Surveillance of human soil-transmitted nematodiasis in Jurong City from 2016 to 2020 / 中国血吸虫病防治杂志

Objective To investigate the prevalence of soil-transmitted nematode human infections in Jurong City from 2016 to 2020, so as to provide the scientific evidence for formulating the control strategy. Methods During the period from 2016 to 2020, the permanent residents at ages of over 3 years living in Jurong City were selected as the study subjects. Stool samples were collected for the detection of soil-transmitted nematode eggs using the modified Kato-Katz thick smear method (two detections for one stool sample), and the species of hookworm was identified in stool-positive stool samples using the culture method. The prevalence and intensity of soil-transmitted nematode infections were calculated, and the change of the infection prevalence among years was examined using the Cochran-Armitage test for trend. Results A total of 10 011 people-time populations were detected for soil-transmitted nematode infections in Jurong City from 2016 to 2020, and 56 egg-positives were identified, with mean prevalence of 0.56%. The prevalence of soil-transmitted nematode human infections appeared a tendency towards a decline year by year in Jurong City (χ2trend = 5.15, P < 0.01). The mean prevalence of hookworm, Ascaris lumbricoides and Trichuris trichiura infections was 0.44%, 0.11% and 0.20% in Jurong City from 2016 to 2020, respectively, and individuals with hookworm infections accounted for 78.57% of all cases with soil-transmitted nematode infections. Single parasite (98.21%) and mild infection were pre-dominant in individuals with soil-transmitted nematode infections, and no multiple infections were seen after 2016. Conclusions The prevalence of human soil-transmitted nematodiasis is low in Jurong City. Based on reinforcement of soil-transmitted nematodiasis surveillance, an increase in the health education investment is required to consolidate the control achievements.

Enhancing Quality of Patients Care and Improving Patient Experience in China with Assistance of Artificial Intelligence / 中国医学科学杂志(英文版)

Improving health of Chinese people has become national strategy according to the . Patient experience evaluation examines health care service from perspective of patients; it is important for improving health care quality. Applying artificial intelligence (AI) in patient experience is an innovative approach to assist continuous improvement of care quality of patient service. A nursing quality platform based on patient experience data which is empowered by AI technologies has been established in China for the purpose of surveillance and analysis of the quality of patient care. It contains data from nearly 1300 healthcare facilities, based on which portraits of nursing service qualities can be drawn. The patient experience big data platform has shown potentials for healthcare facilities to improve patient care quality. More efforts are needed to achieve the goal of enhancing people's sense of health gain.

Case control studies on unilateral or bilateral pedicle fixation at the level of fracture versus posterior fixation alone in the treatment of thoracolumbar fractures / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical effects of three fixation methods at the level of fracture in treating thoracolumbar fractures.</p><p><b>METHODS</b>From June 2012 to June 2015, 67 patients with thoracolumbar fractures were treated with posterior short-segment pedicle fixation. There were 45 males and 22 females, aged from 13 to 63 years old with an average of 42.5 years. According to the methods of fixation at the level of fracture, the patients were divided into three groups. Group A included 26 patients treated by traditional posterior fixation alone. Group B included 19 patients treated by posterior fixation with unilateral pedicle fixation at the level of fracture. In group C, 22 patients were treated by posterior fixation with bilateral fracture-level screws. Radiological parameters and clinical outcomes were compared among the three groups.</p><p><b>RESULTS</b>All the patients were followed up for 12 to 26 months with an average of 17.6 months. No complications such as incision infection, poor wound healing, internal fixation loosening and breakage were found. Preoperative, postoperative 1 week, and final follow-up, there were no significance differences among the three groups with respect to the relative height of the fractured vertebra (>0.05). The sagittal Cobb angles among the three groups were similar preoperatively, and a week after operation (>0.05). At latest follow-up, the sagittal Cobb angles and the correction loss of Cobb angle in group A were significantly larger than that of groups B and C (<0.05), while there was no statistical difference between group B and group C (>0.05). With respect to visual analogue scale (VAS) scores for back pain, the three groups were similar at preoperatively, a week after operation and the latest follow-up(>0.05).</p><p><b>CONCLUSIONS</b>Compared to traditional posterior fixation alone, unilateral or bilateral pedicle fixation at the level of fracture can significantly decrease the loss of correction in the middle-long term, and reduce the incidence of tardive kyphosis deformity and can obtain satisfactory radiological results and clinical outcomes with safe surgical procedures.</p>

