Combining biofeedback based on virtual reality technology with transcranial magnetic stimulation aids the recovery of dysphagic stroke survivors / 中华物理医学与康复杂志

Objective:To observe the effect of combining biofeedback therapy (BFT) based on virtual reality technology with repeated transcranial magnetic stimulation (rTMS) on dysphagia among stroke survivors.Methods:Eighty patients were randomly divided into a control group, an rTMS group, a BFT group and a combined treatment group, each of 20. In addition to routine dysphagia rehabilitation, the rTMS and BFT groups were given those treatments, while the combined treatment group was given both for 4 weeks. Swallowing function was evaluated before and after the treatment using the standardized swallowing assessment (SSA) and the functional oral intake scale (FOIS). Videofluoroscopy was used to quantify the subjects′ oral and pharyngeal phases and their aspiration status.Results:Significant improvement was observed in the average FOIS and SSA scores, as well as in the average oral and pharyngeal phases and in aspiration. The combined treatment group′s results were significantly better in all those aspects than those of the other 3 groups.Conclusion:The combined application of biofeedback therapy based on virtual reality technology and repeated transcranial magnetic stimulation can improve the swallowing function of stroke survivors with dysphagia. It is worthy of clinical promotion.

High-level soluble expression of phospholipase D from Streptomyces chromofuscus in Escherichia coli by combinatorial optimization

BACKGROUND: Phospholipase D (PLD) is used as the biocatalyst for phosphatidylserine (PS) production. In general, PLD was expressed in insoluble form in Escherichia coli. High-level soluble expression of PLD with high activity in E. coli is very important for industrial production of PLD. RESULTS: Streptomyces chromofuscus PLD coding gene was codon-optimized, cloned without signal peptide, and expressed in E. coli. The optimal recombinant E. coli pET-28a+PLD/BL21(DE3) was constructed with pET-28a without His-tag. The highest PLD activity reached 104.28 ± 2.67 U/mL in a 250-mL shake flask after systematical optimization. The highest PLD activity elevated to 122.94 ± 1.49 U/mL by feeding lactose and inducing at 20 C after scaling up to a 5.0-L fermenter. Substituting the mixed carbon source with 1.0 % (w/v) of cheap dextrin and adding a feeding medium could still attain a PLD activity of 105. 81 ± 2.72 U/mL in a 5.0-L fermenter. Fish peptone from the waste of fish processing and dextrin from the starch are both very cheap, which were found to benefit the soluble PLD expression. CONCLUSIONS: After combinatorial optimization, the high-level soluble expression of PLD was fulfilled in E. coli. The high PLD activity along with cheap medium obtained at the fermenter level can completely meet the requirements of industrial production of PLD.

Construction and identification of recombinant adenovirus vector and observation of its transfecting rabbit bone marrow mesenchymal stem cells / 中国骨伤

OBJECTIVE@#To construct and identify adenovirus vector co-expressing hBMP2 and hVEGF165 fusion protein which labeled with green fluorescence protein, and laying the foundtion of the effect of hBMP2 and hVEGF165 gene inducing BMMSCs differentiation to osteoblast and bone defect repaired in the body.@*METHODS@#BMP2 and VEGF165 gene was amplified from cDNA library by PCR and inserted to the polyclonal site of adenovirus shuttle plasmid pAd-MCMV-GFP. Ad-BMP2- VEGF165 was recombinated and propagated in HEK293 cells by co-transfecting with the constructed recombinant shuttle plasmid pAd-MCMV-BMP2-VEGF165 and adenovirus helper plasmid pBHGloxΔ E1, 3Cre. The recombinant adenovirus was purified and virustiter was determined, and then to research GFP expression and to calculate the adenovirus transfection rate in rabbit BMMSCs.@*RESULTS@#The recombinant adenovirus vector Ad-BMP2-VEGF165 was successfully constructed by the methods of gene analyzing, colony PCR, Western blotting and observing GFP expression, and the titer of the adenovirus was 1×10@*CONCLUSION@#Recombinant adenovirus vector containing hBMP2 and hVEGF165 gene was successfully constructed and its high titer was obtained.

