Clinical features and risk factors of pulmonary hemorrhage in extremely preterm infants / 中国新生儿科杂志

Objective:To study the clinical features and risk factors of pulmonary hemorrhage in extremely preterm (EPT) infants.Methods:From February 2018 to January 2022, EPT infants admitted to NICU of our hospital and diagnosed with pulmonary hemorrhage were retrospectively assigned into the observation group and those without pulmonary hemorrhage were assigned into the control group. Univariate analysis and multivariate logistic regression analysis were used to compare the clinical features and determine risk factors of pulmonary hemorrhage in EPT infants.Results:A total of 114 EPT infants were included, including 28 cases (24.6%) in the observation group with pulmonary hemorrhage and 86 cases in the control group. Pulmonary hemorrhage mainly occurred within the first week after birth. Univariate analysis showed that the observation group had higher incidences of following events than the control group: birth asphyxia, delivery room intubation, severe respiratory distress syndrome, hyperglycemia, thrombocytopenia, severe acidosis, shock, score for neonatal acute physiology with perinatal extension-Ⅱ (SNAPPE-Ⅱ) ≥37 and the highest lactate level. Birth weight was lower in the observation group than the control group ( P<0.05). Logistic regression analysis showed that SNAPPE-Ⅱ≥37, shock and hyperglycemia were risk factors of pulmonary hemorrhage ( OR=4.081, 4.610 and 3.355, respectively, all P<0.05). The incidences of mortality and intracranial hemorrhage in the observation group were higher than the control group. The duration of mechanical ventilation in the observation group was longer than the control group ( P<0.05). No significant differences existed in the duration of nasal continuous positive airway pressure, assist mechanical ventilation and total oxygen use, the incidences of grade Ⅱ-Ⅲ bronchopulmonary dysplasia, retinopathy of prematurity and the length of hospital stay ( P>0.05). Conclusions:SNAPPE-Ⅱ≥37, shock and hyperglycemia are early risk factors for pulmonary hemorrhage in EPT infants. EPT infants with pulmonary hemorrhage have higher incidences of mortality and intracranial hemorrhage, requiring longer periods of mechanical ventilation.

Repair of KuwadaⅡand Ⅲ Achilles tendon defects through modified medial J-shaped approach with autologous fascia lata transplantation / 中国骨伤

OBJECTIVE@#To investigate the clinical effect of modified medial J-shaped incision of Achilles tendon combined with fascia lata transplantation in the treatment of Kuwada typeⅡand Ⅲ Achilles tendon defects.@*METHODS@#From January 2016 to August 2018, the clinical data of 15 patients with KuwadaⅡand Ⅲ Achilles tendon defects treated with modified J-shaped approach with autologous fascia lata transplantation were retrospectively analyzed, including 14 males and 1 female, with an average age of 31.7 years old ranging from 24 to 43. There were 9 cases of KuwadaⅡdefect and 6 cases of KuwadaⅢ defect. Postoperative observations were made for incision complications, and the Arner-Lindholm scoring standard was used to evaluate the function of the affected foot at the last follow-up.@*RESULTS@#All 15 cases were followed up from 3 to 16 months with an average of 9.2 months. No skin necrosis or infection occurred after operation, and no Achilles tendon rupture occurred again. According to the Arner-Lindholm scoring standard, 13 cases were excellent, 2 cases were good.@*CONCLUSION@#Modified medial J-shaped incision is a satisfactory approach for repairing Achilles tendon defects. It is helpful to prevent postoperative incision complications, which double-strengthen the Achilles tendon strength, so that patients can perform early rehabilitation and functional exercises with satisfactory clinical results.

Effect of piceatannol against malignant melanoma / 华西口腔医学杂志

OBJECTIVES@#To study the antitumor effect of piceatannol (PIC) on malignant melanoma @*METHODS@#B16F10 cells were cultured @*RESULTS@#The cell viability of B16F10 decreased with increasing PIC concentration. The results of the Transwell assay showed that invasion ability decreased with increasing PIC concentration, and healing time was prolonged at increased PIC concentration in the wound healing assay. Western blot results showed that PIC mainly inhibited the phosphorylation of Syk and inhibited the expression of MMP-2, MMP-9, and VEGF. RNA interference pointed out that blocking the expression of Syk can reveal the same inhibition effect on B16F10 cells as PIC. @*CONCLUSIONS@#PIC might block the progression of malignant melanoma by inhibiting spleen tyrosine kinase.

