OBJECTIVE: To explore the displacement and pressure distribution of American Chiropractic in a model of third lumbar syndrome based on finite element analysis. METHODS: On March 2021, CT and MRI images of a 23-year-old male patient with right third lumbar syndrome were selected. A 3D stl model was established using Mimics and CATIA, and the data was imported into Hypermesh, Abaqus & ANSYS. The elastic modulus and Poisson's ratio of the affected side material were adjusted to establish its finite element model. Based on the comparison of the operating positions and routines of the American Chiropractic and the lumbar spine oblique pull method, but with differences in the focus and direction of force, the experimental group simulated the American Chiropractic with the healthy side (left side) lying position of the model. The upper endplate of L₃ and the lower part below L₃ twisted accordingly with the body position, we applied a vertical forward thrust of 246 N to the plane formed by the L₄, L₅ spinous processes and L₄ upper articular processes;The control group simulates the oblique pull method of the lumbar spine, requiring the model to lie on the healthy side (left side), fix the upper endplate of L₄, and perform a horizontal rotation along the longitudinal axis of L₃ vertebral body. At this time, the contact force in the upward direction is also set to 246 N. Compare the displacement and stress differences between the L₁-L₅ intervertebral bodies, intervertebral discs, articular processes, and transverse process muscles in two intervention models. RESULTS: ① Under safe load conditions, a test force of 246 N was applied to the model, and the maximum vertebral displacement occurred on the right side of the L₃ vertebral body (1.197 mm) after manual intervention in the control group. The vertebral displacement between L₁-L₅ induced by manual intervention in the experimental group was smaller than that of the control group's manual intervention (P<0.05). ② The maximum vertebral body stress occurred on the right side of the L₃ vertebral body after manual intervention in the control group (98.425 MPa). The stress on each vertebral body formed by the experimental group's manual intervention was lower than that of the control group's manual intervention (P<0.05). ③The maximum intervertebral disc stress occurred on the right side of the L_2,3 intervertebral disc (6.282 MPa) after manual intervention in the control group. ④ The maximum joint process stress occurred on the right side of the L₄ upper joint process after manual intervention in the experimental group (1.587 MPa). The joint process stress on the left side below L₁ and the left side above and below L₂ induced by manual intervention in the experimental group was lower than that of the control group (P<0.05). ⑤The maximum stress on the intertransverse process muscle was observed at the right lateral L₃ process end (31.960 MPa) of L_3,4 in the control group after manual intervention. The stress on the L_2,3 and L_4,5 segments of the intertransverse process muscle induced by manual intervention in the experimental group was lower than that of the control group's manual intervention (P<0.05). CONCLUSION The mechanical feedback of the L₁-L₅ vertebral body, the lower left side of the articular process L₁, the upper and lower left side of the articular process L₂, and the L_2,3 and L_4,5 segments of the transverse process muscle in the model indicates that performing American Chiropractic for the treatment of third lumbar transverse process syndrome can accurately hit the target pain point and allow the patient's tissue to form a low stress and low tension state after manual operation, thereby reducing the possibility of tissue damage caused by hypertonia after intervertebral joint movement, making it relatively safe. The application of American Chiropractic will be a new supplement to the traditional treatment plan for third lumbar transverse process syndrome.
Humans ; Finite Element Analysis ; Male ; Lumbar Vertebrae/physiopathology* ; Biomechanical Phenomena ; Young Adult ; Manipulation, Chiropractic ; Adult ; Tomography, X-Ray Computed ; Magnetic Resonance Imaging

Hypoxia-inducible factor 1 (HIF-1), as a main transcriptional regulator of metabolic adaptation to changes in the oxygen environment, participates in many physiological and pathological processes in the body, and is closely related to the pathogenesis of many diseases. This review outlines the mechanisms of HIF-1 activation, its signaling pathways, natural inhibitors, and its roles in diseases. This article can provide new insights in the diagnosis and treatment of human diseases, and recent progress on the development of HIF-1 inhibitors.
Disease ; Humans ; Hypoxia-Inducible Factor 1/physiology* ; Oxygen ; Signal Transduction

