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简介：ＤＥＶＥＬＯＰＥＤＡＮＤＣＬＩＮＩＣＡＬＡＰＰＬＩＣＡＴＩＯＮＯＦＬＯＣＫ－ＲＩＮＧＴＹＰＥＢＩＰＯＬＡＲＨＩＰＰＲＯＳＴＨＥＳＩＳＤＥＶＥＬＯＰＥＤＡＮＤＣＬＩＮＩＣＡＬＡＰＰＬＩＣＡＴＩＯＮＯＦＬＯＣＫ－ＲＩＮＧＴＹＰＥＢＩＰＯＬＡＲＨＩＰＰＲＯ...

简介：C类型natriuretic肽(CNP)是调停的本地规章的因素的一种最新发现的类型它通过specic的生物效果，膜界限natriuretic肽receptor-B(NPR-B)。最近的研究证实了CNP是仔细与男繁殖功能有关。这研究的目的是通过不同方法在人的呼喊的精子决定CNP/NPR-B的分发，然后在精子功能invitro上评估CNP的影响(例如immunolocalization，实时聚合酶链反应和西方的污点)，例如活动性和acrosome反应。人的精液样品从同意的施主被收集为normozoospermia满足了世界健康组织的标准。我们的结果证明CNP的specic受体NPR-B在头和精子的前端尾巴的膜的acrosomal区域是局部性的，并且没有在人的精子的CNP的信号。与控制相比，CNP能在精子活动性和acrosome反应导致signicant剂量依赖者增加。在摘要，CNP/NPR-B能影响精子活动性和acrosome反应，因此调整男性的繁殖功能。CNP可以是在调整精子功能的一个新关键因素。

简介：AbstractEffective prophylactic and therapeutic interventions are urgentlyneeded to address the coronavirus disease 2019 (COVID-19) pandemic. Various antiviral drugs have recently been tested. Type I interferon (IFN) is a regulatory protein involved in the innate immune response, with broad-spectrum antiviral activities and the ability to directly block viral replication and support the immune response to eliminate virus infection. Insufficient virus-induced type I IFN production is characteristic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, because SARS-CoV-2 suppresses the IFN response by interacting with essential IFN signaling pathways. Exogenous type I IFN is recommended for treating COVID-19. Unexpectedly however, angiotensin converting enzyme-2 (ACE2) receptor, which acts as a SARS-CoV-2 receptor, was shown to be stimulated by IFN, raising doubts about the suitability of IFN use. However, further studies have excluded concerns regarding IFN administration. Type I IFNs, including IFN-α1b, have been used clinically as antiviral drugs for many years and have shown strong antiviral activity against SARS-CoV-2 in vitro. Preliminary clinical studies of type I IFNs, especially when delivered via aerosol inhalation, have demonstrated efficacy for the treatment and prevention of COVID-19. Randomized controlled trials of IFN for COVID-19 treatment are ongoing.

简介：BackgroundPatientswithacutetypeAaorticdissectionhaveahighincidenceofpostoperativecerebralcomplication.Betterunderstandingoftheriskfactorscouldhelptooptimizepreventionandtreatmentstrategies.MethodAtotalof298patientsofacutetypeAaorticdissectionoperatedinGuangdongCardiacInstitutionfrom2010.10to2014.12wereincluded,253ofthemweremaleandtheother45werefemale.Theiraverageagewas45.8±12.2y.Allthepatientsweredividedintocerebralcomplicationandnocerebralcomplicationgroups.Datacollectedfrombothgroupswereanalyzedbyunivariateandmultivariateanalysestoidentifytheindependentriskfactorsofpostoperativecerebralcomplication.ResultTheincidenceofpostoperativecerebralcomplicationwas37.9%(113/298).Among113patients,temporarynervedamage(TND)groupandpermanentnervedamage(PND)accountedfor93cases(31.2%)and20cases(6.7%)respectively.LogisticRegressmultivariateanalysisshowedthathistoryofhypertension(OR=2.560,95%CI,1.397-4.692,P<0.01),totalarchreplacement(OR=2.315,95%CI,1.386-3.869,P<0.01),timeofaorticarrest(OR=1.008,95%CI,1.004-1.012,P<0.01)andpostoperativehypoxemia(OR=1.858,95%CI,1.122-3.078,P<0.05)weretheindependentriskfactorsofthepostoperativecerebralcomplicationinpatientswithacutetypeAaorticdissection.ConclusionIncidenceofpostoperativecerebralcomplicationishighintheacutetypeAaorticdissectionpatientsitsmajorriskfactorsarehypertensionhistory,totalarchreplacement,andlongdurationofaorticarrestorhypoxemia.

