Anticancer Activity of Diosgenin and Its Molecular Mechanism / 中国结合医学杂志

Diosgenin, a steroidal sapogenin, obtained from Trigonella foenum-graecum, Dioscorea, and Rhizoma polgonati, has shown high potential and interest in the treatment of various cancers such as oral squamous cell carcinoma, laryngeal cancer, esophageal cancer, liver cancer, gastric cancer, lung cancer, cervical cancer, prostate cancer, glioma, and leukemia. This article aims to provide an overview of the in vivo, in vitro, and clinical studies reporting the diosgenin's anticancer effects. Preclinical studies have shown promising effects of diosgenin on inhibiting tumor cell proliferation and growth, promoting apoptosis, inducing differentiation and autophagy, inhibiting tumor cell metastasis and invasion, blocking cell cycle, regulating immunity and improving gut microbiome. Clinical investigations have revealed clinical dosage and safety property of diosgenin. Furthermore, in order to improve the biological activity and bioavailability of diosgenin, this review focuses on the development of diosgenin nano drug carriers, combined drugs and the diosgenin derivatives. However, further designed trials are needed to unravel the diosgenin's deficiencies in clinical application.

Anticancer Activity of Diosgenin and Its Molecular Mechanism / 中国结合医学杂志

Diosgenin, a steroidal sapogenin, obtained from Trigonella foenum-graecum, Dioscorea, and Rhizoma polgonati, has shown high potential and interest in the treatment of various cancers such as oral squamous cell carcinoma, laryngeal cancer, esophageal cancer, liver cancer, gastric cancer, lung cancer, cervical cancer, prostate cancer, glioma, and leukemia. This article aims to provide an overview of the in vivo, in vitro, and clinical studies reporting the diosgenin's anticancer effects. Preclinical studies have shown promising effects of diosgenin on inhibiting tumor cell proliferation and growth, promoting apoptosis, inducing differentiation and autophagy, inhibiting tumor cell metastasis and invasion, blocking cell cycle, regulating immunity and improving gut microbiome. Clinical investigations have revealed clinical dosage and safety property of diosgenin. Furthermore, in order to improve the biological activity and bioavailability of diosgenin, this review focuses on the development of diosgenin nano drug carriers, combined drugs and the diosgenin derivatives. However, further designed trials are needed to unravel the diosgenin's deficiencies in clinical application.

Traditional Chinese and Western Medicine in Treatment of Postmenopausal Osteoporosis： A Review / 中国实验方剂学杂志

Postmenopausal osteoporosis （PMOP） is a systemic disease characterized by increased bone fragility caused by insufficient estrogen secretion in women after menopause，resulting in decreased bone mass and damage to the microstructure of bone tissues. The main clinical manifestations are low back pain，osteoporotic fractures，spinal deformities，and multiple organ dysfunction. PMOP directly leads to high morbidity， high mortality， and a decline in the quality of life. In addition to miss diagnosis， it is often not treated in time. In recent years， significant progress has been made in the research on factors related to the pathogenesis of PMOP. Based on the previous findings in recent years，this article described three major pathogenesis of PMOP， including intestinal flora imbalance，oxidative stress，and abnormal differentiation of bone marrow mesenchymal stem cells （BMMSCs）， and analyzed the current status of PMOP treatment， such as syndrome differentiation and treatment，acupuncture and moxibustion，exercise therapy， and external treatment in traditional Chinese medicine （TCM）， and basic measures，drug intervention，and physical therapy in western medicine. Among them，drug intervention in western medicine treatment is generally divided into bone resorption inhibitors，bone formation promoters，and other mechanism drugs according to the mechanism of action. This article summarized the specific methods and effects or mechanisms of TCM and western medicine in the clinical treatment of PMOP，which is expected to provide a reference for formulating reasonable health management models and drug treatments in the future.

Expanded curettage and bone cement filling combined with internal fixation for the treatment of Campanacci III giant cell tumour of knee joint / 中国骨伤

