Objective:To compare lumbar fusion effect of unilateral and bilateral internal fixation for lumbar disc herniation, to explore more effective, reliable treatment. Methods:112 cases of lumbar selects my courtyard 2007 April-2010 year in April admitted to the disc herniation were randomly grouped, unilateral group and bilateral group with 56 cases in each group, respectively, to take unilateral or bilateral internal fixation for the treatment of lumbar fusion operation, compared two groups of patients and the therapy effect. Results:the unilateral group operation time, amount of bleeding during the operation and hospitalization expenses below the bilateral group, there was significant difference(t=8.857, t=9.620, t=12.338;P<0.05), the two groups had no significant difference (P>0.05);the two group patients after VAS and ODI were significantly decreased (P<0.05), before and after the treatment of VAS and ODI the comparison between the two groups were not statistically significant difference (P>0.05);the unilateral group at the end of the follow-up of 50 cases of intervertebral fusion, the fusion rate was 96.2%, the bilateral group interbody fusion in 52 cases, the fusion rate was 100%, two groups of patients at the end of the follow-up intervertebral fusion rate has no obvious statistical difference (x2=0.372, P<0.05);unilateral group were no significant complications, bilateral group were found 1 cases of intervertebral fusion device implant bone absorption, 1 cases highlight the root symptoms, complication rate was 3.8%, the two groups of patients with complications were no significant statistical difference. Conclusion:Lumbar unilateral and bilateral internal fixation can effectively improve the patients with lumbar disc herniation pain symptoms, and has good fusion degree, high security, and unilateral internal fixation operation time is shorter, less blood loss and the burden of patients is smaller, need operation treatment for severe lumbar disc herniation, fusion and unilateral internal fixation for the treatment of recommend the use of lumbar.

Objective To investigate the 50% inhibition concentration(IC50)of haematoporphyrin derivative(HpD)and hematoporphyrin monomethyl ether(HMME)at the saturated light dose and 50% inhibition energy density(IED50)at saturated photosensitizer dose in order to find out their photocytotoxicity features.Methods Cell culture and MTT technology were utilized to inspect photosensitizers' photocytotoxicity to the endothelial cells of mouse lung vessel.Exponentially growing cells were incubated with varying concentrations of the photosensitizers in DMEM medium(low glucose)in 96-well microliter plate for 4h.The plate was then exposed to copper vapor laser at 510.6nm and 578.2nm wavelength,respectively,for a period of time.Incubation was continued for another 24h in darkness,and the number of surviving cell was analyzed by MTT assay.Results The findings suggested that the IC50 of HMME was 1.31 and 1.24 times of that of HpD in 510.6nm and 578.2nm wavelengths at saturated light dose,respectively.IED50 of HPD was 1.18 and 1.17 times of that of HMME in 510.6nm and 578.2nm wavelengths at saturated photosensitizer dose,respectively.Conclusion HpD has stronger photocytotoxicity than HMME under 510.6nm and 578.2nm wavelength exposure,and the photocytotoxicity is closely related to light dose and wavelength.

Objective To study both therapeutic and adverse effects of photodynamic therapy for cutaneous malignant tumors.Methods The IEAu-3 gold vapor laser(wavelength 627.8nm),manufactured by the Institute of Electronics,Chinese Academy of Sciences,and diode laser(wavelength 630nm),manufactured by DIOMED Ltd.(GB),were employed as the light source.Power density of the both kinds of laser was 100-150mW/cm2,and energy density was 150-300J/cm2.Haematoporphyrin derivative(HpD)was used as pohotosensitizer at dosage of 5mg/kg.The patients' foci were radiated 12-72h after HpD administration.The patients received 1 to 4 courses of photodynamic therapy.The size of patients' focus was measured before and after treatment and the therapeutic effect was appraised 4 weeks later.Results Evaluation of the therapeutic effect in 30 patients showed that 15 patients(50.0%)responded completely(CR),10 patients(33.3%)responded partially(PR),and 5 patients(16.6%)showed no response(NR).No patients showed progression of the lesion(PD).The total response case(CR+PR)was 25.No adverse effect was found in this group.Conclusions Photodynamic therapy is an effective and safe modality for cutaneous malignant tumor especially for basal cell skin cancer and squamous cell skin cancer.

