Objective To construct an optimal prediction model of chickenpox in Urumqi, and to provide reference for formulating the prevention and control strategies of chickenpox. Methods The multivariate autoregressive moving average model (ARIMAX) and random forest model (RF) were established based on the monthly incidence of chickenpox in Urumqi from 2014 to 2018, and the monthly incidence of chickenpox in 2019 was used to test the models and evaluate their prediction effect. The prediction performance of the two models was compared, and the best model was selected to predict the incidence of chickenpox in Urumqi. Results The incidence of chickenpox in Urumqi showed a regular bimodal distribution with obvious seasonality, and it showed a slow upward trend from July 2014 to December 2019. The fitting model was ARIMA(0,1,0)(0,1,1)₁₂, the root mean square error (RMSE) and mean absolute error (MAE) of ARIMAX model training set were 1.29 and 0.95, respectively, and the RMSE and MAE of the test set were 1.88 and 1.44, respectively. The training set RMSE and MAE of RF model were 1.56 and 1.56, respectively, and the test set RMSE and MAE were 4.83 and 3.96, respectively. Conclusion The performance of ARIMAX model is better than that of RF model, which can better predict the incidence trend of chickenpox in Urumqi. It is necessary to optimize the prediction model according to the actual situation and provide scientific guidance for the prevention and control of chickenpox.

Objective:To develop an EGFR-targeting nanobody engineered exosome drug delivery system and evaluate its antitumor efficacy for colorectal cancer.Methods:The HEK293T cell line stably expressing the pan-cancer inhibitor miR-204-5p, previously established by our group, was selected as a tool cell line to prepare miR-204-5p-enriched exosomes. Using metabolic glycoengineering combined with bioorthogonal reaction strategy, these exosomes were modified with the EGFR-specific nanobody 7D12. Western blot, electron microscopy, and dynamic light scattering were used to characterize the engineered exosomes. The tumor target potential of engineered exosomes was evaluated using immunofluorescence and RT-qPCR. The in vitro anti-tumor activities of engineered exosomes were evaluated using cell growth curves, colony formation, Transwell, and apoptosis analyses. The in vivo anti-tumor activity and safety of engineered exosomes were evaluated using a nude mouse xenograft tumor model. Results:The particle size of 7D12-hExo was (116.8±36.8) nm, with a potential of around -10 mV, and there was no significant change compared with the unmodified hExo. Immunofluorescence assay showed that the fluorescence intensity of the hExo group, 7D12-hExo group, and 7D12+7D12-hExo group were 48.4±3.9, 141.0±6.6, and 38.7±3.2 in EGFR + HCT116 cells, respectively. Compared with the hExo group, the fluorescence intensity of HCT116 cells in the 7D12-hExo group was significantly enhanced ( P＜0.05). Compared with the 7D12-hExo group, the fluorescence intensity in HCT116 cells in the 7D12+7D12-hExo group was significantly decreased ( P＜0.05). However, there was no significant difference in the uptake of hExo and 7D12-hExo in EGFR - SW620 colorectal cancer cells. The number of cell clones, invasion, and migration of HCT116 cells in the hExo (204) group was 215.0±14.0, 862.3±61.4, and 1 197.0 ± 36.7, respectively, with an apoptosis rate of (14.1±1.4)%. The number of cell clones, invasion, and migration of HCT116 cells in the 7D12-hExo (204) group was (65.0±15.1), (232.0±27.9), (725.7±32.7), respectively, with an apoptosis rate of (29.3±1.0)%. The 7D12-hExo (204) significantly inhibited the proliferation, invasion, and migration ability of HCT116 cells ( P＜0.05), resulting in promoting the apoptosis of HCT116 cells ( P＜0.05). Nude mouse experiments showed that 7D12-hExo (204) significantly inhibited the growth of tumors transplanted with HCT116 cells, with the inhibition rate being 82.8%. However, there was no significant change in mouse weight, and H&E staining of major organs such as heart, liver, spleen, lung, and kidney did not show any abnormalities. Conclusion:Naturally miR-204-5p-loaded exosomes were successfully modified with nanobody 7D12, which can efficiently deliver miR-204-5p into EGFR + tumor cells, thereby exerting good anti-tumor therapeutic effects.

