Correlation between Elbow Flexor Muscle Strength and Needle Electromyography Parameters after Musculocutaneous Nerve Injury / 法医学杂志

OBJECTIVES@#To explore the changes of elbow flexor muscle strength after musculocutaneous nerve injury and its correlation with needle electromyography (nEMG) parameters.@*METHODS@#Thirty cases of elbow flexor weakness caused by unilateral brachial plexus injury (involving musculocutaneous nerve) were collected. The elbow flexor muscle strength was evaluated by manual muscle test (MMT) based on Lovett Scale. All subjects were divided into Group A (grade 1 and grade 2, 16 cases) and Group B (grade 3 and grade 4, 14 cases) according to their elbow flexor muscle strength of injured side. The biceps brachii of the injured side and the healthy side were examined by nEMG. The latency and amplitude of the compound muscle action potential (CMAP) were recorded. The type of recruitment response, the mean number of turns and the mean amplitude of recruitment potential were recorded when the subjects performed maximal voluntary contraction. The quantitative elbow flexor muscle strength was measured by portable microFET 2 Manual Muscle Tester. The percentage of residual elbow flexor muscle strength (the ratio of quantitative muscle strength of the injured side to the healthy side) was calculated. The differences of nEMG parameters, quantitative muscle strength and residual elbow flexor muscle strength between the two groups and between the injured side and the healthy side were compared. The correlation between elbow flexor manual muscle strength classification, quantitative muscle strength and nEMG parameters was analyzed.@*RESULTS@#After musculocutaneous nerve injury, the percentage of residual elbow flexor muscle strength in Group B was 23.43% and that in Group A was 4.13%. Elbow flexor manual muscle strength classification was significantly correlated with the type of recruitment response, and the correlation coefficient was 0.886 (P<0.05). The quantitative elbow flexor muscle strength was correlated with the latency and amplitude of CMAP, the mean number of turns and the mean amplitude of recruitment potential, and the correlation coefficients were -0.528, 0.588, 0.465 and 0.426 (P<0.05), respectively.@*CONCLUSIONS@#The percentage of residual elbow flexor muscle strength can be used as the basis of muscle strength classification, and the comprehensive application of nEMG parameters can be used to infer quantitative elbow flexor muscle strength.

Cross-sectional study of low anterior resection syndrome in patients who have survived more than 5 years after sphincter-preserving surgery for rectal cancer / 中华胃肠外科杂志

Objective: In this study, we aimed to investigate the prevalence of low anterior resection syndrome (LARS) in patients who had survived for more than 5 years after sphincter-preserving surgery for rectal cancer and to analyze its relationship with postoperative time. Methods: This was a single-center, retrospective, cross-sectional study. The study cohort comprised patients who had survived for at least 5 years (60 months) after undergoing sphincter- preserving radical resection of pathologically diagnosed rectal adenocarcinoma within 15 cm of the anal verge in the Department of Gastrointestinal Surgery, Peking University People's Hospital from January 2005 to May 2016. Patients who had undergone local resection, had permanent stomas, recurrent intestinal infection, local recurrence, history of previous anorectal surgery, or long- term preoperative defecation disorders were excluded. A LARS questionnaire was administered by telephone interview, points being allocated for incontinence for flatus (0-7 points), incontinence for liquid stools (0-3 points), frequency of bowel movements (0-5 points), clustering of stools (0-11 points), and urgency (0-16 points). The patients were allocated to three groups based on these scores: no LARS (0-20 points), minor LARS (21-29 points), and major LARS (30-42 points). The prevalence of LARS and major LARS in patients who had survived more than 5 years after surgery, correlation between postoperative time and LARS score, and whether postoperative time was a risk factor for major LARS and LARS symptoms were analyzed. Results: The median follow-up time of the 160 patients who completed the telephone interview was 97 (60-193) months; 81 (50.6%) of them had LARS, comprising 34 (21.3%) with minor LARS and 47 (29.4%) with major LARS. Spearman correlation analysis showed no significant correlation between LARS score and postoperative time (correlation coefficient α=-0.016, P=0.832). Multivariate analysis identified anastomotic height (RR=0.850, P=0.022) and radiotherapy (RR=5.760, P<0.001) as independent risk factors for major LARS; whereas the postoperative time was not a significant risk factor (RR=1.003, P=0.598). The postoperative time was also not associated with LARS score rank and frequency of bowel movements, clustering, or urgency (P>0.05). However, the rates of incontinence for flatus (3/31, P=0.003) and incontinence for liquid stools (8/31, P=0.005) were lower in patients who had survived more than 10 years after surgery. Conclusions: Patients with rectal cancer who have survived more than 5 years after sphincter-preserving surgery still have a high prevalence of LARS. We found no evidence of major LARS symptoms resolving over time.

