Expert consensus on platelet-rich plasma treatment for osteochondral lesion of talus (version 2023) / 中华创伤杂志

Osteochondral lesion of talus (OLT) is a foot and ankle disease characterized by ankle pain, which may impact the joint function and life quality. If managed improperly, it may lead to a further ankle arthritis, severely compromising the prognosis. The therapeutic effect of conservative treatment for OLT is still uncertain. Surgery is still the main treatment modality for OLT with various techniques. However, the optimized surgical technique is still inconclusive, furthermore, regeneration and repair of cartilage after debridement is also a great challenge for the treatment of OLT. Platelet-rich plasma (PRP) with good repair effect on cartilage injury is gradually applied in the treatment of OLT. However, there still lacks the unified understanding of the technique and specification of PRP for the treatment of OLT. Therefore, National Orthopedics Center of Shanghai Sixth People′s Hospital allied Foot Ankle Basic Research & Orthopedics Group, Chinese Association of Orthopedic Surgeons; Foot and Ankle Committee of Chinese Association of Sports Medicine Physicians; and Foot and Ankle Group of Orthopedic Specialized Branch of Shanghai Medical Association to organize related experts to formulate the Expert consensus on platelet- rich plasma treatment for osteochondral lesion of talus ( version2023). Fifteen recommendations were put forward upon PRP preparation, indications, contraindications and treatment methods of PRP for OLT, so as to standardize the PRP treatment for OLT.

Expression,purification and bioinformatics analysis of PE＿PGRS35 protein of Mycobacterium tuberculosis H37Rv strain / 中国生物制品学杂志

@#Abstract： Objective To clone PE_PGRS35 gene of Mycobacterium tuberculosis（MTB），construct recombinant vector pET28a⁃PE_PGRS35，express and purify the PE_PGRS35 protein of MTB H37Rv heterologously，and explore a new target against MTB after bioinformatics analysis. Methods The PE_PGRS35 coding gene was amplified by PCR and used to construct the expression vector pET28a⁃PE_PGRS35 by recombinant cloning technology，which was transformed to E. coli BL21（DE3）after successful sequencing and induced by using IPTG. The obtained PE_PGRS35 protein was purified by Ni column affinity chromatography and analyzed by bioinformatics. Results The pET28a⁃PE_PGRS35 prokaryotic expression vector was constructed correctly as identified by sequencing. The PE_PGRS35 protein was mainly expressed in the form of inclusion bodies，with a relative molecular mass of about 53 000 and a purity of 90%. Bioinformatics analysis showed that PE_PGRS35 protein was an acid⁃labile protein，with main secondary structure of β⁃sheet and random coil，and no transme⁃ mbrane region，which was presumed to be an extramembrane protein with 39 phosphorylation sites and two conserved domains. Total 10 proteins，including Rv1769，PPE8，PPE64，PPE54，PPE24，PPE16，PPE35，PPE6，PPE28 and PE2， interacted with PE_PGRS35 protein. Conclusion PE_PGRS35 protein with high purity was successfully obtained，which provided a reference for the further development of new targets for drugs against MTB.

Potential categories of health risk behaviors of college students in Wuling Mountain Area and its association with campus bullying / 中国学校卫生

Objective@#To understand the potential categories of harmful behaviors of college students in Wuling Mountain Area and its relationship with campus bullying, so as to provide a theoretical basis for promoting the development of college students physical and mental health.@*Methods@#The stratified random cluster sampling method was used to select 3 042 college students from six universities in Wuling Mountain Area from October to December, 2022. The "Chinese Youth Health Related/Risk Behaviors Questionnaire" (University Edition) compiled by the National Youth Health Related/Risk Behaviors Survey Group was used to investigate the health risk behaviors. The potential category analysis method was used to analyze the food preference, insecurity, fighting, loneliness, depression, insomnia, heartbreak, suicidal ideation, smoking, drinking, game addiction, Internet addiction of health risk behaviors were used to further analyze the relationship between different categories and campus bullying by using multi category Logistic regression method.@*Results@#College students in Wuling Mountain Area were classified into low risk group of category 1 (44.2%), category 2 (5.4%) substance dependent group, category 3(50.4%) emotional disorder group. The distribution of potential categories of health risk behaviors among college students was statistically significant by gender( χ 2=31.44, 11.69， P < 0.05 ). Logistic regression analysis showed that after controlling demographic variables, campus bullying was the risk factor of category 3 emotional disorder group( OR =1.88, P <0.01).@*Conclusion@#bullying. Colleges and universities should attach great importance to the occurrence of campus bullying, formulate intervention programs for different categories of health hazard behaviors, and promote the healthy development of college students physical and mental health.

