Effectiveness and security of anisodine hydrobromide tablets in treating nonarteritic anterior ischemic optic neuropathy: a Chinese multicenter nonrandomized controlled study / 中华实验眼科杂志

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.

Clinical Study of Cytomegalovirus Infection after Allogeneic Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

OBJECTIVE@#To explore the risk factors of cytomegalovirus (CMV) and refractory CMV infection (RCI) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and their influences on survival.@*METHODS@#A total of 246 patients who received allo-HSCT from 2015 to 2020 were divided into CMV group (n=67) and non-CMV group (n=179) according to whether they had CMV infection. Patients with CMV infection were further divided into RCI group (n=18) and non-RCI group (n=49) according to whether they had RCI. The risk factors of CMV infection and RCI were analyzed, and the diagnostic significance of Logistics regression model was verified by ROC curve. The differences of overall survival (OS) and progression-free survival (PFS) between groups and the risk factors affecting OS were analyzed.@*RESULTS@#For patients with CMV infection, the median time of the first CMV infection was 48(7-183) days after allo-HSCT, and the median duration was 21 (7-158) days. Older age, EB viremia and gradeⅡ-Ⅳacute graft-versus-host disease (aGVHD) significantly increased the risk of CMV infection (P=0.032, <0.001 and 0.037, respectively). Risk factors for RCI were EB viremia and the peak value of CMV-DNA at diagnosis≥1×104 copies/ml (P=0.039 and 0.006, respectively). White blood cell (WBC)≥4×109/L at 14 days after transplantation was a protective factor for CMV infection and RCI (P=0.013 and 0.014, respectively). The OS rate in CMV group was significantly lower than that in non-CMV group (P=0.033), and also significantly lower in RCI group than that in non-RCI group (P=0.043). Hematopoietic reconstruction was a favorable factor for OS (P<0.001), whereas CMV-DNA≥1.0×104 copies/ml within 60 days after transplantation was a risk factor for OS (P=0.005).@*CONCLUSION@#The late recovery of WBC and the combination of EB viremia after transplantation are common risk factors for CMV infection and RCI. CMV-DNA load of 1×104 copies/ml is an important threshold, higher than which is associated with higher RCI and lower OS risk.

Clinical Analysis of Matched Sibling Donor Allogeneic Hematopoietic Stem Cell Transplantation in the Treatment of Young Patients with Multiple Myeloma / 中国实验血液学杂志

OBJECTIVE@#To investigate the efficacy and safety of matched sibling donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of young patients with multiple myeloma (MM).@*METHODS@#The clinical data of 8 young patients (median age：46 years) with MM who underwent allo-HSCT from HLA-indentical sibling donors in the First Affiliated Hospital of Chongqing Medical University from June 2013 to September 2021 were collected, and their survival and prognosis were retrospectively analyzed.@*RESULTS@#All the patients were successfully transplanted, and 7 patients could be evaluated the efficacy after transplantation. The median follow-up time was 35.2 (2.5-84.70) months. The complete response (CR) rate was 2/8 before transplantation and 6/7 after transplantation. Acute GVHD developed in 2 cases and extensive chronic GVHD developed in 1 case. Within 100 days, 1 case died of non-recurrent events, and 1-year and 2-year disease-free survival were 6 and 5 cases, respectively. At the end of follow-up, all the 5 patients who survived for more than 2 years survived, and the longest disease-free survival time has reached 84 months.@*CONCLUSION@#With the development of new drugs, HLA-matched sibling donor allo-HSCT may be a curable treatment for young patients with MM.

On-Site Assessment of a Cryogenic Disinfectant for the Alpine Environment and Outer Packaging of Frozen Items / 生物医学与环境科学（英文）

