BACKGROUND:The authors found that when the bilateral percutaneous vertebral augmentation is used to treat osteoporotic vertebral compression fractures with a total bone cement injection of 4 mL or more,different distribution patterns were usually presented on the X-rays;however,there were few reports addressing the effects of these patterns of bone cement distribution on the biomechanical properties of fractural vertebrae. OBJECTIVE:To further explore the biomechanical effects of different bone cement filling doses and distribution patterns on biomechanics of the fractural vertebrae using the finite element method. METHODS:The L1-L3 finite element models of osteoporosis were established,and the vertebral compression fractures were simulated in L2.Four distribution patterns bilateral partial fusion(FH type),full fusion(FO type),symmetrical separation(SA type),and asymmetric segregation(SN type)were simulated in 4 and 6 mL injections in the osteoporotic vertebral compression fracture models,respectively,and a total of nine sets of models were obtained.These models were solved under the same boundary conditions and compared with the stress and displacement of the L2 fractural vertebra. RESULTS AND CONCLUSION:(1)The maximum stresses of the nine groups of models were concentrated in the L2 fractural area,and the maximum stress and maximum displacement of each filling model were lower than in the osteoporotic vertebral compression fracture model,indicating the effectiveness of bone cement filling in the treatment of osteoporotic vertebral compression fracture.(2)Compared with 4 mL bone cement filling,6 mL bone cement filling could significantly reduce the stress of fractured vertebrae and enhance the strength of fractured vertebrae while improving the stability of fractured vertebrae.(3)In the same state of movement,the FH type stress was the least,followed by the SA type,both of which were close.FO type stress was the largest,especially in the lateral bend,which might be associated with its cluster shape resulting in the concentration of lateral stress.In the aspect of displacement,FH type was the least and FO type was the largest.(4)The results show that increased dose of bone cement injection reduces fractural vertebral stress and improves stability,but increases the risk of leakage.Bilateral symmetrical dispersed bone cement(FH type,SA type)is superior in restoring vertebral strength and stability than full fusion(FO type),asymmetric separated(SN type)bone cement.Therefore,when clinically performing bilateral percutaneous vertebral augmentation treatment of osteoporotic vertebral compression fractures,the bilateral symmetric dispersions of the distribution are first guaranteed;priority is recommended for FH type distribution,for appropriate stress stimulation and best stability.

In traditional Chinese medicine， it is believed that the disease of tubal infertility is located in the uterus vessels， with stasis blocking uterus vessels as the core mechanism， and according to the characteristics of pathological changes in the course of treatment， the "three-stage advanced method" is proposed as the treatment plan. In the first stage of eliminating evil， the disease mechanism is characterized by externally-contracted heat toxin combined with endogenous dampness， stagnation and stasis in the uterus vessels， and the treatment is to clear heat and promote dampness， move qi and activate blood， and the self-prescribed Penyan Xiao Formula （盆炎消方）. In the second stage of dissolving fixed abdominal mass， the disease mechanism is characterized by qi and blood stagnation and uterus vessels obstruction， and the treatment is to break up the stagnation of blood and move qi， drive away blood stasis and clear the channels， with self-prescribed Tongguan Formula （通管方）. In the third stage of reinforcing healthy qi to support pregnancy， the disease mechanism is characterized by stasis of uterus vessels for a long period， and loss of kidney essence， therefore the treatment is to warm up the kidneys and eliminate the stasis， boost qi and nourish yin， with self-prescribed Yulin Zhuyun Formula （毓麟助孕方）. At the same time， attention should be paid to the synergistic diagnosis and treatment of traditional Chinese medicine and Western medicines， and combination of syndrome differentiation with the identification of diseases.

Objective:To evaluate the feasibility of a novel liver fiducial marker implantation method for internal fixation and removal of rabbit livers, in order to use in Cyberknife tracking therapy.Methods:Experiments were conducted in vivo and in vitro. In the in vivo experiment, three fiducial markers were implanted percutaneously in each liver of ten rabbits under anesthesia, and the fourth fiducial marker with an external catheter and fixed thin wire was implanted ten days later. After the reference group (the first and the second maker), and the casing group (the first and the fourth marker) were respectively registered and tracked with the Cyberknife, the implantation success rate, registration accuracy, and removal safety of fiducial markers were assessed. The tensile test was performed using liver in vitro by measuring the resistance required to dislodge the spring coil fiducial markers and the fiducial markers without spring coil from liver. Results:The intrahepatic catheter implantation and removal of fiducial marker in rabbit liver had a success rate of 100% and no distant migration. The operation-related and postoperative complications were not occurred. All fiducial markers were successfully traced. Compared to the reference group, the casing group had slightly higher translational errors in supero-inferior and antero-posterior directions ( Z=-11.77, -4.57, P<0.05), and lower translational errors in left-right direction ( Z=-2.52, P<0.05). The dislodgement forces for spring coil fiducial markers was (2.23±0.85) N, significantly different with (0.81±0.13) N for fiducial markers without spring coil ( Z=- 2.31, P < 0.05). Conclusions:The spiral coil structure provides superior fixation in the punctured needle channel, the thin line limits the distant displacement of the fiducial marker outside the liver, and the catheter establishes a channel for the removal. The general operation is simple and easy.

