Clinical efficacy analysis of transverse tibial bone transport combined with vacuum drainage for the treatment of diabetic foot ulcer / 中国骨伤

<p><b>OBJECTIVE</b>To investigate clinical effect of transverse tibial bone transport micro vessels regeneration technology combined with vacuum drainage in treating diabetic foot ulcer.</p><p><b>METHODS</b>From November 2015 and December 2016, clinical data of 19 diabetic foot ulcer patients treated with transverse tibial bone transport micro vessels regeneration technology combined with vacuum drainage were retrospective analyzed, including 15 males and 4 females aged from 42 to 82 years old with an average of (64.57±7.14) years old;the courses of diabetic ranged was (14.62±6.19) years;12 cases on the left side and 7 cases on the right side;the area of ulcer ranged from 2 cm×3 cm to 8 cm×6 cm. All patients were stage D according to Texas classification, 3 cases were grade 2, 10 cases were grade 3 and 6 cases were grade 4. Ankle-brachial index and Michigan Neuropathy Screening Instrument (MNSI) were used to evaluate recovery of peripheral vessel and nerve before and after operation, the result of angiography and vascular ultrasound were also compared after operation.</p><p><b>RESULTS</b>Seventeen of 19 patients were followed up from 3 to 13 months with an average of 6.9 months. Seventeen patients' surface wound were healed. Ankle-brachial index was increased from (0.51±0.20) before operation to (0.93±0.18) at 3 months after operation, and had significant difference(=13.63, =0.000);MNSI was increased from (4.06±1.36) before operation to(5.76±1.44) at 3 months after operation, and differences were statistically significant (=7.31, =0.000). Postoperative angiography and vascular ultrasound showed satisfied regeneration of micro-vessel and affected foot achieved normal movement and daily life.</p><p><b>CONCLUSIONS</b>Transverse tibial bone transport micro vessels regeneration technology could reconstruct micro-vessel under lower affected limb, promote recovery of peripheral vessel and nerve, while with vacuum drainage could promote wound healing, has advantages of simple operation, obvious clinical effect, and high success rate of limb-salvage, and is one of ideal treatment for diabetic foot ulcer.</p>

Clinical comparative study of laparoscopy versus open surgery for appendicitis / 复旦学报（医学版）

Objective To compare and evaluate the effect of laparoscopic and traditional open surgery in the treatment of appendicitis.Methods From Jan.2013 to Oct.2016,the clinical data of 862 cases with acute appendicitis from Jinshan Hospital,Fudan University were analyzed retrospectively.Among them,335 cases were treated with laparoscopic appendectomy (LA) and 527 cases with open appendectomy (OA).The time of operation,bleeding volume,the postoperative hospital stay,hospitalization costs,incision infection,intestinal obstruction and intra-abdominal abscess were compared between the two groups.Results In LA group,325 cases had successful LA,and 10 cases turned to OA (3.0％).Compared with OA,LA was associated with reduced risk of surgical-site infection (0.9 ％ vs.4.9 ％,P＜ 0.001),less bleeding volume [(16.6 ± 13.2) mL vs.(24.7 ± 18.3) mL,P＜0.001],shorter hospital stay [(4.4 ± 1.9) d vs.(5.1 ± 2.5) d,P＜0.001],less postoperative pain (4.5％ vs.11.6％,P＜0.001).The time of operation and hospitalization costs in the LA group [(41.4 ± 8.1) min,(7 806 ± 1 406) yuan] were longer and higher than that in the OA group [(38.8 ± 11.7) min,(4 871 ± 1 308) yuan],respectively (P all＜0.001).There was no significant difference in intra-abdominal abscesses,intestinal obstruction and reoperation rate between the two groups.The total incidence of complications in LA group [9.55 ％ (32/335)] was lower than that in OA group [14.42 ％(76/527),P =0.035].LA had the advantages of minimal invasion,shorten operation time[(45.2 ±7.7) min vs.(49.0 ± 7.6) min,P =0.004],without increasing the cost [(7 951 ± 1 485) yuan vs.(7 717 ± 1 705) yuan,P =0.396],which was a more popular choice for overweight or obesity (BMI≥24) patients.Conclusions LA is a safe and reliable operational way compared with OA.It has obvious advantages in reducing the complications such as incision infection,postoperative pain and so on.While it is not completely accepted because of its higher costs and longer time of operation for the hospital.LA seems to be favored especially in patients with BMI≥24.

