Objective To observe any effect of transcutaneous electrical nerve stimulation (TENS) on pul monary function,airflow obstruction,dyspnea,exercise capacity and levels of tumor necrosis factor-α (TNF-α) in the sputum of patients with chronic obstructive pulmonary disease (COPD).Methods Thirty patients with stage Ⅰ or Ⅱ COPD were randomly divided into a treatment group and a control group with 15 cases in each.TENS applied at the Feishu acupuncture point (BL13) was used in the treatment group,while sham stimulation of the same point without current output was used in the control group.The treatment was administered 40 minutes once daily,5 days a week for a total of 4 weeks.The outcome measures were measured before and after 4 weeks of treatment.Results FVC,FEV1,FEV1％,and peak expiratory flow rate (PEFR) all improved significantly in the treatment group after 4 weeks of treatment.After treatment,the average TNF-α level in induced sputum and exercise capacity as indicated by the average BODE index had both improved significantly in the treatment group.Compared with the control group,pulmonary function,TNF-α and the BODE index in the treatment group were all significantly better.There was no significant difference in pulmonary function,BODE index or TNF-α before and after treatment in the control group.Conclusion TENS at the Feishu acupoint can reduce airway inflammation,improve pulmonary function and exercise capacity,and decrease TNF-α levels in patients with stage Ⅰ or Ⅱ COPD.This treatment should be very useful for enhancing their ability in the activities of daily living.

Abstract: Objective　To analyze the epidemic characteristics of soil-transmitted helminth (STH) by the spatial epidemiological method in Jiangxi Province. Methods　Surveillance data of STH in Jiangxi Province from 2016 to 2019 were collected for descriptive epidemiological analysis. The space-time permutation distribution of STH infection areas was analyzed with spatial autocorrelation, hotspot analysis methods and retrospective space-time permutation scan statistics. Results　The infection rates of STH were 1.32% (947/71 766), 1.14% (803/70 547), 0.87% (604/69 507) and 0.90% (628/69 620), respectively, and the differences were statistically significant in different years (P<0.01). The rates of hookworm infection were 0.65% (466/71 766), 0.64% (450/70 547), 0.48% (336/69 507) and 0.52% (362/69 620), respectively, and the differences were statistically significant (P<0.01). The infection rates of Ascaris lumbricoides were 0.55% (393/71 766), 0.41% (287/70 547), 0.32% (221/69 507) and 0.32% (225/69 620), respectively, and the differences were statistically significant in different years (P<0.01). The infection rates of Trichuris trichiura were 0.17% (125/71 766), 0.10% (74/70 547), 0.08% (57/69 507) and 0.07% (49/69 620), respectively, and the differences were statistically significant among different years (P<0.01). The results of global spatial autocorrelation analysis showed that there was a spatial autocorrelation index Moran's I value of hookworm infection rate in 2016, Trichuris trichiura infection rate in 2016, 2018 and 2019, with statistical significance (P<0.05). The results of hotspot analysis, SaTScan and FleXScan spatial and temporal scanning analysis showed that there were high-value aggregation regions for each species in each year. Conclusion　The infection rates of STH, hookworm, Ascaris lumbricoides and Trichuris trichiura showed a decreasing trend and space-time clustering from 2016 to 2019. It should be taken into account in the formulation of control strategies.

Objective · To prepare the liposomal pemetrexed and investigate its effects on MCF-7 breast cancer cells in vitro and nude mice bearing MCF-7 xenograft tumors. Methods · Liposomal pemetrexed was prepared by film dispersion method. Inhibition of MCF-7 breast cancer cell lines was evaluated by CCK-8 method, and anti-tumor effects were investigated on Balb/c nude mice bearing MCF-7 xenograft tumors. Results · Liposomal pemetrexed inhibited the growth of MCF-7 cells. When the concentrations of pemetrexed were 0.20, 0.40 and 10.00 μg/mL, the cell viability in experiment group (liposomal pemetrexed) was significantly lower than that in control group (pemetrexed of same concentration gradient), with P values of 0.013, 0.035 and 0.041, respectively. Compared with blank group (same volume of PBS), the volumes and weights of tumors of nude mice in experiment group(liposomal pemetrexed) and control group (same volume of pemetrexed) were significantly lower, and the volume and weight of tumor in experiment group were also significantly lower than those in control group (P=0.000). Conclusion · Compared to bulk drug of pemetrexed, liposomal pemetrexed can inhibit the growth of MCF-7 breast cancer cells and the Balb/c nude mice bearing MCF-7 xenograft tumors.

