BACKGROUND:At present,there is still controversy in clinical practice about the choice of internal fixation of Pauwels type Ⅲ femoral neck fracture,and the selection of internal fixation that provides stable fixation strength is the key basis for achieving Pauwels type Ⅲ fracture fixation. OBJECTIVE:The three-dimensional finite element analysis method was used to test the difference in biomechanical strength of three types of internal fixation in Pauwels type Ⅲ femoral neck fracture,which provided a reference for its clinical treatment. METHODS:Using the CT data of the left femur of a healthy male volunteer,a complete femur and its cancellous bone were reconstructed in Mimics software,and Geomagic studio software was used for reverse modeling.Cannulated compression screw,dynamic hip screw,and femoral neck system were created in UG-NX software.Three kinds of internal fixation models were assembled on the femur model,and Pauwels type Ⅲ femoral neck fracture was simulated by Hypermesh software.Finally,Abaqus software was used to carry out finite element experimental analysis to analyze and compare the stress distribution,stress peak,strain,and displacement distribution caused by fixed femoral neck fracture of different internal fixation systems. RESULTS AND CONCLUSION:(1)The stress of the proximal femur bone mass was mainly distributed in the area below the femoral neck near the fracture end,with the highest stress peak in the dynamic hip screw group and the smallest in the femoral neck system group.(2)The stress distribution of the internal fixation device was mainly concentrated on the screw surface near the fracture line,with the highest stress peak in the femoral neck system group and the smallest in the dynamic hip screw group.(3)The main strain field of the proximal femur bone mass was distributed in the upper surface area where the bone and screw contacted,and the yield strain was the smallest in the femoral neck system group and the largest in the cannulated compression screw group.(4)The main strain field of the internal fixation device model was distributed on the upper surface of the femoral neck screw,with the yield strain being the smallest in the femoral neck system group and the largest in the cannulated compression screw group.(5)The displacement distribution values of femur,proximal bone mass,distal bone block,internal fixation device and internal fixation with the femur as a whole in the three femoral neck fracture internal fixation models decreased gradually from proximal to distal,and the peak displacement of the femoral neck system group was the largest and the lowest in the dynamic hip screw group.(6)The results showed that when the Pauwels type Ⅲ femoral neck fracture was fixed,the stress distribution of femoral neck system was more uniform,the mechanical conduction characteristics were better,and it was subjected to lower yield strain,higher stress and higher displacement.It has relatively better biomechanical stability and can provide a superior mechanical environment for fracture healing.

Assay for transposase-accessible chromatin with high-throughput sequencing (ATAC-seq) is a technique widely used to investigate genome-wide chromatin accessibility. The recently published Omni-ATAC-seq protocol substantially improves the signal/noise ratio and reduces the input cell number. High-quality data are critical to ensure accurate analysis. Several tools have been developed for assessing sequencing quality and insertion size distribution for ATAC-seq data;however, key quality control (QC) metrics have not yet been established to accurately determine the quality of ATAC-seq data. Here, we optimized the analysis strategy for ATAC-seq and defined a series of QC metrics for ATAC-seq data, including reads under peak ratio (RUPr), background (BG), promoter enrichment (ProEn), subsampling enrichment (SubEn), and other measurements. We incorporated these QC tests into our recently developed ATAC-seq Integrative Analysis Package (AIAP) to provide a complete ATAC-seq analysis system, including quality assurance, improved peak calling, and downstream differential analysis. We demonstrated a significant improvement of sensitivity (20％–60％) in both peak calling and differential analysis by processing paired-end ATAC-seq datasets using AIAP. AIAP is compiled into Docker/Singularity, and it can be executed by one command line to generate a comprehensive QC report. We used ENCODE ATAC-seq data to benchmark and generate QC recommendations, and developed qATACViewer for the user-friendly interaction with the QC report. The software, source code, and documentation of AIAP are freely available at https://github.com/Zhang-lab/ATAC-seq_QC_analysis.

