Epidemiology of Sapovirus Infections in a Birth Cohort in Peru.

Background: Sapovirus is one of the primary viral causes of acute gastroenteritis (AGE), especially where rotavirus vaccination has been implemented. The characteristics and impact of natural infection at the community level, however, have not been well documented. Methods: Stool samples were analyzed from 100 children randomly selected from a community-based birth cohort study in Peru. All diarrheal and 1 nondiarrheal stools collected trimonthly from children up to age 2 years (n = 1669) were tested for sapovirus detection. Viral shedding duration was determined by testing additional weekly samples (n = 440) collected before and after a sapovirus-positive sample. Results: The incidence of sapovirus infection in the first and second years of life was 4.3 and 11.1 per 100 child-months, respectively. By age 2 years, 82% of children had at least 1 sapovirus infection, and 64% had at least 1 sapovirus-associated diarrhea episode. The median shedding period was 18.5 days. In 112 of 175 infections, 14 genotypes from 4 genogroups (GI, GII, GIV, and GV) were determined. Among genogroups, GI were more frequently found in symptomatic infections than in asymptomatic infections (odds ratio, 3.1; 95% confidence interval, 1.3-7.4). Fifty-nine children had serial sapovirus infections, but only 3 had repeated infection of the same genotype. Conclusions: Sapovirus was frequently detected in children with AGE at the community level during the first 2 years of life. Serial sapovirus infections by multiple genotypes in a child suggest genotype-specific immunity from each infection, which needs to be taken into account for vaccine development.

The Clinical Study on Short-Term Efficacy of Pelvic Magnetic Stimulation Combined with Pelvic Muscle Biofeedback on Female Idiopathic Overactive Bladder.

Objective: To evaluate the short-term efficacy of pelvic magnetic stimulation combined with pelvic muscle biofeedback on female Idiopathic Overactive Bladder (IOAB). Methods: 96 cases of IOAB females were randomly divided into control group (magnetic stimulation treatment n=48) and observation group (magnetic stimulation with biofeedback n=48). All the patients were dealt with the sacralneuromagnetic stimulation (once, qod), with 5 times in total. Then the patients in observation group were processed with biofeedback (10 times). Overactive Bladder Symptom Score (OABSS), Patients Perception Bladder Condition (PPBC) and Incontinence Quality of Life Scale (I-QOL) were evaluated as the indexes. Results: The effective rate of control group and observation group respectively were 89.58% and 93.75%. There were significant differences (P=0.67). The OABSS and PPBC of two groups were decreased, I-QOL were increased after treatment (P<0.05). Difference was statistically significant in OABSS three months after treatment between the two groups (P=0.00).The recurrence rate of three months after treatment of the two groups were 18.75% and 6.38% (P=0.04). Conclusions: Both magnetic stimulation alone and magnetic stimulation with biofeedback were effective and safe in female patients with IOAB. Magnetic stimulation with biofeedback may reduce the recurrence rate and continue to improve the symptoms in a certain extent.

Correlation between promoter methylation of p14(ARF), TMS1/ASC, and DAPK, and p53 mutation with prognosis in cholangiocarcinoma.

BACKGROUND: To study the methylation status of genes that play a role in the p53-Bax mitochondrial apoptosis pathway and its clinical significance in cholangiocarcinoma. PATIENTS AND METHODS: Out of 36 cases cholangiocarcinoma patients from April 2000 to May 2005 were collected.Promoter hypermethylation of DAPK, p14(ARF), and ASC were detected by methylation-specific PCR on cholangiocarcinoma and normal adjacent tissues samples. Mutation of the p53 gene was examined by automated sequencing. Correlation between methylation of these genes and/or p53 mutation status with clinical characteristics of patients was investigated by statistical analysis. RESULTS: We found 66.7% of 36 cholangiocarcinoma patients had methylation of at least one of the tumor suppressor genes analyzed. p53 gene mutation was found in 22 of 36 patients (61.1%). Combined p53 mutation and DAPK, p14(ARF), and/or ASC methylation was detected in 14 cases (38.9%). There were statistically significant differences in the extent of pathologic biology, differentiation, and invasion between patients with combined p53 mutation and DAPK, p14(ARF), and/or ASC methylation compared to those without (P < 0.05). The survival rate of patients with combined DAPK, p14(ARF), and ASC methylation and p53 mutation was poorer than other patients (P < 0.05). CONCLUSION: Our study indicates that methylation of DAPK, p14(ARF), and ASC in cholangiocarcinoma is a common event. Furthermore, p53 mutation combined with DAPK, p14(ARF), and/or ASC methylation correlates with malignancy and poor prognosis.

