Prevalence and factors associated with flares following COVID-19 mRNA vaccination in patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis: a national cohort study

Abstract Objective To determine prevalence and factors associated with flares post Coronavirus disease 2019 (COVID-19) mRNA vaccination in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (SpA). Methods A retrospective multi-centre study was conducted (January 2021 to February 2022). Data were collected during index visit, defined as first post-vaccine visit in which the patient had a physician-defined flare, or if at least 3 months had elapsed since first vaccine dose, whichever came first. Factors associated with flares were identified using mixed effects Cox regression and expressed as hazard ratio (HR) and 95% confidence interval (CI). Results Total of 2377 patients were included (1563 RA, 415 PsA and 399 SpA). Among patients with RA, PsA and SpA, 21.3%, 24.1% and 21.8% experienced a flare respectively. Of those who experienced a flare, only 10.2%, 11.0% and 14.9% were severe in patients with RA, PsA and SpA respectively. Patients with low or moderate/high disease were more likely to flare compared to those in remission in patients with RA only (HR: 1.68, 95% CI 1.22-2.31; HR: 2.28, 95% CI 1.50-3.48, respectively). Receiving the Moderna vaccine was associated with a higher HR of flare compared to the Pfizer vaccine in patients with PsA only (HR: 2.21, 95% CI 1.20-4.08). Patients who had two vaccine doses were found to be less likely to flare (HR: 0.08, 95% CI 0.06-0.10). HRs of flares were not significantly different among RA, PsA and SpA. Conclusion About one-fifth of patients experienced a disease flare post COVID-19 mRNA vaccination, but most flares were non-severe. Patients with active disease prior to vaccination should be monitored closely for disease flares, especially in patients with RA.

Effectiveness and safety of acupuncture for treating functional constipation: An overview of systematic reviews / 中西医结合学报

BACKGROUND@#Functional constipation (FC) is one of the most prevalent functional gastrointestinal disorders. Dissatisfaction with medications prescribed to treat FC may lead patients to seek alternative treatments. Numerous systematic reviews (SRs) examining the use of acupuncture to treat FC have reported inconsistent results, and the quality of these studies has not been fully evaluated.@*OBJECTIVE@#In this overview, we evaluated and summarized clinical evidence on the effectiveness and safety of acupuncture for treating FC and evaluated the quality and bias of the SRs we reviewed.@*SEARCH STRATEGY@#The search strategy was structured by medical subject headings and search terms such as "acupuncture therapy" and "functional constipation." Electronic searches were conducted in eight databases from their inception to September 2020.@*INCLUSION CRITERIA@#SRs that investigated the effectiveness and safety of acupuncture for managing FC were included.@*DATA EXTRACTION AND ANALYSIS@#Two authors independently extracted information and appraised the methodology, reporting accuracy, quality of evidence, and risk of bias using the following critical appraisal tools: (1) A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2); (2) Risk of Bias in Systematic Reviews (ROBIS); (3) Preferred Reporting Items for Systematic Reviews and Meta-analyses for Acupuncture (PRISMA-A); and (4) the Grading of Recommendations, Assessment, Development and Evaluations (GRADE). A κ index was used to score the level of agreement between the 2 reviewers.@*RESULTS@#Thirteen SRs that examined the clinical utility of acupuncture for treating FC were identified. Using the AMSTAR 2 tool, we rated 92.3% (12/13) of the SRs as "critically low" confidence and one study as "low" confidence. Using the ROBIS criteria, 38.5% (5/13) of the SRs were considered to have "low risk" of bias. Based on PRISMA-A, 76.9% (10/13) of the SRs had over 70% compliance with reporting standards. The inter-rater agreement was good for AMSTAR 2, ROBIS, and PRISMA-A. Using the GRADE tool, we classified 22.5% (9/40) of the measured outcomes as "moderate" quality, 57.5% (23/40) as "low" quality, and 20.0% (8/40) as "very low" quality. The inter-rater agreement was moderate when using GRADE. Descriptive analyses indicated that acupuncture was more efficacious than sham acupuncture for improving weekly complete spontaneous bowel movements (CSBMs) and for raising the Bristol Stool Form Scale (BSFS) score. Acupuncture appeared to be superior to anti-constipation drugs for improving weekly spontaneous bowel movements, the total effective rate, and the Patient Assessment of Constipation Quality of Life score. Although ten SRs mentioned the occurrence of adverse events, serious adverse events were not associated with acupuncture treatment.@*CONCLUSION@#Acupuncture may be more efficacious than sham acupuncture for improving CSBMs and BSFS scores and may be superior to anti-constipation drugs for improving bowel movement frequency, as well as quality of life. Limitations to current studies and inconsistent evidence suggest a need for more rigorous and methodologically sound SRs to draw definitive conclusions.@*SYSTEMATIC REVIEW REGISTRATION@#PROSPERO CRD42020189173.

