Neck dissection(ND)is one of the main treatment methods for oral and maxillofacial malignancies.Although ND type is in con-stant improvement,but intraoperative peal-pull-push injury of the accessory nerve,muscle,muscle membrane,fascia and ligament induced shoulder syndrome(SS)is still a common postoperative complication,combined with the influence of radiochemotherapy,not only can cause pain,stiffness,numbness,limited dysfunction of shoulder neck and arm,but also may have serious impact on patient's life quality and phys-ical and mental health.At present,there is still a lack of a systematic evaluation and rehabilitation management program for postoperative SS of oral and maxillofacial malignant tumors.Based on the previous clinical practice and the current available evidence,refer to the relevant lit-erature at home and abroad,the experts in the field of maxillofacial tumor surgery and rehabilitation were invited to discuss,modify and reach a consenusus on the etiology,assessment diagnosis,differential diagnosis,rehabilitation strategy and prevention of SS,in order to provide clinical reference.

The effect of porcine SIRT5 on replication of foot and mouth disease virus type O(FMDV-O)and the underlying regulatory mechanism were investigated.Western blot and RT-qPCR analyses were employed to monitor expression of endoge-nous SIRT5 in PK-15 cells infected with FMDV-O.Three pairs of SIRT5-specific siRNAs were synthesized.Changes to SIRT5 and FMDV-O protein and transcript levels,in addition to virus copy numbers,were measured by western blot and RT-qPCR analyses.PK-15 cells were transfected with a eukaryotic SIRT5 expression plasmid.Western blot and RT-qPCR analyses were used to explore the impact of SIRT5 overexpression on FMDV-O replication.Meanwhile,RT-qPCR analysis was used to detect the effect of SIRT5 overexpression on the mRNA expression levels of type I interferon-stimulated genes induced by SeV and FMDV-O.The results showed that expression of SIRT5 was up-regulated in PK-15 cells infected with FMDV-O and siRNA interfered with SIRT5 to inhibit FMDV-O replication.SIRT5 overexpression promoted FMDV-O replication.SIRT5 over-expression decreased mRNA expression levels of interferon-stimulated genes induced by SeV and FMDV-O.These results suggest that FMDV-O infection stimulated expression of SIRT5 in PK-15 cells,while SIRT5 promoted FMDV-O rep-lication by inhibiting production of type I interferon-stimula-ted genes.These findings provide a reference to further ex-plore the mechanism underlying the ability of porcine SIRT5 to promote FMDV-O replication.

The working principle of the optical system of Elekta Versa HD Linear Accelerator Agility head was introduced in brief.The causes for its daily failures were analyzed,and the countermeasures were put forward accordingly.References were provided for clinical engineers to treat similar failures.[Chinese Medical Equipment Journal,2024,45(7):118-120]

Objective:To evaluate the stability of the positioning precisions of the leaves of accelerator multi-leaf collimator(MLC)at different gantry angles,so as to determine whether the positioning precision of leaf is affected by the gantry angle.Methods:The HD 120 MLC of American Varian Edge medical linear accelerator at our hospital was selected,and the Varian Eclipse radiotherapy planning system was used to design test cases.One test plan included 5 dynamic subfields(named PMLCE)was designed,which ray amount was 100MU,and small machine head was kept at 0°position,and the numbers of the positions of corresponding leaves of each control point were respectively-20,-15,-10,-5,0,5,10 and 12 that were 8 in total,and the dose rate was set at 500MU/min.In test,all leaves slid as uniform velocity from one extreme position to the opposite extreme position,and the movement distance of leaves between the adjacent control points was 5 cm.The PMLCE test plan was executed on the EDGE linear accelerator by using the IEC1217 coordinate system,and each test was conducted at eight different gantry angles(0°,45°,90°,135°,180°,225°,270° and 315°),and a total of 8 treatment log files of accelerator were obtained.A program was written by using Matlab2016a(MathWorks,USA)software to read the log files of accelerator,and extract out leaf position data,and calculate the deviation between the actual position and planned position of all leaves,and record a total of 960 data of positioning deviations of 120 leaves at 8 leaves positions which included in each file.The above acquisition scheme of data was performed per three days for 10 times,and then the average value was obtained.There were the data of positioning deviations of a total of 8 groups of HD 120 MLC at different gantry angles.The above 8 groups of data were analyzed as statistical method.Results:Under various angles,the range of the percentage of"leaf positioning deviations≤10 μm"was between 45.7%and 58.3%,and that of"leaf positioning deviations≤30 μm"was between 95.6%and 99.2%.When the gantry angle was at 0° and 180°,the leaf positioning accuracy was relatively higher,and the percentages of"leaf positioning deviations≤10 μm"were respectively 58.3%and 57.9%.The maximum positioning error of the HD 120 MLC did not exceed 43.3 μm.The results of the one-way ANOVA showed that there were significant differences in the average positioning precisions between 0° and each one of 45°,90°,135°,225°,270° and 315°,and between 90° and 180°,and between 135° and 180°,and between 180° and each one of 225°,270° and 315° under the gantry angles were respectively 0°,45°,90°,135°,180°,225°,270° and 315°,and under the observation values of the positioning precision of 8 leaf positions(F=4.32,F=5.67,F=3.98,F=3.85,F=6.14,F=2.87,F=4.89,F=4.56,F=4.12,F=5.01,F=6.77,P<0.05).There were no significant differences in the positioning precision among other gantry angles.Conclusion:The positioning precisions of HD 120 MLC leaf under different gantry angles can be kept at higher level,but the influences of gantry angles on the positioning precision of leaf indeed existed.Therefore,doctors and physicists should fully consider these factors under the design stage of treatment plan,so as to optimize the dose distribution and enhance the treatment outcomes.

