Remodeling of the Intra-Conduit Inflammatory Microenvironment to Improve Peripheral Nerve Regeneration with a Neuromechanical Matching Protein-Based Conduit.

Peripheral nerve injury (PNI) remains a challenging area in regenerative medicine. Nerve guide conduit (NGC) transplantation is a common treatment for PNI, but the prognosis of NGC treatment is unsatisfactory due to 1) neuromechanical unmatching and 2) the intra-conduit inflammatory microenvironment (IME) resulting from Schwann cell pyroptosis and inflammatory-polarized macrophages. A neuromechanically matched NGC composed of regenerated silk fibroin (RSF) loaded with poly(3,4-ethylenedioxythiophene): poly(styrene sulfonate) (P:P) and dimethyl fumarate (DMF) are designed, which exhibits a matched elastic modulus (25.1 ± 3.5 MPa) for the peripheral nerve and the highest 80% elongation at break, better than most protein-based conduits. Moreover, the NGC can gradually regulate the intra-conduit IME by releasing DMF and monitoring sciatic nerve movements via piezoresistive sensing. The combination of NGC and electrical stimulation modulates the IME to support PNI regeneration by synergistically inhibiting Schwann cell pyroptosis and reducing inflammatory factor release, shifting macrophage polarization from the inflammatory M1 phenotype to the tissue regenerative M2 phenotype and resulting in functional recovery of neurons. In a rat sciatic nerve crush model, NGC promoted remyelination and functional and structural regeneration. Generally, the DMF/RSF/P:P conduit provides a new potential therapeutic approach to promote nerve repair in future clinical treatments.

Efficacy and Mechanism of Qingre Lishi Prescription in Treating Children with Acute Bacterial Lower Urinary Tract Infection of Bladder Damp-heat Syndrome / 中国实验方剂学杂志

Objective:To observe the efficacy of Qingre Lishi prescription in treating children with acute bacterial lower urinary tract infection of bladder damp-heat syndrome， and to explore its mechanism of action. Method:Eighty children with acute bacterial lower urinary tract infection of late bladder damp-heat syndrome who were admitted to the Affiliated Hospital of Changchun University of Chinese Medicine were divided into control group and observation group， 40 cases in each group. Patients in control group were given Bazhengsan for oral treatment on basis of basic treatment， while patients in observation group were given Qingre Lishi prescription for oral administration plus external washing treatment. After two weeks of treatment， the clinical and etiological effect， traditional Chinese medicine （TCM） syndrome scores， antipyretic time and urinary negative time， adverse reactions， and urine pathogens （<italic>Escherichia coli， Enterococcus faecalis， Strange proteus， Klebsiella pneumoniae</italic>）， serum inflammatory factor indicators ［tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， interleukin-6 （IL-6）， interleukin-8 （IL-8）， calcium lowering PCT， white blood cell count （WBC） and serum C-reactive protein （CRP）］， immune function indicators ［T cell subsets （CD3⁺， CD4⁺， CD8⁺） and complement （C3， C4）］ were comapred between two groups. Result:The clinical efficacy of observation group was 92.50% （37/40）， which was significantly higher than 65.00% （26/40） in control group （<italic>χ²</italic>=9.038， <italic>P</italic><0.01）， the etiological efficacy of observation group was 87.50% （35/40）， which was significantly higher than 60.00% （24/40） in control group （<italic>χ²</italic>=7.813， <italic>P</italic><0.01）. After treatment， the scores of TCM syndromes of the two groups were significantly reduced （<italic>P</italic><0.05）. The scores of fever， frequent urination， urgent urination， painful urination， difficulty urinating and abdominal pain in two groups were significantly lower than those before treatment （<italic>P</italic><0.05）， and the TCM syndrome scores in observation group were lower than those in control group （<italic>P</italic><0.05）， the antipyretic time and urinary bacteria turning negative time of observation group were significantly lower than those in control group （<italic>P</italic><0.05）， the <italic>Escherichia coli， Enterococcus faecalis， Proteus mirabilis， Klebsiella pneumoniae</italic> pathogenic bacteria detected in both groups were both significantly lower than those before treatment （<italic>P</italic><0.05）. After treatment， the levels of inflammatory factors such as TNF-<italic>α</italic>， IL-6， IL-8， PCT， WBC and CRP in two groups were significantly lower than those before treatment （<italic>P</italic><0.05）， the immune function of the two groups was significantly improved， and the levels of CD3⁺， CD4⁺， C3， and C4 in observation group were higher than those in control group（<italic>P</italic><0.05）， and the CD8⁺ level was lower than that in control group （<italic>P</italic><0.05）. The incidence of adverse reactions had no significant difference between two groups. Conclusion:Qingre Lishi prescription has good clinical effect in treating children with acute bacterial lower urinary tract infection with bladder damp-heat syndrome. It can improve TCM syndromes and clinical symptoms. Its mechanism is related to inhibiting pathogenic bacteria， reducing inflammation， and improving immune function， and it has good security.

