Study on the biomechanical analysis and influencing factors study for the treatment of humeral epicondylitis by Bachuorounian manipulation / 中国骨伤

OBJECTIVE@#To quantitatively study the biomechanical parameters of Bachuorounian manipulation in the treatment of humeral epicondylitis, and discuss the effects of individual characteristics on the biomechanical parameters were discussed.@*METHODS@#From July 2019 to February 2020, 40 patients with external humeral epicondylitis were selected, including 18 males and 22 females, ranging in age from 20 to 50 years old, with an average of (34.37±8.41) years old;and the course of disease ranged from 1 to 11 months, with a mean of (6.05±2.71) months. The biomechanical parameters of the elbow joint of the affected side were measured by using the biomechanical sensor. At thesame time, the individual characteristic parameters of patients were collected to analyze the influence of different individual characteristics of patients on biomechanical parameters.@*RESULTS@#The results of mechanical analysis in each stage of the bachuorounian manipulation were as follows:the rolling back rotation force was (31.17±2.99) N;the buckling bending drawing force was (44.99±2.38) N;the rolling pre rotation force was (31.03±2.75) N;and stretching drawing force was (48.75±2.09) N. The correlation analysis between the parameters showed that there was a significant positive correlation between the buckling bending drawing force and the stretching drawing force parameters, and a significant positive correlation between the rolling force back-rotation force and the rolling pre-rotation force parameters. The multivariate linear regression analysis on the parameters of influencing factors and manipulative biomechanics showed that there was a significant correlation between body weight and rolling back-rotation force, significant correlation between elbow tenderness and the buckling bending drawing force, and significant correlation between disease duration and the stretching drawing force.@*CONCLUSION@#The bachuorounian manipulation of humeral epicondylitis has a certain range of operating force. Manipulation of each stage has a correlation and systematic. The patient's weight, elbow tenderness and disease course are important factors affecting the bachuorounian manipulation.

Establishment and clinical application value of an automatic diagnosis platform for rectal cancer T-staging based on a deep neural network / 中华医学杂志(英文版)

BACKGROUND@#Colorectal cancer is harmful to the patient's life. The treatment of patients is determined by accurate preoperative staging. Magnetic resonance imaging (MRI) played an important role in the preoperative examination of patients with rectal cancer, and artificial intelligence (AI) in the learning of images made significant achievements in recent years. Introducing AI into MRI recognition, a stable platform for image recognition and judgment can be established in a short period. This study aimed to establish an automatic diagnostic platform for predicting preoperative T staging of rectal cancer through a deep neural network.@*METHODS@#A total of 183 rectal cancer patients' data were collected retrospectively as research objects. Faster region-based convolutional neural networks (Faster R-CNN) were used to build the platform. And the platform was evaluated according to the receiver operating characteristic (ROC) curve.@*RESULTS@#An automatic diagnosis platform for T staging of rectal cancer was established through the study of MRI. The areas under the ROC curve (AUC) were 0.99 in the horizontal plane, 0.97 in the sagittal plane, and 0.98 in the coronal plane. In the horizontal plane, the AUC of T1 stage was 1, AUC of T2 stage was 1, AUC of T3 stage was 1, AUC of T4 stage was 1. In the coronal plane, AUC of T1 stage was 0.96, AUC of T2 stage was 0.97, AUC of T3 stage was 0.97, AUC of T4 stage was 0.97. In the sagittal plane, AUC of T1 stage was 0.95, AUC of T2 stage was 0.99, AUC of T3 stage was 0.96, and AUC of T4 stage was 1.00.@*CONCLUSION@#Faster R-CNN AI might be an effective and objective method to build the platform for predicting rectal cancer T-staging.@*TRIAL REGISTRATION@#chictr.org.cn: ChiCTR1900023575; http://www.chictr.org.cn/showproj.aspx?proj=39665.

