Objective To discuss the effect of different negative pressure to directional airflow in the main room of BSL-3 laboratory.Methods The author combined the experiment and numerical simulation in the study.Results Under the condition that the air supply volume in the main room of BSL-3 laboratory is ensured invariable,negative pressure is a critical factor to effect air distribution in the lab.Conclusion The simulation result shows that a good form of directional airflow under the condition of-50pa can come into being,which offers some reference to the engineering design.

Objective To explore post-effect of acupuncturing ST36 (Zusanli) on brain functional connectivity. Methods Twelve healthy volunteers participated in this experiment. The fMRI data taken before and 25 minutes after removed acupuncturing stimulation were analyzed, while posterior cingulated cortex were chosen as seed points. Results At 25 minutes after removed acupuncturing stimulation, new increased functional connectivity were found in the left paracentral lobule, right superior parietal lobule and right postcentral gyrus. After acupuncture, there was intensity functional connectivity greater than in primary brain regions. Conclusion Post-effect of acupuncture can increase functional connectivity in healthy volunteer's brain.

Exosomes, as a kind of extracellular vesicles generated by inward budding of the endosomes to form multi-vesicular bodies (MVBs), are secreted into the extracellular milieu and the systemic circulation thereafter. By endocytosis, direct fusion or receptor-ligand interactions, exosomes can interact with receptor cells and involve in various pathophysiological processes. Accumulating evidence have indicated that exosomes may play crucial roles in the pathogenesis of many neurodegenerative diseases including Parkinson's disease (PD), Huntington's disease (HD), Alzheimer disease (AD) and amyotrophic lateral sclerosis (ALS). In this paper, the roles of exosomes in the pathogenesis, diagnosis and treatment of PD and ALS are reviewed.

Objective To explore the metabolism and chronic complication features of type 2 diabetes mellitus patients with hyperferritemia. Methods:A total of 268 type 2 diabetic patients with a disease course of more than 5 years, who were hospitalized in our hospital between January to December 2019 were included in this retrospective study. Serum ferritin was measured by Chemiluminescence in each participant. Patients with other diseases, which might affect serum ferritin level, were excluded. According to the results of serum ferritin, the patients were divided into hyperferritemia group ( n=115) and normal ferritin group ( n=153). The metabolic indexes, including C-reactive protein, blood glucose, blood lipid, liver and kidney function, were measured. Chronic complications and comorbidities, including diabetic retinopathy, urinary microalbumin excretion, hypertension, coronary heart disease and cerebrovascular disease were evaluated. The correlation between hyperferritemia and various variables was analyzed. Results:Body mass index, the levels of serum urea nitrogen, uric acid, C-reactive protein, alanine aminotransferase and γ-glutamyltranspeptidase, as well as prevalence of diabetic retinopathy, microalbuminuria, hypertension and coronary heart disease, were significantly higher in hyperferritemia group than in normal ferritin group (all P<0.05). Hyperferrinemia was positively correlated with C-reactive protein ( r=0.262, P<0.001), coronary heart disease ( r=0.232, P<0.001), alanine transpeptidase ( r=0.216, P<0.001), urea nitrogen ( r=0.201, P=0.001), diabetic retinopathy ( r=0.169, P=0.008) and microalbuminuria ( r=0.176, P=0.004). Multivariate logistic regression analysis showed that hyperferrinemia was an independent risk factor of coronary heart disease and diabetic retinopathy ( OR=2.246, 95% CI 1.310-3.849, P=0.003; OR=2.232, 95% CI 1.287-3.870, P=0.004, respectively) in this patient cohort. Stepwise linear regression showed that there was a significant correlation between hyperferrinemia and microalbuminuria (β=0.165, P=0.009). Conclusions:Our results show that the level of serum C-reactive protein, alanine aminotransferase, γ-glutamyltranspeptidase, urea nitrogen, uric acid and microalbuminuria are significantly increased and the risk of coronary heart disease and diabetic retinopathy are higher in type 2 diabetic patients with hyperferritemia.

OBJECTIVETo detect potential mutations of the spastic ataxia of Charlevoix-Saguenay (SACS) gene in a pedigree affected with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS).

METHODSGenomic DNA was extracted from peripheral blood samples of the proband and her family members. All exons and flanking sequences of the SACS gene were analyzed by high-throughput sequencing. Suspected mutations were verified with Sanger sequencing.

RESULTSNext generation sequencing revealed novel compound heterozygous mutations of the SACS gene, namely c.13085T to G (p.I4362R) and c.5236dupA (p.T1746fs), in the proband, which were respectively derived from her parents. The mutations were confirmed by Sanger sequencing.

CONCLUSIONThe c.5236dupA (p.T1746fs) and c.13085T to G (p.I4362R) mutations of the SACS gene probably underlie the ocular symptoms and hearing loss in the proband.