Effects of Remote Ischemic Preconditioning on Decreasing Troponin Release in Patients Not Taking Sulfonylureas After Cardiac Surgery - A Meta-Analysis

ABSTRACT Introduction: Remote ischemic preconditioning (RIPC) is a new noninvasive myocardial protection strategy that uses blood pressure cuf inflation to simulate transient non-fatal ischemia to protect the myocardium and reduce ischemia-reperfusion injury. Sulfonylureas may mask the effects of RIPC due to their cardioprotec-tive effect. This meta-analysis aimed to evaluate whether RIPC, in the absence of sulfonylureas, reduces troponin release in patients undergoing cardiac surgery. Methods: We conducted a meta-analysis of randomized controlled clinical trials to determine whether RIPC can reduce postoperative troponin release in cardiac surgery patients undergoing cardiopulmonary bypass without treatment with sulfonylureas. The data were normalized to equivalent units prior to the analysis. A random-effects model was used to provide more conservative estimate of the effects in the presence of known or unknown heterogeneity. Results: Six studies with a total of 570 participants were included. The analysis showed that troponin release was lower in the RIPC group than in the control group at six hours (test of standardized mean differences = 0, Z=3.64, P<0.001) and 48 hours (Z=2.72, P=0.007) postoperatively. When the mean of cross-clamping time was > 60 minutes, RIPC reduced troponin release at six hours (Z=2.84, P=0.005), 24 hours (Z=2.64, P=0.008), and 48 hours (Z=2.87, P=0.004) postoperatively. Conclusion: In cardiac surgery patients who are not taking sulfonylureas, RIPC can reduce troponin release at six and 48 hours postoperatively; hence, RIPC may serve significant benefits in certain cardiac surgery patients.

A single-center study on the distribution and antibiotic resistance of pathogens causing bloodstream infection in patients with hematological malignancies / 中华血液学杂志

Objective: To study the incidence of bloodstream infections, pathogen distribution, and antibiotic resistance profile in patients with hematological malignancies. Methods: From January 2018 to December 2021, we retrospectively analyzed the clinical characteristics, pathogen distribution, and antibiotic resistance profiles of patients with malignant hematological diseases and bloodstream infections in the Department of Hematology, Nanfang Hospital, Southern Medical University. Results: A total of 582 incidences of bloodstream infections occurred in 22,717 inpatients. From 2018 to 2021, the incidence rates of bloodstream infections were 2.79%, 2.99%, 2.79%, and 2.02%, respectively. Five hundred ninety-nine types of bacteria were recovered from blood cultures, with 487 (81.3%) gram-negative bacteria, such as Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. Eighty-one (13.5%) were gram-positive bacteria, primarily Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecium, whereas the remaining 31 (5.2%) were fungi. Enterobacteriaceae resistance to carbapenems, piperacillin/tazobactam, cefoperazone sodium/sulbactam, and tigecycline were 11.0%, 15.3%, 15.4%, and 3.3%, with a descending trend year on year. Non-fermenters tolerated piperacillin/tazobactam, cefoperazone sodium/sulbactam, and quinolones at 29.6%, 13.3%, and 21.7%, respectively. However, only two gram-positive bacteria isolates were shown to be resistant to glycopeptide antibiotics. Conclusions: Bloodstream pathogens in hematological malignancies were broadly dispersed, most of which were gram-negative bacteria. Antibiotic resistance rates vary greatly between species. Our research serves as a valuable resource for the selection of empirical antibiotics.

Research progress in diagnosis, treatment and rehabilitation of deltoid ligament injury of ankle joint / 中华创伤杂志

