PACS and Photoshop assisted isosceles triangle osteotomy and Kirschner wire tension buckle fixation in the treatment of cubitus varus in children / 中国骨伤

OBJECTIVE@#To investigate the clinical efficacy of picture archiving and communication system (PACS) and Photoshop assisted isosceles triangle osteotomy and Kirschner wire fixation with tension band in the treatment of cubitus varus in children.@*METHODS@#The clinic data of 20 children with cubitus varus treated with isosceles triangle osteotomy of distal humerus and Kirschner wire fixation with tension band from October 2014 to October 2019, were retrospectively analyzed. There were 13 males and 7 females, aged from 3.2 to 13.5 years old, the median age was 6.65 years old. PACS system was applied for the osteotomy design preoperatively, simulating and measuring the side length of isosceles triangle osteotomy. Then, Photoshop system was used to simulate the preoperative and postoperative osteotomy graphics, which could guide precise osteotomy during operation.@*RESULTS@#All the 20 patients were followed up for 20 to 24 months, with a median of 22.5 months. At the last follow-up, the carrying angle of the affected limb was 5 ° to 13 °, with a median of 8.3 °. The clinical efficacy was evaluated according to the Flynn elbow function score:excellent in 16 cases, good in 2 cases, and fair in 2 cases.@*CONCLUSION@#The treatment of cubitus varus in children by isosceles triangle osteotomy and Kirschner wire fixation with tension band assisted by PACS and Photoshop system has shown good clinical outcome.

Study on mechanisms of Th17/Treg imbalance in patients with cystic echinococcosis based on miRNA expression profiles / 中国血吸虫病防治杂志

OBJECTIVE@#To investigate the serum microRNA (miRNA) expression and examine the impact of miRNA expression profiles on T helper type 17 (Th17)/regulatory T cells (Treg) imbalance among patients with cystic echinococcosis, so as to provide insights into the illustration of the mechanisms underlying chronic Echinococcus granulosus infections, and long-term pathogenesis.@*METHODS@#Total RNA was extracted from the sera of cystic echinococcosis patients and healthy controls, and subjected to high-throughput sequencing with the Illumina sequencing platform. Known miRNAs were annotated and new miRNAs were predicted using the miRBase database and the miRDeep2 tool, and differentially expressed miRNAs were identified. The target genes of differentially expressed miRNAs were predicted using the software miRanda and TargetScan, and the intersection was selected for Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. Among the differentially expressed miRNAs with the 20 highest fold changes, miRNAs that targeted genes relating to key transcription factors RORC and FOXP3 that determine the production of Th17 and Treg cells or their important regulatory pathways (PI3K-Akt and mTOR pathways) were matched.@*RESULTS@#A total of 53 differentially expressed miRNAs were screened in sera of cystic echinococcosis patients and healthy controls, including 47 up-regulated miRNAs and 6 down-regulated miRNAs. GO enrichment analysis showed that these differentially expressed miRNA were involved DNA transcription and translation, cell components, cell morphology, neurodevelopment and metabolic decomposition, and KEGG pathway analysis showed that the differentially expressed miRNA were mainly involved in MAPK, PI3K-Akt and mTOR signaling pathways. Among the differentially expressed miRNAs with the 20 highest fold changes, there were 3 miRNAs that had a potential for target regulation of RORC, and 15 miRNAs that had a potential to target the PI3K-Akt and mTOR signaling pathways.@*CONCLUSIONS@#Significant changes are found in serum miRNA expression profiles among patients with E. granulosus infections, and differentially expressed miRNAs may lead to Th17/Treg imbalance through targeting the key transcription factors of Th17/Treg or PI3K-Akt and mTOR pathways, which facilitates the long-term parasitism of E. granulosus in hosts and causes a chronic disease.

