Effect of morphological changes in the sagittal plane of vertebrae and discs on degenerative kyphodeformity / 中国骨伤

OBJECTIVE@#To explore the effects of morphological changes such as vertebral wedge deformation and disc degeneration (collapse) on adult thoracolumbar/lumbar degenerative kyphosis(TL/LDK) deformity.@*METHODS@#A retrospective analysis of 32 patients with spinal TL/LDK deformity admitted from August 2015 to December 2020, including 8 males and 24 females, aged 48 to 75(60.3±12.4) years old. On the long-cassette standing upright lateral radiographs, the coronal Cobb angle, sagittal thoracic lumbar/lumbar kyphosis angle(KA) of spine were measured, and the height and wedge parameters of apex vertebral(AV) and two vertebrae(AV-1, AV-2, AV+1, AV+2) above and below AV and the intervertebrae and the intervertebral disc(AV-1D, AV-2D, AV+1D, AV+2D) were evaluated, involving anterior vertebral body height(AVH), posterior vertebral body height(PVH), vertebral wedge angle(VWA), ratio of vertebral wedging(RVW), anterior disc height(ADH), posterior disc height(PDH), disc wedge angle(DWA), ratio of disc wedging(RDW), and DWA/KA.@*RESULTS@#The average angle of kyphosis was (44.2±19.1)°. A significant decrease in anterior height of vertebral was observed compared to the posterior height of vertebral(P<0.005). There was no significant difference in anterior and posterior height of discs. The vertebral wedging ratio/contribution ratio:AV-2(14.98±10.95)%/(14.21±8.08)%, AV-1(21.08±12.39)%/(18.09±7.38)%, AV(26.94±11.94)%/(25.52±8.64)%, AV+1(24.19±8.42)%/(20.82±8.69)%, AV+2(20.56±7.80)%/(15.60±9.71)%, total contribution(94.23±22.25)%, the disc wedging ratio/contribution ratio:AV-2D(2.88±2.57)%/(5.27±4.11)%, AV-1D(1.98±1.41)%/(2.29±2.16)%, AV+1D(-5.54±3.75)%/(-0.57±0.46)%, AV+2D(-8.27±4.62)%/(-1.22±1.11)%, total contribution (5.77±4.79)%. And the contribution rate of AV was significantly higher than that of adjacent vertebral(P<0.05).@*CONCLUSION@#The vertebral body and intervertebral disc shape both have influence on thoracolumbar kyphosis. However, the contribution of vertebral morphometry to the angle of TL/LDK deformity is relatively more important than the disc. The contribution of the wedge change of the AV to the TL/LDK deformity is particularly significant.

Acupuncture-moxibustion for essential hypertension: an overview of systematic reviews / 针灸推拿医学（英文版）

Objective: To propose reasonable suggestions to promote the standardization of clinical studies by reviewing the systematic reviews and meta-analyses of acupuncture-moxibustion treatment of essential hypertension (EH). Methods: Computer retrieval was conducted through Excerpta Medica Database (EMBASE), PubMed, China National Knowledge Infrastructure (CNKI), Chongqing VIP Database (CQVIP), China Biology Medicine Disc (CBM), and Wanfang Academic Journal Full-text Database (Wanfang) to collect systematic reviews and meta-analyses relevant to treating EH with acupuncture-moxibustion therapy. The time range was from the database's inception till July, 2020. The studies were screened based on the inclusion and exclusion criteria and then data-extracted. The study's quality and evidence ratings were performed by referring to the preferred reporting items for systematic review and meta-analysis (PRISMA), a measurement tool to assess systematic reviews 2 (AMSTAR 2), and the grading of recommendations, assessment, development, and evaluation (GRADE). Results: A total of 14 studies, 10 in Chinese and 4 in English, published between 2012 and 2019, were included, involving 70 outcome measures. The methodological quality was rated as critically low, the reporting was relatively complete or had certain flaws, and the evidence strength was rated as low or very low. Conclusion: Regarding the acupuncture-moxibustion treatment of EH, the methodological quality and outcome measure evidence of existing systematic reviews and meta-analyses are relatively low, and the reporting quality also expects further improvements.

