HIV-1 Transmission among Injecting Drug Users is Principally Derived from Local Circulating Strains in Guangxi, China / 生物医学与环境科学（英文）

OBJECTIVE@#The mode of human immunodeficiency virus (HIV) transmission via injection drug use (IDU) still exists, and the recent shift in IDU-related transmission of HIV infection is largely unknown. The purpose of this study was to analyze the spatiotemporal sources and dynamics of HIV-1 transmission through IDU in Guangxi.@*METHODS@#We performed a molecular epidemiological investigation of infections across Guangxi from 2009 to 2019. Phylogenetic and Bayesian time-geographic analyses of HIV-1 sequences were performed to confirm the characteristics of transmission between IDUs in combination with epidemiological data.@*RESULTS@#Among the 535 subjects, CRF08_BC (57.4%), CRF01_AE (28.4%), and CRF07_BC (10.7%) were the top 3 HIV strains; 72.6% of infections were linked to other provinces in the transmission network; 93.6% of sequence-transmitted strains were locally endemic, with the rest coming from other provinces, predominantly Guangdong and Yunnan; 92.1% of the HIV transmission among people who inject drugs tended to be transmitted between HIV-positive IDUs.@*CONCLUSION@#HIV recombinants were high diversity, and circulating local strains were the transmission sources among IDUs in Guangxi. However, there were still cases of IDUs linked to other provinces. Coverage of traditional prevention strategies should be expanded, and inter-provincial collaboration between Guangxi, Yunnan, and Guangdong provinces should be strengthened.

Establishment of qRT-PCR for absolute quantitative detection of Chikungunya virus / 中国热带医学

@#Abstract: Objective　To develop a real-time fluorescent quantitative RT-PCR (qRT-PCR) method for qualitative and quantitative Chikungunya virus (CHIKV) analysis. Methods Based on the systematic analysis of the genomic sequences of Chikungunya and its related arboviruses, the specific nucleic acid sequences for Chikungunya virus were screened and identified, and then the primers and TaqMan probe were designed. Meanwhile, the human GAPDH gene was used as an internal reference. The reaction system for qRT-PCR was systematically optimized by L9(34) orthogonal design, and a rapid detection method for Chikungunya by qRT-PCR based on TaqMan probe methods was established. The sensitivity, specificity, reproducibility, and coverage of the established method were analyzed in detail. The standard curve was made, and the absolute quantitative method was established using the cloned nucleic acid fragments as positive samples. Results　A real-time fluorescent quantitative RT-PCR assay was developed for the qualitative and quantitative analysis of Chikungunya virus. The reaction system included Chikungunya virus and reference internal gene specific primers and probe, RT/Taq enzyme mixture, reaction buffer, and negative and positive reference. The established method obtained positive results with the ROSS strain of ECSA subtype, LR2006 strain of IOL branch, 181/25 strain of Asian type and Dongguan 2010 epidemic strains of Chikungunya virus, but there was no cross-reaction with other 18 arboviruses belonging to Flaviviruses, Alphaviruses and Bunyavirus. The minimum detection limit of the established method was 5.80 copies/mL, and a linear relationship was observed between the amount of input plasmid DNA and fluorescence signal value over a range of 5.80×102 copies/mL to 5.80×1010 copies/mL, and the correlation coefficient was 0.999 5. The qRT-PCR amplification efficiency was 91%, and the intra-assay variations and inter-assay variations were 0.01-0.07 and 0.03-0.11, respectively. Conclusions　The TaqMan qRT-PCR method developed in this study can qualitatively and quantitatively detect Chikungunya virus rapidly with specificity and sensitivity, providing a technical method for the prevention and control of this viral disease.

