Coronary intravascular lithotripsy for calcified coronary artery calcification-systematic review of researches / 中国介入心脏病学杂志

Coronary artery calcification commonly results in reduced vascular compliance,facilitating incomplete stent expansion and in-stent restenosis after stent implantation,thereby leading to the failure of interventional treatment.Conventional approaches to managing calcified lesions are constrained by the intricate nature and properties of calcified plaques,which frequently pose challenges in their manipulation,consequently giving rise to numerous approaches complications and an elevated likelihood of adverse cardiovascular events following the procedure.Percutaneous coronary intraluminal shock wave balloon catheter angioplasty,also known as coronary intravascular lithotripsy,utilizing a balloon catheter system,demonstrates the capacity to safely and efficiently modify superficial and deep-seated calcifications,regardless of their concentric or eccentric nature.This intervention significantly enhances vascular compliance,thereby facilitating subsequent interventional therapies.Presently,coronary intravascular lithotripsy has emerged as a crucial approach in the management of coronary artery calcification.This article primarily offers a comprehensive examination of the mechanism of intravascular lithotripsy and the research pertaining to the treatment of coronary artery calcification.

Association of 24hour movement behaviors with emotional and behavioral problems among left-behind children / 中国学校卫生

Objective@#To examine the association of 24 hour movement behaviors with emotional and behavioral problems among left behind children, so as to provide a theoretical reference for the practice of 24 hour activity interventions to promote emotional and behavioral problems in this population.@*Methods@#From February to May 2023, 1 117 left behind children in grades 4-6 from 10 primary schools in five cities in Zhejiang Province were selected using a convenient cluster sampling method to conduct a questionnaire survey examining 24 hour movement behaviors, as well as emotional and behavioral problems. The general linear model was adopted to analyze the association between satisfying the 24 hour movement behavior guidelines, and emotional and behavioral problems among left behind children.@*Results@#The sleep duration compliance rate was the highest (52.19%), while the moderate-to-vigorous PA (MVPA) compliance rate was the lowest (17.73%). The compliance rate of the three activities accounted for 7.43 %. There was a dose response between the number of guidelines satisfied, and the emotional and behavior of left behind children; that was, satisfaction of a higher number of guidelines was associated with a lower risk of emotional and behavioral problems among left behind children (difficulty factor: β=-0.56, 95%CI =-1.23--0.19; strength factor: β=0.50, 95%CI =-0.48-1.22, P < 0.01). Compared to satisfying none of the guidelines, satisfying the guidelines for screen time ( β=-0.23, 95%CI =-2.18- -0.14 ) and sleep duration ( β=-0.13, 95%CI =-1.66--0.11) was negatively correlated with the difficulty factor, while satisfying the guideline for MVPA ( β=0.13, 95%CI =0.09-1.08) and sleep duration ( β=0.18, 95%CI =0.09-1.40) was positively associated with the strength factor. In addition, satisfying two or all three of the guidelines was more strongly associated with these outcomes than satisfying one of the recommendations ( P <0.01).@*Conclusions@#Meeting the 24 hour movement behavior guidelines can improve emotional and behavioral problems among left behind children. It is necessary to raise their awareness of the effect of satisfying the 24 hour movement behavior guidelines and formulate comprehensive intervention measures.

Early Outcomes of Minimally Invasive Right Anterior Thoracotomy vs. Median Full Sternotomy in Isolated Aortic Valve Replacement: A Propensity Score Analysis

ABSTRACT Introduction: This study aimed to compare the early postoperative outcomes of right anterior thoracotomy minimally invasive aortic valve replacement (RAT-MIAVR) surgery with those of median full sternotomy aortic valve replacement (MFS-AVR) approach with the goal of identifying potential benefits or drawbacks of each technique. Methods: This retrospective, observational, cohort study included 476 patients who underwent RAT-MIAVR or MFS-AVR in our hospital from January 2015 to January 2023. Of these, 107 patients (22.5%) underwent RAT-MIAVR, and 369 patients (77.5%) underwent MFS-AVR. Propensity score matching was used to minimize selection bias, resulting in 95 patients per group for analysis. Results: After propensity matching, two groups were comparable in preoperative characteristics. RAT-MIAVR group showed longer cardiopulmonary bypass time (130.24 ± 31.15 vs. 117.75 ± 36.29 minutes, P=0.012), aortic cross-clamping time (76.44 ± 18.00 vs. 68.49 ± 19.64 minutes, P=0.004), and longer operative time than MFS-AVR group (358.47 ± 67.11 minutes vs. 322.42 ± 63.84 minutes, P=0.000). RAT-MIAVR was associated with decreased hospitalization time after surgery, lower postoperative blood loss and drainage fluid, a reduced incidence of mediastinitis, increased left ventricular ejection fraction, and lower pacemaker use compared to MFS-AVR. However, there was no significant difference in the incidence of major complications and in-hospital mortality between the two groups. Conclusion: RAT-MIAVR is a feasible and safe alternative procedure to MFS-AVR, with comparable in-hospital mortality and early follow-up. This minimally invasive approach may be a suitable option for patients requiring isolated aortic valve replacement.

