Objective To explore the method and efifcacy of intervention aortopulmonary septal defect (APSD) in young infant. Methods A four month old APSD infant had undergone interventional treatment using homemade ventricular septal de-fect occluder, and was followed up to observe the curative effect. Results The APSD had been successfully closured, and the clinical symptoms improved instantly. The follow-up showed heart function improved, heart shadow reduced, and growth well. Conclusions APSD interventional therapy is a safe, effective treatment in young infant.

Objective:To investigate the common reasons for the failure of radical mastoidectomy in order to improve the result of treatment and obtain a dry ear.Method:Twenty-eight cases,who achieved no dry ear after radical mastoidectomy,underwent secondary surgery.Result:All cases obtained dry ear without vertigo or facial paralysis after operation and postoperative dressing.Conclusion:The reasons for the failure of radical mastoidectomy result from the incomplete clearance of lesions, the insufficient ventilation of mastoid cavities, the inappropriate postoperative dressings or the residual foreign bodies in surgical cavity.It is the key points to achieve skeletonization adequately, to eliminate the pathological tissues thoroughly under microscope, and to ensure unobstructed drainage of surgical cavities for preventing secondary surgery.

Objective:To evaluate the impact of health education intervention on promoting rural residents to join new rural cooperative medical system(NCMS)and their intention of joining NCMS based on Health Belief Model in project areas in Henan and Jilin Provinces.Methods:Quasi-experiment study was used to evaluate intervention impact.Following the evidence-based approach,according to needs assessment,a half-year health education intervention was implemented among farmers in the experimental counties in Henan and Jilin Provinces respectively.A questionnaire survey was conducted among farmers in intervention and control counties before and after intervention,and intervention impact was evaluated by comparing the indicators' changes in intervention and control counties.Results:After health education intervention,the knowledge level of farmers in two intervention counties increased by 29.0% and 37.8% respectively,their scores of perceived threatens of health risk and perceived barriers of joining NCMS among the respondents were decreased.Meanwhile,their score of perceived benefit of joining NCMS were increased,and the rate of willingness to join NCMS increased remarkably in both intervention counties.Conclusion:Health education was effective and helpful in increasing farmer's knowledge,understanding and cognitive level of NCMS,and it should play an important role for the sustainable development of NCMS.

BACKGROUND: Human transforming growth factor-β1 gene can be used for gene therapy of the degeneration of intervertebral discs, but the key to the experiment is to construct its effective vector.OBJECTIVE: To determine whether or not adult degenerated intervertebrai disc cells cultured in vitro after transfected by eukaryotic expression vector can express the product of human transforming factor-βl, and to provide the experimental basis of gene therapy for intervertebral disc degeneration.DESIGN: Single sample experiment. SETTING: Traumatic Orthopedic Institute of Shandong Province and the Orthopedic Department of Weihai Municipal Hospital.MATERIALS: The experiment was conducted at the laboratory of Traumatic Orthopedic Institute of Shandong Province between October 1999and January 2001. Intervertebral disc samples were from the operated patients with protrusion of irtervertebral disc after the patients were informed.Sample 1 was intervertebral disc at L4/5 from a 30-year-old woman; sample 2 was intervertebral disc at L5/S1from a 30-year-old woman.METHODS: ① Culture of adult degenerated intervertebral disc cells:Samples ex vivo were taken back to the laboratory within 30 minutes; fibrous ring cells and myelin nucleus cells cultured primarily were collected.② Transfection: Cells were put in the 24-well culture plate with 5.5×105cells in each well. Constructed PCI-hTGF-β1 eukaryotic expression vector was used to perform transfection, then transfected PCI group and nontransfected group were set. ③ The expression product of cells transfected for 48 hours was determined with immunohistochemical staining method.MAIN OUTCOME MEASURES: Comparison of absorbance of the positive cell product of eukaryotic expression vector PCI-hTGF-β1 in the primary fibrous ring cells and myelin nucleus cells in each group.RESULTS: ① Sample 1: The absorbance of positive cell product of eukary otic expression vector PCI-hTGF-β1 in the primary fibrous ring cells and myelin nucleus cells was 3.49 and 3.69 times that in PCI group, and 3.55times that in non-transfected group. ② Sample 2: The absorbance of positive cell product of eukaryotic expression vector PCI-hTGF-31 in the primary fibrous ring cells and myelin nucleus cells was 3.56 and 3.46 times that in PCI group, and 3.43 times and 3.33 times that in non-transfected group.CONCLUSION: PCI-hTGF-31, as the effective eukaryotic expression vector in the transfection of transforming growth factor-31 gene to culture degenerated intervertebral disc cells in vitro, can transfect adult degenerated intervertebral disc cells cultured in vitro and obtain the high expression of human transforming growth factorβ1 gene.

