Research progress of sustained-release drug delivery system for uveitis / 国际眼科杂志(Guoji Yanke Zazhi)

Uveitis, a complex ocular disorder with numerous etiologies, can result from infection, autoimmune, and various physicochemical and mechanical injury factors. The treatment of this disease is difficult, and failure to receive timely and effective treatment can often lead to blindness. With the deepening of people's understanding of uveitis and its related mechanisms, various new sustained-release drug delivery systems for uveitis have been studied. However, due to the existence of various anatomical and physiological barriers in the eye, there are multiple obstacles to the sustained release treatment of uveitis. In this paper, the main research results in this field in recent years are reviewed, and the innovations and limitations of various new sustained-release drug delivery systems are discussed in order to provide new ideas for the sustained-release drug delivery treatment of uveitis in the future. These new sustained-release drug delivery systems will help to completely change the traditional treatment mode of uveitis with side effects and poor compliance in the future, bringing longer targeted sustained release and less toxic reactions.

Diagnosis model of the white matter injury of premature infants based on ultrasonography radiomics / 中华超声影像学杂志

Objective:To investigate the value of the ultrasonography in the diagnosis of the white matter injury of premature infants based on gray-scale ultrasonography radiomics.Methods:A total of 256 premature infants in Huazhong University of Science and Technology Union Shenzhen Hospital and Shenzhen Hospital of Southern Medical University from August 2018 to April 2022 were analyzed retrospectively. The computer-generated random numbers were assigned to the training set and the verification set according to 6∶4 ratio. On the basis of standardized collection of craniocerebral ultrasound images, the radiomics features were extracted from imaging by Pyradiomics 3.0.1 software package, the Mann-Whitney U test and the least absolute shrinkage and selection operator (LASSO) and stepwise regression were used to select the optimal features. Then the Logistic regression was used to build radiomics model. According to MRI, ROC curve was utilized to evaluate the performance of the model. The craniocerebral ultrasound images in the validation set were independently diagnosed by a senior physician and a junior physician, and then the above two physicians diagnosed again with the help of the radiomics, and the diagnostic abilities of this model were compared with those of the junior and senior physicians with and without radiomics assist. Results:A total of 5 optimal features were selected to develop radiomics model. The sensitivity, specificity, accuracy and the area under the ROC curve (AUC) in the training and validation sets were 0.861, 0.775, 0.799, 0.818; 0.929, 0.824, 0.853, 0.876, respectively. The sensitivity, specificity, accuracy and AUC in the senior sonographer, the junior sonographer, and both of them with radiomics assist for the dagnosis in the validation set were 0.929, 0.892, 0.902, 0.910; 0.714, 0.743, 0.735, 0.729; 0.929, 0.919, 0.922, 0.924; 0.857, 0.824, 0.833, 0.841, respectively. Performance of radiomics model reached the level of the senior sonographer (AUC: 0.876 vs 0.910, P=0.284), which was significantly better than the performance of the junior sonographer(AUC: 0.876 vs 0.729, P=0.001). Performance of the junior sonographer with radiomics assist was significantly better than the performance of the junior sonographer(AUC: 0.841 vs 0.729, P=0.003). Performance of the senior sonographer with radiomics assist was comparable to that of the senior sonographer(AUC: 0.924 vs 0.910, P=0.156). Conclusions:The ultrasound diagnosis method based on radiomics technology shows good diagnostic performance for the white matter injury of premature infants. It is helpful to improve the diagnostic ability of junior sonographer. It is expected to assist the sonographers in diagnosis and provide objective, consistent and accurate results for clinical practice.

Medical nutrition management and follow-up of patients with late-onset ornithine transcarbamylase deficiency / 中华实用儿科临床杂志

Objective:To explore the clinical characteristics and medical nutritional therapy of 6 patients with late-onset ornithine transcarbamylase (OTC) deficiency.Methods:The clinical features, biochemical data, gene variations and treatment outcomes of 6 children with late-onset OTC deficiency admitted to the Department of Clinical Nutrition, Children′s Hospital of Nanjing Medical University from January 2020 to April 2022 were retrospectively analyzed.The 6 patients were all intervened by a long-term medical nutrition management.Results:Liver dysfunction and hyperammonemia (172.1-348.0 μmol/L) were found in all the 6 children with late-onset OTC deficiency.Serum citrulline decreased in 3 patients (3.95-5.43 μmol/L). Three patients showed increased urine orotic acid (123.48-342.60 mmol/mol Cr). Urine uracil increased in 4 patients (106.77-1 207.26 mmol/mol Cr). Variations of the OTC gene [c.364G>C p. (E122Q), c.1028C>G p. (T343R), c.664-2(IVS6)A>C, c.635G>T p. (G212V), c.929_c.931delAAG p. (E310del), c.829C>T p. (R277W)] were identified in all patients.The 6 children were all managed by individualized medical nutrition program and followed up for a long time.During the follow-up period, 3 cases developed hypoproteinemia, acute metabolic crisis and growth retardation, 3 cases had normal growth and laboratory indicators, and 1 case received liver transplantation after 3 months of nutritional management. Conclusions:The clinical manifestations of OTC deficiency are non-specific.Blood amino acids, urine organic acids and genetic tests are important for the diagnosis.Long-term regular medical nutrition management is helpful to improve the prognosis and quality of life of children.

