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Coronary heart disease (CHD) and stroke are the most well-known cardiovascular diseases, which share many common pathological basis. Yindan Xinnaotong soft capsule (YDXNT) is a commonly used Chinese patent medicine in the treatment of stroke and CHD. However, its action of mechanism of co-treatment for stroke and CHD is still unclear. The aim of this study was to explore the common mechanism of YDXNT in co-treatment of CHD and stroke using network pharmacology, experimental verification and molecular docking. An integrated literature mining and databases of IPA, ETCM, HERB, Swiss Target Prediction, OMIM and GeneCards were used to screen and predict active ingredients and potential targets of YDXNT in co-treatment of CHD and stroke. The protein-protein interaction network, GO analysis and pathway analysis were analyzed by IPA software. The effect of YDXNT on core targets was verified by immunofluorescence. UPLC-QTOF/MS and molecular docking were used to screen and predict the main active constituents of YDXNT and their interactions with core targets. A total of 151 potential targets are predicted for YDXNT in co-treatment of CHD and stroke. Hypoxia-inducible factor-1α (HIF1α)-matrix metalloproteinase-9 (MMP9)-mediated HIF1α signaling pathway serves as one of the common mechanisms. YDXNT could reduce the increase of mitochondrial fluorescence intensity and the protein expression of HIF1α and MMP9 in HL-1 and HA induced by oxygen and glucose deprivation/reperfusion (OGD/R) in a dose-dependent manner. Baicalin may be the material basis for treating stroke and CHD with YDXNT. In conclusion, the HIF1α signaling pathway is one of the common key mechanisms of YDXNT in the co-treatment of stroke and CHD. The study provides support and basis for the in-depth scientific connotation of the traditional Chinese medicine theory of "same treatment to different diseases".
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Objective:By calculating the efficiency of the scientific research laboratory, which reflects the level of the scientific research input and output capacity, provide reference for the evaluation and decision-making of its scientific research sustainable development capacity.Methods:20 scientific research laboratories in a hospital were selected as the research subjects, annual input data were used as the input index. Weighted quantitative scores of the performance of each laboratory in research capacity and contribution, research team construction, discipline development and personnel training, operation management, papers and monographs, patents and transfer, awards, graduate-student training, standards and norms, and academic conferences. All these factors mentioned above were used as output indicators. Then Analytic Hierarchy Process (AHP) and Data Envelopment Analysis (DEA) are used to evaluate the scientific efficiency of each laboratory.Results:The performance of the laboratory is weak in the aspects of patent transfer, awards, standardization. The technical efficiency of laboratory 20 is the lowest, and the scale efficiency of laboratory 12 is the lowest.Conclusions:Scientific Research Laboratories should enhance the effectiveness through input adjustment and output enhancement, meanwhile each laboratory should pay attention to the transformation of scientific achievements and also the optimization of construction system.
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Objective:Take all hospitals in Hubei Province as an example to analyze the patent application and authorization status of hospitals, to make recommendations for hospital patent management.Methods:Use patentics platform to search domestic patent applications of all hospitals in Hubei Province, data regarding to the number and types of patents were classified and analyzed.Results:Hospitals in Hubei Province had 7 694 patent applications and 6 491 authorized patent. Patent applications showed a growth trend; the types of patents were mainly utility models, followed by invention patents; patent IPC classification was concentrated in technical fields such as A61 and G01; the effective patents accounted for relatively low, and the subsequent maintenance work was poor.Conclusions:Hospitals should improve the innovation ability of medical staff and mobilize the enthusiasm of patent applications; strengthen the process management of patent applications and focus on improving the quality of patents; increase investment in technology field with advantage and pay more attention to the identification and transformation of high-value patents; improve the services quality of hospital patent management departments, cultivate patent management talents.