Co-delivery of photosensitizer and diclofenac through sequentially responsive bilirubin nanocarriers for combating hypoxic tumors

Considering that photodynamic therapy (PDT)-induced oxygen consumption and microvascular damage could exacerbate hypoxia to drive more glycolysis and angiogenesis, a novel approach to potentiate PDT and overcome the resistances of hypoxia is avidly needed. Herein, morpholine-modified PEGylated bilirubin was proposed to co-deliver chlorin e6, a photosensitizer, and diclofenac (Dc). In acidic milieu, the presence of morpholine could enable the nanocarriers to selectively accumulate in tumor cells, while PDT-generated reactive oxidative species (ROS) resulted in the collapse of bilirubin nanoparticles and rapid release of Dc. Combining with Dc showed a higher rate of apoptosis over PDT alone and simultaneously triggered a domino effect, including blocking the activity and expression of lactate dehydrogenase A (LDHA), interfering with lactate secretion, suppressing the activation of various angiogenic factors and thus obviating hypoxia-induced resistance-glycolysis and angiogenesis. In addition, inhibition of hypoxia-inducible factor-1α (HIF-1α) by Dc alleviated hypoxia-induced resistance. This study offered a sequentially responsive platform to achieve sufficient tumor enrichment, on-demand drug release and superior anti-tumor outcomes in vitro and in vivo.

Hepatobiliary tumor models and novel technology for accurate drug screening / 临床肝胆病杂志

Hepatobiliary tumor is a type of malignant tumor including primary liver cancer, cholangiocarcinoma, and gallbladder carcinoma. At present, hepatobiliary tumors have become the second leading cause of cancer-related death worldwide, while the treatment methods for such tumors cannot effectively meet clinical needs. Therefore, it is a key scientific problem in this field to explore and develop the experimental technology of accurate drug screening for hepatobiliary tumors, find new strategies and methods for clinical treatment, and provide new ideas for early diagnosis and comprehensive treatment of hepatobiliary tumors. This article introduces the latest research advances in the novel technologies for accurate drug screening for hepatobiliary tumor and their application potential by focusing on the construction of individualized pathological models of hepatobiliary tumor, drug screening technologies, the design and screening strategy of specific target drugs, and drug screening strategy based on artificial intelligence and big data analysis, as well as the directions for future development.

Adherence to adjuvant with therapy imatinib in patients with gastrointestinal stromal tumor: a national multi-center cross-sectional study / 中华胃肠外科杂志

