Objective: To investigate the effect and mechanism of cyclanoline on nitrosamine (BBN)-induced bladder cancer in rats. Methods: Male SD rats were randomly divided into control group, model group, Cyc-low dose (20 mg/kg) group, Cyc-high dose (40 mg/kg) group and cisplatin (5 mg/kg) group. Rats were intragastrically administered with 0.5 mL BBN (0.4 kg/L, twice a week for 8 weeks) to establish bladder cancer model. In addition to control and model group given with normal saline, the other groups were intraperitoneally injected with drugs (once a day for 8 weeks). The bladder tissue was collected after experiment. HE staining was used to investigate the histopathological changes of the bladder in rats. The expressions of MMP9 and Ki67 were observed by immunohistochemistry method, and the expressions of KLF4, p21, CyclinD1, E-cadherin, N-cadherin, Vimentin, Wnt, β-catenin in the bladder tissues were detected by Western bloting. Results: Compared with the model group, cyclanoline effectively inhibited the infiltration of cystitis cells, promoted the degeneration of cancer cells, and reduced the proportion of cytoplasm. Cyclanoline significantly decreased the expressions of MMP9 and Ki67 (P < 0.05, 0.01), up-regulated the expressions of KLF4, p21 and E-cadherin (P < 0.05, 0.01), down-regulated the expressions of CyclinD1, Wnt, β-catenin, N-cadherin and Vimentin in bladder cancer tissues (P < 0.05, 0.01). Conclusion: Cyclanoline promotes the expression of KLF4, inhibits Wnt/β-catenin signaling transduction and the epithelial cell-mesenchymal transition of bladder cancer cells, thereby inhibiting the migration and invasion of bladder cancer cells. Meanwhile, cyclanoline regulates the expressions of p21 and CyclinD1 by up-regulating KLF4, affects the proliferation of bladder cancer cells, and thereby delays the pathological process of BBN-induced bladder cancer in rats.

Objective: To evaluate the aerosol concentration(PM2.5,PM10.0 and aerosol particle number) formation in non-contact "air-puff" tonometry and provide suggestions for medical workers to take appropriate daily protection during the prevalence of 2019-nCoV. Methods: A cross-sectional study was carried out in this study. Thirty healthy subjects were enrolled on February 22, 2020 at Eye Hospital of Wenzhou Medical University. The intraocular pressure (IOP) was measured by non-contact "air-puff" tonometer in the ophthalmic consulting room and the hall with or without masks. PM2.5, PM10.0 and aerosol particles were recorded by air quality detector. The cumulative effects of IOP measurement, PM2.5, PM10.0 and aerosol particle number were analyzed, and the aerosol density of subjects with and without masks was compared. Results: The PM2.5, PM10.0 and aerosol particles produced by the non-contact "air-puff" tonometry and increased with the increase of spray times. The IOP curves of 60 eyes of 30 subjects were measured respectively in two environments of medical consulting room and medical institution hall. It was found that PM2.5, pm10.0 and particle number fluctuated and increased with the increase of IOP measurement person times, showing cumulative effect, and the accumulation speed of aerosol density in hall was faster than that in consulting room. The density of PM2.5 and PM10.0 produced without gauze mask were (53.417±2.306) and (85.350± 3.488) μg/m³, which were higher than those of (50.567±0.862) and (80.617±1.463) μg/m³ with gauze mask. The differences were statistically significant (P=0.028, 0.019). Conclusions Aerosol can be produced by non-contact "air-puff" tonometer spraying, and it fluctuates with the increase of spraying times, showing a cumulative effect. The aerosol accumulation is higher in the hall with insufficient air circulation. And more aerosol can be produced without gauze mask.

