A multicenter clinical study of robot-assisted total knee arthroplasty / 中华骨科杂志

Objective:To evaluate the accuracy of the domestic "Skywalker" surgical robot in implementing personalized lower limb alignment reconstruction scheme in total knee arthroplasty (TKA) and the short-term clinical outcome of robotic assisted TKA.Methods:From September 2020 to January 2021, the data of patients who received surgical robot assisted TKA in 5 clinical centers in China (Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Southwest Hospital affiliated to Third Military Medical University, The Affiliated Hospital of Qingdao University, The First Affiliated Hospital of Chongqing Medical University and Yantai Yuhuangding Hospital, and Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine was the group leader) were prospectively collected and retrospectively analyzed. There were 24 males and 82 females with an average age of 67.6±7.3 years, (range 45-80 years); Average body mass index 26.42±4.31 kg/m 2, all the operation were performed by "Skywalker" surgical robot system according to preoperative design based on CT. The operation time, intraoperative blood loss, hospitalization days and postoperative complications were recorded, and the imaging indexes including hip-knee-ankle (HKA), lateral distal angle of femur (LDFA) and medial proximal angle of tibia (MPTA) measured before and after the operation, implant model indexes (preoperative planning implant model and postoperative implant model) and short-term clinical efficacy indexes [Western Ontario and McMaster Universities (WOMAC) osteoarthritis index] pain score, stiffness score, joint function score, total score and SF-12 score before and 3 months after the operation) were compared. Results:The average follow-up period was 109.60±9.80 d, (range 95-143 d). The average operation time of 106 patients was 105.30±23.22 min; The average intraoperative blood loss was 141.70±58.33 ml; The average length of hospitalization was 5.82±2.80 d. One patient had ischemic stroke after operation, and one patient had abnormal liver function after operation. According to the judgment of the investigator, all of them were not related to the operation. The actual angle error is the difference between the preoperative planning angle and the postoperative measurement angle. The absolute error of 99.1% (105/106) of the HKA angle was within 3°, 90.8% (69/76) of LDFA, 98.7% (75/76) of the MPTA. In 45 patients in one center where data were available, the actual implant models used in all patients were consistent with the preoperative planning size, and there were only differences in version selection such as Asian condyle. WOMAC pain score, joint function score, total score was improved from 7.34±2.85, 25.10±9.85, 34.75±13.02 to 3.34±2.66, 14.68±9.64, 18.66±13.49 before and after operation, respectively, which were statistically significant ( P<0.001) and SF-12 physiological score and psychological score were improved form 27.24±6.42, 30.68±8.26 to 38.83±5.74, 39.36±7.85 before and after operation, respectively, which were statistically significant ( t=7.33, P<0.001; t=4.53, P=0.043). Conclusion:Domestic surgical robot system "Skywalker" can assist the surgeon to achieve accurate and personalized reconstruction of lower limb alignment and achieve satisfactory short-term clinical outcomes. The long-term clinical outcomes of personalized reconstruction and survival rate of implant still need to be further studied.

Progress in the Role of Mechanical Stimulus in Cardiac Development / 中国医学科学院学报

Mechanical stimulus is critical to cardiovascular development during embryogenesis period.The mechanoreceptors of endocardial cells and cardiac myocytes may sense mechanical signals and initiate signal transduction that induce gene expression at a cellular level,and then translate molecular-level events into tissue-level deformations,thus guiding embryo development.This review summarizes the regulatory roles of mechanical signals in the early cardiac development including the formation of heart tube,looping,valve and septal morphogenesis,ventricular development and maturation.Further,we discuss the potential mechanical transduction mechanisms of platelet endothelial cell adhesion molecule 1-vascular endothelial-cadherin-vascular endothelial growth factor receptor 2 complex,primary cilia,ion channels,and other mechanical sensors that affect some cardiac malformations.

Chemical constituents from Morinda citrifolia and their inhibitory activities on proliferation of synoviocytes in vitro / 中国中药杂志

