A device for promoting normal locomotor activity recuperation was made, which was composed by frame, elastic bolt and normal gait mark carpet. The device has the effects of weight relieving, abnormal gait preventing, and safeguards providing. The patient could do gait training by he/her self or assistant self training under the weight reducing and protecting of the device in order to improve the walking ability and the normal gait formation. It is effective for preventing drop foot and leg adduction, and also helpful for the recovery of normal gait ability and the prevention of abnormal gait formation. It is applicable for the patient who can not be trained with ordinary weight relief walking training, such as severe cerebral palsy and severe spasmodic lower extremity and foot drop after brain injury. The results demonstrated that the device is effective in protecting, correcting, preventing abnormal gait as well as forming normal gait.

ObjectiveTo retrospectively analyse the data of patients with suspected primary aldosteronism (PA) during the last five years.The receiver operating characteristic (ROC) curve was used to evaluate the value of aldosterone to renin ratio (ARR) in screening primary aldosteronism.MethodsThe clinical data of ARR in supine and upright positions were collected in 590 patients with suspected during January 2006 to August 2010.There were 357 patients diagnosed as primary aldosteronism and 233 patients as essential hypertension among these patients.100 patients with suspected primary aldosteronism took the upright and random ARR during September 2010 to April 2011 ; Among these patients,29 patients were diagnosed as primary aldosteronism and 71 as cases of essential hypertension.ROC curve was made to retrospectively define the method and the cut-off value of the supine,upright or random ARR.ResultsThe area under the curve(AUC) of the supine ARR in the 590 patients who took the supine and upright ARR during January 2006 to August 2010 was 0.838 (0.805-0.867 ) and the AUC of the upright ARR was 0.873 (0.843-0.899 ).There was significant difference between these two AUC readings (P＜0.01 ).The AUC in the upright ARR of the 100 patients who took the upright and random ARR during Septeuder 2010 to April 2011 was 0.962 (0.928 -0.995 ) and the AUC of the random ARR was 0.944 (0.893-0.994 ).There was no significant difference between these two AUC readings (P＞0.05).The upright ARR cutoff value with 400 ( pg · ml-1 )/( ng· ml-1 · h 1 ) yielded a sensitivity of 91.9％ and a specificity of 64.2％ to diagnosis of PA.ConclusionUpright ARR value was more suitable in the screening test than supine ARR value.Random ARR showed similar effect as the upright ARR.In our research,under strict control of the drug,position and detection time,ARR value with 400 ( pg · ml-1 )/( ng· ml-1 · h-1 ) can be the cutoff point in screening the suspcctcd PA patients.

BACKGROUND:Digital three-dimensional model which can reflect the fine structure of the chambers inside heart not only enhances the understanding of cardiac physiology, but also provides basic medical data for the study of cardiac electrophysiology simulation and endocardial electrophysiological mapping navigation. OBJECTIVE:To construct the digital three-dimensional model of cardiac cavity from sectional data and in conformity with the actual anatomical structure. METHODS:Image segmentation was accomplished in MATLAB environment. Firstly, registration of human cardiac cavity slice dataset was realized. Secondly, classifying each composition was achieved by clustering method according to color characteristics of the image. Then, both cardiac cavity and related connected region was distinguished by region growing method. At last, the processed image was reconstructed through dedicated medical processing software into three-dimensional model of the cardiac cavity. RESULTS AND CONCLUSION:The proposed method could reconstruct quite exquisite three-dimensional model of the cardiac cavity. In models, left and right atrial and ventricular structure was clear. Aorta and superior vena cava were visible. Three tricuspid and mitral valve were also observed. Results indicated that reconstructed model can reflect the anatomical characteristics of cardiac cavity accurately, and provide basic medical data for the study on electrophysiological simulation and endocardial electric mapping.

