Advances in Head-and-Neck Interventional Radiotherapy (Brachytherapy)

@#Interventional radiotherapy, also known as brachytherapy, is the use of sealed radioactive sources that directly deliver radiation to the tumor or tumor bed. Its unique dose distribution profile allows for high conformality, making it a very useful modality in the treatment of cancers in the head and neck, where different organs and substructures that serve various but related functions are situated close to each other. In recent years, we have seen several important technological breakthroughs in the field, especially regarding its application in head and neck cancers. These include advances in treatment delivery, dosimetry planning , image guidance , and catheter positioning techniques . These innovations, which often require interdisciplinary interventions, have resulted in enhanced treatment accuracy, and therefore, major clinical advantages in terms of increased local control and decreased toxicity, as well as economic benefits. In order to highlight the differences from old brachytherapy techniques, a more appropriate terminology should perhaps be adopted, to signify these advancements that resulted in new opportunities, approaches and better outcomes – interventional radiotherapy (IRT). Such a change in terminology will not only allow recognition of these advances, but also a meaningful distinction from obsolete techniques and suboptimal outcomes that are associated with traditional brachytherapy. This is very important in increasing awareness among professionals outside the field of radiation oncology. We briefly review these recent advances, the current indications, and future directions for IRT in head-and-neck cancers.

Early clinical outcomes of the domestic KokaclipTM transcatheter edge-to-edge mitral valve repair system for severe degenerative mitral regurgitation: A single-arm, prospective, single-group target value clinical trial / 中国胸心血管外科临床杂志

@#Objective To summarize and analyze the preliminary clinical outcomes of the KokaclipTM transcatheter edge-to-edge mitral valve repair system for severe degenerative mitral regurgitation (DMR). Methods This study was a single-arm, prospective, single-group target value clinical trial that enrolled patients who underwent the KokaclipTM transcatheter edge-to-edge repair (TEER) system for DMR in the Department of Heart Surgery of Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute from June 2022 to January 2023. Differences in the grade of mitral regurgitation (MR) during the perioperative and follow-up periods were compared, and the incidences of adverse events such as all-cause death, thoracotomy conversion, reoperation, and severe recurrence of MR during the study period were investigated. Results The enrolled patient population consisted of 14 (50.0%) females with a mean age of 70.9±5.4 years. Twenty-eight (100.0%) patients were preoperatively diagnosed with typeⅡ DMR, with a prolapse width of 12.5 (11.0, 16.1) mm, a degree of regurgitation 4+ leading to pulmonary venous reflux, and a New York Heart Association cardiac function class≥Ⅲ. All patients completed the TEER procedure successfully, with immediate postoperative improvement of MR to 0, 1+, and 2+ grade in 2 (7.1%), 21 (75.0%), and 5 (17.9%) patients, respectively. Mitral valve gradient was 2.5 (2.0, 3.0) mm Hg. Deaths, thoracotomy conversion, or device complications such as unileaflet clamping, clip dislodgement, or leaflet injury were negative. Twenty-eight (100.0%) patients completed at least 3-month postoperative follow-up with a median follow-up time of 5.9 (3.6, 6.8) months, during which patients had a mean MR grade of 1.0+ (1.0+, 2.0+) grade and a significant improvement from preoperative values (P<0.001). There was no recurrence of ≥3+ regurgitation, pulmonary venous reflux, reoperation, new-onset mitral stenosis, or major adverse cardiovascular events. Twenty-two (78.6%) patients’ cardiac function improved to classⅠorⅡ. Conclusion The domestic KokaclipTM TEER system has shown excellent preliminary clinical results in selected DMR patients with a high safety profile and significant improvement in MR. Additional large sample volume, prospective, multicenter studies, and long-term follow-up are expected to validate the effectiveness of this system in the future.

Diagnóstico del proceso de reafirmación profesional, en la carrera de Cultura Física, en Granma

La formación de profesionales, con elevada calidad, es tarea esencial de la Educación Superior, por lo que de manera permanente se demanda de graduados comprometidos con los procesos de desarrollo, donde quedan evidenciados los conocimientos, habilidades y valores en los que se han formado. El diagnóstico tuvo como objetivo caracterizar la situación de la orientación y reafirmación profesional (consolidación de los motivos e intenciones profesionales) en el proceso de estudio de la carrera Licenciatura en Cultura Física, en Granma; a partir de tres dimensiones: pedagógica, psicológica y sociológica. Se aplicaron métodos teóricos y empíricos que mostraron insuficiencias en las acciones planificadas en las estrategias educativas y en el plan de trabajo metodológico de las diferentes disciplinas, un limitado aprovechamiento de las potencialidades del contenido y las actividades extensionistas y bajos niveles de satisfacción por el estudio de la Carrera; lo que se manifestó en la no selección de una esfera de actuación para el futuro desempeño profesional, y en los elevados niveles de deserción de los estudiantes, en los dos primeros años de formación.

