Advances of metal nanoadjuvant for cancer immunotherapy / 药学学报

Immunotherapy has become another effective tumor treatment after surgical resection, chemotherapy, radiotherapy and targeted therapy. However, due to the low immunogenicity of tumor cells and immunosuppressive tumor microenvironment, antigen-presenting cells inefficiently process and present tumor antigens, thus leading to insufficient activation of cytotoxic T lymphocytes and tumor infiltration, which significantly affects the effectiveness of tumor immunotherapy. In recent years, it has been demonstrated that multiple metal ions exhibit distinguished modulatory effects in activating innate immune stimulation and conquering acquired immune tolerance. Based on this, scientists have designed a series of nano-adjuvant delivery systems with metal ions or metal nanoparticles to enhance the targeted accumulation of metal ions in tumor tissues or lymphoid organs for efficiently inducing immunogenic cell death or directly activating antigen-presenting cells to initiate anti-tumor specific immune response. This review briefly outlines the role of various metal ions in anti-tumor immunomodulation, summarizes the research progress in using metal nanoadjuvant delivery systems to achieve efficient anti-tumor immunotherapy, and provides foresight on the main challenges and potential directions in this field.

Effects of schoolbags use on musculoskeletal health among adolescents / 中国学校卫生

Abstract@#Previous epidemiological studies indicated that weight of schoolbag in most countries is far higher than that recommended guidelines. Heavy schoolbags seriously affect the healthy development of the musculoskeletal system of adolescents, which not only leads to abnormal posture e.g. rounded shoulders, hunchback and head forward, but also is one of the main causes of adolescent musculoskeletal diseases such as cervical spondylosis, low back pain and scoliosis. However, adolescents and their parents do not fully understand the harm of heavy schoolbags, let alone the health knowledge regarding the choice and use of schoolbags. Therefore, the review introduces current evidence regarding the association between schoolbag and adolescent musculoskeletal system diseases, as well as schoolbag selection and use, with the aim to arouse the attention of teenagers and their parents and relevant health education departments.

School physician in primary and secondary schools in Yichang of Hubei Province during 2019-2020 / 中国学校卫生

Objective@#To understand school physician in primary and secondary schools in Yichang City, Hubei Province from 2019 to 2020, and to provide a reference for strengthening the school physician team in primary and secondary schools.@*Methods@#149 and 102 primary and secondary schools from 6 municipal districts in Yichang City, Hubei Province, were randomly selected in November 2019 and November 2020, respectively, and were administered by questionnaire survey.@*Results@#The proportion of school physicians increased from 39.6% in 2019 to 65.7% in 2020. In the past two years, the equipment rate of school physician in both central and fringe urban areas increased, especially the fringe urban areas, number of school physician increased from 38 to 96. A total of 93 and 141 school physicians were selected to pariticipate in questionaire survey in 2019 and 2020 respectively. The survey showed that more than 90% of school physicians in primary and secondary schools in Yichang received training, and 74.5% had college education level. However, most of them lack professional qualification and medical background.@*Conclusion@#School physician of primary and secondary of Yichang is well development over the past two years, and the proportion substantially increased. However, there is still room for improvement in the quantity and quality of school physicians, and professional qualification needs to be improved. More attention should be paid to the marginal urban areas to achieve a balance between quantity and quality.

Zinc Ion Inhibits Macrophage Foaming during Atherosclerosis / 中山大学学报(医学科学版)

@#【Objective】To investigate the effects of zinc on the formation of atherosclerotic macrophage foaming and plaque formation and its mechanism.【Methods】The macrophage foaming model was established by stimulating THP-1cells with oxLDL. The degree of foaming in different zinc concentrations of 0，30 and 60 μmol/Lwas detected by oil red Ostaining and the intake of lipid by foam cells was measured by DiI-oxLDL fluorescence. The relevant scavenger protein ex⁃pression of CD36，SR-A was detected by immunoblotting. The relative expression level of zinc ion transporters was detect⁃ed by real-time fluorescent quantitative PCR. ApoE-/- mice were randomly divided into 4 groups，the normal feed group（Chow group），the high-fat zinc-deficient group（HFD-ZnD），and the high-fat normal zinc group（HFD），high-fatand zinc-supplement group（HFD-ZnS），blood lipids and the protein of the mice aorta were detected in the 13 week.【Results】Compared with the normal zinc group，the oil red O density increased（P < 0.05），and add zinc ion decreased the intake of the DiI-oxLDL by foam cells（P < 0.01）. In the 0 μmol/L zinc group，the SR-A and CD36 protein expressionin the foam cells increased（P < 0.05）and 15μmol/L Zn2+ treatment before stimulating with oxLDL reduced the contentsof SR-A and CD36 proteins（P < 0.05）. Compared the oxLDL-treated group with the control group，the mRNA expres⁃sion levels of ZIP10，ZIP12 and ZIP14 increased，and the mRNA expression levels of ZIP4，ZIP7 and ZIP8 decreased（P < 0.05）；while the mRNA expression of ZnT4 was up-regulated（P < 0.01），and the mRNA expression of ZnT1 was down-regulated（P < 0.05）. Compared with Chow group，low density lipoprotein cholesterol（LDL-C），total cholesterol（TC）and triglyceride（TG）were increased in HFD group and HFD-ZnD group，respectively（P < 0.05）；HFD-ZnD group High-density lipoprotein cholesterol（HDL-C）was significantly elevated. Moreover，the LDL-C of the HFD-ZnS group was significantly lower than that of the HFD-ZnD group（P < 0.05）. The SR-A protein of the mice aorta of the HFD and HFD-ZnD group increased compared to the Chow group（P < 0.01），HFD-ZnS could restrain the increase（P < 0.05）. Compared with the Chow group，the ratio of plaque area in the aorta to the total arterial lumen area was significantly in⁃creased in the HFD-ZnD group（P < 0.01），and HFD-ZnS significantly inhibited this increase（P < 0.01）.【Conclusions】 Extracellular zinc deficiency aggravates lipid deposition in macrophages，and the mechanism may be regulated by up-reg⁃ulating the scavenger receptor CD36 and SR-A. Zinc ion transporters are involved in macrophage foaming and formation ofarterial plaques. Zinc deficiency can increase LDL-C and promote the increase of arterial plaque induced by high-fat diet.

