Comparison of safety and effectiveness of micropulse transscleral cyclophotocoagulation and "slow cook" diode laser transscleral cyclophotocoagulation in patients with refractory open-angle glaucoma

ABSTRACT Purpose: This study aimed to compare the safety and effectiveness of intraocular pressure reduction between micropulse transscleral cyclophotocoagulation and "slow cook" transscleral cyclophotocoagulation in patients with refractory primary open-angle glaucoma. Methods: We included patients with primary open angle glaucoma with at least 12 months of follow-up. We collected and analyzed data on the preoperative characteristics and postoperative outcomes. The primary outcomes were a reduction of ≥20% of the baseline value (criterion A) and/or intraocular pressure between 6 and 21 mmHg (criterion B). Results: We included 128 eyes with primary open-angle glaucoma. The preoperative mean intraocular pressure was 25.53 ± 6.40 and 35.02 ± 12.57 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean intraocular pressure was reduced significantly to 14.33 ± 3.40 and 15.37 ± 5.85 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups at the last follow-up, respectively (p=0.110). The mean intraocular pressure reduction at 12 months was 11.20 ± 11.46 and 19.65 ± 13.22 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The median preoperative logMAR visual acuity was 0.52 ± 0.69 and 1.75 ± 1.04 in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean visual acuity variation was −0.10 ± 0.35 and −0.074 ± 0.16 in the micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p=0.510). Preoperatively, the mean eye drops were 3.44 ± 1.38 and 2.89 ± 0.68 drugs in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p=0.017), but those were 2.06 ± 1.42 and 1.02 ± 1.46 at the end of the study in the "slow cook" and micropulse transscleral cyclophotocoagulation groups, respectively (p<0.001). The success of criterion A was not significant between both groups. Compared with 11 eyes (17.74%) in the "slow cook" transscleral cyclophotocoagulation group, 19 eyes (28.78%) in the micropulse transscleral cyclophotocoagulation group showed complete success (p=0.171). For criterion B, 28 (42.42%) and 2 eyes (3.22%) showed complete success after micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p<0.001). Conclusion: Both techniques reduced intraocular pressure effectively.

Comparative analysis of depressive symptoms between adolescents and adults based on SCL-90 / 重庆医学

Objective To investigate the difference of depressive symptoms between adolescents and adults,and to provide possible basis for early detection of adolescent depression.Methods From July 2021 to June 2022,a total of 4 096 patients with"depression"in the psychiatric clinic of the First Affiliated Hospital of Chongqing Medical University were selected as the research objects.They were divided into the adolescent group(n=2 439)and adult group(n=1 657)according to their ages,and the results of self-rating depression scale(SDS)and symptom checklist 90(SCL-90)were collected and analyzed.Results There were significant differences in nationality,residence,native place,family history and degree of depression between the two groups(P<0.05).The adolescent group has more severe depressive symptoms,which were mainly manifes-ted in negative ideas,obsessive-compulsive symptoms,hostile and interpersonal relationship,and psychotic symptoms(P<0.05).The adult group showed more obvious in sleep(P<0.05).Conclusion Early inter-vention should be carried out for adolescents'depressive symptoms such as negative thoughts.

Preparation and characteristics comparison of three acute pancreatitis rat models / 中国组织工程研究

BACKGROUND:Establishing a stable and reliable animal model of acute pancreatitis is of great significance for understanding its pathogenesis,pathophysiological characteristics,and clinical medication.Domestic and foreign studies have shown that cerulein,L-arginine,and sodium taurocholate can induce acute pancreatitis,but their pathophysiological characteristics and model characteristics are still unclear. OBJECTIVE:To establish an acute pancreatitis rat model using cerulein,L-arginine,and sodium taurocholate and to observe the changing patterns of model features at different time points. METHODS:Ninety-six healthy male Sprague-Dawley rats were randomly divided into normal group,cerulein group,L-arginine group,and sodium taurocholate group,with 24 rats in each group.Within each group,there were three subgroups(n=8 per group):12-,24-,and 48-hour subgroups.Cerulein was administered via intraperitoneal injection six times with a 1-hour interval.L-arginine was administered through two intraperitoneal injections with a 1-hour interval.Sodium taurocholate was injected for inducing acute pancreatitis models through retrograde injection into the bile-pancreatic duct.By examining the rat survival rate,gross morphology of the pancreas,calculating the pancreatic organ index,and measuring levels of amylase,lipase,alanine transaminase,aspartate transaminase,blood urea nitrogen,and creatinine,as well as observing pancreatic tissue pathological features through hematoxylin-eosin staining and conducting a pancreatic injury scoring,we evaluated the changing patterns of model features at different time points. RESULTS AND CONCLUSION:Compared with the normal group,the overall survival rate of rats was 100%in the cerulein group,88%in the L-arginine group,and 96%in the sodium taurocholate group.The pancreatic organ index was increased in all groups.Gross observation indicated that,In the cerulein group,pancreatic edema,blurred lobes,and looseness were visible.In the L-arginine group,the pancreatic glands were enlarged and thickened with patchy bleeding.In the sodium taurocholate group,pancreatic tissue showed varying degrees of congestion and edema accompanied by scattered flakes of hemorrhage and necrosis.The levels of serum alanine transaminase,aspartate transaminase,blood urea nitrogen,creatinine,amylase,and lipase in rats exhibited consistent changes.In the cerulein group,these parameters possibly peaked at 12 hours(P<0.05)and then showed a declining trend.In the L-arginine group,they reached the highest levels at 24 hours(P<0.05)and significantly decreased at 48 hours.In the sodium taurocholate group,serum amylase and lipase remained at higher levels at 12 hours with a slow decline trend(P<0.05).Compared with the normal group,microscopic examination revealed mild acinar edema and widened interlobular spaces in the cerulein group,with a higher presence of inflammatory cells.In the L-arginine group,there was widening of interlobular spaces,extensive infiltration of inflammatory cells,and patchy necrotic areas.In the sodium taurocholate group,significant pancreatic edema,structural disarray,extensive necrotic foci,and inflammatory cell infiltration were observed.Compared with the normal group,the pathological scores of induced acute pancreatitis in all three models were significantly different at each time point(P<0.05).Moreover,the pathological scores in each group increased over time,indicating a gradual worsening of pancreatic tissue damage.When comparing different models at the same time,there were differences in pathological scores,with the sodium taurocholate group having the highest scores,followed by the L-arginine group,and the cerulein group having the lowest scores.Analyzing the three models at the same time point,the most severe condition was in the sodium taurocholate group,which was characterized by pancreatic hemorrhage and necrosis,followed by the L-arginine group,which was characterized by necrosis,and the least severe condition was in the cerulein group,mainly characterized by edema.The serum biochemical index levels of the cerulein and L-arginine groups decreased at 48 hours,indicating that these two models may have a tendency to self-heal and belong to a self-limiting disease course.The serum biochemical index levels of the sodium taurocholate group decreased slowly after 12 hours.Therefore,pancreatic injury in the sodium taurocholate group might not be relieved after 48 hours or longer.

