3D-printed near-infrared-light-responsive on-demand drug-delivery scaffold for bone regeneration.

Although several bioactive 3D-printed bone scaffolds loaded with multiple kinds of biomolecules for enhanced bone regeneration have been recently developed, the manipulation of on-demand release profiles of different biomolecules during bone regeneration remains challenging. Herein, a 3D-printed dual-drug-loaded biomimetic scaffold to regulate the host stem cell recruitment and osteogenic differentiation in a two-stage process for bone regeneration was successfully fabricated. First, a chemotactic small-molecule drug, namely, simvastatin (SIM) was directly incorporated into the hydroxyapatite/collagen bioink for printing and could be rapidly released during the early stage of bone regeneration. Further, near-infrared (NIR)-light-responsive polydopamine-coated hydroxyapatite nanoparticles were designed to deliver the osteogenic drug, i.e., pargyline (PGL) in a controllable manner. Together, our scaffold displayed an on-demand sequential release of those two drugs and could optimize their therapeutic effects to align with the stem cell recruitment and osteoblastic differentiation, thereby promoting bone regeneration. The results confirmed the suitable mechanical strength, high photothermal conversion efficiency, good biocompatibility of our scaffold. The scaffold loaded with SIM could efficiently accelerate the migration of stem cells. In addition, the scaffold with on-demand sequential release promoted alkaline phosphatase (ALP) activity, significantly upregulated gene expression levels of osteogenesis-related markers, and enhanced new-bone-formation capabilities in rabbit cranial defect models. Altogether, this scaffold not only offers a promising strategy to control the behavior of stem cells during bone regeneration but also provides an efficient strategy for controllable sequential release of different biomolecule in bone tissue engineering.

Value of Molybdenum Target X-Ray and High-Frequency Color Doppler Flow Imaging in Early Diagnosis of Breast Carcinoma: A Comparative Analysis.

Background: Breast carcinoma (BC) threatens the physical and mental health of women worldwide, and early diagnosis is important for improving patient outcomes and ensuring successful treatment. Purpose: This research mainly aims to compare and analyze the value of molybdenum target X-ray and high-frequency color Doppler flow imaging (CDFI) in the early diagnosis of BC. Methods: First, 102 patients with suspected early-stage BC (ESBC) admitted to Henan Provincial People's Hospital were examined by molybdenum target X-ray and CDFI. Based on the pathological findings, the diagnostic efficiency data of the two diagnostic modalities such as positive detection rate (PDR), positive predictive value (PPV), negative predictive value (NPV), sensitivity (SEN), specificity (SPE), and accuracy (ACC), as well as imaging information like masses, microcalcifications (MCs), axillary lymph node (LN) metastases, and blood flow signal or vascular sign abnormalities were analyzed. Results: CDFI contributed to higher PDR, PRV, NPV, SEN, and ACC than molybdenum target X-ray in ESBC diagnosis, but similar SPE. The combined diagnosis of molybdenum target X-ray plus CDFI contributed to even higher PDR, PRV, NPV, SEN, and ACC than molybdenum target X-ray alone and higher ACC than CDFI. Imaging inspection revealed that the number of cases of masses, axillary LN metastases, and abnormalities in blood flow signals or vascular signs detected by CDFI was significantly higher than that by molybdenum target X-ray, while the number of MCs was significantly lower. Conclusion: Molybdenum target X-ray plus CDFI is more effective in the diagnosis of ESBC and plays a complementary role in imaging examination, which can synergistically improve the diagnostic ACC of ESBC and is worthy of clinical promotion.

Simultaneous Minimally Invasive Coronary Artery Bypass Grafting and Lung Resection.

