Early diagnosis of diabetic neuropathy and prophylaxis of diabetic foot / Diagnóstico precoce da neuropatia diabética e profilaxia do pé diabético

Introduction: the diabetic foot is one of the most serious complications of diabetes mellitus. About 50% of non-traumatic amputations occur in these patients. In addition, it is an important public health problem and constitutes a chronic and complex metabolic disorder that is characterized by impaired metabolism of glucose and other complications in essential organs for the maintenance of life. Objective: to evaluate the sensitivity and specificity of diabetic neuropathy using the Michigan self-assessment and physical examination in type 1 and type 2 diabetics. Methods: this is a cross-sectional study. The "Michigan Neuropathy Screening Instruments" classification was used to assess the degree of peripheral neuropathy, in which participants answered the questionnaire and were evaluated for the presence of foot lesions. All participants were stratified by the risk of developing foot ulcers according to the IWGDF protocol. Results: the sample had 200 participants. Regarding the IWGDF classification, 23 patients were classified as moderate risk (11.50%) and 61 as high risk for developing foot ulcers (30.50%). Using a cutoff of 2.5 on the physical examination score to diagnose neuropathy, a sensitivity of 97.62% and a specificity of 47.41% were obtained. Using a score greater than or equal to 6 in the self-assessment for the diagnosis of neuropathy, a sensitivity of 50.00% and a specificity of 94.83% were found. Conclusion: the association of the Michigan physical examination (high sensitivity) with self-assessment (high specificity) increases the accuracy for the diagnosis of diabetic neuropathy

Introdução: o pé diabético é uma das complicações mais sérias do diabetes mellitus. Cerca de 50% das amputações não traumáticas ocorrem nesses pacientes. Além disso, é um importante problema de saúde pública por ser um distúrbio metabólico crônico e complexo que se caracteriza pelo comprometimento do metabolismo da glicose associada a outras complicações em órgãos essenciais para manutenção vital. Objetivo: avaliar a sensibilidade e especificidade para neuropatia diabética da autoavaliação e do exame físico de Michigan nos diabéticos tipo 1 e tipo 2. Método: trata-se de um estudo transversal. Foi utilizada a classificação "Michigan Neuropathy Screening Instruments" para avaliação do grau de neuropatia periférica, em que os participantes responderam ao questionário e foram avaliados quanto a presença de lesões nos pés. Todos os participantes foram estratificados quanto ao risco de desenvolver úlcera nos pés de acordo com o protocolo do IWGDF. Resultados: a amostra contou com 200 participantes. Quanto à classificação do IWGDF, 23 pacientes foram classificados como risco moderado (11,50%) e 61 como alto risco para o desenvolvimento de úlceras nos pés (30,50%). Utilizando-se um corte de 2,5 na pontuação do exame físico para diagnosticar a neuropatia, foi obtida uma sensibilidade de 97,62% e uma especificidade de 47,41%. Utilizando-se uma pontuação maior ou igual a 6 na autoavaliação para o diagnóstico de neuropatia, foi obtida uma sensibilidade de 50,00% e uma especificidade de 94,83%. Conclusão: a associação do exame físico de Michigan (alta sensibilidade) com a autoavaliação (alta especificidade) tem melhor acurácia para o diagnóstico de neuropatia diabética.

Effectiveness of Hydroalcoholic Extract of Terminalia ivorensis on Feet Fungus Disease

Despite the evolution of modern medicine, traditional medicine remains widespread in developing countries and its use continues to increase in industrialized countries.It is the same way that the effectiveness of the hydroalcoholic extract of Terminalia ivorensis was tested on the feet fungus disease of volunteers. Objective: The present work is oriented in the preparation of an antimicrobial hydroalcoholic extract of Terminalia ivorensis, a medicinal plant in order to enhance it. Materials and Methods: One hundred (100) grams of powder from trunk bark’s Terminalia ivorensis were extracted by homogenisation in a solvent mixture of 70% ethanol and 30% distilled water in a blender. After six grinding cycles, the homogenate obtained in each case was first wrung out in a clean white cloth square and then successively filtered twice on cotton wool and on Whatman 3 mm filter paper. The filtrate obtained was dried in a Venticell oven. The powder obtained constitutes the hydroalcoholic extract (or The 70% hydroethanolic extract). The 70% hydroethanolic extract of Terminalia ivorensis obtained was mixed with water to obtain a pasty liquid form before being tested on feet fungus disease using a cotton ball. Results: The extract had activity on these different shapes of feet fungus disease with a marked improvement. The volunteers who finished their treatment have been cured of feet fungus disease. Conclusion: The treatment results obtained revealed that the hydroalcoholic extract has good antimicrobial activity. The hydroalcoholic extract can be an undeniable source for the development of Improved Traditional Medicines (ITM) against feet fungus disease.