OBJECTIVE: To investigate the clinical effect of vancomycin bone cement in the treatment of diabetic foot ulcer (DFU) ruptured Wagner gradeⅡ-Ⅳ. METHODS: From March 2019 to April 2021, 32 patients with Wagner gradeⅡ-Ⅳ diabetic foot were divided into vacuum sealing drainage (VSD) group and bone cement group according to different treatment methods. There were 16 cases in VSD group, 8 males and 8 females;the age ranged from 66 to 81 (70.50±7.20) years, and the course of disease ranged from 8 to 40 (27.56±8.55) months;Wagner gradeⅡin 2 cases, grade Ⅲin 7 cases and grade Ⅳin 7 cases;debridement and VSD were used. There were 16 cases in the bone cement group, 9 males and 7 females;the age ranged from 63 to 79 (69.56±7.29) years, and the course of disease ranged from 11 to 39(22.75±11.43) months;Wagner gradeⅡ in 2 cases, grade Ⅲin 5 cases and grade Ⅳ in 9 cases;vancomycin loaded bone cement was used for treatment. The types of bacteria, negative time of bacterial culture, skin healing time, hospital stay, operation times and complications were observed and compared between two groups. RESULTS: All patients were followed up for 3 to 6 (4.00±1.07) months. The bacterial negative time, skin healing time and hospital stay in bone cement group were significantly lower than those in VSD group ( CONCLUSION Vancomycin loaded bone cement is effective in the treatment of Wagner grade Ⅱ-Ⅳ diabetic foot ulceration wounds. It can reduce the length of hospital stay, shorten the healing time of skin and kill pathogens as soon as possible. It is one of the effective methods to treat Wagner gradeⅡ-Ⅳdiabetic foot ulceration.
Bone Cements/therapeutic use* ; Child ; Child, Preschool ; Diabetes Mellitus ; Diabetic Foot/drug therapy* ; Female ; Humans ; Male ; Treatment Outcome ; Vancomycin ; Wound Healing

Objective To study the survival rate,complications and risk factors affecting clinical outcomes in extremely low birth weight (ELBW) premature infants.Method From January 2008 to December 2017,clinical data of ELBW infants admitted to the department of neonatology of our hospital were collected.The survival rates and the incidences of complications were compared between different subgroups of different birth weight (BW) and discharging date.The risk factors affecting the survival rate of ELBW infants were analysed using multivariate unconditional Logistic regression analysis.Result (1) A total of 438 ELBW infants were enrolled,representing 4.9％ (438/8 910) of all discharged preterm infants,and 2.6％ (438/16 948) of all discharged neonates during the study period.Among them,3 were excluded because of incomplete data and lost of follow-up.The BW was 900 (750,950) g and the gestational age was (28.0±2.1) weeks.The overall survival rate was 81.6％ (209/256) with 179 cases excluded for giving up treatment.(2) From 2008 to 2017,the percentages of ELBW infants among all discharged newborns and all discharged premature infants increased annually (x2 trend=6.818,27.850,P=0.009,＜0.001).(3) No significant differences existed in the survival rates of ELBW infants between 2013-2017 and 2008-2012(P＞0.05).The survival rates of different BW groups (＜700 g,700～799 g,800～899 g,and 900～999 g)increased from 40.0％ (6/15) to 88.5％ (139/157) (x2 trend=32.648,P＜0.001).(4) The main complications in ELBW infants were respiratory distress syndrome 87.5％ (224/256),retinopathy of prematurity 63.1％ (123/195),and bronchopulmonary dysplasia 63.0％ (126/200).(5) Multivariate unconditional logistic regression analysis showed that BW＜900 g (＜700 g∶ OR=10.147,95％CI 2.684～38.360;700～799 g∶ OR=6.978,95％CI 1.647～29.555;800～899 g∶ 0R=4.727,95％CI 1.060～21.082,P＜0.05),and gestational age＜28 weeks (OR=3.529,95％CI 1.601～7.778,P=0.002) were the risk factors for survival rate and antenatal steroids was the protective factor(OR=0.155,95％CI 0.069～0.353,P＜0.001).Conclusion The number of ELBW infants discharged from neonatology department increased annually.The survival rate of ELBW infants was positively correlated with BW.Antenatal steroids may improve the survival rate of ELBW infants.

Objective: To investigate the clinical value of blood routine tests (RT) and coagulation function in differential diagnosis of mild and severe patients infected with bunyamwera virus. Methods: Twenty-five mild patients and 25 severe patients infected with bunyamwera virus were selected and their blood RT and coagulation function tests were performed. Results: The earliest prothrombin time (PT-early) and activated partial thromboplastin time(APTT-early) were significantly lower than those of severe patients(t=-2.43, P<0.05; t=-2.53, P<0.05). The lowest values of white blood cells (WBC-low) of mild patients were significantly higher than those of severe patients (t=5.66, P<0.01). The highest value of D-dimer (DD-high) of mild patients were significantly lower than that of severe patients (z=1.35, P<0.05). When mild patients values were set as outcome variable, AUC of APTT-early was the highest (AUC=0.713, P<0.05). When values of severe patients were set as outcome variable, AUC of DD-high was the highest (AUC=0.874, P<0.01). Conclusions APTT-early and DD-high are suitable for differential diagnosis of mild and severe patients infected with bunyamwera virus.