A formação de profissionais, com elevada qualidade, é uma tarefa essencial do Ensino Superior, razão pela qual existe uma procura permanente de licenciados comprometidos com processos de desenvolvimento, onde se evidenciam os conhecimentos, competências e valores em que foram formados. O objetivo do diagnóstico foi caracterizar a situação de orientação e reafirmação profissional (consolidação de motivos e intenções profissionais) no processo de estudo do Bacharelado em Cultura Física, no Granma; a partir de três dimensões: pedagógica, psicológica e sociológica. a corrida; o que se manifestou na não seleção de uma esfera de atuação para futura atuação profissional, e nos elevados índices de evasão estudantil, nos dois primeiros anos de formação.

The training of professionals, with high quality, is an essential task of Higher Education, which is why there is a permanent demand for graduates committed to development processes, where the knowledge, skills and values in which they have been trained are evidenced. The objective of the diagnosis was to characterize the situation of professional guidance and reaffirmation (consolidation of professional motives and intentions) in the process of studying the Bachelor's degree in Physical Culture, in Granma; from three dimensions: pedagogical, psychological and sociological. Theoretical and empirical methods were applied that showed insufficiencies in the planned actions in the educational strategies and in the methodological work plan of the different disciplines, a limited use of the potential of the content and extension activities and low levels of satisfaction with the study of the career; which was manifested in the non-selection of a sphere of action for future professional performance, and in the high levels of student dropout, in the first two years of training.

Relevancia de la orientación profesional

La importancia de la orientación profesional implica tomar en cuenta muchos elementos a nivel de procedimientos en las pruebas psicológicas para tener un resultado objetivo en la elección de la carrera profesional. El método de investigación es cuantitativo, de tipo descriptivo porque pretende analizar la relevancia del tema. El diseño es no experimental puesto que no se manipulo ninguna variable, con un carácter transversal, ya que la información se recolecto en un tiempo determinado. La población fue los cuatro paralelos (A - B - C - D) de sexto del nivel secundario, en un total de 128 estudiantes entre varones y mujeres. Se aplicaron las baterías de: Test de Aptitudes Diferenciales (DAT), test de inteligencia (RAVEN GENERAL), cuestionario de personalidad para adolescentes (H.S.P.Q) y la escala de preferencias vocacionales (KUDER forma "E"). Los resultados describen la falta de atención del estado para proponer programas de Orientación Profesional a todos los bachilleres a nivel nacional, y con la prueba experimental se demuestra la importancia de test con pruebas psicológicas, que permiten que los estudiantes puedan reconocer sus conocimientos y capacidades intelectuales para elegir una carrera acorde a sus probabilidades psicológicas, del entorno educativo y social, con el apoyo y participación de los profesores/as al brindar un espacio y tiempo determinado para los estudiantes de sexto de secundaria, y de los padres de familia para que puedan apoyar a sus hijos a realizarse en una profesión científica o técnica de acuerdo a su formación y conocimientos.

The importance of professional guidance implies taking into account many elements at the level of procedures in psychological tests to have an objective result in choosing a professional career. The research method is quantitative, of a descriptive type because it intends to analyze the relevance of the topic. The design is non-experimental since no variable was manipulated, with a transversal character, since the information was collected in a determined time. The population was the four parallels (A - B - C - D) of the sixth grade of the secondary level, in a total of 128 students between men and women. The batteries of: Differential Aptitudes Test (DAT), intelligence test (RAVEN GENERAL), personality questionnaire for adolescents (H.S.P.Q) and the scale of vocational preferences (KUDER form "E") were applied. The results describe the lack of attention of the state to propose Vocational Guidance programs to all high school graduates at the national level, and with the experimental test the importance of psychological tests is demonstrated, which allow students to recognize their knowledge and intellectual abilities. to choose a career according to their psychological probabilities, the educational and social environment, with the support and participation of teachers by providing a specific space and time for students in the sixth grade of secondary school, and of parents so that they can support their their children to perform in a scientific or technical profession according to their training and knowledge.

