Treatment of Chronic Aplastic Anemia with Chinese Patent Medicine Pai-Neng-Da Capsule () for Replacing Androgen Partially: A Clinical Multi-Center Study / 中国结合医学杂志

OBJECTIVE@#To evaluate the efficacy and safety of Pai-Neng-Da Capsule (, panaxadiol saponins component, PNDC) in combination with the cyclosporine and androgen for patients with chronic aplastic anemia (CAA).@*METHODS@#A total of 79 CAA patients was randomly divided into 2 groups by a random number table, including PCA group [43 cases, orally PNDC 320 mg/d plus cyclosporine 5 mg/(kg·d) plus andriol 80 mg/d] and CA group [36 cases, orally cyclosporine 5 mg/(kg·d) plus andriol 160 mg/d]. All patients were treated and followed-up for 6 treatment courses over 24 weeks. The complete blood counts, score of Chinese medical (CM) symptoms were assessed and urine routine, electrocardiogram, hepatic and renal function were observed for safety evaluation. Female masculinization rating scale was established according to the actual clinical manifestations to evaluate the accurate degree of masculinization in female CAA patients treated by andriol.@*RESULTS@#The effective rates were 88.1% (37/42) in the PCA group and 77.8% (28/36) in the CA group based on the standard for the therapeutic efficacy evaluation of hematopathy. There was no significant difference in the white blood cell (WBC) counts, platelet counts and hemoglobin concentration of peripheral blood between two groups after 6 months treatment. The masculinization score of female patient in the PCA group was significantly lower than the CA group (P<0.05). The mild abdominal distention was observed in 1 cases in the PCA group. In CA group, the abnormalities in the hepatic function developed in 2 cases and the renal disfunction was found in 1 case.@*CONCLUSION@#The PNDC possesses certain curative effects in the treatment of CAA without obvious side-effects and can partially replace andriol thereby to reduce the degree of masculinization [Registried at Chinese Clinical Trial Registry (ChicTR1900028153)].

Prognostic factors affecting the success of conversion chemotherapy in patients with unresectable liver metastases from initially colorectal cancer / 中华胃肠外科杂志

Objective: To investigate the factors affecting the success of conversion therapy in patients with initially unresectable colorectal cancer liver metastases (CRLM) in order to provide evidence-based medical evidence for formulating individualized treatment strategies for patients. Methods: A retrospective case-control study was used in this study. Clinical data of 232 patients with initially unresectable CRLM receiving first-line systemic treatment in Sun Yat-sen University Cancer Center from January 2013 to January 2020 were collected, including 98 patients of successful conversion and 134 patients of failed conversion as control. Conversion therapy scheme: 38 patients received FOLFOXIRI regimen chemotherapy (irinotecan, oxaliplatin, calcium folinate and fluorouracil), 152 patients received FOLFOX regimen (oxaliplatin, calcium folinate and fluorouracil), 19 patients received FOLRIRI regimen (irinotecan, calcium folinate and fluorouracil), 23 patients received systemic chemotherapy combined with fluorouridine hepatic artery infusion chemotherapy; 168 patients received targeted therapy, including 68 of bevacizumab and 100 of cetuximab. Logistics analysis was used to compare the factors affecting the success of conversion therapy. The Kaplan-Meier method was used to calculate progression-free survival (PFS), and the Log-rank test was used for survival comparison. Results: Among 232 patients, 98 patients had successful conversions and 134 patients had failed conversions with a successful conversion rate of 42.2%, meanwhile 30 patients underwent simple hepatectomy and 68 underwent hepatectomy combined with intraoperative radiofrequency ablation. After first-line chemotherapy, 111 patients (47.8%) were partial remission, 57 patients (24.6%) were stable disease, and 64 patients (27.6%) were progression disease. During the median follow-up of 18.8 (1.0-87.9) months, 148 patients were dead or with tumor progression. The median PFS time of patients with successful conversion was longer than that of patients with failed conversion (31.0 months vs. 9.9 months, P<0.001). Univariate analysis found that the bilobar distribution of liver tumors (P=0.003), elevated baseline carcinoembryonic antigen (CEA) levels (P=0.024), tumor invasion of the portal vein (P=0.001), number of metastatic tumor>8 (P<0.001), non-FOLFOXIRI (P=0.005), and no targeted therapy (P=0.038) were high risk factors for the failed conversion therapy. The results of multivariate logistics analysis indicated that the number of metastatic tumor >8 (OR=2.422, 95%CI: 1.291-4.544, P=0.006), portal vein invasion (OR=2.727, 95%CI: 1.237-4.170, P=0.008) were the independent risk factors for failed conversion therapy, while FOLFOXIRI regimen (OR=0.300, 95%CI: 0.135-0.666, P=0.003) and targeted drugs (OR=0.411, 95%CI: 0.209-0.809, P=0.010) were independent protective factors for successful conversion therapy. Conclusions: The number of metastatic tumor and portal vein invasion are key factors that affect the outcomes of conversion therapy for initially unresectable CRLM. If a patient can tolerate chemotherapy, a combination program of three-drug and targeted therapy is preferred for the active conversion therapy.

