Objective To explored the mental stress situations and the relationship between mental stress, coping style and self-efficacy beliefs of the highland training recruits, and suggestions about mental health education of the recruits to be proposed.Methods The solider mental stress self-reported questionnaire, simplied coping style questionnaire, and generalized self-efficacy beliefs scale were administrated to 256 recruits from 3 companies have been randomly selected in a military training base of Qinghai province.Results The mental stress of the recruits included tension, sleepless, physical and mental exhaustion.The mental stress was significant positive correlation with negative coping style( r=0.349, P＜0.01 ), and significant negative correlation with active coping style( r= -0.179, P＜0.01 ), and with self-efficacy beliefs( r= -0.210, P＜0.01 ).Meantime selfefficacy beliefs was significant positive correlation with active coping style( r = 0.532, P ＜ 0.01 ).Negative coping style and self-efficacy beliefs could significantly predict mental stress.Conclusion Through these ways which improving the self-efficacy beliefs and instructing them to use suitable coping style may help the recruits reduce the mental stress.

Objective To explore the unique relationship between Willis circle and cerebral watershed infarction in a Chinese population. Methods A retrospective analysis of cerebral CT angiography was conducted in 471 non-cere?bral watershed infarctions and 93 MRI-diagnosed cerebral watershed infarctions (CWI)(including External CWI and In?ternal CWI)in Department of Neurology of our hospital and compare the related variations and types of Willis circle be?tween these groups. Results Compared with non-cerebral watershed infarctions, the prevalence of Uni-FTP (short for“fetal type of the Posterior cerebral artery”) in E-CWI (36.4%, P<0.05) and Bi-FTP in I-CWI (0%, P<0.05) was signifi?cantly higher in cerebral watershed infarctions. Conclusion FTP is probably an unique risk factor in Chinese patients with CWI.

BACKGROUND: Migu tablet, a Chinese drug for kidney invigorating, is effective on preventing and treating osteoporosis, but the concrete mechanism of pharmacology is still not clear. Transforming growth factor-β1(TGF-β1) is an important cytokine, which can regulate bone resorption and formation.OBJECTIVE: To investigate the effect of kidney invigorating recipe on mRNA expression of TGF-β1 of osteoblast.DESIGN: A completely randomized controlled study was conducted.SETTING: Department of Traumatic Orthopedics, Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: This experiment was conducted at the laboratory for bone metabolism of integration of Chinese and western medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from May 2003 to April 2004. Experimental rats: Totally 16 newborn SD rats of clean degree were involved. Experimental drug: Medical liquor of Migu tablet was prepared in the Department of Traumatic Orthopedics,Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology. The subscription was mainly composed of Chinese herbs such as Herba Epimedii, Cortex Eucommiae, Semen Juglandis,Radix Rehmanniae, Radix Achyranthis Bidentatae. and so on. Positive control drug: which was recombinant basic fibroblastic growth factor (rbFGF), was purchased from Beijing Banding Company. Negative control group was subdivided into negative control of probe and antibody METHODS: 100,1 000,5 000,10 000 mg/L Chinese herb Migu tablet liquor for kidney invigorating and positive control drug 5 μg/L rbFGF were added into the osteoblasts of cranial bones of newly born SD rats separated and cultured in vitro. 24 hours later, nuclear acid molecular in situ hybridization of osteoblasts were analyzed by self-made digoxin-labeled TGF-β1 cDNA probe . The mean absorbance of positive particles representing the mRNA expression of TGF-β1. A total of 40 osteoblasts were randomly chosen from each group under 200-fold amplification. The average absorbance of hybridized particles of the cells was measured with TJTY-300 automatic image analyzer.MAIN OUTCOME MEASURES: mRNA expression of TGF-β1 in osteoblasts of each group.RESULTS: Automatic image analyzer showed that the TGF-β1 mRNA expressions of Migu liquor groups whose concentration were 5 000 mg/L and 10 000 mg/L were respectively 1.18 times and 1.30 times that of control group, with a significant difference. [The mean absorbance's of hybridized particles of the cells in the 5 000,10 000 mg/L Migu liquor groups and negative control were 0.213 67±0.015 00,0.237 03±0.021 73,0.181 27±0.015 28 ,respectively, P ＜ 0.05 and P ＜ 0.01].Although the mean absorbance ( 0.254 45±0.020 81)of the hybridized particles of the cells in the 5 μg/L recombinant rbFGF was higher than those of 5 000,10 000 mg/L Migu liquor groups, but there was no significant difference(P ＞ 0.05).CONCLUSION: Migu tablet for kidney invigorating can stimulate the secretion and synthesis of TGF-β1 in osteoblasts, thus promote bone formation and inhibit bone resorption.