Construction and verification of an intelligent measurement model for diabetic foot ulcer / 中南大学学报(医学版)

OBJECTIVES@#The measurement of diabetic foot ulcers is important for the success in diabetic foot ulcer management. At present, it lacks the accurate and convenient measurement tools in clinical. In recent years, artificial intelligence technology has demonstrated the potential application value in the field of image segmentation and recognition. This study aims to construct an intelligent measurement model of diabetic foot ulcers based on the deep learning method, and to conduct preliminary verification.@*METHODS@#The data of 1 042 diabetic foot ulcers clinical samples were collected. The ulcers and color areas were manually labeled, of which 782 were used as the training data set and 260 as the test data set. The Mask RCNN ulcer tissue color semantic segmentation and RetinaNet scale digital scale target detection were used to build a model. The training data set was input into the model and iterated. The test data set was used to verify the intelligent measurement model.@*RESULTS@#This study established an intelligent measurement model of diabetic foot ulcers based on deep learning. The mean average precision@.5 intersection over union (mAP@.5IOU) of the color region segmentation in the training set and the test set were 87.9% and 63.9%, respectively; the mAP@.5IOU of the ruler scale digital detection in the training set and the test set were 96.5% and 83.4%, respectively. Compared with the manual measurement result of the test sample, the average error of the intelligent measurement result was about 3 mm.@*CONCLUSIONS@#The intelligent measurement model has good accuracy and robustness in measuring the diabetic foot ulcers. Future research can further optimize the model with larger-scale data samples.

Detection methods and devices of visual detection in closed tube recombinase polymerase amplification of hepatitis B virus / 医学研究生学报

ObjectiveThe traditional detection method of recombinase polymerase amplificaton (RPA) is not suitable for rapid field detection due to the complicated operation and other factors. Taking the detection of hepatitis b virus (HBV) nucleic acid as an example, it established a detection method of HBV nucleic acid isothermal amplification based on recombinase polymerase amplificaton (RPA) and designed a matching visual detection device of RPA product.MethodsFirstly, a RPA product detection device was designed, which can be used to collect images by taking photos of mobile phones and visually interpret the detection results. Secondly, RPA primers and probes were designed according to the design of HBV gene conserved sequence. Amplification efficiency of each primer pairs were compared though monitoring the RPA reaction of real-time fluorescence curve to screen the best primers and optimize the optimal reaction conditions. Visual detection sensitivity was investigated by using artificial synthesis of HBV target plasmid, and was investigated the specificity of the method by the detection of synthetic plasmid containing hepatitis c virus (HCV), human immunodeficiency virus, treponema pallidum, influenza virus, human papilloma virus DNA fragment. Thirdly, the feasibility of RPA product visualization detection device was verified by comparing with the real-time fluorescence amplification curve. Finally, RPA visual detection was performed on 20 serum DNA samples detected by real-time fluorescence PCR to evaluate the applicability of this method to the detection of actual clinical samples.ResultsThe visual detection device of RPA product was used to realize the negative and positive signals that could be detected by mobile phone photography and visual observation. The visual detection method of HBV nucleic acid RPA amplification could realize the visual detection of DNA targets as low as 1-10 copies of HBV within 30 min at 39 ℃ and had good specificity. The test results of 20 serum DNA samples were completely consistent with those of the commercially available qPCR kit, which preliminarily verified the practicability of the method and the device.ConclusionCombined the established HBV-RPA amplification system with the RPA product visualized detection device, it would be expected to develop a low-cost rapid visualization screening technology platform for HBV nucleic acid in blood.

