Objective:To investigate the factors influencing the decision to delivery interval (DDI) in emergency cesarean section in Guangzhou and the impact of DDI on maternal-infant outcomes.Methods:A retrospective study was conducted on clinical data of pregnant women who underwent emergency cesarean section at municipal and district maternal and child health hospitals in Guangzhou city in 2021. Per the classification method of emergency cesarean section and recommendations for DDI provided by National Institute for Health and Clinical Excellence guidelines, these subjects were classified into Category Ⅰ and Category Ⅱ cesarean sections. Each category was further divided into two subgroups based on DDI: the Category Ⅰ group into >30 min and ≤30 min subgroups, and the Category Ⅱ group into >75 min and ≤75 min subgroups. Chi-square test or Fisher's exact test, two independent samples t-test, Mann-Whitney U test, and logistic regression were used to analyze the potential factors influencing DDI and the impact of DDI on maternal-infant outcomes. Results:(1) Totally 502 women underwent urgent cesarean section, including 304 (60.6%) Category Ⅰ and 198 (39.4%) Category Ⅱ, were analyzed. Among the Category Ⅰ group, 30.3% (92/304) achieved a DDI of ≤30 min, while 37.4% (74/198) of Category Ⅱ cases had a DDI of ≤75 min. (2) For the Category Ⅰ cases, multivariate logistic regression showed that more patients under intravertebral anesthesia, than those under general anesthesia, had a DDI >30 min ( OR=14.04, 95% CI: 6.14-32.10) as well as more with ward-based emergencies than those with delivery room emergencies ( OR=3.21, 95% CI: 1.72-6.00, both P=0.001). Among the Category Ⅱ cases, logistic regression revealed that cesarean section during routine working hours was more likely to achieve DDI >75 min than that during resting hours ( OR=3.93, 95% CI: 2.03-7.63, P=0.001). The risk of DDI >75 min was higher in tertiary maternal and child health hospitals compared with secondary maternal and child health hospitals ( OR=2.45, 95% CI: 1.06-5.70, P=0.037). (3) Among the Category Ⅰ cases, compared with the DDI ≤30 min group, the DDI >30 min group had a lower risk of neonatal Apgar score ≤7 at 1 min ( OR=0.31, 95% CI: 0.14-0.69, P=0.004), but there was no significant difference in the risk of neonatal Apgar score ≤7 at 5 min ( OR=0.21, 95% CI: 0.04-1.17) or neonatal asphyxia ( OR=0.32, 95% CI: 0.07-1.44) between the two subgroups. In cases of Category Ⅱ cesarean sections, there was no significant difference in any maternal-infant outcomes between DDI ≤75 min and DDI >75 min subgroups. Conclusions:The location of emergency and types of anesthesia are the influencing factors of DDI for Category Ⅰ cesarean sections, while the operation time and level of maternal and child health hospital are the influencing factors of DDI for Category Ⅱ cesarean sections. We did not find any impact of DDI on maternal or infant outcome.