Towards resolving the co-existing impacts of multiple dynamic factors on the performance of EMG-pattern recognition based prostheses.

BACKGROUND AND OBJECTIVE: Mobility of subject (MoS) and muscle contraction force variation (MCFV) have been shown to individually degrade the performance of multiple degrees of freedom electromyogram (EMG) pattern recognition (PR) based prostheses control systems. Though these factors (MoS-MCFV) co-exist simultaneously in the practical use of the prosthesis, their combined impact on PR-based system has rarely been studied especially in the context of amputees who are the target users of the device. METHODS: To address this problem, this study systematically investigated the co-existing impact of MoS-MCFV on the performance of PR-based movement intent classifier, using EMG recordings acquired from eight participants who performed multiple classes of targeted limb movements across static and non-static scenarios with three distinct muscle contraction force levels. Then, a robust feature extraction method that is invariant to the combined effect of MoS-MCFV, namely, invariant time-domain descriptor (invTDD), was proposed to optimally characterize the multi-class EMG signal patterns in the presence of both factors. RESULTS: Experimental results consistently showed that the proposed invTDD method could significantly mitigate the co-existing impact of MoS-MCFV on PR-based movement-intent classifier with error reduction in the range of 7.50%~17.97% (p<0.05), compared to the commonly applied methods. Further evaluation using 2-dimentional principal component analysis (PCA) technique, revealed that the proposed invTDD method has obvious class-separability in the PCA feature space, with a significantly lower standard error (0.91%) compared to the existing methods. CONCLUSION: This study offers compelling insight on how to develop accurately robust multiple degrees of freedom control scheme for multifunctional prostheses that would be clinically viable. Also, the study may spur positive advancement in other application areas of medical robotics that adopts myoelectric control schemes such as the electric wheelchair and human-computer-interaction systems.

Application and effect evaluation of "3-PR" participatory health education model in the improvement of health literacy of secondary health school / 中国学校卫生

Objective@#To compare the effect of two different methods of "3-PR" participatory health education and traditional distribution of publicity materials on health literacy improvement of medical students, to provide a reference for making more effective measure to improve health literacy.@*Methods@#173 Second-grade students in nursing major were selected in a secondary vocational school in Datong City. Two different intervention methods were used to intervene for 8 weeks. The experimental group (92 students) received "3-PR" participatory health education; the traditional health education intervention in the control group(81 students). The "National Residents’ Health Literacy Monitoring Questionnaire 2015" was used to conduct a questionnaire survey on the experimental group and the control group before and after the intervention, and to compare the effects before and after the intervention.@*Results@#The average score of health literacy was (36.04±9.43) points and (36.01±10.17) points before and after intervention in the control group; (35.78±8.91) points and (49.53±13.53) points before and after intervention in the experimental group; No statistical difference between experimental and control group was found before intervention(t=0.18, P=0.86); There was no significant difference in health literacy score before and after intervention for the control group(t=0.03, P=0.98); Health literacy significantly increased in the experimental group after intervention(t=-11.36, P=0.00). Adequate health literacy accounted for 3.70% and 4.94% before and after intervention in the control group and 4.35% and 45.65% in the experimental group before and after intervention. No significant difference was found in adequate health literacy proportion between the two groups before intervention(χ2=0.00, P=1.00). However, the difference showed statistically significant after intervention(χ2=36.58, P=0.00). The change of health literacy score in the control group and the experimental group was (-0.02±7.52) and (12.75±10.77), respectively, accounting for 1.24% decrement and 41.30% increment. The difference between the two groups was statistically significant (t=-8.93, P=0.00). The dimension-and type-specific score of health literacy showed similar pattern.@*Conclusion@#The "3-PR" participatory health education model is more effective than the traditional health education method in improving health literacy, and it could be carried out by multi-disciplinary students.

