Research progress on the correlation between circadian rhythm and clock genes and the pathogenesis of diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

Diabetic retinopathy(DR)is the most common microvascular complication of patients with diabetes mellitus, and it has become one of the leading causes of visual impairment among working-age people worldwide. The pathogenesis of DR is complicated with multiple mechanisms. Plenty of studies have indicated that circadian rhythm and clock genes are closely related to the pathogenesis of DR. Circadian rhythm is a physiological process regulated by clock genes, which takes 24h as a cycle and is consistent with the changes of light and dark outside. Circadian rhythm regulates various physiological activities of the body. The disturbance of circadian rhythm induces DR by affecting the blood glucose level and the physiological homeostasis of the eye in patients with diabetes mellitus, and clock genes may be involved in the pathogenesis of DR by regulating oxidative stress response, inflammatory response, retinal autophagy rhythm, mitochondrial dysfunction and endothelial progenitor cell function. This paper will introduce the generation and regulation mechanism of circadian rhythm, as well as the internal circadian rhythm of retina, and further discuss the influence of circadian rhythm and clock genes on the occurrence and development of DR, aiming to provide a reference for the prevention and treatment of DR.

Mechanism of Buyang Huanwu Decoction alleviating inflammatory response after cerebral ischemia/reperfusion injury by activating SIRT1 in hippocampus of rats / 中国药理学通报

Aim To explore the inhibitory effect of Buyang Huanwu Decoction on the inflammatory response in the hippocampus of brain tissues of CIRI rats by regulating SIRT1 and the underlying mechanism. Methods The middle cerebral artery embolization (MCAO) model was prepared in rats and divided into sham operation group (Sham), model group (MCAO/R), Buyang Huanwu Decoction group (BYHWT),and BYHWT + SIRT1 inhibitor group (BYHWT + EX527). Zea Longa was used to detect the neurological function score of rats in each group; TTC staining was used to determine the volume of cerebral infarction; HE staining was used to observe the pathological damage of the hippocampus; Western blot was used to detect the expression levels of SIRT1 and IL-6; immunohistochemistry was used to detect TNF-α, IL-1β expression level. Results Compared with the sham group,the neurological function score of the MCAO/R group increased (P < 0.05); the volume of cerebral infarction increased (P < 0.05); the nerve cells in hippocampus were severely damaged, arranged disorderly, and the nucleus was broken; Western blot showed that the expression of SIRT1 decreased, IL-6 expression increased (P <0.05); immunohistochemistry showed that TNF-α,IL-1β expression increased (P < 0.05). Compared with the MCAO/R group, the neurological function score of the BYHWT group decreased (P <0.05); the volume of cerebral infarction decreased (P < 0.05); the damage of nerve cells in hippocampus was reduced; Western blot showed that the expression of SIRT1 increased and IL-6 expression decreased (P < 0.05); immunohistochemistry showed that TNF-α, IL-1β expression decreased (P < 0.05). Compared with the BYHWT group, the neurological function score of the BYHWT + EX527 group increased (P < 0.05); the volume of cerebral infarction was raised (P <0.05); the damage of nerve cells in hippocampus was aggravated; Western blot showed that the expression of SIRT1 decreased and IL-6 expression increased (P < 0.05); immunohistochemistry showed that TNF-α, IL-1β expression increased (P < 0.05). Conclusions Preliminary discussion of Buyang Huanwu Decoction can activate SIRT1 in hippocampus of rat brain tissues to reduce the inflammatory response after CIRI and play a role in brain protection.

Effect of Physical Therapy and Heel Sound Feedback on Motor Function of Lower Limbs for Patients with Stroke Based on ICF Core Set / 中国康复理论与实践

Objective:To study the effect of physical therapy and heel sound feedback on lower limbs motor function, mobility and activities of daily living (ADL) for stroke patients based on International Classification of Functioning, Disability and Health (ICF) core set. Methods:From April, 2018 to May, 2020, 113 stroke patients with motor dysfunction were divided into ischemia group (n = 67) and hemorrhagia group (n = 46) according to the cause of stroke. They received physical therapy for lower limbs and heel sound feedback for eight weeks, and assessed with ICF core set for stroke-gait, Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Timed 'Up and Go' Test (TUGT), and modified Barthel index (MBI) before and after intervention. Results:The main effect of time was significant for qualifiers of ICF core set for stroke-gait, the scores of FMA-LE and MBI, and TUGT time (F > 100.59, P < 0.001), and it improved time by time as Post Hoc test. The main effect of groups was not significant (F < 2.29, P > 0.05), nor as Post Hoc test. The interactive effect between time and groups was significant for TUGT time (F = 6.45, P < 0.01), perhaps improved more in the hemorrhagia group, however, the interactive effect was not significant for the others. Conclusion:Physical therapy and heel sound feedback can improve motor function of lower limb, mobility and ADL for stroke patients.

