The application of silent MR angiography in the imaging of brain arteriovenous malformation in children / 中华放射学杂志

Objective:To explore the application value of silent MR angiography (MRA) in imaging of brain arteriovenous malformation (BAVM) in children.Methods:A total of 20 children with BAVM confirmed by digital subtraction angiography (DSA) were retrospectively collected. All children were imaged by silent MRA and time-of-flight MRA (TOF MRA) in the same examination. The image quality of feeding artery, nidus and drainage vein of BAVM was evaluated using the four-point method. Wilcoxon rank-sum test was utilized to compare the image quality scores between silent MRA and TOF MRA. Weighted Kappa statistics used to evaluate the inter-modality agreement of silent MRA and TOF MRA with DSA in displaying of angioarchitecture characteristics and determination of Spetzler-Martin grading.Results:Among the 20 BAVMs, significant differences in image quality scores of the nidus (2.75±0.55 versus 2.20±0.70) and drainage vein (2.60±0.68 versus 2.20±0.77) were observed between silent MRA and TOF MRA ( Z=-3.05, P=0.002; Z=-2.13, P=0.033, respectively). The agreement between silent MRA and DSA was excellent in nidus size grading, deep venous drainage, associated aneurysm and SM grading (Kappa 0.91, 1.00, 0.83 and 0.93, respectively); The agreement between TOF MRA and DSA was fair to moderate (Kappa 0.46, 0.59, 0.35 and 0.47, respectively). Conclusions:Silent MRA showes better image quality compared to TOF MRA and improves the evaluation of angioarchitecture characteristics and Spetzler-Martin grading of BAVMs in children.

Research progress in plasmacytoid dendritic cells in systemic sclerosis / 中华微生物学和免疫学杂志

Plasmacytoid dendritic cells (pDCs) are a unique subset of dendritic cells that can rapidly produce large amounts of type Ⅰ interferon after activation. They are critical in antiviral immunity and involved in the initiation and development of many autoimmune diseases. Systemic sclerosis (SSc) is an autoimmune disease characterized by immune dysregulation, vasculopathy and progressive fibrosis of the skin and internal organs. Recent studies have found that pDCs are involved in the pathogenesis of SSc. Inhibiting the function of pDCs can effectively prevent inflammation and fibrosis in SSc, highlighting the role of pDCs in the pathogenesis of SSc. Therefore, an in-depth understanding of pDCs and their role in the pathogenesis of SSc is important for the development of pDCs and their mediators as therapeutic targets for SSc.

Clinical characteristics of patients with rheumatic diseases and abnormal liver function / 中华内科杂志

Objective:To investigate the clinical characteristics of patients with rheumatic diseases and abnormal liver function, as well as determine the proportion and severity of liver function abnormalities.Methods:Cross-sectional study. Data were collected from patients registered in the Chinese Rheumatism Date Center from 2011 to 2021. The rheumatic diseases analyzed in this study were rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjogren syndrome (SS), ankylosing spondylitis (AS), and gout. Patient data, including demographic characteristics [ such as age, sex, body mass index,(BMI), and smoking history], liver function test results [including alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase(ALP), and total bilirubin], and use of anti-rheumatic immune drugs and liver-protective drugs, were collected and compared between groups with normal and abnormal liver functions. In addition, the proportions of abnormal liver function were compared between sex and age groups.Results:A total of 116 308 patients were included in this study, including 49 659 with RA, 17 597 with SLE, 9 039 with SS, 11 321 with AS, and 28 692 with gout. The lowest proportion of liver function abnormalities was observed in patients with RA[11.02% (5 470/49 659)], followed by those with SS[17.97% (1 624/9 039)] and AS [18.22% (2 063/11 321) ], whereas patients with SLE [21.14% (3 720/17 597) ] and gout [28.73% (8 242/28 692)] exhibited the highest proportion of these abnormalities. Elevated ALT, mostly classified as grade 1, was the most commonly noted liver function abnormality, whereas elevated ALP was the least common. Some patients who took liver-protective drugs had normal liver function, with the lowest percentage observed in patients with gout [7.45% (36/483) ] and ranging from 21.7% to 30.34% in patients with RA, SLE, SS, and AS. The proportion of liver function abnormalities was higher in males than in females for all disease types [RA: 13.8%(1 368/9 906) vs. 10.3%(4 102/39 753); SLE: 33.6% (479/1 424) vs. 20.0% (3 241/16 173); SS: 25.4%(111/437) vs. 17.6%(1 513/8 602); AS: 20.1%(1 629/8 119) vs. 13.6% (434/3 202); and gout: 29.3% (8 033/27 394) vs. 16.1% (209/1 298)]. In RA, SLE, and AS, the proportions of liver function abnormalities were similar across all age groups. In SS, the proportion of liver function abnormalities increased with age [<40 years: 14.9%(294/1 979); 40-59 years: 18.1%(858/4 741); ≥60 years: 20.4%(472/2 319)], whereas a reversal of this trend was observed in gout [<40 years: 34.9%(4 294/12 320); 40-59 years: 25.5%(2 905/11 398);≥60 years: 21.0%(1 042/4 971)].Conclusions:The proportions of combined liver function abnormalities in patients with rheumatologic diseases were high, and the utilization rates of liver-protective drugs were low. It is necessary to pay more attention to monitoring patients′ liver function, timely administer liver-protective drugs, and optimize liver-protective regimens during the treatment of rheumatic diseases.

