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2020 Vol. 50, No. 3 Published: 2020-03-25   173 Prediction and analysis of B-cell epitopes of SARS-CoV-2 S protein ZHU Shanli, DING Ning, XIANG Dan, DONG Haiyan, XUE Xiangyang, ZHANG Lifang DOI: 10.3969/j.issn.2095-9400.2020.03.001 Objective: To predict the secondary structure and B-cell epitopes of S protein of SARS-CoV-2. Methods: The amino acids of SARS-CoV-2 S protein were selected, and the secondary structure was predicted by SOPMA and GOR methods. A combined comprehensive analysis of transmembrane domain, hydrophilicity profile, surface probability and antigenicity index was further made to predict B-cell epitopes of S protein. Results: Prediction of the secondary structure of SARS-CoV-2 S protein indicated that random coils were the main structural type of the flexible region in secondary structure. The predominant B-cell epitopes were probably in the regions of 354-360, 437-445, 454-471, 527-537, 567-582, 678-685, 772-779 and 806-818 amino acids. Conclusion: The B-cell epitope of SARS-CoV-2 S protein can be predicted by multi parameters, which lays foundations for further study of the function of S protein. 2020 Vol. 50 (3): 173-176 [Abstract] ( 1357 ) HTML (1 KB)  PDF (1723 KB)  ( 1465 ) 177 Application of chest CT examination in screening patients with COVID-19 FU Gangze, XU Chongyong, SUN Houchang, CAO Guoquan, HUANG Dingpin, TAO Jiejie, CHEN Shuangli, LIN Liaoyi, ZHANG Zirui, YANG Yunjun, WANG Meihao, XIA Jinglin DOI: 10.3969/j.issn.2095-9400.2020.03.002 Objective: To explore the application and importance of chest CT in screening COVID-19 patients. Methods: A total of 35 COVID-19 patients from the First Affiliated Hospital of Wenzhou Medical University and the Second Affiliated Hospital of Wenzhou Medical University between January 19th and February 1st, 2020 were divided into CT-positive group (with lung exudation, n=31) and CT-negative group (no lung exudation, n=4). The epidemiological history, clinical symptoms, white blood cell count, and lymphocyte count abnormality in each patient were prospectively recorded, and their clinical features were evaluated. The location, distribution and morphological characteristics of lesions in CT positive group were investigated. Results: Of 35 COVID-19 patients, CT-positive patients accounted for 88.6% (31/35), with a history of the endemic center Wuhan contact accounting for 31.4% (11/35), local confirmed patients contact 31.4% (11/35), no clear epidemiological history 37.1% (13/35), fever 88.6% (31/35), gastrointestinal symptoms 11.4% (4/35), decreased white blood cell count 17.1% (6/35) and decreased lymphocyte count 37.1% (13/35). The median onset time in the CT-positive group was 4 (2, 7) d, significantly longer than CT-negative group of 2 (1, 2) d (P=0.027). Among the 31 COVID-19 patients with CT-positive, 29 (93.5%) had bilateral lung distribution. There were 471 lesions in 31 COVID-19 patients, including 67.3% (318/471) lesions located in the lower lung, and 36.7 % (173/471) in other lung lobes; 75.4% (355/471) in the lung peripheral field, and 76.4% (360/471) in the posterior lung. Of all lesions, 4.9% (23/471) had halo sign, 1.9% (9/471) reverse-halo sign, 2.5% (12/471) paving stone sign. In addition, 12.9% (4/31) of the patients were accompanied by a small amount of pleural effusion (2 cases bilateral and 2 cases unilateral). Conclusion: Chest CT examination is of great significance for the screening of patients with new type of coronavirus pneumonia, but chest CT examination of early symptoms with fever ≤2 d may be negative. 2020 Vol. 50 (3): 177-181 [Abstract] ( 875 ) HTML (1 KB)  PDF (1627 KB)  ( 848 ) 182 Clinical features, CT manifestations and dynamic changes of COVID-19 YE Xiaoxue, XIE Yibing, XU Chongyong, XU Hui, YAN Zhihan, FANG Bidong, YANG Chaoying, CHEN Meikui, CHEN Qi DOI: 10.3969/j.issn.2095-9400.2020.03.003 Objective: To explore the clinical characteristics, CT manifestations and dynamic changes of patients with corona virus disease 2019 (COVID-19). Methods: A total of 39 patients with COVID-19 from Yongjia County People’s Hospital during January 20 2020 to February 10 2020 were collected, and their clinical and laboratory characteristics, CT manifestations