Strategy for reconstruction of irreparable rotator cuff tears / 国际外科学杂志

Rotator cuff tears are very common in middle-aged and older adults and are the leading cause of shoulder surgery in the population. Some patients have rotator cuff tears that are classified as irreparable tears due to the large size of the tear and severe muscle atrophy. The treatment of irreparable rotator cuff tears presents great challenges. How to reconstruct the function of the shoulder joint is the key point. In this review article, authors will focus on partial repair of irreparable rotator cuff tears and tendon transfer for rotator cuff reconstruction, paying attention to its scope of application, efficacy, advantages and disadvantages, and providing reference for clinical diagnosis and treatment.

Effects of enamel adhesives with different components on Porphyromonas gingivalis and Streptococcus mutans / 中国组织工程研究

BACKGROUND:The light curing and fluoride light curing enamel adhesives have a certain sealing effect on the etched enamel surface.The fluoride light curing enamel adhesives can also achieve the anti-caries function by releasing fluoride ions.However,the existing researches lack the long-term tracing of fluoride release effect,especially the amount of local pathogenic bacteria after 1-3 months of local fluoride application. OBJECTIVE:To analyze the changes in the expression of Porphyromonas gingivalis and Streptococcus mutans in subgingival plaque of the upper anterior teeth adhered by different components of enamel adhesives in adolescent patients with fixed appliance. METHODS:Ninety adolescent patients who received orthodontic treatment in Shanghai Stomatological Hospital from January to December 2016 were enrolled,including 43 males and 47 females,with a mean age of(13.27±1.12)years.These patients were randomly divided into three groups(n=30 per group).In the chemical curing group,Unite? bonding resin was used to bond fixed appliances.In the light curing group,Transbond XT light curing resin was used to bond the fixed appliance.In the fluoride light curing group,GC light curing orthodontic adhesive was used to bond the fixed appliance with cement.The subgingival plaque was collected on the day of bonding,1st,2nd,and 3rd month follow-up reviews.The expressions of Porphyromonas gingivalis and Streptococcus mutans in subgingival plaque were detected by PCR. RESULTS AND CONCLUSION:(1)Intragroup comparison:With the increase of bonding time,Porphyromonas gingivalis expression increased significantly in the 3rd month in the chemical curing group(P<0.05).In the light curing group,Porphyromonas gingivalis showed a significant decrease in the 1st month(P<0.05).Porphyromonas gingivalis expression decreased significantly in the 1st and 2nd months compared with initial data in the fluoride light curing group(P<0.05).The expression of Streptococcus mutans was higher in the chemical curing group in the 1st,2nd,and 3rd months compared with the initial data(P<0.05).In the fluoride light curing group,the expression of Streptococcus mutans was lower in the 1st,2nd,and 3rd months compared with the initial data(P<0.05).There was no significant difference in the proliferation and expression of Streptococcus mutans during follow-up in the light curing group compared to the initial adhesion(P>0.05).(2)Intergroup comparison:In the 1st month,the expression of Porphyromonas gingivalis was lower in the light curing group and fluoride light curing group than that in the chemical curing group(P<0.05).In the 2nd and 3rd months,the expression of Porphyromonas gingivalis was lower in the fluoride light curing group than that in the light curing group and chemical curing group(P<0.05).In the 1st,2nd,and 3rd months,the expression of Streptococcus mutans was lower in the light curing group and fluoride light curing group than that in the chemical curing group(P<0.05).The expression of Streptococcus mutans was lower in the fluoride light curing group than that in the light curing group(P<0.05).(3)The results show that in the fixed orthodontic process,the use of different components of enamel adhesives has different effects on the proliferation and expression of oral Porphyromonas gingivalis and Streptococcus mutans in the short term.Fluoride light curing enamel adhesives at the initial stage can reduce the occurrence of enamel demineralization,caries,and periodontal inflammation.

Design and implementation for portable ultrasound-aided breast cancer screening system / 生物医学工程学杂志

Early screening is an important means to reduce breast cancer mortality. In order to solve the problem of low breast cancer screening rates caused by limited medical resources in remote and impoverished areas, this paper designs a breast cancer screening system aided with portable ultrasound Clarius. The system automatically segments the tumor area of the B-ultrasound image on the mobile terminal and uses the ultrasound radio frequency data on the cloud server to automatically classify the benign and malignant tumors. Experimental results in this study show that the accuracy of breast tumor segmentation reaches 98%, and the accuracy of benign and malignant classification reaches 82%, and the system is accurate and reliable. The system is easy to set up and operate, which is convenient for patients in remote and poor areas to carry out early breast cancer screening. It is beneficial to objectively diagnose disease, and it is the first time for the domestic breast cancer auxiliary screening system on the mobile terminal.

