Effect of eccentric training combined with different frequency whole body vibration training on patellar tendinopathy / 中国组织工程研究

BACKGROUND:A large number of studies have investigated the effects of whole body vibration training at different frequencies on muscle strength,but less is reported on the differences in the efficacy of vibration training at different frequencies on patellar tendinopathy. OBJECTIVE:To explore the effect of eccentric training of quadriceps combined with different frequency of whole body vibration training on patellar tendinopathy. METHODS:From April to June 2022,48 patients with patellar tendinopathy were recruited from Wuhan Sports University and randomly divided into eccentric training group(n=12),30 Hz group(n=12),40 Hz group(n=12),and 50 Hz group(n=12).The eccentric training group only completed eccentric training of the quadriceps.The 30 Hz,40 Hz and 50 Hz groups performed the whole body vibration training with the amplitude of 2 mm and frequencies of 30 Hz,40 Hz and 50 Hz respectively on the basis of the eccentric training of the quadriceps.The intervention lasted for 8 weeks,three times a week.Before and after the intervention,the patients'surface electromyography signals of the quadriceps,kinematics and dynamics data of knee joint at the time of landing in deep jump and the time of peak vertical ground reaction,Visual Analogue Scale score,Victorian Institute of Sports Assessment-Patellar score were evaluated. RESULTS AND CONCLUSION:After 8 weeks of intervention,compared with the eccentric training group,the median frequency of the lateral and medial femoris muscles were significantly higher in the 40 Hz and 50 Hz groups(P＜0.05).At the time of landing,the knee joint flexion angle and external rotation moment in the 40 Hz and 50 Hz groups were significantly lower than those in the eccentric training group(P＜0.05),while the knee joint flexion angle in the 50 Hz group was significantly lower than that in the 30 Hz group(P＜0.05).At the peak moment of vertical ground reaction,the knee extension torque in the 40 Hz group was significantly lower than that in the eccectric training group(P＜0.05);the knee flexion angle and knee extension torque in the 50 Hz group were significantly lower than those in the eccentric training group(P＜0.05).The Visual Analogue Scale scores in the 50 Hz and 40 Hz groups were significantly lower than those in the eccentric training group(P＜0.05).The Victorian Institute of Sports Assessment-Patellar score in the 50 Hz group was significantly higher than that in the eccentric training group and 30 Hz group(P＜0.05).To conclude,eccentric training of the quadriceps combined with 50 Hz whole body vibration training can significantly improve quadriceps'strength,endurance and activation rate of the vastus lateralis muscle,reduce the pain of knee joint,and improve the function of the knee joint in patients with patellar tendinopathy.

Rehabilitative efficacy of kinesio taping following anterior cruciate ligament reconstruction:a Meta-analysis / 中国组织工程研究

OBJECTIVE:Some studies have shown that kinesio taping has positive effects in elevating muscle strength,improving joint stability and reducing pain and oedema in patients after anterior cruciate ligament reconstruction.However,existing studies have divergent results on the clinical efficacy of kinesio taping.In this study,a meta-analysis was conducted to systematically evaluate the effect of kinesio taping in postoperative rehabilitation period following anterior cruciate ligament reconstruction. METHODS:Randomized controlled trials about the effects of kinesio taping on anterior cruciate ligament reconstruction were electronically searched in PubMed,Web of Science,Embase,The Cochrane Library,EBSCO,CNKI,WanFang,and VIP databases,from database inception to December 06,2022.The outcome measures included six continuous variables:quadriceps strength,hamstring strength,knee swelling,knee range of motion,Lysholm knee function score,and Visual Analogue Scale score.EndNote X9.1 was used to screen the literature.The Cochrane Risk Bias Assessment Tool and Jadad Scale were used to evaluate the quality of the included literature.RevMan 5.3 software was used for Meta-analysis. RESULTS:A total of 6 randomized controlled trials involving 252 patients undergoing anterior cruciate ligament reconstruction were finally included.There were 126 cases in control group and 126 in kinesio taping group.The results of Meta-analysis showed that compared with the control group,kinesio taping significantly improved hamstring strength[standardized mean difference(SMD)=0.68,95%confidence interval(CI):0.12 to 1.23,P=0.02)and reduced Visual Analogue Scale score[mean difference(MD)=-0.56,95%CI:-1.04 to-0.08,P=0.02).However,for quadriceps strength,knee swelling,knee range of motion,and Lysholm knee function score,kinesio taping did not show significant difference from the control group(P＞0.05). CONCLUSION:Kinesio taping may help to improve hamstring strength and reduce pain in patients after anterior cruciate ligament reconstruction.However,it cannot significantly improve quadriceps strength,knee swelling,knee range of motion,and functional scores.