Medical institutions, with their clinical practice foundation and abundant human use experience data, have become important carriers for the inheritance and innovation of traditional Chinese medicine(TCM) and the "cradles" of the preparation of new TCM. To effectively promote the transformation of new TCM originating from the TCM clinical practice in medical institutions and establish an effective evaluation index system for the transformation of new TCM conforming to the characteristics of TCM, consensus experts adopted the literature research, questionnaire survey, Delphi method, etc. By focusing on the policy and technical evaluation of new TCM originating from the TCM clinical practice in medical institutions, a comprehensive evaluation from the dimensions of drug safety, efficacy, feasibility, and characteristic advantages was conducted, thus forming a comprehensive evaluation system with four primary indicators and 37 secondary indicators. The expert consensus reached aims to encourage medical institutions at all levels to continuously improve the high-quality research and development and transformation of new TCM originating from the TCM clinical practice in medical institutions and targeted at clinical needs, so as to provide a decision-making basis for the preparation, selection, cultivation, and transformation of new TCM for medical institutions, improve the development efficiency of new TCM, and precisely respond to the public medication needs.
Medicine, Chinese Traditional/standards* ; Humans ; Consensus ; Drugs, Chinese Herbal/therapeutic use* ; Surveys and Questionnaires

Objective:To develop an EGFR-targeting nanobody engineered exosome drug delivery system and evaluate its antitumor efficacy for colorectal cancer.Methods:The HEK293T cell line stably expressing the pan-cancer inhibitor miR-204-5p, previously established by our group, was selected as a tool cell line to prepare miR-204-5p-enriched exosomes. Using metabolic glycoengineering combined with bioorthogonal reaction strategy, these exosomes were modified with the EGFR-specific nanobody 7D12. Western blot, electron microscopy, and dynamic light scattering were used to characterize the engineered exosomes. The tumor target potential of engineered exosomes was evaluated using immunofluorescence and RT-qPCR. The in vitro anti-tumor activities of engineered exosomes were evaluated using cell growth curves, colony formation, Transwell, and apoptosis analyses. The in vivo anti-tumor activity and safety of engineered exosomes were evaluated using a nude mouse xenograft tumor model. Results:The particle size of 7D12-hExo was (116.8±36.8) nm, with a potential of around -10 mV, and there was no significant change compared with the unmodified hExo. Immunofluorescence assay showed that the fluorescence intensity of the hExo group, 7D12-hExo group, and 7D12+7D12-hExo group were 48.4±3.9, 141.0±6.6, and 38.7±3.2 in EGFR + HCT116 cells, respectively. Compared with the hExo group, the fluorescence intensity of HCT116 cells in the 7D12-hExo group was significantly enhanced ( P＜0.05). Compared with the 7D12-hExo group, the fluorescence intensity in HCT116 cells in the 7D12+7D12-hExo group was significantly decreased ( P＜0.05). However, there was no significant difference in the uptake of hExo and 7D12-hExo in EGFR - SW620 colorectal cancer cells. The number of cell clones, invasion, and migration of HCT116 cells in the hExo (204) group was 215.0±14.0, 862.3±61.4, and 1 197.0 ± 36.7, respectively, with an apoptosis rate of (14.1±1.4)%. The number of cell clones, invasion, and migration of HCT116 cells in the 7D12-hExo (204) group was (65.0±15.1), (232.0±27.9), (725.7±32.7), respectively, with an apoptosis rate of (29.3±1.0)%. The 7D12-hExo (204) significantly inhibited the proliferation, invasion, and migration ability of HCT116 cells ( P＜0.05), resulting in promoting the apoptosis of HCT116 cells ( P＜0.05). Nude mouse experiments showed that 7D12-hExo (204) significantly inhibited the growth of tumors transplanted with HCT116 cells, with the inhibition rate being 82.8%. However, there was no significant change in mouse weight, and H&E staining of major organs such as heart, liver, spleen, lung, and kidney did not show any abnormalities. Conclusion:Naturally miR-204-5p-loaded exosomes were successfully modified with nanobody 7D12, which can efficiently deliver miR-204-5p into EGFR + tumor cells, thereby exerting good anti-tumor therapeutic effects.

