Comparison of the Effectiveness of Simple Plate Fixation and Plate Combined with Local Fixation of Broken Ends in the Treatment of Oblique Fracture of Midshaft Clavicle

ObjectiveTo compare the clinical efficacy of performing simple plate fixation with that using a plate combined with fracture end fixation to investigate the necessity of fracture end fixation outside the plate in cases of oblique fracture of the middle clavicle.MethodsThis was a retrospective follow‐up study of patients with middle clavicle oblique fractures (Robinson types 2A1 and 2A2) between 2015 and 2020. Patients were divided into two groups according to their treatment options: the simple plate fixation (SPF) group (n = 79; 43 men and 36 women; average age, 46.37 ± 14.54 years) and the plate combined with fracture local fixation (PLFP) group (n = 81; 36 men and 45 women; average age, 48.42 ± 12.55 years). Intraoperative blood loss, operation time, postoperative fracture healing time, postoperative shoulder function score (Constant–Murley and disabilities of the arm, shoulder, and hand [DASH] scores), clinical complications, and postoperative subjective satisfaction were compared between the two groups.ResultsOne hundred sixty patients with a sufficient follow‐up period were included in the final analysis: 79 in the SPF group (follow‐up time: 16.24 ± 3.94 months) and 81 in the PLFP group (follow‐up time: 16.15 ± 3.43 months). Age, sex, body mass index, follow‐up duration, fracture classification, and cause of injury were not significantly different between the two groups. There was no significant difference in blood loss, Constant–Murley and DASH scores, follow‐up period, and postoperative subjective satisfaction between the two groups (P > 0.05). The fracture healing time was shorter in the PLFP group than in the SPF group (4.41 ± 0.99 vs. 4.87 ± 1.60 months, P < 0.05), but the operation duration was longer in the PLFP group than in the SPF group (65.48 ± 16.48 min, P < 0.05). There were seven (complication rate, 8.86%) and five (complication rate, 6.17%) cases that had complications in the SPF and PLFP groups, respectively. There was no significant difference in the complication rates between the two groups (P > 0.05).ConclusionAlthough the healing time was shorter in the PLFP group than in the SPF group, the clinical efficiency of the two methods in the treatment of oblique fracture of the middle clavicle was similar.     

Targeted peptide-modified oxidized mesoporous carbon nanospheres for chemo-thermo combined therapy of ovarian cancer in vitro

Ovarian cancer remains one of serious hazards to human health due to many drawbacks of existing available treatment options. In this study, a multifunctional chemo-thermo combined therapy nanoplatform (OMCNPID) was successfully prepared, which is composed of I₆P₈ peptide as a targeting moiety to interleukin-6 receptors (IL-6Rs), oxidized mesoporous carbon nanospheres (OMCN) as a near infrared (NIR)-triggered drug carrier and doxorubicin (DOX) as a chemotherapeutic drug and fluorescent agent. The synthesized multifunctional nanoplatform displayed high storage capacity for drugs and excellent photothermal properties. Besides, DOX was rapidly released from OMCNPID at the condition of low pH and NIR laser irradiation due to the dissociation of DOX from graphitic cores of OMCN. In vitro experimental results verified that OMCNPID could be markedly taken up by SKOV-3 monolayer cells and tumor spheroids, and revealed a remarkable synergistic chemo-photothermal effect against ovarian cancer. All the results demonstrated that OMCNPID is a pH/NIR dual-stimulus responsive nanoplatform and can achieve efficient chemo-thermo combined therapy.     

PDCA在住院医师规范化培训师资教学查房督导中的应用

目的探讨PDCA循环在师资教学查房督导中运用成效,充分发挥督导作用,从而提升师资教学查房质量。方法将2019年师资作为对照组,采用旧的教学查房督导方法,2020年师资作为实验组,在教学查房督导中采取PDCA循环,每季度循环1次,对比2组师资查房考核成绩。结果对照组师资教学查房成绩为86.1175±5.51864,实验组师资教学查房成绩为87.9536±4.20446,差异具有统计学意义(P<0.05);趋势图显示对照组第1季度至第4季度师资查房成绩分别为87.6、84.95、85.51、86.29,成绩无明显差异,而实验组中第1季度至第4季度师资查房成绩分别为86.8、87.32、88.36、90.15,成绩呈现季度递增。2年度教学查房共性失分点季度改变对比趋势图中显示,PDCA循环后英语教授、检查护理问题、病例特点总结得分呈现季度递增。结论将PDCA循环运用于在师资教学查房督导中,可以有效解决查房中存在的实际问题,使整改更具有目的性,有效提高整改质量,有助于稳步提升师资教学查房水平,具有重要参考意义。     

