Ephedra Herb extract ameliorates adriamycin-induced nephrotic syndrome in rats via the CAMKK2/AMPK/mTOR signaling pathway / 中国天然药物

This study aimed to investigate the effect and mechanisms of Ephedra Herb (EH) extract on adriamycin-induced nephrotic syndrome (NS), providing an experimental basis for the clinical treatment of NS. Hematoxylin and eosin staining, creatinine, urea nitrogen, and kidn injury molecule-1 were used to evaluate the activities of EH extract on renal function. The levels of inflammatory factors and oxidative stress were detected by kits. The levels of reactive oxygen species, immune cells, and apoptosis were measured by flow cytometry. A network pharmacological approach was used to predict the potential targets and mechanisms of EH extract in the treatment of NS. The protein levels of apoptosis-related proteins and CAMKK2, p-CAMKK2, AMPK, p-AMPK, mTOR and p-mTOR in the kidneys were detected by Western blot. The effective material basis of EH extract was screened by MTT assay. The AMPK pathway inhibitor (compound C, CC) was added to investigate the effect of the potent material basis on adriamycin-induced cell injury. EH extract significantly improved renal injury and relieve inflammation, oxidative stress, and apoptosis in rats. Network pharmacology and Western blot results showed that the effect of EH extract on NS may be associated with the CAMKK2/AMPK/mTOR signaling pathway. Moreover, methylephedrine significantly ameliorated adriamycin-induced NRK-52e cell injury. Methylephedrine also significantly improved the phosphorylation of AMPK and mTOR, which were blocked by CC. In sum, EH extract may ameliorate renal injury via the CAMKK2/AMPK/mTOR signaling pathway. Moreover, methylephedrine may be one of the material bases of EH extract.

Platycladi Semen oil ameliorates Aβ_(25-35)-induced brain injury in mice based on network pharmacology and gut microbiota / 中国中药杂志

The present study aimed to investigate the protective effect and underlying mechanism of Platycladi Semen oil(SP) on Aβ_(25-35)-induced brain injury in mice to provide a theoretical basis for the clinical treatment of Alzheimer's disease(AD). Male Kunming(KM) mice were randomly divided into a control group, a model group(brain injection of Aβ_(25-35), 200 μmol·L~(-1), 0.15 μL·g~(-1)), a positive drug group(donepezil, 10 mg·kg~(-1)), and low-and high-dose SP groups(0.5 and 1 mL·kg~(-1)). Learning and memory ability, neuronal damage, levels of Aβ_(1-42)/Aβ_(1-40), p-Tau, related indicators of apoptosis and oxidative stress, and immune cells, and protein and mRNA expression related to the sphingosine kinase 1(SPHK1)/sphingosine-1-phosphate(S1P)/sphingosine-1-phosphate receptor 5(S1PR5) signaling pathway of mice in each group were determined. In addition, compounds in SP were analyzed by gas chromatography-mass spectrometry(GC-MS). The mechanism of SP against AD was investigated by network pharmacology, 16S rDNA gene sequencing for gut microbiota(GM), and molecular docking techniques. The results showed that SP could improve the learning and memory function of Aβ_(25-35)-induced mice, reduce hippocampal neuronal damage, decrease the levels of Aβ_(1-42)/Aβ_(1-40), p-Tau, and indicators related to apoptosis and oxidative stress in the brain, and maintain the homeostasis of immune cells and GM. Network pharmacology and sequencing analysis for GM showed that the therapeutic effect of SP on AD was associated with the sphingolipid signaling pathway. Meanwhile,(Z,Z,Z)-9,12,15-octadecatrienoic acid and(Z,Z)-9,12-octadecadienoic acid, the components with the highest content in SP, showed good binding activity to SPHK1 and S1PR5. Therefore, it is inferred that SP exerts anti-apoptosis and antioxidant effects by regulating GM and inhibiting SPHK1/S1P/S1PR5 pathway, thereby improving brain injury induced by Aβ_(25-35) in mice. Moreover,(Z,Z,Z)-9,12,15-octadecatrienoic acid and(Z,Z)-9,12-octadecadienoic acid may be the material basis for the anti-AD effect of SP.

