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ObjectiveTo investigate the mechanism of quercetin in regulating chondrocyte extracellular matrix metabolism and inflammatory response in knee osteoarthritis （KOA） from the perspective of autophagy. MethodChondrocytes were extracted and cultured， and the primary cells were identified by immunofluorescence staining with collagen Ⅱ. The chondrocytes induced by lipopolysaccharide （LPS） were divided into a control group （without any treatment）， a model group （10 mg·L-1 LPS treatment for 48 h）， and low-， medium-， and high-dose quercetin group （10 mg·L-1 LPS treatment for 48 h combined with 50， 100， and 150 mmol·L-1 quercetin for 24 h）. The inhibitory effects of LPS （2.5， 5， 7.5， 10， 12.5 mg·L-1） on the proliferation of chondrocytes for different periods （24， 48， 72 h） were detected by cell counting kit-8 （CCK-8）. The effects of quercetin （50， 100， 150， 200 mmol·L-1） on the LPS-induced proliferation of chondrocytes for different periods （12， 24， and 48 h） were investigated. The expression of microtubule-associated protein 1 light chain 3Ⅱ （LC3Ⅱ） and ubiquitin-binding protein p62 was detected by Western blot. LPS-induced chondrocytes were treated with 3-methyladenine （3-MA）. The resultant cells were divided into a control group （without any treatment）， a model group （10 mg·L-1 LPS）， a quercetin group （model group + 100 mmol·L-1 quercetin）， a 3-MA group （model group + 100 μmol·L-1 3-MA）， and a 3-MA + quercetin group （model group + 100 μmol·L-1 3-MA + 100 mmol·L-1 quercetin， specifically， LPS for 48 h， 3-MA for 2 h， and then quercetin for 24 h）. The content of interleukin （IL）-1β and tumor necrosis factor （TNF）-α was determined by enzyme-linked immunosorbent assay （ELISA）. The protein expression of matrix metalloproteinase 13 （MMP-13） and tissue inhibitor of metalloproteinase 1 （TIMP1） was detected by Western blot. ResultCollagen Ⅱ immunofluorescence staining showed that the extracted cells were consistent with the characteristics of chondrocytes. As revealed by CCK-8， the optimum concentration of LPS was 10 mg·L-1 with an action time of 48 h， and the optimum concentration of quercetin was 100 mmol·L-1 with an action time of 24 h. Western blot results showed that compared with the control group， the model group showed decreased expression of LC3Ⅱ （P<0.01） and increased expression of p62 （P<0.01）. The expression of LC3Ⅱ in the quercetin groups was higher than that in the control group （P<0.01）， especially in the medium-dose quercetin group. The p62 expression in the quercetin groups was lower than that in the control group （P<0.01）， especially in the medium-dose quercetin group. Compared with the control group， the model group showed increased expression of MMP-13 （P<0.05） and decreased expression of TIMP1 （P<0.01）. Compared with the model group， the quercetin groups and the 3-MA + quercetin group showed decreased expression of MMP-13 （P<0.05， P<0.01）， especially the quercetin groups， and increased expression of TIMP1 （P<0.01）， especially the quercetin groups. Morphological changes in chondrocytes under the inverted microscope showed that quercetin could restore the morphology of damaged chondrocytes. CCK-8 showed that compared with the control group， the model group showed inhibited chondrocyte proliferation （P<0.01）， and compared with the model group， the quercetin groups and the 3-MA + quercetin group showed promoted chondrocyte proliferation （P<0.01）， especially the quercetin groups. ELISA results showed that IL-1β and TNF-α levels in the model group were higher than those in the control group （P<0.01）， and the levels of IL-1β and TNF-α in the quercetin groups and the 3-MA + quercetin group were lower than those in the model group （P<0.05， P<0.01）， and the decrease in the quercetin groups was the most significant. ConclusionQuercetin can promote LPS-induced chondrocyte proliferation， regulate chondrocyte extracellular matrix synthesis and metabolic balance， inhibit the inflammatory response， and restore chondrocyte function. The mechanism may be related to the activation of autophagy by quercetin.
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The management of drug clinical trial institutions from the risk management point of view is investigated. According to the technology of risk assessment in risk management, taking the project audit as an example, basing on the basic procedures of risk identification, risk assessment and risk control, making 8 risk factors into the table of risk management for project approval of clinical trial in order to initially establish a risk management of drug clinical trial institutions. In this way, the management quality of project for drug clinical trials will be probably improved, so that the risk incidence rate will be effectively reduced in the later phase of clinical trial.
