Conical beam CT measurement of alveolar bone structure remodeling in patients with skeletal class Ⅲ malocclusion after orthodontic-orthognathic treatment / 中国组织工程研究

BACKGROUND:Most of the studies on combined orthodontic-orthognathic treatment of skeletal class Ⅲ malocclusions have focused on the improvement of the patient's lateral appearance and recovery in the later stages of the treatment,while there are fewer studies observing the microcosmic nature of the alveolar bone remodeling of the lower anterior teeth. OBJECTIVE:To evaluate the therapeutic effect of lower anterior tooth decompensation and alveolar bone remodeling in patients with skeletal class Ⅲ malocclusion before and after orthodontic-orthognathic treatment based on oral X-ray lateral films and oral cone-beam CT. METHODS:From January 2015 to May 2023,15 patients with skeletal class Ⅲ malocclusion who underwent orthodontic-orthognathic surgery at Qingdao Hospital of Rehabilitation University were enrolled.All patients underwent lateral cephalography and cone beam computed tomography before and after treatment.Cephalometric measurement items related to the angle and line distance,lip/lingual bone cracking length(d-La/d-Li)and bone cracking/bone fenestration of the lower anterior teeth before and after treatment were measured. RESULTS AND CONCLUSION:Lateral X-ray films showed that the amount of alveolar bone remodeling after decompensation of the lower anterior teeth showed significant changes compared to before treatment.The root of the tooth moved significantly towards the center of the alveolar bone,and the specific data was closer to normal data,but there were still some differences compared with normal individuals.Based on the cone-beam CT measurement,the bone cracking/bone fenestration length and width of the alveolar bone were improved in almost all the teeth after orthodontic-orthognathic combined treatment,alveolar bone remodeling in some teeth even reached the level of healthy individuals.Before treatment,most patients often experienced bone fenestration/cracking on the lip/lingual side of the lower incisor due to compensatory tooth growth.However,during the preoperative orthodontic stage,decompensation triggered alveolar bone remodeling and significant changes in tooth angle.Preoperative orthodontic treatment caused the upper anterior teeth to retract and the lower anterior teeth to tilt and control the root,but the amount of decompensation before surgery was often insufficient.In the orthognathic surgery stage,the jaw was removed through the positioning guide plate,the maxilla moved forward,and the mandible retreated.During the postoperative orthodontic process,the effect of fine adjustment was better.Although there is a certain degree of recurrence trend in the position of teeth and jawbones,the postoperative orthodontic treatment is closer to the normal value.

Analysis of clinical phenotype and genotype of PAX2 mutation in Chinese children / 中华肾脏病杂志

Objective:To analyze and summarize the clinical, genotypic and pathological characteristics of children with PAX2 gene mutation in China, and to provide information for the monitoring, treatment and prognosis of the disease. Methods:It was a case series analysis study. The clinical data of children with PAX2 gene mutation in Pediatric Nephrology Department, Tongji Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from January 2014 to December 2022 were collected, and peripheral blood gene DNA was extracted and sequenced for whole exome sequencing. The clinical, pathological and genotypic characteristics of PAX2 gene variation of children in China were summarized by searching PubMed, Medline, China National Knowledge Infrastructure and Wanfang database and compared with the cases in this single center. Results:Among the 13 children with PAX2 gene mutation, there were 9 males and 4 females, 12 patients with abnormal urine tests, 7 patients with small kidney volume by imaging examination, and 5 patients with renal cysts. The clinical phenotypes were congenital renal and urinary tract malformations in 8 cases, renal coloboma syndrome in 1 case, and hematuria or proteinuria in 3 cases. Five patients underwent renal biopsies, showing focal segmental glomerulosclerosis and C3 glomerulopathy in 1 case, focal segmental glomerulosclerosis in 1 case, thin basement membrane lesion in 1 case, and IgA nephropathy in 2 cases. The genetic testing in 13 children showed 9 de novo mutations and 4 new mutations of c.321G>A, c.213-8C>G, c.63C>A and c.449C>T. There were 2 cases of 76dupG (p.V26Gfs*28) mutant. A total of 51 Chinese children with PAX2 gene mutation were found in the literature search. There were 32 males and 19 females, 8 cases with small kidney volume and 12 cases with renal cysts. The clinical phenotypes were congenital anomalies of kidney and urinary tract in 28 cases, renal coloboma syndrome in 17 cases, and hematuria or proteinuria in 6 cases. Seven patients underwent renal biopsies, including 2 cases with focal segmental glomerulosclerosis, 1 case with minimal lesion, 1 case with mesangial proliferative glomerulonephritis, 1 case with IgA nephropathy, 1 case with membranous nephropathy and a case with focal proliferative sclerosing purpura nephritis combined with glomerular hypertrophy. Thirty-four cases were de novo mutations, and 12 mutations were from the father or mother. The father or mother of 5 children had no clinical manifestations, with normal renal function. There were 11 cases of 76dupG (p.V26Gfs*28) mutant. Conclusions:The clinical phenotypes and genotypes of PAX2 gene variation in Chinese children are diverse. The most common clinical phenotype of PAX2 gene variation is congenital anomalies of kidney and urinary tract. c.76dupG (p.V26Gfs*28) is the most common of PAX2 gene variant.

