A modified procedure for replantation of severed digit-tips in Tamai zones I - II and the clinical effects / 中华显微外科杂志

Objective:To explore the clinical effect of a modified surgical procedure for replantation of severed digit-tips in Tamai zones I-II.Methods:From November 2019 to October 2022, the Department of Hand and Foot Microsurgery of the First Affiliated Hospital of Bengbu Medical College employed a modified procedure (to abandon the anatomically labelling of blood vessels and nerves after naked-eye debridement and fracture fixation, then perform the microscopic dissections and anastomoses of blood vessels and nerves, and the anastomosis of dorsal veins though an auxiliary small incision by the lateral nail fold of the severed digit-tip) to replant severed digit-tips in Tamai zones I-II of 26 patients (29 digits). The patients were 20 males (23 digits) and 6 females (6 digits), aged 3-66 years old, with mean age at 28 years old. Nineteen digit-tips were severed in Tamai zone I and 10 in Tamai zone II. The severed digit-tips were 7 of thumbs, 9 of index fingers, 5 of middle fingers, 5 of ring fingers and 3 of little fingers. Causes of injury were 12 of cut, 8 of crush and 6 of avulsion. Postoperative management included infection prevention, antispasmodic for 3 days and keeping in bed for 5 days. The time of surgery was recorded on all patients. Postoperative follow-ups were conducted at outpatient clinics for 6 to 12 months to observe the survival of digit-tips and the appearance, recovery of sensation and motor functions, strength of digits and patient satisfaction.Results:(1)The surgical time was about 1.0 hour for replantation of a severed digit-tip in Tamai zone I, while it took about 1.5 hours for those in Tamai zone II. (2)Survival rate and appearance: all 29 replanted digit-tips survived, except 2 in Tamai zone I which encountered venous occlusion and survived after small incision for bloodletting. Twenty-two digit-tips gained pulp fat pads with full digit pulps. Four avulsed digit-tips had mild atrophy of pulp. The 15 digit-tips severed in Tamai zone I were about 2 mm shorter than the healthy sides, but without deformity. One digit-tip had poor nail appearance due to preoperative fungal infection of nail bed. (3)Sensory recovery: with the British Medical Research Council (BMRC), 23 digit-tips recovered to S 3+, and 2 digit-tips of avulsion and 1 digit-tip of crush recovered to S 3. TPD of the replanted digit-tips were: 4-7 mm in those of cut injury; 6-8 mm in those of crush and 9-11 mm in those of avulsion. (4)Motion and digit strength: results of functional assessment according to the total active mobility standard promoted by China's Society for Surgery of the Hand were: 21 cases of excellent and 5 of good, without pain in digit pulp when pinching and griping. The mobility of the digits with replanted digit-tips of both Tamai zones I and II were close to that of the healthy sides. The motions of the digits with replanted digit-tips in Tamai zone I were close to the healthy sides and the 5 of those in Tamai zone II had 0° in extension and 2°-3° in flexion, due to the severed plane at distal interphalangeal joint. (5)Patient satisfaction: 25 patients were satisfied, however 1 patient was dissatisfied to the poor function of the distal interphalangeal joint due to the severed thumb-tip in Tamai zone II. Conclusion:Modified replantation procedure for severed digit-tip in Tamai zones I-II has significant achievement in cutting down the surgical time through a modified procedure of debridement and fracture fixation (tendon suture) by naked-eyes operation first, followed by dissections and anastomoses of the blood vessels and nerves under the surgical microscope. The auxiliary small incision by the lateral nail fold of digit-tip in Tamai zone I facilitates an exposure of a constant, healthy lateral nail fold vein. It enables the anastomosis with a high-quality vein, hence improves the success rate of replantation. The appearance and function of the replanted digit-tip are found better in the severed digit-tips of cut injury than those with injuries of avulsion and crush.

Relation between sensorimotor network dysfunction and clinical symptoms in patients with obsessive-compulsive disorder / 中华神经医学杂志

Objective:To investigate the changes of abnormal spontaneous brain activity and whole-brain effector connectivity in patients with obsessive-compulsive disorder (OCD) by combining low frequency amplitude (ALFF) and Granger causality analysis (GCA), and explore their relations with clinical symptoms.Methods:Forty-nine patients with OCD admitted to Department of Psychiatry, Second Affiliated Hospital of Xinxiang Medical College from January 2020 to September 2023 were selected as OCD group; 50 healthy volunteers matched with gender, age and years of education were enrolled as healthy control (HC) group. Obsessive-compulsive symptoms and severities in the OCD group were assessed by Yale Brown obsessive-compulsive scale (Y-BOCS). All subjects underwent whole-brain resting-state functional magnetic resonance imaging scanning (rs-fMRI). ALFF differences between the 2 groups were compared. Brain regions with ALFF differences were used as seed points, and effector connectivity changes in seed points were compared with those in whole-brain by GCA. Correlations of ALFF and effector connectivity in brain regions with ALFF differences with total scores, obsession scores and compulsion scores of Y-BOCS were analyzed by partial correlation analysis.Results:(1) Compared with that in the HC group, ALFF was significantly enhanced in the right supplementary motor area, right hippocampus, left caudate nucleus, and right fusiform gyrus, and statistically attenuated in the left suboccipital gyrus in the OCD group ( P<0.05). (2) Compared with that in the HC group, effector connectivity from the right dorsolateral superior frontal gyrus to right supplementary motor area was significantly attenuated, and effector connectivity from the left superior occipital gyrus to right supplementary motor area was significantly enhanced in the OCD group ( P<0.05); compared with that in the HC group, effector connectivity from the right fusiform gyrus to right precentral gyrus was significantly attenuated, and effector connectivity from the right hippocampus to left mesial temporal gyrus was significantly enhanced in the OCD group ( P<0.05). (3) In OCD patients, altered ALFF in the left caudate nucleus was positively correlated with obsession scores ( r=0.357, P=0.027), and altered effector connectivity from the right dorsolateral superior frontal gyrus to right supplementary motor area was negatively correlated with obsession scores ( r=-0.312, P=0.029). Conclusion:Abnormalities in sensorimotor network function are closely related to clinical symptoms in patients with OCD.

