Efficacy of the ACS NSQIP surgical risk calculator in open radical hysterectomy / 实用医学杂志

Objectives To evaluate the complications predicting efficacy of the American College of Surgeons(ACS)National Surgical Quality Improvement Program(NSQIP)surgical risk calculator for cervical cancer patients undergoing open radical hysterectomy in China.Methods This study enrolled the cervical cancer patients(139 cases)undertaken open radical hysterectomy at Women's Hospital of Nanjing Medical University from Janu-ary to December in 2021.Preoperative risk factors were abstracted from medical records and the surgical risk scores were calculated using ACS NSQIP surgical risk calculator.The association between risk scores and actual outcomes were assessed using logistic regression together with the c-statistic(area under ROC)and Brier score.Results The ACSNSQIP calculator did not predict accurately for serious complications,any complications,venous thrombo-embolism(VTE),readmission,return operation room and surgical site infection(SSI)compared with actual out-comes.There was significantly difference in the predicted and actual length of stay(3.93±0.42 days vs.13.11±4.71 days,P<0.001).Conclusions The ACS NSQIP surgical risk calculator failed to predict the postoperative complications and the length of hospital stay for cervical cancer patients undergoing open radical hysterectomy.

Correlation analysis between imaging classification of varus knee osteoarthritis and axis angle of tibiofemoral and patellofemoral joints / 中国骨伤

OBJECTIVE@#To explore correlation between imaging classification of knee osteoarthritis (KOA) and axis angle of tibiofemoral and patellofemoral joints.@*METHODS@#A retrospective analysis of 739 middle-aged and elderly patients with KOA (1 026 knee joints) who underwent vertical X-ray examination of both lower limbs and lateral knee joints from September 2018 to December 2020. Among them, 63 patients with K-L 0 grade (95 knee joints), 100 patients with K-L 1 grade (130 knee joints), 161 patients with K-L 2 grade (226 knee joints), 187 patients with K-L 3 grade (256 knee joints), and 228 patients of K-L 4 grade (319 knee joints). According to relative position of knee joint center and line between hip joint center and ankle joint center, the affected knee was divided into varus group(844 knees joints) and valgus group (182 knees joints). According to Install-Salvati method, the affected knee was divided into three groups, such as high patella (patella height>1.2 mm, 347 knees joints), median patella (patella height ranged from 0.8 to 1.2 mm, 561 knees joints), and low patella (patella height<0.8 mm, 118 knees joints). Lower femur angle, upper tibia angle, femoral neck shaft angle, femoral tibial angle, joint gap angle, hip-knee-ankle angle, patella-femoral angle and patella height among different groups were observed and compared.@*RESULTS@#(1) In varus KOA group, there were statistical differnces in hip-knee-ankle angle, tibiofemoral angle, lower femoral angle, upper tibial angle, joint space angle, and femoral neck shaft angle of patients with different K-L grades (P<0.05). Hip-knee-ankle angle, tibiofemoral angle, lower femoral angle, upper tibial angle, joint space angle and K-L grade were significantly positively correlated at 0.01(P<0.05);femoral neck shaft angle and K-L grade showed negative correlation at 0.01(P<0.05). (2) In valgus KOA group, hip-knee-ankle angle, there were statistical differences in tibiofemoral angle, inferior femoral angle, superior tibial angle, joint space angle, and femoral neck shaft angle of patients with different K-L grades(P<0.05). Hip-knee-ankle angle, tibiofemoral angle, lower femoral angle, upper tibial angle, and femoral neck shaft angle showed negative correlation with K-L grades at level of 0.01 (P<0.05);joint gap angle and K-L grades showed significantly positive correlation at level of 0.01(P<0.05). (3) In high patella group, there were statistically differences in patellar height and patellar femoral angle of different K-L grades(P<0.05);there were no statistical difference in patella height and patellar femoral angle of different K-L grades in median patella group. There was no significant difference in patella heightin low patella group with different K-L grades(P>0.05), and there was statistical difference in patellofemoral angle(P<0.05). Patellar height and patella-femoral angle of high patella group were significantly positively correlated with K-L grades at the level of 0.01 (P<0.05);patella height and patella-femoral angle were not correlated with K-L grades in median patella group(P>0.05). There was no correlation between height of patella and K-L grade in low patella group (P>0.05). There was significant negative correlation between patella-femoral angle and K-L grade at level of 0.05 (P<0.05).@*CONCLUSION@#Inferior femoral angle, tibiofemoral angle, joint gap angle, hip-knee-ankle angle, femoral neck shaft angle and high patella are related to K-L classification of varus KOA, which could be used for early diagnosis and provide objective data for efficacy analysis of conservative treatment.

