Application of LASSO and its extended method in variable selection of regression analysis / 中华预防医学杂志

Multicollinearity is an important issue affecting the results of regression analysis. LASSO developed in recent years has great advantages in selecting explanatory variables, processing high-dimensional data, and solving multicollinearity problems. This method adds a penalty term to the model estimation, which can compress the regression coefficients of some unnecessary variables to zero and then remove them from the model to achieve the purpose of variable screening. This paper focuses on the LASSO method and compares it with optimal subsets, ridge regression, adaptive LASSO, and elastic net results. It is found that both LASSO and adaptive LASSO have good performance in solving independent variable multicollinearity problems and enhancing model interpretation and prediction accuracy.

Leptin relieves ischemia/reperfusion induced acute kidney injury through inhibiting apoptosis and autophagy / 中南大学学报(医学版)

OBJECTIVES@#Acute kidney injury (AKI) can be caused by ischemia/reperfusion (I/R), nephrotoxin, and sepsis, with poor prognosis and high mortality. Leptin is a protein molecule that regulates the body's energy metabolism and reproductive activities via binding to its specific receptor. Leptin can inhibit cardiomyocyte apoptosis caused by I/R, but its effect on I/R kidney injury and the underlying mechanisms are still unclear. This study aims to investigate the effect and mechanisms of leptin on renal function, renal histopathology, apoptosis, and autophagy during acute I/R kidney injury.@*METHODS@#Healthy adult male mice were randomly divided into 4 groups: a sham+wild-type mice (ob/+) group, a sham+leptin gene-deficient mice (ob/ob) group, an I/R+ob/+ group, and an I/R+ob/ob group (n=8 per group). For sham operation, a longitudinal incision was made on the back of the mice to expose and separate the bilateral kidneys and renal arteries, and no subsequent treatment was performed. I/R treatment was ischemia for 30 min and reperfusion for 48 h. The levels of BUN and SCr were detected to evaluate renal function; HE staining was used to observe the pathological changes of renal tissue; TUNEL staining was used to observe cell apoptosis, and apoptosis-positive cells were counted; Western blotting was used to detect levels of apoptosis-related proteins (caspase 3, caspase 9), autophagy-related proteins [mammalian target of rapamycin (mTOR), phosphorylated mTOR (p-mTOR), LC3 I, LC3 II], mTOR-dependent signaling pathway proteins [phosphate and tension homology (PTEN), adenosine monophosphate-activated protein kinase (AMPK), protein kinase B (AKT), extracellular regulated protein kinase (ERK), phosphorylated PTEN (p-PTEN), phosphorylated AMPK (p-AMPK), phosphorylated AKT (p-AKT), phosphorylated ERK (p-ERK)].@*RESULTS@#There was no significant difference in the levels of BUN and SCr between the sham+ob/+ group and the sham+ob/ob group (both P>0.05). The levels of BUN and SCr in the I/R+ob/+ group were significantly higher than those in the sham+ob/+ group (both P<0.05). Compared with the mice in the sham+ob/ob group or the I/R+ob/+ group, the levels of BUN and SCr in the I/R+ob/ob group were significantly increased (all P<0.05). There was no obvious damage to the renal tubules in the sham+ob/+ group and the sham+ob/ob group. Compared with sham+ob/+ group and sham+ob/ob group, both the I/R+ob/+ group and the I/R+ob/ob group had cell damage such as brush border shedding, vacuolar degeneration, and cast formation. Compared with the I/R+ob/+ group, the renal tubules of the mice in the I/R+ob/ob group were more severely damaged. The pathological score of renal tubular injury showed that the renal tubular injury was the most serious in the I/R+ob/ob group (P<0.05). Compared with the sham+ob/+ group, the protein levels of caspase 3, caspase 9, PTEN, and LC3 II were significantly up-regulated, the ratio of LC3 II to LC3 I was significantly increased, and the protein levels of p-mTOR, p-PTEN, p-AMPK, p-AKT, and p-ERK were significantly down-regulated in the I/R+ob/+ group (all P<0.05). Compared with the sham+ob/ob group, the protein levels of caspase 3, caspase 9, PTEN, and LC3 II were significantly up-regulated, and the ratio of LC3 II to LC3 I was significantly increased, while the protein levels of p-mTOR, p-PTEN, p-AMPK, p-AKT, and p-ERK were significantly down-regulated in the I/R+ob/ob group (all P<0.05). Compared with the I/R+ob/+ group, the levels of p-mTOR, p-PTEN, p-AMPK, p-AKT were more significantly down-regulated, while the levels of caspase 3, caspase 9, PTEN, and LC3 II were more significantly up-regulated, and the ratio of LC3 II to LC3 I was more significantly increase in the I/R+ob/ob group (all P<0.05).@*CONCLUSIONS@#Renal function and tubular damage, and elevated levels of apoptosis and autophagy are observed in mice kidneys after acute I/R. Leptin might relieve I/R induced AKI by inhibiting apoptosis and autophagy that through a complex network of interactions between mTOR-dependent signaling pathways.

