ObjectiveTo access the value of combined application of high-resolution interstitial MR lymphangiography (MRL) and heavily T2WI for the visualization of lymphatic vessels in patients with primary lymphedema.Methods Forty lower extremities in 31 patients with primary lymphedema were examined by heavily T2 WI and interstitial MRL with a 3.0 T MR unit (Philips Medical Systems,Best,the Netherlands).Two experienced radiologists analyzed the images and tried to determine the differences in number of lymphatic vessels,and their maximum diameters,SNR and CNR,and accumulated lymph fluid in the tissue.Statistical analyses were conducted by using Wilcoxon test and t test.ResultsDilated lymphatic vessels in 73 leg segments of 40 lower extremities were visualized on heavily T2WI (median 5,1 to 24),which were more than those on MRL ( median 3,1 to 16) (Z =-2.92,P ＜ 0.01 ).The maximum diameter of lymphatic vessels was (4.3 ± 1.5 ) mm on heavily T2 WI,whereas it was ( 3.4 ± 1.0) mm on MRL ( t =6.90,P ＜ 0.0 1 ).The average SNR and CNR in the dilated lymphatic vessels were 257 ± 130,207 ± 113 on MRL and 169 ± 91,135 ± 82 on heavily T2 WI,which was statistically significant ( SNR t =- 5.95,CNR t =-5.10; P ＜ 0.01 ).The visualization of regions of accumulated lymph fluid on heavily T2WI (median 1 ) had a higher score than that on MRL ( median 0 ) ( Z =- 5.64,P ＜ 0.01 ).Conclusions The heavily T2WI has greater sensitivity and the MRL image has better SNR and CNR.Combining these two MR techniques can provide adequate information for clinicians in the therapeutic planning of patients with advanced stages of lymphedema.

[Objective] To discuss the mechanism and relative problems of lumbar traction. [Method] Relevant articles and retrospect clinical data in the author's hospital were reviewed. Review relevant articles and retrospect clinical data of our hospital. [ Result ] Traction force : 40 kg + 15% ～ 20% of body weight, fineness rate reached 83.5% in 1606 patients being treated. According to course of disease, fineness rate was 90. 1% in the group of less than 3 years, 68.2% in the group of more than 3 years. [ Conclusion] Lumbosacral nerve root leave the peak of the protruding nucleus and establish a new harmonious "root-disc" relationship after traction. The pressure and tension to the nerve root reduces or disappears, meanwhile, the pain of low back and leg is alleviated or eradicated. Appropriate traction weight and correct traction body posture are key factors of good therapeutic effect.

Sesamin, a lipid-soluble lignin originally isolated from sesame seeds, which induces cancer cell apoptosis and autophagy. In the present study, has been reported that sesamin induces apoptosis via several pathways in human lung cancer cells. However, whether mitophagy is involved in sesamin induced lung cancer cell apotosis remains unclear. This study, the anticancer activity of sesamin in lung cancer was studied by reactive oxygen species (ROS) and mitophagy. A549 cells were treated with sesamin, and cell viability, migration ability, and cell cycle were assessed using the CCK8 assay, scratch-wound test, and flow cytometry, respectively. ROS levels, mitochondrial membrane potential, and apoptosis were examined by flow cytometric detection of DCFH-DA fluorescence and by using JC-1 and TUNEL assays. The results indicated that sesamin treatment inhibited the cell viability and migration ability of A549 cells and induced G0/G1 phase arrest. Furthermore, sesamin induced an increase in ROS levels, a reduction in mitochondrial membrane potential, and apoptosis accompanied by an increase in cleaved caspase-3 and cleaved caspase-9. Additionally, sesamin triggered mitophagy and increased the expression of PINK1 and translocation of Parkin from the cytoplasm to the mitochondria. However, the antioxidant N-acetyl-L-cysteine clearly reduced the oxidative stress and mitophagy induced by sesamin. Furthermore, we found that cyclosporine A (an inhibitor of mitophagy) decreased the inhibitory effect of sesamin on A549 cell viability. Collectively, our data indicate that sesamin exerts lethal effects on lung cancer cells through the induction of ROS-mediated mitophagy and mitochondrial apoptosis.