Study on the objectivity and biological mechanism of Psoralea corylifolia Linn.'s 'Great dryness damages the liver' / 药学学报

According to the theory of 'Xingben Dazao' of Psoralea corylifolia Linn. (BL), the susceptible syndromes and biomarkers of liver injury caused by BL were searched. Rat models of kidney-yin deficiency syndrome (M_yin) and kidney-yang deficiency syndrome (M_yang) were established, and all animal experimental operations and welfare following the provisions of the First Affiliated Experimental Animal Ethics and Animal Welfare Committee of Henan University of Traditional Chinese Medicine (No. YFYDW2020017). The results showed that BL significantly decreased the body weight, water intake, and urine weight of M_yin rats and increase the organ indexes of the liver, testis, adrenal gland, and spleen and the expression of alanine aminotransferase (ALT). Meantime, BL significantly increased the urine weight of M_yang rats and decreased the expression of ALT and aspartate aminotransferase (AST). Hematoxylin and eosin (HE) staining showed that BL could aggravate inflammatory infiltration of hepatocytes in rats with M_yin and alleviate liver injury in rats with M_yang. Metabolomics identified 17 BL co-regulated significant differential metabolic markers in M_yin and M_yang rats. Among them, 8 metabolites such as glutamine, quinolinate, biliverdin, and lactosylceramide showed opposite trends, mainly involving cysteine and methionine metabolism, tyrosine metabolism, tryptophan metabolism, purine metabolism, sphingolipid metabolism, glycerol phospholipid metabolism, glutamine metabolism, and other pathways. M_yin/M_yang may be the susceptible constitution of BL for liver damage or protection, which may be related to the regulation of amino acid metabolism and sphingolipid metabolism. The study can provide some experimental data support for the safe and accurate use of BL in the clinical practice of traditional Chinese medicine.

Construction and preliminary application of drug carrier system based on yeast membrane vesicles / 药学学报

As an edible eukaryotic microorganism, Saccharomyces cerevisiae has the characteristics of high safety, rapid proliferation, low cost, easy transformation, etc. It has been widely used to produce vaccines, antibodies, insulin, etc. Up to now, yeast components, such as cell wall and yeast microcapsules, have been widely used in the treatment of tumors, inflammatory virus infection, post-traumatic osteoarthritis and other diseases. Among them, the components of yeast cell membrane are relatively simple and stable, which are easy to be extracted on a large scale. Therefore, yeast cell membrane material was used to construct yeast membrane vesicle nanosystem, and its biomedical application was preliminarily explored. In this study, Saccharomyces cerevisiae membrane vesicle (SMV) was prepared by co-extrusion method, and the particle size and surface potential of SMV, drug loading and release characteristics, stability, cell safety, and in vitro therapeutic effect were investigated. The results showed that the average particle size of SMV was 185.1 nm. Curcumin and silica nanoparticles were effectively encapsulated by co-incubation and ultrasonic methods, and the characteristics of cell membrane proteins were maintained. Moreover, SMV had good stability and biocompatibility. In addition, SMV could be effectively uptaken by macrophages RAW 264.7, and curcumin loaded SMV could effectively eliminate reactive oxygen species (ROS). In conclusion, the yeast plasma membrane vesicles prepared in this study could effectively deliver curcumin drugs and encapsulate nanoparticles, and could be effectively absorbed by macrophages and effectively eliminate ROS, providing new ideas and new methods for biomedical applications of yeast membrane materials.

The value of transanal multipoint full-layer puncture biopsy in determining the response degree of rectal cancer following neoadjuvant therapy: a prospective multicenter study / 中华外科杂志