To compare the clinical efficacy of catheter-guided thrombolysis and catheter-guided thrombectomy in the treatment of high-risk pulmonary embolism / 中国医师进修杂志

Objective:To compare the efficacy of catheter-directed thrombolysis versus catheter-directed thrombectomy for high-risk pulmonary embolism.Methods:The clinical data of 105 patients with high-risk pulmonary embolism from April 2020 to January 2023 in Hebei China Petroleum Central Hospital were retrospectively analyzed. Among them, 52 patients were treated with catheter-directed thrombolysis (thrombolysis group), and 53 patients were treated with catheter-directed thrombectomy (thrombectomy group). The efficacy, symptom relief time, oxygen saturation recovery time, mortality rate, Qanadli embolic index, pulmonary artery pressure and complications were compared between two groups.Results:There were no statistical differences in total effective rate, symptom relief time, oxygen saturation recovery time, mortality rate and total incidence of complications between two groups ( P>0.05). Compared with before treatment, the Qanadli embolic index and pulmonary artery pressure after treatment in thrombolysis group and thrombectomy group were significantly lower, thrombolysis group: 22.08 ± 8.57 vs. 45.18 ± 13.27 and (24.18 ± 5.19) mmHg (1 mmHg = 0.133 kPa) vs. (34.15 ± 6.22) mmHg, thrombectomy group: 23.11 ± 8.62 vs. 44.82 ± 13.14 and (23.66 ± 5.02) mmHg vs. (34.89 ± 6.27) mmHg, and there were statistical differences ( P<0.01); but there was no statistical difference the Qanadli embolic index and pulmonary artery pressure before and after treatment between two groups ( P>0.05). Conclusions:In patients with high-risk pulmonary embolism, both catheter-directed thrombolysis and catheter-directed thrombectomy have good efficacy and can promote the relief of clinical symptoms and the recovery of oxygen saturation, improving the prognosis.

AO/OTA 31-A3 intertrochanteric fracture intramedullary nail therapy: comparison of the efficacy of long and short nails / 中华骨科杂志

Objective:To explore the efficacy of long intramedullary nails versus short intramedullary nails in the treatment of AO/OTA 31-A3 intertrochanteric fractures.Methods:A retrospective analysis was conducted on 60 patients with AO/OTA 31-A3 intertrochanteric femur fractures treated between March 2019 and August 2022. The patients were randomly divided into two groups (the long nail group and the short nail group). Thirty-four patients were treated with long intramedullary nails, including 16 males and 18 females, aged 68.41±17.84 years old (range 31-96 years). Twenty-six patients were treated with short intramedullary nails, including 13 males and 13 females, aged 72.23±13.97 years old (range 31-90 years). The causes of injury, fracture classification (AO/OTA classification), intraoperative blood loss, operation time, fracture healing time, imaging indexes (fracture reduction quality, postoperative neck trunk angle, and medial support), Harris score of the hip joint at the last follow-up, one-year mortality rates and complications were compared between the two groups.Results:The follow-up time was 24.26±6.67 months in the long nail group and 24.31±5.60 months in the short nail group, and the general information of the two groups were comparable. Between the long nail and short nail group, the intraoperative blood loss was 281.47±235.28 ml vs. 121.92±84.14 ml and the operation time was 110.44±24.63 min vs. 81.15±28.54 min with significant differences ( P<0.05). While the length of hospital stay was 12.35±4.81 d vs. 10.89±4.30 d, the good rate of fracture reduction was 55.9% vs. 61.53%, the fracture healing time was 120.44±16.43 d vs. 128.07±18.33 d, the presence rate of medial support was 67.6% vs. 79.4%, and the excellent rate of Harris score was 65.4% vs. 65.4% with no significant difference between the two groups ( P>0.05). One-year mortality rates was 5.3% vs. 7.1% and complications was 11.7% vs. 15.4% with no significant difference between the two groups ( P>0.05). Conclusion:Both long intramedullary nails and short intramedullary nails are effective in the treatment of AO/OTA 31-A3 intertrochanteric femur fractures. However, surgical time and intraoperative blood loss was less in the short nail group.

Advances in Comparative Medical Research on Anatomy and Histological Structure of Intervertebral Discs in Humans and Other Animals / 实验动物与比较医学

The 2023 China Health Report on Spine Degeneration noted a significant increase in lumbar surgery among patients under 35 years old in recent years, indicating a trend towards younger onset of cervical and lumbar diseases. Lumbar intervertebral disc herniation has become a major concern, making the study of disc degeneration pathogenesis and treatment methods clinically significant. At present, human intervertebral disc diseases are primarily diagnosed through imaging due to the challenges of obtaining tissue samples from the spine. Therefore, experimental animals have emerged as alternative research subjects because they are cost-effective, have short experimental cycles, and are easily accessible. Given the structural and physiological differences between human and other animal intervertebral discs, comparing their anatomy and histological characteristics forms the foundation of research into human disc degeneration. The purpose of this paper is to collect and review relevant studies on anatomical and histological structures of intervertebral discs in different animals and conduct a comparative analysis from four aspects, namely, intervertebral disc height, lumbar disc geometry, lumbar disc cartilaginous endplate characteristics, and extracellular matrix components. The results show that humans, kangaroos, sheep, pigs, and rats exhibit similar relative heights between the sixth and seventh cervical vertebrae. Mice possess lumbar disc geometries most akin to humans. Compared to other animals, humans have the thickest cartilaginous endplates and the lowest cell densities. The collagen within the fibrous annulus differs most notably in pigs compared to humans, while water content in the nucleus pulposus is consistent across pigs, sheep, rabbits, rats, and humans. Additionally, this paper describes the commonalities and discrepancies in disc degeneration manifestations between humans and animals, and summarizes modeling methods for disc degeneration in different experimental animals. Ultimately, the aims of this paper is to provide fundamental data for selecting suitable experimental animal models for the study of intervertebral disc degeneration.

