Objective To establish a portable gas chromatography-mass spectrometry (GC-MS) method for determining carbon disulfide in workplace air. Methods Samples were collected using the built-in Tenax GR adsorption tube in the portable GC-MS, followed by thermal desorption. The analytes were separated on a DB-1 chromatographic column and detected by a 3D ion trap mass spectrometer, with 1,3,5-tris(trifluoromethyl)benzene used as the internal standard. Qualitative analysis was based on retention time and characteristic ions, and quantitative analysis was performed using the internal standard method. Results The method showed a linear range of 0.034-0.340 mg/m³ with a correlation coefficient of 0.999 4 using the adsorption tube enrichment mode. The detection limit was 0.007 mg/m³, and the lower limit of quantification was 0.022 mg/m³. The average recovery ranged from 97.5% to 104.0%. The within-run and between-run relative standard deviation was 2.7%-10.4% and 8.8%-14.8%, respectively. Conclusion A rapid, green, highly sensitive, and interference-resistant on-site detection method was established. As a supplement to existing national standard methods, this method is suitable for real-time monitoring of carbon disulfide in workplace air and for occupational exposure risk assessment.

BACKGROUND:Traditional 3D dental segmentation methods usually utilize predefined spatial geometric features,such as curvature and normal vectors,as the reference information for tooth segmentation. OBJECTIVE:To propose an algorithm for complex 3D dental segmentation and deeply explore the correlation between segmentation results and application scenarios. METHODS:A 3D dental segmentation algorithm based on dual stream extraction of structural features and spatial features was established,and the modular design of split flow was used to avoid feature confusion.Among them,the attention mechanism on the structural feature flow was used to capture the fine-grained semantic information required for tooth segmentation,and the Tran Net based on the spatial feature flow was used to ensure the robustness of the model to complex tooth and jaw segmentation.This algorithm verified its effectiveness and reliability based on clinical datasets including healthy dental jaws and complex dental jaws such as missing teeth,malocclusion and dentition crowding.The segmentation performance of the model was measured in terms of overall accuracy,mean intersection over union,and directional cut discrepancy. RESULTS AND CONCLUSION:The overall segmentation accuracy of this algorithm in the clinical data set is 97.08%,and the segmentation effect is superior to that of other competitive methods from the qualitative and quantitative perspectives.It is verified that the structural feature flow designed in this paper can extract more precise local details of tooth shape from coordinate and normal information by constructing an attention aggregation mechanism,and the spatial feature flow designed in this paper can ensure the robustness of the model to complex teeth such as missing teeth,dislocated teeth,and crowded dentition by constructing a transformation network(Tran Net).Therefore,this tooth segmentation algorithm is highly reliable for clinicians'practical reference.

Objective:TP53-abnormal MDS/acute myeloid leukemia (AML) patients’ allogeneic hematopoietic stem cell transplantation (allo-HSCT) treatment’s effectiveness and influencing factors should be studied.Methods:42 patients with TP53 gene status change MDS/AML who underwent allo-HSCT from 2014.8.1 to 2021.7.31 at the Hematology Hospital of the Chinese Academy of Medical Sciences were the subject of a retrospective analysis. The 42 patients were divided into three groups: the TP53 deletion group (group A) , TP53 mono-alle mutation group (group B) , and TP53 multi-hit group (group C) . The differences in clinical features and prognostic factors after transplantation were analyzed.Results:There were 42 MDS/AML patients, including 21 patients with MDS, and 21 patients with AML. The median follow-up period was 34.0 (7.5-75.0) months and the median patient age at the time of transplantation was 41.5 (18-63) years old. The total OS was 66.3% (95% CI 53.4%-82.4%) in 3 years after transplantation, and EFS was 61.0% (95% CI 47.7%-78.0%) in 3 years. For 3 years after receiving hematopoietic stem cell transplantation, there were no statistically significant differences in 3-year OS and EFS in groups A, B, and C ( P≥0.05) . The 3 years OS was 82.5% (95% CI 63.1%-100.0%) in group A, 60.6% (95% CI 43.5%-84.4%) in group B, and 57.1% (95% CI 30.1%-100.0%) in group C. Univariate analysis revealed that the number of co-mutant genes, pre-HSCT treatment, and disease type did not affect prognosis, while age, karyotype, co-mutation, positive blast cell before transplantation, and positive blast cell after transplantation were common prognostic factors for OS and EFS ( P<0.1) . MRD levels before transplantation were found to be independent risk factors for OS ( P=0.037, HR=33.40, 95% CI 1.24-901.17) in a multivariate analysis. Conclusion:Patients with MDS/AML who have TP53 mutations can benefit from allo-HSCT, but patients with complex karyotypes have a worse prognosis. Meanwhile, the final flow cytometry (FCM) monitoring blast cell test before HSCT has a certain guiding significance for prognostic assessment.

