Objective:To investigate the anesthetic and analgesic effects of ultrasound-guided high-position fascia iliaca compartment block (FICB) in older adult patients undergoing hip fracture surgery.Methods:A total of 120 older adult patients who underwent hip fracture surgery at the Department of Orthopedics, Dongyang People's Hospital, between January 2022 and October 2023, were enrolled in this study. This is a prospective controlled study. The patients were randomly assigned to either a conventional group or a high-position group, with 60 patients in each group, using a random number table method. The patients in the conventional group received ultrasound-guided routine FICB 30 minutes before entering the operating room, whereas the patients in the high-position group underwent ultrasound-guided high-position FICB 30 minutes prior to entering the operating room. The onset time of nerve block in both groups was observed, specifically targeting the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve. Changes in hemodynamic indicators, including heart rate and mean arterial pressure, were monitored at various time points: before nerve block (T0), upon entering the operating room (T1), during anesthesia positioning (T2), and after anesthesia completion (T3). The pain level was assessed using the Visual Analogue Scale score at the same time points. Changes in pain neurotransmitters prostaglandin E 2 and 5-hydroxytryptamine were analyzed at T0 and T3. Results:The onset time of the femoral nerve, lateral femoral cutaneous nerve, and obturator nerve in the high-position group [(4.02 ± 1.16) minutes, (4.55 ± 1.29) minutes, (7.71 ± 2.02) minutes] were significantly shorter than those in the conventional group [(5.15 ± 1.42) minutes, (6.62 ± 1.78) minutes, (12.24 ± 3.68) minutes, t = 4.77, 7.29, 8.35, all P < 0.001]. At T1 and T2, the heart rates in the high-position group [(77.55 ± 9.19) beats/minute, (75.54 ± 9.37) beats/minute] and mean arterial pressures [(95.62 ± 10.51) mmHg (1 mmHg = 0.133 kPa), (92.72 ± 11.44) mmHg] were significantly higher than those in the conventional group [(74.62 ± 9.68) beats/minute, (72.41 ± 9.36) beats/minute, (92.36 ± 10.04) mmHg, (88.24 ± 11.35) mmHg, t = 1.70, 1.82, 1.73, 2.15, P = 0.046, 0.035, 0.042, 0.017]. At T1 and T2, the VAS scores of the high-position group [(3.05 ± 0.61) points, (3.44 ± 0.89) points] were significantly lower than those in the conventional group [(3.72 ± 0.67) points, (4.29 ± 1.06) points, t = 5.73, 4.76, both P < 0.001]. At T3, the levels of prostaglandin E2 and 5-hydroxytryptamine in the high-position group [(35.38 ± 6.12) mg/L, (0.59 ± 0.09) μmol/L] were significantly lower than those in the conventional group [(44.91 ± 6.72) mg/L, (0.63 ± 0.13) μmol/L, t = 8.12, 1.96, P < 0.001, P = 0.026]. Conclusion:Ultrasound-guided high-position FICB exhibits a favorable application effect in anesthetizing older adult patients undergoing hip fracture surgery. It effectively shortens the onset time of nerve block, stabilizes hemodynamic indicators, and alleviates pain.

Objective To observe the changes in intradiscal internal internal pressure before and after percutaneous nucleoplasty (PN) in the patients with discogenic low back pain (DLBP),and to explore the mechanism of PN for alleviating DLBP.Methods Thirty patients definitely diagnosed as DLBP undergoing PN in the orthopedic department of this hospital from June 2023 to October 2023 were selected.The internal pressure of the lumbar disc was measured before and after the surgery.The visual analog scale (VAS),Japa-nese orthopedic association score (JOA) and Oswestry disability index (ODI) were used to assess the pain level of the patients before operation and at postoperative 1 d,1 month,3 months.The surgical efficacy was e-valuated by using the modified MacNab criteria.The linear correlation analysis was used to observe the relation-ship between the internal pressure of lumbar disc and changes in each pain score,and the factors possibly affecting postoperative effect was analyzed by using the multivariate logistic regression analysis.Results Compared with be-fore the surgery,the immediate postoperative internal pressure of lumbar disc in the patients was significantly decreased.The JOA scores at postoperative 1 d,1 month and 3 months were significantly increased,while the VAS and ODI scores were significantly decreased,and the differences were statistically significant (P<0.05). The excellent rates of surgical efficacy at postoperative 1 d,1 month and 3 months were 66.7％,73.3％ and 63.3％,respectively.The internal pressure of lumbar disc difference value between before operation and on postoperative 1 d and internal pressure of lumbar disc decrease rate had no significant correlation with the change value of each pain score (P>0.05).The multivariate logistic regression analysis showed that the dis-ease duration and the decrease rate of internal pressure of lumbar disc were the influencing factors of clinical efficacy in PN (P<0.05).Conclusion The occurrence of DLBP may be related with the increase of internal pressure of lumbar disc.PN could effectively reduce internal pressure of lumbar disc and achieve the goal of pain relief.