Comparison and inspiration of life education for Chinese and American university students / 中国医学伦理学

Life education is an important course for cultivating students’ comprehensive quality， shaping their personality， and inheriting civilization. This paper compared the historical evolution， teaching contents， and practical approaches of life education between Chinese and American university students， and summarized the following problems faced by life education for Chinese university students： national legislative support and financial support can still be improved； there were few independent life education courses offered in colleges and universities and lack of practical activities； education on setbacks， adversity， and life values， and the students’ ability to independently solve difficulties needed to be improved； the lack of death education and other main challenges. Afterwards， this paper summarized the development of life education in the United States， life education courses were widely and comprehensively offered and had a long history； the content emphasized education on character， setbacks， and safety， more importantly， guided students to face life and death， and practical courses such as end-of-life care drills were provided to establish a positive outlook on life and death for students； the government had introduced laws and regulations to support， and families attached importance to cultivating children’s self-care ability， Finally， it proposed that the life education of Chinese university students should be based on their own cultural and social background： universities should seek breakthroughs in the construction of life education courses， society should form a joint effort to create the atmosphere of life education， and university students should reflect on life education issues independently.

Exploration on the Paths of Traditional Chinese Medicine Constitution Intervention to Improve the Quality of Life：Based on the Perspective of Configuration / 中医杂志

ObjectiveTo adapt to the dynamic multidimensional changes in traditional Chinese medicine （TCM） constitution， the paths of improving the quality of life through TCM constitution intervention are proposed from a configuration perspective. MethodsFive hundred and nine subjects were included in the study， all of whom voluntarily participated in and completed TCM constitution interventions， and completed 60-item Constitution in Chinese Medicine Questionnaire （CCMQ） （including 9 subscales： neutral type， qi deficient type， yang deficient type， yin deficient type， phlegm-dampness type， damp-heat type， blood stasis type， qi stagnation type， and special constitution type） to evaluate the TCM constitution， and the Short Form Health Questionnaire （SF-36） in Chinese version （including overall， physical component scores （PCS）， and mental component scores （MCS）） before and 6 months after the intervention to evaluate the quality of life. The necessary condition analysis （NCA） and fuzzy set qualitative comparative analysis （fsQCA） were used to explore the necessary conditions and advantage configurations for improving the overall， physical and mental quality of life of TCM constitution dimension changes. ResultsThe results of NCA showed that the changes in the scores of neutral type and qi stagnation type can serve as necessary conditions for improving the SF-36 overall quality of life scores （P＜0.05）. The changes in the scores of neutral type and blood stasis type can serve as necessary conditions for improving PCS scores. The changes in scores of the other 7 types can serve as necessary conditions for improving MCS scores. The fsQCA results showed that the necessary consistency of a change in a particular physical subscale score alone did not reach to a necessary condition for a change in SF-36 total score， PCS score， and MCS score （consistency ＜ 0.9 for all）， so the results of NCA were considered. The results of configuration analysis found that 6 configurations were included in increasing the overall quality of life scores and PCS scores， and 7 in increasing the MCS scores， with overall consistency ＞ 0.7. Improving the overall quality of life scores required a focus on lowering the qi deficient type scores， or reducing the yang deficient type scores while increasing the neutral type scores； reducing the scores of phlegm-dampness type and qi stagnation type is beneficial for improving the PCS scores； increasing the neutral type scores and reducing the scores of deficient type， yang deficient type， phlegm-dampness type， and stagnation type is beneficial for increasing MCS scores. ConclusionTCM constitution interventions can improve physical， mental and overall quality of life， and its improvement in the mental domain of quality of life is closely related to the paths of overall quality of life. In order to improve the quality of life， in addition to increasing the tendency of the neutral type， more focused and targeted measures should also be taken to decrease the degrees of qi deficient type， yang deficient type， qi stagnation type， and phlegm-dampness type.

Efficacy of repetitive transcranial magnetic stimulation in the treatment of negative symptoms in patients with schizophrenia / 中国基层医药

Objective:To investigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of negative symptoms in patients with schizophrenia and its effect on brain-derived neurotrophic factor (BDNF).Methods:A total of 130 patients with negative symptoms of schizophrenia who received treatment at The Third Hospital of Quzhou from March 2021 to March 2023 were included in this randomized controlled study. They were divided into a control group and a study group ( n = 65 per group). Both groups of patients were treated with antipsychotic drugs. Based on this, patients in the study group were treated with high-frequency rTMS, while those in the control group were treated with pseudo-rTMS. After 8 weeks of treatment, Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms (SANS), and Personal and Social Performance Scale (PSP) scores were evaluated in each group before and after treatment. Serum BDNF levels were compared between the two groups before and after treatment. Adverse reactions were observed during the treatment. Results:After 8 weeks of treatment, the PANSS negative subscale score and SANS score in the study group were (16.45 ± 3.98) points and (35.41 ± 6.29) points, respectively, which were significantly lower than (20.08 ± 4.16) points and (41.76 ± 7.36) points in the control group ( t = -7.46, -6.85, both P < 0.05). PSP score in the study group was (66.85 ± 8.93) points, which was significantly higher than (58.79 ± 8.28) points in the control group ( t = 5.62, P < 0.001). There were no significant differences in PANSS positive subscale score, general psychopathology scale score or total score between the two groups (all P > 0.05). After 8 weeks of treatment, the serum BDNF level in the study group was (12.05 ± 2.13) μg/L, which was significantly higher than (8.86 ± 1.94) μg/L in the control group ( t = 9.73, P < 0.001). There was no significant difference in the incidence of adverse reactions during the treatment period between the two groups ( P > 0.05). Serum BDNF level was negatively correlated with PANSS and SANS scores ( r = -0.81, -0.85, both P < 0.001), while it was positively correlated with PSP score ( r = 0.82, P < 0.001). Conclusion:High-frequency rTMS can effectively alleviate the negative symptoms of schizophrenia, increase the secretion of BDNF, and be highly safe.