Capsular tension ring and iris hooks for secondary glaucoma associated with lens subluxation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To evaluate the application effect of iris hooks combined with suture fixation of capsular tension ring(CTR)in the treatment of phacoemulsification with secondary glaucoma associated with lens subluxation.METHODS: Retrospective case series. A total of 18 eyes of patients with serious secondary glaucoma associated with lens subluxation were enrolled in Aier Eye Hospital(Changchun)from October 2017 to May 2020 as the observation group. All the patients had iris hooks inserted to support the capsule during the phacoemulsification combined with intraocular lens(IOL)implantation. Iris hooks were inserted through the incisions and placed in the capsulorhexis to support the capsule, then CTR was implanted and sutured onto the sclera of the dislocation side. A total of 11 eyes of patients had intracapsular cataract extraction combined with IOL suspension were enrolled in Aier Eye Hospital(Changchun)from October 2015 to October 2017 as the control group. The postoperative complications were recorded. The postoperative examinations included visual acuity, intraocular pressure(IOP)and positions of the capsule and IOL.RESULTS: The postoperative follow-up at least 12(12-40)mo, both the IOP of observation group and control group returned to normal, with statistically significant difference compared with pre-operation(t=9.994, 8.790, all P&#x003C;0.001). At 12mo after operation, the best corrected visual acuity of the two groups were significantly improved compared with surgery before(Z=-3.900, P&#x003C;0.001; Z=-3.002, P=0.003). The IOL in the observation group of the 18 eyes were in the expected position without complications such as an obvious tilt or displacement. In the control group with 11 eyes, the position of IOL in 8 eyes were centered, 3 eyes were slightly biased, and 2 eyes with cystoids macular edema.CONCLUSION: The application of suture fixation capsular tension ring and iris hooks for secondary glaucoma associated with lens subluxation in patients can be used as an effective auxiliary method, it could effectively control the IOP and maintain long-term stability of the capsule.

Effect of Fang's scalp acupuncture on perceived stress and sleep structure in insomnia patients: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the efficacy on insomnia between Fang 's scalp acupuncture combined with conventional acupuncture and the simple conventional acupuncture.@*METHODS@#A total of 66 patients with insomnia were randomly divided into an observation group (33 cases, 1 case dropped off) and a control group (33 cases, 2 cases dropped off). In the control group, the routine acupuncture therapy was applied to Shenmen (HT 7), Baihui (GV 20), Zhaohai (KI 6) and Sanyinjiao (SP 6), etc. Based on the treatment as the control group, Fang's scalp acupuncture therapy was supplemented at fuxiang tou, fuzang shangjiao, fuzang zhongjiao, siwei, etc. At these scalp points, the needles were inserted perpendicularly with flying needling technique and manipulated with trembling one. In either group, the treatment was given once daily, continuously for 2 weeks. Before and after treatment, separately, the score of Pittsburgh sleep quality index (PSQI) and the score of Chinese perceived stress scale (CPSS) were observed, as well as the parameters monitored by polysomnography, i.g. total sleep time (TST), sleep onset latency (SOL), wakefulness after the sleep onset (WASO), sleep efficiency (SE), the percentages of the time of rapid eye movement sleep phase (REM) and non-rapid eye movement sleep phase 1, 2, 3 and 4 in TST (REM%, N1%, N2%, N3%). The efficacy was compared between two groups.@*RESULTS@#After treatment, the scores of each factor and the total scores of PSQI, as well as CPSS scores were all lower than those before treatment in the two groups (P<0.01, P<0.05); except the score for sleep quality, the score of each factor and the total score of PSQI, as well as CPSS score in the observation group were lower than those in the control group (P<0.01, P<0.05). After treatment, TST, SE%, REM% and N3% were increased and SOL, WASO, N1% were decreased as compared with before treatment in the two groups (P<0.01, P<0.05), and N2% in the observation group was decreased (P<0.01); SE%, REM% and N3% in the observation group were higher than the control group (P<0.05) and N1% and N2% were lower than the control group (P<0.05). The total effective rate was 93.8% (30/32) in the observation group, higher than 87.1% (27/31) in the control group (P<0.05).@*CONCLUSION@#Fang 's scalp acupuncture, on the base of routine acupuncture, obviously improves the sleep quality and perceived stress and adjusts the sleep structure in the patients with insomnia.

