In vitro study on human cytomegalovirus affecting early pregnancy villous EVT's invasion function.

BACKGROUND: Human cytomegalovirus (HCMV) is the most common pathogen in uterus during pregnancy, which may lead to some serious results such as miscarriage, stillbirth, cerebellar malformation, fetus developmental retardation, but its pathogenesis has not been fully explained. The hypofunction of extravillous cytotrophoblast (EVT) invasion is the essential pathologic base of some complications of pregnancy. c-erbB-2 is a kind of oncogene protein and closely linked with embryogenesis, tissue repair and regeneration. Matrix metalloproteinase (MMP) is one of the key enzymes which affect EVT migration and invasion function. The expression level changes of c-erbB-2, MMP-2 and MMP-9 can reflect the changes of EVT invasion function. RESULTS: To explore the influence of HCMV on the invasion function of EVT, we tested the protein expression level changes of c-erbB-2, MMP-2 and MMP-9 in villous explant cultured in vitro infected by HCMV, with the use of immunohistochemistry SP method and western blot. We confirmed that HCMV can reproduce and spread in early pregnancy villus; c-erbB-2 protein mainly expressed in normal early pregnancy villous syncytiotrophoblast (ST) remote plasma membrane and EVT, especially remote EVT cell membrane in villous stem cell column, little expressed in ST proximal end cell membrane and interstitial cells; MMP-2 protein primarily expressed in early pregnancy villous EVT endochylema and rarely in villous trophoblast (VT), ST and interstitial cells; MMP-9 protein largely expressed in early pregnancy villous mesenchyme, EVT and VT endochylema. Compared with control group, the three kinds of protein expression level in early pregnancy villus of virus group significantly decreased (P < 0.05). CONCLUSION: HCMV can infect villus in vitro and cause the decrease of early pregnancy villous EVT's invasion function.

Murine model for congenital CMV infection and hearing impairment.

BACKGROUND: Congenital cytomegalovirus (CMV) infection is the leading cause of sensorineural hearing loss (SNHL), and SNHL is the most frequent sequela of congenital CMV infection. But the pathogenic mechanism remains unknown, and there is no ideal CMV intrauterine infection animal model to study the mechanisms by which SNHL develops. METHODS: We established the congenital murine cytomegalovirus (MCMV) infection model by directly injecting the virus into the placenta on day 12.5 of gestation. Then, we observed the development and the MCMV congenital infection rate of the fetuses on the day they were born. Furthermore, we detected the auditory functions, the conditions of the MCMV infection, and the histological change of the inner ears of 28-day-old and 70-day-old offspring. RESULTS: Both the fetal loss rate and the teratism rate of offspring whose placentas were inoculated with MCMV increased, and their body length, head circumference, and weight decreased. The hearing level of offspring both decreased at both 28- and 70-days post birth; the 70-day-old mice developed lower hearing levels than did the 28-day old mice. No significant inflammatory changes in the cochleae of the mice were observed. MCMV DNA signals were mainly detected in the spiral ganglion neurons and the endolymph area, but not in the perilymph area. The number of neurons decreased, and their ultrastructures changed. Moreover, with age, the number of neurons dramatically decreased, and the ultrastructural lesions of neurons became much more severe. CONCLUSIONS: The results suggest that the direct injection of MCMV into the placenta may efficiently cause fetal infection and disturb the intrauterine development of the fetus, and placental inoculation itself has no obvious adverse effects on offspring. The reduction in the number of spiral ganglion neurons and the ultrastructural lesions of the neurons may be the major cause of congenital CMV infection-induced progressive SNHL.

[Single nucleotide polymorphism of rs28416520 in Piwil1 gene promoter region is associated with an increased risk of gastric cancer].

