Research progress of multi-source information fusion technology in quality evaluation of traditional Chinese medicine / 药学学报

The quality evaluation of traditional Chinese medicine is one of the key issues related to the modernization of traditional Chinese medicine. The quality evaluation technology system of traditional Chinese medicine mainly includes traditional evaluation (traits, microscopic and physicochemical identification), chemical evaluation and biological evaluation. Due to the complex composition of traditional Chinese medicine, the single detection method in the above evaluation technology system usually cannot obtain sufficient quality information. The multi-source information fusion strategy can organically integrate data from multiple analysis and detection technologies to obtain more comprehensive information of samples and improve the quality evaluation effect. At present, multi-source information fusion strategy has been widely used in the fields of military, industrial and food, and it is still in its infancy in the field of quality evaluation of traditional Chinese medicine. This research introduces the definition, structure, method (algorithm) and fusion level of multi-source information fusion, summarizes its research progress in the origin traceability, variety identification and pharmaceutical analysis of traditional Chinese medicine, and sorts out the specific methods of data fusion in each literature. Finally, we summarized, prospected and discussed the application, development and existing problems of information fusion technology and its application in the quality evaluation of traditional Chinese medicine, in order to provide reference for broadening the application of this technology in the field of traditional Chinese medicine.

Chinese medicine dispensing granules: history, status quo, and development prospect in "post-pilot era" / 中国中药杂志

Chinese medicine dispensing granules, the result of the efforts to transform Chinese medicinal decoction pieces in China, features portability and ease of storage. Thus, it is destined to be an indispensible dosage form in the modernization drive of Chinese medicine. The Announcement on Ending the Pilot Project of Chinese Medicine Dispensing Granules was released in February 2021 and relevant regulations went into force in November 2021, which marks the a new journey for the development of Chinese medicine dispensing granules and the beginning of the "post-pilot era". However, it faces the challenges in quality and standard. This study reviewed the history of Chinese medicine dispensing granules, analyzed the technical progress, market, and main problems in development, and proposed suggestions and prospects for its development in the "post-pilot era", which is expected to serve as a reference for its industry development and rational use.

Mechanism of puerarin reversing SH-SY5Y cell injury induced by Aβ_(1-42) based on proteomics / 中国中药杂志

Puerarin has the anti-Alzheimer's disease (AD) activity,which can reverse nerve injury induced by Aβand inhibit neuronal apoptosis.However,its potential pharmacodynamic mechanism still needs to be further researched.The occurrence and development of AD is due to the change of multiple metabolic links in the body,which leads to the destruction of balance.Puerarin may act on multiple targets and multiple metabolic processes to achieve therapeutic purposes.Quantitative proteomic analysis provides a new choice to understand the mechanism as completely as possible.This research adopted SH-SY5Y cells induced by Aβ_(1-42)to establish AD cell model,and Aβimmunofluorescence detection showed that Aβdecreased significantly after puerarin intervention.The mechanism of puerarin reversing SH-SY5Y cell injured by Aβ_(1-42)was further explored by using label-free non-labeled quantitative technology and Western blot detection based on bioinformatics analysis result.The results showed that most of the differential proteins were related to biological processes such as cellular component organization or biogenesis,cellular component organization and cellular component biogenesis,and they mainly participated in the top ten pathways of P value such as pathogenic Escherichia coli infection,m TOR signaling pathway,regulation of autophagy,regulation of actin cytoskeleton,spliceosome,hepatocellular carcinoma,tight junction,non-small cell lung cancer,apoptosis and gap junction.Annexin V/PI flow cytometry and TUNEL were used to detect apoptosis,and the results showed that Aβdecreased significantly and the rate of apoptosis decreased significantly after puerarin intervention.Western blot analysis found that the protein expression level of autophagy related protein LC3Ⅱwas up-regulated after Aβinduction,and the degree of this up-regulation was further enhanced in puerarin intervention group.The trend of the ratio of LC3Ⅱ/LC3Ⅰamong groups was the same as the protein expression level of LC3Ⅱ，the protein expression level of p62 in the control group,AD model group and puerarin intervention group decreased successively.Protein interaction network analysis showed that CAP1 was correlated with TUBA1B,HSP90AB2P,DNM1L,TUBA1A and ERK1/2,and the correlation between CAP1 and ERK1/2 was the highest among them.Western blot showed that the expressions of p-ERK1/2,Bax and CAP1 were significantly down-regulated and the protein expression level of Bcl-2 was significantly up-regulated after puerarin intervention.Therefore,puerarin might improve the SH-SY5Y cells injured by Aβ_(1-42)through the interaction of multiple biological processes and pathways in cells multiple locations,and CAP1 might play an important role among them.