Distribution and drug resistance of wound pathogenic microorganisms in outpatients of wound healing center / 中华创伤杂志

Objective:To analyze the distribution and drug resistance of wound pathogenic microorganisms in outpatients of wound healing center so as to provide a basis for the standardized construction of wound healing centers.Methods:A retrospective case series study was used to analyzed the data of 365 outpatients treated at Ruijin Hospital, Shanghai Jiaotong University School of Medicine from December 2017 to October 2019. There were 220 males and 145 females, aged (58.8±18.9)years (range, 18-98 years). The patients included 92 first-visit patients and 273 re-visit patients. The culture results (positive rate of pathogenic microorganisms, bacterial species, bacterial distribution) and drug sensitivity results of the wound secretions were compared and analyzed.Results:(1) Among 365 samples of wound secretions, 198 patients were positive for pathogenic microorganisms with a positive rate of 54.3%. A total of 107 strains (51.0%) of Gram-positive bacteria were detected, mainly Staphylococcus aureus (70 strains, 33.3%); 95 strains (45.2%) of Gram-negative bacteria were detected, mainly Escherichia coli (20 strains, 9.5%), followed by Pseudomonas aeruginosa (17 strains, 8.1%); 8 strains (3.8%) of fungi were detected. (2) A total of 26 (28.3%) first-visit patients were positive for pathogenic microorganisms, and 172 (63.0%) re-visit patients were positive for pathogenic microorganisms. The rate of positive microorganism detection had significant differences between first-visit and re-visit patients ( P<0.05). (3) A total of 29 strains were detected in first-visit patients, including 16 strains (55.2%) of Gram-positive bacteria, 11 strains (37.9%) of Gram-negative bacteria and 2 strains (6.9%) of fungi. A total of 181 strains were detected in re-visit patients, including 91 strains (50.3%) of Gram-positive bacteria, 84 strains (46.4%) of Gram-negative bacteria and 6 strains (3.3%) of fungi. The microbial distribution was significantly different between first-visit and re-visit patients ( P<0.05). (4) Compared with first-visit patients, the resistance of Staphylococcus aureus isolated from the re-visit patients to spenicillin, oxacillin, ciprofloxacin, tetracycline, clindamycin, moxifloxacin, erythromycin, and levofloxacin were increased variably. No vancomycin-resistant Staphylococcus aureus was detected, indicating that the staphylococcus aureus presented in the wound was highly sensitive to vancomycin. Conclusions:Staphylococcus aureus is the most common microorganism in wound secretions in outpatients of wound healing center. The rate of positive pathogenic microorganisms in wound secretions of re-visit patients is significantly higher than that of first-visit patients, and the distribution of pathogenic microorganisms of first-visited and revisited patients differs significantly. The Staphylococcus aureus detected in re-visit patients has a higher resistance to common antibiotics compared with first-visit patients. It is suggested that timely detection of pathogenic microorganisms in outpatients and effective control and supervision of outpatient infections are important contents that cannot be ignored in the construction of wound healing center.

Pharmacognostical study of Chinese medicine Prinsepiae Nux / 中草药

Objective: To provide scientific evidence for the identification of Prinsepiae Nux by observing the characteristics and microscopic characteristics, which may be of relevance to the compilation of 2020 edition of Chinese Pharmacopoeia. Methods: The pharmacognosy of fruit core from 12 batches of P. uniflora and nine batches of P. uniflora var. serrata were studied by character identification, micro-morphological identification, conventional microscopic identification and polarized light microscopic identification. Results: From the shape, size, color, surface characteristics, texture, cross-section, qi, taste and other aspects, the characteristics of pupae and dentate wood were observed and studied. For the hard texture and after the softening treatment, it is still not suitable to prepare cross-sections to observe the complete plant tissue structure and determine the medicinal material of the tissue site. Using free-hand slicing technology of positioning and taking materials can accurately obtain the microscopic characteristics of plant tissue in specific parts; A medicinal material that integrates a large group of bundles and is difficult to show the complete morphological characteristics of a single cell after pulverization. Using dissociated tissue filming technology, it is possible to obtain clear, complete, and non-overlapping single cell full-spectrum and characteristic information. Conclusion: Micro-morphological characteristics (endocarp,cotyledon and seed coat)were obtained for the first time. the results of microscopic identification and micro-morphological identification fill in the blank of color image information. Stone cells of endocarp can be used as specific markers for microscopic identifying Prinsepiae Nux.