Objective: To analyze the current adherence to imatinib in patients with gastrointestinal stromal tumors (GIST) in China and its influencing factors. Methods: A cross-sectional survey was conducted. Study period: from October 1, 2020 to November 31, 2020. Study subjects: GIST patients taking imatinib who were diagnosed and treated in public tertiary level A general hospitals or oncology hospitals; those who had not been pathologically diagnosed, those who never received imatinib, or those who had taken imatinib in the past but stopped afterwards were excluded. The Questionnaire Star online surgery platform was used to design a questionnaire about the adherence to adjuvant imatinib therapy of Chinese GIST patients. The link of questionnaire was sent through WeChat. The questionnaire contained basic information of patients, medication status and Morisky Medication Adherence Scale. Results: A total of 2162 questionnaires from 31 provinces, autonomous regions, and municipalities were collected, of which 2005 were valid questionnaires, with an effective rate of 92.7%. The survey subjects included 1104 males and 901 females, with a median age of 56 (22-91) years old. Working status: 609 cases (30.4%) in the work unit, 729 cases (36.4%) of retirement, 667 cases of flexible employment or unemployment (33.3%). Education level: 477 cases (23.8%) with bachelor degree or above, 658 cases (32.8%) of high school, 782 cases (39.0%) of elementary or junior high school, 88 cases (4.4%) without education. Marital status: 1789 cases (89.2%) were married, 179 cases (8.9%) divorced or widowed, 37 cases (1.8%) unmarried. Two hundred and ninety-four patients (14.7%) had metastasis when they were first diagnosed, including 203 liver metastases, 52 peritoneal metastases, and 39 other metastases. One thousand eight hundred and sixty-nine patients underwent surgical treatment, of whom 1642 (81.9%) achieved complete resection. The median time of taking imatinib was 25 (1-200) months. Common adverse reactions of imatinib included 1701 cases (84.8%) of periorbital edema, 1031 cases (51.4%) of leukopenia, 948 cases (47.3%) of fatigue, 781 cases (39.0%) of nausea and vomiting, 709 cases (35.4%) of rash, and 670 cases (33.4%) of lower extremity edema. The score of the Morisky Medication Adherence Scale showed that 392 cases (19.6%) had poor adherence, 1023 cases (51.0%) had moderate adherence, and 590 cases (29.4%) had good adherence. Univariate analysis showed that gender, age, work status, economic income, residence, education level, marriage, the duration of taking medication and adverse reactions were associated with adherence to adjuvant imatinib therapy (all P<0.05). Multivariate analysis showed that female (OR=1.264, P=0.009), non-retirement (OR=1.454, P=0.001), monthly income ≤4000 yuan (OR=1.280, P=0.036), township residents (OR=1.332, P=0.005), unmarried or divorced or widowed (OR=1.362, P=0.026), the duration of imatinib medication >36 months (OR=1.478, P<0.001) and adverse reactions (OR=1.719, P=0.048) were independent risk factors for poor adherence to adjuvant imatinib. Among patients undergoing complete resection, 324 (19.7%) had poor adherence, 836 (50.9%) had moderate adherence, and 482 (29.4%) had good adherence. Meanwhile, 55 patients with good adherence (11.4%) developed recurrence after surgery, 121 patients with moderate adherence (14.5%) developed recurrence, 61 patients with poor adherence (18.8%) developed recurrence, and the difference was statistically significant (P=0.017). Conclusions: The adherence to adjuvant therapy with imatinib in Chinese GIST patients is relatively poor. Females, non-retirement, monthly income ≤4000 yuan, township residents, unmarried or divorced or widowed, the duration of imatinib medication >36 months, and adverse reactions are independently associated with poor adherence of GIST patients. Those with poor adherence have a higher risk of recurrence after surgery. Positive interventions based on the above risk factors are advocated to improve the prognosis of patients with GIST.

Cytotoxicity and underlying mechanism of evodiamine in HepG2 cells / 北京大学学报(医学版)