Objective:To explore the factors which influence the outcomes of two-stage radical surgery for the patients with perianal fistulizing Crohn′s disease (pfCD) .Methods:Clinical data of 31 pfCD patients who underwent two-stage radical surgery in the Sixth Affiliated Hospital of Sun Yat-sen University from March 2016 to June 2018 were analyzed retrospectively. All the patients got good drainage results comfirmed by MRI after the treatment of one-stage seton drainage and the following medical treatment. According to the outcome of two-stage radical surgery, the patients were divided into the healing group ( n = 23) and the failed group ( n = 8) . The clinical characteristics between the two groups were analyzed statistically. Wilcoxon rank sum test was used to analyze the difference in C-reactive protein (CRP) , erythrocyte sedimentation rate (ESR) , platelet (PLT) , body mass index (BMI) , hemoglobin (HB) and albumin (ALB) between before the one-stage seton drainage and before the two-stage radical surgery in each group. Results:The healing rate of pfCD after two-stage radical surgery was 74.2% (23/31) . The ratio of proctitis before the one-stage seton drainage (8.70% vs.50.00%, P = 0.026) , the ratio of multiple internal openings or multiple independent fistulas before the one-stage seton drainage (21.74% vs. 75.00%, P = 0.012) and the PLT before the two-stage radical surgery [240.0 (202.0, 277.0) × 10 9/L vs. 319.5 (247.3, 385.5) × 10 9/L, P = 0.04] in the healing group were significantly lower than those in the failed group. The variations of PLT [240.0 (202.0, 277.0) × 10 9/L vs. 300.9 (230.0, 413.0) × 10 9/L, P = 0.004], HB [136.0 (114.0, 144.0) g/L vs. 127.0 (107.0, 137.0) g/L, P = 0.004], ALB[43.10 (39.62, 47.41) g/L vs. 40.45 (36.58, 42.58) g/L, P = 0.011] and BMI [19.93 (17.99, 21.22) kg/m 2 vs. 18.22 (16.61, 19.38) kg/m 2, P<0.001] in the healing group before two-stage radical surgery showed better trends than those before one-stage seton drainage, while there was no significant variation trend of ESR and CRP between the two points in time (both P>0.05) . There were no sigificant differences in all indexes in the failed group between before one-stage seton drainage and before the two-stage radical surgery (all P>0.05) . Conclusions:Beside the initial proctitis and multiple internal openings or multiple independent fistulas, PLT level before the two-stage radical surgery for pfCD is also an influencing factor of surgical outcome. The situations of BMI, HB, ALB, and PLT before the two-stage radical surgery are better than those before the one-stage seton drainage may be used as the screening indications of the radical surgery.

China ; Humans ; Lenalidomide/therapeutic use* ; Multiple Myeloma/drug therapy* ; Thalidomide ; Therapeutic Equivalency

