Epidemiological investigation on a cluster epidemic of COVID-19 in Taizhou， Zhejiang Province / 上海预防医学

Objective:To analyze the epidemiological characteristics of a family and workplace clustering of COVID-19， identify the source of infection and the transmission chain， and provide evidence for prevention and control of COVID-19 pandemic. Method:Field epidemiological method was used to conduct the investigation of confirmed cases and close contacts in this cluster. Data were analyzed with descriptive method. Real-time fluorescent quantitative PCR （RT-PCR） was used to detect the novel coronavirus nucleic acid in the collected respiratory tract samples. Results:A total of 18 epidemiological related cases were collected including 16 confirmed cases and 2 cases of asymptomatic infections. The involved places included 1 beauty clinic workplace and 3 families. Seven cases were males and 11 cases were females， with the minimum， maximum and median age of 3， 65 and 32 years old， respectively. Among them， the employees attack rate was 9.80% （10/102）， the family attack rate was 7.70% （5/78）， and the customer attack rate was 0.58% （1/173）. Positive nucleic acid test result in the respiratory tract sample of asymptomatic infection lasted for more than 2 months. Conclusions:The cause of this clustered COVID-19 epidemic is that the workplace environment is relatively closed with clustering crowds， and the source of imported infection is not discovered in time， which lead to a point-source outbreak and spread through family close contacts and clustering.

Asymmetric degeneration of paravertebral muscles in degenerative lumbar scoliosis and potential significance / 中华骨科杂志

Objective@#To measure the cross-sectional area (CSA) and fatty infiltration (FI) of lumbar paravertebral muscles in patients with degenerative lumbar scoliosis (DLS), and to analyze the mechanism and clinical significance of paravertebral muscles degeneration.@*Methods@#A retrospective study was performed on 118 patients with DLS who were enrolled in our hospital from September 2016 to September 2017. All patients had complete preoperative image data. Preoperative lumbar lordosis (LL), Cobb angle, and vertebral rotation were measured on spinal X-ray plain film. The CSA and FI of the paravertebral muscle on the upper and lower intervertebral level of the scoliosis apical vertebrae were measured by lumbar MRI, and the CSA, FI and their correlation with the Cobb angle were compared.@*Results@#This study enrolled 118 DLS patients, including 49 males and 69 females. The mean age of the patients was 65.4 ± 7.2 years, with an average BMI of 24.7 ± 3.4 and lumbar symptoms including LBP, sciatica, numbness and intermittent claudication, decreased myodynamia and other symptoms. The lasting time of symptoms were 21 months (3-60 months). The Cobb angle of the patients averaged 18.5°±6.7°. Of all patients, 60 patients had a scoliosis to the left, and 58 patients had a scoliosis to the right. The number of patients with lateral apical vertebrae located at L1-L4 were: 12 cases of L1, 41 cases of L2, 49 cases of L3, 16 cases of L4. The CSA of the concave side psoas muscle was significantly larger than that of the convex side(upper intervertebral level, concave side 3.74±2.17 cm2, convex side 3.56±1.91 cm2; lower intervertebral level, concave side 6.54±3.08 cm2, convex side 6.31±3.302 cm2. And the CSA of the concave side multifidus muscle and the extensor muscle group was significantly smaller than the convex side, multifidus muscle: upper intervertebral level, concave side 9.47±3.86 cm2, convex side 10.25±4.20 cm2; lower intervertebral level, concave side 9.30±3.61 cm2, convex side 10.21±3.81 cm2; extensor muscle group: upper intervertebral level, concave side 18.35±4.94 cm2, convex side 19.37±5.17 cm2; lower intervertebral level, concave side 18.98±4.73 cm2, convex side 19.81±5.16 cm2. The concave side FI of extensor muscle group is significantly larger than the convex side, upper intervertebral level, concave side 30.63±15.09, convex side 23.48±15.00; lower intervertebral level, concave side 37.87±19.38, convex side 30.43±16.89. There was a correlation between the degree of asymmetry of CSA and FI in the multifidus, dorsal extension muscles, paravertebral muscle and the scoliosis Cobb angle.@*Conclusion@#The paravertebral muscles of lumbar vertebrae are not a whole in the degenerative changes of DLS. There are different anatomical and physiological effects of lumbar flexion and extension muscle groups. The extensor muscles play an important role in antagonizing the progression of DLS. Improving paravertebral muscle function is an important element in the treatment of DLS.

