Bronchiolitis is the most common lower respiratory tract infection in infancy and early childhood.The main pathogen is respiratory syncytial virus (RSV),which is one of the main factors in hospitalized infants,closely related to asthma.However,the detailed mechanism is not clarified,and there is no specific treatment.Recent studies have showed that Notch signaling pathway plays an important role in its pathogenesis.This review mainly summarizes the association between bronchiolitis immunological mechanisms and Notch siganling pathway.

Objective:To investigate the affection to the differentiation of Th17 cell in rat models of bronchiolitis after blocking Notch signaling by γ-secretase inhibitor and provide rationale to seek new target for bronchiolitis drug treatment. Methods:The rats were randomly divided into normal group,bronchiolitis group andγ-secretase inhibitor group. The model of bronchiolitis was established successfully by nasal dripping,and γ-secretase inhibitor(MW167) was injected into the vena caudalis. The pathological changes of the airway were observed by HE staining;the plasma level of interleukin17 ( IL-17 ) was detected by ELISA;the level of RORγt mRNA in lung tissues and peripheral blood mononuclear cells( PBMCs) was tested by real-time quantitative PCR;the levels of Notch signaling and RORγt protein in lung tissues were examined by Western blot. Results:Compared to the bronchiolitis group, the histopathologic change in MW167 intravenous injection group was significantly alleviated;the plasma level of IL-17 was decreased;the level of RORγt mRNA in lung tissues and PBMCs was lower in MW167-treated group than bronchiolitis group;the levels of Notch signaling and RORγt were decreased. Conclusion:γ-secretase inhibitor through intravenous injection suppresses the differentiation of Th17 cell and relieves the airway inflammation of bronchiolitis in rat models after blocking Notch signaling and has potential therapeutic value for treating bron-chiolitis.

To select the most effective parameters of electroacupuncture (EA) at Hegu (LI4) and Sanyinjiao (SP6), a traditional acupuncture formula that induces labor, by comparing its effects on uterine contraction in late-stage pregnant rats, so as to improve the effects of acupuncture on induction of labor and its clinical maneuverability and provide the basis for further mechanism research.

Objective:To study the performance of the elastic fixation with our self-designed Tightrope system for inferior tibiofibular syndesmosis (ITFS) diastasis.Methods:In this self-control study, 6 specimens of normal cadaveric ankle were used as a normal ITFS group while the models of the ITFS diastasis were constructed as a group of ITFS diastasis. On the models of ITFS diastasis, elastic fixation with transverse Tightrope system (transverse fixation group) or binding Tightrope system (binding fixation group) was applied. The reduction and stability of ITFS were compared between transverse fixation and binding fixation for ITFS diastasis in terms of ITFS parameters on X-Ray[tibiofibular clear space (TFCS) and medial clear space (MCS)] and on CT[inferior tibiofibular anterior clear space (ITFACS), inferior tibiofibular middle clear space (ITFMCS), inferior tibiofibular posterior clear space (ITFPCS), anterior inferior tibiofibular interval (AITFI) and fibular rotation (θfib)].Results:The transverse fixation with Tightrope system for ITFS diastasis on the models led to iatrogenic injury to the fibular and the ITFS interosseous ligaments and to the perforating peroneal artery, and malreduction as well while the binding fixation with Tightrope system caused no injury to the anterior or the posterior ITFS ligament or the superior peroneal retinaculum but fine reduction as well. In comparisons of TFCS, ankle MCS, ITFACS, ITFMCS and AITFI between the 4 groups, normal ITFS group

