Trombo flotante en el arco aórtico, una causa poco frecuente de isquemia de miembros inferiores / Floating thrombus in the aortic arch, a rare cause of lower limb ischemia

Resumen La oclusión arterial aguda de los miembros inferio res es una urgencia médica y quirúrgica por su morbi mortalidad. Presentamos el caso de un hombre de 59 años que ingresó al servicio de urgencias por un dolor agudo y difuso del miembro inferior izquierdo causado por extensos coágulos obstructivos en las arterias del miembro inferior izquierdo. Siendo improbable la cau sa ateromatosa tras realización de la angioscopia de miembros inferiores, se sospechó un origen cardíaco. La ecografía cardiaca no mostró anomalías, sin embargo, la angiotomografía torácica reveló un trombo flotante en el arco aórtico. El paciente fue tratado quirúrgica mente con colocación de una endoprótesis aórtica sin complicaciones.

Abstract Acute arterial occlusion of the lower limbs is a medi cal and surgical emergency due to its morbi-mortality. We present the case of a 59-year-old man admitted to the emergency department for acute and diffuse pain in the left lower limb caused by extensive obstructive clots in the arteries of this limb. Since atheromatous cause was unlikely after angioscopy of the lower limbs, a car diac origin was suspected. Echocardiogram was normal, however, thoracic angiotomography revealed a floating thrombus in the aortic arch. The patient was treated surgically with placement of an aortic endoprosthesis without complications.

Floating hip injury managed in a single stage with good outcome

Introduction: The term floating hip is used to denote a fracture pattern involving fracture of pelvis or acetabulum and ipsilateral femur. These injuries are seen as a result of high velocity trauma. Objective: Our objective was to highlight the usefulness of single stage surgery using a common incision, the order of fracture fixation, in lateral decubitus position for type B floating hip injuries. Case report: A 58-year-old male, was brought presented to our emergency department with pain, swelling, deformity of right lower limb following a road traffic accident. On primary examination, patient was in hypovolemic shock. Imaging revealed the right posterior column and posterior wall of acetabulum with ipsilateral diaphyseal femur fracture. After stabilizing the patient, we operated on him in a single stage in lateral decubitus position, in which we fixed the femur first followed by acetabulum. Conclusion: Single stage fixation in lateral decubitus position after adequate resuscitation and evaluation can offer a good outcome by reducing the operative time and post- operative complications.

Introducción: El término cadera flotante se utiliza para denotar un patrón de fractura que implica fractura de pelvis o acetábulo y fémur ipsilateral. Estas lesiones se ven como resultado de un trauma a alta velocidad. Objetivo: Destacar la utilidad de la cirugía de una sola etapa mediante una incisión común, el orden de fijación de la fractura en decúbito lateral para lesiones de cadera flotante tipo B. Informe de caso: Un varón de 58 años fue llevado a nuestro servicio de urgencias con dolor, hinchazón, deformidad del miembro inferior derecho después de un accidente de tráfico. En el examen primario, el paciente estaba en shock hipovolémico. Las imágenes revelaron la columna posterior derecha y la pared posterior del acetábulo con fractura ipsilateral diafisaria del fémur. Después de estabilizar al paciente, se operó en una sola etapa en posición decúbito lateral, en la que primero se fijó el fémur seguido del acetábulo. Conclusión: La fijación de un solo estadio en posición decúbito lateral después de una reanimación y evaluación adecuadas puede ofrecer un buen resultado al reducir el tiempo de operación y las complicaciones postoperatorias.

Discussion on Acupuncture in the Treatment of Female Stress Urinary Incontinence Based on the Theory of Channel Sinew / 中医杂志

Female stress urinary incontinence （SUI） caused by support structure damage or relaxation of the urethra and bladder belongs to the category of “channel sinew disease” in traditional Chinese medicine （TCM）. The pathogenesis of this disease is “loss of nourishment in the channel sinews， and failure to contract because of relaxation”， which can be divided into two situations： deficiency syndrome mainly refers to qi deficiency， closely related to the three zang （脏） organs including lung， spleen， and kidney； and the excess syndrome mainly refers to heat pathogen and blood stasis. Therefore， the treatment principle of “nourishing the channel sinews， regulating sinews and controlling fluid” is proposed. The acupoints in the lower abdomen， lumbosacral region， and lower limbs are mainly selected in the treatment of SUI with channel sinew needling， such as Qihai （RN 6）， Guanyuan （RN 4）， and Baliao. The selection of acupoints also emphasizes the pain area. Channel sinew needling includes floating needling， round-sharp needling， penetrating needling， and prickly needling， which reflects the integrity of channel sinew system， and emphasizes the local therapeutic effects highlighting arrival of needling effects at the location of disease. The theory of channel sinew opens up new ideas for treating SUI with acupuncture and moxibustion.

