OBJECTIVE To investigate the current status of monitoring indicators related to the"Perioperative In-fection Control"in medical institutions above the secondary level in Guizhou Province,and to delve into the imple-mentation of key measures for infection prevention and control during the perioperative period for patients under-going surgical operations.METHODS Based on the"Implementation Plan for the'Perioperative Infection Control'Initiative in Guizhou Province",a"Case Investigation Form on Key Measures for Infection Prevention and Control During the Perioperative Period for Patients Undergoing Surgical Operation"was developed.A total of 138 medi-cal institutions participated in the case investigation,and a total of 2 128 cases were investigated.RESULTS The overall monitoring indicators for the"Perioperative Infection Control"initiative in the 138 medical institutions a-bove the secondary level in Guizhou Province were at a relatively low level.The skin cleansing compliance rate was 80.32％,the hair removal compliance rate was 16.43％,the prophylactic antibacterial drug administration rate within 0.5-1 hour before surgery was 55.94％and the antibacterial drug discontinuation rate within 24 hours after prophylactic medication for type Ⅰ incision surgeries was 56.48％.The hair removal compliance rate was higher in tertiary medical institutions(19.21％)than in secondary medical institutions(14.34％)(P=0.039).The distri-bution of the four monitoring indicators varied in clinical departments and surgery types,with statistically signifi-cant differences(P＜0.05).The preferred method for surgical site skin cleansing in medical institutions across the province was local wiping,primarily with clean water(57.21％).The primary method for hair removal was razors(68.82％),and hair removal on the day of surgery was most common(61.75％).CONCLUSIONS Conduc-ting a survey on the current status of"Perioperative Infection Control"initiative monitoring indicators in medi-cal institutions in Guizhou Province helps to understand the implementation of key measures for perioperative in-fection prevention and control and set intervention targets,thus providing references for establishing a dynam-ic monitoring indicator change mechanism.

OBJECTIVE To investigate the current status of monitoring indicators related to the"Perioperative In-fection Control"in medical institutions above the secondary level in Guizhou Province,and to delve into the imple-mentation of key measures for infection prevention and control during the perioperative period for patients under-going surgical operations.METHODS Based on the"Implementation Plan for the'Perioperative Infection Control'Initiative in Guizhou Province",a"Case Investigation Form on Key Measures for Infection Prevention and Control During the Perioperative Period for Patients Undergoing Surgical Operation"was developed.A total of 138 medi-cal institutions participated in the case investigation,and a total of 2 128 cases were investigated.RESULTS The overall monitoring indicators for the"Perioperative Infection Control"initiative in the 138 medical institutions a-bove the secondary level in Guizhou Province were at a relatively low level.The skin cleansing compliance rate was 80.32％,the hair removal compliance rate was 16.43％,the prophylactic antibacterial drug administration rate within 0.5-1 hour before surgery was 55.94％and the antibacterial drug discontinuation rate within 24 hours after prophylactic medication for type Ⅰ incision surgeries was 56.48％.The hair removal compliance rate was higher in tertiary medical institutions(19.21％)than in secondary medical institutions(14.34％)(P=0.039).The distri-bution of the four monitoring indicators varied in clinical departments and surgery types,with statistically signifi-cant differences(P＜0.05).The preferred method for surgical site skin cleansing in medical institutions across the province was local wiping,primarily with clean water(57.21％).The primary method for hair removal was razors(68.82％),and hair removal on the day of surgery was most common(61.75％).CONCLUSIONS Conduc-ting a survey on the current status of"Perioperative Infection Control"initiative monitoring indicators in medi-cal institutions in Guizhou Province helps to understand the implementation of key measures for perioperative in-fection prevention and control and set intervention targets,thus providing references for establishing a dynam-ic monitoring indicator change mechanism.