Knockdown of Chloride Channel-3 Inhibits Breast Cancer Growth In Vitro and In Vivo / 한국유방암학회지

PURPOSE: Chloride channel-3 (ClC-3) is a member of the chloride channel family and plays a critical role in a variety of cellular activities. The aim of the present study is to explore the molecular mechanisms underlying the antitumor effect of silencing ClC-3 in breast cancer. METHODS: Human breast cancer cell lines MDA-MB-231 and MCF-7 were used in the experiments. Messenger RNA and protein expression were examined by quantitative real-time polymerase chain reaction and western blot analysis. Cell proliferation was measured by the bromodeoxyuridine method, and the cell cycle was evaluated using fluorescence-activated cell sorting. Protein interaction in cells was analyzed by co-immunoprecipitation. Tumor tissues were stained with hematoxylin-eosin and tumor burden was measured using the Metamorph software. RESULTS: Breast cancer tissues collected from patients showed an increase in ClC-3 expression. Knockdown of ClC-3 inhibited the secretion of insulin-like growth factor (IGF)-1, cell proliferation, and G1/S transition in breast cancer cells. In the mouse xenograft model of human breast carcinoma, tumor growth was significantly slower in animals injected with ClC-3-deficient cells compared with the growth of normal human breast cancer cells. In addition, silencing of ClC-3 attenuated the expression of proliferating cell nuclear antigen, Ki-67, cyclin D1, and cyclin E, as well as the activation of extracellular signal-regulated protein kinases (ERK) 1/2, both in vitro and in vivo. CONCLUSION: Together, our data suggest that upregulation of ClC-3 by IGF-1 contributes to cell proliferation and tumor growth in breast cancer, and ClC-3 deficiency suppresses cell proliferation and tumor growth via the IGF/IGF receptor/ERK pathway.