Herbal Textual Research on Polygoni Multiflori Radix and Polygoni Multiflori Caulis in Famous Classical Formulas / 中国实验方剂学杂志

By reviewing ancient materia medica， medical books， prescription books and modern literature， this paper conducted a systematic research on name， origin， medicinal parts， producing area， quality， harvesting and processing methods， functions and toxicity of Polygoni Multiflori Radix（PMR） and Polygoni Multiflori Caulis（PMC） in famous classical formulas. It was found that the name of Heshouwu was first found in the Biography of Heshouwu and originated from its discoverer， and then still in use today. Since the Song dynasty， Heshouwu has been included in the materia medica with Fallopia multiflora as the mainstream origin. Since the Ming dynasty， in addition to F. multiflora， Cynanchum bungei， C. wilfordii， C. auriculatum have been used as the origin of Heshouwu. Heshouwu is widely distributed， the production areas recorded in ancient times are mainly Luchuan， Guangxi and Ganzhou， Jiangxi， and in modern times， Deqing， Guangdong and other places are respected as the geo-authentic habitats. Its origin processing is mostly dug out， washed， sliced and dried in the sun. Modern literature concludes that the quality of PMR is better in terms of weight， solid quality and powder， while PMC is better in terms of uniformity and purplish-red skin. In the Qing dynasty and before that， it was recorded in the materia medica that PMR was harvested mainly in late spring， mid-summer and early autumn， in modern times， it was harvested mainly in spring and autumn， while PMC was harvested in autumn. In Song dynasty， the processing method of PMR was mainly soaked with rice-washed water， the Ming dynasty for black bean steaming method， the Qing dynasty for steaming followed by black bean juice maceration， while in modern times， it is mostly sliced and steamed with black bean juice and yellow rice wine until the juice is absorbed. PMC is prepared by removing impurities， washing or moistening， and cutting into sections to dry. During the five dynasties， PMR was used to treat infertility as well as gastrointestinal diseases and blood in the stool caused by wind chill， and during the Song dynasty， it was mostly used raw products for the treatment of scrofula and carbuncles， and in the Yuan and Ming dynasties， raw and processed products were used， and Polygoni Multiflori Radix Praeparata was used to treat hemorrhoids， waist and knee soreness. PMC is mainly used for treating insomnia， fatigue and sweating， wind sores and scabies， etc. In the Song dynasty， the ancients considered that PMR was non-toxic， but its toxicity was gradually discovered after the Ming dynasty， and the toxicity mechanism has not been clearly analyzed yet. Based on the results of the textual research， it is recommended that F. multiflora be used as the base for development of famous classical formulas containing PMR， and from the safety perspective， it is recommended to use raw products with caution， oral administration must be used processed products. PMC is recommended to use raw products.

Herbal Textual Research on Alpiniae Officinarum Rhizoma in Famous Classical Formulas / 中国实验方剂学杂志

By reviewing ancient materia medica， medical books and modern literature， this paper conducted a systematic research on name， origin， scientific name evolution， producing area， quality， harvesting and processing methods of Alpiniae Officinarum Rhizoma. The results showed that Alpiniae Officinarum Rhizoma was first published in Mingyi Bielu， and its correct name was Gaoliangjiang. The mainstream origin of Alpiniae Officinarum Rhizoma used in the past dynasties is Alpinia officinarum， which is used to this day， while it used to be mixed with A. galanga because of the similar name and morphology. Alpiniae Officinarum Rhizoma produced in Danzhou and Leizhou was considered to be better in ancient times， and now it mainly produced in Guangdong， Guangxi and Hainan provinces. In addition， it has been concluded that Alpiniae Officinarum Rhizoma with reddish brown， sturdy and firm character， wrinkled skin， convex flesh， aromatic and spicy taste， and few branches is the best. In ancient times， Alpiniae Officinarum Rhizoma was commonly harvested in February and March， whereas it generally harvested in late summer or early autumn at present， and wild products are usually harvested before the rainy season in May. The main processing methods of Alpiniae Officinarum Rhizoma are cleansing and cutting， and some other methods are stir-frying or mixing with auxiliary materials. Based on the research results， it is suggested that the raw products of A. officinarum rhizomes or its processed products according to prescription requirements should be used in the development of famous classical formulas containing Alpiniae Officinarum Rhizoma.