Migration characteristics among HIV/AIDS patients reported in Yiwu City from 2016 to 2020 / 预防医学

Objective@#To investigate the migration characteristics and follow-up treatment among HIV/AIDS patients after HIV confirmation in Yiwu City, Zhejiang Province from 2016 to 2020, so as to provide insights into the optimization of the HIV/AIDS control strategy among floating populations.@*Methods@#The reported HIV/AIDS patients' demographics, follow-up and treatment data in Yiwu City from 2016 to 2020 were captured from the HIV/AIDS Prevention and Control Information System of Chinese Disease Control and Prevention Information System. The migration characteristics, antiretroviral therapy and outcomes of HIV/AIDS patients were analyzed after HIV confirmation, and the factors affecting the migration of HIV/AIDS patients after HIV confirmation were identified using a Cox proportional hazard regression model.@*Results@#A total of 1 189 HIV/AIDS patients were enrolled, including 988 men (83.10%) and 806 cases without Zhejiang provincial household registration (67.79%). There were 441 patients (37.09%) migrating out of Yiwu City after HIV confirmation, with a migration rate of 17.73/100 person-years, and there were 366 patients migrating out of Zhejiang Province, with a cross-province migration rate of 30.78%. Among participants without Zhejiang provincial household registration, 395 patients (49.01%) migrated out of Yiwu City, including 337 patients (85.32%) returning to their household registration provinces, which mainly included Yunnan, Sichuan, Guizhou and Hunan. Cox proportional hazard regression analysis showed a high risk of migration among minority ethnic populations (HR=1.375, 95%CI: 1.044-1.811), retires (HR=3.605, 95%CI: 1.771-7.335), students (HR=8.969, 95%CI: 4.095-19.645), patients without Zhejiang provincial household registration (HR=4.545, 95%CI: 3.164-6.529) and patients identified through physical examination of floating populations or employees (HR=1.318, 95%CI: 1.006-1.727), and a low risk among married patients with spouses (HR=0.721, 95%CI: 0.569-0.913) and with an educational level of junior high school and above (HR: 0.428~0.753, 95%CI: 0.280-0.952). Among all floating HIV/AIDS patients, there were 26 cases lost to follow-up (5.90%) and 49 deaths (11.11%). In addition, the proportion of absence of antiretroviral therapy, HIV infection progressing into AIDS patients and failure in HIV inhibition were all greater among floating HIV/AIDS patients than among non-floating patients (P<0.05).@*Conclusions@#A high risk of migration was found among HIV/AIDS patients without Zhejiang provincial household registration, unmarried patients, patients with a low education level, retirees, students, and patients identified through physical examination of floating populations or employees in Yiwu City from 2016 to 2020, and migration does not facilitate the sustainability of antiretroviral therapy and follow-up, which may affect the prognosis of HIV/AIDS.

Epidemiological characteristics of leprosy in China from 2016 to 2020 / 中华皮肤科杂志

Objective:To analyze epidemiological characteristics of leprosy in China from 2016 to 2020, and to provide a scientific basis for further elimination of leprosy.Methods:Data collation and statistical analysis were conducted on annual reports on leprosy epidemic surveillance in China (excluding Hong Kong, Macao, and Taiwan regions) from 2016 to 2020.Results:From 2016 to 2020, a total of 2 697 new cases of leprosy were reported in China, including 46 (1.71%) children, 894 (33.15%) females, 374 (13.87%) floating people, 2 443 (90.58%) multibacillary cases, and 546 (20.24%) cases of grade 2 disabilities. A total of 203 relapsed cases were reported in the meantime. By the end of 2020, there had been 1 893 registered leprosy cases in China, and the number of cases was 68.62% fewer than that in 2010 (6 032 cases) ; there were 36 (1.2%) counties or cities with a prevalence rate above 1 per 100 000, and 72 (17.73%) new cases suffered from grade 2 disabilities.Conclusion:From 2016 to 2020, the reported incidence and prevalence of leprosy in China steadily decreased year by year, and overall, leprosy was still lowly prevalent.

Trend in incidence of stroke in Nanshan District from 2010 to 2021 / 预防医学

Objective@# To establish a comprehensive health evaluation index system for HIV-infected pregnant women in floating populations, so as to support the elimination of mother-to-child transmission of HIV. @*Methods@# The preliminary framework of the comprehensive health evaluation indicators was constructed based on literature review and focus group discussion. Experts from maternal and child healthcare, clinical medicine and public health were invited to participate in two-round Delphi consultations. The indicators were scored and weighed according to the importance, priority and measurability, and determined according to means and coefficients of variation of scores. The effectiveness of the consultation was evaluated by positive coefficient, authority coefficient and coordination coefficient.@*Results@# Twenty-six experts participated in this study, including 19 women. There were 5 experts aged 30-40 years, 14 experts aged 41-50 years, and 7 experts aged 51 years and over. There were 17 experts with a master degree and above. All experts had vice senior professional titles and above. The positive coefficients in the two rounds of consultations were 96.30% and 100.00%, the authority coefficients were 0.84 and 0.89, respectively. Finally, 4 primary indicators (individuals and families, disease factors, social environment, health service utilization) and 50 secondary indicators were identified, with the coefficients of variation ranging from 0.084 to 0.236 and the coordination coefficients ranging from 0.282 to 0.405 (all P<0.001). Among the secondary indicators, getting antiviral drugs at the place of residence was restricted to floating populations or not (0.780), HIV viral load during pregnancy (0.750), the registration of maternal and childbirth care manuals at the place of residence was restricted to floating populations or not (0.749), and first-trimester registration or not (0.738) had a high weight. @*Conclusion @#This index system can provide the reference for evaluating the health equity of HIV-infected pregnant and lying-in women in floating populations.

