain that did not accumulate the intermediate was optimized by several approaches. A promoter library was used to optimize the expression of crtY and crtZ. The resulting strain DZ12 produced zeaxanthin without intermediates. The expression of ZEP was further systematically optimized by using DZ12 as the chassis host. By using a low copy number plasmid and a modified dithiol/disulfide system, and by co-expressing a full electron transport chain, we generated a strain producing violaxanthin at about 25.28 ± 3.94 mg/g dry cell weight with decreased byproduct accumulation. CONCLUSION: We developed an efficient metabolically engineered Escherichia coli strain capable of producing a large amount of violaxanthin. This is the first report of a metabolically engineered microbial platform that could be used for the commercial production of violaxanthin.

Antidiabetic potential of Gymnemic acid mediated gold nanoparticles (Gym@AuNPs) on Streptozotocin-induced diabetic rats-An implication on in vivo approach.

Gymnemic acid is glycosides of triterpene with recognized and valuable applications for several chronic diseases, mainly diabetics. Despite this, it requires a delivery system in order to range its therapeutic target due to its limited solubility and bioavailability. Therefore, the Gymnemic acid mediated gold nanoparticles (Gym@AuNPs) was synthesised by eco-friendly approach. The synthesised Gym@AuNPs was confirmed by the colour change from light yellow to a deep ruby red. UV - visible spectroscopy results showed a strong narrow peak at 530 nm, confirming the controlled synthesis of monodispersed Gym@AuNPs. The reduction potential of standard Gymnemic acid (Gym) on synthesis of Gym@AuNPs was confirmed by using HPLC analysis. The spherical shaped Gym@AuNPs was observed by FESEM and HR-TEM studies with average size of 48.52 ± 5.53 nm. The XRD analysis exhibited a face-centered cubic (FCC) crystalline nature of Gym@AuNPs. The in vivo antidiabetic activity of Gym and Gym@AuNPs were validated using Streptozotocin induced diabetic Albino wistar rats. The Gym@AuNPs and Gym were regulates the glucose and lipid levels in experimental animals. The histopathology outcomes shown that the Gym@AuNPs were restoration of pancreatic islets cells in the animals. This investigation demonstrated that the Gym@AuNPs had the potential anti-diabetic properties.

Long-Term Impact of Domestic Violence on Individuals-An Empirical Study Based on Education, Health and Life Satisfaction.

This paper takes the China Health and Retirement Longitudinal Survey (CHARLS) as a sample to assess the long-term impacts of domestic violence experienced in childhood on individuals. First, from the four dimensions of injury from violence, negligent care, emotional abuse and witness to domestic violence, an indicator system for quantifying domestic violence is constructed. Second, the simultaneous equation of self-evaluation health and life satisfaction is estimated by the seemingly unrelated regression model. Starting with education, health and life satisfaction, the long-term impact of domestic violence experiences on individuals is quantitatively assessed, providing empirical evidence for preventing and curing domestic violence and healing trauma. The empirical research shows the following: (1) An experience of domestic violence significantly reduces educational achievements. Compared with the three dimensions of injury from violence, negligent care and witnessing domestic violence, emotional abuse has the greatest negative impact on educational achievements. (2) Domestic violence significantly reduces the self-assessed health level and life satisfaction and increases the subjective mental health risk. Based on the complexity and concealment of domestic violence, combined with empirical research conclusions, this paper proposes countermeasures to prevent and control domestic violence.

Global trends of Vaccinia oncolytic virus therapy over the past two decades: Bibliometric and visual analysis.

