Effects and mechanism of Hugan buzure formula on intrahepatic cholestatic liver injury in rats / 中国药房

OBJECTIVE To study the effects of Hugan buzure formula （HBF） on intrahepatic cholestatic liver injury in rats and its potential mechanism. METHODS Rats were randomly divided into control group， model group， ursodeoxycholic acid （UDCA） group （positive control， 60 mg/kg ） and HBF low-dose， middle-dose and high-dose groups （HBF-L， HBF-M， HBF-H groups， 0.4， 0.8， 1.6 g/kg ）， with 6 rats in each group. The rats in each drug group were given the corresponding drug solution intragastrically， once a day， for 7 consecutive days. The rats in the control group and the model group were given equal volumes of water intragastrically. On the 5th day， except for the control group， the rats in other groups were single intragastrically administered with alpha-naphthyl isothiocyanate olive oil solution （100 mg/kg） to establish the model. After 48 h of modeling， the contents of liver function indexes （aspartate aminotransferase， alanine aminotransferase， alkaline phosphatase， total bile acid， total bilirubin， direct bilirubin） and oxidative stress indexes [malondialdehyde （MDA）， glutathione （GSH）， superoxide dismutase] in serum of rats were detected； the pathological changes of liver tissue were observed. The mRNA expressions of inflammation-related factors [tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）] and farnesoid X receptor （FXR） signaling pathway-related factors [FXR， small heterodimer partner （SHP）， multidrug resistance protein 2 （MRP2）， bile salt export pump （BSEP）， Na+-taurocholate cotransporting polypeptide （NTCP）， organic anion-transporting polypeptide 2 （OATP2） and cholesterol 7α-hydroxylase （CYP7A1）]， the expressions of FXR signaling pathway-related proteins （FXR， MRP2， BSEP， NTCP） and nuclear factor- κB p65 （NF- κB p65） in liver tissue were detected.RESULTS Compared with the model group， the contents of liver function indexes and the level of MDA in serum， the mRNA expressions of the above inflammation-related factors and CYP7A1， and the relative expression of NF-κB p65 in liver tissue were significantly decreased； the levels of GSH in serum， the mRNA expressions of FXR， SHP， MRP2， BSEP， NTCP and OATP2， and the relative expressions of FXR， MRP2， BSEP and NTCP in liver tissue were significantly increased （P＜0.05 or P＜0.01）； the pathological changes of liver tissue were significantly improved. Only some indexes in HBF-L group， HBF-M group and UDCA group were significantly reversed （P＜0.05 or P＜0.01）. CONCLUSIONS HBF can prevent intrahepatic cholestatic liver injury in rats， and the effects may be related to the activation of FXR signaling pathway and the reduction of inflammation and oxidative stress.

Real-world outcomes of niraparib treatment in patients with ovarian cancer: the first observational multicenter study in China / 부인종양

Objective@#The objective of this study was to present the real-world patients’ portrait, and the results of niraparib treatment in China. @*Methods@#This study included 142 patients treated with niraparib from 8 hospitals in China between December 2018 and September 2021. Patients’ characteristics were summarized. The efficacy and safety in first-line maintenance (1L-M), platinum-sensitive recurrence maintenance (PSR-M), and treatment for ovarian cancer were evaluated. Survival outcomes and the factors influencing progression-free survival (PFS) were estimated. @*Results@#The 93 patients received Niraparib as 1L-M, 31 as PSR-M and 18 as salvage. BRCA status was wild type or unknown in 87.3% of patients. With a median follow-up time of 8.7 months, the median PFS (mPFS) for 1L-M has not yet been reached, and the mPFS for PSR-M and salvage therapy was 10.5 and 5.7 months, respectively. Responses to last chemotherapy and cancer antigen 125 value before taking niraparib were 2 important factors affecting PFS among 1L and PSR patients. The 12.7% (18/142) of patients experienced grade ≥3 hematologic adverse events and 23.2% experienced dose adjustment. It was noteworthy that when the interval of chemotherapy and niraparib <21 days, the incidence of grade ≥3 adverse events increased significantly (p=0.0355). @*Conclusion@#Generally, niraparib was effective and well tolerated, which was consistent with the results of prospective trials. However, in real world, it was more inclined to use niraparib in late-line treatment without genetic testing.