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Objective To evaluate the clinical characteristics and etiologies of central diabetes insipidus (CDI).Methods The clinical data of 230 patients with CDI in the Department of Endocrinology of Chinese PLA General Hospital from 2008 June to 2014 December were collected and analyzed retrospectively.Results The three most common causes of CDI were idiopathic CDI,lymphocytic hypophysitis and intracranial germ cell tumors.Among all the CDI,the idiopathic CDI accounted for 37.48％.There were significant differences in age onset and gender distribution among the different causes of CDI.The patients with intracranial germ cell tumors [age of onset(19.2± 10.2) years] were younger than the other types of CDI.Germ cell tumors patients were more common in male,and lymphocytic hypophysitis patients were more common in female.The most frequent abnormality of anterior pituitary in patients with CDI was growth hormone deficiency,followed by hypogonadism,adrenal insufficiency and hypothyroidism.The dysfunction of thyroid axis and adrenal axis in patients with germ cell tumor was more common than those in patients with idiopathic and lymphocytic hypophysitis.Conclusions The most common causes of central diabetes insipidus were idiopathic CDI,lymphocytic hypophysitis and intracranial germ cell tumors.There were differences in age of onset,gender distribution and abnormal production of anterior pituitary hormones among all causes of CDI patients.
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Objective To explore the clinical effect of autogenous bone,allograft bone and BMP synthetic bone in the treatment of lum-bar spondylolisthesis,and provide more basis to choose transplant material.Methods A total of 96 patients with lumbar spondylolisthesis were chosen as research subjects,who were cured in our hospital from January 2014 to January 2015.They were divided into group A(who were treated with autogenous bone),group B(who were treated with allograft bone)and group C(who were treated with BMP synthetic bone), according to prospective study method.The indicators of the operation,postoperative adverse reactions,change of intervertebral disc height and bone graft fusion rate of three groups were compared.Results Difference of the operation indexes of three groups had no statistical sig-nificance(P >0.05).The incidences of adverse reactions in group A and group C had no statistically significant difference(P >0.05),but both less than that in group B,with statistically significant difference(P 0.05),but both more than that in group B,with statistically significant difference(P 0.05).And the fusion rates of group A and C in each period were significantly higher than that of group B,with statistically significant difference(P 0.05),but both better than that of group B,with statistically significant difference (P <0.05).Conclusion BMP synthetic bone used in lumbar spondylolisthesis has the same clinical effect as autologous bone.But BMP synthetic bone has faster bone graft fusion rate than autologous bone.And it is beneficial to patients’recovery.
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Objective:To investigate the diagnosis and treatment significance of invasive and noninvasive operation for ventilator?as?sociated pneumonia ( VAP ) . Methods:A total of 80 cases of VAP suspected patients who had received mechanical ventilation at least 48 hours in ICU from Jun 2014 to Mar 2015 were enrolled. Patients were randomly divided into four groups including noninvasive operation group ( F) , invasive operation group ( Q) , mix group 1 ( H1) and mix group 2 ( H2) . VAP diagnosis rate between groups as well as living time, antibiotic use time, survival rate, calcitonin levels and APACHE II score, oxygenation index were analyzed. Results:Specimen from invasive operation had higher specimens to cultivate positive rate than that from noninvasive operation ( P<0?05), but there was no statistic significant difference in VAP diagnosis rate between two methods (P>0?05). Conclusion:Noninva?sive operation collecting samples for VAP diagnosis is also accurate as invasive one. Collecting specimens from sputum suction tube in the clinical treatment on airway suction is a low cost and simple noninvasive operation.
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BACKGROUND:Arthroscopic treatment of tibial eminence fracture requires tiny wire,induces less epiphyseal plate damage during operations,obtains strong fixations,alows early movement postoperatively,obviously attenuate the injuries,facilitate wound healing,and reduce complications.OBJECTIVE:To investigate the biocompatibility of arthroscopic reduction and wire fixation in treatment of fresh and old tibial eminence fractures.METHODS:Twenty-five patients with fresh and old tibial eminence fractures were treated with arthroscopic reduction and wire fixation from January 2010 to April 2012 in the Second People's Hospital of Yichang City.The postoperative fracture healing time and knee function improvement in the two groups were observed.RESULTS AND CONCLUSION: Compared with the fresh fracture patients,the fracture healing time was longer,Lachman test positive rate was higher in the old fracture patients than (P＜0.05),knee flexion and extension activity and Lysholm score were lower (P＜0.05).Experimental findings indicate that,arthroscopic reduction and wire fixation is a feasible clinical treatment of fresh and old tibial intercondylar eminence fractures.
