Influencing factors of prognosis of patients with atrial fibrillation and heart failure after rhythm con-trol therapy / 心血管康复医学杂志

Objective:To study influencing factors of prognosis of patients with atrial fibrillation(AF)and heart fail-ure(HF)after rhythm control therapy.Methods:According to rhythm control methods,a total of 379 AF+HF patients treated in our hospital were divided into medication group(n=133)and surgery group(n=246,received catheter ablation of AF);according to AF type,patients were divided into paroxysmal AF group(n=208)and per-sistent AF group(n=171),and general clinical data and rhythm control effect were compared among all groups.According to NYHA cardiac function classification,patients were divided into NYHA classⅡ group(n=160),classⅢ group(n=188)and class Ⅳ group(n=31),and rhythm control effect was compared among above groups.Re-sults:Compared with medication,there were significant reductions in percentage of AF recurrence and LAD after treatment,and significant rise in percentage of heart function improvement in paroxysmal AF group,persistent AF group,NYHA class Ⅱ and Ⅲ group in those underwent surgery(P＜0.05 or＜0.01).Multivariate Logistic re-gression analysis indicated that medication,persistent AF were independent risk factors for AF recurrence and no cardiac function improvement after rhythm control therapy(OR=2.426～7.908,P=0.001 all),and NYHA classⅡ was an independent protective factor for AF recurrence after rhythm control therapy(OR=0.393,P=0.049).Conclusion:Atrial fibrillation catheter ablation can significantly improve prognosis of AF+HF patients.Persistent AF and antiarrhythmic medication are independent risk factors for poor prognosis after rhythm control therapy.

Efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma / 中华肿瘤杂志

Objective: To explore the efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma. Methods: A total of 296 patients who underwent radical surgery for stage Ⅱ-Ⅲ cutaneous orlimb melanoma at Fudan University Shanghai Cancer Center and Shanghai Electric Power Hospital between 2017 and 2021 and received adjuvant PD-1 monoclonal antibody immunotherapy, low-dose interferon (IFN), or observational follow-up were enrolled in this study. Patients were divided into the PD-1 monoclonal antibody group (164 cases) and the IFN or observation group (IFN/OBS group, 132 cases) based on postoperative adjuvant treatment methods. Patients' disease recurrence and survival were observed. Results: Among the 296 patients, 77 had cutaneous melanoma and 219 had limb melanoma; 110 were stage Ⅱ and 186 were stage Ⅲ. Among stage Ⅱ patients, the median recurrence-free survival (RFS) in the PD-1 monoclonal antibody group (46 cases) did not reach, while the median RFS in the IFN/OBS group (64 cases) was 36 months. The 1-year RFS rates were 85.3% and 92.1% and the 2-year RFS rates were 71.9% and 63.7% in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with no statistically significant difference (P=0.394). Among stage Ⅲ patients, the median RFS rates in the PD-1 monoclonal antibody group (118 cases) and the IFN/OBS group (68 cases) were 23 and 13 months, respectively. The 1-year RFS rates were 70.0% and 51.8% and the 2-year RFS rates were 51.8% and 35.1%in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with a statistically significant difference (P=0.010). Stratified analysis showed that the advantage of PD-1 monoclonal antibody adjuvant therapy in improving RFS persisted in the subgroups of primary ulceration (HR=0.558, 95% CI: 0.348-0.893), lymph node macroscopic metastasis (HR=0.486, 95% CI: 0.285-0.828), stage ⅢC (HR=0.389, 95% CI: 0.24-0.63), and the subgroup without BRAF/c-Kit/NRAS gene mutations (HR=0.347, 95% CI: 0.171-0.706). In terms of recurrence patterns, in stage Ⅱ patients, the recurrence and metastasis rate was 15.2% (7/46) in the PD-1 monoclonal antibody group, significantly lower than the IFN/OBS group [43.8% (28/64), P=0.002]. In stage Ⅲ melanoma patients, the recurrence and metastasis rate was 42.4% (50/118) in the PD-1 monoclonal antibody group, also lower than the IFN/OBS group [63.2% (43/68), P=0.006]. Conclusions: In real-world settings, compared with patients receiving low-dose IFN adjuvant therapy or observational follow-up, PD-1 monoclonal antibody immunotherapy can reduce the recurrence and metastasis rate of cutaneous and limb melanoma, and prolong the postoperative RFS of stage Ⅲ cutaneous and limb melanoma patients. Patients with a heavier tumor burden benefit more from immunotherapy.

Efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma / 中华肿瘤杂志

Objective: To explore the efficacy of adjuvant programmed cell death 1 (PD-1) monoclonal antibody immunotherapy in Chinese patients with resected stage Ⅱ-Ⅲ melanoma. Methods: A total of 296 patients who underwent radical surgery for stage Ⅱ-Ⅲ cutaneous orlimb melanoma at Fudan University Shanghai Cancer Center and Shanghai Electric Power Hospital between 2017 and 2021 and received adjuvant PD-1 monoclonal antibody immunotherapy, low-dose interferon (IFN), or observational follow-up were enrolled in this study. Patients were divided into the PD-1 monoclonal antibody group (164 cases) and the IFN or observation group (IFN/OBS group, 132 cases) based on postoperative adjuvant treatment methods. Patients' disease recurrence and survival were observed. Results: Among the 296 patients, 77 had cutaneous melanoma and 219 had limb melanoma; 110 were stage Ⅱ and 186 were stage Ⅲ. Among stage Ⅱ patients, the median recurrence-free survival (RFS) in the PD-1 monoclonal antibody group (46 cases) did not reach, while the median RFS in the IFN/OBS group (64 cases) was 36 months. The 1-year RFS rates were 85.3% and 92.1% and the 2-year RFS rates were 71.9% and 63.7% in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with no statistically significant difference (P=0.394). Among stage Ⅲ patients, the median RFS rates in the PD-1 monoclonal antibody group (118 cases) and the IFN/OBS group (68 cases) were 23 and 13 months, respectively. The 1-year RFS rates were 70.0% and 51.8% and the 2-year RFS rates were 51.8% and 35.1%in the PD-1 monoclonal antibody group and the IFN/OBS group, respectively, with a statistically significant difference (P=0.010). Stratified analysis showed that the advantage of PD-1 monoclonal antibody adjuvant therapy in improving RFS persisted in the subgroups of primary ulceration (HR=0.558, 95% CI: 0.348-0.893), lymph node macroscopic metastasis (HR=0.486, 95% CI: 0.285-0.828), stage ⅢC (HR=0.389, 95% CI: 0.24-0.63), and the subgroup without BRAF/c-Kit/NRAS gene mutations (HR=0.347, 95% CI: 0.171-0.706). In terms of recurrence patterns, in stage Ⅱ patients, the recurrence and metastasis rate was 15.2% (7/46) in the PD-1 monoclonal antibody group, significantly lower than the IFN/OBS group [43.8% (28/64), P=0.002]. In stage Ⅲ melanoma patients, the recurrence and metastasis rate was 42.4% (50/118) in the PD-1 monoclonal antibody group, also lower than the IFN/OBS group [63.2% (43/68), P=0.006]. Conclusions: In real-world settings, compared with patients receiving low-dose IFN adjuvant therapy or observational follow-up, PD-1 monoclonal antibody immunotherapy can reduce the recurrence and metastasis rate of cutaneous and limb melanoma, and prolong the postoperative RFS of stage Ⅲ cutaneous and limb melanoma patients. Patients with a heavier tumor burden benefit more from immunotherapy.

A Clinical Audit and Impact of Interventions on Antibiotic Prescribing Practices at a Public Dental Primary Care Clinic

