Efficacy and Safety of Decitabine Combined with Modified EIAG Regimen in the Treatment of Patients with Relapsed/Refractory Acute Myeloid Leukemia and High-risk Myelodysplastic Syndrome / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy, prognosis and safety of decitabine combined with modified EIAG regimen in the treatment of patients with relapsed/refractory acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS).@*METHODS@#The clinical data of 44 patients with relapsed/refractory AML and high-risk MDS admitted to our hospital from January 2017 to December 2020 were analyzed retrospectively. The patients were equally divided into D-EIAG group (decitabine combined with EIAG regimen) and D-CAG group (decitabine combined with CAG regimen) according to clinical treatment regimen. The complete response (CR), CR with incomplete hematologic recover (CRi), morphologic leukemia-free state (MLFS), partial response (PR), overall response rate (ORR), modified composite complete response (mCRc), overall survival (OS) time, 1-year OS rate, myelosuppression and adverse reactions between the two groups were compared.@*RESULTS@#In D-EIAG group, 16 patients (72.7%) achieved mCRc (CR+CRi+MLFS), 3 patients (13.6%) achieved PR, and ORR (mCRc+PR) was 86.4%. In D-CAG group, 9 patients (40.9%) achieved mCRc, 6 patients (27.3%) achieved PR, and ORR was 68.2%. Difference was observed in mCRc rate between the two groups (P=0.035), but not in ORR (P>0.05). The median OS time of D-EIAG group and D-CAG group was 20 (2-38) months and 16 (3-32) months, and 1-year OS rate was 72.7% and 59.1%, respectively. There was no significant difference in 1-year OS rate between the two groups (P>0.05). After induction chemotherapy, the median time for absolute neutrophil count recovery to 0.5×109/L in D-EIAG group and D-CAG group was 14 (10-27) d and 12 (10-26) d, for platelet count recovery to 20×109/L was 15 (11-28) d and 14 (11-24)d, the median red blood cell suspension transfusion volume was 8 (6-12) U and 6 (6-12) U, and the median apheresis platelet transfusion volume was 4 (2-8) U and 3 (2-6) U, respectively. There were no statistically significant differences in comparison of the above indicators between the two groups (P>0.05). The hematological adverse reactions of patients were mainly myelosuppression. Grade III-IV hematological adverse events occurred in both groups (100%), with no increase in the incidence of non-hematological toxicities such as gastrointestinal reactions or liver function damage.@*CONCLUSION@#Decitabine combined with EIAG regimen in the treatment of relapsed/refractory AML and high-risk MDS can improve remission rate, provide an opportunity for subsequent therapies, and have no increase in adverse reactions compared with D-CAG regimen.

Thinking on standardized teaching mode of clinical probation in non-directly-administered affiliated hospitals / 中华医学教育探索杂志

At present, the non-directly-administered affiliated hospitals generally have some problems in the teaching of clinical probation such as weak subjective teaching consciousness, few full-time teaching administrators, insufficient investment in teaching facilities, uneven teaching levels, unclear division of responsibilities and so on. Based on this, it is proposed to adopt the measures of strengthening consciousness, creating process and strengthening examination to explore the standardized teaching methods of clinical probation from four aspects: making clear the teaching purpose of the probation, making good preparation for the probation teaching, refining the teaching process of the probation teaching and paying attention to the actual effect evaluation after the probation, so as to improve the quality of clinical probation teaching in non-directly-administered affiliated hospitals.

Association between plasma inflammatory mediators and histological endotypes of nasal polyps / 中华耳鼻咽喉头颈外科杂志

