Mother-reliant or Self-reliant: The germination strategy of seeds in a species-rich alpine meadow is associated with the existence of pericarps.

BACKGROUND AND AIMS: Some plants germinate their seeds enclosed by a pericarp, while others lack the outer packaging. As a maternal tissue, may impart seeds with different germination strategies. Plants in a community with different flowering times may separately disperse and germinate their seeds; therefore, flowering time can be considered as one manifestation of maternal effects on offspring. The mass of the seed is another important factor influencing germination and represents the intrinsic resource of seed that supports the germination. Using seeds from a species-rich alpine meadow located in the Hengduan Mountains of China, a global biodiversity hotspot, we aim to illustrate whether and how the type of seed (with and without a pericarp) modulates the interaction of flowering time and seed mass with germination. METHODS: Seeds were germinated under a generally favorable condition and germination speed (estimated by mean germination time, MGT) was calculated. We quantified the maternal conditions by separation of flowering time for 67 species in the meadow, in which 31 produced seeds with pericarps and 36 yielded seeds without pericarps, respectively. We also weighed one hundred seeds to assess their mass. KEY RESULTS: The MGT varied between the two types of seed. For seeds with pericarps, MGT was associated with flowering time but not with seed mass. Plants with earlier flowering times in the meadow exhibited more rapid seed germination. For seeds without pericarp, the MGT depended on seed mass, with smaller seeds germinating more rapidly than larger seeds. CONCLUSIONS: The distinct responses of germination to flowering time and seed mass observed in seeds with and without pericarp suggest that germination strategies might be mother-reliant for seeds protected by pericarps but self-reliant for those without such protection. This novel finding improves our understanding of seed germination by integrating ecologically mediated maternal conditions and inherent genetic properties.

Floral resource partitioning of coexisting bumble bees: Distinguishing species-, colony-, and individual-level effects.

Resource partitioning is considered a key factor in alleviating competitive interactions, enabling coexistence among consumer species. However, most studies have focused on resource partitioning between species, ignoring the potentially critical role of intraspecific variation in resource use. We investigated floral resource partitioning across species, colonies, and individuals in a species-rich bumblebee community in the diversification center of bumblebees. We used a total of 10,598 bumblebees belonging to 13 species across 5 years in the Hengduan Mountains of southwest China. First, we evaluated the influence of a comprehensive set of floral traits, including both those related to attractiveness (flower color and shape) and rewards (pollen, sugar ratio, nectar volume, sugar concentration, and amino acid content) on resource partitioning at the species level in bumblebee-plant networks. Then, we explored intraspecific resource partitioning on the colony and individual levels. Our results suggest that bumblebee species differ substantially in their use of the available floral resources, and that this mainly depends on flower attractiveness (floral color and shape). Interestingly, we also detected floral resource partitioning at the colony level within all commonest bumblebee species evaluated. In general, floral resource partitioning between bumblebee individuals decreased with species- and individual-level variation in body size (intertegular span). These results suggest that bumblebee species may coexist via the flexibility in their preferences for specific floral traits, which filters up to support the co-occurrence of high numbers of species and individuals in this global hotspot of species richness.

The interplay between scale, pollination niche and floral attractiveness on density-dependent plant-pollinator interactions.

Pollinators mediate interspecific and intraspecific plant-plant indirect interactions (competition vs. facilitation) via density-dependent processes, potentially shaping the dynamics of plant communities. However, it is still unclear which ecological drivers regulate density-dependent patterns, including scale, pollination niches (i.e., the main pollinator functional group) and floral attractiveness to pollinators. In this study, we conducted three-year field observations in Hengduan Mountains of southwest China. By gathering data for more than 100 animal-pollinated plant species, we quantified the effect (positive vs. negative) of conspecific and heterospecific flower density on pollination at two scales: plot-level (4 m2) and site-level (100-5000 m2). Then, we investigated how pollination niches and floral attractiveness to pollinators (estimated here as average per-flower visitation rates) modulated density-dependent pollination interactions. Pollinator visitation depended on conspecific and heterospecific flower density, with rare plants subjected to interspecific competition at the plot-level and interspecific facilitation at the site-level. Such interspecific competition at the plot-level was stronger for plants pollinated by diverse insects, while interspecific facilitation at the site-level was stronger for bee-pollinated plants. Moreover, we also found stronger positive conspecific density-dependence for plants with lower floral attractiveness at the site-level, meaning that they become more frequently visited when abundant. Our study indicates that the role of pollination in maintaining rare plants and plant diversity depends on the balance of density-dependent processes in species-rich communities. We show here that such balance is modulated by scale, pollination niches and floral attractiveness to pollinators, indicating the context-dependency of diversity maintenance mechanisms.

