Objective To analyze the differences of nutritional parameters and body composition in the protein energy wasting (PEW) patients on maintenance hemodialysis with or without diabetic kidney disease (DKD).Methods The patients with PEW were screened by subjective global assessment (SGA) from patients on maintenance hemodialysis from March 2014 to June 2015 in the Fourth Central Hospital of Tianjin.Anthropometric and nutritional parameters were collected before dialysis, and body composition and energy expenditure were examined by the bioelectrica] impedance method.The indexes of the two groups were compared.Results A total of 301 patients on maintenance hemodialysis (DKD 112, non-DKD 189), whose average age was (63.05±14.42) years old, were screened.Among which, 75 patients were diagnosed with PEW, and the overall prevalence rate was 24.92％, including 41 DKD cases with the prevalence of 36.61％ (41/112) and 34 non-DKD cases with the prevalence of 17.99％ (34/189).Compared with uon-PEW patients, the body mass index (BMI), hemoglobin (Hb), albumin (ALB), and total cholestero (TC) of patients with PEW were significantly lower, and C-reactive protein (CRP) were significantly higher (P＜0.05).In the DKD group, the average age of PEW onset ((59.61±13.74) years old), the maintenance dialysis time before PEW ((64± 12.50) months), ALB ((31.34±3.32) g/L), and TC ((4.17±0.95) mol/L) were all lower than those in the non-DKD group ((70.68±14.05) years old, (116.61 ±32.85) months, (32.34±4.64) g/L, (4.95±1.52) mol/L) (P＜ 0.05), respectively.The body composition results showed that muscle mass in the DKD group ((24.84±3.36) kg/ (45.32±6.95)％) was less than that of the non-DKD group ((28.53±3.75) kg/(50.67±7.28)％) (P＜0.05).Conclusions This study indicates that compared with non-DKD dialysis patients, the prevalence of PEW in dialysis patients with DKD is higher, onset age of PEW is younger, the duration of dialysis is shorter, and the muscle consumption is more obvious.

ObjectiveTo investigate the effect of arsenic trioxide (ATO) on anti-dsDNA antibody and the expression of DNA methyltransferase 1-mRNA and CD11a-mRNA in lupus MRL/lpr mice.Methods MRL/lpr mice were divided into three groups:the ATO group,the sodium chloride(NS) group,and the cyclophosphamide(CTX) group.The control group consisted of 20 syngeneic normal C57/BL mice,which were subdivided into the ATO group and the NS group.After two-month treatment,all mice were sacrificed.Blood routine test was conducted by SYSMEX KX21.The anti-dsDNA antibody in the serum were detected by ELISA.The expression of DNMT1 and CD11a was determined by RT-PCR.ANOVA and paired t test were used for statistical analysis.Results① The serum level of anti-dsDNA antibody(0.89±0.07) and the gray scale value of CD11a-mRNA(0.43±0.25) in the ATO group were much lower than those in the NS group of MRL/lpr mice(1.77±0.28,P＜0.01; 0.99±0.31,P＜0.05),while the gray scale value of DNMTI-mRNA (0.32±0.30) was significantly higher than that in the NS group(0.16±0.26,P＜0.05 ).② The serum levels of anti-dsDNA antibody was low in both the ATO group and the CTX group (0.90±0.07,0.66±0.22),and it was higher in the ATO group than that in the CTX group (P＜0.05).The gray scale value of DNMT1 mRNA in the ATO group (0.32±0.30) was higher than that in the CTX group (0.16±0.18,P＜0.05) in MRL/lpr mice,and the gray scale value of CD11a mRNA in the ATO group(0.43±0.25) was lower than that in the CTX group (0.86±0.31,P＜0.05) in MRL/lpr mice.③ There was no difference in above parameters between the ATO-group and NS group in C57/BL mice(P＞0.05).ConclusionArsenic trioxide can reduce the serum level of auto-antibody and reverse low methylation.But it has no effect on normal mice.

