Application of supraclavicular fasciocutaneous island flap for reconstruction after removal of tumors in parotid and auricle area / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the efficacy of supraclavicular fasciocutaneous island flap (SIF) for repairing the defect of parotid or auricle regions after tumor resection. Methods: From February 2019 to June 2021, 12 patients (11 males and 1 female, aged 54-77 years old), of whom 4 with parotid adenoid cystic carcinoma and 8 with auricular basal cell carcinoma underwent reconstruction surgery for postoperative defects in the parotid gland area and auricular area with SIF in the Department of Otorhinolaryngology Head and Neck Surgery, the Second Xiangya Hospital of Central South University and their clinical data were retrospectively analyzed. Size of the SIF, time for harvesting SIF, neck lymph node dissection and postoperative complications were recorded. Results: The flap areas were (6-9) cm × (8-13) cm, and the harvesting time for SIF ranged from 40 to 80 min, averaging 51.7 min. The donor sites were directly closed. All patients underwent ipsilateral levels Ⅰ-Ⅲ neck dissection, with 4 cases undergoing additional level Ⅳ neck dissection and 2 cases undergoing level Ⅳ-Ⅴ neck dissection. Of the 12 SIF, 10 were completely survival and 2 had flap arterial crisis with partial flap necrosis, in addition, 1 had donor site wound dehiscence. With follow-up of 10-42 months, there were no tumor recurrences in 10 patients, 1 patient was lost to follow-up at 10 months postoperatively, and 1 patient experienced local tumor recurrence at 11 months after surgery and died 15 months later. Conclusion: SIF is an easily harvested flap with good skin features matching the skin in parotid and auricle regions and less damage to donor site, and this flap has no need for microvascular anastomosis technique. SIF is feasible and effective for repairing defects in parotid and auricle area.

Predictive value of four items of new thrombus markers combined with conventional coagulation tests for thrombosis in antiphospholipid syndrome / 北京大学学报(医学版)

OBJECTIVE@#To explore the predictive value of four items of new thrombus markers combined with conventional coagulation tests for thrombosis in antiphospholipid syndrome.@*METHODS@#A total of 121 antiphospholipid syndrome (APS) patients who hospitalized at Peking University People's Hospital from March 2022 to January 2023 were selected and divided into thrombus group (50 cases) and nonthrombus group (71 cases) according to whether thrombosis occurred. The differences of laboratory characteristics including antiphospholipid antibodies were compared between the thrombotic and non-thrombotic groups. Chemiluminescent immunoassay was used to detect thrombomodulin (TM), thrombin-antithrombin complex (TAT), Plasmin-α2 plasmin inhibitor complex (PIC), and tissue plasminogen activator inhibitor complex (t-PAIC) in plasma from venous. The independent risk factors of thrombosis in patients with APS were determined using binary Logistic regression. Receiver operating characteristic (ROC) curve analysis was applied to evaluate the efficacy of each index on the prediction of thrombosis.@*RESULTS@#Compared with the patients without thrombosis, the patients with thrombosis were older [49 (32, 64) years vs. 36 (32, 39) years, P < 0.05]. The percentages of male, smoking, hypertension, and global antiphospholipid syndrome score (GAPSS)≥10 in the patients with thrombosis were significantly higher than those in the patients without thrombosis (P < 0.05). The positive rates of anticardiolipin antibody (aCL) and lupus anticoagulant (LA) in the thrombotic group were significantly higher than those in the non-thrombotic group (P < 0.05), and the levels of prothrombin time, activated partial thromboplastin time, fibrinogen, fibrin degradation product in the thrombotic group were significantly higher than those in the non-thrombotic group (P < 0.05).Among the thrombosis group, venous thrombosis accounted for 19 (38.00%), including deep vein thrombosis (16, 84.21%) and pulmonary embolism accounted (5, 26.32%); Arterial thrombosis accounted for 35 (70.00%), including myocardial infarction (6, 17.14%) cerebral infarction (30, 85.71%). The patients in the thrombotic group had significantly greater TM levels than those in the non-thrombotic group (P < 0.05).There were no significant dif-ferences between the two groups in TAT (Z=-1.420, P=0.156), PIC (Z=-0.064, P=0.949), and t-PAIC (Z=-1.487, P=0.137). Univariate and binary Logistic regression analysis of relevant variables showed that advanced age [OR=1.126, P=0.002], elevated TM [OR=1.325, P=0.048], prolonged prothrombin time (PT) [OR=4.127, P=0.008] were independent risk factors for thrombosis in the patients with APS. ROC curve analysis of the above three independent risk factors showed that the combined detection of age, PT and TM had the highest Yoden index (0.727) and sensitivity (83.0%), with a specificity of 89.7%.@*CONCLUSION@#TAT, PIC, TM, and t-PAIC may reflect thrombus formation from the coagulation system, fibrinolysis system, and endothelial system. The combined of age TM and PT is superior to the application of a single marker, which has diagnostic value for the early identification of APS thrombosis.