Research on fungal culturomics based on different universal media / 中国热带医学

@#Abstract: Objective To screen out a more universally applicable culture medium for the isolation and culturing of pathogenic fungi through comparing the performance of various universal fungal culture media, to optimize the fungal culturomics technique, and to better apply it to the culturomics research of pathogenic fungi. Methods Multiple common fungal culture media Sabouraud dextrose agar (SDA), potato dextrose agar (PDA), modified Dixon (mDixon), modified LeemingNotman agar (MLNA), etc., and a new pan-fungal medium (PF) were used to culture 40 strains of common pathogenic fungi to determine the growth states of strains under different conditions. Based on that, PF, SDA, PDA, mDixon and MLNA, a total of 5 culture media, were used to isolate and culture a simulated sample (suspension of Candida albicans and Aspergillus fumigatus), 10 human samples (4 fecal samples and 6 vaginal secretion samples) and 3 environmental samples. Results The positive growth rates of 40 strains of pathogenic fungi in the 7 media were as follows: PDA 95.0% (38/40), SDA 95.0% (38/40), BHI 95.0% (38/40), YPD 90.0% (36/40), mDixon 95.0% (38/40), MLNA 87.5% (35/40), PF 100.0% (40/40). For the simulated samples, PF could effectively promote the self-limited growth of filamentous fungi, performing better in isolation and culture. For the human samples and environmental samples, PF showed the same versatility as SDA and PDA. Conclusions In the isolation and culturing of pathogenic fungi, PF medium can effectively isolate and culture most fungal species. Meanwhile, PF can make the fast-growing fungi show self-limited growth and clear edges, and not easy to cross-contamination, which indicates it is conducive to the isolation and identification of single colonies. PF medium outperforms other common media in isolating strains from unknown samples in culturomics, which illustrates PF medium can be effectively used for the study of fungal culturomics.

Construction of an evaluation index system for the response capacity of universities to public health emergencies / 中国学校卫生

Objective@#To construct an evaluation index system to assess the response capacity of universities to public health emergencies, so as to provide a basis for improvements the response capacity.@*Methods@#In November 2019, in order to develop an evaluation system based on literature review and expert discussions, 15 experts were invited to conduct a subjective evaluation used hierarchical analysis. The objective evaluation was conducted in 120 universities in Jiangsu Province used the inverse entropy weighting method, and the final evaluation employed the joint subjective and objective weighting method.@*Results@#The indicator system consisted of four primary indicators, nine secondary indicators, 32 tertiary indicators and 67 quaternary indicators. The analysis of the combined weighting method showed that the primary indicators, in descending order, included incident handling capability ( 0.666 ), incident detection capability (0.203), prior preparation capability (0.101) and post event recovery capability ( 0.031 ). The top three secondary indicator weights were emergency response (0.480), monitoring and reporting (0.203) and command and coordination (0.151). The results of the evaluation of the consistency indicators showed that the expert authority coefficient was 0.909 and the Kendall s W coordination coefficient was 0.836 ( P <0.01), with all consistency scale values < 0.1.@*Conclusion@#The evaluation system is highly scientific and credible, and provides basis for evaluating the response capability of universities to public health emergencies.

Approaches in the treatment of perianal fistula in Crohn disease

Perianal fistula is a common complication of Crohn disease, and it is a great burden on the life and psychology of patients, but its treatment is still a difficult problem to face. In recent years, progress in the treatment of Crohn disease has progressed rapidly due to the advent of biological agents, but there has been a lack of research on perianal fistula in Crohn disease, and the direction of research has been scattered; therefore, the author reviews the traditional treatment of perianal fistula in Crohn disease in the context of the available literature and discusses emerging and potential therapeutic approaches. (AU)

Impact of eccentric training on jumping ability in athletes / Impactos do treinamento excêntrico sobre a capacidade de salto em atletas / Impacto del entrenamiento excéntrico en la capacidad de salto en atletas

