Humans ; Gastrointestinal Microbiome ; Constipation/therapy* ; Probiotics/therapeutic use* ; Patients

Objective:To explore effects and mechanisms of medium and low doses X-ray irradiation on polarization type changes of tumor associated macrophages(TAMs).Methods:Mouse RAW264.7 macrophage line was cultured with supernatant of 4T1 tumor cell culture(4T1-TCS)of mouse breast cancer,and induced to M2 TAMs.On this basis,medium and low doses X-ray irra-diation was conducted,and NO was detected by Griess method,CD86 and CD206 were detected by flow cytometry.ELISA was use to detect cytokines IL-10 and IL-12p70,immunofluorescence was use to detect iNOS and Arg-1.Western blot was used to detect polariza-tion related pathway proteins,and whether medium and low doses of radiation could alter polarization type of TAMs was observed.Results:4T1-TCS induced TAM had decreasing NO secretion and increasing CD206 and Arg-1 expressions,iNOS expression was decreased;with low doses irradiation(0.075 Gy,0.5 Gy,1 Gy)of TCS-TAM,compared with non irradiation group,NO secretion,expressions of CD86,CD206,Arg-1 and iNOS showed no significant changes;medium doses(2 Gy,4 Gy,6 Gy)of irradiation on TCS-TAM resulted in increased secretion of NO,and flow cytometry results showed increased expressions of CD86,decreased CD206 expression;immunofluorescence results showed an increase in iNOS expression and a decrease in Arg-1 expression in cells;ELISA results showed an increase in secretion of IL-12p70 by cells and a decrease in secretion of IL-10.Western blot results showed that NOX2,ATMS1981*,IRF5 proteins expressions were increased.Conclusion:4T1-TCS can successfully induce macrophage RAW264.7 polarize into M2 phenotype,while low dose irradiation has no significant effect on polarization phenotype of TCS-TAM.Medium dose irradiation can induce TCS-TAM polarization into M1 phenotype that inhibits tumor growth,and reversal mechanism of polarization may be related to IRF5 pathway.

OBJECTIVE: To compare the clinical efficacy of micro steel plate and Kirschner needle oblique and transverse internal fixation of adjacent metacarpal bone in the treatment of metacarpal diaphyseal oblique fracture. METHODS: Fifty-nine patients with metacarpal diaphyseal oblique fractures admitted between January 2018 and September 2021 were selected as the study subjects and divided into the observation group (29 cases) and the control group (30 cases) based on different internal fixation methods. The observation group was treated with Kirschner wire oblique and transverse internal fixation of adjacent metacarpal bones, while the control group was treated with micro steel plate internal fixation. Postoperative complications, operation time, incision length, fracture healing time, treatment cost, and metacarpophalangeal function were compared between the two groups. RESULTS: No incision or Kirschner wire infections occurred in the 59 patients, except for one in the observation group. No fixation loosening, rupture, or loss of fracture reduction occurred in any of the patients. The operation time and incision length in the observation group were (20.5±4.2) min and (1.6±0.2) cm, respectively, which were significantly shorter than those in the control group (30.8±5.6) min and (4.3±0.8) cm (P<0.05). The treatment cost and fracture healing time in the observation group were (3 804.5±300.8) yuan and (7.2±1.1) weeks, respectively, which were significantly lower than those in the control group (9 906.9±860.6) yuan and (9.3±1.7) weeks (P<0.05). The excellent and good rate of metacarpophalangeal joint function in the observation group was significantly higher than that in the control group at 1, 2, and 3 months after operation (P<0.05), but there was no significant difference between the two groups at 6 months after operation (P>0.05). CONCLUSION Micro steel plate internal fixation and Kirschner wire oblique and transverse internal fixation of adjacent metacarpal bones are both viable surgical methods for treating metacarpal diaphyseal oblique fractures. However, the latter has the advantages of causing less surgical trauma, shorter operation time, better fracture healing, lower cost of fixation materials, and no need for secondary incision and removal of internal fixation.
Humans ; Metacarpal Bones/injuries* ; Fractures, Bone/surgery* ; Fracture Fixation, Internal/methods* ; Bone Wires ; Bone Plates ; Treatment Outcome

