Objective To observe the activation patterns in surface electromyographs (sEMGs) of the lumbar dorsal and ventral muscles and the gluteus medius during asymmetrical trunk postures and while carrying loads with the trunk rotated.Methods sEMGs were recorded from ten healthy men as they stood with their feet in 5 positions-rotated clockwise 0°,45°,90°,135° and 180° with respect to the initial plane of the torso.With each foot position they stood in 3 postures:upright,in lateral flexion and in lateral extension.Each posture was recorded with and without carrying a load of 20 kg by the right hand.The EMG activities of the rectus abdominis (RA),obliquus externus abdominis (EO),erector spinae (ES),multifidus (LM) and gluteus medius (GM) on both sides were recorded.Trunk displacement was monitored by 8 cameras.The EMG data of each muscle were normalized with readings from a maximal voluntary contraction (MVC) of the muscle.Results With the feet at 0° and no load the muscle activities on both sides were 1％-2％ of the MVC readings.With a 20 kg load the percentage was 3％-13％.With the feet at 45° and no load the activities were greater,except in the RA on the contralateral side.With no load at 90°,135° and 180° the muscle activities were greater,but a few muscles in the two extreme trunk postures showed greater activity only on one side,especially the ES and LM.With a load and rotational torque in the spine,the ventral muscles were less active but the dorsal muscles were significantly more active on both sides.Conclusion Standing with rotation of the spine,the activity of some trunk muscles shows great asymmetry,particularly with asymmetric loading of the arms.This might create a phenomenon of lumbar flashing and it could possibly be one of the pathological bases of acute lumbar sprain.

BACKGROUND:The third molar extraction may lead to different degrees of soft tissue damage. Ultrasound and ultrashort waves belong to hyperthermia, which can increase tissue temperature and improve the therapeutic efficacy of soft tissue stretch. OBJECTIVE:To observe the effects of soft tissue stretch combined with ultrasound and ultrashort wave therapy for patients who were recently diagnosed with trismus and pain folowing third molar removal. METHODS:Sixteen patients with trismus and pain after third molar removal were randomly divided into two groups: patients in stretch group received soft tissue stretch with ultrasound and ultrashort wave therapy, while those in control group received only ultrasound and ultrashort wave therapy. Patients received the treatment five times per week, totaly for 2 weeks. RESULTS AND CONCLUSION:It was found that after treatment pain was significantly reduced at the temporomandibular joint, and the range of maximum active mouth opening increased significantly. The improvement in mouth opening and temporomandibular joint function was better in the stretch group than the control group. These findings indicate that ultrasound and ultrashort wave therapy can improve symptoms of trismus and pain folowing third molar removal, and the combination of ultrasound and ultrashort wave therapy and soft tissue stretch therapy can achieve more effective results.

Objective To observe the therapeutic effects of extracorporeal shock wave therapy (ESWT) combined with autologous bone marrow stem cells (BMSC) transplantation in treating early-stage osteonecrosis of the femoral head (ONFH).Methods Forty patients diagnosed as stage Ⅰ or Ⅱ according to the classification of osteonecrosis of the femoral head put forward by the Association Research Circulation Osseous were randomly divided into a treatment group and a control group with 20 cases in each group.Both groups were treated with BMSC transplantation,while the treatment group was further treated with ESWT the next day.Harris scores were assigned before the treatment and 3,6,12 and 24 months after the treatment to evaluate hip function,the degree of pain and the effects of the treatment.Frog-bit X-rays of the anteroposterior pelvis were taken to assess the stages.Results There were significant differences in the Harris scores and pain degree of the two groups before and at the different time points after the treatment.After 6,12 and 24 months,significant differences were observed in the two values between the two groups.After 12 months the number of hips rated excellent,good and medium level were 8,18 and 1 in the treatment group and 5,13 and 8 in the control group,showing significant differences.Conclusion Extracorporeal shock wave therapy along with autologous bone marrow stem cell transplantation can be used to treat patients with early stage osteonecrosis of the femoral head,relieving their pain and improving their joint function.

Objective:To explore the diagnostic value of 64‐slice spiral CT for in‐stent restenosis (ISR) after percuta‐neous coronary intervention (PCI) in patients with coronary heart disease (CHD) .Methods :A total of 120 CHD patients after PCI received 64‐slice spiral CT angiography and routine coronary angiography (CAG ) respectively . Then coronary ISR was assessed .Results:With CAG as the gold standard ,sensitivity ,specificity ,positive predictive value and negative predictive value were 87.5% ,95.3% ,80.0% and 97.3% respectively for 64‐slice spiral CT cor‐onary angiography in diagnosis of ISR .Conclusion :The 64‐slice spiral CT coronary angiography possesses high sensitivity and accuracy diagnosing coronary in‐stent restenosis ,which can be used as one of noninvasive measures for postoperative follow‐up after percutaneous coronary intervention .