Disease burden on uterine fibroids in China, 1990 and 2016 / 中华流行病学杂志

Objective To assess the disease burden on uterine fibroids in China in 1990 and 2016.Methods Data were extracted from the Global Burden of Disease Study 2016.Burdens of uterine fibrosis among different age groups and provinces were measured in 1990 and 2016,with key indicators including number of cases,prevalence rates,disability-adjusted life year (DALY) and the rates of DALY.The WHO world standard population,2010-2035 was used to calculate the agestandardized rates.Results In 1990 and 2016,there were 13 695 567 and 27 169 312 women aged 15 years and older,suffered from uterine fibrosis respectively,with prevalence rate as 2.48％ and 4.10％,DALY as 146 045.05 life years and 281 976.67 life years,and the DALY rate as 26.40/100 000 and 42.50/100 000,in 1990 and 2016 respectively.Both the prevalence rate and the DALY rate increased with age,reaching the peak on the 45-49 years-old,in both 1990 and 2016.Women aged 40-54 years accounted for 55.60％ (1990) and 66.74％ (2016) of the total cases while 48.37％ (1990) and 60.65％ (2016) of the total DALY.The first three provinces with highest DALYs were Shandong (1990:12 574.67 life year;2016:22 728.12 life year),Henan (1990:10 849.29 life year;2016:18 454.32 life year) and Jiangsu (1990:10 501.55 life year;2016:18 274.10 life year),while the three provinces with leading standardized DALY rates were Heilongjiang (1990:48.20/100 000;2016:47.00/100 000),Shanxi (1990:44.50/100 000;2016:47.70/100 000) and Tianjin (1990:43.80/100 000;2016:46.40/100 000) in both 1990 and 2016.Compared with 1990,the number of cases with uterine fibroids increased by 13 473 745 (with rate of change as:98.38％),standardized prevalence rate increased by 1.88％,DALY value increased by 135 931.62 life years (with the rate of change as 93.08％) and standardized DALY rate increased by 5.92％ among Chinese women,in 2016.Conclusion Menopausal women were the ones hard hit by uterine fibrosis.Compared with data from 1990,the disease burden of uterine fibrosis increased rapidly in China,in 2016.

Disease burden of diabetes attributable to high body mass index in China,1990-2016 / 中华流行病学杂志

Objective To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016.Methods Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI.Measurements for attributable BOD of diabetes included disability adjusted life years (DALY),years of lost life (YLL),years living with disability (YLD),death number and mortality rate.The average world population from 2010 to 2035 was used as a reference.Results In 2016,death number of diabetes attributable to high BMI was 40 310,which was significantly higher than that in 1990 (15 008).Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016,which showed a more significant increasing trend in both males and people aged 15-49 years.DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years.YLL and YLD also showed increasing trends.The highest increasing rate of YLD was in people aged 15-49 years.High BMI was responsible for 26.01％ of the diabetes deaths in 2016 in China,an increase of 39.39％ compared with that in 1990 (18.66％).Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016.Inner Mongolia,Xinjiang,Zhejiang,Macao SAR,Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period.Conclusions There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI,causing a heavy disease burden,in China from 1990 to 2016.The BOD varied in both different age and gender groups.More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.

Disease burden on uterine fibroids in China, 1990 and 2016 / 中华流行病学杂志

Objective To assess the disease burden on uterine fibroids in China in 1990 and 2016.Methods Data were extracted from the Global Burden of Disease Study 2016.Burdens of uterine fibrosis among different age groups and provinces were measured in 1990 and 2016,with key indicators including number of cases,prevalence rates,disability-adjusted life year (DALY) and the rates of DALY.The WHO world standard population,2010-2035 was used to calculate the agestandardized rates.Results In 1990 and 2016,there were 13 695 567 and 27 169 312 women aged 15 years and older,suffered from uterine fibrosis respectively,with prevalence rate as 2.48％ and 4.10％,DALY as 146 045.05 life years and 281 976.67 life years,and the DALY rate as 26.40/100 000 and 42.50/100 000,in 1990 and 2016 respectively.Both the prevalence rate and the DALY rate increased with age,reaching the peak on the 45-49 years-old,in both 1990 and 2016.Women aged 40-54 years accounted for 55.60％ (1990) and 66.74％ (2016) of the total cases while 48.37％ (1990) and 60.65％ (2016) of the total DALY.The first three provinces with highest DALYs were Shandong (1990:12 574.67 life year;2016:22 728.12 life year),Henan (1990:10 849.29 life year;2016:18 454.32 life year) and Jiangsu (1990:10 501.55 life year;2016:18 274.10 life year),while the three provinces with leading standardized DALY rates were Heilongjiang (1990:48.20/100 000;2016:47.00/100 000),Shanxi (1990:44.50/100 000;2016:47.70/100 000) and Tianjin (1990:43.80/100 000;2016:46.40/100 000) in both 1990 and 2016.Compared with 1990,the number of cases with uterine fibroids increased by 13 473 745 (with rate of change as:98.38％),standardized prevalence rate increased by 1.88％,DALY value increased by 135 931.62 life years (with the rate of change as 93.08％) and standardized DALY rate increased by 5.92％ among Chinese women,in 2016.Conclusion Menopausal women were the ones hard hit by uterine fibrosis.Compared with data from 1990,the disease burden of uterine fibrosis increased rapidly in China,in 2016.

