Effect of orbital decompression on choroidal thickness in patients with thyroid associated ophthalmopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the effect of orbital decompression on the central macular choroidal thickness(CMCT)in patients with thyroid-associated ophthalmopathy(TAO).METHOD: Prospective clinical studies. A total of 29 TAO patients(42 eyes)treated in our department from January 2021 to January 2022 were analyzed, and they were divided into 20 cases(30 eyes)in the moderate and severe group and 9 cases(12 eyes)in the extremely severe group. Both groups of patients received orbital decompression, and the changes of CMCT, visual acuity, intraocular pressure, exophthalmos, and clinical activity score(CAS)at 3 and 6mo before and after surgery were compared between the two groups.RESULTS: All patients completed follow-up. The CMCT, exophthalmos, intraocular pressure, and CAS of the extremely severe group at 3 and 6mo were 355.13±15.59 and 339.61±13.17μm, 19.33±2.23 and 17.83±1.70mm, 18.86±3.05 and 18.09±1.37mmHg, 3.75±0.87 and 2.42±1.00 points, respectively. The moderate and severe group was 325.00±10.48 and 321.04±11.34μm, 16.07±1.74 and 15.6±1.98mm, 16.65±2.04 and 16.03±2.3mmHg, 1.50±0.51 and 1.43±0.50 points, and there was differences with those before operation(extremely severe group: 396.46±17.61μm, 22.00±2.3mm, 21.85±2.82mmHg, 5.33±1.44 points; moderate and severe group: 335.77±11.60μm, 19.07±1.84mm, 18.89±3.06mmHg, 1.63±0.49 points; all P<0.001). The best corrected visual acuity(LogMAR)before surgery was 0.64±0.22 in the extremely severe group, and 0.43±0.20 and 0.34±0.15 at 3 and 6mo after operation, respectively, which were different from those before surgery(all P<0.001)CONCLUSION: Orbital decompression can effectively reduce CMCT, intraocular pressure and exophthalmos in TAO patients, relieve orbital vein stasis, and effectively improve vision and reduce mobility in patients with extremely severe disease.

Efficacy of traditional Chinese medicine combined with 131I in the treatment of Graves hyperthyroidism / 中华核医学与分子影像杂志

Objective:To explore the value of traditional Chinese medicine combined with 131I in the treatment of Graves hyperthyroidism. Methods:From March 2020 to July 2021, 90 patients (39 males, 51 females, age (33.2±7.0) years) with Graves hyperthyroidism who were diagnosed and treated in Changshu No.2 People′s Hospital were retrospectively analyzed. Patients were randomly divided into 3 groups ( n=30 in each group), including group A who received treatment of antithyroid drugs (ATD), group B who received treatment of traditional Chinese medicine, and group C who received treatment of 131I combined with traditional Chinese medicine. Thyroid function indicators and inflammatory indicators before treatment and 1, 3, and 6 months after treatment were determined, including free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid stimulating hormone (TSH) and TSH receptor antibody (TRAb), and C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α). One-way analysis of variance and χ2 test were used to analyze data. Results:The levels of FT 3, FT 4, TSH, TRAb, CRP, IL-6 and TNF-α in group A, B and C before treatment and 1, 3, 6 months after treatment were significantly different ( F values: 193.27-906.11, all P<0.05). The total effective rate in group C (100.0%, 30/30) was significantly higher than that in group A (86.7%, 26/30) or group B (83.3%, 25/30; χ2 values: 8.24, 9.83, P values: 0.006, 0.037), while there was no significant difference between group A and group B ( χ2=3.02, P=0.124). The incidence of adverse reactions in group B (46.7%, 14/30) was significantly higher than that in group A (30.0%, 9/30; χ2=6.59, P=0.042). And the incidence of adverse reaction in group C (13.3%, 4/30) was significantly lower than that in group A or group B ( χ2 values: 12.05, 7.20, P values: 0.004, 0.038). Conclusion:The curative effect of 131I combined with traditional Chinese medicine is effective and reliable, suggesting that clinical researches should be carried out together and perfected.

