Aprendizaje de la lectura mediante la asociación imagen - palabra escrita: una revisión de la evidencia en niños con discapacidad intelectual y autismo / Learning to read through picture-written word association: a review of the evidence in children with intellectual disability and autism / Aprendendo a ler por meio da associação de imagens e palavras: uma revisão das evidências em crianças com deficiência intelectual e autismo

Se tiene como objetivo determinar si la asociación imagen - palabra escrita, como parte del método de instrucción de palabras a la vista limita la adquisición del aprendizaje de la lectura en niños con discapacidad intelectual y autismo. Para lo cual, se realizó una revisión narrativa de los estudios reportados en las bases de datos de Scopus, Willey, ScienceDirect, Taylor & Francis, y Sage. Los hallazgos evidencian que la presentación de imagen y palabra escrita como estímulo compuesto puede obstaculizar el proceso de reconocimiento del texto, lo que sugiere la necesidad de emplear esta estrategia con precaución. En consecuencia, se recomienda fomentar actividades de aprendizaje donde la palabra escrita se presente de manera independiente; entre las prácticas alternativas que pueden implementarse, destacan la presentación de la imagen como retroalimentación posterior a la exposición aislada de la palabra escrita. Otra opción viable consiste en mostrar la palabra escrita, seguida de la instrucción de hacer coincidir palabra con imagen.

The objective was to determine if the image-written word association, as part of the straight forward word instruction method, limits the acquisition of learning to read in children with intellectual disabilities and autism. For which, a narrative review of the studies reported in the Scopus, Willey, ScienceDirect, Taylor & Francis, and Sage databases was carried out. It was considered, the presentation of an image and a written word as a compound stimulus can hinder the text recognition process, suggesting the need to use this strategy with caution. Consequently, it is recommended to encourage learning activities where the written word is presented independently. However, it is possible to use the images as feedback, in order to avoid the negative effect of the images.

O objetivo foi verificar se a associação imagem-palavra escrita, como parte do método de instrução das palavras simples, limita a aquisição da aprendizagem da leitura em crianças com deficiência intelectual e autismo. Para isso, foi realizada uma revisão narrativa dos estudos relatados nas bases de dados Scopus, Willey, ScienceDirect, Taylor & Francis e Sage. Considerou-se que a apresentação de uma imagem e uma palavra escrita, e apresentá-la como um estímulo composto, pode dificultar o reconhecimento do texto, sugerindo a necessidade de emprego dessa estratégia com cautela. Nesse sentido, recomenda-se promover atividades de aprendizagem onde a palavra escrita deve ser apresentado sozinho. No entanto, é possível usar as imagens como feedback, a fim de evitar o efeito negativo das imagens.

Effect of screentime in college students during the COVID-19 online classes on their neck posture and postural control: an observational study

Background: Corona virus which is the source of severe acute pulmonary syndrome causes an airway tract contamination (COVID 19). Prolonged sitting for online classes in the college students leads to the enlarged postural deviation, increased low back pain. Prolonged static contraction of skeletal muscles of the cervical region, lower back leads to impaired flow of blood to the muscle groups together with edema and accumulation of waste metabolites will trigger the muscle spasm. Methods: Total 30 college students aged between 18-25 years who attended the online classes during COVID-19 were included in this study by using a questionnaire. The outcome measures used were the measurement of CV angle, SEBT and BBS. The postural control was estimated by using star excursion balance test and Berg balance scale. Results: Using Karl Pearson抯 correlation coefficient, a positive correlation was observed between CV angle and BBS (r = 0.82). Between BMI and CV angle there exists a statistically significant negative correlation (r = -0.564). Conclusions: This study proved that there exists a forward neck posture in the students who attended the online classes during the COVID-19 pandemic and that also affected their postural control.

Blood group changes in acute myeloid leukemia and their relationship with therapeutic effect / 中国输血杂志

【Objective】 To explore the blood group changes of two acute myeloid leukemia patients with suspected O type, and their relationship with the therapeutic effect. 【Methods】 Serological analysis of ABO blood group of patients was carried out by microcolumn gel method, tube method and absorption-elution test, ABO blood group genotyping was performed by microfluidic chip method. Exons E2 to E7 of ABO gene were amplified by PCR and sequenced by Sanger method. 【Results】 The forward typing of two cases were both O type, but the reverse typing were both A type. The absorption-elution test results all showed detection of antigen A. ABO gene phenotype of the two cases were both A, with genotyping results as A102/A102 and A102/O01, respectively. Sequencing results showed that SNP sites of ABO blood group were 467T/T, 261G/delG and 467C/T, respectively.In one case, the intensity of anti-A agglutination reaction changed significantly from weak to strong with the progress of treatment. 【Conclusion】 For clinical samples of acute myeloid leukemia patients with ABO forward and reverse typing discrepancy and suspected O type, the result of reverse typing should be valued, and absorption-elution test should be performed to further confirm the ABO blood type combining the genetic test results, so as to develop appropriate blood transfusion strategies for patients.

