Prevention of Deep Vein Thrombosis by Panax Notoginseng Saponins Combined with Low-Molecular-Weight Heparin in Surgical Patients / 中国结合医学杂志

OBJECTIVE@#To evaluate the efficacy of deep vein thrombosis (DVT) prevention among real-world surgical inpatients who received panax notoginseng saponins (PNS) combined with low-molecular-weight heparin (LMWH).@*METHODS@#A prospective cohort study was conducted among surgical patients between January 2016 and November 2018 in Xuanwu Hospital, Capital Medical University, Beijing, China. Participants received LMWH alone or PNS combined with LMWH for preventing DVT. The primary outcome was incidence of lower extremity DVT, which was screened once a week. Participants in the LMWH group were given LMWH (enoxaparin) via hypodermic injection, 4000-8000 AxalU once daily. Participants in the exposure group received PNS (Xuesaitong oral tablets, 100 mg, 3 times daily) combined with LMWH given the same as LMWH group.@*RESULTS@#Of the 325 patients screened for the study, 281 participants were included in the final analysis. The cohort was divided into PNS + LMWH group and LMWH group with 134 and 147 participants, respectively. There was a significant difference of DVT incidence between two groups (P=0.01), with 21 (15.7%) incident DVT in the PNS + LMWH group, and 41 (27.9%) incident DVT in the LMWH group. Compared with participants without DVT, the participants diagnosed with DVT were older and had higher D-dimer level. The multivariate logistic regression model showed a significant lower risk of incident DVT among participants in the PNS + LMWH group compared with the LMWH group (odds ratio 0.46, 95% confidence interval, 0.25-0.86). There were no significant differences in thromboelaslography values (including R, K, Angle, and MA) and differences in severe bleeding between two groups. No symptomatic pulmonary embolism occurred during the study.@*CONCLUSION@#Combined application of PNS and LMWH can effectively reduce the incidence of DVT among surgical inpatients compared with LMWH monotherapy, without increased risk of bleeding.

Prevalence and risk factors of renal function decline in elderly people in a community in Shanghai / 上海预防医学

Objective:To determine the prevalence of renal function decline in the elderly population in a community and risk factors. Methods:Data in the physical examination of the elderly population aged over 60 years old in a community in 2018 were collected and analyzed. Estimated glomerular filtration rate was calculated by modified modification of diet in renal disease （MDRD） formula. Association between renal function decline and risk factors were determined. Results:Among the 9 626 elderly people， the prevalence of renal function decline was 10.71%， which increased with age. Multivariate logistic regression showed that men， age， anemia， abnormal uric acid， hypertension， hyperlipidemia， diabetes， glutamine transaminase， and the history of stroke were the independent risk factors associated with renal function decline. Conclusion:The prevalence of renal function decline in elderly people in a community in Shanghai is relatively high. It is necessary to pay attention to early screening and take effective preventive measures， such as health education， scientific exercise and reasonable diet， chronic disease management and other measures.

Differences in Active Ingredients of Steroid Saponins in Rhizomes of 9 Kinds of Paris / 中国实验方剂学杂志

Objective::To investigate the differences and correlations of active ingredients and principal ingredients of steroid saponins in rhizomes of 9 kinds of Paris. Method::The differences and correlations of active ingredients and principal ingredients of steroid saponins in rhizomes of 9 kinds of Paris. were qualitatively analyzed by liquid chromatography-mass spectrometry (LC-MS). Result::PolyphyllinⅠ, polyphyllin Ⅱ, polyphyllin Ⅵ, and polyphyllin Ⅶ, the quality control indexes of medicinal materials in Chinese Pharmacopoeia (2015 edition) were detected in rhizomes of 8 species, namely P. polyphylla var. yunnanensis, P. delavayi, P. mairei, P. polyphylla var. yunnanensis(kuoban), P. veitnamensis, P. axialis, P. thibetica, and P. polyphylla var. polyphylla, polyphyllin Ⅴ was also detected in the study. There were significant differences in active ingredients of polyphyllin Ⅲ (Dioscin), polyphyllin H and gracillin. Meanwhile, P. polyphylla var. yunnanensis (S1), P. delavayi (S2), P. mairei (S3), P. polyphylla var. yunnanensis (kuoban) (S4), P. veitnamensis (S5), P. axialis (S6) and P. polyphylla var. polyphylla (S9) could be classified into one category according to the principal component analysis (PCA) model of the LC-MS data under the positive ion mode of Paris. P. thibetica (S7) and P. forrestii (S8) were clustered as two separate categories, with a longest range from P. polyphylla var. yunnanensi. Conclusion::There are little differences in active ingredients and the principal ingredients of steroid saponins in rhizome of P. polyphylla var. yunnanensis, P. delavayi, P. mairei, P. polyphylla var. yunnanensis, P. veitnamensis, P. axialis and P. polyphylla var. polyphylla. However, further research is required to determine whether these could substitute P. polyphylla var. yunnanensis. as an alternative medicine.

