Application of virtual intelligent system in bronchoscopy theory and operation training for PCCM physicians / 中华医学教育探索杂志

Objective:To evaluate the role of virtual bronchoscopy intelligent system in improving the theory and operation level of bronchoscopy in pulmonary and critical care medicine (PCCM) teaching for standardized training specialists.Methods:A total of 50 PCCM physicians who had participated in virtual bronchoscopy training in Xijing Hospital, Air Force Medical University from 2018 to 2021 were selected as research subjects. In this study, self-controlled method was adopted to evaluate the change of assessment indicators after 1 week and 2 weeks of training. Questionnaire survey was also used to evaluate the training effect. SPSS 23.0 software was used for paired t-test and Chi-square test. Results:All the 50 PCCM physicians successfully completed the training of virtual bronchoscopy operation. The theoretical score was significantly improved after the training [(80.0±5.2) points vs. (92.4±3.8) points]. The basic operation time [(1 050.9±103.3) s vs. (386.4±47.7) s], and the number of hitting the bronchial wall [(88.3±12.7) times vs. (27.0±5.3) times] were significantly reduced. The recovery rate of alveolar lavage fluid [(27.6±7.4)% vs. (58.0±8.2)%] and the positive rate of biopsy [(19.2±13.1)% vs. (86.8±10.8)%] were significantly increased. The learning curve of the final score indicated that the score improved more rapidly in the first week of training, and the score improved more slowly in the second week of training. Questionnaires before and after the training indicated that virtual intelligent training could significantly improve the confidence and proficiency of students in bronchoscopy.Conclusion:Through the systematic training of virtual bronchoscopy intelligent system, the PCCM physicians have significantly improved their theoretical knowledge and operational proficiency. Therefore, the virtual bronchoscopy training system has practical significance for improving the overall training effect of clinical bronchoscopy for PCCM trainees, which is worthy of promotion.

Efficacy and Safety of Pulse Magnetic Therapy System in Insomnia Disorder: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

Objective@#This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. @*Methods@#Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. @*Results@#The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. @*Conclusion@#PMTS is safe and effective in improving insomnia disorders.

Preparation, properties and antibacterial applications of medical nano-metals and their oxides: a review / 生物工程学报

Antibiotics are playing an increasingly important role in clinical antibacterial applications. However, their abuse has also brought toxic and side effects, drug-resistant pathogens, decreased immunity and other problems. New antibacterial schemes in clinic are urgently needed. In recent years, nano-metals and their oxides have attracted wide attention due to their broad-spectrum antibacterial activity. Nano-silver, nano-copper, nano-zinc and their oxides are gradually applied in biomedical field. In this study, the classification and basic properties of nano-metallic materials such as conductivity, superplasticity, catalysis, and antibacterial activities were firstly introduced. Secondly, the common preparation techniques, including physical, chemical and biological methods, were summarized. Subsequently, four main antibacterial mechanisms, such as cell membrane, oxidative stress, DNA destruction and cell respiration reduction, were summarized. Finally, the effect of size, shape, concentration and surface chemical characteristics of nano-metals and their oxides on antibacterial effectiveness and the research status of biological safety such as cytotoxicity, genotoxicity and reproductive toxicity were reviewed. At present, although nano-metals and their oxides have been applied in medical antibacterial, cancer treatment and other clinical fields, some issues such as the development of green preparation technology, the understanding of antibacterial mechanism, the improvement of biosafety, and the expansion of application fields, require further exploration.

Research advances of modern and traditional medicine on dry age-related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

@#Age-related macular degeneration(ARMD)is one of the main causes of irreversible visual impairment in the middle-aged and elderly people, which severely impacts the patient's life quality and poses a substantial health economic burden on society. There are two types of late ARMD in clinic: wet ARMD and dry ARMD. Anti-vascular endothelial growth factor drugs, as first-line clinical drugs for wet ARMD, achieved remarkable efficacy. For dry ARMD, however, effective therapies are in the air. This review focuses on the potential drugs, biological therapies and traditional Chinese medicines that made significant progresses in clinical trials for dry ARMD, including anti-inflammatory drugs(doxycycline and FHTR2163), anti-oxidants(risuteganib and elamipretide), complement inhibitors(APL-2 and zimura), visual cycle modulators(ALK-001), neuroprotective agents(brimonidine), stem cell transplantation(MA09-hRPE and BMMF), gene therapy(HMR59), and traditional Chinese medicine(saffron, curcumin, quercetin and resveratrol). The new drugs exhibited favorable clinical efficacy and broad application prospects, which would foster hope for improvement and treatment of ARMD.