Herbal Textual Research on Huoxiang in Famous Classical Formulas / 中国实验方剂学杂志

By reviewing ancient materia medica， medical books and modern literature， the name， origin， quality evaluation， producing area and processing methods of Huoxiang herbs were systematically investigated and researched， so as to provide reference and basis for the development and utilization of famous classical formulas containing Huoxiang herbs. Through the herbal textual research， it can be seen that most of materia medica in past dynasties have taken Huoxiang as the nominal rectification， and the mainstream base used is Pogostemon cablin. In order to distinguish another plant of the same family， Agastache rugosa， which has been widely used in Chinese folk since the Ming dynasty， and respect geo-authentic region， Pogostemonis Herba is also named Guanghuoxiang. Pogostemonis Herba is native to Vietnam and other Southeast Asian countries， and was introduced to China as a spice through Guangdong and other places in the early days， and has been successfully cultivated in the south of China since the Song dynasty. The medicinal parts are mostly dried aboveground parts， and the leaves and stems are also separated for medicine sometimes. The geo-authentic region of Pogostemonis Herba is Guangdong in the past dynasties， and it is currently cultivated in Guangzhou， Zhaoqing， Zhanjiang of Guangdong province and Hainan province， with the most famous one cultivated in Shipai. Pogostemonis Herba is mainly planted by cutting propagation. It usually sprouts in February and is harvested in June. The main processed method in region is stuffy dry， which is placed in the sun and repeatedly suffocated until it has an aromatic smell and the color turns yellow. The processing method is mostly to use the raw product as medicine after being selected. Based on the research results， it is suggested that the leaves of P. cablin are used in Yangweitang， for Huopo Xialingtang， it is recommended to choose the raw product of A. rugosa that is removed the roots and old stems.

Herbal Textual Research on Benzoinum in Famous Classical Formulas / 中国实验方剂学杂志

Benzoinum has a long history of medicinal use. In order to standardize its clinical use， the author made systematic textual research on the name， origin， evolution of scientific name， producing area， property， quality evaluation， harvesting and processing of Benzoinum by reviewing the ancient materia medica， medical books and modern literature. According to the research， the mainstream variety of Benzoinum recorded in ancient materia medica should be the dry resin of Styrax tonkinensis of Styracaceae. In addition to S. benzoin， which was also used in many applications. In modern times， S. benzoin was the mainstream， but in practice， it was mostly the resin of various plants of the genus Styrax， and then S. tonkinensis and S. benzoides were recorded as the main sources of Benzoinum. Nowadays， it mainly comes from S. tonkinensis. In ancient times， the producing areas of Benzoinum were Persia， Xirong， Annan and other places， whereas now are distributed in Indonesia， Sumatra， Thailand， Vietnam， and Fujian， Guizhou， Yunnan， Guangxi， Guangdong and other places in China， but most of the medicinal materials in China are imported. Traditionally， the medicinal materials of Benzoinum with properties of oily， waxy luster， brittle and fragile， strong aroma， sand feeling when chewing and no impurities are considered better. In antiquity， the harvesting time of Benzoinum was concentrated in July and August， while in modern times， it is harvested in summer and autumn， and collected in various ways， usually the trees are selected to be harvested if they are more than 10 years old， and the best quality being the first， milky resin collected when the time of cutting the trees is from April to June. In the past dynasties， the powdered resin was mainly ground and used in formulas， in addition， there were also records of wine steaming into paste and processing with honey， etc. The 1953 edition of Chinese Pharmacopoeia added records such as sevum benzoinatum and adeps benzoinatus， and now it is mostly used as powder into pills or powers， or used after processing with wine. Based on the results of textual research， it is suggested that although the dry resin of S. benzoin is not a medicinal variety of Benzoinum included in the 2020 edition of Chinese Pharmacopoeia， it has a long history of application and has some clinical value， so its medicinal feasibility can be explored in depth. In the development of famous classical formulas containing Benzoinum， the dry resin of S. tonkinensis or S. benzoin can be used， which should be used in medicine as powder after dried or processed according to the requirements of prescriptions.

Social functioning characteristics of children with co occurrence of attention deficit hyperactivity disorder and oppositional defiant disorder / 中国学校卫生

