[This corrects the article DOI: 10.1016/j.apsb.2019.01.003.].

Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

Scavenging reactive oxygen species (ROS) by antioxidants is the important therapy to cerebral ischemia-reperfusion injury (CIRI) in stroke. The antioxidant with novel dual-antioxidant mechanism of directly scavenging ROS and indirectly through antioxidant pathway activation may be a promising CIRI therapeutic strategy. In our study, a series of chalcone analogues were designed and synthesized, and multiple potential chalcone analogues with dual antioxidant mechanisms were screened. Among these compounds, the most active not only conferred cytoprotection of HO-induced oxidative damage in PC12 cells through scavenging free radicals directly and activating NRF2/ARE antioxidant pathway at the same time, but also played an important role against ischemia/reperfusion-related brain injury in animals. More importantly, in comparison with mono-antioxidant mechanism compounds, exhibited higher cytoprotective and neuroprotective potential and Overall, our findings showed compound could emerge as a promising anti-ischemic stroke drug candidate and provided novel dual-antioxidant mechanism strategies and concepts for oxidative stress-related diseases treatment.

Objective: To evaluate clinical characteristics and prognosis of primary myelofibrosis (PMF) patients with thrombocytopenia in varied degrees. Methods: Clinical features and survival data of 1 305 Chinese patients with PMF were retrospectively analyzed. The prognostic value of thrombocytopenia in patients with PMF was evaluated. Results: 320 subjects (47%) presented severe thrombocytopenia (PLT<50×10⁹/L), 198 ones (15.2%) mild thrombocytopenia [PLT (50-99)×10⁹/L] and 787 ones (60.3%) without thrombocytopenia (PLT ≥ 100×10⁹/L). The more severe the thrombocytopenia, the higher the proportions of HGB<100 g/L, WBC<4×10⁹/L, circulating blasts ≥ 3%, abnormal karyotype and unfavourable cytogenetics (P<0.001, P<0.001, P=0.004, P<0.001 and P<0.001, respectively) were observed in this cohort of patients. The more severe the thrombocytopenia, the lower the proportion of JAK2V617F positive (P<0.001) was also noticed. Platelet count was positively correlated with splenomegaly, HGB and WBC (P<0.001, correlation coefficients were 0.131, 0.445 and 0.156, respectively). Platelet count was negative correlated with constitutional symptoms and circulating blasts (P=0.009, P=0.045, respectively; correlation coefficients were -0.096 and -0.056, respectively). The median survival of patients with severe thrombocytopenia, mild thrombocytopenia and without thrombocytopenia were 32, 67 and 89 months, respectively (P<0.001). Multivariate analysis identified thrombocytopenia in varied degrees (HR=1.693, 95%CI 1.320-2.173, P<0.001) and Dynamic Internation Prognostic Scoring System(DIPSS) prognostic model (HR=2.051, 95%CI 1.511-2.784, P<0.001) as independent risk factors for survival. Conclusion PMF patients with severe thrombocytopenia frequently displayed anemia, leucopenia, circulating blasts and short survival, so active treatment measures should be taken especially in these patients.

Objective To understand the epidemiological characteristics of a healthcare-associated infection(HAI)outbreak due to Norwegian scabies in a hospital,and provide basis for clinical prevention and control of HAI.Methods Through epidemiological investigation,all suspected patients and close contacts were investigated and traced,three dimensional distribution of patients was described,a series of effective comprehensive prevention and control measures were formulated and implemented.Results A total of 16 cases of Norwegian scabies infection occurred in November 3-16,2015,the most frequent cases were in November 11(n=5),the onset time of infection was concentrated in November 9-11(n=10),accounting for 62.50%of total cases.Spatial distribution of 16 cases: 12 cases were in general internal medicine department,2 in nursing department,and 2 were relatives of employees.Population distribution: patients aged 50-59(n=7),female(n=13),and nursing staff(n=9).After taking comprehensive prevention and control measures and medication treatment,16 infected persons were all cured,the cure rate was 100%,there was no new cases occurred in the hospital,epidemic was under control.Conclusion Norwegian scabies is highly contagious,it can cause epidemic in local area.In order to avoid spread of scabies infection in hospital,health care workers should strengthen the diagnosis and precaution level of the disease.