Efficacy and peripheral immunity analysis of allogeneic natural killer cells therapy in patients with hepatocellular carcinoma / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the safety and efficacy of allogeneic natural killer (NK) cells in the treatment of primary hepatocellular carcinoma (HCC), and to elucidate the mechanism of NK cells therapy.@*METHODS@#Twenty-one patients with primary HCC treated with allogeneic NK cells at the Fifth Medical Center of the PLA General Hospital were followed up for 1 year. Peripheral blood mononuclear cells (PBMCs) were isolated from patient-related donors and cultured in vitro for 15 days and infused to the patients in two consecutive days. Clinical data and laboratory data were collected and analyzed, including survival, clinical features, imaging changes, hematology, immunology, and biochemical indicators to evaluate the safety and efficacy of allogeneic NK cell therapy. The changes of peripheral blood lymphocyte subsets after treatment were also analyzed to explore the possible anti-tumor mechanisms.@*RESULTS@#(1) Of the 21 patients with primary HCC, 11 patients were treated once, 5 patients were treated twice, and 5 patients were treated 3 times. After allogeneic NK cells infusion, 10 patients had fever, 1 patient had slight hepatalgia and 1 patient had slight headache, no other adverse events occurred including acute and chronic graft-versus-host disease (GVHD). They resolved spontaneously within 8 hours without other treatment. (2) The total disease control rate was 76.2% during one-year follow-up. Among them, the patients with Barcelona clinic liver cancer (BCLC) stage A had a disease control rate of 100%, stable disease (SD) in 10 cases; BCLC stage B patients had a disease control rate of 60%, partial response (PR) in 1 case, and SD 2 in cases; BCLC stage C patients had a disease control rate of 50%, complete response (CR) in 1 case, and 2 cases of PR. (3) The frequencies of NK cells and CD8+ T cells in peripheral blood were significantly lower than that before at 24 hours after treatment, and the frequencies of CD4+ T cells and CD4/CD8 were significantly higher than the baseline.@*CONCLUSION@#Allogeneic NK cells have good safety and efficacy in the treatment of primary HCC. The anti-tumor effect of the allogeneic NK cells may play an important role in the activation of the patient's natural immune system and delay disease progression, suggesting that allogeneic NK cells combined with sorafenib may be a very effective treatment for advanced HCC, and further large-sample multicenter randomized controlled clinical trials are needed to validate this result.

Differences of accumulation of the major secondary metabolites in Paris L. leaves / 中国药学杂志

OBJECTIVE: To investigate the differences of the accumulation of the main secondary metabolites in the leaves of 11 kinds of Paris L. medicinal plants. METHODS: The contents of the main secondary metabolites, polyphyllin I, II, VI, and VII in the leaves of 11 kinds of Paris L. medicinal plants were determined by UPLC, and the UPLC fingerprints were established. The accumulation of the main secondary metabolites was evaluated by one-way ANOVA and chromatographic analysis. RESULTS: There was significant difference(P<0.01)in the contents of polyphyllin I, II, VI, and VII in the leaves of 11 kinds of Paris L. medicinal plants, and polyphyllin I, II, VI, VII were simutaneously detected only in var. yunnanensis-1, P. axialis, P. thibetica, P. forrestii and var. yunnanensis; there was significant difference in the UPLC chromatograms of 11 kinds of Paris L. medicinal plants, but the similarities among var. yunnanensis-1, P. axialis, P. thibetica, P. forrestii and var. yunnanensis all reached 0.902 with 16 common peaks, indicating smaller difference in their main secondary metabolites. CONCLUSION: There is significant difference in the abilities of the 11 kinds of Paris L.medicinal plants to accumulate polyphyllin I, II, VI, and VII, which may be the main reason that there are significant differences in the contents and classes of the major secondary metabolites of Paris L. roots.