Background: In recent years, the vaccinia oncolytic virus has entered the clinical trial stage of examination and shown good progress. It has many advantages, such as good safety, high oncolytic efficiency, and the regulation ability of the tumor microenvironment, and is expected to be successfully used in the clinical treatment of tumors in the future. However, no bibliometric analysis has so far been performed that generalizes horizontally across this field. Therefore, this study aims to assess the research status and trends in this field from a global perspective to help guide future research priorities. Methods: In this study, the literature related to vaccinia oncolytic virus published in English on Web of Science from 2002 to 2022 was retrieved, and the bibliometric indicators were analyzed using the Histcite. Pro 2.0 tool, while VOSviewer was used to visualize the research trends and hotspots in this field. Results: In total, 408 related studies were included. In the past 20 years, the number of related publications in this field has increased year by year, and breakthroughs were made in this field in 2008 and 2013. The research has grown rapidly since 2008, and will likely continue to expand in the years to come. The United States plays a leading role in this area. "MOLECULAR THERAPY-ONCOLYTICS", "MOLECULAR THERAPY" and "JOURNAL OF TRANSLATIONAL MEDICINE" are core journals that publish high-quality literature on the latest advances in the field. Some authors with numerous high-quality publications include Bell JC and Szalay AA. At present, the research hotspot in this field focus on the clinical application of vaccinia oncolytic virus. Conclusion: Overall, the number of vaccinia oncolytic virus-related studies is growing rapidly, in relation to which the United States is the most influential country. The clinical application of vaccinia oncolytic virus will affect the crucial development of future research.

Light-acquisition traits link aboveground biomass and environment in inner saline-alkaline herbaceous marshes.

A functional response-effect approach could predict how environmental changes affect ecosystem functioning. However, few studies have applied this approach to inner saline-alkaline marsh ecosystems where soil saline-alkaline, flooding/drought and nutrients stresses threat ecological functioning. To disentangle the relationships between environmental conditions and ecosystem functioning, a total of 81 plots were investigated across 22 marsh sites dominated by Phragmites australis and Bolboschoenus planiculmis in Western Songnen Plain wetlands, China. For both plant communities combined, deep flooding supported communities with higher specific leaf area (SLA), plant height and leaf nitrogen (N) content but lower leaf thickness. On the contrary, high soil salt content induced low leaf N and phosphorus (P) content, SLA and plant height. Only light acquisition-related trait, plant height and SLA, was the key traits which determined the relationships between ecosystem functioning (aboveground biomass) and saline-alkaline wetland environment. Yet indirect key traits related nutrient and water acquisition such as leaf thickness, N and P content were also found, and mediated the response of aboveground biomass through the allometric relationships with plant height or SLA. For the individual species community, only plant height was the key trait shared by P. australis and B. planiculmis, indicating the universality of plant height as a key trait for grass and sedge plants to explain how ecosystem functioning responds to abiotic factors. Hence, our findings suggest that saltmarsh plants are more inclined to alter light-acquisition traits to mediate the response of ecosystem functioning to environmental changes and that plant height is a particularly useful trait to predict plant productivity in earth system models under future environmental changes in inner saline-alkaline wetlands.

Analysis of influencing factors for prolonged postoperative hospital stay after Da Vinci robot-assisted mediastinal tumor resection with non-endotracheal intubation and the process optimization / 中国胸心血管外科临床杂志

@# Objective     To analyze the risk factors for postoperative length of stay (PLOS) after mediastinal tumor resection by robot-assisted non-endotracheal intubation and to optimize the perioperative process. Methods    The clinical data of patients who underwent Da Vinci robot-assisted mediastinal tumor resection with non-endotracheal intubation at the Department of Thoracic Surgery, General Hospital of Northern Theater Command from 2016 to 2019 were retrospectively analyzed. According to the median PLOS, the patients were divided into two groups. The univariate analysis and multivariate logistic regression were used to analyze risk factors for prolonged PLOS (longer than median PLOS). Results    A total of 190 patients were enrolled, including 92 males and 98 females with a median age of 51.5 (41.0, 59.0) years. The median PLOS of all patients was 3.0 (2.0, 4.0) d. There were 71 patients in the PLOS>3 d group and 119 patients in the PLOS≤3 d group. Multivariate logistic regression showed that indwelled thoracic catheter [OR=11.852, 95%CI (2.384, 58.912), P=0.003], preoperative symptoms of muscle weakness [OR=4.814, 95%CI (1.337, 17.337), P=0.016] and postoperative visual analogue scale>5 points [OR=6.696, 95%CI (3.033, 14.783), P<0.001] were independent factors for prolonged PLOS. Totally no tube (TNT) allowed patients to be discharged on the first day after surgery. Conclusion    Robot-assisted mediastinal tumor resection with non-endotracheal intubation can promote rapid recovery. The methods of optimizing perioperative process are TNT, controlling muscle weakness symptoms and postoperative pain relief.