Efficacy of Tanzhuo Decoction in the treatment of early diabetic nephropathy in patients with type 2 diabetes mellitus and its effect on cystatin C, C-reactive protein, urinary albumin excretion rate, and creatinine clearance rate / 中国基层医药

Objective:To investigate the efficacy of Tanzhuo Decoction in the treatment of early diabetic nephropathy in patients with type 2 diabetes mellitus and its effect on cystatin C (Cys-C), C-reactive protein (CRP), urinary albumin excretion rate (UAER), and creatinine clearance rate (CCr). Methods:Eighty patients with type 2 diabetes mellitus complicated by early diabetic nephropathy who received treatment at Maanshan Hospital of Traditional Chinese Medicine from 2019 to 2021 were included in this randomized controlled study. They were divided into a control group ( n = 40) and a treatment group ( n = 40) using the random number table method. Patients in the control group received conventional therapy including blood glucose and blood pressure control, while those in the treatment group received Tangzhuo Decoction in addition to the same treatment as that given to the control group. Both groups of patients were treated for 30 days. The clinical efficacy as well as pre- and post-treatment Cys-C, CRP, UAER, and CCr were compared between the two groups. Results:The total response rate in the treatment group was 92.5% (37/40), which was significantly higher than 75.0% (30/40) in the control group ( χ2 = 4.50, P < 0.05). After treatment, Cys-C, CRP, and UAER in the treatment group were (2.04 ± 0.08) mg/L, (3.97 ± 1.71) mg/L, and (91.18 ± 18.68) μg/min, respectively, which were significantly decreased compared with those before treatment ( t = 12.14, 5.59, 4.73, all P < 0.05). After treatment, CCr in the treatment group was (56.3 ± 5.01) mL/min, which was significantly increased compared with that before treatment ( t = -8.56, P < 0.05). After treatment, Cys-C, CRP, and UAER in the control group were (2.17 ± 0.04) mg/L, (4.66 ± 1.47) mg/L, and (103.93 ± 22.62) μg/min, respectively, which were significantly decreased compared with those before treatment ( t = 4.05, 5.00, 2.24, all P < 0.05). After treatment, CCr in the control group was (45.9 ± 4.9) mL/min, which was significantly increased compared with that before treatment ( t = -3.98, P < 0.05). There were significant differences in Cys-C, UAER, and CCr between the treatment and control groups ( t = -7.42, -2.29, 7.82, all P < 0.05). Conclusion:Tanzhuo Decoction for the treatment of early diabetic nephropathy in patients with type 2 diabetes mellitus has a definite effect. It can effectively reduce levels of Cys-C and UAER, reduce inflammatory reactions, improve kidney function, and delay the progression of kidney injury.

Therapeutic effect of acupoint pressing acupuncture combined with moxibustion at Baihui acupoint on infantile cold and nasal obstruction caused by exogenous wind and cold / 中国基层医药

Objective:To investigate the clinical efficacy of acupoint pressing acupuncture combined with moxibustion at Baihui acupoint on infantile cold and nasal obstruction caused by exogenous wind and cold. Methods:This study included a total of 120 children with exogenous wind and cold-induced infantile cold and nasal obstruction who were treated at the Jinhua Maternal & Child Health Care Hospital from February 2021 to May 2022. They were divided into three groups using a random number table method, namely the acupoint pressing acupuncture group, the moxibustion group, and the combined therapy group, each containing 40 children. Based on routine treatment, children in the acupoint pressing acupuncture group received acupoint ( Yintang, Shuangyingxiang, Shuangbitong) pressing acupuncture treatment, while those in the moxibustion group underwent mild moxibustion at Baihui acupoint, and those in the combined therapy group underwent acupoint ( Yintang, Shuangyingxiang, Shuangbitong) pressing acupuncture Baihui combined with mild moxibustion at Baihui acupoint. The clinical efficacy of each group was evaluated. At 2, 24, 48, and 72 hours after treatment, differences in nasal congestion symptom scores were compared among the three groups. Sleep quality was also compared among the three groups before and after treatment. Results:The response rate in the combined therapy group was 92.5% (37/40), which was significantly higher than 75% (30/40) in the acupoint pressing acupuncture group and 65% (26/40) in the moxibustion group ( χ2 = 4.50, 9.04, both P < 0.05). At 2, 24, 48, and 72 hours after treatment, the nasal congestion symptom score in the combined therapy group was (2.05 ± 0.55) points, (1.80 ± 0.64) points, (1.33 ± 0.59) points, and (0.90 ± 0.18) points, respectively, while it was (2.43 ± 0.59) points, (2.15 ± 0.57) points, (1.73 ± 0.84) points, and (1.18 ± 0.80) points, respectively, in the acupoint pressing acupuncture group, and (2.50 ± 0.59) points, (2.13 ± 0.78) points, (1.88 ± 0.81) points, and (1.45 ± 0.81) points, respectively, in the moxibustion group. At the above-mentioned time points, the nasal congestion symptom score was statistically significant among the three groups ( F = 3.15, 9.27, 16.17, 20.22, all P < 0.05). After treatment, daytime sleep duration and nocturnal sleep duration in the combined therapy group were (3.41 ± 0.31) hours and (12.36 ± 1.17) hours, respectively, which were significantly longer than (2.95 ± 1.07) hours and (11.33 ± 1.38) hours in the acupoint pressing acupuncture group and (2.93 ± 0.98) hours and (11.21 ± 1.93) hours in the moxibustion group ( F = 6.37, 12.31, both P < 0.05). Nocturnal wake time, the number of night wakings, and sleep onset time in the combined therapy group were (18.74 ± 2.21) minutes, (1.64 ± 0.18) times, and (15.43 ± 2.03) minutes, respectively, which were significantly shorter or less than (21.13 ± 3.78) minutes, (2.15 ± 0.66) times, and (17.63 ± 5.24) minutes in the acupoint pressing acupuncture group, and (20.53 ± 2.90) minutes, (2.11 ± 0.32) times, and (17.22 ± 2.88) minutes in the moxibustion group ( F = 15.93, 15.36, 10.11, all P < 0.05). There was a significant difference in sleep quality score among the three groups ( F = 23.45, P < 0.05). Conclusion:The combination of acupoint pressing acupuncture and moxibustion at Baihui acupoint is highly effective against infantile cold and nasal obstruction caused by exogenous wind and cold. The combined therapy can alleviate the symptoms of nasal congestion in children and improve sleep quality.