OBJECTIVE@#To evaluate clinical effects of expanded curettage and bone cement filling combined with internal fixation in treating Campanacci III giant cell tumor of knee joint.@*METHODS@#From January 2006 to December 2016, 21 patients with Campanacci III giant cell tumor of knee joint were treated by expanded curettage and bone cement filling combined with internal fixation, including 11 males and 10 females with an average age of(35.24±10.56) years old (ranged from 21 to 61 years old). The courses of disease ranged from 1.5 to 24.0 months with an average of(8.1±4.4) months. Among them, 8 patients were distal femur and 13 patients were proximal tibia. All patients were primary tumors. Musculoskeletal Tumor Society(MSTS) scores were used to evaluate lower limb function before and after operation. X-ray was used to observe healing of lesions and the occurrence of adverse reactions.@*RESULTS@#All incisions were healed at grade A without complications such as infection and internal fixation failure. All patients were followed up from 8 to 56 months with an average of (29.62±9.48) months. MSTS score at the latest follow-up 26.71±2.35 was higher than that of before operation 15.24±1.14, and had statistical significance(=20.160, =0.000). The results of X-ray at final following-up showed internal fixation was well, and no loosening and fracture of subchondral bone. Three patients recurred giant cell tumor and replaced with tumor prosthesis.@*CONCLUSIONS@#Expanded curettage and bone cement filling with internal fixation for the treatment of Campanacci III giant cell tumor of knee joint could effectively retain limb function and reduce tumor recurrence rate.

Effect of Quyu Chencuo Formula () on Renal Fibrosis in Obstructive Nephropathy Rats / 中国结合医学杂志

OBJECTIVE@#To observe the effect of Quyu Chencuo Formula (, QCF) on renal fibrosis in rats with obstructive nephropathy.@*METHODS@#Twenty-four rats were randomly divided into three groups, 4 for sham operation as the control group, 10 for unilateral ureteral obstruction (UUO) model group, and the rest 10 for QCF treating UUO model group. All rats were sacrificed under 3% pentobarbital (50 mg/kg) anesthesia on the 14th day after surgery, then the right kidney samples of rats were harvested for hematoxylin eosin (HE) staining and Masson staining to observe the renal pathological changes. Immunohistochemistry and Western blotting were used to examine the expression of transforming growth factor β1 (TGF-β1), and real-time polymerase chain reaction (RT-PCR) was employed to examine the expressions of TGF-β1, α-smooth muscle actin (α-SMA) and E-cadherin mRNA.@*RESULTS@#HE and Masson staining showed that the renal interstitial of the rats in the control group had no significant fibrotic lesion; in the model group, there were obvious interstitial fibrosis; for the QCF group, there were epithelial cell necrosis, infiltration of lymphocytes and mononuclear cells, aggravated interstitial fibrosis in varied degrees, but the pathological changes were less in the QCF group than in the model group. The immunohistochemistry and Western blotting results showed that the TGF-β1 expression was increased significantly in the model group, while decreased significantly in the QCF group (P<0.05); RT-PCR showed that the mRNA expression of α-SMA and TGF-β1 increased significantly in the model group, while both were significantly decreased in the QCF group compared with the model group (P<0.05). The mRNA expression of E-cadherin was decreased significantly in the model group, and it was significantly increased in the QCF group as compared with the model group (P<0.05).@*CONCLUSION@#QCF may improve renal fibrosis by regulating the expressions of TGF-β1, α-SMA and E-cadherin, and prevent the progress of kidney fibrosis.

Long-term outcomes of Chiari osteotomy for Legg-Calvé-Perthes disease in children / 中国骨伤

OBJECTIVE@#To explore long-term outcomes of Chiari osteotomy for Legg-Calvé-Perthes disease in children with type Catterall III or IV, and to analyze clinical effect of osteotomy angle on clinical and radiographic results.@*METHODS@#From March 2005 to July 2013, 26 children with Legg-Calvé-Perthes disease with type Catterall III or IV were treated by Chiari osteotomy, including 17 males and 9 females, aged from 4 to 13 years old with an average of (8.9±2.6) years old. Children were divided into low osteotomy angle group and high osteotomy angle group. according to osteotomy angle. There were 10 children in low osteotomy angle group with an osteotomy angle of 10 degrees, including 8 boys and 2 girls, aged from 4 to 13 years old with an average of (9.2±3.3) years old; while there were 16 children in high osteotomy angle group with an osteotomy angle of 15 degress, including 9 boys and 7 girls, aged from 6 to 12 years old with an average of (8.8±2.1) years old. HHS score before operation and at the latest follow-up were recorded to observe clinical results. CE angle of hip joint, acetabular index, Sharp angle, Shenton's line continuity, femoral head coverage, acetabular depth ratio were recorded to compare radiographic results. Stulberg classification was analyzed to compare reshaping ability of femoral head.@*RESULTS@#Twenty-six children were followed up for 4.5 to 12.0 years with an average of (7.9±1.8) years. All incisions were healed at stage I for 10 to 14 days, with an average of(12.3±1.1) days. No inflammation, skin necrosis and injury of vessel and nerve occurred. All osteotomies achieved bone union for 8 to 13 weeks, with an average of(9.8±1.4) weeks. HHS score increased from 75.8±6.5 before operation to 93.5±2.5 at the latest follow-up in low osteotomy angle group(<0.05), and form 77.6±6.2 to 97.8±1.6 in high osteotomy angle group (<0.05). HHS score of high osteotomy angle group at the latest follow-up was higher than that of low osteotomy angle group (<0.05). The acetabular index decreased from (10.1±2.5)° before operation to (4.5±1.3)° at the latest follow-up in low osteotomy angle group (<0.05), and from (10.7±3.3)° before operation to (2.0±1.1)° in high osteotomy angle group (<0.05). The acetabular index of high osteotomy angle group at the latest followup was better than low osteotomy angle group(<0.05). There was no significant difference in CE angle, Sharp angle, Shenton's continuity, femoral head coverage, acetabular depth ratio between two groups. According to Stulberg classification, the femoral head reshaping ability in high osteotomy angle group was better than that of low osteotomy angle group(<0.05).@*CONCLUSIONS@#Chiari osteotomy with 15° for Legg-Calvé-Perthes disease in children with type Catterall III or IV could effectively decrease index of acetabulum, and helpful for femoral head reshaping ability, then in further improve clinical effects.