Application of Intraoperative Transesophageal Echocardiography in the Treatment of Renal Cell Carcinoma with Inferior Vena Cava Tumor Thrombus / 中国医学科学院学报

Objective To investigate the value of intraoperative transesophageal echocardiography (TEE) in the diagnosis and treatment of renal cell carcinoma with inferior vena cava tumor thrombus. Methods Ten patients of renal cell carcinoma with inferior vena cava tumor thrombus treated in the Second Hospital of Hebei Medical University from January 2017 to January 2021 were selected.TEE was employed to locate the position of the tumor thrombus,determine the occlusion point of the inferior vena cava,count the intraoperative tumor thrombus shedding rate,examine the tumor thrombus resection integrity,and measure blood loss and other indicators,on the basis of which the application value of TEE in the operation of renal cell carcinoma with inferior vena cava tumor thrombus was evaluated. Results All the 10 patients had completed the operations successfully,including 8 patients of open operation and 2 patients of laparoscopic operation.TEE showed tumor thrombi clearly,and all the tumor thrombi were completely removed.There was no tumor thrombus shedding during the operation.The blood loss varied within the range of 300-800 ml,with the mean of (520.0±193.2) ml.The grade III tumor thrombi in 2 patients and the grade I tumor thrombus in 1 patient diagnosed before operation were reduced to grade Ⅱ and upgraded to grade Ⅱ,respectively,by TEE.One patient had no floating tumor thrombus at the end of tumor thrombus before operation,and the blocking position was adjusted in time with the assistance of TEE to avoid the shedding of the floating tumor thrombus. Conclusion TEE can accurately determine and dynamically monitor the location and shape of inferior vena cava tumor thrombus,which provides an important reference and has a significant clinical value in the operation of renal cell carcinoma with inferior vena cava tumor thrombus.

El peroné flotante: resultado de una luxación tibioastragalina pura con lesión de la articulación tibioperonea proximal: reporte de caso / The floating fibula: outcome of pure tibiotalar dislocation with lesion to the proximal tibiofibular joint: case report

ANTECEDENTES El peroné flotante tras un traumatismo de alta energía es una entidad muy poco frecuente. Este es el primer reporte de caso asociado a luxación del tendón bicipital. OBJETIVO Presentar un caso de peroné flotante tras luxación divergente de tobillo asociado a luxación peronea proximal. MATERIALES Y MÉTODOS Mujer de 17 añ que, tras accidente de tráfico, sufrió caída y presentó dolor y deformidad del tobillo izquierdo, junto con dolor e impotencia funcional de la rodilla ipsilateral. En las radiografías, se apreció una luxación pura divergente del tobillo izquierdo de tipo IV. Se realizó reducción cerrada en urgencias. El estudio se complementó con una resonancia magnética que mostró una rotura completa de la sindesmosis y del ligamento deltoideo, así como una fractura no desplazada de la meseta tibial externa, junto con un desgarro de la cápsula tibioperonea proximal y desprendimiento completo del ligamento lateral externo y del tendón bicipital desde su inserción en la cabeza del peroné. Se realizó reanclaje de la sindesmosis y del ligamento deltoideo, así como del ligamento lateral externo y del tendón bicipital mediante anclajes óseos metálicos y reducción de peroné tanto proximal como distalmente, mediante sistema de sutura tipo botón. Se inmovilizó con férula cruropédica por cuatro semanas. RESULTADOS La paciente presentó recuperación completa de la fuerza a los cinco meses de seguimiento, con movilidad completa del tobillo y de la rodilla. CONCLUSIÓN El peroné flotante es muy poco frecuente; sólo se ha descrito un caso en la literatura. Implica la disrupción de la articulación tibioperonea proximal y distal, lo que puede provocar inestabilidad en la rodilla y en el tobillo. Por tanto, ante un traumatismo de alta energía en el tobillo, es necesaria la exploración minuciosa de la rodilla ipsilateral.

BACKGROUND Floating fibula after high-energy trauma is a very uncommon entity. The present is the first report of a case associated with avulsion of the bicipital tendon. PURPOSE To present a case of floating fibula after divergent ankle dislocation associated with proximal peroneal dislocation. MATERIALS AND METHODOS A 17-year-old woman who fell after a traffic accident and presented pain and deformity of the left ankle with pain and functional impotence in the ipsilateral knee. The radiographs showed a pure divergent type-IV left-ankle dislocation. Closed reduction was performed in the emergency room. The study was complemented with a magnetic resonance imaging scan which showed complete rupture of the syndesmosis and the deltoid ligament, as well as a non-displaced fracture of the external tibial plateau together with a tear of the proximal tibiofibular capsule and complete detachment of the external lateral ligament and bicipital tendon from its insertion in the peroneal head. The syndesmosis and deltoid ligament were reanchored, as well as the external lateral ligament and the bicipital tendon, using metallic bone anchors and fibula reduction both proximally and distally, using a suture-button system. The patient was immobilized with a long-leg splint for four weeks. RESULTS The patient presented complete recovery of strength at five months of follow-up. CONCLUSSION Floating fibula is a rare entity, with only one case described in the literature. It involves a disruption of the proximal and distal tibiofibular joint, which can lead to knee and ankle instability. Therefore, in cases of high-energy trauma to the ankle, a careful examination of the ipsilateral knee is necessary.