Digital medical 3D technology versus traditional 2D technology in the diagnosis and treatment of solid abdominal tumors in children / 中国基层医药

Objective:To investigate the value of digital medical 3D technology versus traditional 2D technology in the diagnosis and treatment of solid abdominal tumors in children. Methods:A total of 80 children with solid abdominal tumors who received surgical treatment guided by digital medical 3D technology at Guigang People's Hospital from January 2018 to January 2022 were included in the observation group. An additional 80 children with solid abdominal tumors who received surgical treatment guided by traditional 2D technology at the same hospital from January 2014 to December 2017 were included in the control group. Clinical efficacy was compared between the two groups.Results:The surgical time, intraoperative blood loss, postoperative exhaust time, postoperative hospital stay in the observation group were (111.8 ± 28.9) minutes, (26.8 ± 25.2) mL, (2.2 ± 1.2) days, (7.5 ± 1.4) days, respectively, which were significantly shorter or less than those in the control group [(193.1 ± 66.0) minutes, (86.2 ± 47.0) mL, (3.7 ± 0.9) days, (12.2 ± 3.5) days, t = 7.00, 6.88, 5.87, 7.53, all P < 0.05]. The complete surgical resection rate in the observation group was significantly higher than that in the control group [92.5% (74/80) vs. 81.3% (65/80), χ2 = 4.44, P < 0.05]. The incidence of complications in the observation group was significantly lower than that in the control group [6.3% (5/80) vs. 16.3% (13/80), χ2 = 4.00, P < 0.05]. Conclusion:The utilization of digital medical 3D technology in the surgical treatment of solid abdominal tumors in children can markedly decrease surgical time, reduce intraoperative blood loss, promote postoperative recovery, achieve a high surgical resection rate, and minimize postoperative complications.

Research on Influencing Factors of Medical Liability in Medical Accidents Appraisal Based on Qualitative Comparative Analysis / 中国医院管理

Objective Explore the key factors and the type of combined role path of medical accident appraisal con-clusion for the medical responsibility,and provide solution countermeasures for the reduction of medical accidents and the construction of a harmonious doctor-patient relationship.Methods Qualitative comparative analysis(QCA)was used to study 125 cases of medical accident appraisal center in a certain province from 2015 to 2019.The fsQCA software was used to detect the necessity of single factor and the configuration path of multiple factors.Results There were three solutions to the configuration of medical liability for medical accidents,with an solution consisten-cy of 0.853 659 and an overall coverage rate of 0.603 448;draw three paths for the conclusion of medical liability,and summarize three types of combined effects:medical institution management vacancy type,medical staff techni-cal negligence type,and comprehensive effect type of both doctors and patients.Conclusion Attaching importance to institutional management is the basis for evading medical liabilities,standardizing medical staff's diagnosis and treatment behavior is the core to reduce medical accidents,and strengthening humanistic concepts and doctor-pa-tient communication are the key to prevent medical accidents.

Cytotoxic effects of crotoxin from Crotalus durissus terrificus snake in canine mammary tumor cell lines

Background: Mammary gland tumors are the most prevalent neoplasm in intact female dogs, and they are good natural models to study comparative oncology. Most canine mammary malignancies, as in women, are commonly refractory to conventional therapies and demand continuous new therapeutic approaches. Crotalus durissus terrificus, also called rattlesnake, has more than 60 different proteins in its venom with multiple pharmaceutical uses, such as antitumor, antiviral, and antimicrobial action. Crotoxin, a potent β-neurotoxin formed by the junction of two subunits, a basic subunit (CB-PLA2) and an acidic subunit (crotapotin), has already been reported to have anticancer properties in different types of cancers. Methods: In this work, we describe the cytotoxic potential of crotoxin and its subunits compared to doxorubicin (drug of choice) in two canine mammary carcinoma cell lines. Results: Crotoxin, CB-PLA2, crotalic venom, and doxorubicin decreased cell viability and the ability to migrate in a dose-dependent manner, and crotapotin did not present an antitumoral effect. For all compounds, the predominant cell death mechanism was apoptosis. In addition, crotoxin did not show toxicity in normal canine mammary gland cells. Conclusion: Therefore, this work showed that crotoxin and CB-PLA2 had cytotoxic activity, migration inhibition, and pro-apoptotic potential in canine mammary gland carcinoma cell lines, making their possible use in cancer research.