Impact of non-pharmacological interventions on COVID-19 boosting vaccine prioritization and vaccine-induced herd immunity: a population-stratified modelling study

BackgroundWhile the COVID-19 pandemic seemed far from the end, the booster vaccine project was proposed to further reduce the transmission risk and infections. However, handful studies have focused on questions that with limited vaccine capacity ether boosting high-risk workers first or prioritizing susceptible normal individuals is optimal, and vaccinating how many people can lead us to the goal of herd immunity. In this study we aimed to explore the conclusions of such two problems with consideration of non-pharmacological interventions including mandatory quarantine for international entrants, keeping social distance and wearing masks. MethodsBy implementing the corresponding proportion of individuals who remain infectious after four lengths of quarantine strategies to the novel population-stratified model, we quantified the impact of such measures on optimizing vaccine prioritization between high-risk workers and normal populations. Furthermore, by setting the hypothetical COVID-19 transmission severity (reproduction number, R0) to the level of the most contagious COVID-19 variant (B.1.617.2, delta variant, R0 = 5.0), we separately estimated the threshold vaccine coverage of five countries (China, United States, India, South Africa and Brazil) to reach herd immunity, with and without the consideration of interventions including wearings masks and keeping social distance. At last, the sensitive analysis of essential parameter settings was performed to examine the robustness of conclusions. ResultsFor Chinese scenarios considered with moderate hypothetical transmission rate (R0 = 1.15-1.8), prioritizing high-risk workers the booster dose reached lower cumulative infections and deaths if at least 7-days of quarantine for international travelers is maintained, and the required screening time to remain such vaccinating strategy as optimal increased from 7-days to 21-days with the transmission severity. Although simply maintaining at least 7-days quarantine can lead to over 69.12% reduction in total infections, the improvement of longer quarantine strategies was becoming minimum and the least one was 2.28% between the 21 and the 28-days of quarantine. Besides, without the vaccination program, the impact of such measures on transmission control dropped significantly when R0 exceeded 1.5 and reached its minimal level when R0 equal to 2.5. On the other hand, when we combat the delta variant, the threshold vaccine coverage of total population to reach herd immunity lay within 74%-89% (corresponding to the vaccine efficiency from 70% to 50%), and such range decreased to 71%-84% if interventions including wearing mask and keeping social distance were implemented. Furthermore, Results of other countries with 85% vaccine efficiency were estimated at 79%, 91%, 94% and 96% for South Africa, Brazil, India and United States respectively. ConclusionsNon-pharmacological interventions can substantially affect booster vaccination prioritization and the threshold condition to reach herd immunity. To combat the delta variant, restrictions need to be integrated with mass vaccination so that can reduce the transmission to the minimum level, and the 21-days might be the suggested maximum quarantine duration according to the cost-effectiveness. Besides, by implementing interventions, the requirement to reach herd immunity can be lower in all countries. Lastly, the following surveillance after vaccination can help ensure the real-time proportion of vaccinated individuals with sufficient protection.

The Incubation Period of Severe Acute Respiratory Syndrome Coronavirus 2:A Systematic Review

While the novel coronavirus continues to spread worldwide, the reported incubation period has varied between studies and is imprecise due to limited data. A literature search with certain selection criteria was conducted on May 30, 2020. In total, sixty-four articles were included, and 854 individual-level data were extracted from 30 studies for pooled analysis. Of these studies, 72% of them reported a median or mean incubation period of 4-7 days, while our estimated median was 4.9 days (95% confidence interval [CI]: 4.6-5.2). However, the inclusion of 81 asymptomatic and presymptomatic patients, as well as 31 cases with incubation periods exceeding 14 days, led to our estimation of 97.5 th percentile with 19.3 days (95% CI: 17.4-21.4), beyond the currently suggested 14-day quarantine period. Therefore, we appeal to prolong the quarantine duration, especially for areas that have insufficient testing resources, to protect susceptible populations from being infected. Article Summary LineThis article reviewed the COVID-19 studies involving incubation period and provided pooled estimation based on available data from these studies.The result showed that our estimated median incubation period is consistent with the estimates of formal studies but the 97.5 percentile is larger than ever on account of including a number of asymptomatic and presymptomatic patients.These finds suggested that we should properly prolong the isolation or quarantine period in order to identify more patients with longer incubation period and those without any symptoms.