Objective:To explore the factors which influence the outcomes of two-stage radical surgery for the patients with perianal fistulizing Crohn′s disease (pfCD) .Methods:Clinical data of 31 pfCD patients who underwent two-stage radical surgery in the Sixth Affiliated Hospital of Sun Yat-sen University from March 2016 to June 2018 were analyzed retrospectively. All the patients got good drainage results comfirmed by MRI after the treatment of one-stage seton drainage and the following medical treatment. According to the outcome of two-stage radical surgery, the patients were divided into the healing group ( n = 23) and the failed group ( n = 8) . The clinical characteristics between the two groups were analyzed statistically. Wilcoxon rank sum test was used to analyze the difference in C-reactive protein (CRP) , erythrocyte sedimentation rate (ESR) , platelet (PLT) , body mass index (BMI) , hemoglobin (HB) and albumin (ALB) between before the one-stage seton drainage and before the two-stage radical surgery in each group. Results:The healing rate of pfCD after two-stage radical surgery was 74.2% (23/31) . The ratio of proctitis before the one-stage seton drainage (8.70% vs.50.00%, P = 0.026) , the ratio of multiple internal openings or multiple independent fistulas before the one-stage seton drainage (21.74% vs. 75.00%, P = 0.012) and the PLT before the two-stage radical surgery [240.0 (202.0, 277.0) × 10 9/L vs. 319.5 (247.3, 385.5) × 10 9/L, P = 0.04] in the healing group were significantly lower than those in the failed group. The variations of PLT [240.0 (202.0, 277.0) × 10 9/L vs. 300.9 (230.0, 413.0) × 10 9/L, P = 0.004], HB [136.0 (114.0, 144.0) g/L vs. 127.0 (107.0, 137.0) g/L, P = 0.004], ALB[43.10 (39.62, 47.41) g/L vs. 40.45 (36.58, 42.58) g/L, P = 0.011] and BMI [19.93 (17.99, 21.22) kg/m 2 vs. 18.22 (16.61, 19.38) kg/m 2, P<0.001] in the healing group before two-stage radical surgery showed better trends than those before one-stage seton drainage, while there was no significant variation trend of ESR and CRP between the two points in time (both P>0.05) . There were no sigificant differences in all indexes in the failed group between before one-stage seton drainage and before the two-stage radical surgery (all P>0.05) . Conclusions:Beside the initial proctitis and multiple internal openings or multiple independent fistulas, PLT level before the two-stage radical surgery for pfCD is also an influencing factor of surgical outcome. The situations of BMI, HB, ALB, and PLT before the two-stage radical surgery are better than those before the one-stage seton drainage may be used as the screening indications of the radical surgery.

