Blue Nevus Hidden within the Nevus of Ota / 中国医学科学杂志(英文版)

A 3-year-old boy presented with bluish patch and scattered blue spots on the left side of his face. After several sessions of laser treatment, the azury patch in the periorbital area became even darker. Histopathology showed many bipolar, pigment-laden dendritic cells scattered in the papillary and upper reticular dermis. Immunohistochemically, these cells were positive for S100, SOX-10, melan-A, P16, and HMB-45. The positive rate of Ki-67 was less than 5%. Finally, the lesion was diagnosed with nevus of Ota concurrent with common blue nevus. Therefore, for cases of the nevus of Ota with poor response to laser treatment, the possible coexisting diseases should be suspected.

Feasibility analysis of puncture robot technology for the application of acupuncture robot / 中国针灸

The difficulties such as how to accurately locate acupoints and safely insert needles are presented in acupuncture robot. The puncture robot with high technological similarity to acupuncture robot is getting mature, and a large number of human trials and animal experiments have been conducted for the development of puncture robot. Through comparing the similarities and differences between puncture robot and acupuncture robot in the aspects of through-skin puncture, needle insertion and needle removal, the valuable technology of puncture robot is analyzed for the development of acupuncture robot, and the crucial direction of technology migration is determined. ①Integrating the mechanical feedback and medical imaging technology and utilizing the multi-modal perception to achieve the safety of acupuncture operation. ②Emphasizing the integration of the existing designs of chest puncture robot to realize the acupuncture operation with inhalation and exhalation involved. ③Focusing on the development of relevant technology of automatic needle removal through conducting the actual scenario of treatment with acupuncture robot in patients under non-anaesthetic condition.

The clinical effects of coronary artery bypass grafting via the left anterior small thoracotomy approach versus the lower-end sternal splitting approach: A propensity score matching study / 中国胸心血管外科临床杂志

@#Objective     To compare the clinical effects of coronary artery bypass grafting (CABG) via the left anterior small thoracotomy (LAST) versus lower-end sternal splitting (LESS) approach in the treatment of coronary heart disease. Methods     The patients who underwent LAST CABG in Tianjin Chest Hospital from October 2015 to December 2020 were allocated to an observation group (LAST group), and the patients who underwent LESS CABG at the same period were allocated to a LESS group. Propensity score matching method was applied with a ratio of 1∶1. The baseline data, perioperative data and grafts data were compared between the two groups after matching. Results     Before matching, there were 110 patients in the LAST group, and 206 patients in the LESS group. After matching, there were 110 patients in each group. In the LAST group, there were 83 males and 27 females with an average age of 60.6±8.3 years. In the LESS group, there were 80 males and 30 females with an average age of 61.0±9.6 years. There was no statistical difference in baseline data between the two groups after matching (P>0.05). The hospital stay time (t=2.255, P=0.025) and ventilator using time (t=−2.229, P=0.027) in the LAST group were significantly shorter than those in the LESS group. There were no statistical differences between the two groups in the postoperative hospital stay time, ICU stay time, postoperative left ventricular ejection fraction, postoperative left ventricular end-diastolic diameter, average number of grafts, secondary intubation, secondary thoracotomy, postoperative wound infection, sternal complications, postoperative atrial fibrillation, postoperative pulmonary infection or main adverse cardiovascular and cerebrovascular events (P>0.05). There was no statistical difference in the distribution of target vessels in the anterior descending branch, diagonal branch or posterior descending branch between the two groups (P>0.05). The grafts of the LAST group were significantly more than those of the LESS group in the area of obtuse marginal branch and posterior ventricular branch, and the grafts of the LESS group were significantly more than those of the LAST group in the area of right coronary artery (P<0.05). Post-operative computerized tomography angiography indicated that 1 patient in the LAST group had obtuse marginal branch vein bridge vessel occlusion, and the bridge vessels in the other patients were unobstructed. Conclusion     Minimally invasive CABG via both LAST and LESS approaches is safe and effective. LAST approach can achieve complete revascularization for multi-vessel lesions, and it is safe and reliable, with the advantages of less trauma and aesthetic appearance. However, it requires a certain learning curve of surgical techniques and certain surgical indications.

