Effect of ultrasonic microbubbles combined with gentamicin in the treatment of diabetic foot ulcer under low-frequency ultrasound / 中华超声影像学杂志

Objective:To investigate the effect of microbubbles combined with gentamicin on the clearance of bacterial biofilms and the healing of diabetic foot ulcers under low-frequency ultrasound.Methods:From July 2021 to June 2022, 27 patients with chronic diabetic foot ulcers complicated with infection were prospectively selected from the Trauma Center of the Second Affiliated Hospital of Chongqing Medical University. The patients were divided into low-frequency ultrasound + microbubbles + gentamicin ointment group, low-frequency ultrasound + microbubbles group, and gentamicin ointment group by using a random number table, with 9 patients in each group. The three groups were all treated with simple debridement by the same surgeon.Afterward, in the low-frequency ultrasound+ microbubbles+ gentamicin ointment group, the wounds covered by 4% microbubble suspension were firstly irradiated with low-intensity focused ultrasound for 5 min, and then evenly applied with gentamicin ointment. In the low-frequency ultrasound + microbubbles group, the wounds covered by 4% microbubble suspension were irradiated with low-intensity focused ultrasound for 5 min. The gentamicin ointment group was treated with gentamicin ointment evenly. The treatment lasted for 2 weeks, and secretions and tissue specimens were collected during and 2 weeks after the treatment, respectively. The general indexes of wound surface (including ulcer depth score, secretion exudation score, fresh granulation tissue growth score, and total index score), ulcer area, ulcer healing rate, as well as negative rate of secretion culture were compared among the three groups after treatment. Additionally, the structural changes in bacterial biofilms under a scanning electron microscope and colony count under a laser confocal scanning microscope were compared among the three groups after treatment.Results:No significant differences were found in the general datas among the three groups (all P>0.05). After treatment for 2 weeks, the overall general indexes showed statistically and significant differences among the three groups (all P<0.05). Each index score in the low-frequency ultrasound + microbubbles + gentamicin ointment group was lower than that in the low-frequency ultrasound + microbubbles group and the gentamicin ointment group (all P<0.05). There were no significant differences in overall ulcer area among the three groups ( P>0.05). The overall ulcer healing rate presented significant differences among the three groups ( P<0.05). The healing rate in the low-frequency ultrasound + microbubbles + gentamicin ointment group was higher than that in the low-frequency ultrasound + microbubbles group and the gentamicin ointment group (all P<0.05). The overall negative rates of secretion culture among the three groups were significantly different ( P<0.05), the negative rate in the low-frequency ultrasound + microbubbles + gentamicin ointment group was higher than that in the low-frequency ultrasound + microbubbles group and the gentamicin ointment group (all P<0.05). Scanning electron microscopy confirmed bacterial biofilm infection in the three groups before treatment. After treatment for 2 weeks, the biofilm formation in the low-frequency ultrasound + microbubbles + gentamicin ointment group reduced significantly, while the low-frequency ultrasound + microbubbles group and the gentamicin ointment group had little change compared with that before treatment. Significant differences were detected in total colony count among the three groups under the confocal microscope ( P<0.05). The colony count in the low-frequency ultrasound + microbubbles + gentamicin ointment group was lower than that in the low-frequency ultrasound + microbubbles group and the gentamicin ointment group (both P<0.05). Conclusions:Ultrasound microbubbles combined with gentamicin can clear bacterial biofilms and promote the healing of diabetic foot ulcers.

Practice and exploration of online teaching in clinical medicine education in military teaching hospitals / 中华医学教育探索杂志

With the rapid development of information technology and the change in military education policy in the new era, online teaching has gradually become one of the main approaches to implement the clinical medical education in military teaching hospitals. In this study, the online teaching was performed mainly by pre-recorded teaching, supplemented by online live teaching. Massive open online courses (MOOCs) and the seminar-style teaching were advocated to be used in advanced disciplines. The quality of online teaching was guaranteed through infrastructure provision, teacher arrangement, teaching preparation, teaching interactivity, after-class test, teaching evaluation, supervision, and summary of teaching, which ultimately achieved a good effect. The results of the two-way questionnaires of 26 teachers and 129 students showed that 23.26% (30/129) of students and 65.38% (17/26) of teachers believed that students' learning ability was insufficient. 34.88% (45/129) of students and 23.08% (6/26) of teachers thought that the existing technology could not meet the requirements of online teaching. 55.04% (71/129) of students and 69.23% (18/26) of teachers held the view that the effect of online teaching was inferior to face-to-face teaching. 28.68% (37/129) of students and 57.69% (15/26) of faculty asked for the return of face-to-face education. Therefore, it is necessary to strengthen the construction of smart classroom platforms, establish a well-developed online teaching quality evaluation system, and integrate various innovative teaching modes with the online teaching. In these ways, it is expected to optimize the online teaching of clinical medicine and achieve the goal of online teaching.

