Diagnostic value of magnetic resonance imaging in neurovascular bundle injury during total hip arthroplasty.

OBJECTIVE: The objective of this study was to evaluate the diagnostic value of magnetic resonance imaging (MRI) in neurovascular bundle injury during total hip arthroplasty. PATIENTS AND METHODS: The magnetic resonance imaging (MRI) examinations of the hip joints of 429 patients were reviewed. The distances on the left and right sides were measured and recorded using small, hydrophilic gadolinium (III)-based chelates as contrast agents. The data were analyzed and handled using Statistical Product and Service Solutions (SPSS). RESULTS: The results showed that each measured distance in males was longer than in females, on both right and left sides (p<0.001). The coefficient of determination (R2) of the influencing factors on the three distances was found to be 0.162, 0.038, and 0.104, respectively, in multiple linear regressions. The results of the Pearson's correlation coefficient also suggested that there was a significant correlation (p<0.05). CONCLUSIONS: This study demonstrates that MRI can be a valuable diagnostic tool for neurovascular bundle injury during total hip arthroplasty. The gender difference in the measured distances indicates that sex should be considered when interpreting MRI findings.

[Intestinal microbiome and its relationship with necrotizing enterocolitis in very low birth weight preterm infants].

Objective: To explore the composition of intestinal microflora prior to onset of necrotizing enterocolitis (NEC) in very low birth weight preterm infants. Methods: This was a multicenter prospective nested case-control study. A total of 46 very low birth weight preterm infants (birth weight <1 500 g and gestional age <35 weeks) within 24 h of life admitted into Neonatal Intensive Care Unit of Children's Hospital of Soochow University and Suzhou Municipal Hospital from April 20 to November 20, 2018 were enrolled. Baseline clinical data and fecal samples of these infants were collected. The subsequent sampling time points were 1st, 4th and 7th day in the first week of life then once per week consecutively. The endpoint of sampling was NEC occurrence, patient discharge or the 8th week post-discharge, whichever came first. Fecal samples were analyzed by 16 S rDNA high-throughput nucleotide sequencing. The control cases were infants without NEC who were matched to the NEC cases with a ratio of 1∶1. The operational taxonomic units (OTU), sequence number and shannon diversity index of the fecal samples were analyzed. Continuous variables were compared with t-test or non-parametric test, and χ2 test or Fisher's exact test was used for categorical variables. Results: There were 23 patients in each group. The gestational age was (29.4±1.8) weeks in NEC group and (29.9±1.6) weeks in control group, including 13 males (57%) and 11 males (48%) in each group, respectively. Species abundance showed that the Firmicutes in both groups decreased temporarily at 7 days of age and then increased with age in control group, but not in NEC group, the Proteobacteria in both groups increased at 7 days of age and then decreased in control group, but kept increasing in NEC group. Regarding the other levels of taxonomy, compared with that of the control group, the NEC group had lower abundance of Proteobacteria, γ-proteobacteria and Enterobacteriaceae at 7 days of age, while higer abundance of Faecalibacterium at 14 days of age, meanwhile, lower Clostridium and Streptococcus at 21 days of age, lower Firmicutes, Clostridia and Clostridium perfringens and higher Proteobacteria and γ-proteobacteria at 28 days of age, these differences were all statistically significant (U=43.00, 43.00, 45.00, 80.00, 74.00, 76.00, 19.00, 8.00, 36.00, 25.00, 25.00,all P<0.05). The shannon index of NEC group was both lower than that of the controls at 21 days of age (2.4 (1.4, 3.0) vs. 3.1 (2.6, 4.0), U=67.00, P=0.027) and 28 days of age (2.4 (1.4, 2.8) vs. 3.9 (3.3, 4.2), U=12.00, P=0.001). Conclusions: The intestinal microflora profile of very low birth weight preterm infants has already changed prior to NEC development. The emergence of differential flora and the reduction of microflora diversity may facilitate early identification and prevention of NEC.

[Lamotrigine induced hypersensitivity syndrome in children: a case report].