Finite element analysis on stress concentration improvement in patellofemoral joint by releasing lateral patellar retinaculum with stiletto needle based on the theory of Jinshugu() / 中国骨伤

OBJECTIVE@#To study mechanism of improvement of stress concentration on patellofemoral joint by stiletto needle releasing lateral patellar retinaculum guided by the theory of Jinshugu() and based on the finite element model of knee joint. and to elucidate the biomechanical mechanism of stiletto needle releasing changing patellar trajectory and reducing patellofemoral joint pressure.@*METHODS@#CT data of knee joint from a normal male (aged 29, heighted 171 cm, weighted 58 kg) was selected. Starting with construction of three-dimensional model of knee joint by using finite element software, the finite element model of knee joint with complete tendonand bone structures were established through several steps, such as geometric reconstruction, reverse engineering, meshing, material assignment and loading analysis. The loading condition was set as 500 N load on knee joint, and the average tensile stress of quadriceps femoris tendon was about 200 N. To simulate the release of lateral patellar retinaculum by stiletto needle at 30 and 90 position of knee flexion in finite element model separately, and to compare the improvement of stress concentration of patellofemoral joint by stiletto needle intervention under different knee flexion conditions.@*RESULTS@#The peak stress of patellofemoral joint and tibiofemoral joint decreased after stiletto needle releasing of patellofemoral lateral retinaculum compared with before intervention, which was(1) knee flexion at 30 degrees:patellar cartilage decreased by 0.498 MPa (decreased 9.06%), femoral trochlea decreased by 0.886 MPa(decreased 16.27%);(2) knee flexion at 90 degrees:patellar cartilage decreased by 0.558 MPa (decreased 8.6%), femoral trochlea decreasedby 0.607 MPa (decreased 9.94%).@*CONCLUSION@#Releasing lateral patellofemoral retinaculum with stiletto needle could effectively alleviate the stress concentration of patellofemoral joint and reduce local stress peak value, which it is helpful to improve patellar trajectory and make stress distribution more uniform.

Construction and simulation mechanical analysis of dynamic knee joint finite element model based on CT image / 中国骨伤

OBJECTIVE@#To construct a dynamic knee joint finite element model based on CT image data and verify the validity of the model. To provide a simulation model and basic data for biomechanical research of the knee joint by further finite element analysis.@*METHODS@#The CT data of a healthy male knee joint was selected. With the help of Mimics 19.0 and Hypermesh 12.0 software, a high simulation finite element model of knee joint was established following steps, including geometric reconstruction, reverse engineering, meshing and material characterization. The dynamic knee flexion model was generated by determining the boundary conditions and torque loading, and the validity of themodel was confirmed. The biomechanical changes of the tibiofemoral and patellofemoral joints under different knee flexion angles were analyzed by applying the loads (500 N) to the finite element model during knee flexion.@*RESULTS@#A finite element model of knee joint was established based on CT images and anatomical characteristics. The model included three-dimensional elements such as bone, ligament, cartilage, meniscus and patellar retinaculum. The different finite element models of knee flexion states were produced by applying different torques after establishing boundary conditions. According to equivalent conditions (knee flexion 30 degrees, quadriceps tendon under 200 N stretch), the peak stress value of patella was 2.209 MPa and the average Mises stress was 1.132 MPa; the peak stress value of femoral trochlear was 1.405 MPa and the average Mises stress was 0.936 MPa. The validity of the model was proved by the difference between the model and previous studies of 1% to 13.5%. Dynamic model loading showed that the Mises stressof tibiofemoral joint decreased with the increase of knee flexion angle, while the Mises stress of patellofemoral joint was positively correlated with knee flexion angle. The Mises stress of cartilage stress planes at different knee flexion angles was significantly different(<0.05).@*CONCLUSION@#The finite element model established in this study is more comprehensive and can effectively simulate the biomechanical characteristics of dynamic knee joint, which provides support for further simulation mechanics researches of the knee joint.