Effect of procalcitonin on lipopolysaccharide-induced expression of nucleotide-binding oligomerization domain-like receptor protein 3 and caspase-1 in human umbilical vein endothelial cells / 中国当代儿科杂志

OBJECTIVES@#To study the effect of procalcitonin (PCT) on lipopolysaccharide (LPS)-induced expression of the pyroptosis-related proteins nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) and caspase-1 in human umbilical vein endothelial cells (HUVECs).@*METHODS@#HUVECs were induced by LPS to establish a model of sepsis-induced inflammatory endothelial cell injury. The experiment was divided into two parts. In the first part, HUVECs were randomly divided into four groups: normal control, LPS (1 μg/mL), PCT (10 ng/mL), and LPS+PCT (n=3 each). In the second part, HUVECs were randomly grouped: normal control, LPS, and LPS+PCT of different concentrations (0.1, 1, 10, and 100 ng/mL) (n=3 each). Quantitative real-time PCR and Western blot were used to measure the mRNA and protein expression levels of NLRP3 and caspase-1 in each group.@*RESULTS@#In the first experiment: compared with the normal control group, the PCT, LPS, and LPS+PCT groups had significantly upregulated mRNA and protein expression levels of NLRP3 and caspase-1 (P<0.05); compared with the LPS group, the LPS+PCT group had significantly downregulated mRNA and protein expression levels of NLRP3 and caspase-1 (P<0.05). In the second experiment: compared with those in the LPS group, the mRNA and protein expression levels of NLRP3 and caspase-1 in the LPS+PCT of different concentrations groups were significantly downregulated in a concentration-dependent manner (P<0.05).@*CONCLUSIONS@#LPS can promote the expression of the pyroptosis-related proteins NLRP3 and caspase-1 in HUVECs, while PCT can inhibit the LPS-induced expression of the pyroptosis-related proteins NLRP3 and caspase-1 in HUVECs in a concentration-dependent manner.

Determination of trans-1,1,1,4,4,4-hexafluoro-2-butene in workplace air by gas chromatography / 中国职业医学

@#Objective - ，，，，，- - - To establish a gas chromatographic method for the determination of trans 1 1 1 4 4 4 hexafluoro 2 ［ - （）］ Methods - （） butene HFO 1366mzz E in workplace air. HFO 1366mzz E in air was directly collected with aluminum foil ， ， ， composite plastic bag separated by dimethylpolysiloxane capillary column detected by flame ionization detector and Results - （） - 3， quantified with external standard method. The linear range of HFO 1366mzz E was 6.82 68 200.00 mg/m with the 3， correlation coefficient of 0.999 9. The detection limit and the lower limit of quantitation were 0.59 and 1.98 mg/m respectively. - - - The recovery rate was within 95.45% 103.05%. The relative standard deviation of within batch precision and between batch - - ， precision were 2.26% 5.07% and 4.09% 6.82% respectively. The samples can be stored at room temperature for at least seven Conclusion ， ， days. This method is simple to use with a wide linear range low detection limit high accuracy and precision and - （） good sample stability. It can be used for the detection of HFO 1366mzz E in the air of workplace

Four new diphenyl ether derivatives from a mangrove endophytic fungus Epicoccum sorghinum / 中国天然药物

Four new diphenyl ethers, named epicoccethers K-N (1-4), were purified from the fermentation medium of a fungus Epicoccum sorghinum derived from Myoporum bontioides, and identified through HR-ESI-MS and NMR spectral analysis. Except that compound 1 showed moderate antifungal activity against Penicillium italicum and Fusarium graminearum, the other three compounds showed stronger activity against them than triadimefon. All of them showed moderate or weak antibacterial activity towards Staphylococcus aureus and Escherichia coli with O6 and O78 serotypes except that 3 was inactive to E. coli O6.

Death and cardiovascular outcomes in end-stage renal failure patients on different modalities of dialysis

INTRODUCTION@#Cardiovascular morbidity and mortality in end-stage renal failure (ESRF) patients are high. We examined the incidence and predictors of death and acute myocardial infarction (AMI) in ESRF patients on different modalities of dialysis.@*METHOD@#Data were obtained from a population-based database (National Registry Disease Offices) in Singapore. The study cohort comprised all adult patients initiated on dialysis between 2007 and 2012 who were closely followed for the development of death and AMI until September 2014. Cox regression methods were used to identify predictors of death and AMI.@*RESULTS@#Of 5,309 patients, 4,449 were on haemodialysis and 860 on peritoneal dialysis (PD). Mean age of the cohort was 61 (±13) years (44% women), of Chinese (67%), Malay (25%) and Indian (7%) ethnicities. By September 2014, the incidence of all-cause death was 34%; close to a third of the patients died from a cardiovascular cause. Age >60 years and the presence of ischaemic heart disease, diabetes, stroke, peripheral vascular disease and PD were identified as independent predictors of all-cause death. PD patients had lower odds of survival compared to patients on haemodialysis (hazard ratio 1.51, 95% confidence interval 1.35-1.70, P<0.0001). Predictors of AMI in this cohort were older age (>60 years) and the presence of ischaemic heart disease, diabetes, stroke, peripheral vascular disease and current/ex-smokers. There were no significant differences in the incidence of AMI between patients on PD and haemodialysis.@*CONCLUSION@#The short-term incidence of death and AMI remains high in Singapore. Future studies should investigate the benefits of a tighter control of cardiovascular risk factors among ESRF patients on dialysis.