Objective: To compare the clinical characteristics and plasma inflammatory markers levels in different endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP), and to explore the plasma biomarkers associated with endotypes of CRSwNP. Methods: A total of 74 CRSwNP patients (male/female: 41/33; average age: 40 years) and 40 control subjects underwent septoplasty in Tongji Hospital from January 2015 to December 2017 were enrolled in this study. The demographic and clinical features of all subjects including age, gender, past history, visual analogue scale (VAS) and CT scores were recorded. Patients with CRSwNP were divided into EoshighNeuhigh, EoshighNeulow, EoslowNeuhigh and EoslowNeulow four endotypes according to the eosinophil (Eos) percentage and neutrophil (Neu) count of nasal polyps tissue. Preoperative blood routine was performed and the levels of 27 biomarkers in plasma were measured by Bio-Plex suspension chip method. The clinical characteristics and the level of serum biomarkers of patients with different endotypes were compared. SPSS 18.0 software was used for statistical analysis. Results: There was no difference in the clinical features including gender ratio, age, course of disease, VAS score, endoscopy and CT score among EoshighNeuhigh, EoshighNeulow, EoslowNeuhigh and EoslowNeulow CRSwNP patients. Compared with EoslowNeuhigh and EoslowNeulow CRSwNP patients, patients with EoshighNeuhigh and EoshighNeulow endotype demonstrated a higher prevalence of atopy, allergic rhinitis and asthma comorbidity, and increased peripheral blood eosinophil absolute count and percentage (all P<0.05). However, there was no significant difference between EoshighNeuhigh and EoshighNeulow CRSwNP. Plasma levels of all 27 mediators including type 1 cytokines (IL-12 and IFN-γ), type 2 cytokines (IL-4, IL-5 and IL-13), type 3 cytokines (IL-17A), pro-inflammatory cytokines (IL-6 and TNF-α) and tissue remodeling-related markers (bFGF, VEGF and PDGF-BB) demonstrated no significant difference among all endotypes of CRSwNP (all P>0.05). Conclusions: Eoshigh and Eoslow CRSwNP patients display significant differences regarding the prevalence of atopy, allergic rhinitis and asthma comorbidity, peripheral blood eosinophil absolute count and percentage, but the clinical characteristics, blood cellular and biological markers can not effectively distinguish four endotypes of CRSwNP. Further studies are warranted to dig out the potential objective, convenient and reliable markers associated with endotypes in patients with CRSwNP.

Factors Defining the Development of Severe Illness in Patients with COVID-19: A Retrospective Study / 生物医学与环境科学（英文）

Objective@#Early triage of patients with coronavirus disease 2019 (COVID-19) is pivotal in managing the disease. However, studies on the clinical risk score system of the risk factors for the development of severe disease are limited. Hence, we conducted a clinical risk score system for severe illness, which might optimize appropriate treatment strategies.@*Methods@#We conducted a retrospective, single-center study at the JinYinTan Hospital from January 24, 2020 to March 31, 2020. We evaluated the demographic, clinical, and laboratory data and performed a 10-fold cross-validation to split the data into a training set and validation set. We then screened the prognostic factors for severe illness using the least absolute shrinkage and selection operator (LASSO) and logistic regression, and finally conducted a risk score to estimate the probability of severe illness in the training set. Data from the validation set were used to validate the score.@*Results@#A total of 295 patients were included. From 49 potential risk factors, 3 variables were measured as the risk score: neutrophil to lymphocyte ratio ( @*Conclusion@#This report may help define the potential of developing severe illness in patients with COVID-19 at an early stage, which might be related to the neutrophil to lymphocyte ratio, albumin, and chest computed tomography abnormalities.

Effect of new simple breathing apparatus on oxygen therapy in patients with severe and critical coronavirus disease 2019 / 中华危重病急救医学

Objective:To make a new simple respirator and observe the oxygen therapy effect of the respirator on patients with severe and critical coronavirus disease 2019 (COVID-19).Methods:Based on the infectivity and hospital requirements of COVID-19, a new simple respirator was designed by the medical staff of the Department of Anesthesiology of the Second Affiliated Hospital of Nanchang University, which was applied on the 22 patients with severe and critical COVID-19 who needed oxygen therapy admitted to the Cancer Center of Tongji Medical College of Huazhong University of Science and Technology from February 15th to March 15th in 2020. The new simple respirator contained two National Utility Model Patents (a respirator: ZL 2015 2 0410623.6, a fluid switch and oxygen suction device: ZL 2017 2 0873509.6), which was mainly composed of anesthesia mask and filter, L-shaped connecting tube, soft breathing bladder, connecting tube and elastic fixing belt. When in use, the anesthesia mask was fixed to the patient's mouth and nose with elastic straps, the connecting tube was inserted into the oxygen meter interface, the oxygen flow was adjusted to 6-10 L/min, and the L-shaped connecting tube was opened immediately after the soft breathing bag was full. The carbon dioxide and excess oxygen in the body was discharged from exhaust port. The oxygen flow was lowered to 2-3 L/min, the patient's respiratory rate (RR) was observed through the soft breathing bag fluctuations, and the oxygen flow was adjusted at any time. The changes of pulse oxygen saturation (SpO 2), RR and heart rate (HR) before and after application of new simple respirator were observed, and the blood gas test results of part of the patients were collected. Results:Twenty-two patients with severe and critical COVID-19 had significantly higher SpO 2 at 10 minutes after application of the new simple ventilator than before application (0.994±0.007 vs. 0.952±0.017, P < 0.01), and RR was significantly lower than that before application (times/min: 27.59±3.63 vs. 29.64±3.81, P < 0.01); after 1 day of application, each index was further improved. All 13 patients who received blood gas analysis indicated no carbon dioxide accumulation. Conclusions:The new simple respirator can significantly improve the oxygen therapy effect of patients with severe and critical COVID-19. At the same time, 2019 novel coronavirus (2019-nCoV) can be filtered through the filter to reduce the formation of aerosol and protect the medical staff and patients.