Floral trait variation across individual plants within a population enhances defense capability to nectar robbing.

Floral trait variation may help pollinators and nectar robbers identify their target plants and, thus, lead to differential selection pressure for defense capability against floral antagonists. However, the effect of floral trait variation among individuals within a population on multi-dimensional plant-animal interactions has been little explored. We investigated floral trait variation, pollination, and nectar robbing among individual plants in a population of the bumble bee-pollinated plant, Caryopteris divaricata, from which flowers are also robbed by bumble bees with varying intensity across individuals. We measured the variation in corolla tube length, nectar volume and sugar concentration among individual plants, and evaluated whether the variation were recognized by pollinators and robbers. We investigated the influence of nectar robbing on legitimate visitation and seed production per fruit. We found that the primary nectar robber (Bombus nobilis) preferred to forage on plants with long-tubed flowers, which produced less nectar and had lower sugar concentration compared to those with shorter corolla tubes. Individuals with shorter corolla tubes had comparatively lower nectar robbing intensity but higher visitation by legitimate visitors (mainly B. picipes) and higher seed production. Nectar robbing significantly reduced seed production because it decreased pollinator visits. However, neither pollination nor seed production differed between plants with long and short corolla tubes when nectar robbers were excluded. This finding suggests that floral trait variation might not be driven by pollinators. Such variation among individual plants thus allows legitimate visitors and nectar robbers to segregate niches and enhances population defense against nectar robbing in unpredictable conditions.

The effects of urbanization on pollinators and pollination: A meta-analysis.

Urbanization is increasing worldwide, with major impacts on biodiversity, species interactions and ecosystem functioning. Pollination is an ecosystem function vital for terrestrial ecosystems and food security; however, the processes underlying the patterns of pollinator diversity and the ecosystem services they provide in cities have seldom been quantified. Here, we perform a comprehensive meta-analysis of 133 studies examining the effects of urbanization on pollinators and pollination. Our results confirm the widespread negative impacts of urbanization on pollinator richness and abundance, with Lepidoptera being the most affected group. Furthermore, pollinator responses were found to be trait-specific, with below-ground nesting and solitary Hymenoptera, and spring flyers more severely affected by urbanization. Meanwhile, cities promote non-native pollinators, which may exacerbate conservation risks to native species. Surprisingly, despite the negative effects of urbanization on pollinator diversity, pollination service measured as seed set is enhanced in non-tropical cities likely due to abundant generalists and managed pollinators therein. We emphasize that the richness of local flowering plants could mitigate the negative impacts of urbanization on pollinator diversity. Overall, the results demonstrate the varying magnitudes of multiple moderators on urban pollinators and pollination services and could help guide conservation actions for biodiversity and ecosystem function for a sustainable future.

Mechanism of action of oxidative stress in severe traumatic brain injury and its complications: recent progress / 中华创伤杂志

Severe traumatic brain injury (sTBI) is characterized by critical condition, high lethality and poor prognosis. Its development and progression will lead to the damage and death of a large number of nerve cells, eventually causing a series of serious complications. The current treatments of sTBI and its complications are not optimistic due to problems such as unclear mechanism of action, challenges in treatment, and lack of effective prevention strategies. In recent years, more research evidences have shown that oxidative stress plays an important role in the development and progression of sTBI and its related complications. Therefore, it is of great significance to clarify the relationship of oxidative stress with sTBI and its complications and to understand the way of oxidative stress participating in the development and progression of sTBI. However, relevant researches are scattered and there lacks comprehensive and systematic summaries of oxidative stress participating in sTBI and its related complications. To this end, the authors reviewed the progress of the mechanism by which oxidative stress involves in sTBI and its complications, hoping to provide references for the research, treatment and prevention of sTBI.

