Repair fingertip defect and soft tissue defect of donor site with nerve anastomosed relay flap / 中华显微外科杂志

Objective:To explore the method and effect of repairing fingertip defect and soft tissue defect in donor area by relay flap with suture nerve.Methods:From January 2017 to May 2019, 11 cases of fingertip defects were repaired with reverse island fascial pedicle flap of dorsal digital artery sutured with nerve, with a flap area of 0.6 cm×1.2 cm-1.6 cm×2.0 cm, and the flap donor area was repaired with dorsal metacarpal artery cutaneous branch flap. The patients were followed-up by outpatient, reexamination and WeChat interviews.Results:Twenty-two flaps of 11 cases survived completely and the wound healed in stage I. The postoperative follow-up ranged from 3 to 36 months, with an average of 13 months. The flap and pedicle were not bloated, the shape of finger was satisfactory, the texture was soft, and the skin color was close to the skin of finger. Sensory recovery≥S 3. The TPD of the flap was 6-11 mm, with an average of 8.4 mm. Hand function was evaluated according to the Trial Standard of Upper Limb Function Evaluation of Chinese Medical Association: excellent in 10 cases and good in 1 case. The patients were satisfied with the repair effect and resumed their daily life and work. Conclusion:This operation is simple, does not need to sacrifice the main blood vessels and nerves, can restore the good shape and sensction of the affected finger, with the activity close to normal. It is an effective method to repair the fingertip defect.

Determination of six effective ingredients in Imperatae Rhizoma concentrated granules by ultra-performance liquid chromatography using two internal references / 药学学报

To simultaneously determine the contents of p-coumaric acid, chlorogenic acid, 5-caffeoylquinic acid, 4-caffeoylquinic acid, caffeic acid and ferulic acid in Imperatae Rhizoma concentrated granules, an ultra-high performance liquid chromatography (UPLC) with two internal references method (TIRM) was established and validated. Chromatographic separation was achieved on a ZORBAX RRHD Eclipse Plus C18 column (2.1 mm × 100 mm, 1.8 µm) using 1.7 mmol·L-1 oxalic acid in water and methanol as mobile phase. The flow rate was 0.4 mL·min-1 and the column temperature was set as 35 ℃. The relative correction factors (RCFs) of caffeic acid and ferulic acid using p-coumaric acid as internal reference were calculated and the RCFs of 4-caffeoylquinic acid and 5-caffeoylquinic acid were calculated using chlorogenic acid as the internal reference. The TIRM was fully validated for linearity, accuracy, repeatability, stability and recovery so that it could be compared with the external standard method (ESM). The RCFs of 5-caffeoylquinic acid, 4-caffeoylquinic acid, caffeic acid, and ferulic acid were 1.069, 1.022, 1.368, and 1.493, respectively. The TIRM and ESM were used to determine the contents of six ingredients in Imperatae Rhizoma concentrated granules from different manufacturers and the variation between results was within acceptable limits. In conclusion, the newly established TIRM allowed simultaneous determination of six ingredients (p-coumaric acid, chlorogenic acid, 5-caffeoylquinic acid, 4-caffeoylquinic acid, caffeic acid, ferulic acid) in Imperatae Rhizoma concentrated granules, providing support for the quality control of this traditional Chinese medicine.

Shenqi Fuzheng Injection () Combined with Chemotherapy for Acute Leukemia: A Meta-Analysis / 中国结合医学杂志

