OBJECTIVETo study the classification and individualized treatment of the terminal phalanx of thumb duplication.

METHODSFrom Apr. 2003 to Dec. 2012, 76 patients with 77 involved thumbs duplication at the level which is distal to the interphalangeal joint were retrospectively studied. Based on the morphology (the nail width and the thumb circumference) and the deviation of the thumb, we classified the terminal phalanx of thumb duplication into 5 types as Type A (no bony connection called floating thumb), Type B(asymmetry and no deviation), Type C(asymmetry and deviation), Type D (symmetry and no deviation) and Type E(symmetry and deviation). Different surgical procedures were selected according to different types. Simple excision of the smaller thumb was adopted for Type A case. Removement of the smaller thumb (usually the radial) and of the collateral ligament of the interphalangeal joint were selected for Type B. Removement of the smaller thumb (usually the radial) and reconstruction of the collateral ligament of the interphalangeal joint, as well as corrective osteotomies at the neck of the proximal phalanx were performed for Type C. The modified Bilhaut-Cloquet procedure with reconstruction of the collateral ligament of the interphalangeal joint were adopted in Type D. The classical Bilhaut-Cloquet procedure, or the modified Bilhaut-Cloquet procedure with reconstruction of the collateral ligament of the interphalangeal joint and corrective osteotomies at the neck of the proximal phalanx were performed in Type E. The results were assessed by an evaluation form for thumb duplication by the Japanese Society for Surgery of the Hand.

RESULTSAccording to our new classification standard, there were 3 cases with Type A duplicated thumbs, 36 with Type B, 13 with Type C, 15 with Type D, 10 with Type E. All the 76 patients underwent the individualized surgical treatment. The patients were followed up for 6-60 months. According to the evaluation form, excellent results were achieved in 66 thumbs, good in 9 thumbs and fair in 2 thumbs.

CONCLUSIONSThe new classification could comprehensively describe the clinical features of the terminal phalanx of congenital thumb duplication. Individualized therapy, including basic and repeated surgical procedure could be adopted for each type with satisfactory results.

Child ; Collateral Ligaments ; surgery ; Finger Phalanges ; surgery ; Humans ; Orthopedic Procedures ; methods ; Osteotomy ; methods ; Polydactyly ; classification ; surgery ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Thumb ; abnormalities

Objective To clarify the role and significance of Toll?like receptor 4(TLR4)in myocardial damage following paraquat(PQ)poisoning in mice. Methods Male wild type C57BL/6J mice(WT)and male TLR4 deficient mice(TLR4?ko)were divided into four groups in the study:(1)control group(WT mice,n=6);(2)TLR4?ko group(TLR4?ko mice,n=6);(3)WT+PQ group(WT mice,n=30);(4)TLR4?ko+PQ group (TLR4?ko mice,n=30). The mice in group 1 and group 2 were injected intraperitoneally with saline;mice in group 3 and group 4 were injected in?traperitoneally with 75 mg/kg of PQ. At 2 h,4 h,8 h,16 h and 24 h after PQ administration,6 mice of WT+PQ group and TLR4?ko+PQ group were euthanized and the heart tissue specimens were harvested. All the specimens were analysed by histology,while the expression of TLR4 mRNA was only detected in samples of WT+PQ mice. The specimens at 2 h,8 h and 24 h after PQ administration were used for cytokines detection for WT+PQ group and TLR4?ko+PQ group;in addition,Western blot analysis was performed for WT+PQ group. At 8 h after treatment,control mice and TLR4?ko mice were euthanized by the same method. Mice were anesthetized for cardiac geometry and functional assessment using a 2?D guide M?mode echocardiography at 8 h following injection of either PQ or saline. Results During myocardial damage due to PQ exposure in WT+PQ mice,obvious histopathological changes were observed,as well as a noticeable decrease of heart function and increased expressions of TNF?αand IL?1β. Compared with the WT mice,TNF?αand IL?1βprotein levels,changes in heart function and histopathological changes were significantly attenuated following PQ exposure in myocardial damage in TLR4?ko mice. Conclusion The TLR4gene is involved with in heart functional injury and histopathological changes in myocardial damage following PQ poisoning in mice,which may through the regulation of TNF?αand IL?1βexpression. Our findings indi?cate that TLR4 plays an important role in mediating myocardial injury due to PQ.