As the main stabilizing structure of the medial ankle joint, deltoid ligament plays a role in counteracting excessive eversion of the hindfoot and external rotation of the talus during ankle movement so as to maintain the biomechanical stability of ankle joint. Although the incidence of deltoid ligament injury is low, improper diagnosis and treatment can affect the path of talus motion and eventually lead to chronic medial instability or traumatic arthritis of the ankle joint, seriously affecting the normal life and motor function of the patients. The diagnosis of deltoid ligament injury needs to be based on the characteristics of the injury, physical examination and imaging, among which X-ray, MRI and ultrasonography are most frequently used. There are various methods to treat deltoid ligament injury according to the type of injury, and thus the choice of treatment has been a hot topic in the field of foot and ankle surgery. The choice of non-surgical or surgical treatment for acute deltoid ligament injury remains controversial. For the treatment of chronic deltoid ligament injury, there is no consensus on direct repair or deltoid ligament reconstruction. In addition, the choice of autologous or allograft tendon or wire anchors for deltoid ligament reconstruction is also disputed. The rehabilitation of deltoid ligament injury is crucial to the early restoration of motor function of the ankle joint, but the related guidelines or consensus are scarce. In order to fully understand the characteristics of deltoid ligament injury, make accurate diagnosis and formulate reasonable treatment and rehabilitation programs, the authors review the research progress in deltoid ligament injury from aspects of anatomical characteristics, biomechanical mechanism of injury, diagnosis, treatment and postoperative functional rehabilitation, hoping to provide a reference for the clinical diagnosis and treatment of deltoid ligament injury.

An evidence-based clinical guideline for the diagnosis and treatment of lateral ankle avulsion fracture (2022 version) / 中华创伤杂志

Lateral ankle avulsion fracture is a common sports injury that can lead to chronic lateral ankle instability and substantial deterioration of the joint function. Currently, problems such as misdiagnosis, inappropriate treatment, disparate outcomes and lack of standardization are usually met in the diagnosis and treatment of lateral ankle avulsion fracture. The Foot and Ankle Committee of Chinese Association of Sports Medicine Physicians thus organized a working group of experts in the field of sports medicine and ankle surgery from China to develop "An evidence-based clinical guideline for the diagnosis and treatment of lateral ankle avulsion fractures (2022 version)" in accordance with the principle of evidence-based medicine and scientificity and practicability. The guideline covered the topics of imaging diagnosis, indications and methods of non-operative and operative treatment as well as postoperative rehabilitation, in order to provide guidance for the diagnosis and treatment of lateral ankle avulsion fracture.

Research progress in the diagnosis, treatment and rehabilitation of peroneal tendon spondylolisthesis / 中华创伤杂志

Peroneal tendon plays an important role in maintaining the alignment of the hindfoot and stabilizing the arch of the foot. It is also the main tendon against ankle varus injuries, and is of great significance in maintaining lateral ankle stability. As an infrequent disease, peroneal tendon spondylolisthesis can be easily misdiagnosed in clinical diagnosis and treatment which results in pain and instability of the lateral ankle and weakness in eversion of the affected foot. Improper diagnosis or treatment can affect patient quality of life. Peroneal tendon spondylolisthesis is mainly treated by non-surgical and surgical treatments, among which surgical treatments mainly include superior peroneal retinaculum repair, superior peroneal retinaculum augmentation, peroneal bone block procedure, peroneal groove deepening technique, and peroneal rearrangement. Surgical indications for different surgical treatments remain controversial. Moreover, there are no rehabilitation guidelines for peroneal tendon spondylolisthesis at home or abroad, and postoperative rehabilitation is generally based on the experience of clinicians. On the basis of related literature, the authors review the research progress in treating peroneal tendon spondylolisthesis from aspects of anatomical characteristics, injury mechanism, diagnosis, treatment and rehabilitation, so as to provide a reference for accurate and effective diagnosis, treatment and rehabilitation of peroneal tendon spondylolisthesis.

Development of grip strength and its relationship with body composition in preschoolers / 中国学校卫生

Objective@#To study the development of grip strength and its relationship with body weight, height and body composition in preschool children.@*Methods@#Data was collected from 900 children aged 3-6 years in 4 preschools in Beijing during Sept. to Oct. of 2020. A questionnaire survey (birth weight, dietary and exercise), height, weight, bioelectrical impedance analysis of body composition and dominant hand grip strength tests were conducted. Partial correlational analysis, multivariate linear regression were used for association between grip strength and body composition.@*Results@#The grip strength gradually increased with age, from (5.2±1.7) to (9.3±2.5)kg in boys ( F=57.93, P <0.01), and from (4.3±1.6) to (7.9±2.5)kg in girls ( F=48.77, P <0.01). Grip strength in boys were significant higher than that of girls ( t=6.42, P <0.01). The grip strength increased with weight status in boys ( F=5.35, P <0.01), with highest in obese group, followed by overweight and normal weight group. After adjusted for height, weight and birth weight, as well as maternal education, food consumption during the past week, grip strength in boys was positively correlated with fat free mass, upper limb muscle mass ( r=0.11, 0.09, P <0.05), and negatively correlated with body fat mass ( r=-0.18, P <0.05). Grip strength in girls was negatively correlated with body fat mass, and positively correlated with fat free mass ( r= -0.09, 0.09, P <0.05). Grip strength varied significantly by age, fat free mass and upper muscle mass in boys ( F=66.75, P < 0.01), and by age and fat free mass in girls ( F=150.81, P <0.01).@*Conclusion@#The grip strength can partially reflect changes in fat free mass for boys and girls, it also reflect changes in upper limb muscle mass for boys. Increases in fat free mass helps grip strength improvement.

