Pediatric SMARCB1/INI1-deficient poorly differentiated chordoma of the skull base: report of five cases and review of literature / 中华病理学杂志

Objective: To investigate the clinicopathological characteristics and differential diagnosis of pediatric SMARCB1/INI1-deficient poorly differentiated chordoma (PDC) of the skull base. Methods: Five cases of SMARCB1/INI1-deficient PDC were identified in 139 cases of chordoma diagnosed in Sanbo Brain Institute, Capital Medical University, Beijing, China from March 2017 to March 2021. The clinical and imaging data of the 5 PDCs were collected. H&E and immunohistochemical staining, and DNA methylation array were used, and the relevant literatures were reviewed. Results: All 5 PDCs were located at the clivus. The average age of the patients was 6.4 years, ranging from 3 to 16 years. Three patients were female and two were male. Morphologically, in contrast with classical chordomas, they presented as epithelioid or spindle tumor cells organized in sheets or nests, with necrosis, active mitoses, and infiltration into surrounding tissue. All cases showed positivity of CKpan, EMA, vimentin and brachyury (nuclear stain), and loss of nuclear SMARCB1/INI1 expression. S-100 protein expression was not frequent (2/5). Ki-67 proliferative index was high (20%-50%). All cases had over-expressed p53. It was necessary to differentiate SMARCB1/INI1-dificient PDC from SMARCB1/INI1-dificient tumors occurring at skull base of children or the tumors with epithelial and spindle cell morphological features. The 3 PDCs with DNA methylation testing showed the methylation profiles different from the pediatric atypical teratoid/rhabdoid tumors. They formed an independent methylation profile cluster. The clinical prognosis of the 5 patients was poor, and the overall survival time was 2-17 months. Conclusions: PDC is a special subtype of chordoma, which often affects children and occurs in the clivus. The PDC shares epithelioid or spindle cell morphologic features which are different from the classic chordoma. Besides the typical immunohistochemical profile of chordoma, PDC also has loss of nuclear SMARCB1/INI1 expression and distinct epigenetic characteristics.

Determination of triglycerides and fatty acids in Coicis Semen from different areas and its quality evaluation / 中草药

Objective: To determine the seven kinds of triglycerides and two kinds of unsaturated fatty acids in Coicis Semen in order to evaluate the quality of Coicis Semen in different producing areas. Methods: HPLC-ELSD method was used to determine the content of seven triglycerides in Coicis Semen. The HPLC-UV method was established to determine the content of oleic acid and linoleic acid. The cluster analysis method was used for quality evaluation. Results: The content of trilinolein, 1,2-dilinoleic acid-3-olein, 1,2-dilinoleic acid-3-palmitin, 1,2-dioleic acid-3-linolein, 1-palmitic acid-2 oleic acid-3-linolein, triolein, 1,2-dioleic acid-3-palmitin were 0.31%-0.83%, 0.81%-1.81%, 0.38%-0.95%, 1.19%-2.39%, 0.67%-1.58%, 0.71%-1.55%, 0.44%-1.13%, respectively. The content of oleic acid and linoleic acid in 14 batches of Coicis Semen were 0.45%-0.72% and 0.37%-0.53%, respectively. Adopting triglyceride and fatty acid as variables, the samples can be grouped into three categories. Conclusion: Some differences existed in content of triglyceride and fatty acid in Coicis Semen from different areas, but the clustering results did not find the correlation between its content and origin. The determination of multi-components comprehensively reflected the quality of Coicis Semen.

Mesoporous silica nanoparticles for bone tissue engineering / 中国骨伤

As a new potential bone graft material, tissue engineered bone effectively compensates for the defects of today's bone repair materials. Meanwhile, mesoporous silica nanomaterials(MSNs) have been widely recognized due to their large specific surface area, good biocompatibility, and capability of further processing and modification. They have promising application prospects in bone tissue engineering. For the basic scientific research results that have been carried out in the early stage, the basic characteristics of mesoporous silica nano biomaterials and their application advantages, research status and development prospects in bone tissue engineering are reviewed. As for the research status, there are two aspects--as a carrier or as a component of engineering scaffolds. For the first aspect, different kinds of loaded drugs and different loading methods are reviewed. For the second, microstructure and mechanical properties of various complex scaffolds containing MSNs and the molecular and cellular behavior of seeded cells on these scaffolds are reviewed. The research of MSNs in bone cements and metal ions doped MSNs in bone tissue engineering are also included. The future development of MSNs in bone tissue engineering is also discussed.

