Dextroscope workstation is an advanced equipment developed in recent years and isused to make virtual reality model.We not only used it in surgical planning of thyroid disease,but also applied it in clinic teaching.Application of Dextroscope virtual reality system can help to improve students'capabilities of clinical thoughts and clinical techniques,stimulate their learning interest,enlarge the knowledge,shorten learning curve and release the conflict in practice.Dextroscope system will push forward the progress of education reform,so it is worth spreading.

In order to clarify material basis of effective parts of liangxue tongyu prescription, blood-heat and blood-stasis rat model induced by dry yeast was established. The changes of rectal temperature, blood viscosity and plasma viscosity were used to evaluate the cooling-blood and activating-blood effects of liangxue tongyu prescription and its parts. Compared with the model group, the extract from liangxue tongyu prescription, its volatile oil and n-butanol part could significantly reduce rectal temperature (P<0.01), and also reduce blood viscosity and plasma viscosity to various degrees (P<0.01 or P<0.05). So volatile oil and n-butanol part were primarily identified as effective parts of liangxue tongyu prescription. By using GC-MS with normalization method of area to analyze volatile oil of liangxue tongyu prescription, 70 compounds were identified, accounting for about 92.54%, mainly as β-asarone, paeonol, α-asarone and shyobunone. 42 compounds such as peony glycosides, tannins, and iridoid glycosides were identified by HPLC-MS techniques and standard comparison. The study determined the effective parts of liangxue tongyu prescription and clarified the chemical composition providing the foundation for further studies on material basis of liangxue tongyu prescription.
Acetophenones ; chemistry ; Animals ; Anisoles ; chemistry ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; Gas Chromatography-Mass Spectrometry ; Oils, Volatile ; chemistry ; Rats ; Tannins ; chemistry

Objective To observe the effect of travoprost on ocular he-modynamics and levels of matrix metalloproteinases( MMP) , tissue inhi-bitor of metalloproteinase-2( TIMP-2) in blood and humor in patients with open-angle glaucoma.Methods A total of 94 patients with pri-mary open-angle glaucoma were divided into treatment group and con-trol group, each group 47 cases.Patients in control group were treated with timolol maleate eye drops, 2 times a day, 1 drop a time.Patients in treatment group were treated with travoprost eye drops, 1 time a day, 1 drop a time.The course was 12 weeks.The intraocular pressure, ocular hemodynamics and levels of MMP, TIMP-2 in blood and humor of the two groups were observed.Results After treatment, the intraocular pressure of two groups all significantly decreased than those before treat-ment ( P <0.05 ) , and treatment group declined more significantly ( P<0.05).The hemodynamics end diastolic blood flow velocity ( EDV) , peak systolic blood flow velocity( PSA) of treatment group sig-nificantly increased, and vascular resistance index ( RI ) significantly lower than that before treatment( P<0.05) , while those of control group had no significant change.The levels of MMP, TIMP-2 in blood and humor of two groups all significantly decreased than those before treatment ( P<0.05 ) , and there was no significant difference between the two groups.There were mild foreign body sensation, mild to moderate conjunctival hyperemia, iris pigmentation deepened and other adverse symptoms appeared, but no heart, blood pressure and lung and other ad-verse reactions of the body appeared.Conclusion Travoprost can significantly reduce intraocular pressure, significant-ly improve hemodynamics of eyes, keep the dynamic expression levels of MMPs, TIMPs-2 in blood and humor.