A importância da orientação profissional implica ter em conta muitos elementos ao nível dos procedimentos em testes psicológicos para ter um resultado objetivo na escolha de uma carreira profissional. O método de pesquisa é quantitativo, do tipo descritivo, pois pretende analisar a relevância do tema. O delineamento é não experimental já que nenhuma variável foi manipulada, com caráter transversal, já que as informações foram coletadas em um tempo determinado. A população foram os quatro paralelos (A - B - C - D) da sexta série do ensino médio, em um total de 128 alunos entre homens e mulheres. Foram aplicadas as baterias de: Teste Diferencial de Aptidões (DAT), teste de inteligência (RAVEN GENERAL), questionário de personalidade para adolescentes (H.S.P.Q) e escala de preferências vocacionais (KUDER forma "E"). Os resultados descrevem a falta de atenção do estado em propor programas de Orientação Profissional a todos os egressos do ensino médio em nível nacional, e com o teste experimental é demonstrada a importância dos testes psicológicos, que permitem aos alunos reconhecer seus conhecimentos e habilidades intelectuais. escolher uma carreira de acordo com suas probabilidades psicológicas, o ambiente educacional e social, com o apoio e participação dos professores ao fornecer um espaço e tempo específico para os alunos da sexta série do ensino médio e dos pais para que eles possam apoiar seus filhos exercer uma profissão científica ou técnica de acordo com a sua formação e conhecimentos.

Career Adapt-Abilities Scale (CAAS-Brasil): propriedades psicométricas, diferenças em função de variáveis sociodemográficas e padrões normativos / Career Adapt-Abilities Scale (CAAS-Brazil): psychometric properties, differences as a function of sociodemographic variables and normative standards / Career Adapt-Abilities Scale (CAAS-Brasil): propiedades psicométricas, diferencias en función de variables sociodemográficas y estándares normativos

O objetivo deste artigo foi propor padrões normativos para a Career Adapt-Abilities Scale (CAAS-Brasil) considerando diferenças em função das variáveis sociodemográficas: sexo, estado civil, faixa etária, escolaridade e faixa de rendimento. A amostra foi composta por 2.999 indivíduos, idades variando de 14 a 77 anos, maioria do sexo feminino (63%) e representantes de 21 estados brasileiros. As propriedades psicométricas da CAAS-Brasil foram investigadas por meio de Teoria de Resposta ao Item e coeficiente ômega. Os resultados evidenciaram invariância para a CAAS-Brasil e maiores diferenças de médias nas variáveis faixa etária, escolaridade e faixa de rendimento. A partir disso, foram apresentados padrões normativos para a amostra geral e dividida, considerando as variáveis que apresentaram diferenças. Os padrões normativos apresentados neste artigo possibilitarão que profissionais de orientação profissional e de carreira interpretem, com base em normas, os escores de adaptabilidade de carreira de seus orientandos, tornando a avaliação mais substantiva. (AU)

This article aimed to propose normative standards for the Career Adapt-Abilities Scale (CAAS-Brazil) considering differences in terms of sociodemographic variables: gender, marital status, age group, education level, and income. The sample consisted of 2999 individuals, within the age range of 14 to 77 years, mostly women (63%) from 21 Brazilian states. The psychometric properties of CAAS-Brazil were investigated using Item Response Theory and the Omega coefficient. Results showed invariance for the CAAS-Brazil and greater mean differences in the variables age group, education, and income. From this, normative standards for the overall sample were presented and divided considering the variables that showed differences. The normative standards presented in this article will enable career guidance professionals to interpret the career adaptability scores of their students, making the assessment more robust. (AU)

El objetivo de este artículo fue proponer estándares normativos para la Career Adapt-Abilities Scale (CAAS-Brasil) considerando diferencias en términos de variables sociodemográficas: género, estado civil, grupo de edad, escolaridad y rango de ingresos. La muestra estuvo constituida por 2.999 individuos, con edades comprendidas entre 14 y 77 años, en su mayoría mujeres (63%) y representantes de 21 estados brasileños. Las propiedades psicométricas de CAAS-Brasil se investigaron mediante la Teoría de Respuesta al Ítem y el coeficiente Omega. Los resultados mostraron invarianza para el CAAS-Brasil y mayores diferencias de medias en las variables edad, escolaridad e ingresos. A partir de esto, se presentaron estándares normativos para la muestra general y se dividieron considerando las variables que manifestaron diferencias. Los estándares normativos presentados en este artículo permitirán a los profesionales de la orientación profesional interpretar y la orientación interpretar, basándose en normas, las puntuaciones de adaptabilidad profesional de sus alumnos, haciendo que la evaluación sea más sustantiva. (AU)

