In recent years,the development of acupuncture and moxibustion(shortened as acup-moxibustion)has flourished.With the verification of clinical efficacy of acup-moxibustion,its basic research has gradually drawn the attention of the practitioners accordingly.But how to scientifically perform the basic research of acup-moxibustion and to serve the clinic effectively has become a major problem for the contemporary Chinese medicine practitioners.By analyzing the characteristics of acup-moxibustion-related research projects funded by the National Natural Science Foundation of China,this paper outlined the current status of domestic research of acup-moxibustion,and proposed four suggestions after analyzing the problems and weaknesses of acup-moxibustion basic research in China:①the clinical evidence-based system in the current acup-moxibustion should be further constructed and the basic research should be focused on the area of advantages;② the key problems of acup-moxibustion basic research should be clarified,and the proportion of original researches should be increased;③ the integration of production,teaching and research of acup-moxibustion should be enhanced to adapt to the era of big science;④ the funding system and its polity and structure needed to be reformed.This study will help to increase the discipline ranking of acup-moxibustion,enhance its high-quality development,and promote its internationalization.

AIM: To evaluate the efficacy and safety of different Conbercept treatment on diabetic macular edema(DME)with 3+PRN and 5+PRN.METHODS: Retrospective case-control study. A total of 51 patients(92 eyes)with DME who were treated in our hospital during December 2019 and June 2020 were included, and they were divided into 3+PRN group with 26 cases(48 eyes)and 5+PRN group with 25 cases(44 eyes). All patients received monthly follow-up for 12mo and the changes of best-corrected visual acuity(BCVA)and central macular thickness(CMT), the number of intravitreal injections and the occurrence of complications were compared and observed in the two groups.RESULTS:After follow-up for 12mo, there was no difference in the average injection times between the 3+PRN group and the 5+PRN group(7.24±0.91 times vs. 7.56±1.04 times, P=0.117). The BCVA and CMT of the two groups improved at 3, 6, 9, and 12mo after treatment compared with those before treatment(all P<0.05), and the BCVA and CMT of the 5+PRN group were better than those of the 3+PRN group at 6, 9, and 12mo after treatment(all P<0.05). During the follow-up period, no serious adverse events occurred in the two groups of patients, and the total incidence of ocular adverse events in the two groups was 27%. All adverse events were improved after symptomatic treatment.CONCLUSION: Both the 3+PRN and 5+PRN treatment strategy of Conbercept can treat DME safely and effectively, the total times of injection were comparable. However, the BCVA and CMT improved more in the 5+PRN group than that in 3+PRN group.

ObjectiveTo explore the occurrence， in vitro culture effect and clinical outcomes of embryo contamination during in vitro fertilization and embryo transfer （IVF-ET） cycles. MethodsA retrospective analysis was made on the embryo contamination cases during IVF-ET treatment at Reproductive Medicine Centre， Department of Obstetrics and Gynecology， Sun Yat-sen Memorial Hospital， Sun Yat-sen University from January 2010 to December 2020. We compared the contamination of 4 different insemination methods， contamination on 3 different in vitro culture days （D1， D2， D3） and contamination of 3 different samples （follicular fluid， semen and culture medium）. The source of contamination and types of microbes were identified. We also compared in vitro culture and clinical outcomes between two groups （42 cases of all embryos contaminated and 28 cases of partial embryos contaminated）. ResultsAmong the 29 583 cycles examined， 70 cycles had microbial contamination （0.24%）， and all contaminated embryos were from in vitro fertilization （IVF） source rather than intracytoplasmic sperm injection （ICSI） source. The contamination rate on D2 was the highest （54.3%）， followed by those on D1 （32.9%） and D3 （12.9%）. Compared with follicular fluid， semen is the most common source of contamination from D1-D3. The most common contaminants identified was Enterococcus faecalis in follicular fluid （18.0%）， while it was Escherichia coli in semen （59.6%） and culture medium （66.7%）. Moreover， the types of bacteria in culture medium were not consistent with those in follicular fluid and semen in 5 cases of microbial contamination. Compared with the Total contaminated group， the Partial contaminated group showed a significant decrease in No available embryo rates （6/28 vs. 34/42， 21.4% vs. 81.0%， P<0.001） and a rising trend in formation of blastocyst rates （5/12 vs. 2/7， 41.2% vs. 28.6%， P=0.656）， meanwhile， the clinical pregnancy cases and live births cases after transplantation of fresh and frozen-thawed cycles in Partial contaminated group were higher than those in the Total contaminated group. ConclusionICSI can effectively reduce embryo contamination. Embryo contamination mainly occurred on D2 in vitro culture and the most common contamination source is Escherichia coli in semen. Partial embryo contamination may still result in good in vitro culture effect and clinical outcomes during IVF-ET cycles.