BACKGROUND: The best surgical treatment strategy for coexisting coronary artery disease (CAD) and lung cancer (LC) remains controversial. This study analyzed the safety and efficacy of a simultaneous minimally invasive procedure for patients with CAD and LC. METHODS: Patients who underwent simultaneous minimally invasive off-pump coronary artery bypass grafting and lung resection from January 2016 to December 2021 were retrospectively analyzed. The procedure was performed in the fourth intercostal space through a small left anterolateral minithoracotomy. Harvesting of the left internal mammary artery (LIMA) and sewing of the anastomoses were performed under direct vision. Lung resections were performed with or without the assistance of a thoracoscope. RESULTS: Sixteen patients were included with a mean age of 67.13 ± 10.61 years. Procedural success occurred in all patients with a mean operative time of 366.88 ± 94.48 minutes. All patients received at least one coronary artery bypass LIMA graft. Pneumonectomy, lobectomy, segment resection, and wedge resection were performed in one (6.25%), eight (50%), two (12.5%), and five (31.25%) patients, respectively. There were no perioperative deaths or new myocardial infarctions. Complications included one case of postoperative bleeding, two lung infections, two cases of atelectasis, one case of pleural effusion, and one case of cardiac arrhythmia. All the patients were followed up for 1 to 57 months, cancer recurrence occurred in two patients, and one patient died. The remaining patients showed no evidence of tumor recurrence or myocardial infarction. CONCLUSION: This simultaneous minimally invasive procedure is safe and effective for selected patients with CAD and LC.

Impact of upadacitinib on the risk of digestive events in patients with rheumatoid arthritis: A systematic review and meta-analysis of randomized controlled trials.

Background: Upadacitinib (UPA), an oral Janus kinase (JAK) inhibitor, is an effective treatment option for rheumatoid arthritis (RA), but its use has been associated with an increased risk of digestive events. This systematic review aimed to investigate the risk of digestive events in RA patients treated with UPA. Methods: Systematic searches of electronic databases (PubMed, Cochrane Library, and EMBASE) from inception to September 2022 were conducted to locate randomized controlled trials (RCTs) that compared UPA with control treatment and reported digestive events in RA patients. We pooled data using the random-effects model and meta-analysis was conducted by Stata software. Results: Ten RCTs met the inclusion criteria and were analyzed, with a total of 6103 patients. Compared with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), pooled analysis of 8 trials revealed no statistical difference in hepatic disorder (HD) risk and gastrointestinal (GI) perforation (GIP) risk ((OR = 1.16, 95% CI 0.86 to 1.56, I2 = 0.00%); OR = 4.49, 95% CI 0.56 to 35.93, I2 = 0.00%)). When we considered the influence of UPA on the grade of liver enzymes, the data indicated that grade 3 and 4 elevations in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were infrequent. Additionally, a dose-dependent impact of UPA on the risks of HD was not observed. The results suggested no interaction by dose of drug, or indication for treatment of GIP risk. Conclusion: Our results showed that RA patients receiving UPA compared with csDMARDs had no significant increased risk associated with digestive events. Further long-term research of emerging data is urgently needed to gain a better understanding of the association between UPA and digestive events in the RA population.

Fast algorithm of single frequency-swept interferometry for the dynamic axial clearance measurement of high-speed rotating machinery.

Utilizing the periodicity of the rotating machinery, dynamic clearance measurement can be achieved with a single swept light source without any additional auxiliary devices, which has the advantages of simplicity and reliability. However, there is a shortcoming that previous algorithm is not fast enough to achieve real-time measurement when the machinery rotates at high speed. Aiming at this shortcoming, utilizing the correlation between mimic signal and measurement signal, combined with information for multiple periods, the fast algorithms and dynamic clearance corrected model were proposed. And the relationship between demodulation speed and cycle numbers was also discussed. Simulation was carried out to discuss the influence of different algorithm on the demodulation speed and accuracy. A test system was set up in the simulated environment for clearance measurement, and the results show that, the demodulation time of the proposed algorithm costs decreased dramatically, the speed has increased by about ten times, and the dynamic clearance measurement error is less than 2 µm.

Blockchain-based medical health record access control scheme with efficient protection mechanism and patient control.

The patient's medical health record (PMHR) has always provided a large amount of research data to medical institutions and pharmaceutical companies, etc., and has contributed to the development in medical research. However, such PMHR data contains the patient's personal privacy and should be shared under the control of the patients, not the hospital where this data is acquired. In order to protect the privacy of PMHR data while realizing efficient data sharing, this paper proposes a blockchain-based sharing and protection scheme. In this solution, the PMHR data are encrypted and stored in a cloud server, which is equipped with an access control scheme implemented as a smart contract on a blockchain. Different from previous works, in order to ensure efficient access and reduce the workload of patients, the types of users who can apply for access are limited to hospitals and pharmaceutical companies. In order to resist the potential Man-in-the-middle (MITM) attack, we have introduced an improved proxy re-encryption scheme to ensure the secrecy of PMHR data while reducing the computational complexity. The whole system is implemented using Solidity and tested on 10 nodes for function verification. Experimental result shows that the proposed system is more efficient than previous systems. Security under the MITM attack is also ensured by security analysis.