BACKGROUND:The therapeutic effects of donkey-hide glue reinforcing bone oral solution on osteoporosis have been determined, but the exact effective mechanism is to be approached. OBJECTIVE: To investigate the effects of donkey-hide glue reinforcing bone oral solution (DGRBOS) medicated serum on osteoprotegerin (OPG)and its ligand(OPGL)mRNAexpression of osteoblast in fetal rats and explore the molecular mechanism of treating osteoporosis with DGRBOS. DESIGN: A randomized controlled trial. MATERIALS: The experiment was carried out from June 2003 to October 2004 in Bone Metabolic Laboratory of Department of Integrative Chinese and Western Medicine, Affiliated Hospital of Tongji Medical College,Huazhong University of Technology and Science. Totally 30 3-month-oldWistar rats (15 males and 15 females) were randomly divided into 3 groups, I.e. DGRBOS group, estrogen group and control group, with 10 rats in every group. 12 clean newborn SD rats were selected to isolate and cul ture osteoblast. METHODS: ①After intragastric administration for 7 days, medicated serum was prepared respectively from the three groups. ②Skull osteoblast isolated from newborn SD rats was made into single cell suspension, then after digestion and passage, the subcultured osteoblast cell was made into cell suspension. The cultured osteoblasts were divided into 5 groups and given equal volumes of drug liquor. The DGRBOS group was given DGRBOS-medicated serum at the concentration of 100, 500 and 1 000 g/L which was diluted by nutrient solution; the estrogen group was given tibolone-medicated serum of 100 and 1 000 g/L; the control group was givenonly culture fluid. Meanwhile every group was given calf serum (100 g/L) for further culture. ③The osteoblast proliferation was measured by antigenic MTT colorimetric analysis and 3H-TdR penetration method. The in tra-cellular BGP contents were evaluated by radioimmunity .The mRNA expression of OPG and RANKL in osteoblast was analyzed by Rt-PCR. ④ One-way analysis of variance was applied to compare data among groups. MAIN OUTCOME MEASURES: mRNA expression of OPG and PAN KL in osteoblasts from fetal rats after intervention by medicated serum ofDGRBOS or Livial. RESULTS: ①The osteoblast proliferation measured by antigenic MTT colorimetric analysis and 3H-TdR penetration method showed that the proliferation in the DGRBOS group and tibolone group was enhanced moresignificantly than that in the control group (P ＜ 0.05-0.01), and reached maximal effect at the concentration of 500 g/L (P ＜ 0.01), but when the concentration was over 500 g/L, the effect tended to saturate. The medicated serum with all concentrations from DGRBOS and estrogen groups could increase the contents of BGP in osteoblasts (P ＜ 0.05). ②The mRNA expression of OPG reached the peak when the DGRBOS medicated serum was 1 000 g/L, and was obviously higher than that at the concentration of 100 and 500 g/L (P ＜ 0.05). The expression in DGRBOS group at the concentration of 1 000 g/L and in the estrogen group at the concentration of 100 and 1 000 g/L was apparently higher than that of the control group (P ＜ 0.01). ③The mRNAexpression of RANKL was the highest in DGR BOS group with 1 000 g/L concentration, and was markedly lower than that of the concentration of 100 and 500 g/L (P ＜ 0.05). The expression in DGRBOS group at the concentration of 1 000 g/L and in the estrogen group at the concentration of 100 and 1 000 g/L was noticeably lower than that in the control group (P ＜ 0.01).CONCLUSION: ①The DGRBOS could remarkably enhance osteoblast proliferation in dose-dependent and a dose-saturable manner, and the effect was close to that of tibolone. ②Partial mechanism of DGRBOS in treating osteoporosis might be promoting osteoblast proliferation and regulating OPG/RANKL expression.