Objective:To explore the effect of neurolysis and tendon transplantation in functional reconstruction of the upper limb with severe thermal crush injury.Methods:A retrospective case series study was conducted to analyze the clinical data of 12 patients with thermal crush injuries of the upper limb admitted to Changhai Hospital of Naval Medical University from January 2014 to December 2018. There were 9 males and 3 females, aged 22-54 years (mean, 38 years). The percentage of total body surface area (TBSA) burn ranged from 3% to 8% [(4.9±1.4)%], and wound depth was III degree. According to the damage condition of nerve/tendon and whether there was any dysfunction of the affected limb after wound healing, 12 patients received 2 to 4 times of neurolysis and tendon transplant-related surgeries, with an average surgery of 2.7 times. Among them, a total of 18 times of neurolysis were performed, including 7 times of radial neurolysis, 6 times of median nerve neurolysis and 5 times of ulnar neurolysis, and 14 times of tendon transplantation were done, including 6 times of anastomosis of superficial flexor tendon and long thumb extensor tendon, 5 times of tendon repair transplantation and 3 times of anastomosis of lateral wrist extensor tendon and long thumb extensor tendon. The time interval of each operation was 3-6 months [(4.5±1.0) months]. The Changhai pain ruler, disability of arm-shoulder-hand table (DASH) and joint activity assessment table were assessed before the first operation, 3 months and 6 months after the last operation.Results:All the patients were followed up for 6-12 months (mean, 9.2 months). The score of Changhai pain ruler in the affected limb improved from 3 (2, 3)points before surgery to 1 (0.5, 1)points 3 months after surgery and 1 (0, 1)points 6 months after surgery ( P<0.01). The score of DASH improved from (69.9±2.7) points before surgery to (35.1±1.7) points 3 months after surgery and (33.8±2.0) points 6 months after surgery ( P<0.01). The range of motion score was improved from (1.3±0.5) points before surgery to (2.4±0.5) points 3 months after surgery and (2.8±0.4) points 6 months after surgery ( P<0.01). Conclusion:Neurolysis and tendon transplantation in the treatment of severe thermal crush injuries of the upper limb can alleviate pain in the affected limbs, improve upper limb dysfunction, increase mobility of the palm and upper limb joints, and enhance the quality of life of the patients.

Objective:To systematically review the care experience of caregivers of burn children, so as to provide references for guiding the continuing care in hospitals, communities, and homes.Methods:Databases including Cochrane Library, PubMed, ScienceDirect, ProQuest, Web of Science, and CINAHL were retrieved with the search terms of " burn" , " care/caregivers/nursing/father/mother/relatives" , " needs/perceptions/exceptions/attitudes/feelings/demands/experiences" , " qualitative research" , and the Chinese Journals Full- text Database, China Biology Medicine disc, VIP Database, and Wanfang Data were retrieved with the search terms in Chinese version of "烧伤/烧伤患儿/烧伤幼儿" , "照顾者/照护者/照料者/照护/父亲/母亲/家属" , "需求/认知/期望/态度/感受/体验" , "质性研究" to search the qualitative researches on care experience of caregivers of burn children published from the establishment of the databases to November 2019. After screening and extracting the data, the quality evaluation criteria for qualitative research of the Australian Joanna Briggs Institute Evidence-Based Health Care Center and its integrative/aggregative synthesis method were used to assess the quality of the included literature and meta-integrate the research results respectively. Results:A total of 16 studies and 269 caregivers were enrolled. The quality of one included literature was grade A, and the quality of 15 included literature was grade B. A total of 65 research results were extracted with totally 6 categories formed after summarization, and 2 integrated results obtained as follows: (1) The caregivers experienced heavy psychological pressure and burden in the care process, which had a significant impact on family, social relations, and daily life. (2) With the care time lapsing, through the support of all sectors of society and self-adjustment, the caregivers gradually accepted the reality and actively took various countermeasures, but they still faced many challenges in disease care.Conclusions:The caregivers of burn children have many physical and mental health problems and face many care challenges. The government, medical and health institutions, and society should give a great attention to these issues, improve the social support system and security system, reduce the family-related pressure of burn children′s families, and improve the quality of family life.