Finite element analysis on inferior cervical spine biomechanics after semi-constrained cervical intervertebral disc arthroplasty and anterior cervical discectomy and fusion / 医用生物力学

Objective To study biomechanical properties such as range of motion (ROM), intervertebral disc stress, ligament tension of inferior cervical spinal segment after the treatment of Discover, Prodisc-C artificial intervertebral disc replacement, and anterior cervical discectomy and fusion (ACDF), as well as mechanical property changes of the prosthesis after implantation. Methods Three kinds of operation plan on C5-6 cervical disc degeneration were established: Discover model, Prodisc-C model and ACDF model, as well as C4-7 segment original model of cervical vertebra. Biomechanical property changes after operation in cervical spine C4-7 segment in sagittal, coronal and transverse section were analyzed. Results ROM changes of cervical segment C5-C6 were as following: in Discover model it increased by 12.7%-73.1%, Prodisc-C model increased by 74%-98%, ACDF decreased by 55.8%-71.8%. The stress of C4-5 intervertebral disc after Discover artificial disc replacement showed no obvious increase, while the stress of C6-7 intervertebral disc decreased by 33.2%-54.2% under flexion, extension and axial rotation conditions. The amplification of ligament tension in Discover model decreased by 30%-40% as compared to that in Prodisc-C model. The maximum stress of Discover model (36.72 MPa) appeared under flexion condition, which was smaller than that in Prodisc-C model. Conclusions Artificial disc replacement can help to keep movement performance for segment after surgery. As a newly developed artificial intervertebral disc prosthesis, Discover makes some progress in the aspect of decreasing ligament stress and maintaining spinal stability. The research findings will provide theoretical basis for the clinical study on ACDF and artificial cervical intervertebral disc replacement surgeries.

Evaluation on dosage-based efficacy-toxicity correlation of Tripterygium wilfordii against immune inflammation in mice / 中国中药杂志

<p><b>OBJECTIVE</b>To study the anti-immune inflammation efficacy and toxicity of Tripterygium wilfordii decoction, in order to provide experimental basis for studies on its "efficacy-toxicity" correlation.</p><p><b>METHOD</b>The delayed hypersensitivity model was established by dinitrofluorobenzene in mice. Different doses of T. wilfordii decoction was administered for 5 consecutive days. The ear swelling inhibition ratio and the toxic action were observed. After the final administration, the biochemical indexes of PGE2, TNF-α, IL-2, ALT, AST, PA, TBA, TBIL in serum were detected, and the visceral indexes of heart, liver, spleen and kidney were measured.</p><p><b>RESULT</b>The DNFB-induced ear swelling could be notably inhibited by multiple oral administration of T. wilfordii decoction, with the ED50 and its 95% confidence limit of 0.34 (0.21-0.42) g x kg(-1). The contents of PGE2, TNF-α, IL-2 in serum decreased in a dose-dependent manner. The activities of serum AST, ALT, TBA, TBIL and the PA content reduced.</p><p><b>CONCLUSION</b>T. wilfordii decoction shows a significant anti-immune inflammation efficacy within the dosage range between 0.59 and 2.34 g x kg(-1) in a dose-dependent manner. With a certain hepatotoxicity, high dose (2.34-4.68 g x kg(-1)) of T. wilfordii decoction can cause substantial liver injury, with a dose dependence in liver function index. Therefore, the efficacy and toxicity of T. wilfordii is dose dependent, which provides reference for preventing adverse drug reactions in clinic and developing early-warning schemes and ensure the clinical medication safety of T. wilfordii.</p>

Finite element analysis on different spine reconstruction methods after total spondylectomy of cervicothoracic spine / 医用生物力学

Objective To establish 3D finite element of human cervicothoracic spine C5-T2 based on CT images, and explore effects on stability of the cervicothoracic spine after total spondylectomy (TS) by using various combinations of internal fixation devices (pedicle screw, titanium mesh, steel plate), including the stress distributions on these internal fixation devices. Methods The intact finite element model of cervicothoracic spine C5-T2 was established and validated by comparing the model’s range of motion (ROM) with that of other in vitro experiments. Then four reconstruction models after TS of cervical spine segment C7 were established: TM+AP+DPS model (titanium mesh + anterior plate + posterior double-segmental pedicle screw), TM+AP+SPS model (titanium mesh + anterior plate + posterior single-segmental pedicle screw), TM+DPS model (titanium mesh + posterior double-segmental pedicle screw), AP+DPS model (anterior plate + posterior double-segmental pedicle screw). ROM of each reconstruction model under flexion, extension, lateral bending and rotation and stress distributions on these internal fixation devices were then analyzed. Results ROM of the reconstruction segments was greatly reduced by over 93% as compare to that of the intact model. Stress concentration phenomenon appeared on the titanium mesh in the TM+AP+SPS model. Conclusions The fixation effects of four reconstruction models are similar. Stresses on 3 DPS fixed-models are more evenly distributed, indicating that the overall stability of DPS fixed-model is superior to that of SPS fixed-model.