Clinical evaluation and prognosis prediction of drug-induced liver injury / 临床肝胆病杂志

Drug-induced liver injury (DILI) is commonly seen in clinical practice and may bring serious harm to health. It is an important reason for the failure of liver disease treatment and new drug research and development. The clinical diagnosis of DILI remains a difficult issue in the world, and therefore, exploration of related risk signs and initiation of clinical evaluation and prognosis prediction are of great significance for the prevention, diagnosis, and treatment of DILI.

A preliminary Study on Clinical Characteristics and Toxicology Mechanism of Tripterygium wilfordii Induced Liver Injury / 世界科学技术-中医药现代化

Tripterygium wilfordii Hook. F. (TWF) belongs to celastraceae under Tripterygium family. It is a traditional Chinese medicine with a variety of pharmacological effects such as anti- inflammatory, analgesic, anti- tumor, immunomodulation and so on, which is applied for many diseases because of its significant effects. However, its toxic and side effects frequently occur, especially liver injury, affecting its safety in clinical practice. In this paper, the clinical characteristics of liver injury of TWF were preliminarily explored by combining with literature analysis and single center clinical epidemiological investigation. Furthermore, the main toxic constituents and mechanism of TWF are reviewed. Finally, the key issues have been raised and analyzed on clinical diagnosis, clinical characteristics and toxicological mechanism of liver injury of TWF, and brought forward the future research directions.

HRCT diagnosis of bronchial invasive pulmonary aspergillosis / 实用放射学杂志

Objective To analyze retrospectively the HRCT signs in the patients with invasive pulmonary aspergillosis and evaluate the value of HRCT in the diagnosis of invasive pulmonary aspergillosis.Methods The cilinical and HRCT images of 30 cases with invasive pulmonary aspergillosis diagnosed by fiber bronchoscopy, CT guided biopsy or sputum culture were collected.HRCT images were analyzed and the HRCT signs were summarized by two experienced chest imaging radiologists.Results 19 patients had a variety of CT signs, the sign of tree in bud was seen in 8 cases, bronchial stenosis 6 cases, bronchiectasis 8 cases, ground-glass opacity 8 cases, acinic nodules 10 cases, nodular lesions 12 cases, acinar nodules with halo sign 4 cases, nodules with halo sign 9 cases, cavity 10 cases.11 cases only had a single CT sign, the sign of tree in bud was seen in 2 cases, bronchiectasis 2 cases, ground-glass opacity 1 case, acinar nodules 2 cases, nodules with halo sign 2 cases, cavity 2 cases.The occurrence rates of various signs in 30 cases were as follows, the sign of tree in bud was 33.3%, bronchial stenosis 20%, bronchiectasis 33.3%, ground-glass opacity 30%, acinar nodule 40%, nodular lesion 46.6%, halo sign 53.3%,cavity 40%.Conclusion The main HRCT signs in the patients with invasive pulmonary aspergillosis includes tree in bud, bronchial stenosis, bronchiectasis, ground-glass opacity, acinar nodules, nodal lesions,pulmonary cavity and halo sign.The signs of bronchiectasis with tree in bud sign, acinar nodule and halo sign in the HRCT images are highly specific in the diagnosis of invasive pulmonary aspergillosis.