The chemical constituents from the stems and leaves of Morinda citrifolia were isolated and purified by column chromatography methods with silica gel, ODS, Sephadex LH-20 and preparative high performance liquid chromatography(HPLC). The structures of the isolated compounds were identified by physicochemical properties and spectroscopic analysis, as well as comparisons with the data reported in literature. 17 compounds were isolated from the 90% ethanol extract of the stems and leaves of M. citrifolia, and were identified as 9,10-dihydroxy-4, 7-megastigmadien-3-one(1), 5,12-epoxy-6,9-hydroxy-7-megastigmen-3-one(2), fukinone(3), β-eudesmol(4), sarmentol F(5), 4, 5-dihydroblumenol A(6), 3-hydroxy-β-ionone(7), aristol-8-en-1-one(8), ergosta-7-en-3β-ol(9), ergosta-7-ene-3β,5α,6β-triol(10),(22E)-5α,8α-epidioxyergosta-6,22-dien-3β-ol(11), olivil(12), 4-epi-larreatricin(13), chushizisin Ⅰ(14), rabdosia acid A(15), glycerol monolinoleate(16) and(9Z,12Z,15Z)-2,3-dihydroxypropyl octadeca-trienoate(17). All compounds were isolated from M. citrifolia for the first time. All isolated compounds were evaluated for their anti-rheumatoid arthritis activities via examining their inhibitory activities on the proliferation of synoviocytes in vitro using MTS met-hod. Compounds 1-11 showed significant anti-rheumatoid arthritis activities, displaying the inhibitory effects on the proliferation of MH7 A synovial fibroblast cell with the IC_(50) values ranging from(38.69±0.86) to(203.45±1.03) μmol·L~(-1).

Effectiveness of Glaucoma Diagnostic Parameters from Spectral Domain-Optical Coherence Tomography of Myopic Patients / 中华医学杂志(英文版)

Background@#Currently, spectral-domain optical coherence tomography (SD-OCT) appears to be a new type of glaucoma diagnostic tool. Thus, this study aimed to evaluate the effectiveness of glaucoma diagnostic parameters from SD-OCT of patients with different severities of myopia.@*Methods@#This was a cross-sectional study. A total of 248 participants (248 eyes) were enrolled, including 51 cases in the early primary open-angle glaucoma group, 79 cases in the control group (0.50 D to -0.50 D, excluding -0.50 D), 47 cases in the low-myopic group (-0.50 to -3.00 D, excluding -3.00 D), 43 cases in the moderate-myopic group (-3.00 to -6.00 D, excluding -6.00 D), and 28 cases in the high-myopic group (≤-6.00 D). All participants were examined using the Humphrey visual field test and SD-OCT. The SD-OCT parameters of the retinal nerve fiber layer (RNFL) and ganglion cell complex were analyzed statistically using the receiver operating characteristic curve and area under the curve (AUC).@*Results@#The AUC showed that the best parameters for the control and low-myopic groups were the inferior and inferior temporal RNFL thicknesses (AUC >0.94), respectively; for the moderate- and high-myopic groups, the best parameter was the temporal low RNFL thickness (AUC, 0.926 and 0.896, respectively). The AUC of the inferior parameters of the moderate-myopic group (0.864) was lower, ranked 15 among all RNFL parameters. When the sensitivity was fixed at 85%, the specificity of the inferior, superior, inferior temporal, and superior temporal quadrants was higher (>80%) in the control and low-myopic groups, while they were lower (20-60%) for the moderate- and high-myopia groups. The green color based on the OCT database was also less for the high-myopic group compared with that of other groups (P < 0.05).@*Conclusions@#Glaucoma diagnostic parameters from SD-OCT were not clinically effective for the moderate- and high-myopic groups. The specificities were low. The moderate- and high-myopic groups require comprehensive analyses for the diagnoses of glaucoma. The SD-OCT database should be improved to better indicate the level of myopia based on the corresponding diopter readings.

Treatment of Pilon fractures complicated with soft tissue injury by plate and lag screw fixation via posterolateral approach / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of plate and lag screw fixation for treatment of Pilon fractures complicated with soft tissue injury via posterolateral approach.</p><p><b>METHODS</b>From May 2013 to June 2016, 25 patients with Pilon fractures complicated with soft tissue injury underwent open reduction and internal fixation via posterolateral approach. There were 15 males and 10 females, aged from 25 to 61 years old with an average of(39.6±0.2) years. Plate and lag screw fixation were used in operation. Healing of soft tissue contusion and abrasions in the ankle wounds and injuries were observed after operation. The Burwell-Charnley standard was applied to assess the quality of fracture reduction and the AOFAS Ankle foot scoring system(total score 100 points) was used to evaluate the clinical effects.</p><p><b>RESULTS</b>All the patients were followed up from 6 to 24 months with an average of 12 months. All operative wounds and soft tissue injuries were healed. According to the Burwell-Charnley standard, 22 cases obtained excellent results with anatomic reduction, while 2 cases were dissatisfied, and 1 case poor. The AOFAS ankle foot scores were 90.2±7.5 on average, with 20 cases of excellent results, 3 good, 2 fair.</p><p><b>CONCLUSIONS</b>Plate and lag screw fixation by posterolateral approach in treating Pilon fracture complicated with soft tissue injury shows advantage of avoiding injury to the anteromedial skin and soft tissue, provides forceful fixation without further injury.</p>