Analysis on the factors that influence the treatment outcome of Tibetan nationality new smear-positive pulmonary tuberculosis patients in Qinghai Province / 中华疾病控制杂志

@#Objective To analyze the treatment outcome and related influencing factors of Tibet- an nationality new smear-positive pulmonary tuberculosis patients in Qinghai Province，so as to provide evidence for tuberculosis control and treatment among Tibetan population． Methods Statistical analysis was conducted on 5 564 Tibetan nationality new smear-positive pulmonary tuberculosis cases in Qinghai province who were reported in the China Tuberculosis Information Management System and approved to receive treatment from 2008 to 2017． The main influencing factors were detected by unconditional Logistic regression model analysis，dependent variable was successful treatment or not，independent variables were other factors related to the treatment outcome． Ｒesults The treatment success rate of Tibetan nationality new smear-positive pulmonary tuberculosis cases was 87. 1% ( 4 848 /5 564) ，and the adverse outcome rate was 12. 9% ( 716 /5 564) ． Unconditional Logistic regression model analysis indicated that non-full- course supervision management，living in agricultural and pastoral area，having severe disease，floating population，and age older than 60 years were risk factors of adverse outcome． The odds ratio( OＲ) 95% confidence interval( CI) of the above risk factors were 13. 044( 10. 671-15. 944) ，2. 305( 1. 703-3. 119) ， 2. 090( 1. 346-3. 243) ，1. 967( 1. 443-2. 682) ，and 1. 909( 1. 410-2. 586) ． Clinical consultation，farmers and herdsmen were protective factors． The OＲ( 95% CI) were 0. 451( 0. 375-0. 543) ，and 0. 786( 0. 627- 0. 985) ． Conclusions Treatment success rate of Tibetan nationality new smear positive pulmonary tuberculosis cases was low． Therefore，the directly observed treatment short-course ( DOTS) strategy should be strictly implemented and the full-course supervision management should be strengthened to improve the treatment success rate． More attention should be paid to the elderly，severe，floating，agricultural and pastoral populations among the Tibetan population．

Effect of acupoint catgut embedding therapy combined with Ziwu-Liuzhu acupuncture on the sleep quality of the patients with depression / 国际中医中药杂志

Objective To investigate the effect of acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture on the clinical efficacy and sleep quality of depressive patients. Methods A total of 64 patients who met the inclusion criteria were randomly divided into two groups, 32 in each group. The control group was treated with routine electro-acupuncture, while the observation group was treated with acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture. Both groups were treated for 8 weeks. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), and depression was assessed by Hamilton Depression Scale (HAMD) to evaluate the clinical efficacy. Results After treatment, the HAMD score (11.3 ± 2.4 vs. 14.5 ± 2.6, t=4.986) and PSQI index (9.6 ± 2.3 vs. 11.8 ± 2.5, t=3.307) in the observation group were significantly lower than those in the control group (P<0.01). The quality of life (12.9 ± 2.3 vs. 11.3 ± 2.5, t=2.598) and mental health score (13.5 ± 2.4 vs. 11.3 ± 2.6, t=3.413) of WHOQOL-BREF scale in the observation group were significantly higher than those in the control group (P<0.01). The total effective rate was 93.8％ (30/32) in the observation group and 75.0％ (24/32) in the control group. There were significant differences between the two groups (χ2=4.246, P=0.038). Conclusions Acupoint catgut embedding combined with Ziwu-Liuzhu theory based acupuncture can effectively improve depressive state, sleep quality and quality of life in patients with depression, and the curative effect is better than conventional electro- acupuncture treatment.

Advances in the study of mechanism of thrombolysis-induced hemorrhagic transformation and therapeutic drugs / 药学学报

Hemorrhagic transformation (HT) is a common complication of ischemic stroke, especially after thrombolytic therapy, which is associated with increased morbidity and mortality. Thrombolysis with tissue plasminogen activator (t-PA) increases the rate of HT by as much as 10-fold, and the mortality by about 60%. The patients who are eligible for t-PA treatment are still between 3.4% and 5.2% of all patients with acute ischemic stroke because of the narrow therapeutic time window. Due to the unknown mechanism and therapeutic target of HT, there are no effective drugs to decrease the incidence of HT. The main mechanism of HT is disruption of the blood-brain barrier (BBB) integrity and neurovascular homeostasis, involving a variety of molecular signaling pathways. In animal and clinical studies, combining therapeutic agents with t-PA, which may help to minimize BBB perturbations, reduces the incidence of HT and increases the safety of thrombolytic therapy. This article is prepared to review the mechanisms, targets and therapeutic drugs of t-PA induced HT in recent years to provide a reference to the basic research and drug development of HT.