OBJECTIVE@#To investigate evodiamine (EVO)-induced hepatotoxicity and the underlying mechanism.@*METHODS@#HepG2 cells were treated with EVO (0.04-25 μmol/L) for different time intervals, and the cell survival rate was examined by cell counting kit-8 (CCK-8) method. After HepG2 cells were treated with EVO (0.2, 1 and 5 μmol/L) for 48 h, the alanine transaminase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), alkaline phosphatase (ALP) activities and total bilirubin (TBIL) content of supernatant were detected. A multifunctional microplate reader was used to detect the intracellular superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in HepG2 cells to evaluate the level of cell lipid peroxidation damage. The interactions between EVO and apoptosis, autophagy or ferroptosis-associated proteins were simulated by molecular docking. The HepG2 cells were stained by mitochondrial membrane potential (MMP) fluorescent probe (JC-10) and annexin V-fluorescein isothiocyanate/propidium iodide (Annexin V-FITC/PI), and MMP and apoptosis in HepG2 cells were detected by flow cytometry. The protein expression levels of caspase-9, caspase-3, bile salt export pump (BSEP) and multidrug resistance-associated protein 2 (MRP2) were detected by Western blot.@*RESULTS@#The cell survival rate was significantly reduced after the HepG2 cells were exposed to EVO (0.04-25 μmol/L) in a time- and dose-dependent manner. The half maximal inhibitory concentration (IC50) of the HepG2 cells treated with EVO for 24, 48 and 72 h were 85.3, 6.6 and 4.7 μmol/L, respectively. After exposure to EVO (0.2, 1 and 5 μmol/L) for 48 h, the ALT, AST, LDH, ALP activities and TBIL content in the HepG2 cell culture supernatant, and the MDA content in the cells were increased, and SOD enzyme activity was decreased. Molecular docking results showed that EVO interacted with apoptosis-associated proteins (caspase-9 and caspase-3) better. JC-10 and Annexin V-FITC/PI staining assays demonstrated that EVO could decrease MMP and promote apoptosis in the HepG2 cells. Western blot results indicated that the protein expressions of cleaved caspase-9 and cleaved caspase-3 were upregulated in the HepG2 cell treated with EVO for 48 h. In contrast, the protein expressions of pro-caspase-3, BSEP and MRP2 were downregulated.@*CONCLUSION@#These results suggested that 0.2, 1 and 5 μmol/L EVO had the potential hepatotoxicity, and the possible mechanism involved lipid peroxidation damage, cell apoptosis, and cholestasis.

The status of grief counseling among front-line nurses during the coronavirus disease 2019 epidemic / 第二军医大学学报

Objective To investigate the status of grief counseling among front-line nurses in Wuhan during the coronavirus disease 2019 (COVID-19) epidemic, so as to provide reference for formulating reasonable nursing management strategies. Methods A total of 225 front-line nurses were investigated with a basic information questionnaire and attitudes and skills of grief counseling scales. Results A total of 214 valid questionnaires were collected, with an effective rate of 95.1%. The score of grief counseling attitudes of nurses was 32.80±9.41, which was in the middle level. Other grief counseling skills, communication ability, whether they had received relevant training, and frequency of contacting bereaved family members had significant impacts on nurses' grief counseling attitudes (P0.05). The score of grief counseling skills was 19.24±4.10, which was in the lower middle level. Grief counseling, frequency of contacting bereaved family members, grief counseling training, and education background had significant impacts on nurses' grief counseling skills (P0.05). Conclusion During the COVID-19 epidemic, there have been room for improvement in grief counseling for bereaved family members among nurses in Wuhan. It is suggested to set up a grief counseling nursing group and establish a long-term and sound training framework.

A survey of grief counseling of clinicians from coronavirus disease 2019 designated hospitals / 第二军医大学学报

Objective To investigate the current status of grief counseling of clinicians from five coronavirus disease 2019 (COVID-19) designated hospitals in Wuhan and to provide reference for hospital management. Methods A total of 223 clinicians from designated hospitals were investigated with a basic information questionnaire and attitudes and skills of grief counseling scales. Results A total of 208 valid questionnaires were collected, with an effective rate of 93.3%. The score of grief counseling skills of clinicians from COVID-19 designated hospitals was 19.35±4.75, which was in the middle and lower level. Responsibilities and roles, and frequency of contacting bereaved family members had significant effects on the grief counseling skills (P0.01). While the score of grief counseling attitudes of clinicians was 33.21±9.23, which was in the middle level. Whether they had received relevant training, the communication ability, and other grief counseling skills had significant impacts on their grief counseling attitudes (P0.01). Conclusion The skills and attitudes of grief counseling of clinicians from COVID-19 designated hospitals in Wuhan still need to be improved. The hospital should set up a grief counseling committee, establish a complete grief guidance system and build a long-term training mechanism.