Quantitative estimation of enzymatic released specific oligosaccharides from Hericium erinaceus polysaccharides using CE-LIF / 药物分析学报

Polysaccharides exhibit multiple pharmacological activities which are closely related to their structural features.Therefore,quantitatively quality control of polysaccharides based on their chemical charac-teristics is important for their application in biomedical and functional food sciences.However,poly-saccharides are mixed macromolecular compounds that are difficult to isolate and lack standards,making them challenging to quantify directly.In this study,we proposed an improved saccharide mapping method based on the release of specific oligosaccharides for the assessment of Hericium eri-naceus polysaccharides from laboratory cultured and different regions of China.Briefly,a polysaccharide from H.erinaceus was digested by β-(1-3)-glucanase,and the released specific oligosaccharides were labeled with 8-aminopyrene-1,3,6-trisulfonic-acid(APTS)and separated by using micellar electrokinetic chromatography(MEKC)coupled with laser induced fluorescence(LIF),and quantitatively estimated.MEKC presented higher resolution compared to polysaccharide analysis using carbohydrate gel elec-trophoresis(PACE),and provided great peak capacity between oligosaccharides with polymerization degree of 2(DP2)and polymerization degree of 6(DP6)in a dextran ladder separation.The results of high performance size exclusion chromatography coupled with multi-angle laser light scattering and refractive index detector(HPSEC-MALLS-RI)showed that 12 h was sufficient for complete digestion of polysaccharides from H.erinaceus.Laminaritriose(DP3)was used as an internal standard for quantifi-cation of all the oligosaccharides.The calibration curve for DP3 showed a good linear regression(R2＞0.9988).The limit of detection(LOD)and limit of quantification(LOQ)values were 0.05 μg/mL and 0.2 μg/mL,respectively.The recovery for DP3 was 87.32(±0.03)％in the three independent injections.To sum up,this proposed method is helpful for improving the quality control of polysaccharides from H.erinaceus as well as other materials.

Evidence mapping analysis of traditional Chinese medicine intervention in pulmonary fibrosis / 中国中药杂志

This study utilized evidence mapping methodology to systematically identify, describe, and evaluate the evidence from relevant research on traditional Chinese medicine(TCM) interventions in patients with pulmonary fibrosis. CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, EMbase, and Cochrane Library were searched from database inception to March 2023 for systematic reviews/Meta-analysis/network Meta-analysis on TCM interventions in pulmonary fibrosis. The quality of included studies was assessed using the AMSTAR 2 scale, and the evidence mapping approach was employed to present comprehensive information on populations, intervention methods, the sample size in systematic reviews/Meta-analysis, and conclusion classifications. Ultimately, 44 systematic reviews/Meta-analysis/network Meta-analysis were included. Apart from syndrome differentiation and treatment, TCM injections accounted for a significant proportion of the observed interventions. The treatment methods were mainly focused on nourishing Qi and Yin, promoting blood circulation, resolving stasis, and dredging collaterals. The results from the included studies demonstrated that TCM treatment for pulmonary fibrosis could improve efficacy, increase lung function, improve PaO_(2 )levels, increase the 6-minute walk distance(6MWD), alleviate clinical symptoms, and enhance patients' quality of life. Based on the assessment using the AMSTAR 2 scale, methodological issues were identified, including the lack of protocol registration, failure to provide a list of excluded literature, and incomplete explanations regarding the impact of heterogeneity and bias on the results. The evidence mapping revealed that 42 conclusions were beneficial, while two conclusions were potentially beneficial. Overall, the quality of evidence was relatively low, primarily due to methodological imprecision and publication bias. Although TCM showed certain efficacy in the treatment of pulmonary fibrosis, the quality of reported literature, methodological quality, and overall evidence quality need improvement. It is recommended to conduct high-quality and standardized studies in the future to provide better evidence-based guidance.

Effect of hepatitis B virus infection on patients with hepatic alveolar echinococcoisis after surgical resection / 中华肝胆外科杂志