Infix plus cannulated screws for the treatment of pelvic injuries caused by pubic symphysis separation in middle-aged and elderly patients / 中华老年医学杂志

Objective:To investigate the clinical effect of Infix combined with hollow screws for the treatment of pelvic injuries with pubic symphysis separation in middle-aged and elderly patients.Methods:Data of 8 middle-aged and elderly patients with pelvic injuries due to pubic symphysis separation undergone treatment from January 2017 to December 2020 were retrospectively analyzed.Results:The average operating time of 8 patients was (46.0±6.2)min(range: 40-62min); the average intraoperative blood loss was (32.0±5.6)ml(range: 25-50 ml); the average length of incisions at the iliac screw was(2.6±0.4)cm(range: 2.0-3.5 cm); the average length of incisions at the hollow screw was (1.1±0.3)cm(range: 0.8-1.5 cm); and the average times of fluoroscopy were (36.0±6.0)times(range: 28-52 times). Postoperative X-ray and CT examinations showed that the reduction of the pubic symphysis was good, the inserted iliac screws and cannulated screws were positioned accurately, and the incision healed well.Based on Matta's criteria, postoperative radiological outcomes were evaluated, with 7 cases rated as excellent and 1 as good, giving an excellent to good rate of 100%(8/8). The average followed up time for all 8 patients was (15.0±4.2)months(range: 6-24 months). Pelvic X-ray and CT examinations at the last follow-up showed that the fractures healed well and the pubic symphysis reduction did not fail.Infix and cannulated screws in the pubic symphysis were removed 10-12 weeks after surgery[average: (10.5±0.5)weeks]. According to the Majeed Pelvic Score, 5 cases were rated as excellent, 2 cases as good and 1 as fair, with an excellent to good rate of 87.5%(7/8). One patient had symptoms related to the lateral femoral cutaneous nerve that disappeared after 3 months.One patient developed deep venous thrombosis after surgery, and the filter was placed and removed 10 weeks later.Conclusions:Using Infix plus cannulated screws for the treatment of pelvic injuries in middle-aged and elderly patients with pubic symphysis separation has the advantages of limited trauma and intraoperative blood loss, good fixation and few complications.

Analysis on tissue-related biomarkers in patients with acute aortic dissection / 中华心血管病杂志

Objective: To explore the clinical implication of tissue-related biomarkers in patients with acute aortic dissection (AAD). Methods: It was a cross-sectional study. Ten Stanford Type A AAD patients, who were diagnosed and surgically treated in the Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, from December 2018 to August 2019, were selected as the case group. Meanwhile, 10 patients with atherosclerotic heart disease, who underwent coronary artery bypass grafting (CABG), were selected as control group. The ascending aorta tissue specimens from patients of the two groups were collected during the operation. Four-dimensional non-standard quantitative proteomics technology (4D-LFQ) was used to detect the protein profile of ascending aorta tissue specimens of the two groups and to screen out differentially expressed proteins and analyze their biological functions. Precise quantification of the selected target proteins was achieved by parallel response monitoring (PRM). Results: A total of 3 985 proteins were identified by 4D-LFQ technology, among which 3 350 proteins could be quantified. There were 39 proteins were significantly upregulated and 47 proteins were significantly downregulated in AAD group. The results of biological function analysis showed that most of the differentially expressed proteins were located in the extracellular, and their functions were mainly involved in cell migration and proliferation, inflammatory cell activation, cell contraction, and muscle organ development. The 15 selected proteins underwent precise quantification by PRM, and the results showed that integrin α-Ⅱb (ITGA2B), integrin α-M (ITGAM), integrin β-2 (ITGB2), integrin β-3 (ITGB3) were significantly upregulated in the ascending aorta tissue of AAD patients. Conclusion: ITGA2B, ITGAM, ITGB2, and ITGB3 are highly expressed in aortic tissues of patients with AAD, which may be used as biomarkers for the diagnosis of AAD patients.

Combined lumbar pelvic fixator for treatment of unstable vertical fracture and dislocation of old posterior pelvic ring / 中华骨科杂志