Fluacrypyrim induced apoptosis in acute myeloid leukemia cell lines / 国际药学研究杂志

Objective To investigate the effect of fluacrypyrim on the induction of apoptosis in human acute myeloid leuke-mia(AML)cell lines,NB4,THP-1 and HL-60,and explore the related mechanisms.Methods Trypan blue dye exclusion assay was used to estimate the growth of NB4,THP-1,and HL-60 cells after treatment with various concentrations of fluacrypyrim(1.25, 2.5,5 and 7.5 μmol/L)for 72 h.Cell apoptosis was evaluated by AnnexinⅤ-FITC/PI double stainning for the NB4 and THP-1 cells treated with fluacrypyrim(1.25,2.5 and 5 μmol/L)for 48 h as well as the HL-60 cells treated with fluacrypyrim(2.5,5 and 7.5 μmol/L) for 72 h.Western blotting was used to examine the protein expression of apoptotic regulators Bax,Mcl-1 and Caspase 3 in the NB4 cells treated with fluacrypyrim(1.25,2.5 and 5 μmol/L)for 24 h.Then,NB4 Cells were pretreated with Caspases inhibitor benzyloxy-carbonyl-Val-Ala-Asp-fluoromethylketone(Z-VAD-FMK)and exposed to fluacrypyrim at 2.5 μmol/L for 24 h,which was then evaluat-ed for the apoptosis using AnnexinⅤ-FITC/PI double stainning.Western blotting was used to examine the expression of the phosphory-lated and total proteins of mitogen-activated protein kinase(MAPK)signaling molecules,ERK,JNK and P38,in the NB4 cells treat-ed with fluacrypyrim(1.25,2.5 and 5 μmol/L)for 24 h. NB4 Cells were pretreated with ERK inhibitor U0126,JNK inhibitor SP600125,or P38 inhibitor SB203580 for 1 h and then exposed to fluacrypyrim at 2.5 μmol/L for 24 h,which was then analyzed for the apoptosis by the AnnexinⅤ-FITC/PI double stainning.Results The proliferation of NB4,THP-1 and HL-60 cells was inhibited by the treatment with fluacrypyrim(2.5,5 and 7.5 μmol/L)for 72 h.The apoptosis induced in the NB4 and THP-1 cells by the fluacry-pyrim treatment at 5 μmol/L for 48 h and in the HL-60 cells by the fluacrypyrim treatment at 7.5 μmol/L for 72 h were significant as compared with the control group(P<0.01).Mechanically,fluacrypyrim at the concentrations of 2.5 and 5 μmol/L effectively up-regu-lated the expression of Bax(P<0.01 and P<0.05)for the 2.5 and 5 μmol/L,respectively,down-regulated the expression of Mcl-1 (P<0.01)and activated Caspase 3(P<0.01)in the NB4 cells when compared with the control group(P<0.01).The pretreatment of the NB4 cells with Z-VAD-FMK blocked the apoptosis induced by fluacrypyrim.Furthermore,the fluacrypyrim(2.5 and 5 μmol/L) treatment increased the ERK,JNK and P38 phosphorylation(P<0.01),while the pretreatment of the NB4 cells with U0126 signifi-cantly inhibited the the fluacrypyrim-induced apoptosis(P<0.01),as compared with the control group.Conclusion Fluacrypyrim effectively inhibits the cell proliferation and induces caspase-dependent cell apoptosis in AML cells.Activation of ERK/MAPK signal-ing pathway might play an important role in the action of fluacrypyrim.

Low triiodothyronine syndrome can predict poor prognosis in peritoneal dialysis patients / 上海交通大学学报（医学版）

Objective· To investigate the prevalence of low triiodothyronine syndrome (LT3S) in peritoneal dialysis (PD) patients and to evaluate the predictive value of long-term prognosis. Methods · From Jan. 2009 to Dec. 2015, all patients who started PD for 3 months were enrolled. According to thyroid hormone levels, there were classified into LT3S group (218 cases) and normal T3group (259 cases). The association between FT3and mortality in PD patients was estimated using Cox risk regression model. Results · Compared to the patients in normal T3group, patients with LT3S had lower hemoglobin[(97.90±23.71)g/L vs(105.54±22.94)g/L],adjusted serum calcium[(2.06±0.35)mmol/L vs(2.17±0.27)mmol/L](all P<0.01).Patients with LT3S had higher BNP{[311.00(134.59,776.00)pg/mL]vs[159.00(58.28,378.75)pg/mL]},hrCRP{[2.85(0.95,6.81)mg/L]vs[1.34(0.54,3.32)mg/L]}and serum total cholesterol[(3.18±1.29)mmol/L vs(2.76±0.93)mmol/L]than that in patients with normal T3group(all P<0.01).LVMI of LT3S group [(154.16±58.15)g/m2] vs (125.24±42.67)g/m2] was much higher than that of normal T3group (P<0.01). Cox risk regression model indicated that FT3 was significantly associated with all-cause mortality(HR 0.51,95% CI 0.41-0.63;P<0.01)and cardiovascular mortality(HR 0.60,95% CI 0.45-0.81;P<0.01). Conclusion·LT3S is common in PD patients.Lower FT3was an independent risk factor of all-cause and cardiovascular mortality in PD patients.

Therapeutic Effect of Recombinant Human Stem Cell Factor on Rhesus Monkeys with Severe Acute Radiation Sickness / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the therapeutic effect of rhSCF early administration on rhesus monkeys with severe acute radiation sickness(ARS).</p><p><b>METHODS</b>Twelve adult monkeys totally exposed to 7.0 GyCo were divided into radiation control and SCF groups, and monkeys in SCF group were subcutaneously injected recombinant human SCF(rhSCF) 200 µg/kg at half an hour and 24 hour after irradiation, while the radiation control monkeys were injected physiological saline. Survival was monitored and hematopoiesis was evaluated at 40 days following early treatment.</p><p><b>RESULTS</b>6 animals treated with rhSCF all survived, while 2 in irradiated controls survived on 40 day after radiation. rhSCF treatment promoted hematopoiesis recovery significantly, increased the nadir of white blood cells, neutrophils and platelets, and simplified supportive care in ARS rhesus monkeys.</p><p><b>CONCLUSION</b>RhSCF injection soon after TBI taken shows an significant therapeutic efficiency on rhesus monkeys with severe acute radiation sickness.</p>

Isoflurane provides neuroprotection in neonatal hypoxic ischemic brain injury by suppressing apoptosis / Isoflurano fornece neuroproteção em lesão cerebral hipóxico-isquêmica neonatal por inibição da apoptose

