Objective:To summarize the clinical researches of Wumei Pill and provide reference for clinical application and follow-up research.Methods:The databases CNKI, VIP, Wanfang, CBM, PubMed, Embase were retrieved from the inception to June 30,2022. CiteSpace 6.1.R3 software was used to analyze the research hotspots and keywords in the literature. Using EndNote X9 software and Microsoft Office Excel 2013, we recorded and analyzed the published year, literature type, affiliated journal, disease treated, TCM syndrome type, single drug dose and treatment duration of the included articles.Results:212 articles were included. Diarrhea, gastritis, diabetes, insomnia were the research hotspots. The types of diseases treated by Wumei Pill mainly include digestive system, endocrine system and tumor, mainly for cold-heat syndrome and Jueyin syndrome. The average dosage of Mume Fructus was the largest, 21 g. The average treatment time was 5.78 weeks. Conclusion:At present, the overall clinical research of Wumei pill shows an increasing tendency, mainly involving gastrointestinal disease.

Objective:To assess the efficacy and safety of acupuncture compound anesthesia(ACA)for traditional thyroidectomy. Methods:Randomized controlled trials(RCTs)studying the use of ACA for traditional thyroidectomy were retrieved from PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,Web of Science,China National Knowledge Infrastructure(CNKI),Chongqing VIP Database(CQVIP),Wanfang Academic Journal Full-text Database(Wanfang),and China Biology Medicine Disc(CBM)from inception to September 30,2021.Two investigators independently extracted data and assessed the risk of bias and quality of the studies.Anesthesia effectiveness was the primary outcome,while the secondary outcomes included various pain scales,vital signs,analgesic consumption,and adverse events.Review Manager 5.3 was used for meta-analysis.Weighted mean difference(WMD),standardized mean difference(SMD),and confidence interval(CI)were used for statistical descriptions. Results:A total of 16 papers were included,involving 1228 patients.Meta-analysis showed that anesthesia effectiveness was significantly improved after adding acupuncture as an adjunct[SMD=0.62,95%CI(0.40,0.83),P<0.0001,I2=36%].Besides,ACA can also moderate vital signs and reduce the feeling of pain[SMD=-1.61,95%CI(-2.61,-0.61),P<0.00001,I2=95%],analgesic consumption,and adverse events.Subgroup analysis of the electroacupuncture(EA)group further revealed that the effectiveness of low-frequency EA[WMD=0.43,95%CI(0.30,0.55),P<0.00001,I2=15%]and the entire operative stimulation of EA[WMD=0.55,95%CI(0.33,0.77),P<0.00001,I2=0%]was significantly better than high-frequency EA and short-time stimulation of EA during the operation.Further,no significant difference existed between conventional analgesia and acupuncture analgesia. Conclusion:ACA is beneficial to traditional thyroidectomy regarding efficacy and safety when acupuncture is applied as an adjunct.However,additional high-quality studies with larger sample sizes are needed to verify the findings.

Objective:To investigate the method of determining oral implantation sites based on an anatomical model of mandibular premolar area of a Beagle dog.Methods:This study was performed in the Second Affiliated Hospital of Zhejiang Chinese Medical University between January 2019 and October 2020. Mandibular anatomical structure and measurement data were compared between before and after removal of premolar teeth to determine safe implantation areas and oral implantation sites.Results:Among all mandibular premolars, the roots of the 1 st to 4 th premolars (P1-P4) gradually increased. The diameter of the mesial roots of the double root teeth P2, P3, and P4 was (2.72 ± 0.45) mm, (3.22 ± 0.32) mm, (4.16 ± 0.34) mm, respectively, which was significantly shorter than those in the distal roots [P2: (2.98 ± 0.29) mm, P3: (3.48 ± 0.27) mm, P4: (4.58 ± 0.22) mm]. The length of distal roots P2, P3 and P4 was (8.79 ± 0.41) mm, (9.21 ± 0.31) mm, (10.12 ± 0.36) mm), respectively, which was significantly shorter than that of mesial root [P2: (8.91 ± 0.69) mm, P3: (9.48 ± 0.27) mm, P4: (11.58 ± 0.24) mm]. Among all mandibles, the distance (H) from the mental foramen to the first molar and the width (W) of the alveolar crest increased successively [H1: (7.24 ± 0.49) mm, H2: (8.28 ± 0.71) mm, H3: (9.52 ± 0.37) mm, W1: (5.71 ± 0.81) mm, W2: (5.82 ± 0.28) mm, W3: (6.72 ± 0.54) mm]. Conclusion:The mental foramen and the distal part outside the canine apical area are safe implantation areas. In the safe implantation area, the length and diameter of the implant prosthesis do not exceed the root length in the implantation area and the maximum diameter in the buccal lingual direction.