OBJECTIVE: To investigate the common reasons for the failure of radical mastoidectomy in order to improve the result of treatment and obtain a dry ear. METHOD: Twenty-eight cases, who achieved no dry ear after radical mastoidectomy,underwent secondary surgery. RESULT: All cases obtained dry ear without vertigo or facial paralysis after operation and postoperative dressing. CONCLUSION The reasons for the failure of radical mastoidectomy result from the incomplete clearance of lesions, the insufficient ventilation of mastoid cavities, the inappropriate postoperative dressings or the residual foreign bodies in surgical cavity. It is the key points to achieve skeletonization adequately, to eliminate the pathological tissues thoroughly under microscope, and to ensure unobstructed drainage of surgical cavities for preventing secondary surgery.
Adolescent ; Adult ; Aged ; Cholesteatoma, Middle Ear ; surgery ; Female ; Humans ; Male ; Mastoid ; surgery ; Middle Aged ; Treatment Outcome ; Young Adult

Objective:To investigate the protective effect of endurance training on Parkinson disease(PD) mice and the effect of AMPK/mTOR pathway on autophagy and exosomes secretion.Methods:Thirty-two 10-week-old male C57BL/6 mice were randomly divided into quiet group, exercise group, PD quiet group and PD exercise group, with 8 mice in each group.The mice in exercise group and PD exercise group received 4-week treadmill endurance training.After training, mice in PD quiet group and PD exercise group were given rotenone (30 mg·kg -1·d -1) dissolved in 0.5% carboxymethyl cellulose salt solution and gavaged for 56 consecutive days.The mice in quiet group and exercise group were given 0.5% carboxymethyl cellulose salt solution by gavage.Then, the mice in exercise group and PD exercise group received treadmill endurance training for 4 weeks.The behaviors of mice in each group were measured after training.The content of tyrosine hydroxylase (TH) in substantia nigra of mice in each group was measured by immunohistochemistry.Western blot was used to detect the expression of plasma α-synuclein(α-syn), exosomes surface marker proteins CD9 and CD63, and the content of microtubule associated protein light chain 3-Ⅱ (LC3-Ⅱ), α-syn, adenine ribonucleotide dependent protein kinase (AMPK) and phosphorylated AMPK (p-AMPK), mammalian target of rapamycin (mTOR) and phosphorylated mTOR (p-mTOR) in substantia nigra of mice in each group.SPSS 20.0 software was used to analyze the data.One-way ANOVA was used for comparison among multiple groups and the LSD method was used for further pairwise comparison. Results:There was significant difference in the residence time of mice in the four groups on the rotarod instrument ( F=2 618.20, P<0.01). Compared with the quiet group, the residence time of PD quiet group decreased ((110.34±8.20) s, (186.20±6.83) s, P<0.01). Compared with the PD quiet group, the residence time of PD exercise group increased ((160.56±8.30)s, P<0.01). (2) There was no significant difference in the expression of plasma exosome marker proteins CD9 and CD63 among the four groups ( F=1.57, 1.26, both P>0.05). (3) There was significant difference in the expression of α-syn in plasma exosomes of the four groups ( F=1 303.99, P<0.01). The expression of α-syn in plasma exosomes in PD quiet group was higher than that of quiet group ((180.57±8.20), (100.00±0.00), P<0.01). Compared with the PD quiet group, the expression of α-syn in plasma exosomes in PD exercise group decreased ((150.23±7.30), P<0.01). (4) There was significant difference in the number of TH positive neurons in substantia nigra among the four groups ( F=447.09, P<0.01). Compared with the quiet group, the number of TH positive neurons in the substantia nigra of PD quiet group decreased ((48.23±6.30), (100.00±0.00), P<0.01). Compared with the PD quiet group, the number of TH positive neurons in the substantia nigra of PD exercise group increased ((68.62±8.20), P<0.01). (5) Western blot showed that there were significant differences in the expression of α-syn, p-mTOR, p-AMPK and LC3-Ⅱ in substantia nigra of the four groups ( F=753.62, 361.48, 261.95, 248.07, all P<0.01). Compared with the quiet group, the expression of α-syn in substantia nigra of PD quiet group increased ((184.16±15.31), (100.00±0.00), P<0.01), the expression of p-mTOR in substantia nigra increased ((156.77±3.99), (100.00±0.00), P<0.01), the expression of p-AMPK decreased ((70.65±8.43), (100.00±0.00), P<0.01), and the expression of LC3-Ⅱ in substantia nigra decreased ((72.25±7.86), (100.00±0.00), P<0.01). Compared with PD quiet group, the expression of α-syn in substantia nigra decreased ((158.23±9.30), P<0.01), the expression of p-mTOR in substantia nigra decreased ((123.61±16.86), P<0.01), the expression of p-AMPK increased ((96.35±9.45), P<0.01), and the expression of LC3-Ⅱ in substantia nigra increased ((108.89±10.67), P<0.01). Conclusion:Endurance training regulates autophagy and the expression of exosomes in PD mice through AMPK/mTOR signal pathway, protects dopaminergic neurons in mouse midbrain and improves motor function.