Biomechanical characteristics of the lower limbs of athletes after anterior cruciate ligament reconstruction during bilateral vertical jumping / 中国组织工程研究

BACKGROUND:At present,postoperative timing or subjective criteria by clinicians are commonly employed to determine the return-to-sport timing for patients undergoing anterior cruciate ligament reconstruction.Unfortunately,these criteria do not adequately consider the biomechanical deficits in patients following anterior cruciate ligament reconstruction. OBJECTIVE:To explore the lower extremity kinematic and kinetic characteristics of athletes after anterior cruciate ligament reconstruction during bilateral vertical jumping. METHODS:Twenty athletes undergoing anterior cruciate ligament reconstruction and twenty healthy athletes,aged 20-24 years,were recruited in Wuhan Sports University from December 2021 to December 2022.All the 40 subjects underwent a bilateral vertical jumping test.The kinematic and dynamic characteristics of the lower limbs at propulsion phase,initial landing time and peak vertical ground reaction force moment. RESULTS AND CONCLUSION:At the initial landing time,the athletes undergoing anterior cruciate ligament reconstruction showed higher hip flexion angle(P=0.031)and lower ankle plantar flexion angle(P=0.018)on the operated side compared with the healthy athletes.At the peak vertical ground reaction force moment,the athletes undergoing anterior cruciate ligament reconstruction had higher hip flexion angle(P=0.016),lower hip abduction angle(P=0.019),lower knee flexion angle(P=0.025),higher knee external rotation angle(P=0.030),and higher ankle external rotation angle(P=0.042)on the operated side compared with the healthy athletes.At the peak vertical ground reaction force moment,the athletes undergoing anterior cruciate ligament reconstruction showed lower knee extension moment(P=0.036),lower knee internal rotation moment(P=0.016),lower hip abduction moment(P=0.004),higher hip extension moment(P=0.040),and higher hip external rotation moment(P=0.005)on the operated side compared with the healthy athletes.To conclude,the athletes undergoing anterior cruciate ligament reconstruction exhibit a stiff landing pattern,in which the knee load on the operated side tends to shift to the hip joint,and show inadequate control of lower limb rotational stability.Therefore,detection and correction of abnormal biomechanical characteristics should be part of the rehabilitation after anterior cruciate ligament reconstruction.

Therapeutic effect of ursodeoxycholic acid-berberine supramolecular nanoparticles on ulcerative colitis based on supramolecular system induced by weak bond / 中国中药杂志

Ulcerative colitis(UC) is a recurrent, intractable inflammatory bowel disease. Coptidis Rhizoma and Bovis Calculus, serving as heat-clearing and toxin-removing drugs, have long been used in the treatment of UC. Berberine(BBR) and ursodeoxycholic acid(UDCA), the main active components of Coptidis Rhizoma and Bovis Calculus, respectively, were employed to obtain UDCA-BBR supramolecular nanoparticles by stimulated co-decocting process for enhancing the therapeutic effect on UC. As revealed by the characterization of supramolecular nanoparticles by field emission scanning electron microscopy(FE-SEM) and dynamic light scattering(DLS), the supramolecular nanoparticles were tetrahedral nanoparticles with an average particle size of 180 nm. The molecular structure was described by ultraviolet spectroscopy, fluorescence spectroscopy, infrared spectroscopy, high-resolution mass spectrometry, and hydrogen-nuclear magnetic resonance(H-NMR) spectroscopy. The results showed that the formation of the supramolecular nano-particle was attributed to the mutual electrostatic attraction and hydrophobic interaction between BBR and UDCA. Additionally, supramolecular nanoparticles were also characterized by sustained release and pH sensitivity. The acute UC model was induced by dextran sulfate sodium(DSS) in mice. It was found that supramolecular nanoparticles could effectively improve body mass reduction and colon shortening in mice with UC(P<0.001) and decrease disease activity index(DAI)(P<0.01). There were statistically significant differences between the supramolecular nanoparticles group and the mechanical mixture group(P<0.001, P<0.05). Enzyme-linked immunosorbent assay(ELISA) was used to detect the serum levels of tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6), and the results showed that supramolecular nanoparticles could reduce serum TNF-α and IL-6 levels(P<0.001) and exhibited an obvious difference with the mechanical mixture group(P<0.01, P<0.05). Flow cytometry indicated that supramolecular nanoparticles could reduce the recruitment of neutrophils in the lamina propria of the colon(P<0.05), which was significantly different from the mechanical mixture group(P<0.05). These findings suggested that as compared with the mechanical mixture, the supramolecular nanoparticles could effectively improve the symptoms of acute UC in mice. The study provides a new research idea for the poor absorption of small molecules and the unsatisfactory therapeutic effect of traditional Chinese medicine and lays a foundation for the research on the nano-drug delivery system of traditional Chinese medicine.

