Construction and application of "Five-in-one" blended teaching model in the course of fundamental nursing / 中华医学教育探索杂志

Objective:To construct a "Five-in-one" blended teaching model in the course of fundamental nursing with ideological and political education as the core, integrated with online and offline, and complemented with theory and experiment, and to explore its application effect.Methods:Eight classes of nursing undergraduates in Batch 2019 were selected through convenience sampling method, and through random cluster sampling, Class 5 to 8 were divided into control group and Class 1 to 4 were divided into experimental group. The control group used the traditional teaching method, the experimental group used the "Five-in-one" mixed teaching model. After the course, the teaching effect was evaluated by the professional commitment scale, the recessive truancy scale for college students, the self-regulated learning ability scale and the examination results. SPSS 23.0 software was used for t test. Results:After teaching, the scores of professional commitment, self-adjustment in recessive truancy, autonomous learning ability and examination results of the experimental group were higher than those of the control group [(91.30±10.38) vs. (87.31±16.40), (23.30±4.50) vs. (21.23±4.51), (82.31±10.06) vs. (79.42±9.79), (72.31±10.13) vs. (70.14±9.67) and (87.93±4.60) vs. (86.50±4.67), respectively]. The scores of academic cognition, learning habit, classroom cognition and learning environment in recessive truancy of the experimental group were lower than those in control group, with statistical significance.Conclusion:The application of "Five-in-one" blended teaching model in the course of fundamental nursing can reduce students' recessive truancy and improve their professional commitment, autonomous learning ability and academic achievement.

Quantitative proteomics revealed extensive microenvironmental changes after stem cell transplantation in ischemic stroke / 医学前沿

The local microenvironment is essential to stem cell-based therapy for ischemic stroke, and spatiotemporal changes of the microenvironment in the pathological process provide vital clues for understanding the therapeutic mechanisms. However, relevant studies on microenvironmental changes were mainly confined in the acute phase of stroke, and long-term changes remain unclear. This study aimed to investigate the microenvironmental changes in the subacute and chronic phases of ischemic stroke after stem cell transplantation. Herein, induced pluripotent stem cells (iPSCs) and neural stem cells (NSCs) were transplanted into the ischemic brain established by middle cerebral artery occlusion surgery. Positron emission tomography imaging and neurological tests were applied to evaluate the metabolic and neurofunctional alterations of rats transplanted with stem cells. Quantitative proteomics was employed to investigate the protein expression profiles in iPSCs-transplanted brain in the subacute and chronic phases of stroke. Compared with NSCs-transplanted rats, significantly increased glucose metabolism and neurofunctional scores were observed in iPSCs-transplanted rats. Subsequent proteomic data of iPSCs-transplanted rats identified a total of 39 differentially expressed proteins in the subacute and chronic phases, which are involved in various ischemic stroke-related biological processes, including neuronal survival, axonal remodeling, antioxidative stress, and mitochondrial function restoration. Taken together, our study indicated that iPSCs have a positive therapeutic effect in ischemic stroke and emphasized the wide-ranging microenvironmental changes in the subacute and chronic phases.

Genetic analysis of a Chinese pedigree affected with branchiootic syndrome due to a nonsense variant of EYA1 gene / 中华医学遗传学杂志

OBJECTIVE@#To analyze the clinical phenotype and genetic basis for a Chinese pedigree suspected for branchiootic syndrome (BOS).@*METHODS@#The proband was subjected to target-capture high-throughput sequencing to detect potential variant of deafness-associated genes. Candidate variants were verified by Sanger sequencing of the family members.@*RESULTS@#The proband was found to harbor a c.1627C>T (p.Gln543Ter) nonsense variant of the EYA1 gene. Sanger sequencing confirmed that all of the 4 patients with the BOS phenotype from the pedigree have harbored the same heterozygous variant. Based on the guidelines of the American College of Medical Genetics and Genomics, the variant was predicted to be pathogenic (PVS1+PS+PP3+PP4).@*CONCLUSION@#The c.1627C>T (p.Gln543Ter) variant of the EYA1 gene probably underlay the BOS phenotype in this pedigree. Above finding has provided a basis for its clinical diagnosis.

