The efficacy of da Vinci robot-assisted lobectomy versus segmentectomy for stage ⅠA non-small cell lung cancer: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To compare and analyze the therapeutic effects of robot-assisted lobectomy and segmentectomy for stage ⅠA non-small cell lung cancer with a diameter≤2 cm. Methods    A total of 181 patients with pathologically confirmed stage ⅠA non-small cell lung cancer (diameter≤2 cm) who underwent robot-assisted lobectomy and segmentectomy in our hospital from 2018 to 2021 were included. There were 74 males and 107 females with an average age of 57.50±10.60 years. They were divided into two groups according to the surgical procedure: a segmentectomy group (85 patients) and a lobectomy group (96 patients). Results    There was no statistically significant  difference between the two groups in terms of clinical data such as age, gender, smoking history, basic disease, pathological type, tumour diameter, operative time, postoperative 24 h drainage volume and overall complications (P>0.05). The intraoperative blood loss (33.88±16.26 mL vs. 39.27±19.48 mL, P=0.046), groups of dissected lymph nodes (4.76±1.19 vs. 5.52±1.46, P=0.000), number of dissected lymph nodes (14.81±7.23 vs. 18.06±7.70, P=0.004) and postoperative 72 h drainage volume (561.65±225.31 mL vs. 649.84±324.34 mL, P=0.037) of patients in the segmentectomy were less than those in the lobectomy group. The chest drainage time (5.49±3.92 d vs. 7.60±4.96 d, P=0.002) and postoperative hospital stay time (7.47±4.16 d vs. 9.67±5.50 d, P=0.003) were shorter than those in the lobectomy group. There was no conversion to thoracotomy or perioperative death in the two groups. The postoperative follow-up rate was 100.0% with a longest follow-up time of 48 months. The 3-year recurrence-free survival rates of the segmentectomy group and lobectomy group were 87.7% and 92.4%, respectively (P=0.465). Conclusion    The da Vinci robot-assisted lobectomy and segmentectomy are safe and feasible surgical procedures for patients with stage ⅠA non-small cell lung cancer (diameter≤2 cm), with a similar 3-year recurrence-free survival rate. The lobectomy group has more lymph nodes dissected, while the segmentectomy group is superior to the lobectomy group in terms of intraoperative blood loss, postoperative 72 h chest drainage volume, chest drainage time and postoperative hospitalization time.

Correlation between theta-gamma neural oscillations in hippocampal CA3 area and the spatial identifying and cognitive ability in rats / 生理学报

The present study was aimed to explore the correlation between θ-γ neural oscillations phase-amplitude coupling (PAC) in hippocampal CA3 area and the changes of spatial identifying and cognitive ability before and after shock avoidance training in rats. According to the results of Y-type maze shock avoidance training, the rats were divided into two groups: the fast avoidance response group and the general avoidance response group. The local field potential (LFP) of hippocampal CA3 area was recorded by wireless telemetry before and after shock avoidance training. The variation of θ oscillation (3-7 Hz) and low-γ neural oscillation (30-60 Hz) PAC in hippocampal CA3 area was analyzed by MATLAB wavelet packet extraction technique. The results showed that, compared with the general avoidance response group, the fast avoidance response group exhibited higher θ-γ neural oscillation PAC in hippocampal CA3 area before training. θ-γ oscillation PAC in hippocampal CA3 area was increased in both groups after training. It was also noticed that θ-γ neural oscillation PAC of some frequency bands in the general avoidance response group were significantly higher than those in the fast avoidance response group. The results suggest that certain intensity of training can change the spatial identifying and cognitive ability of rats, and the mechanism may involve the increase of the synchrony of θ-γ neural oscillation, i.e., the enhancement of θ-γ phase-amplitude alternating frequency coupling in hippocampal neurons.