新生儿人双埃柯病毒的检测及遗传特性分析

目的:了解人双埃柯病毒(human parechovirus,HPeV)在新生儿中的流行情况.方法:采集新生儿血液、粪便及鼻咽分泌物样本各95份,共计285份样本.将其中45份新生儿粪便样本分为5组,利用病毒宏基因组学方法进行文库构建,再经高通量测序检测HPeV.通过Geneious软件拼接获取HPeV全基因组,并对该...     

Study on the Conventional Performance and Microscopic Properties of PPA/SBS-Modified Bio-Mixed Asphalt

To promote the construction of environmentally friendly, sustainable pavements and solve the impact of the scarcity of asphalt resources on highway development, bio-mixed asphalt (BMA) modified by SBS and polyphosphoric acid (PPA) was prepared, and the influence of the ratio of bio-asphalt (BA) replacing petroleum asphalt on different PPA/SBS blending schemes was explored through conventional property tests. According to each PPA/SBS blending scheme, the optimal replacement ratio of bio-asphalt was optimized, and the microstructure and distribution morphology of different PPA/SBS-modified BMA were evaluated. Conventional property test results show that with the same PPA/SBS content, the replacement ratio of bio-asphalt has a significant impact on the conventional performance of composite-modified asphalt, but the appropriate replacement ratio of bio-asphalt can improve the storage stability and conventional performance of composite-modified asphalt; in micromorphological analysis, it was found that the number of bee-like structures on the surface of the modified BMA decreased significantly, which indicated that the molecular heterogeneity of various components in the asphalt was reduced. In addition, bio-asphalt changed the particle morphology and improved the dispersity of SBS in asphalt. The composite-modified BMA had a lower SBS content, but its conventional performance was still excellent—so it has significant application prospects in road engineering.     

Glucose-Dependent Insulinotropic Polypeptide and Substance P Mediate Emetic Response Induction by Masked Trichothecene Deoxynivalenol-3-Glucoside through Ca2+ Signaling

Deoxynivalenol (DON), the most naturally-occurring trichothecenes, may affect animal and human health by causing vomiting as a hallmark of food poisoning. Deoxynivalenol-3-glucoside (D3G) usually co-occurs with DON as its glucosylated form and is another emerging food safety issue in recent years. However, the toxicity of D3G is not fully understood compared to DON, especially in emetic potency. The goals of this research were to (1) compare emetic effects to D3G by oral and intraperitoneal (IP) routes and relate emetic effects to brain-gut peptides glucose-dependent insulinotropic polypeptide (GIP) and substance P (SP) in mink; (2) determine the roles of calcium-sensing receptor (CaSR) and transient receptor potential (TRP) channel in D3G’s emetic effect. Both oral and IP exposure to D3G elicited marked emetic events. This emetic response corresponded to an elevation of GIP and SP. Blocking the GIP receptor (GIPR) diminished emetic response induction by GIP and D3G. The neurokinin 1 receptor (NK-1R) inhibitor Emend^® restrained the induction of emesis by SP and D3G. Importantly, CaSR antagonist NPS-2143 or TRP channel antagonist ruthenium red dose-dependently inhibited both D3G-induced emesis and brain-gut peptides GIP and SP release; cotreatment with both antagonists additively suppressed both emetic and brain-gut peptide responses to D3G. To summarize, our findings demonstrate that activation of CaSR and TRP channels contributes to D3G-induced emesis by mediating brain-gut peptide exocytosis in mink.     

The Genomic Evolution and the Transmission Dynamics of H6N2 Avian Influenza A Viruses in Southern China