Anemia in preschool children in China and its association with neuropsychological development / 中国学校卫生

Objective@#To explore the relationship between anemia and neuropsychological development in various domains among preschool children in China.@*Methods@#Data came from the National Nutrition and Health Systematic Survey for children in China, and 3 261 preschool children aged 2-6 years and their parents from 28 sites across 14 provinces were recruited in this study. Parental and child characteristics were obtained by interview administrated questionnaires. Blood hemoglobin(Hb) concentration was determined by Hemocue method. Neuropsychological development quotients were assessed using the Development Scale for Children Aged 0-6 Years(WS/T 580-2017).@*Results@#The average Hb level was (125.23±11.49)g/L and the overall anemia prevalence was 10.30% among preschool children. After adjusting the confounding factors(sex, age, ethnicity, region, feeding mode, maternal status during pregnancy, etc), developmental quotients of gross motor( β=-2.15, 95%CI =-3.89--0.41), fine motor( β=-2.46, 95%CI =-4.12--0.79), adaptive behavior( β=-2.59, 95%CI =-4.42--0.76), language( β=-3.65, 95%CI =-5.53--1.78), personal social behavior( β=-3.11, 95%CI =-4.94--1.28) and full scale( β=-2.79, 95%CI =-4.10--1.49) among children with anemia were significantly lower than non anemic infants( P <0.05).@*Conclusion@#Anemia was negatively associated with developmental quotient, as well as five domains of gross motor, fine motor, adaptive behavior, language, and personal social behavior in preschool children aged 2-6 years. It is suggested to carry out the work of anemia monitoring and intervention in preschool children to further improve their neuropsychological development.

Relationship between screen time and myopia in children aged 11-14 years in China / 中国学校卫生

Objective@#To explore relationship between screen time and myopia in children aged 11-14 years in China.@*Methods@#The data were extracted from "National Nutrition and Health Systematic Survey and Application for 0-18 Years Old Children". A total of 12 397 children aged 11-14 years old from 14 provinces and 28 districts/counties in seven regions of China were surveyed by using multi stage stratified random sampling method. Daily screen time and visual acuity information were collected through a questionnaire.@*Results@#The myopia rate of 11-14 years old children in China was 45.0%, among which the rate of girls was higher than that of boys, and the rate of urban was higher than that of rural, and it increased with age ( χ 2=178.82,79.25, 495.96 , P <0.01). The daily screen time median of 12 397 children was 40.0 minutes, with boys(40.0 min) longer than girls( 35.0 min ) and urban children(40 min) longer than rural children(33.0 min) ( χ 2=20.86，102.68， P <0.01). The myopia rate of boys ( 42.5 %) with daily screen time greater than or equal to 60 minutes was higher than that of boys (36.4%) with daily screen time less than 60 minutes, and the myopia rate of girls (55.6%) with daily screen time greater than or equal to 60 minutes was higher than that of girls (48.0%)( χ 2=23.62，34.15， P <0.01). After adjusting for age, gender, region, time of medium and high intensity physical activity, intake of sugary food and sugary beverages, daily sleep time, multivariable Logistic regression model showed that girls with daily screen time greater than or equal to 60 minutes ( OR=1.14, 95%CI =1.03-1.27) had a higher risk of myopia than those with less than 60 minutes. After adjusting for confounding factors, there was no correlation between daily screen time and the degree of myopia in boys or girls( P >0.05).@*Conclusion@#Daily screen time greater than or equal to 60 minutes may be a risk factor for myopia in girls aged 11 to 14 years old. Given the complexity of the factors that affect vision, researches are needed to examine the relationship between screen time and myopia.