Research progress in hip-preserving modalities for early osteonecrosis of the femoral head in young and middle-aged patients / 中华创伤杂志

Osteonecrosis of the femoral head (ONFH) is one of the common and difficult-to-treat orthopedic diseases caused by a variety of factors that lead to abnormal blood flow to the femoral head, which in turn leads to deformation and collapse of the femoral head and eventually results in severe hip joint dysfunction. The key to the treatment is early diagnosis and correct treatment according to the stage classification and active prevention of further aggravation of ONFH aiming to delay or avoid hip replacement surgery in young and middle-aged patients. At present, there are various non-surgical and surgical hip-preserving modalities for early ONFH, designed to slow down the progression of the disease, prevent the femoral head from collapsing and stop the mild collapse. In recent years, with the emergence and development of bone reconstruction biomaterials, artificial bone reconstruction after scraping of ONFH lesions has shown great potential in the treatment of early ONFH. The authors review the research progress in hip-preserving modalities for early ONFH in young and middle-aged patients from non-surgical and surgical perspectives, hoping to provide a reference for clinical treatment of early ONFH.

Factors influencing mechanical properties of clear aligners and research progress / 口腔医学

@#In recent years, clear aligner technology has been maturing and is rapidly gaining popularity in the orthodontic market for its aesthetic and removable properties. However, despite the background of its large-scale clinical application, mechanical properties of clear aligners need to be studied in depth. This paper reviews the factors influencing mechanical properties of clear aligners and the current status of research to provide evidence-based guidance for clinical application.

The PK bioanalysis method study of c-Met antibody-drug conjugate (RC108) in cynomolgus monkey / 药学学报

Antibody-drug conjugate (ADC) has the characteristics of low toxicity and high efficiency, and plays an important role in cancer treatment. However, due to the complexity of its structure, it brings difficulties in pharmacokinetic (PK) bioanalysis. This study established an analytical method for the detection of ADC (RC108) in cynomolgus monkey plasma by ligand-binding assay (LBA) and liquid chromatography tandem mass spectrometry (LC-MS/MS), which was used to analyze and quantify the total antibody, bound antibody and free drug in cynomolgus monkey plasma. Based on the LBA method, rabbit anti-RC108 Fab and mouse anti-MMAE (monomethyl auristatin E) mAb were pre-coated in 96-well plates as the total antibody and antibody binding reagents, respectively. The samples to be tested were added, and then the detection reagents were added in turn. Goat anti-human IgG (H+L)-HRP, chromogenic solution tetramethylbenzidine (TMB), H2SO4 terminate the reaction, read data at 450 nm/630 nm wavelength of microplate reader; LC-MS/MS analysis method quantifies MMAE concentration, and refer to relevant regulations for methodological validation. The analytical method for quantifying total antibody, bound antibody and free drug of RC108 drug obtained good accuracy and precision, and the selectivity, dilution linearity, hook effect, parallelism and stability were verified. Meet the requirements of biological analysis. Finally, a bioanalytical method for the determination of the concentration of the test substance RC108 (total antibody, conjugated antibody, free MMAE) in cynomolgus monkey plasma with high sensitivity and high throughput was established by LBA and LC-MS/MS method. Subsequent non-clinical research on PK research in cynomolgus monkeys will provide technical support.