Objective To observe the changes of potassium ion (K+), lactic acid (Lac) and glucose (Glu) in swine with traumatic hemorrhagic shock (THS) inside the dry-heat environment and to explore its possible mechanism. Methods A total of 40 local Landrace piglets were randomly(random number) divided equally into 4 groups: the normal temperature sham operation group (NS), the normal temperature traumatic hemorrhagic shock group (NTHS), the dry-heat sham operation group (DS group) and the dry-heat traumatic hemorrhagic shock group (DTHS). The experiment was carried out in the artifi cia climate cabin simulated the special environment of northwest of China. After exposed to their respective environment[dry-heat environment: (40.5±0.5), plus(10±2)% humidity; normal temperature environment: (25±0.5), plus(35±5)% humidity] for 3 h. Laparotomy were performed in swine of all groups, and then splenectomy and partial hepatectomy were performed only in NTHS and DTHS. The process of exsanguination from the external iliac artery was established to make the MAP reaching to 40-50 mmHg, and thus the traumatic hemorrhagic shock model of swine was successfully made. Blood samples were collected from external iliac artery at different intervals including the time just after exposure for 3 h and the successful establishment of traumatic hemorrhagic shock model (0 h) and then every 30 min after 0 h, serum levels of K+, Lac and Glu were detected. The features of varied serum K+, Lac and Glu were observed in each group. All data were statistically analyzed using One-way ANOVA and Pearson correlation analysis. Results After exposed , the level of serum K+inside the dry-heat environment was higher than that of swine inside the normal temperature group ( P<0.01), however the Glu level was lower in the swine inside dry-heat environment than that of swine inside the normal temperature ( P<0.01).The level of serum K+and Lac of DTHS group were rapidly increased from the establishment of the model to the death in about 3 h, while those of NTHS group were increased slowly. The level of K+and Lac were positively correlated in the two groups amd the correlation coeffi cient were rDTHS=0.927 (P<0.01) and rNTHS=0.539 (P<0.01),respectively. The level of Glu was progressively decrease in DTHS group, while in NTHS group, it was not noticeable. The level of K+and Glu were negatively correlated in the two group, the correlation coeffi cient were rDTHS=-0.804 (P<0.01) and rNTHS=0.420 (P<0.01),respectively. Conclusions The changes of serum K+, Lac and Glu occurred sooner and more obvious in traumatic hemorrhagic shock models inside dry heat environment (DTHS) group than those in NTHS group. The level of serum K+positively correlated with Lac, however, negatively correlated with Glu, which suggested that hyperkalemia and acidosis should be paid more attention to the treatment of traumatic hemorrhagic shock inside the dry heat environment, and the hypoglycemia should be treated at the same time.

Immunomagnetic separation (IMS) was coupled with fluorescent microspheres lateral flow assay (FM-LFA) for rapid detection of S.choleraesuis in this study.The target bacteria were firstly enriched from sample by immunomagnetic beads (IMBs),then eluted by heat treatment and detected by fluorescent microspheres lateral flow test strip.The IMBs was labeled with 30 μg/mg antibody,and the capture efficiency was greater than 90％ against 102-106 CFU/mL of S.choleraesuis with great specificity.The immunofluorescent microspheres were prepared by coupling 300 μg of 11 D8-D4 monoclonal antibody with 1 mg of fluorescent microspheres at pH 6.Monoclonal antibody 5F11-B11 (2.0 mg/mL) and donkey anti-mouse IgG (1.0 mg/mL) were sprayed on nitrocellulose membrane as test line and control line,respectively.The FM-LFA based on IMS was used to detect S.choleraesuis in PBS and milk.The limits of detection in PBS buffer and milk were 1.5×105 CFU/mL and 7.6×105 CFU/mL respectively,which were 10 and 200 times lower than that of traditional fluorescent microspheres lateral flow assay,respectively.The results showed that the method,which could enrich S.choleraesuis in milk effectively,could avoid matrix interference and improve the detection sensitivity,thus had a good application prospect.