Serological characteristics and molecular mechanism of an individual with p phenotype / 中华医学遗传学杂志

OBJECTIVE@#To analyze the serological characteristics and molecular mechanism for an individual with p phenotype.@*METHODS@#An individual with p phenotype upon blood group identification at Jiaxing Blood Center in May 2021 was analyzed. ABO, RhD and P1PK blood groups and irregular antibodies in her serum were identified using conventional serological methods. The encoding region of α1, 4-galactosyltransferase gene (A4GALT) encoding P1 and Pk antigens was analyzed by polymerase chain reaction-sequence-based typing (PCR-SBT).@*RESULTS@#The individual was A group, RhD positive and had a p phenotype of the P1PK blood group system. Anti-PP1Pk was discovered in her serum. Sequencing analysis revealed that she has harbored a homozygous c.343A>T variant of the A4GALT gene.@*CONCLUSION@#The homozygous c.343A>T variant of the A4GALT gene probably underlay the p phenotype in this individual.

The role of natural killer cells in anti-infection and tumor therapy / 细胞与分子免疫学杂志

Natural killer (NK) cells are an important part of the body's innate immune system. As the first line of defense against pathogens, they need to be transformed into a mature state under the control of various cell signaling molecules and transcription factors to play cytotoxic and immune regulatory roles. Under the interaction of activated receptors and inhibitory receptors, NK cells are activated to perform a direct cell killing effect by secreting perforin and granzyme, or indirectly eliminate pathogenic microorganisms in the body by secreting various cytokines, such as type I and type II interferons. These functions of NK cells play a very important role in antiviral and anti-autoimmune diseases, especially in anti-tumor.

Effects of overall planning on staff burnout and group blood donation errors / 中国输血杂志

【Objective】 To analyze the causes of staff burnout and various errors during group blood donation in blood centers, and to explore the significance of overall planning to improve above problems. 【Methods】 Various errors occurred during group blood donation from January 2016 to December 2020 in a blood center were selected as the research object. Job burnout related survey data including emotional exhaustion (MBI-EE), work attitude (MBI-DP), sense of achievement (MBI-PA) etc. were collected. The influence of six variables, including blood collection quantity, staff, order control, plan compliance, overload blood collection and over-stock blood collection, on the occurrence of errors was analyzed, and an ordered logistic regression model was established. After optimizing overall planning measures, the occurrence of errors and the improvement of burnout were compared. 【Results】 In addition to the volume of blood collected (P>0.05), the other five variables had significant influence on the occurrence of errors (P0.05). 【Conclusion】 Scientific inventory management and effective blood collection assessment measures are helpful to improve work quality, and the ordered Logistic regression model has a good fitting degree for error rectification. Analyzing the occurrence of errors during blood collection and supply from the influencing factors is conducive to formulate corrective and preventive measures and promote the continuous improvement of work quality.

