Objective To synthesize the hydrophobic supraparamagnetic ironic oxide(SPIO) loaded and hydrophilic SPIO loaded polymeric nano-vesicles and to investigate the feasibility of using hydrophobic SPIO loaded and hydrophilic SPIO loaded polymeric nano-vesicles to display the tumor in MRI in vivo through animal experiments. Methods The polymeric nano-vesicles were prepared from poly (D, L-lactic acid) (PDLLA) and poly (ethylene glycol) (PEG) by a multiple emulsion/solvent evaporation method.The hydrophobic SPIO and hydrophilic SPIO were loaded in the polymeric nano-vesicles respectively.Eighteen nude mice models with human colorectal carcinoma xenograft were established. They were divided equally into three groups (n = 6). The three groups of nude mice models were injected with water-soluble SPIO, hydrophobic SPIO loaded and hydrophilic SPIO loaded vesicle via the mice caudal vein respectively.Dynamic MRI scan were performed in all the mice models. T2WI signal intensity and T2 relaxation time were measured in the tumor, liver and muscle by using T2 mapping software. ANOVA of repeated measurement was used to analyze if there were significant differences of signal intensity changes among the three groups, while Bonferroni method was used for pair-wise comparison. Results On T2 WI, tumors showed decrease in signal intensity after hydrophobic or hydrophilic SPIO loaded polymeric nano-vesicle injection, while no signal intensity decrease was found in the tumor after water-soluble SPIO administration. The maximum percentage of signal intensity decrease in tumor caused by hydrophobic SPIO loaded and hydrophilic SPIO loaded vesicle were 11.00%, 11.40%, respectively. There was statistical significant difference of signal intensity changes among these three groups (F = 10. 96, P ＜ 0. 01). The decrease in signal intensity in the groups with hydrophilic or hydrophobic SPIO loaded polymeric nano-vesicles injection were more pronounced as compared with that of water-soluble SPIO (P ＜ 0. 05), but there was no significant difference in signal intensity decrease between the groups of hydrophilic and hydrophobic SPIO-loaded polymeric vesicles injection (P ＞0. 05). The three agents could lead to signal intensity decrease in the liver. The maximum percentage of signal intensity decrease in liver caused by water-soluble SPIO, hydrophobic SPIO loaded and hydrophilic SPIO loaded vesicle were 32. 85%, 52. 77%, 56. 89%, respectively. There was statistical significant difference between these groups (F = 161.18, P ＜ 0. 01) . The groups of injecting hydrophilic and hydrophobic SPIO loaded polymeric nano-vesicles had the more obvious signal decrease than the one with water-soluble SPIO (P ＜ 0. 01). Hydrophilic SPIO loaded polymeric nano-vesicles exhibited more signal intensity decrease than hydrophobic SPIO loaded polymeric nano-vesicles (P ＜ 0. 01). All three agents could not lead to T2WI signal decrease in the muscle, and there was no significant difference in signal change on T2 WI among three groups (F = 0. 59, P ＞ 0. 05). Conclusion SPIO loaded polymeric nano-vesicles can cause significant T2WI signal loss in human colonic carcinoma on MR imaging in vivo. It can be used as tumor imaging contrast agents.

OBJECTIVETo study the change of the cracks and the influence on overall displacement of the cracked first mandibular molar under different loadings.

METHODSThree-dimensional finite element models of first mandibular molar with cracks of different depth and length and a control model with no crack were created firstly. Then six loading conditions were applied to the models simulating the real mastication. The changes of the cracks and displacement of the teeth under the six loadings conditions were obtained by finite element method.

RESULTSThe length and depth of the cracks increased, the cracks of the occlusal surface become wider, and the crack was the widest under the fourth loading condition. Moreover, the edge of the cracks was irregular. The adjacent nodes were not in the same plane. The crack of the distal surface was the widest under the sixth loading condition. Compared to the teeth without cracks, the overall displacement of the teeth with cracks increased, but the increment was limited.

CONCLUSIONThe change of the cracks is closely related to the initial crack forms and loading conditions.

