Objective To explore the risk factors of initial surgery and postoperative complications of Crohn's disease (CD).Methods The retrospective case-control study was conducted.The clinical data of 227 patients with CD who were admitted to the Cangzhou Central Hospital from April 2011 to July 2015 were collected.Treatment principles included reducing the clinical symptoms,promoting healing of intestinal mucosa under endoscopy,delaying CD progression and preventing intestinal exhaustion and related complications.The medication was performed in the early period.The resection of partial intestines was applied to patients if there was poor effect of medication or combined with intestinal obstruction,intestinal fistula,digestive tract perforation,abdominal abscess and complex anal fistula.Observation indicators:(1) treatment situation,(2) follow-up situation,(3) related factors analysis affecting initial surgery of patients with CD,(4) related factors analysis affecting postoperative complications of patients after initial surgery for CD.Follow-up using regular telephone interview and outpatient examination was performed up to May 2016.Follow-up included the wound infection,abdominal abscess,intestinal obstruction,anastomotic fistula and pulmonary infection.Measurement data with normal distribution were represented as-x ± s and comparison between groups was analyzed using the t test.Count data were represented as the proportion and analyzed by the chi-square test.The univariate analysis was done using the chi-square test and Kruskal-Wallis test,and multivariate analysis was done using the Logistic regression model.Results (1) Treatment situation:of 227 patients,68 underwent initial surgery and 159 didn't undergo surgery.The duration from diagnosis to initial surgery in 68 patients was (4.7 ± 2.5) months.Of 68 patients with surgery,28 received the emergency surgery and 40 received the selective surgery.Operation time and volume of intraoperative blood loss were (175 ±44) minutes and (285 ± 110) mL,respectively.The side-to-side anastomosis was conducted in 47 patients and non-side-to-side anastomosis in 21 patients.Other 159 patients without surgery received the medication of mesalazine,hydrocortisone,methotrexate and infliximab.(2) Follow-up situation:68 patients with initial surgery were followed up for 5-61 months,and 22 had postoperative complications.Of 9 patients with anastomotic fistula,6 had enterocutaneous fistula (5 patients with enterocutaneous fistula were improved by selective surgery,and the other patient was progress to acute diffuse peritonitis and then was improved by peritoneal lavage,adequate drainage and nutritional support therapy after emergency surgery).Three patients with anastomotic abscess were improved by adequate drainage.Six patients with secondary intestinal obstruction were improved by conservative treatment.Three patients with abdominal abscess were improved after antiinflammatory treatment and adequate drainage.Two patients with wound infection were improved by regular dressing change.Two patients with pulmonary infection were improved by anti-inflammatory and phlegm conservative treatment.(3) The related factors analysis affecting initial surgery of patients with CD.The results of univariate analysis showed that age of diagnosis,smoking history and behavior of disease were the related factors affecting initial surgery of patients with CD (Z =-2.120,x2 =5.082,50.512,P＜ 0.05).The results of multivariate analysis showed that A3 of age of diagnosis,B2 and B3 of pattern of disease were the independent risk factors affecting initial surgery of patients with CD [OR =15.624,10.535,28.509,95％ confidence interval (CI):4.856-29.375,3.609-17.637,8.526-79.228,P ＜ 0.05].(4) The related factors analysis affecting postoperative complications of patients after initial surgery for CD.The results of univariate analysis showed that preoperative levels of albumin (Alb) and hemoglobin (Hb),emergency surgery,operation time and anastomotic method were the related factors affecting postoperative complications of patients after initial surgery for CD (x2 =10.757,7.639,6.773,4.309,16.346,P ＜ 0.05).The results of multivariate analysis showed that preoperative Alb≤28 g/L,Hb≤ 100 g/L,emergency surgery and non-side-to-side anastomosis were the independent risk factors affecting postoperative complications of patients after initial surgery for CD (OR =9.592,8.849,6.538,12.645,95％CI:2.209-25.235,2.034-24.773,1.846-15.893,3.935-38.873,P ＜ 0.05).Conclusions The age of diagnosis ＞ 40 years,B2 and B3 of CD are high risk group of initial surgery.The poor preoperative nutritional status,emergency surgery and non-side-to-side anastomosis are independent risk factors affecting postoperative complications of patients after initial surgery for CD.