In vitro inhibitory effects of acteoside on 6 kinds of CYP enzymes in liver microsomes of rats / 中国药房

OBJECTIVE To inv estigate the in vitro inhibitory effects of acteoside on cytochrome P 450（CYP）enzymes in liver microsomes of rats. METHODS Using probe substrates method ，acteoside（0.1，0.3，1，3，10，30 μmol/L）was incubated with probe substrates phenacetin ，mephentoin，diclofenac，coumarin，dextromethorphan and testosterone （substrates of CYP 1A2， CYP2C19，CYP2C9，CYP2A6，CYP2D6 and CYP 3A4 enzymes，respectively）in liver microsomes of rats. Another blank control group and positive inhibitor group [ α-naphthoflavone，ticlopidine，sulfabendazole，pilocarpine，quinidine and ketoconazole （inhibitors of CYP 1A2，CYP2C19，CYP2C9，CYP2A6，CYP2D6 and CYP 3A4 enzymes，respectively）] were set up. Using indapamide as the internal standard ， the contents of corresponding metabolites （acetaminophen， 4-hydroxymephenytoin， 4-hydroxydiclofenac，7-hydroxycoumarin，dextran，6 β-hydroxytestosterone） were detected by ultra high performance liquid chromatography-tandem mass spectrometry . The IC 50 values were calculated by GraphPad v 8.0 software. By computer molecular docking technology ，acteoside and positive inhibitors were molecularly docked with the CYP enzyme ，and the binding mode and strength of the two molecules were analyzed. RESULTS The IC 50 values of acteoside to CYP 1A2 and CYP 2A6 enzymes were more than 30 μmol/L，and those of acteoside to CYP 2D6，CYP2C19，CYP2C9 and CYP 3A4 enzymes were 24.87，21.52，12.56 and 7.55 μmol/L，respectively. The hydrogen bond and hydrophobic force could form between acteoside and CYP 3A4 enzyme，and the hydrogen bond and electrostatic interaction could form between ketoconazole and CYP 3A4 enzyme. The binding free energy of acteoside and ketoconazole to CYP 3A4 enzyme were － 10.2 and － 12.4 kcal/mol （1 kcal/mol＝4.19 kJ），respectively. CONCLUSIONS Acteoside shows moderate inhibitory effect on CYP 3A4 enzyme in liver microsomes of rats ，and its affinity is equivalent to that of positive inhibitor ；the compound shows weak inhibitory effect on other 5 CYP enzymes.

Effect of vancomycin-loaded microbubbles combined with ultrasound targeted microbubble destruction technology on methicillin-resistant Staphylococcus aureus biofilms / 中华创伤杂志

