Animals ; Bone Regeneration ; Bone Substitutes ; Computer-Aided Design ; Humans ; Lactic Acid ; chemistry ; Microsurgery ; Neovascularization, Physiologic ; Polyesters ; chemistry ; Polyglycolic Acid ; chemistry ; Starch ; chemistry ; Stem Cells ; cytology ; Tissue Engineering ; methods

Experimental studies with only one intervention are not always sufficient for health care issnes, while the method of complex intervention is more useful. But the complex intervention is more complicated and needs carefully design and evaluation. This article will introduce the framework for design and evaluation of complex intervention and the revised version made by Medical Research Council, with five examples showing its application.

Animals ; Biopterin ; analogs & derivatives ; therapeutic use ; Genetic Therapy ; Humans ; Phenylalanine Ammonia-Lyase ; administration & dosage ; Phenylketonurias ; therapy

Objective: To investigate the sonographic features of appendicitis in preterm infants. Methods: A total of 28 cases of premature infants with acute appendicitis diagnosed by bedside abdominal ultrasound in the First Hospital of Jilin University from November 2012 to January 2019 were recruited. Basic clinical information, abdominal ultrasound images, surgical results, management and outcomes were collected and analyzed. Descriptive statistical methods were used for data analysis. Results: Among the 28 cases, 21 (75.0%) were males and seven (25.0%) were females. All of them were diagnosed as having acute appendicitis with perforation according to the bedside ultrasound. Five (17.8%) presented direct signs of appendicitis, i.e. partial structure of the appendix and perforation site. The other 23 (82.2%) showed indirect signs, including heterogeneous echotexture or hypoechoic patterns between the liver and right kidney in six cases, heterogeneously hypoechoic areas between the bowels in the right lower abdomen in seven cases, and dissociative effusion between the bowels in the right lower abdomen with poor sound transmission and disorder of surrounding intestinal structure in ten cases. Twenty-one out of the 28 cases (75.0%) exhibited bowel wall thickening at right lower abdomen, absence of intestinal peristalsis and effusion echoes between the intestines with poor sound transmission. Emergent surgeries were performed and diagnoses of appendicitis with perforation were confirmed. All the 21 cases were discharged after full recovery. Seven cases (25.0%) showed confined cystic images and received conservative treatment. One of them developed adhesive intestinal obstruction during follow-ups and underwent surgical treatment, during which local formations of wrapping after appendiceal perforation and obstruction due to surrounding intestinal adhesion were observed. The other six cases recovered after conservative management with gradually reduced peritoneal effusion, normal omental echo patterns and improved inflammatory indicators and abdominal symptoms, and no ileus occurred during follow-ups after discharge. Conclusions Symptoms of appendicitis in preterm infants are non-specific, and perforation is more likely to be seen. Bedside ultrasonography mainly shows indirect signs of appendicitis, and direct signs in some infants. Bedside ultrasound can be an essential tool for the diagnosis of these conditions with high accuracy.

Ex vivo expansion of hematopoietic progenitor cells (HPCs) is valuable for clinical application, however, traditional ex vivo culture negatively affects long-term hematopoietic reconstitution ability. In the hematopoietic system, the expression of Notch receptors and their ligands has been widely reported. Active Notch signal inhibits the differentiation of HSCs while promotes their expansion, suggesting that ex vivo expansion of hematopoietic progenitor cells could be enhanced by manipulating Notch signal pathways. In this article the Notch signal pathways, Notch signal and maintenance of hematopoietic progenitor cells, Notch signal and expansion of hematopoietic progenitor cells and molecular mechanism of Notch signal maintaining undifferentiation of hematopoietic progenitor cells were reviewed.
Animals ; Hematopoietic Stem Cells ; cytology ; metabolism ; Humans ; Receptors, Notch ; metabolism ; Signal Transduction

Compression fractures are the most common vertebral fractures. They involve the anterior column of the spine, and are considered stable fractures due to the presence of intact posterior ligaments that aid in resisting further collapse and deformity. They are thus often managed conservatively. We describe a series of 3 cases that were initially diagnosed as compression fractures and managed conservatively. With the abundance of compression fractures and increase in preference for conservative management of compression fractures, it is of utmost importance to recognize the possibility of other spinal co-pathologies, especially that of hyperostosis of the spine, both by clinical judgment as well as radiological analysis before embarking on conservative management, should there be under-treatment and development of complications that could have otherwise been avoided, as in the cases presented in this series.
Congenital Abnormalities ; Fractures, Compression* ; Hyperostosis ; Hyperostosis, Diffuse Idiopathic Skeletal* ; Judgment ; Ligaments ; Radiography ; Spine

Acute Disease ; Adult ; DNA, Viral ; blood ; Female ; Genotype ; Hepatitis B virus ; genetics ; Humans ; Male

Adult ; Female ; Hepatitis B ; immunology ; Humans ; Interferon-gamma ; blood ; Interleukin-12 ; blood ; Male ; Middle Aged ; Tumor Necrosis Factor-alpha ; analysis

The clinical data of 2 infants with infantile glycogen storage disease type II (GSD II) from one pedigree were collected. The method of dried blood spots (DBS) was applied to collect peripheral blood samples, and the activity of acid alpha-D-glucosidase (GAA) in leukocytes was measured. The coding region of GAA gene in this pedigree was amplified by polymerase chain reaction and then direct sequencing was used to analyze mutations in GAA gene. The two infants were twins, who were admitted to the hospital due to feeding difficulties, generalized muscle weakness and hypotonia, cardiomegaly, and cardiac insufficiency when they were 10 months old. The GAA activity in leukocytes in the two infants was significantly lower than in normal controls. Gene sequencing revealed 2 compound heterozygous mutations in the two infants, i.e., G1942A and G2214A, respectively. G1942A had been proved pathogenic, and the latter one, G2214A, was a nonsense mutation, resulting in the change of tryptophan, the 738th amino acid of GAA, into a stop codon. The two infants were diagnosed with GSD II by gene detection and no enzyme replacement therapy could be provided to them. Follow-up visits showed that the two infants died at home at the age of 15 months and 17 months, respectively. GSD II is caused by deficiency of GAA activity resulting from mutation of GAA gene. The detection of GAA activity in peripheral blood by DBS and GAA gene detection are effective and feasible methods for diagnosis of GSD II.
Female ; Glycogen Storage Disease Type II ; genetics ; Humans ; Infant ; Mutation ; Pedigree ; alpha-Glucosidases ; genetics

COVID-19/complications* ; Fracture Fixation ; Fractures, Bone/surgery* ; Humans ; Musculoskeletal Diseases/surgery* ; Time Factors