Comparison of the anterior and posterior approach in treating four-level cervical spondylotic myelopathy / 中华医学杂志(英文版)

BACKGROUND@#The optimal surgical approach for four-level cervical spondylotic myelopathy remains controversial. The purpose of this study was to compare clinical and radiological outcomes and complications between the anterior and posterior approaches for four-level cervical spondylotic myelopathy.@*METHODS@#A total of 19 patients underwent anterior decompression and fusion and 25 patients underwent posterior laminoplasty and instrumentation in this study. Perioperative information, intraoperative blood loss, clinical and radiological outcomes, and complications were recorded. Japanese Orthopedic Association (JOA) score, 36-item short form survey (SF-36) score and cervical alignment were assessed.@*RESULTS@#There were no significant differences in JOA scores between the anterior and posterior group preoperatively (11.6 ± 1.6 vs. 12.1 ± 1.5), immediately postoperatively (14.4 ± 1.1 vs. 13.8 ± 1.3), or at the last follow-up (14.6 ± 1.0 vs. 14.2 ± 1.1) (P > 0.05). The JOA scores significantly improved immediately postoperatively and at the last follow-up in both groups compared with their preoperative values. The recovery rate was significantly higher in the anterior group both immediately postoperatively and at the last follow-up. The SF-36 score was significantly higher in the anterior group at the last follow-up compared with the preoperative value (69.4 vs. 61.7). Imaging revealed that there was no significant difference in the Cobb angle at C2-C7 between the two groups preoperatively (-2.0° ± 7.3° vs. -1.4° ± 7.5°). The Cobb angle significantly improved immediately postoperatively (12.3° ± 4.2° vs. 9.2° ± 3.6°) and at the last follow-up (12.4° ± 3.5° vs. 9.0° ± 2.6°) in both groups compared with their preoperative values (P = 0.00). Three patients had temporary dysphagia in the anterior group and four patients had persistent axial symptoms in the posterior group.@*CONCLUSIONS@#Both the anterior and posterior approaches were effective in treating four-level cervical spondylotic myelopathy in terms of neurological clinical outcomes and radiological features. However, the JOA score recovery rate and SF-36 score in the anterior group were significantly higher. Persistent axial pain could be a major concern when undertaking the posterior approach.

Venous thromboembolism in the emergency department: A survey of current best practice awareness in physicians and nurses in China / 世界急诊医学杂志（英文）

BACKGROUND@# For emergency department (ED) patients, risk assessment, prophylaxis, early diagnosis and appropriate treatment of venous thromboembolism (VTE) are essential for preventing morbidity and mortality. This study aimes to investigate knowledge amongst emergency medical staff in the management of VTE.@*METHODS@# We designed a questionnaire based on multiple scales. The questionnaire was distributed to the medical and nursing clinical staff in the large urban ED of a medical center in Northern China. Data was described with percentages and the Kruskal-Wallis test was used to compare ranked data between different groups. The statistical analysis was done using the SPSS 22.0 software.@*RESULTS@# In this survey, 180 questionnaires were distributed and 174 valid responses (response rate of 96.67%) were collected and analyzed. In scores of VTE knowledge, no significant differences were found with respect to job (doctor vs. nurse), the number of years working in clinical medicine, education level, and current position, previous hospital experience and nurses' current work location within the ED. However, in pair wise comparison, we found participants who worked in ED for more than 5 years (n=83) scored significantly higher on the questionnaire than those under 5 years (n=91) (95.75 vs. 79.97, P=0.039). There was a significant difference in some questions based on gender, age, job, and nurse work location, number of working years, education level, and different ED working lifetime.@*CONCLUSION@# Our survey has shown deficiencies among ED medical staff in knowledge and awareness of the management of VTE. We recommend several changes be considered, such as the introduction of an interdisciplinary workshop for medical staff; the introduction of a standardized VTE protocol; a mandatory study module on VTE for new physicians and nurses; the introduction of a mandatory reporting system for adverse events (including VTE).

