1.Study on fatigue vibration evaluation of ultrasonic knife tip based on Q factor
Ke-Sheng WANG ; Ze-Kai LI ; Pei LIU ; Jing-Sheng SUN ; Xu-Guang PENG ; Shuang-Shuang LI ; Qian-Hong HE ; Zhen LIU
Chinese Medical Equipment Journal 2024;45(6):17-22
		                        		
		                        			
		                        			Objective To propose a Q factor-based fatigue vibration evaluation method of the ultrasonic knife tip.Methods Firstly,an ultrasonic cutter fatigue testing table was established to realize repeated cutting,which was composed of a power supply module,a three-axis moving module,an ultrasonic cutter clamping module and a control module.Secondly,10 ultrasonic knives of some brand underwent fatigue testing with the table,during which non-contact measurement of the ultrasonic knife tip vibration was carried out and the Q factors were calculated at the five periods of the fatigue test,including the periods before cutting,after 500 times of cutting,after 1 000 times of cutting,after 2 000 times of cutting and after 3 000 times of cutting.Finally,the average cutting speed and burst pressure for coagulated vessels were computed at each period to validata the effectiveness of the method proposed.Results It's indicated that Q factor could effectively reflect the fatigue degradation of the ultrasonic knife tip,while the average cutting speed and burst pressure for coagulated vessels were difficult to efficiently evaluate the fatigue degradation level of the ultrasonic knife tip due to the uncertainty factors in the measurement process.Conclusion The proposed Q factor-based evaluation method can directly evaluate fatigue vibration of the ultrasonic knife tip in an accurate and quantitative manner.[Chinese Medical Equipment Journal,2024,45(6):17-22]
		                        		
		                        		
		                        		
		                        	
2.Accurate quantitative evaluation of MRI scanning noise based on laser vibrometry technology
Ke-Sheng WANG ; Pei-Jia XU ; Pei LIU ; Jing-Sheng SUN ; Ze-Kai LI ; Xu-Guang PENG ; Shuang-Shuang LI ; Qian-Hong HE ; Zhen LIU
Chinese Medical Equipment Journal 2024;45(10):20-24
		                        		
		                        			
		                        			Objective To carry out accurate quantative evaluation of MRI scanning noise based on laser vibrometry technology.Methods Skull and spine MRI was performed with mute and conventional sequences.A laser vibrometry device was used to sample the surface vibration noise at the outer edge of the inspection hole of MRI system according to GB/T 16539-1996 Acoustics—Determination of sound power levels of noise sources using vibration velocity—Measurement for seal machinery,and the indicators of sound power level,sound pressure level and perceived noise level obtained by the three calculation methods(LPN1,LPN2 and LPN3)were analyzed with some dedicated MRI noise analysis software.Results The peak sound pressure levels for conventional and mute sequences of skull scanning were 81 and 63 dB(A),respectively,and mute sequence reduced the noise level significantly;the peak sound pressure levels for conventional and mute sequences of spine scanning were 79 and 75 dB(A),respectively,and the noise reduction level was significantly lower than that of skull scanning.Significant differences in noise reduction were not found in spine scanning sequences,while were found in skull scanning sequences.During spine and skull scanning LPN1,LPN2 and LPN3 obtained by the three calculation methods of conventional and mute sequences were all higher than the overall sound power and overall pressure levels obviously.Conclusion Mute sequence can not realize linear noise reduction for the whole frequency band,the perceived noise of the human ear during MRI scanning is related directly to the scanning sequence,and there may be some bias when only one physical indicator is involved in the noise evaluation of MRI system.[Chinese Medical Equipment Journal,2024,45(10):20-24]
		                        		
		                        		
		                        		
		                        	
3.Impact of Coronary Plaque on the Precision of Computational Fractional Flow Reserve Derived from CTA
Liu-dan CHEN ; Sheng-xian TU ; Ze-hang LI ; Xu-hui ZHOU
Journal of Sun Yat-sen University(Medical Sciences) 2023;44(5):823-829
		                        		
