BACKGROUND:In recent years, the spinal internal fixation technology has made rapid development based on biomechanics and material sciences.
OBJECTIVE: To review the biomechanical characteristics of the lumbosacral spine and the application of various internal fixation materials in the reconstruction of spinal stability after lumbosacral spinal tuberculosis.
METHODS:A computer-based search of Medline and Chinese Journal Ful-Text Database was performed for relevant articles using the keyword of “lumbosacral spinal tuberculosis, biomaterials materials, fixation” in English and Chinese, respectively.
RESULTS AND CONCLUSION: Rigid internal fixation is a conventional treatment for lumbosacral tuberculosis, which improves the spinal alignment and stability during the spinal reconstruction. Metalic materials such as stainless steel, titanium and titanium aloys have been widely used in rigid internal fixation, but metal sedimentation, non-transparency, stress shielding and osteoporosis after internal fixation impact the fusion effects and imaging observation. Absorbable materials as newly-developing materials have good biocompatibility and biodegradability in orthopedic internal fixation. To select the appropriate material for internal fixation, the biomechanical properties of internal fixation materials wil be investigated according to the degree of vertebral damage and lumbosacral stability.

Aim ?3 adrenoceptor(?3-AR) is predominantly expressed in white and brown adipose tissue.?3 adrenoceptor agonist stimulates the lipolysis of white adipose tissue and non-shivering thermogenesis of brown adipose tissue to exert its antiobese action.Moreover,?3 adrenoceptor agonist increases the sensitivity and response of adipose tissue to insulin and it play an important role in the treatment of type 2 diabetes.In addition,?3 adrenoceptor agonist can also relax gastrointestinal spasm and show cardiovascular effect in human heart and vascular tissues.There has been increasing concerned in the study and development of ?3 AR agonists since 1983.Up to date,32 kinds of ?3 AR agonists have been identified.The development of ?3 AR agonists can provide new strategy and approach for pharmacotherapy of obesity and diabetic mellitus and will have Spaciously the used out look in the field of medicine.

Objective To evaluate the effectiveness and safety of gefitinib retreatment beyond progression(GRBP)in non-small cell lung cancer(NSCLC)patients with rare EGFR mutations.Methods We retrospectively analyzed six rare-EGFR-mutation NSCLC patients from Jan 2011 to Dec 2015.Those patients had previous disease control and then disease progression according to Response Evaluation Criteria in Solid Tumors version 1.1(RECIST v1.1)after taking oral gefitinib 250 mg once a day.After that,continuing gefitinib was decided by clinicians′ experience at the same treatment option.The primary endpoints were response rate(RR),overall survival(OS),the first and second progression-free survival(PFS-1 and PFS-2).Safety was assessed according to the NCI-CTCAE version 4.0.Results After initial treatment of gefitinib,4 patients achieved partial response(PR)and 2 patients showed stable disease(SD),with RR being 66.7％.The median PFS-1 and PFS-2 were 10 months(95％CI 6.6-13.4)and 9 months(95％CI 6.9-11.1),respectively.The median OS time was 28 months(95％CI 10.4-45.6).The most common treatment-related adverse events were fatigue,diarrhea,rash,itching and elevated transaminases.Conclusion In our study,gefitinib retreatment beyond disease progression is effective with a manageable tolerability profile.

Objective: To observe the characteristics of dynamic changes of lysophosphatidic acid (LPA) levels in cerebrospinal fluid (CSF) in patients with subarachnoid hemorrhage (SAH) and its relationship with cerebral vasospasm (CVS) and to explore the pathogenesis of CVS. Methods: Sixty-seven patients with SAH diagnozed by clinical and accessory examinations were selected. The LPA levels in CSF were measured at 24 hours, day 7,14, and 28 respectively after the onset of symptoms,and they were compared with a control group. The correlation between LPA levels and CVS on the time course was also observed at the same time. Results: Of the 67 patients with SAH, a total of 29 patients (43.3%) occurred CVS, the average time of occurrence was 6. 6 days. There was no significant difference between the LPA levels in CSF in patients with SAH and the control group at 24 hours after the onset of symptoms; they were significantly higher than the control group at day 7 (P ＜0. 001); they were significantly higher than the control group at day 14 (P ＜ 0. 001), but they were significantly lower than those at day 7 (P ＜ 0. 01); they decreased to baseline at day 28, and there was significant difference compared with the control group. There was no significant difference between the LPA levels in the CVS group and those in the non-CVS group at 24 hours, they were significantly higher than those in the non-CVS group at day 7 (P ＜0. 001), they were still significantly higher than those in the non-CVS group at day 14 (P ＜0. 01); and there was no significant difference between the 2 groups at day 28. Conclusions: The LPA levels in CSF in patients with SAH increased significantly from day 7 to day 14 after the onset of symptoms, and they had obvious association with CVS on the time course. The detection of the LPA levels in CSF may have important significance in predicting the occurrence of CVS.