Objective:To investigate the effect of vancomycin (Vm)-loaded microbubbles (MBs) combined with ultrasound targeted microbubble destruction (UTMD) technique on the morphological structure, thickness and bacterial viability of methicillin-resistant Staphylococcus aureus (MRSA) biofilms.Methods:Vm-MBs were prepared by thin film hydration. Sterile coverslips in a diameter of 13 mm were placed in 24-well plates to construct in vitro biofilm models using MRSA as the test strain, and the biofilm morphology was observed by naked eye and light microscopy after crystal violet staining. LIVE/DEAD, SYTO59 and DIL were used to stain biofilms and MBs, respectively. After staining, the biofilm morphology and position of the biofilm in relation to MBs were observed using laser confocal scanning microscopy. The biofilms were divided into control group, Vm group, Vm-MBs group, UTMD group and Vm-MBs+UTMD group according to the random number table method, with 9 samples in each group. After biofilms of each group were treated accordingly for 24 hours, the morphological and structural changes of biofilms in each group were observed using laser confocal scanning microscopy and scanning electron microscopy following LIVE/DEAD staining; the difference in biofilm density in each group was measured with the aid of an enzyme marker following crystal violet staining; the difference in biofilm thickness and bacterial viability in each group were observed by laser confocal scanning microscopy. Results:The prepared Vm-MBs met the experimental requirements. The constructed biofilm model observed by naked eye, light microscopy and laser confocal scanning microscopy showed that the biofilm structure was dense with a relatively uniform thickness of (13.8±0.2)nm, a small amount of dead bacteria inside the membrane and the percentage of live bacteria of (94.9±0.3)%. Laser confocal scanning microscopy showed that MBs could penetrate into deeper layers of biofilms. After the respective treatment was given to each group for 24 hours, Laser confocal scanning microscopy and scanning electron microscopy following LIVE/DEAD staining showed that the biofilm morphological structure was most significantly disrupted in Vm-MBs+UTMD group compared to control, Vm, Vm-MBs and UTMD groups. In Vm-MBs+UTMD group, a large number of dead bacteria was observed, with only a few scattered planktonic bacteria and irregular changes in cell membrane morphology. Crystal violet staining showed that the biofilm density was significantly lower in Vm-MBs+UTMD group compared to control group ( P<0.05), while the differences between Vm, Vm-MBs and UTMD groups were not statistically significant (all P>0.05). Laser confocal microscopy showed that the biofilm thickness was thinner in Vm-MBs, UTMD and Vm-MBs+UTMD groups compared to control group (all P<0.05), with no significant difference between Vm group and control group ( P>0.05) and that the biofilm thickness was thinner in Vm-MBs+UTMD group compared to Vm, Vm-MBs and UTMD groups (all P<0.01), with no significant differences between the other groups (all P>0.05). Bacterial activity in Vm, Vm-MBs, UTMD and Vm-MBs+UTMD groups was significantly lower than that in control group (all P<0.01), with lower in Vm-MBs+UTMD group compared to Vm, Vm-MBs and UTMD groups (all P<0.01), but without significant difference between the other groups (all P>0.05). Conclusion:Vm-MBs combined with UTMD technology can effectively destroy the biofilm morphological structure to reduce biofilm thickness. Meanwhile, Vm-MBs combined with UTMD technology can release antibiotics and significantly decrease bacterial viability to improve antibiotic bactericidal efficacy.

Numerical study on the effect of middle ear malformations on energy absorbance / 生物医学工程学杂志

In order to study the effect of middle ear malformations on energy absorbance, we constructed a mechanical model that can simulate the energy absorbance of the human ear based on our previous human ear finite element model. The validation of this model was confirmed by two sets of experimental data. Based on this model, three common types of middle ear malformations,

Advances of high-throughput screening system in reengineering of biological entities / 生物工程学报

Enzymes and cell factories are the core of industrial biotechnology. They play important roles in various fields such as medicine, chemical industry, food, agriculture, and energy. Usually, natural enzymes and cells need to be engineered to improve the catalytic efficiency, stability and enantioselectivity. Directed evolution makes it possible to rapidly improve the properties of enzymes and cell factories. Sensitive and reliable high-throughput screening approaches are the key for successful and efficient engineering of enzymes and cell factories. In this review, we first summarize the advantages and disadvantages of different screening methods and signal generation strategies as well as their application scope; we then describe the latest advances of ultra-high throughput screening technology applied in the directed evolution of enzymes and cell factories in the past three years. On this basis, we discuss the limiting factors that need to be further improved for high-throughput screening systems and forecast the future development trends of high-throughput screening methods, hoping that researchers in various fields including biotechnology and instrument development can cooperate closely to enhance the reliability and applicability of the high-throughput screening techniques.

Research on pseudo CT image synthesis technology based on deep learning method and its application in radiotherapy / 中华放射医学与防护杂志

With the improvement of the complexity of medical image synthesis and the demand for the accuracy of clinical radiotherapy, deep learning algorithm plays an increasingly important role in pseudo CT image synthesis and analysis. This paper classifies and analyzes the pseudo CT image synthesis technology based on deep learning method in terms of the types of image modes, and describes the ongoing application in radiotherapy.