ABSTRACT Introduction: Strength quality can be divided into total strength, rapid strength, endurance strength, and reaction strength, among which rapid strength has been a much-discussed theme in sports industry research. Objective: Study the impacts of eccentric lower limb training on jumping ability in soccer athletes. Methods: A multifunctional centrifugal training device was used as a training tool, and the effect of eccentric training on rapid strength in soccer players was analyzed. Results: The average force of soccer players in the experimental group increased by about 524N, and the completion rate increased by about 76%. Both average strength and completion rate were significantly improved. Compared to the control group, the experimental group benefited more from the explosive power and kinetic indexes. There was also a significant improvement in the four indices of jumping ability, the three indices of sensitivity (except 15s step frequency), and eccentric training in the experimental group (P < 0.01). Conclusion: The proposed lower limb eccentric training resulted in a beneficial effect on the jumping ability of athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A qualidade da força pode ser dividida em força total, força rápida, força à resistência e força de reação, entre as quais a força rápida é um tema bastante discutido nas pesquisas da indústria esportiva pelos últimos anos. Objetivo: Estudar os impactos do treinamento excêntrico dos membros inferiores sobre a capacidade de salto nos atletas de futebol. Métodos: Foi utilizado um dispositivo de treinamento centrífugo multifuncional como instrumento de treino, analisou-se o efeito do treinamento excêntrico sobre a força rápida em jogadores de futebol. Resultados: A força média dos jogadores de futebol do grupo experimental aumentou em cerca de 524N, e a taxa de conclusão aumentou em cerca de 76%. Tanto a força média quanto a taxa de finalização foram significativamente aprimoradas. Em comparação com o grupo controle, o grupo experimental teve um benefício maior do índice de potência explosiva e índice cinético. Também houve melhora significativa nos quatro índices de habilidade de salto, nos três índices de sensibilidade (exceto a frequência de passos de 15s), e no treinamento excêntrico do grupo experimental (P < 0,01). Conclusão: O treinamento excêntrico proposto para membros inferiores resultou em um efeito benéfico sobre a capacidade de salto dos atletas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La calidad de la fuerza puede dividirse en fuerza total, fuerza rápida, fuerza a la resistencia y fuerza de reacción, entre las cuales la fuerza rápida es un tema suficientemente discutido en las investigaciones de la industria del deporte durante los últimos años. Objetivo: Estudiar las repercusiones del entrenamiento excéntrico de los miembros inferiores en la capacidad de salto de los deportistas de fútbol. Métodos: Se utilizó un dispositivo de entrenamiento centrífugo multifuncional como herramienta de entrenamiento, y se analizó el efecto del entrenamiento excéntrico sobre la fuerza rápida en jugadores de fútbol. Resultados: La fuerza media de los futbolistas del grupo experimental aumentó en unos 524N, y la tasa de finalización aumentó en un 76%. Tanto la fuerza media como la tasa de finalización mejoraron significativamente. En comparación con el grupo de control, el grupo experimental obtuvo un mayor beneficio del índice de potencia explosiva y del índice cinético. También hubo una mejora significativa en los cuatro índices de capacidad de salto, los tres índices de sensibilidad (excepto la frecuencia de paso de 15s) y el entrenamiento excéntrico en el grupo experimental (P < 0,01) Conclusión: El entrenamiento excéntrico de las extremidades inferiores propuesto tuvo un efecto beneficioso en la capacidad de salto de los atletas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Diagnosis of sports fatigue and nutritional intervention in track and field / Diagnóstico da fadiga esportiva e intervenção nutricional no atletismo / Diagnóstico de la fatiga deportiva e intervención nutricional en el atletismo

ABSTRACT Introduction As a high-intensity physical sport, athletics can easily cause serious physical injuries and even psychological problems if not diagnosed after sports fatigue. Objective Study the relationship between sports fatigue and nutritional intervention in track and field. Methods One hundred track and field athletes in a province were investigated. Through literature survey, questionnaire survey, and other data testing, track and field athletes' sports fatigue and nutritional status were analyzed to determine the necessary relationship between sports fatigue and nutritional intervention. Results The coach's judgment of sports fatigue during athletes' training is characterized by a lack of technical accuracy, leading to the decline of athletes' physical recovery ability and aggravating sports fatigue to a certain extent. As a high-intensity physical exercise, athletics must diagnose sports fatigue in time and provide effective nutritional intervention. Conclusion The research shows that after high-intensity exercise, the diagnosis of sports fatigue in track and field athletes is of great importance in judging the athletes' physical function, and scientific nutritional intervention plays an important role in athletes' excessive physical function, improving their sports ability and relieving sports fatigue. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução Por ser um esporte físico de alta intensidade, o atletismo pode facilmente causar lesões físicas graves e até mesmo problemas psicológicos se não forem diagnosticáveis a tempo após a fadiga esportiva. Objetivo Estudar a relação entre a fadiga esportiva e a intervenção nutricional no atletismo. Métodos Foram investigados 100 praticantes de atletismo em uma província. Através de pesquisa bibliográfica, levantamento de questionários e outros testes de dados, a fadiga esportiva e o estado nutricional dos esportistas de atletismo foram analisados para descobrir a relação necessária entre a fadiga esportiva e a intervenção nutricional. Resultados O julgamento do treinador sobre a fadiga esportiva durante o treinamento dos atletas é caracterizado pela falta de precisão técnica, levando ao declínio da capacidade de recuperação física dos atletas e agravando a fadiga esportiva em certa proporção. Como um exercício físico de alta intensidade, o atletismo necessita de diagnóstico da fadiga esportiva não apenas no tempo, mas também de uma intervenção nutricional eficaz. Conclusão A pesquisa mostra que após o exercício de alta intensidade, o diagnóstico da fadiga esportiva dos praticantes de atletismo é de grande importância para julgar a função física dos atletas, e a intervenção nutricional científica desempenha um papel importante na função física excessiva dos atletas, melhorando sua capacidade esportiva e aliviando a fadiga esportiva. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción Al ser un deporte físico de alta intensidad, el atletismo puede provocar fácilmente graves lesiones físicas e incluso problemas psicológicos si no se diagnostican a tiempo tras la fatiga deportiva. Objetivo Estudiar la relación entre la fatiga deportiva y la intervención nutricional en el atletismo. Métodos Se investigó a 100 practicantes de atletismo de una provincia. Mediante un estudio bibliográfico, un cuestionario y otras pruebas de datos, se analizó la fatiga deportiva y el estado nutricional de los atletas para averiguar la relación necesaria entre la fatiga deportiva y la intervención nutricional. Resultados El juicio del entrenador sobre la fatiga deportiva durante el entrenamiento de los atletas se caracteriza por la falta de precisión técnica, lo que conduce a la disminución de la capacidad de recuperación física de los atletas y agrava la fatiga deportiva en cierta medida. Como ejercicio físico de alta intensidad, el atletismo necesita un diagnóstico de la fatiga deportiva no sólo a tiempo, sino también una intervención nutricional eficaz. Conclusión La investigación muestra que, tras un ejercicio de alta intensidad, el diagnóstico de la fatiga deportiva de los atletas de atletismo es de gran importancia para juzgar la función física de los atletas, y la intervención nutricional científica desempeña un papel importante en la función física excesiva de los atletas, mejorando su capacidad deportiva y aliviando la fatiga deportiva. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Neuropathologic damage induced by radiofrequency ablation at different temperatures