OBJECTIVE: To investigate the effect of tibial coronal curvature on the alignment of tibial prosthesis in patients undergoing total knee arthroplasty (TKA). METHODS: From July 2019 to April 2021, 100 patients with knee osteoarthritis were treated with total knee arthroplasty. Before operation, the full-length films of lower limbs were taken and the tibial bowing angle(TBA) was measured. TBA more than 2° was tibial bending, which was divided into tibial bending group and non bending group. There were 40 cases in tibial bending group, 9 males and 31 females, aged 56 to 84 years old with an average of (69.22±7.10) years. There were 60 cases in the non bending group, 19 males and 41 females, aged from 51 to 87 years old with an average of (70.80±7.21) years. The preoperative tibial length (TL) and medial proximal tibial angle (MPTA) were measured and compared between the two groups. The full-length X-rays of the lower limbs were taken again 3 days to 1 week after operation. The medial angle of the tibial component coronal aligement angle (TCCA) and the outilier rate of force line of the tibial prosthesis were measured and compared between the two groups. Pearson method was used to analyze the correlation between TCCA and age, TCCA and height, TCCA and weight, TCCA and BMI, TCCA and TBA, TCCA and TL, TCCA and MPTA; Spearman method was used to analyze the correlation between TCCA and gender, TCCA and Kellgren-Lawrence(K-L) grade. RESULTS: All 100 patients successfully completed the operation and obtained satisfactory full-length X-rays in standing position. There was no significant difference in TL, MPTA and TCCA between bending group and non bending group(P>0.05). The outilier rate of force line in tibial bending group was 22.5%, and that in non bending group was 6.67%, the difference was statistically significant(P<0.05). The correlation study found that TCCA was strongly correlated with TBA(r=-0.702, P<0.01), weakly correlated with MPTA(r=0.311, P<0.01), and had no correlation with other parameters(P>0.05). CONCLUSION In patients with knee osteoarthritis undergoing total knee arthroplasty, tibial bending will lead to poor force line of tibial prosthesis. During operation, attention should be paid to osteotomy of proximal tibial vertical tibial mechanical axis and correct installation of prosthesis to avoid poor alignment of prosthesis.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee/adverse effects* ; Female ; Humans ; Knee Joint/surgery* ; Knee Prosthesis/adverse effects* ; Male ; Middle Aged ; Osteoarthritis, Knee/surgery* ; Retrospective Studies ; Tibia/surgery*

OBJECTIVETo evaluate the outcomes of single open door laminoplasty with lateral mass screw fixation in treating cervical spondylotic myelopathy (CSM) with cervical instability.

METHODSFrom March 2010 to October 2012, 25 patients with spondylotic myelopathy and cervical instability underwent single open door laminoplasty with lateral mass screw fixation. There were 18 males and 7 females, aged from 57 to 68 years with the mean of 57 years. Japanese Orthopaedic Association (JOA) scores were used to evaluate clinical effects before operation and final follow up. Radiographical measures were made in change of Cobb angle by sagittal plane from C₂ to C₇, and cervical range of motion.

RESULTSAll the patients were followed up from 18 to 36 months with an average of 25.6 months. Cerebrospinal fluid leakage occurred in 1 case, incision fat necrosis in 1 case, C₅ nerve root palsy in 4 cases. JOA scores was improved from preoperative 5.2±2.1 to 11.3±2.4 final follow up. Cobb angle was changed from preoperative (6.5±3.4)° to (13.2±4.9)° final follow up. Cervical range of motion was changed from preoperative (30.4±9.2)° to (26.5±8.4)° final follow up.

CONCLUSIONSAs an effective treatment to CSM with cervical instability, single open door laminoplasty with lateral mass screw fixation has the advantage of extensive application scope, safety and steady, but the incidence rate of complication must be reduced.

Objective To investigate the effect of hyperbaric oxygen (HBO) on the behaviors, organizational morphology and the expression of protein kinase R-like ER kinase (PERK) in rats with spinal cord injury. Methods Thirty-six male Sprague-Dawley rats were randomly divided into normal group, sham group, model group and HBO group, with nine cases in each group. The normal group did not receive any treatment, the sham group received only laminectomy, and the other two groups were established spinal cord injury model with modified Allen's method. Six hours after operation, the model group was treated with regular air, and HBO group received HBO treatment for seven days. The recovery of locomotor function was evaluated by BBB (Basso Beattie and Bresnahan) on the day before operation and six hours, three days, seven days after operation. HE staining was used to observe the change of tissue morphology in injured spinal cord, and the expression of PERK in spinal cord was detected by Western blotting. Results There was no neurological deficit in the normal group and the sham group. The neurological score was lower in the model group than in the sham group three days and seven days after operation (P < 0.05), and was higher in HBO group than in the model group seven days after operation (P < 0.05). There was no obvious structural change in the normal group and the sham group, however, the model group showed swelling cells, condensed cytoplasm, and nucleus pycnosis hyperchromatic, and the HBO group showed slighter swelling cell compared with the model group. The expression of PERK was higher in the model group than in the sham group, and was lower in HBO group than in the model group seven days after operation (P < 0.05). Conclusion HBO could reduce the expression of PERK in the injured spinal cord, and improve the recovery of hind limb locomotor function in spinal cord injury rats.

OBJECTIVE: To investigate the related factors of aseptic necrosis of femoral head after closed reduction and internal fixation of femoral neck fracture. METHODS: From January 2009 to January 2016, 236 patients with femoral neck fracture were treated with closed reduction and internal fixation with 3 hollow lag screws, including 111 males and 125 females, aged from 19 to 89 (50.17±12.88) years. According to the follow-up results, the correlation of aseptic necrosis of femoral head was analyzed. Univariate analysis of age, gender, injured side, body weight, injury mechanism, preoperative waiting time, Garden classification and whether there was comminution of femoral neck cortex was conducted to obtain the independent variables with significant difference. Then binary logistic regression analysis was conducted to explore the independent risk factors of avascular necrosis of femoral head. RESULTS: The average follow-up period of 236 cases was 4.58 years. There were significant differences in the range of injury (24.69% vs. 5.16%, CONCLUSION High energy injury, preoperative waiting time (>48 h) and comminution of femoral neck cortex were independent risk factors for aseptic necrosis of femoral head. In addition, cortical comminution on the pressure side and tension side of the femoral neck is a strong prognostic risk factor for aseptic necrosis of the femoral head, because it indicates a more serious and complex injury mechanism.
Aged ; Female ; Femoral Neck Fractures/surgery* ; Femur Head Necrosis/surgery* ; Femur Neck ; Fracture Fixation, Internal/adverse effects* ; Fractures, Comminuted ; Humans ; Male ; Risk Factors

