Objective To assess the validity and utility of the four-column concept by comparing the imaging results and clinical efficacy of the four-column concept with the Schatzker typing concept in the treatment of type Ⅰ-Ⅳ tibial plateau fractures.Methods A total of 70 tibial plateau fracture patients selected from Dongguan Hospital,Guangzhou University of Traditional Chinese Medicine from September 1,2022 to April 30,2023,who were divided into treatment group and control group,with 35 patients in each group.All patients underwent complete X-ray and CT three-dimensional reconstruction examination,and regular postoperative review of orthopantomograms of the knee was performed.Data were collected at 1 month and 1 year postoperatively,including measurements of posterior tibial slope(PTSA),tibial plateau anterior(TPA),and secondary displacement of the articular surfaces,as well as the visual analogue scale(VAS),range of motion(ROM),and Lysholm knee score scale(LKSS).Results The operation duration and bleeding volume in treatment group were less than that in control group,and the difference were statistically significant(P＜0.05).There were significant differentes at 1 month after postoperatively in knee ROM and Lysholm scores between two groups(P＜0.05).There were significant differences in PTSA and articular surface collapse at 1 month and 1 year postoperatively(P＜0.05).Conclusion Surgical treatment of Schatzker type Ⅰ-Ⅳ tibial plateau fracture under the guidance of the four-column concept can effectively restore the alignment of fracture ends and fixation strength,and improve the mobility of the knee joint,which is worthy of popularization and application in the clinic.

Objective To assess the validity and utility of the four-column concept by comparing the imaging results and clinical efficacy of the four-column concept with the Schatzker typing concept in the treatment of type Ⅰ-Ⅳ tibial plateau fractures.Methods A total of 70 tibial plateau fracture patients selected from Dongguan Hospital,Guangzhou University of Traditional Chinese Medicine from September 1,2022 to April 30,2023,who were divided into treatment group and control group,with 35 patients in each group.All patients underwent complete X-ray and CT three-dimensional reconstruction examination,and regular postoperative review of orthopantomograms of the knee was performed.Data were collected at 1 month and 1 year postoperatively,including measurements of posterior tibial slope(PTSA),tibial plateau anterior(TPA),and secondary displacement of the articular surfaces,as well as the visual analogue scale(VAS),range of motion(ROM),and Lysholm knee score scale(LKSS).Results The operation duration and bleeding volume in treatment group were less than that in control group,and the difference were statistically significant(P＜0.05).There were significant differentes at 1 month after postoperatively in knee ROM and Lysholm scores between two groups(P＜0.05).There were significant differences in PTSA and articular surface collapse at 1 month and 1 year postoperatively(P＜0.05).Conclusion Surgical treatment of Schatzker type Ⅰ-Ⅳ tibial plateau fracture under the guidance of the four-column concept can effectively restore the alignment of fracture ends and fixation strength,and improve the mobility of the knee joint,which is worthy of popularization and application in the clinic.