The norm of the Physical Activity afterschool Questionnaire for Preschooler (P-PAQ) in urban areas of China / 中国学校卫生

Objective@#To establish the norm of the Physical Activity afterschool Questionnaire for Preschooler(P-PAQ) in urban areas of China, so as to provide a basis for graded guidance from the family perspective and to improve children s physical activity levels.@*Methods@#From October 2020 to January 2021, 6 267 children aged 3-6 years old were recruited from 40 kindergartens in eight cities across six major administrative regions by stratified cluster sampling, and the P-PAQ initially developed by the researchers of this study were completed by the primary caregivers. The questionnaire was administered to collect data relating to the amount of physical activity undertaken by the preschoolers, and the norm was determined by quartiles. Data relating to parental concepts of sports and parental behavior were assessed by calculating mean scores in order to establish the norm.@*Results@#Among preschoolers in urban areas, the M(P 25 ，P 75 ) of total physical activity time (min/day), moderate-to-vigorous physical activity time (min/day), outdoor time (min/day) and screen time (min/day) on school days outside kindergarten and on weekends were 84 (54,120), 22 (8,40), 12 (0,24) and 18 (6,30), and 170 (115,240), 60 (30,95), 90 (35,120) and 30 (20,60), respectively. When the score of parents sports concept and behavior (total score of 40) were≥34, 29-<34, 24-<29, <24, it was defined as four levels about above medium, medium, lower medium and lower, respectively. And for two dimensions，when the score of parental sports concept were ≥19, 17-<19, 15-<17, <15，and the score of parental behaviors were ≥16, 12-<16, 8-<12, <8, it was defined as four levels about upper medium, medium, lower medium and lower, respectively.@*Conclusion@#The norm of extracurricular activities among preschool children in Chinese cities has good representativeness and appropriate threshold values, which could provide a valuable reference for early assessment, as well as guidance in relation to out-of-school physical activity behaviors among children aged 3-6 years old.

Analysis of the clinical features and the risk factors of severe human metapneu movirus-associated community acquired pneumonia in children / 中华儿科杂志

Objective: To investigate the clinical characteristics and the risk factors of severe human metapneumovirus (hMPV)-associated community acquired pneumonia (CAP) in children. Methods: A retrospective case summary was conducted. From December 2020 to March 2022, 721 children who were diagnosed with CAP and tested positive for hMPV nucleic acid by PCR-capillary electrophoresis fragment analysis of nasopharyngeal secretions at the Yuying Children's Hospital, the Second Affiliated Hospital of Wenzhou Medical University were selected as the research objects. The clinical characteristics, epidemiological characteristics and mixed pathogens of the two groups were analyzed. According to CAP diagnostic criteria, the children were divided into the severe group and the mild group. Chi-square test or Mann-Whitney rank and contrast analysis was used for comparison between groups, while multivariate Logistic regression was applied to analyze the risk factors of the severe hMPV-associated CAP. Results: A total of 721 children who were diagnosed with hMPV-associated CAP were included in this study, with 397 males and 324 females. There were 154 cases in the severe group. The age of onset was 1.0 (0.9, 3.0) years, <3 years old 104 cases (67.5%), and the length of hospital stay was 7 (6, 9) days. In the severe group, 67 children (43.5%) were complicated with underlying diseases. In the severe group, 154 cases (100.0%) had cough, 148 cases (96.1%) had shortness of breath and pulmonary moist rales, and 132 cases (85.7%) had fever, 23 cases (14.9%) were complicated with respiratory failure. C-reactive protein (CRP) was elevated in 86 children (55.8%), including CRP≥50 mg/L in 33 children (21.4%). Co-infection was detected in 77 cases (50.0%) and 102 strains of pathogen were detected, 25 strains of rhinovirus, 17 strains of Mycoplasma pneumoniae, 15 strains of Streptococcus pneumoniae, 12 strains of Haemophilus influenzae and 10 strains of respiratory syncytial virus were detected. Six cases (3.9%) received heated and humidified high flow nasal cannula oxygen therapy, 15 cases (9.7%) were admitted to intensive care unit, and 2 cases (1.3%) received mechanical ventilation. In the severe group, 108 children were cured, 42 children were improved, 4 chlidren were discharged automatically without recovery and no death occurred. There were 567 cases in the mild group. The age of onset was 2.7 (1.0, 4.0) years, and the length of hospital stay was 4 (4, 6) days.Compared with the mild group, the proportion of children who age of disease onset <6 months, CRP≥50 mg/L, the proportions of preterm birth, congenital heart disease, malnutrition, congenital airway malformation, neuromuscular disease, mixed respiratory syncytial viruses infection were higher (20 cases (13.0%) vs. 31 cases (5.5%), 32 cases (20.8%) vs. 64 cases (11.3%), 23 cases (14.9%) vs. 44 cases (7.8%), 11 cases (7.1%) vs. 18 cases (3.2%), 9 cases (5.8%) vs. 6 cases (1.1%), 11 cases (7.1%) vs. 12 cases (2.1%), 8 cases (5.2%) vs. 4 cases (0.7%), 10 cases (6.5%) vs. 13 cases (2.3%), χ2=0.42, 9.45, 7.40, 4.94, 11.40, 8.35, 3.52, 6.92, all P<0.05). Multivariate Logistic regression analysis showed that age<6 months (OR=2.51, 95%CI 1.29-4.89), CRP≥50 mg/L (OR=2.20, 95%CI 1.36-3.57), prematurity (OR=2.19, 95%CI 1.26-3.81), malnutrition (OR=6.05, 95%CI 1.89-19.39) were the independent risk factors for severe hMPV-associated CAP. Conclusions: Severe hMPV-associated CAP is most likely to occur in infants under 3 years old and has a higher proportion of underlying diseases and co-infection. The main clinical manifestations are cough, shortness of breath and pulmonary moist rales, fever. The overall prognosis is good. Age<6 months, CRP≥50 mg/L, preterm birth, malnutrition are the independent risk factors for severe hMPV-associated CAP.