		                        			
		                        			ObjectiveThe fractional flow reserve (FFR) computed from coronary computed tomographic (CT) angiograms makes it possible to noninvasively assess coronary artery disease, but the impact of plaque on FFR derived from computed tomography angiography (CTA) is still unknown. The study used invasive FFR as the reference standard to analyze the impact of plaque on coronary computed tomography angiography (CCTA)-based quantitative flow ratio (CT-QFR). MethodsThe retrospective study included 108 patients with suspected coronary heart disease (CHD) who underwent both CCTA and FFR within 60 days. CCTA images were analyzed by the software. We obtained the CT-QFR of target vessels, perfomed the quantitative and qualitative analyses on target vascular plaques, including total plaque volume (TPV), plaque burden, calcified plaque volume (CPV), fibrous plaque volume (FPV), lipid plaque volume (LPV), and the presence or absence of high-risk plaque. ResultsAccording to the difference between CT-QFR and FFR at blood vessel level, 137 target vessels of 108 patients were divided into the overestimated group (difference>0.03, n=29), reference group (-0.03≤difference≤0.03, n=88) and underestimated group (difference<-0.03, n=20). The underestimated group (14.81mm3) presented higher LPV than overestimated group (1.97mm3, P < 0.05). There was a negative correlation between LPV and the difference (P<0.05). ConclusionsWhen CT-QFR is used to estimate hemodynamics of coronary artery stenosis, the presence of lipid plaque may underestimate the virtual FFR. 
		                        		
		                        		
		                        		
		                        	
4.Influence of wind, cold and dampness on clinical manifestation of knee osteoarthritis patients based on the stratifications of traditional Chinese medicine constitution.
Ze-Cheng TAN ; Ding JIANG ; Qin-Guang XU ; Lin WANG ; Xue-Zong WANG ; Bo CHEN ; Jian PANG ; Hong-Sheng ZHAN ; Yue-Long CAO
China Journal of Orthopaedics and Traumatology 2023;36(12):1130-1135
		                        		
		                        			OBJECTIVE:
		                        			To explore influence of external factors of wind, cold and dampness on clinical symptoms in knee osteoarthritis (KOA) patients with different constitutions of traditional Chinese medicine.
		                        		
		                        			METHODS:
		                        			A cross-sectional stratified study was performed to select 108 patients with GradeⅡKOA in Kellgren & Lawrence (K-L) classification, including 22 males and 86 females, aged from 47 to 75 years old with an average of (60.7±6.0) years old;body mass index(BMI) ranged from 17.87 to 31.22 kg·m-2 with an average of (23.80±2.86) kg·m-2. According to Classification and Judgment of TCM Physique (ZYYXH/T157-2009), the types of TCM physique were determined and divided into 4 layers according to the deficiency and actual physique. Among them, there were 24 patients without biased physique, 12 males and 12 females, aged from 51 to 73 years old with an average of(62.8±6.0) years old, BMI ranged from 17.87 to 31.14 kg·m-2 with an average of (24.32±3.25) kg·m-2;there were 46 patients with virtual bias constitution, including 7 males and 39 females, aged from 47 to 70 years old with an average of (60.0±5.8) years old, BMI ranged from 19.38 to 31.22 kg·m-2 with an average of(23.42±2.97) kg·m-2;There were 26 patients with solid bias constitution, including 2 males and 24 females, aged from 48 to 75 years old with an average of (60.4±5.8) years old, BMI ranged from 21.16 to 30.76 kg·m-2 with an average of (24.15±2.33) kg·m-2;there were 9 patients with special constitution, 1 male and 8 female, aged from 53 to 75 years old with an average of (59.8±7.5) years old, BMI ranged from 19.26 to 26.67 kg·m-2 with an average of (23.79±2.49) kg·m-2. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to evaluate severity of clinical symptoms. The wind-cold-dampness external factor score was calculated through the questionnaire of wind-cold-dampness syndrome scale to evaluate degree of influence of wind-cold-dampness external factor. Pearson correlation analysis and partial correlation analysis were used to calculate the correlation coefficient between severity of external factors affecting wind, cold and dampness and severity of clinical symptoms in patients with different TCM constitution stratification.
		                        		