ABO blood group screening results among blood donors in Guangzhou from 2021 to 2022 / 中国输血杂志

【Objective】 To investigate the distribution of ABO and RhD blood groups among voluntary blood donors in Guangzhou, in order to ensure clinical blood safety and better serve blood donors. 【Methods】 Routine ABO and RhD blood group screening tests were carried out among voluntary blood donors from January 2021 to December 2022. The composition ratio of ABO blood group was statistically analyzed. The samples with discrepancy between forward and reverse blood grouping and negative RhD blood group samples were further verified by serological test to analyze the ABO subtypes and the reasons for missed detection. 【Results】 A total of 749 123 blood samples were screened from January 2021 to December 2022, and 513 291 samples were collected after excluding repeat blood donors, with the ABO blood groups as 208 126(40.55%) of O type, 138 859(27.05%) of A type, 130 987(25.52%) of B type and 35 319(6.88%) of AB type. The screening results showed discrepancy between forward and reverse blood grouping in 506 samples, of which 58 were with weak/non-erythrocyte reaction, 16 with erythrocyte reaction, 215 with weak/non-serum reaction, and 217 with serum reaction. Further serological test indicated that 44 samples were ABO subtypes, among which 13 were subtype A, 26 subtype B, 5 subtype AB and 3 B (A) and 14 Bombay-like blood group. The blood group with the highest missed detection rate in repeat blood donors were A3/B3 subtype (68.42%). A total of 128 unexpected antibody positive samples were detected among 513 291 samples A total of 2 277 samples were screened negative for RhD blood type, of which 2 188 were confirmed to be Rh negative (2 188/513 291, 0.43%), 89 were D variants (89/513 291, 0.02%, ) and 30 were detected with unexpected antibodies (30/2 188, 1.37%). 【Conclusion】 The ABO blood group distribution of blood donors in Guangzhou is O>A>B>AB, and the proportion of RhD negative population is 0.43%, slightly highter than 0.3%-0.4% of Han population nationwide. The ABO blood group subtype is dominated by B subtype. The detection rate and missed detection rate of A3/B3 subtypes in routine blood group tests are the highest.

Application of virtual reality technology combined with case-based learning in forward surgical team skill teaching for undergraduates / 中华医学教育探索杂志

Objective:To investigate the application of virtual reality technology combined with case-based learning in forward surgical team (FST) basic skill teaching for undergraduates.Methods:A total of 42 undergraduates who received clinical practice in The Second Affiliated Hospital of Navy Medical University from January 2020 to January 2021 were selected as research subjects, and they were randomly divided into experimental group (virtual reality technology combined with case-based learning for FST basic skill teaching) and control group (traditional teaching methods for FST basic skill teaching). A questionnaire survey and assessments were performed to evaluate the effectiveness of teaching, and SPSS 23.0 was used to perform the t-test, the chi-square test, or the Fisher's exact test. Results:The questionnaire survey showed that there were no significant differences between the two groups in the degree of overall satisfaction with teaching, comprehension and practice in learning, and post-learning memory, and compared with the control group, the experimental group had significantly higher scores of improvement in theoretical knowledge (4.33±0.26 vs. 4.17±0.21, P<0.05), improvement in skill operation (4.32±0.22 vs. 4.12±0.27, P<0.05), improvement in the ability to analyze and solve practical problems (4.04±0.37 vs. 3.69±0.38, P<0.05), learning interest and enthusiasm (4.34±0.28 vs. 3.92±0.43, P<0.05), learning attention (4.21±0.35 vs. 3.81±0.34, P<0.05), and learning interaction (4.18±0.29 vs. 4.01±0.21, P<0.05). The results of assessments showed that compared with the control group, the experimental group had a significantly higher total score (85.96±5.35 vs. 77.03±7.29, P<0.05) and significantly better scores of theoretical knowledge (28.25±4.74 vs. 25.01±5.37, P<0.05) and skill operation (57.47±4.96 vs. 51.99±8.03, P<0.05). Conclusions:Virtual reality technology combined with case-based learning has unique advantages in FST basic skill teaching for undergraduates, and related studies and application research can be conducted in the future.

Identification of B(A) subtype and analysis of bood transfusion strategiaes / 中国输血杂志

【Objective】 To investigate the serology and genotype identification method of B (A) subtype patients. 【Methods】 Test tube method (serology) was used to confirm the clinically difficult ABO blood group samples of 3 patients with ABO blood group; ABO blood group was genotyped by real-time PCR, and the ABO gene exon 1-7 was sequenced to determine the genotype. 【Results】 The forward and reverse blood typing result of three patients was B (A) subtype all with ABO genotype B/O2 and c.640A> G mutation on B allele of exon 7, which meets the characteristics of ABO * BA.04 genotype. 【Conclusion】 The combination of serological and genetic testing could identify difficult blood types such as ABO subtypes accurately and ensure the safety of clinical blood use.

Relationship between serum reproductive hormones and sperm parameters and surgical outcomes in Micro-TESE / 现代泌尿外科杂志

【Objective】 To investigate the relationship between serum reproductive hormones and sperm parameters and outcomes of micro-testicular sperm extraction (Micro-TESE). 【Methods】 Clinical data of 1 091 patients treated in our hospital during Jan. and Dec.2021 were retrospectively analyzed. According to the sperm concentration,the patients were divided into non-obstructive azoospermia (NOA) group (group A,n=418),normal sperm concentration group (group B,n=615),mild to moderate oligospermia group (group C,n=18),severe oligospermia group (group D,n=18),and obstructive azoospermia group (group E,n=22). In group A,244 cases treated with Micro-TESE were grouped into the sperm-acquired group (Micro-TESE positive group,n=82) and non-sperm-acquired group (Micro-TESE negative group,n=162),and according to the pathological types of testicular tissue,the patients were divided into normal testicular tissue with hypospermatogenesis group (HYPO group,n=129),maturation arrest group (MA group,n=10),and support-only cell syndrome group (SCO group,n=122). Differences in semen parameters and reproductive hormone levels were compared,and relationship between reproductive hormones and sperm parameters and Micro-TESE outcomes was determined with Pearson correlation analysis. 【Results】 In the sperm concentration subgroup,the testicular volume of group A was lower than that of group B and group E (P<0.05); the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in group A were the highest (P<0.05),but the level of testosterone (T) was the lowest (P<0.05); the levels of anti-mullerian hormone (AMH) and serum inhibin B (INHB) in group A were lower than those in group B and group E (P<0.05),the normal sperm morphology rate in group B was higher than that in group A and group E (P<0.05); the percentage of forward moving sperm in group B was the highest (P<0.05). Pearson correlation analysis revealed that sperm concentration,normal sperm morphology rate,and percentage of forward moving sperm were negatively correlated with age,FSH,LH (P<0.05),and positively correlated with testicular volume,T,AMH,and INHB (P<0.05). NOA patients were grouped according to testicular histology and pathology. The INHB in the SCO group was the smallest of the three groups (P<0.05); the FSH and LH levels in the SCO group were higher than those in the MA group (P<0.05),while the 17β-estradiol (E2) levels in the HYPO group were higher than those in the SCO group (P<0.05). NOA patients were grouped according to the results of Micro-TESE surgical treatment. There was a statistically significant difference in AMH and INHB levels between the Micro-TESE positive and negative groups (P<0.05). The binary logistic regression analysis of factors affecting the Micro-TESE outcomes of NOA patients showed AMH was negatively correlated with the Micro-TESE outcome (OR=0.904,95%CI:0.91-1.08,P<0.05). 【Conclusion】 Age,FSH,LH,AMH,and INHB are correlated with sperm concentration,normal sperm morphology rate,and percentage of forward moving sperm. The INHB level was the lowest in the SCO group. The results of Micro-TESE in patients with NOA can be predicted by serum AMH level.

