Chronic neck pain is a common chronic musculoskeletal disorder. Research on neck muscle fatigue contributed to the understanding the pathogenesis of chronic neck pain. The influences caused by the neck muscle fatigue, such as the change of cervical proprioception and balance, could easily lead to chronic injury. Changes in morphology and recruitment strategy of cervical muscle could decrease muscle endurance, which bring about further damage. Targeted therapy and training can relieve muscle fatigue, improve muscle function, and reduce the recurrence rate. Surface electromyography has unique advantages in the evaluation of cervical muscle fatigue. The assessment of muscle fatigue could provide for assistance to the treatment and curative effect of chronic neck pain.

Objective To explore and evaluate an extracorporal method for inducing magnetic capsule endoscopy into small intestine. Methods 40 patients receiving magnetic capsule endoscopy were randomly divided in two groups: the control group: doctors stopped manipulating capsule after the examination of stomach, and the capsule entered small intestine by the natural gastrointestinal motility; and the study group: after the examination of stomach, the patient lay on the right side, doctors moved the capsule to the pylorus, and then moved magnetic ball to induce capsule into small intestine. Gastric inspection time, gastric residence time, small intestine transit time and the completion rate were compared between the two groups. Results The average time for checking stomach was (32.50 ± 11.71) min in control group and (31.75 ± 9.12) min in study group respectively, and the difference was not significant (P > 0.05). After the observation of stomach, the gastric residence time in the control group was (40.60 ± 21.43) min, and the completion rate was 40%, while the average gastric residence time in the study group was (13.55 ± 9.62) min, and the completion rate was 75%. The difference between the two groups was statistically significant (P < 0.05). Small intestine transit time was (329.25 ± 90.00) min in the control group and (342.00 ± 89.80) min in the study group, and the difference was not significant (P > 0.05). Conclusion By doctors moving magnetic ball and the patient lying on the right side after the observation of stomach, gastric residence time could be reduced and the completion rate could be elevated obviously.

Objective To study the effect of isometric contraction on subaxial cervical instability with sympathetic nervous symptoms.Methods 41 subaxial cervical instability patients with sympathetic nervous symptoms were assigned to experimental group (n=21) and control group (n=20). Both groups received manipulation therapy. Experimental group received isometric contraction in addition. They were assessed with Visual Analogue Scale (VAS) and heart rate variability (HRV), including total power (TP), low frequency power (LF), high frequency power (HF), and LF/HF before and 3 weeks after treatment. Results The scores of VAS, LF and LF/HF decreased in both groups after treatment (P<0.05), which decreased more in the experiement group than in the control group (P<0.05). Conclusion Isometric contraction can release the sympathetic nervous symptoms post subaxial cervical instability.

Objective To assess the effect of repetitive transcranial magnetic stimulation (rTMS) on motor and ambulatory function in incomplete spinal cord injury (SCI) patients. Methods 18 incomplete SCI patients (AIS D) were randomized to treatment group (n=10) and control group (n=8). The treatment group received rTMS while the control group received sham stimulation for 2 weeks. All the patients received routine rehabilitation. They were assessed with Lower Extremity Motor Score (LEMS), 10 m Walking Test for Walking Speed, modified Ashworth scale (MAS), Walking Index for SCI Scale II(WISCI II), and Spinal Cord Independence Measure (SCIM) before and after treatment, and followed up for 2 weeks after treatment. Results The treatment group significantly improved in LEMS, walking speed, and SCIM after treatment and during follow up (P<0.05), while the control group improved only in SCIM (P<0.05). There was more significant improvement in LEMS in the treatment group than in the control group (P<0.05) after treantment and during follow up. There was no difference between two groups in MAS, walking speed, WISCI II and SCIM. Conclusion rTMS can further improve the motor of lowere limbs for incomplete SCI patients.

Diphylleia sinensis is the dried rhizome of Diphylleia sinensis H.L.Li., which belongs to the subfamily of podophyl-lum ( berberidaceae ) , which is always recorded in monograph on materia medica in all ages as one of traditional Chinese medicine“Guijiu” herbal resources .Based on the previous researches in our laboratory and the literatures , the research progress in pharmacog-nosy, chemical constituent, endogeny fungus, quality control, pharmacology and the other aspects of Diphylleia sinensis were systemati-cally reviewed for the comprehensive utilization of its resources , and the development prospects of Diphylleia sinensis was also discussed in the paper , which can provide complete references and ideas for the rational utilization and development of Diphylleia sinensis.