Progress on the cause and mechanism of a separation of clinical symptoms and signs and imaging features in lumbar disk herniation / 中国骨伤

A few of patients with lumbar disk herniation having a separation of clinical symptoms and signs and imaging features, can be found in clinic, but the traditional theory of direct mechanical compression of nerve roots by herniated nucleus pulposus can't be used to explain this abnormal protrusion of lumbar intervertebral disc. The clinical symptoms and signs of the atypical lumbar disk herniation are affected by multiple factors. The indirect mechanical compression and distraction effect of spinal nerve roots may play an important role in the occurrence of the separation, and the appearance of abnormal clinical symptoms and signs is closely related to the migration of herniated nucleus pulposus tissue, transmission of injury information in the nervous system, and the complex interactions among the nucleus pulposus, dural sac and nerve roots. Moreover,the changes of microcirculation and inflammation secondary to the herniated nucleus pulposus tissue, the hyperosteogeny in the corresponding segment of the lumbar vertebrae and the posture changes all results in a diversity of symptoms and signs in patients with lumbar intervertebral disc herniation. Besides, there exist congenital variation of lumbosacral nerve roots and vertebral bodies in some patients, and the misdiagnosis or missed diagnosis of imaging finding may occur in some cases. However, the appearance of a separation of clinical symptoms and signs and imaging examination in patients may be caused by a variety of reasons in clinic. The exact mechanism involved in the interaction among nucleus pulposus tissue, dural sac and nerve root, secondary changes of pathophysiology and biomechanics around the nucleus pulposus, the determination of lesioned responsible segments, and how to overcome the limitations of imaging all need the further researches.

Anterior decompression and fusion with n-HA/PA66 cage for the treatment of lower cervical fracture and dislocation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effects of anterior decompression and fusion with a nano-hydroxyapatite/ polyamide 66 (n-HA/PA66) cage in treating lower cervical fracture and dislocation.</p><p><b>METHODS</b>From January 2008 to December 2010, the clinical data of 42 patients with lower cervical fracture and dislocation were retrospectively analyzed. There were 29 males and 13 females aged from 20 to 65 years old. The mean age was 46.8 years. Five cases got injuried in C3, 14 cases in C4, 12 cases in C5, 7 cases in C6 and 4 cases in C7. According to Frankel grade, 4 cases were classified in grade A, 11 cases in grade B, 13 cases in grade C, 9 cases in grade D and 5 cases in grade F. Twenty-eight cases were treated with anterior corpectomy and fusion and 14 cases with anterior discectomy and fusion. Frankel grade was used to do neurologic assessment and visual analogue scale (VAS) was used to evaluate the improvement of clinical symptoms. Segmental height and sagittal lordosis were measured by radiographs and cage location. Cage appearance and fusion status were assessed by 3D-CT images.</p><p><b>RESULTS</b>All patients were followed up for 3 to 5.2 years with an average of 4.1 years. Frankel grade had obviously improved than preoperative (Z = -4.845, P < 0.001). There were 2, 3, 11, 8, 11 cases classified in grade A, grade B, grade C, grade D and grade E respectively. At the third day after operation and latest follow-up,VAS was (2.6 +/- 1.8),(1.3 +/- 1.0) scores respectively. Both had improved than preoperative (P < 0.05). Up to the latest follow-up, there was only one patient (2.4%) with slight cage translocation (less than 2 mm), however, no cage prolapsed, or collapse, or breakage were found. Both segmental height and lordosis improved significantly after surgery (P < 0.001). And there was not significant difference in both parameters between each postoperative time points (P > 0.05). The mean distance of cage subsidence was 1.5 mm and the rate of cage subsidence (> 3 mm) was 4.8%.</p><p><b>CONCLUSION</b>The n-HA/PA66 cage can not only restore and maintain the fusion segmental height and radian, but also promote the osseous fusion and profit the radiographic assessment after operation. Thus, it was an ideal material for prop graft.</p>

Expression of ERK and c-fos and effect of brain derived neurotrophic factor in early retinal neuropathy of streptozotocin-induced diabetes in rat / 中华实验眼科杂志

