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Osteoporosis is an important cause of bone weakness and susceptibility to fractures. Anti-osteoporosis drugs of Western medicine cannot reverse its progression， and can only reduce the loss of bone density； long-term use of them is accompanied by certain adverse reactions. Traditional Chinese medicine focuses on syndrome differentiation and holistic approach， which can make up for the shortcomings of Western medicine’s treatment. The mammalian target of rapamycin （mTOR） signaling pathway is involved in the growth， proliferation， and differentiation of bone cells， and is closely related to the occurrence and development of osteoporosis. In recent years， various traditional Chinese medicine monomers （such as flavonoids， polysaccharides， alkaloids， etc.） and traditional Chinese medicine formulas （such as Bushen huoxue decoction， Liuwei dihuang pills， Erzhi pills， etc.） have been proven to promote bone formation， inhibit bone resorption， enhance bone cell autophagy， and delay the progression of osteoporosis by regulating the mTOR signaling pathway. Therefore， the article summarizes the traditional Chinese medicine monomer and formula that intervene in the mTOR signaling pathway for the treatment of osteoporosis， in order to provide medication ideas for the traditional Chinese medicine treatment of osteoporosis.
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Objective:To investigate the effects of laparoscopic surgery versus open surgery on acute appendicitis in children. Methods:We retrospectively analyzed the data of 50 children with acute appendicitis who underwent surgery in Zhoushan Women and Children Hospital from December 2016 to December 2019. They were randomly divided into observation ( n = 27) and control ( n = 23) groups. The observation group underwent three-port laparoscopy. The control group underwent open surgery. Operation-related indicators, postoperative recovery, parental satisfaction, and complications were compared between the two groups. Results:Operative time was significantly longer in the observation group than in the control group [(56.57 ± 5.35) minutes vs. (40.23 ± 6.31) minutes, t = 9.78, P < 0.001). Intraoperative blood loss was significantly less in the observation group than in the control group [(10.11 ± 2.36) mL vs. (18.36 ± 3.21) mL, t = 10.45, P < 0.001]. Duration of pain was significantly shorter in the observation group than in the control group [(1.23 ± 0.23) days vs. (2.98 ± 0.87) days, t = 10.06, P < 0.001). Time to postoperative exhaust was significantly shorter in the observation group than in the control group [(21.39 ± 4.35) minutes vs. (39.88 ±5.39) minutes, t = 13.35, P < 0.001]. Time to defection was significantly shorter in the observation group than in the control group [(50.12 ± 3.35) minutes vs. (61.23 ± 4.21) minutes, t = 10.33, P < 0.001]. Time to first diet was significantly shorter in the observation group than in the control group [(13.25 ± 2.56) hours vs. (19.96 ± 2.67) hours, t = 9.07, P < 0.001]. Length of hospital stay in the observation group was significantly shorter in the observation group than in the control group [(4.13 ± 1.12) days vs. (7.98 ± 1.96) days, t = 8.53, P < 0.001). Parental satisfaction was significantly higher in the observation group than in the control group [96.30% vs. 47.83%, χ2 = 13.360, P < 0.001]. The incidence of complications was significantly lower in the observation group than in the control group [7.41% vs. 52.17%, χ2 = 10.58, P < 0.001]. Conclusion:Laparoscopic surgery is superior and safer to open surgery in the treatment of acute appendicitis in children.
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Post-stroke seizures and epilepsy are common complications of stroke, and its risk factors include age, stroke location, lesion size, stroke type, degree of neurological deficit, reperfusion therapy, use of statins. This article reviews the risk factors for post-stroke seizures and epilepsy, as well as commonly used predictive models.