Objective To develop one kind of device that can not only reduce the body weight,but also provide a good condition for training lower extremity potentialities.Methods The body weight bearing support and protection system,body weight reducing system and scaled footboard were made respectively.The lower extremity potentialities,nervous conduction speed and leg motion coordination ability training were done under protection and body weight reducing.Results The potential training device could exactly protect the patient and reduce body weight,and make the training step by step.Under the effects of protecting and body weight reducing of the potential training device,the training could be performed together with the Chinese traditional medicine rehabilitation method;that was physical and breathing exercises.The lower extremity potentialities were developed nicely.Conclusion The lower extremity potentialities training device is a useful training device which can bear body weight,have protective effect,develop lower extremity potentialities and improve coordination ability of lower extremities.

A medical robot that is used for closed reduction and the internal fixation of intramedullary locking nailing in treatment of tibial fracture is designed.The system is primarily composed of stereotaxic frame and computer system.Using C-shaped arm-taken X-ray images containing various marked points and keyhole-two-end-center of intramedullary nail,the system calculates the actual position of keyhole in the coordinate system of stereotaxic frame according to space mapping relation and locates the pilot hole on the reference coordinate according to computation.Electric-traction system can realize the precise reduction and remote control operation by network transmission of operation data.In the closed reduction and the internal fixation of intramedullary nail for treatment of tibial fracture in 17 patients,robot reducing fracture and computer-assisted localization of distal keyhole were used.Remote control operation was applied in 4 of them.All operations were performed according to the preset procedure and planning of robot and navigation system.All distal lock nails were successfully implanted at one time.Results demonstrated that both medical robot and computer-assisted localization and navigation system can satisfy fracture reduction and distal Iock nail implantation in the closed reduction and the internal fixation of intramedullary nail for treatment of tibial fracture and shorten intraoperative fluoroscopy time;in addition,remote control operation is reliable and easily mastered due to its simple systemic structure.

ObjectiveTo study the effect on humoral immunity with combination of CsA and IL-2 fusion protein. MethodsForty C57/B6 mice were evenly divided into four groups,after receiving skin graft from DBA mouse.Mice in the experimental group was given CsA(30 mg/kg,ip) plus IL-2/Fc (1μg,ip) while the control group was only given CsA,each group was given HBV vaccine after skin graft surgery (2 μg,im),while blank group was only given vaccine after skin transplantation.The fourth group were left intact.Fourteen days later,the level of HBSAb,IL-4,IL-10,IFN-γ,IL-2 were measured with ELISA and IL-21and FoxP3 expression level and Tfh percentage of mixed lymphocytes detected. ResultsThe HBSAb level in experimental group is significantly higher than that in the control group and the survival time of skin graft is longer than that in the control group ( F =29.886,P =0.010 ; F =29.772,P =0.011).IL-2,IFN-γ are significantly higher than that in the control group( F =18.156,P =0.0020;F =90.042,P =0.003 ),but the Th2 cytokines such as IL-4,IL-10 are lower ( F =42.102,P =0.009 ; F =23.734,P =0.015 ).The expression level of both IL-21and FoxP3 are significantly higher than control group( F =9.784,P =0.048 ;F =27.883,P =0.012). ConclusionsCombination of CsA and IL-2 fusion protein can significantly enhance the immunogenicity of HBV vaccine and prolong graft survival time.It may be related to the higher expression level of IL-21and FoxP3.