Pharmacological properties and mechanisms of Notoginsenoside R1 in ischemia-reperfusion injury / 中华创伤杂志(英文版)

Panax notoginseng is an ancient Chinese medicinal plant that has great clinical value in regulating cardiovascular disease in China. As a single component of panax notoginosides, notoginsenoside R1 (NGR1) belongs to the panaxatriol group. Many reports have demonstrated that NGR1 exerts multiple pharmacological effects in ischemic stroke, myocardial infarction, acute renal injury, and intestinal injury. Here, we outline the available reports on the pharmacological effects of NGR1 in ischemia-reperfusion (I/R) injury. We also discuss the chemistry, composition and molecular mechanism underlying the anti-I/R injury effects of NGR1. NGR1 had significant effects on reducing cerebral infarct size and neurological deficits in cerebral I/R injury, ameliorating the impaired mitochondrial morphology in myocardial I/R injury, decreasing kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin in renal I/R injury and attenuating jejunal mucosal epithelium injury in intestinal I/R injury. The various organ anti-I/R injury effects of NGR1 are mainly through the suppression of oxidative stress, apoptosis, inflammation, endoplasmic reticulum stress and promotion of angiogenesis and neurogenesis. These findings provide a reference basis for future research of NGR1 on I/R injury.

Construction of conceptual framework and approaches of music education in special education schools based on ICF / 中国康复理论与实践

