The variation of serum uric acid levels among patients with myocardial infarction treated with ticagrelor and the association between serum uric acid and platelet reactivity / 中华心血管病杂志

Objectives: To compare the impact of ticagrelor or clopidogrel on serum uric acid levels among patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) and further evaluate the effects of variation of serum uric acid levels on platelet reactivity. Methods: STEMI patients who admitted to Fuwai Hospital from April 2017 to January 2020, and underwent primary PCI and discharged alive with aspirin and ticagrelor or clopidogrel were included in this study. Patients were divided into ticagrelor group and clopidogrel group. The baseline clinical data were collected. Serum uric acid and creatinine levels at baseline and 30 days post-PCI were measured. Light transmittance aggregometry was used to assess maximum aggregation rate induced by adenosine diphosphate and arachidonic acid. The changes of serum uric acid and creatinine were compared between the two groups. Multivariate logistic regression was performed to evaluate independent related factors for rise in the uric acid levels, and the effect of variation of serum uric acid level on platelet reactivity was analyzed. Results: A total of 967 patients were included, the age was (59.4±12.1) years, and 163 case were female. There were 550 cases in ticagrelor group (56.9%) and 417 cases in clopidogrel group (43.1%). Baseline serum uric acid and creatinine levels were similar between the 2 groups. At 30 days, the serum uric acid level [(347.2±96.5) mmol/L vs. (341.2±105.3) mmol/L, P=0.009] and absolute [46.4 (-2.4, 88.1) mmol/L vs. 25.0 (-21.9, 73.0) mmol/L, P=0.001] and percentage [13.2 (-0.01, 29.0) % vs. 7.9 (-5.7, 25.0) %, P=0.007] increase in the serum uric acid levels were significantly higher in ticagrelor group than in clopidogrel group. The level of serum creatinine at 30 days was significantly lower in ticagrelor group than in clopidogrel group [(89.7±21.3) μmol/L vs. (94.4±43.9) μmol/L, P<0.05], whereas there were no differences in absolute [8.0 (-1.4, 16.6) μmol/L vs. 7.8 (-2.0, 16.6) μmol/L] and percentage [10.5 (-1.7%, 22.6%) vs. 9.8 (-2.4%, 22.1%)] change in the serum creatinine between the 2 groups (all P>0.05). Logistic regression analysis showed that, after adjusting for confounding factors, ticagrelor therapy was an independent related factor of serum uric acid elevation (OR=1.582, 95% CI:1.023-2.447, P=0.039). The variation of the serum uric acid levels did not affect platelet aggregation and the percentage of high platelet reactivity in both groups. Conclusions: Ticagrelor use is related to a significant increase in the serum uric acid levels at 30 days post-PCI in this patient cohort. The variations in the uric acid levels do not increase the percentage of high platelet reactivity in STEMI patients treated with ticagrelor or clopidogrel.

Real-time transrectal ultrasound-guided seminal vesiculoscopy for the treatment of patients with persistent hematospermia: A single-center, prospective, observational study / 亚洲男科学杂志(英文版)

This study aimed to describe endoscopic anatomy of the seminal tract and summarize our experience of transutricular seminal vesiculoscopy (TSV) guided by real-time transrectal ultrasonography (TRUS) in managing persistent hematospermia. A total of 281 consecutive patients with persistent hematospermia who underwent TSV with or without real-time TRUS were enrolled in this single-center, prospective, observational study. The median follow-up period was 36.5 (range: 8.0-97.5) months. TSV was successfully performed in 272 (96.8%) patients. The approach of a 4.5/6 F rigid vesiculoscope entering the seminal tract was categorized into four types on the basis of endoscopic presentation of the ejaculatory duct orifice and verumontanum. Seven (2.6%), 74 (27.2%), 64 (23.5%), and 127 (46.7%) patients had Types I (through the ejaculatory duct in the urethra), II (through the ejaculatory duct in the prostatic utricle), III (transutricular fenestration through a thin membrane), and IV (real-time transrectal ultrasound-guided transutricular fenestration) approach, respectively. In patients who successfully underwent surgery, bleeding occurred in the seminal vesicle in 249 (91.5%) patients. Seminal vesiculitis, calculus in the prostatic utricle, calculus in the ejaculatory duct, calculus in the seminal vesicle, prostatic utricle cysts, and seminal vesicle cysts were observed in 213 (78.3%), 96 (35.3%), 22 (8.1%), 81 (29.8%), 25 (9.2%), and 11 (4.0%) patients, respectively. Hematospermia was alleviated or disappeared in 244 (89.7%) patients 12 months after surgery. Fifteen patients had recurrent hematospermia, and the median time to recurrence was 7.5 (range: 2.0-18.5) months. TSV guided by TRUS may contribute to successful postoperative outcomes in managing persistent hematospermia.

