Objective To investigate the recurrence and influence factors of spontaneous pneumothorax in patients after thoracoscope surgery. Methods From March 2009 to March 2011,218 patients with spontaneous pneumothorax after thoracoscope surgery in our hospital were surveyed by the self-made general data questionnaire. The clinical data were analyzed by descriptive statistics and binary classification logistic regression analysis of SPSS 19. 0 to find out the infection influential factors of spontaneous pneumothorax for patients after thoraco-scope surgery in order to provide reference basis for reducing postoperative recurrence. Results The recurrence rate of spontaneous pneumo-thorax was 5. 05%(11/218). Multiple logistic regression analysis showed that recurrent pneumothorax ( OR=2. 432,P=0. 000) and multi-ple pulmonary bulla (OR=1. 918,P=0. 000) were the risk factors of spontaneous pneumothorax for patients after thoracoscope surgery. Conclusion The recurrence rate of spontaneous pneumothorax is high,we should strengthen the management of high-risk population and im-prove the prognosis of patients.

The properties of biomedical intelligent polymer materials can be changed obviously when there is a little physical or chemical change in external condition. They are in the forms of solids, solutions and polymers on the surface of carrier, including aqueous solution of hydrophilic polymers, cross-linking hydrophilic polymers (i.e. hydrogels) and the polymers on the surface of carrier. In this paper are reviewed the progress in researches and the application of biomedical intelligent polymer materials.
Biocompatible Materials ; chemistry ; Biotechnology ; Chemical Phenomena ; Chemistry, Physical ; Hydrogel, Polyethylene Glycol Dimethacrylate ; chemistry ; Polymers ; chemistry ; Surface Properties

Sanqi in Chinese herbal medicine is the root and rhi-zoma of Panax notoginseng (Burk.)F.H.Chen. As the effects of strengthening with tonics, promoting blood circulation to re-move blood stasis,relieving swelling and pain and hemostasia,it is widely used as a tonic medicine in the traditional Chinese medicine. The main active constituents of Sanqi are panax noto-ginseng saponins,including ginsenoside Rg1,Rb1 and notogin-senoside R1. Notoginsenoside R1 is one of the unique monomer compositions of panax notoginseng,which is often used as an in-gredient indicator in new drug research and development.In cur-rent years, the scientists have been conducted tremendous fun-damental studies to research the pharmacological activities of no-toginsenoside R1, to reveal its protective effects on the cardio-vascular system,central nervous system as well as to many other aspects. It is hoped that the relevant study about the pharmaco-logical action of notoginsenoside R1 would help its further clini-cal application. This paper mainly reviews the research on the pharmacological mechanism of notoginsenoside R1 in recent years.