Comparison of corneal biomechanical parameters between keratoconus and laser corneal refractive surgery / 眼科新进展

Objective To measure biomechanical parameters of the cornea after keratoconus and laser corneal refractive surgery by Scheimpflug noncontact tonometry (Corvis ST),and analyze the changes and differences in these parameters.Methods From April 2011 to November 2016,63 patients (96 eyes) with clinically diagnosed as keratoconus were selected as the keratoconus group,and 60 patients (120 eyes) underwent laser corneal refractive surgery between November 2016 to March 2017 were selected as postoperative cornea group,and totally 51 healthy person (102 eyes) who received physical examination during the same period were selected as healthy cornea group.Scheimpflug noncontact tonometry (Corvis ST) was performed to measure the length of appl 1,length of appl 2,velocity of appl 1,velocity of appl 2,maximum deformation amplitude,apex distance and radius of curvature in the three groups.Total comparison of biomechanical parameters was performed using ANOVA test among the three groups,while pairwise comparison was performed to analyze the difference of these parameters by SNK methods.Pearson or Spearman correlation analysis was applied to assess the differences in corneal morphological and biomechanical parameters.Results There was no significant difference in length of appl 1,length of appl 2 of the three groups (all P ＞ 0.05).And velocity of appl 1 in the keratoconus group was significantly higher than that of the healthy cornea group [(0.189 ± 0.230) m · s-1 vs.(0.151 ± 0.017)m · s-1] (P ＜ 0.05).As for velocity of appl 2,the keratoconus group was larger than the healthy cornea group,both which were larger than the postoperative cornea group,and the differences were significant (all P ＜ 0.05).And this was true of maximum deformation amplitude in the three groups,with the significant differences(all P ＜ 0.05).The apex distance in the keratoconus group was significantly longer than that in the healthy cornea group (P ＜ 0.05).The radius of curvature of the keratoconus group,postoperative cornea group and healthy cornea group were (5.696 ± 0.881) mm,(7.129 ± 0.681) mm and (7.012 ± 0.728) ram,respectively,which approached significant differences(all P ＜ 0.05).There was significant correlation between the anterior surface refractive power (Km) and apex distance and radius of curvature in the keratoconus group (r =-0.205,0.1 84;P =0.023,0.041),and maximum posterior surface elevation had a statistically significant correlation with velocity of appl 2,maximum deformation amplitude and radius of curvature (r =-0.579,-0.307,0.256,P =0.022,0.002,0.000).For the eyes in the postoperative cornea group,there were no significance correlation between the anterior surface refractive power (Km) and biomechanical properties (P ＞ 0.05),but significant correlation with length of appl 2 (r =-0.297,P =0.026).There were no significant correlation between maximum posterior surface elevation and biomechanical properties (P ＞ 0.05).Conclusion The corneal biomechanical parameters are decreased in eyes after keratoconus and laser corneal refractive surgery,and Corvis ST can become an auxiliary examination tool for earlier diagnosis of secondary keratoconus after corneal refractive surgery.