Objective: To understand the use of condom among middle school students after outpatient abortion operation, so as to provide a basis for safe sex education and intervention. Methods: The questionnaire survey on condom use was conducted among the middle school students who had abortion operation in obstetric and gynecologic out patient clinic of Yuyao People s Hospital from 2016 to 2020. Group differences were compared by using Chi square test. Results: A total of 274 middle school students were investigated. The awareness rates on "AIDS can be transmitted through sexual contact" and "correct use of condoms can reduce the risk of AIDS through sexual transmission" were 93.80% and 91.24% respectively. The rate of condom s usage was 17.88% in the past 6 months, 5.47% of participants used condoms every time, 12.41% used condoms occasionally, and 82.12% never used condoms. About 18.37% of participants who used condoms every time or occasionally could use correctly. The top three reasons were "I don t think it s so coincidental to get pregnant once in a while" (16.44%), "I think it s very troublesome to use it" (14.67%), "I didn t expect to use it, let alone prevent diseases" (14.22%). Conclusion Yuyao City flow of students related AIDS knowledge awareness rate is high, and the condom utilization rate, the correct utilization rate is very low. According to the main reasons of not wearing condoms, do a good job of the correct use of condom publicity, through targeted sex education and intervention, to achieve the purpose of from "knowledge" to "faith" and ultimately to "practice".

OBJECTIVE: To explore gender difference in the clinical manifestations of two children with Keishi-Bukuryo-Gan syndrome (KBGS). METHODS: Clinical manifestations of the two children were reviewed. Genetic testing was carried out through next generation sequencing (NGS). Treatment was summarized, and the prognosis was followed up. RESULTS: Both children showed particular appearance including megatooth, abnormal hair distribution, hands' abnormality and language development delay. NGS revealed that both children have carried pathogenic variants of the ANKRD11 gene (c.1903_1907del and c.4911delT), which resulted in shifting of amino acid sequences starting from the Lysine and Proline at positions 635 and 1638, respectively. The female patient exhibited central precocious puberty. Her height has increased by 13 cm, and sex characteristics has retracted after treatment with leuprorelin for 23 months and recombinant human growth hormone for 1 month. CONCLUSION Comparison of the two cases with different genders and summary of previously reported cases found that male KBGS patients have more obvious dysmorphisms such as triangular face, synophrys, ocular hypertelorism and vertebral body abnormality, with higher morbidity of epilepsy, mental retardation, autism, congenital heart disease, immune thrombocytopenia and other complications. KBGS is an autosomal dominant disease featuring more evident peculiar appearance and global development delay. Male patients often have multi-system involvement, and multidisciplinary cooperation is required for early recognition of particular features in order to improve the prognosis.
Abnormalities, Multiple ; Bone Diseases, Developmental ; Child ; Facies ; Female ; Humans ; Intellectual Disability ; Male ; Phenotype ; Repressor Proteins/genetics* ; Sex Characteristics ; Tooth Abnormalities

The protection of language function is one of the major challenges of brain surgery. Over the past century, neurosurgeons have attempted to seek the optimal strategy for the preoperative and intraoperative identification of language-related brain regions. Neurosurgeons have investigated the neural mechanism of language, developed neurolinguistics theory, and provided unique evidence to further understand the neural basis of language functions by using intraoperative cortical and subcortical electrical stimulation. With the emergence of modern neuroscience techniques and dramatic advances in language models over the last 25 years, novel language mapping methods have been applied in the neurosurgical practice to help neurosurgeons protect the brain and reduce morbidity. The rapid advancements in brain-computer interface have provided the perfect platform for the combination of neurosurgery and neurolinguistics. In this review, the history of neurolinguistics models, advancements in modern technology, role of neurosurgery in language mapping, and modern language mapping methods (including noninvasive neuroimaging techniques and invasive cortical electroencephalogram) are presented.
Brain Mapping ; Brain Neoplasms ; Humans ; Language ; Neurosurgery ; Neurosurgical Procedures

The analysis of big data in medical field cannot be isolated from the high quality clinical database, and the construction of first aid database in our country is still in the early stage of exploration. This paper introduces the idea and key technology of the construction of multi-parameter first aid database. By combining emergency business flow with information flow, an emergency data integration model was designed with reference to the architecture of the Medical Information Mart for Intensive Care III (MIMIC-III), created by Computational Physiology Laboratory of Massachusetts Institute of Technology (MIT), and a high-quality first-aid database was built. The database currently covers 22 941 medical records for 19 814 different patients from May 2015 to October 2017, including relatively complete information on physiology, biochemistry, treatment, examination, nursing, etc. And based on the database, the first First-Aid Big Data Datathon event, which 13 teams from all over the country participated in, was launched. The First-Aid database provides a reference for the construction and application of clinical database in China. And it could provide powerful data support for scientific research, clinical decision making and the improvement of medical quality, which will further promote secondary analysis of clinical data in our country.
Big Data ; Critical Care ; Databases, Factual ; Humans ; Medical Informatics