Aerosol transmission of coronavirus in hospital / 上海预防医学

Coronavirus is human-to-human transmissible and often leads to nosocomial outbreak in the early stage, which poses a great threat to healthcare workers.Due to confined space, crowed population and some aerosol-generating medical procedures, hospital is vulnerable to coronavirus transmission and nosocomial infection.We review the mechanism and risk factors of coronavirus aerosol in hospital and summarize the evidence of aerosol transmission of three coronaviruses and the impact of air flow.Furthermore, we evaluate the effectiveness of personal protection in the above-mentioned scenarios for the prevention and control of nosocomial infection.

Comparison of graft vessel versus native vessel strategies for late saphenous vein graft disease after coronary artery bypass grafting / 中华心血管病杂志

Objective: To compare clinical efficacy of interventional treatment with graft vessel and native coronary artery for patients with late saphenous vein grafts disease(SVGD) after coronary artery bypass grafting (CABG). Methods: A total of 1 608 patients underwent CABG in Tianjin Chest from March 2014 to December 2017 were screened. During the follow-up period, 165 hospitalized patients with recurrence of angina pectoris within one year after CABG, who had at least one narrow vein graft(≥50%) confirmed by the coronary angiography were enrolled. According to the results of angiography and surgeon's clinical experiences, the patients received interventional treatment to vein grafts(grafts group, n=53) or native coronary vessels(native group, n=112). The operation success rate, mortality and incidence of serious complications after interventional treatment in two groups at the time of hospitalization were compared.And the incidence of major adverse cardiovascular events(MACE) in two groups at one year after discharge were also compared. Kaplan-Meier survival curve was used to compare the cumulative event-free survival rates. The risk factors for the MACE in the patients with late SVGD and treated by interventional therapy were analyzed by Cox regression analysis. Results: A total of 165 patients were included for analysis, including 98 males(59.4%). The age was (64.2±7.1) years old. The follow-up time was 12 (8, 12) months. In the grafts group, operation success rate was 90.57%(48/53), and 3 cases(5.66%) suffered from serious complications after interventional treatment, 2 cases(3.77%) died. For native group the operation success rate was 88.39%(99/112), and 7(6.25%) cases suffered from serious complications after interventional treatment, and no deaths. The operation success rate and the incidences of serious complications after interventional treatment in two groups had no statistically significant difference(both P>0.05). The mortality in hospital of native group was lower than that in grafts group(P<0.05). Within 12 months after discharge, there was no statistically significant difference in incidence of MACE of two groups (11.32%(6/53) vs. 10.71%(12/112), P>0.05). Survival analysis showed that the cumulative event-free survival rates in two groups were 73.58% (39/53) and 66.13%(74/112), and there was no statistically significant difference (P>0.05). Cox regression analysis showed acute coronary syndrome (HR=41.203, 95%CI 4.859-349.361, P<0.01), and peripheral vascular diseases (HR=2.808, 95%CI 1.067-7.393, P<0.05) were the risk factors of the MACE for the patients treated by interventional therapy with late SVGD. Conclusion: For the patients with late SVGD after CABG, the success rate of intervention with vein grafts and own coronary vessels are both high with satisfactory safety.The in-hospital mortality of interventional therapy in own coronary vessels is lower than in graft vessel. Patients with acute coronary syndrome and peripheral vascular disease have a poor prognosis.

Sex Estimation of Typical Adult Vertebrae Morphology in Central China Based on CT Technique / 法医学杂志

Objective The morphological data of the second thoracic vertebra and the third lumbar vertebra were measured by computerized tomography （CT）. The sex differences were analyzed and the discrimination equation was obtained. Methods The data of 274 adults （203 cases from experimental group and 69 cases from validation group） from central China were collected. Four linear data （maximum transverse length of vertebral body, maximum longitudinal length of vertebral body, maximum transverse length of vertebral foramen, maximum longitudinal length of vertebral foramen）, one angle data （angle between spinous processes） and two area （vertebral foramen area, total cross-sectional area of vertebral body） data of the second thoracic vertebra and the third lumbar vertebra were collected, respectively. Then three ratios ［maximum transverse length/　maximum longitudinal length of vertebral body, maximum transverse length/ maximum longitudinal length of vertebral foramen, vertebral foramen area/ （total cross-sectional area of vertebral body-vertebral foramen area）］ and one angle （angle between spinous processes） were obtained. The discriminant equation was established for sexual discriminant analysis. Results The morphology of the second thoracic vertebra and the third lumbar vertebra was related with gender. Four single index discriminant formulae and eleven multi-index discriminant formulae were established. The 69 validation group samples were substituted into the formula for testing, and the maximum discriminant accuracy rate of the single-index discriminant formula was 75%. The maximum discriminant accuracy rate of multi-index discriminant formula was 83%. Conclusion It is feasible to conduct individual sex analysis by the morphological indexes of second thoracic vertebra and the third lumbar vertebra. The indexes have important application values in practice.