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简介：AbstractHereditary spastic paraplegia type 56 (SPG56-HSP) is a rare autosomal recessive disorder caused by loss of function mutations in CYP2U1, leading to an early-onset limbs spasticity, often complicated by additional neurological or extra-neurological manifestations. Given its low prevalence, the molecular bases underlying SPG56-HSP are still poorly understood, and effective treatment options are still lacking. Recently, through the generation and characterization of the SPG56-HSP mouse model, we were able to take few important steps forward in expanding our knowledge of the molecular background underlying this complex disease. Leveraging the Cyp2u1-/- mouse model we were able to identify several new diagnostics biomarkers (vitamin B2, coenzyme Q, neopterin, and interferon-alpha), as well as to highlight the key role played by the folate pathway in SPG56-HSP pathogenesis, providing a potential treatment option. In this review, we discuss the major role played by the Cyp2u1-/- model in dissecting clinical and biological aspects of the disease, opening the way to a series of new research paths ranging from clinical trials, biomarker testing, and to the expansion of the underlying genetic and molecular, emphasizing how basic mouse model characterization could contribute to advance research in the context of rare disorders.

简介：AbstractType 2 inflammation is a complex immune response and primary mechanism for several common allergic diseases including allergic rhinitis, allergic asthma, atopic dermatitis, and chronic rhinosinusitis with nasal polyps. It is the predominant type of immune response against helminths to prevent their tissue infiltration and induce their expulsion. Recent studies suggest that epithelial barrier dysfunction contributes to the development of type 2 inflammation in asthma, which may partly explain the increasing prevalence of asthma in China and around the globe. The epithelial barrier hypothesis has recently been proposed and has received great interest from the scientific community. The development of leaky epithelial barriers leads to microbial dysbiosis and the translocation of bacteria to inter- and sub-epithelial areas and the development of epithelial tissue inflammation. Accordingly, preventing the impairment and promoting the restoration of a deteriorated airway epithelial barrier represents a promising strategy for the treatment of asthma. This review introduces the interaction between type 2 inflammation and the airway epithelial barrier in asthma, the structure and molecular composition of the airway epithelial barrier, and the assessment of epithelial barrier integrity. The role of airway epithelial barrier disruption in the pathogenesis of asthma will be discussed. In addition, the possible mechanisms underlying the airway epithelial barrier dysfunction induced by allergens and environmental pollutants, and current treatments to restore the airway epithelial barrier are reviewed.

简介：AbstractBackgrounds:Inadequate sleep duration is associated with a higher risk of type 2 diabetes and the relationship is nonlinear. We aim to assess the curve relationship between night sleep duration and the incidence of type 2 diabetes in China.Methods:A cohort of 11,539 participants from the REACTION study without diabetes at baseline (2011) were followed until 2014 for the development of type 2 diabetes. The average number of hours of sleep per night was grouped. Incidence rates and odds ratios (ORs) were calculated for the development of diabetes in each sleep duration category.Results:Compared to people who sleep for 7 to 8 h/night, people with longer sleep duration (≥9 h/night) had a greater risk of type 2 diabetes (OR: 1.27; 95% CI: 1.01-1.61), while shorter sleep (<6 h/night) had no significant difference in risk of type 2 diabetes. When the dataset was stratified based on selected covariates, the association between type 2 diabetes and long sleep duration became more evident among individuals <65 years of age, male, body mass index <24 kg/m2 or with hypertension or hyperlipidemia, no interaction effects were observed. Furthermore, compared to people persistently sleeping 7 to 9 h/night, those who persistently slept ≥9 h/night had a higher risk of type 2 diabetes. The optimal sleep duration was 6.3 to 7.5 h/night.Conclusions:Short or long sleep duration was associated with a higher risk of type 2 diabetes. Persistently long sleep duration increased the risk.

