Optimize the management of urological tube-related emergencies during the coronavirus disease 2019 (COVID-19) pandemic

BackgroundTo introduce and determine the value of optimized strategies for the management of urological tube-related emergencies with increased incidence, complexity and operational risk during the global spread of coronavirus disease 2019 (COVID-19).MethodsAll emergent urological patients at Tongji Hospital, Wuhan, during the period of January 23 (the beginning of lockdown in Wuhan) to March 23, 2020, and the corresponding period in 2019 were recruited to form this study’s COVID-19 group and control group, respectively. Tongji Hospital has the most concentrated and strongest Chinese medical teams to treat the largest number of severe COVID-19 patients. Patients in the control group were routinely treated, while patients in the COVID-19 group were managed following the optimized principles and strategies. The case incidence for each type of tube-related emergency was recorded. Baseline characteristics and management outcomes (surgery time, secondary complex operation rate, readmission rate, COVID-19 infection rate) were analyzed and compared across the control and COVID-19 periods.ResultsThe total emergent urological patients during the COVID-19 period was 42, whereas during the control period, it was 124. The incidence of tube-related emergencies increased from 53% to 88% (P<0.001) during the COVID-19 period. In particular, the incidence of nephrostomy tube-related (31% vs. 15%, P=0.027) and single-J stent-related problems (19% vs. 6%, P=0.009) increased significantly. The mean surgery times across the two periods were comparable. The number of secondary complex operations increased from 12 (18%) to 14 (38%) (P=0.028) during the COVID 19-period. The number of 2-week postoperative readmission decreased from 10 (15%) to 1 (3%) (P=0.049). No participants contracted during the COVID-19 period.ConclusionsUrological tube-related emergencies have been found to have a higher incidence and require more complicated and dangerous operations during the COVID-19 pandemic. However, the optimized management strategies introduced in this study are efficient, and safe for both urologists and patients.     

2017—2019 年武汉市血吸虫病重点水域哨鼠监测报告

目的 及时发现武汉市血吸虫病重点水域水体感染性,减少血吸虫病传播风险。 方法 选择血吸虫病易感重点水域长江武汉段、府河-沦河水系、东荆河-通顺河水系和金水河水系,采用哨鼠监测法监测水体血吸虫感染风险。 结果 2017—2019 年共开展哨鼠监测 38 点次,涉及全市 8 个区 21 个行政村。 三年共投放哨鼠 760 只,回收哨鼠 742 只,总回收率为 97. 63%;共解剖哨鼠 742 只,未发现阳性,未检获成虫,哨鼠感染率为 0。 结论 武汉市血吸虫病重点水域的水体感染性较低。     

Clinical therapeutic effects of probiotics in combination with antibiotics on periodontitis: A protocol for systematic review and meta-analysis

Background:Dental pain can have a detrimental effect on quality of life. Symptomatic apical periodontitis is the most common cause of dental pain and arise from an inflamed or necrotic dental pulp. There is growing evidence to support the effectiveness of probiotics in combination with antibiotics on periodontitis. We therefor will conduct this study to evaluate the clinical therapeutic effects of probiotics in combination with antibiotics on periodontitis.Methods:We will systematically search the following databases: PubMed, the Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database (CBM), and WanFang database. A grey literature search will be conducted using ZETOC Conference Proceedings and Open Grey. Only randomized controlled trials (RCTs) related to research on probiotics in combination with antibiotics to treatment patients with periodontitis will be included. All sources have to be searched from their inception to October 2020. Two authors will independently select studies, extract study data, and evaluate the quality of the included studies. We will use Review Manager Software (RevMan 5.3) to analyze data.Results:This study will systematically evaluate the clinical therapeutic effects of probiotics in combination with antibiotics on periodontitis.Conclusions:This study will generate evidence for a better clinical decision of patients with periodontitis.Registration number:DOI 10.17605/OSF.IO/QZ6SB (https://osf.io/qz6sb/).     