Expression of plasma Dickkopf-1 in patients with rheumatoid arthritis and its correlation with peripheral blood T cell subsets / 北京大学学报(医学版)

OBJECTIVE@#To detect the levels of Dickkopf-1 (DKK-1) in the plasma of patients with rheumatoid arthritis (RA), and to analyze their correlation with peripheral blood T cell subsets and clinical indicators.@*METHODS@#Enzyme-linked immunosorbent assay (ELISA) was used to detect plasma DKK-1 levels in 32 RA patients and 20 healthy controls, and to record the various clinical manifestations and laboratory indicators of the RA patients, and flow cytometry to detect peripheral blood T cell subsets in the RA patients (Including Treg, nTreg, aTreg, sTreg, Teff, Tfh, CD4+CD161+T, CD8+T, CD8+CD161+T cells). The plasma DKK-1 levels between the two groups were ompared, and its correlation with peripheral blood T cell subsets and clinical indicators analyzed.@*RESULTS@#(1) The plasma DKK-1 concentration of the RA patients was (124.97±64.98) ng/L. The plasma DKK-1 concentration of the healthy control group was (84.95±13.74) ng/L. The plasma DKK-1 level of the RA patients was significantly higher than that of the healthy control group (P < 0.05), and the percentage of CD8+CD161+T cells in the peripheral blood of the RA patients was significantly higher than that of the healthy control group (P < 0.05). (2) The plasma DKK-1 level was positively correlated with erythrocyte sedimentation rate (r=0.406, P=0.021), DAS28 score (r=0.372, P=0.036), immunoglobulin G(r=0.362, P=0.042), immunoglobulin A(r=0.377, P=0.033); it had no correlation with age, course of disease, C-reactive protein, rheumatoid factor, anti-cyclic citrullinated peptide antibody, immunoglobulin M, complement C3, complement C4, white blood cell, neutrophil ratio. (3) The plasma DKK-1 level in the RA patients was positively correlated with the percentage of peripheral blood CD161+CD8+T cells (r=0.413, P=0.019);it had no correlation with Treg, nTreg, aTreg, sTreg, Teff, Tfh, CD4+CD161+T, CD8+T cells. (4) The percentage of CD161+CD8+T cells was negatively correlated with erythrocyte sedimentation rate (r=-0.415, P=0.004), C-reactive protein (r=-0.393, P=0.007), DAS28 score(r=-0.392, P=0.007), rheumatoid factor (r=-0.535, P < 0.001), anti-citrullinated protein antibody (r=-0.589, P < 0.001), immunoglobulin G(r=-0.368, P=0.012) immunoglobulin M (r=-0.311, P=0.035); it had no correlation with age, disease course, immunoglobulin A, complement C3, complement C4, white blood cell, and neutrophil ratio.@*CONCLUSION@#RA patients' plasma DKK-1 levels and the percentage of CD8+CD161+T cells in T cell subsets in peripheral blood increase, which may be related to the secretion of proinflammatory cytokines in patients; DKK-1 is involved in the regulation of bone homeostasis and can be used as a marker of bone destruction in RA.

Detection and evaluation of SARS-CoV-2 nucleic acid contamination in corona virus disease 19 ward surroundings and the surface of medical staff's protective equipment / 北京大学学报(医学版)

OBJECTIVE@#To determine the environmental contamination degree of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in corona virus disease 2019 (COVID-19) wards, to offer gui-dance for the infection control and to improve safety practices for medical staff, by sampling and detecting SARS-CoV-2 nucleic acid from the air of hospital wards, the high-frequency contact surfaces in the contaminated area and the surfaces of medical staff's protective equipment in a COVID-19 designated hospital in Wuhan, China.@*METHODS@#From March 11 to March 19, 2020, we collected air samples from the clean area, the buffer room and the contaminated area respectively in the COVID-19 wards using a portable bioaerosol concentrator WA-15. And sterile premoistened swabs were used to sample the high-frequency contacted surfaces in the contaminated area and the surfaces of medical staff's protective equipment including outermost gloves, tracheotomy operator's positive pressure respiratory protective hood and isolation clothing. The SARS-CoV-2 nucleic acid of the samples were detected by real-time fluorescence quantitative PCR. During the isolation medical observation period, those medical staff who worked in the COVID-19 wards were detected for SARS-CoV-2 nucleic acid with oropharyngeal swabs, IgM and IgG antibody in the sera, and chest CT scans to confirm the infection status of COVID-19.@*RESULTS@#No SARS-CoV-2 nucleic acid was detected in the tested samples, including the 90 air samples from the COVID-19 wards including clean area, buffer room and contaminated area, the 38 high-frequency contact surfaces samples of the contaminated area and 16 surface samples of medical staff's protective equipment including outermost gloves and isolation clothing. Moreover, detection of SARS-CoV-2 nucleic acid by oropharyngeal swabs and IgM, IgG antibodies in the sera of all the health-care workers who participated in the treatment for COVID-19 were all negative. Besides, no chest CT scan images of medical staff exhibited COVID-19 lung presentations.@*CONCLUSION@#Good ventilation conditions, strict disinfection of environmental facilities in hospital wards, guidance for correct habits in patients, and strict hand hygiene during medical staff are important to reduce the formation of viral aerosols, cut down the aerosol load, and avoid cross-infection in isolation wards. In the face of infectious diseases that were not fully mastered but ma-naged as class A, it is safe for medical personnel to be equipped at a high level.

