BACKGROUND:Clavicular hook plates have been used widely to treat acromioclavicular dislocations in recent years. However, it remains controversial whether coracoclavicular ligament should be repaired during the surgery.
OBJECTIVE:To study the clinical effect and MRI manifestations after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate, and to discuss the necessity of repairing coracoclavicular ligament during the surgery.
METHODS:A total of 44 patients with type III and V acute acromioclavicular Rockwood dislocations were treated with clavicular hook plates without repair of coracoclavicular ligaments, and underwent plate removal operations later. At 24 months after the second surgery, X-rays were taken to measure the width of coracoclavicular joints in both normal and affected limbs, Constant-Murley scores were calculated in both sides, and MR images were used to observe the healing of coracoclavicular ligaments.
RESULTS AND CONCLUSION:39 patients (89%) were fol owed up for 36.9±3.1 months (range, 30 to 45 months). The mean duration for retaining clavicular hook plates was 12.9±3.1 months (range, 6 to 21 months). The mean width of coracoclavicular joints was 6.04±1.21 mm (range, 4.3 to 8.8 mm) in normal limb, while 5.09±1.18 mm (range, 3.4 to 7.8 mm) in affected side without significant difference (P>0.05). The mean Constant-Murley score was 98.9±1.2 (range, 96 to 100) in normal limb, while 96.7±3.4 (range, 90 to 100) in affected side without significant difference (P>0.05). MRI showed healing of the coracoclavicular ligaments and the presence of continuous scar tissue in 38 patients, excluding one patient with recurrence of acromioclavicular joint dislocation. The clinical effects after treatment of type III and V acute acromioclavicular Rockwood dislocation with clavicular hook plate are satisfactory, and it is unnecessary to repair coracoclavicular ligament during the surgery. MR images reveal scar healing of the coracoclavicular ligaments without operative repair.

Abstract: Objective　To analyze the recent cluster outbreaks of imported malaria and explore the risks, challenges and countermeasures for dealing with such events during malaria post-elimination era of malaria, and to provide reference for effectively addressing the risks and consolidating the achievements of malaria elimination. Methods　The individual malaria case data from "The Information System for Infectious Disease Surveillance" and "The Information System For Parasitic Diseases Prevention And Control" were collected，and the diagnosis classification, infection source, time and space distribution of cases were analyzed. Results　From January 1 to August 11, 2022, a total of 429 malaria cases were reported nationwide, an 18.9% decrease compared to the same period last year (529 cases), all of which were imported cases. The overall weekly trend of the outbreak remained stable, but since Week 31 (July 25-31), there has been a significant increase in the number of cases, with a peak on August 5. From July 25 to August 11, 2022, a total of 162 malaria cases were reported nationwide, up 315.4% from 39 cases in the same period last year, accounting for 37.8% of the total cases up to August 11, 2022. The main source of imported infections was Guinea (95 cases, 58.6%), with most cases reported in Longgang District, Shenzhen City, Guangdong Province (30 cases), Shilin County, Kunming City, Yunnan Province (21 cases), Chaoyang District, Beijing (11 cases), and Xiaoshan District, Hangzhou City, Zhejiang Province (7 cases). Conclusions　Due to the concentration of returnees to China, several entry port cities simultaneously experienced cluster outbreaks of imported malaria, which brought immense pressure and challenges to local medical and health institutions. Health facilities at all levels need to maintain high vigilance and sensitivity, be well prepared, and avoid death and secondary transmission caused by imported cases.