Objective: To verify the feasibility and accuracy of the transanal multipoint full-layer puncture biopsy (TMFP) technique in determining the residual status of cancer foci after neoadjuvant therapy (nCRT) in rectal cancer. Methods: Between April 2020 and November 2022, a total of 78 patients from the Beijing Chaoyang Hospital of Capital Medical University, the Beijing Friendship Hospital of Capital Medical University, the Qilu Hospital of Shandong University, the Zhongnan Hospital of Wuhan University with advanced rectal cancer received TMFP after nCRT participated in this prospective multicenter trial. There were 53 males and 25 females, aged (M(IQR)) 61 (13) years (range: 35 to 77 years). The tumor distance from the anal verge was 5 (3) cm (range: 2 to 10 cm). The waiting time between nCRT and TMFP was 73 (26) days (range: 33 to 330 days). 13-point transanal puncture was performed with a 16 G tissue biopsy needle with the residual lesion as the center. The specimens were submitted for independent examination and the complications of the puncture were recorded. The consistency of TMFP and radical operation specimen was compared. The consistency of TMPF with clinical remission rates for the diagnosis of complete pathological remission was compared by sensitivity, specificity, negative predictive value, positive predictive value and accuracy. Statistical analysis between groups was performed using the χ2 analysis, and a paired χ2 test was used to compare diagnostic validity. Results: Before TMFP, clinical complete response (cCR) was evaluated in 27 cases. Thirty-six cases received in vivo puncture, the number of punctures in each patient was 13 (8) (range: 4 to 20), 24 cases of tumor residue were found in the puncture specimens. The sensitivity to judgment (100% vs. 60%, χ2=17.500, P<0.01) and accuracy (88.5% vs. 74.4%, χ2=5.125, P=0.024) of TMFP for the pathologic complete response (pCR) were significantly higher than those of cCR. Implement TMFP based on cCR judgment, the accuracy increased from 74.4% to 92.6% (χ2=4.026, P=0.045). The accuracy of the in vivo puncture was 94.4%, which was 83.3% of the in vitro puncture (χ2=1.382, P=0.240). Overall, the accuracy of TMFP improved gradually with an increasing number of cases (χ2=7.112, P=0.029). Conclusion: TMFP is safe and feasible, which improves the sensitivity and accuracy of rectal cancer pCR determination after nCRT, provides a pathological basis for cCR determination, and contributes to the safe development of the watch and wait policy.

Association between early parenteral nutrition and the development of bronchopulmonary dysplasia in preterm infants / 中国当代儿科杂志

OBJECTIVES@#To study the relationship between early parenteral nutrient intake and the development of bronchopulmonary dysplasia (BPD) in preterm infants with gestational age less than 32 weeks who could not receive enteral nutrition within one week after birth.@*METHODS@#A retrospective study was conducted on preterm infants born between October 2017 and August 2022 with gestational age less than 32 weeks who were admitted to the Neonatal Intensive Care Unit in Children's Hospital of Soochow University within 24 hours after birth and relied solely on parenteral nutrition within the first week of life. The study population included 79 infants with BPD and 73 infants without BPD. Clinical data during hospitalization were compared between the two groups.@*RESULTS@#The proportions of infants with weight loss of more than 10% after birth, extrauterine growth retardation, and parenteral nutrition-associated cholestasis in the BPD group were higher than in the non-BPD group (P<0.05). The time to regain birth weight, time to achieve full enteral feeding, and corrected gestational age at discharge were longer in the BPD group than in the non-BPD group. The Z-scores of physical growth at corrected gestational age of 36 weeks were lower in the BPD group than in the non-BPD group (P<0.05). The BPD group had a higher fluid intake and a lower calories intake in the first week than the non-BPD group (P<0.05). The starting dose and total amount of amino acids, glucose, and lipids in the first week were lower in the BPD group than in the non-BPD group (P<0.05). The BPD group had a higher glucose-to-lipid ratio on the third day and higher energy-to-nitrogen and glucose-to-lipid ratios on the seventh day after birth than the non-BPD group (P<0.05).@*CONCLUSIONS@#Preterm infants with BPD had lower intake of amino acids and lipids and a lower proportion of calories provided by amino acids and lipids in the first week of life, which suggests an association between early parenteral nutrition intake and the development of BPD.

Clinical implications of 3D printing technology in preoperative evaluation of partial nephrectomy / 中南大学学报(医学版)

OBJECTIVES@#Renal cancer is a common malignancy of the urinary system, and the partial nephrectomy is a common surgical modality for early renal cancer. 3D printing technology can create a visual three-dimensional model by using 3D digital models of the patient's imaging data. With this model, surgeons can perform preoperative assessment to clarify the location, depth, and blood supply of the tumor, which helps to develop preoperative plans and achieve better surgical outcomes. In this study, the R.E.N.A.L scoring system was used to stratify patients with renal tumors and to explore the clinical application value of 3D printing technology in laparoscopic partial nephrectomy.@*METHODS@#A total of 114 renal cancer patients who received laparoscopic partial nephrectomy in Xiangya Hospital from June 2019 to December 2020 were enrolled. The patients were assigned into an experimental group (n=52) and a control group (n=62) according to whether 3D printing technology was performed, and the differences in perioperative parameters between the 2 groups were compared. Thirty-nine patients were assigned into a low-complexity group (4-6 points), 32 into a moderate-complexity group (7-9 points), and 43 into a high-complexity group (10-12 points) according to R.E.N.A.L score, and the differences in perioperative parameters between the experimental group and the control group in each score group were compared.@*RESULTS@#The experimental group had shorter operative time, renal ischemia time, and postoperative hospital stay (all P<0.05), less intraoperative blood loss (P=0.047), and smaller postoperative blood creatinine change (P=0.032) compared with the control group. In the low-complexity group, there were no statistically significant differences between the experimental group and the control group in operation time, renal ischemia time, intraoperative blood loss, postoperative blood creatinine changes, and postoperative hospital stay (all P>0.05). In the moderate- and high- complexity groups, the experimental group had shorter operative time, renal ischemia time, and postoperative hospital stay (P<0.05 or P<0.001), less intraoperative blood loss (P=0.022 and P<0.001, respectively), and smaller postoperative blood creatinine changes (P<0.05 and P<0.001, respectively) compared with the control group.@*CONCLUSIONS@#Compared with renal tumor patients with R.E.N.A.L score<7, renal cancer patients with R.E.N.A.L score≥7 may benefit more from 3D printing assessment before undergoing partial nephrectomy.

