Clinical characteristics and risk factors of poor prognosis in patients with infected pancreatic necrosis caused by multidrug-resistant bacteria / 中华肝胆外科杂志

Objective:To study the clinical features and risk factors of death in patients with infected pancreatic necrosis (IPN) caused by multidrug-resistant bacteria (MDRB).Methods:The clinical data of 219 IPN patients who were managed at the Department of General Surgery of Xuanwu Hospital, Capital Medical University from January 1, 2016 to December 31, 2021 were retrospectively analyzed. There were 142 males, and 77 females, with a median age [ M( Q1, Q3)] of 51(38, 62) years old. Based on the pre-sence or absence of MDRB infection, these patients were divided into the MDRB-infected group ( n=117) and the non-MDRB-infected group ( n=102). Clinical features and outcomes were compared between the two groups, and the risk factors resulting in death in patients with MDRB infection were analyzed. Logistic regression analysis was used to determine the risk factors for poor outcomes in patients with MDRB. Results:There were significant differences in etiologies, distribution characteristics of necrosis and degrees of pancreatic necrosis between the two groups (all P<0.05). When compared with the non-MDRB-infected group, the CT severity index, the levels of procalcitonin and interleukin-6 were significantly higher in the MDRB group on admission, while the hematocrit was significantly lower (all P<0.05). Furthermore, when compared with the non-MDRB infection group, patients with MDRB infection were significantly more likely to have fungal infections [37.6%(44/117) vs. 21.6%(22/102)] and extrapancial infections [75.2%(88/117) vs. 58.8%(60/102)], more patients underwent surgery [89.7%(105/117) vs. 67.6%(69/102)], and more surgical procedures were performed [3(2, 4) times vs. 2(1, 3) times], with a higher incidence of postoperative complications [36.2%(38/117) vs. 18.8%(13/102)], an increase in a new-onset organ failure after surgery [37.1%(39/117) vs. 21.7%(15/102)], a higher in-hospital mortality rate [25.6%(30/117) vs. 10.8%(11/102)], longer hospitalization [39(28, 67) d vs. 29(18, 35) d] and ICU stays [22(10, 42) d vs. 11(6, 18) d], and a longer need for parenteral nutrition [19(9, 37) d vs. 15(7, 25) d, all P<0.05]. On multivariate regression analysis, the risk factor for death in the MDRB-infected group was co-fungal infection ( OR=1.199, 95% CI: 1.025-1.402). On the other hand, receiving therapy containing tigacycline ( OR=0.831, 95% CI: 0.715-0.965) and minimally invasive surgery ( OR=0.698, 95% CI: 0.562-0.868) reduced the risk of death in the MDRB-infected group (all P<0.05). Conclusions:IPN patients with MDRB infection had higher levels of inflammation, more serious pancreatic necrosis, longer treatment time, and increased need for surgical treatment. Measures involving fungal infection control and the use of tigacyclin and minimally invasive surgery reduced the risks of death in patients with MDRB infection.

Blinding assessment in clinical trials of traditional Chinese medicine: Exploratory principles and protocol / 中西医结合学报

As one of the key components of clinical trials, blinding, if successfully implemented, can help to mitigate the risks of implementation bias and measurement bias, consequently improving the validity and reliability of the trial results. However, successful blinding in clinical trials of traditional Chinese medicine (TCM) is hard to achieve, and the evaluation of blinding success through blinding assessment lacks established guidelines. Taking into account the challenges associated with blinding in the TCM field, here we present a framework for assessing blinding. Further, this study proposes a blinding assessment protocol for TCM clinical trials, building upon the framework and the existing methods. An assessment report checklist and an approach for evaluating the assessment results are presented based on the proposed protocol. It is anticipated that these improvements to blinding assessment will generate greater awareness among researchers, facilitate the standardization of blinding, and augment the blinding effectiveness. The use of this blinding assessment may further advance the quality and precision of TCM clinical trials and improve the accuracy of the trial results. The blinding assessment protocol will undergo continued optimization and refinement, drawing upon expert consensus and experience derived from clinical trials. Please cite this article as: Wang XC, Liu XY, Shi KL, Meng QG, Yu YF, Wang SY, Wang J, Qu C, Lei C, Yu XP. Blinding assessment in clinical trials of traditional Chinese medicine: Exploratory principles and protocol. J Integr Med. 2023; 21(6): 528-536.

