Exploration on the diagnosis and treatment of generalized myasthenia gravis with acupuncture and moxibustion based on the study of ancient medical works / 中国针灸

Through collecting the relevant provisions and medical cases of

Study on the application of a new type of vertebral plate nail guide / 中国骨伤

OBJECTIVE@#To explore safety and accuracy of novel C@*METHODS@#From January 2018 to June 2018, 40 patients who underwent three-dimensional CT of cervical spine were selected, including 21 males and 19 females, heighted from 165 to 180 cm with an average of (172.9±9.5) cm, aged from 38 to 55 years old (51.1±12.8) years old, excluding patients with axis lamina defect and hypoplasia. Two sets of 3D printed specimens were made from the three-dimensional CT data of cervical spine of each patient, and both of than were used for the in vitro nailing experiment. According to different nail placement methods, in vitro experimental part of this experiment was divided into guide nail placement group and hand nail placement group, 40 pieces in each group. At the same time, the three-dimensionalmodel of cervical spine of 40 patients was reconstructed on computer, and the ideal needle point data and inclination angle were obtained by computer simulation of the nail placement. This is 3D simulation nail placement group, 40 pieces. With vitro experiment, the risk level of screw placement, the position of needle exit point and inclination angle were measured in guide nail group and hand nail group. Based on the accuracy of needle point and inclination angle of nail path, the data of guide nail group, the hand nail group and 3D simulation nail group were compared, and the data of each group were statistically analyzed to determine the accuracy.@*RESULTS@#In guide nail group, 75 screws were acceptable and 5 were dangerous. The acceptable rate was 94%, and the double cortical rate was 93%. There were 62 position-acceptable screws in hand nail group, and 18 positions were dangerous, with an acceptable rate of 78% and a double cortical rate of 33%. The difference between two groups was statistically significant (@*CONCLUSION@#The guide is universal, with stable structure, accurate guidance, and easy operation. It could be placed with bilateral lamina screws at the same time, shortening the time of nail placement, avoiding collision of two way cross screws, increase the rate of double cortex. Ultimately, efficiency and security can be improved.

Relationship between lower limb alignment distribution and short-term clinical results after primary total knee arthroplasty in patients with varying degrees of knee varus / 中国骨伤

OBJECTIVE@#To analyze the relationship between the distribution of lower limb alignment and short term clinical efficacy in patients with varus-type osteoarthritis after primary total knee arthroplasty (TKA).@*METHODS@#From December 2016 to March 2018, 87 patients (101 knees) with knee osteoarthritis were treated with the first total knee arthroplasty by the same medical group, including 21 males(25 knees) and 66 females(76 knees), ranging in age from 51 to 85 years old, with a mean of (67.6±7.0) years old. According to the difference of hip knee ankle angle (HKA) after total knee arthroplasty, the patients were divided into 4 groups:neutral position group (group A), -3°≤HKA≤3°, 50 knees;slight varus group (group B), 3°0.05). There was no significant difference in knee joint activity among the 4 groups. The score of femoral prosthesis force line within ±3°was better than that of the other group (0.05).@*CONCLUSION@#The short term clinical efficacy of patients with knee varus osteoarthritis after primary total knee arthroplasty is related to the distribution of lower limbs alignment. The short-term clinical efficacy of slight inversion position can be similar to that of neutral position. The force line distribution of femoral prosthesis is related to the short term clinical efficacy after primary knee arthroplasty.

Safety of protease inhibitors and Arbidol for SARS-CoV-2 pneumonia in Zhejiang Province, China / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

The aim of this study was to evaluate the safety of an antiviral regimen of protease inhibitors combined with Arbidol (umifenovir) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia patients. The genomic sequence of SARS-CoV-2 is highly homologous to that of SARS-CoV (Zhou et al., 2020). Previously published basic and clinical research on anti-SARS-CoV treatment found that lopinavir/ritonavir (LPV/r) could improve the prognosis of SARS patients (Chan et al., 2003; Chu et al., 2004). Darunavir (DRV) is another protease inhibitor that blocks the binding of SARS-CoV-2 to human angiotensin-converting enzyme 2 (Omotuyi et al., 2020). The broad-spectrum antiviral drug Arbidol (umifenovir) also shows in vitro anti-SARS-CoV activity (Khamitov et al., 2008).