Establishment of a novel mouse mode of elastase-induced chronic obstructive pulmonary disease related osteoporosis / 中国骨伤

OBJECTIVE@#To establish and evaluate the model of chronic obstructive pulmonary disease (COPD) with osteoporosis induced by elastase in mice.@*METHODS@#Twenty four healthy female 8-week-old C57BL / 6 mice (weighing about 18 g) were randomly divided into three groups. The control group was given intratracheal drip of normal saline, the experimental group 1 and the experimental group 2 were given intratracheal drip of elastase, the control group and the experimental group 1 were kept for 8 weeks and then killed, the experimental group 2 was kept for 12 weeks and then killed. HE staining was used to evaluate the histopathological changes of lung and tibia in the control and experimental groups. The levels of serum inflammatory factors and broncho alveolar lavage factors (BALF) were detected by ELISA. Micro CT was used to detect the bone mass related parameters of mouse femur. The expression of osteoclastic and osteogenic genes was detected by real-time fluorescence quantitative PCR.@*RESULTS@#Lung histopathology showed that the structure of alveoli in the experimental group was disordered, the walls of alveoli became thin or broken, and the alveoli cavity expanded. IL-6 and TNF-α in BALF were significantly higher than those in control group (<0.001), while IL-1β and TNF-α in serum inflammatory factors were significantly higher than those in control group (<0.001). BV / TV(bone volume fraction), TB.Th(average bone trabecular thickness) and TB.N(average bone trabecular number) in the experimental group were significantly lower than those in the control group (<0.05), TB.Sp (average bone trabecular separation) and BS / BV (bone surface area fraction) in the experimental group were significantly higher than those in the control group (<0.01). Compared with the control group, the expression of osteoclast related marker genes increased in the experimental group (<0.05), but decreased in the experimental group(<0.05). The results of experiment 1 and experiment 2 were time-dependent.@*CONCLUSION@#In this study, elastase was used to construct a COPD model with osteoporosis successfully, which provides a suitable animal model for the future study of the pathogenesis of COPD with osteoporosis.

Salvianolic acid B decreases interleukin-1β-induced colitis recurrence in mice / 中华医学杂志(英文版)

BACKGROUND@#Degree of mucosal recovery is an important indicator for evaluating the therapeutic effects of drugs in treatment of inflammatory bowel disease (IBD). Increasing evidences has proved that tight junction (TJ) barrier dysfunction is one of the pathological mechanisms of IBD. The aim of this study was to observe whether enhancement of TJ can decrease colitis recurrence.@*METHODS@#Eighty C57BL/6 mice were randomly divided into four groups including normal group, colitis group, sulfasalazine (SASP) treated group, and traditional Chinese drug salvianolic acid B (Sal B) treated group. Colitis was established in mice by free drinking water containing dextran sulfate sodium, after treatments by SASP and Sal B, recombinant human interleukin-1β (IL-1β) was injected intraperitoneally to induce colitis recurrence.@*RESULTS@#Compared with sham control, cell apoptosis in colitis group was increased from 100.85 ± 3.46% to 162.89 ± 11.45% (P = 0.0038), and TJ dysfunction marker myosin light chain kinase (MLCK) was also significantly increased from 99.70 ± 9.29% to 296.23 ± 30.78% (P = 0.0025). The increased cell apoptosis was reversed by both SASP (125.99 ± 8.45% vs. 162.89 ± 11.45%, P = 0.0059) and Sal B (104.27 ± 6.09% vs. 162.89 ± 11.45%, P = 0.0044). High MLCK expression in colitis group was reversed by Sal B (182.44 ± 89.42% vs. 296.23 ± 30.78%, P = 0.0028) but not influenced by SASP (285.23 ± 41.04% vs. 296.23 ± 30.78%, P > 0.05). The recurrence rate induced by recombinant human IL-1β in Sal B-treated group was significantly lower than that in SASP-treated group.@*CONCLUSIONS@#These results suggested a link between intestinal mucosal barrier dysfunction, especially TJ barrier dysfunction, and colitis recurrence. The TJ barrier dysfunction in remission stage of colitis increased the colitis recurrence. This study might provide potential treatment strategies for IBD recurrence.