OBJECTIVE: To study the incidence and risk factors of osteonecrosis of the femoral head (ONFH) after internal fixation in adult patients with femoral neck fracture (FNF) after 2000, and identify high-risk population of ONFH. METHODS: PubMed, Medline, The Cochrane Library, CNKI, Wanfang and VIP Database were searched to collect all the literatures on ONFH and related risk factors after internal fixation of FNF from January 1th 2000 to July 1th 2020. Study extraction was performed according to inclusion and exclusion criteria. Endnote X9 and Excel 2019 were used for literatures extraction, management and data entry, and R Studio 3.6.5 software was used for Meta-analysis. Subgroup analysis, sensitivity analysis and publication bias detection were used to explore the sources of heterogeneity and the reliability of the evaluation results. RESULTS: A total of 16 studies with 5521 patients were included. Meta-analysis showed that the incidence of ONFH after internal fixation for adult FNF was 14.5% [95% CI(0.126-0.165)]. Fracture displacement[OR=0.27, 95%CI(0.21-0.35)] and reduction quality [OR=0.15, 95%CI(0.09-0.27)] were related risk factors for ONFH. The results of subgroup rate analysis showed that the non-displaced fracture necrosis rate was 6.2%[95%CI(0.051-0.077)] and the displaced fracture necrosis rate was 20.4% [95%CI(0.166-0.249)];the good reduction fracture necrosis rate was 8.3%[95%CI(0.072-0.095)] and the poor reduction fracture necrosis rate was 35.5%[95%CI(0.233-0.500)]. The included literatures have good consistency and no publication bias. CONCLUSION After 2000, the total incidence of ONFH after internal fixation of adult FNF has decreased, while the necrosis rates of patients with displaced fracture and poor reduction are still at a high level. The interval between injury and surgery was not analyzed in this study because of the inconstant division in the original literature.
Adult ; Femoral Neck Fractures/complications* ; Femur Head ; Femur Head Necrosis/surgery* ; Humans ; Reproducibility of Results ; Risk Factors

OBJECTIVEThe main treatment method used for thoracolumbar fractures is open reduction and internal fixation. Commonly there are three surgical approaches: anterior, posterior and paraspinal. We attempt to compare the three approaches based on our clinical data analysis.

METHODSA group of 94 patients with Denis type A or B thoracolumbar burst fracture between March 2008 and September 2010 were recruited in this study. These patients were treated by anterior-, posterior- or paraspinal-approach reduction with or without decompression. The fracture was fixed with titanium mesh and Z-plate via anterior approach (24 patients), screw and rod system via posterior approach (38 patients) or paraspinal approach (32 patients). Clinical evaluations included operation duration, blood loss, incision length, preoperative and postoperative Oswestry disability index (ODI).

RESULTSThe average operation duration (94.1 min +/- 13.7 min), blood loss (86.7 ml +/-0.0 ml), length of incision (9.3 mm +/- 0.7 mm) and postoperative ODI (6 +/- 0.5) were significantly lower (P less than 0.05) in paraspinal approach group than in traditional posterior approach group (operation duration 94.1 min +/- 13.7 min, blood loss 143.3 ml +/-28.3 ml, length of incision 15.4 cm +/- 2.1 cm and ODI 12 +/- 0.7) and anterior approach group (operation duration 176.3 min +/- 20.7 min, blood loss 255.1 ml +/- 38.4 ml, length of incision 18.6 cm +/- 2.4 cm and ODI 13 +/- 2.4). There was not statistical difference in terms of Cobb angle on radiographs among the three approaches.

CONCLUSIONThe anterior approach surgery is convenient for resection of the vertebrae and reconstruction of vertebral height, but it is more complicated and traumatic. Hence it is mostly used for severe Denis type B fracture. The posterior approach is commonly applied to most thoracolumbar fractures and has fewer complications compared with the anterior approach, but it has some shortcomings as well. The paraspinal approach has great advantages compared with the other two approaches. It is in accordance with the concept of minimally invasive surgery and can replace most posterior approach operations.

OBJECTIVETo investigate the association of filaggrin gene (FLG) polymorphism with atopic dermatitis (AD) in southern Chinese Han population.

METHODSThe frequencies of the 13 known FLG gene single nucleotide polymorphism(SNPs), including 3321delA, 441delA, 1249insG, E1795X, S3296X, R501X, 2282del4, R2447X, S2889X, 7945delA, 3702delG, Q2417X, R4307X, were detected in a cohort of 50 AD patients and 100 control individuals using polymerase chain reaction (PCR) and DNA sequencing.

RESULTSFLG 3321delA and 441delA were detected in 14 (28%) and 6 (12%) AD patients, respectively. The other 11 SNPs were not detected in the patients. None of the 13 SNPs was detected in the controls.

CONCLUSIONThe results suggested that the FLG gene might be associated with atopic dermatitis susceptibility in southern Chinese Han population.

BACKGROUNDFew studies have investigated perioperative major adverse cardiac events (MACEs) in elderly Chinese patients with coronary heart disease (CHD) undergoing noncardiac surgery. This study examined the incidence and risk factors for perioperative MACE in elderly patients who underwent noncardiac surgery, and established a risk stratification system.

