The comparison of anatomical and functional features between patients with ischemic with non-obstructive coronary artery disease and obstructive coronary artery disease by CT / 中华放射学杂志

Objective:To explore the difference of the vessel and plaque characteristics, myocardial perfusion and cardiac function between patients with ischemia with non-obstructive coronary artery disease (INOCA) and obstructive coronary artery disease (CAD).Methods:From July 2021 to June 2022, 101 patients with angina were referred to dynamic computed tomography myocardial perfusion (CTP) and coronary computed tomography angiography (CCTA) and retrospectively included in our hospital. Based on the results of CTP and CCTA, patients were divided into INOCA (27 cases), moderate obstructive CAD (26 cases) and severe obstructive CAD (48 cases). The anatomical coronary artery stenosis, plaque characteristics and myocardial perfusion features of all patients were analyzed. Furthermore, left ventricular global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained on full-phase reconstruction CCTA image by using Medis Suite 3.2 postprocessing software. Multigroup analysis used one way ANOVA or Kruskal Wallis H test. Results:Patients with INOCA were younger than patients with moderate and severe obstructive CAD ( P<0.001). INOCA patients (7.4%, 2/27) had lower rate of positive remodeling than both moderate (57.7%, 15/26, P<0.001) and severe obstructive CAD patients (33.3%, 16/48, P=0.017). The percentage of ischemic myocardium volume in patients with INOCA were similar with those in patients with severe CAD (all P>0.05), but significantly higher than those in patients with moderate CAD (all P<0.05). No significant difference in terms of GLS was detected between patients with INOCA [-17.4% (-21.6%, -11.6%)] and severe CAD [-17.6% (-21.9%, -14.8%), P=0.536], however, patients both with INOCA and severe CAD also had higher GLS than patients with moderate obstructive CAD [-22.3% (-29.8%, -19.0%), all P<0.05]. Conclusions:Based on"one-stop-shop"CTP combined with CCTA imaging, early cardiac functional changes including abnormal myocardial perfusion and myocardial strain in INOCA patients were similar to those in patients with severe obstructive CAD and more severe than those in patients with moderate obstructive CAD.

Efficacy and safety of LY01005 versus goserelin implant in Chinese patients with prostate cancer: A multicenter, randomized, open-label, phase III, non-inferiority trial / 中华医学杂志(英文版)

BACKGROUND@#LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer.@*METHODS@#We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels.@*RESULTS@#On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]).@*CONCLUSION@#LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT04563936.

Evaluation of microvascular flow imaging combined with high-frequency ultrasonography in children with haemophilic arthropathy A / 中华实用儿科临床杂志

Objective:To explore the application of microvascular flow imaging (MVFI) combined with high-frequency ultrasonography in children with haemophilic arthropathy A (HAA).Methods:Retrospective study.A total of 82 children diagnosed with HAA in the First Affiliated Hospital of Zhengzhou University from October 2018 to October 2020 were recruited.The elbow, knee and ankle joints of each child were examined by high-frequency ultrasonography.The numbers of thickened synovial joints were recorded.Blood flow signals of the thickening of synovial joints was checked by the MVFI and power Doppler ultrasound (PDUS), respectively.Color flow signals were graded by the semi-quantitative scoring systems.The chi- square test and independent multi-group ordinal multi-category rank-sum test were used to compare the differences of MVFI and PDUS in the display of thickened synovial blood flow. Results:A total of 254 joints were involved in 82 children with HAA, including synovial hypertrophy in 188 joints, hydrops articuli in 146 joints, fibrotic septa in 66 joints, cartilage damage in 63 joints, haemosider indeposition in 45 joints, bone erosion in 25 joints, osteophytes in 15 joints and bone remodeling in 8 joints.Grade Ⅱ synovial thickened joints were the most common.The proportion of blood flow signals detected by PDUS in thickened synovial membranes was significantly higher than that detected MVFI (52.66% vs.70.21%, χ2=12.225, P<0.05). Numbers of grade 0 and Ⅰ joints with thickened synovial membranes detected by MVFI were less than those of PDUS, while the opposite result was obtained in detecting grade Ⅱ and Ⅲ joints ( H=21.158, P<0.05). Compared with PDUS, MVFI more sensitively visualized the blood flow of the thickened synovial membrane. Conclusions:MVFI can more prominently detect the thickened synovial blood flow in children with HAA.A combined application of MVFI and high-frequency ultrasonography contributes to the evaluation of children with HAA.