Clinical characteristics and risk factors of adverse reactions to blood transfusion in Chinese adults based on evidence-based medicine / 中国输血杂志

【Objective】 To evaluate the clinical characteristics and risk factors of adverse transfusion reactions (ATR) in Chinese adults, and to provide evidence-based medical evidence for early prevention. 【Methods】 The controlled trial (CT) of risk factors for ATR in Chinese adults were collected through PubMed, Embase, Cochrane Library, CNKI, CMB, VIP and Wanfang database, and the retrieval time was from the establishment of those databases to January 31, 2021 Literature was selected and extracted by 2 researchers according to inclusion and exclusion criteria. Meta-analysis was performed by RevMan5.3 software. 【Results】 A total of 28 049 patients in 12 literature were included, 1 190 patients were included into the ART group and 26 859 into the non-ART group. Meta-analysis results showed that the incidence of ART was 1.63% (410/24 361), mainly allergic reaction (43.90%, 188/410) and non-hemolytic fever (40%, 164/410). Primary hematologic disease (OR=27.11, 95%CI=21.64~33.96, P 2 (OR=7.06, 95% CI=5.64~8.84, P30 min interval between blood issuing and transfusion (OR=3.40, 95% CI=2.88~4.00, P2, >30 min interval between blood issuing and transfusion, transfusion of plasma and cryoprecipitates, while transfusion of red blood cells/white blood cells/platelets was the protective factor.

Effect of endothelial dysfunction in hypertrophic scars on fibroblasts biology / 上海交通大学学报（医学版）

Objective: To investigate the effect of endothelial dysfunction in hypertrophic scar regression on the fibroblasts biology. Methods: Scar-derived endothelial cells were isolated and cultured from proliferative scars, regressive scars and mature scars, and the endothelial cells from normal skin as control. After 6 h of culture, the endothelial cell culture medium (ECCM) was harvested. In addition, the fibroblasts from normal skin were cultured and treated with the ECCM. After 48 h, the cell viability, total collagen production, and cell apoptosis were assessed by Alamar blue, sirius red staining, and TUNEL assay, respectively. Furthermore, anti-VEGF (vascular endothelial growth factor), anti-PDGF (platelet derived growth factor), anti-TGF-β1 (transforming growth factor-β1), anti-ET-1 (endothelin 1), and anti-bFGF (basic fibroblast growth factor) neutralizing antibodies were individually added to the ECCM to identify their effects on fibroblasts biology. Results: The results revealed that the ECCM from regressive scars inhibited fibroblasts viability and collagen production, and induced apoptosis (P<0.01). Moreover, after neutralization of TGF-β1, PDGF or bFGF by antibodies, fibroblasts proliferation and collagen production were significantly inhibited (P<0.05), and combined blockade of the three factors could induce apoptosis (P<0.01). Conclusion:Vascular endothelial dysfunction in hypertrophic scars can inhibit fibroblast proliferation and collagen production, and induce cell apoptosis, especially in regressive scars. TGF-β1, PDGF and bFGF may play a major role in this process.

The relationship between drinking tea and frailty in the community elderly / 中国实用护理杂志

Objective To explore the relationship between drinking tea and frailty among the elderly in the community. Methods A self-designed questionnaire was used to investigate the basic data of the elderly and their status of drinking tea. Tilburg Frailty Index scale was used to evaluate the frailty of the elderly. The physical levels of the elderly were assessed by grip strength, 4 m walking time and time up& go. The factors affecting frailty of the elderly and the relationship between status of drinking tea and frailty were analyzed. Results The incidence of frailty in the community with and without habits of drinking tea was 55.6％(69/124) and 79.3％(96/121).There was significantly difference between them (χ2=15.634, P<0.01). The total scores, body function and mental dimensions of frailty of the former were 4.53± 2.51, 2.46±1.86 and 1.11±0.97 and that of the later were 5.52±2.54, 3.20±1.78 and 1.36±0.97. There was significantly difference between them (t=3.064, 3.178, 2.015, P<0.05) . The grip strength of the former and the latter was (29.06 ± 9.02) kg and (23.96 ± 7.48) kg and there was significantly difference between them (t=-4.824, P<0.01). The Logistic regression analysis showed that the number of complications, the habit of exercise and the habit of drinking tea were the factors influencing frailty. Conclusions Drinking tea may decrease the incidence of frailty and improve fitness level in the elderly. However, investigative research involving larger number of subjects and intervention studies are needed to explore further the relationship between drinking tea and frailty in the future.

The relationship between drinking tea and frailty in the community elderly / 中国实用护理杂志

Objective@#To explore the relationship between drinking tea and frailty among the elderly in the community.@*Methods@#A self-designed questionnaire was used to investigate the basic data of the elderly and their status of drinking tea. Tilburg Frailty Index scale was used to evaluate the frailty of the elderly. The physical levels of the elderly were assessed by grip strength, 4 m walking time and time up & go. The factors affecting frailty of the elderly and the relationship between status of drinking tea and frailty were analyzed.@*Results@#The incidence of frailty in the community with and without habits of drinking tea was 55.6%(69/124) and 79.3%(96/121).There was significantly difference between them (χ2=15.634, P<0.01). The total scores, body function and mental dimensions of frailty of the former were 4.53±2.51, 2.46±1.86 and 1.11±0.97 and that of the later were 5.52±2.54, 3.20±1.78 and 1.36±0.97. There was significantly difference between them (t=3.064, 3.178, 2.015, P<0.05). The grip strength of the former and the latter was (29.06±9.02) kg and (23.96±7.48) kg and there was significantly difference between them (t=-4.824, P<0.01). The Logistic regression analysis showed that the number of complications, the habit of exercise and the habit of drinking tea were the factors influencing frailty.@*Conclusions@#Drinking tea may decrease the incidence of frailty and improve fitness level in the elderly. However, investigative research involving larger number of subjects and intervention studies are needed to explore further the relationship between drinking tea and frailty in the future.

