Interpretation of updated NCCN guidelines for non-small cell lung cancer (version 1, 2022) / 中国胸心血管外科临床杂志

@#The National Comprehensive Cancer Network (NCCN) has updated and released the latest content of the NCCN guidelines for the clinical diagnosis and treatment of non-small cell lung cancer (NSCLC) in the version 1, 2022. Based on high-quality clinical evidence and the latest research progress of the diagnosis and treatment of NSCLC, the guidelines have been widely recognized and welcomed by clinicians around the world. Compared with the version 7, 2021, the new version has been updated and revised in some parts of chapters and sections, mainly focusing on targeted therapies and molecular testing. This article will interpret the updated therapy content of the new version.

Effects of using hand-held vibration tool on work-related musculoskeletal disorders in automobile factory workers / 中国职业医学

@#Objective - To analyze the effect of using vibration tools on the prevalence of work related musculoskeletal disorders （ ） Methods ， - WMSDs in automobile factory workers. By judgment sampling method front line workers with more than one year of working experience in an automobile factory were selected as the research subjects. Musculoskeletal Disorders Questionnaire was used for investigation. The workers were divided into the control group and the vibration tool group. The propensity score ∶ ， matching method was used to balance the confounding factors of the two groups of workers by 1 1 and 568 people were Results included in each group. The prevalence of WMSDs was compared between the two groups after matching. After ， ， ， ， ， ， matching the prevalence of WMSDs in the shoulder elbow hand/wrist upper back waist hip/buttock and knee of workers in ， （ P ） the vibration tool group was higher than that in the control group and the differences were statistically significant all <0.05 .， The prevalence of WMSDs in different body parts of workers in the vibration tool group ranking from high to low was waist ， ， ， ， ， ， ， ， ， ， neck shoulder hand/wrist upper back knee ankle/foot elbow and hip/buttock with the rate of 74.3% 61.3% 54.2% ， ， ， ， ， （P ） Conclusions 54.0% 50.9% 39.4% 35.2% 31.0% and 27.1% respectively <0.01 . The use of vibration tools can ， ， ， ， ， increase the risk of WMSDs in shoulder elbow hand/wrist upper back waist hip/buttock and knee of automobile factory workers. Corresponding measures should be taken to reduce vibration intensity and reduce contact time to protect workers'

Interpretation of updated NCCN guidelines for small cell lung cancer (version 1. 2022) / 中国胸心血管外科临床杂志

@#The National Comprehensive Cancer Network (NCCN) released the latest version 1, 2022 of "NCCN guidelines for the clinical diagnosis and treatment of small cell lung cancer" (hereinafter referred to as "guideline"). Based on high-quality evidence-based medicine, this guideline provides references of clinical diagnosis and treatment for clinicians around the world. Compared with the version 3, 2021 of the "guideline", updates and revisions mainly focused on the progress of radiotherapy and systemic treatment. This article will interpret the updated therapy content in this new version of the "guideline".

Efficacy and safety of № I Empirical Prescription for Chronic Prostatitis in the treatment of type Ⅲ refractory chronic prostatitis / 中华男科学杂志