Demethylenetetrahydroberberine protects dopaminergic neurons in a mouse model of Parkinson's disease / 中国天然药物

Parkinson's disease (PD) is a multifactorial disorder of the nervous system where a progressive loss of dopaminergic neurons exist. However, the pathogenesis of PD remains undefined, which becomes the main limitation for the development of clinical PD treatment. Demethylenetetrahydroberberine (DMTHB) is a novel derivative of natural product berberine. This study was aimed to explore the neuroprotective effects and pharmacological mechanism of DMTHB on Parkinson's disease using C57BL/6 mice. A PD model of mice was induced by administration of MPTP (20 mg·kg-1) and probenecid (200 mg·kg-1) twice per week for five weeks. The mice were administered with DMTHB daily by gavage at the dose of 5 and 50 mg·kg-1 for one- week prophylactic treatment and five-week theraputic treatment. The therapeutic effects of DMTHB were evaluated by behavior tests (the open field, rotarod and pole tests), immunohistochemical staining of tyrosine hydroxylase (TH), Nissl staining and biochemical assays. The molecular mechanisms of DMTHB on the key biomarkers of PD pathological states were analyzed by Western blot (WB) and qRT-PCR. DMTHB treatment alleviated the behavioral disorder induced by MPTP-probenecid. Nissl staining and TH staining showed that the damage of dopaminergic neurons in the substantia nigra was remarkably suppressed by DMTHB treatment. Western blot results showed that the ratio of Bcl-2/Bax and TH increased, but the level of α-synuclein (α-syn) was remarkably reduced, which indicated that the apoptosis of dopaminergic neurons in mice was significantly reduced. The protein phosphorylation of p-PI3K, p-AKT and p-mTOR also increased about 2-fold, compared with the model group. Furthermore, qRT-PCR results demonstrated that the mRNA levels of pro-inflammatory cytokines, IL-1β and TNF-α, were reduced, but the level of anti-inflammatory cytokine IL-10 increased after DMTHB treatment. Finally, the cellular assay displayed that DMTHB was also a strong antioxidant to protect neuron cell line PC12 by scavenging ROS. In this study, we demonstrated DMTHB alleviates the behavioral disorder and protects dopaminergic neurons through multiple-target effects includubg anti-apoptotic, anti-inflammatory and antioxidant effects.

Quantitative Classification of Murraya paniculata Leaf Traits and Endogenous Hormone Contents Analysis / 中国实验方剂学杂志

Objective:To carry out germplasm resource evaluation and new variety breeding of <italic>Murraya paniculata</italic> and improve the germplasm quality， so as to ensure the demand， yield and quality of medicinal materials. Method:Following resource investigation and collection， 17 traits of 107 <italic>M. paniculata</italic> germplasm samples， like plant type， basal diameter， leaf shape， leaf length， and leaf width were determined and then subjected to principal component analysis and factor analysis for screening the principal component factors. Nine primary traits were selected as variables for further cluster analysis using Ward's method and Euclidean distance. According to the characteristics of medicinal parts， the core germplasms were screened out. Then the contents of auxin， zeatin， zeatin nucleoside， isopentenyl adenine， isopentenyl adenine riboside， dihydrozeatin， and dihydrozeatinriboside in the leaves were measured by ultra-performance liquid chromatography-tandem mass spectrometry （UPLC-MS/MS）， followed by their correlation analysis with agronomic trait. Result:The variation coefficients of petiole length， branching number， and basal diameter were large. The nine main factors could be classified into four categories， with a contribution rate of 72.822%. The cluster analysis with Ward's method and Euclidean distance showed that 107 germplasm samples were clustered into six clusters and 61 core germplasms were identified. Such traits as leaf length， leaf width， petiole length， leaf surface， and petiole color were found to play an important role in the classification of <italic>M. paniculata</italic> germplasms. The content of zeatin nucleoside exhibited significant positive correlations with leaf length （<italic>P</italic><0.01）， petiole length （<italic>P</italic><0.01）， and leaf width （<italic>P</italic><0.05）. Conclusion:These results have laid the foundation for further selection and breeding of <italic>M. paniculata</italic> new varieties.

Combined detection of urine specific gravity and BK viruria on prediction of BK polyomavirus nephropathy in kidney transplant recipients / 中华医学杂志(英文版)