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OBJECTIVE：To establish the content determin ation method of ferulic acid ，verbascoside，ligustilide and astragaloside in Shengyu decoction lyophilized powder. METHODS ：HPLC method was adopted to determine 4 components in 3 batches of lyophilized powder. The determination of ferulic acid ，verbascoside and ligustilide was performed on Inertsil ODS-SP C 18 column with mobile phase consisted of methanol- 0.1％ phosphoric acid （gradient elution ）at the flow rate of 1.0 mL/min；detector was diode array detector ；detection wavelength was set at 330 nm；column temperature was 30 ℃，the sample size was 10 μL. The determination of astragaloside was performed on Kromasil C 18 column with mobile phase consisted of acetonitrile-water （32∶68，V/ V）；detector was evaporative light scattering detector ；the drift tube temperature wa s 100 ℃，the carrier gas （air）flow rate was 2.5 L/min at the flow rate of 1.0 mL/min；column temperature was 30 ℃，the sample size was 10 μL. RESULTS：The linear ranges of ferulic acid ，verbascoside，ligustilide and astragaloside were 0.050 15-10.03 μg（r＝0.999 8），0.067 80-13.56 μg（r＝ 0.999 9），0.057 30-11.46 μg（r＝0.999 5），1.128-11.28 μg（r＝0.999 3），respectively. The detection limits were 2.12×10－4，1.30× 10－3，8.02×10－4，1.09×10－3 μg，respectively. The limit of quantification were 7.43×10－4，3.87×10－3，2.34×10－3，3.36×10－3 μg， respectively. RSDs of precision ，stability（12 h）and reproducibility tests were all lower than 2％（n＝6）. Average recovery rates were 99.6％（RSD＝0.83％，n＝6），100.9％（RSD＝1.07％，n＝6），98.8％（RSD＝0.84％，n＝6）and 101.3％（RSD＝0.99％， n＝6），respectively. The contents of ferulic acid ，verbascoside，ligustilide and astragaloside in 3 batches of samples were 1.225-1.248， 0.413-0.424， 0.325-0.332， 0.394-0.404 mg/g， respectively （RSDs among batches were lower than 1.5％ ）. CONCLUSIONS：Established method is stable ，reproducible，rapid and accurate for the content determination of ferulic acid ， verbascoside， ligustilide and astragaloside in Shengyu
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Objective:To observe the clinical effect of hernia ring filling tension-free hernia repair on adult inguinal hernia.Methods:From March 2016 to March 2019, 100 adult patients with inguinal hernia who received surgical treatment in Zhoushan Maternal and Child Health Hospital were divided into two groups according to the random number table method, with 50 cases in each group.The control group received the chip without tension hernia repair, and the study group received hernia ring filling type without tension hernia repair.The operation time, length of hospital stay, use of analgesic ratio, ratio of postoperative patients with local foreign body sensation, incidence of adverse reactions (incision infection rate, rate of seroma, scrotal edema rate) were compared between the two groups.Results:The operation time [(0.86±0.22)h] and hospital stay [(5.11±1.56)d] in the study group were shorter than those in the control group [(1.44±0.76)h and (9.87±1.33)d] ( t=5.183, 16.418, all P<0.05). And the ratio of use analgesics (20.00%), the ratio of local foreign body sensation (2.00%), the incidence of adverse reactions (incision infection rate: 2.00%, seroma rate: 4.00%, scrotal edema rate: 2.00%) and other indicators in the study group were lower than those in the control group (36.00%, 18.00%, 8.00%, 10.00%, 8.00%)(χ 2=5.183, 16.418, 3.174, 7.111, 5.740, all P<0.05). Conclusion:Application of the hernia ring filling tension-free hernia repair in the treatment of adult inguinal hernia can shorten the operation time, hospital stay and decrease the incidence rate of adverse reactions.
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Objective To study the effect of pirfenidone (PFD) on the transformation of rat corneal stromal cells into fibroblasts in vitro and further explore the anti-fibrotic effect of PFD. Methods The corneal stromal cells from SD rat was isolated and cultured ,and was determined by vimentin stain. The experiment was divided into control group(DMEM+10%FBS),TGF-β1 group(2 ng/mL TGF-β1+DMEM+10%FBS)and PFD group(1 mg/mL PFD+ 2 ng/mL TGF-β1+DMEM+ 10%FBS). Cell proliferation was detected by CCK-8 assay. Collagen Ⅰ,Collagen Ⅲ,Keratocan and CD99 expression were detected by Western blot. Results Compared with control group and TGF-β1 group,the cell proliferation were significantly decreased in PFD group(P<0.05). Western blot showed that PFD can up-regulated Collagen Ⅰand Keratocan but down-regulated Collagen ⅢCD90 expression(P < 0.05). The ratio of Collagen Ⅲ/Collagen Ⅰ in PFD group was lowest in all groups(P < 0.05). Conclusion PFD can resistant fibration in corneal stromal cells may through the inhibition of TGF-β ,which affect the collagen synthesis and Keratocan,CD90 expression.