Adult ; Burns, Inhalation ; diagnostic imaging ; Explosions ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Radiography

Objective To investigate the function of major histocompatibility complex (MHC)class Ⅰ-related gene (MIC) in ulcerative colitis (UC) pathogenesis. Methods The difference of MICA, M ICB and their ligand NKG2D genes expression in colonic mucosa tissue of 34 UC patients and 12 healthy people were determined by fluorescent real-time reverse-transcriptase polymerase chain reaction (RT-PCR) and the expression location of M ICA in colonic mucosa tissue was obtained by laser scanning confocal microscope. Results The mRNA level of MICA, MICB and NKG2D expression in UC groups (3. 5408±2. 6658, 8. 9879±3. 2893 and 2. 4395±0. 8147 accordingly) was significantly higher than that in the healthy controls ( 1. 0477 ± 0. 7201, 4. 6293 ± 1. 2616 and 1. 1624±0. 3954 accordingly) (P = 0.0053, 0.0039 and 0. 0078 accordingly). It suggested that MICA was expressed in colonic epithelia cell membranes by laser scanning confocal microscopy.Conclusion The mRNA level of MICA, M ICB, and their ligand, NKG2D expression were all up regulated in the colonic mucosa of UC patients, which indicated MIC gene might perform important local function in UC.

OBJECTIVETo investigate the association of gene polymorphism of cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) with ulcerative colitis (UC) in Chinese.

METHODSOne hundred and seventeen patients with UC and 246 healthy controls were genotyped for the polymorphisms of C-658T in the promoter and C61T at the 3' untranslated region of the CTLA-4 gene using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) and polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP), respectively. The genotype and allele frequencies of the two groups were calculated and compared by chi square test.

RESULTSThe frequency of TT+CT genotype at the CTLA-4 gene C-658T in the promoter was significantly higher in UC patients than that in healthy controls (P=0.015). The frequency of the T allele at this locus was also significantly higher in UC patients than that in the controls (P=0.033). The frequencies of TT genotype and T allele at the C-658T locus were highly associated with extensive colitis in UC patients (P=0.037, and P=0.0067, respectively).

CONCLUSIONThe T allele of CTLA-4 promoter C-658T locus was highly associated with UC in Chinese Han of central China.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD ; genetics ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; CTLA-4 Antigen ; Case-Control Studies ; China ; Colitis, Ulcerative ; genetics ; Female ; Genetic Association Studies ; Humans ; Male ; Middle Aged ; Molecular Sequence Data ; Polymorphism, Single Nucleotide ; Promoter Regions, Genetic ; Young Adult