<p><b>Objective</b>To evaluate the efficiency and safety of № I Empirical Prescription for Chronic Prostatitis (№ I EPCP) in the treatment of type Ⅲ refractory chronic prostatitis.</p><p><b>METHODS</b>We randomly assigned 53 cases of type Ⅲ refractory chronic prostatitis with damp-heat and blood stasis to an experimental and a control group to receive № I EPCP at 1 dose per day and saw palmetto extract at 160 mg bid), respectively, all for 8 weeks. Before and after 4 and 8 weeks of treatment, we obtained The National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores, Traditional Chinese Medicine Syndrome Scores (TCMSS), maximum urinary flow rate (Qmax), average urinary flow rate (Qavg), Hamilton Depression Rating Scale (HAMD) scores and Hamilton Anxiety Rating Scale (HAMA) scores, and compared them between the two groups of patients.</p><p><b>RESULTS</b>Totally 48 of the patients completed the medication and follow-up, 25 in the experimental and 23 in the control group. Compared with the baseline, the NIH-CPSI scores after 8 weeks of treatment were significantly decreased in the experimental (27.82 ± 7.25 vs 15.46 ± 4.77, P <0.05) and the control group (25.98 ± 6.47 vs 21.06 ± 5.74, P <0.05), and so were the TCMSSs (24.64 ± 9.82 vs 16.42 ± 6.33 and 9.15 ± 3.74, P <0.05, and 23.67 ± 8.73 vs 18.55 ± 5.92 and 13.48 ± 4.45, P <0.05); the Qmax at 8 weeks were dramatically increased in the experimental group (［18.45 ± 7.81］ vs ［23.44 ± 8.73］ ml/s, P <0.05) and the control (［17.58 ± 6.92］ vs ［21.26 ± 8.32］ ml/s, P <0.05), and so was the Qavg (［11.27 ± 5.33］ vs ［16.51 ± 7.36］ ml/s, P <0.05 and ［10.66 ± 5.82］ vs ［13.44 ± 6.16］ ml/s, P <0.05); the HAMD scores were remarkably reduced in the experimental group (22.74 ± 6.37 vs 17.62 ± 5.71 and 12.54 ± 5.22, P <0.05) and the control (23.55 ± 7.14 vs 22.34 ± 6.88 and 21.62 ± 5.63, P <0.05), and so were the HAMA scores (21.37 ± 7.15 vs 18.42 ± 6.35 and 14.63 ± 7.11, P <0.05 and 20.54 ± 6.77 vs 19.87 ± 6.24 and 19.42 ± 7.04, P <0.05). No obvious adverse reactions were observed in either of the two groups during the medication.</p><p><b>CONCLUSIONS</b>№ I EPCP deserves promotion and clinical application for its definite effectiveness and safety in the treatment of type Ⅲ refractory chronic prostatitis with damp-heat and blood stasis.</p>

Exploration on the construction of discipline of clinical medicine and clinical talent team: a case study of the construction of "Two-hundred Talent" team / 上海交通大学学报（医学版）

Currently, exploring the "World-class" disciplinary construction is a vital strategy in China. Since 2015, Shanghai Jiao Tong University School of Medicine started the project of establishing two distinguish teams—the academic clinicians and clinical investigators ("Two-hundred Talent" team), to fuel the development of clinical research. After two years of practice, both advantages and bottlenecks were found. The advantage contains: increasing selection rate among talent projects, increasing influential output, elevating capacity in clinical research. The bottlenecks contain: unbalanced disciplinary development, poor awareness of the importance of clinical research, lack of relevant supporting policies. In order to improve the quality of the clinical research and the two talent clinical research teams, institutional innovation, personalized supporting system, establishment of clinical research center, training of clinical research nurses are essential.

Research advance on BAP1 and its function in tumor suppression / 上海交通大学学报（医学版）

BAP1 is a member of the ubiquitin C-terminal hydrolases (UCH) subfamily of deubiquitylases with basic function of removing monoubiquitin or ubiquitin chains from the specific substrate proteins. As well, it is a key factor in regulating gene expression, cell cycle, cell differentiation,cell apoptosis and DNA damage response, dependent or independent of its deubiquitination function. Evidences haverevealed that mutation or downregulation of BAP1 can prominently increase the occurrence of cancers, including uveal melanoma, mesothelioma, renal cell carcinoma, breast cancer and lung cancer. Currently, the tumor spectrum and the pathogenic mechanism on BAP1 have not been illustrated clearly, and need to be further researched,which might bring a new opportunity in treatment of cancers.