Combined application of extended depth of field imaging, image stitching and polarized microscopy techniques in identification of Spatholobus suberectus / 中草药·英文版

Objective: As traditional techniques for microscopic identification of Chinese medicines currently lack objective and high-quality reference images, here we developed a systemic procedure to be used in microscopic identification of Chinese medicines, which would lead to more objective, effective and accurate identification process. Methods: Spatholobi Caulis (Jixueteng in Chinese) was used as the specimen in the development of such procedure. Jixueteng samples were microscopically examined in bright- and dark-field microscopy. Microscopic images were obtained by regular, EDF, and image stitching techniques. Results: The microscopic images of the characteristics in pulverized Jixueteng were captured, thanks to EDF imaging and image stitching techniques which allowed the detailed and full sighting of each characteristic to be obtained simultaneously. Different layers in anatomical transverse section, including cork, phelloderm, cortex, phloem, cambium, xylem and pith, were distinctively observed. Moreover, by comparing images of bright- and dark-field microscopy, birefringent and non- birefringent components could readily be distinguished. Conclusion: With application of the developed procedure, high-definition, panoramic and microscopic images were acquired, which could be used as the reference images for microscopic identification of Chinese medicines.

Investigate thenovel coronaviruses in external environmentof COVID-19 / 中华实验和临床病毒学杂志

Objective To understand the distribution of novel coronaviruses in the external environment of confirmed COVID-19 cases. Methods Environmental surface swab specimens such as bed rails, doorknob, closestool, hand washing sink, table, locker,ward pager, mobile phone, cup, clothes, were collected from the sentinel hospital of COVID-19, and samples were collected for the nucleic acid detection by RT-PCR. Results A total of 150 environmental samples were collected from 30 confirmed COVID-19 cases, 6 samples were determined to be novel coronaviruses postive (positive rate 4.00%). The total 14 mobile phone showed 3 novel coronaviruses positive.Among the 30 confirmed COVID-19 cases, 6 cases (positive rate 20.00%)were found novel coronaviruses in the external environment. Conclusions Novel coronaviruses exists in external environment of confirmed COVID-19 cases, which indicates the potential risk of COVID-19 infection.

Comparison of the Curative Efficacy of Elderly Patients with High-Risk MDS and MDS-Transformed AML between Decitabine Combined with Low-Dose CEG Regimen and Decitabine Combined with Low-Dose CAG Regimen / 中国实验血液学杂志

OBJECTIVE@#To evaluate the efficacy of decitabine combined with low-dose CEG regimen (DCEG) and decitabine combined with low-dose CAG regimen (DCAG) in the treatment of elderly patients with MDS and MDS-transformed acute myeloid leukemia (AML).@*METHODS@#A prospective study was conducted in 7 medical centers, 45 patients with MDS (≥ 60 years old) and MDS-transformed AML from October 2016 to January 2019 were enrolled, with the median age of 68.5 years old. The risk stratification of patients was poor or very poor, according to IPSS-R score. The treament results of decitabine combined with CEG and decitabine combined with CAG were compared.@*RESULTS@#The comparison of the two regiem showed that the DCEG regimen had advantages on total effective rate (ORR, 86.4% vs 47.8%, respectively), overall survival time (OS) (10.0 months vs 6.0 months, respectively) and progression-free survival time (PFS) (9.0 months vs 3.0 months, respectively). About 50% of MDS patients treated by DCEG regimen achieved PR or CR, with a median OS of 31 months. Multivariate analysis showed that patients with PR or CR after induction therapy and DCEG regimen had longer survival time (31months). The incidence of bone marrow suppression, infection and treatment-related mortality rate were similar between the two groups.@*CONCLUSION@#Decitabine combined with CEG regimen could improve the survival of patients with high-risk MDS and MDS-transformed AML. The conclusion of the reaserch needs to be validated by a larger prospective randomized clinical trial.

