Objective To determine the prevalence of pain beyond the osteoporotic vertebral com-pression fracture (OVCF) in patients undergoing percutaneous vertebral augmentation and the response of pain to the treatment. Methods A retrospective study of 104 patients undergoing percutaneous vertebral augmentation (pereutaneous vertebroplasty and pereutaneous kyphoplasty) was performed to examine the lo-cations and severities of pain beyond the OVCF before and after operation. The Visual Analog Sscale (VAS,10-point scale) and Activities of Daily Living (ADL, 5-point scale) were used. Results Of the 104 patients, 48 (46.2%) suffered pain beyond the OVCF. The pain was firstly located in the sacrococeygeal region and buttocks (26.0%), secondly in the abdomen and sub-xiphoid process (10.6%) and thirdly in the flank, ribs and chest (9.6%) . For all the cases, the mean VAS score decreased from 8.9±0. 8 before vertebral augmentation to 2.9±1.4 after augmentation (t=37.410, P=0.000), and the mean ADL score decreased from 4.1±0.6 before operation to 2.0±0.7 after operation (t=25.331, P =0.000) . For the patients suffering pain beyond the OVCF, the mean VAS score decreased from 8.8±0.9 before vertebral augmentation to 2.8±1.5 after augmentation (t=23.722, P=0.000), and the mean ADL score decreased from 4.2±0.7 before operation to 2.0±0. 7 after operation (t=15.373, P=0.000). The decreases in VAS and ADL scores were not affected by the pain. Conclusion The pereutaneous vertebral augmentation can effectively relieve the pain beyond the OVCF.

Experimental, clinical and epidemiologic studies have provided strong evidence that physical training has beneficial effects on cardiovascular health. Numerous investigations have demonstrated that exercise increases coronary blood flow and myocardial perfusion. Importantly, training also can stimulate angiogenesis and accelerate collateral vessel growth in animal models with coronary artery occlusion. Cardiac adaptation such as increased vascularity or capillary density has been evidenced after regular endurance exercises. More recently, several studies indicate that physical training induces high levels of myocardial heat shock protein and antioxidant protein expression, which may play an important role in myocardial protection against ischemia-reperfusion injury.

The overseas and domestic application status and research progress of genotoxicity evaluation of medical devices is briefly introduced. The trend of future development is analyzed.
Equipment and Supplies ; adverse effects ; Mutagenicity Tests

Objective To explore the expression of CXCR7 in bladder cancer and analyze its clinical significance and relationship with bladder cancer recurrence. Methods The expressions of CXCR7 protein in 148 specimens of bladder cancer and 30 specimens of normal bladder tissues were detected by immunohistochemical staining and its clinical significance was then analyzed. Results The expression of CXCR7 protein was higher in bladder cancers than in the adjacent normal tissues (P＜0.01). CXCR7 protein expression rates were 49. 4% and 71.2% in mutifocal tumors and unifocal tumors, while 34.0%, 65.8% and 78. 6% in G1, G2, and G3 tumors, respectively (P＜0. 01). Expression of CXCR7 protein was higher in muscle invasive bladder cancers than in non-muscle invasive bladder cancers (72. 7% versus 51.9% ,P＜0.05). In patients followed up for 2-95 months, CXCR7 protein expression was significantly higher in patients with recurrence than with non-recurrence (64. 1% versus 32.5%, P＜0.01). Kaplan-Meier analysis and the log-rark test showed that the recurrence-free survival was significantly different between the group of lower CXCR7 expression group and the higher expression group (P＜0.01). Conclusions The expression of CXCR7 protein is high in bladder cancer and the analysis of CXCR7 protein expression is potentially valuable in prognostic evaluation of bladder cancers. CXCR7 may play a role in the development of bladder urothelial cell cancer.