Critical quality attribute assessment of big brand traditional Chinese medicine: quality control method of Huangjing Zanyu Capsules based on chemical properties of characteristic components / 中国中药杂志

The chemical properties of characteristic components are significant to the manufacturing quality control of big brand traditional Chinese medicine. In this study, the Huangjing Zanyu Capsules were used as the research carrier to determine the content of five characteristic components including icraiin, emodin, schisandrin A, 2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside, and osthole simultaneously by high-performance liquid chromatography(HPLC). The results showed that the chemical properties of five cha-racteristic components had a good linear relationship(r>0.999 9) within the quantitative range; the relative standard deviations(RSD) was 0.11%-2.0% and 0.25%-2.8% respectively for intra-day and inter-day precision; the RSD of repeatability was 1.8%-2.6%; the RSD of stability within 48 hours was 0.19%-2.8%, and the average recovery rate was 95.52%-100.1%, all meeting the requirements of pharmaceutical quantitative analysis. Additionally, the interval estimation method was used to directly reflect the distribution of samples with abnormal chemical properties of characteristic components, and the results showed ten samples were detected beyound the 95% control line of confidence level. Multivariate statistical process control(MSPC) method was used to monitor the abnormal samples of Huangjing Zanyu Capsules collectively, and the results showed that two samples were beyond the 95% control line of Hotelling's T~2 and three samples beyond the 95% control line of squared prediction error(SPE), indicating consistent quality control of Huangjing Zanyu Capsules. In conclusion, the proposed method is not only accurate and efficient but also a compensation for the traditional single-component quality control method, providing a scientific basis for the quality control in manufacturing process of Huangjing Zanyu Capsules. Furthermore, it could also serve as a reference method for the quality control in manufacturing big brand traditional Chinese medicine.

Age and diabetes mellitus associated with worse outcomes after percutaneous coronary intervention in a multi-ethnic Asian dialysis patient population

INTRODUCTION@#There is limited literature on clinical outcomes following percutaneous coronary intervention (PCI) in Asian dialysis patients. We evaluated the angiographic characteristics and clinical outcomes of dialysis patients treated with PCI in an Asian society.@*METHODS@#A retrospective analysis was performed of 274 dialysis patients who underwent PCI in a tertiary care institution from January 2007 to December 2012. Data on clinical and angiographic characteristics was collected. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocardial infarction (AMI) and stroke at two years.@*RESULTS@#274 patients (65.0% male, median age 62.0 years) with 336 lesions (81.8% Type B2) were treated. 431 stents (35.0% drug-eluting stents) with a mean diameter of 2.96 mm and mean length of 21.30 mm were implanted. The MACE rate was 55.8% (n = 153) at two years, from death (36.5%) and AMI (35.0%). In multivariable analysis, age and diabetes mellitus were significant predictors of both mortality (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.05-1.12, p < 0.001; OR 2.65, 95% CI 1.46-4.82, p = 0.001, respectively) and MACE (OR 1.06, 95% CI 1.03-1.08, p < 0.001; OR 1.84, 95% CI 1.07-3.15, p = 0.027, respectively). Left ventricular ejection fraction (LVEF) (OR 0.97, 95% CI 0.95-0.99, p = 0.006) was a significant predictor of mortality but not MACE.@*CONCLUSION@#Asian dialysis patients who underwent PCI had a two-year MACE rate of 55.8% due to death and AMI. Age, LVEF and diabetes mellitus were significant predictors of mortality at two years.