Effect of aqueous extract of Corni Fructus on Aβ_(25-35)-induced brain injury and neuroinflammation in mice with Alzheimer's disease / 中国中药杂志

The purpose of this study was to investigate the effect of aqueous extract of Corni Fructus on β-amyloid protein 25-35(Aβ_(25-35))-induced brain injury and neuroinflammation in Alzheimer's disease(AD) mice to provide an experimental basis for the treatment of AD by aqueous extract of Corni Fructus. Sixty C57BL/6J male mice were randomly divided into a sham group, a model group, a positive control group(huperizine A, 0.2 mg·kg~(-1)), a low-dose aqueous extract of Corni Fructus group(1.3 g·kg~(-1)), a medium-dose aqueous extract of Corni Fructus group(2.6 g·kg~(-1)), and a high-dose aqueous extract of Corni Fructus group(5.2 g·kg~(-1)). The AD model was induced by lateral ventricular injection of Aβ_(25-35) in mice except for those in the sham group, and AD model mice were treated with corresponding drugs by gavage for 24 days. The behavioral test was performed one week before animal dissection. Hematoxylin-eosin(HE) staining was performed to observe the morphology of neurons in the hippocampal region. Flow cytometry was used to detect the apoptosis level of primary hippocampal cells in mice. ELISA kits were used to detect the levels of β-amyloid protein 1-42(Aβ_(1-42)) and phosphorylated microtubule-associated protein Tau(p-Tau) in mouse brain tissues. Immunofluorescence and Western blot were used to detect the expression of related proteins in mouse brain tissues. MTT assay was used to detect the effect of compounds in aqueous extract of Corni Fructus on Aβ_(25-35)-induced N9 cell injury. Molecular docking was employed to analyze the interactions of caffeic acid, trans-p-hydroxy cinnamic acid, isolariciresinol-9'-O-β-D-glucopyranoside, esculetin, and(+)-lyoniresinol with β-amyloid precursor protein(APP), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α). Aqueous extract of Corni Fructus could improve the learning and memory abilities of Aβ_(25-35)-induced mice by increasing the duration of the autonomous activity, the rate of autonomous alternation, the preference coefficient, and the discrimination coefficient, and reduce Aβ_(25-35)-induced brain injury and neuroinflammation in mice by increasing the expression levels of interleukin-10(IL-10) and B-cell lymphoma-2(Bcl-2) in brain tissues, decreasing the expression levels of Aβ_(1-42), p-Tau, IL-6, TNF-α, cysteine aspartate-specific protease 3(caspase-3), cysteine aspartate-specific protease 9(caspase-9), and Bcl-2-associated X protein(Bax), and decreasing the number of activated glial cells in brain tissues. The results of cell experiments showed that esculetin and(+)-lyoniresinol could improve Aβ_(25-35)-induced N9 cell injury. Molecular docking results showed that caffeic acid, trans-p-hydroxy cinnamic acid, isolariciresinol-9'-O-β-D-glucopyranoside, esculetin, and(+)-lyoniresinol had good binding affinity with APP and weak binding affinity with IL-6 and TNF-α. Aqueous extract of Corni Fructus could ameliorate cognitive dysfunction and brain damage in Aβ_(25-35)-induced mice by reducing the number of apoptotic cells and activated glial cells in the brain and decreasing the expression level of inflammatory factors. Caffeic acid, trans-p-hydroxy cinnamic acid, isolariciresinol-9'-O-β-D-glucopyranoside, esculetin, and(+)-lyoniresinol may be the material basis for the anti-AD effect of aqueous extract of Corni Fructus.

Analysis of HIV-1 genetic subtype and pretreatment drug resistance among men who have sex with men infected with HIV-1 from 19 cities of 6 provinces in China / 中华流行病学杂志

Objective: To investigate the distribution of HIV-1 genetic subtypes and pretreatment drug resistance (PDR) among men who have sex with men (MSM) from 19 cities of 6 provinces in China. Methods: From April to November 2019, 574 plasma samples of ART-naive HIV-1 infected MSM were collected from 19 cities in Hebei, Shandong, Jiangsu, Zhejiang, Fujian, and Guangdong provinces, total ribonucleic acid (RNA) was extracted and amplified the HIV-1 pol gene region by nested polymerase chain reaction (PCR) after reverse transcription. Then sequences were used to construct a phylogenetic tree to determine genetic subtypes and submitted to the Stanford drug resistance database for drug resistance analysis. Results: A total of 479 samples were successfully amplified by PCR. The HIV-1 genetic subtypes included CRF01_AE, CRF07_BC, B, CRF55_01B, CRF59_01B, CRF65_cpx, CRF103_01B, CRF67_01B, CRF68_01B and unrecognized subtype, which accounted for 43.4%, 36.3%, 6.3%, 5.9%, 0.8%, 0.8%, 0.4%, 0.4%, 0.2% and 5.5%, respectively. The distribution of genetic subtypes among provinces is statistically different (χ2=44.141, P<0.001). The overall PDR rate was 4.6% (22/479), the drug resistance rate of non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, and protease inhibitors were 3.5% (17/479), 0.8% (4/479) and 0.2% (1/479), respectively. The PDR rate of recent infections was significantly higher than that of long-term infections (χ2=4.634, P=0.031). Conclusions: The HIV-1 genetic subtypes among MSM infected with HIV-1 from 19 cities of 6 provinces in China are diverse, and the distribution of subtypes is different among provinces. The overall PDR rate is low, while the PDR rate of recent infections was significantly higher than that of long-term infections, suggesting the surveillance of PDR in recent infections should be strengthened.