Research progress on medical image dataset expansion methods / 生物医学工程学杂志

Computer-aided diagnosis (CAD) systems play a very important role in modern medical diagnosis and treatment systems, but their performance is limited by training samples. However, the training samples are affected by factors such as imaging cost, labeling cost and involving patient privacy, resulting in insufficient diversity of training images and difficulty in data obtaining. Therefore, how to efficiently and cost-effectively augment existing medical image datasets has become a research hotspot. In this paper, the research progress on medical image dataset expansion methods is reviewed based on relevant literatures at home and abroad. First, the expansion methods based on geometric transformation and generative adversarial networks are compared and analyzed, and then improvement of the augmentation methods based on generative adversarial networks are emphasized. Finally, some urgent problems in the field of medical image dataset expansion are discussed and the future development trend is prospected.

A survey of loss function of medical image segmentation algorithms / 生物医学工程学杂志

Medical image segmentation based on deep learning has become a powerful tool in the field of medical image processing. Due to the special nature of medical images, image segmentation algorithms based on deep learning face problems such as sample imbalance, edge blur, false positive, false negative, etc. In view of these problems, researchers mostly improve the network structure, but rarely improve from the unstructured aspect. The loss function is an important part of the segmentation method based on deep learning. The improvement of the loss function can improve the segmentation effect of the network from the root, and the loss function is independent of the network structure, which can be used in various network models and segmentation tasks in plug and play. Starting from the difficulties in medical image segmentation, this paper first introduces the loss function and improvement strategies to solve the problems of sample imbalance, edge blur, false positive and false negative. Then the difficulties encountered in the improvement of the current loss function are analyzed. Finally, the future research directions are prospected. This paper provides a reference for the reasonable selection, improvement or innovation of loss function, and guides the direction for the follow-up research of loss function.

Analysis of transmission dynamics and effectiveness of control of local epidemics caused by the Omicron BA.2 and BA.5.2 COVID-19 strains in Fujian Province / 中国人兽共患病学报

This study evaluated the scientific nature and effectiveness of iterative optimization of prevention and control measures for local outbreaks caused by the BA.2 and BA.5.2 COVID-19 strains in Fujian Province in 2022,to provide a scientif-ic basis for responding to future new or recurrent respiratory infectious diseases.According to the theory of infectious disease dynamics,relevant information regarding the local epidemic situation caused by the BA.2 sub-type Omicron virus strain in March 2022 and BA.5.2 sub-type Omicron virus strain in October 2022 in Fujian Province was collected.The susceptible exposed infectious removed(SEIAR)model of COVID-19 infection with a latent period and asymptomatic infected persons was used to analyze the transmission dynam-ics of two local epidemic situations,and evaluate the preven-tion and control effects.The incubation period of the BA.2 epidemic was 3 days(1～9 days),the intergenerational inter-val was 3 days(1～5 days),and the initial Rt was 3.0(95％CI:2.7～3.3).The incubation period of the BA.5.2 epidemic was 2 days(1～6 days),the intergenerational interval was 1 day(0～2 days),and the initial R,was 1.9(95％CI:1.7～2.1).The fittingresults for the BA.2 and BA.5.2 epidemics were good,and no statistical difference was observed between the predic-ted and actual numbers of cases(x2BA.2=31.53,x2BA.5.2=27.88,P＞0.05).If an emergency response had not been initiated,the BA.2 epidemic would have continued to spread andpeak on April 7th,with an estimated 638 035 cases.The BA.5.2 epidemic would have rapidly spread,reaching a peak on November 14th,with an estimated 685 940 cases.If one incubation period were detected early,the scale of the BA.2 epidemic would have decreased by 25.73％;if two incubation periods were detected early,the scale would have decreased by 79.56％,and if one incubation period had been delayed,the scale would have expanded by 13.72％.If one incubation period had been detected early in the BA.5.2 epidemic,the scale would have decreased by 35.04％;if two incubation periods had been detected early,the scale would have decreased by 92.47％;and if one incubation period had been delayed,the scale would have increased by 19.75％.The guiding ideology,and the prevention and control measures for handling two local epidemics were optimized and iterated.Our study indicated that implementing the"four early"measures ef-fectively decreased the scale of the epidemic,and earlier detection was associated with more significant control effects.This study provides valuable information for the prevention and control of new or recurrent respiratory infectious diseases.

