BJ-DRGs grouping process was cited as an example, to describe the factors affecting the grouping process, grouping results and assessment results, and the solutions in transferring homepages into WJT form 4-1 for inpatient medical record homepages (WJT form 4-1 for short).Authors analyzed how to better information acquisition quality of such homepages by unifying the data interface standard of WJT form 4-1, for the purposes of enhancing BJ-DRGs grouping efficiency, and expanding its functions as a tool for medical quality management and that for medical insurance payment management.

Objective The periacetabular tumor has a low rate of incidence, but its special location poses a challenge to clinical treatment.The aim of this study was to discuss the methods, effects, and complications of surgical treatment of periacetabular tumors. Methods We retrospectively analyzed the clinical data of 36 cases of periacetabular tumor surgically treated in our depart-ment, including 21 males and 15 females, aged 15 to 64 (45.2 ±6.3) years.Among them, there were 8 cases of benign tumor (4 ca-ses of simple bone cyst, 1 case of desmoplastic fibromas, 1 case of osteofibrous dysplasia, and 2 cases of hemangioma) and 28 cases of malignant tumor (5 cases of osteosarcomas, 12 cases of chondrosarcomas, 2 cases of giant cell tumor of the bone, 1 case of malignant chondroblastoma, 2 cases of malignant fibrohistiocytoma, and 5 cases of metastatic tumor of the bone).The benign cases received sim-ple tumor resection plus bone graft and steel plate system internal fixation, while malignant cases underwent reconstruction by combined pedicle screw fixation system with bone cement. Results No patients died perioperatively and controllable complications occurred in 5 cases after operation.All the patients were followed up for 5 to 96 months except for 1 case of benign tumor.None of the benign cases experienced recurrence, and all of them achieved normal hip function.Lung metastases occurred in 10 malignant cases (4 cases of os-teosarcomas and 6 cases of chondrosarcomas) , who died of respiratory failure, and the other 18 remained tumor-free after surgery.Of the 2 patients with malignant fibrohistiocytoma, 1 died 2 years postoperatively and the other survived with tumor.Neither local recur-rence nor lung metastasis was found in the patients with chordoma and malignant chondroblastoma till the end of follow-up.The 5 pa-tients with metastases died within 3 years after operation.At 3 months after surgery, the Harris scores after total hip replacement were >90 in the 7 benign cases, 70-79 in 9 malignant cases, and <70 in the other 19 malignant cases. Conclusion For the treatment of malig-nant tumors, reconstruction by combined pedicle screw fixation system with bone cement does not affect the general daily activities of the pa-tients.Preoperative embolization of the internal iliac artery can reduce bleeding and improve operation safety, and measures should be taken to minimize postoperative complications.

Objective:To study the association between non-syndrome cleft lip and palate (NSCL/P)and MAFB (rs6072081, rs6065259,rs17820943,rs11696257)gene polymorphism in NingXia Hui and Han population.Methods:512 cases of NSCL/P,258 case of Hui nationality and 254 of Han,174 cases of complete 3 core family members(patients and their parents),142 cases of single parents families(patients and their single parents),were collected in patient group.505 cases of healthy newborns were collected in control group.The MAFB gene SNPs were determined with TaqMan SNPs genotyping methods and the data were analyzed by case-con-trol analysis,transmission disequilibrium test(TDT)and family based association test(FBAT).Results:Case-control analysis found that,there was a statistical significance of the genotypes and allele frequency between patients and the controls in MAFB of the 4 locus (P <0.05);but all of the 4 locus showed no difference in patients with cleft palate(P >0.05).Conclusion:The 4 locus single nucle-otide polymorphism was associated with NSCL/P in Ningxia population.

OBJECTIVESHeparin-binding neurite-promoting factor (HBNF) is a heparin-binding protein primarily found in the brain, which can stimulate neurite outgrowth in vitro. We expressed recombinant human heparin-binding neurite-promoting factor (hrHBNF) using a yeast system, and observed its activity in stimulating neurite outgrowth in vitro.

METHODScDNA encoding mature human HBNF was amplified from total RNA isolated from an 18-week aborted human fetal brain by RT-PCR method. After amplification, the HBNF cDNA gene was cloned into pPIC9K, a shuttle expression vector for yeast system. The positive clone of expression vector bearing HBNF cDNA gene was obtained by screening. Verified recombinant vector was then used to transform Pichia strain GS115 by electroporation. His(+) transformants were selected on minimal dextrose medium (MD) plates which were histidine free. His(+) yeast recombinants with multi-copy inserts were screened in vivo by their resistance to G418. PCR analysis was used to confirm the integration of the HBNF cDNA gene into the Pichia genome. Secreted expression of hrHBNF protein in culture medium was obtained when the positive clone containing the HBNF cDNA gene was induced by methanol. The hrHBNF product purified by gel chromatography was added to cultured rat pheochromocytoma (PC12) cells to observe its ability to stimulate neurite outgrowth.

