Objective:To assess the clinical value of helium-free magnetocardiography(MCG) in the diagnosis of coronary artery disease(CAD).Methods:A total of 213 patients with suspected CAD undergoing MCG in Beijing Anzhen Hospital were enrolled in the study. All patients underwent coronary CT angiography/invasive coronary angiography(CCTA/ICA) within 48 hours after MCG scanning. The parameters of MCG, including magnetic field multipolarization, magnetic field unipolarization, T-wave flattened, change in magnetic field distribution at TT segment, abnormal T-peak amplitude ration of maximum to minimum, significant movement of poles, magnetic field angle deviation and abnormal distribution of positive pole were used for the evaluation of the stenosis of coronary arteries.Results:Among 213 patients, MCG scanning was completed in 193 cases(90.6%), while 20 cases were excluded for various reasons. The CCTA/ICA results were taken as gold standard, the total coincidence rate of MCG with the degree of stenosis was 88.60%(95% CI: 83.25%-92.72%), the sensitivity and specificity of MCG in the diagnosis of CAD was 89.63%(95% CI: 83.21%-94.21%) and 88.23%(95% CI:78.12%-94.78%), respectively; the positive and negative predictive value were 93.80%(95% CI:88.72%-96.68%) and 81.08%(95% CI:72.15%-87.64%), respectively. Conclusion:MCG is highly accurate in the diagnosis of CAD, it may be widely used clinically as an non-invasive method free of radiation or contrast agent.

Objective:To systematically evaluate the clinical efficacy and safety of Xixian Tongshuan Capsules/Pills combined with Western medicine in treating cerebral infarction.Methods:All RCTs about Xixian Tongshuan Capsules/Pills combined with Western medicine in treating cerebral infarction were retrieved from CNKI, Wanfang Database, VIP database, PubMed and CBM. The search period was from the database establishment to December 31, 2021. Two researchers independently extracted the basic literature data and evaluated the methodological quality, then used RevMan5.4 software for meta-analysis.Results:Totally 9 articles were included, involving a total of 988 patients, including 505 cases in the observation group and 483 cases in the control group. Meta-analysis showed that the total effective rate of Xixian Tongshuan Capsules/Pills combined with Western medicine in treating cerebral infarction was higher than that of conventional Western medicine [ RR=1.20, 95% CI (1.13, 1.27), P<0.05]. At the same time, the effect of NIHSS score, Barthel score and FIB were better than those of conventional Western medicine [respectively: MD=-3.21, 95% CI (-4.45, -1.97), P<0.05; MD=11.83, 95% CI (10.66, 13.00), P<0.05; MD=-0.95, 95% CI (-1.36, -0.54), P<0.05]. After treatment with Xixian Tongshuan Capsules/Pills combined with Western medicine, the adverse reactions mainly included dizziness, nausea, indigestion, rash, facial blushing, etc. There was no statistically significant difference in safety between the two groups [ RR=1.50, 95% CI (0.75, 3.01), P>0.05]. Conclusions:Under the treatment of conventional Western medicine, the addition of Xixian Tongshuan Capsules/Pills can improve the clinical efficacy of cerebral infarction treatment, effectively improve the symptoms of neurological impairment, improve the ability of daily life, and promote the prognosis and recovery, and without increasing the incidence of adverse reactions. However, large sample and high quality studies are still needed to support the conclusion.

The clinical manifestations, biochemical parameters and imaging examination, genetic test results, and treatment of 3 cases of X-linked adrenoleukodystrophy(X-ALD) patients were reviewed and analyzed, and the structure of adrenoleukodystrophy protein(ALDP) was analyzed. All 3 patients were male. Patients 1 and 2 were childhood cerebral ALD(CCALD), patients 3 was adrenomyeloneuropathy(AMN), and all of them were misdiagnosed at early stage. Brain magnetic resonance imaging(MRI), and hematologic examinations showed the neurological demyelination of X-ALD, adrenocortical insufficiency, and accumulation of very long chain fatty acids(VLCFAs). Sequencing of ABCD1 gene revealed 3 new pathogenic mutations[c.910delins22(p.A304delins8), c. 887A>C(p.Y296S), and c. 1451_1481del(p.P484fs)], which affected the key structure of ALDP and led to the disease. Patients 1 and 2 received hematopoietic stem cell transplantation, and their condition continued to progress after surgery. Patient 3 was in stable condition. The misdiagnosis rate of X-ALD is high, clinicians should be vigilant. In this study, 3 new mutations were found, which expanded the ABCD1 gene mutation spectrum in patients with X-ALD. It is important to note that early identification and early diagnosis of X-ALD should be made to reduce misdiagnosis and mistreatment.