Reseach on origin identification of commercially available Zaocys dhumnades / 中国中药杂志

Through market investigation, the adulteration of Zaocys dhumnades on markets was found out, and samples of authentic and adulterated Z. dhumnades on markets were collected. The origin and properties of the adulterated Z. dhumnades were studied in order to provide reference for the identification of Z. dhumnades. The counterfeit Z. dhumnades sold on markets were as follows: Ptyas korros, P. mucosus, Najanaja atra, Sinonatrix annularis, Dinodon septentrionalis, etc. It is found that there existed a obvious difference between the traits of the Z. dhumnades and counterfeits. Genuine Z. dhumnades with "sword ridge" "iron tail", strongly ribbed scales and other features, is the key point to identify the difference from adulterants.

Historical Oncomelania hupensis snail environments in Baoshan District, Shanghai City / 中国血吸虫病防治杂志

Objective To understand the distribution and characteristics of historical Oncomelania hupensis snail environ-ments in Baoshan District,Shanghai City,so as to provide the reference for adjusting and formulating the monitoring program of the snail situation in the future.Methods A retrospective survey and a field survey were conducted to collect the information of historical O.hupensis snail environments and set up the database.The distribution and characteristics of them were analyzed.Re-sults There were 53 historical O.hupensis snail environments which distributed in three towns,and the accumulative area was 1 635 530 m2in Baoshan District,Shanghai City.Class Ⅰ,Ⅱ,Ⅲ and Ⅳ accounted for 73.58％,5.66％,16.98％and 3.77％re-spectively.The complete transformation(Class Ⅰ and Class Ⅱ)was done in 42 places which covered the area of 1 622 043 m2,in which Class Ⅰ environments and Class Ⅱ environments accounted for 79.25％and 99.18％of the total,respectively.Conclu-sions There has been a great change in the historical O.hupensis snail environments in Baoshan District,Shanghai City.The information of the field investigation should be enriched and updated at different times to guide the investigation of O.hupensis snails in the future.

Assessment of the effects and traumas of uniportal and two-portal thoracoscopic surgery in treatment for lung cancer / 中国内镜杂志

Objective To investigate the effects and traumas of uniportal and two-portal thoracoscopic surgery in treatment for lung cancer. Methods 100 patients with non-small cell lung cancer between May 2013 and December 2016 were collected, reviewed and divided into single-portal thoracoscope group (n = 40) and two-portal thoracoscope group (n = 60). The surgical efficiency of the two groups was recorded, and the differences in serum levels of tumor markers, inflammatory factors and pain stress indexes were compared before and after surgery. Results Differences in surgical success rate, intraoperative ratio of conversion to thoracotomy as well as serum tumor markers CEA, CYFRA21-1, SCC and CA125 levels were not statistically significant between the two groups (P > 0.05). Serum inflammatory factors IL-1, PCT and CRP levels as well as pain stress indexes SP, PGE2, NE and Cor levels of both groups after operation were higher than those before operation (P < 0.05), and serum inflammatory factors IL-1, PCT and CRP levels as well as pain stress indexes SP, PGE2, NE and Cor levels of single-portal thoracoscope group after operation were lower than those of two-portal thoracoscope group (P < 0.05). Conclusion Single-portal thoracoscope can be successfully used in the treatment of lung cancer and is less traumatic.

Relationship between low basal metabolic rate and mortality in older adults with hip fractures / 中国组织工程研究

BACKGROUND: Basal metabolic rate (BMR) is an important indicator of human energy metabolism, and low BMR leads to the dysfunction of liver and kidney. Low BMR is usually found in patients with hip fractures, but there is a lack of study on the relationship between mortality of hip fracture and low BMR. OBJECTIVE: To investigate the effect of low BMR on the 1-year mortality in older adults with hip fractures. METHODS: Totally 507 patients with hip fractures aged more than 60 years from January 2014 to March 2016 were included in this retrospective study. Age, sex, surgery or not, surgical pathway, duration from injury to surgery, hospitalized pulmonary infection, number and kind of comorbidities, and 1-year mortality were recorded. BMR on admission was recorded, and multiple Logistic regression analysis was applied. RESULTS AND CONCLUSION: All patients were followed up for 13-15 months, and the 1-year mortality was 13.41% (68/507). The mortality in the low BMR group was significantly higher than that in the non-low BMR group (P ＜ 0.05). Logistic regression analysis showed that older age, conventional treatment, number of combined medical diseases, hospitalized pulmonary infection, and low BMR are risk factors for 1-year mortality in older adults with hip fracture. These results imply that low BMR is strongly associated with 1-year mortality in older adults with hip fracture. BMR can reflect the nutritional status, neuroendocrine, cellular and energy metabolism. Thereafter, for older adults with hip fractures and low BMI, nutrition therapy, re-warming, and endocrine therapy may help reduce the trauma-induced mortality.

