Neck dissection(ND)is one of the main treatment methods for oral and maxillofacial malignancies.Although ND type is in con-stant improvement,but intraoperative peal-pull-push injury of the accessory nerve,muscle,muscle membrane,fascia and ligament induced shoulder syndrome(SS)is still a common postoperative complication,combined with the influence of radiochemotherapy,not only can cause pain,stiffness,numbness,limited dysfunction of shoulder neck and arm,but also may have serious impact on patient's life quality and phys-ical and mental health.At present,there is still a lack of a systematic evaluation and rehabilitation management program for postoperative SS of oral and maxillofacial malignant tumors.Based on the previous clinical practice and the current available evidence,refer to the relevant lit-erature at home and abroad,the experts in the field of maxillofacial tumor surgery and rehabilitation were invited to discuss,modify and reach a consenusus on the etiology,assessment diagnosis,differential diagnosis,rehabilitation strategy and prevention of SS,in order to provide clinical reference.

It is a challenge to determine the cause of death in cases caused by both injury and disease in forensic pathology examinations.Here,we retrospectively analyzed 140 such cases enrolled in the Sun Yat-sen University Forensic Identification Center from 2013 to 2021.It was found that the cases caused by both injury and disease accounted for 2.89%of the total number of cases during the same period.The male-to-female ratio was 5.09.Cardiovascular disease accounted for 71.43%of the death-leading diseases,and coronary heart disease accounted for 49.29%.Among the three types of injury and disease relationship,the proportion of disease-based and injury-assisted cases accounted for more than half(65.86%),and the proportion of injury and disease with the same effect cases was the least(12.14%).Medical treatment was involved in as more as 82.86%of the cases.Re-identification were carried out in 10.71%of the cases,53.33%of which were with a≤24-hour-survival time,higher than the proportion(20.80%)of this survival time in initial identification cases(x2 = 13.84,P = 0.000 2).This study revealed the epidemiological characteristics of cases caused by both injury and disease,and supplied useful data for improving the level of forensic identification in such cases.

ObjectiveTo explore the preventive effects of chest compression， abdominal compression and combined thoracoabdominal compression on propofol-induced respiratory depression during gastroscopy. MethodsA total of 544 patients underwent propofol sedation during gastroscopy in our hospital were randomly divided into 4 groups （n=136 each）： Group C （control group）， Group T （chest compression group）， Group A （abdominal compression group） and T&A （combined thoracoabdominal compression group）. Altogether 20 chest， abdominal and combined thoracoabdominal compressions were started respectively on patients in Group T， A and T&A before performing gastroscopy and after unconsciousness at a rate of 30 compressions per minute with a compression depth of 2~3 cm. The incidence of oxygen desaturation （SpO₂2<95%） and hypoxemia （SpO₂<90%） were compared among the groups. Incidence of gastroscope withdrawal and B-mode ultrasound assessment of diaphragm activity were observed. ResultsThere were statistical differences in the incidence of oxygen desaturation and hypoxemia among the four groups （P<0.05）. The incidence of oxygen desaturation in Group T and A were significantly lower than that in Group C （P<0.017）. B-ultrasonography revealed that the diaphragm activity in Group T and T&A were significantly higher than that in Group C （P＜0.01） and the patients in Group T had the highest diaphragm activity. ConclusionBoth chest compression and abdominal compression can reduce the incidence of respiratory depression induced by propofol in patients during gastroscopy， and chest compression is more effective.

OBJECTIVES: To investigate the risk factors for acute kidney injury (AKI) after hematopoietic stem cell transplantation (HSCT) in children. METHODS: A retrospective analysis was performed on the medical data of 111 children who underwent HSCT from January 2018 to January 2020. A multivariate logistic regression analysis was used to identify the risk factors for AKI. The Kaplan-Meier survival analysis was used to compare the prognosis in children with different grades of AKI. RESULTS: Graft-versus-host disease (grade Ⅱ-Ⅳ) (OR=4.406, 95%CI: 1.501-12.933, P=0.007), hepatic veno-occlusive disease (OR=4.190, 95%CI: 1.191-14.740, P=0.026), and thrombotic microangiopathy (OR=10.441, 95%CI: 1.148-94.995, P=0.037) were closely associated with the development of AKI after HSCT. The children with stage Ⅲ AKI had a lower 1-year survival rate than those without AKI or with stage Ⅰ AKI or stage Ⅱ AKI (28.6%±12.1% vs 82.8%±5.2%/81.7%±7.4%/68.8%±11.6%; P<0.05). CONCLUSIONS Children with stage Ⅲ AKI after HSCT have a higher mortality rate. Graft-versus-host disease, hepatic veno-occlusive disease, and thrombotic microangiopathy are closely associated with the development of AKI after HSCT.
Child ; Humans ; Retrospective Studies ; Hematopoietic Stem Cell Transplantation/adverse effects* ; Graft vs Host Disease/complications* ; Risk Factors ; Acute Kidney Injury/therapy* ; Thrombotic Microangiopathies/complications*