The application of intraoperative neurophysiological monitoring in selective dorsal neurotomy for primary premature ejaculation: a prospective single-center study / 亚洲男科学杂志(英文版)

Selective dorsal neurotomy (SDN) is a surgical treatment for primary premature ejaculation (PE), but there is still no standard surgical procedure for selecting the branches of the dorsal penile nerves to be removed. We performed this study to explore the value of intraoperative neurophysiological monitoring (IONM) of the penile sensory-evoked potential (PSEP) for standard surgical procedures in SDN. One hundred and twenty primary PE patients undergoing SDN were selected as the PE group and 120 non-PE patients were selected as the normal group. The PSEP was monitored and compared between the two groups under both natural and general anesthesia (GA) states. In addition, patients in the PE group were randomly divided into the IONM group and the non-IONM group. During SDN surgery, PSEP parameters of the IONM group were recorded and analyzed. The differences in PE-related outcome measurements between the perioperative period and 3 months' postoperation were compared for the PE patients, and the differences in effectiveness and complications between the IONM group and the non-IONM group were compared. The results showed that the average latency of the PSEP in the PE group was shorter than that in the normal group under both natural and GA states (P < 0.001). Three months after surgery, the significant effective rates in the IONM and non-IONM groups were 63.6% and 34.0%, respectively (P < 0.01), and the difference in complications between the two groups was significant (P < 0.05). IONM might be useful in improving the short-term therapeutic effectiveness and reducing the complications of SDN.

Prevention from PICC-related venous thrombosis in the upper limbs of malignant tumor patients with moxibustion combined with plucking at Jiquan (HT 1): a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of moxibustion combined with plucking technique at Jiquan (HT 1) for preventing peripherally inserted central catheter (PICC)-related venous thrombosis in the upper limbs of malignant tumor patients.@*METHODS@#A total of 80 malignant tumor patients undergoing PICC were randomized into an observation group and a control group, 40 cases in each one. In the control group, the routine care for PICC was exerted. In the observation group, besides the routine care, moxibustion combined with plucking technique at Jiquan (HT 1) was added. Mild moxibustion was exerted along the venous distribution of PICC (avoiding the entry site) for 10 to 15 min, and then, the circling moxibustion was applied to Quchi (LI 11), Xuehai (SP 10) and Tianfu (LU 3), 3 to 5 min at each acupoint. Finally, plucking technique was given at Jiquan (HT 1) for 5 to 10 min. This combined therapy was intervened since the 2nd day of PICC placement, once daily, 5 times a week, for 3 weeks totally. The incidence of the PICC-related venous thrombosis in the upper limbs was compared between the two groups on day 42 of placement. On day 2, 7, 14, 21, 28, 35 and 42 of PICC placement, the peak systolic velocity (PSV) and the end-diastolic velocity (EDV) of the subclavicular vein on the placement side were observed separately in the two groups.@*RESULTS@#The incidence of the PICC-related venous thrombosis in the upper limbs in the observation group was lower than that in the control group (2.5% [1/40] vs 17.5% [7/40], P<0.05). From day 7 to 35 of PICC placement, PSV of the subclavicular vein on the placement side was higher than that on the day 2 of PICC placement in the observation group (P<0.05). On day 28 and 42 of PICC placement, PSV of the subclavicular vein on the placement side was lower than that on the day 2 of PICC placement in the control group (P<0.05). In the observation group, EDV of the subclavicular vein on the placement side was higher than that on the day 2 of PICC placement from day 7 to 28 of PICC placement (P<0.05). In the control group, EDV of the subclavicular vein on the placement side from day 28 to 42 of PICC placement was lower than that on the day 2 of PICC placement (P<0.05). From day 7 to 42 of PICC placement, PSV and EDV of the subclavicular vein on the placement side in the observation group were all higher than those in the control group (P<0.01, P<0.05).@*CONCLUSION@#The combined treatment of moxibustion with plucking technique at Jiquan (HT 1) can effectively prevent PICC-related venous thrombosis in the upper limbs and improve venous blood flow velocity in malignant tumor patients.