Repair of tongue defect with submental artery island flap and free anterolateral thigh flap after resection of tongue cancer: A comparative analysis / 中华显微外科杂志

Objective:To compare and analyse the clinical outcome, advantages and disadvantages of submental artery island flap (SAIF) and free anterolateral thigh flap (ALTF) in the repair and reconstruction of tongue after radical surgery of tongue cancer.Methods:From January, 2016 to December, 2018, a total of 40 patients received tongue repair and reconstruction with either SAIF or ALTF after radical resection of tongue cancer. There were 28 males and 12 females, with an average age of 51 years old. Eighteen patients received tongue repair and reconstruction with SAIF and 22 with ALTF. Postoperative follow-up were carried out and the clinical data were collected. Swallowing, speech and softness of the tongue between the 2 repair methods were compared and statistically analysed. P<0.05 indicated a significant statistical difference between 2 groups. Results:All flaps survived. One ALTF had a venous vascular crisis. The flap survived after the removal of thrombus at the anastomotic site. Functional recovery of tongue was analysed after the follow-up of 12-48 months. It was found that there was no significant difference in speech function between the 2 groups (SAIF vs ALTF: 13 vs 15, P=0.206). The swallowing dysfunction in SAIF group was significantly higher than that of the ALTF group (SAIF vs ALTF: 15 vs 7, P=0.014). Moreover, the average time of surgery in SAIF group (3.5 h) was significantly less than that of the ALTF group (6.8 h), which had statistically significance ( P<0.05). Conclusion:The SAIF and ALTF are ideal flaps for repairing the tongue defect caused by tongue cancer surgery. SAIF features a simple surgical procedure and a short time for flap taking. ALTF provides sufficient amount of tissue to cover the scars left by the surgery, reduce donor site complications, and benefit the recovery of swallowing and speech functions.

Effects of Enriched Environment on Neurological Function and Glucose Metabolism in Ischemic Penumbra in Cerebral Ischemia-reperfusion Injury Rats / 中国康复理论与实践

Objective:To explore the effects of enriched environment on neurological function in cerebral ischemia-reperfusion injury rats and the glucose metabolism in ischemic penumbra. Methods:A total of 72 adult male Sprague-Dawley rats were randomly divided into sham group (n = 24), model group (n = 24) and enriched environment group (n = 24). The latter two groups suffered cerebral ischemia 60 minutes and reperfused with modified Longa's method. The enriched environment group was fed in enriched environment after operation. All the rats were assessed with modified Neurological Severity Score (mNSS) before, and one, seven, 14, 21 and 28 days after operation. One and 28 days after operation, twelve rats from each groups were sacrificed after mNSS assessment, respectively. The histopathology was observed with HE staining. The expressions of hypoxia-inducible factor-1α (HIF-1α), glucose transporter 1 (GLUT1) and 6-phosphofructo-2-kinase/fructose-2-bisphosphatase 3 (PFKFB3) in ischemic penumbra were determined with reverse transcription real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting. The levels of ATP, ADP and AMP in ischemic penumbra were measured with high performance liquid chromatography (HPLC) and the energy charge (EC) was calculated. Results:Compared with the model group, the scores of mNSS decreased in the enriched environment group since 14 days after operation (P < 0.05). The cells in the penumbra presented edema, nuclear pyknosis marginalization, vacuolar arrangement and other pathological changes in the model group and the riched environment group one day after operation; while compared with the model group, the levels of ATP and EC decreased and the mRNAs and protein expression of HIF-1α, GLUT1 and PFKFB3 increased in the enriched environment group (P < 0.05). The pathology improved in the riched environment group compared with that in the model group 28 days after operation; while the mRNAs and protein expression of HIF-1α, GLUT1 and PFKFB3 increased, as well as the levels of ATP and EC (P < 0.05). Conclusion:Enriched environment can promote the recovery of neurological function in rats after cerebral ischemia-reperfusion, which may associate with promoting expression of HIF-1α and downstream GLUT1 and PFKFB3, and improving glucose metabolism.

The relationship between knee muscle strength and walking ability after incomplete lumbar spinal cord injury / 中华物理医学与康复杂志

Objective:To explore any correlation between knee muscle strength and walking ability after an incomplete lumbar spinal cord injury and the factors influencing walking ability.Methods:Twenty-seven persons with an incomplete lumbar spinal cord injury were tested. Their bilateral quadriceps and hamstring muscle strength and peak torque during knee extension and flexion were assessed. They completed the 10m walking time test (10MWT) and each person′s WWISCI II spinal cord injury walking index was evaluated. Spearman correlations among the data were computed and stepwise regression was used to analyze the factors significantly influencing the 10MWT and WISCI II results.Results:The average hamstring strength was significantly negatively correlated with the 10MWT times and WISCI II ratings. Hamstring torque also was negatively correlated with the 10MWT times, but positively correlated with the WISCI II ratings. The 10MWT times and WISCI II ratings were significantly inter-correlated. Hamstring strength was the best predictor of 10MWT times (accounting for 63% of the variance) and WISCI II ratings (64%), but quadriceps strength was also a secondary predictor.Conclusions:Knee muscle strength is a useful predictor of 10MWT times and WISCI II ratings after incomplete lumbar spinal cord injury. It can predict early walking ability to some extent.

