Relationship between rotator cuff muscle function and shoulder abduction function in patients with posterior superior rotator cuff tear: a dynamic biomechanical study / 中华创伤杂志

Objective:To evaluate the relationship of rotator cuff muscle function with shoulder abduction function after posterior superior rotator cuff tear via dynamic biomechanical study.Methods:By using the customized dynamic shoulder biomechanical testing system, seven freshly frozen cadaveric shoulders were used to stimulate shoulder abduction at 90° under four statuses: (1) intact rotator cuff with activation (normal rotator cuff group); (2) posterior superior rotator cuff tear with activation (posterior superior rotator cuff tear with activation group); (3) posterior superior rotator cuff tear with posterior superior rotator cuff deactivation (posterior superior rotator cuff tear with deactivation group); (4) none rotator cuff tissue above the geometric rotation center of the humeral head with deactivation (global tear group). The peak and stable value of middle deltoid force were used to evaluate biomechanical status in different rotator cuff tear conditions during shoulder abduction procedure. The peak subacromial pressure, average subacromial pressure, subacromial contact area, and subacromial force were used to evaluate subacromial pressed conditions under different rotator cuff tear conditions. The peak and stable ratio of glenohumeral contact force/middle deltoid force were used to evaluate shoulder stability under different rotator cuff tear conditions.Results:During dynamic abduction at 90°, the peak and stable value of middle deltoid force were (42.1±8.7)N and (29.9±7.4)N in normal rotator cuff group, (45.7±10.3)N and (30.5±7.2)N in posterior superior rotator cuff tear with activation group, and (48.4±13.4)N and (29.9±4.8)N in posterior superior rotator cuff tear with deactivation group (all P>0.05). But the peak and stable value of middle deltoid force were (69.7±9.7)N and (53.7±8.9)N in global tear group, significantly increased compared with other three groups (all P<0.05). The elevated middle deltoid force increased the subacromial contact pressure between glenohumeral head and acromion. The peak subacromial pressure, average subacromial pressure, subacromial contact area, and subacromial force were (0.40±0.05)MPa, (0.22±0.03)MPa, (7.71±5.09)mm 2, and (1.66±1.06)N respectively in normal rotator cuff group, (0.41±0.05)MPa, (0.26±0.07)MPa, (12.71±11.35)mm 2, and (2.93±2.46)N respectively in posterior superior rotator cuff tear with activation group, and (0.50±0.12)MPa, (0.26±0.07)MPa, (17.29±9.11)mm 2, and (4.09±1.46)N respectively in posterior superior rotator cuff tear with deactivation group (all P>0.05). However, the peak subacromial pressure, average subacromial pressure, subacromial contact area, and subacromial force were (3.64±1.70)MPa, (0.98±0.49)MPa, (47.63±11.91)mm 2, and (45.48±23.86)N respectively in global tear group, significantly higher than those in other three groups (all P<0.05). The peak and stable ratio of glenohumeral contact force/middle deltoid force were 2.24±0.30 and 2.46±0.13 in normal rotator cuff group, 2.21±0.19 and 2.52±0.08 in posterior superior rotator cuff tear with activation group, and 2.03±0.14 and 2.42±0.16 in posterior superior rotator cuff tear with deactivation group (all P>0.05). However, the peak and stable ratio of glenohumeral contact force/middle deltoid force were 1.40±0.14 and 1.52±0.41 in global tear group, significantly higher than those in other three groups (all P<0.05). No significant differences of the above parameters were observed in posterior superior rotator cuff tear with activation group, posterior superior rotator cuff tear with deactivation group and global tear group (all P>0.05). Conclusions:After posterior superior rotator cuff tear, rotator cuff muscle function does not affect the whole abduction function of shoulder. When the size of rotator cuff tear involves the whole superior humeral head rotation center, the normal abduction function of shoulder will be significantly impaired.