In China, the broad prevalence of H6 subtype influenza viruses, increasingly detected in aquatic birds, promotes their exchange materials with other highly pathogenic human-infecting H5N1, H5N6, and H7N9 influenza viruses. Strikingly, some H6 subtype viruses can infect pigs, dogs, and humans, posing risks to public health. In this study, 9 H6N2 viruses recovered from waterfowl species in the Guangdong province of China in 2018 were isolated and sequenced. Phylogenetic analysis revealed that the genome sequences of these H6N2 viruses belonged to Group I, except for the NP gene in Group III. Coalescent analyses demonstrated that the reassortment of NA and NS genes have occurred in two independent clusters, suggesting H6 subtype viruses had been undergoing a complex reassortant. To examine the evolutionary dynamics and the dissemination of the H6 subtype viruses, a Bayesian stochastic search variable selection was performed for results showing higher viral migration rates between closer provinces, including Guangdong, Jiangxi, Guangxi, and Fujian. Notably, the transmission routes of the H6 subtype viruses were concentrated in Jiangxi Province, the most frequent location for input and output transmission and a region containing Poyang Lake, a well-known wintering site for migration birds. We also found that the aquatic birds, especially ducks, were the most common input source of the viral transmission. In addition, we also found that eight positively selected amino acid sites were identified in HA protein. Given their continuous dissemination and the broad prevalence of the H6 subtype influenza viruses, continued surveillance is warranted in the future.     

Crack-Resistant Amino Resin Flame-Retardant Coatings Using Waterborne Polyurethane as a Co-Binder Resin

Surface cracking is a major issue in amino resin-based flame-retardant coatings, which can be reduced by mixing flexible resins into the coatings. In this study, flexible waterborne polyurethane (WPU) was added into a melamine-modified, urea-formaldehyde, resin-based intumescent flame retardant (MUF-IFR) coating. A molecular chain of WPU was inserted into the MUF network and formed a WPU/MUF-semi-IPN structure. The cracking resistance of the coating was gradually enhanced with the increase in WPU content. When the WPU content exceeded 25% of the total resin, there were no cracks in the coatings after crack-resistance tests. The coatings before and after toughening showed good transparency on wood surfaces. The influence of WPU on char formation and flame retardant properties were explored by TGA, SEM, and cone calorimetry. The results showed that the decomposition of WPU occurred before char formation, which decreased the integrity of the coating and damaged the compactness of the char. Therefore, the addition of WPU reduced the expansion height and the barrier capacity of the char as well as the flame retardant properties of the coating. When the amount of WPU was 25% of the total resin, compared to the non-WPU coating, the average heat release rate in 300 s (AveHRR_300s) and the total heat release at 300 s (THR_300s) of the samples were increased by 45.8% and 35.7%, respectively. However, compared to the naked wood, the peak heat release rate (pHRR₁), AveHRR_300s, and THR_300s of the samples with the coating containing 25% WPU were decreased by 64.2%, 39.0%, and 39.7%, respectively. Therefore, the thermal stability of WPU affected char formation. The amount of WPU added should be chosen to be the amount that was added just before the coating cracked.     

全反式维甲酸对糖尿病大鼠肾小管-间质TGF-β1表达的影响

目的观察全反式维甲酸对糖尿病肾病肾小管-间质转化生长因子β1表达的影响。方法24只链脲佐菌素（STZ）诱导的糖尿病大鼠模型,随机分为治疗组（T）,模型组（D）各12只,和12只正常组（N）,T组给予全反式维甲酸20mg/（kg·d）油溶液灌胃,D组和N组分别灌等量的溶剂。4、8周每组各处死大鼠6只,测量24h尿微量清蛋白排泄率、肾重/体重、血肌酐、血糖（BX）。肾组织PAS、Masson s染色。免疫组化方法检测肾小管-间质转化生长因子β1的表达。结果全反式维甲酸可减轻肾小球系膜区基质、细胞的增生,明显缓解肾小管的损伤,肾间质的基质减少。4周尿微量清蛋白的排泄实验组低于模型组（3.08±0.48μg/min VS 3.35±0.56μg/min,P〈0.05）,8周时尿微量清蛋白的排泄率明显低于同期模型组（2.49±0.40μg/min VS 4.53±0.87μg/min,P〈0.01）;肾小管上皮细胞转化生长因子β1的表达明显低于模型组。结论全反式维甲酸可减轻糖尿病肾病肾小管-间质的损害,减少蛋白尿。可能通过抑制转化生长因子β1的表达防止肾间质的纤维化,保护肾功能。     

Pediatric Acute Severe Hepatitis of Unknown Origin: What is New?

Globally, there are emerging cases of acute severe hepatitis of unknown origin in children. These cases have gathered increasing attention, owing to the development of acute liver failure in some cases that resulted in liver transplantation. This review briefly summarizes the outbreak and diagnostic criteria of the disease. We further discuss the possible causes and related mechanisms underlying its occurrence and progression, and analyze the challenges in management. Finally, this review emphasizes patient management in clinical settings and a combination of efforts to unmask the disease.