Chemical constituents from fruits of Cornus officinalis and their anti-Alzheimer's disease activity / 药学学报

Fifteen compounds were isolated from fruits of Cornus officinalis by various chromatographic techniques such as Toyopearl HW-40C, Sephadex LH-20, silica gel, and the semi-preparative HPLC. Their chemical structures were identified by analysis of physicochemical properties and spectral data, and determined as neolignan A (1), caffeic acid (2), trans-p-hydroxy cinnamic acid (3), esculetin (4), scopoletin (5), benzyl-7-O-β-D-glucopyranoside (6), tachioside (7), 6-O-(4-hydroxybenzoyl) arbutin (8), 2-(3′,4′-dihydroxyphenyl)-1,3-benzodioxole-5-carboxaldehyde (9), (-)-pinoresinol-4-O-β-D-glucopyranoside (10), (7S,8R)-dihydrodehydrodiconiferyl alcohol-9-O-β-D-glucopyranoside (11), (7S,8R)-dihydrodehydrodiconiferyl alcohol-9′-O-β-D-glucopyranoside (12), (+)-lyoniresinol (13), (+)-isolariciresinol-9-O-β-D-glucopyranoside (14), and isolariciresinol-9′-O-β-D-glucopyranoside (15). Compound 1 was a new compound and named as neolignan A, and compounds 6-9 and 14 were isolated from Cornus officinalis for the first time. Compounds 2, 3 and 15 efficiently alleviated the PC12 cells injury induced by Aβ25-35, suggesting their potential anti-Alzheimer's disease activity.

Analysis of plague monitoring results from 2018 to 2020 in Guizhou Province / 中华地方病学杂志

Objective:To analyze the monitoring results of plague foci in Guizhou Province, to master the epidemic dynamics of the plague and to formulate the prevention and control measures.Methods:The plague monitoring data from 2018 to 2020 in Guizhou Province were collected from China Disease Prevention and Control Information System Plague Prevention and Control Information Management System to analyze the plague epidemic situation. The murine animals capture methods used were cage clip method, 5 m cage clip method and day-by-day rodent capture method. Bacterial culture and hemagglutination were used in laboratory.Results:A total of 2 273 murine animals were captured indoors with cage clip method, and the Rattus norvegicus was the dominant species, accounting for 47.29% (1 075/2 273), Rattus flavipectus and Mus musculus were common species, accounting for 43.55% (990/2 273) and 5.10% (116/2 273). A total of 1 460 murine animals were captured outdoors with 5 m cage clip method, and the Rattus rattus sladoni was the dominant species, accounting for 35.48% (518/1 460), Rattus flavipectus and Eothenomys miletus were common species, accounting for 16.03% (234/1 460) and 8.70% (127/1 460). A total of 5 742 murine animals (including 3 733 animals captured with cage clip method and 5 m cage clip method, 2 009 animals captured with day-by-day rodent capture method) were examined and 1 176 with flea, the flea infestation rate of murine animals was 20.48%, Xenopsylla cheopi was the dominant flea species [56.63% (3 020/5 333)] and the index was 0.53. Laboratory test results were all negative. Conclusions:The plague foci of Guizhou Province is at a quiescent stage, but the reignition cannot be ruled out. The monitoring of plague should be strengthened, the quality of the monitoring should be improved, and health education and publicity should be carried out to prevent the occurrence of human plague outbreaks.

