OBJECTIVETo investigate the effects of manipulative reduction on pain and clinical curative effect in patients with lumbar intervertebral disc herniation.

METHODSEleven thousands one hundred and twenty-eight patients with lumbar intervertebral disc herniation from our hospital were enrolled from November 1986 to June 2007. They were randomly divided into control group and treatment group. Patients of the control group received lumbar traction and various physiotherapies. Patients of the treatment group received manipulative reduction, besides the treatment in the control group. The treatment was performed once a day,ten times as a course. Curative effects were assessed three courses later. Pain was evaluated by visual analogue scale before and after the treatment.

RESULTSNo significant difference in the score of visual analogue scale was found before the treatment in the two groups (P > 0.05). As compared with the score before treatment,it was decreased by 4.73 points after treatment in the control group, and decreased by 6.37 points in the treatment group. The decrease was more significant in the treatment group than the control group (P < 0.01). The healing rate was 47.28% and total effective rate was 96.37% in the control group; The healing rate was 73.44% and total effective rate was 98.61% in the treatment group (P < 0.01).

CONCLUSIONManipulative reduction for lumbar intervertebral disc herniation can remarkably relieve lumbar pain and improve clinical curative effect.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Pain Measurement

Objective: To explore the effect of the Epstein-Barr virus (EBV) BZLF1 gene on the biological behavior of EBV-negative gas-tric cancer cells and the underlying molecular mechanism. Methods: Lentiviral overexpressing BZLF1 was used to infect AGS and HGC27 gastric cancer cell lines. And the cell proliferation, apoptosis and migration invasive ability, and expression changes of cell sig-naling pathway were detected by CCK8 assay, apoptosis detection, migration and invasion assay, as well as western blot. HGC27 cells overexpressing BZLF1 were injected into the dorsal of NOD/SCID mice to construct xenografts, and the effect of BZLF1 on tumor growth was observed. Results: The expression of BZLF1 protein was significantly up-regulated in AGS-BZLF1 and HGC27-BZLF1 infected by over-expressing BZLF1 lentivirus. The cell proliferation in vitro and the tumorigenic ability in mice were significantly increased (P<0.05). Apoptosis was inhibited by BZLF1 protein, and the apoptotic rate of AGS-BZLF1 and HGC27-BZLF1 was (2.40±0.14)% and (3.90± 0.14)%, which was significantly lower than (5.75±0.35)% and (9.70 ± 0.42)% of AGS and HGC cells (P<0.05); however, there was no sig-nificant change in cell migration and invasion ability. In-depth molecular mechanism studies found that PI3K/AKT signaling pathway was significantly activated with enhanced pAKT and pS6 expression. After blocking the PI3K/AKT signaling pathway with BEZ235 inhibi-tor, the growth of HGC27-BZLF1 and AGS-BZLF1 cells was inhibited. Conclusions: EBV BZLF1 may promote the growth of gastric cancer cells by activating the PI3K/AKT signaling pathway and targeting PI3K/AKT pathway inhibitors, and serve as a promising treatment op-tion for EBV-associated gastric carcinoma.

Objective To evaluate the immunogenicity and safety of a split-virion influenza vac-cine after its manufacturing process was improved. Methods The immunological non-inferiority of trial to control vaccines was evaluated in 240 subjects aged 3-<18 years. Another 360 subjects aged 18-<60 years were randomly divided into three groups that were respectively given three consecutive lots of trail vaccine to assess the consistency of immunogenicity. Results There were 4. 17% of the subjects aged 3-<18 years showed adverse reactions following immunization with trail vaccine and it was not significantly different from that of the control group (P>0. 05). No significant difference in seroconversion rate, geometric mean titer (GMT) of haemagglutination inhibition antibodies(HIAb) or protection rate was found between trial and control groups (P>0. 05). No significant difference in seroconversion rate or HIAb GMT was found among the three lots (P>0. 05). Conclusion The trial influenza vaccine has good safety, immunogenicity and lot-to-lot consistency after the manufacturing process was improved.

Objective To evaluate the immunogenicity of inactivated quadrivalent influenza vaccine (QIV) in people over 60 years old. Methods Databases including PubMed, EMBASE, Cochrane Library, China Biology Medicine disc, Wangfang Database and China National for Biotechnology Information were searched for random control studies comparing and analyzing the immunogenicity and safety between QIV and inactivated trivalent influenza vaccine (TIV) in people over 60 years old. Meta-analysis of the included literature data was performed using Stata11.0 software. Results A total of 9 articles were included in this study. There was no difference in seroconversion rates (SCR) and seroprotection rates (SPR) for the same vaccine strain after inoculation between QIV and TIV, while for the B vaccine strain (B/Victoria or B/Yamagata) not included in TIV, the SCR and SPR of QIV were significantly higher: SCR RR of 2.04 (95%CI:1.48~2.83) and SPR RR of 1.21 (95%CI:1.11~1.31) for B/Victoria; SCR RR of 2.35 (95%CI:2.04~2.69) and SPR RR of 1.12 (95%CI:1.02~1.23) for B/Yamagata. Conclusion For people over 60 years old, QIV has good immunogenicity, and produces better immunogenicity against influenza B vaccine strains not included in TIV.