Symmetry of Single Leg Vertical Jump Height Hides Abnormal Lower Limb Biomechanics in Athletes after Anterior Cruciate Ligament Reconstruction / 中国运动医学杂志

Objective To explore whether the single leg vertical jump height limb symmetry index(LSI)＞90%can represent the normal lower limb biomechanics in athletes after anterior cruciate liga-ment reconstruction(ACLR)during jumping.Methods Forty-six athletes after ACLR were divided into a low symmetry group(jump height LSI＜90%,n=23)and a high symmetry group(jump height LSI＞90%,n=23)according to the symmetry of single leg vertical jump height,while 24 healthy counter-part athletes were chosen into the control group.The kinematic and kinetic characteristics were com-pared among the three groups.Results(1)At the take-off stage,compared with the control group,both sides of the low-symmetry group had higher peak hip flexion angle(P＜0.05),but only the operat-ed side showed lower knee flexion moment(P=0.002),knee power(P=0.01),ankle power(P=0.045)and peak vertical ground reaction force(P=0.008).(2)At the take-off stage,there were no significant differences between the operated side of the high symmetry group and the control group in all measure-ments.However,compared with the healthy side,the operated side demonstrated lower knee flexion moment(P=0.001),knee power(P=0.002),total power of lower limb(P=0.001)and peak vertical ground reaction force(P=0.046).(3)During landing,compared with the control group,bilateral sides of the low symmetry group showed a higher peak hip flexion angle(P＜0.05)and a lower peak flexion knee angle(P＜0.05),but its operated side demonstrated lower peak ankle dorsiflexion angle(P=0.018),knee flexion moment(P=0.005),knee power(P=0.037),ankle power(P=0.002),total power of lower limb(P=0.042),and peak vertical ground reaction force(P=0.022).(4)During landing,there were no significant differences in all variables between the operated side of the high symmetry group and the control group.However,compared with its healthy side,the affected side of the high symmetry group demonstrated lower knee flexion moment(P=0.002),ankle dorsiflexion moment(P=0.003),knee power(P＜0.001),total power of lower limbs(P=0.001),and peak vertical ground reaction force(P=0.023).Conclusion Despite achieving the single leg vertical jump height LSI＞90%,athletes after ACLR still showed abnormal lower limb biomechanical characteristics during propulsion and landing.In addition,such abnormality is more obvious in athletes after ACLR with jump height LSI＜90%.Therefore,sym-metry in jump height does not represent normal lower extremity biomechanics in athletes after ACLR.

Effect of acupuncture on default mode network in patients with migraine based on functional Magnetic Resonance Imaging: a preliminary study / 中国针灸

OBJECTIVE@#To investigate the effect of acupuncture on default mode network (DMN) in migraine patients without aura based on functional Magnetic Resonance Imaging (fMRI).@*METHODS@#Fifteen patients with migraine were included and treated with acupuncture based on "root-knot" theory (Zuqiaoyin [GB 44] for @*RESULTS@#Compared before acupuncture, the functional connections of left parahippocampal cortex (PHC) and anterior medial prefrontal cortex (aMPFC), dorsal medial prefrontal cortex (dMPFC) and lateral temporal cortex (LTC) in DMN after acupuncture were weakened (@*CONCLUSION@#Acupuncture shows good clinical efficacy for migraine without aura, and could adjust the functional connection of DMN.

Holistic Pelvic Ring Concept in Treatment of Postpartum Pubic Symphysis Diastasis / 中国康复理论与实践

Objective:To observe the effect of pelvic band fixation with three-dimensional adjustment of suspended pelvis on patients with pubic symphysis diastasis under the holistic pelvic ring concept. Methods:From February, 2018 to February, 2020, 30 parturients with pubic symphysis diastasis were evaluated pelvic ring. They accepted three-dimensional adjustment of pelvis with suspension to restore the anatomical reduction of sacroiliac joint and the symphysis pubis according to the evaluation, and were fixed with pelvic band for six to eight weeks. The pubic symphysis union was monitored with color ultrasonography. They were reviewed with pelvic X-ray two weeks after removal of pelvic band, and assessed with Visual Analogue Scale (VAS) for pain and modified Barthel Index (MBI) before treatment, immediately after removal of the pelvic band and two weeks after removal of the pelvic band, while the pelvic ring structure was measured. Results:The scores of VAS and MBI improved two weeks after pelvic band removal compared with those before treatment, as well as distance of pubic symphysis separation, upper margin difference of pubic symphysis, width difference of iliac wings, transverse and longitudinal diameter difference of obturator foramens (t > 2.509, P < 0.05). However, the scores of VAS and MBI improved two weeks after pelvic band removal compared with those immediately after removal of the pelvic band (|t| > 2.854, P < 0.05), while the distance of pubic symphysis separation increased (t = 2.319, P < 0.05), still in the normal reference value. Conclusion:Correcting the post-partum pubic symphysis diastasis under the holistic pelvic ring concept can restore the anatomical structure of the pelvis, avoid the compensatory movement pattern, and improve the daily living in the later time.

