Objective To investigate the effect of corpectomy decompression by subtotal vertebrectomy and fusion of adjacent segmental artificial disc replacement through anterior intervertenral spance (Hybrid Surgery) in the anteriorcervical spondylotic myelopathy treatment . Methods Hybrid Surgery were operated on 18 patients who suffered from anterior cervi?cal spondylotic myelopathy . Follow up of 1-50 months. Patient’s conditions were assessed according to the Japanese Associ?ation for Department of orthopedics assessment score (JOA score) before and after operation. Effects of Hybrid operation were assessed by the improvement of JOA score, Odom’s follow-up grade and cervical mobility . Results The JOA scores of all 18 operated patients were improved from 10.6 ± 1.7 before operation to 13.5 ± 2.4 after operation. And the difference is statistically significant (t=1.314, P < 0.05). Among all the operated patients, 16 were cured and 2 were effective. As to Odom’s follow up grades, 6 cases were excellent, 11 cases were good and 1 case was acceptable. The postoperative move?ment range of cervical spine (40.1° ± 8.4°) show no statistically difference compared with that in preoperation (42.6° ± 11.9°) (t=0.68, P > 0.05). Conclusion Hybrid Surgery of anterior cervical decompression and fusion can both improve the nerve function and preserve cervical mobility.

High mobility group protein B1 (HMGB1) is the most representative substance in the alarmins family, it is actively or passively release to extracellular by the activation of monocyte/macrophage and the dead cells, and then it stimulates the production of a variety of inflammatory mediators, and increases the organism's inflammatory response through relevant receptors signaling pathways. In recent years, its concentration can reflect the severity of inflammation and injury and was related to the prognosis, HMGB1 has won more and more attention in the development of sepsis. By reviewing the study of HMGB1 in sepsis pathogenesis, signal pathway and reversal measures, it was found that HMGB1 was considered as an important inflammatory mediators and warning signal involved in the pathogenesis of sepsis, and was become a new target in the treatment of sepsis. Further research on the role of HMGB1 in the pathogenesis of sepsis is needed in the future, and the development of new drugs combined with HMGB1 will be used in the study of HMGB1 in animal experiments.

This article summarizes and analyzes the common problems of the preclinical part in medical devices including antimicrobial agents registration. It is hoped to be helpful for researchers and manufacturers in the registration of medical devices including antimicrobial agents.
Anti-Infective Agents ; Equipment and Supplies ; Registries

By discussing the relevant requirements of the Principles of Premarket Pathways for Combination Products Guidance, this study analyzes FDA's review concerns for premarket pathways and predicate product selection of device-led combination products' five typical situations, in order to provide reference for Chinese manufacturers and investigators in device-led combination products registration.

Objective To assess the value of wave intensity (WI) on the discrimination of hypertension with concentric hypertrophy and non-obstructive hypertrophic cardiomyopathy(NOHCM).Methods 36 patients with hypertension with concentric hypertrophy,30 patients with NOHCM and 36 healthy volunteers were randomly selected to perform routine ultrasound examination and carotid arterial WI test.The conventional parameters,inlcuding interventricular septal thickness in diastole (IVSTd),left ventricular posterior wall thickness in diastole(LVPWd),left ventricular diameter in diastole(LVIDd) and WI parameters,including the first peak (W1),the second peak (W2),negative area (NA),the interval between the R wave of the ECG and the peak of W1 (R-1st),the interval between the peaks of W1 and W2 (1st-2nd) were archived and compared among the different groups.Results ① There were statistical significances in IVSTd among the three groups(P ＜0.01).LVPWd of hypertension group was obviously higher than that of normal and NOHCM groups (P ＜0.01),but there were no statistical significances in NOHCM and normal groups(P ＞0.05).There were no statistical significances in LVIDd among different groups(P ＞ 0.05).②Compared with the normal group,W1 in NOHCM group increased significantly,whereas W2 and R-1st was much lower (P ＜0.01);W1 and NA in hypertension group was obviously higher(P ＜0.01).W2 and R-1st in NOHCM group were much smaller than those of hypertension group (P＜0.01).③W2 in 850 mmHg · m · s-3 was an optimal cutoff value to identify NOHCM and hypertension and to yield the sensitivity of 78.9％ and specificity of 72.4％.R-1st in 98.5 ms was a cutoff point to discriminate NOHCM and hypertension and to bring the sensitivity 65.8％ and specificity 72.4％.Conclusions WI analysis can effectively distinguish the difference of NOHCM and hypertension and provide a new viewpoint for the discrimination of hypertension with concentric hypertrophy and non-obstructive hypertrophic cardiomyopathy.