Objective:To investigate the basic characteristics and treatment of aseptic nonunion of femoral shaft in Xi'an Red Cross Hospital from 2013 to 2020.Methods:The data were analyzed retrospectively of the patients with aseptic nonunion of femoral shaft who had been treated at Department of Orthopaedics and Trauma, Red Cross Hospital Affiliated to Medical College, Xi'an Jiaotong University from January 2013 to December 2020. The patients' data from 2013 to 2016 were assigned into group A while those from 2017 to 2020 into group B. The data like gender, age and nonunion were statistically analyzed and compared between the 2 groups.Results:A total of 311 patients with aseptic nonunion of femoral shaft were diagnosed and treated during the 8 years, accounting for 54.6% (311/570) of the femur nonunion, 32.8% (311/949) of the lower extremity nonunion, 25.0% (311/1,242) of the extremity nonunion, and 22.7% (311/1,370) of the whole body nonunion. There were 244 males and 67 females; the majority of patients were in the age group of 21 to 50 (67.2%, 209/311). The occupation distribution was the most common in farmers (49.2%, 153/311). Traffic injury was the most common cause for primary fractures (40.8%, 127/311). The most common type of injury was closed injury (89.4%, 278/311); the most common type of nonunion was atrophic nonunion (87.8%, 273/311); intramedullary nailing was the main treatment for primary fractures (54.3%, 169/311); channel osteogenesis was the main treatment for secondary nonunion (62.1%, 193/311); autologous iliac bone grafting was the most common grafting for atrophic nonunion (83.5%, 228/311). Compared with group A, the proportion of aseptic nonunion of femoral shaft in group B increased by 9.2% in the femoral nonunions, by 6.9% in the lower extremity nonunions, and by 6.0% in the extremity nonunions, and by 5.2% in the whole body nonunions, showing statistically significant differences ( P < 0.05). There were significant differences in the types of nonunion, occupational distribution, first-stage fracture treatment, second-stage nonunion treatment, and bone grafting method between the 2 groups ( P < 0.05). Conclusions:The patients with aseptic nonunion of the femoral shaft were more common in young and middle-aged male heavy manual laborers, and the condition was increasing in recent years. The channel osteogenesis technique was still the preferred treatment method in the hospital investigated.

Objective:To investigate the effects of surgical revision for humeral shaft nonunion on health-related quality of life.Methods:The data of 62 patients were studied retrospectively who had been hospitalized at Department of Orthopaedics and Traumatology, Hong-Hui Hospital for humeral shaft nonunion from March 2013 to September 2018. They were 43 males and 19 females, aged from 20 to 73 years (average, 42.3 years). Their nonunions belonged to the atrophic type in 19 cases, to the ischemic type in 14 cases and to the hypertrophic type in 29 cases. Their demographic and clinical data, imaging manifestations and treatment methods were recorded and analyzed. The 12-item short form health survey (SF-12) and brief pain inventory (BPI) were used to evaluate their health-related quality of life and the Mayo elbow performance score (MEPS) was used to evaluate their elbow function.Results:Upon admission, their physical component summary (PCS) scored 24.3±5.2, mental component summary (MCS) 26.3±3.8, brief pain inventory- severity (BPI-S) 6.5±1.9, and brief pain inventory-interference (BPI-I) 6.7±2.5. At 1-year follow-up, their PCS averaged 43.6±8.1, MCS 34.7±4.4, BPI-S 4.9±1.2, and BPI-I 4.4±1.4. There were statistically significant differences between preoperation and postoperation in the above 4 groups of indicators ( P<0.05). Their MEPS at the last follow-up revealed a 95.2% rate of excellent elbow function (59/62). By comparison with the literature data, their postoperative PCS scores were not significantly different from those for the patients with Barrentt＇s esophagus, primary hypertension, chronic obstructive pulmonary disease and silicosis ( P>0.05). There was no significant difference either in the postoperative MCS scores between them and stroke patients ( P>0.05). Conclusions:As a destructive chronic disease, humeral shaft nonunion has negative effects on physical and mental health and quality of life of the patients. Although the pain effect on the limb can be alleviated by surgical revision, the entire treatment may cause permanent psychological trauma to the patients.