DNA vaccines: mechanisms of action / 中国组织工程研究

BACKGROUND: In 1990, Wolff et al. reported that DNA was examined as a gene therapy tool, and emerged as a promising therapy after observations that simple injection of naked plasmid DNA and RNA led to profound transgene expression in vivo.DNA vaccines are recognized for harboring several distinguishing characteristics and advantages (including low cost, ease and rapidity of manufacturing, and stability) making them a method for addressing global health threats in the future. OBJECTIVE: To review the status and research progress of DNA vaccines in the view of mechanism of action: innate immune signaling from bacterial DNA, transfecting somatic cell by DNA vaccines, cross-presentation and cross-activation, transfecting antigen presenting cells by DNA vaccines, and apoptosis. METHODS: The first author retrieved the databases of PubMed and CNKI for the articles concerning DNA vaccines published between January 2000 and June 2017 using the keywords of "DNA vaccine, gene vaccine, plasmid DNA, cross-presentation, transfection, apoptosis"in English and Chinese, respectively. A total of 105 literatures were searched, and 47 eligible articles were included in accordance with the inclusion criteria. RESULTS AND CONCLUSION: The immunogenicity of DNA vaccines in humans has been limited by low expression levels of antigen, in comparison with the conventional protein vaccines in the past two decades. Studies on the mechanism of action of DNA vaccines in terms of antigen-presenting cell types able to cross-present DNA-encoded antigens, the activation of innate immune responses due to DNA itself and induction of cell apoptosis have suggested the opportunities to increase the immunogenicity of these vaccines.

Clinical effect and morphological analysis of combined therapy for viral corneal endothelial inflammation / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To observe the clinical effect and the changes of corneal endothelial morphology of glucocorticoid combined with antiviral therapy for viral corneal endotheliitis and evaluate the safety of this treatment. ·METHODS: The clinical data like predisposing factors, history and clinical manifestation were retrospectively analyzed, the 48 patients (48 eyes) with viral corneal dermatitis from January 2014 to December 2015 in Xi'an No.4 Hospital were included. A comparative study was conducted between affected eyes and healthy eyes. The cure rate, recurrence rate and corneal endothelial morphological changes of patients treated with combined treatment of glucocorticoid and antiviral drugs after 3mo were compared and analyzed statistically. · RESULTS: Corneal endotheliitis patients had many predisposing factors and symptoms like red eye, eye pain, photophobia, tears and decreased visual acuity, blurred vision and others, clinical manifestations include decreased visual acuity,conjunctival congestion or mixed ciliary congestion, corneal edema, corneal epithelium might have small blisters, Descemet membrane folds, gray white or white like KP, intraocular pressure increased, posterior synechia, cases of several recurrent had corneal bullous occurred. After 1mo of treatment,the effective rate was 100%,the cure rate was 88%,and there was no recurrence; after 2mo of treatment the effective rate and the cure rate was 100%, a total of 1 cases (2%) recurrence;treatment for 3mo, a total of 2 cases (4%) recurrence. After 3mo of treatment cell count (t=2.952, P=0.004) and corneal thickness by OCT (t=2.584, P=0.011) of the treatment group were lower than those of the control group, the difference was statistically significant; cell pleomorphic mutation rate (45. 85% ± 6.29%) of the treatment group was higher than that of the control group (40. 62% ± 5. 16%), the difference was statistically significant (t=4.458, P<0.001). The visual acuity of treatment group was poorer before treatment than that of the control group, the difference was statistically significant (Z = - 5. 766, P < 0. 001); after treatment, the visual acuity increased to 0. 20 (0. 10-0.40),there were significant differences before and after the treatment (Z=-6.089,P<0.001). ·CONCLUSION: The clinical manifestations and etiology of viral corneal endotheliitis is complex. Application of antiviral drugs and glucocorticoid treatment, can obtain good effect, but after the treatment, corneal thickness and corneal endothelial cell count decreased, higher requirements for the safety of the treatment is needed.

The therapeutic effect of rh-aFGF carbomer 940 gel on wound healing in type I diabetic SD rat models / 中国药理学通报

Aim To study the therapeutic effect of re-combinant human acidic fibroblast growth factor (rh-aFGF) carbomer 940 gel in the treatment of skin wound healing in type I diabetic rats. Methods Two types of skin trauma models, namely, full-thickness wound and scalded wound,were established in a model of type I diabetes mellitus using STZ-induced SD rats. The rats were divided into control group, vehicle group,90 AU rh-aFGF gel group and 270 AU rh-aFGF gel group in each skin wound models. The wound area and wound healing rate were used to evaluate the thera-peutic effect. The growth of fibroblasts, fibrocytes, collagen fibers and vessel capillaries in the wound was observed using HE staining and analysed by semi-quantitative score. Results The rh-aFGF carbomer gel significantly reduced the traumatic area as well as promoted the wound healing rate of the skin trauma model of SD rats of type I diabetes mellitus (P <0.05). HE staining showed that rh-aFGF carbomer gel significantly promoted the pathological score of fibro-blasts and collagen fibers(P<0.05). Conclusions rh-aFGF carbomer gel might play a protective role in micro-environment of wound and rh-aFGF, which could benefit for proliferation of fibroblasts and colla-gen, therefore promoting the healing process of skin wound in SD rats with type I diabetes mellitus, and it might be expected to be a new preparation for the treat-ment of chronic trauma in diabetes mellitus.