Objective To investigate the effects of asymmetric dimethylarginine (ADMA) on apoptosis and phosphorylation of c-jun N-terminal kinase (JNK) in endothelial outgrowth cells (EOCs). Methods The mononuclear cells were harvested from umbilical cord blood by ficoll density gradient centrifugation, and induced into EOCs and then expanded in vitro. The identified EOCs were treated with different concentrations of ADMA (0, 1, 5, 10, 20 μmol/L) for 48 h. The adherent cells were treated with 10 μmol/L ADMA,then different concentrations of JNK specific inhibitor SP600125 (0, 5,10,20 and 40 μmol/L) were added and incubated for 48 hours. Caspase-3 activity was measured by microplate reader. Apoptotic incidences of EOCs were quantitatively determined by flow cytometry. The expression of Caspase- 3 and phosphorylase-JNK (p-JNK) were detected by Western blot assay. Results The treatment of ADMA (1-20 μmol/L) significantly induced apoptosis in EOCs by enhancing Caspase-3 express and also induced phosphorylation of JNK (P<0.05). Meantime, the JNK specific inhibitor SP600125 could attenuate the apoptosis induced by ADMA during this process (F=6.733,P<0.05) and inhibit the expression of Caspase-3 and p-JNK. Conclusion ADMA can induce apoptosis in EOC, which may be achieved by activating JNK signal transduction pathway.

In recent years, the relationship between TCM (traditional Chinese medicine) syndrome and intestinal flora has attracted wide attention from the medical community. The syndrome of stagnation of liver qi and spleen deficiency is a common clinical syndrome of multiple diseases, involving multiple system pathological change. And the disorganized intestinal flora also cause a multisystem pathological change. The development of molecular biology and metagenomic technology provides strong support for the study of syndrome diseases and intestinal flora. In this paper, it reviewes the correlation of syndrome of stagnation of liver qi and spleen deficiency and intestinal flora in nerve, digestive, endocrine, metabolic system.

Objective: To assess the role of activated platelets in the inflammatory procession of atherosclerosis(AS) by ultrasound molecular imaging. Methods: Sixty ApoE-/- mice were fed with high fat diet to establish AS model as experimental group, and 40 C57BL/6J mice were fed with normal diet as control group. Biotin-avidin bridging method was used to construct platelet-targeted microbubbles with recombinant vWF-A1 domain (Mb-A1), microbubbles carrying monoclonal antibodies to VCAM-1 (Mb-VCAM1) and microbubbles carrying IgG monoclonal antibody (Mb-ctrl). In vitro and in vivo experiments were carried out to evaluate the ability of Mb-A1 to target platelets on vascular endothelial surface. Contrast enhanced ultrasound molecular imaging of proximal ascending aorta was performed with Mb-A1, Mb-VCAM1 and Mb-ctrl. The expression and distribution of platelets and monocytes/macrophages on the endothelium of ascending aorta of AS mice were observed and analyzed by immunofluorescence staining. Results: ①A large number of Mb-A1 adhering to the surface of activated platelets coated in Petri dishes were observed under fluoresce. ②After platelet immune-depletion in 30-week AS mice, the signal intensity of Mb-A1 decreased significantly in ascending aorta, while that of Mb-ctrl has no obvious change(P<0.05). ③In ApoE-/- mice, signals from platelet targeted microbubbles increased from 8 to 32 weeks of age in ApoE-/- mice, which coincided with the increase of signals from VCAM-1 targeted microbubbles(P<0.05). ④Activated platelets on the endothelial surface of ascending aorta increased progressively with age from 8 weeks, and partly overlapped with the distribution of monocytes/macrophages. Conclusions Platelets contribute to the initiation and progression of atherosclerosis as an inflammatory mediator through the interaction with vascular endothelium.