The inhibitory effect of pulsed ultrasound on skeletal muscle fibrosis after injury in elderly rats / 中华物理医学与康复杂志

Objective To explore the inhibitory effect of pulsed ultrasound on skeletal muscle fibrosis after injury.Methods Thirty elderly male rats with gastrocnemius muscle injury were divided into an ultrasound group (UG) and a control group (CG) using a random number table.The injured muscles in the UG were treated using pulsed ultrasound (frequency 1 MHz,average strength 40 mW/cm2,duty cycle 20％) for 10 min daily from day 3 after the injury.The CG was given no treatment.On days 3,7,14,21 and 28 after the injury,histological and immunohistochemical analyses of the gastrocnemius muscles of both groups were performed.Results The collagen fiber mean optical density of the muscles increased gradually after the injury and reached its peak on day 21.It was significantly lower in the UG than in the CG on each test day.The expression of α-SMA increased gradually after the injury,but it too remained significantly lower in UG than that in CG.Conclusion Pulsed ultrasound may reduce collagen formation and α-SMA expression in injured skeletal muscle,and then inhibit muscle fibrosis.

Fibrosis in Skeletal Muscle: Celluar and Molecular Mechanism (review) / 中国康复理论与实践

@#Skeletal muscle has high regenerative capability. It is able to regenerate completely after acute traumatic damage, while the repairing process often accompanied by fibrosis in the chronic degenerative conditions such as muscular dystrophy and repeated muscle fiber damage. Through in-depth study on the mechanisms of skeletal muscle fibrosis in the past decade, it has been found that a variety of cells and regulatory molecules involved in the process, especially muscle satellite cells-derived myofibroblasts, transforming growth factor β (TGF-β) and other fibrosis promoting growth factors. This review focused on the cellular and molecular mechanisms of the skeletal muscle fibrosis and relevant antagonistic strategies.

Study on value of combination detection of cardiac troponins I and homocysteine in individual diagnosis of non-ST elevation myocardial infarction / 重庆医学

Objective To discuss the effect of the combination detection of cardiac troponin I (cTnI) and homocysteine(Hcy) for increasing the diagnosis and treatment offects of non-ST elevation myocardial infarction (NSTEMI) .Methods The levels of cTnI and Hcy were detected in 47 patients with NSTEMI(NSTEMI group) before and after therapy and 63 healthy individuals(control group) .The detection results were performed the statistical analysis for verifying their value to judge the diagnostic and treatment effect of NSTEMI .Results The levels of cTnI and Hcy were (2 .37 ± 0 .65)ng/mL and(19 .23 ± 2 .94)μmol/L in the NSTEMI group ,which were significantly higher than(0 .33 ± 0 .14)ng/mL and(10 .62 ± 3 .27)μmol/L in the control group ,the differences showing statistical significance (P< 0 .05);the sensitivities of single cTnI and Hcy were 95 .74% and 85 .11% respectively ,and their specificities were 85 .71% and 90 .48% respectively ;the sensitivity and sepecificity of cTnI and Hcy combination detection were risen to 97 .87% and 98 .41% respectively ;after therapy ,the cTnI and Hcy levels in the NSTEMI group were significantly lowered and close to the normal levels .Conclusion The combination detection of cTnI and Hcy can not only be used for the diagno-sis of NSTEMI ,but also has the important significance to the judgment of the therapeutical effect of NSTEMI .