Detection of carotid intima and media thicknesses based on ultrasound B-mode images clustered with Gaussian mixture model / 生物医学工程学杂志

In clinic, intima and media thickness are the main indicators for evaluating the development of atherosclerosis. At present, these indicators are measured by professional doctors manually marking the boundaries of the inner and media on B-mode images, which is complicated, time-consuming and affected by many artificial factors. A grayscale threshold method based on Gaussian Mixture Model (GMM) clustering is therefore proposed to detect the intima and media thickness in carotid arteries from B-mode images in this paper. Firstly, the B-mode images are clustered based on the GMM, and the boundary between the intima and media of the vessel wall is then detected by the gray threshold method, and finally the thickness of the two is measured. Compared with the measurement technique using the gray threshold method directly, the clustering of B-mode images of carotid artery solves the problem of gray boundary blurring of inner and middle membrane, thereby improving the stability and detection accuracy of the gray threshold method. In the clinical trials of 120 healthy carotid arteries, means of 4 manual measurements obtained by two experts are used as reference values. Experimental results show that the normalized root mean square errors (NRMSEs) of the estimated intima and media thickness after GMM clustering were 0.104 7 ± 0.076 2 and 0.097 4 ± 0.068 3, respectively. Compared with the results of the direct gray threshold estimation, means of NRMSEs are reduced by 19.6% and 22.4%, respectively, which indicates that the proposed method has higher measurement accuracy. The standard deviations are reduced by 17.0% and 21.7%, respectively, which indicates that the proposed method has better stability. In summary, this method is helpful for early diagnosis and monitoring of vascular diseases, such as atherosclerosis.

The exploration for strengthening the scientific research ability of laboratory medicine students in the implementation of scientific research projects / 中华医学教育探索杂志

In order to enhance the comprehensive ability,scientific research consciousness and scientific research skills of laboratory medicine students,the clinical laboratory center of Beijing Children's Hospital carried out the exploration for strengthening the scientific research ability of laboratory medicine students in the implementation of scientific research projects.Depending on the platform of National Center for Children's Health,the clinical laboratory center of Beijing Children's Hospital used patient resources and top research facilities to provide comprehensive trainings for students who volunteered to take part in this project with the goal of offering more opportunities for further study and employment to them.Teachers can impart the ideas,thoughts and skills of scientific research to the students through the training,which can help them to improve their core competitiveness by combining the theoretical knowledge and practical work,developing the innovative thinking and improving the ability in scientific research innovation and practice.

Application of Double Contrast-enhanced Ultrasonography in the Diagnosis of Gastric Cancer / 昆明医科大学学报

Objective To investigate the clinical value of double contrast-enhanced ultrasonography (DCUS) for the diagnosis of gastric cancer.Methods A retrospective analysis was performed to review the DCUS data of 26 patients which were diagnosed as gastric cancer by pathology in the third affiliated hospital of Kunming Medical University from October 2014 to July 2015.The analysis results were compared with postoperative pathology to get accuracy rates.Results The located accuracy,qualitative accuracy and accuracy at T phase of DUCS was 100％ (26/26),100％ (26/26) and 88.5％ (23/26),respectively.Compared with color doppler flow imaging (CDFI),the qualitative accuracy of DUCS was much higher (P ＜ 0.05).The accuracy of DUCS at T phase was higher than that of CDFI with no statistical significance (P ＞ 0.05) Conclusion DUCS has an important application value in the diagnosis of gastric cancer.

The ultrasonographic diagnosis and imaging analysis of fetal deformities in limbs hands and feet / 中华医学超声杂志（电子版）

Objective To summarize the sonographic features of fetal limb deformity. Methods Systematic continuous sequence approach (SCSA) was performed with two-dimensional and three-dimensional ultrasonography(USG) in 28 383 fetuses to observe the fetal limb development, posture abnormality and other accompanied malformations. Compared with the pathological and radiological findings, the characteristics of fetal limb deformity on USG were summarized. Results Among 28 383 fetuses prenatal ultrasound detected 207 cases of fetal malformations (0.7%, 207/28 383) including 29 cases of limb deformities (14%, 29/207). In the 29 cases, there were osteogenesis imperfecta in 2 cases, syndactyly in 1 case, cleft hand deformities in 1 case, uncifom hand in 1 case, clubfoot deformity in 12 cases, cleft foot in 1 case, micromelia in 4 cases, limb body wall complex in 1 case, forearm defect in 2 cases, and radius absence in 4 cases. Chromosome karyotype analysis was conducted in 7/29 cases, of which 6 cases were normal and 1 case was trisomy-13 with syndactyly. In addition, the fetal limb deformities were found at 17-19 weeks of gestation in 4 cases, at 20-24 weeks in 23 cases, and at 25-33 weeks in 2 cases. In summary, 27/29 cases were identiifed at 17-24 weeks of gestation. Conclusions Prenatal ultrasound is the ifrst-choice method for screening of fetal limb deformity. The detection rate of limb deformity could be greatly improved by using SCSA method with the supplement of 3D ultrasound.

