Objective To develop a practical image acquisition strategy using intermittent breath?hold cone beam computed tomography (CBCT). Methods A breathing phantom was used to simulate the movement of tumor near the diaphragm during free breathing and breath hold and scanned by conventional breath?hold CBCT and type Ⅰ/Ⅱ intermittent breath?hold CBCT. In the conventional breath?hold CBCT, scan paused and free breathing occurred at the break of breath hold and free breathing was not included in the scan. In the intermittent breath?hold CBCT, one scan covered several breath holds separated by free breathing in a ratio of 3 vs1. Image quality and three?dimensional registration accuracy were quantitatively compared between conventional breath?hold CBCT and type Ⅰ/Ⅱ intermittent breath?hold CBCT. Comparison of image quality parameters between conventional breath?hold CBCT and intermittent breath?hold CBCT was made by paired t test. Results Motion artifacts arose in type I and Ⅱ intermittent breath?hold CBCT scans. There were no significant differences in the reconstructed pixel value or uniformity between intermittent breath?hold CBCT and conventional breath?hold CBCT ( P>0. 05, and P= 0. 02, 0. 53 ) . Compared with conventional breath?hold CBCT images, the signal?to?noise ratios of type I andⅡintermittent breath?hold CBCT images were reduced by 30% and 60%, respectively ( P<0. 05 ) . The registration error was up to 0 . 4 cm in the anterior?posterior direction and less than 0 . 1 cm in other directions . Conclusions The phantom study shows that intermittent breath?hold CBCT does not significantly reduce image quality or registration accuracy compared with conventional breath?hold CBCT. The feasibility of intermittent breath?hold CBCT in clinical application needs to be further validated among a large number of patients.

Objective To investigate the epidemiological features and trends of humeral intercondylar fractures at our hospital from 2003 through 2012.Methods The clinical data were retrospectively analyzed of all the patients with humeral intercondylar fracture who had been treated between January 2003 and December 2012 at our institute.The patients' age,gender,fracture site and AO classification were documented.The data between 2003 and 2007 were classified as group A while the data between 2008 and 2012 as group B.The epidemiological characteristics during the 10 years concerning age,gender and fracture type were compared between the 2 groups.Results A total of 303 humeral intercondylar fractures were recorded,accounting for 5.29％ of the distal humeral fractures,3.39％ of the elbow fractures and 0.24％ of the total fractures at the same period.They involved 197 males and 106 females,with a male/female ratio of 1.86∶ 1.The high-risk age group was adolescent and middle-aged adults,accounting for 63.70％.The high-risk type was type 13-C2,accounting for 44.00％.There were 171 and 132 cases in group A and group B,accounting for 5.40％ and 5.17％ of the contemporary distal humeral fractures,3.72％ and 3.05％ of the contemporary elbow fractures,and 0.26％ and 0.22％ of all the contemporary fractures,respectively,showing no significant differences between the 2 groups(P ＞ 0.05).In groups A and B respectively,the male/female ratios were 1.44∶1 and 2.67∶ 1,the proportions of adolescents and the middle-aged 58.48％ and 70.45％,the proportions of type 13-C1 35.83％ and 18.10％,and the proportions of type 13-C3 14.17％ and 44.76％,showing significant differences between the 2 groups in all the above comparisons (P ＜ 0.05).Conclusion The humeral intercondylar fractures were common in the adolescent and middle-aged patients,with a male predominance (about twice more in males).Compared with the first five years,the latter 5 years witnessed increased proportions of males,adolescent and middle-aged patients,and type 13-C3 but a decreased proportion of type 13-C1.

Objective To investigate the epidemiological features and trends of adult fractures at the base of the first metacarpal bone in The Third Mfiliated Hospital to Hebei Medical University from 2003 through 2012.Methods The data of human fractures treated between January 2003 to December 2012 at our hospital were collected through the PACS system and case reports checking system.Adult fractures at the base of the first metacarpal bone were included in the present study and assigned into 2 groups,group A containing the data between 2003 and 2007 and group B the data between 2008 and 2012.Comparison and analysis was done with analytic items of gender,age and fracture type.Results A total of 378 adult fractures at the base of the first metacarpal bone were included,accounting for 1.92％ of hand fractures and 0.35％ of the total adult fractures at the same period.The fractures involved 311 males (82.28％) and 67 females (17.72％).The youth group had 254 fractures with the highest constituent ratio (67.20％).The right side was involved in 286 cases (75.66％) and the left side in 92 (24.34％).There were 198 cases of extra-articular fracture with the highest constituent ratio (52.38％).Group A had 200 fractures,a male to female ratio of 6.14∶ 1,a median age of 34 years,the highest constituent ratio in youth (73.50％) and in type A1 fractures (53.50％);group B had 178 fractures,a male to female ratio of 3.56∶ 1,a median age of 40 years,the highest constituent ratio in youth (60.11％) and in type A1 fractures (51.12％).Compared with group A,group B had a higher constituent ratio of females,older ages,a higher constituent ratio of elderly patients,a lower constituent ratio of youth,and a lower constituent ratio of type C1 fractures.All these differences between the 2 groups were statistically significant (P ＜ 0.05).Conclusions During the 10 year,the adult fractures at the base of the first metacarpal bone accounted for 1.92％ of hand fractures and 0.35％ of the total adult fractures at the same period.The fractures occurred mostly in men and in the age range of 16 to 44 years.About 3/4 of them occurred on the right side.Compared with the first 5 years,the latter 5 years witnessed increasing trends of female and elderly patients and decreasing trends of young patients and type C1 fractures.

