Clinical application and mechanism research progress of Wuling Powder in the treatment of brain edema / 国际中医中药杂志

Brain edema belongs to the category of "stroke" and "true headache", while Traditional Chinese Medicine mostly understands its core disease mechanisms from the perspectives of stasis, deficiency, and heat, and mostly treats the disease by using warming yang to induce diuresis and eliminating stasis to remove water. Wuling Powder has been lauded as the "first party to typhoid and relieving diuresis", which is used to cure clearing damp and promoting diuresis and warming yang and transforming qi, and has been clinically used in the treatment of brain edema caused by various causes such as head trauma, intracerebral hemorrhage, cerebral infarction, and intracranial space occupying, all with remarkable efficacy. Wuling Powder improves cellular energy supply, scavenges excess oxygen radicals and calcium ions in brain tissue, and reduces the damage to brain tissue caused by vascular inflammatory factors and regulates aquaporins and vascular endothelial growth factor, thereby achieving therapeutic effects.

Risk factors for postoperative pulmonary complications in elderly patients undergoing hip surgery / 中华麻醉学杂志

Objective:To identify the risk factors for postoperative pulmonary complications (PPCs) in elderly patients undergoing hip surgery.Methods:The medical records of elderly patients, aged ≥ 65 yr, of American Society of Anesthesiologists (ASA) physical statusⅠ-Ⅳ, who underwent hip surgery from June 2013 to May 2019, were retrospectively collected.The patients′ sex, age, body weight, preoperative comorbidities, history of smoking and alcohol, results of the last laboratory test before surgery; mode of anesthesia, intraoperative medication, body temperature monitoring, fluid intake and output, operation time, anesthesia time; postoperative PPCs and postoperative nausea and vomiting, requirement for rescue analgesia, length of hospital stay, and perioperative blood transfusion were all collected.According to the occurrence of PPCs, patients were divided into PPCs group and non-PPCs group.Multivariable logistic regression was used to determine the risk factors for PPCs.Results:A total of 1 204 patients were finally enrolled in this study, 75 patients developed PPCs, and the incidence was 6.22%.The results of multivariate logistic regression showed that ASA physical status Ⅲ or Ⅳ, preoperative respiratory disease, postoperative transfer to intensive care unit, and perioperative blood transfusion were risk factors for PPCs, and general anesthesia combined with nerve block was a protective factor for PPCs in elderly patients undergoing hip surgery ( P<0.05). Conclusions:ASA physical status Ⅲ or Ⅳ, preoperative respiratory disease, postoperative transfer to intensive care unit, and perioperative blood transfusion are risk factors for PPCs, and general anesthesia combined with nerve block is a protective factor for PPCs in elderly patients undergoing hip surgery.

Musculoskeletal training and mechanical characteristics of athletes / Treino musculoesquelético e características mecânicas de atletas / Entrenamiento musculoesquelético y características mecánicas de atletas