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Objective To investigate the protective effect of Buyang Huanwu Decoction ( BYHWD) on PC12 cell apoptosis induced by oxygen-glucose deprivation ( OGD) and to screen out the main ingredients of BYHWD on protecting PC12 cell from injury induced by OGD. Methods Seven herbs of BYHWD were selected as the influencing factors, and they were Radix Astragali, Radix Paeoniae Rubra, the carda part of Radix Angelicae Sinensis, Pheretima Asiatica, Rhizoma Chuanxiong, Semen Persicae, and Flos carthami. Two levels were designed for each factor, and the experiment was arranged according to L8 ( 27) orthogonal test table. Apoptosis of PC12 cells induced by OGD was detected by serum pharmacology method and flow cytometry techniques. With apoptotic rate as the evaluation index, visual analysis and variance analysis were used for the comparison of apoptosis of PC12 cells in the blank control group ( oxygen + sugary medium + blank serum) , model group (oxygen-glucose-free medium + blank serum) and drug groups (oxygen-glucose-free medium +serum containing BYHWD or the separate recipe of BYHWD ) . Results Compared with the blank control group, apoptotic rate was increased in PC12 cells of the model group, the difference was statistically significant ( P<0.01) . Compared with the model group, the apoptotic rate was decreased in BYHWD group, and the differences was statistically significant (P<0.01) . The results of orthogonal analysis showed that Semen Persicae, Flos carthami and Radix Paeoniae Rubra were the main active ingredients of BYHWD on depressing apoptosis of PC12 cell induced by OGD ( P<0.01). The apoptotic rate of serum containing the prescription with Radix Paeoniae Rubra was lower than that of the prescription without Radix Paeoniae Rubra. Conclusion BYHWD could inhibit OGD-induced PC12 cell apoptosis, and Radix Paeoniae Rubra is the main active herb on depressing apoptosis in BYHWD.
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Objective To study the preventive effect and mechanism of aesculin on intestinal mucosa in rats with experimental ulcerative colitis (UC) . Methods Forty specific-pathogen free SD rats were randomly divided into normal group, model group, salicylazosulfapyridine (SASP, 600 mg/kg) group and aesculin (EH, 100 mg/kg) group, 10 in each group. Rats in model group, SASP group and EH group were given enema with trinitrobenzene sulfonic acid ( TNBS, 100 mg/kg) for the establishment of UC model. The rats in SASP group and EH group were given gastric gavage of SASP and aesculin respectively. At the end of experiment, the serum levels of tumor necrosis factor alpha ( TNF-α) and interleukin 10 ( IL-10) were detected by enzyme-linked immunosorbent assay (ELISA) . The general state, histological features of intestinal mucosa and serum TNF-αand IL-10 levels of rats in each group were compared. Results Aesculin significantly improved the general state and relieved the inflammation of the colonic mucosa of UC rats. The disease activity index ( DAI) scores and tissue damage index (TDI) scores in the model group were significantly higher than those in the normal group ( P<0.01) . The DAI scores and TDI scores in the medication groups were significantly lower than those in the model group (P<0.01) . The serum TNF-αlevel was significantly higher and IL-10 level was significantly lower in the model group than the normal group ( P<0.01) . After treatment, TNF-α was decreased and IL-10 was increased in SASP group and EH group as compared with the model group (P<0.01) . Conclusion Aesculin has certain therapeutic effect on TNBS-induced UC in rats through significantly relieving the symptoms of UC rats. The mechanism may be related with the inhibition of TNF-α secretion and the increase of IL-10 expression, and then improving the disorder of intestinal immune function.
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Objective To compared different fixation methods for acetabular fractures involving the quadrilateral plate using a finite element model of the acetabulum.Methods A model of acetabular fractures with quadrilateral plate involved was developed in the finite element software and processed in Hypermesh V10.0 to generate internal fixation with dual-column titanium plate (Group A),anterior special titanium moulding plate plus quadrilateral screws (Group B),and anterior special titanium moulding plate plus quadrilateral screws combined with posterior column screws (Group C).Pelvic stress in sitting and standing positions were simulated in sequence with constraint of tuber nodes and inferior femur.Maximum stress and displacement of the acetabulum and displacement of nodes on fracture lines were measured after a force of 600 N was applied to S1 verterbrae in line with the direction of gravity in sitting and standing positions.Results In sitting position,the maximum stress and displacement of the acetabulum exhibited a sequence of Group C (9.47,1.08) ＜ Group B (19.84,1.11) ＜ Group A (29.73,1.14).Moreover,the same result was found in standing position with Group C (9.62,1.09) ＜ Group B (12.18,1.10) ＜ Group A (13.28,1.13).Mean displacement of nodes on fracture lines ranked in order of Group C ＜ Group B ＜ Group A (P ＞ 0.05).Conclusions The finite element model can reflect the distribution of pelvic stress effectively.Anterior special titanium moulding plate plus quadrilateral screws combined with posterior column screws provide favorable biomechanical stability in treatment of acetabular fractures involving the quadrilateral area.