Drug induced hypersensitivity syndrome (DIHS) is often manifested as severe systemic drug trans-reactions characterized by acute and extensive skin lesions (mostly measles-like rash), fever, enlargement of lymph nodes, multiple organ involvement (hepatitis, nephritis, and pneumonia), eosinophilia and mononucleosis,within 2-6 weeks of the application of sensitizing drugs. In the early stage of the lesion, macular papules or erythema multiforme were common, and in severe cases, exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis were also common. Most of them developed after taking allergic drugs for 2-6 weeks (average: 3 weeks). Symptoms persisted after discontinuation of allergic drugs. It takes more than one month to alleviate, which may endanger life in severe cases. Documents report that the most common drugs causing DIHS are phenytoin sodium, carbamazepine and phenobarbital aromatic drugs. However, it was reported that phenobarbital sodium was the most common anticonvulsant among allergenic drugs in children, followed by antipyretics, analgesics and antibiotics, which may be related to the spectrum of childhood diseases and the particularity of the drug. Lamotrigine has been reported to cause DIHS in adults in China, but less in children. In order to improve the understanding of clinical diagnosis and treatment of DIHS in children, reduce misdiagnosis, missed diagnosis, and untimely treatment, and prevent the aggravation of the disease, we studied the case of a 4-year-old 7-month-old girl who presented with systemic erythematous papules, fever, hepatosplenomegaly, marked increase of white blood cells, marked decrease of anemia and platelets, abnormal liver function and coagulation routine after taking lamotrigine for one month due to epilepsy seizures. Now, according to the DIHS diagnostic criteria established by Registration of Severe Cutaneous Adverse Reactions Drug Review Group in 2007, plasma exchange was immediately given to replace the toxic metabolites in hemorrhagic plasma, and methylprednisolone was given intravenously for three days. At the same time, after symptomatic supportive treatments, such as loratadine and albumin, the condition gradually improved without recurrence. Through a case report of Drug reaction with eosinophilia and systemic symptoms in a child caused by lamotrigine, we can strengthen our understanding and improve the level of diagnosis and treatment of drug hypersensitivity syndrome in children. Lamotrigine can cause DIHS in children, which is very dangerous. Early diagnosis and early withdrawal of allergenic drugs, plasma exchange and glucocorticoid therapy are the key to treatment.

Nurses' knowledge, attitudes and practices related to physical restraint: a cross-sectional study.

AIM: To investigate nurses' knowledge, attitudes and practices related to physical restraint in tertiary hospitals and identify the factors that influence physical restraint use. BACKGROUND: Physical restraint is used to maintain patient safety. Nurses play an important role in the restraint process. It is important to identify their understanding, feelings and approach regarding the use of physical restraint. INTRODUCTION: Physical restraint is widely practiced in hospitals in China. However, it results in a range of serious negative consequences. This article provides a clear description of nurses' knowledge, attitudes and practices related to physical restraint. METHODS: A cross-sectional survey was conducted. The participants were asked to complete a questionnaire examining their knowledge, attitudes and practices related to physical restraint use. A total of 200 questionnaires were distributed in four tertiary hospitals in Hubei Province, China between August and October 2014. RESULTS: The nurses' responses indicated a good level of knowledge regarding physical restraint use. However, they held some misconceptions. The nurses' attitudes towards physical restraint tended to be neutral. The nurses were well experienced in the use of physical restraint. Nurses who had received on-the-job training performed better than those who had received no training related to knowledge and practices regarding physical restraint use. CONCLUSIONS AND IMPLICATION FOR NURSING/HEALTH POLICY: In-service training is highly recommended for nursing managers to improve nurses' physical restraint related knowledge and practices. Regulations regarding the use of restraints should be established as soon as possible by healthcare administration system. IMPLICATIONS FOR NURSING: Nurses should be open to evaluate and improve their views and attitudes regarding effective physical restraint use via multidimensional interventions.

[Expression of type 1 and type 2 cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis at earlier stage].