OBJECTIVE@#To evaluate to the efficacy and safety of Shenqi Fuzheng Injection (, SFI) combined with chemotherapy in the treatment of acute leukemia (AL) by meta-analysis.@*METHODS@#PubMed, Cochrane library, Embase, SinoMed, China National Knowledge Infrastructure (CNKI), VIP Journal Integration Platform, Wanfang Database were searched from establishment to November 1, 2018. The randomized controlled trials (RCTs) of SFI combined with chemotherapy in the treatment of AL were included. The Cochrane risk assessment form (RevMan 5.1) was used to evaluate the quality of included studies.@*RESULTS@#A total of 14 RCTs and 1,088 patients was included. The quality evaluation were mostly low risk or unclear. Meta-analysis showed that compared with chemotherapy alone, SFI combined with chemotherapy can improve the total clinical effective rate in patients with AL (RR=1.15, 95% CI: 1.056-1.177; P=0.0001), and relieve adverse reactions caused by chemotherapy drugs, including infection (RR=0.561, 95% CI: 0.397-0.792; P=0.001), nausea and vomiting (RR=0.662, 95% CI: 0.524-0.835; P=0.001), bleeding (RR=0.548, 95% CI: 0.39-0.768; P=0.0001), cardiotoxicity (RR=0.230, 95% CI: 0.080-0.660; P=0.006) and hyperhidrosis (RR=0.348, 95% CI: 0.208-0.581; P=0.0001). The incidence rates of adverse reactions in SFI combined with chemotherapy group were significantly lower than that of the chemotherapy alone group (P<0.01).@*CONCLUSIONS@#Shenqi Fuzheng Injection combined with chemotherapy has good efficacy and safety for AL, and it can alleviate the adverse reactions caused by chemotherapy. However, subject to the limitations of the methodological quality of the literature, the conclusions of this study need to be further verified by large-scale and multi-center RCTs.

Associação da hipertensão com a gravidade e a mortalidade de pacientes hospitalizados com COVID-19 em Wuhan, China: Estudo unicêntrico e retrospectivo / Association of hypertension with severity and mortality in hospitalized patients with COVID-19 in wuhan, China: A single-centered, retrospective study

Resumo Fundamento A doença Coronavírus 2019 (COVID-19), causada pela síndrome respiratória aguda grave Coronavírus 2 (SARS-CoV-2), espalhou-se pelo mundo. Objetivo Investigar a associação entre a hipertensão e a gravidade/mortalidade de pacientes hospitalizados com COVID-19 em Wuhan, China. Métodos Um total de 337 pacientes diagnosticados com COVID-19 no Sétimo Hospital da cidade de Wuhan, de 20 de janeiro a 25 de fevereiro de 2020, foram inseridos e analisados em um estudo de caso unicêntrico e retrospectivo. O nível de significância adotado para a análise estatística foi 0,05. Resultados Dos 337 pacientes com diagnóstico confirmado de COVID-19, 297 (87.8%) tiveram alta do hospital e 40 pacientes (22,9%) morreram. A idade média foi de 58 anos (variando de 18 a 91 anos). Havia 112 (33,2%) pacientes diagnosticados com hipertensão no momento da internação (idade média, 65,0 anos [variação, 38-91 anos]; sendo 67 homens [59,8%, IC95%: 50,6%-69,0%], p=0,0209). Pacientes com hipertensão apresentaram uma porção significativamente maior de casos graves (69 [61,6%, IC95%: 52,5%-70,8%] vs. 117 [52,0%, IC95%: 45,4%-58,6%] em pacientes graves e 23 [19,3%, IC95%: 12,9%-28,1%] vs. 27 [12,0%, IC95%: 7,7%-16,3%] em pacientes críticos, p=0,0014) e maiores taxas de mortalidade (20 [17,9%, IC95%: 10,7%-25,1%] vs. 20 [8,9%, IC95%: 5,1%-12,6%, p=0,0202). Além disso, pacientes hipertensos apresentaram níveis anormais de vários indicadores, como linfopenia e inflamação, e nas funções cardíacas, hepáticas, renais e pulmonares no momento da internação. O grupo de pacientes com hipertensão também demonstrou níveis maiores de TNT e creatinina próximo da alta. Conclusão A hipertensão está altamente associada à gravidade ou mortalidade da COVID-19. Um tratamento agressivo deve ser considerado para pacientes hipertensos com COVID-19, principalmente com relação a lesões cardíacas e dos rins.