Objective:To investigate the clinical effect of using combined lumbar pelvis fixation device in the treatment of old vertical unstable fracture dislocation of posterior pelvic ring.Methods:Data of 7 patients with old vertical unstable fracture dislocation of posterior pelvic ring admitted and followed up from January 2017 to April 2020 were retrospectively analyzed, including 4 males and 3 females with an average age of 42.4 years old (range, 22-73 years old). There were 3 cases of traffic injury, 3 cases of falling injury and 1 case of tumble injury. According to Tile classification for pelvic fractures, there were 5 cases of type C1, 1 case of type C2 and 1 case of type C3. The average time from fracture to surgery was 5.4 weeks (range, 3-10 weeks). Among the 7 patients, 4 patients' posterior ring fractures were fixed by combined lumbar pelvic triangle fixation, and 3 patients' posterior ring fracture were fixed by combined lumbar pelvic fixation. 4 patients' anterior ring injury were not treated, 2 patients' anterior ring injury were treated by closed cannulated screw and internal fixation, and 1 patient's anterior ring injury was fixed by INFIX and cannulated screw. Every patient's operating time, intraoperative blood loss, length of incision and times of X-ray fluoroscopy were recorded. Pelvic X-ray and CT scan were taken postoperatively to observe the condition of reduction and screw position. Postoperative fracture reduction quality was assessed by Matta radiological criteria and Majeed criteria was used at the final follow-ups to evaluate the degree of functional recovery after pelvic fracture.Results:The average operating time of 7 patients was 143 min (range, 96-205 min); the intraoperative average blood loss was 579 ml (range, 300-1 650 ml); the average length of incisions was 12.9 cm (range, 9-15 cm) and the average time of X-ray fluoroscopy was 27 times (range, 15-52 times). Postoperative X-ray and CT scan showed that the displacements of the posterior rings were reset well and all the hollow screws were located accurately and firmly. Postoperative radiation quality was evaluated according to Matta radiological criteria, and there were 4 cases of excellent, 2 cases of good and 1 case of fair, with an excellent and good rate of 85.7% (6/7). Seven patients had good fracture union. The average followed up time for all 7 patients was 12 months (range, 6-16 months). At the last follow-up, imaging examination showed good reduction of the sacroiliac joint, and the reduction of anterior and posterior rings were not lost. The healing time was 14.2 weeks (range, 12-20 weeks). Majeed score: postoperative 4.90±6.64 points (range, 48-58 points), postoperative 3 months 71.40±7.32 points (range, 67-75 points), postoperative 6 months 84.90±8.14 points (range, 68-96 points), the difference was statistically significant ( F=0.614, P=0.004). Majeed score 6 months after operation showed that 5 cases were excellent, 1 case was good and 1 case was fair, and the excellent and good rate was 85.7% (6/7). Conclusion:Using combined lumbar pelvis fixation device in the treatment of old vertical unstable fracture dislocation of posterior pelvic ring has good reduction quality, high fixed strength and good postoperative effect.

Effect of Modified Wuzi Yanzongwan Periodic Staging Treatment on Outcome of Assisted Pregnancy in Patients with Poor Ovarian Response / 中国实验方剂学杂志

Objective:To observe the effect of modified Wuzi Yanzongwan periodic staging treatment on the outcome of assisted pregnancy in patients with poor ovarian response （POR） and kidney deficiency syndrome. Method:One hundred and four patients were randomly divided into observation group and control group， with 52 cases in each group. Both groups received gonadotropin releasing hormone （GnRH） antagonist regimen. The patients in control group additionally took Bushen Yutaiwan orally， 5 g/time， 3 times/day. The patients in observation group additionally took modified Wuzi Yanzongwan during pre-ovulation and post-ovulation periods， 1 dose/day. The treatment courses were 3 menstrual cycles （or termination after clinical pregnancy） in both groups. The number of eggs obtained， the number of available embryos， the number of fertilization， the number of high-quality embryos， the number of embryos implanted， the number of cycles cancelled， and the clinical pregnancy were recorded. Human chorionic gonadotropin （HCG） was injected， and then follicle-stimulating hormone （FSH）， luteinizing hormone （LH）， estrogen （E₂）， anti-Müllerian hormone （AMH）， basal antral follicle count （AFC） and endometrial thickness were measured daily. The number of days and dosage of Gn used， scores of kidney deficiency syndrome were recorded before and after treatment， and the adverse reactions during the study period were recorded. Result:The number of eggs captured， rate of harvested eggs， number of available embryos， rate of available embryos， number of high-quality embryos， rate of high-quality embryos， and fertilization rate in observation group were higher than those in control group （<italic>P</italic><0.05 or <italic>P</italic><0.01）. The cycle cancellation rate was lower than that in the control group； the embryo implantation rate and clinical pregnancy rate were superior than those in control group， but the difference was not statistically significant. The FSH level and FSH/LH ratio in observation group were lower than those in control group during HCG day （<italic>P</italic><0.01）， while E₂， AMH， AFC and endometrial thickness were higher than those in control group （<italic>P</italic><0.01）. Simultaneously， the number of days and amount of Gn used in observation group was lower than that in control group （<italic>P</italic><0.01）. Conclusion:The Modified Wuzi Yanzongwan periodic staging treatment combined with GnRH antagonist scheme for patients with POR kidney deficiency syndrome， can regulate the level of endocrine hormones， promote follicular development， improve ovarian reserve， increase the number of eggs obtained， improve egg quality， help improve pregnancy outcomes， and increase the chances of successful pregnancy with assisted reproductive technology. It is worthy of further clinical research.