Objective To determine the influences of quality control method of process decision program chart ( PDPC ) on preventing complications related to indwelling catheter in female patients with neurogenic urinary incontinence after stroke. Methods We selected 94 female patients with neurogenic urinary incontinence after the first stroke. A total of 48 patients without accepting PDPC interventions from January 2014 to January 2015 were selected as control group. A total of 46 patients accepting systematic PDPC interventions from February 2015 to January 2016 were selected as intervention group. Patients in control group were provided with nursing care based on the nursing requirements of the indwelling catheter in Basic Nursing Science. Patients in intervention group were provided with nursing care according to the process of PDPC. And then, we compared the catheter related complications of patients between two groups and the self-evaluation of nurses. Results The incidence of complications including urinary tract infection and urethral injury in intervention group was lower than that in control group with a significant difference ( P<0.05) . After the PDPC method was carried out, the self-evaluation involving responsibility, work enthusiasm, and self-confidence of nurses was significantly improved. Conclusions The application of PDPC in female patients with neurogenic urinary incontinence and indwelling catheter after stroke not only can reduce the incidence of complications, effectively improve nursing quality, but also can expand nurses′ thinking, hoisting their abilities to solve problems and improve their self-evaluations.

OBJECTIVETo investigate the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.METHODSPatients with postviral olfactory dysfunction were recruited in this study. All patients underwent T&T olfactory testing, sinonasal computer tomgraphy scanning, as well as magnetic resonance scanning of the olfactory pathway. Nebulizing glucocorticoid (pulmicort repulse) was inhaled once daily at the starting dose of 2 mg tapered to 1 mg after two weeks combined with olfactory training for 4 weeks. T&T olfactory testing were repeated after 4-week treatment.RESULTS Twenty four patients received teatment, with a mean age of 54 years old(range 37 to 81 years old), a mean olfactory dysfunction course of 2.20 months(range, 0.25-9 months). Of whom, 21 were anosmia, 3 were hyposmia. After teatment, complete recovery were achieved in 4 patients(16.7%), obvious improvement in 9 (37.5%), improvement in 5 (20.8%), no improvement in 6 (25.0%). No side effect and untoward effect were found.CONCLUSIONThe primmary outcomes suggest the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.

Glucocorticoids ; therapeutic use ; Humans ; Olfaction Disorders ; drug therapy ; Smell

PURPOSE: Leucine-rich repeats and immunoglobulin-like domains 1 (LRIG1) are an inhibitor of receptor tyrosine kinases (RTKs) that was discovered in recent years, and many studies showed that LRIG1 is a tumor suppressor gene and may be related to tumor drug resistance. In this study, we explored whether LRIG1 protein expression can improve the chemosensitivity of glioma cells and what was its mechanism. MATERIALS AND METHODS: We collected 93 cases of glioma tissues and detected the expression of LRIG1 and BCL-2. We constructed a multidrug resistance cell line U251/multidrug resistance (MDR) and examined the change of LRIG1 and BCL-2 at mRNA and protein expression levels. LRIG1 expression was upregulated in U251/MDR cells and we detected the change of multidrug resistance. Meanwhile, we changed the expression of LRIG1 and BCL-2 and explored the relationship between LRIG1 and BCL-2. Finally, we also explored the relationship between LRIG1 and RTKs. RESULTS: LRIG1 was negatively correlated with BCL-2 expression in glioma tissue and U251/MDR cells, and upregulation of LRIG1 can enhance chemosensitivity and inhibit BCL-2 expression. Furthermore, LRIG1 was negatively correlated with RTKs in U251/MDR cells. CONCLUSION: These results demonstrated that LRIG1 can improve chemosensitivity by modulating BCL-2 expression and RTK signaling in glioma cells.
Astrocytoma/drug therapy/genetics/metabolism ; Cell Line, Tumor ; Drug Resistance, Neoplasm/genetics/*physiology ; Gene Expression Regulation, Neoplastic ; Gene Knockdown Techniques ; Glioma/drug therapy/*metabolism ; Humans ; Membrane Glycoproteins/metabolism/*physiology ; Proto-Oncogene Proteins c-bcl-2/*metabolism ; RNA, Messenger/metabolism ; Receptor Protein-Tyrosine Kinases/metabolism