Abstract Background Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide. Objective To investigate the association between hypertension and severity/mortality in hospitalized patients with COVID-19 in Wuhan, China. Methods A total of 337 patients diagnosed with COVID-19 at the Seventh Hospital of Wuhan City, from January 20 to February 25, 2020, were enrolled and analyzed in a retrospective, single-center case study. The significance level adopted in the statistical analysis was 0.05. Results Of the 337 patients with confirmed diagnosis of COVID-19, 297 (87.8%) were discharged from the hospital and 40 patients (22.9%) died. The median age was 58 years (range, 18-91 years). There were 112 (33.2%) patients diagnosed with hypertension at admission (median age, 65.0 years [range, 38-91 years]; 67 [59.8%, 95%CI: 50.6%-69.0%] men, p=0.0209). Patients with hypertension presented a significantly higher portion of severe cases (69 [61.6%, 95%CI:52.5%-70.8%] vs. 117 [52.0%, 95%CI: 45.4%-58.6%] in severe patients and 23 [19.3%, 95%CI:12.9%-28.1%] vs. 27 [12.0%, 95%CI: 7.7%-16.3%] in critical patients, p=0.0014) and higher mortality rates (20 [17.9%, 95%CI: 10.7%-25.1%] vs. 20 [8.9%, 95%CI: 5.1%-12.6%, p=0.0202). Moreover, hypertensive patients presented abnormal levels of multiple indicators, such as lymphopenia, inflammation, heart, liver, kidney, and lung function at admission. The hypertension group still displayed higher levels of TnT and creatinine at approaching discharge. Conclusion Hypertension is strongly associated with severity or mortality of COVID-19. Aggressive treatment may be considered for COVID-19 patients with hypertension, especially regarding cardiac and kidney injury.

Association of diabetes with severity and mortality in hospitalized patients with COVID-19 in Wuhan, China: a single-centered, retrospective study

ABSTRACT Objective: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide. The aim this study was to investigate the association of diabetes with severity and mortality among hospitalized patients with COVID-19 in Wuhan, China. Subjects and methods: This retrospective, single-center case study enrolled a total of 564 patients diagnosed with COVID-19 at the Seventh Hospital of Wuhan City, between January 20 and March 15, 2020. Results: Among the 564 patients with confirmed COVID-19, 509 (85.1%) were discharged and 55 (9.8%) died. The median age was 59 years (range, 10-93 years). A total of 85 (15.1%) patients were diagnosed with diabetes on admission (median age, 65.0 [range, 34-91] years). Patients with diabetes had significantly higher proportions of critical cases (24 [28.2%] vs. 66 [13.8%]) and in-hospital mortality (17 [20%] vs. 38 [7.9%]). Moreover, patients with diabetes presented abnormal levels of multiple indicators concerning lymphopenia, inflammation, heart, liver, kidney, and lung function on admission, while diabetic patient group still display higher troponin T (TnT) levels when approaching discharge. The Kaplan-Meier survival curve indicated a trend toward poorer survival in diabetic patients compared to non-diabetic patients, also evidenced by abnormal laboratory biomarker changes regarding multiple system impairments among COVID-19 patients with diabetes with in-hospital death. Conclusion: The detailed clinical investigation of 564 hospitalized patients with COVID-19 indicated a considerable association between diabetes and COVID-19 severity or mortality. Thus, more intensive treatment may be considered for COVID-19 patients with diabetes, especially regarding to cardiac injury.

Research progress in phosphodiesterase 4 inhibitors in treatment of inflammatory bowel diseases / 中国药理学与毒理学杂志

Inflammatory bowel disease (IBD) is a chronic idiopathic intestinal inflammatory disease that affects all parts of the intestine. Phosphodiesterase 4 (PDE4) is a key enzyme that mediates inflammation, and its inhibitor is useful in many inflammatory diseases. In this review, we summarize the research progress in PDE 4 inhibitors in the treatment of IBD in preclinical studies, such as rolipram, mesopram, roflumilast, tetomilast and apremilast, as well as PDE4 inhibitors in clinical studies, such as apremilast and tetomilast. All PDE4 inhibitors have shown therapeutic effect on IBD, and the mechanisms involve the inhibition of cytokine release, such as tumor necrosis factor-α, lnterleukin-8, suppression thr inflammation in colon, enhancement of the barrier of the intensine, and reduction of the collagen deposition. As a novel drug for IBD therapy, PDE4 inhibitor apremilast might have therapeutic benefit in IBD, and roflumilast, which is yet to enter clinical trial, may have a good therapeutic prospect.