Objective To explore the correlation between socioeconomic status (SES) and mortality of patients with diabetic kidney disease (DKD) on hemodialysis by using a retrospective cohort study.Methods Cases with DKD on hemodialysis in the Fourth Central Hospital of Tianjin from Jan.2006 to Mar.2010 were retrospectively reviewed.SES, including education, the average monthly income of household members, occupation type, was surveyed among all the patients.According to the SES, the patients were divided into two groups.The 1-year, 3-year, and 5-year mortality rates of the two groups were compared respectively.Relative risk (RR), attributable risk (AR) and attributable risk percentage (ARP) were calculated.Further, the relevance of SES and other variables were analyzed.Results The baseline of two groups in age, sex, duration of diabetes, kidney disease progression was consistent and comparable.In the low SES group, 1-year death RR was 1.08, AR was 1.5％ and ARP was 8.1％.Three-year death RR was 1.38, AR was 10.9％ and ARP was 27.6％.Five-year death RR was 1.57, AR was 24.5％ and ARP was 36.4％.Correlation analysis showed that SES scores were negatively correlated to body mass index (BMI), glycated hemoglobin (HbA1c) and C-reactive protein (CRP) (r=-0.542,-0.314,-0.392, P＜0.01), while SES scores were positively correlated to serum albumin (ALB), physiological function, general health, social function, emotional function and mental health scores (r=0.539, 0.243, 0.254, 0.268, 0.253, 0.255, P＜0.01).Conclusions SES is an important social-influencing factor of mortality in patients with DKD,and may have effects on long-term survival of hemodialysis patients by influencing the quality of life, glycemic control, nutrition and inflammation.

Objective: To investigate the difference in behavioral characteristics among different phenotypes of attention deficit hyperactivity disorder (ADHD) using amplitude of low-frequency fluctuation (ALFF), so as to provide insights into clinical differentiation of behavioral characteristics among different phenotypes of ADHD. Methods: The children with ADHD admitted to The Affiliated Hospital of Hangzhou Normal University were enrolled and classified into the inattentive type (ADHD-I), hyperactive/impulsive type (ADHD-HI) and combined type (ADHD-C). The reaction time (RT) was measured using integrated visual and auditory continuous performance test, and the mean (RT-mean) and standard deviation of RT (RT-SD) were estimated. In addition, the ALFF was calculated at 0.010 to 0.027, 0.027 to 0.073, 0.073 to 0.167 Hz, and the difference of ALFF was compared among children with different types of ADHD. Results: A total of 107 children with ADHD were enrolled, including 95 boys and 12 girls, with a mean age of (8.89±1.93) years. There were 69 children with ADHD-I, 8 children with ADHD-HI and 30 children with ADHD-C. The RT-SD was significantly higher among children with ADHD-C than among children with ADHD-I [(126.003±51.619) ms vs. (97.720±45.302) ms; P=0.007]; however, there was no significant difference in RT-mean among children with various ADHD phenotypes (F=1.386, P=0.255). There was an interaction between frequency and ADHD phenotypes (F=2.754, P=0.032), and the ALFF was significantly higher among children with ADHD-C than among children with ADHD-I at 0.010 to 0.027 [(5 590.567±231.595) ms vs. (4 694.001±154.397) ms; P=0.002] and 0.073 to 0.167 Hz [(4 312.609±174.709) ms vs. (3 690.805±116.473) ms; P=0.005]. Conclusions The ALFF varies in ADHD phenotypes, and there is a frequency-specific difference.

To facilitate noninvasive diagnosis of anemia, high-performance and portable near infrared (NIR) spectrometer for human blood constituents was designed and fabricated based on linear variable filter (LVF).Meanwhile, the performance of support vector regression (SVR) model for quantitative analysis of human hemoglobin (Hb) was investigated.Spectral data were collected noninvasively from 100 volunteers by self-designed LVF-NIR spectrometer, then divided into calibration set, validation set 1 and 2.To establish a robust SVR model, grid search method was applied to optimize the penalty parameter and kernel function parameter c=5.28, g=0.33.Then, Hb levels in the validation 1 and 2 sets were quantitatively analyzed.The results showed that the root mean square error of prediction (RMSEP) were 10.20 g/L and 10.85 g/L, respectively, and the relative RMSEP (R-RMSEP) were 6.85% and 7.48%, respectively.The results indicated that the SVR model had high prediction accuracy to Hb level and adaptability to different samples, and could satisfy the requirements of clinical measurement.Based on the SVR algorithm, the self-designed LVF-NIR spectrometer has a wide application prospect in the field of non-invasive anemia diagnosis.