Objective:To investigate whether the mindfulness training can reduce the aggression level and im-prove the sleeping quality among incarcerated people.Methods:Fifty-four male criminals were recruited into the study.They were divided into mindfulness training group (n =25)and control group (n =29).The training group took mindfulness exercise once a week for 6 weeks.While the participants in waiting list control group waited for 6 weeks without intervention.After 6-week mindfulness training for training group and post-assessment for all partici-pants,the waiting list control group went into 6-week mindfulness training.The Five Facet Mindfulness Question-naire (FFMQ),Aggression Questionnaire (AQ)and Pittsburgh Sleep Quality Index (PSQI)were assessed before and after the intervention.Results:There were 19 valid data in training group,and 21 in control group.After 6-week training,the score difference between pre-and post-assessment of FFMQ (P <0.01 )was higher in the training group than in the control group,and the difference of AQ (P <0.01)and PSQI (P <0.01)was lower in training group than in the control group.Conclusion:The results suggest that 6-week mindfulness training could effectively reduce the aggression level and improve the sleep quality in the long-term incarcerated males.

Objective To explore the related neurobiochemical mechanism by comparing the concentration change of dopamine (DA),dihydroxy-phenyl acetic acid (DOPAC),glutamate (Glu),and γ-aminobutyric acid (GABA) in the brain tissues in schizophrenia (SZ) developmental model rats and chronic medication model rats.Methods A total of 60 neonatal male Spragur-Dawley (SD) rats were randomly assigned to 3 groups at the postnatal day 6:an SZ developmental rat model group (subcutaneous injection with MK-801 at the postnatal day 7-10,0.1 mg/kg,Bid),a chronic medication model group (intraperitoneal injection at the postnatal day 47-60,0.2 mg/kg,Qd),and a normal control group (injection with O.9％ normal saline during the corresponding periods).DA,DOPAC,Glu,and GABA of the tissue homogenate from the medial prefrontal cortex (mPFC) and hippocampus were examined with Coularray electrochemic detection by high performance liquid chromatogram technique.The utilization rate of DA and Glu was calculated.Results Compared with the normal control group,the concentration of DA and DOPAC in the mPFC and the hippocampus in the SZ developmental model group significantly decreased ( P ＜ 0.05 ),and the GABA concentration and Glu utilization rate in the mPFC also decreased (P ＜ 0.05 ).Compared with the chronic medication model group,the DA concentration of the mPFC in the SZ developmental group decreased ( P ＜ 0.05 ),and the DOPAC concentration and the utility rate of DA in the hippocampus also decreased (P ＜0.01,P ＜0.05,respectively).Conclusion The activities of DA,Glu and GABA system decrease in the mPFC and the DA system function reduces in the hippocampus of SZ developmental rats.

Objective To further investigate direct effects of dipeptidyl peptidase-4(DPP4) on calcification and to identify responsible signaling pathways in human vascular smooth muscle cells (HVSMC). Methods The effect of DPP-4 on calcification of HVSMC was observed by alizarin red, and Western blot was used to detect whether DPP4 induced calcification-related protein expressions through extracellular signal-regulated kinases 1/2 (ERK1/2) pathway. Results The Alizarin red staining results showed that calcified nodules in DPP4 group were significantly increased as compared with control group, similar to calcification group.The protein expressions of osteoprotegerin (OPG), osteopontin (OPN), Runt-related transcription factor 2 (RUNX2), and bone morphogenetic protein 2 (BMP2) were stimulated by DPP4 in a concentration- and time-dependent manner. The phosphorylation level of ERK1/2 was significantly increased after DPP4 incubation for 15 min (P<0.05). PD98059, an ERK1/2 inhibitor, significantly lowered DPP4-stimulated expressions of calcification-related proteins (P<0.05). Conclusion DPP4 may promote the calcification of HVSMC through ERK1/2 signaling pathways.