Sesamin, a lipid-soluble lignin originally isolated from sesame seeds, which induces cancer cell apoptosis and autophagy. In the present study, has been reported that sesamin induces apoptosis via several pathways in human lung cancer cells. However, whether mitophagy is involved in sesamin induced lung cancer cell apotosis remains unclear. This study, the anticancer activity of sesamin in lung cancer was studied by reactive oxygen species (ROS) and mitophagy. A549 cells were treated with sesamin, and cell viability, migration ability, and cell cycle were assessed using the CCK8 assay, scratch-wound test, and flow cytometry, respectively. ROS levels, mitochondrial membrane potential, and apoptosis were examined by flow cytometric detection of DCFH-DA fluorescence and by using JC-1 and TUNEL assays. The results indicated that sesamin treatment inhibited the cell viability and migration ability of A549 cells and induced G0/G1 phase arrest. Furthermore, sesamin induced an increase in ROS levels, a reduction in mitochondrial membrane potential, and apoptosis accompanied by an increase in cleaved caspase-3 and cleaved caspase-9. Additionally, sesamin triggered mitophagy and increased the expression of PINK1 and translocation of Parkin from the cytoplasm to the mitochondria. However, the antioxidant N-acetyl-L-cysteine clearly reduced the oxidative stress and mitophagy induced by sesamin. Furthermore, we found that cyclosporine A (an inhibitor of mitophagy) decreased the inhibitory effect of sesamin on A549 cell viability. Collectively, our data indicate that sesamin exerts lethal effects on lung cancer cells through the induction of ROS-mediated mitophagy and mitochondrial apoptosis.

Objective To investigate physical development status on soldiers of Chinese people's armed tactical unit, as to provide basic data for selection of soldiers and health evaluation. Methods To measure the height, weight, chest cir-cumference for soldiers of Chinese people's armed tactical unit, to calculate the development index and then to com-pare and analyse Accordingly. Results (1)The height, weight, chest circumference, Index of weight, Index of chest cir-cumference and index of Vervaeck were significantly higher than that of local college students, and had significant dif-ferences (P<0.01). (2)The southern and northern soldiers in three indicators of height, weight, chest circumference were higher than GJB, and they all had significant differences (P<0.01). The height evaluation of northern soldiers was supe-rior to southern.The body symmetry degrees on soldiers of north and south had no significant difference (P > 0.05). Conclusion The physical development state of this armed police tactical unit soldiers were better than that of local col-lege students, achieved and exceeded the GJB, the height of northern soldiers were high than southern. The body sym-metry degrees on soldiers of north and south were all good. The excellent percent and better percent for Comprehensive evaluation of physical development were higher.

Objective:To investigate the threshold of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), synovial fluid white blood-cell count (WBC) and polymorphonuclear cells (PMN) proportion in the diagnosis of periprosthetic joint infection (PJI) in patients with rheumatoid arthritis (RA).Methods:The clinical data of 246 patients with RA and osteoarthritis (OA) who had previously undergone total knee and hip arthroplasty from January 2006 to December 2019 was retrospectively analyzed. The patients were divided into four groups according to the disease type and whether PJI occurred, namely 46 patients in the RA-PJI group, 64 patients in the RA-non-PJI group, 72 patients in the OA-PJI group, and 64 patients in the OA-non-PJI group. The receiver operating characteristics (ROC) curve was used to determine the optimum cut-off values of CRP, ESR, synovial fluid WBC and PMN proportion for diagnosing the RA-PJI and OA-PJI. The optimal cut-off values of serum and synovial fluid indexes were evaluated for the diagnostic efficacy of RA-PJI by comparing the area under curve (AUC) of each index. Further, the values were applied for joint test analysis.Results:For PJI prediction, the results of serological and synovial fluid indexes were different between RA-PJI group and OA-PJI group. The results of ROC curve analysis showed that the optimal cut-off values of each detection index were as follows. The optimal cut-off value of CRP for diagnosing RA-PJI was 14.4 mg/L, ESR was 39 mm/1 h, synovial fluid WBC was 3 654×10 6 /L, and PMN proportion was 0.659. The optimal cut-off value for diagnosing OA-PJI were 8.16 mg/L, 31 mm/1 h, 2 452×10 6 /L, and 0.625, respectively. In the RA-PJI group, the difference between the AUC of each detection index and AUC=0.5 was statistically significant ( P<0.05). Among them, the specificity of synovial fluid WBC was 92.3%, AUC was 0.879 (95% CI: 0.776, 0.982) with 87.8% positive predictive value and 10.21 positive likelihood ratio. These values were higher than those of CRP, ESR, and PMN proportion. The results of joint test analysis for the diagnosis of RA-PJI were as follows. The specificity of the series test was 100%, and the sensitivity of the parallel test was 100%; the specificity of the joint index diagnostic test was 100%, AUC was 0.926 (95% CI: 0.848, 1.000), the difference between AUC and AUC=0.5 was statistically significant ( P<0.05). Conclusion:The optimum cut-off values of CRP, ESR, synovial fluid WBC and PMN proportion for the diagnosis of PJI in patients with RA are all higher than those of patients with OA. Their optimal cut-off values can be used as important auxiliary indexes for a clear diagnosis of PJI in patients with RA. Compared with other indexes, the synovial fluid WBC has strong predicting power and lower misdiagnosis rate, which could be the best detection index for identifying PJI in patients with RA. The joint test could improve the sensitivity or specificity of PJI diagnosis in patients with RA. The combination with multiple detection indexes could provide a reference for the early and accurate diagnosis of PJI in patients with RA.

