Objective:To investigate the needle placement accuracy assisted by our self-designed channel screw guide system for pelvic fractures.Methods:Sixty pelvic models (provided by Shandong Weigao Group) were randomized into 2 groups ( n=30). In the experimental group, 2.0 mm Kirkler needles were implanted into the sacroiliac channel using our self-developed channel needle guide system in corresponding simulated surgical procedures; in the control group, the guide needles for sacroiliac screws were implanted manually under the guidance of C-arm fluoroscopy. The needle positions were assessed by gross observation and the offset distances measured on the X-ray films of pelvic entrance and exit views between the guide needle at the midline of the sacrum and the center point of bone channel. The offset distance, operation time, fluoroscopy frequency, and needle adjustment frequency were compared between the 2 groups of guide needles. Results:Guide needles were successfully implanted in all the pelvic models in the experimental group, with no penetration of guide needles outside the model. In the control group, 3 guide needles penetrated outside the model channel. The X-ray measurements showed that the offset distance of the needle in the experimental group was (2.23±0.82) mm, significantly smaller than that in the control group [(4.46±2.28) mm] ( P<0.05). In the experimental group, the fluoroscopy frequency [(12.0±0.3) times] and the needle adjustment frequency [(8.0±0.3) times] were significantly less than those in the control group [(26.0±0.4) times and (24.0±0.8) times] ( P<0.05). The operation time was (0.52±0.25) hours in the experimental group, significantly shorter than that in the control group [(1.26±0.36) hours] ( P<0.05). With a 2 mm diameter as an acceptable range, the accuracy was as high as 95.5%. Conclusion:Compared with manual placement of guide needles, our self-designed pelvic fracture channel screw guide system can lead to more accurate needle placement, reduced fluoroscopy frequency, fewer guide needle adjustments, and shortened operation time.

Objective:To assess the clinical effectiveness and safety of Omalizumab for treating pediatric allergic asthma in real world in China.Methods:The clinical data of children aged 6 to 11 years with allergic asthma who received Omalizumab treatment in 17 hospitals in China between July 6, 2018 and September 30, 2020 were retrospectively analyzed.Such information as the demographic characteristics, allergic history, family history, total immunoglobulin E (IgE) levels, specific IgE levels, skin prick test, exhaled nitric oxide (FeNO) levels, eosinophil (EOS) counts, and comorbidities at baseline were collected.Descriptive analysis of the Omalizumab treatment mode was made, and the difference in the first dose, injection frequency and course of treatment between the Omalizumab treatment mode and the mode recommended in the instruction was investigated.Global Evaluation of Treatment Effectiveness (GETE) analysis was made after Omalizumab treatment.The moderate-to-severe asthma exacerbation rate, inhaled corticosteroid (ICS) dose, lung functions were compared before and after Omalizumab treatment.Changes in the Childhood Asthma Control Test (C-ACT) and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) results from baseline to 4, 8, 12, 16, 24, and 52 weeks after Omalizumab treatment were studied.The commodity improvement was assessed.The adverse event (AE) and serious adverse event (SAE) were analyzed for the evaluation of Omalizumab treatment safety.The difference in the annual rate of moderate-to-severe asthma exacerbation and ICS reduction was investigated by using t test.The significance level was set to 0.05.Other parameters were all subject to descriptive analysis.A total of 200 allergic asthma patients were enrolled, including 75.5% ( n=151) males and 24.5% ( n=49) females.The patients aged (8.20±1.81) years. Results:The median total IgE level of the 200 patients was 513.5 (24.4-11 600.0) IU/mL.Their median treatment time with Omalizumab was 112 (1-666) days.Their first dose of Omalizumab was 300 (150-600) mg.Of the 200 cases, 114 cases (57.0%) followed the first Omalizumab dosage recommended in the instruction.After 4-6 months of Omalizumab treatment, 88.5% of the patients enrolled ( n=117) responded to Omalizumab.After 4 weeks of treatment with Omalizumab, asthma was well-controlled, with an increased C-ACT score [from (22.70±3.70) points to (18.90±3.74) points at baseline]. Four-six months after Omalizumab administration, the annual rate of moderate-to-severe asthma exacerbation had a reduction of (2.00±5.68) per patient year( t=4.702 5, P<0.001), the median ICS daily dose was lowered [0 (0-240) μg vs. 160 (50-4 000) μg at baseline] ( P<0.001), the PAQLQ score was improved [(154.90±8.57) points vs. (122.80±27.15) points at baseline], and the forced expiratory volume in one second % predicted (FEV 1%pred) was increased [(92.80±10.50)% vs. (89.70±18.17)% at baseline]. In patients with available evaluations for comorbidities, including allergic rhinitis, atopic dermatitis or eczema, urticaria, allergic conjunctivitis and sinusitis, 92.8%-100.0% showed improved symptoms.A total of 124 AE were reported in 58 (29.0%) of the 200 patients, and the annual incidence was 0(0-15.1) per patient year.In 53 patients who suffered AE, 44 patients (83.0%) and 9 patients (17.0%) reported mild and moderate AE, respectively.No severe AE were observed in patients.The annual incidence of SAE was 0(0-1.9) per patient year.Most common drug-related AE were abdominal pain (2 patients, 1.0%) and fever (2 patients, 1.0%). No patient withdrew Omalizumab due to AE. Conclusions:Omalizumab shows good effectiveness and safety for the treatment of asthma in children.It can reduce the moderate-to-severe asthma exacerbation rate, reduce the ICS dose, improve asthma control levels, and improve lung functions and quality of life of patients.