ABSTRACT@#Inappropriate antibiotic prescribing in dentistry has been widely reported but local studies are scarce. We aimed to evaluate antibiotic prescribing practices among dental officers in a public dental primary care clinic against current guidelines: specifically assessing the number, appropriateness, accuracy of prescriptions, type of antibiotics prescribed and repeated prescribing of the same type of antibiotics within a specific duration. A retrospective audit consisting of two cycles (1st cycle: July to September 2018, 2nd cycle: July to September 2019) was carried out by manually collecting relevant data of patients (aged 18 and above) who were prescribed antibiotics from carbon copies of prescription books. Between each cycle, various interventions such as education through a continuous professional development (CPD) session, presentation of preliminary findings and making guidelines more accessible to dental officers were implemented. When the 1st and 2nd cycles were compared, the number of antibiotic prescriptions issued reduced from 194 to 136 (–30.0%) whereas the percentage of appropriate prescriptions increased slightly by 4.1%. Inaccurate prescriptions in terms of dosage and duration decreased (–0.5% and –13.7%, respectively) whilst drug form and frequency of intake increased (+15.7% and +0.7%, respectively). Repeated prescribing of the same antibiotics by the same officer within a period of ≤6 weeks no longer occurred. Amoxicillin and metronidazole were most commonly prescribed in both cycles. Overall, the antibiotic prescribing practices did not closely adhere to current guidelines. However, clinical audit in conjunction with targeted interventions resulted in improvement in the antibiotic prescribing patterns. Thus, further intervention and re-audit is necessary.

YANG Jun's clinical experience of acupuncture for oculomotor paralysis / 中国针灸

Professor YANG Jun's clinical experience of acupuncture and moxibustion for oculomotor paralysis is summarized. Professor YANG Jun pays attention to disease differentiation and syndrome differentiation in the treatment of this disease. According to the characteristics of oculomotor paralysis, "early diagnosis and seeking treatment from the source" is advocated. According to the etiology and pathogenesis, professor YANG divides oculomotor paralysis into three types: the syndrome of wind-evil attacking collaterals, the syndrome of spleen-stomach weakness and the syndrome of qi-deficiency and blood-stasis. As such, the acupoints are selected according to syndrome differentiation, and several different acupuncture methods (pricking needling at eyelids, penetrating needling and lifting eyelids and contralateral- balance needling on the healthy side) are adopted to improve the symptoms of oculomotor paralysis. It is also suggested to use the combination of scalp acupuncture and electroacupuncture to achieve the best dose-effect state. Moreover, local stimulation around the eyes is important to achieve the effects of "qi reaching affected area".

Protective effects of Baicalin injection on severe acute pancreatitis through regulating follistatin-like-1 signaling pathway by down-regulating miR-429 expression in mice

Abstract In China, Scutellaria is used for treating inflammatory-related diseases. Baicalin is the main active component of Scutellaria and has protective effects on acute pancreatitis. However, the mechanism of Baicalin is still unclear. In this study, the protective effects of baicalin on acute pancreatitis induced by taurocholate and its mechanism are investigated. In this study, mice were randomly divided into three groups: sham operation, model, and treatment groups. Acute pancreatitis in mice was induced by intraperitoneal injection of taurocholate (35 mg/kg). The treatment group was given baicalin (100 mg/kg) 2 h before acute pancreatitis induction. The mRNA expression levels of miR-429, nuclear factor kappa B65(NF-kB65), toll-like receptor 4(TLR4), TNF receptor associated factor6 (TRAF6), NF-kappa-B inhibitor(IkB), Follistatin-like 1 (FSTL1), and interleukin-1 receptor-associated kinase (IRAK) in the liver tissues 24 h after intraperitoneal injection were detected by RT-PCR. Then, the expression levels of NF-kB65, p-NF-κB65, TLR4, TRAF6, IkB, FSTL1, IRAK, p- IRAK, and p- IkB-а proteins were detected by Western blot. IL-6, TNF-α and IL-1 ß in plasma were measured by ELISA, and histopathological changes in the pancreases of the mice were observed. The results showed that after baicalin treatment, miR-429 expression in the pancreatic tissues and the expression levels of NF-kB65, TLR4, TRAF6, p-IkB-а, FSTL1, and p-IRAK decreased. Similarly, pancreatic myeloperoxidase (MPO) activity and the plasma levels of IL-6, TNF-а, IL-12, IL-1ß1, endotoxin, serum amylase, and lipase were reduced. Thus, the pancreatic injury induced by taurocholate was alleviated. The present study indicates that pretreatment with Baicalin can alleviate acute pancreatic injury induced by taurocholate in mice. The mechanism may be associated with the decreased miR-429 expression, reduced FSTL1 signaling pathway activity, TLR4 and TLR4/MyD88 signaling pathway inhibition, and reduced pancreatic inflammation. FSTL1 is the regulatory target for miR-429

