Construction and validation of a risk prediction model for pancreatic fistula after pancreaticoduodenectomy / 中华内分泌外科杂志

Objective:To investigate the risk factors of pancreatic fistula after pancreaticoduodenectomy and establish the risk graph model of pancreatic fistula.Methods:The clinical data of 147 patients undergoing pancreaticoduodenectomy from Jan. 2018 to Jan. 2021 in Department of Hepatobiliary Surgery of Northern Theater Command General Hospital were retrospectively analyzed. The independent risk factors for postoperative pancreatic fistula were determined by univariate and multivariate analysis, and the linear graph model for predicting individual pancreatic fistula was drawn. The area under the subject operating characteristic curve was used to evaluate the model differentiation, the calibration curve was used to evaluate the model calibration, and finally the clinical application value of the model was evaluated by the clinical decision curve (DCA) .Results:The incidence of pancreatic fistula was 38.1%, including grade B pancreatic fistula in 49 cases and Grade C pancreatic fistula in 7 cases. Univariate analysis showed that operation method, body mass index (BMI), pancreatic texture, pancreatic duct diameter and lesion location were the related factors for postoperative pancreatic fistula. Multivariate analysis showed that BMI>25 kg/m 2, pancreatic soft texture, pancreatic duct diameter ≤3 mm and non-pancreatic diseases were independent risk factors for postoperative pancreatic fistula. According to the results of multiple factors, a prediction model of the nomogram was drawn, and the area under the subject operating characteristic curve of the model was calculated as AUC=0.792 (95% CI: 0.718-0.867). The calibration curve was drawn through internal verification of re-sampling, and the fitting curve swung around the 45° reference line, showing a high calibration degree; Clinical decision curve (DCA) analysis showed that the threshold probability was between 15% and 75% for maximum net benefit. It had good clinical application value. Conclusions:BMI>25 kg/m 2, soft pancreas, pancreatic duct diameter ≤3 mm and non-pancreatic diseases are independent risk factors for pancreatic fistula after pancreaticoduodenectomy. The established line graph model has good predictive efficiency and can effectively predict the occurrence of postoperative pancreatic fistula.

Renal oncocytoma misdiagnosed as renal cell carcinoma: report of two cases and literature review / 中国基层医药

Objective:To investigate the clinical, imaging, and pathological characteristics of renal oncocytoma, and to improve the understanding, diagnosis, and treatment of renal oncocytoma.Methods:The imaging and pathological data of two patients misdiagnosed with renal cell carcinoma in the 970 Hospital of PLA Joint Logistics Support Force from January to March 2021 were retrospectively analyzed. The relevant literature was reviewed and discussed.Results:The tumors were located in the left kidney of two patients, with diameters of 2.7 cm and 3.2 cm respectively. The patients underwent retroperitoneal laparoscopic removal of partial left kidney and retroperitoneal laparoscopic removal of the whole left kidney separately. The pathological results confirmed the diagnosis of renal oncocytoma.Conclusion:Renal oncocytoma is a rare benign renal cell tumor which is difficult to be diagnosed before surgery. Contrast-enhanced CT can provide evidence for the identification of renal oncocytoma. Its final diagnosis depends on pathological results.

Mixed methods research of pediatric professional training for general practitioners: taking Longhua District of Shenzhen as an example / 中华医学教育探索杂志