Progress of researches on the use of ultrasound in the diagnosis and treatment of hepatic alveolar echinococcosis / 中国血吸虫病防治杂志

The patients with hepatic alveolar echinococcosis have unapparent early symptoms due to invasive and slow growth, and the disease is usually at an advanced stage upon diagnosis, which has a poor prognosis. Early diagnosis of hepatic alveolar echinococcosis is therefore of great importance. The advances in the ultrasound techniques continues to improve the accuracy for the diagnosis of hepatic alveolar echinococcosis, and ultrasound plays a critical role in the treatment and assessment of therapeutic efficacy for hepatic alveolar echinococcosis. This paper mainly reviews the application of ultrasound in the diagnosis and treatment of hepatic alveolar echinococcosis.

Intervention with thumbtack needling on spinal low back pain in Air Force crew: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect on spinal low back pain (SLBP) in Air Force crew treated with novel thumbtack needling therapy and to analyze the relevant factors of the therapeutic effect.@*METHODS@#A total of 120 Air Force crew with SLBP were randomized into a thumbtack needling group (40 cases), an external treatment group (40 cases, 1 case dropped off ) and a combined treatment group (40 cases, 1 case dropped off ). In the thumbtack needling group, the thumbtack needling therapy was adopted. The novel thumbtack needles were inserted at the lower No.6 region of the wrist-ankle acupuncture, Yaotongdian (EX-UE 7), Yaoyangguan (GV 3), etc. Each point was pressed and kneaded for 1 min each time, 3 or 4 times a day. The treatment for 3 days was taken as one course. At the interval of 2 days, 3 courses were required totally. In the external treatment group, @*RESULTS@#Compared with the values before treatment, McGill scores and ODI scores were reduced (@*CONCLUSION@#The thumbtack needling therapy is significantly effective on spinal low back pain in Air Force crew and is of the safety. Hence, this therapy is applicable to be promoted in the primary care army hospital.

Knowledge, behavior and psychological status regarding COVID-19 in elementary and secondary school teachers / 上海预防医学

Objective To evaluate the knowledge, behavior and psychological status regarding COVID-19 epidemic in elementary and secondary school teachers, and to provide a reference for disease prevention and control at schools as well as for preparation of school returning. Methods A survey in 2 338 teachers was conducted using self-designed questionnaires about COVID-19. Results The overall awareness rate of COVID-19 knowledge was 88.79%, knowledge score was 10.65±1.09, and the school health teachers had higher score than other school staff (F＝23.87, P=0.000 1).Respondents with IP address in Hubei had higher score than those in Jiangsu, Zhejiang and Shanghai(F＝10.69, P=0.014).The top three knowledge resources were news apps (Toutiao, Tencent) (87.25%), WeChat (78.06%) and telecast (74.94%).The overall healthy behavior score was 43.59±3.12, and school doctors again had higher score than other school staff (F=11.48, P=0.02).Respondents with IP address in Hubei had higher score than those in Jiangsu, Zhejiang and Shanghai (F=17.08, P=0.000 7). During the epidemic, 100% respondents wore masks when taking public transportation, the highest rate of wearing masks, while 90.93% wore masks at family and friends gathering, the lowest rate of wearing masks.The top three types of masks being used were disposable medical masks (89.14%), surgical masks (43.63%) and N95 medical protective masks (34.09%).The highest rate of hand washing behavior was 99.83% for washing hands after going to toilet, while the lowest was 75.92% for washing hands after touching hair, ears and nose.The highest rate of other healthy behaviors was 94.14% for reducing family and friend gatherings, while the lowest was 71.60% for covering mouth and nose when sneezing or coughing. The correlation between health behavior and knowledge was statistically significant (r=0.081, P < 0.001).Correlation analysis showed that the degree of concern was related to the degree of teaching influence (r=0.768, P=0.0002), and the degree of anxiety was related to the degree of teaching influence (r=0.175, P < 0.001), while there was no correlation between the degree of concern and the degree of anxiety. Conclusion Elementary and secondary school teachers generally have high score in the COVID-19 knowledge test, and behaved well in wearing masks.Hand hygiene education should be further improved.There are concerns about the impact of COVID-19 epidemic on teaching.