Value of transesophageal atrial pacing in neonates with tachyarrhythmia / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the value of transesophageal atrial pacing (TEAP) in neonates with tachyarrhythmia.</p><p><b>METHODS</b>The clinical data of 26 neonates with tachyarrhythmia who underwent TEAP electrophysiological examination or cardioversion were collected.</p><p><b>RESULTS</b>Of the 26 neonates, 15(58%) were diagnosed with atrioventricular reentrant tachycardia, 3(12%) were diagnosed with sinus tachycardia, 3(12%) were diagnosed with ventricular tachycardia, 2(8%) were diagnosed with fast/slow atrioventricular nodal reentrant tachycardia, 2(8%) were diagnosed with atrial tachycardia, and 1(4%) was diagnosed with sinus tachycardia with ventricular preexcitation. Overdrive suppression was performed for 22 neonates, among whom 18 achieved successful cardioversion, and 2 with atrial tachycardia and 2 with ventricular tachycardia failed to restore sinus rhythm.</p><p><b>CONCLUSIONS</b>TEAP is helpful to the diagnosis of tachyarrhythmia in neonates and can bring about a high rate of cardioversion success.</p>

BRAF V600E mutation and clinicopathologic characteristics in 250 cases of brain tumors associated with epilepsy / 中华病理学杂志

Objective@#To investigate the clinicopathologic characteristics and BRAF V600E mutation of brain tumors associated with epilepsy.@*Methods@#Totally 250 patients with brain tumors associated with epilepsy were included from March 2008 to August 2017 retrospectively at Sanbo Brain Hospital, Capital Medical University.The clinical manifestations, histological features and BRAF V600E mutation results were collected and analyzed.@*Results@#There were 132 males and 118 females, and the male to female ratio was 1.1∶1.0. The age of patients ranged from 2 to 67 years(mean 22 years). The tumors had obvious local space occupying effect on MRI. The temporal lobe was the most common site (44.4%, 111/250). There were 58.4% (146/250) of ganglioglioma (GG), 24.0% (60/250) of dysembryoplastic neuroepithelial tumor (DNT), 12.8% (32/250) of pleomorphic xanthoastrocytoma(PXA), 4.0% (10/250) of angiocentric glioma (AG) and 0.8% (2/250) of papillary glioneuronal tumor (PGNT). Mixed GG, PXA and DNT morphological structures were found in 9 of patients. Among 250 cases, 35 cases were accompanied by focal cortical dysplasia(FCD). BRAF V600E was seen in 43 of 74 (58.1%) GG and 13 of 28 (46.4%) PXA. The most common pathologic grade of GG, DNT, AG and PGNT was WHO I. Some of the tumor cells from GG (34 cases) showed higher proliferative activity (WHO Ⅱ/Ⅲ). Most cases of PXA were WHOⅡand high proliferative activity was seen in nine cases.@*Conclusions@#The association of low-grade glioneuronal tumors with intractable epilepsy was well-recognized. The most common low-grade glioneuronal tumors were GG.GG may occur in any part of the central nervous system, with a predilection for temporal lobe. Each type of low-grade glioneuronal tumors has its own unique histological morphology, but some may show complex features with 2 or 3 mixed components. The occurrence of BRAF V600E mutations in GG is common, and their detection may be valuable for the diagnosis and treatment in GG.