Objective:To introduce a novel method of the virtual construction for pedicle screw trajectory (PST) of subaxial cervical spine based on CT data and to investigate its effects on improving the accuracy rate of subaxial cervical pedicle screw technique.Methods:The CT data of cervical spine (C 3, 4) of 60 subjects, including 30 males and 30 females, were collected for analysis. The data were imported into Mimics 20.0. Further, the virtual safe core (G-zone) of the PST was constructed using the method designed by authors. The following data was collected: 1) the efficiency rate of the method for virtual constructed of PST and G-zone; 2) the spatial position of the virtual safe core, including the distance between G-zone and the tangent line of upper and lower outer edge of Luschka's joint on the coronal plane, and the distance between the G-zone and the posterior edge of the vertebral body on sagittal plane; 3) the length, width and height of G-zone; 4) the abduction angle of pedicle screw on axial plane, and the cranial and caudad inclination angle on the sagittal plan of the pedicle; 5) the mean distance between the cortex of lateral mass and the G-zone; 6) the positive projection area of the trajectory on the coronal plan. Results:The efficiency rate of the method for virtual constructed of PST and safe core were C 3 95% (57/60) and C 4 100% with 97.5% (117/120) the total efficiency rate. The mean height of safe core was C 3 4.99±1.04 mm (left) and 4.95±0.88 mm (right), C 4 5.41±0.93 mm (left) and 5.16±1.39 mm (right). The mean width of safe core was C 3 3.79±0.87 mm (left) and 3.44±0.88 mm (right), C 4 3.99±0.68 mm (left) and 3.60±0.92 mm (right). The mean length of safe core was 3.5 mm. The distance between the G-zone and the tangent line of upper and lower outer edge of Luschka's joint on the coronal plane was C 3 0.66±0.54 mm (left) and 0.69±0.67 mm (right), C 4 0.62±0.59 mm (left) and 0.65±0.64 mm (right). The distance between the G-zone and the posterior edge of the vertebral body on sagittal plane was C 3 2.08±0.41 mm and C 4 2.34±0.60 mm, C 4>C 3 ( P<0.05). The interval of abduction angle on the axial plane of C 3 were 28.16°±7.82° to 67.46°±7.54° (left) and 29.46°±7.5° to 64.08°±9.79° (right), C 4 27.64°±4.56° to 69.95°±6.66° (left) and 29.17°±5.92° to 71.14°±5.07° (right). The range of cranial and caudad inclination angle of pedicle screw on sagittal plane were C 3 24.12°±5.35° (left) and 24.40°±4.86° (right), C 4 24.87°±5.7° (left) and 25.65°±5.62° (right). The mean distance between the entering cortex and the center of G-zone was C 3 11.93±0.76 mm (left) and 12.12±0.83 mm (right), C 4 11.24±0.71 mm (left) and 11.34±1.01 mm (right). The positive projection area of the PST on the coronal plan was C 3 41.38±15.68 mm 2 (left) and 37.66±13.77 mm 2 (right), C 4 44.54±12.96 mm 2 (left) and 40.33±15.54 mm 2 (right), C 4 left>C 4 right ( P<0.05). Conclusion:The efficiency rate of the virtual construction method for PST and safe core of the subaxial cervical spine was 97.5%. The length, width, and height of the virtual safe core were suitable for the implantation of the commonly used cervical pedicle screw with a diameter of 3.5 mm. The virtual G-zone was morphologically stable and easy to recognize on the anteroposterior and lateral cervical fluoroscopy view, which can provide a reliable landmark for the implementation of the pedicle screw of the subaxial cervical spine.

OBJECTIVETo investigate the role of Pediatric Critical Illness Score (PCIS) in evaluating the prognosis and severity of severe hand-foot-mouth disease (HFMD).

METHODSThis study included 424 children with severe HFMD, consisting of 390 survivors and 34 deceased patients. Related physiological parameters and clinical data were collected for calculating PCIS scores. The area under receiver operating characteristic curve (AUC) was employed to assess the performance of PCIS in evaluating the complications and outcomes.

RESULTSThe median of PCIS scores for survivors was higher than that for deceased patients (P<0.01). Of the 424 children with severe HFMD, only 26 (6.1%) had critical illness according to the severity assessment using PCIS. The AUC (95%CI) of PCIS was 0.74 (0.66, 0.82) in predicting pulmonary edema, 0.82 (0.74, 0.90) in predicting pulmonary hemorrhage, and 0.83 (0.75, 0.92) in predicting death.

CONCLUSIONSPCIS can predict the complications and prognosis in children with severe HFMD. However, the existing scoring system of PCIS cannot fully assess the severity of HFMD.