Objective:To investigate the risk factors of achilles tendon rupture in male patients and to verify them.Methods:Retrospective analysis was made on the medical records of male inpatients with achilles tendon rupture (242 cases in achilles tendon rupture group) and simple ankle joint injury (825 cases in control group) admitted to Qilu Hospital of Shandong University from May 2013 to June 2020. The tendency score matching method was used to balance the confounding factors at a ratio of 1∶1. After matching, 147 cases were in achilles tendon rupture group and 147 cases in control group. The baseline data and related indicators were compared before and after matching, and the risk factors of achilles tendon rupture were analyzed by constructing a multivariate logistic regression model.Results:The age, smoking rate, drinking rate, family history of hypertension and diabetes, previous history of hypertension, diabetes and coronary heart disease, and BMI of the achilles tendon rupture group before matching were significantly lower than those of the control group (all P<0.05). After matching, there was no significant difference in age, smoking proportion, drinking proportion, family history of hypertension, diabetes and coronary heart disease, previous history of hypertension, diabetes and coronary heart disease, and BMI between the two groups (all P>0.05). After matching, the levels of fasting uric acid (UA), cholesterol (TG) and triglyceride (TC) in achilles tendon rupture group were significantly higher than those in control group, and the differences were statistically significant (all P<0.05). Multivariate binary logistic regression analysis showed UA ( OR=1.006, 95% CI: 1.003-1.010, P<0.001), TC ( OR=2.462, 95% CI: 1.194-5.076, P=0.015) was an independent risk factor for achilles tendon rupture in male. Conclusions:Dyslipidemia and UA may be an independent risk factor for achilles tendon rupture in male.

Objective:To compare minimally invasive percutaneous plate osteosynthesis (MIPPO) and open reduction and internal fixation via traditional lateral L-type approach (ORIF-LA) in the therapeutic effects concerning reduction and calcaneal alignment for Sanders Ⅲ/Ⅳ calcaneal fractures.Methods:A retrospective analysis was conducted of the 105 patients with calcaneal fracture who had been treated at Department of Foot and Ankle Surgery, Qilu Hospital from 2014.1 to 2018.2. Of them, 50 were treated with MIPPO (group A) and the other 55 with ORIF-LA (group B). The X-ray lateral and axial films, three-dimensional computed tomography (CT) of the calcaneal were taken pre-operatively and post-operatively to evaluate the reduction and calcaneal alignment. The American Orthopedic Foot Ankle (AOFAS) Ankle-Hind Foot Scale and Foot Function Index-Verbal Rating Scales (FFI-5pt) were adopted to assess the therapeutic effects. The postoperative complications of the two groups were compared.Results:All patients were followed up for 20-36 months (mean 24 months). The length of hospital stay and incision in group A was shorter than that in group B ( t=-11.276, -25.965, P<0.001). In group A and group B, the correction degrees of B?hler angle and Gissane angle were (34.49±3.81)°, (35.12±3.77)° and (-20.62±9.86)°, (-20.94±8.38)°, respectively ( P>0.05). Posterior calcaneal articular surface defects or steps in group A and group B were 1.55(1.12, 2.00)mm and 1.20(1.03, 1.60)mm, indicating that there was no significant difference in the reconstruction ability between the two groups ( P>0.05). There was no significant difference in VAS pain score between the two groups at 3 months after operation ( P>0.05), but group A was significantly lower than group B at 3 days after operation ( P<0.001). There was no significant difference in AOFAS and FFI-5pt scores between the two groups at 18 months after operation ( P>0.05). The complications of group A (6.0% incision infection, 2.0% incision area sensory disturbance, 2.0% foot stiffness) were lower than those of group B (16.36% incision infection, 14.55% incision area sensory disturbance, 10.9% foot stiffness) ( P<0.05). Conclusions:Compared with ORIF-LA, the MIPPO shows promising results in terms of reduction capacity and safety. Use of the MIPPO technique minimized the risk of postoperative wound complications and achieved superior functional outcomes compared with standard locking plate fixation via the extended lateral approach. MIPPO can be used as a choice for the treatment of calcaneal fracture.