Analysis of the related factors of fever of unknown causes before operation of intertrochanteric fracture in the elderly / 中国骨伤

OBJECTIVE@#To explore the related factors of fever of unknown causes before operation of intertrochanteric fracture of femur in the elderly.@*METHODS@#From August 2015 to August 2018, 156 cases of intertrochanteric fracture of femur were treated by intramedullary nail fixation. According to the preoperative measurement, whether there was fever was divided into fever group and non fever group. There were 80 cases in fever group, 26 males and 54 females, aged 60 to 93 (75.063±13.082) years; 76 cases in non fever group, 39 males and 37 females, aged 60 to 96 (74.763±13.692) years. All patients' sex, age, basic diseases, WBC, NE%, Hb, CRP, D dimer and ALB were observed for single factor analysisand multi factor analysis.@*RESULTS@#Single factor analysis showed that gender, Hb, CRP had influence on preoperative fever, but other indexes had no influence; multi factor analysis showed that gender and CRP might have influence on fever. The probability of fever increased by 1.2%(=0.050) for every increase of CRP, and there was no significant difference between female and male in the probability of fever (=0.061).@*CONCLUSION@#CRP is an independent risk factor of preoperative fever in the elderly patients with intertrochanteric fracture of femur. The abnormality of CRP indicates that patients are more likely to have preoperative fever. Perioperative management should pay attention to the monitoring of CRP and early intervention.

Analysis of Medical Cases of Coronavirus Disease-2019 Treated with Haoqin Qingdantang / 中国实验方剂学杂志

Coronavirus disease-2019 (COVID-19) is highly contagious. In the early stages of the disease, the symptoms of coldness, dampness and depression in the lungs often appear, including fever, fatigue, soreness, dry cough, poor appetite, and white greasy tongue coating. During the development of the disease, the damp toxin epidemic often enters the inner and generates heat, and the damp heat epidemic toxin blocks pleurodiaphragmatic sites, the triple energizer and lungs, with manifestations of chest tightness, shortness of breath, exacerbation after exercise, or high fever without bringing down, poor appetite, bitterness in mouth, fatigue, diarrhea, loose stools, and yellow and thick tongue fur. As the pathogen can go outward or enter more deeply inside to cause death at the moment, it is the crucial time to treat the disease. In this study, Haoqin Qingdantang was used to clear dampness and heat, reconcile Shaoyang channel and recover the triple energizer, detoxify the dampness fever epidemic toxin, and block the toxin inside, with a good efficacy. This prescription focuses on smoothing the Shaoyang gallbladder channel and the triple energizer, and regards the spleen and stomach as the acquired essence. In the prescription, Erchentang reconciles the spleen and stomach, elevates clear Qi and lower turbid Qi. Bupleuri Radix is added to increase its detoxification function, and Paeoniae Rubra Radix is added to circulate the blood and prevent pathogen from the blood. When the condition improves, Sweet Wormwood Herb and talc are often withdrawn, and Codonopsis is added to nourish the spleen and stomach, to strengthening vital qi to eliminate pathogenic factor. Based on the cases of COVID-19 treated in Wuhan Jinyintan Hospital, this paper summarized some experience of applying Haoqin Qingdantang.

