Objective To assess the quality of randomized controlled trials (RCTs) on acupuncture for treating acute migraine attacks. Methods With the searching terms of acupuncture and migraine, the Cochrane Controlled Trials Register (CCTR), PubMed, MEDLINE, EMbase, CBM, CMCC, CNKI and VIP were searched. The reports quality of the included trials, including the quality of methodology, diagnostic criteria, inclusion/exclusion criteria, acupuncture/control interventions, outcome measures, observing time, and adverse effects reports, was evaluated. Results A total 23 RCTs involving 2645 patients were included, of which only 3 RCTs were of high quality with Jadad scores equal to or more than 4. At present, only a few high quality trials on treating acute attacks of migraine with acupuncture had been reported at home and abroad. The international recognized diagnostic criteria and common evaluation methods had not been used generally, and the design of control was kind of irrational. Conclusion Based on current clinical reports, acupuncture may be effective in the management of acute migraine attacks, but some relevant proof is still required. The further domestic studies should be designed strictly following the international recommended diagnosis and evaluation criteria of migraine, and rational control methods as well.
Objective To evaluate the adhesion, prol iferation and osteogenic differentiation of rabbit BMSCs after cultured on freeze-dried demineral ized bone matrix (FDBM) modified with type II cadherin ectodomain (Cad- II). Methods BMSCs isolated from 10 Japanese white rabbits (male and female, 4-week-old, 0.61-0.88 kg) were cultured. The second generation of BMSCs (cell density 1 × 106 /mL) were seeded onto the Cad-II modified allogenic FDBM (experimental group) and only FDBM (control group) respectively, and then cocultured in vitro. The densities of seeded cells, the adhesion rate and their ALP activity were measured. The complex was observed through inverted phase contrast microscope and scanning electron microscope to evaluate the interaction between cells and FDBM. Another group of second generation of BMSCs (cell density 5 × 105 /mL) were seeded onto the Cad-II modified FDBM (experimental group) and only FDBM (control group) respectively, and then cocultured in vitro too. The ALP activity and osteocalcin immunohistochemical was measured. Results There was no significant difference in cell prol iferation between experimental group and control group. The adhesion rate of cells in the experimental group was 87.41% ± 5.19%, higher than that in the the control group 35.56% ± 1.75% (P lt; 0.01); the densities of seeded cells reached 5.0 × 105, showing significant difference compared with the control group (2.6 × 104, P lt; 0.05). Inverted phase contrast microscope showed that in the experimental group, more cultured BMSCs pasted in the hole and edge of the scaffold than that in the control group. HE staining showed the densities of seeded cells in the experimental group was higher than that in the control group. Scanning electron microscope showed that in the experimental group, a lot of cultured BMSCs adhered, spreaded in the scaffold, in the control group only a few BMSCs unevenly distributed in the scaffold. After 7 days of culture, the cultured BMSCs on modified FDBM expressed higher ALP activity; after 14 days of culture, the ALP activity (29.33 ± 1.53) was higher than that cultured on unmodified FDBM (18.31 ± 1.32), the positive rates of osteocucl in were 83% ± 7% in the experimental group and 56% ± 7% in the control group, showing significant difference (P lt; 0.01). Conclusion Cad-II enhanced cell adhesion to FDBM and promoted BMSCs differentiate to osteoblast, but no obvious effects were observed in cell prol iferation.
Radiotherapy is one of the main treatments for tumor with increasingly high request for technique precision and the equipment stability. Machine learning may bring radiotherapy simplicity, individualization and precision, and may improve the automatic level of planning and quality assurance. Based on the process of radiotherapy, this paper reviews the applications and researches on machine learning, with an emphasis on deep learning, and proposes the prospects in the following aspects: segmentation of normal tissue and tumor, planning, treatment delivery, quality assurance and prognosis prediction.