Objective To investigate the correlation between occupational stress,uncertain endur-ance and job burnout of pre-hospital emergency nurses. Methods A total of 380 pre-hospital emergency nurses were recruited by stratified cluster sampling method.The occupational burnout scale(MBI)including emotional exhaustion(EE),depersonalization(D)and diminished personal accomplishment(PA),the In-tolerance of Uncertainty Scale(IUS),the Nursing Stressor Scale(NSS)including stresses associated with nurse expectations(NSS1),with family(NSS2),with interpersonal relationship(NSS3),with nature of work (NSS4),with patient(NSS5)and with work load(NSS6)were applied for all subjects.Results The pre-hospital emergency nurses who had worked less than 3 years got the higher EE score(33.58 ± 4.34)and higher PA score(26.98±4.31)than those who had worked 3 to 10 year(22.33±4.05,16.14±4.28,P<0.05) or longer than 10 years(21.50±4.36,16.81±4.36,P<0.05).Nurses got higher EE score(33.82±4.28,22.96 ±4.39,21.04±4.62,P<0.05),and higher PA scores(27.02±4.21,16.04±4.31,16.01±4.30,P<0.05)than the nurse practitioner or above levels.People whose monthly income were below 0.3 million got higher PA scores than those whose monthly income were 0.3 million or more(26.75±4.24,16.47±4.27,17.11±4.34,P<0.05).People who got degrees of bachelor or above had PA scores which was more than people who got de-grees under bachelor(26.33±4.36,17.24±4.28,P<0.05).Regression analysis showed that the multiplication score between IUS and NSS1 had the interaction effect with EE and D scores(β=0.33,0.33,P<0.05); the multiplication score between IUS and NSS5 had the interaction effect with EE and D scores(β=0.31,0.30, P<0.05)and the multiplication score between IUS and NSS3 had the interaction effect with D scores(β=0.34,P<0.05).Conclusion The pre-hospital emergency nurses'job burnout varies according to their length of service,job title,educational level and salary,and is also influenced by the combination of occupational stress and uncertain endurance.

OBJECTIVETo compare the clinical efficacy of the lymph node dissection patterns of the reverse and the traditional cabbage in hand-assisted laparoscopic D2 radical gastrectomy (HALG).

METHODSFrom December 2010 to October 2013, 194 patients with HALG in Chengdu Military General Hospital were enrolled in this study. According to the pattern of lymph node dissection, 108 patients were performed with the reverse procedure which took spleen as starting point, from left to right, and 86 patients were performed with the traditional cabbage procedure which took the abdominal cavity as the center, from both sides to middle. A retrospective comparative analysis was made on the intra- and post-operative data between the two groups.

RESULTSAll the patients were successfully performed with HALG, and no peri-operative death occurred. There were no significant differences in the incision length [(7.0 ± 0.2) cm vs. (6.9 ± 0.3) cm], the operative time [(170.9 ± 33.8) minute vs. (174.6 ± 22.4) minute], dissected lymph node number (17.6 ± 7.5 vs. 17.1 ± 5.8) and post-operative complications [(6.5%(7/108) vs. 8.1%(7/86)] between the reverse group and cabbage group (all P>0.05). However, less blood loss [(204.6 ± 98.2) ml vs. (259.1 ± 122.6) ml, P<0.01] and shorter postoperative hospital stay [(9.0 ± 1.7) day vs. (10.5 ± 4.0) day, P<0.01] were observed in reverse group as compared to cabbage group. During 1 to 6 months follow-up, no death case was found in reverse group, while 1 case died due to upper gastrointestinal bleeding 48 days after operation in cabbage group.

CONCLUSIONEfficacy is similar between the two HALG procedures in lymph node dissection, while reverse procedure has certain advantages, such as less blood loss and faster recovery.