Study on the correlation between the mandibular masticatory muscle movement and sleep tooth wear / 华西口腔医学杂志

OBJECTIVE@#To investigate the correlation between the clinical diagnostic criteria of sleep bruxism and the frequency of mandibular movements during sleep.@*METHODS@#Video polysomnography was used to record 20 healthy adults with at least one of the following clinical symptoms and signs: 1) report of frequent tooth grinding; 2) tooth wear and dentin exposure with at least three occlusal surfaces; 3) masticatory muscle symptoms in the morning; 4) masseter muscle hypertrophy. The rhythmic masticatory muscle activity (RMMA) and isolated tonic activity were scored to compare the correlations with clinical symptoms and signs. Finally, the incidence of temporomandibular disorders (TMD) was investigated in patients with isolated tonic and RMMA subjects.@*RESULTS@#Among the 20 subjects, RMMA events were observed (5.8±3.1) times·h⁻¹ and isolated tonic episodes were observed (2.1±0.9) times·h⁻¹. The frequency of RMMA events was significantly greater in the patients with acoustic molars than in those without (P<0.05). Similarly, the frequency of RMMA events was significantly greater in the patients with tooth attrition than in those without (P<0.05). However, no difference was observed between the occurrence of RMMA and the symptoms of masticatory muscles or masseter hypertrophy in the morning. The incidence of TMD was significantly higher in the patients with RMMA than in the isolated tonic patients.@*CONCLUSIONS@#The clinical symptoms and signs often used to diagnose sleep bruxism are different clinical and physiological mandibular movements during sleep. RMMA during sleep can reflect the occurrence of tooth attrition and the high risk of TMD.

Reliability and validity of Chinese version of intuitive eating scale in college students / 中华行为医学与脑科学杂志

Objective To translate the English version of the Intuitive Eating scale-2( IES-2) into Chinese,and test the reliability and validity of the Chinese version of IES-2(IES-2-CHI) in college students. Methods The reliability and validity of the Chinese version of IES-2 were tested among 1 309 college students in Liaoning province. All data were analyzed by SPSS 20. 0 and AMOS 21. 0. Results The Chi-nese version of IES-2-CHI, all inter-items and item-to-total correlation coefficients ranged from 0. 444 to 0. 759. The IES-2-CHI had a total Cronbach’s α of 0. 933 and the test-retest correlation was 0. 831. The i-tem-level content validity index(I-CVI)ranged from 0. 830 to 1. 000,the scale-level content validity index(S-CVI/UA)was 0. 870,and the content validity index at the average scale level(S-CVI/Ave)was 0. 978. Four-factors(unconditional permission to eat,eating for physical rather than emotional reasons,reliance on hunger and satiety cues,body-food choice congruence) model were extracted by exploratory factor analysis,and the cumulative variance contribution rate was 58. 974%. The confirmatory factor analysis results showed that χ2/df=2. 941,CFI=0. 959,GFI=0. 920,TLI=0. 954,PGFI=0. 747,RMSEA=0. 055,and the model was basically adaptable. Conclusion The Chinese version of IES-2-CHI scale is reliable and valid instrument, which can be used to measure the level of intuitive eating among the college students in Liaoning province.

Diagnosis and treatment standard for treatment with endoscopy technique in chronic wounds with sinus tract (trial version) / 中华烧伤杂志

The " exploration of treatment technology of chronic wound with sinus tract supported by endoscope and related auxiliary methods" study had been conducted by Wound Healing Center of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. The feasibility and effectiveness of this technique have been confirmed, and good clinic results have been achieved. In order to further promote the new technology and its related research, the theoretical knowledge and technical experience accumulated in the early stage are summarized as diagnosis and treatment standard for treatment with endoscopy technique in chronic wounds with sinus tract, including four parts: the applicable subjects, the diagnosis and treatment procedures and classification criteria, the healing criteria, and the risk assessment and prevention measures. The purpose of this standard is to facilitate the application of standardized endoscopy technique, to make the most of its technological advantages, prevent risks, and provide a reference for the official version of the diagnosis and treatment standard.