Systematic review and Meta-analysis on efficacy and safety of Yangxue Qingnao Granules in treatment of migraine / 中国中药杂志

To evaluate the efficacy and safety of Yangxue Qingnao Granules alone or combined with calcium channel blocker in treatment of migraine. In this study, four Chinese databases(CNKI, VIP, WanFang, CBM), three English databases(Cochrane Library, EMbase, Medline) and clinical trials registration center(ClinicalTrials.gov) were retrieved. The retrieval time was from the establishment of each database to January 8, 2020. According to the set inclusion criteria and exclusion criteria,the randomized controlled trial(RCT) of Yangxue Qingnao Granules alone or combined with calcium channel blocker was selected. The "Cochrane bias risk assessment" tool was used to evaluate the quality of the included studies. RevMan 5.3 was used to conduct Meta-analysis of the included studies and grade system was used to evaluate the evidence quality of the outcome indicators. A total of 583 documents were retrieved and finally included in 23 studies, with a total sample size of 2 308 cases, 1 171 cases in the treatment group and 1 137 cases in the control group. The overall quality of the research included was not high. Meta-analysis showed that,(1)in terms of effective rate, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(RR=1.24, 95%CI[1.17, 1.32], P<0.000 01), and there was no significant difference between Yangxue Qingnao Granules and calcium channel blocker(RR=1.36, 95%CI[0.91, 2.03], P=0.14).(2)In terms of reducing headache frequency, when the unit of headache frequency was times per month, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-1.39, 95%CI[-1.83,-0.95], P<0.000 01), when the unit of headache frequency was times daily, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-2.08, 95%CI[-2.34,-1.82], P<0.000 01).(3)In terms of headache intensity, when headache intensity was scored by pain intensity, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-0.70, 95%CI[-0.81,-0.59], P<0.000 01), when headache intensity was scored by VAS score, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(MD=-1.59, 95%CI[-2.13,-1.06], P<0.000 01).(4)In terms of reducing headache duration, Yangxue Qingnao Granules combined with calcium channel blocker was better than calcium channel blocker(SMD=-3.13, 95%CI[-4.12,-2.15], P<0.000 01). GRADE system showed that the evidence level of the above outcome indicators was low and extremely low. Twelve cases of adverse reactions were reported, all of which were mild. The results showed that the combination of Yang-xue Qingnao Granules can improve the effective rate, reduce the headache frequency, the headache intensity and the headache duration, and had good safety and low incidence of adverse reactions compared with the single calcium channel blocker. However, there was no difference in the effective rate between Yangxue Qingnao Granules alone and calcium channel blocker. In view of the low quality of this study, which affects the reliability of the conclusion, it is necessary to use the conclusion of this study carefully, and more high-quality randomized controlled trials are needed to further verify in the future.

Systematic review and Meta-analysis on randomized controlled trial of efficacy and safety for acupuncture versus Flunarizine in treatment of migraine / 中国中药杂志