Research Progress on Chemical Constituents and Pharmacological Effects of Piperis Fructus / 中国实验方剂学杂志

Piperis Fructus is the dried nearly ripe or ripe fruit of Piperaceae, which is an important spice material and a traditional Chinese medicine (TCM), it is widely used in the world. It is recorded to possess the efficacy of warming spleen and stomach for dispelling cold, depressing Qi and dissolving phlegm. Piperis Fructus mainly contains amide alkaloids with piperine as the main ingredient and volatile oil dominated by monoterpenoids and sesquiterpenoids, which have a wide range of biological activities, such as anti-cancer, anti-oxidation, anti-inflammatory, etc. By referring to relevant papers at home and abroad, the researches on chemical compositions from different parts and pharmacological effects of Piperis Fructus in recent 5 years were summarized and analyzed. It was found that Piperis Fructus has great potential for drug development as a TCM with homology of medicine and food, which can provide a reference for further research and comprehensive utilization of Piperis Fructus.

Feasibility of low-dose radiation CT scanning for liver 3D modeling printing / 医学研究生学报

Objective In the wide clinical practice of liver 3D printing, its related high-dose CT radiation has been somehow neglected and resulted in unnecessary radiation injury to the patients. This study was to explore the feasibility of liver 3D modeling printing with the low-dose radiation CT scanning technique.　Methods　This retrospective study included 40 patients undergoing liver 3D modeling printing from January 2016 to June 2018, who were equally randomized into a low-dose radiation group (100 kVp, by automated tube current modulation [ATCM] and adaptive statistical iterative reconstruction [ASIR]) and a normal-dose radiation group (120 kVp, 250 mA by filter back projection [FBP]), both with contrast agent Iohexol at 300 mgI/m1. We obtained the values of three-phase enhanced CT scanning of the abdominal aorta, portal vein and liver parenchyma, background noise (BN), volume CT dose index (CTDI), dose length product (DLP), contrast noise ratio (CNR) and effective radiation dose (ED). We input the CT DICOM data into the 3D printer for liver modeling printing and subjectively assessed the results. Results There were statistically significant differences between the low-dose and normal-dose radiation groups in the CTDI, DLP and ED (P 0.05). The ED was decreased about 35.8% in the low-dose group as compared with that in the normal-dose group ([2.58 ± 0.79] vs [4.02 ± 0.26] mSv, P 0.05). Conclusion Low-dose radiation CT scanning technology can meet the clinical requirement of liver 3D modeling printing and significantly reduce the patient’s exposure to CT radiation.

Hemiarthroplasty for the treatment of complicated femoral intertrochanteric fracture in elderly patients / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the hemiarthroplasty for the threatment of femoral intertrochanteric fracture in elderly patients.</p><p><b>METHODS</b>From August 2013 to January 2017, 66 elderly patients with complicated femoral intertrochanteric fracture were treated including 20 males and 46 females with an average age of 85 years old ranging from 80 to 95. According to improve Evans classification, 33 cases were type III, 24 cases were type IV, 9 cases were type V. History included 31 cases of hypertension, 10 cases of diabetes, 12 cases of severe osteoporosis, 5 cases of atrial fibrillation, 3 cases of pulmonary heart disease, and 1 case of multiple myeloma. Hip hemiarthroplasty was used in 34 cases and internal fixation in 32 cases. The bleeding volume, complications and Harris scores of the two groups were observed and compared.</p><p><b>RESULTS</b>The amount of blood loss during and after operation were(320±20) ml and(200±25) ml in the joint replacement group, and (350±30) ml and(250±30) ml in the internal fixation group, and there was no statistical difference between the two groups(>0.05). All patients were followed up for an average of 2 years. The Harris score of the joint replacement group was 85.0±6.4, which was higher than that of the internal fixation group (72.0±3.4)(<0.05). The difference of complications between the two groups was statistically significant (<0.05).</p><p><b>CONCLUSIONS</b>The elderly patients with femoral intertrochanteric fractures have many basic diseases, and the expected survival time is short. Using artificial bipolar femoral head prosthesis can restore the hip function early and to the maximum degree, make the patients get down in the bed early, effectively reduce the complications caused by internal fixation, improve the patient's quality of life and satisfaction, and early treatment. It is a kind of supplemental treatment, which conforms to the theory of rapid rehabilitation surgery and injury control, but should not expand the indication and strengthen the management of the perioperative period.</p>

A clinical study of serum protein markers in patients with 1-bromopropane poisoning / 中华劳动卫生职业病杂志

Objective@#To investigate the changes in protein expression in patients with 1-bromopropane (1-BP) poisoning using high-throughput proteomic technique and to screen out protein markers.@*Methods@#Serum samples were collected from 3 patients with 1-BP poisoning and 15 controls. The label-free proteomic tech-nique was used for the quantitation and identification of proteins expressed in these samples, and the results were compared between the patients with 1-BP poisoning and the control population. The bioinformatics tools were used to analyze the function of differentially expressed proteins.@*Results@#Compared with the control popula-tion, the patients with 1-BP poisoning had >2-fold upregulation of 38 proteins and >2-fold downregulation of 68 proteins. The differentially expressed proteins were mainly involved in immune response, signal transduction, and stress response.@*Conclusion@#The proteins screened out may be potential protein markers for 1-BP poison-ing, which provides reliable and precise methods and thoughts for the diagnosis of 1-BP poisoning.