Disease burden of diabetes attributable to high body mass index in China,1990-2016 / 中华流行病学杂志

Objective To analyze the burden of disease (BOD) on diabetes attributable to high BMI in China from 1990 to 2016.Methods Data based on population of the 2016 Global Burden of Disease Study for China were used to analyze the attributable fractions (PAF) of BOD for diabetes attributable to high BMI.Measurements for attributable BOD of diabetes included disability adjusted life years (DALY),years of lost life (YLL),years living with disability (YLD),death number and mortality rate.The average world population from 2010 to 2035 was used as a reference.Results In 2016,death number of diabetes attributable to high BMI was 40 310,which was significantly higher than that in 1990 (15 008).Age-standardized death rate of diabetes attributable to high BMI increased from 2.01/100 000 in 1990 to 2.60/100 000 in 2016,which showed a more significant increasing trend in both males and people aged 15-49 years.DALYs of diabetes attributable to high BMI increased from 1.09 million person years to 3.30 million person years.YLL and YLD also showed increasing trends.The highest increasing rate of YLD was in people aged 15-49 years.High BMI was responsible for 26.01％ of the diabetes deaths in 2016 in China,an increase of 39.39％ compared with that in 1990 (18.66％).Most provinces in China experienced a sharp increase of DALY of diabetes attributable to high BMI from 1990 to 2016.Inner Mongolia,Xinjiang,Zhejiang,Macao SAR,Sichuan and Qinghai had the most significant increase tendency in terms of DALY rate during this period.Conclusions There was a rapid increase of the deaths and mortality rate of diabetes attributable to high BMI,causing a heavy disease burden,in China from 1990 to 2016.The BOD varied in both different age and gender groups.More attention should be paid to males and people aged 15-49 years in the prevention and control programs of diabetes.

InAs/GaAs Quantum Dot Dual-Mode Distributed Feedback Laser Towards Large Tuning Range Continuous-Wave Terahertz Application.

In this paper, a laterally coupled distributed feedback (LC-DFB) laser based on modulation p-doped multiple InAs/GaAs quantum dot (QD) structures has been fabricated. The device exhibits a high side-mode suppression ratio (SMSR) of > 47 dB and a high thermal stability of dλ/dT = 0.092 nm/K under continuous-wave (CW) operation, which is mainly attributed to the high material gain prepared by modulation p-doping and rapid thermal annealing (RTA) process, and the significantly reduced waveguide losses by shallow-etched gratings and its close proximity to the laser ridge feature in the LC-DFB laser. With this superior performance of the DFB laser, the wide tunable dual-wavelength lasing operation has been obtained by delicately defining different periods for the grating structures on the two sides of the laser ridge or combining the reduced laser cavity length. The wavelength spacing between the two lasing modes can be flexibly tuned in a very wide range from 0.5 to 73.4 nm, corresponding to the frequency difference from 0.10 to 14 THz, which is the largest tuning range by the utilization of single device and hence providing a new opportunity towards the generation of CW THz radiation.

Near-infrared and mid-infrared semiconductor broadband light emitters.

Semiconductor broadband light emitters have emerged as ideal and vital light sources for a range of biomedical sensing/imaging applications, especially for optical coherence tomography systems. Although near-infrared broadband light emitters have found increasingly wide utilization in these imaging applications, the requirement to simultaneously achieve both a high spectral bandwidth and output power is still challenging for such devices. Owing to the relatively weak amplified spontaneous emission, as a consequence of the very short non-radiative carrier lifetime of the inter-subband transitions in quantum cascade structures, it is even more challenging to obtain desirable mid-infrared broadband light emitters. There have been great efforts in the past 20 years to pursue high-efficiency broadband optical gain and very low reflectivity in waveguide structures, which are two key factors determining the performance of broadband light emitters. Here we describe the realization of a high continuous wave light power of >20 mW and broadband width of >130 nm with near-infrared broadband light emitters and the first mid-infrared broadband light emitters operating under continuous wave mode at room temperature by employing a modulation p-doped InGaAs/GaAs quantum dot active region with a 'J'-shape ridge waveguide structure and a quantum cascade active region with a dual-end analogous monolithic integrated tapered waveguide structure, respectively. This work is of great importance to improve the performance of existing near-infrared optical coherence tomography systems and describes a major advance toward reliable and cost-effective mid-infrared imaging and sensing systems, which do not presently exist due to the lack of appropriate low-coherence mid-infrared semiconductor broadband light sources.