Clinical efficacy of combined therapy in children with stage 4 neuroblastoma / 中国当代儿科杂志

OBJECTIVES@#To study the early clinical efficacy of combined therapy of stage 4 neuroblastoma.@*METHODS@#A retrospective analysis was performed on the medical data and follow-up data of 14 children with stage 4 neuroblastoma who were diagnosed in Hong Kong University-Shenzhen Hospital from January 2016 to June 2021.@*RESULTS@#The median age of onset was 3 years and 7.5 months in these 14 children. Among these children, 9 had positive results of bone marrow biopsy, 4 had N-Myc gene amplification, 13 had an increase in neuron-specific enolase, and 7 had an increase in vanilmandelic acid in urine. Based on the results of pathological examination, differentiated type was observed in 6 children, undifferentiated type in one child, mixed type, in one child and poorly differentiated type in 6 children. Of all the children, 10 received chemotherapy with the N7 regimen (including 2 children receiving arsenic trioxide in addition) and 4 received chemotherapy with the Rapid COJEC regimen. Thirteen children underwent surgery, 14 received hematopoietic stem cell transplantation, and 10 received radiotherapy. A total of 8 children received Ch14.18/CHO immunotherapy, among whom 1 child discontinued due to anaphylactic shock during immunotherapy, and the other 7 children completed Ch14.18/CHO treatment without serious adverse events, among whom 1 child was treated with Lu177 Dotatate 3 times after recurrence and is still undergoing chemotherapy at present. The median follow-up time was 45 months for all the 14 children. Four children experienced recurrence within 2 years, and the 2-year overall survival rate was 100%; 4 children experienced recurrence within 3 years, and 7 achieved disease-free survival within 3 years.@*CONCLUSIONS@#Multidisciplinary combined therapy is recommended for children with stage 4 neuroblastoma and can help them achieve better survival and prognosis.

CiteSpace knowledge map analysis of research progress on Tripterygium wilfordii toxicity / 中国中药杂志

This study systematically searched CNKI and Web of Science(WoS) for the research papers on the toxicity of Tripterygium wilfordii included from database inception to August 31, 2021, and visually displayed the authors, research institutions, keywords, and other contents using bibliometrics and CiteSpace 5.8.3. Furthermore, the current situation and research progress on T. wilfordii safety were also analyzed based on information extraction to find the research hotspot, evolution path, and development trend, and to provide references for future research. A total of 1 876 Chinese papers and 243 English papers were included in the study. The analysis of authors showed that WANG Qi and ZHANG Luyong had the most publications in Chinese and English papers, respectively. According to the analysis of research institutions, National Institutes for Food and Drug Control and China Pharmaceutical University possessed the largest number of Chinese and English papers, respectively, but there was less cooperation between them. The analysis of keywords in Chinese and English papers showed that the research contents of the safety of T. wilfordii mainly focused on clinical monitoring, mechanism, dosage form improvement, quality standard, component analysis, monomer research, efficiency and toxicity reduction, etc. Metabonomics, tripterine, and the underlying mechanism of toxicity were the research hotspots in the future. At present, the research on the toxicity of T. wilfordii is still under development. It is necessary to highlight the in-depth research and strengthen the inter-group and inter-region cooperation of authors or institutions to provide references for the research on the toxicity of T. wilfordii.

Clinical and prognostic features of ovarian endometrioid carcinoma with synchronous endometrial lesions / 中华妇产科杂志

Objective:To compare the clinical and prognostic characteristics of ovarian endometrioid carcinoma (OEC) patients with synchronous endometrial lesions and patients with pure OEC.Methods:A retrospective review of the medical records of patients received initial treatment and a postoperative pathological diagnosis of OEC at Peking University People′s Hospital between August 1998 and December 2017 were performed. According to the inclusion criteria, a total of 56 patients with OEC were included in the study, including 13 patients concurrent with simultaneous endometrial lesions (Group A) and 43 patients with pure OEC (Group B).Results:Patients with synchronous endometrial lesions accounted for 23% (13/56). Mean age of Group A at diagnosis was (44.9±8.3) years old, 2/13 of patients were postmenopausal, and no one had a history of hypertension, the first symptom of 5/13 people was irregular vaginal bleeding. Mean age of Group B patients at diagnosis was (52.7±10.2) years old, 53% (23/43) of patients were postmenopausal, and 28% (12/43) patients had the history of hypertension, the first symptom of 4 (9%, 4/43) people was irregular vaginal bleeding. The differences of age, menopause status, history of hypertension and initial symptoms between the two groups were statistically significant (all P<0.05). There were no significant differences in fertility history, dysmenorrhea history, age of menarche, history of endometriosis, preoperative and postoperative CA 125 level, International Federation of Gynecology and Obstetrics (FIGO) stage, tumor grade, metastatic site and platinum-based chemotherapy drug resistance between the two groups (all P>0.05). The overall 5-year survival rate of OEC patients was 91.6%, and the overall 5-year progression-free survival rate was 76.6%. Among them, the 5-year survival rate of the OEC concurrent with simultaneous endometrial lesions group was 80.2%, and the pure OEC group was 93.4%; the 5-year progression-free survival rate of the OEC concurrent with simultaneous endometrial lesions group was 74.1%, and the 5-year progression-free survival rate of the pure OEC group was 77.3%. There were no significant differences between the two groups (all P>0.05). Multivariate analysis showed that the independent factors for the prognosis of OEC patients were FIGO stage ( P=0.006) and residual lesion size ( P=0.020). Conclusions:OEC patients have a high proportion of simultaneous endometrial lesions. OEC with simultaneous endometrial lesions are younger than patients with pure OEC. Synchronous endometrial lesions do not affect the prognosis of patients with OEC.