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OBJECTIVE@#To investigate the clinical application and efficacy of 125Ⅰ radioactive seeds implantation in the treatment of recurrent salivary gland carcinoma after external radiotherapy.@*METHODS@#From July 2004 to July 2016, 43 cases of recurrent salivary gland carcinoma of the neck after external radiotherapy or surgery combined with external radiotherapy were treated. According to the conventional segmentation radiotherapy for head and neck cancer (once a day, 1.8-2.0 Gy each time, 5 days per week), the cumulative radiation dose of the patients in this group was calculated. In the study, 26 patients received 50-60 Gy, 7 patients received less than 50 Gy, 4 patients received 60-70 Gy, and 6 patients received more than 80 Gy (range: 80-120 Gy). The interval between the last external irradiation and local recurrence was 4-204 months, and the median interval was 48 months. Among them, 25 cases were treated with 125Ⅰ radioactive seeds implantation only and 18 cases were treated with 125Ⅰ radioactive seeds implantation after operation. The prescription dose was 100-140 Gy. The control rate, survival rate and disease-free survival rate were recorded to evaluate the side effects.@*RESULTS@#The median follow-up time was 27 months (ranging from 2.5 to 149.0 months). Among them, the median follow-up time of adenoid cystic carcinoma patients was 31 months (range: 2.5-112.0 months), and the median follow-up time of mucoepidermoid carcinoma patients was 18 months (range: 5-149 months). The local control rates for 1, 3 and 5 years were 66.5%, 48.8% and 42.7%, respectively. The 1-, 3- and 5- year survival rates were 88.0%, 56.7% and 45.8%, respectively. The disease-free survival rates of 1, 3 and 5 years were 58.3%, 45.4% and 38.1%, respectively. There was no statistically significant difference in local control rate, survival rate, and disease-free survival between the radioactive seeds implantation group and the radioactive seeds implantation group after surgical resection. There were 2 cases of acute radiation reaction Ⅰ/Ⅱ and 3 cases of reaction Ⅲ or above. In the late stage of radiotherapy, there were 8 cases with Ⅰ/Ⅱ grade reaction and 3 cases with Ⅲ grade or above reaction. The incidence of radiation reactions of Grade Ⅲ and above was 7%.@*CONCLUSION@#125Ⅰ radioactive seeds implantation provides an alternative method for the treatment of recurrent salivary gland carcinoma after external radiotherapy. The local control rate and survival rate are improved on the premise of low incidence of side effects.
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Humans , Brachytherapy/adverse effects , Iodine Radioisotopes/therapeutic use , Neoplasm Recurrence, Local/radiotherapy , Salivary Gland Neoplasms/radiotherapy , Salivary GlandsABSTRACT
Objective:Analyze and discuss the research situation and hot topics of Chinese medical science research management in the past ten years, provide reference for the managers in this field.Methods:Using Excel and CiteSpace to analyze the papers on medical science research management in Wanfang Med Online, information about the journals, institutions, authors, hot topics and frontier related data was analyzed.Results:There are 2176 valid records in total, among which the most was recorded in 2012, these paper were mainly published in the " Chinese Medical Science Research Management" , up to 187, accounting for 8.6% of the total. The institutions of paper publication are ranked in the following order: Peking Union Medical College Hospital, Academy of Military Medical Sciences, Peking University, Capital Medical University, Sichuan Provincial People's Hospital. The authors who have published more articles include Liu Yan, He Youqin, Yan Junxia, Zhang Huanping, Niu Yuhong and so on.Conclusions:Authors within the same institution have close cooperation and there is less cooperation among different institutions. This paper briefly discusses the more researched aspects of medical science research management, evaluation index system, scientific research personnel training, data mining and system design.