Three-dimensional finite element study on the effects of maxillary anterior two-step retraction and en-masse retraction with clear aligners / 中华口腔医学杂志

Objective: To investigate the effects of two-step retraction and en-masse retraction on tooth movement pattern of anterior teeth and posterior anchorage with clear aligners using three-dimensional finite element analysis. Methods: A finite element model of maxillary first premolar extraction case undergoing clear aligner treatment was established based on maxillofacial cone-beam CT data of a 24-year-old adult male with individual normal occlusion, who visited Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine for impacted mandibular third molar in June, 2022. The initial tooth displacement of five anterior retraction protocols (two-step with canine retraction, two-step with incisor bodily retraction, two-step with incisor retraction-overtreatment, en-masse bodily retraction, and en-masse retraction-overtreatment) were evaluated. Results: Two step with canine retraction caused distal tipping of the canine and labial tipping of the incisors (0.18° for central incisor and 0.13° for lateral incisor). Two step with incisor retraction caused mesial tipping of the canine. In two step with bodily retraction protocol, uncontrolled lingual tipping was found in central incisor (0.29°) and lateral incisor (0.32°). In two-step with incisor retraction-overtreatment protocol, the movement pattern of the incisors didn't change, but the inclinations reduced to 0.21° and 0.18°. En-masse retraction caused distal tipping of the canine. In en-masse bodily retraction protocol, uncontrolled lingual tipping was also found in central incisor (0.19°) and lateral incisor (0.27°). In en-masse retraction-overtreatment protocol, the central incisor showed controlled lingual tipping (0.02°) and the lateral incisor showed palatal root movement (0.03° labial inclination). Posterior teeth exhibited mesial tipping in all five protocols. Conclusion: En-masse retraction with incisor overtreatment was beneficial to incisor torque control in clear aligner treatment.

Associations of sex hormone levels with body mass index (BMI) in men: a cross-sectional study using quantile regression analysis / 亚洲男科学杂志(英文版)

Body mass index (BMI) has been increasing globally in recent decades. Previous studies reported that BMI was associated with sex hormone levels, but the results were generated via linear regression or logistic regression, which would lose part of information. Quantile regression analysis can maximize the use of variable information. Our study compared the associations among different regression models. The participants were recruited from the Center of Reproductive Medicine, The First Hospital of Jilin University (Changchun, China) between June 2018 and June 2019. We used linear, logistic, and quantile regression models to calculate the associations between sex hormone levels and BMI. In total, 448 men were included in this study. The average BMI was 25.7 (standard deviation [s.d.]: 3.7) kg m-2; 29.7% (n = 133) of the participants were normal weight, 45.3% (n = 203) of the participants were overweight, and 23.4% (n = 105) of the participants were obese. The levels of testosterone and estradiol significantly differed among BMI groups (all P < 0.05). In linear regression and logistic regression, BMI was associated with testosterone and estradiol levels (both P < 0.05). In quantile regression, BMI was negatively associated with testosterone levels in all quantiles after adjustment for age (all P < 0.05). BMI was positively associated with estradiol levels in most quantiles (≤80th) after adjustment for age (all P < 0.05). Our study suggested that BMI was one of the influencing factors of testosterone and estradiol. Of note, the quantile regression showed that BMI was associated with estradiol only up to the 80th percentile of estradiol.

Study on mandibular movement trajectory and virtual occlusal pre-adjustment under light and heavy bite force / 中华口腔医学杂志

Objective: To investigate the influence of light and heavy bite force on the mandibular movement trajectories, and the influence of bite force on virtual occlusal pre-adjustment of digital full crown. Methods: From October 2021 to March 2022, 10 postgraduate volunteers (3 males and 7 females, aged 22-26 years) were recruited from Peking University School and Hospital of Stomatology. Maxillary and mandibular digital models of the participants were obtained by intraoral scanning. Jaw relations were digitally transferred under heavy bite force and mandibular movement trajectories under light and heavy bite force were recorded by jaw motion analyser. Three mandibular markers were chosen, namely the mesial proximal contact point of the central incisor (incisal point) and the mesial buccal cusp tips of the bilateral first molars. The three-dimensional displacements of the markers under two kinds of bite force in the intercuspal position (ICP), the sagittal projection of the three-dimensional displacements in the protrusive edge-to-edge position, and the coronal projection of the three-dimensional displacements in the lateral edge-to-edge position of upper and lower posterior teeth were measured. Single-sample t-test was used to compare the three-dimensional displacements and the corresponding sagittal projection and coronal projection with 0, respectively. The left maxillary central incisor and left mandibular first molar were virtually prepared by the reverse engineering software. Then dental design software was used to design digital full crown using the copy method. The mandibular movement trajectories under light and heavy bite force were separately used to guide virtual occlusal pre-adjustment. The three-dimensional deviations (mean deviations and root mean square) between the lingual surface of the left maxillary central incisor or the occlusal surface of the left mandibular first molar and that of the natural tooth before preparation were calculated (light bite force group and heavy bite force group), and the differences between the two groups were compared by the paired t-test. Results: Under the two kinds of bite force, the three-dimensional displacements of the markers in the ICP were (0.217±0.135), (0.210±0.133) and (0.237±0.101) mm, respectively; the sagittal projection of the three-dimensional displacements of the markers in the protrusive edge-to-edge position were (0.204±0.133), (0.288±0.148) and (0.292±0.136) mm, respectively; the coronal projection of the three-dimensional displacements of the mesial buccal cusp tips of the bilateral first molars in the lateral edge-to-edge position were (0.254±0.140) and (0.295±0.190) mm, respectively. The differences between the above displacements and 0 were statistically significant (P<0.05). The results of occlusal pre-adjustment showed that the mean deviations of the lingual surface of the left maxillary central incisor in the light and heavy bite force groups were (0.215±0.036) and (0.195±0.041) mm (t=3.95, P=0.004), respectively. The mean deviations of the occlusal surface of the left mandibular first molar were (0.144±0.084) and (0.100±0.096) mm (t=0.84, P=0.036), respectively. Conclusions: Both the light and heavy bite force have an influence on the mandibular movement trajectories. Virtual occlusal pre-adjustment of prostheses with mandibular movement trajectories under heavy bite force can obtain morphology of lingual or occlusal surfaces closer to the natural teeth before preparation.