Mechanism of Traditional Chinese Medicine in Prevention and Treatment of Precancerous Lesions of Gastric Cancer： An Exploration Based on Gastric Microenvironment / 中国实验方剂学杂志

At present， the incidence and mortality of gastric cancer in China are 10.26% and 12.45%， ranking the second and third places， respectively， in the incidence and mortality of malignant tumors in China. Cancer often goes through three stages： precancerous lesions， carcinoma in situ， and invasive carcinoma. It is of great significance to advance cancer prevention and control to the stage of precancerous lesions. The popularization of digestive endoscopy-assisted diagnosis and treatment has enabled the timely diagnosis and treatment of early gastric cancer and severe dysplasia. However， the endoscopic mucosal resection is not suitable for most precancerous lesions of gastric cancer （PLGC）， and the effective drugs are not available. The long-term clinical dynamic monitoring has imposed considerable physical and mental burdens on patients. Gastrointestinal microenvironment is a dynamic balance system composed of gastrointestinal flora， chemical barrier， mechanical barrier， immune barrier， and gastrointestinal nerves. The imbalance of gastric microenvironment has been proved to be the key mechanism of PLGC. According to traditional Chinese medicine （TCM）， PLGC is a result of long-term interaction between deficient healthy Qi and excessive pathogens. In syndrome differentiation and treatment， PLGC is often believed to be developed from chronic gastritis. Besides， the inflammation-cancer transformation model put forward by Correa and the evolution of its TCM pathogenesis are also considered. Guided by the basic treatment principle of reinforcing healthy Qi to eliminate pathogenic factors， we determined the basic therapeutic methods as follows： invigorating spleen， clearing heat， and resolving dampness. At the same time， such methods as soothing liver and regulating Qi， resolving phlegm and dissipating mass， activating blood and resolving stasis， clearing heat and removing toxin， and tonifying deficiency can be combined based on the results of syndrome differentiation. After discussing the correlation between the imbalance of gastric microenvironment and PLGC and summarizing TCM intervention methods and mechanisms against PLGC from the perspective of gastric microenvironment regulation， this paper believed that TCM improved the gastric microenvironment by regulating the disorder of gastric flora， eliminating the gastric mucosal inflammation， and relieving the abnormal immune response， thereby preventing and controlling the PLGC.

Influencing factors analysis of thoracic drainage time after da Vinci robot lung cancer surgery and preventive solution / 中国胸心血管外科临床杂志

@#Objective    To explore the factors that affect the drainage time of da Vinci robot lung cancer surgery, to analyze the coping strategies, and to provide a basis for shortening the drainage time of patients after surgery and speeding up the patients' recovery. Methods    The clinical data of 131 patients who underwent da Vinci robot lung cancer surgery at the Department of Thoracic Surgery, General Hospital of Northern Theater Command from January 2019 to October 2019 were retrospectively analyzed. Among them, 68 were males and 63 were females, with an average age of 59.84±9.66 years. According to the postoperative thoracic drainage time, the patients were divided into two groups including a group A (drainage time≤ 5 days) and a group B (drainage time >5 days). Univariate analysis and logistic multivariate regression analysis were used to analyze the factors that may affect postoperative drainage time, and the correlation between different influencing factors and thoracic drainage time after da Vinci robot lung cancer surgery. Results    Logistic multivariate analysis showed that age≥60 years (P=0.014), diabetes mellitus (P=0.035), operation time≥130 min (P=0.018), number of lymph node dissections≥15 (P=0.002), and preoperative albumin<38.45 g/L (P=0.010) were independent factors affecting the drainage time of da Vinci robot lung cancer surgery. Conclusion    For elderly patients with diabetes mellitus during the perioperative period, blood glucose should be actively controlled, reasonable surgical strategies should be formulated to ensure the safety and effectiveness of the operation, while reducing intraoperative damage and shortening the operation time. After the operation, patients should be guided to strengthen active coughing, expectoration and lung expansion. Thereby it can shorten drainage time and speed up the recovery of patients after operation.

The complications and prevention strategies of Dynesys dynamic stabilization for lumbar degenerative disease / 中华骨科杂志