Research on computer aided diagnosis of otitis media based on faster region convolutional neural network / 生物医学工程学杂志

Otitis media is one of the common ear diseases, and its accurate diagnosis can prevent the deterioration of conductive hearing loss and avoid the overuse of antibiotics. At present, the diagnosis of otitis media mainly relies on the doctor's visual inspection based on the images fed back by the otoscope equipment. Due to the quality of otoscope equipment pictures and the doctor's diagnosis experience, this subjective examination has a relatively high rate of misdiagnosis. In response to this problem, this paper proposes the use of faster region convolutional neural networks to analyze clinically collected digital otoscope pictures. First, through image data enhancement and preprocessing, the number of samples in the clinical otoscope dataset was expanded. Then, according to the characteristics of the otoscope picture, the convolutional neural network was selected for feature extraction, and the feature pyramid network was added for multi-scale feature extraction to enhance the detection ability. Finally, a faster region convolutional neural network with anchor size optimization and hyperparameter adjustment was used for identification, and the effectiveness of the method was tested through a randomly selected test set. The results showed that the overall recognition accuracy of otoscope pictures in the test samples reached 91.43%. The above studies show that the proposed method effectively improves the accuracy of otoscope picture classification, and is expected to assist clinical diagnosis.

Research status of ultrasound-guided radiotherapy for tumors / 中华放射肿瘤学杂志

Image-guided techniques are critical to improving the accuracy of radiotherapy for tumors. Ultrasound images have been gradually applied in the set-up verification of clinical radiotherapy and adaptive radiotherapy because of the real-time, reproducible and non-radiative characteristics. In this paper, the application of ultrasound image-guided technology in radiotherapy was classified and analyzed, and the latest research progress was introduced.

Numerical analysis of the influence of otitis media on the hearing compensation performance of round-window stimulation / 生物医学工程学杂志

In order to study the influence of tympanic membrane lesion and ossicular erosion caused by otitis media on the hearing compensation performance of round-window stimulation, a human ear finite element model including cochlear asymmetric structure was established by computed tomography (CT) technique and reverse engineering technique. The reliability of the model was verified by comparing with the published experimental data. Based on this model, the tympanic membrane lesion and ossicular erosion caused by otitis media were simulated by changing the corresponding tissue structure. Besides, these simulated diseases' effects on the round-window stimulation were studied by comparing the corresponding basilar-membrane's displacement at the frequency-dependent characteristic position. The results show that the thickening and the hardening of the tympanic membrane mainly deteriorated the hearing compensation performance of round-window stimulation in the low frequency; tympanic membrane perforation and the minor erosion of ossicle with ossicular chain connected slightly effected the hearing compensation performance of round-window stimulation. Whereas, different from the influence of the aforementioned lesions, the ossicular erosion involving the ossicular chain detachment increased its influence on performance of round-window stimulation at the low frequency. Therefore, the effect of otitis media on the hearing compensation performance of round-window stimulation should be considered comprehensively when designing its actuator, especially the low-frequency deterioration caused by the thickening and the hardening of the tympanic membrane; the actuator's low-frequency output should be enhanced accordingly to ensure its postoperative hearing compensation performance.

Numerical Analysis on Sound Compensation Performance of Round Window Stimulation in Middle Ear Malformation / 医用生物力学

Objective To study the influence of middle ear malformation on the performance of round window stimulation, so as to provide references for optimization of the round window stimulation middle ear implant. Methods The finite element model of human ear including an asymmetrical two-cavity non-helical cochlea was constructed and compared with experimental data to verify reliability of the model. Based on this model, the effects of three kinds of middle ear malformation, i.e., ossicular chain fixation, ossicular chain fusion and ossicular defect on round window stimulation were simulated by changing material properties of the corresponding tissues. Results The middle ear malformation mainly affected the low-frequency performance of round window stimulation. The ossicular chain fixation and the ossicular chain fusion had a deteriorating effect on round window stimulation. The stapes fixation had the greatest effect on the performance of round window stimulation, with the reduction as high as 47.93 dB. Ossicles defects could improve the performance of round window stimulation, with the maximum increment of 6.24 dB. Conclusions The middle ear malformation had an effect on the low frequency performance of round window stimulation. It is necessary to specifically increase output of the actuator when implanting the round window stimulation middle ear implant.