Comparison of three different posterior cervical approaches for treating cervical spine trauma with ossification of posterior longitudinal ligament / 中华外科杂志

Objective@#To investigate the clinical application value of using laminoplasty combine with short-segment pedicle screw fixation in the treatment of cervical spine trauma patients with ossification of posterior longitudinal ligament (OPLL).@*Methods@#Fifty-four cervical spine trauma patients with OPLL from June 2014 to June 2016 were retrospectively analyzed of Department of Spine Surgery, Changzheng Hospital, Naval Military Medical University. There were 31 males and 23 females, aging (68.4±4.3) years (rang: 46 to 82 years). All patients had a history of cervical spine trauma, confirmed by imaging examination of OPLL, and there are signs and symptoms related to cervical spinal cord compression. Eighteen patients underwent one-stage laminoplasty combine with short-segment pedicle screw fixation(group A), and 15 patients underwent posterior cervical laminectomy and pedicle screw fixation (group B). Twenty-one patients underwent posterior laminoplasty (C group). According to the range of OPLL and the compression of the spinal cord, the range of laminoplasty was selected. MRI scan was used to evaluated the compression condition of cervical spine and the injury condition of anterior longitudinal ligament injury and other factors that can cause local instability of the cervical spine. Posterior unilateral pedicle screw fixation (two pedicles) were performed in the instability segment. The neurological function of the patients was assessed by the Japanese Orthopedic Association (JOA) Score before surgery, the second day after surgery, 3 months, 1 year and the last follow-up. The cervical spine X-ray films were used to evaluate cervical curvature, cervical spine activity and internal fixation-related complications.@*Results@#The average follow-up time was 18 months (6-30 months). Satisfactory neurological improvement was achieved in all three groups, and no internal fixation-related complications occurred during follow-up. The range of laminoplasty was 22 cases in 4 segments (C3-C6, C4-C7) and 17 cases in 5 segments (C3-C7). Unilateral pedicle screw fixation was performed in 11 patients with C3-4 fixation and 7 patients with C4-5 fixation. Cervical curvature was basically the same in the three groups after operation and at the last follow-up. No significant changes in cervical curvature and kyphosis were observed during the follow-up period. The overall cervical mobility (C2-C7) in group A and group C had no significant difference compared with preoperative (P=0.077). The overall mobility of cervical vertebrae in group B was significantly lower than that before surgery (P=0.013).@*Conclusions@#For cervical spine trauma patients with OPLL, laminoplasty combined short-segment pedicle screw fixation can increase cervical segmental stability while extensive decompression of cervical spinal cord compression. At the same time, to some extent, the complications of postoperative axial symptoms caused by posterior cervical laminectomy and pedicle screw fixation were avoided.

Case control study on Zero-profile intervertebral fusion system and conventional cage-plate intervertebral fusion system for the treatment of multi-segment cervical spondylosis / 中国骨伤

OBJECTIVE@#To explore the clinical effect in the near future between Zero-profile intervertebral fusion system (Zero-P) and conventional cage-plate intervertebral fusion system (CCP) for the multi-segment(>=2 segments) cervical spondylosis.@*METHODS@#Forty-two patients with cervical spondylosis who underwent multi-segment decompression of the cervical spine from October 2012 to October 2017 were selected as subjects. Zero-P was applied in 21 patients (Zero-P group) and CCP was applied in 21 patients(CCP group). The general condition and perioperative parameters of all the patients were recorded. VAS, JOA scores and incidence of dysphagia were observed before and after operation. The prevertebral soft tissue thickness was measured at 1 week, 1 month after operation and at the last follow-up. At the same time, the Cobb angle of the functional unit of the fusion segments was measured, and the overall curvature change of the cervical vertebra was observed. The clinical efficacy was reviewed at 1 week, 1, 3, 12 months after surgery, and the AP and lateral cervical X-rays were reviewed to evaluate the internal fixation effect.@*RESULTS@#There were no significant differences in age, gender, duration of disease, surgical segment, follow-up time and hospitalization time between two groups(>0.05). The length of the surgical incision, intraoperative blood loss, operation time, postoperative drainage volume in the Zero-P group were(4.37±0.72) cm, (50.9±7.98)ml, (84.4±8.18) min, (76.2±10.13) ml, respectively, and those in CCP group were (6.50±0.71) cm, (108.6±9.25) ml, (118.6±8.55) min, (130.1±9.42) ml, respectively. There were signigicant differences in above items between two groups(0.05). There was no significant difference in the overall physiological curvature of the cervical vertebra between two groups (>0.05). The prevertebral soft tissue thickness at 1 week, 1 month after operation, final follow-up respectively was(11.6±1.9), (9.8±1.4), (9.5±1.6) mm in Zero-P group, and in CCP group those were(12.5±2.6), (11.1±2.4), (11.0±1.9) mm, respectively. There were significant differences in each time point between two groups(<0.05). At the last follow-up, no complication of dysphagia was found in Zero-P group, and three patients had dysphagia in CCP group, with a statistically significant difference between two groups (<0.05).@*CONCLUSIONS@#Multiple segmental decompression fusion to treat cervical spondylosis, regardless of the traditional CCP system or new Zero-P system are effective methods, but the Zero-P system has advantages of small surgical incision, short operation time, less intraoperative bleeding, convenient operation, better recovery of prevertebral soft tissue swelling, and lower possibility of postoperative dysphagia.