Associations between postprocedural D-dimer, hs-CRP, LDL-C levels and prognosis of acute myocardial infarction patients treated by percutaneous coronary intervention / 中华心血管病杂志

Objective: To investigate the association between postprocedural D-dimer, high sensitivity C-reactive protein(hs-CRP) and low-density lipoprotein-cholesterol(LDL-C) and outcomes of acute myocardial infarction (AMI) patients treated by percutaneous coronary intervention(PCI), in order to clarify the impacts of thrombotic, inflammatory and cholesterol risks on long-term prognosis. Methods: Patients with AMI who underwent emergency PCI from January 2010 to June 2017 in Fuwai Hospital with complete baseline data were enrolled. Patients were stratified into four groups according to quartiles of D-dimer, hs-CRP and LCL-C. Cox regression was used to analyze the relationship between these biomarkers and prognosis. Restricted cubic spline (RCS) was used to characterize the continuous association between risk of all-cause death and biomarkers. The primary outcome was all-cause death. Results: A total of 3 614 patients were included in the analysis. The age was (59.2±12.0) years old, and 2 845 (78.7%) were male and 3 161 (87.5%) patients were diagnosed as ST-segment elevation myocardial infarction. The follow-up time was 652 (414, 1 880) days. Survival analysis showed that postprocedural D-dimer and hs-CRP were significantly associated with all-cause mortality (all P<0.05). Cox regression with multiple adjustments showed that patients with D-dimer≥580 μg/L presented higher risk of all-cause death (HR=2.03, 95%CI 1.22-3.38, P=0.006), compared to patients with D-dimer<220 μg/L. RCS analysis showed that risk of all-cause death was stably high when D-dimer reached 500 μg/L. Multivariable Cox regression also showed that patients with hs-CRP<2.74 mg/L (HR=1.86, 95%CI 1.10-3.15, P=0.020)or hs-CRP≥11.99 mg/L (HR=2.14, 95%CI 1.35-3.40, P=0.001) presented higher mortality compared to patients whose hs-CRP was 2.74-7.18 mg/L. RCS analysis indicated a J-shaped relation between hs-CRP and mortality, as greater risk of death was observed when hs-CRP was lower than 2 mg/L or higher than 10 mg/L. LDL-C was not associated with outcomes (all P>0.05). Conclusions: Postprocedural D-dimer is significantly associated with long-term prognosis of AMI patients treated by PCI. Patients with extremely high or low levels of hs-CRP presents worse outcomes. Intensive and tailored antithrombotic or anti-inflammatory therapies should be considered for patients with increased thrombotic risk and those with extremely high or low inflammatory risk.

Comparison of six-month follow-up results of primary percutaneous coronary intervention guided by optical coherence tomography or coronary angiography / 中华心血管病杂志

Objective: To compare the 6-month follow-up results of primary percutaneous coronary intervention (PPCI) guided by optical coherence tomography (OCT) or coronary angiography (CAG) alone in a larger ST-segment elevation myocardial infarction (STEMI) cohort. Methods: We enrolled 275 STEMI patients undergoing OCT-guided PPCI from March 2017 through December 2018. Two hundred and seventy-five propensity score matched STEMI patients undergoing CAG-guided PPCI served as control group. The 6-month clinical follow-up results were compared between the two groups. The demographic data, complications, coronary angiography and OCT characteristics were evaluated. Results: OCT evaluation showed that there were 151 patients (54.9%) with plaque prolapse and 113 patients (41.1%) with stent malposition. Proximal and/or distal dissection of stents occurred in 38 patients (13.8%), of which 3 patients (1.1%) had both proximal and distal dissection. Of the 38 patients, 2 patients received rescue stent implantation. Results of clinical follow-up at 6 months showed that there was no significant difference in cardiovascular death, repeat myocardial infarction, target vessel revascularization, stroke and hemorrhage endpoint events between OCT-guided PPCI patients and CAG-guided PPCI patients (P=0.682). Conclusion: Clinical events at 6 months are similar between OCT-guided PPCI and CAG-guided PPCI for STEMI patients.

