Retrospective study on the types and characteristics of shock in polytrauma patients at different stages after trauma / 中华急诊医学杂志

Objective:To investigate the types, incidences, and clinical characteristics of shock in polytrauma patients at different stages after polytrauma.Methods:A retrospective study was conducted on polytrauma patients admitted to multiple trauma centers from June 2020 to December 2021. The inclusion criteria were patients >18 years old and treated due to polytrauma. Exclusion criteria included an admission time of more than 48 h after trauma, a history of malignancy, or metabolic, consumptive, and immunological diseases. The early stage was defined as the period of ≤48 h after polytrauma, and the middle stage was defined as the period between 48 h and 14 days. The patient’s medical history, clinical manifestations, laboratory tests, imaging examination, injury severity score (ISS), and Glasgow coma scale (GCS) were collected. The types, incidences, and clinical characteristics of shock in different stages after polytrauma were analyzed, according to the diagnostic criteria of each type of shock. The differences between the groups were compared by Student’s t test, χ2 test or Mann-Whitney U test. Results:The incidence of the early and middle stage shock after polytrauma were 73.1% and 36.4%, respectively, with statistically significant difference between stages ( P<0.01). There were significant differences in the incidence of hypovolemic shock (83.6% vs. 28.4%), distributed shock (13.7% vs. 80.9%) and cardiogenic shock (3.5% vs. 6.6%) between stages (all P<0.05). The incidence of obstructive shock (8.4% vs. 9.7%, P>0.05) was similar between stages. The incidence of undifferentiated shock was 1.6% and 1.2%, respectively. There were 9.5% patients with multifactorial shock in the early stage and 14.4% in the middle stage. Totally 7 combinations of multifactorial shock were found in different stages after polytrauma. In the early stage, the combination of HS and DS accounted the highest ratio (42.3%) and followed by HS and OS for 28.8%. In the middle stage, the combination of HS and DS was the most common (48.6%) and followed by DS and OS (24.3%). Conclusions:The incidence of shock in polytrauma patients is high. Different types of shock can occur simultaneously or sequentially. Therefore a comprehensive resuscitation strategy is significant to improve the success rate of treatment.

Efficacy of external treatment of integrated traditional Chinese and Western medicine on chloasma / 中华医学美学美容杂志

Objective:To explore the efficacy of external treatment of integrated traditional Chinese and Western medicine on melanized type complicated with vascularized type of chloasma.Methods:A total of 82 patients (aged 26-50 years, with an average age of 44.5 years) with melanized type complicated with vascularized type of chloasma were selected, and randomly divided into groups: 28 cases in the traditional Chinese medicine control group were treated with traditional Chinese medicine pourmask combined with surrounded facial acupuncture; 26 cases in Western medicine control group underwent wet compress with 0.5% tranexamic acid solution. In the integrated Chinese traditional and Western medicine treatment group, 28 cases were treated with 2 regimens. After 8 weeks, MASI score was carried out, and vascular hyperplasia in skin lesions was observed by polari-light skin scope.Results:After treatment, the MASI scores in the three groups were all decreased, and the decreasing rate of MASI scores from high to low was as follows: Integrated Chinese traditional and Western medicine treatment group (8.60±4.53) > TCM control group (6.26±3.20) > Western medicine control group (4.39±2.11). After treatment, the vascular hyperplasia scores in the three groups were all decreased, and the value of vascular hyperplasia in the integrated Chinese traditional and Western medicine treatment group (2.57±0.63) and Western medicine control group (1.55±0.51) was greater than that in TCM control group (0.96±0.51), but there was no significant difference between the integrated Chinese traditional and Western medicine treatment group and Western medicine control group.Conclusions:External treatment of integrated traditional Chinese and Western medicine is effective in the treatment of melanized type complicated with vascularized type of chloasma, and wet compress with tranexamic acid solution can inhibit vascular hyperplasia in patients with chloasma.

Actively separated microneedle patch for sustained-release of growth hormone to treat growth hormone deficiency

Growth hormone deficiency (GHD) has become a serious healthcare burden, and presents a huge impact on the physical and mental health of patients. Here, we developed an actively separated microneedle patch (PAA/NaHCO3-Silk MN) based on silk protein for sustained release of recombinant human growth hormone (rhGH). Silk protein, as a friendly carrier material for proteins, could be constructed in mild full-water conditions and ensure the activity of rhGH. After manually pressing PAA/NaHCO3-Silk MN patch to skin for 1 min, active separation is achieved by absorbing the interstitial fluid (ISF) to trigger HCO3 ‒ in the active backing layer to produce carbon dioxide gas (CO2). In rats, the MN patch could maintain the sustained release of rhGH for more than 7 days, and produce similar effects as daily subcutaneous (S.C.) injections of rhGH in promoting height and weight with well tolerated. Moreover, the PAA/NaHCO3-Silk MN patch with the potential of painless self-administration, does not require cold chain transportation and storage possess great economic benefits. Overall, the PAA/NaHCO3-Silk MN patch can significantly improve patient compliance and increase the availability of drugs, meet current unmet clinical needs, improve clinical treatment effects of GHD patients.