Objective: To investigate the safety and effect of tranexamic acid combined with drainage tube clamping to reduce perioperative blood loss of Schatzker V and VI tibial plateau fracture. Methods: A prospective case-control study was performed on 87 patients with Schatzker V and VI tibial plateau fracture admitted from March 2018 to January 2019 in Honghui Hospital, including 53 males and 34 females, aged 24 to 69 years [(39.05±2.7)years]. All patients underwent tibial plateau reduction and internal fixation. According to the random number table method, the patients were divided into intravenous group (27 cases), articular cavity group (30 cases) and control group (30 cases). The intravenous group were given a total of 1 g of tranexamic acid intravenously 5-10 minutes before loosening the tourniquet, the joint cavity group were perfused with 1 g of tranexamic acid before closing the incision, and the control group were given the same amount of normal saline. The drainage tube was temporarily clamped for 4 hours in the three groups. Data were recorded and compared among the groups, including the surgical limb side, tourniquet use time, hemoglobin (Hb), D-dimer level, drainage, total blood loss, number of allogeneic blood transfusions, postoperative complications, and presence or absence of deep vein thrombosis (DVT) of the lower extremities at 72 hours after discharge. Results: There was no significant difference in baseline data between the three groups (P>0.05). There were no significant differences in the extremity side, tourniquet use time, and number of allogeneic blood transfusions among the three groups (P>0.05). At postoperative 24 hours, the Hb was (112.7±11.8)g/L in the intravenous group, (107.7±16.1) g/L in the articular cavity group, At (100.0±10.4) g/L in the control group. At postoperative 24 hours, the D-dimer vein was (5.5±2.9)mg/L in the intravenous group, (5.9±2.5)mg/L in the joint cavity group, and (7.5±3.6)mg/L in the control group. At postoperative 24 hours, the drainage volume was (62.8±20.5)ml in the intravenous group, (60.2±17.4)ml in the articular cavity group, and (81.2±21.1)ml in the control group. The hidden blood loss was (577.1±212.1)ml in the intravenous group, (634.2±139.8)ml in the articular cavity group, (750.3±124.1)ml in the control group. The total blood loss was (950.1±170.5)ml in the intavenous group, (1 005.4±179.8)ml in the articular cavity group, and (1 148.8±129.1)ml in the control group. The incidence of postoperative wound swelling and exudation was 1 case (4%) in the intravenous group, 0 cases in the articular cavity group, 5 cases (17%) in control group. The above indexes showed significant differences between the three groups (P<0.05 or 0.01), but there was no significant difference between the intravenous group and the articular cavity group (P>0.05). The Hb at 72 hours postoperatively, total drainage, number of allogeneic blood transfusions, lower extremity DVT and incidence of skin ecchymosis had no significant difference among the three groups(P>0.05). No pulmonary embolism occurred after the operation. Conclusions For patients with Schatzker V and VI tibial plateau fracture, tranexamic acid combined with drainage tube clamping is safe and effective when used perioperatively. Either intravenous infusion or local joint cavity injection of tranexamic acid can effectively reduce the drainage volume at 24 hours postoperatively, hidden blood loss and total blood loss without increasing the risk of postoperative DVT. Tranexamic acid can reduce the and exudation after operation.

