Clinical Efficacy of Chonglian Oral Liquid on COVID-19 Patients / 中国实验方剂学杂志

ObjectiveTo observe the effect of Chonglian oral liquid on inflammatory and immune markers as well as the clinical outcomes of patients with mild-to-moderate corona virus disease 2019（COVID-19） and comprehensively evaluate its efficacy and safety. MethodA clinical randomized controlled trial （RCT） was conducted， involving 120 confirmed cases of mild-to-moderate COVID-19. The patients were randomly divided into two groups， with 55 cases in the observation group and 56 cases in the control group. According to the updated diagnosis and treatment protocol， the control group received standard western medical treatment， while the observation group received Chonglian oral liquid in addition to standard western medical treatment. Both groups were treated continuously for 10 days. The traditional Chinese medicine （TCM） syndrome scores， syndrome efficacy， fever abatement time， nucleic acid negative conversion time， inflammatory and immune markers， improvement in imaging findings， clinical outcomes， and occurrence of adverse events were compared between the two groups. ResultBoth groups showed a significant decrease in TCM syndrome scores after treatment （P<0.01）. Compared with the control group after treatment， the observation group exhibited a more significant improvement in cough， dry throat， sore throat， fatigue， and muscle pain （P<0.05）. The total effective rate in the observation group was 100% （55/55）， significantly higher than 98.21% （55/56） in the control group （Z=3.707， P<0.01）. The observation group also showed a significantly shorter duration of fever abatement and nucleic acid negative conversion compared with the control group after treatment （P<0.05）. Both groups had a significant increase in lymphocyte count （LYM）， lymphocyte percentage （LYM%）， mature T lymphocytes （CD3+）， and helper/inducer T lymphocytes （CD4+） after treatment （P<0.01）. Compared with the control group after treatment， the observation group showed greater improvement in these markers （P<0.05）. In terms of inflammatory markers， both groups had a significant decrease compared with those before treatment （P<0.01）. The observation group exhibited lower levels of high-sensitivity C-reactive protein （hs-CRP）， interleukin-6 （IL-6）， and procalcitonin （PCT） than the control group after treatment （P<0.05）. There was no statistically significant difference in imaging efficacy evaluation and clinical outcomes between the two groups. No adverse events were reported in either group during the treatment period. ConclusionChonglian oral liquid combined with standard western medical treatment significantly improves clinical symptoms， shortens fever abatement and nucleic acid negative conversion time， regulates immune function， and inhibits inflammatory responses in patients with mild-to-moderate COVID-19， leading to improved clinical efficacy.

Dynamic changes of inflammation parameters in patients after neurosurgery / 中华神经医学杂志

Objective To observe the postoperative dynamic changes of body temperature (BT),C-reactive protein (CRP) and white blood cell (WBC) count.Methods One hundred and two consecutive patients with surgically treated intracranial or spinal lesions,admitted to our hospital from July 2011 to February 2012,were chosen and divided into group A (non infection) and group B (infection) depending on whether postoperative bacterial infections (POBIs) were occurred.Evaluation of postoperative BT and CRP levels,as well as WBC count,was performed.Results WBC and BT levels would elevate in majority of patients with or without POBIs one day after the operation; the difference between the two groups showed no significant difference (P＞0.05).Elevation of BT and WBC levels was noted in 23.8％ and 21.4％ patients from group A and in 88.9％ and 83.3％ patients from group B five days after the operation,with significant difference between the two groups (P＜0.05).Similar results were seen seven day after the operation.Five and seven days after the operation,78 patients (92.8％) and 68 patients (80.9％) still had abnormal CRP level in group A.ROC curve revealed that better diagnostic performance five and seven days after the operation could be found as compared with that one and three days after the operation.Conclusion Elevation of serum CRP,WBC and BT levels can occur in patients with or without POBIs on the first three days of neurosurgical operation; persistent anomalies or secondary elevation could indicate ongoing infection,which needs attention from clinic.