Reparation role of recombinant human bone morphogenetic protein-4 mature peptide on hematopoietic system of mice with acute radiation injury / 新乡医学院学报

Objective To explore the reparation role of recombinant human bone morphogenetic protein-4 mature peptide (rhBMP-4m) on hematopoietic system injury induced by irradiation in mice.Methods Ninety BALB/c mice were randomly divided into normal control group,model group and rhBMP-4m treatment group,with 30 mice in each group.The mice in model group and rhBMP-4m treatment group were irradiated by 60Co γ-ray(7.5 Gy) for 200 s;while the mice in normal control group did not receive irradiation.After irradiation,the mice in model group were given physiological saline 1.0 mL by peritoneal injection per day for 6 days;the mice in rhBMP-4m treatment group were given rhBMP-4m 0.5 mg by peritoneal injection per day for 6 days.The peripheral white blood cell count and marrow mononuclear cells,the percent of CD34 + cells in marrow mononuclear cells of mice were detected on the first,third,fifth,seventh,ninth day after irradiation;the number of spleen nodus and the pleen weight/body weight ratio were detected at the ninth day after irradiation.Results There was no statistic difference in the number of peripheral white blood cells of mice among the three groups on the first day after irradiation(P ＞ 0.05).The peripheral white blood cell count of mice in model group was significantly lower than that in the normal control group on the third,fifth,seventh,ninth day after irradiation (P ＜ 0.01).There was no statistic difference in the number of peripheral white blood cells of mice between rhBMP-4m treatment group and model group on the third,fifth day after irradiation (P ＞ 0.05);the peripheral white blood cell count of mice in rhBMP-4m treatment group was significantly higher than that in model group on the seventh,ninth day after irradiation (P ＜ 0.05).The number of marrow mononuclear cells of mice in model group was significantly lower than that in the normal control group at each time piont after irradiation(P ＜ 0.05).There was no statistic difference in the number of marrow mononuclear cells of mice between the rhBMP-4m treatment group and model group on the first,third day after irradiation (P ＞ 0.05);the number of marrow mononuclear cells of mice in rhBMP-4m treatment group was significantly higher than that in the model group on the fifth,seventh,ninth day after irradiation(P ＜ 0.05).The proportion of CD34 + cells in mononuclear cells of mice in model group was significantly lower than that in the normal control group at each time piont after irradiation(P ＜0.01).There was no statistic difference in the proportion of CD34 + cells in mononuclear cells of mice between the rhBMP-4m treatment group and model group on the first,third day after irradiation (P ＞ 0.05);the proportion of CD34 + cells in mononuclear cells of mice in rhBMP-4m treatment group was significantly higher than that in the model group on the fifth,seventh,ninth day after irradiation(P ＜ 0.05).Compared with the normal control group,the number of spleen nodus was increased and the spleen weight/body weight ratio of mice was decreased in model group on the ninth day after irradiation(P ＜ 0.05);the number of spleen nodus and the spleen weight/body weight ratio of mice in rhBMP-4m treatment group were significantly higher than those in the model group on the ninth day after irradiation (P ＜ 0.01).Conclusion rhBMP-4m can accelerate the reconstruction of bone marrow hematopoietic system of mice with hematopoietic system injury induced by irradiation.

