Objective To observe the efficacy and safety of ultrasound-guided musculocutaneous nerve(MCN)block anesthesia in alleviating operative pain during percutaneous transluminal angioplasty(PTA)for hemodialysis internal fistula.Methods A total of 112 patients undergoing internal fistula PTA in the hemodi-alysis center of the nephrologic department of the Second Affiliated Hospital of Army Military Medical Uni-versity from February 2022 to February 2023 were selected.Among them,47 patients applied the ultrasound-guided MCN block anesthesia(MCN block group)and other 65 patients adopted perivascular local infiltration anesthesia in the injured blood vessel section(local anesthesia group).Anesthesia was independently operated by the vascular access doctor.The VAS score,analgesic satisfaction investigation and motor block evaluation were compared between the two groups,and the efficacy and safety of MCN block anesthesia were under-stood.Results The proportion of the patients with motor block score grade 1 in the MCN block group was the highest(93.6％),and there were no patients with the grade ≥3.The proportion of the patients with the VAS score(4-6)points in the local anesthesia group was the highest(52.3％),while the proportion of the patients with the VAS score(1-3)points in the MCN block group was the highest(76.6％);the proportions of(1-3)points,(4-6)points,(7-10)points and the patients with additional anesthesia had statistical differences between the MCN block group and local anesthesia group(P＜0.05).The satisfaction degree of postoperative analgesia in the local anesthesia group was 55.4％,which was lower than 85.1％in the MCN block group,and the difference was statistically significant(P＜0.05).Conclusion The upper arm MCN block anesthesia could effectively relief the operative pain in arteriovenous internal fistula PTA,and is an effective anesthesia method suitable for the independent operation of hemodialysis channel surgeons.

Entinostat plus exemestane in hormone receptor-positive (HR+) advanced breast cancer (ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized (2:1) to oral exemestane 25 mg/day plus entinostat (n = 235) or placebo (n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic committee (IRC)-assessed progression-free survival (PFS). The median age was 52 (range, 28-75) years and 222 (62.7%) patients were postmenopausal. CDK4/6 inhibitors and fulvestrant were previously used in 23 (6.5%) and 92 (26.0%) patients, respectively. The baseline characteristics were comparable between the entinostat and placebo groups. The median PFS was 6.32 (95% CI, 5.30-9.11) and 3.72 (95% CI, 1.91-5.49) months in the entinostat and placebo groups (HR, 0.76; 95% CI, 0.58-0.98; P = 0.046), respectively. Grade ≥3 adverse events (AEs) occurred in 154 (65.5%) patients in the entinostat group versus 23 (19.3%) in the placebo group, and the most common grade ≥3 treatment-related AEs were neutropenia [103 (43.8%)], thrombocytopenia [20 (8.5%)], and leucopenia [15 (6.4%)]. Entinostat plus exemestane significantly improved PFS compared with exemestane, with generally manageable toxicities in HR + ABC (ClinicalTrials.gov #NCT03538171).

Adolescent ; Adult ; Beijing/epidemiology* ; Contact Tracing ; Female ; Humans ; Male ; Prevalence ; Tuberculosis/transmission* ; Universities ; Young Adult

Objective: Using data of health information system (HIS) of medical institutions to study the incidence and hospitalization of herpes zoster in three districts of Beijing. Methods: According to the different level of economic development and geographical features in Beijing, 3 districts of Xicheng, Changping and Miyun were chosen and all 110 medical institutions of the first level and above in the 3 districts are included in the survey. All the outpatient and inpatient herpes zoster cases in 2015 were retrospectively reviewed by HIS system. After distinguishing the reduplicated cases, Using the first outpatient case as a molecule and the resident population as denominator to estimate the annual incidence rate, as well as the annual hospitalization rate was estimated based on primary diagnostic hospitalized cases as molecule and the resident population as denominator. Results: A total of 32 313 primary visit outpatient cases were investigated, of which 18 360 cases (56.8%) were women and 20 923 cases (64.8%) were ≥50 years old. The overall estimated incidence of the 3 districts was 8.8‰ with an increase trends with age and reached to the highest in ≥80 years old (30.5/1 000). The incidence of Xicheng, Changping and Miyun districts are respectively 16.2‰, 4.0‰ and 5.7‰. A total of 701 primary visit inpatient cases were identified, of which 366 cases (52.2%) were women and 651 cases (92.9%) were ≥50 years old. The estimated annual hospitalization rate was 19.4/100 000, with the primary and secondary diagnostic hospitalization rate are respectively 5.9/100 000 (212 cases) and 13.5/100 000 (489 cases). The disease types of secondary diagnostic inpatient herpes zoster cases were as follows: cardiovascular disease (19.0%, 93 cases), stroke (14.5%, 71 cases), pneumonia/chronic obstructive pulmonary disease (14.1%, 69 cases), tumor (12.5%, 61 cases) and diabetes (5.7%, 28 cases). Conclusion Most of the herpes zoster cases in Beijing are over 50 years old, and the incidence of female is slightly higher than male. This disease should become a public health issue of great concern.