Objective:To investigate the risk factors of venous thrombosis associated with peripherally inserted central catheter (PICC) in lymphoma patients undergoing chemotherapy.Methods:Using the convenient sampling method, a total of 135 patients with lymphoma undergoing chemotherapy who were admitted to Department of Oncology in Xinxiang Central Hospital from September 2019 to September 2020 were selected as the research objects. According to the occurrence of PICC-related venous thrombosis, they were divided into the thrombosis group ( n=23) and the non-thrombotic group ( n=112) . The general data, PICC catheter vein, catheter tip position, PICC catheter limb and other data were collected. Binomial Logistic regression analysis was used to analyze the risk factors of PICC-related venous thrombosis. Results:The incidence of PICC-related venous thrombosis in lymphoma patients undergoing chemotherapy was 17.04% (23/135) . Binomial logistic regression analysis showed that the catheterized vein was the cephalic vein, the catheter tip was located within the upper 2/3 of the superior vena cava, and the ratio of catheter diameter divided by vein diameter greater than or equal to 67% were independent risk factors of PICC-related venous thrombosis in lymphoma chemotherapy patients ( P<0.01) . Conclusions:The risk factors of PICC-related venous thrombosis in lymphoma chemotherapy patients mainly include the cephalic vein, the catheter tip within the upper 2/3 of the superior vena cava and the ratio of catheter diameter to vein diameter greater than or equal to 67%.Nursing staff should focus on high-risk population and actively take interventions to reduce the incidence of PICC-related venous thrombosis.

Objective:To investigate the pathogenesis, precaution and treatment of neonatal congenital complete heart block (CCHB) in twins.Methods:The clinical data of a case of premature twins with neonatal CCHB from the Department of Neonatology, the First Affiliated Hospital of Xinxiang Medical University were retrospectively analyzed and related literature was reviewed.Results:(1)Case review: the 37-year-old gravida had no symptoms.Fetal ultrasound cardiogram(fUCG)at 23 weeks of gestation indicated bradycardia and CCHB.Then, the mother was diagnosed with undifferentiated connective tissue disease.After treatment with human immunoglobulin, dexamethasone and hydroxychloroquine, fUCG at 31 weeks of gestation still suggested CCHB.An emergency cesarean section was performed on the diagnosis of threatened preterm labor.With weakly positive neonatal antinuclear antibody (ANA), and positive Ro60 and Ro52 autoantibodies, twins were diagnosed with CCHB by 24 hour-Holter monitors.One of the twins was discharged with CCHB (ventricular rate of 80-90 times/min) after systemic therapy, but the weight increased to 2 200 g. The other one of the twins suffered from the sudden decrease of heart rate and blood pressure and finally died of sudden cardiac arrest.(2) Literature search: two cases in Chinese and 9 cases in English were reviewed.Among them, 9 cases were sjogren syndrome type A (SSA)/Ro and sjogren syndrome type B(SSB)/La related CCHB, and 2 cases were idiopathic CCHB.Conclusions:The placental transfer of anti-SSA or anti-SSB is an important mechanism of neonatal CCHB in twins, and other factors may also be involved.Current treatments are unsatisfactory.Most patients need pacemaker implantation.Early diagnosis and prenatal management can improve the prognosis.

Humans ; Benzodiazepines ; Hypnotics and Sedatives/therapeutic use* ; Intensive Care Units ; Midazolam

Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a life support technique for patients with severe respiratory failure. In the past, single lumen cannula was mostly used to constract the vascular pathway of extracorporeal membrane oxygenation. Compared with single-lumen cannula, double lumen cannula (DLC) can reduce recirculation fraction, reduce complications such as infection and bleeding, and facilitate patient's rehabilitation. DLC requires accurate positioning of the catheter. It has been gradually applied in China. This paper will review the key points related to the use of DLC, such as the insertion, position, and complications, etc. to provide guidance for clinical application practice.

Veno-veous extracorporeal membrane oxygenation (VV-ECMO) has been widely used in the treatment for severe acute respiratory distress syndrome (ARDS). Up to now, the routine access to establish VV-ECMO involves two-sites single lumen cannula via femoral vein and internal jugular venous in adult and children, while few studies about the dual lumen cannula (DLC) in VV-ECMO implemented in adult and children have been reported. On December 16, 2021, an unconscious child with severe ARDS due to multiple trauma caused by fatal falling from a height was admitted to Taihe Hospital. The initial diagnosis was hemorrhagic shock, bilateral hemopneumothorax, sternal fracture, cavity organ perforation, splenic rupture, and pelvic fracture and severe ARDS. Despite mechanical ventilation, he progressed to refractory hypoxemia and was treated with VV-ECMO after successful DLC placement in the right internal jugular vein by the mobile ECMO team of intensive care unit of the Union Hospital eventually. In addition, he received endoscopic sputum aspiration, prone position ventilation, anti-infection and nutritional treatment. His oxygenation gradually improved and he was successfully weaned from ECMO after 11 days. In this case, DLC simplified the process without any related complications, suggesting that it can be safely and effectively used in the treatment of Child's severe ARDS.