Role and mechanism of Epac protein in regulation of inflammatory pain in paraventricular nucleus of hypothalamus / 中国药理学通报

Aim To investigate the role and mecha-nism of exchange protein directly activated by cAMP (Epac) protein in the paraventricular nucleus(PVN) of the hypothalamus in the development of inflammatory pain in rats. Methods Adult SD male rats were cho-sen to establish the model of inflammatory pain through subcutaneous injection of complete Freund's adjuvant(CFA) on the center of left hind foot. Western blot was used to detect the changes of the expression of Ep-ac protein. Thermal withdrawal latency(TWL) was ob-served after the PVN injecting 8p-CPT-2′-O-Me-cAMP (8p-CPT),the agonist of Epac. Then activated down-stream MEK1/2 protein of Epac in PVN was detected using Western blot when the potency was the strongest.Results ① Compared with normal saline(control group),TWL decreased significantly on d 1, d 3, d 5, d 7,d 9 on the ipsilateral foot of CFA group rats(P<0.01),whereas it returned to normal level in d 13;the paw mechanical withdrawal threshold(PMWT) de-creased significantly on d 6,d 8,d 10,d 12 and d 14 (P<0.05);②Compared with the control,the Epac1 protein in CFA group rats began to decrease from d 3, and significantly decreased on d 3 and d 9(P<0.05), however the expression of Epac2 had no significant change, meanwhile p-MEK1/2 protein decreased sig-nificantly on d 3(P<0.05);③Compared with micro-injection of saline into the PVN(Saline group), the heat hyperalgesia of 20 min and 1h decreased signifi-cantly and TWL increased significantly after PVN ad-ministration of 8p-CPT(8p-CPT group)(P <0.05);paraventricular nucleus p-MEK1/2 protein expression increased significantly in 30 min(P <0.05) and re-covered to normal level 2 h after administration. Con-clusion The Epac1-MEK1/2 signaling pathway in the paraventricular nucleus of the hypothalamus may be in-volved in the development of chronic inflammatory pain induced by CFA.

Effect of lifestyle intervention among high risk group of chronic diseases in Shenzhen Futian district / 中华预防医学杂志

Objective@#To evaluate the effect of lifestyle intervention among high risk group of chronic diseases in Shenzhen Futian district.@*Methods@#12 out of 115 communities were randomly selected in Futian district of Shenzhen city from October to November, 2013, and 1 923 cases were screened by multiple ways as high risk groups of chronic diseases. High risk groups of chronic diseases were divided into intervention group (1 338 cases, from five residential communities and three villages within city) and control group (585 cases, from four residential communities). The intervention group received group based health education activities as well as lifestyle intervention. The intervention group was provided with health management which was mainly lifestyle intervention. No intervention was implemented in the control group. All participants were followed up over two years. 1 563 participants (1 002 in intervention group and 561 in control group) were followed up from October to November, 2015. The changes of lifestyle related outcome indicators were analyzed to examine the effect of intervention.@*Results@#In the intervention group, 21.8% (219 persons) in high risk groups of chronic diseases became healthy individuals and 15.2% (152 persons) became patients with chronic diseases. In the control group, 9.6% (54 persons) in high risk groups of chronic diseases became healthy individuals and 20.5% (115 persons) became patients with chronic diseases. The outcome of the intervention group was better than that of the control group and the difference was statistically significant (χ2=-5.67, P<0.001). The proportion of people who knew how to correctly use of oil control pot in the intervention group increased from 61.00% (61/100) to 80.00% (280/350). The proportion of people who took oil control measures in the intervention group increased from 36.43% (365/1 002) to 56.99%(571/1 002). The changes in the intervention group were statistically different (P<0.001), but there was no statistical difference in the control group over the years (P>0.05). The proportion of people who knew how to correctly use of the salt restriction spoon increased from 81.95% (109/133) to 97.99% (342/349). The proportion of people who took salt control measures increased from 45.61% (457/1 002) to 62.67% (628/1 002) in the intervention group. The changes in the intervention group were statistically different (P<0.001). There was no statistical difference in the control group over the years (P>0.05).@*Conclusion@#The proportion of people who adopted healthy lifestyles has increased after 2 years intervention and the lifestyle intervention demonstrated good effect.