Bushen Daozhuo Granules for type Ⅲ prostatitis: A multicenter randomized controlled clinical trial / 中华男科学杂志

Objective@#To study the safety and efficacy of Bushen Daozhuo Granules (BDG) in the treatment of type Ⅲ prostatitis.@*METHODS@#This multicenter randomized controlled clinical trial included 478 patients with type Ⅲ prostatitis, 290 in the trial group and 188 as controls, the former treated with BDG at 200 ml bid and the latter with tamsulosin hydrochloride sustainedrelease capsules at 0.2 mg qd, both for 4 weeks. Before treatment, after 4 weeks of medication, and at 4 weeks after drug withdrawal, we obtained the NIH Chronic Prostatitis Symptom Index (NIHCPSI) scores and compared the safety and effectiveness rate between the two groups of patients.@*RESULTS@#Compared with the baseline, the NIHCPSI score was markedly decreased in the control group after 4 weeks of medication (21.42 ± 4.02 vs 15.67 ± 3.65, P 0.05), while the NIHCPSI score in the trial group was remarkably lower than the baseline both after 4 weeks of medication and at 4 weeks after drug withdrawal (10.92 ± 2.06 and 12.91 ± 2.64 vs 21.58 ± 3.67, P < 0.05). The trial group exhibited both a higher rate of total effectiveness and safety than the control (P < 0.05).@*CONCLUSIONS@#BDG is safe and effective for the treatment of type Ⅲ prostatitis.

Repairing diabetic rats with bone defect by VEGF165 gene modified adipose-derived stem cells / 中国骨伤

<p><b>OBJECTIVE</b>To explore repairing results of VEGF165 gene modified adipose-derived stem cells for diabetic rats with bone defect.</p><p><b>METHODS</b>Seventy-eight male Wistar rats weighted 180 to 220 g were selected, 72 rats were established diabetic animal models by streptozotocin inducement method, blood glucose level was more than 16.7 mmol/L. Experimental animals were randomly divided into 5 groups, 6 rats in normal group and each 18 rats in other groups. VEGF165 gene modified adipose-derived stem cells were implanted into normal group with bone defect; single diabetic rats with bone defect were named as diabetic group;vascular endothelial growth factor implanted into single diabetic rats with bone defect named as growth factor group; adipose-derived stem cells implanted into diabetic rats with bone defect names as stem cell group; VEGF165 gene modified adipose-derived stem cells implanted diabetic rats with bone defect named as experimental group. After combination of VEGF165-ADSCs (5×106) cells combined with gel sponge, implanted into diabetic rats with bone defect. On the forth week, general form of defect repairing tissue were observed by optical microscopy;local density of micro-vessel were detected by immunohistochemistry method; content of Ca, P and ALP of repairing callus were detected by IRIS Intrepid XSP inductively coupled plasma emission spectrometer. Efficacy of the VEGF165-ADSCs repairing function was evaluated by SPSS statistic software.</p><p><b>RESULTS</b>Fluorescent staining results showed that expression of VEGF165 located on cytoplasm of ADSCs, expression percentage was more than 87%; general histology results showed that callus formation and quality was near to normal group, repairing results in diabetes group, growth factor group and stem cell group were poor. On the Forth week after implantation, content of Ca, P and ALP of repairing callus in experimental group were higher than those in growth group and stem cell group, and without significant differences compared with normal group; blood vessel density in experimental group was lower than normal group, but higher than other groups.</p><p><b>CONCLUSIONS</b>VEGF165 gene modified adipose-derived stem cells for repairing diabetic rats with bone defect has advantages of osteogenesis and angiogenesis, and should be one of the effective method for repairing diabetic rats with bone defect.</p>

Revisional surgery for nonstandard gastric bypass: a case report / 南方医科大学学报

Bariatric surgery is the most effective treatment for obesity with or without type 2 diabetes mellitus and its complications. With the growing incidence of type 2 diabetes mellitus, the number of hospitals performing bariatric surgery and surgical cases increase substantially. The problems in operation standardization, quality control of operation and postoperative management of the patients cause the failure in weight loss, hypoglycemia and severe complications, and revisional surgery is often required to correct the condition. We report a case of laparoscopic revisional surgery following nonstandard gastric bypass, and the reasons for failure of weight loss in first bariatric surgery, the current situation of bariatric surgery and revisional metabolic surgery were analyzed. This case demonstrates the clinical necessity of revisonal bariatric surgery and the importance of selection of the surgical approaches and indications.