Asymmetric degeneration of paravertebral muscles in degenerative lumbar scoliosis and potential significance / 中华骨科杂志

To measure the cross?sectional area (CSA) and fatty infiltration (FI) of lumbar paravertebral mus?cles in patients with degenerative lumbar scoliosis (DLS), and to analyze the mechanism and clinical significance of paravertebral muscles degeneration. Methods A retrospective study was performed on 118 patients with DLS who were enrolled in our hospi?tal from September 2016 to September 2017. All patients had complete preoperative image data. Preoperative lumbar lordosis (LL), Cobb angle, and vertebral rotation were measured on spinal X?ray plain film. The CSA and FI of the paravertebral muscle on the upper and lower intervertebral level of the scoliosis apical vertebrae were measured by lumbar MRI, and the CSA, FI and their correlation with the Cobb angle were compared. Results This study enrolled 118 DLS patients, including 49 males and 69 fe?males. The mean age of the patients was 65.4 ± 7.2 years, with an average BMI of 24.7 ± 3.4 and lumbar symptoms including LBP, sciatica, numbness and intermittent claudication, decreased myodynamia and other symptoms. The lasting time of symptoms were 21 months (3-60 months). The Cobb angle of the patients averaged 18.5°±6.7°. Of all patients, 60 patients had a scoliosis to the left, and 58 patients had a scoliosis to the right. The number of patients with lateral apical vertebrae located at L1-L4 were: 12 cases of L1, 41 cases of L2, 49 cases of L3, 16 cases of L4. The CSA of the concave side psoas muscle was significantly larger than that of the convex side(upper intervertebral level, concave side 3.74±2.17 cm2, convex side 3.56±1.91 cm2; lower intervertebral lev?el, concave side 6.54±3.08 cm2,convex side 6.31±3.302 cm2. And the CSA of the concave side multifidus muscle and the extensor muscle group was significantly smaller than the convex side, multifidus muscle: upper intervertebral level, concave side 9.47±3.86 cm2, convex side 10.25±4.20 cm2; lower intervertebral level, concave side 9.30±3.61 cm2, convex side 10.21±3.81 cm2; extensor muscle group: upper intervertebral level, concave side 18.35±4.94 cm2, convex side 19.37±5.17 cm2; lower intervertebral level, concave side 18.98±4.73 cm2, convex side 19.81±5.16 cm2. The concave side FI of extensor muscle group is significantly larger than the convex side, upper intervertebral level, concave side 30.63±15.09, convex side 23.48±15.00; lower intervertebral level, concave side 37.87±19.38, convex side 30.43±16.89. There was a correlation between the degree of asymmetry of CSA and FI in the multifidus, dorsal extension muscles, paravertebral muscle and the scoliosis Cobb angle. Conclusion The paravertebral mus?cles of lumbar vertebrae are not a whole in the degenerative changes of DLS. There are different anatomical and physiological ef?fects of lumbar flexion and extension muscle groups. The extensor muscles play an important role in antagonizing the progression of DLS. Improving paravertebral muscle function is an important element in the treatment of DLS.

Application of the nail ridge formation for the wassel type Ⅰ and type Ⅱ thumb duplication with connected nail / 中华整形外科杂志

Objective@#To report the clinical outcome for Wassel Type I and Ⅱ thumb duplication with connected nail by excising the extra digit and reconstructing of nail ridge with the flap from the ablated digit.@*Methods@#63 polydactyly of the thumbs in 61 patients with connected nail were treated the procedure by excising of the inferior phalangeal bones and nails and straightening the IP joint by orthroplasty or wedge osteotomy and reconstructing the nail ridge with the flap from the extra digit. The patients were followed up postoperatively for the assessment of thumb′s appearance and function by using the modified TADA scoring.@*Results@#All cases acquired primary wound healing and 55 of 63 cases were followed up for 6 months to 4 years. The nails were flat and the width were more than 80% of the contralateral side. Symmetric nail lunula was found in 46 thumbs (80.7%) as well as symmetric nail ridge in 40 thumbs (70.1%), but 50 thumb′s nail grooves were not obvious (87.7%). All incisions were made at the lateral of thumbs and no scars were found in the finger pulps. Except mild IP joint deviation was found in 6 thumbs, the others were roughly normal. The range of motion of the IP joint was more than 45° in all cases. Modified TADA scoring result: 52 fingers were excellent and 5 were good.@*Conclusions@#Satisfactory surgical outcome and better parental acceptance can be obtained after the procedures of excising the extra digit and forming of nail ridge, including aesthetics appearance, unaffected sense of touch with finger pulp intact and good mobility of the joint.