Establishment and validation for a 3D finite element model of cervicothoracic junction C5-T2 / 医用生物力学

Objective To establish a 3D finite element model of cervicothoracic spinal segments C5-T2 based on CT images and test its validity and effectiveness. Methods By using the Mimics, Geomagic and Hypermesh software, the 3D model of cervicothoracic spinal segments C5-T2 was reconstructed, repaired and pre-processed. Moment of ±0.5, 1, 1.5, 2 N•m were applied on top of the model to simulate loads produced during the flexion and extension movement of human body. The range of motion (ROM) of the segments C5-T2 during flexion and extension was calculated by ANSYS, and the reliability of the model was verified by comparing the experimental results in the previous literature with the finite element analysis results obtained in this study. Results Under the moment of 1 N•m, the ROMs of C5-6, C6-7, C7-T1 and T1-2 during flexion were 4.30°,3.21°,1.66° and 1.41°, and those during extension were 3.47°, 2.86°, 0.96° and 0.92°, respectively. The maximum stress during flexion appeared on the front of the vertebral body, while that during extension appeared on the back of the vertebral body. The trends of ROM and stress distributions were consistent with results reported in the previous literature. Conclusions The 3D model established in this study is accurate and realistic, and conforms to biomechanical properties of the cervicothoracic spine. The simulation results can be further used to explore clinical pathology of the spine and provide theoretical references for evaluation on cervicothoracic spine surgery.

Idiopathic thoracolumbar/lumbar scoliosis treated with anterior correction and interbody fusion with calcium phosphate cement / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical outcome and fusion rate in patients with idiopathic thoracolumbar/lumbar scoliosis treated with anterior correction and interbody fusion with calcium phosphate cement.</p><p><b>METHODS</b>From October 2006 to March 2008, 24 cases undergoing anterior correction and interbody fusion with calcium phosphate cement were enrolled. All of them were female, with an age ranged from 12 to 25 years. The mean Cobb angle of main curve was 46° ± 5° (range, 40° - 56°) before surgery. During operation, the most proximal and distal disc spaces were filled with rib autograft, while the remaining levels were filled with calcium phosphate cement. The interbody fusion rate, coronal correction and sagittal profile reconstruction were evaluated respectively by using χ² test and t test.</p><p><b>RESULTS</b>Interbody fusion was performed in 103 levels, including 48 levels with rib autograft and 55 levels with calcium phosphate cement. The mean follow-up period was 23.8 months (range, 12 - 33 months) in this series. At the follow-up of 6 months, fusion rate was found as 54.2% in the levels filled with rib autograft, while 50.9% in those filled with calcium phosphate cement. Solid fusion of the whole instrumented area was achieved in all cases with a minimum one-year follow-up. No instrumentation-related complications occurred. The correction rate of main curve was on an average of 76% ± 11% after surgery. A significant difference was found between preoperative and immediate postoperative value in terms of the main curve magnitude (46° ± 5° vs. 14° ± 5°, t = -26.95, P < 0.05). The correction loss of the main curve was -5.1° - 10.4° at the final follow-up. The coronal balance and lower instrumented vertebra tilting were significantly improved after operation. The thoracolumbar kyphosis was significantly reduced postoperatively (t = 3.11, P < 0.05).</p><p><b>CONCLUSION</b>Satisfactory bone fusion and correction maintenance can be achieved in idiopathic thoracolumbar/lumbar scoliosis treated by anterior instrumentation combined with interbody fusion using calcium phosphate cement.</p>