Objective:To explore the differences of risk stratification of very high-risk or extreme high-risk atherosclerotic cardiovascular diseases (ASCVD) and the attainment rates of low-density lipoprotein cholesterol (LDL-C) management targets evaluated by three different criteria, and the causal attributions of these differences.Methods:Patients with ASCVD were consecutively enrolled from January 1 to December 31 in 2019, and were evaluated for very high-risk or extreme high-risk and LDL-C goal attainment rates with 2018 American guideline on the management of blood cholesterol (2018AG), 2019 China Cholesterol Education Program (CCEP) Expert Advice for the management of dyslipidemias (2019EA) and 2020 Chinese expert consensus on lipid management of very high-risk ASCVD patients(2020EC), respectively. The causal attributions of the differences in attainment rates were analyzed as well.Results:A total of 1 864 ASCVD patients were included in this study. According to 2018AG, 2019EA and 2020EC, the proportions of the patients with very high-risk or extreme high-risk were 59.4%, 90.7%, and 65.6%, respectively. The absolute LDL-C target attainment rates were 37.2%, 15.7%, and 13.7%, respectively, the differences between each two rates were statistically significant (all P<0.001). As to the differences in attainment rates between 2020EC and 2018AG, 61.5% were due to the different LDL-C goal attainment values and 38.5% were caused by the different risk stratifications, while for the differences between 2020EC and 2019EA attainment rates, different LDL-C goal attainment values were responsible for 13.2%, and different risk stratifications were responsible for 86.8% of the differences. Conclusions:There are significant differences in the proportions and LDL-C attainment rates among the three different criteria for very high-risk or extreme high-risk ASCVD. 2020EC showed a moderate proportion of patients with extreme high-risk, and had the lowest LDL-C attainment rate. The differences between 2020EC and 2018AG are mainly due to the LDL-C target values, and the differences between 2020EC and 2019EA are mainly caused by the risk stratifications.

The etiology of 46, XY disorders of sex development is complex and the clinical manifestations are various. Patients with a female phenotype often present with primary amenorrhea during adolescence, which is difficult to find. We analyze the clinical features of 3 cases of female phenotype diagnosed by gene sequencing. The pathogenesis, clinical manifestations, diagnosis, and treatment were reviewed.

Objective: In view of the difficulty of the shortage of new coronavirus nucleal acid test in the early COVID-19 outbreak, to explore the application value of chest CT in screening COVID-19 patients. Methods: Retrospective analysis was performed on the data of patients with fever who received chest CT and new coronavirus nucleal acid test during January 25, 2020 to February 2, 2020 in Zhongnan Hospital of Wuhan University. A total of 587 patients were enrolled, including 290 males and 297 females, aged from 11.0 to 96.0 (51.3±17.1) years old. Take the nucleic acid test results as the gold standard, the sensitivity, specificity and rate of missed diagnosis of CT screening COVID-19 were calculated. Results: Among the 587 patients, there were 433 positive cases (73.8%, 433/587) and 154 negative cases (26.2%, 154/587) of novel coronavirus nucleic acid test. Using CT screening, 494 cases (84.2%, 494/587) were positive and 93 cases (15.8%, 93/587) were negative. The sensitivity of CT screening COVID-19 was 97.7% (423/433), specificity was 53.9% (83/154) and rate of missed diagnosis was 2.3% (10/433). Conclusions In the early COVID-19 outbreak, CT screening has the advantages of high sensitivity and low rate of missed diagnosis of COVID-19, which can compensate for the shortage of new coronavirus nucleal acid test and can be used as the basis for rapid screening for early prevention and control of COVID-19 outbreak.

Objective:To investigate the curative effect of Doppler ultrasound-guided management of vascular injury of Gartland type Ⅲ supracondylar fractures of humerus in children.Methods:A prospective study on 18 children with vascular complications of pulseless Gartland type Ⅲ supracondylar humeral fracture who were admitted at Department of Pediatric Orthopedic Surgery, Wuhan Children′s Hospital from March 2017 to March 2018 was conducted.Among these children, 12 were male and 6 were female, with the age of 2.1-8.6 years (mean 4.4 years old), and 10 cases were injured on the left and 8 cases on the right.All patients were satisfied with closed reduction and internal fixation within 24 hours after injury.Before the operation, Doppler ultrasound was performed to determine the shape of brachial artery and it relationship with fracture.During reduction, Doppler ultrasound was used to assess brachial pulse and blood perfusion.Then, the brachial artery was assessed by palpable radial pulse and peripheral blood supply, and elbow joint function was evaluated with Mayo Elbow Performance Score and Flynn criteria.Results:Eighteen patients were followed up for 6 to 12 months (average 9 months) after operation.Before reduction, radial pulse disappeared and peripheral blood supply was good in 18 cases.Preoperative Doppler ultrasonography showed that the brachial artery was located in front of the proximal humerus fracture fragment.A proximal stream of the brachial artery was identified, but the distal blood vessels were compressed by the fragment.A stream of radial artery was identified in 5 patients with Doppler, and no stream was identified in 13 patients.After reduction, the peripheral blood supply of all the affected limbs was good, among which the peripheral blood supply, 1 case returned to normal after 5 minutes waiting.Specifically the palpable radial pulse was immediately restored in 14 patients.The palpable radial pulse did not restore but the peripheral blood supply was good in 4 cases.Intraoperative ultrasonography showed that brachial artery blood flow was good, and palpable radial pulse was restored between 3 to 5 weeks later.In patients with at average sixteen-week neurological follow-up, 5 patients had complete resolution of nerve palsy.No complications such as forearm compartment syndrome and elbow joint dysfunction occurred.Functional outcome as measured by Flynn criteria was excellent in 12 patients, good in 6 patients, the excellent and good rate was 100%.Functional outcome as measured by Mayo Elbow Performance Score was excellent in 17 patients, good in one patient, the excellent and good rate was 100%.Conclusion:Ultrasound-guided is a safe and reliable option to treat pulseless Gartland type Ⅲ supracondylar humeral fracture.