Experience in Treatment of COVID-19 by Elimination of Pathogens Through Purgation and Diuresis / 中国实验方剂学杂志

Coronavirus disease-2019 (COVID-19) outbreaks were spreading rapidly around the world in early 2020. This disease is within the category of "damp epidemic" and "damp toxin epidemic" in traditional Chinese medicine, with lung and spleen as the lesion focuses, while dampness and toxin as especially prominent properties. Through clinical observation, we found that dampness would often transform into damp heat during the development and evolution of the disease, and the "triple energizer" treatment was an important therapeutic method, eliminating pathogens through purgation and diuresis: for those with damp-heat accumulation toxin diffused to the triple energizer, we could use Ganlu Xiaodudan as primary prescription, which can spread the upper part, smooth the middle part and infiltrate the lower part, so as to provide a way out for the pathogenic factors and regulate Qi movement. For those with damp-heat in Shaoyang channel, we could use Haoqin Qingdantang to clear heat and promote diuresis, harmonize Shaoyang, eliminate damp-heat and epidemic pathogenic factor. For those with pathogen hidden in membrane source dampness trapping and hidden heat, we could use Dayuanyin to eliminate pathogens between interior and exterior parts, and regulate Qi movement. At the same time we shared three typical cases treated in Wuhan, and conducted an in-depth analysis in this study. Clinically, the method of elimination of pathogens through purgation and diuresis is mainly used in the early and middle stage of this disease. When the disease is still located in Qi system, it also can be applied to mild, ordinary patients and severe patients that have accurate syndrome differentiation. In such cases, it can effectively improve symptoms, reduce pathogenic toxin, truncate and reverse the course of disease, give way to pathogen, and avoid disease aggravating.

Mechanism action of Chinese herbal compound and target network pharmacology of / 中国骨伤

OBJECTIVE@#To explore compounds, targets and mechanism of @*METHODS@#The known effective Chinese herbal compound of YG pill was searched from traditional Chinese medicine integrated database(TCMID). Bioinformatics analysis tool for molecular mechanism of traditional Chinese medicine (BATMAN-TCM) was used to predict target of components;DisGeNET and artificial literature reading were used to obtain targets of osteoporosis and bone remodeling;Cytoscape 3.7.1 software and its plug-ins BiN-GO and ClueGO were used to enrich the GO annotation and pathwaysof the related targets, and validation of the predicted target of YG pill were validated by 87 differentially expressed proteins in postmenopausal osteoporosis and postmenopausal osteoporosis disease models in postmenopausal patients with normal bone mass from the previous serum proteomics data.@*RESULTS@#Totally 392 compounds were retrieved from YG pill, including 83 sovereign drugs (monkshood, cinnamon, deerhorn gelatin), 127 ministerial drugs (prepared rehmannia root, dogwood, wolfberry fruit and Chinese yam) and 182 supplementary drugs (cuscuta chinensis, eucommia ulmoides and Chinese angelica). Among them, there were 4 same compounds between sovereign drug and ministerial drug, 1 same compound between sovereign drug and supplementary drug, and 14 same compounds between ministerial drug and supplementary drug. Totally 2 112 trusted targets were identified, included 775 sovereign drugs, 1 483 ministerial drugs and 1 491 supplementary drugs;227 targets were selected from YG pill for treating osteoporosis, which participate in nearly 20 process of metabolic process, cell differentiation and biology, and data mining revealed that the process involved bone remodeling and bone mineralization. Acting site of cell mainly inclded 9 kinds of cell which had 13 molecular function. Results of KEGG metabolic pathway enrichment analysis showed 137 signal passages were obviously enriched. Among them, classical osteoclast differentiation signal passages and relative estrogen regulates signaling pathways of menopause were widely distributed in 27 signal passages. Sixtargets were screened by target validation, such as AGT, FGA, APOE, DKK3, P4HB and RAB7A.@*CONCLUSION@#The characteristics of multi-targets and multi-pathways of YG pill for the treatment of osteoporosis were clarified, which provided a clear direction for the in-depth research. The pharmacodynamic components of YG pill include 36 compounds, and their main action targets include FGA, AGT, APOE, DKK3, P4HB and RAB7A.