Objective: To investigate the in vitro and in vivo effects of apatinib in esophageal squamous cell carcinoma and the underlying mechanisms. Methods: The esophageal cancer cells, KYSE-150 and ECA-109, were divided into control group and apatinib treatment group at the concentrations of 2.5, 5, 10, 20 and 40 μmol/L respectively. All of experiments were performed in triplicate. MTT and colony formation assays were used to measure cell proliferation. Transwell assay was used to determine the migration capacity. The effect of apatinib on cell cycle and apoptosis was analyzed by flow cytometry. The expression of VEGF and VEGFR-2 was measured by real-time quantitative PCR (qRT-PCR). The concentration of VEGF in the cell supernatant was assessed by enzyme-linked immunosorbent assay (ELISA). The expression levels of MEK, ERK, p-MEK, p-ERK, JAK2, STAT3 and p-STAT3 after VEGF stimulation were detected by Western blot. Furthermore, the nude mice xenograft model was established. The tumor-bearing mice were randomly divided into control group, apatinib low dose treatment group (250 mg) and apatinib high dose treatment group (500 mg), respectively. Tumor inhibition rates of different groups were calculated. And then the expressions of VEGF and VEGFR2 were detected in xenograft tissues by immunohistochemical staining. Results: In the presence of 20 μmol/L and 40 μmol/L of apatinib for 24 hours, the migration cell numbers of KYSE-150 and ECA-109 were 428.67±4.16 and 286.67±1.53 as well as 1 123.67±70.00 and 477.33±26.84, respectively, that were significantly lower than control group (P<0.05 for all). In addition, after treatment with 10 μmol/L, 20 μmol/L and 40 μmol/L of apatinib for 7 days on KYSE-150 and ECA-109, the colony formation rates were (65.12±25.48)%, (58.19±24.73)% and (29.10±22.40)% as well as (70.61±15.14)%, (61.12±17.21)% and (43.09±11.13)%, respectively. The colony formation rates of 20 μmol/L and 40 μmol/L of apatinib treatment groups were significantly lower than control group (100.00±0.00, P<0.05). The cell cycle ratio of G₂/M phase and apoptosis rate of control group and 20 μmol/L apatinib group in KYSE-150 cells were (12.14±2.13)% and (3.49±0.74)% as well as (26.27±3.30)% and (15.65±1.54)%, respectively. The corresponding ratios in ECA-109 cells were (3.44±0.57)% and (6.31±1.43)% as well as (22.64±2.36)% and (49.26±1.62)%, respectively. The results show that apatinib suppressed cell cycle progression at G₂/M phase and induced cell apoptosis in both KYSE-150 and ECA-109 cells (P<0.05 for all). In the presence of 20 μmol/L and 40 μmol/L of apatinib in KYSE-150 cells, the relative levels of VEGF mRNA were (42.57±10.43)% and (25.69±1.24)%, and those of VEGF-2 mRNA were (36.09±10.82)% and (13.99±6.54)%, which were all significantly decreased compared to control group (100.00±0.00, P<0.05 for all). For ECA-109 cells, the relative expression of VEGF and VEGFR2 showed similar tendency (P<0.05 for all). Moreover, after treatment with 20 μmol/L and 40 μmol/L of apatinib in KYSE-150 cells, the VEGF concentrations were (766.48±114.27) pg/ml and (497.40±102.18)pg/ml, which were significantly decreased compared to control group [(967.41±57.75) pg/ml, P<0.05)]. The results in ECA-109 were consistent (P<0.05). Furthermore, after treatment with 40 μmol/L of apatinib in KYSE-150 and ECA-109, the relative expression of p-MEK and p-ERK were 0.49±0.05 and 0.28±0.03 as well as 0.63±0.03 and 1.22±0.15, which were significantly lower than control group (1.23±0.19 and 0.66±0.07 as well as 1.03±0.20 and 1.76±0.20; P<0.05). The relative expression of STAT3, p-STAT3 in control group and experimental group were 0.96±0.15 and 0.85±0.16 as well as 0.62±0.09 and 0.36±0.13, respectively. The results showed that the protein levels of STAT3 and p-STAT3 were significantly lower than the control group (P<0.05 for all). The inhibition rates of apatinib in xenograft nude mice were 29.25% and 19.96% for 250 mg and 500 mg treatment groups. The concentration of VEGF were (25.11±4.12) pg/ml, (16.40±2.81) pg/ml and (15.04±4.88)pg/ml for control, 250 mg and 500 mg treatment groups, respectively. Conclusions Apatinib can inhibit cell proliferation, induce apoptosis and suppress migration of esophageal cancer cells in vitro and in vivo. This effect was mainly mediated via the alterations of Ras/Raf/MEK/ERK pathway and JAK2/STAT3 pathway.