Objectives: To explore the expression regulation of type 1 and type 2 (Th1 and Th2) cytokines from serum of coal miners and the evaluation in surveillance of coal workers' pneumoconiosis, 630 coal miners were studied. Methods: A total of 90 male patients diagnosed as coal workers' pneumoconiosis (CWP) in a institute for occupational health and 19 male workers newly diagnosed as CWP patients was chosen as CWP group with simple random sampling method from a coal mine group from January 2013 to December in 2015. 180 male coal miners with abnormal but not diagnosed as CWP were selected as CWP suspected group with simple random sampling methods, meanwhile 180 male coal miners with normal chest X-ray photograph was as dust-exposed group by 1∶1 matched as age. And 161 healthy males accepted pre-employed examination were selected as control group, CWP suspected group, dust-exposed group and control group called as non-CWP group. According to screening test and diagnosis test, the basic information and occupational history of all subjects were collected, and cytokines including IL-1ß, IL-8, IFN-γ, IL-6 and IL-10 of serum were detected. Receiver operator characteristic (ROC) curve was used to determine the optimal cutoff value of each cytokine. Area under curve (AUC), the validity and reliability were calculated and judged. Results: The average age of control group, dust-exposed group, CWP suspected group and CWP group were (27.4±5.0) , (43.4±10.7) , (48.2±6.2) , (64.7±7.0) years old, respectively. The median level of IL-1ß, IL-8, IFN-γ and IL-6 in cases group (1 638.30, 2 099.49, 815.18,140.32 pg/ml) were higher than that of non-cases group (1 445.57, 1 402.26, 736.38, 95.73 pg/ml) (P<0.05) . The level of IL-8 (1 503.99 pg/ml) in CWP suspected group was higher than that of control group (1 295.67 pg/ml) and dust-exposed group (1 376.94 pg/ml) , but the level of IL-10 (654.08 pg/ml) was lower than that of control group (596.64 pg/ml) . The ratio of IFN-γ/IL-6 ranged from 5 to 8, and the ratio in CWP group (5.87) was lower than that of non-CWP group (7.61) . The IL-6 and IL-8 among the subjects of dust-exposed group in terms of the age distribution of among had reached statistical significance. According to ROC, the cutoff value of IL-1ß, IL-6, IL-8, IL-10 and INF-γ reached 1 582.65, 116.53, 1 791.54, 581.08 and 792.69 pg/ml, respectively. The AUC was 0.668, 0.895, 0.859, 0.716 and 0.637, respectively. It was found that IL-6 and IL-8 could be used as biomarkers in detecting CWP, the sensitivity and specificity was 82.6% and 84.6%, 78.0% and 84.8%, respectively; Youden's index was 0.674 and 0.628 and the consistency rate was 84.3% and 83.7%, while Kappa value was 0.55 and 0.52. Conclusion: There was Type 1 and type 2 cytokine dysregulation in CWP patients. IL-6 and IL-8 can be used as effective biomarkers to forecast lung injury before X-ray changes.

Down-regulation of miR-1236-3p is correlated with clinical progression and unfavorable prognosis in gastric cancer.

OBJECTIVE: MiRNAs have been considered to participate in many processes of various cancers, including gastric cancer (GC). However, the significance of miRNAs in the progression prognosis of GC is largely unknown. The goal of this study was to determine the expression level of miR-1236-3p in GC and its clinical association. PATIENTS AND METHODS: Clinical specimens from GC patients were obtained to quantify the expression level of miR-1236-3p using quantitative Real-time PCR. The correlation between the miR-1236-3p levels and the clinicopathological factors of the GC patients was analyzed. The association between miR-1236-3p expression and overall survival was estimated by the Kaplan-Meier method. The significance of different variables with respect to survival was analyzed using the univariate and multivariate Cox proportional hazards model. RESULTS: We found that miR-1236-3p was significantly downregulated in GC tissues compared to non-tumor gastric tissues (p < 0.01). The levels of miR-1236-3p expression were associated significantly with clinical stage (p = 0.002), lymph node metastasis (p = 0.000) and distant metastasis (p = 0.017). Kaplan-Meier survival analysis showed that patients in the high miR-1236-3p expression group had better overall survival than those in the low miR-1236-3p expression group (p = 0.0039). Moreover, we confirmed that miR-1236-3p was an independent poor prognostic factor for GC patients through univariate and multivariate analysis. CONCLUSIONS: Our findings provide evidence that miR-1236-3p expression is frequently decreased in GC tissues, and its low expression may be a significant prognostic factor for poor survival in GC patients.