Status of microbiological reports at partial provincial level annual academic conference of healthcare-associated infection from 2015 to 2017 / 中国感染控制杂志

Objective To understand the present status of special reports relating to microbiology at China provincial-level annual academic conference of healthcare-associated infection (HAI), and provide basis for the training and capacity-building of HAI management staff.Methods The conference arrangements for annual academic conference of provincial HAI quality control centers and HAI management societies from January 2015 to May 2017 were collected, and the special reports on microbiology were summarized and analyzed.Results A total of 35 annual academic conferences held by 17 provinces/municipalities directly under the central government/autonomous regions were included in the study, most conferences (42.31％) were concentrated on the fourth quarter. 15 annual academic conferences were related to microbiology report, accounting for 5.91％ of the total reports, reporting time accounted for 4.81％ of total time. There were various forms of microbiological thematic reports, subject reports, literature exchange, and interactive exchange accounted for 68.96％, 24.14％, and 6.90％ respectively. The proportion of topics related to microbiology reports increased to a certain extent, but the proportion of reporting time decreased.Conclusion At present, the proportion and reporting time of microbiology reports in China provincial-level annual academic conference of HAI is relatively low, it is necessary to increase the number of microbiology reports in the future annual conference of HAI.

Design and finite element analysis of customized pelvic prosthesis / 中国骨伤

OBJECTIVE@#To introduce the design of customized pelvic prosthesis, to evaluate the biomechanical property under three load conditions of customized pelvic prosthesis under three load cinditions.@*METHODS@#A titanium alloy prosthesis for reconstruction of pelvic tumors was designed by CAD software. The strength and stiffness of the custom prosthesis under static and slow gait conditions were analyzed and evaluated by finite element method.@*RESULTS@#The results of the finite element analysis suggested that the maximum von Mises stress in the pelvic under three load conditions were 39.0, 202.8 and 42.4 MPa; the maximum displacement were 0.199, 0.766 and 0.847 mm. The maximum von Mises stress in the prosthesis under three load conditions were 62.3, 318 and 468 MPa. The maximum Von Mises stress in the Ti-alloy prosthesis and pelvic was far smaller than the yield strength of Ti-alloy.@*CONCLUSIONS@#The study can design the size and shape of prosthesis accurately according to patient's condition. The finite element method can reduce the bone stress level and fracture risk, prolong the service life of prostheses, and ensure the safety and stability of the postoperative patients under normal gait.

Emergency Response for a Laboratory Biosafety Incident / 生物医学与环境科学（英文）

On December 14, 2017, a faculty member of a university in Hunan Province reported that an anthrax vaccine strain might have recovered virulence during an undergraduate experiment and potential exposure could not be ruled out for the students involved. Upon receiving the case report, the CDC, health bureaus, and local governments at the county, prefectural, and provincial levels promptly organized experts in different fields (including epidemiologists, biosafety experts, and laboratory testing experts) for case investigation, evaluation, and response. As the investigation results showed, no virulence recovery was identified in the involved anthrax vaccine strain; and no contamination of Bacillus anthracis was detected at the involved areas. Thus, the university returned to normal functioning.

