[Correlation of environment temperature with the incidence of testicular torsion].

Objective： To explore the influence of environment temperature on the incidence of testicular torsion. METHODS: We collected the clinical data on 172 cases of testicular torsion diagnosed in the Second Hospital of Hebei Medical University from December 2013 to December 2020. According to the local environment temperature on the day of onset, we divided the patients into groups A (below 0℃), B (0－10℃), C (10－20℃) and D (above 20℃), and compared the incidence rates of testicular torsion among the four groups, followed by correlation analysis. RESULTS: The incidence rate of testicular torsion was 12.8% (n = 22) in group A, 35.5% (n = 61) in B, 34.9% (n = 60) in C and 16.9% (n = 29) in D, the highest at 0－10℃ in group B, with statistically significant difference among the four groups (χ2 = 29.07, P <0.001). Spearman correlation analysis indicated that the incidence of testicular torsion was negatively correlated with the environment temperature (r = －0.261, P <0.01), with no statistically significant difference among different seasons (χ2 = 5.349, P >0.05), but higher in autumn and winter than in the other two seasons. CONCLUSION: The incidence of testicular torsion is negatively correlated with the environment temperature, elevated when the temperature decreases, but has no statistically significant difference among different seasons, though relatively higher in autumn and winter.

The food security risks in the Yangtze River Delta of China associated with water scarcity, grain production, and grain trade.

Grain production consumes a large amount of water and is affected by the degree of water scarcity and participation in the grain trade in various regions. The grain trade has changed the food security risks in regions where grain exports and imports. Therefore, it is crucial to consider regional water scarcity to understand food security risks from the grain trade network. Here, we construct a new framework for measuring regional food security risks associated with water scarcity, grain production, and grain trade based on a cross-city grain trade network combined with virtual water flows to evaluate the regional food security risks in the Yangtze River Delta region (YRD) of China in 2017. The results show that under the current domestic grain trade pattern in China, the YRD and its four provincial-level administrative regions are in a net grain import state. The grain trade within the YRD is concentrated in exports from the two major grain-producing areas of Anhui and Jiangsu to Zhejiang and Shanghai, especially from northern Jiangsu to southeastern Zhejiang. The net import results of virtual blue water in most cities indicate that the YRD has shifted its water resource pressure to other grain exporting regions in China, with Shanghai and Zhejiang being the greatest beneficiaries. Extreme risk only exists in Shanghai, and severe and moderate risks are concentrated in Jiangsu. The current grain trade has reduced the overall food security risk in the YRD by 1.3 % but increased the risks in Shanghai and Zhejiang by 2.1 % and 0.8 % respectively. This study highlights the potential risks that excessive production of food in water-scarce areas in the grain trade system may bring to a stable food supply, providing useful information for a comprehensive understanding of the food and water security situation and for future trade-offs.

The association of regional block with intraoperative opioid consumption in patients undergoing video-assisted thoracoscopic surgery: a single-center, retrospective study.

BACKGROUND: Regional block, such as thoracic epidural analgesia (TEA), thoracic paravertebral block (TPVB), or serratus anterior plane block (SAPB) has been recommended to reduce postoperative opioid use in recent guidelines, but the optimal options for intraoperative opioid minimization remain unclear. The aim of this study was to evaluate the intraoperative opioids-sparing effects of three regional blocks (TEA, TPVB, and SAPB) in patients undergoing video-assisted thoracoscopic surgery (VATs). METHODS: This was a retrospective study of the adults undergoing VATs at a tertiary medical center between January 2020 and February 2022. According to the type of regional block used, patients were classified into 4 groups: GA group (general anesthesia without any regional block), TEA group (general anesthesia combined with TEA), TPVB group (general anesthesia combined with TPVB), and SAPB group (general anesthesia combined with SAPB). Cases were matched with a 1:1:1:1 ratio for analysis by age, sex, ASA physical status, and operation duration. The primary outcome was the total intraoperative opioid consumption standardized to Oral Morphine Equivalents (OME). Multivariable linear regression was used to estimate the association of the three regional blocks with the OME. RESULTS: A total of 2159 cases met the eligibility criteria. After matching, 168 cases (42 in each group) were included in analysis. Compared with GA without any reginal block, the use of TEA, TPVB, and SAPB reduced the median of intraoperative OME by 78.45 mg (95% confidence interval [CI], -141.34 to -15.56; P = 0.014), 94.92 mg (95% CI, -154.48 to -35.36; P = 0.020), and 11.47 mg (95% CI, -72.07 to 49.14; P = 0.711), respectively. CONCLUSIONS: The use of TEA or TPVB was associated with an intraoperative opioid-sparing effect in adults undergoing VATs, whereas the intraoperative opioid-sparing effect of SAPB was not yet clear.