Effect of Removing Core on Quality of Phyllanthi Fructus / 中国实验方剂学杂志

Objective:The differences of chemical compositions and pharmacological activities between the core and pulp of Phyllanthi Fructus were investigated by chemical analysis and <italic>in vitro</italic> test to explore the effect of the core on the quality of this medicinal material. Method:Literature， medicinal material standards and market research on the appearance of Phyllanthi Fructus were conducted based on existing databases. Ultra-high performance liquid chromatography-quadrupole-electrostatic field orbital trap high resolution mass spectrometry （UPLC-Q-Orbitrap HRMS） was used to identify the constituents of the core and pulp. The analysis was performed on Thermo Scientific Accucore C₁₈ column （2.1 mm×100 mm， 2.6 μm） with the mobile phase of 0.1% formic acid aqueous solution （A）-methanol （B） for gradient elution （0-25 min， 5%B； 25-30 min， 5%-95%B； 30-35 min， 95%-5%B）， the flow rate was 0.2 mL·min^-1， heating electrospray ionization （HESI） was adopted with positive and negative ion modes， and the scanning range was <italic>m</italic>/<italic>z</italic> 100-1 500. High performance liquid chromatography （HPLC） was used to determine the contents of gallic acid， corilagin， chebulagic acid and ellagic acid in the core and pulp of Phyllanthi Fructus. Analysis was performed on Welchrom C₁₈ column （4.6 mm×250 mm， 5 μm） with mobile phase of methanol （A）-0.05% phosphoric acid aqueous solution （B） for gradient elution （0-6 min， 5%A； 6-15 min， 5%-7%A； 15-20 min， 7%-15%A； 20-25 min， 15%-21%A； 25-31 min， 21%-22%A； 31-41 min， 22%A； 41-47 min， 22%-28%A； 47-51 min， 28%-32%A； 51-57 min， 32%-38%A； 57-70 min， 38%-45%A； 70-80 min， 45%-65%A； 80-85 min， 65%-5%A）， the detection wavelength was set at 270 nm. The antibacterial effects of the core and pulp of Phyllanthi Fructus on <italic>Escherichia coli</italic> and <italic>Staphylococcus aureus</italic> were investigated by filter paper method， and their antioxidant activities were compared by 1，1-diphenyl-2-picrylhydrazyl （DPPH） free radical scavenging assay. Result:A total of 47 compounds were identified in the core and pulp of Phyllanthi Fructus， mainly including tannins， flavonoids， phenolic acids， fatty acids， amino acids， organic acids， saccharides and glycosides， most of which were concentrated in the pulp， and the fatty acids in the core accounted for a higher proportion. The contents of gallic acid， corilagin， chebulagic acid， ellagic acid and other phenolic compounds in the pulp of 20 batches of Phyllanthi Fructus were much higher than those in the core. The results of antibacterial test showed that the core of Phyllanthi Fructus with different concentrations had no antimicrobial effect. The DPPH radical scavenging test showed that the antioxidant activity of the core ［half-inhibitory concentration （IC₅₀）=199.632 mg·L^-1］ was much less than that of the pulp （IC₅₀=12.688 mg·L^-1）. Conclusion:From the perspectives of polyphenol content， antibacterial and antioxidant activities， it is scientific to use Phyllanthi Fructus pulp in ancient and modern times， which may be to remove the secondary parts of Phyllanthi Fructus， so as to enhance the actual utilization rate and therapeutic effect of medicinal materials. In view of the large proportion of the core of Phyllanthi Fructus and its high content of fatty acids and other components， whether or not to use it remains to be further studied in clinical application.

Preliminary Study on Commodity Grade Classification of Phyllanthi Fructus Based on Color Component Correlation / 中国实验方剂学杂志

Objective:To provide a scientific basis for the classification of Phyllanthi Fructus product grades. Method:A total of 30 batches of Phyllanthi Fructus currently available in the market were collected for quantification based on such appearance indexes as diameter， thickness， grain weight， and crust colour （<italic>L</italic>^*， <italic>a</italic>^*， and <italic>b</italic>^* values）. The contents of gallic acid， corilagin， chebulagic acid， and ellagic acid were measured by high performance liquid chromatography （HPLC）， followed by descriptive statistical analysis （DSA）， analysis of variance （ANOVA）， and principal component analysis （PCA） to determine the importance of each main index and explore the correlations between the appearance indexes and internal components. The classification standard of Phyllanthi Fructus product grades was formulated， and its scientificity was verified in hepatocelular carcinoma HepG2 cells. Result:The correlation analysis revealed that the crust colour <italic>L</italic>^*， <italic>a</italic>^*， and <italic>b</italic>^* values were significantly negatively correlated with corilagin， chebulagic acid， and ellagic acid （<italic>|r|</italic>>0.5， <italic>P</italic><0.01）， but irrelevant to gallic acid （<italic>|r|</italic><0.1）. Considering the variable coefficient of each index， PCA results， and the requirement of gallic acid as quality indicator for Phyllanthi Fructus in <italic>Chinese Pharmacopoeia</italic>， the crust colour <italic>L</italic>^*， <italic>a</italic>^*， and <italic>b</italic>^* values and gallic acid content were determined to be the classification indexes. The K-means cluster analysis confirmed that products with crust colour <italic>L</italic>^*<44， <italic>a</italic>^*<7， and <italic>b</italic>^*<10 and gallic acid content >1.6% could be classified into the first class， and those failing to meet the above requirements into the second class. The cell experiment demonstrated that the half-maximal inhibitory concentration （IC₅₀） of the first-class product against hepatocelular carcinoma HepG2 cells was lower than that of the second-class product. A colourimetric card was developed based on crust colour <italic>L</italic>^*， <italic>a</italic>^*， and <italic>b</italic>^* values to provide a visual tool for on-site evaluation of Phyllanthi Fructus products. Conclusion:This study has initially established the classification standard of Phyllanthi Fructus product grades， which contributes to guiding price negotiation of Phyllanthi Fructus products based on quality grade and thus ensuring high quality and high price.