Chemical constituents from root bark of Litsea glutinosa / 中草药

Objective: To study the chemical constituents from the root bark of Litsea glutinosa. Methods: Silica gel and Sephedex LH-20 column chromatographies as well as semi-preparative HPLC were applied to isolate and purify the compounds. Their structures were elucidated based on the spectrum analysis. Results: Fifteen compounds were obtained and identi-fied as schizandriside (1), lyonside (2), coclaurine (3), alangisesquin A (4), alangisesquin B (5), dihydrobuddlenol (6), ssioriside (7), dendranthemoside B (8), epi-anhydrocinnzeylanol (9), isolariciresinol-5’-methoxy-iso-larixa-9’-O-β-D-xylopyranoside (10), benzyl alcohol-β-D- glucopyranoside (11), phenylethyl-β-D-glucopyranoside (12), n-butyl-β-D-fructoside (13), N-cis-feruloyl tyramine (14), and N-trans-sphingoyl tyramine (15). Conclusion: Compounds 1-13 are isolated from this plant for the first time.

Clone correlation of carbapene m-resistant Acinetobacter baumannii in en-vironment of intensive care units in Guangzhou City / 中国感染控制杂志

Objective To understand the clone correlation of carbapenem-resistant Acinetobacter baumannii (CRAB)in the environment of intensive care units(ICUs)in Guangzhou City,identify genotypes,and provide basis for prevention and control of healthcare-associated infection(HAI).Methods 39 strains of CRAB isolated from en-vironment of ICUs in 7 hospitals in Guangzhou City were collected,susceptibility to 10 kinds of antimicrobial agents was detected by Kirby-Bauer method,OXA gene of strains was detected by polymerase chain reaction(PCR),clone polymorphism analysis was performed with pulsed-field gel electrophoresis(PFGE)and multilocus sequence typing (MLST).Results Among 39 strains of CRAB,resistance rate to levofloxacin was the lowest(56.4%),resistance rates to other 9 antimicrobial agents were all>90%. PCR results showed that 39 strains(100%)of CRAB all car-ried OXA-51 gene,37(94.9%)carried OXA-23 gene,but OXA-24 and OXA-58 genes were not found. PFGE showed that 38 CRAB strains were divided into 5 clones,group A was the main epidemic clone,MLST analysis showed that the main clone of CRAB was ST195.Conclusion Transmission of CRAB clone carrying OXA-23 gene exists in the ICU environment of Guangzhou City,cleaning and disinfection of ICU environment should be intensi-fied,so as to reduce HAI caused by CRAB.

5-Hydroxytryptamine Changes under Different Pretreatments on Rat Models of Myocardial Infarction and/or Depression / 中华医学杂志(英文版)