A diblock copolymer, poly(ethylene glycol) methacrylate-block-glycidyl methacrylate (PEGMA-GMA), was prepared on glass substrate by surface-initiated atom transfer radical polymerization (SI-ATRP), and endothelial specific peptide Arg-Glu-Asp-Val (REDV) was immobilized at the end of the PEGMA-GMA polymer brush by ring opening reaction through the rich epoxy groups in the GMA. The structure and hydrophilicity of the polymer brushes were characterized by static water contact angle, X-ray photoelectron spectroscopy (XPS) and atomic force microscopy (AFM). The results showed that the REDV modified copolymer brushes were successfully constructed on the glass substrates. The REDV peptide immobilized onto surface was quantitatively characterized by ultraviolet-visible spectroscopy (UV-VIS). The blood compatibility of the coating was characterized by recalcification time and platelet adhesion assay. The results showed that the polymer coating had good blood compatibility. The multifunctional active polymer coating with PEGMA and peptide produced an excellent prospect in surface construction with endothelial cells selectivity.
Biocompatible Materials ; Cells, Cultured ; Endothelial Cells ; Glass ; Humans ; Immobilized Proteins ; Methacrylates ; Oligopeptides ; Platelet Adhesiveness ; Polyethylene Glycols ; Polymers ; Surface Properties

OBJECTIVE: To explore the mediating role of psychological capital in the sense of occupational mission and work engagement in preschool teachers.METHODS: A method of stratified cluster sampling was used to select 464 preschool teachers from 16 kindergartens in a city of Hubei Province. Occupational Mission Scale, Psychological Capital Questionnaire and Job Involvement Questionnaire were used to investigate their sense of occupational mission, psychological capital and job engagement. RESULTS: The total score of occupational mission was(48.6±6.9); the total score of psychological capital was(87.1±11.8); and the total score of work engagement was(79.8±11.4). Occupational mission was positively correlated with job engagement [correlation coefficient(r) was 0.607, P<0.01].The self-efficacy, hope, tenacity and optimism were positively correlated with job engagement(r were 0.526, 0.544, 0.573, 0.415, respectively, P<0.01). The mediating effect of psychological capital on occupational mission and work engagement was 0.15, accounting for 26.8% of the total effect. CONCLUSION: The sense of occupational mission can directly or indirectly promote job engagement. The psychological capital plays a mediating role between occupational mission and job engagement.

Objective To investigate the effect of suction assisted closure (SAC) in treatment of children's leukemia with refractory ulcers.Methods The clinical data of 15 children who had leukemia associated with refractory ulcers from January 2013 to April 2017 in Department of Orthopedics,Wuhan Children's Hospital,Tongji Medical College of Huazhong University of Science & Technology were retrospectively analyzed.There were 8 males and 7 females,among whom 9 cases were acute non-lymphocytic leukemia and 6 cases were acute lymphoblastic leukemia.Patient's ages ranged from 2 to 9 years old with the mean age of 6.2 years.There were 5 cases of refractory ulcers located in the medial side of thigh and 4 cases in the perineum and around anus,3 cases in the ankle,2 cases in the crus and 1 case in the lateral side of thigh.The refractory ulceration area varied from 2 cm × 3 cm-7 cm × 5 cm,and the depth varied from 0.6-1.8 cm.All the 15 cases were cultured with secretions,including 7 cases of Staphylococcus aureus,4 cases of Escherichia coli,2 cases of Klebsiella pneumoniae,1 case of Pseudomonas aeruginosa,and 1 case with no bacteria detected.These children were transferred from Department of Hematology to Department of Orthopedics when there was no improvement in conventional therapy with the average treatment of 26 d (11-36 d).All of these children underwent SAC after thorough debridement.Secondary suturing of ulcers closure was performed or skin transplantation according to the recovery condition of ulcers.Results All the 15 patients of refractory ulcers achieved fresh granulation tissue after SAC treatment.Ten of them who had refractory ulcers could be sutured directly after once SAC treatment,and 5 cases who had refractory ulcers underwent SAC treatment again,in which 3 cases could be sutured directly,and the other 2 cases needed to reduce the wound area and autologous skin graft.All of these patients had refractory ulcers healed after SAC treatment,without any local or systemic complications.Conclusions SAC can bring the deep refractory ulcers into full drainage,protect the refractory ulcers against contamination,stimulate the growth of granulation tissue.SAC is a simple and effective method in treatment of children's leukemia with refractory ulcers.