Objective To evaluate the efficacy of the first metatarsophalangeal joint arthrodesis versus resection arthroplasty for rheumatoid forefoot deformity.Methods Randomized controlled studies in the first metatarsophalangeal joint arthrodesis versus resection arthroplasty for rheumatoid forefoot deformity were collected in data bases like Cochrane library (Issue 3,2011),OVID (from January 1996 to June 2012),PubMed (from January 1990 to June 2012),CNKI (from January 1990 to June 2012),CBM,EMBASE (from January 1966 to June 2012) and Wanfang (from January 1990 to June 2012).Software RevMan 5.1 was used to analyze the trials included in terms of patient satisfaction,hallux area weight-bearing,AOFAS score,FFI score,HAV angle,IMA angle,operative time and complications.Results The totals of 5 RCTs were included in the study which involved 285 patients.The results of meta-analysis showed that the efficacy of the arthrodesis group was superior to that of the arthroplasty group in footwear (MD=-0.88,95％CI [-1.55,-0.22],P=0.010)and alignment (MD=-5.04,95％CI [-8.94,-1.14],P=0.01) significantly.The arthrodesis group also has an advantage of IMA and HAV angle correction (MD=1.43,95％CI [0.37,2.48],P=0.008; MD=13.27,95％CI [11.44,15.09],P＜ 0.00001).Significant difference was found between the two groups in the rate of complications.The rate of complication in the arthrodesis group was lower than that of the arthroplasty group (OR=2.32,95％CI [1.06,5.05],P=0.03).No significant difference was found between the two groups in patient satisfaction and FFI score.Conclusion Compared with resection arthroplasty,first metatarsophalangeal joint arthrodesis could be a better choice.It alleviates the pain effectively,improves the appearance and functions of the foot,and has a lower rate of postoperative complications.

Objective To investigate the differences in chemical components and bacterial diversity on the surface of Citrus reticulata at various drying temperatures(35、45、55、65℃).Methods At various drying temperatures,Citrus reticulata from Dahongpao produced in Chongqing Wanzhou was dried.By using HPLC,the effects of various drying temperatures on the hesperidin,hesperidin,and kaempferin concentrations in Citrus reticulata were examined.By using GC-MS,the effects of various drying temperatures on the Citrus reticulata volatile components were examined.The differences in bacterial population structure on the surface of Citrus reticulata at various drying temperatures were examined using high throughput sequencing.Results The higher the temperature,the quicker Citrus reticulata will dry.The amount of hesperidin and hesperidin in Citrus reticulata was not significantly affected by different drying temperatures.The amount of Citrus reticulata increased as the drying temperature rose.GC-MS analysis identified 15 main components in Citrus reticulata,and the proportion of some volatile aroma components decreased with the increase of drying temperature;Such as laurylene,linalool,carvol α-Orange aldehyde,etc.With the increase of drying temperature,the dominant bacteria of Proteobacteria has an upward trend.At the same time,the dominant bacteria of Halomonas and Porphyromonas have changed to Metallobacterium.Conclusion If the drying temperature is too high,the volatile components in the dried Citrus reticulata may be transformed or destroyed due to the instability of heating.The difference of the bacterial flora on the surface of Citrus reticulata at different drying temperatures may cause the change of the volatile components in the later aging process.Considering the quality of dried tangerine peel,low temperature and hot air drying is the better drying method.

