Clinical characteristics and prognosis in 12 children with SARS-CoV-2 Omicron variant infection-associated acute necrotizing encephalopathy / 中国当代儿科杂志

OBJECTIVES@#To study the clinical characteristics and prognosis of SARS-CoV-2 Omicron variant infection-associated acute necrotizing encephalopathy (ANE) in children .@*METHODS@#A retrospective analysis was conducted on the medical data of 12 children with SARS-CoV-2 Omicron variant infection-associated ANE who were admitted to the Pediatric Intensive Care Unit, Qingdao Women and Children's Hospital from December 18 to 29, 2022. The children were divided into two groups based on outcomes: death group (7 cases) and survival group (5 cases). The clinical manifestations and auxiliary examination results were compared between the two groups.@*RESULTS@#The median age of the 12 patients was 30 months, with a male-to-female ratio of 1:1. All patients presented with persistent high fever, with a median highest body temperature of 41℃. The median time from fever onset to seizure or consciousness disturbance was 18 hours. The death group had a higher proportion of neurogenic shock, coagulation dysfunction, as well as elevated lactate, D-dimer, interleukin-6, interleukin--8, and interleukin-10 levels compared to the survival group (P<0.05).@*CONCLUSIONS@#Children with SARS-CoV-2 Omicron variant infection-associated with ANE commonly present with persistent high fever, rapidly progressing disease, and have a high likelihood of developing consciousness disorders and multiorgan dysfunction within a short period. The occurrence of neurogenic shock, coagulation dysfunction, and significantly elevated cytokine levels suggests an increased risk of mortality.

Application of multimodal electromagnetic navigation in endoscopic endonasal skull base anatomical measurement of fresh cadavers / 解剖学报

Objective Electromagnetic navigation was used to observe and measure important anatomical structures through endoscopic endoscopic approach (EEA) to the ventral skull base to provide data for clinical surgery. Methods Using electromagnetic navigation to measure the anatomical structure of the central and paracentral ventral skull base on 10 fresh cadavers, the internal carotid artery (ICA) was the most important. Results Electromagnetic navigation helped to determine the course of important neurovascular. The ICA of the ventral skull base was divided into 5 segments+ 7 major branches, and the length and course of each were measured and recorded. Conclusion The identification and protection of ICA is the key to EEA treatment of ventral skull base lesions, and electromagnetic navigation assistance can improve the efficiency and safety of EEA surgery.

Exploration of acupuncture treatment for insomnia induced by mental retardation: based on "trinity theory of shaoyang, sanjiao and haishi" / 中国针灸

Insomnia induced by mental retardation is related to the synergistic dysfunction of "shaoyang, sanjiao and haishi (the period of the day from 9 pm to 11 pm) " in pathogenesis. Based on "trinity theory of shaoyang, sanjiao and haishi ", the acupoints of hand and food shaoyang meridians on the head and face (Fengchi [GB 20], Sizhukong [TE 23] and Jiaosun [TE 20]) and those on the four limbs (Sanyangluo [TE 8], Zhongzhu [TE 3], Qiuxu [GB 40] and Xiaxi [GB 43]) are selected to regulate the pivot function of shaoyang. Front-mu and back-shu points (Sanjiaoshu [BL 22], Danzhong [CV 17] and Tianshu [ST 5]), as well as auricular points (Gan [CO12], Dan [CO11] and Sanjiao [CO17]) are chosen to promote qi circulation of shaoyang and sanjiao meridians. In association with the relevant knowledge of time acupuncture at haishi, the circadian rhythm of sleep is set up and the appropriate sleep pattern is developed.