Abstract Background and objectives: Isoflurane is halogenated volatile ether used for inhalational anesthesia. It is widely used in clinics as an inhalational anesthetic. Neonatal hypoxic ischemia injury ensues in the immature brain that results in delayed cell death via excitotoxicity and oxidative stress. Isoflurane has shown neuroprotective properties that make a beneficial basis of using isoflurane in both cell culture and animal models, including various models of brain injury. We aimed to determine the neuroprotective effect of isoflurane on hypoxic brain injury and elucidated the underlying mechanism. Methods: A hippocampal slice, in artificial cerebrospinal fluid with glucose and oxygen deprivation, was used as an in vitro model for brain hypoxia. The orthodromic population spike and hypoxic injury potential were recorded in the CA1 and CA3 regions. Amino acid neurotransmitters concentration in perfusion solution of hippocampal slices was measured. Results: Isoflurane treatment caused delayed elimination of population spike and improved the recovery of population spike; decreased frequency of hypoxic injury potential, postponed the onset of hypoxic injury potential and increased the duration of hypoxic injury potential. Isoflurane treatment also decreased the hypoxia-induced release of amino acid neurotransmitters such as aspartate, glutamate and glycine induced by hypoxia, but the levels of γ-aminobutyric acid were elevated. Morphological studies showed that isoflurane treatment attenuated edema of pyramid neurons in the CA1 region. It also reduced apoptosis as evident by lowered expression of caspase-3 and PARP genes. Conclusions: Isoflurane showed a neuro-protective effect on hippocampal neuron injury induced by hypoxia through suppression of apoptosis.

Resumo Justificativa e objetivos: Isoflurano é um éter volátil halogenado usado para anestesia por via inalatória. É amplamente usado na clínica como um anestésico para inalação. A lesão hipóxico-isquêmica neonatal ocorre no cérebro imaturo e resulta em morte celular tardia via excitotoxicidade e estresse oxidativo. Isoflurano mostrou ter propriedades neuroprotetoras que formam uma base benéfica para o seu uso tanto em cultura de células quanto em modelos animais, incluindo vários modelos de lesão cerebral. Nosso objetivo foi determinar o efeito neuroprotetor de isoflurano em hipóxia cerebral e elucidar o mecanismo subjacente. Métodos: Fatias de hipocampo, em fluido cerebrospinal artificial (CSFA) com glicose e privação de oxigênio, foram usadas como um modelo in vitro de hipóxia cerebral. O pico de população ortodrômica (PPO) e o potencial de lesão hipóxica (PLH) foram registrados nas regiões CA1 e CA3. A concentração de neurotransmissores de aminoácidos na solução de perfusão das fatias de hipocampo foi medida. Resultados: O tratamento com isoflurano retardou a eliminação do PPO e melhorou a recuperação do PPO; diminuiu a frequência do PLH, retardou o início do PLH e aumentou a duração do PLH. O tratamento com isoflurano também diminuiu a liberação de neurotransmissores de aminoácidos induzida pela hipóxia, como aspartato, glutamato e glicina, mas os níveis de ácido γ-aminobutírico (GABA) estavam elevados. Estudos morfológicos mostram que o tratamento de edema com isoflurano atenuou o edema de neurônios piramidais na região CA1. Também reduziu a apoptose, como mostrado pela expressão reduzida da caspase-3 e genes PARP. Conclusões: Isoflurano mostrou um efeito neuroprotetor na lesão neuronal no hipocampo induzida por hipóxia através da supressão de apoptose.

Therapy and Prevention of Postoperative Urosepsis of Ureter Endoscopic Lithotripsy for Non-infection / 中国医学科学杂志(英文版)

Objective To analyze the risk factors causing postoperative urosepsis in ureter endoscopic lithotripsy without infection preoperatively, in order to make a more effective and safer preventive and therapeutic strategy.Methods From January 2010 to January 2015, 5 ureteral calculus patients undergoing ureter endoscopic lithotripsy with holmium laser were retrospectively enrolled in this clinical study. These patients suffered urosepsis postoperatively confirmed by the clinical presentations and laboratory Results, while they had no infection in their blood and urine preoperatively. Without delay, 5 patients were treated by anti-inflammation and anti-shock.Results The vasopressor drug was stopped gradually after 12-36 hours. The body temperature was recovered to normal in 2 or 3 days, and the blood and urine test Results were not abnormal in 7 days. At last, 5 patients were all cured.Conclusions Stone and operation themselves are potential factors to cause urosepsis after ureter endoscopic lithotripsy. Especially for patients who had not presented infection preoperatively, careful preparation preoperatively, corrective manipulation, low pressure irrigation, drainage and controlling time during operation, and early diagnosis, appropriate treatment postoperatively are the key to cure and prevent urosepsis.