Clinical characteristics and risk factors of gastrointestinal involvement in patients with systemic lupus erythematosus / 中华风湿病学杂志

Objective:To study the clinical features and prognostic risk factors of gastrointestinal (GI) involvement in systemic lupus erythematosus (SLE), and improve clinicians' understanding of GI involvement in SLE.Methods:The clinical data of SLE patients admitted to the First Affiliated Hospital of Guangxi Medical University from September 1, 2012 to September 1, 2019 were retrospectively analyzed. Two hundred and forty-three patients with GI system involvement were the GI system affected group, and 486 patients with-out GI system involvement at the same period were randomly selected as the control group. The clinical mani-festations, laboratory tests and treatment effects of the two groups were compared by t test, Wilcoxon signed-rank test and χ2 test and Logistic regression was used to analyze the prognostic risk of SLE with GI system involvement. Results:① There were 243 SLE patients with GI involvement, with the proportion of GI involvement in SLE patients of 6.4%(243/3 820), and as the first manifestation with GI system symptoms accounted for 20.2%(49/243). The common causes were lupus hepatitis accounted for 52.3%(127/243), lupus mesenteric vasculitis (LMV) for 35.0%(85/243), pseudo Intestinal obstruction (IPO) for 9.9%(24/243), lupus-related pancreatitis for 8.6%(21/243), and protein-losing enteropathy (PLE) as 7.0%(17/243). ② Compared with the control group, the group with GI involvement had a lower average age [(38±14) year vs(32±15) year, t=-2.47, P=0.014], a shorter median duration of illness [12.0(3.0, 72.0) months vs 5.0(1.1, 24.8) months, Z=-5.67 , P<0.001], a higher median systemic lupus erythematosus disease activity index (SLEDAI) score [10(6,28) vs 16(9, 37), Z=2.24 , P<0.001], the occurrence of skin rash (38.7% vs 53.5%, χ2=14.46), arthritis (36.4% vs 46.7%, χ2=7.12 , P=0.008), myositis (43.0% vs 56.4%, χ2=11.53 , P=0.001), pericarditis [(216±111)×10 9/L vs (175±114)×10 9/L, t=-4.69 , P<0.001], thrombocytopenia, and hydroureterosis (1.0% vs 12.8%, χ2=47.47 , P<0.001) were high, but the incidence of pulmonary arterial hypertension (PAH) (31.2% vs 10.7%, χ2=36.99 , P<0.001) was low; Serum alanine aminotransferase (ALT) [17(10, 29) U/L vs 59(16, 127) U/L, Z=9.65 , P<0.001], aspartate aminotransferase (AST) [25.0 (18.0, 37.0) U/L vs 82.5(25.0, 289.0) U/L, Z=10.57 , P<0.001], alkaline phosphatase (ALP) [58(46, 76) U/L vs 82(56, 187)U/L, Z=8.42 , P<0.001], Creatine kinase (CK) [44.0(28.0, 83.0) U/L vs 58.5(34.0, 176.0) U/L, Z=4.46 , P<0.001], lactate dehydrogenase (LDH) [(309±206) U/L vs (443±332) U/L, t=5.64 , P<0.001], fasting blood glucose (FBS) [(5.0±1.5) mmol/L vs (5.3±1.7) mmol/L, t=2.16 , P=0.031], triglyceride (TG) [(2.0±1.3) mmol/L vs (2.7±2.2) mmol/L, t=4.55 , P<0.001] increased, albumin (ALB) [(30±7) g/L vs (27±7) g/L, t=5.87 , P<0.001)] and high-density lipoprotein (HDL) [(1.1±0.8) mmol/L vs (0.9±0.5) mmol/L, t=-4.20 , P<0.001] decrease, and anti SSB antibody positive rate (16.0% vs 9.5%, χ2=5.60 , P=0.018) decreased.③ After 3 months' follow-up, 203 patients with SLE GI involvement were relieved, 30 patients (12.3%) died, and 9 patients (1.8%) died in the control group. Ninety-five (46.8%) patients in the remission group had a significantly higher rate of cyclophosphamide treatment when compared with 5(12.5%) in the non-remission group ( χ2=16.23, P<0.001) . Logistic regression analysis showed that no increase of PAH, elevated erythrocyte sedimentation rate (ESR), ALT, glutamyl transpeptidase (GGT), indirect bilirubin (IBIL) and high SLEDAI scores, hydroureteral dilatation, decreased ALB and HDL were independent related factors for SLE GI involvement, while ascites and elevated FBS were SLE GI involvement factors of poor prognosis. Conclusion:SLE patients with GI involvement have a high mortality rate, and lupus hepatitis and LMV are common. Hydroureterosis, high SLEDAI score, abnormal liver function are risk factors for GI involvement. Jaundice and elevated FBS are the risk factors for poor prognosis, and treatment with cyclophosphamide is the protective factor.