Clinical analysis on the root fracture of the maxillary first molar / 华西口腔医学杂志

OBJECTIVES@#This study aimed to investigate the common types and directions of root fractures of the maxillary first molar and the influence of root canal treatment on the prevalent sites of root fractures.@*METHODS@#A total of 274 maxillary first molars with root fractures diagnosed via cone beam computed tomography were included. The root fractures of nonendodontically and endodontically treated teeth were identified to be spontaneous and secondary root fractures, respectively. The sites, types, and directions of spontaneous and secondary root fractures were determined.@*RESULTS@#Among the spontaneous root fractures, the proportion of palatal root fractures (56.1%) was higher than those of mesial buccal root fractures (36.1%) and distal buccal root fractures (7.8%). Among the secondary root fractures, the proportion of mesial buccal root fractures (52.7%) was higher than those of palatal root fractures (36.5%) and distal buccal root fractures (10.8%). The distribution of predominant fracture sites was statistically significant (@*CONCLUSIONS@#This study provided an epidemiological basis for the clinical features of root fractures of the maxillary first molar. During the dia-gnosis and treatment of the maxillary first molar, the possibility of palatal root fractures should be considered. The occurrence of mesial buccal root fractures may be related to root canal treatment. Therefore, the risk of mesial buccal root fractures caused by iatrogenic factors should be minimized.

Gene Cloning and Bioinformatics Analysis of Limonene-3-hydroxylase from Schizonepeta tenuifolia / 中国实验方剂学杂志

Objective:This paper aims to clone the cDNA sequence of<italic> limonene</italic>-3-<italic>hydroxylase</italic>（<italic>StL</italic>3<italic>OH</italic>） in <italic>Schizonepeta tenuifolia</italic> and analyze its sequence by bioinformatics. Method:Specific primers were designed based on sequences of<italic> StL</italic>3<italic>OH </italic>gene screened from transcriptome sequencing data of <italic>S. tenuifolia</italic> and the cDNA sequence of <italic>StL</italic>3<italic>OH </italic>gene was cloned by reverse transcription polymerase chain reaction （RT-PCR） and analyzed for its bioinformatics. Result:The <italic>StL3OH</italic> gene cDNA sequence length was 1 598 bp，containing a 1 497 bp long complete open reading frame which encoded 498 amino acids. StL3OH protein had a theoretical relative molecular mass of 56.40 kDa，with a hydrophilic and unstable nature. Bioinformatics analysis showed that StL3OH protein had no signal peptide but had a transmembrane domain which might be located in endoplasmic reticulum. Multiple sequence alignment and cluster analysis showed that the amino acid sequence of MsL3OH protein had a high similarity with StL3OH protein，both of which contained cytochrome P450 heme binding region，belonging to the D subfamily of cytochrome CYP71 family. Codon bias analysis showed that <italic>StL</italic>3<italic>OH</italic> gene preferred guanine/cytosine（G/C） ending codon，with 27 skewed codons， and Nicotiana benthamiana was proven to be the most suitable host for exogenous expression of <italic>StL</italic>3<italic>OH</italic> gene. Conclusion:The cDNA sequence of<italic> StL3OH</italic> gene was cloned from <italic>S. tenuifolia</italic> for the first time，which will provide a basis for further study on the structure and function of StL3OH protein and the regulation mechanism of <italic>StL3OH </italic>gene in the accumulation and biosynthesis of monoterpenes in<italic> S. tenuifolia</italic>.