Explore Effective Constituents and Mechanism of Tingli Dazao Xiefeitang in Treatment of Heart Failure Based on Network Pharmacology and Mass Spectrometry / 中国实验方剂学杂志

Objective:To investigate the effective constituents and mechanism of Tingli Dazao Xiefeitang for the treatment of heart failure through network pharmacology and high resolution mass spectrometry technique as well as molecular docking technique. Method:Chemical components and potential targets in Descurainiae Semen Lepidii Semen and Jujubae Fructus were searched by referring to literature and BATMAN-TCM database. The disease targets were searched in GeneCards database with ''heart failure'' as the key word. STRING platform was used to construct protein-protein interaction（PPI） network based on common targets of drugs and disease. The network topology was analyzed by using Cytoscape 3.7.2 software to obtain the core targets eventually. Kyoto encyclopedia of genes and genomes（KEGG） enrichment analysis of the core targets was conducted through DAVID database to draw a network of “herb-compound-target-pathway”. Based on the results of the network pharmacology research above，high resolution mass spectrometry was used to analyze the decoction and confirm the selected active components. AutoDock 4.2.6 software was used for molecular docking verification of key active components and related targets. Result:A total of 85 components were obtained in Descurainiae Semen Lepidii Semen，and 49 components were obtained in Fructus Ziziphi Jujubae. A total of 1 078 drug targets and 1 549 disease targets were identified. After PPI analysis and network topology analysis，23 core targets and 33 active components were obtained，involving 19 signaling pathways （<italic>P</italic><0.05）. Mass spectrometry analysis results indicated that 18 components such as isovanillic acid，descuraininA and kaempferol-7-<italic>O-β-D</italic>-glucopyranoside were confirmed in decoction. Molecular docking analysis results indicated that 6 core components （degree value top 6），such as isovanillic acid，descurainin A and kaempferol-7-<italic>O-β-D</italic>-glucopyranoside，had good binding activity with silent information regulatory factor 1（SIRT1），interleukin（IL）1B，protein kinase B<italic>α</italic>（AKT1） and tumor necrosis factor（TNF）. The compound recipe for heart failure mainly involved mitogen-activated protein kinase（MAPK），hypoxia inducible factor-1（HIF-1），Mammalian target of rapamycin（mTOR） and other signaling pathways. Conclusion:This study preliminarily investigated the effective constituents and mechanism of Tingli Dazao Xiefeitang in the treatment of heart failure. It can provide references for the precise clinical medication and screening of quality control markers，as well as the discovery of active components in the treatment of heart failure.

Rental Service of Assistive Devices in China: Policy Research / 中国康复理论与实践

Objective:To sort out the current situation of rehabilitation assistive devices rental service in China, and suggest the policy for its development. Methods:Based on the four-dimensional social security policy analysis framework, with the combination of subject retrieval and field research, the market players, supporting systems, rental products, financial security and professionals in some pilot areas of community rental of assistive devices in China were summarized. Results:There were still some problems in the rental service of assistive devices in China, mainly as insufficience of main players of the rental market, supporting policies and systems, payment security system, professionals, and social recognition, etc. Conclusion:It is important to reasonably set up rental products, standardize service enterprises, cultivate market players, increase investment, promote talent training, and strengthen publicity, to promote the development of the rental of assistive devices.

Gait Characteristics in Old People with Various Risks of Falling as Obstacle Crossing in Community / 中国康复理论与实践

Objective:To explore the kinematics characteristics of obstacle crossing in old people with high or low falling risks in Community. Methods:From July to September, 2016, 27 old persons in community were divided into high falling risk group (H group, n = 15) and low fall risk group (L group, n = 12) according to the performance of Timed "Up and Go" Test and Five Times Sit to Stand Test. The kinematics characteristics were analyzed with Ariel Performance Analysis System as obstacle crossing. Results:The total time of crossing and the swing time of crossing legs were longer in H group than in L group (t > 2.073, P < 0.05), and the maximum height of standardized centre of mass was less in H group than in L group (t =-2.014, P < 0.05). As the crossing leg was just above the obstacle, the angle of knee of crossing leg was more in H group than in L group (t > 2.106, P < 0.05), the velocity of hip of crossing leg was less in H group than in L group (t = -2.119, P < 0.05), and the acceleration of ankle of swinging leg was less in H group than in L group (t = -3.038, P < 0.05). Conclusion:When the old people cross the obstacle, they trend to fall if they spend more time to overcome, lower in mass centre, in less speed of crossing hip and less acceleration of swinging ankle.

