ObjectiveTo investigate the genetic polymorphism and structure of 47 autosomal microhaplotypes in the Han population in Changshu City, Jiangsu Province, and to evaluate the forensic efficiencies and forensic parameters. MethodsThe DNA library of unrelated individual samples was prepared according to MHSeqTyper47 kit manual and sequenced on the MiSeq FGx platform. Microhaplotype genotyping and sequencing depth statistics were processed using MHTyper. The genetic information of samples was then evaluated. The fixation index and genetic distance between the Jiangsu Changshu population and the reference populations in the 1000 Genomes Project phase 3 (1KG) were calculated, and forensic parameters were evaluated. ResultsThe fixation index and genetic distance between the Han population in Changshu, Jiangsu, and the CHB (Han Chinese in Beijing, China) reference population in 1KG were the lowest. The effective allele number (A_e) of each locus is also the closest between the two populations. The combined matching probability (CMP) of the Changshu Han population is close to the 5 populations of the East Asian reference super-population in 1KG, which is 1.25×10^-36, and the combined probability of exclusion reached 0.999 999 999 964 1. ConclusionThis study reported the genetic polymorphism and allele frequency of 47 microhaplotypes in a Han population in Changshu City, Jiangsu Province. This information provides a data basis for 47 microhaplotypes in forensic applications. In addition, the polymorphism differences between the 1KG reference population and the Han population in Changshu, Jiangsu were compared, and the genetic structure of 47 microhaplotypes in the Han population in Changshu, Jiangsu was revealed. In general, the reference data of the East Asian super-population in 1KG is more in line with the genetic characteristics of Han population in Changshu, Jiangsu.

Objective To compare clinical efficacy and complication rate of percutaneous endoscopic transforaminal discec-tomy(PETD),percutaneous endoscopic interlaminar discectomy(PEID)and unilateral biportal endoscopic(UBE)in treating single-segment lumbar disc herniation(LDH).Methods From October 2019 to August 2021,121 LDH patients with single-segment treated by spinal endoscopy were retrospectively analyzed and divided into three groups.In PETD group,there were 48 patients,including 19 males and 29 females,aged from 18 to 72 years old with an average of(44.0±13.9)years old;3 patients with L3,4 segments,27 patients with L4,5 segments,and 18 patients with L5S1 segments.In PEID group,there were 43 patients,including 23 males and 20 females,aged from 20 to 69 years old with an average of(40.1±12.1)years old;1 patient with L3.4 segments,15 patients with L4.5 segments,and 27 patients with L5S1 segments.In UBE group,there were 30 patients,including 12 males and 18 females,agedfrom29 to 72 years old with an average of(41.2±15.0)years old;1 patient with L3,4 segments,18 patients with L4,5 segments,and 11 patients with L5S1 segments.Operation time,blood loss,fluoroscopy times and complica-tions among three groups were observed and compared.Before opertaion,3 months after operation and at the latest follow-up,visual analogue scale(VAS)was used to evaluate low back pain and lower extremity pain,Oswestry disfunction index(ODI)was used to evaluate lumbar function,and modified MacNab was used to evaluate clinical efficacy at the latest follow-up.Re-sults All patients were performed endoscopic spinal surgery completely and were followed up for at least 12 months.One patient occurred dural sac rupture both in PETD and PEID group,and dural sac rupture was small,and there was no obvious discomfort after operation.Two patients were occurred intraoperative rupture of dural sac in UBE group.One patient was occurred cere-brospinal fluid leakage after operation,and was improved after rest in supine position and fluid rehydration.One patient without no significant postoperative discomfort.(1)There were no significant difference in operating time,blood loss and hospital stay between PETD and PEID group(P＞0.05),while UBE group was higher than those of PETD and PEID group(P＜0.05).There was no statistical significance in fluoroscopy times between PEID and UBE group(P＞0.05),but PETD group was higher than that of PEID and UBE group(P＜0.05).(2)VAS of low back pain at 3 months after operation in UBE group was higher than that in PETD and PEID group(P＜0.05),but there was no significant difference between PETD and PEID group(P＞0.05).At the latest follow-up,there was no significant difference in VAS of low back pain among three groups(P＞0.05).(3)Lower ex-tremity pain of VAS and ODI among 3 groups after operation were significantly improved at all time points compared with those before opertaion(P＜0.05),and there were no statistical significance between groups(P＞0.05),and there were no statistical significance in interaction between different time points and operation groups(P＞0.05).(4)At the latest follow-up,according to the modified MacNab standard,the results of PETD group were excellent in 27 patients,good in 16 patients,moderate in 4 patients,poor in 1 patient;in PEID group,27 patients got excellent result,12 good,3 moderate,and 1 poor;in UBE group,16 patients got excellent,10 good,2 moderate,and 2 poor.There was no significant difference among three groups(x2=0.308,P＞0.05).Recurrence of lumbar disc herniation occurred in 1 patient among each three groups,symptoms were improved in 2 pa-tients after symptomatic treatment,and 1 patient was treated in other hospitals.Conclusion PETD,PEID and UBE techniques could achieve good early clinical effects in treating lumbar disc herniation with similar complication rates.Both of PETD and PEID are single-channel minimally invasive surgery,with mild intraoperative tissue damage and quick postoperative recovery;while intraoperative fluoroscopy of PETD was relatively more frequent,and PEID was more suitable for L5S1 segment;UBE is a two-channel surgery,in which the intraoperative soft tissue damage is more severe,but exposure is broad,which is more suit-able for complex cases.