Mechanism of astragaloside Ⅳ in regulating autophagy of PC12 cells under oxygen-glucose deprivation by medicating Akt/mTOR/HIF-1α pathway / 中国中药杂志

This study explored the protective effect of astragaloside Ⅳ(AS-Ⅳ) on oxygen-glucose deprivation(OGD)-induced autophagic injury in PC12 cells and its underlying mechanism. An OGD-induced autophagic injury model in vitro was established in PC12 cells. The cells were divided into a normal group, an OGD group, low-, medium-, and high-dose AS-Ⅳ groups, and a positive drug dexmedetomidine(DEX) group. Cell viability was measured using the MTT assay. Transmission electron microscopy was used to observe autophagosomes and autolysosomes, and the MDC staining method was used to assess the fluorescence intensity of autophagosomes. Western blot was conducted to determine the relative expression levels of functional proteins LC3-Ⅱ/LC3-Ⅰ, Beclin1, p-Akt/Akt, p-mTOR/mTOR, and HIF-1α. Compared with the normal group, the OGD group exhibited a significant decrease in cell viability(P<0.01), an increase in autophagosomes(P<0.01), enhanced fluorescence intensity of autophagosomes(P<0.01), up-regulated Beclin1, LC3-Ⅱ/LC3-Ⅰ, and HIF-1α(P<0.05 or P<0.01), and down-regulated p-Akt/Akt and p-mTOR/mTOR(P<0.05 or P<0.01). Compared with the OGD group, the low-and medium-dose AS-Ⅳ groups and the DEX group showed a significant increase in cell viability(P<0.01), decreased autophagosomes(P<0.01), weakened fluorescence intensity of autophagosomes(P<0.01), down-regulated Beclin1, LC3-Ⅱ/LC3-Ⅰ, and HIF-1α(P<0.05 or P<0.01), and up-regulated p-Akt/Akt and p-mTOR/mTOR(P<0.01). AS-Ⅳ at low and medium doses exerted a protective effect against OGD-induced autophagic injury in PC12 cells by activating the Akt/mTOR pathway, subsequently influencing HIF-1α. The high-dose AS-Ⅳ group did not show a statistically significant difference compared with the OGD group. This study provides a certain target reference for the prevention and treatment of OGD-induced cellular autophagic injury by AS-Ⅳ and accumulates laboratory data for the secondary development of Astragali Radix and AS-Ⅳ.

Acupuncture randomized controlled trials: comparing China-based vs. Western-based studies / 中国针灸

With the worldwide spread of acupuncture as a therapeutic modality and the rapid development of acupuncture clinical research, the number of acupuncture randomized controlled trial (RCT) studies is steadily increasing in China and around the world. However, the results of these studies seem to come from two different worlds indeed. Chinese RCT studies overwhelmingly demonstrate positive outcomes from acupuncture, whereas Western-based studies generally conclude that there is no discernible difference between acupuncture and a placebo. Why should there be such different outcomes when the same scientific method is being used? This paper analyzes factors that may be contributing to the different outcomes between China-based and Western-based RCT studies by considering and comparing starting points, purpose, study design, investigators, acupuncture treatment regimen, methodological quality, results, conclusions, and deficiencies in acupuncture RCT. Based on these comparisons, this paper examines the value of acupuncture RCT in general, and the methodological confusion which seems to have propagated from study to study. We propose the following suggestions to remediate the acupuncture clinical research paradigm: First, acupuncture clinical researches should be carried out step-by-step according to universal, agreed-upon research protocols. Second, norms for reporting outcome metrics need to be standardized for each stage of a study.