To systematically evaluate the efficacy and safety of acupuncture versus Flunarizine hydrochloride in the treatment of migraine. Four Chinese databases(CNKI, VIP, WanFang, CBM), three English databases(Cochrane Library, EMbase, Medline) and ClinicalTrail.gov were systematically and comprehensively retrieved. The retrieval time was from the establishment of each database to January 8, 2020. Randomized controlled trial(RCT) for acupuncture versus Flunarizine in the treatment of migraine were screened out according to inclusion criteria and exclusion criteria. The included studies were evaluated with the Cochrane bias risk assessment tool. The included studies was conducted by RevMan 5.3, and the outcome indicators were evaluated for evidence quality and strength of recommendation by the GRADE system. A total of 1 033 literatures were retrieved, and 23 studies were finally included. Except for 4 multiarm tests, the total sample size was 1 548, including 785 in acupuncture group and 763 in Flunarizine group. The overall quality of the included studies was not high. Meta-analysis results showed that the acupuncture group was superior to the Flunarizine group in reduction of headache frequency(SMD=-1.00, 95%CI[-1.45,-0.54], P<0.000 1). In reduction of headache intensity, acupuncture group was superior to Flunarizine group(SMD=-1.05, 95%CI[-1.41,-0.68], P<0.000 01). In reduction of headache duration, acupuncture group was superior to Flunarizine group(SMD=-1.42, 95%CI[-1.83,-1.02], P<0.000 1). The acupuncture group was superior to Flunarizine group(MD=-0.17, 95%CI[-0.21,-0.13], P<0.000 01) in reduction of the painkillers taking frequency. The acupuncture group was superior to Flunarizine group(SMD=-0.94, 95%CI[-1.35,-0.52], P<0.000 1) in allevia-tion of paroxysmal symptoms, such as nausea and vomiting. The GRADE system showed that the evidence level of the above indicators was extremely low, and the strength of recommendation was low. As for the occurrence of adverse reactions, the adverse reactions reported in the acupuncture group included in the study were all mild adverse reactions, like drowsiness, subcutaneous bleeding, local pain, subcutaneous hematoma and dizziness needle. The available evidence showed that acupuncture has a better efficacy than Flunarizine hydrochloride in the treatment of migraine in adult patients. However, due to the high bias risk in the included studies, the conclusions of this study shall be adopted with caution, and more high-quality studies shall be carried out for verification in the future.

Analysis and forecasting of the epidemiological characteristics of mumps in Zaozhuang City between 2010 and 2017 / 中华疾病控制杂志

Objective To analyze the epidemiological characteristics of mumps in Zaozhuang city from 2010 to 2017, and establish a predictive model to predict prevalence trend, so as to provide scientific basis for the prevention and control of mumps. Methods Mumps cases between 2010 and 2017 screened from Infectious Diseases Report Information Management System of Chinese Information System of Disease Prevention and Control were analyzed by the descriptive epidemiologic method. The time series analysis method was applied to model and predict the trend of disease. Results A total of 6 353 mumps cases were reported in Zaozhuang city from 2010 to 2017. The average annual incidence was 19.75/100 000. The incidence of men was higher than that of women. The seasonal indices for December to next January and April to July were all above 1. The incidence rates of Shizhong and Yicheng were higher than in other areas. The incidences aged from 3 to 14 accounted for 76.85 % of the total number of cases, while students, scattered children and childcare accounted for 86.11%. The established time series model was ARIMA (1, 0, 0) * (0, 0, 0)12. The mean absolute percentage error of the predictive values based on the model was 39.99% and the number of cases predicted by the model in 2018 was 471. The predictive incidence rate was 11.13/100 000. Conclusions Primary and secondary school students and scattered children are the main population for the prevention and control of mumps. The model obtains better forecasting results and can be used for short-term prediction and dynamic analysis of mumps.

Chevron osteotomy versus Scarf osteotomy for the efficacy of radiographic and clinical in moderate and severe hallux valgus:a systematic review / 中国骨伤