OBJECTIVE: To evaluate the applicative value of computer assisted navigation system in endoscopic sinus and skull base surgery. METHOD: Forty-nine endoscopic surgery procedures were performed with the help of computer assisted navigation system, among which there were 25 cases of recurrent sinusitis and nasal polyps, 9 cases of nasal and sinus tumour, 7 cases of cerebrospinal fluid rhinorrhea, 2 cases of meningoencephalocele, 4 cases of congenital choanal atresia, 1 case of pituitary tumor and 1 case of foreign body in middle cranial fossa. RESULT: The preoperative time was 5-13 minutes for preparation, 7 minutes in average. The target error was less than or equal to 1.5 mm. All the 49 cases had successful surgery without complications. CONCLUSION Computer assisted navigation system can help the surgeon to determine the sinus, skull base and adjacent anatomic landmarks correctly, improve surgical accuracy and safety, and reduce intraoperative and postoperative complications.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Computer Systems ; Female ; Humans ; Infant ; Male ; Middle Aged ; Paranasal Sinuses ; surgery ; Skull Base ; surgery ; Surgery, Computer-Assisted ; methods ; Young Adult

Curriculum for undergraduate medical education in the United Kingdom consists of two parts, namely pre-clinical and clinical courses. Medical undergraduate students are encouraged to study for a second degree and individualized education is emphasized. Various methods are employed in teaching highly integrated courses, mainly according to human organs and systems or physiological functions. Drawing lessons from relevant experiences of the United Kingdom, China should further strengthen the formulation and supervision of standards and guidelines for undergraduate medical education, and actively promote the reform of teaching models in order to facilitate the connection and integration between basic medical education and clinical practice. It's also suggested that priorities be given to the cultivation of compound medical talents and individualized education for medical students. Finally, educational system should be further improved in order to enhance the effects of clinical practice.

Objective ToevaluatethevalueofMRDKIandDWIindiagnosingendometrialcarcinomaandevaluatingitspathologicalgrade. Methods TheDKIandDWIdataof48patientswithendometrialcarcinomaand27patientswithnormalendometrium wereanalyzed retrospectively.Thevaluesofmeankurtosis (MK),meandiffusion (MD)andADCinendometrialcarcinomaandnormalendometrium were measuredrespectively.Thesimilaritiesanddifferencesoftheparametersbetweentheendometrialnormalgroup(G0)andtheendometrialcarcinoma group (G1,G2,G3)werecomparedandanalyzed.TheROCcurvewasemployedtoevaluatethediagnosticefficacyandthresholdof eachparameter.P earson correlation wasappliedtoanalyzethecorrelationbetweeneachparametervalueandpathologicalgrade.Results The MK valuesincreasedgradually,meanwhiletheMDandADCvaluesdecreasedgraduallyinG0,G1,G2andG3groups.ExceptforMDand ADCvaluesbetweenG0andG1groups,othervalueswerestatisticallysignificantdifferent(P<0.05)betweendifferentgroups.In differentiatingoftheG0/(G1+G2+G3),G0/G1,G1/G2,G2/G3,theMKvalueshadthehighestdiagnosticefficacy(AUC=09.2,07.6,09.0,0.96, P<0 .05 ).M oreover ,in the correlation of pathological grading ,M K>M D>A D C (r=0 .850 ,0 .781 ,0 .709 ,P<0 .05 ).Conclusion Both DKIandDWIcandiagnoseandevaluatepathologicalgradeofendometrialcarcinoma.ComparedwithDWI,DKIembracesmoreperfectmathematical modelandmoresensitiveparameters,andcanbeusedasaneffectivemethodtoevaluatethepathophysiologicalfeaturesofendometrialcarcinoma.

To further demonstrate the toxicity of the catheter, cytotoxicity evaluation was conducted in registration inspection products and the relationship between testing methods and materials were analyzed. This result showed that to strengthen cytotoxicity assay in registration inspection is important to choose catheter in clinic.
Cells, Cultured ; Cytotoxins ; toxicity ; Disposable Equipment ; Humans ; Materials Testing ; Urinary Catheters ; adverse effects

In the United Kingdom,undergraduate education of geriatric medicine focuses on helping students understand or describe relevant contents,with only a few ability requirements.At most medical schools,the teaching of geriatric medicine is integrated with other clinical curriculums,such as mental health and internal medicine.The pedagogy of geriatric medicine that consists of formal and informal ones,tends to become varied and has some innovations in terms of simulation education,interdisciplinary education,and student-centered education.Based on the relevant experience in the UK,it is suggested that China should study and formulate the teaching requirements of geriatrics for undergraduate clinical medicine specialty in order to standardize and promote related work.Medical colleges and universities can better integrate geriatric knowledge into the existing curriculum system,constantly innovate geriatric teaching methods,actively use simulation teaching,student-centered education and other ways to improve the teaching effect.