Topical Oxygen Jet Therapy (TOJT) for treating infected chronic surgical wounds

ABSTRACT Objectives: To evaluate the effectiveness of Topical Oxygen Jet Therapy (TOJT) in the treatment of surgical wounds in adult patients who has clinical signs of infection for over 30 days; and to identify the pathogens causing complicated skin and soft tissue infections. Method: Parallel, randomized clinical trials randomly divided into "Control Group" (CG) and "Treatment Group" (TG), which were followed up for 10 consecutive days. Venous antibiotics and dressings were used in both groups. In addition, TOJT were used on the wounds in the TG. The outcome criteria were based on clinical indicators: Pressure Ulcer Scale for Healing (PUSH) and Visual Analog Scale Pain (VAS). The paired t-test or Wilcoxon, chi-squared or Fisher's exact test, and Student's t-test or Mann-Whitney tests were used with a significance level of 5%. Results: 73 inpatients were included and followed up: 39 in TG and 34, CG. There were no significant differences in socio-demographic variables or of initial laboratory tests, except for blood glucose that was higher in TG than in CG (p = 0.044). Ten days into treatment, both the area of PUSH wounds (p < 0.001) and the pain scale (p = 0.029) were significantly reduced in TG. Staphylococcus aureus was the most prevalent pathogen (40%) with no significant difference between the two groups. Discussion: Although the follow-up time was of only ten days, a significant improvement was observed in TG. As a limitation of the study, the small sample size precluded the comparison of S. aureus infections between the two groups. Conclusion: TOJT accelerated the healing process, reduced pain and contributed to an improvement in the clinical status of the wounds when compared to CG. These findings demonstrate the effectiveness and relevance of the employed technique. It can be easily incorporated as a routine procedure in hospitals without extra investment.

Three-dimensional morphological changes in the temporomandibular joints of patients with anterior disc displacement with reduction / 华西口腔医学杂志

OBJECTIVES@#To investigate the differences in the temporomandibular joints (TMJs) between patients with anterior disc displacement with reduction (ADDwR) and asymptomatic subjects by using 3D morphometric measurements.@*METHODS@#A total of 15 patients with ADDwR and 10 asymptomatic subjects were enrolled. Then, 3D models of the maxilla and mandible were reconstructed using MIMICS 20.0. Nine morphologic parameters of TMJs on both sides were measured on the 3D solid model. The differences in the parameters were analyzed between the patients and the asymptomatic subjects and between the left and right sides of each group.@*RESULTS@#The horizontal and coronal condylar angles on the ipsilateral side of the patients were significantly greater than those of the asymptomatic subjects (@*CONCLUSIONS@#ADDwR will increase the condylar angles to be significantly greater than the normal level and decrease SRA and articular spaces to be significantly smaller than the normal level. The condyles will be displaced upward, closer to the fossa.