Physical exercise in remote employees during covid-19 / Exercício físico nos colaboradores remotos durante a covid-19 / Ejercicio físico de los empleados a distancia durante el covid-19

ABSTRACT Introduction: During COVID-19, home office activity increased significantly for professionals, especially high-tech companies dominated by information production. Physical health problems attracted great attention from departments responsible for exercise prescriptions. Objective: Discuss the positive and negative effects of home exercise behavior on the health of people working from home, and propose countermeasures to prevent and improve physical health during the epidemic. Methods: Survey questionnaires and mathematical statistics were used to analyze the factors influencing home exercise behavior on the physical health of remote employees. Results: Mathematical statistics from the questionnaire showed that among all investigated factors, more than 90% showed that home exercise behavior positively impacted remote employees' physical health, and less than 10% showed that home exercise behavior did not correlate with physical health. Conclusion: Under the significance level of α= 0.05, it is believed that home exercise behavior can effectively improve physical health. Therefore, if the epidemic control policy cannot be changed, it is recommended to further promote home exercise. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Durante a COVID-19, a atividade em escritório doméstico aumentou significantemente aos profissionais, especialmente empresas de alta tecnologia dominadas pela produção de informações. Os problemas de saúde física atraíram grande atenção dos departamentos responsáveis pela prescrição de exercícios físicos. Objetivo: Compreender os efeitos positivos e negativos do comportamento de exercícios domésticos relacionados à saúde de pessoas que trabalham desde suas casas, propondo contramedidas de intervenção direcionadas à prevenção e melhora na saúde física durante a epidemia. Métodos: Foram utilizados questionários de pesquisa e estatísticas matemáticas para analisar os fatores que influenciam o comportamento do exercício em casa na saúde física dos colaboradores remotos. Resultados: Os resultados estatísticos matemáticos do questionário mostraram que entre todos os fatores investigados, mais de 90% mostraram que o comportamento do exercício em casa teve um impacto positivo na saúde física dos colaboradores remotos, e menos de 10% mostraram que o comportamento do exercício em casa não teve correlação com a saúde física. Conclusão: Sob o nível de significância de α= 0,05, acredita-se que o comportamento de exercício em casa pode efetivamente melhorar a saúde física. Portanto, se a política de controle de epidemias não puder ser alterada, recomenda-se promover ainda mais o exercício físico em casa. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Durante el COVID-19, la actividad del home office aumentó significativamente para los profesionales, especialmente para las empresas de alta tecnología dominadas por la producción de información. Los problemas de salud física atrajeron una gran atención de los departamentos responsables de la prescripción del ejercicio. Objetivo: Comprender los efectos positivos y negativos de la conducta de ejercicio en el hogar relacionados con la salud de las personas que trabajan desde casa, proponiendo contramedidas de intervención dirigidas a la prevención y mejora de la salud física durante la epidemia. Métodos: Se utilizaron cuestionarios de encuesta y estadísticas matemáticas para analizar los factores que influyen en el comportamiento de ejercicio en casa sobre la salud física de los empleados a distancia. Resultados: Los resultados de la estadística matemática del cuestionario mostraron que, entre todos los factores investigados, más del 90% mostraba que el comportamiento de ejercicio en casa tenía un impacto positivo en la salud física de los empleados a distancia, y menos del 10% mostraba que el comportamiento de ejercicio en casa no tenía ninguna correlación con la salud física. Conclusión: Bajo el nivel de significación de α = 0,05, se cree que el comportamiento de ejercicio en casa puede mejorar efectivamente la salud física. Por lo tanto, si no se puede cambiar la política de control de la epidemia, se recomienda promover más el ejercicio en casa. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Pro-angiogenic effect of SEHM formula on HUVEC cells in vitro and Zebrafish in vivo and action mechanism study / 中国药理学通报