Analysis of serum uric acid levels and associated factors among primary and middle school students in Tongzhou District, Beijing / 中国学校卫生

Objective@#To examine uric acid (UA) levels and their influencing factors among primary and middle school students in the Tongzhou District of Beijing, and to provide referential guidance for the prevention and control of hyperuricemia in teenagers.@*Methods@#A total of 1 483 students from four middle schools and four primary schools in three cities and three towns in Tongzhou District were selected for a questionnaire survey, physical examination, and blood examination using a multi-stage stratified cluster sampling method. The results of the serum uric acid (SUA) examinations were statistically analyzed and the influencing factors were evaluated.@*Results@#The UA level of the students was skewed, with a median value of 296.0 mol/L and an interquartile distance of 96.0 mol/L. The overall detection rate of hyperuricemia was 14.83% (220/1 483). Middle school students (342 μmol/L), students from villages and towns (307 μmol/L), males (309 μmol/L), family dining students (298 μmol/L), students with high levels of triglyceride (TG) (318 μmol/L), students with low levels of high-density lipoprotein cholesterol (HDL-C) (329 μmol/L), and obese students (303 μmol/L) all had statistically higher SUA levels(H/U value was 119 938, 229 525, 212 043, 156 347, 42 052, 63 375, 33.49, P<0.05). The univariate analysis showed that the HUA detection rate was higher in older age groups, middle school students, township students, overweight or obese students, and low HDL-C students(χ 2=614.55, 73.20, 6.16, 30.56, 14.50, P<0.05). Multivariate Logistic regression showed that older age, being male, low HDL-C, high LDL-C, overweight, and obesity were risk factors for HUA(P<0.05).@*Conclusion@#The SUA level and the detection rate of hyperuricemia among primary and middle school students in Tongzhou District were high, and the risk of disease and influencing factors had significant characteristics. Therefore, targeted prevention and control measures should be strengthened.

Progress on the application of positron emission tomography imaging of cannabinoid type 1 receptor in neuropsychiatric diseases / 浙江大学学报·医学版

Cannabinoid type 1 receptor (CB1R), as the major member of the endocannabinoid system, is among the most abundant receptors expressed in the central nervous system. CB1R is mainly located on the axon terminals of presynaptic neurons and participate in the modulation of neuronal excitability and synaptic plasticity, playing an important role in the pathogenesis of various neuropsychiatric diseases. In recent years, the consistent development of CB1R radioligands and the maturity of molecular imaging techniques, particularly positron emission tomography (PET) may help to visualize the expression and distribution of CB1R in central nervous system . At present, CB1R PET imaging can effectively evaluate the changes of CB1R levels in neuropsychiatric diseases such as Huntington's disease and schizophrenia, and its correlation with the disease severity, therefore providing new insights for the diagnosis and treatment of neuropsychiatric diseases. This article reviews the application of CB1R PET imaging in Alzheimer's disease, Parkinson's disease, Huntington's disease, schizophrenia, post-traumatic stress disorder, cannabis use disorder and depression.

Evaluation and analysis on the degree of patients′ trust in community TCM physicians under the TCM service capability promotion program / 中华医院管理杂志

Objective@#To evaluate the degree of trust of patients in community traditional Chinese medicine(TCM)physicians, based on the TCM service capability promotion program, and to analyze the impacts by TCM prevention and health care service.@*Methods@#1 391 patients at 22 primary health service centers in 3 cities from Zhejiang province were investigated using the Chinese version of Wake Forest Physician Trust Scale(WFPTS)in September, 2017. Quantitative and qualitative variables were described by mean±SD, and ratio respectively. Differences were compared by t test, ANOVA and Kruskal-Wallis test.@*Results@#Chinese version of WFPTS had good reliability and validity in measuring community TCM physicians. The average scoring of patients′ trust in community TCM physicians was 38.00±6.42, while their benevolence and competence were 19.14±3.41, 18.82±3.50 respectively.For patients with different demographic characteristics, their quantity and the way to acquire and utilize TCM prevention and health care service had different degrees of trust in community TCM physicians. Patients′ gender, age, awareness and utilization of TCM prevention and health care service, etc. affect the degree of trust in community TCM physicians.@*Conclusions@#Patients have higher degree of trust in community TCM physicians, and improving the rate of awareness and utilization of TCM prevention has positive impacts on the degree of trust in these physicians. It is proposed that health knowledge education be strengthened and skills of community TCM physicians′ capacity be enhanced through various ways.