RESULTSIn the recombinant expression vector, the insert was sequenced to show exactly the sequence encoding human HBNF according to Genbank data. The HBNF cDNA gene was cloned downstream to the alpha-factor, and its open reading frame was in frame with the alpha-factor signal sequence in pPIC9K. SDS-PAGE showed that the molecular weight of the induced expression product was about 18 kDa, consistent with that of human HBNF reported in the literature. The protein product did promote neurite outgrowth in cultured rat pheochromocytoma (PC12) cells.

CONCLUSIONRecombinant human heparin-binding neurite-promoting factor can be expressed with a yeast system, and its product possesses the biological activity to promote neurite outgrowth.

Animals ; Base Sequence ; Carrier Proteins ; biosynthesis ; genetics ; pharmacology ; Cytokines ; biosynthesis ; genetics ; pharmacology ; DNA, Complementary ; chemistry ; Genetic Vectors ; Humans ; Molecular Sequence Data ; Neurites ; drug effects ; physiology ; PC12 Cells ; Pichia ; genetics ; Rats ; Recombinant Proteins ; biosynthesis ; Reverse Transcriptase Polymerase Chain Reaction

Objective To investigate the effects of ginkgo biloba extracts ( EGb761) on learning and memory and the protective effect on hippocampal neurons in rats with vascular dementia (VD). Meth-ods Ninety rats were randomly divided into sham-operated group,model group and EGb761-treated group, with 30 rats in each group. Rats in each group were examined at 15 days,1 month and 2 months,with 10 rats in each time point. VD model was established by bilateral carotid artery occlusion combinding with injection of sodium nitroprusside. Morris water maze test was used to detect the learning and memory function of rats. The expression of glial fibrillary acidic protein (GFAP) was observed by immunofluorescence. Western-blot was used to detect the protein expression of P-glycoprotein ( P-GP ), excitatory amino acid transporters 2 ( EAAT2),caspase-3 and cleaved caspase-3. RT-PCR was used to detect the mRNA expression of P-GP and EAAT2 in the hippocampus of rats in each group. Results Compared with sham-operated group,the escape latency (EL) was significantly prolonged at each time point in model group ( sham-operated group:15 days (15. 52±3. 23) s,1 month ( 14. 21 ± 2. 62) s,2 months ( 15. 37 ± 1. 66) s;model group:15 days ( 30. 35 ± 2. 30)s,1 month(40. 78± 3. 55) s, 2 months( 33. 88± 1. 47) s; all P<0. 01). The EL of EGb761-treated group was significantly shorter than that of the model group(EGb761-treated group:15 days(25. 69±2. 44)s, 1 month(20. 78±1. 72)s,2 months(18. 23±1. 67)s,all P<0. 01). Immunofluorescence showed that the ex-pression of GFAP in EGb761-treated group was lower than that of the model group (P<0. 01). Western blot showed that cleaved caspase-3 protein expression in EGb761-treated group at each time point was significant-ly lower than that in the model group (P<0. 01). Western-blot and RT-PCR results showed that the protein and mRNA expression of P-GP and EAAT2 in EGb761-treated group at 15 day and 1 month time points were significant increased than those in the model group (P<0. 01). At 2 month time point,which were lower than those in the model group (P<0. 01). Conclusion EGb761 can improve the learning and memory ability of VD rats,and regulate the protein and mRNA expression of P-GP and EAAT2 in hippocampus of VD rats at different time points (up-regulated in 1 month and down-regulated in 2 month),and down-regulate the ex-pression of cleaved caspase-3 and GFAP at different time points,thereby delaying the brain damage of VD rats and protecting neurons.

OBJECTIVETo investigate the association between rs142167, rs7216231 single nucleotide polymorphism (SNP) in Wnt3 and nonsyndromic cleft lip and palate (NSCL/P) in Hui and Han population of Ningxia Autonomous Region.

METHODSThe study consisted of 371 NSCL/P patients from Ningxia Hui and Han population (Han population 166, Hui population 205), their parents (196 fathers, 224 mothers, 150 trios) and 258 normal controls (Han population 190, Hui population 68). Polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLP) was used to identify rs142167, rs7216231 genotypes of the samples. The data was analyzed by case-control analysis, transmission disequilibrium test (TDT) and family based associated test (FBAT).

RESULTSCase-control study showed that no differences in cleft lip, cleft palate, cleft lip and palate, and the total case group compared with the control group at rs142167 and rs7216231 (P > 0.05) in Hui and Han population and in stratified comparison. TDT test showed that rs142167 and rs7216231's allele had not over-transmitted (P > 0.05) in NSCL/P. FBAT test showed that G-G specific haplotypes showed statistically significant (P < 0.05).

