Objective:To investigate the correlation between macular cherry red spot (CS) and severity of neurological manifestations in Chinese children with sialidosis (SD) type I.Methods:A evidence-based medical study. "China", "Sialidosis" and "Sialidoses" were used as Chinese and English search terms. The literature was searched in CNKI, Wanfang and PubMed. The cases were all from China and matched the diagnostic criteria. According to the presence or absence of CS in the fundus, the SD children were divided into a group with CS (+) and a group without CS (-), and the correlation between the occurrence of ocular CS and neurological manifestations was compared with meta-analysis by RevMan 5.3 software.Results:Sixty-eight studies were initially retrieved according to the search strategy, and 17 studies were finally included, and 5 studies with CS+ and CS- were meta-analyzed. Among the 43 patients, 28 were male and 15 were female, with a median age of 12 years. Visual impairment was observed in 37 cases (90.2%, 37/41, 2 cases not recorded), and CS was present in 24 cases (55.8%, 24/43). The most common neurological manifestation was myoclonus (97.7%, 42/43), followed by cerebellar ataxia (95.1%, 39/41, 2 cases not recorded) and seizures (91.4%, 32/35, 8 cases not recorded). Pathogenic NEU1 gene mutations were detected in 42 cases and one case was undocumented. The incidence of seizure in group CS+ (100%, 20/20) was higher than that in group CS- (80%, 12/15). Meta-analysis showed that there was no statistically significant difference between the incidence of myoclonus or ataxia [relative risk ( RR)=1.13, 95% confidence interval ( CI) 0.79-1.63, P=0.49] and seizure ( RR=1.13, 95% CI 0.84-2.06, P=0.24) among the children in the CS+ and CS- groups. Conclusions:The incidence of ocular CS in Chinese children with type I SD was 55.8%. There was no correlation with neurological manifestations, however the incidence of seizure was significantly higher in patients with CS than in others without CS.

Myocardial infarction (MI) is one of the leading causes of death in the world. With the improvement of clinical therapy, the mortality of acute MI has been significantly reduced. However, as for the long-term impact of MI on cardiac remodeling and cardiac function, there is no effective prevention and treatment measures. Erythropoietin (EPO), a glycoprotein cytokine essential to hematopoiesis, has anti-apoptotic and pro-angiogenetic effects. Studies have shown that EPO plays a protective role in cardiomyocytes in cardiovascular diseases, such as cardiac ischemia injury and heart failure. EPO has been demonstrated to protect ischemic myocardium and improve MI repair by promoting the activation of cardiac progenitor cells (CPCs). This study aimed to investigate whether EPO can promote MI repair by enhancing the activity of stem cell antigen 1 positive stem cells (Sca-1⁺ SCs). Darbepoetin alpha (a long-acting EPO analog, EPO_anlg) was injected into the border zone of MI in adult mice. Infarct size, cardiac remodeling and performance, cardiomyocyte apoptosis and microvessel density were measured. Lin^- Sca-1⁺ SCs were isolated from neonatal and adult mouse hearts by magnetic sorting technology, and were used to identify the colony forming ability and the effect of EPO, respectively. The results showed that, compared to MI alone, EPO_anlg reduced the infarct percentage, cardiomyocyte apoptosis ratio and left ventricular (LV) chamber dilatation, improved cardiac performance, and increased the numbers of coronary microvessels in vivo. In vitro, EPO increased the proliferation, migration and clone formation of Lin^- Sca-1⁺ SCs likely via the EPO receptor and downstream STAT-5/p38 MAPK signaling pathways. These results suggest that EPO participates in the repair process of MI by activating Sca-1⁺ SCs.
Animals ; Mice ; Ventricular Remodeling ; Erythropoietin ; Myocardial Infarction ; Heart ; Stem Cells