Dental Stress Analysis ; Finite Element Analysis ; Humans ; Mastication ; Molar ; Tooth ; Tooth Fractures

Objective:To observe the clinical and fundus imaging features of acute macular neuroretinopathy (AMN) associated with COVID-19.Methods:A retrospective case study. A total of 32 eyes of 18 patients diagnosed of AMN associated with COVID-19 at Chengdu Aidi Eye Hospital from December 2022 to February 2023 were included. All patients had a history of fever 1 to 5 days prior to ocular onset and tested positive for SARS CoV-2 antigen. All patients were examined by best-corrected visual acuity (BCVA), color fundus photography, scanning laser ophthalmoscope (SLO), infrared fundus photography (IR), and optical coherence tomography (OCT); OCT angiography, visual field and multifocal electroretinogram (mf-ERG) were performed in 6 patients (11 eyes), 3 patients (6 eyes) and 1 patient (2 eyes), respectively. Follow-up time was 8-10 weeks. The clinical and fundus imaging features were observed and analyzed.Results:There were 6 males (12 eyes) and 12 females (20 eyes), aged from 15 to 36 years, with the mean age of (28.00±5.86) years. Fourteen patients were bilateral and 4 patients were unilateral. The time from the onset of eye symptoms to seeing a doctor was ranged from 1 day to 8 weeks. Among them, 6 patients (10 eyes) visited the doctor within 3 days of onset, while 12 patients (22 eyes) visited the doctor after 3 days of onset. The BCVA was 0.80±0.29. Fundus color photography and SLO examination showed that only 2 patients (4 eyes) showed sheet or petal-like dark red lesions in the macular area, and no obvious abnormal changes were observed in other patients. No obvious abnormalities were found in AF examination of all patients. IR examination showed no significant abnormality in 6 cases which came to hospital within 3 days after the onset, but irregular hyporeflective dark shadow lesions in the macular region of patients with more than 3-day course of disease was observed. OCT examinations of all eyes showed hyperreflective band or patchy lesion on the outer plexiform layer (OPL) and outer nuclear layer (ONL) and affect the ellipsoid zone (EZ) and interdigitation zone (IZ). In 11 eyes of 6 patients undergoing OCTA examination, the blood flow density of the choroidal capillary layer in the focal area decreased. In 6 eyes of 3 patients who underwent visual field examination, the physiologic scotoma was slightly enlarged. One patient (2 eyes) receiving mf-ERG showed a concave reduction in macular center amplitude. The hyperreflective band lesion on OPL and ONL disappear rapidly within 2 weeks, while the continuity of EZ recovered slowly, and the disruption of IZ kept existing for more than 10 weeks.Conclusions:Most AMN associated with COVID-19 are young women; IR showed irregular weak reflex in the lesion area. OCT showed strong OPL and ONL reflection. OCTA was characterized by decreased blood flow density in the choroidal capillary layer of the focal area.

Objective To elucidate the malnutrition in patients with hospital-acquired acute kidney injury(AKI), and to examine the association betweensubjective global assessment (SGA) and prognosis.Methods Adult patients with hospital-acquired AKI were prospectively enrolled in this cohort study.Nutritional evaluations, including SGA, anthropometric and serum nutritional markers were conducted at enrollment.Overall survival at 90 days among different SGA scores was analyzed using Kaplan-Meier methods, and differences were tested using the log-rank test.The Cox model was used to analyze the relationship between SGA scores and all-cause mortality after adjusting for confounders.Results A total of 170 patients were enrolled.The prevalence of moderate malnutrition(SGA B) and severe malnutrition(SGA C) was 51.8％ and 22.9％ respectively, while patients with normal nutrition(SGA A) accounted for 25.3％.After 90 days follow-up, all-cause mortality was 9.8％ in SGA A group, 34.9％ in SGA B group and 56.8％inSGACgrouprespectively. Afteradjustingforage,sex,dialysis,ventilation, hemoglobin, platelets and bilirubin, the hazard ratio(HR) of 90 days all-cause mortality was 4.0(95％ CI 1.42-11.22, P=0.008) in malnutrition group (SGA B group and SGA C group) compared with SGA A group.The Kaplan-Meier curve also revealed that the worse the SGA score was, the lower the cumulative survival became (P＜0.01).Conclusion SGA score is an independent risk factor for all-cause mortality within 90 days in patients with hospital-acquired acute kidney injury.