Effect of miRNA-193b-5p-mediated decreased expression of transcriptional regulator CITED2 on melanogenesis / 中华皮肤科杂志

Objective:To investigate the effect of miRNA (miR) -193b-5p on melanogenesis and its possible mechanisms.Methods:Human primary melanocytes were isolated from discarded normal foreskin tissues of healthy males after circumcision, and cultured in vitro. miR-NC mimics (miR-NC mimic group) and miR-193b-5p mimics (miR-193b-5p mimic group) were transfected into human primary melanocytes and human MNT1 melanoma cells, separately. After transfection, real-time quantitative PCR (RT-qPCR) was performed to determine the overexpression efficiency of miR-193b-5p at 48 hours, Western blot analysis to determine the expression of melanogenesis-related proteins tyrosinase (TYR) and microphthalmia-associated transcription factor (MITF) in human primary melanocytes and human MNT1 melanoma cells at 72 hours, and the melanin content in the above cells was determined by a sodium hydroxide solubilization method at 1 week. The target gene of miR-193b-5p was predicted by using Targetscan algorithms and verified by dual-luciferase reporter assay, and RT-qPCR and Western blot analysis were performed to analyze changes in mRNA and protein expression of the target gene respectively after the overexpression of miR-193b-5p. Two-independent-samples t test was used for comparisons between two groups. Results:In human primary melanocytes and human MNT1 melanoma cells, the miR-193b-5p expression levels were significantly higher in the miR-193b-5p mimic groups than in the miR-NC mimic groups ( t = 65.57, 22.49, respectively, both P < 0.001) , and the melanin content was significantly lower in the miR-193b-5p mimic groups (0.091 ± 0.007, 0.130 ± 0.004, respectively) than in the miR-NC mimic groups (0.117 ± 0.002, 0.188 ± 0.032, t = 5.98, 3.24, P < 0.01, < 0.05, respectively) . Western blot analysis showed that the expression of melanogenesis-related proteins TYR and MITF in both human primary melanocytes and human MNT1 melanoma cells was significantly lower in the miR-193b-5p mimic groups than in the miR-NC mimic groups (all P < 0.01) . TargetScan analysis and dual-luciferase reporter assay revealed a binding site for miR-193b-5p in the 3′ untranslated region of the transcriptional regulator CITED2. After up-regulation of miR-193b-5p expression in human primary melanocytes and human MNT1 melanoma cells, the CITED2 mRNA and protein expression levels significantly decreased compared with the miR-NC mimic groups (all P < 0.05) . Conclusion:miR-193b-5p overexpression can down-regulate the expression of melanogenesis-related proteins TYR and MITF, and then inhibit melanogenesis, which may be related to the targeted inhibition of CITED2 expression.

Association between the Wnt signaling pathway and hepatic fibrosis / 临床肝胆病杂志

Hepatic fibrosis (HF) is a self-healing pathological process after all kinds of chronic liver injuries and can cause diseases such as liver cirrhosis and liver cancer. The Wnt signaling pathway is highly conserved in species evolution and widely exists in invertebrates and vertebrates, and many studies have confirmed that the Wnt signaling pathway is closely associated with the development and progression of HF. This article reviews the mechanisms of the classical and non-classical Wnt signaling pathways in regulating hepatic stellate cells, hepatic macrophages, and hepatic progenitor cells, so as to provide new ideas for subsequent studies on the mechanism of the Wnt signaling pathway in regulating HF and further exploration of therapeutic targets that can reverse HF.

Thoughts on the development of International Organization for Standardization standards for Traditional Chinese Medicine information models / 国际中医中药杂志

The development of the International Organization for Standardization (ISO) standard for Traditional Chinese Medicine (TCM) information model is needed to promote the coordinated development of TCM information research and application on a global scale, and it is of great significance to promote the use of TCM data. Based on the 13 years of experience in the development of the ISO standard for the TCM information model, we introduced and discussed the development background, development platform, internationality and classification of the standard development. We determined the necessity of the ISO standard of TCM information model to be independent of modern medical information model standard, the necessity of developing standards on a large scientific platform, and the necessity of health informatics experts participating in standard development. We summarized the main points of international and domestic coordination. We emphasized the balance between the overall layout and new areas development, and the importance of application and promotion.