Objective To prospectively compare the clinical efficacy and radiographic outcomes between interlaminar per-cutaneous endoscopic lumbar decompression(IL-PELD)and transforaminar percutaneous endoscopic lumbar decompression(TF-PELD)in the treatment of single-segment lumbar lateral recess stenosis.Methods From April 2018 to July 2021,85 pa-tients with single-segment lumbar lateral recess stenosis underment percutaneous endoscopic lumbar decompression.There were 44 males and 41 females,aged from 49 to 81 years old with an average of(65.5±8.3)years old,duration of lumbar lateral re-cess stenosis ranging from 3 to 83 months with an average of(26.7±16.5)months.They were divided into IL-PELD group and TF-PELD group according to the different operation methods.There were 47 patients in the IL-PELD group,including 28 males and 19 females aged from 50 to 80 yeaes old with an average age was(66.7±9.3)years old.The disease duration ranged from 3 to 65 months with an average of(25.7±15.0)months.There were 38 patients in the TF-PELD group,including 16 males and 22 females,aged from 51 to 78 years old with an average of(64.1±7.6)years old.The disease duration ranged from 4 to 73 months with an average of(27.9±18.3)months The operation time,intraoperative blood loss,intraoperative fluoroscopy,hospi-talization day and complications of the two groups were recorded.Visual analogue scale(VAS)to evaluate low back pain and lower limb pain,Oswestry disability index(ODI)to evaluate lumbar function in preoperative and postoperative period(1 month,6 months and last follow-up)were recorded.the sagittal diameter of the lateral recess of the responsible intervertebral space in preoperative and 1 week after the operation were recorded.Results The operation was successfully completed in both groups without serious complications such as vascular injury,dural sac tear and nerve injury.The operation time in IL-PED group(69.3±19.3)min was significantly longer than that in TF-PELD group(57.5±14.5)min(P＜0.05).There was no significant dif-ference in the intraoperative blood loss between the two groups(P＞0.05).The number of intraoperative fluoroscopy in TF-PELD group(8.8±2.6)times was significantly higher than that in IL-PED group(4.8±1.2)times(P＜0.05).The hospitalization days of the two groups were not statistically significant(P＞0.05).VAS for low back and lower extremity pain and ODI were(5.1±2.2),(6.9±1.3)scores and(71.4±12.6)％in IL-PELD group,and(4.7±1.8),(6.9±1.3)scores and(68.4±13.9)％in TF-PELD group.In the IL-PELD group,the VAS of low back pain was(2.4±1.5),(1.6±0.8),(1.4±0.9)scores,and the VAS of lower extremity pain was(3.0±1.2),(1.6±0.7),(1.5±1.0)scores,ODI was(32.6±11.9)％,(17.4±6.5)％,(19.3±9.3)％;In TF-PELD group,the VAS of low back pain was(2.6±1.4),(1.5±0.6),(1.4±1.0)scores,and the VAS of lower extremity pain was(2.8±1.2),(1.6±0.6),(1.5±1.2)scores,The ODI was(32.0±11.2)％,(15.0±6.1)％,and(20.0±11.3)％.The VAS and ODI of the two groups at each time point after operation were significantly improved compared with those before operation(P＜0.05),but there was no statistically significant difference between the groups(P＞0.05),and there was no statistically sig-nificant difference in the interaction between different time points and groups(P＞0.05).At 1 week after operation,the sagittal diameter of lateral recess in both groups was significantly increased compared with that before operation(P＜0.05),but there was no significant difference between the two groups at each time point(P＞0.05).According to the modified Macnab criteria,IL-PELD group was rated as excellent in 24 cases,good in 19 cases and fair in 4 cases.In TF-PELD group the results were ex-cellent in 19 cases,good in 15 cases,fair in 3 cases and poor in 1 case.There was no significant difference between the two groups(P＞0.05).Conclusion IL-PELD and TF-PELD can expand the lateral recess in the treatment of single level lumbar lateral recess stenosis,and have achieved good clinical effects.