Modal Analysis of the Whole Lumbar Spine after Posterior Lumbar Interbody Fusion / 医用生物力学

Objective To study the effect of vibration environments on patients with posterior lumbar interbody fusion in daily life. Methods Finite element models of an intact lumbar spine and a postoperative model with fixed L4-5 segments were established. Subsequently, a 40-kg mass point was applied to the upper end plate of the L1 segment to perform a modal analysis. Results In comparison with an intact lumbar spine, the resonance frequency for each order of the whole lumbar spine was reduced after posterior lumbar interbody fusion, and the primary movement of the corresponding modes were also changed. The first two inherent frequencies of the modal in the fusion model were 2.94 Hz and 3.81 Hz, which were close to the vibration frequencies in daily life. In the first three order vibrations, the mode amplitudes of the posterior elements for the L2 and L3 segments increased in the fusion model, which could increase the risk of postoperative degeneration at such locations. In addition, the vibration amplitude of the intervertebral disc of the L3-4 segments clearly increased, particularly at the part of the disc near the L3 vertebral body, which could lead to increased stress and strain and further accelerate its degeneration. Conclusion sBased on the modal analysis of a lumbar spine after posterior lumbar interbody fusion, the investigation of the vibration characteristics of the postoperative lumbar spine will provide some theoretical guidance for the recovery and healthy life of the patients after the corresponding surgery.

Genotyping and molecular tracing of the first local infection of dengue virus in Taizhou / 中华实验和临床病毒学杂志

Objective@#To determine the first dengue fever case in Taizhou and trace probable transmission sources.@*Methods@#Collected serum of three patients for antigen, antibody and nucleic acid detection. Dengue viruses were isolated and cultured in C6/36 cell. The whole length of E gene was amplified by reverse transcriptase-polymerase chain reaction(RT-PCR) and then sequenced. The phylogenetic tree was drawn.@*Results@#Three cases were positive in nucleic acid detection. Two cases were IgM positive. One case was NSI antigen postive. Three strains of type I dengue virus were isolated from samples. The phylogenetic trees shown that the three strains were on the same branch. The identities of nucleotide were 99.87%. The identities of amino acid were 99.6%-99.8%.@*Conclusions@#The dengue virus strains isolated in Taizhou was imported from Guangdong or Southeast Asia and caused location infection.

Effects of strontium ranelate on the rats' palatal suture after rapid maxillary expansion / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study investigated the effects of strontium ranelate (SrR) on the rats' palatal suture after rapid maxillary expansion (RME).</p><p><b>METHODS</b>Thirty-six male 6-week-old Wistar rats were randomly divided into three groups: control group (A), expansion only group (B), and expansion plus SrR group (C). Each group comprised 12 rats. Neither expansion nor SrR was given to group A. Each rat in groups B and C was set an orthodontic appliance with an initial expansive force of 1 N. The rats in group C were administered with SrR (600 mg·kg⁻¹ body weight) at the same time every day after RME. All the rats were then euthanized in batches on days 4, 7, and 10. The width of the rats' upper jaw was measured. Histological observation was used to section the rats and count the osteoblasts.</p><p><b>RESULTS</b>After the RME, no statistical difference was observed on the rats' upper jaw width in group A (P>0.05). However, the change of upper jaw width in groups B and C presented a statistical significance (P<0.05). By contrast, no statistical difference was observed between groups B and C (P>0.05). The rats' sections were placed under a microscope, and some red fibrous tissues, mesenchymal cells, chondrocytes, and osteoblasts were observed in group A. More red fibrous tissues, mesenchymal cells, and chondrocytes were observed in groups B and C. In addition, more osteoblasts were observed on the edge of mid-palatal suture of the rats. Group C contains more osteoblasts than group B.</p><p><b>CONCLUSIONS</b>RME can expand the mid-palatal suture of rats, which were in the growth development period, and increase the width of dental arch. SrR may promote osteoblast differentiation and hasten new bone formation in the expanded mid-palatal suture. Both conditions accelerate new bone formation and bone deposition calcification, which may be therapeutically beneficial to prevent relapse after RME.</p>