功能性心肌血流指数评价缺血性冠心病可行性分析

目的:运用功能性心肌血流指数(MBFI)评价缺血性冠心病(ICAD)可行性分析。方法:回顾性分析冠心病疑似患者行冠状动脉CT血管成像(CCTA)检查,同期接受有创冠状动脉造影(ICA)及导管法心肌血流储备分数(FFR)检查共81例患者,其中男性43例,女性38例,年龄(59.27±9.09)岁;计算MBFI;以FFR≤0.80为金标准,分别以四格表诊断试验确定MBFI与ICA的最佳切点值来判断ICAD;评价MBFI、ICA的ROC曲线特征及诊断准确度。结果:81例患者,CCTA扫描平均剂量为(3.06±1.22)mSv。MBFI、ICA最佳切点值分别为0.074、70%,25例患者FFR≤0.80。MBFI、ICA两者ROC曲线下面积分别为0.825、0.699(Z=2.024,P=0.0429),其敏感度、特异度、阳性预测值、阴性预测值分别为88.00%、80.35%、66.67%、93.75%和76.00%、51.79%、41.30%、82.86%,诊断准确度分别为82.72%、59.26%(χ2=10.753,P<0.01)。33例患者(40.74%,33/81)ICA狭窄程度为65%或70%,其中27例患者(81.82%,27/33)心肌不缺血,运用MBFI值大于0.074可明确23例患者心肌并不缺血(69.70%,23/33)。结论:MBFI属于功能性指标,可用于排查缺血性冠心病。     

Electroacupuncture improves learning and memory functions in a rat cerebral ischemia/reperfusion injury model through PI3K/Akt signaling pathway activation

Electroacupuncture has been widely used to treat cognitive impairment after cerebral ischemia, but the underlying mechanism has not yet been fully elucidated. Studies have shown that autophagy plays an important role in the formation and development of cognitive impairment, and the phosphoinositide 3-kinase(PI3 K)/Akt signaling pathway plays an important role in autophagy regulation. To investigate the role played by the PI3 K/Akt signaling pathway in the electroacupuncture treatment of cerebral ischemia/reperfusion rat models, we first established a rat model of cerebral ischemia/reperfusion through the occlusion of the middle cerebral artery using the suture method. Starting at 2 hours after modeling, electroacupuncture was delivered at the Shenting(GV24) and Baihui(GV20) acupoints, with a dilatational wave(1–20 Hz frequency, 2 mA intensity, 6 V peak voltage), for 30 minutes/day over 8 consecutive days. Our results showed that electroacupuncture reduced the infarct volume in a rat model of cerebral ischemia/reperfusion injury, increased the mRNA expression levels of the PI3 K/Akt signaling pathwayrelated factors Beclin-1, mammalian target of rapamycin(mTOR), and PI3 K, increased the protein expression levels of phosphorylated Akt, Beclin-1, PI3 K, and mTOR in the ischemic cerebral cortex, and simultaneously reduced p53 mRNA and protein expression levels. In the Morris water maze test, the latency to find the hidden platform was significantly shortened among rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation. In the spatial probe test, the number of times that a rat crossed the target quadrant was increased in rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation. Electroacupuncture stimulation applied to the Shenting(GV24) and Baihui(GV20) acupoints activated the PI3 K/Akt signaling pathway and improved rat learning and memory impairment. This study was approved by the Animal Ethics Committee of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, China(approval No. 8150150901) on March 10, 2016.     

百草枯致小鼠肺泡上皮细胞损伤过程中microRNA表达谱分析

目的 研究百草枯(PQ)致小鼠肺泡上皮细胞损伤过程中microRNA(miRNA)表达谱的变化,并预测差异表达的miRNA靶基因和相关的生物学功能.方法 体外培养小鼠肺泡上皮细胞系MLE12细胞,加入不同浓度的PQ,通过CCK-8方法检测细胞活力以及流式细胞术检测细胞凋亡率,最终选择100μ MPQ作为合适的实验浓度.进一步设立对照组和实验组,对照组加入等量PBS的培养液,实验组加入100μ MPQ的培养液,24h后用基因芯片检测两组microRNA表达谱的改变,分析差异表达的miRNA并用生物信息学方法预测靶基因及相关信号调节通路.结果 100μmol/LPQ处理MLE-12细胞24h后,细胞活性下降约50％,细胞凋亡率约15％.基因芯片共筛选出11个差异表达的miRNA,其中1个被上调,10个被下调.预测这些上下调的miRNA靶基因与细胞的线粒体凋亡途径以及DNA的甲基化相关,参与PI3K-Akt、mTOR、RAS、TNF和MAPK等与氧化应激以及凋亡相关的信号通路的调节.结论 PQ对小鼠肺泡上皮细胞的损伤进程中microRNA表达谱发生了改变,这些差异表达的miRNA可能是细胞氧化应激及凋亡的重要调节因素.     