Objective To compare the biomechanical stability of 4 internal fixations in treatment of acetabular fracture of the lower anterior column through finite element analysis.Methods One normal adult male pelvis was subjected to 0.7mm thin-section CT scanning and 379 CT pictures were obtained.Finite element modeling software was used to establish internal fixation models for acetabular fracture of the lower anterior column,including lag screws (A),anterior column reconstruction plate (B),subcutaneous plate not crossing the pubic symphysis (C) and subcutaneous plate crossing the pubic symphysis (D).Finite element analysis was carried out to compare the biomechanical differences among the 4 internal fixation models which were subjected to the same loading conditions at both standing and sitting positions.Results At standing and sitting positions,the maximum displacement and the mean node displacement of fracture lines were the greatest in group A (0.558 mm and 0.462 ±0.092 mm at standing;0.634 mm and 0.473 ±0.108 mm at sitting),the smallest in group D (0.512 mm and 0.425 ±0.083 mm at standing;0.031 mm and 0.025 ± 0.004 mm at sitting),and in between in group B (0.513 mm and 0.432 ±0.085 mm at standing;0.630 mm and 0.466 ± 0.109 mm at sitting) and in group C (0.514 mm and 0.433 ± 0.085 mm at standing;0.627 mm and 0.464 ± 0.107 mm at sitting).At both standing and sitting positions,the maximum stress at the fracture line was the greatest in group D (10.519 MPa and 24.879 MPa),the smallest in group A (3.254 MPa and 8.954 MPa),and in between in group B (4.873 MPa and 9.431 MPa) and in group C (4.384 MPa and 10.128 MPa).Conclusions In treatment of acetabular fracture of the lower anterior column,subcutaneous plate crossing the pubic symphysis may result in the greatest biomechanical stability,lag screws the smallest biomechanical stability,and anterior column reconstruction plate and subcutaneous plate not crossing the pubic symphysis the moderate biomechanical stability.

Objective:To explore the effects of the second dorsal metacarpal artery perforator flap relaying the dorsal island flap of index finger in repairing thumb wounds.Methods:The study was a retrospective observational study. From May 2021 to January 2023, 14 patients with thumb wounds who met the inclusion criteria were admitted to Gansu Provincial People's Hospital, including 8 males and 6 females, aged 24 to 63 years. After debridement, the wound area was 2.1 cm×1.2 cm to 5.5 cm×3.5 cm. The dorsal island flap of index finger with incision area of 2.4 cm×1.5 cm to 5.5 cm×3.5 cm was used to repair the thumb wound, and then the second dorsal metacarpal artery perforator flap with incision area of 2.7 cm×1.6 cm to 5.7 cm×3.6 cm was cut through the same incision to repair the donor wound in the index finger, and the donor wound in the dorsal of hand was directly sutured. The survival of flap was observed, and the healing of the donor wound in the dorsal of hand was observed after operation. The condition of donor wound in the dorsal of hand, the color, appearance, and texture of flap, postoperative complications, return to work, and satisfaction with the treatment effect of patients were followed up. At the last follow-up, the function of the thumb and the index finger was evaluated with the trial standards for evaluation of partial function of upper extremity by the Hand Surgery Society of Chinese Medical Association.Results:After operation, all flaps survived, and the donor wounds on the back of the hands healed. During follow-up of 6-12 months, only linear scars remained on the donor wounds in the dorsal of hands, and the color of flaps was similar to that of the surrounding normal skin, with a full appearance and soft texture. There were no complications such as scar tenderness or scar contracture in any patient. All patients had normal sensation in the thumb and index finger, resumed normal work, and were satisfied with the treatment effects. At the last follow-up, the function of thumb and index finger was evaluated as excellent in 9 cases and good in 5 cases.Conclusions:The second dorsal metacarpal artery perforator flap can repair the thumb wound by relaying the dorsal island flap of index finger, without damaging the major blood vessels, with only linear scars remained on the donor wounds in the dorsal of hands after operation, with good appearance of flap and function of thumb and index finger. The operation is relatively simple with good clinical effects.

Objective To investigate the impact of Coronavirus Disease 2019 (COVID-19) on long-term renal function in patients with chronic kidney disease (CKD) who received no renal replacement therapy. Methods Thirty-nine CKD patients with an estimated glomerular filtration rate (eGFR) < 60 mL/(min·1.73 m²) at the time of COVID-19 diagnosis, admitted to Guizhou Aerospace Hospital from December 2022 to March 2023, were enrolled in the COVID-19 group. Additionally, 40 CKD patients without COVID-19 from September to December 2021, were included in control group. Changes in eGFR were compared between the two groups, and the temporal trend of eGFR in the COVID-19 group was analyzed using a mixed-effects linear model. Results No statistically significant differences were observed in eGFR levels at baseline, 1- and 3-month of follow-up between the COVID-19 and control groups (P>0.05). However, at 1 year of follow-up, the eGFR level in the COVID-19 group was significantly lower than that in the control group (P < 0.05). The mixed-effects linear model analysis revealed a decrease in eGFR by 1.84 mL/(min·1.73 m²) within 1 year of COVID-19 onset in the COVID-19 group, which inclined 4.62% from baseline, with the most significant decline (7.45%) observed among diabetic patients. Conclusion Patients with CKD who have not undergone renal replacement therapy experience a substantial decline in eGFR and worsened renal function within 1 year of COVID-19, necessitating close long-term renal function monitoring and timely interventions.

OBJECTIVETo analyze a fetus with heart defects and to assess the recurrence risk for her family.