Perioperative effects of da Vinci robot with totally no tube versus subxiphoid video-assisted thymectomy surgery for thymic tumors: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective     To compare the clinical efficacy and safety of da Vinci robot with totally no tube (TNT) versus subxiphoid video-assisted thymectomy surgery (SVATS) in the treatment of thymic tumors. Methods     From 2019 to 2021, a retrospective analysis was conducted on patients with thymic tumor resection in the Department of Thoracic Surgery, General Hospital of Northern Theater Command. All patients underwent total thymectomy and mediastinal fat removal, and they were divided into a TNT group and a SVATS group according to the operation method. The intraoperative blood loss, conversion rate, postoperative visual analogue score (VAS), postoperative hospital stay time and postoperative complications were compared between the two groups. Results     We finally included 435 patiets. There were 168 patients with 83 males and 85 females at an average age of 61.920±9.210 years in the TNT group and 267 patients with 147 males and 120 females at an average age of 61.460±8.119 years in the SVATS group. There was no death or postoperative myasthenic crisis in both groups. There was no statistical difference in postoperative hospital stay (1.540±0.500 d vs. 3.400±0.561 d, P=0.000), intraoperative blood loss (13.450±5.498 mL vs. 108.610±54.462 mL, P=0.000), postoperative 24 h VAS score (4.960±1.757 points vs. 3.600±1.708 points, P=0.000), or postoperative complication rate (3.0% vs. 11.6%, P=0.001). Conclusion     TNT is a more efficient, safe, and effective surgical approach for treating thymic tumors, which can shorten hospital stay time and reduce postoperative complications. However, SVATS can minimize postoperative pain.

Validation of a fast and reliable liquid chromatography tandem mass spectrometry for simultaneous quantitation of Voriconazole, Posaconazole and Linezolid in human serum / 中华检验医学杂志

Objective:To establish a high-performance liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of voliconazole (VRC), posaconazole (PCZ), and linazolam (LNZ) in human serum.Methods:This study is a methodological validation by LC-MS/MS. The blood concentration results of VRC, PCZ, and LNZ in our hospital′s anti-infection patients were collected. Voriconazole, Posaconazole, and Linezolid were accurately weighed and prepared. Linezolid-[2H3] was used as the internal standard. After gradient elution on the ACE PFP column, the residuals were analyzed by LC-MS/MS in the positive electrospray ionization mode and multiple reaction monitor (MRM) mode. The method′s linearity, precision, lower limit of detection, and recovery rate were validated according to standard guidelines.Results:The linear correlation coefficient ( r) of the standard curve was above 0.99 ( r>0.99). The linear range of VRC and PCZ were 0.10 mg/L~10.00 mg/L, and the lower limit of detection were 0.01 mg/L. The linear range of LNZ was 0.50 mg/L~50.00 mg/L, and the lower limit of detection was 0.05 mg/L. The recoveries of VRC, PCZ and LNZ were 90.96%-103.18%, 91.84%-99.17%, and 97.04%-100.41%, respectively. Intra-and inter-batch precision (% CV) for VRC were less than 8.30%. Intra-and inter-batch precision (% CV) for PCZ was less than 9.78%. Intra-and inter-batch precision (% CV) for LNZ was less than 7.14%. Drug concentrations in 155 cases of VRC, 44 cases of PCZ, and 59 cases of LNZ were detected. Conclusion:We have established an LC-MS/MS method for the rapid, accurate, highly specific determination of VRC, PCZ, and LNZ concentrations in human serum. This method is suitable for analyzing large clinical sample sets.

