Serum cystatin C (Cys-C) is a cysteine protease inhibitor and has been used as an indicator of early renal function damage.The recent studies have found that Cys-C is closely related to the occurrence,development and prognosis of heart failure.This article reviews the recent research progress on the association between Cys-C and heart failure.

Avian influenza virus H6N1 subtype has been circulating in aquatic bird and terrestrial bird,and is the most frequently detected subtype of influenza A virus in those hosts.Genetic analysis results suggested that this virus might be the progenitor of the highly pathogenic avian influenza H5N1 virus,as seven of eight gene segments of those viruses had a common source.As continuing evolution of H6N1,it could spread across species barriers to mammals and had strong infection ability in mice,swine and ferrets.Serological epidemiological survey showed that a few people were positive for H6 avian influenza virus antibody and then the world's first human infection with influenza virus H6N1 subtype was reported in May 2013.Therefore,with the expansion of the host range of the virus,gene mutation and gene reassortment of H6N1 virus can occur in these hosts,and then it may evolve into novel variant strain with infected human potential.

Objective To study the regional cerebral blood flow (rCBF) and correlated factors in patients with hepatolenticular degeneration (HLD).Methods The rCBF of lentiform nucleus,thalamus and other sites in 14 patients with HLD of cerebral type (cerebral type group) and 10 patients with HLD of non-cerebral type (non-cerebral type group) were determined by magnetic resonance-perfusion imaging technology,meanwhile 13 healthy volunteers were selected as control group,and calculated the relative regional cerebral blood flow (rrCBF) for avoiding perfusion time lag.The correlation between the clinical symptom scores,the content of urinary copper,duration and rrCBF in HLD patients were evaluated.Results The rrCBF of cerebral type group in the left and right frontal lobe,temporal lobe,lentiform nucleus,caudate nucleus,thalamus,midbrain,pons and the left hippocampus,cerebellar cortex,dentate nucleus were lower than those of control group (1.91 ±0.35 vs.2.44 ±0.64,1.80 ±0.30 vs.2.37 ±0.65,1.37 ±0.35 vs.2.14 ±0.91,1.58 ±0.52 vs.2.39 ±0.99,1.61 ±0.38 vs.2.59 ±0.74,1.52 ±0.64 vs.2.63 ±0.73,1.88 ±0.32 vs.2.61 ±0.67,1.70 ±0.40 vs.2.35 ±0.50,1.48 ±0.13 vs.2.01 ±0.59,1.46 ±0.38 vs.2.38 ±0.99,1.47 ±0.55 vs.2.02 ±0.72,1.27 ±0.48 vs.1.91 ±0.51,1.24 ±0.38 vs.1.47 ±0.29,1.25 ±0.39 vs.1.53 ±0.37,1.74 ±0.27 vs.2.40 ±0.89,1.79 ±0.50 vs.2.22 ±0.66,2.15 ±0.41 vs.2.64 ± 0.61),and there were significant differences (P ＜ 0.05 or ＜ 0.01).There were no significant differences in the rrCBF of the parietal and occipital lobe,etc between cerebral type group and control group (P ＞ 0.05).The rrCBF of cerebral type group in the left and right lentiform nucleus were lower than those of non-cerebral type group (1.61 ± 0.38 vs.1.94 ± 0.58,1.52 ± 0.64 vs.1.99 ± 0.59),and there were significant differences (P ＜ 0.05).The clinical symptom scores were positively correlated with the rrCBF of the left and right lentiform nucleus in 24 patients with HLD (r =-0.792 and-0.764,P ＜ 0.01),the content of urinary copper and duration had no correlation with the rrCBF of the left and right lentiform nucleus(P ＞ 0.05).Conclusions The rCBF of cerebral type and non-cerebral type HLD is significantly reduced,cerebral type patients have lower rCBF than non-cerebral type patients.The rCBF is correlated with the clinical symptom scores.

SAαt2,6 and SAα2,3 linked sialic acid molecules on epithelial cell membrane served as receptors for influenza virus, which axe specifically recognized by human and avian influenza viruses, respectively. The distribution of these two species of sialic acids in human respiratory tract from different anatomical sites and different age groups was investigated. The results showed that SAα2,3Gal species was prevalent in respiratory bronchiole and lung alveolar epithelium, but was infiequent in trachea, bronchus and bronchiole. On the contrary, the SAα2,6Gal species was more common in the trachea and bronchus and to a lesser degree in the alveolar epithelium. When compared the expression levels of SAα2,6Gal and α2,3Gal in the respiratory tract among different age groups, no significant difference was found. In the ex vivo H5N1 virus infection study, alveolus epithelium were found to be more susceptible to avian influenza than trachea and bronchus epithelial cells. These results suggest that the human respiratory tract, to some extent, is permissive for avian influenza viruses. The currently-observed limited human to human transmission of H5N1 virus may be associated with the different abundance of SAα2,3Gal linkages in human upper respiratory tract among individuals.

