Objective To observe the clinical effect of neuromuscular electrical stimulation combined with kinesitherapy on dysfunction after brachial plexus injury. Methods 60 cases with brachial plexus injury following dysfunction were divided into two groups. The experimental group (n=30) was treated with neuromuscular electrical stimulation combined with kinesitherapy. The control group (n=30) was treated with kinesitherapy. Two groups were assessed by the brachial plexus function evaluation standard before and 3 months after the treatment.Results Two group all improved 3 months after the treatment (P<0.05), while the experimental group was better than the control group (P<0.01). Conclusion Neuromuscular electrical stimulation combined with kinesitherapy is more effective to improve the function after brachial plexus injury.

Through comparing problem-based learning and lecture-based learning, the PBL teaching can improve the learning interest and self-learning ability of students and also can accomplish the task of teaching better.

ABSTRACT:Objective To observe the effect of curcumin on RAW264.7 macrophages induced with LPS and IFNγ(M1)and the mechanisms involved.Methods Curcumin of different concentrations (6.25 μmol/L,12.5μmol/L and 25 μmol/L)was used to treat RAW264.7 macrophages induced with LPS and IFNγ(M1)for 12 h,and RAW264.7 macrophages induced with LPS and IFNγ(M1)were incubated with 20μmol/L GW9662 and 25 μmol/L curcumin for 12 h.Using Real-time PCR,ELISA and Western blotting analysis,we examined the expressions of IL-1β,IL-6,PPARγand phenotype markers M2 (KLF4,FIZZ1,and MGL1 )and the expressions of KLF4 and FIZZ1 when PPARγwas inhibited.Results Curcumin of different concentrations all could inhibit the expressions of IL-1βand IL-6 in RAW264.7 macrophages induced with LPS and IFNγ(M1).Curcumin of different concentra-tions could upregulate the expression of M2 markers (KLF4,FIZZ1 and MGL1)and PPARγin RAW264.7 macro-phages induced with LPS and IFNγ(M1).When M1 macrophages were incubated with curcumin and GW9662,the expression of the M2 phenotype markers was reduced.Conclusion Curcumin polarized the M1 phenotype macro-phages derived from RAW264.7 macrophages to become M2 phenotype through activating PPARγ.

Objective To explore the association between glycated hemoglobin (HbA1c) level at admission and coronary plaque characteristics under intravenous ultrasound (IVUS) study in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Methods 118 patients with NSTE-ACS were divided into the low(HbA1c ≤ 5.6％), medium(HbA1c 5.7％-6.4％)and high(HbA1c ≥ 6.5％)level groups based on admission HbA1c. IVUS was performed in all target lesions. Results As compared with the other two groups, patients with high level HbA1c had higher mean body weight index, higher co-morbidities of diabetes mellitus, dyslipidemia and non-ST-elevation acute myocardial infarction.The high HbA1c level group had more diffuse coronary atherosclerosis ,increased plaque burden and higher rates of positive remodeling, soft plaque and plaque rupture. Conculsions The HbAlc level of admission is associated with plaque vulnerability in NSTE-ACS patients.

OBJECTIVE: To construct and obtain ideal protein delivery vectors by researching the delivery efficiency and cytotoxicity to Hela cells using mPEG-PLGA-BSA-FITC-NPs. METHOD: The mPEG-PLGA nanoparticle was obtained through surface modification of PLGA with PEG, and deliver BSA-FITC into Hela cells in vitro. The positive cells were counted by Laser scanning confocal microscopy and the survival rate of Hela cells was calculated by MTT assay at different time points. RESULT: mPEG-PLGA-BSA-FITC-NPs shows the classic nanometer size, and the encapsulation efficiency reached 51. 2%. At the same time, the nanoparticles possess characteristics of slow release. By optimizing the delivery conditions, the highest efficiency of mPEG-PLGA-BSA-FITC-NPs was above 65.2%, and the cellular viability was about 85.7%. CONCLUSION mPEG-PLGA-BSA-FITC-NPs nanoparticles can successfully carry the target protein into cells as safe and effective as novel delivery materials of protein in vitro, and has shown slow release characteristics. The mPEG-PLGA-BSA-FITC-NPs provide ideal delivery vector for future application in clinical treatment of disease using nano-materials.
Drug Carriers ; Fluorescein-5-isothiocyanate ; analogs & derivatives ; HeLa Cells ; Humans ; Nanoparticles ; Particle Size ; Polyesters ; Polyethylene Glycols ; Serum Albumin, Bovine

Objective To investigate the clinical efficacy of double locking mini-plates for fixation of the comminuted fracture of the first metacarpal base.Methods Twenty-four patients with the comminuted fracture of the first metacarpal base were treated by double locking mini-plates in our hospital from January 2013 to January 2016.They were 17 males and 7 females,from 27 to 65 years of age (average,33.5 years).By the Green classification,6 cases were type Ⅰ,13 cases type Ⅱ and 5 cases type Ⅲ.All the fractures were closed.The average time from injury to surgery was 2.3 days (from 8 hours to 7 days).After open reduction via the palmar-radial incision,the fracture was fixated with 2 mini-plates,one locking T-plate on the radial side and one straight locking plate on the dorsal side.Fracture healing time,pain and finger function were followed up postoperatively.Visual analogue scale (VAS) was used to evaluate the pain at 12 months and scoring for digital total range of motion to assess the function of the affected finger at the final follow-up.Results The 24 patients obtained follow-up for 8 to 28 months (average,18 months).All the Fractures healed after 9 to 12 weeks (average,10.5 weeks).The VAS scores at 12 months ranged from 0 to 3 (average,1.5).The function of the affected finger at the final follow-up was excellent in 20 cases and good in 4,giving an excellent to good rate of 100％.Two patients complained of pain after frequent motion of the finger.No complications like skin problems,dislocation of the first metacarpal base,implant failure,necrosis or irritation of the soft tissue were observed during follow-up.No angulation or rotational deformity occurred after fracture union.Conclusion Fixation with double locking mini-plates can effectively treat comminuted fractures of the first metacarpal base,because it can provide rigid stabilization which promotes early functional exercise of the finger,and prevents joint stiffness as well.