Relationship between Fractional Anisotropy of Diffusion Tensor Imaging and Motor Function after Ischemic Stroke / 中国康复理论与实践

Objective:To explore the relationship between diffusion tensor imaging (DTI) parameter of fractional anisotropy (FA) and recovery of upper-extremity motor function in patients with ischemic stroke. Methods:From January to December, 2019, 20 ischemic stroke patients accepted routine medication and rehabilitation for three weeks. They received DTI examination and were measured FA of the infarct and the corresponding area on the contralateral side, the cerebral foot and the posterior limb of internal capsule of affected and unaffected sides, while the bilateral FA ratio (rFA) of them were calculated, before and after treatment. Meanwhile, all the patients were assessed with Fugl-Meyer Assessment-Upper Extremity (FMA-UE). Results:The FMA-UE score improved after treatment (t = 9.074, P < 0.001), while FA and rFA increased in infarct area (t > 14.519, P < 0.001). The difference before and after treatment of FA and rFA in all of the areas positively correlated with that of FMA-UE scores (r = 0.445~0.565, P < 0.05), which was the most in posterior limb of internal capsule of the affected side. Conclusion:FA of DTI alters with the recovery of motor function of the upper extremity after ischemic stroke, especially in the posterior limb of internal capsule.

Pharmaceutical mechanism and control strategy for storage of ellagic acid stably in traditional Chinese medicine oral liquid / 药学学报

Ellagic acid is ubiquitous in plants and is considered as a potential candidate for antioxidant and antineoplastic drugs. However, ellagic acid has poor solubility and precipitates easily even after initial solubilization. Improvement of its bioavailability has been a concern of pharmaceutical industry. It was found that storage in Sanlejiang oral liquid at low temperature keeps its stability. Ellagic acid is anomalous in a way that is easily soluble at low temperatures but precipitates at high temperatures. In order to reveal the mechanism of this phenomenon and develop precipitation prevention and control strategies, ellagic acid in Sanlejiang oral liquid was stored at high, medium and low temperatures for three months. The changes of composition and phase state of the whole system during storage were systematically tracked and studied by means of precipitation amount or morphology, HPLC chemical profile of supernatant versus precipitates, and comprehensive characterization of physical phase state. The results show that the amount of precipitation at low temperature is only 1/3 of that at normal room temperature. As the temperature rises, the sedimentation increases sharply. HPLC analyses of supernatant versus precipitates revealed that ellagic acid precipitation originated from two ways: chemical degradation and physical deposition. The chemical sedimentation is related to the hydrolysis of tannins under acidic condition, forming chebulagic acid and corilagin. Physical sedimentation is related to the decrease of the association degree and viscosity of polyphenol colloids when temperature rises. This study elucidated the stability mechanism of ellagic acid in liquid preparations of TCM, and provided the mechanistic basis for efficient utilization and solution prepartion of ellagic acid.

Digital screw path analog measurement of C4-6 posterior fixation parameters in adolescents aged 12-14 years and its clinical significance / 中国组织工程研究

BACKGROUND: For recent decades, there has been a younger tendency in age of occurrence of the cervical spondylosis, and posterior fusion is the main method for cervical degeneration and injury, but no relevant fixation parameters are available in clinical practice for adolescents. OBJECTIVE: To measure the anatomical parameters of C4-6posterior fixation in the adolescents aged 12-14 years after three-dimensional reconstruction. METHODS: Twenty-one adolescents aged 12-14 years, who underwent cervical examination at the Affiliated Hospital of Inner Mongolia Medical University and Department of Orthopedics of the Second Hospital of Ulanqab between January 2014 and December 2016 were randomly selected, and the CT data of the C4-6were collected, and then imported into Mimics16.01 software for three-dimensional reconstruction. We measured the anteroposterior and transverse diameters and the heights of the vertebral body, anteroposterior and transverse diameters of the transverse foramina, angles of the left and right pedicle axes to sagittal and horizontal axes, and left and right pedicle axis lengths. RESULTS AND CONCLUSION: (1) Both anteroposterior and transverse diameters of the transverse foramina were increased with vertebral level incveasing. Both angles of pedicle axis to sagittal and horizontal axes, and pedicle axis lengths were increased with vertebral level. The anteroposterior diameter of the vertebral body at C4-6was in the range of 6.0-8.0 mm, the transversal diameter was in 25.0°-30.0°, the angle between the posterior screw and the horizontal axis was 29.0°-35.0°; in the sagittal plane, the angle to the sagittal axis was no more than 5°; and the pedicle screw path length was in 6-7 mm. (2) These results show the anatomical parameters of C4-6posterior fixation in the adolescents aged 12-14 years are successfully obtained by three-dimensional reconstruction.