Objective To prepare an egg yolk antibody ( IgY) against the recombinant human A rotavirus VP8 and evaluate its biological characteristics .Methods The complete VP4 gene was used as the template to clone VP8 DNA fragment by PCR .The VP8 gene was then cloned into the vector pET 28a for ex-pression of VP8 protein in the prokaryotic system.The expression plasmid of pET28a-VP8,identified by DNA sequencing,was transformed into E.coli BL21 to induce the expression of protein by 0.5 mmol/L IPTG at 30℃.The purified and refolded recombinant VP 8 protein was used to immunize laying hens in combination with complete Freund′s adjuvant ( CFA ) .Anti-VP8 IgY antibodies were extracted from egg yolks by using water dilution-ultrafiltration assay and were further analyzed by SDS-PAGE,ELISA,Western blot and Dot blot assay,respectively.Results The recombinant VP8 protein was expressed in E.coli BL21 as an inclusion body and its molecular weight was about 35 ×10 3 .The VP8 protein was well refolded in a buffer containing Tris-HCl (pH8.0).The isolated anti-VP8 IgY antibodies showed a high titer of 1∶100 000 and a high stabil-ity under the condition of pH3-11 and temperature 25-65℃.Moreover,the anti-VP8 IgY antibodies specific-ally recognized the wild type human A rotavirus .Conclusion The prepared anti-VP8 IgY antibodies showed the advantages of high titer ,good specificity and stability .It might be used as the tool in further investigation for the prevention and treatment of diarrhea caused by human A rotavirus .

We describe an interactive viewer for the All-Species Living Tree (LVTree). The viewer incorporates treeing and lineage information from the ARB-SILVA website. It allows collapsing the tree branches at different taxonomic ranks and expanding the collapsed branches as well, keeping the overall topology of the tree unchanged. It also enables the user to observe the consequence of trial lineage modifications by re-collapsing the tree. The system reports taxon statistics at all ranks automatically after each collapsing and re-collapsing. These features greatly facilitate the compar-ison of the 16S rRNA sequence phylogeny with prokaryotic taxonomy in a taxon by taxon manner. In view of the fact that the present prokaryotic systematics is largely based on 16S rRNA sequence analysis, the current viewer may help reveal discrepancies between phylogeny and taxonomy. As an application, we show that in the latest release of LVTree, based on 11,939 rRNA sequences, as few as 24 lineage modifications are enough to bring all but two phyla (Proteobacteria and Firmicutes) to monophyletic clusters.

The Chinese Guidelines on Diagnosis and Management of Atrial Fibrillation, jointly formulated by the Chinese Society of Cardiology, Chinese Medical Association and the Heart Rhythm Committee of Chinese Society of Biomedical Engineering, was first released on June 15, 2023. The guidelines elaborate the various aspects of atrial fibrillation management, in which emergency management of atrial fibrillation is also an integral part. This article interpreted the emergency management part in the guidelines in detail by reviewing relevant literature.

The World Health Organization (WHO) released the WHO 2020 guidelines on physical activity and sedentary behaviour in November 2020. Compared with the 2010 WHO guidelines, this guideline has incorporated more extensive medical evidence and made targeted recommendations for special populations. The main content includes physical activity and sedentary behaviour advice for children and adolescents, adults, older adults, pregnant and postpartum women, people with chronic conditions, and disability. This review will interpret the 2020 WHO guidelines in detail.

ObjectiveTo analyze the production of Poria in 5 major producing areas and the problems through field investigation and literature review and thus to lay a foundation for healthy development of Poria industry. MethodEach production process of Poria in Anhui， Hubei， Hunan， Yunnan， and Sichuan was probed and related research was retrieved for the analysis. ResultSichuan， Guangxi， Guizhou， and other areas have been the emerging producers of Poria. However， a few Poria cocos lines were used and the variety breeding lagged behind. Different cultivation techniques were adopted in different production areas. For example， the "induction" method failed to be widely used. Moreover， the harvest time was mainly dependent on the market demand not matter it was suitable or not. Furthermore， steaming has replaced the traditional diaphoretic processing in the processing of this medicinal material in production areas. In addition， fumigation with sulphur was still used in the processing of Poria. ConclusionAn excellent variety is the key to the quality of Poria. Efforts should be made to strengthen the evaluation of the germplasm resources of P. cocos and variety breeding and standardize the processing in production areas， thereby ensuring the safety and effectiveness of Poria and the decoction pieces. In addition， the contradiction between artificial cultivation and woodland ecology should be fully coordinated to ensure the sustainable development of Poria industry in China.

ObjectiveTo study the accumulation and absorption of dry matter and nutrients in Curcuma phaeocaulis from Sichuan， the origin of Curcumae Radix （tuber） and Curcumae Rhizoma （rhizome）， to explore the growth and development laws and nutrient demand characteristics of the medicinal species， and thus to lay a theoretical basis for rational fertilization. MethodThe plant growth indexes， dry matter accumulation， and nutrient content of C. phaeocaulis at different growth stages in Sichuan were measured and analyzed. ResultThis medicinal species featured the dominant growth of aboveground leaves and stems before October and growth of underground part （particularly the rhizomes and tubers） from October. During the whole growth period， the accumulation of nitrogen， phosphorus， potassium， calcium， magnesium， iron， manganese， zinc， and copper per plant was 2 450.31， 907.09， 3 171.18， 625.94， 493.38， 14.53， 2.24 ， 2.93， 0.46 mg， respectively， with the order of potassium > nitrogen > phosphorus > calcium > magnesium > iron > zinc > manganese > copper. ConclusionThe species needs sufficient potassium and nitrogen， appropriate amount of phosphorus， calcium， and magnesium， a small amount of iron， and very little zinc， manganese， and copper for growth， and potassium is particularly important. Nitrogen， phosphorus， and potassium fertilizers supply macroelements and nitrogen fertilizer should be supplemented at seedling stage， leafy stage， early rhizome expansion stage， tuber expansion stage， and the second expansion stage of rhizome. Phosphorus and potassium fertilizers should be applied at seedling stage， tuber expansion stage， secondary expansion stage of rhizome， and dry matter accumulation stage of tuber and rhizome. At seedling stage， leafy stage， early rhizome expansion stage， tuber expansion stage， and the second expansion stage of rhizome， a variety of medium and trace elements-containing foliar fertilizers should be used.

