Topical application of vancomycin in prevention of early incision infection in total knee arthroplasty / 中国组织工程研究

BACKGROUND:The use of vancomycin in total knee arthroplasty is a controversial strategy for the prevention of incisional infection.At present,there is little evidence to evaluate the efficacy of this preventive measure in China. OBJECTIVE:To evaluate the efficacy of local vancomycin in the prevention of early postoperative incision infection during total knee arthroplasty. METHODS:120 patients with osteoarthritis of the knee who received unilateral total knee arthroplasty for the first time at Department of Joint Surgery of First Affiliated Hospital of Anhui Medical University from March to June 2022 were included in this study.They were randomly divided into the observation group and the control group,with 60 cases in each group.All patients gave informed consent to the treatment plan.In the observation group,1 g of vancomycin was applied intraoperatively;in the control group,no vancomycin was applied intraoperatively.Erythrocyte sedimentation rate,C-reactive protein,fever rate on seven consecutive days after surgery,degree of knee joint swelling,cumulative drainage volume,and incidence of periprosthetic joint infection were recorded in two groups of patients on days 1,3,and 5 after surgery so as to evaluate the efficacy of topical vancomycin in total knee arthroplasty for the prevention of incision infection in the early postoperative period. RESULTS AND CONCLUSION:(1)The differences in erythrocyte sedimentation rate and C-reactive protein between the two groups on days 1,3,and 5 after surgery were not significant(P>0.05).(2)The difference in fever rate between the two groups for 7 consecutive days after surgery was not significant(P>0.05).(3)There was no significant difference in the degree of postoperative knee swelling and cumulative drainage flow between the two groups(P>0.05).(4)The difference in the incidence of periprosthetic joint infection one year after surgery was not significant between the two groups(P>0.05).(5)The results suggest that the local use of vancomycin in total knee arthroplasty has not shown significant efficacy in preventing incision infection in the early postoperative period.

Logistics operation and management of public hospitals based on the"one center,four platforms"model / 现代医院

Objective To evaluate the effectiveness of a hospital logistics operation and management based on the"one center,four platforms"model.Methods In line with the grading evaluation standards for hospital intelligent management,we used technologies such as big data,Internet of Things,Internet Plus,and artificial intelligence to develop a"one center,four platforms"model.This model consisted of a logistics intelligent operation and maintenance management center,an equipment control information platform,a security prevention information platform,an energy consumption monitoring information platform,and an operation management information platform.Results The equipment fault resolution capability,enhanced by the"smart linkage",showed a significant improvement.In 2022,false alarms decreased by 28.63%compared to 2021,with high-level and ordinary-level alarms decreasing by 69.53%and 33.15%,respectively.The"one-stop"logistics service capability was signifi-cantly improved,as indicated by a 2.92%decrease in maintenance frequency in 2022 compared to 2021.This improvement was further reflected in the quality of maintenance and a decrease in the repeated maintenance occurrences.The energy consumption control capability,based on the"data mining",showed a significant improvement,with an 8.71%year-on-year decrease in en-ergy expenditure of ten thousand yuan in 2022 compared to 2021.Conclusion The"one center,four platforms"model can sig-nificantly enhance the efficiency of logistics operation and maintenance management.

Strategies to improve functional integration of transplanted photoreceptors / 中华实验眼科杂志

The final outcome of the retinal degenerative diseases is the massive loss of photoreceptors, resulting in irreversible visual impairment which lacks effective treatment at present.As a potential therapeutic approach, photoreceptor transplantation can be used to restore retinal function to a certain extent by replacing the lost photoreceptors and rebuilding the retinal circuits.However, the discovery of material exchange unveiled a number of problems in previous studies, including low cellular integration, insufficient outer segment and synapse formation, highlighting the challenges of clinical translation.To explore the possibility of increasing the functional integration of photoreceptors, this article reviewed a variety of strategies, including selection of the transplanted cells with optimal developmental stage to enhance the interaction with the host retina, disruption of the outer limiting membrane and alleviation of retinal remodeling to improve the migration and integration of the transplanted photoreceptors, regulation of immunity can be used to reduce microglial activation to create a better host microenvironment for transplantation, use of retinal sheets or biological scaffolds to improve photoreceptor organization, rational development and use of biomaterials to optimize the physiological microenvironment of the transplanted cells, adequate evaluation of surgical parameters to reduce the effect of surgery on the transplanted cells and the host retina.