Joint angles and muscle activations in the lower limb of young women during slope walking / 医用生物力学

Objective To illustrate the influences of walking speed and road slope on lower limb motions by quantitative analysis on the changes of joint angles and muscle activation. Method Five walking speeds and three road slopes were selected from slow to fast according to the related measurement. The gaits of 15 young women were measured using the motion capture system and the EMG signals of 8 major muscles in lower limbs were collected simultaneously. The mean joint angles of hip, knee and ankle in sagittal plane at different speeds and different slopes were calculated. The subject whose data was closest to the mean value could be easily found. Results The joint angles of the subject’s hip, knee and ankle in sagittal plane at different speeds and different slopes in a gait cycle were presented and the activation curves of the 8 major muscles during lower limb movements were obtained. Conclusions In each gait cycle, the curves of joint angles and muscle activations varied little with 5 different speeds, while curves for 3 different road slopes only showed similar tendencies but with different peaks.

Clinical study of pineal region tumors: experience with 132 patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To review the clinical manifestations, imaging, tumor markers, treatment methods, pathology results and clinical curative effects of pineal region tumors and to evaluate the characteristics and intervention strategies for those tumors.</p><p><b>METHODS</b>The clinicopathological data of 132 patients with pineal region tumor treated in our department between January 2000 and May 2008 were retrospectively studied.</p><p><b>RESULTS</b>A moderate predominance in males was presented. The clinical manifestations of the disease included increased intracranial pressure and ocular movement impairment. There were some features but no regularity and specific appearance on imaging including CT and MRI. 88.6% of patients associated with hydrocephalus. A high serum level of alpha-fetoprotein (AFP) was presented in 14 cases and high HCG in 9 cases. Eighteen cases received direct radiation therapy and 7 had radiotherapy post biopsy. 107 cases were treated surgically and 63 cases received postoperative adjuvant treatment. 114 cases had pathology results including 56 germ cell tumors. The patients were followed up for 12 approximately 132 months. Recurrence developed in 23 cases and 12 cases died. The 5-year survival rate was 89.3%.</p><p><b>CONCLUSION</b>Pineal region tumors are often associated with hydrocephalus and this makes preoperative diagnosis difficult. Imaging examination may help diagnosis but less specific. Germ cell tumors may diagnosed by some tumor markers. Radiation therapy is the choice of treatment for pure germinomas. Other types of pineal region tumors should receive surgical treatment. Postoperative adjuvant treatment based on pathology can provide a good prognosis in pineal region tumor.</p>

Relationship between calcification and ossification in craniopharyngioma / 中华神经医学杂志

Objective To investigate the fine structure of ossification in craniopharyngioma and its relationship with calcification. Methods The data of 54 patients (31 male and 23 female) with craniopharyngioma aged from 3 to 66 years, admitted to our hospital and received surgery from May 2004 to March 2006, were analyzed. The samples resected from the patients were routinely fixed with 10% formalin and embedded in paraffin. Segments were studied with HE staining. Pathological examination confirmed that 41 patients had craniopharyngioma that was ameloblastoma type and 13 were with craniopharyngioma that was squamous cell type. Microstructure and tissue type of the tumor specimens, and the characteristics of ossification were analyzed; electron microscope was employed to observe the ultrastructure of craniopharyngioma ossification; the surgical and imaging data were also compared; based on the above results, the relationship between calcification and ossification in craniopharyngioma was analyzed. Results Calcification was found negative in 7 patients, mild result in 11, egg-shell calcification in 11 and severe calcification in 12 in patients with craniopharyngioma that was ameloblastoma type. Calcification was found negative in patients with craniopharyngioma that was squamous cell type. The ossifications were found in the tumor with egg-shell or severe calcification, but absent in the tumor with mild or negative calcification. The distribution of ossification was closely related to the degree of calcification. Conclusion Calcification is the basement for the formation of ossification, and the ossification makes the tumor cell colonized in the calcification.

