The risks related to the essential performance were analyzed with considerations on the concept of the essential performance in GB 9706.1-2020 Medical electrical equipment-Part 1:General requirements for basic safety and essential performance,and the determination process for the essential performance of medical electrical equipment was summarized.The essential performance of the example equipment was clarified with the semi-quantitative risk analysis,and the influences of the arrangement of the electromagnetic compatibility test on the determination of the essential performance were explored with the conducted immunity test and conventional test.References were provided for standard users to understand and determine the essential performance effectively.[Chinese Medical Equipment Journal,2024,45(11):72-76]

Growing clinical evidence shows that Qufeng Gutong Cataplasm may exert a significant analgesic effect. However, the pharmacological characteristics and mechanisms underlying this prescription are still unclear. In the current study, a "disease-syndrome-symptom-formula" association network analysis was performed to explore the pharmacological characteristics and mechanisms of Qufeng Gutong Cataplasm against osteoarthritis (OA), neuropathic pain (NP), chronic inflammatory pain (CIP) and myofascial pain syndrome (MPS) by integrating clinical phenomics data, transcriptomics data and biological interaction network mining. As a result, the three functional modules (Qufeng Sanhan-QFSHG, Shujin Huoxue-SJHXG and Xiaozhong Zhitong-XZZTG) enriched by the drug network targets were all related to the pharmacological effects of Qufeng Gutong Cataplasm, including dispersing cold and relieving pain, activating blood and relieving pain, reducing swelling and relieving pain. In addition, the main pharmacological effects of QFSHG and XZZTG were dispelling wind and dispersing cold and dehumidifying, promoting Qi and reducing swelling and relieving pain, respectively. In terms of reversing the imbalance of "immune-inflammation-vascular axis", the main pharmacological effects of SJHXG were regulating the liver and promoting Qi, activating blood circulation and removing stasis. Mechanically, the key network targets of Qufeng Gutong Cataplasm against OA, NP, CIP and MPS may play a therapeutic role in relieving hyperalgesia and paresthesia by reversing the "neuro-endocrine-immune" imbalance system during the occurrence and progression of diseases. In conclusion, our data indicate that Qufeng Gutong Cataplasm may relieve the pain and wind-cold-dampness arthralgia syndrome related symptoms by regulating the "neuro-endocrine-immune" system, neurological and endocrine disorders and reversing the imbalance of "immunity-inflammation". The relevant results may provide a network-based evidence for clinical positioning of Qufeng Gutong Cataplasm, and offer a direction for further clinical and experimental validation.

OBJECTIVE: To explore the clinical value and safety of unilateral pedicle screw fixation combined with contralateral translaminar facet screw fixation and interbody fusion by muscle-splitting approach treatment of recurrent lumbar disc herniation. METHODS: The clinical data of 51 patients with recurrent lumbar disc herniation treated from June 2012 to December 2017 were retrospectively analyzed. There were 32 males and 19 females, aged 34 to 64 years with an average of (51.11± 7.28) years. Lesions invoved L RESULTS: There was no statistical difference in operation time between two groups ( CONCLUSION Muscle-splitting approach is feasible for thetreatment of recurrent lumbar disc herniation with pedicle screw fixation combined with contralateral translaminar facet screw fixation and interbody fusion. Compared with the median incision approach, the muscle-splitting approach has the advantages of small incision, less trauma, less bleeding, rapid recovery. Also it can protect multifidus and do not increase the incidence of serious complications. Thus, it can be used as a choice for fixation and fusion of recurrent lumbar disc herniation.
Adult ; Female ; Humans ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement/surgery* ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Muscles ; Pedicle Screws ; Retrospective Studies ; Spinal Fusion ; Treatment Outcome