Objective:To study the trinucleotide repeats of GCN (GCA, GCT, GCC, GCG) encoding Alanine in exon 3 of the PHOX2B gene among healthy individuals from southwest China and two patients with Congenital central hypoventilation syndrome (CCHS). Methods:The number and sequence of the GCN repeats of the PHOX2B gene were analyzed by capillary electrophoresis, Sanger sequencing and cloning sequencing of 518 healthy individuals and two newborns with CCHS, respectively. Results:Among the 1036 alleles of the 518 healthy individuals, five alleles were identified, including (GCN) 7, (GCN) 13, (GCN) 14, (GCN) 15 and (GCN) 20. The frequency of the (GCN) 20 allele was the highest (94.79%). And five genotypes were identified, which included (GCN) 7/(GCN) 20, (GCN) 13/(GCN) 20, (GCN) 14/(GCN) 20, (GCN) 15/(GCN) 20, (GCN) 20/(GCN) 20. The homozygous genotypes were all (GCN) 20/(GCN) 20, and the carrier rate was 89.58%. Four GCN sequences of the (GCN) 20 homozygous genotypes were identified among the 464 healthy individuals. The GCN repeat numbers in the exon 3 of the PHOX2B gene showed no significant difference between the expected and observed values, and had fulfilled the, Hardy-Weinberg equilibrium. The genotypes of the two CCHS patients were (GCN) 20/(GCN) 25 and (GCN) 20/(GCN) 30, respectively. Conclusion:It is important to determine the GCN repeats and genotypic data of the exon 3 of the PHOX2B gene among the healthy individuals. The number of GCN repeats in 518 healthy individuals was all below 20. The selection of appropriate methods can accurately detect the polyalanine repeat mutations (PARMs) of the PHOX2B gene, which is conducive to the early diagnosis, intervention and treatment of CCHS.

Background and Aims:Recurrent laryngeal nerve (RLN) injury during endoscopic thyroid cancer radical surgery significantly affects postoperative recovery and quality of life. Avoiding RLN injury has always been a key concern during thyroid surgeries. Choosing an appropriate and safe approach to expose the RLN in endoscopic thyroid cancer surgery may reduce the risk of RLN injury. However,the optimal approach for RLN exposure in endoscopic thyroid cancer radical surgery through the anterior chest approach remains inconclusive. This study was performed to compare the surgical outcomes of using the medial and lateral approaches to expose the RLN in endoscopic thyroid cancer surgery through the anterior chest approach,so as to provide reference for clinical practice.Methods:The clinical data of 85 patients who underwent endoscopic thyroid cancer radical surgery (ipsilateral lobectomy and ipsilateral central lymph node dissection) via the anterior chest approach at Zhuzhou Hospital Affiliated to Xiangya Medical College,Central South University,from January 2020 to January 2023 were retrospectively analyzed. Among the patients,medial approach was used in 45 cases (medial approach group) and lateral approach was used for RLN exposure in 40 cases (lateral approach group). The main clinical variables were compared between the two groups. Results:No statistically significant differences were found in baseline data between the two groups (all P>0.05). Both groups successfully completed endoscopic thyroidectomy via the anterior chest approach with complete RLN exposure at the main trunk and its entry into the larynx. The RLN exposure time and endoscopic surgery time in the medial approach group were significantly shorter than those in the lateral approach group (both P<0.05). Intraoperative blood loss was significantly less in the medial approach group compared to the lateral approach group (P<0.05). There were no cases of transient RLN injury in the medial approach group,whereas 5 cases of transient RLN injury occurred in the lateral approach group,with a statistically significant difference (P<0.05). The medial approach group had fewer cases of thyroid tissue residue at the Berry's ligament and transient hypoparathyroidism than the lateral approach group,but the differences were not statistically significant (both P>0.05). There were no statistically significant differences between the two groups in postoperative hospital stay or postoperative drainage volume (both P>0.05). Conclusion:The medial approach for RLN exposure in endoscopic thyroid cancer surgery is safe and feasible. Compared to the lateral approach,it allows faster RLN exposure,effectively reduces the risk of transient RLN injury,decreases intraoperative blood loss and operative time,and may also reduce the incidence of transient hypoparathyroidism and thyroid tissue residue to some extent.