Objective:To investigate the past continuing medical education (CME) in pediatrics for general practitioners in community health centers in Longhua District, Shenzhen, so as to explore the willingness, needs and suggestions of general practitioners for CME in pediatrics.Methods:A mixed methods research were used in this study. Firstly, the purpose sampling method was used to select general practitioners in community health centers in Longhua District, Shenzhen for personal in-depth interviews. The interview contents were recorded and transcribed. The interview contents were coded by NVivo software. Theme frame analysis method was used for data sorting and theme extraction. Based on the results of qualitative interviews, the questionnaire was developed and distributed through the electronic questionnaire platform, and relevant questionnaire data were analyzed by Excel.Results:The results of qualitative research showed that after personal in-depth interviews with 10 general practitioners, the information reached saturation. Through repeated reading, induction and analysis of the interview data, four themes were extracted: ① previous pediatric training opportunities and satisfaction; ② willingness to participate in pediatric training; ③ the demand of training content, form and duration; ④ measures to encourage participation in training. In terms of quantitative research results, a total of 223 electronic questionnaires were collected, among which there were 219 valid questionnaires. Besides, 150 (68.5%) general practitioners said that they had no or only a few training opportunities in pediatrics CME in the past. There were some problems in the past CME training, such as unsystematic training (39 practitioners, 66.1%), narrow course coverage (30 practitioners, 50.8%), the content divorced from clinical practice (29 practitioners, 49.2%), monotonous teaching method (27 practitioners, 45.8%), etc. And 210 (95.9%) general practitioners were willing to participate in pediatric training, and 161 (73.5%) hoped that the form of training would be a combination of online and offline. In terms of pediatrics specialty content training needs, the general practitioners had higher demand for respiratory (188 practitioners, 85.8%), digestive (160 practitioners, 73.1%), infectious (145 practitioners, 66.2%) and dermatology (136 practitioners, 62.1%) specialty.Conclusion:There are still some problems in pediatrics CME, such as few training opportunities, unsystematic training, etc. In the future, we need to formulate systematic training plans and incentive measures according to the needs of general practitioners, to strengthen the pediatric professional training for general practitioners and improve their ability to receive children, in order to promote the implementation of hierarchical medical system for children.

Survey on status quo of reception of pediatric patients by general practitioners in Longhua District of Shenzhen / 中华全科医师杂志

Objective:To investigate the status quo and related issues of reception of pediatric patients by general practitioners in community health centers in Longhua District of Shenzhen through qualitative and quantitative studies.Methods:In qualitative study, 10 general practitioners (GPs) from community health centers in Longhua District of Shenzhen were selected by the purpose sampling method for personal in-depth interviews. The interview contents were recorded and transcribed, then coded by Nvivo software. Theme frame analysis method was used for data sorting and theme extraction. Based on the results of qualitative interviews, the questionnaire was developed and distributed through the electronic questionnaire platform. The contents of the questionnaire included general information, the situation of pediatric patient reception in community health centers, the willingness and ability of GPs to receive children, the existing problems and the measures to promote receiving pediatric patients in community health centers.Results:The results of personal in-depth interviews with 10 GPs showed that the obtained information reached saturation. Through repeated reading, induction and analysis of the interview data, four themes were extracted: ① GPs in community health centers received a large number of pediatric outpatients with common diseases; ② GPs in community health centers are willing to receive child patients, but they were lack of ability; ③ there were many problems of pediatric patients reception in community health centers; ④ training and incentive policies would help to promote child patient reception in community health centers. A total of 223 electronic questionnaires were collected, 219 of which were valid for analysis. All the community health centers in Longhua District received pediatric patients, the number accounted for 20%-60% of the total outpatients; 84.5%(185/219)of the responders were willing to receive child patients, 65.8% (144/219)of them assumed that the consulting ability was average. The main problems for GPs to receive pediatric patients were "insufficient training" (76.7%,168/219) and "lack of consulting ability" (55.3%,121/219). The important measures to promote GPs to receive child patients were to improve their own clinical competence (94.1%,206/219), to have clinical faculty with pediatric background mentoring at the community health center (74.9%,164/219), to improve the supporting facilities (42.9%,94/219) and continuous professional support (38.8%,85/219).Conclusion:The status quo of pediatric patient reception in the community of Shenzhen Longhua District is generally satisfactory. The main problems in this aspect are insufficient training for general practitioners and lack of clinical competence, which should be strengthened and improved in the future.

Development of an online continuing education course of pediatrics for primary physicians with ADDIE model and its evaluation:a qualitative study / 中华全科医师杂志

Objective:To develop an online continuing education course of pediatrics for primary physicians using the ADDIE model and to evaluate its application effect.Methods:Experts in fields of general practice and pediatrics were invited to develop an online continuing education course of pediatrics for general practitioners using ADDIE model from June to July 2020. From August 2020 to September 2020 the course was conducted with 12 live sessions on the open platform. In September 2020, 16 primary pediatricians and 15 general practitioners who completed whole courses were invited to attend focus group interviews. The interview contents were recorded, transcribed, and coded using Nvivo software; the subject frame analysis method was used to sort the data and refine the theme.Results:Information was saturated by focus group interviews with 14 general practitioners and 14 pediatricians. Finally, three themes were extracted from the interview results:(1)The advantages of this course were practicality, comprehensiveness and online teaching; (2) The course improved the diagnosis and treatment ability of participants, increased self-confidence of doctors and satisfaction of patients, and also promoted academic exchanges among colleagues; (3) For future improvement of the course, the clinical knowledge points, practical procedures, new thinking of diagnosis and treatment, progress in guidelines, and knowledge depth should be added; and the use of case teaching and combination of online with offline, and extending teaching time should be considered.Conclusion:An online continuing education course of pediatrics for primary physicians has been developed based on the ADDIE model, which received favorable feedback from the primary pediatricians and general practitioners who attended the course.