Objective To compare the diagnostic accuracy of magnifying chromoendoscopy (MCE) and endoscopic ultrasonography (EUS) for preoperative endoscopic assessment of the invasion depth of colorectal laterally spreading tumour(LST).Methods Data of 104 cases of colorectal LST were included.With the final pathological diagnosis as the golden standard,the accuracies of MCE and EUS for preoperative assessment of the invasion depth of colorectal LST were compared.Results The diagnostic accuracies of MCE and EUS for evaluating the invasion depth of LST were 89.4％ (93/104) and 73.1％ (76/104),respectively(P＜0.05).The lesion size and the endoscopist could affect the accuracy of the EUS evaluation (P=0.017,OR=3.561;P=0.035,OR =1.399).The accuracy of EUS seemed to show a downward trend for colorectal LST of larger diameters.Conclusion Both MCE and EUS are effective for evaluating the invasion depth of colorectal LST,but the accuracy of MCE may be higher than that of EUS.Large diameter of the lesion and the doctor's experience inadequacy may be the risk factors for the accuracy of EUS.

Objective:To test the validity and reliability of the Chinese version of the Br?set Violence Check-list (BVC-C).Methods:With the authorizing permission by the author,the BVC was translated into Chinese and a-dapted,and five psychiatry experts who had worked more than 20 years were invited (3 clinical doctors and 2 nur-ses)to evaluate the content validity of the scale as the content validity index.Totally 556 inpatients who met the di-agnosis criteria for mental disorders according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10)were totally selected to proceed the formal testing.The BVC scale was used to evaluate inpatients every 8 hours,the Modified Overt Aggression Scale (MOAS)was used to test concurrent validity;the results of the real attacking incidents were used to test the criterion validity;the internal consistency re-liability of the scale was tested by Cronbach αcoefficient.Results:The content validity index of the scale was0.93.In addition to the own attack subscale,the MOAS total scores and the other 3 subscales scores were positively correlated with the BVC total scores and each item score (r =0.11 -0.69,P <0.01).The best criterion validity was 8 hours through analyzed,the AUC was 0.98.When the cut-off was 2,the sensitivity and specificity were 78.9% and 95.1% respectively.The Cronbach αcoefficient was 0.76 and the item total correlations were 0.47 -0.80 (P <0.01).Conclusion:It suggests that the BVC-C has good validity and reliability,which could be used as an effective prediction tool for psychiatric violence risk assessment.

OBJECTIVETo explore the appropriate acoustic parameters for augmenting the permeability of tumor cells using microbubble-enhanced ultrasound.

METHODSNinety intramuscular VX2 tumors grown in New Zealand white rabbits were randomly divided into 4 parts by 4 factors, namely sound intensity, pulse width, insonation time and microbubble dose, each at different levels. Therapeutic ultrasound was delivered directly to the tumor surface during intravenous infusion of microbubbles. The tumor was excised after the treatment and sliced to investigate the change in tumor cell permeability using lanthanum nitrate electron microscopy. The appropriate acoustic parameters of the 4 factors were investigated.

RESULTSSonoporation induced by microbubble-enhanced ultrasound augmented the permeability of the tumor cells, and the appropriate sound intensity, pulse width, insonation time and microbubble dose were 0.43 W/cm(2), 2.42 ms, 10 min, and 0.50 ml/kg, respectively.

CONCLUSIONSonoporation induced by microbubble-enhanced ultrasound can induce pores in tumor cell membrane, which may potential increase the efficacy of tumor chemotherapy.

Acoustics ; Animals ; Cell Line, Tumor ; Cell Membrane Permeability ; Microbubbles ; Neoplasms ; therapy ; Rabbits ; Ultrasonic Therapy ; Ultrasonics

Objective To explore the appropriate acoustic parameters for augmenting the permeability of tumor cells using microbubble-enhanced ultrasound. Methods Ninety intramuscular VX2 tumors grown in New Zealand white rabbits were randomly divided into 4 parts by 4 factors, namely sound intensity, pulse width, insonation time and microbubble dose, each at different levels. Therapeutic ultrasound was delivered directly to the tumor surface during intravenous infusion of microbubbles. The tumor was excised after the treatment and sliced to investigate the change in tumor cell permeability using lanthanum nitrate electron microscopy. The appropriate acoustic parameters of the 4 factors were investigated. Results Sonoporation induced by microbubble-enhanced ultrasound augmented the permeability of the tumor cells, and the appro-priate sound intensity, pulse width, insonation time and microbubble dose were 0.43 W/cm2, 2.42 ms, 10 min, and 0.50 ml/kg, respectively. Conclusion Sonoporation induced by microbubble-enhanced ultrasound can induce pores in tumor cell membrane, which may potential increase the efficacy of tumor chemotherapy.