Polymer Surface Textured with Nanowire Bundles to Repel High-Speed Water Drops.

Water drops impacting windshields of high-speed trains and aircraft as well as blades in steam turbine power generators obliquely and at high speeds are difficult to repel. Impacting drops penetrate the void regions of nanotextured and microtextured superhydrophobic coatings, with this pinning resulting in the loss of drop mobility. In order to repel high-speed water drops, we nanotextured polymer surfaces with nanowire bundles separated from their neighbors by microscale void regions, with the nanowires in a bundle separated from their neighbors by nanoscale void regions. Water drops with speeds below a critical speed rebound completely. Water drops with speeds exceeding a critical speed rebound partially, but residual droplets that begin to be pinned undergo a spontaneous dewetting process and slide off. The natural oscillations of residual droplets drive this dewetting process in the interbundle void regions, resulting in a transition from the sticky Wenzel state to the slippery Cassie state without external stimuli.

Identifying the germ cells during embryogenesis and gametogenesis by germ-line gene vasa in an anadromous fish, American shad Alosa sapidissima.

American shad Alosa sapidissima, an anadromous clupeid, exhibits variation in reproductive strategies, including semelparity and iteroparity. It provides an excellent model for studying the behaviour of germ cells in anadromous fish during their migration from sea to river. The vasa gene was characterized in A. sapidissima as a germ-cell marker to elaborate the process of germ-cell development and differentiation in anadromous species. A complementary (c)DNA fragment of 819 bp, partial open reading frame (ORF), was cloned by degenerate PCR and named as ASvas. In adult A. sapidissima, vasa transcript was exclusively detected in gonads by reverse-transcription (RT)-PCR. Through chromogenic in situ hybridization, the vasa messenger (m)RNA was specifically detected in primordial germ cells (PGC) in embryos and germ cells at early stages in ovary and testis. Besides, the cellular distribution profile of Vasa protein also proved that vasa gene could be used as a germ-line marker to trace the PGCs migration during embryogenesis and the germ-cell differentiation during gametogenesis in A. sapidissima. During embryogenesis, the migrating PGCs were clearly detected at tail-bud stage and the PGCs reached the genital ridge at the stage of pre-hatching stage in A. sapidissima embryos. During gametogenesis, the Vasa protein was dynamically expressed in differentiating germ cells at different stages in adult gonads. As far as we know, this is the first report to demonstrate the PGCs migration and germ-cell differentiation through vasa gene expression in the anadromous species. The findings will pave a way for investigating germ-cell development and maturation in the A. sapidissima and other anadromous fish.

Effects of tetramethylpyrazine phosphate on pancreatic islet microcirculation in SD rats.

PURPOSES: Abnormal islet microcirculation impetus the insulin production and accelerates progression of Type 1 and 2 diabetes. In this study, we investigated whether tetramethylpyrazine phosphate (TMPP), a vasoactive substance, could regulate the islet microcirculation and insulin concentration and improve glycaemia in SD rats. METHODS: SD rats were randomly divided into two groups, the control and TMPP groups. Each group was further divided into three subgroups according to the intravenous injection of either saline, 15 or 30% glucose. The non-radioactive microsphere technique was adopted to measure the organ blood flow. Nitric oxide synthase (NOS) blocker L-NAME was used to address whether NO was involved in mediating the vasoactive effects of TMPP. RESULTS: In the TMPP group, TMPP increased the PBF (pancreatic blood flow), IBF (islet blood flow), and fIBF (fraction of islet blood flow out of pancreatic blood flow) by 57, 76 and 47%, respectively, after 30% glucose infusion, compared with the control, indicating that TMPP could regulate islet microcirculation. Furthermore, TMPP induced a 66% elevation of IBF and 37% of fIBF in the 30% glucose subgroups than the 15% ones. In 30% glucose-treated subgroups, TMPP improved the blood glucose concentration by 10%, compared with the control (19.3 ± 0.64 vs 17.32 ± 0.56 mmol/l, P < 0.05), without influencing the insulin secretion. Blocking NO formation prevented the enhanced PBF and IBF, evoking by TMPP with 30% glucose. CONCLUSIONS: TMPP can regulate the pancreatic islet microcirculation and possess a hypoglycemia effect after glucose infusion through affecting the islet microcirculation.