Predicting value of serum chemokine interleukin 8 for acute exacerbation of chronic obstructive pulmonary disease / 第二军医大学学报

Objective To explore the predictive value of serum chemokine interleukin (IL)-8 for acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A total of 112 COPD patients with acute exacerbation, who were initially diagnosed or did not receive standardized treatment in our hospital from Sep. 2015 to May 2016, were included in this study. According to serum level of IL-8, the patients were divided into high IL-8 group (<62 pg/mL) and low IL-8 group (≥62 pg/mL). The blood test results, serum levels of immunoglobulin E (IgE), IL-8, IL-6, tumor necrosis factor α (TNF-α), and superoxide dismutase (SOD), fractional exhaled nitric oxide (FeNO) and pulmonary function parameters were compared between the two groups. The interval time between beginning of follow-up and the first moderate to severe acute exacerbation and the times of acute exacerbation were recorded and compared between the two groups during one-year follow-up. Univariate analysis between serum IL-8 and variables was performed by Spearman correlation analysis. Cox regression was used to analyze the relative risk (RR) of acute exacerbation of the COPD patients in the two groups. Kaplan-Meier curve was used to analyze the proportion of the patients without acute exacerbation and hazard ratio (HR) during the follow-up in the two groups. Results The median levels of IL-8 were 170.00 (111.00, 472.00) pg/mL and 22.40 (7.90, 34.45) pg/mL in the high IL-8 group (n=47) and low IL-8 group (n=65), respectively. The proportion of allergic rhinitis cases and COPD assessment test (CAT) score were significantly higher in the high IL-8 group than those in the low IL-8 group (51.06% [24/47] vs 10.77% [7/65], P<0.01; 24.81±5.10 vs 19.38±4.27, P<0.01). The acute exacerbation times were significantly more in the high IL-8 group than those in the low IL-8 group (1.5 [1.0, 2.5] vs 1.0 [0.0, 1.5], P<0.01). Before inhaling bronchodilators, the high IL-8 group had significantly lower forced expiratory flow at 25%-75% of forced vital capacity (FEF25%-75%), FEF25%-75% as percentage of predicted, forced expiratory flow at 75% of forced vital capacity (FEF75%) and FEF75% as percentage of predicted versus the low IL-8 group ([0.73±0.55] L/min vs [1.26±1.15] L/min, [23.89±16.64]% vs [35.21±26.88]%, [0.32±0.19] L/min vs [0.57±0.53] L/min, and [25.32±13.27]% vs [39.97±29.42]%, all P<0.05). The serum IL-8 level was significantly negatively correlated with diffusion capacity for carbon monoxide as percentage of predicted (DLCO%Pred; r=-0.402 1, P=0.001 8), and the DLCO%Pred was significantly lower in the high IL-8 group than that in the low IL-8 group ([51.52±26.41]% vs [72.98±18.70]%, P=0.029). The cumulative risk of acute exacerbation was significantly higher in high IL-8 group than that in the low IL-8 group, with RR being 3.75 (95% confidence interval [CI] 1.200-11.716, P=0.029). The median interval time to the first acute exacerbation was significantly shorter in the high IL-8 group than that in the low IL-8 group (HR=3.066, 95% CI 1.053-8.927, P=0.039). Conclusion Serum IL-8 can be used as a predictive biomarker for acute exacerbation of COPD patients, which may involve allergic constitution, small airway function deterioration, and decreased diffuse capacity among these patients.

Separation and Identification of Microplastics in Digestive System of Bivalves / 分析化学

