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Objective:To explore the key amino acids of side chain dioxate dehydrogenase complex E2 protein (BCOADC-E2) that can react specifically with specific autoantibody anti-mitochondrial antibodies (AMA)-M2 in patients with primary biliary cholangitis (PBC).Methods:The homologous target gene BCKD, which expressed the epitopes of BCOADC-E2 protein, was cloned and recombined with the engineering plasmid pGEX-4T1. Fifteen point mutant plasmids were obtained by polymerase chain reaction (PCR) and transferred to the prokaryotic expression strain for protein expression and purification. Fourteen mutant proteins and one wild-type protein were obtained. The AMA-M2 specificity of the 14 mutant proteins was measured by enzyme-linked immuno sorbent assay (ELISA), and the amino acids that were critical to the specificity of BCOADC-E2 and AMA-M2 were identified by comparing the specificity of the 14 mutant proteins with that of the wild type proteins. Differences between groups were analyzed by analysis of variance, LSD- t test. Results:A total of 14 mutant proteins and 1 wild-type protein were obtained.The specific reaction degree of mutant protein pGEX-BCKD-S1A (1.634±0.328) and pGEX-BCKD-C3A (1.744±0.345) with serum AMA-M2 in patients with PBC was higher than that of wild-type protein pGEX-BCKD (1.000±0.000) with AMA-M2; Mutant protein pGEX-BCKD-E4A (0.157±0.067), pGEX-BCKD-V5A (0.057±0.029), pGEX-BCKD-Q6A (0.580±0.166), pGEX-BCKD-S7A (0.744 ±0.125), pGEX-BCKD-D8A (0.351 ±0.135), pGEX-BCKD-S10A (0.496 ±0.158), pGEX-BCKD-V11A(0.149±0.089), pGEX-BCKD-T12A(0.061±0.043), pGEX-BCKD-I13A(0.007±0.017), pGEX-BCKD-T14A (0.198±0.101), pGEX-BCKD-S15A (0.156±0.087), The specific reaction degree of pGEX-BCKD-R16A (0.884±0.099) with AMA-M2 was lower than that of wild-type protein pGEX-BCKD (1.000±0.000) with AMA-M2.Conclusion:The cysteines at positions 1 and 3 of BCOADC-E2 protein were the key amino acids to improve the specific reaction between BCOADC-E2 and AMA-M2. The mutant proteins formed after amino acids at position 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 15 and 16 are replaced by alanine can decrease the specificity of AMA-M2. Amino acids at positions 5 and 13 are the key amino acids that affect the specific reaction between BCOADC-E2 and AMA-M2, and have an important effect on the function of BCOADC-E2 protein.
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BACKGROUND: The perioperative blood loss of total knee arthroplasty is large. The “cocktail” containing tranexamic acid has the dual function of hemostasis and analgesia. However, how to further reduce blood loss with intravenous tranexamic acid is still worth exploring. OBJECTIVE: To compare the hemostatic effect and safety of tranexamic acid combined with different intravenous applications of tranexamic acid in total knee arthroplasty under the premise of using “cocktail” containing tranexamic acid. METHODS: Data of 62 patients with osteoarthritis, who underwent primary unilateral total knee arthroplasty in the First Department of Orthopedics of Zhongshan People’s Hospital from June 2017 to September 2019, were retrospectively analyzed and divided into three groups. In the Group A, 26 patients administrated “cocktail” containing tranexamic acid before closing the wound. In the Group B, 25 patients administrated intravenously 1.0 g tranexamic acid before cutting skin on the basis of group A. In the Group C, 11 patients administrated intravenously 1.0 g tranexamic acid on the basis of group B 3 hours postoperatively. Dominant, hidden, and total blood loss, postoperative hemoglobin biggest loss, blood transfusion rate, postoperative hospital stay and postoperative complications were compared and analyzed among three groups. RESULTS AND CONCLUSION: (1) In terms of blood loss (including total, hidden, intraoperative, postoperative and dominant) and the maximum loss of hemoglobin, both groups B and C were lower than group A, with statistically significant differences (P 0.05). (2) There were no statistically significant differences in blood transfusion rate and postoperative hospital stay among three groups (P > 0.05). (3) There were no statistically significant differences among the three groups in the incidence of wound complications, articular effusion, and complications of intermuscular vein thrombosis (P > 0.05). No lower limb deep vein thrombosis or pulmonary embolism was found in the three groups. (4) The results showed that intravenous administration of 1.0 g tranexamic acid before cutting skin and combination with “cocktail” containing 0.5 g tranexamic acid before closing the wound can have obvious hemostatic effect. However, intravenous administration of 1.0 g tranexamic acid 3 hours postoperatively failed to further reduce the bleeding; moreover, the first two administrations did not increase the postoperative complications, and had certain security.