Efficacy of intravascular ultrasound versus coronary angiographic guided drug-eluting stent implantation in the treatment of left main coronary artery disease: a meta-analysis / 中华心血管病杂志

Objective: To compare the efficacy of intravascular ultrasound (IVUS) and coronary angiography guided drug eluting stent (DES) implantation for the treatment of left main coronary artery (LMCA) lesions. Methods: Randomized controlled trials (RCT) and observational studies, which compared IVUS with coronary angiography guided DES implantation for the treatment of LMCA lesions published before August 2021 were searched in PubMed, Embase and Cochrane Library databases. Baseline data, interventional procedures and endpoint events of each study were collected. The primary endpoint was major cardiovascular adverse events (MACE), and the secondary endpoints were all-cause death, cardiac death, myocardial infarction (MI), target lesion revascularization (TLR) and target vessel revascularization (TVR). The Newcastle-Ottawa Scale (NOS) and the Cochrane Collaboration Risk of Bias tool were used to evaluate the quality of the included studies. Results: Nine studies were included, including 3 RCT and 6 observational studies, with a total of 5 527 cases of LMCA. All the 6 observational studies had NOS scores≥6, and the 3 RCT had a low risk of overall bias. The results of meta-analysis showed that compared with coronary angiography guided group, MACE rate (OR=0.55, 95%CI 0.47-0.66, P<0.001), all-cause death (OR=0.56, 95%CI 0.43-0.74, P<0.001), cardiac death (OR=0.43, 95%CI 0.30-0.61, P<0.001), MI (OR=0.64, 95%CI 0.52-0.79, P<0.001), TLR (OR=0.49, 95%CI 0.28-0.86, P=0.013) and TVR (OR=0.77, 95%CI 0.60-0.98, P=0.037) were all significantly lower in the IVUS guided group. Conclusions: Compared with angiography guided, IVUS guided PCI with DES implantation in LMCA lesions could significantly reduce the risk of MACE, death, MI, TLR and TVR. IVUS is thus superior to coronary angiography for guiding PCI treatment among patients with LMCA.

Mediation effect of resilience on pregnancy stress and prenatal depression in pregnant women / 中南大学学报(医学版)

OBJECTIVES@#Pregnancy stress is the psychological confusion or threat caused by various stress events and adverse factors during pregnancy. Pregnant women exposed to many stressors, they will be easy to produce bad mood and prenatal depression if they cannot adapt to their own changes. Prenatal depression is one of the major global public health problems, with a higher incidence in developing countries and a negative impact on the health of pregnant women and fetus. Resilience refers to pregnant women using their own positive psychological capital, can self-emotional adjustment and improve their ability to adapt to the response state. A better level of resilience can enable pregnant women to face various negative and adaptive problems positively. This study aims to investigate the relationship between pregnancy stress, resilience and prenatal depression through a mental health survey of pregnant women.@*METHODS@#A total of 750 pregnant women in a Grade A tertiary hospital in Urumqi were investigated by self-designed demographic questionnaire, Pregnancy Pressure Scale (PPS) and Patient Health Questionnaire-9 (PHQ-9), Connor-Davidson Resilience Scale (CD-RISC), and the levels of stress during pregnancy, prenatal depression and resilience were analyzed. Pearson correlation analysis was used to explore the correlation between the three. Bootstrap mediation effect test was used to test the mediation effect relationship among the three. If the mediation effect was confirmed, AMOS software was used to establish the mediation effect structural equation model to analyze the mediation effect among the three.@*RESULTS@#Among 750 respondents, 709 (94.53%) had mild or above pregnancy pressure, 459 (61.20%) had mild or above depressive symptoms and 241 (32.13%) had a good or above level of resilience. Pearson correlation analysis showed that prenatal depression was significantly positively correlated with pregnancy stress (P<0.01), prenatal depression and pregnancy stress were significantly negatively correlated with resilience (all P<0.01). Mediation effect test analysis showed that all the pathways were statistically significant (P<0.01). Mediation effect of resilience between pregnancy stress and prenatal depression was significantly found (95% CI 0.022-0.068, P<0.001). Pregnancy pressure negatively affected resilience (β=-0.38, P<0.01), and resilience negatively affected prenatal depression (β=-0.10, P<0.01). The mediation effect of resilience was 6.5%.@*CONCLUSIONS@#Pregnant women's pregnancy pressure, resilience and prenatal depression are significantly correlated, and the mediation variable resilience plays a partial mediating role in the impact of pregnancy pressure on prenatal depression. Pregnant women can reduce the incidence of prenatal depression and promote their physical and mental health by exercising their resilience.