and dynamic changes were retrospectively analyzed. Results: Of 39 COVID-19 patients, 3 were mild, 28 normal and 8 severe; 37 of them had a clear epidemiological history. In the first admission, peripheral blood leukocyte counts decreased in 5 cases, lymphocyte counts decreased in 7 cases, and C-reactive protein levels increased in 18 cases, serum amyloid A levels increased in 35 patients. By the time of discharge, their clinical symptoms were obviously relieved, and laboratory indicators of peripheral blood returned to normal. Pulmonary lesions showed a natural course. On admission, the initial CT manifestations included subpleural patchy, nodular ground glass density shadows, with or without thickening of the lobular septum. 3 to 6 days after admission, the lesions increased, the scope expanded, and the consolidation became obvious, and air bronchus signs were seen. The new lesions showed a thin ground-glass density shadow, and the sub-pleural distribution of the middle and lower lobe of both lungs was dominant. 9 to 11 days after admission, CT showed that the lesion area and density were reduced in mose cases, completely absorbed in 4 cases, and fibrous lesions remained in 3 cases. Conclusion: Certain CT dynamic changes, clinical and laboratory manifestations are characteristic of COVID-19. A deeper understanding of them will make up for the false negative of virus nucleic acid test, so that patients can be early isolated and intervened. 2020 Vol. 50 (3): 182-186 [Abstract] ( 867 ) HTML (1 KB)  PDF (1681 KB)  ( 1070 ) 187 Analysis on Chinese medical clinical characteristics of 64 patients with common type COVID-19 PAN Xiaoqiong, HU Zhen DOI: 10.3969/j.issn.2095-9400.2020.03.004 Objective: To investigate the general features and distribution of Chinese medical syndrome of common type COVID-19 patients. Methods: A total of 64 common type COVID-19 patients from the Second Affiliated Hospital of Wenzhou Medical University during February 5 to February 20 2020 were enrolled. The epidemiological date, including blood routine, C-reactive protein, initial symptom and tongue image were collected on the first day of admission, and analyzed and differentiated according to traditional Chinese medicine diagnosis and treatment of COVID-19. Results: The average age of common type COVID-19 patients was (48.8±12.9), the ratio of male to female was 1.56:1. Of all patients, 14 cases (21.88%) had the history of visiting or living in Wuhan/Hubei, 38 cases (59.38%) had the history of close contact with the confirmed patients, 15 cases (23.44%) had decreased count of leukocyte, 17 cases (26.56%) had decreased lymphocyte count and 35 cases (54.69%) had increased C reactive protein. Most of the initial symptoms were fever (42 cases, 65.63%) and cough (9 cases, 14.06%), but 6 cases (9.38%) had no symptoms. The main tongue features were red tongue with yellow greasy coat (14 cases, 21.88%), light red with white thin and greasy coat (8 cases, 12.50%), red tongue with white greasy coat (8 cases, 12.50%). The Chinese medical syndrome were present in 6 cases with dampness-cod pestilence attack lung (9.38%), and dampness-heat pestilence accumulate lung in 58 cases (90.62%). Dampness-heat pestilence accumulate lung included 20 cases (34.48%) of heat predominating over dampness and 38 cases (65.52%) of dampness predominating over heat. Conclusion: The main type of the Chinese medical syndrome of COVID-19 is dampness-heat pestilence accumulate lung with the pathological factors all related to cold, heat, dampness, toxicity and deficiency, and “damp-toxicity” is the its critical pathology. 2020 Vol. 50 (3): 187-190 [Abstract] ( 934 ) HTML (1 KB)  PDF (1486 KB)  ( 945 ) 191 Practice of infection management in non-isolation examination rooms of radiology department during the epidemic of COVID-19 ZHANG Xiaoqin, PAN Kehua, CAO Guoquan, CHEN Xiaoyu, XU Haoli, XIA Nengzhi, WANG Sini, SUN Houzhang, YANG Yunjun, WANG Meihao, LI Jiance DOI: 10.3969/j.issn.2095-9400.2020.03.005 COVID-19 is a new acute respiratory infectious disease, highly contagious and rapidly progressing. Large general hospitals play an important role in the prevention and treatment. Department of Radiology is an important auxiliary for clinical diagnosis and