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This meta-analysis aimed to confirm the efficacy and safety [side effect] of curcumin for osteoarthritis [OA]. Two researchers independently searched the database of Pub Med, EMBASE and Cochrane Library updated to November 2015 to find randomized controlled trials that reported the effect of curcumin on OA. The outcomes of this meta-analysis were Visual analogue scale [VAS], Western Ontario and McMaster Universities Osteoarthritis Index scale [WOMAC] and side effect. Furthermore, the quality assessment was performed with Cochrane Collaboration's tool. In addition, standardized mean difference [SMD] and 95% confidence interval [CI] were used for the analysis of continuous data, and the risk ratio [RR] and 95% CI were used to analyze dichotomous data. Sensitivity analysis was performed by using Stata 12.0. A total of 5 studies with 599 patients were included in this study. The results showed that curcumin could significantly improve the WOMAC score [SMD=-0.96; 95% CI:-1.81, -0.10; P=0.03] and VAS score of OA patients [SMD=-1.65; 95% CI:-2.11, -1.19]. Furthermore, the side effect rate of curcumin treatment was 0.81times higher than that of ibuprofen treatment. Curcumin can treat OA patients effectively, improving WOMAC score and VAS score, and the side effect of curcumin was not higher than that of ibuprofen
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OBJECTIVE@#To retrospectively analyze the results of treatment outcome by surgery combined with 125I brachytherapy and correlative factors of adenoid cystic carcinoma (ACC).@*METHODS@#In the study, 75 patients with primary ACC of oral and maxillofacial region were treated by surgery combined with 125I seeds brachytherapy. Radical resection or subtotal resection was applied for the tumor. The brachytherapy treatment planning system was used to create implant plans with the prescribed dose of 60 Gy to 120 Gy. The 125I seeds were implanted intraoperatively or postoperatively. The regular follow-up was required. The Kaplan-Meier method was used to assess the tumor control rate and the patients' survival rates. Meanwhile, the Cox regression analysis was used to find out the prognostic factors.@*RESULTS@#Local control rates at the end of 3 and 5 years were as follows: T1-T2, 92.2% and 82.0%; T3-T4, 82.6% and 82.6%; and overall, 90.0% and 78.8%. The disease-free survival rates were 74.9% and 54.3%, respectively. The overall survival rates for all the patients were 86.0% and 79.6%, respectively at the end of 3 and 5 years and were 91.3% and 91.3% for T1-T2 patients vs. 73.9% and 59.7% for T3-T4 patients. Distant metastasis-free survival rates at the end of 3 and 5 years were 84.4% and 76.7%, respectively. The distant metastasis-free survival rates at the end of 3 and 5 years were 83.4% and 79.6% with T1-T2 lesion compared with 86.0% and 67.8% with T3-T4 lesion. According to the COX univariate analysis and multivariate analysis, the risk of local recurrence would be raised by the age. Tumor stage and tumor site were the prognostic factors of the overall survival rates.@*CONCLUSION@#125I brachytherapy conducted as an adjuvant therapy postoperatively of ACC of oral and maxillofacial region can acquire satisfactory localregional control, distant metastasis-free survival, disease-free survival and overall survival. Tumors are prone to recur on the older patients. Patients having advanced tumor stage or tumor located in the nasal cavity or sinuses will suffer lower survival rates.
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Humans , Brachytherapy , Carcinoma, Adenoid Cystic , Combined Modality Therapy , Iodine Radioisotopes , Neoplasm Recurrence, Local , Neoplasm Staging , Retrospective Studies , Survival RateABSTRACT
Objective There are few comparative researches on open reduction internal fixation, hemishoulder arthroplasty and reverse total shoulder arthroplasty for the treatment of complex proximal humeral fractures. The purpose of this study was to explore the clinical efficacy of three surgical Methods for the treatment of complex proximal humeral fractures.Methods A retrospective study of 55 cases of complex proximal humeral fractures treated in our department from November 2013 to May 2016. According to different surgical Methods , the patients were divided into three groups: open reduction internal fixation group of 20 cases (open reduction and internal fixation using locking plate), hemishoulder arthroplasty group of 20 cases (artificial humeral head replacement), reverse total shoulder arthroplasty group of 15 cases (head-glenoid inverted shoulder replacement). Regular postoperative review was done to record the ranges of motion. The function of shoulder joint was evaluated by ASES score, VAS pain score, UCLA score and SST score.Results 6 months after the operation, the internal rotation function of the hemishoulder arthroplasty group\[(49.1±3.3)°\] was better than those of reverse total shoulder arthroplasty group \[(43.7±4.5)°\] and open reduction internal fixation group \[(41.7±5.0)°\], but the external rotation function\[(25.7±5.4)°\] was worse than the other two groups\[(38.0±5.6)°, (39.5±4.6)°\], the differences representing statistical significance(P0.05).Conclusion Three surgical Methods can all be used in the treatment of complex proximal humeral fractures with equivalent efficacy. Reverse total shoulder arthroplasty leads to earlier shoulder joint range of motion, but lacks middle-term and long-term curative effect. Clinicians should take surgical indications and individualization into consideration comprehensively to make the choice among three surgical Methods .