TGF-β1-regulated miR-3691-3p targets / 亚洲男科学杂志(英文版)

Transforming growth factor-β1 (TGF-β1) acts as a tumor promoter in advanced prostate cancer (PCa). We speculated that microRNAs (miRNAs) that are inhibited by TGF-β1 might exert anti-tumor effects. To assess this, we identified several miRNAs downregulated by TGF-β1 in PCa cell lines and selected miR-3691-3p for detailed analysis as a candidate anti-oncogene miRNA. miR-3691-3p was expressed at significantly lower levels in human PCa tissue compared with paired benign prostatic hyperplasia tissue, and its expression level correlated inversely with aggressive clinical pathological features. Overexpression of miR-3691-3p in PCa cell lines inhibited proliferation, migration, and invasion, and promoted apoptosis. The miR-3691-3p target genes E2F transcription factor 3 (E2F3) and PR domain containing 1, with ZNF domain (PRDM1) were upregulated in miR-3691-3p-overexpressing PCa cells, and silencing of E2F3 or PRDM1 suppressed PCa cell proliferation, migration, and invasion. Treatment of mice bearing PCa xenografts with a miR-3691-3p agomir inhibited tumor growth and promoted tumor cell apoptosis. Consistent with the negative regulation of E2F3 and PRDM1 by miR-3691-3p, both proteins were overexpressed in clinical PCa specimens compared with noncancerous prostate tissue. Our results indicate that TGF-β1-regulated miR-3691-3p acts as an anti-oncogene in PCa by downregulating E2F3 and PRDM1. These results provide novel insights into the mechanisms by which TGF-β1 contributes to the progression of PCa.

Predictive value of neutrophil/lymphocyte ratio on myocardial injury in severe COVID-19 patients / 中华心血管病杂志

Objective: To explore the predictive value of neutrophil/lymphocyte ratio (NLR) on myocardial injury in severe COVID-19 patients. Methods: In this single-center retrospective cohort study, we collected and analyzed data form 133 severe COVID-19 patients admitted to Renmin Hospital of Wuhan University (Eastern District) from January 30 to February 18, 2020. Patients were divided into myocardial injury group (n=29) and non-myocardial injury group (n=104) according the presence or absence of myocardial injury. The general information of patients was collected by electronic medical record database system. All patients were followed up for 30 days, the organ injury and/or dysfunction were monitored, the in-hospital death was compared between the two groups, and the disease progression was reevaluated and classified at 14 days after initial hospitalization. Logistic regression analysis was performed to identify risk factors of myocardial injury in severe COVID-19 patients. The ROC of NLR was calculated, and the AUC was determined to estimate the optimal cut-off value of NLR for predicting myocardial injury in severe cases of COVID-19. Results: There was statistical significance in age, respiratory frequency, systolic blood pressure, symptoms of dyspnea, previous chronic obstructive pulmonary disease, coronary heart disease history, white blood cells, neutrophils, lymphocytes, platelets, C-reactive protein, platelet counting, aspartate transaminase, albumin, total bilirubin, direct bilirubin, urea, estimated glomerular filtration rate, total cholesterol, low-density lipoprotein cholesterol, D-dimer, CD3+, CD4+, partial pressure of oxygen, partial pressure of CO2, blood oxygen saturation, other organ injury, clinical outcome and prognosis between patients with myocardial injury and without myocardial injury (all P<0.05). Multivariate logistic regression analysis showed that NLR was a risk factor for myocardial injury (OR=1.066，95%CI 1.021-1.111，P=0.033). ROC curve showed that NLR predicting AUC of myocardial injury in severe COVID-19 patients was 0.774 (95%CI 0.694-0.842), the optimal cut-off value of NLR was 5.768, with a sensitivity of 82.8%, and specificity of 69.5%. Conclusion: NLR may be used to predict myocardial injury in severe COVID-19 patients.