Receptors for advanced glycation end products is associated with autophagy in the clear cell renal cell carcinoma

Background: The receptor for advanced glycation end-product (RAGE) was one of the signal transduction receptors. RAGE interacted with various signaling molecules which were involved in human disease processes including tumorigenesis. Previous reports have indicated that RAGE/high-mobility group box 1 (HMGB1) could regulate autophagy in different carcinomas. However, the functional role of RAGE/ HMGB1 in the regulation of clear cell renal cell carcinoma (ccRCC) autophagy remained unrevealed. Methods: Western blot, quantitative real-time polymerase chain reaction (qRT-PCR) and immunofluorescence were used in the present study. Results: In this study, we demonstrated that the levels of RAGE/HMGB1 and autophagic protein LC3, Beclin-1, PI3K were much higher in ccRCC samples than those of in adjacent normal tissues. RAGE and autophagic protein expression was regulated with RAGE/HMGB1 in human RCC cell lines. Conclusion: Our results implicated that RAGE and autophagy played important roles in ccRCC, and RAGE/HMGB1 might serve as a novel therapeutic target for future ccRCC treatment

Effects of goal-directed hemodynamic management therapy on prognosis of patients undergoing off-pump coronary artery bypass surgery / 医学研究生学报

Objective Fluid therapy strategy on cardiac surgical patients has always been disputing. The aim of the present study was to observe the effects of goal-directed hemodynamic management strategy on the prognosis of patients undergoing off-pump coronary artery bypass graft. Methods The study was a prospective quality improvement study. Patients who underwent elective off-pump coronary artery bypass grafting in our hospital from January to December 2016 were included in the study, and the implementation of improvement approach was started on June 20, 2016. A total number of 98 patients were included: 56 cases before the improvement (control group) and 42 cases after the improvement (experimental group). The approach of optimizing hemodynamic was standardized vasoactive usage based on the goal-directed fluid therapy taking SVV (Stroke Volume Variation) and CI (Cardiac Index) as the target. Intraoperative and postoperative data were collected through the medical record system. Comparison was done between two groups in the aspects of liquid intake and output, length of postoperative stay in hospital and complications, postoperative awaken time, volume of thoracic drainage in 24h, extubation rate in 6h, time of ICU stay, concentration of Troponin I on the first day after surgery, mortality rate within 30 days and 6 months. Results There was no statistically difference in total fluid intake after the improvement, while the volume of voluven(676.79± 380.90 mL vs 890.48 ±222.58mL,P < 0.05) and urine volume (516.07±224.87 mL vs 695.24± 311.53mL,P < 0.05) increased significantly, the volume of crystal decreased significantly (663.84 ±224.97mL vs 430.24 ±201.76mL,P < 0.001). The positive liquid balance of intake and output volume was significantly reduced (683.82 ±556.08ml vs 456.43 ±505.36ml, P < 0.05). There were no significant differences in proportion of autologous blood or erythrocyte transfusion and volume of blood loss between the two groups (P > 0.05). There were no significant differences between the two groups in postoperative awaken time, volume of thoracic drainage within 24h, extubation rate within 6, concentration of Troponin I on the first day after surgery and ICU stay(P > 0.05). After the improvement, the length of postoperative stay in hospital was reduced compared with the control group (11.81 vs 13.82, P < 0.05). Multiple linear regression analysis was performed after the logarithmic transformation, and the standardized coefficient B of the improvement was -0.296 (SE=0.061, P < 0.05), indicating that the goal-directed hemodynamic management would reduce the length of postoperative stay in hospital by 19.4 %( 95%CI 7.3%~31.5%) with other conditions being equal. Postoperative complications decreased from 41.07% to 16.67 %( P < 0.05). Conclusion The implementation of goal-directed hemodynamic management strategy can reduce postoperative complications, postoperative hospital stay and improve short-term prognosis of patients undergoing off-pump coronary artery bypass surgery.

Effects of delivery history on the dosage of propofol in painless hysteroscopy patients / 医学研究生学报