Comparison between the ion-specific electrode and SPADNS methods for analysis of fluoride concentration in the water supply

The maintenance of adequate fluoride (F) concentration in the public water supply is fundamental for ensuring that the community use of F can reach the maximum benefit for caries control and minimum risk for dental fluorosis. Thus, surveillance systems must use accurate and valid analytical methods to determine F concentration and, according to the literature, give preference to the ion-specific electrode (F- ISE) analysis. Aim: The objective of this study was to compare the accuracy of the ISE and SPADNS methods in the determination of the F concentration in the same water sample. Methods: Duplicate water samples were taken from 30 sampling sites in the municipality of Maringá, state of Paraná, monthly for 12 months, totaling 276 samples. An aliquot was analyzed by the FOP-UNICAMP Oral Biochemistry laboratory, using the F- ISE method, and the other one, by the SANEPAR laboratory in Maringá/PR, using the SPADNS method. Descriptive analysis and Pearson's correlation test were applied, with a significant level of p<0.05. Results: Results were expressed as ppm F (mg F/L), and a very strong positive correlation (r= 0.91; p<0.001) was detected between the two methods of analysis. Conclusion: Our findings suggest that the determination of f luoride concentration in water can be made with accuracy by the SPADNS method, a standardized analysis protocol

Comparison of dynesys and hybrid system for multi-segmental ldd / Comparação entre dynesys e sistema híbrido para ldd multissegmental

ABSTRACT Objective: To compare effectiveness of Dynesys and hybrid system in treating patients with multi-segmental lumbar degenerative disease (LDD). Methods: Patients involved in this retrospective study were divided into Dynesys (n = 22) and Hybrid (n = 13) groups. Clinical outcomes were evaluated using Oswestry Disability Index (ODI), and Visual Analogue Scale (VAS). Radiologic evaluations included X-ray, MRI, and CT. Furthermore, different complications were analyzed. Results: At the last follow-up, ODI and VAS of each group were improved (p < 0.05), and the range of motion (ROM) of operating segments decreased. However, Dynesys group preserved a larger extent of ROM at the final follow-up (p < 0.05). ROM of the upper adjacent segment was increased in both groups (p < 0.05), while the disc heights were decreased at the final follow-up (p < 0.05). Besides, Dynesys group had a more obvious decrease in the disc height of dynamic segments (p < 0.05). No significant difference existed in complications between both groups (p > 0. 05). Conclusion: In our study, similar satisfactory results were obtained in both groups. Both surgical procedures can be employed as effective treatments for middle-aged and physically active patients with multi-segmental LDD. Level of Evidence III; Retrospective Comparative Study.

RESUMO Objetivo: Comparar a eficácia do Dynesys e do sistema híbrido no tratamento de pacientes com doença degenerativa lombar multissegmentar (DLD). Métodos: Os pacientes envolvidos neste estudo retrospectivo foram divididos em grupos Dynesys (n = 22) e Híbrido (n = 13). Os desfechos clínicos foram avaliados por meio do Oswestry Disability Index (ODI) e da Escala Visual Analógica (EVA). As avaliações radiológicas incluíram radiografia, ressonância nuclear magnética (RNM) e tomografia computadorizada. Ademais, diferentes complicações foram analisadas. Resultados: No acompanhamento final, o ODI e a EVA de todos os grupos melhoraram (p < 0,05), e houve diminuição da amplitude de movimento (ADM) dos segmentos operacionais. No entanto, o grupo Dynesys preservou uma maior extensão da ADM no acompanhamento final (p < 0,05). A ADM do segmento superior adjacente foi ampliada em ambos os grupos (p < 0,05), enquanto as alturas dos discos foram reduzidas no acompanhamento final (p < 0,05). No entanto, o grupo Dynesys apresentou uma redução mais evidente na altura do disco dos segmentos dinâmicos (p < 0,05). Não houve diferença significativa nas complicações entre esses dois grupos (p > 0,05). Conclusão: Neste estudo, resultados satisfatórios semelhantes foram obtidos em ambos os grupos. Ambos os procedimentos cirúrgicos podem ser empregados como tratamentos eficazes para pacientes de meia-idade e fisicamente ativos com LDD multissegmentar. Nível de Evidência III; Estudo Retrospectivo Comparativo.

Ethno-racial segregation in São Paulo and London metropolitan regions: reflections on a comparative study / A segregação étnico-racial nas regiões metropolitanas de São Paulo e Londres: reflexões sobre um estudo comparativo / Segregación étnico-racial en las regiones metropolitanas de San Pablo y Londres: reflexiones sobre un estudio comparativo

Abstract This paper analyzes ethno-racial residential segregation in two large metropolitan areas across the Global North and South: London (UK) and São Paulo (Brazil). Residential segregation is measured and mapped using global and local spatial segregation indices that portray different spatial dimensions across scales. To interpret results, the study adopted a relational approach that juxtaposes global figures and local variations of segregation, complementary dimensions of segregation (dissimilarity and exposure/isolation), multiple scales of segregation, and location patterns of different ethno-racial groups. Results indicate that London and São Paulo metropolitan regions have similar, although inverse, core-periphery patterns of ethno-racial segregation. The findings also revealed that segregation levels are higher for London than São Paulo across scales and dimensions, indicating that, against common assumptions, London is more ethno-racially segregated than São Paulo. These findings are discussed in the context of existing literature, exploring similarities and differences between ethno-racial segregation in the two metropolitan regions. The paper concludes with a discussion on the relevance of the comparative findings for segregation studies, and a reflection on future studies on urban segregation.

Resumo Este artigo analisa a segregação residencial do ponto de vista étnico-racial em duas grandes regiões metropolitanas localizadas no Sul e Norte Globais: Londres (Reino Unido) e São Paulo (Brasil). Utilizaram-se índices espaciais globais e locais para mapear e mensurar as diferentes dimensões espaciais e escalas da segregação étnico-racial nas duas metrópoles. O estudo adotou uma abordagem relacional para a interpretação dos resultados que justapõe resultados globais e variações locais da segregação, dimensões espaciais complementares (dissimilaridade e exposição/isolamento), múltiplas escalas geográficas e padrões de localização espacial dos diferentes grupos étnico-raciais. Os resultados indicam que as regiões metropolitanas de Londres e São Paulo apresentam padrões espaciais de segregação centro-periferia similares, mas inversos. Os resultados também relevaram que os níveis de segregação de Londres são mais altos do que os de São Paulo, indicando que contraintuitivamente Londres é mais segregada étnico-racialmente do que São Paulo. Esses resultados são discutidos no contexto da literatura, explorando as similaridades e diferenças entre as duas regiões metropolitanas. O artigo conclui com uma discussão sobre a relevância dos resultados e uma reflexão sobre a agenda futura para os estudos sobre a segregação urbana.