Localization of Chinese acupuncture-moxibustion in the United States: the openness of modern acupuncture-moxibustion system / 中国针灸

The internationalization of Chinese acupuncture-moxibustion is inevitably accompanied by the localization of acupuncture-moxibustion. The localization of acupuncture-moxibustion will inevitably promote the diversified development of acupuncture-moxibustion technique and theory, which fully demonstrates the openness of modern acupuncture-moxibustion. In this study, the characteristics of localization of Chinese acupuncture-moxibustion in the United States are explored and studied from the following aspects: legal adjustment, technical adjustment, educational adjustment, service adjustment and theoretical adjustment.

Mental health status of students with self reported learning disabilities in Beijing / 中国学校卫生

Objective@#Understanding mental health status of students with learning disabilities in Beijing to provide a basis for mental health promotion of students with learning disabilities.@*Methods@#By means of random cluster sampling, 5 787 enrolled students in grade one and grade two of 11 public junior middle schools in Beijing were selected as the survey subjects. A self designed questionnaire was used to investigate the students’ learning disabilities and mental health status through anonymous self filling.@*Results@#About 11.6% students self reported learning disabilities. The proportions of students with learning difficulty in mathematical reasoning and calculation were higher, 44.1% and 40.7% respectively. The reported rate of mental health problems was 38.3%. The top four of the 10 symptoms were obsessive compulsive symptoms, learning pressure, emotional instability and anxiety(2.19±0.77)(2.17±0.99)(2.09±0.90)(2.07±1.08). Compared with students without learning disabilities, students with self reported learning disabilities had poorer mental health status(OR=1.47), and learning disabilities were related to most factors of mental health. Different types of learning disabilities were associated with different mental health factors.@*Conclusion@#Mental health problems of students with learning disabilities are higher than that of students without learning disabilities. It is necessary to strengthen the mental health support for students with learning disabilities and improve their mental health.

Convergence of Medicines: West Meets East in Newly-Discovered Organs and Functions / 中国结合医学杂志

Although the foundations and evolution of Chinese medicine and Western medicine are very different, an increasing amount of research has revealed that those Eastern medicine principles practiced over thousands of years are confirmed by new technologies applied to the basic science of the human body. Recent scientific discoveries present enticing opportunities to reconcile Chinese medicine theories with Western biomedicine. Is there a trend toward the convergence of Eastern and Western medicine? Four studies which exemplify the potential for convergence are described in this article. The studies present findings in regard to mesentery, interstitium, a gut-lung axis, and lung-centered hematopoiesis, and were published recently in leading journals such as Science, Nature, and Lancet.

Clinical effects of clomiphene citrate combined with low molecular weight heparin calcium in the treatment of patients with polycystic ovary syndrome infertility / 中国实用妇科与产科杂志

OBJECTIVE: To discuss the clinical effects of clomiphene citrate combined with low molecular weight heparin calcium in the treatment of patients with polycystic ovarian syndrome(PCOS)infertility. METHODS: A total of 105 patients with PCOS infertility who were admitted to the Outpatient Department of Women and Children's Hospital of Qingdao University from September 2016 to April 2018 were taken as research subjects.They were randomly divided into observation group(57 cases)and control group(48 cases).The control group received clomiphene citrate for ovulation treatment,the observation group was given clomiphene citrate combined with low molecular weight heparin calcium for ovulation treatment,and the endometrial receptivity changes,pregnancy rate and the incidence of adverse reactions of patients were compared between the two groups.RESULTS: In the observation group,the endometrial thickness,blood flow index(FI),endometrial spiral arterial blood flow resistance index(RI)and pulsatility index(PI)decreased,and the pregnancy rate was better than that in the control group;the difference was statistically significan(t P0.05).CONCLUSION: Clomiphene citrate combined with low molecular weight heparin calcium in the treatment of polycystic ovary syndrome infertility can improve the treatment efficiency,and is safe and reliable.It is worthy of clinical promotion.