Effects of stepping exercise with single-tooth sandals on medial longitudinal arch and sole surface temperature / 体力科学

Single-tooth sandals under new development have special material and shape characteristics. Exercises with single-tooth sandals can increase pressing stimulus on the soles of the feet, thereby suppressing a decline in medial longitudinal arch and elevating sole surface temperature. This study thus aimed to examine the effects of exercise with single-tooth sandals on medial longitudinal arch and sole surface temperature. Sixteen young adults (23 ± 5 years) participated in 20 min of stepping exercise on the spot. They randomly put on a regular normal sandal (N conditions) or a single-tooth sandal (Z conditions) on each left and right side. Before and after exercise, medial longitudinal arch and sole surface temperature were assessed by digital caliper and straightedge and thermography, respectively. No significant differences in baseline parameters were observed between N and Z conditions. After exercise, arch height and arch height ratio significantly reduced in N conditions, but not in Z conditions. Central sole surface temperature in Z conditions also increased significantly, and the changes in surface temperature were significantly higher in Z conditions than in N conditions. Therefore, these findings suggest that exercise with single-tooth sandals has a positive effect on a suppressing decline in medial longitudinal arch and an elevation in sole surface temperature.

Antioxidant and anti-inflammatory activities of four kinds of Huangshan chrysanthemum / 药学实践杂志

Objective To investigate the antioxidant and anti-inflammatory activities of four kinds of Huangshan chrysanthemum. Methods ABTS, FRAP and DPPH were used to detect the antioxidant activities of Huangshan golden silk chrysanthemum, Huangshan chrysanthemum, Huangshan gongju, and Huangshan dendranthema. Their anti-inflammatory activities were evaluated by NF-κB reporter gene assay and rat foot swelling models. Results The outcomes of ABTS，FRAP and DPPH showed that the water extracts of four kinds of chrysanthemum all had certain antioxidant activities and the activities of Huangshan golden silk chrysanthemum were strongest, followed by Huangshan chrysanthemum , Huangshan gongju , and Huangshan dendranthema. Results of NF-κB reporter gene assay and rat foot swelling models showed that four extracts of chrysanthemum morifolium could inhibit the transcription of NF-κB induced by LPS and alleviate foot swelling of rat induced by carrageenan, with the strongest activity of Huangshan chrysanthemum, followed by Huangshan golden silk chrysanthemum, Huangshan gongju, and Huangshan dendranthema. Conclusion The antioxidant activities of Huangshan golden silk chrysanthemum were strongest, followed by Huangshan chrysanthemum, Huangshan gongju, and Huangshan dendranthema. The anti-inflammatory activities of Huangshan chrysanthemum were strongest, followed by Huangshan golden silk chrysanthemum, Huangshan gongju, and Huangshan dendranthema.

Histopathological Spectrum of Myxoid Soft‑Tissue Neoplasms in a Tertiary Care Center with a Special Focus on Vascular Patterns: A 13‑Year Compilation

Introduction: Myxoid soft‑tissue tumors are a diverse group of tumors which have similar histomorphology but have varied geneticsequence and clinical outcome, hence differentiating and diagnosing them is a challenge for any pathologist. This study describes the varioushistomorphological spectrum and vascular pattern of various myxoid soft‑tissue tumors. Materials and Methods: This was a retrospective and prospective observational study of myxoid soft‑tissue tumors over a period of 13 years. A total of 224 cases with myxoid morphology were included and were examined morphologically with a special focus on the vascular pattern. SPSS v 24 was used for statistical analysis. Results: The predominant lesions were benign in 164 (73.21%) cases, followed by malignant lesions in 43 (19.19%) cases and intermediate lesions 17 (7.58%) cases. Both benign and malignant lesions showed a male preponderance and were seen to arise predominantly from the extremities. The most common benign myxoid lesions in this study were of neural origin with myxoid neurofibroma constituting 65 (29. 01%) cases, followed by schwannoma 38 (16.9%) cases. Myxoid dermatofibrosarcoma protuberans was the most common intermediatelesion. Tumors with adipocytic differentiation were the predominant lesions among the malignant group, i.e myxoid liposarcoma seen in 17 (7.5%) cases. Conclusions: Vascular pattern in the myxoid lesions are subtle yet crucial in arriving at a histo‑morphological diagnosis. Further studies correlating the vascular pattern with the genetic profile of these tumours can help arriving at a histo‑morphological diagnosisof myxoid lesions.

Efficacy of intense pulse light and M22-ResurFx fractional laser on lateral crow＇s feet / 中华医学美学美容杂志

Objective:To evaluate the efficacy and patients＇ satisfaction of the intense pulse light (IPL) and M22-Resur Fx non-ablative fractional laser (NAFL) for the treatment of lateral static crow＇s feet.Methods:A prospective split-face, randomized, controlled study of 60 consecutive patients with lateral static crow＇s feet was performed. The patients aged 30 to 55 years, who were enrolled in the Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University from January 2018 to January 2020. The two sides of each patient＇s face were randomized to receive different treatment, and according to their treatment, the patients were divided into 3 groups with 20 cases each: Group A, in which 20 patients＇ one side face was treated with IPL, and other side was treated with NAFL; Group B, in which one side face was treated with IPL, and another side was treated with IPL immediately followed by NAFL; Group C, in which one side face was treated with NAFL, and another side was treated with IPL immediately followed by NAFL. The improvements including the water content of stratum corneum of skin and the patients＇ satisfaction, as well as the improvement of the lateral static crow＇s feet were evaluated.Results:The IPL plus NAFL combined treatment group and the NAFL treatment group showed the effective rate of the improvement for lateral static crow＇s feet of patients on days 60 and 90 was statistically significant ( P<0.05) compared with that before the treatment. And the improvement for lateral static crow＇s feet of patients on days 60 and 90 in combined treatment side was significantly different from either NAFL side ( P<0.05). 60 days and 90 days after treatment, the satisfaction of combined treatment side was significantly higher than that of either NAFL side or IPL side ( P<0.05). Conclusions:The treatment with an optimized IPL immediately followed by a NAFL is clinically superior to those with the NAFL or IPL alone for improving the lateral static crow＇s feet of patients. The satisfaction treated by NAFL combined with IPL is higher than using the NAFL or IPL alone.