Clinical study on acupoint catgut embedding combined with abdominal massage in treatment of female abdominal obesity with spleen deficiency and Dampness Retention syndrome / 国际中医中药杂志

Objective To evaluate the efficacy of acupoint catgut embedding combined with abdominal massage in the treatment of female abdominal obesity with spleen deficiency and dampness. Methods A total of 300 female abdominal obesity patients who met the inclusion criteria were divided into observation group (200 cases) and control group (100 cases) according to the ratio of 2:1 by random number table. The control group was treated with abdominal massage, while the observation group was treated with acupoint catgut embedding on the basis of the control group. The changes of body weight, waist circumference, waist-hip ratio, BMI, FPG, TC and TG levels before and after treatment were compared between the two groups, and the clinical efficacy was evaluated. Results After treatment, the body weight, waist circumference, waist-hip ratio and BMI of the observation group were significantly lower than those of the control group (t values were 10.869, 6.058, 2.941, 21.267, P<0.01 or P<0.05), and the serum levels of FPG, TC and TG were significantly lower than those of the control group (t values were 21.147, 18.325, 19.931, P<0.01). The total effective rate was 91.5％ (183/200) in the observation group and 65.0％ (65/100) in the control group. There was significant difference between the two groups (χ2=32.671, P<0.001). Conclusions Acupoint catgut embedding combined with abdominal massage can improve the obesity index and blood lipid level of women with abdominal obesity, and the curative effect is better than that of abdominal massage alone.

The prevalence of metabolic syndrome among adults in rural areas of Ningxia Hui autonomous region / 中华内科杂志

Objective To investigate the prevalence of metabolic syndrome (MS) among adults in rural areas of Ningxia Hui autonomous region.Methods A cross-sectional study was conducted in 10 639 adults enrolled with a multistage method from Jingyuan County.The MS was identified according to Chinese type 2 diabetes prevention guide (2013).Results Among all the subjects, 17.4% of them met the MS definition with the standardized prevalence of 14.7% after adjustment of sex and age.The prevalence and standardized rate of MS in men were 19.9% and 17.3%, and in women were 15.3% and 13.5%.The prevalence of MS in men was higher than that in women(P<0.001) and increased with aging in both genders.The prevalence and standardized rate of abdominal obesity,hyperglycemia,hypertension,high triglycerides,and low HDL-C were 19.5% and 16.7%, 15.0% and 12.9%, 42.0% and 37.1%, 25.8% and 23.1%, 28.5% and 27.7%,respectively.The rate of abdominal obesity was higher in women than in men (20.5% vs 18.2%, P=0.004), whereas the rate of hypertension, high triglycerides, and low HDL-C were higher in men than in women (all P<0.01).The prevalence of having one parameter of the MS was 68.4%.Conclusion The prevalence of MS is higher in rural areas of Ningxia Hui autonomous region, suggesting that a series of comprehensive prevention measures should be carried out to prevent and control the MS so as to improve the public health conditions in rural areas.

Neuropathologic findings in intractable epilepsy: a clinicopathologic analysis of 822 cases / 中华病理学杂志

Objective@#To investigate the clinicopathologic characteristics of intractable epilepsy.@*Methods@#Based on the classification criteria proposed by the International League Against Epilepsy (ILAE), a retrospective analysis of the pathological characteristics was done in 822 patients who underwent epilepsy surgery in Sanbo Brain Hospital, Capital Medical University, from June 2008 to December 2012.@*Results@#The mean age of epilepsy onset was 9.9 years, mean duration of epilepsy was 11.9 years. Complex partial seizures were the main presenting features. Histopathological study showed 33 cases (4.01%) with mild forms of cortical malformations, 690 cases (83.94%) with focal cortical dysplasia (FCD) and 99 cases with others (including 39 pure hippocampal sclerosis, 20 cystosclerosis, 19 Sturge-Weber syndrome, 8 tuberous sclerosis complex, 6 without significant pathological changes, 5 gyral malformations and 2 hamartoma). Among the 690 FCD cases, 106 were FCD typeⅠ, 91 were FCD typeⅡ and 493 were FCDⅢ(Ⅲa: 160, Ⅲb: 106, Ⅲc: 26 and Ⅲd: 201).@*Conclusions@#FCDⅢd is the most common histopathological subtype causing intractable epilepsy, mainly due to focal hypoxia/ischemia in the perinatal period, which results in scarring of local brain tissue; this is followed by other isolated forms of FCD (FCDⅠand FCDⅡ), and then FCD Ⅲa and FCD Ⅲb. The reason to distinguish isolated forms of FCD (types Ⅰ and Ⅱ) from FCD Ⅲ and to subclassify FCD Ⅲ is to allow better definition of cortical dyslamination. Therefore, the pathogenic factors of intractable epilepsy can be grouped in greater details, and facilitate the diagnosis and potential curative treatment of intractable epilepsy.

