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Intestinal flora imbalance and abnormal glucose and lipid metabolism are important risk factors and pathological mechanisms of colorectal polyps. "Spleen deficiency and dampness accumulation" is the core pathogenesis of colorectal polyps. The imbalance of intestinal flora is related to spleen deficiency, and the application of Chinese herbs for invigorating spleen is helpful to the recovery of intestinal flora balance. Abnormal glucose and lipid metabolism is related to dampness accumulation, and it is effective to treat it with bitter and spicy herbs or spleen-invigorating and dampness-eliminating herbs. The interaction between intestinal flora imbalance and abnormal glucose and lipid metabolism changes intestinal microenvironment, damages intestinal epithelial cells, causes abnormal proliferation of intestinal stem cells and leads to colorectal polyps, which is consistent with the pathogenesis of spleen deficiency and dampness accumulation in Traditional Chinese Medicine. Thus, we tried to explore the biological connotation of the pathogenesis of "spleen deficiency and dampness accumulation" of colorectal polyps from the perspective of the interaction of intestinal flora and glucose and lipid metabolism, in order to provide reference for identifying high-risk population and analyzing the therapeutic mechanism of compound prescription for invigorating spleen and removing dampness.
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Objective:To analyze the prescriptions for the treatment for epigastric pain in A Hundred Years of Traditional Chinese Medicine Clinicians in China. Methods:The clinical medical records of well-known TCM doctors for the treatment of epigastric pain were included in the A Hundred Years of Traditional Chinese Medicine Clinicians in China. The database of clinical prescriptions and medicines was built, and the ancient and the Ancient and Modern Medical Records Cloud Platform (V 2.1) was applied and the evaluation of drug efficacy, sex, taste, and menstruation were conducted. Descriptive analysis, association rules, hierarchical clustering, and complex network analysis were applied in the rule of medication, drug pairs and core prescriptions. Results:Data was cleaned according to the inclusion and exclusion criteria, and 270 prescriptions were collected, involving 265 kinds of drugs, and the cumulative frequency of drug use was 3 249. The analysis showed that the drugs commonly used by famous traditional Chinese medicine doctors for the treatment of epigastric pain were mainly warm drugs, tast-balance drugs, and mildly cold drugs. The main flavors of medicines were pungent medicines, bitter medicines, sweet medicines, and effects were mainly drugs that regulate qi, clear heat, and invigorate the spleen. The frequency of drug meridians mainly belonged to spleen meridian, stomach meridian, lung meridian, liver meridian, heart meridian. The effects of the drug were mainly to dry dampness, reduce side effects, regulate qi, clear heat, invigorate spleen, and soften liver and analgesics. Association rule analysis found that the commonly used drug pairs were Pinellia- Tangerine Peel, Atractylodes Macrocephala- Poria, Poria- Tangerine Peel, Atractylodes- Tangerine Peel, Amomum tangerine Peel, Ochre- generation- Inula, Rhizoma Coptis- Evodia, and so on. Cluster analysis showed that Liujunzi Decoction, Zuojin Pill, and Shaoyao Gancao Decoction were mainly used. The drug complex network diagram showed that the core prescription of the drug is Xiangsha Liujunzi Decoction. Conclusion:The well-known TCM doctor focuses on strengthening the spleen and regulating qi, reconciling qi and blood, The treatment identified that the mutual warming and clearing, tonifying and deoppilation, and neutral are the main principles.
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Objective:To investigate the therapeutic effects of antibiotic articular cement spacer on shoulder joint infection in the elderly patients during stage-one operation.Methods:The data of 3 patients were analyzed retrospectively who had been treated at Department of Orthopaedics, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University for shoulder infection from May 2018 to December 2019. They were one man and 2 women with an average age of 65.3 years (from 64 to 67 years). One case of infection followed shoulder puncture, another proximal humeral fracture and another shoulder prosthesis replacement. All the 3 patients underwent radical debridement and implantation of antibiotic shoulder cement spacer in stage-one operation but no stage-two operation. The therapeutic effects were evaluated by American Shoulder and Elbow Surgeons (ASES) scoring, Quick Disabilities of the Arm, Shoulder, and Hand (Quick-DASH) scoring, Visual Analog Scale (VAS), and range of shoulder motion.Results:The 3 patients were followed up for 18 to 28 months (mean, 22.7 months). There was no recurrence of infection and the spacers were in good position. The microorganisms detected were Bifidobacterium brevis in one case and methicillin-resistant Staphylococcus aureus in 2 cases. At the final follow-up, the ASES scores averaged 54.4 (from 46.3 to 60.0), Quick-DASH scores 45.1 (from 40.8 to 50.0), VAS scores 2.3 (from 2 to 3), ranges of elevation 65.7 °, ranges of abduction 43.8° and ranges of external rotation 21.7°.Conclusion:For the elderly patients with shoulder infection, implantation of antibiotic shoulder cement spacer after radical debridement can well control infection, relieve pain and improve shoulder functions, sparing them secondary operation.