Radiographic study of the patellofemoral axial alignment with episodic patellar dislocation / 中华创伤杂志

Objective:To explore the diagnostic performance of patella-tilt angle and congruence angle in episodic patellar dislocation (EPD) and the quantitative measurements of the patellar and femoral axial parameters as well as their correlation with and contributions to the patellofemoral joint alignment with the knee extended.Methods:A case control study was conducted to analyze the radiological data of EPD patients (EPD group, n=106) and patients without patellar instability (control group, n=106) admitted to Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University from January 2016 to December 2019. Each group consisted of 55 females and 51 males with the age range of 14-45 years [(23.0±5.3)years], showing 1∶1 match. Axial parameters included patellar parameters (patellar width, patellar thickness, Wiberg angle and Wiberg index), femoral parameters [trochlear sulcus angle, trochlear sulcus depth, trochlear sulcus height, trochlear width ratio (lateral/medial), trochlear height ratio (lateral/medial), lateral trochlear inclination and trochlear groove medialization], and patellofemoral joint parameters (patellar tilt angle and congruence angle). The receiver operating characteristic (ROC) curve of patellofemoral joint parameters for the prediction of EPD was analyzed. Univariate analysis was performed to determine the difference of those axial parameters between the two groups. Pearson correlation analysis was used to identify the correlation between those bony parameters and patellofemoral joint parameters. Stepwise regression model was further established to determine the influencing factors and corresponding contributions for patellofemoral joint parameters. Results:When the optimal cut-off values of patellar tilt angle and congruence angle were 17.2° and 25.5°, the area under the ROC curve (AUC) for predicting EPD was 0.91 (95% CI 0.87-0.95, P<0.01) and 0.92 (95% CI 0.87-0.95, P<0.01), and the Youden index was 0.745 (sensitivity=83.96%, specificity=90.57%) and 0.717 (sensitivity=81.13%, specificity=90.57%). Univariate analysis showed that Wiberg index, femoral parameters and patellofemoral joint parameters were significantly different between the two groups (all P<0.01). For all patients, Pearson correlation analysis showed that patellar tilt angle was moderately to strongly correlated with Wiberg index, trochlear sulcus angle, trochlear sulcus depth, trochlear width ratio (lateral/medial), trochlear height ratio (lateral/medial) and lateral trochlear inclination ( r=0.51, 0.41, -0.62, 0.43, -0.49, -0.65, all P<0.01) and that congruence angle has a moderate correlation with trochlear sulcus angle, trochlear sulcus depth, trochlear width ratio (lateral/medial) and lateral trochlear inclination ( r=0.43,-0.59,0.38,-0.51, all P<0.01). For all patients, Stepwise regression model analysis showed that lateral trochlear inclination, trochlear sulcus depth, trochlear sulcus angle, Wiberg index and trochlear height ratio (lateral/medial) could explain 60% of the variation of patellar tilt angle ( R 2=0.60, P<0.01) and that trochlear sulcus depth, lateral trochlear inclination, trochlear groove medialization, trochlear sulcus angle and Wiberg index could explain 44% of the variation of congruence angle ( R 2=0.44, P<0.01). Conclusions:The patellar tilt angle and congruence angle are reliable quantitative indicators representing patellofemoral axial alignment, with a good diagnostic performance for EPD. Variations in the patellar and femoral bony structures of EPD patients are related to the patellofemoral axial alignment, with the axial parameters differently contributing to the patellofemoral alignment.

Clinical value of serum cystatin C measurements in patients with HBV related acute-on-chronic liver failure / 中华实验和临床病毒学杂志