Objective@#To explore the social functioning characteristics of children with co ocurrence of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) for intervention reference.@*Methods@#The Chinese Version of Swanson Nolan and Pelham, Version IV Scale-Parent Form(SNAP-IV), the Chinese Version of Weiss Functional Impairment Scale-Parent(WFIRS-P), and the Questionnaire-Children with Difficulties (QCD) were applied to 192 children with ADHD, 243 children with co occurrence of ADHD and ODD, who firstly visited the Department of Children Psychological Health of Zhuhai Maternal and Child Health Care Hospital, and 118 healthy control children from a school in Zhuhai.@*Results@#The scores of attention deficit factor in SNAP-Ⅳ scale of children in three groups were[1.9(1.7, 2.1), 1.8(1.6, 1.9), 1.0(0.6, 1.2)], the scores of hyperactive impulsivity were[1.8(1.4, 2.1), 1.6(1.1, 1.8), 0.7(0.2, 1.0)] the scores of oppositional defiant were[1.6(1.5, 1.9), 1.0(0.8,1.1), 0.8(0.5, 1.0)], the differences were statistically significant( H=268.44, 237.97, 418.66, P <0.01). The dimensions and total scores of the three groups of children s WFIRS-P scale were family[0.8(0.6, 1.1), 0.6(0.3, 0.8), 0.3(0.1, 0.6)]; learning and school[0.8(0.5, 1.1), 0.8(0.5, 1.0), 0.3(0.1, 0.5)]; life skills[1.0(0.7, 1.2), 0.8(0.6, 1.0), 0.6(0.4, 0.8)]; self management [1.0(0.3, 1.0), 0.7(0.3, 1.0), 0.3(0.0, 0.7)]; social activities [0.7(0.4, 1.0), 0.6(0.3, 0.9), 0.3(0.0, 0.4 )]; adventure activities[0.3(0.2, 0.5), 0.2(0.1, 0.4), 0.1(0.0, 0.2)]; the total score[0.8(0.6, 1.0), 0.6(0.5, 0.8), 0.4( 0.2 , 0.6)], the difference between the groups was statistically significant( H=108.82, 122.45, 60.17, 40.58, 96.17, 76.57, 138.30, P <0.01). The difference between the QCD scale scores of children in the three groups was statistically significant[30.0( 24.0 , 37.0), 32.0(27.0, 40.0), 47.0(37.0, 52.3), H=124.65, P <0.01). Multiple regression analysis showed that attention deficit, and oppositional defiant symptoms were associated with both the total WFIRS-P score and the QCD score of children( R 2= 0.40 , 0.25, P <0.05).@*Conclusion@#Children with co occurrence of ADHD and ODD have more severe deficits in all dimensions of social functioning than children with ADHD, which might be associated with attention deficit and oppositional defiant symptoms.

Efficacy and safety of partial tubeless versus standard percutaneous nephrolithotomy in the treatment of upper urinary tract calculi / 现代泌尿外科杂志

【Objective】 To compare the efficacy and safety between partial tubeless and standard percutaneous nephrolithotomy in the treatment of upper urinary tract calculi. 【Methods】 The clinical data of 802 patients with upper urinary tract calculi treated at our hospital during Jun.2018 and Dec.2021 were retrospectively analyzed. The patients were divided into the partial tubeless group and standard group, and 60 cases in either group were selected by a simple random method. Clinical data, complications and stone-free rate were compared between the two groups. 【Results】 All 120 patients completed the operation successfully. The postoperative hospital stay, pain score and postoperative recovery of the partial tubeless group were significantly superior to those of the standard group (P0.05). 【Conclusion】 In the treatment of upper urinary tract calculi, partial tubeless percutaneous nephrolithotomy can achieve satisfactory surgical results, and has obvious advantages in postoperative recovery and patients’ experience. It is worthy of clinical application.

3.0T multimodal MRI for evaluating T stage and therapeutic efficacy of neoadjuvant for rectal cancer / 中国医学影像技术

Objective To observe the value of 3.0T multimodal MRI for preoperative evaluation of T stage and therapeutic efficacy of neoadjuvant for rectal cancer.Methods 3.0T multimodal MRI data,including T1WI,T2WI/diffusion weighted imaging(DWI),dynamic contrast enhanced MRI(DCE-MRI)and intravoxel incoherent motion DWI(IVIM-DWI)of 150 patients with rectal cancer were retrospectively analyzed,and the value of different sequences for evaluating T stage and therapeutic efficacy of neoadjuvant for rectal cancer were assessed.Results The sensitivity,specificity and accuracy of T1WI,T2WI/DWI,DCE-MRI and IVIM-DWI for evaluating T1-T2 and T3-T4 stage rectal cancer were all significantly different(all P＜0.05).The diagnostic efficacy of DCE-MRI and IVIM-DWI were all higher than that of T1WI and T2WI/DWI(all P＜0.05).Combination evaluation of DCE-MRI and IVIM-DWI for T stage of rectal cancer had good consistency with pathological results(Kappa=0.943,P＜0.05).Significant differences of volume transfer constant(Ktrans),true diffusion coefficient(D)and apparent diffusion coefficient(ADC)were found among different T stage rectal cancers(all P＜0.05).Totally 80 patients received neoadjuvant therapy,and significant differences of Ktrans,D and ADC were noticed between patients with good(n=32)or poor efficacy(n=48)(all P＜0.05).The area under the curve(AUC)of Ktrans,D and ADC for evaluating therapeutic efficacy of neoadjuvant for rectal cancer was 0.774,0.837 and 0.758,respectively,of the combination of above three was 0.929,higher than that of single indexes(all P＜0.05).Conclusion Combination of 3.0T DCE-MRI and IVIM-DWI was helpful for preoperative evaluating T stage and therapeutic efficacy of neoadjuvant for rectal cancer.

Exploration and practice of the blended teaching model based on BOPPPS classroom reconstruction in Diagnostic Radiology / 中华医学教育探索杂志

Objective:To investigate the feasibility and effectiveness of the blended teaching model for diagnostic radiology based on BOPPPS classroom reconstruction, i.e., bridge-in, objective, pre-assessment, participatory-learning, post-assessment, and summary.Methods:The undergraduate students in the classes of 2017 and 2018 in Department of Medical Imaging were selected as research subjects. The students in the class of 2018 were established as observation group and received the innovative blended teaching model based on BOPPPS classroom reconstruction, and those in the class of 2017 were established as control group and received teaching with traditional theoretical lectures. At the end of the course, 80 students were randomly selected from the observation group and the control group for performance analysis and teaching evaluation. SPSS 26.0 was used to perform the t-test. Results:The observation group had a total score of (82.66±6.18), while the control group had a total score of (76.47±5.42), and compared with the control group, the observation group had significantly higher scores of homework score, course discussion, and final examination ( P<0.05). Compared with the control group, the observation group had significantly higher scores of "understanding of the basic knowledge of imaging", "improvement of comprehensive diagnostic thinking ability", "stimulating the interest in learning and expanding horizons", and "cultivating clinical competence" in the self-evaluation survey ( P<0.05). Conclusion:The blended teaching model based on BOPPPS classroom reconstruction is suitable for the teaching of radiology diagnostics. It not only enriches teaching means and methods and enhances classroom participation and interaction, but also expands teaching space and teaching content.