Objective To investigate the common bacteria and change in antimicrobial resistance in an intensive care unit (ICU)in the past 5 years,and provide evidence for rational use of antimicrobial agents.Methods Bacteria isolated from ICU patients in a tertiary first-class hospital from 2009 to 2013 were collected,identified,and per-formed antimicrobial susceptibility testing.Results A total of 1 196 bacteria isolates were isolated in 2009-2013, the top five species were Acinetobacter baumannii (A.baumannii,29.60%),Pseudomonas aeruginosa (P . aeruginosa,14.38%),Staphylococcus aureus (S .aureus ,12.21 %),Escherichia coli (E.coli,12.21 %),and Klebsiella pneumoniae (K .pneumoniae ,11 .37%).Resistance rates of S .aureus to oxacillin,gentamycin, clindamycim,ciprofloxacin,and rifampicin showed a decreasing tendency from 2009 to 2013(all P <0.05),and no strain was detected to be resistant to vancomycin during 5 years.Resistance rates of P .aeruginosa to ceftazidime, cefepime,aztreonam,gentamycin,amikacin,tobramycin,and piperacillin/tazobactam decreased gradually (all P <0.05),imipenem resistance rates were 32.26% -46.43% in 2009 -2012 and 16.00% in 2013;A.baumannii maintained a low level resistance to amikacin,tobramycin,and compound sulfamethoxazole(all P <0.05),resistance rates to imipenem were all >80% in 2009-2011 and 10.53% in 2013,A.baumannii had high resistance rates to most antimicrobial agents(resistance rates were >80%)during 5 years.Resistance rates of K .pneumoniae and E. coli to piperacillin/tazobactam,cefazolin,cefepime,amikacin,and aztreonam had a decreased tendency in 2009 -2013(all P <0.05).Conclusion The common bacteria causing infection in the ICU of this hospital showed a down-ward trend,which may be related to the introduction of national policies and management of hospital,continuous management of antimicrobial agents is suggested,antimicrobial agents should be used rationally to prevent the in-crease of bacterial resistance.

Objective:To compare the clinical efficacy between our first generation and second generation dynamic anterior plate-screw system for quadrilateral area (DAPSQ) in the treatment of T-shaped acetabular fractures.Methods:A retrospective study was conducted of the 28 patients with T-shaped acetabular fractures who had been treated at Department of Orthopaedics, General Hospital of Central Theater Command from January 2008 to December 2019. They were divided into 2 groups according to fixation methods. Group A [15 patients, 11 males and 4 females, an age of (43.5±9.1) years] were treated with the first generation DAPSQ while Group B [13 patients, 8 males and 5 females, an age of (42.5±7.0) years] with the second generation DAPSQ. Operation time, intraoperative bleeding, fracture reduction, function of the affected hip and postoperative complications were recorded and compared between the 2 groups.Results:The 2 groups were comparable because there was no significant difference between them in the preoperative general data ( P>0.05). The 28 patients were followed up for 12 to 60 months (average, 35.0 months). The operation time [(193.9±33.3) min] and intraoperative bleeding [(830.8±177.4) mL] for Group B were significantly less than those for Group A [(231.3±40.0) min and (1,043.3±190.7) mL] ( P<0.05). In Group A, according to the Matta scoring, the fracture reduction was rated as excellent in 8 cases, good in 5 and poor in 2; in Group B, the fracture reduction was rated as excellent in 8 cases, good in 4 and poor in one. According to the modified Merle d'Aubigné & Postel scoring at the final follow-up, the function of the affected hip was rated as excellent in 9 cases, as good in 3, as fair in 2 and as poor in one in Group A while as excellent in 9 cases, as good in 2 and as fair in 2 in Group B. There were no statistically significant differences between the 2 groups in reduction quality or in the function of the affected hip ( P>0.05). Follow-up observed hip traumatic arthritis in 2 cases in Group A and in one in Group B. Conclusion:In the treatment of T-shaped acetabular fractures, compared with the first generation DAPSQ, the second generation DAPSQ can shorten operation time and decrease intraoperative bleeding significantly, though both achieve comparable functional outcomes.