Pharmacognostical study of Chinese medicine Mylabris / 中草药

Objective: To provide the scientific evidence for the identification of Mylabris phalerata and Mylabri scichorii by observing the characteristics and microscopic characteristics of the two species, which may be of relevance to the compilation of 2020 edition of Chinese Pharmacopoeia. Methods: The pharmacognosy of six batches of M. phalerata and four batches of M. scichorii were studied by character identification, micro-morphological identification, conventional microscopic identification, polarized light microscopic identification and microsublimation methods. Results: Colored holographic image of the micro-morphological characteristics (body length, antenna, elytron and hind-wing), microscopic characteristics (bristle, body wall fragment, elytron debris, hind-wing debris, muscle fiber, debris of gas pipeline and undigested plant tissue) and crystalline sublimate characteristics were obtained for the first time. Conclusion: The results of micro-morphological identification complement the fine structural characteristics of traditional character identification. The microscopic and microsublimation methods for identification can be used as specific markers for identifying Mylabris.

Study on the clinical benefits of endoscopy combined with contrast fistulography in the diagnosis and treatment of chronic wound with sinus tract adjacent to body cavity / 中华烧伤杂志

Objective@#To explore the advantages of endoscopy combined with contrast fistulography in the clinical diagnosis and treatment of chronic wound with sinus tract adjacent to body cavity.@*Methods@#Thirty-two patients (14 males and 18 females, aged 17 to 87 years) of chronic wounds with sinus tracts adjacent to body cavity, who underwent endoscopy combined with contrast fistulography (CT or magnetic resonance imaging) for the diagnosis and treatment in the Outpatient Department of Wound Healing Center of our hospital from October 2017 to March 2019, were enrolled in the study. Their diagnosis and treatment results were retrospectively analyzed. The following data were calculated. (1) The incidence rates of sinus wound involving body cavity or fistula. (2) The detection rates of sinus wound involving body cavity detected by routine examination and by endoscopy combined with contrast fistulography. (3) The detection rate of pathological features at deep part of wound by routine examination and by endoscopy combined with contrast fistulography. (4) The proportion of patients who benefited from routine examination and from endoscopy combined with contrast fistulography. Data were processed with paired chi-square test and Fisher′s exact probability test.@*Results@#(1) The incidence rate of sinus wound involving body cavity was 43.75% (14/32); the incidence rate of fistula was 0. (2) The detection rate of sinus wound involving body cavity detected by endoscopy combined with contrast fistulography was 43.75% (14/32), which was obviously higher than that by routine examination [12.50% (4/32), χ2=32.0, P<0.01]. (3) The detection rate of pathological features at deep part of wound by endoscopy combined with contrast fistulography was 37.50% (12/32), which was obviously higher than that by routine examination (0, P<0.01). (4) The proportion of patients who benefited from endoscopy combined with contrast fistulography was 71.43% (20/28), which was obviously higher than that from routine examination [12.50% (4/32), χ2=21.6, P<0.01].@*Conclusions@#Compared with routine examination, endoscopy combined with contrast fistulography is more accurate in detecting chronic wound with sinus tract adjacent to body cavity. The diagnosis and treatment of chronic wound with sinus tract adjacent to the body cavity can benefit from this joint examination.

Minocycline inhibits formalin-induced inflammatory pain and the underlying mechanism / 北京大学学报(医学版)