Oclusión basada en evidencia: rompiendo paradigmas / Occlusion based on evidence: breaking paradigms

La odontología basada en evidencias es una metodología que busca que las decisiones clínicas diarias que toman los profesionales en estomatología se encuentren fundamentadas en la evidencia científica, en ella se integran las experiencias clínicas, las necesidades, las preferencias del paciente y la evidencia clínicamente relevante más actual analizada por pares. Estos pilares son parte del proceso en la toma de decisiones para la atención al paciente. La odontología basada en evidencias surge de las exitosas experiencias obtenidas con el desarrollo e implementación de la medicina fundamentada en pruebas, al aplicar el método científico en la evaluación, planificación y toma de decisiones de las prestaciones sanitarias, sobre todo a través de los estudios controlados. En general, toda la práctica odontológica ha tenido grandes avances basados en evidencias, con hechos verídicos comprobados, pero los conceptos fundamentales de oclusión no han tenido una mejora cimentada en el conocimiento científico, prueba de ello es que se siguen ocupando teorías y conceptos de las filosofías de oclusión en la rehabilitación de muchos pacientes, seguimos creyendo en mitos y sofismas que no han podido ser demostrados. En esta revisión, demostramos los grandes avances en los conceptos de oclusión e invitamos a todos los odontólogos a romper los paradigmas de la oclusión antigua sin evidencias científicas y a utilizar las herramientas del método científico en la práctica clínica odontológica (AU)

Evidence-based dentistry is a strategy that seeks to ensure that the daily clinical decisions made by the dental professional are based on scientific evidence. It integrates the clinical experience of the dentist, the needs and preferences of the patient, and the most current relevant clinical evidence. All three are part of the decision-making process for patient care. Evidence-based dentistry arises from the successful experiences obtained with the development and implementation of evidence-based medicine, applying the scientific method in the evaluation, planning and decision-making of health benefits, especially through controlled studies. In general, all dental practice has had great advances based on evidence, with proven true facts, but the fundamental concepts of occlusion have not had an improvement based on scientific knowledge, proof of this is that theories and concepts continue to be used. of the philosophies of occlusion in patient rehabilitation, we follow myths and sophisms that have not been demonstrated, in this review, we demonstrate the great advances in the concepts of occlusion and we know all dentists to break the paradigms of the old occlusion without scientific evidence (AU)

Does premature birth affect Brazilian parents' practices related to infant positioning? / A prematuridade afeta as práticas maternas brasileiras relacionadas ao posicionamento de lactentes?

Abstract Objective: To verify whether the time spent in prone, supine, or seated positions differed between term and preterm infants; and to determine whether a single verbal guidance session for parents changed the time spent in different positions, and, consequently, the motor development scores, after one month in preterm infants. Methods: Sixty-one infants from a full-term and preterm group from Brazil were included. Motor development was assessed by the Alberta Infant Motor Scale (AIMS) and the parents registered the time spent in each position on a 24-hour schedule. A month after verbal guidance, a second assessment was performed only on the preterm infants. Results: The positioning times awake determined for the full-term and preterm parents were similar. Preterm infants spent more time in the prone sleeping position (2.1 vs. 0.8 h; p=0.037) than full-term infants. The AIMS percentile scores did not differ significantly between the groups. For preterm infants, the time spent in all positions did not change during the second assessment (n=18). Conclusions: The fact that some parents position their infants in the prone posture during sleeping periods reinforce the importance of parental education approaches for sudden infant death syndrome (SIDS) prevention during the first months of life. The verbal guidance provided to parents of preterm infants did not influence the AIMS percentile and time spent in various positions but increased preterm parents' confidence in placing their infants in a prone position to play.

RESUMO Objetivo: Verificar se o tempo nas posições prono, supino ou sentado difere entre lactentes a termo e pré-termo; bem como determinar se uma única sessão de orientação verbal aos pais alterou o tempo despendido nas diferentes posições e, consequentemente, o escore de desenvolvimento motor, após um mês em lactentes pré-termo. Métodos: Foram incluídos 61 lactentes brasileiros nos grupos a termo e pré-termo. O desenvolvimento motor foi avaliado pela Alberta Infant Motor Scale (AIMS), e os pais registraram o tempo despendido em cada posição em uma linha do tempo de 24 horas. Um mês após a orientação verbal, uma segunda avaliação foi realizada apenas nos lactentes pré-termo. Resultados: O tempo de posicionamento acordado determinado pelos pais de lactentes a termo e pré-termo foi semelhante. Os lactentes pré-termo passaram mais tempo dormindo na posição prona (2,2 vs. 0,8 h; p=0,037) do que os lactentes a termo. Os escores de percentil AIMS não diferiram significativamente entre os grupos. Para lactentes pré-termo, o tempo despendido em todas as posições não se modificou durante a segunda avaliação (n=18). Conclusões: O fato de alguns pais posicionarem os lactentes em decúbito ventral durante os períodos de sono reforça a importância das abordagens educativas parentais para a prevenção da síndrome da morte súbita do lactente (SMSL) durante os primeiros meses de vida. A orientação verbal fornecida aos pais de prematuros não influenciou o percentil da AIMS e o tempo de permanência em várias posições, mas aumentou a confiança dos pais de lactentes prematuros em utilizar a posição prona para brincar.