		                        			RESULTS:
		                        			There was no statistical significance between total score of wind-cold-dampness and WOMAC score in patients with no biased constitution and special condition. Total wind-cold-dampness score of patients with virtual biased constitution was positively correlated with WOMAC stiffness score (r=0.327, P=0.032), and total wind-cold-dampness score of patients with solid biased constitution was positively correlated with WOMAC pain score (r=0.561, P=0.005) and WOMAC overall score (r=0.446, P=0.033). After further adjusting for the interaction of external factors of wind-cold-dampness, there was no statistical significance between wind-cold-dampness scores and WOMAC scores in patients with solid biased constitution. The score of dampness and pathogenic factors was positively correlated with WOMAC stiffness score (r=0.414, P=0.007).
		                        		
		                        			CONCLUSION
		                        			The external factors of wind-cold dampness have different effects on the clinical symptoms of KOA patients with different TCM constitutions. Compared with other constitutions, the rigid symptoms of patients with asthenic biased constitutions are more susceptible to dampness pathogenic factors.
		                        		
		                        		
		                        		
		                        			Aged
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Cross-Sectional Studies
		                        			;
		                        		
		                        			Medicine, Chinese Traditional
		                        			;
		                        		
		                        			Osteoarthritis, Knee
		                        			;
		                        		
		                        			Syndrome
		                        			;
		                        		
		                        			Wind
		                        			;
		                        		
		                        			Cold Temperature
		                        			
		                        		
		                        	
6.MicroRNA-99b-5p Aggravates Cardiomyocyte Hypertrophy by Down-regulating Fgf21
Li-wen CHEN ; Jing GUO ; Ze-run CHEN ; Jie-ning ZHU ; Jin-dong XU ; Hui-ming GUO ; Zhi-xin SHAN ; Sheng WANG
Journal of Sun Yat-sen University(Medical Sciences) 2022;43(2):192-202
		                        		
		                        			
		                        			ObjectiveTo explore the role of microRNA-99b-5p (miR-99b-5p) in cardiomyocyte hypertrophy and the related mechanism involved. MethodsThe expression of miR-99b-5p in myocardium was detected by real-time quantitative PCR(RT-qPCR)in the myocardium of patients with heart failure(HF)and healthy controls, as well as in the myocardium of mouse model of transverse aortic restriction (TAC)-induced cardiac hypertrophy. Phalloidin-iFluor 647 staining was used to show the size of neonatal mouse ventricular cardiomyocytes(NMVCs)after AngⅡ treatment. MiR-99b-5p expression was determined by RT-qPCR in AngⅡ-treated NMVCs. After transfection with miR-99b-5p mimic, the expression of cardiac hypertrophy-associated genes and Fgf21 in NMVCs was detected by RT-qPCR and Western blot assay, respectively. We identified the interaction between miR-99b-5p and the 3’UTR of Fgf21 mRNA by dual luciferase reporter assay. The recombinant Ffg21 adenovirus(rAd-Fgf21)and rAd-Sod2 were used to infect NMVCs, and the expression of β-MHC, ANP, FGF21 and SOD2 was detected by Western blot assay. We knocked down Fgf21 and Sod2 in NMVCs to investigate the role of FGF21/Sod2 axis in miR-99b-5p-regulated NMVC hypertrophy. ResultsMiR-99b-5p expression was elevated in the myocardium of HF patients and TAC-operated mice, and in AngⅡ-treated NMVCs (P<0.01, respectively). MiR-99b-5p promoted the expression of hypertrophy-related genes in NMVCs (P<0.01). Results of dual luciferase reporter gene assay revealed the interaction between miR-99b-5p and Fgf21 mRNA. MiR-99b-5p down-regulated the expression of Fgf21 and the down-stream gene of Sod2( P<0.01). Overexpression of FGF21 or SOD2 could inhibit NMVC hypertrophy and effectively reversed the pro-hypertrophy effect of miR-99b-5p on NMVCs (P<0.05, respectively). ConclusionMiR-99b-5p is up-regulated in the hypertrophic myocardium and enhances cardiomyocyte hypertrophy via suppressing Fgf21/Sod2 axis. 
		                        		