Objective To investigate the epidemiological features and trends of supracondylar humeral fractures from 2003 to 2012 at The Third Affiliated Hospital to Hebei Medical University.Methods The data of the patients with supracondylar humeral fracture who had been treated between 2003 and 2012 at our hospital were collected through the PACS system and case reports checking system.The data between 2003 and 2007 were classified as group A and those between 2008 and 2012 as group B.The data concerning gender,age and fracture type were statistically analyzed and compared between the 2 groups.Results Atotalof3,111 supracondylar humeral fractures were treated,accounting for54.4％ (3,111/5,723) of the distal humeral fractures,34.8％ (3,111/8,932) of the elbow fractures and 2.5％ (3,111/126,479) of the total fractures.They were 2,018 males (64.9％) and 1,093 females (35.1％).The age range from 1 to 10 years obtained the highest constitute ratio for both genders,77.0％ (1,554/2,018) for males and 78.2％ (854/1,093) for females.The extension type and flexion type had 2,693 (86.6％) and 418 (13.4％) cases,respectively,and their male to female ratios were 2.0:1 and 1.2:1 respectively,all showing significant differences (P ＜ 0.001).There were 1,902 cases in group A and 1,209 cases in group B,accounting for 60.0％ (1,902/3,168) and 47.3％ (1,209/2,555) of the distal humeral fractures,41.4％ (1,902/4,199) and 27.9％ (1,209/4,333) of the elbow fractures,and 2.9％ (1,902/65,267) and 2.0％ (1,209/61,212) of the total fractures,respectively,all showing significant differences between groups (P ＜ 0.001).The male to female ratio was 1.9:1 for group A and 1.8:1 for group B,showing an insignificant difference (P ＞ 0.05).The age range from 1 to 10 years had a constitute ratio of 75.0％ (1,426/1,902) for group A and that of 81.2％ (982/1,209) for group B,showing a significant difference (P ＜ 0.001).The proportion of extension type was 85.4％ (1,624/1,902) for group A and 88.4％ (1,069/1,209) for group B,showing a significant difference (P ＜ 0.05).Conclusions The current investigation has revealed the epidemiological features and trends of supracondylar humeral fractures which had been treated between 2003 and 2012.They were mostly seen in children from 1 to 10 years old.The extension type predominated.Compared with the first 5 years,the proportion of age range from 1 to 10 years and the extension type increased in the latter 5 years.

Objective:To compare the specific mechanism and effects between christina loosestrife and snowbellleaf tickclover herb on kidney calcium oxalate calculi in rats.Methods:A total of 54 SPF grade SD male rats were fed adaptically for 1 week to 180-200 g, the models of rats with kidney calcium oxalate calculi were established by intragastric administration with glycol, and divided into nine groups according to random number table method and controlled, which were healthy control group (group A), positive control group (model group, group B), low, medium and high doses of christina loosestrife groups (C1, C2, C3, 3 groups), low, medium and high doses of snowbellleaf tickclover herb groups (D1, D2, D3, 3 groups), therapeutic control group (potassium sodium hydrogen citrate group, group E), 6 rats in each group. After 4 weeks, samples were collected to determine the urine and serum biochemical indexes of each group, and Von Kossa staining was used to detect kidney calcium oxalate crystals. Calcium oxalate crystal deposition in kidney tissues of rats was observed under polarization microscope, and the difference of efficacy between the two drug effects was determined by the percentage of positive area in photos and the urine and serum biochemical indexes. The measurement data were expressed as mean ± standard deviation ( ± s), one-way analysis of variance was used for comparison between groups, and SNK- q test was used for comparison between two groups. Kruskal-Wallis test was used to compare crystal formation between groups. Results:Compared with the positive control group and christina loosestrife groups, high dose of snowbellleaf tickclover herb could significantly reduce serum creatinine level ( P<0.01), the mean serum creatinine of rats with christina loosestrife was (86.70±11.49) μmol/L, that of rats with snowbellleaf tickclover herb was (70.72±9.08) μmol/L, the difference was statistically significant ( P<0.01). High dose of christina loosestrife and snowbellleaf tickclover herb could significantly increase urinary magnesium and decrease serum urea levels, and there was no statistical significance between them ( P>0.05). Compared with the positive control group, high dose of christina loosestrife ( P<0.000 1) and snowbellleaf tickclover herb ( P<0.000 1) could both inhibit the formation of calcium oxalate crystals and protect the kidney of rats, and there was no statistical significance between the two effects ( P>0.05). The levels of urine pH value could not be increased, while the levels of urinary calcium urinary oxalic acid and 24 h urine volume, serum calcium, serum phosphorus, serum magnesium, blood uric acid and content of kidney oxalate could not be decreased significantly after using these two drugs. Conclusion:Snowbellleaf tickclover herb is better than christina loosestrife in preventing recurrence of kidney calcium oxalate calculi and protecting renal function.