METHODSSingle nucleotide polymorphism-based arrays (SNP-Array) analysis using Affymetrix Genome Wide Human SNP CytoHD was performed to analyze the fetus and her parents. Karyotype analysis was also carried out.

RESULTSSNP-Array has detected a 14.5 Mb duplication at 9p and a 14.7 Mb deletion at 11q. Karyotype analysis indicated that the fetus' mother has a karyotype of 46, XX, t(9;11) (p23;q24). Therefore, the fetus has inherited a derivative chromosome 11 derived from the maternal translocation, and her karyotype was 46, XX, der(11) t(9;11) (p23;q24) mat.

CONCLUSIONSNP-Array combined with high resolution GTG banding has confirmed that the fetus has a derivative chromosome 11 derived from her mother's balanced translocation, resulting in partial 9p trisomy and partial 11q monosomy. This couple therefore have a high recurrence risk. SNP-Array is capable of detecting small chromosomal imbalance in abnormal fetuses and can pinpoint the breakpoints. It therefore has the advantage for the detection of unbalanced translocation which is difficult to detect with GTG banding, which is important for assessment the recurrence risk for cryptic balanced translocation carriers.

Adult ; Chromosomes, Human, Pair 11 ; Female ; Heart Defects, Congenital ; genetics ; Humans ; Karyotyping ; Male ; Oligonucleotide Array Sequence Analysis ; methods ; Polymorphism, Single Nucleotide ; Translocation, Genetic

OBJECTIVETo investigate the relationship between fetal lateral ventriculomegaly and chromosomal microarray analysis (CMA) abnormalities.

METHODSFifty fetuses with lateral ventriculomegaly detected by ultrasound and a normal karyotype were included. Forty four fetuses were classified as mild ventriculomegaly (MVM), in which the lateral ventricular atrium was 10-15 mm. Six had severe ventriculomegaly (SVM), with the lateral ventricularatrium being ≥ 15 mm. The fetuses were also divided into isolated (n= 21) and non-isolated groups (n= 29) based on whether they are associated with other anomalies.

RESULTSThirteen (26%) of the fetuses were found to be abnormal by CMA. For the 44 cases with MVM, 9 (20.9% ) were found to be abnormal, while for the 6 cases with SMV, 4 (66.7%) were found to be abnormal (P>0.05). CMA abnormalities were found in 2 (9.5%) of the 21 fetuses with isolated ventriculomegaly group and 11 (37.9%) of the 29 fetuses with non-isolated ventriculomegaly group (P<0.05).

CONCLUSIONChromosome microdeletions and microduplications are the most common abnormalities found in fetal lateral ventriculomegaly. When ventriculomegaly is associated with other anomalies, the incidence of CMA abnormally is much higher. Prenatal diagnosis is necessary for fetuses with lateral ventriculomegaly.

Adult ; Chromosome Aberrations ; Chromosome Deletion ; Chromosome Duplication ; Female ; Gestational Age ; Humans ; Hydrocephalus ; diagnosis ; diagnostic imaging ; genetics ; Lateral Ventricles ; abnormalities ; diagnostic imaging ; metabolism ; Microarray Analysis ; methods ; Pregnancy ; Reproducibility of Results ; Sensitivity and Specificity ; Ultrasonography, Prenatal ; methods ; Young Adult

We report a case of a newborn baby who suffered from hemolytic disease of fetus and newborn (HDFN) caused by anti-Di a. The baby presented with worsening jaundice started at three hours after birth and was transferred to Dongguan Maternal and Child Health Care Hospital. The newborn's hemoglobin (Hb) was 82 and 76 g/L at five and nine hours after birth, and the total bilirubin (TBIL) was 243.2 and 309.8 μmol/L, respectively. Blood samples of the newborn and the parents were collected for HDFN immunohematology test twelve hours after birth. They showed that the newborn and the father's blood type was A and RhDCCee, while the mother was A and RhDCcee. Direct antiglobulin test (DAT) indicateda strong positive for the newborn and negative for the parents. The reaction of the reagent to red blood cells for antibody screening with the patient's plasma, red cells eluate, and the mother's plasma were all negative, but were positive with the father's red blood cells. The newborn was recovered after treating with phototherapy, intravenous immunoglobulins and urgent blood exchange (the exchanged blood was the same ABO and RhD blood type and cross-matched). The newborn's plasma and red cells eluate were collected before blood exchange, and the mother's plasma were used to assess the red blood cells reaction, and IgG anti-Di a was identified in each sample. Di a blood typing was positive for the newborn and the father, and negative for the mother. Therefore, the newborn was diagnosed as HDFN caused by anti-Di a.