Background and Aims:Recurrent laryngeal nerve (RLN) injury during endoscopic thyroid cancer radical surgery significantly affects postoperative recovery and quality of life. Avoiding RLN injury has always been a key concern during thyroid surgeries. Choosing an appropriate and safe approach to expose the RLN in endoscopic thyroid cancer surgery may reduce the risk of RLN injury. However,the optimal approach for RLN exposure in endoscopic thyroid cancer radical surgery through the anterior chest approach remains inconclusive. This study was performed to compare the surgical outcomes of using the medial and lateral approaches to expose the RLN in endoscopic thyroid cancer surgery through the anterior chest approach,so as to provide reference for clinical practice.Methods:The clinical data of 85 patients who underwent endoscopic thyroid cancer radical surgery (ipsilateral lobectomy and ipsilateral central lymph node dissection) via the anterior chest approach at Zhuzhou Hospital Affiliated to Xiangya Medical College,Central South University,from January 2020 to January 2023 were retrospectively analyzed. Among the patients,medial approach was used in 45 cases (medial approach group) and lateral approach was used for RLN exposure in 40 cases (lateral approach group). The main clinical variables were compared between the two groups. Results:No statistically significant differences were found in baseline data between the two groups (all P>0.05). Both groups successfully completed endoscopic thyroidectomy via the anterior chest approach with complete RLN exposure at the main trunk and its entry into the larynx. The RLN exposure time and endoscopic surgery time in the medial approach group were significantly shorter than those in the lateral approach group (both P<0.05). Intraoperative blood loss was significantly less in the medial approach group compared to the lateral approach group (P<0.05). There were no cases of transient RLN injury in the medial approach group,whereas 5 cases of transient RLN injury occurred in the lateral approach group,with a statistically significant difference (P<0.05). The medial approach group had fewer cases of thyroid tissue residue at the Berry's ligament and transient hypoparathyroidism than the lateral approach group,but the differences were not statistically significant (both P>0.05). There were no statistically significant differences between the two groups in postoperative hospital stay or postoperative drainage volume (both P>0.05). Conclusion:The medial approach for RLN exposure in endoscopic thyroid cancer surgery is safe and feasible. Compared to the lateral approach,it allows faster RLN exposure,effectively reduces the risk of transient RLN injury,decreases intraoperative blood loss and operative time,and may also reduce the incidence of transient hypoparathyroidism and thyroid tissue residue to some extent.

Objective To explore the role of lung dendritic cells (DCs) and Th17/regulatory T cells (Treg) pathway in the pathogenesis of chronic obstructive pulmonary disease(COPD).Methods COPD patients who received lobectomy from Sep.2015 to Mar.2016 in our hospital were enrolled and classified into non-smoking non-COPD group,smoking without COPD group and COPD group.The expression of CD80,chemokine recepter-6 (CCR6),interleukin-17A (IL-17A) and fork-head transcription factor P3 (FoxP3) were detected by immunohistochemistry (IHC) in lung tissue.Mature DCs (mDCs),immature DCs (imDCs),Th17 cells and Treg cells in lung tissue were detected by flow cytometry (FCM) and the correlation between Th17/ Treg cells with lung function was analyzed.Results (1) The expression of CD80 and FoxP3 in COPD group was decreased,while the expression of CCR6 and IL-17A was increased (P＜0.05).(2) The percentage of mDCs and Treg in lung tissue of COPD group was significantly decreased.In contrast,the proportion of imDCs and Th17 cells in COPD group was significantly increased (P＜0.05).(3) The imbalance of Th17/Treg ratio in lung tissue was seen in patients with COPD,suggesting the potential mechanism of Th17 cell-mediated proinflammatory response.(4) The percentage of Th17 cells and Th17/Treg ratio in COPD patients was negatively correlated with forced expiratory volume in the first second (FEV1) as a percentage of predicted value (FEV1％ pred),forced vital capacity(FVC) as a percentage of predicted value (FVC％ pred),FEV1/FVC.On the other hand,the percentage of Treg cells was positively correlated with FEV1％ pred,FVC％ pred,FEV1/FVC.Conclusions The data in this study demonstrate the maturation disorder of dendritic cells in lung tissue of COPD patients.The imbalance of Th17/Treg ratio suggests that Th17 cell-mediated proinflammatory response may be involved in the pathogenesis of COPD.