Floating Drug Delivery System: A New Approach

Floating drug delivery system (FDDS) helps to improve the buoyancy property of the drug over the gastric fluids and hence maintain the longer duration of action. The aim of the present study is on floating drug delivery systems (FDDS) was to compile the recent literature with particular focus on the main floating mechanism to achieve gastric retention. Floating multi-particulate are gastro-retentive drug delivery systems which are based on non-effervescent and effervescent approach. This type of drug delivery method would have comparatively less side effect and would eliminate the need for repeated dosages.

Dental caries and anthropometrics of children living in an informal floating Amazonian community: a cross-sectional pilot study

Abstract Aims: Increasing evidence supports a relationship between poor oral health and growth in children. Our objective was to assess the association between the presence of dental caries and anthropometric measurements of children residing in Claverito, a floating slum community in the Peruvian Amazon. Methods: For this cross-sectional study, presence of caries was assessed using dmft/DMFT (decayed, missing, filled teeth) scores and the SiC Index (mean dmft/DMFT of one-third of the study group with the highest caries score). Anthropometric categories for age-sex-specific z-scores for height and weight were calculated based on WHO standardized procedures and definitions. The association between SiC (measured by dmft/DMFT) and anthropometric measures was estimated using unadjusted and adjusted multivariable linear regression models. Critical value was established at 5%. Results: Our study population consisted of 67 children between the ages of 1 and 18 years old. Mean age was 9.5 years old (SD: 4.5), and the majority were female (52.2%). Almost all had dental caries (97.0%) and the mean dmft/DMFT score was 7.2 (SD: 4.7). The SiC Index of this population was 9.0. After adjusting for confounding variables, participants who had permanent dentition with the highest dmft/DMFT levels had statistically significant decreased height-for-age z-scores (HAZ) (p=0.04). Conclusions: We found an inverse linear association between SiC Index and height-for-age z-scores (HAZ) among children living in poverty in a floating Amazonian community in Peru. Children from under-resourced communities, like floating slums, are at high risk for oral disease possibly negatively impacting their growth and development.

Resumo Objetivos: Há cada vez mais evidências apoiando uma relação entre a saúde bucal precária e o crescimento das crianças. Nosso objetivo foi avaliar a associação entre a presença de cárie dentária e medidas antropométricas de crianças residentes em Claverito, uma comunidade flutuante de favelas na Amazônia peruana. Métodos: Para este estudo transversal, a presença de cárie foi avaliada utilizando os escores dmft/DMFT (dentes cariados, ausentes, preenchidos) e o Índice SiC (média dmft/DMFT de um terço do grupo de estudo com a maior pontuação de cárie). As categorias antropométricas para pontuações z específicas de idade e sexo para altura e peso foram calculadas com base nos procedimentos e definições padronizados da OMS. A associação entre SiC (medido por dmft/DMFT) e medidas antropométricas foi estimada usando modelos de regressão linear multivariável não ajustados e ajustados. O valor crítico foi estabelecido em 5%. Resultados: A população do estudo consistia de 67 crianças entre 1 e 18 anos de idade. A idade média era de 9,5 anos (DP: 4,5), e a maioria era do sexo feminino (52,2%). Quase todas tinham cárie dentária (97,0%) e a média da pontuação dmft/DMFT foi de 7,2 (DP: 4,7). O índice SiC desta população era de 9,0. Após ajuste para variáveis confusas, os participantes que tinham dentição permanente com os níveis mais altos de dmft/DMFT tinham diminuído estatisticamente a pontuação z de altura por idade (HAZ) (p=0,04). Conclusões: Encontramos uma associação linear inversa entre o Índice SiC e as pontuações z de altura por idade (HAZ) entre crianças que vivem na pobreza em uma comunidade amazônica flutuante no Peru. Crianças de comunidades com poucos recursos, como favelas flutuantes, correm alto risco de contrair doenças orais, possivelmente impactando negativamente seu crescimento e desenvolvimento.

Study on the quality standard of Kuipingning gastric floating tablets / 中国药房

OBJECTIVE To establish the quality standard of Kuipingning gastric floating tablets. METHODS Kuipingning gastric floating tablets were prepared and investigated in terms of property ，weight difference and friability. Crydalis yanhusuo was identified qualitatively by thin layer chromatography （TLC）method. High performance liquid chromatography method was used to determine the content of total anthraquinones in Rheum palmatum ，and set the content limit of total anthraquinones. The floating performance and release degree of the preparation were investigated ，and the release kinetic process was fitted. RESULTS Kuipingning gastric floating tablets prepared in this study were gray white to gray tablets with slight smell and bitter taste ；the weight difference and friability were all in line with relevant regulations ；the established TLC method possessed strong specificity and could accurately identify C. yanhusuo . The average content of total anthraquinones in R. palmatum was 17.95 mg/tablet，and its content limit would not be less than 14.36 mg/tablet. The initial floating time of the preparation was no more than 10 s，and the holding time was more than 8 h. The release kinetics process accorded with the Retger-Peppas release model. CONCLUSIONS The method established in this study shows good reliability ，stability and feasibility ，and can effectively control the quality of Kuipingning gastric floating tablets.