Clinical Study of Patients with Myelodysplastic Syndrome Transformed into Acute Myeloid Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the biological characteristics and treatment response of patients with myelodysplastic syndrome (MDS) transformed into acute leukemia(AL).</p><p><b>METHODS</b>Using WHO standard method, the clinical characteristics of patients with MDS into AML were retrospectively analyzed, the related factors influencing the MDS into AML and the treatment response of patients were analyzed.</p><p><b>RESULTS</b>Twenty-six cases (17%) of MDS were transformed into AL among 153 cases of middle and high risk MDS, all of which were AML. The median time of transformation from MDS into AML was 4 months (1-29),and these cases transformed into AML-M2, M4, M5 and M6. In these 26 cases of AML patients, the varying degrees of anemia symptom appeared, 2 cases were with marrow infiltration, 18 cases (69.2%) were with abnormal chromosome karyotype. Compared with karyotype before transformation into AML, the abnormal karyotype in 9 cases had been conversed (new karyotype or disappear once of existing karyotype). Total efficiency of individualized treatment for MDS transformed into AML was 80%. This treatment could improve the patients quality of life.</p><p><b>CONCLUSION</b>Middle and high risk MDS patients are prone to be tranformed into AML. Multiple factors are involved in the transformation of MDS into AML. These patients showed the special biological characteristics and poorer prognosis. Demethylation treatment is helpful to achieve a good near-term curative effect.</p>

The secondary metabolites from a mutant 3d10-01 derived from Penicilliumchrysogenum S-3-25 by diethyl sulfate mutagenesis / 国际药学研究杂志

Objective To investigate the secondary metabolites from diethyl sulfate(DES)mutant 3d10-01 derived from Peni-cillium chrysogenum S-3-25. Methods The secondary metabolites were isolated by multiple separation techniques,such as silica gel,Sephadex LH-20 column chromatography and HPLC. The structures of the compounds were determined by ESI-MS and NMR spectroscopic data. The antitumor activity was assayed by the MTT method. HPLC-UV analysis was used to determine if compounds 1-7 were newly produced by the mutant. Results Seven secondary metabolites,including methyl 2,4-dihydroxy-3,5,6-trimethylbenzo-ate(1),6-hydroxymethyl-2,2-dimethylchromanone(2),regiolone(3),(3S,4S)-3,4-dihydro-3,4,8-trihydroxy(2H)naphthalenone (4),cerebroside C(5),cerebroside D(6)and dankasterone A(7),were isolated from the fermentation products of the mutant 3d10-01. Compounds 1,4 and 7 showed strong inhibitory effects on the five tested cell lines,but 2,3 and 6 only exhibited the proliferation of HL-60 cells to some extent. Compounds 1-4 and 7 were newly produced by the mutant 3d10-01. Conclusion Compounds 1-7 are firstly isolated from P. chrysogenum. The inhibitory effects on certain tested antitumor cell lines of compounds 1-4,6 and 7 are report-ed for the first time.

The relationship between status of fatigue and compliance,quality of life in patients after liver transplantation / 中国实用护理杂志

Objective To investigate the relationship between status of fatigue and compliance, quality of life in patients after liver transplantation, which in order to provide a scientific basis for improving compliance and quality of life of them. Methods One hundred and four liver transplant recipients who received liver transplantation from Jun 2012 to Jun 2015 were recruited in this study.The status of fatigue, compliance and quality of life of these patients were assessed by Fatigue Assessment Instrument(FAI),compliance scale and the MOS 36-item short-form health survey(SF-36)respectively. Spearman correlation coefficients were used to analyze the relationship between status of fatigue and compliance, quality of life. Results The degree of fatigue in patients after liver transplantation was significantly higher than that in the general population and patients with coronary heart disease. Except the fatigue factor 4, the fatigue factor 1, factor 2 and factor 3 scores of the patients at the end of the 12 month after liver transplantation were lower than those at the end of the 1 month and 6 months after liver transplantation(P<0.05).There was no significant difference in the scores of fatigue factors between 1 and 6 months after liver transplantation(P>0.05).The patients were graded according to the FAI fatigue rating scale factor 1 score,of which 63 cases were moderate fatigue,and the other was severe fatigue(n=41).The Results showed that the total score of compliance, the total score of SF-36 physical health and the total score of SF-36 mental health of the moderate fatigue group were higher than that of the severe fatigue group (P<0.05).Spearman correlation coefficients showed that all fatigue factors of patients post-transplantation was negatively correlated with quality of life and compliance(P<0.05). Conclusions There is high level of fatigue in patients after liver transplantation, and which negatively correlated with quality of life and compliance.Nursing staff should comprehend the fatigue status of patients after liver transplantation and relieve timely.Which could improve the quality of life of patients post-transplantation.