Abstract: Objective To investigate the molecular characteristics of the H9N2 avian influenza virus (AIV) causing human infection in Yunnan Province in 2019, and to provide the scientific basis for the prevention and control of avian influenza in Yunnan Province. Methods Influenza virus typing was performed by real-time RT-PCR in two influenza-like illness samples, and the Illumina Miseq high-throughput sequencer was used to determine the viral genome sequence. HA and NA gene sequence alignment and phylogenetic tree construction were performed using Mega7.0 software. Results Real-time RT-PCR results showed that two influenza-like illness samples were positive for H9N2 subtype. The full length of HA and NA were obtained by genomic sequencing. Sequence system evolution analysis showed that the HA and NA of the two AIVs in Yunnan Province were in the same evolutionary clade as A/Chicken/Zhejiang/HJ/2007 and belonged to the G57 type. The HA nucleotide and amino acid homology of the two AIVs were 93.92% and 95.00%, respectively, and the NA nucleotide and amino acid homology was 93.31% and 82.03%, respectively. The nucleotide (amino acid) homology of HA was 92.29%-96.94% (93.77%-98.43%) and 92.84%-94.92% (94.18%-96.23%), respectively, and NA nucleotide homology (amino acid) were 91.81%-97.60% (77.82%-94.83%), 94.38%-97.22% (85.47%-94.55%), respectively, compared with that of human infected H9N2 epidemic strains obtained in China from 2015 to 2020. Both AIVs HA protein cleavage site sequences were PSRSSR↓GLF, which was in line with the characteristics of low pathogenic influenza. The analysis of HA protein receptor binding site showed that amino acids at positions 109, 161, 163, 191, 202, 203 and 234 were consistent with the reference strains, while amino acids at position 198 were mutated to T. N166D and 168N mutations were also found in HA protein, and both AIVs had 7 potential glycosylation sites. Analysis of the erythrocyte binding site of NA gene found that there were amino acid mutations at positions 369, 402, 403, and 432, and amino acid deletion at positions 63-65 was found in the NA genes. There were 4 and 5 potential glycosylation sites in the two AIVs, respectively, and no drug resistance site mutations were found. Conclusions　The receptor binding sites, erythrocyte binding sites and glycosylation sites of HA and NA genes of H9N2 AIV in Yunnan Province have different degrees of variation, and monitoring and prevention and control should be strengthened.

Here,a styrene-based polymer monolithic column poly(VBS-co-TAT-co-AHM)with reversed-phase/hydrophilic interaction liquid chromatography(RPLC/HILIC)bifunctional separation mode was success-fully prepared for capillary electrochromatography by the in situ polymerization of sodium p-styrene sulfonate(VBS)with cross-linkers 3-(acryloyloxy)-2-hydroxypropyl methacrylate(AHM)and 1,3,5-triacryloylhexahydro-1,3,5-triazine(TAT).The preparation conditions of the monolith were optimized.The morphology and formation of the poly(VBS-co-TAT-co-AHM)monolith were confirmed by scanning electron microscopy(SEM)and Fourier transform infrared spectroscopy(FT-IR).The separation perfor-mances of the monolith were evaluated systematically.It should be noted that the incorporation of VBS functional monomer can provide π-π interactions,hydrophilic interactions,and ion-exchange in-teractions.Hence,the prepared poly(VBS-co-TAT-co-AHM)monolith can achieve efficient separation of thiourea compounds,benzene series,phenol compounds,aniline compounds and sulfonamides in RPLC or HILIC separation mode.The largest theoretical plate number for N,N'-dimethylthiourea reached 1.7×105 plates/m.In addition,the poly(VBS-co-TAT-co-AHM)monolithic column showed excellent reproducibility and stability.This novel monolithic column has great application value and potential in capillary electrochromatography(CEC).

OBJECTIVE: To study the polymorphism of human platelet antigen (HPA) system 10 among ethnic Han Chinese from Shandong, China so as to supplement the data of platelet donor bank in the region. METHODS: Peripheral blood samples of platelet donors from the region were genotyped for HPA-10 alleles by PCR-sequence specific primer (PCR-SSP) and direct sequencing. RESULTS: Among 1401 donors, a rare heterozygote carrier of HPA-10w (a+b+) was identified, which gave an allelic frequency of approximately 0.035%. CONCLUSION The detection of rare HPA-10bw antigen allele among ethnic Han Chinese from Shandong is useful for the diagnosis and prevention of neonatal alloimmune thrombocytopenia and post-transfusion purpura in the region.
Alleles ; Antigens, Human Platelet/genetics* ; Asians/genetics* ; Gene Frequency ; Genotype ; Humans ; Infant, Newborn ; Polymorphism, Genetic