China ; Humans ; Otolaryngology

Objective:To explore the mechanism and compatibility characteristics of Baimai ointment （BMO） in the treatment of white vein disease from the network perspective based on system theory， so as to provide biological basis for its clinical application. Method:The chemical components and the corresponding candidate target spectra of BMO were obtained from The Encyclopedia of Traditional Chinese Medicine （ETCM） and Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine （TCMIP）. According to the clinicopathological characteristics of white vein disease， focusing on four diseases/symptoms including neuropathic pain， inflammatory pain， chronic pain and lumbar disc herniation root neuralgia， the gene sets related to white vein disease were collected in Human Phenotype Ontology （HPO）， DisGeNET and other databases， then the interaction network of the targets of active components in BMO-gene sets related to white vein disease was constructed. On this basis， the hub network nodes were selected and enriched for exploring the mechanism of four functional groups of BMO in the treatment of white vein disease such as Huoxue Tongluo group （Curcumae Longae Rhizoma， Moschus， Tronae）， Xingqi Zhitong group （Myristicae Semen， Nardostachyos Radix et Rhizoma， Acori Calami Rhizoma）， Wenjing Sanhan Tongluo group （Zingiberis Rhizoma， Zanthoxyli Pericarpium， Caraway） and Jianpi Wenshen Qianggu group （Actinolite， Glycyrrhizae Radix et Rhizoma）. Result:The enriched pathways of the four functional groups in BMO were mainly distributed in three modules of nervous system function， inflammation-immune system regulation and body energy metabolism， and each module was connected by common target genes especially had its own focus. Among them， the regulation of nervous system function in Huoxue Tongluo group and Xingqi Zhitong group could be summarized as Huoxue Buqi and Xingshen Kaiqiao. Xingqi Zhitong group and Jianpi Wenshen Qianggu group were mainly used to promote the operation of Qi， promote blood metaplasia， enhance immunity and maintain the regulation of inflammation-immune system. Jianpi Wenshen Qianggu group and Wenjing Sanhan Tongluo group mainly regulated body energy metabolism by invigorating the spleen and supplementing Qi as well as warm-heat medicine. The whole formula focused on the multi-dimensional and multi-level mechanism of BMO in the intervention of white vein disease. Each functional group emphasized its respective characteristics in nervous system function， inflammation-immune regulation， and body energy metabolism. Two types of networks analysis models complemented and verified each other. Conclusion:BMO plays a role in the treatment of white vein disease mainly by regulating the function of nervous system， maintaining the balance of inflammation-immune system and interfering with energy metabolism. The relevant research results can provide reference for the in-depth exploration of the mechanism of BMO， and help to guide the clinical rational use of this preparation.

Traditional Chinese medicine （TCM） is a great treasure house， exhibiting unique advantages in the treatment of some difficult and critical diseases. The incidence rate of membranous nephropathy has increased year by year in recent years， and has become the first cause of primary glomerular diseases. However， its pathogenesis is not clear. Modern medicine often uses immunosuppressive therapy， but it often faces the problems of high side effects and high recurrence rate. The China Association of Chinese Medicine （CACM） invited clinical experts of TCM and western medicine to fully discuss membranous nephropathy， which was later confirmed to be one of the clinical diseases responding specifically to TCM. Apart from summarizing the pathogenesis and clinical diagnosis and treatment of membranous nephropathy in both TCM and western medicine， this paper also detailed TCM cognition， syndrome differentiation， and therapeutic schemes of membranous nephropathy， aiming to improve the clinical remission rate of membranous nephropathy and provide reference for its clinical treatment.

OBJECTIVE: To compare well-known preload dynamic parameters intraoperatively including stroke volume variation (SVV), pulse pressure variation (PPV), and plethysmographic variability index (PVI) in children who underwent craniotomy for epileptogenic lesion excision. METHODS: A total of 30 children aged 0 to 14 years undergoing craniotomy for intracranial epileptogenic lesion excision were enrolled. During surgery, we measured PPV, SVV (measured by the Flotrac/Vigileo device), and PVI (measured by the Masimo Radical-7 monitor) simultaneously and continuously. Preload dynamic parameter measurements were collected at predefined steps: after induction of anesthesia, during opening the skull, intraoperative electroencephalogram monitoring, excision of epileptogenic lesion, skull closure, at the end of the operation. After exclusion of outliers, agreement among SVV, PPV, and PVI was assessed using repeated measures of Bland-Altman approach. The 4-quadrant and polar plot techniques were used to assess the trending ability among the changes in the three parameters. RESULTS: The mean SVV, PPV, and PVI were 8%±2%, 10%±3%, and 15%±7%, respectively during surgery. We analyzed a total of 834 paired measurements (3 to 8 data sets for each phase per patient). Repeated measures Bland-Altman analysis identified a bias of -2.3 and 95% confidence intervals between -1.9 and -2.7 (95% limits of agreement between -6.0 and 1.5) between PPV and SVV, showing significant correlation at all periods. The bias between PPV and PVI was -5.0 with 95% limits of agreement between -20.5 and 10.5, and that between SVV and PVI was -7.5 with 95% limits of agreement between -22.7 and 7.8, both not showing significant correlation. Reflected by 4-quadrant plots, the con-cordance rates showing the trending ability between the changes in PPV and SVV, PPV and PVI, SVV and PVI were 88.6%, 50.4%, and 50.1%, respectively. The concordance rate between PPV and SVV was higher (92.7%) in children aged less than 3 years compared with those aged 3 and more than 3 years. The mean angular bias, radial limits of agreement, and angular concordance rate in the polar analysis were not clinically acceptable in the changes between arterial pressure waveform-based parameters and volume-based PVI (PPV vs. PVI: angular mean bias 8.4°, angular concordance rate 29.9%; SVV vs. PVI: angular mean bias 2.4°, angular concordance rate 29.1%). There was a high concordance between the two arterial pressure waveform-based parameters reflected by the polar plot (angular mean bias -0.22°, angular concordance rate 86.6%). CONCLUSION PPV can be viewed as a surrogate for SVV, especially in children aged less than 3 years. The agreement between arterial pressure waveform-based preload parameters (PPV and SVV) and PVI is poor and these two should not be considered interchangeable. Attempt to combine PVI and PPV for improving the anesthesiologist's ability to monitor cardiac preload in major pediatric surgery is warranted.
Arterial Pressure ; Blood Pressure ; Child ; Craniotomy ; Humans ; Monitoring, Intraoperative ; Stroke Volume