OBJECTIVE@#To unravel the underlying mechanism of minocycline in formalin-induced inflammatory pain, and to investigate the effects of minocycline on synaptic transmission in substantia gela-tinosa (SG) neurons of rat spinal dorsal horn.@*METHODS@#Behavioral and immunohistochemistry experiments: 30 male Sprague-Dawley (SD) rats (3-5 weeks old) were randomly assigned to control (n=8 rats), model (n=8 rats), saline treatment model (n=6 rats) and minocycline treatment model (n=8 rats) groups. The control group was subcutaneously injected with normal saline on the right hindpaws. Acute inflammatory pain model was established by injecting 5% (volume fraction) formalin into the right hindpaws. The rats in the latter two groups received intraperitoneal injection of saline and minocycline 1 h before the formalin injection, respectively. The time of licking and lifting was recorded every 5 min within 1 h after the subcutaneous injection of normal saline or formalin for all the groups, which was continuously recorded for 1 h. One hour after the pain behavioral recording, the spinal cord tissue was removed following transcardial perfusion of 4% paraformaldehyde. The expression of c-Fos protein in spinal dorsal horn was observed by immunohistochemistry. Electrophysiological experiment: In vitro whole-cell patch-clamp recordings were performed in spinal cord parasagittal slices obtained from 26 male SD rats (3-5 weeks old). Two to five neurons were randomly selected from each rat for patch-clamp recording. the effects of minocycline, fluorocitrate and doxycycline on spontaneous excitatory postsynaptic currents (sEPSCs) or spontaneous inhibitory postsynaptic currents (sIPSCs) of SG neurons were investigated.@*RESULTS@#Compared with the control group, both the licking and lifting time and the expression of c-Fos protein in ipsilateral spinal dorsal horn of the model group were significantly increased. Intraperitoneal injection of minocycline largely attenuated the second phase of formalin-induced pain responses (t=2.957, P<0.05). Moreover, c-Fos protein expression was also dramatically reduced in both the superficial lamina (I-II) and deep lamina (III-IV) of spinal dorsal horn (tI-II=3.912, tIII-IV=2.630, P<0.05). On the other side, bath application of minocycline significantly increased the sIPSCs frequency to 220%±10% (P<0.05) of the control but did not affect the frequency (100%±1%, t=0.112, P=0.951) and amplitude (98%±1%, t=0.273, P=0.167) of sEPSCs and the amplitude (105%±3%, t=0.568, P=0.058) of sIPSCs. However, fluorocitrate and doxycycline had no effect on the frequency [(99%±1%, t=0.366, P=0.099); (102%±1%, t=0.184, P=0.146), respectively] and amplitude [(98%±1%, t=0.208, P=0.253); (99%±1%, t=0.129, P=0.552), respectively] of sIPSCs.@*CONCLUSION@#Minocycline can inhibit formalin-induced inflammatory pain and the expression of c-Fos protein in spinal dorsal horn. These effects are probably due to its enhancement in inhibitory synaptic transmission of SG neurons but not its effect on microglial activation or antibiotic action.

Application value of endoscope in probing chronic wound with sinus tract in clinic / 中华烧伤杂志

Objective@#To explore the application value of endoscope in probing the chronic wound with sinus tract in clinic.@*Methods@#Twenty-eight chronic wounds with sinus tracts from 27 patients conforming to the inclusion criteria admitted to Outpatient Department of Wound Healing Center of Ruijin Hospital from December 2017 to March 2018 were investigated in a prospective and self-controlled trial. After being cleaned, the diameter of the opening of sinus tract was measured with a rule. A probe was used to measure the depth of a sinus tract according to the touch from the probe extremity in operation, and to measure the depth of a sinus tract that could be observed with naked eyes with the help of a pair of hemostatic forceps. Five minutes later, a probe was inserted deeply into the sinus tract to measure the depth under the endoscopic view combined with touch from the probe extremity in operation. Afterwards, the sinus tract was observed with endoscope, and the depth of the tract which could be observed under the endoscopic view was measured using a probe inserted deeply into the sinus tract. After completion of the above exploration, the sinus tract was infused with contrast agent Omnipaque 350 and scanned by computed tomography (CT) later to obtain its depth. The following indicators were calculated: the ratio of the depth of the sinus tract measured by CT to the diameter of the opening of the sinus tract (hereinafter referred to as the depth/diameter ratio of the sinus tract), the deviation rate comparing the depth of the sinus tract measured by conventional method (measured by probe only) and by endoscope (measured by probe under the endoscope view) with the depth of the sinus tract measured by CT (hereinafter referred to as the deviation rate of the measured depth of the sinus tract), the deviation rate comparing the depth of the sinus tract that could be observed measured by conventional method and by endoscope with the depth of the sinus tract measured by CT (hereinafter referred to as the deviation rate of the depth of the sinus tract that could be observed). Data were processed with paired t test. Pearson correlation analysis was applied to analyze the correlation between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method and by endoscope.@*Results@#The depth/diameter ratio of the sinus tract of this group of wounds was 1-32 (8±7). The deviation rate of the measured depth of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method were (19±14)% and (79±18)%, respectively, both obviously larger than (9±9)% and (25±25)% by endoscope (t=3.837, 13.626, P<0.01). Positive correlation existed between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract by conventional method, and between the depth/diameter ratio of the sinus tract and the deviation rate of the depth of the sinus tract that could be observed by conventional method and by endoscope (r=0.514, 0.585, 0.651, P<0.01). However, there was no obvious correlation between the depth/diameter ratio of the sinus tract and the deviation rate of the measured depth of the sinus tract by endoscope (r=0.113, P>0.05).@*Conclusions@#Compared with the conventional method, application of endoscope is able to get more accurate data of chronic wounds with sinus tracts and observe the wounds with wider range.

