BACKGROUND:With the increasing number of tendon transplantation surgeries for tendon injuries,the demand for tendon tissue engineering scaffolds is increasing.Research has found that good pore size and porosity of implants contribute to tissue healing. OBJECTIVE:To review the types of materials currently published for tendon tissue engineering scaffolds and investigate the correlation between various tendon tissue engineering scaffold materials and pores. METHODS:Articles were retrieved on PubMed,Embase,and Web of Science databases,using keywords"tendon"or"ligament"and"tissue scaffold"as well as"porosity"or"permeability".A total of 84 articles meeting the criteria were included to summarize,discuss and anticipate future development directions. RESULTS AND CONCLUSION:The materials used in the research of tendon tissue engineering are mainly divided into two categories:natural tendon scaffold materials and artificial synthetic tendon scaffold materials.Natural scaffold materials include autologous tendons,allogeneic tendons,and xenogeneic tendons.Autogenous tendons and allogeneic tendons have been used in clinical practice for many years.During the preparation of allogeneic tendons and animal experiments,it was found that the process of acellular disinfection resulted in an increase in the pore size and porosity of both types of tendons,but the specific reasons and mechanisms have not been further studied.There are many types of artificial tendon scaffold materials currently being studied,among which artificial ligament products such as Leeds Keio and LARS(Ligament Advanced Reinforcement System)are still in use in some countries.Other materials have not been promoted in clinical practice due to immature technology and other issues.The pores and porosity of artificial tendon scaffold materials also show different trends due to their different materials and preparation techniques.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Objective To investigate the effect of circ_0114427 on apoptosis and inflammation of alveolar epithelial cells induced by lipopolysaccharide (LPS) and its mechanism. Methods Human alveolar epithelial cells were cultured in vitro and transfected with si-circ_0114427, microRNA (miR)-330-5p mimics or co-transfected with si-circ_0114427 and anti-miR-330-5p, and the cellswere then treated with 10 mg/L LPS for 24 hours. The expression levels of circ_0114427 and miR-330-5p in the cells were detected using real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). The protein levels of Cleaved-caspase3 and Cleaved-caspase9 were evaluated using western blot. Enzyme-linked immunosorbent assay (ELISA) was used to assess the expression of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α). Cell apoptosis was analyzed using flow cytometry. The interaction between circ_0114427 and miR-330-5p was validated using a dual luciferase reporter assay. Results After LPS treatment of alveolar epithelial cells, the expression of circ_0114427 was upregulated, while miR-330-5p expression was downregulated in in the cells (P < 0.05). Knockdown of circ_0114427 or upregulation of miR-330-5p could inhibit LPS-induced apoptosis, Cleaved-caspase3, Cleaved-caspase9, IL-6, and TNF-α levels in alveolar epithelial cells (P < 0.05). Circ_0114427 directly interacted with and negatively regulated miR-330-5p. Downregulation of miR-330-5p reversed the inhibitory effect of circ_0114427 knockdown on LPS-induced cell apoptosis and inflammation. Conclusion Knockdown of circ_0114427 can inhibit LPS-induced apoptosis and inflammation in alveolar epithelial cells, possibly through upregulation of miR-330-5p.

Parkinson disease （PD） is a common neurodegenerative disease. Cognitive dysfunction seriously affects the quality of life of patients with PD， increasing their family burden. Currently， there are no clinically identified biomarkers to assist with the early diagnosis of cognitive impairment in patients with PD. Event-related potential P300 is a sensitive electrophysiological indicator to detect early insidious cognitive decline in PD. This article reviews the diagnostic value and clinical application of P300 for cognitive impairment in patients with PD.