Ascending， Descending， Floating and Sinking Properties of Descurainiae Semen Lepidii Semen Based on Pulmonary Edema Model / 中国实验方剂学杂志

ObjectiveThe pulmonary edema （PE） model where the disease was located in the viscera was established according to the treatment principle that patients with the disease location inside should be treated with descending and sinking medicine， combined with changes in the disease tendency， to verify the scientificity of descending and sinking properties of Descurainiae Semen Lepidii Semen （SD）， and to preliminarily elucidate the scientific connotation of descending， ascending， floating and sinking of Chinese medicine. MethodSixty male SD rats were randomly divided into normal control group， model group （20 mg·kg-1）， positive drug group （dexamethasone， 0.075 mg·kg-1） and SD low （1.167 g·kg-1）， medium （2.334 g·kg-1）and high （4.668 g·kg-1） dose groups. The PE model was established by intrapleural injection of 1% carrageenan （2 mL·kg-1）. The evaluation indexes （lung autopsy， amount of pleural effusion， number of white blood cells， lung wet/dry weight ratio， lung water content and lung permeability） were tested to determine the optimal dose of SD decoction for intervention of PE. The relevant indexes of the five major systems （central nervous system， respiratory system， circulatory system， digestive system and urinary system） closely related to the body's Qi movement were detected and changes in the disease tendency in PE rats were analyzed， to determine the descending， ascending， floating and sinking properties of SD. In addition， histopathological changes were investigated by hematoxylin-eosin （HE） staining， and types and numbers of inflammatory cells and mediators were detected to preliminarily explore the mechanism of SD in improving PE. ResultCompared with the conditions in the normal control group， the amount of pleural effusion， number of white blood cells in pleural effusion， lung wet/dry weight ratio， lung water content and lung permeability were increased （P<0.01） in the model group， where the rats presented cough， dyspnea， shortness of breath and arched back， and a small number of them had wet nose and bubble liquid in nostrils. In the autopsy of the rats in the model group， the lungs were enlarged or accompanied by congestion and plenty of pink bubble liquid appeared at the trachea. Compared with the conditions in the model group， SD reduced the amount of pleural effusion， number of white blood cells in pleural effusion， lung coefficient， lung wet/dry weight ratio and lung water content （P<0.01）， and improved pulmonary edema symptoms such as damage， inflammation and infiltration around the lumen， thickening of the trachea， and accumulation of edema fluid， and the SD medium dose group had the best effect on the treatment of PE. In terms of respiratory system， compared with the normal control group， the model group had reduced latent time of cough and asthma （P<0.05， P<0.01） and elevated number of cough and wheezing （P<0.01）. The three SD groups had increased latent time of cough and asthma and decreased number of cough and wheezing （P<0.01）. In terms of urinary system， compared with the normal control group， the model group presented decreased urine volume. The SD low， medium and high dose groups had increased urine volume （P<0.05， P<0.01）， but they had no effect on perspiration. In terms of digestive system， compared with the conditions in the normal control group， the gastric residual rate and gastrin （GT） level were increased （P<0.05， P<0.01）， and the gastric emptying rate and small intestine transit rate were decreased （P<0.01）. The SD low dose group had elevated small intestine transit rate （P<0.01）， and the SD high and medium groups had enhanced gastric emptying rate and small intestine transit rate （P<0.01）， reduced gastric residual rate， lowered GT level to promote gastrointestinal movement and transportation （P<0.01）， and increased motilin （MTL） level to promote gastric emptying in rats （P<0.05， P<0.01）. In terms of circulatory system， compared with the normal control group， the model group displayed reduced left ventricular ejection fraction （LVEF）， left ventricular short axis shortening rate （LVFS） and cardiac output （CO） （P<0.01）， and elevated tendency of heart rate， systolic blood pressure （SBP， P<0.01） and diastolic blood pressure （DBP， P<0.05）. Compared with the model group， the SD low dose group increased LVEF and decreased DBP （P<0.05）， while the SD medium dose group increased LVEF， LVFS， CO and SBP （P<0.01） and decreased DBP （P<0.05）， and the SD high dose group increased LVFS （P<0.01） and decreased SBP （P<0.01） and DBP （P<0.05）. In terms of central nervous system， compared with the conditions in the normal control group， the standing times dropped in the model group （P<0.01）. SD reduced the movement distance， movement time， standing times and activity time in the center of the open field， and increased the rest time and activity time at the edge of the open field （P<0.05， P<0.01）. Moreover， compared with the normal control group， the model group had serious inflammatory infiltration around the lung lumen， thickened trachea with accumulated edema fluid， seriously damaged lung tissue， increased number of white blood cells and percentage of neutrophils in blood （P<0.01）， elevated percentage of monocytes， interleukin-4 （IL-4）， immunoglobulin E （IgE） level and reactive oxygen species （ROS） level in lung tissue （P<0.05，P<0.01）， and decreased IFN-γ in alveolar lavage fluid （P<0.01）. Compared with the model group， SD decreased the number of white blood cells， neutrophil accumulation， pulmonary congestion and interstitial edema， IFN-γ and IL-4 levels in alveolar lavage fluid and ROS level in lung tissue， and increased IgE level （P<0.05， P<0.01）. ConclusionSD had a significant improvement effect on PE model where the disease was located in the viscera. It could regulate the excretion of water by purgation， regulate Qi movement and expel Qi stagnation by descending and sinking lung Qi， and promote purification and descent of lung qi to make Qi movement downward. This indicated SD had the descending and sinking properties. The medium dose of SD decoction exerted the best effect， and its mechanism of action might be through regulating the neutrophil inflammatory response.