Serum concentrations of perfluoroalkyl and polyfuoroalkyl substances and determinants in men of childbearing age / 环境与职业医学

Background Perfluoroalkyl and polyfluoroalkyl substances (PFASs) exposure may affect male reproductive health. There are regional differences in PFASs exposure levels among men of childbearing age in China, and current research results on associated influencing factors are inconsistent. Objective To investigate the levels of PFASs in serum and their determinants among men of childbearing age. Methods The participants (n=113, 22-45 years old) were from a cross-sectional study of exposure to environmental pollutants and male reproductive health damage in Hubei Province conducted from April to June 2013 at the Reproductive Medicine Center of Tongji Hospital, Wuhan, Hubei Province. Eleven kinds of PFASs were measured in serum by isotopic dilution-high performance liquid chromatography-tandem mass spectrometry. The included PFASs were prefluorohexanoic acid (PFHxA), perfluoroheptanoic acid (PFHpA), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUdA), perfluorododecanoic acid (PFDoA), perfluorotridecanoic acid (PFTrDA), perfluorotetradecanoic acid (PFTeDA), perfluorohexane sulfonate (PFHxS), and perfluorooctane sulfonate (PFOS). Information about participants' demographic characteristics, lifestyle, and habits was collected by a set of self-designed questionnaires. The associations of demographic characteristics, lifestyle, and habits with exposure to PFASs were analyzed by linear regression. Results The major components of PFASs were PFOS and PFOA, and the concentrations expressed as M (P25, P75) were 8.31 (4.90, 17.79) ng·mL−1 and 2.77 (2.18, 3.46) ng·mL−1, respectively. The positive rates of six PFASs (PFOA, PFNA, PFDA, PFUdA, PFHxS, and PFOS) were 100%, followed by PFDoA and PFTrDA (87.61% and 88.59%, respectively). The linear regression results showed that age was positively associated with the levels of Σ8PFASs (sum of the concentrations of the eight PFASs with a positive rate greater than 80%) (P < 0.05). The concentration of serum PFOA in men with monthly family income of 2000-4000 yuan was 53.73% (P < 0.01) higher than those in men with monthly family income of <2000 yuan. The serum concentrations of PFNA and PFTrDA were both 32.31% (P < 0.05) higher in men with monthly family income ≥4000 yuan than those in men with monthly family income <2000 yuan. The serum concentration of PFHxS in men who used plastic cups was 33.64% (P < 0.01) higher than that in men who did not report oral contact with plastic products (plastic tableware, plastic cups, and plastic bags for packing food). The serum concentrations of PFHxS, PFOS, and Σ8PFASs were 33.64% (P < 0.01), 43.33% (P < 0.01), and 36.34% (P < 0.05) higher in men who bathed with laundry soap than those in men who did not use detergents. Men who bathed with toilet soap had a 34.99% (P < 0.05) higher serum concentration of PFHxS than those who bathed without detergents. Conclusion Men of childbearing age are exposed to PFASs extensively. Age, monthly household income, usage of laundry soap or toilet soap in bathing, and usage of plastic cups may influence the level of PFASs in serum. However, further investigation is needed to confirm these results.

Value of transrectal multimodal ultrasound combined with prostate specific antigen in predicting clinically organ-confined prostate cancer / 中华健康管理学杂志

Objective:To explore the predictive value of transrectal multimodal ultrasound and prostate specific antigen (PSA) in clinically organ-confined prostate cancer.Methods:It was a cross-sectional study. The clinical data of patients with suspected prostate nodules treated in the First Hospital of Shanxi Medical University from May 2014 to April 2020 were analyzed retrospectively. Of the patients, 48 cases of clinically organ-confined prostate cancer and 51 cases of benign prostatic hyperplasia confirmed by clinical data and pathology were selected as research objects. The characteristics of transrectal multimodal ultrasound in the two groups were compared. Combined with PSA, logistic regression analysis was applied to screen the statistically significant features, and then the diagnosis model was established, and odds ratio of the variables were compared. The receiver operating characteristic (ROC) curve was constructed to analyze the predicting ability of the diagnosis model.Results:Four features were obtained with logistic regression analysis finally, including enhancement type, enhancement degree, elastography mode and PSA. The odds ratio of enhancement degree was higher than those of the other independent variables. The area under ROC curve of the diagnosis model was 0.868 ( P<0.01), the cut-off value was 0.514. The sensitivity and specificity of the diagnosis model in predicting clinically organ-confined prostate cancer was 79.2% and 80.4%, respectively. Conclusions:This combined diagnosis model of transrectal multimodal ultrasound and PSA has a certain clinical value in predicting clinically organ-confined prostate cancer.

Epidemiological characteristics of 17 imported patients infected with SARS-CoV-2 Omicron variant / 中南大学学报(医学版)