Application of SifaInDel 45plex System in the Han and Mongolian Populations / 法医学杂志

OBJECTIVES@#To investigate the genetic polymorphism of InDel loci in SifalnDel 45plex system in the Han population in Jiangsu Province and the Mongolian population in Inner Mongolia, and to evaluate the effectiveness of the system in forensic medicine.@*METHODS@#SifaInDel 45plex system was used for genotyping in blood samples of 398 unrelated individuals from the above two populations, and allele frequencies and population genetic parameters of the two populations were calculated respectively. Eight intercontinental populations in the gnomAD database were used as reference populations. The genetic distances between the two studied populations and eight reference populations were calculated based on the allele frequencies of 27 autosomal-InDels (A-InDels). The phylogenetic trees and multidimensional scaling (MDS) analysis diagrams were constructed accordingly.@*RESULTS@#Among two studied populations, the 27 A-InDels and 16 X-InDels showed no linkage disequilibrium between each other and the allele frequency distributions were in Hardy-Weinberg equilibrium. The CDP of the 27 A-InDels in two studied populations were all higher than 0.999 999 999 9, and the CPEtrio were all less than 0.999 9. The CDP of the 16 X-InDels in Han in Jiangsu and Mongolian in Inner Mongolia female and male samples were 0.999 997 962, 0.999 998 389, and 0.999 818 940, 0.999 856 063, respectively. The CMECtrio were all less than 0.999 9. The results of population genetics showed that the Jiangsu Han nationality, Inner Mongolia Mongolian nationality and East Asian population clustered into one branch, showing closer genetic relationship. The other 7 intercontinental populations clustered into another group. And the above 3 populations displayed distant genetic relationships with the other 7 intercontinental populations.@*CONCLUSIONS@#The InDels in the SifaInDel 45plex system have good genetic polymorphism in the two studied populations, which can be used for forensic individual identification or as an effective complement for paternity identification, and to distinguish different intercontinental populations.

The effects of mechanical vibration on the expression of estrogen and brain-derived neurotrophic factor after ovariectomy / 中华物理医学与康复杂志

Objective:To explore any effect of mechanical vibration on the expression of estrogen and brain-derived neurotrophic factor (BDNF) in ovariectomized rats with an osteoporotic fracture.Methods:Thirty 3-month-old female Wistar rats were divided randomly into a control group, an ovariectomy group and a vibration group, each of 10. Fractures were induced in the rats of all three groups. Twenty minutes of whole-body vertical vibration was applied to the vibration group at a frequency of 35Hz, 5 days a week for 6 weeks. After 2 and 6 weeks the fracture healing of each group was evaluated using X-rays, the levels of hippocampal estrogen were measured using enzyme-linked immunosorbent assays and fracture-end BDNF was quantified by immunoblotting.Results:After 2 and 6 weeks of vibration the average fracture healing in the vibration group was significantly greater than in the other 2 groups. The average estrogen content in the hippocampus of the vibration group was significantly higher than in the other 2 groups after both 2 and 6 weeks, while the average BDNF content in their fracture ends was significantly lower. The BDNF expression at the fracture end was significantly correlated with the fracture healing.Conclusion:Mechanical vibration can promote the expression of estrogen and BDNF in the hippocampus and accelerate fracture healing in osteoporotic rats.

Comparison of complications between continuous negative pressure drainage and intermittent negative pressure drainage after expanded flap repair and abdominal wall plasty / 中华医学美学美容杂志

Objective:To compare the use of continuous constant negative pressure drainage and intermittent suction mode drainage in abdominal wall angioplasty to minimize the impact of complications.Methods:From May 2017 to August 2019, the Department of Medical Cosmetology and Plastic Surgery, Wuhan Third Hospital treated 76 female patients after expanded flap repair, aged 27-35 years, with an average age of 30.5±14.2 years, and 58 female patients after abdominal wall plasty, aged 38-55 years, with an average age of 47.8±7.8 years. They were divided into intermittent negative pressure drainage group and continuous negative pressure drainage group. The negative pressure values in different intervals were set according to the type of operation. The drainage volume, drainage time, incidence of hematoma, subcutaneous effusion, flap necrosis rate, primary wound healing rate and drainage related bleeding were recorded and compared between the two groups.Results:After expanded flap repair in 38 cases, flap necrosis occurred in 1 case and hematoma in 3 cases; After abdominal wall plasty in 29 cases, flap necrosis occurred in 0 cases and hematoma in 1 case. The primary healing of incision was higher ( P<0.05), the drainage volume was larger, but the drainage time was shorter ( P<0.05), and no bleeding related to drainage was observed. The effect of monitoring drainage was positively correlated with the effect of operation. Conclusions:Continuous and constant negative pressure drainage is related to the prognosis of patients undergoing expansion flap repair and abdominal wall plasty. It is helpful to improve the effect of plastic surgery and the quality of nursing work. It is an effective method for nursing management after plastic surgery.