Objective:To investigate the complications and prevention strategies of Dynesys stabilization in the treatment of lumbar degenerative disease.Methods:Two hundred and forty-three patients underwent lumbar spine stabilization with Dynesys owing to lumbar degenerative disease were retrospectively analyzed from July 2008 to December 2016. The mean follow-up time was 5.6 years (48-148 months). There were 152 patients with lumbar disc herniation and 91 patients with lumbar spinal stenosis. 167 cases underwent single-level operation, 71 cases underwent two-level operation, and 5 cases underwent three-level operation. All patients had low back pain, radiating pain in the lower extremities, and/or intermittent claudication. Clinical outcomes were evaluated using Oswestry disability index (ODI) and visual analogue scale (VAS). The occurrence of perioperative complications (with in 3 months) and postoperative complications (after 3 months) after the operation were recorded and analyzed. Radiographic adjacent segment degeneration (ASD) was evaluate dusing University of California at Los Angeles Grading Scale (UCLA).Results:All patients underwent surgery successfully. ODI score of patients improved from 55.1%±16.8% preoperatively to 15.6%±5.8% at the final follow-up, the difference was statistically significant ( t=34.6, P<0.01). VAS score decreased from 6.4±2.3 preoperatively to 1.1±0.4 at the final follow-up, the difference was also statistically significant ( t=35.4, P<0.01). There were 25 cases (10.29%) with complications, and 3 cases (1.23%) underwent secondary operation. Perioperative complications occurred in 13 patients (5.35%), including 5 cases of cerebros pinal fluid leakage, 5 cases of poor wound healing (2.06%), and 3 cases of deep wound infection (1.23%). Twelve patients (4.94%) had long-term postoperative complications, including 6 patients (2.47%) of unilateral screw loosening at the 5-year follow-up, 3 patients (1.23%) of screw fracture, and 3 patients (1.23%) of symptomatic ASD, among whom 2 patients underwent secondary operation, and 1 patient underwent conservative treatment. There was no recurrence at the operated segments in all patients. At the final follow-up, 41 patients (16.87%) had radiographic ASD. The UCLA score atthe final follow-up was significantly different from that preoperatively ( Z=2.60, P=0.01). Conclusion:Dynesys dynamic system combined with decompression in the treatment of degenerative lumbar spine diseases can achieve good long-term clinical outcome, with low incidence of complications and ASD.

Inflammation-mediated age-dependent effects of casein kinase 2-interacting protein-1 on osteogenesis in mesenchymal stem cells / 中华医学杂志(英文版)

BACKGROUND@#The casein kinase 2-interacting protein-1 (CKIP-1) is important in the development of osteoblasts and cardiomyocytes. However, the effects of CKIP-1 on osteoblast precursor mesenchymal stem cells (MSCs) remain unclear. This study aimed to determine whether CKIP-1 affects osteogenic differentiation in MSCs and explore the relationship of CKIP-1 and inflammation.@*METHODS@#Bone marrow MSCs of CKIP-1 wild type (WT) and knockout (KO) mice were cultivated in vitro. Cell phenotype was analyzed by flow cytometry, colony formation was detected to study the proliferative ability. Osteogenic and adipogenic induction were performed. The osteogenic ability was explored by alizarin red staining, alkaline phosphatase (ALP) staining and ALP activity detection. Quantitative real-time polymerase chain reaction (qRT-PCR) was carried out to determine the mRNA expression levels of osteoblast marker genes. The adipogenic ability was detected by oil red O staining. Content of the bone was analyzed to observe the differences of bone imaging parameters including trabecular bone volume/tissue volume (BV/TV), bone surface area fraction/trabecular BV, trabecular number (Tb.N), and trabecular spacing (Tb.sp). Interleukin (IL)-1β was injected on WT mice of 2 months old and 18 months old, respectively. Difference in CKIP-1 expression was detected by RT-PCR and western blot. The relationship between CKIP-1 and inflammation was explored by RT-PCR and western blot.@*RESULTS@#ALP assays, alizarin red staining, and qRT-PCR showed that MSCs derived from CKIP-1 KO mice exhibited a stronger capability for osteogenesis. Micro-computed tomography detection showed that among 18-month-old mice, CKIP-1 KO mice presented significantly higher bone mass compared with WT mice (P = 0.02). No significant difference was observed in 2-month-old mice. In vivo data showed that expression of CKIP-1 was higher in the bone marrow of aging mice than in young mice (4.3-fold increase at the mRNA level, P = 0.04). Finally, the expression levels of CKIP-1 in bone marrow (3.2-fold increase at the mRNA level, P = 0.03) and cultured MSCs were up-regulated on chronic inflammatory stimulation by IL-1β.@*CONCLUSIONS@#CKIP-1 is responsible for negative regulation of MSC osteogenesis with age-dependent effects. Increasing levels of inflammation with aging may be the primary factor responsible for higher expression levels of CKIP-1 but may not necessarily affect MSC aging.