ObjectiveHigh performance liquid chromatography （HPLC） was used to establish the specific chromatograms of Aurantii Fructus from different origins， and the quality variability of Aurantii Fructus from Sichuan was analyzed and evaluated by combining entropy weighting method and grey correlation method. MethodHPLC was performed on an Agilent Eclipse Plus C₁₈ column （4.6 mm×250 mm， 5 μm） with a gradient elution of methanol （A）-0.1% phosphoric acid aqueous solution as the mobile phase （0-12 min， 25%-33%A； 12-21 min， 33%-41%A； 21-30 min， 41%-42%A； 30-40 min， 42%-59%A； 40-53 min， 59%-72%A； 53-60 min， 72%A； 60-65 min， 72%-100%A； 65-70 min， 100%A； 70~71 min， 100%-25%A； 71-80 min， 25% A） at a flow rate of 1.0 mL·min^-1， the injection volume was 10 μL and the detection wavelength was 330 nm. Fifty batches of Aurantii Fructus samples from different origins （Sichuan， Chongqing， Jiangxi and Hunan） were tested， and the similarity evaluation software is used to generate characteristic profiles and compare them with control profile for peak identification， and then to evaluate the similarity of the samples. IBM SPSS 19.0 and SIMCA 14.1 were used to perform multivariate statistical analysis on the results of the samples， and then the entropy weighting method and grey correlation were used to calculate the overall quality score of samples from Sichuan. ResultHPLC specific chromatogram of Aurantii Fructus was established， and 14 common peaks were identified as eriocitrin， neoeriocitrin， narirutin， naringin， hesperidin， neohesperidin， meranzin hydrate， poncirin， meranzin， marmin， nobiletin， 3，3′，4′，5，6，7，8-heptamethoxyflavone， tangeretin and auraptene. And the similarities between the samples from Sichuan and the control chromatogram were all above 0.980. The samples could be classified into four categories according to their main origins by chemical pattern recognition， and the results of cluster analysis， principal component analysis and orthogonal partial least squares-discriminant analysis were all able to discriminate the samples of different main origins effectively. The comprehensive evaluation results of entropy weighting method combined with grey correlation showed that the quality of Aurantii Fructus from Sichuan varied greatly among different origins， and the quality of Aurantii Fructus from Sichuan was ranked as Bazhong>Luzhou>Chongqing>Neijiang. ConclusionIn this study， the characteristic mapping of Aurantii Fructus from Sichuan is established， and combined with the analytical methods of chemometrics and grey correlation， the quality of samples from different origins can be effectively differentiated， which can provide a reference for the comprehensive evaluation and control of the quality of Aurantii Fructus from Sichuan.

Objective    To analyze prognostic ability of inflammation-based Glasgow prognostic score (GPS) in patients with ST-segment elevation myocardial infarction (STEMI). Methods    We retrospectively analyzed the clinical data of 289 patients with STEMI admitted to the Department of Emergency in West China Hospital from April 2015 to January 2016. All study subjects were divided into three groups: a group of GPS 0 (190 patients including 150 males and 40 females aged 62.63±12.98 years), a group of GPS 1 (78 patients including 58 males and 20 females aged 66.57±15.25 years), and a group of GPS 2 (21 patients including 16 males and 5 females aged 70.95±9.58 years). Cox regression analysis was conducted to analyze the independent risk factors of predicting long-term mortality of patients with STEMI. Results    There was a statistical difference in long-term mortality (9.5% vs. 23.1% vs. 61.9%, P<0.001) and in-hospital mortality (3.7% vs. 7.7% vs. 23.8%, P<0.001) among the three groups. The Global Registry of Acute Coronary Events (GRACE) scores and Gensini scores increased in patients with higher GPS scores, and the differences were statistically different (P<0.001). Multivariable Cox regression analysis showed that the GPS was independently associated with STEMI long-term all-cause mortality (1 vs. 0, HR: 2.212, P=0.037; 2 vs. 0, HR: 8.286, P<0.001). Conclusion    GPS score is helpful in predicting the long-term and in-hospital prognosis of STEMI patients, and thus may guide clinical precise intervention by early risk stratification.