Objective@#To study the clinical value of serum cystatin C, neutrophil gelatinase-associated lipocalin (NGAL) and matrix metalloproteinase (MMP)-9/NGAL-1 measurements for early diagnosis of acute kidney injury (AKI) in patients with acute-on-chronic liver failure (ACLF).@*Methods@#This study included 102 patients with hepatitis B virus related ACLF and 31 patients with chronic hepatitis B (CHB) were enrolled as controls. Biomarkers including serum cystatin C, NGAL and MMP-9/NGAL-1 were measured twice in the patients with ACLF at admission and at the time progressed to AKI and once in the controls.@*Results@#In patients with ACLF, serum cystatin C levels was higher than that of the CHB control (t=3.609, P=0.000), whereas NGAL and MMP-9/NGAL-1 levels were lower in patients with ACLF than that of CHB controls (t=3.016, P=0.003; t=7.514, P=0.000, respectively). Thirty-three patients (32.4%) progressed to AKI during hospitalization period. In AKI group of the patients serum cystatin C levels was higher than that of non-AKI group of the patents (t=4.543, P=0.000). MMP-9/ NGAL-1 and NGAL levels were not different in patients with and without AKI (t=0.905, P=0.368; t=0.061, P=0.952). Serum cystatin C in patients with mild AKI (serum creatinine<1.5 mg/dl) and AKI serum creatinine>1.5 mg/dl were 33.59± 9.19 ng/ml and 43.32±9.02 ng/ml respectively. That was higher than that of non-AKI patients (27.94±7.93 ng/ml, P=0.022, 0.000, respectively). Serum cystatin C was the independent risk factors associated with development of AKI by a multivariate logistic regression in patients with ACLF.@*Conclusions@#Serum cystatin C measurement may contribute to more earlier diagnosis of AKI even in patients with S. creatinine<1.5 mg/dl. NGAL and MMP-9/NGAL-1 may be the biomarker of progress for ACLF.

Research of biological effect of different dose of satereotactic body radiation therapy on hepatoma Hep G2 ceils / 中国医师杂志

Objective To study the biological effect of different dose of satereotactic body radiation therapy (SBRT) on hepatoma Hep G2 Cells.Methods Hep G2 hepatumor cells vitality of 0,2,4,6,8,and 10 Gy doses of SBRT were determined by methyl thiazolyl tetrazolium (MTT) method.The cell colony formation rate and the cell survival fraction were detected.The cell apoptosis was detected by flow cytometry.The expressions of cyclin D1,Bax,Bcl-2,and caspase-3 protein were detected by Western blot.Results Hep G2 cells vitality was obvious inhibitory effect in different doses of SBRT,increasing with the SBRT dose,the cell vitality inhibition [2 Gy group (4.29 ± 0.63) ％,4 Gy group (19.37 ± 4.54) ％,6 Gy group (41.35 ±4.51)％,8 Gy group (86.34 ±5.68)％,10 Gy group (97.24 ±5.41)％] was increased,compared to 0 Gy group [(2.94 ± 0.52) ％],the difference was statistically significant (all P ＜ 0.01 or P ＜0.05).The cell colony formation rate and survival score in different doses of SBRT were statistically lower than the control group,increasing with the SBRT dose,the cell colony formation rate [4 Gy group (83.15 ± 4.71),6 Gy group (65.23 ± 5.47),8 Gy group (41.28 ± 5.36),10 Gy group (8.14 ± 5.22)] and survival score [2 Gy group (95.49 ±3.21),4 Gy group (84.23 ±3.45),6 Gy group (66.08 ± 3.71),8 Gy group (41.82 ± 3.82),10 Gy group (8.25 ± 3.56)] were decreased,compared to 0 Gy group [(98.72 ± 1.23),(100.00 ±0.00)],the differences were statistically significant (all P ＜0.01 or P ＜ 0.05).The cell apoptosis in different doses of SBRT was increased,increasing with the SBRT dose,the Hep G2 cells apoptosis [4 Gy group (13.67 ±4.62),6 Gy group (28.71 ±5.13),8 Gy group (54.16 ±5.24),10 Gy group (76.31 ± 5.17)] were significantly increased,compared to 0 Gy group (1.35 ±0.46),the difference was statistically significant (all P ＜ 0.01).The expressions of cyclinD1,Bax,Bcl-2,and caspase-3 protein in different doses of SBRT were decreased,increasing with the SBRT dose,the cyclin D1 [6 Gy group (1.94 ± 0.57),8 Gy group (1.38 ± 0.41),10 Gy group (0.52 ± 0.34)],Bax[6 Gy group (2.67 ±0.59),8 Gy group (1.73 ±0.45),10 Gy group (0.63 ±0.37)],Bcl-2 [4 Gy group (1.78 ±0.41),6 Gy group (1.03 ±0.35),8 Gy group (0.76 ±0.28),10 Gy group (0.38 ± 0.21)],Caspase-3 [6 Gy group (0.76 ± 0.31),8 Gy group (0.42 ± 0.24),and 10 Gy group (0.24 ± 0.21)] were obviously decreased,compared to 0 Gy group [(3.41 ± 0.75),(4.36 ± 0.87),(2.57 ± 0.46),(1.67 ± 0.55)],the difference was statistically significant (all P ＜ 0.05).Conclusions Different dose of SBRT can reduce Hep G2 cell vitality,enhance radiation sensitivity,have a dose dependent,maybe related to promote cell apoptosis and inhibit the proliferation of protein expression.