<p><b>Background:</b>Psychocardiological researches have suggested a central role of 5-hydroxytryptamine (5-HT) on psychocardiological mechanism. This study aimed to further explore the central role of 5-HT and pretreatment effects of XinLingWan on rats with myocardial infarction (MI) and/or depression.</p><p><b>Methods:</b>Ninety Sprague-Dawley rats were randomly divided into three groups: MI group, depression group, and MI + depression group (n = 30 in each group). Each group was then divided into three subgroups (n = 10 in each subgroup): a negative control subgroup (NCS), a Western medicine subgroup (WMS), and a traditional Chinese medicine subgroup (TCMS), which were received pretreatment once a day for 4 weeks by saline, 20 mg/kg sertraline mixed with 2 ml saline, and 40 mg/kg XingLingWan mixed with 2 ml saline, respectively. Different rat models were established after different pretreatments. Rats were then sacrificed for detection of serum 5-HT, platelet 5-HT, 5-HTreceptors (5-HTR), and serotonin transporter (SERT). Data were analyzed by one-way analysis of variance (ANOVA) and least-significant difference (LSD) testing.</p><p><b>Results:</b>MI group: compared with NCS, there was a significant increase in WMS and TCMS of serum 5-HT (176.15 ± 11.32 pg/ml vs. 334.50 ± 29.09 pg/ml and 474.04 ± 10.86 pg/ml, respectively, both P = 0.000), platelet 5-HT (129.74 ± 27.17 pg/ml vs. 322.24 ± 11.60 pg/ml and 340.4 5 ± 17.99 pg/ml, respectively, both P = 0.000); depression group: compared with NCS, there was a significant increase in WMS and TCMS of serum 5-HT (194.69 ± 5.09 pg/ml vs. 326.21 ± 39.98 pg/ml and 456.33 ± 23.12 pg/ml, respectively, both P = 0.000), platelet 5-HT (175.15 ± 4.07 pg/ml vs. 204.56 ± 18.59 pg/ml and 252.03 ± 22.26 pg/ml, respectively, P = 0.004 and P = 0.000, respectively); MI + depression group: compared with NCS, there was a significant increase in both WMS and TCMS of serum 5-HT (182.50 ± 10.23 pg/ml vs. 372.55 ± 52.23 pg/ml and 441.76 ± 23.38 pg/ml, respectively, both P = 0.000) and platelet 5-HT (180.83 ± 11.08 pg/ml vs. 221.12 ± 22.23 pg/ml and 265.37 ± 29.49 pg/ml, respectively, P = 0.011 and P = 0.000, respectively).</p><p><b>Conclusions:</b>By elevating the amount of 5-HT and modulating 5-HTR and SERT levels in serum and platelets, XinLingWan and sertraline were found to exert pretreatment effect on rat models of MI and/or depression.</p>

Clinical analysis of ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma / 中国生化药物杂志

Objective To analyze the clinical efficacy of ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma. Methods 100 patients with acute attack of asthma treated from March 2015 to October 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group received terbutaline sulfate inhalation, and the experimental group received ipratropium bromide combined with terbutaline sulfate inhalation treatment. The patients in the experimental group and the control group were treated for 7 days continuously. The therapeutic effects of the two groups were compared and analyzed. Results After the corresponding treatment, the effective rate of treatment in the experimental group (94.0%) was significantly higher than that in the control group (72.0%),the difference was statistically significant(P<0.05). The improvement time of dyspnea, rale and cough in control group was significantly longer than that in the experimental group, the difference was statistically significant(P<0.05). Conclusion Ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma has better clinical efficacy and shorter clinical symptoms.

FERMT2 expression in hepatocellular carcinoma and its effect on cell growth / 中国病理生理杂志

AIM:To identify the expression of fermitin family homolog 2 (FERMT2) in hepatocellular carci-noma ( HCC) tissues and the effect of FERMT 2 on the cell growth and related protein expression .METHODS:Real-time PCR and immunohistochemistry were used to detect FERMT 2 expression in the HCC tissues .The technique of CRISPR/Cas9 was applied to construct stable FERMT2 knockout MHCC97H cell line.WST-1 assay and flow cytometry were used to measure the cell viability , cell-cycle distribution and cell apoptosis .Western blot was used to determine the expression of related proteins in the MHCC97H cells.RESULTS:In HCC tissues, the expression level of FERMT2 was higher than that in adjacent liver tissues (P<0.05).High expression of FERMT2 was significantly correlated with postoperative recurrence of tumor.Knockout of FERMT2 gene evidently inhibited MHCC97H cell viability and accelerated cell apoptosis .Mean-while, the expression levels of proliferating cell nuclear antigen , cyclins, cyclin-dependent kinases 2 and anti-apoptotic fac-tors were significantly downregulated in MHCC97H cells with FERMT2 knockout (P<0.05).CONCLUSION:FERMT2 may function as a promoter of hepatocarcinogenesis and progression via regulating the cell viability , cell-cycle distribution and cell apoptosis , which is related with the expression of cell cycle regulators and anti-apoptotic factors .