Study on Sparganium stoloniferum from different regions in China based on appearance characters and ISSR markers / 中国中药杂志

Based on the characteristics and ISSR molecular marker technology, the study is aimed to compare and perform genetic diversity analysis on Sparganium stoloniferum from 7 regions. Molecular identification method was established for S. stoloniferum from Hunan province. Differences among Sparganii Rhizoma samples from seven habitats were analyzed via measuring weight, length, width and thickness of them. Genetic diversity of S. stoloniferum from 7 regions was analyzed by screening out primers amplifying clear band and showing rich polymorphism, then a cultivars dendrogram was built. The target primer was screened out, and the specific band was sequenced. Nine ISSR primers were selected to amplified clear band, rich polymorphism. A total of 73 bands were amplified by nine ISSR primers selected from 27 ISSR primers. On average, each primer produced 8.0 bands. A total of 38 bands were polymorphic, which occupied 52.8% of all bands. The cultivars dendrogram showed the genetic similarity was 0.54-0.94. Genetic similarity coefficient of S. stoloniferum from Jiangsu province, Anhui province and Jiangxi province was big, indicating the differences among them were slight on genetic level. S. stoloniferum from Hunan province is quite different from samples from the other six habitats on appea-rance and genetic level. A specific band(327 bp) in S. stoloniferum from Hunan province was obtained via ISSR-857 primer, and was sequenced. According BLASTn database, there were few sequences similar to the gene fragment and had little correlation with the growth process of plant. ISSR molecular marker technology provides a new idea for the identification of S. stoloniferum. This result confirmed the particularity of S. stoloniferum from ancient Jingzhou.

Effects on the recruitment of inactive and lapsing blood donors, Questionnaire study based on motivators and deterrents / 中国输血杂志

【Objective】 To explore the effect of questionnaires on the re-recruitment of lapsed blood donors, and to ensure the retention of regular blood donors for blood supply in blood stations. 【Methods】 Blood Donation Motivation Questionnaire and Blood Donation Deterrents Questionnaire were designed for inactive and lapsing blood donors to inquire the motivation of the latest blood donation, such as "blood donation can save lives" and the reasons for no longer participating in blood donation, such as "there are no blood donation sites nearby", respectively. 13 093 blood donors with donation frequency ≥3 times and last donation during January 1 to May 17, 2018 in Guangzhou were selected as subjects. Text messages containing the links to the correspondent electronic questionnaires were sent to intervention group 1 (n=4 364) to fulfill the Blood Donation Motivation Questionnaire and intervention group 2 (n=4364) to fulfill Blood Donation Deterrents Questionnaire from May 18 to 25, 2020. None questionnaire was issued to the control group (n=4 365). The re-donation rates in the three groups within 2 months after the questionnaire delivery were analyzed by intention to treat (ITT) analysis and average treatment effect (ATT) estimation. 【Results】 The response rate of valid questionnaires was 5.422% (710/13 093), of which 7.424% (324/4 364) were in intervention group 1 and 8.845% (386/4 364) in intervention group 2. The collected questionnaire showed that the score of "blood donation can save lives" was the highest (2.31±0.79)in intervention group 1, and the score of "no blood donation site nearby" was the highest (2.31±0.80). in intervention group 2.2 months of observation showed that the re-donation rate was similar among all three groups by ITT analysis (Ps>0.05). ATT estimation results showed that the re-donation rates of intervention group 1 and intervention group 2 were 5.56%(18/324) and 3.11%(12/386), respectively(P<0.05). 【Conclusion】 Motivation questionnaire is a simple and convenient way to remind blood donors who have multiple donations to donate blood again.

Laparoendoscopic single-site surgery using a homemade glove port in the treatment of 60 benign gynecologic cases / 中国实用妇科与产科杂志

OBJECTIVE:To investigate the safety and clinical value of laparoendoscopic single-site surgery(LESS)using a homemade glove port in benign gynecologic diseases.METHODS:From December 2017 to May 2018,60 LESSs were performed in the First Affiliated Hospital of Chongqing Medical University,including hysterectomy,myomectomy,etc.The operations were performed using a patented homemade glove port with conventional laparoscopic instruments.The clinical data were recorded and analyzed retrospectively.RESULTS:All surgeries were successfully completed,including1 case of conversion to laparotomy and 4 cases of an additional site.The mean operation time was 104.4 min.The mean blood loss was 57.8 mL.The average hemoglobin decrease was 16.3 g/L 24 h after surgery.The pain score was 2.8 24 h af⁃ter surgery.No fever happened postoperatively.The average hospital stay was 2.9 days after surgery.One case of navel wound was poorly healed.No poor wound healing or umbilical hernia occurred at the 1-month follow-up. The main medi⁃cal cost of LESS was from the wound retractor,which cost around 700 RMB.CONCLUSION:LESS using a homemade glove port has the advantage of high safety and low cost in gynecological benign diseases,which is suitable for wide application.