miR-124a inhibited cell proliferation, migration and invasion of rheumatoid arthritis synovial fibro-blasts by tar-geting AKT2 gene / 中华风湿病学杂志

Objective@#To investigate the effects of miR-124a on proliferation, migration and invasion in rheumatoid arthritis synovial fibroblasts (RASFs) and the underlying mechanisms.@*Methods@#RASFs were isolated and cultured from synovial tissue, then qRT-PCR was used to detect the levels of AKT2 mRNA and miR-124a in RASFs. Western blot was applied to determin the expression level of AKT2 protein. RASFs were transfected with miR-124a, anti-miR-124a, si-AKT2 or pcDNA-AKT2 to up-regulate or down-regulate the expression level of miR-124a or AKT2 protein. The cells were divided into normal group of normal synovial tissue, control NC group, miR-con group, miR-124a group, si-con group, si-AKT2 group, miR-124a+pcDNA group and miR-124a+pcDNA-AKT2 group. MTT assay was carried out to measure the proliferation of RASFs. Transwell assay was carried out to detect the migration and invasion cell number of RASFs. Dual-luciferase reporter assay system was implemented to verify the relationship between miR-124a and AKT2. Independent sample t-test and one way analysis of variance (ANOVA) test (square deviation) were used for statistical analysis.@*Results@#① Compared with normal group, the expression of miR-124a (0.92±0.19) decreased significantly (t=5.788, P<0.01), AKT2 mRNA (3.15±0.63) increased significantly (t=-3.486, P=0.025), AKT2 protein (2.09±0.64) increased significantly (t=-2.959, P=0.042). ② Ccompared with NC group and miR-con group, miR-124a expression (4.17±0.46) increased significantly (F=131.830, P<0.01), migration cell number (34±6) decreased significantly, invasion cell number (14.5±3.1) decreased significantly (F1=35.788, F2=27.211, P<0.01). ③ Compared with mir-con group (1.02±0.18), WT-AKT2 in miR-124a group showed a significant decrease in its relative activity (0.31±0.11) (t=5.830, P<0.01). ④ Compared with NC group and si-con group, the expression of AKT2 protein (0.97±0.03) in si-AKT2 group decreased significantly (F=128.056, P<0.01), the number of migrating cells (32±4), and the number of invasive cells (18.6±2.2) (F1=-70.082, F2=36.524, P<0.01) were decreased significantly. ⑤ Compared with miR-con group, AKT2 protein expression in miR-124a group decreased significantly (0.21±0.03); compared with miR-124a+pcDNA group, AKT2 protein expression in miR-124a+pcDNA-AKT2 group was increased significantly (F=52.487, P<0.01). ⑥ Compared with miR-con group, the number of RASFs migrating cells (30±5) and invasive cells (12.5±1.8) in miR-124a group were significantly decreased; compared with miR-124a+pcDNA group, the number of RASFs migrating cells (71±4) and invasive cells (26.4±4.5) in miR-124a+pcDNA-AKT2 group were significantly increased (F1=30.957, F2=49.960, P<0.01).@*Conclusion@#MiR-124a can inhibite the proliferation, migration and invasion of RASFs by targeting AKT2 gene. MiR-124a is expected as a molecular target for diagnosis and treatment of rheumatoid arthritis.

Tooth loss and multivariable analysis after 5-year non-surgical periodontal treatment on molars with furcation involvement / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the tooth loss status of mandibular molars with furcation involvements after 5-year non-surgical periodontal treatment, and to analyze the factors that affected the tooth loss.@*METHODS@#A retrospective analysis was conducted in 79 patients with chronic periodontitis, who had received non-surgical periodontal treatment and 5 years of periodontal maintenance treatment in Department of Periodontology, Peking University School and Hospital of Stomatology from 1988 to 2012. Their clinical indexes, including probing depth (PD), bleeding index (BI), furcation index (FI) and tooth mobility were both evaluated before treatment and at the last time of the maintenance treatment. Bone resorption at furcation area was measured at the first visit by periapical radiographs taken by professional doctors of medical imaging. The status of tooth loss after 5-year non-surgical periodontal treatment on mandibular molars with furcation involvement, and the factors that affected the tooth loss were analyzed.@*RESULTS@#(1) Non-surgical treatment was significantly effective on the changes of PD in the patients of chronic periodontitis with furcation involvement, while the presence of furcation involvement could affect the improvement of PD here. (2) PD at the furcation area, tooth mobility, vertical bone resorption, and bone resorption area were all significant risk factors of mandibular molar missing (P<0.001), and the same with FI=3 and FI=4 (P=0.017, P=0.007), while age (P=0.703), gender (P=0.243) and smoking history (P=0.895) were not related to the tooth loss in this study. (3) The risk of tooth loss in mandibular molars with FI≥3 were significantly higher than those with FI≤2, and the survival rate of the former was less than 50%.@*CONCLUSION@#The loss of mandibular molars with furcation involvement was related to the furcation involvement, meanwhile the degree of furcation involvement and bone resorption can significantly increase the risk of tooth loss.