Aim To investigate pro-angiogenic effect of SEHM formula on HUVEC cells in vitro and Zebrafish in vivo and the related action mechanism .Methods VEGFR tyrosine kinase inhibitor II ( VRI)-induced ze-brafish intersegmental vessels ( ISVs ) damaged model was established to observe the protective effect of SE-HM formula on ISVs under fluorescence microscope . The pro-angiogenic effect on subintestinal vessels ( SIVs ) of water decoction of SEHM formula in ze-brafish was observed and the mRNA level of VEGFRs , including flt-1, kdr, kdrl, was measured by real-time PCR.The experimental models of the HUVEC cells were set up and the toxicity and promoting proliferation effect of water decoction of SEHM formula in HUVEC cells were assessed by cell viability assay (MTT), and then the levels of Akt, p38, p-p38, p44/42, p-p44/42, VEGFR-1 were detected by Western blot at 6, 12 and 24 h.Results SEHM formula treatment groups could significantly protect VRI-induced zebrafish ISVs loss(P<0.01) and presented pro-angiogenic effect on zebrafish SIVs obviously(P<0.01).The mRNA level of VEGFRs, including flt-1, kdr, kdrl.was up-regula-ted by SEHM formula treatment group significantly (P<0.05) compared with VRI group.Compared with control group , and SEHM formula treatment group could apparently promote proliferation in HUVEC cells and up-regulate the level of Akt, p38, p-p38, p44/42, p-p44/42, VEGFR-1.Conclusions Water de-coction of SEHM formula could present pro-angiogenic effect on SIVs in zebrafish and promote proliferation of HUVEC cells significantly , and its action mechanism may be related to up-regulating the expression of VEG-FR.

Corrosion behavior and microstructure of biomedical Mg-Zn-Mn-Gd alloys / 中国组织工程研究

BACKGROUND: As a metal internal fixation material, magnesium alloy has more unique advantages, such as biodegradability and elastic modulus. The elastic modulus of magnesium alloy is similar to the compact bone,which is enough to avoid stress-shelter effect. However, biological activity represents bonding ability with the bone in the body for fracture fixation materials, which is of great significance for studies on new kinds of magnesium alloys.OBJECTIVE: To observe the microstructure of Mg-Zn-Gd alloys and to analyze the corrosion products on the material surface after immersed in simulation body fluid.METHODS: The Mg-Zn-Gd alloys were manufactured by the method of fusion casting. Scanning electron microscope with spectrometer was applied to observe microstructure and distribution of precipitated phase and corrosion products of Mg-Zn-Gd alloys in simulated body fluid.RESULTS AND CONCLUSION: The Mg-Zn-Gd alloy was composed of α-Mg solid solution containing Gd and Zn elements and eutectic structure. The eutectic structure was almost feathery, oval-shaped, herringbone-shaped and strip-shaped along the grain boundary. The main ingredients of eutectic structure included Mg, Zn and Gd elements.Deposition layer was composed of O, Mg, Ca and P elements on the surface of Mg-Zn-Gd alloy after 72 hours soak in Hank's solution. X-ray diffraction analysis showed that film layer contained Mg(OH)2 phase, which promoted calcium salt deposition and reduced the corrosion rate. So Mg-Zn-Gd alloy can obtain better biological activity.