Wenyang-Shengji ointment regulates GRP78/CHOP pathway to inhibit excessive endoplasmic reticulum stress for facilitating diabetic refractory wound repair / 中国病理生理杂志

AIM:To study the regulation of endoplasmic reticulum stress(ERS)using the glucose regulated protein 78(GRP78)/CCAAT/enhancer binding protein homologous protein(CHOP)pathway and explore the related mech-anism of Wenyang-Shengji ointment in facilitating the repair of diabetic refractory wounds.METHODS:To establish a rat model of diabetic refractory wound repair,Sprague-Dawley(SD)rats were fed a high-fat diet and intraperitoneally in-jected with streptozotocin.Subsequently,full-thickness skin defects were induced in the dorsal region of the rats.The ex-periment included 4 groups:normal,model(diabetic refractory wounds),Wenyang-Shengji ointment,and Beifuxin(re-combinant bovine basic fibroblast growth factor gel)groups.The normal and model groups were treated with normal saline after disinfection.In the Wenyang-Shengji ointment and Beifuxin groups,the wounds were topically treated with the re-spective ointments once daily.After 14 d of treatment,wound healing was assessed and quantified using the wound healing rate.Hematoxylin-eosin(HE)staining was employed to examine the micromorphology of the wound tissue.Western blot analysis was performed to measure GRP78,CHOP and caspase-12 levels in the wound tissue.Immunohistochemical analy-sis was used to detect the expression and distribution patterns of GRP78,CHOP and caspase-12 in the wounds.Transmis-sion electron microscopy was used to observe reticulum numbers and swelling.Enzyme-linked immunosorbent assay was used to determine interleukin-1β(IL-1β)level as a pro-inflammatory factor within the wound.RESULTS:Indexes of each group were assessed 14 d after the corresponding intervention.Compared with normal group,the rats in model group exhibited a significant decrease in the wound healing rate(P＜0.01),accompanied by increased inflammatory exudation and poor granulation tissue growth.Additionally,there were increases in the expression levels of GRP78,CHOP and cas-pase-12 proteins(P＜0.01),as well as a significant elevation in the content of inflammatory factor IL-1β(P＜0.01).In contrast,compared with model group,treatment with Wenyang-Shengji ointment resulted in a significant improvement in wound healing rate(P＜0.01),reduction in inflammatory exudation,and enhanced granulation tissue growth(P＜0.01).Furthermore,there was a notable decrease in the protein expression of GRP78/CHOP/caspase-12 within the wound tissue following treatment with Wenyang-Shengji ointment(P＜0.01).The levels of inflammatory factor IL-1β also showed a sig-nificant decrease(P＜0.01).CONCLUSION:Wenyang-Shengji promotes the healing of diabetic refractory wounds,which may be associated with the downregulation of the GRP78/CHOP pathway,inhibition of excessive ERS,and reduc-tion in the level of wound cell apoptosis.

Analysis of the frequency of therapy-oriented oral radiation in Nanping, China / 中国辐射卫生

Objective To investigate the frequency of therapy-oriented oral radiation in Nanping, China and its distribution, and to provide a basis for the rational application of therapy-oriented oral radiation and the effective allocation of resources in Nanping. Methods A questionnaire was designed to investigate the frequency of therapy-oriented oral radiation in all oral radiation diagnosis and treatment institutions in Nanping. Results In 2021, there were 54 oral radiation diagnosis and treatment institutions and 79 oral radiation machines in Nanping. The total frequency of therapy-oriented oral radiation was 61593 visits and the radiation frequency was 19.54 visits per thousand patients. The average annual frequency of medical institutions at all levels was 721.87 to 3713.25 visits per institution; the male-to-female composition ratio of frequency of therapy-oriented oral radiation in December 2021 was 50.5%:49.5%. The proportion of radiation frequency of different devices was as follows: 38.7% (intraoral dental film), 46.5% (oral panorama), 10.3% (oral computed tomography [CT]), and 4.5% (cranial photography). The proportion of radiation frequency in patients of different ages was as follows: 17.1% (0−15 years), 48.2% (15−40 years), and 34.7% (over 40 years). The frequency of therapy-oriented oral radiation grew by 77.43%, 35.18%, and 8.16% every two years from 2015 to 2021, respectively. Conclusion The frequency level of therapy-oriented oral radiation in Nanping is at the level of Class II health care. The distribution of therapy-oriented oral radiation is highly unbalanced and is related to the level of economic development. Private healthcare institutions are growing rapidly, and public healthcare institutions of grade two and above occupy the main healthcare resources. The oral panorama accounts for the most, cranial photography accounts for the least, and oral CT is the fastest-growing portion. Therapy-oriented oral radiation is predominantly performed in the young and middle-aged populations, regardless of sex. Except for intraoral dental films, the general trend is upward.