Prognostic value of pretreatment body mass index in patients with unresectable locally advanced non-small cell lung cancer after chemoradiotherapy / 肿瘤研究与临床

Objective:To explore the effect of pretreatment body mass index (BMI) on the prognosis of patients with unresectable locally advanced non-small cell lung cancer (NSCLC) after chemoradiotherapy.Methods:The clinical data of 711 patients with locally advanced NSCLC treated with radiotherapy, sequential chemoradiotherapy or concurrent chemoradiotherapy from January 2013 to December 2017 in Cancer Hospital of Chinese Academy of Medical Science and Peking Union Medical College were retrospectively analyzed. Radiotherapy was performed with intensity-modulated radiotherapy (IMRT) or volumetric-modulated arc therapy (VMAT), and the chemotherapy regimens were paclitaxel+carboplatin, pemetrexed+cisplatin or etoposide+cisplatin. The effects of pretreatment BMI and other clinical factors on overall survival (OS) of patients were analyzed. Survival analysis was performed by using Kaplan-Meier method; univariate and multivariate analyses were performed by using Cox proportional hazards model.Results:According to the World Health Organization (WHO) recommended BMI grouping method for Asian, the median OS time of low BMI group (<18.5 kg/m 2, 23 cases), normal BMI group (18.5-23.9 kg/m 2, 293 cases) and high BMI group (≥24.0 kg/m 2, 395 cases) was 17 months (95% CI 11-29 months), 29 months (95% CI 22-36 months) and 30 months (95% CI 27-34 months), respectively. OS in the low BMI group was poorer than that in the normal BMI group and high BMI group ( χ2 = 11.20, P = 0.004). Maximally selected rank statistics was used to determine the optimal cut-off value of BMI for prediction of survival as 21.31 kg/m 2, according to which patients were divided into low BMI group (BMI<21.31 kg/m 2, 130 cases) and high BMI group (BMI≥21.31 kg/m 2, 581 cases), the median OS time of the two groups was 20 months (95% CI 17-27 months) and 32 months (95% CI 28-35 months), respectively. OS in the low BMI group was poorer than that in the high BMI group ( χ2 = 12.30, P < 0.001). Multivariate analysis showed that age ≥ 65 years old, male, Karnofsky score < 80 points, low BMI, smoking, histological type of squamous cell carcinoma and radiotherapy alone were independent risk factors for OS (all P < 0.05). Conclusions:For patients with unresectable locally advanced NSCLC who received chemoradiotherapy, those with low pretreatment BMI have poor prognosis.

Advances in application of ctDNA in radiotherapy for non-small cell lung cancer / 中华放射肿瘤学杂志

Circulating tumor DNA (ctDNA) has been the most common biomarker in liquid biopsy because of non-invasive detection and overcoming intratumor heterogeneity. Lung cancer remains the leading cause of cancer-related morbidity and mortality all over the world, with non-small cell lung cancer (NSCLC) constituting 85% of the total cases. Radiotherapy plays an important role in phase Ⅰ-Ⅳ NSCLC. It can not only kill tumor cells to eradicate cancer directly, but also increase the release of ctDNA indirectly, which improves the accuracy of liquid biopsy. As a result, ctDNA has the potential to be widely used in radiotherapy for NSCLC. In this review, research progress on ctDNA in the diagnosis, prognosis assessment, recurrence detection and response prediction in NSCLC patients treated with radiotherapy were summarized.

Application of Artificial Intelligence in Clinical Genomics / 中国医学科学院学报

Clinical genomics mainly studies the clinical application of genomics in diagnosis,treatment decision,and prognosis prediction.Artificial intelligence enables the processing of complex and massive data in genomics which are difficult to be dealt with traditional algorithms and techniques.At present,artificial intelligence is involved in many tasks of clinical genomics,such as variant calling and classification,imaging and genetic diagnosis,electronic health record-based genetic diagnosis,and prediction of drug effect and adverse reaction.This review elaborates the application of artificial intelligence in different aspects of clinical genomics.

Establishment and evaluation of an artificial intelligence model for the diagnosis of facial vitiligo / 中华皮肤科杂志