Application of back-forward Bending CT localization image in the prediction of proximal junctional kyphosis after spinal deformity surgery in adults / 中国修复重建外科杂志

OBJECTIVE@#To investigate the feasibility of predicting proximal junctional kyphosis (PJK) in adults after spinal deformity surgery based on back-forward Bending CT localization images and related predictive indicators.@*METHODS@#A retrospective analysis was performed for 31 adult patients with spinal deformity who underwent posterior osteotomy and long-segment fusion fixation between March 2017 and March 2020. There were 5 males and 26 females with an average age of 62.5 years (range, 30-77 years). The upper instrumented vertebrae (UIV) located at T 5 in 1 case, T 6 in 1 case, T 9 in 13 cases, T 10 in 12 cases, and T 11 in 4 cases. The lowest instrumented vertebrae (LIV) located at L 1 in 3 cases, L 2 in 3 cases, L 3 in 10 cases, L 4 in 7 cases, L 5 in 5 cases, and S 1 in 3 cases. Based on the full-length lateral X-ray film of the spine in the standing position before and after operation and back-forward Bending CT localization images before operation, the sagittal sequence of the spine was obtained, and the relevant indexes were measured, including thoracic kyphosis (TK), lumbar lordosis (LL), local kyphosis Cobb angle (LKCA) [the difference between the different positions before operation (recovery value) was calculated], kyphosis flexibility, hyperextension sagittal vertical axis (hSVA), T 2-L 5 hyperextension C 7-vertebral sagittal offset (hC 7-VSO), and pre- and post-operative proximal junctional angle (PJA). At last follow-up, the patients were divided into PJK and non-PJK groups based on PJA to determine whether they had PJK. The gender, age, body mass index (BMI), number of fusion segments, number of cases with coronal plane deformity, bone mineral density (T value), UIV position, LIV position, operation time, intraoperative blood loss, osteotomy grading, and related imaging indicators were compared between the two groups. The hC 7-VSO of the vertebral body with significant differences between groups was taken, and the receiver operating characteristic curve (ROC) was used to evaluate its accuracy in predicting the occurrence of PJK.@*RESULTS@#All 31 patients were followed up 13-52 months, with an average of 30.0 months. The patient's PJA was 1.4°-29.0° at last follow-up, with an average of 10.4°; PJK occurred in 8 cases (25.8%). There was no significant difference in gender, age, BMI, number of fusion segments, number of cases with coronal plane deformity, bone mineral density (T value), UIV position, LIV position, operation time, intraoperative blood loss, and osteotomy grading between the two groups ( P>0.05). Imaging measurements showed that the LL recovery value and T 8-L 3 vertebral hC 7-VSO in the PJK group were significantly higher than those in the non-PJK group ( P>0.05). There was no significant difference in hyperextension TK, hyperextension LL, hyperextension LKCA, TK recovery value, LL recovery value, kyphosis flexibility, hSVA, and T 2-T 7, L 4, L 5 vertebral hC 7-VSO ( P>0.05). T 8-L 3 vertebral hC 7-VSO was analyzed for ROC curve, and combined with the area under curve and the comprehensive evaluation of sensitivity and specificity, the best predictive index was hC 7-L 2, the cut-off value was 2.54 cm, the sensitivity was 100%, and the specificity was 60.9%.@*CONCLUSION@#Preoperative back-forward Bending CT localization image can be used to predict the occurrence of PJK after posterior osteotomy and long-segment fusion fixation in adult spinal deformity. If the patient's T 8-L 2 vertebral hC 7-VSO is too large, it indicates a higher risk of postoperative PJK. The best predictive index is hC 7-L 2, and the cut-off value is 2.54 cm.

Effect of therapeutic exercise on functional disability and quality of life in patients with forward head posture and neck pain: a meta-analysis / 中国康复理论与实践

ObjectiveTo systematically analyze the effect of therapeutic exercise on neck function and quality of life in patients with neck pain and forward head posture. MethodsRandomized controlled trials about the effects of exercise training on forward head posture and neck pain were searched from PubMed, Web of science, Embase, Medline, Science Direct, EBSCO, Springlink, CNKI, VIP, and Wanfang Data from database establishment to April, 2022. The literature was screened by two researchers independently. Cochrane bias risk assessment tool and Physiotherapy Evidence Database Scale were used to evaluate the quality of the included articles. Revman 5.4 software was used for meta-analysis. ResultsA total of 416 patients from eleven literatures were included. Level 1a evidence indicated scapula stability training could effectively improve cranial vertebral angle (MD = 3.62, 95%CI 2.41 to 4.83, P < 0.001), and relieve pain (MD = 1.32, 95%CI 0.18 to 2.46, P = 0.02). Level 1b evidence indicated scapula stability training could reduce functional disability (MD = -0.92, 95%CI -1.11 to -0.74, P < 0.001). Level 1b evidence indicated deep cervical flexor training could improve cranial vertebral angle (MD = -0.83, 95%CI -1.56 to -0.10, P = 0.03), relieve pain (MD = 0.93, 95%CI 0.54 to 1.32, P < 0.001), and improve neck functional disability (MD = 2.17, 95%CI 1.39 to 2.95, P < 0.001). ConclusionScapula stability training and deep cervical flexor training can effectively improve cranial vertebral angle, relieve neck pain, and improve neck function.