Clinical study of Dihuang-Yinzi Decoction combined with donepezil hydrochloride tablets in the treatment of mild to moderate Alzheimer's disease / 国际中医中药杂志

Objective:To evaluate the efficacy of Dihuang-Yinzi Decoction combined with donepezil hydrochloride in the treatment of mild to moderate Alzheimer's disease (AD). Methods:114 patients with mild to moderate AD in the First Hospital of Yulin in Suide District from February 2017 to February 2019 were divided into two groups according to the method of random number table, with 57 cases in each group. The control group took donepezil hydrochloride tablets orally, and the study group took Dihuang-Yinzi Decoction based on the control group. Both groups were treated continuously for 3 months. The activities of daily living scale (ADL), Mini-Mental State Examination (MMSE) and the Alzheimer’s disease assessment scale-cognitive section (ADAS-cog) were used to evaluate the life ability and cognitive function of patients. The concentrations of Notch 1 signaling protein, a disintegrin and metalloproteinase 10 (ADAM10) and β-amyloid precursor protein endonuclease 1 (BACE1) in serum were detected by Western blot. The levels of acrolein were detected by ELISA, the adverse reactions during the treatment were recorded, and the clinical efficacy was evaluated. Results:The total effective rate was 84.2% (48/57) in the study group and 64.9% (37/57) in the control group. The difference between the two groups was statistically significant ( χ2=5.596, P=0.018). After the treatment, the ADL and ADAS-cog scores of the study group were lower than those of the control group ( t values were 5.939, 6.124, respectively, all Ps<0.01), and MMSE scores were higher than that of the control group ( t=6.087, P<0.01). The levels of Notch1 signaling protein (3.43 ± 0.58 vs. 1.31 ± 0.47, t=21.440) and ADAM10 (1.86 ± 0.23 vs. 1.12 ± 0.25, t=16.446) in the study group were higher than those of the control group ( P<0.01), and the levels of BACE1 (0.62 ± 0.15 vs. 0.98 ± 0.17, t=11.988) and acrolein (2.19 ± 0.39 nmol/mg vs. 4.76 ± 0.54 nmol/mg, t=12.354) were lower than those of the control group ( P<0.01). The adverse reaction rate was 14.7% (11/57) in the study group and 14.0% (8/57) in the control group, and there was no significant difference between the two groups ( χ2=0.568, P=0.451). Conclusions:Dihuang-Yinzi Decoction combined with donepezil hydrochloride tablets can effectively improve the cognitive function and life ability of patients with mild to moderate AD, with clinical efficacy.

Targeted therapy and immunotherapy for recurrent liver cancer / 中国实用外科杂志

The recurrence and metastasis rate of hepatocellular carcinoma(HCC) is high after operation,and more than 50% of HCC patients will eventually receive systemic treatment. There is a lack of systemic treatment for advanced liver cancer,so that Sorafenib is the only first-line therapeutic drug in the past ten years. Recently,positive results have been obtained in the III phase clinical trials of lenvatinib,regorafenib,cabozantinib and Ramucirumab,and anticancer effect of the immunotherapy of liver cancer shows gratifying,but there are still some shortcomings,such as low objective response rate and lack of effective clinical biomarkers. The antitumor effect of immunotherapy-based combined therapy is more satisfactory than that of single drug without more serious side effects in I/II phase clinical trials,which means immunotherapy-based combined therapy should be the future treatment strategy.

Effect of Angelica sinensis radix on colonic morphology and mucus secretion of experimental XuexuBianmi model mice / 中国应用生理学杂志

OBJECTIVE@#To study the effects of Angelicaesinensis radix (Danggui) decoction on the therapeutic action and the colonic morphology and mucus secretion in XuexuBianmi model mice.@*METHODS@#Sixty Kunming mice, maleandfemaleinhalf, were randomly divided into six groups according to gender and weight (=10):normal control group, XuexuBianmi model group, positive control group, and high-dose, middle-dose and low-dose Danggui groups. Except the normal control group, the mice in the rest groups were orally administrated with diphenoxylate (DPN) and subcutaneously injected with acetylphenyhydrazine (APH) and intraperitoneally injected with cyclophosphamide (CPA) to copy XuexuBianmi model. Fromthe 14th day, the mice in Danggui groups were orally administered with different doses of Danggui decoction (16.67、8.33、4.17 g/kg), the mice in positive control group were orally administered with Changtongshu granule (5 g/kg), the mice in XuexuBianmi model group were administered with normal saline (NS) at the same volume (10 ml/kg), once a day for consecutive 28 days. The general status were observed, the first black defecation time (FBDT), the water content in stool and in colon in mice of all groups were tested. And the colon tissue was stained with hematoxylin-eosin (HE) and AB-PAS to observe the changes of colonic morphology and the mucus secretion.@*RESULTS@#Compared with the normal control group, there appeared the XuexuBianmi syndromes in model group as follows, the defecation time (FBDT) was significantly prolonged, the water contentinstool and in colon were decreased (<0.01), the colonic mucosa and gland were atrophied, mucous membrane layer was thinned (<0.01), mucus secretion was decreased. Compared with the XuexuBianmimodel group, the Xuexu and Bianmi syndromes were improved, the FBDT was significantly shortened (<0.05, <0.01), the water content of colon was increased in the three groups of Danggui decoction (<0.05, <0.01). The water content of the stool was obviouslyincreased in groups of 16.67and 8.33kg.dDanggui decoction (<0.05). The atrophy of colon mucosa and gland was improved, the mucus secretion was increased, and the colon lubrication function was improved in the three groups in different doses of Danggui decoction.@*CONCLUSIONS@#Dangguican improve the mucosal atrophy, and increase the secretion of colonic mucus, then the stool is softened and promoted to discharge.