Objective:To construct an artificial intelligence model for the diagnosis of facial vitiligo, so as to realize artificial intelligence-assisted diagnosis of facial vitiligo.Methods:Based on digital single-lens reflex (SLR) camera images of vitiligo skin lesions and YOLO (You Only Look Once) v3 algorithm, a skin lesion detection model Vit3 was established, and its performance was evaluated by comparing its detection results and labeling results of dermatologists. On the basis of the Vit3 model, both optical and ultraviolet images of vitiligo and non-vitiligo skin lesions were taken by using an artificial intelligence-based facial skin image collector, and the gray values of vitiligo and non-vitiligo skin lesion areas on the ultraviolet images were measured by using an image processing technique. According to the gray-value threshold between vitiligo and non-vitiligo skin lesions, a facial vitiligo diagnosis model Vit4 was established. Cochran′s Q test was used to compare the diagnostic results of the Vit4 model and dermatologists, and the diagnostic performance of the Vit4 model was evaluated. Results:For 100 SLR camera images of vitiligo skin lesions (167 lesional sites) and 100 SLR camera images of normal skin, the diagnostic sensitivity of the Vit3 model was 92.81% (155/167) . For 97 pairs of facial skin images (including 50 vitiligo lesions, 30 pityriasis alba lesions, 7 amelanotic nevus leisons, and 10 normal skin tissues) , the diagnostic accuracy rate, sensitivity and specificity of the Vit4 model were 88.66% (86/97) , 88.00% (44/50) and 89.36% (42/47) respectively, and there was no significant difference in the diagnostic accuracy rate between the Vit4 model and dermatologists (92.78%[90/97], χ2=2.323, P > 0.05) . Conclusion:The artificial intelligence model Vit4 was established for the diagnosis of facial vitiligo with favorable diagnostic performance, and could serve as an objective and convenient method for the auxiliary diagnosis of facial vitiligo.

Effect and Safety of Modified Buzhong Yiqitang on VEGF， IGF-1， TGF-β1， and Immune Function in Postoperative Patients with Non-small Cell Lung Cancer After Chemotherapy / 中国实验方剂学杂志

Objective:To explore the application value of modified Buzhong Yiqitang （BZYQT） in the treatment of postoperative patients with non-small cell lung cancer （Qi deficiency in lung and spleen） after chemotherapy， and to observe its effect on tumor angiogenesis， immune function， tumor indicators， and lung function indicators. Method:Ninety-six patients who were treated in the Kunming municipal hospital of traditional Chinese medicine from March 2018 to February 2020 due to postoperative chemotherapy for non-small cell lung cancer were selected and assigned into a control group （<italic>n</italic>=48， western medicine） and an observation group （<italic>n</italic>=48， western medicine+modified BZYQT） by the random number table. The curative efficacies were compared after the treatment. Result:After treatment， the serum levels of carcinoembryonic antigen （CEA）， cytokeratin 19 fragment 21-1 （CYFRA21-1）， serum insulin-like growth factor-1 （IGF-1）， vascular endothelial growth factor （VEGF）， and transforming growth factor（TGF）-<italic>β</italic>₁ in the observation group were lower than those in the control group （<italic>P</italic><0.05）， while the serum CD4⁺/CD8⁺，CD4⁺ cells， immunoglobulin G （IgG） levels， forced expiratory volume in one second （FEV₁），and FEV₁/forced vital capacity （FVC） in the observation group were higher than those in the control group （<italic>P</italic><0.05）. A significant difference was observed in the total response rate between the observation group ［56.25% （27/48）］ and the control group ［35.42% （17/48）］ （<italic>χ</italic>²＝4.191，<italic>P</italic><0.05）. For adverse reactions，the incidence of bone marrow suppression（<italic>χ</italic>²＝4.002）， gastrointestinal reaction （<italic>χ</italic>²＝7.069），and hepatic and renal injury （<italic>χ</italic>²＝5.151） was lower in the observation group than in the control group （<italic>P</italic><0.05）. Conclusion:For postoperative patients with non-small cell lung cancer （Qi deficiency in lung and spleen） after chemotherapy， western medicine combined with modified BZYQT could ameliorate immune function， promote pulmonary function recovery， improve clinical efficacy， and reduce the incidence of adverse reactions.

Mental health and related influencing factors among rural elderly in 14 poverty state counties of Chongqing, Southwest China: a cross-sectional study