Epidemiological investigation on natural infection of different canine breeds with Borna disease virus in Ili, China / 中华流行病学杂志

Objective To investigate the epidemioiogical pattern of Borna disease virus (BDV) among different canine breeds in Ili, China, and to analyze its potential phylogeny. Methods BDV p24 RNA fragments were detected from peripheral blood mononuclear cells (PBMCs) of canine by modified nested RT-PCR (nRT-PCR). Possible false positives were excluded by determination of both BDV p40 RNA fragments and PMD19 plasmid standards. Analysis were performed on genetic sequence, homologous comparison, amino acid sequence and phylogeny after p24 positive products were validated. Results BDV p24 RNA fragments were found only in Kazakh Tobet (a shepherd dog) in 8 breeds of 150 cases and their overall positive rate was 11.0% (10/91). Compared with the strain of He/80 from horse and that of S6 from sheep in Germany, the homologous similarities of Kazakh Tobet was 99.2% and 95.7%, and that of amino acid as 100% and 89.3%, respectively. The kinship of Kazakh Tobet was close to He/80 and next to S6. Conclusion There was potential natural BDV infection in Kazakh Tobet in Ili, and its endemic strain was concerned with He/ 80 infecting Ili horse and S6 of German Merino sheep introduced into the region from Germany.

Epidemiological investigation on natural infection to Borna disease virus (BDV) among horses in Yili,Xinjiang / 中华流行病学杂志

Objective To investigate the epidemiological pattern of Borna disease virus (BDV)infection in horses and to analyze the phylogenetic tree of derived BDV in Yili, Xinjiang. Methods We established a modified nested RT-PCR (nRT-PCR) to detect BDV p24 segment in peripheral blood mononuclear cells (PBMCs) and brain tissues of 120 horses in Yili, Xinjiang. Positive products were analyzed by sequencing and homology analysis. Results The positive rate of BDV infection was 2.5% in both PMBCs and brain tissues at the same time. The gene sequence revealed in positive PCR samples was more than 93 % ,identical to that of BDV derived from horses in other countries. We also noticed a high degree of identity ( >98 % ) to standard strain He/80 in gene sequence of positive PCR samples. Conclusion Our study found the presence of BDV natural infection in horses in Yili. The endemic BDV had a high degree of identity to standard strain He/80.

Study on extraction technics and variety trends of the flavonoids in Sarcandrae glabra / 中国中药杂志

<p><b>OBJECTIVE</b>To study on extraction technics and variety trends of the flavonoids in Sarcandrae glabra.</p><p><b>METHOD</b>By using S. glabra in Guizhou as materials and the experiment of L9 (3(4)) by ethanol as extracting way, The variety trends of the flavonoids from S. glabra are studied under the optimum extracting conditions during different raw stored times, different gathering season, different S. glabra position.</p><p><b>RESULT</b>The flavonoid's contains was more low when the raw material was stored more long and descended average 24.74% annually. The flavonoid's contains had the tallest in 10-12 month by gathering indifferent season. The flavonoids contains were the tallest in the leaf of S. glabra in Guizhou than in the root and stem, and the contains were the lowest in stem.</p><p><b>CONCLUSION</b>The optimum conditions of extracting flavonoids from S. glabra are obtained when the condition is 60% of density of ethanol at 10 times of volume, 80 degrees C of extracting temperature, 3 h of extracting hours, 3 times of extracting number of times in 10-12 month, in the leaf, the raw material was stored more shortest, the flavonoid's contains had the tallest.</p>

Effect of strengthening Pi and activating blood circulation therapy on serum levels of adrenocorticotrophic hormone and vascular endothelial growth factor in rheumatoid arthritis patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of strengthening Pi and activating blood circulation therapy (SPAB) on serum levels of adrenocorticotrophic hormone (ACTH) and vascular endothelial growth factor (VEGF) in rheumatoid arthritis (RA) patients.</p><p><b>METHODS</b>Seventy RA patients were randomly assigned to 3 groups. The 30 in the Chinese medicine (CM) group were treated with SPAB; the 20 in the Western medicine (WM) group were treated with indomethacin and methopterin; and the 20 in the CM-WM group were treated with the combination of the therapy in the above two groups, and the course of treatment was 3 months for all. Serum levels of ACTH and VEGF were determined before and after treatment.</p><p><b>RESULTS</b>The total effective rate in the CM group was 80.0%, WM group 85.0% and CM-WM group 95.0%, the last one showed the best efficacy (P<0.05). Serum level of ACTH increased and level of VEGF decreased after treatment in all groups (P<0.05 or P<0.01), but the increment/decrement in the CM-WM group was higher than that in the other two groups (P<0.01), while comparison between that in the CW group and WM group showed insignificant difference.</p><p><b>CONCLUSION</b>SPAB therapy has the effect in alleviating the condition of RA, similar to that of Western medicine, it can increase the serum level of ACTH and decrease the serum level of VEGF remarkably in RA patients.</p>