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Objective: To design a management system of medical consumables that has concise interface in good taste, simple operation, rational construction and well usability so as to achieve informatization and delicacy management for medical consumables. Methods: Through utilized computer networking technology(CNT), and adopted a special architectural pattern of browser and servicer(B/S), and depended on the process of purchase, application and usage, to design and establish a logistics management system of hospital, and to construct a scientific and reasonable management platform for logistics informationization. Result: The application of the logistics management system has solved many problems happened in formerly medical consumables management, such as confusion of qualification management, cumbersome signing approval, the problems of "running, emitting, dripping and leaking" that existed in part of materials and others. Conclusion: The design and application of logistics management system have established a networking approval process which can extremely enhance working efficiency and provide a digital platform for achieving a new model of informatization and delicacy management of medical consumables.
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Objective To investigate the efficacy of an anti-vascular endothelial growth factor (VEGF) antibody,MIL60,in inhibiting corneal neovascularization (CoNV) formation in a rat model of alkali cauterization and its involved mechanisms.Methods Rat CoNV model induced by alkali burn was founded in the right eyes,and then 72 cases were randomly divided into four groups according to the subconjunctival administration of medicine next day after the successful establishment of this model:25mg· mL-1 MIL60 group,dexamethasone group,MIL60 solvent group and NaCl group.Then CoNV was observed for recording the its length and the involved area using digital photograph.Next the rats were sacrificed on day 7,14,21 and 28,followed by the collection of rats' cornea for HE and immunohistochemical staining to analyze the protein expression of VEGF,VEGF receptor-1 (VEGFR-1),VEGFR-2 and matrix metallopeptidase-9 (MMP-9).Results At each time point,the area and length of CoNV in the 25 mg· mL-1 MIL60 and dexamethasone group were significantly less than those in the MIL60 solvent and NaC1 group,and the differences were statistically significant (all P ＜0.01),and 25 mg· mL-1 MIL60 group had the similar CoNV area and length with the dexamethasone group (all P ＞ 0.05).Moreover,HE and immunohistochemical staining showed that MIL60 could inhibit the protein expression of VEGF,VEGFR-1,VEGFR-2 and MMP-9,which could explain its effective anti-angiogenic activity.Conclusion Subconjunctival administration of MIL60 can significantly inhibit corneal neovascularization formation and alleviate the inflammation in rats suffered from alkali burn.
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Objective:To describe the surgical technique of direct anterior approach to total hip arthroplasty and to report the early clinical outcomes.Methods: A series of 100 consecutive,unselected patients who had 116 primary total hip arthroplasty surgeries (16 bilateral) done through direct anterior approach from March 11 2015 to June 21 2016 was reviewed.There were 50 male patients and 50 female patients.The average patient age was 51 years,and the average body mass index was 24.69 kg/m2.The preoperative diagnosis included avascular necrosis of femoral head,hip osteoarthritis,osteoarthritis se-condary to acetabular dysplasia,sequelae of hip old infection,ankylosing spondylitis,rheumatoid arthritis and avascular necrosis of femoral head after cannulated screws fixation of femoral neck fracture.There were 7 hips which had surgical history prior to the index hip arthroplasty,including 3 cases with bone graft treatment for avascular necrosis of femoral head through Smith-Peterson approach,2 cases with acetabular shelf procedures for acetabular dysplasia through Smith-Peterson approach,and 2 cases with cannulated screws fixation for femoral neck fracture (internal fixation residual).All were uncemented hips.The stems used in this study included 67 Triloc stems (DePuy company,USA),45 Corail stems (DePuy company,USA),2 Accolade stems (Stryker company,USA),1 Synergy stem (Smith-Nephew company,USA) and 1 Polarstem (Smith-Nephew company,USA).Results: The average follow up period was 8.5 months,the average incision scar length was 10 cm,and the average postoperative Harris score was 93.62.There was 95％ postoperative leg length discrepancy within 3 mm.The average cup inclination angle was 38.7°with 94.8％ in the range of 30° to 50°.The average cup anteversion angle was 14.3° with 94.2％ within the target range of 5° to 25°.The were 15 (12.9％) operative complications,including two femoral perforations (changing stem from Triloc to Corail),three calcar fractures (treated with cerclage wires),four greater trochanter fractures (2 were treated wire tension band,and 2 nondisplaced fractures untreated),one deep infection (debridement and retaining of the prothesis),one superficial infection (debridement),one hematoma and three wound healing complications (debridement).All the complications were successfully treated without any sequelae at the end of the latest follow-up.There was no postoperative dislocation.There was no major nerve and vascular injuries.There were 35 cases (30.2％) reporting symptoms of lateral femoral cutaneous nerve palsy.Conclusion: Direct anterior approach to total hip arthroplasty allows accurate and reproducible cup orientation positioning and leg length restoration and decreases the risk of postoperative dislocation,which is helpful for early rapid postoperative recovery.