BackgroundRecent studies showed that diabetic retinal neuropathy is an earlier and more dangerous complication and neurotrophin has a protective effect on retina.ObjectiveThe present study was to observe the changes of brain derived neurotrophic factor (BDNF),its receptor TrkB,signal pathway protein phosphatized extracellular signal-regulated protein kinase1/2 (p-ERK1/2) and c-fos in the retina after injection of BDNF into the vitreous in STZ induced Wistar diabetic rats.MethodsWistar rats aged 9 weeks-old were randomly divided into BDNF injection group,diabetes mellitus (DM) control group and normal control group and 20 rats for each group.STZ was intraperitoneally injected in the rats of BDNF injection group and DM control group to create the experimental DM.BDNF was intravitreously injected in the rats of BDNF group 2 weeks after administration of STZ in three-day interval for 5 times,and BSS containing O.1％ bovine serum albumin (BSA) was used at the same way in the DM control group and normal control group.The retina was isolated for hybridization in situ for BDNF,and TrkB,p-ERK1/2 and c-fos.Levels in retina were detected using sandwich method ELISA.ResultsThe number of BDNF positive cells and the gray scale were lower obviously in the rat retina of DM control group than those of BDNF injection group and normal control group,showing significant differences among the 3 groups ( F =102.36,92.55 ;P＜0.05 ).ELISA assay showed that TrkB,p-ERK1/2 and c-fos values in retina were statistically significantly different among the 3 groups ( F =92.54,95.46,94.84,P＜0.05 ).The TrkB level in retina was statistically reduced,but the p-ERK1/2 and c-fos levels in retina were increased statistically in DM control group compared with BDNF injection group and normal control group( P＜0.05 ).No statistical difference was found in TrkB,p-ERK1/2 and c-fos values between the BDNF injection group and normal control group(P＞0.05).ConclusionsThe injection of BDNF into the vitreous cavity can protect retina from downregulating BDNF and TrkB levels and up-regulating the p-ERK1/2 and c-fos protein levels in the early stage of DM.

Misdiagnosis and management of iatrogenic pseudoaneurysm of vertebral artery after Harms technique of C₁-C₂ fixation / 中华创伤杂志(英文版)

Harms technique of C₁-C₂ fixation for atlantoaxial complex becomes more popular due to good fusion rate and low vertebral artery injury (VAI) rate. But considering the unique and variable anatomy of atlantoaxial complex, iatrogenic VAI will result in catastrophic consequences and provides particular surgical challenges for surgeons. To our knowledge, comparing with iatrogenic VAI in the screw hole, iatrogenic VAI in the "open space" is much rarer during the Harms technique of C₁-C₂ fixation. In this article, we present a case of iatrogenic vertebral artery pseudoaneurysm after Harms technique of posterior C₁-C₂ fixation. This case of iatrogenic VAI effectively treated by endovascular coil occlusion and external local compression was initially misdiagnosed as VAI by pedicle screw perforation. It can be concluded that intraoperative or postoperative computed angiography is very helpful to diagnose the exact site of VAI and the combination of endovascular coil occlusion as well as external local compression can further prevent bleeding and abnormal vertebral artery flow in the pseudoaneurysm. However, patients treated require further follow-up to confirm that there is no recurrence of the pseudoaneurysm.

The significance of change of Th22 cells in patients with acute lymphoblastic leukemia / 中华血液学杂志

<p><b>OBJECTIVE</b>To investigate the proportion of Th22 cells in peripheral blood of patients with acute lymphoblastic leukemia (ALL) and evaluate its significance.</p><p><b>METHODS</b>The proportions of Th22 cells in peripheral blood of B-ALL and T-ALL patients before therapy (group 1), B-ALL and T-ALL patients in complete remission (ALL-CR, group 2) and healthy donors (group 3) were evaluated by flow cytometry. The cytokines IL-22, TGF-β, TNF-α and IL-6 in peripheral blood of each group were measured by enzyme-linked immunosorbent assay (ELISA). The levels of IL-22 mRNA in peripheral blood mononuclear cells of each group were examined by reverse transcription-PCR (RT-PCR).</p><p><b>RESULTS</b>The percentages of Th22 cells and the levels of IL-22, TNF-α, IL-6 and IL-22 mRNA in B-ALL and T-ALL patients before therapy were (0.44 ± 0.10)%, (10.9 ± 3.4) ng/L, (110.7 ± 26.5) ng/L, (60.2 ± 13.8) ng/L, 0.17 ± 0.04 and (0.46 ± 0.11)%, (11.2 ± 3.5) ng/L, (114.6 ± 27.0) ng/L, (58.7 ± 12.4) ng/L, 0.19 ± 0.04, respectively; Which in B-ALL and T-ALL patients in complete remission were(0.59 ± 0.15)%, (14.3 ± 4.1) ng/L, (142.5 ± 32.7) ng/L, (83.7 ± 18.9) ng/L, 0.25 ± 0.06 and(0.60 ± 0.15)%, (14.6 ± 4.3) ng/L, (140.4 ± 31.4) ng/L, (81.4 ± 18.2) ng/L, 0.26 ± 0.06, significantly lower than those in healthy donors \[(1.24 ± 0.31)%, (19.7 ± 6.6) ng/L, (238.3 ± 50.4) ng/L, (138.0 ± 27.1) ng/L, 0.49 ± 0.09\] (P < 0.01). The percentages of Th22 cells and the levels of IL-22, TNF-α, IL-6 and IL-22 mRNA in group l were lower than those in group 2 (P < 0.05), there was not significant difference between B-ALL and T-ALL (P > 0.05). But the levels of TGF-β in B-ALL and T-ALL patients before therapy \[(30.6 ± 8.2) ng/L, (31.4 ± 8.8) ng/L\] and in complete remission \[(24.2 ± 5.8) ng/L, (25.1 ± 6.1) ng/L\] were significantly higher than those in group 3\[(9.6 ± 2.8) ng/L\] (P < 0.01). However, the level of TGF-β in group 1 was higher than that of group 2 (P < 0.05), there was not significant difference between B-ALL and T-ALL (P > 0.05).</p><p><b>CONCLUSION</b>Both the number and function of Th22 cells reduced in ALL patients. Th22 cells might be negatively correlated with ALL progression. The lower levels of TNF-α and IL-6, and overexpression of TGF-β in ALL patients might suppress the differentiation of Th22 cells.</p>