OBJECTIVE@#To study the effectiveness and feasibility of cryogenic disinfectants in different cold scenarios and analyze the key points of on-site cryogenic disinfection.@*METHODS@#Qingdao and Suifenhe were selected as application sites for the manual or mechanical spraying of cryogenic disinfectants. The same amount of disinfectant (3,000 mg/L) was applied on cold chain food packaging, cold chain containers, transport vehicles, alpine environments, and article surfaces. The killing log value of the cryogenic disinfectant against the indicator microorganisms ( Staphylococcus aureus and Escherichia coli) was used to evaluate the on-site disinfection effect.@*RESULTS@#When using 3,000 mg/L with an action time of 10 min on the ground in alpine regions, the surface of frozen items, cold-chain containers, and cold chain food packaging in supermarkets, all external surfaces were successfully disinfected, with a pass rate of 100%. The disinfection pass rates for cold chain food packaging and cold chain transport vehicles of centralized supervised warehouses and food processing enterprises were 12.5% (15/120), 81.67% (49/60), and 93.33% (14/15), respectively; yet, the surfaces were not fully sprayed.@*CONCLUSION@#Cryogenic disinfectants are effective in disinfecting alpine environments and the outer packaging of frozen items. The application of cryogenic disinfectants should be regulated to ensure that they cover all surfaces of the disinfected object, thus ensuring effective cryogenic disinfection.

Effect and mechanism investigation on improving kidney deficient in mice of Polygoni Multiflori Radix Praeparata based on plasma metabolomics / 药学学报

Plasma nontargeted metabolomics technology was developed for investigating the effect and mechanism of improving kidney deficient in mice of Polygoni Multiflori Radix Praeparata. Thirty-five ICR mice were randomly divided into the control group, the model group, the BB24 h (braising with black bean sauce for 24 hours) group, the BB32 h group, and the BB40 h group. Biochemical indices in blood plasma of mice were measured by collecting eye blood after modeling. Changes in plasma endogenous metabolites of mice from each group were determined by ultra-performance liquid chromatography-linear trap quadrupole-orbitrap XL (UPLC-LTQ-orbitrap XL), and differential metabolites were screened. The results of pharmacodynamic investigation showed that compared to the model group, the levels of estradiol increased obviously in the BB24 h (P < 0.05), and the levels of cortisol increased obviously in BB32 h (P < 0.05). The hormone level of mice with kidney deficiency was significantly improved after taking processed Polygonum multiflorum. A total of 70 differential endogenous metabolites in blood plasma of mice were identified from all treatment groups, which mainly involved glycerophospholipid meta-bolism, arachidonic acid metabolism, phenylalanine metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, and linoleic acid metabolism. The study indicated that Polygoni Multiflori Radix Praeparata may play the role of tonifying liver and kidney by improving the disorder of hypothalamic-pituitary-adrenal axis and regulating lipid metabolism in mice. Correlation analysis on differential metabolites in blood plasma and the chemical constituents showed that stilbene glycosides and saccharides may be the key pharmacodynamic material basis. The present study provides a new reference and theoretical foundation for revealing the potential pharmacodynamic material basis and mechanism investigation on tonifying liver and kidney of Polygoni Multiflori Radix Praeparata. This study was carried out following the ethical guidelines and regulations for the use of laboratory animals of the Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences and passed the animal experimental ethical review [No. SYXK (Jing) 2019-0003].

Clinical Study of Haploid Allogeneic Hematopoietic Stem Cell Transplantation Combined with Post-transplant Cyclophosphamide in Severe Aplastic Anemia Patients / 中国实验血液学杂志

OBJECTIVE@#To evaluate the clinical effect of haploid allogeneic hematopoietic stem cell transplantation(haplo-HSCT) in the treatment of severe aplastic anemia (SAA), and to explore the efficacy different between post-transplant cyclophosphamide (PT/Cy) and standard-dose ATG.@*METHODS@#The clinical data of 38 patients with SAA in our hospital from January 2012 to December 2019 were collected and retrospectively analyzed. The efficacy was evaluated. The patients with haplo-HSCT were divided into low-dose ATG combined with PT/Cy group and standard-dose ATG group, and the blood cell hematopoietic reconstruction time, GVHD incidence, mortality and survival time of the patients in the two groups was compared.@*RESULTS@#Among the 32 patients, hematopoietic reconstitution were detected in 9375%(30/32) recipients. The median time of neutrophil and platelet engraftment was 15(10-22) days and 13(7-30) days, respectively. The incidence of GVHD was 21.89%, the incidence of infection was 93.75%, and the 2-year overall survival rate was 84.38%. The hematopoietic reconstitution time, incidence of GVHD, mortality rate and survival time were no statistical differences between the patients in the two groups(all P>0.05).@*CONCLUSION@#Haplo-HSCT is an effective method for the treatment of SAA，low-dose ATG combined with PT/Cy can lighten the economic burden on patients, it would be a feasible treatment plan for SAA with light side effect.