ObjectiveTo apply International Classification of Functioning, Disability, and Health (ICF) to systematically analyze the functional characteristics of children with intellectual and developmental disabilities (IDD) in special education schools, and develop a theoretical framework and methodology for music education that suits the students' functional profiles. MethodsUsing the ICF's functional classification approach, the study focused on children with IDD in special education schools. It conducted a systematic analysis of the special music curriculum and students' learning behaviors from three levels: body functions, activity and participation, and environmental factors. The study then constructed function-oriented, adapted and inclusive principles, core curriculum content, and an education and evaluation system for music education.ResultsThe main functional characteristics of children with IDD were at three levels: at the body function level, students may experience impairments in Global psychosocial functions (b122), psychomotor functions (b147), energy and drive functions (b130), high-level cognitive functions (b164), attention functions (b140), control of voluntary movement functions (b760), and involuntary movement functions (b765), among others; at the music-related activity and participation level, students may experience impairments in play (d9200), sports (d9201), arts and culture (d9202), social activities (d9205), and other specified or unspecified changes in maintaining body posture (d429); at environmental factors level, there may be influenced on products and technology for education (e130), natural environment and human-made changes to the environment, unspecified (e299), immediate family (e310), friends (e320), other professionals (e360), attitudes (e4), and educational and training services, systems and policies (e585). In music teaching activities, child-centered principles were established, advocating function-oriented inclusive music education activities. The study used the ICF's method to construct music curriculum objectives and conduct function-oriented music learning activities. These activities included welcoming and warm-up activities, music appreciation activities, singing and learning songs, combining music with dance activities, music composition activities, as well as exploring instrument playing, choir, and ensemble activities for higher grades. By using the ICF's three functional levels, a comprehensive functional assessment and music learning needs assessment can be conducted for students. Based on the assessment results, a function-oriented adaptive music education program can be developed, including: setting adapted music learning objectives and developing corresponding teaching strategies based on the analysis of students' functional characteristics; establishing accessible music education environments considering the impact of the students' environment on their music participation, and providing supportive and accessible music education environments within the family and school settings; developing and implementing function-oriented music education based on the analysis and evaluation of students' music activity needs and functional characteristics, providing inclusive or individualized music education practices, and offering opportunities for special needs students to enjoy music learning activities and social interactions. By applying the ICF to the assessment of music education for students, a function-oriented music learning assessment system can be established, including diagnostic, formative, and summative assessments of music learning.ConclusionThis study systematically analyzed the functional characteristics of IDD children in special education schools based on the ICF's three levels of body function, activity and participation, and environmental factors. It constructed a function-oriented, adapted and inclusive theoretical framework, and core curriculum content for music education in special education schools. Using the ICF, the study established function-oriented music education objectives, set up accessible music education environments, developed and implemented function-oriented, adapted and inclusive music education curricula, and conducted student music learning assessments.

Construction of special music educational objectives based on ICF and Hauenstein taxonomy of educational objectives / 中国康复理论与实践

ObjectiveTo construct a special music education goal framework with functional orientation and behavioral integration. MethodsUtilizing the International Classification of Functioning, Disability, and Health (ICF) theory and the Hauenstein educational objectives taxnomony, and by analyzing the core content of the China Special Education School Compulsory Education Curriculum Standards (2016 edition), objectives for special music education were constructed. A method is established based on the ICF and the functional characteristics of special-needs children to adjust the objectives of special music education. ResultsThe framework system of special music education goals should follow the principles of functional orientation, adaptability and inclusiveness. The framework mainly composed of the goals of cognitive domain, psycho-motor domain, emotional domain and behavioral field, and the goals of each domain could be divided into five levels according to the level of development and achievement. The cognitive domain mainly focused on feeling and appreciation, which made a foundation for music learning. The psychomotor domain developed the movements, skills and related abilities of musical performance. The emotional domain focused on the impact of special music education on behaviors in terms of emotions, values, and beliefs. The behavioral domain was the synthesization of the cognitive, emotional and psychomotor domains, to enable students to use musical elements and skills to create musical works and performance. The music education objectives should be adjusted according to students' functional and developmental levels and special music learning needs. For the cognitive domain, visual support, simplification and repetition might be useful. For the psychomotor domain, visual aids, multisensory experiences and supportive technological equipment might be needed. For the emotional domain, scenario simulation, role play and music environment setting could be used to promote the connection among music and the individual and the world. For the behavioral domain, creating an inclusive environment, affirming and encouraging, and providing opportunities for creative expression might help the students apply the musical elements and techniques. ConclusionBased on the ICF theory and the Hauenstein educational objectives taxnomony theory, and referencing the China Special Education School Compulsory Education Curriculum Standards (2016 edition), this study constructed an educational objectives framework for special music. Principles for building functionally oriented, adaptive, and inclusive music education were proposed, as well as a systematic method for adjusting the objectives of special music education.

Intervention of ERRα Expression on Apoptosis Induction of Multiple Myeloma MM.1S Cells Cultured in Vitro / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of two different approaches ERRα strategy on the apoptosis in multiple myeloma cell line MM.1S.@*METHODS@#For the one strategy, shRNA was mediated by lentivirus. Stable cell clones were established by transfecting the lentivirus into MM.1S cells and screened by puromycin. For the other strategy, XCT790, a specific reverse agonist of ERRα, was used to treat MM.1S cells. The apoptosis of the cells was analyzed by flow cytometry after ERRα was down-regulated. Western blot assay was used to detect the apoptosis of related proteins.@*RESULTS@#The knocked down ERRα was achieved, lentivirus with shERRα were successfully infected into MM.1S and ERRα was reduced significantly. Knockdown of ERRα could induce MM.1S cell apoptosis dramatically. Meanwhile, the expression of cleaved PARP (a kind of apoptosis related markers) was significantly increased following depletion of ERRα in MM.1S cells. XCT790 could significantly down-regulate the expression of ERRα protein in MM.1S cells, which was consistent with the effect caused by shRNA.@*CONCLUSION@#Interference the expression of ERRα by shRNA or XCT790 can induce apparent apoptosis in MM.1S cells, which indicating that ERRα is crucial for the survival of myeloma cells.