Snitrosylating protein disulphide isomerase mediates increased expression of α synuclein caused by methamphetamine in mouse brain / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the role of Snitrosylation of protein disulphide isomerasec in methamphetamine (METH)-induced expression of alpha synuclein (αSN) in mouse hippocampus and striatum neurons.</p><p><b>METHODS</b>Forty C57BL/6 mice were randomized equally into saline control group, METH group, L-NNA (a NOS inhibitor) group and L-NNA plus METH group. All the agents were injected intraperitoneally at an interval of 12 h, and a total of 8 injections were administered; in L-NNA plus METH group, METH was injected 30 min after LNNA in each treatment. Western Blotting was used to detect the expression of nitric oxide synthase (NOS), αSN, PDI and Snitrosylation of protein disulphide isomerase (PDI-SNO) in the hippocampus and striatum of the mice, and nitric oxide (NO) levels were determined using a NO assay kit.</p><p><b>RESULTS</b>In METH group, the levels of NOS, PDISNO, αSN and NO all increased significantly compared with those in the control group (P<0.05). Combined treatment with L-NNA and METH, compared with METH alone, resulted in significantly lowered expression of NOS, NO, PDI-SNO and αSN in the hippocampus and striatum of the mice (all P<0.05). No significant differences were found in NOS, NO, PDI-SNO or αSN expressions among METH+L-NNA, L-NNA and control groups (P>0.05).</p><p><b>CONCLUSION</b>METH induces the activation of NOS and increases NO level to cause the occurrence of PDI-SNO, leading subsequently to increased expression of αSN in mouse striatum and hippocampus. L-NNA, the inhibitor of NOS, can partly relieve nervous system toxicity induced by METH.</p>

Corneal Biomechanical Parameters and Asymmetric Visual Field Damage in Patients with Untreated Normal Tension Glaucoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>High intraocular pressure (IOP) and low central corneal thickness (CCT) are important validated risk factors for glaucoma, and some studies also have suggested that eyes with more deformable corneas may be in higher risk of the development and worsening of glaucoma. In the present study, we aimed to evaluate the association between corneal biomechanical parameters and asymmetric visual field (VF) damage using a Corvis-ST device in patients with untreated normal tension glaucoma (NTG).</p><p><b>METHODS</b>In this observational, cross-sectional study, 44 newly diagnosed NTG patients were enrolled. Of these, 31 had asymmetric VF damage, which was defined as a 5-point difference between the eyes according to the Advanced Glaucoma Intervention Study scoring system. Corneal biomechanical parameters were obtained using a Corvis-ST device, such as time from start until the first and second applanation is reached (time A1 and time A2, respectively), cord length of the first and second applanation (length A1 and length A2, respectively), corneal speed during the first and second applanation (velocity A1 and velocity A2, respectively), time from start until highest concavity is reached (time HC), maximum amplitude at the apex of highest concavity (def ampl HC), distance between the two peaks at highest concavity (peak dist HC), and central concave curvature at its highest concavity (radius HC).</p><p><b>RESULTS</b>Time A1 (7.19 ± 0.28 vs. 7.37 ± 0.41 ms, P = 0.010), length A1 (1.73 [1.70-1.76] vs. 1.78 [1.76-1.79] mm, P = 0.007), length A2 (1.58 [1.46-1.70] vs. 1.84 [1.76-1.92] mm, P< 0.001), peak dist HC (3.53 [3.08-4.00] vs. 4.33 [3.92-4.74] mm, P = 0.010), and radius HC (6.20 ± 0.69 vs. 6.59 ± 1.18 mm, P = 0.032) were significantly lower in the worse eyes than in the better eyes, whereas velocity A1 and def ampl HC were significantly higher (0.156 [0.149-0.163] vs. 0.145 [0.138-0.152] m/s, P = 0.002 and 1.19 ± 0.13 vs. 1.15 ± 0.13 mm, P = 0.005, respectively). There was no significant difference in time A2, velocity A2, and time HC between the two groups. In addition, no difference was observed in IOP, CCT, and axial length. In the univariate and multivariate analyses, some of the Corvis-ST parameters, including time A1 and def ampl HC, were correlated with known risk factors for glaucoma, and there was also a significant positive correlation between def ampl HC and age.</p><p><b>CONCLUSIONS</b>There were differences in dynamic corneal response parameters but not IOP or CCT between the paired eyes of NTG patients with asymmetric VF damage. We suggest that the shape of the cornea is more easily altered in the worse eyes of asymmetric NTG patients.</p>

Drug analysis of Li zhenhua for the treatment of chronic atrophic gastritis based on the data mining / 国际中医中药杂志