Role of neuropeptide substance P and the bone morphogenetic protein signaling pathway in osteogenic differentiation of ST2 cells / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aimed to investigate the role and mechanism of neuropeptide substance P (SP) in ST2 cell (bone mesenchymal stem cells of mice) osteogenic differentiation to provide a basis for the treatment of temporomandibular joint osteoarthritis.</p><p><b>METHODS</b>Third-generation ST2 cells were cultured with different concentrations of SP (0, 10⁻¹⁰, 10⁻⁸, 10⁻⁶, and 10⁻⁵ mol·L⁻¹). After 24, 48, and 72 h, cell proliferation was detected by CCK-8. The ST2 cells were cultured with 10⁻⁶ mol·L⁻¹ SP for 1, 3, 5, and 7 days. Subsequently, the expression of alkaline phosphatase (ALP), collagen typeⅠ(CollaⅠ), and osteocalcin (OCN) in the culture supernatant was tested by enzyme-linked immunosorbent assay (ELISA). ALP activity was detected by immunofluorescence staining. The ST2 cells were cultured with SP, Noggin (inhibitor of the bone morphogenetic protein signaling pathway), SP+Noggin, and 2% fetal bovine serum, respectively. Finally, the expression of ALP, CollaⅠ, and OCN in the culture supernatant was tested by ELISA.</p><p><b>RESULTS</b>CCK-8 showed that the effect of cell proliferation was most obvious when the SP concentration was 10⁻⁶ mol·L⁻¹ (P<0.01). The ELISA results demonstrated that ALP expression significantly increased at day 5 compared with that in the control group (P<0.01), whereas the expression of CollaⅠand OCN significantly increased at day 7 (P<0.05). Immunofluorescence results showed that ALP activity was strongest at day 5. The expression of ALP, CollaⅠ, and OCN decreased after Noggin addition (P<0.05).</p><p><b>CONCLUSIONS</b>SP can promote the proliferation and osteogenic differentiation of ST2 cells, and the bone morphogenetic protein signaling pathway may be involved in this process.</p>

Effects of Angelica Sinensis Radix on Expressions of AQP8 in Colon of Blood-deficiency Constipation in Mice / 中国中医药信息杂志