Antiviral and antifibrotic therapies reduce occurrence of hepatocellular carcinoma in patients with chronic hepatitis B and liver fibrosis: a 144-week prospective cohort study / 南方医科大学学报

OBJECTIVE@#To compare the efficacy and safety of different antiviral and antifibrotic regimens in patients with chronic hepatitis B (CHB) and hepatic fibrosis and the incidence of hepatocellular carcinoma (HCC) associated with these therapies.@*METHODS@#A total of 840 patients with CHB and concurrent hepatic fibrosis, who received antiviral therapy in Nanfang Hospital between June, 2010 and June, 2018, were enrolled in this follow-up cohort study. The patients were assigned to 3 cohorts matched for gender, age (difference≤5 years), HBeAg status and liver stiffness measurement (LSM) for treatment with one of the 3 antiviral drugs, namely entecavir, tenofovir dipivoxil and adefovir dipivoxil; each cohort was divided into 2 groups, with one of the groups having a combined treatment with Fufang Biejiaruangan tablet. The cumulative negative conversion rate of HBV DNA, normalization rate of ALT, hepatic fibrosis regression and the incidence of HCC were compared among the 3 cohorts and across the 6 groups at 144 weeks.@*RESULTS@#A total of 749 patients were available to follow-up at 144 weeks. Compared with the baseline data, the cumulative negative conversion rate of HBV DNA increased gradually and the abnormal rate of ALT decreased significantly over time during the treatment in all the 6 groups (all < 0.001). Compared with the any of the antiviral drugs used alone, the combined treatments all resulted in significantly better antifibrotic effects (χ=11.345, χ=10.160, χ=6.358; all < 0.05). At 144 weeks, the incidence of HCC were 2.2%, 1.7%, 1.7% and 3.3% in enecavir group, enecavir with Biejiaruangan tablet group, adefovir group, and adefovir with Biejiaruangan tablet group, respectively, showing no significant difference between the two cohorts (4 groups; χ=6.813, =0.138). None of the patients in the 2 groups with tenofovir treatment had HCC by the end of the observation.@*CONCLUSIONS@#Antiviral therapy combined with antifibrotic therapy can effectively reverse hepatic fibrosis and reduce the incidence of HCC in patients with CHB; among the 3 antiviral drugs, tenofovir dipivoxil can be a better option for reducing the incidence of HCC in these patients.

Incidence and characteristics of benign liver space-occupying mass in 17 721 patients with chronic hepatitis B: a color Doppler ultrasound-based case-control study / 南方医科大学学报

OBJECTIVE@#To analyze the incidence and risk factors of benign liver space-occupying mass in patients with chronic hepatitis B (CHB) and the ultrasound features that differentiate these masses from small hepatocellular carcinoma.@*METHODS@#We retrospectively analyzed the color Doppler and clinical data of 17 721 patients with CHB treated in the Hepatology Unit of Nanfang Hospital between January, 2016 and December, 2017. The data were compared with those of 21629 healthy control subjects undergoing routine physical examination in the Center of Heath Management of Nanfang Hospital during the same period.@*RESULTS@#Compared with the control subjects, the patients with CHB had significantly higher incidences of hepatic cysts (11.8% 8.7%, 0.05). Sonographically, the benign liver masses commonly showed homogeneous echo within the lesion with clear boundaries and regular shape. Hepatic hemangioma was distinctively hyperechoic in 83.32% (1579/1895) of the patients, while small hepatocellular carcinoma presented with weaker peripheral and internal blood flow signals with a lower flow velocity in the arteries and a higher flow velocity in the portal vein. Liver cirrhosis nodules mostly showed a mixture of strong and weak echoes (79.60%; 7637/9595) without blood flow signal within or around the nodule; an increased volume of the nodule accompanied by heterogeneous echoes within the nodule indicated an increased probability of malignant lesion. Hepatic cysts often displayed no echo within the lesion, but the echo could be enhanced posteriorly.@*CONCLUSIONS@#The patients with CHB are at a significantly higher risk of developing hepatic cysts, hepatic hemangiomas and hepatic cirrhosis nodules than the control population, and an older age and the male gender are associated with a higher incidence of hepatic cysts or cirrhosis. The differences in the sonographic and hemodynamic features can help to differentiate hepatic benign mass from malignant lesions, and kinetic changes in sonography can be used to monitor potential malignant transformation of the cirrhotic lesions.