OBJECTIVE: To analyze the correlation between the single nucleotide polymorphisms (SNPs) in the promoter of Piwil1 gene and gastric cancer. METHODS: The expression of Piwil1 mRNA in the tumor tissues of 3 patients with gastric cancer was detected by RT-qPCR, and RNA-Sequencing data from the Cancer RNA-Seq Nexus were analyzed for Piwil1 mRNA expression in gastric patients. Blood samples were collected from 24 gastric cancer patients and 29 healthy control subjects for PCR amplification of Piwil1 gene promoter region. The SNP loci in the promoter region of Piwil1 gene were determined by direct sequencing, and the results were analyzed by SnapGene software. RESULTS: Analysis of the data from Cancer RNA-Seq Nexus and the results of RT-qPCR in 3 gastric cancer patients all showed significantly increased Piwil1 expression in gastric cancer tissues compared with the adjacent tissues. Seven SNP loci in two CpG regions of the Piwil1 gene promoter were genotyped, and only one SNP locus was found to be related to gastric cancer. The frequencies of GG, GA, and AA genotypes at the rs28416520 locus in CpG 67 region were 79.2%, 16.7%, and 4.1% in the gastric cancer group, and were 37.9%, 55.2%, and 6.9% in the control group, respectively, showing a significantly higher frequency of the GG genotype in gastric cancer group (OR=0.144, 95%CI: 0.045-0.564, χ2=9.071, P < 0.01). The frequency of allele G of the rs28416520 locus was significantly higher in gastric cancer group than in the control group (87.5% vs 65.5%; OR=0.271, 95%CI: 0.099-0.766, χ2=6.856, P < 0.01). The genotype or allele frequencies of the other 6 SNPs locus did not differ significantly between gastric cancer group and control group. CONCLUSIONS: The expression of Piwil1 is increased in gastric cancer tissues as compared with the adjacent tissues. The GG genotype and G allele of rs28416520 within CpG 67 region are associated with an increased risk of gastric cancer.

[rhPDCD5 suppresses pro-inflammatory cytokine secretion and proliferation and induces apoptosis of activated lymphocytes from rats with collagen-induced arthritis].

OBJECTIVE: To investigate the effect of recombinant human PDCD5 (rhPDCD5) treatment in a rat model of bovine II collagen (CII)-induced arthritis (CIA) on inflammatory cytokine secretion, proliferation and apoptosis of activated lymphocytes and explore the mechanisms of rhPDCD5-induced immunosuppression on activated lymphocytes. METHODS: Female Wistar rats were randomly divided into normal control group, CIA+ ovalbumin (OVA) group, CIA+ rhTNFR: Fc group, and CIA+rhPDCD5 group. The rats in the latter 3 groups received intraperitoneal injections of OVA (14 mg/kg), rhTNFR: Fc (3.5 mg/kg) or rhPDCD5 (14 mg/kg) from day 2 to day 26 following CII injection. On day 28, the spleens of the rats were harvested for preparing single cell suspensions of splenocytes, which were activated by CII (20µg/mL) or anti-CD3 (1µg/mL)+ anti-CD28 (2µg/mL) for 48 h and 72 h. The production of interferon-γ(IFN-γ) and interleukin-17A (IL-17A) by the activated lymphocytes was determined by ELISA of the culture supernatants. The proliferation and apoptosis of the activated lymphocytes were assessed using [3H]-thymidine incorporation assay and flow cytometry, respectively. RESULTS: Compared with those in CIA + OVA group, IFN-γand IL-17A secretions by the activated lymphocytes from rhPDCD5-treated CIA rats significantly decreased. RhPDCD5 treatment of the CIA rats obviously suppressed the proliferation and promoted apoptosis of the lymphocytes activated by CII or by anti-CD3 + anti-CD28. CONCLUSIONS: rhPDCD5 reduces pro-inflammatory cytokine secretion, inhibits the proliferation and promotes activation-induced cell death of activated CD4 + lymphocytes to produce immunosuppression in rat models of CIA.

Application of CICARE communication model in patient communication in the waiting room for cardiac interventional therapy / 中国医学伦理学

ObjectiveTo explore the application effect of the CICARE communication model in patient communication in the waiting room for cardiac interventional therapy. MethodsThe 108 patients in the waiting room for cardiac interventional therapy at a hospital from January 2023 to May 2023 were selected as the study subjects. Among them， 55 patients from January to March 2023 were assigned to the control group， and 53 patients from April to May 2023 were assigned to the intervention group. The control group received the traditional communication model for communication and health education， and the intervention group received the CICARE communication model for communication and health education. The intervention effects were compared between the two groups. ResultsAfter implementing the CICARE communication model， the preoperative anxiety level of patients in the intervention group was significantly lower than that in the control group ［（12.30±4.30） Vs. （15.41±2.35）， P<0.01］. The intervention group had a significantly better understanding of surgical objectives and procedures ［（4.70±0.54） Vs. （3.66±0.67）， P<0.001］， preoperative preparation （P<0.001）， intra-operative position and communication ［（3.89±0.32） Vs. （3.03±0.57）， P<0.001］， and post-operative precautions ［（5.26±0.71） Vs. （4.17±0.71）， P<0.001］ than the control group. In addition， the number of people in the intervention group who was satisfied with the evaluation of nursing work （χ2=23.923， P<0.001） and the overall satisfaction score were significantly higher than those in the control group ［（68.48±6.42） Vs. （45.79±12.56）， P<0.001］. ConclusionPatient education based on the CICARE communication model can effectively inprove communication efficiency， improve the body stress response， enhance patient satisfaction with nursing work， and promote a harmonious nurse-patient relationship.