Objective:To investigate the effect of hepatitis B virus (HBV) infection in patients with hepatic alveolar echinococcoisis after surgical resection and determine the differences of liver function between patients with different HBV-DNA levels.Methods:Patients were selected from January 2014 to July 2018 in the Affiliated Hospital of Qinghai University. Twenty-eight patients with hepatitis B and hepatic alveolar echinococcoisis were included in the experimental group, and 20 patients with hepatic alveolar echinococcoisis but without hepatitis B virus were included in the control group. Based on HBV-DNA level, the experimental group was divided into low-level group (HBV-DNA level<200 IU/ml, n=6), intermediate-level group (HBV-DNA level 200-20 000 IU/ml, n=15) and high level group (HBV-DNA level>20 000 IU/ml, n=7). Comparison of complications and liver function after liver resection in two groups.Univariate and multivariate logistic regression were used to analyze the influential factors of postoperative complications in patients.Comparison of postoperative liver function indexes in patients with different HBV-DNA levels. Results:In the control group, postoperative total bilirubin 10.6(8.3, 16.9) μmol/L, direct bilirubin 5.3(3.4, 10.0) μmol/L, prothrombin time 13.6(13.0, 15.8)s, and the incidence of complications 25.0%(5/20), were better than the experimental group 12.6(8.4, 46.9) μmol/L, 6.7(3.1, 26.4) μmol/L, 15.4(13.5, 18.1)s, 78.6% (22/28), the differences were statistically significant significance (all P<0.05). Multivariate logistic analysis showed that patients with HBV infection ( OR=4.593, 95% CI: 1.128-18.708) and intraoperative blood loss ≥1 000 ml ( OR=2.200, 95% CI: 1.106-4.378) were the hepatic alveolar echinococcoisis independent risk factors for postoperative complications. There were no significant differences in total bilirubin and albumin between the three groups of patients with different HBV-DNA levels ( P>0.05). Conclusion:Patients with HBV and hepatic alveolar echinococcoisis have worse liver function and are more prone to complications after surgical resection, but there is no significant difference in liver function among patients with different HBV-DNA levels.

Arthroscopic treatment of intraarticular displaced fractures of the calcaneus in children / 中华创伤骨科杂志

Objective:To explore the clinical effects of arthroscopic treatment of intraarticular displaced fractures of the calcaneus in children.Methods:The clinical data were analyzed retrospectively of the 11 children who had been treated for intraarticular displaced fractures of the calcaneus at Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University from January 2015 to June 2018. They were 6 boys and 5 girls, aged from 8 to 12 years (average, 10.6 years) and involving the left foot in 7 cases and the right foot in 4. By the Sanders classification, there were 10 cases of type Ⅱ and one of type Ⅲ. Preoperative evaluation of the injury was conducted by X-ray examination and three-dimensional CT reconstruction of the calcaneus. After arthroscopic prying reduction, internal fixation with mere Kirschner wire was performed for 8 cases and internal fixation with Kirschner wire plus hollow screws for 3. The affected feet were fixated with plaster bracket or brace for one month after operation. The Kirschner wires were removed 4 to 6 weeks after operation when X-ray films revealed fracture union. The clinical effects were evaluated by anatomic recovery of the calcaneus in terms of preoperative and postoperative B?hler and Gissane angles and functional recovery of the calcaneus in terms of ankle-hindfoot scores of American Orthopedic Foot Ankle Society (AOFAS) scale.Results:All the 11 pediatric patients were followed up for 12 to 19 months (average, 14 months). No bone grafting was applied. Their operation time averaged 63 min (from 50 to 75 min). Their incisions healed at one stage without infection. All their fractures healed within 2 to 3 months without any delayed union or nonunion. The B?hler angle (28.4°±2.9°) and Gissane angle (125.6°±3.1°) at the final follow-up were significantly improved than the preoperative values (11.8°±5.4° and 138.8°±6.3°) ( P< 0.05). The AOFAS ankle-hindfoot scores were 89.6 points at the final follow-up. Conclusion:Arthroscopic percutaneous prying reduction combined with internal fixation with Kirschner wire and hollow screws can effectively reduce and fixate the intraarticular displaced fracture of the calcaneus in children, leading to limited surgical trauma and fine curative effects.

Diagnostic performance of T-SPOT test for pediatric tuberculosis / 中国基层医药

Objective:To investigate the diagnostic performance of T-SPOT test for pediatric tuberculosis (TB).Methods:The results of T-SPOT and PPD in 67 TB children and 71 TB-excluded children that diagnosed and treated in the People's Hospital of Jianyang from June 2014 to May 2017 were retrospectively analyzed.The diagnostic efficacy and consistency of the two tests, and the diagnostic efficacy of combined examination were evaluated.Results:The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, Youden′s index of T-SPOT were 88.1%, 94.4%, 93.7%, 89.3%, 15.6, 0.13, 0.83, respectively.While the above parameters of PPD were 68.7%, 74.6%, 71.9%, 71.6%, 2.71, 0.42, 0.43, respectively.T-SPOT had higher sensitivity, specificity, positive predictive value, negative predictive value compared with PPD, and the differences were statistically significant(χ 2=7.44, 10.54, 10.51, 7.45, all P<0.01). The positive rates of T-SPOT for pulmonary and extra-pulmonary TB were 90.9% and 82.6%, and the difference was not statistically significant ( P>0.05). The positive rate of T-SPOT was higher in 5-18 years old group than that in 0-4 years old group(95.1% vs.76.2 %, χ 2=5.01, P<0.05). The latter group held a diagnostic concordance greater than the former(kappa value 0.78 vs.0.23). The sensitivity of combined tests had no statistically significant difference compared with T-SPOT alone( P>0.05). Conclusion:T-SPOT outperformed PPD in diagnostic assistance of pediatric TB overall.The diagnostic superiority is noticeable in the>4-18 years old other than the 0-4 years old.Compared with T-SPOT alone, combined tests should not be regarded to have increased sensitivity.