Effects of cluster needling at the scalp points on the expression of ChAT and AchE of hippocampus in rats with Alzheimer's disease / 中国针灸

OBJECTIVE@#To explore the effects of cluster needling at the scalp points on the expression of choline acetyl transferase (ChAT) and choline cholinesterase (AchE).@*METHODS@#A total of 60 Wistar rats were randomized into a sham-operation group, a model group, a medication group and a cluster needling group, 15 rats in each one. In the model group, the medication group and the cluster needling group, the models of Alzheimer's disease (AD) were established by the orienteering injection with Aβ1-42 in the bilateral hippocampal CA1 in the rats. In the sham-operation group, the distilled water was injected in bilateral hippocampus of rats. In the medication group, the lavage with aricept was adopted for the basic treatment, once a day, for 4 weeks consecutively. In the cluster needling group, on the base of the treatment as the medication group, the cluster needling at the scalp points was adopted, once a day, 6 times a week, for 4 weeks totally. In the sham-operation group and the model group, the normal feeding was provided. After intervention, the learning and memory ability was measured with Morris water maze in the rats of each group. The changes in the hippocampal gross structure were observed with HE staining. The changes in the positive expressions of hippocampal ChAT and AchE were determined with the immunohistochemical method.@*RESULTS@#Compared with the sham-operation group, the escape latency was prolonged and the percentage of the second quadrant and the frequency of platform leaping were reduced in the rats of the model group (all 0.05) and the expression of AchE was reduced (<0.05) in the medication group; the expression of ChAT was increased (<0.05) and that of AchE decreased (<0.01) in the cluster needling group. Compared with the medication group, the expression of ChAT was increased and that of AchE decreased in the cluster needling group (both <0.05).@*CONCLUSION@#The effect mechanism of cluster needling at the scalp points on AD could be related to the up-regulation of ChAT expression and down-regulation of AchE expression in the hippocampus. The combined treatment with the cluster needling and aricept achieves the better therapeutic effect on AD.

Enhanced recovery after surgery protocols in functional endoscopic sinus surgery for patients with chronic rhinosinusitis with nasal polyps: a randomized clinical trial / 中华医学杂志(英文版)

BACKGROUND@#Enhanced recovery after surgery (ERAS) protocols are a series of perioperative care to optimize preoperative preparation, prevent postoperative complications, minimize stress, and speed up recovery. This study aimed to assess the impact of ERAS protocols for functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).@*METHODS@#One hundred and two patients with CRSwNP undergoing FESS were randomly divided into the ERAS group and the control group. The outcomes of the Self-Rating Anxiety Scale (SAS), Visual Analogue Scale (VAS), Medical Outcomes Study Sleep Scale (MOS-SS) and Kolcaba Comfort Scale Questionnaire (GCQ) were determined in both groups. The serum levels of C-reactive protein (CRP) were compared preoperatively and 24 hours postoperatively.@*RESULTS@#The ERAS group had a significantly better SAS scores than did the control group (28 [24, 35] vs. 43 [42, 47], Z = 5.968, P  0.05); However, the CRP level in 24 hours postoperatively was significantly lower in the ERAS group than that in the control group (2.5 [1.4, 3.9] vs. 6.6 [3.8, 9.0], Z = 5.027, P  0.05), hemorrhage, aspiration and tumble, were not increased in the ERAS group compared with those in the control group. The ERAS group had a significantly shorter length of hospital stay (5 [4, 5] days vs. 8 [8,9] days, Z = 8.939, P < 0.001) and hospitalization expenses ($ 2670 [2375, 2740] vs. $3129 [3116, 3456], Z = 8.514, P < 0.001).@*CONCLUSIONS@#ERAS protocols might optimize FESS for patients with CRSwNP by reducing psychological and physical stress, shortening the length of hospital stay and lowering hospitalization expenses without increasing postoperative complications.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry, No. ChiCTR1800015791; http://www.chictr.org.cn/showproj.aspx?proj=26872.