[Kirenol relieves dextran sulfate sodium-induced ulcerative colitis in mice by inhibiting inflammatory cytokines and inducing CD4+ T lymphocyte apoptosis].

OBJECTIVE: To investigate whether kirenol, the major pharmacologically active compound of the Chinese medicinal herb Herba Siegesbeckiae, can protect mice from dextran sulfate sodium (DSS)-induced ulcerative colitis (UC). METHODS: C57BL/6 mice with or without kirenol pretreatment were treated with DSS in drinking water for 7 days to induce UC. The symptoms of UC including weight loss, diarrhea and bloody stool were observed daily and graded using the disease activity index (DAI). Colon injury of the mice was assessed by measuring the length of the colon and HE staining of the colon tissue. The levels of inflammatory cytokines produced by the mesenteric lymph nodes (MLNs) lymphocytes were measured using enzyme-linked immunosorbent assay; the apoptosis of the lymphocytes and CD4+ T cells was analyzed using flow cytometry. RESULTS: The mice receiving pretreatment with kirenol showed obviously ameliorated symptoms of UC and milder pathological changes in the colon as compared with the control mice. Kirenol treatment significantly down-regulated the secretion of IFN-γ, IL-17A, IL-6 and TNF-α by the MLNs lymphocytes and increased the apoptosis of lymphocytes, especially CD4+ T cells in the DSS-treated mice. CONCLUSIONS: Kirenol can protect against T cell-mediated colon injury in DSS-treated mice possibly by suppressing the secretion of inflammatory mediators and inducing apoptosis of the inflammatory lymphocytes.

Prediction of Coagulation Factor Ⅷ Level in Chinese Hemophilia A Patients by the Pharmacokinetic Management Tool myPKFiT / 中国医学科学院学报

Objective To evaluate the performance of myPKFiT,a tool guiding the dosing of antihemophilic factor (recombinant) plasma/albumin-free method (rAHF-PFM),in maintaining the coagulation factor Ⅷ (FⅧ) level above a target threshold at the steady state and estimating the pharmacokinetics (PK) parameters in hemophilia A patients in China. Methods The data of 9 patients with severe hemophilia A in a trial (CTR20140434) assessing the safety and efficacy of rAHF-PFM in the Chinese patients with hemophilia A were analyzed.The myPKFiT was used to predict the adequate dose to maintain a patient's FⅧ level above target threshold at the steady state.Furthermore,the performance of myPKFiT in estimating the pharmacokinetics parameters of individuals was evaluated. Results Twelve combinations of two dosing intervals and six sparse sampling schedules were investigated,and 57%-88% of the patients remained the FⅧ level above the target threshold of 1 U/dl (1%) for at least 80% of the dosing interval.The clearance and time to FⅧ level of 1% obtained from sparse sampling by myPKFiT were similar to those obtained from extensive sampling. Conclusions The myPKFiT can provide adequate dose estimates to maintain the FⅧ level above the target threshold at the steady state in Chinese patients with severe hemophilia A.Moreover,it demonstrates good performance for estimating key pharmacokinetics parameters,including clearance and time to FⅧ level of 1%.