Introduction and reflection on the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine / 中华医学教育探索杂志

Taking the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine as an example, the cultivation models for comprehensive quality of medical students in China and Canada was compared. In University of Ottawa faculty of medicine, the curriculum "society, the individual & medicine" is throughout the whole medical education, including three themes of statistics and epidemiology related knowledge, health related issues and professional development. The varied teaching modes are combined with electronic teaching equipment and students' subjectivity in learning is emphasized. Drawing insights from the medical education in Canada, we should focus on promoting early contact and lifelong study of medical humanities curriculum for medical students, enriching the curriculum content, enhancing the curriculum practicality, diversifying the teaching methods, strengthening the teachers' training, improving the assessment system and establishing the long-term mechanism.

Introduction and reflection on the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine / 中华医学教育探索杂志

Taking the curriculum "society, the individual & medicine" in university of Ottawa faculty of medicine as an example, the cultivation models for comprehensive quality of medical students in China and Canada was compared. In University of Ottawa faculty of medicine, the curriculum "society, the individual&medicine" is throughout the whole medical education, including three themes of statistics and epidemiology related knowledge, health related issues and professional development. The varied teaching modes are combined with electronic teaching equipment and students' subjectivity in learning is emphasized. Drawing insights from the medical education in Canada, we should focus on promoting early contact and lifelong study of medical humanities curriculum for medical students, enriching the curriculum content, enhancing the curriculum practicality, diversifying the teaching methods, strengthening the teachers' training, improving the assessment system and establishing the long-term mechanism.

The Mediating Effect of Body Dissatisfaction in Association between Obesity and Dietary Behavior Changes for Weight Loss in Chinese Children / 生物医学与环境科学（英文）

OBJECTIVE@#The aim of this study was to analyze the mediating effect of body dissatisfaction in correlation between obesity and dietary behavior changes for weight loss (DBCWL).@*METHODS@#A total of 680 primary and middle school students were included in this study. Their body height, weight, and waistline were effectively measured, and they were also evaluated to assess their body dissatisfaction, perception of dietary behaviors, and DBCWL. The correlation among these factors was analyzed using mediating effect models.@*RESULTS@#The prevalence of overweight/obesity and abdominal obesity was significantly higher in males than in females (P < 0.05). Overweight/obesity, abdominal obesity, and body dissatisfaction significantly increased the risk for DBCWL (OR = 2.57, 2.77, and 1.95, respectively). Overweight/obesity and abdominal obesity significantly increased the risk for body dissatisfaction (OR = 6.00 and 4.70, respectively). Significant mediating effects of body dissatisfaction were observed in correlation between overweight/obesity and DBCWL and between abdominal obesity and DBCWL (OR = 2.20 and 1.92, respectively; P < 0.05), and the proportions of mediating effects among the total effects were 48.89% and 46.60%, respectively.@*CONCLUSION@#Body dissatisfaction might play an important mediating effect in association between DBCWL and obesity, which indicates that guiding children to correctly recognize their body might be more conducive than promoting obese children toward weight loss through dietary behavior changes.

Analysis of Related Factors Affecting the Nosopoiesis of Childhood Acute Leukemia / 中国实验血液学杂志

OBJECTIVE@#To analyze the related factors affecting the nosopoiesis of childhood acute leukemia from the perspective of indoor environmental exposure, behavior and lifestyle.@*METHODS@#The clinical data of 64 children with acute leukemia were retrospectively analyzed, and 50 healthy children were selected as the control group during the same period. The basic data of children, indoor environment, behavior and lifestyle of parents in 2 groups were recorded. Univariate and multivariate logistic regression analysis were used to analyze the related factors affecting the incidence of childhood acute leukemia, and the OR (95%CI) value was calculated.@*RESULTS@#The unvariate analysis showed that the daily wine-drinking rate of father and pesticide use rate in acute leukemia group were significantly higher than those in control group (P<0.05). Multivariate Logistic regression analysis showed that indoor ventilation during summer sleep of children (OR=0.35, 95%CI: 0.14-0.88) and contact with other children before 3 years old (OR=0.34, 95%CI: 0.18-0.65) were protective factors for provention of childhood acute leukemia (P<0.05). Mothers had a history of exposure to chemical substances (OR=3.68, 95%CI: 1.64-8.27), and children had a history of exposure to chemical substances (OR=3.84, 95%CI: 1.64-9.01), family had internal decoration history after child birth (OR = 1.38, 95%CI: 1.05-1.81) and family uses of pesticides (OR=2.17, 95%CI: 1.08-4.36), all these factors were independent risk factors for acute leukemia (P<0.05).@*CONCLUSION@#Indoor environmental exposure, behavior and lifestyle of children and parents may be closely related with the nosopoiesis of childhood acute leukemia.