Objective To investigate the clinical efficacy of endoscopic submucosal dissection (ESD)for the treatment of colorectal tumors, and to analyze risk factors affecting operation time. Methods A retrospective study was conducted using data of 74 cases with colorectal tumor,who underwent ESD in Department of Gastroenterology of Wuhan University Renmin Hospital from January 2014 to September 2015. The clinical efficacy of ESD, occurrence of complications and follow-up results were summarized,and the risk factors of operation time were analyzed. Results The rate of ESD en bloc resection and histological complete resection was 97.30%(72/74)and 89.19%(66/74), respectively. Among the 8 cases of histological non-curative resection, 2 cases received appended surgical procedures because of deep invasion of tumor(SM2),6 cases were given close follow-up according to the pathological result of adenomas. Among the 74 cases, no acute hemorrhage or pneumoperitoneum occurred. Four cases (5.41%, 4/74)had postoperative delayed bleeding, and were successfully treated by endoscopic hemostasis. Four cases(5.41%, 4/74)had intraoperative perforation, and were successfully treated by endoscope. No recurrence or abnormal lesions occurred during the follow-up of 15-35 months. Multivariate linear regression analysis showed that tumor size was a main risk factor for ESD operation time(P=0.000). Conclusion ESD, as a minimally invasive treatment, is safe and effective for the treatment of colorectal tumors,and the tumor size is a main risk factor of ESD operation time.

Objective To introduce the application of computer aided technology in the treatment of pelvic malunion and observe the effect of this technique on the operation.Methods Data of 9 consecutive patients with pelvic malunion who were enrolled in our hospital from January 2009 to December 2012 were retrospectively observed.There were 4 patients who had undergone surgery with computer aided technology,including 3 men and 1 woman with an average age of 34 years (computer aided technology,CAT) group.According to the Tile classification,4 cases were all type C.There were 1 case with open pelvic fractures,2 associated with the craniocerebral injury,2 associated with the thoracic injury and 2 associated with the abdomen trauma.There were 5 patients who had undergone surgery without computer aided technology,including 3 men and 2 women with an average age of 32.6 years (conventional group).According to the Tile classification,4 cases were all type C.There were 1 case with open pelvic fractures,2 associated with the craniocerebral injury,3 associated with the thoracic injury and 1 associated with the abdomen trauma.The Majeed score,the visual analogue score (VAS),operation time,blood loss,blood transfusion,intraoperative fluoroscopy,degree of improvement in lower limb length,iatrogenic injury and the complication were all recorded respectively.Results For the CAT group,the operation time was 195-230 min,the blood loss was 800-1 6 00 ml,the blood transfusion was 6-16 U,intraoperative fluoroscopy was 6-11 times and the degree of improvement in lower limb length was 2-3 cm.The Majeed score in the final follow-up was 78-90 points,including 3 excellent cases and 1 good.The VAS after surgery was 0-4 points.For the conventional group,the operation time was 210-330 min,the blood loss was 600-4 500 ml,the blood transfusion was 6-28 U,intraoperative fluoroscopy was 7-18 times and the degree of improvement in lower limb length was 1-3 cm.The Majeed score in the final follow-up was 79-89 points,including 3 excellent cases and 2 good.The VAS after surgery was 1-4 points.Conclusion Surgeons can make full preoperative planning by the computer aided technology before the operation.This technology which reduces the operation time can make the operation more accurately,effectively and safely.

Antiviral Agents ; therapeutic use ; Chemoprevention ; Hepatitis B ; prevention & control ; Hepatitis C ; prevention & control ; Humans ; Interferon-alpha ; therapeutic use ; Lamivudine ; therapeutic use ; Liver Transplantation ; pathology ; Ribavirin ; therapeutic use ; Secondary Prevention