Application of Forward Projected Model-Based Iterative Reconstruction Solution in Improving Image Quality of Head and Neck CT Angiography / 中国医学影像学杂志

Purpose To explore the application value of forward projected model-based iterative reconstruction solution(FIRST)algorithm improving image quality of 100 kV low-dose head and neck CT angiography(CTA).Materials and Methods A total of 32 patients who underwent head and neck CTA examinations in the Beijing Hospital from September to October 2021 were retrospectively recruited.All patients were divided into three groups based on different reconstruction,including the filtered back projection(FBP)group,the adaptive iterative dose reduction 3D(AIDR 3D)group,and the FIRST group.The average CT value,image noise,signal-to-noise ratio,contrast to noise ratio and other objective indicators of the main blood vessels images(including common carotid artery,vertebral artery,internal carotid artery C1,C4,middle cerebral artery M1,M3 and anterior cerebral artery A1,A3)and background(including muscle,brain tissue)in the head and neck of the three groups were recorded and analyzed,respectively.The subjective imaging evaluation was scored and analyzed.Digital subtraction angiography(DSA)was used as the gold standard to evaluate the detection of vascular stenosis in the head and neck by each reconstruction algorithm.Results Compared with the AIDR 3D group and the FBP group,the FIRST group significantly reduced the image noise of the blood vessels and the background(muscle,brain tissue)(t=-13.19--7.28,all P<0.001).The signal-to-noise ratio and contrast to noise ratio of the FIRST group were significantly higher than those of the FBP group,AIDR 3D group(t=2.17-9.67,all P<0.001).The CT values of FIRST group were significantly higher than those of AIDR 3D group in the common carotid artery,internal carotid artery C1 and C4,middle cerebral artery M1,and anterior cerebral artery A1 segment(t=1.28-3.60,all P<0.05).The CT value of background(muscle,brain tissue)in FIRST group was significantly lower than those in the FBP group and the AIDR 3D group,with statistically significant difference(t=-7.63--4.03,all P<0.001).The images of FIRST group and AIDR 3D group met the diagnostic requirements,and the subjective scores of the two groups were significantly higher than those of the FBP group images(all P<0.05).The imaging scores of FIRST group were significantly higher than those of AIDR 3D group(P<0.05).Compared with DSA,FBP was ineffective for mild and moderate stenosis;FIRST and AIDR 3D algorithms were consistent with DSA.Conclusion Compared with traditional FBP and AIDR 3D reconstruction algorithms,FIRST algorithm can effectively improve the image quality of low-dose head and neck CTA and obtain better image quality and meet the diagnostic performance of head and neck vascular diseases.

Application of forward-return way in endoscopic resection for gastric fundus stromal tumor (with video) / 中华消化内镜杂志

To evaluate the value of forward-return way in endoscopic resection for the treatment of gastric fundus stromal tumor, patients with gastric fundus stromal tumor in muscularis propria diagnosed by endoscopy and endoscopic ultrasonography at the Department of Digestive Endoscopy of the Fourth Affiliated Hospital of China Medical University from June 2020 to June 2021 were prospectively enrolled in the study. All patients were treated with endoscopic full-thickness resection under general anesthesia with endotracheal intubation. The success of forward-return way, endoscopic procedure, operation performance, pathological classifications and complications were analyzed. A total of 12 patients were enrolled. All of them were confirmed as having stromal tumor by postoperative pathology, with 10 of very low risk and 2 of low risk. Forward-return way was successful in 9 patients and failed in 3 patients. Nine patients were successfully treated with endoscopic procedure eventually. No intraoperative bleeding occurred in any patient. In endoscopic resection, the scores of same direction of forward and backward, endoscopic field of view, and endoscopic body stability were all 2.00 points. Forward-return way has clinical application value for the endoscopic treatment of gastric fundus stromal tumor.

Imaging study of the mandibular forward canal in adults based on cone beam CT / 口腔疾病防治

Objective @#To explore the imaging characteristics of the mandibular nerve canal in adults to provide a reference for clinical mandibular surgery.@*Methods@# One thousand adult patients in Guiyang Stomatological Hospital from January 2018 to January 2021 were randomly selected. Cone beam CT (CBCT) was used to observe the anterior mandibular canal and other branches, and the incidence of anterior canal in the mandibular ramus area, posterior molar area and molar area and the distance to each point of the mandible were measured.@*Results@#Of the 901 patients (1 802 sides) included in the study, 386 patients (42.84%) found branches of the mandibular canal, and 182 patients (97 males and 85 females) found the Anterograde Canal 20.20% (182/901). In total, 225 mandibles were found to have anterior canals. There were 101 cases of left mandible and 124 cases of right mandible. The forward canal mainly occurred in the molar area, the molar posterior area and the ascending branch area, and the ascending branch area was the best starting point of the forward canal and the molar stopping point (P < 0.05). The average length of the forward canal (L1) was (10.364 ± 3.833) mm, the average height of the forward canal to the main trunk of the mandibular nerve (L2-RRB) was (3.623 ± 2.035) mm, and the average height of the forward canal to the crest of the alveolar ridL3 (l3) was (9.280 ± 3.240) mm.@*Conclusion@#Mandibular nerve canal branches are common, and there were no differences in male, female and lateral distribution. In this study, the incidence of mandibular anterior canal was the highest, and it often occurred in the molar area.