基于泛素-蛋白酶体途径探讨远志散“益气化痰开窍”治疗阿尔茨海默病的科学内涵＊

阿尔茨海默病（Alzheimer′s disease，AD）是一种常见的神经系统退行性疾病，磷酸化Tau蛋白异常聚集所形成的神经纤维缠结（Neurofibrillary tangles，NFTs）是AD的典型病理特征，直接参与AD的发生发展。因此，AD的治疗可从调节磷酸化Tau蛋白异常聚集入手。中医学认为“痰浊”是导致AD发生的重要病理因素之一，“正气亏虚，痰浊蒙窍”是AD的核心病机。“痰浊”与磷酸化Tau蛋白异常聚集密切相关，磷酸化Tau蛋白异常聚集可归属“痰浊”的范畴。化痰开窍与减少磷酸化Tau蛋白聚集在AD的治疗中有不谋而合之处。泛素-蛋白酶体系统（Ubiquitin-proteasome system，UPS）是细胞内蛋白降解的主要途径，参与AD进程中磷酸化Tau蛋白的降解。UPS功能受损是磷酸化Tau蛋白异常聚集和AD发生的重要原因。本文试图从中医“痰”的视角认识磷酸化Tau蛋白异常聚集，探讨中医“痰浊”与现代医学磷酸化Tau蛋白异常聚集的相关性，并从UPS视角提出益气化痰开窍法治疗AD的作用机制假说，推测UPS可能是远志散益气化痰开窍干预AD的主要途径，精确调控UPS可能是未来研究防治AD的新视角，为科学阐释通过调控UPS蛋白降解途径治疗AD的作用机制提供新思路。     

Medial sustainable nail versus proximal femoral nail antirotation in treating AO/OTA 31-A2.3 fractures: Finite element analysis and biomechanical evaluation

Objectives

Using finite element analysis and biomechanical tests, the biomechanical behaviors of Medial Sustainable Nail (MSN) and Proximal Femoral Nail Antirotation (PFNA) were compared for the fixation of fracture type of AO/OTA 31-A2.3.

Do men with normal testosterone–oestradiol ratios benefit from letrozole for the treatment of male infertility?

Research question

Previous studies of aromatase inhibitors on male infertility have focused on men with low testosterone–oestradiol ratio of less than 10. Can aromatase inhibitors improve spermatogenesis in men with idiopathic male infertility with normal testosterone–oestradiol ratio?

Effect of high salt diet on the renal medullary cyclooxygenase 2 expression

Objective To examine the effect and mechanism of high salt diet on the renal medullary cyclooxygenase 2 (COX2) expression and urinary sodium excretion. Methods Thirty male C57BL/6j mice were divided into four groups: (1) normal salt diet group (0.4%NaCl, n=5); (2) high salt diet group (8% NaCl, n=5); (3) Bortezomib+normal salt diet group (n=10); (4) Bortezomib+high salt diet group (n=10). The different groups were pre-treated with saline or bortezomib，followed by normal salt diet or high salt diet for three days. All the mice were maintained on metabolic cage at the last day and allowed free access to water. Twenty-four hours urine was collected. Body weight, urine volumes were documented. At the end of experiments, mice were sacrificed under anesthesia and the kidneys were harvested for Western blotting and immunohistochemistry. The transgenic mice carrying a luciferase reporter driven by an NF-κB response promoter, HIV long terminal repeat (LTR) (HLL mice) were used to explore the effect of high salt diet on renal medullary NF-κB activity. HLL mice were fed with normal salt diet or high salt diet for 3 days, after which renal medullary luciferase activity was determined using a commercial luciferase assay kit. Luciferase activity was quantified with a luminometer and adjusted for the total amount of proteins. The cellular location of NF-κB was examined using immunohistochemistry of NF-κB p65 staining. Results (1) Western blotting results showed high salt diet significantly increased the COX2 expression in the renal medulla of C57BL/6j mice (P﹤0.05). (2) High salt diet significantly increased NF-κB luciferase reporter activity in the HLL mice renal medullary tissues when compared to normal salt diet (P﹤0.05). The immunohistochemistry of NF-κB p65 showed the expression of NF-κB was mainly in the renal interstitial cells. (3) Western blotting results showed bortezomib inhibited the renal medullar COX2 expression induced by high salt diet (P﹤0.05). (4) Bortezomib decreased the urinary sodium excretion of high salt diet mice (P﹤0.05), but had no change on urine volume. Conclusions High salt diet induce renal medullary COX2 over-expression and activate the activation of NF-κB in renal medullary. Bortezmoib can inhibit the renal medullar COX2 expression induced by high salt diet. The NF-κB pathway activation may involve in the regulation of renal medullar COX2 expression by high salt diet.