Abstract Objective To explore the molecular mechanism of neuropathologic damage induced by radiofrequency ablation at different temperatures. Methods This is basic research, and 36 SD rats were used to construct the neuropathological injury model. The rats were subjected to radiofrequency stimulation at different temperatures and were divided into 6 groups according to the temperature injury: 42°, 47°, 52°, 57°, 62°, and 67°C groups. Conduction time, conduction distance, and nerve conduction velocity were recorded after temperature injury. HE-staining was used to observe the histopathological morphology of the sciatic nerve. The expression of SCN9A, SCN3B, and NFASC protein in sciatic nerve tissue were detected by western blot. Results With the increase in temperature, nerve conduction velocity gradually decreased, and neurons were damaged when the temperature was 67°C. HE-staining showed that the degrees of degeneration of neurons in rats at 47°, 52°, 57°, 62°, and 67°C were gradually increased. The expression of SCN9A, SCN3B protein in 57°, 62°, 67°C groups were much higher than that of NC, 42°, 47°, 52°C groups. However, the expression of NFASC protein in 57°, 62°, 67°C groups was much lower than that of the NC, 42°, 47°, 52°C groups. Conclusion There was a positive correlation between temperature caused by the radiofrequency stimulation to neuropathological damage. The mechanism is closely related to the expression of SCN9A, SCN3B, and NFASC protein in nerve tissue caused by heat transfer injury.

Simulation of the relationship between exercise and cardiopulmonary function at high altitude / Simulação da relação entre exercício e função cardiopulmonar em grandes altitudes / Simulación de la relación entre el ejercicio y la función cardiopulmonar a gran altura

ABSTRACT Introduction: Due to various uncertain and unexpected factors in life such as diseases, natural disasters, traffic accidents, and congenital disabilities, the number and proportion of lower limb amputations are still rising for many reasons, so the research on lower limb prostheses is particularly important. Objective: This work aimed to study the relationship between altitude exercise and cardiopulmonary function. Methods: A model of abnormal changes in cardiopulmonary function was established, and then 40 plateau exercisers were selected, all of whom arrived in Tibet in March 2017. The relationship between pulmonary circulation volume and internal pressure in the chest was observed and compared. The relationship between cardiopulmonary sensory reflex and exercise (high altitude) breathing and heart rate was analyzed. A comparison of the cardiopulmonary function of subjects of different genders was implemented. Moreover, the influence of different altitudes on the subjects' cardiopulmonary function and the subjects' cardiopulmonary function changes before departure and during the first, second, and third week after departure were observed and compared. Results: I. As the pressure in the thoracic cavity increased, the subjects' pulmonary circulation blood volume gradually decreased, and the decrease was most obvious in the stage of thoracic pressure −50 to 0. II. As the cardiorespiratory reflex coefficient increased, the subjects' breathing and heart rate compensatory acceleration appeared. III. Tracking and monitoring of the subjects' cardiopulmonary indicators revealed that with the increase in altitude, the subjects' average arterial pressure, respiratory frequency, and heart rate all showed an upward trend, while the blood oxygen saturation value showed a downward trend. IV. No matter how high the altitude was, the average arterial pressure, respiratory rate, and heart rate monitored of the subjects under exercise were significantly superior to the indicator values under resting state. In contrast, the blood oxygen saturation value showed the opposite trend. V. The subjects' average arterial pressure, respiration, and heart rate in the first week were higher than other periods, but the blood oxygen saturation was relatively lower. In the second and third weeks, the changes in cardiopulmonary function were relatively smooth (all P<0.05). VI. The changes in the index of the cardiopulmonary function of subjects of different genders were small (p>0.05). Conclusion: Through modeling, the results of the plateau environment on the cardiopulmonary function of the body were made clearer, and these research data provided theoretical references for the training of the sports field in the plateau area. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Contexto: devido a vários fatores incertos e inesperados da vida, como doenças, desastres naturais, acidentes de trânsito e defeitos congênitos, o número e a proporção de amputações de membros inferiores ainda estão aumentando por muitos motivos, portanto, a pesquisa sobre próteses de membros inferiores é particularmente importante. Objetivo: Este trabalho teve como objetivo estudar a relação entre o exercício em altitude e a função cardiopulmonar. Métodos: Um modelo de alterações anormais da função cardiopulmonar foi estabelecido e, em seguida, 40 praticantes de exercícios de platô foram selecionados, todos chegaram ao Tibete em março de 2017. A relação entre o volume de circulação pulmonar e a pressão interna no tórax foi observada e comparada. A relação entre o reflexo sensorial cardiopulmonar e a respiração do exercício (altitude) e a frequência cardíaca foi analisada. A comparação da função cardiopulmonar de indivíduos de diferentes gêneros foi implementada. Além disso, a influência de diferentes altitudes na função cardiopulmonar dos indivíduos e as mudanças na função cardiopulmonar dos indivíduos antes da partida e durante a primeira, segunda e terceira semanas após a partida foram observadas e comparadas. Resultados: I. À medida que a pressão na cavidade torácica aumentou, o volume de sangue da circulação pulmonar dos indivíduos diminuiu gradualmente, e a diminuição foi mais óbvia no estágio de pressão torácica −50 a 0. II. À medida que o coeficiente do reflexo cardiorrespiratório aumentou, a respiração dos indivíduos e a aceleração compensatória da frequência cardíaca apareceram. III. O rastreamento e o monitoramento dos indicadores cardiopulmonares dos indivíduos revelaram que, com o aumento da altitude, a pressão arterial média, a frequência respiratória e a frequência cardíaca dos indivíduos mostraram uma tendência ascendente, enquanto o valor de saturação de oxigênio no sangue mostrou uma tendência descendente. 4. Por mais alta que fosse a altitude, a pressão arterial média, a frequência respiratória e a frequência cardíaca monitoradas dos indivíduos em exercício foram significativamente superiores aos valores do indicador em repouso, enquanto o valor da saturação de oxigênio no sangue apresentou tendência oposta. V. A pressão arterial média, respiração e frequência cardíaca dos indivíduos na primeira semana foram maiores do que em outros períodos de tempo, mas a saturação de oxigênio no sangue foi relativamente menor. Na segunda e terceira semanas, as mudanças na função cardiopulmonar foram relativamente suaves (todos P <0,05). VI. As mudanças no índice de função cardiopulmonar de sujeitos de diferentes gêneros foram pequenas (p> 0,05). Conclusão: Por meio da modelagem, os resultados do ambiente de planalto sobre a função cardiopulmonar do corpo ficaram mais claros, e os dados dessas pesquisas forneceram referenciais teóricos para o treinamento do campo esportivo na área de planalto. Nível de evidência II; Estudos terapêuticos- investigação dos resultados do tratamento.