Ambystoma mexicanum/immunology* ; Amputation ; Animals ; Biomarkers/metabolism* ; Blastomeres/immunology* ; Cell Lineage/immunology* ; Connective Tissue Cells/immunology* ; Epithelial Cells/immunology* ; Forelimb ; Gene Expression ; High-Throughput Nucleotide Sequencing ; Humans ; Immunity ; Peroxiredoxins/immunology* ; Regeneration/immunology* ; Regenerative Medicine/methods* ; Single-Cell Analysis/methods*

Objective:To analyze the clinical characteristics of acute drug poisoning, and provide better management for poisoned patients in Emergency Department.Methods:We retrospectively enrolled 197 patients diagnosed as acute drug poisoning in Emergency Department of Beijing Chaoyang Hospital from January 1, 2019 to December 31, 2019. Medical records included age, gender, baseline diseases, medication time, visit time, kinds of drugs, drug concentrations, accompanying symptom, hospitalization duration, treatment, fluid resuscitation and outcomes. The inclusion criteria were as follows: age≥ 14 years old, and met the criteria of acute poisoning. The exclusion criteria were as follows: age<14 years old; incomplete clinical data; pesticide poisoning; toxic gas poisoning; and other non-drug poisoning. All patients were divided into the survival group and death group according to their outcomes at the discharge. Clinical characteristics, laboratory parameters and treatments were compared using the Student’s t test, Mann-Whitney U test, as appropriate. Results:The mean age of all the patients was 38.9±20.4 years. The majority were young patients, accounting for 134 cases (68.0%). The accompanying symptoms included consciousness disturbance (106 cases), dizziness (56 cases), fatigue (38 cases), and nausea and/or vomiting (42 cases). The duration of medication-to-visit time was 0.5-96 h, with an average of 7.17±0.89 h. The types of drugs included 105 (53.2%) sedatives and hypnotics, 73 antipsychotics (37.1%), 17 antibiotics (8.6%), and 20 antipyretic analgesics (10.2%). The Glasgow comascale (GCS) score of patients in the survival group was higher than that of the death group (12.47±3.05 vs 7.60±4.43, P<0.01). In the death group, the alanine aminotransferase, urea nitrogen, creatinine, cardiac troponin I, prothrombin time, activated partial thromboplastin time, plasma fibrinogen and D-dimer were higher than those of the survival group (all P<0.05). One hundred and eighty-seven patients were cured, while 10 patients died. One hundred and fifty-nine patients were treated with gastric lavage, and 23 patients were treated with blood purification. The concentrations of toxic drugs before and after treatment in 134 poisoned patients were compared. The concentration of drugs after treatment was significantly lower than that before treatment. Conclusions:Acute non-pesticide poisoning in Emergency Department is mainly caused by sedatives, hypnotics, antipsychotics, and antipyretics and analgesics. It is important to conduct laboratory examinations for toxic medications to provide better management for poisoned patients. It is necessary to establish a standardized monitoring system and management path for acute drug poisoning.