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

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

A Hypoxia-Induced SCFFBXL1 E3 Ligase Ubiquitinates and Degrades the MEN1 Tumor Suppressor to Promote Colorectal Cancer Tumorigenesis / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Emerging evidence has shown that SKP1-cullin-1-F-box-protein (SCF) E3 ligases contribute to the pathogenesis of different cancers by mediating the ubiquitination and degradation of tumor suppressors. However, the functions of SCF E3 ligases in the pathogenesis of colorectal cancer (CRC) remain obscure. @*Materials and Methods@#The cancerous and adjacent noncancerous tissues from CRC patients were collected, and protein levels were analyzed. Lentiviral short hairpin RNA (shRNA) and plasmid transfection were used to knock down and overexpress gene expression in CRC cell lines. Immunoprecipitation (IP), mass spectrometry, and co-IP analyses were used to determine protein interactions and the assembly of the SCF complex. Cell proliferation, migration, and tumor xenograft assays were performed to examine the effects of SCF members on CRC cell growth in vitro and in vivo. @*Results@#Hypoxia activated the docking of hypoxia-inducible factor 1α (HIF1α) onto the CUL1 promoter and induced CUL1 expression in CRC cells. CUL1 coupled with RBX1, SKP1, and FBXL1 to assemble the SCFFBXL1 complex in CRC biopsies and cells. The SCFFBXL1 E3 ligase specifically ubiquitinated and degraded the MEN1 tumor suppressor. Knockdown of HIF1α or SCFFBXL1 members, or blockage of SCFFBXL1 by two inhibitors (DT204 and SZLP1-41) caused the accumulation of MEN1 protein and led to a significant decrease in cell proliferation and migration in vitro and tumor growth in vivo. @*Conclusion@#The SCFFBXL1 E3 ligase is required for the ubiquitination of MEN1, and disruption of this complex may represent a new therapeutic strategy for the treatment of CRC.

Observation of the optic disc vessel density in the affected eye with non-arteritic anterior ischemic optic neuropathy of different stages / 中华眼底病杂志

Objective:To observe the changes in blood flow density of radial retinal peripapillary capillary (RPC) around the optic disc in patients with non-arteritic anterior ischemic optic neuropathy (NAION) at different stages of the continuous course of the disease.Methods:A prospective cohort study. From January to December 2020, 29 cases of 29 eyes of NAION patients diagnosed in the Eye Center of the Second Affiliated Hospital of Zhejiang University School of Medicine were included in the study. Among them, there were 18 males with 18 eyes and 11 females with 11 eyes. The average age was 53.62±6.67 years old. The affected eye underwent routine eye examination and visual field, optic cohenrence tomography angiography (OCTA) examination. Visual field inspection was performed to obtain the average visual mean defect (MD) value. OCTA was used to measure the thickness of the peripapillary retinal nerve flayer (pRNFL) around the optic disc, the whole en face image vessel density (wiVD), intro disc vessel density (diVD), RPC blood flow density around the optic disc, and macular ganglion cell complex (GCC). The course of disease ≤3 weeks was defined as the acute phase; 4-12 weeks was defined as the subacute phase; >12 weeks was defined as the chronic phase. The changes of visual field MD, optic disc RPC blood flow density, pRNFL thickness and macular GCC thickness were observed in the acute, subacute and chronic phases (12-24, >24 weeks). A completely randomized design of variance analysis was used to compare the differences in visual field MD, RPC blood flow density, GCC, and pRNFL thickness in different courses. Pearson correlation analysis was used to analyze the correlation between pRNFL thickness, macular GCC thickness, visual field MD changes and RPC blood flow density around the optic disc sex.Results:The wiVD of the eyes in the acute phase, subacute phase, and chronic phase (12-24 weeks, >24 weeks) were (44.96±2.76)%, (41.50±3.49)%, (39.08±5.43)%, (38.56±6.48)%. There was a statistically significant difference in wiVD of eyes with different disease courses ( F=8.939, P<0.001). The average difference of wiVD between 12-24 weeks and >24 weeks in the chronic phase was -0.984, and the difference was not statistically significant ( P>0.05). There was no statistically significant difference in diVD of patients with different courses of disease ( F=1.079, P=0.365). The blood flow density of RPC around the optic disc of the affected eye, except for the lower part, the blood flow density of the nasal side, the temporal side, and the upper quadrant, decreased significantly with the progression of the disease, and the difference was statistically significant ( F=8.816, 6.069, 8.943; P<0.05). In the chronic phase, the average difference of blood flow density between the nasal, temporal, and upper sides of the eyes between 12-24 weeks and more than 24 weeks in the chronic phase was -0.984, -0.230, -0.198, and the difference was not statistically significant ( P>0.05). There was no statistically significant difference in the visual field MD of patients with different courses of disease ( F=0.277, P=0.842); the overall pRNFL thickness and average macular GCC thickness were compared with statistical significance ( F=47.122, 14.954; P<0.001, <0.001), all became significantly thinner with the progression of the disease. The results of Pearson correlation analysis showed that the blood flow density of the entire optic disc wiVD, the blood flow density of RPC in the temporal quadrant around the optic disc and the visual field MD ( r=-0.225, -0.268; P<0.05), and the average thickness of GCC ( r=0.480, 0.436; P<0.01) were all related. Conclusion:The blood flow density of RPC in the entire optic disc and around the optic disc (except the lower quadrant) of NAION eyes gradually decrease with the progression of the disease, and stabilize after 12 weeks of the disease.