Relationship between the structural and functional changes of macular and HbA1c after cataract surgery in diabetic patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the relationship between HbA1c and the changes of retinal and choroidal structures in macular region, and between HbA1c and corrected distant visual acuity before and after cataract surgery in diabetic patients.<p>METHODS: It is a prospective randomized clinical trial. According to the patient's history, the subjects were divided into the non-diabetes group and the diabetic group. According to the level of HbA1c before operation, the diabetic group was divided into the high HbA1c group(HbA1c>7.0%)and the normal HbA1c group(HbA1c≤7.0%). All 87 eyes from 82 patients who met the criteria from October 2016 to December 2017 in the Department of Ophthalmology at Qingdao Municipal Hospital were enrolled in this study. There were 30 eyes from 28 patients in the non-diabetes group(4%≤HbA1c≤6.0%), 29 eyes from 28 patients in the high HbA1c group and 28 eyes from 26 patients in the normal HbA1c group. Spectral-domain optical coherence tomography(SD-OCT)was used to examine central subifield thickness(CST), central volume(CV)and subfoveal choroidal thickness(SFCT)at 1d before surgery, 1d after surgery, 1wk after surgery, 1mo after surgery and 3mo after surgery. The variance analysis and Pearson correlation analysis were used to analyze the changes and the correlation with HbA1c value. At the same time, the incidence of macular edema after surgery(PCME)was compared among the groups, and the relationship between HbA1c and postoperative corrected distance visual acuity(CDVA)in diabetes patients was also analyzed. <p>RESULTS: In non diabetic group, high HbA1c group and normal HbA1c group, CST was 239.03+11.55μm, 254.38+26.44μm, 247.07+19.51μm at 1wk after cataract surgery. Their CST was 241.00±11.15μm, 271.55±61.05μm, 248.64±38.28μm at 1mo after cataract surgery(<i>F</i>=3.001, <i>P</i>=0.048). Besides, there was a positive correlation between HbA1c and CST at 1wk and 1mo after operation in the two groups at <i>P</i>=0.01 level(<i>r</i>1wk=0.338, <i>r</i>1mo=0.297)(<i>P</i><0.05). The postoperative macular cystoid edema in non-diabetic group, high HbA1c group and normal HbA1c group were 0, 5(5 eyes, 17%)and 1(1 eye, 4%)respectively. In non diabetic group, high HbA1c group and normal HbA1c group, CDVA was 0.07±0.06, 0.12±0.10, 0.09±0.08 at 1wk after cataract surgery. Their CDVA was 0.03±0.06, 0.11±0.15, 0.11±0.09 at 1mo after cataract surgery. Their CDVA was 0.02±0.04, 0.08±0.12, 0.06±0.06 at 3mo after cataract surgery(<i>F</i>=3.272, <i>P</i>=0.045). The differences among three groups in the CDVA were statistically significant at 1wk, 1mo and 3mo after surgery. There was no significant difference between the high HbA1c group and the normal HbA1c group(<i>P</i>>0.05). However, CDVA(LogMAR)of the two groups was positively correlated with HbA1c at <i>P</i>=0.01 level(<i>r</i>1wk=0.425, <i>r</i>1mo=0.235, <i>r</i>3mo=0.332). There was no statistically significant difference in the changes of CV and SFCT among the three groups, and the trend of changes among these groups was approximately the same. <p>CONCLUSION: There is a close relationship between the microscopic structure of macula and HbA1c before phacoemulsification in diabetic patients. The risk of macular edema increased in patients with hba1c >7.0% before surgery. The best corrected visual acuity of diabetes patients after surgery was significantly related to the hba1c value before surgery. The higher the hba1c value before surgery, the poorer the improvement of vision after surgery. The level of HbA1c before surgery in diabetic patients is related to the anatomical structure of macular after cataract surgery. The risk of macular edema after surgery is increased in patients with high HbA1c(HbA1c>7.0%)before surgery. Meanwhile, the preoperative HbA1c of diabetic patients is closely related to CDVA after cataract surgery. The higher the preoperative HbA1c value, the worse the CDVA in diabetics after surgery.