Objective To evaluate the role of nutritional parameters in prognosis,especially in the early and late mortality of hospital-acquired acute kidney injury (AKI) patients.Methods This study was a prospective cohort study conducted in a hospital comprising 1500 beds in Shanghai, China. One hundred ninety-four patients with hospital-acquired AKI, as determined using the RIFLE staging criteria,were enrolled as subjects after obtaining informed consent.Patients with AKI caused by postrenal obstruction,glomerulonephritis,interstitial nephritis or vasculitis were excluded.Nutritional evaluation,including subjective global assessment (SGA),anthropometric and laboratory examination,was conducted. Other laboratory measurements and clinical data were recorded.The primary outcome was early mortality (≤ 7 days) and late mortality (8-28 days) after enrolling into the study. Results AKI patients at enrollment were characterized by a high prevalence of malnutrition as determined by SGA, anthropometric and laboratory examination.Univariate analysis showed that the SGA,the serum levels of prealbumin,cholesterol and total lymphatic cells, and the Maastricht index were significantly different among early mortality,late mortality and survival groups.The serum prealbumin and cholesterol levels in the early death group were significantly lower than those in the survival and late death groups (P＜0.05).Multivariate analysis revealed that SGA,albumin,prealbumin and cholesterol remained independently and significantly associated with early mortality after adjusting for age,sex,dialysis,ventilation,hemoglobin,platelets,bilirubin,and Glasgow coma score.The areas under the receiver operating characteristic curve to predict early mortality for albumin,prealbumin and cholesterol were 0.591,0.736 and 0.603,respectively,with that of prealbumin significantly higher than others (P＜0.05). Conclusion Low levels of serum prealbumin,albumin and cholesterol at enrollment are independtly associated with increased early mortality in hospital-acquired AKI patients.

OBJECTIVE: To obtain the coding genes related to Schistosoma japonicum (Sj) cercariae 66 to approximately 68 kD antigens,and to provide antigens for diagnosis and vaccine of schistosomiasis. METHODS: Sj cercariae cDNA library was screened using the monospecific anti-sera of rabbit against soluble cercariae 66 to approximately 68 kD antigens as probes.The inserted cDNA fragments of the positive clones were amplified with PCR and identified by agarose gel electrophoresis. Four strong positive clones were further sequenced and analyzed through the internet NCBI/BLAST software. RESULTS: Twenty-one positive clones were obtained, 10 of which revealed a single band (0.5 to approximately 3.0 kb).The 4 strong positive clones showed high identity to SJCHGC05187,SJCHGC05173,SJCHGC06989, and SJCHGC01894 at the nucleotide level. CONCLUSION Four coding genes related with Sj antigens are obtained.
Animals ; Antibodies, Helminth ; immunology ; Antigens, Helminth ; immunology ; Cercaria ; genetics ; immunology ; DNA, Complementary ; genetics ; Gene Library ; Immune Sera ; immunology ; Schistosoma japonicum ; genetics ; immunology

OBJECTIVETo study risk factors of death cases of hand foot and mouth diseases (HFMD) in Hunan province, so as to provide scientific evidence for further prevention and control.

METHODSThe 105 death cases of HFMD between January and October, 2010 in Hunan Province were selected as case group; and the 210 survival cases of serious HFMD, which were matched by gender and resident places with a ratio at 2:1 in the same period in Hunan were selected as control group. The basic information, hospitalized experience and previous medical history had been surveyed and the relevant risk factors were analyzed by single factor and multi-factor logistic regression.

RESULTSIn case group, 79.05% (83/105) of the cases lived in rural area and 9.52% (10/105) of the cases lived in urban-rural midst area. In control group, 87.62% (184/210) of the cases lived in rural area and 11.43% (24/210) of the cases lived in urban-rural midst area. In case group, 59.05% (62/105) of the patients first visited rural (private) clinics and 20.00% (21/105) first visited community hospitals in villages and towns; while in control group, 43.81% (92/210) and 13.33% (28/210) chose rural (private) clinics and community hospitals in villages and towns as the first choice respectively.22.86% (24/105) of the case group and 39.05% (82/210) of the control group were diagnosed as HFMD in their first visit to hospital.27.62% (29/105) of the case group and 7.14% (15/210) in control group were provided pyrazolone in the treatment. For glucocorticoid, 80.95% (85/105) and 5.71% (6/105) of the case group were given as treatment by rural (private) clinics and community hospitals in villages and towns separately; while the proportions in the control group were 41.43% (87/210) and 0.48% (1/210) respectively. For antibiotics, 35.24% (37/105) and 23.81% (25/105) of the case group were prescribed by rural (private) clinics and community hospitals in villages and towns separately; while the percentages in the control group were 15.71% (33/210) and 7.14% (15/210). 3.81% (4/105) of the case group and 11.90% (25/210) of the control group were vaccinated in one month before the onset. The results of single-factor logistic regression indicated that living in rural areas (OR = 0.075, 95%CI: 0.016 - 0.343) and in rural-urban midst areas (OR = 0.069, 95%CI: 0.013 - 0.368), diagnosis of HFMD in the first visit to hospital (OR = 0.463, 95%CI: 0.271 - 0.788) and vaccination one month before the onset (OR = 0.293, 95%CI: 0.099 - 0.866) were four protective factors; while rural (private) clinics as the first choice (OR = 4.717, 95%CI: 1.891 - 11.767), community hospital in villages and towns as the first choice (OR = 5.250, 95%CI: 1.883 - 14.641), medication of pyrazolone (OR = 4.961, 95%CI: 2.520 - 9.766), medication of glucocorticoid in rural (private) clinics (OR = 6.009, 95%CI: 3.435 - 10.510) and in community hospital in villages and towns (OR = 12.667, 95%CI: 1.505 - 106.638), medication of antibiotics in rural (private) clinics (OR = 2.918, 95%CI: 1.690 - 5.040) and in community hospital in villages and towns (OR = 4.062, 95%CI: 2.036 - 8.108) were seven risk factors. The results of multi-factors logistic regression showed that medication of pyrazolone (OR = 2.311, 95%CI: 1.062 - 5.030), medication of glucocorticoid in rural (private) clinics (OR = 5.480, 95%CI: 3.039 - 9.880), medication of antibiotics in rural (private) clinics (OR = 2.430, 95%CI: 1.301 - 4.538) and medication of antibiotics in community hospitals in villages and towns (OR = 3.344, 95%CI: 1.477 - 7.569) were the risk factors of death of HFMD.