Objectives To evaluate the results and efficacy of gas-insufflated retroperitoneoscopic necrosectomy (GIRN) for proven infected necrotizing pancreatitis (INP).Methods 24 patients presenting proven infected pancreatic necrosis during course of acute pancreatitis were prospectively offered minimally invasive necrosectomy.A descriptive explanation of the GIRN was given together with the results of a retrospective analysis of all patients.Results All 24 patients who underwent retroperitoneoscopic necrosectomies survived.Postoperative hospitai stay ranged from 7 to 105 d (median,29 d).In 14 patients,GIRN yielded excellent results and avoided complementary treatment after a single session.7 patients underwent only one repeated session and the other 3 patients underwent 3 times.3 patients finally underwent laparotomy and necrosectomy due to remaining infected necroses in the peritoneal cavity.Conclusion GIRN has been found safe and is associated with a high success rate in our limited number of patients,and it should be regarded as a first-choice surgical option for INP.

Objective:To compare the clinical outcomes between modified percutaneous kyphoplasty (PKP) and conventional PKP in the treatment of Kümmell disease.Methods:A retrospective cohort study was conducted of the 57 patients with single level kummell disease who had undergone PKP between January 2015 and December 2017 at Department of Spinal Surgery, Jiangmen Hospital Affiliated to Sun Yat-sen Uni-versity.Of them, 36 received modified PKP and 21 conventional PKP.In the modified PKP group, there were 24 males and 12 females with an age of 73.9 years±9.4 years and a course of disease of 2.2 months±1.5 months; the disease was located at a thorocic vertebra in 20 cases and at a lumbar vertebra in 16.In the conventional PKP group, there were 15 males and 6 females with an age of 72.6 years±11.9 years and a course of disease of 1.8 months±1.1 months; the disease was located at a thorocic vertebra in 10 cases and at a lumbar vertebra in 11.The 2 groups were compared in terms of operation time, bone cement volume, cement leakage, visual analogue scale (VAS), Oswestry disability index (ODI), anterior and middle heights and cobb angle of injured vertebra at postoperative 3 days, 1 and 3 months, and final follow-up.Results:There were no significant differences in the general clinical data between the 2 groups, showing compatibility between groups ( P>0.05).All the operations were accomplished uneventfully with no such serious complications as spinal cord nerve injury, wound infection, pulmonary embolism, bone cement poisoning reaction or death. There was no significant difference between the 2 groups in operation time or bone cement volume ( P>0.05).The rate of cement leakage in the modified PKP group [33.3%(9/27)] was significantly lower than that [52.4%(11/21)] in the conventional PKP group ( P<0.05).There were no significant differences be-tween the 2 groups in VAS, ODI, anterior or middle height of injured vertebra or cobb angle at postoperative 3 days or one month ( P>0.05), but the postoperative values were improved compared to the preoperative ones.At postoperative 3 months and final follow-up, the modified PKP group was significantly better in all the indexes than the conventional PKP group ( P<0.05). Conclusion:Compared with conventional PKP, the modified PKP may lead to better outcomes for Kümmell disease.