Observation on therapeutic efficacy of tuina plus cupping for chronic fatigue syndrome / 针灸推拿医学（英文版）

Objective: To observe the therapeutic efficacy of tuina plus cupping on chronic fatigue syndrome (CFS). Methods: A total of 100 CFS patients meeting the inclusion criteria were randomly divided into a treatment group and a control group according to the random number table in the sequence of visit, with 50 patients in each group. The treatment group was treated with tuina plus cupping therapy, 3 times a week. The control group was given oral tablets of wild American ginseng lozenges. After 3 months of treatment, the score of fatigue questionnaire scale (FS-14) was observed and the efficacy was evaluated. Results: The total effective rate was 92.0％ in the treatment group, versus 76.0％ in the control group and the difference between the two groups was statistically significant (P<0.05). After treatment, the FS-14 scores of the two groups decreased, and the intra-group differences were statistically significant (both P<0.05). The change of FS-14 score after treatment in the treatment group was more significant than that in the control group (P<0.05). Conclusion: Tuina plus cupping is effective for CFS, and can improve fatigue symptoms significantly.

Preparation and Quality Evaluation of Gastric Floating Tablets of Schisandra chinensis Total Lignans / 中国药房

OBJECTIVE：To study the prepar ation technology of gastric floating tablets of Schisandra chinensis total lignans （SCTL），and evaluate the quality of prepared tablets. METHODS ：Based on single factor test ，the orthogonal experiment was conducted to optimize the formulation of SCTL gastric floating tablets with the contents of hydroxypropylmethylcellulose （HPMC） K15M，NaHCO3 and microcrystalline cellulose as the factors ，using starting time ，holding time and cumulative release rate of gastric floating tablets as evaluation indexes. The properties ，weight difference ，floatability and accumulative release rate of the prepared SCTL gastric floating tablets were determined. The gastric floating tablets were qualitatively identified by TLC ，and the contents of schisandrin A and total lignans were determined by HPLC and UV spectrophotometry. RESULTS ：The optimal formulation of SCTL gastric floating tablets was made up of 23％ SCTL extract ，20％ HPMC K 15M，40％ microcrystalline cellulose，15％ sodium bicarbonate ，1％ octadecyl alcohol and 1％ polyvinylpyrrolidone. The results of detection of this preparation were in line with the related provisions of “0101 tablet”stated in 2015 edition of Chinese Pharmacopoeia （part Ⅳ）. TLC indicated that the chromatogram of the test sample showed the main spots of same color as the corresponding positions of the chromatogram of schizandrol A control ，Schisandra chinensis reference substance and raw material ，while the negative control has no interference. Content determination results shows that the average content of schizandrol A and total lignans in SCTL gastric floating tablets is 3.187，19.617 mg. It was preliminarily formulated that the content limitation of schizandrol A in one tablet should not be less than 2.50 mg，and the content of total lignans （calculated by schizandrol A ）should not be less than 15.50 mg. CONCLUSIONS：The preparation technology of SCTL gastric floating tablets is stable ，feasible and controllable in quality.

Analysis on self-evaluation health management service capability of primary medical staff in Zhejiang′s county-level medical alliances / 中华医院管理杂志

Objective:To measure with Zhejiang province as an example the situation of the self-evaluation health management service capability of primary medical staff in county-level medical alliances.Methods:A self-evaluation scale for health management service capability by primary medical staff was customized, covering 5 dimensions of professional attitude, interpersonal communication ability, comprehensive knowledge integration ability, professional practice ability and professional development ability, as well as 29 items. In July-September 2019, medical alliances were selected from three counties/cities based on economic development as the survey targets, and a total of 264 primary medical staff were surveyed. Quantitative data were described in mean and standard deviation, while qualitative data were described in composition ratio, and the differences were compared by Kruskal-Willis test.Results:The self-evaluation scoring of health management service capability of the primary medical staff was (59.75±18.64) points, and the average scoring of the items was (2.06±0.64) points. The scoring of knowledge integration (1.98±0.70)and professional practical ability (2.03±0.67) were lower than the average scoring of the items; gender and occupation type of primary medical staff present statistical significances in the self-evaluation scoring of health management service capability.Conclusions:Given the health management service capabilities of primary medical staff, they still need to upgrade their knowledge integration and professional practice capabilities. County-level medical alliances should enhance their training of health management knowledge and skills, promote doctor-nurse collaboration in health management services to broaden the depth of primary health management services.