Study on surface electromyography characteristics of erector spinae muscles at different spinal anteversion angles of the scrapers / 中华劳动卫生职业病杂志

Objective: To simulate and evaluate the scraping and grinding work of workers with different spinal anteversion angles, and to explore the effects of different anteversion angles on the erector spinae muscles of scrapers. Methods: In November 2019, 16 male college student volunteers were recruited to simulate workers' scraping and grinding work. The parameters were 25°, 15 times/min, 15°, 30 times/min, 5°, 60 times/min respectively. The surface electromyography (sEMG) was used to collect the electromyographic signals of the erector spinae muscles, and the surface electromyographic characteristics of the erector spinae muscles were evaluated with Borg Scale. Results: There were significant differences between the maximum voluntary contraction percentage (MVE%) of the left and right erector spinae muscles groups in the three groups with different spinal anteversion angles (F(left)=13.41, P(left)<0.001; F(right)=4.74, P(right)=0.005) , and the EMG amplitude was higher at 25°, 15 times/min. At 15°, 30 times/min, MVE% of the left side was significantly higher than that of the right side (t=2.58, P=0.021) . There was significant difference in the mean power frequency (MPF) of the right erector spinae muscle in the three groups (F=9.42, P<0.001) , but there was no significant difference in the MPF of the left erector spinae muscle (F=0.30, P=0.823) . The fitting line showed that the left erector spinae muscle showed a downward trend at 5°, 60 times/min (t=-5.39, P=0.012) . Conclusion: Scrapers are less likely to be fatigued when the posture is 15°, 30 times/min, but they are more likely to be fatigued when working at 5°, 60 times/min.

Causes of ABO forward and reverse grouping discrepancy: 75 cases / 中国输血杂志

【Objective】 To analyze the causes and solutions of ABO forward and reverse grouping discrepancy, and to ensure the safety of blood transfusion in clinical. 【Methods】 Samples from 75 patients with discrepancy between forward and reverse grouping in December 2019 and March 2022 were tested and analyzed in combination with saline method(forward and reverse grouping), direct antiglobulin test, antibody screening, antibody identification, increasing plasma volume, incubation enhancement test at 4℃, absorption-eluation test and molecular biological tests. 【Results】 Causes for abnormal reverse typing were as follows : weak antibody in 11 cases(14.67%), unexpected antibody in 19 cases(25.33%), inverted albumin and globulin ratios in 9 cases(12.00%), increased white blood cells in 3 cases(4.00%), inadequate anticoagulation in 3 cases(4.00%), bone marrow transplantation in 2 cases(2.67%), multiple myeloma in 4 cases(5.33%), acute gastrointestinal bleeding in 3 cases(4.00%). Causes for abnormal forward typing were as follows: self-coagulating in 1 case(1.33%), acute leukemia in 7cases(9.34%), post-transplantation in 1 case(1.33%). Causes for abnormal forward/reverse typing: acute leukemia in 1 case(1.33%), condensin syndrome in 1 case(1.33%), autoimmune hemolytic anemia in 6 cases(8.00%), subtype in 4 cases(5.33%). Results of genotying in 7 cases were as follows: B(A) 04 for 1 case, B(A)02 2 cases, AB3 1case, A1 2 cases, and 1case with new genotype. 【Conclusion】 For patients with forward and reverse typing discrepancy for ABO blood group, several studying methods, such as clinical/serological tests inquiring, absorption-eluation tests and molecular biological tests, should be combined to ensure blood transfusion safety.

Impacto da retroflexão na detecção de lesões de cólon proximal: avaliação de 393 pacientes em hospital privado terciário / Impact of retroflexed view on the detection of lesions in the proximal colon: assessment of 393 patients in a private tertiary hospital

ABSTRACT BACKGROUND: The gold standard test for colorectal cancer screening the colonoscopy. Although this is the test of choice, colonoscopy misses a significant number of lesions, mainly in the proximal colon. With the purpose of reducing the number of lesions missed, new techniques have been studied, amongst them, retroflexed view in the right side of the colon and the second direct forward view. OBJECTIVE: Assessing the safety of the retroview in the proximal colon (cecum and ascending colon), its impact on the detection of lesions in the proximal colon and its advantage over the double right forward view using adenoma detection rate and adenoma miss rate. METHODS: Three hundred and ninety-three patients who came to Hospital Mater Dei to undergo colonoscopy from March to July 2017, prospectively. Out of these, 372 were included in the study based on the following exclusion criteria: being under 18 years of age, inadequate bowel preparations (Boston scale <7), history of colectomy, inflammatory bowel disease or polypoid diseases. First, an endoscopist inserted the colonoscope into the cecum and examine the cecum and the ascending colon with a forward view twice. In the third insertion into the cecum, retroflexed view was performed, cecal mucosa was examined until the hepatic flexure in search of polyps missed on forward view. All lesions found were resected and sent for histological analysis. RESULTS: In 334 (89.8%) patients, retroflexed view was performed successfully, 65.8% of failures were attributed to the loops of the device which prevented the maneuver. The direct view identified 175 polyps in the proximal colon in 102 people. Retroflexed view detected 26 polyps missed by the direct view in 24 (6.5%) people, with a missing rate of 12.9% in the test with only the forward view. Out of the 26 polyps found in retroview, 21 (80.76%) were adenomas, one of them with a high-grade dysplasia. Eleven patients had polyps seen only in retroflexed view. Retroview has increased the polyp detection rate from 27.41% to 31.72% and the adenoma detection rate from 21.77% to 25%. The adenoma miss rate by the double direct view was 12.8%. Without the retroview, one polyp in every 13.91 colonoscopies would be missed (number needed to treat - NNT=13.91). There was no adverse event. CONCLUSION: The retroflexed view technique in the proximal colon was shown to be safe, fast and feasible in most cases. It increased the adenoma detection rate and was shown to be advantageous in this study wit benefit beyond the double direct view.

