Clavicular crook plate is designed based on anatomic features of acromioclavicular joint,which matches clavicle appearance,and well attaches the shaft.Not passing through the joint,the internal fixation exhibits many advantages,such as convenient usage,reliable fixation and micromovement of fixed acromioclavicular joint.So the patients could move the joint early and avoid osteoarthritis.Allogenous tendon has abundant sources,simple sampling process,and short repairing duration and can reduce injury to patients.Cryopreserved allogenous tendon has low antigenicity and immunological refection,good histocompatibility.Reconstructed coracoclavicular ligament by allogenous tendon has good material intensity,and can meet the requirements of local stress,better substitute integrity and function of coracoclavicular ligament.Moreover,it has precise effect and simple operation.It acts as long-term fixator following plate removal,thus is important supplement of clavicular crook plate fixation.Clavicular crook plate fixation in combination with allogenous tendon transplantation reconstructs acromioclavicular joint stability,effectively provides early mechanical stability and subsequent biological stability,and maximizes restoration of acromioclavicular joint structure and function.

Objective:To test the validity and reliability of the Chinese version of the Snaith-Hamilton Pleasure Scale (SHAPS).Methods:Totally 166 patients with major depression completed the Chinese version of SHAPS,Beck Depression Inventory (BDI-Ⅰ) and Hamilton Depression Scale (HAMD-17).The validity was tested by using correlation analysis and exploratory factor analysis.The reliability was tested by using internal consistency coefficient and Pearson correlation analysis.Results:The ICCs between three different Scale score were 0.90 and 0.91(Ps ＜ 0.001).Exploratory factor analysis identified 2 common factors,which explained 62.8％ of total variancel.The Cronbach coefficient of SHAPS was 0.94.The test-retest coefficient was 0.91 (P ＜ 0.001).The intercorrelations of 14 items ranged from 0.30 to 0.93 and item-total correlations ranged from 0.61 to 0.79.Conclusion:The Chinese version of SHAPS has good validity and reliability,it could be used to assess anhedonia in Chinese patients with major depression.

Objective To explore the levels of leptin(LEP) and soluble leptin receptor (sOB‐R) in breast cancer patients′ser‐um ,and to discuss the relationship between LEP ,sOB‐R ,free leptin index(FLI) and the patients′clinical pathologic features .Meth‐ods 70 serum specimens of breast cancer patients who confirmed by pathological diagnosis were collected before the surgery ,the serum of benign breast disease group(n=50) and normal group(n=50) were also collected as control .The levels of LEP and sOB‐Rinserumweredetected,andtheresultafterbodymassindex(BMI)correctionwereanalyzed.Finally,therelationshipbetweenthe expression of LEP ,sOB‐R and clinical pathologic features were analyzed .Results The serum level of LEP in breast cancer group was highly increased than the other two groups (P<0 .05) ,and sOB‐R was reduced(P<0 .05) .After BMI correction ,LEP was still highly increased(P<0 .05) ,but sOB‐R was no significant difference (P>0 .05) .The level of LEP in the postmenopausal breast cancer patients were highly increased than menopause patients (P>0 .05) ,and the expression of LEP in cancer group were signifi‐cant higher than two control groups by both postmenopausal and menopause (P>0 .05) .The result suggested the serum level of LEP and FLI are associated with pTNM stages and lymph node metastases (P<0 .05) ,and elevated level of LEP in postmenopausal patients had differences in pTNM stages and lymph node metastases (P< 0 .05) .Conclusion The serum LEP level and the FLI may be potential indicators to evaluate the prognosis of the patient with breast cancer .The serum LEP may promoted the process of the postmenopausal patients of breast cancer .

Acupuncture is a promising treatment for relieving pain and improving lower back function in clinical practice. However, evidence from randomized clinical trials (RCTs) remains controversial. Most RCTs conclude that acupuncture procedures for chronic low back pain (CLBP) had no significant difference in efficacy and belonged to placebo. We carefully reviewed and analyzed the methodology and implementation of sham acupuncture in RCTs. Controversial evidence of acupuncture for CLBP is only a microcosm of the evaluation methodological limitation of acupuncture. Inappropriate selection of sham acupuncture controls, rigorous RCT research models, and incorrect interpretation of results may contribute to negative evidence. Evaluating and disregarding the holistic efficacy of acupuncture with an explanatory RCT model based on evaluation drugs may be unwise. Moreover, sham acupuncture is often proven to be non-inert, unreasonable, and with low fidelity. Pitfalls of the explanatory RCT model and sham acupuncture design should be avoided. Establishing a new evaluation system that is in line with the clinical characteristics of acupuncture and obtaining high-quality evidence are difficult but promising tasks.
Acupuncture Therapy ; Chronic Pain/therapy* ; Humans ; Low Back Pain/therapy* ; Randomized Controlled Trials as Topic ; Treatment Outcome

The construction of a countywide community for medical and health services is designed to upgrade the service capacity of primary medical and health institutions, to promote resource sharing and collaborative services, and promote the hierarchical medical system. Huzhou of Zhejiang province has launched its initiative in building a countywide community for medical services since 2018. The authors summarized its main practices in promoting the integration of the management system and optimizing operating mechanism of countywide medical and health institutions, promoting the reform of the county medical and health governance system, as well as the achievements and shortcomings, with a view to providing reference for promoting the high-quality development of the countywide medical and health service system.

Fusobacterium nucleatum is an opportunistic pathogenic bacterium that can be enriched in colorectal cancer tissues, affecting multiple stages of colorectal cancer development. The two-component system plays an important role in the regulation and expression of genes related to pathogenic resistance and pathogenicity. In this paper, we focused on the CarRS two-component system of F. nucleatum, and the histidine kinase protein CarS was recombinantly expressed and characterized. Several online software such as SMART, CCTOP and AlphaFold2 were used to predict the secondary and tertiary structure of the CarS protein. The results showed that CarS is a membrane protein with two transmembrane helices and contains 9 α-helices and 12 β-folds. CarS protein is composed of two domains, one is the N-terminal transmembrane domain (amino acids 1-170), the other is the C-terminal intracellular domain. The latter is composed of a signal receiving domain (histidine kinases, adenylyl cyclases, methyl-accepting proteins, prokaryotic signaling proteins, HAMP), a phosphate receptor domain (histidine kinase domain, HisKA), and a histidine kinase catalytic domain (histidine kinase-like ATPase catalytic domain, HATPase_c). Since the full-length CarS protein could not be expressed in host cells, a fusion expression vector pET-28a(+)-MBP-TEV-CarS_cyto was constructed based on the characteristics of secondary and tertiary structures, and overexpressed in Escherichia coli BL21-Codonplus(DE3)RIL. CarS_cyto-MBP protein was purified by affinity chromatography, ion-exchange chromatography, and gel filtration chromatography with a final concentration of 20 mg/ml. CarS_cyto-MBP protein showed both protein kinase and phosphotransferase activities, and the MBP tag had no effect on the function of CarS_cyto protein. The above results provide a basis for in-depth analysis of the biological function of the CarRS two-component system in F. nucleatum.
Humans ; Histidine Kinase/metabolism* ; Fusobacterium nucleatum/metabolism* ; Automobiles ; Protein Kinases/genetics* ; Escherichia coli/metabolism* ; Colorectal Neoplasms