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Objective To compare the clinical value of XELOX and FOLFOX6 in the treatment of elderly patients with colorectal cancer. Methods Clinical data of 68 elderly patients(aged>60 years)with colorectal cancer were retrospectively analyzed.The patients were divided into XELOX group(n =32)and FOLFOX6 group(n =36) according to the chemotherapy regimen.The response evaluation criteria in solid tumors,progression free survival, 2 -year mortality,chemotherapy related adverse reactions and health related quality of life in the two groups were compared.Results Compared with the FOLFOX6 group,the neurotoxicity incidence in the XELOX group was signifi-cantly lower (3.13% vs.22.22%,χ2 =5.380,P =0.020).The neutrophils reduced incidence was significantly lower(9.38% vs.30.56%,χ2 =4.649,P =0.039).The hand foot syndrome complications significantly increased (34.38% vs.8.33%,χ2 =7.027,P =0.008).There was no significant difference in the incidence of nausea,vomi-ting,diarrhea,oral mucosal ulcer,thrombocytopenia and elevation of transaminase in the two groups(χ2 =0.001, 0.000,0.008,2.102,1.071,1.851,all P >0.05).The quality of health related quality of life was significantly higher in the XELOX group than in the FOLFOX6 group at 6 months after the operation[(67.94 ±12.49)points vs. (57.39 ±13.59)points,t =3.198,P =0.015].There were no significant differences in the curative effect grade at 6 months after the operation,2 -year mortality rate and progression free survival time between the two groups(χ2 =0.949,0.008,t =0.573,all P >0.05).Conclusion Although XELOX increases the incidence of hand foot syn-drome in elderly patients with colorectal cancer,but it significantly reduces the incidence of neurotoxicity and neutro-phil,and improves the quality of life of patients after surgery.
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National traditional Chinese medicine (TCM) master professor Ban Xiuwen had rich experiences on treatment of gynecological diseases with unique insights on diagnosis and treatment for disorders of menstruation, leukorrhea, pregnancy and delivery. FemaleYin-Wei, which was a gynecological disorder, was recorded in the book ofHuang-Di Nei-Jing. However, due to different reasons, TCM study on femaleYin-Wei was far less than the study on male impotence. ProfessorBan Xiuwen had specific considerations for this disease on the book of Treatment of Miscellaneous Gynecological Diseases. In his understanding, femaleYin-Wei was due to four aspects, which were the innate deficiency, yang deficiency and coldness of the uterus; seven emotion damage, liver-qi soothing disorder; spleen-stomach deficiency,qi-blood deficiency; and phlegm-dampness stasis,qi stagnation. Through the analysis and study on case records of femaleYin-Wei treatment by national TCM master professorBan Xiuwen, this article briefly elaborated professorBan Xiuwen’s understandings on femaleYin-Wei treatment from etiology, pathogenesis, treatment according to syndrome differentiation, and clinical experiences. Two femaleYin-Wei cases treated by professorBan Xiuwen were given as examples in order to analyze the etiology, pathogenesis, treatment according to syndrome differentiation and treatment experiences in details. The therapeutic effects of both cases were obvious, which were also important study documents.