Retrospective Analysis on 1 900 Cases of Medical Malpractices / 法医学杂志

Objective To study the change trend, distribution characteristics and causes of medical malpractices in 18 years, through retrospective analysis of 1 900 cases of medical malpractices, in order to provide guidance for the precaution and the treatment of medical malpractices. Methods A thousand and nine hundred medical malpractice cases that were accepted by Hunan Xiangya Judical Identification Center from 2000 to 2017 were collected. Statistical analysis on the caseloads, the clients, the department distributions, the levels of the hospital and the causes of medical malpractices, etc were conducted. Results The number of cases commissioned by third-party accreditation agencies for medical fault identification was on the rise; The clients of medical malpractices changed significantly in 18 years. Most of the medical malpractice cases occurred in secondary and tertiary hospitals, significantly more in surgery, obstetrics and gynecology. The occurrence of medical malpractices was related to the doctor's insufficient prediction of the severity of the disease and the possible complications, and failure to fully inform the relevant duty of care, etc. Conclusion China's medical malpractice solutions and medical fault identification procedures are gradually improving. Strengthening the medical malpractice precaution awareness of medical workers in surgery, obstetrics and gynecology will be conducive to resolution of medical malpractices.

In Vitro Angiogenesis Effect of Xuefu Zhuyu Decoction () and Vascular Endothelial Growth Factor: A Comparison Study / 中国结合医学杂志

<p><b>OBJECTIVE</b>To compare the angiogenesis behaviors of vascular endothelial growth factor (VEGF) and Chinese medicine Xuefu Zhuyu Decoction (, XZD) treatments.</p><p><b>METHODS</b>Human microvascular endothelial cells (HMEC-1) were treated with various concentrations of either XZD-containing serum (XZD-CS) or VEGF for 24, 48, and 72 h, respectively. Cell viability, proliferation, migration, adhesion, and in vitro tube formation assays were used to assess their angiogenic effects.</p><p><b>RESULTS</b>VEGF promoted all cellular phases involved in angiogenesis including cell viability, proliferation, migration, adhesion, and tube formation (<0.05 or <0.01). Unlike the continuous promotion effects of VEGF at the above stages, XZD inhibited cell viability and proliferation (<0.05 or <0.01) and only promoted tube formation in the early phase of angiogenesis (<0.01).</p><p><b>CONCLUSIONS</b>These two medications promote different angiogenesis behaviors, which might be an important reason for their distinct therapeutic profile in clinical usage.</p>

Effects of low-intensity pulsed ultrasound on fracture healing and caveolin-1 gene expression in the radius defects of rabbits / 复旦学报（医学版）

Objective To explore the effect of low-intensity pulsed ultrasound (LIPUS) on long bone fracture healing and to examine caveolin-1 gene expression in the radius defects of rabbits.Methods A total of 24 New Zealand rabbits with 3-mm bone defects at lower 1/3 in both radii were randomly assigned to 4 groups (n=6).Daily LIPUS treatment was performed to the right fracture sites at a intensity of 30 mW/cm2 for 20 minutes,while the left sites received sham treatment with power off.To assess the effects of LIPUS on bone defects,X-ray imaging and hematoxylin-eosin staining were applied 7,14,21,28 days after the surgery.Additionally,the immunohistochemical staining was used to determine the subcllular localization of caveolin-1 and semi-quantify the caveolin-1 level,qPCR was performed to detect the mRNA level of caveolin-1,gene Col2a1 and Col10a1,and osteocalcin.Results On day 14,the radiological score of the right radii and mineralized callus area were significantly higher than that of the left ones,both of them were elevated with time flied.Histological examination suggested that the differentiation and apoptosis of chondrocytes along with the formation and bridging of the bone trabeculas appeared earlier in the right radius defects.The immunohistochemical staining showed that on day 7 and 14,the level of caveolin-1 increased with the proliferation and differentiation of condrocytes,and was significantly higher in callus tissues on the right sites.On day 21 and 28,the mesenchymal stem cells migrated to the surface of cartilage matrix started to differentiate into osteoblasts,the level of caveolin-1 decreased,and was significantly lower on the right sites.The result of qPCR indicated that compared with the left sites the caveolin-1 gene expression on the right sites was significantly higher on day 7,while significantly lower on day 21.The mRNA expression levels of Col2a1,Col10a1 and osteocalcin on the right sites were significantly higher on day 7 and 14,but they were significantly lower on day 21 and 28,except for Col10a1 on day 28.Conclusions Advancing endochondral ossification is considered to be a crucial mechanism during long bone fracture healing promoted by LIPUS.The caveolin-1 gene expression first increased in the chondrocytes then decreased in the mesenchymal stem cells during the process.