Progress of gait analysis in adolescent idiopathic scoliosis / 中华骨科杂志

Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine,which not only affects spinal anatomy,mobility and trunk symmetry,but also leads to the changes of human locomotion through pelvic.During the past 30 years,though great progress has been made in the treatment of AIS,the pathogeny of AIS is still uncertain.Most scholars believe that many factors contribute to the pathogeny of AIS,however,some studies have shown that poor posture during walking and poor manage of balance could lead to the progress of scoliosis.Gait is a behaviour characteristic during walking,and normal gait is the result of nervous system,musculoskeletal system,proprioception and vision.Any disease of the system above may cause abnormal gait.Gait analysis can spot the key links and impact factors of abnormal gait by observing and measuring the testers' walking,reflect the abnormal gait objectively and quantitatively,and provide reference opinions for the recovery and treatment of patients.At present,gait analysis has been mostly applied in hemiplegia,cerebral palsy and knee osteoarthritis.In recent years,gait analysis has been increasingly used in AIS patients.There have been many researches about the kinematics and kinetics of gait analysis in adolsecent idiopathic scoliosis abroad and some positive results have been reported..But in China,it's still in the initial stage.We reviewed the published papers about gait analysis in AIS patients,and summarized the kinematics,kinetics and different means of intervention on gait in AIS patients.We hope it will provide references for our researches.

Study on the morphology of sagittal of lumbar endplate in healthy adult / 中华外科杂志

<p><b>OBJECTIVE</b>To provide a theoretical basis for designing of lumbar intervertebral disc prosthesis by collecting the data of the lumbar endplate morphology.</p><p><b>METHODS</b>A total of 100 healthy adults were measured about the following parameters: lumbar lordosis, the Cobb angle of each segment, the concavity depth (ECD) of the endplate, the location of concavity apex (ECA) of the endplate. And a correlation analysis on lumbar lordosis and ECD, ECA was made, respectively.</p><p><b>RESULTS</b>In total, 100 volunteers were measured. The mean age of the volunteer was 40 years (range 20 - 50 years); the average depth of ECD was (2. 37 ± 1. 42) mm, the average location of ECA was (52. 21 ± 9. 70) %; the average depth of ECD of inferior endplate (IEP) was (2. 81 ± 1. 52) mm (0. 54 - 7. 60 mm), and the parameter of the superior endplate (SEP) was (1. 94 ± 1. 16)mm(0. 39 - 6. 10 mm). The average depth of ECD of the IEP was bigger than of the SEP for each lumbar vertebral body. Most of the location of ECA was at the back of the intervertebral body, the average location of ECA of IEP was (49. 60 ± 8. 78) % (22. 57% - 75. 58%), and the parameter of the SEP was (55. 03 ± 9. 90) % (16. 03% -75. 58%); the mean angle of lumbar lordosis was 39. 760 11. 25°(13. 8° - 72. 00°). There was no obvious correlation between the lumbar lordosis and the ECD (r -0. 193, P =0. 195), neither was the location of ECA(r =0. 080, P =0. 592).</p><p><b>CONCLUSION</b>Most of the location of ECA is at the back of the intervertebral body, the average depth of ECD is 2. 37 mm, the average location of ECA is 52. 21%.</p>

Expression of nucleophosmin in glandular epithelium of non-pregnant human endometrium during the menstrual cycle / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Nucleophosmin plays a critical role in embryonic development. This study aimed to examine the expression pattern of nucleophosmin in glandular epithelium of human endometrium during the menstrual cycle.</p><p><b>METHODS</b>Endometrial tissues used for this study were obtained from 46 non-pregnant patients who underwent hysterectomy which had been performed to treat benign diseases. Nucleophosmin expression was assessed by in situ hybridization and immunohistochemistry.</p><p><b>RESULTS</b>At the early-, mid- and late-proliferative phase, nucleophosmin mRNA was highly expressed in glandular epithelium of human endometrium. At the secretory phase, the expression of nucleophosmin mRNA was reduced in glandular epithelium in early-secretory phase, and the expression in mid- and late-secretory phases was not detected. Similarly, nucleophosmin protein was strongly expressed in endometrial glands throughout the proliferative phase, but was gradually reduced during secretory phase.</p><p><b>CONCLUSION</b>Nucleophosmin mRNA and protein are expressed in glandular epithelium of human endometrium throughout the menstrual cycle.</p>