Targeting "undruggable" c-Myc protein by synthetic lethality / 医学前沿

Synthetic lethal screening, which exploits the combination of mutations that result in cell death, is a promising method for identifying novel drug targets. This method provides a new avenue for targeting "undruggable" proteins, such as c-Myc. Here, we revisit current methods used to target c-Myc and discuss the important functional nodes related to c-Myc in non-oncogene addicted network, whose inhibition may cause a catastrophe for tumor cell destiny but not for normal cells. We further discuss strategies to identify these functional nodes in the context of synthetic lethality. We review the progress and shortcomings of this research field and look forward to opportunities offered by synthetic lethal screening to treat tumors potently.

Activated PKB/GSK-3β synergizes with PKC-δ signaling in attenuating myocardial ischemia/reperfusion injury via potentiation of NRF2 activity: Therapeutic efficacy of dihydrotanshinone-I

@#Disrupted redox status primarily contributes to myocardial ischemia/reperfusion injury (MIRI). NRF2, the endogenous antioxidant regulator, might provide therapeutic benefits. Dihydrotanshinone-I (DT) is an active component in Salvia miltiorrhiza with NRF2 induction potency. This study seeks to validate functional links between NRF2 and cardioprotection of DT and to investigate the molecular mechanism particularly emphasizing on NRF2 cytoplasmic/nuclear translocation. DT potently induced NRF2 nuclear accumulation, ameliorating post-reperfusion injuries via redox alterations. Abrogated cardioprotection in NRF2-deficient mice and cardiomyocytes strongly supports NRF2-dependent cardioprotection of DT. Mechanistically, DT phosphorylated NRF2 at Ser40, rendering its nuclear-import by dissociating from KEAP1 and inhibiting degradation. Importantly, we identified PKC-δ-(Thr505) phosphorylation as primary upstream event triggering NRF2-(Ser40) phosphorylation. Knockdown of PKC-δ dramatically retained NRF2 in cytoplasm, convincing its pivotal role in mediating NRF2 nuclear-import. NRF2 activity was further enhanced by activated PKB/GSK-3β signaling via nuclear-export signal blockage independent of PKC-δ activation. By demonstrating independent modulation of PKC-δ and PKB/GSK-3β/Fyn signaling, we highlight the ability of DT to exploit both nuclear import and export regulation of NRF2 in treating reperfusion injury harboring redox homeostasis alterations. Coactivation of PKC and PKB phenocopied cardioprotection of DT in vitro and in vivo, further supporting the potential applicability of this rationale. Graphical abstract

Application of exosomes in prostates cancer / 国际肿瘤学杂志

Exosomes derived from prostate cancer cells can directly or indirectly promote the growth and metastasis of prostate cancer cells. It was found that it can be used as a marker for diagnosis and prognosis evaluation of prostate cancer, and participate in the clinical treatment of prostate cancer, such as targeted therapy, drug resistance assessment, tumor vaccine preparation, etc. With the development of various studies and technological progress, exosomes will play a huge role in the diagnosis and treatment of prostate cancer.

Promoting effect of 810 nm low-level laser on axonal regeneration of neurons in mice with spinal cord injury and its related mechanism / 中华创伤杂志