Clinical study of distribution and drug resistance of pathogens in patients with severe acute pancreatitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous researches about necrotic pancreatic tissue infections are numerous, but the study on systemic infection related to the severe acute pancreatitis (SAP) treatment period is limited. This study aimed to investigate the distribution and drug resistance of pathogenic bacteria in patients who had hepatobiliary surgery for SAP during the past three years.</p><p><b>METHODS</b>A retrospective study was conducted on the distribution, category and drug resistance of pathogenic bacteria in patients who had hepatobiliary surgery for SAP from 2008 to 2011.</p><p><b>RESULTS</b>A total of 594 pathogenic bacteria samples were isolated. Among them 418 isolates (70.4%) were Gram bacteria negative, 142 isolates (23.9%) were Gram bacteria positive, and 34 isolates (5.7%) were found fungi. The most common Gram negative bacteria were Escherichia coli (19.8%), and the dominant Gram positive pathogenic bacteria were Enterococcus faecium. The distribution of SAP-related infectious pathogens was mainly in peritoneal drainage fluid, sputum, bile, and wound secretions. Almost all the Gram negative pathogenic bacteria were sensitive to carbapenum. Extended-spectrum β-lactamases (ESBLs) producing strains were more resistant to penicillins and cephalosprins than the ESBLs non-producing strains. Staphylococcus was sensitive to vancomycin and linezolid. The drug resistance of meticillin-resistant staphylococcus (MRS) to commonly used antibiotics was higher than meticillin-sensitive streptococcus (MSS). Enterococcus sp. exhibited lower drug-resistance rates to vancomycin and linezolid.</p><p><b>CONCLUSIONS</b>Gram negative bacteria were the dominant SAP-related infection after hepatobiliary surgery. A high number of fungal infections were reported. Drug resistant rates were high. Rational use of antibiotics according to the site of infection, bacterial species and drug sensitivity, correctly executing the course of treatment and enhancing hand washing will contribute to therapy and prevention of SAP-related infection and decrease its mortality.</p>

Association between tartrate-resistant acid phosphatase 5 gene polymorphism and adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate whether the titrate-resistant acid phosphatase 5 (ACP5) gene polymorphisms were associated with the occurrence or curve severity of adolescent idiopathic scoliosis (AIS).</p><p><b>METHODS</b>There were 372 AIS patients from January 2006 to December 2008 and 239 normal controls from March 2005 to August 2006 were recruited. The Cobb angles were ≥ 10° in all AIS patients. Using the haplotype data of Han population from the Hapmap Project, two tag SNPs (rs2229531, rs2071484) were defined for ACP5 gene. PCR-restriction fragment length polymorphism was used for the genotyping.</p><p><b>RESULTS</b>No polymorphism in rs2229531 was found in this study. The genotype and allele frequency distribution in rs2071484 were similar between AIS patients and normal controls (χ(2) = 3.336 and 1.438, P > 0.05). The mean maximum Cobb angles of different genotypes of rs2071484 in ACP5 gene were 38° ± 19° in AA, 34° ± 14° in AG and 38° ± 21° in GG, which were similar with each other among AIS patients who reached skeletal maturity or received surgery treatment (P = 0.157).</p><p><b>CONCLUSION</b>The ACP5 gene is neither associated with the occurrence nor the curve severity of AIS.</p>

Comparison of the sagittal profiles between thoracic idiopathic scoliosis patients with different curve progression / 中华外科杂志

<p><b>OBJECTIVES</b>To compare the sagittal profiles between thoracic idiopathic scoliosis (IS) patients with different curve progression and to determine the risk factors associated with curve progression.</p><p><b>METHODS</b>A total of 83 thoracic IS patients from September 2009 to May 2010 were included in this study and were divided into 3 groups according to different curve progression. All the patients did not receive any previous treatments. There were 26 skeletally mature patients whose Risser sign were 5 degree with Cobb angle < 40° in non-curve progression group (NCP group), 29 mature patients whose Risser sign were 5 degree with Cobb angle ≥ 40° in moderate curve progression group (MCP group) and 28 immature patients whose Risser sign ≤ 3 degree with Cobb angle ≥ 40° in severe curve progression group (SCP group). Five sagittal parameters, including thoracic kyphosis (TK), lumbar lordosis (LL), sacral slope (SS), pelvic incidence (PI) and pelvic tilt (PT) were measured on the lateral X-ray films. Analysis of variance was used to compare these parameters among the 3 groups.</p><p><b>RESULTS</b>The average thoracic Cobb angle was significantly smaller in NCP group when compared with MCP group (P < 0.01) or SCP group (P < 0.01), but not significantly different between the 2 latter groups (P = 0.619). The average TK was 19° ± 7° in NCP group, 13° ± 6° in MCP group and 8° ± 5° in SCP group. The average TK was significantly smaller in SCP group when compared with MCP group (P = 0.011) or NCP group (P < 0.01), while the average TK was significantly smaller in MCP group when compared with NCP group (P < 0.01). None of the other 4 parameters showed any significant difference between the 3 groups (P > 0.05).</p><p><b>CONCLUSIONS</b>Thoracic hypokyphosis is strongly associated with curve progression in thoracic IS patients. Pelvic sagittal profile may not be involved in the underlying mechanism of curve progression in thoracic IS patients.</p>