Genome cloning and phylogenetic analysis of human bocavirus capsid gene / 病毒学报

The full-length genome of one human bocavirus (HBoV) and the VP1 sequences of nine HBoV were amplified from patients' samples by PCR, cloned into pGEM-T vector separately, and sequenced. In this study, the one full length gemome and nine VP1 sequences of HBoV were aligened with 14 sequences of Parvoviruses which were canonical exemplars in Parvovirinae. Phylogenetic analysis showed that HBoV capsid sequences positioned closely to B19 parvovirus, although they positioned far in phylogenetic tree based on full length genome. Many similarities were found between HBoV and B19 in capsid by alignment on secondary structural elements. Because both B19 and HBoV are the only Parvoviruses that infect mankind, so study on HBoV may be used for reference to B19 which had been studied for about 30 years. By analysis of mutational sites, HBoV capsid protein showed a highly conserved secondary structural elements, but highly active in VP1-U, leading end of VP2 and insertions between the strands of the betaG-H. This cued that HBoV inclined to immune evasion and infectant adaptive faculty.

Separation and purification of flavonoids from chrysanthemum indicum with macroporous resin / 中国中药杂志

<p><b>OBJECTIVE</b>A method for separation and purification of flavonoids from C. indicum with macroporous resin was studied.</p><p><b>METHOD</b>By using C. indicum in Guizhou as the materials and with the content and recovery rate of flavonoids as indexes, the static and dynamic adsorption tests were employed to investigated effects and affective factors of separation and purification of flavonoids from C. indicum with macroporous resin.</p><p><b>RESULT</b>Results show that the static adsorption capacity of AB-8 type resin was 114.65 mg x g(-1), the static elution ratio were 94.9%, the dynamic adsorption capacity of AB-8 type resin was 94.5 mg x g(-1), the recovery rate was more than 92.6% and the purity of flavonoids was more than 90%. AB-8 type resin is the best for separating and purificating C. indicum in flavonoids.</p><p><b>CONCLUSION</b>The optimum conditions is AB-8 type macroporous resin, 70% alcohol as the eluant and 2 to approximately 3 times volume of the resin as the eluant volume, the ratio of flavonoids to the volume of the resin as 1:10.6, concentration of flavonoids of sample as 19.8 mg x mL(-1) and current velocity as 2 to approximately 3 mL x min(-1), pH value of sample as 4 to approximately 5. [Key words]' macroporous resin; Chrysanthemum indicum; flavonoids; separation; purification</p>

Noradrenaline release by activation of κ-bungarotoxin-sensitive nicotinic acetylcholine receptors participates in long-term potentiation-like response induced by nicotine / 生理学报

Nicotine enhances the function of learning and memory, but the underlying mechanism still remains unclear. Hippocampal long-term potentiation (LTP) is assumed to be a cellular mechanism of learning and memory. Our previous experiments showed that with the single pulses evoking 80% of the maximal population spike (PS) amplitude, nicotine (10 μmol/L) induced LTP-like response in the hippocampal CA1 region. In the present study, the nicotinic acetylcholine receptor (nAChR) subtypes and relevant neurotransmitter releases involved in LTP-like response induced by nicotine were investigated by extracellularly recording the PS in the pyramidal cell layer in the hippocampal CA1 region in vitro. LTP-like response induced by nicotine was blocked by mecamylamine (1 μmol/L) or κ-bungarotoxin (0.1 μmol/L), but not by dihydro-β-erythtroidine (DHβE, 10 μmol/L). Moreover, it was inhibited by propranolol (10 μmol/L), but not by phentolamine (10 μmol/L) or atropine (10 μmol/L). The results suggest that noradrenaline release secondary to the activation of κ-bungarotoxin-sensitive nAChRs participates in LTP-like response induced by nicotine in the hippocampal CA1 region.