Mahuang Shengmatang Based on Five Depression Syndromes in Huangdi Neijing / 中国实验方剂学杂志

Mahuang Shengmatang was first recorded in the chapter "Reverting Yin Diseases" in the Treatise on Cold Damage （《伤寒论》）. Whether it is a classic prescription created by ZHANG Zhong-jing is controversial among scholars and physicians due to its distinctiveness in contexts and drug composition. In fact， its proven efficacy in a number of clinical cases cannot be denied， and it is rather biased to judge that Mahuang Shengmatang is a fallacy of later generations. The present study pointed out that Mahuang Shengmatang was a representative in the Treatise on Cold Damage in the treatment of diseases with complicated syndromes. In this formula， although the compatibility of drugs effective in dispersion， astringing， nourishing Yin， assisting Yang， clearing heat， dissipating cold， ascending， floating， sinking， and descending seems complex， it follows certain therapeutic principles. Five depression syndromes in the Huangdi Neijing （《黄帝内经》） highly reflect the Five Elements losing the nature， and embody multiple characteristics of the five elements， such as the movement forms， functions， and disease nature. Furthermore， the corresponding treatment methods were pointed out in the Plain Questions · Major Discussion on the Progress of the Six Climatic Changes of Huangdi′s Internal Classic， including "stagnation of wood should be treated by smoothing， stagnation of fire by dispersing， stagnation of earth by attacking， stagnation of metal by dredging， and stagnation of water by inhibiting"， aiming to restore the physiological conditions of the five elements. The indicated syndromes of Mahuang Shengmatang are complex in superior-inferior， asthenia-sthenia， and cold-heat. The five depression syndromes and their treatment methods recorded in the Huangdi's Internal Classic can reflect the key syndrome pathogenesis and therapeutic principles， which are conducive to analyzing the syndrome differentiation and formulating principles of Mahuang Shengmatang. In the disease progression， impaired Yang Qi in greater Yin and inward invasion of cold pathogens in reverting Yin happen in the initial stage of indicated syndromes of Mahuang Shengmatang， with characteristics of water stagnation， earth stagnation， and wood stagnation. Furthermore， mental stagnation and fire stagnation triggered by Yang Qi accumulation in greater Yang and Yang brightness are the secondary consequences. The compatibility of five types of drugs in Mahuang Shengmatang can act on five depression syndromes in a targeted manner. Based on the five-depression theory in the Huangdi′s Internal Classic and available literature， the present study summarized syndrome pathogenesis and medication characteristics of Mahuang Shengmatang， clarified the correlation between formula and syndrome， and reviewed clinical reports in recent years， which is expected to provide references for the clinical application of Mahuang Shengmatang.

Formulation, Optimization, in vitro and in-vivo evaluation of levofloxacin hemihydrate Floating Tablets

Abstract The objective of the present investigation was to design, optimize and characterize the gastro retentive floating levofloxacin tablets and perform in-vivo evaluation using radiographic imaging. The floating tablets were prepared by using polymers i.e hydroxy propyl methyl cellulose (HPMC-K4M) and carbopol-940 individually and in combination by nonaquous granulation method. All the Formulations were evaluated for swelling index (S.I), floating behavior and in-vitro drug release kinetics. The compatibility study of levofloxacin with other polymers was investigated by FTIR, DSC, TGA and XRD. Results from FTIR and DSC revealed no chemical interaction amongst the formulation components. The optimized formulation (F11) showed floating lag time (FLT), total floating time (TFT) swelling index (S.I) of 60 sec, >16h and approximately 75 %, respectively. Moreover, F11 showed zero order levofloxacin release in simulated gastric fluid over the period of 6 h. X-ray studies showed that total buoyancy time was able to delay the gastric emptying of levofloxacin floating tablets in rabbits for more than 4 hours. In conclusion the optimized formulation (F11) can be used for the sustained delivery of levofloxacin for the treatment of peptic ulcer.