OBJECTIVES@#With the continuous generation of new variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pressure of epidemic prevention and control continues to increase in China. Omicron with stronger infectiousness, immune escape ability and repeated infection ability spread to many countries and regions around the world in a short period of time. China has also successively reported cases of imported Omicron infections. This study aims to understand the epidemiological characteristics of Omicron variant via analyzing the epidemiological characteristics of imported patients with Omicron in Hunan Province, and to provide reference for preventing and controlling the imported epidemics.@*METHODS@#The clinical data of imported patients with coronavirus disease 2019 admitted to Hunan Province from December 16 to December 31, 2021 were retrospectively collected. The epidemiological information, general information, clinical classification, clinical symptoms, vaccination status, and lung CT were analyzed. Nasopharyngeal swabs and blood samples were collected. Virus nucleic acid was detected by magnetic beads method using SARS-CoV-2 detection kit. Ct values of ORF1ab gene and N gene were compared between asymptomatic infected patients and confirmed patients. The specific IgM and IgG antibodies were detected by chemiluminescence assay using SARS-CoV-2 IgM test kit and SARS-CoV-2 IgG test kit, respectively. Ct values of IgM and IgG antibodies were compared between asymptomatic infected patients and confirmed patients.@*RESULTS@#Seventeen patients with Omicron variant infection were treated in Hunan, including 15 confirmed patients (5 common type and 10 mild type) and 2 asymptomatic infection patients. The 17 patients were all Chinese, they were generally young, and 16 were male. There were 9 patients with diseases. Of them 3 patients had respiratory diseases. All 17 patients had completed the whole process of vaccination, but only one person received a booster shot of SARS-CoV-2 vaccine. The clinical manifestations of the patients were mild, mainly including dry/painful/itchy throat, cough, and fatigue. The total protein and creatine in the asymptomatic infection and confirmed cases infected with Omicron variant were all within the normal range, but other biochemical indicators were abnormal. There were the significant differences in C-reactive protein and fibrinogen between asymptomatic infection and confirmed patients (both P<0.05). There were more patients with elevated C-reactive protein in confirmed patients than without confirmed ones. The detection rate of specific IgM and IgG antibodies on admission was 100%, and there was no significant difference in the specific antibody levels between asymptomatic infection and confirmed patients (P>0.05). There were no significant differences in Ct values of ORF1ab gene and N gene (21.35 and 18.39 vs 19.22 and 15.67) between the asymptomatic infection and the confirmed patients (both P>0.05). Only 3 patients had abnormal lung CT, showing a small amount of patchy and cord-like shadows. One of them had no abnormality on admission but had pulmonary lesions and migratory phenomenon after admission.@*CONCLUSIONS@#The patients with Omicron variant tend to be young people and have milder clinical symptoms, but the viral load is high and the infectiveness is strong. Therefore, the timely identification and effective isolation and control for asymptomatic infections and confirmed patients with mild symptoms are extremely important. In terms of epidemic prevention and control, the government still needs to strengthen the risk control of overseas input, adhere to normalized epidemic prevention and control measures, to effectively control the source of infection, cut off the route of transmission, and protect vulnerable people.

Risk factors of long-term mortality in patients with acute pulmonary embolism and the predictive value of echocardiography / 中华全科医师杂志

Objective:To investigate the risk factors of long-term mortality in patients with acute pulmonary embolism (APE) and to explore the predictive value of echocardiography.Methods:A total of 109 APE patients admitted in First Hospital of Shanxi Medical University between December 2010 and November 2014 were enrolled in this study. APE was diagnosed by computed tomography pulmonary angiography (CTPA) or ventilation-perfusion pulmonary scintigraphy. Transthoracic echocardiography (TTE) parameters and clinical parameters within 48 h of onset were collected. All the patients were treated with standard anticoagulation, thrombolysis, or thrombectomy. Regular follow-up was carried out, with the average follow-up period of (7.20±1.04) years. The patients were divided into survival group and fatal group according to their follow-up results. The echocardiographic parameters and primary biochemical laboratory parameters within 48 h after onset were compared between the survival group and the fatal group by t test or χ 2 test. Cox regression analysis was conducted to analyze the influencing factors of long-term prognosis of patients with APE. Survival analysis was performed in patients with echocardiographic assessment of right ventricular (RV) enlargement and/or dysfunction and without RV enlargement and/or dysfunction by Kaplan-Meier method, and the survival curves were plotted. The comparison between the two groups was performed by log-rank test. Results:The average follow-up period was (7.20±1.04) years. Fourteen patients were lost in the follow-up, and 95 patients were included in the final analysis, among whom 58 survived and 37 died with a fatality rate of 39.0%. Cox regression analysis showed that age ( HR=2.32, 95% CI:1.31-4.13, P=0.004), malignancy ( HR=6.49, 95% CI:2.32-18.14, P<0.001), right atrial (RA)/left atrial (LA) area ratio ( HR=2.01, 95% CI:1.16-3.48, P=0.013), RV enlargement and/or dysfunction ( HR=5.90, 95% CI: 1.45-23.94, P=0.013), Charlson comorbidity index (CCI) score ( HR=1.75, 95% CI: 1.04-2.96, P=0.035), low oxygen saturation ( HR=1.70, 95% CI:1.14-2.53, P=0.009) were independent risk factors associated with long-term mortality in patients with APE. Kaplan Meier survival curve analysis showed that the cumulative survival rates of patients with RV enlargement and/or dysfunction at 1, 3, 5 and 7 years were 92.8%, 66.7%, 59.4% and 52.2% respectively, and those without RV enlargement and/or dysfunction were 96.2%, 92.3%, 84.6% and 84.6%,respectively (log rank test, P=0.006). Conclusions:Patients with APE have high long-term mortality. Early echocardiographic RV enlargement and/or dysfunction, RA/LA area ratio, age, malignant tumor, CCI score and low oxygen saturation are independent risk factors related to long-term mortality in patients with APE. Ultrasound evaluation of patients with RV enlargement and/or dysfunction has a certain value in predicting long-term mortality in patients with pulmonary embolism.