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

Through the textual research and analysis of ancient and modern documents of Acanthopanacis Cortex（AC）， this paper combed the variety， origin， harvesting， processing and ancient quality evaluation methods of AC， and clarified the historical context of the mixing of its common counterfeit product（Periplocae Cortex）， in order to provide a basis for the development of famous classical formulas containing AC. AC was first published in Shennong Bencaojing with the name of Wujia， Wujiapi is the name rectification in all dynasties since Leigong Paozhilun. According to the description of inflorescence location and fruit morphology of Wujia in the materia medica， it is judged that the mainstream origin of AC used in previous dynasties was Acanthopanax gracilistylus. Periplocae Cortex was mixed with AC in the period of the Republic of China because it was in line with the "like Lycii Cortex， light， brittle and fragrant". The origin of Wujiapi recorded in past dynasties was concentrated in the middle and lower reaches of the Yangtze River， mainly in Hubei， Henan， Anhui and other places. Since modern times， the traditional quality evaluation of AC has been gradually summarized， with thick skin， white color and fragrant smell as the best. The traditional harvesting and processing of AC involved picking the stems in May and July of the lunar calendar， picking the roots in October， and drying in the shade. In modern times， the roots of AC are harvested， washed， peeled and dried in summer and autumn. In the past dynasties， there were rice wine processing， Euodiae Fructus boiling， ginger juice processing and other methods. In modern times， it is usually cut into thick slices after the cleansing. According to the research results， it is suggested that the root bark of A. gracilistylus should be selected as the origin of AC in famous classical formulas， which should be processed into the medicine according to the specific prescription requirements. In addition， it is suggested to restore the medicinal name of Periplocae Cortex as Yangtao， in order to reduce its chaotic influence on the medicinal use of AC.

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

Through the textual research and analysis of the variety， origin， processing， quality evaluation and clinical application of Moslae Herba in ancient and modern literature， its origin of materia medica was clarified. Moslae Herba has experienced variety changes in history. Elsholtzia ciliata was the mainstream variety during and before the Song dynasty， however， during the Ming and Qing dynasties， emerging variety of Mosla chinensis rose to the mainstream status due to its remarkable efficacy and the formation of cultivation， and differentiated into two commodities（wild variety of Qingxiangru and cultivated variety of Jiangxiangru）， cultivated products formed an authentic producing area in Jiangxi. The three varieties coexisted during the Ming and Qing dynasties， and the Elsholtzia varieties were gradually eliminated. Variety changes have caused changes in the functions and indications of drugs. E. ciliata had the effect of clearing heat and was mainly used to treat heatstroke and cholera， while M. chinensis was used for exogenous wind cold and dampness in the summer because of its warm and strong sweating properties， but not for cholera. Traditional Moslae Herba is mainly harvested in the summer and autumn （flowering to fruiting stage） and the above-ground parts are dry in the shade and used as medicine. Modern Qingxiangru is mostly harvested before the flowering period， and Jiangxiangru is harvested after flowering and fruiting in late summer and early autumn. In summary， according to the 2020 edition of Chinese Pharmacopoeia， the dried above-ground parts of Moslae Herba should be selected for Xinjia Xiangruyin in the Catalogue of Ancient Famous Classical Formulas（The First Batch）， mainly the cultivated variety of Jiangxiangru， and the raw products is cut into segments and used as medicine. It is suggested that when applying and developing famous classical formulas containing Moslae Herba at different periods of time today， the origin should be established in conjunction with clinical efficacy.

Association Between Ferroptosis and Central Nervous System Diseases and A Review of Traditional Chinese Medicine Intervention / 中国实验方剂学杂志

Central nervous system （CNS） is a sophisticated system subject to complex regulation， which dominates the high-level neural activities of the human body. Due to its complex physiological structure and refined regulatory mechanism covering a variety of diseases， CNS is the place where many chronic， refractory and rare diseases occur. Nerve cell is the basic unit of CNS， and its dysfunction and death is the root cause of CNS diseases. Ferroptosis is a new form of programmed cell death proposed in recent years， and has been proved to be closely related to the production and development of multiple CNS diseases. Traditional Chinese medicine （TCM）， including Chinese herbs， acupuncture and moxibustion， and massage， has shown unique advantages in the treatment of CNS diseases for a long time. A large number of studies have demonstrated that TCM participates in the regulation of CNS diseases via regulating ferroptosis and shows a good research prospect. This paper summarized the characteristics of ferroptosis and discussed the association between ferroptosis and CNS diseases in pathological mechanism. We also reviewed the regulation of various CNS diseases by different TCM interventions through ferroptosis， providing references for TCM to participate in the treatment of CNS diseases properly in the future.