Research on the oxidation damage of sodium arsenite on rat lung / 中国职业医学

OBJECTIVE: To explore the oxidation damage of sodium arsenite( NaAsO_2) drinking exposure on rat lung.METHODS: Thirty-two specific pathogen free healthy adult male SD rats were randomly divided into 4 groups: control group,low-,medium- and high-dose groups,with 8 rats in each group. The 3 arsenic exposure groups were intoxicated by NaAsO_2 with mass concentrations of 10. 00,100. 00 and 1 000. 00 μg / L in drinking water,respectively,while the control group was given ultrapure water for free drinking. All the rats were sacrificed after 28 days. The total number of white blood cells and the cell death rate in bronchoalveolar lavage fluid( BALF) were measured. The level of reactive oxygen species( ROS),nicotinamide adenine dinucleotide phosphate( NADPH),the antioxidant ability and the nitric oxide( NO) level in BALF were measured by the enzyme-linked immunosorbent assay. RESULTS: The total number of white blood cells in BALF in medium-dose group was higher than those of the control group and high-dose group( P < 0. 05).The cell death rate of BALF in high-dose group was higher than those of the other groups( P < 0. 01). The ROS levels in BALF of rat lung in 3 exposure groups were higher than that of the control group( P < 0. 01). The NADPH levels in medium- and high-dose groups were higher than those of the control group and low-dose group( P < 0. 05). The total antioxidant ability in medium- and high-dose groups were lower than that of the control group( P < 0. 01). The NO levels in medium- and high-dose groups were higher than that of the control group( P < 0. 05). CONCLUSION: The NaAsO_2 exposure in rats could lead to high expression of oxidase ROS by activating NADPH followed by increasing NO level,resulting in imbalanced organism oxidation and anti-oxidation system and causing oxidative stress injury in tissues.

Study on mechanism of sodium arsenite-induced lung injury in male rats / 中国职业医学

OBJECTIVE: To observe the effects of lung injury caused by sodium arsenite in male rats,and to explore its cell senescence mechanism. METHODS: Specific pathogen free healthy adult male Wistar rats were randomly divided into 4groups with 8 rats in each group: a control group( given ultrapure water) and low-,medium- and high-sodium arsenite dose groups( 10,100 and 1 000 μg / L sodium arsenite in drinking water,respectively). The rats were euthanized after 4weeks of treatment. The pathologic changes in the lung were examined and the levels of interleukin( IL)-1β,IL-6,IL-10 and β-galactosidase( β-Gal) in broncho-alveolar lavage fluid( BALF) were determined by enzyme-linked immunosorbent assay. RESULTS: The lung tissue of the 3 treatment groups showed early inflammatory pathological changes. With the increase of dose,lung histopathology gradually showed the alveolar interval widened,infiltrating with protein-rich fluid and a large number of inflammatory cells. The levels of IL-1β,IL-6 and β-Gal in BALF of the medium- and high-dose groups were higher than those of the control group( P < 0. 05). The levels of IL-10 in BALF of the 3 treatment groups were lower than that of the control group( P < 0. 05). The levels of β-Gal and IL-1β in BALF of rats as well as with IL-6 was positively correlated [the correlation coefficient( r) were 0. 691 and 0. 410 respectively,P < 0. 05]. The levels of β-Gal and IL-10 were not correlated( r =- 0. 117,P > 0. 05). CONCLUSION: Sodium arsenite in drinking can result in inflammatory injury in lung in male rats. The mechanism may be related to the cell senescense that activates the inflammatory cascade.