Clinical Observation of Sofren Injection Combined with Vinpocetine Injection in the Treatment of Acute Massive Cerebral Infarction / 中国药房

OBJECTIVE:To investigate clinical efficacy of Sofren injection combined with Vinpocetine injection in the treatment of acute massive cerebral infarction,and its effects on hemorheological indexes and serum NOS.METHODS:A total of 60 patients with acute massive cerebral infarction in our hospital during Jan.2014-Jun.2016 were selected as research objects and divided into trial group and control group according to random number table,with 30 cases in each group.Control group was given Citicoline injection 0.5 g,ivgtt,qd.Trial group was additionally given Vinpocetine injection 20 mg added into 0.9％ Sodium chloride injection 250 mL,ivgtt,qd;1 h later washing tube,they were given Sofren injection 10 mL added into 0.9％ Sodium chloride injection 250 mL,ivgtt,for consecutive 14 d.Clinical efficacies and safety of 2 groups were observed,and hemorheological indexes and NOS levels were observed before and after treatment.RESULTS:The total response rate (83.33％)of trial group was significantly higher than that (50.00％) of control group,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in hemorheological indexes or serum NOS levels between 2 groups (P＞0.05).After treatment,hemorheological indexes of 2 groups were decreased significantly,and the trial group was significantly lower than the control group.The level of serum NOS in 2 groups were increased significantly,and the trial group was significantly higher than the control group,with statistical significance (P＜0.05).No obvious ADR was found in 2 groups.CONCLUSIONS:Sofren injection combined with Vinpocetine injection show significant therapeutic efficacy for acute massive cerebral infarction,can reduce blood viscosity and increase blood perfusion with good safety.

The potential molecular effects of bursal septpeptide II on immune induction and antitumor activity

The bursa of Fabricius (BF) is the acknowledged central humoral immune organ in birds. Bursal septpeptide II (BSP-II) is an immunomodulatory bioactive peptide isolated from BF. To understand the effects of BSP-II on immune induction, gene expression profiles of hybridoma cells treated with BSP-II were evaluated. Pathway analysis showed that regulated genes were involved in cytokine-cytokine receptor interactions, T cell receptor signaling pathway, and pathway in cancer. It was observed that BSP-II reduced tumor cells proliferation and stimulated p53 expression. These results indicate potential mechanisms underlying the effects of the humoral immune system on immune induction, including antitumor activities. Our study has provided a novel insight into immunotherapeutic strategies for treating human tumors.

Derivatization of berberine based on its synergistic antifungal activity with fluconazole against fluconazole-resistant Candida albicans / 药学学报

Abstract: Our previous work revealed berberine can significantly enhance the susceptibility of fluconazole against fluconazole-resistant Candida albicans, which suggested that berberine has synergistic antifungal activity with fluconazole. Preliminary SAR of berberine needs to be studied for the possibility of investigating its target and SAR, improving its drug-likeness, and exploring new scaffold. In this work, 13-substitutited benzyl berberine derivatives and N-benzyl isoquinoline analogues were synthesized and characterized by 1H NMR and MS. Their synergetic activity with fluconazole against fluconazole-resistant Candida albicans was evaluated in vitro. The 13-substitutited benzyl berberine derivatives 1a-1e exhibited comparable activity to berberine, which suggested that the introduction of functional groups to C-13 can maintain its activity. The N-benzyl isoquinolines, which were designed as analogues of berberine with its D ring opened, exhibited lower activity than berberine. However, compound 2b, 2c, and 4b showed moderate activity, which indicated that berberine may be deconstructed to new scaffold with synergistic antifungal activity with fluconazole. The results of our research may be helpful to the SAR studies on its other biological activities.

Influence of preoperative thoracic kyphosis on the sagittal profile of the lumbar spine in idiopathic thoracic scoliosis following selective thoracic fusion / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the influence of thoracic kyphosis on the sagittal compensatory mode of the spine in idiopathic thoracic scoliosis after the selective thoracic fusion.</p><p><b>METHODS</b>Ninety AIS patients (mean age 14.5 years old) who received selective thoracic fusion from February 1999 to December 2005 in one institution with at least 24-month follow-up were evaluated. Forty-one patients underwent anterior spinal fusion and forty-nine patients underwent posterior spinal fusion. And then the patients were divided into two subgroups according to the magnitude of preoperative thoracic kyphosis (TK): Group A, TK less than 10 degrees ; and Group B, TK more than 10 degrees . The radiological parameters were measured including: thoracic and lumbar curve magnitude, TK, lumbar lordosis (LL), thoracolumbar junction kyphosis (T(10)-L(2), TJK), distal junctional kyphosis (DJK), sagittal vertical axis (SVA).</p><p><b>RESULTS</b>At final follow-up, TK, TJK and DJK increased significantly compared with preoperative Cobb angle in subgroup A patients who underwent anterior spinal fusion (P < 0.05). Generally, there was a lordosis loss of TJK and DJK during follow-up. While in subgroup B, TJK at final follow-up increased apparently compared with preoperative Cobb angle (P < 0.05). And there was a increased trend of DJK in spite of no significant difference, however, there was no obvious change of TK in subgroup B. At the final follow-up, TK and TJK increased significantly in subgroup A patients who underwent posterior spinal fusion (P < 0.05). And there was a increased tendency of DJK during follow-up, although there was no significant difference. And there was no obvious change of TK, TJK and DJK in subgroup B. There was a increased trend of LL in spite of no significant difference in group A patients who underwent anterior or posterior spinal fusion. The sagittal balance maintained well during follow-up in both groups.</p><p><b>CONCLUSIONS</b>For AIS patients with thoracic hypokyphosis, normal TK and LL could be achieved during follow-up with selective thoracic instrumentation. However, the increase of DJK and TJK may occur during the follow-up, and the risk factors may be the anterior short segmental fusion and the reconstruction of the sagittal profile in the hypokyphosis patients.</p>