OBJECTIVE: To explore the genetic basis for an individual with a para-Bombay phenotype. METHODS: A proband with mismatched forward and reverse serotypes for the ABO blood group was identified. Weakly expressed ABH blood type antigen on the surface of red blood cells was verified by absorption and release test, and the blood group substances in saliva was detected by sialic acid test. Exons 6 and 7 of the ABO gene and exons of the FUT1 and FUT2 genes were subjected to direct sequencing. RESULTS: The proband was found to be of O type by forward ABO serotyping and AB type by reverse ABO serotyping, though H and substance A and B were detected in her saliva. DNA sequencing revealed that she has harbored c.35C/T, c.328G/A, and c.504delC compound heterozygous variants of the FUT1 gene. Haploid analysis showed that her FUT1 genotype was h328A/h35T+504delC, which has been uploaded to the NCBI website (No. MW323551). CONCLUSION The para-Bombay phenotype of the proband may be attributed to the novel compound heterozygous variants including c.504delC of the FUT1 gene, which may affect its function by altering the activity of FUT1 glycotransferase.
ABO Blood-Group System/genetics* ; Alleles ; China ; Female ; Fucosyltransferases/genetics* ; Genotype ; Humans ; Phenotype

Objective:To investigate the effect of oblique lateral lumbar intervertebral fusion (OLIF) on inflammatory factors in patients with degenerative spinal canal stenosis (DLSS).Methods:Retrospective analysis of clinical data of 64 DLSS patients in the department of orthopedics, Jizhong Energy Fengfeng Group Hospital from June 2016 to June 2018 was performed. There were 35 males and 34 females, aged (60.70±6.27) years, and the age range was 20 to 80 years. According to the different surgical methods, they were divided into posterior decompression and internal fixation fusion (PLIF) group ( n=32) and OLIF group ( n=32). The coperation time, intraoperative bleeding volume, postoperative bed rest time, hospitalization time , the back and leg pain visual analogue score (VAS) , Japanese Orthopaedic Association(JOA) score of lumbar vertebrae and serum inflammatory factors [tumor necrosis factor-alpha(TNF-α), interleukin-1alpha(IL-1α), C-reactive protein(CRP)] were observed at preoperative, 3 months and last follow-up. Follow-up using outpatient examination and telephone interview was performed and survial up to March 2019. Measurement data were expressed as mean±standard deviation ( Mean± SD), comparison between groups was performed using independent sample t test or analysis of variance of repeated measurement data. Internal comparisons were performed using paired t tests. Count data were expressed as percentage (%), and χ2 test was used. Results:There was no significant difference in operation time between OLIF group and PLIF group ( P>0.05). In OLIF group, the amount of blood loss (119.72±30.41) mL, bedridden time (2.16±0.35) d and postoperative hospital stay (5.18±2.06) d were significantly lower than that of PLIF group[(318.26±94.62) mL, (3.17±0.54) d, (7.35±1.24) d], the differences between the two groups were statistically significant( P<0.05). All patients were followed for 8 months. The 3 months after operation and last follow-up, the VAS scores of back pain in OLIF group [(1.93±0.54) scores, (1.74±0.63) scores]were significantly lower than that in PLIF group [(4.05±0.62) scores, (3.87±0.74) scores]. The VAS scores of leg pain in OLIF group [(1.56±0.71) scores, (1.37±0.52) scores] were significantly lower than that of PLIF group [(3.74±0.79) scores, (2.53±0.59) scores]. The JOA scores of lumbar vertebrae in PLIF group [(22.57 ±1.83) scores, (24.38±1.65) scores] were significantly higher than that of PLIF group [(20.35±1.78) scores, (22.14±1.35) scores], the differences between the two groups were statistically significant( P<0.05). At 3 months after operation, the levels of serum TNF-α(16.95±3.92) ng/L, IL-1α(9.17±3.78) ng/L and CRP (1.97±0.24) mg/L in OLIF group were significantly lower than those in PLIF group [(20.46 ±4.27) ng/L, (11.51±4.25) ng/L, (2.36±0.32) mg/L]. Last follow-up, the level of serum TNF-α(13.47±3.54) ng/L, IL-1α(6.52±2.09) ng/L and CRP (1.42±0.16) mg/L in the OLIF group were significantly lower than those in the PLIF group [(18.08±3.84) ng/L, (8.73±5.43) ng/L, (2.04±0.25) mg/L], the differences between the two groups were statistically significant ( P<0.05). Conclusion:Compared with PLIF, OLIF can reduce the amount of intraoperative bleeding, shorten the recovery time, reduce the expression of inflammatory factors and improve the prognosis of patients with DLSS.