Back arm flexion and extension combined with manipulation for the treatment of patient with adhesive scapulohumeral periarthritis / 中国骨伤

OBJECTIVE@#To observe clinical efficacy of back arm flexion and extension combined with manipulation in treating adhesive scapulohumeral periarthritis.@*METHODS@#From March 2016 to April 2018, 53 patients with adhesive scapulohumeral periarthritis were treated with back arm flexion and extension combined with manipulation, the main symptoms were shoulder pain and limited activity. There were 22 males and 31 females aged from 45 to 71 years old with an average of (51.63±5.79) years;the courses of disease ranged from 3 to 24 months with an average of (8.62±3.73) months. Manipulation treatment was carried out once a week, and back arm flexion and extension were performed for 3 times a day with15 movements each time, totally 4 weeks for a single course. Visual analogue scale (VAS) and Constant-Murley shoulder function score were observed and compared before treatment and one week, one and three months after treatment.@*RESULTS@#All patients were followed up from 3 to 12 months, with an average of (5.91±3.55) months. VAS score before treatment was 4.02±1.46, and was improved to 3.15±1.54, 1.98±1.37, 1.12±0.86 respectively at one week, one and three months after treatment. Constant-Murley score before treatment was 42.70 ±5.72, and improved to 54.25 ±6.34, 67.45 ±6.84, 82.40 ±6.63 at one week, one and three months after treatment respectively;19 patients got excellent result, 22 good, 9 fair and 3 poor.@*CONCLUSION@#Back arm flexion combined with manipulation for the treatment of adhesive scapulohumeral periarthritis could effectively relieve pain, improve shoulder function, which is a simple effective treatment strategy.

Inflammatory mechanism of hippocampal tissue injury induced by PM in nasal drip in mice / 中国应用生理学杂志

To investigate the inflammatory mechanism of nasal instillation of fine particulate matter (PM)on hippocampal tissue injury in mice. Thirty C57BL/6J mice were randomly divided into 3 groups(n=10):control group, low-dose group, high-dose group. The nasal instillation doses of PM in the low-dose group and the high-dose group were 1.5 mg/kg BW and 7.5 mg/kg BW, respectively, and the control group was given saline with an equal volume. Saline was sprayed once every other time for 12 times. The serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were determined by ELISA method. HE staining and electron microscopy were used to observe the pathological changes and ultrastructure of lung tissue and hippocampus. The inflammatory cytokine levels in hippocampus were detected by antibody chip technique. There was no significant effect of PM nasal instillation on serum TNF-α, IL-1β and IL-6 levels (P＞0.05), and there was no obvious pathological changes in lung tissue structure. In hippocampus, low-dose and high-dose PM exposure could lead to disordered neuronal arrangement in the hippocampal CA3 region, and there were neurological changes around the neuron cells and ultrastructural changes such as edema around small blood vessels. Compared with the control group, the levels of inflammatory cytokines such as CX3CL1, CSF2 and TECK in the low-dose group were increased significantly (P ＜0.05), while sTNFR1 was decreased significantly (P＜0.05); the inflammatory factors CX3CL1, CSF2, and TCA-3 were significantly increased in the high-dose group (P＜0.05), while leptin, MIG, and FASLG were significantly decreased (P＜0.05). Nasal instillation of PM can induce tissue damage in the hippocampus of mice, and its mechanism of action may be the olfactory brain pathway. The increasing of TNF-α and IL-6 and the decreasing of sTNFR1 and FASLG may be involved in inflammatory mechanisms.