Expressions and Significance of Livin, Survivin, Pak-1 and Caspase-7 in Different Gastric Mucosal Lesions / 胃肠病学

Background: Livin, survivin and Pak-1 are all related to the occurrence and development of gastric cancer. Livin and survivin play their roles by inhibiting the activity of caspase-7. Aims: To investigate the expressions and significance of livin, survivin, Pak-1 and caspase-7 in different gastric mucosal lesions. Methods: A total of 45 cases of gastric cancer and paracancerous tissue, 45 chronic atrophic gastritis with intestinal metaplasia, 45 chronic non-atrophic gastritis from Jan. 2015 to Dec. 2019 at the Second Affiliated Hospital of Baotou Medical College were collected. Immunohistochemistry was used to detect the expressions of livin, survivin, Pak-1 and caspase-7, and their correlations with clinicopathological features of gastric cancer patients were analyzed. Results: Compared with chronic non-atrophic gastritis group and paracancerous group, the positivity expression rates of livin, survivin and Pak-1 in intestinal metaplasia group were significantly increased (P<0.05), while caspase-7 was significantly decreased (P<0.05). Compared with intestinal metaplasia group, the positivity expression rates of livin, survivin and Pak-1 in gastric cancer group were significantly increased (P<0.05), while caspase-7 was significantly decreased (P<0.05). Expressions of livin, survivin, Pak-1 and caspase-7 were correlated with the differentiation degree, TNM stage, depth of infiltration and lymph node metastasis in patients with gastric cancer (P<0.05). Conclusions: Livin, survivin, Pak-1 and caspase-7 play important roles in the occurrence and development of gastric cancer.

Risk factors for 10-year mortality in patients with stable chronic obstructive pulmonary disease / 中华全科医师杂志

Objective:To explore the independent risk factors that predict 10-year mortality in patients with stable chronic obstructive pulmonary disease(COPD).Methods:The baseline data from a prospective cohort study were analyzed and long-term follow-up were performed. Patients with confirmed diagnosis of stable COPD were consecutively enrolled in the outpatient clinic from January 2010 to December 2010, and were followed up until December 31, 2020. Cox regression analysis was used to determine the independent risk factors for all-cause mortality and mortality from respiratory causes in stable COPD patients.Results:A total of 182 stable COPD patients were enrolled and followed up for a median of 89 months. The 10-year mortality was 51.1%(93/182), and 9 patients died within one year. The leading cause of death was respiratory disorder, followed by cardiovascular and cerebrovascular diseases. The risk factors independently associated with all-cause mortality included old age( HR=1.936,95% CI: 1.610~2.328, P<0.01), increased baseline COPD Assessment Test(CAT)( HR=1.331,95% CI: 1.049-1.689, P=0.02) and the increased CAT in one year( HR=1.314,95% CI: 1.197-1.420, P<0.01). The risk factors independently associated with respiratory cause mortality included increased baseline CAT( HR=1.719,95% CI: 1.026-2.880, P=0.04), emphysema index(LAA%)( HR=1.062,95% CI: 1.007-1.120, P=0.03), and one year inecreased CAT( HR=1.342,95% CI: 1.198-1.505, P<0.01)was a protective factor. Conclusions:Old age, baseline CAT, one year increased in CAT and LAA% were independent influencing factors for 10-year mortality of stable COPD patients.

Prenatal ultrasonic diagnosis of umbilical cord ulcer: analysis of three cases and literature review / 中华围产医学杂志

Objective:To investigate the features, diagnostic value and clinical significance of prenatal ultrasound for umbilical cord ulcer (UCU).Methods:Ultrasonographic characteristics of three fetuses with UCU diagnosed at Guangzhou Women and Children's Medical Center from January 2014 to June 2020 were reviewed. Relevant articles published from January 1, 1990, to June 1, 2020, were retrieved from Wanfang, CNKI and PubMed databases and analyzed. Likelihood ratio, adjusted Chi-square test and Fisher's exact test were used to analyze the association between the pathological results and fetal outcomes. Results:(1) Among the three fetuses with UCU, two were complicated by upper gastrointestinal obstruction and one by intrauterine infection. Two of them survived and one died after birth. Prenatal ultrasound examination of the umbilical cord and amniotic cavity showed one case was normal, while the other two showing features such as flocculent hypoechoic sign around the umbilical cord, cloudy hyperechoic sign ejecting from the umbilical cord lesion in dynamic observation, exposed umbilical vessels and ribbon-like echo around the umbilical cord. (2) No reported case of UCU had been found in any publications in China. A total of 39 reported cases of UCU complicated by duodenal or jejunal obstruction were retrieved from English literature, among which intrauterine fetal death, neonatal death and live births accounted for 30.8% (12/39), 28.2% (11/39) and 41.0% (16/39), respectively. Six cases with intrauterine abnormalities detected by prenatal ultrasound survived after emergent cesarean section, showing a positive detection rate of 15.4% (6/39), of which three obtained a snapshot of umbilical cord bleeding and three were characterized by lamellar and linear echoes around the amniotic cavity or umbilical cord. Hemorrhagic amniotic fluid was observed in 66.7% (26/39) of the fetuses and decreased heart rate occurred in 35.9%(14/39). The site, number and pathological grade of UCU were not related to the pregnancy outcomes (all P>0.05). Conclusions:Prenatal ultrasound for detecting abnormalities in umbilical cord and amniotic cavity is of a certain value in the diagnosis of UCU. Lamellar and linear echoes around the umbilical cord may be the ultrasonographic characteristics of UCU. The real-time detection of UCU bleeding by prenatal ultrasound can provide direct evidence for timely clinical treatment.