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Objective To investigate the severity of allogenic rejection after partial liver transplantation (PLTx) with different graft weight to recipient liver weight (GW/RLW).Methods The full-size liver transplantation (group A),GW/RLW ＞33％ PLTx (group B) and GW/RLW ＜ 30％ PLTx (group C) were set up using BN rats and Lewis rats as donors and recipients,respectively.All recipients were observed for 28 days.The Banff RAI grading,survival rate,jaundice and body weight recovery were evaluated to determine the severity of acute allogeneic rejection.Two PLTx groups,group B1 (GW/RLW＞33％) and group C1 (GW/RLW＜30％),were established to assess the mRNA level of IL-2,GranzymeB,Perforin and CD3 48 h and 7 days postoperatively.Additionally,the mRNA level of B7-H1,the ratio of Ki67 + hepatocytes and the liver enzymes were also assessed 7 days postoperatively.Results All recipients in group C died within 22 days postoperatively,presenting with severe lymphocytic infiltration and vascular endothelialitis.All recipients in group A and group B survived until the end of observation time.All recipients in group A survived and presented with a mild lymphocytic infiltration and rare vascular endothelialitis.Group B presented with moderate lymphocytic infiltration and moderate vascular endothelialitis.The Banff RAI grading in group C was significantly higher than that in group A and group B (P ＜ 0.05).In accordance with the result of histology and survival rate,group B and group C presented with earlier jaundice and lower body weight recovery than that of group A (P＜0.05).As compared with group B1,group C1 presented with higher mRNA levels of Perforin,GranzymeB,IL-2 and CD3,higher level of liver enzymes and heavier liver graft weights.Besides,the mRNA level of immunosuppresive molecule B7-H1 in group C1 was lower than that of group B1.However,there was no significant difference in the ratio of Ki67 + hepatocytes between group B1 and group C1.Conclusion The allogenic liver rejection may be enhanced by reducing the GW/RLW.
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Objective To report the treatment of type A3 distal tibiofibular fractures with the fibular posterolateral approach and minimally invasive percutaneous plate osteosynthesis (MIPPO).Methods We reviewed 61 patients with type A3 distal tibiofibular fracture (observation group) who had been treated with MIPPO and the fibular posterolateral approach from June 2011 to May 2015.Our control group included 78 patients with type A3 distal tibiofibular fracture who had been treated by traditional open reduction and internal fixation from April 2009 to September 2013.Interval between injury and surgery,surgical time,intraoperative bleeding,hospital stay,postoperative complications,X-ray Lane-Sandhu osteotylus score and limb weight-bearing score one year after operation were compared between the 2 groups.Results All the 139 patients were followed up for more than one year.There were significant differences between the 2 groups in terms of interval between injury and surgery (8.0 ± 3.5 h versus 140.7 ± 52.4 h),surgical time (66.2 ± 7.2 min versus 92.1 ±6.6 min),intraoperative bleeding (59.8 ± 12.8 mL versus 209.5 ±50.4 mL),hospital stay (9.4 ± 1.9 d versus 26.1 ± 15.7 d),postoperative complications,X-ray Lane-Sandhu osteotylus score (3.9 ±0.2 points versus 3.0 ±0.6 points) and limb weight-bearing score (3.9 ±0.1 points versus 3.0 ±0.7 points) one year after operation,favoring the observation group(P ＜ 0.001).Conclusions In the treatment of type A3 tibiofibular fractures,MIPPO plus the fibular posterolateral approach is superior to the traditional open reduction and internal fixation because it can benefit fracture healing by shortening the time for preoperative preparation,surgery and hospitalization,and decreasing the amount of intraoperative bleeding and the incidence of postoperative complications.