Acupuncture and the Opioid Epidemic in America / 中国结合医学杂志

The opioid epidemic has become a signifificant public health crisis in the United States of America. This crisis has elicited a response at high levels of governmental and health care organizations including the American College of Physicians, the Food and Drug Administration, the Joint Commission, the National Academies of Science, Engineering and Medicine, the National Association of Attorneys General, and the White House. In various ways, these organizations have recognized that acupuncture can play an important role in dealing with the opioid epidemic. This paper presents and analyzes the scientifific evidence supporting the effificacy of acupuncture in regard to opioid addiction.

Treatment of Chronic Glomerulonephritis from Lung / 中国中医药信息杂志

Chronic glomerulonephritis is with edema, proteinuria, hematuria and high blood pressure as the main clinical manifestations. The pathogenesis is complex, and disease locations are related to the lung, spleen, kidney, heart, and liver. Based on the relationship between lung and chronic glomerulonephritis, this article discussed the feasibility, common treatment and prescription of chronic glomerulonephritis from the lung, which could provide a theoretical basis for the treatment of chronic glomerulonephritis in clinic.

Treatment of Chronic Glomerulonephritis from Lung / 中国中医药信息杂志

Chronic glomerulonephritis is with edema, proteinuria, hematuria and high blood pressure as the main clinical manifestations. The pathogenesis is complex, and disease locations are related to the lung, spleen, kidney, heart, and liver. Based on the relationship between lung and chronic glomerulonephritis, this article discussed the feasibility, common treatment and prescription of chronic glomerulonephritis from the lung, which could provide a theoretical basis for the treatment of chronic glomerulonephritis in clinic.

To be, or not to be: The calculated politics of acupuncture in JAMA / 中国结合医学杂志

Ten acupuncture-related articles were published in The Journal of the American Medical Association (JAMA) between 1998 and 2017. Five studies showed positive results in terms of the effectiveness of acupuncture/Chinese medicine (CM); five studies showed negative results. This article summarizes the acupuncturerelated clinical trials published over the last 20 years in JAMA, and addresses what seems to be a fundamental ambivalence in Western medical journals regarding the scientific validity of acupuncture/CM. As yet there has been no consensus on the role of acupuncture in healthcare in Western countries. This is hardly surprising, considering the conflicting evidence found in published studies. Skepticism regarding acupuncture/CM is largely grounded in the fact that an accurate model for assessing the true clinical effects of acupuncture has yet to be created. This article discusses some of the pitfalls which result from applying Western-based scientific principles to CM, and suggests that in many cases, "negative" studies have been misinterpreted. The clinical experience of acupuncture practitioners is often in direct conflict with many of the negative conclusions published in journals. We are in need of an accurate model for sham and placebo treatments, and must analyze all published studies for design flaws and faulty conclusions.

The effect of high mobility group box 1 with interleukin-1β or lipopolysaccharide on the proliferation and inflammatory phenotype of synoviocytes in rheumatoid arthritis / 中华风湿病学杂志