Femoral revision of the hip: reason, type and different techniques / 中国组织工程研究

BACKGROUND: Total hip arthroplasty has been widely used in clinical practice, and achieved good clinical efficacy. However, with the yearly increased number of patients receiving primary arthroplasty, the number of revision hip arthroplasty patients has increased. However, hip arthroplasty is one of the most difficult hip surgery, and it is challenging. OBJECTIVE: To review the causes of femoral revision of the hip arthroplasty, the classification of the femoral bone defect, and the type of prosthesis available in the clinical revision, and the clinical effect of the different prosthesis, so as to provide reference for femoral revision. METHODS: CNKI, Web of Science, and PubMed were searched for the literatures published between January 1975 and August 2017 with the key words of "Revision total hip arthroplasty, Femur revision, Cemented femoral revision, Cemenless femoral revision Reoperation, Porous-coated stems, Modular, tapered stem, Wagner SL revision Stem". RESULTS AND CONCLUSION: (1) A total of 1 041 articles were retrieved. After reading the abstract, unrelated and repeated studies were excluded. Finally, 109 studies were included. Of them, there were 106 English studies and 3 Chinese studies. Femoral revision was analyzed and summarized. (2) Femoral revision of the hip is still the future challenges facing the joint surgeon. We continue to strive to overcome the direction. Although the current material science and surgical technology are now rapidly developed, only the analysis of the reasons for the revision of the femoral side, identifying the femoral side bone defect classification, mastering the treatment of different defects and the application of the principle of prosthesis type, making reasonable femoral revision program is the key to success according to the patient's age and activity.

Expression of NOD2 and NLRP3 in the articular cartilage of a rabbit model of osteoarthritis established by arthrorisis using plaster cast / 中国组织工程研究

BACKGROUND: Nucleotide-binding oligomerization domain (NOD)-like receptor plays an important role against inflammatory responses caused by pathogens and non-pathogens, as well as in the initial stage of autoimmune response. Meanwhile, NOD2 and NOD-like receptor protein 3 (NLRP3) are the representative proteins of NOD-like receptor family. OBJECTIVE: To detect the expression of NOD2 and NLRP3 in a rabbit model of osteoarthritis. METHODS: Thirty New Zealand rabbits were randomly divided into six groups (n=5 per group), including five experimental groups (2, 4, 6, 8 and 10 weeks) and one control group. The model of osteoarthritis was established by fixing the left knee joints using plaster cast, and were sacrificed at postoperative 2, 4, 6, 8 and 10 weeks. The controls received no intervention, and were killed at 10 weeks postoperatively. The left distal femur articular cartilage was taken for safranin-fast green staining. The pathological changes were evaluated by Mankin's scores, and the expression levels of NOD2 and NLRP3 were detected by immunohistochemistry. RESULTS AND CONCLUSION: The Mankin's scores in the experimental groups were significantly higher than those in the control group (P <0.01). Moreover, the scores in the experimental groups were significantly increased with time (P < 0.01). The expression levels of NOD2 and NLRP3 in the chondrocytes were also increased with time (P < 0.01). These results indicate that the expresison of NOD2 and NLRP3 in the cartilage cells is positively correlated with the pathological changes of osteoarthritis, which may be through promoting apoptosis in cartilage cells, thus accelerating the development of osteoarthritis.

Biomimetic nanoparticles for inflammation targeting

There have been many recent exciting developments in biomimetic nanoparticles for biomedical applications. Inflammation, a protective response involving immune cells, blood vessels, and molecular mediators directed against harmful stimuli, is closely associated with many human diseases. As a result, biomimetic nanoparticles mimicking immune cells can help achieve molecular imaging and precise drug delivery to these inflammatory sites. This review is focused on inflammation-targeting biomimetic nanoparticles and will provide an in-depth look at the design of these nanoparticles to maximize their benefits for disease diagnosis and treatment.

Primary intracranial chondrosarcoma:A report of 2 cases and literature review / 吉林大学学报(医学版)

Objective:To analyze the clinical data of 2 patients with primary intracranial chondrosarcoma,and to improve its climical awareness and management. Methods:One patient admitted to the hospital because of his left eye with oculomotor palsy,and he was considered as craniopharyngioma before operation and received radiotherapy after operation.The other patient admitted to the hospital for the vision loss,and he was considered as chordoma and received subtotal resection.Results:Both two patients were confirmed as chondrosarcoma by postoperative pathological examination.One patient's clinical symptoms relieved after operation,and there was no obvious progress from the begining of follow-up to now;the other patient died of severe intracranial infection on the 10th day after operation.Conclusion:Primary intracranial chondrosarcoma is easy to be misdiagnosed before operation and needs to be confirmed by postoperative pathology. Operation is the first choice for its treatment, and the postoperative radiotherapy can achieve the good results.