Influence of jogging speed on lower limb joints and muscles of young women / 医用生物力学

Objective To study the effect of reasonable jogging speed on body shape and walking gait to make people acquire graceful posture through jogging. Method Five jogging speeds were selected according to related measurements. Kinematical data of subjects (15 young women volunteers) in jogging were measured by the motion capture system, while the EMG signals of 8 major muscles in lower limb were collected simultaneously. The mean angles of hip, knee and ankle joints in sagittal plane at different speeds were calculated. The subject whose data was closest to the mean value was chosen as the research subject and analyze the kinematical data. Results The angles of the subject's hip, knee and ankle joints in sagittal plane at different speeds in a gait cycle were presented, and activation curves of her 8 major muscles were obtained during lower limb movements. Relationships between the jogging speed, jogging stage, muscle activation and joint angle were described by the scoring method. Conclusions The range of joint angle and maximum of muscle activation don't change with jogging speed monotonously. The study provides a reference for young women to choose their own jogging speed.

Anatomical study of the lateral ventricle and choroid plexus in endoscopic surgery through the occipital horn approach / 中华神经医学杂志

Objective To provide an anatomical basis for endoscopic surgery of lateral ventricular choroid plexus. Methods Eight formalin-fixed adult human head specimens (16 sides) were observed for the morphologies of the choroid plexus and the distribution of the supplying arteries. The distances from the margin of the choroid plexus to the midline of brain and the diameter of choroid vessels were measured, and the location of optimal puncture point for endoscopic transoccippital surgery was determined. Results Measurements showed that the lateral ventricular choroid plexus was located mostly in the triangular region and the temporal horn of the lateral ventricle. The distances from the ehoroid point, temporal protruding point, and frontal horn to the midline of the brain were 25.6±2.0 mm, 32.2±1.1 mm, and 29.1+1.3 mm, respectively. The widths of the temporal choroid plexus, chorod glomuis and the body of the choroid plexus were significantly different [(6.40+0.64) mm vs (13.53±1.03) nun vs (3.70±0.59) ram, P<0.05]. Choroid plexus was supplied by the vessels from choroid fissure, and the choroid glomus was supplied by the lateral branch of the anterior choroid artery. The optimal puncture site for endoscopic transoccippital surgery should be 5 cm above the occipital protuberance and 3 cm lateral to the midline, and the puncture should be carried out in the direction of the collateral eye. Conclusion Endoscopic choroid plexus surgery through the optimal puncture point allows maximal treatment of the choroid plexus. The lateral branch of the anterior choroid artery can be safely severed without affecting the blood supply of the thalamus, subependyma or temporal lobe.

Regional anatomy of the diaphragmatic foramen and its clinical significance / 中华神经医学杂志

Objective To perform an anatomical study of the structures around the diaphragmatic foramen and analyze the mechanism of cerebrospinal fluid leak and empty sella(ES).Methods With HE and Masson staining,the structures around the diaphragmatic foramen were observed microscopically on serial histological sections of 8 fetal specimens.The transsphenoidal approach was then simulated in 10 adult cadaver heads,and the structures around the diaphragnmatic foramen were observed under an operating microscope.Results The suprasellar arachnoid adhered tightly to the pia mater covering the upper part of the pituitary stalk,and folded into the sella through the diaphragmatic foramen.On the upper surface of the pituitary gland,the diaphragm adhered to the pia mater of the gland around the foramen,and their histological boundaries could not be distinctly identified on the serial sections.The suprasellar cistern terminated above the foramen due to the restriction by the arachnoid,pia mater and sellae diaphragma.Conclusion The close anatomic relationship between the sellae diaphragm,pia mater,and suprasellar arachnoid is critical to prevention of cerebrospinal fluid leak,and the breach of this anatomic relation,especially in the transsphenoidal approach for pituitary adenoma management that causes excessive traction of the tumor,results in separation or rupture of the arachnoid and pia mater,which can be an important factor contributing to cerebrospinal fluid leak.The separation of the sellae diaphragm,pia mater and the upper surface of the pituitary gland may also play an important role in the occurrence of ES.

A hybrid method including optimization and force-EMG relationship for predicting muscle force / 生物医学工程学杂志

A hybrid method based on optimization and force-EMG relationships for predicting muscle force was presented and applied to the flexion movement of upper limb. The results were compared with those from classical optimization and from the method based on force-EMG relationships. The classical optimization can not predict the force of antagonistic muscles. The method based on force-EMG relationships can not satisfy the mechanical equilibrium. The hybrid method overcomes the two disadvantages, but the forces predicted by it fluctuate excessively. Now the hybrid method is just appropriate for use in predicting isometric and isokinetic movements.