Research Progress on Mechanism of Tongxie Yaofang in Treating Diarrhea-Predominate Irritable Bowel Syndrome Based on Brain-gut Interaction Function / 中国实验方剂学杂志

Diarrhea-predominant irritable bowel syndrome (IBS-D) is one of the common functional gastrointestinal diseases in clinical practice, its pathogenesis is diverse. Because of its sudden and lingering intractable symptoms, it seriously affects patients' work and life. IBS-D patients suffer from repeated illnesses, which often affect their lives with mental symptoms such as anxiety and depression. Anxiety and depression can also affect visceral sensation, increase intestinal sensitivity, aggravated by interaction between physical symptoms and mental symptoms. The main pathogenesis of IBS-D such as visceral hypersensitivity, gastrointestinal motility disorders, intestinal infections, and psychosocial factors are all related to brain-gut interaction disorders. Patients with IBS-D are prone to brain-gut interaction disorders due to long-term chronic mental stress. Brain-gut interaction is the main mode of regulation of gastrointestinal function in the brain-gut axis. Traditional Chinese medicine （TCM） believes that the main syndrome type of IBS-D patients is liver stagnation and spleen deficiency, while liver stagnation will be unsatisfactory, and the secretion and content of various neurotransmitters in the brain are closely related to emotions. Tongxie Yaofang is a commonly basic prescription used for the clinical treatment of IBS-D liver stagnation and spleen deficiency syndrome. It has the functions of softening the liver and replenishing the spleen, removing dampness and stopping diarrhea, and has a significant clinical effect. At present, many animal experiments and clinical studies have explored the mechanism of Tongxie Yaofang in treating IBS-D and its effect on brain-gut interaction function and brain-gut peptide content, but the main liver drainage and brain-gut interaction have not been linked. The author took the correlation between liver liver govers regulating and brain-gut interaction as the starting point, explored the mechanism of Tongxie Yaofang in treating IBS-D based on brain-gut interaction disorder, and explained the correlation between the three. Based on the research literature of Tongxie Yaofang in the past 5 years and the interaction between Tongxie Yaofang and brain-gut interaction, the author explored the effect of Tongxie Yaofang in treating IBS-D by affecting the brain-gut axis and brain-gut peptides.

Effect of Medicated Serum Prepared with Chang'an Ⅰ Prescription on Sensitized Mast Cell Degranulation / 中国实验方剂学杂志

Objective:To observe the influence of Chang'an Ⅰ prescription drug-containing serum on IgE-mediated RBL-2H3 cell degranulation model， and explore the mechanism of Chang'an Ⅰ prescription in inhibiting RBL-2H3 activation degranulation and releasing inflammatory mediators with v-yes-1 Yanaguchi sarcoma viral related oncogene homolog （Lyn）/spleen tyrosine protein kinase （Syk）/mitogen-activated protein kinase （MAPK） signal pathway. Method:Preparation for Chang'an Ⅰ prescription serum. Animal group， SD male rats were randomly divided into Chang'an Ⅰ prescription serum high， medium， low dose， and blank control groups with 10 rats in each group. Dosage： 10 mL·kg-1 distilled water was given to blank control group， while Chang'an Ⅰ prescription serum high， medium and low dose groups were respectively given to the Chang'an Ⅰ prescription concentrated crude drug with concentration of 1.15，2.30，4.60 g·kg-1， respectively once a day for 7 days continuously and then blood was taken from aorta ventralis and centrifuged. Ketotifen as the positive control drug. Mast cells are counted with toluidine blue staining. Cellular release of β-aminohexose was detected by colorimetric method. Contents of MCT， TNF-α， MCP-1 and histamine were measured by enzyme-linked immunosorbent assay （ELISA） kits， Lyn/Syk/MAPK protein levels were detected by immunoblotting. Result:For cell activation and degranulation， compared with the blank control group， the model group had more cell degranulation （P<0.05）， compared with model group， the cell degranulation rate of each dose group of Chang'an Ⅰ prescription decreased （P<0.05）. The release rate of β-hexosamine in each dose group of Chang'an Ⅰ prescription decreased significantly （P<0.01）. For the release of active mediators， compared with the blank control group， the contents of histamine， MCT， TNF-α and MCP-1 all increased in the model group （P<0.01）， compared with the model group， the contents in each dose group of Chang'an Ⅰ prescription all decreased significantly （P<0.01）. Compared with the normal group， the phosphorylation levels of Lyn and Syk， extracellular regulatory protein kinase 1/2（ERK1/2）， c-Jun N-terminal kinase （JNK）， and mitogen-activated protein kinase p38 increased in the model group （P<0.05）. Compared with the model group， the Lyn， Syk and ERK1/2， JNK and p38 protein phosphorylation levels reduced in Chang'an Ⅰ prescription group （P<0.05）. Conclusion:Chang'an Ⅰ prescription drug-containing serum down-regulates the phosphorylation levels of proteins Lyn， Syk， and ERK1/2， JNK， and p38， inhibits RBL-2H3 cell activation and degranulation， reduces the release of cytokines and chemokines， such as histamine， MCT， TNF-α and MCP-1， it may be one of its mechanisms for treating IBS-D visceral hypersensitivity.