treatment of COVID-19, and a key node in the whole epidemic prevention and control chain of the hospital. In Department of Radiology, in addition to special isolation room for COVID-19 patient, there are many non-isolation rooms for outpatient running at the same time. However, compared with the special isolation examination room, their protection is often ignored. Therefore, it is necessary to improve the protection awareness and to refine the measures of the non-isolation examination rooms. Our department has taken a series of measures including infection management, internal space division and personnel protection, which were implemented one by one for the non-isolation examination rooms. In this way, hidden dangers of transmission were eliminated, cross infections were avoided and protective materials were saved to the greatest extent. 2020 Vol. 50 (3): 191-194 [Abstract] ( 907 ) HTML (1 KB)  PDF (1522 KB)  ( 802 ) 195 The prevention strategies of device related pressure injuries for medical staff in the COVID-2019 epidemic situation HUANG Wen, ZHOU Xiaodan, WANG Jian, XIAO Jian, LI Xiaokun DOI: 10.3969/j.issn.2095-9400.2020.03.006 Starting with the cause and symptoms of device related pressure injuries (DRPI), the treatment and prevention strategies of DRPI were discussed. Through the review of the latest international biomedical literature QUOTE, this paper aims to give corresponding suggestions for the front-line medical staff in the prevention and control of the new COVID-2019 epidemic, and also to provide references for the future prevention and treatment of DRPI. 2020 Vol. 50 (3): 195-198 [Abstract] ( 765 ) HTML (1 KB)  PDF (1519 KB)  ( 1083 ) 199 Bioinformatics study on the screening of long-chain noncoding RNA for prognostic risk of glioma U Shengjian, MA Huailu, CHEN Wangyang, DING Xiaofei, CHEN Guang, LIANG Yong DOI: 10.3969/j.issn.2095-9400.2020.03.007 Objective: To screen long-chain non-coding RNA (lncRNA) for prognostic risk of gliomas based on bioinformatics. Methods: Transcript data of glioma samples were downloaded from the open Cancer Gene Atlas (TCGA) and Genotype-Tissue Expression (GTEx) data platform, using R language to compare and analyze glioma and normal differentially expressed genes. The risk model was constructed by Cox analysis. Functional annotation and pathway enrichment analysis of differentially expressed genes were performed through the DAVID gene function and KEGG pathway database. The relationship between the expression of HOXA-AS2 and the clinical tissue characteristics of glioma was evaluated by qPCR. Results: By comparing the gene transcription level data between glioma and normal brain tissue samples, 424 differentially expressed lncRNA (211 up-regulated and 213 down-regulated) and 3 827 differentially expressed mRNA (1 618 up-regulated and 2209 down-regulated) were obtained. A risk model containing 9 lncRNAs was constructed. The results of the enrichment analysis of co-expressed genes showed that they were mainly enriched in the control of channel protein activity and molecular adhesion. The high expression of HOXA-AS2 in glioma was verified by qPCR. Conclusion: HOXA-AS2 may be a prognostic risk lncRNA for glioma, which can be a reference for subsequent studies on the mechanism of glioma. 2020 Vol. 50 (3): 199-205 [Abstract] ( 816 ) HTML (1 KB)  PDF (1661 KB)  ( 1057 ) 206 The design of brain-targeted Ag2S quantum dot and its property of crossing the in vitro blood brain barrier XU Yi, YAN Meiling, MA Jifei, ZHAO Fangfei, SUN Yanhong, WANG Lihua, GAO Jimin DOI: 10.3969/j.issn.2095-9400.2020.03.008 Objective: To design the brain targeted Ag2S and Ag2S-PEG quantum dots and evaluate the property of the modified quantum dots in crossing the in vitro blood-brain barrier. Methods: Ag2S was conjugated with Angiopep-2 (Ag2S-ANG) and Ag2S-PEG was conjugated with Angiopep-2 (Ag2S-PEG-ANG) through the condensation reaction of amino and carboxyl groups mediated by EDC and NHS. The structure and size of Ag2S, Ag2S-ANG, Ag2S-PEG, Ag2S-PEG-ANG were characterized by agarose electrophoresis, dynamic light scattering transmission, electron microscope (TEM). The property of four kinds of quantum dots across the blood-brain barrier was evaluated in vitro by using the in