Characterization of Vibrio parahaemolyticus isolated from diarrhea patients in Jinshan District，Shanghai / 上海预防医学

Objective:To determine the distribution and epidemic characteristics of Vibrio parahaemolyticus in Jinshan District of Shanghai from 2016 through 2018. Methods:Serotype analysis，examination of virulence genes， including thermolabilehemolysin（TLH），thermostable direct hemolysin（TDH），and TDH related hemolysin（TRH），and antimicrobial susceptibility test and pulsed field gel electrophoresis （PFGE） molecular typing were performed on 218 Vibrio parahaemolyticus isolated from diarrhea patients. Results:A total of 218 strains were divided into 8 groups and 21 serotypes. Of them， 147 strains were serotyped，with O3：K6 as the most common serotype （57.3%）. All tested strains were divided into 25 clusters based on the similarity of 85% and above，in which the dominant cluster was JSVP02，and the total similarity was 56.3%-100.0%. Two hundred and one strains （92.2%） carried tdh gene，13 strains （6.0%） carried trh gene，and 7 strains were negative for both tdh and trh. A total of 35 strains were completely sensitive to 17 kinds of antibiotics，while the remaining 183 strains showed different drug resistance. Conclusion:Vibrio parahaemolyticus isolated from diarrhea patients in Jinshan District from 2016 through 2018 is diverse. Majority of the strains have TDH gene and are resistant to the first generation cephalosporins such as cefazolin and penicillin ampicillin. Construction of regional PFGE molecular typing database will facilitate screening，identification and early warning of high-risk strains.

Impact of BMI on fresh cycle embryo transfer outcome of IVF/ICSI in patients with early follicular phase prolonged protocol / 中华妇产科杂志

Objective:To investigate the impact of body mass index (BMI) on clinical effect and fresh cycle embryo transfer pregnancy outcome of in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) in patients with early follicular phase prolonged protocol.Methods:From January 1st, 2018 to July 1st, 2020, 2 257 cases of early follicular long-term protocol in IVF/ICSI and embryo transfer were collected using the clinical assisted reproductive technologies management system software database of the First Affiliated Hospital of Nanjing Medical University. Patients were divided into three groups according to the recommended Asian BMI cut-off points: low body mass group (BMI<18.5 kg/m 2), normal body mass group (18.5≤BMI<24.0 kg/m 2), and high body mass group (BMI≥24.0 kg/m 2). The ovarian stimulation characteristics among the groups were investigated. Then 1 741 fresh embryo transfer cycles were selected and divided into three groups as above, and then the ovulation induction and clinical outcomes were analyzed among the groups. Results:There were significant differences in the starting dosage of gonadotrophin (Gn), total dosage of Gn and days of Gn used among the low body mass group, normal body mass group, and high body mass group in the 2 257 IVF/ICSI cycles (all P<0.01). The high body mass group needed the most amount of Gn [(2 159±668) U] and longest Gn days [(12.3±2.5) days]. The estradiol and progesterone levels [(7 474±4 852) pmol/L, (3.4±1.9) nmol/L] on hCG trigger day in the high body mass group were lower than those in the low body mass group and normal body mass group (all P<0.01). The oocytes retrieved in high body mass group (8.4±4.1) were significantly lower than normal body mass group ( P<0.05). The normal fertilization number, the available embryo number and high quality embryo number were all lower in the high body mass group than other two groups, while no significant difference showed (all P>0.05). In 1 741 cycles of fresh embryo transfer, the average number of transplanted embryos in the low body mass group (1.2±0.4) was decreased compared with the other two groups ( P<0.05), while the biochemical pregnancy rate, clinical pregnancy rate and live birth rate in the normal body mass group were higher compared with the other two groups, but the differences showed no statistically significance (all P>0.05). Conclusions:Increased BMI might affect ovulation induction response in early follicular phase prolonged protocol IVF/ICSI patients, leading to the increase of Gn dosage and the extension of Gn induction days. Although there is no significant difference in pregnancy outcome among different BMI groups, considering the increased risk of adverse perinatal outcomes during subsequent pregnancy in overweight or obese patients, certain attention should still be paid to the control of BMI in patients receiving assisted reproduction treatment with early follicular phase prolonged protocol.