ObjectiveTo evaluate the diagnostic value of multi-slice CT (MSCT) and multi-dimensional reconstructions for congenital pulmonary stenosis (PS) in children.MethodsThe enhanced thin CT images of 33 patients with PS were retrospectively analyzed,the data was transmitted to the workstation for multi-planar reformation ( MPR),volume rendering technique (VRT) and maximum intensity projection (MIP).The CT imaging features of PS were analyzed combining with operation resul ts and Ultrasonic Cardiogram (UCG).ResultsIn 33 cases of PS,there were 17 cases with pulmonary valve stenosis (PVS),10 cases with right ventricular infundibulum stenosis (RVIS),and 6 cases with pulmonary trunk stenosis (PTS).The first two were correctly diagnosed by UCG,5 cases of PVS and Icases of RVIS were correctly diagnosed by MSCTA,the later was correctly diagnosed by UCG and MSCTA.In 14 cases with collateral circulations between aorta and pulmonary artery ( APC ),all were correctly diagnosed by MSCTA,only 3 case was diagnosed by UCG,1 case was misdiagnosed as PDA.UCG can clearly demonstrate the others intra-cardiac deformities,such as ASD,VSD,RVH,PFO,SV,DORV,TECD and TBD,the accuracy rate of MSCTA was 39.4％,and MSCTA can clearly demonstrate the origin,course and diameter of extracardiac vascular abnormalities,such as PDA,RAA,TGA,TAPVD,CoA,PLSV and VLSA,the accuracy rate of UCG was 697％.ConclusionsMSCT and multi-dimensional reconstruction were a kind of non-invasive method,it was a good approach for extra-cardiac vascular malformations and APC in PS.Combining with UCG,it can further be used to improve the diagnostic accuracy of intra-cardiac malformation and supply diagnostic evidence for clinical treatment.

OBJECTIVETo study the combination of Mandibular distraction and orthognathic techniques for the reconstruction of adult hemifacial microsomia.

METHODSThe three-dimensional CT reconstruction data was used with Mimics for preoperation design. The osteotomy location, distraction vector, distraction distance were decided before operation with a surgical guider. At the first stage, internal distractor was implanted after ostetomy through an extra-oral approach. The distraction begun 5-7 days after operation with a frequency of 1 mm/day. After distraction, the distractor was maintained for 3-6 months. At the second stage, the distractor was removed. Le Fort I osteotomy was performed in order to correct the cross-bite and improve the facial contour. Usually, bone graft was inserted into the gap after Le Fort I osteotomy. The genioplasty was also performed if necessary.

RESULTS9 cases of adult hemifacial microsomia with severe mandibular deviation were treated. The facial asymmetry were improved greatly. 1 patient suffered an wound infection in the maxillary region after Le Fort I osteotomy and healed uneventfully with wound irrigation.

CONCLUSIONSMandibular distraction combined with orthognathic surgery is an effective procedure for adult hemifacial microsomia with complicated mandibular hypoplasia.

Adult ; Aged ; Bone Transplantation ; Facial Asymmetry ; surgery ; Goldenhar Syndrome ; surgery ; Humans ; Mandible ; surgery ; Osteogenesis, Distraction ; methods ; Osteotomy, Le Fort ; methods

With the development of the health service in china,the old talent-training program for clinical medicine major was failed in meeting higher demands for talents of clinical medicine. To create the new talent-training program,therefore,has become the main content of teaching reform for medical col-leges and universities. Taking University of South China as an example,the paper analyzed the changing trend of talent-training program for five-year clinical medicine majors from talent-training goal,curriculum system,practical teaching and content of courses,which proposed some thoughts on the optimization of training program for clinical medicine majors.

Objective To compare the effect of various manipulation of Tuina on surface electromyogram (sEMG) in hemiplegics after stroke. Methods From January to May, 2016, 20 inpatients with hemiplegia after stroke accepted Tuina on bilateral rectus femoris by the same therapist, with the techniques of rolling, patting, rubbing, shaking, kneading and pressing, one minute a manipulation and interval one minute. Integrated electromyography (iEMG), root mean square (RMS) and median frequency (MF) of sEMG were compared, both in rest and during Tuina. Results There was no significant difference of iEMG, RMS and MF between affected and unaffected sides in rest (t<1.147, P>0.05). iEMG and RMS were the most under patting (F>21.376, P<0.001), and MF was the highest under pressing (F>11.772, P<0.001). iEMG, RMS and MF were not very different under other manipulation (P>0.05). iEMG and RMS were less in the affected side than in the unaffected side under patting (P<0.05). Conclusion Various manipulation of Tuina may be different in neuromuscular stimulation, that patting may stimulate more muscles and motor units.