CONCLUSIONWnt3 gene polymorphism is not relevant with NSCL/ P in Ningxia Hui and Han population.

Brain ; abnormalities ; Case-Control Studies ; Cleft Lip ; Cleft Palate ; Genotype ; Humans ; Polymorphism, Genetic ; Polymorphism, Single Nucleotide

OBJECTIVETo investigate the life quality and their influence factors in cleft lip and palate parents and to provide evidences for improving the life quality of the parents.

METHODSOne hundred and forty-three parents whose children accepted the primary surgery of cleft lip and palate were selected as the case group, and 109 normal adults as the control group. Both groups were investigated by 3 questionnaires that included questionnaire of general status, generic quality of life inventory-74 (GQOLI-74), social support rating scale (SSRS). The results of two groups were analyzed and the influence factors on life quality were studied by stepwise multiple regression analysis.

RESULTS1)The scores of the life quality, mental function, social function, material life in the case group were significantly low compared with the control group(P<0.05). 2)The social support total scores, subjective support and utilization of social support were lower than the control group(P<0.05). 3)Social support, objective support, subjective support positively correlated with life quality scores and every dimension score in the case group. 4)The relevant factors affecting life quality were social support and income.

CONCLUSIONThe life quality and social support of cleft lip and palate patients is poor, we should give more support and help to improve their life quality.

Adult ; Cleft Lip ; Cleft Palate ; Humans ; Parents ; Quality of Life ; Social Adjustment ; Surveys and Questionnaires

Objective:To comparae the accuracy of imaging examination in preoperative parathyroid localization, and the safety and effect of total parathyroidectomy on secondary hyperparathyroidism complicated by chronic renal failure.Method:A total of 257 patients with secondary hyperparathyroidism who underwent total parathyroidectomy at the Department of General Surgery , Zhongshan Hospital, Dalian University from Mar 2012 to Mar 2022 were analyzed retrospectively.Result:Six hundred fourty parathyroid glands were found by color Doppler ultrasound and 954 parathyroid glands were by enhanced CT before the operation. Among them, the number of patients with accurate location of all 4 parathyroid glands by color Doppler ultrasound was 54, while that by enhanced CT was 216. The parathyroid detection rate by enhanced CT was significantly higher than that of color Doppler ultrasound ( χ2=325.480, P<0.001), and the accuracy rate was significantly higher tnan that of color ultrasound ( χ2=215.146, P<0.001). The average values of iPTH before operation, on the day after operation, on the 1st day and 7th day after operation were (1 880±890), (137±82), (66±46) and (34±23) pg/ml, respectively. The clinical symptoms of all patients were significantly relieved. Conclusions:Enhanced CT is superior to color Doppler ultrasound in the overall detection rate and individual localization accuracy of preoperative parathyroid localization. Total parathyroidectomy is safe and reliable in the treatment of secondary hyperparathyroidism complicated by chronic renal failure.

Objective To evaluate the safety,tolerability and clinical effects of magnetic resonance imaging(MRI)-guided personalized repetitive transcranial magnetic stimulation(rTMS)in adolescents with depression.Methods Select 80 patients with depression who visited Hangzhou Seventh People's Hospital from February to December 2023 as the research subjects.According to the random number table method,it is divided into precision localization group and routine group.The precision localization group targeted the left dorsolateral prefrontal cortex(DLPFC)as the stimulus target based on MRI,while the conventional group used the traditional"5cm"to locate the left DLPFC.Treatment of all particioants was administered five times,continues two weeks,per week for a total of 10 sessions(resting motor threshold with 90％,stimulation frequency with 10Hz,40 pulses per session,inter-train interval 10 seconds,60 trains per day,totaling 2400 pulses).Changes of Hamilton depression rating scale 17(HAMD-17)and Hamilton anxiety rating scale(HAMA)were evaluated,with treatment response defined as ≥50％reduction in HAMD-17 or HAMA scores.Adverse events were collected and recorded during daily interviews.Results There were no significant differences in baseline HAMD-17 and HAMA scores between precision localization group and routine group(P＞0.05).However,after 2 weeks of treatment,there were significant differences in HAMD-17 and HAMA scores(t=3.940,P=0.027;Z=-2.060,P=0.039).The effective rates for depression and anxiety symptoms in precision localization group was 81.48％and 51.85％respectively,and 43.33％and 23.33％respectively in routine group,with statistically significant differences between two groups(x2=8.730,P=0.003;x2=4.970,P=0.026).No serious adverse events occurred in two groups.Conclusion For adolescents with depression,rTMS guided by MRI for individualized precise localization is an effective and safe treatment option,rapidly alleviats depressive and anxiety symptoms.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.