Analysis and prevention of perioperative complications of Da Vince robotic radical resection for lung cancer / 中华胸心血管外科杂志

Objective:To investigate the characteristics, causes and preventive strategies of intraoperative and postoperative complications of Da Vince robotic radical resection for lung cancer.Methods:From January 2018 to June 2020, 306 patients with lung cancer who underwent robotic radical resection of lung cancer in our department were reviewed, the perioperative data were statistically analyzed. There were 154 males and 152 females, aged(58.5±10.3) years old, 238 lobectomy cases and 68 segmental lobectomy cases.Results:There were no perioperative death, no conversion to thoracotomy, and no intraoperative vascular injury. Intraoperative blood loss was(41.5±37.4)ml, 302 cases(98.7%) underwent R0 resection, 54 cases(17.6%) of intraoperative bleeding from troca mouth of robot operating arm. 32 cases(10.5%) of postoperative complications, including 3 cases(1.0%) of chylothorax, 1 case(0.3%) of pleural effusion, 28 cases( 9.2%) of alveolar fistula over 7 days with 5 cases of large area subcutaneous emphysema.Conclusion:The most common intraoperative complication in robotic lung cancer radical operation is troca bleeding, and the most common postoperative complication is alveolar fistula. Robot surgery is safe, and targeted preventive measures can reduce the incidence of complications.

Prediction of signalling pathway of synaptic cell adhesion molecules mediating early synapse formation based on bioinformatics / 上海交通大学学报（医学版）

Objective • To investigate the signalling pathways mediated by synaptic cell adhesion molecules (sCAMs) in the process of human prenatal synapse formation. Methods • The single-cell RNA-sequencing dataset of prenatal human prefrontal cortex was downloaded from GEO (Gene Expression Omnibus) database. The gene expression dynamics was modelled with pseudotime ordering approach and the protein-protein interaction (PPI) network was constructed by utilizing gene co-expression analysis and PPI database. The interacting molecules and associated pathways of sCAMs were explored. Results • The gene expression dynamics of early synapse formation in excitatory neurons can be modelled with linear trajectory. PPI network analysis identified the interacting molecules of neurexins, neuroligins, and LAR-type receptor-type protein tyrosine phosphatases (LAR-type RPTPs). Guanine nucleotide exchange factor 9 (ARHGEF9) interacted with neurexins and neuroligins, while cell division cycle 42 (CDC42) was the hub of the network. Amyloid precursor protein (APP) interacted with neuroligins and leucine-rich repeat transmembrane neuronal protein 3 (LRRTM3), which is a ligand of neurexins. Finally, mitogen-activated protein kinase 8 (MAPK8), dual specificity phosphatase 4 (DUSP4), and CDC42, which participate MAPK signalling pathways, were involved in the PPI network of protein tyrosine phosphatase receptor type D (PTPRD, a member of LAR-type RPTPs) and its ligands leucine rich repeat and fibronectin type III domain containing 1 (LRFN1), LRFN2, and LRFN5. Conclusion • Interacting proteins and associated pathways of neurexins, neuroligins, and LAR-type RPTPs can be predicted with bioinformatics methods, which may provide insights in experimental studies.

A Paired Case Controlled Study Comparing the Short-term Outcomes of Da Vinci RATS and VATS Approach for Non-small Cell Lung Cancer / 中国肺癌杂志

BACKGROUND@#Da Vinci Surgical System is one of the greatest inventions of the 20th century, which represents the development direction of the precise minimally invasive surgical techniques, the aim of this study was to comparing the short-term outcomes between da Vinci robot-assisted lobectomy and video-assisted thoracic surgery (VATS) lobectomy for non-small cell lung cancer.@*METHODS@#45 pairs of non-small cell lung cancer patients underwent pulmonary lobectomy with da Vinci Robotic assisted thoracoscopic (RATS) and VATS approach during the same period from January 2014 to January 2017. The operative time, estimated blood loss (EBL), total number and total groups of dissected lymph nodes, postoperative duration of drainage, the first day volume of drainage, total volume of drainage were compared.@*RESULTS@#No perioperative death and convertion to thoracotomy occured in both groups. There were significant difference between RATS group and VATS group in EBL [(50.30±32.33) mL vs (208.60±132.63) mL], the first day volume of drainage [(275.00±145.42) mL vs (347.60±125.80) mL], the dissected total number [(22.67±9.67) vs (15.51±5.41)] and total team [(6.31±1.43) vs (4.91±1.04)] of lymph node. There were no significant difference in other outcomes.@*CONCLUSIONS@#RATS is safe and effective and took better short-outcomes than VATS in non-small cell lung cancer.