Objective:To learn about the clinical manifestations, laboratory characteristics and treatment of patients with acute and chronic brucellosis.Methods:Clinical data of 153 brucellosis patients admitted to the Guangzhou Eighth People's Hospital, Guangzhou Medical University from 2012 to 2022 were retrospectively collected, including general information, epidemiological characteristics, clinical manifestations, laboratory test results, imaging examination results, treatment and prognosis. According to the course of disease < 180 d and ≥180 d, these patients were divided into acute brucellosis group and chronic brucellosis group, and the clinical data of the two groups of patients were compared and analyzed.Results:A total of 153 patients with brucellosis were included, including 119 in the acute brucellosis group and 34 in the chronic brucellosis group. The age was (46.2 ± 13.8) years old, with 115 males (75.2%) and 38 females (24.8%), and 85 patients (55.6%) were occupational exposed. Complications occurred in 90 patients (58.8%), and the incidence of complications in the acute brucellosis group was lower than that in the chronic brucellosis group [76.5% (26/34) vs 53.8% (64/119), χ 2 = 5.62, P = 0.018]. The most common clinical manifestations were fever and arthralgia, with 128 cases (83.7%) and 124 cases (81.0%), respectively. The incidence of fever in the acute brucellosis group was higher than that in the chronic brucellosis group [87.4% (104/119) vs 70.6% (24/34), χ 2 = 5.46, P = 0.019], while the incidence of arthralgia was lower than that in the chronic brucellosis group [77.3% (92/119) vs 94.1% (32/34), χ 2 = 4.83, P = 0.027]. In laboratory tests, the positive rate of blood culture was 59.5% (91/153), and it was higher in the acute brucellosis group than that in the chronic brucellosis group [67.2% (80/119) vs 32.4% (11/34), P < 0.05]. The incidence of elevated procalcitonin [PCT, 58.6% (58/99) vs 24.1% (7/29), χ 2 = 10.65, P = 0.001] and the incidence of liver dysfunction [33.9% (40/118) vs 15.2% (5/33), χ 2 = 4.33, P = 0.037] in the acute brucellosis group were higher than those in the chronic brucellosis group. In the imaging examination, 61 patients (39.9%) experienced bone destruction, and the incidence of bone destruction in the chronic brucellosis group was higher than that in the acute brucellosis group [55.9% (19/34) vs 35.3% (42/119), χ 2 = 4.68, P = 0.031]. All patients were treated with antibiotics, with a median of 3 and 4 types of antibiotics used in the acute and chronic brucellosis groups, respectively. The overall incidence of adverse drug reactions was 5.2% (8/153). After treatment, 65 cases (42.5%) recovered, 70 cases (45.8%) improved, and 18 cases (11.8%) did not recover. Conclusions:The main clinical manifestations of brucellosis patients are fever and arthralgia, with a high incidence of complications. All patients are treated with combined antibiotics therapy. Patients in acute brucellosis group have a higher incidence of fever, positive blood culture, elevated PCT and abnormal liver function, while patients in chronic brucellosis group have a higher incidence of complications, arthralgia and bone destruction.

Objective:To investigate the efficacy and safety of high-precision transcranial direct current stimulation (tDCS) targeting the anterior prefrontal cortex (aPFC) in prospective memory (PM) deficits in patients with schizophrenia.Methods:A total of 38 schizophrenia patients with PM deficits admitted to Outpatient Department of Psychiatry, Beijing Anding Hospital Affiliated to Capital Medical University from March 2022 to March 2023 were included and divided into true stimulus group ( n=19) and pseudo-stimulus group ( n=19) by random envelope method. Two mA stimulation current intensity with duration of 20 min was given to the true stimulus group, and same stimulation current intensity with duration of 40 s was given to the pseudo-stimulus group twice daily for 5 d. PM function was assessed by Cued Unfocused Laboratory Prospective Memory Task before and 1 week after stimulation, cognitive function and severity of clinical symptoms were evaluated by Positive and Negative Symptom Scale (PANSS) and Chinese version of MATRICS consensus cognition test (MCCB). Safety was assessed by tDCS adverse reaction questionnaire at the end of stimulation. Results:The time (before and 1 week after stimulation) and group interactions of PM trial accuracy and PM trial response time between the two groups were not significantly different ( P>0.05). Compared with that before stimulation, the PM trial accuracy 1 week after stimulation was significantly improved in the true stimulus group ([0.38±0.22] % vs. [0.57±0.28] %, P<0.05). No significant difference in PM trial accuracy ([0.56±0.25] % vs. [0.67±0.25] %) or PM trial response time ([2 216.46±570.03] ms vs. [2 059.59±378.41] ms) between before and 1 week after stimulation was noted in the pseudo-stimulus group ( P>0.05). In terms of severity of clinical symptoms and cognitive function, no significant difference in PANSS or MCCB scores were noted between the true stimulus group and pseudo-stimulus group 1 week after treatment ( P>0.05); no significant difference was noted between the two groups in time (before and 1 week after stimulation) and group interaction of all indexes ( P>0.05). In terms of adverse reactions, compared with the pseudo-stimulus group, the true stimulus group had significantly higher score of "skin redness" ( P<0.05); no significant differences in scores of other adverse reactions were noted between the two groups ( P>0.05). No serious adverse events occurred in all patients. Conclusion:In this study, no positive results have been found in improving PM deficits in patients with schizophrenia with high-precision tDCS targeting aPFC, but existing results suggest an improved trend, which can provide preliminary evidence for subsequent large-sample clinical trials to improve PM deficits in schizophrenia.