简介：AIM:Tostudyhowlymphnodemetastasis(LNM)riskisstratifiedinundifferentiated-typeearlygastriccancer(undiff-EGC)dependentoncombinationsofriskfactors.METHODS:Fivehundredandsixty-sevencaseswithundiff-EGCundergoinggastrectomywithlymphadenectomywereexaminedretrospectively.Usingclinicopathologicalfactorsofpatientage,location,size,anendoscopicmacroscopictumorform,ulceration,depth,histology,lymphaticinvolvement(LI)andvenousinvolvement(VI),LNMriskwasexaminedandstratifiedbyconventionalstatisticalanalysisanddatamininganalysis.RESULTS:LNMwaspositivein44of567cases(7.8%).Univariateanalysisrevealed>2cm,protrusion,submucosal(sm),mixedtype,LIandVIassignificantprognosticfactorsand>2cmandLI-positivewereindependentfactorsbymultivariateanalysis.InpreoperativelyevaluablefactorsexcludingLVI,smand>2cmwereindependentfactors.Accordingtothedepthandsize,caseswerecategorizedintothelow-riskgroup[mand≤2cm,0%(LNMincidence)],themoderateriskgroup(mand>2cm,5.6%;andsmand≤2cm,6.0%),andthehigh-riskgroup(smand>2cm,19.3%).Ontheotherhand,LNMoccurredin1.4%inallLI-negativecases,greatlylowerthan28.2%inallLI-positivecases,andLNMincidencewaslowinLInegativecaseseveninthemoderate-andhigh-riskgroups.CONCLUSION:LNM-relatedfactorsinundiff-EGCweredepthandsizepreoperativelywhilethosewereLIandsizepostoperatively.Amongthesefactors,LIwasthemostsignificantlycorrelatedfactor.

简介：AbstractPurpose:The poor prognosis in patients with floating knee injuries is mainly contributed to articular involvement (Fraser's type II). This study aims to evaluate and compare the functional outcomes among different Fraser's type II floating knee injuries after surgical management.Methods:Twenty-seven patients with Fraser's type II floating knee injuries (54 fractures) between September 2014 and December 2015 were enrolled prospectively in this study and were distributed according to Fraser's floating knee classification into three different groups as type IIA (ipsilateral femoral shaft and tibial intra-articular involvement, n = 11), type IIB (ipsilateral tibial shaft and femoral intra-articular involvement, n = 9) and type IIC (both femoral and tibial intra-articular involvement, n = 7). The differences among the groups were evaluated and compared. The functional outcomes of these injuries at one year were analyzed using Knee Injury and Osteoarthritis Outcome Score (KOOS) which covers 5 subscales of pain, other symptoms, activities of daily living, sports and recreation, and quality of life. The result was also compared with standardized age-sex matched healthy population using paired samples t-test.Results:All the patients were male, and the injury mechanism was solely roadside accident. The mean age was 29.8 years and injury severity score 17.9 (comparable in all the three groups). Most injuries were observed on the right side (20 cases, 74.1%). Based on paired samples t-test, the KOOS score of patients with Fraser's type IIA was found to be better than that of type IIB and type IIC. Compared with the reference age-sex matched control group, patients with Fraser's type IIB and IIC fractures had significantly lower mean score in all KOOS subscales (all p < 0.01). However, Fraser's type IIA only revealed significant difference regarding the subscales of activities of daily living (p < 0.0001), sports and recreation (p < 0.0001), and quality of life (p < 0.0001).Conclusion:The results of this study show that patients with Fraser's type IIA fractures had a better functional outcome as compared to those with type IIB and IIC fractures. This might be due to the open intra-articular involvement of the distal femur of the latter two fracture types.