Artificial intelligence system of faster region-based convolutional neural network surpassing senior radiologists in evaluation of metastatic lymph nodes of rectal cancer / 中华医学杂志(英文版)

BACKGROUND@#An artificial intelligence system of Faster Region-based Convolutional Neural Network (Faster R-CNN) is newly developed for the diagnosis of metastatic lymph node (LN) in rectal cancer patients. The primary objective of this study was to comprehensively verify its accuracy in clinical use.@*METHODS@#Four hundred fourteen patients with rectal cancer discharged between January 2013 and March 2015 were collected from 6 clinical centers, and the magnetic resonance imaging data for pelvic metastatic LNs of each patient was identified by Faster R-CNN. Faster R-CNN based diagnoses were compared with radiologist based diagnoses and pathologist based diagnoses for methodological verification, using correlation analyses and consistency check. For clinical verification, the patients were retrospectively followed up by telephone for 36 months, with post-operative recurrence of rectal cancer as a clinical outcome; recurrence-free survivals of the patients were compared among different diagnostic groups, by methods of Kaplan-Meier and Cox hazards regression model.@*RESULTS@#Significant correlations were observed between any 2 factors among the numbers of metastatic LNs separately diagnosed by radiologists, Faster R-CNN and pathologists, as evidenced by rradiologist-Faster R-CNN of 0.912, rPathologist-radiologist of 0.134, and rPathologist-Faster R-CNN of 0.448 respectively. The value of kappa coefficient in N staging between Faster R-CNN and pathologists was 0.573, and this value between radiologists and pathologists was 0.473. The 3 groups of Faster R-CNN, radiologists and pathologists showed no significant differences in the recurrence-free survival time for stage N0 and N1 patients, but significant differences were found for stage N2 patients.@*CONCLUSION@#Faster R-CNN surpasses radiologists in the evaluation of pelvic metastatic LNs of rectal cancer, but is not on par with pathologists.@*TRIAL REGISTRATION@#www.chictr.org.cn (No. ChiCTR-DDD-17013842).

Construction of fresh cervical vertebral artery determination model: influence of variant positions on vertebral artery flow / 中国组织工程研究

BACKGROUND: As a reliable biomechanical model, human fresh isolated cervical specimens provide the basis for studying the pathogenesis of cervical vertigo from the perspective of blood flow of vertebral artery.There is a lack of an in vitro cervical model that can simulate the physiological state of the cervical vertebrae and achieve complex posture, as well as can measure the blood flow of vertebral artery. OBJECTIVE:To study the influence of variant position of human fresh isolated cervical vertebrae on the blood flow of vertebral artery in vitro through constructing the fresh specimen of cervical vertebral artery determination model. METHODS: Six human fresh isolated cervical specimens were selected for constructing the vertebral artery determination model. The pressure of human vertebra artery was simulated by pressure pump. The change of normal saline height was measured by digital motion capture system dynamically under different positions. RESULTS AND CONCLUSION: (1) Eight vertebral arteries in the six models were in good condition. (2) The vertebral artery flow under neutral position was significantly richer than that under contralateral rotation-anteflexion and ipsilateral/contralateral rotation-postexion (P <0.05). (3) The vertebral artery flow under contralateral rotation-anteflexion and rotation-postexion was significantly poorer than that under natural position, ipsilateral rotation and ipsilateral rotation-anteflexion (P < 0.05). (4) In summary, the cervical vertebral artery determination model is constructed successfully that can simulate the influence of the position on vertebral artery flow. Additionally, different positions of rotation make a different effect on vertebral artery flow.

Three-dimensional finite element analysis on splint fixation for treating ulnar styloid process fracture / 中国组织工程研究

BACKGROUND: Distal radius fractures are often accompanied by the ulna styloid process fractures, and the treatment of the ulna styloid process fracture is disputed in clinic. Manipulative reduction and splint fixation is a common method to treat such diseases. The mechanism of intervention on ulnar styloid process is difficult to obtain in the corpse mechanics experiments. In recent years, the finite element analysis method has been widely used in the field of orthopedics, which has opened up a way for the study of orthopedic disease. OBJECTIVE: To explore the biomechanical mechanism of splint intervention on ulnar styloid fracture by finite element analysis, and to provide the basis for clinical treatment choice. METHODS: A three-dimensional finite element model of normal wrist joint was established based on the forearm and wrist CT images of a healthy volunteer. The validity of the model was verified by comparing with the experimental data in the literature. On this basis, four wrist joint finite element models with and without splint fixation for ulnar styloid type I and type II fractures were established. Under axial compression, lateral extension, pronation and supination working conditions, the changes of the relative displacement of the distal radioulnar joint and the ulnar styloid fracture broken end were analyzed. RESULTS AND CONCLUSION: (1) A three-dimensional finite element model of normal wrist joint was established and validated, and the other four models were established based on this model. (2) In pronation and supination conditions, the relative displacement values of the ulnar and radial joints in the ulnar styloid type I and II fracture models were greater than those in the normal wrist joint model, and the displacement was smaller in the type I fracture model than in the type II fracture model; the displacement was significantly reduced after the intervention on the two fracture models by the splint. (3) In the lateral tension, pronation and supination conditions, the displacement values of the ulnar styloid fracture end in the ulnar styloid type I fracture model were smaller than in the type II fracture model, and the displacement values were significantly reduced after the intervention by the splint. Under the remaining conditions, the change of the above values was not obvious. (4) In conclusion, the stability of distal radioulnar joint became worse after ulnar styloid fracture, and the stability of distal radioulnar joint after type I fracture was less than that after type II fracture. As an elastic fixation method, splint can increase the stability of the wrist ulnar column during the treatment.