Correlation between severity of nausea and vomiting after thoracoscopic pulmonary surgery and quality of postoperative recovery and capacity of mobility / 临床麻醉学杂志

Objective To assess the correlation between the severity of postoperative nausea and vomiting(PONV)with the quality of postoperative recovery and capacity of mobility in patients after video-assisted thoracoscopic surgery.Methods A total of 125 patients,80 males and 45 females,aged 18-64 years,BMI 18-35 kg/m2,ASA physical status Ⅰ-Ⅲ,undergoing video-assisted thoracoscopic surgery were observed.The severity of PONV was assessed using the simplified PONV impact scale day 1 after sur-gery.The patients were divided into three groups according to the severity of PONV:non-PONV group(n = 87),mild PONV group(n = 31),and moderate to severe PONV group(n = 7).The quality of recovery was assessed using the quality of recovery-15(QoR-15)on the first day after surgery,and the capacity of mobility was assessed using the 6-minute walk test(6-MWT)on the second day after surgery.The multiple linear regression model was used to analyze the correlation between the severity of PONV and quality of post-operative recovery and capacity of mobility.Results The results of the corrected multiple linear regression model showed that,compared with the patients without PONV,the QoR-15 scores of the patients with mild and moderate-severe PONV on the first day after surgery were reduced by 4.5 scores(95%CI-8.9 to-0.04 scores,P = 0.048)and 15.8 scores(95%CI-24.8 to-6.8 scores,P = 0.001),respectively.Mild(MD =-27.4 m,95%CI-70.1 to 15.4 m,P = 0.207)and moderate-severe PONV(MD =-57.0 m,95%CI-145.7 to 31.6 m,P = 0.204)were not significantly associated with 6-MWT distance shortening on the second day after surgery.Conclusion Increased PONV severity is associated with poorer recovery quality in patients undergoing pulmonary surgery.Active prevention and treatment of PONV may contribute to early recovery of patients.

Adrenomedullin/FOXO3 enhances sunitinib resistance in clear cell renal cell carcinoma by inhibiting FDX1 expression and cuproptosis.

Cuproptosis, a new type of copper-induced cell death, is involved in the antitumor activity and resistance of multiple chemotherapeutic drugs. Our previous study revealed that adrenomedullin (ADM) was engaged in sunitinib resistance in clear cell renal cell carcinoma (ccRCC). However, it has yet to be investigated whether and how ADM regulates sunitinib resistance by cuproptosis. This study found that the ADM expression was elevated in sunitinib-resistant ccRCC tissues and cells. Furthermore, the upregulation of ADM significantly enhanced the chemoresistance of sunitinib compared with their respective control. Moreover, cuproptosis was involved in ADM-regulated sunitinib resistance by inhibiting mammalian ferredoxin 1 (FDX1) expression. Mechanically, the upregulated ADM activates the p38/MAPK signaling pathway to promote Forkhead box O3 (FOXO3) phosphorylation and its entry into the nucleus. Consequently, the increased FOXO3 in the nucleus inhibited FDX1 transcription and cell cuproptosis, promoting chemoresistance. Collectively, cuproptosis has a critical effector role in ccRCC progress and chemoresistance and thus is a relevant target to eradicate the cell population of sunitinib resistance.

[Application of Intraoperative Transesophageal Echocardiography in the Treatment of Renal Cell Carcinoma with Inferior Vena Cava Tumor Thrombus].