简介：Objective:ToanalyzetypeⅡtopoisomerasegenesinclinicalisolatesoffluoroquinolone-resistantMycoplasmahominis.Methods:EightisolatesofM.hominiscrossresistantto6fluoroquinoloneswereselectedfrom103clinicalstrainsofM.hominisusingabrothmicrodilutionmethod.TypeIItopoisomerasegeneswereamplifiedbyPCRanddirectlysequenced.Nucleotidesequenceswerecomparedtosequencesfromasusceptiblestrain(M.hominisPG2I).Results:MICsofresistantMhisolateswere4-to512-foldhigherthanMICsfromthesusceptiblereferencestrain.SequencecomparisonrevealedaCtoTchangeat113ntingyrAQRDRledtothesubstitutionofSer83byLeucineandnoaminoacidchangeingyrB.AchangeofGtoTat134ntinparCQRDRledtothesubstitutionofSer80byIsoleucineandaGtoAchangeat70ntinparEQRDRledtothesubstitutionofAsparticacidbyAsparagine.Conclusion:TheseresultssuggestthataCtoTchangeatll3ntingyrA,aGtoTchangeat134ntinparCandaGtoAchangeat70ntinpatrEareassociatedwithfluoroquinoloneresistanceofM.hominis.

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简介：Objective:Toobservethetherapeuticeffectofhydro-acupuncturetherapyfortreatmentofvertigoinducedbyvertebroarterytypecervicalspondylopathyandtostudyitsactionmechanisms.Methods:Atotalof54casesofvertebroarterytypecervicalspondylopathypatientswereobservedinthepresentstudy.Fengfu(GV16)andJiaji(EX-B2)neartheregeneratedcervicalvertebralbodywereusedforinjectionofLigustrazineinjectio,1mLeveryacupoint,onceeveryotherday,with7sessionsbeingatherapeuticcourse.Beforeandaftertreatment,cerebralbloodflowvolumewasdeterminedusingaDopplervelocimeter.Results:After2weeks'treatment,ofthe54cases,28(51.9%)hadtheirvertigodisappeared,13(24.1%)hadremarkableimprovement,10(18.5%)hadimprovementand3(5.5%)failedinthetreatment,withaneffectiverateof94.5%.Aftertreatment,thepeakandmeanvaluesofthebloodflowvelocityofthebilateralvertebralarteriesandthebasilararteryincreasedsignificantlyincomparisonwithpre-treatment(P＜0.01).Conclusion:Hydro-acupuncturetherapyhasanobvioustherapeuticeffectforrelievingvertebroarterytypevertigoandamelioratingcerebralbloodsupply.

简介：AIM:Toinvestigatetheprevalenceandriskfactorsofdiabeticretinopathy(DR)innorthernChinesepatientswithtype2diabetesmellitus(T2DM).METHODS:Thisretrospectivecross-sectionalstudywasperformedbetweenMay2011andApril2012.Atotalof1100patients(male/female,483/617)wereincludedinthisstudy.DRwasdefinedfollowingtheEarlyTreatmentDiabeticRetinopathyStudy(ETDRS)severityscale.Allincludedpatientsacceptedacomprehensiveophthalmicexaminationincludingretinalphotographs.Logisticregressionmodelswereusedtoestimateoddsratios(ORs)and95%confidenceinterval(CI)afteradjustingforageandgender.RESULTS:Retinopathywaspresentin307patientswithaprevalenceof27.9%.Inunivariatelogisticanalysis,presenceofDRwasassociatedwithlongerdurationofdiabetes(OR,5.70;95%CI,2.91-12.56),higherconcentrationoffastingbloodglucose(OR,12.94;95%CI,2.40-67.71),higherlevelofglycosylatedhemoglobinHbA1c(OR,5.50;95%CI,3.78-11.97)andinsulintreatment(OR,6.99;95%CI,1.39-35.12).ThelifestyleofpatientswithT2DMincludingsmoking,alcoholconsumptionandregularexerciseseemednotassociatedwiththedevelopmentofDR.CONCLUSION:Ourstudysuggeststhatfastingserumglucoseconcentration,HbA1clevel,durationofdiabetesandinsulintreatmentarepotentialriskfactorsforDRinnorthernChinesepatientswithT2DM,whilethelifestyleofincludedpatientsseemsnotassociatedwithDR.