Expression of IL-17 and Syndecan-1 in Nasal Polyps and Their Correlation with Nasal Polyps / 华中科技大学学报（医学）（英德文版）

Nasal polyp (NP) is a common chronic inflammatory disease of the nasal cavity and sinuses.Although some authors have suggested that NP is related to inflammatory factors such as interleukin (IL)-1β,IL-5,IL-8,granulocyte-macrophage colony-stimulating factor (GM-CSF),tumor necrosis factor (TNF)-α,and IL-17,the mechanisms underlying the pathogenesis and progression of NP remain obscure.This study investigated the expression and distribution of IL-17 and syndecan-1 in NP,and explored the roles of these two molecules in the pathogenesis of eosinophilic chronic rhinosinusitis with nasal polyps (Eos CRSwNP) and non-Eos CRSwNP.Real-time PCR and immunohistochemistry were used to detect the expression of IL-17 and syndecan-1 in samples [NP,unciform process (UP) from patients with CRS,and middle turbinate (MT) from healthy controls undergoing pituitary tumor surgery].The results showed that the expression levels of IL-17 and syndecan-1 were upregulated in both NP and UP tissues,but both factors were higher in NP tissues than in UP tissues.There was no significant difference in IL-17 levels between the Eos CRSwNP and non-Eos CRSwNP samples,and syndecan-1 levels were increased in the non-Eos CRSwNP tissues as compared with those in Eos CRSwNP tissues.In all of the groups,there was a close correlation between the expression of IL-17 and syndecan-1 in nasal mucosa epithelial cells,glandular epithelial cells,and inflammatory cells,suggesting that IL-17 and syndecan-1 may play a role,and interact with each other,in the pathogenesis ofnon-Eos CRSwNP.

Effect of Resveratrol on Preventing Steroid-induced Osteonecrosis in a Rabbit Model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Prevention of osteonecrosis (ON) has seldom been addressed. The purpose of this study was to evaluate the effect of resveratrol on preventing steroid-induced ON in rabbits.</p><p><b>METHODS</b>Seventy-two rabbits were divided into four groups: (1) NEC (ON) group: thirty rabbits were treated with lipopolysaccharide (LPS) once, then with methylprednisolone (MPS) daily for 3 days; (2) PRE (prevention) group: thirty rabbits were given one dose of LPS, then MPS daily for 3 days, and resveratrol on day 0 and daily for 2 weeks; (3) RES (resveratrol) group: six rabbits were given resveratrol for 2 weeks but without LPS/MPS; (4) CON (control) group: six rabbits were given alcohol for 2 weeks but without LPS/MPS. Levels of plasma tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), thrombomodulin (TM), vascular endothelial growth factor (VEGF), maximum enhancement (ME) by magnetic resonance imaging, and ON incidence were evaluated.</p><p><b>RESULTS</b>The PRE group had a lower ON incidence than the NEC group, but with no significant differences at 2 weeks and 12 weeks. The RES and CON groups did not develop ON. TM and VEGF were significantly higher in the NEC group compared with the PRE group at weeks 1, 2, and 4 (TM: 1 week, P = 0.029; 2 weeks, P = 0.005; and 4 weeks, P = 0.047; VEGF: 1 week, P = 0.039; 2 weeks, P = 0.021; 4 weeks, P = 0.014), but the difference disappeared at 12 weeks. The levels of t-PA and PAI-1 were not significantly different between the NEC and PRE groups. The TM, t-PA, PAI-1, and VEGF concentrations in the RES and CON groups did not change over time. Compared to the baseline, ME in the NEC group decreased significantly (P = 0.025) at week 1, increased significantly (P = 0.021) at week 2, and was decreased at week 12. The variance was insignificant in the PRE group.</p><p><b>CONCLUSIONS</b>Resveratrol may improve blood supply to bone in a rabbit model of ON of the femoral head via anti-inflammatory effects to protect the vascular endothelium and reduce thrombosis.</p>