Mechanism of Wenfei Huaxian Decoction-containing Serum in Delaying Inflammatory Senescence of Lung Mesenchymal Stem Cells Based on NAMPT/SIRT1 / 中国实验方剂学杂志

ObjectiveThe lung mesenchymal stem cells （LMSCs） induced by D-galactose （D-gal） were intervened by Wenfei Huaxian decoction-containing serum to explore the mechanism of Wenfei Huaxian decoction in delaying the senescence of LMSCs through the nicotinamide phosphoribosyltransferase/silent information regulator 1 （NAMPT/SIRT1） signaling pathway. MethodWenfei Huaxian decoction-containing serum was prepared. LMSCs were isolated by gradient density centrifugation， and they were cultured and identified in vitro. The senescence model in vitro was established by stimulating cells via D-gal for 24 h. LMSCs cells were modeled after being treated with different volume fractions （5%， 10%， 20%， 40%， and 80%） of Wenfei Huaxian decoction-containing serum for 24 h， and the cell proliferation level was detected by methyl thiazolyl tetrazolium （MTT） method. The cells were randomly divided into blank serum group， model group， and high， medium， and low dose groups of Wenfei Huaxian decoction-containing serum. Senescence-associated β-galactosidase （SA-β-gal） staining was used to detect the senescence of LMSCs in each group. The content of NAD + was detected by colorimetry. The levels of senescence-associated factors （p16 and p53）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） in cell culture supernatant were detected by enzyme-linked immunosorbent assay （ELISA）. Western blot was used to detect the relative expression of senescence-associated proteins and NAMPT/SIRT1 signaling pathway-related proteins. ResultCompared with the blank serum group， the proliferation of LMSCs was significantly inhibited after D-gal stimulation for 24 h （P<0.01）. Compared with the model group， the proliferation of LMSCs could be promoted after intervention with the corresponding Wenfei Huaxian decoction-containing serum （P<0.05， P<0.01）. Compared with the blank serum group， the SA-β-gal staining of LMSCs in the model group after D-gal stimulation was enhanced， and the content of NAD+ was increased （P<0.01）. The expression levels of senescence factors p16 and p53， as well as SASP pro-inflammatory factors IL-6 and TNF-α in the cell culture supernatant， were significantly increased （P<0.01）. The expression of senescence-associated proteins p16， p21， and p53 increased （P<0.01）， and the protein expression of NAMPT， SIRT1， peroxisome proliferator-activated receptor γ coactivator 1α （PGC-1α）， and forkhead box family transcription factor O1 （FoxO1） decreased （P<0.01）. Compared with the model group， the SA-β-gal staining of LMSCs in each group of Wenfei Huaxian decoction-containing serum was significantly reduced， and the content of NAD+ was decreased （P<0.01）. The senescence factors （p16 and p53） and inflammatory factors （IL-6 and TNF-α） in the cell culture supernatant were significantly decreased （P<0.01）. The expression of senescence-associated proteins （P16， P21， and P53） decreased （P<0.05， P<0.01）. The protein expressions of NAMPT， SIRT1， PGC-1α， and FoxO1 were significantly up-regulated （P<0.05， P<0.01）. ConclusionWenfei Huaxian decoction can alleviate senescence and inflammatory response damage of D-gal-induced LMSCs， and its mechanism may be related to the regulation of the NAMPT/SIRT1 signaling pathway.