The air quality of simulated moxibustion clinic was tested, which could provide references for the evaluation on air pollution in moxibustion clinic. After the clinical environment of moxibustion was established,the contents of CO,NO, PM 10 and PM 2.5 in the air at 5 different time points (0.5 h, 1 h and 2 h after 10 moxa sticks were ignited as well as 5 min ventilation after 0.5 h moxibustion burning and 5 min ventilation after 1 h moxibustion burning) were measured by testing organizations.0.5 h, 1 h and 2 h after 10 moxa sticks were ignited, the content ranges of CO,NO, PM 10 and PM 2.5 in the air were 15.9 to 37.0 mg/m,0.012 6 to 0.022 4 mg/m,0.22 to 1.28 mg/mand 0.13 to 0.53 mg/m, respectively; the contents of CO, PM 10 and PM 2.5 were higher than national standard. With 5 min ventilation after 0.5 h moxibustion burning and 5 min ventilation after 1 h moxibustion burning, the content ranges of CO,NO,PM 10 and PM 2.5 were 0.3 to 0.4 mg/m,0.015 5 to 0.018 0 mg/m,0.11 to 0.13 mg/mand 0.04 mg/m, respectively; the contents of CO, PM 10 and PM 2.5 were lower than national standard. It is concluded that long-time moxibustion could cause relatively high concentration of moxa smoke, and the contents of CO, PM 10 and PM 2.5 in the air will exceed the national standard. However, by keeping good ventilation, the contents of CO,NO,PM 10 and PM 2.5 in the air can be controlled within safe ranges.

OBJECTIVE: To explore the role of calpain in pulmonary vascular remodeling in hypoxia-induced pulmonary hypertension and the underlying mechanisms.
 METHODS: Sprague-Dawley rats were randomly divided into the hypoxia group and the normoxia control group. Right ventricular systolic pressure (RVSP) and mean pulmonary artery pressure (mPAP) were monitored by a method with right external jugular vein cannula. Right ventricular hypertrophy index was presented as the ratio of right ventricular weight to left ventricular weight (left ventricle plus septum weight). Levels of calpain-1, -2 and -4 mRNA in pulmonary artery were determined by real-time PCR. Levels of calpain-1, -2 and -4 protein were determined by Western blot. Primary rat pulmonary arterial smooth muscle cells (PASMCs) were divided into 4 groups: a normoxia control group, a normoxia+MDL28170 group, a hypoxia group and a hypoxia+MDL28170 group. Cell proliferation was detected by MTS and flow cytometry. Levels of Ki-67 and proliferating cell nuclear antigen (PCNA) mRNA were determined by real-time PCR.
 RESULTS: RVSP, mPAP and right ventricular remodeling index were significantly elevated in the hypoxia group compared to those in the normoxia group. In the hypoxia group, pulmonary vascular remodeling was significantly developed, accompanied by up-regulation of calpain-1, -2 and -4. MDL28170 significantly inhibited hypoxia-induced proliferation of PASMCs concomitant with the suppression of Ki-67 and PCNA mRNA expression.
 CONCLUSION Calpain mediates vascular remodeling via promoting proliferation of PASMCs in hypoxia-induced pulmonary hypertension.
Animals ; Calpain ; genetics ; physiology ; Cell Proliferation ; Dipeptides ; physiology ; Hypertension, Pulmonary ; chemically induced ; genetics ; physiopathology ; Hypertrophy, Right Ventricular ; Hypoxia ; Ki-67 Antigen ; drug effects ; Myocytes, Smooth Muscle ; physiology ; Proliferating Cell Nuclear Antigen ; drug effects ; Pulmonary Artery ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Up-Regulation ; Vascular Remodeling ; genetics ; physiology