CONCLUSIONThe risk factors of HFMD deaths include the medication of pyrazolone, glucocorticoid and antibiotics by rural (private) clinics and medical institutions in villages and towns. The department concerned should revise the technical manual to standardize the medication of the above drugs.

Child ; Child, Preschool ; China ; epidemiology ; Female ; Hand, Foot and Mouth Disease ; drug therapy ; epidemiology ; mortality ; Humans ; Infant ; Logistic Models ; Male ; Risk Factors ; Survival Rate

OBJECTIVETo investigate the effect of the escharectomy during burn shock stage on expression of glucose translator-4 (GLUT4) mRNA in skeletal muscle and adipose tissue.

METHODS30% TBSA scalded rats were employed. Escharectomy were conducted at 8 h, 24 h, 168 h after burns respectively. Insulin, glucagon, cortisol and glucose levels in serum were analyzed. RT-PCR were employed to analyze GLUT4 mRNA expression in skeletal muscle and adipose tissue.

RESULTSGlucagon, cortisol and glucose levels in serum were declined in groups which escharectomy were conducted during burn shock stage. GLUT4 mRNA expression in both skeletal muscle and adipose tissue were downregulated after burns and escharectomy conducted during burn shock stage made it restored to near normal.

CONCLUSIONGLUT4 mRNA expression will declined after major burns in skeletal muscle and adipose tissue. Escharectomy during shock stage could make it upregulated, which will be helpful to improve glucose metabolism and hypermetabolism after major burns.

Adipose Tissue ; metabolism ; Animals ; Blood Glucose ; Burns ; physiopathology ; surgery ; Gene Expression ; Glucagon ; blood ; Hydrocortisone ; blood ; Insulin ; blood ; Male ; Monosaccharide Transport Proteins ; genetics ; Muscle, Skeletal ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Wistar ; Reverse Transcriptase Polymerase Chain Reaction ; Shock, Traumatic ; physiopathology