Objective:To explore the tracking accuracy of the surface optically guided tracking system (OGTS) in radiotherapy.Methods:Phantom verification and clinical trial verification were adopted. Specialized equipment was employed for the phantom verification. Specifically, the displacement of the optical markers as they moved from a predetermined position to the target position on the reflector ball platform was captured using the OGTS, and then the obtained displacement was compared with the fixed distance within the phantom to calculate the accuracy and repeatability of the OGTS. For the clinical trial verification, 45 patients treated with radiotherapy, which consisted of 15 cases with head, breast, and rectal tumors each, were selected to investigate the tracking accuracy and repeatability of the OGTS. For each patient, the values derived from the image-guided positioning system (IGPS) and the OGTS before and after image-guided setup error correction during three times of fractionated radiotherapy were randomly obtained. The translational errors of each error correction were also recorded. Before radiotherapy, patients′ setup errors were corrected and relevant data were obtained using the IGPS. The correction result of translation errors obtained using the IGPS served as a gold standard to verify the accuracy of the OGTS in monitoring the translational motion of patients. Finally, the comprehensive translational deviation of both method was calculated.Results:The phantom measurements showed that the comprehensive translational deviation for tracking accuracy and tracking repeatability of the OGTS had a maximum deviation and a standard deviation of 0.18 mm and 0.03 mm, respectively. The clinical trial result indicated that the tracking accuracy of IGPS and OGTS exhibited statistically significant differences only for the head in the z direction ( t = 2.21, P < 0.05). Conversely, no statistically significant differences were observed for the head in the remaining directions or for the breast and rectum in the three translational directions ( P > 0.05). The analysis showed that comprehensive translational deviations for the head, breast, and rectum derived from OGTS and IGPS were (0.91±0.62), (1.64±1.30), and (1.52±1.29) mm, respectively, satisfying the requirement that the deviations should be below 2 mm. Conclusions:The OGTS, featuring easy operation and high tracking accuracy, can assist the IGPS in real-time respiratory monitoring during radiotherapy.

Objective:To make an empirical study on verifying whether the self-developed simple laparoscopic simulator can play a good role in the training of laparoscopic skills.Methods:Twenty-four Batch 2018 and Batch 2019 undergraduates of five-year clinical medicine of the Army Medical University were recruited in this study, and they were randomly divided into a research group and a control group for 4 weeks of simulation training, 3 times a week, 1 class hour each time. The training content was fundamental laparoscopic skills (FLSs). Before and after the training, the assessment was performed and the results and completion time were recorded. After the training, a satisfaction questionnaire was conducted among all trainees. SPSS 22.0 was used for data statistical analysis.Results:There was no statistical difference between the completion time and assessment results of the two groups before training ( P > 0.05). After four weeks of training, the completion time of the research group was shortened by 10.03% and the training performance increased by 35.17%; the completion time of the control group was shortened by 2.09%, and the training performance improved 12.34%. The comparison between groups found that the research group was superior than the control group, and the performance of the two groups were all improved after training. Most trainees recognized the simulator and were willing to promote it to other trainees according to the questionnaire feedback. Conclusion:The original laparoscopic simulator has a better training effect on simulation training than the traditional apprenticeship teaching has, which is of great significance for the promotion and optimization of laparoscopic skills teaching.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause acute respiratory distress syndrome, hypercoagulability, hypertension, and multiorgan dysfunction. Effective antivirals with safe clinical profile are urgently needed to improve the overall prognosis. In an analysis of a randomly collected cohort of 124 patients with COVID-19, we found that hypercoagulability as indicated by elevated concentrations of D-dimers was associated with disease severity. By virtual screening of a U.S. FDA approved drug library, we identified an anticoagulation agent dipyridamole (DIP) , which suppressed SARS-CoV-2 replication . In a proof-of-concept trial involving 31 patients with COVID-19, DIP supplementation was associated with significantly decreased concentrations of D-dimers ( < 0.05), increased lymphocyte and platelet recovery in the circulation, and markedly improved clinical outcomes in comparison to the control patients. In particular, all 8 of the DIP-treated severely ill patients showed remarkable improvement: 7 patients (87.5%) achieved clinical cure and were discharged from the hospitals while the remaining 1 patient (12.5%) was in clinical remission.

