ObjectiveTo compare the efficacy between needling peri-ocular points plus abducens oculi and needling peri-ocular points alone in treating abducens paralysis, for evaluating the effectiveness and advantage of needling peri-ocular points plus abducens oculi.MethodFollowing the random number table, 86 patients with postnatal unilateral abducens oculi were divided into two groups: 43 cases in the control group were intervened by conventional acupuncture at peri-ocular points including bilateral Taiyang (EX-HN5), Cuanzhu (BL2), Fengchi (GB20), Hegu (LI4) and Waiguan (TE5), plus Baihui (GV20), Sizhukong (TE23) and Tongziliao (GB1) on the affected side; 43 cases in the treatment group were intervened by acupuncture at peri-ocular points and abducens oculi, i.e. to puncture the abducens oculi (1~3 mm behind the attached point of the extrarectus to eyeball) in addition to the treatment given to the control group. After 3 treatment courses, the total effective rate, average recovery time and improvement of strabismus angle were observed.ResultThe total effective rate was 93.0% in the treatment group, significantly higher than 81.4%in the control group (P<0.05); of the 28 cured patients in the treatment group, the average recovery time was (34.51±7.91)d, versus (41.88±7.87)d in the 22cured patients in the control group, and the difference was statistically significant (P<0.01). There was a significant difference in comparing the improvement of strabismus angle between the two groups (P<0.01); after treatment, the strabismus angle was (11.23±6.32)° in the treatment group versus (14.14±6.85)° in the control group, and the difference was statistically significant (P<0.05).ConclusionNeedling peri-ocular points and abducens oculi can improve the strabismus angle, shorten treatment duration and reduce patient’s sufferings in treating postnatal abducens paralysis, significantly superior to conventional acupuncture at peri-ocular points.

BACKGROUND:Emerging evidence demonstrates that low density lipoprotein receptor-related protein 1 (LRP1)isinvolved in lipid metabolism and regulation of inflammatory reaction.
OBJECTIVE:To explore the effectof lentivirus-induced knockdown of low density lipoprotein receptor-related protein 1 on cartilage damage and matrix metaloproteinase 13 in a rat model of osteoarthritis, so as to assess the role of low density lipoprotein receptor-related protein 1 in the pathogenesis of osteoarthritis.
METHODS:Sixty-fourSprague-Dawleyratswere included andramdomlydivided into four groups (n=16 for each): negative control group, no surgery; sham-surgery group, onlythearticular cavity of the knee was exposed; osteoarthritisplus shLRP1 group, rat osteoarthritis models were established by cutting anterior cruciate ligament and removing the medial meniscus partly folowed by an intra-articular injection of lentivirus-mediated siRNA at 2 days after surgery, once a week for 2 consecutive weeks; osteoarthritis group,an intra-articular injection of the negative control lentivirus was performed after surgery. Rats inthe four groups started running on theself-made electric treadmil from 5 days after modeling, 30 minutes per day,totaly 500 meters. Cartilage damage and matrix metaloproteinase 13 expression in cartilage tissues were determined at 2, 4, 6 weeks after surgery.
RESULTS AND CONCLUSION:Gross and pathological observations showed that lentivirus-induced knockdown of lowdensity lipoprotein receptor-related protein 1 aggravatedcartilage damage intherat model of osteoarthritis. At 6 weeks after surgery, Mankin’s scoreand matrix metaloproteinase 13 expression inthecartilage tissues in osteoarthritis plus shLRP1 groupweresignificantly increased compared with other three groups (P< 0.05). These findings indicate that a simulation model of osteoarthritis is developed by cutting anterior cruciate ligament and removing the medial meniscus partly combined with running onthe treadmil. Lentivirus-induced knockdown ofLRP1aggravates cartilage damage in a rat model of osteoarthritis

