Objective To study the clinical effect of subtotal parathyroidectomy on secondary hyperparathyroidism(SHPT) in uremic patients undergoing hemodialysis.Methods The data of 10 uremic patients undergoing hemodialysis who received subtotal parathyroidectomy from Jun.2006 to Jun.2011 in our hospital were retrospectively analyzed.Intact parathyroid hormone (iPTH),serum calcium,phosphorus and calcium-phosphorus product were analyzed statistically before operation,1 week,1 month,3 months,and 6 months after the operation.The joint pain relief and postoperative complications were studied.Results ①All of the 10 patients were successfully operated.No complication occurred.The intraoperative site of the parathyroid was consistent with that positioned by the preoperative B ultrasound guidance.②Postoperative bone pain and pruritus were obviously relieved.③iPTH decreased significantly at 1 week,1 month,3 months,6 months after surgery compared with that before surgery.The difference had statistical significance(P ＜ 0.05).④Postoperative serum calcium,serum phosphorus and calcium-phosphorus product decreased significantly at 1 week,1 month,3 months,6 months after surgery compared with that before surgery.The difference had statistical significance (P ＜ 0.05).Conclusions Preoperative localization for neck parathyroid by ultrasound scan is feasible.Subtotal parathyroidectomy can be effective in treatment of SHPT in uremic patients.The surgery were safe and with satisfactory treatment outcome.

This article presents concepts related to Rho/ROCK signal pathway, and its effect on axonal regeneration and the mechanism of its action to provide a theoretical basis for the inhibition of this signal pathway to promote neural regeneration and functional recovery and further for clinical treatment of nerve injuries and other nervous system diseases.

Objecive:To observe the clinical effects of one-off root canal therapy using iRoot SP in the treatment of chronic apical periodontitis with sinus in anterior teeth.Methods:240 anterior teeth of chronic apical periodontitis witn sinus were randomly divided into 2 groups(n=120).One-off root canal filling were performed using iRoot SP(group A) and AH-plus(group B) respectively after Nd:YAG laser disinfection.Clinical effects were evaluated 48 h,10 days and 1 year after treatment.Results:In group A and B,the 48 h postoperative pain reaction rate was 7.14% and 15.0%(P<0.05),10 days postoperative effective rate was 95.8% and 88.3%(P<0.05),1 year after treatment the effective rate was 98.3% and 94.8%(P>0.05) respectively.Conclusion:iRoot SP and AH-plus show reliable effect in the treatment of chronic apical periodontitis with sinus in anterior teeth with one-off root canal therapy.iRoot SP may result in sligher postoperative reaction and shorter healing time.

Objective To investigate the relationship between microalbuminuria to estimated glomerular filtration rate (mALB/GFR) ratio and incidence of contrast induced nephropathy (CIN) after underwent percutaneous coronary intervention (PCI). Between March 2010 to August 2011, a total of 137 patients who underwent PCI were selected. Anthropometric measures, lipid profiles, fasting blood glucose, CRP, base creatinine and microalbuminuria were measured before operation. Glomerular filtration rate was calculated by MDRD formula. Contrast volume (CV) was recorded after the operation for each patient. Serum creatinine was measured 24 h, 48 h, 72 h after operation, respectively. CIN was defined as an increase in serum creatinine levels of 25% or 44 μmol/L or more from baseline within 72 h after PCI. All patients were divided into group A (CIN group) and group B (No CIN group). Results Eighteen (13.1%) patients developed CIN(group A). The others were group B (no CIN group). The level of CRP, base creatinine, microalbuminuria and mALB/GFR in group A were significantly higher than that in group B ( P < 0 . 01 ) . GFR in group A was lower than that in group B (P < 0.05). Logistic regression analysis indicated that the level of base creatinine , microalbuminuria GFR and mALB/GFR were independent risk factors of CIN occurrence (P < 0.05). The receiver-operator characteristic curve analysis indicated that a mALB/ GFR ratio of 1.17 was a fair discriminator for CIN,and sensitivity were 94.1%, specifity were 72.5%. Conclusion A mALB/ GFR ratio was a independent predictor of CIN after PCI.

Objective To develop a human Tim-3 specific monoclonal antibody and evaluate its biological activity and possible use in clinical diseases associated with dysregulated Tim-3 expression .Methods The BALB/c mice were immu-nized by conventional method, and positive clones were used to develop anti-human Tim-3 antibody, the binding and neutralization activities of which in vitro and in vivo were investigated.Results ①A monoclonal antibody (clone L3D) which could specifically bind to human Tim-3 protein in ELISA assay was obtained and the subtype of the monoclonal antibody was IgG2a .②Flow cytometry indicated that the monoclonal antibody could bind to Tim-3 expressed in human U937 cells.This antibody also showed a cross activity to mice′Tim-3.③The monoclonal antibody inhibited the apoptosis of THP1 cells induced by Gal-9, the ligand of Tim-3.④Injection of Tim-3 antibody exacerbated sepsis in mice as marked by the decreased survival rate and increased expression of pro-inflammatory cytokines .Conclusion An anti-human Tim-3 monoclonal antibody is successfully obtained.The excellent binding and neutralization activities of this antibody enable it to be widely used in clinical diseases associated with deregulated Tim-3 expression .