Radiation field reconstruction and hand dose estimation for operators injured by a X-ray device radiological accident / 中华放射医学与防护杂志

Objective:To evaluate the radiation dose to the injured persons in a radiological accident, provide the guidance on the diagnosis and treatment of radiation injury, and provide the basis for determination of the level of radiological accident.Method:Firstly, the air-absorbed dose rates at 206 locations surrounding a X-ray device were measured by using LiF (Mg, Cu, P) thermoluminescence detectors and self-made radiation field measuring frames. Secondly, the spatial distribution of radiation level was obtained by fitting the inverse square law between absorbed dose rate and distance, which is used as the basis of dose estimation. Finally, based on the actual working conditions of injured operators, a parameter calculation method was proposed for estimating hand skin absorbed dose.Results:The air-absorbed dose rate surrounding X-ray beam outlet was higher than 1.0 mGy/h. The maximum air-absorbed dose rate value in the space of within 200 cm outside X-ray beam outlet was 262 μGy/h and the minimum value was 2.1 μGy/h, 2 orders of magnitude higher than environmental background level. During normal operation, the total absorbed doses to the hand skin of two injured female operators were 36.9 and 16.9 Gy, respectively. During extreme operation, the hand skin-received total absorbed doses to the two operators were 85.2 and 38.9 Gy, respectively. Under the occupational health standard GBZ 106-2020, the two persons had acute radiation skin injury of grade Ⅲ or Ⅳ on their hands.Conclusions:The results of hand skin exposure doses provide effective support for diagnosis and treatment of radiation injuries and for the determination of radiological accident level. The method used in radiation field reconstruction and dose estimation mentioned in this study can provide reference for the treatment in the similar radiological accident.

Expert consensus on clinical application of GBE50 Dispersible Tablets for ischemic cardiovascular and cerebrovascular diseases / 中国中药杂志

Ginkgo biloba Extract( GBE50) Dispersible Tablets is a new standardized prescription,which is widely used in the treatment of ischemic cardiovascular and cerebrovascular diseases. However,there are still many problems in its clinical application.Rational and safe use of GBE50 Dispersible Tablets is pivotal to the medication safety and clinical prognosis of patients. This consensus has been jointly formulated by clinical experts of traditional Chinese medicine and western medicine in cardiovascular and cerebrovascular diseases and followed the Manual for the Clinical Experts Consensus of Chinese Patent Medicine published by the China Association of Chinese Medicine. The present study identified clinical problems based on clinical investigation,searched the research papers according to PICO clinical problems,carried out evidence evaluation,classification,and recommendation by GRADE system,and reached the expert consensus with nominal group technique. The consensus combines evidence with expert experience. Sufficient evidence of clinical problems corresponds to " recommendations",while insufficient evidence to " suggestions". Safety issues of GBE50 Dispersible Tablets,such as indications,usage and dosage,and medication for special populations,are defined to improve clinical efficacy,promote rational medication,and reduce drug risks. This consensus needs to be revised based on emerging clinical issues and evidencebased updates in practical applications in the future.