Clinical analysis of 10 children with cardiac thrombus associated with Mycoplasma pneumoniae infection / 中华实用儿科临床杂志

Objective:To explore the case characteristics, treatment and prevention measures of cardiac thrombus in children caused by Mycoplasma pneumoniae infection, so as to improve the clinicians′ understanding of the disease.Methods:The clinical data of 10 children with cardiac thrombus caused by Mycoplasma pneumoniae infection treated in Department of Respiratory Intervention, Jinan Children′s Hospital from November 2015 to January 2020 were retrospectively analyzed, including datum of cases, laboratory results, imaging data and follow-up results.Results:A total of 10 children (7 males and 3 females) were included with the median age of 6.5 years old, and all had fever for more than 1 week.The plasma D-dimer (D-D) of 9 children was significantly increased, and the C-reactive protein (CRP) of 6 children was increased.After anti-infection treatment, the absorption of pneumonia with atelectasis was better than before.The embolus disappeared after operation in 1 case, and the remaining 9 cases received anticoagulant therapy, among which 7 cases received Heparin anticoagulant therapy alone: cardiac embolus disappeared during hospitalization in 2 cases, disappeared after 2 weeks of oral administration of Dipyridamole outside the hospital in 1 case, and the other 4 cases received Heparin anticoagulant therapy alone during hospitalization with poor effect, embolus disappeared in 2 cases 4 and 5 months after discharge respectively, and 2 cases were not reexamined due to personal reasons; the embolus disappeared 2 months after discharge in 2 cases who were changed to low-molecular weight Heparin + Warfarin anticoagulant therapy after failing to respond to Heparin anticoagulant therapy.All the 10 cases showed no symptoms of tachypnea or chest pain during telephone follow-up.Conclusions:Children with long fever time and significantly elevated CRP and D-D are more likely to form thrombus.Anticoagulant therapy is effective after thrombosis, and surgical thrombectomy can be performed in children who have failed to respond to anticoagulant therapy or worry about complications caused by dropped embolus.

Clinical and Histological Characteristics of Esophageal Heterotopic Gastric Mucosa: Analysis of 1 229 Cases / 胃肠病学

Background: There is still controversy whether the existence of esophageal heterotopic gastric mucosa (EHGM) and its histological type are related to the laryngopharyngeal symptoms. Aims: To analyze the clinical and histological characteristics of EHGM and its correlation with gastroesophageal reflux. Methods: A retrospective study was conducted in consecutive gastroscopy-proved EHGM cases from September 2018 to January 2020 at the Second Affiliated Hospital of Baotou Medical College. Besides clinical data review and questionnaire survey on reflux symptoms, histological typing of EHGM and immunohistochemistry were also performed in some cases. Results: A total of 1 229 cases of EHGM were recruited. The male-to-female ratio was 1.67:1, and middle-aged people were predominant. Most of the heterotopic mucosa were located 15-18 cm away from the incisors, and were mainly single. Two hundred and ninety-four cases (23.9%) were complicated with reflux esophagitis (RE), of which Los Angeles grade A and B accounted for 96.6%. Regurgitation/acid reflux (15.5 %) and heartburn (12.3%) were the most common esophageal symptoms, while extraesophageal symptoms were rare. Histological typing was obtained in 57 cases, of which, 37 (64.9%) were cardia-type, 18 (31.6%) were fundic-type, and 2 (3.5%) were mixed type. There were no significant differences in gender, age, location and number of EHGM, expression levels of H

Ultrasonographic diagnosis of congenital membranous jejunal stenosis and gastric duplication cyst in a newborn: a case report.

INTRODUCTION: Congenital jejunal stenosis and gastric duplication cysts are very rare congenital anomalies of the gastrointestinal tract in the newborn. We present a case of congenital membranous jejunal stenosis associated with gastric duplication cysts, which was diagnosed by ultrasonography. To the best of our knowledge, this is the first report of ultrasonographic diagnosis of congenital membranous jejunal stenosis associated with a gastric duplication cyst in a newborn. CASE PRESENTATION: A 1-month-old Chinese baby girl presented with projectile vomiting and hyperpyrexia for 3 days. An upper gastrointestinal contrast study showed incomplete duodenal obstruction; however, ultrasonography revealed congenital membranous jejunal stenosis associated with a gastric duplication cyst. After surgical excision of the jejunal membrane and gastric duplication cyst, she recovered well with no bilious vomiting at the 1-year follow-up. CONCLUSION: Ultrasonography is a useful tool for the evaluation of membranous jejunal stenosis and the identification of small, asymptomatic gastrointestinal duplication cysts.