Effect of acupuncture combined with hyperbaric oxygen therapy on neurological function of patients with hypertensive cerebral hemorrhage / 中国综合临床

Objective To investigate the effect of acupuncture combined with hyperbaric oxygen therapy on neurological function and daily living ability of patients with cerebral hemorrhage. Methods From January 2014 to June 2017,one hundred and twenty-three patients with cerebral hemorrhage which hospitalized in the Department of Neurosurgery of Hebei Provincial Corps Hospital were selected and randomly divided into three groups: acupuncture group, acupuncture + hyperbaric oxygen group ( combined group ) and control group. The acupuncture group was given acupuncture on the basis of routine medical treatment after minimally invasive surgery treatment; the combined group was treated with acupuncture treatment as well as hyperbaric oxygen therapy after minimally invasive surgery; the control group was only treated with conventional medical therapy without any special treatment. The scores of nerve function defect,Fusl-Meyer motor function assessment scale,daily living ability score,cognitive function score,Glasgow coma scale at the 40th day of admission were evaluated and compared respectively,and the clinical effect were evaluated as well. Results After treatment, the NHISS score of the control group,the acupuncture group and the combined group decreased in turn. The score of Fusl-Meyer exercise function rating scale, the daily living ability score, the cognitive function score and the Glasgow coma scale were increased in turn, and the differences were statistically significant ( F=276. 620, 76. 050,31. 770,116. 598,33. 745,P<0. 01) . The total effective rate of the control group,acupuncture group and combined group increased sequentially (61％,76％,90％),and the difference was statistically significant (χ2=18. 547,P<0. 01) . Conclusion Acupuncture therapy for patients with cerebral hemorrhage can effectively promote the improvement of nerve function, daily living ability and prognosis. Acupuncture combined with hyperbaric oxygen can get more obvious therapeutic effect.

Correlation between the Expression of High Temperature Requirement Serine Protease A1 in Nucleus Pulposus Tissue and the Degree of Intervertebral Disc Degeneration / 中国医学科学院学报

Objective To investigate the correlation between the expression level of high temperature requirement serine protease A1 (HtrA1) in nucleus pulposus and the degree of intervertebral disc degeneration (Pfirrmann grade).Methods Thirty-six patients who underwent excision of nucleus pulposus were examined by magnetic resonance imaging (MRI) before operation,and the Pfirrmann grading of all patients was performed according to the sagittal T2 weighted MRI.The expression of HtrA1 in nucleus pulposus tissue was detected by reverse transcription polymerase chain reaction and Western blot.The correlation between the expression level of HtrA1 in nucleus pulposus tissue and Pfirrmann grade was analyzed.Results MRI in all 36 patients showed that there were 3 cases of Pfirrmann grade Ⅰ,10 cases of grade Ⅱ,11 cases of grade Ⅲ,7 cases of grade Ⅲ,and 5 cases of grade Ⅴ.The mRNA and protein expressions of HtrA1 in nucleus pulposus tissue increased with the increase of Pfirrmann grade.There were significant differences in the expression level of HtrA1 among different Pfirrmann grade groups (P<0.05) except for the difference between grade Ⅲ and Ⅴ (P>0.05).Spearman rank correlation analysis revealed that there was a rank correlation between expression level of HtrA1 and Pfirrmann grade (P<0.000 1).Conclusion The mRNA and protein expressions of HtrA1 in nucleus pulposus tissue increase with the increase of Pfirrmann grade,indicating HtrA1 is correlated with the degree of intervertebral disc degeneration.

Advances in Tissue-engineered Oral Mucosa / 中国医学科学院学报

The large defect of oral and maxillofacial region doesn't only affect the function and aesthetics but also has an adverse impact on patients' psychology. The traditional way to restore the defects are limited by donor site and secondary trauma. In recent years,the oral mucosal tissue engineering has developed rapidly and provides a new solution for craniofacial reconstruction. Tissue-engineered oral mucosa is an ideal substitute of oral mucosa. It can be used in clinical settings and in vitro experiments. This articles review the recent advances in tissue-engineered oral mucosa and its applications.