Objective:To explore the effects of the extract of Sanchen powder(ESCP)combined with vancomycin on methicillin-resistant Staphylococcus aureus(MRSA)planktonic cells,biofilms,and virulence factors.Methods:The herbs in Sanchen powder(SCP)were extracted separately with 50％ethanol.Then,the content of hydroxysafflower yellow A(HSYA)and cholic acid in the extract of artificial cattle bezoar(artificial Calculus bovis)and safflower(Carthamus tinctorius L.)was measured by ultraviolet visible-vis spectrophotometry and high-performance liquid chromatography.The effects of ESCP combined with vancomycin on MRSA by observing its biofilm viability were assessed using a 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium5-carboxanilide reduction assay and scanning electron microscopy.Additionally,enzyme activity was measured by plasma coagulase test and DNase test.Results:The cholic acid content of the artificial C.bovis extract was 7.34(0.81)mg/g,and the HSYA content of the C.tinctorius extract was 9.18(0.09)mg/g.The minimal inhibitory concentrations of ESCP and vancomycin were 25.6 mg/mL and 2 μg/mL.The minimum bactericidal concentration of ESCP was 51.2 mg/mL.ESCP combined with vancomycin could inhibit the expression of coagulase and bacteria in mature biofilms.Neither ESCP nor vancomycin had a significant effect on DNase.Conclusion:This study is the first to show that ESCP combined with vancomycin inhibits coagulase and MRSA embedded in mature biofilms and that it represents a promising treatment for MRSA infection.

Objective:To analyze the compliance with enhanced recovery after surgery (ERAS) protocol in geriatric patients with fresh fracture.Methods:A retrospective study was conducted on the data of the patients with fresh extremity fracture which had been included in the ERAS perioperative protocol database during May 2019 and January 2022 at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital. The patients ≥65 years were selected as a study group which was matched by a control group of the patients < 65 years in sex, fracture type and date frame of hospitalization at a ratio of 1∶1. The 2 groups were compared in the compliance with the 14 ERAS core perioperative elements.Results:The study group and the control group each included 66 patients who were matched in sex and fracture type. 62.1% (41/66) of the patients in the study group had combined diseases, significantly more than that [16.7% (11/66)] in the control group( P<0.001). Altogether, the compliance with the 14 ERAS core perioperative elements was 78.6 (71.4, 85.7) % in both groups, showing no significant difference between them ( P>0.05). Respectively, the compliance with the postoperative oral intake in the study group (80.3%, 53/66) was significantly lower than that in the control group (92.4%, 61/66) ( P<0.05); the compliance with the other 13 elements showed no statistically significant difference between the 2 groups ( P>0.05). Conclusion:The ERAS perioperative protocol can be carried out smoothly in geriatric patients with fresh fracture whose compliance may be comparable to that of the none-elderly patients.

Art therapy plays an important role in enhancing the emotional expression of patients, treating mental and psychological diseases, and promoting the recovery of cancer patients.Due to its extensive meaning and various intervention measures, strengthening the guidance and monitoring of art therapy are important in improving the medical quality of related fields.Clinical practice guidelines are important tools to guide and standardize medical behavior, and also are important guarantees for the implementation effect of medical behavior.Therefore, this article will summarize the current situation of art therapy guidelines, and on this basis, reflect on the formulation and implementation of relevant guidelines and recommendations.