Objective:To analyze the mutation sites and characteristics of phospholipase CE1( PLCE1) gene in children with primary nephrotic syndrome(PNS) in Zhuang, Guangxi, China, so as to explore the expression status of PLCE1 protein in peripheral blood of PNS patients. Methods:(1)Blood samples of 154 Zhuang children with PNS and 98 healthy children of Zhuang nationality from July 2015 to September 2017 in Affiliated Hospital of Youjiang Medical College for Nationalities were collected to sequence PLCE1 gene with FastTarget target gene capture method in the combination with next generation sequencing.Based on the comparison between mutation results and information from the database, the pathogenicity, phenotype and distribution characteristics of these mutation sites were discovered and appraised.(2)The concentration of PLCE1 protein in serum samples were measured by enzyme-linked immuno sorbent assay, then the data of PNS group and healthy control group were compared and analyzed statistically with SPSS 25.0. Results:(1)A total of 18 low-frequency mutations of PLCE1 were observed, 5 of them(c.670C>T, c.578T>C, c.923G>T, c.4916C>T, and c. 5927_5929del) were found only in the PNS group, and 3 of them occurred in both PNS group and healthy control group: c.176C>T, c.389T>C, and c. 4304C>T.Five newly discovered mutations (c.923G>T, c.958T>A, c.1151C>T, c.2341A>G, and c. 3592G>C)were discovered and only c. 923 G>T is pathogenic mutation of PLCE1.(2)The concentration of PLCE1 protein in healthy control group was 414.65 (231.20, 729.81) ng/L and the level of PLCE1 in PNS group was 237.84 (116.14, 535.85) ng/L, ( Z=-3.212, P<0.001), and the value of PNS group was lower than that in the healthy control group. Conclusions:(1)As a new pathogenic mutation of PLCE1, c.923G>T was found.(2)The phenotype of PLCE1 gene mutation in Zhuang children with PNS was diverse, and they may differ by race and region.(3) PLCE1 protein of serum may act as a protective protein to guarantee various life activities of cells by participating in multiple signal transduction pathways.

Objective:To explore the application value of asthma prediction index (API) in the management of young wheezing children in primary hospitals.Methods:From July 2014 to December 2016, 137 children with recurrent wheezing diagnosed and treated in the People's Hospital of Qidong were selected for API evaluation.Forty-six children with positive API (treatment group) were given standardized treatment for childhood asthma, 43 patients with API positive (observation group) and 48 patients with API negative (control group) were given routine treatment (intermittent anti-inflammatory and antiasthmatic treatment). All children were given breathing nursing education and management, followed up to observe breathing control.Results:One child in the treatment group was withdrawn from the cohort, and the complete remission rates in the treatment group, observation group and control group were 86.7% (39/45), 9.3% (4/43) and 43.8% (21/48), respectively.The complete response rate in the treatment group and control group was higher than that in the observation group, and the differences were statistically significant (χ 2=53.39, 14.78, all P<0.05). Conclusion:API can effectively help pediatricians in primary hospitals to manage young wheezing children and improve the complete remission rate.