Finite element analysis of the stress distribution of dental implant crowns with different all-ceramic materials and thicknesses / 口腔疾病防治

Objective@# To compare the stress distribution of different all-ceramic restoration materials and thicknesses in dental crown restorations using the finite element method and provide a reference for the selection and design of clinical crown restoration materials.@*Methods@#A finite element model of mandibular first molar implant crown restoration was created, and 6 crown thickness designs and 4 different crown restoration materials were evaluated, namely, resin-based ceramics (Lava Ultimate and Vita Enamic), lithium disilicate glass-ceramics (IPS e.max CAD), and zirconia ceramic (Cercon) designs. The mandibular first molars were loaded at 600 N, and the stress distribution was analyzed by using the finite element software ANSYS 10.0.@*Results@#The crown stress analysis showed that 156.05 MPa was the highest in 4 mm Cercon group and 18.85 MPa was the lowest in 1 mm Lava Ultimate group. The stress analysis of resin cement showed that 62.52 MPa was the highest in the 4 mm Lava Ultimate group and 16.74 MPa was the lowest in 1 mm IPS e.max CAD group. During the use of the finished platform, the stress concentration of the Lava Ultimate group in the crown prosthesis and resin cement was higher than that of the personalized platform with the same crown thickness.@*Conclusion@# With increasing crown thickness, the maximum principal stress concentration in crown restoration and resin cement increases. Personalized abutments are more conducive to reducing stress concentrations for resin-based ceramics.

Effects of the different materials and thicknesses on endocrown stress distribution / 口腔疾病防治

Objective@#To analyze the effects of different restorations and the thickness of the occlusal space on the stress distribution of endodontically treated molars with endocrowns.@*Methods @# The finite element model of the restoration of the first mandibular molar was created, and four different endocrown materials were used including two resin based ceramics (Lava Ultimate, Vita Enamic), one lithium disilicate ceramic (IPS e.max CAD) and one zirconia ceramics (Cercon), and four kinds of surface space thickness were designed: 1 mm, 2 mm, 3 mm and 4 mm. A total of 600 N was loaded to simulate the maximum bite force in the vertical and inclined directions, and the finite element software ANSYS 10.0 was used to analyze the stress distribution@*Results@#The vertical loading analysis showed that the crown stress of the 1 mm-Cercon group was the highest at 211.30 MPa, and that of the 4 mm-Lava Ultimate group was the lowest at 11.56 MPa; the highest dentin stress was 38.84 MPa in the 3 mm-Lava Ultimate group, and the lowest was 11.68 MPa in 1 mm-Cercon group. The stress in the periodontal ligament and alveolar bone had little change. The inclined loading analysis showed that the crown stress of the 1 mm-Cercon group was the highest at 78.73 MPa and that of the 1 mm-Lava Ultimate group was the lowest at 35.51 MPa; the highest dentin stress was 41.63 MPa in the 1 mm-Cercon cervical group, and the lowest was 10.81 MPa in the 4 mm-Cercon coronal group. The stress concentration of cement and cervical dentin under inclined loading was higher than that under vertical loading.@* Conclusion @# The results of finite element analysis show that the elastic modulus of the endocrown increases, the stress of the crown restoration shows an upward trend, and the stress in the tooth shows a downward trend. With increasing crown thickness, the stress of the crown prosthesis decreased.

