Finite element analysis on relationship between wearing high-heeled shoes and stresses in intermetatarsal region of foot / 医用生物力学

Objective To study stress changes in forefoot intermetatarsal region when wearing high-heeled shoes, so as to provide references for quantitative analysis on inducement mechanism of intermetatarsal neuroma and corresponding treatment strategy. Methods Based on the validated foot-ankle-shoe finite element platform, changes of stress levels and tendency in intermetatarsal region were analyzed for both in balanced standing when wearing 0-3 inch (0, 2.54, 5.08, 7.62 cm) high-heeled shoes and walking when wearing 5.08 cm high-heeled shoes in a gait cycle. Results With the increase of heel height, the stresses in intermetatarsal region were significantly increased, and the stress in the third web space of toes when wearing 7.62 cm high-heeled shoes reached 312% of that when wearing flat shoes (0 cm high-heeled shoes). When walking with 5.08 cm high-heeled shoes, the third web space of toes at push-off instance had the largest stress, reaching 90 kPa, which agreed with the most commonly pathogenic site of intermetatarsal neuroma in clinic. Conclusions Wearing high-heeled shoes can obviously increase the stress in intermetatarsal region. Squeezing by upper extrusion of shoes can result in the largest stresses in the third web space of toes region, which is most likely to cause the development of intermetatarsal neuroma.

Effect of Chuanhuang No. 1 recipe on renal function and micro-inflammation in phase 3 chronic kidney disease patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Chuanhuang No.1 Recipe (CHR) on renal function and micro-inflammation in phase 3 chronic kidney disease (CKD) patients.</p><p><b>METHODS</b>Totally 60 phase 3 CKD patients were randomly assigned to the treatment group (treated by CHR) and the control group (treated by Losartan Potassium), 30 in each group. All patients received basic treatment. Patients in the treatment group took CHR decoction, 400 mL each time, one dose per day, while those in the control group took Losartan Potassium, 50-100 mg per day. All medication lasted for 24 weeks. Changes of serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), serum uric acid (UA), 24 h urinary protein excretion (24 h U-pro), urinary microalbumin (U-Alb), high-sensitivity C-reactive protein (hs-CRP), serum tumor necrosis factor (TNF)-alpha, and serum IL-6 were detected and compared before and after treatment. Efficacy was also compared.</p><p><b>RESULTS</b>Compared with before treatment, SCr and BUN significantly decreased in the treatment group (P<0.05, P<0.01); eGFR in- creased (P<0.05). Only UA obviously decreased in the control group (P<0.05), but with no obvious change in SCr, BUN, or eGFR. Compared with before treatment, 24 h U-pro decreased after treatment in the treatment group (P<0.05), but with less decreased level when compared with the control group. U- Alb was also significantly decreased in the control group (P<0.01). There was statistical difference in 24 h U-pro and U-Alb between the two groups after treatment (P<0.05). Compared with before treatment, hs-CRP obviously decreased after treatment in the two groups, but serum levels of TNF-alpha and IL-6 obviously decreased only in the treatment group (P<0.05). The total effective rate was obviously higher in the treatment group than in the control group (70.00% vs. 43.33%, P<0.01).</p><p><b>CONCLUSION</b>CHR could efficiently improve the renal function of phase 3 CKD patients and alleviate the micro-inflammation.</p>

Research advances on associated genes and pathogenesis of hydrocephalus / 浙江大学学报·医学版

Hydrocephalus is a common medical condition characterized by abnormalities in the secretion,circulation or resorption of cerebrospinal fluid (CSF), resulting in ventricular dilatation. The pathogenetic mechanism for the hydrocephalus is attributed to: the overproduction of CSF by the choroid plexus; the defect in CSF absorption and obstruction of CSF flow in the cerebral ventricles. However, the underlying etiology is poorly understood. With the development of genetic engineering, a growing body of evidence indicates that genetic factors play an essential role in the pathogenesis of hydrocephalus. It is the aim of this review to summarize these findings.