In order to establish a stable in vitro culture platform for chicken small intestine three-dimensional (3D) organoids, in this study, crypt cells were collected from the small intestine of 18-day-old embryos of AA broilers. On the basis of the L-WRN conditioned medium, we optimized the culture conditions of chicken small intestinal organoids by adjusting the proportions of nicotinamide, N-acetylcysteine, LY2157299, CHIR99021, Jagged-1, FGF, and other cytokines to select the medium suitable for the long-term stable growth of the organoids. The optimization results showed that the addition of 1.5 µmol/L CHIR99021 significantly improved the organoid formation efficiency and organoid diameter. When 0.5 µmol/L Jagged-1 was added, a small amount of bud-like tissue appeared in organoids. After the addition of 50 ng/mL FGF-2, the rate of organoid germination was significantly increased. The 1.5 µmol/L CHIR99021, 0.5 µmol/L Jagged-1, and 50 ng/mL FGF-2 added in the medium can cooperate with each other to improve the formation and speed up the proliferation and differentiation of organoids, while improving the stemness maintenance of cells. The morphology, cell types, and culture characteristics of chicken small intestinal organoids were studied by HE staining, transmission electron microscopy, reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR), indirect immunofluorescence, and immunohistochemistry. The results showed that the 3D organoids of the chicken small intestine cultured in vitro were morphologically consistent with the chicken intestinal tissue and contained differentiated epithelial cells. In summary, we successfully established an in vitro culture system for chicken small intestinal organoids, providing a new method for the subsequent research on chicken intestinal physiology, pathology, and host-pathogen interaction mechanism and the development of relevant drugs.
Animals ; Organoids/metabolism* ; Intestine, Small/drug effects* ; Chickens ; Cell Culture Techniques/methods* ; Culture Media ; Chick Embryo ; Tissue Culture Techniques/methods*

Objective To investigate the value of Charlson comorbidity index (CCI) in predicting the short- and long-term risks of death in patients with acute-on-chronic liver failure (ACLF). Methods A total of 317 patients with ACLF who attended The First Hospital of Lanzhou University from December 1, 2016 to December 1, 2021 were enrolled, and according to their prognosis, they were divided into death group with 169 patients and survival group with 148 patients. The two groups were analyzed in terms of clinical data and follow-up data. The group t -test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The univariate and multivariate Cox proportional-hazards regression model analyses were used to investigate the influencing factors for the prognosis of ACLF patients. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was used for comparison of survival time between patients with different CCI scores. The receiver operating characteristic (ROC) curve was used to evaluate the performance of CCI and other indices in assessing the prognosis of ACLF patients. Results Among the 317 patients, there were 225 (71.0%) male patients. There were significant differences between the death group and the survival group in age, hemoglobin, white blood cell count, total bilirubin, albumin, Model for End-Stage Liver Disease (MELD) score, prothrombin time activity, CCI, age-adjusted Charlson co-morbidity index (ACCI), and follow-up time (all P < 0.05). The multivariate Cox regression analysis showed that the CCI (hazard ratio [ HR ]=1.351, 95% confidence interval [ CI ]: 1.112-1.641, P =0.002), ACCI ( HR =1.200, 95% CI : 1.011-1.423, P =0.037), and MELD score ( HR =1.076, 95% CI : 1.054-1.099, P < 0.001) were independent risk factors for the prognosis of ACLF patients. Based on CCI score, the patients were divided into CCI ≤4 group with 167 patients, CCI=5 group with 64 patients, and CCI ≥6 group with 86 patients, with a 3-year mortality rate of 26.5%, 83.2%, and 96.9%, respectively, and there was a significant difference in survival time between any two groups after 3 years of follow-up and at the time of follow-up till September 2022 (all P < 0.001). CCI, ACCI, and MELD scores had an area under the ROC curve of 0.845, 0.811, and 0.790, respectively, in predicting the prognosis of ACLF patients. Conclusion As commonly used comorbidity assessment indices, CCI and ACCI scores have certain value in evaluating the short- and long-term prognosis of ACLF patients.