In the study of oral orthodontics, the dental tissue models play an important role in finite element analysis results. Currently, the commonly used alveolar bone models mainly have two kinds: the uniform and the non-uniform models. The material of the uniform model was defined with the whole alveolar bone, and each mesh element has a uniform mechanical property. While the material of the elements in non-uniform model was differently determined by the Hounsfield unit (HU) value of computed tomography (CT) images where the element was located. To investigate the effects of different alveolar bone models on the biomechanical responses of periodontal ligament (PDL), a clinical patient was chosen as the research object, his mandibular canine, PDL and two kinds of alveolar bone models were constructed, and intrusive force of 1 N and moment of 2 Nmm were exerted on the canine along its root direction, respectively, which were used to analyze the hydrostatic stress and the maximal logarithmic principal strain of PDL under different loads. Research results indicated that the mechanical responses of PDL had been affected by alveolar bone models, no matter the canine translation or rotation. Compared to the uniform model, if the alveolar bone was defined as the non-uniform model, the maximal stress and strain of PDL were decreased by 13.13% and 35.57%, respectively, when the canine translation along its root direction; while the maximal stress and strain of PDL were decreased by 19.55% and 35.64%, respectively, when the canine rotation along its root direction. The uniform alveolar bone model will induce orthodontists to choose a smaller orthodontic force. The non-uniform alveolar bone model can better reflect the differences of bone characteristics in the real alveolar bone, and more conducive to obtain accurate analysis results.
Biomechanical Phenomena ; Computer Simulation ; Finite Element Analysis ; Humans ; Models, Biological ; Periodontal Ligament ; Stress, Mechanical ; Tooth Movement Techniques

Objective To study the effects of different root control attachment on root control and periodontal ligament （PDL） stress during canine distal translation in plastic aligner-based orthodontic treatment. Methods Through three-dimensional (3D) finite element technology, 11 models composed of 4 attachments and 3 kinds of loading were established. Namely, attachment A: no attachments; attachment B: traditional vertical rectangular attachment; attachment C: 1/4 spherical double optimized attachment; attachment D: double optimized door arch attachment; load a: 0.15 mm distal translation of the canine; b: load a+ application of 30 N·mm counterclockwise torque to stress surface of the attachment; load c: load a+ application of 30 N·mm counterclockwise torque to the entire crown. The root control effect of distal translation of the right maxillary canine was simulated with plastic aligner under different loads. Results Displacement modes of all models were distally tipped translation. The double optimized door arch attachment showed the optimal root control effect during canine distal translation. The root control effect for two groups of double optimized attachment was better than that of traditional rectangular attachment. The effect of adding attachments on root control of the canine was better than that of applying only counterclockwise couple. The PDL stress mainly appeared in distal alveolar ridge and root apex without attachment, while the PDL stress mainly appeared in distal alveolar ridge with attachment. Conclusions The most suitable measure to improve the effect of root control during canine distal translation is to use the double optimized door arch attachment in clinic.