Transcranial direct current stimulation for the relief of neuropathic pain in rats and the underlying mechanism / 中华物理医学与康复杂志

Objective:To observe any therapeutic effect of repeated transcranial direct current stimulation (tDCS) on rats modeling neuropathic pain and explore possible mechanisms.Methods:Forty adult male Sprague-Dawley rats were randomly divided into a normal group ( n=10), a sham operation group ( n=10), a treatment group ( n=10) and a sham treatment group ( n=10). A model of chronic constriction injury of the sciatic nerve was established in the latter two groups. Fourteen days after the modeling, the treatment group was given tDCS for 8 consecutive days, while the sham treatment group received sham stimulation, and the other 2 groups did not receive any intervention. Von Frey and hotplate tests were used to test the rats′ pain thresholds 1 day before, as well as 14 and 22 days after the surgery (i.e., 8 days after the end of the treatment). Spinal cord tissue samples were taken to detect the protein expressions of N-methyl-D-aspartic acid receptor 2B, gamma-aminobutyric acid receptor types A (GABA a-R) and B (GABA b-R) using western blotting. Results:On the 14th day after the operation the average 50% MWT and WTL values of the sham treatment and treatment groups had decreased significantly compared with the sham operation group. By the 22nd day the average 50% MWT and WTL values of the treatment group were significantly higher than those of the sham treatment group, but there was no significant change in the treatment group′s average WTL between the 21st and 22nd days. On the 22nd day after the operation the average NR2B-NMDA-R level of the sham treatment group were significantly higher than that of the sham operation group, while the average GABA a-R and GABA b-R levels were significantly lower. At the same time point the treatment group′s average NR2B-NMDA-R level had decreased significantly compared to the sham treatment group, while the average GABA a-R level had increased significantly. There was no significant difference in average GABA b-R level between the treatment group and the sham treatment group at that point. On the 22nd day there was also no significant difference in the average NR2B-NMDA-R level between the treatment group and the sham operation group. Conclusions:Repeated tDCS can effectively relieve neuropathic pain. The relief of hyperalgesia is more significant than that of mechanical allodynia. A possible mechanism may be the down-regulation of spinal NR2B-NMDA-R to normal levels and modest up-regulation of GABA a-R.

Two cases of Christianson syndrome caused by SLC9A6 gene mutation / 中华神经科杂志

Christianson syndrome is a rare X-linked disease caused by mutations in the SLC9A6 gene. The clinical manifestations are male developmental delay, language disorder, seizures, mental retardation, ataxia, microcephaly and so on. Two cases of male children with Christianson syndrome were reported. The proband was 1 year and 11 months old. Clinical manifestations include microcephaly, global developmental delay, and seizures. The electroencephalogram showed that the central midline region of spikes and slow waves were emitted, and all exons sequencing detected a mutation in the SLC9A6 gene chrX: 135084373 [c.803+1(IVS6)G>A]. The proband′s brother was 4 years and 8 months old. The clinical manifestations were similar. The electroencephalogram showed spikes and spines in the Rolandic area on both sides. Slow waves and spiny slow waves were emitted. Magnetic resonance imaging suggested brain atrophy. The genetic verification results were consistent with the proband. The SLC9A6 gene c.803+1(IVS6) G>A splicing mutation was a pathogenic mutation in this family.

Network Meta-analysis of efficacy and safety of Chinese patent medicines in treatment of ankylosing spondylitis / 中国中药杂志

To evaluate the efficacy and safety of Chinese patent medicines in the treatment of ankylosing spondylitis(AS) by frequency network Meta-analysis. Randomized controlled trials(RCTs)of Chinese patent medicines for AS were retrieved from CNKI, Wanfang, VIP, CBM, PubMed, EMbase and Cochrane Library databases from the time of database establishment to January 2021. The quality of the included RCTs was evaluated according to the Cochrane bias risk standard, and the data was analyzed by RevMan 5.3 and Stata/MP 15.1. A total of 12 kinds of Chinese patent medicines in 55 RCTs were included. According to Meta-analysis, in term of the effectiveness, the top three optimal medication regimens were Biqi Capsules, Yishen Juanbi Pills and Yaobitong Capsules combined with western medicine. The top three interventions to reduce the erythrocyte sedimentation rate(ESR)were Yishen Juanbi Pills, Xianling Gubao Capsules and Fufang Xuanju Capsules combined with western medicine. The top three interventions to reduce the C-reactive protein(CRP)were Biqi Capsules, Xianling Gubao Capsules and Fufang Xuanju Capsules combined with western medicine. In terms of the safety, top three optimal medication regimens were Total Glucosides of Paeony Capsules, Yishen Juanbi Pills, and Wangbi Tablets combined with western medicine. This network Meta-analysis suggests that Chinese patent medicines combined with conventional western medicine can effectively improve the joint pain symptoms of AS patients and reduce the acute inflammatory indicators, with high safety. However, the literature included in this study is generally of low methodological quality, and the conclusion needs to be verified by high-quality research.