Objective:To investigate the influence of long-term wear of soft contact lenses on corneal transparency.Methods:A cross-sectional study was conducted.The corneal optical density of female myopic patients who planned to undergo corneal refractive surgery in Jinan Mingshui Eye Hospital from January 2018 to December 2020 was examined.The patients were divided into ≥2-<5 years group, ≥5-<10 years group, and ≥10 years group according to the duration of wearing contact lenses.Age- and sex-matched patients without wearing soft contact lenses were enrolled as a control group.There were 50 eyes from 50 cases in each group.The cornea was divided into 0-2, 2-6, 6-10, and 10-12 mm corneal vertex-centered annuli.The cornea over each annulus was divided into a superficial layer (≤120 μm from the outer surface of the cornea), a deep layer (≤60 μm from the inner surface of the cornea) and a central layer (between the superficial and deep layers). Measurements of the right eye were taken for analysis.The corneal optical density of different layers over different corneal ring regions was compared.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Jinan Mingshui Eye Hospital (No.2018-005). Written informed consent was obtained from each subject before any medical examination.Results:The corneal optical density tended to decrease as the wearing duration of corneal contact lens extended.The corneal optical density values of control group, ≥2-<5 years group, ≥5-<10 years group, and ≥10 years group were 18.51±1.79, 18.25±2.10, 18.16±1.89 and 17.83±1.65, respectively, showing no significant difference ( F=1.152, P=0.329). There was no significant difference in the corneal optical density of the superficial layer over 0-2, 2-6, and 6-10 mm annuli among the four groups ( F=2.077, 2.080, 2.229; all at P>0.05). There was a significant difference in the corneal optical density of the superficial layer over 10-12 mm annulus among the four groups ( F=5.016, P=0.002), and the corneal optical density of the superficial layer was greater in ≥5-<10 years group than in ≥2-<5 years, and greater in ≥10 years group than in control group, showing statistically significant differences (both at P<0.05). There were significant differences in the corneal optical density of the central layer over 0-2 and 6-10 mm annuli ( F=3.808, 2.813; both at P<0.05), and the corneal optical density of the central layer was lower in ≥10 years group than in control group, showing a statistically significant difference ( P<0.05). There were significant differences in the corneal optical density of the deep layer over 0-2, 2-6, 6-10 and 10-12 mm annuli ( F=5.485, 5.625, 3.398, 2.775; all at P<0.05). The optical density of the deep layer was lower in ≥5-<10 years than in control and ≥2-<5 years groups over 0-2, 2-6, and 10-12 mm annuli, lower in ≥5-<10 years group than in control group over the 6-10 annulus, and lower in ≥10 years group than in control group over 0-2, 2-6, and 6-10 mm annuli, and the differences were statistically significant (all at P<0.05). Conclusions:For women, the long-term wear of soft contact lenses for 5 years does not affect corneal transparency, and long-term wear for more than 5 years can cause a decrease in the transparency of the superficial peripheral cornea.

Objective To validate the analytical performance of a cardiac troponin I(cTnI)assay AccuTnI+3 on chemiluminescnet analyzer DXI800 and Access2;and to establish the 99th percentile of cTnI in an apparently healthy Chinese population.Methods The subjects are composed of 1 369 apparently healthy people and 20 acute myocardial infarction(AMI)patients from Wuhan Asian Heart Hospital and Fuwai Hospital from October 2014 to June 2015.The healthy people include 680 males and 689 females;with 340 subjects aged 18-30,674 subjects aged 31-64, and 355 subjects aged ≥65.The detection limits and imprecision of AccuTnI +3 assays were validated according to CLSI EP 15-A2 and EP17-A2 documents;the same samples were analyzed on DXI800 and Access2 to assess the consistency between the two analyzers using Bland Altman plot and Passing-Bablok regression.The correlation between different sample types (lithium heparin plasma, EDTA plasma & serum)were assessed using linear regression analysis.The lithium heparin plasmasamples from 1 369 apparently healthy people were analyzed to calculate the 99th percentile of cTnI.The cTnI concentrations were compared among age and sex groups.The 99th percentile of cTnI were also calculated for each group.The detection rate of cTnI in apparently healthy people was calculated using SPSS23.0.Results The limit of blank(LoB), limit of detection(LoD), and limit of quantification(LoQ)where CV%=10% were 0.007 ng/ml,0.010 ng/ml and 0.016 ng/ml on DXI800;0.008 ng/ml,0.012 ng/ml and 0.026 ng/ml on Access2,respectively.The cTnI measurements on DXI800 and Access2 were consistent and comparable.The cTnI concentrations of lithium heparin plasma, EDTA plasma and serum samples were linearly correlated pairwise: EDTA plasma measuremen t =0.76 heparin plasma measurement, R2=0.999(n=40, P<0.001); serum measuremen t =1.05 heparin plasma measurement,R2=0.996(n=40,P<0.001); serum measuremen t=1.38 EDTA plasma measurement, R2=0.993(n=40,P<0.001).The 99th percentiles were 0.030 ng/ml and 0.035 ng/ml on DXI800 and Access2,respectively,from 1 369 apparently healthy Chinese people.cTnI is significantly higher in elder group than in younger group.The 99th percentiles in 18-30 years old group,31-64 years old group,and≥65 years old group are:0.011 ng/ml,0.029 ng/ml,and 0.035 ng/ml respectively for DXI800;0.023 ng/ml,0.034 ng/ml, and 0.045 ng/ml respectively for Access2.cTnI is significantly higher in men than in women.The 99th percentiles in men and women are: 0.034 ng/ml and 0.032 ng/ml respectively for DXI800;0.043 ng/ml and 0.031 ng/ml respectively for Access2.cTnI was measurable in 62%and 87%of healthy subjects on DXI800 and Access2 systems,respectively.Conclusions The analytical performance of AccuTnI+3 assay fulfills the need of clinical use and the criteria of high-sensitive cardiac troponin assay.