Effects of 10-Week Nordic Hamstring Training on Knee Eccentric Control Angle and Muscle Strength / 医用生物力学

Objective To compare the effects of different support method on eccentric control angle and muscle strength of knee joints in 10-week Nordic hamstring exercise.Methods Twenty-eight college male football players were randomly divided into hand support group (HS group, n=14) and non-hand support group (NHS group, n=14) for 10 weeks. The eccentric control angle and eccentric muscle strength of knee joints were tested before and after the intervention.Results After 10 weeks of Nordic hamstring training, the eccentric control flexion angle of knee joint in HS group and NHS group was significantly decreased by 8° and 10°, and the knee joint angle in NHS group was 12° lower than that in HS group (P<0.05); the peak torque of hamstring and quadriceps femoris in both HS group and NHS group was significantly increased, and the peak torque of hamstring centrifugal motion at 60°/s and 120°/s in NHS group was 16 and 13 N·m higher than that in HS group, respectively (P<0.05).Conclusions NHS group is better than HS group in improving knee flexion angle and centrifugal muscle force. It is suggested that Nordic hamstring training should be taken as one of the daily training tasks for football players to prevent hamstring injury.

Changes of gingival thickness, gingival papilla and marginal bone resorption in patients with chronic local periodontitis after single implant restoration / 中国基层医药

Objective:To investigate the functional and structural recovery of posterior teeth in patients with chronic local periodontitis after single implant restoration.Methods:A total of 133 patients with tooth loss who need single posterior tooth fixation and implantation in Shaoxing People's Hospital from January to December 2019 were included in this study. These patients were divided into periodontitis ( n = 40) and periodontitis-free ( n = 93) groups according to whether they had chronic local periodontitis. All patients were followed up for 6 months. Probing depth (PD), gingival thickness, papilla index score (PIS), modified sulcus bleeding index (mSBI) and marginal bone resorption were compared between the two groups at 1, 3 and 6 months after implant repair. The success rate of tooth implant was compared between the two groups. Results:There was no significant difference in success rate of tooth implant between periodontitis and periodontitis-free groups [100.0% (93/93) vs. 95.0% (38/40), χ2 = 1.94, P = 0.163]. There was no significant difference in the incidence of postoperative complications between periodontitis and periodontitis-free groups [0.0% (0/93) vs. 2.5% (1/40), χ2 = 0.19, P = 0.663]. In the periodontitis group, PD was significantly greater at 3 and 6 months after surgery than that at 1 month after surgery ( t = 2.31, 4.30, P = 0.020, < 0.001). In the periodontitis group, mSBI was lower at 6 months after surgery than that at 1 month after surgery ( t = 1.97, P = 0.048). In the periodontitis-free group, mSBI was lower at 3 and 6 months after surgery than that at 1 month after surgery ( t = 3.64, 4.50, both P < 0.001). There were significant differences in PD and mSBI between periodontitis and periodontitis-free groups at 6 months after surgery ( t = 2.06, 2.13, P = 0.041, 0.035). At 6 months after surgery, marginal bone resorption in both periodontitis and periodontitis-free groups improved compared with that immediately after surgery. In the periodontitis group, marginal bone resorption at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 1.64, 0.63, P = 0.100, 0.524). In the periodontitis-free group, marginal bone resorption at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 1.70, 1.18, P = 0.088, 0.236). In the periodontitis group, gingival thickness at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 0.99, 0.49, P = 0.321, 0.620). In the periodontitis-free group, gingival thickness at 1 month after surgery was not significantly different from that at 3 and 6 months after surgery ( t = 0.87, 1.36 P = 0.379, 0.173). Gingival thickness and marginal bone resorption at 1 month after surgery were not significantly different from those at 3 and 6 months after surgery in each group ( t = 0.49, 0.39, 0.54, 0.77, 0.55, 0.38, P = 0.623, 0.693, 0.590, 0.439, 0.580, 0.699). Conclusion:Single implant restoration exhibits good short-term effects on tooth loss combined with chronic local periodontitis. Single implant restoration does not have a great impact on gingival thickness and marginal bone absorption, but it leads to a higher incidence of peri-implantitis in patients with periodontitis than in patients with healthy periodontal tissue.