Anatomical study on reconstruction of calcaneus fibula ligament / 中国骨伤

OBJECTIVE@#To measure anatomical data of calcaneofibular ligament (CFL), relevant data of CFL attachment to provide an anatomical basis for CFL reconstruction.@*METHODS@#Twenty-seven adult ankle specimens were selected, including 11 males and 16 females, aged from 22 to 71 years old with an average of (41.6±17.2) years old;9 cases on the left side and 18 cases on the right side. The specimens reserved at least 20 cm above ankle joint and a complete foot, and exclude deformities, fractures, incomplete development and degenerative lesions. CFL was performed detailed anatomical observation, morphological parameters of CFL was measured, and coordinates of fibula side and calcaneal side of CFL in the coordinate axis were measured. The distance between fibula insertion of CFL and fibula tip, distance between calcaneal insertion of CFL and lateral calcaneal nodule, and Angle between CFL and long axis of fibula were also measured.@*RESULTS@#In these 27 specimens, CFL cases were all single bundles and the length of CFL was (32.83 ± 8.19) mm. The center point of fibula attachment in CFL was(2.87± 1.21) mm proximal with a coefficient of variation of 42.16% and (2.08±1.34) mm anteriorly with a coefficient of variation of 64.42%. The center point of calcaneal attachment region of CFL was located on coordinate axis on the distal end (15.32±5.33) mm, with a coefficient of variation of 34.79%, and the posterior part (6.38±2.15) mm, with a coefficient of variation of 33.86%. The distance between center point of fibula attachment and fibula tip was (4.81±0.82) mm. The distance between center point of calcaneal attachment area of CFL and lateral calcaneal nodules was(17.25±3.12) mm. Angle between CFL and fibula axis is (43 ±18)° .@*CONCLUSION@#According to anatomical studies, we could locate the fibula and calcaneal attachment of CFL by anatomical markers around ankle joint. However, the location of CFL attachment has a large variation, and the anatomical characteristics need to be considered in anatomical reconstruction.

Ultrasonographic assessment and differentiation of spontaneous degenerating cystic thyroid nodules and papillary thyroid carcinomas / 中华耳鼻咽喉头颈外科杂志

Objective: To analyze the features of degenerating cystic thyroid nodules (DCTN) on conventional ultrasound and contrast-enhanced ultrasound (CEUS), and to explore the differentiation between DCTN and papillary thyroid carcinomas (PTC). Methods: A total of 46 DCTN (39 cases, including 12 males and 27 females, with an age range of 25 to 76 years) and 36 PTC (32 cases, including 8 males and 24 females, with an age range of 23 to 68 years) diagnosed via fine- needle aspiration (FNA) or surgery from February 2019 to January 2020 in the First Affiliated Hospital of Nanchang University were enrolled. The size, shape, margin, echogenicity, presence of shadowing, calcification and vascularity of DCTN and PTC were retrospectively evaluated, and 28 DCTN and 30 PTC underwent CEUS were separately analyzed and compared.The t test, χ² test or Fisher's exact test were implemented to compare the features of ultrasound among the two groups. The binary Logistic regression test was performed to determine whether the feature whose difference was statistically significant was an independent predictive risk factor. Results: A univariate analysis indicated that DCTN more frequently showed wider-than-tall shapes, marked hypoechogenicity, well-defined margin and no or dot-lined enhancement (wider-than-tall shapes: 36 vs. 17, χ2=8.511; well-defined margin: 30 vs. 15, χ2=4.523; marked hypoechogenicity: 27 vs. 9, χ2=9.310; no or dot-lined enhancement: 24 vs. 3, χ2=33.369; all P＜0.05). A multivariate analysis demonstrated that wider-than-tall shapes, well-defined margin and marked hypoechogenicity were independent predictors for DCTN (OR values were 5.204, 3.134 and 5.042, P values were 0.003, 0.031, and 0.003, respectively). Among 28 DCTN, 15 showed a decrease in mean maximum diameter (24.3±11.4 mm) with a mean time span of (18.6±10.5) months between the presence and absence of suspicious ultrasound features. Conclusions: Compared with PTC, DCTN shows the ultrasound characteristics of wider-than-tall shapes, well-defined margin, marked hypoechogenicity and no or dot-lined enhancement pattern. Ultrasound follow-up can help to identify spontaneous DCTN.

