Tuina alleviates neuropathic pain through regulate the activation of microglia and the secretion of inflammatory cytokine in spinal cord.

OBJECTIVE: To observe the analgesic effects of Tuina on neuropathic pain (NPP) and the underlying mechanisms. METHODS: Forty-eight Sprague-Dawley (SD) rats were assigned by random into three treatment groups: sham, chronic constriction injury (CCI), and Tuina. Each group contained sixteen rats. CCI model was generated by ligating the right sciatic nerve. Behavioral changes of CCI were assessed by the paw withdrawal threshold (PWT) and paw withdrawal latency (PWL). In addition, biochemical techniques such as immunofluorescence staining, enzyme-linked immunosorbent assay (ELISA) and Western blotting were used to profile levels of microglia activation and inflammatory factors in the spinal dorsal horn (SDH) of rats. Tuina (clockwise pressing and rubbing) was performed at Chengshan (BL57) to observe the analgesic effects on CCI rats and the underlying mechanisms. RESULTS: Rats with CCI experienced significant reduction in the PWT and PWL of the right hind paw relative to CCI group at day 3. Tuina treatment rescued this situation significantly on days 10 and 14. Besides, Iba-1, microglia M1 receptor CD68, tumor necrosis factor-α (TNF-α), and interleukin-1ß (IL-1ß) were higher in the right SDH for CCI group compared to the sham group on day 14. As expected, Tuina partially downregulated the CCI-induced overexpressed Iba-1, CD68, TNF-α, and IL-1ß in the SDH of CCI model. CONCLUSION: Tuina induces a time-dependent cumulative analgesic effect in CCI rats by inhibiting the activation of microglia and the secretion of IL-1ß and TNF-α in SDH.

Evaluation of corpus callosum absence and intracranial accompanying abnormalities via prenatal MRI / 实用放射学杂志

Objective To evaluate the absence of corpus callosum(ACC)and intracranial accompanying abnormalities in fetus via prenatal MRI.Methods A total of 61 cases of fetal ACC diagnosed by prenatal MRI were analyzed retrospectively.The types and numbers of intracranial accompanying abnormalities were observed,and the probability of accompanying abnormalities was counted.According to whether the corpus callosum was completely absent,all cases were divided into complete ACC and partial ACC.Statistical differences of probability of accompanying abnormalities between the two groups were analyzed.Results A total of 54.1%(33/61)patients were complicated with other intracranial abnormalities,among which the most common was cerebral cortical dysplasia,accounting for 26.2%(16/61).The probability of complete ACC and partial ACC complicated with other intracranial abnormalities was 63.4%(26/41)and 35.0%(7/20),respectively,and there was statistical difference in intracranial abnormalities between complete ACC and partial ACC(χ2=4.37,P=0.037).The probability of complete ACC and partial ACC complicated with cerebral cortical dysplasia was 39.0%(16/41)and 5.0%(1/20),respectively,and there was statistical difference in cerebral cortical dysplasia between complete ACC and partial ACC(χ2=7.74,P=0.005).Conclusion MRI can accurately diagnose the fetal ACC and intracranial accompanying abnormalities.Complex ACC is more common than isolated ACC.Compared with partial ACC,complete ACC is more likely to be complicated with other intracranial abnormalities,and cerebral cortical dysplasia is the most common,which provides reliable diagnostic basis for fetal prognosis in clinical practice.

Analysis on Ethical Issues in Off-label Use of Antitumor Drugs / 中国医学伦理学

The phenomenon of off-label use of antitumor drugs in the treatment of malignant tumors is relatively common. Although it is conducive to the development of clinical medical practice, but it is still necessary to pay attention to ethical issues such as medication risks and inadequate implementation of informed consent. Therefore, to effectively avoid ethical risks and standardize the rational use of off-label antitumor drugs, this paper proposed that pharmacists should actively participate in the process of off-label use of antitumor drugs, improve the evidence level of evidence-based medicine, implement patients’ right to informed consent, and improve the hospital’s supervision system of off-label drug use, so as to ensure the reasonable and legal use of drugs by patients.

Analysis on Kinematic Characteristics of Patients with Lumbar Disc Herniation During Sitting and Standing / 医用生物力学

Objective To study changes in kinematics and joint coordination of the waist and hips during sit-to-stand and stand-to-sit tasks in patients with lumbar disc herniation (LDH). Methods The Vicon 3D motion capture system was used to collect the kinematics data from 20 healthy controls and 20 LDH subjects, and differences in movement patterns of the lumbar spine and hip joints during sitting and standing tasks were compared between two groups through statistical parametric mapping (SPM). Results During sit-to-stand task, the lumbar spine flexion and extension range and hip joint abduction angle of LDH subjects were significantly limited, and the hip flexion angle increased. SPM analysis showed that for both groups at initial stage of sit-to-stand (10%-13%), there was a statistically significant difference in flexion angle of the lumbar spine, and lumbar flexion angle of LDH subjects was significantly reduced, while hip flexion angle at 2%-14% phase was significantly increased. During stand-to-sit phase (65%-69%), LDH subjects showed increased hip abduction angle. Conclusions LDH subjects have limited lumbar flexion and hip abduction functions during sitting and standing, and they need to be compensated with increased hip flexion activities to complete functional tasks. In clinical evaluation, changes in motor function of the spine and hips should be focused on.