BACKGROUND@#China has the largest elderly population in the world; little attention has been paid to the mental health of elderly in areas of extreme poverty. This is the first study to investigate the mental health of the rural elderly in poverty state counties in Chongqing and was part of the Chongqing 2018 health literacy promotion project.@*METHODS@#In 2019, a cross-sectional study was conducted to investigate the mental health status of the rural elderly in fourteen poverty state counties of Chongqing, in which a total of 1400 elderly aged ≥ 65 years were interviewed, where mental health status was measured by the ten-item Kessler10 (K10) scale. Ordered multivariate logistic regression was performed to evaluate the influencing factors related to mental health of the elderly in these areas.@*RESULTS@#The average score of K10 in 14 poverty state counties was 17.40 ± 6.31, 47.6% was labeled as good, 30.2% was moderate, 17.0% was poor, and lastly 5.1% was bad, and the mental health status of the elderly in the northeastern wing of Chongqing was better than the one in the southeastern wing of Chongqing. A worse self-rated health was the risk factor for mental health both in the northeastern and southeastern wings of Chongqing (all P < 0.001). Lower education level (OR (95% CI) = 1.45 (1.12-1.87), P = 0.004) was a risk factor in the northeastern wing, whereas older age (OR (95% CI) = 1.33 (1.13-1.56), P = 0.001) was a risk factors in the southeastern wing.@*CONCLUSIONS@#The results showed that mental health of the elderly in poverty state counties was poor, especially in the southeastern wing of Chongqing. Particular attention needs to be paid to the males who were less educated, older, and single; female with lower annual per capital income; and especially the elderly with poor self-rated health.

Precision and biomechanical properties of 3D printed artificial bone trabeculae based on Voronoi Tessellation algorithm / 中华创伤杂志

Objective:To investigate the processing accuracy and biomechanical properties of 3D printed artificial bone trabeculae with different porosity generated by the Voronoi Tessellation algorithm, and to provide a reference for improving the biomechanical properties of titanium alloy implants in orthopedics.Methods:A healthy adult male volunteer (aged: 30 years, tall: 175 cm and weight: 70 kg) was selected to collect CT scan data of the lumbar spine. Five kinds of biomimetic artificial bone trabeculae with different porosity were generated using the Voronoi Tessellation algorithm, and divided into Tra_A (73.7%), Tra_B (74.1%), Tra_C (80.0%), Tra_D (80.2%) and Tra_E (85.7%) groups according to the porosity. Selective laser melting (SLM) 3D printing technology was used to process trabecular bone structures with different porosity into titanium alloy prosthesis with a diameter of 18 mm and a height of 20 mm. Each group had 3 samples. The internal structure of each sample was observed by industrial microscope, and the actual porosity of artificial bone trabecular of each group was calculated and compared with the theoretical porosity to evaluate the machining accuracy of artificial bone trabecular with different porosity. Finally, the ultimate load, yield strength and elastic modulus of each sample were evaluated by in vitro mechanical test, and the biomechanical properties of artificial bone trabeculae with different porosity were evaluated.Results:There were no cracks, fracture of connecting rod or accumulation of titanium alloy powder in all specimens. The average actual porosity of the five groups of artificial bone trabecular specimens was 66.0%, 65.5%, 71.8%, 72.5% and 78.1%, respectively. Compared with the theoretical porosity, it was smaller by 10.5%, 11.6%, 10.2%, 9.7% and 8.8%, respectively. In the in vitro mechanical tests for the five groups of artificial bone trabecular specimens, the mean value of ultimate load was 23.6 kN, 18.9 kN, 17.0 kN, 16.3 kN, 10.7 kN, respectively; the mean value of yield strength was 72.2 MPa, 58.7 MPa, 54.9 MPa, 52.2 MPa, and 36.1 MPa, respectively; the mean value of the actual elastic modulus was 7.5 GPa, 6.3 GPa, 4.5 GPa, 4.3 GPa and 2.4 GPa, respectively. With the increase of the porosity of artificial bone trabeculae, all three indicators above showed a decreasing trend. Conclusions:The artificial bone trabeculae generated by the Voronoi Tessellation algorithm and printed by SLM 3D have better machining quality. With the increase of porosity, the processing precision of the titanium alloy artificial bone tray specimens is better. Limit load, yield light and elastic modulus of artificial bone trabecula decrease with the increase of porosity.