Comparison of the objective ocular torsion measured with GMPE module-based OCT and fundus color photography / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the consistency and feasibility of objective ocular torsion measured with GMPE module-based optical coherence tomography(OCT)and fundus color photography(FCP).METHODS: Patients were enrolled in our strabismus clinic from December 2020 to March 2021, and the objective ocular torsion of the eyes was measured by both GMPE module-based OCT and FCP on the same day. FCP was used to measure the fovea-disc angle(FDA)manually by using the Adobe Photoshop software, while the GMPE module-based OCT software positioned automatically the macula and the center of the optic disc to measure the FDA.RESULTS: Fifty-five patients were included, the FDA measured by OCT was -6.6°±4.5° in the right eye and -8.8°±4.7° in the left eye, respectively; The FDA measured by FCP was -6.6°±4.7° in the right eye and -8.4°±4.1° in the left eye, respectively, with no statistically significant difference between the results of the two methods(Pright eye=0.90, Pleft eye=0.08). In patients with exotropia, the FDA measured by OCT was -5.8°±4.9° in the right eye and -9.1°±4.5° in the left eye, respectively, the FDA measured by FCP was -5.7°±5.0° in the right eye and -8.6°±4.3° in the left eye, respectively,(Pright eye=0.75, Pleft eye=0.15). Similarly, the patients with esotropia, the FDA measured by OCT was -9.0°±7.3° in the right eye and -11.3°±3.5° in the left eye, respectively, while the FDA measured by FCP was -10.0°±7.0° in the right and -10.1°±2.8° in the left eye(Pright eye=0.21, Pleft eye=0.10), respectively. There were no significant differences between the two methods in patients with esotropia or exotropia(P>0.05). The results of both Pearson test and Bland-Altman analysis were highly correlated(rright eye=0.93, rleft eye=0.94, P<0.01). CONCLUSION: GMPE module-based OCT can be used for objective ocular torsion measurement with high reliability and reproducibility, and is a promising clinical alternative to the fundus color photographic method.

Anti-liver Cancer Mechanism of Hypericin Based on Network Pharmacology and Molecular Docking / 中国实验方剂学杂志

ObjectiveTo explore the mechanism of hypericin against liver cancer using network pharmacology. MethodThe traditional Chinese medicine systems pharmacology database and analysis platform （TCMSP）， Drug Gene Interaction Database （DGIdb）， Comparative Toxicogenomics Database （CTD） and SwissTargetPrediction were used to predict the targets of hypericin. Five databases including GeneCards and Online Mendelian Inheritance in Man （OMIM） were employed to obtain liver cancer-related targets. The intersection was performed to obtain the targets of hypericin against liver cancer. The Database for Annotation， Visualization and Integrated Discovery （DAVID） v2021q4 was used for Gene Ontology （GO） function annotation and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis. The protein-protein interaction （PPI） network of the targets was constructed by Cytoscape 3.6.1 to screen the core targets，and the affinity between hypericin and the core targets was verified by molecular docking. The effects of hypericin on liver cancer and the migration of liver cancer cells were observed by cell viability assay and would healing assay， respectively， and its effects on the mRNA and protein expression of key targets cysteinyl aspartate-specific protease-3（Caspase-3） and mitogen-activated protein kinase 3 （MAPK3） were detected by real-time polymerase chain reaction（Real-time PCR） and Western blot， respectively. ResultA total of 45 genes related to the anti-liver cancer effect of hypericin were obtained， and six core target genes were screened. The signal pathways enriched by KEGG pathway analysis included apoptosis，tumor necrosis factor （TNF） and cancer signal pathways. Molecular docking showed that the core target genes Caspase-3，TNF，estrogen receptor 1 （ESR1），MAPK3，catalase （CAT） and cyclooxygenase 2 （PTGS2） had good affinity with hypericin，especially Caspase-3 and MAPK3. In addition，compared with the conditions in control group， cell experiments demonstrated that hypericin could reduce the viability of liver cancer cells （P<0.05），inhibit their migration，increase the mRNA expression of Caspase-3 （P<0.05） and decrease that of MAPK3 （P<0.05）. ConclusionHypericin exerted the anti-liver cancer effect by affecting the core targets such as Caspase-3，TNF，ESR1，MAPK3，CAT and PTGS2 and jointly interfering with apoptosis，TNF and cancer signal pathways.

Surgical strategies and approaches for the management of tumors at cervicothoracic junction / 中华胸心血管外科杂志