Effects of medical resource capacities and intensities of public mitigation measures on outcomes of COVID-19 outbreaks

The COVID-19 pandemic is complex and is developing in different ways according to the country involved. To identify the key parameters or processes that have the greatest effects on the pandemic and reveal the different progressions of epidemics in different countries, we quantified enhanced control measures and the dynamics of the production and provision of medical resources. We then nested these within a COVID-19 epidemic transmission model, which is parameterized by multi-source data. We obtained rate functions related to the intensity of mitigation measures, the effective reproduction numbers and the timings and durations of runs on medical resources, given differing control measures implemented in various countries. Increased detection rates may induce runs on medical resources and prolong their durations, depending on resource availability. Nevertheless, improving the detection rate can effectively and rapidly reduce the mortality rate, even after runs on medical resources. Combinations of multiple prevention and control strategies and timely improvement of abilities to supplement medical resources are key to effective control of the COVID-19 epidemic. A 50% reduction in comprehensive control measures would have led to the cumulative numbers of confirmed cases and deaths exceeding 590000 and 60000, respectively, by 27 March 2020 in mainland China. The proposed model can assist health authorities to predict when they will be most in need of hospital beds and equipment such as ventilators, personal protection equipment, drugs and staff. One sentence summaryMultiple data sources and cross validation of a COVID-19 epidemic model, coupled with a medical resource logistic model, reveal that the key factors that affect epidemic progressions and their outbreak patterns in different countries are the type of emergency medical response to avoid runs on medical resources, especially improved detection rates, the ability to promote public health measures, and the synergistic effects of combinations of multiple prevention and control strategies.

Progress in the diagnosis and treatment of croup / 国际儿科学杂志

The croup is a common disease of upper airway obstruction in children, with high incidence rate.In severe case, it is life-threatening.Because there is no guidelines or consensus on diagnosis and treatment in China, the evidence-based research on Chinese children′s croup is also seriously lacking.Therefore, the article mainly reviews the recent research progress of croup abroad.

Progress in the diagnosis and treatment of croup / 国际儿科学杂志

The croup is a common disease of upper airway obstruction in children,with high incidence rate.In severe case,it is life-threatening.Because there is no guidelines or consensus on diagnosis and treatment in China,the evidence-based research on Chinese children's croup is also seriously lacking.Therefore,the article mainly reviews the recent research progress of croup abroad.

Ultrafast Synthetic Transmit Aperture Imaging Using Hadamard-Encoded Virtual Sources With Overlapping Sub-Apertures.

The development of ultrafast ultrasound imaging offers great opportunities to improve imaging technologies, such as shear wave elastography and ultrafast Doppler imaging. In ultrafast imaging, there are tradeoffs among image signal-to-noise ratio (SNR), resolution, and post-compounded frame rate. Various approaches have been proposed to solve this tradeoff, such as multiplane wave imaging or the attempts of implementing synthetic transmit aperture imaging. In this paper, we propose an ultrafast synthetic transmit aperture (USTA) imaging technique using Hadamard-encoded virtual sources with overlapping sub-apertures to enhance both image SNR and resolution without sacrificing frame rate. This method includes three steps: 1) create virtual sources using sub-apertures; 2) encode virtual sources using Hadamard matrix; and 3) add short time intervals (a few microseconds) between transmissions of different virtual sources to allow overlapping sub-apertures. The USTA was tested experimentally with a point target, a B-mode phantom, and in vivo human kidney micro-vessel imaging. Compared with standard coherent diverging wave compounding with the same frame rate, improvements on image SNR, lateral resolution (+33%, with B-mode phantom imaging), and contrast ratio (+3.8 dB, with in vivo human kidney micro-vessel imaging) have been achieved. The f-number of virtual sources, the number of virtual sources used, and the number of elements used in each sub-aperture can be flexibly adjusted to enhance resolution and SNR. This allows very flexible optimization of USTA for different applications.

Repeated magnetic stimulation improves the effectiveness of exercise therapy in relieving ankle spasticity after stroke / 中华物理医学与康复杂志

Objective To study the effect of repetitive peripheral magnetic stimulation combined with exercise on spasticity in the ankle plantar flexors among stroke survivors.Methods Sixty stroke survivors with spasticity in their ankle plantar flexors were randomly divided into a treatment group and a control group,each of 30.Both groups were given conventional kinesitherapy,while the treatment group were additionally provided with repeti-tive peripheral magnetic stimulation for 4 weeks.The myoelectric activity of the agonist and antagonist muscles was recorded using surface electromyography during maximum isometric voluntary contractions of the ankle dorsiflexors and co-contraction ratios (CRs) were calculated.The motor function,walking ability and ankle plantar flexor spasticity were evaluated using the Fugl-Meyer lower extremity assessment (FMA-LE),functional ambulation categories (FACs) and a composite spasticity scale (CSS).Results Before the intervention there was no signification difference between the two groups in terms of any of the assessments.After 4 weeks of treatment,the average integrated EMG of the anterior tibialis in the treatment group was significantly better than in the control group.That group's average FMA-LE and FAC scores were also significantly better.The experimental group's average spasticity score and co-contraction ratio during maximum isometric voluntary contractions of the ankle dorsiflexors had both decreased significantly.All of the improvements in the treatment group were significantly better than those in the control group.Conclusion Repetitive peripheral magnetic stimulation combined with the exercise therapy can effectively reduce ankle plantar flexior spasticity while improving motor function and walking ability.It is more effective than exercise alone.