Establishment and validation of clinical prediction model for steroid-resistant nephrotic syndrome in children / 中华儿科杂志

Objective: To identify the clinically relevant factors of steroid-resistant nephrotic syndrome (SSNS) in children and establish a predictive model followed by verifying its feasibility. Methods: A retrospective analysis was performed in a total of 111 children with nephrotic syndrome admitted to Children's Hospital of ShanXi from January 2016 to December 2021. The clinical data of general conditions, manifestations, laboratory tests, treatment, and prognosis were collected. According to the steroid response, patients were divided into SSNS and steroid resistant nephrotic syndrome (SRNS) group. Single factor Logistic regression analysis was used for comparison between the 2 groups, and variables with statistically significant differences were included in multivariate Logistic regression analysis. The multivariate Logistic regression analysis was used to identify the related variables of children with SRNS. The area under the receiver operating characteristic curve (ROC), the calibration curve and the clinical decision curve were used to evaluate its effectiveness of the variables. Results: Totally 111 children with nephrotic syndrome was composed of 66 boys and 45 girls, aged 3.2 (2.0, 6.6) years. There were 65 patients in the SSNS group and 46 in the SRNS group.Univariate Logistic regression analysis showed that the 6 variables, including erythrocyte sedimentation rate, 25-hydroxyvitamin D, suppressor T cells, D-dimer, fibrin degradation products, β2-microglobulin, had statistically significant differences between SSNS and SRNS groups (85 (52, 104) vs. 105 (85, 120) mm/1 h, 18 (12, 39) vs. 16 (12, 25) nmol/L, 0.23 (0.19, 0.27) vs. 0.25 (0.20, 0.31), 0.7 (0.6, 1.1) vs. 1.1 (0.9, 1.7) g/L, 3.1 (2.3, 4.1) vs. 3.3 (2.7, 5.8) g/L, 2.3 (1.9,2.8) vs. 3.0 (2.5, 3.7) g/L, χ2=3.73, -2.42, 2.24, 3.38, 2.24,3.93,all P<0.05), were included in the multivariate Logistic regression analysis. Finally, we found that 4 variables including erythrocyte sedimentation rate, suppressor T cells, D-dimer and β2-microglobulin (OR=1.02, 1.12, 25.61, 3.38, 95%CI 1.00-1.04, 1.03-1.22, 1.92-341.04, 1.65-6.94, all P<0.05) had significant correlation with SRNS. The optimal prediction model was selected. The ROC curve cut-off=0.38, with the sensitivity of 0.83, the specificity of 0.77 and area under curve of 0.87. The calibration curve showed that the predicted probability of SRNS group occurrence was in good agreement with the actual occurrence probability, χ2=9.12, P=0.426. The clinical decision curve showed good clinical applicability. The net benefit is up to 0.2. Make the nomogram. Conclusions: The prediction model based on the 4 identified risk factors including erythrocyte sedimentation rate, suppressor T cells, D-dimer and β2-microglobulin was suitable for the early diagnosis and prediction of SRNS in children. The prediction effect was promising in clinical application.

Efficacy of external treatment of integrated traditional Chinese and Western medicine on chloasma / 中华医学美学美容杂志

Objective:To explore the efficacy of external treatment of integrated traditional Chinese and Western medicine on melanized type complicated with vascularized type of chloasma.Methods:A total of 82 patients (aged 26-50 years, with an average age of 44.5 years) with melanized type complicated with vascularized type of chloasma were selected, and randomly divided into groups: 28 cases in the traditional Chinese medicine control group were treated with traditional Chinese medicine pourmask combined with surrounded facial acupuncture; 26 cases in Western medicine control group underwent wet compress with 0.5% tranexamic acid solution. In the integrated Chinese traditional and Western medicine treatment group, 28 cases were treated with 2 regimens. After 8 weeks, MASI score was carried out, and vascular hyperplasia in skin lesions was observed by polari-light skin scope.Results:After treatment, the MASI scores in the three groups were all decreased, and the decreasing rate of MASI scores from high to low was as follows: Integrated Chinese traditional and Western medicine treatment group (8.60±4.53) > TCM control group (6.26±3.20) > Western medicine control group (4.39±2.11). After treatment, the vascular hyperplasia scores in the three groups were all decreased, and the value of vascular hyperplasia in the integrated Chinese traditional and Western medicine treatment group (2.57±0.63) and Western medicine control group (1.55±0.51) was greater than that in TCM control group (0.96±0.51), but there was no significant difference between the integrated Chinese traditional and Western medicine treatment group and Western medicine control group.Conclusions:External treatment of integrated traditional Chinese and Western medicine is effective in the treatment of melanized type complicated with vascularized type of chloasma, and wet compress with tranexamic acid solution can inhibit vascular hyperplasia in patients with chloasma.