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Campus bullying victimization and its influencing factors among middle school students in Dalian / 中国学校卫生

Objective@#To describe bullying victimization of middle school students in Dalian and associated factors, so as to provide scientific basis for campus bullying prevention.@*Methods@#The stratified cluster sampling method was used to select 2 540 middle school students from urban and rural areas in Dalian, who were investigated with campus bullying victimization and related factors.@*Results@#The reported rate of campus bullying victimization among middle school students in Dalian was 25.11%. The rates of physical violence (5.99%, 3.66%) and verbal violence(24.93%, 15.87%) of male students were higher than that of female students( χ 2=6.56, 27.94, P <0.05). The rates of verbal violence (22.84%, 16.25%) and emotional neglect(16.84%, 13.18%) of junior high school students were higher than those of high school students( χ 2=14.21, 5.44, P < 0.05 ). The rates of physical violence(6.07%, 3.55%), verbal violence(24.58%, 16.05%) and emotional neglect(18.88%, 12.06 %) of rural students were higher than those of urban students( χ 2=7.72, 24.81, 19.64, P <0.05). Male students, junior high school students and rural students suffered more severe campus bullying than female students, high school students and urban students( Z =3.46, 3.75, 5.89, P <0.01). The structural equation model showed that academic performance (path coefficient -0.003) and father s education (path coefficient -0.004 ) have a direct negative effect on campus bullying behavior, while mother s education (indirect action coefficient -0.000 8), height(indirect action coefficient -0.000 3), father s education (indirect action coefficient -0.000 3) and weight (indirect action coefficient 0.000 2) indirect effects on campus bullying through academic performance.@*Conclusion@#The prevalence of campus bullying victimization among middle school students in Dalian is relatively high, which worths further attention to. Rural students, junior high school students and boys are more likely to suffer campus bullying. Improving academic performance might be beneficial for campus bullying prevention.

Application and exploration of modular training using endoscopic simulator in the teaching of endoscopic skills in surgery / 中华医学教育探索杂志

Objective:To explore how to carry out endoscopic skill training in undergraduate medical education and evaluate the teaching effect of modular skill training using endoscopic simulator.Methods:After completing the basic teaching content of the surgical practice course, we added the learning course of the basic theory and basic operation of endoscopy to the students of Clinical Medicine Department from Nantong University. In the experimental group, 292 students were trained by the modular training using the endoscopic simulator. The control group consisted of 114 students, who were treated with ordinary video teaching and instrument operation exercises. After the same class hours of training, the two groups of students were evaluated with intermittent suture and knotting under endoscope as the skill assessment criteria. The chi-square test was performed using SPSS 19.0.Results:The excellent rate and qualified rate of the medical students after the modular training of the endoscopic simulator were 7.5% and 42.8% respectively, which were significantly higher than 0% and 11.4% of the control group, while the unqualified rate of the experimental group was 49.7%, which was also lower than 88.6% of the control group, with significant differences ( P<0.01). Conclusion:Modular training using endoscopic simulator helps the medical undergraduates to quickly increase the ability of endoscopic operation. And in the stage of undergraduate, medical education implementation of the training can shorten the learning curve of endoscopic skills for medical students after they enter clinical practice.