Relationship between Water Temperature and Floating Time of Aquatic Cadavers / 法医学杂志

OBJECTIVES@#To study the relationship between water temperature and floating time of aquatic cadavers, providing a reference for more precise positioning and searching for floating corpses.@*METHODS@#The floating model of guinea pig after drowning at 17-30 ℃ was established, and the floating times of carcasses were recorded. The collected data of 32 floating corpse cases in the Pearl River were sorted out and analyzed according to the floating time of corpses corresponding to each degree of water temperature. The relationship models between water temperature and the floating time of guinea pig carcass, and between that and the floating time of real cases were established.@*RESULTS@#The floating time of the cadaver was negatively correlated with water temperature. The power function fitting equation of the relationship between floating time and water temperature of guinea pig carcass was y=1×1015x-10.530(R2=0.871, P<0.01), and the power function fitting equation of the relationship between corpse floating time and water temperature was y=3×106x-3.467(R2=0.802, P<0.01).@*CONCLUSIONS@#It is found that average floating cadaver time has a power function with water temperature, which provides a reference for locating floating cadavers and establishing search models.

Formulation of stomach-specific floating microparticles of nizatidine and their radiographic evaluation

Nizatidine is an anti-secretogogue and a gastroprotective drug with a half-life of 1-2 h and is well absorbed in the stomach. This study aimed to optimize the process and develop floating microparticles of nizatidine that are based on low methoxyl pectin. Oil-in-oil dispersion method and Taguchi orthogonal array design were employed, and the prolonged residence time of the microparticles in the stomach was demonstrated. The constraints for independent variables, viz. A-polymer, B-internal solvent volume, C-surfactant, D-stirring rate and E-stirring time were set to generate the experimental runs. Particle size, percentage yield, micromeritic properties, entrapment efficiency, in vitro buoyancy and in vitro release were characterized. Surface morphology, zeta potential, in vitro release kinetics and in vivo floating performance of the optimized formulation was examined. The microparticles were free-flowing, irregular in shape and had a mean particle size distribution of 73-187 µ. Low methoxyl pectin played a predominant role in achieving buoyancy and optimum gastric retention for the modified release of the drug, suggesting Korsmeyer-Peppas model as the possible release mechanism. In vivo radiographic study in rabbits revealed that the drug was retained in the stomach for a period of 6 h. These results indicate that nizatidine floating microparticulate system provides modified drug release for the effective treatment of gastric ulcer

Terapia asistida con vacío y estoma flotante (floating stoma): una nueva forma de tratar un absceso periostomal / Vacuum assisted therapy and floating stoma: S new way to treat a periostomal abscess

Resumen Introducción: Los estomas flotantes se definen como un estoma que no está fijado a la piel de la pared abdominal, esta técnica se ha descrito en cirugía para fístulas entero-atmosféricas y de control de daños. Caso Clínico: Presentamos un reporte de caso de manejo de absceso paraostomal en paciente con antecedente de laparotomía por abdomen agudo, por lo que se decide uso de terapia de presión negativa asociada a estoma flotante, demostrando su utilidad en este tipo complejo de pacientes.

Introduction: Floating stomata are defined as a stoma that is not attached to the skin of the abdominal wall, this technique is described in surgery for entero-atmospheric fistulas and damage control. Clinical Case: We present a case report of the management of paraostomal abscess in a patient with a history of laparotomy due to acute abdomen, it was decided to use negative pressure therapy associated with a floating stoma, demonstrating its usefulness in this complex type of patient.

Growth and survival of the native oyster Crassostrea gasar cultured under different stocking densities in two grow-out systems in tropical climate / [Crescimento e sobrevivência da ostra nativa Crassostrea gasar cultivada em diferentes densidades em dois sistemas em clima tropical]

Survival and growth of the native oyster Crassostrea gasar along the juvenile and adult phases were evaluated in three different stocking densities [low (D), medium (2D) and high (3D)] and in two grow-out systems (fixed and floating system). The fixed system consisted of a rack made with PVC, fixed from the bottom with wood sticks. The floating system consisted of floating bags suspended by a rack made with PVC and maintained submerged from the seawater surface by eight floats. Survival and shell height of oysters cultured after 30, 60 and 90 days were registered in each phase and in each grow-out system. Results showed that the grow-out system did not affect survival and growth of C. gasar in the juvenile and adult phases. The tested densities affected the survival of oysters cultured over time in both phases but did not affect oyster growth. At times analyzed, it was observed positive growth in juvenile oysters grow after 90 days of culture. However, in the adult phase, no growth was observed after 90 days of culture. Oyster yield was higher in the density 3D, in both juvenile and adult phases. These findings contributed to the development of the oyster C. gasar culture.(AU)

A sobrevivência e o crescimento da ostra nativa Crassostrea gasar nas fases juvenil e adulta foram avaliados sob três diferentes densidades de estocagem [baixa (D), média (2D) e alta (3D)] e dois sistemas de engorda (fixo e flutuante). O sistema fixo consistiu em uma mesa de PVC, fixada na parte inferior com varas de madeira. O sistema flutuante consistiu em travesseiros flutuantes suspensos por uma mesa de PVC e mantidas submersas da superfície da água do mar por oito flutuadores. Registraram-se sobrevivência e altura da concha de ostras cultivadas após 30, 60 e 90 dias, em cada fase (juvenil e adulta) e em cada sistema (fixo e flutuante). Os resultados mostraram que o sistema de engorda não afetou a sobrevivência e o crescimento de C. gasar nas fases juvenil e adulta. As densidades testadas afetaram a sobrevivência das ostras ao longo do tempo, em ambas as fases, mas não afetaram o crescimento em altura. Nos tempos analisados, ostras juvenis apresentaram crescimento após 90 dias de cultivo. Porém, na fase adulta, não foi observado crescimento após 90 dias de cultivo. A produção de ostras, foi maior na densidade 3D, nas fases juvenil e adulta. Os presentes achados contribuíram para o desenvolvimento do cultivo da ostra C. gasar.(AU)