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Objective:To analyze the operation technique and the methods to avoid early complications on the learning curve for bilateral direct anterior approach (DAA) total hip arthroplasty (THA).Methods: We retrospectively studied a series of continued cases with bilateral avascular necrosis of the femoral head (AVN) or degenerative dysplastic hip and rheumatoid arthritis that were treated by DAA THA in Beijing Jishuitan Hospital.A total of 22 patients with 44 hips were analyzed from June 2014 to August 2016 in this study.There were 17 males and 5 females,and the median age was 48 years(range: 34-67 years).All the surgery was done by DAA method by two senior surgeons.The clinic characters,early surgery treatment results and complications were analyzed.Results: We used the cementless stems in all the cases.The average operating time was (167±23) min;the average blood loss was (775±300) mL;the blood transfusion was in average (327±341) mL;the wound drainage in average was (111±73) mL Most of the patients could move out of the bed by themselves on the first day after operation,5 patients could walk without crutches on the first operating day,and 13 patients could squat on the third days after operation.The patients were discharged averagely 4 days after operation.We followed up all the patients for averagely 16 months (range: 8-24 months).There was no loosening or failure case in the latest follow up.In the study,2 patients had great trochanter fracture,2 patients had thigh pain,4 patients had lateral femoral cutaneous nerve palsy,and 3 patients had muscle damage.The Harris scores were improved from 29±8 preoperatively to 90±3 postoperatively (P<0.01).Conclusion: The DAA THA can achieve faster recovery and flexible hip joint after operation.However it is a kind of surgery with high technique demanding.Carefully selected patients,and skilled technique,can help the surgeon avoid the early complications.It is associated with high complication rate in the learning curve for bilateral DAA THA.
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<p><b>OBJECTIVE</b>To investigate the expression and the subcellular localization of HDAC9 in different brain regions of mice after cerebral ischemic injury and explore the association between HDAC9 and ischemic stroke.</p><p><b>METHODS</b>Twenty-one male C57BL/6 mice were randomly divided into sham-operated group (n=9) and operated group (n=12). In the latter group, the mice with Zea-Longa neurological deficit scores of 2 or 3 following middle cerebral artery occlusion (MCAO) were assigned into MCAO group (n=9). Immunofluorescence was performed to investigate the subcellular localization of HDAC9 in the brain tissues on day 3 after MCAO. Western blotting and qRT-PCR were used to analyze the expression of HDAC9 in different regions of the brain. Results Immunofluorescence showed more intense HDAC9 expressions in the brain tissues around the infarct focus, and in the cells surrounding the infarct, HDAC9 expression was obviously increased in the cytoplasm and reduced in the cell nuclei. Compared with the other brain regions, the ipsilesional cortex with MCAO showed more abundant HDAC9 expressions at both the mRNA and protein levels (P<0.05).</p><p><b>CONCLUSION</b>HDAC9 may be closely related to cerebral ischemic injury and participate in the pathophysiological process of ischemic stroke.</p>
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Objective Toexploretheassociationamongseruminsulin,IGFBP3,andendometrialcancerriskinChinese women.Methods SeruminsulinandIGFBP3weredetectedbyELISAmethodin206patientswithendometrialcarcinoma and 310 healthy women.Using logistic regression analysis after adjustments for BMI,serum glucose and triglycerides to exploretheassociationamongthetwoindicatorsandtheriskofendometrialcarcinoma.Results Increasedinsulinwere found in the women with endometrial carcinomas as compared with that of controls [Mean ±SD:insulin (14.84 ±16.72) uU·mL-1 in women with cancer versus (8.13 ±9.40)uU·mL-1 in controls,P<0.01].However,serum IGFBP3 was not significantly higher in women with endometrial cancer [Mean ±SD:IGFBP3 (1.76 ±2.44)mg·L-1 in women with cancer versus (1.57 ±1.80)mg·L-1in controls,P>0.05].The risk for endometrial cancer was significantly higher in the upper quartile relevant to the lowest quartile of serum insulin,and lower in the upper quartile of serum IGFBP3 (P<0.05).Logistic regression analysis showed that serum insulin was the risk factor of endometrial carcinoma(OR=2.34, 95%CI:1.32 -4.14),after adjusting obesity/overweight status,serum glucose,total cholesterol,total glyceride,and HDL-C.Conclusion HyperinsulinemiawasanindependentriskfactorforendometrialcarcinomasinChinesewomen. However,the protective role of increased serum IGFBP3 should be validated further.