cDNA cloning of a novel lectin that induce cell apoptosis from Artocarpus hypargyreus / 中国天然药物

We isolated a novel lectin (AHL) from Artocarpus hypargyreusHance and showed its immunomodulatory activities. In this study, the amino acid sequence of AHL was determined by cDNA sequencing. AHL cDNA (875bp) contains a 456-bp open reading frame (ORF), which encodes a protein with 151 amino acids. AHL is a new member of jacalin-related lectin family (JRLs), which share high sequence similarities to KM+ and Morniga M, and contain the conserved carbohydrate binding domains. The antitumor activity of AHL was also explored using Jurkat T cell lines. AHL exhibits a strong binding affinity to cell membrane, which can be effectively inhibited by methyl-α-D-galactose. AHL inhibits cell proliferation in a time- and dose-dependent manner through apoptosis, evidenced by morphological changes, phosphatidylserine externalization, poly ADP-ribose polymerase (PARP) cleavage, Bad and Bax up-regulation, and caspase-3 activation. We further showed that the activation of ERK and p38 signaling pathways is involved for the pro-apoptotic effect of AHL.

Fabrication of guide and removal of fiber post by tetrahedron positioning technology at the chair side: a case report and literature review / 口腔疾病防治

Objective @#To explore the technology and efficacy of fabrication of a guide and removal of a fiber post by tetrahedron positioning technology at the chair side.@*Methods@# For one patient with acute chronic periapical periodontitis of the left maxillary lateral incisor who needed to have the fiber post removed, the chair side tetrahedral positioning technique was used to make a guide plate to remove the fiber post. Cone beam CT (CBCT) data were imported into the software to design the guide plate for fiber post removal. The guide plate design on CBCT was transferred to a solid model by using tetrahedral positioning technology. The guide plate was made to guide the removal of the fiber post, and then left maxillary lateral incisor root canal was performed. We evaluated the effect of fiber post removal with tetrahedral positioning technology by reviewing the literature.@*Results @#The guide plate made by tetrahedral positioning technology can accurately locate the position and direction of fiber posts at a low cost and with high speed. After the fiber post was removed, the root canal could be dredged by using root canal preparation instruments. After root canal preparation, the root canal was filled with warm gutta-percha to complete the root canal treatment. After 3 months, the apical radiograph showed that the transmission shadow of the apical area was reduced. The results of the literature review showed that the fiber post removal with guide plates provides a predictable result and a lower risk of iatrogenic damage. Minimally invasive treatment can be carried out, and chair time can be reduced.@*Conclusion@#On the basis of CBCT data, using tetrahedral positioning technology to make fiber post removal guides can help reduce the risk of fiber post removal and has the characteristics of speed, low cost and short chair side processing. However, the accuracy comparison between tetrahedral positioning technology and 3D printing guides needs further study.

Holistic view of surgery based on membrane anatomy for gastrointestinal tumor / 中华胃肠外科杂志

The mesentery is a continuous unity and the operation of digestive carcinoma is the process of mesenteric resection. This paper attempts to simplify the formation process of all kinds of fusion fascia in the process of digestive tract embryogenesis, and to illuminate the continuity of fusion fascia with a holistic concept. This is helpful for beginners to reversely dissect the fusion fascia and maintain the correct surgical plane during operation, and to achieve the purpose of complete mesenteric resection.