ABSTRACT Introduction: Studying the biomechanical characteristics of lower limb muscles during depth jumps is of great significance, but it is also important in meeting the practical needs of strength training. Objective: To explore the musculoskeletal exercise training and mechanical characteristics of athletes' lower limbs. Methods: Analysis and discussion of the test results of kinematics, dynamics and the EMG of 8 muscles of the lower extremity when athletes jump at different falling heights and different motion states. Results: only by using different falling heights in a certain proportion can training efficiency be improved and the training effect of depth jumps reach the practical purpose of sports training. Conclusions: from the point of view of exercise physiology, the generation, storage and reuse of muscle elastic deformation energy and the reflex regulation of the central nervous system are the main reasons for the economic and efficient contractive ability of the extensor muscle group of lower limbs during depth jumps. From the point of view of muscle mechanical properties, the centrifugal contractility of lower limb muscles is the primary factor that determines the athletes' lower limb muscle explosive push ability. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: O estudo das características dos músculos dos membros inferiores durante o salto de profundidade é de extrema importância, mas é também importante para se conhecer as necessidades práticas do treino de força. Objetivo: Explorar o treino de exercícios musculoesqueléticos e as características dos membros inferiores de atletas. Métodos: Análise e discussão dos resultados de testes cinemáticos e dinâmicos, além do EMG de 8 músculos de membros inferiores quando atletas saltam de diferentes alturas de queda e em diferentes estados de movimento. Resultados: É apenas quando se usam diferentes alturas de queda em certa proporção que a eficiência do treino pode ser melhorada e o efeito do treino de saltos de profundidade pode alcançar o objetivo prático do treinamento esportivo. Conclusões: do ponto de vista da fisiologia do exercício, a geração, o armazenamento e a reutilização da energia da fadiga elástica do musculo e a regulação reflexa do sistema nervoso central são os motivos principais para a habilidade contrativa econômica e eficiente do grupo de músculos extensores dos membros inferiores durante saltos de profundidade. Do ponto de vista das propriedades mecânicas, a contratilidade centrifuga dos músculos dos membros inferiores é o fator principal determinando a habilidade do impulso explosivo dos músculos de membros inferiores de um atleta. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Introducción: El estudio de las características de los músculos de los miembros inferiores durante el salto en profundidad es de extrema importancia, pero es también importante para conocerse las necesidades prácticas del entrenamiento de fuerza. Objetivo: Explorar el entrenamiento de ejercicios musculoesqueléticos y las características de los miembros inferiores de atletas. Métodos: Análisis y discusión de los resultados de testes de cinemática, dinámica y EMG de 8 músculos de miembros inferiores cuando los atletas saltan de diferentes alturas en caída y en diferentes estados de movimiento. Resultados: Es solo cuando se usan diferentes alturas de caída en cierta proporción que la eficiencia del entrenamiento puede mejorarse y el efecto del entrenamiento de saltos en profundidad puede alcanzar el objetivo práctico del entrenamiento deportivo. Conclusiones: Del punto de vista de la fisiología del ejercicio, la generación, el almacenamiento y la reutilización de la energía de deformación elástica del músculo y la regulación refleja del sistema nervioso central son los motivos principales para la habilidad contractiva económica y eficiente del grupo de músculos extensores de los miembros inferiores durante saltos en profundidad. Del punto de vista de las propiedades mecánicas, la contractilidad centrífuga de los músculos de los miembros inferiores es el factor principal a determinar la habilidad del impulso explosivo de los músculos de miembros inferiores de un atleta. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

Antitumor effects of different Ganoderma lucidum spore powder in cell- and zebrafish-based bioassays / 中西医结合学报

OBJECTIVE@#Ganoderma lucidum spore (GLS) is gaining recognition as a medicinal part of G. lucidum and has been reported to possess various pharmacological properties, such as antitumor activity. In this work, wall-broken GLS powder (BGLSP) and wall-removed GLS powder (RGLSP), two kinds of GLS powder with different manufacturing techniques, were compared in terms of contents of active constituents and in vivo and in vitro antitumor effects.@*METHODS@#The ultraviolet and visible spectrophotometry method was used to determine the contents of polysaccharides and total triterpenoids in BGLSP and RGLSP. Seventeen individual triterpenoids were further quantified using ultra-high-performance liquid chromatography and quantitative analysis of multi-components by single marker. The antitumor effects of BGLSP and RGLSP were evaluated using in vitro cell viability assay against human gastric carcinoma SGC-7901, lung carcinoma A549 and lymphoma Ramos and further validated by in vivo zebrafish xenograft models with transplanted SGC-7901, A549 and Ramos.@*RESULTS@#The results showed that the contents of polysaccharides, total triterpenoids and individual triterpenoids of RGLSP were significantly higher than those of BGLSP. Although both BGLSP and RGLSP inhibited the three tumor cell lines in vitro in a dose-dependent manner, the inhibitory effects of RGLSP were much better than those of BGLSP. In the in vivo zebrafish assay, RGLSP exhibited more potent inhibitory activities against tumors transplanted into the zebrafish compared with BGLSP, and the inhibition rates of RGLSP reached approximately 78%, 31% and 83% on SGC-7901, A549 and Ramos, respectively.@*CONCLUSION@#The results indicated that the antitumor effects of GLS were positively correlated with the contents of the polysaccharides and triterpenoids and demonstrated that the wall-removing manufacturing technique could significantly improve the levels of active constituents, and thereby enhance the antitumor activity.

Risk factors for nausea and vomiting after total hip arthroplasty in elderly patients / 中华麻醉学杂志

This study was a single-center large-sample case-control study.Data of 1 106 elderly patients who underwent unilateral total hip arthroplasty from June 2013 to May 2019 were collected, including items such as patient′s baseline characteristics, comorbidities, perioperative medication, intraoperative blood pressure, and postoperative outcomes.Patients were divided into postoperative nausea and vomiting(PONV)group and non-PONV group according to whether nausea and vomiting occurred within 24 h after operation.Logistic regression analysis was used to determine the risk factors for PONV.The incidence of PONV was 11.03%.Female, intraoperative use of dezocine, and intraoperative hypotension(duration>3 min or cumulative time>6 min)are independent risk factors for PONV, while femoral neck fractures and intraoperative use of dexamethasone are protective factors.