Application value of artificial neural network in laparoscopic surgery training / 中华消化外科杂志

Objective:To investigate the application value of artificial neural network in laparoscopic surgery training.Methods:The prospective cohort study was conducted. A total of 158 trainees from the First Hospital Affiliated to Army Medical University between Semptember and November, 2019 who had no experience in laparoscopic technology were selected for laparoscopic surgery training, including 52 graduate students of surgery from grade 2019, 2018 and 2017, 58 surgeons receiving standardized residency training, 12 interns and 36 refresher physicians. The 158 trainees were divided into two groups using the random number table. Trainees trained by artificial neural network laparoscopic simulator were allocated into artificial neural network group, and trainees trained by box laparoscopic simulator were allocated into general laparoscopic simulator group. Trainees in both groups were trained using the laparoscopic simulator for 10 hours (5-day continuous training, 2 hours per day) on fundamentals of laparoscopic surgery. Observation indicators: (1) comparison of operation grades on laparoscopic simulator before and after training in the two groups; (2) comparison of improvement of the operation grades on laparoscopic simulator after training between the two groups. Measurement data with normal distribution were represented as Mean± SD, comparison within groups was analyzed using the paired t test and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M (range). Results:A total of 158 trainees were selected for eligibility, including 140 males and 18 females, aged from 23 to 34 years, with a median age of 27 years. Of the 158 trainees, 79 were in the artificial neural network group and 79 were in the general laparoscopic simulator group. (1) Comparison of operation grades on laparoscopic simulator before and after training in the two groups: operation grades of the nails transferring, pattern cutting, ligation, sewing knots in vivo and sewing knots in vitro for the artificial neural network group before training were 51.2±4.9, 45.6±3.7, 43.0±3.6, 42.1±3.1, and 39.6±3.1, respectively. The above indicators for the artificial neural network group after training were 78.6±3.0, 76.4±3.9, 79.9±2.5, 78.3±3.5, and 84.1±3.8, respectively. There were significant differences in the above indicators for the artificial neural network group before and after training ( t=-42.490, -56.256, -80.373, -70.802, -79.742, P<0.05). The above indicators for the general laparoscopic simulator group before training were 50.1±2.9, 45.4±3.9, 42.7±3.0, 42.3±3.4, and 39.2±4.7, respectively. The above indicators for the general laparoscopic simulator group after training were 70.4±5.0, 69.8±4.0, 72.3±3.3, 72.3±3.5, and 72.8±3.2, respectively. There were significant differences in the above indicators for the general laparoscopic simulator group before and after training ( t=-28.942, -42.436, -58.357, -52.322, -53.098, P<0.05). (2) Comparison of improvement of the operation grades on laparoscopic simulator after training between the two groups: improvement of the operation grades in the nails transferring, pattern cutting, ligation, sewing knots in vivo and sewing knots in vitro for the artificial neural network group after training were 27.4±5.7, 30.8±5.0, 36.9±4.1, 36.2±4.5 and 39.5±5.4, respectively. The above indicators for the general laparoscopic simulator group after training were 20.3±6.2, 24.4±5.1, 29.6±4.5, 29.9±5.1 and 33.5±5.6, respectively. There were significant differences in the above indicators between the two groups ( t=7.597, 7.946, 10.638, 8.200, 6.969, P<0.05). Conclusion:The introduction of artificial neural network in laparoscopic surgery training can improve the training effects.