Avaliação do pé nos portadores de diabetes melitus / Evaluation of the foot in melitus diabetes

Objetivo: Avaliar o pé dos indivíduos portadores de Diabetes Melitus atendidos na atenção básica de um município do interior paulista. Método: Trata-se de um estudo quantitativo. Foram examinados 100 pés dos portadores de diabetes, no período de 1 a 31 de julho de 2019, aos usuários dos serviços de saúde do município (Estratégia Saúde da Família (ESF) e Unidade Básicas de Saúde (UBS)). Resultados: Houve predominância do sexo feminino, 56% declararam que continham ensino fundamental incompleto. A hipertensão arterial foi a comorbidade mais citada. Na avaliação da história clinica associada aos cuidados com os pés, 87% dos entrevistados, declararam que nunca tiveram nenhum tipo de ulceração nos pés. Na inspeção e avaliação dos pés dos entrevistados, constatou-se que 94% não tinham nenhum tipo de lesões nos pés. Conclusão: O estudo reforçou a importância da participação dos profissionais de saúde atuando na prevenção do pé diabético.(AU)

Objective: To evaluate the foot of individuals with Diabetes Melitus assisted in primary care in a city in the interior of São Paulo. Method: This is a quantitative study. One hundred feet of people with diabetes were examined, between the 1st and 31st of July, 2019, users of health services in the municipality (Family Health Strategy (ESF) and Basic Health Units (UBS). Results: There was a predominance of females, 56% declared that they had incomplete primary education. Hypertension was the most cited comorbidity. In the evaluation of the clinical history associated with foot care, 87% of the interviewees stated that they had never had any type of foot ulceration. Upon inspection and assessment of the respondents' feet, it was found that 94% did not have any type of foot injury. Conclusion: The study reinforced the importance of the participation of health professionals working in the prevention of diabetic foot.(AU)

Objetivo: Evaluar el pie de personas con Diabetes Melitus atendidas en atención primaria en una ciudad del interior de São Paulo. Método: Este es un estudio cuantitativo. Se examinaron cien pies de personas con diabetes, del 1 al 31 de julio de 2019, usuarios de los servicios de salud del municipio (Estrategia Salud de la Familia (ESF) y Unidades Básicas de Salud (UBS). Resultados: Predominó el sexo femenino, el 56% declaró tener educación primaria incompleta. La hipertensión fue la comorbilidad más citada. En la evaluación de la historia clínica asociada al cuidado de los pies, el 87% de los entrevistados afirmó no haber tenido nunca ningún tipo de ulceración del pie. Tras la inspección y evaluación de los pies de los encuestados, se encontró que el 94% no tenía ningún tipo de lesión en el pie. Conclusión: El estudio reforzó la importancia de la participación de los profesionales sanitarios que trabajan en la prevención del pie diabético.(AU)

Agreement between ultrasound-detected inflammation and clinical signs in ankles and feet joints in patients with rheumatoid arthritis / 北京大学学报(医学版)

OBJECTIVE@#To investigate the agreement between clinical signs (tenderness and/or swelling) in ankles and feet joints and ultrasound findings in patients with rheumatoid arthritis (RA).@*METHODS@#RA patients with at least 1 tender and/or swollen joint in bilateral ankles and metatarsophalangeal (MTP) joints detected by physical examination were enrolled and underwent ultrasound examination by greyscale (GS) and power Doppler (PD) mode. The agreement between clinical signs and ultrasound-detected inflammation (joint effusion, synovitis, or tenosynovitis) was analyzed.@*RESULTS@#In the study, 113 consecutive RA patients were included, with mean age of (52.5±12.6) years, median duration of 60 (13, 129) months, mean disease activity score in 28 joints based on erythrocyte sedimentation rate [DAS28 (ESR)] of 5.1±1.7, mean disease activity score in 28 joints based on C reactive protein[DAS28 (CRP)]of 4.6±1.5. The tenderness and swelling was most commonly detected in ankles (52.7% and 31.9%, respectively), while GS (+) synovitis was most frequently detectable in MTP2 (34.1%), followed by ankles (32.7%) and MTP1 (27.9%), and PD (+) synovitis was most frequently detectable in MTP1 (14.2%), followed by ankles (12.4%) and MTP2 (10.6%). The prevalence of tenosynovitis was 41.1%, which mostly located in tibialis posterior tendon (22.1% of GS positive and 17.6% of PD positive). The highest prevalence of joint effusion was detected in ankles (9.7%), while that of bone erosion in MTP5 (19%). The overall concordance rate between positive clinical signs and ultrasound-determined joint inflammation was poor in the above joints (κ < 0.2, P < 0.05), in which swelling had the highest κ coefficient with ultrasound-determined joint inflammation in ankles (κ=0.225, P < 0.05). Moreover, swelling had the highest κ coefficient with synovitis in ankles (κ=0.231, P < 0.05).The concordance between tenosynovitis and signs in ankles was also poor (κ < 0.20, P < 0.05). There was no significant agreement between joint effusion and clinical signs (P > 0.05).@*CONCLUSION@#The overall concordance between clinical signs and inflammation on ultrasound was poor in ankles and feet joints. Tenderness and swelling was more common in ankles, while more lesions were detected by ultrasound at MTP joints. Ultrasound is useful in assessing the lesions besides physical examination in patients with RA.