Pulmonary dysfunction patterns in patients with Marfan and Marfanoid syndrome associated with scoliosis and the influencing factors / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the impairment pattern and the influencing factors of pulmonary function in patients with Marfan and Marfanoid syndrome associated scoliosis (MS).</p><p><b>METHODS</b>In this retrospective study, totally 25 MS patients (aged 11 - 20 years, 11 boys and 14 girls) who received posterior instrumentation and fusion (Group A) and 38 adolescent idiopathic scoliosis (AIS) patients (Group B) (aged 10 - 19 years, 11 boys and 27 girls) were included from February 1998 to September 2007. The curve pattern was matched in both groups. The preoperative pulmonary function test (PFTs) were compared in two groups. And the parameters influencing the preoperative pulmonary function were analyzed in group A.</p><p><b>RESULTS</b>In Group A, the Cobb angle of thoracic curve was negatively correlated with the percentage of predicted pulmonary volumes (VC%, FVC% and FEV1%) (r = -0.514, -0.503, -0.464, P < 0.05). And the reduction of lung function parameters (VC%, FVC%, FEV1% and MMEF%) was more severe in Group A than in Group B with compared magnitude of thoracic curve (P < 0.05). In Group A, the extent of impairment of pulmonary function in patients with the number of vertebrae involved ≥ 8 were more severe than those involved < 8 vertebrae (P < 0.05). However, there was no significant difference of deterioration of lung function between the higher apex (T₄₋₈) subgroup and lower apex (T₉₋₁₂) subgroup. And no correlation was found between thoracic kyphosis and the degrees of impairment of respiration function.</p><p><b>CONCLUSIONS</b>Patients with MS have mixed ventilation dysfunction, which is more severe than AIS patients with matched age and Cobb angle. The pulmonary dysfunction in MS patients can be influenced by the severity of thoracic curve and the number of involved vertebrae.</p>

Analysis of the psychological impact of medical disputes on clinical doctors and a discussion of counter-measures / 中华医院管理杂志

Objective Identifying the factors of psychological pressure from medical disputes on clinical doctors and possible solutions. Methods Self-rating Anxiety Scale (SAS) and the Occupational Stress Indicator (OSI) were called into play, to study 52 clinical doctors in a tertiary hospital in a city, who had encountered medical disputes in recent two years. In parallel, 63 clinical doctors without such disputes and 50 non-clinical workers were randomly selected as the control group for questionnaires. Results Clinical doctors with such an experience were commonly found to be anxious, and their SAS score (58. 27±11.38)averaged higher than those in the control group. Doctor-patient relationship, legal liabilities and clinical positions were found to be positively correlated to psychological pressure of clinical doctors. Conclusions Medical disputes tend to add to psychological pressure of the doctors. Clinical doctors deserve psychological counseling and training and improvement of their working conditions.

The influence of thoracic kyphosis on sagittal balance of the lumbosacral spine in thoracic idiopathic scoliosis patients / 中华外科杂志