RESUMO CONTEXTO: O exame padrão ouro para rastreamento de câncer colorretal é a colonoscopia. Apesar de ser o exame de escolha, a colonoscopia perde um número não desprezível de lesões, principalmente no cólon proximal. Com a intenção de reduzir a perda de lesões, novas técnicas são estudadas, dentre elas, a retroflexão em cólon direito e a segunda visão frontal direta. OBJETIVO: Avaliar a segurança da retrovisão no cólon proximal (ceco e cólon ascendente), o seu impacto na detecção de lesões em cólon proximal e sua superioridade sobre a dupla visão frontal direta usando taxa de detecção de adenoma e taxa de adenoma perdido. MÉTODOS: Foram avaliados 393 pacientes de forma prospectiva que procuraram o Hospital Mater Dei para realizar colonoscopia entre março e julho de 2017. Desses, 372 foram incluídos baseados nos critérios de exclusão: menores de 18 anos, preparos intestinais inadequados (escala de Boston <7), com antecedente de colectomia, doença inflamatória intestinal ou síndromes polipoides. Primeiramente um endoscopista realizou a inserção do colonoscópio até o ceco e examinou o ceco e o cólon ascendente em visão frontal por duas vezes. Na terceira reinserção até o ceco era realizada a retroflexão e inspeção da mucosa do ceco até a flexura hepática em busca de pólipos perdidos à visão frontal. Todas lesões encontradas foram ressecadas e enviadas para análise histológica. RESULTADOS: Em 334 (89,8%) pacientes a retroflexão foi realizada com sucesso, 65,8% dos insucessos foram atribuídos a alças no aparelho que impediram a manobra. A visão direta identificou 175 pólipos no cólon proximal em 102 pessoas. A retroflexão detectou 26 pólipos perdidos pela visão direta em 24 (6,5%) pessoas, com uma taxa de perda de 12,9% no exame apenas em visão frontal. Dos 26 pólipos encontrados em retrovisão, 21 (80,76%) eram adenomas, um deles com displasia de alto grau. Onze pacientes tinham pólipos vistos apenas em retroflexão. A realização da retrovisão aumentou a taxa de detecção de pólipo de 27,41% para 31,72% e a taxa de detecção e adenomas de 21,77% para 25%. A taxa de adenoma perdido pela dupla visão direta foi de 12,8%. Se a retrovisão não fosse realizada, um pólipo a cada 13,91 colonoscopias seria perdido (NNT=13,91). Não houve nenhum evento adverso. CONCLUSÃO: A técnica de retroflexão em cólon proximal mostrou-se segura, rápida e factível na maioria dos casos. Ela aumentou a taxa de detecção de adenomas e mostrou-se soberana neste estudo com benfeitorias além da dupla visão direta.

Efeito da manipulação visceral na postura da cabeça para frente em sujeitos com dor pescoço crônica não específica - um estudo piloto / Effect of visceral manipulation on forward head posture in subjects with chronic non-specific neck pain ­ a pilot study

INTRODUÇÃO: A postura anterior da cabeça é considerada o desequilíbrio postural musculoesquelético mais comum, causando protrusão da cabeça anterior ao tronco. Os órgãos internos são interconectados e fixados posteriormente à coluna por meio das membranas de suporte. A tensão nessas membranas de suporte pode ainda causar restrições mecânicas, afetando a mobilidade do órgão visceral e a estrutura musculoesquelética associada em um mecanismo de mão dupla. OBJETIVO: Explorar o efeito da manipulação visceral específica de órgão na postura, incapacidade, força e dor em indivíduos com dor cervical crônica inespecífica. De acordo com a hipótese deste estudo, a manipulação visceral tem como objetivo explorar o efeito da manipulação da fáscia específica do órgão na postura, incapacidade, força e dor em indivíduos com dor cervical crônica inespecífica. MATERIAL E MÉTODO: cinco indivíduos com dor cervical inespecífica crônica com postura anterior da cabeça foram recrutados usando o método de amostragem de conveniência. Este estudo foi conduzido em um departamento de Fisioterapia de um hospital multi-especializado reconhecido, Mohali. Os indivíduos foram encaminhados após o diagnóstico de dor cervical crônica dos departamentos. Uma única sessão de manipulação visceral placebo foi administrada na primeira semana, seguida de uma única sessão de manipulação visceral da cúpula pleural e ligamentos pericárdicos na segunda semana. Aplicação móvel de tela de postura (postura), unidade de biofeedback de pressão (ativação muscular), Índice de Incapacidade Pescoço e Escalas Visuais Analógicas foram utilizados para medir os resultados pré e pós. RESULTADO: a comparação entre os grupos do desfecho mostrou diferença estatisticamente significativa na EAV (p = 0,001), aplicação da triagem postural (p = 0,02) e NDI (p = 0,07). Não foram observadas mudanças significativas no desfecho força. CONCLUSÃO: Sessão única de manipulação visceral da cúpula pleural e ligamentos pericárdicos pode se beneficiar na melhora da postura anterior da cabeça, incapacidade cervical e redução da dor.