Survey on Assistive Devices Utilization for Old Adults Supported by Community-based Homecare in Dongcheng, Beijing / 中国康复理论与实践

Objective:To investigate the awareness, use, price acceptance, satisfaction, feedback on quality problems, compliance and access methods of assistive devices for the old adults in Dongcheng, Beijing. Methods:From April to December, 2017, 166 homecare old adults from six communities of Dongcheng, Beijing accepted assistive devices after adaption, and were taught how to use. They were followed up once half a month for six months to investigate activities of daily living, satisfaction, awareness and expectation for their assistive devices. Results:There were 22% of them never used their assistive devices. For those assistive devices had been used, 62% were mobile products, 48% were homecare products, 44% were visual products, 20% were hearing products, and 4% were other products. The score of Quebec User Evaluation of Satisfaction with Assistive Technology was (4.04±0.46) in total, with 2% abandoning. Practicalness, good quality, multi-function and high performance-cost were the most important factors in mind to buy the assistive products. Common quality problems were infirmness of assembly (43%), rough appearance (27%), damaged parts (15%), hidden danger (13%), unsuitable size (3%), poor reliability (3%) and lack of structural strength (3%). The ways to obtain assistive devices included self-purchase (80%), government adaptation (13%), family and friends giving (6%), and lease (0%). Conclusion:Assistive devices can improve quality of life for the old adults. They prefer to choosing assistive devices of multi-function, cost-effective, for daily living, communication and homecare. Professional fitting, regular visit and maintenance can increase the satisfaction, and reduce abandonment of assistive devices. Assistive devices leasing service may help to promote the access of assistive devices.

Acupuncture combined with granule for nerve-root type cervical spondylosis and its effects on IL-6、TNF-α、IL-1β and hemorheological indexes / 中国针灸

OBJECTIVE@#To explore the clinical efficacy of acupuncture combined with granule for nerve-root type cervical spondylosis and its effects on serum interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β) and hemorheological indexes.@*METHODS@#A total of 114 patients with nerve-root type cervical spondylosis were randomly divided into an observation group and a control group, 57 cases in each group. The patients in both groups were treated with traction. The patients in the control group were treated with oral administration of granule, 4 g each time, 3 times a day, while based on the treatment of control group, the patients in the observation group were treated with acupuncture at Dazhui (GV 14), Tianzhu (BL 10), Houxi (SI 3), cervical Jiaji (EX-B 2), Quchi (LI 11), Hegu (LI 4) and Waiguan (TE 5), once a day. Both groups were treated for 4 weeks. The simplified McGill pain questionnaire (MPQ), neck disability index (NDI), numbness score, levels of IL-6, TNF-α, IL-1β in serum and hemorheological indexes were observed before and after treatment, and the clinical efficacy was compared between the two groups.@*RESULTS@#The total effective rate was 91.2% (52/57) in the observation group, which was higher than 71.9% (41/57) in the control group (<0.05). Compared before treatment, the scores of MPQ, NDI and numbness in the two groups were reduced after treatment (<0.05). After treatment, the scores of MPQ, NDI and numbness in the observation group were lower than those in the control group (<0.05). After treatment, the serum levels of IL-6, TNF-α and IL-1β in the two groups were reduced (<0.05), and those in the observation group were lower than the control group (<0.05). After treatment, the plasma viscosity, fibrinogen, low shear rate of whole blood viscosity and high shear rate of whole blood viscosity in the two groups were lower than before treatment (<0.05), and those in the observation group were lower than the control group (<0.05).@*CONCLUSION@#Acupuncture combined with granule have significant clinical efficacy for nerve-root type cervical spondylosis, which could reduce the serum levels of IL-6, TNF-α and IL-1β and improve hemorheology.

Analysis of mortality trend and related factors for aged in-patients with diabetes mellitus / 中国实用内科杂志

OBJECTIVE: To find out the mortality trend and related factors in aged hospitalized patients with diabetes mellitus(DM). METHODS: The case information diabetic in patients who died during the period from 2005 to 2014 were collected and the mortality and causes of death were analyzed. RESULTS: From 2005 to 2014, 1297 diabetic patients died, and the mortality of elderly DM inpatients was 4.44%(1162 cases), significantly higher than that of the non-elderly of 0.94%(P<0.001). The death rate of elderly diabetic patients was significantly higher in males than in females(5.22% vs. 3.47%, P<0.001). The mortality of the aged diabetic patients decreased within 10 years(P<0.001), decreasing from 4.75% in 2005 to 3.01% in 2009(P<0.001) in the year of 2005-2009, while there were no differences in the year of 2010-2014. The main death causes of the aged diabetic in-patients were as follows: infections(27.71%), cardiovascular diseases(25.22%), tumor(21.34%), cerebral vascular diseases(10.41%) and diabetic complications(5.51%). The first death cause in the 60-79 yrs group was cardiovascular diseases, while in the ≥80 yrs group, it was infections. The constituent ratio of infection as death cause in the aged during 2010-2014 significantly increased(22.60% vs. 32.50%, P<0.001), increasing by 43.81%, and it became the first cause of death in 2010. CONCLUSION: The death rate of the elderly DM in-patients has decreased significantly within 10 years, from 2005 to 2014, while the rate has kept steady from 2010. Infections and cardiovascular diseases are the main cause of death. So it's important to prevent the elderly hospitalized DM patients from infection, in addition to cardiovascular diseases, and to control in time.