Effect of electroacupuncture on expressions of acetylcholine and mucin 5AC in the lungs of rats with chronic obstructive pulmonary disease / 针灸推拿医学（英文版）

Objective:To observe the effect of electroacupuncture (EA) on the expressions of acetylcholine (ACh) and mucin 5AC (MUC5AC) in the lungs of rats with chronic obstructive pulmonary disease (COPD),and explore the mechanism of EA in treating COPD.Methods:Thirty Sprague-Dawley (SD) rats were randomly divided into a control group,a COPD group,and an EA group,with 10 rats in each group.The control group was a group of normal rats.The COPD rat model was induced by cigarette smoke combined with lipopolysaccharide (LPS).The COPD rats were treated with EA at bilateral Feishu (BL 13) and Zusanli (ST 36) in the EA group,30 min each time,once a day,successively for 14 d.The lung function was tested.The contents of ACh and MUC5AC in lungs and bronchoalveolar lavage fluid (BALF) were detected by enzyme-linked immunosorbent assay (ELISA).Pearson method was used to analyze the correlation between pulmonary function and the content of MUC5AC in lungs.The mRNA and protein expressions of MUC5AC in lung tissues were detected by real-time polymerase chain reaction (RT-PCR) and Western blot (WB),respectively.The immune response of MUC5AC was observed by immunohistochemistry.Results:Eight rats were left in each group,and the other two died.Compared with the control group,the total airway resistance (Raw) increased significantly and dynamic compliance (Cdyn) decreased significantly in the COPD group (P＜0.01);compared with the COPD group,the Raw level declined significantly and Cdyn increased significantly in the EA group (P＜0.01).The contents of ACh and MUC5AC in the lungs and BALF were remarkably higher in the COPD group compared with those in the control group (P＜0.01,P＜0.001);compared with the COPD group,the contents of ACh and MUC5AC were significantly lower in the EA group (P＜0.05,P＜0.001).There was a negative correlation between MUC5AC content and lung function (P＜0.001).The mRNA and protein expressions of MUC5AC in the lungs were significantly higher in the COPD group than in the control group (P＜0.001);compared with the COPD group,the expressions were significantly lower in the EA group (P＜0.01).Compared with the control group,the immune response of MUC5AC in the airway epithelium significantly increased in the COPD group (P＜0.001);the immune response of MUC5AC was significantly lower in the EA group compared with that in the COPD group (P＜0.001).Conclusion:EA treatment can improve the lung function of COPD rats,which may be related to its effect in the down-regulation of ACh and MUC5AC contents in the lungs as well as the inhibition of mucus hypersecretion.

Electro-acupuncture regulates the cholinergic anti-inflammatory pathway in a rat model of chronic obstructive pulmonary disease / 中西医结合学报

<p><b>OBJECTIVE</b>Acupuncture has a definite therapeutic effect on chronic obstructive pulmonary disease (COPD), and the cholinergic anti-inflammatory pathway (CAP) has been shown to be involved in regulation of inflammation. In this study, we investigated whether electro-acupuncture (EA) affects the CAP in COPD.</p><p><b>METHODS</b>Sprague-Dawley rats were induced into COPD through exposure to cigarette smoke combined with lipopolysaccharide. EA treatment was applied at Zusanli (ST36) and Feishu (BL13) points for 30 min/d for 7 d. Seventy-two rats were randomly divided into six study groups, including normal, normal + EA, normal + α-bungarotoxin (α-BGT) (the antagonist of the nicotinic acetylcholine receptor α7 subunit (α7nAChR)) + EA, COPD, COPD + EA, and COPD + α-BGT + EA. Lung function, pathology and vagus nerve discharge were tested. The levels of acetylcholine (ACh), acetylcholinesterase (AChE), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in bronchoalveolar lavage fluid (BALF) and lung tissue were measured by enzyme-linked immunosorbent assay. The mRNA and protein expression and immunoreactivity of α7nAChR and its postreceptor inflammation signal pathway, including janus kinase 2 (JAK2), signal transducers and activators of transcription 3 (STAT3), nuclear factor-κB (NF-κB), were observed by quantitative reverse transcription-polymerase chain reaction, Western blot and immunohistochemistry.</p><p><b>RESULTS</b>Compared with normal rats, there were a significant decline in lung function and discharge of the vagus nerve (P < 0.01), a marked sign of lung inflammation and an increase of ACh, AChE, IL-6 and TNF-α level in BALF or lung tissue (P < 0.05, P < 0.01) and higher expression of α7nAChR, JAK2, STAT3 and NF-κB (P < 0.05, P < 0.01) in the COPD rats. In rats receiving EA, the lung function and vagal discharge were enhanced (P < 0.01), lung inflammation was improved and the levels of ACh, AChE, IL-6 and TNF-α were decreased (P < 0.01). Further, the expression of α7nAChR, JAK2, STAT3 and NF-κB was downregulated (P < 0.05, P < 0.01). However, the above effects of EA were blocked in rats injected with α-BGT (P < 0.01).</p><p><b>CONCLUSION</b>EA treatment can reduce the lung inflammatory response and improve lung function in COPD, which may be related to its involvement in the regulation of CAP.</p>