As a new type of pollutants,microplastics (small pieces of plastic with the longest dimension less than 5 mm) are bringing wide concerns by policy makers and researchers. The impact of microplastics on marine life is closely related to human health. Bivalves, as filter feeding creatures, can easily ingest microplastics in their feeding process. The microplastics in these bivalves can easily enter the human body through the food chain. In this study,a bivalve sample pretreatment method was established for separating the microplastics in their digestive system. Qualitative and quantitative analysis of microplastics was carried out by micro-Fourier transformed infrared spectroscope (μ-FT-IR) and Stereo microscope. By comparing the digestion systems of using 10% KOH and 30% H2O2, respectively, it was found that the digestion system using 10% KOH had better digestion efficiency. The recoveries of polypropylene (PP),polyethylene (PE), polystyrene (PS) and polyvinyl chloride (PVC) ranged from 96.7% to 98.6%, with RSD of less than 3.2%. Therefore, 10% KOH was used to digest organic tissue for separating the microplastics from the bivalves'digestive system. With this digestion system,the microplastics in Chlamys farreri from local markets and Mytilus galloprovincialis from both local markets and wild environments in Qingdao were separated and analyzed. The results showed that microplastics were found in over 80% of the individuals purchased from the market and 40% in the collected wild individuals. The average abundance of microplastics in Chlamys farreri purchased from different markets varied from 5.2 to 19.4 items/individual and 3.2-7.1 items/g, while in Mytilus galloprovincialis, the numbers varied from 1.9 to 9.6 items/individual and 2.0-12.8 items/g. Farmed mussels contained more microplastics (average 1. 9 items/individual, 3. 17 items/g) than wild mussels (average 0.53 items/individual, 2.0 items/g). There were various colors of microplastics. The detected microplastics came from three shapes: fibers, fragments and granules. Fibrous microplastics, being the most dominant ones,accounted for 84.11%. The average size of fibrous microplastics(0.66±0.70 mm) was larger than that of the other two shapes of microplastics. The number of microplastics decreased with increasing microplastic sizes. Microplastics of less than 500 μm coming from different markets were in the range of 26% to 84%. There was great spatial difference in the size of microplastics. The polymer composition of the microplastic was identified by μ-FT-IR. And it was found that the most common polymer component sin the samples were cellophane(CP),followed by polypropylene(PP). In the farmed mussels,PP was the most abundant component. The results showed that the abundance and types of microplastics in cultured or wild bivalves were closely related to their growing environment.

Asthenozoospermia is not correlated with 3' UTR polymorphisms of the GRP78 gene / 中华男科学杂志

<p><b>Objective</b>To investigate the correlation of the single nucleotide polymorphisms (SNPs) rs12009, rs1140763 and rs16927997 in the 3'-untranslated region (3'UTR) of the glucose-regulated protein 78 (GRP78) gene with the risk of male asthenozoospermia (AZS).</p><p><b>METHODS</b>We included 400 AZS patients in the AZS group and another 400 fertile men as normal controls. Using the SNaPshot technique, we genotyped the rs12009, rs1140763 and rs16927997 polymorphisms in the 3'UTR of the GRP78 gene in all the male subjects and analyzed the association of the three SNPs with AZS.</p><p><b>RESULTS</b>The percentage of progressively motile sperm was significantly lower in the AZS group than in the normal controls (［20.09 ± 8.18］ % vs ［57.16 ± 13.45］ %, P <0.01). Three genotypes of CC, CT and TT and 2 alleles of C and T were found in rs12009 and rs1140763 of the GRP78 gene, and another three genotypes of GG, GA and AA and two alleles of G and A were observed in rs16927997. There were no statistically significant differences between the control and AZS groups in the frequencies of the C and T alleles in rs12009 (44.3% vs 47.3% and 55.7% vs 52.7%, P >0.05) or rs1140763 (50.0% vs 52.0% and 50.0% vs 48.0%, P >0.05) or those of the G and A alleles in rs16927997 (6.0% vs 4.4% and 94.0% vs 95.6%, P >0.05), nor in the genotypes and allele frequencies of the 3 polymorphisms (P >0.05). Furthermore, three haplotypes of C-C-A, T-C-G and T-T-A were observed in the male subjects but showed no evident correlation between the AZS and normal control groups.</p><p><b>CONCLUSIONS</b>The polymorphisms in the 3'UTR of the GRP78 gene are not correlated with the risk of male asthenozoospermia.</p>

Research Progress on the Health Benefits and Mechanisms of Stretching Exercise / 中国康复理论与实践

@#Stretching exercise is a common method used in physical fitness training and exercise rehabilitation. The study about stretching exercise started from the motor system, then subsequently extended to other systems. This paper systematically reviewed the latest research progress on the influence of stretching exercise on multi-systems of the motor system, circulatory system, nervous system, endocrine system, respiratory system, and digestive system and the effects on pain and emotion, and briefly analyzed the related mechanism.