A new aurone glycoside from Veratrum dahuricum (Turcz.) Loes. f / 药学学报

To study the chemical constituents of Veratrum dahuricum (Turcz.) Loes. f., a new aurone glycoside named as (Z)-7, 4'-dimethoxy-6-hydroxyl-aurone-4-O-β-glucopyranoside was isolated from the 95% ethanol extracts of the rhizomes and roots of Veratrum dahuricum (Turcz.) Loes. f. by repeated column chromatography on silica gel and recrystallization. Its structure was established by extensive spectroscopic analyses, and its cytotoxicities against HepG-2, MCF7 and A549 cell lines were measured in vitro.

Surgical Fixation of Fourth and Fifth Metacarpal Shaft Fractures with Flexible Intramedullary Absorbable Rods: Early Clinical Outcomes and Implications / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>To avoid the irritation of tendons and soft tissues as well as hardware-related problems, we designed an intramedullary fixation with bioabsorbable rods for the treatment of the metacarpal shaft fractures.</p><p><b>METHODS</b>Five patients with nine shaft fractures of the fourth and fifth metacarpi were treated with intramedullary absorbable implants and followed up with an average of 4.2 months postoperatively.</p><p><b>RESULTS</b>At final follow-up, all patients achieved fracture union with no signs of inflammatory or subcutaneous effusion. There was no shortening, angulatory, or rotatory deformity. There was almost full active extension range of motion (ROM) of the metacarpophalangeal joints while the active flexion ROM of these joints was 80.7 ± 9.6°. Compared with the contralateral hand, the grip strength of the injured hand was 94.0 ± 9.6%. X-rays showed that the arch of the second to fifth metacarpal heads was smooth. There were no intramedullary lytic changes and soft tissue swellings.</p><p><b>CONCLUSION</b>The intramedullary absorbable implants are a safe, simple, and practical treatment for fourth and fifth metacarpal fractures with good early clinical outcomes and no significant complications.</p>

A comprehensive evaluation of the health services in Hunan Province / 中南大学学报(医学版)

OBJECTIVE@#To establish a comprehensive evaluation system for the development of health services, and to assess the levels of health services in 2008 and 2009 in Hunan compared with seven other provinces in central China, so as to provide a basis for hygiene management decisions.@*METHODS@#In order to establish a comprehensive evaluation system, a Delphi method, a boundary value method, and an RSR method were applied, respectively, to survey indices of health service development, to screen indices, and to determine index weights. A weighted TOPSIS method was used to evaluate the development status of health services of the eight provinces.@*RESULTS@#The Cronbach's alpha coefficient of the questionnaire was 0.884, indicating a proper surface validity and a content validity. The expert positive coefficient, authority coefficient and Kendall coefficient were 93.75%, 0.8117, and 0.31, respectively. A comprehensive evaluation system, which consisted of 3 primary indices, 10 secondary indices and 52 tertiary indices, was established. The result of the comprehensive evaluation showed that the health services development of Hunan Province ranked 7th and 6th among the 8 central provinces for 2008 and 2009, respectively.@*CONCLUSION@#The established, comprehensive evaluation system has a high reliability. Health services development of Hunan Province is relatively backward among the 8 central provinces.

Development of health service in Hunan Province / 中南大学学报(医学版)

OBJECTIVE@#To study the health service development in Hunan Province, and to find out the advantages and disadvantages, and to make tentative specific suggestions.@*METHODS@#Comparison was made in Yunnan, Hunan, and Zhejiang Provinces in 4 major areas: health institutions, personnels, facilities, and funding.@*RESULTS@#The overall health service of Hunan Province was good: The health resources increased, the allocations were reasonable, and the health expenditure decreased. Some problems appeared, such as backward primary health, shortage of medical talents, inefficient use of hospital beds, deducted government investment, increased business income, and large urban-rural gap.@*CONCLUSION@#There is urgent need to further develop health institutions and increase personnels, particularly improving the primary health care and making use of traditional Chinese medicine; improving the management of hospital beds to increase efficiency, increasing financial support to reduce the patients' burden, and ensuring the need of rural health care.