Research advances of photosensitizer in photodynamic therapy of glioblastoma / 药学学报

Glioblastoma is a malignant tumor in central nervous system, which has strong invasion, poor prognosis and short survival time. At present, the main treatment strategy of glioblastoma is surgical excision, supplemented by radiotherapy and chemotherapy. However, due to incomplete resection and high recurrence rate, it is urgent to find novel therapeutic method for glioblastoma. Photodynamic therapy, as a promising non-surgical treatment, provides a new strategy for postoperative adjuvant therapy of glioblastoma. This review summarizes the mechanism and clinical application of photodynamic therapy mediated by various photosensitizers in glioblastoma, in order to provide help for the treatment of glioblastoma.

Molecular Mechanism of "Transmission Between Lung and Brain" of Influenza and Intervention Effect of Maxing Shigantang Based on JAK1/STAT1 Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo explore the molecular mechanism of "transmission between the lung and brain" of influenza based on Janus kinase 1/signal transducer and activator of transcription 1（JAK1/STAT1） signaling pathway and further investigate the intervention effect of Maxing Shigantang （MXSGT）. MethodA total of 100 SPF BALB/c mice were randomly divided into a normal group，a model group，an oseltamivir group （21.63 mg·kg-1·d-1），an antiviral granules group（3.9 g·kg-1·d-1）， and an MXSGT group（6.05 g·kg-1·d-1）， with 20 mice in each group. The pneumonia model was induced in mice except for those in the normal group by intranasal infection of influenza A virus（IAV）. Twenty-four hours after modeling，mice were treated with corresponding drugs， while those in the normal group and the model group received the same amount of normal saline by gavage， once a day for 3 and 7 days. The pathological changes in the lung and brain were observed by hematoxylin-eosin（HE）staining. The mRNA expression of IAV nucleoprotein（NP），JAK1， and STAT1 in the lung and brain was detected by real-time quantitative polymerase chain reaction（Real-time PCR）， and the protein expression of JAK1 and STAT1 in the lung and brain was detected by Western blot. Immunohistochemical method was used to detect the expression of phosphorylated（p）-STAT1 in the lung and brain tissues， and enzyme-linked immunosorbent assay（ELISA） was used to detect the serum levels of interleukin-1β（IL-1β） and interleukin-10（IL-10）. ResultCompared with the normal group， the model group showed obvious pathological changes in the lung tissues and cerebral cortex， increased relative mRNA expression of IAV NP in the lung （P<0.01）， elevated mRNA and protein expression of JAK1 and STAT1 in the lung and brain tissues （P<0.05，P<0.01），up-regulated expression level of p-STAT1 in lung tissues and cerebral cortex （P<0.05，P<0.01）， and increased serum level of IL-1β （P<0.05）. Compared with the model group， the MXSGT group showed alleviated pathological damage to lung tissues and cerebral cortex， decreased relative mRNA expression of IAV NP in lung tissues（P<0.01），reduced mRNA and protein expression levels of JAK1 and STAT1 in lung tissues and brain tissues（P<0.05，P<0.01）， and increased serum level of IL-10（P<0.01）. ConclusionThe abnormal activation of the JAK1-STAT1 signaling pathway may be one of the molecular mechanisms of "transmission between the lung and brain" of influenza. As an effective compound prescription against the influenza virus，MXSGT can alleviate the pathological damage of brain tissues in mice infected with IAV by regulating the level of cytokines mediated by this pathway.