Objective The aim of this experiment was to study the improving effects of a ginsenoside hydrolysis product DS-1227 on scopolamine-induced learning and memory impairment in mice.Methods Sixty healthy 5-6-week old male ICR mice (body weight 22 ±2 g) were randomly divided into control group, model group, three DS-1227 groups (25 mg/kg, 50 mg/kg, 100 mg/kg), and positive control group (0.3 mg/kg).Fourteen days after oral administration of DS-1227, an open-field test was conduct to determine the mouse locomotor activity.Fifteen days after oral administration of DS-1227, all experimental animals were intraperitoneally administered scopolamine (0.75 mg/kg) and the mice of control group received the same volume of saline.In addition to scopolamine, the mice of positive control group received intraperitoneal injection of physostigmine in a dose of 0.3 mg/kg.Twenty minutes after completion of all the drug administration, object recognition test and Morris water maze test were conducted to evaluate the learning and memory abilities of the mice.Results DS-1227 had no significant effect on locomotor activity of the mice.Scopolamine obviously decreased the discrimination indexes in object recognition test, and prolonged the escape latency of water maze place navigation test.While 25 mg/kg, 50 mg/kg, 100 mg/kg of DS-1227 increased the discrimination indexes and decreased the escape latency of place navigation in the mice.Conclusion DS-1227 can improve the learning and memory impairment induced by scopolamine in mice.

Medical education of PhD candidates is of great importance to medical personnel training in our country. With the development of society, the progress of science and technology and renewal of knowledge, cultivation of innovative talents and improvement of graduate education quality is priority nowadays. This paper reflects on the progress we’ve made on medical education of PhD candidates. Though efforts have been made to improve the innovative ability of talents in our country gradually, we still need to be more innovative, more consistent and more scientific in the future. According to the state Degree Requirements and our goal of talent training, we should combine courses with scientific research systematically, pay more attention to scientific methodology and academic training, finally form a better training mode of PhD candidates majoring in medical science.

OBJECTIVES: We sought to identify the expression of CD68-tumor-associated macrophages (TAMs) and CD34-microvascular density (MVD) in laryngeal squamous cell carcinoma (LSCC), to study the relationship with clinical pathological parameters and to determine whether their expression is predictive of disease. METHODS: Pathologically confirmed 45 LSCC tissue and 20 peritumoral non-tumor tissue were examined. Immunohistochemical studies were used to detect the expression of CD68-TAMs and CD34-MVD. RESULTS: The positive expression rate of CD68 in LSCC tissue was 82% (37/45), which was higher than the 10% (2/20) expression rate of the peritumoral tissue (P<0.05). The CD34-MVD positive expression rate in the LSCC tissue was 26.5±6.4, which obviously higher than 12.2±4.0 expression rate of the peritumoral tissue (P<0.05). The positive expression rates of both CD68 and CD34-MVD were higher in the lymph node metastasis (LNM) positive group than in the LNM negative group. The expression of CD68 had positive correlation with CD34-MVD. The 5-year disease-free survival rate in the group with the low CD68 expression was significantly higher than that in the group with high CD68 expression (76% vs. 42%, respectively). CONCLUSION: The high expression of CD68-TAMs in LSCC and its positive correlation with CD34-MVD illustrates that both play an important role in promoting the metastasis and angiogenesis of this cancer. Their expression was also positively correlated with the prognoses of these patients, suggesting that they could be used as important prognostic markers for LSCC.
Carcinoma, Squamous Cell* ; Disease-Free Survival ; Epithelial Cells* ; Humans ; Laryngeal Neoplasms ; Lymph Nodes ; Macrophages* ; Neoplasm Metastasis ; Prognosis*