vitro blood-brain barrier model. The cytotoxicity of four kinds of materials on U87 MG and bEnd.3 cells was observed. Results: Ag2S-ANG and Ag2S-PEG-ANG had a shorter migration distance compared with Ag2S and Ag2S-PEG in the agarose gel electrophoresis. The hydrate particle size of Ag2S-ANG and Ag2S-PEG-ANG was respectively increased compared with Ag2S and Ag2S-PEG. And their Zeta potential exhibited electropositive reinforcement. From the TEM results, we founded that the partical size of Ag2S-ANG and Ag2S-PEG-ANG was bigger than Ag2S and Ag2S-PEG (P<0.05). Ag2S, Ag2S-ANG, Ag2S-PEG, Ag2S-PEG-ANG QDs had no obvious cytotoxicity when the concentration was lower than 100 μg/mL. In vitro blood-brain barrier cell model, Ag2S-ANG, Ag2S-PEG and Ag2S-PEG-ANG quantum dots could cross the bEnd.3 cells in the upper layer, especially when the uptake of Ag2S-ANG was 6 times that of Ag2S by U87 MG cells in the lower layer (P<0.01). Conclusion: Brain targeted Ag2S-ANG and Ag2S-PEG-ANG are synthesized successfully. Ag2S-ANG QDs exhibit excellent ability to cross the blood-brain barrier system in vitro and target glioma cells, which lays the foundations for further study of in vivo brain targeting imaging. 2020 Vol. 50 (3): 206-211 [Abstract] ( 735 ) HTML (1 KB)  PDF (1748 KB)  ( 1150 ) 212 The value of parameters derived from diffusion-weighted imaging intravoxel incoherent motion model in the diagnosis of benign and malignant breast lesions XIE Xiaoxiao, QIN Le, YE Xinjian, ZHAO Xiaojun, LIU Kun, YAN Zhihan, CHENG Jianmin DOI: 10.3969/j.issn.2095-9400.2020.03.009 Objective: To evaluate the quantitative parameter values of incoherent motion diffusion weighted imaging (IVIM) in magnetic resonance magnetins for the diagnosis of mammary good malignant lesions. Methods: Totally 50 cases who underwent breast MR and confirmed pathologically were collected from January to December, 2017 in the Second Affiliated Hospital of Wenzhou Medical University. Multiple b-value DWI (b=0-2 000 s/mm2) was examined for all patients, and quantitative parameters of IVIM disease levels were measured, including standardized epigenetic diffusion coefficient (ADC standard), true diffusion coefficient (D), false diffusion coefficient (D*) and perfusion score (f). According to their pathological results, the patients were divided into 2 groups, with 21 malignant (malignant group) and 29 benign (benign group). Their IVIM parameters of lesions were statistically analyzed, the differences between the two groups were compared, the ROC curve drawn, and the diagnostic efficiency was analyzed. Results: There was significant difference between the benign group and the malignant group in ADC standard and D value (P<0.05), while there was no statistical difference between the D*-value and the f-value (P>0.05). In the malignant group, the ADC standard and D values were (1.10±0.38)×10-3 mm2/s, (0.88±0.24)× 10-3 mm2/s, significantly lower than the ADC standard and D values in the benign group (1.69±0.26)×10-3 mm2/s, (1.56±0.25)×10-3 mm2/s, ADC standard and D value diagnosed as good malignant lesions ROC area 0.879, 0.966, best threshold for diagnosis is 1.26×10-3 mm2/s, 1.18×10-3 mm2/s. ADC standard’s sensitivity and specificity to good malignant tumors in the breast were 83.33% and 95.45% respectively, and the sensitivity and specificity of D value were 91.67% and 90.91% respectively. Conclusion: The quantitative parameters obtained by the IVlM model are helpful to the differential diagnosis of mammary malignant lesions, of which the D value is the best diagnostic index to distinguish between good malignant mammopathy. 