Chemical constitutents in the fruits of Gardenia jasminoides var. radicans Makino / 中国药学杂志

OBJECTIVE: To study the chemical constituents in the fruits of Gardenia jasminoides var. radicans Makino. METHODS: Percolation with alcohol and liquid-liquid extraction methods were used to extract the constituents. And silica gel, reverse-phase octadecylsilyl(ODS), and sephadex LH-20 chromatographic methods were applied to isolate and purify compounds. MS, NMR spectroscopic methods were used to elucidate their structures. RESULTS: Ten compounds were isolated from the ethyl acetate fraction of the ethanolic extract of fruits from Gardenia jasminoides var. radicans Makino, and their structures were identified as seven iridoids: geniposide (1), 6α-hydrogeniposide (2), 6β-hydrogeniposide (3), 6α-methoxygeniposide (4), 6β-methoxygeniposide (5), 2'-O-(4″-Hydrooxycinnamoyl) mussaenosidic acid(6), 6″-O-trans-p-coumaroylgenipin genitiobioside(7); two quinic acid derivatives: 3, 5-di-O-caffeoyl-4-O-(3-hydroxyl-3-methyl) glutaroylquinic acid(8), methyl 3, 5-di-caffeoyl-4-O-(3-hydroxy-3-methyl)-glutaroylquinate(9); and one flavonoid: quercetin-3-O-β-D-glucopyranoside(10). CONCLUSION: Compounds 3-10 are isolated from Gardenia jasminoides var. radicans Makino for the first time.

Irregularly shaped lacunar infarction: risk factors and clinical significance / Infartos lacunares com morfologia irregular: fatores de risco e significado clinico

Objective Our study focused on acute lacunar infarct shapes to explore the risk factors and clinical significance of irregularly shaped lacunar infarctions. Methods Based on the shape of their acute lacunar infarct, patients (n=204) were classified into the “regular” group or “irregular” group. The characteristics of the lacunar infarction were compared between the regular and irregular groups, between patients with and without neurological deterioration, and between patients with different modified Rankin scale (mRS) scores. The risk factors for irregularly shaped lacunar infarctions, neurological deterioration, and high mRS scores were identified. Results Blood pressure variability (BPV) was an independent risk factor for irregularly shaped lacunar infarction. Infarction size, prevalence of advanced leukoaraiosis, and irregularly shaped lacunar infarcts were independent risk factors for higher mRS scores. Conclusions The irregularly shaped lacunar infarcts were correlated with BPV. Irregularly shaped lacunar infarctions and leukoaraiosis may be associated with unfavorable clinical outcomes. .

Objetivo Estudar as diferentes formas dos infartos lacunares agudos, investigando os fatores de risco e o significado clinico daqueles com morfologia irregular. Métodos Os 204 pacientes com infartos lacunares agudos foram classificados em dois grupos: aqueles com morfologia regular e aqueles com morfologia irregular. Foram estudadas as características dos dois grupos e caracterizados os fatores de risco para infartos irregulares, deterioração neurológica e altos escores da escala de Rankin modificada. Resultados Variabilidade da pressão arterial é fator de risco independente para infartos lacunares irregulares. Tamanho do infarto, prevalência de leucoaraiose e formato irregular dos infartos lacunares são fatores de risco independentes para escores mais elevados na escala de Rankin modificada. Conclusões Variabilidade da pressão arterial está relacionada ao formato irregular dos infartos lacunares agudos. Este tipo de infarto e a leucoaraiose podem estar relacionado a desfechos clínicos desfavoráveis. .

Discectomy and discectomy plus Coflex fixation for lumbar disc herniation, a clinical comparison study / 中华外科杂志

<p><b>OBJECTIVE</b>To compare clinical efficacy between discectomy and discectomy plus Coflex fixation for lumbar disc herniation.</p><p><b>METHODS</b>From December 2007 to August 2008, 50 patients (31 males and 19 females) were treated by surgery of discectomy and discectomy plus Coflex fixation. The average age was 52.5 years (range, 30 - 72 years). There were 24 cases in the group of discectomy plus Coflex fixation and 26 cases in the group of discectomy. Preoperative and postoperative visual analogue scales (VAS), Japanese Orthopadic Association (JOA) and Oswestry disability index (ODI) were recorded, as well as radiological index. And use a paired t-test and one-way analysis of variance (one-way ANOVA) statistical method to evaluate the Coflex dynamic stabilization system in value in the treatment of lumbar disc herniation.</p><p><b>RESULTS</b>Both groups received significant improvement of JOA, ODI and VAS (t = -33.2 - 64.5, P < 0.01), but the group of discectomy was found with deterioration of ODI at last follow-up, 12 months after surgery 6.7 ± 1.5 to 10.2 ± 2.3 (t = -19.3, P < 0.05). The group of discectomy plus Coflex fixation was found with significant increase of height of dorsal intervertebral discs (HD), distance across the two adjacent spinous processes (DS), distance of intervertebral foramina (DIF) and spinal canal area(SA) (t = -34.4 - 4.5, P < 0.05). In contrast, the group of discectomy was found with significant decrease of HD, DS, DIF and SA (t = 3.4 - 52.8, P < 0.05). Coflex fixed group in HD, DIF, DS significant difference with simple discectomy group, with a statistically significant (F = 14.1 - 25.6, P < 0.05).</p><p><b>CONCLUSIONS</b>Both discectomy and discectomy plus Coflex fixation are apparently effective when treating lumbar disc herniation. Coflex can significantly increase the HD and DIF when used for lumbar disc herniation, and it has positive influence for keeping height of lumbar vertebral space and treating the nerve root symptom of lumbar disc herniation. Discectomy plus Coflex is better than pure discectomy in preventing lumbar degeneration.</p>