Regulations of function and maturation of plasmacytoid dendritic cells from primary immune thrombocytopenia patients by triptolide / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the mechanism of immunomodulatory activity of triptolide on primary immune thrombocytopenia (ITP)patients-derived plasmacytoid dendritic cells (pDCs).</p><p><b>METHODS</b>pDCs in peripheral blood of ITP patients before therapy (group 1), ITP patients in complete response (ITP-CR, group 2) and healthy donors (group 3) were sorted by flow cytometry, then incubated with triptolide at 0, 5, 10 or 30 µg/L. After 24 hours, we collected the supernatants and then detected the concentrations of IFN-α, IL-6 and TNF-α using ELISA. After 5 days, the cultured cells were collected and CD11c, CD80 and CD86 expressions of myeloid dendritic cells (mDCs) were analyzed by flow cytometry, the morphology of mDC was observed by light microscope and electron microscope.</p><p><b>RESULTS</b>After incubation with triptolide at 10 µg/L, the levels of IFN-α, IL-6 and TNF-α in group 1 \[(451.32 ± 85.77) ng/L, (105.68 ± 23.85) ng/L and (135.78 ± 30.62) ng/L\] and group 2 \[(391.71 ± 72.49) ng/L, (84.73 ± 17.77) ng/L and (108.16 ± 23.21) ng/L\] were significantly higher than those in group 3 \[(335.51 ± 67.54) ng/L, (73.62 ± 21.82) ng/L and (95.58 ± 32.85) ng/L\] (all P < 0.05); the levels of IFN-α, IL-6 and TNF-α in group 1 were significantly higher than those in group 2 (all P < 0.05) in a dose-dependent manner (P < 0.05). CD11c, CD80 and CD86 expressions of mDC in group1 and group 2 were significantly higher than those in group 3 (all P < 0.05); CD11c, CD80 and CD86 expressions of mDC in group 1 were significantly higher than those in group 2 (all P < 0.05) also in a dose-dependent manner (all P < 0.05). Triptolide could inhibit pDCs from differentiation into mDCs, the latter displayed more immature morphology than untreated-pDCs.</p><p><b>CONCLUSION</b>Triptolide could decrease the immune function of pDCs from ITP, inhibit pDCs from differentiation and maturation.</p>

Comparison of screw' inserting angle through the 11th and 12th rib anterior approaches for L1 burst fracture / 中国骨伤

<p><b>OBJECTIVE</b>To compare screw's inserting angle through the 11th and 12th rib in treating L1 burst fracture, explore effects on inserting screw and postoperative angle.</p><p><b>METHODS</b>From October 2007 to October 2010, 108 patients with L1 brust fracture treated through anterior approach were analyzed,including 68 males and 40 females, aged from 21 to 64 years (mean 38.22 years). All patients were divided into the 11th (A, 51 cases) and 12th (B, 57 cases) approach. The data of operation time,blood loss, duration of incision pain, JOA score, Oswestry score, VAS score, quality of life (SF-36), recovery of nervous function, coronal Cobb angle, included angle between screw and plate were observed.</p><p><b>RESULTS</b>All patients were followed up for 9 to 37 months, mean 23 months. The operation time, blood loss, duration of incision pain, in group A were lower than group B (P<0.05), JOA score, Oswestry score, VAS score, SF-36, recovery of nervous function had no significant differences (P>0.05). There were no differences in Cobb angle before operation, but had significance after operation (P=0.000). There were statistically significance between two group in angle between screw and plate (P=0.000, P=0.003).</p><p><b>CONCLUSION</b>The 11th rib approach for the treatment of L1 burst fracture has less effects on screw, less trauma and less angle between screw and plate.</p>