Clinical efficacy of da Vinci Xi surgical system assisted programmed six-hole method anterior resection of rectal cancer / 中华消化外科杂志

Objective:To investigate the clinical efficacy of da Vinci Xi surgical system assisted programmed six-hole method anterior resection of rectal cancer.Methods:The retrospec-tive cohort study was conducted. The clinicopathological data of 102 patients with middle and low rectal cancer who were admitted to the Affiliated Hospital of Xuzhou Medical University from August 2020 to June 2021 were collected. There were 62 males and 40 females, aged (53±12)years. Of the 102 patients, 51 cases undergoing da Vinci Xi surgical system assisted programmed six-hole method anterior resection of rectal cancer were divided into the robotic group and 51 cases undergoing laparoscopic anterior resection of rectal cancer were divided into the laparoscopic group. Observa-tion indicators: (1) treatment; (2) postoperative pathological examination; (3) follow-up. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Repeated measurement data were analyzed using the repeated ANOVA. Results:(1) Treatment. All patients of the two groups under-went radical resection of rectal cancer successfully, and none of patient with intraoperative blood transfusion, conversion to open surgery, and death within 30 days after surgery. The operation time, volume of intraoperative blood loss, number of lymph nodes dissected, time to postoperative first flatus, time to postoperative first liquid food intake, time to postoperative catheter removal, cases with postoperative pain grading as grade 1, grade 2, grade 3, grade 4, cost of treatment were (170±12)minutes, (73±50)mL, 23±6, (35.1±9.4)hours, (2.1±0.8)days, (2.9±2.7)days, 13, 15, 17, 6, (7.1±4.5) ten thousand yuan in patients of the robotic group, versus (153±22)minutes, (119±66) mL, 15±4, (40.7±1.9)hours, (2.9±0.4)days, (5.3±2.1)days, 6, 7, 26, 12, (6.7±1.6) ten thousand yuan in patients of the laparoscopic group, showing significant differences in the above indicators between the two groups ( t=6.79, -4.46,20.09, -3.01, -5.54, -16.69, Z=-2.87, t=4.22, P<0.05). (2) Postoperative patho-logical examination. The tumor diameter, length of specimen resected, distance of upper resection margin to tumor, distance of lower resection margin to tumor, cases with mesorectal specimens as integrity and mostly integrity, cases with tumor differentiation as high differentiation, moderate differentiation, low differentiation, cases with postoperative TNM staging as stage Ⅰ, stage Ⅱ, stage Ⅲ were (3.8±1.1)cm, (18.7±3.2)cm, (11.8±3.6)cm, (2.7±0.8)cm, 48, 3, 4, 41, 6, 6, 17, 28 in patients of the robotic group, versus (3.7±1.0)cm, (18.3±2.8)cm, (10.2±2.7)cm, (2.5±0.6)cm, 46, 5, 6, 39, 6, 5,20, 26 in patients of the laparoscopic group, showing no significant difference in the above indicators between the two groups ( t=1.72, 1.29, 1.64, 1.11, χ2=0.14, Z=-0.42, -0.26, P>0.05). Cases with positive circumferential margin and cases with destruction of mesentery was 0 and 0 in patients of the robotic group, versus 1 and 1 in patients of the laparoscopic group, showing no significant difference in the above indicators between the two groups ( P>0.05). (3) Follow-up. All patients in the two groups were followed up for 12 months after surgery and none of patient had postoperative local recurrence and distant metastasis of tumors. The anal incontinence score, low anterior resection syndrome score, international prostate symptom score, night urination score, international index of erectile score, female sexual function index score in patients of the robotic group were 0, 12.25±1.08, 4.43±0.33, 0.49±0.09, 24.07±2.75, 65.84±1.79 before surgery and 1.34±0.11, 18.11±3.54, 4.03±0.26, 1.08±0.28, 22.63±2.03, 38.57±6.13 at postoperative 12 months, respectively. The above indicators in patients of the laparoscopic group were 0, 12.60±1.11, 4.56±0.36, 0.46±0.07, 23.11±2.77, 66.31±1.73 before surgery and 1.99±1.33,20.85±6.19, 6.43±1.78, 2.27±0.23, 21.00±2.73, 27.62±8.20 at postoperative 12 months, respectively. There were significant differences in the above indicators between the two groups ( P<0.05). Conclusions:The oncological effects of da Vinci Xi surgical system assisted programmed six-hole method anterior resection of rectal cancer and lapa-roscopic anterior resection of rectal cancer are comparable. However, robotic surgery is superior to laparoscopic surgery in terms of intraoperative bleeding, lymph node dissection, gastrointestinal function recovery, and pelvic autonomic nerve protection.