Importância do estudo das construções de carreira de adultos(as) emergentes no pós-pandemia: revisão narrativa e agenda de pesquisa para a orientação profissional e de carreira / Reasons for studying the career constructions of emerging adults in the post-pandemic: narrative review and a research agenda for career guidance and counseling

A crise gerada pela pandemia da covid-19 vem impactando o mundo do trabalho e os(as) adultos(as) emergentes estão se configurando como um dos grupos que será mais afetado no pós-pandemia, pois irão reconstruir esse mundo e ditar as tendências para seu futuro. Assim, este artigo propôs uma revisão narrativa que legitimasse a importância do estudo das construções de carreira de adultos(as) emergentes no pós-pandemia e as potenciais implicações para a orientação profissional e de carreira (OPC). Para tal, identificou o cenário para potenciais agendas de pesquisa pós-pandemia no campo de estudos do trabalho e sistematizou o estado da arte de estudos sobre construção da carreira de adultos(as) emergentes no Brasil, as lacunas de pesquisas e intervenções em OPC e os principais impactos gerados pela pandemia, destacando os impactos específicos para os(as) adultos(as) emergentes. Todas essas sistematizações apontaram a necessidade de estudar a vida de trabalho desse grupo, que se encontra sub-representado nos estudos de trabalho em geral, com destaque para o campo da OPC, e que, potencialmente, deve sofrer consequências significativas e relevantes no pós-pandemia

The crisis generated by the COVID-19 pandemic has been impacting the working world, and emerging adults are shaping up to be one of the groups that will be most affected post-pandemic, since they will reconstruct this world and dictate trends for the future. Thus, this article proposed a narrative review for legitimizing the importance of studying emerging adult career constructions in the post-pandemic and the potential implications for career guidance and counseling (CGC). To this end, the article identified the scenario for potential post-pandemic research agendas of the working studies field and systematized the state of the art of studies on career construction of emerging adults in Brazil, the gaps in research and interventions in CGC, and the main impacts generated by the pandemic, highlighting the specific impacts for emerging adults. All these systematizations stressed the need to study the working lives of this group, which is under-represented in working studies in general, mainly in the CGC field, and which, potentially may suffer significant and relevant consequences in the post-pandemic

Expression and effect of roundabout guidance receptor 1 during valproate induced neural stem cells differentiation / 解剖学报

Objective To investigate the expression and role of roundabout guidance receptor 1 (Robo1) in the neuronal differentiation of neural stem cells (NSCs) induced by valproate (VPA). Methods The hippocampus NSCs of SD rats were isolated and cultured. Normal NSCs and VPA-treated NSCs were extracted from 10 SD rats. After VPA treatment, the proportion of neuron-specific marker β-tubulin III (Tuj1) positive neurons differentiated from NSCs were detected by immunofluorescence. The differentially expressed mRNA in normal NSCs and VPA-induced NSCs were detected by gene chip technology. After VPA treatment, the expression levels of Robo1 mRNA and protein were detected by Real-time PCR and Western blotting. The dynamic changes of Robo1 mRNA were detected by Real-time PCR after the differentiation of NSCs. After the expression of Robo1 was down-regulated in NSCs by small interfering RNA, the expression of Robo1 protein was detected by Western blotting, and the expression levels of neuron-specific markers Tuj1 and microtubule associated protein-2 (MAP-2) were detected by Real-time PCR and immunofluorescence. Results VPA induced NSCs to differentiate into neurons. Compared with the control group, the expression levels of Robo1 mRNA and protein in the differentiation of NSCs were significantly up-regulated during valproate treatment. After interference of Robo1 expression, not only Robo1 upregulation was inhibited during the differentiation of NSCs induced by VPA, but also the proportion of NSCs differentiated into neurons decreased. Conclusion VPA may promote the differentiation of NSCs into neurons by up-regulating the expression of Robo1.