Application of n-HA/PA66 composite artificial vertebral body in anterior reconstruction of lower cervical spine fracture and dislocation / 中华外科杂志

<p><b>OBJECTIVE</b>To initially evaluate the application of artificial vertebra of n-HA/PA66 in anterior reconstruction of lower cervical spine fracture and dislocation.</p><p><b>METHODS</b>In this study, 84 patients with lower cervical spine fracture and dislocation received anterior cervical discectomy, spinal canal decompression or subtotal corpectomy, spinal canal decompression and reconstruction by n-HA/PA66 composite artificial vertebral body combined with plate instrumentation. Neurological function was followed up by improvement rate of Frankel and situations of the supporting body was observed by X ray and 3D-CT in 3, 12, 24 months postoperatively. The intervertebral height, physical arc (reflected by Cobb angle) and the locations and fusion rate of the supporting body were assessed in order to evaluate the stability of the cervical spine and alignment improvements.</p><p><b>RESULTS</b>All the patients underwent operation successfully and were followed up for 6 to 24 months with an average of 12 months. The preoperative symptoms were improved to varying degrees. Imaging studies showed that in all cases graft fusion were achieved, and cervical alignments, intervertebral height, cervical spine stability and the locations of the artificial vertebral body were well maintained. No displacement and subsidence of the artificial vertebral body occurred. Postoperative immediate intervertebral height (2.4 ± 0.2) cm, preoperative intervertebral height (1.9 ± 0.1) cm, comparisons of the two groups was statistically significant (q = 2.48, P < 0.001). The immediate, 3 month, 1 year, 2 year period follow-up group intervertebral height was not statistically significant (P > 0.05). Preoperative Cobb angle was 9.8° ± 1.2°, postoperative immediate Cobb angle was 16.6° ± 1.2°, comparisons of the two groups was statistically significant (q = 14.25, P < 0.001). The immediate, 3 month, 1 year, 2 year period follow-up group Cobb angle was not statistically significant (P > 0.05).</p><p><b>CONCLUSIONS</b>n-HA/PA66 artificial vertebral body can provide early cervical spine support and stability and effectively maintain the biological alignment and cervical intervertebral height. It has high rate of graft fusion and is convenient to observe by X-ray. Therefore, n-HA/PA66 can be taken as an ideal graft for anterior lower cervical spine fracture and dislocation operation, but further follow-up study is still required to evaluate the long-term effects.</p>

Multicenter follow-up study of ankle fracture surgery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Few data on ankle fractures in China from large multicenter epidemiological and clinical studies are available. The aim of this research was to evaluate the epidemiological features and surgical outcomes of ankle fractures by reviewing 235 patients who underwent ankle fracture surgery at five hospitals in China.</p><p><b>METHODS</b>This study included patients who underwent ankle fracture surgery at five Chinese hospitals from January 2000 to July 2009. Age, gender, mechanism of injury, Arbeitsgemeinschaft für Osteosynthesefragen (AO) fracture type, fracture pattern, length of hospital stay and treatment outcome were recorded. Statistical analyses were conducted using SPSS software. The American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, visual analogue scale (VAS), and arthritis scale were used to evaluate outcome.</p><p><b>RESULTS</b>Of 235 patients with ankle fractures, 105 were male with an average age of 37.8 years and 130 were female with an average age of 47.3 years. The average follow-up period was 55.7 months. There were significant differences in the ratios of patients in different age groups between males and females, and in mechanisms of injury among different age groups. There were also significant differences in the length of hospital stay among different fracture types and mechanisms of injury. In healed fractures, the average AOFAS ankle-hindfoot score was 95.5, with an excellence rate of 99.6%, the average VAS score was 0.17, and the average arthritis score was 0.18. Movement of the injured ankle was significantly different to that of the uninjured ankle. There were no significant differences between AO fracture types, fracture patterns or follow-up periods and AOFAS score, but there were some significant differences between these parameters and ankle joint movements, pain VAS score and arthritis score.</p><p><b>CONCLUSIONS</b>Ankle fractures occur most commonly in middle-aged and young males aged 20 - 39 years and in elderly females aged 50 - 69 years. The most common mechanisms of injury are twisting injuries and falls from a standing height or less. The results of surgical treatment are satisfactory.</p>