Effects of low-carbohydrate diet versus low-fat diet on non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials / 中华临床营养杂志

Objective:To compare the effects of low-carbohydrate diet (LCD) and low-fat diet (LFD) in the lifestyle intervention of non-alcoholic fatty liver disease (NAFLD) through a meta-analysis of randomized controlled trials.Methods:PubMed, Embase, Web of Science, Cochrane, CNKI and Wanfang were searched for relevant studies and study references and conference proceedings were manually searched. Two authors independently screened the items retrieved, extracted the data and assessed the quality of included studies. Meta-analysis was performed using R4.4.1 and RevMan5.4.1. Data were pooled using random-effects models and potential sources of heterogeneity were investigated using stratified meta-analysis. Funnel plots and Peters' test were used to assess publication bias.Results:Nine studies with a total of 510 participants met our inclusion criteria. Meta-analysis results showed that LCD and LFD interventions had similar effects on the reduction of intrahepatic lipid content in NAFLD patients ( SMD: -0.31,95% CI: 0.97 to 0.35, P = 0.36). There were no significant differences in changes of alanine aminotransferase ( SMD: -0.25, 95%CI: 0.91 to 0.41, P = 0.45) and aspartate aminotransferase ( SMD: -0.45, 95%CI: 1.63 to 0.72, P = 0.45) levels, either. Subgroup analyses implied that the duration of different interventions might be the cause of heterogeneity across studies. No significant publication bias was showed in the meta-analysis. Conclusion:Current evidence from randomized controlled studies does not support the superiority of LCD over LFD in the treatment of NAFLD.

The role of autophagy in the pathogenesis of children immune thrombocytopenia / 国际儿科学杂志

Immune thrombocytopenia (ITP) is a common hemorrhagic disorder among children.Its pathogenesis is mainly based on impaired platelet production or increased platelet destruction.The development of ITP is not just due to abnormalities in the immune system.With the role of autophagy being revealed, more and more studies have proven its importance in hematopoietic stem cells, megakaryocytes and platelets.The paper aims to review the role of autophagy in the pathogenesis of ITP.

Relationship between urinary iodine level before 131I treatment and excellent response in differentiated thyroid carcinoma patients with low-to-intermediate risk / 中华核医学与分子影像杂志

Objective:To explore the relationship between level of urinary iodine excretion (UIE) before 131I treatment and excellent response (ER) in low-to-intermediate risk differentiated thyroid carcinoma (DTC) patients. Methods:A retrospective analysis was performed with 432 DTC patients (124 males, 308 females, age: (42.1±11.0) years) who were treated with 131I for the first time after total thyroidectomy from June 2017 to October 2018 in Department of Nuclear Medicine, the Second Hospital of Shandong University. All patients were divided into 4 groups: G1, group 1, UIE<50 μg/L; G2, group 2, 50 μg/L≤UIE<100 μg/L; G3, group 3, 100 μg/L≤UIE<200 μg/L; G4, group 4, UIE≥200 μg/L. Patients were given 131I with a fixed dose (3 700 MBq). Response was evaluated 6 to 8 months after 131I treatment: ER, indeterminate response (IDR), biochemical incomplete response (BIR), and structural incomplete response (SIR). χ2 test and Kruskal-Wallis rank sum test were used to analyze the data. The adjusted standardized residual (residual) and Cramer′s V between G1-G4 and different treatment reactions were calculated to judge the difference among groups. IDR, BIR and SIR were classified into non-ER (NER) group, and binary logistic regression analysis and receiver operating characteristic (ROC) curve analysis were performed to find the influencing factors of treatment reactions. Results:There were 51.9%(41/79), 64.9%(98/151), 53.8%(63/117), 30.6%(26/85) patients achieved ER in G1-G4, and the proportion of G4 was significantly lower than that of G1-G3 ( χ2 values: 7.695-25.697, all P<0.05), and there was no significant difference among G1-G3 ( χ2 values: 0.072-3.667, all P>0.05). The UIE level of patients in ER, IDR, BIR, SIR group was 87.5(57.0, 129.0), 97.0(55.7, 211.5), 141.0(74.0, 231.0), 148.0(68.5, 221.0) μg/L( H=15.977, P=0.001), and there was significant difference between those of patients in ER and SIR groups ( χ2=8.729, P=0.019). There was a certain correlation between UIE levels and different treatment reactions (Cramer′s V=0.151, P=0.001). UIE (≥200 μg/L), gender and preablative stimulated thyroglobulin could be used as independent factors affecting ER ( Wald values: 4.029, 7.185, 56.301, all P<0.05). Conclusion:Among DTC patients with low-to-intermediate risk, 131I treatment does not affect ER when the UIE level is less than 200 μg/L, while 131I treatment should be performed carefully when the UIE level is more than 200 μg/L.