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Objective To compare the perioperative outcomes of robot-assisted partial nephrectomy (RAPN) with transperitoneal laparoscopic partial nephrectomy (LPN).Methods From July 2009 to March 2013,114 patients were treated in our hospital due to renal carcinoma,including RAPN in 45 patients and LPN in 69 patients.Their data were retrospectively reviewed.Clinical and pathological variables,R.E.N.A.L nephrometry score,operation time (OT),warm ischemia time (WIT),estimated blood loss (EBL),drainage volume,the length of hospitalization,estimated glomerular filtration rate (eGFR) outcomes,and complications were analyzed.Results There were no significant differences between the RAPN and LPN group with respect to patient age,sex,tumor laterality,size,R.E.N.A.L nephrometry score,the rate of hilar tumor and preoperative eGFR (P＞0.05).The median OT was shorter in the RAPN group than that in LPN group (165 min vs.196 min,P＜0.05).The median WIT was shorter in the RAPN than that in LPN group (21 min vs.25 min,P＜0.05).However,there were no significant differences in the postoperative eGFR and changing of eGFR within the 2 groups (P＞0.05).The rate of transfusion was similar between the RAPN (2/45) and LPN (4/69) group (P=0.72).There was also no significant difference in EBL (P=0.16).The drainage volume was also similar within two groups (167 ml vs.163 ml,P=0.81).The length of hospitalization was more favorable in the RAPN group (6.5 d vs.8.0 d,P=0.01).In RAPN group,27 cases were clear-cell carcinoma,5 cases were papillary cell carcinoma,2 cases were chromophobe cell carcinoma and 1 1 cases were angioleiomyolipoma.In LPN group,45 cases were clear-cell carcinoma,9 cases were papillary cell carcinoma,3 cases were chromophobe cell carcinoma and 12 cases were angioleiomyolipoma.There was no difference of pathological types between LPN and RAPN groups (P＞0.05).The rate of positive surgical margins was 0％ (0/45) in RAPN group and 1.4％ (1/69) in LPN group (P=0.69).The rates of complication requiring intervention (Clavien grade Ⅲ) were 2.2％ (1/45) and 2.9％ (2/69) in the RAPN and LPN group,respectively (P＞0.05).Median follow up was 12 (4-36) months in the RAPN and 13 (5-34) months in the LPN group.No local recurrence or metastasis occurred in two groups.Conclusions Early comparative outcomes suggest that RAPN has a significant benefit over the LPN in terms of OT,WIT and hospital stay.Meanwhile,it offers equivalent prognosis and postoperative renal function preservation compared with LPN.
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ObjectiveTo study the risk factors of renal artery pseudoaneurysm (RAP) following partial nephrectomy.MethodsOpen partial nephrectomy was performed on a total of 464 cases of renal cell cancer from July 2003 to May 2010. Five patients ( 1.1％ ) had postoperative hemorrhage from RAP.The surgery technique of the open partial nephrectomy, the clinical presentation, imaging findings and treatment of RAP were reviewed. The anatomical characteristics of these five renal tumors on enhanced CT were quantified using the R.E.N.A.L. Nephrometry Score System.ResultsAll five cases were male, two had tumors on the left side and three on the right side. Median tumor size was 3.6 cm ( range from 2.5 to 5 cm; Radius score 1 - 2). Four tumors were exophytic of these, three had a major endophytic component (≥50％) deep in the parenchyma (Exophytic/endophytic score 2 ), one was entirely endophytic (score 3 ). The distance of all the tumors to the collecting system was ≤4 mm ( Nearness score 3 ). Four of the five tumors were across the polar line and/or renal axial midline ( Location score 3 ). The other tumor was located under the lower pole ( Location score 1 ) but close to the renal hilar. All patients presented with delayed gross haematuria and decreasing hemoglobin occurred on mean postoperative day 12 (3 -23 day). Four patients complained of flank pain, two of which had signs of hypovolemia requiring blood transfusion. The diagnosis was confirmed by the contrast medium-enhanced CT and selective angiography, and RAP was found most commonly arising from the segmental branch of renal artery. Superselective microcoil angioembolization was successfully performed in four cases, once in three cases and twice in the remaining case. The procedure failed in one patient and a nephrectomy was done. At a mean follow-up of 21 months (12 -30) , all patients had normal renal function without evidence of recurrence.ConclusionsRAP should be considered in all patients who had delayed hematuria after partial nephrectomy. A central, deep tumor and its relationship to the segmental branch of renal artery could be an important risk factor for this complication. Choosing the case properly for partial nephrectomy and suturing the transected vessels and the defect of parenchymal correctly could reduce occurrence of this serious complication. Early use of selective angioembolization could be a primary choice of treatment.
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Objective To evaluate the clinical value of preserving the intercostobrachial nerve after radical operation for breast carcinoma.Methods The clinical data of patients with breast cancer were analyzed retrospectively,all cases were divided into the observation group and the control group.all cases were followed up after operation from six months to six years in order to observe the abnormal sensation of the skin and the recurrence rate.Results The abnormal sensation of the skin:1 case in the observation group(4.5%),17cases in the control group(73.9%),Two groups have significant difference(x2=20.79 P＜0.01),both groups had not found partial recurrence.Conclusion Preseving the intereostobmchial nerve in modified radical mastectomy for patients with breast cancer,dichat increase the partial recurrence,can increase the life quality of patients after operation,decrease the abnormal sensation of the skin.promote the health both body and mind.