Chemical constituents from Commelina communis / 中国中药杂志

To investigate the chemical constituents from Commelina communis, fifteen compounds were separated and purified by silica gel, Sephadex LH-20, and ODS column chromatography, and semi-preparative HPLC. By analyses of NMR and MS data as well as their physical and chemical properties, the structures of these compounds were identified as chrysoeriol-7-O-beta-D-glucoside( 1), methyl gallate(2), p-coumaric acid(3), protocatechuic acid(4), caffeic acid(5), p-hydroxybenzoic acid(6), 2-phenethyl-beta-D-gly-cosidase(7) , rhaponticin(8) , (7S, 8R) -dihydrodehydrodiconiferyl alcohol-9-O-beta-D-glucoside (9), isovitexin (10) , isofurcatain (11), isorhamnetin-3-O-beta-D-glucoside(12) , quercetin-3-O-alpha-L-rhamnoside (13) , isoquercitrin (14) , and 1, 2-dihydro-6, 8-dime-thoxy-7-1-(3, 5-dimethoxy-4-hydroxyphenyl) -N1, N2-bis-[2-( 4-hydroxyphenyl) ethyl] -2, 3-naphthalene dicarboxamide (15). Compounds 2, 5-9, 11, 13 were obtained from the genus Commelina for the first time.

Clinical evaluation of interspinous process device Coflex for degenerative disk diseases / 中华外科杂志

<p><b>OBJECTIVE</b>To study indications and complications of interspinous process device Coflex for degenerative disk diseases.</p><p><b>METHODS</b>One hundred and eight patients with degenerative lumbar disc diseases were underwent procedures of surgical decompression and additional fixation of Coflex between November 2007 and October 2010. Sixty-eight patients were male and the other fourty were female, and their average age was 53.5 years (range from 37 to 75 years). Fifty-nine patients were underwent surgery of excision of nucleus pulposus and Coflex fixation, 41 patients were underwent surgery of decompression by fenestration and Coflex fixation, 6 patients were underwent surgery of topping-off, and 2 patients were underwent surgery of Coflex fixation for two level. Preoperative and postoperative visual analogue scales (VAS) and Oswestry disability index (ODI) were recorded, as well as height of ventral intervertebral space (HV), height of dorsal intervertebral space (HD), height of intervertebral foramen (HIF) and segmental range of motion (ROM). One-way ANOVA was used for statistical analysis. Surgical complications were also recorded.</p><p><b>RESULTS</b>The average follow-up time was 28.8 months. All groups had apparent improvement of VAS and ODI, and maintained well to last follow-up (F = 6.16-25.92, P = 0.00). Statistical analysis showed that HD and HIF increased significantly in group with excision of nucleus pulposus and Coflex fixation and group with decompression by fenestration and Coflex fixation (F = 7.37 - 11.68, P < 0.05). Although both HD and HIF decreased one-year after surgery, they were still higher than those preoperatively (F = 6.31 and 7.05, P = 0.00). Preoperative segmental ROM was respectively 6.3° ± 1.8° and 6.2° ± 1.7° in group with excision of nucleus pulposus and Coflex fixation and group with decompression by fenestration and Coflex fixation, and 3.1° ± 0.6° and 3.0° ± 0.8° at last follow-up. Three cases were found with device-related complications and five with non-device-related complications, and all five cased were cured after appropriate treatment.</p><p><b>CONCLUSIONS</b>Surgical method assisted with Coflex has significant clinical efficacy for degenerative disc disease, it can maintain segmental stability, simultaneously, partly reserve movement. It's key to strictly master indications and precisely choose patients.</p>

Influence of intravertebral cleft for outcome of percutaneous kyphoplasty / 中华外科杂志

