Human amniotic membrane allograft,a novel treatment for chronic diabetic foot ulcers: A systematic review and meta‐analysis of randomised controlled trials

To evaluate the efficacy and safety of human amniotic membrane (HAM) allograft in treating chronic diabetic foot ulcers (DFUs), a comprehensive search of randomised controlled trials in MEDLINE, EMBASE, PubMed, CENTRAL and Web of Science was conducted to December 7, 2019. Two reviewers independently screened the studies, extracted data, and evaluated the quality of studies. The primary outcome was the proportion of complete healing. The secondary outcomes were mean time to complete healing and adverse events. Statistical analyses were performed using RevMan 5.3. We identified 257 articles, of which 7 articles (465 participants) were included in the meta‐analysis. The proportion of complete wound healing in HAM plus standard of care (SOC) group was 3.88 times as high as that in SOC alone (RR: 3.88 [95% CI: 2.34, 6.44]) at 6 weeks, and 2.01 times at 12 weeks (RR: 2.01 [95%CI: 1.45, 2.77]). The intervention group had a significantly shorter time to complete healing (MD: −30.33 days, [95% CI: −37.95, −22.72]). The number needed to treat within 6 weeks was 2.3 ([95% CI: 1.8, 3.1]). No significant difference was shown in adverse events. Results were consistent in a sensitivity analysis. Hence, HAM plus SOC is effective and safe in treating chronic DFUs.     

Phylogeny,pathogenicity and transmissibility of a genotype XII Newcastle disease virus in chicken and goose

Although Newcastle disease virus (NDV) has a worldwide distribution, some NDV genotypes have more regional geographical ranges within continents. In this study, we isolated a subgenotype XIIb NDV strain, Goose/CH/GD/E115/2017 (E115), from geese in Guangdong province, Southern China, in 2017. Phylogenetic analysis showed that E115 and six other NDVs from geese in China were grouped under subgenotype XIIb and were distinct from subgenotype XIIa, isolated from chickens in South Africa, and subgenotype XIId, isolated from chickens in Vietnam. To better understand the pathogenicity and transmission of the subgenotype XIIb NDVs from geese in Guangdong province, we inoculated chickens and geese with 10⁶ EID₅₀ of the E115 virus. Eight hours after inoculation, three naïve chickens and three naïve geese were co‐housed with the infected chickens or geese to assess intraspecific and interspecific horizontal transmission of the E115 virus. The E115 virus induced significant clinical signs without mortality in chickens, while it was not pathogenic to geese. Intraspecific and interspecific horizontal transmission of the E115 virus was observed among chickens and geese via direct contact. Furthermore, although the current vaccines provided complete protection against disease in chickens after challenging them with the E115 virus, the virus could also be transmitted from vaccinated chickens to naïve contact chickens. Collectively, our findings highlight the need for avoiding the mixing of different bird species to reduce cross‐species transmission and for surveillance of NDV in waterfowl.     

股骨转子下骨折术后不愈合并内固定断裂1例

患者,女,69岁,既往高血压病史,慢性胃溃疡30余年,无糖尿病、冠心病、肝炎等病史。患者于13个月前从约1.5 m高处摔落致右大腿上部疼痛肿胀,伴髋部活动受限,在当地医院行X线检查,诊断为右股骨转子下骨折,AO分型32-A2型(见图1A)。于当地医院行切开复位动力髋螺钉内固定术治疗,术后X线片显示对位对线良好(见图1B)。术后患者能缓慢行走,定期当地门诊复查,见折端骨痂生长,但愈合迟缓,右侧股骨有逐渐内翻趋势。3 d前晨起时突发右侧大腿疼痛肿胀,中段可扪及异物感,行走困难,遂于2017年1月20日至我院门诊就诊。行X线检查提示:右股骨转子下骨折,内固定术后改变,折端部分愈合,股骨上段内固定钢板外移,螺钉断裂(见图1C)。     

Relationship between parathyroid oxyphil cell proportion and clinical characteristics of patients with chronic kidney disease

International Urology and Nephrology - Parathyroid glands consist of chief cells and oxyphil cells. The parathyroid oxyphil cell proportion increased dramatically in patients with chronic kidney...     

Effects of liver-regulating herb compounds on testicular morphological and ultrastructural changes in varicocele rats through SCF/C-KIT pathway

Liver-regulating herb compound (LRHC) has good effects on improving sperm quality and male fertility of varicocele (VC) patients. But the mechanism of LRHC on VC is still not clear. This study explored the effects of LRHC on histomorphological and ultrastructural changes and expression of stem cell factor (SCF) and C-KIT of VC rat testis. Twenty-four male rats were divided into three groups with eight rats in each group as sham, varicocele and LRHC groups. Testis specimens were collected for light microscopy and transmission electron microscopy respectively. The expression of SCF/C-KIT was detected with Western blot. Results showed that seminiferous tubules in VC rats were damaged and cell numbers were decreased. Ultrastructural alterations were observed, such as increased thickness of lamina propria, vacuolation in Sertoli cells, spermatocytes and spermatids, and abnormal head and mitochondria in spermatozoa. While in LRHC-treated rats, the architectures of seminiferous tubules were as organised and compact as that of sham animals, and ultrastructure of Sertoli, Leydig and germ cells developed well. LRHC ameliorated histological appearance and ultrastructure by VC. In addition, the abnormal expression of SCF and C-KIT were observed in testicular tissues from rats with VC, which were brought back to normal level by LRHC.     

Design and evaluation of puborectalis-like artificial anal sphincter that replicates rectal perception

While fecal incontinence (FI) is not fatal, it can dramatically decrease the patient’s quality of life. An artificial anal sphincter (AAS) is an implantable device that treats FI by replacing a diseased or damaged anal sphincter, thus allowing the patient’s continence to be maintained. Here, we report a novel implantable puborectalis-like artificial anal sphincter (PAAS) that replicates rectal perception and has a low risk of ischemia necrosis. Using the pressure sensors embedded in the PAAS, the relationship between the mass of feces and the pressure was determined, and a feces mass estimation model was developed based on in vitro studies. Rectal perception is provided through the real-time monitoring of rectal feces, and the feeling of defecation is quantified based on a comparison between the feces mass and a preset threshold mass. In vivo studies were performed for validation, and the accuracy of the model was determined to be as high as 90%. The performance of the PAAS in the real-time monitoring of rectal feces and its in vivo biocompatibility were also evaluated. The device should further the functionality of existing AAS systems while improving their biosafety and thus expand the applicability of implantable AAS systems in the treatment of FI.     

高危早产儿矫正月龄3月时母亲情绪及家庭应对与神经发育的关系

目的探讨高危早产儿临床特征、母亲情绪、早产家庭应对对高危早产儿神经行为发育的作用机制,为针对性干预提供参考。方法采用焦虑自评量表、围产期创伤后应激障碍问卷和早产影响家庭应对量表对随访的202对高危早产儿及其母亲进行调查,基于文献回顾建构路径分析模型进行分析。结果母亲焦虑通过创伤后应激障碍及早产影响家庭应对对神经发育产生间接影响,总效应系数为-0.10;创伤后应激障碍通过早产影响家庭应对对神经发育产生间接影响,总效应系数为-0.12。喂养是否含母乳、败血症、呼吸窘迫综合征、早产影响家庭应对对神经发育的直接效应系数分别为-0.30、-0.29、0.25、-0.19。结论早产儿的神经行为发育影响因素多而复杂,随访时应加强早产儿神经发育评估,重点关注患有败血症、未采用母乳喂养的早产儿。同时,加强对母亲不良情绪和早产家庭应对的指导以促进早产儿神经发育。