Effects of zinc gluconate carbon dots in cell imaging and inducing osteoblastic differentiation in vitro / 吉林大学学报(医学版)

Objective: To synthesize the zinc gluconate carbon dots (Zn-CDs) by one-step hydrothermal method, and to investigate their effects on the cell imaging and inducing osteoblastic differentiation of preosteoblasts in the mice. Methods: The Zn-CDs were synthesized by one-step hydrothermal method, and the characteristics were observed and detected by transmission electron microscope (TEM), Fourier transform-infrared spectrum (FT-IR) and fluorescence spectrometer. The MC3T3-E1 cells were divided into blank control group and experimental groups; different concentrations (0.01, 0.10, 1.00, 10.00, 100.00, 1 000 mg middot; L-1) of Zn-CDs were added into the cells in experimental groups, and nothing was added into the cells in blank control group. MTT assay was used to determin the relative growth rate (RGR) of MC3T3-E1 cells in various groups; the imaging characteristics of MC3T3-E1 cells were observed under confocal microscope; the relative expression levels of Runt-relateed transcription factor-2 (Runx2), alkaline phosphatase (ALP) and osteocalcin (OC) mRNA in the MC3T3-E1 cells in various groups were detected by qRT-PCR; the number of calcified nodules was detected by alizarin red staining. Results: The TEM results showed that the particle size of Zn-CDs was about 5. 25 nm. The fluorescence spectrometer results showed that the Zn-CDs had the fluorescence properties of 360 nm ultraviolet excited light and 450 nm blue emission light, and the Zn-CDs showed the characteristics of excitation wavelength dependence. The FT-IR results showed that the surface of Zn-CDs was mainly composed of carboxyl groups and hydroxyl groups. Compared with blank control group, the RGR of MC3T3-E1 cells in 1 000. 00 mg middot; L-1 Zn-CDs group was decreased significantly at 24 h after co-culture (P<0. 01). The results of fluorescence imaging showed that the blue, green and red fluorescence in the MC3T3-E1 cells, the outline was clear, and the fluorescence intensity of the cytoplasm was stronger than that of the nucleus after co-cultured with Zn-CDs. The qRT-PCR results showed that the relative expression levels of Runx2, ALP and OC mRNA were significantly increased with the increasing of Zn-CDs concentration. The alizarin red staining results showed that the number of calcium deposits in the MC3T3-E1 cells in different concentrations of Zn-CDs groups were more than that in blank control group after induced for 21 d. Conclusion: Zn-CDs can effectively perform the fluorescence imaging in the MC3T3-E1 cells, and Zn-CDs have a certain ability to promote the osteoblastic differentiation of the MC3T3-E1 cells.

Clinical significance of detection of soluble interleukin 2 receptor alpha chain in the assessment of rheumatoid arthritis disease activity / 北京大学学报(医学版)