Purification of H5N1 influenza virus by different chromatography media / 中华微生物学和免疫学杂志

Objective:To purify H5N1 influenza virus concentrate prepared by MDCK cells with a new mixed-mode chromatography medium Capto Core700 and the traditional medium Sepharose 4FF, and to compare the separation and purification efficacy of the two media.Methods:Capto Core700 and Sepharose 4FF were used to purify inactivated H5N1 influenza virus concentrate. The morphology of virus particles in different samples was then observed under a transmission electron microscope. Single radial immunodiffusion (SRID), Folin-Phenol (Lowry) method, double-antibody sandwich ELISA and qPCR were used to detect hemagglutinin, total protein, host cell protein (HCP) and host cell DNA (HCD) before and after purification. The recovery rate of virus antigen and the removal rate of impurities were calculated. The immunogenicity of the viruses purified with different media was analyzed using animal experiments. Difference in the purification efficacy of the two chromatography media was analyzed by t-test. Results:H5N1 influenza viruses purified by Capto Core700 or Sepharose 4FF showed the typical influenza virus morphology under transmission electron microscope. There was no significant difference in the recovery rate of hemagglutinin between the two chromatography media ( P>0.05), but compared with Sepharose 4FF, Capto Core700 had a higher removal rate of impurities (total protein, HCP, HCD) and the difference was statistically significant ( P<0.05). Animal experiments showed that the viruses purified by the two chromatography media had good immunogenicity. Conclusions:Compared with Sepharose 4FF chromatography medium, Capto Core700 could more effectively remove process-related impurities such as HCP, HCD and total protein without affecting the recovery rate of viral antigen. This study provided reference for the development of purification technology in the production of H5N1 influenza virus vaccine in MDCK cells.

Autologous serum skin test: immunological mechanisms and its associations with clinical features and prognosis of chronic spontaneous urticaria / 中华皮肤科杂志

Autologous serum skin test (ASST) is commonly used as a screening test to assess immune subtypes of chronic spontaneous urticaria (CSU) in clinical practice, but its immunological mechanisms and associations with clinical features and prognosis of CSU are not yet clear. Studies have shown that positive ASST is associated with increased immunoglobulin G autoantibodies, decreased eosinophil and basophil counts, increased CD63 expression on basophils, and changes in circulating inflammatory cytokine levels in CSU patients, but not associated with age, disease duration, and personal or family history of CSU patients, and may be a predictor of severity of chronic urticaria. ASST-positive patients may respond poorly to second-generation H1 antihistamines, slowly to omalizumab, but respond well to cyclosporine and autologous whole blood/serum injections. This review summarizes the immunological and clinical characteristics of ASST-positive patients, and discusses the predictive value of positive ASST for the efficacy of different treatment regimens.

Predictive value of early international normalized ratio for Warfarin overanticoagulation in elderly patients with atrial fibrillation / 中华老年医学杂志

Objective:To investigate the relationship between early international normalized ratio(INR)and overanticoagulation in elderly patients with atrial fibrillation(AF)treated with Warfarin, and to evaluate its clinical value in predicting overanticoagulation.Methods:A total of 470 elderly patients with AF treated with Warfarin for anticoagulation were enrolled retrospectively.INR was detected in the morning of the next day after 3 days and 7 days of Warfarin treatment.According to whether INR was greater than 3.0 after 7 days of Warfarin treatment, the patients were divided into over-anticoagulation group(n=107)and non-over-anticoagulation group(n=363). The general clinical data of the two groups were analyzed.The receiver operating characteristic curve(ROC)was used to evaluate the value of 3-day INR(early INR)level in predicting overanticoagulation.Logistic regression was used to analyze the factors related to overanticoagulation in elderly AF patients receiving Warfarin treatment.Results:The age, initial warfarin dose, early INR and serum aspartate transferase level in the over-anticoagulation group were higher than those in the non-over-anticoagulation group( P<0.05 for all). The proportions of patients with initial Warfarin dose≥2.5 mg, age≥70 years old, body weight≤65 kg, valvular atrial fibrillation, hypoproteinemia, abnormal liver function, and combined use of antibiotics were higher in the over-anticoagulation group than those in the non-over-anticoagulation group( P<0.05 for all). The body weight, serum albumin level and the proportion of diabetes mellitus in the over-anticoagulation group were lower than those in the non-over-anticoagulation group( P<0.05). ROC curve showed that the area under the curve(AUC)of early INR in predicting over-anticoagulation was 0.927(95% CI: 0.900-0.949, P<0.0001), the sensitivity was 82.86% and the specificity was 88.43%, the optimal cutoff value for predicting overanticoagulation was INR≥1.66.Multiple Logistic regression analysis showed that early INR level≥1.66( OR=33.871, P<0.001), initial warfarin dose≥2.5 mg( OR=17.062, P=0.011), body weight≤65 kg( OR=2.824, P=0.002), age≥70 years old( OR=2.678, P=0.003), and abnormal liver function( OR=2.091, P=0.022)were related factors for over-anticoagulation in elderly patients with atrial fibrillation. Conclusions:Early INR level is closely related to overuse of anticoagulation in elderly AF patients receiving Warfarin treatment, which can be regarded as a predictor of overuse of anticoagulation.Early INR level in elderly AF patients receiving warfarin treatment should be monitored to reduce the incidence of anticoagulant overuse.