Objective To observe the effects of Angelica Sinensis Radix on the expression of aquaporin 8 (AQP8) and the levels of AC-cAMP-PKA in colon of blood-deficiency constipation in mice; To identify mechanism of Angelica Sinensis Radix for loosening the bowels to relieve constipation. Methods Sixty Kunming mice were randomly divided into control group, model group, positive medicine group, and Angelica Sinensis Radix high-, medium-, and low-dose groups, with ten mice in each group. Diphenoxylate, acetylphenlyhydrazine and cyclophosphamide were used to establish blood-deficiency constipation mice models. From the 14thday of the experiment, Angelica Sinensis Radix high-, medium-, and low-dose groups were given 16.7, 8.8, and 4.2 g/kg Angelica Sinensis Radix Decoction for gavage. Positive medicine group was given 5.0 g/kg Changtongshu Granules Liquid for gavage. Control group and model group were given equal volume of saline for gavage. The symptoms of blood deficiency constipation were observed and defecation time. Immunohistochemistry, Western blot and qRT-PCR were used to detect the expression of AQP8 protein and mRNA in colon, and the expression of AC-cAMP-PKA in colon was detected by ELISA. Results The mice in the model group developed blood deficiency constipation syndrome; the defecation time was significantly prolonged (P＜0.01); the expression level of colonic AQP8 protein and mRNA, AC, cAMP and PKA significantly increased (P＜0.05, P＜0.01). Compared with model group, the defecation time was significantly shortened in Angelica Sinensis Radix high-, medium-, and low-dose groups; the expression of AQP8 protein and mRNA and the levels of AC, cAMP and PKA were significantly decreased (P＜0.05, P＜0.01). Conclusion The treatment of Angelica Sinensis Radix for blood-deficiency constipation may be related to adjusting the AC-cAMP-PKA signaling pathways and reducing the expression of AQP8 protein and mRNA.

Social network analysis of traditional Chinese medicine on treatment of constipation / 中国中药杂志

The methods of literature metrology and data mining were used to study the research topics and social network analysis of traditional Chinese medicine for constipation. The major Chinese databases were searched to include the research studies of traditional Chinese medicine for constipation. BICOMS analysis software was used to extract and collect the main information and produce co-occurrence Matrix; gCLUTO software was used for cluster analysis. Data analysis was conducted by using SPSS 19.0 software. The results showed that the number of studies on traditional Chinese medicine for constipation was constantly increased, with two literature volume peaks respectively in 2003 and 2006. Related studies have been published in 31 provinces, autonomous regions and municipalities have published, but the studies in developed areas were more than those in developing areas. There was little cooperation between research institutions and the authors, especially the cooperation between different areas. At present, the research field of Chinese medicine for constipation is divided into five research topics. In terms of specific traditional Chinese medicine, angelica sinensis is in the core position. The results showed regional imbalance in the number of studies on Chinese medicine treatment for constipation, as well as little cooperation between researchers and research institutions. The research topics mainly focused on the evaluation of clinical efficacy, but the research on optimizing the prescriptions was still not enough, so the future researchers shall pay more attention to the studies of constipation prescriptions with Angelica sinensis as the core herb.

Objective tongue inspection on 142 liver cancer patients with damp-heat syndrome / 中国结合医学杂志

<p><b>OBJECTIVE</b>To establish the diagnosis evidence of objective tongue inspection for liver cancer (LC) patients with damp-heat syndrome (DHS) by dynamically observing their tongue figures using modern tongue image analytic apparatus, and to explore the effect of intervention on the tongue figures.</p><p><b>METHODS</b>Tongue figures were collected from 142 LC patients with DHS by tongue image analytic apparatus. Red (R), green (G) and blue (B) values were analyzed. The r and g values were calculated requesting r=R/(R+G+B), g=G/(R+G+B), and b=1-r-g, and scored in combination with Chinese medical symptoms scale. The tongue figure and correlated scores were collected from 59 of them 3 days after transcatheter arterial chemoembolization intervention.</p><p><b>RESULTS</b>The range of objective tongue inspection of LC patients with DHS was as follows: as for tongue fur, 0.360<r<0.402 and 0.280<g<0.322; as for tongue proper, 0.404<r<0.470 and 0.243<g<0.301. The tongue figures and the average scores of quality of life, DHS, poor appetite, aggravated pain, decreased sleep quality and aggravated fever were obviously changed in the 59 LC patients with DHS after intervention, showing statistical difference when compared with before intervention (P<0.05 or P<0.01).</p><p><b>CONCLUSION</b>The range of objective tongue inspection of LC patients with DHS could be known by collecting and analyzing objective indicator of tongue figures, thus laying foundation for further studies with analysis of correlation between intervention and Chinese medicine based on tongue figures.</p>

The influence of graft-host diameter ratio on flow fields in fully-occluded artery bypass graft / 医用生物力学