Objective To evaluate the left ventricular flow field characteristics in patients with obstructive and non-obstructive hypertrophic cardiomyopathy (HCM) using vector flow mapping (VFM),then assess the left ventricular hemodynamics.Methods 40 patients with HCM were randomly selected as case group,among which 20 patients with left ventricular outflow tract(LVOT) obstruction (group Ⅰ) and 20 patients without LVOT obstruction(group Ⅱ),40 healthy adult volunteers served as control group.The conventional parameters:left ventricular ejection fraction(LVEF),interventricular septal thickness and radial and pressure gradient of left ventricular outflow tract and VFM parameters:left ventricular peak systolic velocity (Vs),systolic flow (Fs),total negative systolic flow (SQ-) and vortex parameters were measured and compared.The correlation between LVOT pressure gradient and VFM parameters were assessed.Results There was no significant difference of LVEF in three groups.Compared with control group,interventricular septal thickness in group Ⅰ and group Ⅱ was much higher(P ＜0.05).Radius in group Ⅰ was much lower than that of group Ⅱ and pressure gradient of LVOT in group Ⅰ was significantly higher compared with group Ⅱ (P ＜0.05).Comparison of VFM parameters:①Compared with control group,SQ-of basal segments in case groups were lower (P ＜0.05),while SQ-of mid and apical segments were higher(P ＜ 0.05),Vs and Fs of all segments increased (P ＜0.05),and number of vortex,vortex diameter and vorticity of obstruction and non-obstruction groups were higher(P ＜0.05).②Compared with group Ⅱ,SQ-of basal segments decreased and SQ-of mid and apical segments increased in group Ⅰ,Vs and Fs of all segments were higher.The number of vortex,vortex diameter were higher in group Ⅰ (P ＜ 0.05).③ Correlation analysis:Fs in apex,the number of vortex relatively correlated with press gradient of LVOT(r =0.60,0.65,respectively).Conclusions VFM can effectively evaluate the flow field characteristics of left ventricle in patients with obstructive and non-obstructive HCM,and Fs in apex,number of vortex were correlated with the degree of obstruction,then further assess the left ventricular hemodynamics quantitively.

Adult ; Hand Injuries ; epidemiology ; Humans ; Occupational Injuries ; epidemiology ; Surveys and Questionnaires

Objective:To explore the application of speckle tracking imaging (STI) stratification strain technique in the assessment of circumferential myocardial function and the myocardial protection of ATP-postconditioning (ATP-PostC) in a rabbit model of acute myocardial infarction.Methods:A total of 40 rabbits were randomly divided into 2 groups: pure ischemia reperfusion group (IR group)and ATP-PostC group. STI images were recorded before and 45 min after occlusion of coronary artery, post low-dose dobutamine stress echocardiography, 60 and 120 min after reperfusion, respectively. The following parameters were obtained: left ventricular ejection fraction(LVEF), heart rate (HR), endocardial circumferential systolic strain (CSsys-endo), mid-myocardial circumferential systolic strain (CSsys-mid) and epicardial circumferential systolic strain (CSsys-epi) at left ventricular short-axis level. At different time points after occlusion and reperfusion, 5 experimental rabbits were killed in each group for pathological examination.Results:①Forty-five min after coronary artery occlusion in both groups, the values of LVEF and HR were decreased( P<0.05), and the absolute values of CSsys-endo, CSsys-mid and CSsys-epi were significantly reduced( P<0.01). After LDDSE, the absolute values of CSsys-endo, CSsys-mid and CSsys-epi were increased, which were different from those after blockade( P<0.05). ②After reperfusion, the circumferential strains were not significantly different from those after blockade in IR group ( P>0.05). After blockade, the absolute values of circumferential strains were increased significantly in the ATP-PostC group compared with IR group( P<0.05). In the ATP-PostC group, the absolute values of CSsys-endo at different time points after reperfusion increased significantly compared with that after blockade ( P<0.05). The absolute values of CSsys-endo and CSsys-mid 120 min after reperfusion continued to increase significantly compared with those 60 min after reperfusion( P<0.05). ③Pathological examination: After 60 min of blockade, there was no significant difference in myocardial infarction area between the IR group and the ATP-PostC group( P>0.05). The percentage of infarct areas at each time point of reperfusion in the ATP-PostC group was decreased compared with that after blockade( P<0.05). Compared with the IR group, the percentage of infarct area in the ATP-PostC group was smaller after 120 minutes of reperfusion and the difference was statistically significant ( P<0.05). Conclusions:The applications of STI stratification strain technique and LDDSE can assess left ventricular circumferential strains at each of myocardial layers before and after reperfusion in rabbit myocardial ischemia ATP-PostC model, identify and evaluate the function of viable myocardium, and exhibit the significant protective effects of ATP-PostC on myocardial reperfusion injury.

With the recognition of antineutrophil cytoplasmic antibodies (ANCA)-related vasculitis and widespread vaccination against viral hepatitis B, the prevalence of polyarteritis nodosa (PAN) varied considerably. In our study, patients diagnosed as polyarteritis nodasa (PAN)based on the 1990 American College of Rheumatology(ACR) criteria were reclassified using 2007 European Medicines Agency(EMA) algorithm modified by 2012 Chapel Hill Consensus Conference(CHCC) definitions, aiming to evaluate the new classification criteria for the diagnosis of PAN. A total of 113 PAN patients admitted to Peking Union Medical College Hospital from January 2002 to December 2018 were retrospectively analyzed, who were classified into three subtypes including 9 patients with cutaneous, 80 with classic and 24 Hepatitis B virus (HBV) associated PAN. All patients were reclassified according to 2007 EMA algorithm using CHCC 2012 definitions. As a result, 7 patients were diagnosed as microscopic polyangiitis(MPA) and 19 patients with unclassified vasculitis based on the new classification criteria. The diagnostic rate of PAN was gradually declined as the classification criteria of vasculitides was update. However, there are quite a few PAN patients in China, whom rheumatologists should pay attention to the early diagnosis and treatment.

Clustered regularly interspaced short palindromic repeats (CRISPR) is an acquired immune system existing in archaea and bacteria with the long-term process of evolutionary.CRISPR/Cas9 gene editing system is a new type of gene editing technology developed based on the system.CRISPR/Cas9 is a more efficient method for gene targeting than the previous methods.It has been successfully applied for gene-modified of eukaryotes since 2012,but the reports about pathogenic microorgaisms are rarely.Here,the research progress in the structure,mechanism of CRISPR/Cas9 system and its applications on pathogenic microorgaisms is reviewed.