2020 Vol. 50 (3): 212-216 [Abstract] ( 1424 ) HTML (1 KB)  PDF (1624 KB)  ( 748 ) 217 Safety and effectiveness of arthroscopic biceps brachial plexus and supraspinatus tendon in the treatment of massive rotator cuff injury HUANG Donghui, MEI Zhengfeng, YE Xin, LEI Wentao, ZHANG Miaofeng, FENG Gang DOI: 10.3969/j.issn.2095-9400.2020.03.010 Objective: To investigate the safety and effectiveness of arthroscopic biceps brachial plexus and supraspinatus tendon fixation for the treatment of huge rotator cuff injury. Methods: A retrospective analysis of the massive rotator cuff injury treated with arthroscopic tendon and biceps brachial plexus combined with arthroscopy in our hospital from January 2016 to March 2017, accompanied by severe biceps brachi in 74 patients with wear, including 38 males and 36 females, the average age being (64.3±10.1) years. All patients underwent preoperative and postoperative follow-up of 1 month, 3 months, 6 months, 1 year, 2 years. Shoulder joint examination was performed to record the flexion of the bilateral shoulder joints, the lateral side rotation activity, and the front Flexed muscle strength, body side external rotation muscle strength, and also recorded were Constant-Merly score, pain visual analogue (VAS) score, American Shoulder and Elbow Surgery Association (ASES) score, shoulder joint simple (SST) score, and University of California (UCLA) score. The patients underwent preoperative and last follow-up of anterior flexion, body lateral rotation, anterior flexion and upper extremity muscle strength, and body lateral external rotation force and functional score. Results: At the last follow-up, the degree of flexion and lifting, the degree of lateral rotation, the muscle strength of flexion and lifting, and the muscle strength of lateral rotation were significantly better than those before operation (P<0.05). At the last follow-up, the Constant-Merly score, ASES score, SST score and UCLA score were significantly higher than those before operation (P<0.05). At the last follow-up, VAS score was significantly lower than those before operation (P<0.05). All patients had no complications such as bleeding, infection, adhesion, neuro-vascular damage, internal fixation loosening and re-tearing. Conclusion: It is highly effective and safe for arthroscopic biceps femoris longus sacral tendon combined with supraspinatus tendon fixation in the treatment of massive rotator cuff injury with severe wear of the biceps longhead tendon. 2020 Vol. 50 (3): 217-220,226 [Abstract] ( 671 ) HTML (1 KB)  PDF (1565 KB)  ( 889 ) 221 The modulation of LyciumBarbarum polysaccharides on cytochrome P450 enzymes in rats HUANG Aifang, WANG Chenxiang, JIN Hui, YE Qizhen, JIN Mi, ZHOU Ziye DOI: 10.3969/j.issn.2095-9400.2020.03.011 Objective: To evaluate the regulating effect of LyciumBarbarum polysaccharides (LBP) on activities and mRNA expressions of cytochrome P450 (CYP450) in rats. Methods: SD rats were randomly divided as test group (low-dose group, high-dose group) and control group. Treated with LBP and given pure water respectively for 14 days, the test group and control group were simultaneously given the mixture of four probes on day 15. Plasma concentration of probes was determined at a series of time-points after dosing. The activities of CYP450 were evaluated according to the pharmacokinetic parameters of corresponding probes. Real-time PCR was applied to assess the mRNA levels of CYP450. Results: Compared with control group, CLz/F of tolbutamide in high dose group rats decreased by 27%, AUC(0-t) and Cmax increased by 50% and 28%; CLz/F and Vz/F of midazolam in low dose group rats decreased by 25% and 35%, AUC(0-t) increased by 38%; CLz/F and Vz/F of midazolam inhigh dose group rats decreased by 34% and 38%, while AUC(0-t), Tmax and Cmax increased by 51%, 50% and 65%, respectively. In addition, treatment with LBP significantly down-regulated the mRNA expressions of CYP2C11 in high dose group and CYP3A1 in both low and high dose groups by 56%, 44% and 68% respectively. LBP had no impact on pharmacokinetics of phenacetin, bupropion and mRNA expressions of CYP1A2, CYP2B1. Conclusion: LBP can down-regulate the activities and mRNA expressions of CYP2C11 and CYP3A1. 2020 Vol. 50 (3): 221-226 [Abstract] ( 724 ) HTML (1 KB)  PDF (1711 KB)  ( 854 ) 227 The protective effect of melatonin on oxidative stress injury in hippocampal neurons of schizophrenia model rats CHEN Hong, LIANG Yan, JIN Yingli, YU Xichong, ZHAO Yongzhong, WANG Weiqian, LIN Qingxia, LIN Haixi, YANG Chuang DOI: 10.3969/j.issn.2095-9400.2020.03.012 Objective: To study the protective effect of melatonin (MT) on oxidative stress injury and its mechanism in hippocampal neurons of schizophrenia model rats. Methods: Sixty male Sprague-Dawley rats were divided into 5 groups: control, model, model with low dose of MT (12.5 mg/kg), model with high dose of MT (25 mg/kg), and model with MT receptor blocker (Luzindole, 1 mg/kg). Model of schizophrenia was established by intraperitoneal injection of MK-801. After successful modeling, the low- and high-dose of MT and MT receptor blocker groups were intraperitoneally injected with the corresponding drugs, and the control group and model group were injected with 10% absolute ethanol solution for 21 days. The learning and memory ability of SD rats was detected by Morris water maze test. The content of oxidative stress related factors ROS, SOD and MDA in hippocampal tissue homogenate was detected by kit. The expression of neuron marker protein NeuN was detected by immunohistochemistry and Western-blot was used to detect the levels of Nrf2 and HO-1 in hippocampus. Results: Compared with the control group, the model group was impaired in the learning and memory ability (P<0.05), the content of ROS and MDA in hippocampus was significantly increased (P<0.01), and the activity of SOD was decreased (P<0.05). The number of NeuN positive cells was significantly decreased (P<0.01), and the expression of Nrf2 and HO-1 protein in hippocampus was significantly increased (P<0.01). Compared with the model group, the high-dose MT group was significantly improved in the learning and memory ability (P<0.05), the hippocampal ROS and MDA content decreased and SOD increased (P<0.05). NeuN expression was increased (P<0.01), and Nrf2 and HO-1 protein expression was significantly increased (P<0.01). Administration of MT receptor blockers increased hippocampal ROS content in model rats (P<0.05) and mediated neuronal oxidative stress injury. Conclusion: Melatonin protects hippocampal neurons from oxidative stress in schizophrenia rats, and its mechanism is related to the regulation of Nrf2/HO-1 signaling pathway. 2020 Vol. 50 (3): 227-231 [Abstract] ( 898 ) HTML (1 KB)  PDF (1506 KB)  ( 1558 ) 232 Clinical features and prognosis of adult severe adenovirus pneumonia ZHANG Shengnan, ZHOU Ying, YE Junru, ZHANG Dongqing, ZHOU Lingping, LI Yuping DOI: 10.3969/j.issn.2095-9400.2020.03.013 Objective: To investigate the clinical features and prognosis of adult severe adenovirus pneumonia. Methods: Adult cases with severe adenovirus pneumonia who were admitted in the First Affiliated Hospital of Wenzhou Medical University from March 2017 to May 2019 were retrospectively analyzed. Results: Seven male patients aged 23-50 years, with an average age of (35±10) years, were enrolled. The main clinical symptoms were fever (7/7 cases), dyspnea (7/7 cases), cough (7/7 cases) and chest pain (1/7 cases). APACHE II score was 5-20 points, with an average points (10.1± 5.0). Laboratory test included normal BRT value and increased creatine kinase. Adenovirus was identified by metagenomics next-generation sequencing (mNGS) in 6 cases, and 1 case was confirmed through positive adenovirus antigen from BALF. There were 3 cases of serotype 7, 2 cases of type 55, 1 case of type 4, and 1 case unknown. Three patients were supported by tracheal intubation ventilator, 1 patient underwent tracheotomy and ventilator support and 3 patients were supported by noninvasive ventilator, with the mechanical ventilation time lasting from 5 to 46 days. Once the adenovirus was diagnosed, all patients were treated with intravenous gamma globulin, three of whom were treated with intravenous ganciclovir and ribavirin. Six cases were discharged and one patient died. Conclusion: Adult severe adenovirus pneumonia occurs most common in young and middle-aged males. mNGS can identify the pathogen rapidly. Active and effective treatment is necessary. 2020 Vol. 50 (3): 232-236 [Abstract] ( 715 ) HTML (1 KB)  PDF (2146 KB)  ( 821 ) 237 Association between SLC1A1 gene polymorphism and obsessive-compulsive disorder in Chinese Han population REN Jianjuan, TANG Mouni, CHEN Xiaoying, FU Zhengchuang DOI: 10.3969/j.issn.2095-9400.2020.03.014 Objective: To investigate the relationship between solute carrier family 1 member 1 gene (SLC1A1) and obsessive-compulsive disorder (OCD) in Chinese Han population. Methods: A case-control study was conducted on 125 patients (OCD group) and 125 normal people (control group) to detect 3 loci of SLC1A1 gene (rs301430, rs301434, rs301979). The allele and