Preparation of a poIy(3-hydroxybutyrate-4-hydroxybutyrate)/poIyvinyI aIcohoI composite scaffoId by coaxiaI eIectrospinning and its biocompatibiIity / 中国组织工程研究

BACKGROUND: Poly(3-hydroxybutyrate-4-hydroxybutyrate) (P3HB4HB) is a kind of polymer material that can be completely degraded, has good film-forming property and physical properties, but has poor hydrophilicity. OBJECTIVE: To prepare P3HB4HB/polyvinyl alcohol (PVA) coaxial electrospun scaffolds, and to investigate the physical properties and biocompatibility of scaffolds in vitro. METHODS: We prepared P3HB4HB electrospun scaffold, PVA electrospun scaffold and P3HB4HB/PVA coaxial electrospun composite scaffold, and then detected the morphology and characterization, contact angle, and tensile mechanical properties of the scaffolds. Passage 4 bone marrow mesenchymal stem cells (BMSCs) from Sprague-Dawley rats were seeded on the three kinds of scaffolds. Cell adhesion rate was detected at 1, 3, 6 hours after seeding; cell proliferation was detect at 1, 3, 5, 7 days after seeding; and cell viability was observed fluorescence staining at 7 days after seeding. Passage 4 BMSCs were seeded onto the three kinds of scaffolds followed by 14 days of osteogenic and chondrogenic induction. Then, alizarin red staining and toluidine blue staining were used to verify BMSCs differentiation potentials. RESULTS AND CONCLUSION: (1) Scaffold morphology: Under the scanning electron microscope, the structure of the scaffold in each group was a three-dimensional interconnected network. The fiber diameters of P3HB4HB electrospun scaffold and P3HB4HB/PVA electrospun scaffold were homogeneous and ordered. The P3HB4HB/PVA scaffold showed an obvious core-shell structure under the transmission electron microscope. (2) Scaffold characterization: The tensile strength, tensile modulus and maximum stress of the P3HB4HB and P3HB4HB/PVA scaffolds were significantly higher than those of the PVA electrospun scaffold (P < 0.05). The contact angle of the P3HB4HB/PVA composite scaffold was less than 90°. (3) Cell adhesion rate was ranked as follows: PVA electrospun scaffold group >P3HB4HB/PVA composite scaffold group > P3HB4HB electrospun scaffold group (P < 0.05). (4) Proliferation and activity of cells: The cell proliferation of the P3HB4HB/PVA composite scaffold group was faster than that of the other two groups at 5 and 7 days (P < 0.05). There were more viable cells on the PVA electrospun scaffold and composite scaffold than on the P3HB4HB electrospun scaffold. (5) Cell differentiation: Osteogenesis and cartilage specific staining of the composite scaffold were stronger than those in the other two groups. Overall, the P3HB4HB/PVA coaxial electrospun scaffold has good biocompatibility and a certain mechanical strength.

Thoughts and principles of diagnosis and treatment of chronic refractory wounds in China / 中华烧伤杂志

The correct thoughts and principles of diagnosis and treatment of chronic refractory wounds need to be formulated. Through the relevant domestic and international consensus and based on clinical experience, the Thoughts and principles of diagnosis and treatment of chronic refractory wounds in China is proposed. It is considered that in the diagnosis and treatment of chronic refractory wounds, in the case of fully understanding the patient′s medical history, the following thoughts and principles should be complied in order. (1) Pay attention to the cleanliness of the wound after being cleaned. (2) Reasonably perform debridement to avoid being " excessive" or " not thorough". (3) Reasonably perform examination, diagnosis, and differential diagnosis of pathogenic factors. (4) Treat according to etiology. (5) Find comorbidities and prevent adverse outcomes. (6) Select the correct wound treatment method reasonably and timely. When the conservative wound care treatment is considered, pay attention to embodying the concept of etiological treatment, treat the wound according to the principles of safety, phase, selectivity, and effectiveness, and make a reasonable choice of continuing conservative treatment or surgical treatment in time after completing the preparation of the wound bed. When surgical treatment is considered, pay attention to the selection of reasonable surgical method and donor site, pay attention to the healing rate of surgical wound site and the outcome of donor site, and give reasonable protection to the wound site after surgery. (7) Carry out rehabilitation treatment after wound healing and related health education.