Objective To evaluate the values of bilateral inferior petrosal sinus sampling ( BIPSS),high dosage dexamethasone suppression test (HDDST) and pituitary image in the differential diagnosis of ACTH-dependent Cushing's syndrome. Methods Totally 87 patients with confirmed pathological diagnosis were recruited in the study.All received the procedure of BLPSS,HDDST,and pituitary MRI with dynamic enhancement.The diagnostic performances of three differential diagnosis methods in ACTH-dependent Cushing's syndrome were evaluated.Results Seventy-eight patients were diagnosed as cases of pituitary ACTH adenoma,and the remaining 9 were confirmed cases of ectopic ACTH syndrome due to the thymic carcinoid.The sensitivity and specificity of HDDST,pituitary MRI,and BIPSS for the diagnosis of ACTH-dependent Cushing's syndrome were 82.1％ and 100％,79.5％ and 44.4％,92.3％ and 100％,respectively.In Cushing's disease,the diagnostic accuracy was 83.9％ with HDDST,77.0％with pituitary MRI,and93.1％ with BIPSS.In those patients with Cushing's disease,the coincidence of lateralization was 83.9％ with BIPSS and 64.5％ with MRII.Conclusion BIPSS was better than the other two methods in differential diagnosis of ACTH-dependent Cushing's syndrome.Compared with the pituitary MRI,the concordant rate of BIPSS in lateralization of the tumor is higher,and it is more reliable.

ObjectiveTo investigate the efficacy and safety of CalliSpheres microsphere-transcatheter arterial chemoembolization (CSM-TACE) versus conventional transcatheter arterial chemoembolization (cTACE) in the treatment of hepatocellular carcinoma (HCC) through a meta-analysis. MethodsPubMed, Web of Science, Cochrane Library, CNKI, Wanfang Data, and VIP were searched for all Chinese and English articles on the application of CSM-TACE and cTACE in HCC published up to the end of October, 2020. After quality assessment was performed for the articles included, RevMan 5.3 software provided by Cochrane Library was used for analysis. ResultsA total of 15 studies were included, with 1535 patients in total. This meta-analysis showed that compared with the patients receiving cTACE, the patients receiving CSM-TACE had significantly higher 1-year overall survival rate (odds ratio ［OR］=2.26, 95% confidence interval ［CI］: 1.63-3.13, P＜0.000 01), 2-year overall survival rate (OR=1.73, 95%CI: 1.20-2.50, P=0.003), and 2-year progression-free survival rate (OR=1.60, 95%CI: 1.05-2.43, P=0.03). In terms of safety, compared with the patients receiving cTACE, the patients receiving CSM-TACE had significantly lower incidence rates of postoperative vomiting (OR=0.65, 95%CI: 0.46-0.92, P=0.01), bone marrow suppression (OR=0.17, 95%CI: 0.05-0.54, P=0.003), and neutropenia (OR=0.18, 95%CI: 0.07-045, P=0.000 3), while there were no significant differences between the two groups of patients in postoperative pyrexia, abdominal pain, and ascites (all P＞0.05). ConclusionCSM-TACE has significant advantages in improving 1- and 2-year overall survival rates and 2-year progression-free survival rates and can significantly reduce the incidence rates of postoperative vomiting, bone marrow suppression, and neutropenia. Therefore, CSM-TACE is a safe and effective treatment method.

As a kind of immunosuppressive cells, myeloid-derived suppressor cells (MDSCs) are an important component of the immune microenvironment. MDSCs play a significant role in promoting tumor immune escape. In addition, non-immunological functions such as promoting angiogenesis can also promote tumor development with the deepening of research. MDSCs can promote tumor angiogenesis directly through vascular endothelial growth factor signaling pathway, or promote tumor growth and angiogenesis by secreting cytokines such as matrix metalloprotein-9, basic fibroblast growth factor, angiogenic peptide Bv8, platelet derived growth factor, exosomes, or interacting with other cells. Exploring the expansion, activation, recruitment and angiogenesis mechanism of MDSCs will provide new ideas for regulating the individualized diagnosis and treatment based on targeted MDSCs.

MET exon14 (METex14) skipping mutation is an independent driver gene in non-small cell lung cancer (NSCLC) . About 3%-4% of NSCLC patients carry METex14 skipping mutation. These patients have poor prognoses and poor responses to traditional chemotherapy and immunotherapy. Highly selective MET inhibitors such as capmatinib, tepotinib, savolitinib have shown good efficacy and safety data in clinical trials, which bring new treatment options for patients with METex14 skipping mutations.