Effects of TFDP3 knock-out by CRISPR/Cas9 on biological function of prostate cancer PC3 cells / 中国肿瘤生物治疗杂志

@#目的：通过 CRISPR/Cas9 技术构建前列腺癌 PC3 细胞 TFDP3 基因敲除的稳转株，探讨抑制 TFDP3 表达对 PC3 细 胞周期、凋亡、迁移和侵袭能力的影响。方法：通过生物信息学筛选 sgRNA，通过 CRISPR/Cas9 技术、构建抑制 TFDP3 基因表达 的 sgRNA-Cas9 共转染慢病毒，感染 PC3 细胞后筛选获取稳转细胞株。通过流式细胞术对 TFDP3 基因敲除的实验组与空白对照 组进行细胞周期和凋亡检测，并进一步通过划痕实验和 Transwell 实验进行细胞迁移和侵袭能力检测。结果：通过生物信息学 筛选获得 3 条 sgRNA，其中 sgRNA2 有明显的抑制前列腺癌细胞基因表达的功能；通过 CRISPR/Cas9 技术成功构建了基于 CRISPR/Cas9 介导的 TFDP3 低表达的 PC3 细胞稳转株。抑制 TFDP3 基因表达后，相比于对照组，KO 组中 G0/G1 期细胞 百分比增加、G2/M 期细胞百分比下降（P<0.05 或 P<0.01），细胞凋亡率显著升高（P<0.05），细胞迁移率明显下降 [24 h 迁移率： (44.00±1.60)% vs (65.00±4.40)%，P<0.01]，穿过聚碳酸酯膜的侵袭细胞数明显下降 [（185.89±11.71）vs （248.33±11.95）个， P<0.01]。结论：通过 CRISPR/Cas9 技术抑制 TFDP3 基因表达后，PC3 细胞发生周期阻滞、凋亡率也有所增加、迁移和侵袭能力 显著减弱，提示 TFDP3 是一个前列腺癌促癌基因。

Efficacy and Safety of Emricasan in Liver Cirrhosis and/or Fibrosis

This study aimed to perform a meta-analysis to determine the efficacy and safety of emricasan. Nine databases were searched for clinical trials investigating the efficacy of emricasan treatment in patients with liver cirrhosis or fibrosis. A manual search was conducted to identify the missing trials. The quality of the included studies was assessed using the revised Cochrane risk of bias tool. Efficacy of emricasan treatment was defined as a positive change in apoptosis-related parameters from baseline to the last follow-up visit. Overall, emricasan treatment is more effective in patients with liver cirrhosis or fibrosis than placebo (standardized mean difference [SMD] [95% confidence intervals (CI)]=0.28 [0.14; 0.41]). No significant change in model for end-stage liver disease (MELD) score between the emricasan and placebo groups was noted (SMD [95% CI]=0.18 [-0.01; 0.36]; p=0.058). A 50 mg dose of emricasan had the highest efficacy rate compared to placebo (SMD [95% CI]=0.28 [0.06; 0.50]; p=0.012), followed by the 5 mg dosing regimen (SMD [95% CI]=0.28 [0.06; 0.50]; p=0.012). Treatment with emricasan resulted in significant reductions in ALT (mean difference (MD) [95% CI]=-5.89 [-10.59; -1.20]; p=0.014) and caspase3/7 levels (MD [95%CI]=-1215.93 [-1238.53; -1193.33]; p<0.001), respectively. No significant increase in the rate of overall adverse events was noted (OR [95% CI]=1.52 [0.97; 2.37]; p=0.069). Treatment with emricasan is more effective in improving liver function and apoptosis parameters compared to placebo, with a well-tolerated safety profile. However, due to the poor quality of the analyzed studies, the small number of trials and patients, and the short follow-up periods, more robust trials are still warranted.

Analysis of medication regularity and pharmacodynamic characteristics of traditional Chinese medicine treatment in 444 severe cases of COVID-19 / 中国中药杂志