Clinical analysis of cervical intraepithelial lesion in postmenopausal women / 中华妇产科杂志

Objective To investigate the pathological escalation after cervical cone resection in postmenopausal women, and analyze the related influencing factors. Methods A retrospective cohort study was conducted at the Sir Run Run Shaw Hospital,School of Medicine, Zhejiang University between July 2013 and January 2015. Seven hundred and fifty cases of cervical cone-cut were enrolled in this study, 129 cases of them were postmenopausal women, and 621 were premenopausal women. All results of patients'liquid-based thin-layer cytology(TCT), HPV test, colposcopy and biopsy pathology, cervical cone resection and postoperative pathological examination were collected. Then the compliance with the pathological examination results after colposcopic cervical biopsy and cervical cone resection, and the related factors affecting the pathological escalation after cervical cone resection were analyzed. The pathological escalation of patients with different menopausal conditions after cervical cone resection was also analyzed. Results (1)Of the 750 patients, there were 329 patients had the same pathological examination results after colposcopic cervical biopsy and cervical cone resection, which accounted for 43.9％(329/750). And 216 cases demonstrated pathological escalation after cervical cone resection, which accounted for 28.8％(216 / 750). The results of TCT examination and menopause were significantly correlated with the pathological escalation after cervical cone resection(P<0.05). However, the condition of HPV infection was unrelated to pathological escalation after cervical cone resection(P>0.05).(2)Compared with the different results of TCT examination [including non-intrusive load monitoring(NILM), atypical squamous cell of undetermined signification (ASCUS), low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion(HSIL)], the ratio of pathological escalation after cervical cone resection was not statistically significant difference between postmenopausal and non-menopausal patients(P>0.05). The proportion of pathological escalation of patients with >5 years of menopause was significantly higher than that of patients with menopause time ≤5 years(40.3％ vs 27.7％, OR=1.8, 95％CI: 1.1-2.8, P=0.029). Among them, when the result of TCT examination was LSIL, the rate of pathological escalation in patients >5 years of menopause was significantly higher than that in menopause time ≤5 years(6/10 vs 26.3％, OR=4.2, 95％CI: 1.1-15.8, P=0.033). While the results of TCT examination were NILM, ASCUS or HSIL showed there was no statistically significant difference between two groups(P>0.05).(3)Among the 143 cases, of which the result of TCT examination was LSIL, 9 cases of the pathological examination results after cervical resection were escalated to cervical cancer, which accounted for 6.3％ (9 / 143). Among 10 cases of menopause time >5 years, 2 cases(2 / 10)of the pathological examination results after cervical cone resection were escalated to cervical cancer. Among 133 cases with menopause time ≤ 5 years, 7 cases (5.3％)were upgraded to cervical cancer after cervical cone resection. The ratio of pathological escalation to cancer in postmenopausal patients with >5 years was higher than that of menopause time ≤5 years. Due to the data volume limitation, the comparison was not statistically significant difference(χ2=0.460, P>0.05). Conclusions In postmenopausal women, especially when menopausal time is > 5 years, the proportion of pathological escalation after cervical cone resection following colposcopic cervical biopsy is increased. And the pathological escalation after cervical cone resection is significantly correlated with the results of TCT examination and menopausal status. Therefore, doctors should treat the colposcopic biopsy pathological results with caution during clinic. Depending on TCT results, loop electrosurgical excision procedure (LEEP) sampling could be administrated directly in case of avoid missing diagnosis.

Application of PBL combined with laparoscopy in teaching of gynecology / 中华医学教育探索杂志

Objective To explore the value of problem-based learning (PBL) model combined with laparoscopy in the standardized training for gynecological residents. Methods A total of 46 standardized surgical trainees students in obstetrics and gynecology in Sir Run Run Shaw Hospital of Zhejiang University from September 2015 to September 2016 were enrolled and randomly divided into the observation group and the control group. The observation group was taught with PBL combined with laparoscopic teaching, while the control group was taught with the traditional teaching mode. Examinations and questionnaires were conducted to evaluate the teaching effect of the two groups. Statistical analyses were performed with Chi-square test or t-test using SPSS software (version 20.0). Results The scores of theoretical and practical skill examination were significantly higher in the observation group than in the control group [(90.78±2.73) vs. (85.09±3.78);(89.13±2.90) vs. (80.87±4.19)],and the difference was significant. The pass rate of laparo-scopic operation examination in the observation group was higher than that in the control group(91.30% vs. 65.21%, P=0.035). Moreover, the operating time was significantly less in the observation group than in the control group [(16.74±3.08) vs. (20.43±3.94), P=0.001]. The clinical adaptability, clinical operation skills, learning enthusiasm and satisfaction with teaching(P<0.05)were better in the observation group than in the control group. Conclusion During the same class hours, PBL combined with laparoscopic surgery can effectively improve the basic theoretical knowledge and clinical practice ability of residents.

