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As Traditional Chinese Medicine (TCM) becomes widely used in many countries around the world, global demand for intelligent and modernized medical devices of TCM is increasing. Medical devices of TCM have played an important role in diagnosis and treatment of disease. Standardization on medical devices of TCM cannot only be beneficial to ensuring the life safety of patients, but also to enhancing the effectiveness of diagnosis and treatment. This paper includes (1) classification and trends in medical devices of TCM; (2) status review on international standardization of medical devices of TCM; (3) key technical factors in developing international standards for medical devices of TCM and (4) prospects for international standardization development of medical devices of TCM., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background & Aims: Alcoholic liver disease (ALD) is a major cause of morbidity and mortality worldwide. However, the cellular defense mechanisms underlying ALD are not well understood. Recent studies highlighted the involvement of chaperone-mediated autophagy (CMA) in regulating hepatic lipid metabolism. Sorting nexin (SNX)-10 has a regulatory function in endolysosomal trafficking and stabilisation. Here, we investigated the roles of SNX10 in CMA activation and in the pathogenesis of alcohol-induced liver injury and steatosis., Methods: Snx10 knockout (Snx10 KO) mice and their wild-type (WT) littermates fed either the Lieber-DeCarli liquid alcohol diet or a control liquid diet, and primary cultured WT and Snx10 KO hepatocytes stimulated with ethanol, were used as in vivo and in vitro ALD models, respectively. Activation of CMA, liver injury parameters, inflammatory cytokines, oxidative stress and lipid metabolism were measured., Results: Compared with WT littermates, Snx10 KO mice exhibited a significant amelioration in ethanol-induced liver injury and hepatic steatosis. Both in vivo and in vitro studies showed that SNX10 deficiency upregulated lysosome-associated membrane protein type 2A (LAMP-2A) expression and CMA activation, which could be reversed by SNX10 overexpression in vitro. LAMP-2A interference confirmed that the upregulation of Nrf2 and AMPK signalling pathways induced by SNX10 deficiency relied on CMA activation. Pull-down assays revealed an interaction between SNX10 and cathepsin A (CTSA), a key enzyme involved in LAMP-2A degradation. Deficiency in SNX10 inhibited CTSA maturation and increased the stability of LAMP-2A, resulting in an increase in CMA activity., Conclusions: SNX10 controls CMA activity by mediating CTSA maturation, and, thus, has an essential role in alcohol-induced liver injury and steatosis. Our results provide evidence for SNX10 as a potential promising therapeutic target for preventing or ameliorating liver injury in ALD., Lay Summary: Alcoholic liver disease is a major cause of morbidity and mortality worldwide. Recent studies highlight the involvement of chaperone-mediated autophagy (CMA) in regulating hepatic lipid metabolism. Our study reveals that deficiency of sorting nexin (SNX) 10 increases the stability of LAMP-2A by inhibiting cathepsin A maturation, resulting in the increase of CMA activity and, thus, alleviates alcohol-induced liver injury and steatosis., (Copyright © 2018 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)