Resumen Este artículo analiza la segregación residencial desde un punto de vista étnico-racial en dos grandes regiones metropolitanas ubicadas en el Sur y el Norte Global: Londres (Reino Unido) y San Pablo (Brasil). Se usaron índices espaciales globales y locales para mapear y medir las diferentes dimensiones espaciales y escalas de la segregación étnico-racial en las dos metrópolis. El estudio adoptó un enfoque relacional para interpretar los resultados que yuxtapone resultados globales y variaciones locales de segregación, dimensiones espaciales complementarias (disimilaridad y exposición/aislamiento), múltiples escalas geográficas y patrones de ubicación espacial de diferentes grupos etnorraciales. Los resultados indican que las regiones metropolitanas de Londres y San Pablo presentan patrones espaciales similares, pero inversos, de segregación centro-periferia. Los resultados también revelaron que los niveles de segregación en Londres son más altos que en San Pablo, lo que indica que, contraintuitivamente, Londres está más segregada étnico-racialmente que San Pablo. Estos resultados se discuten en el contexto de la literatura, explorando las similitudes y diferencias entre las dos regiones metropolitanas. El artículo concluye con una discusión sobre la relevancia de los resultados y una reflexión sobre la agenda futura de estudios sobre segregación urbana.

Estudo estrutural e comparativo entre Sirtuínas 2 de diferentes espécies de Leishmania / Structural and comparative study between Sirtuins 2 of different species of Leishmania by means of Comparative Modeling and Molecular Dynamic

As leishmanioses são doenças negligenciadas que afetam mais de um bilhão e meio de pessoas ao redor do mundo, principalmente nos países em desenvolvimento, provocando grandes impactos socioeconômicos. Os fármacos disponíveis para o tratamento dessas doenças são ineficazes e apresentam graves efeitos adversos. O processo de pesquisa de novos fármacos envolve, entre outras coisas, a seleção de alvos bioquímicos essenciais para a sobrevivência e desenvolvimento do agente causador. Neste sentido, a Sirtuína 2, uma enzima epigenética com atividade hidrolase essencial para a sobrevivência dos parasitas do gênero Leishmania se apresenta como um alvo validado na busca de novos fármacos contra essas parasitoses. O planejamento de fármacos baseado na estrutura do receptor requer o conhecimento da estrutura tridimensional da proteína alvo. Desta forma, a elucidação estrutural e um estudo minucioso das Sirtuínas das várias espécies do gênero Leishmania apresenta-se como uma importante abordagem na aplicação desta estratégia na busca por agentes quimioterápicos. Até o momento, na família Trypanosomatidae, a única estrutura tridimensional resolvida experimentalmente de uma enzima Sirtuína 2 é a da espécie L. infantum. Assim, este trabalho aplicou a abordagem de Modelagem Comparativa utilizando o software Modeller na construção de modelos da Sir2rp1 das espécies L. infantum, L. major e L. braziliensis, cujas sequências de aminoácidos foram extraídas do banco de dados UNIProt. Os modelos construídos foram validados por meio da função de escore DOPE do Modeller e dos servidores PROCHECK, MolProbity e QMEAN, avaliando sua qualidade estereoquímica e seu enovelamento. Os ligantes naturais da enzima foram sobrepostos nos modelos construídos por alinhamento estrutural utilizando o software PyMol e os complexos validados foram submetidos a simulações de Dinâmica Molecular através do pacote GROMACS. Os complexos refinados foram então analisados por meio dos softwares PyMol e LigPlotPlus e dos pacotes GROMACS e gmx_MMPBSA, e foram estudados os sítios de ligação dos substratos e os resíduos de aminoácidos relevantes envolvidos em sua ligação e reconhecimento. A Modelagem Comparativa da Sirtuína 2 humana e seus homólogos das espécies L. infantum, L. major e L. braziliensis, as simulações de Dinâmica Molecular realizadas com os modelos enzimáticos construídos e validados complexados com seus ligantes naturais, os cálculos de energia de interação entre os modelos e seus substratos e o estudo estrutural comparativo realizado entre eles nos fornecem uma base teórica para a busca de novos inibidores da Sirtuína 2 que sejam mais seletivos e potentes contra as enzimas parasitárias, abrindo caminho para o desenvolvimento de candidatos a fármacos leishmanicidas mais seguros e eficazes

Leishmaniasis are neglected diseases that affect more than one and a half billion people around the world, mainly in developing countries, causing major socioeconomic impacts. The drugs available for the treatment of these diseases are ineffective and have serious adverse effects. The process of researching new drugs involves, among other things, the selection of biochemical targets essential for the survival and development of the causative agent. In this sense, Sirtuin 2, an epigenetic enzyme with hydrolase activity essential for the survival of parasites of the Leishmania genus, presents itself as a validated target in the search for new drugs against these parasites. Structure-Based Drug Design requires knowledge of the three-dimensional structure of the target protein. In this way, structural elucidation and a detailed study of Sirtuins from various species of the genus Leishmania presents itself as an important approach in the application of this strategy in the search for chemotherapeutic agents. To date, in the Trypanosomatidae family, the only experimentally resolved three-dimensional structure of a Sirtuin 2 enzyme is that of the species L. infantum. Thus, this work applied the Comparative Modeling approach using the Modeller software in the construction of Sir2rp1 models of the species L. infantum, L. major and L. braziliensis, whose amino acid sequences were retrieved from the UNIProt database. The constructed models were validated using Modeller's DOPE score function and the PROCHECK, MolProbity and QMEAN servers, evaluating their stereochemical quality and folding. The enzyme's natural ligands were superimposed on the built models by structural alignment using the PyMol software and the validated complexes were subjected to Molecular Dynamics simulations using the GROMACS package. The refined complexes were then analyzed using the PyMol and LigPlotPlus softwares and the GROMACS and gmx_MMPBSA packages, and the substrate binding sites and relevant amino acid residues involved in their binding and recognition were studied. The Comparative Modeling of human Sirtuin 2 and its homologues from the species L. infantum, L. major and L. braziliensis, the Molecular Dynamics simulations carried out with the constructed and validated enzymatic models complexed with their natural ligands, the interaction energy calculations between the models and their substrates and the comparative structural study carried out between them provide us with a theoretical basis for the search for new Sirtuin 2 inhibitors that are more selective and potent against the parasitic enzymes, paving the way for the development of safer and more effective leishmanicidal drug candidates

