Epidemiological investigation of Kaschin-Beck disease prevention and control in Fu County, Shaanxi Province from 1954 to 2022 / 中华地方病学杂志

Objective:To analyze the prevention and treatment of Kaschin-Beck disease in Fu County, Shaanxi Province, so as to provide basis for consolidating the results of Kaschin-Beck disease prevention and control and the treatment of patients with Kaschin-Beck disease.Methods:The epidemiological investigation of data and clinical data Kaschin-Beck disease from 1954 to 2022 were collected from the Fu County Institute for Endemic Disease Prevention and Control and People's Hospital of Fu County in Shaanxi Province, respectively. The retrospective study was used to investigate the prevention and control of Kaschin-Beck disease in Fu County through the adoption of comprehensive measures such as relocation, grain exchange, water improvement, conversion of farmland to forest and so on.Results:In 1954, there were 6 endemic townships and 127 endemic villages of Kaschin-Beck disease in Fu County, with a total population of 78 781. A total of 16 327 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 20.72%, including 5 434 patients without clinical symptoms. There were 5 850 patients with clinical grade Ⅰ, 3 725 patients with clinical grade Ⅱ and 1 318 patients with clinical grade Ⅲ. In 1975, the first general survey of Kaschin-Beck disease was conducted in the whole county, with a total population of 101 341. A total of 9 575 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 9.45%, including 3 247 cases without clinical symptoms. Among the patients with symptoms, there were 3 704 cases of clinical grade Ⅰ, 2 006 cases of clinical grade Ⅱ and 618 cases of clinical grade Ⅲ. The patients with Kaschin-Beck disease were mainly local residents, accounting for 93.92% (8 993/9 575). In 1997, 27 320 students aged 7 to 16 years in 342 schools of 15 townships were examined and found that there were 169 cases without clinical symptoms with X-ray changes, only 2 cases with clinical grade Ⅰ, and the detection rate decreased to 0.63%. In 1997, Fu County began to encourage relocation and grain exchange to prevent Kaschin-Beck disease. The relocation targets were mainly the seriously ill villages with new cases among children and poor living conditions. By 1999, a total of 100 households and 469 people were relocated, and by 2020, 1 569 households and 5 334 people were relocated. In 1997 and 1998, measures were taken to improve water quality in 43 natural villages in 6 townships, with 1 591 households and 7 375 people benefiting. In 2010, a general survey of Kaschin-Beck disease was conducted in 15 townships of Fu County, with a total population of 135 858, and 3 424 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 2.52%. There were 2 885 cases with clinical symptoms, including 1 584 cases with clinical grade Ⅰ, 1 024 cases with clinical grade Ⅱ and 277 cases with clinical grade Ⅲ. Among them, 32 561 minors under 16 years old were examined, and 49 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 0.15%, and all of them were clinical gradeⅠ patients. In 2014, a total of 73 600 people were surveyed in 170 endemic villages of Fu county, and 2 885 patients with Kaschin-Beck disease were detected by X-ray examination, with a detection rate of 3.92%. Compared with 2010, the number of patients with Kaschin-Beck disease increased zero, and there were no underage patients under the age of 16 for 4 consecutive years. By the end of 2016, 666.67 hm 2 of farmland had been converted to forest in Fu County, involving 9 townships (including communities), 33 administrative villages and 1 993 households. In 2018, another general survey of Kaschin-Beck disease was conducted in Fu County, with a total population of 157 362. A total of 2 308 patients were detected by X-ray examination, with a detection rate of 1.47%. Among them, there were 1 270 cases of clinical grade Ⅰ, 870 cases of clinical grade Ⅱ and 168 cases of clinical grade Ⅲ, and there were no patients with Kaschin-Beck disease under 16 years old in the county for 8 consecutive years (2011-2018). In the same year, 22 cases of Kaschin-Beck disease joint replacement were completed in Fu County, and by January 2022, about 60 cases had completed joint replacement. Conclusion:The prevention and control of Kaschin-Beck disease in Fu County has achieved remarkable results through comprehensive measures such as relocation, grain exchange, water improvement and conversion of farmland to forest.

A Case Study of the Technology Transfer in Johns Hopkins University / 中华医学科研管理杂志

This article introduces the details in technology transfer in the Johns Hopkins University (JHU),such as the scope of intellectual property,disciplines and the transfer domains,procedures,items,human resources,faculties motivation measures,categories of license.We also tried to find common contents in its technology transfer works and hoped to provide information to help on the medical science transfer in China.