Objective The method of data mining and sorting analysis was used to analyze and summarize the drug experience of Professor Li Zhenhua in the treatment of chronic atrophic gastritis (CAG). Methods Professor Li’s medical records of effective diagnosis and treatment of 139 CAG patients were collected. Find-Replace method of Microsoft office word 2007 was used to count the major syndromes and main prescription of CAG. SPSS statistical software was adopted to perform entry-analysis-descriptive statistics and data analysis of and main syndrome, main formula and frequency of administration so as to obtain the commonly used drugs, commonly used prescription and drug laws of CAG. Results Professor Li Zhenhua believed that the clinical syndromes of CAG included the disharmony of liver-stomach-spleen syndrome, the damp heat of spleen-stomach syndrome, the deficiency and damp heat of spleen syndrome, the liver depression and spleen deficiency syndrome, the deficiency of spleen-stomach syndrome, the liver and stomach yin deficiency and qi stagnation syndrome, the stagnant heat of liver-stomach syndrome and the blood stasis of stomach meridian syndrome;the commonly used drugs were:bupleurum, white peony root, orange peel, licorice, poria, skullcap, ginger, fried atractylodes, golden thread, prepared pinellia, licorice, lily, stir-baking Sanxian, nutgrass galingale rhizome, heterophylly falsesatarwort root, combined spicebush root, Chinese date, tangshen, immature orange fruit, prepared rhizome pinellize without adjuvant, and oyster shell..The commonly used prescriptions were: Xiaochaihu decoction, Sini powder, Chaihu-Guizhi-Longgu-Muli decoction, Chaihu-Shugan powder, Huanglian-Wendan decoction, Banxia-Xiexin decoction, Xiaoyao powder, Xiangsha-Liujunzi decoction. Conclusion Professor Li pay attention to treat spleen and stomach disease from liver by clearing heat and removing dampness from spleen and stomach. He used the dialectical methods like invigorating qi and strengthening the spleen, regulating qi digestion, activating blood flow to eliminating blood stasis.

Effect of Low Molecular Weight Heparin Calcium Combined Compound Danshen Injection on Perinatal Outcomes of Nephrotic Syndrome Patients with Early Onset Severe Pre-eclampsia / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of low molecular weight heparin calcium (LMWHC) combined Compound Danshen Injection (DI) on nephrotic syndrome patients with early onset severe preeclampsia.</p><p><b>METHODS</b>Totally 80 nephrotic syndrome patients with early onset severe pre-eclampsia were randomly assigned to four groups voluntarily, i.e., Group A (22 cases, treated by magnesium sulfate), B (19 cases, treated by magnesium sulfate plus LMWHC), C (21 cases, magnesium sulfate plus DI), D (18 cases, magnesium sulfate plus LMWHC and DI). Umbilical arterial S/D ratios, amniotic fluid index (AFI), prolonged gestational age, placenta weight, neonatal weight, and Apgar score were compared among the four groups.</p><p><b>RESULTS</b>Compared with before treatment in the same group, umbilical arterial S/D ratios decreased in the four groups (P <0. 05). AFI decreased in Group A, while it increased in Group B, C, and D (P<0. 05). Compared with Group A at the same time point, umbilical arterial S/D ratios decreased, and AFI increased in Group B, C, and D (P <0. 01 , P <0. 05). Prolonged gestational age and neonatal weight were increased in Group B, C, and D (P <0. 01, P <0. 05). Placenta weight were increased in Group B and D (P <0. 05). Apgar scores at 1 and 5 min were improved in Group D (P <0. 05). Compared with Group B and C at the same time point, umbilical arterial S/D ratios decreased, and AFI increased in Group D (P<0. 05). Compared with Group B, prolonged gestational age and placenta weight were decreased in Group C, but prolonged gestational age and placenta weight were increased in Group D (P <0.05). Compared with Group C, prolonged gestational age, placenta weight, and neonatal weight were increased in Group D (P <0. 05).</p><p><b>CONCLUSION</b>Treatment of nephrotic syndrome patients with early onset severe pre-eclampsia by LMWHC combined DI could prolong gestational ages, obviously improve prenatal outcomes, with better effect obtained than using any of them alone.</p>

Measurement of anterior scleral thickness and its correlation with central corneal thickness and axial length in different types of glaucoma patients / 中华实验眼科杂志