Sertraline hydrochloride combined with four-spot caressing for primary premature ejaculation / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the clinical effectiveness of sertraline hydrochloride combined with four-spot caress in the treatment of primary premature ejaculation (PE).</p><p><b>METHODS</b>We randomly assigned 90 primary PE patients to three groups of equal number. The patients in group A (aged [28.1 ± 5.2] yr and with a disease course of [3.1 ± 1.9] yr) were treated with oral sertraline hydrochloride at 50 mg qd, those in B (aged [27.8 ± 4.1] yr and with a disease course of [3.2 ± 2.0] yr) by four-spot caressing (caressing the tongue, breasts, and vulva prior to intercourse), and those in C (aged [27.1 ± 4.7] yr and with a disease course of [3.1 ± 2.0] yr) by the combination of oral sertraline hydrochloride and four-spot caressing, all for 12 weeks. Before and after 4, 8, and 12 weeks of treatment, we obtained the intravaginal ejaculatory latency time (IELT) and Chinese Index of Sexual Function for Premature Ejaculation-5 (CIPE-5) scores and compared them among the three groups of patients.</p><p><b>RESULTS</b>The IELT was dramatically prolonged in groups A, B, and C after 4 weeks ([1.08 ± 0.29], [0.93 ± 0.28] and [1.21 ± 0.27] min), 8 weeks ([1.43 ± 0.30], [1.20 ± 0.33] and [1.72 ± 0.42] min) and 12 weeks of treatment ([2.12 ± 0.63], [1.90 ± 0.65] and [2.67 ± 0.82] min) as compared with the baseline ([0.63 ?0.14] , [0.60 ?0.14] and [0.62 ?0.11] min) (P < 0.05), even longer in group C than in A and B (P < 0.05). The CIPE-5 scores were markedly improved in groups A, B and C after 4 weeks ([15.17 ± 1.74], [14.57 ± 1.94] and [15.60 ± 1.63] min), 8 weeks ([17.13 ± 1.63], [16.37 ± 1.97] and [18.00 ± 1.05] min) and 12 weeks of intervention ([18.93 ± 1.57], [18.53 ± 1.67] and [20.00 ± 1.46] min ) as compared with the baseline ([12.57 ± 2.05], [13.20 ± 2.51] and [13.07 ± 2.01] min) (P < 0.05), even higher in group C than in A and B (P < 0.05).</p><p><b>CONCLUSION</b>Sertraline hydrochloride combined with four-spot caressing, with its definite efficacy and rare adverse reactions, deserves wide clinical application in the treatment of primary PE.</p>

Effects of electromagnetic fields on bone regeneration in experimental and clinical studies: a review of the literature / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To assess the experimental and clinical data regarding the effects of electromagnetic fields (EMFs) on fracture non-union.</p><p><b>DATA SOURCES</b>The English language literature regarding EMFs on fracture non-union were searched using MEDLINE, Web of Science and Embase, for the period January 2006 to June 2011. The search terms were electromagnetic fields and non-union/bone marrow stem cells (BMSCs)/bone.</p><p><b>STUDY SELECTION</b>Articles were included in the review if they were related to the use of EMFs on BMSCs or bone tissue. Papers without full manuscripts available were excluded.</p><p><b>RESULTS</b>The basic and clinical research in this field, while somewhat limited, supports the insightful application of EMFs to ameliorate disability due to fracture non-union.</p><p><b>CONCLUSIONS</b>Further basic and clinical research to validate the use of EMFs in facilitating function and bone reparative processes in fracture non-union is required.</p>

Selection of allografts for impaction bone grafting for bone defect reconstruction on the acetabular side / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To review the choices of allografts for bone defect reconstruction in acetabular revision surgery using the technique of impaction bone grafting.</p><p><b>DATA SOURCES</b>The data cited in this review were mainly obtained from articles listed in PubMed that were published from January 1993 to July 2009. The search terms were "impaction bone grafting", "particle size", "mechanical property" and "biological behavior".</p><p><b>STUDY SELECTION</b>Articles relevant to the choices of allografts and their results for bone defect reconstruction on the acetabular side were selected.</p><p><b>RESULTS</b>Different choices of allografts, including the particle size, process of irradiation or fat reduction, composition and particle grade, are made to improve the survival rate of a prosthesis in acetabular revision surgery. This review, which compares both mechanical and biological factors, summarizes the experimental and clinical results for different techniques.</p><p><b>CONCLUSIONS</b>Fresh frozen cancellous allografts with particle sizes ranging from 7 to 10 mm are a favorable choice for reconstruction of bone defects of American Academy of Orthopedic Surgeons (AAOS) types II (cavitary defect) and III (combined cavitary and segmental defect) on the acetabular side. A fat-reducing procedure with saline or solvent/detergent is controversial. Adding autologous marrow into irradiated allografts, which provides reliable mechanical stability and biological safety, may be a substitute for fresh frozen allografts. Cortical bone can be a supplementary material in cases of insufficiency of cancellous allografts. Cartilage should be excluded from the graft material. Further research is required to demonstrate the best particle grade, and randomized controlled trials in clinical practice are required to obtain more information about the selection of allografts.</p>