Expression and clinical significance of P-selectin and HPA in benign and malignant hydatidform mole tissues / 临床与实验病理学杂志

Purpose To investigate the expression characteristics and significance of P-selectin and HPA in benign and malignant hydatidform mole tissues. Methods By using immunohistochemical technique SP and RT-PCR, the expression of Pselectin and HPA was detected in 40 cases of benign hydatidiform mole tissues, and 12 malignant hydatidiform mole tissues.Meanwhile, 40 cases of normal placental villi tissues were observed. Results The protein positive rate and protein relative quantity expression and the mRNA relative quantity expression of P-selectin and HPA were gradually increasing in normal placenta villi tissues, benign hydatidiform mole tissues, and malignant hydatidiform mole tissues. The differences between groups were statistically significant (all P<0.05). The expression of P-selectin and HPA showed positive correlation (all P<0.05) in benign and malignant hydatidform mole tissues. Conclusion The over-expression of P-selectin and HPA promotes the occurrence and development of hydatidform mole. The detection of the expression levels of P-selectin and HPA is of great significance for the differential diagnosis and prognosis assessment of benign and malignant hydatidform mole. It could become a biological predictor of malignant development of hydatidform mole.

The application of thyroid function tests in elderly patients with cardiovascular disease / 国际检验医学杂志

Objective To investigate the clinical application value of thyroid examination for elderly pa-tients with cardiovascular disease.Methods 845 cases from 60 to 89 years old ,who were initially diagnosed as cardiovascular disease in a hospital in Chongqing from December 2013 to November 2014 ,were selected as the case group.Another 200 healthy persons in the same age group who underwent the healthy assessment in the physical examination center of the hospital during the same period were selected as the control group.The lev-els of thyroid hormone were detected in two groups.Results The abnormal type of thyroid function in the case group had a statistically significant difference in different age distribution (P＜0.05).The detection rate of thyroid dysfunction was significantly higher in the case group than that in the control group ,and the differ-ence was statistically significant (P＜0.05).The differences of thyrotropin stimulating hormone (TSH) ,free triiodothyronine(FT3) and free thyroxine(FT4) concentrations between the control group and the case group were statistically significant (P＜0.01).In comparison with the results in the control group ,the concentration of TSH in patients with coronary heart disease and atrial fibrillation increased significantly ,the TSH concen-tration of patients with arrhythmia decreased significantly ,the concentrations of FT3 and FT4 in patients with hypertension and coronary heart disease increased significantly ,the FT3 concentration in patients with ar-rhythmia significantly increased ,and the concentrations of FT 3 and FT4 in patients with atrial fibrillation sig-nificantly decreased ,and the differences were statistically significant (P＜0.01).Conclusion The thyroid dys-function has a high detection rate in elderly patients with cardiovascular disease ,and all kinds of abnormalities may have an effect on the cardiovascular system.Thus ,active control of the abnormal thyroid hormone value can significantly improve the patients' cardiac function.Therefore ,for elderly patients with cardiovascular dis-ease ,routine screening of thyroid function is conducive to the diagnosis and treatment of their cardiovascular diseases.