Objective:To explore the effect of Internet + technical liaison service mode on the postoperative continuing nursing of elderly patients with osteoporotic hip fractures.Methods:A total of 92 elderly patients with osteoporotic hip fractures who were admitted into in Orthopaedics Department of the First Affiliated Hospital of Soochow University from July 2018 to December 2019 were selected, and randomly divided into intervention group and control group by random number table method, with 46 cases in each group. The control group was given routine follow-up outside hospital, while the intervention group was given the continuing nursing led by the orthopedic specialist nurses based on the Internet + Technology home orthopedic care platform. All patients were followed up to 6 months after operation, and the differences of Harris Hip Score (Harris), Numeric Rating Scales (NRS), Barthel Index, Short Form 36-item Health Survey (SF-36) between the two groups were compared.Results:The Harris scores were 49.74 ± 4.28, 76.59 ± 4.33 and 90.78 ± 2.61 in the intervention group, and 46.17 ± 3.85, 74.26 ± 4.24 and 88.65 ± 2.17 in the control group in 1, 3 and 6 months after operation, respectively. The differences were statistically significant ( t=-4.20, -2.60, -4.26, all P<0.05). The NRS scores in the intervention group were 1.33 ± 0.47, 0.83 ± 0.38 and 0.76±0.43 in 1, 3 and 6 months after operation respectively, while the NRS scores in the control group were 1.61 ± 0.54, 0.96 ± 0.42 and 0.84 ± 0.38, respectively. The difference in pain scores between the two groups was statistically significant only at 1 month after operation ( t=2.68, P<0.05). The Barthel Index in the intervention group were 61.74 ± 8.90, 93.80 ± 5.29 and 98.26 ± 2.83 in 1, 3 and 6 months after operation respectively, while those of the control group were 60.33 ± 5.81, 91.09 ± 7.52 and 97.83 ± 3.10, respectively. The difference in Barthel Index between the two groups was statistically significant only in 3 months after operation ( t=-2.00, P<0.05). The scores of SF-36 in the intervention group were 93.73 ± 3.89, 100.26 ± 3.77 and 107.50 ± 3.56 at 1, 3 and 6 months after operation respectively, while those of the control group were 92.67±3.42, 97.71±2.67 and 103.68±2.83, respectively. The difference in SF-36 scores between the two groups was statistically significant only at 3 and 6 months after operation ( t=-3.74, -5.71, P<0.05). Conclusions:The continuing nursing based on multi-disciplinary team cooperation in hospital + Internet + Technology home orthopaedic nursing platform led by orthopaedic specialist nurses can improve joint function, relieve pain and improve quality of life of elderly patients with osteoporotic hip fractures after operation.

Candida auris is emerging as a major global threat to human health. C. auris infections are associated with high mortality due to intrinsic multi-drug resistance. Currently, therapeutic options for the treatment of C. auris infections are rather limited. We aim to provide a comprehensive review of current strategies, drug candidates, and lead compounds in the discovery and development of novel therapeutic agents against C. auris. The drug resistance profiles and mechanisms are briefly summarized. The structures and activities of clinical candidates, drug combinations, antifungal chemosensitizers, repositioned drugs, new targets, and new types of compounds will be illustrated in detail, and perspectives for guiding future research will be provided. We hope that this review will be helpful to prompting the drug development process to combat this fungal pathogen.