Objective To investigate the value of intraoperative transesophageal echocardiography (TEE) in the diagnosis and treatment of renal cell carcinoma with inferior vena cava tumor thrombus. Methods Ten patients of renal cell carcinoma with inferior vena cava tumor thrombus treated in the Second Hospital of Hebei Medical University from January 2017 to January 2021 were selected.TEE was employed to locate the position of the tumor thrombus,determine the occlusion point of the inferior vena cava,count the intraoperative tumor thrombus shedding rate,examine the tumor thrombus resection integrity,and measure blood loss and other indicators,on the basis of which the application value of TEE in the operation of renal cell carcinoma with inferior vena cava tumor thrombus was evaluated. Results All the 10 patients had completed the operations successfully,including 8 patients of open operation and 2 patients of laparoscopic operation.TEE showed tumor thrombi clearly,and all the tumor thrombi were completely removed.There was no tumor thrombus shedding during the operation.The blood loss varied within the range of 300-800 ml,with the mean of (520.0±193.2) ml.The grade III tumor thrombi in 2 patients and the grade I tumor thrombus in 1 patient diagnosed before operation were reduced to grade Ⅱ and upgraded to grade Ⅱ,respectively,by TEE.One patient had no floating tumor thrombus at the end of tumor thrombus before operation,and the blocking position was adjusted in time with the assistance of TEE to avoid the shedding of the floating tumor thrombus. Conclusion TEE can accurately determine and dynamically monitor the location and shape of inferior vena cava tumor thrombus,which provides an important reference and has a significant clinical value in the operation of renal cell carcinoma with inferior vena cava tumor thrombus.

Procyanidin B2 protects H / 中国药理学通报

Aim To explore the protective effect of proanthocyanidin B2 (PC-B2) on oxidative damage of PC 12 cells induced by hydrogen peroxide (H

Multi-point resistivity measurement system for full-diameter long cores during fluid displacement.

Water injection is often used to improve oil and gas recovery in the late stage of oil and gas reservoir development. Studies show that this process leads to complex changes in reservoir resistivity and affects the evaluation of remaining oil and gas saturation in the reservoir. In this study, a multi-point resistivity measurement experimental system suitable for full-diameter rock samples during fluid displacement was designed to simulate and explore the distribution and variation of resistivity in the reservoir flooding process. In this regard, two columnar electrodes were installed on the end face of the core sample to serve as fluid injection and outflow channels. Moreover, five groups of nail-shaped electrodes arranged at equal intervals were embedded on the rubber sleeve of the core holder. The electrical bridge metering combined with seven electrodes was used to measure the resistivity and variation of six parts of the core sample during fluid displacement. A confining pressure was applied to the core sample to simulate the underground high-pressure environment and force the nail-shaped electrodes to cling to the sample to improve the accuracy of resistivity measurement. The simulated water flooding experiment was carried out with a sandstone sample from Tarim Oilfield in western China, and the distribution and variation of the sample's resistivity were recorded. The experimental results conform to the laws of rock physics and confirm the reliability of the experimental system. The experimental system provides a guideline for determining the resistivity variation and evaluating the remaining oil and gas saturation of water-flooded reservoirs.

Feasibility and Tolerability of Lenvatinib, Plus PD-1 Blockades for Patients with Unresectable Hepatocellular Carcinoma: A Retrospective Exploratory Study.

Objective: Lenvatinib was the standard first-line therapy for patients with unresectable HCC. PD-1 blockades demonstrated promising efficacy for patients with previously-treated HCC. Therefore, this study was to investigate the feasibility and tolerability of lenvatinib plus PD-1 blockades for patients with unresectable HCC retrospectively. Methods: A total of 37 patients with unresectable HCC who received lenvatinib plus PD-1 blockades in first-line setting were included in this study retrospectively. Efficacy of the patients was evaluated with the change of target lesion using mRECIST criteria per investigator and all the subjects were followed up regularly. Adverse reactions were collected and documented. Exploratory analysis between prognosis and baseline characteristics was performed using log rank test and multivariate analysis were performed using Cox regression analysis. Results: The best overall response of the 37 patients suggested that complete response was observed in one patient, partial response was noted in 11 patients, stable disease was noted in 16 patients and 9 patients had progressive disease, which yielded an objective response rate (ORR) of 32.4% (95%CI: 18.0-49.8) and a disease control rate (DCR) of 75.7% (95%CI: 58.8-88.2). Furthermore, the median progression-free survival (PFS) of the 37 patients with advanced HCC was 8.3 months (95%CI: 3.34-13.26). And the median overall survival (OS) was 17.8 months (95%CI: 7.19-28.41). In addition, the median duration of response (DoR) in 12 patients with response was 9.6 months (95%CI: 3.03-16.17). Furthermore, adverse reactions that were attributed to the combination administration were detected in 36 patients (97.3%), among whom a total of 22 patients (59.5%) were observed of the grade ≥3 adverse reactions. And the most common adverse reactions were hypertension, fatigue, nausea and vomiting, and hepatotoxicity. Conclusion: Lenvatinib plus PD-1 blockades demonstrated promising anticancer activity and acceptable toxicity for patients with unresectable HCC. And the conclusion should be validated in prospective clinical trials subsequently.