Stem cell models for commercialization / 中国组织工程研究

BACKGROUND: Stem cells are the potentially immortal cells capable of self-renewal, which are essential to the mystery of human development and aging, and are also the core of research for regenerative medicine. OBJECTIVE: To summarize the biological characteristics of embryonic stem cells, adult stem cells and induced pluripotent stem cells, to review the clinical and commercial applications in stem cell therapy and drug screening, and to analyze the problems and prospects in stem cell industry. METHODS: We searched relevant articles about stem cell models in PubMed and CNKI databases during 1995 to 2017 on internet, and took"stem cells, embryonic stem cells, adult stem cells, induced pluripotent stem cells, stem cell therapy, drug screening" as the keywords in English and Chinese, respectively. RESULTS AND CONCLUSION: According to the origin, stem cell models are divided into three types: embryonic stem cells, adult stem cells and induced pluripotent stem cells. Different types of stem cells have their unique biological advantages. Embryonic stem cells can generate all somatic cell types, but the application is limited by ethical disputes. As for adult stem cells, there are the most extensive and in-depth, studies as the well as the most prevalent and mature applications. Induced pluripotent stem cells have similar characteristics as embryonic stem cells, and furthermore their use avoids source restriction, moral and ethical controversies, bringing new opportunities for stem cell application. Stem cell-based cell therapy has shown successful achievement. There have been a few commercial products about adult stem cells-based cell therapy; in the meanwhile both embryonic stem cells and induced pluripotent stem cells are making their way into clinical trials. In addition, pluripotent stem cells hold great promise for the specific drug screening because they enable scientists to establish a variety of cell and disease models in vitro.

Expression of c-IAPl protein and mRNA in gastric adenocarcinoma and its clinical significance / 临床与实验病理学杂志

Purpose To investigate the protein and mRNA expression of c-IAPl in gastric adenocarcinoma tissue and its clinical significance. Methods Immunohistochemistry technique, Western blot and realtime fluorescent quantitative PCR(qRT-PCR) were used to detect the protein and mRNA expression of c-IAPl in 50 cases of gastric adenocarcinoma tissues and40 cases of adjacent normal gastric mucosa tissues to analyze its role in the development and progression of gastric adenocarcinoma, the relationship between the protein and mRNA expression of c-IAPl and the clinicopathological features. Results The relative expression level of c-IAPl protein in gastric adenocarcinoma tissues was significantly higher than that in adjacent normal gastric mucosa tissues, the difference was statistically significant (P＜ 0.05 ). The mRNA expression of c-IAPl in gastric adenocarcinoma was significantly higher than normal gastric mucosa tissues, the difference was statistically significant (P＜0.05). The protein and mRNA expression of c-IAPl were correlated with the degree of differentiation of gastric adenocarcinoma tissues, TNM clinical stage, lymph node metastasis and infiltration depth, the difference was statistically significant (P＜0.05 ), while there was no correlation with gender and age, the difference was not statistically significant (P＞ 0.05). Conclusion The high protein and mRNA expression of c-IAPl in gastric adenocarcinoma tissues inhibit the apoptosis of gastric adenocarcinoma cells, which contribute to the development and progression of gastric carcinoma and it may provide a new theoretical basis for the clinical targeted therapy of gastric adenocarcinoma.

Relationship between Laterality of Auditory Brainstem Response and Speech Comprehension in Children with Autism Spectrum Disorders : A Preliminary Retrospective Controlled Study / 中山大学学报(医学科学版)

[Objective] To explore the relationship between laterality of auditory brainstem response and speech comprehension in children with autism spectrum disorders preliminarily.[Method] Review hearing diagnosis data in clinical audiology center from September 2013 to August 2015.We compare auditory brainstem responses in children with autism spectrum disorders (ASD group) and with other disorders (control group),and we further divide children with autism spectrum disorders into two groups (high ability group and low ability group) in terms of their speech comprehension and compare their auditory brainstem responses.[Result] The latencies of waves Ⅲ and Ⅴ,and interpeak latencies Ⅰ to Ⅲ and Ⅰ to Ⅴ of the ASD were significantly prolonged than the control group.And the laterality of waves Ⅲ and Ⅴ,and interpeak latencies Ⅰ to Ⅲ and Ⅰ to Ⅴ present in the ASD group,but not in the control group.Meanwhile,the laterality of waves Ⅲ and Ⅴ,and interpeak latencies Ⅰ to Ⅲ and Ⅰ to Ⅴ present in the high ability group,but not in the low ability group.[Conclusion] Laterality was not a common phenomenon in auditory brainstem response,and it may be associated with the development of speech comprehension in children with autism spectrum disorders.