The treatment effect of group cognitive behavioral therapy for insomnia / 解放军医学杂志

Objective To explore the treatment effect of group cognitive behavioral therapy (GCBT) for patients with insomnia.Methods Two hundred and forty-one cases of insomnia were collected in the department of Sleep and Neurology Psychological in D aping Hospital and Field Surgery Research Institute of Army Medical University from March 2016 to June 2017.They were randomly divided into GCBT group (n=128) and pharmacotherapy group (n=113),and the treatment last for 8 weeks for each group.Then the differences of the sleep parameters,Insomnia Severity Index (ISI) scores,Hamilton Depression Scale (HAMD)scores and Hamilton Anxiety Scale (HAMA) scores were compared in two groups at per-treatment,four-week treatment time point and eight-week treatment time point.Results At the four week treatment time point,the differences of sleep onset latency (SOL),total sleep time (TST),time in bed (TIB),number of awakenings (NOA) and insomnia severity index (ISI) in GCBT group compared to pharmacotherapy group were statistically significant (P＜0.05).While the differences of sleep efficiency (SE),HAMA and HAMD were of no statistically significant difference (P＞0.05).At the eight week treatment time point,the differences of SOL,SE,NOA,HAMA,HAMD and ISI in GCBT group compared to pharmacotherapy group were statistically significant (P＜0.05),and there is no significant difference in TST and TIB (P＞0.05).Conclusion GCBT and pharmacotherapy can improve insomnia symptoms,reduce the level of anxiety and insomnia severity.GCBT can also reduce the level of depression,although GCBT improve insomnia symptoms were slower than pharmacotherapy,but curative cffect is superior to pharmacotherapy,and it should be popularized in clinic.

Progress on the Muscle Function Evaluation and Its Forensic Application / 法医学杂志

Accurate evaluation of muscle function helps to understand the recovery of muscle, bone, nervous system diseases or injuries, especially for muscle dysfunction caused by peripheral nerve injury.Therefore, the methods of muscle function evaluation have been the focus of researchers, with new methods having been constantly proposed.Muscle strength testing is an important part of muscle function evaluation.Besides hand muscle strength assessment, currently used muscle function assessments include simple instrumental test, isokinetic muscle test, electrophysiological test, etc.In addition, the application of needle electromyography, motor unit number estimation, motion unit index in muscle function evaluation has also been reported for several times.This paper reviews the research progress and practical application of these methods.

Range of Hip Joint Motion and Weight of Lower Limb Function under 3D Dy-namic Marker / 法医学杂志

Objective To explore the range of reasonable weight coefficient of hip joint in lower limb function. Methods When the hip joints of healthy volunteers under normal conditions or fixed at three different positions including functional, flexed and extension positions, the movements of lower limbs were recorded by LUKOtronic motion capture and analysis system. The degree of lower limb function loss was calculated using Fugl-Meyer lower limb function assessment form when the hip joints were fixed at the aforementioned positions. One-way analysis of variance and Tamhane's T2 method were used to proceed statistics analysis and calculate the range of reasonable weight coefficient of hip joint. Results There were significant differences between the degree of lower limb function loss when the hip joints fixed at flexed and extension positions and at functional position. While the differences between the degree of lower limb function loss when the hip joints fixed at flexed position and extension posi-tion had no statistical significance. In 95％ confidence interval, the reasonable weight coefficient of hip joint in lower limb function was between 61.05％ and 73.34％. Conclusion Expect confirming the rea-sonable weight coefficient, the effects of functional and non-functional positions on the degree of lower limb function loss should also be considered for the assessment of hip joint function loss.