Correlations between diagnostic information and therapeutic efficacy in rheumatoid arthritis analyzed with decision tree model / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the correlations between diagnostic information and therapeutic efficacy in rheumatoid arthritis (RA) with decision tree model analysis.</p><p><b>METHODS</b>Three hundred and ninety seven patients came from 9 clinical centers were randomly divided into the Western medicine (WM) group (n=194) treated with non-steroidal anti-inflammatory drugs and slow-acting antirheumatic drug and the Chinese medicine (CM) group (n=203) with basic therapy and syndrome-differentiation dependant TCM treatment. TCM and WM diagnostic information were collected. The ACR 20 was used for efficacy evaluation and the information of patients before treatment was analyzed by SAS 8.2 statistical package. Through single-factor exploratory analysis, odds ratio of efficacy and variable was calculated taken P < 0.2 as the including criteria for data mining analysis with decision tree model. All data were classified into the training set (75%) and verifying set (25%) with efficacy as the variable for layering to make further verification of the data-mining analysis.</p><p><b>RESULTS</b>Twenty variables were included in the CM group and 26 in the WM group in the data-mining model. In the former, 9 variables were positively correlated to the efficacy, including degree of arthralgia, tenderness and morning stiffness, number of swollen joint, and joint with tenderness, levels of IgM, rheumatoid factor (RF), C-reactive protein (CRP), and total assessment from doctor; and disease duration and degree of nocturnal polyuria were negatively correlated to that. While in the latter, 8 were positively correlated to the efficacy, including erythrocyte sedimentation rate (ESR), sour and weak waist and knees, white fur in tongue, joint ache and stiffness, swollen joint, and total assessment from doctor and patient, and red tongue with yellow fur and leucocyte count negatively correlated to it. Data mining with decision tree analysis revealed that different combinations of morning stiffness, slight red tongue, joint tenderness and nocturnal polyuria in the CM group, and those of white fur in tongue, CRP level, leucocyte count and morning stiffness in the WM group showed different efficacy, which were also verified in the randomly chosen verifying set.</p><p><b>CONCLUSION</b>To analyze the correlations between diagnostic information and therapeutic efficacy with decision tree analysis is conformed to the theory of TCM in applying treatment according to syndrome differentiation individually, thus it would contribute to elevate the accuracy of therapy.</p>

Clinical and pathological characteristics in patients with clinically presumed hypertensive nephrosclerosis / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the clinical and pathological characteristics of patients with clinically presumed hypertensive nephrosclerosis (HN).</p><p><b>METHODS</b>Clinical data and renal biopsy results were obtained in 63 patients diagnosed clinically as HN (primary hypertension plus renal injury).</p><p><b>RESULTS</b>HN was confirmed by biopsy in 47 out of 63 patients (74.6%, 12 malignant nephrosclerosis and 35 benign nephrosclerosis). Primary nephritis (PN) was diagnosed by biopsy in 10 patients (7 IgA nephropathy, 2 mesangial proliferative nephritis, 1 chronic interstitial nephritis) and focal and segmental glomerulosclerosis (FSGS) in 6 patients. Blood pressure, body mass index, GFR and blood lipids were similar among groups. HN patients were related to higher age, more frequent family history of hypertension, longer hypertension duration, higher left ventricular mass index, lower serum creatinine and lower incidence of microscopic hematuria. Most patients with malignant nephrosclerosis and FSGS patients showed grades III and IV retinopathy.</p><p><b>CONCLUSION</b>Our results show that HN was misdiagnosed in nearly 25% patients in this cohort. Since the clinical features are similar between HN, PN and FSGS, renal biopsy is needed to establish the diagnosis of HN.</p>

Expression of Bcl-2 and Bax in renal tissues of patients with hepatitis B virus-associated glomerulonephritis / 第二军医大学学报

Objective:To investigate the expression of Bcl-2 and Bax in renal tissues of patients with hepatitis B virus- associated glomerulonephritis(HBV-GN).Methods:Twenty HBV-GN specimens with complete nephrology data and 10 normal renal specimens were randomly chosen for the present study.Cell apoptosis was detected by means of terminal deoxynucleotidyl transferase mediated d-UTP nick end labeling(TUNEL)and the apoptotic index was calculated;immunohistochemistry was used to detect the protein expression of Bax and Bcl-2.ResuLts:The apoptotic index in HBV-GN group was obviously higher than that of the control group;the apoptotic cells were mainly distributed in the proximal and distal renal tubules and the collecting duct epithelial cells,seldom seen in the glomerular cells.The expression of Bcl-2 in HBV-GN patients was predominately present in the renal tubular epithelia cells(positive in the plasma,membrane and nuclear);the expression of Bax was found in both glomerular cells and renal tubular cells,mainly in tubular epithelial cells,seldom seen in Bowman's capsule or glomerular mesangial region.Conclusion:Apoptosis in the kidney of HBV-GN patients mainly occurs in the renal tubular epithelial cells;expression of Bax and Bcl-2 is mainly in the renal tubular epithelial cells,suggesting that the injury of tubular interstitial damage may be one of the important factors for the development of HBV-GN.