Imaging assessment of therapeutic efficacy of neoadjuvant therapy for locally advanced rectal cancer / 中华消化外科杂志

The standard treatment for colorectal cancer still have not been unified,especially the treatment for patients with locally advanced rectal cancer (T3 or T4 stage) is controversial,and multidisciplinary comprehensive treatment is recommended by most of the scholars.Precise preoperative diagnosis and staging for locally advanced rectal cancer is very important.Currently,transrectal ultrasound (TRUS),multi-slice spiral computed tomography,magnetic resonance imaging (MRI) are playing important roles in the preoperative diagnosis and staging,while controversies on the efficacies of different imaging diagnosis on the evaluation of rectal cancer exist between domestic and overseas scholars.From October 2010 to October 2012,the imaging data of 30 patients with locally advanced rectal cancer who were admitted to the Tumor Hospital of Yunnan Province were retrospectively analyzed.The results showed that TRUS,computed tumography and MRI had guidance value in preoperative tumor staging and evaluation of neoadjuvant therapy for patients with locally advanced rectal cancer,which provide a more reliable basis for the selection of appropriate treatment programs.

Optimization of the Extraction Technology of Zishen Yangyin Granules by Orthogonal Experiment / 中国药房

OBJECTIVE:To optimize the extraction technology of Zishen yangyin granules.METHODS:The yield of the extractum and the content of the extraction using 80% alcohol as solvent were used as indexes to optimize the extraction technology of Zishen yangyin granules by orthogonal experiment with the times of extraction,the extraction time and the amount of water added as factors.RESULTS:The optimal extraction conditions were as follows:the extraction was carried out for 3 times by adding water at an amount of 9 times,6 times and 6 times,respectively that of solid substance with decoction time of 3 h,2 h and 1 h,respectively.CONCLUSION:The optimal extraction process was proved to be time-saving and energy-saving and suitable for large production.

Determination of Hesperidin in Yangweishu Tablets by RP-HPLC / 中国药房

OBJECTIVE: To establish a RP-HPLC method for the determination of the content of hesperidin in Yangweishu tablets.METHODS: The samples were separated on octadecyl silane bonded gel silica column(150 mm?4.6 mm,5 ?m) with the mobile phase consisted of methanol-7% acetic acid solution(32∶68) under a detection wavelength of 283nm.RESULTS: The linear range of hesperidin was 49.6～892.8 ng(r=0.999 9) with an average recovery rate of 99.02%(RSD=0.45%,n=9).CONCLUSION:The method is simple,accurate,reproducible and applicable for the quality control of Yangweishu tablets.

Arthroscope-assisted diagnosis and treatment of intraarticular synovial hemangioma of knee / 第三军医大学学报

Objective To retrospectively review the diagnosis and treatment of intraarticular synovial hemangioma of the knee under arthroscope. Methods Six cases of intraarticular synovial hemangioma of the knee were included. The examination of X ray and MRI before surgery indicated intraarticular synovial hemangioma in 5 cases and pigmented villonodular synovitis in 1 case, then arthroscopic diagnosis and excision of the lesions were followed. Results The six cases were definitely diagnosed as intraarticular synovial hemangioma. Under arthroscope, the lesions exhibited as irregular dark blue or purple capillary clumps of different sizes. The postoperative follow-up of 10.7 months in average (range 4-23 months) shows good joint function for all the patients and no signs of recurrence at the last follow-up. Conclusion Intraarticular synovial hemangioma is rare with a high rate of misdiagnosis. Careful physical examination and MRI can help to make the diagnosis. Arthroscopic surgery is a choice of diagnosis and treatment for intraarticular synovial hemangioma of knee.

Refining processing of Radix Polygoni Multiflori Granula with ceramic membranes / 中草药

Objective To observe the effect of the different bore diameter membranes on technological parameters of Radix Polygoni Multiflori Granula and to optimize the process of membrane filtration.Methods Three different membranes were tested under different parameters of operation to observe the changes in membrane flux and the content of effective components by Radix Polygoni Multiflori Granula.Results The membrane(50 nm)had the great flux,the transfering rate of stilbene glucoside was the highest;The optimum conditions:the operation differential pressure was 0.8-1.2 MPa;The operation temperature was 50-60 ℃;the membrane surface flow rate was 3.0 m/s.When the volume of filtration solution was condensed to 1/10 of former,entering the same volume deionized water into it,and when the effective components transfering rate reached 80%,the filtration was finished.Using the strong acid and strong alkali to wash it in turn,the flux could revive above 90%.Conclusion It can be obtained a good result that adopts the technology of ceramic membranes microfiltration to refine Radix Polygoni Multiflori Granula.This can provide the foundation for the application of ceramic membrane microfiltration in the refinement of water extraction of other Chinese materia medica.