The small ubiquitin-like modified protein (SUMO) is a protein structurally similar to ubiquitin which is involved in post-translational modification of proteins. SUMOylation refers to the process that SUMO molecule covalently binding to the specific lysine site of target proteins through maturation, activation, binding and ligation by ubiquitin-like specific protease 1 (Ulp1), E1 activating enzyme, E2 binding enzyme, and E3 ligase. SUMOylation alters the activity of target proteins, which is involved in the regulation of various cellular functions such as transcriptional regulation, regulation of embryonic development, cellular stress, maintenance of chromatin structure and genomic stability. In recent years, it has been found that SUMOylation modification is also widely involved in DNA damage repair, especially DNA double-strand breaks (DSBs), which are the most serious types of DNA damage. SUMOylation is involved in almost all processes of DSBs repair, so its role in DNA damage repair has become a research hotspot. In this paper, the research progress of the regulation of SUMOylation in DSBs repair was reviewed.

OBJECTIVETo study a case with weak D59 phenotype identified among ethnic Han Chinese population.

METHODSRoutine serological tests were used to analyze the reaction patterns, and the RhD epitopes were verified with 12 monoclonal antibodies. Sequence-specific primer PCR was applied for typing the weak RhD and RhD zygosity in the proband and his family members.

RESULTSA c.1148T>C variant was identified in the proband, for which serological test indicated a weak D phenotype. RHD zygosity testing confirmed that the proband had a RHD+ /RHD- genotype.

CONCLUSIONA weak D59 phenotype was firstly identified in a Chinese individual.

Asian Continental Ancestry Group ; genetics ; China ; ethnology ; Humans ; Male ; Middle Aged ; Phenotype ; Rh-Hr Blood-Group System ; genetics

Objective To investigate the characteristics of cognitive development of children with attention deficit hyperactivity disorder (ADHD) by using resting-state functional magnetic resonance imaging (fMRI) degree centrality (DC) from the view of neuro-imaging.Methods Forty-five ADHD children were diagnosed at specialist clinic of Changzhou Children's Hospital,Nantong University from June 2015 to December 2016,and they were divided into 3 groups according to their ages (children aged 7-8 years old,9-10 years old and 11-12 years old,15 children in each group) and received the resting-state fMRI scans.DC value was used to analyze fMRI data.Comparative analysis was done pairwise between the three groups.Results Compared with 7-8 years old group,9-10 years old group showed lower DC value in cerebellum posterior lobe (t =-4.36) and higher DC in inferior parietal lobe (t =-5.86),and the differences were statistically significant (all P ＜ 0.05,after correction).Compared with 7-8 years old group,11-12 years old group showed lower DC value in cerebellum posterior lobe (t =-4.99) and higher DC in left superior temporal gyrus (t =5.18) and superior frontal gyrus (t =4.58),and the differences were statistically significant (all P ＜ 0.05,after correction).Compared with 9-10 years old group,11-12 years old group showed lower DC value in inferior parietal lobe (t =-5.71) and higher DC value in left superior temporal gyrus (t =5.05) and superior frontal gyrus (t =4.36),and all the differences were statistically significant (all P ＜ 0.05,after correction).Conclusion Children with ADHD at different ages had different characteristics of brain regions of fMRI.It can offer objective evidence for early cognitive intervention of children with ADHD at different ages.

Objective To investigate the dynamic changes of gene expressions in mouse jejunum after lethal dose abdomen irradiation (ABI).Methods RNA was extracted from mouse jejunum at 0 and 6 h,3.5 and 5 d after 14 Gy 137Cs γ-ray ABI and then subjected to RNA-sequence analysis.Gene with expressions changed more than 2-fold of control were identified as differentially expressed ones.The selected genes were subsequently analyzed using IPA,Funrich,GO and KEGG software.Results Gene analysis of mouse jejunum samples showed that radiation activated p53 pathway at 6 h and 3.5 d after ABI.Interaction network analysis of genes suggested that Lck,Cdkl and Fyn,genes could play an important role in jejunum damage at 3.5 d after ABI.The gene expression profiles demonstrated that ABI up-regulated DNA damage repair pathways and down-regulated cell adhesion molecules,focal adhesion and IgA production pathways.Conclusions The p53 signaling pathway and some key genes such as Lck,Cdkl,and Fyn may contribute to the radiation-induced intestinal injury.