Objective To investigate the effect of high mobility group box chromosomal protein 1 (HMGB-1) on the proliferation and inflammatory phenotype of human fibroblast like synoviocytes (FLS).Methods FLSs were isolated from the synovial tissues of rheumatoid arthritis (RA) patients undergoing joint replacement surgery.All the experiments described here utilize the FLSs between the third and sixth passages.FLS were incubated with HMGB1 at (100,500,2 000 ng/ml) or interleukin (IL)-1β (0.5 ng/ml) or lipopolysaccharide (LPS) (100 ng/ml) alone or HMGB1/IL-1β complexes or HMGB1/LPS complexes.Cell proliferation assay were used by CCK-8,IL-6,IL-8 and matrix metalloproteinase-3 (MMP-3) in culture supernatants were measured using enzyme-linked immunosorbent assays.The measurement data were compared with single factor analysis of variance.Results Stimulation with all concentrations of HMGB1,IL-1β and LPS alone did not affect the cell proliferation of FLS.HMGB1/IL-1β complexes and HMGB1/LPS complexes did not affect the cell proliferation of FLS,neither (F=0.415.P=0.915).Except high concentration of HMGB1 (2 000 ng/ml) could significantly stimulate the secretion of IL-6 from FLS [(23.0±1.1) ng/ml],HMGB1,IL-1β and LPS alone did not affect the production of IL-6,IL-8 and MMP-3.However,HMGB1/IL-1β complexes and HMGB1/LPS complexes increased IL-6,IL-8 and MMP-3 production from FLS (F=97.804,117.383,70.179,P=0.000).Conclusion Neither HMGB1,IL-1β,LPS alone nor HMGB1/IL-1β complexes or HMGB1/LPS complexes affect the cell proliferation of FLS.HMGB1 in complex with LPS or IL-1β boost IL-6,IL-8 and MMP-3 production in synovial fibroblasts from RA patients.

Cloning of IPO8 promoter and analysis of its transcription activity / 中南大学学报(医学版)

OBJECTIVE@#To clone 5' untranslated region of human IPO8 gene and determine its transcription activity.@*METHODS@#We used 5' rapid amplification of cDNA ends (RACE) analysis to identify the IPO8 transcription start site (TSS), and amplified series truncated 5' UTR fragment containing transcription start site. The PCR productions were inserted into luciferase report vector pGL3- Basic. After confirmation by restriction enzyme digestion, the recombinant plasmids were cotransfected into Saos-2 cells with plasmid pRL-TK. The luciferase activities were measured by dual luciferase reporter system.@*RESULTS@#The IPO8 gene transcription start site was established. The electrophoresis analysis of restriction enzyme digestion and DNA sequencing verified the fragments were successfully amplified and inserted into pGL3-Basic. After the recombinant plasmids transfected, the highexpressions of luciferase were detected in Saos-2 cells.@*CONCLUSION@#The recombinant vector containing IPO8 promoter is constructed successfully, which provides a foundation for determining expressional regulation of IPO8 in the further study.

Test results analysis on wild measles virus neutralizing antibodies in 70 pairs of mother and infant / 上海预防医学

[Objective] To investigate the level of wild -measles neutralization antibody of both mother and infant , and its correlation between the paired mother and infant . [ Methods] The wild-mea-sles neutralization antibody in the serum of the women and their infants were detected directly by a neutral -ization test (NT) methods. [ Results] The positivity rates of neutralization antibody in mothers and their infants were 91.52%and 88.57%respectively, geometric mean title of neutralization antiboby (GMT) being 61.32 and 58.17 respectively.And the titer of neutralization antibody was highly correlated ( r=0.899, P<0.01)between mother and infant in pairs.When the GMT of mother was ≥1∶16,the positivity rate of neutralization antibody in their infants might reach 100.00%. [ Conclusion] It is important to increase the maternal measles antibody level in order to prevent infants from measles .

Epidemiological characteristics and impact factors of adult measles during 2009-2012 in shanghai / 上海预防医学

[Objective] To analyse the impact factors for adult measles and its epidemiological characteristics in shanghai . [ Methods] The data on adult measles incidence during 2009-2012 were analyzed using descriptive epidemiology method .And the blood antibody titers was measured by ELISA method in the adult over18 years old in Hong Kou District of Shanghai . [Results] Zero dose vaccination and vaccination failure were the key reasons for the increase of adult measles , which were closely related to our history of prevention and treatment of measles . [ Conclusion ] Adult immunization should be strengthened to improve immune barrier and to reduce the measles incidence in adults , and it is suggested that the immunization for 10-15 year-olds should be strengthened so as to improve the overall antibody levels in adults as a whole .