Correlation between life events and apheresis platelet donors lapsing / 中国输血杂志

【Objective】 To explore the causes of apheresis platelet donors lapsing in Huzhou area, so as to provide basis for better maintenance of blood donor team. 【Methods】 The data of 1 128 platelet donors from November 1, 2018 to October 31, 2021 were collected, and they were divided into regular blood donor group and lapsed blood donor group, and their work situation, social relations and donation process were investigated through questionnaire survey.Based on the basic characteristics of blood donors, 15 variables were set and analyzed by t test, chi-square test and multivariate logistic regression analysis using SPSS 23.0 software. 【Results】 There were 602 (53.37%, 602/1 128) regular blood donors and 526 (46.63%, 526/1 128) lapsed blood donors in the donor bank during recent 3 years.No significant differences were found in age, gender, educational background, blood donation reaction as well as the satisfaction to service attitude and technical level of blood station staff between the two groups (P>0.05), but significant difference was noticed in whether they were freelancers or changed jobs recently, the working hours per week (h), whether they had friends who donated platelets, had relatives who received/had a serious disease, had children or not, whether satisfied with the frequency of recruitment, and whether the donation was convenient (P<0.05, P<0.01). Multivariate logistic regression analysis showed that recruitment frequency (OR=2.679), convenience of blood donation (OR=2.486), having friends who donated blood (OR=1.791), the working hours per week (OR=1.011), changing jobs (OR=0.558) and having children (OR=0.465) were included in the final regression model and were the influencing factors of blood donor lapsing(P<0.01). 【Conclusion】 Platelet donor lapsing is prominent in Huzhou, therefore efficient communication approaches should be established between blood stations, between blood donors and blood donor, and between blood banks; personalized service should be adopted to maintain apheresis platelet donors.

Genotype and phenotype analysis of children with autosomal dominant inheritance Alport syndrome / 中华实用儿科临床杂志

Objective:To analyze the clinicopathological and gene mutation characteristics of children with autosomal dominant inheritance Alport syndrome (ADAS), and to improve the understanding of ADAS.Methods:Ten children with ADAS diagnosed in the Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from September 2016 to February 2020 were enrolled.The clinicopathological and gene mutation features were retrospectively analyzed, and the patients were followed up.Results:(1) The median age at diagnosis was 5.7 (2.4, 9.8) years.Of 10 children, 6 cases (60.0%) showed a family history of renal failure, 4 cases (40.0%) presented with hematuria and proteinuria at diagnosis, and 2 cases (20.0%) suffered a high-frequency hearing loss.Renal biopsy showed extensive splitting and lamellation of the glomerular basement membrane (GBM) dense layer in 4 cases (40.0%), and segmental splitting and lamellation in 6 cases (60.0%). (2)Among 10 children, 4 cases (40.0%) were heterozygous mutations of COL4A3 gene, including 2 point mutations of glycine, and 2 splicing mutations.The other 6 cases (60.0%) were heterozygous mutations of COL4A4 gene, including collagen glycine point mutations in 4 cases, nonsense mutation in 1 case and large deletion in 1 case.Six mutations were new and never reported before. Conclusions:The early clinical presentations of children with ADAS are often atypical and extrarenal manifestations are less common.The GBM dense layer is mainly featured by segmental splitting and lamellation.Glycine point mutations account for the majority of the gene mutations.