Objective To analyze the global status of COVID-19 epidemics, so as to preliminarily forecast the epidemic trend. Methods The epidemiological data of 208 countries and the prevention and control policies implemented by typical countries from December 31, 2019 to December 14, 2020 were collected. We use the cumulative incidence rate, cumulative mortality, cumulative fatality and real-time dependent reproduction number (R_t) to analyze the epidemic status. We use the provenance package to group different countries and discuss the effect of prevention and control measures. Results As of December 14, 2020, a cumulative incidence of 93.49 per 10000, a cumulative mortality rate of 0.21‰, and a cumulative fatality rate of 3.1‰ had been reported globally.112 of the 208 countries still had R_t ≥ 1.0, and 96 countries had R_t <1.0. The grouping of 208 countries showed that countries from the same continent often gather together and were geographically adjacent. Countries that were geographically adjacent could easily be grouped together. Conclusion As of December 14, 2020, the epidemic situation in most countries had not been effectively controlled, and epidemic prevention and control are facing greater pressure. Sub-Saharan countries currently had a high R_t , and the government had adopted more relaxed epidemic prevention measures. The epidemic situation in this region may continue to deteriorate, and needs to be focused in the later period.

Objective:To establish the normal values of water-perfused high resolution esophageal manometry (HREM)(GAP-36A) at resting period, water swallowing, semisolid swallowing and solid swallowing in Chinese population.Methods:From September 1, 2019 to June 30, 2020, 91 healthy volunteers receiving water-perfused HREM (GAP-36A) at resting period, water swallowing, semisolid swallowing and solid swallowing were selected from 9 hospitals (Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; the First Affiliated Hospital of Dalian Medical University; the Second Hospital of Hebei Medical University; the Second Affiliated Hospital, Naval Medical University; the First Affiliated Hospital, Sun Yat-sen University; the First Affiliated Hospital, University of Science and Technology of China; Aviation General Hospital of China Medical University; the Affiliated Hospital of Medical School of Nanjing University and the First People′s Hospital of Yichang). Parameters included the position of the upper and lower edges of the upper esophageal sphincter (UES) and lower esophageal sphincter (LES), the length of the LES and UES, the position of the pressure inversion point (PIP), the resting pressure of UES and LES and swallow-related parameters such as the distal contraction integral (DCI), 4 s integrated relaxation pressure (IRP), distal latency (DL) and UES residual pressure. One-way analysis of variance, post-hoc test and sum rank test were used for statistical analysis.Results:A total of 87 healthy volunteers were enrolled, including 40 males and 47 females, aged (38.5±14.2) years old (ranged from 19 to 65 years old). The position of the upper and lower edges of the LES was (42.7±2.8) and (45.6±2.8) cm, respectively, the length of the LES was (2.9±0.4) cm, and the position of PIP was (43.3±2.8) cm. The position of the upper and lower edges of the UES was (18.1±3.0) and (22.6±2.0) cm, respectively, and the length of the UES was (4.8±1.0) cm. The resting pressure of LES and UES was (17.4±10.7) and (84.1±61.1) mmHg (1 mmHg=0.133 kPa), respectively. The DCI value at solid swallowing was higher than those at water swallowing and semisolid swallowing ((2 512.4±1 448.0) mmHg·s·cm vs. (2 183.2±1 441.2) and (2 150.8±1 244.8) mmHg·s·cm), and the differences were statistically significant ( t=-4.30 and -3.74, both P<0.001). The values of 4 s IRP at semisolid swallowing and solid swallowing were lower than that at water swallowing ((4.6±4.1) and (4.9±3.9) mmHg vs. (5.4±3.9) mmHg), and the differences were statistically significant ( t=3.38 and 2.09, P=0.001 and 0.037). The DL at water swallowing was shorter than those at semisolid swallowing and solid swallowing ((8.5±1.8) s vs. (9.8±2.2) and (10.6±2.8) s), and the DL at semisolid swallowing was shorter than that at solid swallowing, and the differences were statistically significant ( t=-10.21, -13.91 and -4.68, all P<0.001). The UES residual pressure at water swallowing was higher than those at semisolid swallowing and solid swallowing (9.5 mmHg, 6.5 to 12.3 mmHg vs. 8.0 mmHg, 4.5 to 11.7 mmHg and 5.5 mmHg, 2.0 to 9.3 mmHg), and the UES residual pressure at semisolid swallowing was higher than that at solid swallowing, and the differences were statistically significant ( t=3.48, 10.30 and 6.35, all P<0.001). Conclusions:The normal values of water-perfused HREM (GAP-36A) in Chinese population at resting period, water swallowing, semisolid swallowing and solid swallowing can provide a reference basis for clinical diagnosis and treatment for patients receiving water-perfused HREM examination.

Objective To evaluate the safety of a Chinese thimerosal-free trivalent split influenza virus vaccine after being marketed in a large population. Methods Through the information management system of adverse event following immunization (AEFI), the adverse events in healthy people aged 6 months and above who were vaccinated with split influenza virus vaccine in Hubei Province from October to December 2015 were collected. The data was analyzed by descriptive methodology. Results From October 1, 2015 to June 30, 2016, among the 227 920 people in Hubei Province who were vaccinated with split influenza virus vaccine, the common adverse reactions were mainly fever, redness, irritability, pain and itching. Four cases of AEFI were passively observed and reported in the system, with a reporting rate of 1.76/100 000, among which 3 cases were anaphylactic rash and 1 case was optic neuritis. Conclusion The Chinese thimerosal-free trivalent split influenza virus vaccine used in Hubei Province had a good safety record and is suitable for the general vaccination of people without vaccination contraindications.