Objective : To explore the correlation between air pollution and outpatient visits,and to provide evidence for health risk assessment of air pollutants and intervention. Methods : The data of air pollutants and outpatient visits in 2016 in Zhoushan Hospital were collected,and the outpatient volume on the days when the concentration of air pollutants reached and exceeded the standard were compared. Spearman rank correlation analysis was used to explore the relationship between outpatient volume and the concentration of air pollutants. Results : In 2016,the median（inter-quartile range）of daily outpatient volume in Zhoushan Hospital was 3 304（1 638）person-times. O3,PM2.5 and PM10 were the primary air pollutants in Zhoushan in 2016. The average daily outpatient volume of internal medicine,circulatory system,other diseases and all when the air was polluted at light level or above were higher than those when the air quality was good（P< 0.05）. CO concentration was positively correlated with the average daily outpatient volume of respiratory system and circulatory system（P< 0.05）,was negatively correlated with the average daily outpatient volume of all（P< 0.05）. O3-8 h concentration was positively correlated with the average daily outpatient volume of internal medicine,other diseases and all（P< 0.05）,and was negatively correlated with the average daily outpatient volume of respiratory system and pediatrics（P< 0.05）. SO2 concentration was negatively correlated with the average daily outpatient volume of respiratory system,skin and subcutaneous tissue（P< 0.05）. The concentration of NO2,PM10 and PM2.5 were positively correlated with the average daily outpatient volume of respiratory system and pediatrics（P< 0.05）. Conclusion The main air pollutants in Zhoushan were O3,PM2.5 and PM10. When they exceed the limits,the outpatient volume would increase.

OBJECTIVE: To explore the clinical effect of minimally invasive technique combined with locking plates for the treatment of osteoporotic humeral shaft fractures in elderly patients. METHODS: From July 2012 to December 2016, 26 patients were treated by minimally invasive technique combined with the locking plate for osteoporotic humeral shaft fractures, including 10 males and 16 females, ranging in age from 61 to 81 years old, with an average of 70.3 years old. The T-score of mean bone density was -2.74. All 26 patients had closed fractures, including 6 cases of type A, 7 cases of type B and 13 cases of type C. All patients were followed up for 12 months after surgery, and the Constant shoulder joint score and Mayo elbow score were calculated before surgery and 12 months after surgery. RESULTS: All 26 patients were followed up, and the duration ranged from 12 to 16 months, with an average of 13.2 months. All fractures healed within 16 weeks, with an average healing time of 14.3 weeks. The average Constant shoulder joint score before surgery and 12 months after surgery was 54.61±2.09, 88.50±2.47. The average score of Mayo elbow joint before surgery and 12 months after surgery was 58.19±2.74, 90.30±2.16. CONCLUSIONS The shoulder and elbow joint function of elderly patients with osteoporotic humeral fractrues treated with minimally invasive technology combined with locking plate recovered well postoperatively. It is an effective method for the treatment of osteoporotic humeral shaft fractures in elderly patients.
Aged ; Aged, 80 and over ; Bone Plates ; Elbow Joint ; Female ; Fracture Fixation, Internal ; Humans ; Humeral Fractures ; Humerus ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Treatment Outcome

OBJECTIVETo assess the net health effect caused by the consumption of specific marine species based on Benefit-Risk Analysis for Foods (BRAFO)-tiered approach.

METHODSTwenty species were collected from the Zhoushan Archipelago, China. Concentrations of n-3 long-chain polyunsaturated fatty acids, methyl mercury (MeHg), and dioxin-like compounds (DLCs) in the samples were analyzed for benefit risk assessment based on BRAFO-tiered approach.

RESULTSBased on the BRAFO-tiered approach, reference scenario (no intake) and alternative scenario (intake of specific species of 200 g/week) were determined. The exposure to MeHg/DLCs via alternative scenario of all studied species did not exceed provisional tolerable weekly/monthly intake. However, the adult population with high DLCs exposure in China would significantly exceed the upper limit of DLCs via an additional alternative scenario of some species such as Auxis thazard. The results of deterministic computation showed that alternative scenario of all studied species generated clear net beneficial effects on death prevention and child IQ gain.

CONCLUSIONThe alternative scenario of all studied species could be recommended to population with average DLCs exposure, and the reference scenario of species with relatively high DLCs concentration could be recommended to population exposed to high DLCs.

Animals ; China ; Dioxins ; analysis ; Environmental Pollutants ; analysis ; Fatty Acids, Omega-3 ; analysis ; Fishes ; Humans ; Methylmercury Compounds ; analysis ; Risk Assessment ; Seafood ; analysis ; Species Specificity