Objective: To study the resistance characteristics, carbapenemase genotypes and the homology of carbapenem-resistantEscherichia coli(CREC). Methods: 6 092Escherichia coliisolated from clinical specimens in The First Affiliated Hospital of Anhui Medical University were collected and 71 strains of CREC were selected. The identification and antimicrobial susceptibility test were carried out by Vitek-2 Compact. Confirmation of carbapenemase phenotype was performed by modified hodge test(MHT), modified carbapenem inactivation method(mCIM) and carbapenemase nordmann-poirel(Carba NP) test. Carbapenemase-encoding genes(blaKPC, blaNDM, blaVIM, blaIMP,etc.) were identified by PCR and positive amplification products were sequenced, and then analyzed by using BLAST programs. ERIC-PCR fingerprinting was used to determine the clonal relationship between the different strains. Results: CREC strains were mainly distributed in intensive care unit(ICU) and burn department, and the source of specimens was mainly urine. The drug susceptibility results showed that the resistance rates of CREC to ciprofloxacin, levofloxacin and cotrimoxazole were all above 70%, and the resistance rates to amikacin and tobramycin were less than 50%. Among 71 CREC strains, the number of positive strains for MHT, mCIM and Carba NP were 45, 67 and 69, and the positive rates were 63.38%, 94.37% and 97.18%, respectively. Carbapenemase genes were detected in 43 CREC isolates, of which 34 strains(79.07%, 34/43) carried blaNDM, 9 strains(20.93%, 9/43) carried blaKPC-2. In addition, the rates of strains harbored blaNDM-1or blaNDM-5were 20.59%(7/34) and 79.41%(27/34), respectively. Other carbapenem genes such as blaIMP, blaVIMand blaOXA-48were not detected. According to the fingerprint of ERIC-PCR, CREC was divided into 19 genotypes A-S, and no dominant genotype was found. Conclusion Drug resistance rate of clinically isolated CREC in our hospital is high, showing multi-drug resistance. blaNDMis the main carbapenemase gene of CREC. The epidemic CREC in our hospital has high genetic diversity and the homology of CREC is dispersive.

Objective:To assess the predictive values of bioelectrical impedance analysis(BIA)-measured body fat indices to abnormal lipid profiles, and to preliminary propose optimal cut-off values of body fat in children and adolescents.Methods:Children and adolescents, aged 6-16 years, were selected from 30 schools (8 primary schools, 21 middle schools and one 12-year education school) in Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by adopting a stratified cluster sampling method from November 2017 to January 2018.Questionnaire survey, body mass index(BMI), body fat mass index (FMI), fat mass percentage (FMP) and four lipid profiles were conducted.Results:A total of 14 309 participants, aged (11.0±3.3) years, were enrolled in the analysis, with 49.9% boys.In boys and girls, the percentile values ( P60- P95) fitted by FMI and FMP with K-median-coefficient of variation(LMS) method were taken as the cutting points, and P75 values were selected as the cut-off points of excessive body fat for their better sensitivity, specificity, predictive value and area under curve (AUC) for identification of abnormal lipid profiles.Boys with FMI above P75 accounted for 28% of the total population, and controlling boys with FMI below P75 could prevent dyslipidemia of 8%-57%.FMI in girl population occupied about 26% of the above, and controlling FMI in girl population below this cut-off point may prevent dyslipidemia from 8%-42%.FMP observed similar results to FMI.Assessed by FMI or FMP with P75 cut-off values, adiposity performed better than BMI for recognizing abnormal lipid profiles in boys (AUC: 52.4%-69.6% vs.50.2%-67.1%, P<0.05) rather than in girls ( P>0.05). In addition, when FMI or FMP beyond P90, the specificity of each abnormal lipid profiles was around 90%. Conclusions:The recommend cut-off points for body fat may be to assess children′s adiposity, and can be applied in preventive activities.

Objective:To analyze the influence of obesity status on the development of cardiometabolic disorders in school-age children.Methods:Information about children's body weight, body height and cardiovascular risk factors were collected in baseline survey in 2017 and follow-up survey in 2019. The school-age children were divided into four groups based on their baseline and follow-up obesity status, i.e. sustained non-obesity group, restored obesity group, newly classified obesity group, and persistent obesity group. Analysis of covariance was used to compare the difference of change in levels of cardiometabolic factors among the four groups. The multivariate logistic regression model was used to analyze the relationship between obesity status and the incidence risk of cardiometabolic disorders.Results:The present study included 11 379 school-age children (boys accounting for 49.6%). During the 2 years, the incidence of obesity was 3.2% (95% CI: 2.9%-3.5%) with the restoration ratio of obesity of 4.4% (95% CI: 4.0%-4.8%). Compared with the sustained non-obesity group, increases in SBP, DBP, TG, LDL-C and non-HDL-C were much higher in newly classified obesity group and persistent obesity group, but lower in restored obesity groups except for DBP (all P<0.05). In addition, the incidence risk of hypertension, high glucose, dyslipidemia and cardiometabolic disorders (≥2 risks) were much higher in newly classified and persistent obese children than in sustained non-obese children. No difference was found in incidence risks of most cardiovascular disorders between restored obese children and sustained non-obese children, except for hypertension and cardiometabolic risks. Conclusion:Both newly classified obesity and persistent obesity increased the incidence risks for multi cardiovascular disorders, while these risks could be reduced when non-obese status restore.