Transplantation time and detection method of allo-HSCT and the DNA of the recipients and its significance ;in forensic medicine( / 中国法医学杂志

There were many factors that affect the chimerism of donor DNA, such as the type of disease, the treatment of the disease, the severity of the disease, the source of hematopoietic stem cells, HLA, GVHD, and so on. This paper mainly discussed the two factors that affect forensic science, including the posttransplantation intervals and sensitivity of the detection method. Forensic workers in forensic practice and paternity and individual identification of allo HSCT recipients, should pay attention to the time after transplantation and the detection method of sensitivity of chimerism. When female recipients received HSCT in the case of male donors, Y chromosome DNA of the donor can be detected from the recipient's hair follicles. The case of biological specimens from the crime scene can not only detect Y chromosome speciifc genetic markers, so as to avoid wrong identiifcation.

Risk Factors for Adjacent Segment Disease Development after Lumbar Fusion

STUDY DESIGN: Retrospective cohort study. PURPOSE: To identify factors which may be important in the occurrence of symptomatic adjacent segment disease (ASD) after lumbar fusion. OVERVIEW OF LITERATURE: Many reports have been published about the risk factors for ASD after lumbar fusion. Despite on the great numbers of risk factors identified for ASD development, study results have been inconsistent and there is controversy regarding which are the most important. METHODS: This study evaluated 120 patients who underwent 360degrees fusion lumbar surgery from 2007 to 2012. We separated the population into two groups: the first group included 60 patients with long lumbar fusion (three or more levels) and the second group included 60 patients with short lumbar fusion (less than three levels). RESULTS: In the first group, symptomatic ASD was found in 19 cases during the one year follow-up. There were 14 cases with sagittal imbalance and 5 cases at the incipient stage of disc degeneration according to the preoperative magnetic resonance imaging. At the three year follow-up, symptomatic ASD was diagnosed in 31 cases, of which 17 patients had postoperative sagittal balance disturbance. In the second group, 10 patients had ASD at the one year follow-up. Among these cases, preoperative disc degenerative changes were identified in 8 patients. Sagittal imbalance was found only in 2 cases with symptomatic ASD at the one year follow-up. At the three year follow-up, the number of patients with symptomatic ASD increased to 14. Among them, 13 patients had initial preoperative adjacent disc degenerative changes. CONCLUSIONS: Patients with postoperative sagittal imbalance have a statistically significant increased risk of developing symptomatic ASD due to an overloading the adjacent segments and limited compensatory capacities due to the large number of fixed mobile segments. In the case of a short fixation, preoperative degenerative changes are more important factors in the development of ASD.

Differentiation Study of Chinese Medical Syndrome Typing for Diarrhea-predominant Irritable Bowel Syndrome Based on Information of Four Chinese Medical Diagnostic Methods and Brain-gut Peptides / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To establish discriminant functions of diarrhea-predominant irritable bowel syndrome (IBS-D) by studying it from quantitative diagnosis angle, hoping to reduce interference of subjective factors in diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.</p><p><b>METHODS</b>A Chinese medical clinical epidemiological survey was carried out in 439 IBS-D patients using Clinical Information Collection Table of IBS. Initial syndromes were obtained by cluster analysis. They were analyzed using step-by-step discrimination by taking information of four Chinese medical diagnostic methods and serum brain-gut peptides (BGP) as variables.</p><p><b>RESULTS</b>Clustering results were Gan stagnation Pi deficiency syndrome (GSPDS), Pi-Wei weakness syndrome (PWWS), Gan stagnation qi stasis syndrome (GSQSS), Pi-Shen yang deficiency syndrome (PSYDS), Pi-Wei damp-heat syndrome (PWDHS), cold-damp disturbing Pi syndrome (CDDPS). Of them, GSPDS was mostly often seen with effective percentage of 34. 2%, while CDDPS was the least often seen with effective percentage of 5.5%. A total of 5 discriminant functions for GSPDS, PWWS, GSQSS, PSYDS, and PWDHS were obtained by step-by-step dis- crimination method. The retrospective misjudgment rate was 4.1% (16/390), while the cross-validation misjudgment rate was 15.4% (60/390).</p><p><b>CONCLUSION</b>The establishment of discriminant functions is of value in objectively diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.</p>