Expression of nerve growth factor in urine of patients with interstitial cystitis and its clinical significance / 中华泌尿外科杂志

Objective Evaluate the clinical value of nerve growth factor (NGF) in patients with interstitial cystitis for diagnosis and predicting the prognostic.Methods From January 2013 to January 2017,22 cases of interstitial cystitis patients,including 20 female cases and 2 male cases,were collected.Their mean age was (48.5 ± 12.8) years old.The average frequency of urination was 25.4 ±4.6 before treatment.The average frequency of nocturia was 4.6 ± 0.5.The average maximal bladder volume was (223.4 ± 39.5)ml.Their IPSS and QOL scores were 17.3 ± 1.2,12.7 ± 1.7,respectively.Meanwhile,22 healthy volunteers,including 18 female cases and 4 male cases,were collected.Their mean age was (40.2 ± 8.7) years old.The average frequency of urination was 4.2 ± 2.6 before treatment.The average frequency of nocturia was 1.1 ± 0.4.Urine NGF of these patients were collected before and after sodium hyaluronate bladder perfusion treatment,and the levels of NGF were detected by ELISA method.The correlationship between NGF and the severity of the symptoms were evaluated before and after treatment.Results After 1,3 and 6 months' treatment,the levels of NGF were dropped from (243.5 ±37.8) ng/L to (187.3 ±28.7) ng/L,(141.5 ± 21.3) ng/L and (123.1 ± 15.9) ng/L,which was positively associated with the degree of clinical symptom.The number of urination droppted from 25.4 ± 4.6 to 21.7 ± 5.2,17.2 ± 3.9 and 14.6 ± 3.8.The number of nocturia was dropped from 4.6 ± 0.5 to 3.8 ± 0.6,3.0 ± 0.8 and 1.7 ± 1.1.The maximum volume of bladder increased from (223.4 ± 39.5) ml to (258.7 ± 40.2) ml,(289.6 ± 37.1) ml and (305.2±40.4) ml.The IPSS scores dropped from 17.3 ± 1.2 to 15.1 ±2.4,12.4 ± 1.82and 9.8 ± 1.4.The QOL scores dropped from 12.7 ± 1.7 to 10.6 ± 1.2,8.5 ± 1.5 and 7.1 ± 1.3 (P ＜ 0.05).The logistic regression analysis showed the level of NGF in IC patients has positive relationship with frequency of urination,nocturia,QOL scores,IPSS scores and maximal bladder volume (P ＜ 0.05).Conclusions The level of NGF in urine is associated with IC symptom severity and NGF has the potential to be used as a marker for the diagnosis of IC.

Optimization of extraction process of total triterpenoid from root of Rose odorata var.gigantean by orthogonal test and its inhibitory effect on contraction of isolated rat intestinal smooth muscle / 药物评价研究

Objective To optimize the extraction technology of total triterpenoid from root of Rose odorata var.gigantean (TTROG) by orthogonal test combined with the contraction effect of TTROG on the isolated intestinal smooth muscle of rats in vitro.Methods UV spectrophotometric method was used to determine the contents of total triterpenoids in the TTROG extractive at the wavelength of 550 nm by taking ursolic acid as standard substance,and vanillin acetic acid as chromogenic reagent.The extraction rate of total triterpenoids was used as index to evaluate the technology based on single factor test,in which three factors were considered as follows:the concentration of extraction solvent,ratio of material to liquid,extraction time,and their interaction on extraction were studied by orthogonal experimental design.The inhibition effect of different extracts obtained from the optimized extraction process on the contraction of intestinal smooth muscle were recorded by tension transducer to the BL-420 biological experimental multi-channel physiological signal acquisition and processing system.The extraction process of TTROG was evaluated by the combination of biological activity and extraction rate with weighting method.Results The optimal extraction conditions of TTROG were as follows:extraction solvent 80％ ethanol,solid-liquid ratio 1∶10,extraction time for 2 h,three times and extraction temperature of 80 ℃.The optimized extraction rate could reach 42.12 mg/g.TTROG obtained using the optimized method showed significantly contraction effect on rat intestinal smooth muscle with dose effect dependence,and the effect on jejunum was the strongest,and the inhibition rate was 41.96％.Conclusion The optimized extraction technology is stable and effective with high extraction rate.TTROG showed the significant inhibitory function on contraction of isolated rat intestinal smooth muscle.