Efficacy and Safety of Zhuanggu Joint Capsules in Combination with Celecoxib in Knee Osteoarthritis: A Multi-center, Randomized, Double-blind, Double-dummy, and Parallel Controlled Trial / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Knee osteoarthritis (KOA) is a chronic joint disease that manifests as knee pain as well as different degrees of lower limb swelling, stiffness, and movement disorders. The therapeutic goal is to alleviate or eliminate pain, correct deformities, improve or restore joint functions, and improve the quality of life. This study aimed to evaluate the efficacy and safety of Zhuanggu joint capsules combined with celecoxib and the benefit of treatment with Zhuanggu alone for KOA.</p><p><b>METHODS</b>This multi-center, randomized, double-blind, double-dummy, parallel controlled trial, started from December 2011 to May 2014, was carried out in 6 cities, including Beijing, Shanghai, Chongqing, Changchun, Chengdu, and Nanjing. A total of 432 patients with KOA were divided into three groups (144 cases in each group). The groups were treated, respectively, with Zhuanggu joint capsules combined with celecoxib capsule simulants, Zhuanggu joint capsules combined with celecoxib capsules, and celecoxib capsules combined with Zhuanggu joint capsule simulants for 4 weeks consecutively. The improvement of Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index and the decreased rates in each dimension of WOMAC were evaluated before and after the treatment. Intergroup and intragroup comparisons of quantitative indices were performed. Statistically significant differences were evaluated with pairwise comparisons using Chi-square test (or Fisher's exact test) and an inspection level of α = 0.0167.</p><p><b>RESULTS</b>Four weeks after treatment, the total efficacies of Zhuanggu group, combination group, and celecoxib group were 65%, 80%, and 64%, respectively, with statistically significant differences among the three groups (P = 0.005). Intergroup pairwise comparisons showed that the total efficacy of the combination group was significantly higher than that of the Zhuanggu (P = 0.005) and celecoxib (P = 0.003) groups. The difference between the latter two groups was not statistically significant (P > 0.0167). Four weeks after discontinuation, the efficacies of the three groups were 78%, 95%, and 65%, respectively, with statistically significant differences (P < 0.0001). Intergroup pairwise comparisons revealed that the efficacy of the combination group was significantly better than that of the Zhuanggu and the celecoxib groups (P < 0.0001). The difference between the latter two groups was not statistically significant (P > 0.0167). The incidences of adverse events in Zhuanggu group, combination group, and celecoxib group were 8.5%, 8.5%, and 11.1%, respectively, with insignificant differences (P > 0.05).</p><p><b>CONCLUSIONS</b>Zhuanggu joint capsules alone or combined with celecoxib showed clinical efficacy in the treatment of KOA. The safety of Zhuanggu joint capsules alone or combined with celecoxib was acceptable.</p><p><b>TRIAL REGISTRATION</b>Chinese Clinical Trial Registry, ChiCTR-IPR-15007267; http://www.medresman.org/uc/project/projectedit.aspx?proj=1364.</p>

Study on the correlation between monocular mild myopic juvenile myopia degree and dominant eye / 国际眼科杂志(Guoji Yanke Zazhi)

?AlM: To study the correlation between monocular mild myopic juvenile myopia degree and dominant eye. ? METHODS: Totally 158 patients with juvenile monocularly mild myopia in our hospital from December 2012 to December 2013 were retrospectively analyzed, and cylindrical mirror astigmatism was used for spherical equivalent conversion. On the basis of the myopic degree, they were divided into three groups, 30 cases in group A (-0. 25~-0. 75D), 92 cases in B group (-1. 0~-2. 0D), 36 cases in group C (-2. 25 ~ -3. 0D). The card hole method was selected to measure dominant eye for subjectsat nearly 33cm and 5m. After glasses correction of ametropia, the far and near dominant eyes were received measurement again. ?RESULTS:The monocular mild myopia of dominant eye was compared with the non-dominant eye adjustment function, and there was no significant difference ( P>0. 05 ) . The dominant eye, non - dominant eye mean diopter and other correlations of eyes in the three groups were compared, and there was no significant difference (P>0. 05). The dominant eye of three groups at 5m was compared, and there was significant difference (P ?CONCLUSlON: The formation of myopic anisometropia is related to the degree of clearly seeing objects, although glasses correction can improve the clarity and visual, but affect the choice of the dominant eye, because the myopic anisometropia appears most early in the dominant eye, therefore optician correction stage, which should be taken into consideration, and avoid the severity of the adolescent myopia.

Simple Pemberton's ilium osteotomy and combined unter-trochanter derotation-varisation osteotomy for developmental dysplasia of the hip / 中国骨伤

<p><b>OBJECTIVE</b>To retrospectively compare the therapeutic effects of simple Pemberton's ilium osteotomy and combined unter-trochanter derotation-varisation osteotomy for developmental dysplasia of the hip (DDH).</p><p><b>METHODS</b>Clinical data of 141 DDH patients who received either simple Pemberton's ilium osteotomy (n=57; 12 male and 45 female; age range 3-8 years) or combined unter-trochanter derotation-varisation osteotomy (n=84; 15 male and 69 female; age range 4-9 years) from January 2004 to January 2009 were collected. Postoperative complications, Severin's radiological outcomes and therapeutic outcomes as evaluated by Mcay criteria were compared between the two groups 2 years after operation.</p><p><b>RESULTS</b>The patients in simple Pemberton group were followed-up for 30-52 months (mean 38 months) and the patients in the combination group were followed-up for 32-51 months (mean 37 months). There were 7 cases of dislocation, 4 cases of avescular necrosis of femoral head and 5 cases of joint stiffness in simple Pemberton group vs 0 case of dislocation, contraction of the limb and ANFH,2 cases of joint stiffness in the combination group. Two years after surgery, the result as evaluated by McKay criteria was excellent in 27 cases, good in 18 cases and fair in 12 cases in simple Pemberton group vs. 52, 25 and 7 cases in the combination group. The overall clinical outcome in the combination group was better than that in simple Pemberton group. Severin X-ray evaluation showed excellent in 27 cases, good in 15 cases and fair in 15 cases in simple Pemberton group vs. 53, 22 and 9 cases in the combination group,indicating that the overall result in the combination group was better than that in simple Pemberton group.</p><p><b>CONCLUSION</b>The overall clinical outcome of the combination group is better than that of simple Pemberton group in the treatment of pediatric DDH, especially in reducing postoperative complications and functional recovery. The patients in the combination group reported a higher postoperative satisfaction as compared with those in simple Pemberton group.</p>