Objective: To understand the status quo and differences of the rights and interests of primary medical staff in a community, and to provide targeted suggestions for improving the rights of such staff. Methods: From October to November 2018, a questionnaire survey was conducted on all the medical staff of 8 community health service centers in a district of Shanghai, and 562 valid samples were obtained. Results: The primary medical staff had the highest demands for " pay rise" (4.783±0.598), " paid vacation" (4.569±0.873)and " additional reserve fund" (4.553±0.963); the lowest demands were placed on " education-based promotion" (3.797±1.382), " refresher training" (3.801±1.314), and " opinion feedback mechanism" (4.018±1.223). At the same time, the rights and interests of these staff in different occupational categories were significantly different(P<0.05)in " daily reimbursement" , " housing subsidy" , " refresher training" and " opinion feedback mechanism" . Conclusions The salary demands of the primary medical staff are the most obvious, and there are differences in the demands of medical staff in different occupational categories. It is suggested to establish a more reasonable salary system and pay attention to the differentiated appeals of different medical personnel.

Objective To investigate the antibiotic resistance of clinical isolates in the First Affiliated Hospital of Anhui Medical University during 2017. Methods Antimicrobial susceptibility testing was carried out according to a unified protocol using automated system or Kirby-Bauer method. Results were interpreted according to the breakpoints of CLSI 2017. The data were analyzed by WHONET 5.6 software. Results A total of 6 495 non-duplicate clinical isolates were collected in 2017. There were 1 727 strains (26.6％) of gram-positive bacteria and 4 768 strains (73.4％) of gram-negative bacteria. The most frequently isolated microorganisms were E. coli (19.8％), followed by Klebsiella pneumoniae and Acinetobacter baumannii. The strains were mainly isolated from respiratory tract (37.0％) and urine (23.1％). The prevalence of MRSA and MRCNS in Staphylococcus aureus and coagulase-negative Staphylococcus was 50.1％ and 82.1％, respectively. No Staphylococcus strains were found resistant to vancomycin or linezolid. E. faecalis and E. faecium accounted for 49.9％ and 40.4％ of total Enterococcus isolates. The prevalence of ESBLs-producing strains was 57.6％ in E. coli, 27.1％ in Klebsiella spp. and 33.0％ in Proteus mirabilis. Enterobacteriaceae strains were still highly susceptible to carbapenems antibiotics. The Klebsiella pneumoniae isolates in 2017 showed significantly higher resistance rate to imipenem and meropenem than the strains in 2016. However, Pseudomonas aeruginosa and Acinetobacterbaumannii strains showed lower resistance rates to carbapenems than the strains in 2016. Conclusions The bacterial isolates in 2017 pose serious threat to clinical antibiotic therapy. More attention should be paid to rational use of antimicrobial agents and infection control measures.

The pathogenesis of narcolepsy type 1 is characterized by massive loss of hypocretin neurons in the lateral hypothalamus.Due to the extensive interaction between the hypocretin signalling pathway and the autonomic nerve centre of brain stem and spinal cord,narcolepsy type 1 patients often showed autonomic nervous dysfunctions,such as circadian rhythms/sleep abnormalities,energy metabolism and body temperature regulation disorder,pupil adjustment disorder,sexual dysfunction and autonomic fluctuations during cataplexy.We reviewed the autonomic dysfunction of the narcolepsy type 1 patients in general and during cataplexy,in order to strengthen the attention to autonomic nervous dysfunction in narcolepsy type 1.