High-volume peritoneal dialysis rescues a severe influenza A child with multiple organ dysfunction syndrome / 中华实用儿科临床杂志

A 3-year-old girl was hospitalized for cough and asthma for 2 days, and fever and anuria for 1 day in Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in January 2019.Retrospective analysis was used.She developed end-stage renal disease and received peritoneal dialysis 6 months ago.After admission, she was diagnosed as acute-on-chronic renal failure, respiratory failure, heart failure, severe influenza A (H1N1). The patient was rapidly recovered by the management of high-volume peritoneal dialysis, mechanical ventilation, and medications of Peramivir and Methylprednisolone.Through literature review, case report or cohort study about the treatment of acute kidney disease by high-volume peritoneal dialysis has not been previously reported.This case report suggested that high-volume peritoneal dialysis is able to effectively remove solutes and control volume without causing severe hypoproteinemia and hyperglycemia, which may become an effective renal replacement therapy for children with multi-organ dysfunction syndrome.

Key technology of brain-computer interaction based on speech imagery / 生物医学工程学杂志

Speech expression is an important high-level cognitive behavior of human beings. The realization of this behavior is closely related to human brain activity. Both true speech expression and speech imagination can activate part of the same brain area. Therefore, speech imagery becomes a new paradigm of brain-computer interaction. Brain-computer interface (BCI) based on speech imagery has the advantages of spontaneous generation, no training, and friendliness to subjects, so it has attracted the attention of many scholars. However, this interactive technology is not mature in the design of experimental paradigms and the choice of imagination materials, and there are many issues that need to be discussed urgently. Therefore, in response to these problems, this article first expounds the neural mechanism of speech imagery. Then, by reviewing the previous BCI research of speech imagery, the mainstream methods and core technologies of experimental paradigm, imagination materials, data processing and so on are systematically analyzed. Finally, the key problems and main challenges that restrict the development of this type of BCI are discussed. And the future development and application perspective of the speech imaginary BCI system are prospected.

Effects of synonymous codon usage bias on mRNA half-life and translational regulation / 生物工程学报

With the widespread application of genomics and transcriptomics in the genetics and cell biology of different species, synonymous codon usage bias has been gradually accepted and used to study the deep connection between biological evolution and biological phenotypes. It is an important part of the life activities that mRNA is expressed into proteins with normal biological activities. The synonymous codon usage patterns, which were named as 'the second genetic codon', can express genetic information carried by themselves at the levels of transcriptional regulations, translational regulations and metabolic activities through molecular mechanisms such as fine-tune translation selection. Some studies have shown that the length of mRNA half-life has significant impacts on mRNA activity and the process of transcription and translation. This review summarized the roles of synonymous codon usage patterns in transcription, translational regulation and post-translational modification, with the aim to better understand how organisms skillfully utilize the genetic effects caused by codon usage patterns to accurately synthesize different types of proteins, so as to ensure the growth or differentiation of the specific gene expression procedures to carry out smoothly and maintain the normal life cycle.

Radiofrequency ablation of benign thyroid nodules: recommendations from the Asian Conference on Tumor Ablation Task Force

Radiofrequency ablation (RFA) is a thermal ablation technique widely used for the management of benign thyroid nodules. To date, five academic societies in various countries have reported clinical practice guidelines, opinion statements, or recommendations regarding the use of thyroid RFA. However, despite some similarities, there are also differences among the guidelines, and a consensus is required regarding safe and effective treatment in Asian countries. Therefore, a task force was organized by the guideline committee of the Asian Conference on Tumor Ablation with the goal of devising recommendations for the clinical use of thyroid RFA. The recommendations in this article are based on a comprehensive analysis of the current literature and the consensus opinion of the task force members.

Occult hepatitis B virus load and molecular mutation in blood donors, Huzhou / 中国输血杂志