The effect of hematoma puncture drainage before decompressive craniectomy on the prognosis of hypertensive intracerebral hemorrhage with cerebral hernia at a high altitude / 中华创伤杂志(英文版)

PURPOSE@#Rapid decompressive craniectomy (DC) was the most effective method for the treatment of hypertensive intracerebral hemorrhage (HICH) with cerebral hernia, but the mortality and disability rate is still high. We suspected that hematoma puncture drainage (PD) + DC may improve the therapeutic effect and thus compared the combined surgery with DC alone.@*METHODS@#From December 2013 to July 2019, patients with HICH from Linzhi, Tibet and Honghe, Yunnan Province were retrospectively analyzed. The selection criteria were as follows: (1) altitude ≥1500 m; (2) HICH patients with cerebral hernia; (3) Glascow coma scale score of 4-8 and time from onset to admission ≤3 h; (4) good liver and kidney function; and (5) complete case data. The included patients were divided into DC group and PD + DC group. The patients were followed up for 6 months. The outcome was assessed by Glasgow outcome scale (GOS) score, Kaplan-Meier survival curve and correlation between time from admission to operation and prognosis. A good outcome was defined as independent (GOS score, 4-5) and poor outcome defined as dependent (GOS score, 3-1). All data analyses were performed using SPSS 19, and comparison between two groups was conducted using separate t-tests or Chi-square tests.@*RESULTS@#A total of 65 patients was included. The age ranged 34-90 years (mean, 63.00 ± 14.04 years). Among them, 31 patients had the operation of PD + DC, whereas 34 patients underwent DC. The two groups had no significant difference in the basic characteristics. After 6 months of follow-up, in the PD + DC group there were 8 death, 4 vegetative state, 4 severe disability (GOS score 1-3, poor outcome 51.6 %); 8 moderate disability, and 7 good recovery (GOS score 4-5, good outcome 48.4 %); while in the DC group the result was 15 death, 6 vegetative state, 5 severe disability (poor outcome 76.5 %), 4 moderate disability and 4 good recovery (good outcome 23.5 %). The GOS score and good outcome were significantly less in DC group than in PD + DC group (Z = -1.993, p = 0.046; χ@*CONCLUSION@#PD + DC treatment can improve the good outcomes better than DC treatment for HICH with cerebral hernia at a high altitude.

Analysis of characteristics of lumbar spine-pelvic structural parameters in degenerative lumbar spondylolisthesis / 中国骨伤

OBJECTIVE@#To analyze the characteristics of lumbar spine-pelvic structure in degenerative lumbar spondylolisthesis and its significance in degenerative lumbar spondylolisthesis(DLS).@*METHODS@#The clinical data of 45 patients with simple degenerative L-segment lumbar spondylolisthesis (spondylolisthesis group) admitted from April 2015 to January 2017 were retrospectively analyzed, which were compared with 50 healthy people with complete physical examination data in the same period(control group). Statistical analysis of the lumbar spine-pelvic structure parameters of the subjects through imaging data was performed to analyze the characteristics of the spine-pelvis of DLS patients. The degenerative characteristicsof intervertebral disc and articular process joint were observed in degenerative lumbar spondylolisthesis. Use Spearson to analyze the correlation between observation items.@*RESULTS@#The facet joint angle, lumbar lordosis angle (LL), pelvic incidence angle(PI), pelvic tilt angle (PT), sacral slope angle (SS) in spondylolisthesis group of L-segment were (36.5±11.2)°, (44.2±7.3)°, (66.5±11.6)°, ( 22.2±10.0)°, (33.4±11.3)°, respectively, while in control group were (44.4±8.2)°, (36.7±8.5)°, (55.4± 13.2)°, (14.4±7.0)°, (42.3±13.1)°. PI, LL, PT of spondylolisthesis group were obviously larger than that of control group (< 0.05), the facet joint angle and SS of spondylolisthesis group were smaller than that of control group(<0.05). The correlation analysis showed that PI value was related to the PT and SS in two group. The degree of degeneration of intervertebral disc was related to the degree of spondylolisthesis. The degree of degeneration of L-S intervertebral disc and L facet jointin spondylolisthesis group was more serious (P <0.05).@*CONCLUSION@#Lumbar spinal pelvic structure of degenerative lumbar spondylolisthesis has undergone significant changes. Lumbar lordosis and pelvic dumping phenomenon in the mechanism of lumbar degeneration plays an important role. Lumbar facet joint degeneration and lumbar intervertebral disc degeneration are mutually promoted, and lumbar spondylolisthesis aggravates intervertebral disc and facet joint degeneration.