Cytokine Profiles and Virological Marker Monitoring during 48 Weeks Peginterferon Alfa Treatment for HBeAg-Positive Chronic Hepatitis B / 生物医学与环境科学（英文）

Objective@#This study aimed to investigate whether cytokine profiles and virological markers might add value in monitoring the effects of peginterferon (PEG-IFN) therapy for hepatitis B e-antigen (HBeAg) positive chronic hepatitis B (CHB).@*Methods@#HBeAg positive patients with CHB were treated with PEG-IFN for 48 weeks. Clinical biochemical, and HBV serological indexes, as well as cytokines, were detected at baseline and every 12 weeks.@*Results@#A total of 116 patients with CHB were enrolled in this study; 100 patients completed the 48-week treatment and follow-up, of whom 38 achieved serum HBeAg disappearance, 25 achieved HBeAg seroconversion, 37 showed HBsAg decreases ≥ 1 log 10 IU/mL, 9 showed HBsAg disappearance, and 8 became HBsAb positive. The cytokine levels at baseline and during treatment were similar between the HBeAg disappearance group and non-disappearance group. The disappearance of HBeAg was independently associated with HBeAg levels at weeks 12 and 24, and with the HBeAg decline at week 24 ( P < 0.05). The HBsAg response was independently associated with HBsAg, the HBsAg decline, HBeAg, the HBeAg decline at week 12, and HBsAg at week 24 ( P< 0.05).@*Conclusion@#There was no significant correlation between the response to interferon (IFN) and cytokines during PEG-IFN treatment. The changes in virological markers predicted the response to IFN after 48 weeks.

Comparing the clinical characteristics and prognosis of seropositive and seronegative rheumatoid arthritis patients in China: a real-world study / 中华风湿病学杂志

Objective:In general, patients with seropositive rheumatoid arthritis (RA) are considered to show an aggressive disease course. However, the relationship between the two subgroups in disease severity is controversial. Our study is aimed to compare the clinical characteristics and prognosis of double-seropositive and seronegative RA in China through a real-world large scale study.Methods:RA patients who met the 1987 American College of Rheumatology (ACR) classification criteria or the 2010 ACR/European Anti-Rheumatism Alliance RA classification criteria, and who attended the 10 hospitals across the country from September 2015 to January 2020, were enrolled. According to the serological status, patients were divided into 4 subgroups [rheumatoid factor (RF)(-) anti-cyclic citrullinated peptide (CCP) antibody (-), RF(+), RF(+) anti-CCP antibody(+), anti-CCP antibody(+)] and compared the disease characteristics and treatment response. One-way analysis of variance was used for measurement data that conformed to normal distribution, Kruskal-Wallis H test was used for measurement data that did not conform to normal distribution; paired t test was used for comparison before and after treatment within the group if the data was normally distributed else paired rank sum test was used; χ2 test was used for count data. Results:① A total of 2 461 patients were included, including 1 813 RF(+) anti-CCP antibody(+) patients (73.67%), 129 RF(+) patients (5.24%), 245 RF(-) anti-CCP antibody(-) patients (9.96%), 74 anti-CCP antibody(+) patients (11.13%). ② Regardless of the CCP status, RF(+) patients had an early age of onset [RF(-) anti-CCP antibody(-) (51±14) years old, anti-CCP antibody(+) (50±15) years old, RF(+) anti-CCP antibody(+) (48±14) years old, RF(+)(48±13) years old, F=3.003, P=0.029], longer disease duration [RF(-) anti-CCP antibody(-) 50 (20, 126) months, anti-CCP antibody(+) 60(24, 150) months, RF(+) anti-CCP antibody(+) 89(35, 179) months, RF(+) 83(25, 160) months, H=22.001, P<0.01], more joint swelling counts (SJC) [RF(-) anti-CCP antibody(-) 2(0, 6), Anti-CCP antibody(+) 2(0, 5), RF(+) anti-CCP antibody(+) 2(0, 7), RF(+) 2(0, 6), H=8.939, P=0.03] and tender joint counts (TJC) [RF(-) anti-CCP antibody(-) 3(0, 8), anti-CCP antibody(+) 2(0, 6), RF(+) anti-CCP antibody(+) 3(1, 9), RF(+) 2(0, 8), H=11.341, P=0.01] and the morning stiff time was longer [RF(-) anti-CCP antibody(-) 30(0, 60) min, anti-CCP antibody(+) 20(0, 60) min, RF(+) anti-CCP antibody(+) 30(10, 60) min, RF(+) 30(10, 60) min, H=13.32, P<0.01]; ESR [RF(-) anti-CCP antibody(-) 17(9, 38) mm/1 h, anti-CCP antibody(+) 20(10, 35) mm/1 h, RF(+) anti-CCP antibody(+) 26(14, 45) mm/1 h, RF(+) 28(14, 50) mm/1 h, H=37.084, P<0.01] and CRP [RF(-) anti-CCP antibody(-) 2.3 (0.8, 15.9) mm/L, Anti-CCP antibody(+) 2.7(0.7, 12.1) mm/L, RF(+) anti-CCP antibody(+) 5.2(1.3, 17.2) mm/L, RF (+) 5.2(0.9, 16.2) mm/L, H=22.141, P<0.01] of the RF(+)patients were significantly higher than RF(-) patients, and RF(+) patients had higher disease severity(DAS28-ESR) [RF(-) anti-CCP antibody(-) (4.0±1.8), anti-CCP antibody(+) (3.8±1.6), RF(+) anti-CCP antibody(+) (4.3±1.8), RF(+) (4.1±1.7), F=7.269, P<0.01]. ③ The RF(+) anti-CCP antibody(+) patients were divided into 4 subgroups, and it was found that RF-H anti-CCP antibody-L patients had higher disease severity [RF-H anti-CCP antibody-H 4.3(2.9, 5.6), RF-L anti-CCP antibody-L 4.5(3.0, 5.7), RF-H anti-CCP antibody-L 4.9(3.1, 6.2), RF-L anti-CCP antibody-H 2.8(1.8, 3.9), H=20.374, P<0.01]. ④ After 3-month follow up, the clinical characteristics of the four groups were improved, but there was no significant difference in the improvement of the four groups, indicating that the RF and anti-CCP antibody status did not affect the remission within 3 months. Conclusion:Among RA patients, the disease activity of RA patients is closely related to RF and the RF(+) patients have more severe disease than RF(-) patients. Patients with higher RF titer also have more severe disease than that of patients with low RF titer. After 3 months of medication treatment, the antibody status does not affect the disease remission rate.