Objective:To compare the clinical characteristics and etiology changes of patients with bronchiolitis before the pandemic of coronavirus disease 2019(COVID-19)with those after the pandemic, and to provide a basis for the clinical diagnosis, treatment and prevention of bronchiolitis.Methods:Retrospective analysis were made on the clinical characteristics and etiological changes of patients who were hospitalized with bronchiolitis in the Department of Pulmonology, Children′s Hospital of Soochow University before COVID-19 pandemic(from February 1, 2019 to January 31, 2020, called as Group 2019-2020)and after COVID-19 pandemic(from February 1, 2020 to January 31, 2021, called as Group 2020-2021). Medical records were reviewed to compare general conditions, clinical manifestations, and laboratory tests.Nasopharyngeal secretion examination results were collected to compare the differences in pathogenic composition.Results:A total of 285 patients were enrolled in the Group 2019-2020, while 190 patients in the Group 2020-2021.There were no significant differences in gender, age, symptom duration prior to admission and length of stay between the two groups( P>0.05). The proportion of moderate/severe cases in the Group 2020-2021 was lower than that in the Group 2019-2020[10.53%(20/190)vs 21.75%(62/285)]and the difference was statistically significant( χ2=10.062, P<0.05). The proportion of stuffy nose rhinorrhea in the Group 2020-2021 was higher than that in the Group 2019-2020, while the proportion of gastrointestinal symptoms(vomiting and diarrhea)in the Group 2020-2021 was lower than that in the Group 2019-2020 [57.37%(109/190)vs 47.37%(135/285)and 15.79%(30/190)vs 24.56 %(70/285)]and the differences were statistically significant( χ2 were 4.563 and 5.278 respectively, all P<0.05). There were no significant differences in the proportions of fever, dyspnea, shortness of breath and cyanosis between the two groups(all P>0.05). The creatine kinase isoenzyme(CK-MB)in the Group 2020-2021 was lower than that in the Group 2019-2020[4.15(2.90~5.60)vs 6.70(4.20~22.10)]and the difference was statistically significant( Z=-8.757, P<0.05). There were no statistically significant differences in white blood cell count(WBC), percentage of neutrophil(N%), blood platelet count(PLT), percentage of eosinophil(EOS%), C-reactive protein(CRP), alanine aminotransferase(ALT)and lactate dehydrogenase(LDH)between the two groups(all P>0.05). The total pathogen detection rate, positive rate of respiratory syncytial virus(RSV), positive rate of mycoplasma pneumoniae(MP)and mixed infection rate in the Group 2020-2021 were lower than those in the Group 2019-2020[65.26%(124/190)vs 75.09%(214/285), 14.21%(27/190)vs 30.18%(86/285), 6.32%(12/190)vs 15.09%(43/285), 16.84%(32/190)vs 25.61%(73/285)], with statistically significant differences( χ2 were 5.361, 16.026, 8.568 and 5.094 respectively, all P<0.05). The positive rate of rhinovirus in the Group 2020-2021 was higher than that in the Group 2019-2020[13.16%(25/190)vs 4.91%(14/285)]and the difference was statistically significant( χ2=10.285, P<0.05). There were no significant differences in the positive rates of human metapneumovirus, Boca virus and parainfluenza virus 3 between the two groups(all P>0.05). Conclusion:The clinical characteristics and etiology of patients with bronchiolitis have changed after the COVID-19 pandemic.The quarantine and protection measures reduce the transmission of associated pathogens and the severity of the disease.

Objective:To investigate the factors associated with complications following the implantation of external-expansion devices with an injection port.Methods:A retrospective study was conducted, including 68 patients who underwent expansion device implantation at the Department of Plastic Surgery, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, from January 2019 to May 2022 and the patients experienced postoperative complications (case group). Additionally, 195 patients who underwent the same procedure during the same period but did not experience complications were selected as control group, following a 1∶3 ratio. Preoperatively, different shapes and sizes of expansion devices were chosen according to the lesion location and area. Observational indicators included admission diagnosis, preoperative white blood cell count, preoperative hemoglobin count, gender, age, implantation site of the expander, season of admission, and duration of postoperative drainage tube placement. Univariate and multivariate logistic regression analyses were used to analyze factors associated with postoperative complications.Results:Univariate logistic regression analysis revealed that implantation at the trunk ( OR=0.439, 95% CI: 0.207-0.901, P=0.028), admission diagnosis of microtia ( OR=4.155, 95% CI: 1.735-10.206, P=0.001), and admission season from April to September ( OR=3.269, 95% CI: 1.819-6.073, P<0.001) were associated with complications following expansion device implantation. Multivariate logistic regression analysis showed that admission season from April to September ( OR=3.272, 95% CI: 1.796-6.156, P<0.001) was a significant factor associated with postoperative complications. Conclusion:Implantation site at the trunk, admission diagnosed with microtia, and admission season from April to September are the factors associated with complications following expansion device implantation.