Objective To observe the effect of vaginal delivery history on the dosage of propofol and the quality of postoperative recovery in painless hysteroscopy patients. Methods 120 patients from November 2018 to May 2019 who required painless hysteroscopy were enrolled in the First Affiliated Hospital of Anhui Medical University. According to their previous history, the patients were divided into two groups: the control group (no history of delivery, 60 cases) and the observation group (had a history of delivery, 60 cases). Basic vital signs (MAP, HR) of the two groups were compared at the following five time points: baseline, uterin edilation, immediately, 10 min and 30 min after surgery. The dosage of sufentanil, the total and induced dosage of propofol, the additional cases and dosage of propofol, the time of surgery and recovery, the satisfaction of doctor and patients were recorded. Results Compared with the control group, the observation group showed significant decrease in the total dosage of propofol [(133.3±25.4)mg vs (145.1±27.8)mg], the additional cases [(28,46.7%) vs (39,65%)] and dosage of propofol [(1.0, 2.0)mg vs (0.0,40.0)mg], and shorter recovery time [(32.7±10.2)s vs (42.8±11.5)s] (all P<0.05). The satisfaction of doctor and patients were significantly higher in the observation group than in the control group. There was no significant difference in adverse events between the two groups (P>0.05). Conclusion In painless outpatient hysteroscopy, in order to shorten the recovery time of patients, improve the quality of postoperative recovery, improve the efficiency and safety of painless hysteroscopic surgery, anesthesiologists should reduce the additional dosage of propofol for patients with previous vaginal delivery.

Mean platelet volume might be an effective indicator of arterial erectile dysfunction / 亚洲男科学杂志(英文版)

The aim of our study was to investigate the role of platelet parameters including mean platelet volume (MPV) and platelet count (PC) in the pathogenesis of penile arteriogenic erectile dysfunction (ED) and to evaluate the association between the platelet parameters and arteriogenic ED. There were 244 patients with ED (based on the International Index of Erectile Function [IIEF]-5 ≤21) and 60 healthy controls (IIEF-5 >21) enrolled. All participants were asked to undergo a laboratory examination, and penile vascular function was evaluated using penile color Doppler ultrasonography (pDUS). Among these ED patients, 24 patients with no abnormality on nocturnal penile tumescence (NPT) and 84 with normal vasculature or mixed vascular abnormalities were excluded. The other patients were classified into three groups as follows: control (n = 60), arteriogenic ED (n = 99), and venous leakage (n = 37) groups. MPV and PC were significantly higher in the arteriogenic ED group compared with the venous and control groups (P < 0.05). Receiver operating characteristic curve analysis revealed that the area under the curve for MPV to predict arteriogenic ED was 0.707. MPV ≥9.65 fl was recognized as a cut-off value for potential arteriogenic ED (sensitivity: 47.5%; specificity: 91.7%). A significant inverse correlation was detected between MPV and 10-min peak systolic velocity (PSV) (r =-0.34; P < 0.001) in the arteriogenic ED group. These findings suggest that the MPV might be a powerful indicator to predict and diagnose arteriogenic ED, and MPV may be a marker for ED when using pDUS.

Analysis of curative effect of traditional Chinese bone setting manipulation for the treatment of femoral neck fracture / 中国骨伤

<p><b>OBJECTIVE</b>To analysis the outcome of modified closure bone setting manipulation for the treatment of femoral neck fracture.</p><p><b>METHODS</b>From January 2012 to December 2012, 47 cases of femoral neck fracture were treated and included 25 males and 22 females with an average age of (44.58±10.32) years old ranging from 23 to 61 years old. All patients had a history of trauma, hip pain and movement limited, limb shortening extorsion deformity, X-ray showed fracture between femoral head and femoral neck basic. Among them, 32 cases were Garden type III and 15 cases were type IV. Patients were performed surgical treatment at 2 to 5 days after admission with 45 degrees abduction and extension position, internal rotation reduction, and 3 guide pins were inverted in a equilateral triangular structure of upside down arrangement. The postoperative recovery quality, fracture healing, femoral head necrosis and hip function were observed.</p><p><b>RESULTS</b>Operation time was 40 to 70 min, intraoperative bleeding was 20 to 50 ml. All patients received good reposition, and the intraoperative perspective was 12 to 25 times. Forty-five patients were followed up for 24 to 36 months, and 2 cases were lost. Fracture of 45 cases were got bony healing, 3 cases with partial necrosis of femoral head, both in the ARCO stage II. Twenty-four months after operation, Harris hip function score was 43.24±2.74 in pain, 42.82±1.95 in function, 3.72±0.45 in deformity, 2.77±0.52 in activity, 92.56±4.42 in total;the outcome was excellent in 39 cases, good in 4 cases, fair in 2 cases, without unbroken nails, infection, deep venous thrombosis, fracture and other complications.</p><p><b>CONCLUSIONS</b>Treatment of femoral neck fracture with the modified bone setting manipulation has an advantages of good effect, postoperative hip function recovery, curative effect.</p>