Objective:To explore the effects and mechanism of annexin A1 ( ANXA1)-overexpressing human adipose-derived mesenchymal stem cells (AMSCs) in the treatment of mice with acute respiratory distress syndrome (ARDS). Methods:The experimental study method was adopted. After the adult AMSCs were identified by flow cytometry, the 3 rd passage cells were selected for the follow-up experiments. According to the random number table (the same grouping method below), the cells were divided into ANXA1-overexpressing group transfected with plasmid containing RNA sequences of ANXA1 gene and no-load control group transfected with the corresponding no-load plasmid. The other cells were divided into ANXA1-knockdown group transfected with plasmid containing small interfering RNA sequences of ANXA1 gene and no-load control group transfected with the corresponding no-load plasmid. At post transfection hour (PTH) 72, the fluorescence expression was observed under a fluorescence microscope imaging system, and the protein and mRNA expressions of ANXA1 were detected by Western blotting and real-time fluorescence quantitative reverse transcription polymerase chain reaction respectively (with the sample numbers being 3). Fifty male C57BL/6J mice aged 6-8 weeks were divided into sham injury group, ARDS alone group, normal cell group, ANXA1-overexpressing group, and ANXA1-knockdown group, with 10 mice in each group. Mice in the last 4 groups were treated with endotoxin/lipopolysaccharide to make ARDS lung injury model, and mice in sham injury group were simulated to cause false injury. Immediately after injury, mice in sham injury group and ARDS alone group were injected with normal saline through the tail vein, while mice in normal cell group, ANXA1-overexpressing group, and ANXA1-knockdown group were injected with normal AMSCs, ANXA1-overexpressing AMSCs, and ANXA1-knockdown AMSCs, correspondingly. At post injection hour (PIH) 24, 5 mice in each group were selected, the Evans blue staining was performed to observe the gross staining of the right lung tissue, and the absorbance value of bronchoalveolar lavage fluid (BALF) supernatant of left lung was detected by microplate reader to evaluate the pulmonary vascular permeability. Three days after injection, the remaining 5 mice in each group were taken, the right lung tissue was collected for hematoxylin-eosin staining to observe the pathological changes and immunohistochemical staining to observe the CD11b and F4/80 positive macrophages, and the levels of tumor necrosis factor α (TNF-α), interleukin-6 (IL-6), and IL-1β in BALF supernatant of left lung were determined by enzyme-linked immunosorbent assay. Data were statistically analyzed with paired sample t test, one-way analysis of variance, and least significant difference test. Results:At PTH 72, AMSCs in both ANXA1-overexpressing group and ANXA1-knockdown group expressed higher fluorescence intensity than AMSCs in corresponding no-load control group, respectively. At PTH 72, compared with those in corresponding no-load control group, the protein and mRNA expressions of ANXA1 in ANXA1-overexpressing group were significantly increased (wth t values of 249.80 and 6.56, respectively, P<0.05), while the protein and mRNA expressions of ANXA1 in ANXA1-knockdown group were significantly decreased (wth t values of 176.50 and 18.18, respectively, P<0.05). At PIH 24, compared with those in sham injury group (with the absorbance value of BALF supernatant being 0.041±0.009), the lung tissue of mice in ARDS alone group was obviously blue-stained and the absorbance value of BALF supernatant (0.126±0.022) was significantly increased ( P<0.05). Compared with those in ARDS alone group, the degree of blue-staining in lung tissue of mice was significantly reduced in normal cell group or ANXA1-overexpressing group, and the absorbance values of BALF supernatant (0.095±0.020 and 0.069±0.015) were significantly decreased ( P<0.05), but the degree of blue-staining in lung tissue and the absorbance value of BALF supernatant (0.109±0.016, P>0.05) of mice in ANXA1-knockdown group had no significant change. Compared with that in normal cell group, the absorbance value of BALF supernatant of mice in ANXA1-overexpressing group was significantly decreased ( P<0.05). Three days after injection, the lung tissue structure of mice in ARDS alone group was significantly damaged compared with that in sham injury group. Compared with those in ARDS alone group, hemorrhage, infiltration of inflammatory cells, alveolar collapse, and interstitial widening in the lung tissue of mice were significantly alleviated in normal cell group and ANXA1-overexpressing group, while no significant improvement of above-mentioned lung tissue manifestation was observed in ANXA1-knockdown group. Three days after injection, the numbers of CD11b and F4/80 positive macrophages in the lung tissue of mice in ARDS alone group were significantly increased compared with those in sham injury group. Compared with those in ARDS alone group, the numbers of CD11b and F4/80 positive macrophages in lung tissue of mice in normal cell group, ANXA1-overexpressing group, and ANXA1-knockdown group reduced, with the most significant reduction in ANXA1-overexpressing group. Three days after injection, compared with those in sham injury group, the levels of TNF-α, IL-6, and IL-1β in BALF supernatant of mice in ARDS alone group were significantly increased ( P<0.05). Compared with those in ARDS alone group, the levels of TNF-α, IL-6, and IL-1β in BALF supernatant of mice in normal cell group and ANXA1-overexpressing group, as well as the level of IL-1β in BALF supernatant of mice in ANXA1-knockdown group were significantly decreased ( P<0.05). Compared with that in normal cell group, the level of TNF-α in BALF supernatant of mice was significantly decreased in ANXA1-overexpressing group ( P<0.05) but significantly increased in ANXA1-knockdown group ( P<0.05). Conclusions:Overexpression of ANXA1 can optimize the efficacy of AMSCs in treating ARDS and enhance the effects of these cells in inhibiting inflammatory response and improving pulmonary vascular permeability, thereby alleviating lung injury of mice with ARDS.