Circumlimbal suture and laser burns:Comparison between two different chronic glaucoma models / 中南大学学报(医学版)

Objective:Glaucoma is a multifactorial optic neuropathy with a high rate of irreversible visual loss,and its pathogenesis is complex and still unclear.Elevated intraocular pressure(IOP)is well recognized as the sole modifiable risk factor for the development of glaucoma in the majority of cases.This study aims to compare 2 different methods of inducing chronic ocular hypertension by circumlimbal suture or by laser burns in degree and lasting time of the IOP,different status of the retina and retinal ganglion cells(RGCs),and changes of the microstructure of neurons. Methods:The chronic ocular hypertension models were induced by 2 different ways.One kind of the models was built by unilateral circumlimbal suture(10/0)implantation(suture group),another kind of model was built by laser burns at trabecular meshwork and episcleral veins(laser group).The untreated contralateral eye served as the control group.Changes in IOP were observed and regularly monitored in the 2 groups of rats.HE staining was applied to observe the retinal and optic nerve pathology.Transmission electron microscope(TEM)was used to observe the mitochondrial morphology.RGCs were specifically labeled with Brn3b antibody and counted.The expression of caspase-3 was detected by Western blotting to clarify the apoptosis of RGCs. Results:Compared with the control group,IOP were significantly increased in the suture group and the laser group(both P<0.05).The suture group induced a 1.5-fold elevation of IOP,and sustained for 8 weeks.The laser group induced a 2-fold elevation of IOP for 12 weeks.Both methods could cause RGCs loss(both P<0.05),which were verified by pathology and immune staining of Brn3b.The expressions of caspase-3 were also increased(both P<0.05).The mitochondrial morphology became more fragment,which changed from long shape to round and small one under TEM in 2 models.For comparison,the pathology changes of retinal structure in suture group were not obviously than those in the laser group. Conclusion:Circumlimbal suture can build an effective model of chronic elevated IOP and induce glaucomatous pathologic changes similar to those in the laser photocoagulation,but the pathologic changes are milder than those in laser photocoagulation.Compare with translimbal laser photocoagulation,equipment and skill demand for circumlimbal suture is less.

Primary hyperparathyroidism with negative 99mTc-MIBI imaging:one case report / 复旦学报（医学版）

This article reports the diagnosis and treatment of a patient with primary hyperparathyroidism(PHPT)and vitamin D deficiency.The patient was a young male with a insidious onset.Multiple tests have shown hypercalcemia,hypophosphatemia,hypercalciuria,and hyperparathyroidism.There was no renal dysfunction,and the diagnosis of PHPT was clear.There were kidney stones and vitamin D deficiency at the same time.The patient met the surgical indications,but the difficulty in preoperative localization was that ultrasound examination showed suspicious masses in both parathyroid regions,and the 99mTc-MIBI imaging result was negative.Finally,accurate preoperative localization was achieved through 18F-fluorocholine PET/CT,and the patient was cured after surgery.

Expert consensus on cryoablation therapy of oral mucosal melanoma / 实用口腔医学杂志

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

Mechanism by which Bushen Yiqi Huayu granule improves callus angiogenesis in osteoporotic rats after fracture operation / 中国组织工程研究