Comparison of Autogenous Tooth Materials and Other Bone Grafts

Autogenous odontogenic materials are a new, highly biocompatible option for jaw restoration. The inorganic component of autogenous teeth acts as a scaffold to maintain the volume and enable donor cell attachment and proliferation; the organic component contains various growth factors that promote bone reconstruction and repair. The composition of dentin is similar to that of bone, which can be a rationale for promoting bone reconstruction. Recent advances have been made in the field of autogenous odontogenic materials, and studies have confirmed their safety and feasibility after successful clinical application. Autogenous odontogenic materials have unique characteristics compared with other bone-repair materials, such as the conventional autogenous, allogeneic, xenogeneic, and alloplastic bone substitutes. To encourage further research into odontogenic bone grafts, we compared the composition, osteogenesis, and development of autogenous odontogenic materials with those of other bone grafts. In conclusion, odontogenic bone grafts should be classified as a novel bone substitute.

Fetoscopic cord laser therapy in management of monochorionic monoamniotic twin pregnancies / 中华围产医学杂志

Objective:To analyze fetoscopic cord laser therapy for management of monochorionic monoamniotic (MCMA) twin pregnancies.Methods:The clinical data of fetoscopic cord laser therapy, including cord occlusion, transection, and disentanglement in three pairs of MCMA twins from January 2020 to January 2021 in Peking University Third Hospital were summarized. Literature on cord occlusion and/or transection in MCMA twins were retrieved from Cochrane Library, PubMed, EMBASE, CBM, WanFang, and CNKI from the time at establishment to December 2020. The clinical conditions, surgical indications and methods, disease progression, and maternal and infant prognosis were analyzed.Results:Three cases of MCMA twins in this study period received fetoscopic cord laser therapy between 17-24 weeks, among which two cases gave birth at full-term without any maternal or infant complications, and one was terminated due to fetal malformation. Seven English articles including 29 MCMA twin pregnancies were retrieved. In addition to the three cases reported in this article, a total of 32 cases were analyzed. The indication of cord occlusion and/or transection included twin-reversed arterial perfusion sequence (21.9%, 7/32), fetal malformation (46.9%, 15/32), selective fetal growth restriction (sFGR) (21.9%, 7/32), twin-to-twin transfusion syndrome (TTTS) (3.1%, 1/32), TTTS combined with sFGR (3.1%, 1/32), single intrauterine death (3.1%, 1/32). Gestational age at surgery was between 14 +1 to 27 +3 weeks. No maternal complication due to the operation was reported. After exclusion of two cases who did not receive cord transection and one case was terminated due to fetal malformation, all the other 29 co-twins were born alive at the gestational age between 24 +3 to 40 weeks and birth weight between 800-3 800 g. Among the 29 live born babies, four died soon after birth with unclarified reasons in the literature and one was born with multiple malformations which were detected prenatally, and the other 24 neonates were healthy during the follow-up from 1 month to 9 years old. Conclusions:For MCMA twin pregnant women with umbilical cord entanglement or other indications for fetal reduction, cord occlusion, transection, and disentanglement using fetoscopic cord laser is safe and effective for protecting the surviving fetus.

Molecular mechanism of Fagopyri Dibotryis Rhizoma in treatment of acute lung injury based on network pharmacology and in vitro experiments / 中国中药杂志

The present study explored the mechanism of Fagopyri Dibotryis Rhizoma(FDR) and its main active components in the treatment of acute lung injury(ALI) based on the network pharmacology and the in vitro experiments. The main active components of FDR were obtained from the TCMSP database and screened by oral bioavailability and drug-likeness. The related target proteins of FDR were retrieved from the PubChem database, and the target genes related to ALI were screened out from the GeneCards database. A protein-protein interaction(PPI) network of compound target proteins and ALI target genes was constructed using STRING 11.0. Ingenuity Pathway Analysis(IPA) platform was used to analyze the common pathways of the potential compound target proteins of FDR and ALI target genes, thereby predicting the key targets and potential signaling pathways of FDR for the treatment of ALI. Finally, the potential pathways and key targets were verified by the in vitro experiments of lipopolysaccharide-induced RAW264.7 cells intervened by epicatechin(EC), the active component of FDR. The results of network pharmacology showed that 15 potential active components such as EC, procyanidin B1, and luteolin presumedly functioned in the treatment of ALI through nuclear transcription factor-κB(NF-κB) signaling pathway, transforming growth factor-β(TGF-β) signaling pathway, and adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK) signaling pathway through key targets, such as RELA(P65). The results of in vitro experiments showed that 25 μmol·L~(-1) EC had no toxicity to cells and could inhibit the expression of the p65-phosphorylated protein in the NF-κB signaling pathway to down-regulate the expression of downstream inflammatory cytokines, including tumor necrosis factor-α(TNF-α), IL-1β and nitric oxide(NO), and up-regulate the expression of IL-10. These results suggested that the therapeutic efficacy of FDR on ALI was achieved by inhibiting the phosphorylation of p65 protein in the NF-κB signaling pathway and down-regulating the level of proinflammatory cytokines downstream of the signaling pathways.