Application of Virtual Monochromatic Images Reconstructed by Dual-energy Computed Tomography in Radiotherapy Treatment Planning System / 中国医疗器械杂志

Virtual monochromatic images (VMI) that reconstructed on dual-energy computed tomography (DECT) have further application prospects in radiotherapy, and there is still a lack of clinical dose verification. In this study, GE Revolution CT scanner was used to perform conventional imaging and gemstone spectral imaging on the simulated head and body phantom. The CT images were imported to radiotherapy treatment planning system (TPS), and the same treatment plans were transplanted to compare the CT value and the dose distribution. The results show that the VMI can be imported into TPS for CT value-relative electron density conversion and dose calculation. Compared to conventional images, the VMI varies from 70 to 140 keV, has little difference in dose distribution of 6 MV photon treatment plan.

Flavorand taste change rules of Sophora Flavescentis Radix processed using ancient classical method:an exploration based on intelligent sensory analysis / 中国中药杂志

This study was designed to investigate the flavor and taste change rules of Sophora Flavescentis Radix processed using the ancient classical method documented in Master Lei's Discourse on Medicinal Processing(Lei Gong Pao Zhi Lun). The Sophora Flavescentis Radix pieces and the corresponding test samples in each processing stage were first prepared based on the processing method for Sophora Flavescentis Radix recorded in Master Lei's Discourse on Medicinal Processing(Lei Gong Pao Zhi Lun). Then the flavors and tastes of Sophora Flavescentis Radix test samples undergoing the soaking in rice-washed water, washing with clean water, and steaming for different time were compared with the electronic nose and tongue. The results showed that in the preparation of Sophora Flavescentis Radix with the ancient method, such processes as soaking in rice-washed water and washing with clean water had no significant influences on the flavor, which, however, was weakened by steaming. In terms of the taste, soaking with rice-washed water enhanced the bitter taste of Sophora Flavescentis Radix, which remained unchanged after being washed with the clean water. The steaming would also diminish the bitter taste, making it taste similar to the original Sophora Flavescentis Radix medicinal materials. During the steaming for six to eight hours, the flavor did not vary significantly over time, while the bitter taste was first weakened and then intensified. The bitter taste of Sophora Flavescentis Radix steamed for six hours was similar to that steamed for eight hours. In addition, the differences in flavor and taste between Sophora Flavescentis Radix pieces processed by the ancient method in Master Lei's Discourse on Medicinal Processing(Lei Gong Pao Zhi Lun)and those by the modern method in the 2020 edition of Chinese Pharmacopoeia were analyzed. The findings demonstrated that the flavor of Sophora Flavescentis Radix pieces prepared by the ancient method was weaker than that by the modern method, whereas the bitter taste showed the opposite trend. The exploration on the flavor and taste change rules of Sophora Flavescentis Radix in its preparation by the ancient classical method and the differences in flavor and taste between Sophora Flavescentis Radix decoction pieces prepared by ancient and modern methods will lay a foundation for further elucidation of the scientific connotation of the ancient processing method and the medication principles of Sophora Flavescentis Radix in both ancient and modern times.