Objective:To evaluate the epidemiology of bacterial bloodstream infections in patients submitted to hematologic wards in southern China.Methods:A total of 50 teaching hospitals were involved based on the China Antimicrobial Resistance Surveillance System. The data of clinical isolates from blood samples were collected from January 1, 2019, to December 31, 2019. Antimicrobial susceptibility testing was conducted by the Kirby-Bauer automated systems, and the results were interpreted using the CLSI criteria.Results:The data of 1,618 strains isolated from hematologic wards in 2019 were analyzed, of which gram-negative bacilli and gram-positive cocci accounted for 71.8% and 28.2%, respectively. Of those, the five major species were most often isolated, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, coagulase-negative staphylococcus, and Streptococcus viridans. The prevalence rates of methicillin-resistant strains in Staphylococcus aureus and coagulase-negative staphylococcus were 19.7% and 80.6%, respectively. No gram-positive cocci were resistant to vancomycin, linezolid, and teicoplanin, and none of the enterococci were resistant to linezolid. The resistance rate of S. viridans to penicillin G was 6.9%, and those to ceftriaxone and cefotaxime were more than 25%. The resistance rate of E. coli and K. pneumoniae in Enterobacteriaceae was higher in children than that in adults. The resistance rate of K. pneumoniae to meropenem was 14.1%. The resistant rate of Enterobacter cloacae to carbapenem was more than 25%. P. aeruginosa was more sensitive to more antibiotics than 80%, but the resistance rate to meropenem in children was higher than that in adults (11.8% vs. 6.5%). The proportion of gram-positive cocci in the ICU and respiratory departments was higher than that in the hematology department. The detection rates of carbapenem-resistant E. coli and K. pneumoniae in the respiratory department were the lowest with 0.3% and 3.7%, respectively, while those of CRPA and CRAB in the hematology department were the lowest with 8.3% and 25.8%, respectively. The detection rate of all carbapenem-resistant organisms in the ICU was the highest among the three departments.Conclusion:The etiology and drug resistance of bacteria from blood samples in the hematology department are different from those in the ICU and respiratory departments. The proportions of K. pneumoniae, P. aeruginosa, E. cloacae, and S. viridans dominating in the department of Hematology were significantly higher than those in the ICU and respiratory departments in Guangdong region.

OBJECTIVE： To investigate the effects and its mechanism of calcium phosphate bone cement （CPC） loading total flavonoids of Davallia mariesii on osteogenic differentiation of induced membrane in rats. METHODS： Drug-loading CPC and drug-loading polymethyl methacrylate （PMMA） cement were prepared with the contents of Qianggu capsules （total flavonoids of D. mariesii as active ingredient） using CPC and PMMA cement as carrier. Totally 64 male SD rats were randomly divided into drug-loading CPC group， drug-loading PMMA cement group， no-drug CPC group， no-drug PMMA cement group， with 16 rats in each group. The femur of rats was separated and osteotomized to prepare bone defect model， and then the corresponding bone cement was implanted. Four weeks after modeling， the induced membranes of rats were cut and protected. Bone cement was taken out and autogenous cancellous bone was implanted. At the 4th week after modeling， X-ray photographs were taken on the hind limb bones of rats. At the 4th week after modeling and 6th week after bone grafting， induced membranes and new bone were taken from the bone defect area of rats respectively. HE staining was used to observe the morphology of induced membrane， and the width of bone rabecular and the number of osteoblasts of new bone tissue were measured. Immunohistochemistry was used to detect the protein expression of BMP-2 and VEGF in induced membrane. Western blotting assay was used to detect the protein expression of Smad1， Smad4 and Smad7 in new bone. RESULTS： Compared with other 3 groups， the degradation of bone cement in drug-loading CPC group was more obvious in the bone defect areas， which showed that the formation of induced membrane was observed and the bone defect areas were smaller； capillary endothelial cells were abundant and orderly arranged in the induced membranes， and the width of bone trabeculae and the number of osteoblasts in the new bone tissue increased significantly （P＜0.05）； the protein expression of BMP-2 and VEGF in the induced membrane， the protein expression of Smad1， Smad4 and Smad7 in new bone were increased significantly （P＜0.05）. CONCLUSIONS： CPC loading total flavonoids of D. mariesii promotes the formation of induced membrane osteoblast in bone defect model rats， which may be associated with regulating osteoblast differentiation by activating BMP-2/Smad pathway； at the same time， it can promote bone healing by promoting the differentiation of vascular endothelial cells， accelerating the formation of capillary network and increasing the expression of vascular endothelial cells.