Background: Fracture and dislocation of the proximal humerus is common. It is associated with a number of vascular, neurologic, and orthopedic complications; these include brachial plexopathy and avascular necrosis (AVN) of the humeral head. These complications are rare but can potentially cause severe disability to patients; however, they remain poorly described in the literature. To describe vascular, orthopedic, and neurologic outcomes after axillary artery repair, in patients with proximal humeral fractures or dislocations., Methods: We conducted a retrospective review of patients admitted to 2 tertiary trauma centers in Victoria, Australia, with fracture or dislocation of the proximal humerus and associated axillary artery injury. Patients were selected according to guidelines for trauma call or alert and the presence of high-risk mechanism of injury. Data on vascular, orthopedic, and neurologic complications were collected., Results: Twenty-one patients were identified. Injury to the first part of the axillary artery was noted in 11 patients (52%). Brachial plexus exploration was performed in 17 patients (81%). Four patients (19%) underwent nerve repair. Long-term neurologic recovery was universally poor. Major orthopedic complications included AVN of the humeral head, delayed union, and the need for prosthesis or arthrodesis. Eleven patients (52%) received upper limb fasciotomy. Five patients (24%) underwent delayed secondary upper limb amputation., Conclusions: There was an unusually high rate of injuries to the first part of the axillary artery. Close clinical observation is recommended for such patients. AVN of the humeral head and brachial plexopathy remain significant and debilitating complications., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Objective: In this study, we investigated the developmental potential of single blastomeres that were obtained from 4-cell mice embryos that were split during the blastocyst stage., Materials and Methods: Imprinting Control Region (ICR) mice (age: 6-8 weeks), were superovulated and mated with a single fertile male of the same strain. We obtained 2-cell embryos that were then cultured in 4 groups (×4) with Human tubal fluid (HTF) supplemented with 12% fetal bovine serum. When these embryos reached the 4-cell stage, their zonae pellucidae were removed and every single blastomere was isolated by repeated pipetting with Ca/Mg(2+)-free medium. The isolated blastomeres (study group) and the intact embryos (control group) were then cultured to determine the blastocyst formation rate and quality., Results: We collected a total of 936 embryos from 524 morphologically intact, top-grade embryos in the 4-cell stage from 80 stimulated mice. We used 356 of these embryos to isolate the blastomeres. The remaining 168 embryos were cultured as controls. A total of 1312 single blastomeres were obtained and cultured in vitro. Among these, 620 blastocysts were harvested from the original embryos compared with 136 blastocysts that were harvested from the control group. The overall blastocyst formation rate was 174.2% (620 blastocysts from 356 embryos) for the study group compared with 81.5% (136 blastocysts from 168 embryos) for the control group. The study group was 43.3% (268 of 620) top-grade blastocysts compared with 91% (152 of 168) of the control group. Taken together, the percentage of top-grade blastocysts obtained per original embryo in the split group was 75.4% (174.2%×43.3%) compared with 74.2% (81.5%×91%) for the control group., Conclusions: Embryo splitting can increase the number of blastocysts. However, the percentage of available top-grade blastocysts is the same compared with nonsplit embryos. Embryo splitting may not be a cost-effective technique for the generation of high-quality mouse blastocysts., (Copyright © 2012. Published by Elsevier B.V.)

Objective: The aim of this study was to identify an optimal stimulation protocol for intrauterine insemination (IUI) to obtain an acceptable pregnancy rate and low frequency of multiple pregnancies., Materials and Methods: In total, 340 patients, who received intrauterine insemination because of ovulation dysfunction, were enrolled in this study. Group I consisted of 203 patients who received recombinant FSH (r-FSH) 150U every other day as an ovulation induction agent. Group II consisted of 137 patients who received r-FSH 100U every other day as an ovulation induction agent. All patients in both groups also received clomiphene citrate 100 mg/day for consecutive five days from the fifth day of the cycle. Only patients with at least two follicles >18 mm on the human chorionic gonadotropin injection days were included in this study., Results: The clinical pregnancy rate was 14.8% (30/203) in Group I compared with 20.4% (28/137) in Group II, p > 0.05. The incidence of multiple pregnancy was 41.7% (10/24) in Group I compared with 12.5% (3/24) in Group II, p < 0.05., Conclusions: The concurrent use of low-dose r-FSH and clomiphene citrate would seem not only to be cost-effective but also highly satisfactory in that it prevents high-order multiple pregnancies., (Copyright © 2011. Published by Elsevier B.V.)

Objective: Simultaneous mifepristone 200mg and vaginal misoprostol 800μg produces a complete abortion rate of approximately 90% at up to 63 days of gestation. The aim of this study was to determine the effectiveness of concurrent administration of mifepristone 200mg and vaginal misoprostol 600μg with respect to early medical abortion., Materials and Methods: A total of 254 women with undesired pregnancies of less than 49 days of gestation were enrolled. All women received oral mifepristone 200mg and vaginal misoprostol 600μg concurrently. Follow-up assessment by transvaginal ultrasonography was performed 3 days and 2 weeks after treatment., Results: Efficacy outcome was analyzed for 242 women (95.3%) after excluding 12 individuals lost to follow-up. The complete abortion rate was 92.6%. The mean induction to abortion interval was about 5.8hours. The mean bleeding duration was about 12.6 days. The women indicated that the side effects were tolerable and 90% of them said that their experience was satisfactory., Conclusion: Concurrent administration of oral mifepristone 200mg and vaginal misoprostol 600μg is an efficacious regimen for medical abortion of pregnancies up to 49 days of gestation., (Copyright © 2011. Published by Elsevier B.V.)