OBJECTIVETo assess the accuracy of quantitative fluorescence PCR(QF-PCR) for the detection of fetal chromosomal aneuploidies and its values for prenatal diagnosis.

METHODSQF-PCR and chromosomal karyotyping were used to analyze 6066 amniotic fluid samples derived from 6034 pregnant women.

RESULTSBoth QF-PCR and karyotyping analysis have detected 135 cases of fetal aneuploidies involving chromosomes 21, 18, 13, X, and Y. The QF-PCR assay was also successful in 67 cases for which amniotic fluid culture has failed. Furthermore, it has identified maternal cell contamination in 7 cases. By determining the consistency of short tandem repeat (STR) sites, the QF-PCR assay has identified 22 dizygotic twins among 32 twins with double chorions and double amniotic sacs. In 12 cases, it has signaled numerical chromosomal aberration by critical or partial abnormal values for the fluorescence peak area ratio, which were verified by karyotyping analysis as mosaicisms of chromosome aneuploidies.

CONCLUSIONThe QF-PCR can provide an useful supplement for chromosomal karyotyping and has an important role in rapid prenatal diagnosis.

Adolescent ; Adult ; Aneuploidy ; Female ; Fluorescence ; Humans ; Karyotyping ; Microsatellite Repeats ; Middle Aged ; Polymerase Chain Reaction ; methods ; Pregnancy ; Prenatal Diagnosis ; methods ; Young Adult

As a model organism, zebrafish have many advantages over other animal models and is suitable for studies on establishment of human disease model and mechanism.In zebrafish, there are two phases of endocrine formation during early development, which are directed by concomitant activity of many signaling pathways.Zebrafish pancreas possess similar cell structure with that of other animals, which can express various endocrine hormones including insulin.The main organs required for metabolic control, such as the pancreas, islet, and insulin sensitive tissue (muscle, liver) are conserved in zebrafish, and the mechanisms of glucose regulation in zebrafish is similar to that seen in mammalian models.These render it an excellent model to study glucose metabolism.Hyperglycemia in zebrafish model can be induced by administration of the diabetogenic drug, streptozotocin (STZ), alternatively immersion of the fish in glucose solution and water, or disturbing of signaling pathways associated with glucose metabolism.Glucose levels in adult zebrafish blood or embryo tissue and phenotype of retinal cell layers or retinal vasculature are the commonly used measurement organs in zebrafish diabetic models.