Primary sclerosing cholangitis （PSC） is an immune-mediated chronic cholestatic liver disease and can progress to end-stage liver diseases such as liver cirrhosis and liver failure， and there are still no effective treatment methods at present. Studies have found that T lymphocytes are closely associated with the development and progression of PSC. This article reviews the role of T lymphocytes in PSC， so as to provide new ideas for research on the pathogenesis of PSC and the clinical diagnosis and treatment of PSC.

Objective:To analyze the clinical and laboratory characteristics of mpox patients in Guangzhou City.Methods:The general conditions, symptoms and signs, and laboratory test results of mpox patients admitted to Guangzhou Eighth People′s Hospital, Guangzhou Medical University from June 8 to June 21, 2023 were collected. The clinical characteristics of human immunodeficiency virus (HIV)-infected patients and HIV-negative patients were compared.Independent sample t test, Mann-Whitney U test and Fisher exact probability method were used for statistical analysis. Results:Nineteen mpox patients were included in this study, none of them had been vaccinated with smallpox vaccine. All of them were identifed as gay men with an age of (33.2±6.4) years. And all of them had sex with men within 21 days of onset. There were eight cases with HIV infection and syphilis, respectively. All of these 19 patients had skin lesions which were the first symptom of 15 patients, and appeared during the course of the disease of four patients. Other common symptoms and signs were lymph node enlargement (17 cases), lymph node tenderness (15 cases), pharyngeal congestion (15 cases), tonsil enlargement (13 cases), fever (11 cases) and pruritus (10 cases). There were 13 cases with elevated CD8 + T lymphocytes, interleukin-10 level and procalcitonin level, respectively, 12 cases with elevated serum amyloid A level, and seven cases with elevated blood lymphocyte count. Eight patients were infected with HIV, including one acute infection and seven chronic infections (all of them had received regular antiviral therapy and had a CD4 + T lymphocyte count of 657(400, 757)/μL before onset). There were no significant differences in age ( t=1.55), incidence of complications (Fisher exact probability method), number of skin lesions ( Z=-0.21), incidence of lymph node enlargement (Fisher exact probability method), incidence of fever (Fisher exact probability method), duration of fever ( Z=-0.48), lymphocyte count ( t=-1.55), CD4 + T lymphocyte count ( Z=-0.17) and CD8 + T lymphocyte count ( Z=-1.49) between the HIV-infected patients and HIV-negative patients (all P>0.05). The number of skin lesions was 19(6, 26), and the locations of skin lesions were mainly in perineum and nearby areas (17 cases). The most frequent morphology of skin lesions at admission were papules (15 cases), eschar (15 cases) and pustules (12 cases). All patients recovered after topical medication and symptomatic treatment. Conclusions:Mpox mainly occurs in young and middle-aged men who have sex with men in Guangzhou City. Skin lesions, lymph node enlargement accompanied by tenderness, pharyngeal congestion, tonsil enlargement and fever are the most common features. Common laboratory abnormities are elevated inflammatory markers. The clinical characteristics of HIV-infected patients with normal immune function are similar to those of HIV-negative patients.