The effect of preload and support's stiffness on the performance of round window stimulation: a numerical analysis / 生物医学工程学杂志

To investigate the influence of the preload and supporting stiffness on the hearing compensation performance of round window stimulation, a coupling finite model composed of a human ear, an actuator and a support was established. This model was constructed based on a complete set of micro-computed tomography (Micro-CT) images of a healthy adult's right ear by reverse engineering technology. The validity of the model was verified by comparing the model's calculated results with experimental data. Based on this model, we applied different amplitude preloads on the actuator, and changed the support's stiffness. Then, the influences of the actuator's preload and the support's stiffness were analyzed by comparing the corresponding displacements of the basilar membrane. The results show that after applying a preload on the actuator, its hearing compensation performance was increased at the middle and high frequencies, but was deteriorated at low frequencies; besides, compared with using the fascia as the actuator's support in clinical practice, utilizing the titanium alloy to fabricate the support would enhance the hearing compensation performance of the round window stimulation in the whole frequency range.

Preparation and evaluation of an articular cartilage extracellular matrix/human umbilical cord Wharton gel composite scaffold / 中国组织工程研究

BACKGROUND:Soft tissue engineering mainly includes seed cells,scaffolds,cytokines and bioreactors,among which,the scaffolds are the key link in the construction of tissue-engineered cartilage.OBJECTIVE:To prepare an articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffold,and to evaluate its physicochemical properties and biocompatibility.METHODS:The articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffold was prepared by freeze thawing drying method using porcine articular cartilage extracellular matrix and human umbilical cord Wharton glue as raw materials.The porosity,water absorption,tissue composition and longitudinal compressive elastic modulus of the scaffold were measured and histologically stained.Rabbit chondrocytes were co-cultured with the articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffold for 7 days.Then,scanning electron microscopy,live-dead cell staining and hematoxylin-eosin staining were performed.In addition,rabbit chondrocytes were cultured in the extract of the articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffold and cell culture medium for 6 days,respectively;and MTT assay was used to detect cell proliferation.RESULTS AND CONCLUSION:The articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffolds had a cross-section of uniform porous network structure and a vertical cross-section of the vertical tubular structure,and the pore wall was densely covered with cartilage fibers.The composite porous scaffold was positive for hematoxylin-eosin staining,safranin O staining and toluidine blue staining,and contained collagen and glycosaminoglycan ingredients.The water absorption,porosity and longitudinal compressive elastic modulus of the scaffolds were (17.418 8±0.909 0)％,(81.495 1±6.621 0)％ and (2.833 3±0.456 4) kPa,respectively.After 7 days of co-culture,rabbit chondrocytes adhered to the scaffold and proliferated,and further grew into the pores of the scaffold.Moreover,the scaffold was non-toxic to the rabbit chondrocytes.To conclude,the physiochemical properties and biochemical components of articular cartilage extracellular matrix/human umbilical cord Wharton gel porous scaffolds are similar to those of natural cartilage,and the scaffold has good biocompatibility.

Construction and evaluation of models for early diagnosis and prognosis assessment of trauma sepsis risks / 中华创伤杂志