Diagnosis and treatment of internal hernia after laparoscopic surgery for gastric cancer / 中华消化外科杂志

With the development of laparoscopic surgery for gastric cancer, more and more surgeons use laparoscopic techniques and even totally laparoscopic techniques in gastric cancer surgery. However, technological progress brings not only smaller trauma, but also new problems and risks. Compared with traditional open surgery, the high incidence of internal hernia after laparoscopic gastric cancer surgery is an urgent problem to be solved. As the incidence of internal hernia often occurs after discharge, patients usually choose the nearest hospital for diagnosis and treatment due to the urgent course of disease. As a result, patients with internal hernia often have serious complications due to delayed treatment because of the difficulty in diagnosis. Sometimes, there are patients even death. The authors review the relevant research on postoperative internal hernia of gastric cancer in recent years and combine with practical experience to discuss the diagnosis and treatment strategy of internal hernia after laparoscopic surgery for gastric cancer, aiming to improve the clinicians′ attention to the disease and provide reference for its diagnosis and treatment.

Application value of short-term prehabilitation in elderly patients undergoing gastrointestinal tumor surgery / 中国实用护理杂志

Objective:To explore the effectiveness of short-term prehabilitation in elderly patients undergoing gastrointestinal tumor surgery.Methods:Elderly patients(139 cases) with gastrointestinal tumors who were admitted to Nanfang Hospital, Southern Medical University for surgery from December 2020 to January 2022 were included through the purposive sampling method, and were divided into the intervention group (69 cases) and the control group (70 cases) according to the patient's wishes using a quasi-experimental research design of non randomized grouped. Routine perioperative nursing was used in the control group, while the short-term prehabilitation was used in the intervention group in addition. The incidence of postoperative complications, the performance indicators, and postoperative functional recovery indicators were analyzed in the two groups.Results:The 6MWD in the intervention group of 1 day and 7 days after the surgery were (460.93 ± 76.36) m and (391.72 ± 72.93) m, which were significant higher than those in the control group, (423.69 ± 72.88) m and (351.13 ± 65.04) m ( t = 8.65, 12.01, both P<0.05). The first exhaust time, first postoperative ambulatory time, the first full fluid intake time and the duration of drainage tube indwelling in the intervention group were (51.28 ± 21.74) h, (33.93 ± 12.50) h, (69.39 ± 29.36) h and (4.30 ± 1.44) d, which were significant lower than those in the control group, (71.51 ± 23.68) h, (47.37 ± 14.58) h, (96.29 ± 38.36) h and (5.35 ± 2.09) d ( t values were -5.83 - -3.44, all P<0.05). Besides, the best critical value of preoperative 6MWD to predict postoperative rehabilitation effect was 477.5 m, with a sensitivity of 68% and specificity of 71%. Conclusions:Short-term prehabilitation improves the perioperative functional reserve and promotes overall functional recovery after surgery to a certain extent, and the postoperative functional recovery effect may be better when the patient′s preoperative 6MWD reaches 477.5 m.

Biomechanical Study on Contiguous Three-Level Cervical Hybrid Surgery and Anterior Cervical Discectomy and Fusion / 医用生物力学

Objective To compare the biomechanical effects of contiguous three-level cervical Hybrid surgery[anterior cervical discectomy and fusion (ACDF) + cervical disc arthroplasty ( CDA)] and three-level ACDF. Methods The finite element model of C1-T1 cervical-thoracic spine was developed based on CT data. Three models were simulated by the implantation of Prestige LP and Zero-P prostheses, including two Hybrid models (AFA, Prestige LP implanted at C3-4 and C5-6 segments and Zero-P implanted at C4-5 segment; FAF, Zero-P implanted at C3-4 and C5-6 segments and Prestige LP implanted at C4-5 segment) and three-level ACDF model(FFF). The changes in range of motion (ROM) of adjacent levels during flexion, extension, lateral bending and axial rotation, the overall ROM, as well as the intradiscal pressure ( IDP) and facet contact force ( FCF) of adjacent levels were compared. Results The ROM in adjacent levels and the overall ROM of the AFA modelwere closer to the intact model, and the maximum increases in the ROM of the adjacent levels for the FAF and FFF models were 15. 0% and 23. 4% , respectively. For AFA, FAF and FFF models, the maximum increases in the maximum IDP of adjacent levels were 19. 0% , 66. 7% , 147. 6% , and the maximum increases in FCF were 17. 4% , 55. 7% , 80. 1% , respectively. Conclusions This study provides biomechanical basis for three-level cervical Hybrid surgery in treating patients with the contiguous three-level cervical degenerative disc disease.

