A single-center retrospective analysis of 77 traumatic arterial injuries of lower extremities / 中华外科杂志

Objective: To analyze the treatment and clinical prognosis of lower extremity arterial injury caused by trauma. Methods: The clinical data of 77 patients with traumatic lower extremity arterial injury admitted to Department of Vascular Surgery,Yichang Central People's Hospital from January 2013 to June 2021 were collected retrospectively. There were 65 males and 12 females, with an average age of 47.4 years (range: 7 to 75 years). Among the 77 patients, 56 cases (72.7%) had open injury and 21 cases (27.3%) had closed injury. Iliac artery was injured in 9 cases (11.7%), common femoral artery in 7 cases (9.1%), superficial femoral artery in 1 case (1.3%), popliteal artery in 11 cases (14.3%) and inferior knee artery in 49 cases (63.6%). The treatment methods and clinical effects were analyzed. Results: One case with pelvic fracture combined the internal iliac artery injury and 1 case with multiple injuries involving the common femoral artery died of circulatory failure before surgery. Seventy-five cases received vascular-related operations, including arterial ligation in 24 cases, arterial reconstruction in 40 cases, stent graft implantation in 1 case, primary amputation in 2 cases, and arterial embolization in 8 cases. The overall mortality rate was 6.5% (5/77), all of which were closed injuries. Except for 2 cases who died before surgery, 3 cases with pelvic fracture combined the internal iliac artery injury died of multiple organ failure after internal iliac artery embolization. There were 8 cases received amputation (10.4%, 8/77), 5 cases with closed injury and 3 cases with open injury. In addition to 2 cases with primary amputation, 6 cases underwent secondary amputation due to ischemia-reperfusion injury after revascularization (4 cases with popliteal artery injury and 2 cases with subpatellar artery injury). The average followed-up time was 17 months (range: 2 months to 8 years). One patient with femoral artery injury underwent autologous great saphenous vein bypass, and lower limb artery CT angiography was re-examined 6 months after the operation, and 30% distal anastomotic stenosis was found. Ankle brachial index<0.8 was found in two patients 1 year after popliteal artery repair, but none of the patients had intermittent claudication symptoms, and no further intervention was performed. Five patients suffered delayed healing due to severe lower limb injury, fracture and skin injury. Among them, 2 cases had poor wound healing at the stump of amputation, which gradually healed 3 to 5 months after several debridements. The other 3 vascular injury combined with tibial fracture patients had delayed tibial healing after surgery, but no symptoms of vascular ischemia occurred. All the other patients recovered well and no other serious complications occurred. Conclusions: The proportion of death and disability in patients with lower limb artery injury caused by trauma is high. Active and orderly surgical repair according to the site and type of injury can reduce the mortality, save the function of the affected limb, and promote the healing of injury.

Analysis of chemical constituents of Ginseng-Douchi compound fermentation products based on UPLC-Q-TOF-MS / 中国中药杂志

In this experiment, ultra high performance liquid chromatography-quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF-MS) was used to analyze and identify chemical constituents of Ginseng-Douchi(GD) compound fermentation, and explore the conversion rules of ginsenosides and soybean isoflavones after compound fermentation. Waters Acquity UPLC BEH C_(18) column(2.1 mm×100 mm, 1.7 μm) was adopted, with 0.1% formic acid aqueous solution(A)-0.1% formic acid acetonitrile solution(B) as mobile phase for gradient elution; electrospray ion source(ESI) was used to collect data in positive and negative ion modes; according to the exact mass number, the secondary spectrum comparison of the database and the existing literature reports, Peakview 2.0/masterview 1.0 software was used to determine the common ion structure formula. Finally, a total of 133 chemical constituents were analyzed and identified from the GD. Ginseng saponins and isoflavone glycosides were significantly converted after fermentation. Among them, peak areas of prototype ginsenosides Rk_3, Rh_1, Rh_2, Rh_3, daidzin, glycitin and genistin decreased significantly; whereas peak areas of se-condary ginsenoside Rb_1, Rb_2, Rk_1, glycitein, genistein and daidzein increased significantly. In this experiment, liquid-mass spectrometry technique was used to investigate the conversion of active ingredients of GD compound fermented products after co-fermentation, so as to provide a scientific basis for elucidating pharmacodynamics material basis and quality control.