Objective To investigate the influence of graft-host diameter ratio on the flow field of fully-occluded artery bypass grafts and provide a theoretical guidance for reducing restenosis in artery bypass graft surgery. Methods Five models were employed to numerically investigate the influence of graft-host diameter ratio on the flow field of fully-occluded artery bypass grafts. The distributions of hemodynamic parameters such as velocity, second flow, wall shear stress (WSS) and wall shear stress gradient (WSSG) and their change in line with the increase of diameter ratio were analyzed. In addition, comparison of hemodynamic differences in a fully-occluded complete model (Model A), a fully-occluded partial model (Model B) and a 75% stenosis complete model (Model C) with graft-host diameter ratio of 1.0 was conducted to validate the fully-occluded complete model established in this study. Results The hemodynamic performance of Model A was totally different from that of Model C, and the velocity distribution at the graft top had an obvious influence on the WSS distribution at host artery bed in the downstream anastomosis, with maximum WSS differences reaching 79%. A large graft-host diameter ratio resulted in a large size of low WSS region at the host artery bed, but with uniformly distributed WSS and small WSSG. A small graft-host diameter ratio resulted in a small size of low WSS region at the host artery bed, but with large WSSG. Conclusions It is necessary to adopt a complete model to study the influence of graft-host diameter ratio on the flow field of fully-occluded artery bypass grafts. The diameter ratio had a significant impact on the flow field of fully-occluded artery bypass graft, thus a large ratio could be helpful to reduce the occlusion resulted from the restenosis at the downstream anastomosis in artery bypass graft.

Time-effect study on instant analgesic effect of the dragon-tiger fighting needling method on primary dysmenorrhea / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical analgesic efficacy and the relation between clinical analgesic effect and duration of effect of two acupuncture methods of Longhu Jiaozhan (fight of dragon and tiger, an acupuncture reinforcing and reducing manipulation characterized with nine counterclockwise and six clockwise rotations) and even manipulations.</p><p><b>METHODS</b>Sixty-two patients with primary dysmenorrhea were randomly divided into an observation group (32 cases) and a control group (30 cases). The observation group was applied with Longhu Jiaozhan manipulation, while the control group was applied with even manipulation. Acupuncture treatment was given on both of the groups since onset of the pain. The score of the visual analogue scale (VAS) of the 2 groups was observed at different times. And 8 VAS values were recorded at the point right before acupuncture, needle remaining of 5 min, 10 min, 20 min and 30 min as well as and 30 min, 60 min, 120 min after needle withdrawal. Comparison was made on differences between the 2 groups.</p><p><b>RESULTS</b>Comparison with the same group before acupuncture showed that the VAS difference of the time from needling remaining of 5 min to 120 min after acupuncture were all with statistic significance (all P<0. 01). The score of VAS of needle remaining for 20 min and 30 min of the observation group was without significant difference (P>0. 05). The score of VAS value of needle remaining for 20 min and 30 min of the control group was with significant difference (P<0. 01). Comparison of the VAS scores before the treatment and the scores of the 2nd menstrual cycle were found with significant difference (P<0. 01). The VAS score of 2nd menstrual cycle was (28. 73 +/- 16. 15) in the observation group, which was better than (46. 93+/-12. 18) in the control group (P<0. 001). Comparison of the VAS score of the two groups at 5 min r emaining of the needle was without statistic significance between two groups (P>0. 05). However, the VAS impairment magnitude difference at that moment was with statistic significance (P<0.01). From the time of needle remaining for 10 min, 20 min, 30 min until 120 min after needling, the differences of the VAS scores and impairment range were all with statistic significance (all P<0. 01). The effects of the two acupuncture techniques could both be maintained up to 2 hours after needling.</p><p><b>CONCLUSION</b>Both methods of acupuncture have immediate and long-term analgesic effect in a certain degree on primary dysmenorrhea. However, compared with the control group, the advantage of analgesic effect in the observation group is significantly superior. 20 min needling remaining can reach the best analgesic effect.</p>

Acquired Localized Hypertrichosis Induced by Internal Fixation and Plaster Cast Application

Hypertrichosis refers to increased vellus hair growth and is independent to androgen excess. The acquired localized hypertrichosis (ALH) is one of the typical hypertrichosis, which mainly results from chronic irritation, inflammation, friction, and occlusion by plaster of Paris. Here, we report a young boy who had ALH on his right hand following a closed fracture with internal fixation and plaster cast application. The case is unusual because the hairy area is limited to the operative region of internal fixation. We suggest that the local vascular changes and skin inflammation induced by internal fixation and plaster cast application may be associated with ALH.