BACKGROUND: Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China. METHODS: The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD. RESULTS: A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to ≥2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation ≥7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05). CONCLUSION Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.
Birth Weight ; Bronchopulmonary Dysplasia ; China/epidemiology* ; Delivery Rooms ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Extremely Premature ; Infant, Newborn ; Male ; Pregnancy

As the famous Chinese patent medicine, Yinhua Miyanling Tablets, which was derived from ancient prescription denominated Bazhengsan, has not only the effects in clearing away heat and purging pathogenic fire, removing dampness and relieving stranguria, but also have the functions of detoxifying and tonifying. A great number of scientific studies have demonstrated that Yinhua Mi-yanling Tablets played significant roles in destroying harmful microbes and resisting inflammatory and diuresis. Compared with antibiotics, traditional antibacterial Chinese patent medicine Yinhua Miyanling Tablets has the advantage in bacterial resistance in long-term use. Fundamental studies about the content of pharmaceutical ingredients and the modern pharmacology of Yinhua Miyanling Tablets were collected and summarized, which conduces to indicating the active ingredients of Yinhua Miyanling Tablets with the medicinal efficacy from the molecular level and the internal mechanism of Yinhua Miyanling Tablets in the treatment of urinary tract infection(UTI) from the scientific perspective. In the field of clinical research, literatures associated with Yinhua Miyanling Tablets for the treatment of UTI were summarized and analyzed in terms of treatment type, administration mode, dosage, frequency of medication, course, efficiency, side effects and whether combined with healthy lifestyle. These literatures confirmed the medicinal values and the application prospect of Yinhua Miyanling Tablets in treating UTI, especially acute UTI, which provides a scientific theoretical foundation and a correct direction for the clinical application of Yinhua Miyanling Tablets. In conclusion, this article contributes to the standardization of Yinhua Miyanling Tablets in the treatment of UTI, in the expectation of giving the scientific guidance for clinical practice.
Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Research ; Tablets ; Urinary Tract Infections ; drug therapy

While it is known that spermatogonial stem cells (SSCs) initiate the production of male germ cells, the mechanisms of SSC self-renewal, proliferation, and differentiation remain poorly understood. We have previously identified Strawberry Notch 1 (SBNO1), a vertebrate strawberry notch family protein, in the proteome profile for mouse SSC maturation and differentiation, revealing SBNO1 is associated with neonatal testicular development. To explore further the location and function of SBNO1 in the testes, we performed Sbno1 gene knockdown in mice to study the effects of SBNO1 on neonatal testicular and SSC development. Our results revealed that SBNO1 is required for neonatal testicular and SSC development in mice. Particularly, in vitro Sbno1 gene knockdown with morpholino oligonucleotides caused a reduction of SSCs and inactivation of the noncanonical Wnt pathway, through Jun N-terminal kinases. Our study suggests SBNO1 maintains SSCs by promoting the noncanonical Wnt pathway.
Adult Germline Stem Cells/metabolism* ; Animals ; Cell Proliferation/physiology* ; Gene Knockdown Techniques ; Male ; Mice ; Proteome ; Repressor Proteins/metabolism* ; Testis/metabolism* ; Wnt Signaling Pathway/physiology*

A questionnaire survey of 1 000 clinicians having experience in treating uncomplicated lower urinary tract infections from different levels of hospitals was conducted to mainly evaluate the applicability and effectiveness of clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for uncomplicated lower urinary tract infection(hereinafter referred to as Guideline). The research was conducted with the three-level quality control strictly throughout the process, and the data was real and reliable. The survey's results showed that: most clinicians considered that the Guideline had good clinical applicability. The availability and price of the recommended medicine were moderate. Traditional Chinese medicine had obvious features and advantages in treating lower urinary tract infection for it could reduce the usage of antibiotics and shorten the course of antibiotic application. In the recommendation section, clinicians proposed increasing medication guidance, updating the Guideline timely, as well as increasing treating methods and techniques, strengthen propaganda and promotion, and improve the use of evidence-based methods. In the evaluation of effectiveness, the majority of clinicians agreed that the definition in both traditional Chinese medicine (TCM) and Western medicine and differential diagnosis in the Guideline were accurately described and the basic principle of treatment as well as the treating method of TCM were recommended appropriately. The TCM formulas and Chinese patent medicine had good effect. Some clinicians suggested refining the syndrome differentiation of stranguria. Some clinicians considered that the formulas and herbs recommended in Guideline didn't have obvious effect and some had doubts about the manipulation of fumigation and washing in the part of other methods recommended in Guideline. Moreover, specification and procedure of manipulation of fumigation and washing using herbs and the acupuncture included in characteristic TCM therapy treating uncomplicated lower urinary tract infection remained to be developed.
Acupuncture Therapy ; Anti-Bacterial Agents ; Diagnosis, Differential ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Urinary Tract Infections