Ineffective peripheral tissue perfusion in patients with diabetic foot: a mid-range theory / Perfusión de tejido periférico ineficaz en pacientes con pie diabético: una teoría de rango medio / Perfusão tissular periférica ineficaz em pacientes com pé diabético: uma teoria de médio alcance

ABSTRACT Objective: to develop a mid-range theory for nursing diagnosis ineffective peripheral tissue perfusion in patients with diabetic foot. Method: the theory construction was carried out in six stages: approach definition; theoretical-conceptual model definition; definition of the main concepts; pictogram development; construction of propositions and establishment of causal relationships evidence for practice. Results: twelve etiological factors and 22 clinical indicators were included in the theory, some of which were not listed in NANDA International (Inc.) and others were adapted to better characterize patients with diabetic foot. A pictogram was constructed and eight propositions were established to verify causal relationships and evidence for practice. Conclusion: medium-range theory made it possible to broaden the concepts and demonstrate the causal relationships between the elements of ineffective peripheral tissue perfusion, providing subsidies to minimize gaps in knowledge and assist clinical nursing practice.

RESUMEN Objetivo: desarrollar una teoría de rango medio para el diagnóstico de enfermería de la perfusión tisular periférica ineficaz en pacientes con pie diabético. Método: la construcción de la teoría se realizó en seis etapas: definición del enfoque; definición del modelo teórico-conceptual; definición de los principales conceptos; desarrollo de pictogramas; construcción de proposiciones y establecimiento de relaciones causales basadas en evidencia para la práctica. Resultados: se incluyeron en la teoría 12 factores etiológicos y 22 indicadores clínicos, algunos de los cuales no estaban incluidos en NANDA International (Inc.) y otros se adaptaron para caracterizar mejor a los pacientes con pie diabético. Se construyó un pictograma y se establecieron ocho proposiciones para verificar las relaciones causales y la evidencia de la práctica. Conclusión: la teoría de rango medio permitió ampliar los conceptos y demostrar las relaciones causales entre los elementos del diagnóstico de perfusión tisular periférica ineficaz, brindando subsidios para minimizar las brechas en el conocimiento y ayudar a la práctica clínica de la enfermería.

RESUMO Objetivo: desenvolver uma teoria de médio alcance para o diagnóstico de enfermagem perfusão tissular periférica ineficaz em pacientes com pé diabético. Método: a construção da teoria foi realizada em seis etapas: definição da abordagem; definição do modelo teórico-conceitual; definição dos conceitos principais; desenvolvimento de pictograma; construção das proposições e estabelecimento das relações de causalidade evidências para a prática. Resultados: foram incluídos na teoria 12 fatores etiológicos e 22 indicadores clínicos, alguns destes não estavam listados na NANDA Internacional (Inc.) e outros foram adaptados para melhor caracterização dos pacientes com pé diabético. Construiu-se um pictograma e foram estabelecidas oito proposições para verificar as relações causais e evidências para a prática. Conclusão: a teoria de médio alcance possibilitou ampliar os conceitos e demonstrar as relações causais entre os elementos do diagnóstico perfusão tissular periférica ineficaz, fornecendo subsídios para minimizar as lacunas no conhecimento e auxiliar a prática clínica da enfermagem.

Formulation of fishburgers with the addition of different protein sources and taro flour / Formulação de fishburgers com adição de diferentes fontes proteicas e farinha de taro

ABSTRACT: The present study aims to develop Nile tilapia hamburger with incorporation of whey, collagen from chicken feet and taro flour. A complete factorial design 2³ was performed to investigate the influence of the variables on weight loss, shrinkage, color and shear force, that were used to propose mathematical models. Proximate composition, microbiological characteristics and sensory properties were also evaluated. Factors such as taro flour and whey were significant and contributed to a higher yield for fish burgers, with negative effects on shrinkage and weight loss. The fishburgers had a soft texture, although collagen and its interaction with taro flour contributed to the increase in shear force. The factors had influence only on the b* value with yellowish hue. The protein and ash values obtained were higher than those of the control formulation. The sensory characteristics of the hamburgers were not affected by the factors, being all classified with high acceptability. The formulation represented by the central point (F9) containing 3.0% of taro flour, 0.5% chicken feet collagen and 3.0% powdered whey, obtained greater purchase intention. Therefore, the addition of taro flour, collagen from chicken feet and whey is an alternative in the use of industrial by-products to add value to fish burgers with market potential.