Background A close relation between sclera thickness and glaucoma has been determined.Clinical features vary in different types of glaucoma patients,which hints that the scleral thickness might be distinct among these patients.Objective The aim of this study was to investigate the differences of central corneal thickness(CCT),anterior scleral thickness(AST) and axial length in glaucomatous patients.Methods This study was approved by the Ethic Commission of First Hospital of Peking University.Written informed consent was obtained from each individual prior to the examination.A retrospective descriptive study was designed.One hundred and sixty consecutive patients were recruited from March,2009 to November,2010 in First Hospital of Peking University,including 35 eyes with primary angle closure glaucoma(PACG) (35 cases),34 eyes with primary open-angle glaucoma POAG) (34 cases),37 eyes with normal tension glaucoma(NTG) (37 cases)and 17 eyes of ocular hypertension OHT) (17 cases).Thirty-seven eyes of 37 subjects with incipient cataract served as the control group.CCT and ocular axial length were measured with ultrasonic pachymeter and A-scan unit,respectively,and AST at the temporal quadrant 2 mm posterior to the scleral spur was measured by ultrasonic biomicroscopy (UBM).The measuring parameters among different groups were compared by analysis of covariance,and the correlations of AST,CCT with ocular axial length were analyzed using Pearson linear correlation and linear regression.The differences and correlation of CCT,AST and AL among five groups were analyzed.Results The CCT values in PACG group,POAG group,NTG group,OHT group and control group were (535.54 ± 5.20),(550.47 ± 5.28),(521.61 ± 5.07),(575.75 ± 7.76) and (535.06± 5.06) μm,respectively,showing a significant difference among them (F =9.560,P =0.000),and the CCT value of OHT group was increased in comparison with POAG group,PACG group,NTG group and control group(all P =0.000).The CCT of the POAG group was thicker than that in the PACG group,NTG group and control group(P=0.046,0.000,0.040).No significant difference was found in CCT among NTG group,PACG group and control group(P=0.950,0.060).The AST values of PACG group,POAG group,NTG group,OHT group and control group were(0.593±0.050),(0.600±0.050),(0.592-±0.060),(0.610-±0.060) and(0.604±0.060) mm,respectively,showing a insignificant difference among them (F =0.700,P =0.590).The axial length in the patients with PACG was shorter than that of the POAG group,NTG group,OHT group and control group (all P =0.000).The Pearson correlation analysis showed significantly positive correlation between CCT and AST in POAG group and NTG group(r=0.445,P=0.008;r=0.400,P=0.014).Conclusions This study confirms that there is dissimilarity in CCT but not in AST among different types of glaucomatous patients.The changes of CCT and AST are consistent in POAG and NTG patients.

The study of anterior sclera thickness and associated ocular parameters / 中华实验眼科杂志

Background The condition of the sclera is associated with many ocular diseases.The measurement of human scleral thickness in vivo is helpful for us to understand the features of the sclera and related diseases.Objective The present study was to measure the anterior sclera thickness(AST) in patients with senile cataract and to analyze the relationship among AST and other associated ocular parameters.Methods This study was approved by the Ethic Commission of First Hospital of Peking University.Written informed consent was obtained from each individual prior to examination.One hundred and five senile cataract patients were recruited in this study.Central corneal thickness (CCT),corneal curvature (CCV) and axial length were measured using ultrasonic pachymeter,keratometer,and A-scan unit,respectively.The AST was measured at 2 mm posterior to the scleral spur in the temporal meridian using ultrasound biomicroscope (UBM).The differences of CCT,CCV,ocular axial length and AST between bilateral eyes and the different sexes were compared by the Paired test and independent sample t test.The correlations among various parameters were assessed by the Pearson linear correlation analysis.The differences of CCT and AST among different axial length groups were evaluated by one-way ANOVA.Results No significant differences were found in the CCT,CCV,axial length and AST between bilateral eyes (t =0.584,P =0.561 ; t =1.161,P =0.248 ; t =0.140,P =0.889 ; t =0.342,P =0.773).Temporal AST at 2 mm posterior to the sclera spur was (0.589 ±0.051)mm in the right eyes.An insignificant decline in CCT was found in the male group compared with the female group (right eyes:t =0.469,P =0.641 ; left eyes:t =0.465,P =0.643).However,compared with the female group,the increase of axial length,reduction of the mean CCV value and enhancement of the mean AST were observed(right eyes:all P＜0.01 ;left eyes:all P＜0.01).CCV showed a negative correlation with ocular axial length (r =-0.50,P＜0.01),but no significant correlation was found among age,CCT,ocular axial length and AST(P＞0.05).No remarkable differences were found in CCT and AST among the various axial length groups (CCT:F =0.998,P=0.372;AST:F=1.919,P=0.383).Conclusions In senile cataract patients,correlation is not found between AST and CCT;the increase of axial length is not associated with the thinning of the eyeball wall to a certain extent.Differences exist in some ocular parameters between different sexes.