Improved Design and Acceptance Test of Localization Couch for New Type of CT Simulator / 中国医疗器械杂志

Accurate CT simulation is the key link of precision radiotherapy, and the performance of the localization couch of CT simulator directly affects the accuracy of radiotherapy. With the rapid development of precision radiotherapy, conventional large aperture radiotherapy special CT simulator is difficult to meet the needs of precision radiotherapy localization, so most radiotherapy centers choose high-end diagnostic CT machines equipped with a flat tabletop for radiotherapy localization. In clinical work, the performance testing of the CT simulator localization couch is easy to be ignored. In addition, there are some problems such as insufficient precision in transforming the cradle-shaped couch top of diagnostic CT into a special flat couch top for radiotherapy. This paper provided an in-depth description of the improved design and performance test of the localization couch of the first special GE Revolution CT simulator for radiotherapy introduced by West China Hospital of Sichuan University. After the improvement, all the acceptance tests of the localization couch are in line with the standard, and the performance meets the high-precision radiotherapy localization needs of patients with different body weight in the center.

Application of Statistical Process Control in Evaluation of Performance for Beam-matched Medical Electron Linacs / 中国医疗器械杂志

Clinically, beam matching can greatly improve the flexibility and efficiency of treating patients between different medical electron linacs. However, in addition to the regular quality assurance (QA) test of the machine performance of linacs, there is still a lack of comprehensive evaluation of the clinical radiotherapy performance of beam-matched linacs. In this paper, the performance of volumetric modulated arc therapy (VMAT) between three closely matched linacs was evaluated by statistical process control (SPC) technology. It was found that the average and median γ passing rates of the VMAT QA processes of the three linacs had little difference, but the process capability levels were at three different levels. The results show that SPC technology can effectively evaluate the performance of beam matching for medical electron linacs, improve the patient-specific VMAT QA processes, and guide clinical decision-making.

Preparation and stability evaluation of artemether-loaded mixed micelles composed of the sodium glycocholate and soybean lecithin / 药学学报

In this study, artemether (ARM)-loaded mixed micelles (MM) composed of the sodium glycocholate (SGC) and soybean lecithin (SL) were prepared by film dispersion method. The effects of hydration medium, SL mass ratio and total concentration of excipients on the solubilization of ARM were investigated and the stability of MM was evaluated. Results showed that the particle size distribution of SGC-SL-MM prepared by phosphate buffer solution (PBS, pH 7.4, 0.05 mol·L-1) was uniform, with an average size of 3.58 ± 0.14 nm and the polydispersity index (PDI) value was 0.16 ± 0.04. The solubility of ARM increased significantly from 0.64 ± 0.04 mg·mL-1 to 13.7 ± 0.13 mg·mL-1 along with the concentration of total excipient increasing from 1.0% to 30.0% (w/w). The calculated results of Arrhenius parameter and storage stability showed that the degradation rate constant of ARM in MM was smaller than that in acetonitrile-PBS (pH 7.4) at either 37 ℃ or 60 ℃. The experimental ARM-MM was clear after storing for two months at 25 ℃ and the degradation of ARM was less than 7.0%. In conclusion, the SGC-SL-MM can not only improve the solubility of ARM in aqueous solution, but also improve its chemical stability in aqueous solution at low temperature.