BACKGROUND:Bushen Yiqi Huayu granule has the effect of replenishing qi and eliminating blood stasis,tonifying kidney and smoothing collages,and is often used in the treatment of osteoporosis.At present,there are few studies on the effect of Bushen Yiqi Huayu granule on the callus angiogenesis of osteoporotic fractures. OBJECTIVE:To explore the mechanism of Bushen Yiqi Huayu granule by up-regulating extracellular signal-regulated kinase/mitogen-activated protein kinases(ERK/MAPK)signaling pathway to improve callus angiogenesis after fracturing in osteoporotic rats. METHODS:(1)Bone marrow mesenchymal stem cells from osteoporotic SD rats and bone marrow monocytes from C57BL/6 mice were collected.MTT assay was used to detect different doses of Bushen Yiqi Huayu granule on bone mesenchymal stem cell toxicity.Bone mesenchymal stem cells and bone marrow monocytes were cultured in the medium supplemented with 0 and 1.5 mg/mL Bushen Yiqi Huayu granules,respectively,and osteogenic differentiation and osteoclast differentiation were carried out in vitro.(2)144 SD rats were randomly divided into sham operation group,model group,granule group and granule+PD98059 group with 36 rats in each group.The osteoporotic model was established in the model group,granule group and granule+PD98059 group,and only part of the adipose tissue near the ovary was removed in the sham operation group.8 weeks later,all rats received left tibial osteotomy.In the granule+PD98059 group,5 g/kg Bushen Yiqi Huayu granule was given intragastrically,and 0.3 mg/kg PD98059 was injected into the tail vein.The granule group was given 5 g/kg Bushen Yiqi Huayu granule,and the same volume of normal saline was injected into the tail vein.The sham operation group and model group were given an equal volume of normal saline,and the caudal vein was injected with an equal volume of normal saline.Drug administration was conducted once a day for 8 weeks.Fracture healing and callus angiogenesis were observed by X-ray,micro-computed tomography and microvascular perfusion angiography.Bone mineral density and mechanical strength of the callus were measured.The tibia was observed by hematoxylin-eosin staining and Masson staining.Western blot assay and immunohistochemistry were used to examine the expression of ERK/MAPK signaling pathway-related molecules. RESULTS AND CONCLUSION:(1)Compared with the 0 mg/mL group,the alkaline phosphatase activity,mineralization level,p-ERK1/2 and p-p38 MAPK expression levels of osteocytes increased(P<0.05),while the density and volume of osteoclasts decreased in the 1.5 mg/mL group(P<0.05).(2)Compared with the sham operation group,the fracture healing degree of the granule group was similar at 4 and 8 weeks,but there was no significant difference in Lane-Sandhu score,total callus volume,mineralized callus volume,mineralized callus volume/total callus volume,trabecular thickness,vascular number,spacing,thickness,vascular volume/total volume,bone mineral density,ultimate load of callus,stiffness,p-ERK1/2,p-p38 MAPK,p-IκB-α,and p-p65 expression levels(P>0.05).In the model group and granule+PD98059 group,fracture healing was slow,Lane-Sandhu score,total callus volume,mineralized callus volume,mineralized callus volume/total callus volume,trabecular thickness,vascular number,thickness,vascular volume/total volume,bone mineral density,ultimate load of callus,stiffness,p-ERK1/2,p-p38 MAPK,p-IκB-α,and p-p65 expression levels decreased(P<0.05),and vascular spacing increased(P<0.05),compared with the sham operation group.(3)It is indicated that Bushen Yiqi Huayu granule can improve fracture healing,promote callus angiogenesis and alleviate the symptoms of osteoporosis by enhancing the expression of the ERK/MAPK signaling pathway-related molecules in osteoporotic rats.

Interpretation of the updates of the NCCN esophageal and esophagogastric junction cancers clinical practice guidelines in oncology (version 3. 2023) / 中国胸心血管外科临床杂志

@#Esophageal cancer is the seventh most common cancer worldwide. On August 29, 2023, National Comprehensive Cancer Network (NCCN) released the NCCN esophageal and esophagogastric junction cancers clinical practice guidelines in oncology (version 3. 2023). This article aims to highlight the key updates in treatment and follow-up recommendations between the version 3 and the version 2 in 2023, providing the latest guidance for the management of esophageal cancer in our country.

Practice of model-informed drug development in pharmaceutical in-dustry in China / 中国临床药理学与治疗学

Guideline of model-informed drug de-velopment was published by National Medical Products Administration in 2020,which provided technical guidance for the application of modeling and simulation in the process of new drug develop-ment.In July 2022,Center of Drug Evaluation con-ducted a questionnaire survey on the practical abili-ty of pharmaceutical industry to apply model-in-formed drug development(MIDD)in the process of new drug development,in order to investigate the practice of MIDD in China.Based on the feedback data collected from enterprises,this paper analyzes the practice of MIDD in domestic pharmaceutical industry,and briefly discusses several problems that still exist at present.