Dopamine D1 receptor in ventrolateral periaqueductal gray modulates propofol anesthesia in rats / 医学研究生学报

ObjectiveVentrolateral periaqueductal gray (vlPAG) locates in ascending reticular activating system, which plays a key role in the sleep-wake circle. However, the role of vlPAG in general anesthesia has not been identified. To investigate the effect of the dopamine receptor in vlPAG neurons on propofol anesthesia, we used real-time in vivo fiber photometry, microinjection and EEG.MethodsTo observe the alteration of neuronal activity in the vlPAG throughout propofol anesthesia, 10 Sprague-Dawley rats were used for calcium fiber photometry recording. 50 vlPAG bilateral microinjection models were established and assigned into five groups randomly, including D1R agonist group, D1R antagonist group, D2R agonist group, D2R antagonist group, and control group (n=10). Under propofol anesthesia, 1 μL of D1R agonist, D1R antagonist, D2R agonist, D2R antagonist, and isotonic saline were microinjected into the vlPAG of animals in the corresponding groups, respectively. The induction time, recovery time and the changes in electroencephalogram (EEG) before and after microinjection were recorded and analyzed.ResultsThe neuronal activity in the vlPAG was significantly inhibited during the induction period and markedly recovered during the recovery period from propofol anesthesia (P<0.05). Subsequently, the microinjection of D1R agonist into the vlPAG notably prolonged the induction time and reduced the emergence time of propofol anesthesia with a decrease of δ-band ratio. While the microinjection of D1R antagonist accelerated the induction time and prolonged the emergence time of propofol anesthesia with an increase of δ-band ratio and a decrease in β-band ratio in cortical EEG (P<0.05). The induction and recovery time of D2R agonist /antagonist group did not differ with those of control group. As well, EEG before and after microinjection in D2R agonist /antagonist group did not different.ConclusionThese results indicate that vlPAG modulates the process of propofol anesthesia via D1R.

Effects of Attentional Distribution on Balance and Arithmetic Ability of Dual Task Model / 中国康复理论与实践

Objectives:To explore the impact of attentional distribution principle on balance and arithmetic ability when performing calculation-balance dual task. Methods:From October, 2016 to December, 2017, 20 healthy young subjects were selected, and asked to perform eyes opened + calculation and eyes closed + calculation tests under sitting position, and perform single leg standing + eyes opened, single leg standing + eyes closed, single leg standing + eyes opened+ calculation and single leg standing + eyes closed + calculation tests in the static balance instrument. The maximum displacement in mediolateral direction and anteroposterior direction of center of gravity, sway area and sway path length were recorded, as well as the accuracy of counting backwards in steps of seven. Results:The maximum displacement in mediolateral direction and anteroposterior direction, sway area, sway path length were significantly less when eyes opened than eyes closed (t > 8.775, P < 0.001). The maximum displacement in mediolateral direction and anteroposterior direction, and sway area were less when eyes closed during the dual task than single task (t > 2.276, P < 0.05). There was no statistical difference in the maximum displacement in mediolateral direction and anteroposterior direction, and sway area and sway path length when eyes opened during the dual task compared with single task (t < 1.379, P > 0.05). There was no significant difference in the calculation accuracy among the eyes opened + sitting group, the eyes closed + sitting group, the eyes opened + balance test group and the eyes closed + balance test groups (P > 0.05). Conclusion:The low-difficult cognitive dual task does not affect the balance stability and arithmetic ability through the attentional distribution principle, on the contrary, the arithmetic task improves the static balance ability of single leg standing when eyes closed, however, it has no effect on the static balance ability of single leg standing when eyes opened.

Safety and efficacy of picosecond Alexandrite laser with a diffractive lens array for treatment of facial photoaging / 中华医学美学美容杂志

Objective To evaluate the efficacy and safety of a 755 nm picosecond Alexandrite la-ser with a diffractive lens array in the treatment of facial photoaged skin .Methods Twenty-six pa-tients with facial photoaging were recruited and received 3 treatments at 4-week intervals .Laser energy was applied over the entire face at a fixed spot size of 6 mm ,with a fluence of 0 .71 J/cm2 and 5Hz . Blinded clinical assessment was performed by 2 independent dermatologists on a 5-point global pho-toaging scale (GPS) .Patients were also questioned on the extent of improvement of rhytides ,skin tightening ,and complexion with a 4-point global aesthetic improvement scale (GAIS) and satisfaction . Adverse events were also evaluated .Results Twenty-six patients completed the treatment .Compared with the baseline ,there was a significant improvement in facial photoaged skin after 3 treatments ,and these positive outcomes were maintained up to the 3-month follow-up ,according to the GPS and GAIS scores .Moderate pain and transient erythema were observed as the two main discomforts associated with the treatment .Most patients were satisfied with the treatment .Conclusions This 755 nm pico-second Alexandrite laser with a diffractive lens array optic is effective in the treatment offacial pho -toaged skin ,and the therapy also seems safe and well tolerated .