Objective:To investigate the surgical treatment of the tumors at cervicothoracic junction.Methods:A retrospective analyses was performed for 63 patients with tumors at the cervicothoracic junction receiving surgery from Mar 2008 to May 2020 in the Department of Thoracic Surgery, Zhongshan Hospital, Fudan University. Clinical data about manifestation, surgical approach, resection degree and pathological types were collected. There were 43 cases of asymptomatic patients and 20 cases of patients with ≥1 clinical manifestations. Twenty two patients receiving radical resection with video-assisted thoracoscopic surgery. Anterior approach was the most popular treatment in open surgery (24 cases, 38.1%), and 8 cases of anterolateral approach(6 cases of Hemiclamshell incisions, 2 cases of trap-door incisions), 1 case of posterior approach, 2 cases of posterolateral approach and 1 case of supraclavicular combined posterolateral approach.Results:Pathological examination suggested 61 cases of radical resection and 2 cases of microscopic residual. Neurilemmoma was the most common pathological type (27 cases, 42.9%), the second common pathological type was tumor originated from fibrous tissues (6 cases, 9.5%). The 3-year overall survival rate of those 63 patients was 88.9%, while the 5-year overall survival rate was 84.1%.Conclusion:Tumors involving the cervicothoracic junction are characterized as special location, complicated anatomy and various histopathological subtypes. Individualized approach and surgery improve safety and normalization of tumors at cervicothoracic junction treatment.

Renal ischemia reduction in TAAA hybrid operation by VORTEC renal artery revascularization / 中华普通外科杂志

Objective:To compare the effect of hybrid open-endovascular repair (HOER) and Viabahn open revascularization technique (VORTEC)+HOER in the treatment of thoracoabdominal aortic aneurysms (TAAA).Methods:From Apr 2005 to Jul 2019, 33 TAAA patients underwent HOER including 21 cases of standard HOER, and 12 of VORTEC+HOER. The intraoperative renal ischemia time (RIT), incidence of postoperative acute kidney injury (AKI), rate of renal artery patency (RAP) and another short-term outcome were observed.Results:RIT was significantly shorter in the VORTEC+HOER group than in the standard treatment group [(9±3) minutes vs. (15±6) minutes, P<0.05]. The increase in serum creatinine (SCr) levels on the 1st postoperative day in the standard treatment group was significantly higher than that in the VORTEC+HOER group [(1.68±0.79) μmol/L vs. (1.05±0.06) μmol/L, P<0.05]. AKI occurred in 5 patients in the standard HOER treatment group (5/21, 24%), while no patient experienced AKI in the VORTEC+HOER group (0/12, 0). Conclusion:VORTEC significantly reduces RIT and postoperative SCr increasing, thereby potentially decreasing the incidence of postoperative AKI.

Textual Research on Ranae Oviductus / 中国实验方剂学杂志

Ranae Oviductus has a good tonic effect and is commonly used for both medicine and food. The use of Ranae Oviductus was confused because the origin of Ranae Oviductus was roughly recorded in ancient herbal literatures. In order to clarify the confusing literatures and trace the origin of Ranae Oviductus，this paper conducted a textual research on the name，origin，distribution，harvesting and processing，efficacy of the Chinese medicine by consulting ancient herbal books，modern literatures and monographs of traditional Chinese medicine. The results of the textual research showed that Ranae Oviductus belongs to Manchu medicine，which was first applied by the Manchu people because of its tonic effect. The original animal of Ranae Oviductus has many names，which are all translated from Manchu language. By analyzing the descriptions of Ranidae in various herbal books，it is concluded that the earliest description of the original animals of Ranae Oviductus appeared in the Shengjing Tongzhi compiled by Agui in the Qing dynasty. After summarization of the taxonomic changes of some species of Rana，the original animals of Ranae Oviductus were preliminarily determined as Rana dybowskii，R. amurensis and R. huanrenensis. We excluded R. huanrenensis by its size and R. amurensis by its poor quality. Therefore，the original animal of Ranae Oviductus is R. dybowskii，the main production area is northeast China and the best capture time is in October. Ranae Oviductus is often eaten after being stewed. The study can provide the effective basis for the identification of the original animal of Ranae Oviductus，the distribution of production area and the utilization of resources.

Identification of 24 Rana Species Including Rana dybowskii and Rana chensinensis Based on COⅠ Sequences / 中国实验方剂学杂志

