Objective To provide anatomical,radiological,and clinical diagnostic and therapeutic references for ankylosing spondylitis and spinal surgical operations.Methods Non-measurement spinal observations,X-ray examinations,and measurements were performed on two spinal specimens,along with digital image acquisition and processing.Results The first specimen included thoracic vertebra 7(T7)to lumbar vertebra 3(L3),with an average total length of 29.7 cm;the second specimen ranged from cervical vertebra 7(C7)to lumbar vertebra 2(L2),with an average total length of 38.3 cm.The specimens showed partial or complete calcification of ligaments,ossification of the small joints and intervertebral discs,and osteoporosis;The anterior-posterior diameter(width)of the vertebral foramen was narrower than that of a normal adult,while most of the superior-inferior diameter(height)was wider.Radiographically,the anterior longitudinal ligament calcification appeared as dot-like or striated,but it was actually flaky in the actual specimens.The specimens provided views of the facet joints,costovertebral joints,and intervertebral foramina that was difficult to demonstrate on two-dimensional X-ray images.Conclusion As ankylosing spondylitis progresses,the range of motion in spinal bending and rotation decreases,as does the extent of thoracic expansion,thereby affecting respiration and complicating procedures such as intraspinal anesthesia and sacral canal injections.In terms of diagnosis,bone specimens and X-ray films allow us to understand the development process and severity of ankylosing spondylitis more directly and accurately.

Objective To evaluate the corneal biomechanical changes after femtosecond laser-assisted in situ kerato-mileusis(FS-LASIK)combined with accelerated corneal cross-linking(FS-LASIK Xtra)for the correction of high myopia u-sing Corvis ST.Methods In this prospective case-control study,185 patients(185 eyes)who underwent surgical correc-tion of high myopia in the Affiliated Eye Hospital of Shandong University of Chinese Medicine from July 2020 to July 2022 were selected,including 93 patients receiving FS-LASIK Xtra in the FS-LASIK Xtra group and 92 patients receiving FS-LASIK in the FS-LASIK group.All patients had their right eyes included in the study.During the 6-month follow-up,the uncorrect-ed visual acuity,spherical equivalent(SE),mean corneal curvature,thinnest corneal thickness,corneal biomechanical pa-rameters[deformation amplitude ratio at 2 mm(DAR 2 mm),integrated radius(IR),stiffness parameter at the first appla-nation(SP-A1),stress-strain index(SSI)],and changes in corneal biomechanical parameters before and after surgery(difference between 6 months after surgery and before surgery,namely ΔDAR 2 mm,ΔIR,ΔSP-A1,and ΔSSI)were recor-ded.Independent sample t test and Mann-Whitney U test were used to compare the data between groups.Results Three months after surgery,the SE in the FS-LASIK group and the FS-LASIK Xtra group was(-0.21±0.31)D and(-0.04±0.36)D,respectively,and the difference was statistically significant(t=3.49,P=0.001).Six months after surgery,the SE in the FS-LASIK group and the FS-LASIK Xtra group was(-0.33±0.31)D and(-0.14±0.37)D,respectively,and the difference was statistically significant(t=4.00,P＜0.001).There was no significant difference in efficacy index and safety index between the FS-LASIK group and the FS-LASIK Xtra group at 6 months after operation(both P＞0.05).There were no significant differences in DAR 2 mm,IR,SP-A1,SSI and other biomechanical parameters between the two groups before surgery(all P＞0.05).At 6 months postoperatively,ΔIR in the FS-LASIK group and the FS-LASIK Xtra group was 3.03±0.78 and 2.67±0.80,respectively;ΔSP-A1 was-35.93±12.04 and-30.43±12.44,respectively;and ΔSSI was-0.09±0.10 and-0.03±0.06,respectively.The differences between the two groups were all statistically significant(all P＜0.05).Conclusion FS-LASIK Xtra for correction of high myopia improves the stability of postoperative visual acuity and SE with good safety and efficacy,but reduces the stability of comeal biomechanical parameters compared with before surgery;still,it is better than conventional FS-LASIK,and the long-term effect needs to be further assessed.