Modified Banxia Baizhu Tianmatang Combined with Acupuncture for Migraine (Wind-phlegm Upset Syndrome) Observe / 中国实验方剂学杂志

Objective:To observe theclinical efficacy of modified Banxia Baizhu Tianmatang combined with acupuncture on migraine with wind phlegm disturbance syndrome， and the regulatory effect on neurovasoactive peptide and vascular endothelial activator. Method:Two hundred and fifty patients were randomly divided into control group （75 cases） and observation group （75 cases）. Patients in Two group got acupuncture for 6 times， 1 time/day， after a day of rest， they got placebogranules of Banxia Baizhu Tianmatang， 10 g/time， 2 times/day. Patients in observation group got Banxia Baizhu Tianmatang， 1 dose/day， and also the same acupuncture with the therapyof control group. And the treatment lasted for 4 weeks. At the half， 1^st， 2^nd， 6^th， 12^th， 24^th， and 48^th hour after treatment， VAS were scored， rate of pain relief within 6， 12， and 24 hours， disappearance rate and recurrence rate of pain within 72 hours， migraine attack times， headache duration and headache degree before 4 weeks of treatment， during the treatment and after the treatment were recorded. Before and after treatment， accompanying symptoms， wind phlegm disturbance syndrome， headache impact test version-6 （HIT-6） and the migraine disability assessment questionnaire （MIDAS） were scored. And levels of calcitonin gene-related peptide （CGRP）， nitric oxide （NO）， endothelin-1 （ET-1）， pituitary adenylate cyclase activating peptide （PACAP）， S100B protein， substance P（SP）， von Willebrand factor （vWF） and fibrinogen （FIB） were detected. And safety was evaluated. Result:VAS in two groups decreased at different time points （<italic>P<</italic>0.01）， and VAS in observation group at 6^th， 12^th， 24^thand 48^th hour after treatment were lower than those in control group （<italic>P<</italic>0.01）. The rate of pain relief in observation group at 6^th and 12^th hours after treatment and the disappearance rate of pain at 72^th hour were 67.14%（47/70）， 87.14% （61/70） and 92.86% （65/70）， which were higher than 50.00% （34/68）， 70.59% （48/68） and 79.41% （54/68） in control group. The recurrence rate of pain in observation group was 21.43% （15/70）， which was lower than 39.71% （27/68） in control group （<italic>P<</italic>0.05）. During the treatment and drug withdrawal， times of migraine attack， headache duration and headache degree were all less than those in control group （<italic>P<</italic>0.01）. Scores of accompanying symptoms， wind phlegm disturbance syndrome， HIT-6 and MIDAS were all lower than those in control group （<italic>P<</italic>0.01）. The clinical effect was better than that in control group （<italic>Z</italic>=2.106， <italic>P<</italic>0.05）. Levels of CGRP， PACAP， S100B protein， SP， ET-1， vWF and FIB were lower than those in control group， while level of NO was higher than control group （<italic>P<</italic>0.01）. Conclusion:Modified Banxia Baizhu Tianmatang combined with acupuncture had a better instant analgesic effect， with a significant effect on continuing analgesia and reducing headache recurrence. It can also alleviate migraine symptoms and accompanying symptoms， andreduce the impact of migraine on daily life and the degree of disability. Its mechanism may be related to the regulation of neurovasoactive peptides and vascular endothelial substances. It is worth for further study.

Allium tuberosum alleviates pulmonary inflammation by inhibiting activation of innate lymphoid cells and modulating intestinal microbiota in asthmatic mice / 中西医结合学报

OBJECTIVE@#This study tests whether long-term intake of Allium tuberosum (AT) can alleviate pulmonary inflammation in ovalbumin (OVA)-induced asthmatic mice and evaluates its effect on the intestinal microbiota and innate lymphoid cells (ILCs).@*METHODS@#BALB/c mice were divided into three groups: phosphate buffer saline, OVA and OVA + AT. The asthmatic murine model was established by sensitization and challenge of OVA in the OVA and OVA + AT groups. AT was given to the OVA + AT group by oral gavage from day 0 to day 27. On day 28, mice were sacrificed. Histopathological evaluation of lung tissue was performed using hematoxylin and eosin, and periodic acid-Schiff staining. The levels of IgE in serum, interleukin-5 (IL-5) and IL-13 from bronchoalveolar lavage fluid (BALF) were measured by enzyme-linked immunosorbent assay. The ILCs from the lung and gut were detected by flow cytometry. 16S ribosomal DNA sequencing was used to analyze the differences in colon microbiota among treatment groups.@*RESULTS@#We found that long-term intake of AT decreased the number of inflammatory cells from BALF, reduced the levels of IL-5 and IL-13 in BALF, and IgE level in serum, and rescued pulmonary histopathology with less mucus secretion in asthmatic mice. 16S ribosomal DNA sequencing results showed that AT strongly affected the colonic bacteria community structure in asthmatic mice, although it had no significant effect on the abundance and diversity of the microbiota. Ruminococcaceae and Desulfovibrionaceae were identified as two biomarkers of the treatment effect of AT. Moreover, AT decreased the numbers of ILCs in both the lung and gut of asthmatic mice.@*CONCLUSION@#The results indicate that AT inhibits pulmonary inflammation, possibly by impeding the activation of ILCs and adjusting the homeostasis of gut microbiota in asthmatic mice.