OBJECTIVE To compare the effectiveness，safety and economy of bovine pulmonary surfactant （PS） and porcine PS in the treatment of preterm neonates with respiratory distress syndrome （RDS）. METHODS Retrieved from PubMed，Embase， Cochrane Library，CNKI，SinoMed，Wanfang and health technology assessment （HTA） organization websites and relevant database， HTA report，systematic review/meta-analysis and pharmacoeconomic study about bovine PS versus porcine PS in the treatment of preterm neonates with RDS were included from the inception to Feb 2022. Data extraction and quality evaluation were carried out for the included literature，and then research results were summarized and analyzed descriptively. RESULTS A total of 1 HTA report，6 systematic reviews/meta-analyses，and 6 pharmacoeconomic studies were included. There appeared to be no significant differences between bovine PS and porcine PS in terms of time staying in neonatal intensive care unit and extra-pulmonary outcomes. In terms of PS re-treatment，blood gas index，total effective rate and the incidence of patent ductus arteriosus，porcine PS was superior to bovine PS. Results from other indicators，such as mortality， the incidence of bronchopulmonary dysplasia，air leakage syndrome，pulmonary hemorrhage，were still controversial. In terms of economy，there was no statistical difference in average hospital charges and administration cost per dose between two groups （P＞0.05）； compared with porcine PS，mean wastage cost per dose of bovine PS was higher （P＜0.001），and 24 h treatment cost of bovine PS was lower （P＜0.05）； the results of average medication cost were controversial. CONCLUSIONS The effectiveness， safety and economy of bovine PS are found to be similar or inferior to porcine PS. It is not certain whether the inferiority has clinical significance.