Inspiration of Canadian medical education curriculum system to medical education in China: A case analysis of Ottawa University School of Medicine / 中华医学教育探索杂志

Canada is one of the leading countries in the world with a leading position in medical education and high quality of medical education.Based on the Ottawa-Shanghai joint medical school collaborative program,this article introduces and analyzes the curriculum system of University of Ottawa School of Medicine.The curriculum is designed based on organs and systems,with a focus on the integration of basic and clinical research from the early stage.It adopts a diversified and student-centered teaching method,with practice teaching running through the whole course.Moreover,it attaches importance to family medical education and strengthens the cultivation of medical humanities.Learning from the advanced teaching concepts and methods in North America may help to promote the reform of medical education in China and cultivate high-quality medical talents in line with international standards.

Effect of stellate ganglion block on vascular cognitive impairment in rats / 中华麻醉学杂志

Objective To evaluate the effect of stellate ganglion block (SGB) on vascular cognitive impairment (VCI) in rats.Methods Forty SPF healthy male Sprague-Dawley rats,aged 4-6 weeks,weighing 200-220 g,were divided into 4 groups (n =10 each) using a random number table method:sham operation group (group Sham),VCI group,right SGB group (group R) and left SGB group (groupL).VCI was induced by permanently ligating bilateral common carotid arteries of anesthetized rats.SGB model was established by transection of the left and right cervical sympathetic trunk while establishing the VCI model in group L and group R,respectively.At 8 weeks after establishing VCI model,Morris water maze test was performed to evaluate the spatial learning and memory abilities,serum neuron-specific enolase (NSE) and S100β protein concentrations were determined by enzyme-linked immunosorbent assay,the hippocampal superoxide dismutase (SOD) activity and malondialdehyde (MDA) contents were measured using microplate method,and the expression of peroxisome proliferator-activated receptor gamma coactivator1α (PGC-1α),NADPH oxidase 1 (NOX1),zonula occludens-1 (ZO-1),and claudin-5 was detected by Western blot.Results Compared with group Sham,the escape latency was significantly prolonged,the time of staying at the target quadrant was shortened,the hippocampal MDA content and concentration of serum S100β protein and NSE were increased,hippocampal SOD activity was decreased,the expression of PGC-1α,ZO-1 and claudin-5 was down-regulated,and the expression of NOX1 was up-regulated in group VCI (P＜0.05).Compared with group VCI,the escape latency was significantly shortened,the time of staying at the target quadrant was prolonged,the hippocampal MDA content and concentration of serum S100β protein and NSE were decreased,hippocampal SOD activity was increased,the expression of PGC-1α,ZO-1 and claudin-5 was up-regulated,and the expression of NOX1 was down-regulated in group R,and the escape latency was significantly prolonged,the hippocampal SOD activity was increased,the MDA content was decreased,and the expression of NOX1 was down-regulated in group L (P＜0.05).Compared with group R,the escape latency was significantly prolonged,the time of staying at the target quadrant was shortened,the hippocampal MDA content and serum NSE concentration were increased,the hippocampal SOD activity was decreased,the expression of PGC-1α and claudin-5 was down-regulated,and the expression of NOX1 was up-regulated in group L (P＜0.05).Conclusion SGB can alleviate VCI,and left SGB produces better efficacy than right SGB,and the mechanism may be related to inhibiting the oxidative stress responses and reducing the damage to blood brain barrier in rats.