Influences of warming kidney prescription on antiviral therapeutic efficacy and creatine kinase in telbivudine-treated HBeAg-positive chronic hepatitis B patients / 中华肝脏病杂志

To study the influences of warming kidney prescription on antiviral therapeutic efficacy and creatine kinase (CK) level in telbivudine-treated HBeAg-positive chronic hepatitis B patients with kidney yang deficiency syndrome. Ninety-six cases were enrolled and randomly divided into two groups (n=48 each): warming kidney prescription treatment or control. Both groups were treated for 52 weeks with telbivudine monotherapy, but the treatment group received additional treatment with the warming kidney prescription. Traditional Chinese medicine (TCM) syndrome score, biochemical response, virological response, serological response, CK level, and adverse reactions were recorded for each group in order to perform comparative analysis of the warming kidney prescription's effects. A total of 84 patients, including 43 cases in the treatment group, completed the study. The warming kidney prescription led to significantly improved total clinical syndrome efficacy, TCM syndrome score, biochemical response, virological response, and HBeAg serological responses, as evidenced by changes for each parameter observed in the treatment group versus the control group (respectively, 88.37% vs. 63.41%, 4.97+/-1.88 vs. 10.13+/-3.72, 95.35% vs. 75.61%, 81.40% vs. 56.10%, 48.84% vs. 26.83% (all, P less than 0.05)). No patient in either group experienced primary treatment failure. Seven cases, all from the control group, experienced virological breakthrough. Elevated CK was observed in both the treatment and control groups, but significantly more patients in the control group experienced this adverse reaction (respectively, 73.17% vs. 44.19%; P less than 0.01). The warming kidney prescription can increase telbivudine antiviral therapeutic efficacy and decrease the telbivudine-induced increase in creatine kinase in HbeAg-positive chronic hepatitis B patients with kidney yang deficiency syndrome.

Effects of interferon-alpha combined with saikosaponin on serum T lymphocyte subgroups and hepatic cytokines in mice with immune hepatic injury / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effects of interferon-alpha combined with saikosaponin on serum T lymphocyte subgroups and hepatic cytokines in mice with immune hepatic injury.</p><p><b>METHODS</b>The mice were randomly divided into five groups, i. e., the normal control group, the model group, the interferon group, the saikosaponin group, and the interferon combined saikosaponin group. Corresponding medication was given to mice in respective groups for two days. Peripheral blood was collected 8 and 24 h after concanavalin A (Con A) was injected. Serum lymphocyte subgroups, tumor necrosis factor alpha (TNF-alpha), levels of interleukin 18 (IL-18) and IL-10, activities of alanine aminotransferase (ALT) and aspartate transaminase (AST) were detected. Pathological changes of the liver tissue were observed.</p><p><b>RESULTS</b>(1) Compared with the normal control group, serious inflammation and necrosis was significant in the liver tissue of the model group. The serum levels of ALT and AST obviously increased. Meanwhile, the 24-h peripheral blood CD4+ T cell and CD8+ T cell ratios and the hepatic IL-10 level obviously decreased (P < 0.01). The levels of IL-18 and TNF-alpha significantly increased (P < 0.05, P < 0.01). (2) Compared with the model group, dot and lamellar necrosis was dispersedly seen in the liver tissue in the three medication groups. The serum activities of ALT and AST significantly decreased (P < 0.01). Meanwhile, the peripheral blood CD4+ T cell and CD8+ T cell ratios, as well as the hepatic IL-10 level obviously increased (P < 0.01, P < 0.05). The levels of IL-18 and TNF-alpha significantly decreased (P < 0.05, P < 0.01). (3) In the interferon combined saikosaponin group, the 24-h peripheral blood CD4+ T cell and CD8+ T cell ratios increased more obviously than those of the interferon group. The 8- and 24-h IL-18 levels were obviously lower than those of the interferon group, while the 24-h TNF-alpha level significantly decreased more than that of the interferon group (P < 0.05).</p><p><b>CONCLUSION</b>Interferon-alpha combined saikosaponin could effectively play a role in fighting against the immune hepatic injury.</p>