Knockdown of EMMPRIN (OX47) in MRMT-1 Carcinoma Cells Inhibits Tumor Growth and Decreases Cancer-Induced Bone Destruction and Pain / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Bone destruction and pain caused by cancer is one of the most devastating complications of cancer patients with bone metastases, and it seriously affects the quality of patients’ life. Extracellular matrix metalloproteinase inducer (EMMPRIN) is a cell adhesion molecule with increased expression in a variety of tumors. This study focused to clarify the specific function of EMMPRIN in bone metastasis of breast cancer. @*Materials and Methods@#Adenovirus with shRNA-EMMPRIN was transfected into MRMT-1 rat breast carcinoma cells, and the MRMT-1 cells with different expression levels of EMMPRIN were implanted into the bone marrow cavity of rat tibia. Next, the effect of down-regulation of EMMPRIN was evaluated as follows: bone damage was detected by X-ray radiological and tartrate-resistant acid phosphatase staining; the tumor burden was evaluated by hematoxylin and eosin staining; the test of pain-related behaviors was assessed used the bilateral paw withdrawal mechanical threshold; and the levels of secretory factors in tumor conditioned medium were determined by using enzyme-linked immunosorbent assay. @*Results@#We found that down-regulation of EMMPRIN in tumor cells can simultaneously reduce tumor burden, relieve cancer-induced bone destruction and pain. @*Conclusion@# @*Materials and Methods@#EMMPRIN is expected to be a therapeutic target for relieving bone metastasis of breast cancer and alleviating cancerinduced bone destruction and pain. The method of targeting EMMPRIN may be a promising strategy for the treatment of cancer in the future.

Preparation and Quality Evaluation of Azelnidipine Enteric Solid Dispersion / 中国药房

OBJECTIVE：To prepare Azelnidipine enteric solid dispersion and evaluate its quality. METHODS ：Azelnidipine enteric solid dispersion was prepared by solvent method. Taking cumulative dissolution rate as the index ，single factor test was used to optimize carrier material type and its ratio. The quality of the product was evaluated by DSC ，XRD and FTIR ，and its stability was investigated. RESULTS ：After azelnidipine and carrier material of Eudragit L 100-55 acrylic resin were prepared to enteric solid dispersion at a ratio of 1∶5（m/m），its dissolution rate was significantly improved. DSC ，XRD and FTIR method had all verified the crystal form of azelnidipine changed and it existed in amorphous form. The results of stability test showed that Azelnidipine enteric solid dispersion was stable under high temperature （60 ℃），high humidity （75％）and strong light [ （4 500±500）lx] for 10 days. CONCLUSIONS ：Azelnidipine enteric solid dispersion by solvent method with Eudragit L 100-55 acrylic resin as carrier can eliminate the influence of crystal form ，improve dissolution and has good stability.