Involvement of p38-p53 signal pathway in resveratrol-induced apoptosis in MCF-7 cells / 药学学报

This paper is to report the study of resveratrol-induced apoptosis and its mechanisms in MCF-7 cells. MTT assay was performed to assess the cytotoxicity of resveratrol on MCF-7 cells. Hoechst 33258 staining was used to observe cellular morphologic changes in apoptosis. Apoptosis was measured by flow cytometric analysis and the protein expression was examined by Western blotting analysis. The results indicated that resveratrol could inhibit MCF-7 cell growth in a time- and concentration-dependent manner. Remarkable morphologic changes in the cells after 60 micromol L(-1) resveratrol treatment, including cell nuclear shrinkage, DNA condensation and apoptotic bodies, were observed by Hoechst 33258 staining. Resveratrol could induce apoptosis and activate p38 and p53 in a time dependent manner in MCF-7 cells. In addition, the cell growth inhibitory ratio and the apoptotic ratio of resveratrol-treated group decreased markedly by the p38 MAPK inhibitor SB203580 or p53 inhibitor pifithrin-alpha. Further experiments confirmed that resveratrol-induced p53 activation was reduced by SB203580 whereas the activation of p38 was not affected by pifithrin-alpha. In conclusion, resveratrol induced apoptosis in MCF-7 cells could be through activating p38-p53 signal pathway.

Investigation of TCM Syndrome in 516 pulmonary tuberculosis patients / 国际中医中药杂志

Objective To investigate characteristics of TCM syndromes of pulmonary tuberculosis,and to explore new methods for its treatment. Methods TCM syndrome scale was designed to investigate and summarize the characteristic of the syndrome, the syndrome of the general information, and the main clinical symptoms of 516 pulmonary tuberculosis patients. Results The between-group comparison of distribution of TCM syndromes in patients with pulmonary tuberculosis showed statistical difference (P＜0.05) . The occurrence rate of TCM syndromes in the 516 pulmonary tuberculosis patients were listed in descending order as follows:syndrome of both Qi and yin deficiency complicated with stasis ＞ syndrome of lung yin deficiency complicated with stasis＞syndrome of both Qi and yin deficiency＞syndrome of yin deficiency with various with age (P＜0.05) . Patients with blood stasis syndrome occupied 66.15% of the total number in the youth group; Patients with blood stasis syndrome occupied 78.03% of the total number in the middle-aged group;distribution of TCM syndromes was statistically different with the initial treatment and re-treatment (P＜0.05) .Patients with the blood stasis syndrome occupied 72.73% of the total number in the initial group, patients with effulgent fire ＞ lung yin deficiency syndrome.① The distribution of TCM syndromes was statistically various with age (P＜0.05) . Patients with blood stasis syndrome occupied 66.15％ of the total number in the youth group; Patients with blood stasis syndrome occupied 78.03％ of the total number in the middle-aged group; Patients with blood stasis syndrome occupied 78.22％ of the total number in the old-aged group. ② The distribution of TCM syndromes was statistically different with the initial treatment and re-treatment (P＜0.05) . Patients with the blood stasis syndrome occupied 72.73％ of the total number in the initial group, patients with the blood stasis syndrome occupied 75.61％ of the total number in the re-treatment group.③ The distribution of TCM syndromes was statistically different with the main symptoms (P＜ 0.05 ) . Conclusion All 516 cases of pulmonary tuberculosis had Yin deficiency. There were 380 patients had the stasis, occupying 73.64%.Therefore, the methods of nourishing yin and removing blood stasis should be used to treat patients with pulmonary tuberculosis.