Total trans-oral endoscopic thyroidectomy and cervical lymphadenectomy: a human cadavers surgery study / 中华外科杂志

<p><b>OBJECTIVE</b>To find an approach for trans-oral endoscopic thyroidectomy (TOET) and cervical lymphadenectomy using conventional endoscopic surgical instruments on frozen fresh cadavers.</p><p><b>METHODS</b>Six frozen fresh cadavers were used in three groups of trans-oral trocar installation experiments: oral vestibule installation, sublingual region installation, and combined bi-vestibular and sublingual installation. TOET (with pretrachealis method to thyroid fixation removal) and cervical lymphadenectomy were performed experiments on another 6 frozen fresh cadavers using the best access approach found in the aforementioned experiments.</p><p><b>RESULTS</b>In oral vestibule trocar installations, the trocars caused large lacerated wound and damaged air tightness. In sublingual installations, only one trocar could be installed in the sublingual area because the space in sublingual area was limited. In combined bi-vestibular and sublingual installations, no gland, vessel or nerve was damaged. Combined bi-vestibular and sublingual access were selected as the surgical approach on the basic of analysis the merits of each approach. TOET and cervical lymphadenectomy in area III, IV, VI, VII were performed without making any accessory damage through combined bi-vestibular and sublingual access approach.</p><p><b>CONCLUSIONS</b>TOET is feasible. Combined bi-vestibular and sublingual approach is available for TOET. Part of the cervical lymph nodes could be resected. Pretrachealis approach to thyroid fixation removal can still be used.</p>

Changes of hearing threshold and calcium/calmodulin in the cochlear nucleus cells of mice with cytomegalovirus intracranial infection / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the changes in the threshold of auditory brainstem response (ABR) and [Ca(2+)]I and calmodulin (CaM) in cochlear nucleus of newborn mice infected by murine cytomegalovirus (MCMV) in the brain.</p><p><b>METHODS</b>Sixty-nine newborn mice were randomized into model group and control group. The model group (54 mice) was established by intracranial injection with MCMV viral suspension 20 l and the same volume of 0.9% sodium chloride was injected in the control group (15 mice). After 1 month, the ABR was tested in a sound-electric screen environment and the threshold was recorded. Then intracellular free calcium [Ca(2+)]i and the mRNA level of CaM in the cochlear nucleus were assayed by flow cytometry and RT-PCR.</p><p><b>RESULTS</b>Compare to the control group [(64.0 ± 1.3) dBSPL], the threshold of ABR in the model group [(84.5 ± 2.7) dBSPL] was increased (F = 2.789,P = 0.000). Moreover, in the model group the intracellular free calcium [Ca(2+)]i and the mRNA level of CaM in the cochlear nucleus were increased (F = 1.290, P = 0.000; F = 4.252, P = 0.023), and the differences were statistically significant.</p><p><b>CONCLUSIONS</b>The intracranial injection of MCMV can lead to abnormal changes in the threshold of ABR in mice, and the change of [Ca(2+) ]I/CaM in cochlear nucleus may be the important pathological basis of sensorineural hearing loss induced by MCMV infection.</p>

Dickkopf-1 and bone metastases / 国际肿瘤学杂志

Recent studies show that the abnormalities of dickkopf-1 (DKK-1)are closely related to the bone metastasis and therapeutic effect of breast cancer,prostatic carcinoma,multiple myeloma,neuroblastoma and non-small cell lung cancer.Clinical researches of large sample on the relationships between serum DKK-1 concentration and malignant tumors bone metastases have important clinical significance for evaluating the value of DKK-1 as a clinical biological biomarker of bone metastases and understanding the tumor mechanisms of bone metastases.