Immunogenicity of a vaccine of S fragments from a new type reovirus generates humoral and cellular immune responses in mice / 中国实验动物学报

Objective To explore the humoral and cellular immune responses of a vaccine of S fragments from a new type reovirus R4 strain in mice.Methods Four recombinant plasmids were constructed by respectively cloning S 1, S2, S3,S4 genes into pcDNA3.1+, and mice were intramuscularly immunized with the recombinant plasmids in a dose of 100 μg/mouse.Control vector pcDNA3.1 +and phosphate buffered saline (PBS) were used as negative controls.The spe-cific antibody level and IgG subclass (IgG1, IgG2a, and IgG2b) were detected by ELISA, and cellular immune responses to R4 were assessed using an interferon ( IFN)-γELISpot assay .Results All recombinant plasmids induced significantly higher levels of anti-R4 IgG compared with that of the controls (pcDNA3.1 +and PBS), and the titers were highest in the mice immunized with S1 and S3.On the other hand, S1 gene induced highest IgG2a antibody and the cellular immune re-sponse was best .Conclusions After the mice immunized with S 1 gene recombinant plasmid , this plasmid can initiate both cellular and humoral immune responses in mice .S1 gene recombinant plasmid is a promising vaccine candidate .

Three Electrodes Biosensor for Alcohol in Whole Blood Based on Multi-wall Carbon-nanotube / 分析化学

A novel disposable three electrodes blood alcohol biosensor strip was fabricated by a screen printing technique. Multi-wall carbon nanotube(MWCNT), Meldola′s(MB), alcohol dehydrogenase(ADH)and nicotinamide adenine dinucleotide cofactor (NAD+) were modified on the surface of the carbon working electrode. Then hydrophilic membrane was stuck in the outermost of the three electrodes to make a reaction camera of 5 μL. Experimental results indicated that the biosensor possessed good accuracy and stability, the linear response range was 0.5-20 mmol/L with correlation coefficient of 0.9949, detection limit was 0.22 mmol/L, and the response time was less than 15 s. Some influencing factors to the biosensor were investigated, such as the pH, temperature and interferences. Correlation analysis showed that there was a significant correlation between the methods of biosensor and the headspace vapor phase chromatography in 10 whole blood samples(r=0.97583). Small volume whole blood sucked using siphonage to detect blood alcohol directly and quantitatively was the obvious character of the biosensor.

The progress in researches on biocompatibility for direct brain-machine interface / 生物医学工程学杂志

An important application of the direct brain-machine interfaces are providing an outlet for severely paralyzed individuals to communicate with the world. According to different type of microelectrodes, brain-machine interfaces are divided into indirect-BMI and direct-BMI. Direct-BMI are intracortical recording devices designed to capture the action potentials of many individual neurons, especially those that code for movement or its intent. A key problem in research of BMI is how to enhance biocompatibility for direct-BMI. This review introduces some new microelectrodes of direct brain-machine interface which all have higher biocompatibility.

Quality course construction of ‘the clinical laboratory equipment' / 中华医学教育探索杂志

By updating their concepts of education,carrying out the reform of teaching content,teaching methods and means,strengthening the construction of teaching materials,creating a high standard teaching team,the author aims to implement the construction of quality course of clinical testing equipment and comprehensively improve the teaching quality.