Patients Administered Neoadjuvant Chemotherapy Could be Enrolled into an Enhanced Recovery after Surgery Program for Locally Advanced Gastric Cancer / 中华医学杂志(英文版)

<p><b>Background</b>Most studies on enhanced recovery after surgery (ERAS) for gastric cancer exclude patients who received neoadjuvant chemotherapy. Here, we aimed to evaluate whether patients who received neoadjuvant chemotherapy can be enrolled into the ERAS program for locally advanced gastric cancer.</p><p><b>Methods</b>From April 2015 to July 2017, 114 patients who received neoadjuvant chemotherapy for locally advanced gastric cancer were randomized into ERAS and standard care (SC) groups. Postoperative length of stay, complications, bowel function, and nutritional status were recorded.</p><p><b>Results:</b>The postoperative length of stay of the ERAS group was shorter compared with that of the SC group (5.9 ± 5.6 vs. 8.1 ± 5.3 days, P = 0.037). The postoperative complication rate was 9.3% in the ERAS group and 11.5% in the SC group (P = 0.700). The time to first flatus (2.7 ± 2.0 vs. 4.5 ± 4.6 days, P = 0.010) and time to a semi-liquid diet (3.2 ± 2.1 vs. 6.3 ± 4.9 days, P < 0.001) in the ERAS group were shorter compared with those in the SC group. On the 10day after surgery, the values of weight, total protein, albumin, and prealbumin of the ERAS group were lower compared with those of the SC group.</p><p><b>Conclusions:</b>Patients who received neoadjuvant chemotherapy could be enrolled into ERAS programs for locally advanced gastric cancer. The nutritional status of these patients was not adversely affected.</p>

Study on role of TIGIT signal in Th1/Th2 balance in Schistosoma japonicum-infected mice / 中国血吸虫病防治杂志

Objective To investigate the role of TIGIT signal in Th1/Th2 balance in the process of Schistosoma japonicum in-fection.Methods Male C57BL/6 mice were infected with cercariae of S.japonicum,and normal uninfected mice served as the controls.The percentages of TIGIT+cells,Ki67+CD3+CD4+TIGIT+cells,Ki67+CD3+CD4+TIGIT-cells,IFN-γ+CD3+CD4+TIGIT+cells,IFN-γ+CD3+CD4+TIGIT- cells,IL-4+CD3+CD4+TIGIT+cells and IL-4+CD3+CD4+TIGIT- cells were evaluated in mouse spleen by flow cytometry.Results The proportion of TIGIT+CD4+T cells was higher in the spleen of S.japonicum-infected mice than in the normal uninfected mice(29.30%±0.70% vs.3.09%±0.50%;t=8.834,P<0.01).However,no significant differ-ence in the percentages of TIGIT+CD8+T cells between the infection group and normal controls(3.61% ± 0.26% vs. 3.58% ± 0.16%;t=0.108,P>0.05),and no significant difference was detected in the percentages of TIGIT+cells in non-T cells be-tween the infection group and controls(1.86%±0.19% vs.1.37%±0.17%;t=1.931,P>0.05).In addition,the proportion of Ki67 in the TIGIT+cells was higher than that in the TIGIT-cells(17.03%±0.64% vs.6.59%±0.37%;t=14.09,P<0.01).The Th2/Th1 ratio was higher in the TIGIT+CD4+T cells than in the TIGIT-CD4+T cells(39.28%±3.75% vs.11.79%±1.64%;t=6.721,P<0.01).Conclusion The TIGIT signaling may be involved in the development of Th2 responses in the mice infected with S.japonicum.