Clinical effectiveness assessment of compound danshen injection on early onset severe preeclampsia patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To analyze the clinical effectiveness of Compound Danshen Injection (CDI) in treating patients with early onset severe preeclampsia.</p><p><b>METHODS</b>One hundred and twenty patients with early onset severe preeclampsia were recruited and their gestational age ranged between 26 and 34 weeks. Sixty patients who volunteered to receive CDI were recruited as the treatment group, while 60 inpatients were recruited as the control group at the same time period. The routine therapy was given to those in the control group. CDI was intravenously dripped to those in the treatment group additionally by adding in 250 mL 5% glucose injection, once daily. The treatment for all lasted for 7 successive days. The D-dimer (DD), fibrinogen (Fg), hematocrit (HCT), tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1), mean arterial pressure (MAP), 24 h urine volume (UV), 24 h urine protein (24 hUP), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (apoA1), apolipoprotein B (apoB), umbilical arterial S/D ratio (S/D), and amniotic fluid index (AFI) were compared between the two groups before and after treatment. The placenta weight (PW), neonatal weight (NW), 1 min Apgar scoring were compared between the two groups before and after treatment.</p><p><b>RESULTS</b>There was no difference in DD, Fg, HCT, t-PA, PAI-1, MAP, UV, 24 hUP, TC, TG, HDL-C, LDL-C, apoA1, apoB, S/D, or AFI between the two groups before treatment (P>0.05). In the treatment group PAI-1, Fg, and 24 hUP decreased more after treatment, and they were lower than those of the control group after treatment. The UV and AFI increased and they were higher than those of the control group after treatment with statistical difference shown (P<0.05, P<0.01). In the control group the UV increased and 24 hUP decreased after treatment (P<0.01). There was no improvement in the rest indices (P>0.05). The PW, NW,and 1 min Apgar score > or = 7 were all higher in the treatment group than in the control group, showing statistical difference (P<0.05).</p><p><b>CONCLUSION</b>CDI was helpful to improve the high condensation state of patients with early onset severe preeclampsia, protect important organs of the mother, and improve the prognosis of neonates.</p>

Surgical anatomy of totally trans-oral video-assisted thyroidectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To define the anatomical approach, anatomical planes and related vessels and nerves to create a safe and reproducible combined sublingual and bi-vestibular access for trans-oral video-assisted thyroidectomy.</p><p><b>METHODS</b>From November 2009 to May 2011, twenty-five embalmed human specimens were dissected for anatomical information of the cervical region, the mandible region and the supra-hyoid muscles. On twenty fresh frozen human specimens after an experimental trans-oral endoscopic thyroidectomy, the related vascular, neural structures and muscles were evaluated.</p><p><b>RESULTS</b>The optical access port was placed in the midline sublingual. The geniohyoid muscle, mylohyoid muscle and the anterior belly of the digastric muscle were divided in the midline in order to reach the plane under the platysma muscle. The mucosa was sagittal incised bilaterally in the vestibular of oral cavity for working trocar, at the level of the first molar of the mandible. The working trocar reached directly the periosteum of the mandible, under the facial vessel and the marginal branch of facial nerve, and then passed below the platysma muscle into the infra-laryngeal working area. The distance from mental nerve to mandibular midline and between mental nerve and facial artery were (25.8 ± 0.9) mm and (29.4 ± 0.9) mm respectively. Anatomical dissections showed that after an experimental trans-oral combined sublingual and bi-vestibular access, all muscles of the floor of the oral cavity as well as the related vascular and neural structures are intact. The maximum nodule size of the resected specimens in the totally trans-oral approach was up to 50 mm.</p><p><b>CONCLUSION</b>The combined sublingual and bi-vestibular access of trans-oral video-assisted thyroidectomy is safe and reproducible.</p>

Construction of fusion gene vaccine of WT1 multi-epitope fused with stimulating epitope of mycobacterium tuberculosis heat shock protein 70 and its expression and immunogenicity / 中国实验血液学杂志

This study was purposed to construct a fusion DNA vaccine containing WT1 multi-epitope and stimulating epitope of mycobacterium tuberculosis heat shock protein 70 and to detect its expression and immunogenicity. On the basis of published data, a multi-epitope gene (Multi-WT1) containing three HLA *0201-restricted CTL epitopes: one HLA*2402-restricted CTL epitope, two Th epitopes and one universal Th Pan-DR epitope (PADRE) was constructed. DNA-coding sequence was modified by Computer-Aided Design (CAD) to optimize proteasome-mediated epitope processing through the introduction of different amino acid spacer sequences. The synthetic nucleotide sequence was then inserted into an eukaryotic vector to construct the plasmid pcDNA3.1-WT1.For enhancing CTL activity, HSP70 fragment including stimulatory domain P407-426 was amplified by PCR from mycobacterial HSP70 gene and cloned into pcDNA3.1(+). Then Multi-WT1 was fused to the N-terminal of pcDNA3.1-mHSP70(407-426) to make the multi-epitope fusion gene vaccine pcDNA3.1-WT1-mHSP70(407-426). HEK-293T cells were transfected with this vaccine and the expressed product was identified by RT-PCR. Enzyme-linked immunospot assay (ELISPOT) was used to evaluate the immunological responses elicited by vaccine. The results showed that the most of WT1 epitopes could be correctly cleaved which was confirmed by software Net Chop 3.1 and PAPROCIanalysis. RT-PCR showed correct expression of target gene in HEK293T cells and ELISPOT showed specific T-cell responses. It is concluded that the eukaryotic expression vector PcDNA3.1-WT1-mHSP70(407-426) fusion gene has been successfully constructed and the immunity response is also elicited, which is a good candidate for further research of DNA vaccine.