Effects of Prevention and Treatment by Integrated Traditional Chinese and Western Medicine on TCM Constitutions of Community Diabetic Patients / 中国中医药信息杂志

Objective To analyze the improved the effects of prevention and treatment by integrated tradition Chinese and Western medicine on TCM constitutions and relevant indexes of community diabetic patients; To provide a reference for the comprehensive prevention and treatment of community diabetes.Methods By using cluster sampling method, 700 patients with diabetes aged 45 to 65 in healthcare service center in Minhang District in Shanghai were chosen randomly and divided into intervention group and control group, with 350 cases in each group. The control group used information platform, and was treated with standardized management and treatment of diabetes. On the basis of the treatment of the control group, the intervention group was identified TCM constitutions once a month, developed personalized community diabetes prevention and treatment of TCM norms, and gave guidance and intervention for health preserving and disease prevention for a year. The TCM constitution improvement was observed. Diabetic symptoms grading scale and anxiety self-rating scale, depression self-rating scale were assessed, and the complications were observed.Results Before intervention: TCM constitution of yin-yang harmony (51.43％) > yin asthenia (18.29％) > qi asthenia (11.71％) > yang asthenia (9.71％) > damp-heat (1.57％). After intervention: TCM constitution of yin-yang harmony (63.71％) > yin asthenia (8.71％) > qi asthenia (6.57％), yang asthenia (6.29％) > damp-heat (1.71％). There was difference in constitutions of yin-yang harmony, yang asthenia, and damp-heat before and after and through intervention and group interaction (P<0.05). There was statistical significance in diabetes symptoms curative effect index between the two groups (P=0.021). There was statistical significance in ophthalmoscopy results before and after and through intervention and group interaction (P=0.002).Conclusion The prevention and treatment by intervention of integrated traditional Chinese and Western medicine can improve the TCM constitutions of diabetic patients in community and influence the symptoms of diabetes.

Successful treatment in a patient with sudden cardiac arrest due to anomalous left coronary artery arising from pulmonary artery / 中南大学学报(医学版)

To enhance the understanding of the left coronary artery originating from the pulmonary artery,we report a case of sudden cardiac arrest during exercise.After successful cardiopulmonary resuscitation,the patient underwent echocardiography and selective coronary angiography,and the disease was firmly diagnosed.Consequently,a thoracic surgery was performed.During the operation,the left coronary artery was transplanted to the root of the aorta and the pulmonary valve and artery were reconstructed.Finally,the surgery was successful.

The diagnosis and treatment of 72 old heart failure patients complicated with hyponatremia / 中国基层医药

Objective To analyze the clinical treatment and curative effect of heart failure complicated with hyponatremia in elderly patients.Methods The clinical data were retrospectively analyzed in 72 aged patients with heart failure and hyponatremia,by controlling the intake of fluid and using diuretics and the drugs of heart failure,not restrict a low sodium diet,by adding sodium chloride,analyzed the effect and prognosis after moderate supplement of sodium for 7 days.Results The use of loop diuretics reduced cardiac edema,renew and sodium chloride without aggravating heart failure or hypernatremia,total effective rate was 95.83％,and it was safe and effective.Conclusion For the elderly patients with heart failure complicated with hyponatremia,should be based on the conventional symptomatic treatment of heart failure,correction of hyponatremia,improve cardiac function and prognosis of patients.

The application status quo of structured education in patients with type 2 diabetes mellitus / 中国实用护理杂志

The application of structured education in patients with type 2 diabetes mellitus showed significant effect. This paper introduced relevant content of structured education, the application status quo of structured education in patients with type 2 diabetes mellitus at home and abroad, aiming to provide reference for exploring health education models of patients with diabetes mellitus and reduce patients' complications, thus improving their quality of life.

Anti-atherosclerotic Effects of Bear Bile Powder in Shexiang Tongxin Dripping Pill: a Mechanism Study / 中国中西医结合杂志