Evaluation and analysis on the degree of patients′ trust in community TCM physicians under the TCM service capability promotion program / 中华医院管理杂志

Objective:To evaluate the degree of trust of patients in community traditional Chinese medicine(TCM)physicians, based on the TCM service capability promotion program, and to analyze the impacts by TCM prevention and health care service.Methods:1 391 patients at 22 primary health service centers in 3 cities from Zhejiang province were investigated using the Chinese version of Wake Forest Physician Trust Scale(WFPTS)in September, 2017. Quantitative and qualitative variables were described by mean±SD, and ratio respectively. Differences were compared by t test, ANOVA and Kruskal-Wallis test. Results:Chinese version of WFPTS had good reliability and validity in measuring community TCM physicians. The average scoring of patients′ trust in community TCM physicians was 38.00±6.42, while their benevolence and competence were 19.14±3.41, 18.82±3.50 respectively.For patients with different demographic characteristics, their quantity and the way to acquire and utilize TCM prevention and health care service had different degrees of trust in community TCM physicians. Patients′ gender, age, awareness and utilization of TCM prevention and health care service, etc. affect the degree of trust in community TCM physicians.Conclusions:Patients have higher degree of trust in community TCM physicians, and improving the rate of awareness and utilization of TCM prevention has positive impacts on the degree of trust in these physicians. It is proposed that health knowledge education be strengthened and skills of community TCM physicians′ capacity be enhanced through various ways.

Application of a novel porous tantalum implant in rabbit anterior lumbar spine fusion model: in vitro and in vivo experiments / 中华医学杂志(英文版)

BACKGROUND@#Some porous materials have been developed to enhance biologic fusion of the implants to bone in spine fusion surgeries. However, there are several inherent limitations. In this study, a novel biomedical porous tantalum was applied to in vitro and in vivo experiments to test its biocompatibility and osteocompatibility.@*METHODS@#Bone marrow-derived mesenchymal stem cells (BMSCs) were cultured on porous tantalum implant. Scanning electron microscope (SEM) and Cell Counting Kit-8 assay were used to evaluate the cell toxicity and biocompatibility. Twenty-four rabbits were performed discectomy only (control group), discectomy with autologous bone implanted (autograft group), and discectomy with porous tantalum implanted (tantalum group) at 3 levels: L3-L4, L4-L5, and L5-L6 in random order. All the 24 rabbits were randomly sacrificed at the different post-operative times (2, 4, 6, and 12 months; n = 6 at each time point). Histologic examination and micro-computed tomography scans were done to evaluate the fusion process. Comparison of fusion index scores between groups was analyzed using one-way analysis of variance. Other comparisons of numerical variables between groups were made by Student t test.@*RESULTS@#All rabbits survived and recovered without any symptoms of nerve injury. Radiographic fusion index scores at 12 months post-operatively between autograft and tantalum groups showed no significant difference (2.89 ± 0.32 vs. 2.83 ± 0.38, F = 244.60, P = 0.709). Cell Counting Kit-8 assay showed no significant difference of absorbance values between the leaching liquor group and control group (1.25 ± 0.06 vs. 1.23 ± 0.04, t = -0.644, P = 0.545), which indicated the BMSC proliferation without toxicity. SEM images showed that these cells had irregular shapes with long spindles adhered to the surface of tantalum implant. No implant degradation, wear debris, or osteolysis was observed. Histologic results showed solid fusion in the porous tantalum and autologous bone implanted intervertebral spaces.@*CONCLUSION@#This novel porous tantalum implant showed a good biocompatibility and osteocompatibility, which could be a valid biomaterial for interbody fusion cages.

PET imaging on neurofunctional changes after optogenetic stimulation in a rat model of panic disorder / 医学前沿

Panic disorder (PD) is an acute paroxysmal anxiety disorder with poorly understood pathophysiology. The dorsal periaqueductal gray (dPAG) is involved in the genesis of PD. However, the downstream neurofunctional changes of the dPAG during panic attacks have yet to be evaluated in vivo. In this study, optogenetic stimulation to the dPAG was performed to induce panic-like behaviors, and in vivo positron emission tomography (PET) imaging with F-flurodeoxyglucose (F-FDG) was conducted to evaluate neurofunctional changes before and after the optogenetic stimulation. Compared with the baseline, post-optogenetic stimulation PET imaging demonstrated that the glucose metabolism significantly increased (P < 0.001) in dPAG, the cuneiform nucleus, the cerebellar lobule, the cingulate cortex, the alveus of the hippocampus, the primary visual cortex, the septohypothalamic nucleus, and the retrosplenial granular cortex but significantly decreased (P < 0.001) in the basal ganglia, the frontal cortex, the forceps minor corpus callosum, the primary somatosensory cortex, the primary motor cortex, the secondary visual cortex, and the dorsal lateral geniculate nucleus. Taken together, these data indicated that in vivo PET imaging can successfully detect downstream neurofunctional changes involved in the panic attacks after optogenetic stimulation to the dPAG.