Objective:To explore the changes of serum levels of copeptin and α-amylase and their correlations with sleep and cognition in patients with chronic insomnia (CI).Methods:From September 1, 2018 to May 31, 2019, fifty CI outpatients or inpatients from the Department of Sleep Disorder, Affiliated Chaohu Hospital of Anhui Medical University, were enrolled continuously, and thirty good sleepers from the Physical Examination Center of the hospital, were also enrolled to serve as controls. Pittsburgh Sleep Quality Index (PSQI), polysomnography (PSG) and Pre-Sleep Arousal Scale (PSAS) were used to assess the insomnia severity and sleep disorder susceptibility. Montreal Cognitive Assessment scale (MoCA) and Nine-Box Maze were used to respectively assess general cognition and memories. The serum levels of copeptin and α-amylase were detected using enzyme linked immunosorbent assay.Results:Compared to the controls, the CI patients had increased PSQI score (16.0 (15.0, 17.0) vs 4.0 (2.8, 6.0); Z=-7.678, P<0.001) and PSAS score (33.0 (30.0, 37.5) vs 17.0 (16.0, 18.5); Z=-7.350, P<0.001), decreased MoCA score (24.1±2.5 vs 26.7±1.9, t=-4.625, P<0.001), increased numbers of errors in the object working (1.0 (0, 1.0) vs 0 (0, 1.0), Z=-2.099, P=0.036), spatial working (2.0 (1.0, 4.0) vs 1.0 (0, 2.0), Z=-3.935, P<0.001) and object recognition (1.0 (0, 2.0) vs 0 (0, 0), Z=-2.266, P=0.023) memories, and elevated serum levels of copeptin ((35.1±19.9) pg/ml vs (14.8±6.9) pg/ml, t=5.414, P<0.001) and α-amylase ((990.1±193.7) U/L vs (728.9±230.5) U/L, t=5.597, P<0.001). In the CI patients, the level of copeptin was positively correlated with PSQI score ( r=0.338, P=0.013), PSAS score ( r=0.316, P=0.021), sleep latency ( r=0.324, P=0.018), number of awake ( r=0.325, P=0.017) and stage 1 percent of non-rapid eye movement sleep ( r=0.278, P=0.044), and negatively correlated with stage 2 percent of non-rapid eye movement sleep ( r=-0.279, P=0.043); α-amylase was positively correlated with numbers of awake in PSG ( r=0.293, P=0.033). Multiple linear regression analysis showed that copeptin level affected PSQI score (β=0.255, P=0.043) and sleep latency (β=0.254, P=0.043). Conclusion:The levels of copeptin and α-amylase in CI patients elevate, and copeptin may be associated with initial sleep difficulties, but not with cognitive ability, in patients with CI.

Objective:To demonstrate the clinical effect of latissimus dorsi musculocutaneous flap with primary closure in V-Y suture in the repair of major lesions in the anterior chest wall that was left after mastectomies with locally advanced breast cancer (LABC) surgery.Methods:From September 2018 to February 2021, the technique was employed on 14 female cancer patients who had LABC surgery in the Department of Breast Surgery of the First Affiliated Hospital of Kunming Medical University. The patients received radical mastectomies with major resection of cutaneous tegument. The defect areas in chest wall were 15.0 cm×15.0 cm-22.0 cm×35.0 cm. The sizes of flap were 12.0 cm×28.0 cm-18.0 cm×35.0 cm. The sizes of musculocutaneous flap were 12.0 cm×28.0 cm×2.0 cm~18.0 cm×35.0 cm×3.5 cm. All patients were entered the postoperative follow-up through out-patient clinic and telephone interviews.Results:The flap provided an efficient coverage in closing the defects among all 14 patients. Three patients presented small areas (1.0-3.0 cm) of superficial necrosis in Y-cross area of the flap. None of the patient had back swelling. The average operation time was 6.3 hours. Postoperative follow-up varied from 4 to 41 months(18 months in average). The colour, texture, elasticity of the flaps were acceptable, with good shapes. Function of upper limbs was normal in 13 cases without lymphedema, except 1 who had lymphedema of affected limb at 3 years after surgery. Eleven cases had radiotherapy after surgery with good tolerance. None of the cases had local recurrence of breast cancer. Five cases had metastasis, 3 cases died of metastasis.Conclusion:The latissimus dorsi musculocutaneous flap with primary closure in V-Y suture is easy to perform and an reliable and efficient technique in repairing large defects in the anterior chest wall left after a LABC surgery.