Nucleos(t)ide analogues (NAs), which are widely used as the first-line anti-hepatitis B virus (HBV) drugs in clinical practice, can effectively inhibit the replication of HBV DNA, significantly slow down disease progression in chronic hepatitis B (CHB) patients, and reduce the development of end-stage liver diseases such as liver failure and liver cancer. However, for some CHB patients receiving first-line NAs for 48 weeks or longer, serum HBV DNA is still persistently or intermittently higher than the lower detection of limit of sensitive nucleic acid detection reagents. After discussion by the authors, low-level viremia (LLV) is defined as follows: persistent LLV refers to the condition in which CHB patients, who receive entecavir, tenofovir disoproxil fumarate, or tenofovir alafenamide fumarate for ≥48 weeks, test positive for HBV DNA by two consecutive detections with sensitive quantitative PCR, with an interval of 3-6 months, but have an HBV DNA level of ＜2000 IU/ml; intermittent LLV refers to the condition in which patients test positive for HBV DNA intermittently by at least three consecutive detections with sensitive quantitative PCR, with an interval of 3-6 months, but have an HBV DNA level of ＜2000 IU/ml. For the diagnosis of LLV, the issues of poor compliance and drug-resistant mutations should be excluded. LLV might be associated with the increased risk of progression to liver fibrosis or hepatocellular carcinoma in patients with liver cirrhosis under NA treatment, but there are still controversies over whether the original treatment regimen with NAs should be changed after the onset of LLV. This article summarizes the incidence rate of LLV under NA treatment and the influence of LLV on prognosis and analyzes the possible mechanisms of the osnet of LLV, so as to provide a reference for the management of LLV in patients treated with NAs.

Messenger RNA (mRNA) vaccines emerge as promising vaccines to prevent infectious diseases. Compared with traditional vaccines, mRNA vaccines present numerous advantages, such as high potency, safe administration, rapid production potentials, and cost-effective manufacturing. In 2020, two COVID-19 vaccines (BNT162b2 and mRNA-1273) were approved by the Food and Drug Administration (FDA). The two vaccines showed high efficiency in combating COVID-19, which indicates the great advantages of mRNA technology in developing vaccines against emergent infectious diseases. Here, we summarize the type, immune mechanisms, modification methods of mRNA vaccines, and their applications in preventing infectious diseases. Current challenges and future perspectives in developing mRNA vaccines are also discussed.
United States ; Humans ; mRNA Vaccines ; BNT162 Vaccine ; COVID-19 Vaccines/genetics* ; Communicable Diseases ; RNA, Messenger/genetics*

Based on the theory of qi， blood and fluids， and taking into account of the pathogenesis evolution process from constraint to phlegm， stasis and then mass in pulmonary nodules， an attempt has been made to construct a three-dimensional differentiation system for pulmonary nodules from the dimensions of time and space. The temporal progression of the early， middle， and late stages of pulmonary nodules reflects the pathological changes from constraint to phlegm and then stasis in the metabolism disorders of qi， blood and fluid. The spatial structures such as size， density， and morphology of pulmonary nodules reflect the pathological states of the duration， severity， and primary and secondary conditions of qi， blood and fluid metabolism disorders. Based on the temporal progression， the therapeutic principles have been proposed， which are dispelling pathogenic factors and promoting the use of beneficial factors to interrupt the growth momentum in the early stage， removing turbidity and dispersing phlegm to reduce the degree of nodules in the middle stage， and dispersing nodulation and eliminating abnormalities in the late stage. Based on the spatial structures， the suggested therapeutic methods are using wind herbs， employing multiple approaches to treat phlegm， and promoting blood circulation to resolve stasis， so as to provide theoretical reference for the systematic diagnosis and treatment of pulmonary nodules in traditional Chinese medicine.

Pulmonary nodule is a key window for moving ahead the diagnosis and treatment of lung cancer. Traditional Chinese medicine （TCM） can delay the transformation of lung nodules into lung cancer， improve the prognosis of patients， effectively fill the treatment gap during the follow-up period of pulmonary nodules， and has been applied it in the whole cycle and multi-dimensional management of pulmonary nodules. This paper discussed the construction ideas and feasible paths of the whole process management diagnosis and treatment system of pulmonary nodules in TCM， proposed the diagnosis and treatment database of TCM for pulmonary nodules based on the social module of “family-community-hospital”. Through artificial intelligence， we can develop， improve and promote the multi-level and multi-modal “disease-symptom combination” risk prediction model and effectiveness evaluation system of pulmonary nodules. At the same time， the biological connotation of the prevention and treatment of pulmonary nodules by TCM is excavated， which provided empirical evidence for the construction of TCM diagnosis and treatment system， in order to further improve the quality and diagnosis and treatment level of the whole course management of pulmonary nodules.