Objective To observe the changes in the lung aquaporin 1 (AQP1) expression in adrenaline-induced pulmonary edema(PE),and the effect of Methylprednisolone (MP) on its expression.Methods Fifty Wister rats of 1-month old were randomly divided into 5 groups (10 rats in each group):control,adrenaline PE,MP A,MP B,and MP C groups,respectively.Control group animals were treated with 0.27 mL 9 g/L saline;PE group was given 2.7 mg/kg adrenaline (1 ∶ 1 000) by intraperitoneal injection;MP A,MP B and MP C groups rats were intraperitoneally injected 10 mg/kg,20 mg/kg,and 30 mg/kg MP intraperitoneally immediately after intraperitoneal injection of adrenaline,respectively.The morphology changes in the lungs were observed with HE staining,and lung wet/dry weight (W/D) was measured.The levels of AQP1 mRNA,AQP1 protein,and AQP1 distribution in the lung tissues were detected by using real time-polymerase chain reaction,Western blot,and immunohistochemical method.Results (1)PE group exhibited a faster breathing rate,and double lung volume increased significantly;there was a visible hemorrhagic distribution in the lung surface and cross section,endotracheal filled with white or pink foam liquid.(2) The W/D of rats in PE group was higher than that of the control group (6.50 ± 0.53 vs.4.59 ± 0.36,P ＜ 0.05).(3) Pathological grading of PE group (3.80 ± 0.42) increased significantly compared with that of the MP A group (3.30 ± 0.48),MP B group (2.30 ± 0.68) and MP C group (1.20 ± 0.42),and there were significant differences (all P ＜ 0.05).(4) Immunohistochemistry showed that the expression of AQP1 in PE group (1.20 ± 0.79) was reduced compared with that of the control group (4.20 ± 1.03),and there were significant differences (all P ＜ 0.05).(5) The levels of AQP1 mRNA and AQP1 protein (0.12 ± 0.43 and 0.20 ± 0.04) were significantly lower than those of the control group (0.90 ± 0.32 and 0.60 ± 0.15),and there were significant differences (all P ＜ 0.05);compared with PE group,AQP1 mRNA and AQP1 protein of each group with MP treatment showed the highest values (MP A group:0.17 ±0.06 and 0.32 ±0.04,MP B group:0.39 ±0.13 and 0.37-±0.09,MP C group:0.61 ±0.21 and 0.44 ± 0.07) (all P ＜ 0.05).Conclusion The expression of AQP1 reduced in adrenaline-induced PE rats.MP could improve the expression of AQP1,and significantly ameliorate the PE and bleeding.

Objective To evaluate the short-term prediction of high-sensitivity cardiac troponin T (hs-cTnT) and other cardiovascular risk biomarkers in patients undergoing maintenance hemodialysis (MHD).Methods We conducted a cohort survey in 296 consecutive MHD patients whose clinical data were retrospectively analyzed.Before MHD,hs-cTnT and other relative cardiovascular biomarkers were detected.The end point (all-cause death) and time of occurring were recorded in the next 13 months.The differences between survival and all-cause death were analyzed by t-test,Mann-Whitney test and x2 test.The best two percentile cutoff point was calculated by X-tile and the survival rate was calculated by Kaplan-Meier Logistic regression analysis was applied to analyze the odd ratio between high risk and non-high risk hs-cTnT group.Non-high risk group was divided into intermediate risk and low risk group based on the 99th percentile of hs-cTnT in healthy population,to further evaluate its short-term prediction value for MHD patients.The short-term significance of hs-cTnT was proved to be independently associated with all-cause death by Logistic regression analysis.Results The mean value of serum hs-cTnT in survival group was 0.05 (0.03～0.07) ng/mL,while in the death group it was 0.07 (0.04～0.14) ng/mL,which had statistical significance (P =0.027).The best two percentile cutoff of hs-cTnT in MHD patients was 0.1 ng/mL.The survival rate in high risk group (hs-cTnT＞0.1 ng/mL) is lower than it in non-high risk group (hs-cTnT≤0.1 ng/mL) (76.67％ vs.96.62％,P ＜0.05).The odd ratios for high risk group and non-high risk group was 7.288 (P＜ 0.001).Moreover,further grouping the non-high risk group by hs-cTnT =0.014 ng/mL,intermediate risk group (hs-cTnT＞0.014 ng/mL) group has lower survival rate than low risk group (hs-cTnT≤0.014ng/mL),while there wasn't any death case occurred in the low risk group.Conclusions Hs-cTnT is an independent risk factor to all-cause death.Thus hs-cTnT can be a strong indicator of short-term prediction and prognostic evaluation.