Effect of Brucea javanica oil emulsion on proliferation inhibition of multi-drug resistant K562/VCR cell line of human leukemia / 中国医师进修杂志

Objective:To investigate the inhibitory effect of Brucea javanica oil emulsion on the proliferation of human leukemia multi-drug resistant K562/VCR cell line.Methods:Methyl thiazolyl tetrazolim (MTT) colorimetric method was used to detect the proliferation inhibition rate of K562/VCR cells in vitro after intervention with Brucea javanica oil emulsion.Results:With the increasing concentration of Brucea javanica oil emulsion (125,250,500,750,1 000 mg/L), the inhibition ratio to K562 cells continued to increase ( P<0.05), and with the increasing duration of Brucea javanica oil emulsion(24,48,72 h), the inhibition ratio to K562 cells continued to increase ( P<0.05). With the increasing concentration of Brucea javanica oil emulsion(500,750,1 000,1 500,2 000 mg/L), the inhibition ratio of K562/VCR cells continued to increase ( P<0.05), and with the increasing action time of Brucea javanica oil emulsion (24,48,72 h), the inhibition ratio of K562/VCR cells continued to increase ( P<0.05). With the increasing concentration of Brucea javanica oil emulsion(blank control group , Brucea javanica oil emulsion group for 500,750,1 000,1 500 mg/L), the G 0/G 1 ratio in K562/VCR cell cycle continued to increase, while the S ratio and G 2/M ratio continued to decrease ( P<0.05). After injection of Brucea javanica oil emulsion, ADM concentration (fluorescence intensity) in the cells increased significantly(161.4 ± 10.9 vs. 95.9 ± 8.1)( P<0.05). Conclusions:Brucea javanica oil emulsion can inhibit the proliferation of multi-drug resistant K562/VCR cell lines and induce the arrest of multi-drug resistant cell cycle. Brucea javanica oil emulsion increasesd the accumulation of chemotherapeutic agents in multi-drug resistant K562/VCR cell lines.

Application of satisfaction index of basic medical insurance for rural and urban residents to pupils familial decision making in Kunming and Changsha City / 中南大学学报(医学版)

OBJECTIVES@#To verify the applicability and extensibility of the satisfaction index of basic medical insurance for rural and urban residents, and to explore the mechanism responsible for the satisfaction index in Kunming and Changsha City, and provide references for effective management and policy making.@*METHODS@#A stratified cluster sampling method was conducted. A total of 560 familial decision makers were randomly selected in 24 classes of 14 schools of Kunming and Changsha City. Model reliability was tested by SPSS18.0. In addition, Smart PLS 3.0 was applied to conduct model validity test, calculate the satisfaction index, and to compare the model path coefficients of Kunming and Changsha by multi-group analysis.@*RESULTS@#In the application of the satisfaction index of basic medical insurance for rural and urban residents in Kunming, Cronbach's α of the model was 0.93, split-half reliability coefficient was 0.90, and the latent variable composite reliability coefficient values were more than 0.86; the latent variable average variance extraction (AVE) values were greater than 0.66, and the square root of the AVE of each latent variable (all greater than 0.66) was larger than the correlation coefficient with other latent variables. The factor loading values were greater than 0.70, with statistical significance. The basic health insurance satisfaction index of Kunming and Changsha was 60.40 and 52.05, respectively. The difference between the path coefficient of Kunming and Changsha was not statistically significant except the path from public satisfaction to public loyalty. Perceived value had the largest direct and total effect on public satisfaction latent variable in Kunming City. While the perceived value had the largest direct effect on public satisfaction, and the perceived quality had the largest total effect on public satisfaction in Changsha City.@*CONCLUSIONS@#The satisfaction index model reflects the satisfaction of pupils' basic medical insurance for urban and rural residents, and it also shows good reliability and validity in Changsha and Kunming. What's more the model can be extended to the national level to evaluate the satisfaction of basic medical insurance for urban and rural residents for primary school students. The basic health insurance satisfaction index of familial decision makers in Kunming is higher than that of Changsha. There are differences between Kunming and Changsha in the influential mechanism of the satisfaction index of for Chinese pupils with basic medical insurance for rural and urban residents, and the measures taken by the government and relevant departments to improve the satisfaction of basic medical insurance should be based on local conditions.

Analysis of clinical features of 58 patients with severe or critical 2019 novel coronavirus pneumonia / 中华急诊医学杂志

Objective:To analyze the clinical features of severe or critical 2019 novel coronavirus pneumonia (NCP) patients.Methods:Clinical data of 58 patients with severe or critical NCP in Wuhan Union Hospital, Tongji Medical College of Huazhong University of Science and Technology from January 29 to February 26, 2020 were collected. The general information, clinical symptoms, results of blood test and chest computed tomography (CT) imagings, treatments and outcomes of patients were analyzed retrospectively.Results:Among the 58 patients, 36 patients (62.1%) were severe and 22 (37.9%) were critical, 28 (48.3%) were male and 30 (51.7%) female, with an average age of (62.12±12.95) years. Twenty-eight patients (48.2%) had previous underlying diseases, including 21 patients (36.2%) with hypertension, 11 patients (19.0%) with diabetes mellitus, 6 patietns (10.3%) with coronary heart disease, 2 patients (3.4%) with chronic renal failure, and 1 patient (1.7%) with malignant tumor. The symptoms included fever (54 cases, 93.1%), dyspnea (48 cases, 82.8%), cough (46 cases, 79.3%), muscle soreness (32 cases, 55.2%), sore throat (15 cases, 25.9%), and diarrhea (6 cases, 10.3%). Decreased or increased white blood cell count was found in 7 patients (12.1%) and 6 patietns (10.3%). Decreased percent of lymphocyte, increased percent of neutrophil, and decreased hemoglobin level were found in 35 patients (60.3%), 27 patients (46.6%), and 24 patients (41.4%), respectively. Elevated CRP, PCT and D-dimmer level were demonstrated in 38 patients (65.5%), 36 patients (62.1%), and 45 patients (77.5%). Increased level of ALT, AST, LDH and decreased serum albumin were found in 32 patients (55.2%), 25 patients (43.1%), 39 patietns (67.2%) and 43 patietns (74.1%), respectively. The main features of CT imaging were diffuse lesion in both lungs, which were mainly manifested as multiple patchy shadows and ground-glass shadows, bilateral and peripheral distribution, consolidation and interlobular septal thickening. Twenty-nine patients (50.0%) were treated with antibiotics, and 14 patients (24.1%) with systemic glucocorticoid. In addition to supportive and antivirus treatment, oxygen therapy methods including nasal catheter (9 cases, 15.5%), oxygen mask (33 cases, 56.9%), high-flow nasal catheter (8 cases, 13.3%) and invasive mechanical ventilation were adopted. Twenty-one patients (36.2%) were discharged from the hospital, 27 patients (46.6%) in remission were still in the isolation wards, 3 patients (5.2%) were transferred to the ICU for further treatment, and 7 patients (12.1%) died.Conclusions:Severe and critical NCP are at higher risk in the elderly and those having underlying diseases. Severe/critical NCP patients often show extrapulmonary abnormity as well as lung dysfunction. Comprehensive treatment as early as possible is the key to improve the prognosis and reduce the mortality.