The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral specialists. The expert consensus was conducted to summarize the diagnostic work-up for difficult and complicated oral ulcers, based on factors such as detailed clinical medical history inquiry, histopathological examination, and ulceration-related systemic diseases screening. Not only it can provide a standardized procedure of oral ulceration, but also it can improve the diagnostic efficiency, in order to avoid misdiagnosis and missed diagnosis.
Consensus ; Humans ; Oral Ulcer/therapy*

Management of bone defects caused by fractures，bone tumors or infections is clinically difficult as well as a hot topic in current studies. With further researches over bone defects，the construction of tissue-engineered bone has played a great role in the treatment of bone defects. Blood vessels not only provide the necessary nutritional mineral salts，growth factors，hormones for bone formation，also are able to mediate the interaction among osteoblasts and osteoclasts，osteocytes，bone autonomic nerve and endothelial cells，since bone formation exist spatially and temporally connection with angiogenesis. Therefore，the authors make a systematic literature review on the research progress of the coupling mechanism of angiogenesis and osteogenic differentiation，blood vessels and related signal pathways on osteogenic differentiation and angiogenesis-related molecules in osteogenic differentiation during the process of traumatic bone defects，so as to provide new ideas for the treatment of bone defects.

Plasticity in the glutamatergic synapses on striatal medium spiny neurons (MSNs) is not only essential for behavioral adaptation but also extremely vulnerable to drugs of abuse. Modulation on these synapses by even a single exposure to an addictive drug may interfere with the plasticity required by behavioral learning and thus produce impairment. In the present work, we found that the negative reinforcement learning, escaping mild foot-shocks by correct nose-poking, was impaired by a single in vivo exposure to 20 mg/kg cocaine 24 h before the learning in mice. Either a single exposure to cocaine or reinforcement learning potentiates the glutamatergic synapses on MSNs expressing the striatal dopamine 1 (D1) receptor (D1-MSNs). However, 24 h after the cocaine exposure, the potentiation required for reinforcement learning was disrupted. Specific manipulation of the activity of striatal D1-MSNs in D1-cre mice demonstrated that activation of these MSNs impaired reinforcement learning in normal D1-cre mice, but inhibition of these neurons reversed the reinforcement learning impairment induced by cocaine. The results suggest that cocaine potentiates the activity of direct pathway neurons in the dorsomedial striatum and this potentiation might disrupt the potentiation produced during and required for reinforcement learning.

Objective: To study the application value of augmented-reality (AR) surgical navigation technology combined with indocyanine green (ICG) molecular fluorescence imaging in three-dimensional (3D) laparoscopic hepatectomy. Methods: The clinical data of forty-eight patients who had undergone 3D laparoscopic hepatectomy for hepatocellular carcinoma at First Department of Hepatobiliary Surgery, Zhujiang Hospital, Southern Medical University from January 2018 to April 2019 were retrospectively analyzed.The patients were divided into two groups: the group of 3D laparoscopic hepatectomy navigated by augment reality technology combined with ICG molecular fluorescence imaging (Group A) , and group of conventional 3D laparoscopic hepatectomy (Group B) . Patients in Group A (n=23) underwent 3D laparoscopic hepatectomy using augmented-reality technology combined with ICG molecular fluorescence imaging. In this group, the self-developed three-dimensional laparoscopic augmented-reality surgical navigation system (No. 2018SR840555) was operated to project the preoperative three-dimensional model to the surgical field, and the use of this system in combination with ICG molecular fluorescence imaging navigated laparoscopic hepatectomy. No surgical navigation technology was applied in Group B (n=25) . All patients signed the informed consent, which were in accordance with the requirements of medical ethics (Ethics No.: 2018-GDYK-003) . The preoperative data, surgical indicators and postoperative complications between the two groups were compared and analyzed. Results: The median amount of intraoperative blood loss of Group A was 250 (200) ml (M (Q_R) ) , which was significantly lower than that of Group B (300 (150) ml) (Z=-2.307, P=0.021) .The transfusion rate of Group A was 13.0% (3/23) , which was significantly lower than that of Group B (40.0%, 10/25) (χ²=4.408, P=0.036) .The median postoperative hospitalization time of Group A was 8 (2) d, which was significantly shorter than that of Group B (11 (6.5) d) (Z=-2.694, P=0.007) . There were no serious complications and perioperative death in both groups.The incidence of postoperative complications in Group A was 17.4% (4/23) , which was not significantly different from that in group B (28%, 7/25) (χ²=0.763, P=0.382) . Conclusion Augmented-reality surgical navigation technology combined with ICG molecular fluorescence imaging has better effect in 3D laparoscopic hepatectomy.