Objective: To analyze the risk factors of blood-borne occupational exposure among medical staff and explore the relevant intervention measures. Methods: In June 2020, the data of blood-borne occupational exposure and related factors reported by medical staff in a grade Ⅲ, Grade A general hospital from 2011 to 2019 were analyzed by retrospective investigation. Results: Among 431 cases of blood-borne occupational exposure, 69.37% were nurses. It mainly occurred in medical staff with 0-4 years of service, accounting for 63.57%; The main place of occupational exposure was in the ward 47.56%; Sharp instrument injury was the main occupational exposure route 91.65%. Occupational exposure department was mainly surgery department 17.87%; The main source of exposure was hepatitis B virus (HBV) 37.12%, followed by treponema pallidum 20.19%. Statistical analysis results show that: Exposure sites (χ(2)=43.585, P<0.01) , exposure sources (χ(2)=22.693, P<0.01) , treatment methods after exposure (χ(2)=18.866, P<0.01) , Flushing (χ(2)=31.963, P<0.01) and disinfection (χ(2)=14.216, P<0.01) were significantly different. Conclusion: The effective measures to reduce blood-borne occupational exposure are to strengthen occupational protection training of medical staff, standardize operation procedures, strengthen supervision of key groups and departments, improve reporting, monitoring and follow-up systems to realize informatization, and do a good job in risk control.
Blood-Borne Pathogens ; Humans ; Medical Staff ; Needlestick Injuries ; Occupational Exposure/prevention & control* ; Retrospective Studies ; Risk Factors

To investigate the effect of electroacupuncture on motor function in hemiplegic patients with spasticity after stroke. Methods 80 patients with Hemiplegia spasticity after stroke were selected and randomly divided into treatment group （n=40） and control group （n=40）. All the patients used the same rehabilitation training. The treatment group used Hemiplegia side electroacupuncture therapy. The control group used traditional acupuncture therapy. Before treatment and 8 weeks after treatment，the degree of spasticity was evaluated with the improved Ashworth scale，the simplified FuglMeyer motor function scale （FMA） and the modified Barthel index （MBI） were used to assess motor function and activities of daily living （ADL）. Results Before treatment there were no significant difference between the two groups （P>0.05）. After 8 weeks of treatment，the FMA，MBI and mproved Ashworth scale of patients in each group were significantly improved （P<0.01）and （P<0.05）respectively. The improved Ashworth scale，FMA and MBI in the treatment group were better than those in the Control Group （P<0.05）. Conclusion Electroacupuncture therapy combined with rehabilitation training on Hemiplegic side is helpful to relieve spasticity and improve the motor function and daily living ability of the patients. The effect is better than traditional acupuncture treament bombined with rehabilitation training.

From the event of TU You-you winning the Nobel Prize, this paper briefly reviewed the history of formation and development of policies on Chinese medicine (CM) in China. On the basis of analyzing the causes of policies on CM, it is believed that policies on CM in China may have 4 kinds of enlightenments to the development of complementary and alternative medicine (CAM) in the world. Forming the political advantages of policy-making by main leaders of the country attaching importance to CAM; implementing a diversified health care system policy for the goal of maximizing people's health interests; ensuring development of CAM by the coerciveness of law and the timeliness of policy adjustment; and promoting the protection and mining, sorting out and improving of CAM based on open and comprehensive policies.

Three features of ethics review in Chinese medicine (CM) and integrative medicine (IM) were put forward in this paper. It is consistent with the principles of ethical review in Western medicine; it has to be compliant with the laws of CM and IM; emphasis should be laid on the review of clinical practice facts and experience. Three problems were pointed out. The characteristics of CM and IM are not distinctive enough, operation procedures need to be refined and effectiveness remains to be improved. Based on the mentioned above, seven measures were proposed to improve the level and quality of ethics review in CM and IM, including better brand awareness, considerable tolerance, treatment based on disease differentiation and syndrome differentiation, scientific review and toxicity and side effects of CM, perfection of the ethics review system, reasonable procedures of ethics review and more specialized ethics review workers.
Ethics ; Humans ; Integrative Medicine ; ethics ; standards ; Medicine, Chinese Traditional ; standards ; Practice Patterns, Physicians'