Objective: This study aims to survey the incidence of surgical site infection (SSI) in China and to analyze its risk factors, so as to prevent and control SSI after colorectal surgery. Methods: An observative study was conducted. Based on a program of Chinese SSI Surveillance from 2018 to 2020, the clinical data of all adult patients undergoing colorectal surgery during this time period were extracted. These included demographic characteristics and perioperative clinical parameters. Minors, pregnant women, obstetric or gynecological surgery, urological system surgery, retroperitoneal surgery, resection of superficial soft tissue masses, and mesh or other implants were excluded. A total of 2122 patients undergoing colorectal surgery from 50 hospitals were included, including 1252 males and 870 females. The median age was 63 (16) years and the median BMI was 23 (4.58) kg/m². The primary outcome was the incidence of SSI within 30 days after colorectal surgery. The secondary outcomes were mortality within 30 days postoperatively, length of ICU stays and postoperative hospital stays, and cost of hospitalization. Patients were divided into the SSI group and non-SSI group based on the occurrence of SSI. Multivariable logistic regression was performed to analyze risk factors of SSI after colorectal surgery, and subgroup analysis was conducted for open and laparoscopic surgery. Results: The incidence of SSI after colorectal surgery was 5.6% (119/2122), including 47 cases (47/119, 39.5%) with superficial incisional infections, 24 cases (24/119, 20.2%) with deep incisional infections, and 48 cases (48/119, 40.3%) with organ/space infections. The occurrence of SSI significantly increased mortality [2.5% (3/119) vs. 0.1%(3/2003), χ²=22.400, P=0.003], the length of ICU stay [0 (1) day vs. 0(0) day, U=131 339, P<0.001], postoperative hospital stay [18.5 (12.8) days vs. 9.0 (6.0) days, U=167 902, P<0.001], and medical expenses [75 000 (49 000) yuan vs. 60 000 (31 000) yuan, U=126 189, P<0.001] (P<0.05). Multivariate analysis revealed that hypertension (OR=1.782, 95%CI: 1.173-2.709, P=0.007), preoperative albumin level (OR=1.680, 95%CI: 1.089-2.592, P=0.019), a contaminated or infected incision (OR= 1.993, 95%CI: 1.076-3.689, P=0.028), emergency surgery (OR=2.067, 95%CI: 1.076-3.972, P=0.029), open surgery (OR=2.132, 95%CI: 1.396-3.255, P<0.001), and surgical duration (OR=1.804, 95%CI: 1.188-2.740, P=0.006) were risk factors for SSI, while preoperative skin preparation (OR=0.478, 95%CI: 0.310-0.737, P=0.001) was a protective factor for SSI. Subgroup analysis was performed on patients undergoing open or laparoscopic surgery. The incidence of SSI in the open surgery group was 10.2%, which was significantly higher than that in the laparoscopic or robotic group (3.5%, χ²=39.816, P<0.001). Subgroup analysis identified that a contaminated or infected incision (OR=2.168, 95%CI: 1.042-4.510, P=0.038) and surgical duration (OR=2.072, 95%CI: 1.171-3.664, P=0.012) were risk factors for SSI after open surgery, while mechanical bowel preparation (OR=0.428, 95%CI: 0.227-0.807, P=0.009) and preoperative skin preparation (OR=0.356, 95%CI: 0.199-0.634, P<0.001) were protective factors for SSI after open surgery. In laparoscopic surgery, diabetes mellitus (OR= 2.292, 95%CI: 1.138-4.617, P=0.020) and hypertension (OR=2.265, 95%CI: 1.234-4.159, P=0.008) were risk factors for SSI. Conclusions: The incidence of SSI after colorectal surgery is 5.6%. Minimally invasive surgery should be selected to reduce the occurrence of postoperative SSI. To prevent the occurrence of SSI after open surgery, skin preparation and mechanical bowel preparation should be performed before the operation, and the duration of the operation should be shortened as much as possible. In the perioperative period, care of patients with hypertension, diabetes, and contaminated or infected incisions should be given particular attention.
Adult ; Albumins ; China/epidemiology* ; Colorectal Surgery/adverse effects* ; Female ; Humans ; Hypertension/complications* ; Male ; Middle Aged ; Pregnancy ; Surgical Wound Infection/etiology*

Objective:To analyze the clinical characteristics and risk factors for mortality of severe pneumocystis carinii pneumonia(PCP)in pediatric liver transplant(LT)recipients.Methods:The data of severe PCP in LT recipients diagnosed at Shanghai Children′s Medical Center from November 2019 to February 2021 were collected.The clinical characteristics and risk factors for 28-day mortality were analyzed.Results:Fifteen patients were enrolled in the study.Thirteen cases survived and 2 cases were non-survived.There was no routine anti-pneumocystis prophylaxis after LT.The median age of onset of PCP was 12(7, 26)months.The median time after LT was 3.00(0.33, 4.00)months.The onset clustered in November-December and June-August.All patients were mechanically ventilated, and some patients were given prone ventilation(11 cases), neuromuscular blocking agents(13 cases)and high concentration oxygen(more than 60%, nine cases). Fourteen cases were complicated with other infections.Two cases were complicated with pneumothorax and subcutaneous/mediastinal emphysema.There were 2 cases with septic shock-like manifestation, 1 case of right heart insufficiency, 1 case of right heart failure(death), and 1 case of multiple organ failure(death). Compared with the survived group, the non-survived group had higher pediatric risk of mortality Ⅲ score[3.5(0.0, 6.0)vs.8.5(5.0, 12.0), Z=1.993, P=0.046] and lactate dehydrogenase level[1 731.5(1 012.0, 3 270.0)U/L vs.4 387.5(3 606.0, 5 169.0)U/L, Z=2.148, P=0.032]. Conclusion:PCP in pediatric LT is critical and complicated.Pediatric risk of mortality Ⅲ scores and lactate dehydrogenase increase in 28-day hospitalized deaths.