BACKGROUND@#BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) is an important cause of dysfunction and failure of renal transplants. This study aimed to assess the diagnostic performance of morning urine specific gravity (MUSG) in diagnosing BKPyVAN in kidney transplant recipients.@*METHODS@#A total of 87 patients, including 27 with BKPyVAN, 22 with isolated BKPyV viruria, 18 with T cell-mediated rejection (TCMR), and 20 with stable graft function, were enrolled in the First Affiliated Hospital of Sun Yat-Sen University from March 2015 to February 2017. MUSG at biopsy and during a follow-up period of 24 months after biopsy was collected and analyzed. Receiver operating characteristic (ROC) curve analysis was used to determine the ability of MUSG to discriminate BKPyVAN.@*RESULTS@#At biopsy, the MUSG of BKPyVAN group (1.008 ± 0.003) was significantly lower than that of isolated BK viruria group (1.013 ± 0.004, P < 0.001), TCMR group (1.011 ± 0.003, P = 0.027), and control group (1.014 ± 0.006, P < 0.001). There was no significant difference in MUSG among the isolated BK viruria group, TCMR group, and control group (P = 0.253). In BKPyVAN group, the timing and trend of MUSG elevate were consistent with the timing and trend of the decline of viral load in urine and plasma, reaching a statistical difference at 3 months after treatment (1.012 ± 0.003, P < 0.001) compared with values at diagnosis. ROC analysis indicated that the optimal cut-off value of MUSG for diagnosis of BKPyVAN was 1.009, with an area under the ROC curve (AUC) of 0.803 (95% confidence interval [CI]: 0.721-0.937). For differentiating BKPyVAN and TCMR, the optimal MUSG cut-off value was 1.010, with an AUC of 0.811 (95% CI: 0.687-0.934).@*CONCLUSION@#Combined detection of MUSG and BKPyV viruria is valuable for predicting BKPyVAN and distinguishing BKPyVAN from TCMR in renal transplant recipients.

Clinical effect of artificial semi-shoulder joint replacement in treatment of humeral head necrosis / 局解手术学杂志

Objective To explore the clinical effect of the semi-shoulder arthroplasty in the treatment of humeral head necrosis.Methods Twenty patients with head necrosis of the humerus in first hospital affiliated to army medical university from February 2008 to January2018 were collected, including 8 cases of males, 12 cases of females, 7 cases of left shoulder and 13 cases of right shoulder.The patients were aged from 45 to 83 years old, mean (67.40±5.06) years old.All patients were followed up for at least 6 months, the anterior flexion angle, abduction angle, external rotation angle and internal rotation angle of shoulder joint were measured, the function of shoulder joint was evaluated by ASES, UCLA, SST, and VAS, and the imaging examination was conducted.Results All patients were followed up for 6 to 37 months after surgery, with average (18.50±5.31) months, 2 patients presented mild pain during shoulder joint activity, 1 patient presented brachial plexus nerve damage, but returned to normal 3 months after surgery.No complication happened.X-ray reexamination showed good position and angle of the prosthesis during the follow-up period.The preoperative anteflexion angle, angle of outreach, swing angle and swing angle of the shoulder joint were respectively (55.24±8.21) °, (42.58±6.21) °, (12.95±2.74) °, (17.79±3.65) °, the last follow-up were respectively (120.76±13.15) °, (103.08±10.54) °, (33.51±3.14) °, (50.10±7.25) °, the differences were significant (P＜0.01);The preoperative ASES score, UCLA score, SST score, VAS score of the shoulder joint were respectively (38.24±5.21), (12.58±3.93), (3.25±1.42), (6.79±1.65), the last follow-up were respectively (75.74±9.69), (33.08±4.5), (9.11±1.85), (1.45±0.24), the differences were significant (P＜0.01).Conclusion Artificial semi-shoulder replacement for the treatment of humeral head necrosis can significantly improve the range of limb function, relieve the pain symptoms of patients and improve patients'quality of life, which has excellent and good shoulder function rate and fewer complications.

Selection of modeling time for type 2 diabetes mellitus mouse / 中国应用生理学杂志

OBJECTIVE@#To analyze the changes of blood biochemical index and the pathological changes of myocardium and kidney in type 2 diabetic mouse at different time points, which can provide the basis for the selection of type 2 diabetic modeling time for later research.@*METHODS@#After 6 weeks of feeding with high-fat diet, 24 healthy male ICR mice were injected with streptozocin (STZ, 30 mg/kg) intraperitoneally for 5 days to establish diabetic models. After 9 days, a random blood glucose ≥ 11.1 mmol / L was measured as diabetic mice. 4, 6 and 8 weeks after successfully preparing the diabetic mouse, 8 diabetic mice (a group)would be sacrificed each time. Then the biochemical and pathological conditions were analyzed: ① the indexes of heart and kidney were calculated. ②the serum levels of creatine kinase (CK), lactate dehydrogenase (LDH), creatinine (Cr) and blood urine nitrogen (BUN) were determined. ③ Histopathological changes of myocardium and renal tissues were observed by hematoxylin and eosin (HE) staining. Masson staining was used to observe the fibrosis of myocardium. PAS staining was adopted to observe the pathological changes of renal tissue. In addition, 8 ICR male mice were taken as the control group.@*RESULTS@#At the 4, 6 and 8 week, cardiac organ coefficient, the values of LDH and CK were all increased compared with the control group. Cardiomyocyte hypertrophy and myocardial fibrosis could be observed. Renal organ coefficient, the values of Cr and BUN were increased. Glomerular hypertrophy, basement membrane thickening and atrophy could be perceived.@*CONCLUSION@#At the 6 week, related biochemical and pathological changes in diabetic mice were comparatively obvious and breeding time was relatively short. Thus, 6 weeks after the preparation of the diabetic mice would be the optimal time for type 2 diabetes mellitus modeling, proper for inventions of drugs and other research purposes including pathology, physiology, biochemistry, etc.