Association between tissue inhibitor of metalloproteinase-2 gene polymorphism and adolescent idiopathic thoracic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the association between the tissue inhibitor of metalloproteinase-2 (TIMP-2) gene polymorphisms with the predisposition and disease severity of thoracic adolescent idiopathic scoliosis (AIS).</p><p><b>METHODS</b>Three hundred and fifty-four female thoracic AIS patients treated from January 2007 to March 2009 and 210 healthy female who underwent health examination during March 2005 to June 2006 as normal controls were recruited in this study. One SNP-418G/C (rs8179090) in the promoter region were selected for TIMP-2 gene. PCR- RFLP was used for genotyping.</p><p><b>RESULTS</b>No significant differences of genotype and allele frequency distribution were found between AIS patients and normal controls (P > 0.05). In AIS patients, the frequency of C allele of the patients with the body mass index (BMI) < 17 kg/m(2) was significantly higher than those with the BMI > or = 17 kg/m(2) (P < 0.05), and the frequency of C allele of cases with the major Cobb angle > or = 40 degrees was significantly higher than that with Cobb angle < 40 degrees (P < 0.05). Among the patients who reached skeletal maturity without any interference of natural history, significantly higher average maximum Cobb angle was found in patients with GC and CC genotype compare with those with GG genotype.</p><p><b>CONCLUSIONS</b>The SNP-418G/C (rs8179090) in the promoter region of TIMP-2 gene may be associated with abnormal growth pattern and curve progression of thoracic AIS. TIMP-2 gene is a disease-modifier gene of thoracic AIS.</p>

Effects of doxazosin enantiomers on alpha-adrenoceptors of isolated rabbit blood vessels / 药学学报

Doxazosin, a high selective alpha1-adrenoceptor antagonist, is considered as the first-line therapy for the patients with benign prostatic hyperplasia (BPH) and also produce several side effects in cardiovascular system. In this study, we observed the isometric vasoconstrictive responses of the rabbit isolated arterial rings to electric field stimulation and noradrenaline ( NA ) to study the effects of R-doxazosin ( R-DOX ) and S-doxazosin ( S-DOX ) on the alpha1-adrenoceptor-regulated vasoconstrictive responses in the rabbit isolated ear artery, mesenteric artery and pulmonary artery, and the effects of higher concentration of S-DOX and R-DOX on presynaptic alpha2-adrenoceptor-regulated purinergic vasoconstriction in the rabbit isolated saphenous artery. We found that R-DOX and S-DOX competitively inhibited the vasoconstriction induced by NA in the rabbit isolated ear artery, mesenteric artery and pulmonary artery. The pA2 values of R-DOX and S-DOX against NA in the rabbit isolated ear artery, mesenteric artery and pulmonary artery were 7. 91 +/- 0. 03 and 7. 53 +/- 0. 05, 7. 80 +/- 0. 05 and 7. 29 +/-0. 07, 8. 32 +/- 0. 06 and 7. 97 +/- 0. 07, respectively. The pA2 values of R-DOX in the three arterial preparations were significantly higher than those of S-DOX (P < 0. 01). R-DOX and S-DOX at the concentrations of 0. 1 - 10 micromol x L (-1) did not affect the vasoconstriction induced by electric stimulation in the rabbit isolated saphenous artery. R-DOX and S-DOX at 100 micromol x L(-1) in the rabbit isolated saphenous artery completely inhibited the vascular responses to exogenous NA, but did not affect the vascular responses to exogenous adenosine triphosphate (1 mmol x L(-1) ). It is reasonable to suggest that R-DOX and S-DOX competitively inhibit the vasoconstriction induced by NA in the rabbit ear artery, mesenteric artery and pulmonary artery, and the pA2 values of S-DOX are significantly lower than those of R-DOX. The higher concentration (10 micromol x L(-1)) of R-DOX and S-DOX does not affect the presynaptic alpha2-adrenoceptors at sympathetic nerve terminals of the rabbit saphenous artery.