Bispecific antibodies in cancer therapy: Target selection and regulatory requirements

In recent years, the development of bispecific antibodies (bsAbs) has been rapid, with many new structures and target combinations being created. The boom in bsAbs has led to the successive issuance of industry guidance for their development in the US and China. However, there is a high degree of similarity in target selection, which could affect the development of diversity in bsAbs. This review presents a classification of various bsAbs for cancer therapy based on structure and target selection and examines the advantages of bsAbs over monoclonal antibodies (mAbs). Through database research, we have identified the preferences of available bsAbs combinations, suggesting rational target selection options and warning of potential wastage of medical resources. We have also compared the US and Chinese guidelines for bsAbs in order to provide a reference for their development.

Application and research progress of ultrasound in acupuncture treatment / 中国针灸

The operation standardization, quantitative standard and safety of acupuncture treatment are important links in the development of acupuncture modernization. In recent years, with the continuous development of ultrasonic imaging technology, ultrasonic medicine has the characteristics of visualization, quantitative analysis and real-time dynamics, which could play a unique role in acupuncture treatment. In this paper, the research progress of the combined application of ultrasonic medicine and acupuncture treatment is described from three aspects: ultrasound guidance helping to standardize acupuncture operation, ultrasound guidance helping to improve and evaluate the clinical efficacy of acupuncture, and ultrasound guidance helping to improve the safety of acupuncture, aiming to providing new ideas for the application of modern medicine in traditional medicine.

Construction of nutrition health educational guidance outline for primary and secondary school students in Shanghai / 中国学校卫生

Objective@#Develop a nutrition health educational guidance outline for primary and secondary school students which is adapted to the characteristics of Shanghai and meets the cognitive level of students at different levels, so as to provide a reference for planning the content and target of nutrition health education among students of different school stages.@*Methods@#Through literature search and qualitative interviews, the framework of nutrition health education for primary and secondary school students in Shanghai was developed, and 21 experts in the fields of nutrition, school health and health education were invitied to conduct a Delphi consultation, and determined the content of nutrition and health education for students in each school section based on the consultation results.@*Results@#The recall rate for both rounds of consultation was 100%, the degree of expert authority was 0.74 and 0.89 , and the coordination coefficients were 0.31 and 0.33( P <0.01), suggesting high credibility of expert opinion. The resulting guidance outline included 2 first level entries, 6 second level entries, 60 third level entries and corresponding entry explanations. The 2 first level entries were rational nutrition and food safety; the 6 second level entries were food and nutrients, balanced diet, good eating habits, nutritional practices, good hygiene habits and food borne diseases; the 60 third level entries needed to be studied in Level 1 were 24, Level 2 were 41, Level 3 were 55, and Level 4 were 59.@*Conclusion@#The nutrition health educational guidance outline for primary and secondary school students in Shanghai developed in this study focuses on key nutrition knowledge, rational dietary behaviors and nutrition practice skills, which can provide a reference and basis for the phased implementation of nutrition health education in primary and secondary schools.

Advances in the raw material selection and functional design of artificial nerve guidance conduits / 生物工程学报

Artificial nerve guidance conduits (NGCs) are synthetic nerve grafts that are capable of providing the structural and nutritional support for nerve regeneration. The ideal NGCs have plenty of requirements on biocompatibility, mechanical strength, topological structure, and conductivity. Therefore, it is necessary to continuously improve the design of NGCs and establish a better therapeutic strategy for peripheral nerve injury in order to meet clinical needs. Although current NGCs have made certain process in the treatment of peripheral nerve injury, their nerve regeneration and functional outcomes on repairing long-distance nerve injury remain unsatisfactory. Herein, we review the nerve conduit design from four aspects, namely raw material selection, structural design, therapeutic factor loading and self-powered component integration. Moreover, we summarize the research progress of NGCs in the treatment of peripheral nerve injury, in order to facilitate the iterative updating and clinical transformation of NGCs.

The introduction to and inspiration from FDA Guidance: alternative procedures for the manufacture of cold-stored platelets intended for the treatment of active bleeding when conventional platelets are not available or their use is not practical / 中国输血杂志

U.S. Food and Drug Administration recently issued a guidance on alternative procedures for the manufacture of cold-stored platelets intended for the treatment of active bleeding when conventional platelets are not available or their use is not practical. It was allowed to use platelets stored at 1 ℃ to 6 ℃, with a storage period of up to 14 days from the date of collection.The validation and quality monitoring of platelet manufacture retained pH items testing at the end of the storage, and platelet count and actual plasma volume testing items were not required. The guidance provided the recommendations and considerations for the manufacture, labeling, storage, transportation, bacterial contamination control, process validation, and quality monitoring sampling of cold-stored platelets, as well as the further research needs for its efficacy, particularly when conventional platelets are available and their use is practical. The scientific and regulatory considerations on cold-stored platelets in the guidance would be informative and instructive to the development of blood regulation and standards related with urgent transfusion in China.