Investigation of efficacy of virtual navigation contrast enhanced sonography during microwave ablation of small liver tumors undetectable by conventional sonography / 实用医学杂志

Objective To evaluate the feasibility and accuracy of virtual navigation contrast enhanced sonography in accurately location of small liver tumors which cannot be detected by conventional sonography during microwave ablation therapy. Methods Twenty-three patients with 28 small liver tumors,which could not be detected by conventional sonography but CT/MRI,underwent microwave ablation with virtual navigation contrast enhanced sonography from January 2015 to March 2017 at Nanfang Hospital. After fusion of images from both sonography and CT/MRI,small liver tumors were ablated under the real-time monitoring of navigated sonography. Virtual navigation contrast enhanced sonography was also utilized to evaluate the efficacy of ablation after the ablation.All patients underwent CT/MRI examination at one month post-ablation to evaluate the efficacy of ablation. Results Virtual navigation system successfully provided image fusion for all patients and all lesions(image fusion efficacy was 100%). All patients underwent virtual navigation contrast enhanced sonography monitored microwave ablation.Only one patient received extra ablation since a small proportion of residual tumor checked after the initial ablation. No severe complications occurred in the present study. One-month after ablation,all patients showed complete ablation by further CT/MRI examinations.Conclusion Virtual navigation sonography can precisely target small liver tumors which are undetected by conventional sonography.Evaluation of lesions and ablation efficacy can be performed with the help of virtual navigation contrast enhanced sonography during the ablation period,which have shown satisfactory clinical efficacy.

Comparision of clinical effects between one-stage anterior and posterior approach in treating thoracolumbar tuberculosis with debridement and internal fixation / 中国骨伤

<p><b>OBJECTIVE</b>To compare the outcomes of surgical operation by posterior or anterior approach only for thoracolumbar tuberculosis.</p><p><b>METHODS</b>The clinical data of 97 patients with thoracolumbar tuberculosis underwent debridement and internal fixation from January 2005 to December 2014 were retrospectively analyzed. The study included 59 males and 38 females, with a mean age of 53.7 years ranged from 20 to 68 years. The course of disease was from 1 to 13 months with an average of (6.9±2.3) months. Among these patients, 43 cases were treated through one-stage anterior approach (anterior approach group) and 54 cases were treated through posterior approach (posterior approach group). The clinical data and imaging data of 97 cases were analyzed, including the operation time, intraoperative and postoperative blood loss, postoperative hospitalization time, complications, visual analogue scale(VAS), Oswestry Disability Index(ODI), Frankle grade, bone fusion time, and corrective rate of Cobb angle.</p><p><b>RESULTS</b>Operation time, intraoperative and postoperative blood loss, postoperative hospitalization time, complication rate, and corrective rate of Cobb angle were(174.4±9.9) min, (885.0±95.7) ml, (103.2±11.5) ml, (15.1±0.7) d, 9.3%, (73.4±3.2)% in posterior group respectively, while in anterior approach group were(229.5±15.2) min, (1326.0±113.5) ml, (153.2±16.7) ml, (19.0±0.8) d, 16.3%, (62.3±2.5)%, respectively, and there was significant difference between two groups. There was no significant difference in graft bone fusion between two groups. Postoperative VAS, ODI, Frankel grade of all patients were obviously improved, but there was no significant difference between two groups.</p><p><b>CONCLUSIONS</b>Thoracolumbar tuberculosis could be cured by one-stage anterior or posterior approach with debridement, bone grafting and internal fixation, but posterior approach has advantages of less trauma and better deformity correction.</p>

Splenic thickness combined with routine clinical markers predicts esophageal varices in patients with liver cirrhosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the noninvasive indicators for predicting the occurrence of esophageal varices (EV) in patients with liver cirrhosis.</p><p><b>METHODS</b>A total of 202 patients with liver cirrhosis caused by hepatitis B or C or alcoholic hepatic disease were enrolled in this study. EV and high risk esophageal varices (HREV) were confirmed in these patients by gastroscopy. The hematological, serum biochemical and ultrasonic parameters of the patients were analyzed, and a model for predicting EV was established by stepwise logistic regression analysis.</p><p><b>RESULTS</b>The areas under receiver operating characteristics curve (AUROC) of splenic thickness (SPT) for detecting EV and HREV were 0.827 and 0.766, respectively. The combined index USWA (SPT, US, WBC and albumin [ALB]) showed an AUROC of 0.873 for detecting EV, and the index SPA (combining SPT and ALB) showed an AUROC of 0.777 for detecting HREV. The direct combination of SPT with USWA or with platelet/splenic thickness ratio (PSA) was capable of completely excluding a definite diagnosis of EV, while the sequential combination of SPT with USWA or with platelet was capable of a diagnosis of EV and clarifying the condition of EV in approximately half of the cirrhotic patients in the absence of gastroscopic findings. The combination of SPT and SPA allowed for a definite diagnosis of the condition of HREV in 10% of the cirrhotic patients.</p><p><b>CONCLUSION</b>SPT combined with SPT derived indexes or platelet status allows for a definite diagnosis of EV in patients with liver cirrhosis to offer a noninvasive option for diagnosis.</p>