OBJECTIVE@#To evaluate efficacy of radiographic and clinical of Chevron osteotomy versus Scarf osteotomy for hallux valgus at moderate and severe degree.@*METHODS@#Randomized controlled trial (RCT) about Chevron and Scarf osteotomy for hallux valgus, in PubMed, Embase, Cochrane Library, CBM, CNKI, Wanfang Data were searched by computer from establishing database to June 2018. According to inclusion and exclusion criteria, two researchers independently screened the literatures, evaluated risk of bias and extracted related observation index, RevMan 5.3.5 software was used to perform Meta-analysis. Postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), AOFAS score, complications and patients' satisfaction degree between Chevron and Scarf osteotomy.@*RESULTS@#Six RCT literatures were included, involving 507 patients, 92.5% patients were at moderate and severe degree, and 261 patients were performed by Chevron osteotomy and 246 patients were performed by Scarf osteotomy. Meta analysis results showed that Chevron osteotomy was better than Scarf osteotomy in correcting HVA [MD=-1.95, 95%CI(-2.64, -1.27), <0.000 01]. While there were no statistical differences in IMA [MD=-0.42, 95%CI(-1.04, 0.21), =0.19], DMAA[MD=0.78, 95%CI(-0.72, 2.29), =0.31], AOFAS score [MD=2.47, 95%CI(-2.38, 7.33), =0.32], complications [RR=1.09, 95%CI(0.54, 2.20), =0.82], and patients' satisfaction degree [RR=1.00, 95%CI(0.96, 1.05), =0.92].@*CONCLUSIONS@#Chevron osteotomy, which has advantages in simple operation, shorten metatarsal bone, less trauma, was better in correcting HVA of hallux valgus at moderate and severe degree, and had similar effects in IMA, DMAA, AOFAS score, complications and patients' satisfactory degree.

Middle-term follow-up results of Pipkin type IV femoral head fracture patients treated by reconstruction plate and bioabsorbable screws / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To investigate the mid-term curative effects of the treatment of Pipkin type IV femoral head fractures using a reconstruction plate and bioabsorbable screws and provide the evidence for clinical practice.</p><p><b>METHODS</b>From February 2010 to September 2014, 21 patients with Pipkin type IV femoral head fractures were treated surgically. There were 13 males and 8 females with an average age of 41.1 years (range, 20-65 years). The causes of the fractures included traffic accidents (13 cases), falls from a height (four cases), heavy lifting injuries (three cases), and sport injury (one case). All patients were followed up with radiography and three-dimensional reconstruction computed tomography and other checks and any complications were actively managed. Closed reduction of fracture-dislocation of the hip was attempted under general anesthesia using the Kocher-Langenbeck approach. Femoral head fractures were treated with internal fixation or excision based on the size of the fracture fragments, whereas acetabular fractures were fixed with a reconstruction plate and screws following anatomic reduction.</p><p><b>RESULTS</b>The incisions healed by primary intention in all patients after surgery, without any infection, deep venous thrombosis, or other complications. All 21 patients were followed up for 36-76 months, with an average follow-up duration of 49 months. Postoperative imaging data showed that all dislocations and fractures were anatomically reduced, and bony union of the fractures was achieved. Heterotopic ossification was found in four patients, post-traumatic osteoarthritis in three, and avascular necrosis of the femoral head in two. At the final follow-up, the assessment of hip joint function according to the Thompson-Epstein scoring scale was excellent in 10 cases, good in six cases, fair in three cases, and poor in two cases. The rate of excellent and good functional outcomes was 76.1%.</p><p><b>CONCLUSION</b>The mid-term curative effects of a reconstruction plate and bioabsorbable screws in the treatment of Pipkin type IV femoral head fractures is significant, and such the treatment can significantly improve the patient's joint function and quality of life.</p>