Research progress on esophageal stents for children / 上海交通大学学报（医学版）

Currently, benign esophageal stricture is a common clinical esophageal disease in children, and its common treatment is balloon dilatation. According to the complexity of the lesion, the child often suffers from multiple esophageal dilation. Besides, esophageal stent provides a new choice for the treatment of esophageal stricture in children because of the long-lasting support. However, the complications limit its clinical application, such as chest pain, restenosis, and stent displacement. This article reviewed the current research and clinical application of esophageal stents for children.

The CXCL12 (SDF-1)/CXCR4 chemokine axis: Oncogenic properties, molecular targeting, and synthetic and natural product CXCR4 inhibitors for cancer therapy / 中国天然药物

Chemokine 12 (CXCL12), also known as stromal cell derived factor-1 (SDF-1) and a member of the CXC chemokine subfamily, is ubiquitously expressed in many tissues and cell types. It interacts specifically with the ligand for the transmembrane G protein-coupled receptors CXCR4 and CXCR7. The CXCL12/CXCR4 axis takes part in a series of physiological, biochemical, and pathological process, such as inflammation and leukocyte trafficking, cancer-induced bone pain, and postsurgical pain, and also is a key factor in the cross-talking between tumor cells and their microenvironment. Aberrant overexpression of CXCR4 is critical for tumor survival, proliferation, angiogenesis, homing and metastasis. In this review, we summarized the role of CXCL12/CXCR4 in cancer, CXCR4 inhibitors under clinical study, and natural product CXCR4 antagonists. In conclusion, the CXCL12/CXCR4 signaling is important for tumor development and targeting the pathway might represent an effective approach to developing novel therapy in cancer treatment.

Optimized reconstruction of oral and maxillofacial defects with common soft-tissue free flaps / 口腔疾病防治

@#Severe tissue defects in the oral and maxillofacial region are commonly caused by tumor resection and trauma and can impair physiological function and aesthetics in patients. Applying a soft-tissue free flap transfer may avoid exposing important blood vessels and nerves and restore basic anatomical structures and facial features. However, the outcomes of soft-tissue free flap transfer have tended to be unsatisfactory because of the exquisite anatomical structure and complicated functions of the oral and maxillofacial region. Therefore, it is clinically important to choose a proper reconstructive method based on specific tissue defects and to optimize the processes involved in the designing and harvesting of soft-tissue free flaps. In this review, we summarize the application of soft-tissue free flaps in oral and maxillofacial defects and strategies for optimizing the quality of tissue reconstruction.

The CXCL12 (SDF-1)/CXCR4 chemokine axis: Oncogenic properties, molecular targeting, and synthetic and natural product CXCR4 inhibitors for cancer therapy / 中国天然药物

Chemokine 12 (CXCL12), also known as stromal cell derived factor-1 (SDF-1) and a member of the CXC chemokine subfamily, is ubiquitously expressed in many tissues and cell types. It interacts specifically with the ligand for the transmembrane G protein-coupled receptors CXCR4 and CXCR7. The CXCL12/CXCR4 axis takes part in a series of physiological, biochemical, and pathological process, such as inflammation and leukocyte trafficking, cancer-induced bone pain, and postsurgical pain, and also is a key factor in the cross-talking between tumor cells and their microenvironment. Aberrant overexpression of CXCR4 is critical for tumor survival, proliferation, angiogenesis, homing and metastasis. In this review, we summarized the role of CXCL12/CXCR4 in cancer, CXCR4 inhibitors under clinical study, and natural product CXCR4 antagonists. In conclusion, the CXCL12/CXCR4 signaling is important for tumor development and targeting the pathway might represent an effective approach to developing novel therapy in cancer treatment.