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Objectives: To detect the risk factors for deep venous thrombosis [DVT] in patients after neurosurgery
Methods:Three hundred and seventy-six patients treated in the department of neurosurgery of our hospital from February 2013 to November 2015 were reviewed retrospectively. The clinical data including age, gender, hospital stay, operation time, occupation type, hypertension, coronary heart disease, diabetes, smoking status, drinking status, postoperative exercises, malignant tumor, and postoperative hormone or dehydrating agent were collected
Results:In this study, 52 patients were included in the DVT group and 295 patients in the Non-DVT group. There was significant difference in age, hypertension, occupation type, malignant tumors, operation time, smoking status, and postoperative exercises between the two groups [p<0.05]. However, there was no significant difference in gender, drinking status, coronary heart disease, diabetes, hospital stay, and postoperative hormone or dehydrating agent [p>0.05]. In multivariate analysis, age, malignant tumor, hypertension were independent risk factors, while physical labour and postoperative exercises were protective factor for DVT
Conclusion:The postoperative patients with older age, malignant tumor or hypertension should be paid high attention to prevent DVT, and postoperative exercises should be selected as precautionary measures
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Objective To observe the clinical efficacy of concurrent radiochemotherapy in the treatment of intermediate and advanced cardiac cancer.Methods Involved 34 intermediate and advanced cardiac patients,using concurrent radiochemotherapy treatment,the radio treatment with 3D -CRT method,2Gy/time,Qd,5 times per week, total 60Gy/6 week,at the same time,combined with gemcitabine treatment,1 000mg/m2 ,intravenous infusion of 30min.First day and eighth day of medication,forbidding 1 week and used 2 cycles.Results 34 patients all took part in the follow up,the total effective rate was 88.2%,the 1 -,2 -,3 -year survival rate was 70.1%(24 /34),47.0%(16 /34)and 26.5%(9 /34).Adverse reactions were mainly gastrointestinal reaction,bone marrow suppression,etc. Conclusion The concurrent radiochemotherapy treatment can really control the progressive disease,and receive an ideal survival rate,the adverse reactions can limit in tolerance scope.
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Objective:To optimize the matrix formula of Qingre Zhitong cataplasm. Methods:An orthogonal test was performed to study the matrix formula of Qingre Zhitong cataplasm with the comprehensive score of continued adhesion and integrated sensory as the evaluation indices and the ratio of sodium polyacrylate, carboxymethylcellulose sodium, aluminum chloride hydrate and glycerin as the influencing factor. Results:The optimal matrix formula of Qingre Zhitong cataplasm was as follows: the ratio of sodium polyacrylate, carboxymethylcellulose sodium, aluminum chloride hydrate and glycerin was 14 ∶1 ∶1 ∶120. Conclusion: Qingre Zhitong cataplasm prepared with the optimal matrix formula has good continued adhesion and integrated sensory, and the process parameters are stable and feasible.
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Objective To investigate the value of 64-slice spiral CT angiography in diagnosis of the origin of abdominal large masses.Methods Twenty patients who were proven by operation and pathology to be abdominal massive tumor were collected in this study,tumor diameter average 17.8cm.All patients accepted plain and enhanced CT scanning,and their data were transferred to Philips IntelliSpace Portal.The tumor vessel were reconstructed with multiplanar reformation(MPR),maximum intensity projection(MIP),and volume rendering(VR).The origin of tumor were judged according to the feeding arteries by 2 attending physician,and the results were compared with pathology.Results Of these 20 cases,15 cases were malignant tumor,5 benign.Blood supply arteries were found in 19 patients,36 vessels.Lateral branch vessels in 6 cases and arteriovenous fistula in 4 cases.MSCTA findings were consistent with operation and pathology,with the accuracy of 90％.One case had no tumor vessel,one was misdiagnosed.Conclusion MSCT could be taken good use in diagnosis of large abdominal masses by tracking down the nourishing artery of masses.