Clinical study on treatment of thoracolumbar spinal tuberculosis through one-stage anterolateral-posterior approach / 西安交通大学学报(医学版)

Objective To explore the clinical efficacy of one-stage anterolateral-posterior approach debridement,bone graft and internal fixation in treatment of thoracolumbar spinal tuberculosis.Methods From January 2010 to December 2014,56 cases of thoracolumbar spinal tuberculosis were retrospectively analyzed, including 31 males and 25 females,aged 18 -72 years (mean 43.1 years).All patients were managed by standard courses of chemotherapy with quadruple anti-TB drugs for 2 - 4 weeks.Patients were treated by anterolateral debridement,autologous iliac bone graft fixed by absorbable screw fixation,and posterior pedicle screw fixation via multi-split muscle gap (Wiltse approach).We recorded the operation time,the amount of bleeding,bone graft fusion,postoperative erythrocyte sedimentation rate (ESR),Cobb angle,VAS score,and American Spinal Injury Association (ASIA)score to evaluate the surgical results.Results The average operation time was 175-290 min, with an average of (248±42)min.The bleeding volume was 300 -900 mL with an average of (420 ±68)mL.The average follow-up time was (24 ± 5.2 )months,bone fusion rate was 100%,and fusion time was (4.7 ± 0.5 ) months.At the last follow-up,the average Cobb angle was (8.2±3.1)°,VAS was (2.1±0.8),and ESR was (17± 4.2)mm/h.The ASIA neurological functions were all classified as Grade E except for 3 cases of Grade D.All these were significantly different from the preoperative ones.Six patients had complications of different degree but without serious complications.Conclusion One-stage anterolateral debridement,autologous iliac bone graft fixedby absorbable screw fixation,and posterior pedicle screw fixation via multi-split muscle gap (Wiltse approach)can completely remove the tuberculosis lesions and achieve ideal kyphosis correction,high bone graft fusion,and satisfactory neurological function recovery.Absorbable screws can be safely applied to the bone graft site after debridement.

Clinical study on treatment of thoracolumbar spinal tuberculosis through one-stage anterolateral-posterior approach / 西安交通大学学报(医学版)

Objective To explore the clinical efficacy of one-stage anterolateral-posterior approach debridement,bone graft and internal fixation in treatment of thoracolumbar spinal tuberculosis.Methods From January 2010 to December 2014,56 cases of thoracolumbar spinal tuberculosis were retrospectively analyzed, including 31 males and 25 females,aged 18 -72 years (mean 43.1 years).All patients were managed by standard courses of chemotherapy with quadruple anti-TB drugs for 2 - 4 weeks.Patients were treated by anterolateral debridement,autologous iliac bone graft fixed by absorbable screw fixation,and posterior pedicle screw fixation via multi-split muscle gap (Wiltse approach).We recorded the operation time,the amount of bleeding,bone graft fusion,postoperative erythrocyte sedimentation rate (ESR),Cobb angle,VAS score,and American Spinal Injury Association (ASIA)score to evaluate the surgical results.Results The average operation time was 175-290 min, with an average of (248±42)min.The bleeding volume was 300 -900 mL with an average of (420 ±68)mL.The average follow-up time was (24 ± 5.2 )months,bone fusion rate was 100%,and fusion time was (4.7 ± 0.5 ) months.At the last follow-up,the average Cobb angle was (8.2±3.1)°,VAS was (2.1±0.8),and ESR was (17± 4.2)mm/h.The ASIA neurological functions were all classified as Grade E except for 3 cases of Grade D.All these were significantly different from the preoperative ones.Six patients had complications of different degree but without serious complications.Conclusion One-stage anterolateral debridement,autologous iliac bone graft fixedby absorbable screw fixation,and posterior pedicle screw fixation via multi-split muscle gap (Wiltse approach)can completely remove the tuberculosis lesions and achieve ideal kyphosis correction,high bone graft fusion,and satisfactory neurological function recovery.Absorbable screws can be safely applied to the bone graft site after debridement.

Discussions on diversity of new drug creation in China / 中草药

It is a long journey to create a new medicine from discovering the lead to market, which deal with various fields and aspects. There are also many ways and entrances or starting points for the creation of a new medicine. In this article, the following aspects including the ways from traditional Chinese materia medica, folk herbal medicine, active components, and structure modification involved in new medicine creation were discussed. Biomimetic syntheses, metabolites, and key technologies to affect the creative medicine were also summarized based on author's experiences. It is expected to be referenced information and inspired for the colleagues.

Ebola virus and innate immunity / 第二军医大学学报

Ebola virus disease (EVD) caused by Eora igs(EBOV) is one of the most violent infectious disease so far. It is so highly infective and fatal that there has beenno effective treatment until now. Ebola viral infection can cause a series of immune responses. Specific and nonspecific antistl innate immune deficiency in the hosts is a recognized important reason for EVD associated death. This paper reviewsheinfluence of EBOV on innate immune reaction of humans and the corresponding countermeasures.