Fibrosis in Skeletal Muscle:Celluar and Molecular Mechanism (review) / 中国康复理论与实践

Skeletal muscle has high regenerative capability. It is able to regenerate completely after acute traumatic damage, while the repairing process often accompanied by fibrosis in the chronic degenerative conditions such as muscular dystrophy and repeated muscle fi-ber damage. Through in-depth study on the mechanisms of skeletal muscle fibrosis in the past decade, it has been found that a variety of cells and regulatory molecules involved in the process, especially muscle satellite cells-derived myofibroblasts, transforming growth factor β(TGF-β) and other fibrosis promoting growth factors. This review focused on the cellular and molecular mechanisms of the skeletal muscle fibrosis and relevant antagonistic strategies.

The effects of low intensity pulsed ultrasound on the proliferation and differentiation of myoblasts in vitro / 中华物理医学与康复杂志

Objective To study in vitro the effects of low-intensity pulsed ultrasound (LIPUS) on the proliferation and differentiation of cultured myoblasts,and to explore the cellular and molecular mechanisms behind any therapeutic effect of LIPUS.Methods Myoblasts were isolated from the skeletal muscles of mice and cultured in vitro.Treatment and control groups of proliferating and differentiating myoblasts were defined.The treatment groups were exposed to LIPUS at 1.5 MHz and a spatial and temporal average intensity of 30 mW/cm2,for 20 min daily,the proliferation group for 6 consecutive days and the differentiation group for 4 consecutive days.The cell proliferation kinetics of the proliferation group were analyzed using flow cytometry.The expression of myogenic regulation factor MyoD and heme oxygenase-1 (HO-1) in the proliferation group,and of myosin heavy chain (MHC) in the differentiation group were examined by immunofluorescent staining.Myoblast fusion indexes were analyzed.Results In the LIPUS treatment groups the proliferating myoblasts had a higher ratio of active cells in the G2 and S phases (19.30％ ±5.14％,37.00％ ±8.72％),compared with the controls (10.33％ ± 1.53％,25.00％ ±4.36％),and the proliferation index increased significantly.The expression of HO-1 was up-regulated,while MyoD staining was unchanged.During the induction of differentiation,the myoblasts of the treatment group fused into smaller myotubes and the myoblast fusion index (18.73％ ± 6.81％) was significantly lower than that of the control group (37.52％ ± 11.23％),while MHC expression did not change markedly.Conclusion LIPUS can promote myoblast proliferation while inhibiting their differentiation,but it does not affect the cells' myogenic properties.HO-1 may be involved in the regulation process.

Surgical Treatment of 38 Patients with Acetabular Fractures / 中国基层医药

Objective To investigate the clinical effect of surgical treatment of acetabular fractures. Meth-ods According to Letoumel and Judet typing, 17 cases of posterior wall fractures, 5 cases of transverse fractures, 3 cases of anterior wall fractures, 2 cases of anterior column fractures,5 cases of transverse and posterior wall fractures, 2 cases of posterior column and wall fractures, 2 cases of T-type fractures, 1 case of anterior and hemi-transverse fractures and 1 case of fractures of both column). Kocher Langenbeck (K-L) approach was applied in 30 cases, ilio-inguinal approach in 7, and combined approaches (K-L plus ilioinguinal) in 1. Results According to Matta evalua-tion, anatomical reduction(displace < 1 mm) was applied in 30 patients. Satisfactory reduction(displace 2～3 mm) was attained in 6 patients, unsatisfactory reduction(displace >3 mm) was in 2 patients. 38 patients were followed up for 6～48 months (mean: 25 months). The hip function was evaluated according to the modified Postel-D, Aubigne score and rated as excellence in 31 patients(81.5%), good in 5 patients(13.1%), fair in 1 patient(2.6%) and poor in 1 petient(2.6%). The excellent and good rate was 81.5%. Conclusions It is the important guarantee to elevate the therapeutic efficacy of acetabular fracture that shoud be correcdy analyze the fracture displacement and type, choose proper surgical approach, have good restitution implement and operate at the right moment. The quality of surgical reduction has a close correlation with the clinical results.