Automatic measurement of range of motion of human lower limbs using Kinect technique / 中华物理医学与康复杂志

Objective In order to improve the accuracy and efficiency of the measurement of range of motion (ROM) of human lower limbs and simplify process of ROM measurement,an automatic measurement of ROM of human lower limbs based on Kinect technique was proposed and tested in this study.Methods Fifty examinee were randomly divided into 5 groups,namely groups a,b,c,d and e,respectively,each group had 10 members.Using the human skeleton tracking technology from Kinect,the positions of the examinee's lower limbs were captured and tracked by processing the depth data of lower limbs' key joints.Then the information of ROM of hip and knee was output on human-computer interaction interface in real-time.By comparison with traditional manual measurement results,the accuracy of automatic measuring method could be verified.Meanwhile,with the aid of speech recognition and output technology,the mode of warning information transfer and the way of subject switch were optimized.Results According to the method of Grubbs-test and t-test,the ROM values | t | from the subjects' hip abduction (t =0.57,P =0.597),hip adduction (t =0.52,P =0.621),hip anteflexion (t =1.01,P =0.371),hip postextension (t =0.12,P =0.902),hip external rotation (t =0.00,P =1.000),hip internal rotation (t =0.34,P =0.753),knee flexion and extension (t =1.12,P =0.280) all were under the threshold value t0.025 (4) =2.776 on the premise of a level of significance α =0.05,which indicated that there was no significant difference between measured results and expected values(P ＞ 0.05).Conclusion The automatic measurement of ROM of lower limbs can be realized which can improve the measurement accuracy,simplify the measurement process and enhance the practicability of ROM of lower limbs measurement.

Impacts of rotating or lifting-thrusting manipulation on distant vision of naked eye in patients of juvenile myopia: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the differences in the efficacy on distant version of naked eye in the patients of juvenile myopia between rotating manipulation and lifting-thrusting manipulation of acupuncture.</p><p><b>METHODS</b>One hundred and twenty cases (240 eyes) were randomized into a rotating manipulation group and a lifting-thrusting manipulation group, 60 cases (120 eyes) in each group. Additionally, a corrective lenses group, 60 cases (120 eyes), was set up as the control. In both manipulation groups, Cuanzhu (BL 2),Yuyao (EX-HN 4), Sizhukong (TE 23), Taiyang (EX-HN 5), Fengchi (GB 20), Zusanli (ST 36), Guangming (GB 37) and Sanyinjiao (SP 6) were punctured, but stimulated with rotating manipulation and lifting-thrusting manipulation respectively three times per week, 10 times as a treatment session and totally one session was required. In the corrective lenses group, the glasses were applied at daytime. The clinical efficacy and the changes in distant vision of naked eye before and after treatment were compared among the three groups.</p><p><b>RESULTS</b>The total effective rate was 87.5% (105/120) in the rotating manipulation group, which was better than 69.2% (83/120) in the lifting-thrusting manipulation group (P < 0.05). The distant vision of naked eye was improved apparently in the rotating manipulation group and the lifting-thrusting manipulation group after treatment (both P < 0.05). But it was not improved in the corrective lenses group (P > 0.05). The distant vision of naked eye was improved more apparently after treatment in the rotating manipulation group as compared with that in the lifting-thrusting manipulation group (0.75 +/- 0.23 vs 0.68 +/- 0.24, P < 0.05). For 96 cases (192 eyes) with acupuncture treatment, in 3-month follow-up, 87.0% (167/192) of the cases maintained the stable vision as the original level and 13.0% (25/192) of them were reduced in the vision In the acupuncture groups, it was found that the improvement of distant vision of naked eye was more obvious after treatment with younger age, better basic vision and shorter duration of sickness (all P < 0.05).</p><p><b>CONCLUSION</b>Acupuncture achieves the positive and sustainable clinical effect on juvenile myopia, and the results of rotating manipulation are superior to that of lifting-thrusting manipulation. Age, basic vision and duration of sickness impact the clinical efficacy.</p>

Somatic Sense Interactive Technology and Its Application in Motor Rehabilitation (review) / 中国康复理论与实践

@#The application and advance of somatic sense interactive devices, such as EyeToy, Wii and Kinect, in the motor rehabilitation were introduced in this paper. The prospect of application of somatic sense interactive technology as an effective approach in rehabilitation is wide and bright.