Objective To examine whether Tim-3 plays a protective role in paraquat poisoning induced excessive immune response and tissue damage based on the critical roles of Tim-3 controlling inflammatory response.Methods A paraquat poisoning model was established in wild type and in Tim-3 transgenic C57BL/6 mice by intraperitoneal injection of paraquat (40 mg/kg) .In addition, C57BL/6 mice with paraquat poisoning were injected with Tim-3 soluble protein( sTim-3) or control protein to see the effect of Tim-3 blocking on the progression of paraquat poisoning.Samples were collected at 6 and 24 h after paraquat injection respectively and were examined for tissue damage, cytokine expression and paraquat metabolism.Results After paraquat poisoning, there was significantly attenuated tissue damage in the lungs and kidneys and decreased TNF-α,IL-6 and IL-1 beta expression in the PBMCs or in the serum from Tim-3 transgenic mice compared to wild type mice.The serum concentration of paraquat in Tim-3 transgenic mice was also significantly decreased.However, in sTim-3 treated paraquat poisoning mice, there was significantly increased cytokine expression and tissue damage compared to control protein treated mice.The in vitro data showed that Tim-3 signaling negatively regulated macrophages mediated inflammatory response.Conclusion Tim-3 plays a critical role in maintaining the homeostasis after paraquat poisoning. Further investigation on the regulatory roles of Tim-3 in inflammation will shed new light on the pathogenesis of paraquat poisoning and provide new therapeutic strategies.

In the paper, it is introduced professor's recognition on the pathogenesis and professor's experience in the treatment of the motor impairment of the trunk after stroke. Professorbelieves that the motor impairment of the trunk after stroke is the essential factor affecting the rehabilitation in stroke. The motor impairment of the trunk after stroke results from brain marrow damage and spiritual impairment. Hence, regaining the consciousness and promoting the circulation of the governor vessel are the basic principles of the treatment, named regulating the mind and controlling, benefitingand warming, tonifying the kidney and filling up the essence, and promoting the circulation of the governor vessel. Those four therapeutic methods are equally important. Acupuncture, moxibusiton and herbal medicine are applied in combination in the treatment. Additionally, the psychotherapy and rehabilitation are the accessory therapies.

Objective:This study sought to investigate the feasibility, anatomical indications and operating points of transcatheter aortic valve replacement (TAVR) procedure in the treatment of pure aortic regurgitation (AR).Methods:The medical records of 4 elderly patients with pure AR who were treated in the cardiology department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from March 2020 to March 2021 were retrospectively analyzed. All patients were implanted with self-expandable valve stents via peripheral artery approach for TAVR treatment. The feasibility, anatomical indications and key points of TAVR were analyzed.Results:The 4 patients with pure AR who were carefully screened had an average age of 66 years, and all achieved TAVR treatment success without serious perioperative complications and death. Postoperative examination and follow-up data showed that cardiac functions and cardiac remodeling indexes were significantly improved.Conclusions:This exploratory study shows that TAVR is technically feasible and effective treatment option for selected elderly patients with native pure AR, which is worthy of further study.

OBJECTIVES: Shelter hospital was an alternative way to provide large-scale medical isolation and treatment for people with mild coronavirus disease 2019 (COVID-19). Due to various reasons, patients admitted to the large shelter hospital was reported high level of psychological distress, so did the healthcare workers. This study aims to introduce a comprehensive and multifaceted psychosocial crisis intervention model. METHODS: The psychosocial crisis intervention model was provided to 200 patients and 240 healthcare workers in Wuhan Wuchang shelter hospital. Patient volunteers and organized peer support, client-centered culturally sensitive supportive care, timely delivery of scientific information about COVID-19 and its complications, mental health knowledge acquisition of non-psychiatric healthcare workers, group activities, counseling and education, virtualization of psychological intervention, consultation and liaison were exhibited respectively in the model. Pre-service survey was done in 38 patients and 49 healthcare workers using the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Patient Health Questionnaire 2-item (PHQ-2) scale, and the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (PC-PTSD-5). Forty-eight healthcare workers gave feedback after the intervention. RESULTS: The psychosocial crisis intervention model was successfully implemented by 10 mental health professionals and was well-accepted by both patients and healthcare workers in the shelter hospital. In pre-service survey, 15.8% of 38 patients were with anxiety, 55.3% were with stress, and 15.8% were with depression; 16.3% of 49 healthcare workers were with anxiety, 26.5% were with stress, and 22.4% were with depression. In post-service survey, 62.5% of 48 healthcare workers thought it was very practical, 37.5% thought more practical; 37.5% of them thought it was very helpful to relief anxiety and insomnia, and 27.1% thought much helpful; 37.5% of them thought it was very helpful to recognize patients with anxiety and insomnia, and 29.2% thought much helpful; 35.4% of them thought it was very helpful to deal with patients' anxiety and insomnia, and 37.5% thought much helpful. CONCLUSIONS Psychological crisis intervention is feasible, acceptable, and associated with positive outcomes. Future tastings of this model in larger population and different settings are warranted.
Humans ; COVID-19 ; Sleep Initiation and Maintenance Disorders ; Crisis Intervention ; Psychosocial Intervention ; SARS-CoV-2 ; Mental Health ; Depression/epidemiology* ; Health Personnel/psychology* ; Anxiety/etiology*