Clinical evaluation of the anti-gingivitis efficacy of a novel stabilized stannous-containing sodium fluoride dentifrice / 实用口腔医学杂志

Objective: To evaluate the anti-gingivitis efficacy of a novel stabilized stannous-containing sodium fluoride dentifrice. Methods: A randomized, controlled and double blind clinical study was conducted. 156 adults with gingivitis were enrolled and randomly assigned to experimental group(group of novel stabilized stannous-containing sodium fluoride dentifrice, n = 51), positive control group (group of Yunnan Baiyao dentifrice, n = 54) and negative control group (group of Crest dentifrice, n = 51). Gingival health was assessed using Mazza Modification of the Papillary Bleeding Index(Mazza GI) at Baseline, day 3 and week 4 and pocket depth was evaluated at baseline and week 4, respectively. Results: At day 3 and week 4, the experimental and positive control groups exhibited lower clinical parameters than the negative control group(P＜ 0. 000 1). At week 4, the mean Mazza GI scores and PD of the experimental group were significantly lower than those of the positive control group(P＜ 0. 05). Conclusion: The novel stannous-containing sodium fluoride dentifrice has anti-gingivitis efficacy.

The strategy and results of percutaneous endoscopic surgery for cervical disc herniation / 中华骨科杂志

Objective To evaluate the strategy and clinical effects of percutaneous endoscopic surgery for cervical disc herniation.Methods Fifty-one patients with cervical disc herniation were treated with percutaneous endoscopic surgery from June 2015 to March 2017,including 32 men and 19 women,with an average age of 52.2 years (range,28-66 years).Radicular symptoms were present in all patients,while 23 patients had mild myelopathy (Nurick Grade:0-3) and 3 patients of multilevel stenosis had severe myelopathy (Nurick Grade:4-5).According to axial image of preoperative magnetic resonance imaging (MRI),31 patients had lateral herniation that was located lateral to the edge of spinal cord,20 patients had central herniation that was located within the lateral edge of spinal cord.Among them,48 patients had soft herniation and 3 patients had ossified lateral herniation combined with foraminal stenosis.All surgery was carried out under general anesthesia,while posterior and anterior percutaneous endoscopic surgeries were performed for lateral herniation and central herniation respectively.Posterior endoscopic surgery was performed with "keyhole" fenestration at "V" point (the junction of lateral edge of lamina space and inner edge of facet).Lateral edge of thecal sac and nerve root were exposed and decompressed,soft herniation was explored and removed.Anterior endoscopic surgery was performed through puncture and 4mm tube between the visceral sheath and vascular sheath.The tube was inserted through disc to the base of herniation under fluoroscopy.The herniation was removed until the dura sac was exposed and relaxed.One stage open-door laminoplasty was performed for 3 patients with severe multiple segmental stenosis and huge central herniation.The operative time and blood loss were recorded,and patients were followed-up (range,6-18 months,average 12.1 months) to evaluate the clinical efficacy.Results The mean operative time of posterior endoscopic surgery was 90 min (range,45-150 min).The nerve root was not well exposed,and the fenestration was too lateral in 1 patient,with partial relieve of symptoms;and simple nerve root decompression was performed for 3 patients of ossified herniation combined with foraminal stenosis.Herniated or sequestered nucleus pulposus was removed for 27 patients,one of them had transient paralysis ipsilateral limb and 2 of them had linkage of cerebrospinal fluid.The Visual Analogue Score (VAS) score improved form preoperative 8.9±1.6 to 0.5±0.4,and the Oswestry Disability Index (ODI) score improved form 32.8±4.2 to 2.3± 1.9 at final follow-up.For anterior percutaneous endoscopic surgery,the mean operative time was 80 min (range,45-120 min).Herniated or free nucleus was successfully removed for all patients.The thecal sac was lacerated due to unclear exposure in 1 case.The VAS score improved form preoperative 6.9±2.3 to 0.9±0.8,and the ODI score improved form 40.1±8.6 to 5.6±3.0 at final follow-up,with improvement of myelopathy at least one Nurick Grade.During follow-up,the alignment of cervical spine was well preserved without kyphosis for two groups,while the height of intervertebral space decreased with 0.4±0.3 mm and 0.9±0.6 mm in posterior and anterior surgery respectively.Conclusion Percutaneous endoscopic surgery provides minimally invasive alternatives for some cervical disc herniation with predominant radicular pain.Posterior endoscopic surgery is suitable for lateral herniation,and anterior endoscopic discectomy is suitable for some central soft herniation without obvious collapse and instability.However,the long-term results of disc space collapsed after anterior approach remains unclear.