genotype distribution of these loci and the relationship between haploid and OCD were analyzed. Results: There was no significant difference in allele and genotype frequency distribution of 3 loci between OCD group and control group (P>0.05). Gender stratified analysis showed that the frequency distribution of allele and genotype of rs301979 site in female patients was significantly different from that in the control group (χ2=7.875, P=0.019; χ2=7.331, P=0.007), while the distribution of allele and genotype frequency of all loci in male patients was not statistically significant (P>0.05). The difference between haploid T-A-G of 3-loci in the 2 groups was statistically significant (χ2=6.206, P=0.013). Conclusion: The rs301979 site of SLC1A1 gene may be the susceptibility gene site of female OCD, and the haploid T-A-G of rs301430, rs301434 and rs301979 may be related to the incidence of OCD in Chinese Han population. 2020 Vol. 50 (3): 237-240 [Abstract] ( 695 ) HTML (1 KB)  PDF (1458 KB)  ( 824 ) 241 The value of forearm bone mineral density and bone metabolism index in the diagnosis of postmenopausal female rheumatoid arthritis complicated with osteoporosis XU Xiaozuo, ZHU Xiaochun DOI: 10.3969/j.issn.2095-9400.2020.03.015 Objective: To investigate the value of forearm bone mineral density (BMD) and bone metabolism markers in the diagnosis of postmenopausal female rheumatoid arthritis (RA) with osteoporosis (OP). Methods: Ninety six postmenopausal female rheumatoid arthritis (RA) and 25 postmenopausal healthy female were determined by DXA. Age, body mass index, erythrocyte sedimentation, C reaction protein, rheumatoid factor, type I collagen N-terminal peptide (PINP) and serum type I collagen crosslinked C-terminal peptide (β-CTX) horizontal bone metabolism index were collected.The correlation between bone density and experimental index was analyzed. Results: Bone density and bone mineral content in RA group were significantly lower than those in the control group, P<0.01). Statistical differences were found between RA and control group in bone metabolism index PINP [(79.01±44.72)μg/L vs. (96.74±50.92)μg/L, P=0.036] and β-CTX [(0.51±0.35)μg/L vs. (0.37±0.26)μg/L, P=0.009]; Linear correlation analysis showed that β-CTX was negatively related to BMD and BMC (r=-0.259, P=0.011; r=-0.300, P=0.003) in RA; Age is negatively related to BMD and BMC (r=-0.706, P<0.001; r=-0.743, P<0.001); DAS28 is negatively related to BMD and BMC (r=-0.400, P<0.001; r=-0.330, P=0.001); PINP is positively correlated with BMD and BMC (r=0.308, P=0.020; r=0.244, P=0.010); The logistic regression analysis showed that only age, β-CTX were the risk factors for osteoporosis (OR=0.450, 95%CI=0.606-0.921, P=0.006; OR=1.008, 95%CI=1.002-1.016, P=0.031); PINP is a protective factor for osteoporosis (OR=1.060, 95%CI=1.005-1.118, P=0.003). Conclusion: Postmenopausal female RA patients are more prone to osteoporosis than normal postmenopausal female, and bone metabolism index β-CTX may be an independent risk factor for postmenopausal female RA osteoporosis. 2020 Vol. 50 (3): 241-244 [Abstract] ( 621 ) HTML (1 KB)  PDF (1444 KB)  ( 779 ) 245 Effects of continuous popliteal sciatic nerve combined with saphenous nerve block on the survival of circulation skin flap after free flap transplantation for the foot and ankle WANG Jue, ZHANG Yiwei, WANG Xiuzhen, CHEN Jie, YUAN Na, GE Yeying DOI: 10.3969/j.issn.2095-9400.2020.03.016 Objective: To evaluate the effects of continuous popliteal sciatic nerve combined with saphenous nerve block on the local blood supply and survival of circulation skin flap in patients after free flap transplantation for the foot and ankle. Methods: A prospective study was made on 60 patients with ASA I-II who underwent anterolateral thigh flap transplantation for skin and soft tissue defects of the feet and ankles treated in Ningbo NO.6 Hospital from March 2018 to April 2019. All the patients were randomly assigned to receive either continuous popliteal sciatic nerve combined saphenous nerve block (S group) or controlled intravenous analgesia (C group), with 30 cases in each group. The blood circulation and survival of free flap were compared between two groups, VAS score was recorded at 6 h, 12 h, 24 h, 2 d, 3 d