INTRODUCTION: Forward head posture is considered to be the most common musculoskeletal postural imbalance causing protrusion of head anterior to trunk. Internal organs are interconnected and attached posteriorly to the spine through the support membranes. Tension in these support membranes may further cause mechanical restrictions, thereby affecting the mobility of the visceral organ and associated musculoskeletal structure in a two-way mechanism. OBJECTIVE: To explore the effect of organ-specific visceral manipulation on posture, disability, strength, and pain in subjects with chronic non-specific neck pain. According to this study hypothesis visceral manipulation aim to explore the effect of organ-specific fascia manipulation on posture, disability, strength, and pain in subjects with chronic non-specific neck pain. MATERIAL AND METHOD: Five subjects with chronic non-specific neck pain with forwarding head posture were recruited using a convenience sampling method. This study was conducted in a Physiotherapy department of a recognized multispecialty hospital, Mohali. Subjects were referred after diagnosis from chronic neck pain from the departments. A single session of placebo visceral manipulation was administered in the first week, followed by a single session of visceral manipulation of the pleural dome and pericardial ligaments in the second week. Posture screen mobile application (posture), Pressure biofeedback unit (muscular activation), Neck Disability Index, and Visual Analog Scales were used to measure the pre and post outcomes. RESULT: Between-group comparison of the outcome showed a statistically significant difference in the VAS (p=0.001), Posture screening application (p=0.02), and NDI (p=0.07). No significant changes were observed in the strength outcome. CONCLUSION: Single session of visceral manipulation for the pleural dome and pericardial ligaments may benefit in improving the forward head posture, neck disability and reducing the pain.

Evaluation Deviation of Round-Window Stimulation Based on Basilar Membrane Response / 医用生物力学

Objective To study the accuracy of traditional basilar membrane displacement evaluation criteria for evaluating hearing compensation performance of round window-stimulated middle ear implant, so as to provide the theoretical basis for performance evaluation of round window-stimulated middle ear implant. Methods An acoustic microscopic finite element model of cochlea was constructed based on experimental data of the cochlea geometry. Reliability of this model was verified by comparison with experimental measurement values of inner hair cell, outer hair cell, tectorial membrane displacement. Based on this model, the displacement of basilar membrane and the stereocilia shear displacement of inner hair cells under forward stimulation and round-window stimulation were comparatively analyzed. Using the stereocilia shear displacement of inner hair cells as the criterion for sense of sound, the equivalent sound pressure level (SPL) deviation under round-window stimulation was studied when using traditional basilar membrane displacement as evaluation criterion. Results At 5 kHz characteristic frequency of the studied slice of cochlea, under sound pressures with the same amplitude, the displacement of basilar membrane and the stereocilia shear displacement of inner hair cells under round-window stimulation were lower than that under forward stimulation. Conclusions Under forward stimulation, the inner hair cells were more excited and the performance for sense of sound was better than that under round-window stimulation. Concurrently, using the displacement of basilar membrane under forward stimulation as the criterion of hearing compensation performance would overestimate hearing compensation performance of middle ear implant under round-window stimulation; but the deviation was relatively small, which was a relatively reliable evaluation method.

Ligands of TetR family transcriptional regulators: a review / 生物工程学报

TetR family transcriptional regulators (TFRs) are widely distributed in bacteria and archaea, and the first discovered TFR was confirmed to control the expression of tetracycline efflux pump in Escherichia coli. TFRs can bind DNAs and ligands. Small molecule ligands can induce conformational changes of TFRs, inhibiting or promoting TFRs to control target gene expression. Currently, TFRs have a wide variety of ligands, including carbohydrates, proteins, fatty acids and their derivatives, metal ions, and so on. Due to the diversity of ligands, TFRs regulate a wide range of physiological processes, from basic carbon metabolism and nitrogen metabolism to quorum sensing and antibiotic biosynthesis. On the basis of the recent studies in our laboratory and the literature, we review here the regulatory mechanism mediated by ligands of TFRs in primary and secondary metabolism, as well as the application of ligands for TFRs in the development of gene route and the activation of antibiotic biosynthesis.

Effect of fatigue load on internal mechanical properties of the intervertebral disc / Efecto de la carga de fatiga en las propiedades mecánicas internas del disco intervertebral

SUMMARY: Lumbar disc herniation is considered to be the main pathological factor for the common clinical disease of low back pain. Biomechanical factor is an important cause of lumbar disc herniation, so it is urgent to analyze the stress/strain behavior of intervertebral disc under different loading condition. Slow repetitive loading is considered to be an important factor of spine and disc injuries, and the effect of fatigue load on internal displacement in the intervertebral disc was investigated by applying the optimized digital image correlation technique in this study. The first finding was that fatigue load had a significant effect on the displacement distribution in the intervertebral disc under compression. Superficial AF exhibited the largest axial displacements before fatigue load, while it exhibited the smallest axial displacements after fatigue load. Inner AF exhibited slightly smaller radial displacements than outer AF before fatigue load, while it exhibited significantly greater radial displacements than outer AF displacements after fatigue load. The second finding was that fatigue load had a certain effect on the internal displacement distribution in the flexed intervertebral disc under compression. Middle AF exhibited the smallest axial displacements before fatigue load, while deep AF exhibited the smallest axial displacements after fatigue load. The radial displacement distribution did not change before and after fatigue load, as the radial displacement in outer AF was the smallest, while the radial displacement in inner AF was the largest. The third finding was that with the increase in fatigue time and amplitude, the Young's modulus of the intervertebral disc increased significantly. This study can provide the basis for clinical intervertebral disc disease prevention and treatment? and is important for mechanical function evaluation of artificial intervertebral disc as well.