Similar change laws of content of nine components in four processing methods of Polygoni Multiflori Radix Praeparata / 中国中药杂志

To standardize the processing technology of Polygoni Multiflori Radix Praeparata and stabilize its quality, the similar change laws of Polygoni Multiflori Radix Praeparata with different processing methods and time were analyzed. The processing time of Polygoni Multiflori Radix Praeparata was studied at 24, 32, 40, 48 h, and 4 different processing methods were studied, namely stewed with black bean sauce, steamed, steamed with black bean sauce, and steamed with black bean sauce and rice wine. The content of stilbene glycosides and anthraquinones were determined by HPLC-DAD method. UV method was used to determine the content of polysaccharides, and HPLC-ELSD method was used to determine the monosaccharides and oligosaccharides. The comparative chart of content determination, cluster analysis and entropy weight TOPSIS model was used to find the similar change laws and time interval of different processing methods of Polygoni Multiflori Radix Praeparata. The results demonstrated that around 32 h, the content of nine components in Polygoni Multiflori Radix Praeparata with different processing methods had similar change laws, and the decoction pieces had a high quality, indicating that the four processing methods of Polygoni Multiflori Radix Praeparata are likely to be used as one type of decoction piece with the same name.

Influencing factors of knee flexion limitation after total knee arthroplasty with posterior stabilized prostheses / 中国组织工程研究

BACKGROUND: Total knee arthroplasty is an important treatment for patients with ineffective conservative treatment or terminal knee osteoarthritis, but its surgical effect and patients’ satisfaction still need to be improved. Range of motion is an important parameter to evaluate patients' postoperative function and satisfaction. OBJECTIVE: To investigate the influencing factors of knee flexion limitation after total knee arthroplasty with posterior stabilized prostheses. METHODS: From January 2010 to December 2018, 117 patients with knee osteoarthritis were treated in the Second Affiliated Hospital of Chengdu Medical College/Nuclear Industry 416 Hospital, including 29 males and 88 females, all of whom received total knee arthroplasty. After a follow-up of more than 6 months, single factor analysis and Logistic regression analysis were performed on the influencing factors (surgical factors: postoperative joint line height change, postoperative tibial plateau retroversion, femoral condyle offset ratio change; non-operative factors: age, body mass index, preoperative HSS score, preoperative joint range of motion, preoperative visual analogue scale score, and postoperative active exercise) of postoperative knee flexion limitation to identify the independent impact factors of flexion limitation after total knee arthroplasty. The reaserch was approved by the Ethics Committee of the Second Affiliated Hospital of Chengdu Medical College/Nuclear Industry 416 Hospital. RESULTS AND CONCLUSION: (1) Single factor analysis showed that the patient’s age, body mass index, preoperative HSS score, preoperative range of motion, preoperative visual analogure scale score, postoperative active exercise and postoperative joint line height change had a significant effect on postoperative knee flexion function (all P < 0.05). (2) Logistic regression analysis: body mass index [OR=0.131, 95%CI (0.065,0.261), P < 0.001], preoperative HSS score [OR=4.297, 95%CI (2.139,8.634), P < 0.001], and preoperative range of motion [OR=10.612, 95%CI (6.565,17.153), P < 0.001] were non-operative independent influencing factors for patients with limited knee flexion after total knee arthroplasty. postoperative joint line height change [OR=0.255, 95%CI(0.167,0.387), P < 0.001] was an independent surgical influencing factor for patients with limited knee flexion after total knee arthroplasty. Body mass index and postoperative joint line height change were negatively correlated with postoperative knee flexion function; and preoperative HSS score and preoperative range of motion were positively correlated with postoperative knee flexion function. (3) The results showed that knee flexion function after total knee arthroplasty with posterior stabilized prostheses had correlations with patient's body mass index, preoperative HSS score, preoperative range of motion and postoperative joint line height change.

Clinical Significance of Minimal Residual Disease Monitoring by Multi-parameter Flow Cytometry before Allogeneic Hematopoietic Stem Cell Transplantation for Prognosis of Acute Leukemia Patients / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical significance of minimal residual disease (MRD) monitoring by multiparameter flow cytometry (MFC) before allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute leukemia.@*METHODS@#81 cases of patients with AL treated with allo-HSCT in Department of Hematology, the First Affiliated Hospital of Chongqing Medical University form July 2015 to July 2018 was selected and retorspectively analyed. of which 79 patients were in CR and two patients were in non-CR. The CR group was further divided into two groups of MRD and MRD based on the MRD level prior to HSCT.@*RESULTS@#Among 81 patients, there were statistically significant differences in the three-year overall survival(OS) (CR 82.2%: NCR 0%), cumulative relapse incidence(RI) (CR 17.7%; NCR 100%) and leukemia-free survival rate(LFS) (CR 42.3%: NCR 0%) between CR and NCR group(P<0.05). Among 79 CR patients, MRD was negative in 30 patients while positive in 49 patients, there was significant differences in the three-year overall survival between MRD and MRD group. The results of univariate analysis showed that the MRD group showed lower LFS compared with that of MRD group （10.5% vs 36.2%）(P＜0.001，95%CI).@*CONCLUSION@#MRD patients shows longer LFS as compared with that of MRD patients, therefore, MRD monitoring by MFC before allo-HSCT is very important for the prognosis of the AL patients.