Discussion on the Pathogenesis and Treatment of Sjögren's Syndrome Based on YE Gui's Theory of “Upper Dryness Treats Qi and Lower Dryness Treats Blood” / 中医杂志

The pathogenesis of Sjögren's syndrome （SS） was considered to involve external dryness， internal injured essence and blood， yin-deficiency endowment， and abnormal emotion and spirit， and it was believed that SS has the characteristics of dryness and impassability， and the pathogenesis of deficiency-excess in complexity. According to the theory “upper dryness treats qi， and lower dryness treats blood” in YE Gui's monograph “Medical Records for Clinical Guidance”， the dryness was divided into upper dryness and lower dryness syndromes to be differentiated and treated. When treating dryness syndrome， the patient should follow the characteristics of the five zang organs， using soft and cool medicines， avoiding warm and dry medicines， and valuing the animal products. The upper dryness could be treated with Sangxiang Decoction （桑杏汤） to clear the qi and moisten the dryness， Qiaohe Decoction （翘荷汤） to clear the upper with pungent-cool， and Shashen Maidong Decoction （沙参麦冬汤） to nourish yin and promote the production of body fluid. The lower dryness could be treated with Fumai Decoction （复脉汤） to enrich and nourish the five kinds of fluid. Liuwei Dihuang Pill （六味地黄丸） to nourish the kidneys and supplement essence， and Wuren Pill （五仁丸） to moisten the dryness and nourish the blood， which provided a new way of thinking for differentiation of the dryness syndrome.

Interpretation of guidance on non-clinical safety evaluation for nanomedicines / 药学学报

With the rapid development of nanotechnology, the research and development of nanomedicines have become one of the development directions of drug innovation. Nanomedicines have special physical and chemical properties, such as nanoscale effects and nanostructure effects, so they have special biological properties, which may change the pharmacokinetic profiles such as absorption and tissue distribution of drug molecules, and thus affect their safety and effectiveness. There are many special concerns on the non-clinical safety evaluation of nanomedicines at the basis of ordinary drug because of the particularity of nanomedicines. On August 25, 2021, China issued Guidance on Non-clinical Safety Evaluation for Nanomedicines(interim). This article interprets comprehensively the guidance, focuses on the key points of non-clinical safety evaluation for nanomedicines, and expounds combined with some cases, aiming to provide reference for drug researchers.

Neuronal guidance genes in health and diseases

Neurons migrate from their birthplaces to the destinations, and extending axons navigate to their synaptic targets by sensing various extracellular cues in spatiotemporally controlled manners. These evolutionally conserved guidance cues and their receptors regulate multiple aspects of neural development to establish the highly complex nervous system by mediating both short- and long-range cell-cell communications. Neuronal guidance genes (encoding cues, receptors, or downstream signal transducers) are critical not only for development of the nervous system but also for synaptic maintenance, remodeling, and function in the adult brain. One emerging theme is the combinatorial and complementary functions of relatively limited classes of neuronal guidance genes in multiple processes, including neuronal migration, axonal guidance, synaptogenesis, and circuit formation. Importantly, neuronal guidance genes also regulate cell migration and cell-cell communications outside the nervous system. We are just beginning to understand how cells integrate multiple guidance and adhesion signaling inputs to determine overall cellular/subcellular behavior and how aberrant guidance signaling in various cell types contributes to diverse human diseases, ranging from developmental, neuropsychiatric, and neurodegenerative disorders to cancer metastasis. We review classic studies and recent advances in understanding signaling mechanisms of the guidance genes as well as their roles in human diseases. Furthermore, we discuss the remaining challenges and therapeutic potentials of modulating neuronal guidance pathways in neural repair.