OBJECTIVETo establish the intrauterine growth percentile curves of full-term neonates with different gestational ages (GAs) born to primiparous or multiparous women, and to investigate the influence of parity on intrauterine growth potential.

METHODSCross-sectional cluster sampling was performed from April 2013 to September 2015 to measure physical growth in full-term singleton infants with a GA of 37-41 weeks in two hospitals in Shenzhen, China. The Lambda-Mu-Sigma method was used for curve fitting.

RESULTSThe mean values of birth weight, body length, head circumference, chest circumference, and crown-rump length were obtained in 14 529 full-term infants. The 10th, 25th, 50th, 75th, and 90th percentile curves of the five indices were established. The full-term infants born to multiparous women had similar patterns and growth trends of the five percentile curves of the above five indices to those born to primiparous women, while the full-term infants with a GA of 37-41 weeks born to multiparous women had higher mean values and percentile curve values of the above five indices than those born to primiparous women. In the group with a GA of 41 weeks, there was no significant difference in the crown-rump length between the infants born to primiparous women and those born to multiparous women, but there were significant differences in the means of the above five indices in all the other GA groups between the two group infants (P<0.05).

CONCLUSIONSFull-term infants with a GA of 37-41 weeks born to multiparous women have higher intrauterine growth levels of birth weight, body length, head circumference, chest circumference, and crown-rump length than those born to primiparous women, suggesting that parity is an important influencing factor for intrauterine growth potential.

Birth Weight ; Body Height ; Cross-Sectional Studies ; Female ; Fetal Development ; Gestational Age ; Humans ; Infant, Newborn ; Male ; Parity ; Pregnancy

BACKGROUND: Peripheral nerve injury can lead to extensive changes in central nervous system, and exercise training can promote the recovery of locomotor function following central nervous system injury. OBJECTIVE: To observe the changes of locomotor function and the expression levels of vesicular glutamate transporter VGLUT1 in the spinal cord in a rat model of dorsal root ganglion resection after treadmill exercise and to explore the effect of treadmill training on the locomotor function after peripheral nerve injury. METHODS: Thirty-nine 10-week-old male Wistar rats were randomized into experimental (n=15), control (n=15) and sham operation (n=9) groups. The rats in the experimental and control groups received the dorsal root ganglion resection at L3and L4segments to establish the model of peripheral nerve injury under local anesthesia, while the rats in the sham operation group were only subjected to dorsal root ganglion exposure. The rats in the experimental group underwent 15 m/minute treadmill training at postoperative 7 days, while rats in the other two groups were in free movement. Gait analysis was performed at preoperative 3 days, postoperative 7, 14, 21, and 28 days, respectively, and the behavioral changes of rats were observed. The tissue sections were obtained from L3segment at postoperative 7, 14, and 28 days to detect the expression levels of VGLUT1 in the spinal cord by immunohistochemistry. RESULTS AND CONCLUSION: The peroneal nerve function index in the experimental and control groups was lower than that before surgery and that in the sham operation group at postoperative different time points (all P ＜ 0.05). The index in the experimental and control groups was the lowest on day 7 postoperatively (P ＜ 0.05), then the index gradually increased, but was still lower than the preoperative level (P ＜ 0.05). The index in the experimental group was significantly higher than that in the control group at postoperative 21 and 28 days (P ＜ 0.05). The expression levels of VGLUT1 in the lamina IX in the experimental and control groups were significantly lower than those in the sham operation group at different time points after surgery (P ＜ 0.01). The levels in the experimental group were significantly higher than those in the control group at postoperative 14 and 28 days (P ＜ 0.05). The levels in both groups on a decline after surgery, especially the control group (P ＜ 0.05). These results suggest that treadmill can promote the recovery of locomotor function post peripheral nerve injury.