Efficacy and Safety of Zhuanggu Joint Capsules in Combination with Celecoxib in Knee Osteoarthritis: A Multi-center, Randomized, Double-blind, Double-dummy, and Parallel Controlled Trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Knee osteoarthritis (KOA) is a chronic joint disease that manifests as knee pain as well as different degrees of lower limb swelling, stiffness, and movement disorders. The therapeutic goal is to alleviate or eliminate pain, correct deformities, improve or restore joint functions, and improve the quality of life. This study aimed to evaluate the efficacy and safety of Zhuanggu joint capsules combined with celecoxib and the benefit of treatment with Zhuanggu alone for KOA.</p><p><b>METHODS</b>This multi-center, randomized, double-blind, double-dummy, parallel controlled trial, started from December 2011 to May 2014, was carried out in 6 cities, including Beijing, Shanghai, Chongqing, Changchun, Chengdu, and Nanjing. A total of 432 patients with KOA were divided into three groups (144 cases in each group). The groups were treated, respectively, with Zhuanggu joint capsules combined with celecoxib capsule simulants, Zhuanggu joint capsules combined with celecoxib capsules, and celecoxib capsules combined with Zhuanggu joint capsule simulants for 4 weeks consecutively. The improvement of Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and the decreased rates in each dimension of WOMAC were evaluated before and after the treatment. Intergroup and intragroup comparisons of quantitative indices were performed. Statistically significant differences were evaluated with pairwise comparisons using Chi-square test (or Fisher's exact test) and an inspection level of α = 0.0167.</p><p><b>RESULTS</b>Four weeks after treatment, the total efficacies of Zhuanggu group, combination group, and celecoxib group were 65%, 80%, and 64%, respectively, with statistically significant differences among the three groups (P = 0.005). Intergroup pairwise comparisons showed that the total efficacy of the combination group was significantly higher than that of the Zhuanggu (P = 0.005) and celecoxib (P = 0.003) groups. The difference between the latter two groups was not statistically significant (P > 0.0167). Four weeks after discontinuation, the efficacies of the three groups were 78%, 95%, and 65%, respectively, with statistically significant differences (P < 0.0001). Intergroup pairwise comparisons revealed that the efficacy of the combination group was significantly better than that of the Zhuanggu and the celecoxib groups (P < 0.0001). The difference between the latter two groups was not statistically significant (P > 0.0167). The incidences of adverse events in Zhuanggu group, combination group, and celecoxib group were 8.5%, 8.5%, and 11.1%, respectively, with insignificant differences (P > 0.05).</p><p><b>CONCLUSIONS</b>Zhuanggu joint capsules alone or combined with celecoxib showed clinical efficacy in the treatment of KOA. The safety of Zhuanggu joint capsules alone or combined with celecoxib was acceptable.</p><p><b>TRIAL REGISTRATION</b>Chinese Clinical Trial Registry, ChiCTR-IPR-15007267; http://www.medresman.org/uc/project/projectedit.aspx?proj=1364.</p>

Comparison of the effect of total hip arthroplasty through mini invasive direct anterior approach during learning curve period and posterolateral approach for the treatment of femoral head necrosis / 中国骨伤

<p><b>OBJECTIVE</b>To compare clinical results of treating femoral head necrosis staged Ficat III or IV with total hip arthroplasty (THA) between mini invasive direct anterior approach (DAA) and posterolateral approach.</p><p><b>METHODS</b>From January 2008 to December 2009, 48 patients with femoral head necrosis staged Ficat III or IV treated with THA were compared and analyzed. There were 21 patients in mini invasive direct anterior approach group including 11 males and 10 females with an average age of (65.2±4.3) years old;while there were 27 patients in posterolateral approach group including 16 males and 11 females with an average age of (63.6±4.0) years old. Operative time, blood loss during operation, bed rest time and complications of two groups were observed and compared. Acetabular abduction and stem shaft angle were measured 1 month after operation and compared between two groups. Postoperative Harris Hip scoring and VAS scoring were applied for evaluating hip function and pain at 1, 6 months and 5 years after operation respectively.</p><p><b>RESULTS</b>All patients were followed up for 48 to 73 months with an average of 60.4 months. Operative time, blood loss in DAA group was (78.30±5.08) min, (351.30±21.46) ml, respectively, in posterolateral approach group was (75.61±10.60) min, (362.20±26.15) ml, and no significant differences between two groups. Bed rest time in DAA group was (2.05±1.10) days, better than that of in posterolateral approach which was (3.30±1.35) days. No significant differences were found between two groups in acetabular abduction and stem shaft angle at 1 month after operation. There was no significant differences between two groups in HHS and VAS score at 1, 6 months and 5 years after operation. There was 1 case with injury of ascending branch of the lateral circumflex femoral artery, 1 case with great trochanter fracture and 1 case with superficial infection in DAA group, 1 case with dislocation in posterolateral group. No prosthesis loosening occurred in two groups.</p><p><b>CONCLUSIONS</b>Both DAA and posterolateral approach are effective in treating femoral head necrosis staged Ficat III or IV, and could obtain excellent outcomes. However, DAA seemed to has disadvantage in learing curve compared posteriolateral approach in complex cases.</p>