Objective To investigate the value of muhiple inflammatory cells and clinical score in early diagnosis and prognosis assessment of trauma sepsis risks.Methods This retrospective control study enrolled 209 severe trauma patients admitted from January 2010 and May 2016.White blood cell count,lymphocyte count and percentage,monocyte count and percentage,neutrophil count and percentage,ratio of neutrophil to lymphocyte count (N/L),acute physiology and chronic health evaluation (APACHE) Ⅱ score,sequential organ failure assessment (SOFA),improved early warning score (MEWS),Glasgow coma score (GCS),multiple organ dysfunction syndrome (MODS) score and lactic acid (LAC) were collected on the day of admission and 3,5,7 days after trauma.These data were applied to construct weighted and biological score models for early diagnosis and prognosis of traumatic sepsis.Receiver operating characteristic curve (ROC) was performed and area under the curve (AUC) was calculated to measure the value of the two models in early diagnosis and prognosis of sepsis.Results AUC of the weighted model combined by APACHE Ⅱ score,SOFA score and MEWS was 0.729 on the day of admission.AUC of the weighted model combined by inflammatory cells was 0.680 and AUC of the biological score model was 0.800 3 days after trauma (P ＜ 0.05).AUC of the weighted models combined by inflammatory cells was 0.798 and AUC of the biological score model was 0.812 5 days after trauma (P ＜ 0.05).AUC of the weighted models combined by inflammatory cells was 0.706 and AUC of the biological score model was 0.713 7 days after trauma (P ＞ 0.05).AUC of the biological score model had significant difference 3 days and 5 days after trauma (P ＜ 0.05).Of the weighted model combined by APACHE Ⅱ score,MODS score,GCS and LAC to evaluate the prognosis of sepsis,the AUC showed significant difference on the day of admission (0.838),3 days after trauma (0.878),5 days after trauma (0.947) and 7 days after trauma (0.936) (P ＜ 0.05).Conclusions Biological score possesses better effect on early diagnosis of sepsis 3 days after trauma.Weighted model combined by APACHE Ⅱ score,MODS score,GCS and LAC can effectively predict the prognosis of sepsis 5 days after trauma.

Five years progression of high myopia in 5-12 years old children / 眼科新进展

Objective To investigate the changes of refractive status in 5-12 years old high mypoic children,and determine their visual prognosis after 5 years.Methods A total of 52 high myopic patients treated in our hospital,aged 5 years to 12 years,were enrolled in the study.Every enrolled patient underwent complete ophthalmological examinations every 6 months to 1 year,including best corrected visual acuity (BCVA),cycloplegic refraction,fundus examination and axial length measurement.Resuits The mean myopia progression of the 52 patients was (-0.66 ± 0.43) D per year.32 patients(61.5％)showed binocular progression,4 patients(7.7％)showed monocular progression,and 16 patients (30.8％) showed binocular stability.The myopic progression rate of the patients whose initial refraction from-6.0 D to-9.0 D was 86.4％,from-9.0 D to-12.0 D was 68.8％,and ＞-12.0 D was 42.9％,respectively,there were obvious differences (P ＜ 0.05).The myopic progression rate of the patients who had family history of high myopia was 88.2％,and no family history was 60.0％,there was obvious difference (P ＜ 0.05).The myopic progression rates were not significant different between different age level and different sex (all P ＞ 0.05).41 patients (78.8％) of high myopes demonstrated a final BCVA ≥ 0.5 in both eyes,and 34 patients(65.4％) ≥0.8.The rates of patients whose fmal BCVA ≥0.5 in both eyes were 95.5％,75.0％ and 57.1％ for whose initial refraction were from-6.0 D to-9.0 D,from-9.0 D to-12.0 D and ＞-12.0 D,respectively,there was obvious difference (P ＜ 0.05).Conclusion The 5-12 years old high myopic children will progress in a relatively quick level every year.The initial refraction level and family history of high myopia are risk factors associated with myopia progression.Most of high myopic children will have a relatively good vision.

Low power consumption structure design of an incus-stimulating middle ear implant based on piezoelectric stack / 医用生物力学

Objective To improve the design plan and get a piezoelectric actuator with displacement magnification structure,so as to reduce power consumption of the existing incus-stimulating piezoelectric actuator for middle ear implant.Methods Based on anatomical structure of human ear,the piezoelectric actuator with displacement magnification structure,and the one only composed of piezoelectric stack were designed,respectively,then the corresponding coupled mechanical models of the middle ear with the piezoelectric actuator were established.By comparing the calculation results from the two types of coupled mechanical models,the hearing compensation property and power consumption of the actuator before and after the implantation with the displacement magnification structure were analyzed.Results After adding the displacement magnification structure,the sound pressure level (SPL) at 1 kHz frequency was increased from 100 dB to 113 dB when the piezoelectric actuator was stimulated by 10.5 V effective voltages.In addition,for the piezoelectric stack,its power consumption at the frequency of 1,2 and 4 kHz were 6.42,1.56 and 0.28 mW,respectively;after introducing the displacement magnification structure,the power consumption at the above-mentioned 3 frequencies decreased to 0.39,0.09 and 0.01 mW,respectively.Conclusions Piezoelectric actuator with displacement magnification structure in this study can improve hearing compensation ability of the incus-stimulating middle ear implant,and effectively reduce the power consumption.The research findings will help to further improve the structure design of middle ear implant,thus achieving better hearing compensation effect.

