[Efficacy of CT-guided percutaneous stylomastoid foramen puncture through the mandibular angle approach and radiofrequency ablation of facial nerve for the treatment of hemifacial spasm].

Objective: To investigate the efficacy of CT-guided percutaneous mandibular angle radiofrequency thermocoagulation (RFT) of facial nerve through stylomastoid foramen for the treatment of hemifacial spasm. Methods: A total of 82 patients with primary facial spasm who underwent CT-guided RFT in the Department of Pain Medicine of Zhejiang Integrated Traditional Chinese and Western Medicine Hospital and Department of Pain Medicine of the First Hospital of Jiaxing from January 2019 to June 2021 were retrospectively analyzed, including 27 males and 55 females, aged 24-85 (59±11) years. All patients were divided into three groups according to the different puncture approaches: anterior mastoid approach group (Group A, n=35), posterior mastoid approach group (Group P, n=25) and mandibular angle approach group (Group M, n=22). The puncture time, the minimum stimulating current inducing the twitch of facial muscles on the affected side, the temperature at the end of RFT and the duration of RFT at this temperature, the total treatment time, as well as the degree of facial paralysis and complications 1 day after operation were compared among the three groups. Results: The puncture time of the Group A, Group P and Group M was (31.0±4.9) min, (31.9±6.5) min and (35.3±5.9) min, respectively, and the difference was statistically significant (P=0.020). The puncture time of the Group M was longer than that of the Group A and P (both P<0.05). The minimum stimulation current inducing the twitch of the affected facial muscle in the three groups was (0.5±0.2) mA, (0.4±0.1) mA and (0.3±0.1) mA, respectively, with a statistically significant difference (P=0.000). The minimum stimulation current in the Group M was less than that in the Group A and P (both P<0.05). The temperature at the end of RFT of the three groups was (78.6±8.1) ℃, (76.6±8.3) ℃ and (67.0±8.4) ℃, respectively, and the difference was statistically significant (P<0.001). The temperature of the Group M was lower than that of the Group A and P (both P<0.05). There were no significant differences among the three groups in the duration of RFT at the final temperature, the total treatment time, and the degree of facial paralysis 1 day after operation (all P>0.05). No hematoma, infection, hearing impairment and other complications occurred in all patients. Conclusion: CT-guided percutaneous RFT through stylomastoid foramen is efficacious in the treatment of hemifacial spasm, and the mandibular angle approach provides better performance.

[Development of a Ranking Tool for Scientificity, Transparency and Applicability of Clinical Practice Guidelines].

Objective: To address the limitations of existing methods and tools for evaluating clinical practice guidelines, we aimed to develop a comprehensive instrument focusing on the three main dimensions of guideline development: scientificity, transparency, applicability. We will use it to rank the guidelines according to the scores. We abbreviated it as STAR, and its reliability, validity and usability were also tested. Methods: A multidisciplinary expert working group was set up, including methodologists, statisticians, journal editors, medical professionals, and others. Scoping review, Delphi methods and hierarchical analysis were used to determine the final checklist of STAR. Results: The new instrument contained 11 domains and 39 items. Intrinsic reliability of each domain was indicated by Cronbach's α coefficient, with a average value of 0.646. The Cohen's kappa coefficients for methodological evaluators and clinical evaluators were 0.783 and 0.618. The overall content validity index was 0.905. The R2 for the criterion validity analysis was 0.76. The average score for usability of the items was 4.6, and the mean time spent to evaluate each guideline was 20 minutes. Conclusion: The instrument has good reliability, validity and evaluating efficiency, and can be used for evaluating and ranking guidelines more comprehensively.

[Effect of RKIP on proliferation and migration of malignant melanoma cells and potential mechanism].

Objective: To explore the effect and mechanism of Rafkinase inhibitor protein (RKIP) on proliferation and migration of malignant melanoma cells in vitro. Methods: The RKIP overexpression and down-regulated stable transfected strains of mouse malignant melanoma cell line B16 were constructed by recombinant lentiviral transfection technique and established as RKIP overexpression group and RKIP down-regulation group, the mouse malignant melanoma B16 cells without any treatment were used as a blank control group, and the proliferation activity and migration ability of each group were detected by cell counting kit-8 (CCK-8) and cell scratch test. The relative expression levels of CyclinD1, Calcium-dependent cell adhesin, Ki-67, Matrix metalloproteinase (MMP)-9, MMP-13, MMP-2 and Phosphatidylethanolamine binding protein (PEBP-1) were detected by quantitative real-time polymerase chain reaction (qPCR). Western blot was used to detect the difference of RKIP expression and the protein expression level of nuclear factor-kappa B (NF-κB) signaling pathway in each group. Results: Comparison of RKIP overexpression group and blank control group shown cell proliferation and migration were significantly inhibited in RKIP overexpression group (0.794±0.038 vs 1.200±0.081) (P<0.001). However, there was no significant difference in cell proliferation between RKIP down-regulation group and blank control group (1.077±0.084 vs 1.200±0.081) (P>0.05), and the cell migration ability of RKIP down-regulation group was significantly higher than that of the blank control group (P<0.001). In addition, there was no significant difference between the RKIP down-regulation group and the blank control group in PEBP-1 expression (P>0.05), while the expression levels of the remaining genes in the RKIP overexpression group were significantly lower than those in the blank control group, and the expression levels in the RKIP down-regulation group were significantly higher than those in the blank control group (P<0.001). Furthermore, the protein level of phosphorylated P65 (p-P65) in RKIP overexpression group was significantly lower than that in blank control group (0.080±0.000 vs 0.236±0.000), and RKIP down-regulation group was significantly higher than that in blank control group (1.139±0.001 vs 0.236±0.000) (both P<0.001). Conclusion: RKIP overexpression can inhibit the proliferation and migration of malignant melanoma cells, which may be related to the regulation of NF-κB signaling pathway-related protein p-P65.