Exploring Research on Processing Method of Polygoni Multiflori Radix Praeparata / 中国实验方剂学杂志

Objective::To investigate the effects of black bean juice with different stewing times on the appearance character and the content changes of effective components of Polygoni Multiflori Radix Praeparata. Method::HPLC was employed with Agilent ZORBAX Extend-C18 column (4.6 mm×250 mm, 5 μm), a gradient mobile phase of methanol (A)-water (B) was eluted (0-30 min, 5%-100%A; 30-40 min, 100%A), the flow rate was 1.0 mL·min-1, the injection volume was 10 μL and the column temperature was 35 ℃, detection wavelength was set at 280 nm. The contents of stilbene glycoside, emodin, emodin methyl ether, emodin-8-O-β-D-glucoside and emodin methyl ether-8-O-glucoside in samples prepared at different processing times were simultaneously determined by HPLC. Result::The content of stilbene glycoside decreased gradually with the increase of stewing time, compared with 8 h, its content decreased by 76% at 64 h. The contents of emodin-8-O-β-D-glucoside and emodin methyl ether-8-O-glucoside increased first, and then decreased, reaching the highest value at 24 h, and then decreased to the level similar to the content of 8 h after 40 h, and then fluctuated slightly. The contents of emodin and emodin methyl ether increased first, and then decreased, reached the maximum when stewed for 32 h, then decreased slowly and tended to be stable. Conclusion::The stewing time has significant influence on the content of various components in Polygoni Multiflori Radix Praeparata, and the changing trend is different, the processing time of Polygoni Multiflori Radix Praeparata shall be standardized. At the same time, it is not sufficient to take stilbene glycoside and anthraquinones as the indicator ingredients for this decoction pieces, the quality control indicators such as polysaccharides shall be considered.

Effect of Ginsenoside Rg1 on Lipid Uptake and Oxidation in HepG2 Cells of Nonalcoholic Fatty Liver Disease / 中国实验方剂学杂志

Objective:To investigate the effect and mechanism of ginsenoside Rg1（G-Rg1）in ameliorating lipid uptake and oxidation in HepG2 cells induced by free fatty acids (FFA). Method:HepG2 cells were divided into normal group, model group，low-dose ginsenoside Rg1 group (25 μmol·L-1) and high-dose G-Rg1 group (50 μmol·L-1). HepG2 cells were treated with 1 mmol·L-1 free fatty acid for 24 h to construct the NAFLD cell model, and then treated with 25，50 μmol·L-1 G-Rg1 for 24 h. The effect of G-Rg1 on HepG2 cell activity was determined by cell counting kit-8（CCK-8） assay. The level of triglyceride (TG) was detected by micro method. The accumulation of lipid droplets was observed by oil red O staining. Quantitative real-time fluorescence polymerase chain reaction (Real-time PCR) and Western blot were used to detect the alterations of key genes and proteins relating to lipid uptake and metabolism. Result:Compared with the normal group, the intracellular TG level and the absorbance of the oil red O staining in the model group were significantly increased (P<0.01). Compared with the model group, G-Rg1 reduced TG and lipid deposition were significantly reduced (P<0.01).Results of Real-time PCR and Western blot showed that compared with normal group, model group peroxisome proliferators-activated receptors gamma（PPARγ），fatty acid binding protein 1（FABP1），fatty acid transport protein 2/5（FATP2/5）and fatty acid translocase（CD36）expressions increased（P<0.05），whereas peroxisome proliferators-activated receptors α（PPARα），carnitine palmitoyltransferase 1（CPT1）and peroxisomal acyl-coenzyme A oxidase 1（ACOX1）expressions decreased（P<0.05）. Compared with the model group, the expressions of PPARγ, FABP1, FATP2, FATP5 and CD36 in the G-Rg1 group were decreased (P<0.05，P<0.01), while the expressions of PPARα, CPT1 and ACOX1 were increased (P<0.05，P<0.01). Conclusion:G-Rg1 can ameliorate lipid deposition in NAFLD cell model by reducing lipid uptake and increasing lipid oxidation.