A preliminary report of patellofemoral arthroplasty in isolated patellofemoral arthritis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Isolated patellofemoral osteoarthritis is not uncommon. Surgical treatment of isolated patellofemoral arthritis remains controversial and poses a challenging treatment dilemma. The present study aimed to evaluate the short-term results of patellofemoral arthroplasty for patients with isolated patellofemoral osteoarthritis.</p><p><b>METHODS</b>We analyzed 11 patellofemoral arthroplasties performed from March 2006 to September 2009 in 11 patients with isolated patellofemoral arthritis. The patients comprised 2 males and 9 females with an average age of 53.7 years (range, 46 - 74 years). Standard weightbearing radiographs were taken in the anteroposterior, lateral, and 45° axial views. The knee pain and functional status were evaluated by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scales and American Knee Society (AKS) scores. For comparison, 23 total knee arthroplasties in 23 patients with primary tibiofemoral osteoarthritis were matched according to age, gender, bilaterality and body mass index. The duration of follow-up was 23.7 months (range, 12 - 47 months).</p><p><b>RESULTS</b>The majority of the 11 patients experienced improvement in their patellofemoral symptoms after patellofemoral arthroplasty. The WOMAC scores improved considerably by 7.4 points with respect to pain and by 5.2 points with respect to function. The AKS scores also improved considerably by 23.9 points with respect to pain and 44.3 points with respect to function. Although the clinical outcomes after patellofemoral arthroplasty were not better than those after total knee arthroplasty, patellofemoral arthroplasty exhibited advantages in the shorter operation time, lower blood loss and increased postoperative range of motion. At the latest follow-up, there was no clinical or radiographic evidence of patellofemoral maltracking, loosening or wear.</p><p><b>CONCLUSIONS</b>On the basis of our experience in this relatively small series of patients with a short-term follow-up, patellofemoral arthroplasty is an effective treatment alternative to total knee arthroplasty in isolated patellofemoral arthritis. MRI and arthroscopy may contribute to define those patients with isolated patellofemoral degeneration.</p>

Therapeutic effect of left medullary microvascular decompression on primary hypertension / 中华神经医学杂志

Objective To explore the clinical effect of left medullary microvascular decompression (MVD) on primary hypertension complicated by cerebral hematoma and cranial nerve disease. Methods After left cerebral hematomas in 26 patients and cerebellar hematomas in 2 patients were evacuated, left medullary MVD was performed via suboccipital retromastoidal approach. Fifteen of them were operated emergently. Eight hypertensive patients complicated by cranial nerve diseases (4trigeminal neuralgia, 1 glossopharyngeal neuralgia, 2 acoustic neuroma, 1 trigeminal neuroma) underwent left medullary MVD after the planned cranial nerve MVD and tumor resection. Blood pressure was monitored and the variety and dosage changes of anti-hypertension were recorded. Results Vessel loops that compressed, contacted or transfixed the medulla oblongata and vagus nerve root entry zone (REZ) were found in all patients. The offending vessel loops included posterior inferior cerebellar artery (PICA, n=20), vertebral artery (VA, n=11), and anterior inferior cerebellar artery (AICA, n=5). The relationship between the offending vessel loops and medulla oblongata, vagus nerve REZ were divided into four types: Contacting type (n=14), compressing type (n=10), adhesion type (n=9) and transfixing type (n=3). In the 36 patients, 24 hypertension cases (66.7%) were cured, 10 (27.8%) were improved, and2 (5.5%) did not get better. Conclusions Left medulla oblongata MVD is effective in treating primary hypertension. To explore and settle carefully of the drag stimulation like a string from the vessel loops deviated from the medulla, vague nerve REZ will improve the effects of medullary MVD for primary hypertension.

Induction of inflammatory cell accumulation using human mast cell tryptases.

The aim of this study was to investigate the effects of human tryptases on inflammatory cell accumulation in vivo. Various concentrations of purified lung or skin tryptases were injected into the peritoneum of BALB/c mouse. At 6 hours or 16 hours following injection, cells from the peritoneal lavage were collected and stained with modified Wright's stain. Differential cell counts were performed and results were expressed as absolute numbers of each cell type per mouse peritoneum. The results showed a dose-dependent infiltration of neutrophils with a maximal increase of up to 32 fold or 43 fold in numbers at 16 hours following an injection of skin and lung tryptases, respectively. Skin tryptase was able to attract more eosinophils than lung tryptase. Significant increases in lymphocyte and macrophage numbers were also observed. In conclusion, both skin and lung tryptases are able to induce nucleated cell accumulation in the peritoneum of mice with similar specificity and potency.