Effects of glycolytic pathway on generation of regulatory T cells during Schistosoma japonicum infection / 中国血吸虫病防治杂志

Objective To assess the influence of glycolytic pathway on the proportion and numbers of regulatory T cells dur-ing Schistosoma japonicum infection. Methods A S. japonicum-infected mouse model was established,and C57/BL6 male mice infected with S.japonicum were subjected to intraperitoneal injections of with the glycolytic inhibitor 2-Deoxy-D-glucose (2DG)or PBS for 6 times,and then the cells from spleen or mesenteric lymph nodes(LNs)were isolated and analyzed by flow cytometry(FCM)to detect the percentage of Glut1+CD4+T cells and Treg cells. Results The proportions of Glut1+CD4+T cells in the spleen(43.58%±2.50% vs.21.15%±0.96%;t=8.834,P<0.01)and mesenteric LNs(38.97%±1.97% vs.28.40%± 2.11%;t=3.662,P<0.05)were higher in the normal mice than those in the infected mice,and the percentages of Treg cells in the spleen(6.83% ± 0.21% vs. 13.30% ± 0.35%;t = 15.65,P < 0.01)and LNs(8.26% ± 0.15% vs. 14.37% ± 0.44%;t =13.14,P<0.01)were lower in the normal mice than those in the infected mice.In addition,the proportions of Treg cells in the spleen(15.50%±0.76% vs.13.07%±0.15%;t=3.130,P<0.05)and LNs(17.00% ± 0.41% vs.13.83% ± 0.18%;t=6.947, P<0.01)were higher in the infected mice injected intraperitoneally with 2DG than those in the infected mice injected intraperi-toneally with PBS. Conclusion Glycolytic pathway inhibits Treg differentiation in the spleen and mesenteric LNs of S.japoni-cum-infected mice.

Expression of BRAF protein in patients with papillary thyroid carcinoma and clinical significance of the research / 中国现代普通外科进展

Objective:To explore the Papillary thyroid carcinoma(PTC) in patients with the expression of BRAF protein and correlation with clinical indicators.Methods:During the selection from June 2015 to June 2016 in our hospital diagnosis and treatment of 120 patients with PTC as the observation group,the other choice during the same period in our hospital make a diagnosis and give treatment of PCT 57 cases as control group,patients with thyroid cancer by immunohistochemical method to detect mutated BRAF protein expression in two groups of patients,and analyze the BRAF protein positive expression and the correlation of PTC clinical indicators.Results:Observation group of patients BRAF protein positive rate was 74.17％,the negative rate was 25.83％,control group patients BRAF protein positive rate was 7.02％,the negative rate was 92.98％,the comparison between groups have significant statistical difference(P＜0.01);Age≤45 years,diameter of tumor＞1 cm,TNM staging for Ⅲ ～Ⅳ stage of PTC patients of BRAF protein positive rate were 96.43％,82.35％,95.65％,significantly higher than the age＞45 years,tumor diameter＜1cm,TNM staging for Ⅰ ～ Ⅱ stage were 67.39％,63.46％,69.07％,and the corresponding comparison have significant statistical difference(P＜0.05).Conclusion:PTC mutated BRAF protein positive rate was significantly higher in patients with non PTC thyroid cancer patients,patients with PTC BRAF protein positive expression related to age,tumor diameter and tumor stage.

Methological quality of systematic reviews and meta-analyses on acupuncture for stroke: A review of review / 中国结合医学杂志

<p><b>OBJECTIVE</b>To assess the methodological quality of systematic reviews and meta-analyses regarding acupuncture intervention for stroke and the primary studies within them.</p><p><b>METHODS</b>Two researchers searched PubMed, Cumulative index to Nursing and Allied Health Literature, Embase, ISI Web of Knowledge, Cochrane, Allied and Complementary Medicine, Ovid Medline, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang and Traditional Chinese Medical Database to identify systematic reviews and meta-analyses about acupuncture for stroke published from the inception to December 2016. Review characteristics and the criteria for assessing the primary studies within reviews were extracted. The methodological quality of the reviews was assessed using adapted Oxman and Guyatt Scale. The methodological quality of primary studies was also assessed.</p><p><b>RESULTS</b>Thirty-two eligible reviews were identified, 15 in English and 17 in Chinese. The English reviews were scored higher than the Chinese reviews (P=0.025), especially in criteria for avoiding bias and the scope of search. All reviews used the quality criteria to evaluate the methodological quality of primary studies, but some criteria were not comprehensive. The primary studies, in particular the Chinese reviews, had problems with randomization, allocation concealment, blinding, dropouts and withdrawals, intent-to-treat analysis and adverse events.</p><p><b>CONCLUSIONS</b>Important methodological flaws were found in Chinese systematic reviews and primary studies. It was necessary to improve the methodological quality and reporting quality of both the systematic reviews published in China and primary studies on acupuncture for stroke.</p>