Clinical characteristics and prognostic factors analysis of ethambutol-induced optic neuropathy / 中华眼底病杂志

Objective:To observe the clinical features and visual prognostic factors of ethambutol-induced optic neuropathy (EON).Methods:A cohort study. Twenty-four inpatients (46 eyes) identified as EON in Neuro-Ophthalmology Department of Chinese PLA General Hospital from January 2014 to December 2017 were enrolled, including 14 males (26 eyes) and 10 females (20 eyes) with a ratio of 1.4/1 male/female. The average age was 42.79±15.12 years and the average weight was 62.46±12.31 kg. The average time duration between oral administration of ethambutol and occurrence of EON was 9.94±16.49 months. The average time of ethambutol duration was 7.06±11.68 months, with an average accumulative dose of 156.7±1 779.0 g and the average daily dose of 15.07±8.95 mg/(kg·d). All patients were tested with visual acuity, fundus photos, colour vision, OCT, visual field, VEP, orbital MRI and the gene of OPA1 and mitochondrial deoxyribonucleic acid(mtDNA). All the patients accepted drug withdrawal immediately after diagnosis, and were given the treatment of systemic nerve nutrition and improvement of microcirculation for 2 weeks. The time of follow-up was more than 12 months. According to whether the visual acuity (VA) in any of eyes was over than 0.1 at the last follow- up, all the patients were divided into two groups: the bad VA group (VA less than or equal to 0.1) and the better VA group (VA over than 0.1) group. The χ2 test and Fisher's exact probabilistic method test were used to compare the counting data between groups, and the Wlincox rank sum test was used to compare the measurement data. Multiple factors of VA outcome between the patients with bad or better va were analyzed by logistic regression. Results:Thirty eyes (65.2%) had VA less than or equal to 0.1 and 5 eyes (10.9%) had VA over than 0.5 at EON onset. The VA of the rest 11 eyes (23.9%) was higher than 0.1 and lower than 0.5. At the last follow- up, 20 eyes (43.5%) had VA less than or equal to 0.1 and 9 eyes (19.6%) had VA over than 0.5, the VA of the rest 17 eyes (36.9%) was higher than 0.1 and lower than 0.5. Fundus examination revealed 7 eyes (15.3%) with optic disc edema. OCT revealed significant loss of the retinal nerve fiber layer (RNFL) in the affected eyes, mainly in the temporal RNFL of the optic disc. All patients had dyschromasia, mainly in distinguishing the color of red and green. The types of visual field defect was as following: central dark spot (52.2%), diffuse visual acuity decreased (30.4%), temporal hemianopsia (17.4%). Orbital MRI revealed that 12/24 (50.0%) patients had T2 lesions with T1 enhancement in 6/24 patients (25.0%). Genetic test showed that 4 patients (16.7%) had gene mutation. Among them, there were 2 patients with OPA1 mutation, 1 with mtDNA 14340 point mutation and 1 with the mtDNA 11778 point mutation. Thirteen patients showed better VA outcomes (over than 0.1) while 11 showed bad VA outcomes after discontinuation of ethambutol. Between the better VA group and the bad VA group, there were statistically significant differences in the daily dose of ethambutol and gene mutation( P=0.031, 0.023). The daily dose was related to visual prognosis of EON while only the daily dose of more than 18 mg/(kg·d) may lead to bad VA outcomes according to the logistic analysis (95% CI 0.007-0.736, OR=0.069, P=0.027). Conclusions:EON may have OPA1 and mtDNA mutation with more bilateral eyes involved and less optic edema, which about 43.5% of the patients showed irreversible visual impact. The daily dose of ethambutol is related to the vision recovery.