Clinical application of extracorporeal membrane oxygenation in 4 children with severe adenovirus pneumonia / 中华实用儿科临床杂志

Objective:To retrospectively analyze the clinical application of extracorporeal membrane oxygenation (ECMO) in severe adenovirus pneumonia, and to evaluate the application value of ECMO in children with severe adenovirus pneumonia.Methods:Children diagnosed with severe adenovirus pneumonia and intervened with ECMO in the Hunan Children′s Hospital from January 1, 2018 to December 31, 2019 were recruited in this study for analyzing.The gender, age, clinical manifestations, mechanical ventilation duration, ECMO duration, the length of hospital stay, complications and prognosis were collected and analyzed.Results:A total of 4 children were included in the study, involving 2 cases were successfully evacuated from ECMO.Finally, 3 children died, and 1 case survived.Three death cases had a longer than 18 days of duration from the onset to the start with ECMO.Their ventilator assist time before star-ting ECMO was 3-5 days, and ECMO intervention time was longer, with the maximum of 27.5 days.The survived case had an 11-day duration from the onset to the start with ECMO, and the ventilator assisted time and ECMO intervention time were 5 days, and less than 10 days, respectively.Conclusions:ECMO treatment for children with severe adenovirus pneumonia has a low success rate, but it is still the most important way to save children.Early application of ECMO can improve the prognosis of children with severe adenovirus pneumonia.

Mechanism Analysis of Bianketong Tablet in Treatment of Constipation-predominant Irritable Bowel Syndrome Based on Network Pharmacology and Bioinformatics / 中国实验方剂学杂志

Objective:To explore the potential mechanism of Bianketong tablet （BKT） in the treatment of constipation-predominant irritable bowel syndrome （C-IBS） based on network pharmacology and bioinformatics. Method:The BKT-meridian network was constructed for analyzing the combined effect of the nine Chinese herbs in BKT. The active components and targets of BKT were collected from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform （TCMSP） and then screened according to the oral bioavailability （OB） and drug likeness （DL） criteria. Following the acquisition of C-IBS target set from GeneCards， Online Mendelian Inheritance in Man （OMIM）， Drugbank and DisGeNet， the protein-protein interaction （PPI） network was constructed. Cytoscape 3.7.2 was utilized for network visualization. The screened key targets were subjected to gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis using DAVID platform. The C-IBS mouse model was established via intragastric administration of ice water， and the key targets of BKT against C-IBS were verified by enzyme linked immunosorbent assay （ELISA） and immunohistochemistry. Result:The large intestinal meridian was the main site where BKT acted. There were 70 potential active components in BKT， which acted on 227 intersection targets. Through T helper cell 17（Th17） differentiation， Toll-like receptor （TLR）， tumor necrosis factor and other signaling pathways， BKT participated in inflammatory response， immune regulation， intestinal nerve regulation， hormonal regulation， and oxidative stress response， thus exerting the therapeutic effects against C-IBS. As reveled by <italic>in vivo</italic> experiments， BKT significantly improved the small intestinal propulsion rate， up-regulated the expression of vasoactive intestinal peptide （VIP） in serum and colon tissue of C-IBS mice， and down-regulated the expression of nuclear transcription factor-<italic>κ</italic>B （NF-<italic>κ</italic>B）， interleukin（IL）-6， and TLR2 in serum and colon tissue， which confirmed the reliability of integration analysis. Conclusion:BKT inhibits C-IBS via multiple components， multiple targets， and multiple pathways. This study has provided ideas for further clinical research and experimental verification of BKT in the treatment of C-IBS.

Site-directed mutagenesis of long gene by partial amplification combining with double fragments ligation / 生物工程学报