Objective To explore the correlations between septic acute kidney injury (SAKI) and immune condition and provide the clinical basis of predictable diagnosis and treatment in patients with SAKI.Methods Patients diagnosed with sepsis admitted to department of emergency intensive care unit of Peking Union Medical College Hospital between January 1st,2013 and September 30th,2014 were retrospectively studied.A total of 91 patients with sepsis were included,and they were divided into secondary immune deficient (SID) group (n =46) or control group (n =45).According to the diagnostic criteria and stage of the guidelines of Kidney Disease:Improving Global Outcomes 2012 (KDIGO-AKI 2012),patients in each group were divided into non-SAKI group (n1 =16,n2 =23)、KDIGO-1 group (n1 =15,n2 =13)、KDIGO-2 group (n1 =11,n2 =1) or KDIGO-3 group (n1 =4,n2 =8).The morbidity of each stage and the renal index along with the progression of SAKI was also compared in patients with SAKI in two groups.Results While there was a significant difference in the morbidity of KDIGO-2 (23.9％ vs.2.2％,x2 =0.321,P =0.002) in patients with SAKI between immune deficient group and control group,the morbidity of KDIGO-1 and KDIGO-3 had no significant difference (KDIGO-1:32.6％ vs.29.8％,x2 =0.040,P =0.701;KDIGO-3:8.7％ vs.17.8％,x2 =-1.805,P =0.200).There was also no significant difference in the renal index (△Scr、△eGFR) and progression of SAKI (elapsed days from the diagnosis of sepsis to the occurance and most severe stage of SAKI) in patients with SAKI in two groups (P ＞ 0.05).Conclusion There was no significant difference of the severity of septic acute kidney injury in patients with and without secondary immune deficiency.Inflammatory mediators-induced kidney injury in the process of immune response may not be the main mechanism in SAKI.

Objective To assess the alterations of the systolic peak radial strain (RS) and the time to systolic peak radial strain(TRS) in ischemic myocardial segments with different extent of coronary artery stenosis using three-dimensional ultrasound speckle tracking imaging(3D-STI).Methods RS and TRS of 16 left ventricular segments were analyzed by 3D-STI in 87 patients,every left ventricular segment of all patients were divided into 5 groups according to coronary stenosis based on the results of selected coronary angiography:normal,≤25 ％,＞25 ％ - ≤50 ％,＞50 ％ - ≤ 75 ％,＞ 75 ％.All times were corrected by heart rate.Results In the coronary normal group,coronary stenosis extent ≤25％ group and coronary stenosis extent ＞25％ - ≤50％ group,the variance of RS was non-significant( P ＞0.05).Compared with the coronary normal group,coronary stenosis extent ≤25％ group and coronary stenosis extent ＞ 25％ -≤ 50％ group,RS was decreased in groups of coronary stenosis ＞50％ - ≤75％ and ＞75％.Between the coronary normal group and coronary stenosis extent ≤25 ％ group,the variance of TRS was non-significant( P ＞0.05).Compared with coronary normal and coronary stenosis extent ≤25 ％ group,TRS was increased in groups of coronary stenosis ＞25％ - ≤50％,＞50％ - ≤75％,＞75％.Compared with group of coronary stenosis ＞ 50％ -≤ 75％,TRS was shorter in group of coronary stenosis ＞ 75％,some variance was significant( P ＜0.05).Conclusions The RS was decreased along with the coronary stenosis increase,but TRS was increased along with the coronary stenosis increase.There is a tendency that TRS was decreased when the coronary stenosis is more than 75 ％ compared with the coronary stenosis ＞50％ - ≤75 ％ group.3D-STI can access the regional radial systolic function of the ischemic myocardial segment.