Study on the mechanism of improving islet β-cell function in patients with type 2 diabetes mellitus by Alogliptin benzoate / 中国糖尿病杂志

Objective To investigate the effect of Alogliptin benzoate on the serum autophagy markers in type 2 diabetes mellitus(T2DM)patients.Methods Eighty newly diagnosed T2DM patients who visited the Department of Endocrinology in Baoding No.1 Central Hospital from December 2021 to October 2022 were randomly divided into a group treated with Metformin(Met group,n=40)and a group treated with Met and Alog(Met+Alog group,n=40).The differences in BMI,WHR,FPG,HbA1c,Atg7 and Beclin-1 between two groups before and after 12 weeks of treatment were compared.Results After treatment,the levels of Atg7 and Beclin-1 increased in both groups(P<0.05),while FPG,HbA1c and HOMA-IR decreased(P<0.05).After treatment,Atg7,Beclin-1 and HDL-C in Met+Alog group were higher than those in Met group(P<0.05).Pearson correlation analysis showed that Atg7 was negatively correlated with BMI,FPG and HbA1c(P<0.05);Beclin-1 was positively correlated with HDL-C(P<0.05),and negatively correlated with BMI,FPG,HbA1c,and TG(P<0.05).Meta linear regression analysis showed that BMI was the influencing factor of Atg7,while BMI and HDL-C were the influencing factors of Beclin-1.Conclusion Alogliptin benzoate may improve islet β cell function by up-regulating the expression of autophagy related factors Atg7 and Beclin-1 in patients with T2DM.

Current research status of mesenchymal stem cell therapy for chronic obstructive pulmonary disease / 中国医师杂志

Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition characterized by persistent airflow obstruction caused by long-term airway inflammation or alveolar abnormalities, often manifested as chronic respiratory symptoms and decreased lung function. In recent years, experimental research has shown that mesenchymal stem cells (MSC) have anti-inflammatory, immunomodulatory, and repairing properties of lung epithelial cells, which can be used to treat various diseases including COPD. This article is mainly based on the main findings of in vitro and in vivo animal model experiments and clinical studies of MSC treatment for COPD. It summarizes and discusses the possible mechanisms of action of MSC as a new therapy, and provides new ideas for clinical treatment of COPD.

Application of electromagnetic-guided placement of nasoenteral feeding tubes among aged bedridden patients / 中华护理杂志

Objective To investigate the application effect of electromagnetic navigation bedside nasoenteral intubation technology in elderly bedridden patients.Methods A total of 92 elderly patients with tube feeding in bed in a tertiary A hospital in Beijing from June 2021 to December 2022 were selected by convenience sampling method,and they were divided into an experimental group and a control group with 46 patients in each group by random number table method.The experimental group adopted the electromagnetic navigation bedside nasoenteral catheterization technique and the control group adopted the blind catheterization method.The total success rate of catheterization,the success rate of the first catheterization,the time taken for catheterization,the proportion of catheter tip reaching jejunum,and the incidence of catheter-related complications were compared between the 2 groups.Results There were no shedding cases in both groups.The success rate of total catheterization was 95.7％in the experimental group and 80.4％in the control group.The success rate of first catheterization was 95.7％in the experimental group and 71.7％in the control group.The time taken for catheterization was(12.37±4.19)min in the experimental group and(19.22±5.48)min in the control group.The proportion of catheter tip reaching the jejunum was 60.9％in the experimental group and 28.3％in the control group.The above data were compared between the 2 groups,and the differences were statistically significant(P＜0.05).In terms of the incidence of catheter-related complications,the incidence of epistaxis in the experimental group was 6.5％and it was 21.7％in the control group,and the difference was statistically significant(P=0.036).The positive rate of fecal occult blood test was 2.2％in the experimental group and 17.4％in the control group,and the difference was statistically significant(P=0.030).There was no significant difference in the incidence of nausea,vomiting and abdominal distension between the 2 groups(P＞0.05).No serious complications such as catheter ectopic placement,pneumothorax and perforation occurred in the 2 groups.Conclusion The application of electromagnetic navigation bedside nasoenteral intubation technology for elderly bedridden patients has a high success rate and takes a short time,which can improve the proportion of catheter tip reaching the jejunum and reduce the incidence of epistaxis and fecal occult blood test.