Aiming at the current situation of high cost, huge volume, complex operation and difficulty in real application of pulse analyzer, this study designs and implements a portable pulse detection system based on IoT. The design utilizes Raspberry Pi 3B+, STM32 series MCU and cloud server to collect, store, display and recognize pulse signals at CUN, GUAN and CHI. The system is small in size and low in cost, which can be connected with cloud server through network to make full use of resources. The experimental results show that the recognition accuracy of the main feature points of the pulse signal by the portable pulse analyzer is higher than 97%, which has a broad prospect of development and application.
Computers ; Heart Rate

Objective: To investigate the expression and molecular mechanism of dickkopf 1 ( DKK1 ) in tongue squamous cell carcinoma (TSCC) by bioinformatics method and molecular biology experiments． Methods: The patients information wasdownload from TCGA-TSCC database，the differentially expressed genes between the cancer and normal tissues were screened by NetworkAnalysed site，the key genes and clinical prognosis were identified through Kaplan-Meier analysis and Lasson regression，the functions and pathways of differentially expressed genes were gained by GO and KEGG database，the expression of DKK1 mRNA and protein in TSCC as well as its relationship with clinicopathological features were analyzed by UALCAN database and immunohistochemistry．Western blot assay was conducted to detect the protein expression of DKK1 in TSCC cells，and siRNA was used to konck down the expression of DKK1 protein in Cal27 cells. Results : The three key genes DKK1，CYP19A1 and IRX4， which were highly expressed in tongue squamous cell carcinoma and the survival rate of TSCC patients with high expression group was poor，were screened through NetworkAnalysed ，Kaplan-Meier analysis and Lasson regression method．UALCAN database showed that the mRNA level of DKK1 in TSCC tissues was higher than that in normal tissues，and its high expression was significantly correlated with clinical stage，histological grade and lymph node metastasis of TSCC patients．The immunohistochemistry assay suggested that the positive rate of DKK1 protein in clinical stage Ⅲ + Ⅳ TSCC tissues was significantly higher than that in stage Ⅰ + Ⅱ TSCC tissues．In addition， the expression level of DKK1 protein in TSCC tissues was significantly higher than that in adjacent tissues．Western blot assay also showed that the protein expression of DKK1 in TSCC cell Cal27 was much higher than normal oral epithelial cell HOEC．When knock down the protein expression of DKK1 in Cal27，the expression of β-catenin、p- p65 和 p65 werealso reduced． Conclusion DKK1 is highly expressed in tongue squamous cell carcinoma tissues and cells and plays an important role．It may be a new target for early diagnosis and drug treatment of TSCC.