Prognosis of BK polyomavirus nephropathy: 10-year analysis of 133 renal transplant recipients at a single center / 中华医学杂志(英文版)

BACKGROUND@#BK virus-associated nephropathy (BKVN) is an important cause of chronic allograft dysfunction. The objective of our study was to evaluate the prognosis of BKVN.@*METHODS@#We retrospectively reviewed the data of 133 renal transplant recipients with BKVN treated at the First Affiliated Hospital of Sun Yat-Sen University between July 2007 and July 2017. BK viral loads, graft function, and pathologic indexes were compared between initial diagnosis and last follow-up.@*RESULTS@#After a mean follow-up period of 14.4 (range, 0.3-109.6) months after diagnosis of BKVN, BK viruria, and BK viremia become negative in 19.5% and 90.2% of patients, respectively. The mean estimated glomerular filtration rate (eGFR) at last follow-up was lower than at diagnosis of BKVN (18.3 ± 9.2 vs. 32.8 ± 20.6 mL·min·1.73 m, t = 7.426, P < 0.001). Eight (6.0%) patients developed acute rejection after reducing immunosuppression. At last follow-up, the eGFR was significantly lower in patients with subsequent rejection than those without (21.6 ± 9.8 vs. 33.5 ± 20.9 mL·min·1.73 m, t = 3.034, P = 0.011). In 65 repeat biopsies, SV40-T antigen staining remained positive in 40 patients and became negative in the other 20 patients. The eGFR (42.6 ± 14.3 vs. 26.5 ± 12.3 mL·min·1.73 m), urine viral loads (median, 1.3 × 10vs. 1.4 × 10 copies/mL), and plasma viral load (median, 0 vs. 0 copies/mL) were all significantly lower in patients with negative SV40-T antigen staining than those with persistent BK involvement (all, P < 0.05). Five (3.8%) recipients lost their graft at diagnosis of BKVN, and 13 (9.8%) lost their graft during the follow-up period. The 1-, 3-, and 5-year graft survival rates after diagnosis of BKVN were 99.2%, 90.7%, and 85.7%, respectively. Higher pathologic stage correlated with lower allograft survival rate (χ = 6.341, P = 0.042).@*CONCLUSION@#Secondary rejection and persistent histologic infection in BKVN lead to poor prognosis.

Effects of ursolic acid on liver injury and its possible mechanism in diabetes mellitus mice / 中国应用生理学杂志

OBJECTIVES@#To study the effects of ursolic acid on liver injury in diabetic mice induced by high-fat diet combined with streptozotocin(STZ), and to explore its possible mechanisms.@*METHODS@#Diabetes mellitus was induced in twenty male ICR mice by a combination of high-fat diet for 6 weeks with low-dose streptozotocin (30 mg/kg, i. p.) for 5 consecutive days. After 9 days, fasting blood glucose levels were determined. Mice with fasting blood glucose levels exceeded 11. 1 mmol/L were diagnosed as diabetic mice and selected for further experiment. These mice were randomly divided into two groups(each group of 10):diabetic group, ursolic acid group (100 mg/kg, i. g.), and another 10 mice were set as control group. After continuous administration for 8 weeks, body weight (BW) were weighed, fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), alanine aminotransferase (ALT), aspartate transaminase (AST) in serum and superoxide dismutase (SOD), malondialdehyde (MDA) in liver were measured. HE staining was used to observe pathological changes of liver tissue.@*RESULTS@#Compared with the control group, the level of FBG, TC, TG, ALT, AST, MDA were dramatically increased (<0. 05, <0. 01) and SOD was markedly decreased (<0.01) in the diabetic group; HE staining showed that parts of liver cells swelled and had a light fatty degeneration as well as lymphocyte infiltrated around the portal area in model group. Compared with the diabetic group, the level of FBG, TC, TG, ALT, AST, MDA were significantly declined (<0.05, <0.01) and SOD was considerably increased (<0.01) in the ursolic acid group; HE staining showed that the liver cells relatively arranged in order, edema was not obvious and inflammatory cells infiltrated lightly in the ursolic acid group.@*CONCLUSIONS@#Ursolic acid has a protective effect on liver injury in diabetic mice induced by high-fat diet combined with STZ by intraperitoneal ingector, and its mechanism may be associated with lowering blood glucose, regulating the lipid metabolism, reducing oxidative stress and enhancing the ability of anti-oxidation in liver.