Fabrication of polydimethylsiloxane/graphene flexible strain sensors by using the scraping and coating method.

Production of flexible strain sensors is complex, time-consuming, and expensive. In this study, a novel fabrication method of polydimethylsiloxane/graphene nanocomposite conductive materials was proposed by using the scraping and coating method for manufacturing sandwich-shape flexible strain sensors. A ZQ-60B tensile testing machine was employed to test the mechanical properties of flexible sensors with 1%, 3%, and 5% graphene content. The results revealed that the stress and strain of the flexible strain sensor exhibited a linear relationship, and the linear correlation coefficients were 0.99706, 0.99819, and 0.99826, respectively. The concentration of graphene was 1%, 3%, and 5%, and the gauge factors (GFs) of the sensor were 24, 6, and 3, respectively. With the increase in the graphene content, the GF decreased gradually. This phenomenon could be attributed to tunneling, which increased the number of conductive pathways with an increase in the graphene content. Furthermore, the sensor exhibited excellent stability after 100 cycles of stretching/scaling. The finger joint bending test revealed that the flexible strain sensor is reproducible and exhibits excellent application prospects in monitoring human movement and health.

Clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version) / 中华创伤杂志

The anterior cruciate ligament (ACL) injury is a common sports injury that has a significant impact on knee function and patients′ mobility. With the popularity of national fitness campaign in China, the incidence of ACL injury is increasing year by year. Currently, there still lacks clinical standards or guidelines on how to choose appropriate treatment methods, surgical plans and rehabilitation protocols for ACL injury. In order to timely reflect the new treatment concept of ACL injury, standardize its diagnosis and treatment and improve the curative effect, the Sports Medicine Society of Chinese Research Hospital Association and the Editorial Board of Chinese Journal of Trauma organized domestic orthopedic and sports medicine experts to formulate the "clinical evidence-based guideline for the diagnosis and treatment of anterior cruciate ligament injury (2022 version)" based on the level of evidence-based medicine and in compliance with the principle of scientificity, practicability and advancement. The present guideline includes 12 recommendations for the diagnosis, treatment and rehabilitation of ACL injury in order to provide guidance and assistance for the clinical diagnosis and treatment of ACL injury in China.

Radiographic study of the patellofemoral axial alignment with episodic patellar dislocation / 中华创伤杂志

Objective:To explore the diagnostic performance of patella-tilt angle and congruence angle in episodic patellar dislocation (EPD) and the quantitative measurements of the patellar and femoral axial parameters as well as their correlation with and contributions to the patellofemoral joint alignment with the knee extended.Methods:A case control study was conducted to analyze the radiological data of EPD patients (EPD group, n=106) and patients without patellar instability (control group, n=106) admitted to Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University from January 2016 to December 2019. Each group consisted of 55 females and 51 males with the age range of 14-45 years [(23.0±5.3)years], showing 1∶1 match. Axial parameters included patellar parameters (patellar width, patellar thickness, Wiberg angle and Wiberg index), femoral parameters [trochlear sulcus angle, trochlear sulcus depth, trochlear sulcus height, trochlear width ratio (lateral/medial), trochlear height ratio (lateral/medial), lateral trochlear inclination and trochlear groove medialization], and patellofemoral joint parameters (patellar tilt angle and congruence angle). The receiver operating characteristic (ROC) curve of patellofemoral joint parameters for the prediction of EPD was analyzed. Univariate analysis was performed to determine the difference of those axial parameters between the two groups. Pearson correlation analysis was used to identify the correlation between those bony parameters and patellofemoral joint parameters. Stepwise regression model was further established to determine the influencing factors and corresponding contributions for patellofemoral joint parameters. Results:When the optimal cut-off values of patellar tilt angle and congruence angle were 17.2° and 25.5°, the area under the ROC curve (AUC) for predicting EPD was 0.91 (95% CI 0.87-0.95, P<0.01) and 0.92 (95% CI 0.87-0.95, P<0.01), and the Youden index was 0.745 (sensitivity=83.96%, specificity=90.57%) and 0.717 (sensitivity=81.13%, specificity=90.57%). Univariate analysis showed that Wiberg index, femoral parameters and patellofemoral joint parameters were significantly different between the two groups (all P<0.01). For all patients, Pearson correlation analysis showed that patellar tilt angle was moderately to strongly correlated with Wiberg index, trochlear sulcus angle, trochlear sulcus depth, trochlear width ratio (lateral/medial), trochlear height ratio (lateral/medial) and lateral trochlear inclination ( r=0.51, 0.41, -0.62, 0.43, -0.49, -0.65, all P<0.01) and that congruence angle has a moderate correlation with trochlear sulcus angle, trochlear sulcus depth, trochlear width ratio (lateral/medial) and lateral trochlear inclination ( r=0.43,-0.59,0.38,-0.51, all P<0.01). For all patients, Stepwise regression model analysis showed that lateral trochlear inclination, trochlear sulcus depth, trochlear sulcus angle, Wiberg index and trochlear height ratio (lateral/medial) could explain 60% of the variation of patellar tilt angle ( R 2=0.60, P<0.01) and that trochlear sulcus depth, lateral trochlear inclination, trochlear groove medialization, trochlear sulcus angle and Wiberg index could explain 44% of the variation of congruence angle ( R 2=0.44, P<0.01). Conclusions:The patellar tilt angle and congruence angle are reliable quantitative indicators representing patellofemoral axial alignment, with a good diagnostic performance for EPD. Variations in the patellar and femoral bony structures of EPD patients are related to the patellofemoral axial alignment, with the axial parameters differently contributing to the patellofemoral alignment.