Value of high-frequency ultrasound combined with contrast-enhanced features in predicting cervical lymph node metastasis in thyroid micropapillary carcinoma / 中华全科医师杂志

Objective:To explore the predictive value of high frequency ultrasound and contrast-enhanced imaging features in predicting cervical lymph node metastasis of papillary thyroid microcarcinoma (PTMC).Methods:A retrospective analysis of 184 patients with PTMC confirmed by surgery and pathology in the First Hospital of Shanxi Medical University from March 2015 to December 2018 was performed. According to the presence or absence of lymph node metastasis, the patients were divided into metastasis group and non-metastasis group. Univariate analysis was used to compare the features of high frequency ultrasound and contrast-enhanced ultrasound in the two groups, and multivariate regression analysis was used to determine the independent risk factors of cervical lymph node metastasis, and their prediction value was analyzed with ROC curves.Results:Among 184 patients, 50 (27.2%) had lymph node metastasis. Univariate analysis showed that age (χ 2=10.026) , number of nodules (χ 2=10.497) , calcification (χ 2=17.414) , aspect ratio (χ 2=4.564) , nodule location (χ 2=20.542) , enhancement time (χ 2=7.882) , enhancement mode (χ 2=6.416) and enhancement intensity (χ 2=9.899) were significantly associated with cervical lymph mode metastasis (all P<0.05). Multivariate analysis showed that age<45 years old ( OR=2.626, 95 %CI:1.141-6.052) , multifocal lesions ( OR=3.648, 95 %CI:1.542-8.631) , microcalcification ( OR=2.925, 95 %CI:1.055-8.115) and equal/high enhancement ( OR=8.042, 95 %CI: 1.879-34.429) were independent risk factors for lymph node metastasis ( P<0.05). The area under the ROC curve of above indicators combined was 0.762. Conclusions:High frequency ultrasonography combined with contrast-enhanced imaging can provide useful information for predicting cervical lymph node metastasis of PTMC. For PTMC patients aged<45 years with multifocal lesions, microcalcification and equal/high enhancement, the risk of cervical lymph node metastasis is significantly increased.

Predictive role of clinical features in patients with coronavirus disease 2019 for severe disease / 中南大学学报(医学版)

OBJECTIVES@#Since the outbreak of coronavirus disease 2019 (COVID-19), it has spread rapidly in China and many other countries. The rapid increase in the number of cases has caused widespread panic among people and has become the main public health problem in the world. Severe patients often have difficult breathing and/or hypoxemia after 1 week of onset. A few critically ill patients may not only rapidly develop into acute respiratory distress syndrome, but also may cause coagulopathy, as well as multiple organs failure (such as heart, liver and kidney) or even death. This article is to analyze the predictive role of clinical features in patients with COVID-19 for severe disease, so as to help doctor monitor the severity-related features, restrain the disease progress, and provide a reference for improvement of medical treatment.@*METHODS@#The clinical data of 208 patients with COVID-19 who were isolated and treated in Changsha Public Health Treatment Center from January 17, 2020 to March 14, 2020 were collected. All patients were the mild and ordinary adult patients on admission, including 105 males and 103 females from 19 to 84 (median age 44) years old. According to the "Program for the diagnosis and treatment of novel coronavirus (COVID-19) infected pneumonia (Trial version 7)" issued by the General Office of National Health Committee and Office of State Administration of Traditional Chinese Medicine as the diagnostic and typing criteria. According to progression from mild to severe disease during hospitalization, the patients were divided into a mild group (=183) and a severe transformation group (=25). The clinical features such as age, underlying disease, blood routine, coagulation function, blood biochemistry, oxygenation index, and so on were analyzed. Among them, laboratory tests included white blood cell (WBC), lymphocytes (LYM), neutrophil (NEU), hemoglobin (Hb), platelet (PLT), prothrombin time (PT), plasma fibrinogen (Fib), activated partial prothrombin time (APTT), thrombin time (TT), -dimer, total bilirubin (TBIL), albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), serum creatinine (Cr), creatine kinase (CK), creatine kinase isoenzyme-MB (CK-MB), lactate dehydrogenase (LDH), C-reactive protein (CRP), and oxygen partial pressure in arterial blood. Partial pressure of oxygen in arterial blood/fractional concentration of inspiratory oxygen (PaO/FiO) was calculated. The variables with statistical significance were analyzed by logistic regression analysis.@*RESULTS@#Patients in the severe transformation group had more combined underlying diseases than those in the mild group (<0.05). From the perspective of disease distribution, patients in the severe transformation group had more combined hypertension (<0.05). In the severe transformation group, PT was significantly longer, the levels of Fib, ALT, AST, CK, LDH, and CRP were significantly higher than those in the mild group (<0.05 or <0.001), while LYM, ALB, and PaO/FiO were significantly lower than those in the mild group (<0.05 or <0.001). Logistic regression analysis was performed on clinical features with statistically significant differences. Combined with hypertension, LYM, PT, Fib, ALB, ALT, AST, CK, LDH, and CRP as independent variables, and having severe disease or not was the dependent variable. The results show that combined hypertension, decreased LYM, longer PT, and increased CK level were independent risk factors that affected the severity of COVID-19 (<0.05).@*CONCLUSIONS@#The patients with mild COVID-19 who are apt to develop severe diseases may be related to combined hypertension, decreased LYM, and longer PT, and increased CK level. For the mild patients with these clinical features, early intervention may effectively prevent the progression to severe diseases.