Effect of ursolic acid on cardiomyopathy of mice with diabetes and its mechanism / 中国应用生理学杂志

OBJECTIVE@#To study the effect of ursolic acid on cardiomyopathy in mice with diabetes induced by high-fat diet combined with low dose streptozotocin, and to explore its possible mechanism.@*METHODS@#Thirty male ICR mice were randomly divided into control group (=10) and moulding group (=20), the mice in the two groups were fed with regular diet and high-fat diet respectively for 6 weeks, and then the mice in the moulding group were injected with streptozotocin (30 mg/kg) for 5 successive days to induce diabetes mellitus (DM). Fasting blood glucose (FBG) was measured after 9 days. Mice with FBG over 11.1 mmol/L were regarded as DM. Twenty DM mice were randomly divided into model group and ursolic acid group (=10). Mice in each group were continuously administrated ursolic acid (100 mg/kg) or corresponding solvent intragastrically for 8 weeks. After that, FBG was measured, body weight (BW), heart weight and left ventricular weight were weighed in order to calculate the heart mass index (HMI) and left ventricular mass index (LVMI). Levels of creatine kinase (CK), lactate dehydrogenase (LDH) in serum and the level of superoxide dismutase (SOD), malondialdehyde (MDA) in myocardial tissue were detected. HE staining was used to observe pathological changes of myocardial tissue. Immunohistochemistry was employed to determine the expression of NOD-like receptor protein 3 (NLRP3) and interleukin 1β (IL-1β).@*RESULTS@#Compared with the control group, HMI, LVMI were apparently enlarged, levels of FBG, CK, LDH in serum and MDA in myocardial tissue were extremely increased, while the activity of SOD in myocardial tissue were extraordinary decreased in diabetic group. HE staining of myocardium showed that arrangement disorder of myocardial fibers, edema and hypertrophy in myocardial cell, as well as inflammatory cell infiltration in model group. Immunohistochemistry showed that the expression of NLRP3 and IL-1β in myocardial tissue increased obviously in model group, the above changes inursolic acid group were significantly ameliorated.@*CONCLUSIONS@#Ursolic acid has a obvious protective effect on myocardial injury in mice with diabetes induced by high-fat diet combined with low dose streptozotocin, and its mechanism may be associated with inhibiting NLRP3 inflammasome activation, reducing IL-1β generation and alleviating myocardial inflammatory injury.

Associations of VDR polymorphisms with tacrolimus concentrations in Chinese renal transplant recipients / 药学学报

The paper was aimed to investigate the association of VDR polymorphisms with tacrolimus (FK506) concentration in Chinese renal transplant recipients. A total of 114 renal transplant recipients receiving tacrolimus were genotyped for VDR rs1540339 and rs2853559 by Agena Bioscience MassARRAY® system and CYP3A5*3 by PCR-RFLP method. Trough concentrations of tacrolimus on day 7 after renal transplantation were collected from clinical data. Statistical analysis was performed with Spearman's correlation, Mann-Whitney U test and Kruskal-Wallis H test. The dose-adjusted concentration of tacrolimus in VDR rs2853559 GA and GG carriers were considerably higher than that of AA carriers. After stratification by CYP3A5*3 genotypes, VDR rs2853559 GA and GG carriers had a higher dose-adjusted tacrolimus concentration than that in AA carriers in CYP3A5 nonexpresser. CYP3A5*3 and VDR rs2853559 explained 45.6% variability of tacrolimus C0/D. In CYP3A5 non-expressers, VDR rs2853559 explained 14.4% variability of tacrolimus C0/D. The results illustrated that VDR rs2853559 polymorphisms was associated with tacrolimus concentrations, and the determination of this SNP may be useful for individualized medicine of tacrolimus.