The length of guide RNA and target DNA heteroduplex effects on CRISPR/Cas9 mediated genome editing efficiency in porcine cells

The clustered regularly interspaced short palindrome repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) system is a versatile genome editing tool with high efficiency. A guide sequence of 20 nucleotides (nt) is commonly used in application of CRISPR/Cas9; however, the relationship between the length of the guide sequence and the efficiency of CRISPR/Cas9 in porcine cells is still not clear. To illustrate this issue, guide RNAs of different lengths targeting the EGFP gene were designed. Specifically, guide RNAs of 17 nt or longer were sufficient to direct the Cas9 protein to cleave target DNA sequences, while 15 nt or shorter guide RNAs had loss-of-function. Full-length guide RNAs complemented with mismatches also showed loss-of-function. When the shortened guide RNA and target DNA heteroduplex (gRNA:DNA heteroduplex) was blocked by mismatch, the CRISPR/Cas9 would be interfered with. These results suggested the length of the gRNA:DNA heteroduplex was a key factor for maintaining high efficiency of the CRISPR/Cas9 system rather than weak bonding between shortened guide RNA and Cas9 in porcine cells.

Motor nerve conduction and clinical characteristics of POEMS syndrome / 中华神经科杂志

Objective@#To summarize the clinical characteristics and nerve conduction damage in patients with early POEMS syndrome, and to explore the value of segment nerve conduction velocity in the diagnosis of POEMS syndrome. @*Methods@#A total of 73 patients with POEMS syndrome and 27 healthy controls in Peking Union Medical College Hospital from September 2009 to June 2019 were recruited in this study. The motor and sensory nerve conduction characteristics of median, ulnar, tibial, and peroneal nerves and the clinical features of the participants were analyzed. The analysis parameters included: (1) distal motor latency (DML), compound muscle action potential (CMAP); (2) the median velocity from elbow to wrist, the median velocity from axillary to elbow, the ulnar velocity from the site below elbow to wrist, the ulnar velocity from the site above elbow to below elbow, the ulnar velocity from axillary to the site above elbow, the tibial velocity from ankle to knee, the peroneal velocity from ankle to fibulae capitulum; (3) sensory nerve conduction velocity and amplitude of these nerves; (4) terminal latency indices (TLI) of median; (5) motor nerve conduction blocks. @*Results@#Peripheral nerve damages were the initial symptoms in thirty-two patients in this group, accounting for 43.8% (32/73), and 81.3% (26/32) of these patients only showed numbness in lower extremities. All POEMS syndrome patients with numbness had abnormal sensory nerve conduction, and 9.5% (7/73) of patients without sensory symptoms also had abnormal sensory nerve conduction. On the other hand, the decrease of CMAP amplitude corresponded to clinical muscle strength decline and motor dysfunction. In the patients with POEMS syndrome, motor nerve conduction in the lower limbs were more likely to be affected and the damages were more severe than in the upper limbs: the proportion of CMAP disappearance in the lower limbs and upper limbs was 47.6% (112/235) vs 2.8% (7/252; χ2=133.698, P<0.01). Sensory nerve conduction damage was more severe than motor nerve conduction: the proportion of amplitude disappearance in sensory and motor conduction was 43.0% (141/328) vs 24.4% (119/487; χ2=133.698, P<0.01). The slowing of motor nerve conduction velocity was more common than the decrease of CMAP amplitude: the rate of slowing down of motor nerve conduction was 88.7% (432/487), and the rate of decrease of amplitude was 52.8% (257/487; χ2=151.905, P<0.01). The DML of median and ulnar nerve in the POEMS syndrome group was longer than that in the control group (median nerve: 4.4 (3.7, 5.0) ms vs 3.2 (3.0, 3.5) ms, U=854.000, P<0.01; ulnar nerve: 3.1 (2.7, 3.8) ms vs 2.5 (2.2, 2.7) ms, U=1 077.500, P<0.01). The TLI of median nerve in patients with POEMS syndrome was significantly higher than that of healthy controls (0.40±0.11 vs 0.35±0.06, t=3.466, P=0.001). There was no statistically significant difference in nerve conduction velocity between the forearm segment and the upper arm segment in the POEMS group. @*Conclusions@#Neurological damages were common in patients with POEMS syndrome with sensory nerve damage often being the initial clinical manifestation. In patients with POEMS syndrome, the nerve damage in the lower limbs was more severe than in the upper limbs, and sensory nerve damage was more severe than motor nerve damage. Segmental motor nerve conduction results suggested that demyelination damage occurred earlier than axonal damage, and proximal lesions were slightly heavier than distal lesions. No conduction block was detected in these patients. These characteristics of segmental nerve conduction can provide more evidence for clinical diagnosis of POEMS syndrome.