A comparative study of artificial intelligence nasal polyp classification based on whole-slide imaging and JESREC diagnostic criteria / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the types and clinical characteristics of chronic rhinosinusitis with nasal polyps (CRSwNP) based on artificial intelligence and whole-slide imaging (WSI), and to explore the consistency of the diagnostic criteria of the Japanese epidemiological survey of refractory eosinophilic chronic rhinosinusitis (JESREC) in Chinese CRSwNP patients. Methods: The data of 136 patients with CRSwNP (101 males and 35 females, aging 14 to 70 years) who underwent endoscopic sinus surgery from 2018 to 2019 in the Department of Otorhinolaryngology Head and Neck Surgery, the Third Affiliated Hospital of Sun Yat-sen University were analysed retrospectively. The preoperative clinical characteristics of patients were collected, such as visual analogue scale (VAS) of nasal symptoms, peripheral blood inflammatory cell count, total immunoglobulin E (IgE), Lund-Kennedy score and Lund-Mackay score. The proportion of inflammatory cells such as eosinophils, lymphocytes, plasma cells and neutrophils were calculated on the WSI of each patient through artificial intelligence chronic rhinosinusitis evaluation platform 2.0 (AICEP 2.0), and the specific type of nasal polyps was then obtained as eosinophilic CRSwNP (eCRSwNP) or non-eosinophilic CRSwNP (non-eCRSwNP). In addition, the JESREC diagnostic criteria was used to classify the nasal polyps, and the classification results were compared with the current gold standard for nasal polyps diagnosis (pathological diagnosis based on WSI). The accuracy, sensitivity and specificity of the diagnostic criteria of JESREC were evaluated. The data were expressed in M (Q1, Q3) and statistically analyzed by SPSS 17.0. Results: There was no significant difference between eCRSwNP and non-eCRSwNP in age distribution, gender, time of onset, total VAS score, Lund-Kennedy score or Lund-Mackay score. However, there was a significant difference in the ratio of nasal polyp inflammatory cells (eosinophils 40.5% (22.8%, 54.7%) vs 2.5% (1.0%, 5.3%), neutrophils 0.3% (0.1%, 0.7%) vs 1.3% (0.5%, 3.6%), lymphocytes 49.9% (39.3%, 65.9%) vs 82.0% (72.8%, 87.5%), plasma cells 5.1% (3.6%, 10.5%) vs 13.0% (7.4%, 16.3%), χ2 value was 9.91, 4.66, 8.28, 5.06, respectively, all P<0.05). In addition, eCRSwNP had a significantly higher level of proportion of allergic symptoms (nasal itching and sneezing), asthma, peripheral blood eosinophil and total IgE (all P<0.05). The overall accuracy, sensitivity and specificity of the JESREC diagnostic criteria was 74.3%, 81.3% and 64.3%, respectively. Conclusions: The eCRSwNP based on artificial intelligence and WSI has significant high level of allergic symptoms, asthma, peripheral blood eosinophils and total IgE, and the percentages of inflammatory cells in nasal polyps are different from that of non-eCRSwNP. The JESREC diagnostic criteria has good consistency in our research.

NLRP3 inflammasome and development of diabetic cardiomyopathy / 中国药理学通报

Diabetic cardiomyopathy(DCM) is a specific cardiac complication of diabetes, which occurs independently of coronary artery disease, hypertension or valvular heart disease. Although diabetic cardiomyopathy is increasingly recognized, the underlying mechanisms are still under controversial. Recently, the putative pathological mechanism involves hyperglycemia, protein nonenzymatic glycosylation, oxidative stress, abnormal calcium ion transport, etc. Inflammation is an independent risk factor for left ventricular diastolic dysfunction. NLRP3 inflammation is the most common inflammasome, which can secrete pro-inflammatory cytokines such as IL-1β, IL-18, and mediate pyroptosis after activated. It manifests a high level of NLRP3 inflammasomes in DCM animal model, which aggravates the damage of pancreatic β-cell function, myocardial injury and the process of myocardial fibrosis. It has been confirmed that Chinese herbal medicine can affect the initiation and activation of NLRP3 inflammasomes, as well as the expression of downstream genes, and then improve the cardiac function of diabetic cardiomyopathy. In this paper, we have summarized the involvement of NLRP3 inflammasomes in the process of diabetic cardiomyopathy and the therapeutic effects of Chinese herbal medicine.

Relationship between ferroptosis and oxidative stress and its research progress in locomotor diseases / 医学研究生学报

Ferroptosis is an iron-dependent, non-apoptotic form of cell death characterized by accumulation of intracellular lipid reactive oxygen species. It exists in many fields such as nervous system, tumor, acute kidney injury, ischemia reperfusion injury. Oxidative stress (OS) is resulted from by excessive accumulation of ROS produced by an organism undergoing aerobic metabolism. Both of these eventually lead to excessive ROS accumulation, which leads to cell damage and death. This paper first summarized the relationship between ferroptosis and oxidative stress, and then described the current achievement of research on ferroptosis in locomotor diseases, trying to provide a theoretical support to find ferroptosis in more diseases through taking the oxidative stress as a bridge.