<p><b>OBJECTIVES</b>To study incidence and radiological features of intravertebral cleft (IVC) in patients with chronic pain due to osteoporotic vertebral compression fractures (OVCFs), and analyze influence of IVC for surgery of percutaneous kyphoplasty (PKP).</p><p><b>METHODS</b>Seventy-six patients with osteoporotic vertebral compression fractures and pain duration more than one month were underwent procedures of PKP between August 2005 and August 2010. The incidence and radiological features of IVC were analyzed. Sixty-one patients with single-level OVCFs were divided into two groups with and without IVC. Preoperative and postoperative kyphotic angle and relative anterior vertebral height were recorded, as well as visual analogue scales (VAS) and Oswestry disability index (ODI). Cement patterns of opacification and leakage were also recorded.</p><p><b>RESULTS</b>Thirty two patients with 39 vertebrates were found with IVC sign. The diagnostic sensitivity of X ray, CT and MRI for IVC was respectively 33.3%, 85.7% and 84.6%. Two groups with IVC and without IVC both had apparent correction of kyphotic angle and reduction of anterior height at 3 days after surgery and last follow-up (F = 21.82 - 72.18, P < 0.01). There was no statistical significance between two groups (P > 0.05). In addition, both groups had significant improvement as regard to VAS and ODI (F = 131.06 - 364.12, P < 0.01). Solid pattern accounted for 72.0% of all cemented vertebrates in the group with IVC and 19.4% in the group without IVC. Four cement leakage were found in the group with IVC and another four in the group without IVC.</p><p><b>CONCLUSIONS</b>There is a high incidence of IVC in patients with chronic pain due to osteoporotic vertebral compression fractures. CT and MRI are sensitive for detection of IVC. The procedure of PKP is effective for both groups with and without IVC. IVC produces an apparent influence on cement opacification and leakage location during the procedure of PKP.</p>

Therapeutic effects and complications of percutaneous pedicle screw fixation for thoracolumbar fractures / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effects and complications of percutaneous pedicle screw fixation for thoracolumbar fractures.</p><p><b>METHODS</b>From January 2002 to December 2008, 103 patients with thoracolumbar fractures were treated with percutaneous pedicle screw fixation, including 75 males and 28 females, the average age was 45.6 years (range, 18 - 72 years). All of them were of no neurological deficits. There were 65 cases of traffic injury, 23 cases of fall injury and 15 cases of smashed injury. According to the Denis classification, 64 patients were of compression fractures, and 39 patients of burst fractures. There were 5 cases had fractures in T(11), 30 in T(12), 42 in L(1), 15 in L(2), 4 in L(3), 3 in L(4), 2 in T(11-12), 1 in L(1-2), and 1 in L(2-3). Radiological examinations, including X-ray and CT examinations, and clinical examinations were carried out to evaluate the therapeutic effects.</p><p><b>RESULTS</b>Twenty one patients were lost to follow up, the remaining were followed up from 10 to 48 months with an average of 27.4 months. Before the operation, the vertebral height, the kyphosis angle and the occupation of spinal canal were (54.5 ± 8.7)%, 16.4° ± 2.9° and 1.2 ± 1.0, and were improved to (88.6 ± 6.4)%, 11.6° ± 2.7° and 0.5 ± 0.6 respectively after the operation. Preoperatively the visual analogue scale and the Oswestry disability index were 8.0 ± 1.2 and 41.2 ± 9.3, and were improved to 1.7 ± 1.8 and 6.7 ± 5.6 postoperatively, respectively. All of these values between pre- and post-operatively were significantly different (P < 0.01). Screw misplacement was found in 7 patients, superficial wound infection in 1, screw breakage in 3, screw dislodgment in 2, cement leakage in 5, transient neurological symptoms in 4, and 8 patients with low back pain remained, of which 2 patients required occasional oral analgesics. Bone fusion achieved in all cases.</p><p><b>CONCLUSIONS</b>The clinical efficacy of percutaneous pedicle screw fixation is similar with conventional open surgery. With the advantages of convenient procedure, less invasive, and rapid recovery, percutaneous pedicle screw fixation is an alternative method for thoracolumbar fractures without neurological deficits.</p>

Prediction of spinal cord decompression after cervical laminoplasty: the SC-line / 中华外科杂志

<p><b>OBJECTIVES</b>To report a new index (the SC-line) and a new classification for predicting of postoperative spinal cord decompression after cervical laminoplasty.</p><p><b>METHODS</b>From March 2008 to August 2009, MRI images of 25 patients treated with cervical laminoplasty were retrospectively studied. Using T2-weighted images of the cervical spine, point A was anterior point of the spinal cord at inferior endplate level of cranial compressed vertebra. Point B was anterior point of the spinal cord at superior endplate level of caudal compressed vertebra. The SC-line was defined as a line that connects A and B. Posterior surface of compressor at compression level did not exceed the line in Type I, connected the line in Type II, and exceeded it in Type III. Twenty-five patients who underwent cervical laminoplasty were classified into 3 groups according to the SC-line classification. The posterior shift of the spinal cord after the posterior decompression procedure was evaluated by using a modified gradation of degree of anterior spinal cord compression by MRI finding. The relationship between the degree of anterior spinal cord compression after surgery and the SC-line types were analyzed.</p><p><b>RESULTS</b>Preoperative cervical SC-line classification showed high correlations to the degree of spinal cord decompression. There were 3.82 ± 0.39 points in Type I before surgery, 3.90 ± 0.32 points in Type II, and 4.00 ± 0.00 points in Type III, respectively. After surgery, there were 1.15 ± 0.50 points in Type I, 2.70 ± 0.48 points in Type II, and 3.50 ± 0.55 points in Type III, respectively. Significant differences were found between each Type (F = 42.49, P < 0.01; Type I vs. Type II: P < 0.01; Type I vs. Type III: P < 0.01; Type II vs. Type III: P = 0.038).</p><p><b>CONCLUSION</b>SC-line can be used to predict the degree of postoperative spinal cord decompression following cervical laminoplasty.</p>