Application effect of mixed reality in the teaching of hepatobiliary surgery / 中华医学教育探索杂志

Objective@#To explore the application effect of mixed reality technology in the teaching of hepatobiliary surgery.@*Methods@#A total of 120 professional postgraduates majored in surgery who had received the four-month standardized training of residents in hepatobiliary surgery department of the First Affiliated Hospital of Army Military Medical University and the First Affiliated Hospital of Chongqing Medical University during 2016-2018 were selected and were equally allocated into the control group and the research group via random number table method. Students in the control group were trained with traditional surgical teaching mode and in the research group were trained with three-dimensional visualization model which was constructed by mixed reality. Students in both groups received assessment and questionnaires at the end of training.@*Results@#Scores of theoretical examination and surgical operation assessment of students in the research group were higher than those in the control group (P<0.05). The error rate for separating gallbladder artery and bile duct in the laparoscopic simulated system of students in the research group was significantly lower than that in the control group (P<0.05). Students-teacher satisfaction degree in the research group was higher than that in the control group (P<0.05).@*Conclusion@#Using mixed reality technology to construct a three-dimensional visualization model and to implement hepatobiliary surgery teaching enables the trainees to better master anatomical key points in the hepatobiliary system and the hepatobiliary surgical approach, with good feedback.

Application effect of mixed reality in the teaching of hepatobiliary surgery / 中华医学教育探索杂志

Objective To explore the application effect of mixed reality technology in the teaching of hepatobiliary surgery.Methods A total of 120 professional postgraduates majored in surgery who had received the four-month standardized training of residents in hepatobiliary surgery department of the First Affiliated Hospital of Army Military Medical University and the First Affiliated Hospital of Chongqing Medical University during 2016-2018 were selected and were equally allocated into the control group and the research group via random number table method.Students in the control group were trained with traditional surgical teaching mode and in the research group were trained with three-dimensional visualization model which was constructed by mixed reality.Students in both groups received assessment and questionnaires at the end of training.Results Scores of theoretical examination and surgical operation assessment of students in the research group were higher than those in the control group(P＜0.05).The error rate for separating gallbladder artery and bile duct in the laparoscopic simulated system of students in the research group was significantly lower than that in the control group(P＜0.05).Students-teacher satisfaction degree in the research group was higher than that in the control group(P＜0.05).Conclusion Using mixed reality technology to construct a three-dimensional visualization model and to implement hepatobiliary surgery teaching enables the trainees to better master anatomical key points in the hepatobiliary system and the hepatobiliary surgical approach,with good feedback.

Transfer of flexor hallucis longus tendon for obsolete Achilles tendon rupture / 中华创伤骨科杂志

Objective To report the therapeutic effects of transfer of flexor hallucis longus tendon on the treatment of obsolete Achilles tendon rupture with a defect greater than 5 cm.Methods The clinical data were retrospectively analyzed of the 39 patients with obsolete Achilles tendon rupture who had been treated at Department of Bone and Joint Surgery,Affiliated Hospital of Southwest Medical University from September 2010 to January 2017.They were 33 males and 6 females,aged from 15 to 46 years(average,31.6 years).All the defects of Achilles tendon were greater than 5 cm.The duration between injury and operation ranged from 5 to 32 weeks(mean,16 weeks).All the 39 patients underwent transfer of flexor hallucis longus tendon to reconstruct their Achilles tendons.The tendons were harvested using double incisions in 23 patients and using a single incision in 16.The functional recovery of the ankle was evaluated according to ankle-hindfood score of American Orthopaedic Foot and Ankle Society(AOFAS),Achilles tendon total rupture score(ATRS),visual analogue scale(VAS),dorsal extension and plantar flexion of the ankle and patient's satisfaction as well.Results Healing by the first intention was achieved in 38 cases.Delayed healing occurred in one patient due to wound infection.One patient had postoperative numbness in the medial plantar region which disappeared 3 months later with no special treatment.All the 39 patients were followed up for 24 to 91 months(mean,32 months).None of the tendons was re-ruptured during the follow-up.The AOFAS scores at postoperative 3 months,one year and last follow-up were significantly higher than the preoperative one(P<0.05);the postoperative VAS scores were significantly lower than the preoperative one(P<0.05);the postoperative ranges of dorsal extension and plantar flexion of the ankle were all significantly larger than the preoperative ranges(P<0.05).At the last follow-up,31 patients expressed great satisfaction,7 satisfaction,and one neutral attitude.Conclusion Reconstruction of the Achilles tendon with transfer of flexor hallucis longus tendon is an effective surgical option for obsolete rupture of Achilles tendon with a defect greater than 5 cm.