【Objective】 To investigate the prevalence of occult hepatitis B virus infection (OBI) among blood donors in Huzhou, and to analyze the viral load and molecular characteristics of OBI. 【Methods】 45 368 blood samples were screened by enzyme linked immunosorbent assay (ELISA) and nucleic acid testing (NAT) for HBV infection from October 2018 to February 2020 in our center. HBsAg-/NAT+ blood donors were studied as experimental group, contemporary HBsAg+ /NAT+ donors as the control. The serum viral nucleic acids of the two groups were extracted, and HBV DNA copies were detected by real-time PCR, the differences between the two groups were compared. The S region gene of the virus was amplified and sequenced by Nested PCR, then compared with the reference sequence of HBV wild type, in order to confirm the genotyping and molecular mutation characteristics of S region. 【Results】 36 samples were confirmed as OBI (0.08%, 36 / 45 368). The HBV DNA load of 8 samples was lower than the detection limit, and the average HBV DNA load of other 28 samples was (42.3±1.24) IU / mL, which was significantly lower than that of the controls (3.32±1.94) ×104 IU / mL(P<0.05). Among the 28 OBI samples, 20 were type B (71.43%), and 8 were type C (28.57%). The frequency of amino acid variation in HBsAg epitopes was significantly higher in OBI than in MHR(P<0.05). 【Conclusion】 The viral load of OBI blood donors in Huzhou, mainly genotype B, is low, and the variation sites were mainly focused in HBsAg epitope and amino acid region (124~147).

Analysis of clinical phenotype and genotype of LAMB2 mutation / 中华肾脏病杂志

Objective:To report two cases of steroid-resistant nephrotic syndrome (SRNS) caused by LAMB2 gene mutation, and summarize the characteristics of genotype, clinical and pathological phenotypes of children with LAMB2 gene mutation. Methods:Two cases with SRNS caused by LAMB2 gene mutation were from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology in December 2013 and September 2019. The demographic, family history and clinical data of two cases were collected, and the peripheral blood genomic DNA was captured and sequenced by whole exome sequencing. PubMed, Medline, CNKI and Wanfang databases were searched to summarize the clinicopathological phenotypes and genotypes of patients with LAMB2 mutation. Results:Among the two cases with SRNS caused by LAMB2 gene mutation, the clinical phenotypes were all manifested as nephrotic level of proteinuria and hypoalbuminemia, and there was no extrarenal clinical manifestation. One case presented with basement membrane delamination and the other with focal segmental glomerulosclerosis (FSGS). LAMB2 mutations of two cases were Exon32 c.5390G>T(p.Cys1797Phe), Exon19 c.2557C>T(p.Arg853*) and Exon27 c.4370G>A(p.R1457Q), Exon23 c.3325G>A(p.E1109K), respectively. In literature retrieval, there were 37 cases with LAMB2 gene mutation, including 24 cases with renal biopsy data, 13 cases of focal segmental glomerulosclerosis (FSGS), 4 cases of minimal change disease, one case of diffuse mesangial sclerosis, one case of IgM nephropathy, two cases of thin basement membrane nephropathy, and three cases of mesangial hyperplasia. Among them, eight cases had basement membrane delamination tear. Among the 37 cases, 11 cases were homozygous, 22 cases were complex heterozygosity, and 4 cases were heterozygous mutation. Conclusions:LAMB2 mutation may cause delamination tear of glomerular basement membrane. The clinical phenotype is congenital nephrotic syndrome or SRNS. The literature review shows the extrarenal manifestations caused by LAMB2 mutation are mostly various ocular abnormalities, as well as respiratory, digestive and nervous system abnormalities, and the time of progression to end-stage renal disease is also different.

Pedicled bridge transplantation for soft tissue defects at the contrallateral leg with medial leg skin flap and medial hemi-soleus muscle flap / 中华创伤骨科杂志