Research progress of selective dorsal penile neurotomy in the treatment of primary premature ejaculation / 医学研究生学报

Selective dorsal penile neurotomy is a surgical method proposed for the treatment of primary premature ejaculation in recent years. In view of the inconsistency of surgical methods and the controversy of the operation itself, Large-scale, multi-center research evidence is needed for comprehensive evaluation. This article starts with the etiology of premature ejaculation, and reviews the anatomical basis, indications, contraindications, surgical methods, efficacy evaluation, complications and combined treatment methods of selective dorsal neurotomy.

Construction of Professional Training System of Assistive Technology:in Perspective of ICF / 中国康复理论与实践

Objective To explore a training system of high level professionals with international vision and meeting the develop-ment of assistive technology in China. Methods The training system was constructed in the theory framework of International Classification of Functioning, Disability and Health,and work process-oriented. Results and Conclusion A curriculum system with tree-type modes and a practice system with three-level and multi-form of assistive technology specialty were constructed,that was recognized by industry and society in the developing.

Mechanism of lysosome-mediated eradication activity of macrophages on specific anti-Helicobacter pylori of patchouli alcohol / 中国中药杂志

The aim of this paper is to investigate the effect of patchouli alcohol in enhancing Helicobater pylori's action in eradicating macrophages and its mechanism. H. pylori was co-cultured with macrophages at a ratio of MOI=100 in different concentrations of patchouli alcohol. The effect of patchouli alcohol in eradicating macrophages was detected by agar dilution method. The effect of patchouli alcohol on NO and myeloperoxidase (MPO) levels in macrophages were measured by H. pylori by biochemical methods. Patchouli alcohol effect on H. pylori-induced pro-inflammatory gene expression and protein secretion in macrophages were detected by RT-qPCR and ELISA method. The eradication of H. pylori has significantly enhanced, and the destabilization of lysosomes has been reversed. Meanwhile, patchouli alcohol has an effect in inhibiting pro-inflammation and oxidation. The mechanism of patchouli alcohol in eradicating H. pylori and resisting oxidative stress may be associated to the blocking of bacteria escape lysosome combination procedures.

Advances in the studies of testicular microlithiasis / 中华男科学杂志

With the increased attention to men's health and development of ultrasound imaging technology, clinicians are achieving a better understanding of testicular microlithiasis. This review presents an overview on recent studies of the etiology, pathogenesis, and imaging characteristics of testicular microlithiasis, its impact on male reproductive function, and its relation ship with testis tumors and other related diseases, as well as its treatment strategies and follow-up proposals, aiming to provide some new evidence for further understanding and management of the disease.

Correlation between ectopic fat accumulation and insulin sensitivity in obese individuals with different glucose tolerance levels / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the correlation between liver and skeletal muscle fat contents and insulin resistance in obese individuals with different levels of glucose tolerance.</p><p><b>METHODS</b>RESULTS: Ten non-obese individuals with normal glucose tolerance (NGT), 9 obese individuals with NGT, and 7 obese individuals with impaired glucose tolerance (IGT) were enrolled in this study. All the participants were examined for insulin sensitivity by hyperinsulinemic-euglycemic clamp and for liver and skeletal muscle fat accumulation quantified by proton magnetic resonance spectroscopy (1H MRS). The data were collected from the subjects including somatometric measurements, fasting plasma glucose, 2-h plasma glucose (2hPG), fasting insulin, and blood biochemistry. Linear correlation analysis and multiple linear stepwise regression analysis were used to analyze the relationship between ectopic fat accumulation and insulin resistance.</p><p><b>RESULTS</b>The glucose infusion rates (GIR, presented as the M value) differed significantly among IGT-obese (3.95∓1.66 mg·kg·min), NGT-obese (6.14∓1.90 mg·kg·min) and NGT-non-obese (8.78∓2.46 mg·kg·min) groups (P<0.05). The 3 groups also showed significant differences in liver fat contents [(15.23∓3.09)%, (6.25∓0.38)%, and (1.89∓0.90)%, respectively, P<0.05] and intramyocellular lipids in the tibialis anterior (2.69∓0.95, 2.61∓1.45, and 1.54∓0.66 mmol/kg, respectively, P<0.05). Linear analysis revealed that liver fat content, but not skeletal muscle fat content, was significantly correlated with the M value. Multiple linear stepwise regression analysis using M value as the dependent variable (Y) revealed that liver fat content (X) was an independent factor inversely correlated with the M value (regression equation: Y=-30.562X+9.007, R=0.717, P<0.01).</p><p><b>CONCLUSIONS</b>Liver fat accumulation, but not skeletal muscle fat accumulation, is correlated with insulin resistance and impaired glucose metabolism.</p>