Objective To compare the three methods in intensity modulated radiation therapy(IMRT)dose verification using PTW Detector729.Methods A total of 50 patients with nasopharyngeal cancer,lung cancer,breast cancer,cervical cancer and whole brain radiation therapy who completed radiation treatment at some hospital from January to December 2022 were selected retrospectively.Two-dimensional(zero and actual gantry angles)and three-dimensional dose verifications were carried out for the IMRT plans using PTW Detector729 2D ionization chamber matrix combined with PTW RW3 solid water and PTW Ocavius 4D rotation unit.The dose assessment threshold was set to 10％,and the γ pass rates of the three verification methods were counted under four assessment criteria,namely 3％/1 mm,2％/2 mm,3％/2 mm and 3％/3 mm.SPSS 22.0 statistical software was used for data analysis.Results Under the 10％dose assessment threshold criterion,zero-gantry-angle 2D dose verification had the highest γ pass rate,and the differences were statistically significant(P＜0.05);actual-gantry-angle 2D dose verification had the γ pass rate higher than that of 3D verification,and the differences were statistically significant(P＜0.05).The γ pass rates of the three verification methods gradually increased under four criteria,namely,3％/1 mm,2％/2 mm,3％/2 mm and 3％/3 mm,and exceeded 90％under the 3％/2 mm criterion,and the results met the requirements of clinical radiotherapy.Conclusion The results of the three verification methods satisfy the requirements of the IMRT dose verification practice guidelines,and the selection of appropriate verification methods is of great significance to ensure the implementation of the treatment plan.[Chinese Medical Equipment Journal,2024,45(5):56-59]

AIM To observe the ameliorative effects of hesperidin on gentamicin-induced acute kidney injury(AKI)in mice,and to explore the correlation between the effects and inflammation and apoptosis.METHODS The mice were randomly divided into the normal group,the model group,the verapamil group(21.43 mg/kg)and the low and high dose hesperidin groups(100,200 mg/kg).With the AKI model established by intraperitoneal injection of gentamicin,the mice of each group underwent 14 days corresponding drug administration.After the intervention,the mice had their levels of 24-hour urine protein,renal index and renal function indexes detected;their levels of IL-10,IL-6 and TNF-α in serum and kidney tissue detected by ELISA;their renal pathological damage detected by HE staining;their renal apoptosis detected by TUNEL staining;their renal mRNA expressions of caspase-3,Bcl-2 and Bax detected by RT-qPCR;and their renal expressions of cleved caspase-3 and PI3K/Akt signaling pathway related proteins detected by Western blot.RESULTS Compared with the model group,the hesperidin groups displayed decreased levels of 24-hour urinary protein and renal index(P＜0.05);improved renal pathological damage in varying degrees;decreased levels of serum BUN,Scr and CysC(P＜0.05);increased IL-10 levels of serum and renal tissue(P＜0.05);decreased levels of IL-6 and TNF-α(P＜0.05);decreased renal apoptosis rate,caspase-3,Bax mRNA expressions and cleaved caspase-3 protein expression(P＜0.05);and increased expressions of Bcl-2 mRNA and PI3K/Akt proteins(P＜0.05).CONCLUSION Hesperidin can ameliorate gentamicin-induced AKI in mice,which is related to its anti-inflammatory efficacy and anti-apoptotic activity via PI3K/Akt signaling pathway.