Objective:To evaluate the pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap for the treatment of soft tissue defects at the contrallateral leg.Methods:Between January of 2012 and January of 2016, 8 patients with soft tissue defects at the leg were treated at Department of Orthopedic Surgery, Hand and Foot Surgery Hospital of Lanzhou. They were 5 men and 3 women, aged from 19 to 50 years (mean, 35 years). All of them were treated by bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap pedicled with posterior tibial artery. The size of the defects ranged from 10 cm×9 cm to 13 cm×8 cm. The immediate coverage of the muscle flaps and vessel pedicle was repaired by a meshed split-thickness skin graft. The donor site was closed directly. The therapeutic efficacy was assessed at the final follow-up according to the criteria by Iowa for tibial fractures.Results:All the skin flaps and muscle flaps survived without any vascular crisis. One case developed necrosis of small skin graft at the distal muscle flap which spontaneously healed after dressing change for 2 weeks. Their follow-up ranged from 2.5 to 4.5 years (mean, 3.8 years). A good contour was confirmed at the recipient area. By the Iowa criteria at the final follow-up, 3 cases were excellent, 4 good and one fair.Conclusion:Pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap is a good treatment for soft tissue defects at the contrallateral leg which has only one major blood vessel, reducing damage to the donor site.

Shear-Wave Elastography of the Breast: Added Value of a Quality Map in Diagnosis and Prediction of the Biological Characteristics of Breast Cancer

The value of preoperative ultrasound in predicting microvascular invasion of hepatocellular carcinoma / 中华超声影像学杂志

Objective To analyze the ultrasound imaging features and clinical characteristics in patients with hepatocellular carcinoma ( HCC ) , and assess the value of ultrasound in preoperatively predicting microvascular invasion ( M VI) of HCC . Methods One hundred and seventy‐one patients with HCC were retrospectively collected from January 2016 to July 2018 . T he ultrasound imaging features and clinical data that may be associated with M VI were analyzed by univariate and multivariate analyses ,and the diagnostic efficacy of independent risk factors was further evaluated . ROC curves were plotted to compare the diagnostic efficacy of combined diagnostic mode 1 ,mode 2 ,peritumoral enhancement ,and tumor margin . Results Univariate analysis showed that the serum AFP level ,tumor size ,peritumoral hypoechoic halo , peritumoral enhancement , and tumor margin were significantly correlated with M VI ( P ＜ 0 .05 ) . M ultivariate logistic regression analysis further indicated that peritumoral enhancement and non‐smooth tumor margin were the independent risk factors for predicting M VI . T he sensitivity ,specificity ,positive predictive value and negative predictive value of peritumoral enhancement and non‐smooth tumor margin were 51 .4% vs 83 .8% ,81 .4% vs 48 .5% ,67 .9% vs 55 .4% ,and 68 .7% vs 79 .7% ,respectively . T he AUC of mode 1 ,mode 2 ,peritumoral enhancement and tumor margin were 0 .741 ,0 .716 ,0 .664 ,and 0 .661 , respectively . Conclusions Preoperative ultrasound is valuable in predicting M VI of HCC . Peritumoral enhancement and non‐smooth tumor margins are independent risk factors for predicting M VI of HCC . T umor size ,hypoechoic halo around the tumor ,and serum AFP levels must be taken into account w hen predicting MVI of HCC by using preoperative ultrasound .

Minimally invasive splayed incisions for calcaneal fractures of sanders types Ⅱ and Ⅲ / 中华创伤骨科杂志