<p><b>UNLABELLED</b>OBJECTIVE : To study the anti-atherosclerotic mechanism of bear bile powder (BBP) in Shexiang Tongxin Dripping Pill (STDP) , and to provide scientific evidence for treating atherosclerosis (AS) by its therapeutic characteristics of cool resuscitation.</p><p><b>METHODS</b>AS model was duplicated using ApoE-/- gene knocked mice fed with high-fat diet. Thirty ApoE-/- deficient male mice were divided into four groups according to body weight using random digit table, i.e., the model group (A, n =9), the STDP group (B, n=E7), the STDP without BBP group (C, n =7), and the BBP group (D, n =9). Besides, another 9 C57BL/6J male mice of the same age were recruited as a normal control group (E). All mice in Group B, C, and D were respectively administered with corresponding drugs (30, 30, and 0. 33 mg/kg) by gastrogavage. Equal volume of normal saline was administered to mice in Group A and E. All medication lasted for 8 successive weeks. Serum levels of inflammatory cytokines such as interleukin 2 (IL-2), interleukin 6 (IL-6), tumor necrosis factor a (TNF-α), interferon y (IFNγ), and oxidized low-density lipoprotein (ox-LDL) were measured by ELISA. Serum levels of malondialdehyde (MDA), activities of glutathione (GSH) and superoxide dismutase (SOD) were determined using biochemical assay. Contents of reactive oxygen species (ROS) in the aortic root was detected by dihydroethidum (DHE) fluorescent probe. Expression levels of microRNAs (such as miR-20, miR-21, miR-126, and miR-155) were detected by real-time PCR.</p><p><b>RESULTS</b>The fluorescence intensity of the aorta was obviously enhanced in Group A. But it was obviously attenuated in Group B, C, and D, and the attenuation was the most in Group B. Compared with Group E, serum levels of IL-2, IL-6, TNF-α, IFN-γ, oxLDL, and MDA all increased (P <0. 01), GSH contents and SOD activities decreased (P <0. 01), expression levels of miR-126, miR-21, and miR-155 in aorta increased (P <0. 01), and the expression level of miR-20 decreased in Group A (P<0. 01). Compared with Group A, serum levels of IL-2, IL-6, TNF-α, IFN-γ, oxLDL, and MDA were all down-regulated (P <0. 01), GSH contents and SOD activities were up-regulated (P <0. 01), expression levels of miR-126, miR-21, and miR-155 in aorta were down-regulated in Group B, C, and D (P <0. 01). The expression level of miR20 was up-regulated in Group B and D (P <0. 01). Compared with Group B, serum levels of IL-2, IL-6, TNF-α, IFN-γ increased (P <0.01); GSH contents and SOD activities decreased, levels of MDA and oxLDL increased (P <0. 01) in Group C and D. Expression levels of miR-20 and miR-155 were down-regulated in Group C and D (P <0. 01).</p><p><b>CONCLUSIONS</b>STDP played roles in significantly regulating inflammatory factors and oxidative stress factors. Its mechanism might be possibly associated with regulating expressions of miR-126, miR-21, miR-155, and miR-20 in aorta. BBP played significant roles in STDP.</p>

Correlation study between the reason of heterotopic ossification after cervical artificial disc replacement and the degeneration of cervical facet joints / 中华骨科杂志

Objective To investigate the correlation between the reason of heterotopic ossification after cervical artificial disc replacement and the degeneration of cervical facet joints.Methods From May 2009 to May 2012,133 patients who had undergone cervical artificial disc replacement were included into this study.There were 74 males and 59 females with an average age of 42.63±4.15 years old (range,23-56 years old).There were 109 patients who had undergone single level implant,and 24patients double level implant.Cervical spine A-P and the flexion-extension X-rays were taken to assess the range of motion (ROM)of the surgical level.Degeneration degree of patients' cervical facet joints were evaluated by Park grading standards with the preoperative cervical CT scan images on GE-PACS system.Heterotopic ossification (HO) situation were evaluated by McAfee classification through cervical lateral X-ray film.Patients were divided into two groups (HO group and non-HO group) according to whether heterotopic ossification appeared during the follow-up period.The data were collected before surgery to the latest follow-up.Results The average follow-up time was 2.9 years (range,2.0-4.8 years).HO was detected in 25 patients (18.80％,25/133) at latest follow-up.The ROM of surgical level of patients in HO group was significantly lower than non-HO group (6.8°±3.9° vs 9.1 °±2.4°).In addition,the degeneration degree of cervical facet joints of patients in HO group was significantly higher than that in non-HO group.There was a significant correlation between preoperative cervical facet joint degeneration and the occurrence of HO after CDR (r=0.683,P=0.033).Conclusion There was a significant correlation between preoperative cervical facet joint degeneration and the occurrence of HO after CDR.Patients present HO after surgery have significantly higher degeneration degree of cervical facet joints than patients without HO.Patients with higher degree of HO may have a higher level of cervical facet joints degeneration.