Angiographic predictors of side branch occlusion in patients with acute myocardial infarction undergoing emergency interventions / 中国介入心脏病学杂志

Objective To explore the predictive factors of side branch occlusion in patients with ST-segment elevation myocardial infarction by coronary angiography. Methods A total of 1223 patients with acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention were consecutively enrolled in Fuwai hospital from January 2014 to December 2015. According to the coronary angiography there were 256 patients with bifurcation in the culprit lesions. Demographic data, past medical history and coronary angiography characteristics were collected in all patients. Results Among the 256 patients, there were 33 patients with branch occlusion and 223 patients without branch occlusion. Multivariate analysis demonstrated that severe stenosis of side branch ostium odds ratio 1.06, 95% confi dence interval 1.03-1.09,P < 0.001) and thrombus in side branch ostium (odds ratio 5.43, 95% confidence interval 1.23-23.93, P=0.025) were independent risk factors for predicting branch occlusion. Conclusions Side branch occlusion in culprit lesions of patients with ST-segment elevation myocardial infarction is related to the severity of branch ostium stenosis and thrombosis in branch ostium.

Temozolomide resistance in high grade gliomas / 上海交通大学学报（医学版）

High grade gliomas are always the research focus in the field of neurosurgery due to their poor prognosis despite the current standard therapeutic regimen of surgical resection followed by radiation therapy and chemotherapy.Alkylating agent temozolomide has been established as the standard chemotherapy while its resistance inevitable during treatment.This phenomenon seriously influences the prognosis of patients suffering from high grade gliomas.This review aims to elucidate temozolomide chemoresistance mechanisms through three chapters including O6-methylguanine-DNA methyltransferase (MGMT) methylation,mismatch repair mutation and epigenetic regulation consisting of p21,chromatin and histone,Y-box binding protein-1 and microRNAs.

NSAIDs combined with radiotherapy to prevent heterotopic ossification after total hip arthroplasty / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the preventive effects and differences of NSAIDs combined with radiotherapy, NSAIDs and radiotherapy for heterotopic ossification(HO) after total hip arthroplasty(THA).</p><p><b>METHODS</b>From February 2015 to July 2016, 168 hips undergoing primary THA were divided into group A, B and C, and 163 patients were followed up (54 cases and 54 hips in group A, 55 cases and 55 hips in group B, 54 cases and 54 hips in group C). Among group A, 5 hips were primary osteoarthritis, 37 hips were secondary osteoarthritis due to avascular necrosis of the femoral head, 12 hips were secondary osteoarthritis due to acetabular dysplasia. Patients in group A received oral celecoxib (0.2 g, 2 times a day) for 2 weeks after operation. Among group B, 6 hips were primary osteoarthritis, 32 hips were secondary osteoarthritis due to avascular necrosis of the femoral head, 17 hips were secondary osteoarthritis due to acetabular dysplasia, all of which in group B were treated with preoperative single 7 Gy radiotherapy. Among group C, 5 hips were primary osteoarthritis, 35 hips were secondary osteoarthritis due to avascular necrosis of the femoral head, 14 hips were secondary osteoarthritis due to acetabular dysplasia. Patients in group C were treated with preoperative radiotherapy and celecoxib after operation. The side effects of gastrointestinal reactions were observed after operation, and the heterotopic ossification was evaluated by pelvic anterior and posterior X-ray (Brooker grading).</p><p><b>RESULTS</b>The mean clinical and radiological follow-up was 21 months(12 to 30 months). In group A, 54 hips were followed up with 7 hips with heterotopic ossification, including 5 hips of Brooker I and 2 hips of Brooker II. In group B, 55 hips were successfully followed up, with 8 hips of heterotopic ossification occurred, including 6 hips of Brooker I, 2 hips of Brooker II. In group C, 54 hips were successfully followed up, with 5 hips of heterotopic ossification occurred , including 4 hips of Brooker I, 1 hip of Brooker II. There was no significant difference in efficacy among 3 groups (²=0.743, 0.690) by chi-square test. The prevalence of side effects were as following: in group A, there were 6 hips with side effects;in group B, there were 6 hips with side effects;in group C, there were 7 hips with side effects. There was also no significant difference in side effects among 3 groups (²=0.135, 0.935).</p><p><b>CONCLUSIONS</b>The combined-therapy group has lower prevalence of HO than the NSAIDs group or radiotherapy group, but the statistical difference between them is not significant. NSAIDs is still the first choice to prevent HO after THA.</p>