Acquired Localized Hypertrichosis Induced by Internal Fixation and Plaster Cast Application

Hypertrichosis refers to increased vellus hair growth and is independent to androgen excess. The acquired localized hypertrichosis (ALH) is one of the typical hypertrichosis, which mainly results from chronic irritation, inflammation, friction, and occlusion by plaster of Paris. Here, we report a young boy who had ALH on his right hand following a closed fracture with internal fixation and plaster cast application. The case is unusual because the hairy area is limited to the operative region of internal fixation. We suggest that the local vascular changes and skin inflammation induced by internal fixation and plaster cast application may be associated with ALH.

Numerical simulation on two-phase blood flow in a helical tube / 医用生物力学

Objective To investigate effects of pressure and tail suspension on the growth of rat skeletal muscles by establishing the tail-suspended rat model and pressure-induced rat model, respectively. Methods Thirty-six male Sprague-Dawley rats were randomly divided into three groups: the control-group (CON), the tail-suspended group (SUS), the pressure group (PRE), and each group was undergoing two stages (7, 14 d) for observation. At the end of the experiment, the muscle wet weight/body weight (Mww/Bw), muscle fiber cross-sectional area (MFCSA), muscle fiber diameter (MFD) of soleus and extensor digitorum longus (EDL) and the IGF-1 concentration were measured, respectively. Results For both the SUS group and PRE group with 7 d, their Mww/Bw, MFCSA and MFD of soleus were significantly reduced (P<0.05) as compared to the CON group, which were reduced by 23.52%, 14.26%, 13.47% in PRE group, respectively, while these indexes in SUS group were reduced by 23.52%, 33.07%, 25.09%, respectively. Meanwhile, the decrease of Mww/Bw, MFCSA and MFD in PRE group with 14 d was reduced by 20.51%, -10.49%, -5.73%, respectively, which was less than that in PRE group with 7 d. However, the decrease of Mww/Bw in SUS group with 14 d reached 46.15%, showing significantly higher than that of the SUS group with 7 d. For the IGF-1 concentration and EDL changes, no remarkable differences were found among the CON, PRE and SUS groups. Conclusions The impact of pressure on the process of soleus growth is different from that of the suspension (disuse). During the early stage of pressure application, the deep tissue injury mainly with inflammatory responses can be found in the muscle. When the muscle cells adapt to the pressure environment, they may produce a functional adaptation to growth. Therefore, such effect of socket pressure on skeletal muscle should be considered in clinic for prosthetic socket design or rehabilitation training, which will help protect the muscle tissues.

Numerical analysis of effects from drug-eluting stent height on drug concentration and wall shear stress distribution / 医用生物力学

Objective To investigate effects from the protrusion height of drug-eluting stent (DES) on kinetics of drug release and hemodynamics, so as to provide references for the optimization of DES design. Methods Based on computational fluid dynamics (CFD), coupling analysis on kinetics of drug release and hemodynamics was conducted by studying three stent models with different protrusion height to numerically investigate the distribution of drug concentration and wall shear stress. Results The increase in protrusion height of the stent was beneficial to the drug deposition; however, it could also increase the length in the low shear stress area. Comparatively, the increase percentage of drug concentration with the increasing protrusion height was remarkably less than that of the increasing length in low shear stress area. Conclusions By comprehensive consideration of both the drug concentration and wall shear stress, lower protrusion height is recommended for DES so as to effectively reduce the risk of restenosis.