Clinical Characteristics and Mutation Landscape of Chinese Mucosal Melanoma / 中山大学学报(医学科学版)

@#【Objective】 To use next generation sequencing （NGS） for examing 295 gene mutations in Chinese mucosal melanoma，and explore the mutation landscape of Chinese mucosal melanoma for potential therapeutic targets. 【Methods】The specimens were from 25 mucosal melanoma patients from September 2017 to September 2018 in Biotherapy Center，Sun Yat-sen University Cancer Center. Mutations of 295 genes were detected by NGS sequencing in the Department of Molecular Diagnostics in our hospital. 【Results】 The mutation frequency of major driver genes of melanoma was：BRAF 20%（5/25），KIT 20%（5/25），NRAS 12%（3/25），and NF1 8%（2/25），respectively. The most common mutation was an increase copy number in MYC（9/25，36%），followed by an increase in KDR copy number，24%（6/25）. DNA damage repair，cell cycle，PI3K-mTOR，growth factor receptor，MAPK，immune response and WNT/NOTCH related pathways were widely mutated. Mutation rates were 76%（19/25），72%（18/25），56%（14/25），60%（15/25），36%（9/25），28%（7/25），and 24%（6/25），respectively. Multiple therapeutic targets were observed，such as ATM，ATRX，EMSY， FANCI，RAD52，MET，PDGFRA，KDR，FLT4，ALK，ERBB3 and ROS1.【Conclusion】Gene mutations in Chinese mucosal melanoma were different from that of Chinese cutaneous melanoma and that of Caucasians. NGS could provide potential therapeutic targets for the treatment of Chinese mucosal melanoma.

Cabozantinib Combined with Anti-PD-L1 Antibody Produced Antitumor Effect on Mice Melanoma Xenograft and its Mechanism / 中山大学学报(医学科学版)

@#【Objective】The aim of this study was to investigate the effect and mechanism of cabozantinib combined with anti-PD-L1 antibody on the growth of subcutaneous transplanted malignant melanoma in mice.【Methods】Established mouse subcutaneous xenograft model using mouse melanoma cell line B16- F10，and then randomly divided into five groups：saline control group，vehicle control group，anti PD- L1 antibody group，cabozantinib group，cabozantinib in combined with anti- PD- L1 antibody group （combination group）. Tumor growth was observed and tumor volume was measured every 2 days. The research endpoint was defined as when the tumor volume reached 2 000 mm3 or the difference between the groups was statistically significant. Then the mice were sacrificed and tissue samples were taken at the endpoint of the study. Infiltrating immune cells including CD4 + ，CD8 + T lymphocytes and myelogenous suppressor cells （MDSC）were detected by flow cytometry. In addition，B16-F10 cells cultured in vitro were treated with different drugs， the apoptosis was detected by flow cytometry ，and the protein expressions of AKT ，p-AKT ，mTOR and p-mTOR were detected by western blot assay.【Results】B16- F10 melanoma xenograft model showed that anti- PD- L1 antibody group had no obvious antitumor effect ，while both cabozantinib group and combination group produced significant antitumor effect，and the combination group had more obvious antitumor effect compared to cabozantinib group（P=0.001 5）. B16- F10 cells were treated with different drugs in vitro，and the apoptosis rate of the combination group was significantly higher than that of cabozantinib group at 24 h and 48 h，respectively（24 h:P=0.003 5；48 h:P=0.002 9）. Western blot assay showed that the combination group and cabozantinib group had no significant effect on the protein expression of AKT and mTOR，but both could reduce their phosphorylation levels，and the combination group was more remarkable. 【Conclusion】Cabozantinib in combined with anti-PD-L1 antibody had synergistic anti-tumor effect，which might be achieved by promoting B16-F10 cells apoptosis and inhibiting of AKT/mTOR pathway.

