Objective: To investigate the use of e-cigarette and analyze its influencing factors among high school students in Wuhan City, so as to provide insights into developing control measures for adolescents. Methods: From September to November 2019, high school students in Wuhan City were selected by the multi-stage stratified cluster random sampling method, and basic information, e-cigarette use and second-hand smoke exposure were collected through questionnaire surveys. Proportions of e-cigarette current use and attempt to use were analyzed, and factors affecting the current use of e-cigarettes were identified using a multivariable logistic regression model. Results: Totally 5 700 questionnaires were allocated, and 5 602 valid questionnaires were recovered, with an effective rate of 98.28%. The respondents included 2 925 males (52.21%) and 2 677 females (47.79%); 4 033 high school students (71.99%) and 1 569 vocational high school students (28.01%). The proportion of attempt to use e-cigarettes was 9.23%, and the proportion of current e-cigarette use was 2.03%. Multivariable logistic regression analysis identified male (OR=2.112, 95%CI: 1.285-3.471), vocational high school (OR=1.967, 95%CI: 1.214-3.186), private high school (OR=9.684, 95%CI: 5.648-16.605), family second-hand smoke exposure (OR=3.064, 95%CI: 1.741-5.392), second-hand smoke exposure in public places (OR=4.402, 95%CI: 1.687-11.484) and having close friends who were smokers (OR=6.432, 95%CI: 3.219-12.852) as factors affecting current e-cigarette use among high school students. Conclusions The proportion of current e-cigarette use among high school students in Wuhan City was 2.03%. Male, vocational high school, private high school, second-hand smoke exposure and having close friends who were smokers may be promoting factors for e-cigarette use.

Fragile X syndrome(FXS)is caused by abnormal duplication and amplification of the FMR1 gene CGG.This article reports a pair of brothers diagnosed with FXS by genetic testing.Two patients,aged 15 and 14 years old respectively,both had clinical manifestations such as language disorders,intellectual disabilities,attention deficit disorder,autism spectrum disorder,and FXS's characteristic facial features.The proband had a rare late-onset epileptic seizure,which was well treated with levetiracetam,while his younger brother had no electroencephalogram abnormalities after repeated follow-up.This pair of cases suggests that the clinical phenotype of FXS has diversity and heterogeneity.