Inhibition of CD38/Cyclic ADP-ribose Pathway Protects Rats against Ropivacaine-induced Convulsion / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The CD38/cyclic ADP-ribose (cADPR) pathway plays a role in various central nervous system diseases and in morphine tolerance, but its role in local anesthetic intoxication is unknown. The aim of this study was to determine the role of the CD38/cADPR pathway in ropivacaine-induced convulsion.</p><p><b>METHODS</b>Forty male Sprague-Dawley rats were randomly divided into five groups (n = 8 per group): sham group, ropivacaine group, ropivacaine+8-Br-cADPR (5 nmol) group, ropivacaine+8-Br-cADPR (10 nmol) group, and ropivacaine+8-Br-cADPR (20 nmol) group (no rats died). Rats were intracerebroventricularly injected with normal saline or 8-Br-cADPR 30 min before receiving an intraperitoneal injection of ropivacaine. Electroencephalography and convulsion behavior scores were recorded. The hippocampus was harvested from each group and subjected to nicotinamide adenine dinucleotide and cADPR assays, Western blotting analysis, and malondialdehyde (MDA) and superoxide dismutase (SOD) assays.</p><p><b>RESULTS</b>Intraperitoneal injection of ropivacaine (33.8 mg/kg) induced convulsions in rats. CD38 and cADPR levels increased significantly following ropivacaine-induced convulsion (P = 0.031 and 0.020, respectively, compared with the sham group). Intraventricular injection of 8-Br-cADPR (5, 10, and 20 nmol) significantly prolonged convulsion latency (P = 0.037, 0.034, and 0.000, respectively), reduced convulsion duration (P = 0.005, 0.005, and 0.005, respectively), and reduced convulsion behavior scores (P = 0.015, 0.015, and 0.000, respectively). Intraventricular injection of 8-Br-cADPR (10 nmol) also increased the B-cell lymphoma-2 (Bcl-2)/Bcl-2-associated X protein ratio (P = 0.044) and reduced cleaved Caspase 3/Caspase 3 ratio, inducible nitric oxide synthase, MDA and SOD levels (P = 0.014, 0.044, 0.001, and 0.010, respectively) compared with the ropivacaine group.</p><p><b>CONCLUSIONS</b>The CD38/cADPR pathway is activated in ropivacaine-induced convulsion. Inhibiting this pathway alleviates ropivacaine-induced convulsion and protects the brain from apoptosis and oxidative stress.</p>

Micro-CT evaluating inhibitory effect of zoledronic acid on polyethylene particle-induced periprosthetic osteolysis model / 中国骨伤

<p><b>OBJECTIVE</b>To observe inhibitory effect of zoledronic acid on polyethylene particle-induced periprosthetic osteolysis model.</p><p><b>METHODS</b>Thirty male adult specific-pathogen-free SD rats (weighted 250 to 300 g) were randomly divided into sham group, model group, and zoledronic acid group, 10 in each group. Modeling were building by titanium screws and polyethylene particles implanted into right femur of rats, sham group and model group were performed hypodermic injection by 0.9% saline with 2 ml/kg, zoledronic acid with 0.1 ml/mg were injected into zoledronic acid group, once a week for 8 weeks. After 8 weeks, right femur specimens were drawn and used to san microstructure of femoral cancellous bone in rats model was examined by Micro-CT, and the images were treated with three-dimension reconstruction and analysis software BMD, BV/TV, Tb.N, Tb.Th, SMI, BS/BV, Tb.Sp and Tb.Pf and other parameters include.</p><p><b>RESULTS</b>According to Micro-CT three-dimensional imaging, BMD in model group was significantly decreased than sham group, bone microstructure damage was serious, bone trabecula changed thinning continuity; while bone microstructure was obviously improved compared with model group and zoledronic acid group. After analyzing Micro-CT parameters of femur microstructure, BMD in model group(0.081±0.020) was significantly decreased than control group(0.160±0.018) and zoledronic acid group(0.125±0.012); BV/TV in model group (10.563±1.070) was obviously lower than control group(27.935±1.834) and zoledronic acid group(14.559±1.258); Tb.N in model group (1.005±0.165) was lower than control group(2.058±0.108) and zoledronic acid group(1.515±0.126); while Tb.Th in model group (0.075±0.016) was decreased than control group(0.158±0.016) and zoledronic acid group(0.124±0.011). Meanwhile, SMI in model group(1.817±0.127) was significantly higher than control group(1.104±0.120) and zoledronic acid group(1.547±0.122); BS/BV in model group(35.784±1.650) was higher than control group(21.506±2.771) and zoledronic acid group(30.399±2.730); Tb.Sp in model group(0.735±0.107) was higher than control group(0.423±0.057) and zoledronic acid group(0.577±0.082), TB.Pf in model group(9.088±1.283) was higher than control group(2.447±0.703) and zoledronic acid group(5.862±1.042).</p><p><b>CONCLUSIONS</b>Zoledronic acid could change bone microstructure of rats to inhibit polyethylene particle-induced bone solution, which provides a scientific basis for prevent bone solution by zoledronic acid as a therapeutic intervention.</p>

