Anatomical Study of the Accessory Tendon of the Extensor Hallucis Longus Muscle and Its Clinical Application

Background@#The accessory tendon of the extensor hallucis longus (ATEHL) muscle is a common abnormal structure, and its clinical significance remains debatable. In this study, we provide the incidence of the ATEHL and characterize its morphological types in Asian cadavers and investigate its clinical applications. @*Methods@#The tendons from 50 adult cadaveric feet, fixed in 10% formalin, were analyzed. We measured the length and width of both the ATEHL and the extensor hallucis brevis (EHB). @*Results@#All dissected specimens had an ATEHL. The first metatarsophalangeal joint was surrounded by an accessory tendon that inserted onto the joint capsule and the dorsal base of the proximal phalanx. We classified the ATEHL into 3 types based on their directions. Differences in ATEHL type based on sex were not statistically significant. @*Conclusions@#We found an ATEHL in all cadaveric specimens in this study. We surmise that the ATEHL acts as an antagonist with the EHB when the toe is extending, which might help prevent the occurrence of hallux valgus deformity.

Anatomical Study of the Accessory Tendon of the Extensor Hallucis Longus Muscle and Its Clinical Application

Background@#The accessory tendon of the extensor hallucis longus (ATEHL) muscle is a common abnormal structure, and its clinical significance remains debatable. In this study, we provide the incidence of the ATEHL and characterize its morphological types in Asian cadavers and investigate its clinical applications. @*Methods@#The tendons from 50 adult cadaveric feet, fixed in 10% formalin, were analyzed. We measured the length and width of both the ATEHL and the extensor hallucis brevis (EHB). @*Results@#All dissected specimens had an ATEHL. The first metatarsophalangeal joint was surrounded by an accessory tendon that inserted onto the joint capsule and the dorsal base of the proximal phalanx. We classified the ATEHL into 3 types based on their directions. Differences in ATEHL type based on sex were not statistically significant. @*Conclusions@#We found an ATEHL in all cadaveric specimens in this study. We surmise that the ATEHL acts as an antagonist with the EHB when the toe is extending, which might help prevent the occurrence of hallux valgus deformity.

Impact of oxidative stress on dental pulp stem cells: a key issue in tissue repair / 中国组织工程研究

BACKGROUND: The low success rate of dental implants under oxidative stress is one of the problems that needs to be resolved urgently. Human dental pulp stem cells (HDPSCs) have a high potential for multiplication, self-renewal and multidirectional differentiation. HDPSCs have achieved some success in tissue engineering for repairing tissue defects. However, with the in-depth research on oxidative stress, eliminating the adverse effect of oxidative stress on HDPSCs used in tissue engineering becomes urgent. OBJECTIVE: To review the application progress of HDPSCs in tissue engineering in recent years and to summarize the effects of oxidative stress on HDPSCs. METHODS: Using "dental pulp stem cells; oxidative stress" as the Chinese and English search terms, we retrieved CNKI and PubMed databases for relevant articles published from January 2001 to December 2017, respectively. After initial screening, 50 eligible articles were further detailed, analyzed and summarized. RESULTS AND CONCLUSION: HDPSCs have the potential of multiplication, self-renewal and multidirectional differentiation. Immunoregulatory mechanism of HDPSCs is achieved through sub-secreting soluble factors and cytokines and inhibiting the upregulation of T lymphocytes and regulatory T cells, which leads to immune tolerance. Oxidative stress as an important factor affecting cell survival impedes cell proliferation and differentiation via a variety of signal transduction pathways. Current studies on the application of HDPSCs in tissue engineering and regenerative medicine for tissue defect repair are still in its infancy, and there are many problems concerning its regulatory mechanism. Further determination of the oxidative stress mechanism of HDPSCs is warranted.