Objective To screen an ssDNA aptamer for rabbit mesenchymal stem cells (MSCs) and to identify the ability of the aptamer to recognize MSCs of a variety of species origin.Methods MSCs were isolated from the thigh bone of immature rabbits and identified by induced osteogenic and adipogenic differentiation,respectively.Aptamers were screened by cell SELEX (systematic evolution of ligands by exponential enrichment) technique targeting to isolated MSCs.Enrichment of the 5th pool was evaluated through binding assay of FAM modified pool to MSCs by confocal microscopy.The enriched 5th pool was then cloned into pGE-T vector and the cloned sequences were determined randomly.The candidates were chosen based on primary sequence conservation and predicted secondary structure by RNA structure and MEME online analysis.Flow cytometry analysis was used to identify the aptamers binding to MSCs of rabbit, rat, and human origin.Results The isolated MSCs had the potential of osteogenic differentiation and adipogenic differentiation under certain conditions.Aptamer 5-1-12 from 5th enriched pool was characterized as MSCs recognizing aptamer binding to MSCs of rabbit, rat and human origin.Conclusion Aptamer 5-1-12 that recognizes MSCs of different species origin is obtained through live cell-SELEX.

Objective To investigate the effects of heat preconditioning (HP) on the expression of protein kinase C (PKC) δ and PKCε in the myocardium of overload exercise rats. Methods 25 male three-month-old Sprague-Dauley rats were divided into control group (n=5), exercise group (n=10) and HP group (n=10). The expression of PKCδ and PKCε in the myocardium was detected with immunohistochemistry, real-time PCR and Western blotting 8 weeks after overload exercise. Results The expression of PKCδ significantly increased in the exercise group compared with the control group and the HP group (P<0.05). In another hand, PCR and immunohistochemistry showed the expression of PKCε in the exercise group decreased compared with the control group and the HP group (P<0.05), but it was not significantly different among the groups using Western blotting (P>0.05). Conclusion PKCs may play an important role in the HP-induced cardio-protection during overload exercise.

Objective To comprehensively evaluate the effect of the program of treatment and assistance to advanced schis-tosomiasis patients in Hunan Province from 2004 to 2013. Methods The fund investment of the program,the profits of hospi-tals and the improvement of the patients’health were investigated by data collection and questionnaire survey. The evaluation index system of treatment and assistance to advanced schistosomiasis in Hunan Province was constructed by the Delphi method and analytic hierarchy process,and the program was assessed comprehensively. Results The evaluation index system includ-ing 6 primary indices and 33 secondary indices was established. Among all the primary indices,the score of the treatment and assistance(22.25)was the highest,and that of the satisfaction assessment(8.15)was the lowest,and the score of the compre-hensive assessment was 87.06. The average cure rate of the patients was 13.08%from 2004 to 2013. More than 60%of the pa-tients’disease condition got better,and nearly 70%of the patients’psychological condition improved,and more than 70%of patients’self-help ability and social contact improved,as well as family happiness increased. In addition,the annual average cost for caretakers decreased by 2000 Yuan,and the profits of all the fixed-point hospitals for treatment and assistance in-creased. Conclusion The effectiveness and efficiency of the treatment and assistance to advanced schistosomiasis patients in Hunan Province is obvious,and the government should continuously invest in the program.

Objective To evaluate the surgical therapy on dislocated fracture of talus. Methods Retrospective analysis was mode in 21 patients with dislocated fracture of talus collected from Jan. 2004 to Jan.2010, which were treated with open reduction, cannulated screw fixation, and kept neutral position plaster fixation with no weight loading, to do functional exercise depending on the Ⅹ film demonstrations. Results All the patients were followed up from 6 months to 3.8 years post-operation, and according to the evaluation standard by American Foot-Ankle Surgery Society, good rate was 61.91%. Conclusion Treating dislocated fracture of talus with emergency operation, anatomical reduction, valid internal fixation and no weight loading plaster fixation post-operation, shows good effect with low rate of complication.