Research progress in healing mechanism and treatment approach for tendon-bone interface injury / 中华创伤杂志

Tendons and bones are connected at the tendon-bone interface to transmit force and exchange biological information. However, the formation of fibrous scars after injury to the tendon-bone interface makes it difficult to recover the original structure during surgery and thus reduces its performance. Therefore, the healing of the tendon-bone interface is a hotspot in sports medicine. Numerous studies have already demonstrated that a variety of molecules and cells participate in the tendon-bone interface reconstruction process, and yet the specific mechanism remains unclear. At present, a great number of studies have been carried out on treatment methods, but clinical treatment are varied with no unification. Therefore, the authors review the advances in the biology and mechanics of healing mechanisms of tendon-bone interface as well as the main methods promoting tendon-bone interface healing, so as to provide references and new ideas for further researches on tendon-bone interface healing.

Relationship between rotator cuff muscle function and shoulder abduction function in patients with posterior superior rotator cuff tear: a dynamic biomechanical study / 中华创伤杂志

Objective:To evaluate the relationship of rotator cuff muscle function with shoulder abduction function after posterior superior rotator cuff tear via dynamic biomechanical study.Methods:By using the customized dynamic shoulder biomechanical testing system, seven freshly frozen cadaveric shoulders were used to stimulate shoulder abduction at 90° under four statuses: (1) intact rotator cuff with activation (normal rotator cuff group); (2) posterior superior rotator cuff tear with activation (posterior superior rotator cuff tear with activation group); (3) posterior superior rotator cuff tear with posterior superior rotator cuff deactivation (posterior superior rotator cuff tear with deactivation group); (4) none rotator cuff tissue above the geometric rotation center of the humeral head with deactivation (global tear group). The peak and stable value of middle deltoid force were used to evaluate biomechanical status in different rotator cuff tear conditions during shoulder abduction procedure. The peak subacromial pressure, average subacromial pressure, subacromial contact area, and subacromial force were used to evaluate subacromial pressed conditions under different rotator cuff tear conditions. The peak and stable ratio of glenohumeral contact force/middle deltoid force were used to evaluate shoulder stability under different rotator cuff tear conditions.Results:During dynamic abduction at 90°, the peak and stable value of middle deltoid force were (42.1±8.7)N and (29.9±7.4)N in normal rotator cuff group, (45.7±10.3)N and (30.5±7.2)N in posterior superior rotator cuff tear with activation group, and (48.4±13.4)N and (29.9±4.8)N in posterior superior rotator cuff tear with deactivation group (all P>0.05). But the peak and stable value of middle deltoid force were (69.7±9.7)N and (53.7±8.9)N in global tear group, significantly increased compared with other three groups (all P<0.05). The elevated middle deltoid force increased the subacromial contact pressure between glenohumeral head and acromion. The peak subacromial pressure, average subacromial pressure, subacromial contact area, and subacromial force were (0.40±0.05)MPa, (0.22±0.03)MPa, (7.71±5.09)mm 2, and (1.66±1.06)N respectively in normal rotator cuff group, (0.41±0.05)MPa, (0.26±0.07)MPa, (12.71±11.35)mm 2, and (2.93±2.46)N respectively in posterior superior rotator cuff tear with activation group, and (0.50±0.12)MPa, (0.26±0.07)MPa, (17.29±9.11)mm 2, and (4.09±1.46)N respectively in posterior superior rotator cuff tear with deactivation group (all P>0.05). However, the peak subacromial pressure, average subacromial pressure, subacromial contact area, and subacromial force were (3.64±1.70)MPa, (0.98±0.49)MPa, (47.63±11.91)mm 2, and (45.48±23.86)N respectively in global tear group, significantly higher than those in other three groups (all P<0.05). The peak and stable ratio of glenohumeral contact force/middle deltoid force were 2.24±0.30 and 2.46±0.13 in normal rotator cuff group, 2.21±0.19 and 2.52±0.08 in posterior superior rotator cuff tear with activation group, and 2.03±0.14 and 2.42±0.16 in posterior superior rotator cuff tear with deactivation group (all P>0.05). However, the peak and stable ratio of glenohumeral contact force/middle deltoid force were 1.40±0.14 and 1.52±0.41 in global tear group, significantly higher than those in other three groups (all P<0.05). No significant differences of the above parameters were observed in posterior superior rotator cuff tear with activation group, posterior superior rotator cuff tear with deactivation group and global tear group (all P>0.05). Conclusions:After posterior superior rotator cuff tear, rotator cuff muscle function does not affect the whole abduction function of shoulder. When the size of rotator cuff tear involves the whole superior humeral head rotation center, the normal abduction function of shoulder will be significantly impaired.

Effect of tadalafil combined with atorvastatin on hemodynamics and sexual function in middle-aged and elderly patients with hyperlipidemia complicated with erectile dysfunction.

OBJECTIVE: To evaluate the effect and clinical significance of tadalafil combined with atorvastatin on hemodynamics and sexual function in middle-aged and elderly patients with hyperlipidemia complicated with Erectile dysfunction (ED). METHODS: Eighty patients with hyperlipidemia complicated with ED who were treated at The Second Hospital of Hebei Medical University from January 2019 to June 2020 were selected. Using a completely randomized design experimental method, these 80 patients were randomly divided into two groups: the experimental group and the control group, with 40 cases in each group. The control group was treated with a single drug, atorvastatin calcium, while the experimental group was given tadalafil orally on the basis of the control group for 3 months. Changes in the levels of inflammatory factors such as IL-6, TNF and CRP, adverse drug reactions, changes in hemodynamic indicators such as HSV, LSV, PSV, HCT and ESR before and after treatment, as well as changes in sexual function after treatment were compared and analyzed between the two groups. RESULTS: TNF-a, CRP and IL-6 in the experimental group were significantly lower than those in the control group after treatment, with statistically significant differences (p<0.05). There was no significant difference in the incidence of adverse drug reactions between the two groups (p=0.18). After treatment, hemodynamic indexes and sexual function indexes of the experimental group were significantly improved compared with those in the control group, with statistically significant differences (p<0.05). CONCLUSION: A significant improvement effect can be achieved by tadalafil combined with atorvastatin on hemodynamics and sexual function in middle-aged and elderly patients with hyperlipidemia complicated with ED. At the same time, the combination of the two has synergism on inflammatory factors and blood rheology, and the incidence of adverse reactions is not significantly increased.

Essence of acupoints and meridians based on the studies of myofascial trigger points / 中国针灸

Based on the modern anatomy and physiology, the referred pain of myofascial trigger points of each muscle is integrated; compared with the twelve meridians as well as conception vessel and governor vessel, the similarity of their position and running course is observed. With the current research progress of myofascial trigger points and fasciology, based on the running course of referred pain of trigger points, combined with fascia mechanics, nerve and vascular, the location of acupoints and meridians, as well as the relationship between acupoints and meridians, are discussed.