The movable artificial lumbar vertebralbody: development and biomechanical study / 中华骨科杂志

Objective To develop a new type of lumbar prosthesis,movable artificial lumbar vertebral body (MALV) and evaluate the stability and activity of the prosthesis by in vitro biomechanical test.Methods Fifteen adult fresh lumbar spine specimens were randomly divided into three groups:intact group,fusion group and non-fusion group.The anatomical parameters of L2 vertebral body and adjacent intervertebral discs were collected by software (Mimics 16.0,Materialise Company,USA) and the new prosthesis was personalized by 3D printing and mechanical processing.All specimens in fusion group and in non-fusion group were implanted with titanium cage,titanium plate and MALV respectively after partial resection of L2 vertebra and adjacent intervertebral disc.No other intervention was conducted on physiological specimens.All specimens were examined by imaging to determine the position of the prosthesis and the condition of the spinal cord.Specimens in all groups were subjected to a 7.5 N · m load biomechanical test in flexion,extension,left and right lateral bending,left and right rotation aiming to evaluate the mobility of operative site and adjacent discs.Results The new prosthesis consists of three parts,vertebral body,intervertebral disc and composite material ball.All 15 cadavers were free of spinal deformity,fracture and osteoporosis.Postoperative radiographic examination indicated no prosthesis displacement and spinal compression without adverse phenomena.The results in vitro mechanical test were as followed.There was no statistical difference in ROM of the T12L1 intervertebral in non-fusion group (3.68°±0.86°,3.52°± 0.86°,2.64°±0.93°,2.58°±0.76° respectively) and in intact group (3.98°±0.90°,3.74°±0.91°,2.94°±1.10°,2.96°±0.86° respectively) in flexion,extension,left and right lateral bending (P＞0.05).The ROM of the T12L1 intervertebral in fusion group (5.28°±0.83°,5.32°±0.42°,4.72°±1.10°,4.94°±1.17° respectively) was significantly larger than that in intact group and non-fusion group (P＜0.05).There was no statistically significant difference between the ROM of L1.2 and L2.3 intervertebral in flexion,extension and left and rightlateral bending in the non-fusion group (ROM of L1.2 were 4.62°±0.51 °,4.34°±0.67°,3.16°±0.55°,3.28°±0.41 ° respectively;ROM of L2.3 were 4.54°±0.58°,4.36°±0.65°,3.26°±0.21°,3.42°±0.37° respectively) and the intact group (ROM of L1.2 were 4.10°±0.53°,3.72°±0.42°,2.74°±0.50°,3.04°±0.40° respectively;ROM of L2.3 were 4.26°±0.72°,4.08°±0.77°,3.00°±0.36°,3.20°±0.31° respectively) (P＞0.05).The ROM of L1.2 and L2.3 in intact group and in non-fusion group were significantly greater than those in the fusion group (ROM of L1.2 were 1.10°± 0.35°,1.28°±0.31°,0.84°±0.34°,0.80°± 0.43° respectively;ROM of L2.3 were 1.14°±0.30°,1.18°±0.28°,0.94°± 0.36°,1.06°±0.32°) (P＜0.05).There was no statistically significant difference in the ROM of the T12-L3 full segment in the left and right rotation of the three groups (Intact group:4.47°± 0.99°,4.40°±0.70°;Non-fusion group:4.60°±0.90°,4.50°±0.77°;Fusion group:3.85°±0.50°,3.72°±0.70°)(P＞0.05).Conclusion The MALV can retain the mobility of the operative site in flexion,extension,lateral bending and rotation.Furthermore,it can effectively avoid the increased mobility of adjacent segment intervertebral.After implantation,the prosthesis can obtain satisfied immediate stability.

Analysis on the specificity of the relevant points along the governor vessel in chronic gastritis based on tenderness reaction and tenderness threshold / 中国针灸

OBJECTIVE@#To explore the specificity of the relevant points along the governor vessel in chronic gastritis through the synchronous observation of the tenderness reaction and tenderness threshold on the back along the governor vessel in the volunteers with chronic gastritis and make the comparison with healthy volunteers.@*METHODS@#A chronic gastritis group and a healthy volunteer group were prepared, 30 cases in each one. Using synchronous comparison, the tenderness reaction at the point inferior to each of the spinous processes from T to L along the governor vessel was observed. The mechanical pressure pain threshold was determined.@*RESULTS@#Regarding the tenderness reaction at the point inferior to each spinous process on the back along the governor vessel, the occurrence rate was different significantly between the chronic gastritis group and the healthy volunteer group (0.05).@*CONCLUSION@#The point inferior to the spoinous process of T on the governor vessel, Shendao (GV 11, T) and Lingtai (GV 10, T) are the points with the high specificity in chronic gastritis, which provides the reference to clinical treatment with acupuncture and moxibustion. The occurrence rate of high tenderness reaction and the low tenderness threshold may be the important manifestation of the point specificity on the back along the governor vessel in chronic gastritis.