Effect of rapid rehabilitation surgical nursing in perioperative period of minimally invasive transforaminal fusion / 中国实用护理杂志

Objective:To explore the perioperative effect of rapid rehabilitation surgical nursing (FTS) in patients undergoing minimally invasive transforaminal fusion.Methods:A total of 74 patients with lumbar spondylolisthesis who received minimally invasive transforaminal fusion in the department of orthopedics of the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2018 were selected as the study subjects. The control group and the experimental group each contained 37 cases. Patients in the experimental group received perioperative FTS nursing, while patients in the control group received routine nursing.Numerical Rating Scale (NRS), Oswestry Disability Index (ODI) and postoperative rehabilitation status of patients in the two groups were compared under different nursing interventions.Results:After nursing, the curative effect of the experimental group was 27 (72.97%), 7 (18.92%), 2 (5.41%) and 1 (2.70%) cases, and the control group was 18 (48.65%), 8 (21.62%), 6 (16.22%) and 5 (13.51%) cases, respectively. The difference of the curative effect between the two groups was statistically significant ( χ2 value was 4.593, P<0.05). Patients during perioperative operation time, blood loss, hospital stay, bed time value respectively for the first time (205.44±22.85) min, (185.71±12.21) ml, (2.52±0.82) d, (11.64±3.32) d and control group respectively (213.73±17.12) min, (253.58±16.01) ml, (4.15±0.97) d, (14.56±4.43) d. Blood loss, hospital stay, out of bed time for the first time showed statistically difference between two groups ( t value was 20.504, 7.806, 3.208, all P < 0.05); NRS score and ODI score were 2.26±0.93 and 32.35±5.36 respectively in the experimental group and 4.50±1.09 and 20.62±6.23 in the control group after nursing. The difference between the two groups was statistically significant ( t value was 9.509, 8.682, both P<0.05). Nursing satisfaction was 86.49% (32/37) in the experimental group and 67.57% (25/37) in the control group, and the difference between the two groups was statistically significant ( χ2 value was 3.742, P<0.05). Conclusion:FTS nursing intervention can effectively reduce perioperative discomfort symptoms of patients, promote the recovery of various rehabilitation indicators of perioperative patients, and has positive significance for the improvement of lumbar spine function and lower limb dysfunction.

Roles of Cilia in Heart Development and Congenital Heart Disease / 中国医学科学院学报

Cilia are protruding cell structures on the cell surface and are found in almost every type of cell.According to the different structures and quantity of tubulins,cilia can be divided into two categories:motor cilia and sensory cilia.Sensory cilia are also called non-motor cilia and primary cilia,due to the composition and number of tubulins.They are closely related to the development of internal organs and many human physiological activities.Recent studies have demonstrated that cilia are involved in regulating the formation of left and right symmetry of the heart structure,and eventually the heart develops into the left-right asymmetry structures.Since congenital heart diseases(CHD)are characterized by abnormalities in the spatial structure of the heart chamber and outflow tract,cilia may play an important role in the pathogenesis of CHD.Cilia,mainly through ciliary transduction signal pathways,regulate both the formation of left and right asymmetrical structures and the polarity and the migration of cells.Therefore,a clear understanding of the regulation mechanism of ciliary signaling pathway on heart development can provide new therapeutic targets and new ideas for the clinical treatment of CHD and may offer new target genes for prenatal screening of CHD.This article summarizes recent advances in the role of cilia in heart development and CHD pathogenesis and its mechanisms.

The study on the segmentation of carotid vessel wall in multicontrast MR images based on U?Net neural network / 中华放射学杂志