Objective: To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture. Methods: From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same group of doctors at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right. The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment-Achilles(VISA-A), the Achilles tendon Total Rupture Score(ATRS) and the Tegner Activity Score of patients were collected and compared by paired-t test. Results: The patients were followed up for (45.6±17.2) months (range:17-28 months).No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow-up,the VAS decreased from 1.0(2.0) (M(Q_R) preoperative to 0.0(0.8)(Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359, P=0.00), VISA-A increased from 51.3±9.8 to 87.8±18.0(t=-17.656, P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=-12.524, P=0.00) and ATRS increased from 40.0±3.5 to 97.9±3.9(t=-64.133, P=0.00). Twenty-eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner-Lindholm curative effect evaluation criteria, 32 cases(91.4%) gained the excellent results, 1 case (2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%.All except 2 patients with bad results could perform a single-limb heel rise painlessly. Conclusions Primary repair is an efficient approach for chronic Achilles tendon rupture.The mid-and-long curative effect is satisfactory and stable. Compared with other surgical techniques, operation is relatively simple and economical.The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.

Objective To examine the surgical method and clinical outcome of primary repair of chronic Achilles tendon rupture. Methods From March 2012 to August 2017, clinical data of 35 consecutive patients with chronic Achilles tendon rupture who were treated with primary repair by the same group of doctors at Department of Sports Medicine, Peking University Third Hospital were retrospectively analyzed.There were 29 males and 6 females with age of (41.0±9.3)years(range:29-65 years). All the patients had unilateral tendon rupture with 22 cases on the left and 13 cases on the right. The preoperative and postoperative Visual Analogue Scale(VAS), American Orthopaedic Foot and Ankle Society Ankle?Hindfoot Score(AOFAS), the Victorian Institute of Sport Assessment?Achilles(VISA?A), the Achilles tendon Total Rupture Score(ATRS) and the Tegner Activity Score of patients were collected and compared by paired?t test.Results The patients were followed up for (45.6±17.2)months(range:17-28 months).No serious postoperative complications such as infection or nerve damage and rerupture outcomes were reported. At the last follow?up, the VAS decreased from 1.0(2.0) (M(QR) preoperative to 0.0(0.8) (Z=-3.586, P=0.00), AOFAS increased from 64.3±12.5 to 97.0±5.0(t=-14.359, P=0.00), VISA?A increased from 51.3±9.8 to 87.8±18.0(t=-17.656,P=0.00), Tegner increased from 0.9±0.3 to 4.6±1.7(t=-12.524,P=0.00) and ATRS increased from 40.0 ± 3.5 to 97.9 ± 3.9(t=-64.133, P=0.00). Twenty?eight patients (80.0%) had returned to their preinjury activity levels, and 7 patients (20.0%) no longer participate in recreational sports. According to Arner?Lindholm curative effect evaluation criteria, 32 cases(91.4%) gained the excellent results, 1 case (2.9%) of good and 2 cases(5.7%) bad, and the percentage of the cases with the excellent or good results was 94.3%.All except 2 patients with bad results could perform a single?limb heel rise painlessly.Conclusions Primary repair is an efficient approach for chronic Achilles tendon rupture.The mid?and?long curative effect is satisfactory and stable. Compared with other surgical techniques, operation is relatively simple and economical.The primary repair is considerably safe, with few serious complications such as infection or nerve damage and reruptures.