Protective effect of Agaricus bisporus intracellular polysaccharides and exopolysaccharides against concanavalin A-induced immunological liver injury in mice / 中国药理学与毒理学杂志

OBJECTIVE To evaluate the protective effect of Agaricus bisporus intracellular polysaccharides(IPS) and exopolysaccharides (EPS) on immunological liver injury induced by concanavalin A (Con A). METHODS Mice were pretreated with IPS and EPS (100, 200 and 400 mg kg- 1, ig) daily for 12 d. Immunological liver injury was induced by Con A 25 mg·kg-1 byinjection via the tail vein of mice.Eight hours after injection of Con A, the indexes of the liver, spleen and thymus, serum level of glutamicpyruvic transaminase (GPT), glutamic-oxalacetic transaminase (GOT), tumor necrosis factor-α (TNF-α) and interferon- γ (IFN- γ), splenic lymphocyte percentages of CD4 + and CD8 + , and liver homogenate content of superoxide dismutase (SOD) and malondialdehyde (MDA) were measured. Liver pathological changes were observed by HE staining. RESULTS Compared with normal group, the autoimmune liver injury in mice induced by Con A resulted in an increase in the liver index (P<0.01) , spleen index (P<0.01), the activity of GPT (P<0.01) and GOT (P<0.01), the content of TNF- α (P<0.01) and IFN- γ (P< 0.01), and the level of MDA (P<0.01), but a decrease in the thymus index (P<0.01), the percentage of CD4+ (P<0.01) , the ratio of CD4+/CD8+ (P<0.01), and SOD activity (P<0.01). Compared with model group, treatment with IPS (200 and 400 mg·kg-1) and EPS (200 and 400 mg·kg-1 ) respectively resulted in an increase in the thymus index (P<0.01) but in a decrease in the liver index and spleen index (P<0.01). Similarly, the activity of GOT and GPT was decreased obviously (P<0.01), and the content of TNF-α and IFN-γ in IPS and EPS 200 and 400 mg·kg-1 groups was decreased. Compared with model group, the activity of SOD in IPS and EPS (200 and 400 mg·kg- 1) group was increased (P<0.01) while MDA was decreased (P<0.01). Moreover, the percentage of CD4 + Iymphocytes decreased (P<0.01), whereas no significant difference was found in the ratio of CD4 +/CD8 + .Pathological changes of the liver were observed under a microscope. Pretreatment with IPS and EPS could effectively reduce the liver injury induced by Con A. CONCLUSION IPS and EPS have certain protective effect on immunological liver injury, which may be related to their ability to clean up free radicals, control lipid peroxidation and regulate the balance of the immune system.

Ultrasound mediated hysteroscopy in diagnosis and treatment of corneal pregnancy / 中国医学装备

Objective:To explore the effect of diagnosis and treatment in corneal pregnancy by hysteroscope under ultrasound mediated.Methods: Twelve corneal pregnancy wemen as retrospective analysis were collected and observed the gestational sac location, shape, size, echo, blood flow distribution and whether the consolidated common postoperative complications. Results: Twelve patients under ultrasound monitoring by hysteroscopy positioning, removal of lesions one-time success in 11 cases. The residual of palace angle, 1 case of hysteroscopy prompt receives review of the palace using ring of hysteroscopic resection lesions. This group of patients was cured.Conclusion: Orientation of ultrasound mediated by hysteroscopy diagnosis and curettage surgery, is an effective method of diagnosis and treatment of pregnancy of palace angle, judgment cornual pregnancy in high accuracy, preserve fertility in patients, can be repeated.