Advancement on targeted therapy of malignancies with superantigens / 国际肿瘤学杂志

Superantigens are potent activators of T cells,causing rapid and massive proliferation of T cells and superantigen-dependent-cell-mediated cytotoxicity with extremely low doses.However such antitumor effects lack selectivity.Thus with the methods including monoclonal antibody targeting or binding superantigens to the surface of tumor cells as well as genetic engineering,scientists have done lots of work on targeted therapy of malignancies with superantigen.

Kanamycin induced ototoxicity in three kinds of mouse strains and its effects on the expression of na-K-2Cl co-transporter-1 in stria vascularis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To establish a mice model of aminoglycoside antibiotics (AmAn) induced ototoxicity. Then to investigate the sensitivity of AmAn induced ototoxicity in three mouse strains and effect of kanamycin on the expression of Na-K-2Cl co-transporter-1 (NKCC1) in stria vascularis.</p><p><b>METHODS</b>C57BL/ 6J, CBA/CaJ, NKCC1 +/- mice (each of twenty-four) were randomly divided into four experimental groups A, B, C and D (A kanamycin alone, B kanamycin plus 2, 3-dihydroxybenzoate, C 2, 3-dihydroxybenzoate alone, D control group). Mice were injected with kanamycin or/and 2, 3-dihydroxybenzoate for 14 days. Auditory function was measured by auditory brainstem response (ABR) and morphology of cochlea was observed by succinate dehydrogenase staining. Expression of NKCC1 was detected by immunohistochemistry.</p><p><b>RESULTS</b>Mice in group A developed significant ABR threshold shifts (P < 0.01), which were accompanied by out hair cells loss. Mice in group B significantly attenuated ABR threshold shifts with out hair cells loss (P <0.01). The immunostaining of NKCC1 in stria vascularis was attenuated significantly in group A compared with group D (P < 0.01) while the immunostaining in group B was enhanced than which in group A (P < 0.01). CBA/CaJ mice has the highest sensitivity to AmAn in three mouse strains.</p><p><b>CONCLUSIONS</b>An mouse model of AmAn induced ototoxicity could be established by administration of kanamycin. Kanamycin could inhibit the expression of NKCC1 in stria vascularis. 2, 3-dihydroxybenzoate could attenuate AmAn induced ototoxicity maybe by enhancing the expression of NKCC1. Mice that had the characteristic of presbycusis didn't show additional sensitivity of AmAn induced ototoxicity.</p>

Association of age-related hearing loss with mice which expressed only one copy of gene encoding NKCC1 co-transporter / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To generate transgenic mice of NKCC1 +/- (heterozygous) and NKCC1 +/+ (wild-type) that have a targeted disruption in the NKCC1 gene in order to investigate the relationship of one copy of NKCC1 gene (NKCC1 +/-) and age-related hearing loss (AHL) and to study the possible pathogenesis of AHL METHODS: Auditory function of NKCC1 +/- mice was detected regularly by auditory brain response (ABR) and endocochlear potential (EP). Morphology of cochlea was observed by scanning electron microscope and content of NKCC1 protein was detected by Western blot.</p><p><b>RESULTS</b>The mean value for ABR thresholds was elevated in NKCC1 +/- mice more than that of NKCC1 +/+ mice (P < 0.01). A progression of age-related hearing loss was found in NKCC1 +/- mice. Compared with younger NKCC1 +/- mice, the mean value for ABR thresholds in aged NKCC1 +/- mice was significantly increased (P < 0.05). The EP of NKCC1 +/- aged mice was also significantly decreased more than that of the younger NKCC1 +/+ mice (P < 0.05). And content of NKCC1 protein were reduced with the growth of the age. The scanning electron microscope showed a kind of scattered punctiform absence of outer hair cells in elder NKCC1 +/- mice cochlea.</p><p><b>CONCLUSIONS</b>NKCC1 gene maybe takes part in the pathogenesis of AHL. Mice that expressed only one copy of NKCC1 could lead to AHL. AHL may be correlative with the amounts of NKCC1 protein and its function and also with the loss of outer hair cells perhaps.</p>