Objective To investigate the effect of 810 nm low-level laser on neuronal axonal regeneration of mice with spinal cord injury and its related mechanism.Methods In vivo experiment:20 Balb/c mice were randomly divided into the spinal cord injury group(SCI group)and the 810 nm low-level laser irradiation group(low-level laser group)after spinal cord injury according to the random number table method,with each group containing ten mice.A mice SCI model was established through clamp injury and the low-level laser group continuously irradiated the damaged area with weak 810 nm low-level laser with selected parameters(continuous wave with wave length 810 nm,power density 2 mW/cm2,spot are 4.5 cm2,irradiation time 50 minutes,energy 6000J/cm2).Then immunofluorescence staining was used to observe the M1 macrophage marker-inducible nitric oxide synthase(iNOS),the M2 macrophage marker arginase 1(Arg-1)and the universal marker F4/80 of macrophages after 14 days.Furthermore,in the in vitro experiment,standardized low-level laser-macrophage irradiation model was established.Another 20 Balb/c mice were used to obtain primary bone marrow-derived macrophages which were induced into M1 macrophages using lipopolysaccharide(LPS)and interferon-gamma(INF-γ).The M1 macrophages were randomly divided into the M1 macrophage group(M1 group)and the low-level laser therapy group(M1 + low-level laser group)equally according to the random number table method.The M1 group was not treated,and the M1 + low-level laser group was treated with low-level laser of selected parameters.RT-qPCR and ELISA were used to detect the expression of interleukin-1 receptor antagonist(IL-1RA)and interleukin-10(IL-10)in M1 macrophages 24 hours after irradiation.Western blot was used to analyze the expression of iNOS,Arg-1,differentiation antigen cluster 206(CD206),protein kinase B(AKT),phosphorylated protein kinase B(p-AKT),cyclic adenosine response element binding protein(CREB)and phosphorylated cyclic adenosine response element binding protein(p-CREB)in M1 macrophages 48 hours after irradiation.Dorsal root gangtion neurons(DRG)were cultured in two groups of macrophage conditioned medium,and the length of DRG axon growth was measured 48 h later to evaluate the effect of low-level laser on neuronal axon growth.Results In the in vivo experiment,compared with mice with spinal cord injury alone,the fluorescence intensity of F4/80+ iNOS+ in the spinal cord injury area decreased(1.00±0.08vs. 0.06±0.04)(P＜ 0.05)and the fluorescence intensity of F4/80 + Arg-1 + increased after low-level laser(1.00±0.07vs.2.15±0.12)(P＜0.01).In the in vitro experiment,compared with the M1 group,the expression of the M1 macrophage marker iNOS in the M1 + low-level laser group decreased(1.00±0.11 vs.0.08±0.01)(P＜ 0.01);the M2 macrophage marker Arg-1(1.00±0.14vs.2.44±0.16)(P＜0.01),and the expression of CD206(1.00±0.12 vs.1.83±0.05)(P＜0.01)increased.In addition,IL-1RA expression was increased in the M1 + low-level laser group compared with the M1 group(RT-qPCR:1.00±0.00vs.2.27±0.22)(P＜0.01)(ELISA:1435.58±100.48vs.2006.12±123.91(P＜0.05);IL-10 expression was also increased in the M1 +low-level laser group compared with the M1 group(RT-qPCR:1.00±0.00 vs. 3.45±0,56)(P＜0.05)(ELISA:137.13±4.20 vs.188.29±8.49)(P＜ 0,01);compared with the M1 group,the macrophage polarization pathway protein in the M1 + low-level laser group increased,AKT(1.07±0.12vs.1.74±0.04)(P＜0.01),p-AKT(1.00±0.12 vs.1.64±0.15)(P＜0.05),p-CREB(1.00±0.10vs.2.12±0.18)(P＜0.01).Compared with the M1 group,the conditioned medium of the M1 + low-level laser group significantly promoted DRG axon growth(567.66±63.59 vs.1068.95±130.14)(P＜ 0,05).Conclusions The 810 nm low-level laser irradiation can promote neuronal axon regeneration of mice with spinal cord injury,which may be related to the regulation of macrophage polarization phenotype by low-level laser through AKT/CREB pathway.

Clinical application of tip-flexible semirigid ureterorenoscope for the treatment of impacted upper ureteral calculi / 中华泌尿外科杂志

Objective To study the clinical efficacy and advantages of tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy for the treatment of impacted upper ureteral calculi.Methods We retrospectively analyzed 75 cases of impacted upper ureteral calculi treated in our hospital between September 2015 and December 2017.There were 45 males and 30 females,aged from 35 to 65 years,mean (42.5 ± 3.5)years.All patients were diagnosed by B-ultrasound and CT with impacted upper ureteral calculi.The mean stone diameter was (1.6 ± 0.3) cm.The CT value of stone was (1 025.3 ± 215.4) HU.Tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy were performed in all of the cases,which were under general anesthesia with lithotomy position,to observe the successful rate of lithotripsy,operation time,intraoperative and postoperative complications,postoperative hospitalization time and stone-free rate.Results All 75 cases were successfully operated.The operation time was (38.5 ± 11.2) min.Three cases had postoperative fever.No severe perioperative complications such as septic shock,ureteral perforation or avulsion occurred.The mean hospital stay of the patients was (2.7 ± 0.4) d.A follow up by non-contrast CT scan was done 4 weeks after the procedure to evaluate the result.Sixty seven cases had stone clearances at the primary operation and the stone clearance rate was 89.3％ (67/75).Eight cases undergone ESWL and physical vibration lithecbole,the CT examination showed that the stones were cleared after 1 month.Conclusions Tip-flexible semirigid ureterorenoscope combined with Holmium laser lithotripsy in the treatment of impacted upper ureteral calculi had a definite effect,safe and comfortable for doctors.