Renal malakoplakia invading descending colon complicated with bladder malakoplakia: a case report / 中华泌尿外科杂志

Malacoplakia is a rare granuloma disease mainly occurred in the urinary system, it is even rarer for renal malacoplakia invading the descending colon complicated with bladder malacoplakia. In this study, one such case was reported. Imaging examination suggested that the left kidney was a large patchy mixed density shadow, and enhancement scan lesion was uneven enhancement. CT guided renal puncture biopsy was performed, and postoperative pathology suggested renal malacoplakia. Transurethral cystoscopy was performed, and postoperative pathology confirmed that it was malacoplakia of the bladder. The effect of conservative antibiotic treatment was not good. The patient underwent radical nephrectomy + left hemicolectomy under general anesthesia, and postoperative pathology confirmed the diagnosis of renal malacoplakia, which involved the mucosa of the intestinal tube and the entire muscular layer. The patient was followed up for 6 months after surgery, and no recurrence was seen on CT.

Transcranial magnetic stimulation can alleviate sleep disorders in children with cerebral palsy / 中华物理医学与康复杂志

Objective:To observe any effect of repetitive transcranial magnetic stimulation (rTMS) on sleep disorders among children with cerebral palsy (CP).Methods:A total of 102 children with CP and disordered sleep were randomly divided into an experimental group and a control group, each of 51. All were given routine rehabilitation and sleep health education, but the experimental group additionally received rTMS for two weeks. The polysomnography (PSG) results of the two groups were recorded and analyzed.Results:The PSG parameters had improved greatly in both groups after the treatment. The percentage of N2 sleep (depth of sleep during light sleep) in the severe cerebral palsy group and of N3 sleep (depth of sleep during deep sleep) in the moderate cerebral palsy group had increased significantly more than in the mild cerebral palsy group, on average. After the intervention the percentages of N2 and N3 in those with mixed cerebral palsy and of N3 in those with involuntary motor cerebral palsy had increased significantly more than in those with spastic cerebral palsy, on average.Conclusion:rTMS treatment can improve the sleep disorders of children with cerebral palsy, especially N2 sleep among children with moderate to severe cerebral palsy, N3 sleep in cases of mixed or dyskinetic CP.

Research progress in the relationship between vitamin D deficiency and central precocious puberty in children / 中国儿童保健杂志

Central precocious puberty (CPP) is an endocrine disease of children due to the early onset of hypothalamic-pituitary-gonadal axis function. This leads to increased secretion of gonadotropin release impulse, causing the development of internal and external genitalia and the presentation of secondary sex characteristics. Studies have found that the onset of CPP in children may be related to vitamin D deficiency. Vitamin D, affected by sunlight duration, acts on neurons and neurotransmitters in the hypothalamic-pituitary-gonadal axis, promotes obesity and affects the expression level of insulin-like growth factor-1, which are four factors involved in the occurrence and development of CPP. The overall effect of vitamin D combined with gonadotropin-releasing hormone analogues on CPP is significant. This article reviews the correlation between vitamin D deficiency and CPP, as well as the possible mechanism of action, in order to provide some theoretical basis for researchers.

Clinical Effectiveness and Safety of Bairui Granules （百蕊颗粒） in Treating Patients with Acute Pharyngitis with Wind-Heat Syndrome： A Multi-Center， Double-Blind， Double-Simulation， Randomized Controlled Trial / 中医杂志