Separation and identification of specific components and quality standard of stem of Dendrobium officinale / 中国中药杂志

The violanthin, a specific component, was separated and identified from the stems of Dendrobium officinale by chromatographic technique and spectroscopic method for the first time. The microscopic characteristics of D. officinale powder were examined under a microscopy and described. Thin layer chromatography (TLC) method was used for qualitative analysis of the violanthin from D. officinale stems with a mixture of ethyl acetate, butanone, formic acid and water (4∶3∶1∶1) as the developing solvent on high performance silica gel precoated plate (SGF254) and using aluminium trichloride as a chromagenic agent. The results showed significant characteristics of violanthin from D. officinale stems on TLC, with certain specificity, and could be used to distinguish it from other easily confusing processed medicinal stems of D. devonianum, D. gratiosissimum and D. aphyllum. The content of naringenin, an active ingredient in D. officinale stems was determined by HPLC analysis on a Bischoff Chromatography HIPAK NC-04 ODS AB column (4.4 mm×250 mm, 5 mm) with acetonitrile-0.1% phosphoric acid solution as the mobile phase for gradient elution. The wavelength was set at 226 nm and column temperature was 25 ℃. The HPLC method showed good linearity within the range of 3.90-250.00 g•mL⁻¹ (r = 0.999 9) for naringenin. The average recovery of naringenin was 99.20% with 0.17% of RSD. The mass fraction of 20 batches of D. officinale stems was between 0.190 and 0.498 mg•g⁻¹. The established qualitative and quantitative method was simple and rapid with good repeatability and accuracy, providing experimental basis for improving the quality standard of D. officinale, with a very important significance to ensure its quality and clinical effect.

extract of Perilla stem inhibits Src homology phosphatase-1 [SHP]-1 and influences insulin signaling

Protein tyrosine phosphatases [PTPs] are enzymes that catalyze protein tyrosine dephosphorylation of which Src homology phosphatase-1 [SHP-1] is one of the best-validated, a widely distributed intracellular tyrosine phosphatase that contains two SH2 domains. Down regulation of SHP-1 tyrosine phosphatases was significantly increased sensitivity to insulin in insulin signaling pathway. Through in vitro enzymatic reaction kinetics experiment, we found that the extract of Perilla stem was a potential inhibitor to [delta]SHP-1, the catalytic domain of SHP-1 protein tyrosine phosphatase, and its IC[50] was 4ug/ml, and was more sensitive towards SHP-1than other PTPs, which indicated that SHP-1 might be a target of the extract of Perilla stem. It can strengthened the level of tyrosine phosphorylation of insulin receptor [IR] and extracellular signal-regulated protein kinase [ERK] in HepG2 cells, and then activated the insulin signaling pathway through inhibiting the protein phosphorylation of SHP-1. These results demonstrated that the extract of Perilla stem could play an important role for diabetes treatment through inhibiting the level of SHP-1 in insulin signaling pathway

Estimation of postmortem interval by detecting thickness of cornea using ultrasonic method / 法医学杂志

OBJECTIVE@#To explore the postmortem changes of cornea thickness measured by ultrasonic pachymetry.@*METHODS@#Eleven rabbits were randomly divided into two groups: one group with intact corneal epithelium and another group without intact corneal epithelium. In the later group, the corneal epithelium of the rabbit was scraped using mechanical elimination method. The corneal thickness was monitored continuously by ultrasonic pachymetry at several postmortem interval points in rabbits of the two groups. The changes of corneal thickness and postmortem interval were explored by relative regression analysis.@*RESULTS@#The thickness of the cornea showed a strong non-linear correlation with the postmortem interval in the group with intact corneal epithelium. The group with intact corneal epithelium showed the correlation coefficient 0.922 and the group without intact corneal epithelium showed the correlation coefficient 0.822, respectively.@*CONCLUSION@#The corneal thickness measured by ultrasonic pachymetry shows a potential value for estimating early postmortem interval. The intact corneal epithelium is a crucial factor for the measurement of cornea thickness by ultrasonic pachymetry.

Identification of the metabolites of Sinisan extract in rat plasma, urine, feces and bile after intragastric administration / 药学学报

Sinisan is a widely used traditional Chinese medicine (TCM) in treating various diseases; however, the in vivo metabolic profile of its multiple components remains unknown. In this paper, ultra-high performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) was applied to identify the metabolites of Sinisan extract in rat plasma, urine, feces and bile after intragastric administration. Using MS(E) and mass defect filter techniques, 41 metabolites of 10 parent compounds (naringin, naringenin, hesperidin, neohesperidin, liquiritin, liquiritigenin, glycyrrhizic acid, glycyrrhetinic acid, saikosaponin a and saikosaponin d) were detected and tentatively identified. It was shown by our results that these compounds was metabolized to the forms of hydroxylation, glucuronidation, sulfation, glucuronidation with sulfation and glucuronidation with hydroxylation in vivo.