Short Communication Development of microsatellite markers and genetic diversity analysis for Pelodiscus sinensis.

Pelodiscus sinensis is a common freshwater soft-shell turtle found in China, and is an important aquaculture species. In this study, 20 polymorphic microsatellite primers were developed from the transcriptome. The genetic diversity of three populations of P. sinensis was evaluated, using 72 individuals. The number of alleles per locus ranged from 3 to 26. The observed and expected heterozygosities varied from 0.208 to 0.958, and from 0.302 to 0.963, respectively. The polymorphic information content varied from 0.283 to 0.953. No significant linkage disequilibrium was detected. These markers will be useful for future population genetic studies and molecular breeding of P. sinensis.

[Quantitative analysis of the corneal subbasal nerves in different degrees of dry eye with AutoCAD].

OBJECTIVE: To evaluate the practical value of AutoCAD in quantitative analysis of corneal subbasal epithelial nerves with different degrees of dry eye. METHODS: Ninety patients were divided into groups of mild, moderate, and severe dry eye, 30 patients (60 eyes) in each group. And 30 healthy volunteers were recruited as the normal control group. Confocal microscopy was used to observe the length of the subbasal epithelial nerve plexus. The images were analyzed by AutoCAD software to determine the density (mm/mm(2)), the number of branches, and the curvature score of the subbasal epithelial nerves. These data of patients with dry eye and the controls were statistically compared, by analysis of variance(ANOV). RESULTS: By AutoCAD software, quantitative analysis of the corneal subbasal epithelial nerves was successfully performed. The nerve density in the patients with mild dry eye[(16.70±3.43) mm/mm(2)] was not significantly different from the controls[(15.87 ± 2.75) mm/mm(2)] (P=0.880), but the number of nerval branches 13.43±2.46 and the curvature 3.10±0.80 increased significantly (P<0.001). The nerve density in the patients with moderate and severe dry eye was significantly different from that in the normal control group (F=114.739, P<0.001). The neural density was significantly lower in the patients with severe dry eye than the controls, but there was no significant difference in the curvature scores between the two groups (P= 0.557). CONCLUSIONS: AutoCAD software is useful in the quantitative analysis of corneal nerve images under a confocal microscope. The corneal subbasal epithelial nerve density, the number of branches, and the curvature of the nerves are related to the degree of dry eye, and may be used as clinical indicators.

Predicting the incidence of hand, foot and mouth disease in Sichuan province, China using the ARIMA model.

Hand, foot and mouth disease (HFMD) is an infectious disease caused by enteroviruses, which usually occurs in children aged <5 years. In China, the HFMD situation is worsening, with increasing number of cases nationwide. Therefore, monitoring and predicting HFMD incidence are urgently needed to make control measures more effective. In this study, we applied an autoregressive integrated moving average (ARIMA) model to forecast HFMD incidence in Sichuan province, China. HFMD infection data from January 2010 to June 2014 were used to fit the ARIMA model. The coefficient of determination (R 2), normalized Bayesian Information Criterion (BIC) and mean absolute percentage of error (MAPE) were used to evaluate the goodness-of-fit of the constructed models. The fitted ARIMA model was applied to forecast the incidence of HMFD from April to June 2014. The goodness-of-fit test generated the optimum general multiplicative seasonal ARIMA (1,0,1) × (0,1,0)12 model (R 2 = 0·692, MAPE = 15·982, BIC = 5·265), which also showed non-significant autocorrelations in the residuals of the model (P = 0·893). The forecast incidence values of the ARIMA (1,0,1) × (0,1,0)12 model from July to December 2014 were 4103-9987, which were proximate forecasts. The ARIMA model could be applied to forecast HMFD incidence trend and provide support for HMFD prevention and control. Further observations should be carried out continually into the time sequence, and the parameters of the models could be adjusted because HMFD incidence will not be absolutely stationary in the future.