after operation, and adverse reactions occur were analyzed. Results: The scores of flap elasticity, capillary refill time and flap survival rate in S group were higher than those in the C group. The incidence of vascular crisis in the S group was lower than that in the C group, with statistical difference (P<0.05). VAS of 6 h, 12 h, 24 h, 2 d, 3 d and the incidence of adverse reactions after operation in S group were lower than the C group. Conclusion: Continuous popliteal sciatic nerve combined saphenous nerve block could improve the local flap of patients with free flap transplantation for the foot and ankle, and improve the survival rate of flap. 2020 Vol. 50 (3): 245-248，253 [Abstract] ( 650 ) HTML (1 KB)  PDF (1651 KB)  ( 745 ) 249 Effect of interdisciplinary team-managed dietary intervention on inhalation pneumonia in elderly patients with dysphagia in ICU MENG Xiaomin, WANG Yingying, YANG Yongli, HUANG Min DOI: 10.3969/j.issn.2095-9400.2020.03.017 Objective: To analyze the effect of dietary intervention with interdisciplinary team management on inhalation pneumonia in elderly patients with dysphagia in ICU, and to provide evidence-based support for clinical diagnosis and treatment management of these groups. Methods: A total of 96 elderly patients with dysphagia who were treated in ICU of NO.2 People’s Hospital of Fuyang City from March 2017 to December 2018 were collected. According to the random number table, the subjects who met the inclusion criteria were divided into study group and control group, with 48 cases in each group. Among them, the control group was given traditional nursing intervention, while the research group was given dietary intervention with interdisciplinary team management. The cases of cough and Antifeedant were recorded, and the time of eating per meal was compared between the two groups. The incidence of aspiration pneumonia before and after the intervention was compared between the two groups. Results: The incidence of cough and antifeeding in the study group were 4.2% and 6.3% respectively, which were lower than those in the control group (16.7% and 20.8%). The feeding time per meal was (17.3±2.1) min, which was shorter than that in the control group (26.9±3.4) min, with significant difference (P<0.05). After intervention, the incidence of inhalation pneumonia in the study group was 6.3% (3/48), lower than that in the control group (16.7%; 8/48), with significant difference (P<0.05). Conclusion: Interdisciplinary team-managed dietary intervention in elderly patients with dysphagia in ICU can reduce the incidence of aspiration pneumonia, reduce the incidence of potential adverse events, which enables patients to obtain a certain nutritional reserve in the recovery period. 2020 Vol. 50 (3): 249-253 [Abstract] ( 607 ) HTML (1 KB)  PDF (1471 KB)  ( 900 ) 254 Evaluation of the optimized consecutive operation process for day-care and in-patient cataract surgery CHEN Cong, CAI Junjie, JIN Yuexi, CHEN Fang DOI: 10.3969/j.issn.2095-9400.2020.03.018 Objective: To optimize the cooperation of cataract surgery, so as to improve the operating room cooperation efficiency, as well as the satisfaction of patients and surgeons. Methods: A total of 1 046 patients underwent daytime or hospitalized cataract surgery were included in our study from June 2018 to January 2019, with. 482 patients from June 2018 to September 2018 as the pre-optimization group and 564 patients from October 2018 to January 2019 as the post-optimization group. Main outcome measurements were the efficiency of operating room cooperation, the punctuality of the first surgery, the satisfaction of surgeons and patient before and after the optimization. Results: Compared with the pre-optimization group, post-optimization group achieved higher punctuality of the first operation (P<0.01), reduced non-surgical time (P<0.01), and greater satisfaction from patients and surgeons (P<0.05). Conclusion: Optimized cooperation of cataract surgery can improve the efficiency of operation room, reduce the waste of medical resources, and improve the satisfaction of patients and surgeons. 2020 Vol. 50 (3): 254-256 [Abstract] ( 627 ) HTML (1 KB)  PDF (1434 KB)  ( 788 )

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