Early and mid-term results of transarticular external fixation in the treatment of supination-external rotation type IV equivalent ankle fractures / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To investigate the early and mid-term results of open reduction and internal fixation (ORIF) with transarticular external fixation (TEF) but no deltoid ligament repair (DLR) in the treatment of supination-external rotation type IV equivalent (SER IV E) ankle fractures (AO/OTA classification 44-B 3.1) and provide evidence for clinical practice.</p><p><b>METHODS</b>This study cohort consisted of 22 patients with SER IV E ankle fractures that underwent ORIF with TEF but no DLR between December 2011 and December 2014. There were 13 males and 9 females, mean age 38.9 years (range, 17-73 years). Eight cases involved the left side and 14 the right side. The causes of fractures included road traffic accidents (11 cases), falling from height (6 cases) and sports injuries (5 cases). The mean period of hospitalization was 9.8 days (range, 6-14 days). For all the patients, MRI and three-dimensional CT were done before surgery and X-rays done preoperatively and during follow-ups. The external frame was kept for 8-10 weeks. The preoperative American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 56.86 ± 4.400, the Medical Outcomes Short Form 36-item (SF-36) questionnaire score was 57.41 ± 4.102 and the visual analog score (VAS) was 5.50 ± 1.058. Patients' main complaints about inconvenience of daily life were also recorded.</p><p><b>RESULTS</b>All the 22 patients were followed up for 24-63 months (mean, 33.6 months). None of them developed nonunion during the follow-up; pin site infection was observed in one patient and posttraumatic osteoarthritis in another. At the final follow-up, the average AOFAS score, SF-36 score and VAS score were respectively 90.59 ± 5.096, 79.59 ± 5.394 and 1.82 ± 1.181, which were significantly improved compared with the preoperative data (t = 26.221, p < 0.001; t = 11.910, p < 0.001; t = 11.571, p < 0.001). The therapeutic effect was excellent in 13 cases, good in 7 cases and fair in 2 cases, with a good-excellent rate of 90.9%. Patients' main complaints were inconvenience of clothing (17 cases) and extremity cleaning (5 cases).</p><p><b>CONCLUSION</b>In the treatment of SER IV E ankle fractures, ORIF with TEF but no DLR can achieve satisfactory outcome, but long-term effect should be confirmed by large sample randomized controlled trials.</p>

Systematic review of mindfulness intervention in improving physical and mental symptoms in diabetic patients / 天津医药

Objective To evaluate the effect of mindfulness intervention (MBI) on physical and mental symptoms in patients with diabetes mellitus. Methods Data of the relevant MBI in the physical and psychological symptoms were reviewed in patients with diabetes. The quasi-experimental studies or randomized controlled trials were used to retrieval from May 2016, and back into the study of references. According to the inclusion and exclusion criteria, the literature was screened and the quality was evaluated to extract the data. Review Manager 5.3 software was used for Meta-analysis. Results The total of 9 studies and 474 patients were included in this study. Patients were divided into MBI group (n=251) and control group (n=223). Meta-analysis showed that mindfulness therapy was effective in relieving depression, anxiety, stress and diabetes distress symptoms in diabetic patients compared with those of controls [MD=-5.35, 95%CI:-7.11--3.59;MD=-1.91, 95%CI:-3.04--0.79;MD=-4.65, 95%CI:-6.68--2.44;MD=-6.37, 95%CI:-10.84--1.90], the differences were statistical significance (P < 0.05). The improvement of the negative emotions was sustained long-term effect, and patients can benefit from it. The effects of MBI on the quality of life, whether short-term or long-term, were inconsistent and required further verification. The effects of glycemic control were generally better in MBI group than those of the control group. Conclusion Mindfulness intervention shows beneficial non-drug adjuvant therapy in reducing depression, anxiety, stress and diabetes related distress in patients with type 2 diabetes. The effects of MBI on improving the quality of life, blood glucose control need further verification.

Systematic review of mindfulness intervention in improving physical and mental symptoms in diabetic patients / 天津医药

Objective To evaluate the effect of mindfulness intervention (MBI) on physical and mental symptoms in patients with diabetes mellitus. Methods Data of the relevant MBI in the physical and psychological symptoms were reviewed in patients with diabetes. The quasi-experimental studies or randomized controlled trials were used to retrieval from May 2016, and back into the study of references. According to the inclusion and exclusion criteria, the literature was screened and the quality was evaluated to extract the data. Review Manager 5.3 software was used for Meta-analysis. Results The total of 9 studies and 474 patients were included in this study. Patients were divided into MBI group (n=251) and control group (n=223). Meta-analysis showed that mindfulness therapy was effective in relieving depression, anxiety, stress and diabetes distress symptoms in diabetic patients compared with those of controls [MD=-5.35, 95%CI:-7.11--3.59;MD=-1.91, 95%CI:-3.04--0.79;MD=-4.65, 95%CI:-6.68--2.44;MD=-6.37, 95%CI:-10.84--1.90], the differences were statistical significance (P < 0.05). The improvement of the negative emotions was sustained long-term effect, and patients can benefit from it. The effects of MBI on the quality of life, whether short-term or long-term, were inconsistent and required further verification. The effects of glycemic control were generally better in MBI group than those of the control group. Conclusion Mindfulness intervention shows beneficial non-drug adjuvant therapy in reducing depression, anxiety, stress and diabetes related distress in patients with type 2 diabetes. The effects of MBI on improving the quality of life, blood glucose control need further verification.