Background Osteoclast stimulatory transmembrane protein (OC-STAMP) is involved in silicosis fibrosis induced by silicon oxide (SiO₂) exposure. Its role in silicosis fibrosis by inducing ferroptosis of alveolar type II epithelial cells and its related mechanism remain unclear. Objective To explore the effect and possible mechanism of OC-STAMP on ferroptosis of alveolar type II epithelial cells and silicosis fibrosis in rats under SiO₂ exposure. Methods Twenty male Wistar rats of SPF grade were randomly divided into two groups: control (Sham) group and SiO₂ group, 15 rats in each group. Rats in the SiO₂ group were given 1 mL of 50 mg·L⁻¹ SiO₂ suspension at one time through the non-exposed intratracheal instillation method to establish an animal model of silicosis, and rats in the Sham group were give 1 mL of 0.9% sodium chloride solution in the same way. Rats were sacrificed after 8 weeks. Samples of lung tissue were fixed in glutaraldehyde or paraformaldehyde for observing ultrastructure of mitochondria by transmission electron microscopy; HE, Masson, VG, and Prussian blue were used to observe changes in lung tissue structure and iron deposition. The expression level of OC-STAMP and the degree of lung fibrosis were evaluated by immunohistochemistry and immunofluorescence. The expression level of OC-STAMP in rat lung tissue was detected and the transfection effect of OC-STAMP was verified by real-time fluorescence quantitative polymerase chain reaction (RT-PCR). Overexpression (OCS group) and inhibition expression (SI-OC group) models were constructed by OC-STAMP plasmid and OC-STAMP small interfering RNA (siRNA) transfection to cultured MLE-12 cells, respectively. The relative expression levels of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), and other proteins in lung tissue and MLE-12 were detected by Western blotting. Results The results of HE, Masson, and VG staining showed that the silicosis modeling was successful after 8 weeks of SiO₂ exposure. The immunofluorescence results showed that OC-STAMP and ATP binding cassette subfamily A member 3 (ABCA3) co-localized in alveolar type II epithelium. The immunohistochemical results showed that the levels of OC-STAMP and collagen I in the SiO₂ group were significantly higher than those in the Sham group (P<0.01). The RT-PCR results showed that the OC-STAMP mRNA in the lung tissue of the SiO₂ group was significantly higher than that of the Sham group (P<0.01). The Prussian blue staining in the lung tissue of the SiO₂ group showed positive brownish-yellow particles. Compared with the Sham group which showed normal mitochondrial structure, the mitochondrial structure was generally swollen and the mitochondrial cristae dissolved and disappeared in the SiO₂ group by transmission electron microscope observation. The Western blotting results showed that the expression levels of SLC7A11 and GPX4 both decreased in the lung tissue of the SiO₂ group (P<0.05, P<0.01), and the expression level of Vimentin increased (P<0.01). In the transfected MLE-12 cells, compared with the Sham group, the expression levels of SLC7A11 and GPX4 in the OCS group were significantly reduced (P<0.05, P<0.01). Conclusion OC-STAMP may affect the expression of proteins related to ferroptosis, and promote lung fibrosis induced by SiO₂ exposure.

Objective: To investigate the current situation of influenza vaccination, vaccination willingness, recommended behavior and influencing factors of health care workers (HCWs) under the policy of free vaccination. Methods: A cross-sectional survey was conducted among 3 167 medical staff from 8 hospitals in Nanshan district of Shenzhen city based on a web-based questionnaire platform. The logistic regression was used to analyze the data. Results: The influenza vaccination rate in HCWs was 23.97%, and the recommendation rate was 25.69% from 2019 to 2020. Staff with high professional titles, high academic qualifications, and positive awareness about influenza vaccine had a higher vaccination rate. The main reasons for not recommending influenza vaccine were the fear of patients' misunderstanding of commercial benefits, fear of possible disputes caused by recommended vaccination, lack of national or institutional requirements for recommended influenza vaccine, and fear of adverse reactions of influenza vaccines. Conclusion: Under the free policy, the influenza vaccination rate and recommendation rate of HCWs in Nanshan district of Shenzhen city are relatively low. Strengthening health education on influenza and related knowledge, publicizing the policy of free influenza vaccination, providing convenient vaccination services and promoting the construction of relevant policies and regulations are the key to improve the influenza vaccination rate and recommendation rate among HCWs.
Humans ; Influenza Vaccines ; Influenza, Human/prevention & control* ; Vaccination Coverage ; Cross-Sectional Studies ; Attitude of Health Personnel ; Vaccination ; Health Personnel ; Surveys and Questionnaires ; Policy