OBJECTIVE@#To evaluate soluble interleukin-2 receptor alpha chain (sIL-2Rα, sCD25) in serum for the determination of rheumatoid arthritis (RA) activity.@*METHODS@#Peripheral blood was collected from 108 patients with RA, 39 patients with osteoarthritis (OA) and 50 healthy control subjects, and synovial fluids were from 40 patients with RA. The sera from the patients with RA, the disease control group (osteoarthritis), the healthy control group, and the synovial fluids of the RA patients were detected by enzyme-linked immunosorbent assay (ELISA).The clinical manifestations and laboratory parameters of the patients with RA were recorded and the correlation with the serum sCD25 level was analyzed.@*RESULTS@#The serum sCD25 concentration in RA group was (2 886±1 333) ng/L, the serum sCD25 concentration in OA group was (2 090±718) ng/L, and the serum sCD25 concentration in healthy group was (1 768±753) ng/L. The serum sCD25 level in the patients with RA was significantly higher than that in the disease controls and healthy controls (P<0.001). Sensitivity of serum sCD25 in the diagnosis of RA was 66.1% and specificity was 83.0%;serum sCD25 levels and erythrocyte sedimentation rate (r=0.321, P=0.001), C-reactive protein (r=0.446, P<0.001), DAS28 score (r=0.324, P<0.001), joint tenderness count (r=0.203, P=0.024), D-dimer levels (r=0.383, P<0.001), age (r=0.24, P=0.007), IgG (r=0.207, P=0.028), HRF-IgG (r=0.345, P=0.034) showed a significant positive correlation, and disease duration (r=-0.206, P=0.021) showed a negative correlation with sCD25;In patients with rheumatoid arthritis, the positive rates of serum ESR, CRP, and sCD25 were 14.3% (2 cases), 14.3% (2 cases), and 71.4% (10 cases) in the low disease activity group. The positive rates of serum ESR, CRP and sCD25 in the moderate disease activity group were 94.2% (49 cases), 82.7% (43 cases), and 86.5% (45 cases). The positive rates of serum ESR, CRP, and sCD25 in the high disease activity group were 100% (42 cases), 95.2% (40 cases), and 90.5% (38 cases);36 cases of ESR and/or CRP were negative (about 33.3%) in 108 patients, serum sCD5 levels of 17 cases in these 36 cases (about 47.2%)increased, of which 14 cases (about 82.4%) had a DAS28 score higher than 3.2.@*CONCLUSION@#The serum sCD25 has a high specificity for diagnosis of RA and a poor sensitivity. The serum level is closely related to the activity of RA, indicating that sCD25 may be involved in the inflammatory process of RA and may become a new inflammatory marker of RA. It is more meaningful for detection of serum sCD25 when RA is active, but ESR and/or CRP is negative.

Study on Efficacy of Shunwei Jiangni Fang in Treating the Recurrent Reflux Esophagitis / 世界科学技术-中医药现代化

Objective: To evaluate the clinical efficacy and long-term efficacy of Shunwei Jiangni Fang in treating the liver- spleen- stomach disharmony and cold- dampness- heat recurrent reflux esophagitis. Methods: A total of 100 recurrent RE patients were divided into treatment group and control group by the random and control principle, with 50 cases in each group. Patients of 2 groups were treated with Shunwei Jiangni Fang and pantoprazole sodium entericcoated capsules respectively for 8 weeks. By comparing TCM syndrome scores and esophagus 24 h- pH parameters improvement, the clinical efficacy and safety of Shunwei Jiangni Fang in treating the liver-spleen-stomach disharmony and cold-dampness-heat recurrent reflux esophagitis, and perform statistics on the recurrence 6 months after treatment ending were evaluated. Results: ① For the patients with TCM syndromes in the treatment group, 4 cases were recovered, 17 cases were improved, 22 cases were effective, and the total effective rate was 86％; for the patients with TCM syndromes in the control group, 2 cases were recovered, 8 cases were improved, 14 cases were effective, and total effective rate was 48％. Difference of total effective rate for 2 groups was significant (P ＜ 0.05). The heartburn, belching, dry mouth, bitter taste, tiredness, distended abdomen and sticky stool in treatment group were more improved than those of control group (P ＜ 0.05); ② In the control group, the patient's 24 h-pH parameters could be improved, especially, the 24h gastric reflux times and times of reflux ＞ 5min could be reduced more than the control group, and difference was significant (P ＜ 0.05). ③ The treatment group was able to improve the patients' esophageal mucosal inflammation, with no statistically significant difference from the control group (P ＞ 0.05). ④ At 6 months after treatment, the recurrence rate of treatment group and control group was 6.0％ and 28％ respectively, and difference was significant (P ＜ 0.05). Conclusions: Shunwei Jiangni Fang can treat the liver-spleen-stomach disharmony and cold-dampness-heat recurrent reflux esophagitis, with apparently efficacy. It can effectively improve the clinical symptoms, reduce the reflux occurrence times, reduce esophageal mucosal inflammation, lower the recurrence rate, prevent apparent adverse reactions, thus, it shall be widely promoted.