Establishment and validation of a dynamic finite element model of human head-neck / 医用生物力学

Objective To construct a three-dimensional (3D) dynamic head-neck finite element model which accords with the anatomical structure, and study its dynamic responses under the external force. Methods By using the neck CT images of a Chinese adult male volunteer and obtaining the 3D cervical point cloud data, the finite element model of cervical spine was established using ICEM-CFD and HyperMesh software. This model, including vertebrae, intervertebral discs, facet joints, ligaments and cartilage tissues, and combining with the established and verified head finite element model, was assembled as human head-neck finite element model with detailed anatomical structures. Results The model was validated by data of head-neck axial impact experiments reported in previously published literature. The simulation results showed that the neck deformation, head acceleration, head force and injury positions were preferably consistent with the experimental data. Conclusions The established 3D dynamic finite element model can be used to study head-neck dynamic responses and damage mechanism in the fields of traffic safety and impact injuries.

Shapes of posterior sclera and macular in high myopia / 眼科新进展

Objective To observe the types of posterior sclera shape (PSS) and macular shape (MS) in high myopia (HM) and its distributions in the pure HM and pathologic myopia (PM).Methods Together 90 patients with high myopia (163 eyes) in the Third Affiliated Hospital of Nanchang University were included in this study.The medical records from deep range imaging optical coherent tomography (DRIOCT) Atlantis and fundus photography examination were used to analyze the types and distributions of PSS and MS.Then all eyes were grouped into the pure HM group and MP group according to META-PM classification standard for comparing and analyzing the types and distributions of PSS and MS.Results Of all 90 patients (163 eyes),The type Ⅰ,Ⅱ,Ⅲ,ⅨX and Ⅶ PSS was in 44 eyes (27.0％),85 eyes (52.1％),15 eyes (9.2％),15 eyes (9.2％),4 eyes (2.5％),respectively.The type Ⅰ,Ⅱ,Ⅲ,Ⅳ horizontal MS was in 31 eyes (20.3％),23 eyes (15.0％),87 eyes (56.9％),12 eyes (7.8％),respectively.The type Ⅰ,Ⅲ,Ⅳ vertical MS was in 104 eyes (69.8％),28 eyes (18.8％) and 17 eyes (11.4％),respectively.As for horizontal MS combined with vertical MS,type Ⅲ + Ⅰ was in 62 eyes (38.8％),type Ⅰ + Ⅰ in 26 eyes (16.3％),type Ⅲ + Ⅲ in 22 eyes (13.8％),type Ⅱ + Ⅰ in 20 eyes (12.5％),and type Ⅳ + Ⅳ in 10 eyes(6.3％);the others 7 types were in 20 eyes (12.5％).There were statistically significant differences in distribution of PPS and horizontal MS between the pure HM and MP group (x2 =12.67,47.60;P ＜ 0.01).Conclusion Patients with pure high myopia has mainly type Ⅰ,Ⅱ PPS,and type Ⅲ horizontal MS together with type Ⅰ vertical MS plus type Ⅲ + Ⅰ horizontal combined with vertical MS,while type]X PSS and type Ⅳ horizontal MS were commonly seen in PM.

Establishment and validation of a dynamic finite element model of human head-neck / 医用生物力学

Objective To construct a three-dimensional (3D) dynamic head-neck finite element model which ac cords with the anatomical structure,and study its dynamic responses under the extemal force.Methods By using the neck CT images of a Chinese adult male volunteer and obtaining the 3D cervical point cloud data,the finite element model of cervical spine was established using ICEM-CFD and HyperMesh software.This model,including vertebrae,intervertebral discs,facet joints,ligaments and cartilage tissues,and combining with the es tablished and verified head finite element model,was assembled as human head-neck finite element model with detailed anatomical structures.Results The model was validated by data of head-neck axial impact experiments reported in previously published literature.The simulation results showed that the neck deformation,head acceleration,head force and injury positions were preferably consistent with the experimental data.Conclusions The established 3D dynamic finite element model can be used to study head-neck dynamic responses and damage mechanism in the fields of traffic safety and impact injuries.