Use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannoma / 中华医学杂志(英文版)

BACKGROUND@#Extra-corporeal video telescope operating monitor system provides a necessary instrument to perform high-precision neurosurgical procedures that could substitute or supplement the traditional surgical microscope. The present study was designed to evaluate a compact high-definition two-dimensional exoscope system for assisting in surgical removal of large vestibular schwannoma (VS), as an alternative to a binocular surgical microscope.@*METHODS@#Patients with Koos grade 3 and grade 4 VS undergoing surgery were enrolled in this prospective cohort study between January 2013 and June 2018. The demographics and tumor characteristics (size, Koos grade, composition [cystic or solid mass]) were matched between the two groups of patients. The following outcome measurements were compared between the two groups: duration of surgery, volume of blood loss, extent of tumor resection, number of operating field adjustments, pre- and post-operative facial and cochlear nerve function evaluated at 3 months post-surgery, complications and surgeons' comfortability.@*RESULTS@#A total of 81 patients received tumor resection through the retrosigmoid approach under either an exoscope (cases, n = 39) or a surgical microscope (control, n = 42). Patients in the two groups had comparable tumor location (P = 0.439), Koos grading (P = 0.867), and composition (P = 0.891). While no significant differences in the duration of surgery (P = 0.172), extent of tumor resection (P = 0.858), facial function (P = 0.838), and hearing ability (P = 1.000), patients operated on under an exoscope had less blood loss (P = 0.036) and a fewer field adjustments (P < 0.001). Both primary and assistant surgeons reported a high level of comfort operating under the exoscope (P = 0.001 and P < 0.001, respectively).@*CONCLUSIONS@#The compact high-definition two-dimensional exoscope system provides a safe and efficient means to assist in removing large VSs, as compared to a surgical microscope. After the acquaintance with a visual perception through a dynamic hint and stereoscopically viewing corresponding to the motion parallax, the exoscope system provided a comfortable, high-resolution visualization without compromising operational efficiency and patient safety.

Regulatory Effect of Yangxue Jiedu Decoction on Tight Junction of Keratinocytes in Psoriasis / 中国实验方剂学杂志

Objective::To observe the expressions of tight junction proteins (claduin-1, claudin-7 occludin)of psoriasis-like lesions in mice, and clarify the effect of Yangxue Jiedu decoction on the epidermal barrier of psoriasis, so as to provide scientific basis for the treatment of psoriasis with Yangxue Jiedu decoction. Method::C57BL/6J mice were randomly divided into control group, model group, methotrexate group and Yangxue Jiedu decoction.Methotrexate solution and water decoction of Yangxue Jiedu decoction were prepared, and the mice were given imiquimot to induce psoriasis-skin lesions after the hair was shaved.Daily photos were taken to record the forms of skin lesions and psoriasis area and severity index(PASI) scores.Water and oil test pens were used to detect skin moisture content. The pathological changes were observed by htoxylin eosin (HE) staining, and the epidermal thickness was measured.Ki67 was detected by immunofluorescence. Immunohistochemistry was used to detect the expressions of loricrin, CD3+ T lymphocyte infiltration and claduin-1, claudin-7, occludin.In addition, the expressions of claudin-7 and occludin in skin lesions were detected by Western blot.Meanwhile, interleukin-17(IL-17) (1 mg·L-1) was used to simulate the microenvironment of psoriasis skin lesions, and the intervention was conducted by making Yangxue component, Jiedu component and Yangxue Jiedu dry powder.The toxicity of the drug on Hacat cells was detected by cell counting kit-8(CCK-8)method.The effect of the drugs on the expressions of claudin-1, claudin-7, occludin in Hacat was detected by immunofluorescence assay. Result::Yangxue Jiedu decoction could significantly reduce the psoriasis skin lesions in mice, and reduce the PASI score and skin thickness (P<0.01). Compared with the model group, the skin moisture content in the lesion was increased (P<0.01). Abnormal expressions of ki67 and loricrin in epidermis and infiltration of CD3+ T cells were reduced (P<0.01). In addition, the expressions of claudin-1, claudin-7, occludin proteins (P<0.05), and the integrity of the tight junction structure were increased.In vitro studies, compared with the model group, the expressions of claudin-1, claudin-7, and occludin in the Yangxue Jiedu group and Yangxue group were increased (P<0.05). Compared with the model group, there was no statistically significant difference in protein expression in the Jiedu group. Conclusion::By regulating the expressions of tight junction proteins between keratinocytes, Yangxue Jiedu decoction can inhibit the abnormal proliferation and differentiation, and further restore the broken epidermal barrier.Yangxue Jiedu decoction plays a role in regulating tight junction mainly through Yangxue component.