Objective To investigate the curative effects of Retzius sparing robotic assisted laparoscopic radical prostatectomy(RARP) through anterior path.Methods From July 2015 to July 2017,75 patients undergoing Retzius sparing RARP(Rs-RARP group) and 75 patients undergoing conventional anterior approach RARP(CA-RARP group) were retrospectively reviewed.Preoperative data of patients was collected as follows:age of (68.6 ± 5.3) years,median prostate volume of 38.9 (20.6-60.1) m1,tPSA of (15.7 ± 3.3) ng/ml,BMI of (25.2 ± 3.6) kg/m2,biopsy Gleason score of 3 + 3 in 24 cases,3 + 4 in 28 cases,4 + 3 in 23 cases,cTMN T1c in 11 cases,T2a-T2b in 59 cases,T2c in 5 cases,in Rs-RARP group;age of (69.6 ± 5.6) years,median prostate volume of 38.3 (18.4-59.8)ml,tPSA of (17.6 ± 4.4) ng/ml,BMI of (27.5 ± 2.7) kg/m2,biopsy Gleason score of 3 + 3 in 29 cases,3 + 4 in 26 cases,4 + 3 in 20 cases,cTMN T1c in 17 cases,T2a-T2b in 51 cases,T2c in 7 cases,in CA-RARP group.The clinical data of the two groups,including operation time (OT),intraoperative blood loss,perioperative blood transfusion rate,24h/1m/3m/6m/12m continence situation and erectile function recovery,and postoperative oncological results were analyzed statistically.Results All cases were successfully performed robotically without conversion or major intraoperative or postoperative complications.For operative time,Rs-RARP group was (125.3 ± 15.6) mins and CA-RARP group was (108.4 ± 21.7) mins,and the difference was not statistically significant (P ＞ 0.05).For estimated blood loss (EBL),Rs-RARP group was (106.1 ± 10.3) ml,with perioperative blood transfusion in 2 cases (2.67％),and CA-RARP group was (82.2 ± 18.4)ml,with perioperative blood transfusion in 1 cases(1.33％).The Rs-RARP group had more EBL than the CA-RARP group(P ＜0.05).No difference was found in perioperative blood transfusion rate(P ＞ 0.05).The postoperative oral intake time was (1.5 ± 0.6) d,postoperative hospital stay was (8.0 ± 1.2) d,total hospitalization expense was (58.4 ± 13.2) thousand Yuan,and there were 5 cases (6.67％) with postoperative complications in Rs-RARP group,and was (2.0 ±0.6) d,(9.0 ± 1.8) d,(60.2 ± 16.4)thousand Yuan and 3 cases (4.00％) in corresponding items in CA-RARP group.No significant difference was found in the above mentioned parameters (all P ＞ 0.05).Postoperative pathology confirmed pT1c of 18 cases,T2a-T2b of 52 cases,and pT2c of 5 cases in Rs-RARP group and pT1c of 12 cases,T2a-T2b of 56 cases,pT2c of 7 cases in CA-RARP group (P ＞ 0.05).There was no significant difference between RsRARP and CA-RARP groups in the surgical positive margin (5 cases vs.4 cases,P ＞ 0.05).No tumor recurrence appeared for all cases (tPSA ＜0.2 ng/ml) during 12 months follow-up.The continence rate for Rs-RARP group and CA-RARP group were 84.0％ (63/75) vs.28.0％ (21/75) (24h postoperatively),90.7％ (68/75) vs.46.7％ (35/75) (1 month postoperatively),93.3 ％ (70/75) vs.57.3％ (43/75)(3 months postoperatively),96.0％ (72/75) vs.89.3％ (67/75) (6 months postoperatively) and 100％ (75/75) vs.96.3％ (72/75) (1 year postoperatively).Rs-RARP group showed superiority in continence recovery at 24 h and 1,3 months postoperatively (all P ＜ 0.05),but no statistical differences at 6,12 months postoperatively(all P ＞ 0.05).On erectile function,Rs-RARP group was significantly better than the conventional group at 1,3,6,12 months postoperatively in ≤75-year-old patients(all P ＜ 0.05).But in ＞ 75-year-old patients,two groups had no difference during the follow-up (all P ＞ 0.05).Conclusions Retzius sparing RARP through anterior path can treat early and intermediate stage prostate cancer effectively,and continence and erectile function recovered shortly.

Objective To explore the incidence and related predictive factors for acute symptomatic esophagitis in patients with locally advanced non?small cell lung cancer ( NSCLC ) treated with intensity?modulated radiation therapy ( IMRT) . Methods Data were collected retrospectively from 256 patients with inoperable or unresectable stage Ⅲ NSCLC treated in our hospital between January 2007 and December 2011. The radiotherapy target volume included primary lung cancer and lymphatic drainage area involved,with a median dose of 60 Gy in 30 fractions (50-70 Gy).Of all the patients,109 patients (42.6%) received concurrent chemotherapy. Grade ≥2 acute esophagitis ( AE ) ( symptomatic esophagitis ) which occurred during radiotherapy and within 3 months after completion of radiotherapy served as the outcome event. National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0( NCI?CTCAE3.0) was used to evaluate the grade of AE. The logistic regression model was used to analyze the predictive factors. Results A total of 174 patients ( 68%) had treatment?related grade ≥2 AE;154 patients ( 60. 2%) had grade 2 AE and 20 patients (7.8%) had grade 3 AE.The median dose when grade≥2 AE occurred was 30 Gy (11?68 Gy).For grade≥2 AE,multivariate analysis showed that esophageal V5?V60,mean dose,and age were independent predictive factors (P=0.021,0,0.010).For grade ≥3 AE,multivariate analysis showed that esophageal V50?V60 ,concurrent chemotherapy,and body mass index ( BMI) were independent predictive factors ( P= 0.010,0.003,0.019 ) . Old age and higher BMI were the protective factors for grade≥2 and ≥3 AE, respectively. Conclusions For patients with locally advanced NSCLC treated with IMRT, esophageal V50—V60 and concurrent chemotherapy are predictive factors for grade ≥3 AE,and esophageal V50 has a high predictive value for both grade ≥2 and ≥3 AE.