METHODSThis retrospective observational clinical study included 482 patients aged ≥60 years with CHD who underwent elective major noncardiac surgery at the Peking Union Medical College Hospital. The primary outcome was MACE within 30 days after surgery. Risk factors were evaluated using multivariate Logistic regression analysis.

RESULTSPerioperative MACE occurred in 61(12.66%) of the study patients. Five independent risk factors for perioperative MACE were identified: history of heart failure, preoperative arrhythmia, preoperative diastolic blood pressure ≤75 mmHg, American Society of Anesthesiologists grade 3 or higher, and intraoperative blood transfusion. The area under the receiver operating characteristic curve for the risk-index score was 0.710±0.037. Analysis of the risk stratification system showed that the incidence of perioperative MACE increased significantly with increasing levels of risk.

CONCLUSIONSElderly Chinese patients with CHD who undergo noncardiac surgery have a high risk of perioperative MACE. Five independent risk factors for perioperative MACE were identified. Our risk stratification system may be useful for assessing perioperative cardiac risk in elderly patients undergoing noncardiac surgery.

Salmonella is a gram-negative bacterium that has an ability of tumor-targeting growth and proliferation. Attenuated Salmonella VNP20009 is a virulence genes-knockout bacterial strain based on Salmonella typhimurium, and it has an advantage of good therapeutic effect and low toxicity. One of the mechanisms of anti-tumor effect of VNP20009 is the induction of inflammatory reaction within tumor tissues. We used B16F10 melanoma model to investigate the mechanism of the anti-tumor effect of VNP20009. VNP20009 treatment effectively inhibited tumor growth and promoted the apoptosis and necrosis of tumor cells. VNP20009 increased the accumulation or infiltration of CD8⁺ T cells and CD11b⁺ monocytes within tumor tissue by raising the level of immune response and thus, induce the production of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) to kill tumor cells by breaking the immuno-evasion barrier in the tumor microenvironment.

Objective::To observe the efficacy of modified Shoutaiwan on recurrent abortion due to prethrombotic status with kidney deficiency and blood stasis and investigate its effect on coagulation factors. Method::The 100 cases were randomly divided into control group and observation group, 50 cases in each group. Bushen Yangxue capsule + enoxaparin sodium were given in control group, while modified Shoutaiwan + enoxaparin sodium were given in observation group, with a treatment course of 60 d in both groups. The serum clotting factor activated protein S (PS), activated protein C (PC), platelet aggregation function (PAF), platelet aggregation rate (PagT), antithrombin (AT), lupus anticoagulant material positive positive predictive value (LA), anti cardiolipin antibody positive rate of positive predictive value (ACA), plasminogen activator inhibitor-1(PAI-1), tissue factor (TF), fibrinogen (Fig), fibrinogen (FIB), fibrinogen alpha granule membrane glycoprotein-140 (GMP-140), fibrinogen fragment (F_{1+ 2}), tissue fibrinogen activation factor (t-PA), D-dimer (D-D), activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) were observed. Clinical efficacy, pregnancy rate, traditional Chinese medicine(TCM) syndromes and adverse reactions were compared between the two groups. Result::4 cases withdrew from the study. The total effective rate in observation group was 97.9% (48/49), higher than 85.1% (40/47) in control group (χ²=5.713, P<0.05). The pregnancy rate in observation group was 89.8% (44/49), higher than 70.2% (33/47) in control group (χ²=6.351, P<0.05). The score of traditional Chinese medicine syndromes in observation group was lower than that in control group. The indexes of PS, PC, AT, TF, Fig, FPA, APTT and TT in observation group were significantly higher than those in control group (P<0.05), while PAF, PagT, LA, ACA, PAI-1, PAP, TAT, FIB, GMP-140, F_{1+ 2}, t-PA, D-D and PT were lower than those in control group (P<0.05). The incidence of adverse reactions in observation group was 10.2% (5/49), lower than 35.4% (17/48) in control group (P<0.05). Conclusion::Modified Shoutaiwan can effectively improve the clinical symptoms of recurrent abortion due to prethrombotic status and improve the coagulation factors in patients with kidney deficiency and blood stasis.