Combining respiratory-muscle resistance training with feedback respiratory electrical stimulation improves the diaphragm and pulmonary function of stroke survivors / 中华物理医学与康复杂志

Objective:To document any effect of combining respiratory-muscle resistance training with feedback respiratory electrical stimulation in rehabilitating the diaphragm function and lung function of stroke survivors.Methods:Sixty hemiplegic stroke survivors were randomly assigned to an observation group or a control group, each of 30. Both groups were given conventional rehabilitation, including respiratory-muscle resistance training. The observation group additionally received feedback respiratory electrical stimulation twice a day, six days a week for 3 weeks. Before and after the treatment, ultrasound was used to measure the end-inspiratory and end-expiratory thickness of the diaphragm. Diaphragm movement during quiet breathing and deep breathing was also observed, and the diaphragm thickening fraction was calculated. The incidence of diaphragm dysfunction on the affected and healthy sides of the two groups before and after the treatment was also analyzed and compared.Results:Diaphragm dysfunction on either side had decreased significantly more in the observation group than in the control group after the treatment. The observation group also showed significantly greater average improvement in the thickening functions and in diaphragm movement on both the affected and healthy sides during quiet breathing and deep breathing. All of the pulmonary function indicators improved significantly in both groups after the treatment, but those of the observation group were, on average, significantly better than the control group′s averages.Conclusions:Combining 3 weeks of respiratory muscle resistance training with electrical stimulation feedback can effectively increase the bilateral thickness of the diaphragm and diaphragm movement in deep breathing of hemiplegic stroke survivors. That reduces the incidence of diaphragm dysfunction.

Preparation, characterization and activity evaluation of Spirulina-chitooligosaccharides capable of inhibiting biofilms / 生物工程学报

The biofilms formed by pathogenic microorganisms seriously threaten human health and significantly enhance drug resistance, which urgently call for developing drugs specifically targeting on biofilms. Chitooligosaccharides extracted from shrimp and crab shells are natural alkaline oligosaccharides with excellent antibacterial effects. Nevertheless, their inhibition efficacy on biofilms still needs to be improved. Spirulina (SP) is a microalga with negatively charged surface, and its spiral structure facilitates colonization in the depth of the biofilm. Therefore, the complex of Spirulina and chitooligosaccharides may play a synergistic role in killing pathogens in the depth of biofilm. This research first screened chitooligosaccharides with significant bactericidal effects. Subsequently, Spirulina@Chitooligosaccharides (SP@COS complex was prepared by combining chitooligosaccharides with Spirulina through electrostatic adsorption. The binding of the complex was characterized by zeta potential, z-average size, and fluorescence labeling. Ultraviolet-visible spectroscopy (UV-Vis) showed the encapsulation efficiency and the drug loading efficiency reached up to 90% and 16%, respectively. The prepared SP@COS2 exhibited a profound synergistic inhibition effect on bacterial and fungal biofilms, which was mainly achieved by destroying the cell structure of the biofilm. These results demonstrate the potential of Spirulina-chitooligosaccharides complex as a biofilm inhibitor and provide a new idea for addressing the harm of pathogenic microorganisms.

Research progress on signaling pathways related to fluoride induced spleen immune function damage / 中华地方病学杂志

Fluorine is widely present in nature, and long-term excessive intake of fluoride by the body can cause damages to bone tissues such as teeth and bones, as well as non bone tissues and organs such as nervous, cardiovascular, digestive and immune systems. Fluoride can cause apoptosis and autophagy of spleen lymphocytes, ultimately leading to damage to the structure and function of spleen. This article reviews the research progress of signaling pathways related to fluoride induced spleen immune function damage, in order to provide a theoretical basis for molecular mechanism study.

Effects of sports training associated with nutritional intervention on athletes' post-competition recovery / Efeitos do treinamento esportivo associado à intervenção nutricional sobre a recuperação dos atletas pós-competição / Efectos del entrenamiento deportivo asociado a una intervención nutricional en la recuperación post competición de los deportistas