BACKGROUND: Acute type A aortic dissection (ATAAD) and acute type A intramural hematoma (ATAIMH) are life-threatening diseases with high mortality. To better understand their clinical features in the Chinese population, we analyzed the data from the first Registry of Aortic Dissection in China (Sino-RAD) to promote the understanding and management of the diseases. METHODS: All patients with ATAAD and ATAIMH enrolled in Sino-RAD from January 1, 2012 to December 31, 2016 were involved. The data of patients' selection, history, symptoms, management, outcomes, and postoperation complications were analyzed in the study. The continuous variables were compared using the Student's t test for normal distributions and the Mann-Whitney U test for non-normal distributions. Categorical variables were compared using the Chi-square test or Fisher exact test. RESULTS: A total of 1582 patients with ATAAD and 130 patients with ATAIMH were included. The mean age of all patients was 48.4 years. Patients with ATAAD were significantly younger than patients with ATAIMH (48.9 years vs. 55.6 years, P < 0.001). For the total cohort, males were dominant, but the male ratio of patients with ATAAD was significantly higher compared to those with ATAIMH (P = 0.01). The time range from the onset of symptom to hospitalization was 2.0 days. More patients of ATAIMH had hypertension than that of ATAAD (82.3% vs. 67.6%, P < 0.05). Chest and back pain were the most common clinical symptoms. Computerized tomography (CT) was the most common initial diagnostic imaging modality. 84.7% received surgical treatment and in-hospital mortality was 5.3%. Patients with ATAAD mainly received surgical treatment (89.6%), while most patients with ATAIMH received medical treatment (39.2%) or endovascular repair (35.4%). CONCLUSIONS Our study suggests that doctors should comprehensively use clinical examination and genetic background screening for patients with ATAAD and ATAIMH and further shorten the time range from symptoms onset to intervention, achieving early diagnosis and treatment, thereby reducing the mortality rate of patients with aortic dissection in China. We should standardize the procedures of aortic dissection treatment and improve people's understanding. Meanwhile, the curing and transferring efficiency should also be improved.
Acute Disease ; Aneurysm, Dissecting/diagnosis* ; China ; Hematoma ; Humans ; Male ; Middle Aged ; Registries ; Retrospective Studies ; Time Factors ; Treatment Outcome

Objective: The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population. Methods: The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models. Results: A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices). Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.
Aged ; Asian Continental Ancestry Group ; Blood Glucose/analysis* ; China/epidemiology* ; Cohort Studies ; Diabetes Mellitus/blood* ; Female ; Glucose Tolerance Test ; Glycated Hemoglobin A/analysis* ; Glycemic Index ; Humans ; Male ; Middle Aged ; Uric Acid/blood*

Macleaya cordata, a perennial plant in the genus Macleaya, it mainly distributed in most provinces and regions south of the Yangtze river and north of Nanling mountains of China and has been used as a Chinese traditional medicine. It is bitter, cold, warm, poisonous. M. cordata has the functions of dispelling wind, analgesia, detoxification and detumescence. It mainly treats poisonous abscess, cachexia, ulcer, scabies, trichomonal vaginitis, etc. It also has insecticidal and anti-itching activities. The main chemical constituents of M. cordata are isoquinoline alkaloids, sanguinarine, chelerythrine, protoopioid and allocrine alkaloids are the higher ones. In addition, it also contains phenylpropanoids, steroids, organic acids, phenols and volatile oils. The pharmacological effects of M. cordata are mainly anti-bacterial, anti-inflammatory, anti-tumor and improving liver function. In agriculture, it can be used as botanical insecticides and bacteriostasis, and also as feed additives for animal husbandry. By reviewing and analyzing domestic and foreign researches that isoquinolines were the main active constituents and characteristic components of M. cordata. This paper provides theoretical basis for the development and utilization of M. cordata extract and its' monomer compounds.