LPL gene Pvu II polymorphism and hypertriglyceridemia: a meta-analysis involving 1,640 subjects

BACKGROUND/AIMS: Although lipoprotein lipase (LPL) gene Pvu II polymorphism has been associated with an increased risk of hypertriglyceridemia (HT), there is no clear consensus within the scientific community. METHODS: A meta-analysis of 1,640 subjects from six individual studies was conducted to better elucidate the potential relationship between the LPL gene Pvu II polymorphism and HT within the Chinese population. Pooled odds ratios (ORs) and their corresponding 95% confidence intervals (CIs) were evaluated by using fixed effect models. RESULTS: Our analysis indicated a significant association between LPL gene Pvu II polymorphism and HT within the Chinese population under allelic (OR, 1.550; 95% CI, 1.320 to 1.830; p = 1.158 × 10-7), recessive (OR, 0.540; 95% CI, 0.390 to 0.750; p = 0.0002), dominant (OR, 1.889; 95% CI, 1.501 to 2.377; p = 5.960 × 10-8), homozygous (OR, 2.167; 95% CI, 1.531 to 3.067; p = 1.242 × 10-5), heterozygous (OR, 1.810; 95% CI, 1.419 to 2.309; p = 1.842 × 10-6), and additive genetic models (OR, 1.553; 95% CI, 1.320 to 1.828; p = 1.158 × 10-7). CONCLUSIONS: Because LPL gene Pvu II restriction fragment length polymorphism polymorphism was associated with an elevated risk of HT, the P+ allele carriers of the LPL gene might be predisposed to HT.

Effect of Intensive Scapular Control Training on Post-stroke Shoulder Pain / 中国康复理论与实践

@#Objective To observe the effect of intensive scapular control training on pain, upper limb motor function and activities of daily living (ADL) in patients with post-stroke shoulder pain. Methods 58 patients with hemiplegia after stroke were randomly assigned into routine exercise group (group A, n=27) and intensive scapular control training group (group B, n=31). They were assessed with visual analogue scale for pain, simplified Fugl-Meyer Assessment and modified Bathel Index before and 8 weeks after treatment. Results All the assessment appeared better in group B than in group A after treatment (P<0.05). Conclusion Intensive scapular control training can promote the recovery of motor function and ADL, relieve the pain in patients with post-stroke shoulder pain.

Effect analysis of femtosecond laser micro incision corneal stroma lens removal / 国际眼科杂志(Guoji Yanke Zazhi)

AlM:To analyze and compare the effect of femtosecond laser micro - incision corneal stromal lens excision ( SMlLE) and excimer laser in situ keratomileusis ( LASlK) in the treatment of myopia after operation, to explore the safety, operability and prediction of SMlLE.METHODS:ln this prospective clinical controlled study, 100 cases ( 200 eyes ) received SMlLE and 100 cases ( 200 eyes) undergone LASl in our hospital in the same period were selected. Uncorrected visual acuity, diopter, corrected visual acuity, slit lamp examination, intraocular pressure and corneal anterior segment OCT, corneal topography (Obscan ll) of two groups in 1d, 1wk, 1, 3, 6mo, 1a were compared. lndependent samples t test was used for data analysis.RESULTS:1) Postoperative slit lamp examination:after 1d in SMlLE group, there were less eyes had corneal layer between mild cloudy or edema; postoperative 1wk corneal layer disappeared, cornea became clear and transparent. 2 ) Postoperative vision recovery: 1d after operation, vision recovery in LASlK group was better than that in SMlLE group, the difference was statistically significant (P0. 05 ). 3 ) Obscan ll examination: graphics in the SMlLE group was more regular and placed in the center, no eccentric and irregular graphics, better than that in the LASlK group. 4) Anterior segment OCT examination:postoperative corneal flap in the SMlLE group was more uniform and accurate, but it was thin in the center and slightly thick the peripheral part in the LASlK groups. 5 ) Postoperative visual quality assessment used subjective questionnaire survey. The two groups had statistically significant difference on 4 points and 1 points (P<0. 05). Complains in the LASlK groups were more that that in the SMlLE group. While, no complain of the SMlLE group was higher than that of the LASlK group. Glare of postoperative patients with night vision and dark environment in the SMlLE group was better than that of the LASlK group.CONCLUSlON: SMlLE is safe, effective, stable and predictable for the correction of myopia.