San-Cao Granule () Ameliorates Hepatic Fibrosis through High Mobility Group Box-1 Protein/Smad Signaling Pathway / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the possible mechanism of San-Cao Granule (SCG, ) mediating antiliver fibrosis.</p><p><b>METHODS</b>A total of 60 male Sprague-Dawley rats were randomly divided into the normal control group, porcine serum-treated group, ursodesoxycholic acid (UDCA, 60 mg/kg), SCG (3.6 g/kg) group, SCG (1.8 g/kg) group and SCG (0.9 g/kg) group, with 10 rats in each group. Liver fibrosis was induced with porcine serum by intraperitoneal injection for 8 weeks, except for the normal control group. Then, the rats in the three SCG-treated groups and UDCA group were administered SCG and UDCA respectively for 4 weeks. The serum levels of alanine transaminase (ALT), aspartate transaminase (AST), albumin (ALB), total bilirubin (TBIL), hyaluronic acid (HA), laminin (LN), and type IV collagen (IVC) were examined using commercial kits and hepatic histopathology was examined with hematoxylin and eosin and Masson staining. Moreover, the protein expression levels of high mobility group box-1 protein (HMGB1), transforming growth factor β1 (TGF-β1), phosphorylated mothers against decapentaplegic homolog 3 (p-Smad3), Smad7, toll-like receptor 4 (TLR4), myeloid differentiation factor 88 (MyD88), nuclear factor-kappa B (NF-κB) and α-smooth muscle actin (α-SMA) were determined by western blot, immunohistochemistry and real time quantitative-reverse transcription polymerase.</p><p><b>RESULTS</b>Both SCG (3.6 and 1.8 g/kg) and UDCA significantly ameliorated the liver fibrosis induced by porcine serum as indicated by retarding the serum levels increasing of ALT, AST, TBIL, HA, LN and IVC and preventing the serum level reducing of ALB compared with the model group (all P<0.01). Meanwhile, the collagen deposition was attenuated by SCG and UDCA treatment. Furthermore, SCG markedly reduced the expressions of HMGB1, TGF-β1, p-Smad3, TLR4, MyD88, NF-κB and α-SMA, and enhanced the expression of the Smad7 compared with the model group (all P<0.01).</p><p><b>CONCLUSION</b>SCG ameliorates hepatic fibrosis possibly through inhibiting HMGB1, TLR4/NF-κB and TGF-β1/Smad signaling pathway.</p>

Efficacy and safety of picosecond Alexandrite laser in treatment of nevus of Ota / 中华医学美学美容杂志

Objective To analyze the efficacy,safety and the correlative influencing factors of picosecond Alexandrite laser in the treatment of nevus of Ota.Methods 49 patients with nevus of Ota receiving picosecond Alexandrite laser in our department from October 2015 to October 2017 were retrospectively analyzed,and grouped according to patient gender,age of onset,age of first treatment,Tanino classification of skin lesions and color grading.Clinical characteristics,treatment effects,adverse reactions,influencing factors and other factors were analyzed.Results 49 patients with nevus of Ota were treated 1-4 times,and 9 cases were cured.After one treatment,the significant effective rate was 28.6 ％,the effective rate was 53.1 ％,and the effective rate was 100 ％ after 3 treatments,and the effective rate was 100％ after 4 treatments.No significant difference was found in the first treatment efficacy between different genders,age of onset,Tanino classification and color grading (P＞0.05).There was a significant difference in the first treatment effect between different first treatment age groups (P＜0.05).The inverse relationship between age and efficacy was found.The younger the age,the better the first treatment effect.Pigmentation appeared in 2 patients after treatment and subsided after 6 months.No adverse reactions such as scars and hypopigmentation appeared.Conclusions Picosecond Alexandrite laser is a safe and highly effective therapy for nevus of Ota.