ObjectiveTo evaluate the clinical effectiveness and safety of Bairui Granules （百蕊颗粒） in the treatment of acute pharyngitis with wind-heat syndrome. MethodsA multicenter， double-blind， double-simulation， randomised controlled trial was conducted， in which 162 patients with acute pharyngitis and wind-heat syndrome from 7 centers were recruited， and each center was divided into trial group and control group on the ratio of 2∶1. In the trial group， 108 cases were orally administered with Bairui Granules plus Reyanning Granules （热炎宁颗粒） simulant， and in the control group， 54 cases were orally administered with Reyanning Granules plus Bairui Granules simulant for 5 days， with a follow-up visit on the 6th day. Full analysis set （FAS） analysis and per protocol set （PPS） were used for analysis， respectively. The primary efficacy index was the disappearance rate of sore throat after 5-day treatment； the secondary efficacy indexes were the disappearance rate of sore throat after 3-day treatment， as well as the visual analogue score （VAS） of sore throat before treatment， every day during the treatment， and follow-up on day 6， and the traditional Chinese medicine （TCM） syndrome score was performed before treatment and at the follow-up on day 6. The effectiveness on TCM syndrome was evaluated at the follow-up on day 6， and the changes of vital signs， blood routine， urine routine， liver functions， kidney function， the adverse events before and after the treatment were recorded， and safety analysis set （SS） was analysed. Results162 patients entered the FAS and SS analyses， and 158 cases （105 cases in the trial group and 53 cases in the control group） entered the PPS analysis. FAS analysis showed that the disappearance rate of sore throat after 5-day treatment was 80.56% （87/108） in the trial group and 64.81% （35/54） in the control group， and the difference between groups was statistically significant （χ2 = 5.10， P = 0.0239）. PPS analysis showed that the disappearance rate of sore throat after 5-day treatment was 80.00% （84/105） in the trial group and 64.15% （34/53） in the control group， and the difference between groups was statistically significant （χ2 =4.85， P = 0.0277）. FAS and SS analyses both showed that the difference in disappearance rate of sore throat between groups on 3-day treatment was not statistically significant （P＞0.05）. Compared with those before treatment， the VAS scores of sore throat were lower in both groups during treatment on day 2， 3， 4， 5， and follow-up on day 6 （P＜0.01）， but the difference between groups at each time point was not statistically significant （P＞0.05）. TCM syndrome scores of both groups at the follow-up were lower than that before treatment， and those of the trial group were lower than those of the control group （P＜0.01）. The cure rate and effective rate of TCM syndrome of the trial group were significantly higher than those of the control group （P＜0.01）. There was no significant difference in blood routine， urine routine， liver function， kidney function between groups before and after treatment （P＞0.05）， and no serious adverse events occured in both groups. ConclusionBairui Granules showed clinical effectiveness in the treatment of acute pharyngitis of wind-heat syndrome， and it could significantly improve the clinical symptoms， accelerate the disappearance time of sore throat with good safety.

Effects of salvage therapies for local recurrence of tumor following prostate cryoablation / 现代泌尿外科杂志

【Objective】 To explore the effectiveness and safety of different salvage therapies for local recurrence of tumor following primary prostate cryoablation so as to provide the reference for the treatment of prostate similar cases. 【Methods】 The clinical data of patients with prostate cancer (cT1c-4N0M0) who received salvage therapy for local recurrence of tumor following primary prostate cryoablation in the Sun Yat-Sen University Cancer Center during June 2014 and Dec. 2020 were retrospectively analyzed. Salvage therapies included local therapy (salvage radiotherapy, salvage cryoablation or salvage radical prostatectomy) and androgen deprivation therapy (ADT). 【Results】 Altogether 8 patients were involved. The median age was 71(63-76) years, the median prostate specific antigen (PSA) at the first diagnosis was 17.650(10.380-325.100) ng/mL, the median nadir post-cryoablation PSA was 0.041(0.003-0.541) ng/mL, and the median PSA at local recurrence was 3.030(2.090-19.180) ng/mL. Abnormal digital rectal examination was found in 3 cases, and radiographic evidence of local recurrence was found in 7 cases. Prostate biopsy was performed in 4 cases, 2 of which had positive results. The median follow-up after salvage therapy lasted for 54 (9-75) months. Four cases received salvage radiotherapy, 2 of which developed bloody stool, hematuresis and urinary tract infection, and recovered after conservative treatment; 1 case received salvage cryoablation without side effects; 1 case underwent radical prostatectomy and radiotherapy, developed lymphorrhagia and recovered after conservative treatment; 2 cases received ADT alone, one experienced hot flashes and recovered after conservative treatment, and the other progressed into castration-resistant prostate cancer after 63 months. No other progression or death occurred at the termination of follow-up. 【Conclusion】 Salvase therapy (salvage radiotherapy, salvage cryoablation, salvage radical prostatectomy) and ADT can be used for local recurrence of tumor following primary prostate cryoablation. However, large-scale prospective research is needed to confirm the effectiveness and safety of different therapies.