Clinical features of children with incomplete Kawasaki disease / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the clinical features of children with incomplete Kawasaki disease (IKD), and to provide reference for the early diagnosis of IKD.</p><p><b>METHODS</b>The clinical data of 22 hospitalized children with IKD were analyzed retrospectively and compared with the data of 63 children with Kawasaki disease (KD) who were hospitalized during the same period of time. Another 20 children with pyrexia were enrolled as the control group.</p><p><b>RESULTS</b>Pyrexia was observed in all children. Compared with the KD group, the IKD group had significantly lower proportions of children with changes in the limbs, conjunctival hyperaemia, and cervical lymphadenectasis (P<0.05), a significantly higher serum level of glutamic-pyruvic transaminase (P<0.05), and significantly lower levels of plasma albumin, serum sodium, and interleukin-6 (P<0.05). There was no significant difference in the rate of γ-globulin application between the IKD and KD groups; however, the IKD group had a significantly higher incidence rate of coronary artery lesion than the KD group (P<0.05).</p><p><b>CONCLUSIONS</b>The symptoms and signs in children with IKD are untypical. The liver function test and serum hyponatremia and IL-6 measurements may be useful for the diagnosis of IKD.</p>

Study on the plasma protein binding rate of Schisandra lignans based on the LC-IT-TOF/MS technique with relative quantitative analysis / 中国天然药物

The main objective of the current study was to develop a universal method for a protein binding assay of complicated herbal components, and to investigate the possible relationship between compound polarity and protein binding using Schisadra lignans as an example. Firstly, the rat, dog and human plasma were spiked with three different concentrations of Schisandra chinensis extract (SLE), and ultramicrofiltration was used to obtain the unbound ingredients. Secondly, thirty-one Schisandra lignans in total plasma and ultrafiltered fluid were measured by LC-IT-TOFMS. Lastly, a relative exposure approach, which entailed calculating the relative concentrations of each Schisandra lignan from the corresponding calibration equation created from the calibration samples spiked with the stock solution of SLE, was applied in order to overcome the absence of authentic standards. The results showed that Schisandra lignans exhibited a high capability to bind with plasma protein, furthermore, the protein binding ratio of the lignan components increased proportionally with their individual chromatographic retention time, which indicated that the ratio of protein binding of lignans might increase accordingly with decreasing polarity. This study suggested that the compound polarity might be an important factor affecting the plasma protein binding of herbal components.

Effect of Toll-like receptor 2 and Toll-like receptor 4 on expression of receptor activator of nuclear factor-kappaB ligand in human periodontal ligament fibroblasts induced by lipopolysaccharide / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The aim of this study was to survey the influence of Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) repression to receptor activator of nuclear factor-kappaB ligand (RANKL) expression of human periodontal ligament fibroblasts (HPDLFs) under the stimulation of lipopolysaccharide (LPS).</p><p><b>METHODS</b>The level of RANKL in HPDLFs stimulated by 100 ng x mL(-1), 1 microg x mL(-1) and 10 microg x mL(-1) Escherichia coli (E. coli) LPS after 6, 12, 24 and 48 h was detected by enzyme linked immunosorbent assay (ELISA). The level of RANKL in HPDLFs stimulated by 1 microg x mL(-1) E. coli LPS after pretreatment with different titre anti-TLR2+anti-TLR4, anti-TLR2 and anti-TLR4 antibody were observed respectively.</p><p><b>RESULTS</b>RANKL was detected at 6 h after stimulation with LPS, and the levels of these cytokine were highest at 24 h, and then gradually decreased. The regularity of each LPS concentration was approximately similar. After pretreatment with anti-TLR2+anti-TLR4, anti-TLR2 and anti-TLR4 antibody, the level of RANKL was significantly decreased under the stimulation of 1 microg x mL(-1) LPS (P<0.05). In the three groups, the expression of RANKL was significantly different (P<0.05). The level of RANKL in anti-TLR2+anti-TLR4 antibody pretreatment group was the lowest, the level in anti-TLR4 antibody pretreatment group was higher, and the level in anti-TLR2 antibody pretreatment group was the highest.</p><p><b>CONCLUSION</b>TLR2 and TLR4 participate in the process of RANKL expres-in HPDLFs induced by LPS. Anti-TLR4 antibody has better inhibition effect to RANKL expression of HPDLFs stimulated by LPS than anti-TLR2.</p>