Expression and clinical significance of serum interleukin -33 in patients with chronic severe hepatitis B / 中国基层医药

Objective To explore the changes of interleukin -33 in serum of patients with chronic severe hepatitis B.Methods 25 patients with mild chronic hepatitis B ( MCHB group) and 25 patients with severe chronic hepatitis B(SCHB group) were collected.18 healthy people were collected as control (HC group).ELISA method was used to detect IL -33 level in peripheral blood .Results The IL-33 levels in MCHB and SCHB group were (11.7 ±6.9)ng/L and (16.5 ±9.1)ng/L,respectively,which were significantly higher than (5.1 ±2.9)ng/L in HC group(t=4.037,5.434,P=0.000,0.000).The IL-33 level in MCHB group was lower than that in SCHB group(t=2.108,P=0.040).The IL-33 level was positively correlated with ALT ,AST and HBV DNA(r=0.526, 0.568,0.285,P=0.000,0.000,0.045 ).Conclusion IL -33 is involved in the pathogenesis of hepatitis B . IL-33 plays an important role in HBV -relate injury.

The research and practice of cultivating way to innovation and entrepreneurship ability of college students in TCM university: take Beijing University of Chinese Medicine as an example / 中华医学教育探索杂志

TCM university students' active participation in innovation and entrepreneurship practice has far-reaching significance for the cause of Chinese medicine and individual development. This paper introduces the preliminary exploration of Beijing University of Traditional Chinese Medicine to enhance students' innovative and entrepreneurial abilities, and reveals the problems existing in the innovation and entrepreneurship of college students in TCM colleges and universities, that is, the atmosphere of innovation and entrepreneurship is not strong enough, the relevant education is seriously shrinking, and the problem of practice is highlighted. It puts forward the specific ways to cultivate students' innovative and entrepreneurial ability in TCM colleges and universities: strengthening the construction of innovative and entrepreneurial teachers, reforming the curriculum system and teaching content of TCM colleges and universities, transform-ing the teaching and management methods of college students' innovative and entrepreneurial education, and establishing and improving innovative and entrepreneurial practice base and incubation fund, hoping to propel the reform of educational teaching in TCM university and cultivate talents with innovation and entrepreneurship ability.

Correlation among vasoactive factors,blood lipids and anticardiolipin antibody levels in ICVD patients / 心血管康复医学杂志

Objective:To observe serum levels of high sensitive C reactive protein(hsCRP),interleukin(IL)-6, tumor necrosis factor(TNF)-α and hepatocyte growth factor(HGF)in patients with ischemic cerebrovascular dis-ease(ICVD),and analyze their correlation with blood lipids and anticardiolipin antibody(ACA)levels.Methods:A total of 45 ICVD patients treated in our hospital from Mar 2015 to Aug 2016 were regarded as ICVD group.An-other 45 non-ICVD patients treated in our hospital during the same period were regarded as non-ICVD control group.Serum levels of hsCRP,IL-6,TNF-α,HGF,blood lipids and ACA were observed and compared between two groups,and correlation among serum levels of hsCRP,IL-6,TNF-α and HGF,blood lipids and ACA levels were analyzed in ICVD patients.Results:Compared with non-ICVD control group,there were significant rise in se-rum levels of hsCRP[(4.69 ± 1.31)mg/L vs.(8.87 ± 1.56)mg/L],IL-6[(12.17 ± 4.33)mg/L vs.(34.26 ± 5.15)mg/L],TNF-α[(28.45 ± 2.18)pg/ml vs.(48.35 ± 3.15)pg/ml],HGF[(502.34 ± 15.36)pg/ml vs. (876.25 ± 18.15)pg/ml],ACA[(4.11 ± 0.65)IU/L vs.(7.89 ± 1.02)IU/L],total cholesterol[(4.68 ± 1.12) mmol/L vs.(5.57 ± 1.21)mmol/L],low density lipoprotein cholesterol[(2.62 ± 0.49)mmol/L vs.(3.24 ± 0.87) mmol/L]and triglyceride[(1.42 ± 0.31)mmol/L vs.(1.84 ± 0.37)mmol/L],and significant reduction in serum level of high density lipoprotein cholesterol[(1.28 ± 0.25)mmol/L vs.(1.02 ± 0.22)mmol/L]in ICVD group,P=0.001 all.Pearson correlation analysis indicated that serum levels of hsCRP,IL-6,TNF-α and HGF were signifi-cant positively correlated with serum levels of ACA,TC,LDL-C and TG(r=0.468~0.632,P<0.05 or <0.01), and significant inversely correlated with HDL-C level(r= -0.571~ -0.511,P<0.05 or < 0.01)in ICVD pa-tients.Conclusion:Serum levels of hsCRP,IL-6,TNF-α and HGF significantly rise in ICVD patients,and they are closely correlated with levels of blood lipids and ACA,which can serve as important indexes monitoring ICVD.