Characteristic spectrum and decoction process of classical prescription Qingwei San / 中国中药杂志

In this experiment, by determination of the HPLC characteristic spectrum of the classical prescription Qingwei San decoction, the contents of isoferulic acid, palmatine and paeonol in Qingwei San decoction and the extraction rate were investigated. The factors such as the crushing degree of decoction pieces, the amount of decocting water, the decocting time, the filter material and the decocting container involved in Qingwei San decoction process were examined to make a detailed comparison of Qingwei San's decoction processes during the development.HPLC characteristic spectrum method of Qingwei San was established, and then the decoction process parameters of Qingwei San were optimized, with the similarity of characteristic spectrum, the concentration of the index components and the extraction rate as indexes. The decoction process of Qingwei San was determined as follows: Qingwei San decoction pieces were weighed according to the prescription amount and pulverized into the most coarse powder; the powder was put in a ceramic pot, added with 225 mL water, heated to boiling, cooked for 50 minutes with gentle heat(100 W), and filtered with a layer of 300 mesh nylon cloth.The similarity of Qingwei San's characteristics pectrum of different decoction methods was all above 0.9, and the concentration of isoferulic acid, palmatine and paeonol in Qingwei San under determined decoction process was 40.74, 26.73, 65.73 μg·mL~(-1), respectively, with an extraction rate of 33.80%.The characteristic spectrum determined in this experiment can better express the information and index components of Qingwei San, and if combined with the extraction rate information, it can provide the general information, index component content and extraction information. The decoction process after detailed investigation can better reflect the quality of Qingwei San decoction, with easier control and operation. It can provide a basis for the subsequent research and development of Qingwei San decoction standard, and can also provide experimental basis and reference for the decoction process research of other classical prescriptions.

Active loading of verteporfin into cationic liposome for neovasculature- and tumor-targeted photodynamic therapy / 药学学报

To target neovasculature and tumor cells, a novel cationic liposome with verteporfin (BPD) active-loaded in lumen (CLL) was designed and its basic in vitro and in vivo behaviors were evaluated in this study. Calcium acetate gradient loading method was applied to encapsulate BPD actively and cationic lipid (2,3-dioleoy-loxy-propyl)-trimethylammonium (DOTAP) was added by post-insertion for the positive charge of CLL. Results of characterization showed that the diameter and zeta-potential of CLL were around 100 nm and 28 mV, respectively. Compared with passive loading liposomes, CLL significantly enhanced the stability of BPD loading. What's more, the loaded BPD in lumen could switch off the fluorescence and photosensitization during blood circulation by homo-fluorescence resonance energy transfer (homo-FRET) effect, leading to the diminished phototoxicity to normal tissues. In vitro cellular uptake and cytotoxicity assay exhibited that positive charge dramatically enhanced the uptake of CLL both in vascular endothelial cells and tumor cells leading to superior therapeutic efficacy. In vivo study further showed that CLL reduced the clearance rate and increased tumor accumulation compared with passive loading group. Quantitative results of exvivo organ indicated that negligible CLL distributed in normal organs contributing to low phototoxicity. Animal experiments were conducted according to the Guidelines of the Experimental Animal Ethics Committee of Peking University Health Science Center and International Animal Experiments. In conclusion, we successfully designed a novel cationic targeting liposome that overcame the limitations of passive loading and significantly enhanced the efficacy of photodynamic therapy.