The application of minimally invasive surgery for different type of thoracolumbar fractures / 中华外科杂志

<p><b>OBJECTIVE</b>To study the therapeutic method and effect of minimally invasive surgery for the thoracolumbar fractures.</p><p><b>METHODS</b>A retrospective review of the minimally invasive surgically treatment thoracolumbar fractures from February 2005 to June 2010 was performed. There were 183 cases, 126 males and 57 females, aged 18 to 68 years, average 38.9 years. The involved levels of fractures were T(11) in 22, T(12) in 61, L(1) in 71, L(2) in 29. According to Gertzbein classification, 145 cases were type A fractures, 34 cases were type B fractures, 4 cases were type C fractures; According to Load-sharing score, 51 cases were 4 scores, 56 cases were 5 scores, 17 cases were 6 scores, 12 cases were 7 scores, 24 cases were 8 scores, 23 cases were 9 scores. Different surgical methods were selected according to the minimally invasive surgical strategy, 22 patients were treated with the minimally invasive percutaneous pedicle screws osteosynthesis (MIPPSO group), 102 patients were treated with the small-incision pedicle screws osteosynthesis (SISPSO group), 31 patients were treated with the small incision anterior thoracolumbar surgery (SIATS group) assisted by thoracoscope or headlight, and 28 patients were treated with the 270° decompression and reconstruction surgery (270° DRS group) via a posterior small incision. Preoperative and postoperative neurological status, the correction and loss of Cobb's angle, the decompression scope of spinal canal, the location and union of bone graft were followed up and reviewed.</p><p><b>RESULTS</b>All of 183 cases had successful surgery and were followed up. In the MIPPSO group, operative time was 52 - 100 min, blood loss was 35 - 55 ml. In the the SISPSO group, operative time was 48-68 min, the blood loss was 45 - 65 ml the correction of Cobb's angle in the two groups was 8° - 19°. In the SIATS group, operative time was 140 - 220 min, the blood loss was 160 - 1500 ml the correction of Cobb's angle was 15° - 25°, 1 case had pleural effusion, 1 had lateral femoral cutaneous nerve damage, the complications disappeared after treatment. In the 270° DRS group the operative time was 160-280 min, the blood loss was 700 - 4700 ml, the correction of Cobb's angle was 15° - 28°. The spinal canal mass was removed, the spinal canal was enlarged and completely decompressed. Neurological status improved in all of the preoperative incomplete paraplegia patients except 1 case whose neurological symptoms aggravated.</p><p><b>CONCLUSION</b>It is satisfactory that the minimally invasive surgical strategy was rational used in the treatment of thoracolumbar fractures.</p>

Biomechanical comparison with cervical spines of porcin, calf and human / 医用生物力学

Objective To identify whether the calf or porcine cervical spine is a suitable substitute specimen for vitro spine study by comparing the biomechanical characteristics of porcin, calf and human cervical segments. Method Twelve fresh (age: 1 year; average weight: 60-80 kg) porcine cervical spines (C0-T1) and twelve fresh (age: 1 week; average weight： 40-50 kg) calf cervical spines (C0 T1) were taken. The twelve specimens were divided into two groups. One group of six was divided into C2-C3, C4-C5, C6-C7; the other group was divided into C3-C4, C5-C6. The muscle and soft tissue of each functional segment (C2-C3, C3-C4, C4-C5, C5-C6, C6-C7) were removed, preserving the full ligament, and then each functional segment was tested respectively. The flexion/extension, axial left/right rotation, and right/left lateral bending were applied continuously on the range of motion(ROM) and neutral zone(NZ). The findings in the study were compared with the published data of human cervical spine. Results In rotating and extension/flexion of NZ, the calf and human cervical spines were relatively similar, but they were far greater than that of the porcine cervical spine. In the lateral bending, the NZ of porcine C2-C3 was 69.7% of human, the NZ of porcine C6-C7 was 60.4% of human, and other segments were far smaller than human; the calf cervical spines were different from human, except the C2-C3. In bending and extension flexion of ROM, the porcine and human cervical spines were very similar. But they were far less than the calf, approximately 50% of calf; in the rotation, C2-C3 of porcin was about 69% of human, and other segments were less than the human. The calf cervical spine was much larger than human, and the smallest gap was in C4-C5 of 3.5 °. Conclusions The C2-C3 and C6-C7 of porcin can replace the human cervical spine in nearly all biomechanical experiments on spines. The ROM of calf is bigger than human cervical, but the C2-C3 and C3-C4 of calf are similar to human in biomechanics.