Randomized controlled study of integrated treatment of traditional Chinese medicine and western medicine on AIDS with pulmonary inflammation patients / 中国中药杂志

<p><b>OBJECTIVE</b>To compare effects of integrated treatment traditional Chinese medicine and Western medicine (TCM-WM) and simple western medicine on TCM clincal symptoms in the patient of AIDS with pulmonary inflammation.</p><p><b>METHOD</b>A multicenter randomized controlled trials of 164 subjects evaluated the effects of clinical symptoms of AIDS with pulmonary inflammation of TWO regimens: the TCM-WM group (n = 111) and western medicine treatment group (n = 53), while incidence of TCM symptoms in different time points in two groups were analyzed.</p><p><b>RESULT</b>Twenty eight days after treatment, the cured and markedly effective rate of TCM symptoms in the TCM-WM group significantly exceeding that in the western medicine treatment group (cured and markedly effective rate significant efficiency 44.55% vs 20.00%), while the incidence rate for the TCM symptoms of fever and headache in the TCM-WM group was significantly lower than that in western medicine group.</p><p><b>CONCLUSION</b>The integrated treatment of traditional Chinese medicine and Western medicine helps to alleviate the TCM clinical symptoms of AIDS with pulmonary inflammation.</p>

Preliminary study on features of syndrome distribution and cluster analysis for AIDS patients with pulmonary infection / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate Chinese medical features of acquired immunodeficiency syndrome (AIDS) patients with pulmonary infection.</p><p><b>METHODS</b>Using cluster analysis method, Chinese medical syndromes of 196 AIDS patients with pulmonary infection were analyzed. The distribution features of each syndrome type were analyzed according to the severity and CD4+ numerical analysis.</p><p><b>RESULTS</b>Basic Chinese medical syndrome types could be summed up as three kinds: exterior invasion of wind heat and phlegm heat obstructing Fei syndrome (61 cases, 31.1%), Fei-Pi deficiency and Fei stagnation of phlegm syndrome (64 cases, 32.7%), Fei-Shen deficiency and yin deficiency induced inner heat syndrome (71 cases, 36.2%). There was statistical difference in the severity degree and the distribution of CD4 among the three syndrome types (P < 0.05).</p><p><b>CONCLUSIONS</b>AIDS patients with pulmonary infection involve Fei, Shen, and Pi. The pathogenic factors were related to "wind", "heat", "phlegm", and "xu". The Chinese medical syndrome distribution was closely correlated with patients' immunity.</p>

Clinical effect study of low molecular weight heparin calcium in the treatment of chronic obstructive pulmonary disease combined with pulmonarv heart disease / 中国医师进修杂志

ObjectiveTo observe the clinical effect of low molecular weight heparin calcium in the treatment of chronic obstructive pulmonary disease combined with pulmonary heart disease.MethodsA total of 64 patients with chronic obstructive pulmonary disease combined with pulmonary heart disease from December 2008 to December 2010 were enrolled in this study and divided into treatment group and control group by random digits table with 32 cases each.The control group was given routine treatment and the treatment group was given low molecular weight heparin calcium for 7 days at the basis of routine treatment.ResultsThe total effective rate in treatment group[ 90.6％ (29/32) ] was significantly higher than that in control group [ 68.8％ (22/32) ] (P ＜ 0.05 ).In treatment group,the levels of arterial carbon dioxide tension (PaCO2) and arterial oxygen tension (PaO2) after treatment [(54.64±9.63),(74.21 ± 11.76) mm Hg (1 mm Hg =0.133 kPa)] were significantly decreased compared with before treatment [(78.66 ± 11.22),(53.42 ± 8.84 ) mm Hg ] (P ＜ 0.01 ).In control group,the levels of PaCO2 and PaO2 after treatment [ (61.10 ±7.24),(65.07 ± 8.21 ) mm Hg] were significantly decreased compared with before treatment[ (79.52 ± 12.54),(51.35 ± 7.31 ) mm Hg ] (P ＜ 0.05 ).After treatment the levels of PaCO2 and PaO2 in treatment group were better than those in control group (P ＜ 0.05).ConclusionsThe low molecular weight heparin calcium in treatment of chronic obstructive pulmonary disease combined with pulmonary heart disease can effectively improve the clinical manifestation.It is worth the clinical promoted application.