Clinical observation of inferior alveolar nerve block combined with parecoxib sodium intravenous analgesia after mandible orthognaxillary surgery / 口腔疾病防治

Objective @# To compare the analgesic effect and safety of bilateral inferior alveolar nerve block combined with parecoxib sodium analgesia and simple intravenous analgesia pump in analgesia after orthognathic surgery.@*Methods @#Forty patients with simple ascending sagittal split osteotomy and ankle plasty were randomly divided into the experimental group and the control group, with 20 patients in each group. The experimental group received 2 mL 1% ropivacaine by inferior alveolar nerve block anesthesia on both sides. Immediately after surgery, parecoxib sodium 40 mg was intravenously administered. The control group was given an intravenous analgesia pump for analgesia. Pain intensity (VAS pain score) and Ramsay sedation score were recorded at 2 h, 4 h, 8 h, 24 h, 48 h after operation, and the incidence of postoperative adverse reactions was observed.@*Results@#There was no significant difference in pain intensity and Ramsay sedation score between the two groups at each time point (P>0.05). During the analgesic treatment, the incidence of nausea and vomiting in the experimental group was significantly lower than that in the control group (P<0.05).@*Conclusion@# Bilateral inferior alveolar nerve block combined with parecoxib sodium analgesia and simple intravenous analgesia pump are effective for analgesia after mandibular orthognathic surgery, but the former has a lower incidence of adverse reactions, more suitable for analgesia after mandibular orthognathic surgery.

Comparison of Volatile Components in Citri Sarcodactylis Fructus from Guangdong Province Before and After Being Steamed by GC-MS / 中国实验方剂学杂志

Objective:To compare volatile components in raw products and steamed products of Citri Sarcodactylis Fructus. Method:Volatile oil in different batch of raw products and steamed products of Citri Sarcodactylis Fructus was extracted by steam distillation, and volatile components were identified by GC-MS.The determination was performed with injector temperature of 280℃, high pure helium(≥ 99.999%) as carrier gas, split ratio of 10:1, and sample size of 3 μL with temperature programming.Mass spectrum conditions included electron bombardment ion source, electron bombardment energy of 70 eV, ion source temperature of 230℃, acceleration voltage of 34.6 V, resolution of 2 500, scanning range of m/z 40-350.Peak matching, cutting and noise filtering were used in analyzing data based on GC-MS combined with orthogonal partial least square-discriminant analysis(OPLS-DA). Result:A total of 58 components were separated and identified from the different batches of raw Citri Sarcodactylis Fructus and their processed products, and 27 differential chemical components were identified by multivariate statistical analysis, among them, 15 common differential components presented different changing laws.The relative contents of α-pinene, β-pinene, p-cymene, β-linalool, L-4-terpinenol, α-terpineol, nerol, β-cyclocitral, geraniol and α-citral in raw products were higher than that of their corresponding processed products.The relative contents of β-caryophyllene, cis-α-bergamotene, γ-muurolene, γ-elemene and β-bisabolene in processed products were higher than that of their corresponding raw products. Conclusion:The content and composition of volatile components in Citri Sarcodactylis Fructus from Guangdong province have changed after being steamed.The results can provide experimental basis for expounding the processing principle and quality evaluation of Citri Sarcodactylis Fructus, and have positive significance for promoting the research and development of this Lingnan characteristic decoction pieces.

Retrospective analysis of mediastinal mass resection with totally no tube during da Vinci robotic surgery for 79 patients / 中国胸心血管外科临床杂志