Effects of different modes of mild treadmill exercise on cognitive function of Alzheimer's disease mice / 重庆医学

Objective To investigate the effects and possible mechanisms of different modes of mild treadmill exercise on cognitive function in Alzheimer's disease(AD) APP transgenic mice.Methods Twenty-four 6-month-old APP+ mice were randomly and equally divided into the four groups:control group(Con),regular exercise group(RE),irregular time-of-day exercise group (ITE) and irregular different duration exercise group(IDDE).After treadmill exercise,the spatial cognitive ability was tested.Soluble and insoluble Aβ40,42 levels,activity of β-secretase and γ-secretase in hippocampal tissue were compared among 4 groups.The mRNA levels of NEP,IDE and MMP-9 in the hippocampal tissue were detected.The number of hippocampal survival neurons and protein levels of BDNF,TrkB and p-TrkB were detected.Results Compared with the control group,the spatial cognitive ability in the RE group was significantly increased(P＜0.05),the levels of soluble and insoluble Aβ40,42 and activity of β-secretase and γ-secreatase were significantly reduced in the hippocampal tissue of th RE group(P＜ 0.05).However,the mRNA levels of NEP,IDE and MMP-9 had no statistically significant difference among the four groups(P＞0.05).Compared with the control group,the number of survival neurons and protein levels of BDNF and p-TrkB in the hippocampal of the RE group tissue were significantly increased(P＜0.05).The cognitive function,levels of Aβ40,42,BDNF and p-TrkB,number of survival neurons in the RE group had statistically significant differences when compared with the ITE and IDDE groups(P＜0.05).Conclusion Mild and regular treadmill exercise can effectively increase the cognitive function of AD mice,which might be related with the regulation of BDNF/TrkB pathway.

Identification of Asymmetry Gait in Parkinson's Disease Based on Kinect / 中国康复理论与实践

@#Objective To develop a non-contact identification method for gait asymmetry in Parkinson's disease based on depth image to assist medical diagnosis and assessment, to avoid the cost, impact on normal life, and complex process of high wear-out sensing equipment. Methods From July to August, 2016, eight patients with Parkinson's disease and ten healthy subjects were collected the gait parameters of walking six meters with Kinect V2.0. The parameters of left and right foot were filtered and clustered. Then similarity matrix algorithm was used to find the difference between healthy subject and patient similarity values. Finally, the recognition effect of this method was verified by Hidden Markov Model. Results The similarity of clustering sequences of left and right foot parameters was less in the patients than in the healthy individuals. There were twelve of 14 data identified in patients, and 35 of 46 in the healthy. Conclusion A non-contact identification method for the asymmetry of gait has been developed based on the parameter clustering results of left and right foot, which is some effective on identifying Parkinson's patients.

The expression and significance of hypoxia-inducible factors-1α and pyruvate kinase type M2 in gastric carcinoma patients with Hp infection / 中华普通外科杂志

Objective To study the expression of hypoxia-inducible factors-1 α and pyruvate kinase type M2 in Hp infected gastric carcinoma and their clinical significances.Methods The expression levels of hypoxia-inducible factors-1α and pyruvate kinase type M2 in 85 cases of gastric carcinoma tissues were detected by using RT-PCR and immunohistochemical method.The Virulence level of CagA gene were detected in Hp infected gastric tissue.Results As the degree of tumor differentiation,invasion depth and clinical stage of tumor increased,the positive expression rate of HIF-1 α and PKM2 increased,and the expression level of the two was in positive correlation.The positive expression rate of HIF-1α (73％)was related to lymph node metastasis (x2 =4.204,P =0.041).The positive expression rate of PKM2 (85 ％)was related to tumor diameter.The positive expression rate of HIF-1α and PKM2 (75％ and 85％,respectively)significantly increased in Hp infected gastric carcinoma tissue (x2 =6.486,P =0.010;x2 =7.341,P =0.009,respectively) and related to CagA + type.Conclusion HIF-1α and PKM2 may be closely correlated to development and metastasis of gastric carcinoma with Hp infection.