Adult ; COVID-19/virology* ; China ; Cross Infection/virology* ; Epidemics ; Female ; Health Personnel/statistics & numerical data* ; Hospitals/statistics & numerical data* ; Hospitals, Isolation/statistics & numerical data* ; Humans ; Male ; Multiple Pulmonary Nodules/diagnostic imaging* ; Retrospective Studies ; SARS-CoV-2/physiology* ; Tomography, X-Ray Computed ; Young Adult

Objective: To elucidate the possible role of human lysozyme-like protein 4 (LYZL4) in fertilization and characterize its enzymatic properties. METHODS: The localization of LYZL4 in human spermatozoa was investigated by immunofluorescence staining, the sources of LYZL4 on the sperm surface examined by RT-PCR, and the role of LYZL4 in fertilization assessed by the zona-free hamster egg penetration test. The recombinant plasmid pPIC9K-LYZL4 was constructed and its expression induced with methanol after transformed into competent Pichia pastoris GS115. The recombinant LYZL4 protein (rLYZL4) was purified from the fermentation supernatant and subsequently identified by Western blot. The hyaluronan binding ability of rLYZL4 was determined by ELISA and the muramidase activity, hyaluronidase activity, and free radical scavenging ability examined by spectrophotometric methods. RESULTS: Immunodetection with a specific antiserum localized LYZL4 on the acrosomal membrane of mature spermatozoa, which was exclusively secreted from the testis and epididymis as shown by RT-PCR. Immunoneutralization of LYZL4 significantly decreased the number of human spermatozoa bound to zona-free hamster eggs in a dose-dependent manner in vitro. The recombinant protein was expressed successfully by the P. pastoris strain GS115. Purified rLYZL4 exhibited a potent hyaluronan binding ability and a strong free radical scavenging ability but no muramidase or hyaluronidase activity. CONCLUSIONS LYZL4 secreted from the testis and epididymis is localized on the acrosomal membrane of mature spermatozoa and plays a role in sperm-egg binding as well as in binding hyaluronan and scavenging free radicals, which suggests that it might be a multi-functional molecule contributive to sperm protection and sperm-egg binding.
Acrosome ; enzymology ; Animals ; Blotting, Western ; Cricetinae ; Enzyme-Linked Immunosorbent Assay ; Epididymis ; Female ; Fertilization ; physiology ; Free Radical Scavengers ; metabolism ; Humans ; Hyaluronic Acid ; metabolism ; Male ; Muramidase ; analysis ; physiology ; Pichia ; Plasmids ; metabolism ; Recombinant Proteins ; analysis ; metabolism ; Sperm-Ovum Interactions ; physiology ; Spermatozoa ; enzymology ; Testis

To treat respiratory distress syndrome, surfactant is currently delivered via less invasive surfactant administration (LISA) or INtubation SURfactant Extubation (INSURE). The aim of this study was to compare the effect of the two delivery methods of surfactant on cerebral autoregulation. Near infrared spectroscopy monitoring was carried out to detect cerebral oxygen saturation (ScO), and the mean arterial blood pressure (MABP) was simultaneously recorded. Of 44 preterm infants included, the surfactant was administrated to 22 via LISA and 22 via INSURE. The clinical characteristics, treatments and outcomes of the infants showed no significant differences between the two groups. The correlation coefficient of ScOand MABP (r) 5 min before administration was similar in the two groups. During surfactant administration, rincreased in both groups (0.44±0.10 to 0.54±0.12 in LISA, 0.45±0.11 to 0.69±0.09 in INSURE). In the first and second 5 min after instillation, rwas not significantly different from baseline in the LISA group, but increased in the first 5 min after instillation (0.59±0.13, P=0.000 compared with the baseline in the same group) and recovered in the second 5 min after instillation (0.48±0.10, P=0.321) in the INSURE group. There were significant differences in the change rates of rbetween the two groups during and after surfactant administration. Our results suggest that cerebral autoregulation may be affected transiently by surfactant administration. The effect duration of LISA is shorter than that of INSURE (<5 min in LISA vs. 5-10 min in INSURE).
Administration, Intranasal ; adverse effects ; Brain ; metabolism ; Female ; Homeostasis ; Humans ; Infant, Newborn ; Infant, Premature ; Intubation ; adverse effects ; Male ; Oxygen Consumption ; Pulmonary Surfactants ; administration & dosage ; therapeutic use ; Respiratory Distress Syndrome, Newborn ; drug therapy ; therapy

BACKGROUNDOld pelvis fractures are among the most challenging fractures to treat because of their complex anatomy, difficult-to-access surgical sites, and the relatively low incidence of such cases. Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture. The goal of this study was to assess the use of three-dimensional (3D) printing techniques for surgical management of old pelvic fractures.