Clinical and radiographic evaluation for total hip arthroplasty in treatment of bony ankylosis of hips / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical and radiographic effects of total hip arthroplasty (THA) in the treatment of bony ankylosis of hips.</p><p><b>METHODS</b>From January 2003 to August 2009, 20 patients (30 hips) with bony ankylosis of hips were treated with THA. There were 12 males and 8 females, with an average age of 36 years old. After operation, the follow-up results were evaluated with clinical and radiographic criteria. The clinical follow-up results were evaluated with Harris score, satisfaction of pain relief, limb length discrepancy, ROM of hip and the strength of hip abductor. The X-ray imaging follow-up results were evaluated with acetabula and periprosthetic osteolysis, prosthesis loosening, radiolucent and heterotopic ossification.</p><p><b>RESULTS</b>The average following-up was 4 years. The mean preoperative Harris score was (40.75 +/- 6.52) as opposed to postoperative Harris score of (86.40 +/- 5.42). Total pain relief was 65% and partial pain relief was 35% around the affected hips. The recovery of abductors strength was satisfactory in 13 cases, with limp symptoms was relieved obviously, and limb shortening decreased to less than 0.5 cm. The postoperative ROM of hip was significantly improved compared with the preoperative ROM. Radiographic analysis showed that heterotopic ossification in 2 cases, and radiolucent around prosthesis in one case. There were no dislocation and revision cases.</p><p><b>CONCLUSION</b>The THA can provide satisfactory clinical results in bony ankylosis of hips, which not only correct the deformity and recover the functions of hip, but also relieve the pain of hip to improve quality of life.</p>

Treatment of humeral supracondylar fracture in children with neurovascular complications / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the treatment methods of humeral supracondylar fracture in children with neurovascular complications.</p><p><b>METHODS</b>Ninety-six children (59 males, 37 females) with humeral supracondylar fractures were treated by surgery from February 2002 to November 2007, with the mean age of 6.4 years old (ranged from 4 to 16 years). Seventeen symptoms of nerve damage occurred in 16 cases, including radial nerve injury in 5 cases,median nerve injury in 7 cases,of which 1 cases with ulnar nerve injury, ulnar nerve injury in 5 cases; 13 patients had symptoms of vascular injury such as pulse weakness and hands coldness. The patients accompanied by nerve, blood vessel injury symptoms were all treated with open reduction and internal fixation.</p><p><b>RESULTS</b>Eighty-five patients were followed up with an average duration of 11 months(ranged from 6 to 18 months). Seventy-three patients had incision healing at the first stage and other 12 patients had incision healing at the second stage. All the 85 patients had no complications such as incision infection and functional disturbance of elbow joint. Among 5 patients with radial nerve injury, 3 patients had symptoms disappeared completely at 3 months after operation; one patient underwent exploration lysis at 3 months after operation and the symptoms disappeared at 5 months after operation; another 1 patient with iatrogenic injury of radial nerve had nerve function recovered at 3 months after releasing plaster compression. Among 7 patients with median nerve injury, 6 patients had nerve function recovered completely at 6 months after operation; another 1 patient combined with ulnar nerve injuries had nerve function recovered at 9 months after exploring of nerve at the second stage. Five patients with ulnar nerve injury had nerve function recovered completely at 6 months after operation. Preoperative symptoms of radial artery pulse weakness and cold hand in 13 patients disappeared after fracture reduction.</p><p><b>CONCLUSION</b>The ulnar nerve should be explored during the operation at the first stage of supracondylar fracture. Wether the median nerve, radial nerve and blood vessel be explored or not should be decided by preoperative examination results. The preoperative EMG and Doppler ultrasound examination is not a routine examination before surgery.</p>