Meta-analysis of pylorus-preserving pancreaticoduodenectomy in the treatment of periampullary adenocarcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of pylorus-preserving pancreatico-duodenectomy(PPPD) in the treatment of periampullary adenocarcinoma by using Meta-analysis.</p><p><b>METHODS</b>From January 1, 1980 to November 8, 2013, the articles of randomized controlled trials (RCTs) about PPPD versus PD in the treatment of periampullary adenocarcinoma were collected from Cochrane Libriary, Embase, PubMed, Ovid, Web of science and CBM etc. The methodological quality of the included studies was evaluated according to Cochrane system review valuator handbook of risk of bias standards. Meta-analysis was performed by RevMan 5.2 software.</p><p><b>RESULTS</b>Seven RCTs were enrolled in the meta-analysis. Compared to PD group, PPPD group was associated with significantly less intraoperative blood loss (MD=-200.10, 95% CI:-400.66 to 0.46, P=0.05), shorter operation time (MD=-46.55, 95% CI:-91.02 to -2.07, P=0.04), and less postoperative blood transfusion (MD=-0.89, 95% CI:-1.59 to -0.19, P=0.01). There were no significant differences between the PPPD and PD group in pancreatic fistula, biliary fistula, intestinal fistula, abdominal abscess, postoperative bleeding, wound infection, relaparotomy, mortality and survival rate(all P>0.05).</p><p><b>CONCLUSIONS</b>PPPD in the treatment of the periampullary adenocarcinoma is safe and effective with similar survival of PD surgery. PPPD can reduce operative time, intraoperative blood loss, transfusion and does not increase the surgery complications as compared to PD.</p>

Effect of GEPT extracts on spatial learning ability of APPV717I transgenic mice at early stage of dementia and its possible mechanism / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the effect of GEPT extracts on spatial learning ability of the APPV717I transgenic mice at the early stage of dementia and its possible mechanism.</p><p><b>METHOD</b>Thirty APPV717I transgenic mice were randomly divided into three GEPT groups by intragastric administration at doses of 0.075, 0.15, 0.3 g x kg(-1) x d(-1), and a donepezil group by intragastric administration of 0.92 mg x kg(-1) x d(-1), a APPV717I transgenic model group and a normal group by intragastric administration of distilled water. A four-month treatment regimen with GEPT extracts was administered to APPV717I transgenic mice. Results showed that Spatial memory ability was measured in Morris water maze. The total area covered by shank1 and integral optical density in CA1 subfield within the hippocampus were determined using immunohistochemical stains and Image-Pro plus analysis. The ultrastructure of synapses in the hippocampal CA1 region was observed by electronic microscope.</p><p><b>RESULT</b>After a four-month of GEPT treatment regimen, the mean escape latency period were significantly shortened (P < 0.05), and the target quadrant search time were significantly increased (P < 0.05) compared to the APPV717I transgenic model mice. There was a significant higher level in the expression of shank1 detected in the hippocampal CA1 area of APPV717I transgenic mice associated with an increase in the number of synapses treated with GEPT than the levels in the APPV717I transgenic model mice alone. The total area of positive cells covered by shank1 and their integral optical density in the hippocampal CA1 area of the APPV717I transgenic mice treated with GEPT were significantly increased more than those of the APPV717I transgenic model mice.</p><p><b>CONCLUSION</b>GEPT extracts can obviously improve the spatial memory ability of APPV717I transgenic mice at the early stage of dementia through enhancing the number of synapses and the expression of shank1, and this might lead to development of novel treatment therapies for the memory loss associated with AD.</p>

Study on Blood-stasis Syndrome Induced by Cold: Target on the Tongue / 中国实验方剂学杂志

Objectives:To observe the changes of the tongues in rats with blood-stasis syndrome induced mainly by cold. To explore the evidence that tongues were the target of blood stasis syndrome and the target of medication. Methods: Rats with blood-stasis syndrome induced by cold (BSC group) were dipped into ice water (0 ℃) for 5 minutes every day and lasted 20d individually. Different drugs were given orally after the model establishment. And then we took photos of tongues of all rats by digital camera, analyzed the gray scale value of all rats' tongues using image analysis software, and observed the capillaries in tongues by electron microscope. Results: The tongues of rats which had been frozen in ice water for 20 d (once a day) were dark purple, the same as that of models induced by chemical materials .While as for the normal rats, the tongues were lustrous and ruddy. The changes of color of the tongues persisted about 1 week and were great obvious at the 3rd day after the model establishment among different time-points. After given different drugs, the degree of dark purple tongue degraded, showed significant difference (P < 0.01) from that of model rats. The capillary stegnosis and nucleus turgescence of vascular endothelial cell were observed in tongues in BSC group by using electron microscope. After medication, the above changes recovered. Conclusion: The degree of dark purple tongue indicates the degree of diseases with blood-stasis syndrome. The tongue probably is a target of drug treatment.