Clinical analysis of ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma / 中国生化药物杂志

Objective To analyze the clinical efficacy of ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma. Methods 100 patients with acute attack of asthma treated from March 2015 to October 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group received terbutaline sulfate inhalation, and the experimental group received ipratropium bromide combined with terbutaline sulfate inhalation treatment. The patients in the experimental group and the control group were treated for 7 days continuously. The therapeutic effects of the two groups were compared and analyzed. Results After the corresponding treatment, the effective rate of treatment in the experimental group (94.0%) was significantly higher than that in the control group (72.0%),the difference was statistically significant(P<0.05). The improvement time of dyspnea, rale and cough in control group was significantly longer than that in the experimental group, the difference was statistically significant(P<0.05). Conclusion Ipratropium bromide combined with terbutaline sulfate inhalation in the treatment of acute attack of asthma has better clinical efficacy and shorter clinical symptoms.

Upregulation of FcγRIIB by resveratrol via NF-κB activation reduces B-cell numbers and ameliorates lupus

Resveratrol, an anti-inflammatory agent, can inhibit pro-inflammatory mediators by activating Sirt1, which is a class III histone deacetylase. However, whether resveratrol can regulate inhibitory or anti-inflammatory molecules has been less studied. FcγRIIB, a receptor for IgG, is an essential inhibitory receptor of B cells for blocking B-cell receptor-mediated activation and for directly inducing apoptosis of B cells. Because mice deficient in either Sirt1 or FcγRIIB develop lupus-like diseases, we investigated whether resveratrol can alleviate lupus through FcγRIIB. We found that resveratrol enhanced the expression of FcγRIIB in B cells, resulting in a marked depletion of plasma cells in the spleen and notably in the bone marrow, thereby decreasing serum autoantibody titers in MRL/lpr mice. The upregulation of FcγRIIB by resveratrol involved an increase of Sirt1 protein and deacetylation of p65 NF-κB (K310). Moreover, increased binding of phosphor-p65 NF-κB (S536) but decreased association of acetylated p65 NF-κB (K310) and phosphor-p65 NF-κB (S468) to the −480 promoter region of Fcgr2b gene was responsible for the resveratrol-mediated enhancement of FcγRIIB gene transcription. Consequently, B cells, especially plasma cells, were considerably reduced in MRL/lpr mice, leading to improvement of nephritis and prolonged survival. Taken together, we provide evidence that pharmacological upregulation of FcγRIIB expression in B cells via resveratrol can selectively reduce B cells, decrease serum autoantibodies and ameliorate lupus nephritis. Our findings lead us to propose FcγRIIB as a new target for therapeutic exploitation, particularly for lupus patients whose FcγRIIB expression levels in B cells are downregulated.

Efficacy of and Patient Compliance with a Ketogenic Diet in Adults with Intractable Epilepsy: A Meta-Analysis

BACKGROUND AND PURPOSE: Despite the successful use of a ketogenic diet in pediatric epilepsy, its application in adults has been limited. The aim of this meta-analysis was to summarize the findings of relevant published studies in order to identify the efficacy of and compliance with a ketogenic diet and its main subtypes (i.e., classic ketogenic diet and modified Atkins diet) in adults with intractable epilepsy, and to provide useful information for clinical practice. METHODS: Electronic searches of PubMed, EMBASE, Google Scholar, and the ISI Web of Science were conducted to identify studies of the efficacy of and patient compliance with a ketogenic diet in adults with intractable epilepsy; the included studies were reviewed. Meta-analyses were performed using STATA to determine combined efficacy rates and combined rates of compliance with the ketogenic diet and its main subtypes. RESULTS: In total, 12 studies qualified for inclusion, and data from 270 patients were evaluated.The results of the meta-analysis revealed combined efficacy rates of all types of ketogenic diet, a classical ketogenic diet, and a modified Atkins diet were 42%, 52%, and 34%, respectively; the corresponding combined compliance rates were 45%, 38%, and 56%. CONCLUSIONS: The results indicate that a ketogenic diet is a promising complementary therapy in adult intractable epilepsy, and that while a classical ketogenic diet may be more effective, adult patients are likely to be less compliant with it than with a modified Atkins diet.