Abstract: Objective　To analyze the nucleic acid detection results of severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) by droplet digital PCR (ddPCR) and compare with the detection results of real-time fluorescence quantitative RT-PCR (qRT-PCR), so as to evaluate the advantages and disadvantages of detection, and to provide data support for optimizing the nucleic acid detection scheme of SARS-CoV-2. Methods　According to the SARS-CoV-2 specific primer probe published by the China Center for Disease Control and Prevention, a ddPCR detection method for SARS-CoV-2 was designed. One sample was selected for sensitivity test after gradient dilution; six respiratory virus nucleic acid positive samples including seasonal H3N2 influenza virus and SARS-CoV-2 positive samples were selected for specificity test; five SARS-CoV-2 positive samples were selected for repeatability test; in addition, 30 positive and 20 negative SARS-CoV-2 samples were selected for multiple clinical samples testing, and the results were analyzed and compared with those of qRT-PCR. Results　The ddPCR method can specifically detect SARS-CoV-2, and directly obtain the original copy number of the sample target gene to achieve accurate quantification; the sensitivity test of gradient dilution positive samples showed that qRT-PCR detected target genes in part of the 10-5 dilution of samples, and no target genes were detected in 10-6 dilution, while ddPCR detected all target genes in both 10-5 and 10-6 dilution of samples. The detection limit of ddPCR was two orders of magnitude higher than that of qRT-PCR, and the sensitivity was higher than that of qRT-PCR; in the comparison of the repeatability test results of the two methods, the coefficient of variation of ddPCR was 1.266%-11.814%, lower than 1.729%-26.174% of qRT PCR, and the repeatability was higher than qRT-PCR; among 50 clinical samples, 30 positive samples of confirmed cases of Coronavirus Disease 2019 (COVID-19) were detected by both methods, SARS-CoV-2 was successfully detected by both methods, and 20 negative samples of COVID-19 were detected by both methods, and the results were negative, with a coincidence rate of 100.00% (50/50). Conclusion　The ddPCR method can accurately quantify SARS-CoV-2 with strong specificity, and its sensitivity and repeatability are higher than those of qRT-PCR, but it also has certain detection limitations and is more suitable for the detection of low load samples. In the actual detection, the two methods can be reasonably combined to improve the detection accuracy.

Objective: To analyze the survival time of reported HIV/AIDS and influencing factors of Yunnan Province from 1989 to 2021. Methods: The data were extracted from the Chinese HIV/AIDS comprehensive response information management system. The retrospective cohort study was conducted. The life table method was applied to calculate the survival probability. Kaplan-Meier was used to draw survival curves in different situations. Furthermore, the Cox proportion hazard regression model was constructed to identify the factors related to survival time. Results: Of the 174 510 HIV/AIDS, the all-cause mortality density was 4.23 per 100 person-years, the median survival time was 20.00 (95%CI:19.52-20.48) years, and the cumulative survival rates in 1, 10, 20, and 30 years were 90.75%, 67.50%, 47.93% and 30.85%. Multivariate Cox proportional risk regression model results showed that the risk of death among 0-14 and 15-49 years old groups were 0.44 (95%CI: 0.34-0.56) times and 0.51 (95%CI:0.50-0.52) times of ≥50 years old groups. The risk for death among the first CD4⁺T lymphocytes counts (CD4) counts levels of 200-349 cells/μl, 350-500 cells/μl and ≥501 cells/μl groups were 0.52 (95%CI: 0.50-0.53) times, 0.41 (95%CI: 0.40-0.42) times and 0.35 (95%CI: 0.34-0.36) times of 0-199 cells/μl groups. The risk of death among the cases that have not received antiretroviral therapy (ART) was 11.56 (95%CI: 11.26-11.87) times. The risk for death among the cases losing to ART, stopping to ART, both losing and stopping ART was 1.66 (95%CI:1.61-1.72) times, 2.49 (95%CI:2.39-2.60) times, and 1.65 (95%CI:1.53-1.78) times of the cases on ART. Conclusions: The influencing factors for the survival time of HIV/AIDS cases were age at diagnosis in Yunnan province from 1989 to 2021. The first CD4 counts levels, antiretroviral therapy, and ART compliance. Early diagnosis, early antiretroviral therapy, and increasing ART compliance could extend the survival time of HIV/AIDS cases.