Stereoscopic 3D/4D technology training combined with refractive correction and masking therapy for adult amblyopia / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the effect of stereoscopic 3D/4D technology as a visual training system combined with refractive correction and masking therapy for adult amblyopia.<p>METHODS: A retrospective study. From July 2018 to October 2020, totally 41 cases(57 eyes)adult amblyopia in our hospital were divided into severe, moderate, mild group, effect of stereoscopic 3D/4D technology training were analyzed after 6mo, including the best corrected visual acuity, visual evoked potentials, stereoscopic function.<p>RESULTS: After treatment, best corrected visual acuity of the patients were significantly improved, the effective rate of severe, moderate, mild amblyopia group were 69%, 88%, 75%, the total effective rate was 79%. The stereoscopic function of the patients were significantly improved, the effective rate of severe, moderate, mild amblyopia group were 62%, 75%, 80%, the total effective rate was 74%. The P100 wave latency periods of the visual evoked potentials were shortened after 6mo treatment, and the P100 wave amplitudes were increased(<i>P</i><0.05). <p>CONCLUSION:Stereoscopic 3D/4D technology training combined with refractive correction and masking therapy can effectively treat the adult amblyopic.

Analysis of correlation between eye strain and eye health behavior in college students during the period of COVID-19 epidemic / 中国学校卫生

Objective@#To understand the relationship between eye strain and eye health behavior in college students learning at home during the period of COVID-19 epidemic, and to provide a scientific reference for improving the hygiene of using eyes among the college students.@*Methods@#A cross sectional study and stratified cluster sampling was used to select 2 671 college students from 8 colleges in Anhui Province during the March 1st to July 1st in 2020, and an online questionnaire was survey included general information,eye strain,and daily eye health behavior.@*Results@#The prevalence of eye strain in college students was 69.64%. Multivariable Logistic regression analysis showed that eye strain was correlated with gender, myopia, siesta habit, staying up until 2:00 am, and the use of eye liquid, with OR values(95% CI ) were 0.64(0.53-0.76), 1.77(1.42- 2.20 ),0.71(0.59-0.86), 1.39(1.17-1.65), and 2.18(1.71-2.79), respectively. There was no correlation among daily outdoor activity time, daytime reading time and the occurrence of eye strain( P >0.05).@*Conclusion@#During the period of COVID-19 epidemic, eye strain among college students is common. The daily eye health behavior is related to the occurrence of eye strain. Under the special learning context, eye care measures should be encouraged specifically.

Assessment of perineal body characteristics in patients with stress urinary incontinence by two-dimensional ultrasound combined with shear wave elastography / 中华超声影像学杂志

Objective:To investigate the value of two-dimensional ultrasound combined with shear wave elastography (SWE) in assessing perineal body characteristics in patients with stress urinary incontinence(SUI).Methods:Sixty-four patients with stress urinary incontinence from December 2019 to August 2020 in the Affiliated Hospital of Qingdao University were selected as the SUI group, in addition, seventy healthy females at the same time were selected as the control group. The clinical information data were collected, two-dimensional ultrasound and SWE examination were performed to obtain the perineal body length, height, perimeter, area and the maximum(Emax) and the mean(Emean) modulus of elasticity both at the resting and maximum Valsalva conditions, ROC curve was plotted to evaluate the effectiveness of elastic modulus in evaluating perineal body in SUI.Results:In the resting state, the length, height, perimeter and area of perineal body in the SUI group were not significantly different from those of the control group ( P=0.590, 0.291, 0.082, 0.063). At the maximum Valsalva, the perineal body length, height, perimeter and area in the SUI group were significantly different from those of the control group ( P=0.005, 0.010, 0.001, 0.008). In the resting, the Emax and Emean values of perineal body elastic modulus in the SUI group were higher than those in the control group, but the difference was not statistically significant [(36.61±9.81)kPa vs (34.66±10.38)kPa, (27.43±9.78)kPa vs (26.97±8.85)kPa, all P>0.05]. At the maximum Valsalva, the Emax and Emean of the SUI group were significantly smaller than those of the control group, with statistically significant difference[(47.73±8.03)kPa vs (58.06±10.02)kPa, (35.78±7.89)kPa vs (44.33±9.62)kPa, all P<0.001]. The area under ROC curve of Emax and Emean at the maximum Valsalva was 0.738 and 0.647 respectively, the Emax was better than the Emean in assessment of the characteristics of perineal body in SUI patients. Conclusions:Two-dimensional ultrasound combined with SWE technique can quantitatively evaluate the characteristics of perineal body and provide an important imaging method for the diagnosis of SUI.