The coronavirus disease 2019(COVID-19) is developing rapidly and posing great threat to public health. There is no effective intervention for the severe patients, and their prognosis is poor. It is worth noting that in the fight against COVID-19, China has always put equal emphasis on both Chinese and Western medicine. Traditional Chinese medicine has played an important role in the whole process. It is of great significance to discuss the rules and characteristics of the prescription of traditional Chinese medicine in the treatment of COVID-19. In this study, information was collected from 444 severe COVID-19 patients who were admitted to a hospital designated to treat patients with severe COVID-19 in Wuhan before March 20, 2020. We collected traditional Chinese medicine prescriptions for patients with severe COVID-19, referred to Chinese Pharmacopoeia to standardize the names of traditional Chinese medicine, and extract the property, flavor and channel tropism of traditional Chinese medicines to analyze the rules of the prescriptions. IBM SPSS Modeler 18.0 software was used to conduct correlation analysis of traditional Chinese medicine. Effective traditional Chinese medicines against COVID-19 was identified by the TCMATCOV platform. In the end, 1 532 effective prescriptions were included. Among them, the high-frequency drugs are Poria, Astragali Radix, Pogostemonis Herba, Armeniacae Semen Amarum, Atractylodis Macrocephalae Rhizoma, Pinelliae Rhizoma, Glycyrrhizae Radix et Rhizoma, Magnoliae Officinalis Cortex, Ephedrae Herba, Cinna-momi Ramulus. Most of the drugs have the following functions: resolving dampness, replenishing deficiency, resolving phlegm, cough, and asthma. The core combinations are Pogostemonis Herba-Poria, Astragali Radix-Pogostemonis Herba-Poria, Amomi Fructus-Poria, Amomi Fructus-Pogostemonis Herba, Amomi Fructus-Astragali Radix. The majority of the medicines are with cold and warm properties, and the proportions are 41.03% and 38.46%, respectively. The medicinal flavors are mainly concentrated in sweet and bitter, and the proportions are 34.71% and 30.58%, respectively. The meridian of the drug is more into the lung, stomach and spleen, with lung accounting for 22.87%. From the analysis of high-frequency drugs to the core combinations, one can see that the main treatment principle for severe COVID-19 is to remove internal and external dampness, protect the spleen and stomach, remove evil energy, and support righteousness. TCMATCOV platform was used to calculate the network disturbances of the high-frequency drugs. It was found that the traditional Chinese medicine with a high disturbance score accounted for a high proportion of the classic anti-COVID-19 prescriptions used by clinicians. Among them, the drugs with top scores are Ephedrae Herba, Citri Reticulatae Pericarpium, Eupatorii Herba, Platycodonis Radix, Cinnamomi Ramulus, Astragali Radix, Magnoliae Officinalis Cortex, Atractylodis Macrocephalae Rhizoma, Pogostemonis Herba, Scutellariae Radix. After a further exploration of the action targets, it was showed that disease-specific factor TNF was the target of the above ten drugs, and traditional Chinese medicine can exert anti-inflammatory and immune-modulating effects.

Prostate cancer LNCaP-AI+F cell-derived exosomes promote activation of stromal cell WPMY-1 / 中国肿瘤生物治疗杂志

@# Objective: To investigate the effects of prostate cancer exosomes on the migration and invasion ability of stromal cells (WPMY-1), and to explore its mechanism. Methods: Exosomes in LNCaP-AI+F prostate cancer cell supernatant were isolated by ultracentrifugation and the typical structure of exosome was captured by electron microscope. The particle size distribution was analyzed by Zetaview, and Wb was used to identify the marker proteins and other proteins.After co-incubation of WPMY-1 cells and prostate cancer exosomes (40 µg/ml), laser confocal microscope was used to observe the uptake of PKH67-labeled exosomes by WPMY-1 cells; Transwell assay was used to detect the migration and invasion ability of WPMY-1 cells; qPCR was performed to detect the expression of three cancer-associated fibroblast (CAF)-related molecules (IL-8, PDGFB and MMP9) at mRNA level; and the phosphorylation of EGFR and ERK1/2 was analyzed by Wb. Results: Typical cup-shaped structure of exosomes was observed under electron microscope. The Zetaview results showed that the particle size distribution was concentrated at about 100 nm. The expression of exosome marker proteins CD63 andALIX further verified that the isolated particles were exosomes. Besides, EGFR, HER2 and SRC, which were related to the progression of prostate cancer, were also enriched in exosomes. After co-incubation, confocal microscope imaging showed a number of PKH67 labeled exosomes in recipient WPMY-1 cells. Transwell experiments showed that exosomes could significantly enhance the migration and invasion ability of WPMY-1 cells (all P<0.01). Compared with the control group, increased secretion of IL-8, PDGFB and MMP9 was observed after exosome treatment (40 µg/ml) (P<0.05 or P<0.01). Wb indicated that exosomes could promote the phosphorylation of EGFR and ERK1/2 of WPMY-1 cells (P<0.01). Conclusion: Prostate cancer cell exosomes could act on the stromal cell WPMY-1 to highly express multiple CAF-related molecules, promote the phosphorylation of EGFR and ERK1/2 and enhance the migration and invasion ability of WPMY-1 cells.

Quantitative determination of monotropein in rat plasma and tissue by LC-MS/MS and its application to pharmacokinetic and tissue distribution studies

Abstract A selective and sensitive liquid chromatography tandem with mass spectrometry was developed and validated for accurate determination of monotropein in rat plasma and tissues. All biological samples were prepared by simple protein precipitation method using catalpol as an internal standard. The analyte and internal standard were separated on a C18 analytical column with 2 min of run time, at flow rate of 0.5 ml/min. The detection was performed on a triple-quadrupole tandem mass spectrometer equipped with negative-ion electrospray ionization by selected-reaction monitoring of the transitions at m/z 389→147 for monotropein and m/z 361→169 for the internal standard. The calibration curves for plasma and tissue samples were linear over the concentration range of 4-2000 ng/ml, with a lower limit of quantification of 4 ng/ml. The method was successfully applied to a pharmacokinetic and tissue distribution study of monotropein in rats.