The feasibility and safety of ultrasound-guided needle-perc assisted retrograde intrarenal surgery in the treatment of small but complex renal calculi / 中华泌尿外科杂志

Objective:To analyze the safety and efficacy of ultrasound-guided needle-perc assisted retrograde intrarenal surgery (RIRS) in the treatment of small but complex renal calculi, and summarize our clinical experience.Methods:The clinical data of 36 patients with small but complicated renal stones treated by ultrasound-guided needle-perc assisted RIRS in Beijing Tsinghua Changgung Hospital from January 2020 to April 2022, were retrospectively analyzed. There were 25 males and 11 females. The average age was (54.7±6.1) years, and the body mass index (BMI) was (26.3±3.1) kg/m 2. The maximum diameter of the calculi was (1.8±0.7) cm. There were 28 patients without renal hydronephrosis before operation, 8 patients with mild to moderate renal hydronephrosis, 4 patients with caliceal diverticular stones, 32 patients with lower pole stones, 10 patients with ureteral stones, 6 patients with previous surgical history of ipsilateral kidney stones, and 3 patients with stones in the solitary kidneys. Patients were placed in oblique supine lithotomy position or prone split leg position (female). For lower pole stones or diverticular stones that were difficult to be handled by flexible ureteroscope, the needle-perc was used to puncture the stones in target calyx under ultrasound guidance. Holmium laser was then used to pulverize or fragment the calculi, and the flexible ureteroscope was used to remove or further pulverize the stone fragments. Perioperative indexes and postoperative complications were recorded, and stone-free rate was analyzed. Results:All 36 cases were successfully operated. The median operation time was 61.5(59.0, 66.8)min, with a median decrease in hemoglobin on the first postoperative day of 1.6(0.8, 2.0)g/ L, a median postoperative hospital stay of 1.5(1.0, 2.0)days, and a median needle-perc tract of 1(1, 2). The complications were recorded in 4 patients (11.1%), all of which were Clavien-Dindo grade I, including postoperative fever in 2 patients and analgesic use in 2 patients. The primary stone-free rate was 83.3% (30/36). The 6 patients with residual stones were treated by external physical vibration lithecbole on the 3rd to 7th day after surgery. After 1 month follow-up, residual stone expulsion were seen in 3 patients. Three patients with residual stones were followed up regularly. The final stone-free rate was 91.7% (33/36).Conclusions:Ultrasound-guided needle-per assisted RIRS is safe and effective in the treatment of small but complex renal calculi, with high postoperative stone free rate and low complication rate.

Intraoperative contrast-enhanced ultrasound guided surgery for isoechoic completely endogenous renal tumor: a case report / 中华泌尿外科杂志

Intraoperative ultrasound assisted localization is routinely used in the surgical treatment of completely endogenous renal cell tumor, however the localization and guidance ability of conventional ultrasound will decline to a certain extent for isoechoic renal tumor. A 62 years old female patient with right renal tumor was reported. The tumor diameter was about 2.3 cm× 1.7 cm, equivalent to the isoechoic of kidney. Laparoscopic partial nephrectomy was performed under the real-time guidance of contrast-enhanced ultrasound. The tumor was found to be lack of blood supply during the operation, and the tumor contour was clearly developed by contrast agent.The operation was successfully completed, and the pathological diagnosis was polycystic renal tumor with low malignant potential.The incisional margin was negative.The patient recovered well after operation without complications.No recurrence or metastasis was found after 6 months of follow-up.The renal function was good.

3D-PCT-assisted CT-guided radioactive particle implantation precision / 中华放射医学与防护杂志

Objective:To study the precision of 3D printing coplanar template (3D-PCT) assisted CT-guided radioactive particle implantation using two types of phantoms, and compare the differences between the phantoms, in order to provide reference for radioactive particle implantation.Methods:The needle inserting path was designed in the brachytherapy treatment planning system (BTPS) and the needle tip coordinates were obtained. Following the needle inserting path, the implant needles were inserted into the custom and the liver phantoms, respectively. Then gold markers were implanted through the needles. Subsequently, the needles were withdrawn by 10 mm, and the cold sources were implanted. The coordinates of needle tips, gold markers, and cold sources were recorded. The precision of implanted needles, first particles, and particles after needle withdrawal were obtained by calculating the distance between two points in the space. Finally, the differences between the two phantoms were compared through independent samples t-test. Results:In the 3D-PCT-assisted CT-guided radioactive particle implantation, the precision of implanted needles, first particles, and particles after needle withdrawal in the custom and the liver phantoms was (1.89±0.72) and (2.14±0.88 ) mm ( P>0.05), (2.03±1.14) and (2.42±1.12) mm ( P>0.05), and (-1.96±1.29) and (-2.82±0.91) mm ( t=2.09, P=0.046), respectively. Conclusions:The 3D-PCT-assisted CT-guided radioactive particle implantation is efficient, stable, and precise, showing slight precision differences between the two phantoms.