Background: The transvenous approach to the treatment of cerebral arteriovenous malformation (AVM) is difficult and requires strict blood pressure and blood flow control; however, the cure rate is very high. Appropriate blood pressure control techniques can greatly benefit these patients.Case: A 55-year-old male patient was found to have an aneurysm complicated with a cerebral AVM (length: 2.0 cm, width: 1.6 cm, height: 1.2 cm). Aneurysm embolization was considered for the first-stage surgery and transvenous AVM embolization for the second-stage surgery. Rapid ventricular pacing (RVP) provided a stable blood flow environment for the surgery, which was completed successfully. Conclusion RVP can thus provide an ideal condition for the embolization of cerebral AVM through the transvenous approach and can be a viable surgical option.

Background: The transvenous approach to the treatment of cerebral arteriovenous malformation (AVM) is difficult and requires strict blood pressure and blood flow control; however, the cure rate is very high. Appropriate blood pressure control techniques can greatly benefit these patients.Case: A 55-year-old male patient was found to have an aneurysm complicated with a cerebral AVM (length: 2.0 cm, width: 1.6 cm, height: 1.2 cm). Aneurysm embolization was considered for the first-stage surgery and transvenous AVM embolization for the second-stage surgery. Rapid ventricular pacing (RVP) provided a stable blood flow environment for the surgery, which was completed successfully. Conclusion RVP can thus provide an ideal condition for the embolization of cerebral AVM through the transvenous approach and can be a viable surgical option.

Background: The transvenous approach to the treatment of cerebral arteriovenous malformation (AVM) is difficult and requires strict blood pressure and blood flow control; however, the cure rate is very high. Appropriate blood pressure control techniques can greatly benefit these patients.Case: A 55-year-old male patient was found to have an aneurysm complicated with a cerebral AVM (length: 2.0 cm, width: 1.6 cm, height: 1.2 cm). Aneurysm embolization was considered for the first-stage surgery and transvenous AVM embolization for the second-stage surgery. Rapid ventricular pacing (RVP) provided a stable blood flow environment for the surgery, which was completed successfully. Conclusion RVP can thus provide an ideal condition for the embolization of cerebral AVM through the transvenous approach and can be a viable surgical option.

Background: The transvenous approach to the treatment of cerebral arteriovenous malformation (AVM) is difficult and requires strict blood pressure and blood flow control; however, the cure rate is very high. Appropriate blood pressure control techniques can greatly benefit these patients.Case: A 55-year-old male patient was found to have an aneurysm complicated with a cerebral AVM (length: 2.0 cm, width: 1.6 cm, height: 1.2 cm). Aneurysm embolization was considered for the first-stage surgery and transvenous AVM embolization for the second-stage surgery. Rapid ventricular pacing (RVP) provided a stable blood flow environment for the surgery, which was completed successfully. Conclusion RVP can thus provide an ideal condition for the embolization of cerebral AVM through the transvenous approach and can be a viable surgical option.

Fusobacterium nucleatum (F. nucleatum) is an early pathogenic colonizer in periodontitis, but the host response to infection with this pathogen remains unclear. In this study, we built an F. nucleatum infectious model with human periodontal ligament stem cells (PDLSCs) and showed that F. nucleatum could inhibit proliferation, and facilitate apoptosis, ferroptosis, and inflammatory cytokine production in a dose-dependent manner. The F. nucleatum adhesin FadA acted as a proinflammatory virulence factor and increased the expression of interleukin(IL)-1β, IL-6 and IL-8. Further study showed that FadA could bind with PEBP1 to activate the Raf1-MAPK and IKK-NF-κB signaling pathways. Time-course RNA-sequencing analyses showed the cascade of gene activation process in PDLSCs with increasing durations of F. nucleatum infection. NFκB1 and NFκB2 upregulated after 3 h of F. nucleatum-infection, and the inflammatory-related genes in the NF-κB signaling pathway were serially elevated with time. Using computational drug repositioning analysis, we predicted and validated that two potential drugs (piperlongumine and fisetin) could attenuate the negative effects of F. nucleatum-infection. Collectively, this study unveils the potential pathogenic mechanisms of F. nucleatum and the host inflammatory response at the early stage of F. nucleatum infection.
Humans ; Fusobacterium nucleatum/metabolism* ; NF-kappa B/metabolism* ; Periodontal Ligament/metabolism* ; Signal Transduction ; Fusobacterium Infections/pathology* ; Stem Cells/metabolism*

The rapid changes in the research and development environment of new anti-tumor drugs in China have brought various challenges to drug innovation. How to explore the clinical advantages of new drugs in the early phase, and design scientific, reasonable and efficient pivotal clinical trials for drug registration accordingly, is one of the key challenges. This article takes innovative new drugs for hematological malignancies as an example, comprehensively elaborates the considerations on the timing for entering the pivotal clinical trial and the key elements of the trial design from the perspective of clinical reviewers.