Analgesic effect of local anesthesia combined with nerve block anesthesia on golden micro-needles for improving facial aging / 中华医学美学美容杂志

Objective:To observe the analgesic effect of local anesthesia combined with nerve block anesthesia on golden microneedles for improving facial aging.Methods:Between December 2018 and December 2019 in Burn and Plastic Surgery of Nanchong Central Hospital, sixty female patients (between 30 and 58 years old, with an average of 45.2 years old) with natural facial skin aging were randomly divided into two groups: Group A: surface anesthesia group (30 cases); Group B: local anesthesia combined with nerve block anesthesia (30 cases). Intraoperative and postoperative pain scores, length of operation, and incidence of adverse reactions were compared between groups A and B.Results:Pain score during surgery was (6.90±0.96) points in Group A, (3.63±0.72) points in Group B. The difference between the two groups was statistically significant ( t=14.93, P<0.05); Pain score at 30 minutes after operation was (2.03±0.62) in Group A, (0.77±0.73) in Group B, the difference between the two groups was statistically significant ( t=7.28, P<0.05). There was no statistically significant difference between the two groups in the pain score at 24 hours after operation ( P>0.05); The operation process in group B was simplified, and the treatment time was significantly shortened. The difference between the two groups was statistically significant ( t=17.93, P<0.05). Conclusions:The method of local anesthesia combined with nerve block anesthesia is used in the treatment of gold microneedles to improve the analgesic effect in facial aging, which significantly shortens the treatment time and has fewer adverse reactions. This method is worth popularizing.

Effect of skull drilling combined with artificial dermis and vacuum sealing drainage in repairing scalp defect with skull exposure / 中华医学美学美容杂志

Objective:To investigate the therapeutic effect of skull drilling and/or grinding combined with artificial dermis and vacuum sealing drainage in repairing scalp defects with skull exposure.Methods:From October 2014 to May 2018, 18 patients with scalp defect and skull exposure were treated in the Department of Burn and Plastic Surgery, the Second Clinical College of North Sichuan Medical College, including 10 males and 8 females, with an average age of 64 years (range, 34-86 years). The patients were divided into two groups: group A (by drilling skull or/and grinding combined with artificial dermis cover and vacuum sealing drainage plus two split thickness skin graft repair) and group B (by drilling skull or/andgrinding combined with artificial dermis cover plus two covering leather grinding stage split thickness skin graft repair), 9 cases in each group. The head wound granulation tissue, postoperative complications, skin graft survival rate and wound healing time were compared between the two groups. Vancouver scar assessment scale (VSS) was used to evaluate the wound healing in the two groups.Results:The time of granulation cultivation in group A and group B was (16.44±1.42) days and (29.11±13.32) days, the difference was statistically significant ( P<0.05); The wound healing time of group A and group B was (26.00±3.32) days and (40.67±14.37) days, the difference was statistically significant ( P<0.05); The postoperative complications of group A and group B were 1 case and 5 cases respectively, the difference was statistically significant ( P<0.05). The skin graft survival rates of group A and group B were (97.11±3.44)% and (95.00±4.74)%, the difference was not statistically significant ( P>0.05); The wound scar VSS scores of group A and group B were (7.67±1.32) points and (8.78±1.99) points, the difference was not statistically significant ( P>0.05). Conclusions:By drilling skull and/or grinding combined with artificial dermis cover and vacuum sealing drainage and two stage split thickness skin graft for repairing scalp defect with skull exposure wound can not only better scalp defect with skull exposure wounds, and reduce the postoperative complications, and significantly accelerate wound healing, but also can effectively improve the quality of wound healing, which is worthy of clinical application.

Tissue-engineered cartilage nanoscaffolds prepared with collagen, hyaluronic acid and chondroitin sulfate / 中华医学美学美容杂志

Objective:To explore the possibility of constructing tissue-engineered cartilage three-dimensional nanoscaffolds with collagen Ⅱ (COLⅡ), hyaluronic acid (HA) and chondroitin sulfate (CS).Methods:The tissue-engineered cartilage scaffolds were prepared by electrospinning techniques with the mixture COLⅡ-HA-CS solvent, which dissolved by 3-trifluoroethanol-water. The surface topography was observed under electron microscope (SEM). And the diameter of nanofibers, the water absorption rate, contact angle and degradation rate were also detected. Generation 2 rabbit chondrocytes were seeded into the scaffold. The cell survival rate and proliferation were evaluated by Cell Counting Kit-8.Results:When the concentration range of electrospinning was 80-120 mg/ml and the mixing ratio of Col, HA and CS was 6-8∶1∶1-2, the tissue engineered cartilage nanoscaffolds could be successfully prepared. Their diameters were mainly distributed between 126.5±23.3 nm and 374.7±14.1 nm. The scaffolds had satisfactory hydrophilicity and degradability. The chondrocytes could well adhere and proliferate on the scaffold.Conclusions:The COLⅡ-HA-CS tissue-engineered cartilage nanoscaffolds have good physical and biological properties, which suggests its promising application in tissue-engineered cartilage.