Suspected or probable ebola virus disease cases in Liberia: Medical observation and treatment experience of 32 cases / 第二军医大学学报

Objective To summarize our experience on medical observation and treatment of 32 cases with suspected or probable Ebola virus disease (EVD) under level 4 personnel bio-protective condition in Liberia. Methods A total 32 suspected or probable EVD cases admitted in China Ebola Treatment Unk (ETU) in Liberia during January 14，2015 to March 14 were included in the present study. Khe doctors made the ward rounds under level C personal bio-protective conditions.1'hey were diagnosed by inquiring the detailed history and performing partial physical examination， and were given dihydroartemisinin piperaquine phosphate tablets (3 tablets，1/d &，levofloxacin (0. 5 g，1/d)，centrum (1 tablet，1/d &，oral rehydration satt (2 bags，3/d)，and nutrients (40 g，3/d) as basic treatments initially combined with supportive medication，which was aimed to relieve their symptoms. The clinical data， including the epidemiologic history， clinical symptoms and signs， diagnosis， treatment efticiency and adverse effects were retrospectively analyzed. Results The mean age of the 32 patients was (40. 53 13. 89) years old (ranging 14-83)，with 22 males and 10 females. The average time after the onset of illness was 4. 5(1-30) d. All the patients had fever， with the average maximum temperature being (38. 36 1. 01)C. The main symptoms included fatigue in 25 cases (78. 12X)，joint/muscle pain in 22 patients (68. 75X)，nausea/vomiting in 17 cases (53. 12X)，headache in 16 cases (50. 00X)，anorexia/loss of appetite in 15 cases (46. 88X)，diarrhea in 14 cases (43. 75X)，abdominal pain in 14 cases (43. 75X)，cough in 12 cases (37. 50X)，chest pain in 10 cases (31. 25X)，dyspnea in 5 cases (15. 62X)，dysphagia in 4 cases (12. 50X)，hiccup in 3 cases (9. 38X)， and gastrointestinal hemorrhage in 2 cases (6. 25X). The mean time of hospitalization was (3. 942. 29) d. The final clinical diagnosis were: acute gastroenteritis in 13 cases，acute respiratory tract infection in 7 cases， upper gastrointestinal bleeding in 1 case， ascites of unknown cause (suspected hepatoma) in 1 case， jaundice of unknown cause in 1 case，asthma exacerbation in 1 case，malaria in 1 case，and incomplete intestinal obstruction in 1 case. Twenty-six cases were discharged and 6 cases died，showing an improvement rate of 81. 25% (26/3z). The temperature restored the normal level in 23 cases and the mean time tt'took was (3. 511.60) d. The treatment was tolerable and there were no severe side effects. Conclusion Close medical, observation， professional inquiry and physical examination are important methods to make clinical diagnosis for suspected Ebola cases in ETU. Empiric therapy with oral drugs combined with supportive therapy is safe and effective for suspected or probable EVD patients in Liberia.

Study on effect of huatuo zaizao extractum on focal cerebral ischemia/reperfusion neurogenesis in rats and its mechanisms / 中国中药杂志

<p><b>OBJECTIVE</b>To observe the effect of Huatuo Zaizao extractum (HTZZ) on focal cerebral ischemia/reperfusion (I/R) neurogenesis in rats induced by middle cerebral artery occlusion (MCAO) and its mechanism.</p><p><b>METHOD</b>Totally 55 healthy adult male Sprague-Dawley rats were divided into the sham operation group, the MCAO model group and HTZZ high, middle and low dose groups (5, 2.5, 1.25 g x kg(-1)), with 11 rats in each group, and orally administered with drugs. The focal cerebral ischemia model was established by performing a middle cerebral artery occlusion (MCAO, 90 min) followed by a seven-day reperfusion (once a day). The neurogenesis and expressions of extracellular signal-regulated kinase (ERK) and cAMP response element binding protein (CREB) were detected by the immunofluorescent staining. The enzyme linked immunosorbent assay (ELISA) was adopted to determine the vascular endothelial growth factor (VEGF) and brain-derived neurotrophic factor (BDNF).</p><p><b>RESULT</b>MCAO (90 min) followed by a seven-day reperfusion resulted in the significant increase in the number of penumbra cortex newborn neurons (BrdU(+) -NeuN(+)), which was accompanied by the growth of ERK and CREB phosphorylation and VEGF and BDNF levels. HTZZ could promote the generation of newborn neurons (BrdU(+)-NeuN(+)) and the ERK and CREB phosphorylation and increase VEGF and BDNF levels at the ischemic side.</p><p><b>CONCLUSION</b>HTZZ could promote the neurogenesis, which may be the interventional targets of effective traditional Chinese medicine Huatuo Zaizao extractum in promoting the self-repair function of the cerebral ischemic areas.</p>

The effect of bone morphogenetic protein-2 on epithelial-mesenchymal transition in lung cancer cells and its related mechanism / 肿瘤