RESUMO: O objetivo do presente estudo foi desenvolver hambúrguer de tilapia do Nilo com a incorporação de soro de leite, colágeno de pés de frango e farinha de taro. Para tanto, um planejamento fatorial 2³ completo foi realizado para investigar a influência das variáveis sobre a perda de peso, encolhimento, cor e força de cisalhamento e propor modelos matemáticos. Avaliaram-se também a composição centesimal, características microbiológicas e propriedades sensoriais. Os fatores como farinha de taro e whey foram significativos e contribuíram com o maior rendimento dos hambúrgueres com efeitos negativos sobre a perda de peso e encolhimento. Os hambúrgueres apresentaram uma textura macia, embora o colágeno e sua interação com a farinha de taro tenham colaborado com o aumento da força de cisalhamento. Os fatores influenciaram somente o valor de b* com tonalidade amarelada. Os valores de proteína obtidos foram maiores que da formulação controle. As características sensoriais dos hambúrgueres não foram afetadas pelos fatores, sendo todos classificados com alta aceitabilidade. A formulação representada pelo ponto central (F9) contendo 3,0% de farinha de taro, 0,5% de colágeno de pés de frango e 3,0% de soro de leite em pó, obteve maior intenção de compra. Portanto, a adição de farinha de taro, colágeno de pés de frango e soro de leite é uma alternativa no uso de subprodutos industriais para agregar valor aos hambúrgueres de peixe com potencial mercadológico.

Alterações podais em idosos: revisão integrativa / Changes in the feet oldder adults: an integrative review

Compreendendo a magnitude do cuidado integral à saúde da população idosa e considerando o quanto as alterações nos pés podem interferir nas atividades de vida diária, e consequentemente na qualidade de vida desses idosos, o presente estudo teve como objetivo: identificar na literatura evidências científicas acerca das alterações mais frequentes nos pés dos idosos. Levantou-se como questão da pesquisa: Como a literatura tem abordado o tema alterações nos pés dos idosos? Trata-se de uma Revisão Integrativa, e para tal foi realizada busca de artigos publicados e indexados na Biblioteca Virtual em Saúde utilizando a combinação dos seguintes Descritores em Ciências da Saúde em língua portuguesa: "Pé" e "Idoso" acompanhados do operador booleano "and". O resultado final deste levantamento é constituído por dez artigos publicados entre os anos de 2008 e 2017 em duas bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Medical Literature Analysis and Retrieval System on-line (MEDLINE). Os artigos foram divididos em duas categorias: Alterações nos pés relacionadas à incapacidade no idoso; Hospitalizações em decorrência de alteração podal: o pé diabético na população idosa. As alterações nos pés dos idosos são frequentes e podem ocorrer tanto como resultado de maus tratos aos pés, como uso de calçados inadequados e traumas, como em consequência de doenças como diabetes mellitus. As alterações podais mais frequentes foram hálux valgo, deformidades nos pequenos artelhos, calosidades, ressecamento, fissuras, unhas quebradiças, encravadas e compridas. Estas alterações podem comprometer a mobilidade e até o favorecer as quedas, colocando em risco a independência dos idosos.(AU)

Understanding the magnitude of comprehensive health care for the older population and considering how changes in the feet can interfere with activities of daily living, and consequently, the quality of life of these older adults, the present study aimed to: identify in the literature scientific evidence about most frequent changes in the feet of older adults. The following research question was raised: How has the literature approached the subject of foot changes in older adults? This is an Integrative Review, and for this purpose a search was made for articles published and indexed in the Virtual Health Library using the combination of the following Health Sciences Descriptors in Portuguese: "Foot" and "Elderly" accompanied by the Boolean operator "and". The final result of this survey consists of ten articles published between 2008 and 2017 in two databases: Latin American and Caribbean Health Sciences Literature (LILACS) and Online Medical Literature Analysis and Retrieval System (MEDLINE). The articles were divided into two categories: Changes in the feet related to disability in older adults; Hospitalizations due to foot alteration: the diabetic foot in the older population. Changes in the feet of older adults are frequent and may occur as a result of foot abuse, such as wearing inappropriate shoes and trauma, and as a consequence of diseases such as diabetes mellitus. The most common foot changes were hallux valgus, small toe deformities, callus, dryness, fissures, brittle, ingrown and long nails. These changes may compromise mobility and even favor falls, jeopardizing the independence of older adults.(AU)

Historical evolution in processing and some problems in modern research of Mylabris / 中草药

Mylabris is a traditional Chinese medicine and ethnic medicine, which has significant effects on treatment of malignant tumors and dermatophytosis and so on. It has been recorded in most historical Chinese Pharmacopoeias. However, because of its hypertoxicity in the crud forms, Mylabris needs to be furtherly processed if it is taken orally. There are various methods about how to process it in previous Materia Medica Classics, whereas the most modern approaches are mainly using cleansing technology and stir-baked with rice technology. Moreover, the technologies stipulated by local processing regulations are different from the stipulations of pharmacopoeias. This research combs through the history evolution systematically in the processing of Mylabris, and analyzed the existential issues in modern research on it, so as to provide references for the processing and the quality control of Mylabris.

Knee Support-based Study on Sit to Stand Transfer Trajectory of Human Body / 中国康复理论与实践

Objective:To study the human body's sit to stand transfer trajectory and kinematics based on knee joint support to provide a basis for designing the transfer aid with knee joint support. Methods:From April to June, 2019, 20 healthy volunteers were recruited and divided into three groups according to height and gender. Under the premise of knee support, the sit to stand transfer experiments with 20 cm and 30 cm between feet were conducted respectively. All subjects were repeated twice for each experiment with an interval of one minute. High-definition camera was used to record the motion trajectories of each subject's shoulder (armpit) and knee joint during the experiment, and the kinematics rules of subjects with different heights and masses were analyzed. Results:The body forward leaning displacement was less with 20 cm between feet than with 30 cm for subjects less than 172 cm tall; and was less with 30 cm than with 20 cm for subjects more than 173 cm tall. The forward flexion displacement of trunk was less with 20 cm between feet than with 30 cm for subjects with body mass index (BMI) < 23.9 kg/m2; and was less with 30 cm than with 20 cm for subjects with BMI > 23.9 kg/m2. The average time during sit to stand transfer was (1.7±0.05) s. Conclusion:In the process of sit to stand transfer, distance between feet may affect the way of joint extension, the body forward leaning distance and the forward flexion displacement of trunk. With the increase of height and mass, appropriate increase of distance between feet can reduce the difficulty of sit to stand transfer. With the increase of BMI, the time of sit to stand transfer also increases. The time spent on sit to stand transfer is more in female than in male.