Efficacy of peg interferon alpha-2a in combination with ribavirin in treatment of with hepatitis C cirrhosis patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the clinical efficacy of PEG Interferon alpha-2a combined with ribavirin in treatment of with hepatitis C cirrhosis patients.</p><p><b>METHODS</b>21 patients with chronic hepatitis C cirrhosis (treated group) ,were treated with peg-IFNalpha-2a 135 -180 microg subcutaneously, 1 week,ribavirin tablets 800 -1000 mg/d,48 weeks of treatment and follow-up 24 weeks, 20 patients with Chronic hepatitis C (control group), were treated with peg-IFNalpha-2a 135 -180 microg subcutaneously, 1 week,ribavirin tablets 600 -1000 mg/d, 48 weeks of treatment, follow-up 24 weeks, comparison of rapid virological response (RVR) rates, early virologic response (EVR) rate, sustained virologic response (SVR) rate, adverse reactions was observed.</p><p><b>RESULTS</b>The differences of RVR, EVR, ETVR in two groups is not significant, but SVR in treatment group was lower (P < 0.05), and has a higher incidence bone marrow suppression and anemia (P < 0.05). Flu-like symptoms, hair loss, gastrointestinal reactions and other adverse reactions was no significant difference between the two groups.</p><p><b>CONCLUSION</b>The use of 135 microg peg-IFNalpha-2a and individual in low-dose ribavirin hepatitis C patients with cirrhosis is more security,could get a good early response, but sustained virologic response (SVR) rates is lower than hepatitis C patients. Blood, liver and kidney function should be closely observed during treatment process.</p>

Effects of corticosterone, cAMP, cGMP, Ca2+, and protein kinase C on apoptosis of mouse thymocytes induced by X-ray irradiation / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To observe the effects of signal factors of corticosterone (CS), cAMP, cGMP, Ca2+ andprotein kinase C (PKC) on lymphocyte apoptosis in mouse thymus induced by X-rays of 4 Gy in vitro.</p><p><b>METHODS</b>The DNA lytic rate for thymocytes was measured by fluorospectrophotometry.</p><p><b>RESULTS</b>The DNA lyric rate for thymocytes 4-8 hours after irradiation with 2-8 Gy was significantly higher than that in the control (P<0.01). As compared with the control, the DNA lytic rate for thymocytes treated with 0.01 micromol/L CS (P<0.01), 50 ng/mL cAMP (P<0.01), 0.05-0.4 microg/mL ionomycin (Iono, P<0.05 or P<0.01) or 0.05-0.4 ng/mL phorbol myristate acetate (PMA, P<0.05 or P<0.01), respectively, was significantly increased, while the rate for thymocytes treated with 50 ng/mL cGMP was not significantly increased. The DNA lytic rate for thymocytes treated with 0.01 micromol/L CS (P<0.01), 50 ng/mL cAMP (P<0.01), 0.2 and 0.4 microg/mL Iono (P<0.05), and 0.2 and 0.4 ng/mL PMA (P<0.05) plus 4-Gy irradiation, respectively, was significantly higher than that treated with single 4-Gy irradiation, while the rate for thymocytes treated with 50 ng/mL cGMP plus 4-Gy irradiation was not increased. When both 0.4 microg/mL Iono and 0.4 ng/mL PMA acted on the thymocytes, the DNA lytic rate for thymocytes was significantly higher than that in the control (P<0.01), the DNA lytic rate for thymocytes treated with both 0.4 microg/mL Iono and 0.4 ng/mL PMA plus 4-Gy irradiation was significantly higher than that treated with single 4-Gy irradiation (P<0.05), but was not significantly higher than that treated with 0.4 microg/mL Iono plus 4-Gy irradiation or 0.4 ng/mL PMA plus 4-Gy irradiation.</p><p><b>CONCLUSION</b>CS, cAMP, Ca2+, and PKC signal factors can promote thymocyte apoptosis induced by larger dose X-rays.</p>