Methylation-Based Age Estimation Model Construction and Its Effectiveness Evaluation / 法医学杂志

OBJECTIVES@#To screen the DNA methylation loci associated with the age of Han males in northern China and to construct an age estimation model.@*METHODS@#Twenty-one candidate methylation loci were screened. The DNA methylation levels of 476 blood samples from Chinese Han males were detected for 21 amplicons using EpiTYPER technology platform, and data on 153 DNA methylation loci were obtained.@*RESULTS@#After correlation analysis, 8 age-related DNA methylation loci were finally screened. CpG1, CpG2, CpG4, CpG7, CpG8 were located on TRIM59, RASSF5, Clorf132, CSNK1D, ELOVL2,CpG5, CpG6 on PDE4C, and CpG3 on chr17:21452808. Based on the 8 loci, 352 samples were used for model construction. A multivariate linear regression age estimation model was constructed （R2=0.93）, with mean absolute deviation （MAD） of 2.69 years old. When 109 samples were used for model validation, the MAD was 3.80 years old. The test was repeated 3 times in 15 new samples, with MADs of 4.08, 4.68 and 3.93 years old, respectively.@*CONCLUSIONS@#The age estimation model on Han males in northern China constructed in this study can be used to estimate the age of victims and suspects and to narrow the scope of investigation, and therefore has practical application value.

Comparison of Apixaban and Low Molecular Weight Heparin in Preventing Deep Venous Thrombosis after Total Knee Arthroplasty in Older Adults

PURPOSE: To compare the effect of apixaban and low molecular weight heparin (LMWH) in the prevention and treatment of deep venous thrombosis (DVT) after total knee arthroplasty in older adult patients. MATERIALS AND METHODS: A total of 220 patients (average age of 67.8±6.4 years) undergoing total knee arthroplasty were randomly selected as research subjects and were divided into apixaban and LMWH groups (110 in each group). RESULTS: The incidence of DVT was lower in the apixaban group than in the LMWH group (5.5% vs. 20.0%, p=0.001). Activated partial thromboplastin times (35.2±3.6 sec vs. 33.7±2.2 sec, p=0.010; 37.8±4.6 sec vs. 34.1±3.2 sec, p<0.001; 39.6±5.1 sec vs. 35.7±3.0 sec, p=0.032) and prothrombin times (14.0±1.0 sec vs. 12.8±0.9 sec, p<0.001; 14.5±1.2 sec vs. 13.0±1.1 sec, p<0.001; 15.3±1.4 sec vs. 13.2±1.3 sec, p=0.009) in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were higher than those in the LMWH group. Platelet and fibrinogen levels in the apixaban group were lower than those of the LMWH group. Also, capillary plasma viscosity and erythrocyte aggregation in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were lower than those in the LMWH group. CONCLUSION: Apixaban, which elicits fewer adverse reactions and is safer than LMWH, exhibited better effects in the prevention and treatment of DVT after total knee arthroplasty in older adults.