Humans ; Middle Aged ; Retrospective Studies ; China/epidemiology* ; Acquired Immunodeficiency Syndrome/epidemiology* ; Anti-Retroviral Agents/therapeutic use* ; Asian People

OBJECTIVE: To compare the clinical efficacy between the combined therapy of fire needling and cupping, and western medication on herpes zoster of acute stage, as well as the effects on Th17 and Treg cells and inflammatory factors, i.e. IL-10 and IL-17 in the peripheral blood. METHODS: Eighty patients with herpes zoster of acute stage were randomly divided into a combined therapy (fire needling plus cupping) group and a western medication group, 40 cases in each one. In the combined therapy group, the pricking and scattering techniques with fire needle were used at ashi points and Jiaji (EX-B 2) corresponding to the affected spinal segments; afterwards, cupping therapy was delivered. The combined treatment was given once daily. In the western medication group, valaciclovir hydrochloride tablet and vitamin B₁ tablet were administered orally. The duration of treatment in each group was 10 days. Before each treatment from day 1 to day 10 and on day 11 , the score of symptoms and physical signs was observed in the two groups separately. Before each treatment from day 1 to day 10 and on day 11, 30, 60, the score of visual analogue scale (VAS) and skin lesion indexes were observed in the two groups. On day 60, the incidence of postherpetic neuralgia was recorded in the two groups. The levels of Th17 and Treg cells, Th17/Treg ratio in the peripheral blood, as well as serum levels of IL-10 and IL-17 were detected before and after treatment in the two groups. The clinical efficacy was compared between the two groups. RESULTS: From day 6 to day 10 during treatment and on day 11, the scores of symptoms and physical signs in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 3, day 6 to day 10 during treatment and day 11, day 30, VAS scores in the combined therapy group were lower than those of the western medication group (P<0.05, P<0.01). On day 60, the incidence of postherpetic neuralgia in the combined therapy group was lower compared with that in the western medication group (P<0.05). The blister arresting time and scabbing time in the combined therapy group were shorter than those of the western medication group (P<0.05). After treatment, the level of Th17, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 were all lower in comparison with those in the western medication group (P<0.05). The curative and remarkably effective rate was 82.5% (33/40) in the combined therapy group, higher than 62.5% (25/40) in the western medication group (P<0.05). CONCLUSION The early application of fire needling combined with cupping therapy can effectively treat herpes zoster of acute stage, relieve pain, and reduce the incidence of postherpetic neuralgia, which may be related to reducing the levels of Th17 and Treg cells, and Th17/Treg ratio in the peripheral blood, as well as the serum levels of IL-10 and IL-17 so that the cellular immune balance is modulated.
Humans ; Neuralgia, Postherpetic ; Acupuncture Therapy/methods* ; Interleukin-10 ; Interleukin-17 ; T-Lymphocytes, Regulatory ; Cupping Therapy ; Th17 Cells ; Herpes Zoster/therapy* ; Treatment Outcome ; Tablets

Huangqi Guizhi Wuwu Decoction is a classic prescription in traditional Chinese medicine(TCM) and is known for its effects of tonifying Qi, warming the meridians, and promoting blood circulation to alleviate obstruction. It is primarily used to treat conditions characterized by Qi stagnation, Yang deficiency, and obstruction, and it exhibits pharmacological effects such as immune regulation, anti-inflammation, analgesia, protection of the cardiovascular and cerebrovascular systems, itch relief, reduction of frostbite symptoms, antioxidative stress, promotion of cell apoptosis, and kidney protection. In modern clinical practice, it is commonly used to treat acute myocardial infarction, sequelae of cerebral infarction, cervical spondylosis, frozen shoulder, lower limb arteriosclerosis, lower limb vascular disorders, peripheral neuropathy in diabetes, and lupus nephritis. Recent research has focused on the chemical components, pharmacological effects, and clinical applications of Huangqi Guizhi Wuwu Decoction. Based on the "five principles" of quality markers(Q-markers) in TCM, this study predicted and analyzed the Q-markers of Huangqi Guizhi Wuwu Decoction. It suggested that astragaloside Ⅳ, formononetin, kaempferol, quercetin, cinnamic acid, cinnamaldehyde, 6-gingerol, paeoniflorin, albiflorin, and gallic acid could serve as Q-markers for Huangqi Guizhi Wuwu Decoction. The findings of this study can provide references for quality control of Huangqi Guizhi Wuwu Decoction and the development of new Chinese medicinal formulations.