Anterior cervical hybrid surgical treatment for multilevel cervical spondylotic myelopathy / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical results of anterior cervical discectomy and reconstruction with a self-locking cage and internal fixation with short segmental plate for multilevel cervical spondylotic myelopathy.</p><p><b>METHODS</b>From January 2012 to June 2015, a total of 106 patients received anterior cervical discectomy and reconstruction with a self-locking cage and internal fixation with short segmental plate were followed up. There were 71 males and 35 females, aged from 42 to 74 years old with an average of(55.4±5.1) years. Three segments were involved in 82 cases and four segments in 24 cases. Operation time, blood loss, postoperative drainage, and hospitalization time were recorded. Visual analogue scale(VAS) and Japanese Orthopaedic Association Score (JOA) were analyzed before and after operation(including 5 days, 3, 6, 12 months after operation and final follow-up), and the JOA improvement rate was analyzed. The cervical lordosis and ROM were measured before and after operation(including the follow-up point above) by X-rays. The postoperative complications were recorded and analyzed as well.</p><p><b>RESULTS</b>All the operations were successful. The average operative time was (126.2±25.1) min, and the amount of blood loss was (82.1±26.3) ml. All the patients were followed up from 12 to 48 months with an average of (30.4±10.5) months. The VAS score of neck pain and JOA score was significantly better from 6.11±1.54 and 9.22±2.42 preoperatively to 2.14±0.51 and 12.46±1.42 at 5 days post-operation, respectively(<0.05). The improvement rate of JOA was (56.7±21.6)%, there was no statistically significant difference of VAS, JOA scores and the improvement rate of JOA at each time after operation (>0.05). Postoperative cervical lordosis at 3 months was significantly improved from preoperative (11.5±6.8)° to (19.6±8.9)°(<0.05), and it can keep satisfactory stability until final follow-up(>0.05). Postoperative ROM at 3 months was significantly decreased from the preoperative (37.6±10.4)° to (18.2±5.9)°(<0.05), but there was no significant change in the process of follow-up (>0.05). All the complications such as dysphagia (19 cases), axial neck pain(6 cases), cerebral fluid leakage(3 cases), and hoarseness(2 cases), got better after conservative treatment. Three cases had intervertebral space non-fusion until final follow-up(without clinical symptom), but no loosening, breakage, or displacement of internal fixation were found.</p><p><b>CONCLUSIONS</b>Anterior cervical discectomy, reconstruction with a self-locking cage and internal fixation with short segmental plate which can reduce intraoperative injury, restore cervical lordosis, improve neurological function and lower postoperative complications, it is an alternative treatment for multilevel cervical spondylotic myelopathy.</p>

Seasonal and geographical dispersal regularity of airborne pollens in China / 解放军医学杂志

Allergic diseases can be induced by abundant airborne allergenic pollens with symptoms such as allergic rhinitis and bronchial asthma,which can seriously threaten human health.The species and distribution of airborne pollens differed in different regions,based on the difference of geographical environment and climate conditions.Therefore,the occurrence of pollinosis was of obviously regional and seasonal divergence.Inappropriate urban greening,tree species selection and environmental pollution have contributed to a dramatic increase in the number of pollen sensitizing plants and hay fever.The species and dispersal regularity of allergenic pollen plants in different administrative areas in China in recent 10 years are reviewed in present paper for providing scientific basis on controlling pollinosis and reasonable greening of urban environment.

Influence of different designs of marginal preparation on stress distribution in the mandibular premolar restored with endocrown / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of different designs of marginal preparation on stress distribution in the mandibular premolar restored with endocrown using three-dimensional finite element method.</p><p><b>METHODS</b>Four models with different designs of marginal preparation, including the flat margin, 90° shoulder, 135° shoulder and chamfer shoulder, were established to imitate mandibular first premolar restored with endocrown. A load of 100 N was applied to the intersection of the long axis and the occlusal surface, either parallel or with an angle of 45° to the long axis of the tooth. The maximum values of Von Mises stress and the stress distribution around the cervical region of the abutment and the endocrown with different designs of marginal preparation were analyzed.</p><p><b>RESULTS</b>The load parallel to the long axis of the tooth caused obvious stress concentration in the lingual portions of both the cervical region of the tooth tissue and the restoration. The stress distribution characteristics on the cervical region of the models with a flat margin and a 90° shoulder were more uniform than those in the models with a 135° shoulder and chamfer shoulder. Loading at 45° to the long axis caused stress concentration mainly on the buccal portion of the cervical region, and the model with a flat margin showed the most favorable stress distribution patterns with a greater maximum Von Mises stress under this circumstance than that with a parallel loading. Irrespective of the loading direction, the stress value was the lowest in the flat margin model, where the stress value in the cervical region of the endocrown was greater than that in the counterpart of the tooth tissue. The stress level on the enamel was higher than that on the dentin nearby in the flat margin model.</p><p><b>CONCLUSIONS</b>From the stress distribution point of view, endocrowns with flat margin followed by a 90° shoulder are recommended.</p>