Modelos legislativos e sistemas de políticas esportivas:brasil e portugal em perspectiva comparada / Modelos legislativos y sistemas de política deportiva: brasil y portugal en perspectiva comparativa / Legislative models and sports policy systems: brazil and portugal in comparative perspective

Resumo Este artigo aborda as normas gerais do esporte no Brasil e Portugal a partir de uma perspectiva comparativa. Parte-se do pressuposto que o esporte deve ser foco de atenção estatal e das políticas públicas como estratégia de desenvolvimento da cidadania. O objetivo principal é analisar comparativamente a legislação esportiva de Brasil e Portugal, sobretudo os atos que estabeleceram as normas gerais para este setor em âmbito nacional. Para isso, realizou-se uma pesquisa descritivo-analítica de abordagem qualitativa e abrangência exploratória, organizada a partir de trabalho de campo e análise e tratamento do material empírico e documental. A análise de conteúdo dos documentos confirmou que no Brasil o financiamento é o tema de destaque na atuação normativa do Estado, ao passo que em Portugal o exercício regulatório é a principal preocupação. Nos dois países foi possível observar o impacto dos megaeventos na esfera legislativa, com a produção de atos excepcionais.

Resumen Este artículo aborda las reglas generales del deporte en Brasil y Portugal, desde una perspectiva comparada. Se parte del supuesto de que el deporte debe ser el foco de atención estatal y de las políticas públicas como estrategia de desarrollo de la ciudadanía. El objetivo principal es analizar comparativamente la legislación deportiva en Brasil y Portugal, especialmente las leyes que establecieron las reglas generales para este sector a nivel nacional. Para ello, se realizó una investigación descriptivo-analítica con enfoque cualitativo y alcance exploratorio, organizada a partir del trabajo de campo y el análisis y tratamiento de material empírico y documental. El análisis de contenido de los documentos confirmó que en Brasil el financiamiento es el tema principal en la acción normativa del Estado, mientras que en Portugal el ejercicio regulatorio es la principal preocupación. En ambos países se pudo observar el impacto de megaeventos en el ámbito legislativo, con la producción de actos excepcionales.

Abstract This article addresses the general rules of sport in Brazil and Portugal, from a comparative perspective. It starts from the assumption that sport should be the focus of state attention and public policies as a citizenship development strategy. The main objective is to comparatively analyze the sports legislation in Brazil and Portugal, especially the acts that established the general rules for this sector at the national level. For this, a descriptive-analytical research with a qualitative approach and exploratory scope was carried out, organized from field work and analysis and treatment of empirical and documental material. The content analysis of the documents confirmed that in Brazil financing is the main issue in the State's normative action, while in Portugal the regulatory exercise is the main concern. In both countries, it was possible to observe the impact of mega-events in the legislative sphere, with the production of exceptional acts.

A comparative analysis between Mexican and Chinese health systems / Un análisis comparativo entre los sistemas de salud de México y China

Abstract Objective: The comparative network analysis of national health macrosystems is an area whose academic development has not reached due relevance if its influence on decision-making related to the design of public health policies is considered; the establishment of comparative elements between two socially, economically and culturally distant countries, such as Mexico and China, is a complex process given the difficulty of locating equivalent evaluation indicators among some of its elements. Materials and methods: The present work reflects on the similarities and dissimilarities between the national health systems, with an impact on the care provided to the most vulnerable population segments, applying a comparative nodes and networks analysis considering social and economic factors. Results: The network analysis shows that, for practical purposes, the nodes considered in the Mexican health system is superior to those nodes identified in the Chinese health system in terms of quality, mainly in nodes such as convenience of the location, using cutting-edge technology in health institutions and the skill and competence of medical personnel; conversely, the Chinese system is superior to the Mexican in terms of efficiency, mainly involuntary co-payment insurance systems to reduce the catastrophic health expenditure of the vulnerable rural population. Conclusions: The conclusions drawn may serve for subsequent studies to identify opportunities for improvement, correlations and/or trends that could be implemented in the Mexican health system, once the pertinent feasibility studies have been carried out.

Resumen Objetivo: El análisis de redes comparativo de macrosistemas nacionales de salud es un ámbito cuyo desarrollo académico no ha alcanzado la relevancia debida si se considera su influencia en la toma de decisiones relativas al diseño de políticas de salud pública. Así, el establecimiento de elementos comparativos entre dos países social, económica y culturalmente distantes, como México y China, es un proceso complejo dada la dificultad de ubicar indicadores equivalentes de evaluación entre algunos de sus elementos. Materiales y método: El presente trabajo reflexiona sobre las similitudes y diferencias entre los mencionados sistemas nacionales de salud, con incidencia en la atención que se brinda a los segmentos poblacionales más vulnerables, aplicando un análisis comparativo de nodos y redes considerando factores sociales y económicos. Resultados: El análisis de red muestra que, para efectos prácticos, los nodos considerados en el sistema de salud mexicano son superiores a los nodos identificados en el sistema de salud chino en términos de calidad, principalmente en nodos como conveniencia de la ubicación, utilizando tecnología de punta en instituciones de salud y la habilidad y competencia del personal médico; Por el contrario, el sistema chino es superior al mexicano en términos de eficiencia, principalmente sistemas de seguro de copago involuntario para reducir el gasto catastrófico en salud de la población rural vulnerable. Conclusiones: Las conclusiones extraídas podrán servir a estudios posteriores para identificar oportunidades de mejora, correlaciones y/o tendencias que pudieran implementarse en el sistema mexicano de salud, una vez efectuados los estudios de viabilidad pertinentes.