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Objective To summary the experience in surgical treatment of differentiated thyroid carcinoma (DTC).Methods The clinical data and follow-up results of 110 cases of DTC were retrospectively analyzed.Results 110 patients received operation and TSH suppress therapy.Histologic examination after operation revealed that papillary thyroid carcinoma(PTC) 88 cases(80%) ,follicular thyroid carcinoma 22 cases(20%) ,cervical lymph node metastasis were found in 22 cases(20%).The operation procedure consists of excision of the suffered lobe,isthmus and greater partial of the opposite lobe 59 cases(along with functional cervical dissection 12 cases) ;excision cf the sufferedlobe,isthmus 29 cases(along with functional cervical dissection 7 cases) ;excision of the suffered lobe,isthmus greater partial of the opposite lobe 18 cases(along with functional cervical dissection 5 cases) ;total thyroidectomy and bilateral cervical dissection 2 cases;total thyroidectomy and bilateral cervical dissection with postoperative 131I therapy,1 cases with metastasis to lung.98 cases 10-year survival rate was 91.8%.Conclusion Differentiated thyroid carcinoma has a good prognosis,a proper surgical procedure is the key point to get a good outcome.
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@#Objective To explore the restoration of motor function and the expression of calcitonin gene-related peptide(CGRP)and acetylcholine esterase(AChE)in the anterior horn motoneurons after different types of spinal cord injury.Methods 60 adult female Wistar rats were randomly assigned to 3 groups:sham group,completely transection group and contusion group.Average combined scores(ACOS)were applied to assess the motor function at various time after the surgery.The content of AChE in the anterior horn of L2-L4 was detected with Karnovsky-Roots staining and the expression of CGRP was then determined with immunohistochemistry.Results The scores of ACOS were much higher in the contusion group than in the transection group at each time point examined.The content of both AChE and CGRP significantly decreased after either type of spinal cord injury.However,their activity gradually recovered to the normal level in the contusion group,but not in the transection group.Moreover,the changes of CGRP occurred earlier than those of AChE.Conclusion There is strong relationship between the motor function recovery and the functional state of anterior horn cells.CGRP or AChE may play an important role in the functional recovery of locomotion after spinal cord injury in rats.
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@#Objective To observe the effect of the chitosan tube combined with basic fibroblast growth factor(bFGF) on inducing nerve axon regeneration of rats with peripherial nerve injury.MethodsA novel chitosan tube combined with bFGF was developed and used to suture the 10 milimeter long right sciatic nerve gap of 10 rats,single injury group(10 rats) were the control with sciatic nerve injury alone,and other 10 rats were assigned to sham group.Immunohistochemistry and electrophysiology study had been done to observe the effect of repairing.Results3 months after operations,the sciatic nerve gap were repaired by the regeneration nerve in the experiment group.And there was no evident inflammation in the defects.ConclusionThe chitosan tube combined with bFGF can induce the sciatic nerve to regenerate.
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@#Objective To explore the degeneration of motor end plates (MEP) by observing the expression of calcitonin gene-relative peptide (CGRP) and acetylcholine esterase (AChE) in the MEP after different types of spinal cord injury. Methods 60 adult female Wistar rats were randomly assigned to 3 groups: sham group, completely transection group and contusion group. The content of AChE in the MEP was detected with Karnovsky-Roots staining and the expression of CGRP was then determined with immunohistochemistry. Results The content of both AChE and CGRP significantly decreased after either type of spinal cord injury. However, their activity gradually recovered to the normal level in the contusion group, but not in the transection group. Moreover, the changes of CGRP occurred earlier than those of AChE. Conclusion The motor end plate degenerates differently after different kinds of spinal cord injury in adult rat, CGRP and AChE are related to the degeneration of MEP.