Effect of Corn Silk on Adipose Tissues in Type 2 Diabetic Rats Based on GC-MS / 中国实验方剂学杂志

Objective:To evaluate the regulation effect of corn silk on fatty acid compositions in adipose tissues of rats with type 2 diabetes mellitus（T2DM） based on gas chromatography-mass spectrometry （GC-MS）， and explore the mechanism of corn silk water decoction for lipid metabolism disorder in . Method:Rat model of T2DM was established by high-sugar and high-fat diet combined with intraperitoneal injection of 35 mg·kg-1 streptozocin （STZ）. They were randomly divided into model group，metformin group，and low，medium and high dose groups（5.4，10.8，21.6 g·kg-1） of corn silk decoction， with administration of 4 weeks. Serum was taken from the abdominal aorta for the determination of free fatty acids （FFAs），blood lipids ［total cholesterol（TC），triglyceride（TG），high-density lipoprotein（HDL-C），low density lipoprotein（LDL-C）］，and adipose tissue was taken for pathological section analysis. At the same time，GC-MS technology and multivariate statistical analysis methods were adopted to investigate the fatty acid compositions in adipose tissue. Result:After treatment with corn silk decoction，the contents of FFAs，TC，TG，HDLC and LDLC in T2DM rats were all reversed. As compared with the model group，the morphology of rat adipocytes，macrophage infiltration，vascular congestion and other phenomena were restored after administration. GC-MS analysis showed that the contents of palmitic acid and stearic acid in the adipose tissue of T2DM rats were significantly increased，while the contents of tetradecanoic acid，pentadecanoic acid，9-octadecenoic acid，9-hexadecenoic acid and 5，8，11，14-eicosatetraenoic acid were decreased significantly，and all the dose groups of corn silk had a reversing effect on differentially expressed fatty acids. Conclusion:Corn silk can be able to reverse the fatty acid content in adipose tissue and restore the morphology of adipose tissue，with a regulating effect on the lipid metabolism disorder in T2DM rats.

Review of Anemone raddeana Rhizome and its pharmacological effects / 中国结合医学杂志

The chemical compositions of Anemone raddeana Rhizome, a kind of traditional Chinese medicine, were reviewed, along with its bioactivity and pharmacological properties and method improvements of extracting and detecting triterpenoid saponins. A. raddeana Rhizome is used to treat neuralgia and rheumatism, and is rich in triterpenoid saponins, most of which are pentacyclic, with oleanane as the nucleus. So far, 37 triterpenoid saponins have been determined from the herb. Its reported bioactivity and pharmacological properties have been described as anticancerous, antimicrobial, anti-inflammatory, analgesic, antipyretic, anticonvulsive, antihistaminic, and sedative. It has also been used for the induction of the humoral immune response and treatment of liver fibrosis in chronic hepatitis. However, the herb also has hemolytic effects and can be toxic, which limits its clinical application. Further studies are needed on the pharmaceutical functions, mechanisms, and immunological responses to contribute to the herb's clinical applications.

Minimally invasive treatment of intertrochanteric fractures with locking compression plate in the elderly / 中国骨伤

<p><b>OBJECTIVE</b>To study the effect of minimally invasive treatment with the locking compression plate (LCP) in the treatment of intertrochanteric fractures in the elderly age.</p><p><b>METHODS</b>Twenty-eight cases of intertrochanteric fracture were retrospective studied from August 2007 to January 2009, included 13 males and 15 females with an average age of 78.6 years ranging from 70 to 102 years. All the 28 patients were treated with minimally invasive operations with locking compression plates. The time from injury to operation was ranged from 3 to 8 days (with an average of 4.5 days).</p><p><b>RESULTS</b>The operation time was from 40 to 90 minutes (with an average of 55 minutes). The average bleeding volume during the operation was 70 ml (from 50 to 150 ml). One patient died during hospital stay. Twenty-five patients were followed up from 6 months to 2 years with an average of 15 months after operation. The fracture healing time was from 10 to 12 weeks (10.4 weeks in average). According to an evaluation standard of HUANG Gong-yi, the results were excellent in 20 cases,good in 4 cases, poor in 1 case.</p><p><b>CONCLUSION</b>Minimally invasive approaches with LCP could treat the elder intertrochanteric fractures with the advantages such as minimal invasive, stable fixation and less blood loss.</p>