Alterações neoplásicas e não neoplásicas das mãos e dos pés de cães (2003-2016) / Neoplastic and non-neoplastic lesions of the hands and feet of dogs (2003-2016)

Mãos e pés de cães são comumente afetados por lesões neoplásicas e não neoplásicas. Estas alterações podem apresentar prognóstico histopatológico ou clínico ruim e a amputação tende a ser o tratamento de escolha. Estudos prévios avaliando a prevalência e os aspectos clínicopatológicos de alterações digitais em cães têm sido realizados em outros países, entretanto trabalhos similares não foram realizados no Brasil. O objetivo do presente estudo foi descrever e caracterizar histologicamente as lesões das mãos e pés de cães. Amostras de 105 lesões tumoriformes das mãos e pés de cães foram avaliadas. Essas amostras foram coletadas entre 2003 e 2016 e foram obtidas de três laboratórios brasileiros de diagnóstico veterinário. Todos espécimes foram fixados em formol tamponado 10%, processados rotineiramente e corados por hematoxilina-eosina. Adicionalmente, as colorações de azul de toluidina, Brown e Breen, periodic acid Schiff (PAS), Grocott Methenamine Silver (GMS) e Ziehl Neelsen foram utilizados em casos específicos. Imuno-histoquímica foi realizada usando os anticorpos anti-Leishmania spp., anti-CD117, anti-CD79, anti-CD3, anti-Melan A, anti-lisozima, anti-Pancytokeratin AE1/AE3 e anti-vimentina. Os neoplasmas (62,9%) foram as alterações mais frequentes, seguidas por inflamações (19%) e outras alterações (18,1%). Entre os neoplasmas, 40,9% foram mesenquimais, 39,4% epiteliais e 19,7% de células redondas. Todos os neoplasmas de células redondas e a maioria dos epiteliais e mesenquimais eram malignos. Não se observou predileção de prevalência dos neoplasmas em relação ao sexo. As raças Labrador Retriever, Schnauzer, Teckel, SRD, Pastor Alemão, Rottweiler e Pit Bull foram as mais afetadas. Fila Brasileiro, Pit Bull e Schnauzer tiveram alta incidência de neoplasmas mesenquimais, epiteliais e de células redondas, respectivamente. Inflamação foi mais comumente observada em cães Labrador Retriever e as outras alterações em Teckel, Labrador Retriever e SRD. A idade e o peso médio dos animais afetados foram de 8,4 anos e 28,5 kg, respectivamente. O diâmetro médio das lesões tumoriformes foi de 2,5 cm e as lesões neoplásicas apresentaram as maiores médias. As lesões ocorreram principalmente em animais de pelagem amarela. A maioria das biópsias incisionais (56,4%) e amputações (85,3%) consistiram de neoplasmas. O principal membro afetado foi o torácico direito e o dígito foi a estrutura anatômica acometida mais frequentemente. Carcinoma de células escamosas (14,2%) foi o neoplasma mais frequente, seguido do mastocitoma (7,6%), melanoma (7,6%) e sarcoma indiferenciado (7,6%). Em metade dos casos de inflamação, a lesão acometeu o folículo piloso e derme adjacente, e o infiltrado foi predominantemente piogranulomatoso ou lnfoplasmocítico. Cistos foliculares, calcinose circunscrita e acrocordoma foram as principais lesões não neoplásicas e não inflamatórias diagnosticadas.(AU)