Objective: To investigate the spectrum of gene mutations in adult patients with B-acute lymphoblastic leukemia (B-ALL), and to analyze the influences of different gene mutations on prognosis. Methods: DNA samples from 113 adult B-ALL patients who administered from June 2009 to September 2015 were collected. Target-specific next generation sequencing (NGS) approach was used to analyze the mutations of 112 genes (focused on the specific mutational hotspots) and all putative mutations were compared against multiple databases to calculate the frequency spectrum. The impact of gene mutation on the patients' overall survival (OS) and recurrence free survival (RFS) was analyzed by the putative mutations through Kaplan-Meier, and Cox regression methods. Results: Of the 113 patients, 103 (92.0%) harbored at least one mutation and 29 (25.6%) harbored more than 3 genes mutation. The five most frequently mutated genes in B-ALL are SF1, FAT1, MPL, PTPN11 and NRAS. Gene mutations are different between Ph⁺ B-ALL and Ph^- B-ALL patients. Ph^- B-ALL patients with JAK-STAT signal pathway related gene mutation, such as JAK1/JAK2 mutation showed a poor prognosis compared to the patients without mutation (OS: P=0.011, 0.001; RFS: P=0.014,<0.001). Patients with PTPN11 mutation showed better survival than those without mutation, but the difference was not statistically significant (P value > 0.05). Besides, in Ph⁺ B-ALL patients whose epigenetic modifications related signaling pathway genes were affected, they had a worse prognosis (OS: P=0.038; RFS: P=0.047). Conclusion: Gene mutations are common in adult ALL patients, a variety of signaling pathways are involved. The frequency and spectrum are varied in different types of B-ALL. JAK family gene mutation usually indicates poor prognosis. The co-occurrence of somatic mutations in adult B-ALL patients indicate the genetic complex and instability of adult B-ALL patients.
Adult ; B-Lymphocytes ; DNA Mutational Analysis ; Humans ; Mutation ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Prognosis

Objective To compare the effectiveness of snail control between immersion of molluscicides through tide diversion and mollusciciding by spraying in marshland areas. Methods Immersion of 26% suspension concentrate of metaldehyde and niclosamide through tide diversion and spraying 26% suspension concentrate of metaldehyde and niclosamide alone were employed for snail control in two neighboring snail-breeding marshlands, and snails were surveyed before and after mollusciciding. The mortality of snails and the density of living snails were estimated. Results The density of living snails reduced by 72.19% and 100.00% 1 and 2 years after immersion of 26% suspension concentrate of metaldehyde and niclosamide through tide diversion, and 5.93% and 18.15% 1 and 2 years after spraying 26% suspension concentrate of metaldehyde and niclosamide alone. Conclusion Immersion of 26% suspension concentrate of metaldehyde and niclosamide through tide diversion is significantly superior to spraying 26% suspension concentrate of metaldehyde and niclosamide along for snail control, and implementation of immersion of 26% suspension concentrate of metaldehyde and niclosamide through tide diversion for more than 2 successive years may achieve a higher snail control efficiency.

Autopsy of patients who died of infectious diseases is of significance for public health management. Few forensic autopsies have been performed since the outbreak of the corona virus disease 2019 （COVID-19） due to some limitations, thus forensic pathological examination failed to contribute to the prevention and treatment of infectious diseases. Virtual autopsy has unique advantages in the forensic examination of patients who died of infectious diseases. Accumulated virtual autopsy image data are of great value to the study of the pathological mechanism and diagnosis of COVID-19. This article reviews the relationship between imaging changes and pathology of the COVID-19 as well as the application of virtual autopsy in autopsy of patients who died of infectious diseases, in order to provide reference for performing virtual autopsy in the outbreak of COVID-19.
Autopsy ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/pathology* ; Forensic Pathology ; Humans ; Pandemics ; Pneumonia, Viral/pathology* ; SARS-CoV-2