Objective To investigate the effect of education in pregnant women’s school on primipara mode of delivery and puerperal behavior.Methods Two hundred and twenty cases who delivered in our hospital and paid postpartum visits were divided into observation group and control group equally according to whether they had attended the pregnant women’s school.The observation group included those having attended the school and the control those who had not.The two groups were compared in terms of primipara mode of delivery and puerperal behavior.Results The rates of maternal vaginal delivery and cesarean section rate in observation group were 71.8%and 28.2%,both significantly higher than those of the control group(52.7%and 47.3%)(P<0.01).The rate of caesarean section due to social factors in the observation group was significantly lower than that of the control group(P<0.05).Besides,the observation group had higher rates of puerperiumal shampoo, showering, eating vegetables and fruits,brushing,use of air-conditioners than the control group did(all P<0.01).Conclusions Prenatal maternal health education in the pregnant women’s school affects puerperous behavior.It suggests that prenatal parturients actively participate in related education on maternal health care,which can help establish a good pregnancy and puerperium maternal behavior,reduce maternal cesarean section and thus help them live through puerperium.

Objective To study the anatomy of the innervation of hallucis longus muscle,and discuss the clinical value of the innervation.Methods Nineteen limbs of 10 cadavers were studied.There were 4 female cadavers and 6 male cadavers.Nine were left legs and 10 were right legs.The specimens were anatomied to confirm the tibialis anterior,extensor digitorum longus and hallucis longus muscle.The innervation of hallucis longus muscle was been observed along the deep peroneal nerve.Measuring the muscular branches length (nerve length,NL),the distance from the tip of the fibular head to the muscular brance (nerve-fibula head length,NFL),and fibular length (fibula length,FL).The hematoxylin and eosin stain was used to observe the numbers of nerve fascicle for each branch of EHL.Results Twenty-three muscle branches of hallucis longus muscle were found in 19 limbs,15 limbs had a single branch,4 limbs had the double branches.All branches were originated in the deep peroneal nerve.Fourteen branches were into hallucis longus muscle from the fibular side,3 from anterior side,6 from the tibial side.The fibula length was 37.0±1.9 cm (range,34.5-40.6 cm); the nerve-fibula head length was 89.0±5.2 mm (range,75.4-97.2 mm);nerve length was 48.5±5.0 mm (range,33.6-57.4 mm); the nerve-fibula head length/fibula length was 0.245±0.020 (range,0.211-0.280).Among 15 specimens with single branch,3 branches had a unique nerve fascicle and 12 had two fascicles.Among 4 specimens with doulbe branches,only 1 branch had two fascicles,7 branches had a unique fascicle.Conclusion Special anatomical features of muscular branches might be the reason of isolated extensor hallucis longus dysfunction.

Aim To investigate the effect of hesperidin on human lung cancer cell A549 and the possible mechanism.Methods The cell apoptosis and necrosis of A549 treated with hesperidin were measured by the Hoechst 33342/PI fluorescent dye based on microfluidic chip technology.Cell cycle and apoptosis rate were evaluated by flow cytometry(FCM).The expressions of the related genes were detected through the real-time fluorescent quantitative PCR technology(RT-PCR) including VEGF, PI3K and PTEN.The protein expressions of Bcl-2, Cyclin B1, PI3K, Akt and PTEN were detected by Western blot after hesperidin intervention.Results The proliferation of A549 cells was significantly inhibited by hesperidin in a dose-dependent manner.FCM results showed that hesperidin could not only influence the G0/G1 phase and S phase, but also promote the apoptosis of lung cancer cells.Meanwhile, the apoptosis and necrosis rate was increased from(6.7±0.6)% to(27.9±1.1)% compared with that of control group(P<0.05).From the level of molecular, the gene expressions of VEGF and PI3K were decreased, while the PTEN was increased after hesperidin stimulation.Western blot results showed that the expression of protein Bcl-2, Cyclin B1 and Akt were decreased, which all showed close relationship with cell apoptosis, cell cycle and PI3K-Akt signaling pathway.The expression of PI3K was increased, but the change of PTEN was not statistically significant compared with that of control group.Conclusion Hesperidin induces lung cancer cell apoptosis through PI3K-Akt signaling pathway, which blocks cancer cell division and destroys the balance of related protein expression.

Nowadays,with the rapid development of science and technology of medicine,the detection rate of obstructivc azoospermia increased gradually,clinically not uncommon.Surgical treatment of obstructive azoospermia is also improved from traditional vasovasostomy and epididymovasostomy to microsurgical vasovasos-tomy and microsurgical va-soepididymostomy,and from 3-suture intussusception vasoepididymostomy to 2-suture intussusception vasoepididymostomy,then our modified reverse single needle anastomosis,and finally to the robot assisted anastomosis.Therefore,the anastomosis is more precise,the recanalization rate and the pregnancy rate have a revolutionary improvement.The robot era is coming.The article focuses on surgical treatment of obstructive azoospermia,comparison of the advantages and disadvantages of each operation,and prediction of the future direction of development.