Investigation on shielding reconstruction with clay bricks for medical linear accelerator room / 医疗卫生装备

Objective To provide a solution to improve the radiation shielding for medical accelerator room with clay bricks.Methods According to the basic shielding equations provided by the relevant national standards and international reports,equations for shielding reconstruction calculation were derived to calculate the required thickness of clay bricks wall,which reached the reference dose rate control level.The dose rates at reference points after reconstruction were also estimated based on the measured dose rates at reference points before reconstruction of accelerator room,calculated distance correction factors and transmission factors of added clay bricks wall.Results The measured dose rates satisfied the requirement of reference dose rate control level.The estimated dose rates were slightly higher than the measured values.Conclusion The radiation shielding requirement of medical accelerator room is fulfilled with the presented shielding reconstruction method by building clay bricks wall,measured dose rates could be conservatively predicted with the dose rates calculated by derived equations.

Investigation on shielding reconstruction with clay bricks for medical linear accelerator room / 医疗卫生装备

Objective To provide a solution to improve the radiation shielding for medical accelerator room with clay bricks.Methods According to the basic shielding equations provided by the relevant national standards and international reports,equations for shielding reconstruction calculation were derived to calculate the required thickness of clay bricks wall,which reached the reference dose rate control level.The dose rates at reference points after reconstruction were also estimated based on the measured dose rates at reference points before reconstruction of accelerator room,calculated distance correction factors and transmission factors of added clay bricks wall.Results The measured dose rates satisfied the requirement of reference dose rate control level.The estimated dose rates were slightly higher than the measured values.Conclusion The radiation shielding requirement of medical accelerator room is fulfilled with the presented shielding reconstruction method by building clay bricks wall,measured dose rates could be conservatively predicted with the dose rates calculated by derived equations.

Progress of primary intracranial alveolar soft part sarcoma / 肿瘤研究与临床

Alveolar soft part sarcoma (ASPS) is a kind of extremely rare malignant soft tissue sarcoma, which was first discovered and defined by American scholars in 1952. Its main manifestation is painless and slow growth mass, and distant metastasis often occurs in lung, bone, brain, liver with poor prognosis. In recent years, with the accumulation of the number of cases and the development of related technology, the diagnosis and treatment of ASPS have been improved greatly. However, the primary intracranial ASPS is still rare, this paper reviews the progress of primary intracranial ASPS, in order to provide help for its clinical diagnosis and treatment.

Comparative analysis between extend endoscopic endonasal and open transcranial resection for craniopharyngiomas / 中国神经精神疾病杂志

Objective To compare the efficacy and complications of the extend endoscopic endonasal approach (EEA) and open transcranial approach for resection of craniopharyngiomas. Methods The clinical data from 46 patients with craniopharyngiomas with extend EEA and 54 patients with transcranial route in our department was analyzed retrospectively. The gross total resection (GTR) rate,length of hospital stays and complications of the two groups were compared. Results The tumor diameters of were larger in the endoscopic group than in the transcranial group (3.5 ± 1.3cm vs. 3.0±0.8 cm, P<0.05). The endoscopic group had a greater GTR rate (67.4％vs. 46.3％, P<0.05)and improved visual outcome(84.2％ vs. 59.5％,P<0.05),but lower rate of hypopituitarism (56.5％ vs. 75.9％,P<0.05)and permanent diabetes insipidus (51.4％ vs.72.7％,P<0.05). On the contrast, the endoscopic group had a greater rate of cerebrospinal fluid leak(4.3％ vs. 0.0％,P>0.05)and longer hospital stays(17.0±3.6 d vs. 13.1±2.3 d,P<0.01). Hyposmia(34.8％)and hemorrhinia (2.2％)only happened in the endoscopic group. Conclusion Compared with transcranial route, the extend EEA for craniopharyngiomas is minimal invasion and effective, which can effectively improve the GTR rate and reduce the clinical symptoms.

