Objective:To evaluate the therapeutical effects of sodium hyaluronate and triamcinolone acetonide on secondary temporomandibular synovitis.Methods:67 patients with secondary temporomandibular synovitis were divided into two groups:A group received the intraarticular injection of sodium hyaluronate and B group received triamcinolone acetonide injection.The effects of two groups were observed.Results:Patients were followed up at 1 week,2 months and 3 months after being treated respectively.Although 1 week after treatment,A group showed better curative effect(P0.05).After 3 months,B group showed better effects than A group(P

Objective:To construct an evaluation indicator system for the health management effects in high-risk stroke population.Methods:From March to May 2020, based on health ecology theory, social cognitive theory and knowledge, attitude/belief, practice theory, the first draft of the evaluation index system for health management effects of high-risk stroke groups was drawn up by literature review and group discussion. Through two rounds of Delphi expert consultation, the evaluation index system of health management effects of high-risk stroke groups was established, and the weight of each index was determined by analytic hierarchy process (AHP). A total of 22 experts were invited to participate in expert consultation. Twenty-two questionnaires were sent out in the first round, and 20 questionnaires were recovered, of which 20 were valid (90.9%). In the second round of correspondence, 20 questionnaires were sent out and 19 questionnaires were recovered, of which 19 were valid (95.0%).Results:The authority coefficients of the two rounds of expert consultation (Cr) was 0.933 and 0.937, respectively. The Kendall coordination coefficients W of importance in the second round was significantly higher than that in the first round (0.299 vs 0.172) ( P<0.001). The mean of importance score (Mj) of each index was 4.10-5.00, coefficient of variation (CV) was 0-0.235, and full mark ratio (Kj) was 0.26-1.00. Finally, an evaluation index system of the health management effects for high-risk stroke population was constructed, which included 3 first-level indicators (individual characteristics, behavior style, environmental support), 12 second-level indicators and 58 third-level indicators. Conclusions:The evaluation index system of the health management effects for high-risk stroke population is established in this study, which provides scientific quantitative indicators and evaluation tools. The enthusiasm, authority and coordination of consultation experts are strong, which indicates that the indicator system is feasible.

Tripterygium wilfordii is a valuable medicinal plant rich in biologically active diterpenoids, but there are few studies on the origins of these diterpenoids in its secondary metabolism. Here, we identified three regions containing tandemly duplicated diterpene synthase genes on chromosomes (Chr) 17 and 21 of T. wilfordii and obtained 11 diterpene synthases with different functions. We further revealed that these diterpene synthases underwent duplication and rearrangement at approximately 2.3-23.7 million years ago (MYA) by whole-genome triplication (WGT), transposon mediation, and tandem duplication, followed by functional divergence. We first demonstrated that four key amino acids in the sequences of TwCPS3, TwCPS5, and TwCPS6 were altered during evolution, leading to their functional divergence and the formation of diterpene secondary metabolites. Then, we demonstrated that the functional divergence of three TwKSLs was driven by mutations in two key amino acids. Finally, we discovered the mechanisms of evolution and pseudogenization of miltiradiene synthases in T. wilfordii and elucidated that the new function in TwMS1/2 from the terpene synthase (TPS)-b subfamily was caused by progressive changes in multiple amino acids after the WGT event. Our results provide key evidence for the formation of diverse diterpenoids during the evolution of secondary metabolites in T. wilfordii.