简介：AbstractPurpose:The purpose of this study was to assess and compare elbow range of motion, triceps extension strength and functional results of type C (AO/OTA) distal humerus fractures treated with bilateral triceps tendon (BTT) approach and olecranon osteotomy (OO). At the same time, we are also trying to know whether BTT approach can provide sufficient vision for comminuted intra-articular fractures of the distal humerus, and whether it is convenient to convert to the treatment to total elbow arthroplasty (TEA) or OO.Methods:Patients treated with OO and BTT approaches for type C distal humerus fractures between July 2014 and December 2017 were retrospectively reviewed. Inclusion criteria include: (1) patients' age were more than 18 years old, (2) follow-up was no less than 6 months, and (3) patients were diagnosed with type C fractures (based on the AO/OTA classification). Exclusion criteria include: (1) open fractures (Gustillo type 2 or type 3), (2) treated by other approaches, and (3) presented with combined injuries of ipsilateral upper extremities, such as ulnar nerve. Elbow range of motion and triceps extension strength testing were completely valuated, when the fractures had healed. Assessment of functional results using the Mayo elbow performance score and complications were conducted in final follow-up. The data were compared using the two tailed Student's t-test. All data were presented as mean ± standard deviation.Results:Eighty-six patients of type C distal humerus fractures, treated by OO and BTT approach were retrospectively reviewed between July 2014 and December 2017. Fifty-five distal humerus fractures (23 males and 32 females, mean age 52.7 years) treated by BTT approach or OO were included in this study. There were 10 fractures of type C1, 16 type C2 and 29 type C3 according to the AO/OTA classification. Patients were divided into two surgical approach groups chosen by the operators: BTT group (28 patients) and OO group (27 patients). And the mean follow-up time of all patients was 15.6 months (range, 6-36 months). Three cases in BTT group were converted to TEA, and one converted to OO. Only one case in BTT group presented poor articular reduction with a step more than 2 mm. There were not significantly different in functional outcomes according to the Mayo elbow performance score, operation time and extension flexion motion are values between BTT group and OO group (p > 0.05). Complications and reoperation rate were also similar in the two groups. Triceps manual muscle testing were no significant difference in the two groups, even subdivided in elder patients (aged >60 years old).Conclusion:BTT is a safe approach to achieve similar functional result comparing with OO. BTT were not suitable for every case with severe comminuted pattern, but it avoids the potential complications related to OO, and has no complications concerning with triceps tendon. It is convenient for open reduction internal fixation and flexible to be converted to OO, as well as available to be converted to TEA in elder patients.

简介：AbstractPurpose:Stable Weber B ankle fractures are treated by a walking boot for 6 weeks and bearing full weight through the boot as tolerated. The aim of the present study was to assess the outcome parameters of this treatment protocol, evaluate the efficacy of using the walking boot, and investigate any possible predicting factors that could affect the outcomes.Methods:All the patients with stable Weber B ankle fractures, treated in our hospital between January 2018 and December 2018, were prospectively included to the study. The patients were evaluated clinically, and the patient-reported outcome measures data were collected at the 2 and 6 weeks post-injury. Chi square, Spearman's rho test, independent samples and paired sample t-tests were used for the monovariant analysis.Results:A total of 128 consecutive patients (aged 52.2 ± 19.1 years) with supination external rotation type 2 fracture were finally included to the study. At the 2 weeks follow-up, the reported outcome measures scores were in moderate levels, but improved significantly at the 6 weeks follow-up (p < 0.0001). Multivariant analysis revealed that the ability to bear full weight without the boot at the 2 weeks after diagnosis was the only variable, which made statistically unique contribution to the foot and ankle disability index score at the 6 weeks (p = 0.005).Conclusion:Conservative treatment using a walking boot with advice to bear full weight of stable ankle Weber B fractures can bring to good functional outcomes. The ability to bear full weight without the aid of the walking boot at 2 weeks after diagnosis was the only significant predicting factor for better outcomes at 6 weeks after diagnosis.

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