Treatment of restrictive strabismus of thyroid associated ophthalmopathy by rectus muscle release and recession combined with orbital fat resection / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To investigate the clinical effect of rectus muscle release and recession combined with orbital fat resection on restrictive strabismus of thyroid associated ophthalmopathy.<p>METHODS: From March 2018 to June 2019, 27 cases of restrictive strabismus with thyroid associated ophthalmopathy were retrospectively analyzed, 34 eyes in total. Under general anesthesia, all patients underwent rectus muscle release and orbital fat resection. The range of orbital fat resection was selected according to the degree of the ophthalmologic process in the subnasal, subtemporal, superior nasal, or superior temporal quadrants.Inferior rectus recession was performed in 25 eyes, medial rectus recession in 5 eyes and superior rectus recession in 4 eyes. According to the degree of exophthalmos, he internal and external fat of inferior nasal, infratemporal, Supranasal or supratemporal quadrant muscles were excised respectively during the operation. According to the preoperative strabismus degree and the degree of contraction of external rectus muscle, the recession amount of rectus operation was designed,and the strength of passive rotation test was estimated intraoperatively. The amount of fat removed during the operation was designed according to the degree of protrusion before operation, and it was designed to remove about 1mL fat and retract the eyeball by 1mm.The postoperative follow-up time was once a week, once a month after 1mo, and irregular follow-up after 3mo. All patients were followed up for more than 6mo.<p>RESULTS: The amount of fat removed was 2.1-3.4mL, with an average of 2.6mL.The visual(LogMAR)acuity was 0-0.2 in the 1mo after operation, with an average of 0.11±0.16. The visual acuity was 0-0.3 in the 6mo after operation, with an average of 0.12±0.17.There was no significant difference in visual acuity before and after operation(<i>P</i>>0.05). The degree of eyeball protrusion was 13-16mm, with an average of 14.4±0.8mm, and the degree of corrected eyeball protrusion was 2-4mm, with an average of 2.4mm(<i>q</i>=10.737, <i>P</i><0.01). The degree of eyeball protrusion at 6mo after surgery was 13-15.5mm, with an average of 14.5±0.6mm, showing no significant difference from 1mo after surgery(<i>q</i>=0.624, <i>P</i>=0.173). 1mo after surgery, the strabismus was 2△-10△, with an average of 6.7△±2.3△, all of which were under correction(<i>q</i>=18.068, <i>P</i><0.01). Before surgery, all the patients had diplopia at the first sight, and the first diplopia disappeared one month after surgery. All patients showed significant improvement in compensatory head position. The strabismus(undercorrection)of the patients at 6mo after surgery was 0△-7△, with an average of 3.4△±1.2△, and the difference was statistically significant compared with 1mo after surgery(<i>q</i>=5.385, <i>P</i>=0.015). The patient had no diplopia at the first and lower transitory position. The mean intraocular pressure after surgery(17.12±1.89mmHg)was lower than that before surgery, and the difference between preoperative and postoperative intraocular pressure was statistically significant(<i>q</i>=4.258, <i>P</i>=0.018).The mean intraocular pressure at 6mo after surgery was 17.53±1.67mmHg, with no significant difference from 1mo after surgery(<i>q</i>=0.729, <i>P</i>=0.154).<p>CONCLUSION: Orbital fat resection can improve the protrusion of the eyeball, but has no significant influence on the surgical design and effect of restrictive strabismus. It is a kind of controllable operation scheme to treat the limited strabismus with exophthalmos of thyroid associated ophthalmopathy with rectus muscle release and recession combined with orbital fat resection.

Comparison of the relative renal function evaluated by 99Tcm-DMSA and 99Tcm-DTPA imaging in children with acute urinary tract infection / 中华核医学与分子影像杂志

Objective@#To compare the relative renal function (RRF) evaluated by 99Tcm-dimercaptosuccinic acid (DMSA) and 99Tcm-diethylene triamine pentaacetic acid (DTPA) imaging in children with acute urinary tract infection (UTI).@*Methods@#A total of 69 children (29 males, 40 females, age: (45±38) months; duration of disease: <6 months) with acute UTI diagnosed clinically in Wuxi People′s Hospital from January 2017 to June 2019 were enrolled retrospectively. All children underwent 99Tcm-DMSA renal static imaging and 99Tcm-DTPA renal dynamic imaging, and the regions of interest (ROI) were drawn manually to calculate the RRF of the right and left kidneys. The consistency of RRF evaluated by the two imaging methods was analyzed by Bland-Altman analysis, the correlation was analyzed by Pearson correlation analysis, and the difference was compared by the independent-sample t test.@*Results@#The values of RRF measured with 99Tcm-DMSA and 99Tcm-DTPA were (52.27±14.53)% and (52.22±14.14)% for the left kidney (t=0.913, P>0.05), those for the right kidney were (47.73±14.53)% and (47.78±14.14)% (t=0.913, P>0.05), respectively. A significant positive correlation was found between the RRF measured with the two imaging methods both for left and right kidneys (r values: 0.959, 0.959; both P<0.01). Bland-Altman analysis showed that the average difference of RRF measured with the two imaging methods for left kidney was 0.1% and the 95% limits of agreement (LoA) was from -8.0% to 8.1%, those for right kidney were -0.1% and from -8.1% to 8.0%.@*Conclusions@#There is a good correlation between RRF measured with 99Tcm-DMSA renal static imaging and that measured with 99Tcm-DTPA renal dynamic imaging in children with acute UTI. Both imaging methods can be used to evaluate the RRF in children with acute UTI.