Objective:To investigate the efficacy of internal fixation maintenance after fracture-related infection (FRI).Methods:Retrospectively analyzed were the data of 81 patients with deep FRI after 6 weeks of internal fixation who had been treated with hardware maintenance at Department of Orthopedics, The Second Hospital Affiliated to School of Medicine, Zhejiang University between 2013 and 2021. They were 61 males and 20 females, aged from 11 to 73 years (average, 11 years). After admission, the patients received bacterial culture, thorough debridement, negative pressure suction, soft tissue repair, and local and intravenous antibiotics. If a joint was affected by FRI, its cavity was cleaned and drained. Infection control and fracture healing were regularly observed in all patients. A treatment was considered successful when the internal fixation was maintained until fracture union, and considered as unsuccessful when the internal fixation was removed before fracture union. Risk factors associated with treatment failure were identified from gender, age, smoking, diabetes, fracture type, methicillin-resistant Staphylococcus aureus (MRSA) infection, methicillin-susceptible staphylococcus (MSSA) infection, Pseudomonas aeruginosa infection, Escherichia coli infection, infection by two kinds of bacteria, negative bacterial culture, early infection (within 2 weeks) and local use of antibiotics.Results:All patients were followed up for an average of 30 months (from 6 to 84 months). Fracture union was achieved in 62 (76.5%) patients with infection control and internal fixation retained. Masquelet technique was used to treat bone defects in 2 patients; a muscle flap or skin flap was used to reconstruct soft tissue coverage in 11 cases; fracture union was achieved by antibiotics and dressing changes in 2 patients with sinus tract. Amputation was performed in one unsuccessful case due to uncontrollable infection, and internal fixation was changed to external fixation in the other 18 unsuccessful cases, of which 3 achieved final bone union after application of Masquelet technique, 7 achieved final bone union after application of bone transfer technique, and 3 achieved soft tissue coverage after reconstruction with flap technique. Pseudomonas aeruginosa infection, open fractures and FRI for more than 2 weeks were high risk factors for failure in internal fixation maintenance ( P<0.05). Conclusions:If internal fixation is still stable and effective, hardware maintenance should be tried first in the patients with FRI within 6 weeks after fracture internal fixation. Muscle flap or skin flap surgery should be performed as soon as possible to effectively control infection and promote fracture union in the patients with soft tissue defects after thorough and effective debridement. History of open fracture, Pseudomonas aeruginosa infection, and FRI for over 2 weeks may be risk factors for failure in internal fixation maintenance.

OBJECTIVE： To compare inhibitory effects of ethanol extract of different medicinal parts （root， stem， leaf， seed， flower and flesh） from Syzygium jambos on the activities of α-glycosidase and α-amylase. METHODS： Using half-inhibitory concentration value （IC50） as evaluation index， acarbose as positive control， inhibitory effects of ethanol extract of different medicinal parts from S. jambos on the activities of α-glycosidase （from yeast and small instestine in mice） and α-amylase were evaluated with in vitro inhibition model. The enzymatic dynamics and Lineweaver-Burk methods were used to analyze the inhibitory type of the best medicinal part on the activities of α-glycosidase and α-amylase. RESULTS： In the yeast α-glucosidase inhibitory activity test， the order of inhibitory activity was S. jambos seed＞S. jambos stem＞S. jambos leaf＞S. jambos root＞S. jambos flower＞S. jambos flesh＞acarbose. In the mice intestine α-glucosidase inhibitory activity test， the order of inhibitory activity was S. jambos seed＞S. jambos stem＞S. jambos root＞S. jambos leaf＞S. jambos flower＞S. jambos flesh＞acarbose. In the α-amylase inhibitory activity test， the order of inhibitory activity was acarbose＞S. jambos seed＞S. jambos stem＞S. jambos root＞S. jambos leaf＞S. jambos flesh＞S. jambos flower. Ethanol extract of S. jambos seed had the stronger inhibition activity against α-glucosidase from yeast，α-glucosidase from small intestine in mice and α-amylase than other medicinal parts [IC50 were（6.64±0.24）， （32.77±2.46） and （41.18±1.63） μg/mL]. Ethanol extract of S. jambos seed had the stronger inhibition activity against α-glucosidase than acarbose [IC50 to α-glucosidase from yeast and α-glucosidase from small intestine in mice were （2 833.33±5.48）， （1 304.21±6.45） μg/mL] （P＜0.05）. The inhibitory effect of ethanol extract from S. jambos on the activity of α-amylase was less than that of acarbose [IC50 was （27.27±1.24） μg/mL] （P＜0.05）. Enzymatic dynamics showed that the inhibitory type of ethanol extract from S. jambos seed on α-glucosidase and α-amylase were both reversible competitive inhibition. CONCLUSIONS： Among different parts of S. jambos such as root， stem， leaf， seed， flower and flesh， S. jambos seed shows the strongest inhibitory effects on the activities of α-glucosidase and α-amylase， which has the value of being developed for the treatment of diabetes or health food.