Objective To study the variation of CD105+/CD166+ cells and its multilineage potential in early osteoarthritis (OA) cartilage so as to lay a foundation for cartilage repair and pathologic cartilage remodeling in arthritis. Methods The knee OA model was established in the right knee of 30 adult New Zealand rabbits (8-12 months old). The chondrocytes were harvested from normal cartilage of the left knee (group A), OA cartilage of the right knee at 2 weeks (group B), at 4 weeks (group C), and at 8 weeks (group D) after modeling, and BMSCs were used in group E for the expression of CD105 and CD166. The percentage of CD105+/CD166+ cells in each group was counted by flow cytometry, and CD105+/CD166+ cells were isolated and purified by magnetic-activated cell sorting. The expressions of CD105 and CD166 were observed in 5 groups by laser scanning confocal microscope. Chondrogenesis, osteogenesis, and adipogenesis were evaluated with Alcian blue cytochemistry and collagen type II immunohistochemistry, by detecting the deposition of calcium, and with oil red O staining, respectively. Results The percentage of CD105+/CD166+ cells in group A, B, C, and D was significantly lower than that in group E (P lt; 0.05); it was significantly higher in groups B, C, and D than in group A (P lt; 0.05), and in group D than in groups B and C (P lt; 0.05), but no significant difference was found between groups B and C (P gt; 0.05). Laser scanning confocal microscope results confirmed the expressions of CD105+ and CD166+ cells in groups A, B, C, D, and E, no obvious difference in expression was shown among 5 groups. At 1 week after chondrogenic induction, positive expressions of proteoglycan and collagen type II were observed in 5 groups, no obvious difference was noticed among 5 groups. At 2 weeks after osteogenic induction, calcium level in group E was significantly higher than that in groups A, B, C, and D (P lt; 0.05), but no significant different was found among groups A, B, C, and D (P gt; 0.05). At 4 weeks after adipogenic induction, there were more red lipid droplets in group E than in groups A, B, C, and D. Conclusion CD105+/CD166+ cells in early OA cartilage increase, which show chondrogenic differentiation potential.
Objective To investigate if the course of intervertebral disc degeneration (IDD) is delayed by injecting lentivirus (Lv) vector carrying bone morphogenetic protein 2 (BMP-2) and inhibitor of differentiation 1 (Id1) genes directly into the nucleus pulposus. Methods Thirty-two New Zealand white rabbits, 2.0-2.5 kg in weight and 4 months in age, were used to establish the IDD models at L3, 4, L4, 5, and L5, 6 discs with annular puncture via transabdominal approach. Thirty rabbits with successful modeling were randomly divided into 5 groups, 6 rabbits every group. At 4 weeks after modeling, rabbits were injected with Lv-BMP-2 (group A), with Lv-BMP-2 and Lv-Id1 (group B), with Lv-Id1 (group C), with Lv-green fluorescent protein (group D), and with PBS (group E). At 2, 4, and 8 weeks after injection, T2-mapping MRI was performed on 2 rabbits each group to obtain the T2 values, and then subsequently the lumbar disc tissues were harvested to test the mRNA expressions and contents of collagen type II and proteoglycan by real-time fluorescent quantitative PCR and ELISA methods. Results T2-mapping MRI demonstrated that there was no significant difference in the T2 value between different groups at immediate and 2 weeks after injection (P>0.05). The T2 value of groups A and B was significantly higher than that of groups C, D, and E at 4 weeks after injection (P<0.05), but no significant difference was observed between group A and group B (P>0.05). The T2 value of group B was significantly higher than that of the other groups at 8 weeks after injection (P<0.05). The real-time fluorescent quantitative PCR and ELISA showed that the expressions and contents of collagen type II and proteoglycan in group B were significantly higher than those in the other groups at 2, 4, and 8 weeks after injection (P<0.05). Conclusion Combined application of Lv-BMP-2 and Lv-Id1 can delay IDD changes in rabbit IDD models.