Study on formulation of liquid-solid compressed tablets of total triterpenoids from Sclerotii Poriae Cortex / 中草药

Objective: To improve the dissolution rate of total triterpenoids from Sclerotii Poriae Cortex. Central composite design response surface methodology was used to optimize formulation of liquid-solid compressed tablets. Methods: The types and ratio of excipients were determined by preliminary test and single factor experiments. Central composite design response surface methodology was used in the optimization of formulation, with dissolution rate as the index. Liquisolid compacts powders, crude drugs, and excipients were characterized by differential scanning calorimetry (DSC). Results: The best prescription was as follow: Liquid ratio was 1:1.67; R value was 18.25; Disintegrating agent was 8%; The ratio of PVPPXL-10 and CMSNa was 1.27 and the tablets hardness was 40-50 N. DSC showed that the characteristic peaks of drug in liquisolid tablets had vanished, and suggested that drugs might be present in liquid-solid compressed tablets as amorphous substance. Conclusion: The formulation of liquid-solid compressed tablet is reasonable. Liquisolid compacts can increase the dissolution rate of total triterpenoids from Sclerotii Poriae Cortex, and suggest that drugs may be present in liquid-solid compressed tablets as amorphous substance.

Optmization for cutting procedure of astragali radix with Box-Behnken design and response surface method / 中国中药杂志

Astragali Radix was firstly recorded in the "Shen Nong's Herbal Classic" as a top-grade and commonly used traditional Chinese medicine. Its frequently used slices include raw Astragali Radix and honey-processed products. In current studies, many reports were made on honey-processed Astragali Radix, whereas fewer study reports were made on the cutting process of Astragali Radix. Currently, because Astragali Radix is primarily cut by drug workers according to their operating experience, but with out specific cutting parameters, it is easy to cause the loss or mildew of active ingredients. As a result, the quality of Astragali Radix circulated in the market is not guaranteed, and the quality of their slices and preparations are hard to be controlled, which seriously impact the clinical efficacy. In response, this experiment was performed, in which the optimum cutting process of Astragali Radix was taken as the study objective, the Box-Benhnken central composite design in the response surface analysis was adopted, and the content and appearance character of astragaloside and calycosin-7-glucoside were regarded as the study indicators. Three factors, namely the softening time, the drying temperature and the drying time, were selected to optimize the cutting process of Astragali Radix and obtain the optimum cutting process parameters as follows: the softening time was 3 hours, the drying temperature was 50 degrees C, and the drying time was 4 hours. According to the verification test, the Astragali Radix cutting process is steady and feasible, which has certain significance for normalizing the cutting process of Astragali Radix.

Plasma concentration and pharmacokinetics of ursolic acid carried in self-microemulsifying drug delivery system in rats studied by UPLC-MS/MS / 药学学报

This study is to report the establishment of an UPLC-MS/MS method for the determination of plasma concentration of UA carried in self-microemulsifying drug delivery system (SMEDDS) and its pharmacokinetics in rats. It was used for determination and analysis when serum with internal standard was extracted from C18 solid-phase column. Acquity UPLC BEH C18 column (100 mm x 2.1 mm, 1.7 microm) was used for separation. The mobile phase was acetonitrile -0.1% ammonia with gradient elution at the flow rate of 0.2 mL x min(-1). The column temperature was 40 degrees C and the detection wave length was 210 nm. It was detected by negative ion using electrospray ionization source (ESI) and scanned by multiple reaction ion monitoring (MRM) mode. The liner relationship of UA was very good in the range of 1.19-3 815.00 ng x mL(-1) (r = 0.999 0). Recovery rate of different concentrations were 87.42%-89.95%. The precision of inter-day and intra-day were less than 11%. The method developed in our study was proved to be sensitive, rapid and simple. It is suitable for the pharmacokinetic study of UA-SMEDDS in rats.