Effect of Interferon Combined with Thalidomid on HEL Cell Apoptosis and JAK2V617F Mutation Gene Expression / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effects of interferon-α2b combined with thalidomid(THD) on the proliferation and apoptosis of HEL cells, and expression of JAK2V617F-mutated gene.</p><p><b>METHODS</b>The cell survival rates were assayed by CCK-8 after HEL cells were treated by interferon-α2b, thalidomid and thalidomid combined with interferon-α2b for 24, 48 and 72 hours, while the apoptosis and expression of JAK2V617F mutation gene were detected by flow cytometry and fluorescence quantitative PCR respectively after treatmemt for 48 hours.</p><p><b>RESULTS</b>IFN-α2b combined with THD could more obviously inhibit the proliferation of HEL cells than IFN-α2b or THD alone for 24 and 48 and 72 hours, and the differences between groups were statistically significant(P<0.05). In addition, the apoptosis-inducing effect of IFN-α2b combined with THD on HEL cells was more obvious than that of IFN-α2b used alone, the differences was statistically significant(P<0.05). Although IFN-α2b combined with THD can decrease the JAK2V617F mutation gene expression more obviously than IFN-α2b alone,but the difference was no statistically significant (P>0.05). And the remaining groups showed statistically significance(P<0.05).</p><p><b>CONCLUSION</b>IFN-α2b combined with THD can obviously inhibit the proliferation and induce apoptosis of HEL cells more than that of IFN-α2b alone, but the effect of reducing JAK2V617F mutation gene expression is not different.</p>

Clinical observation of improved proximal femoral locking plate in treating osteoporotic intertrochanteric fractures / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effects of proximal femoral locking plate (PFP) in treating osteoporotic intertrochanteric fractures and to analyze the failure cases.</p><p><b>METHODS</b>Totally 32 patients with osteoporotic intertrochanteric fractures of Evans I and II were treated with improved locking PFP, including 17 males and 15 females with an average age of 77.3 years old ranging from 70 to 86 years old. After operation, according to Harris hip scores, the hip function and therapeutic effects were evaluated.</p><p><b>RESULTS</b>The observed 32 patients' operative time was (60.5±15.7) min, intraoperative blood loss was (128.8±73.6) ml;perioperative blood transfusion was (224.0±72.7) ml. Hospitalization time was from 14 to 20 d with an average of 17.2 d. All patients were followed up from 6 to 18 months with an average of 14.1 months. The fracture healing time was from 3 to 6 months with an average of 3.1 months. One patient occurred internal fixation loosening and screw backward, 4 cases occurred urinary tract infection, 1 patient died of cardiovascular disease for 6 months postoperative, 2 patients died of a stroke for 1 year postoperative. No incision deep infection, peri internal fixation fractures, lower extremity deep venous thrombosis, internal fixation breakage, nonunion, severe coax vara and coax valgus occurred. The final Harris score was 89.74±6.84, the result was excellent in 10 cases, good in 16 cases, fair in 4 cases, and poor in 2 cases.</p><p><b>CONCLUSIONS</b>Locking PFP can provide relative stable fixation to proximal end of osteoporotic femoral fractures, which is a good choice for the treatment of intertrochanteric fractures. It could provide stableness of fractures and bone union, even avoid screws loose or slide out.</p>

Research progress on wear particles and periprosthetic osteolysis after artificial joint replacement / 中国骨伤

It is an important influencing factor that the generated wear particles lead to periprosthetic osteolysis after artificial joint replacement. Current research suggests that the primary cause of wear particles results in periprosthetic osteolysis is relate to the prosthetic materials and the stimulations because of these materials generated wear particles to relevant cells such as macrophage, osteoblast, osteoclast. Induced a variety of inflammatory cytokines, activating and openning the cell signal and channels, producing the long term chronic inflammation leads to periprosthetic osteolysis. Therefor, the paper mainly studies the different types of wear particles influence on periprosthetic osteolysis, and the wear particles around the periprosthetic osteolysis mechanism in the process of progress, moreover, to explore how to reduce the occurrence of wear particles and blocking its role in the periprosthetic osteolysis, in order to achieve the purpose of prevention and treatment of periprosthetic osteolysis.