Mechanism of Modified Maimendong Tang Combined with Cisplatin in Enhancing Chemosensitivity on Human Lung Adenocarcinoma A549 Cells / 中国实验方剂学杂志

Objective: To observe effect of modified Maimendong Tang combined with cisplatin on the cell proliferation, apoptosis, invasion and metastasis and the protein expressions of Caspase-3, epidermal growth factor receptor(EGFR)of human lung adenocarcinoma A549 cells in vitro, so as to investigate their relevant mechanisms in inhibiting cells proliferation, invasion and metastasis and inducing apoptosis of A549 cells. Method: The lung cancer cells A549 were respectively treated with modified Maimendong Tang(15 g·L-1), cisplatin(9 mg·L-1), and combined drugs. Afterwards, they were divided into control group, modified Maimendong Tang group, cisplatin group and modified Maimendong Tang combined with cisplatin group. Thiazolyl blue tetrazolium bromide (MTT) assay was used to evaluate the proliferation of A549 cells treated with different concentrations of modified Maimendong Tang(0, 5, 10, 15, 20, 25 g·L-1) and cisplatin(0, 3, 6, 9, 12, 15 mg·L-1) for 24, 48, 72 h. The proliferation of A549 cells in each group was detected by MTT assay; flow cytometry was used to detect the degree of apoptosis and cycle in the above four groups of cells; scratch test and transwell migration test were performed to observe the abilities of invasion and metastasis of each group; Western blot was used to detect Caspase-3 and EGFR protein expression. Result: The concentration of modified Maimendong Tang and cisplatin and the time of intervention were negatively correlated with the proliferative capacity of A549 cells (PP0/G1 phase increased apparently, and the cells in S phase decreased significantly (PPConclusion: Modified Maimendong Tang combined with cisplatin can inhibit the proliferation, invasion and metastasis and induce the apoptosis of lung cancer cells. Modified Maimendong Tang can synergistically enhance the action of cisplatin. The mechanism may be related to the down-regulation of Caspase-3 and EGFR protein expressions.

The connection between the night pain of patients with rotator cuff tears and circadian clock / 医学研究生学报

Patients with rotator cuff tears often have repeated irregular neck and shoulder pain, and all of them are aggravated at night. The patient is very painful and cannot suffer from lateral position. Most of them cannot or do not do the exercises such as stretching the elbow and bending the arm, which seriously affect sleep. Numerous studies have shown that in addition to inflammation, the two-way interaction to the circadian clock, the circadian clock also regulated many aspects of the immune system. And the mechanism of night pain caused by rotator cuff injury was related to factors such as inflammation of the acromion sac. This suggests that the night pain of rotator cuff tears may have a circadian rhythm. This article mainly reviews the mechanism of night pain caused by rotator cuff tears.

Analysis of limb swelling and pain caused by a tourniquet after total knee arthroplasty / 医学研究生学报

The advantages of the tourniquet in total knee arthroplasty are favored by surgeons. However, tourniquets can aggravate the swelling and pain of postoperative limbs，which is not good for early functional exercise. Researchers conducted many related studies which only stayed in clinical manifestations and did not clarify the causes and mechanisms of swelling and pain，So there are no positive effect on the prevention and treatment of swelling and pain. Tourniquets can cause ischemia, hypoxia and reperfusion injury in limbs, leading to local tissue inflammatory reactions, vascular injury, microcirculatory disorders, abnormal coagulation, deep venous thrombosis, lymphatic drainage disorders, joint cavity occult hemorrhage, effusion and the damage of distant organs, which eventually exacerbated the degree of swelling and pain of the limb. Therefore, the above factors are reviewed in this article.