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Objective To establish the modified Ziehl-Neelsen acid -fast staining method and to investigate the value of modi-fied Ziehl-Neelsen acid-fast staining method of bronchoalveolar lavage fluid in the diagnosis of pulmonary tuberculosis(TB)with negative sputum specimen.Methods 50 cases of negative sputum pulmonary TB were performed the bronchoalveolar lavage by the fiberoptic bronchoscope before the treatment,at the same time,the bronchoalveolar lavage fluids were collected and detected by the two methods of the traditional and modified Ziehl-Neelsen staining.The diagnostic positive rates were compared between the two groups.Results The positive rates of the two kinds of acid-fast staining method were 38% and 82% respectively,the difference showing statistical significance(P <0.05 ).Conclusion The modified Ziehl-Neelsen acid-fast staining of bronchoalveolar lavage fluid can highly improve the positive diagnostic rate of pulmonary TB patients with negative sputum and deserves to be clinically promoted.
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Objective To evaluate the relationship between 25-(OH) vitamin D [25-(OH) D] level and peripheral neuropathy in patients with type 2 diabetes mellitus.Methods Eighty patients with type 2 diabetes mellitus were enrolled in this cross-sectional study,including 37 subjects with and 43 without diabetic neuropathy.Anthropometric data was collected and serum levels of 25-(OH) D,HbA1c,blood lipid,and hepatic and renal functions were determined in all patients.Results Serum 25-(OH) D level was significantly lower in patients with diabetic neuropathy compared to those without neuropathy [(12.73 ± 4.68 vs 17.56 ± 5.28) ng/ml,P＜0.01].Logistic regressions demonstrated that vitamin D level was associated with diabetic neuropathy (OR=1.222,95％ CI 1.095-1.364).Conclusions Vitamin D insufficiency is associated with diabetic peripheral neuropathy.25-(OH) D level seems to be an independent risk factor of diabetic neuropathy in patients with type 2 diabetes mellitus.
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Many previous studies have shown that auditory cortical neurons are sensitive to sound spatial information, however, the mechanism of sound spatial coding is still not fully understood. Until now, detail studies on sound spatial coding have not been reported in the rat primary auditory cortex. Using electrophysiological technique, spatial response areas of 151 neurons in the rat primary auditory cortex were investigated. The relationships between spike counts and average first-spike latencies in the spatial response areas were analyzed. The results showed that, the majority (52.32%) of cortical neurons exhibited contralateral preference in the frontal auditory space whereas other neurons exhibited ipsilateral preference (18.54%) and midline preference (18.54%), and only a few neurons were included in the category of omnidirection (3.31%) and complex (7.28%). For the majority of cortical neurons, the arithmetic center of the preferred spatial area were distributed in the up and middle portion of the contralateral space relative to the recording side. Most neurons responded strongly to stimuli from their preferred space with shorter average first-spike latencies, and responded weakly to stimuli from non-preferred space with longer average latencies. In the spatial response area, the spike counts were negatively correlated with average first-spike latencies. The auditory cortex might use the information of both spike counts and average response time to code sound spatial information.
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Three-dimensional virtual surgery experiment is the application of virtual reality technology in the medical field.Doctors use the information in the virtual environment to develop surgical planning,surgical drills.surgical teaching,surgical skills training,to lead the surgical technique and postoperative rehabilitation,and the information is available for surgery every sur-gical member to share.Virtual Surgery experiments combined with the real operation together constitute complete experimental teaching system,making telemedicine experimental teaching methods and teaching content rich and varied.