Objective: To investigate the predictive value of serum lactate dehydrogenase (LDH) in the prognosis of patients with paraquat (PQ) poisoning, and to provide evidence for early prognosis assessment. Methods: In February 2022, 50 patients with PQ poisoning who completed serum LDH detection admitted to the Department of Emergency Medicine, the First Affiliated Hospital of Wenzhou Medical University from January 2012 to December 2021 were selected as the observation group, and 50 healthy physical examination personnel were randomly selected as the control group. Patients with PQ poisoning were divided into survival group and death group according to the prognosis, and the differences of blood routine routine, liver and kidney function and other indicators in the first admission between the two groups were compared. Multivariate logisitic regression model was established, ROC curve was drawn, and the influencing factors of prognosis of patients with PQ poisoning were analyzed. Results: Compared with the control group, the white blood cell count (WBC), total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), LDH, glucose (GLU) and creatinine (Cr) in observation group were significantly increased, while albumin (ALB) and total cholesterol (TC) were significantly decreased (P<0.05). Univariate analysis showed that WBC, elevated LDH (>247 U/L), TBil, ALT, AST and Cr were significantly different between PQ poisoning survival group and death group (P<0.05). Multivariate logisitic regression analysis showed that elevated serum LDH was an independent risk factor for the prognosis of PQ poisoning patients (OR=9.95, 95%CI: 1.34-73.82, P=0.025). The area under the ROC curve of LDH was 0.811 (95%CI: 0.692-0.930). When the cut-off value was 340 U/L, the sensitivity was 0.889 and the specificity was 0.719. Log-rank test showed that there was a statistically significant difference in survival rate between the normal LDH group and the elevated LDH group (P=0.001) . Conclusion: Serum LDH has a good predictive value in evaluating the prognosis of patients with PQ poisoning. Elevated LDH is a risk factor for poor prognosis of patients with PQ poisoning.

Objective To evaluate the effect and cost-effectiveness of three commonly used molluscicides, 4% "Luo-wei" (tea-seed distilled saponins, TDS), 50% niclosamide ethanolamine salt wettable powder (NESWP), and 26% metaldehyde and niclosamide suspension concentrate (MNSC) in large-scale field application, so as to provide the references for formulating the strategy of snail control. Methods The field test and parallel comparison were implemented. A marshland with Oncomelania hupensis snails of the Yangtze River was divided into 4 parts (10 hm²) for the research, and three of them were experimental areas while the last one was a blank control area. The experimental areas were sprayed with 4% "Luo-wei", 50% NESWP and 26% MNSC respectively for 3 times and the interval was 1 week. Seven days after each spraying the effect of snail control was investigated, and the costs of molluscicides, labor, transportation, fuel consumption and mechanical loss were recorded. The cost of each molluscicide, snail mortality, snail density, and the cost of increasing 1% of snail mortality per 100 m² were analyzed and compared. Results After the first, second and third spraying, the corrected snail mortality rates were 67.34%, 76.55% and 84.60% respectively in the 4% "Luo-wei" group; the corrected snail mortality rates were 64.71%, 75.17% and 83.89% respectively in the 50% NESWP group; the corrected snail mortality rates were 66.55%, 76.27% and 86.67% respectively in the 26% MNSC group. There was no significant difference among the 3 groups in the snail mortality at the same spraying time (χ² = 1.590, 0.571, 3.238, all P > 0.05) . In addition, along with the increase of the spraying times, the snail mortality of each group was increased significantly compared to that of the control group (χ² = 79.333, 94.718, 117.020, all P < 0.01) . After the first, second and third spraying, the reduction rates of snail density were 69.82%–86.60% in the 4% "Luo-wei" group, 68.66%–86.55% in the 50% NESWP group, and 71.89%–88.87% in the 26% MNSC group respectively. The decreasing amplitude of the snail density was more than 85% in all the experimental areas after 3 rounds of spraying molluscicide. The snail control costs per 100 hm² were 19.57, 11.97 Yuan and 10.47 Yuan in the 4% "Luo-wei" group, 50% NESWP group, and 26% MNSC group respectively. After the first, second and third spraying, the costs of increasing 1% of snail mortality per 100 m² were 0.30, 2.08 Yuan and 2.38 Yuan in the 4% "Luo-wei" group, 0.20, 1.10 Yuan and 1.32 Yuan in the 50% NESWP group, and 0.17, 1.04 Yuan and 0.97 Yuan in the 26% MNSC group respectively, and the cost-effectiveness was the highest at the first spraying in all the three groups. Conclusions The effects of the three molluscicides for snail control are similar, but the efficacy of snail control is reduced as the spraying time increases.