A review: biosynthesis of plant-derived labdane-related diterpenoids / 中国天然药物

Plant-derived labdane-related diterpenoids (LRDs) represent a large group of terpenoids. LRDs possess either a labdane-type bicyclic core structure or more complex ring systems derived from labdane-type skeletons, such as abietane, pimarane, kaurane, etc. Due to their various pharmaceutical activities and unique properties, many of LRDs have been widely used in pharmaceutical, food and perfume industries. Biosynthesis of various LRDs has been extensively studied, leading to characterization of a large number of new biosynthetic enzymes. The biosynthetic pathways of important LRDs and the relevant enzymes (especially diterpene synthases and cytochrome P450 enzymes) were summarized in this review.

Frequent Import and Multiple Sources of Dengue Fever have Changed the Epidemic Situation of the Disease in Fujian Province, China / 生物医学与环境科学（英文）

Objective@#The aim of this study was to update the epidemic situation of dengue fever (DF) and provide new insights for the consideration of disease control in Fujian province, China.@*Methods@#Details about DF cases in Fujian reported during 2004-2017 were collected and analyzed. The envelope (E) genes of isolates of dengue virus (DENV) were sequenced for phylogenetic analysis.@*Results@#The number of imported DF cases had increased dramatically since 2013, and the source regions expanded from Southeast Asia to South Asia, America, Oceania, and Africa, as well as the surrounding provinces. This resulted in local outbreaks and indigenous cases of DF that occurred more frequently, with 10 of 13 local outbreaks and 85.9% (1,252/1,458) of indigenous cases reported in 2013-2017. Compared with only two coastal cities before 2013, four coastal and one inland city in 2013-2017 experienced the local DF outbreaks. The phylogenetic analysis of E genes confirmed that the import of DENV, not only from abroad but also from the surrounding provinces, played an important role in dissemination and local outbreaks of DF in Fujian.@*Conclusions@#The frequent import of DF cases from not only abroad but also the surrounding provinces resulted in increased incidence, frequent local outbreaks, and expansion of distribution in Fujian in recent years. There is a need for urgent measures to improve disease control in this province.

Advance in Rehabilitation for Vestibular Dysfunction after Mild Traumatic Brain Injury (review) / 中国康复理论与实践

Traumatic brain injury (TBI) would result in structural injury and/or physiological disruption of brain. Mild traumatic brain injury (mTBI) can result in vestibular dysfunctions, such as dizziness, vertigo and imbalance. Vestibular rehabilitation is effective on vestibular dysfunction after mTBI. This paper reviewed the possible mechanisms of vestibular dysfunction caused by mTBI, the common assessments of vestibular function and the new progress in vestibular rehabilitation.

RT-nPCR Assays for Amplification and Sequencing of VP1 Genes in Human Enterovirus A-D from Clinical Specimens / 生物医学与环境科学（英文）

Objective@#To develop RT-nPCR assays for amplifying partial and complete VP1 genes of human enteroviruses (HEVs) from clinical samples and to contribute to etiological surveillance of HEV-related diseases.@*Methods@#A panel of RT-nPCR assays, consisting of published combined primer pairs for VP1 genes of HEV A-C and in-house designed primers for HEV-D, was established in this study. The sensitivity of each RT-nPCR assay was evaluated with serially diluted virus stocks of five serotypes expressed as CCID @*Results@#The sensitivity of RT-nPCR assays for amplifying partial VP1 gene of HEVs was 0.1 CCID @*Conclusion@#This RT-nPCR system is capable of amplifying the partial and complete VP1 gene of HEV A-D, providing rapid, sensitive, and reliable options for molecular typing and molecular epidemiology of HEVs in clinical specimens.