Mindfulness-based intervention to prevent relapse and relevant imaging studies / 上海交通大学学报（医学版）

Drug abuse is an important issue in China, while there is no effective drug to control the craving, which is the main reason that leads to the relapse. Mindfulness-based relapse prevention, as a novel treatment approach, has been used in the treatment of drug dependence, and a number of researches on this topic have been conducted. The current paper provided a review of recent clinical researches and relevant imaging studies to discuss the application of mindfulness-based relapse prevention, which hopes to provide theoretical basis for future study.

Initial experience with circumferential pulmonary vein isolation guided by Overlay Ref and CartoMerge in the treatment of paroxysmal atrial fibrillation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>CartoMerge has been widely used in guiding circumferential pulmonary vein isolation (CPVI) for the treatment of paroxysmal atrial fibrillation (PAF). However, the procedure of landmarks selection varies among operators according to their experience. Techniques have to be established to standardize this procedure. We propose that Overlay Ref could facilitate this procedure. This paper aimed to report our initial experience with CPVI guided by Overlay Ref and CartoMerge for the treatment of PAF.</p><p><b>METHODS</b>Fifty-nine patients with PAF were enrolled in this study. Using Overlay Ref technique, a reference image (inverted) was faded into the live fluoroscopic image. Landmarks of CartoMerge were selected from anatomic points of the top of superior pulmonary veins (PVs) and the bottom of inferior PVs guided by Overlay Ref image. Overlay Ref images were also used to guide the ablation procedure combining with CartoMerge.</p><p><b>RESULTS</b>All patients were successfully mapped by CartoMerge guided by Overlay Ref. The distance between the mapping points and the CT surfaces was (1.42 +/- 0.67) mm for the patients as a whole. This led to a successful rate of 96% for isolation of pulmonary veins. Duration of ablation procedure was (92 +/- 17) minutes. And the total duration of procedure was (139 +/- 32) minutes. CartoMerge could also be performed just with 3 paries to 4 paries selected landmarks guided by Overlay Ref without a full anatomic model constructed by Carto. Then, the total duration of procedure could be shortened to (115 +/- 38) minutes.</p><p><b>CONCLUSIONS</b>Overlay Ref technique can facilitate the catheter ablation of PAF and can help to standardize the procedure of landmarks selection.</p>

Study on the mechanism of acupoint sticking therapy with Chuan fuling for treatment of asthma model rats / 中国针灸

<p><b>OBJECTIVE</b>To investigate the mechanism of the acupoint sticking therapy with Chuanfuling for preventing and treating asthma.</p><p><b>METHODS</b>Thirty male SD rats were randomly divided into a control group (normal saline, p.i. +no acupoint sticking+ normal saline, spray inhalation), model group (normal saline with ovalbumin, p.i. +no acupoint sticking+ normal saline with ovalbumin, spray inhalation), and acupoint sticking group (normal saline with ovalbumin, p.i. +acupoint sticking with Chuan fuling+normal saline with ovalbumin, spray inhalation), 10 rats in each group. The incubation period of nodding breath, symptom of asthmatic attack, expression level of interleukin-4 mRNA (IL-4 mRNA) and interferon-gamma mRNA (IF-gamma mRNA), as well as pathological changes on the middle leaf of right lung, were observed in each group.</p><p><b>RESULTS</b>(1) Comparing with the control group, the model group was showed that the expression level of IL-4 mRNA in the peripheral blood cells (PBMC) was increased, while hyperemia, edema and eosinocyte (EOS) invasion of lung tissue was more serious (P < 0.01). (2) Comparing with the model group, the acupoint sticking group was showed that the expression level of IL-4 mRNA in PBMC was decreased, the incubation period of nodding breath was prolonged for induced asthma on the fifth and seventh time with lower frequency, while in the lung tissue EOS invasion was reduced (P < 0.05), but there were no significant changes on the hyperemia and edema (P > 0.05).</p><p><b>CONCLUSION</b>Acupoint sticking for treating asthma of model rats with Chuanfuling can inhibit the expression level of IL-4 mRNA in PBMC, and the release of the inflammatory mediator and cytokine from the EOS to the air passage, in order to reduce the injury of epithelial layer and high reaction on the air passage.</p>