		                        		
		                        		
		                        	
7.Construction of quality evaluation strategy for Chinese medicine based on ambient mass spectrometry.
Chang-Jiang-Sheng LAI ; Zi-Dong QIU ; Xu-Ya WEI ; Ze-Yan CHEN
China Journal of Chinese Materia Medica 2022;47(1):279-284
		                        		
		                        			
		                        			Quality is the guarantee for the clinical safety and effectiveness of Chinese medicine. Accurate quality evaluation is the key to the standardization and modernization of Chinese medicine. Efforts have been made in improving Chinese medicine quality and strengthening the quality and safety supervision in China, but rapid and accurate quality evaluation of complex Chinese medicine samples is still a challenge. On the basis of the development of ambient mass spectrometry and the application in quality evaluation of complex Chinese medicine systems in recent years, the authors developed the multi-scenario Chinese medicine quality evaluation strategies. A systematic methodology was proposed in specific areas such as real-time monitoring of the quality of complex Chinese medicine decoction system, rapid toxicity grading of compound Chinese patent medicine, and evaluation of bulk medicinals of Chinese patent medicine. Allowing multi-scenario analysis of Chinese medicine, it is expected to provide universal research ideas and technical methods for rapid and accurate quality evaluation of Chinese medicine and boost the high-quality development of Chinese medicine industry.
		                        		
		                        		
		                        		
		                        			China
		                        			;
		                        		
		                        			Drugs, Chinese Herbal
		                        			;
		                        		
		                        			Mass Spectrometry
		                        			;
		                        		
		                        			Medicine, Chinese Traditional
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		                        			Nonprescription Drugs
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		                        			Reference Standards
		                        			
		                        		
		                        	
9.Tiaohe Yinyang acupotomy for knee osteoarthritis: a randomized controlled trial.
Dang-Han XU ; Yu-Xiang LIN ; Jia WEI ; Ci-Hui HUANG ; Ming-Hui LI ; Tao-Tao YAO ; Xu-Bo HONG ; Ze-Sheng ZHANG ; Liang ZHENG
Chinese Acupuncture & Moxibustion 2022;42(12):1351-1356
		                        		
		                        			OBJECTIVE:
		                        			To observe the clinical efficacy of Tiaohe Yinyang acupotomy (acupotomy for regulating and harmonizing yin and yang) for knee osteoarthritis (KOA).
		                        		
		                        			METHODS:
		                        			A total of 88 patients with KOA were randomized into a acupotomy group and a sham-acupotomy group, 44 cases in each group. In the acupotomy group, acupotomy was applied at yin side (4-5 high stress points i.e. pes anserinus and terminal of popliteus) and yang side (1-2 high stress points i.e. stimulation point of infrapatellar ligament and suprapatellar bursa) of knee joint. In the sham-acupotomy group, sham-acupotomy was applied at the same points as the acupotomy group. The treatment was given once a week for 2 weeks in the two groups. Before and after treatment, the Western Ontario and McMaster Universities arthritis index (WOMAC) score, visual analogue scale (VAS) score, thickness of medial and lateral collateral ligaments of knee joint, motion range of knee joint and plantar pressure distribution were observed in the two groups. In the follow-up of 3 months after treatment, the WOMAC and VAS scores were recorded in the acupotomy group.
		                        		
		                        			RESULTS:
		                        			After treatment, the sub item scores (pain, stiffness and function) and total scores of WOMAC and VAS scores were decreased in the both groups (P<0.05), pain score, function score and total score of WOMAC and VAS score in the acupotomy group were lower than those in the sham-acupotomy group (P<0.05). Before and after treatment, there were no statistical differences in thickness of medial and lateral collateral ligaments of knee joint and motion range of knee joint between the two groups (P>0.05). After treatment, the plantar medial pressure was increased while the plantar lateral pressure was decreased (P<0.05), and the plantar force line moved medially in the acupotomy group. In the follow-up, the sub item scores and total score of WOMAC and VAS score were lower than those before and after treatment in the acupotomy group (P<0.05).
		                        		