Objective:To evaluate the effect of Jianxin-Pinglyu Pills combined with routine western medicine therapy on the patients with diabetes mellitus and ventricular arrhythmia (VA). Methods:A total of 92 patients with type 2 diabetes mellitus (T2DM) and VA who met inclusion criteria and treated in the hospital were enrolled between June 2019 and December 2020. According to random number table method, they were divided into observation group ( Jianxin-Pinglyu Pills on basis of control group) and control group (routine treatment), 46 cases in each group. Both groups were continuously treated for 2 months. Before and after treatment, TCM symptoms (chest pain and palpitation, chest distress and shortness of breath, dry mouth and thirst, fatigue) were scored. The fingertip blood was collected to detect levels of fasting blood glucose and 2 hPG. The 24 h dynamic electrocardiogram examination was conducted by electrocardiograph. The standard deviation of NN intervals (SDNN), standard deviation average of NN intervals (SDANN), the root mean square of successive R-R interval (RMSSD) and the percentage of adjacent NN intervals over 50 ms (PNN50) were statistically analyzed. The creatine kinase (CK) and creatine kinase isoenzymes (CK-MB) were detected by biochemical analyzer. The plasma brain natriuretic peptide (BNP) were detected by chemiluminescence immunoassay. The adverse reactions were recorded, and clinical curative effect was evaluated. Results:The differences in total response rate between observation group and control group were statistically significant [93.5% (43/46) vs. 78.3% (36/46); χ2=4.390, P=0.036]. After treatment, TCM symptoms (chest pain and palpitation, chest distress and shortness of breath, dry mouth and thirst, fatigue) in observation group were significantly lower than those in control group ( t=4.319, 2.714, 3.196, 4.667, P<0.01 or P<0.05), levels of fasting blood glucose and 2 hPG were significantly lower than those in control group ( t=2.025, 6.462, P<0.05 or P<0.01). After treatment, SDNN [(119.72 ± 5.86) ms vs. (115.27 ± 6.10) ms, t=3.568], SDANN [(112.80 ± 13.36) ms vs. (98.62 ± 14.51) ms, t=4.876], RMSSD [(46.87 ± 5.44) ms vs. (42.58 ± 5.73) ms, t=3.683] and PNN50 [(6.84 ± 0.66)% vs. (6.21 ± 0.64)%, t=4.648] in observation group were significantly higher than those in control group ( P<0.01), while the levels of CK [(263.82 ± 52.18) U/L vs. (306.59 ± 48.45) U/L, t=4.074] and CK-MB [(2.02 ± 0.62) g/L vs. (3.25 ± 0.49) g/L, t=10.556] were significantly lower than those in control group ( P<0.01), and level of plasma BNP [(126.99 ± 49.02) ng/L vs. (188.26 ± 54.30) ng/L, t=5.681] was significantly lower than that of control group ( P<0.01). During treatment, difference in incidence of adverse reactions between observation group and control group was not statistically significant [10.9% (5/46) vs. 4.3% (2/46); χ2 =0.619, P=0.432) ]. Conclusion:Jianxin-Pinglyu Pills combined with routine western medicine can effectively relieve clinical symptoms in patients with T2DM and VA, control hyperglycemia, improve heart rate variability, control levels of myocardial enzymes and plasma BNP, and safety.

Objective:To evaluate the efficacy of orthogonal low profile double-plate osteosynthesis (DPO) in the treatment of Neer type IIB distal clavicular fractures.Methods:A retrospective case-control study was carried out to analyze the clinical data of 31 patients with Neer type IIB distal clavicular fractures admitted to Second Affiliated Hospital of Zhejiang University School of Medicine from June 2016 to October 2017. There were 23 males and 8 females, aged 45-76 years(mean, 61.8 years). The left side was involved in 24 patients and right sidein 7. Out Of them, 7 patients were treated with hook plate osteosynthesis (HPO) (HPO group), 13 patients with precontoured distal clavicular locking plate osteosynthesis (LPO) (LPO group), and 11 patients with DPO (DPO group). The Constant-Murley shoulder functional outcomes, clavicle-coracoids distance (CCD), complications and hardware related symptomswere compared between groups.Results:All the patients were followed up for 10-27months(mean, 15.1 months). At the latest follow-up, Constant-Murley score was (93.8±5.1)points in LPO group and (94.8±5.8)points in DPO group, better than (84.3±13.2)points in HPO group ( P<0.05), while there was no significant difference between DPO and LPO groups ( P>0.05). CCD was increased(1 patient in HPO group, 5 in LPO group, 3 in DPO group), but there was no significantdifference between groups( P>0.05). No infection or implant breakage occurred in each group. One patient had nonunion in HPO group, 1 had malunion at trapezoid ligament bony end in LPO group and all had bone union in DPO group, showing no significant difference between groups ( P>0.05). Two patients had acromial bone corrosion and 1 had distal clavicle osteolysisin in HPO group, but not in LPO and DPO groups ( P<0.05). Three patients had hardware related symptoms in HPO group, 6 in LPO group, and none in DPO group ( P<0.05). Conclusion:Orthogonal low profile DPO can be a good choice for the treatment of distal clavicle Neer type IIB fractures, for it has advantages of good functional outcomes, lower complications and less hardware related symptoms.