An explanation on "guiding principles of clinical research on mild cognitive impairment (protocol)" / 中西医结合学报

In order to provide the "guiding principles of clinical research on mild cognitive impairment (MCI) (protocol)" edited by Beijing United Study Group on MCI of the Capital Foundation of Medical Developments (CFMD) with evidence support, clinical criteria, subtypes, inclusion and exclusion of MCI, and use of rating scales were reviewed. The authors suggested that MCI clinical criteria and new diagnosis procedure from the MCI Working Group of the European Alzheimer's disease Consortium (EADC) may better reflect the heterogeneity of MCI syndrome. Diagnostic rating scales including Clinical Dementia Rating (CDR), Global Deterioration Scale (GDS), Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Instrumental Activities of Daily Living (IADL) are very useful in definition of MCI but can not replace its clinical criteria. Absence of major repercussions on daily life in patients with MCI was emphasized, but the patients may have minimal impairment in complex IADL. According to their previous research, the authors concluded that highly recommendable neuropsychological scales with cut-off scores in the screening of MCI cases should include Mini-Mental State Examination (MMSE), logistic memory test such as Delayed Story Recall (DSR), executive function test such as Clock Draw Test (CDT), language test such as Verbal Category Fluency Test (VCFT), etc. And finally, the detection of biological and neuroimaging changes, including atrophy in hippocampus or medial temporal lobe in patients with MCI, was introduced.

Guiding principles of clinical research on mild cognitive impairment (protocol) / 中西医结合学报

Mild cognitive impairment (MCI), as a nosological entity referring to elderly people with MCI but without dementia, was proposed as a warning signal of dementia occurrence and a novel therapeutic target. MCI clinical criteria and diagnostic procedure from the MCI Working Group of the European Alzheimer's Disease Consortium (EADC) may better reflect the heterogeneity of MCI syndrome. Beijing United Study Group on MCI funded by the Capital Foundation of Medical Developments (CFMD) proposed the guiding principles of clinical research on MCI. The diagnostic methods include clinical, neuropsychological, functional, neuroimaging and genetic measures. The diagnostic procedure includes three stages. Firstly, MCI syndrome must be defined, which should correspond to: (1) cognitive complaints coming from the patients or their families; (2) reporting of a relative decline in cognitive functioning during the past year by the patient or informant; (3) cognitive disorders evidenced by clinical evaluation; (4) activities of daily living preserved and complex instrumental functions either intact or minimally impaired; and (5) absence of dementia. Secondly, subtypes of MCI have to be recognized as amnestic MCI (aMCI), single non-memory MCI (snmMCI) and multiple-domains MCI (mdMCI). Finally, the subtype causes could be identified commonly as Alzheimer disease (AD), vascular dementia (VaD), and other degenerative diseases such as frontal-temporal dementia (FTD), Lewy body disease (LBD), semantic dementia (SM), as well as trauma, infection, toxicity and nutrition deficiency. The recommended special tests include serum vitamin B12 and folic acid, plasma insulin, insulin-degrading enzyme, Abeta40, Abeta42, inflammatory factors. Computed tomography (or preferentially magnetic resonance imaging, when available) is mandatory. As measurable therapeutic outcomes, the primary outcome should be the probability of progression to dementia, the secondary outcomes should be cognition and function, and the supplement outcome should be the syndrome defined by traditional Chinese medicine. And for APOE epsilon4 carrier, influence of the carrier status on progression rate to dementia and the effect of treatment should be evaluated.

Influence of calcium preconditioning and streptomycin on ventricular dilation-induced arrhythmias in isolated rat hearts / 老年心脏病学杂志（英文版）

Objective To investigate the mechanism of ventricular dilation-induced arrhythmias by dilating isolated rat hearts. Methods Isolated rat hearts were perfused by Langerdorff method. After equilibration, 80 hearts were randomly divided into four groups as follows: (1) control group (n=20), (2) Ca2+ preconditioning (CPC) group (n=20), (3) streptomycin group (n=20), and (4) CPC + streptomycin group (n=20). A latex balloon which can be filled with fluid was anchored in the left ventricle through the left atrium and mitral valve. Epicardial ECG of the left ventricle, left ventricular pressure, coronary flow and heart rate were recorded before and during ventricular dilation by injecting fluid into the latex balloon. The rate and duration of ventricular dilation-induced arrhythmias were recorded. Results Under the same increase in ventricular end-diastolic pressure made by inflation of the balloon, the rate of arrhythmias was 100% and duration of arrhythmias was 2.56±0.46 s in the control group. Both the rates of premature ventricular beat (90 %) and ventricular tachycardia 70 % ) were high. Compared with the control group, the total rate (60 % ) of arrhythmias was lower, and duration (1.67±0.61 s ) of arrhythmias was shorter in the CPC group. Both the rates of premature ventricular beat (60%) and ventricular tachycardia (40%) were low comparatively. The rate of arrhythmias (45 %) was lower and duration ( 1.64±0.42 s)of arrhythmias was shorter, and the rates of premature ventricular beat (30 % ) or ventricular tachycardia (35 %) were lower in the streptomycin group than in the control one. The least ventricular dilation-induced arrhythmias occurred in the CPC + streptomycin group. The rate of arrhythmias (10%) was the lowest and duration (1.01±0.37s) of arrhythmias was the shortest; both the rates of premature ventricular beat (5%) and ventricular tachycardia (10%) were the lowest. Conclusions Ventricular dilation may induce arrhythmias in isolated rat hearts. Stretch-activated ion channel and the increase in [Ca2+]I are supposed to play important roles in the pathological mechanism.