METHODSFirst, 16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data. Next, nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models. The pelvic injuries were all type C, and the average time from injury to reconstruction was 11 weeks (range: 8-17 weeks). The workflow consisted of: (1) Printing patient-specific bone models based on preoperative computed tomography (CT) scans, (2) virtual fracture reduction using the printed 3D anatomic template, (3) virtual fracture fixation using Kirschner wires, and (4) preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation. These models aided communication between surgical team members during the procedure. This technique was validated by comparing the preoperative planning to the intraoperative procedure.

RESULTSThe accuracy of the 3D printed models was within specification. Production of a model from standard CT DICOM data took 7 hours (range: 6-9 hours). Preoperative planning using the 3D printed models was feasible in all cases. Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases. The patients were followed for 3-29 months (median: 5 months). The fracture healing time was 9-17 weeks (mean: 10 weeks). No delayed incision healing, wound infection, or nonunions occurred. The results were excellent in two cases, good in five, and poor in two based on the Majeed score.

CONCLUSIONSThe 3D printing planning technique for pelvic surgery was successfully integrated into a clinical workflow to improve patient-specific preoperative planning by providing a visual and haptic model of the injury and allowing patient-specific adaptation of each osteosynthesis implant to the virtually reduced pelvis.

Adolescent ; Adult ; Female ; Fractures, Bone ; diagnosis ; pathology ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Pelvic Bones ; surgery ; Reconstructive Surgical Procedures ; Young Adult

OBJECTIVETo analyze clinical characteristics and therapy of pan-resistant Acinetobacter baumannii (PDRAB) infection and explore the methods for effective therapy and prevention of this infection.

METHODSNine hospitalized patients with PDRAB infection confirmed by pathogen and susceptibility testing were analyzed for the risk factors and the treatment outcomes were assessed by case analysis.

RESULTSPDRAB infections occurred mainly in patients with severe complications, most of whom had complications by diabetes or hypertension or damaged mucosal integrity due to mechanical ventilation, surgery and catheterization. The polymyxin sensitivity were 100% for these infections, but all the bacteria identified showed a antimicrobial resistance rates of 100%. The majority of the infections were acquired during hospitalization occurring mainly in the lungs; all the patients had prolonged hospitalization and received antibiotic treatments with high proportions of broad-spectrum antimicrobial agents especially third-generation cephalosporins and quinolones. Exclusive or sequential use of carbapenems and sulbactam in combination with quinolone or aminoglycoside produced favorable effects.

CONCLUSIONSThe prevalence of hospital-acquired pan-resistance of PDRAB infections increased significantly in recent years, particularly in patients with high risk factors. The widespread use of broad-spectrum antibiotics may have some relevance to drug resistant occurrence. The application of carbapenems or sulbactam, or their sequential use, in combination with other agents may produce good effects.

Acinetobacter Infections ; drug therapy ; microbiology ; Acinetobacter baumannii ; drug effects ; Anti-Infective Agents ; therapeutic use ; Cross Infection ; drug therapy ; microbiology ; Drug Resistance, Multiple, Bacterial ; Humans ; Microbial Sensitivity Tests ; Middle Aged

Objective To investigate the relationship between cortical watershed infarction and carotid artery stenosis and evaluate the stent insertion operation.Methods After 23 cortical watershed infarction patients diagnosed by CT or MRI received DSA detection,we performed stent insertion operationon 11 patients according to their requirements,and conservative treatment on the remaining 12 patients.All the patients underwent follow up for 6-12 months post-operatively.Results Among the 23 cortical watershed infarction patients,22 Were detected with carotid artery stenosis.Statistical analysis showed that the degree of carotid artery stenosis was associated With the elinical svmDtoms and the volume of steal phenomenon(P<0.05);further,the artery stenosis improvement was over 90%with the stent inserted;conversely,dizziness and steal phenomenon disappeared.The post procedure follow-up,ranging 6-12 months,showed that the patients with stent insertion got less new symptoms,steal phenomenon and artery stenosis,compared with the patients with conservation treatment(P<0.05).Conclusion Cortical watershed infarction is associated with carotid artery stenosis.The stent insertion iS useful for the treatment ofcarotid artery stenosis and prevention of cortical watershed infarction.