ObjectiveTo evaluate the clinical effect of holmium laser lithotripsy combined with fiber choledochoscope in the treatment of intra- and extra-hepatolithiasis. MethodsSixty-four patients who were diagnosed with intra- and extra-hepatolithiasis in our hospital from January 2012 to July 2014 were assigned to receive fiber choledochoscope treatment (33 cases) or holmium laser lithotripsy combined with fiber choledochoscope (31 cases). The one-time stone removal rate and incidence of complications were compared between the two groups. Comparison of categorical data was made by chi-square test, while comparison of continuous data was made by t test. ResultsThe fiber choledochoscope group had a significantly lower one-time stone removal rate and a significantly higher incidence of complications compared with the combination therapy group (72.73% (24/33) vs 93.55% (29/31), χ2=4.868, P=0.027; 21.21%(7/33) vs 323%(1/31), χ2=4.728, P=0.030). ConclusionHolmium laser combined with fiber choledochoscope can effectively increase the one-time stone removal rate and reduce the incidence of complications in patients with intra- and extra-hepatolithiasis. This therapy holds promise for clinical application.

Objective To discuss the antigenic change caused by the mutation of amino acid on the epitopes of the hemagglutinin of measles virus.Methods The B cell linear epitopes in the hemagglutinin were predicted with bioinformatics software.Peptide pairs,which located on the same region but originated from measles vaccine and wild-type virus respectively,were designed and synthesized.After detecting the immunogenicity of peptides with indirect ELISA assay,sera against each peptide was prepared.Antigenic specificity between the two peptides within each peptide pair were tested by using cross ELISA assay,and then antigen ratios were calculated.Results All the synthesized peptides could bind with immune sera against measles virus,of which the peptide pair CW23/CW22 designed on the epitope region (273-282 aa) possessed the highest binding ability,while the peptide pair CW150/CW151 designed on the non-epitope region (418-427 aa) showed the lowest binding ability.The difference in antigenic specificity between the two peptides from different sources was significant.The antigenic ratio was up to 16 between CW23 (vaccine-originated) and CW22 (wild-type originated),and 2.877 ± 0.583 between CW123 (vaccine-originated) and CW124 (wild-type originated) (236-246 aa).On the non-epitope regions,the antigenic ratios was only 1.631 ± 0.481 between peptide pair CW125 and CW126(356-364 aa),but reached to 10.367± 1.617 between CW150 and CW151.Conclusion Although there were several conservative epitopes,specific amino acid mutation on the predicted epitope or non-epitope regions might cause the antigenic change of wild-type measles virus.

Objective To study the effect of Jiaweiyunvjian on periodontitis in the old.Methods A total of 180 periodontitis patients were randomly recruited into a treatment group and a control group,90 patients in each.The control group was treated with calculus removal and oral metronidazole,while the treatment group was treated with Jiaweiyunvjian on the basis ofthe control group.After both groups were treated for 7 days,therapeutic effects were observed.Results The total effective rate was 90.4%and 73.3%in the treatment group in the control group respectively.There was significant diffefence (P<0.01).In the 6-month follow-up,there were 7 cases(7.4%)relapsed in the treatment group and 16 cases(18.6%)relapsed in the control group,also showing significant difference(P<0.05).Conclusion Jiaweiyunvjian has curative effects on periodontitis of the old people.

Objective To observe the effects of Shuangliao Houfeng Powder on complications of dental extraction .Methods 280 patients who need dental extraction were recruited into a treatment group and a control group. The treatment group was applied with Shuangliao Houfeng Powder externally on alveolus dentalis after dental extraction, while the control group received no post-treatment after dental extraction. Wound healing and incidence of complications were observed after three days. Results Wound healing in stage 1 showed better results in the treatment group than the control group (P<0.05). Postoperative bleeding time of the treatment group was significantly shorter than the control group (P<0.01) . Besides the treatment group got better improvements in such symptoms as gingival swelling, pain, and difficulty in mouth opening than the control group (P< 0.05). Conclusion Shuangliao Houfeng Powder is effective on complications of dental extraction and worthy of promotion in clinic.