Distribution of gene polymorphism in folate metabolism pathway and its effect on serumhomocysteine concentration / 中国临床药理学与治疗学

AIM: To study the polymorphism distribution of methylenetetrahydrofolate reductase (MTHFR) and methionine synthase reductase (MTRR) genes and their influence on serum homocysteine (Hcy) concentration. METHODS: A total of 148 patients diagnosed with ischemic stroke from November 2020 to February 2021 in Yijishan Hospital of Wanan Medical College were selected for the study, and patients were typed for MTHFR 677C/T and MTRR 66A/G genes using fluorescent staining in situ hybridization technique. Serum Hcy concentrations were measured in 21 patients using a circulating enzyme assay. The distribution of MTHFR 677C/T and MTRR 66A/G gene polymorphisms were analyzed, and the differences in serum Hcy concentrations between patients with different genotypes were compared. RESULTS: The mutation rates of MTHFR 677C/T and MTRR 66A/G genes were 42.57% and 26.01%, respectively, and no significant differences in gene distribution frequencies were observed between men and women (P>0.05). The mean Hcy serum concentration was (16.04±4.34) μmol/L in 21 patients, including 8 patients (38.10%) with 0.05). CONCLUSION: MTHFR gene polymorphisms can affect serum Hcy concentrations. The MTHFR genotyping can be considered for individualized folic acid supplement. This conclusion should be further verified by expanding the clinical sample size.

Identification of stress-related microRNA biomarkers in type 2 diabetes mellitus: A systematic review and meta-analysis.

BACKGROUND: Many studies have investigated microRNAs (miRNAs) in the detection of type 2 diabetes mellitus (T2DM). Herein, the dysregulated direction of stress-related miRNAs used as biomarkers of T2DM are summarized and analyzed. METHODS: PubMed, EMBASE, ISI Web of Science, and three Chinese databases were searched for case-control miRNA profiling studies about T2DM. A meta-analysis under a random effect was performed. Subgroup analysis was conducted based on different tissues and species. Sensitivity analysis was conducted to confirm the robustness among studies. The effect size was pooled using ln odds ratios (ORs), 95% confidence intervals (95% CIs), and P-values. RESULTS: The present meta-analysis included 39 case-control studies with a total of 494 miRNAs. Only 33 miRNAs were reported in three or more studies and, of these, 18 were inconsistent in their direction of dysregulation. Two significantly dysregulated miRNAs (let-7 g and miR-155) were identified in the meta-analysis. Four miRNAs (miR-142-3p, miR-155, miR-21, and miR-34c-5p) were dysregulated in patients with T2DM, whereas five miRNAs (miR-146a, miR-199a-3p, miR-200b, miR-29b and miR-30e) were dysregulated in animal models of diabetes. In addition, two dysregulated miRNAs (miR-146a and miR-21) were highly cornea specific and heart specific. In sensitivity analysis, only miR-155 was still significantly dysregulated after removing studies with small sample sizes. CONCLUSIONS: The present meta-analysis revealed that 16 stress-related miRNAs were significantly dysregulated in T2DM. MiR-148b, miR-223, miR-130a, miR-19a, miR-26b and miR-27b were selected as potential circulating biomarkers of T2DM. In addition, miR-146a and miR-21 were identified as potential tissue biomarkers of T2DM.

Application effect of extended nursing service in improving malnutrition status of patients undergoing maintenance hemodialysis combined with peritoneal dialysis / 中国实用护理杂志