Infection of different corneal surgeries on subbasal nerves / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the recovery of corneal subbasal nerves after laser - assisted subepithelial keratomileusis (LASEK), laser in situ keratomileusis ( LASIK), femto-second lenticule extraction ( FLEx ) and small incision lenticule extraction ( SMILE) . METHODS: Confocal microscopy was used to observe subbasal nerves 1mo after surgery in 12 eyes of 12 LASEK patients, 12 eyes of 12 LASIK patients, 12 eyes of 12 FLEx patients and 12 eyes of 12 SMILE patients as well as some other follow-up times. RESULTS: Subbasal nerves 1mo after SMILE were almost complete and regular, showing no significant differences from those 2wk after surgery or even unoperated eyes. The nerves cut off at the incision were well involuted 1mo after surgery. Subbasal nerves were damaged in different degrees and got repaired to form communicating branches with time lapse after LASEK, LASIK and FLEx. CONCLUSION: SMILE exerted small infections on subbasal nerves. It may be superior to other corneal refractive surgeries in terms of postoperative nerve recovery.

Electroacupuncture at Feishu (BL13) and Zusanli (ST36) down-regulates the expression of orexins and their receptors in rats with chronic obstructive pulmonary disease / 中西医结合学报

<p><b>OBJECTIVE</b>Inflammation and lung function decline are the main pathophysiological features of chronic obstructive pulmonary disease (COPD). Acupuncture can improve lung function in patients with COPD, but the underlying mechanisms are not well understood. Orexins (OXs), which are found in peripheral plasma, are neuropeptides that regulate respiration and their levels are related to COPD. Therefore, we hypothesized that acupuncture might alter OXs, reduce lung inflammation and improve lung function in COPD.</p><p><b>METHODS</b>COPD was induced in rats by exposure to cigarette smoke for 8 weeks and injecting with lipopolysaccharide twice. Electroacupuncture (EA) was performed at Feishu (BL13) and Zusanli (ST36) for 30 min/d for 2 weeks. Rat lung function and morphology were assessed after EA. The levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in bronchoalveolar lavage fluid (BALF) and orexin A and B levels in the lung tissue were detected by enzyme-linked immunosorbent assay. OX receptor mRNA levels and immunopositive cells were assessed with real-time polymerase chain reaction and immunohistochemical methods, respectively. The relationships among lung function, cell factors, and OX levels were analyzed by Pearson correlation analyses.</p><p><b>RESULTS</b>Compared with the control group, lung function was significantly decreased in the rats with COPD (P<0.05). There were increases in TNF-α and IL-1β levels in BALF (P<0.05 and P<0.01, respectively), orexin A level in lung tissue (P<0.01; but not orexin B) and mRNA expressions of OX (OXR1) and OX 2 (OXR2) in lung tissue (P<0.05 and P<0.01, respectively); the integrative optical densities (IODs) of both receptors were greater in the COPD group (P<0.05). For rats with COPD subjected to EA, lung function was improved (P<0.05). There were notable decreases in TNF-α and IL-1β levels (P<0.05 and <0.01, respectively) in BALF. Orexin A, but not orexinB, levels in lung tissue also decreased (P<0.01), as did mRNA expression of OX1R and OX2R in lung tissue (P<0.05 and P<0.01, respectively). Receptor IODs were also reduced after EA treatment (P<0.05). Furthermore, orexin A levels and ratio of forced expiratory volume in 0.3 s to forced vital capacity were strongly negatively correlated (P<0.01), and orexin A was positively correlated with TNF-α and IL-1β (P<0.001 and P<0.05, respectively).</p><p><b>CONCLUSION</b>EA at Zusanli and Feishu improved lung function of rats with COPD and had an anti-inflammatory effect, which may be related to down-regulation of OXA and its receptors.</p>

Investigation of screening methods for identifying population susceptible to noise-induced hearing loss / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the screening methods for identifying the populations susceptible and resistant to noise-induced hearing loss (NIHL) and to provide a reference for future research.</p><p><b>METHODS</b>Workers who were exposed to 75 ∼ 120 dB noise in enterprises were included in the study. Field investigation of occupational health was conducted; workers' basic information and data on hearing threshold levels were collected. Paired chi-square test was used to compare each two of three screening methods, which were used at home and abroad to identify noise-susceptible and noise-sensitive populations, in terms of noise exposure level, general information, and noise-induced hearing threshold shift.</p><p><b>RESULTS</b>There were no significant differences in the noise exposure level, basic information, and left and right ears' hearing threshold levels of noise-susceptible and noise-sensitive populations between each two of the three screening methods (P > 0.05), according to the paired chi-square test. However, high-frequency hearing threshold had statistically significant difference among the three methods. As a whole, methods B and C were superior to method A.</p><p><b>CONCLUSION</b>The workers in China are younger than before, with more awareness of self-protection, and individual protection is enhanced in them. Currently, method B is more suitable for screening out the population susceptible to NIHL in China.</p>