According to the world epidemic report, the mortality of patients with severe coronavirus disease 2019 (COVID-19) is high. Diabetic patients are more susceptible to COVID-19. Since the mortality of COVID-19 patients with diabetes is on the top of list, hyperglycemia is considered an independent risk factor for severe COVID-19. Up to now, there is few effective treatment for severe patients infected with 2019 novel coronavirus (2019-nCoV). Clinical studies observed that cytokine storms existed in patients with severe COVID-19. Sustained high levels of cytokines cause diffuse damage to pulmonary capillary endothelial cells and alveolar epithelial cells, resulting in acute respiratory distress syndrome (ARDS). ARDS is the main cause of death in COVID-19 patients. Host-directed therapy (HDT) is an emerging therapeutic method in the field of anti-infection, which can activate the self-protective immune response, suppress excessive inflammatory response, and be used to assist the treatment of traditional drugs to shorten the course of disease. Metformin has been shown to be effective in HDT and can assist in the treatment of the viral and bacterial infectious disease. This paper discusses the rationality and potential therapeutic mechanism of metformin in the treatment of severe COVID-19. It was speculated that the use of metformin for controlling blood glucose in severe COVID-19 patients with diabetes may prevent or inhibit the occurrence of ARDS, thereby reducing the mortality of COVID-19 patients. The possible mechanism is that metformin could inhibit cytokine storm via suppressing interleukin-6 (IL-6) signaling, prevent the process of lung fibrosis, suppress endocytosis, thereby elevating angiotensin converting enzyme 2 (ACE2) expression.

Objective To investigate the morbidity, diagnostic profile and perinatal outcome of pregestational diabetes mellitus (PGDM) in 15 hospitals in Guangdong province. Methods A total of 41338 women delivered in the 15 hospitals during the 6 months,195 women with PGDM(PGDM group) and 195 women with normal glucose test result(control group)were recruited from these tertiary hospitals in Guangdong province from January 2016 to June 2016. The morbidity and diagnostic profile of PGDM were analyzed. The complications during pregnancy and perinatal outcomes were compared between the two groups. In the PGDM group, pregnancy outcomes were analyzed in women who used insulin treatment (n=91) and women who did not (n=104). Results (1)The incidence of PGDM was 0.472%(195/41338). Diabetes mellitus were diagnosed in 59 women (30.3%, 59/195) before pregnancy, and 136 women (69.7%,136/195) were diagnosed as PGDM after conceptions. Forty-six women (33.8%) were diagnosed by fasting glucose and glycohemoglobin (HbA1c) screening. (2) The maternal age, pre-pregnancy body mass index (BMI), prenatal BMI, percentage of family history of diabetes, incidence of macrosomia, concentration of low density lipoprotein were significantly higher in PGDM group than those in control group (all P<0.05). Women in PGDM group had significantly higher HbA1c concentration((6.3±1.3)% vs (5.2±0.4)%), fasting glucose [(6.3±2.3) vs (4.8±1.1) mmol/L], oral glucose tolerance test(OGTT)-1 h glucose((12.6±2.9) vs (7.1± 1.3) mmol/L)and OGTT-2 h glucose [(12.0±3.0) vs (6.4±1.0) mmol/L] than those in control group (P<0.01). (3)The morbidity of preterm births was significantly higher (11.3% vs 1.0%, P<0.01), and the gestational age at delivery in PGDM group was significantly smaller [(37.6±2.3) vs (39.2±1.2) weeks, P<0.01]. Cesarean delivery rate in the PGDM group (70.8% vs 29.7%) was significantly higher than the control group (P<0.01). There was significantly difference between PGDM group and control in the neonatal male/female ratio (98/97 vs 111/84, P=0.033). The neonatal birth weight in PGDM group was significantly higher((3159±700) vs (3451±423) g, P<0.01). And the incidence of neonatal hypoglycemia in the PGDM group was higher than the control group (7.7% vs 2.6%, P=0.036).(4)In the PGDM group, women who were treated with insulin had a smaller gestational age at delivery [(36.9±2.9) vs (37.9±2.5) weeks, P<0.01], and the neonates had a higher neonatal ICU(NICU)admission rate (24.2% vs 9.6% , P<0.01). Conclusions The morbidity of PGDM in the 15 hospitals in Guangdong province is 0.472%. The majority of PGDM was diagnosed during pregnancy; HbA1c and fasting glucose are reliable parameters for PGDM screening. Women with PGDM have obvious family history of diabetes and repeated pregnancy may accelerate the process of diabetes mellitus. Women with PGDM have higher risk for preterm delivery and neonatal hypoglycemia. Unsatisfied glucose control followed by insulin treatment may increase the need for NICU admission.