Long-term outcomes of surgical closure of atrial septal defects and concomitant surgical radiofrequency ablation for atrial fibrillation / 中国胸心血管外科临床杂志

@#Objective    To evaluate long-term outcomes of surgical closure of atrial septal defect (ASD) and combined surgical radiofrequency ablation for atrial fibrillation (AF). Methods    A total of consecutive 15 patients with ASD undergoing surgical closure of ASD and combined surgical radiofrequency ablation in our department between March 2003 and April 2015. There were 7 males and 8 females at an average age of 47.1±10.8 years ranging from 16 to 62 years. Retrospective analysis and follow-up were performed to evaluate long-term success rate freedom from AF after surgery. Results    All patients recovered and discharged, and no patient suffered death or stroke. The duration of follow-up was from 3 to 136 months for all patients. Success rate freedom from AF at 1, 3, 5 and 10 years was 81.3%, 75.0%, 68.8% and 61.1%, respectively. During follow-up, there was no death or stroke. One patient required permanent pacemaker implantation. Conclusion    Concomitant surgical closure of ASD and biatrial radiofrequency ablation is safe and effetive with better long-term outcomes. It is necessary to perform the two procedures together for ASD patients.

Immune Thrombocytopenic Purpura in Children of Eastern Henan Province, China.

In this retrospective cohort study conducted in 63 children with idiopathic thrombocytopenic purpura (ITP) in China; petechiae, bruises and bleeding were the major presentations. Most cases required therapy with one/more treatment options.

Occupational Exposure to Indium of Indium Smelter Workers / 生物医学与环境科学（英文）

Case reports of indium-related lung disease in workers have raised public concern to the human toxicity of indium (In) and its compounds. However, studies evaluating the exposure or health of workers in In smelting plants are rare. Therefore, in this study, we focused on four In smelting plants, with the main objective of characterizing In in smelter plants in China and discussing the potential exposure biomarkers of In exposure. We recruited 494 subjectsat four In smelting plants in China. Personal air samples, first morning urine and spot blood samples were collected. In concentrations in samples were analyzed using inductively coupled plasma mass spectrometry. In concentrations in air samples did not exceed the permissible concentration-time weighed average, but the smelter workers had a higher internal exposure to In. Positive correlations were observed between the air In and urine In concentrations, and between the air In and blood In concentrations. This study provides basic data for the following In exposure and health risk assessment.

Regulation of Host Cell Signaling Pathways by Respiratory Syncytial Virus Nonstructural Protein NS1 and NS2

Human Respiratory Syncytial virus (hRSV) is a leading cause of severe lower respiratory tract diseases in the pediatric population.hRSV frequently causes severe morbidity and mortality in high risk groups including infants with congenital heart disease and the immunosuppressed patients. Although hRSV is recognized as a major public health threat and economic burden worldwide, there is no licensed vaccine and effective therapeutic agent. Viral nonstructural (NS) proteins have been known to play multiple functions for efficient viral replication and pathogenesis. Especially, diverse functions of influenza A virus NS1 have been extensively studies. Recent studies demonstrated that NS1 and NS2 of RSV also exert diverse functions to modulate cellular environment and antiviral immune responses. Since NS proteins of RSV are required for efficient replication and pathogenesis, NS mutant viruses have been tested as live-attenuated vaccines. This review will outline the recent progress in understanding the various functions of RSV NS1 and NS2.

Sensing DNA Viruses and Bacteria by Intracellular DNA Sensors

The innate immune system confers first-line defense against various pathogens including bacteria and viruses. Early detection of invading pathogens by the host depends on a limited number of specific pattern recognition receptors (PRRs) that detect pathogen associated molecular patterns (PAMPs) and activate signal transduction cascades that lead to activation of defense mechanisms. Among those sensors, RIG-I-like receptors (RLRs) play crucial roles in the detection of viruses by recognizing intracellular viral patterns such as viral RNAs to induce type-I interferon production. The discovery of intracellular RNA sensing mechanism by RIG-I prompted the investigations to find out intracellular DNA sensors. Recently, several proteins including DAI, AIM2, IFI16, and cGAS have been suggested as DNA sensing molecules to detect DNA viruses and bacteria, suggesting there are multiple receptors for microbial DNA. In this review, we discuss the current our understanding of sensing microbial DNA and subsequent induction of immune responses.

Laparoscopic treatment of a massive fibroepithelial polyp accompanied by ureteral intussusception / 中华医学杂志(英文版)

Ureteral fibroepithelial polyp accompanied by intussusception is a rare occurrence. Currently, most ureteral polyps could be removed readily by ureteroscopy. Nevertheless, endoscopic resection can be difficult in patient with a large polyp, especially accompanied by an intussusception. We described our experience and laparoscopic technique for treatment of a symptomatic 63-year-old woman who presented with a pedunculated, 9-cm-long, left lower ureteral, fibroepithelial polyp accompanied by a 2-cm-long intussusception.