Design of ABC damage variable and positioning system for acetabular fractures and 1122 cases multi-center statistic analysis / 中国骨伤

<p><b>OBJECTIVE</b>To design ABC damage variable and positioning system for acetabular fracture and explore the feasibility and clinical practical value of the system through the multi-center analysis of 1122 acetabular fractures.</p><p><b>METHODS</b>According to acetabular three-column conception, and pelvic ring lesions damage direction caused by acetabular fracture domino effect and injury degree of proximal femur joint, it defined class A as any column acetabular fracture; class B as any two-column acetabular fracture; class C as front, dome and posterior mixture acetabular fracture. Lower case English letters a, m, p represented front, dome, posterior fracture, respectively. Acetabular damage variables: 1 was simple displaced fractures; 2 was comminuted fractures; 3 was compression fractures. Pelvic ring lesions damage variables: alpha was sacroiliac joints or sacroiliac fracture horizontal separation deflection; beta was sacroiliac joints or sacroiliac fracture vertical separation deflection; gamma was pubic symphysis separation/superior and inferior ramus of pubis fracture deflection; alpha beta gamma delta was compound floating damage. Proximal humerus joint damage variables: I was femoral head fracture; II was femoral neck fracture; II was intertrochanteric fractures of femur; IV was I to III compound fracture. The ABC damage variable positioning system for acetabular fracture was made up by the above-mentioned variables. The statistics from March 1997 to February 2010 showed 1122 cases acetabular fractures with 18 cases of double side acetabular fracture and 1140 cases of acetabular fractures. The pelvics anterior-posterior view, ilium and obturator oblique view, and 2/3D-CT materials were analyzed and researched.</p><p><b>RESULTS</b>Each damage variables distribution situation in 1140 cases of acetabular fracture involved A in 237 cases (20.8%), B in 605 cases (53.1%), C in 298 cases (26.1%);front column fracture in 808 cases(70.9%), dome fracture in 507 cases (44.5%), posterior fracture in 1026 cases (90%). Acetabular variables: variabe 1 in 203 cases of simple displaced fracture (17.8%); variabe 2 in 516 cases of comminuted fracture(45.3%); variabe 3 in 421 cases of compression fracture (36.9%); 249 cases of pelvic ring lesions damage (21.8%), 75 cases femoral head fracture (6.6%); 18 cases of double side acetabular fracture and relative pelvic ring and proximal humerus joint variables (1.58%). Key part and curative effect elements of 1140 cases acetabular fracture: 507 cases of dome or posterior acetabular fracture (44.5%); 421 cases of compression fracture (36.9%); 249 cases of pelvic ring variables (21.8%); 75 cases of proximal humerus joint variables (6.6%); 486 cases of simple Aa/pl/2,Bapl/2 acetabular fracture (42.6% ).</p><p><b>CONCLUSION</b>Compression fracture, especially defected compression fracture, takes important part in acetabular damage variables, and also presents that acetabular fracture with pelvic ring and proximal femoral damage variables are not rare at all. The relationship of the acetabular fracture damage variables, and its percentage shows the key points and elements in clinical treatment: weight-bearing to dome accounts for 44.5%; compression to defects account for 36.9%, pelvic ring to float accounts for 21.8%; dome fracture to double side fracture account for 6.6%. The system has significant guiding effects on clinic in terms of evaluation of injury severity, anatomic localization, difficulty index, alternative strategy, operative approach, effect of treatment,and prognosis. And the most important thing is that the system creates the comparison of damage variables in same type of fracture and the communication of homo-language and explores a new method.</p>

Effect of astragalus polysaccharide on the function and maturation of plasmacytoid dendritic cells from chronic myelogenous leukemia before and after treatment / 中华血液学杂志

<p><b>OBJECTIVE</b>To explore the effect of astragalus polysaccharide (APS) on the function and maturation of chronic myelogenous leukemia (CML) peripheral blood mononuclear cells (PBMC)-derived plasmacytoid dendritic cells (pDCs).</p><p><b>METHODS</b>CML-derived pDCs were sorted by flow cytometry, and then incubated with APS (at 0, 50, 100 and 200 mg/L). After 24 hours, the concentrations of IFN-α, IL-6, TNF-α were detected with ELISA. Five days later, the cultured cells were collected and analyzed for immotype, morphology and ultramicrostructure.</p><p><b>RESULTS</b>The level of IFN-α, IL-6, TNF-α was significantly higher in samples from CML remission group than that in untreated pDCs, and newly diagnosed pDC (P < 0.05) or untreated group. APS could promote more pDCs differentiating to dendritic cells (DCs) in CML remission group than in untreated-pDCs in a dose-dependant manner (P < 0.05).</p><p><b>CONCLUSION</b>APS can enhance the immune function of pDCs, promote differentiation and maturation of pDCs from CML patients.</p>