OBJECTIVE: To explore clinical effect of internal and external fixation combined with second-stage perforator fiap for the treatment of ankle fracture dislocation of Gustilo-Anderson types ⅢB and ⅢC. METHODS: From May 2014 to July 2017, 20 patients with Gustilo-Anderson types ⅢB and ⅢC ankle fracture dislocation were treated with internal and external fixation combined with second-stage perforator fiap, including 14 males and 6 females, aged from 18 to 58 years old with an average of (39.0±9.7) years old;17 patients were type ⅢB and 3 patients were type ⅢC according to Gustilo-Anderson classification;4 patients were type A, 7 patients were type B, and 9 patients were type C according to AO classification. The size of wound ranged from 4 cm×3 cm to 20 cm×9 cm. Second-stage perforator flap, 11 patients were performed with posterior tibial artery perforator flap, 5 patients were performed with fibular artery perforator flap, 1 patient was performed with anterior ankle flap, and 3 patients were performed with posterior tibial artery perforator flap combined with fibular artery perforator flap. Postoperative wound healing, flap survival and fracture healing were observed, AOFAS score was used to evaluate at the latest follow up. RESULTS: All limbs were preserved successfully without amputation. Nine patients occurred superficial infection without deep infection and osteomyelitis occurring. The flaps of 19 patients survived. All patients were followed up for 6 to 18 months with an average of (12.0±2.9) months. The flaps healed well without sinus tract, bone exposure and bone disunion occurring. Fracture healing time ranged from 4 to 10 months with an average of (6.6±1.7) months. PostoperativeAOFAS score was 76.7± 16.4, among which 4 patients got excellent result, 11 patients good, 3 patients fair, and 2 poor. CONCLUSION Internal and external fixation combined with second stage perforator fiap for the treatment of ankle fracture dislocation of Gustilo-Anderson types ⅢB and ⅢC could effectively close the wound, improve fracture healing and restore appearance and function of limbs to the maximum.
Adolescent ; Adult ; Ankle ; Female ; Fracture Dislocation ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Perforator Flap ; Reconstructive Surgical Procedures ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVE: To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China. METHODS: According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017. RESULTS: A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66). CONCLUSIONS Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.
China ; Female ; Humans ; Infant, Newborn ; Meconium Aspiration Syndrome ; Pregnancy ; Respiratory Distress Syndrome, Newborn ; Retrospective Studies

Objective:To investigate the clinical therapy of one-stage internal and external fixation combined with early perforator fiap for treatment of ankle fracture dislocation with soft tissue defects of Gustilo types Ⅲ.Methods:A retrospective study was conducted of the 20 patients with ankle fracture dislocation of Gustilo type Ⅲ who had been treated from May 2014 to July 2017 at Deparment of Traumatic Orthopaedics, the Second Hospital of Tangshan. There were 14 males and 6 famales among the patients, aged from 18 to 58 years (average, 40 years). There were 5 cases of Gustilo type ⅢA, 12 cases of type ⅢB, and 3 cases of type ⅢC; AO classification of ankle fractures: 4 cases of type A, 7 cases of type B, and 9 cases of type C; The wound size ranged from 4 cm×3 cm to 20 cm×9 cm. All patients were treated by primary internal and external fixation plus secondary transfer with a perforator flap. The times from injury to initial surgery ranged from 1 to 8 h (average, 5.5 h), the period from injury to secondary flap transfer ranged from 7 to 21days (average, 12 days). Among them, 11 cases of posterior tibial artery perforator flap, 5 cases of fibular artery perforator flap, 1 case of anterior ankle flap, and 3 cases of posterior tibial artery perforator flap combined with fibular artery perforator flap.Results:All 20 cases of limb preservation were successful, and there were no amputees. 9 patients showed superficial infection, no deep infection and osteomyelitis occurred. All 19 cases of flap survived, 1 case of distal part of posterior tibial artery perforator flap was necrosis, and the skin graft was cured later. All patients were followed up for 6 to 18 months (average, 12 months). The flap healed well. There was no sinus tract and bone exposure. The sensory recovery was S1 in 2 fiaps, S2 in 12 flaps, S3 in 6 flaps. The fracture healing time vanged from 4 to 10 months (average, 6.5 months), no bone disunion in patients. According to the American foot ankle surgery scoring system, the efficacy was assessed: 4 excellent cases, 11 good cases, 3 fair cases, 2 poor cases, yielding an excellent to good rate of 75%.Conclusions:One-stage internal and external fixation combined with early perforator fiap transfer is an effective strategy for treatment of ankle fracture dislocation with soft tissue defects of Gustilo types Ⅲ, due to its advantages of shortened treatment period, possibility for early rehabilitation, decreased complications and satisfactory functional recovery.