Avaliação da eficiência de ilhas flutuantes com plantas para a melhoria da qualidade hídrica de ecossistemas aquáticos / Evaluation of the efficiency of floating islands with plants for improving the water quality of aquatic ecosystems

RESUMO A utilização da água sempre foi vital para a sobrevivência humana, mas com suas ações surgiram os impactos aos ecossistemas comprometendo a qualidade. O ecossistema aquático tem sido prejudicado por isso, principalmente, pelo descarte inadequado de efluentes não tratados. Este trabalho visou avaliar a eficiência de ilhas flutuantes com plantas, a fim de observar a melhoria da qualidade hídrica de ecossistemas aquáticos. Para isso foi analisado o comportamento das macrófitas nas ilhas flutuantes, por meio de experimento controlado. A ilha se mostrou eficiente e resistente e pode ser utilizada para a remoção de macronutrientes. A eficiência na remoção foi cerca de 25% de fosfato e fósforo total, em um período de análise de 60 dias. Isso indica que com um período maior de análises, o resultado de remoção poderá ser maior, bem como a densidade de biomassa para o povoamento da ilha e a sua aplicação em corpos hídricos comprometidos.

ABSTRACT The use of water has always been vital for human survival, but with its actions, impacts on ecosystems have emerged, compromising quality. The aquatic ecosystem has been harmed by this, mainly, by the inadequate disposal of untreated effluents. This work aimed to evaluate the efficiency of floating islands with plants, in order to observe the improvement of the water quality of aquatic ecosystems. For this, the behavior of macrophytes on floating islands was analyzed, using a controlled experiment. The island proved to be efficient and resistant and can be used to remove macronutrients. The removal efficiency was about 25% of total phosphate and phosphorus, in an analysis period of 60 days. This indicates that with a longer period of analysis, the removal result may be higher, as well as the density of biomass for the island's population and its application in compromised water bodies.

Gastrotrichs and tardigrades in a remnant of Atlantic Forest (Serra do Japi, SP, Brazil) / Gastrótricos e tardígrados em um remanescente de Mata Atlântica (Serra do Japi, SP, Brasil)

Abstract: Serra do Japi, located in the southeast of São Paulo State, is considered a priority area for conservation, as it houses original Atlantic Forest cover remains. Despite the significant number of studies about vertebrates and invertebrates that were carried out in this region, the meiofauna biodiversity is completely unknown. Thus, the present study aimed to investigate for the first time freshwater Gastrotricha and limnoterrestrial Tardigrada in Serra do Japi Biological Reserve. Samples of sediments, periphyton and floating vegetation in reservoirs and natural lagoons, and mosses growing on native and non-native tree trunks were collected in May 2019. At least five gastrotrichs morphotypes were identified and three of them were formally described: Chaetonotus acanthocephalus, C. dadayi (first record in Brazil), and Heterolepidoderma mariae (first record outside the type locality). In regards to tardigrades, twelve morphotypes were identified and four of them were formally described: Pseudechiniscus juanitae, Minibiotus cf. acontistus, Echiniscus dreyfusi and Itaquascon umbellinae (last two species reported for the first time outside the type locality). This study reinforces that meiofaunal diversity and distribution have been underestimated, even in one of the five largest hotspots in the world.

Resumo: A Serra do Japi, localizada no sudeste do Estado de São Paulo, é considerada uma área prioritária para conservação, por abrigar vestígios de cobertura original de Mata Atlântica. Apesar do número significativo de estudos sobre vertebrados e invertebrados realizados nesta região, a biodiversidade de grupos meiofaunais é completamente desconhecida. Assim, o presente estudo teve como objetivo investigar pela primeira vez Gastrotricha de água doce e Tardigrada limnoterrestre na Reserva Biológica da Serra do Japi. As amostras de sedimentos, perifíton e vegetação flutuante em reservatórios e lagoas naturais, e musgos presentes em troncos de árvores nativas e não nativas foram coletadas em maio de 2019. Foram encontrados cinco morfotipos de gastrótricos, sendo que apenas três deles já foram formalmente descritos: Chaetonotus acanthocephalus, C. dadayi (primeiro registro no Brasil) e Heterolepidoderma mariae (primeiro registro fora da localidade-tipo). Em relação aos tardígrados, foram identificados doze morfotipos, sendo que quatro deles já formalmente descritos: Pseudechiniscus juanitae, Minibiotus cf. acontistus, Echiniscus dreyfusi e Itaquascon umbellinae (as duas últimas espécies relatadas pela primeira vez fora da localidade-tipo). Este trabalho reforça que a diversidade e distribuição da meiofauna têm sido subestimadas, mesmo em um dos cinco maiores hotspots do mundo.