Hands and feet of dogs are commonly affected by neoplastic and non-neoplastic lesions. These lesions may commonly present poor clinical or histopathological prognosis and amputation tends to be the treatment of choice. Previous studies regarding the prevalence and the clinicopathological aspects of digital changes in dogs have been performed abroad, with no similar investigations in Brazil. The aim of this manuscript was to perform a histopathological study to characterize hands and feet lesions of dogs from Brazil.Tissue samples from 105 tumor-like lesions of dogs hands and feet were used in this study. The samples came from three Brazilian veterinary diagnostic laboratories and were collected between 2003 and 2016. All specimens were fixed in 10% buffered formalin, and routinely processed for paraffin embedding and hematoxylin-eosin staining. Additionally, toluidine blue, Brown and Breen, periodic acid Schiff (PAS), Grocott Methenamine Silver (GMS) and Ziehl Neelsen were used in selected cases. Immunohistochemistry using anti-Leishmania spp., anti-CD117, anti-CD79, anti-CD3, anti-Melan A, anti-lysozyme, anti-Pancytokeratin AE1/AE3, and anti-vimentin antibodies were also performed. Neoplasia (62.9%) was the most frequently found lesion, followed by inflammation (19%), and other changes (18.1%). Among the neoplasms, 40.9% were mesenchymal, 39.4% epithelial, and 19.7% round cells. All round cells and most of the epithelial and mesenchymal neoplasms were malignant. There was no difference between males and females regarding neoplasia prevalence. Labrador Retriever, Schnauzer, Teckel, mongrel, German Shepherd, Rottweiler, and Pit Bull were the most frequently affected breeds. Fila Brasileiro (aka Brazilian Mastiff), Pit Bull and Schnauzer had higher incidence of mesenchymal, epithelial, and round cells neoplasms, respectively. Inflammation was more commonly observed in the Labrador Retriever and other changes were more commonly in Teckel, Labrador Retriever, and mongrel dogs. Medium age and weight were 8.4 years and 28.5 kg, respectively. Medium diameter of the tumor-like lesions was 2.5 cm and the neoplastic lesions presented higher averages. Lesions were mainly in yellow-coated dogs. Incisional biopsy samples (56.4%) and amputations (85.3%) were mostly from neoplastic cases. Right forelimb was the most affected limb, and digits were the main injured anatomic structures. Squamous cell carcinoma was the most (14.2%) commonly diagnosed neoplasm, followed by mast cell tumor (7.6%), melanoma (7.6%), and undifferentiated sarcoma (7.6%). In half of the inflammatory cases, the lesion was centered in hair follicle and surrounding dermis. The inflammatory infiltrate was predominantly piogranulomatous or lymphoplasmacytic. Follicular cyst, calcinosis circumscripta, and acrochordons were the main non neoplastic and non-inflammatory changes.(AU)

Endoscopic transthoracic sympathectomy:effects on the treatment of hyperhidrosis palmaris and quality of life / 中华老年医学杂志

Objective To investigate the effects of endoscopic transthoracic sympathectomy on the treatment of hyperhidrosis palmaris(sweaty hands)and quality of life.Methods The clinical data of 62 patients with sweaty hands admitted from June 2010 to May 2016 were retrospectively analyzed.The 62 patients were randomly divided into two groups:thoracoscopic sympathectomy was performed at T2-3 in the control group,while at T3-4 in the experimental group.The self-reports of quality of life(QOL)before and after the operation were collected as follows:the severity of sweaty hands assessed by hyperhidrosis disease severity scale (HDSS:the higher score the more severe hyperhidrosis),the improvement of QOL assessed by sweaty hands assessment scale(the higher score the more improvement)and surgical efficacy.Results The improvements of HDSS and satisfaction score were higher in the experimental group than in the control group(P＜0.05).The differences between pre-and post-operation in the five dimensions of social interaction,gestation,daily behavior,work and social psychology were better in the experimental group than in the control group(all P＜ 0.05).Conclusions Thoracoscopic sympathectomy at T2-4 and T3-4 is an effective treatment for sweaty hands.But surgery at T3-4 levels,which is associated with a larger improvement in quality of life and fewer complications,is recommended as a priority option for a surgical treatment.

Effect on influence of continuous closed negative pressure drainage on serum IGF1 and NO in patients with diabetic feet / 国际检验医学杂志

Objective To observe the clinical effect of continuous vacuum sealing drainage (VSD) in trea-ting diabetic foot and its influence on the expression of serum insulin-like growth factor(IGF1) and nitric ox-ide(NO) .Methods Sixty-eight cases of diabetic foot in this hospital from June 2014 to December 2015 served as the research subjects and randomly divided into the control group and observation group .The control group took the common wound dressing treatment ,while the observation group adopted the VSD treatment ;the clin-ical efficacies after three courses of treatment were compared between the two groups .The treatment time , number of dressing change and wound healing time in the two groups were performed the statistics .The data after completely statistics were performed the contrastive analysis ;glycosylated hemoglobin (HbA1c) ,IGF1 and NO expression levels before and after treatment were compared between the two groups .The correlation between clinical effect with the levels of IGF1 ,NO and HbA1c was analyzed .Results The clinical cure rate of the observation group was 52 .94％ ,the total effective rate was 94 .12％ ,the clinical cure rate of the control group was 35 .29％ ,the total effective rate was 67 .65％ ,and the results of curative effect evaluation in the ob-servation group was better than that of the control group ,the difference was statistically significant ( P<0 .05) .The observation group was significantly better than the control group in the treatment time ,dressing change frequency and wound healing time ,the difference was statistically significant (P<0 .05) .After three courses of treatment ,the average expression level of IGF1 and NO in the observation group were higher than those in the control group ,the difference was statistically significant (P<0 .05) .There was a negative correla-tion between the curative effect and the level of serum IGF1 and NO (r= -0 .997 ,-0 .923 ,P< 0 .05) ,and there was a positive correlation between the curative effect with the HbA 1c level(r=0 .816 ,P<0 .05) .Conclu-sion VSD has an ideal effect in the treatment of diabetic feet ,can effectively shorten the treatment time ,and has the recovery of serum IGF1 and NO expression level .