@#Objective To analyze the feasibility of totally no tube (TNT) in da Vinci robotic mediastinal mass surgery and its significance for fast track surgery. Methods A total of 79 patients receiving robotic mediastinal TNT surgery in the General Hospital of Shenyang Military Command from January 2016 to December 2017 were enrolled as a TNT group; 35 patients receiving robotic mediastinal surgery in General Hospital of Shenyang Military Command from January 2014 to December 2017 and 54 patients receiving thoracoscopic mediastinal surgery during the same period were enrolled as a non-TNT group and a video-assisted thoracoscopic surgery (VATS) group. The muscle relaxation and tracheal intubation/laryngeal masking time, operation time, intraoperative blood loss, postoperative ICU stay, postoperative hospital stay, postoperative visual analogue scale (VAS), hospitalization costs and postoperative complications and other related indicators were retrospectively analyzed among the three groups. Results Surgeries were successfully completed in 168 patients with no transfer to thoracotomy, serious complications (postoperative complications in 9 patients) or death during the perioperative period. All patients were discharged. Compared with the non-TNT group, the TNT group had significantly less muscle relaxation-tracheal intubation/laryngeal masking time, operation time, intraoperative blood loss, VAS pain score, ICU stay, postoperative hospital stay (P<0.01); there was no significant difference in the total cost of hospitalization between the two groups (P>0.05). Between the non-TNT group and the VATS group, there was no significant difference in time of muscle relaxation and tracheal intubation, operation time and ICU stay (P>0.05). The non-TNT group was superior to the VATS group in terms of intraoperative blood loss, VAS pain scores on the following day after operation, chest drainage volume 1-3 days postoperatively, postoperative catheterization time and postoperative hospital stay (P<0.05); but the cost of hospitalization in the non-TNT group was significantly higher (P=0.000). Conclusion The da Vinci robot is safe and feasible for the treatment of mediastinal masses. At the same time, TNT is also safe and reliable on the basis of robotic surgery which has many advantages such as better comfort, less pain, ICU stay and hospital stay as well as faster recovery.

Compound odontoma: a case report and literature review / 口腔疾病防治

@#Odontoma is one of the most common odontogenic tumors in the jaws, and it is widely considered as tooth hamartomas. This article reports a rare compound odontoma with 39 denticles which was checked and diagnosed radically by CBCT, and relevant literatures are reviewed.

Cefoxitin plus levofloxacin for prevention of severe infection after transrectal prostate biopsy / 中华男科学杂志

<p><b>Objective</b>To evaluate the effect of cefoxitin prophylactic in reducing the incidence of severe infection after transrectal prostate biopsy (TRPB).</p><p><b>METHODS</b>This retrospective study included 155 cases of TRPB with a 5-day administration of oral levofloxacin at 200 mg bid (the control group) and another 167 cases with a 3-day administration of oral levofloxacin at the same dose plus intravenous cefoxitin at 2.0 g 2 hours before TRPB (the experimental group) according to the distribution characteristics of drug-resistance bacteria in our department. The patients of the control and experimental groups were aged (68.68 ± 8.12) and (68.72 ± 7.51) years, with PSA levels of (19.78 ± 21.57) and (21.15 ± 42.63) μg/L, involving (11.68 ± 1.44) and (11.77±1.02) biopsy cores, respectively. Comparisons were made between the two groups of patients in the incidence rate of severe infection, which was defined as lower urinary track symptoms plus the systemic inflammatory response syndrome (SIRS) within 7 days after TRPB.</p><p><b>RESULTS</b>The incidence rate of postoperative severe infection was significantly lower in the experimental group than in the control (0.6% ［1/167］ vs 5.8% ［9/155］, P < 0.05). Blood cultures revealed positive E-coli strains in 6 cases in the control group, including 5 ESBL-positive and 4 quinolone-resistant and amikacin-sensitive cases, all sensitive to cefoxitin, cefoperazone/sulbactam and imipenem. The only one case of severe infection was shown to be negative in blood culture.</p><p><b>CONCLUSIONS</b>Preoperative intravenous administration of cefoxitin according to the specific distribution characteristics of drug-resistance bacteria can significantly reduce the incidence of severe infection after TRPB.</p>

Effects of metformin on insulin sensitivity and islet beta cell secretion in obesity patients / 基础医学与临床