Objective To explore the appropriate acoustic parameters for augmenting the permeability of tumor cells using microbubble-enhanced ultrasound. Methods Ninety intramuscular VX2 tumors grown in New Zealand white rabbits were randomly divided into 4 parts by 4 factors, namely sound intensity, pulse width, insonation time and microbubble dose, each at different levels. Therapeutic ultrasound was delivered directly to the tumor surface during intravenous infusion of microbubbles. The tumor was excised after the treatment and sliced to investigate the change in tumor cell permeability using lanthanum nitrate electron microscopy. The appropriate acoustic parameters of the 4 factors were investigated. Results Sonoporation induced by microbubble-enhanced ultrasound augmented the permeability of the tumor cells, and the appro-priate sound intensity, pulse width, insonation time and microbubble dose were 0.43 W/cm2, 2.42 ms, 10 min, and 0.50 ml/kg, respectively. Conclusion Sonoporation induced by microbubble-enhanced ultrasound can induce pores in tumor cell membrane, which may potential increase the efficacy of tumor chemotherapy.

Parathyroid adenoma is the main cause of primary hyperparathyroidism and often associated with thyroid nodular goiter.Thyrothymic thyroid rest belong to the ectopic thyroids which are classified into 4 grades according to the state of their connection with the proper neck thyroid gland.Thyrothymic thyroid remnant can also develop into nodular goiter and may be difficult to be distinguished from parathyroid adenoma.We present herewith the diagnosis and treatment of a rare case of parathyroid adenoma accompanied by thyrothymic thyroid remnant nodular goiter in order to remind clinicians of the attention to the thyrothymic thyroid remnant disease.

In patient with primary biliary cirrhosis,the metabolism of calcium and vitamin D could be affected and osteomalacia and secondary hyperparathyroidism might occurr.Besides,hypoalbuminemia may mask the real level of serum calcium and thus lead to misdiagnosis of coexisting parathyroid adenoma.Therefore,a rare case of parathyroid adenoma associated with primary biliary cirrhosis was herewith presented to call attention to the effect of hypoalbuminemia on serum calcium.

BACKGROUND: Preliminary study has proved that the bone marrow-derived mesenchymal stem cells (MSCs) in a rat emphysema model produced by use of trypsin alone can "homing" to the lesioned lung tissues, and participate in the formation of pulmonary arteries to promote lung tissue repair. Basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) play equally a powerful role in promoting angiogenesis. OBJECTIVE: To observe the influence of bFGF, VEGF and MSCs in regeneration of pulmonary capillary and pathological repair of pulmonary emphysema rats. METHODS: Except normal control group, the remaining 5 groups of rats were exposed to tobacco smoke and received a single intratracheally instillation of porcine pancreatic elastase to induce emphysema models. Following successful modeling, rats of bFGF group were intratracheally injected with 400 U bFGF and rats of VEGF group with 2 μg VEGF, once a week for three times. MSCs group was injected 1 mL suspension of 4×10~9/L MSCs into tail vein. MSCs+VEGF group was injected MSCs into tail vein and intratracheally injected VEGF (2 ug, three times) at the same time. Model control and normal control groups were intratracheally injected with equal volume of sodium chloride. Four weeks after treatment, arterial blood gas analysis was performed to observe pathological and morphological changes of lung tissues. CD34~+ expression in lung tissues was determined using immunohistochemistry method. RESULTS AND CONCLUSION: Compared with model control group, PaO_2 values dramatically increased in VEGF group (P <0.05), while other indices remained unchanged (P > 0.05); there were no obvious changes in each index in other groups (P >0.05). Gross and microscopic observations showed that, lung was smooth, pale pink, and elastic in normal control group, with uniform size of pulmonary alveoli on cross-section; pathological changes of chronic obstructive pulmonary emphysema existed in model control group, but improved in other 4 groups. Compared with model control group, mean pulmonary alveoli number and CD34~+ relative positive area dramatically increased in bFGF, VEGF, MSCs, MSCs+VEGF groups (P < 0.05), mean linear intercept and mean alveoli area were significantly reduced (P < 0.05). No significant difference was observed in each index among these 4 groups (P > 0.05). bFGF, VEGF and MSCs could improved the pathology of pulmonary emphysema models produced by tobacco smoking and intratracheally instillation of porcine pancreatic elastase. The possible mechanism of recovering the pulmonary emphysema is the proliferation of pulmonary capillary and enlargement of pulmonary artery, improved blood flow in the lung, improved ventilation/perfusion shunt, reduced pulmonary alveolus size and volume of the lung through self-compensation.