Absorption of flavonoids from Abelmoschus manihot extract by in situ intestinal perfusion / 药学学报

To explore the mechanism of the absorption of flavonoids from Abelmoschus manihot flowers, in situ intestinal recirculation was performed to study the effect of the absorption at different concentrations and different intestinal regions. To evaluate the conditions of the absorption of six flavonoids from Abelmoschus manihot flowers, the concentrations of Abelmoschus manihot in the perfusion solution were determined by HPLC at predesigned time. And we have investigated the inhibitory effect of six flavonoids from Abelmoschus manihot flowers on P-glycoprotein (P-gp) drug efflux pump. The results demonstrated that the absorption rates of flavonoids from Abelmoschus manihot flowers are not significantly different (P > 0.05) at various drug concentrations, the absorption of flavonoids from Abelmoschus manihot flowers is a first-order process with the passive diffusion mechanism. The absorption rates of each of flavonoids are significantly different. The absorption rate of flavonoid glycoside was lower than that of aglycone; the flavonoids from Abelmoschus manihot flowers could be absorbed in all of the intestinal segments. The best parts of intestine to absorb hyperoside and myricetin are jejunum and duodenum, separately. Verapamil could enhance the absorption of isoquercitrin, hyperoside, myricetin and quercetin-3'-O-glucoside by inhibiting P-glycoprotein (P-gp) drug efflux pump.

Effect of musk soluble components on the growth, the differentiation and the transfection efficiency of rat neural stem cells (NSC) in vitro / 中国应用生理学杂志

<p><b>AIM</b>To investigate the effect of musk soluble components on the growth, the differentiation and the transfection efficiency of rat neural stem cell (NSC) in vitro.</p><p><b>METHODS</b>The growth and the differentiation of rat NSC were observed when musk soluble components were added into the culture medium of NSC. Meanwhile, the pEGFP-C1, which expressed the enhanced GFP protein, was transfected into the NSC by method of electro- transfection.</p><p><b>RESULTS</b>When NSC was treated with musk soluble components, the neurites were outgrowth around NSC and attached to the plate, and the neural spheres were disassociated. The glia-like cells appeared at the concentration of 0.3 per thousand. When the concentration of musk soluble components was lower than 3 per thousand, the transformative cells could recover. Furthermore, the efficiency of transfection pEGFP into NSC was remarkably increased after the treatment with musk.</p><p><b>CONCLUSION</b>After the treatment of NSC with musk soluble components, the neural spheres were disassociated, and then attached to the plate. Musk soluble components could induce NSC differentiation into glia-like cells and improve the transfection efficiency of pEGFP-C1 in vitro.</p>

Recent progress in research on positional asphyxia of restraint / 法医学杂志

Positional asphyxia of restraint means that when an individual was limited in an abnormal body position, asphyxia would take place owing to the disorder of spontaneous respiratory function, and finally it lead to die. So, it belongs to a special type of the mechanical asphyxia. From the cases reported, we could found that it would take place in several conditions. Because the cases were not caused enough recognition, the study has been researched carefully only in recent years. Following the more cases reported, many experts of forensic medicine had investigated it on the mechanism of death and the standard of identification, but they could not reach to agreements. So, they have changed the directions of the researches, began to value the factors of risk and research how to avoid it. In the following text, the mechanism of death, factors of risk, preventive methods, standard of identification and prospecting of positional asphyxia of restraint were reviewed.

The role of diaphgram fatigue in the death from hanging with bound upper limbs of rabbits / 法医学杂志

OBJECTIVE@#To explore the role of diaphgram fatigue in the death from hanging with bound upper limbs of rabbits.@*METHODS@#Rabbits were hanged with upper limbs bound, then the data of EMGdi were gathered@*RESULTS@#By analyzing power spectral of EMGdi in experiment, we compare the ratio change of H/L between pre-experiment and post-experiment. There is a significance decrease of the ratio of H/L, so it indicates that diaphgram fatigue does exist.@*CONCLUSION@#Diaphgram fatigue plays an important role in the death from hanging with limbs of rabbits bound.