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BACKGROUND: After reviewing the literature, the author found that most of the epidemiological data related to cancer pain was reported by physicians from the point of view of treatment, or of patients' response to the treatment. Although the nurses in oncology department are most direct participants in the cancer pain management, there is less investigation about the nurses' knowledge, attitudes to and skills of cancer pain management.OBJECTIVE: The purpose of this investigation was to provide information so as to suggest the nursing managers and educators in specifically propagating and disseminating the knowledge of cancer pain management.DESIGN: A sampled investigation.SETTING: Integrated Medicine Ward, College of Clinical Oncology,Peking University.PARTICIPANTS: The participants of this investigation were 128 nurses who took part in the National Tumor Care Academic Exchanges and Seminar Conference held in June 1998.METHODS: This investigation was carried out through a survey questionnaire and the questionnaire was designed on the basis of the Cancer Analgesics Questionnaire (for nurses use only) established by the Oncology Profession Committee of Chinese Nursing Association in 1993, furthermore,suggestions from experts were adopted.MAIN OUTCOME MEASURES:①The perception about "three-step analgesic ladder";②currently most commonly used analgesics in clinical;③assessment methods for cancer pain④knowledge of being addicted to analgesics⑤attitude of nursing staff to cancer pain management.RESULTS: The number of those who could correctly designate the relationship of three steps and pain intensity was 82(64.0% ). Only one person could correctly write down the contents of three steps analgesic ladder (0.7%) . Physician's orders for analgesics for cancer pain in the responders' hospitals were classified into the following types: temporary order:54.0%; when necessary, 38.0%; long-term order, 24.0%. But none of the nurses could mark correctly the range of mild, moderate and severe grade on the scale. Only 49.2% (63/128) of the nurses considered that "The pain scale should be determined according to the cancer patients' self-perception to the pain intensity(chief complaint)" . Among the responders, only 12.5% (16/128) of them accepted that "the incidence of addiction occurred as a result of analgesics used for pain control is less than 1% ". Only 26. 5% (34/128) of the responders could distinguish the concepts of tolerance, physical dependence, and addiction.CONCLUSION: From the results of the investigation, we can see that, the nursing professionals do not have sufficient knowledge about "three-step analgesic ladder". The popularization of related knowledge among nurses has been delayed severely. Nurses will obtain the knowledge of cancer pain management by clinical experience instead of in regular ways. The attitude of nursing personnel to cancer pain treatment is one of the important factors that affect the pain management. The frontline nurses should master the pharmacological characteristics of opioids so as to explain it to the patients and their relations distinctly. Nurses should bring into play a more powerful action in reducing the "addiction-phobia" due to their professional characteristics. We suggest that the latest new progress in cancer pain treatment should be incorporated into the normal textbooks on the management of cancer pain. We also propose that the methods of cancer pain treatment,contents of the principle of drug prescription be included in the training of a medical care personnel of oncology professional before entering into clinic.
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BACKGROUND: Trigeminal ganglion percutaneous puncture is one of the methods for the therapy of primary trigeminal neuralgia. The difficulties in percutaneous puncture technique and operation can lead accidental injury and some serious complications. The application of DZY-C trigeminal nerve stereoguide in the treatment of trigeminal neuralgia has the features of high accuracy in puncture and low complications, which can reduce the chances of accidental injury to surrounding vessels and nerves.OBJECTIVE: To evaluate the therapeutic effects of DZY-C trigeminal nerve stereoguide in the treatment of trigeminal neuralgia.DESIGN: A before-and-after experimental study based on patients.SETTING: Department of cerebral surgery of a municipal hospital of tradi tional Chinese medicine and a municipal hospital.PARTICIPANTS: Ninety patients including 39 male and 51 female patients with primary trigeminal neuralgia aged between 21 and 90 years old were selected from outpatient or inpatient department of Foshan Hospital of Traditional Chinese Medicine between 2001 and 2003.INTERVENTIONS: Glycerine was injected into trigerminal ganglion of each patient through percutaneous puncture under the guidance of DZY-C trigeminal nerve stereoguide. Therapeutic effects were evaluated by visual analogue scale(VAS) before and 30 minutes after the treatment.MAIN OUTCOME MEASURES: Results of therapeutic effects.RESULTS: Ninety patients with primary trigeminal neuralgia received trigeminal ganglion puncture with the application of DZY-C trigeminal nerve stereoguide. All punctures succeeded with one shot. After the injection of glycerine, the original trigeminal neuralgia disappeared in all 90 cases with the good and excellent rate of 100%.CONCLUSION: Trigeminal nerve stereoguide(DZY-C model) has the features of reasonable structural design, easy surgical operation, agile adjustment, less tissue injury, and safe manipulation, which can significantly eliminate trigeminal neuralgia.
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300mg%). Conclusion: Acetylshikonin's content was high, radix arnebiae oil colour was very red, It was up to the mustard.
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AIM: To explore the influence of processing with fresh-scorpion on element contents in crude scorpion in order to elucidate the processing method. METHODS: Macro-elements Ca,Mg and trace-elements Fe,Cu,Zn and Pb in crude scorpion were determined with emission spectrometric method. RESULTS: Contents of Ca,Mg in live-scorpion group were obviously lower than that in commercial-scorpion(P0.05). CONCLUSION: Processing with live-scorpion has obviously advantage over one with commercial scorpion on element contents.