Exploration and practice of building "Clinical testing of equipment" course / 中华医学教育探索杂志

Clinical testing of equipment is an interdisciplinary professional and technical course,of which we made continuous innovation and practice by optimizing the curriculum system ,upgrading teaching contents,reforming teaching methods,opening up the construction of teach-ing materials,building the teaching staff and improving teaching quality management etc.After five years of positive efforts the remarkable teaching results were achieved.

Discussion on the Elective Course of Clinical Laboratory Management / 中华医学教育探索杂志

Students will be familiar with the major contents of clinical laboratory management,such as clinical laboratory quality management,laboratory creature safety containment,clinical laboratory accredit action through the course of clinical laboratory management for laboratory medicine students.Meanwhile,by continuously perfecting the teaching contents and methods,students' satisfaction with this course has been improved,and they pay more attention and give higher appraisement to this course.

Problems and Countermeasures of Experimental Teaching for Medical Laboratory Instruments / 中华医学教育探索杂志

Objective: To investigate the problems and improve the quality of experimental teaching for medical laboratory instruments.Method: A questionnaire was made among 100 laboratory medicine students in Chongqing University of Medical Sciences.Result: About eighty-six percent of the students were satisfied with the experimental teaching for medical laboratory instruments,but there were still problems: absence of clear objectives in experimental teaching;shortage of activity of medical laboratory instruments experiment;lack of modern large-scale instruments.Conclusion: the key points to improve experimental teaching quality are to set up clear experimental teaching objective;update instruments for experimental teaching;structure simulator laboratory with modern education simulator technology.

An experimental study on the acquisition of HRV signals with high reliability / 生物医学工程学杂志

The acquisition of heart rate variability (HRV) signals is very important to physiological research and clinical diagnosis. In order to ensure the accuracy of acquired heart rate variability signals, we must consider the method of acquisition of heart rate variability signals. By using the relation between the signal singularity and its wavelet transforms, a software for R wave in detection is designed. The result is very satisfying in detecting R wave of ECG database of MIT/BIH.

Diagnostic evaluation of viral myocarditis by combined determination of cTnI,MYO and CK-MB mass / 解放军医学杂志

Objective To appraise the values of combined determination of cTnI,MYO and CK-MB mass in the diagnosis of viral myocarditis.Methods The myocardial injury markers(cTnI,MYO and CK-MB mass)and myocardial enzyme(LDH,AST,CK and ?-HBDH)of 61 patients with viral myocarditis(VMC),74 patients with non-viral myocarditis(NVMC)and 46 healthy subjects were determined,respectively,by microparticle chemiluminescent immunoassay and continuous monitoring assay.Diagnostic efficiency was calculated by matrix decision method.Results The serum levels of cTnI,MYO and CK-MB mass of the patients in VMC group were obviously higher than that of the patients in NVMC group(0.46?0.21 vs 0.06?0.04?g/L,98.7?38.2 vs 39.2?26.8?g/L and 6.1?4.2 vs 2.2?1.7?g/L,respectively)as well as that of healthy subjects(0.46?0.21 vs 0.07?0.04?g/L,98.7?38.2 vs 36.5?24.7?g/L and 6.1?4.2 vs 2.1?1.5?g/L,respectively,P0.05).For preliminary diagnosis of VMC,the SE of MYO is highest,but the SP of cTnI and CK-MB mass were better choice.Restoration of MYO was earliest while cTnI was latest during convalescence of the patients.Conclusion Combined and uninterrupted determination of the myocardial injury markers can provide better diagnostic accuracy.

The application of data mining technology based on rough sets to medical diagnosis / 医疗卫生装备

Rough set is a mathematical approach to study imprecise, uncertain or incomplete information or knowledge. The data mining technology based on the rough set theory can be trained through the training data set. The technology is applied to such fields as the prognosis of the pain in the chest, emergence diagnosis in ICU, distinguishing and diagnosis of lung tumor and rheumatoid disease, diagnosis of galactophore disease, diagnosis of premature birth, classification and diagnosis of liver disease and acute appendicitis. The technology has a brilliant future in medical data mining.