<p><b>OBJECTIVES</b>To evaluate the influence of thoracic kyphosis to sagittal alignment and balance of the lumbosacral vertebrae in thoracic adolescent idiopathic scoliosis patients.</p><p><b>METHODS</b>Standing posteroanterior and lateral x-rays of a cohort of 55 patients with thoracic adolescent idiopathic scoliosis were obtained. The patients were classified according to their thoracic kyphosis, the first group TK < 10 degrees and the second group 10 degrees < or = TK < or = 40 degrees . The following parameters were measured: lumbar lordosis (LL), upper and lower arc of lumbar lordosis, sagittal vertical axis, sacral slope (SS), pelvic incidence (PI), pelvic tilt (PT). Sagittal plane parameters were analyzed using t-test between two groups, with significance set at P < 0.05. Linear correlations between parameters were calculated using Pearson correlation coefficients, with significance set at P < 0.01.</p><p><b>RESULTS</b>There were smaller LL and upper arc of lumbar lordosis in the first group. Significant linear correlations were found between each single adjacent shape parameter. Significant correlations were also found between TK, LL and upper arc of lumbar lordosis, as well as between PT, SS and PI.</p><p><b>CONCLUSIONS</b>Sagittal alignment and balance of the lumbosacral vertebrae may influence the thoracic kyphosis in AIS patients. The mechanism of this influence may through the adaptation of upper arc of lumbar lordosis. This influence must be considered in thoracic adolescent idiopathic scoliosis patients who undergo selective posterior thoracic fusion.</p>

Subgrouping and outcome prediction of diffuse large B-cell lymphoma by immunohistochemistry / 中华病理学杂志

<p><b>OBJECTIVE</b>To categorize diffuse large B-cell lymphoma (DLBCL) into germinal center B cell-like (GCB) and non-germinal center B cell-like (non-GCB) subgroups by immunohistochemistry; and to investigate the underlying prognostic significance.</p><p><b>METHODS</b>Immunohistochemical study for CD10, bcl-6 and MUM1 was performed on 133 cases of DLBCL. The cases were then categorized into GCB and non-GCB subgroups. The 5-year overall survival and 5-year progression-free survival rates were compared between the GCB and non-GCB groups, and among the cases with different immunohistochemical expression or with different IPI.</p><p><b>RESULTS</b>Amongst the 133 case studied, CD10 was expressed in 33.1%, while bcl-6 was positive in 34.6% and MUM1 in 45.1%. CD10 expression had a favorable impact on 5-year overall survival (P=0.041) and 5-year progression-free survival (P=0.031). On the other hand, bcl-6 expression had a favor able impact on 5-year progression-free survival (P=0.044). Expression of MUM1 carried an adverse effect on 5-year overall survival (P=0.031) and 5-year progression-free survival (P=0.028). GCB immunophenotype was demonstrated in 40.6% of the cases, while 59.4% showed a non-GCB profile. GCB DLBCL had a significantly longer 5-year overall survival (P=0.004) and 5-year progression-free survival (P=0.003), as compared with the non-GCB group. When dividing the cases into two groups according to their IPI score (IPI=0 to 1 and IPI=2 to 5), it turned out that the 5-year overall and progression-free survival rates of the GCB group were significantly higher than those of the non-GCB group (P=0.019 and 0.014 respectively in cases with IPI of 0 to 1 and P=0.006 and 0.009 respectively in cases with IPI of 2 to 5). The non-GCB cases with a IPI of 2 to 5 had the poorest prognosis.</p><p><b>CONCLUSION</b>DLBCL subgrouping by immunohistochemistry and analysis of the subgrouping with IPI is feasible and useful in predicting clinical outcome.</p>

Influence of epitope A modification and N-linked glycosylated site mutation of PRRSV NJ-a strain ORF5 gene on the ability to induce neutralizing antibodies and T cell proliferation response / 生物工程学报

To enhance the DNA immunogencity of PRRSV ORF5 gene, CpG sequence and the universal helper T cell antigen epitope (PADRE) sequence were inserted between the decoy epitope and the neutralizing epitope. At the same time, site-mutations were introduced at N33 and N51 to diminish the coverage effect to epitope B from the polysaccharides. Subsequently, the modified ORF5 gene (MORF5) and PRRSV ORF6 gene were cloned into the eukaryotic expression vector pcDNA3.0 under the control of two CMV promoters, respectively. With indirect immunofluorescence assay and Western-blot the expression in vitro of the two genes was confirmed, then six-week-old Balb/C mouse were immunized with the modified expression plasmid pcDNA-M5A-6A. The non-modified expression plasmid pcDNA-5A-6A, the blank eukaryotic expression plasmid pcDNA3.0, living attenuated vaccine and inactivated vaccine were used as controls. The PRRSV specific neutralizing antibodies and the T cell proliferation response were elevated with virus neutralization assay and MTf method. Results indicate that the modified plasmid pcDNA-M5A-6A can elicit not only higher titer of neutralizing antibodies in a rapid time, but also more vigorous T cell proliferation response compared with the non-modified plasmid pcDNA-5A-6A and commercial vaccines, indicating that DNA vaccine pcDNA-M5A-6A maybe a promising candidate for PRRS prevention.