Exploration on Medication Rules of Chinese Marine Materia Medica Prescriptions based on Literature Recordings / 世界科学技术-中医药现代化

Through the literature collection on Chinese marine materia medica,this study analyzed medication rules of Chinese marine materia medica prescription,understood general conditions of Chinese marine materia medica prescription,in order to conduct data mining on medication rules of Chinese marine materia medica prescription.The name of Chinese marine materia medica was used as the search term.Chinese marine materia medica prescriptions were searched in related literatures of Chinese Medicine Code,Chinese Marine Materia Medica,Chinese Materia Medica,Chinese Pharmacopoeia and Great Dictionary of Chinese Medicine.The information was extracted and standardized to construct database for the initial data mining of related information and medication rules of Chinese marine materia medica prescriptions.The results showed that 16715 Chinese marine materia medica prescriptions were screened,which contained 144014 items of data,involving 218 kinds of Chinese marine materia medica.Decoction was the most common dosage form.The amount of Chinese marine materia medica prescription in the Ming and Qing dynasties was the largest.The highest frequency of Chinese marine materia medica in one prescription was 1 to 3 types.The prescription composed all by Chinese marine materia medica occupied 8.065％.Other prescriptions contained the compatibility of Chinese terrestrial materia medica.The prescription containing materia medica half from the sea and half from the land,occupied 7.754％.The Chinese marine materia medica used with the highest frequency in all prescriptions was oyster.The frequently used Chinese terrestrial materia medica was licorice and angelica in Chinese marine materia medica prescriptions.It was concluded that the number of Chinese marine materia medica prescription was large.Its compatibility and clinical application had a certain characteristic,which provided data foundation for the further research and development of Chinese marine materia medica.

Accuracy Assessment of Type III Portable Monitor of Sleep Apnea for In-hospital Patients With Cardiovascular Disease / 中国循环杂志

Objective: To assess the accuracy and application value of type III portable monitor (III PM) of sleep apnea (SA) for in-hospital patients with cardiovascular disease (CVD). Methods: A total of 101 CVD patients received sleep apnea monitoring by both type II polysomnography ( II PSG) and III PM were enrolled to compare the apnea-hypopnea index (AHI) measured by 2 instruments. AHI was assigned into 4 grades: Normal (AHI0.05. Kendall correlation coefficient for 4 AHI grades was 0.701, P<0.01 which assumed strong correlation; Kappa value of consistency was 0.493, P<0.01 which assumed medium strong correlation. Using AHI≥15 as cut-off point, Kappa coefficient for the consistency between II PSG and III PM was 0.679, P<0.05, which meant high consistency. Taking II PSG as standard and AHI≥15 as cut-off point, the AUC of III PM measured AHI was 0.918 with the specificity at 80.4% and sensitivity at 87.3%. The best diagnosing cut-off value of III PM was AHI=15.70, at this point, the maximum Youden's index was obtained as 0.695. Conclusion: Using AHI≥15 as standard, III PM and II PSG had the favorable consistency and accuracy for monitoring the severity of SA for in-hospital patients with cardiovascular disease. AHI=15.7 was the best cut-off point of III PM in diagnosing moderate and severe SA in relevant patients.

Strategic information analysis of hotspots in studies on Alzheimer's disease / 中华医学图书情报杂志

Objective To provide the scientific evidence for studying Alzheimer's disease (AD) and decision-making for its management by analyzing the strategic information of hotspots in studies on AD.Methods Citation strategic coordinate diagram was plotted by describing the history of studies on AD with co-citation clustering for further understanding the novelty and concern of hotspots in studies on AD.The current hotspots in studies on AD were discovered by co-words clustering and their strategic coordinates were analyzed to reveal their development periods.Results The current hotspots in studies on AD were substance metabolism in AD patients, etiology of AD and therapies for AD.The diagnosis of AD according to its clinical characteristics and hypothesis on amyloid cascade in AD patients were greatly concerned.Conclusion Citation strategic coordinate analysis and co-words strategic coordinate analysis can display the hotspots in studies on AD and their development history.