A randomized prospective comparison of CartoMerge and CartoXP to guide circumferential pulmonary vein isolation for the treatment of paroxysmal atrial fibrillation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>CartoXP and CartoMerge have been used to treat atrial fibrillation (AF) for several years. Our randomized prospective study compared clinical outcomes of these two versions of three dimensional electroanatomic mapping system in guiding catheter ablation for paroxysmal atrial fibrillation (PAF).</p><p><b>METHODS</b>Eighty-one patients with symptomatic, drug refractory PAF were randomly assigned to CartoMerge group (n=42, mean age (54.5+/-13.1) years, history of AF=3.2 years) or CartoXP group (n=39, mean age (59.8+/-15.6) years, history of AF = 2.9 years). All patients underwent 64-slice computed tomography (MSCT) 1 to 3 days prior to ablation procedure. Using CartoMerge(TM) Image Integration Module, 3D anatomical images of the left atrium (LA) and pulmonary veins (PVs) derived from MSCT of CartoMerge group were established and merged with the electroanatomical map. The integrated images were used to guide the procedure of circumferential pulmonary vein isolation (CPVI). In the other group, CPVI was guided just by CartoXP. The endpoint of CPVI in both groups was abolition or dissociation of pulmonary vein potentials (PVPs).</p><p><b>RESULTS</b>Mapping points to establish the electroanatomical model of the LA/PVs were 48.7+/-13.4 in CartoMerge group and 62.5+/-15.7 in CartoXP group (P<0.001). Mean distance between mapping points and the MSCT surfaces in CartoMerge group was (1.59+/-0.33) mm. Accomplishment of abolition or dissociation of PVPs was achieved 95.2% in CartoMerge group and 92.3% in CartoXP group. Durations of procedure and exposure to X-ray were (156+/-25) minutes, (179+/-21) minutes (P<0.001) and (19.6+/-7.5) minutes, (28.5+/-12.8) minutes (P<0.001), respectively. After a follow-up with duration of (11.9+/-3.1) months vs (12.4+/-3.6) months post the first ablation procedure, patients free of AF were 33 (78.6%) in CartoMerge group and 29 (74.4%) in CartoXP group (P>0.50). No patient suffered pulmonary vein stenosis, atrioesophageal fistula, stroke or death.</p><p><b>CONCLUSION</b>Compared to CartoXP, CartoMerge shortened the catheter ablation procedure and exposure to X-ray, without affecting the clinical outcomes of circumferential pulmonary vein isolation for the treatment of paroxysmal atrial fibrillation in experienced centres.</p>

Clinical study on effect of acupoint sticking of chuanfuling in dog-days in preventing and treating children asthma in remission stage / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect and mechanism of acupoint sticking of Chuanfuling (CFL) in dog-days (the hottest periods of the year) in preventing and treating children asthma in remission stage.</p><p><b>METHODS</b>Ninety patients were divided into three groups, 30 in each. Patients in the CFL group were treated with CFL sticking, in the Western medicine (WM) group treated with Pulmicort inhalation, and in the control group was untreated. The clinical effect and indexes of humoral immunity (IgE, IgA, IgG) and cellular immunity (Eos, IL-4, IFN-gamma) before and after treatment were observed.</p><p><b>RESULTS</b>After treatment in the CFL group all the immune parameters were significantly improved (P<0.05 or P<0.01), all were better than those in the control group (P<0.05 or P<0.01), and the effect on IgA and IgG was better than that in the WM group. In the WM group after treatment, improvement was shown on the IgE and cellular immune parameters with signifian difference (P<0.05 or P<0.01), better than those in the control group (P<0.05 or P<0.01). Besides, significant difference was shown in comparing IL-4 level between the WM group and the CFL group (P<0.05).</p><p><b>CONCLUSION</b>CFL sticking in dog-days could significantly improve the immune function in children with asthma to alleviate and control the attack.</p>