Objective: To investigate the origin of infection and risk factors of a case with SARS-CoV-2 infection associated with overseas countries in the Ningbo-Zhoushan Port, Zhejiang Province, so as to provide the evidence for improving the COVID-19 control measures at ports. Methods: Ningbo Center for Disease Control and Prevention ( CDC ) and Beilun CDC conducted case finding and epidemiological surveys immediately after being informed. The general information, history of vaccination and the travel during the latest 14 days were collected from the positive case, and all close contacts were tracked. Saliva samples were collected for SARS-CoV-2 nucleic acid testing and whole-genome sequencing, and the sequencing results were aligned with the GISAID's EpiCoV database. The origin of infection and transmission route of the positive case was investigated. Results: A case was identified positive for SARS-CoV-2 nucleic acid during company M's routine screening in the Ningbo-Zhoushan Port on August 10, 2021, and was confirmed positive for SARS-CoV-2 nucleic acid by Beilun CDC and Ningbo CDC on August 11. Whole-genome sequencing showed SARS-CoV-2 B.1.617.2 ( Delta ) variant, which shared the highest homology with the virus sequence uploaded by Russia on June, 2021 ( Russia/MOW-RII-MH27356S/2021 ). The case was a bundling worker for overseas container ships, and reported communicated with foreign boatmen and contacted materials without protected interventions on the SINOKOR AKITA Container Ship between August 4 and 5, 2021. This ship anchored at Vladivostok, Russia from July 27 to 29, anchored at Ningbo Harbor on August 4, and departed on August 5. Then, 11 boatmen from this ship were tested positive for SARS-CoV-2 nucleic acid on August 8. One asymptomatic case was reported in this epidemic; 254 close contacts and 617 secondary close contacts were identified, and all were tested negative for SARS-CoV-2 nucleic acid. No new cases with SARS-CoV-2 infections were detected until August 25, 2021, and the emergency response was therefore terminated. Conclusions The infection was a sporadic COVID-19 epidemic associated with overseas countries, which was caused by Delta variant infection through contacts with foreign boatmen or materials by a bundling worker in Ningbo-Zhoushan Port; fortunately, no epidemic spread occurred. Intensified closed-loop management and increased frequency of SARS-CoV-2 nucleic acid test among high-risk populations, and improving the precision and rapid emergency treatment of COVID-19 epidemics are required for the containment of COVID-19 at ports.

Objective To investigate the effect of time interval between diagnosis and surgical treatment on the prognosis of breast cancer.Methods A retrospective study that include a total of 252 female patients who underwent breast cancer diagnosis and treatment in the Second Affiliated Hospital of Xi'an Jiaotong University from April 2012 to August 2014 were included in the present study,the average age was (58.2 ± 10.8) years old,range from 31 to 67 years old.General demographic information and data of tumor were collected.Information on postoperative recurrence,metastasis,death,and disease-free survival status of breast cancer patients were followed up 5 years by outpatient follow-up or telephone follow-up.All participants were divided into four groups (＜2 weeks,2-4 weeks,4-8 weeks,≥8 weeks) by the time interval between diagnosis and surgical treatment,including 26,118,78 and 30 cases,respectively.In addition,according to the diameter of breast cancer tumors,all participants were divided into three groups (＜20 mm,20-40 mm,and ≥40 mm),including 99,124,and 29 cases,respectively.According to the results of pathological examination of the lymph nodes obtained during intraoperative dissection,the all participants were divided into three groups (lymph nodes without metastasis,1 to 3 metastasis,and ≥3 metastasis),including 66,124,and 62 cases,respectively.The Cox proportional regression risk models were used to assess the hazard ratio (HR) and its 95％ confidence interval (CI) of time interval between diagnosis and surgical treatment with the prognosis of breast cancer,with adjustment for age,education levels and body mass index.Further,stratified analysis by tumor characteristics,including pathological type,histological grade,tumor diameter,lymph node metastasis,and receptor expression were also conducted to evaluated the above association.Kaplan-Meier survival curve was used to evaluate the effects of time interval between diagnosis and surgical treatment on the prognosis of breast cancer.Results The Kaplan-Meier survival curves for the five-year follow-up of total survival time between 4 different time intervals groups showed significantly different (P ＜0.001),and patients with a pre-treatment interval of ＜2 weeks had the longest survival time,while those with ≥8 weeks had the lowest survival time.With a one-week interval before treatment,the overall risk of death in breast cancer patients increased by 6％ (HR =1.06,95％ CI:1.01-1.1 l),and the risk of breast cancer death increased by 8％ (HR =1.08,95％ CI:1.02-1.14),the risk of distant metastasis of breast cancer cells increased by 10％ (HR =1.10,95％ CI:1.08-1.13).With the increase in breast cancer tumor diameter (＜20 mm,20-40 mm,≥40 mm),the overall risk of death due to prolonged treatment interval increased gradually,with HR (95％CI) were 1.06 (1.03-1.09),1.08 (1.02-1.12) and 1.11 (1.05-1.17),respectively.With the increase of lymph node metastasis in breast cancer (no metastasis,metastasis at 1-3,≥ 3 metastasis),the total mortality risk caused by prolonged treatment time interval also showed an increasing trend,with HR (95％CI) were 1.04 (1.02-1.08),1.06 (1.04-1.08) and 1.08 (0.99-1.11),respectively.The same results were also shown in the effect of tumor diameter or distant lymph node metastasis on the association between treatment time interval and breast cancer survival and distant metastasis of breast cancer cells.Conclusion With the prolongation of the time interval between the diagnosis of the breast cancer and the surgical treatment of breast cancer patients,the risk of postoperative death is significantly increased,and the association is more pronounced in breast cancer patients with larger tumor volume or higher distant lymph node metastasis.