Rapid identification and differential markers of Curcumae Radix decoction pieces of different sources based on Heracles Neo ultra-fast gas phase electronic nose / 中国中药杂志

Since Curcumae Radix decoction pieces have multiple sources, it is difficult to distinguish depending on traditional cha-racters, and the mixed use of multi-source Curcumae Radix will affect its clinical efficacy. Heracles Neo ultra-fast gas phase electronic nose was used in this study to quickly identify and analyze the odor components of 40 batches of Curcumae Radix samples from Sichuan, Zhejiang, and Guangxi. Based on the odor fingerprints established for Curcumae Radix decoction pieces of multiple sources, the odor components was identified and analyzed, and the chromatographic peaks were processed and analyzed to establish a rapid identification method. Principal component analysis(PCA), discriminant factor analysis(DFA), and soft independent modeling cluster analysis(SIMCA) were constructed for verification. At the same time, one-way analysis of variance(ANOVA) combined with variable importance in projection(VIP) was employed to screen out the odor components with P<0.05 and VIP>1, and 13 odor components such as β-caryophyllene and limonene were hypothesized as the odor differential markers of Curcumae Radix decoction pieces of diffe-rent sources. The results showed that Heracles Neo ultra-fast gas phase electronic nose can well analyze the odor characteristics and rapidly and accurately discriminate Curcumae Radix decoction pieces of different sources. It can be applied to the quality control(e.g., online detection) in the production of Curcumae Radix decoction pieces. This study provides a new method and idea for the rapid identification and quality control of Curcumae Radix decoction pieces.

Portable Monitoring Device for Motor Rehabilitation Equipment with Rotor Shaft / 中国医疗器械杂志

A novel and portable device is proposed to monitor motor rehabilitation equipment, which can be mounted on most equipment with rotor shaft. The software of the device, whose main functions include equipment configuration, monitoring and statistical computation, is developed based on available sensor. The data collected by the device serve both department managers to learn the efficiency of the equipment, and physicians and therapists to understand the physical conditions of the patients who perform training exercises with the monitored rehabilitation equipment. About 2000 hours' monitoring has been carried out, and the experimental result indicates that the monitoring device is applicable to many types of motor rehabilitation equipment and achieves good monitoring accuracy. The data aggregated by the device can be used to evaluate the motor functions of the patients and make rehabilitation training plan. Besides, it is agreed by physicians and therapists that the device is easy-to-use, robust and has good real-time performance. The monitoring device thus holds the promise of boosting the development of digitalized rehabilitation medicine.

Computer-assisted cognition training relieves cognitive dysfunction after a stroke: A multicenter randomized and controlled study / 中华物理医学与康复杂志

Objective:To explore the clinical efficacy of computer-assisted cognitive training in the treatment of cognitive impairment after stroke.Methods:A total of 155 stroke survivors with vascular cognitive impairment were identified at 31 hospitals. They were randomly divided into a control group of 72 and an experimental group of 77 (6 failed to follow up). The control group received 30 minutes of conventional cognition training 5 times a week for 2 weeks, while the experimental group was given computer-assisted cognition training. Before and after the treatment, both groups′ cognition was evaluated using Chinese versions of the Mini Mental State Assessment Scale (MMSE) and the Montreal Cognitive Test (MoCA).Results:After the treatment, the average MMSE and MoCA scores of the observation group [(22.5±3.62) and (19.69±4.43)] and the control group [(21.7±4.30) and (19.10±5.58)] were significantly better than those before the treatment [(19.3±3.08) and (16.79±4.58); (19.7±3.11) and (17.74±5.25)]. The post-treatment difference between the groups′ averages was not significant, but the observation group′s improvements on the immediate memory, delayed memory and calculation portions of the MMSE were significantly greater than those of the control group.Conclusions:Computer-assisted cognition training can improve the overall cognitive functioning of stroke survivors, achieving the same therapeutic effect as conventional cognitive therapy. It is more effective than conventional cognitive therapy in promoting immediate memory, delayed memory and calculation ability.