Posterior lumbar dynamic stabilization system in the treatment of degenerative lumbar spinal stenosis:efficacy and safety / 中国组织工程研究

BACKGROUND: Lumbar posterior dynamic stabilization system is a new nonfusion method for the treatment of lumbar degenerative disease, mainly including interspinous dynamic fixation system and the posterior pedicle fixation device. Wallis system and Dynesys system are representative of two different fixation systems. There is little study on above two fixation systems in the treatment of degenerative lumbar spinal stenosis. OBJECTIVE: To compare the effectiveness and safety of Wallis system interspinous fixation, Dynesys system transpedicular fixation and fusion in the treatment of degenerative lumbar spinal stenosis. METHODS: Totally 79 cases of degenerative lumbar spinal stenosis voluntarily receiving the surgery were divided into three groups according to fixation mode. In the fusion group, 30 cases underwent full decompression combined with posterior lumbar interbody fusion. In the Wallis group, 25 cases underwent full decompression combined with interspinous Wallis fixation. In the Dynesys group, 24 cases underwent full decompression combined with pedicle screw fixation with Dynesys system. The follow-up data of all patients were complete at postoperative 3 years. RESULTS AND CONCLUSION: (1) There was no significant difference in baseline data, intraoperative bleeding and postoperative drainage volume among the three groups (P > 0.05). The operation time of the fusion group was obviously longer than in the other two groups (P <0.05). (2) There were no significant differences between the Wallis group and the Dynesys group in spinal function scores, visual analogue score of the low back pain, the Oswestry dysfunction index and the imaging measurement indexes (P > 0.05). The spinal function score and Oswestry dysfunction index of the fusion group were significantly decreased at postoperative 3 years (P < 0.01). The spinal function score and Oswestry dysfunction index of the Wallis and Dynesys groups at 1 month after operation were significantly lower than that in the fusion group (P < 0.01). The operation range of the three groups decreased significantly after operation (P < 0.01). Compared with the fusion group, the range of adjacent segments increased significantly in the Wallis group and the Dynesys group; and the intervertebral height, the height of the intervertebral foramen and the area of the intervertebral foramen in the three groups were significantly higher than those before the operation (P < 0.01). (3) There were no significant differences among the three groups in the evaluation of the clinical efficacy and the incidence of complications (P > 0.05). It was shown that lumbar posterior dynamic stabilization system (Wallis and Dynesys systems) internal fixation for degenerative lumbar spinal stenosis can effectively relieve low back pain and maintain lumbar function and activity, and the short-term curative effect is reliable.

Value of heart rate variability and sympathetic skin response in differential diagnosis of Parkinson's disease / 西安交通大学学报(医学版)

Objective To evaluate the value of heart rate variability (HRV ) and sympathetic skin response (SSR) in differential diagnosis of Parkinson's disease (PD) .Methods We selected 36 PD ,17 essential tremor (ET) and 59 Parkinsonism-Plus (PD-plus) patients diagnosed in our department .We recorded HRV during the period of quiet breath ,deep breath and Vasaval as well as SSR incubation period of the upper limbs and lower limbs . Results ① During the period of quiet breath ,HRV decreased significantly in PD group compared with that in ET group (P< 0 .05) ,and abnormality rate of HRV in PD group was higher than that in ET group .HRV did not significantly differ between PD and PD-plus .HRV did not significantly differ among the three groups during the period of deep breath and Vasaval .② SSR incubation period showed no significant difference among PD ,PD-plus and ET groups .③ The specificity and sensibility of HRV in PD and PD-plus differential diagnosis were 22 .8% and 82 .6% , while for PD and ET differential diagnosis the values were 66 .9% and 82 .6% . The specificity and sensibility of SSR in PD and PD-plus differential diagnosis were 39 .0% and 52 .6% , 29 .4% and 52 .6% , respectively ,for PD and ET differential diagnosis .Conclusion Compared with those in ET patients ,HRV in PD patients decreases and HRV abnormality rate increases .HRV is of great value in differential diagnosis of PD and ET but not in differential diagnosis of PD and PD-plus .Determining SSR incubation period does not have much value in differential diagnosis of PD ,PD-plus and ET .