Objective:This study aims to construct a prognostic model of bladder cancer (BLCA) based on lncRNA.Methods:BLCA lncRNA expression data and clinical information were downloaded from TCGA. Univariate Cox regression was used to evaluate the correlation between the expression level of each lncRNA and overall survival (OS), and the lncRNAs with a corrected P-value<0.01 were selected as candidate predictors. In the training queue, the prediction model is constructed by methods such as least absolute shrinkage and selection operator, and multi-factor stepwise Cox regression, and verified in the verification queue at the same time.. Evaluation the area under the curve of time-dependent receiver operating characteristic (tROC) and Harrel C index. According to the median risk score of the prediction model, patients were divided into high-risk group and low-risk group and the differences in clinicopathological characteristics between the two groups were compared by t-test or chi-square test. Results:Establish a BLCA prognostic model based on 13 lncRNAs, of which LINC01465, ARHGAP5-AS1, ZFHX4-AS1, MAFG-AS1 are prognostic risk factors (β regression coefficients are 0.32, 0.16, 0.06, 0.20, respectively, all>0), and the rest are protection factors (β regression coefficients are all<0); the prediction model of the overall survival in the first year, the third year, and the fifth year in the complete cohort has an area under the tROC curve of 0.79, 0.82, and 0.80 respectively, and the Harrell C index is 0.74. Its predictive ability is better than the previously published BLCA prognostic model based on lncRNA. Adjusting for confounding factors including age and tumor stage found that the risk score of this model was an independent poor prognostic factor for overall survival in BLCA patients (hazard ratio 4.05; P<0.001). Comparison of clinicopathological characteristics of patients in the high-risk and low-risk groups showed that in the high-risk group, there were more old patints (70.0 vs. 66.1, P<0.001), more non-papillary patients (74.2% vs. 61.2, P=0.005), more high-stage patients (37.6% vs. 28.0%, P<0.001 for stage Ⅳ patients), and more high-grade tumors (98.0% vs. 92.0%, P=0.005). Conclusion:In this study, a prognostic model of bladder cancer based on 13 lncRNAs was constructed. This model has good predictive ability and can provide value for clinical decision-making and patient consultation.

Objective:To compare the clinical effects of bridge combined internal fixation system and locking plate system in treating closed humeral shaft fracture.Methods:From August 2017 to August 2020, there were 45 patients with closed humeral shaft fracture treated with surgery. Bridge combined internal fixation system were performed in 19 patients (bridge combined group, aged 38.3±11.9, range 21-72 years), including 13 males and 6 females. Further, there were 26 patients underwent locking plate system (locking plate group, aged 41.2±14.7, range 20-79 years), including 20 males and 6 females. The operation was performed by minimal invasive percutaneous osteosynthesis with fixators. The patients were followed up every 4 weeks. The fracture healing condition was recorded. Shoulder function was assessed according to University of California at Los Angeles (UCLA) shoulder rating scale and elbow function was assessed according to Mayo elbow performance score (MEPS).Results:The follow-up duration of all patients were 14.2±4.7 (range 10-32) months. All wound were healed completely. The operation duration in bridge combined group (68.1±12.5 min) was longer than that in locking plate group (56.3±11.6 min) ( t=3.32, P=0.002). The blood loss of bridge combined group and locking plate group were 112.6±20.2 ml and 104.2±14.1 ml, respectively ( t=1.65, P=0.107). The volume of drainage of bridge combined group was 68.4±16.2 ml and that of locking plate group was 73.1±14.9 ml ( t=1.00, P=0.323). The hospitalization time of bridge combined group was 9.7±2.3 d and the locking plate group was 9.4±1.9 d ( t=0.57, P=0.573). All above parameters had no statistical significance between the two groups. Fracture nonunion occurred in 1 of 19 patients in bridge combined group. The fracture healing time was 15.3±4.3 weeks in another 18 cases, while that of locking plate group was 15.9±3.9 weeks ( t=0.47, P=0.638). At 4-weeks postoperative follow-up, the UCLA shoulder score (18.1±3.9) and the MEPS (55.4±6.8) of bridge combined group were lower than those of locking plate group ( P<0.05). At 8-weeks postoperative follow-up, the shoulder score (26.2±4.3) and the MEPS (70.9±6.5) of bridge combined group were lower than those of locking plate group ( P<0.05). At 12-weeks postoperative follow-up, the UCLA shoulder score (33.6±1.0) and the MEPS (91.0±3.7) of bridge combined group had no statistical difference with those of locking plate group ( P>0.05). Conclusion:The bridge combined internal fixation system could provide personalized and multidimensional fixation according to the fracture type. The clinical effects of bridge combined internal fixation system on humeral shaft fracture are similar to the locking plate system at 12 weeks postoperatively. However, the operation duration of bridge combined system is longer and with increased the risk of nonunion.

The meniscus in the knee joint plays an important role in bearing load,shock absorption,joint lubrication,and increasing the stability of the knee joint in various directions.Meniscal injury is a common ailment in knee joint injuries,which can cause severe knee pain and limited knee joint movement,significantly affecting the patient's quality of life.Arthroscopic minimally invasive treatment has become the main approach for treating meniscal injuries,with the consensus being to preserve the meniscus morphology and structure as much as possible.By introducing the structure and function of the meniscus,the mechanism of injury,and focusing on several suture techniques for arthroscopic meniscal injury treatment,analyzing their advantages and disadvantages,it aims to provide some reference for clinical research on arthroscopic suture of the meniscus.