Objective:To analyze the clinical features of patients with severe dengue (SD) in Guangdong Province, and to improve the understanding of the diagnosis and treatment of SD in China.Methods:The clinical data, laboratory examination and etiological test results of 257 SD cases from 29 dengue fever designated hospitals in Guangdong Province from January 1, 2013 to December 31, 2019 were respectively collected. The relevant indicators of the criteria for severe organ involvement were quantified. Logistic regression analysis was performed to analyze the risk factors for the development of multiple organ failure in SD patients.Results:Among the 257 SD patients, age was (64.1±20.1) years old, with 65.4%(168/257) of them ≥60 years old, 142 were male and 115 were female. One hundred and fifty-two (59.1%) patients had underlying conditions, including 115(44.7%) patients with hypertension. The clinical manifestations were mainly fever (98.4%(253/257)), fatigue (70.0%(180/257)), cough or expectoration (44.4%(114/257)), lethargy or irritability (39.3%(101/257)), vomiting (30.4%(78/257)), abdominal pain or tenderness (20.6%(53/257)), hepatomegaly (2.3%(6/257)), bleeding tendency (59.5%(153/257)), and pleural effusion or ascites (43.6%(112/257)). Platelet count levels were decreased in 90.9%(231/254) of the cases, and 97.1%(234/241) of patients had normal or decreased hematocrit. The most common of severe manifestations were severe organ involvement (61.1%(157/257)), followed by severe bleeding (37.0%(95/257)) and severe plasma leakage (30.0%(77/257)). Severe organ involvements were more common in the kidney (27.6%(71/257)) and heart (26.8%(69/257)). Multivariate logistic regression analysis showed that age (odds ratio ( OR)=1.051, 95% confidence interval ( CI) 1.004 to 1.100, P=0.035), hypertension ( OR=5.224, 95% CI 1.272 to 21.462, P=0.022), elevated aspartate aminotransferase (AST) level ( OR=1.002, 95% CI 1.001 to 1.003, P=0.001), blood urea nitrogen (BUN) ( OR=1.050, 95% CI 1.005 to 1.098, P=0.030), and international normalized ratio (INR) ( OR=4.604, 95% CI 1.601 to 13.238, P=0.005) were risk factors for the development of multiple organ failure in SD patients. The detection results of serum samples form 113 SD patients in acute phase showed that dengue virus (DENV)-1 accounted for 89.4%(101/113), DENV-2 accounted for 9.7%(11/113), and DENV-3 accounted for 0.9% (1/113). Conclusions:Elderly and those with co-existing conditions such as hypertension in SD patients in Guangdong Province are more common. Severe organ involvement such as kidney and heart is the main cause of SD. DENV-1 infection is predominant. Significant elevated levels of AST, BUN and INR may be related to a poor prognosis.

Objective:To investigate the cardiac presentations and the possible influencing factors of severe and critical coronavirus disease 2019 (COVID-19).Methods:A retrospective study was conducted. Patients with severe and critical COVID-19 admitted to the Eighth People's Hospital of Guangzhou from January 21st to February 24th 2020 were enrolled. According to the clinical classification, the patients were divided into severe group and critical group. The myocardial injury markers, such as lactate dehydrogenase (LDH), aspartate aminotransferase (AST), creatine kinase (CK), cardiac troponin I (cTnI), myoglobin (MYO), MB isoenzyme of creatine kinase (CK-MB), B-type natriuretic peptide (BNP) and electrocardiogram (ECG) changes were compared between the two groups.Results:A total of 55 COVID-19 patients were selected, including 15 critical cases and 40 severe cases. The patients with severe and critical COVID-19 were male-dominated (61.8%), the average age was (61.2±13.0) years old, 83.6% (46 cases) of them had contact history of Hubei, 38.2% (21 cases) of them were complicated with hypertension. There was no significant difference in baseline data between the critical group and the severe group. Myocardial injury markers of critical and severe COVID-19 patients were increased in different proportion, LDH increased in most patients (20 severe cases and 7 critical cases), followed by AST (16 severe cases and 5 critical cases). There was significant difference in the number of patients with elevated CK between severe group and critical group (cases: 1 vs. 4, P = 0.027). Abnormal ECG was found in 39 of 42 patients with ECG examination. Nonspecific change of T wave was the most common. Before and after treatment, 9 of 15 patients with changes of ECG and myocardial injury markers had oxygenation index less than 100 mmHg (1 mmHg = 0.133 kPa), and the prominent changes of ECG were heart rate increasing and ST-T change. Conclusions:The increase of myocardial injury markers and abnormal ECG were not specific to the myocardial injury of severe and critical COVID-19 patients. At the same time, the dynamic changes of myocardial injury markers and ECG could reflect the situation of myocardial damage.