Objective To evaluate clinical efficacy of mFOLFOX6 combined with aspirin in treatment of advanced gastric cancer following perioperative period of laparoscopic distal subtotal gastrectomy. Methods One hundred and seven patients with advanced gastric cancer were assigned to observation group (57 cases) and control group (50 cases). The patients in the observation group received the mFOLFOX6 chemotherapy and regular intake of aspirin (100 mg/d) and the control group received the mFOLFOX6 chemotherapy alone. The recurrence or metastasis rate, rate of disease progress, toxicity, median survival time, and 3-year survival rate were compared between the observation group and the control group. Results ① There were no significant differences in the gender, age, pathological type, and so on between the observation group and the control group (P>0.05). ② The rates of toxicity such as the white blood cell reduction, granulocyte reduction, thrombocytopenia had no significant differences in these two groups (P>0.05). ③ The follow-up time was 4–45 months with an average 3.5 years, the rate of disease progress was lower (P=0.032), the median survival time was longer (P=0.043), the cumulative 3-year overall survival (P=0.015) and the cumulative 3-year disease-free survival (P=0.037) were better in the observation group as compared with the control group. Conclusion Preliminary results in this study show that mFOLFOX6 regimen combined with low-dose aspirin could significantly improve efficacy of advanced gastric cancer following perioperative period of laparoscopic distal subtotal gastrectomy, reduce rate of disease progress, and improve survival rate without increasing side effects.
Objective To explore the feasibility of mean temporal phase images calculated from perfusion CT datasets by using CT perfusion (CTP) of liver on the third-generation dual-source CT. Methods Twenty-two consecutive patients with suspected hepatocellular carcinoma were enrolled, we retrospectively compared objective and subjective image quality, leson detectability, and radiation dose between mean temporal arterial (mTA) and mean temporal portal venous (mTPV) images which calculated from perfusion CT datasets with conventional enhanced arterial and portal venous datasets. Results ① Image quality: compared with the conventional enhancement image, the standard deviation (SD) values of CTP images on liver (arterial phase), portal vein (arterial phase), and liver (portal vein phase) were lower (P<0.05); the signal-to-noise ratio (SNR) values of CTP images on aorta (arterial phase), portal vein (arterial phase), aorta (portal vein phase), and portal vein (portal vein phase) were all higher (P<0.05), the contrast-to-noise ratio (CNR) value of CTP images on aorta (arterial phase) was higher (P<0.05). ② The subjective image quality: the subjective image quality scores of CTP images (mTA and mTPV images) were higher when compared to responding conventional enhanced arterial and portal venous datasets (P<0.05). ③ The diagnostic efficiency: the CTP images and conventional enhancement images showed all the lesions, but the diagnostic efficiency images of CTP images was better than the conventional enhancement images, both on lesions of blood supply and lack of blood supply (P<0.05). Conclusions The image quality of mTA and mTPV datasets calculated from CTP datasets are non-inferior when compared to conventional enhanced arterial and portal venous acquisitions in patients with suspected hepatic lesions. Thus, CTP could be used as a stand-alone imaging technique without additionally performed conventional arterial and portal venous CT acquisitions.
ObjectiveTo evaluate the performance, safety, and precision of the Yuanhua robotic-assisted total knee arthroplasty system (YUANHUA-TKA) through animal experiments, which will provide reference data for human clinical trials.MethodsSix 18-month-old goats, weighing 30-35 kg, were used in this study. The experimental study was divided into two parts: the preoperative planning and intraoperative bone resection. CT scans of the goats’ lower extremities were firstly performed before the experiments. Then the CT scans were segmented to generate the femoral and tibial three-dimensional (3D) models in the YUANHUA-TKA system. The volumes and angles of each resection plane on the femur and tibia were planned. The bone resection was finally implemented under the assistance of the YUANHUA-TKA system. After completing all bone resections, the lower extremities of each goat were taken to have CT scans. By comparing the femoral and tibial 3D models before and after the experiments, the actual bone resection volumes and angles were calculated and compared with the preoperative values.ResultsDuring the experiments, no abnormal bleeding was found; the YUANHUA-TKA system ran smoothly and stably and was able to stop moving and keep the osteotomy in the safe zone all the time. After the experiment, the resection planes were observed immediately and found to be quite flat. There was no significant difference between the planned and actual osteotomy thickness and osteotomy angle (P>0.05); the error of the osteotomy thickness was less than 1 mm, and the error of the osteotomy angle was less than 2°.ConclusionThe YUANHUA-TKA system can assist the surgeons to perform osteotomy following the planned thickness and angle values. It is expected to assist surgeons to implement more accurate and efficient osteotomy in the future clinical applications.