Neurotization of free gracilis transfer with the brachialis branch of the musculocutaneous nerve to restore finger and thumb flexion in lower trunk brachial plexus injury: an anatomical study and case report

OBJECTIVE: To investigate the feasibility of using free gracilis muscle transfer along with the brachialis muscle branch of the musculocutaneous nerve to restore finger and thumb flexion in lower trunk brachial plexus injury according to an anatomical study and a case report. METHODS: Thirty formalin-fixed upper extremities from 15 adult cadavers were used in this study. The distance from the point at which the brachialis muscle branch of the musculocutaneous nerve originates to the midpoint of the humeral condylar was measured, as well as the length, diameter, course and branch type of the brachialis muscle branch of the musculocutaneous nerve. An 18-year-old male who sustained an injury to the left brachial plexus underwent free gracilis transfer using the brachialis muscle branch of the musculocutaneous nerve as the donor nerve to restore finger and thumb flexion. Elbow flexion power and hand grip strength were recorded according to British Medical Research Council standards. Postoperative measures of the total active motion of the fingers were obtained monthly. RESULTS: The mean length and diameter of the brachialis muscle branch of the musculocutaneous nerve were 52.66±6.45 and 1.39±0.09 mm, respectively, and three branching types were observed. For the patient, the first gracilis contraction occurred during the 4th month. A noticeable improvement was observed in digit flexion one year later; the muscle power was M4, and the total active motion of the fingers was 209°. CONCLUSIONS: Repairing injury to the lower trunk of the brachial plexus by transferring the brachialis muscle branch of the musculocutaneous nerve to the anterior branch of the obturator nerve using a tension-free direct suture is technically feasible, and the clinical outcome was satisfactory in a single surgical patient.

Sanders II-III calcaneal fractures fixed with locking plate in elderly patients / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To evaluate the clinical outcomes of locking calcaneal plate in treating calcaneal fracture (Sanders II-III) in elderly patients.</p><p><b>METHODS</b>From October 2012 to December 2013, 23 elderly patients suffering from calcaneal fracture (Sanders II-III) were treated and followed up. There were 15 males and 8 females with the mean age of 68.5 years (range: 65-79 years). According to Sander's classification, 16 cases (16 feet) were type II fractures and 7 cases (7 feet) were type III fractures. Anteroposterior, lateral and axial views of X-ray were taken to detect the calcaneum. CT scan was done to assess the amount of comminution and articular depression. Radiological assessment was performed using Bohler's angle and Gissane's angle. Functional outcome was assessed using the Maryland foot score.</p><p><b>RESULTS</b>All the patients were followed up for 13.7 months on average (10-20 months). The mean time of bone union was 3.2 months (3-4 months). The mean time of complete weight bearing was 3.2 months (3.1-4.0 months). The soft tissue necrosis was found in 1 case. The mean Bohler's angle and Gissane's angle were 25.31° and 117.5°respectively. The overall excellent to good rate was 82.6%.</p><p><b>CONCLUSION</b>Open reduction and internal fixation with locking calcaneal plate can obtain good functional outcome for Sanders II-III calcaneal fractures in elderly patients.</p>

A review of 3D printing via fused deposition modeling in pharmaceutics / 药学学报

Three dimensional printing (3D printing) has been known as additive manufacturing technique based on digitally-controlled deposition of materials. Fused deposition modeling (FDM) is one of techniques commonly used in 3D printing, in which materials are soften or melt by heat to create objects during printing. This paper is prepared to review the research and application of 3D printing via FDM in the pharmaceutical sciences, including its advantages and limitations.