Objective To investigate the effect of different lower extremity force lines after initial total knee arthroplasty(TKA)on the early clinical outcomes of patients with varus knee osteoarthritis(KOA).Methods Fifty-five patients(73 knees)with KOA who underwent TKA at the First Affiliated Hospital of Xinxiang Medical University from October 2018 to March 2022 were selected as research subjects.According to the postoperative hip-knee-ankle angle(HKA),the patients were divided into the valgus alignment group(HKA＜-3°,4 knees),neutral alignment group(-3°≤HKA ≤3°,32 knees),mild varus alignment group(3°＜HKA＜6°,30 knees),and severe varus alignment group(HKA ≥6°,7 knees).The mechanical lateral distal femoral angle(mLDFA),mechanical medial proximal tibial angle(mMPTA),range of motion(ROM)of knees,and joint line convergence angle(JLCA)of the four groups of patients were measured before and 1 week after surgery.The Hospital for Special Surgery Knee Scores(HSS),The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores,and numeric rating scale(NRS)scores of the knee joints of patients in the four groups were also recorded preoperatively and 6 months postoperatively.Results The overall postoperative mLDFA,mMPTA,ROM and HSS scores were significantly greater than the preoperative values and the JLCA,WOMAC and NRS scores were significantly less than the preoperative values in 55 patients(73 knees)(P＜0.01).There was no statistically significant difference in the preoperative mLDFA,mMPTA,JLCA and ROM among the patients in the four groups(F=2.689,0.692,0.476,0.892;P＞0.05).Postoperative mLDFA,mMPTA,and ROM were significantly greater than preoperative values and JLCA was significantly less than preoperative value in patients in the neutral alignment,mild varus alignment,and severe varus groups(P＜0.05).Postoperative mMPTA and ROM were significantly greater than preoperative values and JLCA was significantly less than preoperative value in patients in the valgus group(P＜0.05);the difference was not statistically significant when compared with preoperative and postoperative mLDFA in patients in the valgus group(P＞0.05).There was no statistically significant difference in the postoperative JLCA and ROM among the four groups(F=1.164,1.045;P＞0.05).The difference in postoperative mLDFA and mMPTA was statistically significant among the four groups(F=21.068,4.551;P＜0.05);the mLDFA of patients in the neutral alignment,mild varus alignment,and severe varus alignment groups was significantly greater than that of the valgus alignment group,and patients in the mild varus alignment and severe varus alignment groups had greater mLDFA than those in the neutral alignment group,patients in the severe varus alignment group had greater mLDFA than those in the mild varus alignment group(P＜0.05);the mMPTA of patients in the neutral alignment,mild varus alignment,and severe varus alignment groups was less than that of patients in the valgus alignment group(P＜0.05);there was no statistically significant difference in the mMPTA among patients in the neutral alignment,mild varus alignment and severe varus alignment groups(P＞0.05).There was no statistically significant difference in the preoperative HSS,WOMAC and NRS scores among the four groups(F/x2=0.141,1.587,3.811;P＞0.05).Postoperative HSS scores were significantly higher and WOMAC and NRS scores were significantly lower than preoperative scores in all groups(P＜0.05).The difference between the postoperative HSS and WOMAC scores of patients in the four groups was statistically significant(F=6.216,7.632;P＜0.05).The postoperative HSS scores of patients in the neutral alignment group and the mild varus alignment group were significantly higher than those of the valgus alignment group and the severe varus alignment group(P＜0.05);the difference in the postoperative HSS scores of patients in the neutral alignment group compared with those of patients in the mild varus alignment group was not statistically significant(P＞0.05);and the difference in the postoperative HSS scores of patients in the valgus alignment group compared with those of patients in the severe varus alignment group was not statistically significant(P＞0.05).The postoperative WOMAC scores of patients in the valgus alignment,mild varus alignment and severe varus alignment groups were significantly higher than those in the neutral alignment group,and the postoperative WOMAC scores of patients in the valgus alignment and severe varus alignment groups were significantly higher than those of patients in the mild varus alignment group(P＜0.05);the difference in postoperative WOMAC scores of patients in the valgus alignment group compared with those in the severe varus alignment group was not statistically significant(P＞0.05).There was no statistically significant difference in the postoperative NRS scores among the four groups(P＞0.05).Conclusion The lower extremity force line in a neutral position after TKA has the best early clinical outcome for patients with preoperative varus KOA,and the lower extremity force line should be reconstructed to a neutral level during TKA.

Objective: To investigate the prevalence of daily smoking among residents at ages of 15 years and older in Wuhan City, so as to provide insights into tobacco control. Methods: A total of 2 700 permanent residents at ages of 15 years and older were sampled using a multistage random sampling method in three districts of Wuhan City in July, 2019. Residents' demographics, tobacco use, secondhand smoke exposure and awareness of harmful effects of tobacco were collected using the core questionnaire of the Global Adult Tobacco Survey, and the factors affecting daily smoking were identified among residents at ages of 15 years and older using a multivariable logistic regression model. Results: A total of 2 700 questionnaires were allocated, and 2 551 valid questionnaires were recovered, with an effective recovery rate of 94.48%. The respondents included 1 272 men (49.86%) and 1 279 women (50.14%), and the proportion of daily smoking was 19.84% among the respondents, with a mean daily tobacco use of 16.6 cigarettes. Multivariable logistic regression analysis identified men (OR=66.191, 95%CI: 25.344-172.873), ages of 45 to 64 years (OR=2.586, 95%CI: 1.158-5.775), farmers (OR =8.477, 95%CI: 1.126-63.786), secondhand smoke exposure at home (OR=9.395, 95%CI: 5.401-16.340), secondhand smoke exposure in workplaces (OR=1.923, 95%CI: 1.081-3.423) and no smoking at home (OR=0.459, 95%CI: 0.277-0.763) as factors affecting daily smoking among residents at ages of 15 years and older in Wuhan City. Conclusions There is a high likelihood of daily smoking among men, the middle-aged and elderly, farmers and individuals with exposure to secondhand smoke in workplaces at ages of 15 years and older in Wuhan City. Health education pertaining to tobacco control requires to be reinforced among high-risk populations, and creation of a tobacco-free home is recommended in public places and workplaces based on the complete smoking ban.