Clinical application of adjustable traction skin stretchers in repair of wounds at the lower leg, foot and ankle / 中华创伤骨科杂志

Objective:To evaluate the clinical effects of adjustable traction skin stretchers used in repair of wounds at the lower leg, foot and ankle.Methods:A retrospective study was performed to analyze the clinical data of 56 patients who had been treated for skin defects at the lower leg, foot and ankle from August 2016 to September 2022 at The First Affiliated Hospital of Zhengzhou University, Honghui Hospital, Affiliated to Xi'an Jiaotong University Medical College, The First Affiliated Hospital of Henan Polytechnic University, and Yunnan Zhongde Orthopedic Hospital. There were 35 males and 21 females, aged (39.9±18.7) years. There were 43 traumatic wounds, 3 burns, 6 inflammatory wounds, 3 relief incisions due to osteofascial compartment syndrome, and 1 scar. The areas of skin defect ranged from 2.5 cm × 2.0 cm to 20.0 cm × 10.0 cm. The duration of wounds was (8.6±7.8) d. All the wounds were repaired with adjustable traction skin stretchers. The row-hook type of skin stretchers was used in 28 cases, the single-rod type in 20 cases, the single-rod type combined with an external fixator in 5 cases, and a combination of the row-hook type and the single-rod type in 3 cases.The time for wound traction closure, color of wound skin margin, skin swelling around the wound, functional recovery of affected limb and complications were recorded.Results:The time from skin stretching to wound closure was (7.8±3.8) d in the 56 patients. The color of wound skin edge after stretching was normal in 16 cases, dark red in 38 cases, and dark in 2 cases; the skin swelling around the wound was degree 1 in 21 cases, degree 2 in 33 cases, and degree 3 in 2 cases. The 56 patients were followed up for (8.9±4.1) months. Primary wound closure was achieved in 48 patients, and secondary wound closure in 8 patients after repair with an autologous skin graft. Partial skin necrosis occurred due to tension blisters after skin stretching in 2 patients, one of whom was repaired with an autologous skin graft and the other of whom by dressing change. Deep bone infection recurred in 2 patients whose wounds healed after their bone defects were repaired using Ilizarov technique of bone transfer. In the 56 patients, the muscle strength of the lower extremity beyond the wound was recovered to normal, and the range of motion of the joints adjacent to the wound also recovered to normal.Conclusion:In repair of wounds at the lower leg, foot and ankle, adjustable traction skin stretchers can lead to fine clinical effects and limited complications, because the stretchers can control the tension of skin digitally and precisely.

Prevalence and influencing factors of sleep disorder in HIV/AIDS patients before antiviral therapy / 中国医师杂志