To investigate the resistance mechanisms of tigecycline-non-susceptible Acinetobacter baumannii and for providing the evidence of the control of nosocomial infection and rational use of antibiotics. The minimum inhibitory concentrations (MICs) of 94 non repetitive tigecycline-non-susceptible A. baumannii from 20 hospitals in 12 cities of China were determined by agar dilution method and broth microdilution method. The molecular epidemiology was studied by Multilocus sequence typing (MLST) and eBURST software. PCR and sequencing techniques were used to analyze the resistance genes (blaOXA-40-like, blaOXA-58-like, blaOXA-23-like, blaOXA-51-like, blaNDM-1), ISAba1, and the mutation sites of adeR, adeS, and trm. The activity of polymyxin B and minocyclinem against tigecycline-non-susceptible A. baumannii were 100% and 25.5%, respectively. The sensitivities of other antibiotics were less than 3.5%, and the sensitivities of imipenem and meropenem totigecycline-nonsusceptible A. baumannii were only 1.1%. A total of 12 ST types were identified, including ST195 (45, 47.9%), ST208 (19, 20.2%) and ST457 (10, 10.6%). EBURST analysis found that 8 of the ST types belonged to the clone complex 92 (Clonal Complex 92, CC92). The blaOXA-23-like type carbapenem gene was identiefied in 93 strains (99% positive); and none of the strains contained the blaNDM-1 gene. The detection rates of adeR and adeS were 73.4% and 91.5% respectively and high frequency mutation sites were located in adeR (Asp26Asn) and adeS (Ala97Glu); The ISAba1 located upstream of the adeS gene was detected in 12 strains of A. baumannii, mainly from the northern region of China. The 240 nucleotide deletion of the trm gene caused a frameshift leading to a premature stop. So the tigecycline-non-susceptible A. baumannii showed high resistance against most antibiotics except polymyxin B. The deletion and mutation of adeR, adeS and trm were the main resistant mechanisms in tigecycline-non-susceptible A. baumannii in China.

Objective: To investigate the situations of AIDS related knowledge, sexual behavior with various partners among HIV positive patients in Shenzhen before highly active anti-retroviral therapy, and to provide evidences for health education intervention. Methods: Questionnaire survey and information collection were carried out among HIV positive patients, under the informed consent, during the first physical examination before highly active anti-retroviral therapy. Results: The overall awareness rate of AIDS knowledge was 91%, 94.46% and 80.95% respectively for homosexual and heterosexual populations, with significant difference between the two groups (χ²=21.254, P<0.001). In addition, there were significant differences in the factors related to education, income, route of infection, marital status, residence and other related factors (P<0.05). In HIV positive MSM, primary sexual behavior occurred mainly at the age of less than 30 (96.8%) and in university or earlier stage (58.3%), college students as the first sexual partner accounted for 44.9%, and once used Rush accounted for 42.7%. There were significant differences in the number of temporary sexual partners and condom use frequency between homosexual and heterosexual subjects (P<0.05). Conclusions Individuals infected with HIV via different routes are variant on AIDS cognition. Health education on AIDS related knowledge and sexual security before and after antiviral treatment can not only improve the awareness rate of HIV/AIDS infection, but also can reduce the risk of the spread of HIV/AIDS.

OBJECTIVE: To explore the diagnostic value of human papillomavirus E6/E7 mRNA for residue and recurrence of cervical intraepithelial neoplasia (CIN) patients after cervical conization.
 METHODS: A total of 154 patients, who underwent cervical conization and possessed complete follow-up data of high-grade cervical intraepithelial neoplasia (CINII, III), were subjected to thin-prep cytology test (TCT), HPV-DNA typing and HPV E6/E7 mRNA test in 3-6 months and 12 months after cervical conization. Abnormal cytology (≥ASC-US) or high-risk HPV-DNA (+) or HPV E6/E7 mRNA (+) cases were found by colposcopy and cervical biopsy pathological diagnosis.
 RESULTS: Nine patients had residue and 22 recurred. HPV-DNA detections after cervical conization in 57 patients were positive. Among them, 30 patients had residual/recurrent lesions. HPV E6/E7 mRNA detections in 26 patients were positive. Among them, 24 patients had residual/recurrent lesions. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnosis in the detection of HPV-DNA were 96.8%, 78%, 52.6%, 99%, and 81.8%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnosis in the detection of HPV E6/E7 mRNA were 77.4%, 98.4%, 92.3%, 94.5%, and 94.2%, respectively. The specificity and positive predictive value of HPV E6/E7 mRNA test were greater than those of HPV-DNA typing test. There was a significant difference between the two groups (P<0.05).
 CONCLUSION Detection of HPV E6/E7 mRNA during the follow-up period could timely and effectively forecast the risk of residue and recurrence of CIN after cervical conization, and reduce excessive examination and treatment.
Cervical Intraepithelial Neoplasia ; Conization ; Female ; Humans ; Neoplasm Recurrence, Local ; Papillomaviridae ; Papillomavirus Infections ; RNA, Messenger ; RNA, Viral ; Uterine Cervical Neoplasms