Drugs, Chinese Herbal/therapeutic use* ; Medicine, Chinese Traditional ; Astragalus propinquus ; Frostbite/drug therapy*

Objective: To evaluate the effects of antiretrovirals on cardiovascular function and some biochemical indexes in gestational female rats. Methods: Nineteen 9-week-old female and six 10-week-old male SD rats were divided into normal control group (CON) and highly active antiretroviral therapy group (HARRT), 9/10 female rats and 3 male rats were combined into one cage, totally 2 cages. Female rats in CON group were intragastrically given with normal saline (NS, 10 ml/kg) every morning and evening, while female rats in HARRT group were treated with equal volume antiretrovirals (AZT 31.25 mg/kg + 3TC 15.63 mg/kg + LPV/r (41.67/10.42) mg/kg) for 3 months. The body weight and survival rate of female rats were recorded. Echocardiography and multichannel physiological recorder were used to detect arterial blood pressure and cardiac hemodynamic parameters. The levels of blood glucose, blood lipids, myocardial enzymes and liver enzymes were detected by corresponding kits. Myocardial collagen fibers were observed by Masson staining and the ultrastructure of myocardial cells were observed by transmission electron microscopy. Results: All female rats in CON group survived (9/9), while only 6 rats in HARRT group survived (6/10). Compared with CON group, the body weight of female rats in HAART group was decreased significantly(P＜0.01); the levels of left ventricular end diastolic diameter (LVDd), interventricular septal thickness (IVST), thickness of left ventricular posterior wall (LVPWT) , left atrial diameter (LAD) and arterial diastolic pressure were increased significantly (P＜0.05); the level of LVP+dP/dtmax was decreased (P＜0.01). The levels of triglyceride, creatine kinase, and glutamic oxaloacetic transaminase were decreased (P＜0.05 or P＜0.01), while the level of glucose was increased (P＜0.05). The collagen fibers were increased in myocardial tissue, and ultrastructure of myocardial cells was abnormal. Conclusion: Antiretrovirals during gestation can cause cardiovascular diseases in female rats.
Animals ; Anti-Retroviral Agents/adverse effects* ; Body Weight ; Cardiotoxicity ; Collagen ; Female ; Myocytes, Cardiac/ultrastructure* ; Pregnancy ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: To evaluate the accuracy of trephine bur drilling at different depths guided by dynamic navigation system in 3D printing in vitro model. METHODS: A model at the depth of 5 mm, 10 mm, and 15 mm from the outer surface of which hemispherical cavities was reserved and the 3D printing technology was used to make the standardized model with Veroclear resin. The cone beam CT (CBCT) was taken and the data were imported into the dynamic navigation software (DCARER, China) to establish navigation path programming. Under the guidance of dynamic navigation, a trephine bur with a diameter of 4.5 mm was used to complete the access operation. At each depth, 10 approaches were completed. The postoperative model CBCT was taken. The approach trajectory under navigation was reconstructed and compared with the designed path. The two-dimensional distance deviation, depth deviation, three-dimensional distance deviation, and angle deviation between the actually prepared path and the designed path were calculated. RESULTS: At the depth of 5 mm, the two-dimensional distance deviation between the end position of the prepared path and the designed path was (0.37±0.06) mm, the depth deviation was (0.06±0.05) mm, the three-dimensional distance deviation was (0.38±0.07) mm, and the angle deviation was 2.46°±0.54°; At the depth of 10 mm, the four deviations between the end position of prepared path and the designed path were (0.44±0.05) mm, (0.16±0.06) mm, (0.47±0.05) mm, and 2.45°±1.21°, respectively; At the depth of 15 mm, the four deviations were (0.52±0.14) mm, (0.16±0.07) mm, (0.55±0.15) mm, and 3.25°±1.22°, respectively. With the increase of entry depth, the three-dimensional and depth accuracy of dynamic navigation system decreased (P < 0.01), and the positioning angle deviation had no relation with the entry depth (P>0.01). CONCLUSION Dynamic navigation technology can achieve high positioning accuracy in the depth range of 15 mm, but its deviation increases with the increase of entry depth.
China ; Cone-Beam Computed Tomography ; Printing, Three-Dimensional ; Surgery, Computer-Assisted