Objective: To understand the level of health behaviors related to prevention and control of Corona Virus Disease 2019, COVID-19 among primary school students in Wuhan during the epidemic, and to provide a basis for further targeted health education and promotion. Methods: Stratified random sampling was used to select 12 primary schools in Wuhan. Relying on the "questionnaire star", the head teacher of the selected school sent the questionnaire link to students through the QQ or WeChat group, and all students participated in the survey voluntarily. Results: A total of 8 569 valid questionnaires were collected. The rate of prevention and control of COVID-19 among primary school students in Wuhan was 39.3%. Among them, wearing masks, hand hygiene and other healthy behavior accounted for 53.4%, 42.0% and 75.2%, respectively. Multivariate logistic regression analysis showed that girl, grade 3-4 and 5-6, higher maternal education (>graduate degree) were more likely to have overall health behaviors in the prevention and control of COVID-19, and the OR values were 1.13(95%CI=1.04-1.24), 1.18(95%CI=1.06-1.31) 1.58(95%CI=1.41-1.75) and 1.62(95%CI=1.00-2.62)(P<0.05), respectively. Compared with fathers whose occupations were state agencies, managers of enterprises and institutions, students whose fathers’ occupations were professional technicians and ordinary employees were less likely to have level of overall health behaviors in the prevention and control of COVID-19, and the OR values were 0.78(95%CI=0.61-0.99) and 0.72(95%CI=0.58-0.90)(P<0.05), respectively. Conclusion The level of health behaviors of primary school children in Wuhan against COVID-19 was not high and targeted health education and promotion should be provided.

Objective To study the protein expression levels of matrix metalloproteinases (MMPs)and their inhibitors in bone tissues of rat femoral head and to explore the relationship between necrosis of femoral head and glucocorticoid.Methods Twenty healthy adult SD rats were randomly divided into glucocorticoid group and control group,with 10 rats in each.Glucocorticoid group was treated with intramuscular injection of hydrocortisone twice a week.The control group received normal saline of the same volume.Four weeks later,bone tissues of left femoral head were collected from each group of rats for HE determination of femoral head necrosis.The expressions of matrix metalloproteinase-1 (MMP-1 ), matrix metalloproteinase-2 (MMP-2 ), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1 ),and tissue inhibitor of matrix metalloproteinase-2 (TIMP-2 )at mRNA and protein levels were detected by RT-PCR and Western blot techniques,respectively.Results The expressions of MMP-1 and MMP-2 at mRNA and protein levels were higher in glucocorticoid group than those in the control group. However,TIMP-1 and TIMP-2 gene and protein expression levels were lower in glucocorticoid group (all P<0.05). Conclusion The expressions of MMPs in bone tissues of rat femoral head in early necrosis were increased,but their inhibitors had decreased expressions. We can draw the conclusion that glucocorticoid-induced necrosis of femoral head may be related to its regulation of the expression levels of MMPs and their related inhibitors.

Objective To analyze the clinical characteristics of children with knee joint diseases and discuss the curative effect of arthroscopy.Methods Eighty-nine children with knee joint diseases in Department of Orthopedics,the First Affiliated Hospital of Xinxiang Medical University from October 2012 to October 2015 were selected,and they were given knee arthroscopic surgery according to the disease types and characteristics,such as meniscal suture,suture plus angioplasty and synovectomy etc.All the symptoms,signs and the joint functions were recorded preoperatively and postoperatively.At the end of follow-up,surgical results were analyzed according to Lysholm score and International Knee Documentation Committee Knee evaluation form (IKDC) classification standard.Results The patients with discoid meniscus tear were the most,accounting for 55.55％ (55/99 knees).All patients were followed up for 6-30 months(the average time was 21 months) to find that all symptoms were relieved or disappeared within 1 year after operation.The outcome was evaluated according to the Tegner knee function:76 knees (76.76％) were markedly effective,16 knees (16.16％) were effective,6 knees (6.06％) were invalid and 1 knee (1.01％) was poor,and the excellent rate was 92.92％.The curative effect was evaluated according to Lysholm knee function score and IKDC score at the last follow-up.The Lysholm score in preoperation [(52.46 ± 4.79) scores] improved to (96.52 ± 3.97) scores in postoperation,and the difference was significant (t =-36.24,P ＜ 0.05);the IKDC score in preoperation [(46.52 ± 10.25) scores] improved to (90.67-± 5.89) scores in postoperation,and the difference was significant (t =-50.69,P ＜ 0.05).There was no joint infection,blood vessel or nerve damage and so on.Conclusions Meniscus tear is common in children with knee joint diseases,and most common is discoid lateral meniscus tear,and arthroscopy can have satisfactory outcome,with no obvious complications.Therefore,arthroscopic surgery is an ideal method for surgical treatment of children with knee joint disease.