Objective:To identify 24 <italic>Rana</italic> species such as <italic>Rana dybowskii</italic> by mitochondrial cytochrome C oxidase subunit I （<italic>CO</italic>Ⅰ） gene-based DNA barcoding and build the neighbour-joining （NJ） tree for hierarchical cluster analysis， so as to provide a basis for the identification and classification of <italic>Rana</italic> species as well as the discovery of new species. Method:<italic>R. dybowskii</italic>， <italic>R. chensinensis</italic>， <italic>R. amurensis</italic>， <italic>R. culaiensi</italic>s， and <italic>R. huanrenesis</italic>， ten for each species， were collected for DNA extraction and polymerase chain reaction （PCR） amplification<italic> </italic>and sequencing. A total of 50 <italic>CO</italic>Ⅰ gene sequences were obtained. Then 163 <italic>CO</italic>Ⅰ gene sequences for 24 species of <italic>Rana</italic> and one <italic>CO</italic>Ⅰ gene sequence for <italic>Pelophylax</italic>，<italic> Odorrana</italic>， <italic>Nidirana</italic>， <italic>Hylarana</italic>， and <italic>Amolops</italic> were harvested from GenBank. After sequence alignment by MEGA X， the parsimony-informative sites of <italic>CO</italic>Ⅰ gene sequences were analyzed and the intraspecific and interspecific genetic distances were calculated， followed by the built of NJ tree and hierarchical cluster analysis. Result:The <italic>CO</italic>Ⅰ gene sequences of 24<italic> Rana</italic> species including <italic>R. dybowskii</italic> were 554 bp in length and there were 210 parsimony-informative sites in total. The intraspecific genetic distance of each species was smaller than 2%. Except that the interspecific genetic distance between <italic>R. sangzhiensis</italic> and <italic>R. zhengi</italic> was 0.004， the genetic distances between the other species ranged from 0.024 to 0.228. <italic>R. sangzhiensis</italic> and <italic>R. zhengi</italic> were clustered into one branch and some <italic>R. dybowskii</italic> and <italic>R. uenoi</italic> into one branch. There were two separate branches for <italic>R. chensinensis</italic> and the other species were all clustered independently. Conclusion:<italic>CO</italic>Ⅰ-based DNA barcoding enabled the identification of 24 species of <italic>Rana</italic> including <italic>R.dybowskii</italic>. The findings supported that <italic>R. sangzhiensis</italic>， <italic>R. zhengi</italic>， <italic>R. coreana</italic>， and <italic>R. kunyuensis</italic> were the same species. One branch of <italic>R. chensinensis </italic>might be one of the four undownloaded species in Ranidae or a new species. The results have demonstrated that <italic>CO</italic>Ⅰ-based DNA barcoding allows not only the identification of 24 species of Rana including <italic>R. dybowskii </italic>but also the classification of ranidae species and the discovery of new species or subspecies.

Adapted Rhythmic Gymnastics Based on ICF-CY for Children with Low Function Autism Spectrum Disorder / 中国康复理论与实践

Objective:To study the effect of adapted rhythmic gymnastics based on International Classification of Functioning, Disability and Health-Children and Youth Version (ICF-CY) on the fundamental motor skill development for children with low function autism spectrum disorder (ASD). Methods:Three boys aged 7.2 to 8 years with low function ASD (IQ 47 to 53) participated in the exercise since September, 2019. Their activities and motor function were analyzed with ICF-CY to develop a 12-week rehabilitation exercise, including physical fitness, gymnastics skills content and game. They were assessed with ICF-CY based Questionnaire and gross motor of Peabody Developmental Motor Scales (PDMS-2) before and after training. Results:The qualifiers of body structure, body function, activity and participation improved somehow after training. The scores of gross motor skills of PDMS-2 improved. Conclusion:The adapted rhythmic gymnastics training based on ICF-CY may improve the functioning, especially motor function, for children with low function ASD, which can be a kind of rehabilitation exercise.

Plantar Pressure Features under Different Walking Conditions in Patients after Trimalleolar Fracture Surgery / 医用生物力学

Objective To analyze plantar pressure features of patients in injured and healthy sides of the lower limbs under different walking conditions after the trimalleolar fracture surgery, and compare these characteristics with healthy subjects. Methods Twelve Trimalleolar fracture patients and twenty-three healthy subjects were recruited and their plantar pressure characteristics under different walking conditions were tested, including peak pressure, contact area and contact time percentage. Results Comparison between injured and healthy sides: during level walking, peak pressure of the 3rd-5th toe in the injured feet were smaller than those in the healthy sides; in inversion position, peak pressure and contact area of the 3rd-5th toe area in the injured feet were smaller than those in the healthy side; in eversion position, peak pressure, contact area and contact time of the 3rd-5th toe in the injured feet were smaller than those in the healthy sides, and peak pressures of the hindfoot area were larger than those in the healthy sides. Comparison between patients and healthy subjects: under three kinds of walking conditions, peak pressures of the 2nd and 3rd metatarsus bones, the 2nd toe, the 3rd-5th toe, contact area of the 1st-5th toe and contact time percentage of the 2nd toe, the 3rd-5th toe area were all smaller than those of healthy subjects, while contact time of the hindfoot and mid-foot area were all smaller than those of healthy subjects. Conclusions The plantar pressure characteristics of Trimalleolar fracture patients were asymmetrical. Compared with healthy subjects, the plantar pressure features of patients were abnormal during stance phase. Compared with healthy subjects, the motor control ability and stability of patients in eversion positions were decreased. The plantar pressure characteristics at ankle eversion can be used to evaluate ankle joint function.