Optimization of pyrethroid and repellent on fabrics against Stegomyia albopicta (=Aedes albopictus) using a microencapsulation technique.

A new approach employing a combination of pyrethroid and repellent is proposed to improve the protective efficacy of conventional pyrethroid-treated fabrics against mosquito vectors. In this context, the insecticidal and repellent efficacies of commonly used pyrethroids and repellents were evaluated by cone tests and arm-in-cage tests against Stegomyia albopicta (=Aedes albopictus) (Diptera: Culicidae). At concentrations of LD50 (estimated for pyrethroid) or ED50 (estimated for repellent), respectively, the knock-down effects of the pyrethroids or repellents were further compared. The results obtained indicated that deltamethrin and DEET were relatively more effective and thus these were selected for further study. Synergistic interaction was observed between deltamethrin and DEET at the ratios of 5 : 1, 2 : 1, 1 : 1 and 1 : 2 (but not 1 : 5). An optimal mixing ratio of 7 : 5 was then microencapsulated and adhered to fabrics using a fixing agent. Fabrics impregnated by microencapsulated mixtures gained extended washing durability compared with those treated with a conventional dipping method. Results indicated that this approach represents a promising method for the future impregnation of bednet, curtain and combat uniform materials.

The association between trauma and melanoma in the Chinese population: a retrospective study.

BACKGROUND: The association between trauma and melanoma has been a controversial issue. OBJECTIVES: To analyse the profiles of melanoma, and to determine whether trauma is associated with development of acral melanoma in the Chinese population. PATIENTS AND METHODS: Retrospective analysis of 685 cases of cutaneous melanoma in the dermatology departments of Xijing Hospital in northwestern China and Xinan Hospital in southwestern China from 1982 to 2011. RESULTS: Of the 685 patients included in the study, 437 (63.8%) suffered from melanoma on the extremities. A total of 104 patients (15.2%) exhibited an association between trauma and melanoma. The primary anatomic sites of the tumours were the upper extremities (17, 16.3%), lower extremities (74, 71.2%) and other sites (13, 12.5%). Among these cases, the extremities were with remarkably higher risks of post-trauma melanoma than the other sites [adjusted odds ratio (OR) 3.968; 95% confidence interval (CI) 2.267-5.592]. Notably, patients in the south part of China were with a stronger risk of post-trauma melanoma on the lower extremities than those in the north (adjusted OR 1.764; 95% CI 1.192-2.666) part. In addition, a significant higher risk of post-trauma melanoma on the extremities was observed in the male gender (adjusted OR 1.848; 95% CI 1.186-2.887). CONCLUSIONS: Our findings provide epidemiological evidence for a potential association between traumatic events and melanoma of the extremities, especially the lower limbs, where a history of trauma is more likely.

Development of a bispecific monoclonal antibody to pesticide carbofuran and triazophos using hybrid hybridomas.

A mouse hybrid hybridoma (tetradoma) was derived from fusing hybridomas producing monoclonal antibody to N-methylcarbamate pesticide carbofuran with hybridomas producing monoclonal antibody to organophosphorus pesticide Triazophos. The prepared tetradoma line (12C1 to 2H12) secreted hybrid immunoglobulin exhibiting parental and bispecific binding characteristics. The effect of relevant physicochemical factors on the immunoassay based on the 12C1 to 2H12 bispecific monoclonal antibody had been studied to optimize the ELISA performance. The developed immunoassay showed that the detection limit (I(20)) were 0.36 and 1.89 ng/mL for triazophos and carbofuran, respectively, without obvious cross-reactivity to other related compounds. Water samples spiked with triazophos at 0.5, 1, and 5 ng/mL or carbofuran at 5, 10, and 20 ng/mL were directly analyzed by the developed ELISA format. The mean recovery of triazophos and carbofuran were 108.1% and 107.5%, with variation coefficient of 15.9% and 17.7%, respectively.