Effects of cadmium chloride on testicular autophagy and blood-testis barrier integrity in prepubertal male rats / 中华劳动卫生职业病杂志

Objective: To study the effects of cadmium chloride (CdCl(2)) exposure on testicular autophagy levels and blood-testis barrier integrity in prepubertal male SD rats and testicular sertoli (TM4) cells. Methods: In July 2021, 9 4-week-old male SD rats were randomly divided into 3 groups: control group (normal saline), low dose group (1 mg/kg·bw CdCl(2)) and high dose group (2 mg/kg·bw CdCl(2)), and were exposed with CdCl(2) by intrabitoneal injection. 24 h later, HE staining was used to observe the morphological changes of testis of rats, biological tracer was used to observe the integrity of blood-testis barrier, and the expression levels of microtubule-associated protein light chain 3 (LC3) -Ⅰ and LC3-Ⅱ in testicular tissue were detected. TM4 cells were treated with 0, 2.5, 5.0 and 10.0 μmol/L CdCl(2) for 24 h to detect the toxic effect of cadmium. The cells were divided into blank group (no exposure), exposure group (10.0 μmol/L CdCl(2)), experimental group[10.0 μmol/L CdCl(2)+60.0 μmol/L 3-methyladenine (3-MA) ] and inhibitor group (60.0 μmol/L 3-MA). After 24 h of treatment, Western blot analysis was used to detect the expression levels of LC3-Ⅱ, ubiquitin binding protein p62, tight junction protein ZO-1 and adhesion junction protein N-cadherin. Results: The morphology and structure of testicular tissue in the high dose group were obvious changed, including uneven distribution of seminiferous tubules, irregular shape, thinning of seminiferous epithelium, loose structure, disordered arrangement of cells, abnormal deep staining of nuclei and vacuoles of Sertoli cells. The results of biological tracer method showed that the integrity of blood-testis barrier was damaged in the low and high dose group. Western blot results showed that compared with control group, the expression levels of LC3-Ⅱ in testicular tissue of rats in low and high dose groups were increased, the differences were statistically significant (P<0.05). Compared with the 0 μmol/L, after exposure to 5.0, 10.0 μmol/L CdCl(2), the expression levels of ZO-1 and N-cadherin in TM4 cells were significantly decreased, and the expression level of p62 and LC3-Ⅱ/LC3-Ⅰ were significantly increased, the differences were statistically significant (P<0.05). Compared with the exposure group, the relative expression level of p62 and LC3-Ⅱ/LC3-Ⅰ in TM4 cells of the experimental group were significantly decreased, while the relative expression levels of ZO-1 and N-cadherin were significantly increased, the differences were statistically significant (P<0.05) . Conclusion: The mechanism of the toxic effect of cadmium on the reproductive system of male SD rats may be related to the effect of the autophagy level of testicular tissue and the destruction of the blood-testis barrier integrity.

Empirical analysis on lumbar disc herniation treated with "sinew-bone three needling technique" of Chinese medicine / 中国针灸

The paper presents professor WU Han-qing's experience in treatment of lumbar disc herniation (LDH) with "sinew-bone three needling technique" of Chinese medicine. Based on the theory of meridian sinew, the points are located by "three-pass method" in terms of the distribution of meridian sinew and syndrome/pattern differentiation. The cord-like muscles and adhesion are relieved by relaxing technique to work directly on the affected sites and alleviate the local compression to the nerve root. The needle technique is operated flexibly according to the affected regions involved, due to which, the needling sensation is increased while the safety ensured. As a result, the meridian qi is enhanced, the mind and qi circulation is regulated; and the clinical effect is improved.