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Objective:To find out whether it is accurate to estimate femoral version based on femoral broach after femoral neck osteotomy using computed tomography scans.Methods:In 32 total hip arthro-plasty (THA),we performed CT scans before and after operation.Four possible levels (lesser trochan-ter,5 mm above,10 mm above and 15 mm above the lesser trochanter)of broach version were calculated based on the pre-operative CT scan.Stem versions were measured on the post-operative CT scan.We de-termined the difference between the preoperative broach version and the postoperative stem version using the Student’s t-test for paired samples assuming equal variance.Results:For the operated hips,pre-operative hip version differed according to the level of measurement.Our findings showed that the average femoral version was 37.0°±11.0°at the level of the lesser trochanter (section 1),34.3°±10.6°at 5 mm above the lesser trochanter (section 2),28.1°±10.9°at 10 mm above the lesser trochanter (sec-tion 3),and 22.4°±13.7°at 15 mm above the lesser trochanter (section 4),and that the average ver-sion for the femoral neck (FNV)was 12.9°±13.8°.The postoperative hip version was the stem version (FSV),which we found to be an average of 26.1°±11.0°.The mean femoral version for section 1 and 2 was larger than the mean postoperative stem version (P0.05).The mean femoral neck version was less than the mean postoperative stem version (P<0.01);the difference was 13.2°±11.1°of the in-creased anteversion on average for the FSV compared with FNV.Conclusion:The accuracy of estimated femoral version after arthroplasty depends on broach level.When it is 10 mm above the lesser trochanter, stem version estimation is accurate,but below that level,there is a tendency to overestimate.
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Objective To study the correlation between the red cell distribution width (RDW) ,cystatin C (Cys c) and lipopro‐tein (a) [LP (a)]with the lesion severity of coronary heart disease .Methods 130 cases of coronary heart disease(CHD) definitely diagnosed by coronary arteriography in the cardiology department of our hospital from March 2012 to September 2014 were select‐ed .The subjects were divided into the single‐vessel lesion group ,double‐vessel lesion group and multiple‐vessel lesion group accord‐ing to the coronary arteriographic results;furthermore the subjects were divided into the 1-30 points group ,31 -60 points group and the >60 points group according to the Gensini scores ;other contemporaneous 45 individuals of normal coronary arteriography were selected as the control group .RDW ,Cys C and LP (a) levels were detected in each group and the detection results were per‐formed the comparative analysis .Results The RDW ,CysC and LP (a) levels in the CHD group were significantly higher than those in the control group ,the differences were statistically significant (P< 0 .05) .With the increase of coronary lesion vessels number and Gensini score ,the RDW ,CysC and LP (a) levels showed roughly increasing trend ,the correlation analysis showed that the RDW ,CysC and LP (a) were positively correlated with Gensini scores .Conclusion The RDW ,CysC and LP (a) levels in the patients with CHD are higher than those in the normal control group ,which are closely related with the lesion severity of CHD and may be the new predictors of coronary lesion severity .