Effects of Xuesaitong Injection on expression of Lingo-1 in SH-SY5Y cells after oxygen and glucose deprivation / 中草药

Objective: To establish an oxygen and glucose deprivation model (OGD) of SH-SY5Y cells, and investigate the effects of Xuesaitong Injection on the cell survival, apoptosis rate of SH-SY5Y cells and the mRNA and protein expressions of Lingo-1. Methods: The model was established using 1640 sugar-free medium and three-gas incubator. The cell survival rate was determined by CCK8 method to determine the optimal time for hypoxia and the optimal concentration of Xuesaitong Injection. The apoptosis rate of SH-SY5Y cells was detected by Annexin V-FITC/PI double staining. The mRNA and protein expressions of Lingo-1 were determined by qRT-PCR and Western blotting, respectively, and the effect of Xuesaitong on Lingo-1 expression was finally determined. Results: In this study, the optimal hypoxia time for the establishment of the OGD model of SH-SY5Y cells was 16 h and the optimum concentration of Xuesaitong Injection was 640 mg/L. The apoptosis rate of SH-SY5Y cells was significantly reduced, and the expression levels of lingo-1 mRNA and protein were decreased in the Xuesaitong group compared with the model group under the condition of this concentration. Conclusion: The apoptosis rate was significantly increased and Lingo-1 was highly expressed when SH-SY5Y cells were damaged by oxygen and glucose deprivation. Xuesaitong can significantly reduce the apoptosis of SH-SY5Y cells induced by oxygen and glucose deprivation, and inhibit the high expression of lingo-1, which has the anti-apoptosis and significant neuroprotective effect.

Evaluation of photodynamic therapy based on indocyanine green angiography for circumscribed choroidal hemangioma / 中华实验眼科杂志

Objective To observe the efficacy of photodynamic therapy (PDT) based on indocyanine green angiography (ICGA) for circumscribed choroidal hemangioma (CCH).Methods A retrospective observational case series study was performed.Seventeen eyes of 17 patients were diagnosed with CCH and then underwent PDT based on ICGA image in Xuzhou Municipal Hospital from August,2010 to May,2018.The size of the treatment spot was decided according to ICGA images.The period of mean follow-up visit ranged from 6 to 36 months,with an average of (23.3± 1 1.8) months.Best corrected visual acuity (BCVA),sub-retinal fluid (SRF) and central retinal thickness (CRT) based on optical coherence tomography (OCT),the tumor diameter based on ICGA and the tumor thickness based on coloured doppler imaging (CDI) before and after treatment were analyzed.Results Sixteen cases received only one PDT session,one case had ever received PDT and another case had ever received focal laser photocoagulation.The mean BCVA (LogMAR) was 0.99±0.52,1.09±0.50,0.97±0.53,0.81±0.66,0.79±0.69,and the mean CRT was (440.76±281.34),(329.18± 175.02),(274.24± 169.55),(271.53 ± 150.00),(291.06 ± 201.41)μm before PDT,at 1 week,1 month,3 months and the last visit after treatment,with significant differences among the follow-up time (F =6.965,P =0.006;F =8.784,P =0.002).The decimal visual acuity was increased by at least 2 lines in 9 eyes (52.9％),fluctuated within 2 lines in 7 eyes (41.2％),while decreased by at least 2 lines in one eye (5.9％).SRF of all patients was involved in macular area.The absolute absorption of SRF was found in 7 eyes (41.2％) and partial absorption in 8 eyes (47.1％) at 3 months follow-up visit.In the last follow-up visit,the absolute absorption of SRF was found in 12 eyes (70.6％),partial absorption was found in 3 eyes (17.6％) and 2 eyes (11.8％) underwent no change.On FFA and ICGA,the decrease of tumor size was found in 15 patients,while the others underwent no change.All patients underwent less enhanced hyperfluorescent after treatment.The mean tumor height was (3.80± 1.13)mm before PDT and (3.42± 1.14)mm on the last visit,with a significant difference between them (t=4.101,P=0.010).Conclusions PDT with verteporfin for CCH can promote the improvement of visual acuity,the absorption of SRF,the anatomical reposition of the retina and the decrease of tumor size.The majority of patients can get therapeutic effect after one PDT session.