Aim To investigate the influence of different concentrations of dextran sulfate sodium (DSS) and administration approaches on the establishment of mouse model of acute ulcerative colitis(UC). Methods Mice were randomly divided into the normal control group, 3% DSS free drinking group, 4% DSS free drinking group, 30% DSS intragastric administration group and 40% DSS intragastric administration group. The amount and average dosage of intaken DSS by mice in free drinking group were measured and the intragastric administration group were given the same dosage. The survival rate, disease activity index (DAI), the lengths and pathological changes of colon were observed, and the coefficients of variation of each indicator described above were compared among the groups. Results Except for the normal control group, other groups developed experimental UC. Among these four approaches, 3% DSS solution free drinking showed appropriate incidence, higher animal survival rate and operability and lower cost, while there was no significant difference in the coefficients of variation of DAI between 3% DSS solution free drinking group and the others. Conclusion 3% DSS solution free drinking has more advantages in the establishment of a murine model with acute UC than other approaches.

Objective To realize the automated bone age assessment by applying deep learning to digital radiography(DR)image recognition of left wrist joint in Uyghur teenagers, and explore its practical ap-plication value in forensic medicine bone age assessment. Methods The X-ray films of left wrist joint after pretreatment, which were taken from 245 male and 227 female Uyghur nationality teenagers in Uygur Autonomous Region aged from 13.0 to 19.0 years old, were chosen as subjects. And AlexNet was as a regression model of image recognition. From the total samples above, 60% of male and fe-male DR images of left wrist joint were selected as net train set, and 10% of samples were selected as validation set. As test set, the rest 30%were used to obtain the image recognition accuracy with an error range in ±1.0 and ±0.7 age respectively, compared to the real age. Results The modelling results of deep learning algorithm showed that when the error range was in ±1.0 and ±0.7 age respectively, the accuracy of the net train set was 81.4% and 75.6% in male, and 80.5% and 74.8% in female, respectively. When the error range was in ±1.0 and ±0.7 age respectively, the accuracy of the test set was 79.5% and 71.2% in male, and 79.4% and 66.2% in female, respectively. Conclusion The combination of bone age research on teenagers' left wrist joint and deep learning, which has high accuracy and good feasi-bility, can be the research basis of bone age automatic assessment system for the rest joints of body.

OBJECTIVE This work aimed to investigate the anti-rheumatoid arthritic effect of gentio-picroside from Gentiana macrophylla Pall using an animal model of adjuvant induced arthritis. METH-ODS Adjuvant arthritis was induced in fifty SD male rats,which were randomly divided into five groups (n=10):control(0.5% CMC-Na)group,AIA(rats with CFA)group,dexamethasone(1 mg·kg-1)group, gentiopicroside(50 mg·kg-1)group,and gentiopicroside(100 mg·kg-1)group.Rats were administered intragastrically with drugs or CMC-Na once a day for a period of 2 weeks.Paw swelling,arthritic index, histological changes were assessed to evaluate the anti-arthritic effect.Weight growth,spleen and thymus indexes were also investigated in.RESULTS Gentiopicroside at dose of 100 mg·kg-1significantly inhibited the secondary paw swelling(P<0.05)and arthritis index(P<0.05),decreased synovial inflammatory infil-tration, synovial hyperplasia and bone erosion. Furthermore, gentiopicroside showed no immunosup-pressive adverse effects in body weight, index of spleen and thyums compared with dexamethasone administration (P<0.05, P<0.01). CONCLUSION Gentiopicroside possessed anti-arthritic efficacy in AIA rats without immunosuppressive effects.