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OBJECTIVE: To investigate the effects of Wenyang Huoxue Recipe (WRHXR), a compound traditional Chinese herbal medicine for warming yang and promoting blood flow, on the expression of angiopoietin mRNA in rats with chronic aristolochic acid nephropathy induced by Caulis Aristolochia Manshuriensis (CAM) decoction, and to explore the protection mechanism of WYHXR against kidney damage. METHODS: Twenty-eight male SD rats were randomly divided into normal control group, CAM group and WYHXR-treated group. Rats in the normal control group (n=8) and CAM group (n=10) were intragastrically administered with normal saline 10 ml/(kg.d) or CAM decoction 10 ml/(kg.d) respectively. Rats in the WYHXR-treated group (n=10) were intragastrically administered with WYHXR 30 g/(kg.d) and CAM decoction 10 ml/(kg.d). The expressions of Ang-l and Ang-2 mRNAs were detected by real-time reverse transcription polymerase chain reaction (RT-PCR) after 20-week treatment. RESULTS: Compared with the normal control group, the expression of Ang-l mRNA was significantly decreased, and the expression of Ang-2 mRNA was significantly increased in the CAM group (P0.05). Renal pathology showed that renal damage in WYHXR-treated group was significantly reduced as compared with the CAM group. CONCLUSION: WYHXR can up-regulate the expression of Ang-l mRNA, which may be its action mechanism in protecting the kidneys.
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@#ObjectiveTo evaluate the biocompatibility of a kind of scaffolding material,Injured Nerve Regenerated Materid(INRM), which play the roles of regeneration of nerve after traumatic brain injury.MethodsINRM scaffolding material were transplanted into cortex of rats after traumatic injury.The brain coronal sections were stained for Nissel, astrocyte and microglia at 1 week, 1 month, and 2 months after injury.ResultsThe presence of INRM did not alter patterns of astrocyte compared with the control group (detected with antibodies against GFAP) at any time point; but decreased the expression of microglias (detected with antibodies against OX42) compared with the control group.ConclusionThe biomaterial INRM is well suited as a biocompatible scaffold material for the repair of brain injury in the brain.
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@# ObjectiveTo explore the possibility of repairing sciatic nerve gap of rats with artifical nerve graft.MethodsA novel artifical nerve guide was developed and used to suture the 15 milimeter long right sciatic nerve gap of 10 rats, other 7 rats were the control with the right sciatic nerve gap alone.2 and 4 monthes after operation, immunohistochemistry, Osmium staining, Bodian staining,motor end plate staining,WGA-HRP stain tracing have been done to observe the effect of repairing.Results2 months after operations, the sciatic nerve gap were repaired by the regeneration nerve.There was not evident inflammation in the defects.ConclusionsThe artifical nerve graft can induce the nerve to regenerate.
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@#ObjectiveTo study the effect the chitosan tube combined with the bio active carrier system on inducing nerve axon regeneration of rats with spinal cord injury.Methods50 female Wister rats were characterized by the right spinal cord hemisections at the seventh and eighth thoracic segment to make the model of spinal cord hemisection. The chitosan tube serving as a regenerative loculus was implanted in the defect location of the experimental models.In the experimental group,the bio active carrier system was injected into the chitosan tube,while in control group injected nothing.The drua was sutured to restore cerebrospinal fluid circulation.Results6 months and 12 months after operation,the regenerative nerve axon had passed the defect area of spinal cord in the experiment group. According to WGA-HRP anterograde axonal tracing study, some TMB-positive axons were observed in the distal graft host interface,and came into the host environment. TEM-ultrastructure indicate some neonate synapse, myelinated nerve fibers.In the control group,few regenerative axon could be seen, there was no regenerative axon pass the middle of the tube.ConclusionsThe chitosan tube in which the bio active carrier system was injected can induce the spinal cord nerve axon regeneration.
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Objective To evaluate the outcome of a new modality of operation—tensionfree vaginal tape (TVT) in treatment of female stress urinary incontinence. Methods Thirteen female patients suffering from stress urinary incontinence were treating with TVT operation.All the patients were confirmed to have stable bladder without outlet obstruction via clinical routine and urodynamic examination before operation.TVT tape of Prolene was implanted around mid-urethra via a minimal vaginal incision. Results The mean operation time was (38?7)min and the mean intraoperative bleeding was (45?10)ml.The mean catheterization time was 2 days and mean hospital stay was 4 days.No major bleeding was observed in operation.All patients were cured and the clinical symptoms disappeared after operation except for one patient with post-operative urine retention.This patient was catheterized for 2 weeks and the tape was cut under local anesthesia;then the urine retention disappeared and no incontinence relapsed. Conclusions TVT is a simple,reliable mini-invasive procedure with low incidence of complications.It can be used routinely for treating female stress urinary incontinence.