BACKGROUND:The gluteus medius not only abducts the hip joint,but also plays an important role in limiting the external movement of the femoral head.At present,there is a lack of research on the correlation between gluteus medius status and non-traumatic femoral head necrosis. OBJECTIVE:To investigate the relationship between the gluteus medius width ratio and the medial space ratio of the hip joint and the progression of non-traumatic femoral head necrosis,and to explore the effect of gluteus medius atrophy on the surface and necrotic zone stress of the femoral head necrosis through finite element analysis. METHODS:Retrospective analysis of unilateral non-traumatic femoral head necrosis patients admitted to Third Affiliated Hospital of Guangzhou University of Chinese Medicine was performed.All patients were followed up for an average of more than 2 years.They were divided into a collapsed group and a non-collapsed group based on whether there was collapse of the femoral head during the follow-up.Medial space ratio,gluteus medius width ratio,Sharp angle,gluteus medius length ratio,and gluteus medius activation angle were measured and calculated.The differences in these indicators were compared between the two groups.At the first visit and follow-up at 3,6,12,and 24 months,the medial space ratio and gluteus medius width ratio were measured and calculated to explore the changes of these two indicators in the course of non-traumatic femoral head necrosis.In addition,using three-dimensional finite element analysis,a Japanese Investigation Committee classification C1 type femoral head necrosis model was constructed based on CT data.At the same time,based on MRI data,a model of the gluteus medius muscle was constructed and divided into a gluteus medius muscle atrophy group(gluteus medius width ratio:74%-76%)and a gluteus medius muscle normal group(gluteus medius width ratio:94%-96%).Each group constructed 10 models,with 6 degrees of freedom of the distal femur constrained to zero.600 N pressures were applied along the Z-axis to the upper surface of the sacrum.The stress distribution,maximum stress values on the surface and necrotic area of the femoral head,and the maximum displacement of the necrotic area were compared between two groups of models. RESULTS AND CONCLUSION:(1)A total of 153 patients(67 males and 86 females)with 153 hips were included in this study.(2)At the 24-hour follow-up,the medial space ratio of the collapsed group was significantly higher than that of the non-collapsed group(P<0.05).The gluteus medius width ratio of the collapsed group was significantly lower than that of the non-collapsed group(P<0.05).There was no statistically significant difference in Sharp angle,gluteus medius activation angle,and gluteus medius length ratio between the two groups(P>0.05).(3)Since the follow-up time exceeded 3 months,the gluteus medius width ratio of the collapsed group was lower than that of the non-collapsed group(P<0.05).Since the follow-up time exceeded 12 months,the medial space ratio of the collapsed group was higher than that of the non-collapsed group(P<0.05).(4)Pearson correlation analysis showed a significant positive correlation between follow-up time and medial space ratio in the collapsed group(P<0.05),and a significant negative correlation between follow-up time and gluteus medius width ratio(P<0.05).The regression coefficient of gluteus medius width ratio was larger than that of medial space ratio.(5)The group with middle gluteal muscle atrophy showed significant stress concentration on the surface of the femoral head,and the stress zone was significantly located on the outside.The maximum stress on the surface of the femoral head in the group with middle gluteal muscle atrophy was significantly greater than that in the group with normal middle gluteal muscle(P<0.05).There was significant stress concentration in the necrotic area of the middle gluteal muscle atrophy group,and the maximum stress was located at the edge of the necrotic area.The maximum stress and maximum displacement in the necrotic area of the middle gluteal muscle atrophy group were significantly greater than those of the normal group(P<0.05).(6)It is indicated that gluteus medius width ratio is an effective indicator for evaluating changes in gluteal muscle atrophy.In the progression of non-traumatic femoral head necrosis,atrophy of the gluteus medius muscle first occurs,followed by widening of the medial hip joint space.The mechanical mechanism may be that the atrophy of the gluteus medius muscle affects the stability of the hip joint,leading to external displacement of the femoral head,and increasing stress and displacement on the surface and necrotic area of the femoral head.