Clinical Efficacy of Yang Warming, Stasis Dissipating and Detoxifying Method on Sepsis-induced Myocardial Dysfunction / 中国实验方剂学杂志

Objective:To observe clinical efficacy of Shengma Biejia Tang combined with Shenfutang on sepsis-induced myocardial dysfunction (SIMD) and study the controlling effect on inflammatory reaction. Method:Eighty-eight patients with SIMD were randomly divided into control group (44 cases) and observation group (44 cases) by random number table. Patients in control group received the early bundle therapy of sepsis, including fluid resuscitation, anti-infection treatment and vasoactive drugs. In addition to the therapy of control group, patients in observation were also given Shengma Biejia Tang combined with Shenfutang, 1 dose/day. And a course of treatment was 7 days. Before and after treatment, levels of troponin (cTnI), creatine kinase isoenzyme (CK-MB), N terminal brain natriuretic precursor (NT-proBNP), calcitonin (PCT), hypersensitivity C reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukins-6 (IL-6) and blood lactic acid (LAC) were detected. And color Doppler ultrasound examination of the heart was performed to record left ventricular ejection fraction (LVEF), blood flow velocity of early mitral valve diastole and ratio of blood flow velocity at atrial systolic peak (E/A) and stroke volume (SV). And lactate clearance rate (LCR) was calculated. And sequential (sepsis-related) organ failure assessment (SOFA), acute physiology and chronic health (APACHEⅡ) and traditional Chinese medicine(TCM)syndromes were scored. Result:After treatment, levels of cTnI, NT-ProBNP, CK-MB, Hs-CRP, IL-6, PCT, TNF-α and LAC in observation group were lower than those in control group (PPPConclusion:In addition to the integrated western medicine, Shengma Biejia Tang combined with Shenfutang can control inflammatory reaction, relieve myocardial inhibition and myocardial damage, and protect and improve heart function, and alleviate the symptoms.

Efficacy of clinical immunology intervention for patients with glucocorticoid refractory subacute thy-roiditis / 中华核医学与分子影像杂志

Objective To assess the efficacy and clinical value of immunoglobulin combined with interferon ( IFN) α-2b in treatment of patients with glucocorticoid refractory subacute thyroiditis. Methods Thirty-five cases of subacute thyroiditis (12 males, 23 females, age (58.1±12.0) years) from January 2016 to May 2017 were retrospectively analyzed. Patients were resistant to the treatment of glucocorticoid and as-pirin, or were not suitable for that treatment because of accompany diseases. Thirty-four healthy controls (16 males,18 females, age (57.0±10.0) years) were included. Thyroid hormone, C-reactive protein (CRP), erythrocyte sedimentation rate ( ESR) and 24 h iodine uptake rate tests, as well as 99 Tcm O-4 thyroid imaging and thyroid ultrasonography were performed before and after co-administration of immunoglobulin and IFNα-2b. Paired t test or Wilcoxon signed rank test, two-sample t test or Wilcoxon rank test were used for data anal-ysis. Results The levels of free triiodothyronine ( FT3 ) , free thyroxine ( FT4 ) and thyroid stimulating hor-mone ( TSH) 4 weeks after immunology intervention were restored compared with the levels before treatment ( t:4.81, 7.76, z=4.60, all P<0.01) and were not significantly different compared with those in the con-trol group ( t:0.02, 0.33, z=0.37, all P>0.05) . CRP and ESR were sharply decreased compared to those before treatment (t:9.59, 13.78, both P<0.01). The 24 h iodine uptake rate was restored 4 weeks after treatment (t=13.92, P<0.01). The positive result was found in 1 patient (2.9％, 1/35) by 24 h iodine uptake rate test, and 5.7％(2/35) of patients were positive in 99TcmO-4 static imaging and 1 patient(2.9％, 1/35) had positive ultrasonography result. The 3-month follow-up showed that 32 cases were cured and the treatment was effective in all 35 patients. Only 1 case recurred after 12-month follow-up, and the effective rate was 96.9％(31/32, 3 cases were lost to follow-up). Conclusion Immunology intervention is an effective way to treat glucocorticoid refractory subacute thyroiditis and should be applied extensively in clinical treatment.