Clinical efficacy of Ginkgo Leaf Extract and Dipyridamole Injection and Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection in treatment of acute myocardial infarction / 药物评价研究

Objective To discuss the efficacy of Ginkgo Leaf Extract and Dipyridamole Injection and Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection in treatment of acute myocardial infarction.Methods 60 cases of acute myocardial infarction were randomly divided into two groups.They were treated with routine treatment.The observation group (30 cases) was treated with Ginkgo Leaf Extract and Dipyridamole Injection on the basis of routine treatment.The control group (30 cases) was treated with Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection on the basis of routine treatment.The efficacy of Ginkgo Leaf Extract and Dipyridamole Injection and Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection in treatment of acute myocardial infarction was evaluated by the efficacy,hemorheology before and after treatment,adverse reaction during treatment.Results The effective rate of observation group was 86.7％.The effective rate of control group was 90.0％.There was no statistical significance on effective rate between two groups.Before treatment,there were no statistical significance on blood viscosity,hematocrit,platelet aggregation rate between two groups.After treatment,the blood viscosity,hematocrit,platelet aggregation rate were decreased in two groups (P ＜ 0.05).The observation group ofhematocrit and platelet aggregation rate was lower than the control group (P ＜ 0.05).But the blood viscosity of two groups had no significant difference.According to the cost and the efficiency of single drug treatment,calculate the cost/effect ratio,the Ginkgo Leaf Extract and Dipyridamole Injection of cost/effect ratio was significantly less than that of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection (P ＜ 0.05).During treatment,there was no statistical significance on adverse reaction rate between two groups.Conclusion Ginkgo Leaf Extract and Dipyridamole Injection and Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection had a therapeutic effect on acute myocardial infarction with high safety.The Ginkgo Leaf Extract and Dipyridamole Injection could inhibit the platelet aggregation,reduce the hematocrit with low cost/effect value.

Development of laparoscopic technology in biliary surgery in the past 23 years: a single-center experience / 南方医科大学学报

<p><b>OBJECTIVE</b>To summarize the 23-year experience of laparoscopic biliary surgery in General Hospital of PLA and evaluate the application of laparoscopic surgery in the treatment of biliary diseases.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 11 419 consecutive patients with biliary diseases undergoing laparoscopic surgery from April, 1992 and December, 2014. The disease spectrum was compared between patients treated before December 31, 2003 and those treated after the time point.</p><p><b>RESULTS</b>The 11419 patients receiving laparoscopic surgery accounted for 56.3% of the total patients undergoing biliary surgeries during the 23 years, including 4701 male and 6718 female patients with a mean age of 50.9∓13.2 years (6-93 years). Most (80.83%) of the patients received laparoscopic surgery for gallbladder stones, and 12.53% patients had the operation for gallbladder polyps. The laparoscopic operation rate was 84.81% in patients with gallbladder stones and 34.91% in patients with extrahepatic bile duct stones, but remained low in patients with biliary carcinoma. In laparoscopic operations, laparoscopic cholecystectomy was the most frequent (96.18%) followed by operations for extrahepatic bile duct stones, in which primary suture accounted for 1.38%, traditional T tube drainage for 0.90% and laparoscopic transcystic duct exploration for 0.72%. For malignant tumors, laparoscopic technique was used mainly for the purpose of exploration (0.34%). The application of laparoscopic technique in biliary surgery tended to increase after the year 2004, especially for benign gallbladder diseases and extrahepatic bile duct stones (P<0.05).</p><p><b>CONCLUSION</b>Laparoscopic technique in biliary surgery is gradually replacing the traditional open operation and becomes the gold standard for the treatment of benign biliary diseases.</p>

Clinical Observtion to 30 Cases of Mild and Moderate Ovarian Hyperstimulation Syndrome Treated with Resvised Wupi Decoction / 浙江中医药大学学报

[Objective] To observe the clinical effects of resvised wu pi decoction on mild and moderate ovarian hyperstimulation syndrome. [Method]To 30 of such cases ,take resvised wu pi decoction to strengthen spleen and tonify kidney, remove dampness and prevent miscarriage, observe patient chest dis-tress, abdominal distension and liquid intake and output volume of 24 hours etc.;Then estimate the clinical effect,and analyze one typical case.[Result]The marked effective rate was 60.00%, with total effective rate 96.67%. [Conclusion] The clinical application of resvised wu pi decoction treating mild and moderate OHSS by strengthening spleen and tonifying kidney,removing dampness and preventing miscarriage has excellent curative effect.