Objective To investigate the preventive effect of TGF-?_1 neutralizing antibody on flexor tendon adhesion from operation.Methods One hundred and eight leghon cocks performed anastomonsis op- eration were divieded into three groups randomly,as normal saline(control group),5?g/ml group,10?g/ml group of TGF-?_1,antibody.At 1 st,3rd,8th and 12th weeks respectively after operation,the flexor biomechan- ics test,HE staining,Masson staining,Sirius red-polarization staining and TGF-?_1 immunohistochemistry stai- ning were used.Results The max of strength of tendon and the stimulate active flexor from the experiment groups(5?g/ml group,10?g/ml) are higher than from the control group,The max of strength of tendon of the experiment groups are less at 8th weeks,and no difference at 12th weeks from the control group;Compared with the control group,the 10?g/ml group were less shorten the progress of inflammation and accelerated the progress of molding;In the experiment groups(5?g/ml group,10?g/ml),the density of the collagenⅠtype were less,the ratio ofⅠ/Ⅲcollagen and expression of the TGF-?_1 were decreasing.Condusion The study showed that applying of TGF-?_1 muhiclonal neutralizing antibody can inhibit efficiently the function of the TGF-?_1 during the flexor tendon repair,reduce tendon adhesion and scar fromation,however has no affec- tion of tendon intensity,suggesting it is a latent and efficient method for preventiong flexor tendon from adhe- ring after operation.

An old male patient visited the hospital due to shortness of breath and palpitation for 6 h, with fever 3 days before and pump failure at admission. Having no risk factor of coronary diseases such as hypertension, diabetes mellitus and obesity, with ST-T changes and abnormal Q wave on ECC, the signs were compatible with those of acute anterior wall myocardial infarction, while the characteristics of cardiac biomarkers ( significant increase in Troponin I and creatine kinase's isoform, and normal creatine kinase) were not in accordance with those of acute myocardial infarction. Emergency angiography was performed, which indicated normal coronary artery, normal pulmonary artery and global systolic dysfunction of left ventricle. The diagnosis of acute severe myocarditis was established, and intra-aortic balloon pump (IABP) was employed to provide hemodynamic support. Severe myocarditis mimicking acute myocardial infarction may be fatal, and can be easily misdiagnosed. Careful analysis of clinical manifestations, early diagnostic angiography and possible IABP placement are important for the successful treatment.

OBJECTIVETo study the effect of ursolic acid (UA), apentacyclic triterpene acid, on MCF-7 cell apoptosis, and probable mechanism involved by detecting the expressions of caspase-3 and poly ADP-ribose polymerase(PARP) at protein level.

METHODMCF-7 cells were cultured with different concentrations of UA. Growth inhibition of UA on MCF-7 cells was evaluated by MTT assay. Cell cycle and sub-G1 peak were performed by FCM. Morphologic changes of UA-treated cells were observed by light microscope. Apoptotic cells with condensed or fragmented nuclei were visualized by Ho 33258 staining by a fluorescence microscope (EX: U. V.). The protein expression of caspase-3 and PARP was analyzed by immunofluorescence cell staining (SABC-Cy3).

RESULT24 hours after UA treatment, inhibition of MCF-7 cell growth was concentration-dependent. The IC50 value for UA was (22.6 +/- 3.0) micromo x L(-1). Cell cycle anaysis by FCM showed that 50 micromol x L(-1) of UA arrested MCF-7 cell cycle at G0 - G1 phase. Morphological changes of MCF-7 Cells exhibited many of the hallmark features of apoptosis, including chromatin clumps and aggregation and DNA fragmentation. UA increased caspase-3 protein expression.

CONCLUSIONThe results suggest that UA evokes MCF-7 cell apoptosis is correlation with the up-regulation of caspase-3. Our study indicated that UA might be a potential Chinese medical component for breast neoplasm.

Antineoplastic Agents, Phytogenic ; pharmacology ; Apoptosis ; drug effects ; Breast Neoplasms ; enzymology ; pathology ; Caspase 3 ; Caspases ; metabolism ; Cell Cycle ; drug effects ; Cell Line, Tumor ; Female ; Humans ; Poly(ADP-ribose) Polymerases ; metabolism ; Triterpenes ; pharmacology

Depression is a serious mental illness with a high incidence. At present, we do not fully understand the specific pathological mechanisms of depression, and the efficacy of drug treatments is very limited. Recent studies have shown that epigenetic changes that occur in specific brain regions may be a key mechanism by which environmental factors to interact with individuals to influence the risk of depression. Therefore, drugs that target epigenetic regulation may become a new direction for the development of antidepressants. Histone deacetylase inhibitors (HDACi) are a class of compounds that inhibit histone deacetylase activity, which has been reported to be associated with depression; this article addresses the use of HDACi in preclinical studies, and their potential therapeutic role and limitations of use in depression.