		                        			CONCLUSION
		                        			Tiaohe Yinyang acupotomy can improve the clinical symptoms of knee joint in patients with KOA by changing the local biological stress.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Social Group
		                        			;
		                        		
		                        			Pain
		                        			
		                        		
		                        	
10.Comparative study of two elastic fixation systems in single-segment lumbar disc herniation surgery for nucleus pulposus extraction.
Ze-Xuan WU ; Hong-Hai XU ; Xiao-Fan HAN ; Wei-Wei LI ; Liang DUAN ; Da-Peng DUAN ; Jun-Sheng YANG
China Journal of Orthopaedics and Traumatology 2022;35(10):951-956
		                        		
		                        			OBJECTIVE:
		                        			To investigate the clinical application of two elastic pedicle internal fixation systems in single-segment lumbar disc herniation fenestration.
		                        		
		                        			METHODS:
		                        			A retrospective analysis of 64 patients with lumbar intervertebral disc herniation treated by surgery from June 2019 to March 2021. According to the different elastic fixation systems placed during the operation, the patients were divided into ordinary pedicle screw elastic rod link group (elastic rod group) and a special elastic pedicle screw rigid rod fixed connection group (elastic screw group). There were 33 cases in the elastic rod group, including 18 males and 15 females, aged from 30 to 69 years old with an average of(49.18±10.23) years old;and 31 cases in the elastic screw group, including 16 males and 15 females, aged from 32 to 68 with an average of (49.81±9.24) years old. The operation time, intraoperative blood loss, postoperative wound drainage, and postoperative landing time of the two groups were recorded separately. The visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) score, and Oswestry Disability Index (ODI) were compared before and 3, 12 months after operation. The height of the adjacent vertebral space on the lateral DR film before and 12 months after the operation was measured. The clinical efficacy was evaluated by Macnab standard.
		                        		
		                        			RESULTS:
		                        			All the patients successfully completed the operation, and were followed up. The operation time, intraoperative blood loss, postoperative wound drainage and postoperative landing time in the elastic rod group were(63.73±12.01) min, (89.55±16.07) ml, (81.67±16.00) ml, (3.45±0.75) d , while in the elastic nail group was (62.96±11.54) min, (88.35±17.14) ml, (82.29±15.40) ml, (3.29±0.78) d, the difference was not statistically significant. The symptoms of low back pain and lower extremity numbness were significantly improved in all patients after operation. There was no significant difference in VAS, JOA score and ODI between the two groups before and after surgery (P>0.05). At 12 months after operation, there was no significant difference in the height of the adjacent vertebral space between the upper adjacent vertebral body and the same segment before operation(P>0.05), and there was no significant difference between the groups before and after the operation. According to Macnab criteria, the elastic rod group was excellent in 30 cases, good in 2 cases, fair in 1 case, while the elastic nail group was excellent in 29 cases, good in 2 cases, fair in 0 cases, and there was no significant difference(Z=-0.42, P=0.68).
		                        		
		                        			CONCLUSION
		                        			In fenestrated nucleus pulposus extraction for lumbar disc herniation, the two elastic pedicle internal fixation systems are equally effective and can be used. The elastic screw internal fixation system has certain advantages when the distance between the two vertebral bodies is short, and the elastic rod cannot be placed or is difficult to be placed, and it is more widely used.
		                        		
		                        		
		                        		
		                        			Male
		                        			;
		                        		
		                        			Female
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		                        			Humans
		                        			;
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Middle Aged
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		                        			Aged
		                        			;
		                        		
		                        			Intervertebral Disc Displacement/surgery*
		                        			;
		                        		
		                        			Lumbar Vertebrae/surgery*
		                        			;
		                        		
		                        			Spinal Fusion
		                        			;
		                        		
		                        			Nucleus Pulposus
		                        			;
		                        		
		                        			Retrospective Studies
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		                        			Pedicle Screws
		                        			;
		                        		
		                        			Treatment Outcome
		                        			;
		                        		
		                        			Postoperative Hemorrhage
		                        			
		                        		
		                        	
            
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