Gastrectomy ; methods ; Hand-Assisted Laparoscopy ; Humans ; Length of Stay ; Lymph Node Excision ; Operative Time ; Postoperative Complications ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms ; surgery

Objective To investigate the effect of mixed-skin grafting with autologous microskin and allogenetic acellular dermal matrix microskin on wound healing in rats,and to make a further study on the related mechanism.Methods Wistar rats were served as a allogenetic acellular dermal matrix donor rats,and SD rats as acceptors with mould of full thickness skin defects on their back.The ninety SD rats were divided into 5 groups with 18 rats in each group.Group 1 was transplanted with autologous microskin,and group 2 with allogenetic acellular dermal matrix microskin.Groups 3,4 and 5 were grafted with mixed-skin ratio between autologous microskin and allogenetic acellular dermal matrix microskin 1 ∶ 1,1 ∶ 0.5 and 1 ∶ 0.25,repectively.The rate of wound healing was measured,wound samples collected,hematoxylin and eosin stain carried out,fibronectin (FN) and laminin (LN)detected,and intergroup comparison made,respectively,2,3 and 4 weeks after skin grafting.Results The wound healing rates and FN and LN expression of mixed-skin grafting groups were higher than those of the group with autologous microskin grafting.The group of 1 ∶ 0.25 obviously increased (P＜0.05 or P＜0.01).Conclusions The wound healing rate with mixed-skin grafting is higher than that with autologous microskin grafting.The best effect is achieved when the skin ratio between autologous microskin and allogenetic acellular dermal matrix microskin is 1 ∶ 0.25.It is possibly due to the increase of FN and LN on wound skin surface.

Objective To explore the clinical value of CT-guided 125I radioactive seeds implantation and chemical ablation for malignant retroperitoneal tumors.Methods Because of the rejection of the second surgery resection and insensitivity of chemotherapy and radiotherapy,nineteen patients with recurrent or metastasis malignant retroperitoneal tumors were treated by CT-guided125I radioactive seeds implantation according to TPS or Halarism's experienced function,and percutaneous ethanol injection was performed if the way of punctuation Was limited.The extent of pain relief was assessed one month later after therapy.All the patients received enhanced CT scan 6 months after the first treatment,and imaging evaluation wag performed according to WHO criteria.Results For the 19 patients.pain relief Was achieved more or less in all patients.Imaging evaluation revealed complete relief,partial relief,no change in 10,7,2 cases respectively.All patients are still alive now.The longest followed span is 31 months.and the shortest is 7 months,the average followed span is 13.5 months.Conclusion CT-guided 125I radioactive seeds implantation and chemical ablation ore effective for malignant retropefitoneal tumors.

To detect the cellular immunity state of New Zealand white rabbit immunized by pig type II collagen. The New Zealand white rabbit was immunized by type II collagen for sixty days. The plasma was collected at a regular interval and the anti-type II collagen antibodies were examined. At the sixtieth day, the peripheral circular lymphocytes and the lymphocytes separated from spleen cells of rabbit and lymph nodes were collected and were stimulated by type II collagen in vivo again. The regulation of reactive cellular proliferation caused by the stimulation was detected. The experiment samples were divided into two groups. The first group was the positive control group by adding different concentrations of PHA and the non-specific immunity was assayed. The different concentrations of type II collagen were added to the second group and the specific immunity was assayed. The lymphocytes of normal rabbits showed proliferation by PHA stimulation but no proliferation by the first stimulation of type II collagen. Obvious proliferation due to the stimulation of both PHA and type II collagen in the immunized rabbit were observed. It shows that certain concentration of heterogeneous collagen may cause an increase of anti-type II collagen antibody in immunized rabbit and may cause a proliferation of lymphocytes in rabbit spleen and peripheral blood. The heterogeneous type II collagen causes cellular immunity in vivo.
Animals ; Cell Division ; drug effects ; Collagen Type II ; administration & dosage ; immunology ; Cytotoxicity, Immunologic ; Female ; Histocompatibility Antigens ; Lymphocytes ; cytology ; immunology ; Male ; Rabbits ; Spleen ; cytology ; Swine ; Transplantation, Heterologous