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Objective:To evaluate the efficacy of individualized preoperative planning combined with various fixations in the treatment of complex multiplanar deformities at lower extremity.Methods:Four patients with complex multiplanar deformities at lower extremity were treated at Department of Orthopedics, The First Affiliated Hospital to Harbin Medical University from January 2018 to May 2019. They were one male and 3 females, aged from 12 to 65 years (average, 28.8 years). All patients underwent thin-layer (1 mm) CT scan before surgery. Individualized preoperative planning and surgical simulation were conducted using the CT data. 3D printing technology was used to fabricate individualized surgical templates to facilitate osteotomy. Recorded were operation time, frequency of intraoperative fluoroscopy, fracture healing time, Lysholm scores before and after operation, Hospital for Special Surgery (HSS) knee function scores, pain scores of visual analogue scale (VAS) and postoperative complications in this cohort.Results:The operation time averaged 160.0 min, the frequency of intraoperative fluoroscopy 5.0 times, the follow-up duration for the 4 patients 8.8 months, the fracture healing time 6.3 months, the Lysholm scores before and after operation 55.8 and 80.5 points respectively, the HSS scores before and after operation 61.0 and 80.8 points respectively, and the VAS scores before and after operation 3.8 and 1.0 points respectively. Accurate osteotomy was achieved with assistance of the templates and no deformation or breakage of the templates was observed. Follow-ups showed fine alignment of the lower extremities by the full-length X-ray films and no recurrence of deformity, infection, implant breakage, or delayed union or non-union of the osteotomy sites.Conclusions:For patients with multiplanar deformities at lower extremity, individualized preoperative planning can be made before surgery to obtain the accurate parameters relevant to the osteotomy. In combination with various fixations, a patient-specific template made by 3D printing can be used to achieve accurate osteotomy, ensuring good efficacy, safety, efficiency and accuracy of the surgery.
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Objective:To explore the reliability of preoperative diagnosis of low-grade infectious nonunion using haematological testing and radioisotope scanning (bone 3-phase image).Methods:A retrospective study was conducted of the 265 patients with bone nonunion who had been treated at Department of Orthopaedics, The Sixth People’s Hospital Affiliated to Shanghai Jiaotong University and at Department of Orthopaedics, The Eighth People’s Hospital Affiliated to Shanghai Jiaotong University from June 2010 to June 2018.They were 151 males and 114 females, aged from 19 to 64 years (average, 39.7 years).The nonunions occurred mainly at the tibia (113 cases) and the femur (72 cases).The preoperative results of their white blood cell count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and radioisotope scanning were recorded.Taking the intraoperative pathological observations as the gold standards, the sensitivity, specificity, area under curve (AUC) of receiver operator characteristic (ROC) and Youden index were statistically analyzed respectively for every preoperative haematological tests and radioisotope scanning as well as for different combinations of the radioisotope scanning and one or more haematological tests.Results:Compared with the pathological observations, the radioisotope scanning showed a sensitivity of 80.7%, a specificity of 73.3%, an AUC of 0.770 and a Youden index of 0.540.In the combinations of radioisotope scanning and one haematological test, that of radioisotope scanning and CRP produced the largest AUC of 0.683, a sensitivity of 98.0%, a specificity of 70.3%, and a Youden index of 0.848.In the combinations of radioisotope scanning and 2 haematological tests, that of radioisotope scanning and WBC and ESR produced the largest AUC of 0.895, a sensitivity of 94.3%, a specificity of 67.3%, and a Youden index of 0.616 and all the 3 ones yielded an AUC of more than 0.880.The combination of radioisotope scanning and all the 3 haematological tests produced a sensitivity of 96.5%, a specificity of 79.7%, an AUC of 0.925 and a Youden index of 0.762.Conclusion:Combination of haematological testing and radioisotope scanning can be a reliable preoperative diagnosis of low-grade infection nonunion.