Objective: To investigate the effect of bone morphogenetic protein-2 (BMP-2) on epithelial-mesenchymal transition (EMT) of lung cancer cells and its possible molecular mechanism. Methods: Human lung adenocarcinoma cancer A549 cells were treated with different concentrations of BMP-2 (10, 50 and 100 μg/mL) for 24 h. The protein expression levels of EMT markers including E-cadherin (E-cad), vimentin and matrix metalloproteinase-2 (MMP-2) were detected by immunohistochemistry and Western blotting. The migration and invasion capacities of A549 cells were examined by wound healing and Matrigel invasion assays. The apoptosis was analyzed by cytometry flow (FCM). The EMT, migration and invasion capabilities and the apoptosis of A549 cells treated with p38 mitogen-activated protein kinase (p38 MAPK)-specific inhibitor SB203580 combined with 100 μg/mL BMP-2 were detected. Results: BMP-2 could reduce E-cad expression and increase vimentin and MMP-2 protein expressions in A549 cells in a concentration-dependent manner. The wound healing rate of the intervention group (100 μg/mL BMP-2) was significantly higher than that of the blank control group (P < 0.05). The number of the cells penetrating the membrane was increased significantly (P < 0.05), and the early apoptosis rate of A549 cells was decreased through 100 μ g/mL BMP-2 stimulation (P < 0.05). p38MAPK pathway-specific inhibitor SB203580 could partially decrease the expression of E-cad (P = 0.039) and increase the expressions of vimentin and MMP-2 (P = 0.023, P = 0.040). As compared with the cells treated with BMP-2 alone, the combination of BMP-2 and SB203580 could decrease the wound healing rate of A549 cells (P = 0.029), the number of the cells pentrating the membrane was reduced (P = 0.009), and the early apoptosis rate of the cells was increased (P = 0.046). Conclusion: BMP-2 can promote the EMT of human lung adenocarcinoma cancer A549 cells in vitro, inhibit the early apoptosis, and increase the migration and invasion capacities of lung cancer cells. This process is associated with the activation of p38MAPK signaling pathway.

Relationship between chronic obstructive pulmonary disease (COPD) assessment test score and prognostic factors of COPD patients / 第二军医大学学报

Objective To observe the correlation between chronic obstructive pulmonary disease (COPD) assessment test (CAT) score and prognostic factors, so as to investigate the value of CAT score in predicting the prognosis of COPD. Methods A total of 81 patients with newly diagnosed COPD in our hospital during Jul. 2011 to Sep. 2012, without using inhaled corticosteroid (ICS)/long-acting β2 agonist (LABA) or long-acting antimuscarinic agent (LAMA), were divided into group A (low risk, less symptoms), B (low risk, more symptoms), C (high risk, less symptoms) and D (high risk, more symptoms) groups according to Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2011 edition), and the patients were given ICS/LABA or ICS/LABA+ LAMA treatment for 3 months. The CAT score, age, smoking quantity, pulmonary function indices, body mass index (BMI), 6-min walking distance (6MWD), modified medical British research council (mMRC) dyspnea scale, and the times of acute exacerbation of COPD (AECOPD) in previous one year were collected before and after treatment. The clinical characteristics analysis and correlation analysis were performed. Results The average age of the 81 COPD patients was (66.27±8.52) years, with 88.89% being males and 85.19% having smoking history. The proportions of group A, B, C and D were 8.64%, 30.86%, 4.94% and 55.56% before treatment, repectively. The values of the forced expiratory volumein one second (FEV1), predicted amount as a percentage of FEV1 (FEV1%Pred), forced vital capacity (FVC), predicted amount as a percentage of FVC (FVC% Pred), peak expiratory flow (PEF), predicted amount as a percentage of PEF (PEF%Pred), and 6MWD in CAT score ≥ 10 groups were significantly less than those in CAT score 10 group (P < 0. 05). The above parameterswere not significantly different between patients with CAT score being 10-20, 20-30 and ≥ 30 groups. mMRC scale and times of AECOPD in CAT score ≥20 groups were significantly higher than those in CAT score 10 group (P < 0. 05). No significant difference in FEV1/FVC was found in different CAT score groups. The CAT score was significantly correlated with mMRC scale (pre-treatment r2 = 0. 417, P lt; 0. 001; post-treatment r2 =0. 19, P < 0. 001), 6MWD (pretreatment r2 = 0. 320, P < 0. 001 post-treatment r2 = 0. 19, P < 0. 001), pre-treatment FEV1 (r2 = 0. 177, P = 0. 001 5), FEV1 %Pred(r2 = 0. 125, P = 0. 002), PEF(r2=0. 164, P = 0. 002 4), PEF%Pred (r2=0. 129, P = 0. 007 6), FVC (r2 = 0. 098, P=0. 021), FVC%Pred (r2 = 0. 094, P = 0. 024), FEV1/FVC(r2 = 0. 101, P = 0. 005 7), and AECOPD number (r2 = 0. 059, P = 0. 028); and not correlated with the quantity of smoking (r2 = 0. 041, P = 0. 083), BMI (r2 =0. 00, P = 0.89), and post-treatment FEV1 (r2 =0. 01, P = 0. 22) or FEV1 %Pred (r2 =0. 003, P = 0. 09). Conclusion COPD is prone to occur in the male smokers, with the highest proportion found in group D. CAT score has a good correlation with pre- and pos-- treatment mMRC scale and exercise capacity, suggesting it has a potential for predicting prognosis of COPD.