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Objective To investigate the diagnostic value of multi -modal MRI for prostate cancer .Methods The multi modalitymagnetic resonance data of 43 patients with prostatic diseases were retrospectively analyzed ,selected biopsy or operation pathology results as the control ,analyzed their unenhanced MRI ,DWI,MRS and DCE -MRI. Results (1)In 43 patients,29 cases were diagnosed by biopsy of prostate cancer .37 cancer lesions were found,and 28 cancer lesions showed obviously low signal intensity in T 2WI.(2)The mean ADC value of the cancer lesions and normal areas were (0.69 ±0.09) ×10 -3 mm2/s and (1.31 ±0.18) ×10-3 mm2/s,there was significant difference in ADC value between the two groups (t=21.06,P<0.01);(3) The mean Cho +Cre/Cit value of the cancer lesions and normal areas were (2.67 ±1.58) and (0.74 ±0.28),there was significant difference in ADC value between the two groups (t=7.34,P<0.01);(4)32 rapidly ascending and slowly descending type ROI's,4 flat type ROI's and 1 rising type ROI's were founded in cancer lesions .Conclusion Multi-modal MRI can further provide the blood perfusion of prostate cancer ,water molecule diffusion and microcirculation state ,metabolism and biochemical composi-tion change information .The combination of T2WI,DWI,MRS and DCE-MRI can improve the diagnostic efficiency for the detection of prostate cancer prominently .
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Objective: To synthesize 10-position schiff base derivatives of emodin and study the anti-tumor activity. Methods:The 10-position schiff base derivatives of emodin were synthesized through emodin reacting with ammonia derivatives in absolute alcohol with acetic acid as the catalytic agent. Their structures were characterized by 1 H-NMR and ESI-MS, and the anti-tumor activity on k562 cells was determined by MTT method. Results:Three 10-position schiff base derivatives were synthesized and the structures were confirmed, and the IC50 on k562 cells was 4. 5, 3. 8 and 2. 0 μmol·L-1 , respectively. Conclusion:The 10-position schiff base de-rivatives of emodin can improve the anti-tumor activity and druggability of the parent compound, which are worthy of further study.
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Objective To evaluate the efficacy and safety of mometasone furoate dry powder inhalation(MF DPI) in treating mild and moderate asthma .Methods The databases of PubMed ,EMBASE ,CINAHL were retrieved .The randomized ,controlled trials(RCT) on mometasone furoate dry powder inhalation in treating mild and moderate asthma were collected .The quality evalua‐tion and the data extraction were performed according to the Cochrane systematic evaluation method .The RevMan 5 .0 .2 software was adopted for conducting statistical analysis .Results A total of 9 RCT involving 1 795 patients with mild and moderate asthma were included .The meta‐analysis results showed that MF DPI 200 mcg/d improved FEV1(MD=0 .24 ,95% CI:0 .17 -0 .30) ,am‐PEF(MD= 25 .25 ,95% CI:8 .18 -42 .32) ,pmPEF(MD= 16 .00 ,95% CI:2 .10 -29 .90);MF DPI 400 mcg/d improved FEV1 (MD=0 .32 ,95% CI:0 .25-0 .39) ,amPEF(MD=36 .44 ,95% CI:23 .82-49 .05) ,pmPEF (MD=28 .50 ,95% CI:14 .11-42 .89) , which suggested that MF DPI 200 mcg/d and MF DPI 400 mcg/d improving FEV1 ,amPEF and pmPEF was higher than the place‐bo ;for reducing patient′s early morning dyspnea and albuterol dose ,MF DPI 200 mcg/d and MF DPI 400 mcg/d were superior to placebo .For reducing patient′s early morning wheezing ,MF DPI 200 mcg/d and MF DPI 400 mcg/d were not superior to placebo . For the occurrence of adverse events ,there was no statistical difference between MF DPI 200 mcg/d and MF DPI 400 mcg/d with placebo(P>0 .05) .Conclusion The existing evidence indicates that MF DPI has higher effect and safety in treating mild and mod‐erate asthma .