Effect of admission blood urea and creatinine levels on mortality in elderly patients with hip fracture / 中国骨伤

<p><b>OBJECTIVE</b>To observe the effect of admission blood urea and creatinine levels on mortality in elderly patients with hip fracture.</p><p><b>METHODS</b>Form January 2013 to December 2014, 767 elder patients with hip fracture were treated in our hospital including 253 males and 514 females, aged from 65 to 96 years old with an average of(75.67±6.81) years old. According blood urea and creatinine levels, the 767 hip fracture patients were divided into four groups as follow: group A(blood urea>=5 mmol/L, creatinine>=70 μmol/L); group B (blood urea>=5 mmol/L, creatinine<70 μmol/L); group C (blood urea<5 mmol/L, creatinine>=70 μmol/L); group D(blood urea<5 mmol/L, creatinine<70 μmol/L). In group A, there were 211 patients including 70 males and 141 females, aged from 65 to 95 years old with an average of(80.24±6.51) years old; in group B, there were 355 patients including 125 males and 230 females, aged from 65 to 93 years old with an average of(78.46±7.09) years old; in group C, there were 36 patients including 11 males and 25 females, aged from 65 to 95 years old with an average of (77.83±6.78) years old; in group D, there were 165 patients including 47 males and 118 females, aged from 65 to 96 years old with an average of (76.71±8.35) years old. The survivals and dead patients in four groups were collected and in-hospital mortality rate, 3-month, 12-month and 18-month mortality rate of patients were calculated. COX regression analysis was performed on these data, and clinical significance of serum urea and creatinine at admission in the elderly patients was researched.</p><p><b>RESULTS</b>All 767 hip fracture patients were followed up from 18 to 24 months with an average of (21.33±1.25) months, 159 patients were died in follow up period. The in-hospital mortality rate in 3-month, 12-month and 18-month mortality rate of the patients with high blood urea and high blood creatinine (urea>=5 mmol/L, creatinine>=70 μmol/L) were 2.37%, 9.95%, 16.11% and 26.07%, and were higher than other three groups respectively. COX regression analysis revealed that the independent predictors effecting the mortality rate included age [=0.000, OR=1.375, 95%CI(1.155, 1.637)], blood urea at admission [=0.000, OR=1.375, 95%CI(1.155, 1.637)], and blood creatinine at admission[=0.037, OR=1.213, 95%CI(1.121, 1.484)].</p><p><b>CONCLUSIONS</b>Elderly hip fracture patients with high serum urea and high serum creatinine at admission indicate higher fatality rate. Age, serum urea and serum creatinine at admission were independent predictors of fatality rate of elderly hip fracture patients.</p>

Formulation Optimization of Indomethacin-loading Solid Lipid Nanoparticles by Box-Behnken Response Surface Methodology / 中国药房

OBJECTIVE:To optimize the formulation of indomethacin-loading solid lipid nanoparticle(SLN). METHODS:Us-ing indomethacin as model drug,glyceryl behenate as oil phase,poloxamer 188 and polyethylene glycol-12-hydroxystearic acid as emulsifier,with turbidity,entrapment efficiency and drug loading amount as index,Box-Behnken response surface methodology was used to optimize the amount of oil phase,emulsifier-oil phase ratio,drug-oil phase ratio. The physicochemical properties of SLNs were characterized by SEM and DSC. RESULTS:The optimal formulation was as follows as oil phase of 0.91%,emulsifier-oil ratio of 1∶1,drug-oil phase ratio of 1∶5. The turbidity,entrapment efficiency and drug loading amount of prepared nanoparticle were 1 025-1 030 NTU,98.94%-99.08%,2.43%-2.46%,respectively;particle size and polydispersity index(PDI)were 181.5-182.3 nm and 0.340-0.341(n=3). The results of DSC showed that indomethacin was not present in crystalline state dispersed into SLNs. CONCLUSIONS:The optimal formulation is screened successfully,and indomethacin-loaded SLNs have been prepared.

Role of TRPV4 channels in regulation of eNOS expression in brain microvascular endothelial cells under the condition of mechanical stretch / 中南大学学报(医学版)

OBJECTIVE@#To identify the subtype of transient receptor potential (TRPs) channel involved in stretch-induced injury of human brain microvascular endothelial cells (HBMEC) and to explore the mechanism responsible for eNOS expression.
@*METHODS@#TRPs expression was examined by Western blot and immunocytofluoresence in the cultured HBMEC. Mechanical stretch was performed by mini-type multi-functional bio-impact machine. The levels of free calcium ion in cells were examined by the flow cytometry. The eNOS expression was detected by Western blot.
@*RESULTS@#The mRNA and protein expression of TRPV4 was detected in HBMEC by qRT-PCR, Western blot and immunocytofluoresence. The levels of free calcium ion in the stretch-treated HBMEC was significantly decreased in the presence of TRPV4 specific inhibitor (P0.05).
@*CONCLUSION@#The eNOS expression is up-regulated under the condition of mechanic stretch, which is related to the activation of TRPV4, resulting in the influx of calcium.