ABSTRACT Introduction: The athletes' physiological capacity and psychological level are raised to the limit during the competition, which is necessary for adequate recovery after the dispute. Objective: Study the effect of sports training associated with nutritional intervention on athletes' post-competition recovery. Methods: In the first two weeks of the experiment, training was done in slow aerobic exercise, aerobics, and running. Strength training and a small amount of anaerobic training were added to the training with the gradual practice of the experiment. Results: The proportion of breakfast, lunch, and dinner was 25.33%, 42.55%, and 32.12%, respectively; protein intake decreased from 34.23% to 20.13%, and the proportion of fat intake decreased from 15. 56% to 12.3%, and IgG content changed from 7.654 ± 0.283 (mmol/L) at the end to 8.586 ± 0.651 (mmol/L); IgM content changed from 3.382 ± 0.875 (g/L) at the end to 3.169 ± 1.002 (g/L). Conclusion: Athletes can effectively, through sports training and nutritional intervention, adjust body changes caused by competition while maintaining a good exercise level. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A capacidade fisiológica e o nível psicológico dos atletas são elevados ao limite durante a competição, sendo necessária uma recuperação adequada após a disputa. Objetivo: Estudar o efeito do treinamento esportivo associado à intervenção nutricional para a recuperação dos atletas após a competição. Métodos: Nas duas primeiras semanas da experiência, realizou-se o treinamento na forma de exercício aeróbico lento, aeróbica e corrida. O treinamento de força e uma pequena quantidade de treinamento anaeróbico foram adicionados ao treinamento com a prática gradual do experimento. Resultados: A proporção de café da manhã, almoço e jantar foi de 25,33%, 42,55% e 32,12% respectivamente, a proporção de ingestão de proteínas diminuiu de 34,23% para 20,13%, a proporção de ingestão de gordura diminuiu de 15,56% para 12,3%, e o conteúdo de IgG mudou de 7,654 ± 0,283 (mmol/L) no final para 8,586 ± 0,651 (mmol/L); o conteúdo de IgM mudou de 3,382 ± 0,875 (g/L) no final para 3,169 ± 1,002 (g/L). Conclusão: Os atletas podem de maneira eficaz, através de treinamento esportivo e intervenção nutricional, ajustar as alterações corporais ocasionadas pela competição, mantendo um bom nível de exercício. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La capacidad fisiológica y el nivel psicológico de los atletas se elevan al límite durante la competición, siendo necesaria una adecuada recuperación tras la disputa. Objetivo: Estudiar el efecto del entrenamiento deportivo asociado a la intervención nutricional para la recuperación de los deportistas tras la competición. Métodos: En las dos primeras semanas del experimento, el entrenamiento se realizó en forma de ejercicio aeróbico lento, aeróbic y carrera. El entrenamiento de fuerza y una pequeña cantidad de entrenamiento anaeróbico se añadieron al entrenamiento con la práctica gradual del experimento. Resultados: La proporción de desayuno, comida y cena fue del 25,33%, 42,55% y 32,12% respectivamente, la proporción de ingesta de proteínas descendió del 34,23% al 20,13%, la proporción de ingesta de grasas descendió del 15. 56% a 12,3%, y el contenido de IgG pasó de 7,654 ± 0,283 (mmol/L) al final a 8,586 ± 0,651 (mmol/L); el contenido de IgM pasó de 3,382 ± 0,875 (g/L) al final a 3,169 ± 1,002 (g/L). Conclusión: Los atletas pueden ajustar eficazmente, mediante el entrenamiento deportivo y la intervención nutricional, los cambios corporales provocados por la competición, manteniendo un buen nivel de ejercicio. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Analysis of the effects of high-intensity strength training on musculature and metabolism in college students / Análise dos efeitos do treinamento de força de alta intensidade sobre a musculatura e o metabolismo de estudantes universitários / Análisis de los efectos del entrenamiento de fuerza de alta intensidad sobre la musculatura y el metabolismo en estudiantes universitarios

ABSTRACT Introduction: Recent studies shows that college students have decreased physical fitness and increased obesity rates, and the rate of obesity will continue to increase over time. Objective: Study the effect of high-intensity strength training on college students' muscle optimization and metabolic recovery. Methods: This paper adopts the experimental control method. An experimental group performed high-intensity strength training and completed the training with the help of the existing equipment in our school's gym. The control group used normal aerobic training to complete the running training and other movements in athletics. The experimental and control groups were trained three times a week for one hour at a time. Results: In the experimental group, left arm elbow joint extension was optimized to (18.405 ± 2.8878) kg after the experiment, P<0.05; right leg knee joint extension was optimized to (38.754 ± 6.6556) kg after the experiment, P<0.01; serum total cholesterol was optimized to (3.682 ± 0.2643) mmol/L after the experiment, P<0.01. Conclusion: High-intensity strength training, when compared with ordinary aerobic training, has a better optimizing effect on college students' indicators and higher exercise efficiency. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: Segundo consta nas pesquisas recentes, os estudantes universitários têm diminuído a aptidão física e aumentado a taxa de obesidade, e o índice de obesidade permanecerá aumentando com o tempo. Objetivo: Estudar o efeito do treinamento de força de alta intensidade sobre a otimização muscular e a recuperação metabólica dos estudantes universitários. Métodos: Este trabalho adota o método experimental de controle. Um grupo experimental realizou o treinamento de força de alta intensidade e completou o processo de treinamento com a ajuda do equipamento existente na academia da nossa escola. O grupo de controle usou o treinamento aeróbico normal para completar o treino de corrida e outros movimentos no atletismo. O grupo experimental e o grupo de controle foram treinados três vezes por semana durante uma hora de cada vez. Resultados: No grupo experimental, a extensão da articulação do cotovelo do braço esquerdo foi otimizada para (18,405 ± 2,8878) kg após o experimento, P<0,05; a extensão da articulação do joelho da perna direita foi otimizada para (38,754 ± 6,6556) kg após o experimento, P<0,01; o colesterol total sérico foi otimizado para (3,682 ± 0,2643) mmol/L após o experimento, P<0,01. Conclusão: O treinamento de força de alta intensidade, quando comparado com o treinamento aeróbico comum, tem um melhor efeito de otimização nos indicadores dos estudantes universitários e uma maior eficiência no exercício. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: Según las investigaciones recientes, los estudiantes universitarios presentan una disminución de la forma física y un aumento de la tasa de obesidad, y la tasa de obesidad seguirá aumentando con el tiempo. Objetivo: Estudiar el efecto del entrenamiento de fuerza de alta intensidad sobre la optimización muscular y la recuperación metabólica en estudiantes universitarios. Métodos: Este trabajo adopta el método de control experimental. Un grupo experimental realizó el entrenamiento de fuerza de alta intensidad y completó el proceso de entrenamiento con la ayuda del equipamiento existente en el gimnasio de nuestro colegio. El grupo de control utilizó el entrenamiento aeróbico normal para completar el entrenamiento de carrera y otros movimientos en atletismo. El grupo experimental y el grupo de control se entrenaron tres veces por semana durante una hora cada vez. Resultados: En el grupo experimental, la extensión de la articulación del codo del brazo izquierdo se optimizó a (18,405 ± 2,8878) kg después del experimento, P<0,05; la extensión de la articulación de la rodilla de la pierna derecha se optimizó a (38,754 ± 6,6556) kg después del experimento, P<0,01; el colesterol total sérico se optimizó a (3,682 ± 0,2643) mmol/L después del experimento, P<0,01. Conclusión: El entrenamiento de fuerza de alta intensidad, en comparación con el entrenamiento aeróbico ordinario, tiene un mejor efecto optimizador sobre los indicadores de los estudiantes universitarios y una mayor eficacia del ejercicio. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Effects of trioxygen preconditioning on cerebral ischemia/reperfusion injury and glutamate receptor in rats / 中华危重病急救医学