Therapeutic effect of acupuncture combined electrical stimulation on aged patients with post‐stroke de‐pression／ / 心血管康复医学杂志

To explore therapeutic effect of acupuncture combined electrical stimulation on aged patients with post‐stroke depression .Methods : A total of 78 patients with post‐stroke depression were randomly and equally divided into routine treatment group (received health education based on routine treatment ) and combined treatment group (received acupuncture combined low‐frequency electrical stimulation based on routine treatment group ).After four‐week treatment , score of Hamilton rating scale for depression (HAMD) and therapeutic effect were compared between two groups .Results : Compared with before treatment , there was significant reduction in HAMD score in two groups after treatment ;compared with routine treatment group after treatment , there was significant reduction in HAMD score [(19.72 ± 2. 04) scores vs.(14. 94 ± 1. 86) scores] in combined treatment group , P＝0. 001 all.To‐tal effective rate of combined treatment group was significantly higher than that of routine treatment group (87.18% vs.64.1%, P＝0.018).Conclusion : Acupuncture combined low‐frequency electrical stimulation possesses significant therapeutic effect on post‐stroke depression , which is worthy of clinical application .

Comparison of the relative renal function evaluated by 99 Tcm-DMSA and 99 Tcm-DTPA imaging in children with acute urinary tract infection / 中华核医学与分子影像杂志

Objective To compare the relative renal function (RRF) evaluated by 99 Tcm-dimer-captosuccinic acid (DMSA) and 99 Tcm-diethylene triamine pentaacetic acid (DTPA) imaging in children with acute urinary tract infection (UTI). Methods A total of 69 children (29 males, 40 females, age:(45±38) months; duration of disease: <6 months) with acute UTI diagnosed clinically in Wuxi People's Hospital from January 2017 to June 2019 were enrolled retrospectively. All children underwent 99 Tcm-DMSA renal static imaging and 99 Tcm-DTPA renal dynamic imaging, and the regions of interest (ROI) were drawn manually to calculate the RRF of the right and left kidneys. The consistency of RRF evaluated by the two im-aging methods was analyzed by Bland-Altman analysis, the correlation was analyzed by Pearson correlation analysis, and the difference was compared by the independent-sample t test. Results The values of RRF measured with 99 Tcm-DMSA and 99 Tcm-DTPA were (52.27±14.53)％ and (52.22±14.14)％ for the left kidney (t= 0.913, P>0.05), those for the right kidney were (47.73±14.53)％ and (47.78±14.14)％ (t=0.913, P>0.05), respectively. A significant positive correlation was found between the RRF measured with the two imaging methods both for left and right kidneys (r values: 0.959, 0.959; both P<0.01). Bland-Altman analysis showed that the average difference of RRF measured with the two imaging methods for left kidney was 0.1％ and the 95％ limits of agreement (LoA) was from -8.0％ to 8.1％, those for right kidney were -0.1％and from -8.1％ to 8.0％. Conclusions There is a good correlation between RRF measured with 99Tcm-DMSA renal static imaging and that measured with 99 Tcm-DTPA renal dynamic imaging in children with acute UTI. Both imaging methods can be used to evaluate the RRF in children with acute UTI.

Improvement and application of the opening method of mechanical ventilator humidification tank liquid / 中国实用护理杂志

Objective@#To improve the opening method of humidifier, enhance the efficiency and success rate of opening the humidifiers.@*Methods@#Use all the recycled humidifier from respirators in the wards from 1st of May to 31st of October 2015 as control group. Use the recycled humidifiers from 1st Feb to 31st July 2016 as the test group. Use metal tools to open humidifier bottles in the control group while use the newly developed and improved opening device to open the bottles in the test group to test and compare the damage rate.@*Results@#The testing group that used the practical opening device for humidifier has a decrease in damage rate from 5.97% (16/268) to 1.22% (3/245), and this difference before and after was statistically significant (χ2=8.082, P<0.01).@*Conclusions@#The use of the opening device for humidifier can enhance the intact rate, greatly improve working efficiency and save the cost.

Three-step Method of Treatment Based on Syndrome Differentiation for Primary Bile Reflux Gastritis / 中国中医药信息杂志

Based on the records of ancient medical books, this article analyzed the etiology and pathogenesis of primary bile reflux gastritis. Combined with the clinical diagnosis and treatment experience and thinking, this article explained from various aspects of the principle, method, formula, and medicine, and divided the treatment into three steps, with a purpose to provide references for clinical treatment.