Objective To resolve the problem of sharing and storing medical images and diagnostic reports among different hospitals and to help primary health care institutions to obtain the technical supports from a major hospital in a large city for the improvement of medical imaging diagnosis.Methods The paper utilizes the existing parallel and distributed technology of cloud computing and the cloud storage virtualization to design a regional image service platform,which provides computing,storage and software services to users.In addition,the design of medical image flie accessing system (MIFAS) further raise the performance of storage and access for medical image.Results The trial results showed that the medical image file accessing system had run in the actual hospital environmental for a few months with stable and good application effect.Conclusion The proposed system can improve the stability and reliability of medical imaging storage,transmission and further improve the level of medical imaging diagnosis in primary health care institutions.

Objective:To provide a reference for establishing the evaluation system of the implementation effect of cross provincial direct settlement policy.Methods:By referring to the public policy evaluation model and using the expert consultation method, the authors built an evaluation index system for the implementation effect of cross provincial direct settlement policy for urban and rural residents. The multi-attribute group decision-making analytic hierarchy process, Matlab software and Yaahp software, combined with Spearman correlation coefficient method, were used to cluster the expert opinions and further determine the weight of each element at different levels.Results:The evaluation index system of the implementation effect of direct settlement policy for urban and rural residents′ cross provincial medical insurance was constructed, including 3 first-class indicators, 9 second-class indicators and 20 third-class indicators, and the weight of each index was calculated.Conclusions:The designed index system is suitable for grasping the implementation level of the cross provincial direct settlement policy from a macro perspective, and find out the problems in the implementation process. Efforts should be made to refine the evaluation criteria of the indicators in the index system.

Aluminum salts are the most popular adjuvants applied in human vaccines currently. However,they can′t achieve satisfying results in the development of novel vaccines because of the cellular immune responses induced by them are weak and their adjuvant activities for some novel vaccines are poor, especially in vaccination against peptide antigens with small molecular weight. cGAMP (cyclic guanosine monophosphate-adenosine monophosphate) has recently been known as a mammalian second messenger, which plays an important role in the innate immune signaling pathway and is capable of boosting the immuno-genicity of vaccines,activating antigen-presenting cells and enhancing specific T cell responses. cGAMP is expected to become a new generation of vaccine adjuvants against infectious diseases and cancer. In this re-view,we summarize the application and current situation of vaccine adjuvants, describe the discovery of cGAMP and its mechanism as a vaccine adjuvant,and focus on the advances in using cGAMP in the fields of vaccination against infectious diseases, intradermal immunization and tumor immunotherapy. Finally, it is also pointed out that cGAMP,as a novel vaccine adjuvant,will have a broad prospect of application in areas such as anti-tumor,anti-virus,anti-inflammatory and vaccines.

Objective To investigate the efficacy of sakubatril valsartan combined with tolvaptan in the treatment of heart failure patients with reduced ejection fraction(HFrEF)and the effects on echocardiography and cardiovascular events.Methods According to the random number table method,400 patients with HFrEF admitted to the First People's Hospital from September 2017 to January 2022 were divided into the control group and the combination group with 200 cases each.Both groups were given conventional treatment,based on which the control group was given sacubitril valsartan and the combination group was given sacubitril valsartan combined with tolvaptan.The efficacy,echocardiographic indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic internal diameter(LVEDD),left ventricular end-systolic internal diameter(LVESD)],myocardial injury indexes[serum brain natriuretic peptide(BNP),high-sensitivity troponin T(hs-CTnT),growth transforming factor-15(GDF-15)],urine output,neuroendocrine factors[antidiuretic hormone(ADH),angiotensin(PRA),angiotensin Ⅱ(Ang Ⅱ)],cardiovascular events and adverse effects were compared between the two groups.Results The total effective rate was 94.50%(189/200)higher in the combined group than 86.00%(172/200)in the control group(P＜0.05);LVEF was high-er in the combined group than in the control group after treatment,and LVEDD and LVESD were lower than in the control group(P＜0.05);BNP,hs-CTnT,GDF-15,ADH PRA,and Ang II were lower in the combined group than in the control group,and urine volume was higher than in the control group(P＜0.05);at 6-month follow-up after treatment,there were no statistically significant differences in the rehospitalization rate of heart failure,the incidence of non-fatal infarction,post-discharge cardiovascular mortali-ty and all-cause mortality in the combined group compared with those of the control group(P＞0.05);there were no statistically significant differences in the incidence of adverse events in the combined group compared with that of the control group(P＞0.05).Conclusion Sacubitril valsartan combined with tolvaptan is effective in treating HFrEF,by reducing myocardial inju-ry,promoting urination,and improving patients'cardiac function without increasing the risk of cardiovascular events and adverse reactions.