Changes of Serotonin (5-HT), 5-HT2A Receptor, and 5-HT Transporter in the Sprague-Dawley Rats of Depression, Myocardial Infarction and Myocardial Infarction Co-exist with Depression / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>To evaluate whether serotonin (5-HT), 5-HT2A receptor (5-HT2AR), and 5-HT transporter (serotonin transporter [SERT]) are associated with different disease states of depression, myocardial infarction (MI) and MI co-exist with depression in Sprague-Dawley rats.</p><p><b>METHODS</b>After established the animal model of four groups include control, depression, MI and MI with depression, we measured 5-HT, 5-HT2AR and SERT from serum and platelet lysate.</p><p><b>RESULTS</b>The serum concentration of 5-HT in depression rats decreased significantly compared with the control group (303.25 ± 9.99 vs. 352.98 ± 13.73; P = 0.000), while that in MI group increased (381.78 ± 14.17 vs. 352.98 ± 13.73; P = 0.000). However, the depression + MI group had no change compared with control group (360.62 ± 11.40 vs. 352.98 ± 13.73; P = 0.036). The changes of the platelet concentration of 5-HT in the depression, MI, and depression + MI group were different from that of serum. The levels of 5-HT in above three groups were lower than that in the control group (380.40 ± 17.90, 387.75 ± 22.28, 246.40 ± 18.99 vs. 500.29 ± 20.91; P = 0.000). The platelet lysate concentration of 5-HT2AR increased in depression group, MI group, and depression + MI group compared with the control group (370.75 ± 14.75, 393.47 ± 15.73, 446.66 ± 18.86 vs. 273.66 ± 16.90; P = 0.000). The serum and platelet concentration of SERT in the depression group, MI group and depression + MI group were all increased compared with the control group (527.51 ± 28.32, 602.02 ± 23.32, 734.76 ± 29.59 vs. 490.56 ± 16.90; P = 0.047, P = 0.000, P = 0.000 in each and 906.38 ± 51.84, 897.33 ± 60.34, 1030.17 ± 58.73 vs. 708.62 ± 51.15; P = 0.000 in each).</p><p><b>CONCLUSIONS</b>The concentration of 5-HT2AR in platelet lysate and SERT in serum and platelet may be involved in the pathway of MI with depression. Further studies should examine whether elevated 5-HT2AR and SERT may contribute to the biomarker in MI patients with depression.</p>

Effect of pretreatment with qishen yiqi dropping pills on right cardiac function of patients undergoing valve replacement / 中国中药杂志

In this study, 120 patients with rheumatic heart disease undergoing valve replacement were randomly divided into the control group and the Qishen group, with 60 cases in each group. Before the operation, the control group was given routine heart and diuretic treatments and placebo of Qishen Yiqi dropping pills for seven days (0.5 g each time, three times a day); While the Qishen group was given Qishen Yiqi dropping pills for seven days (0.5 g each time after meal, three times a day) on the basis of the routine treatments. The right ventricular end-diastolic volume (RVEDV), end-systolic volume (RVESV), stroke volume (SV) and right ventricular ejection fraction (RVEF) were detected after the operation. The results showed that patients in the two groups showed significantly lower right ventricular end diastolic volume (RVEDV), right ventricular end systolic volume (RVESV) and stroke volume (SV) decreased than that before the operation, but with significantly higher Ejection fraction (RVEF) significantly than that before the operation. However, the Qishen group showed a significantly lower right heart function reduction than the control group, with the statistical significance in the differences (P < 0.05). This indicated that the pretreatment with Qishenyiqi Drop Pills showed a remarkable efficacy in the improvement of right ventricular function after valve replacement.

Diagnostic value of real-time three-dimensional ultrasound for urethral vaginal fistulas / 中国基层医药

Objective To explore the Diagnostic value of real-time three-dimensional ultrasound for urethral vaginal fistulas.Methods 5 patients with urethral vaginal fistulas were checked using real-time three-dimensional ul-trasound ,respectively by the abdomen and the sonographic appearance of pudendal observation of female urethral vagi -nal interval sagittal and transverse ,sagittal and transverse section by measuring the size of the fistula ,and voiding trial or colored liquid test injection from urethral to confirm .Results 5 cases of urethra,vagina ultrasonography can dis-play and urethral vaginal interval throughout the sagittal plane and different levels of cross section ,urethral vaginal in-terval by low echo-band-low echo constitute the sandwichsign in the fistula showed partial loss ,local band echo in-terruption,urethral and vaginal local fusion ,voiding trial or from the urethra into the colored liquid test further con-firmed the fistula,fistula and verify the existence of fistula after the operation the size .Conclusion Real time three-dimensional echocardiography by urethral vaginal interval in the axial and sagittal plane ultrasound at different levels , combining with the history and voiding trial or injected with colored liquid test from the urethra ,can provide a new i-dea for diagnosis of urethral vaginal fistula .