Comparison of the effect of ultrasound-guided thoracic paravertebral nerve block and intercostal nerve block for video-assisted thoracic surgery under spontaneous-ventilating anesthesia

SUMMARY OBJECTIVE The aim of the current study was to compare the efficacy of two different techniques for blocking chest nerves during video-assisted thoracic surgery (VATS) under spontaneous-ventilating anesthesia. METHODS One hundred patients were recruited in this study and divided into two groups. The first, P group, underwent the TPVB approach; the second, I group, underwent the ICNB approach. Then, the rate of clinical efficacy, duration of the block procedure, and its complications were recorded for comparison of the effect of the two approaches. RESULTS No difference was found in the clinical effect of chest nerve blocks between the two groups. Two patients in the ICNB group were converted to general anesthesia due to severe mediastinal flutter (grade three). The number of patients who had grade one mediastinal flutter in the TPVB group was significantly higher than in the ICNB group. Vascular puncture was detected in four patients in the ICNB group and in one patient in the TPVB group. No other complications were observed. CONCLUSIONS No difference was found regarding the clinical efficacy in the two groups. However, ultrasound-guided TPVB was superior to ultrasound-guided ICBN during VATS for pulmonary lobectomy under spontaneous-ventilating anesthesia. Additionally, vascular puncture should receive more attention.

RESUMO OBJETIVO O objetivo do presente estudo é comparar a eficácia de duas técnicas diferentes para o bloqueio nervoso torácico durante cirurgia torácica vídeo-assistida (CTVA) e anestesia com ventilação espontânea. METODOLOGIA Cem pacientes foram incluídos no estudo e divididos em dois grupos. Em um (grupo P), foi utilizada a abordagem de BPVT e no outro (grupo I), a abordagem de BIC. Então, a taxa de eficácia clínica, duração do procedimento de bloqueio e suas complicações foram registradas para a comparação do efeito das duas abordagens. RESULTADOS Nenhuma diferença foi observada no efeito clínico do bloqueio nervoso torácico entre os dois grupos. Dois pacientes no grupo de BIC foram convertidos para anestesia geral devido a fibrilação mediastinal grave (grau três). O número de pacientes com fibrilação mediastinal de grau um no grupo de BPVT foi significativamente maior do que no grupo de BIC. Perfuração vascular foi detectada em quatro pacientes do grupo de BIC e em um do grupo de BPVT. Não foram observadas outras complicações. CONCLUSÃO Não houve diferença de eficácia clínica entre os dois grupos. No entanto, BPVT guiado por ultrassom foi superior ao BIC guiado por ultrassom durante CTVA para lobectomia pulmonar com anestesia em ventilação espontânea. Além disso, deve-se prestar mais atenção quanto à perfuração vascular.

Analysis of relevant factors for influencing renal recovery at discharge in critically ill patients with acute kidney injury requiring continuous renal replacement therapy / 中国医师进修杂志

Objective To investigate the potential risk factors for influencing renal recovery at discharge in critically ill patients with acute kidney injury (AKI) requiringcontinuous renal replacement therapy (CRRT). Methods This was a single-center, retrospective study. Critically ill patients with AKI requiring CRRT adimitted to the Department of Intensive Care Unit (ICU) in Taizhou Municipal Hospital, Zhejiang province, from June 2014 to December 2017 were included and divided into two groups according to the status of renal recovery at discharge as renal recovery group and renal non-recovery group. The data of acute physiology and chronic health evaluationⅡ(APACHEⅡ) score and sequential organ failure assessment (SOFA) score at adimission to ICU, initial serum creatinine (initial SCr) and lactate level and initial estimated glomerular filtration rate (initial eGFR) at time of AKI diagnosis, and total time of RRT and duration of anuria before CRRT were analyzed. Length of ICU stay and length of hospital stay in both groups were also analyzed. Multivariate logistic regression was taken to analyze the potential risk factors for influencing renal recovery at discharge in critically ill patients with AKI. Results A total of 115 critically ill patients with AKI requiring CRRT were included, of which whom 45 cases were in renal recovery group and 70 cases were in renal non-recovery group, and the renal recovery rate at discharge was 39.1% (45/115); 59 patients were dead during hospitalization and the hospital mortality was 51.3% (59/115). Compared with renal non-recovery group, renal recovery group have a lower value of APACHEⅡscore [(21.73 ± 2.66) scores vs. (23.19 ± 4.41) scores, Pi0.03), SOFA score [(11.02 ± 2.22) scores vs. (12.79 ± 2.82) scores, Pi0.001], lactate level [(3.82 ± 1.34) mmol/L vs. (4.47 ± 1.52) mmol/L, Pi0.021], initial SCr [(2.151 ± 0.677) mg/dl vs. (2.505 ± 0.792) mg/dl, Pi 0.015], duration of anuria before CRRT[(11.80 ± 4.71) h vs. (19.11 ± 5.98) h, Pi0.005] and total time of RRT [(8.64 ± 3.42) d vs. (15.81 ± 5.07) d, Pi0.001], and have a higher value of initial eGFR [(36.26 ± 14.74) ml/(min·1.73 m2) vs. (30.07 ± 10.38) ml/(min·1.73 m2), Pi0.009]. In addition, length of ICU stay [(12.58 ± 4.78) d vs. (15.30 ± 5.45) d, Pi0.007] and length of hospital stay [(19.58 ± 6.44) d vs. (22.11 ± 5.90) d, Pi0.032] in renal recovery group were also significantly lower than those in renal non-recovery group. Multivariate logistic regression analysis indicated that SOFA score ( OR i0.700, 95% CI 0.521-0.941, P i0.018), duration of anuria before CRRT ( OR i0.782, 95% CI 0.689-0.888, P<0.01) and total time of RRT ( OR i0.673, 95% CI 0.565-0.801; P<0.01) were independent risk factors influencing renal recovery at discharge in critically ill patients with AKI, and initial eGFR was a independent protective factor. Conclusions As to critically ill patients with AKI requiring CRRT, there are many factors that affect renal recovery at discharge,. SOFA score, duration of anuria before CRRT and total time of RRT are independent risk factors, and initial eGFR is an independent protective factor.