An HPLC-MS/MS method for the determination of trans-ferulic acid in human plasma / 药学学报

In this study, we developed a sensitive and rapid HPLC-MS/MS method for the determination of trans-ferulic acid (trans-FA) in plasma samples, and investigated the pharmacokinetics characteristics in healthy volunteers. The plasma samples were extracted with acetic ether, and then separated on a Hedera ODS-2 column with a mobile phase of methanol and 5 mmol·L-1 ammonium acetate buffer solution containing 0.05% acetic acid (34:66) at a flow rate of 0.4 mL·min-1. Electrospray ionization source was applied and operated in the positive ion mode using MRM. The method exhibited a good linearity over the concentration range of 0.1-5 ng·mL-1 (r ≥ 0.9992). The values on both the occasions (intra-and inter-day) were all within 9.2%, and the accuracy was 95.4%-111.4%. No matrix effect and carry-over effect were observed. Trans-FA was stable in human plasma under different storage conditions. The developed HPLC-MS/MS method is rapid, sensitive, accurate, and reproducible, and suitable for the pharmacokinetic study of trans-FA in healthy Chinese volunteers.

Flow-through anastomosis using a T-shaped vascular pedicle for gracilis functioning free muscle transplantation in brachial plexus injury

OBJECTIVE: In gracilis functioning free muscle transplantation, the limited caliber of the dominant vascular pedicle increases the complexity of the anastomosis and the risk of vascular compromise. The purpose of this study was to characterize the results of using a T-shaped vascular pedicle for flow-through anastomosis in gracilis functioning free muscle transplantation for brachial plexus injury. METHODS: The outcomes of patients with brachial plexus injury who received gracilis functioning free muscle transplantation with either conventional end-to-end anastomosis or flow-through anastomosis from 2005 to 2013 were retrospectively compared. In the flow-through group, the pedicle comprised a segment of the profunda femoris and the nutrient artery of the gracilis. The recipient artery was interposed by the T-shaped pedicle. RESULTS: A total of 46 patients received flow-through anastomosis, and 25 patients received conventional end-to-end anastomosis. The surgical time was similar between the groups. The diameter of the arterial anastomosis in the flow-through group was significantly larger than that in the end-to-end group (3.87 mm vs. 2.06 mm, respectively, p<0.001), and there were significantly fewer cases of vascular compromise in the flow-through group (2 [4.35%] vs. 6 [24%], respectively, p=0.019). All flaps in the flow-through group survived, whereas 2 in the end-to-end group failed. Minimal donor-site morbidity was noted in both groups. CONCLUSIONS: Flow-through anastomosis in gracilis functioning free muscle transplantation for brachial plexus injury can decrease the complexity of anastomosis, reduce the risk of flap loss, and allow for more variation in muscle placement. .

Efficacy of open reduction and internal fixation with a miniplate and hollow screw in the treatment of Lisfranc injury / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To investigate efficacy of open reduction and internal fixation with the miniplate and hollow screw in the treatment of Lisfranc injury.</p><p><b>METHODS</b>Ten cases of Lisfranc injury treated by open reduction, miniplate and hollow screw in our hospital were retrospectively analyzed. There were 6 males and 4 females with age ranging from 25 to 45 years (mean 32 years). Among them, one case was classified as Type A, six Type B and three Type C. Injury mechanism included road traffic accidents (3 cases), fall from height (5 cases) and hit by heavy object (2 cases). All injuries were closed without cerebral trauma or other complicated injuries. The time interval between injury and operation was 6-10 days (average 6.6 days). Postoperatively, the foot function was assessed using Visual Analogue Scales (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) Scales. Healing time and complications were observed.</p><p><b>RESULTS</b>All patients were followed up for 18-24 months (average 20 months). Anatomic reduction was achieved in all patients on images. There was statistical significance between preoperative score (7.89 ± 0.34) and score at postoperative 8 weeks (0.67 ± 0.13). According to the AOFAS score, 5 cases were defined as excellent, 3 cases as good and 2 cases as fair. During follow-up, there was no wound infection or complications except for osteoarthritis in 2 cases. Healing time ranged from 3 to 6 months with an average of 3.6 months.</p><p><b>CONCLUSION</b>Anatomical reduction of Lisfranc injury can be achieved by open reduction and internal fixation with the miniplate and hollow screw. Normal structure of Lisfranc joint is regained to a great extent; injured ligaments were also repaired. Therefore, this method offers excellent curative effect and can avoid postoperative complications and improve the patients' quality of life.</p>