Objective To evaluate the minimally invasive splayed incisions in the internal fixation with a conventional calcaneal plate for calcaneal fractures of sanders types Ⅱ and Ⅲ.Methods This prospective study was conducted from May 1st,2016 to December 1st,2017 in the 40 patients with calcaneal fracture at Department of Orthopedics,Shanghai Pudong Hospital.Their ages ranged from 23 to 55 years (average,39.5 years).According to the Sanders classification,27 fractures were type Ⅱ and 13 type Ⅲ.They were all treated with a conventional calcaneal plate through minimally invasive splayed incisions.The B(o)hler and Gissane angles,the height,width and length of the affected calcaneus were compared between preoperation,3 months after operation and the last follow-up;the clinical function of the affected feet was graded using the Maryland foot score;postoperative complications were observed.Results The 40 patients were followed up for an average of 12.5 months (from 11 to 16 months).All the skin incisions healed well with no skin necrosis or wound infection.No injury to the sural nerve occurred.All the fractures healed after an average of 8 weeks (from 7 to 10 weeks).All the patients resumed their routine daily activities and returned to their former work post after an average time of 4.1 months (from 3 to 6 months).At pre-operation,3 months after operation and the last follow-up,their B(o)hler angles were respectively 19.2°± 6.3°,30.5°±6.4° and 29.9° ± 6.5°;their Gissane angles 103.9° ± 14.8°,119.3° ± 5.6° and 119.8° ± 6.3°;their calcaneal heights (32.5 ±3.5) mm,(36.8 ± 1.5) mm and (36.5 ± 1.8) mm;their calcaneal widths (36.8 ± 3.4) mm,(33.1 ±3.8) mmand (33.0±3.2) mm;their lengths (61.4±4.5) mm,(65.5±6.9) mmand (65.5 ±9.4) mm.In all the patients,the B(o)hler and Gissane angles and the calcaneal heights and lengths increased significantly while the calcaneal widths decreased significantly at 3 months after operation and the last follow-up (P ＜ 0.05).There were no significant differences between 3 months after operation and the last follow-up in the B(o)hler or Gissane angle,the height,width or length of the affected calcaneus (P ＞ 0.05).Their Maryland foot scores showed 35 excellent cases,4 good cases and one fair case,giving an excellent and good rate of 97.5％.Conclusions A conventional calcaneal plate plus minimally invasive splayed incisions can be effective for calcaneal fractures of Sanders types Ⅱ and Ⅲ,leading to reduced wound complications,anatomical restoration of calcaneal morphology,and smooth subtalar articular surface.

Renal re-transplantation in a pre-sensitized small infant and literature review / 中华器官移植杂志

Objective To explore the feasibility and safety of kidney transplantation for pre-sensitized infants using deceased donors and summarize the relevant literature reports .Methods A second kidney transplantation was successfully performed for an 8-month-old pre-sensitized girl in July 2017 .She had a low level of donor specific antibody (DSA ) against human leucocyte antigen (HLA ) B62 due to severe acute rejection (AR) after her first kidney transplantation .For desensitization , plasmapheresis and intravenous immunoglobulin plus anti-CD20 antibodies were offered on operative day .Clinical data and outcomes were retrospectively analyzed .Results Renal graft regained immediate function after transplantation .Preformed DSA could be detected at 1 week .However ,there was no de novo DSA .At 1 year post-transplantation ,preformed DSA turned negative .During a follow-up period of 2 years ,renal graft showed an excellent function with a serum creatinine of 31 μmol/l and eGFR of 110 ml/min/1 .73m2 .No AR episode or proteinuria occurred .DSA stayed negative .Simultaneously physical development also caught up .Her height of 93 cm tall and weight of 13 .5 kg at month 24 & 8 months corresponded to normal grow th curve of her age .Conclusions Pre-sensitized infant could tolerate desensitization therapy well and achieve satisfactory outcomes .With surgical precisions and optimized managements ,kidney transplantation provides excellent renal functions and survivals for infants with organs from deceased donors .

Minimally invasive splayed incisions for calcaneal fractures of sanders types Ⅱ and Ⅲ / 中华创伤骨科杂志