Efficacy of ultrasound-guided lauromacrogol sclerotherapy for benign thyroid cysts and factors affecting the therapeutic effect / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of ultrasound-guided lauromacrogol sclerotherapy for benign thyroid cysts and analyze the factors affecting the efficacy.</p><p><b>METHODS</b>Ultrasound-guided lauromacrogol sclerotherapy was performed in 97 patients with a total of 99 benign thyroid cysts. The changes in cystic volume and other thyroid parameters were evaluated at 1, 3, 6, and 12 months after sclerotherapy. According to changes in the cystic volume, the efficacy of sclerotherapy was defined as therapeutic failure (with a volume reduction <50%), treatment success (volume reduction ≥50%) and cure (volume reduction ≥90%). The factors of affecting the efficacy of sclerotherapy was analyzed using COX regression.</p><p><b>RESULTS</b>The mean cystic volume at 1, 3, 6 and 12 months after sclerotherapy were reduced from the baseline volume of 12.08∓11.56 cmto 5.63∓8.51 cm, 5.96∓8.42 cm, 3.80∓5.50 cmand 2.85∓3.98 cm, respectively, with an average cystic volume reduction rate of (70.02∓33.72)%. Therapeutic success was achieved 82 of the 99 cysts (82.83%) and cure was achieved 63cysts (63.64%) at 12 months after the procedure. A second sclerotherapy was performed for 13 cysts which did not show a volume reduction at 1-3 months after the initial procedure. A disease course of over 12 months was an independent risk factor for a second sclerotherapy (23.7% [9/38] vs 6.6% [4/61], OR=4.473 [1.238-16.169], P=0.022). The efficacy of sclerotherapy was related to cystic cavity separation, cystic fluid viscosity, cystic/solid ratio and cystic wall thickness. COX regression analysis revealed that cystic cavity separation (HR=2.25, 95%CI: 1.19-4.25) and cystic fluid viscosity (HR=2.02, 95%CI: 1.19-3.43) were the major factors affecting the treatment efficacy.</p><p><b>CONCLUSION</b>Ultrasound-guided lauromacrogol sclerotherapy is effective and safe for treatment of benign thyroid cysts, and the maximal treatment effect can be achieved at 6 months after sclerotherapy and in cases of uncomplicated cysts with non-viscous cystic fluid, no solid cystic cavity separation and a disease course of less than 12 months.</p>

Computer Access Assessment and Adaptation:Methods and Challenges (review) / 中国康复理论与实践

The computer access, such as special mouse keyboard, software of the voice input and the magnified or reading screen, etc., can facilitate the people with disabilities to use the computer more efficiently. The computer access adaption should be evaluated to meet the users' needs, their function and the circumstances in which they live. The products should be easily designed, remade, and used for the cus-tomers and the prices should be available. For China, it is important to form professional teams, establish the good service process, achieve more supports, especially financial support, to research and develop more varieties of products.

Adaptation of Assistive Devices for Bilateral Wrist- palm Disarticulation Amputee: A Case Practice Based on Framework of ICF / 中国康复理论与实践

@#Objective To carry out the function evaluation and clinical adaptation service of assistive devices for a bilateral wrist-palm disarticulation case in the framework of International Classification of Functioning, Disability and Health (ICF). Methods By evaluating dysfunction and actual demand of the case, assistive devices were selected and applied in daily living, home, education and employment to achieve corresponding accessibility in activities and participation. Results and Conclusion The framework of ICF is important in evaluation of limb dysfunction and adaptation of assistive devices.