Surgical treatment for idiopathic trigeminal neuralgia caused by venous compression: analysis of 33 cases / 中华神经医学杂志

Objective To explore the operative features and results of idiopathic trigeminal neuralgia (TN) caused by venous compression. Methods Surgical management technique and outcomes in 33 TN patients were retrospectively analyzed. Compressing venules were electrically coagulated and blocked, and the offending branches of superior petrosal vein complex (SPVC) were partially blocked with the vein trunk preserved. After the veins were divided away from the compressed nerve and the entire cisternal trigeminal nerve were exposed, Teflon graft was properly interpositioned to encircle the whole range of it. Results Location of the vein compression can be at all along the cistemal trigeminal nerve. In the 33 TN patients, 22 were attributed to vein compression associated with artery offence, and 11 to simple vein conflict venous compression, among them 3 to anonymous veins and 8 to SPVC near Meckel's cave. The drainage patterns of the SPVC were classified into 3 groups. The pain get completely relieved in all patients after microvascular decompression(MVD). No recurrence was found during the follow-ups of 2.5 years on average. Four patients developed trigeminal nerve impairment and 2 suffered from disordered cerebellum function after operation, but these complications were all improved through treatment. Conclusions SPVC is the most common offensive vein.Whether the venous compression is main compressing factor or not, it was essential to deal with them properly to get the trigeminal nerve completely decompressed from veins. MVD can accurately identify the venous compression and reduce the recurrence, however, it may result in higher postoperative complications.

Whole-range encirclement method versus conventional method for microvascular decompression for treatment of hemifacial spasm / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the efficacy and micromanipulation techniques of microvascular decompression with whole-range encirclement method and the conventional method in 65 cases of hemifacial spasm.</p><p><b>METHODS</b>The data of 65 surgically managed cases of hemifacial spasm were retrospectively analyzed for intraoperative findings, surgical techniques, and the patients' outcomes. Microvascular decompression with the conventional approach was performed in 30 patients (group A), and whole-range encircling method was used in the other 35 patients (group B). The patients were also divided into group C (below 40 years, n=27) and group D (above 40 years, n=38) according to the onset age of the symptom.</p><p><b>RESULTS</b>In these patients, 4 patterns of facial nerve compression were identified: simple contact, contact and indentation, adhesion and encasement, and unidentified offending vessels. The offending vessels included the arteries, veins, and vascular loops. In most patients in group C, the arachnoid membrane around the facial nerve thickened and encircled the offending ve;ssel; in group D, the characteristic changes of the vasculature occurred in the offending artery, resulting in its displacement. In groups A and B, the overall efficacy rate was 80% and 97.1%, with recurrence rates of 13.3% and 2.9%, respectively. The major permanent complications in group A included hearing impairment (10.0%) and ataxia (6.7%), whose incidences in group B were 2.9% and 2.9%, respectively.</p><p><b>CONCLUSION</b>Microvascular decompression with whole-range encircling method is a safe approach associated with high cure rate, in which careful avoidance of injuries to the cranial nerves and the penetrating vessels from the root entry/exit zone and the pons ensure good outcome and minimize the likeliness of recurrence and complications.</p>

Combined modality therapy for primary choriocarcinoma in the pineal region: report of two cases / 南方医科大学学报

We report two rare cases of primary choriocarcinoma in the pineal region verified histologically. In both cases, the pre-operative serum level of human chorionic gonadotropin (HCG) was significantly elevated to 128-/+935.7 and 9 -/+088.9 mIU/ml, respectively, and serum alpha-fetoprotein (AFP) was negative. The tumors were microsurgically removed, and postoperative hydrocephalus were treated by endoscopic third ventriculostomy. Both patients underwent chemotherapy and radiotherapy. After adjunctive treatment, the serum HCG decreased within normal range. During the two-year-long follow-up, no radiological (MRI) evidence was found to suggest recurrence in MR imaging, and the serum HCG was normal in one patient, but mildly elevated in the other. HCG measurement can be crucial to the diagnosis and post-treatment monitoring of choriocarcinoma, and radical surgical tumor removal and combined modality therapy including chemotherapy and radiotherapy may ensure good results.