Numerical analysis of effects from atherosclerotic plaque on drug diffusion in drug-eluting stent / 医用生物力学

Objective To study the effect from drug diffusion coefficient of atherosclerotic plaque on drug diffusion within the arterial wall, so as to truly reflect the drug distributions. Methods Using computational fluid dynamics (CFD) method, five plaque models with different diffusion coefficients were employed to numerically investigate the distributions of drug concentration both within the arterial wall and the plaque. Results The drug concentration in the arterial wall was increased gradually with the diffusion coefficient of the plaque increased; however, the increment would become gentle. Conclusions When the diffusion coefficient in the plaque was smaller than the tissue, the plaque inhibited the drug diffusion within the arterial wall, or conversely, it would promote the diffusion. Especially when the diffusion coefficient in the plaque was much larger than the tissue, it no longer affected the drug diffusion within the arterial wall. It is necessary to consider the impact of plaque in further research, which is beneficial to the optimization design of drug-eluting stents.

Effect of local injection of recombinant hirudin on survival of skin flaps with venous congestion in a rabbit model / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe the effect of local injection of recombinant hirudin on survival of skin flaps with venous congestion in a rabbit model.</p><p><b>METHODS</b>Eighteen healthy rabbits were enrolled and divided into heparin-treatment (HT), recombinant hirudin treatment (RHT) and control (C) groups according to the random number table, with 6 rabbits in each group. After intravenous anesthesia with 20 g/L pentobarbital sodium, model of skin flaps with venous congestion in the size of 6 cm × 3 cm was reproduced in the dorsal side of left ear of each rabbit, in which central artery of ear served as the only blood supply, and a pedicle of 1 cm in width including central vessel of ear and its accompanying nerves as the only venous return pathway. Each flap in RHT, HT, C groups was respectively given 1 mL recombinant hirudin (1 U), low-molecular-weight heparin (625 U), and isotonic saline via multi-point and homogenous injection, then they were sutured in site. Appearance and survival rate of the flaps were observed after operation. Specimens of the distal part of flaps were harvested for determination of thromboxane B2 (TXB2) on post operation day (POD) 1, 3, 5, 7. Data were processed with one-way analysis of variance and t test.</p><p><b>RESULTS</b>Rabbit model of skin flaps with venous congestion was reproduced successfully. Obvious hair loss was observed in completely necrotic parts of flap in each group. Obvious edema was observed in all flaps with venous congestion at distal site. The color of flaps in HT and RHT groups were lighter as compared with that in C group, and apparent hematoma of flap was observed in 1 rabbit of RHT group, 2 rabbits of HT group, 4 rabbits of C group on POD 1. The survival rate of flap in HT and RHT groups was respectively (92.3 ± 1.7)% and (94.8 ± 1.9)%, both higher than that in C group [(77.9 ± 1.2)%, F = 191.29, P < 0.05]. There was no statistical difference in survival rate of flap between HT group and RHT group (t = 2.75,P > 0.05). The content of TXB2 in HT and RHT groups on POD 3, 5 was respectively lower than that in C group (with t value from 6.68 to 30.55, P values all below 0.01), but there was no statistical difference between HT and RHT groups (with t value respectively 1.22, 6.44, P values all above 0.05).</p><p><b>CONCLUSIONS</b>Local injection of low-molecular-weight heparin or recombinant hirudin can significantly ameliorate venous congestion of skin flap in rabbit ear, and improve its survival rate.</p>

Numerical analysis on drug deposition from drug eluting stents in curved artery / 医用生物力学

Objective To investigate the influence of the location of drug release and the stent spacing on drug deposition in curved artery walls. Method 2D curved artery and strut models were employed to carry out a numerical investigation on drug deposition under different drug release surfaces or stent spacing ( 1 strut length, 3 strut lengths, 7 strut lengths ). The results were compared with those in a straight artery. Results The drug depositions produced by four different surfaces of a single strut were quite different. Compared with the curved artery, the superiority of drug release from the top surface of the straight artery was reduced, while the weakness of drug release from proximal surface was substantially increased. There was no significant change for drug release from the distal surface. The average drug concentration increased with interstrut spacing increasing, but the percentage increase was less than that in the straight artery. Concentration differences were observed between the inside and outside of the curved artery, which on the outside showed much lower. Conclusions The local flow alteration, the drug release location and the stent spacing have significant effects on drug deposition in a curved artery and the result is obviously different from that in a straight artery.