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Objective To observe the expression of apoptosis related protein c-inhibitor of apoptosis protein (IAP)2 by RNA interference of human immunodeficiency virus-1 (HIV-1)vpr gene and analyze the apoptosis of Jurkat cells.Methods Vector (NC),HIV-1vpr (vpr),vpr+ pRNAT-U6.1/Neo-vpr-56 (Si56) and vpr+ pRNAT-U6.1/Neo-vpr-160 (Si160) were transfected to Jurkat cells and cultured for 48 hours.The total RNA and protein were extracted.Expression of vpr gene was detected by reverse transcription (RT)-polymerase chain reaction (PCR) to confirm the success of transfection.Expression of c IAP2 was detected by RT-PCR and Western Blot.The apoptosis of Jurkat cells was observed by flow cytometry.Results Expression of vpr gene was detected in vpr,Si56 and Si160 groups.The mRNA expression levels in Si56 and Si160 groups were significantly lower than that in vpr group,which declined 87.2％ and 82.2％,respectively (P＜0.05).The levels of c IAP2 mRNA expression in vpr,Si56 and Si160 groups were increased by 3.75,2.49 and 2.65 folds,respectively,compared to that in NC group.However,the c-IAP2 mRNA expressions in Si56 and Si160 groups were lower than that in vpr group,which declined 33.7％ and 29.5％,respectively (P ＜ 0.05).The c-IAP2 protein expression was consistent with mRNA by immunoblotting,and those in Si56 and Si160 groups were declined 42.2％ and 46.8％,respectively,compared to that in vpr group (P＜0.05).The apoptosis of J urkat cells was detected in all groups.Compared to NC group,the apoptotic rate in vpr group was increased by 1.76 folds.However,the differences of apoptosis rate among NC,Si56 and Si160 groups were not statistically significant (all P＞0.05).Compared to vpr group,the apoptotic rates in Si56 and Si160 were significantly decreased by 19.26％ and 18.05％,respectively (P＜0.05).Conclusions The expression of c-IAP2 could be downregulated by knockdown of HIV-1 vpr gene in transcription and protein levels,and the apoptosis of Jurkat cells is inhibited.
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Objective Wnt signaling plays an important role in the development and progression of renal cell carcinoma (RCC).This study aimed to evaluate the effects of the Wnt signaling inhibitor 15-oxospiramilactone on the proliferation , migration, cell apoptosis, and cycles of the human RCC cell line 786-0, and to investigate the possible mechanisms of this small molecule acting on RCC in ivtro. Methods We treated 786-0 cells with DMSO ( blank control group ) and 15-oxospiramilactone at the concentrations of1.25μmol/L (low 15 -OSL), 2.5μmol/L (medium 15-OSL), and 5μmol/L (high 15-OSL), respectively, for 72 hours.Then we observed the changes in the proliferation and migration of the 786-0 cells by MTT and scratch-wound assay and determined their apopto-sis and cycles by Annexin V-FITC/PI assay and flow cytometry . Results 15-oxospiramilactone significantly inhibited the growth of the 7860-cells, with the IC 50of 1.088 μmol/L at 72 hours, and decreased their migration distance (P<0.05).After 36 hours of treatment, the apoptosis rates of the 786-0 cells in the low, medium, and high 15-OSL groups were (12.17 ±0.56), (18.54 ± 1.07), and (50.74 ±1.28) %, respectively, significantly increased as compared with (7.85 ±0.42) %in the blank control group (P<0.05), and in an obviously concentration-dependent manner.15-oxospiramilactone remarkably reduced the number of cells in the G0/G1 phase and increased that in the G 2/M phase (P<0.05). Conclusion 15-oxospiramilactone can significantly inhibit the pro -liferation and migration and induce the apoptosis of 786-0cells in vitro.It may be a potential anti-RCC agent.
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0.05) between two groups in the above results.Disc agar diffusion test showed the sensitivity rates of overall clinical isolates to gatifloxacin and levofloxacin were 97.56% and 92.68%,respectively.The incidence of adverse drug reactions(ADR) of two groups were 23.91% and 43.75%,respectively.In 5 cases severe ADR were found. CONCLUSIONS Sequential therapy of gatifloxacin may get satisfactory results in lower respiratory tract infections of elder people.The irrational use of drugs is an important factor to increase ADR(including collateral damage).So we should pay attention to the ADR and grasp the indications strictly and use the drugs appropriately,especially for the elder patients.