Effect of Tuina Combined with Traditional Chinese Exercise on Nonspecific Chronic Neck Pain / 中国康复理论与实践

Objective To explore the effect of Tuina combined with Traditional Chinese exercise (TCE) on nonspecific chronic neck pain (NCNP). Methods 80 eligible patients were recruited in our hospital from October, 2014 to October, 2015. They were randomized to observation group (n=40) and control group (n=40). The observation group received Tuina combined with TCE, and the control group re-ceived intermittent cervical traction, 5 times a week for 2 weeks. They were assessed with Visual Analog Scale (VAS) and Neck Disability Index (NDI) before, immediately after intervention, and at 1 month follow-up. Results 77 patients completed the treatment and follow-up. The scores of VAS and NDI significantly decreased after a 2-week intervention (t>9.330, P8.338, P<0.01). The NDI score was significantly lower in the observation group than in the control group at 1-month follow-up (F=9.053, P=0.004). Conclusion Tuina combined with TCE could relieve pain and improve cervical function in patients with NCNP, which was superior to inter-mittent cervical traction.

Cognition in clinical traditional Chinese medicine by Lu Zhaolin / 国际中医中药杂志

Lu Zhaolin professor thinks,at present,according to the efficacy of traditional Chinese medicine classification method is not conducive to a comprehensive understanding and grasp of the knowledge of traditional Chinese medicine in clinical application.Understanding of the efficacy of traditional Chinese medicine,we should start from the overall regulation of drugs on the human body,and make full use of the theory closely related to traditional Chinese medicine properties such as the four properties and five tastes,ascending-descending-floating-sinking,medicinal guide,etc.Meanwhile the modern pharmacological research achievements should be taken to accurately grasp the efficacy of traditional Chinese medicine.

Foot inversion during walking among hemiplegic stroke survivors / 中华物理医学与康复杂志

Objective To find the plantar pressure readings which best indicate foot inversion during the stance phase of walking among hemiplegic stroke survivors.Methods Twenty-two hemiplegic stroke survivors who were able to walk without extra aid were recruited as the experimental group, while 17 healthy elderly men of similar age and body weight were selected as the control group.Those in both groups were asked to walk at their preferred speed over a Footscan device which measured medio-lateral pressure ratios, maximum plantar pressures and the contact areas of both feet.The Clinical Spasticity Index (CSI) was used to evaluate the affected feet.Results The average medial forefoot pressure of the affected side in the experimental group was significantly lower than that of the control group, but their average mesopodium and heel pressure was significantly higher.The average pressure applied by the great toe on the uninjured side in the experimental group was significantly smaller than that of the control group, but the average mesopodium and heel pressure of both feet among the hemiplegics were significantly higher than those of the control group.Among the experimental group, the average medial forefoot pressure of the affected foot was significantly greater than that of the healthy foot.The average contact area of the great toe on the affected side was significantly bigger than was observed in the control group.That of the medial forefoot was, however, significantly smaller than in the control group.There was no significant difference in the contact area between the healthy and affected feet in the experimental group, though the maxmium medio-lateral pressure ratios of their full feet and forefeet on the affected side were significantly lower than those in the healthy group.No significant differences in the maxmium medio-lateral pressure ratios of the heel were observed between the two groups, nor of the full feet, forefeet and heels of the affected and unaffected sides in the experimental group.The patients demonstrated consistently reduced joint mobility on both sides during the stance phase, coinciding with increased inversion.A significant negative correlation was found between the maxmium medio-lateral pressure ratios of the full foot and the maximum pressure of the lateral part of forefoot in the experimental group, but there was no significant correlation with contact area or CSI.Conclusions Plantar pressure data can be used to describe the amount of foot inversion in the stance phase of walking with hemiplegic patients after stroke.The maxmium medio-lateral pressure ratios can effectively reflect their foot inversion.

Analysis onZhang Yuqing’s medical recordsin treating gynecological diseases / 国际中医中药杂志

The present paper has reviewed and researched on 112 gynecological records from volume 17 ofZhang-Yuqing’s medical records, and has found that there were 9 common methods of treating gynecological diseases, namely dredging and regulatingqi and blood, adjusting qi to nourish ying, soothing the liver wood, harmonizing the liver and spleen (stomach), tonifying spleen and kidney, nourishing liver and kidney, regulating vital and conception vessels, eliminating dampness and phlegm, and nourishing Yin and clearing away heat.The treatment of gynecological diseases reflects the holistic concept and dialectical concept, and the valuable experience still has a high theoretical value, as well as clinical value, which is worth exploring and discussing.