Clinical study of anterior cervical decompression assisted with microscope versus mobile microendoscopic discetomy for cervical spondylotic myelopathy / 中华骨科杂志

Objective To explore the feasibility of anterior cervical decompression assisted with the microscope and mobile microendoscopic discectomy (MMED),and to compare their clinical efficacy.Methods From May 2015 to February 2017,thirty patients with cervical spondylotic myelopathy (CSM) underwent anterior cervical decompression assisted with microscope or MMED.Among them,conventional transverse anterior cervical incisions were used,and intervertebral distractors were placed in order to complete the decompression,then the fusion and fixation procedure were conducted under direct vision,and the operative time and intraoperative blood loss were recorded.Of 30 cases,15 cases were in microscope cohort (anterior cervical discectomy and fusion,ACDF 12 cases;anterior cervical corpectomy and fusion,ACCF 3 cases),including 4 males and 11 females with a mean age of 54.00±11.10 years (range,32-71 years).Another 15 cases were in MMED cohort (ACDF 13 cases,ACCF 2 cases),including 9 males and 6 females with a mean age of 59.60± 11.10 years (range,39-73 years).Neurological and cervical function were evaluated before surgery and at the follow-up according to the Japanese Orthopaedic Association (JOA) and the neck disability index (NDI) scores,and the neurologic improvement grade (NIG) was used to evaluate the neurological function.Results Both the microscope and MMED cohort underwent decompression successfully,and the visual field was clear.No neurological symptoms became worse.For the microscope,its lens and the instrument had to be adjusted separately,whereas MMED lens could move synchronously with the instrument.It was easier for MMED to reveal the posterior edge of the vertebral body and the left and right side of the spinal canal.The operation time of the microscope cohort was 90-180 min,with an average of 124.67±36.42 min;the M MED cohort was operated for 80-130 min with an average of 110.00± 15.12 min,and there was no significant difference between the two cohorts (t=1.440,P=0.161).The intraoperative blood loss for microscope cohort was 20-200 ml,with an average of 66.00±49.11 ml;MMED cohort was 30-150 ml with an average of 60.00±35.25 ml;there was no significant difference between the two cohorts (t=0.384,P=0.704).The JOA score of the microsurgery cohort improved from 8.67±3.20 preoperatively to 15.93± 1.53 at the latest follow-up,and its difference was significant (t=8.687,P=0.000).According to NIG,neurological improvement was excellent in 12 cases and good in 3 cases,giving an excellent to good rate of 100％.NDI was reduced from 18.00％±9.75％ preoperatively to 5.93％±2.58％ at the latest follow-up,with significant difference (t=5.137,P=0.000).The JOA score in MMED cohort improved from 8.87±3.11 preoperatively to 15.53±1.69 at the latest follow-up,and its difference was significant (t=9.413,P=0.000).and Among these 15 patients,11 were excellent and 4 were good,giving an excellent-good rate 100％.NDI decreased from 17.13％± 8.00％ preoperatively to 5.80％±2.43％ at the latest follow-up,and its difference was significant (t=5.592,P=0.000).There was no significant difference in JOA (t=0.680,P=0.502),NIG (P=1.000) and NDI (t=0.146,P=0.885) between the two cohorts at the latest follow-up.Conclusion Both microscope and MMED could provide a clear and magnified field of view,which was beneficial for adequate decompression during the anterior cervical surgery to ensure better clinical results.Compare to the microscope,MMED has relatively narrow indications and steep learning curve,so the surgeon should select cases strictly.

Disease burden for gynecological disease in China, 2016 / 中华妇产科杂志

Objective To assess the disease burden for gynecological disease in China in 2016. Methods Data were extracted from the global burden of disease study 2016(GBD 2016). The burden of gynecological disease among age groups and provinces groups was assessed by prevalence rate, mortality rate, years lived with disability (YLD), years of life lost due to premature mortality (YLL) and disability-adjusted life years(DALY). An average world population age-structure for the period 2010-2035 was adopted to calculate age-standardized rates. Results In 2016, the prevalence rate of gynecological disease in women aged 15 years and above in China was 24.94%, of which was 36.71%to women of childbearing age. The number of DALY from gynecological disease was 2727637.82 life years in 2016, with the DALY rate was 411.12/100000 and standardized DALY rate was 341.80/100000. The first three gynecological diseases with highest DALY and DALY rate among Chinese women aged ≥15 years were premenstrual syndrome(815004.64 life years, 122.84/100000), uterine fibroids(281976.67 life years, 42.5/100000) and endometriosis (154792.89 life years, 23.33/100000). The DALY caused by gynecological disease in Guangdong (220871.19 life years), Shandong (190968.72 life years), Henan (171273.92 life years), Jiangsu(168404.27 life years)and Sichuan(144358.5 life years)were higher than other provinces. The standardized DALY rate attributable to gynecological disease were highest in Xinjiang Uygur Autonomous Region(404.00/100000), Shanghai(394.90/100000), Heilongjiang(382.00/100000), Beijing(365.70/100000)and Jiangsu (357.50/100000). Conclusions Gynecological disease is a great threat to women' s reproductive health. Effective measures should be taken to address the issue, especially to women of childbearing age.