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OBJECTlVE To investigate the association between CYP3A5 genotypes and the early efficacy of tacrolimus ( Tac) and cyclosporin A ( CsA) in renal transplantation recipients, and provide a basis for individualized treatment. METHODS Seventy-four kidney transplantation recipients were en-rolled in this study between August 2012 and April 2013. Thirty-one patients were treated with the combi-nation of CsA, MMF and methylprednisolone while the rest were treated with Tac, MMF and methylpred-nisolone. The genotype CYP3A5 was detected by sequence specific primer-polymerase chain reaction ( SSP-PCR) before transplantation. The levels of Tac and CsA were detected by ELlSA and chemilumi-nescence, respectively, to monitor the blood concentration/dose of drugs ( c/D) at 2 weeks, 1 month, 2 months, 3 months and 6 months after transplantation. Simultaneously, the concentrations of blood glu-cose, creatinine, urea nitrogen and uric acid were determined with hexokinase method, creatininase method, urease method and uricolase method, respectively. RESULTS Among the 74 recipients, 9.5%carried CYP3A5?1/?1, 48.6%carried CYP3A5?1/?3 and 41.9%carried CYP3A5?3/?3. According to the phenotype of CYP3A5, the patients were divided into CYP3A5 expression group ( including CYP3A5?1/?1 and CYP3A5?1/?3) and non-expression group ( including CYP3A5?3/?3) , which accounted for 58.1%and 41.9%of the cases, respectively. Among the patients taking Tac, the median value of c/D at 2 weeks, 1 month, 2 months, 3 months and 6 months was 25.49, 49.64, 53.72, 51.9 and 44.5 in CYP3A5 expression group, and 65.48,100.84,99.54,123.01 and 133.21 in non-expression group. The c/D ratio of CYP3A5 non-expressers was higher than among CYP3A5 expressers at each time point ( P<0.05) . The initial dose of Tac 0.1 mg·kg-1 was high for CYP3A5 non-expressers, and the kidney function recovered more slowly than among CYP3A5 expressers and kidney damage occurred. However, there was no association between CYP3A5 genotype and the early efficacy of CsA. The levels of blood glucose, creatinine, urea nitrogen and uric acid were not significantly different between CYP3A5 expression and non-expression groups. CONCLUSlON CYP3A5 non-expression recipients whose starting amount of Tac was 0.1 mg·kg-1 have drug overdoses. CYP3A5 genotype is one of the factors affecting the efficacy of Tac. CYP3A5 genotype has no association with the efficacy of CsA in renal transplantation recipients.
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Objective To evaluate percutaneous transluminal angioplasty ( PTA) for stenosed arteries of the lower extremities in patients with ischaemic diabetic foot. Methods We retrospectively analyzed the clinical and follow-up data of using PTA to treat diseased infrapopliteal arteries in diabetic patients who were hospitalized from Oct,2006 to May,2008. Results Technical success rate was 87% , procedure related complications developed in 8. 9% of patients, postoperative complications were 11. 1% , perioperative mortality was 2. 5% , limb salvage rate was 90% , pain symptom was significantly mitigated or relieved, ulcer healed well. The median hospitalstay was 10 days. Restenosis rates were 38. 1 % , 50% respectively at 1 year and 2 years. Rest pain and ulcer recurrence rates were 10% and 12% at 1 year and 2 years respectively; Amputation rates were 10% and 15. 3% at 1 year and 2 years. Restenosis ( or occlusion) , rest pain or ulcer recurrence and amputation rate in Fontain Ⅳ group is significantly poorer than that in Fontain Ⅰ - Ⅲ group (P ＜0. 05). Conclusions Percutaneous transluminal angioplasty (PTA) for critical limb ischeamia in patients with ischaemic diabetic foot are feasible, with minimal invasiveness, low complications. Fontain classification predicts PTA thrapeutic results.