Objective:To explore the clinical efficacy of different modes of continuous negative pressure wound therapy (NPWT) on venous ulcer wounds of lower limbs, and to analyze the influencing factors.Methods:From January 2018 to December 2019, 53 patients with venous ulcer of lower limbs who met the inclusion criteria and hospitalized in the Affiliated Hospital of Jiangnan University were recruited in this prospective randomized controlled study. According to the random number table, the patients were divided into single negative pressure therapy (SNPT) group (19 patients, 11 males and 8 females), cyclic alternating negative pressure therapy (CANPT) group (17 patients, 12 males and 5 females), and routine dressing change (RDC) group (17 patients, 10 males and 7 females), aged (47±11), (49±10), and (47±10) years respectively. After admission, patients in SNPT group were given continuous NPWT with the single negative pressure setting at -13.3 kPa, patients in CANPT group were also given continuous NPWT but with the cyclic alternating negative pressure setting from -16.0 to -10.7 kPa, while patients in RDC group were given dressing change with vaseline gauze soaked with iodophor. The wound healing rate was calculated on treatment day 7 and 14. Transcutaneous oxygen pressure (TcPO 2) around the wound was detected by TcPO 2 meter before treatment and on treatment day 7 and 14. The wound exudate/drainage fluid was collected on treatment day 1, 4, 7, 10, and 14, with the pH value measured using a pH meter, and the volume of exudate/drainage fluid recorded. Before treatment and on treatment day 7 and 14, venous blood was collected to detect the serum levels of interleukin 1β (IL-1β), IL-6, tumor necrosis factor α(TNF-α), transforming growth factor-β 1 (TGF-β 1), vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF). Before treatment and on treatment day 7 and 14, wound exudates were collected for bacterial culture, and Visual Analogue Scale and Hamilton Anxiety Scale were used to evaluate the degree of wound pain and anxiety of patients respectively. The length of hospital stay and the total treatment cost were counted. Analysis of variance for repeated measurement, one-way analysis of variance, least significant difference test, Kruskal Wallis H test, Mann Whitney U test, chi-square test, Fisher′s exact probability method test, and Bonferroni correction were used to analyze the data. According to the wound healing rate on treatment day 14, the efficiency of patients were divided into two grades of significant healing with wound healing rate≥70% and non significant healing with wound healing rate<70%. According to the two categories of wound healing rate as dependent variables, the levels of TcPO 2, IL-1β, IL-6, TNF-α, TGF-β 1, VEGF, bFGF levels and bacterial detection, wound pain and anxiety before treatment, wound exudate/drainage fluid volume and pH value on treatment day 1 were taken as covariates, and binary classification multifactor logistic regression analysis was used to analyze the risk factors of significant wound healing. Results:(1) On treatment day 7, the wound healing rate of patients in SNPT group was (33±10) %, which was significantly higher than (24±9) % of RDC group ( P<0.05). On treatment day 14, the wound healing rates of patients in SNPT group and CANPT group were (71±15)% and (66±18)%, respectively, which were significantly higher than (45±19)% of RDC group ( P<0.01). (2) Compared with those of RDC group, the TcPO 2 value around the wound of patients was significantly increased in SNPT group on treatment day 14 and in CANPT group on treatment day 7 and 14 ( P<0.05 or P<0.01), the pH value of wound drainage fluid of patients was significantly decreased in SNPT group on treatment day 10 and 14 and in CANPT group on treatment day 7 and 14 ( P<0.05), the volume of wound drainage fluid of patients was significantly reduced in SNPT group on treatment day 10 and 14 and in CANPT group on treatment day 7, 10, and 14 ( Z=-4.060, -4.954, -2.413, -4.085, -4.756, P<0.05 or P<0.01), the serum levels of IL-1β, IL-6, and TNF-α of patients were significantly decreased in SNPT group and CANPT group on treatment day 7 and 14 ( P<0.01), the serum level of TGF-β 1 of patients was significantly increased in CANPT group on treatment day 14 ( P<0.05), the serum levels of VEGF and bFGF were significantly increased in SNPT group and CANPT group on treatment day 14 ( P<0.01), the bacteria detection proportion of wound exudate, wound pain, and anxiety scores of patients were significantly decreased in SNPT group and CANPT group on treatment day 7 and 14 ( P<0.01). Compared between the negative pressure therapy two groups, except the wound pain score of patients in CANPT group was significantly lower than that in SNPT group ( P<0.01) on treatment day 7, the other indicators mentioned above were similar. (3) The length of hospital stay of patients in SNPT group was similar to that in CANPT group ( P>0.05), which were significantly shorter than the time in RDC group ( P<0.01). The total treatment cost of patients among the three groups was similar ( F=1.766, P>0.05). (4) Before treatment, the serum levels of TNF-α and bFGF, TcPO 2 around the wound, and the degree of wound pain were risk factors for significant wound healing (odds ratio=1.109, 0.950, 1.140, 2.169, 95% confidence interval=1.012-1.217, 0.912-0.988, 1.008-1.290, 1.288-3.651, P<0.05 or P<0.01). Conclusions:Clinical application of continuous NPWT under single negative pressure mode and cyclic alternating negative pressure mode has a positive effect on improving the wound base and healing rate of venous ulcer of lower limbs. But cyclic alternating negative pressure mode is significantly more effective than single negative pressure mode in improving TcPO 2 around the wound, reducing wound pH value, reducing exudate volume and relieving pain. The serum levels of TNF-α and bFGF, TcPO 2 around the wound and the degree of wound pain were the risk factors that affect the wound healing significantly.