Objective To compare and analyze the epidemiological features of fractures at the base of the first metacarpal bone between East and West China.Methods We retrospectively analyzed the clinical data of the patients with fracture at the base of the first metacarpal bone who had been treated from January 2010 to December 2011 in 63 hospitals in the east and west areas of China.The data from 35 hospitals in East China were classified as group A while the data from 28 hospitals in West China as group B.The analytic items included gender,age,age distribution and fracture classification.Results A total of 890 cases were collected.The total male/female ratio was 4.56∶ 1.The youth accounted for the highest proportion and the high-risk type of fracture was type Ⅲ (44.49％,396/890).The male/female ratio was 4.59∶1 in group A of 621 patients and 4.49∶1 in group B of 269 patients,showing no statistic between-group difference (P ＞ 0.05).The median age in group A was 39 years,significantly older than that in group B (35 years) (Z =-3.687,P ＜ 0.001).In both groups,the youth accounted for the highest proportion and there were more right-side fractures than left-side ones.Group A had a significantly lower proportion of the youth and a significantly higher proportion of the middle-aged than group B (P ＜ 0.05),but there was no statistic difference in proportions of the children and the aged (P ＞ 0.05).Type Ⅲ was the high-risk type in both groups;group A had significantly more fractures of type Ⅰ and significantly fewer fractures of type Ⅱ than group B (P ＜ 0.05),but there was no statistic difference in proportions of type Ⅲ and type Ⅳ between the 2 groups (P ＞ 0.05).Conclusions Fractures at the base of the first metacarpal bone mostly occurred in the young males.There were more fractures at the right side than at the left side.The most frequent type was type Ⅲ.The proportion of type Ⅰ fractures in East China was higher than in West China while the proportion of type Ⅱ fractures in East China lower than in West China.

Pheretima,also called"earthworms",is a well-known animal-derived traditional Chinese medicine that is extensively used in over 50 Chinese patent medicines(CPMs)in Chinese Pharmacopoeia(2020 edi-tion).However,its zoological origin is unclear,both in the herbal market and CPMs.In this study,a strategy for integrating in-house annotated protein databases constructed from close evolutionary relationship-sourced RNA sequencing data from public archival resources and various sequencing al-gorithms(restricted search,open search,and de novo)was developed to characterize the phenotype of natural peptides of three major commercial species of Pheretima,including Pheretima aspergillum(PA),Pheretima vulgaris(PV),and Metaphire magna(MM).We identified 10,477 natural peptides in the PA,7,451 in PV,and 5,896 in MM samples.Five specific signature peptides were screened and then validated using synthetic peptides;these demonstrated robust specificity for the authentication of PA,PV,and MM.Finally,all marker peptides were successfully applied to identify the zoological origins of Brain Heart capsules and Xiaohuoluo pills,revealing the inconsistent Pheretima species used in these CPMs.In conclusion,our integrated strategy could be used for the in-depth characterization of natural peptides of other animal-derived traditional Chinese medicines,especially non-model species with poorly annotated protein databases.

【Objective】 Based on ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS), the potential biomarkers and metabolic mechanisms of adult calcium oxalate urolithiasis were identified to guide the diagnosis and treatment of calcium oxalate lithiasis. 【Methods】 Blood samples of 36 patients diagnosed with bilateral upper urinary tract calcium oxalate stones and 36 healthy controls admitted to our hospital during Oct.2017 and Jul.2018 were collected.Metabolic fingerprints were analyzed with UPLC-Q-TOF/MS.The multivariate data were analyzed with principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA).Potential biological markers were identified by comparing human metabolome datasets.Finally, the metabolic pathways of the identified compounds were analyzed and the metabolic network map was constructed. 【Results】 PCA and OPLS-DA showed significant differences in blood metabolites between patients and healthy controls, and identified 29 blood-related metabolites, including linoleic acid, citric acid, uric acid and so on.The most relevant blood metabolic pathways were bile acid synthesis pathway, fatty acid biosynthesis pathway, glycerophospholipid metabolism pathway, sphingolipid metabolism pathway and purine metabolism pathway. 【Conclusion】 Blood metabolomics analysis based on the UPLC-Q-TOF/MS platform identified 29 potential blood biomarkers of adult calcium oxalate urolithiasis, and purine and lipid metabolism may be related to the genesis of calcium oxalate stones.