ObjectiveTo evaluate the diagnostic accuracy and efficacy of X-ray for evaluating the tip position of umbilical venous catheterization (UVC). MethodsThe PubMed, Embase, Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect diagnostic tests for UVC tip localisation from inception to 1 May 2023. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data and assessed the quality of the studies using the QUADAS-2 tool. Then, meta-analysis was performed by using Stata 16.0 software. Results Twelve articles involving 1 055 patients were included. The sensitivity and specificity of Negar Yazdani’s study were both 100%. The results of the meta-analysis (the remaining eleven articles, n=951) indicated a pooled sensitivity of 0.7 (95%CI 0.6 to 0.8), a pooled specificity of 0.8 (95%CI 0.7 to 0.9), a positive likelihood ratio of 4.0 (95%CI 2.0 to 8.1), a negative likelihood ratio of 0.4 (95%CI 0.2 to 0.6) and a diagnostic odds ratio of 11 (95%CI 3 to 36) with an area under the cumulative receiver operating characteristic curve of 0.8 (95%CI 0.8 to 0.9). A subgroup analysis was performed according to the different methods of judging X, the 8th–9th thoracic, the 9th–10th thoracic and combined judgement of the diaphragmatic plane + the vertebral body + the heart shadow. The sensitivities of the 3 groups were 0.8 (95%CI 0.5 to 0.9), 0.5 (95%CI 0.4 to 0.7) and 0.8 (95%CI 0.6 to 0.9); the specificities of the 3 groups were 0.8 (95%CI 0.6 to 0.9), 0.76 (95%CI 0.6 to 0.9) and 0.91 (95%CI 0.79 to 0.96). The areas under the cumulative receiver operating characteristic curve were 0.9 (95%CI 0.8 to 0.9), 0.7 (95%CI 0.6 to 0.7) and 0.92 (95%CI 0.89 to 0.94). ConclusionSome error is present when determining the catheter tip position by X-ray, in which the evaluation of the umbilical vein catheter tip position through a comprehensive evaluation of the diaphragmatic plane, the heart margin and the vertebral body is more powerful than the evaluation of the vertebral body alone.
ObjectiveTo evaluate the efficiency and safety of intraprocedural valve-in-valve deployment for treatment of aortic regurgitation following transcatheter aortic valve replacement (TAVR).MethodsConsecutive patients (n=333) who diagnosed with severe aortic stenosis and underwent TAVR in Zhongshan Hospital affiliated to Fudan University from October 3rd, 2010 to April 21st, 2021 were included. There were 208 males and 125 females aged 76.0±7.0 years. There were 316 patients underwent simple TAVR (simple TAVR group) and 17 patients underwent intraprocedural valve-in-valve deployment following TAVR (valve-in-valve group). Their clinical and echocardiographic outcomes were evaluated and compared.ResultsThere was no significant difference between the two groups of patients at postoperative 30 d and 1 year in all-cause mortality (4.4% vs. 0, P=1.000; 6.3% vs. 0, P=1.000), incidence of pacemaker implantation (10.4% vs. 17.6%, P=1.000; 11.8% vs. 17.6%, P=1.000), incidence of ischemic stroke (1.3% vs. 0, P=1.000; 1.3% vs. 0, P=1.000), mean trans-aortic pressure gradient (11.4±6.4 mm Hg vs. 8.9±4.9 mm Hg, P=0.099; 10.5±7.6 mm Hg vs. 11.2±5.2 mm Hg, P=0.432), left ventricular ejection fraction (62.0%±9.0% vs. 57.0%±12.0%, P=0.189; 63.0%±7.0% vs. 60.0%±8.0%, P=0.170), and incidence of mitral valve dysfunction (0.6% vs. 5.9%, P=1.000; 0.6% vs. 5.9%, P=1.000).ConclusionIt is feasible to treat perivalvular leakage with valve-in-valve technology in the procedure of TAVR, and the short and medium-term effects are satisfied.