CD127 and T Lymphocytes / 中国生物工程杂志

CD127 is the interleukin7 receptor ?(IL7R?),it regulates the specific respond of T lymphocytes to IL7.CD127 plays an indispensable role in the development of thymocytes into T lymphocytes,the survival and homeostatic proliferation of memory T cells.There are only two phases of the life period of T cells that do not express CD127:immature CD4+8+double positive(DP)thymocytes and activated T cells.Recently,it was found that CD127 play an important role as the specific marker of memory T cells and regulator T cells.The role and mechanism of CD127 in the life period of T cells were discussed herein.

Changes of cycle and apoptosis of spermatogenic cells and antioxidant capacity in male rats with diabetes mellitus / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the changes of cycle and apoptosis of spermatogenic cells and antioxidant capacity of the serum and testis in male rats with diabetes mellitus.</p><p><b>METHODS</b>Thirty male rats were divided into two groups, 10 for normal control and 20 for the diabetes group. The rats were injected intraperitoneally with streptozocin (TZ) to develop diabetes, and 12 weeks later, their survival rate and testis weight were recorded. The percentage of G0/G, S and G2/M phases and apoptosis in spermatogenic cells were measured with flow cytometry (FCM). Malondialdehyde (MDA) and nitric oxide (NO) levels, superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and NO synthase (NOS) activities in the serum and testis were measured with thiobarbituric acid reactive substances (TBARs), nitric acid reoxidized enzyme, xanthine oxidative enzyme, 5,5 Dithiobis (2,2 nitrobenzoate) (TNB) and visible light photometer methods, respectively.</p><p><b>RESULTS</b>Twelve weeks after the male rats got diabetes, their survival rate, body weight and testis weight were significantly lower (p < 0.05), and the percentages of G0/G1 phases and apoptotic spermatogenic cells were obviously higher (P < 0.05) than the normal control. At the same time, the percentage of S and G2/M phases spermatogenic cells decreased. So the spermatogenic cells were arrested in G0/G1 phase. In the diabetic rat serum and testis, especially in the testis, MDA levels were distinctly higher and SOD activities were significantly lower than those in the control. Serum GSH-Px activities of the diabetic rats were significantly lower (p < 0.05), while testis GSH-Px activities were significantly higher than those in control group (P < 0.01). NO contents in the serum and testis of the diabetic rats (P < 0.01) increased significantly, particularly the former, while NOS activities in the serum decreased significantly as compared with the control (P < 0.5).</p><p><b>CONCLUSION</b>The increase in testis and serum MDA levels and NO contents and the decrease in the antioxidant enzyme activity of the diabetic rats may be relevant to spermatogenic disorder caused by the increase of G0/G1 phases arrest and spermatogenic cells apoptosis.</p>

Effect of zishuijianghuoyin on expression of lymphocyte AngII receptor (AT-1) mRNA of experimental hypertension rats / 中国中药杂志

<p><b>OBJECTIVE</b>To explore the immuno-neurologic regulation of hypertension and its inherent law as well as the mechanisms of curing and systemic regulating effect of ZiShuiJiangHuoYin(ZSJHY).</p><p><b>METHOD</b>To detect expression level of AT-1mRNA in two-kidney-one-clamp renal hypertension rat lymphocyte cell by means of RT-PCR.</p><p><b>RESULT</b>The level of AT-1 mRNA in lymphocyte was higher in group of 2K1C-RHR than that in normal group. ZSJHY (20 g/kg, 40 g/kg) had regulating effect on this.</p><p><b>CONCLUSION</b>Depressing excessive expression of lymphocyte AT-1 mRNA may be one of the mechanisms where ZSJHY exert immunoregulation action.</p>