Development of medical treatment for eye injuries in the mainland of China over the past decade / 中华创伤杂志(英文版)

In the article, the development of medical treatment for eye injuries in the mainland of China was reviewed. According to the data provided in Eye Injury Vitrectomy Study (EIVS), 27% of 72 eyes with no light perception (NLP) gained recovery in term of antomy and visual function. Vitrectomy initiated at more than 4 weeks after open eye injury is an independent risk factor for developing PVR. Prognosis of anatomy and visual function of the injured eye with PVR is markedly worse than that without PVR. Serious injuries of ciliary body, choroid and retina are three key parts of the eye with NLP. The concept that the treatment of the eye injury gradually focus on the whole globe is embodied. The data from 13575 in patients with traumatic eyes in 14 hospitals revealed that the rate of immediate enucleation was remarkable reduced with comparison of 20 years ago.

Ability of Mn(2+) to Permeate the Eye and Availability of Manganese-enhanced Magnetic Resonance Imaging for Visual Pathway Imaging via Topical Administration / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Manganese-enhanced magnetic resonance imaging (MEMRI) for visual pathway imaging via topical administration requires further research. This study investigated the permeability of the corneal epithelium and corneal toxicity after topical administration of Mn2+ to understand the applicability of MEMRI.</p><p><b>METHODS</b>Forty New Zealand rabbits were divided into 0.05 mol/L, 0.10 mol/L, and 0.20 mol/L groups as well as a control group (n = 10 in each group). Each group was further subdivided into epithelium-removed and epithelium-intact subgroups (n = 5 in each subgroup). Rabbits were given 8 drops of MnCl2in 5 min intervals. The Mn2+ concentrations in the aqueous and vitreous humors were analyzed using inductively coupled plasma-mass spectrometry at different time points. MEMRI scanning was carried out to image the visual pathway after 24 h. The corneal toxicity of Mn2+ was evaluated with corneal imaging and pathology slices.</p><p><b>RESULTS</b>Between the aqueous and vitreous humors, there was a 10 h lag for the peak Mn2+ concentration times. The intraocular Mn2+ concentration increased with the concentration gradients of Mn2+ and was higher in the epithelium-removed subgroup than that in the epithelium-intact subgroup. The enhancement of the visual pathway was achieved in the 0.10 mol/L and 0.20 mol/L epithelium-removed subgroups. The corresponding peak concentrations of Mn2+ were 5087 ± 666 ng/ml, 22920 ± 1188 ng/ml in the aqueous humor and 884 ± 78 ng/ml, 2556 ± 492 ng/ml in the vitreous body, respectively. Corneal injury was evident in the epithelium-removed and 0.20 mol/L epithelium-intact subgroups.</p><p><b>CONCLUSIONS</b>The corneal epithelium is a barrier to Mn2+, and the iris and lens septum might be another intraocular barrier to the permeation of Mn2+. An elevated Mn2+ concentration contributes to the increased permeation of Mn2+, higher MEMRI signal, and corneal toxicity. The enhancement of the visual pathway requires an effective Mn2+ concentration in the vitreous body.</p>

Clinical observation on cervical type cervical spondylosis treated with sword-like needle and chiropractic spinal manipulation / 中国针灸