Objective To evaluate the role of α2A adrenergic receptor (α2AAR) in dexmedetomidine-induced inhibition of TLR4/NF-κB signaling pathway activation during hypoxia-reoxygenation (H/R)caused injury to alveolar type Ⅱ epithelial cells.Methods Type Ⅱ] alveolar epithelial cells of rats RLE6TN cells cultured in vitro were divided into 4 groups (n =6 each) using a random number table method:control group (group C),H/R injury group (group H/R),dexmedetomidine group (group D) and α2A AR small interfering RNA (siRNA) plus dexmedetomidine group (group α2AAR-siRNA+D).H/R was produced by exposing cells to 1％ O2-5％ CO2-94％ N2 for 24 h followed by 4-h reoxygenation.Cells were incubated for 1 h with dexmedetomidine at the final concentration of 1 nmol/L,and then H/R model was established in group D.In group α2AAR-siRNA+D,cells were transfected with 50 nmol/L α2AAR-siRNA,48 h later dexmedetomidine at the final concentration of 1 nmol/L was added,cells were incubated for 1 h,and then H/R model was established.The cell viability was measured using CCK-8 method,cell apoptosis rate was determined by flow cytometry,and the expression of TLR4 and NF-κB was detected by immunofluorescence.Results Compared with group C,the cell viability was significantly decreased,the apoptosis rate was increased,and the expression of TLR4 and NF-κB was up-regulated in group H/R (P＜0.05),and no significant change was found in the parameters mentioned above in group D (P＞0.05).Compared with group H/R,the cell viability was significantly increased,the apoptosis rate was decreased,and the expression of TLR4 and NF-κB was down-regulated in group D (P＜0.05),and no significant change was found in the parameters mentioned above in group α2AAR-siRNA+D (P＞0.05).Compared with group D,the cell viability was significantly decreased,the apoptosis rate was increased,and the expression of TLR4 and NF-κB was up-regulated in group α2AAR-siRNA+D (P＜0.05).Conclusion The mechanism by which dexmedetomidine inhibits TLR4/NF-κB signaling pathway activation may be related to activating α2AAR during H/R-caused injury to alveolar type Ⅱ epithelial cells.

Objective To compare the correlation and consistency of liquid chromatography-tandem mass spectrometry(LC-MS/MS)and electrochemiluminescence immunoassay(ECLIA)in the determination of se-rum 25-hydroxyvitamin D[25(OH)D],in order to guide the clinical selection of appropriate detection meth-ods.Methods A total of clinical serum samples were collected from the laboratory,and 25(OH)D levels were detected by LC-MS/MS and ECLIA,respectively.Passing-Boblok regression was used to analyze the correla-tion between the two methods,and Bland-Altman and Mountain plot were used to evaluate the agreement be-tween the two methods.Serum 25(OH)D<20.0 ng/mL was defined as vitamin D deficiency,and serum 25(OH)D as 20.0-<30.0 ng/mL was defined as vitamin D insufficiency.Kappa analysis was used to determine the coincidence rate of the two methods in the diagnosis of vitamin D nutritional status.Results The 25(OH)D levels detected by LC-MS/MS and ECLIA were(26.67±4.79)ng/mL and(39.33±4.09)ng/mL,respec-tively.The regression equation of the two methods was YECLIA=-4.558 1+1.719 8XLC-MS/MS,the slope was 1.719 8(95%CI 1.586 3-1.828 4),excluded 1,and the intercept was 4.558 1(95%CI-7.692 2--2.122 1),excluded 0,prompt system difference or ratio differences of the two methods.There were system-atic or proportional differences between the two methods.The Bland-Altman figure showed two methods aver-ages was 12.7,and the difference of out points(ratio)was 3.19%.The peak value of the mountain plot was-9.17 ng/mL,with more deviations from 0,indicating poor agreement between the results measured by the two methods.The Kappa coefficient of the two methods for judging vitamin D deficiency was 0.875,and the diagnostic coincidence rate was 94.68%.The Kappa coefficient of the two methods for judging vitamin D in-sufficiency was 0.538,and the diagnostic coincidence rate was 75.53%.Conclusion The agreement between ECLIA and LC-MS/MS is poor,but the agreement between ECLIA and LC-MS/MS in the diagnosis of vita-min D deficiency and insufficiency based on nutritional status is high.