RESUMEN: La hernia de disco lumbar se considera el principal factor patológico para la enfermedad clínica común del dolor lumbar. El factor biomecánico es una causa importante de hernia de disco lumbar, por lo que es urgente analizar el comportamiento de esfuerzo / tensión del disco intervertebral bajo diferentes condiciones de carga. La carga repetitiva lenta se considera un factor importante de lesiones de columna y disco, y en este estudio el efecto de la carga de fatiga sobre el desplazamiento interno en el disco intervertebral se investigó mediante la aplicación de la técnica de correlación de imagen digital optimizada. El primer hallazgo fue que la carga de fatiga tuvo un efecto significativo en la distribución del desplazamiento en el disco intervertebral bajo compresión. El AF superficial exhibió los desplazamientos axiales más grandes antes de la carga de fatiga, mientras que exhibió los desplazamientos axiales más pequeños después de la carga de fatiga. El AF interno exhibió desplazamientos radiales ligeramente más pequeños que el AF externo antes de la carga de fatiga, mientras que exhibió desplazamientos radiales significativamente mayores que los desplazamientos AF externos después de la carga de fatiga. El segundo hallazgo fue que la carga de fatiga tenía un cierto efecto sobre la distribución del desplazamiento interno en el disco intervertebral flexionado bajo compresión. El AF medio exhibió los desplazamientos axiales más pequeños antes de la carga de fatiga, mientras que el AF profundo exhibió los desplazamientos axiales más pequeños después de la carga de fatiga. La distribución del desplazamiento radial no cambió antes ni después de la carga de fatiga, ya que el desplazamiento radial en la FA externa fue el más pequeño, mientras que el desplazamiento radial en la FA interna fue el más grande. El tercer hallazgo fue que con el aumento del tiempo de fatiga y la amplitud, el módulo de Young del disco intervertebral aumentó significativamente. Este estudio puede proporcionar la base para la prevención y el tratamiento clínico de la enfermedad del disco intervertebral, y también es importante para la evaluación de la función mecánica del disco intervertebral artificial.

Acciones técnico-tácticas para mejorar la efectividad del trabajo de la mano de alante en boxeadores / Ações técnico-tácticas para melhorar a eficácia do trabalho na linha da frente em boxeadores / Technical-tactical actions to improve the effectiveness of the forward hand in boxers

Resumen El entrenamiento deportivo es un proceso pedagógico encaminado a lograr la adecuada preparación del deportista y controlar sistemáticamente su evolución. El boxeo como deporte de combate requiere de acciones precisas en un período muy corto de tiempo porque si se es más rápido en el accionar técnico en los ataques, se imposibilita al contrario a defenderse y contraatacar. De ahí la importancia del trabajo de la mano de alante para ganar un combate. Es por ello que, el objetivo de este estudio se encamina a proponer un conjunto de acciones técnico-tácticas para contribuir al perfeccionamiento del trabajo de la mano de adelante, a la cara y al tronco de los boxeadores primera categoría de la Academia Provincial de boxeo de Pinar del Río. Se seleccionó una muestra de cinco entrenadores y de diez atletas; todos pertenecientes al equipo primera categoría de la Academia Provincial de Pinar del Río. Se utilizaron métodos investigativos teóricos y empíricos como histórico-lógico, análisis-síntesis, sistémico-estructural, revisión de documentos, entrevista, encuesta, observación y la estadística descriptiva. Las acciones se fundamentan en cinco premisas básicas y tres momentos de la sesión de entrenamiento, según la técnica a ejecutar, brindándose orientaciones generales, ejercicios para el perfeccionamiento (desde la escuela de boxeo, de combate y desde los aparatos fijos y colgantes) y cómo realizar el control. La evaluación teórica por el criterio de especialistas y una aplicación práctica de tres meses corroboran que la propuesta resultó efectiva.

Resumo O treino desportivo é um processo pedagógico que visa alcançar uma preparação adequada do atleta e controlar sistematicamente a sua evolução. O boxe como desporto de combate requer ações precisas num período de tempo muito curto porque se se é mais rápido na ação técnica nos ataques, é impossível, pelo contrário, defender e contra-atacar. Daí a importância de trabalhar lado a lado para ganhar uma luta. Portanto, o objetivo deste estudo é propor um conjunto de ações técnico-tácticas para contribuir para a melhoria do trabalho da mão da frente, do rosto e do tronco dos boxeadores da primeira categoria da Academia Provincial de Boxe de Pinar del Río. Foi selecionada uma amostra de cinco treinadores e dez atletas; todos eles pertencem à equipa da primeira categoria da Academia Provincial de Pinar del Río. Foram utilizados métodos teóricos e empíricos de investigação, tais como histórico-lógico, análise-síntese, sistémico-estrutural, revisão documental, entrevista, inquérito, observação e estatística descritiva. As ações baseiam-se em cinco premissas básicas e três momentos da sessão de treinamento, de acordo com a técnica a ser executada, fornecendo orientações gerais, exercícios de aperfeiçoamento (da escola de boxe, da escola de combate e do aparelho fixo e suspenso) e como realizar o controle. A avaliação teórica pelo critério dos especialistas e uma aplicação prática de três meses corroboram que a proposta foi eficaz.

Abstract Sports training is a pedagogical process aimed at achieving adequate preparation of the athlete and systematically controlling his or her evolution. Boxing as a combat sport requires precise actions in a very short period of time because if one is faster in the technical action in the attacks, it is impossible to defend and counterattack. Hence the importance of working with the forward hand to win a fight. Therefore, the objective of this study is to propose a set of technical-tactical actions to contribute to the improvement of the work with the forward hand, the face and the trunk of the first category boxers of the Provincial Boxing Academy of Pinar del Río. A sample of five coaches and ten athletes was selected; all of them belong to the first category team of the Provincial Academy of Pinar del Río. Theoretical and empirical research methods were used, such as historical-logical, analysis-synthesis, systemic-structural, document review, interview, survey, observation and descriptive statistics. The actions are based on five basic premises and three moments of the training session, according to the technique to be executed, offering general orientations, exercises for the improvement (from the boxing school, from the combat school and from the fixed and hanging apparatus) and how to carry out the control. The theoretical evaluation by specialists and a practical application of three months corroborate that the proposal was effective.