<p><b>OBJECTIVE</b>To compare the difference in the efficacy on cervical type of cervical spondylosis (CS) between the combined treatment of sword-like needle and chiropractic spinal manipulation (the combined therapy) and the simple chiropractic spinal manipulation.</p><p><b>METHODS</b>One hundred and thirty-eight cases of cervical type of CS were randomized into a combined therapy group (76 cases) and a simple chiropractic spinal manipulation group (62 cases). In the combined therapy group, the sword-like needle therapy was applied at Fengchi (GB 20), Tianzhu (BL 10) and Jiaji (EX-B 2) C3-C5. The chiropractic spinal manipulation was used in combination. In the chiropractic spinal manipulation group, the simple chiropractic spinal manipulation was adopted. The treatment was given once every other day in the two groups, 10 days made one session. One session of treatment was required. Visual analog scale (VAS) score was observed before and after treatment in the two groups and the efficacies were compared between the two groups.</p><p><b>RESULTS</b>VAS score after treatment was reduced obviously as compared with that before treatment in the patients of the two groups (both P < 0.01) and VAS score after treatment in the combined therapy group was lower than that in the simple chiropractic spinal manipulation group (1.50 +/- 0.58 vs 1.87+/-1.05, P < 0.01). In the combined therapy group, 48 cases were cured, 20 cases remarkably effective, 8 cases improved and 0 case failed. In the chiropractic spinal manipulation group, 30 cases were cured, 16 cases remarkably effective, 15 cases improved and 1 case failed. The overall efficacy in the combined therapy group was better than that in the chiropractic spinal manipulation (P < 0.05).</p><p><b>CONCLUSION</b>The sword-like needle therapy combined with chiropractic spinal manipulation relieve effectively pain in cervical type of CS and the efficacy is superior to the simple chiropractic spinal manipulation.</p>

Acupuncture combined with auricle cutting method for blood stasis-type psoriasis: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To verify the clinical efficacy of acupuncture combined with auricle cutting method for treatment of blood stasis-type psoriasis.</p><p><b>METHODS</b>Fifty-six cases of blood stasis-type psoriasis were randomly divided into a combined therapy group, a auricle cutting group, an acupuncture group and a control group, 14 cases in each one. Based on regular treatment of TCM decoction in four groups, the combined therapy group was treated with acupuncture and auricle cutting method, and the auricle cutting group was treated with sham-acupuncture and auricle cutting, and the acupuncture group was treated with acupuncture and sham auricle cutting, and the control group was treated with sham-acupuncture and sham auricle cutting. The acupuncture was applied at Dazhui (GV 14), Feishu (BL 13), Ganshu (BL 18) and Geshu (BL 17), etc., and manipulated with routine technique; in the sham acupuncture, the needle was inserted into dermis layer so that the needles could be swung without being dropped out. In the auricle cutting, erbeixin (P1) of unilateral auricle was selected and cut by Chan needle to perform bloodletting; in the sham auricle cutting, the neighborhood approximately 0.5 cm next to erbeixin (P) of auricle was selected as cutting area. The treatment was given once a day, seven days as a treatment session for totally two sessions. Psoriasis area and severity index (PASI) before and after treatment was observed and efficacy of each group was compared.</p><p><b>RESULTS</b>The effective rate was 57.1% (8/14) in the combined therapy group, which was superior to 14.3% (2/14) in the auricle cutting group, 7.1% (1/14) in the acupuncture group and 0.0% (0/14) in the control group (all P < 0.05). The scores of PASI were all decreased in each group after the treatment (all P < 0.05), which was the most significant in the combined therapy group (all P < 0.05). After factorial analysis, the main effect was P < 0.05 in the auricle cutting, P < 0.05 in the acupuncture and P < 0.05 in interaction effect of combined therapy.</p><p><b>CONCLUSION</b>The scores of PASI of blood stasis-type psoriasis could be effectively reduced by acupuncture, auricle cutting method and TCM decoction, among which the interaction effect of auricle cutting and acupuncture combined with TCM decoction is the most significant.</p>