Long Term Effect of Custom-Molded Foot Orthoses on Foot Pain and Balance in Children with Symptomatic Flexible Flat Feet

OBJECTIVE: To evaluate the long termeffect of custom-molded foot orthoses on foot pain and balance ability in children with symptomatic flexible flat feet after 1 year.METHOD: A total of 35 children over 6 year-old with flexible flat feet and foot pain for at least 6 months were recruited. Individual custom-molded rigid foot orthoses fabricated with the inverted orthotic technique was prescribed. Pain related parameters (pain sites, degree, and frequency) were obtained through questionnaires. Pain assessment was performed prior to application of the foot orthoses, and 1, 3, 6, 12 months after applying the orthoses. Balance ability was tested by computerized posturography. Such measures were evaluated prior to, 3 months, and 12 months after applying the foot orthoses. Additionally, the difference inbalance ability between barefoot and withfoot orthosesat 12 months was assessed to estimate carryover effect.RESULTS: 17 out of 35 children completed the study. Significant improvements were noted upto 12 months in pain parameters and balance ability. The carry over effect of the orthoses was confirmed.CONCLUSION: There were significant improvements offoot pain and balance ability in children with symptomatic flexible flat foot after wearing foot orthoses fabricated with the inverted orthotic technique over 1year period.

Consideration on Adaptive Condition of Soshikokito / 日本東洋医学雑誌

Soshikokito has long been used to treat cough in frail patients with cold sensation in their feet, based on the Japanese traditional Kampo textbook “Iryo-Shuhou-Kiku”. In many old documents including “Wazai-Kyokuho,” where soshikokito was first described, it is suggested that airways obstructed by a large quantity of watery expectoration should be the proper indication for the use of this formula. However, in the five cases that we successfully treated, the quantity of sputum was relatively small. To determine the practical indications for this, we examined their abdominal strength and the presence or absence of “cold feet” sensation. In addition, we investigated the nature of sputum in the past clinical reports in which successful treatment using soshikokito was described. It has become clear that we can prescribe soshikokito as an antitussive regardless of the patients' physical fitness as deduced from the abdominal strength. The “cold feet” sensation was not an essential symptom and was regarded as one of the symptoms of qi counterflow. Regarding the properties of sputum, it was viscous and small in quantity. In the cases where soshikokito was effective, it was speculated that viscous sputum would result in airway obstruction, coughing, and wheezing. These conditions will be ameliorated by the antitussive and expectorant effect of this formula, which improves qi counterflow and mildly tonifies water. In the treatment of cough with respiratory distress, “sputum with high viscosity and hard to discharge” is considered to be the targeted symptom in the practical usage of soshikokito.

Podiatric Conditions of Athletes in the Sixth National Special Olympics / 中国康复理论与实践

Objective To analyze the podiatric conditions of athletes with intellectual disabilities.Methods From May eleventh to 17th, 2015,779 athletes who participated in the sixth National Special Olympics were enrolled partly.Their lower limbs and feet were evaluated with Fit Feet Healthy Athletes Screening Form.Results Common podiatric conditions found in Special Olympics athletes included flat feet (52.2% in left side and 51.7% in right side), over pronation (56.1% in left side and 56.9% in right side), callus (44.7%), wrong nail cut (46.6%),ingrown nail(21.1%),and cross over toes(6.8%),etc.Conclusion Special Olympics athletes have podiatric structural,functional, nail and skin problems,which may relate to intellectual disabilities.

The orbicularis muscle partial resection combined with orbital fat flap or orbicularis muscle flap graft for treatment of crow′s feet in women / 中华整形外科杂志

Objective@#To observe the effect of the outer orbicularis muscle partial resection combined with orbital fat flap or orbicularis muscle flap transfer to block orbicularis muscle for improvement of crow′s feet.@*Methods@#From October 2010 to May 2015, 82 cases of females (aged from 27 to 54 years old) with crow′s feet were treated with new method(n=41) and traditional method(control, n=41). The new method included partial resection and orbital fat flap or orbicularis muscle flap transfer to block orbicularis muscle. The traditional method was performed to lift the skin and orbicularis oculi muscle to improve the crow′s feet. The operation time, the postoperative recovery time, eyes closing function and hematoma, nerve injury and other complications were recorded. 1, 3, 6 and 12 months after operation, the effect was assessed by one cosmetic surgeon who is unkown the groups. Completely correction was assed as 5 points and no improvement or even worse as 0 point. 12 months after operation, the patients satisfactory rate was recorded.@*Results@#75 cases were followed up, including 39 in new method group and 36 in control group. The operative time and postoperative recovery time were (50±5) min, (58±4) min and (5±1) d, (6.0±1.5) d in the new method group and control group respectively (P<0.05). The two groups both had good eyes closing function, no eyes closing fatigue or difficult or other serious complications such as hematoma, nerve injury. Visual analog scale were 3.2±0.6, 3.5±0.5, 4.2±0.8, 4.3±0.8 and 3.1±0.6, 3.4±0.9, 3.0±0.6, 2.8±0.5 in the new method group and control group at 1, 3, 6, 12 months after surgery respectively . Obviously, the effect in new method group was much better than that in control group after 6 and 12 months with statistical significance (P<0.05). 12 months after surgery, the satisfaction surveys showed satisfactory in 33 cases; fairly satisfactory in 4 cases; dissatisfactory in 2 cases in new method group, and satisfactory in 10 cases; fairly satisfactory in 15 cases; dissatisfactory in 11 cases in the control group, showing significant difference between the 2 groups (P<0.05).@*Conclusions@#The outer orbital orbicularis muscle partial resection combined with orbital fat flap or orbicularis muscle flap is reasonable and reliable to correct crow′s feet with short recovery and less complication. It is a worthy new method for recommendation.