Research progress of microglia-P2X4 receptor in neuropathic pain / 医学研究生学报

Neuropathic pain is a typical chronic pain that has a great impact on the psychology and physiology of patients. Recent studies have shown that spinal microglial activation and the up-regulated expression of P2X4 receptor on its surface were occured after peripheral nerve injury. P2X4 receptor is an ionic subtype of ATP receptor, and was regulated by various factors under pathological conditions of nerve injury, such as chemokines, extracellular matrix fibronectin and interferon regulatory factor 5. Inhibition of microglial activation and P2X4 receptor expression can reduce neuropathic pain. Therefore, this article mainly describes the research progress of P2X4 receptor in the pathogenesis of neuropathic pain.

Maxillary first premolar with four canals: a case report / 华西口腔医学杂志

This article presented a case of discovering and diagnosing three roots with four canals of the maxillary first premolar. We found and located the extra root canal by clinical diagnosis, careful observation during the operation, and multiangle X-ray. We further confirmed the existence of the three roots with four canals with the help of cone-beam computed tomography. Finally, we verified the success of the high-quality root-canal therapy through root optical microscopy.

The clinical significance of thrombospondin-1 in systemic lupus erythematosus / 中华风湿病学杂志

Objective To evaluate the clinical significance of serum thrombospondin-1 (TSP-1) in systemic lupus erythematosus (SLE), and explore its possible involvement in SLE pathogenesis. Methods One hundred and thirty-eight patients diagnosed with SLE, including 124 cases of females and 14 males, as well as 60 healthy controls were recruited into this study. Enzyme-linked immunosorbent assay (ELISA) was used to determine serum TSP-1 expression level between the two groups. Spearman correlation analysis method was used to analyze the correlation between TSP-1 level of complement 3, complement 4, anti-double-stranded DNA, Rheumatoid factor and systemic lupus erythematosus disease activity index (SLEDAI). Results TSP-1 level in healthy control group was much higher than that in SLE patients. TSP-1 serum levels in SLE patients was positively correlated with complement 3 (r=0.386, P<0.01), complement 4 (r=0.301, P<0.01), and negatively correlated with anti-double-stranded DNA (r=-0.221, P=0.009), RF (r=-0.186, P=0.029) and SLEDAI (r=-0.273, P=0.001). Conclusion TSP-1 may play an immune-regulatory role in the development of SLE by inhibiting inflammation and autoantibody production. It could become a potential therapeutic target for the treatment of SLE.

The clinical significance of thrombospondin-1 in systemic lupus erythematosus / 中华风湿病学杂志

Objective To evaluate the clinical significance of serum thrombospondin-1 (TSP-1) in systemic lupus erythematosus (SLE), and explore its possible involvement in SLE pathogenesis. Methods One hundred and thirty-eight patients diagnosed with SLE, including 124 cases of females and 14 males, as well as 60 healthy controls were recruited into this study. Enzyme-linked immunosorbent assay (ELISA) was used to determine serum TSP-1 expression level between the two groups. Spearman correlation analysis method was used to analyze the correlation between TSP-1 level of complement 3, complement 4, anti-double-stranded DNA, Rheumatoid factor and systemic lupus erythematosus disease activity index (SLEDAI). Results TSP-1 level in healthy control group was much higher than that in SLE patients. TSP-1 serum levels in SLE patients was positively correlated with complement 3 (r=0.386, P<0.01), complement 4 (r=0.301, P<0.01), and negatively correlated with anti-double-stranded DNA (r=-0.221, P=0.009), RF (r=-0.186, P=0.029) and SLEDAI (r=-0.273, P=0.001). Conclusion TSP-1 may play an immune-regulatory role in the development of SLE by inhibiting inflammation and autoantibody production. It could become a potential therapeutic target for the treatment of SLE.

Effect of different heights of artificial cervical disc replacement on the range of motion of the treated segment / 中华骨科杂志