Overlap extension PCR is a common method for site-directed mutagenesis. As objective gene sequence growing longer, it is often difficult to obtain the target product in the second round of PCR, and it is highly possible to introduce unexpected mutations into a long gene fragment by PCR. To circumvent these problems, we can only amplify a small gene fragment which contain the target mutation by overlap extension PCR, and then ligate it with vector to get target plasmid. If the restriction site at the end of the amplified fragment was not a single one on plasmid vector, double fragments ligation method could be used to construct target plasmid. Partial amplification, combined with double fragments ligation, could solve lots of problems in long gene mutagenesis. Taking retinoblastoma gene 1 S780E mutagenesis as an example, it is difficult to amplify whole retinoblastoma gene 1 by overlap extension PCR because of long fragment interfering the overlapping extension of second round PCR. However, it is relatively easy to amplify the F3 (1 968-2 787) fragment which contains target mutation S780E. There is a Nhe I site which can be used for ligation on 5' end of F3 fragment, but another Nhe I site on the plasmid restrained from doing so directly. In order to circumvent this obstacle, we ligated F3 fragment, combining with F2 (900-1 968) fragment which was digested from wild type plasmid, with the vector which contain F1 (1-900) fragment of the gene. That double fragments ligated with one vector at the same time, though less efficient, can recombine into a complete plasmid. The sequences of the two selected recombinant plasmids were consistent with the target mutation, which verified the feasibility of this scheme. As an improvement of overlap extension PCR, partial amplification and double fragments ligation methods could provide solutions for site directed mutagenesis of many long genes.

Effects of hospital-community-family trinity health education model on household disposal of insulin waste needles / 中国实用护理杂志

Objective@#To conduct the integrated management of hospital, community and family for patients with insulin injection at home, in order to explore the influence of this trinity health education model on the knowledge of medical waste and the standard disposal of discarded needles.@*Methods@#The self-designed questionnaire was used to investigate the knowledge and disposal of medical waste in outpatients, and the causes were analyzed carefully after the problems were found. The hospital, community and family were timely communicated and fed back to the ward and community. After 1, 3 and 6 months of educational intervention, the disposal of insulin needles, the knowledge of medical waste and the recovery of sharp instrument boxes were observed.@*Results@#After 1, 3 and 6 months of health education, the final rate of insulin needles mixed into domestic waste was 51.8% (144/278), 15.1% (42/278) and 4.7% (13/278), respectively. Compared with the first result of 99.6% (277/278), the difference was statistically significant (χ2=173.046, 406.136, 502.346, P<0.01); The first survey found that the correct rate of responding to medical waste knowledge items was low. After health education for 1, 3 and 6 months, the correct rate of medical waste related knowledge items was significantly higher than that of the first survey, and the difference was statistically significant (OR=3.016-3 548.810; 95%CI 2.108-917.869, 4.315-19 777.062; χ2=25.180-524.895; P<0.01) ; After 1, 3 and 6 months of health education, the qualified rate of medical waste knowledge was 82.4% (229/278),75.9% (211/278) and 97.1% (270/278), respectively, which was significantly higher than the first result of 6.5% (18/278). The difference was statistically significant (χ2=324.328, 273.712, 453.832, P<0.01). The sharp box recovery of hepatitis B patients was relatively good.@*Conclusion@#Hospital-community-family Trinity health education model can improve the breadth and depth of education objects, not only can improve the knowledge of medical waste related to insulin injection patients at home, but also can improve the standardized disposal ability of insulin waste needles. With the passage of time, the effect of health education continues to be good. This integrated health education model is worth popularizing in clinic.

Debridement and bone grafting with internal fixation via anterior approach for the treatment of tuberculosis of lower cervical vertebrae / 中国骨伤

OBJECTIVE@#To evaluate the clinical effects of debridement and bone grafting with internal fixation via anterior approach in treatment of tuberculosis of lower cervical vertebrae.@*METHODS@#The clinical data of 15 patients with tuberculosis of lower cervical vertebrae who accepted the treatment of one-stage debridement and bone grafting with internal fixation from June 2010 to December 2018 were retrospectively analyzed. There were 9 males and 6 females, aged from 39 to 72 years with an average of (54.67±10.75) years. The lesion segment was C to C. Pre- and post-operative neurologic functions were evaluated by ASIA grade. All the patients underwent the X-ray films of positive and lateral of cervical spine before and after the operation and accepted the periodic review of CT to evaluate the bone grafting.@*RESULTS@#All the 15 operations were successful, no neurological or vascular injury occurred during the operation, and all patients were followed up for 18 to 52 months. The clinical symptoms improved significantly during the follow-up period and CT showed good bone grafting fusion. One patient suffered a relapse of the illness 3 years later, but was healed during the follow-up visit by strengthening the anti tuberculosis therapy.@*CONCLUSION@#For the patients with vertebral destruction and loss of cervical stability, one-stage debridement and bone grafting with internal fixation via anterior approach has definite curative effects. On the basis of standard anti tuberculosis treatment before operation, the long-term standard anti-tuberculosis treatment after operation is the key to healing the tuberculosis of lower cervical vertebrae.