Objective:To assess the clinical effectiveness and safety of Omalizumab for treating pediatric allergic asthma in real world in China.Methods:The clinical data of children aged 6 to 11 years with allergic asthma who received Omalizumab treatment in 17 hospitals in China between July 6, 2018 and September 30, 2020 were retrospectively analyzed.Such information as the demographic characteristics, allergic history, family history, total immunoglobulin E (IgE) levels, specific IgE levels, skin prick test, exhaled nitric oxide (FeNO) levels, eosinophil (EOS) counts, and comorbidities at baseline were collected.Descriptive analysis of the Omalizumab treatment mode was made, and the difference in the first dose, injection frequency and course of treatment between the Omalizumab treatment mode and the mode recommended in the instruction was investigated.Global Evaluation of Treatment Effectiveness (GETE) analysis was made after Omalizumab treatment.The moderate-to-severe asthma exacerbation rate, inhaled corticosteroid (ICS) dose, lung functions were compared before and after Omalizumab treatment.Changes in the Childhood Asthma Control Test (C-ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) results from baseline to 4, 8, 12, 16, 24, and 52 weeks after Omalizumab treatment were studied.The commodity improvement was assessed.The adverse event (AE) and serious adverse event (SAE) were analyzed for the evaluation of Omalizumab treatment safety.The difference in the annual rate of moderate-to-severe asthma exacerbation and ICS reduction was investigated by using t test.The significance level was set to 0.05.Other parameters were all subject to descriptive analysis.A total of 200 allergic asthma patients were enrolled, including 75.5% ( n=151) males and 24.5% ( n=49) females.The patients aged (8.20±1.81) years. Results:The median total IgE level of the 200 patients was 513.5 (24.4-11 600.0) IU/mL.Their median treatment time with Omalizumab was 112 (1-666) days.Their first dose of Omalizumab was 300 (150-600) mg.Of the 200 cases, 114 cases (57.0%) followed the first Omalizumab dosage recommended in the instruction.After 4-6 months of Omalizumab treatment, 88.5% of the patients enrolled ( n=117) responded to Omalizumab.After 4 weeks of treatment with Omalizumab, asthma was well-controlled, with an increased C-ACT score [from (22.70±3.70) points to (18.90±3.74) points at baseline]. Four-six months after Omalizumab administration, the annual rate of moderate-to-severe asthma exacerbation had a reduction of (2.00±5.68) per patient year( t=4.702 5, P<0.001), the median ICS daily dose was lowered [0 (0-240) μg vs. 160 (50-4 000) μg at baseline] ( P<0.001), the PAQLQ score was improved [(154.90±8.57) points vs. (122.80±27.15) points at baseline], and the forced expiratory volume in one second % predicted (FEV 1%pred) was increased [(92.80±10.50)% vs. (89.70±18.17)% at baseline]. In patients with available evaluations for comorbidities, including allergic rhinitis, atopic dermatitis or eczema, urticaria, allergic conjunctivitis and sinusitis, 92.8%-100.0% showed improved symptoms.A total of 124 AE were reported in 58 (29.0%) of the 200 patients, and the annual incidence was 0(0-15.1) per patient year.In 53 patients who suffered AE, 44 patients (83.0%) and 9 patients (17.0%) reported mild and moderate AE, respectively.No severe AE were observed in patients.The annual incidence of SAE was 0(0-1.9) per patient year.Most common drug-related AE were abdominal pain (2 patients, 1.0%) and fever (2 patients, 1.0%). No patient withdrew Omalizumab due to AE. Conclusions:Omalizumab shows good effectiveness and safety for the treatment of asthma in children.It can reduce the moderate-to-severe asthma exacerbation rate, reduce the ICS dose, improve asthma control levels, and improve lung functions and quality of life of patients.