Effects of tanycytes transplantation on the motor function score and rubrospinal motor evoked potentials of adult rats after spinal cord completely transected / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To determine whether tanycytes be able to support the regeneration of completely transected spinal cord in adult rats.</p><p><b>METHODS</b>Subcultured tanycytes was transplanted into completely T8 transected spinal cord using the untranslated completely transected rats as control. After transplantation the rubrospinal motor evoked potentials were recorded below the injury level at the end of 12th week, assistant by Basso-Beatie-Bresnahan locomotor rating scale and histology method.</p><p><b>RESULTS</b>At the end of 12th week the total peak amplitude of rubrospinal motor evoked potentials (MD = 133.2 microV, P < 0.01) and BBB locomotor rating scale (MD = 5.0000, P < 0.01) were both significantly improved in cell transplanted group compared with that in the untranslated control group, while the latency of the first peak was shortened (MD = 0.061 ms, P = 0.040). HE staining showed more integrity in transected spinal cords in cells transplanted groups.</p><p><b>CONCLUSION</b>Transplanted tanycytes can support the regeneration of transected spinal cords in rats.</p>

Key sperm membrane proteins in sperm-egg fusion / 中华男科学杂志

Fertilization is a complex process involving multiple steps, of which sperm-egg fusion is most important. This article presents a detailed review of some of the key sperm membrane proteins closely related with fertilization, such as the Izumo, the ADAMs gene family and the Crisp gene family proteins, which is of practical significance for deeper insights into the mechanisms of sperm-egg fusion, as well as for the improvement of clinical diagnosis of male infertility and development of novel contraceptive drugs.

Study on genetic polymorphisms of 13 SNP loci in Guangxi Zhuang population of China / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>The fluorescence labeled multi-PCR system was applied to investigate the allele frequency of the 13 single nucleotide polymorphism (SNP) in 314 Guangxi Zhuang populations, and to evaluate their application value in forensic medicine.</p><p><b>METHODS</b>Thirteen autosomal diallelic SNP loci were selected and the SNP genotyping system of fragment length discrepant allele specific fluorescence labeled multi-PCR technique was applied to investigate their allele frequency distribution in Guangxi Zhuang population.</p><p><b>RESULTS</b>The allele frequencies of the 13 single nucleotide pdymorphism (SNP) in Guangxi Zhuang population were obtained, which shows that the allele frequency distribution is in accordance with Hardy-Weinberg equilibrium. Their heterozygosity was between 0.2166 and 0.5478, the polymorphism information content was between 0.2084 and 0.3750, their cumulate discrimination probability was 99.99%, and the cumulate exclusion power was 87.71%.</p><p><b>CONCLUSION</b>Several SNP loci could be genotyped simultaneously using the fluorescence labeled fragment length discrepant multiplex-PCR technique; the 13 SNP loci have a highly applicable value in the field of forensic personal identification.</p>

A new method for SNP typing based on allele specific PCR / 法医学杂志

OBJECTIVE@#To establish a new method of SNP typing.@*METHODS@#Based on the principle of allele specific PCR and capillary electrophoresis technique, 11 diallelic SNP loci were selected and two forward primers with different length were designed for each SNP, with their 3' ends matched to the two alleles, respectively. An artificially mismatched base was also introduced into the third or fourth base in the 3' end area of the two forward primers in order to enhance the specificity of amplification. A common reverse primer was designed 100-300 bp away from the forward primers, and labeled with fluorescence. The PCR products were separated and analyzed by ABI Prism 310 Genetic Analyzer after all of the 11 SNPs were multiply amplified.@*RESULTS@#A single product peak was observed while the SNP was homozygous, and two product peaks with different height were observed while the SNP was heterozygous. The length of PCR products was different with the different SNPs. According to the length of the products and the number of the product peaks, the genotypes of the 11 SNPs can simultaneously be analyzed, and the results were in accordance with the direct sequencing.@*CONCLUSION@#Fragment length discrepant allele specific fluorescence labeled multi-PCR (FLDASFLM-PCR) is a simple, rapid and efficient new method for SNP typing.