Activation and inflammation of microglial correlate with progressive neuronal apoptosis in neurodegenerative disorders such as Parkinson’ s disease (PD). γ-Aminobutyric acid (GABA), the major inhibitory neurotransmitter in the central nervous system, has recently been shown to play an inhibitory role in the immune system, but the mechanism is unclear. In this study, the results showed that LPS promoted the release of inflammatory factors in a dose-dependent manner compared with the control group (P<0. 01). Meanwhile, cell viability and cytotoxicity assays showed that the released inflammatory factors could induce the decline of SH-SY5Y cell viability. BV2 microglia cells were pretreated with GABA and Muscimol, a GABA

OBJECTIVES: To study whether diatoms can enter the body through the lymphatic system of the digestive tract. METHODS: Twenty experimental rabbits were divided into the test group and the control group randomly, and intragastric administration was performed with 20 mL water sample from the Pearl River and 20 mL ultrapure water, respectively. After 30 min, lymph, lungs, livers and kidneys were extracted for the diatom test. The concentration, size and type of diatoms were recorded. RESULTS: The concentration of diatoms of the test group was higher than that of the control group (P<0.05). In the test group, Stephanodiscus, Coscinodiscus, Cyclotella, Melosira, Nitzschia, Synedra, Cymbella, and Navicula were detected; in the control group, Stephanodiscus, Coscinodiscus and Cyclotella were detected. The long diameter and the short diameter of diatoms of the test group were higher than those of the control group (P<0.05). In the test group, 1-2 diatoms were detected in 3 lung samples and 2 liver samples, which were Stephanodiscus or Cyclotella, and no diatoms were detected in the kidney samples; in the control group, 1-2 diatoms were detected in 2 lung samples and 3 liver samples, which were Stephanodiscus or Coscinodiscus, and no diatoms were detected in the kidney samples. CONCLUSIONS Diatoms can enter the body through the lymphatic fluid, which is one of the reasons for the presence of diatoms in tissues and organs of non-drowning cadavers.
Animals ; Diatoms ; Drowning ; Gastrointestinal Tract ; Lung ; Lymphatic System ; Rabbits ; Water/metabolism*

OBJECTIVE: To study the detection rate, epidemic pattern, and clinical features of respiratory syncytial virus (RSV) in hospitalized children with acute lower respiratory infection (ALRI). METHODS: Nasopharyngeal aspirates were collected from children with ALRI, aged < 2 years, who were hospitalized in Children's Hospital of Chongqing Medical University from June 2013 to May 2018. Multiplex PCR was used to detect 16 common respiratory viruses. The epidemiological characteristics of RSV were analyzed. RESULTS: A total of 2 066 hospitalized children with ALRI were enrolled. Among the children, 1 595 (77.20%) tested positive for virus and 826 (39.98%) tested positive for RSV [410(49.6%) positive for RSV-A, 414 (50.1%) positive for RSV-B, and 2 (0.2%) positive for both RSV-A and RSV-B]. RSV-B was the main subtype detected in 2013-2014 and 2016-2017, while RSV-A was the main subtype in 2014-2015 and 2017-2018, and these two subtypes were prevalent in 2015-2016. The highest detection rate of RSV was noted in winter. RSV + human rhinovirus was the most common combination of viruses and was detected in 123 children. These children were more likely to develop wheezing than those with single RSV detected ( CONCLUSIONS In Chongqing in 2013-2018, RSV-A and RSV-B not only can predominate alternately, but also can co-circulate during a season. RSV is the major viral pathogen of hospitalized children with ALRI and can cause severe lower respiratory tract infection. There are no differences in clinical manifestations between children with RSV-A infection and those with RSV-B infection, but boys are more susceptible to RSV-A infection.
Child ; Child, Hospitalized ; Child, Preschool ; China/epidemiology* ; Female ; Humans ; Infant ; Male ; Respiratory Syncytial Virus Infections/epidemiology* ; Respiratory Syncytial Virus, Human ; Respiratory Tract Infections/epidemiology*

Abscess/diagnosis* ; Diagnostic Errors ; Humans ; Mycoses ; Penicillium ; Talaromyces