Changes of brain myelin sheath structure and myelin basic protein content induced by amyloid β peptide (Aβ) and effect of GETO on these changes / 中国康复理论与实践

@# ObjectiveTo observe the injured changes of brain myelin sheath structure and myelin basic protein (MBP) content induced by amyloid β peptide (Aβ) and effect of GETO on these changes.MethodsThe experimental rat model of Alzheimer's disease was established with Aβ1-42 injection into hippocampus. 4 weeks later, the myelin sheath structure of the CA1 area of the rat hippocampus was taken and observed by electromicroscope, and distribution and content of MBP were examined with immunohistochemical method.ResultsThe electromicroscope showed that the structure of myelin sheath became relaxing, disorder, homogenization and default of hippocampus CA1 in the model rats. In GETO treated group, the structure of myelin sheath was integrity and continuum. Immunohistochemical test showed that the staining and numbers of myelin sheath of model rats was thinner than that of normal rats and GETO treated rats. The numbers, mean area and mean density of positive staining axon in hippocampus CA1 of MBP in the model rats were significantly different from those in the normal group and GETO group (P<0.01).ConclusionAβ1-42 injection into hippocampus in rats can impair myelin sheath to make MBP release and GETO can ameliorate these changes.

Association between Carotid Atherosclerotic Plaque and Blood Stasis Syndrome in Patients with Cerebral Infarction / 中华中医药杂志

Objective:To investigate frequency of blood stasis syndrome(BSS) defined by traditional Chinese medicine in cerebral infarction and its correlations with carotid atherosclerotic plaque(CAP).Methods: All subjects comprised 151 patients aged 40 to 80 years(Mean ? SD age,65 ?11 years) with 67.9% for males and 32.1% for females.With the use of ACUSON7 color Doppler ultrasound,carotid atherosclerosis was evaluated by the plaque score,the left plaque score,the right plaque score,the numbers of the plaque respectively as defined by the sum of all plaque heights in bilateral carotid arteries.On the basis of neurological signs and symptoms,medical history,and brain MRI,we diagnosed stroke and its subtypes as follows: stroke(n=117),and vertebrobasilar insufficiency(VBI)(n=34) without the history of the stroke,which were based on Diagnostic Criteria for Cerebral Vascular Diseases in 2005.Diagnosis for syndromes defined by traditional Chinese medicine were made according to Diagnostic Criteria for Stroke in 1994.One-way ANOVA was used in comparison between groups,and multivariant Logistic Regression Analysis was conferred in correlations between several variables.Results: 47.0% of all cases with cerebral infarction presented the BSS,with as lower than syndrome of fire-heat(51.0%),as but significantly higher than syndrome of Qi deficiency(32.0%),liver-wind syndrome(27.0%),phlegm syndrome(23.0%) and syndrome of asthenic yin causing predominant yang(6.0%).There is a significant difference between groups for 44(79.0%) cases of 56 patients with cerebral infarction and the BSS have CAP,and only 35(57.0%) cases of 61 patients with cerebral infarction but without the BSS have CAP(P

Changes of cortisol content in plasma and hippocampus after focal cerebral ischemia-reperfusion in rats / 中国病理生理杂志

AIM: To investigate the relationship between glucocorticoid (Gc) and injury of hippocampus neurons and the effect of Gc on dementia episode after cerebral ischemia-reperfusion. METHODS: The rat model of middle cerebral artery occlusion (MACO) was established. Cortisol contents in hippocampus and plasma of the model rats were examined by means of the radioimmunoassay at 2 h, 6 h, 12 h, 24 h after reperfusion. RESULTS: The levels of cortisol content in model group were significantly higher than those in sham group and normal group both in hippocampus and plasma. The highest cortisol content was observed at 6 hours after reperfusion. HE staining showed that the impairment of hippocampus neurons was aggravated progressively with reperfusion interval elongating. CONCLUSION: The increased cortisol in hippocampus and plasma, after 2 h cerebral ischemia and 24 h reperfusion, could aggravate the injury of hippocampus neurons and lead to dementia post stroke.