Combined Effects of Family History of Cardiovascular Disease and Serum C-reactive Protein Level on the Risk of Stroke: A 9.2-year Prospective Study among Mongolians in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>We aimed to evaluate the combined effect of a family history of cardiovascular disease (CVD) and high serum C-reactive protein (CRP) on the stroke incidence in an Inner Mongolian population in China.</p><p><b>METHODS</b>A prospective cohort study was conducted from June 2002 to July 2012, with 2,544 participants aged 20 years and over from Inner Mongolia, China. We categorized participants into four groups based on the family history of CVD and CRP levels.</p><p><b>RESULTS</b>We adjusted for age; sex; smoking; drinking; hypertension; body mass index; waist circumference; and blood glucose, triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol levels. Compared with the group with no family history of CVD/low CRP levels, the group with family history of CVD/high CRP levels had a hazard ratio (HR) of 1.78 [95% confidence interval (CI), 1.03-3.07; P = 0.039] of stroke, and an HR of 2.14 (95% CI, 1.09-4.20; P = 0.027) of ischemic stroke. The HRs of hemorrhagic stroke for the other three groups were not statistically significant (all P > 0.05).</p><p><b>CONCLUSION</b>Participants with both a family history of CVD and high CRP levels had the highest stroke incidence, suggesting that high CRP levels may increase stroke risk, especially of ischemic stroke, among individuals with a family history of CVD.</p>

Design, synthesis and biological evaluation of pyridine-based IRAK4 inhibitors / 中国药科大学学报

Based on the known IRAK4 inhibitors MK-32 and AU-5,we designed and synthesized 12 pyridine-based target compounds by adopting open-ring and hybrid strategies,and combining molecular docking technology.The bioassays determined by radioisotope labeling demonstrated that the target compounds displayed good inhibitory activity against IRAK4.Among them,the IC50 value of 5 compounds was less than 1 μmol/L,suggesting that these compounds may be candidates for further investigation.

Forensic Analysis of 6 Cases of Sudden Death due to Hyperthyroid Heart Disease / 法医学杂志

Objective To analyse the cases of sudden death due to hyperthyroid heart disease,and explore the general information of deaths and the forensic pathological characteristics to provide reference evidence for forensic identification of such cases.Methods Six cases of sudden death due to hyperthyroid heart disease between 2001 and 2016 were selected from School of Forensic Medicine,China Medical University.The general information (gender and age),clinical manifestations,medical history,anatomical and histopathological findings,biochemical parameters and cause of death were analysed retrospectively.Results Most of the 6 patients had definite history of hyperthyroidism,and they all showed certain degrees of symptoms of cardiovascular disease;had obvious incentive factors of death;histopathological examination of thyroid conformed to the performances of diffuse toxic goiter;with increase of cardiac weight,dilatation of cardiac chambers,myocardial hypertrophy and focal necrosis;postmortem biochemical analyses of pericardial fluid could be used as an additional method for diagnostic of sudden death due to hyperthyroid heart disease.Conclusion The identification of death due to hyperthyroid heart disease should be based on the clinical history and the results of autopsy,histopathological examination,postmortem toxicology tests.The postmortem biochemical detection of thyroid and cardiac function should be performed if necessary.

Randomized controlled trials of needle knife therapy combined with rotation traction manipulation for the treatment of cervical spondylotic radiculopathy / 中国骨伤

<p><b>OBJECTIVE</b>To compare the therapeutic effects between needle knife therapy combined with rotation traction manipulation and rotation traction manipulation for the treatment of cervical spondylotic radiculopathy.</p><p><b>METHODS</b>From November 2013 to June 2015, 80 patients with cervical spondylotic radiculopathy meeting the inclusion criteria were divided into two groups randomly:the control group in which 39 patients were treated with rotation traction manipulation, and the treatment group in which 41 patients were treated with needle knife combined with rotation traction manipulation. The patients in the control group were treated once dayly for 2 weeks, which was 1 course. The patients in the treatment group were treated with needle knife firstly once a week for 2 weeks, which was 1 course;then were treated with the same methods as the patients in the control group. The symptoms, signs score and the therapeutic effects of the two groups before and after treatment were observed.</p><p><b>RESULTS</b>After treatment, symptoms and signs scores declined in both groups(<0.05). The results of the treatment group were better than effects in the control group(<0.05). In the treatment group, 19 patients got an excellent result, 16 good, 5 fair and 1 bad;while in the control group, 10 patients got an excellent result, 10 good, 16 fair and 3 bad;the results of the treatment group were better than the results of the control group(<0.01).</p><p><b>CONCLUSIONS</b>Needle knife combined with rotation traction manipulation is an effective method for the treatment of cervical spondylotic radiculopathy, which is better than using manipulation method simply. Needle knife therapy has follow advantages:improving local blood circulation, reducing local content of pain substance, increasing production of substances resisting pain, opening channels and collaterals, and make body reaching new static and dynamic balance on the new foundation.</p>