Clinical outcome of endoprosthetic replacement for failed treatment of intertrochanteric fractures: a retrospective case series

Objective: The treatment methods for the failed internal fixation in elderly patients suffering from several osteoporostic fractures are still inconclusive. We aimed to evaluate the clinical effects of endoprosthetic replacement for failure treatment of intertrochanteric fracture

Methodology: A total of 13 patients with failed internal fixation for intertrochanteric fracture were collected between January 2002 and October 2009. All of them were treated with endoprosthetic replacement and followed up till October 2010. Four of them received total hip replacement and the remained nine received artificial bipolar femoral head replacement. Clinical and functional outcomes of patients were assessed

Results: Of 13 patients, nine were females and four were males with the mean age of 76.5 years [SD, 11.7, range, 58-92 years] at the time of fracture. The average time of operation and follow-up was 124 minutes [89-187minutes] and 31 months [14-68 months], respectively. The average blood loss during the operation was 631 ml [450-1560 ml]. All patients showed good pain relief and functional improvement. Final postoperative Harris and WOMAC scores were significantly improved from pre-operative levels [P < 0.05]. Only five patients showed operative complications

Conclusions: Our finding indicated that endoprosthetic replacement is an effective salvage procedure for failed internal fixation of intertrochanteric fracture in elderly patients with effective pain relief and functional improvement as well as few serious complications

Improvement in JOA score of treatment for complex atlas-axis fractures

The aim of this study was to explore the role of treatment for complex Atlas-Axis fractures, and compare the JOA score of surgical and conservation methods. From June 2008 to May 2012, 33 patients suffering from Atlas-Axis fracture were included in our study. Fifteen patients received posterior cervical pedicle screw fixation, and 18 patients received the conservation treatment. All the patients were followed up for 12 months after discharge. The mean operative time was about 128 minutes [ranged: 92 to 165 minutes], the mean hospital stay time was 15.5 days [ranged: 8-21 days], and the mean follow-up of all the patients was 27months [ranged: 7 to 43 months]. All patients gained a solid fusion, and no one showed any disability at the end of the follow-up. The JOA scores before treatment were 6.4 +/- 0.3 and 7.1 +/- 0.4 before and after treatment, and they significantly increased to 13.8 +/- 0.8 and 13.7 +/- 0.9 when following up for 12 months [P < 0.05]. Posterior cervical pedicle screw fixation is a feasible, effective and safe method for complex atlantoaxial fractures. This technique could achieve high JOA score, decreased blood loss and post-operative complications

Radical Surgical Excision and Use of Lateral Thoracic Flap for Intractable Axillary Hidradenitis Suppurativa

Current treatments for hidradenitis suppurativa (HS) include prolonged courses of antibiotics, retinoids, immunosuppressants, and biologics. Severe cases that are resistant to prolonged medical treatment pose a therapeutic challenge. We propose radical excision and lateral thoracic flap reconstruction as a treatment option for such cases. In our experience with two patients, good aesthetic and functional outcomes were achieved, with a high level of patient satisfaction. The availability of suitable flap coverage allows for wide resection of all of the hair-bearing skin, leading to a low incidence of residual disease and subsequent recurrence. Following excision of the affected tissue, the ideal reconstructive method in the axilla provides suitable coverage without unacceptable donor site morbidity and also avoids axillary contractures. A long lateral thoracic flap with delay has excellent coverage with minimal donor tissue sacrifice. With a suitable flap coverage option, the management paradigm of intractable HS should shift from prolonged medical treatment to allow decisive radical excision, which will improve the quality of life for patients.