Objective To investigate the value of automatic segmentation of carotid vessel wall in multicontrast MR images using U?Net neural network. Methods Patients were retrospectively collected from 2012 to 2015 in Carotid Atherosclerosis Risk Assessment (CARE II) study. All patients who recently suffered ischemic stroke and/or transient ischemic attack underwent identical, state?of?the?art multicontrast MRI technique. A total of 17 568 carotid vessel wall MR images from 658 subjects were included in this study after inclusion criteria and exclusion criteria. All MR images were analyzed using customized analysis platform (CASCADE). Randomly, 10 592 images were assigned into training dataset, 3 488 images were assigned into validating dataset and 3 488 images were assigned into test dataset according to a ratio of 6∶2∶2. Data augmentation was performed to avoid over fitting and improve the ability of model generalization. The fine?tuned U?Net model was utilized in the segmentation of carotid vessel wall in multicontrast MR images. The U?Net model was trained in the training dataset and validated in the validating dataset. To evaluate the accuracy of carotid vessel wall segmentation, the sensitivity, specificity and Dice coefficient were used in the testing dataset. In addition, the interclass correlation and the Bland?Altman analysis of max wall thickness and wall area were obtained to demonstrate the agreement of the U?Net segmentation and the manual segmentation. Results The sensitivity, specificity and Dice coefficient of the fine?tuned U?Net model achieved 0.878,0.986 and 0.858 in the test dataset, respectively. The interclass correlation (95% confidence interval) was 0.921 (0.915-0.925) for max wall thickness and 0.929 (0.924-0.933) for wall area. In the Bland?Altman analysis, the difference of max wall thickness was (0.037±0.316) mm and the difference of wall area was (1.182±4.953) mm2. The substantial agreement was observed between U?Net segmentation method and manual segmentation method. Conclusion Automatic segmentation of carotid vessel wall in multicontrast MR images can be achieved using fine?tuned U?Net neural network, which is trained and tested in the large scale dataset labeled by professional radiologists.

Treating intractable lateral epicondylitis by extracurricular arthroscopic operation based on pressure point / 中国骨伤

OBJECTIVE@#To evaluate clinical efficaly of intractable lateral epicondylitis by extracurricular arthroscopic operation based on pressure point.@*METHODS@#From October 2015 to September 2017, 19 patients with intractable lateral epicondylitis were treated with extraarticylar arthroscopic operation based in pressure point. Among patients, including 7 males and 12 females, aged from 33 to 62 years old with an average of(43.16±8.12) years old, The courses of conservative treatment ranged from 7 to 41 months, with an average of(15.47±7.08) months. Postoperative complications were observed, VAS score and Mayo score before and after operation at 3 months were observed and compared.@*RESULTS@#All patients were followed up from 6 to 26 months, with an average (17.16±5.25) months. No infection, skin necrosis and nerve injury occurred. No group weakness occurred within six months after operation. VAS score decreased from 4.42±1.17 before operation to 0.53±0.61 after operation at 3 months. Mago was improved from 62.63±7.88 before operation to 93.42±5.28 after operation at 3 months. According to Mayo score, 17 cases got excellent results, and 2 cases were good.@*CONCLUSIONS@#Intractable lateral epicondylitis by arthroscopic extracurricular operation based on pressure point, which deal with main extracurricular root cause, could anatomical level is understand easily, field of vision is good and diseased tissue is cleaned up thoroughly, and has obvious curative effect.

Treatment for posterior root tear of lateral meniscus through bone tunnel suture under arthroscopy / 中国骨伤

OBJECTIVE@#To evaluate clinical effects of posterior root tear of lateral meniscus through bone tunnel suture under arthroscopy.@*METHODS@#From January 2012 to December 2014, 23 patients with posterior root tear of lateral meniscus repaired through bone tunnel suture under arthroscopy, including 15 males and 8 females, aged from 19 to 48 years old with an average age of (25.0±4.7) years old; 10 knees on the left side and 13 knees on the right side. Complications were observed, Lysholm score before and after operation at 12 months were used to evaluate clinical results, and VAS score was applied to assess pain relief. MRI was used to check recovery outcomes of lateral meniscus injury.@*RESULTS@#All patients were followed up from 13 to 24 months with an average of (17.0±4.3) months. No injury of vessels, nerve and incision infection occurred. Motion of knee joint of 19 patients reached normal, 4 patients manifested limited activity of knee joint at12 months after operation. Postoperative Lysholm score 88.52±6.48 at 12 months was higher than that of before operation 46.12±7.35; Postoperative VAS score 0.8±0.7 at 12 months was lower than that of before operation 4.3±1.6.@*CONCLUSIONS@#Bone tunnel suture under arthroscopy for the treatment of posterior root tear of lateral meniscus could relieve pain, decrease postoperative complications and obtain good clinical efficacy.