Surgery of ventilation tube insertion in the middle ear and the external auditory canal for chronic secretory otitis media in children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the therapeutic effect of ventilation tube insertion in the middle ear and the external auditory canal on chronic secretory otitis media in children.</p><p><b>METHODS</b>A retrospective study on 30 patients (40 ears) with chronic secretory otitis media and who underwent the operation of middle ear exploration and ventilation tube insertion in the middle ear and the external auditory canal was performed. Poor tympanic membrane, even with adhesion, was seen in 23 ears. Ten patients had evidence of bilateral secretory otitis media. From this group one ear was first injected with drugs (dexamethasone, mucosolvin, etc) and then tube insertion into the auditory tube was performed; the other ear only received drug injections into the auditory tube. The remaining 20 patients who had evidence of unilateral secretory otitis media only received drug injections into the auditory tube.</p><p><b>RESULTS</b>The tubes inserting into the auditory tube all dropped out 5-8 days after operation. None of the ventilation tubes into the middle ear dropped out and the patients' tympanum recovered after the ventilation tubes were removed (6-8 months after operation). The total cure rate was 87.5% (35/40) and the improvement rate was 12.5% (5/40). The operation of inserting tubes into the auditorytube did not improve the therapeutic effects. In the 0.5-2 years postoperative follow-up, middle ear effusions recurred in one ear, and three ears were transferred from type C to type A.</p><p><b>CONCLUSIONS</b>The surgery of ventilation tube insertion in the middle ear and the external auditory canal for chronic secretory otitis media can prevent the tympanic membrane from damage and dropping out of the ventilation tube and reduce recurrence in children. It is a preferred selection for the patients with poor tympanic membrane or adhesive tympanic membrane. It is no use to insert the tube into the auditory tube for the improvement of therapeutic effects.</p>

Neurologic examination for primary care physicians

No abstract available.

A Case of Chronic Inflammatory Demyelinating Polyneuropathy in Lupas Nephritis / 대한신장학회잡지

Systemic lupus erythematosus(SLE) is a multisys-temic disease. Peripheral neuropathy occurs in about 10% of patients with SLE. Chronic inflammatory demyelinating polyneurpathy has been reported rarely in SLE. We experienced a case of chronic inflammatory polyneuropathy in lupus nephritis. 32-year-old housewife presented to chronic progressive muscle weakness and heavy proteinuria. Kidney biopsy showed compatible with lupus nephritis (WHO Class V, membranous nephropathy). Nerve conduction studies showed reduction in conduction velocity and sural nerve biopsy revealed demyeli-nating polyneuropathy. Steroid therapy led to improvement in clinical symptoms and proteinuria.

Treatment of Common Headaches for Primary Care Physicians

No abstract available.

Prognosis of Isolated Symptomatic Middle Cerebral Artery Stenosis

BACKGROUND: Middle cerebral artery (MCA) stenosis is relatively an uncommon disorder that has not been studied as extensively as extracranial or intracranial internal carotid artery. The long term risk of recurrent stroke or transient ischemic attack (TIA) in patients with isolated symptomatic MCA stenosis remains controversial. Transcranial Doppler sonography (TCD) and magnetic resonance angiography (MRA) are excellent noninvasive tools for a prospective study of MCA stenosis and obstruction. We evaluated the prognosis of isolated symptomatic MCA stenosis prospectively. METHODS: We studied 14 symptomatic patients aged 30-56 years with isolated MCA stenosis who had had TIA or minor stroke. Ten patients had history of two or even more stereotyped TIA or stroke and four patients had a history of single TIA or minor stroke. MCA stenosis was assessed by MRA, TCD and/or conventional angiography (CA) in selected cases at entry. CA and/or MRA showed MCA stenosis in the M1 segment in all patients without the evidence of the widespread atherosclerotic disease. Patients with the potentials of embolic source in the heart or the proximal vessel system were excluded. All patients were treated with antiplatelet agents or anticoagulants. The mean duration of follow-up was 22 months (3-39 months) and TCD was done in 2 to 12 month interval. RESULTS: During follow-up, one of 14 patients had TIAs, the other 13 patients experienced neither subsequent transient attack nor new stroke. TCD demonstrated regression of stenosis in 7 patients, and progression in one patient. TCD findings did not change in 6 patients. CONCLUSIONS: These findings suggest that the prognosis is good for patients with isolated symptomatic MCA stenosis under treatment with antiplatelet agents or anticoagulants.