Clinical Observation of Kangfuxin Liquid Combined with Oral Ulcer Powder in the Threatment of Recur-rent Aphthous Ulcer / 中国药房

OBJECTIVE:To explore the effects of Kangfuxin liquid combined with Oral ulcer powder on inflammatory cyto-kines and therapeutic efficacy of recurrent aphthous ulcer. METHODS:134 patients with recurrent aphthous ulcer were randomly divided into observation group and control group,with 67 cases in each group. Both groups received routine treatment;control group was additionally given Oral ulcer powder,q2 h;observation group was additionally given Kangfuxin liquid,10 ml/time,gar-gling for 5-10 min and then swallowing slowly,tid. Treatment course of 2 groups lasted for 7 d. Clinical symptoms,serum inflam-matory cytokines,clinical symptom improvement and recurrence were observed in 2 groups. RESULTS:Total effective rate of ob-servation group was 95.52%,which was significantly higher than that of control group(82.09%),with statistical significance(P<0.05). The levels of TNF-α,IL-1 and IL-6 in observation group were significantly lower than those of control group,with statisti-cal significance(P<0.05);ulcer duration and VAS score of observation group were significantly shorter or lower than those of con-trol group,with statistical significance(P<0.05);after followed up for 6 months,recurrence rate of observation group(11.94%) was significantly lower than that of control group(31.34%),with statistical significance(P<0.05). CONCLUSIONS:Kangfuxin liquid combined with Oral ulcer powder helps to lower levels of inflammatory cytokines of patients with recurrent aphthous ulcer, relieve the clinical symptoms,then improve therapeutic efficacy and reduce recurrence rate.

Combined application of PBL teaching method and brainstorming method in the training of medical students' medical record writing ability / 中华医学教育探索杂志

Objective To explore the application of PBL teaching method and brainstorming method in the training of medical students' medical record writing ability,in order to strengthen the cultivation of medical students' medical record writing ability.Methods 122 medical undergraduate interns of Grade 2010 majoring in clinical medicine in our hospital were taken as the research object,of which 60 were in the experimental group,62 were in the control group.PBL teaching combined with brainstorming method was used in the experimental group,while the control group used the traditional teaching method of teaching.After the end of the training course,data were analyzed using SPSS 19.0 software,count data and measurement data were analyzed using chi square test and t test to carry out the significant test between the two groups of data,the training effect was compared between the two groups.Results The results of questionnaire in the experimental group were significantly higher than those in the control group,and the difference was statistically significant,The experimental group theory test scores were higher than the control group[(84.28 ± 6.65) vs.(74.52 ± 6.75)],and the difference was statistically significant;The experimental group outstanding achievement ratio was higher than the control group,and the difference was statistically significant;The proportion of operation and non operative medical records in the experimental group were higher than that in the control group (P=0.005,P=0.004).Conclusion Combined application of PBL teaching method and brainstorming method plays a positive role in superposition and complementation.It gives full play to and mobilizes the students' enthusiasm and initiative,and the training effect is obviously superior to the traditional teaching method,therefore it is worth popularization and application in the training of students' medical record writing ability.

Efficacy of fluticasone propionate aerosol versus budesonide suspension in treatment of recurrent wheezing caused by bronchiolitis / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of fluticasone propionate aerosol (flixotide) versus budesonide suspension in the treatment of recurrent wheezing caused by bronchiolitis.</p><p><b>METHODS</b>A total of 214 infants with newly diagnosed bronchiolitis were randomly divided into flixotide treatment (106 infants) and budesonide treatment groups (108 infants), and were given aerosol inhalation of flixotide or budesonide for 3 months after achieving remission of clinical symptoms. Another 136 infants with bronchiolitis who did not receive regular inhalation of corticosteroid after achieving remission of clinical symptoms were enrolled as the control group. The follow-up visits were performed for 1 year, and the effects of the two therapeutic methods on recurrent wheezing were evaluated.</p><p><b>RESULTS</b>Compared with the control group, both the flixotide and budesonide treatment groups had significantly fewer times of wheezing episodes within 1 year and a significantly lower recurrence rate of wheezing within the first 3 months after regular inhalation of corticosteroid, but no significant differences were observed between the two treatment groups. The amount of corticosteroid inhaled and hospital costs in the budesonide treatment group were significantly higher than in the flixotide treatment group (P<0.01).</p><p><b>CONCLUSIONS</b>Continuous inhalation of flixotide or budesonide after remission of clinical symptoms in children with bronchiolitis can reduce wheezing episodes and the recurrence of wheezing, and flixotide treatment is superior to budesonide treatment in the aspects of hospital costs and the amount of corticosteroid used.</p>