Value of Exhaled Nitric Oxide and FEF(25–75) in Identifying Factors Associated With Chronic Cough in Allergic Rhinitis

PURPOSE: Chronic cough in allergic rhinitis (AR) patients is common with multiple etiologies including cough variant asthma (CVA), non-asthmatic eosinophilic bronchitis (NAEB), gastroesophageal reflux-related cough (GERC), and upper airway cough syndrome (UACS). Practical indicators that distinguish these categories are lacking. We aimed to explore the diagnostic value of the fraction of exhaled nitric oxide (FeNO) and forced expiratory flow at 25% and 75% of pulmonary volume (FEF(25–75)) in specifically identifying CVA and NAEB in these patients. METHODS: Consecutive AR patients with chronic cough were screened and underwent induced sputum, FeNO, nasal nitric oxide, spirometry, and methacholine bronchial provocation testing. All patients also completed gastroesophageal reflux disease questionnaires. RESULTS: Among 1,680 AR patients, 324 (19.3%) were identified with chronic cough, of whom 316 (97.5%) underwent etiology analyses. Overall, 87 (27.5%) patients had chronic cough caused by NAEB, 78 (24.7%) by CVA, 16 (5.1%) by GERC, and 81 (25.6%) by UACS. Patients with either NAEB or CVA (n = 165, in total) were further assigned to a common group designated as CVA/NAEB, because they both responded to corticosteroid therapy. Receiver operating characteristic curves of FeNO revealed obvious differences among CVA, NAEB, and CVA/NAEB (area under the curve = 0.855, 0.699, and 0.923, respectively). The cutoff values of FeNO at 43.5 and 32.5 ppb were shown to best differentiate CVA and CVA/NAEB, respectively. FEF(25–75) was significantly lower in patients with CVA than in those with other causes. A FEF(25–75) value of 74.6% showed good sensitivity and specificity for identifying patients with CVA. CONCLUSIONS: NAEB, CVA, and UACS are common causes of chronic cough in patients with AR. FeNO can first be used to discriminate patients with CVA/NAEB, then FEF(25–75) (or combined with FeNO) can further discriminate patients with CVA from those with CVA/NAEB.

A personalized 3D printing guide in total hip arthroplasty / 中华创伤骨科杂志

Objective To explore the role of a customized 3D printing guide in total hip arthroplasty (THA).Methods A retrospective analysis was performed of the 60 patients who had been treated by THA for avascular necrosis of the femoral head at Department of Orthopaedics and Traumatology,Foshan Hospital of Traditional Chinese Medicine from January 2018 to May 2019.Half of them used the personalized 3D printing guide in THA and half did not.In the guide group there were 17 men and 13 women with an age of 53.4 ± 8.9 years while in the conventional group 19 men and 11 women with an age of 54.7 ± 9.4 years.The acetabular cups were orientated at an abduction angle of 40° and an anteversion angle of 15°.The intraoperative blood loss,operation time and acetabular abduction angle were compared between the 2 groups.Results The 2 groups were comparable due to insignificant differences between them in gender,age,body mass,cause of disease or staging of avascular necrosis of the femoral head (P ＞0.05).The guide group had significantly less intraoperative blood loss (286.7 ± 150.8 mL) and operation time (90.5 ± 34.4 min) than the conventional group did (438.3 ± 292.6 mL and 115.6 ± 58.6 min) (P ＜0.05).The acetabular cup abduction was 38.9° ± 4.2° in the guide group and 37.2° ± 5.5° in the conventional group,showing no significant difference (t =1.315,P =0.194).Conclusion Use of a personalized 3D printing guide in THA can shorten the time for installation of an acetabular prosthesis and reduce the amount of intraoperative blood loss,but it leads to insignificant difference in the postoperative acetabular cup abduction compared with no use of the guide.