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Objective To explore the factors related to the delayed graft function (DGF). Methods Clinical data of 150 recipients were collected and performed by Cox proportional hazards regression analysis . In addition, the glutathione S-transferase (GST) gene polymorphism of 172 donors and 157 healthy persons was analyzed by multiple PCR and SSP-PCR. Results DGF was observed in 24 patients among 150 recipients. Pretranplantation dialysis mode, PR A levels and recipient gender were uncorrelated with the incidence of DGF(P>0. 05). Urinary volume of the second 24 hours after transplantation was an independent predictor of DGF(RR=1. 002, P = 0. 001). The frequency of donor's null GSTM1 in DGF group was significantly higher than that in non-DGF group(P<0. 05). Conclusions Urinary volume of the second 24 hours after transplantation could be a predictor for DGF. The null GSTM1 in donor might be one of the factors related to the EGF.
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Objective To observe the curative effect of Bitongding capsule for RA. Methods 100 cases were randomly divided into 2 groups. The control group (30 cases) was treated by Zhengqing Fengtongning, and the treatment group (70 cases) was treated by Bitongding capsule. One course was three months and two courses of treatment was statistics date. Results The total effective rate of 3 months was 91.43% in treatment group and 76.67% in control group. AF and IgG of treatment group were improved obviously (P 0.05), while the clear effective rate was 65.71% in treatment group and 36.67% in control group (P
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Objective To assess the correlation of the characteristics of coronary lesion and the risk factors to the coronary heart diseases using angiography techniques. Methods Coronary heart disease (CHD) patients were divided into two groups according to the ages of patients: elderly group (67 cases, 60 88 years); non elderly group(61 cases, 25 59 yeas). Angiography was performed in all CHD patients and their risk factors were analyzed by Logistic regression. Results The coronary changes were characterized in most patients by multi vessels lesion(76 1%) in elderly group, while by single vessel lesion (54 1%) in non elderly group. Stenosis of the coronary artery in the elderly group was severer than that in the non elderly. Logistic regression showed that ageing, sex, hyperlipemia were the risk factors for CHD( P
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Objective To explore the clinical results of internal fixation of patellar transverse body fracture by comparing figure-of-eight tension band wiring combined with cannulated compression screws technique with traditional modified tension band (AO technique). Methods There were 14 cases in the cannulated screws combined with tension band wire group, it involved 9 males and 5 females, the average age was 46 years. The patients were followed up for an average of 30 weeks with a range from 16 to 48 weeks. Another 20 cases were in the modified tension band group, it involved 13 males and 7 females, the average age was 42 years. The patients were followed up for an average of 42 weeks with a range from 36 to 72 weeks. The t test was used to compare the clinical results between two groups, including the mean knee flexion at the 2nd and 4th week, the mean clinical union time and the mean flexion loss at the 24th week postoperatively. Results In the cannulated screws combined with tension band wire group, the mean knee flexion at the 2nd week and 4th week postoperatively was 59??14.8? and 98??15.1? respectively. The mean clinical union time was (10?3.0) weeks and the mean flexion loss at the 24th week postoperatively was 11??6.3? without any complication. In the traditional modified tension band group, the mean knee flexion at the 2nd week and 4th week was 31??13.3? and 63??13.7? respectively. The mean clinical union time was (13?3.8) weeks and the mean flexion at the 24th week postoperatively was 18??6.2?. In this group, 2 cases failed because loosening of the tension band with the pin pulled out. One was managed with the plaster brace, the other underwent re-operation. Conclusion With stable construct, the internal fixation of transverse patellar body fracture with figure-of-eight tension band wiring combined with cannulated compression screws is less invasive to local soft tissue, optimal on knee functional recovery and fracture union. No complication has occurred, but the long-term clinical result and complication should be followed up for longer time.
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OBJECTIVE:To establish the quality standard of Tongfeng granules.METHODS:Coix lacryma-jobi,Radix Paeoniae Rubra and Radix et Rhizoma Glycyrrhizae in the granules were identified by TLC,and the content of sarsasapogenin in Tongfeng granules was determined by HPLC-ELSD.RESULTS:The TLC characteristics were distinctive and specific.The linear range for sarsasapogenin was 0.546～4.368 ?g(r=0.999 8) and the average recovery was 97.74%(RSD=1.3%,n=6).CONCLUSION:The established standard can be used for the quality control of Tongfeng granules.