Objective To establish and verify the microscopic review rules of Dirui GMD-S600 gynecologi-cal secretion analysis system.Methods A total of 2 619 samples of vaginal secretions were collected and test-ed for tangible components and dry chemistry items using the Dirui GMD-S600 gynecological secretions analy-sis system.All samples were subjected to manual microscope examination using a double blind method,and the results of instrument testing,manual image review of instrument testing,and manual microscope examina-tion were recorded separately.Using the results of manual microscope examination as the standard,the false negative rates and the false positive rates of instrument testing results and tangible component results after manual image review of instrument testing were analyzed.At the same time,the false negative rates and the false positive rates of instrument detection dry chemistry items and their corresponding tangible components were analyzed,and the review rules were derived based on this.Subsequently,344 samples were selected to verify the effectiveness of the review rules.Results The false positive rates of white blood cells,fungi,trichomonas and clue cells detected by the instrument were 28.77%,14.71%,20.09%and 2.30%,and the false negative rates were 0.28%,15.06%,4.35%and 10.34%.After manual image review and correction,the false positive rates of white blood cells,fungi,trichomonas and clue cells were 28.77%,7.06%,8.67%,0.66%,and the false negative rates were 0.28%,3.35%,4.35%and 10.34%.The false positive rates of white blood cell esterase(LE)for white blood cells,N-acetylhexylglucosidase(NAG)for fungi,NAG for trichomonas,hydrogen peroxide(H2O2)for bacteria,lactic acid(LA)for bacteria,sialidase(SNA)for clue cells,and proline aminopeptidase(PIP)for clue cells were 13.83%,22.47%,24.10%,95.52%,2.52%,12.92%and 5.54%,and the false negative rates were 28.17%,48.12%,0.00%,23.55%,78.82%,0.00%and 74.14%.The false positive rate of 260 validation samples was 1.68%,the false negative rate was 4.22%,and the review rate was 45.38%.Conclusion The review rules of the Dirui GMD-S600 gynecological secretion analysis system are as follows(1)All specimens need to be reviewed with images,and the following rules are based on this rule.(2)When the result of white blood cell shows positive,then the microscopic exam-ination is required.(3)When the result of fungi shows positivity,then the microscopic examination is re-quired.(4)When the result of trichomonas shows positive,then the microscopic examination is required.(5)When the result of SNA does not match the positive result of clue cells,then the microscopic examination is required.

Objective To compare the cumulative analgesic effects of electroacupuncture at Sanyinjiao (SP6), Xuanzhong (GB39) and non-acupoint in treating primary dysmenorrhea. Method By adopting a multi-centered randomized controlled study method, 501 patients recruited from Dongzhimen Hospital of Beijing University of Chinese Medicine, China-Japan Friendship Hospital, Beijing Hospital of Traditional Chinese Medicine of Capital Medical University, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Huguosi Hospital of Chinese Medicine of Beijing University of Chinese Medicine and the Outpatient of Shandong University of Traditional Chinese Medicine were randomized into a Sanyinjiao group, a Xuanzhong group, and a non-acupoint group, 167 subjects in each group. The electroacupuncture intervention was applied when dysmenorrhea flared up and the Visual Analogue Scale (VAS) ≥40 mm, with frequency at 2/100 Hz and intensity during patient’s endurance, 30 min each time, once a day, and for successive 3 d. Before the first treatment, 30 min after the first treatment, and respectively prior to the second and third treatment, VAS was used to measure the pain intensity. Meanwhile, the Retrospective Symptom Scale (RSS-COX 2) was investigated before the first treatment, right after the removal of needles for the first treatment, before the second and third treatment. Result The decrease of VAS in Sanyinjiao group was more significant than that in Xuanzhong group and non-acupoint group (MD=﹣2.92 mm, P=0.028; MD=﹣3.47 mm, P=0.009), while there was no significant difference between Xuanzhong group and non-acupoint group (MD=﹣0.56 mm, P=0.674); there were no significant differences in comparing the RSS-COX2 total score among the three groups (P=0.086). Conclusion Sanyinjiao (SP6) can produce a more significant cumulative analgesic effect for primary dysmenorrhea patient than Xuanzhong and non-acupoint, and the effects of Xuanzhong and non-acupoit are equivalent.