Objective To examine the efficacy and safety of pregabalin in patients with neuropathic cancer pain (NCP).Methods A prospective randomized control multicenter trial was conducted in five hospitals;from January 2015 to January 2016,one hundred and twenty two eligible inpatients and outpatients were divided into pregablin treatment group (n=60) and control group (n=62).Patients in the pregablin group added pregablin to opiod background analgesia,while those in the control group raised opioid dose instead.The Numerical Pain Rating Scale (NRS) scores,paraesthesia scale scores,Hamilton's Depression (HAMD) scale scores,analgesia dose,patiends satisfaction,and adverse events were recorded 14 d after each treatment.Results After each treatment,the NRS scores were decreased by (2.3 ±1.1) and (1.3±1.5),the paraesthesia scale scores were decreased by (1.6±0.6) and (0.4±0.3),and the HAMD scale scores were decreased by (4.4±1.2) and (2.4±1.0) in the pregablin treatment group and control group,respectively,with significant differences (P＜0.05).Morphine dose for breakthrough pain in pregabalin group was statistically less than that in control group ([30.6±3.5] mg/d vs.[70.9±12.3] mg/d,P＜0.05).Patients satisfaction in the pregablin treatment group was significantly higher than that in the control group (P＜0.05).Pregabalin treatment group had less severe adverse effects (3/56,5％) as compared with control group (10/59,16.1％,P＜0.05).Conclusion Pregabalin has positive roles in patients with NCP already receiving opioid;pregabalin has better pain-control and mood improvement.

Objective To determine the risk factors for post-operative delirium(POD)and post-operative cognitive dysfunction(POCD)in patients undergoing spine surgery.Methods One hundred and twenty ASA Ⅰ-Ⅲ of both sexes aged 50-76 yr undergoing elective spine surgery under general anesthesia were studied.POD was assessed by Delirium Rating Scale revised 98 at 2 days after operation and the patients were assigned into POD and nonPOD group.Cognitive function was assessed by Mini-Mental State Examination(MMSE)at 1 day before and 3 days after operation.The patients were diagnosed as having POCD if MMSEpre-MMSEpost ≥ 3.The palients were assigned into POCD and nonPOCD group.Executive function and depression were assessed by stroop interference test and Beck Depression Inventory(BDI)at 1 day before operation.Age,sex,education,alcohol consumption per week,a history of psychiatric disease,ASA physical status,Charlson comorbidity score,type of anesthesia,anticholinergic drug administration and VAS score at 1 day after operation were recorded.If there was signifirant difference between the 2 groups,the factor was analyzed using multi-factor logistic regression to select risk factor for incidence of POD and POC).Results Eleven patients developed POD(9.2％)and 30 patients developed POCD(25.0％).Logistic regression model showed that lower Stroop-CW,higher BDI score,higher Charlson comorbidity score and a history of psychiatric disease were risk factors for POD,while lower Stroop-CW,higher BDI score,higher Charlson comorbidity score and higher alcohol consumption per week were risk factors for POCD.Conclusion Preoperative executive dysfunction,depression and greater preoperative comorbidity are risk factors for both POD and POCD.A history of psychiatric disease is a risk factor for POD and higher alcohol consumption is a risk factor for POCD in patients undergoing spine surgery.

Objective To investigate the effects of cytokines on the expression of angiotensin Ⅱ type 1 receptor (AT1R) in vascular smooth muscle cells (VSMCs) in rats. Methods Primary cultured VSMCs from SD rat thoracic aorta were cultured in serum-free DMEM for 24 h, and then in DMEM supplemented with 10% fetal bovine serum for another 12 h. The cultured VSMCs were randomly divided into 5 groups (n =6 each): control group (group C); 10% cytokine group (group L); 50% cytokine group (group N); 100% cytokine group (group H) and L-arginine methy ester (L-NAME), an inhibitor of nitric oxide synthase) group. In group C, the cellswere cultured continuously for 12 h. In L, N and H groups, 10%, 50% and 100% cytokines (IL-1β 50 ng/ml +TNF-α 100 ng/ml + IFN-γ 500 ng/ml) were added to the culture medium respectively and the cells were then incubated for 12 h. In group L-NAME, 100% cytokines + L-NAME 5 mmol/L were added to the culture medium and the cells were then incubated for 12 h. The expression of AT1R mPNA and protin was determined by RT-PCR and Western blot respectively.Results Cytokines down-regulated AT1R mRNA and protein expression in a concentration-dependent manner (P ＜ 0.05 or 0.01). L-NAME reversed cytokines-induced changes in AT1R mRNA and protein expression ( P ＜ 0.01). Conclusion Cytokines can down-regulate the expression of AT1R in rat VSMCs and the mechanism is related to the NO synthesis.