Evaluation of hepatoprotective activity of Syringa oblata leaves ethanol extract with the indicator of glutathione S-transferase A1

Abstract The leaves of Syringa oblata Lindl., Oleaceae, had been extensively used as a folk medicine to treat various infections, heal inflammations, icteric hepatitis and acute mastitis. The study was designed to evaluate the hepatoprotective activity of S. oblata leaves ethanol extract against CCl4-induced hepatotoxicity in primary hepatocytes and mice with the indicator of glutathione S-transferase alpha 1. The hepatoprotective effects of S. oblata leaves ethanol extract were evaluated on the basis of liver histopathology and biochemical parameters as well as hepatic oxidative stress markers. The results showed that CCl4 negatively modulated biochemical parameters and liver antioxidant activities. However, the use of S. oblata leaves ethanol extract restored altered-serum biochemical parameters and liver antioxidant activities in a dose-dependent manner. Importantly, the trends in S-transferase alpha 1 were similar to alanine aminotransferase and aspartate aminotransferase level, and S-transferase alpha 1 was suggested to be a marker for the evaluation of hepatoprotective activity of S. oblata leaves ethanol extract. Histopathological examination showed that CCl4 causes significant hepatic injury relative to control group. The above findings suggested that S. oblata leaves ethanol extract has hepatoprotective effects against CCl4-induced hepatic injury and S-transferase alpha 1 may be an indicator to evaluate the protective effects of S. oblata leaves ethanol extract.

A Study of Treatment Model on Community-based Rehabilitation among Patients with Cerebral Apoplexy during the Recovery Period / 昆明医科大学学报

Objective To discuss the model and the effects of intervention treatment among patients with cerebral apoplexy during the recovery period in the primary and tertiary hospitals. Methods From Mar. 2015 to Feb. 2016, we selected 119 patients with cerebral apoplexy cured in our department and randomly divided them into two groups: 61 cases in the combined treatment group and 58 cases in the control group. After 6-month treatment, the effects were evaluated using FMA and BI index. Results FMA and BI indexes of patients with cerebral apoplexy improved significantly after the treatment (P ＜0.05). The effect of using the combined treatment is better than that of the control group (P＜0. 05). Conclusion The recovery model performed in the primary hospital together with the tertiary hospital is beneficial to the recovery of patients with cerebral apoplexy and worthy to generalize.

Salvianolate Reduces Glucose Metabolism Disorders in Dimethylnitrosamine-Induced Cirrhotic Rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the preventive effect of salvianolate (Sal B) on glucose metabolism disorders of dimethylnitrosamine (DMN)-induced cirrhotic rats.</p><p><b>METHODS</b>Fifty-five Wistar rats were randomly divided into a control group (n=10) and a cirrhotic group (n=45) according to a random number table. Liver cirrhosis was induced by intraperitoneal administration of DMN. The cirrhotic rats were divided into model, Sal B and metformin groups (n=15), respectively. Rats in the model group were given saline, two treatment groups were given Sal B (50 mg/kg), metformin (150 mg/kg) respectively for 28 consecutive days, while rats in the control group were injected 0.9% saline with same volume of vehicle. Body weight was measured everyday. Insulin sensitivity was determined by euglycemic hyperinsulinemic clamp. Organ index, glucose tolerance test (OGTT), and fasting plasma glucose (FPG), fasting insulin (FINS), hepatic glycogen, hydroxyproline (HYP) and liver function were detected at the end of the treatment. Area under the curve (AUC) for OGTT was calculated. Liver and pancreas histology were determined by histopathological examination with hematoxylin and eosin staining (HE), Sirius Red staining and Masson's trichrome staining, respectively. Hepatic expression of α-smooth muscle actin (α-SMA) and collagen (Col I) were evaluated by immunohistochemical staining.</p><p><b>RESULTS</b>Compared with the model group, Sal B significantly increased body and liver weight, liver-body ratio, glucose infusion rate (GIR), FPG, FINS levels and hepatic glycogen at the end of administration (P<0.05 or P<0.01). Meanwhile, Sal B significantly decreased AUC for OGTT, spleen weight, spleen-body ratio, aminotransferase and HYP level (P<0.05 or P<0.01). Sal B was also effective in alleviating necrosis of liver tissue, suppressing fibrosis progression and inhibiting the expression of α-SMA and Col I in liver. Compared with the metformin group, Sal B had advantages in ameliorating FPG, hepatic glycogen, spleen weight, organ index, liver function and cirrhosis (P<0.05). Metformin increased insulin sensitivity more potently than Sal B (P<0.05).</p><p><b>CONCLUSIONS</b>Sal B could improve glucose metabolism in cirrhotic rats by protecting hepatic glycogen reserve, increasing insulin sensitivity, and alleviating pancreatic morphology abnormalities. Sal B was clinically potential in preventing glucose metabolism anomalies accompanied with cirrhosis.</p>