Quality value transmitting of substance benchmarks of Zhuru Decoction / 中国中药杂志

A total of 18 batches of Zhuru Decoction samples were prepared. Chromatographic fingerprints were established for Zhuru Decoction and single decoction pieces, the content of which was then determined. The extraction rate ranges, content, and transfer rate ranges of puerarin, liquiritin, and glycyrrhizic acid, together with the common peaks and the similarity range of the fingerprints, were determined to clarify key quality attributes of Zhuru Decoction. The 18 batches of Zhuru Decoction samples had 25 common peaks and the fingerprint similarity higher than 0.95. Puerariae Lobatae Radix, Glycyrrhizae Radix et Rhizoma, and Zingiberis Rhizoma Recens had 21, 3, and 1 characteristic peaks, respectively. The 18 batches of samples showed the extraction rates within the range of 18.45%-25.29%. Puerarin had the content of 2.20%-3.07% and the transfer rate of 38.5%-45.9%; liquiritin had the content of 0.24%-0.85% and the transfer rate of 15.9%-37.5%; glycyrrhizic acid had the content of 0.39%-1.87% and the transfer rate of 16.2%-32.8%. In this paper, the quality value transmitting of substance benchmarks of Zhuru Decoction was analyzed based on chromatographic fingerprints, extraction rate, and the content of index components. A scientific and stable method was preliminarily established, which provided a scientific basis for the quality control and formulation development of Zhuru Decoction.

Progress of Telerehabilitation Techniques in Stroke Patients with Lower Extremity Dysfunction / 中国医疗器械杂志

Stroke has the characteristics of high prevalence, high morbidity, and high mortality, which seriously affects life quality of patients and also creates a huge social burden. Telerehabilitation technology is on the basis of traditional rehabilitation equipment and it integrates with cloud computing and big data technologies. It provides a new way for rehabilitation by providing comprehensive rehabilitation technology and service based on the cloud platform. Therefore, it provides a solution for the situation that the rehabilitation medical resources and the rehabilitation talents in China are relatively insufficient. This article mainly discusses the telerehabilitation technologies of lower extremity motor dysfunction in patients with stroke, the problems and the future development direction.

Acupuncture Treatment for Post-Stroke Dysphagia: An Update Meta-Analysis of Randomized Controlled Trials / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the effectiveness and safety of acupuncture in patients with post-stroke dysphagia by an update meta-analysis.</p><p><b>METHODS</b>Potentially eligible RCTs aimed to evaluate the effects of acupuncture vs. non-acupuncture treatments, such as rehabilitation training or routine medication on the swallowing difficulty after stroke were searched from PubMed, Cochrane Library, China National Knowledge Infrastructure, and other database from the earliest record to June 2016. Patient demographics, regimens for acupuncture, type of controls, methods of randomization, and measurements of the clinical symptoms of dysphagia were retrieved. The relative risk (RR) and 95% confidence interval (CI) of effective rate of dysphagia was calculated after intervention performed following admission. Subgroup analyses and a metaregression analysis were performed to describe the heterogeneity.</p><p><b>RESULTS</b>Twenty-nine RCTs comprising 2,190 patients were included. The included studies had a medium quality grade based on the Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklist. Acupuncture therapy provided a higher effective rate compared with nonacupuncture treatments [RR=1.33, 95% confidence interval (CI), 1.25 to 1.43]. Subgroup and meta-regression analyses suggested that acupuncture intensity and measurement method were main sources of heterogeneity and resulted in a significant difference for pooled effect size. No severe adverse events were documented in these RCTs.</p><p><b>CONCLUSIONS</b>Our meta-analysis provides a new evidence supporting the efficacy and safety of acupuncture in treatment to post-stroke dysphagia in short-term compared with rehabilitation or medication. More high-quality and large-scale research studies are needed.</p>

Design and Trial Operation of Tele-rehabilitation Gradient Motor Function Self-evaluating System for Stroke Patients / 中国医疗器械杂志

In order to overcome the defects of the motor function evaluation systems contained in current tele-rehabilitation devices, such as inconvenient, incomplete of measurement position, nonstandard and lacking of humanized design, we designed and developed a tele-rehabilitation gradient motor function self-evaluating system in this paper. Based on Brunnstrom stage, this system which was competitive comparing to manual evaluations, common tele-rehabilitation assessments and similar nonmedical products, realized the quantitative motor assessment for both limbs of stroke patients using the self-developed algorithms. The clinical trials proved that the system was feasible and accurate.