Objective@#To evaluate the minimally invasive splayed incisions in the internal fixation with a conventional calcaneal plate for calcaneal fractures of sanders types Ⅱ and Ⅲ.@*Methods@#This prospective study was conducted from May 1st, 2016 to December 1st, 2017 in the 40 patients with calcaneal fracture at Department of Orthopedics, Shanghai Pudong Hospital. Their ages ranged from 23 to 55 years (average, 39.5 years). According to the Sanders classification, 27 fractures were type Ⅱ and 13 type Ⅲ. They were all treated with a conventional calcaneal plate through minimally invasive splayed incisions. The Böhler and Gissane angles, the height, width and length of the affected calcaneus were compared between preoperation, 3 months after operation and the last follow-up; the clinical function of the affected feet was graded using the Maryland foot score; postoperative complications were observed.@*Results@#The 40 patients were followed up for an average of 12.5 months (from 11 to 16 months). All the skin incisions healed well with no skin necrosis or wound infection. No injury to the sural nerve occurred. All the fractures healed after an average of 8 weeks (from 7 to 10 weeks). All the patients resumed their routine daily activities and returned to their former work post after an average time of 4.1 months (from 3 to 6 months). At pre-operation, 3 months after operation and the last follow-up, their Böhler angles were respectively 19.2°±6.3°, 30.5°±6.4° and 29.9°±6.5°; their Gissane angles 103.9°±14.8°, 119.3°±5.6° and 119.8°±6.3°; their calcaneal heights (32.5±3.5) mm, (36.8±1.5) mm and (36.5±1.8) mm; their calcaneal widths (36.8±3.4) mm, (33.1±3.8) mm and (33.0±3.2) mm; their lengths (61.4±4.5) mm, (65.5±6.9) mm and (65.5±9.4) mm. In all the patients, the Böhler and Gissane angles and the calcaneal heights and lengths increased significantly while the calcaneal widths decreased significantly at 3 months after operation and the last follow-up (P<0.05). There were no significant differences between 3 months after operation and the last follow-up in the Böhler or Gissane angle, the height, width or length of the affected calcaneus (P>0.05). Their Maryland foot scores showed 35 excellent cases, 4 good cases and one fair case, giving an excellent and good rate of 97.5%.@*Conclusions@#A conventional calcaneal plate plus minimally invasive splayed incisions can be effective for calcaneal fractures of Sanders types Ⅱ and Ⅲ, leading to reduced wound complications, anatomical restoration of calcaneal morphology, and smooth subtalar articular surface.

Study on Quality Standard Improvement of Qiju Dihuang Oral Liquid / 中国药房

OBJECTIVE： To provide reference for perfecting and improving the quality standard of Qiju dihuang oral liquid. METHODS： According to No. 0502 method stated in 2015 edition of Chinese Pharmacopeia （part Ⅳ）， TLC method was used to identify the fruit of Chinese wolfberry， Dendranthema morifolium and Paeonia suffruticosa in Qiju dihuang oral liquid. Using the fruit of C. wolfberry， D. morifolium and paeonol as control， the deployment systems were trichloromethane-ethyl acetate-formic acid （6 ∶ 1 ∶ 0.5， V/V/V）， trichloromethane-isopropanol-formic acid （10 ∶ 1 ∶ 0.5， V/V/V） and cyclohexane-ethyl acetate （3 ∶ 1， V/V）. The contents of morroniside， loganin and paeonol in Qiju dihuang oral liquid were determined by HPLC. The determination was performed on InertSustain C18 column with mobile phase consisted of acetonitrile-0.03％ phosphoric acid solution（gradient elution）at the flow rate of 1.0 mL/min. The detection wavelength was set at 240 nm （morroniside and loganin） and 274 nm （paeonol）， and the column temperature was 40 ℃. The sample size was 10 μL. RESULES： In TLC of the fruit of C. wolfberry， D. morifolium and P. suffruticosa， same color spots were shown in the corresponding positions of reference substance/control chromatogram without interference from negative control. The linear ranges of morroniside， loganin and paeonol were 2.12-106.17， 1.91-95.63 and 4.78-239.16 μg/mL （R2＝0.999 9， 0.999 9， 0.999 8）， respectively. The limits of quantitation were 2.12， 1.91， 2.39 μg/mL； the limits of detection were 0.53， 0.48， 0.59 μg/mL， respectively； RSDs of precision， reproducibility and stability tests were lower than 2％ （n＝6）. The average recoveries were 98.27％， 97.06％ and 97.65％ RSD were 0.80％， 1.18％ and 1.36％ （n＝6）. RSDs of durability tests were all lower than 2％ （n＝3）. CONCLUSIONS： The established method is simple， specific and durable， and can provide reference for improving the quality standard of Qiju dihuang oral liquid.