Objective:To explore the effect of extended nursing service on malnutrition in patients undergoing maintenance hemodialysis combined with peritoneal dialysis.Methods:According to the formula, 124 patients with malnutrition in maintenance hemodialysis combined with peritoneal dialysis were divided into intervention group and control group by lottery, 62 in intervention group and 62 in control group. The control group received routine specialist nursing and health education during hospital dialysis, while the intervention group received extended nursing services for 6 months, including telephone follow-up, knowledge lectures and Wechat interaction. The nutritional status of two groups of patients was assessed by modified subjective comprehensive nutrition assessment (MQSGA) one day before the implementation of extended nursing service, three months and six months after the implementation of extended nursing service, and the body mass index(BMI), albumin, prealbumin, hemoglobin, serum calcium and serum phosphorus were measured at the same time.Results:There was no significant difference in nutritional status, BMI and blood index between the two groups before intervention ( P > 0.05). After 3 months and 6 months of intervention, MQSGA scores of intervention group were (13.28±3.99), (10.17±3.43) respectively, which were significantly lower than those of control group (15.32±3.52), (14.37±3.73). There were significant differences between the two groups ( t=2.946, 6.336, P<0.01). After 3 months and 6 months of intervention, BMI was (18.29±2.27), (20.27±2.09) kg/m 2, respectively, which were significantly higher than those of control group (16.41±2.32), (16.49±2.26) kg/m 2. The difference between the two groups was significant ( t=-4.430, -9.372, P <0.01). After 3 months of intervention, albumin, preaalbumin, hemoglobin, serum calcium, and serum inorganic phosphorus in intervention group were (35.63±4.24) g/L, (277.57±29.52) mg/L, (102.03±11.21) g/L,(2.01±0.19) mmol/L, (1.74±0.37) mmol/L; and the control group were (33.19±4.89) g/L, (216.81±24.06) mg/L, (92.58±13.79) g/L, (1.91±0.21) mmol/L, (2.05±0.49) mmol/L, respectively. After 6 months of intervention, the intervention groups were (41.49±6.14) g/L, (344.60±30.56) mg/L, (111.34±10.09) g/L, (2.28±0.18) mmol/L, (1.45±0.33) mmol/L, the control group were (34.16±4.71) g/L, (218.63±24.85) mg/L, (94.36±11.21) g/L, (1.99±0.24) mmol/L, (1.95±0.41) mmol/L. There were significant differences between the two groups ( t=-24.484-7.220, P<0.01). Conclusions:Extended nursing service can significantly improve the nutritional status of patients undergoing maintenance hemodialysis combined with peritoneal dialysis.

Application effect of extended nursing service in improving malnutrition status of patients undergoing maintenance hemodialysis combined with peritoneal dialysis / 中国实用护理杂志

Objective@#To explore the effect of extended nursing service on malnutrition in patients undergoing maintenance hemodialysis combined with peritoneal dialysis.@*Methods@#According to the formula, 124 patients with malnutrition in maintenance hemodialysis combined with peritoneal dialysis were divided into intervention group and control group by lottery, 62 in intervention group and 62 in control group. The control group received routine specialist nursing and health education during hospital dialysis, while the intervention group received extended nursing services for 6 months, including telephone follow-up, knowledge lectures and Wechat interaction. The nutritional status of two groups of patients was assessed by modified subjective comprehensive nutrition assessment (MQSGA) one day before the implementation of extended nursing service, three months and six months after the implementation of extended nursing service, and the body mass index(BMI), albumin, prealbumin, hemoglobin, serum calcium and serum phosphorus were measured at the same time.@*Results@#There was no significant difference in nutritional status, BMI and blood index between the two groups before intervention (P > 0.05). After 3 months and 6 months of intervention, MQSGA scores of intervention group were (13.28±3.99), (10.17±3.43) respectively, which were significantly lower than those of control group (15.32±3.52), (14.37±3.73). There were significant differences between the two groups (t=2.946, 6.336, P<0.01). After 3 months and 6 months of intervention, BMI was (18.29±2.27), (20.27±2.09) kg/m2, respectively, which were significantly higher than those of control group (16.41±2.32), (16.49±2.26) kg/m2. The difference between the two groups was significant (t=-4.430, -9.372, P <0.01). After 3 months of intervention, albumin, preaalbumin, hemoglobin, serum calcium, and serum inorganic phosphorus in intervention group were (35.63±4.24) g/L, (277.57±29.52) mg/L, (102.03±11.21) g/L,(2.01±0.19) mmol/L, (1.74±0.37) mmol/L; and the control group were (33.19±4.89) g/L, (216.81±24.06) mg/L, (92.58±13.79) g/L, (1.91±0.21) mmol/L, (2.05±0.49) mmol/L, respectively. After 6 months of intervention, the intervention groups were (41.49±6.14) g/L, (344.60±30.56) mg/L, (111.34±10.09) g/L, (2.28±0.18) mmol/L, (1.45±0.33) mmol/L, the control group were (34.16±4.71) g/L, (218.63±24.85) mg/L, (94.36±11.21) g/L, (1.99±0.24) mmol/L, (1.95±0.41) mmol/L. There were significant differences between the two groups (t=-24.484-7.220, P<0.01).@*Conclusions@#Extended nursing service can significantly improve the nutritional status of patients undergoing maintenance hemodialysis combined with peritoneal dialysis.