Objective To investigate the incidence of intercalary fragment in adult ankle fractures and analyze the morphological characteristics of intercalary fragment as well as its relationship with the type of posterior malleolus fractures.Methods Data of 247 cases with posterior malleolus fractures from 369 cases of adult ankle fractures who were treated from January 2014 to January 2016 were retrospectively analyzed.The pre-operative Ⅹ-ray and CT data of the group were analyzed,and the incidence of intercalary fragment was measured.The intercalary fragment was classified by position,size and shape of its morphological features.The posterior malleolus fracture was classified according to Bartonícek classification system.The relationship between type of posterior malleolar fracture and the intercalary fragment was studied.The incidence of malreduction was also studied using the criterion of more than 2 mm separation or step.Results One hundred and six cases had intercalary fragment,accounting for 42.91％ (106/247) of the posterior malleolus fracture,and 28.73％ (106/369) of all ankle fractures.There were 81 cases with intercalary fragment larger than 2 mm,accounting for 32.79％ (81/247) of the posterior malleolus fracture.There were 33 cases with intercalary fragment larger than 5 mm,accounting for 13.36％ (33/247) of the posterior malleolus fracture.The incidence of intercalary fragment occurred in the posterolateral side was 64.15％ (68/247).According to Bartonícek classification,the incidence of type Ⅰ,Ⅱ,Ⅲ,and Ⅳ posterior ankle fracture was 8.91％ (22/247),49.39％ (122/247),21.86％ (54/247),and 19.84％ (49/247),respectively.The incidence of intercalary fragment was 4.54％ (1/22) in type Ⅰ posterior ankle fractures,40.16％ (49/122) in type Ⅱ,70.37％ (38/54) in type Ⅲ,and 36.73％ (18/49) in type Ⅳ.The incidence in type Ⅲ posterior malleolus fracture was significantly higher than that of other types of posterior malleolus fracture.CT scan after operation was conducted in 43 cases in which 19 cases had their intercalary fragment malreducted,accounting for 44.19％(19/43).Conclusion Intercalary fragment has high incidence in the posterior malleolus fracture,and the highest incidence occurs in Bartoníeek Ⅲ type posterior malleolus fracture.The study helps to further understanding and treatment of the posterior malleolus fracture.

Objective To observe the capability of inducing cerebral ischemia tolerance of Zingibers aqueous extract. Method Comparing the volume of cerebral infarction and the level of neurologic impairment in the model of middle cerebral artery occlusion in rats. Result The volume of cerebral infarction is (120.6?21.57)mm3 and (155.9?21.34)mm3 in the preconditioning group by Zingibers aqueous extract and control group respectively (P

Objective:To study the relationship between the levels of serum insulin,C-reactive protein(CRP),Tumor Necrosis Factor(TNF-?),insulin resistance index,blood fat,and phlegm-stagnation stasis syndrome of metabolic syndrome(MS),so as to discuss the signifi cance of phlegm-stagnation stasis syndrome in treatment based on syndrome differentiation of MS,in order to fi nd the objective evidence of differentiation of symptoms and signs of TCM of MS.Methods: In this study,54 cases with MS were divided into groups of phlegm-stagnation stasis syndrome and non-phlegm-stagnation stasis syndrome according to the clinical symptoms,tongue demonstration and pulse tracings.There were 25 cases in phlegm-stagnation stasis group,29 cases in non-phlegm-stagnation stasis group.The levels of serum insulin,CRP,TNF-?,blood fat were checked,the insulin resistance index was calculated.Results:The levels of serum insulin,CRP,TNF-? of the two groups of metabolic syndrome were signifi cantly higher than those of the healthy persons(P