Unintentional injuries in children: an analysis of 924 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the causes of unintentional injuries in children and to provide reference for reducing the incidence of unintentional injuries in children.</p><p><b>METHODS</b>A retrospective analysis was performed on the clinical data of 924 children with unintentional injuries who were hospitalized in Zhongshan Boai Hospital from January 2008 to December 2010.</p><p><b>RESULTS</b>Of the 924 cases, 26.4% suffered falls, which was the most common cause of injuries, 15.7% suffered burns and scalds, 14.0% were injured by foreign bodies, and 13.1% were injured in traffic accidents. Unintentional injuries occurred mainly among children aged 0-3 years (67%). The proportion of cases in summer (July to September) was significantly higher than in any other season (P < 0.05), and burns were the common causes of injuries in summer. Home was the most common place where unintentional injuries occurred (36.9%). The incidence of traffic accidents was significantly higher in non-local children than in local children (P < 0.001). As for the parents' educational levels, the children whose parents had an education level below junior middle school accounted for the highest proportion of all cases of unintentional injury (45.5%). Injuried cases in rural areas accounted for a significantly higher percentage than in urban areas (P < 0.05).</p><p><b>CONCLUSIONS</b>Falls are the principal cause of unintentional injuries in children. Young children (0-3 years) are most vulnerable to unintentional injuries. Unintentional injuries mostly occur at home. The incidence of traffic accidents is higher in non-local children than in local children. Parents' education levels are associated with the incidence of unintentional injuries. In order to reduce the incidence of unintentional injuries in children, preventive measures must be carried out, and safety education should be enhanced in consideration of children's age, sex and family background.</p>

Association of the xeroderma pigmentosum group D DNA repair gene with hepatocellular carcinoma / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore the association between polymorphisms in the DNA repair gene, xeroderma pigmentosum group D (XPD), and development of hepatocellular carcinoma (HCC) in the Chinese population by performing a systematic review of the previously published clinical data.</p><p><b>METHOD</b>A comprehensive literature search of the BIOSIS Previews and PubMed databases was carried out to identify all case-control studies of XPD polymorphisms and HCC risk. Meta-analysis was conducted to calculate the pooled odds ratios (ORs) with 95% confidence intervals (CIs) of developing HCC for carriers of the various XPD polymorphisms.</p><p><b>RESULTS</b>Six case-control studies were selected for this meta-analysis, and comprised a total of 3424 HCC cases and 3636 controls. The pooled ORs (95% CIs) of XPD codon 751 and 312 allelomorphs were 1.25 (0.70 to 2.24) and 0.85 (0.58 to 1.25), respectively. Compared with the XPD wild-type homozygote Lys/Lys genotype of codon 751, the pooled OR (95% CI) of Lys/G1n + Gln/Gln genotypes for HCC risk was 1.31 (0.71 to 2.42). Compared with the XPD wild-type homozygote Asp/Asp genotype of codon 312, the pooled OR (95% CI) of Asp/Asn + Asn/Asn genotypes for HCC risk was 1.19 (0.73 to 1.95).</p><p><b>CONCLUSION</b>Polymorphisms in the XPD codons 751 and 312 are not associated with HCC risk in the Chinese population.</p>

Study of the relationship between glutathione S-transferase genetic polymorphisms M1 and T1 and susceptibility to primary liver cancer in Chinese: a meta-analysis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To study the association of genetic polymorphism of glutathione S-transferase (GSTM1 and GSTT1) with susceptibility to primary liver cancer in Chinese.</p><p><b>METHODS</b>Literature search of the PubMed, Chinese National Knowledge Infrastructure, and ISI Web of Science databases identified 25 relevant case-control studies of glutathione S-transferase genetic polymorphisms and primary liver cancer, representing a total of 2788 cases and 5548 controls. The extracted data was applied to the RevMan v4.2 software for meta-analysis. Data with significant heterogeneity was assessed by the fixed effects model, otherwise a random effects model was applied. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.</p><p><b>RESULTS</b>The correlation between the GSTM1 and GSTT1 null genotypes and susceptibility to primary liver cancer showed statistical significance (cases: P = 1.8 * 10(-11) and controls: P = 4.6 * 10(-11); Pearson's Chi-squared test). The OR value for GSTM1 was 1.67 (95% CI: 1.39-2.01) and for GSTT1 was 1.59 (95% CI: 1.26-1.96). In the GSTM1-GSTT1 interaction analysis, both GSTM1 and GSTT1 were null genotypes with OR = 3.34 (95% CI: 2.23-5.00), which was higher than the null genotype for either one of them alone and which indicated higher relative susceptibility. Compared with individuals for whom both GSTM1 and GSTT1 were non-null genotypes, the presence of at least one null genotype showed higher risk of primary liver cancer.</p><p><b>CONCLUSION</b>The null genotypes of glutathione S-transferase genetic polymorphisms GSTM1 and GSTT1 are risk factors for primary liver cancer respectively, and their associated risk is increased when both are present.</p>