Effects of hospital-community-family trinity health education model on household disposal of insulin waste needles / 中国实用护理杂志

Objective:To conduct the integrated management of hospital, community and family for patients with insulin injection at home, in order to explore the influence of this trinity health education model on the knowledge of medical waste and the standard disposal of discarded needles.Methods:The self-designed questionnaire was used to investigate the knowledge and disposal of medical waste in outpatients, and the causes were analyzed carefully after the problems were found. The hospital, community and family were timely communicated and fed back to the ward and community. After 1, 3 and 6 months of educational intervention, the disposal of insulin needles, the knowledge of medical waste and the recovery of sharp instrument boxes were observed.Results:After 1, 3 and 6 months of health education, the final rate of insulin needles mixed into domestic waste was 51.8% (144/278), 15.1% (42/278) and 4.7% (13/278), respectively. Compared with the first result of 99.6% (277/278), the difference was statistically significant ( χ2=173.046, 406.136, 502.346, P<0.01); The first survey found that the correct rate of responding to medical waste knowledge items was low. After health education for 1, 3 and 6 months, the correct rate of medical waste related knowledge items was significantly higher than that of the first survey, and the difference was statistically significant ( OR=3.016-3 548.810; 95% CI 2.108-917.869, 4.315-19 777.062; χ2=25.180-524.895; P<0.01) ; After 1, 3 and 6 months of health education, the qualified rate of medical waste knowledge was 82.4% (229/278),75.9% (211/278) and 97.1% (270/278), respectively, which was significantly higher than the first result of 6.5% (18/278). The difference was statistically significant ( χ2=324.328, 273.712, 453.832, P<0.01). The sharp box recovery of hepatitis B patients was relatively good. Conclusion:Hospital-community-family Trinity health education model can improve the breadth and depth of education objects, not only can improve the knowledge of medical waste related to insulin injection patients at home, but also can improve the standardized disposal ability of insulin waste needles. With the passage of time, the effect of health education continues to be good. This integrated health education model is worth popularizing in clinic.

Research progresses of Annexin A3 in malignant tumors / 医学研究生学报

Annexin A3(ANXA3), is a crucial member of the membrane associated protein superfamily, whose function research is still insufficient. Previous researches have confirmed that Annexin A3 is involved in a variety of cellular processes, but its function is still unclear. Accumulating evidences suggested that Annexin A3 is closely related to various malignant tumors, and plays an important role in tumor development, metastasis, invasion and drug resistance. Therefore, Annexin A3 is expected to be a new therapeutic target for malignant tumors. This article provided an overview about the role of Annexin A3 in malignant tumors.

Progress on vaccination of children with hemophilia A / 国际儿科学杂志

Hemophilia A is a hereditary hemorrhagic disease.Vaccination can prevent certain diseases,while intramuscular vaccination may lead to muscle hematoma in children with hemophilia A,even become a high risk factor for increasing production of inhibitors.Therefor,there are concerns about vaccination of hemophilia A.Children with hemophilia A can be vaccinated in a relatively safe manner,such as subcutaneous injections,or vaccinated after replacement treatment.There is no clear correlation between the immune response induced by vaccination and the mechanism of inhibitor production,and the safety of vaccination remains to be further studied.This review focuses on the progress of vaccination for children with hemophilia A.

Association between depression behavior and expression of calreticulin precursor, tropomyosin 1, milogen activated prolein kinase 1 and dual specificity mitogen-activated protein kinase 1 in spontaneous diabetes mellitus rats / 实用医学杂志