Life-limiting fetal condition (LLFC) is a devastating event for the entire family, and it can also cause work distress and negative emotions for healthcare workers. The implementation of high-quality perinatal palliative care (PPC) can help pregnant women and families cope with the pain caused by trauma and maximize the quality of life and comfort of the fetus. Perinatal palliative care knowledge, skills, and attitudes of health care workers are closely related to the quality of palliative care services and maternal and infant outcomes. This article summarizes the knowledge, skills, and attitude assessment tools of perinatal palliative care of health care workers, in order to provide a reference for the development of perinatal palliative care assessment tools suitable for China.

Objective To explore the application of 3D printing templates for titanium plate contouring (TrPC) in pelvic ring surgery.Methods From May 2016 to June 2018,12 patients with pelvic ring injury were treated by internal fixation with 24 titanium plates at Department of Orthopedics and Trauma,Sanshui People's Hospital.After solid digital models of the damaged pelves of the patients were reconstructed from their CT images via software,the hollowed ones were created with the wall thickness of 1.2 mm.After the models of damaged pelves were restored to be intact,the templates for titanium plate contouring were designed based on the area of fixation and manufactured via a stereo lithography apparatus.The total manufacturing time and material consumption of 3D printing TTPC were recorded and compared with those of 3D printing solid and hollow models.Before operation,the titanium plates were contoured according to the templates.The time for preoperative shaping the plate and the time for intraoperative preparing the plate before installation were recorded.After operation,all patients underwent CT scan again for reconstruction of 3D models of the postoperative pelves which were compared with their corresponding preoperative ones in the software.Matta criteria were used to evaluate the pelvic reduction and Majeed criteria to evaluate the functional recovery 6 months after operation.Results All patients were followed up for 6 to 28 months (average,16.3 months).The total manufacturing time and material consumption of 3D printing a TTPC were significantly less than those of 3D printing a solid or hollow model (P ＜ 0.05).The time for preoperative shaping the plate was 12.8 ± 4.1 minutes and the time for intraoperative preparing the plate was 1.4 ± 1.1 minutes.The average deviation between the preoperative 3D models and the postoperative ones was 1.4 ± 1.1 mm.According to the Matta criteria for pelvic reduction,6 cases were excellent,4 good and 2 satisfactory.According to the Majeed criteria,the pelvic functions were excellent in 7 cases,good in 4,and fair in one.Conclusion Application of 3D printing TTPC in the surgery for pelvic ring injury is advantageous in lowering the costs of 3D printing and reducing the intraoperative time for contouring the titanium plate,leading to satisfactory outcomes.

Objective To investigate the method of modeling, finite element modeling and AnyBody musculoskeletal multi-body dynamics simulation technique analyze the biomechanics of clinical orthopaedic surgery. Methods The AnyBody software was used to establish the musculoskeletal motor model of the individualized upper limbs according to the height, weight and CT data of the volunteers. The flexion motion of the elbow in normal people was simulated, and the muscle force, joint force, torque, constraint condition of the humerus during the flexion movement were derived and used as the boundary conditions of finite element analysis.Then, the 3D reconstruction was conducted in the MIMICS software based on CT data. In the Geomagic Studio software, the humeral curved surface and position coordinate matching were completed, and grid division and material assignment were done in the HyperMesh software. Finally, the 3D reconstruction for finite element model of the humerus was introduced into ABAQUS software. The boundary condition data derived from the AnyBody software were applied and the stress calculation analysis was performed. Results The results of the stress and displacement of the humerus during elbow flexion motion were calculated in the ABAQUS software. The maximum stress and displacement of the humerus were 0.76 MPa and 20 μm when flexion of the elbow joint was about 90°. Conclusions A continuous dynamic analysis of humeral stress and displacement during elbow flexion motion was realized, which was more consistent with the requirements of human physiological anatomy and could provide an efficient analysis platform and a new way for studying clinical orthopedic problems.

Objective To analyze the epidemiological characteristics of human brucellosis in northern and southern areas of China,and to develop national strategies for brucellosis prevention and control.Methods Individual data on human brucellosis was collected from the National Notifiable Infectious Disease Reporting Information System to describe the situation of brucellosis in China during 2015-2016.Epidemiological features of the disease in northem and southern areas of China were analyzed.Results A total of 104 125 cases were reported in mainland China during 2015-2016,with an average incidence rate as 3.81/100 000.The overall incidence rate from the northem provinces was 7.77/100 000 in 2016,a 18.6％ decrease from 2015 (9.55/100 000),whereas the incidence rate in the southern provinces was 0.27/100 000 in 2016,with an increase of 28.6％ than 0.21/100 000 in 2015.90.0％ of the newly infected counties mainly distributed in southern China.As for the locations of reporting cases,most of them were in the same counties in the northern areas (52.3％) while most cases in the southern areas (59.6％) were imported from other counties.The median age of the cases was 48 (IQR:38-58) years,with male-to-female ratios as 2.7 ∶ 1 in the north and 2.2 ∶ 1 in the south.Majority of the cases were occupation-related,from both the northern (86.8％) and southern (62.7％) areas.Human brucellosis occurred every month throughout the year but with an obvious seasonal increase between March and July.Conclusions Different epidemiological features of human brucellosis appeared in both northern and southern areas of China.The disease was seen endemic in the northem and dispersal in the southem provinces.Appropriate strategies for brucellosis prevention and control should be developed,according to the different epidemiological characteristics in the northcm or southcm areas.