Finite element analysis of anterior ring injuries in unstable pelvic fractures treated by different methods / 中国骨伤

OBJECTIVE@#To compare the biomechanical stability of different fixation methods for anterior ring injury of unstable pelvic fractures, and to provide reference for clinical treatment.@*METHODS@#An unstable pelvic fracture model (Tile C) with one side of the sacroiliac joint dislocation and the pubic rami fracture was constructed via three-dimensional finite element analysis. Five different fixation methods were used in the front, and the rear was fixed with sacroiliac screws. The von Mises stress and strain distributions of different combinations of fixation methods were analyzed under mimicking standing conditions.@*RESULTS@#After being loaded with 500 N vertically, the maximum stress in the anterior fracture was 3.56 MPa in anterior pelvic external fixation (AEF) group, the total displacement and the vertical displacement of the Y axis at the sacroiliac joint and the fracture were not more than 1.5 mm. The maximum stress at fixation, the front of the fracture and sacroiliac joints in the anterior pelvic subcutaneous approach(APA) group and AEF, was significantly higher than anterior modified Stoppa approach(ASA) group, anterior pelvic Ilioinguinal approach (AIA) group, and canulated screw fixation(CSF) group. The total displacement and the vertical displacement of the Y axis at the sacroiliac joint and the fracture in APA group and AEF group were also greater than the other three groups.@*CONCLUSIONS@#Anterior ring injury of unstable pelvic fractures can be significantly improved after the fixation of the implants in the five combined methods. However, overall biomechanical properties of ASA, AIA and CSF group are superior to APA and AEF group.

Current evaluation situation and research strategies on enhanced immune function of health food containing Chinese materia medica / 中国中药杂志

At present,the function evaluation of health food containing Chinese materia medica is in lack of theoretical support of Chinese medicine,which can't reflect the function characteristics,dose-effect relationship and mechanism of functional food. What' s more,the evaluation technology of health food containing Chinese materia medica is relatively lagging behind and has been abolished now,which seriously restricts the development of health food containing Chinese materia medica industry. The proportion of health food containing Chinese materia medica with enhancing immune function is the highest among approved products,which is up to 30.33%. By collecting,analyzing and digging the current evaluation situation of enhancing immune function of health food containing Chinese materia medica,this paper has shown that there is no difference between health food containing Chinese materia medica evaluation and other functional food evaluation. What's more,there is a lack of characteristics of traditional Chinese medicine(TCM). The technological means including evaluation of immune active substances is under-developed and the immune cell evaluation needs to be refined and improved urgently,restricting the development of health food containing Chinese materia medica industry. Therefore,the evaluation of the enhanced immune function of health food containing Chinese materia medica should be guided by health-preserving theory in TCM,and based on the identification of TCM constitution for its claim of health function. With TCM theory and modern scientific technological means,a new evaluation model for immune function enhancement of health food containing Chinese materia medica is put forward to distinguish it from other functional food and traditional medicines. Formulation of the evaluation technology and technical specifications suitable for health food containing Chinese materia medica can fundamentally ensure the healthy,orderly,fast and sustainable development of health food containing Chinese materia medica industry.

Metabonomics Analysis of Sailuotong Capsules in Treatment of Acute Cerebral Ischemia in Rats / 中国实验方剂学杂志

Objective:To explore the mechanism of Sailuotong capsules in treating acute cerebral ischemia from the perspective of metabonomics. Method:A total of 24 SD rats were randomly divided into 3 groups, including sham-operated group, model group and Sailuotong group (33 mg·kg-1). The rat model of acute multiple cerebral infarction was established by injecting fluorescent microspheres into internal carotid artery. After the successful operation, rats in Sailuotong group were administered by duodenal injection immediately, and the dosage volume was 2 mL·kg-1. Endogenous metabolites in rat brain tissues of each group were determined by UPLC-Q-TOF-MS. The relevant data and biomarkers were analyzed by principal component analysis (PCA) and partial least squares-discriminant analysis (PLS-DA). Result:The analysis of pattern recognition indicated that the metabolite profiles in model group and sham-operated group were separated obviously, and ten biomarkers related to acute cerebral ischemia were also identified. Compared with the sham-operated group, contents of N-acetylaspartate (NAA), fumaric acid, glutathione, dehydroascorbic acid, aspartic acid and S-adenosylhomocysteine were decreased, while the contents of arginine, citrulline, saccharopine and hydantoin-5-propionic acid were increased in the model group. Meanwhile, the ten abnormal biomarkers mentioned above got restoration in Sailuotong group. Conclusion:The main regulated metabolic pathways of Sailuotong capsules are NAA metabolism, arginine metabolism, energy metabolism, oxidative stress, etc.