Objective To summarize the revascularization surgery results of patients with unilateral absence of a pulmonary artery.Methods From November 2014 to July 2016,5 patients with unilateral absence of a pulmonary artery underwent surgical revascularization at Guangzhou Women and Children Medical Center.The age and body weight at surgery was 1-6 months and 3.9-5.8 kg.One patient was diagnosed with unilateral absence of left pulmonary artery.The other 4 patients were diagnosed with unilateral absence of right pulmonary artery.Three patients were diagnosed with isolated unilateral absence of a pulmonary artery.One was associated with Tetralogy of Fallot.One was associated with atrial septal defect.Revascularization was performed by connection of hilar artery and the main pulmonary artery,using direct anastomosis,Gore-Tex conduit or pericardial conduit.Results There was no mortality.The ICU stay after operation were 3-14 days.The follow-up duration was 14-34 months.All patients were alive and free from significant pulmonary stenosis.Conclusion Revascularization surgery for patients with unilateral absence of a pulmonary artery is effective and achieved satisfactory results.

Znic (Zn) alloys with good cytocompatibility and suitable degradation rate have been a kind of biodegradable metal with great potential for clinical applications. This paper summarizes the biological role of degradable Zn alloy as bone implant materials, discusses the mechanical properties of different Zn alloys and their advantages and disadvantages as bone implant materials, and analyzes the influence of different processing strategies (such as alloying and additive manufacturing) on the mechanical properties of Zn alloys. This paper provides systematic design approaches for biodegradable Zn alloys as bone implant materials in terms of the material selection, product processing, structural topology optimization, and assesses their application prospects with a view to better serve the clinic.
Orthopedics ; Zinc ; Alloys ; Dental Materials ; Prostheses and Implants

Objective To assess the application value of juxtaposition of the great vessels in diagnosis of right atrial isom-erism( RAI) by echocardiography.Methods We retrospectively analyzed 73 patients with right atrial isomerism in Guangzhou Women and Children's Medical Center from 2010-2017.All these patients were performed by echocardiography and compu-ted tomography(CT).We used the results of CT as the golden standard.Results 73 cases of RAI were diagnosed by CT.60 cases of RAI were diagnosed by echocardiography.Juxtaposition of the descending aorta(DAO) and inferior vena(IVC) was demonstrated in all these 60 patients.29 of 60 were on the left side of the spine(39.73％).31 of 60 were on the right side of spine(42.47％).In the other 13 patients of echocardiography missed diagnosis, the arrangement of the great vessels was nor-mal in 10 cases, and inverse in 3 cases.Conclusion Juxtaposition of the great vessels is one of the most important findings in patients with RAI.It is quick and simple and has a higher application value in diagnosis of RAI.

Objective To summarize the outcomes and experience of arterial switch operation (ASO) in the past 10 years in our center.Methods From September 2008 to July 2017,238 patients underwent ASO at Guangzhou Women and Children Medical Center for repair of transposition of the great arteries and Taussig-Bing anomaly.There were 193 male and 45 female.Median age at operation was 2 months (2 days to 10 years) and mean body weight was(4.2 ± 1.7) kg (1.8-20.6 kg).There were TGA and VSD 91 cases,TGA/IVS 110 cases,and Taussig-Bing anomaly 37 cases.Among them 24 patients had an aortic arch anomaly.Intramural coronary artery was found in 8 patients.Results All patients successfully completed the operation,one-stage ASO was perfonned in 232 patients.Two-stage ASO was performed in 6 patients.The mortality was 14.2％.The follow-up duration was 1-10 years (median time,46 mouths).There were 3 died.Two suffered sudden death,and another one arrhythmia.10-year survival rate was 92.8％.Conclusion The outcomes of ASO were satisfactory.The long-term reoperation rate was rare.