Design of Remote Sleep Monitoring Mobile Devices / 中国医疗器械杂志

In view of the multiple and diversity of sleep disorders, this paper develops and designs mobile portable devices based on remote monitoring and assessment of sleep quality. Using psychological scale, the patient's vital signs, sleeping data collection, statistics, and information transfer through remote signals to self-developed software for information entry and calculation, which could objectively display the quality of patient's sleep, so that medical staff might manage the patient's sleep better. Due to the features of portable device, such as its convenient to carry about, low price and else, the remote device can provide timely and effective information to help the majority of insomnia patients sleep therapy.

Effects of NF-κB/p65 siRNA on Apoptosis and Bax Expression in Lung Tumour Cell Xenografts of Nude Mouse / 中国医科大学学报

Objective To investigate the effects of nuclear factor-kappaB(NF-κB)/p65 signaling transduction on the apoptosis and expressions of apoptosis-related genes Bax in nude mouse lung tumour cell xenografts. Methods The nude mice Lewis lung carcinoma cell xenograft model was established,and then the mice were intraperitoneally injected with NF-κB/p65 small interfering RNA(siRNA). The apoptosis of xenografted tumor cells in nude mice was detected by TUNEL assay. Expressions of Bax mRNA and protein were detected by RT-PCR and Western blotting. Results The result of TUNEL assay demonstrated that p65 siRNA evidently evoked cell apoptosis. Compared to the PBS treatment group or the normal control mice,both mRNA and protein expression levels of Bax in tumor xenografts were significantly up-regulated. There were significant differences among three groups(P<0.05). Conclusion NF-κB/p65 subunit may play an essential role in cell apoptosis of Lewis lung tumor.

Influence of Emodin Gel on the Fibroblasts of Hypertrophic Scars in Rabbit Ear Model / 生物医学工程学杂志

This research was aimed to study the effect of Emodin gel on the hypertrophic scars of rabbit ears. A total of 18 rabbits were randomly divided into Emodin group (9 rabbits) and control group (9 rabbits) after the successful animal model for hypertrophic scars had been made. The rabbits in the Emodin group were treated with Emodin Gel, while no special treatment was given to those in the control group. The other living conditions were all kept the same in the two groups. The diameter,hardness, and expression of transforming growth factor-beta (TGF-beta) and interleukin-1 (IL-1) of hypertrophic scars were measured after 4 weeks. Transmission electron microscopy was applied to observe the ultra-structure of the fibroblasts of hypertrophic scars. But there was no difference between the two groups in the diameter of hypertrophic scars (P>0.05). The hardness, expression of TGF-beta and IL-1 in hypertrophic scars in the Emodin group decreased, compared to the control group (P<0.05, P<0.01, P<0.05). Transmission electron microscopy showed that the fibroblast and organelle lessened in the cytoplasm and the collagen fibers dissolved obviously. The study showed that Emodin gel decreased the hardness of hypertrophic scars in the rabbit ears, and inhibited the proliferation of fibroblasts in local area. Therefore, Emodin gel treatment would be one of the methods to prevent and treat hypertrophic scars.

Analysis on the clinical efficacy of TCM internal and external treatment on acne / 国际中医中药杂志