Objective:To understand the incidence of sleep disorder in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients before antiviral therapy, and to explore its risk factors.Methods:200 newly treated HIV/AIDS patients who visited the Eighth Affiliated City Hospital of Guangzhou Medical University from January to June 2016 were randomly selected. According to the Pittsburgh Sleep Quality Index (PSQI), they were divided into a good sleep group and a Sleep disorder group; The influencing factors of sleep disorder in HIV/AIDS patients were analyzed by univariate analysis and multivariate logistic regression.Results:The incidence of Sleep disorder in 200 HIV/AIDS patients before antiviral therapy was 22.5%(45/200); CD4 + T cell count was (414.13±202.16)/μl; 29%(58/200) of patients had CD4 + T cell counts<200/μl. There were significant differences in CD4 + T cell count and the proportion of patients with syphilis infection, comorbidity anxiety and comorbidity depression between the good sleep group and the Sleep disorder group (all P<0.05). Multivariate logistic regression analysis showed that syphilis infection ( OR=4.606; 95% CI: 1.973-10.752; P<0.001), comorbidity anxiety ( OR=2.496; 95% CI: 1.086-5.737; P=0.031) and comorbidity depression ( OR=2.087; 95% CI: 0.915-4.760; P=0.040) were risk factors for sleep disorder in HIV/AIDS patients before antiviral treatment. Conclusions:The incidence of Sleep disorder in HIV/AIDS patients before antiviral therapy in Guangzhou is high, especially in patients with syphilis infection, comorbidity anxiety and comorbidity depression. The sleep disorder of HIV/AIDS patients should be assessed and detected early, and multiple interventions should be taken to improve sleep quality.

Establishment and application of a quantitative real-time PCR detection system for Brucella S2 vaccine strain / 中华地方病学杂志

Objective:To establish a quantitative real-time PCR detection system for Brucella S2 vaccine strain. Methods:Based on the differences in the entire genome sequence between Brucella S2 vaccine strain and other reference strains of Brucella, primers and probes were designed to establish a quantitative real-time PCR detection system for Brucella S2 vaccine strain. The DNA of 22 reference strains of Brucella and 8 non- Brucella control strains were obtained from the National Institute for Infectious Disease Control and Prevention of the Chinese Center for Disease Control and Prevention. At the same time, environmental samples were obtained from the brucellosis vaccine manufacturers, and bacterial DNA from environmental samples was extracted using a blood/tissue genomic DNA extraction kit. The obtained DNA was pre-amplified by conventional PCR, and then subjected to quantitative real-time PCR secondary amplification (nested fluorescence quantitative PCR) using the amplified PCR product as a template. The specific fluorescence curve and corresponding number of cycles (Ct value) were observed, and the sensitivity was tested. Results:The quantitative real-time PCR detection system established did not detect specific fluorescence curves (without Ct values) for 21 reference strains of Brucella and 8 non- Brucella control strains, except for S2 vaccine strains. The established detection system had a minimum detection limit of 4.34 fg (genomic DNA) for detecting the DNA of Brucella S2 vaccine strain; DNA of Brucella S2 vaccine strain was detected in 3 of the 14 environmental samples collected. Conclusion:The quantitative real-time PCR detection system established can detect Brucella S2 vaccine strain in samples, with good sensitivity and specificity.

A nested-PCR for detection and identification of Brucella vaccine A19 strain / 中华地方病学杂志

Objective:A nested-PCR assay is developed to detect and identify the genomic DNA of Brucella vaccine A19 strain. Methods:The whole genomic sequences of Brucella vaccine A19 strain and other Brucella spp. strains were compared and analyzed. The primers were designed by nucleotide difference sites. The nested-PCR assay was established to detect and identify Brucella vaccine A19 strain. The genomic DNA of Brucella vaccine A19 strain was extracted and diluted. The diluted template DNA was tested for sensitivity of using nested-PCR assay. And the specificity of nested-PCR assay was tested for the genomic DNA of other Brucella spp. strains and non- Brucella spp. strains. Results:The minimum detection limit of the nested-PCR assay was 3.43 fg. The nested-PCR assay established for amplification of Brucella vaccine A19 strain showed 246 bp electrophoresis bands, while other Brucella spp. strains showed 314 bp electrophoresis bands, and non- Brucella spp. strains did not produce electrophoresis bands. Conclusions:The nested-PCR assay established has the characteristics of high sensitivity and specificity. It can be detected when there is one copy of Brucella vaccine A19 strain genomic DNA in the reaction system. This method is particularly suitable for the detection and identification of trace genomic DNA of Brucella vaccine A19 strain in sample.