Objective To investigate the feasibility of osteoarthritis (OA) model in rabbits by injuring medial meniscus so as to understand the role of interleukin-1 beta (IL-1β) and matrix metalloproteinase-13 (MMP-13) in pathological mechanism of articular cartilage and synovial fluid of OA model in rabbits.Methods We randomly divided 40 New Zealand white rabbits into experimental group (n =30) and control group (n =10).Pathological changes in articular cartilage of the femoral condyle were scored at weeks 2,6 and 12 after surgery.We detected the expressions of IL-1β and MMP-13 by immunohistochemistry.The cell fractions of IL-1β and MMP-13 were recorded by ELISA.Results The articular cartilage score and HE staining significantly differed at various time points of gross and pathological observation between control group and experimental group (P＜ 0.05).Immunohistochemistry showed that IL-1β was expressed in both groups and that the cell fraction differed significantly at weeks 6 and 12 (P＜0.05),but not at week 2 between the two groups.MMP-13 protein expression was not detected in articular condrocytes in control group,but was detected in experiment group with a significant difference (P＜0.05).IL-1β expression was consistent in articular cartilage and synovial fluid.Conclusion The reasonable rabbit animal OA model could be established by knee meniscus injury caused by surgical method.Expressions of IL-1β and MMP-13 change obviously in the pathomechanism of OA.Further clinical studies are needed to determine whether they can be used as markers in early diagnosis of OA.

Objective To systematically review the efficacy and safety of solifenacin in the treatment of patients with bladder spasm after transurethral resection of prostate based on current evidence.Methods We searched Pubmed,EMbase,the Cochrane Library,CBM,CNKI,VIP and Wanfang Database from the establishment to October 2016 for the published literature on the treatment of patients with bladder spasm after transurethral resection of prostate with solifenacin.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Then,meta-analysis was performed using RevMan 5.3 software.Results A total of 11 RCTs involving 621 patients were included.The results of meta-analysis showed that:compared with the no-solifenacin group(n=311),the numbers of bladder spasm episodes[MD=-1.38,95%CI(-1.97,-0.97)P<0.00001],duration of bladder spasm[MD=-0.26,95%CI(-0.41,-0.11),P=0.0008],the time of bladder perfusion clearance[MD=-0.59,95%CI(-0.88,-0.29),P<0.0001],indwelling catheter delivery[MD=-0.29,95%CI(-0.48,-0.11),P=0.09]in solifenacin group(n=310) reduced significantly,and there was no statistical difference in the incidence of overall adverse events between the two groups[RR=0.71,95%CI(0.17,2.98),P=0.64].Conclusion Current evidence indicates that solifenacin is more effective and safe in the treatment of patients with bladder spasm after transurethral resection of prostate.Due to the limited quantity and quality of the include studies,more high quality studies are needed to verify the above conclusion.

D-psicose 3-epimerase (DPEase) is demonstrated to be useful in the bioproduction of D-psicose, a rare hexose sugar, from D-fructose, found plenty in nature. Clostridium cellulolyticum H10 has recently been identified as a DPEase that can epimerize D-fructose to yield D-psicose with a much higher conversion rate when compared with the conventionally used DTEase. In this study, the crystal structure of the C. cellulolyticum DPEase was determined. The enzyme assembles into a tetramer and each subunit shows a (β/α)(8) TIM barrel fold with a Mn(2+) metal ion in the active site. Additional crystal structures of the enzyme in complex with substrates/products (D-psicose, D-fructose, D-tagatose and D-sorbose) were also determined. From the complex structures of C. cellulolyticum DPEase with D-psicose and D-fructose, the enzyme has much more interactions with D-psicose than D-fructose by forming more hydrogen bonds between the substrate and the active site residues. Accordingly, based on these ketohexose-bound complex structures, a C3-O3 proton-exchange mechanism for the conversion between D-psicose and D-fructose is proposed here. These results provide a clear idea for the deprotonation/protonation roles of E150 and E244 in catalysis.
Binding Sites ; Biocatalysis ; Catalytic Domain ; Clostridium cellulolyticum ; enzymology ; Hexoses ; chemistry ; Manganese ; chemistry ; Protein Structure, Quaternary ; Racemases and Epimerases ; chemistry ; metabolism ; Substrate Specificity