Objective To evaluate the clinical efficacy and safety of traditional Chinese medicine on internal and external treatment of acne.Methods 128 patients in Dermatology Department of Xiyuan Hospital CACMS from May 2012 to March 2013 were collected and randomly divided into Chinese medicine group and western medicine group.The patients of Chinese medicine group were divided into invasion of the Lung by Wind-Heat syndrome and damp-heat oflmg and stomach syndrome,respectively taking acne liquid 1 or 2 orally and using the herb mask once a week.The western medicine group took Roxithromycin Capsules orally and smeared 0.3％ Viaminate and Vitamin E Cream.The treatment period lasted for 6 weeks,and collected the photograph of the target lesion before and after research every 2 week and evaluated the efficacy.Result The total efficacy rate were 90.77％ (59/65) and 74.60％ (47/63) for Chinese medicine group and western medicine group respectively,with significant difference between them(x2=11.83,P＜0.05).The efficacy rates were 87.50％ and 93.94％ for invasion of the Lung by Wind-Heat syndrome and damp-heat of lung and stomach syndrome respectively,with no significant difference between them(x2=0.416,P＞0.05).The TCM symptom scores after treatment [Chinese medicine group (4.36 ± 2.45),western medicine group (8.62± 2.49)] had significant difference in two groups respectively compared with before treatment[Chinese medicine group(15.33±6.08),western medicine group(14.34±5.29),P＜0.05].The difference of TCM symptom scores after treatment between the two groups also had a significant difference (P＜0.05).The TCM symptom scores after treatment of invasion of the Lung by Wind-Heat syndrome group and damp-heat of lung and stomach syndrome group were (4.50±3.01) and (4.24±1.83),which had a significant difference compared with before treatment respectively[(15.37±7.03)and(15.29±5.13),P＜0.05].Conclusion The TCM internal and external treatment on acne could reduce the number of lesions and improve TCM symptom scores.The effect of treating invasion of the Lung by Wind-Heat syndrome and damp-heat of lung and stomach syndrome with TCM was almost equal.

Meta-analysis of the effect of low-frequency repetitive transcranial magnetic stimulation on paretic hand recovery after stroke / 生物医学工程学杂志

Low-frequency repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation method that has been used in the treatments of stroke patients. Our purpose was to investigate the effects of low-frequency rTMS on the hand motor function recovery for stroke patients. After searching from electronic database from January 1990 to April 2012, we collected randomized controlled trials explored the low-frequency rTMS effects on the hand motor function rehabilitation. A total of 7 comparisons (N = 216) from 5 articles were included in this study. We summarized the effect size by calculating the standardized mean difference (SMD). Summary of effect size (SES) indicated positive effects of low-frequency rTMS on the finger motor ability (SMD = 0.58) and hand function (SMD = -0.98). Few adverse effects occurred. The evidence showed that low-frequency rTMS could improve the paretic hand recovery after stroke.

Investigation of Rehabilitation in Rural Community Health Service after Earthquake in Sichuan / 中国康复理论与实践

@#Objective To study the condition of rehabilitation in Community Health Service (CHS) in rural areas after earthquake. Methods 274 medical personnels of CHS were invistigated with the questionnaire. Results There was no rehabilitation therapist in those medical personnel, and no difference of requirement, referral will and acquaintance of therapy between rehabilitation and acupuncture in CHS （P=0.056，P=0.293，P=0.654）. There was a significant difference in acquaintance of rehabilitation among different ages of medical personnel （P<0.01）, but there wasn't of acupuncture （P=0.104）. Conclusion It still lack rehabilitation therapist in CHS. Techniques and resources were the key points in the development of community-based rehabilitation.

Systematic assessment of acupoint stimulating therapy for deglutition disorders after apoplexy / 中国针灸

<p><b>OBJECTIVE</b>To assess the therapeutic effect of acupoint stimulating therapy on deglutition disorders after apoplexy, so as to provide basis for clinical treatment and further study.</p><p><b>METHODS</b>According to Cochrane systematic assessment method of evidence-based medicine, Meta analysis on randomized controlled trials or half randomized controlled trials of acupoint stimulating therapy for deglutition disorders after apoplexy were made.</p><p><b>RESULTS</b>In 37 Chinese literatures, 3 697 patients in total were enrolled, and the results indicated that the effective rate of acupoint stimulating therapy on deglutition disorders after apoplexy was better than that in the control group [RR was 1.38, 95% CI (1.28, 1.49), Z = 8.38, P < 0.01]; and the cured rate also was better than that of the control group [RR was 2.56, 95% CI (2.15, 3.04), Z = 10.70, P < 0.01].</p><p><b>CONCLUSION</b>The therapeutic effect of acupoint stimulating therapy on deglutition disorders after apoplexy is better than that of the control group, but more randomized, double blind, controlled trials with good designs are needed to confirm this result.</p>