Objective To establish a Real-time quantitative PCR method (qPCR) for the detection of diatom UPA barcoding genes and evaluate its application in the drowning diagnosis. Methods The homologous sequences of diatoms UPA gene was obtained by Blast from GeneBank, based on which the universal primers for diatoms were designed. DNA were extracted from 2 common human symbiotic bacteria (Escherichia coli, Bifidobacterium longum), 3 species of planktonic bacteria, 15 species of planktonic algae, tissue samples (lung, liver and kidney) from human cadavers (28 drowning victims, 1 victims by non-drowning in the water, 3 victims deaths on land) in 32 cases. The specificity, sensitivity and repeatability of the designed primers were tested. The positive rates of diatoms detection in the drowning cases were calculated. The results of the real-time quantitative method were evaluated comparatively by Microwave Digestion-Vacuum Filtration-Automated Scanning Electron Microscopy (MD-VF-Auto SEM) and PCR-Capillary Electrophoresis (PCR-CE). Results The results showed that the primers UPA99 had strong specificity for the diatomaceae (Synedra radians, Navicula sp., Melosira varians, Cyclotella sp. and Nitzschia sp.) DNA. The melting curve of the amplified product was smooth; the peak was narrow; the melting temperature was (87±1)℃. The sensitivity of qPCR method was 1.56×10-5ng/μL with the detection range of 1.56×102ng/mL~1.56×10-5ng/μL, in contrast with the PCR-CE method (1.56×10-3ng/μL). This real-time PCR method showed high repeatability and stability with the coefficient of variation less than 2%. The detection rate of lung, liver and kidney was 89.3%, 71.4% and 64.3% respectively. Conclusion The established qPCR method, based on the universal primers designed for diatom UPA gene, has high specificity, high sensitivity and good repeatability. With a promising prospect for application, qPCR is suitable for drowning diagnosis.

PURPOSE: The measuring Epstein-Barr virus (EBV) DNA is an important predictor of nasopharyngeal carcinoma (NPC). This study evaluated the predictive value of pretreatment serum amyloid A (SAA) and C-reactive protein (CRP) comparing with EBV DNA in patients with NPC. MATERIALS AND METHODS: In an observational study of 419 non-metastatic NPC patients, we prospectively evaluated the prognostic effects of pretreatment SAA, CRP, and EBV DNA on survival. The primary end-point was progress-free survival (PFS). RESULTS: The median level of SAA and CRP was 4.28 mg/L and 1.88 mg/L, respectively. For the high-SAA group (> 4.28 mg/L) versus the low-SAA (≤ 4.28 mg/L) group and the high-CRP group (> 1.88 mg/L) versus the low-CRP (≤ 1.88 mg/L) group, the 5-year PFS was 64.5% versus 73.1% (p=0.013) and 65.2% versus 73.3% (p=0.064), respectively. EBV DNA detection showed a superior predictive result, the 5-year PFS in the EBV DNA ≥ 1,500 copies/mL group was obviously different than the EBV DNA < 1,500 copies/mL group (62.2% versus 77.8%, p < 0.001). Multifactorial Cox regression analysis confirmed that in the PFS, the independent prognostic factors were including EBV DNA (hazard ratio [HR], 1.788; p=0.009), tumour stage (HR, 1.903; p=0.021), and node stage (HR, 1.498; p=0.049), but the SAA and CRP were not included in the independent prognostic factors. CONCLUSION: The results of SAA and CRP had a certain relationship with the prognosis of NPC, and the prognosis of patients with high level of SAA and CRP were poor. However, the predictive ability of SAA and CRP was lower than that of EBV DNA.
C-Reactive Protein* ; DNA* ; Herpesvirus 4, Human* ; Humans ; Observational Study ; Prognosis ; Prospective Studies* ; Serum Amyloid A Protein* ; Survival Analysis