BACKGROUND:Tumor necrosis factor α, as a pathogenic factor, induces the inflammatory reaction mainlyvia the activation of the nuclear factor kappa B signaling pathway. Low density lipoprotein receptor-related protein 1 (LRP1) is involved in the regulation of the inflammatory reaction induced by cytokines.
OBJECTIVE:To study the effect of knockdown of LRP1 on tumor necrosis factor α-induced inflammatory reaction.
METHODS: Primary cultured rat chondrocytes were transfected with lentivirus-mediated RNA interference to knockdown LRP1 gene. Three days after lentivirus transfection, chondrocytes were pretreated with Bay 11-7082 (10 μmol/L) for 30 minutes prior to the addition of tumor necrosis factor α (30 μg/L) for 30 minutes. Signaling protein and mRNA expressions in chondrocytes were detected by western blot assay and real-time PCR analysis, respectively. Chondrocytes were pretreated with or not Bay 11-7082 (10 μmol/L) 30 minutes prior to the addition of tumor necrosis factor α (30 μg/L) for 12 hours after starvation in DMEM for overnight, and the culture medium was colected for ELISA determination of matrix metaloproteinase 13 level.
RESULTS AND CONCLUSION:Tumor necrosis factor α receptor 1 expression was upregulated in chondrocytes after lentivirus-induced knockdown of LRP1. Increased expression of inducible nitric oxide synthase and activation of the nuclear factor kappa B signaling pathway were found after the addition of tumor necrosis factor α in shLRP1 group. Moreover, increased level of matrix metaloproteinase 13 was determined by ELISA. Taken together, knockdown of LRP1 up-regulates the expression of tumor necrosis factor α-induced inducible nitric oxide synthase and matrix metaloproteinase 13 through the activation of the nuclear factor kappa B signaling pathway.

ObjectiveTo investigate the relationship between intervertebral disc pressure and clinical efficacy after the minimally invasive treatment of cervical disc herniation. MethodsForty-seven patients with cervical disc herniation treated by disc radiofrequency ablation, and monitored the intervertebral disc pressure after that. Moreover, the correlation between the pressure and the clinical efficacy was observed. ResultsAll cases were successfully completed under pressure monitoring. Forty-seven cases underwent a follow-up of 1-25 months,according to JOA score,using postoperative improvement rate (Hirabashi formula) to assess the clinical efficacy. High efficacy in 25 cases,fine efficacy in 19 cases,good efficacy in 3 cases,high and fine efficacy rate was 93.6％ (44/47). The postoperative intervertebral discpressure was significantly correlated with improvement rate after cervical minimally invasive surgery (P ＜0.05). ConclusionsRadiofrequency ablation treatment of cervical disc herniation is safe and effective minimally invasive technique. If the pressure in the postoperative intervertebral disc is 3 kPa,it will get better prognosis.

Objective:To understand the changes in the practice environment from the perspective of doctors in 136 tertiary public hospitals, and to provide evidence for formulating strategies and measures to improve the practice environment of doctors.Methods:The data was collected from five rounds of China Healthcare Improvement Evaluation Survey from December 2015 to March 2021. The sample size was 17 945, 19 774, 20 786, 23 289, and 22 836, with a total of 104 630. The self-designed questionnaire on four dimensions of doctor-patient relationship, workload, administrative logistics support and professional identity was performed.Results:From the 1st to the 5th survey, the approval ratio of " the administrative and logistics department of this hospital is highly efficient" showed the characteristics of " U-shaped distribution" , and the approval ratio of " approve or encourage children to continue to engage in medical work" increased from 13.38% to 23.91%.From the 2nd to the 5th survey, the percentage of doctors who experienced doctor-patient disputes dropped from 28.96% to 23.20%, and the percentage of doctors agreeing that the relationship between doctors and patients in this hospital was improving continued to increase from 33.20% to 60.45%.From the 3rd to the 5th survey, the proportion of doctors experiencing medical troubles dropped from 15.10% to 14.19%, and the recognition rate of " the cafeteria of this hospital provided medical staff with nutritious and delicious meals" increased from 36.25% to 47.52%, and the approval proportion of " my current work load is heavy" dropped from 61.55% to 45.24%. The results of the 5th survey showed that there were significant differences in the approval ratios of each dimension in different genders, job titles and hospital types( P<0.001). Conclusions:From the perspective of doctor-patient relationship, workload, administrative logistics support, and professional identity, the improvement of doctors′ practice environment is still insufficient. Hospital administrators should continue to focus on the improvement of the doctor-patient relationship, and take necessary measures to reduce doctors′ workload and improve doctors′ professional identity.