Objective To investigate the effects of metformin on insulin sensitivity and secretion in patients with obesity and insulin resistance. Methods This study enrolled 42 obesity patients with insulin resistance who were regularly followed-up in Peking Union Medical College Hospital from September 2012 to May 2016. They were divided into two groups according to their different status of glucose metabolism: normal glucose tolerance( NGT) and impaired glucose regulation( IGR) . Life style intervention and metformin were given to all these patients. The antropometric and metabolic data were collected before treatment, 3 and 6 months after treatment respectively. Results 42 patients, aged (23.6±6.5) years, including 11 males and 31 females were enrolled. 19 of them were NGT and 23 were IGR (8 of IGT and 15 of IFG) . Among all these patients, fasting insulin was significantly higher at 3 months after treatment(P＜0.05).The same results were shown in group-NGT(P＜0.05). Fasting insulin was significantly lower at 6 months after treatment than at baseline among all patients( P＜0.05) . HOMA-IR showed no significant difference between the baseline and 3 months after treatment, but significantly higher at baseline and 3 months after treatment than 6 months after therapy( P＜0.001) . HOMA-beta was significantly( P＜0.001) lower be-fore treatment and 6 months treatment the effect was more significant than 3 months after treatment among all pa-tients. HOMA-beta was significantly lower at baseline in group-IGR than at baseline in group-NGT ( P＜0.05) . Conclusions The effect of metformin on insulin secretion is earlier than that of improving the insulin sensitivity in patients with obesity and insulin resistance. Metformin is more likely to promote insulin secretion in patients with normal glucose tolerance than those with IGR within 3 months of intervention.

Compound odontoma: a case report and literature review / 口腔疾病防治

@#Odontoma is one of the most common odontogenic tumors in the jaws, and it is widely considered as tooth hamartomas. This article reports a rare compound odontoma with 39 denticles which was checked and diagnosed radically by CBCT, and relevant literatures are reviewed.

Simultaneous determination of eight constituents in Yuye Xiaoke Granules by QAMS / 中成药

AIM To establish a quantitative analysis of multi-components by single-marker (QAMS) method for the simultaneous content determination of 3'-hydroxy puerarin,puerarin,3'-methoxy puerarin,neomangiferin,mangiferin,calycosin-7-O-β-D-glucoside,astragaloside Ⅳ and batatasin Ⅰ in Yuye Xiaoke Granules (Astragali Radix,Dioscoreae Rhizoma,Puerariae lobatae Radix,etc.).METHODS The analysis of methanol extract of this drug was performed on a 30℃ thermostatic Kromasil C1scolumn (4.6 mm ×250 mm,5 μm),with the mobile phase comprising of methanol-acetonitrile (1 ∶ 1) and 0.4％ glacial acetic acid flowing at 0.9 mL/min in a gradient elution manner,and the detection wavelengths were set at 210,250,254,274 nm.With astragaloside Ⅳ as an internal standard,the relative correction factors of the other seven constituents were calculated,after which the con tent determination was made.RESULTS Eight constituents showed good linear relationships within their own ranges (r ＞ 0.999 0),whose average recoveries were 97.06％-99.95％ with the RSDs of 0.54％-1.44％.The results obtained by QAMS approximated those obtained by external standard method.CONCLUSION This stable and reliable method can be used for the quality control of Yuye Xiaoke Granules.

Effect of ethyl acetate extract of Shenbing No. 1 Decoction on renal interstitial fibrosis caused by unilateral ureteral obstruction in rats / 中草药

Objective: To investigate the effect of ethyl acetate extract of Shenbing No. 1 Decoction (EASD) on the expression of TGF-β1 and a-SMA in rats with renal fibrosis. Methods: Totally 50 SD rats were randomly divided into Sham operation group, unilateral ureteral obstruction (UUO) model group, Lotensin treated group (1.67 mg/kg), Shenbing No. 1 Decoction group (18.75 g/kg) and EASD group (300 mg/kg). A rat model of renal fibrosis was induced by unilateral ureteral ligation. The rats were executed after 14 d. The contents of 24 h urinary protein (24hUP), serum blood urea nitrogen (BUN), and serum creatitine (Scr) were tested. Renal tubular interstitial fibrosis was evaluated by HE staining and Masson staining. The protein expression levels of TGF-β1 and a-SMA were observed by immunohistochemical method. Quantitative real-time PCR was adopted to inspect the mRNA expression of a-SMA and TGF-β1. Results: Compared with Sham-operation group, in rats of other groups, the serum levels of BUN and SCr increased (P 0.05). Conclusion: Shenbing No. 1 Decoction and EASD may ameliorate renal interstitial fibrosis by down-regulating the expression levels of TGF-β1 and a-SMA.