Serum metabolomic profiling among different Traditional Chinese Medicine syndromes of patients with high-risk for diabetes foot ulceration / 国际中医中药杂志

Objective:To explore the metabolic regulations of different Traditional Chinese Medicine (TCM) syndromes in the diabetic patients with high risk for foot ulceration.Methods:Based on gas chromatography-mass spectrometer and multi-dimensional data processing methods, the metabolomics analysis was used to compare the serum metabolites profile of healthy people (32 cases) and the high-risk foot patients in Cold and Blood Stagnation syndrome (44 cases), Heat-toxin hurting Yin syndrome (54 cases), and Qi-Blood deficiency syndrome (33 cases), who were hospitalized at Shanghai TCM-Integrated Hospital from Apirl to December, 2018.Results:This study suggested that compared with healthy people, the diabetic patients with high risk for foot ulceration showed significantly lower serum level of urea [(2.41 ± 1.57)×10 5vs. (3.32 ± 2.10)×10 5], L-leucine [(4.94 ± 3.15)×10 5vs. (6.39 ± 3.57)×10 5], aspartic acid [(3.94 ± 4.48)×10 5vs. (9.62 ± 6.93)×10 5], 9H-purine [(1.74 ± 1.95)×10 5vs. (3.34 ± 2.23)×10 5] ( P<0.05 or P<0.01), while higher level of d-Glucose [(3.72 ± 1.71)×10 5vs. (2.21 ± 1.32)×10 5] and d-glucopyranose [(3.32 ± 2.10)×10 5vs. (1.35 ± 1.43)×10 5] ( P<0.01). Energy metabolism, amino acid metabolism and sugar metabolism were mainly involved. the content of L-tyrosine in the group of patients with Cold and Blood Stagnation syndromewas significantly higher than that in healthy people. The urea, purine, leucine, aspartic acidcontent in patients of Heat-toxin hurting Yin syndrome were significantly lower than that in healthy people. The purine content in patients of Qi and Blood Deficiency Syndrome was significantly lower than that in healthy people. Compared with the syndrome of Heat-toxin hurting Yin syndrome, patients in Cold and Blood Stagnation syndrome showed a significantly higher content of beta-1-galactopyranoside and butanoic acid. Compared to the Qi-Blood deficiency syndrome, serum urea level in patients of Heat-toxin hurting Yin syndrome was significantly higher than those in the patients of other two TCM syndromes. Conclusions:The serum metabolomics profiling differentiate three TCM-syndrome in high-risk DF patients, which can provide objective basis for clinical TCM syndrome differentiation and treatment of high-risk diabetic foot patients.

Comparison of Autogenous Tooth Materials and Other Bone Grafts

Autogenous odontogenic materials are a new, highly biocompatible option for jaw restoration. The inorganic component of autogenous teeth acts as a scaffold to maintain the volume and enable donor cell attachment and proliferation; the organic component contains various growth factors that promote bone reconstruction and repair. The composition of dentin is similar to that of bone, which can be a rationale for promoting bone reconstruction. Recent advances have been made in the field of autogenous odontogenic materials, and studies have confirmed their safety and feasibility after successful clinical application. Autogenous odontogenic materials have unique characteristics compared with other bone-repair materials, such as the conventional autogenous, allogeneic, xenogeneic, and alloplastic bone substitutes. To encourage further research into odontogenic bone grafts, we compared the composition, osteogenesis, and development of autogenous odontogenic materials with those of other bone grafts. In conclusion, odontogenic bone grafts should be classified as a novel bone substitute.

Expert consensus on Tongsaimai Tablets/Capsules in treatment of peripheral vascular diseases in clinical practice / 中国中药杂志

Tongsaimai Tablets/Capsules are composed of Lonicerae Japonicae Flos, Angelicae Sinensis Radix, Achyranthis Bidentatae Radix, Codonopsis Radix, Dendrobii Caulis, Astragali Radix, Scrophulariae Radix, and Glycyrrhizae Radix et Rhizoma, and are effective in promoting blood circulation, removing blood stasis, supplementing Qi, and nourishing Yin. It is widely used in the treatment of peripheral vascular diseases. With 40 years of clinical application, it has accumulated substantial research data and application experience. Its good clinical efficacy and pharmacoeconomic benefits in improving the clinical symptoms of peripheral vascular diseases have been confirmed by relevant research. Meanwhile, this drug has also been recommended by many expert consensus, guidelines, and teaching materials, serving as one of the most commonly used Chinese patent medicines in clinical practice. To further improve the understanding of the drug among clinicians and properly guide its clinical medication, the China Association of Chinese Medicine took the lead and organized experts to jointly formulate this expert consensus. Based on the questionnaire survey of clinicians and the systematic review of research literature on Tongsaimai Tablets/Capsules with clinical problems in the PICO framework, the consensus, combined with expert experience, concludes recommendations or consensus suggestions by GRADE system with the optimal evidence available through the nominal group technique. This consensus defines the indications, usage, dosage, course of treatment, medication time, combined medication, and precautions of Tongsaimai Tablets/Capsules in the treatment of peripheral vascular diseases, and explains the safety of its clinical application. It is recommended for clinicians and pharmacists in the peripheral vascular department(vascular surgery), traditional Chinese medicine surgery(general surgery), and endocrinology department of hospitals at all levels in China.