Objective:To study the effects of trioxygen pretreatment on cerebral ischemia/reperfusion (I/R) injury in rats.Methods:A total of 24 clean grade male Sprague-Dawley (SD) rats were randomly divided into Sham group, brain I/R group (I/R group) and Ozone pretreatment group (Ozone group), with 8 rats in each group. The animals were routinely fed, and the operation was performed 5 days after the intervention of Ozone group by intraperitoneal injection of trioxygen water (concentration 80 mg/L, 0.01 mL/g), and the Sham group and I/R group were injected with equal volume normal saline. The Sham group only separated the arteries without ligation, and the I/R group and Ozone group established the rat cerebral I/R model. Neurological deficit score (NDS) was performed 2 hours after ischemia and modified neurological deficit score (mNSS) was performed 24 hours after reperfusion. Brain tissue was collected after anesthesia. Cerebral infarction was observed by 2, 3, 5-triphenyltetrazolium chloride (TTC) staining and the percentage of cerebral infarction volume was calculated. Protein expression of metabolic glutamate receptor 5 (mGluR5) and ionic glutamate α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR) subunit GluA2 in cerebral ischemic penumbra was determined by Western blotting.Results:Compared with the Sham group, NDS score, mNSS score and percentage of cerebral infarction volume in I/R group were increased [NDS score: 2.63±0.52 vs. 0, mNSS score: 9.63±1.19 vs. 1.13±0.64, cerebral infarction volume: (41.25±2.93)% vs. 0%, all P < 0.05], and expressions of mGluR5 and GluA2 in penumbra area of cerebral ischemia were decreased [mGluR5 protein (mGluR5/β-actin): 0.44±0.14 vs. 1.00±0.10, GluA2 protein (GluA2/β-actin): 0.23±0.08 vs. 1.00±0.25, both P < 0.05]. Compared with the I/R group, mNSS score and percentage of cerebral infarction volume in the Ozone group were decreased [mNSS score: 7.00±1.20 vs. 9.63±1.19, cerebral infarction volume: (27.23±6.21)% vs. (41.25±2.93)%, both P < 0.05], and mGluR5 and GluA2 expressions in the penumbra of cerebral ischemia were up-regulated [mGluR5 protein (mGluR5/β-actin): 0.81±0.10 vs. 0.44±0.14, GluA2 protein (GluA2/β-actin): 0.76±0.13 vs. 0.23±0.08, both P < 0.05]. Conclusion:Trioxygen preconditioning can alleviate cerebral I/R injury in rats, and its mechanism may be related to the upregulation of GluR5 and GluA2 in the ischemic penumbra.

Progress of drug resistance mechanism of poly adenosine diphosphate ribose polymerase inhibitors and the combined medication in patients with ovarian cancer / 肿瘤研究与临床

Ovarian cancer seriously threats women's health. The emergence of poly adenosine diphosphate ribose polymerase inhibitor (PARPi) has broken the barrier for ovarian cancer treatment. PARPi has been widely used and along with it comes the problem of drug resistance. Fully understanding the drug resistance mechanism of PARPi is expected to be an important way to reverse PARPi resistance. The combination of PARPi and other drugs for ovarian cancer may expand the benefits of patients using PARPi. This article reviews the drug resistance mechanism of PARPi and combined medication.