Effect of HR-HPV positive,load and SCC-Ag positive on recurrence rate after radical resection for cervical cancer / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the effect of HR-HPV positive,HR-HPV load and SCC-Ag positive on the recurrence of cervical cancer after radical resection.METHODS: The clinical data of cervical cancer patients who underwent radical resection of cervical cancer in People's Hospital of Zengcheng District from January 2010 to January2019 were retrospectively collected.The patients were followed up regularly,and the preoperative HR-HPV positive,loading,the amount of SCC-Ag expression were determined;the recurrence and metastasis of cervical cancer were analyzed,and the value of HR-HPV positive,HR-HPV loading and SCC-Ag in predicting the recurrence and metastasis of cervical cancer were analyzed.RESULTS: A total of 438 patients with cervical cancer were included.There was no significant difference in pathological type,or postoperative Meigs-Brunschwig pathological staging between the recurrence group(n=42)and the non-recurrence group(n=396)(P>0.05).The difference in the proportion of HRHPV positive(40/42 vs. 144/396),HR-HPV loading and SCC-Ag positive(34/42 vs. 64/396)was statistically significant between non-recurrence group and recurrence group(P0.05).Multivariate logistic regression analysis showed that distant metastasis,FIGO staging of cervical cancer,HR-HPV positive,and SCC-Ag were independent factors affecting cervical cancer recurrence(P<0.05).When predicting by individual indicator,the specificity and positive predictive value of HR-HPV positive for predicting cervical cancer recurrence were 99.18% and 95.23% at the highest,and the negative predictive value of HR-HPV was87.37% at the highest.When SCC-Ag was used to predict cervical cancer recurrence,the sensitivity was up to 33.33%.The sensitivity of combined prediction was 64.51%,the specificity was 99.46%,the positive predictive value was97.41%,and the negative predictive value was 94.44%.CONCLUSION: Distant metastasis,FIGO staging,HR-HPV positive,and SCC-Ag are independent factors affecting cervical cancer recurrence.The combination of HR-HPV positive,HR-HPV loading and SCC-Ag has certain value for predicting recurrence of cervical cancer,and the prediction value is the highest.

Dose-effect relationship in treatment of chronic neck pain with the direct moxibustion of small moxa cone / 中国针灸

OBJECTIVE@#To evaluate the effectiveness in treatment of chronic neck pain with the direct moxibustion of small moxa cone and explore the dose-effect relationship in treatment of chronic neck pain with different small moxa cones.@*METHODS@#A total of 120 patients with chronic neck pain were randomized into a 3-moxa-cone group, a 5-moxa-cone group, a 7-moxa-cone group and a sham-moxibustion group, 30 cases in each one. Fengchi (GB 20), Tianzhu (BL 10), Jingbailao (EX-HN 15), Jianzhongshu (SI 15) and Jianjing (GB 21) were selected in each of the groups. The direct moxibustion with 3, 5 and 7 moxa cones as well as the sham-moxibustion therapy were provided successively in each of the above groups. In the sham-moxibustion group, the lower 1/3 section of moxa cone (about 1.5 mm in length) was soaked in oil before used in treatment. In each group, the treatment was given twice a week, for 10 treatments totally. Separately, before treatment, after treatment and in 1-month follow-up, the scores of the Northwick Park neck pain questionnaire (NPQ), the scores of McGill pain questionnaire (MPQ) and the local pressure pain threshold (PPT) were observed in each group. After treatment and in 1-month follow-up, the therapeutic effects were evaluated in each group.@*RESULTS@#After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were reduced as compared with those before treatment separately (all 0.05). After treatment and in 1-month follow-up, NPQ scores and MPQ scores in the 3-moxa-cone group, the 5-moxa-cone group and the 7-moxa-cone group were lower as compared with the sham-moxibustion group separately (all 0.05).@*CONCLUSION@#The direct moxibustion therapy with different small-moxa-cones effectively relieves chronic neck pain. There is a trend of improvement of the therapeutic effects with increase of the numbers of moxa cones.