Bond strength evaluation of four adhesive systems to dentin in vitro / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To compare the adhesive strength and observe the bonding interface. According to statistic analysis and scanning electron microscope (SEM) observation, the resistance capacity of four adhesive systems is evaluated.</p><p><b>METHODS</b>Prime & Bond NT (PBNT), Tetric N-Bond (TNB), Clearfil SE Bond (CSEB), G Bond (GB) were bonded to the occlusal surfaces and mesial surfaces of third molars respectively. The mesial resins received shear force experiment and the fracture load were recorded. The tensile bond strength (TBS) of the remaining parts were tested. The interfacial configuration were observed under SEM.</p><p><b>RESULTS</b>In the shear bond strength (SBS) experiment, PBNT and TNB showed the best result, but there was no significant difference between them (P>0.05). The SBS of PBNT was stronger than that of CSEB and GB (P<0.05). The SBS of TNB was stronger than that of GB (P<0.05). There was no significant difference between TNB and CSEB (P>0.05). In accordance with the shear force result, the TBS of PBNT and TNB was larger than CSEB and GB (P<0.05). Under SEM, resin tags of PBNT and TNB were longer and slender, the bonding layer was thick. Resin tags of CSEB were shorter, the ones of GB were the fewest and shortest.</p><p><b>CONCLUSION</b>Compared to self-etching system, total-etching system could reach better bonding strength. There is some connection between the interfacial configuration of adhesives and bond strength of them.</p>

Histological observation of implant-bone interface in immediate loading implant with platform switching / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the effect of implant superstructure with platform switching to the osseointegration of implant-bone interface in immediate loading.</p><p><b>METHODS</b>The bilateral mandiblular fourth premolars of 5 beagle dogs were extracted, and 3 months later, 10 implants were implanted and the abutments were accessed immediately to form immediate loading. Using self-control, the abutment with platform switching was used in the experimental side, and the traditional abutment used in the control side. The experimental animals were sacrificed after 3 months, and non-decalcified implant-bone sections were made.</p><p><b>RESULTS</b>A favorable osseointegration of implant-bone interface in 4 animals (8 implants) was observed except for one failed case. A large number of osteoblasts and different mineralized bone were observed. In experimental side, the bone and implant-neck were nearly in the same level, but the bone around the implant-neck was significantly absorbed in control side.</p><p><b>CONCLUSIONS</b>Using different superstructure in immediate loading could affect the osseointegration of implant-neck. The platform switching technology is conducive to the keeping of implant-neck bone.</p>

Correlation of renal AQP1-4 protein expression with renal parenchyma thickness and glomerular filtration rate in children with congenital hydronephrosis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the relationship of renal aquaporin -1, -2, -3, and -4 (AQP1-4) expression with renal parenchymal thickness and glomerular filtration rate (GFR) in children with congenital hydronephrotis.</p><p><b>METHODS</b>Renal tissue samples were obtained from 10 kidneys of 10 children (age: 62.3±18.3 months) with hydronephrosis and who underwent Anderson-Hynes pyeloplasty. Renal control samples were obtained from 6 children (age: 62.7±17.1 months) undergoing nephrectomy for nephroblastoma and were confirmed histologically as normal renal tissues. Renal parenchymal thickness of the hydronephrotic kidneys was measured by ultrasound preoperatively and was verified at operation. Renal GFR was assessed using 99mTc-DTPA scintigraphy preoperatively. Western blot was used to examine the expression of AQP1-4 in the renal tissues. The correlations of renal AQP1-4 expression with the renal parenchymal thickness and GFR were assessed by Pearson correlation analysis.</p><p><b>RESULTS</b>The expression of AQP1-4 in the hydronephrotis group was markedly reduced compared to that in the control group (P<0.05). The mean renal parenchymal thickness of the hydronephrotic kidney was 4.59±2.25 mm measured by ultrasound preoperatively. The mean GFR of the obstructed kidney was significantly lower than that of the contralateral kidney in the hydronephrosis group (40±12 mL/min vs 105±20 mL/min; P<0.05). The expression of AQP1, 2, 3 and 4 was positively correlated with preoperative renal GFR and renal parenchymal thickness in the hydronephrosis group (P<0.05). Renal parenchymal thickness was positively correlated with renal GFR (P<0.05).</p><p><b>CONCLUSIONS</b>The expression of renal AQP1-4 is reduced in children with congenital hydronephrosis. The expression levels of AQP1-4 are positively correlated with renal parenchymal thickness and GFR.</p>