Comparative study on etiology and complications of liver cirrhosis in a 5-year period / 中国实用内科杂志

OBJECTIVE: To investigate the variation of etiology and complication of liver cirrhosis(LC) by the comparative analysis of etiology,complications, sex and age in LC patients in 2012 and in 2017. METHODS: In this cross-sectional study, we collected cases of LC admitted in 2012 and 2017 and reviewed the medical records. The demographics, etiology and complications were collected and we compared the composition ratios of etiology and complications as well as the sex composition and age differences between different etiology in the 5-year period. RESULTS: 3065 patients(including 1451 in 2012 and 1614 in 2017) were identified in this study. There was no significant difference in etiology of LC caused by HBV infection(that was 56.31% in 2012 and 53.41% in 2017, respectively.(χ2=2.591, P=0.107). The composition ratio of alcohol and autoimmune diseases increased. That of alcohol diseases was 12.96% in 2012 and 16.36% in 2017(χ2=7.027, P=0.008).That of autoimmune diseases was 9.92% in 2012 and 13.07% in 2017(χ2=7.398, P=0.007). The composition ratio of HCV infection decreased from 14.82% to 11.28% having statistically significant difference(χ2=8.497, P=0.004). The three former complications in 2012 were UGH(15.64%), HCC(15.30%,), SBP(12.68%,), which were HCC(21.07%), UGH(13.38%), SBP(11.03%) in 2017. HCC was more common(that was 15.30% in 2012 and 21.07% in 2017) having significant difference(χ2=16.964, P<0.001).LC caused by HBV and alcohol were mainly males, which slightly decreased having no significant difference. LC caused by autoimmune diseases was mainly female, which slightly increased having no significant difference. The LC patients infected by HBV and HCV were older than before when were hospitalized.That of HBV was(50.08±11.11) years old in 2012 and(52.39±11.56) years old in 2017(t=-4.163, P=0.004). That of HCV was(57.22±10.52)years old in 2012 and(61.13±10.25) years old in 2017(t=-3.732, P <0.001). CONCLUSION: Compared with 5 years ago, HBV infection remained the major cause of liver cirrhosis, whereas alcohol and autoimmune diseases increased and HCV infection decreased. HCC was the most common of LC complications. LC patients caused by different etiology had different prevalence in sex and were hospitalized in different ages. Patients infected by HBV/HCV seemed to be older than before when they were hospitalized.

Analysis on spatial epidemiological characteristics of human infection with avian influenza A(H7N9) virus in Fujian Province / 中华疾病控制杂志

Objective The aim is to analyze the spatial epidemiological characteristics for human infection with avian influenza H7N9 in Fujian Province, so as to provide scientific evidence for developing and adjusting related control strategies. Methods The epidemiological data of human infection with H7N9 avian influenza in Fujian Province, from 2013 to 2017 was analyzed by SAS 9.2, ArcGIS 10.3 and SaTScan 9.4 software.Results There were a total of 108 cases and 28 deaths reported in Fujian Province, up to December 31, 2017. The case fatality rate was 25.93%.96.30% of cases were sporadic. There were more incidences in winters and springs, more incidences in rural areas. The global spatial autocorrelation and high/low clustering analysis indicated that clusters at the county level were in the shore areas (Z=3.74, P<0.001; Z=5.26, P<0.001). The cities of Changle, Fuqing, Jinjiang and Siming were the high-high clustered areas and local hot-points. There were two clusters, from December 2014 to March 2015, the most likely cluster regions was centered around Zhangpu County with a radius of 63.04 km (RR=4.72, LLR=11.41, P<0.001). The secondary cluster regions was centered around Fuqing City with a radius of 81.98 km (RR=4.07, LLR=7.96, P=0.037). Conclusions Human infection with avian influenza H7N9 in Fujian Province is spatially and temporally clustered. The measures of prevention and control should be focused on high incidence seasons and key regions, and the surveillance of etiology should be strengthened.