Two different kinds of total hip arthroplasty for unilateral Crowe IV developmental dysplasia of the hip in adults / 中国骨伤

OBJECTIVE@#To compare the clinical effects of total hip arthroplasty(THA) with non-osteotomy and subtrochanteric osteotomy in the treatment of Crowe type IV hip dysplasia (DDH) in adults.@*METHODS@#Data of 35 Crowe type IV DDH patients who underwent THA were analyzed retrospectively, the patients were divided into two groups:15 cases of non-osteotomy and 20 cases of subtrochanteric osteotomy. There was no significant difference in age, gender, body mass index between two groups (>0.05). The operative time, bleeding volume, hospitalization duration, Harris hip score and the limb length discrepancy (LLD) were evaluated.@*RESULTS@#All of the patients were followed up for 12 to 48 months, no prosthesis loosening or infection occurred by the end of follow-up. In non-osteotomy group, 1 case had occurred by sciatic nerve injury and 1 case developed cutaneous branch injury of the femoral nerve, both of which were spontaneously recovered completely without treatment after 3 months. One case of dislocation occurred in subtrochanteric osteotomy group, after closed reduction, dislocation did not recur; three cases had proximal femoral crack fractures and received steel plate fixation; no reoperation was needed. There was significant difference in operation duration, bleeding volume, and hospitalization days between two groups(0.05). The postoperative discrepancy of bilateral lower limbs had significant difference(<0.05).@*CONCLUSIONS@#THA with no femoral shortening osteotomy can achieve good clinical results in patients with unilateral Crowe IV developmental dysplasia of hip. Comparing with subtrochanteric osteotomy, the procedure of no femoral shortening osteotomy is easier technically. For unilateral high dislocation DDH patients with limb lengthening <=4 cm and good tissue conditions, THA without femoral osteotomy may be considered.

The application of serum endotoxin detection in the diagnosis of artificial prosthetic joint loosening / 医学研究生学报

Objective The dynamic detection of endotoxin is of great significance for the early diagnosis and treatment of prosthesis loosening after joint replacement. This study aimed to explore and analyze the clinical significance and efficacy of endotoxin detection in prosthetic joint loosening after joint replacement.Methods Fifty-eight patients who underwent arthroplasty in the department of orthopedics in Nanjing General Hospital from January 2015 to June 2016 were selected for prospective study. The patients were divided into the infection loosening group (patients with infectious loosening after arthroplasty, n=15), the aseptic loosening group (patients with aseptic loosening of after arthroplasty, n=23) and the control group (patients were normal after arthroplasty, n=20) according to the postoperative complications. Endotoxin was detected with MB-80 microbial dynamic rapid detection system. We compared the endotoxin level and the ROC curve was made to acquire the sensitivity and specificity under the different cut-off values. Eventually find the best diagnostic threshold.Results The levels of endotoxin in the infection loosening group and the aseptic loosening group \[(0.56±0.11, 0.49±0.08) ng/mL\] were significantly higher than that in the control group \[(0.24±0.06) ng/mL\]. The difference was statistically significant (P0.05). ROC curve analysis showed that when the serum endotoxin concentration was 0.36 ng/mL, the Youden index was the highest, which could be the best cut-off value for diagnosis. It had the best accuracy to judge the prosthesis loosening with a sensitivity of 66.7% and specificity of 88.2%.Conclusion The endotoxin can be a good indicator for early diagnosis of prosthesis looseness. It is helpful to the diagnosis of the prosthesis loosening after arthroplasty.

An overview oflncRNA involved in articular cartilage injury and repair / 医学研究生学报

Long noncoding RNAs (lncRNAs) are important regulators for a variety of biological process. miRNAs appear to be important modulators of chondrogenesis and osteoarthritis (OA). LncRNAs are widely involved in the regulation of proliferation and apoptosis of chondrocytes as sponge of microRNAs. In this review, we discuss the role of lncRNA in cartilage repairation from the aspects of cartilage injury, chondrocyte proliferation and chondrocyte apoptosis. These findings will promote the development of novel molecular drugs which regulate the balance of cartilage injury and repairation.