Objective To investigate the association between depression behavior and the expression of calreticulin precursor, tropomyosin I, milogen activated prolein kinase 1 and dual specificity mitogen-activated protein kinase 1 in spontaneous diabetes mellitus rats. Methods Twenty adult male healthy rats (control group) and 40 spontaneous diabetic rats were studied. Forty spontaneous diabetic rats were further divided into diabetes group and diabetic depression group, and the latter was to construct depression model. The depressive behavior of the 3 groups was measured by sucrose water consumption test and wilderness test. The expression level of calreticulin precursor, tropomyosin 1, milogen activated prolein kinase 1, and dual specificity mitogen-activated protein kinase 1 in the hippocampus of the 3 groups was measured by western blot. Results In the 15 th day and 22 nd days of stress, the amount of sucrose water drinking of the rats in diabetic depression group was significantly lower than that of the control group and the diabetes group (P < 0.05) , and there was no significant difference between the control group and the diabetic group (P> 0.05). The score of field test and vertical score in the diabetic depression group were significantly lower than those of the control group and the diabetes group (P < 0.05) , but there was no significant difference between the control group and the diabetic group (P> 0.05). The expression of calreticulin precursor, tropomyosin 1, milogen activated prolein kinase 1, and dual specificity mitogen-activated protein kinase 1 in the hippocampus of diabetic depression group was significantly lower than that in the control group and the diabetic group (P < 0.05) , and there was no significant difference between the control group and the diabetic group (P> 0.05).Conclusions The depressive behavior of spontaneously diabetic rats is associated with the decrease of the expression level of calreticulin precursor, tropomyosin 1, milogen activated prolein kinase 1, and dual specificity mitogenactivated protein kinase 1 in the hippocampus of rats.

Association between maternal syphilis treatment and adverse pregnancy outcomes / 中华传染病杂志

Objective To examine the association between maternal syphilis treatmentand the adverse pregnancy outcomes.Methods Syphilis-infected pregnant women retrieved from Information System of Prevention Mother-to-child Transmission of Human Immunodeficiency Virus (HIV),Syphilis,and Hepatitis B Management in Hu'nan Province between January 2012 and December 2017 were retrospectively studied.Information of demographic characteristics,pregnancy history,and syphilis infection/treatment history among these syphilis-infected pregnant women were collected and analyzed.According to the anti-syphilis treatment situation during pregnancy,syphilis-infected pregnant women were divided into three groups:non-treatment group,non-standardized treatment group and standardized treatment group.The incidences of adverse pregnancy outcomes among the three groups were calculated.Multivariate logistic regression was used to control confounding factors and analyze the association between maternal syphilis treatment and the adverse pregnancy outcomes.The adjusted odds ratios (aOR) and 95％ confidence interval (CI) were calculated.Results Among 9 059 syphilis-infected pregnant women,13.9％ (1 262),31.3％ (2 834),and 54.8％ (4 963)were untreated,non-standardized treated and standardized treated patients,respectively.The incidences of total adverse pregnancy outcomes in the non-treatment,non-standardized treatment and standardized treatment groups were 25.5％ (322),20.8％ (589),and 16.2％ (806),respectively.The incidences of stillbirth in the three groups were 2.3％ (29),1.3％ (38),and 0.6％ (28),respectively;those of preterm birth were 12.6％(159),10.5％ (297),and 6.0％ (299),respectively;those of low birth weight were 6.4％ (81),6.2％(175),and 3.3 ％ (162),respectively;those of small for gestational age were 10.9％ (138),8.4％ (237),and 8.0％ (399),respectively;those of neonatal death were 1.3％ (17),1.0％ (28) and 0.3％ (15),respectively;those of neonatal asphyxia were 1.9％ (24),0.9％ (25),and 0.9％ (46),respectively;those of neonatal pneumonia were 0.6％ (8),0.9％ (26),and 0.6％ (32),respectively;those of birth defects were 2.8％(35),1.3％ (37),and 1.1％ (57),respectively;those of neonatal congenital syphilis were 2.5％ (31),2.4％ (69),and 0.8％ (42),respectively.Compared with standardized treatment group,maternal syphilis without treatment was associated with increased risks of total adverse pregnancy outcomes (aOR =1.73),stillbirth (aOR =4.82),preterm birth (aOR =2.52),low birth weight (aOR =1.88),neonatal death (aOR =3.29),neonatal asphyxia (aOR =2.42) and birth defects (aOR =3.26) all P ＜ 0.01;maternal syphilis with non-standardized treatment was associated with increased risks of total adverse pregnancy outcomes (aOR =1.34),stillbirth (aOR =2.54),preterm birth (aOR =1.98),low birth weight (aOR =1.84),neonatal death (aOR =2.49) and neonatal congenital syphilis (aOR =1.70,P ＜ 0.05 or 0.01).Conclusions Maternal syphilis without treatment or with non-standardized treatment would increase the risks of adverse pregnancy outcomes.It is necessary to further strengthen the early screening and early treatment for syphilis-infected pregnant women,and improve the rate of standardized treatment to reduce the occurrence of adverse pregnancy outcomes.