Deaths attributable to alcohol use and its impact on life expectancy in China, 2013 / 中华流行病学杂志

Objective To analyze the deaths attributable to alcohol use and its impact on people's life expectancy in China in 2013.Methods The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance (2013) were used.The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction.Results In 2013,alcohol use resulted in 381 200 deaths,including 97 100 hemorrhagic stroke deaths,88 200 liver cancer deaths,61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths,and prevented 76 500 deaths,including 68 500,4 900 and 3 100 deaths which might be caused by ischemic heart disease,hemorrhagic stroke and diabetes respectively.If risk factor of alcohol use is removed,the people's life expectancy would rise by an average of 0.43 years,especially in westem China by 0.52 years,which was 0.12 years higher than that in eastern and central China,and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively.Conclusions Although alcohol has a protective effect on reducing ischemic heart disease,stroke and diabetes deaths,alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China.It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.

Deaths attributable to alcohol use and its impact on life expectancy in China, 2013 / 中华流行病学杂志

Objective To analyze the deaths attributable to alcohol use and its impact on people's life expectancy in China in 2013.Methods The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance (2013) were used.The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction.Results In 2013,alcohol use resulted in 381 200 deaths,including 97 100 hemorrhagic stroke deaths,88 200 liver cancer deaths,61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths,and prevented 76 500 deaths,including 68 500,4 900 and 3 100 deaths which might be caused by ischemic heart disease,hemorrhagic stroke and diabetes respectively.If risk factor of alcohol use is removed,the people's life expectancy would rise by an average of 0.43 years,especially in westem China by 0.52 years,which was 0.12 years higher than that in eastern and central China,and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively.Conclusions Although alcohol has a protective effect on reducing ischemic heart disease,stroke and diabetes deaths,alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China.It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.

Comparison of different shielding methods in acquisition of physiological signals.

Power line interference in the surrounding environment could usually introduce many difficulties when collecting and analyzing physiological signals. Since power line interference is usually several orders of amplitude larger than the physiological electrical signals, methods of suppressing power line interference should be considered during the signal acquisition. Many studies used a hardware or software band-stop filter to suppress power line interference but it could easily cause attenuations and distortions to the signal of interest. In this study, two kinds of methods that used different signals to drive the shields of the electrodes were proposed to reduce the impacts of power line interference. Three channels of two physiological signals (ECG and EMG) were simultaneously collected when the electrodes were not shielded (No-Shield), shielded by ground signals (GND-Shield) and shielded by buffered signals of the corresponding electrodes (Active-Shield), respectively, on a custom hardware platform based on TI ADS1299. The results showed that power line interference would be significantly suppressed when using shielding approaches, and the Active-Shield method could achieve the best performance with a power line interference reduction up to 36dB. The study suggested that the Active-Shield method at the analog front-end was a great candidate to reduce power line interference in routine acquisitions of physiological signals.

Realization of III-V Semiconductor Periodic Nanostructures by Laser Direct Writing Technique.

In this paper, we demonstrated the fabrication of one-dimensional (1D) and two-dimensional (2D) periodic nanostructures on III-V GaAs substrates utilizing laser direct writing (LDW) technique. Metal thin films (Ti) and phase change materials (Ge2Sb2Te5 (GST) and Ge2Sb1.8Bi0.2Te5 (GSBT)) were chosen as photoresists to achieve small feature sizes of semiconductor nanostructures. A minimum feature size of about 50 nm about a quarter of the optical diffraction limit was obtained on the photoresists, and 1D III-V semiconductor nanolines with a minimum width of 150 nm were successfully acquired on the GaAs substrate which was smaller than the best results acquired on Si substrate ever reported. 2D nanosquare holes were fabricated as well by using Ti thin film as the photoresist, with a side width of about 200 nm, but the square holes changed to a rectangle shape when GST or GSBT was employed as the photoresist, which mainly resulted from the interaction of two cross-temperature fields induced by two scanning laser beams. The interacting mechanism of different photoresists in preparing periodic nanostructures with the LDW technique was discussed in detail.