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Objective:To evaluate the effectiveness of conducting multiple arthroplasty to treat multiple joints disease in terms of quality of life ( QOL) and function improvement.Methods:We compared our results with the reported results of single and dual arthroplasty to see if there is any improvement in QOL, functional scores or complications.In this study, 13 patients admitted to Department of Adult Reconstruc-tive Surgery, Beijing Jishuitan hospital from 2005 to 2009 were included.Questionnaires SF-36 were used to evaluate the QOL.Harris hip score, American Knee Society Score ( KSS) were used to evaluate the joint function.The patients were evaluated before surgery to the latest follow up.Results:SF-36 has changed as follow:physical function 4.17 ±14.43→65.83 ±24.76, role physical 25.00 ±26.11→60.42 ±45.8, bodily pain 23.83 ±21.41→76.88 ±20.89, general health 53.33 ±33.87→76.67 ± 14.67, vitality 50.42 ±17.25→71.67 ±16.28, social functioning 29.17 ±33.50→73.96 ±33.90, role emotional 22.08 ±35.61→77.77 ±41.03, mental health 53.33 ±25.70→82.67 ±14.41, which indicated that they all improved greatly after the surgery ( P <0.05 ) .Harris score increased from 37.68 ±14.71 before the surgery to 83.36 ±13.54 after the surgery.KSS has also showed sharp im-provement (P<0.001) in both clinical score (42.52 ±23.83→77.74 ±20.67) and function score (-2.61 ±22.56→65.65 ±30.76).Conclusion:Multiple arthroplasty is one of the most effective me-thods which can markedly improve the quality of life in patients with multiple joints disease.But compli-cations are common and joint functions are relatively poor.
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PD-1/PD-L1 signaling pathway as a T cell immune response co-stimulatory signaling pathway plays an important role in adaptive immunity. PD-1 is a major co-receptor expressing on T cells, binding with its ligands(PD-L1 and PD-L2), PD-1 can inhibit T cell activation and protect the body against the attacks from its own immune system. In addition to adjusting and maintaining autoimmune tolerance, in tumor cells PD-L1 expression is up-regulated, while in the virus-infected T cells PD-L1 expression is also upregulated. PD-1 / PD-L1 are involved in the tumor and infectious pathogen immune evasion, thus blocking the PD-1 / PD-L1 signaling pathway has become a hot research of cancer and chronic diseases. Currently, there are several anti-PD-1 or PD-L1 monoclonal antibodies approved by the FDA to enter clinical studies, which have shown significant anti-cancer effect.
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Objective Our goal was to summarize the clinical data of the combined anteversion of both stem and cup measured by CT method after total hip arthroplasty and to evaluate the accuracy of conventional freehand technique for positioning the combined anteversion by comparing the results to the Dorr′s “safe zone” .Methods We prospectively studied 206 primary total hip arthro-plasties .For all the arthroplasties ,we used posterior lateral approach and conventional freehand technique without any alignment guides .12 surgeons performed all the 206 arthroplasties .Postoperatively all the patients were examined by CT scan within one week .We measured radiographic anteversion of acetabular components using a 3D CT method and measured femoral components anteversion using CT scans .Acetabular anteversion ,femotal component anteversion and combined anteversion were statistically ana-lyzed .Results In all the 206 hips ,the mean acetabular components anteversion was 16 .23° ± 8 .27° ,76 .21% of cases was in Lewin-neck′s safe range of 5°-25° .The mean femoral components anteversion was 23 .79° ± 10 .70° .The mean combined anteversion was 40 .02°± 13 .50° ,65 .05% was in safe range of 25°-50°recommended by Dorr .The acetabular components anteversion ,femoral com-ponents anteversion and combined anteversion placed by senior surgeons was no significantly different from those placed by junior orthopedic surgeons(P>0 .05 ,0 .726 ,0 .143 ,0 .061 ,respectively) .Conclusion The conventional freehand technique is an inaccurate method for positioning the cup anteversion or the combined anteversion .The experience of surgeons can not significantly improve this accuracy .
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For the establishment of chemical library of protoberberines provided for the bio-activity screening, the target compounds were synthesized by thermal degradation and nucleophilic substitution reactions with the bio-active alkaloid, palmatine (1), as the raw material, and their structures were identified and conformed by 1H-NMR and MS spectra. Among them, 13 compounds were new.