Epidemiological characteristics and molecular evolution analysis of HIV-1 CRF07_BC in Nanjing from 2015 to 2019 / 中华微生物学和免疫学杂志

Objective:To investigate the epidemiology, evolution and transmission characteristics of HIV-1 CRF07_BC in Nanjing between 2015 and 2019 to provide scientific basis for precise prevention and control of HIV-1 transmission.Methods:Pol gene sequences of 319 patients with HIV-1 CRF07_BC infection in Nanjing were amplified and sequenced and a maximum likelihood phylogenetic tree was then constructed. Markov Chain Monte Carlo sampling method was used to generate Maximum Clade Credibility Tree. Bayesian Skyline Plot was used to reconstruct the changing trend of the effective population size. Pairwise gene distance method was used to construct molecular network to investigate the transmission features. Results:Among the 319 patients, 303 (95.0%) were male; 264 (82.8%) had multiple sexual partners; only 14 (4.4%) had been using condoms. Most of the infections were occurred in men who have sex with men (MSM), accounting for 77.4%. The maximum likelihood phylogenetic analysis of HIV-1 CRF07_BC revealed two clusters: Cluster1 and Cluster2. Cluster1 mainly contained the strains isolated from MSM and Cluster2 mainly consisted of the strains isolated from heterosexual patients. The most recent common ancestor was 2002.47(1999.91, 2005.43) year for Cluster1 and 1996.38(1992.55, 1999.76) year for Cluster2. The evolutionary rates (95% highest posterior density, 95%HPD) of Cluster1 and Cluster2 were 1.73×10 -3 (1.36×10 -3-2.16×10 -3) substitutions·site -1·year -1 and 2.09×10 -3 (1.50×10 -3 -2.79×10 -3 ) substitutions·site -1·year -1, respectively. The effective population sizes of Cluster1 and Cluster2 tended to be stable after 2002 and 2003, respectively. In addition, Cluster1 and Cluster2 formed eleven and eight unique branches, respectively, suggesting the possibility of divergent epidemics of this genotype. A total of 35 propagation clusters were formed in the molecular propagation network, including 92 Nanjing sequences with an average degree of 4.3. Males, MSM and people with multiple sexual partners were more likely to be connected to the network. Students and young patients were more likely to be connected to the network. Conclusions:HIV-1 CRF07_BC infection was characterized by low age, multiple sexual partners, unprotected behaviors and transmission among MSM in Nanjing from 2015 to 2019. It was recommended to pay more attention to students and young people, to formulate more effective prevention and control measures for high-risk sexual behaviors, and to carry out continuous molecular monitoring of CRF07_BC strain, so as to provide scientific basis for the prevention and control of HIV CRF07_BC.

Reconstruction of defects of distal-and-middle segments of finger pulps with striated wrist transverse flap carrying superficial palmar branch of radial artery with sensory nerve / 中华显微外科杂志

Objective:To evaluate the clinical effect of striated free wrist transverse flap pedicled with superficial palmar branch of radial artery carrying sensory nerve in repairing pulp defect of middle-and-distal segments of fingers.Methods:From February 2019 to March 2021, the data of 20 patients with defects of middle-and-distal finger segment were collected. The defects were repaired with striated free wrist transverse flaps pedicled with superficial palmar branch of radial artery. The defects sized were 2.0 cm×1.5 cm-4.0 cm×1.5 cm, and the flaps sized were 2.5 cm×2.0 cm-4.5 cm×2.0 cm. The flap carried metacarpal cutaneous branch of median nerve for the reconstruction of the sensation of finger pulps. The donor sites were directly sutured. After operation, the patients were evaluated according to the shape, sensation and functional recovery of the repaired fingers through outpatient visits and reviews via WeChat.Results:All 20 flaps survived and the wounds healed well. All patients entered regular follow-up for 6-12(average, 8) months. The colour of the flaps was close to the finger skin, without bloating flaps. The flaps were soft in good shapes and function. TPD were 6-11 mm, at 8 mm in average. The scars at the donor sites were hidden and the wrist function was not affected. According to the Trial Evaluation Standard of Upper Limb Function of Hand Surgery Society of Chinese Medical Association, 16 patients were classified as excellent and 4 as good.Conclusion:The striated transverse wrist flap with radial artery palmar superficial branch and sensory nerve offers many advantages, such as a good texture, hidden donor site, convenient flap harvesting, good recovery of sensation, etc. More clinical studies and the promotion of the technique are expected.

AAnalysis of the Status of Career Decision-making and Its Influencing Factors among Nursing Postgraduate Students / 中国实用护理杂志

Objective:To examine the status of career decision-making and its influencing factors among nursing postgraduate students.Methods:From October 2018 to December 2019, 249 nursing postgraduate students from universities were selected by convenience sampling method and were investigated using general information questionnaire, Career Decision-making Difficulties Questionnaire, Professional Identity Scale and Proactive Personality Scale.Results:The score of postgraduate nursing students' career decision-making difficulties was (58.10±8.98). Correlation analysis showed that the score of the career decision-making difficulties was positively correlated with professional identity and proactive personality of nursing postgraduate students ( r=0.187, 0.581, P<0.01). Multiple linear regression analysis showed that gender, whether they had received career counseling and proactive personality scores were influencing factors of career decision-making difficulties which explained 38.0% of the total variation. Conclusions:The career decision-making difficulties of nursing postgraduate students is at a medium level. Educators can reduce the career decision-making difficulties of nursing postgraduate students by conducting career counseling, improving professional identity or enhancing career initiative.