Objective To cxplore the variation of the range of motion (ROM) of operative level after different heights of artificial cervical disc replacement,and to provide guidance for clinical work in selecting appropriate height of artificial cervical disc prosthesis.Methods The preoperative cervical anteroposterior and lateral Ⅹ-rays of 9 fresh male cadaveric cervical spine specimens were obtained to measure the intervertebral height of C5-6,and 3 screened specimens with the height of about 5 mm were included in the experiment.The experiment was designed to test self-control,and other four groups of cervical specimens including intact group,appropriate height (5 mm) of C5.6 artificial cervical disc replacement group,1mm increased (6 mm) group and 2 mm increased (7 mm) group were made biomechanical test sequentially.The specimens were fixed to the cervical three-dimensional movement machine,with a 75 N follower load and pure moments of 2 Nm for flexion/extension 、left/right bending and left/right axial rotation,to measure the ROM of operative level under the condition of changes in 0.2 Nm/s.Results There were no significant differences in the ROM of flexion/extension,lateral bending and axial rotation between 5 mm group and intact group;the ROM of flexion/extension、lateral bending and axial rotation in 6 mm group increased compared with 5 mm group,but the difference was not statistically significant;the ROM of flexion/extension in 7 mm group was significantly less than that of intact,5mm and 6 mm group (9.5°± 1.0° vs 12.5°±0.9°、11.3°±0.8°、11.6°±0.9°),but significantly greater in axial rotation than 6 mm group (10.4°±1.4°vs 8.6°±0.3°),and there was no significant difference in lateral bending compared with other 3 groups.Conclusion 2 adjacent heights of cervical disc prostheses are implantedsuitably when testing the mold of disc prosthesis,the choice of cervical disc prosthesis with 1 mm increased can improve the ROM of operative level to some extent;while the height with 2 mm increased can lead to the ROM of flexion/extension at the operative level reduced,but the ROM of rotation shows an increasing trend.

The Role of PDCA Cycle Management in Standardizing Clinical Application of Atomization Inhalation Drugs / 中国药房

OBJECTIVE:To evaluate the role of PDCA cycle management on standardizing clinical use of atomization inhala-tion drug. METHODS:Using a retrospective method,300 medical records of atomization inhalation drug use were collected from our hospital during Jan.-Dec. in 2013(non-intervention group),200 medical records collected during Apr.-Jun. in 2014(one cycle intervention group),and 180 medical records collected during Oct.-Dec. in 2014(two rounds of cycle intervention group). The use of atomization inhalation drugs was compared before and after the application of PDCA cycle management. Before and after two cy-cle intervention,4 types of medical staff were investigated on cognition of the related knowledge of atomization inhalation drugs, as physicians,pharmacists,nurses and mechanic. RESULTS:After two rounds of PDCA cycle management and intervention,the proportion of unsuitable route of administration of antibiotics,long acting glucocorticoid,non-atomization inhalation dosage form of resolving phlegm drugs,protease decreased from 54.0%,62.0%,59.7%,44.7% before intervention to 0.6%,1.1%,15.0%, 1.1% after intervention;those phenomena had not been found,such as unsuitable route of administration of TCM injection and non-atomization dosage form of theophyllines,unsuitable atomization frequence,unsuitable indication,drug mixture for preventing and controlling symptom,etc. The proportion of medical staffs being familiar with medical device,drug classification,drug selec-tion for prerention and treatment and the proportion of hospital drug stock to 93.4%,86.7%,92.4%,96.2% after intervention from 38.0%,79.0%,49.0%,39.5%before intervention. CONCLUSIONS:The application of PDCA cycle management can effec-tively regulate the use of atomization inhalation drugs in our hospital;the method can be promoted and applied.

Subtype analysis and clinical significance of HPV infection in laryngeal squamous cell carcinoma and precancerous lesions / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the correlation of laryngeal squamous cell carcinoma (LSCC) and precancerous lesion with HPV infection subtypes and possible clinical relationship.@*METHOD@#Eighty-three cases in paraffin embedded tissues were detected with thirty seven HPV subtypes by flow-through hybridization and gene chip (HybriMax), including 31 cases of laryngeal squamous cell carcinoma, 52 cases of precancerous lesions (29 cases of vocal cord leukoplakia and 23 cases of laryngeal papilloma), and 36 cases of vocal cord polyp as normal vocal mucosa were used as control.@*RESULT@#The total positive rate of HPV was 19.4% in the group of laryngeal squamous cell carcinoma (6/31), 0 in vocal cord leukoplakia, 65.2% in laryngeal papilloma (15/23), and the control group were all negative, HPV virus subtype of HPV-positive laryngeal squamous cell carcinoma were all high-risk HPV16; and there were 6 HPV virus subtypes in laryngeal papilloma (8: HPV6,4: HPV52, 1: HPV11, 1: HPV18, 2: HPV45, 3: HPV16), individual mixing two or more subtypes infection. HPV infection of laryngeal squamous cell carcinoma and precancerous lesions has no statistically significant difference according to gender, high low-risk subtypes.@*CONCLUSION@#HPV infection related to laryngeal squamous cell carcinoma and precancerous lesions, but no significant correlation with the subtype distribution of high and low risk; HPV detection is making positive sense to clinical diagnosis of laryngeal carcinoma and precancerous lesions as well as the development of specific HPV subtype vaccine.