Determination of gross α and gross β radioactivity in IAEA-2020-intercomparison samples / 中华放射医学与防护杂志

Objective:To summarize the practices in measuring the gross α and gross β radioactivity in IAEA-2020-intercomparison samples, which could be expected to be beneficial to the similar analysis and research.Methods:With 241Am, Th, 90Sr/ 90Y, 40K and 137Cs solution as standard materials, the gross α and gross β radioactivity in water and aerosol samples were determined using thin source method. With 241Am, 40K powder as standard materials, the gross α and gross β radioactivity in water and fish samples were measured using thick source method combined with evaporation. Results:The result showed that the relative deviation and Z-score by using thin source method were 4.12%-31.6% and 0.14-1.71, respectively, and those from thick source combined with evaporation were 2.63%-32.5% and 0.11-0.93, respectively, with the acceptance rate being 100%. Conclusions:Generally, standard material shall be selected in the same types of radionuclides and energies as in samples. The thin source method is appropriate for emergency monitoring in the event of an accident. The thick source combined with evaporation should be perfered to the environmental monitoring or the analysis of unknown samples in laboratory. And then an intercomparison should be done with thin source method based on the radioactivity in samples. This work can provide a technical reference for similar measurements.

Monitoring and analysis of gross radioactivity of centralized drinking-water of township in Beijing / 中国辐射卫生

Objective To investigate the distribution of gross α and gross β levels of centralized drinking-water of township in Beijing from 2018 to 2019, so as to carry out better monitoring and evaluating the radioactivity in water. Methods A total of 215 underground drinking water samples were collected from 12 districts of Beijing, then monitored and evaluated according to the Determination of gross alpha activity in water-thick source method EJ/T 1075—1998 and Determination of gross beta activity in water-evaporation method EJ/T 900—1994. Results The gross α level of centralized drinking water of township in Beijing was 0.050 (0.052) Bq/L, ranging from 0.001 to 0.210 Bq/L, and the gross β level was 0.048 (0.038) Bq/L, ranging from 0.002 to 0.261 Bq/L from 2018 to 2019. Gross α and gross β levels of all samples did not exceed the guidance value recommended by standards for drinking water quality. There was no significant difference in the distribution of gross α and gross β levels of samples of all districts from 2018 to 2019(P > 0.05), there were significant differences in the distribution of gross α and gross β levels of samples from different district in the same period (P < 0.05). And the levels of Miyun, Huairou and Shunyi in Chaobai River system were higher than other districts. Conclusion The distribution of radioactive background of centralized drinking-water of township in Beijing was mastered, which was in the normal range.

Study on the contents of 210Po in food and estimation of the internal irradiation dose of residents / 中国辐射卫生

Objective To investigate radioactive nuclide 210Po content in the diet of residents and internal irradiation dose caused by them. Methods The major food distribution market is selected, more than 50 kinds of food samples such as meat, vegetables, fruits, aquatic products, cereals, milk are collected, the combined method ofwet ashingand metal deposition is used to measure 210Po content of food samples, and analysis of monitoring data and estimationof irradiationexposure dose of residents caused by 210Po and their relative contribution are made. Results In the food samples, the specific activity of 210Po was 8.34 mBq/kg· fresh～16.9 Bq/kg· fresh, and the content of 210Po in hairtail was higher, its value was16.9 Bq/kg· fresh, which was higher than other freshwater fish. According to the data, the annual intake of residents was 108 Bq/person, and the annual effective dose of adult caused by 210Po was 129 μSv/a.The relatively large contribution were from flour (15.2%), eggs (22.0%), aquatic products (17.1%) and vegetable oil (18.1%). Conclusion The annual intake of 210Po for residents is lower than the current limit for adults of which the value is 2 200 Bq.

Protective effects of metformin on myocardial injury in patients with COVID-19 combined with coronary heart diseases and diabetes / 中国胸心血管外科临床杂志

@#Objective    To investigate whether metformin has protective effect on myocardial injury in patients with coronavirus disease 2019 (COVID-19) combined with coronary heart diseases and diabetes. Methods    COVID-19 patients with coronary heart disease and diabetes who were admitted to Tongji Hospital from January 18 to April 25 in 2020 were enrolled. They were divided into a metformin group and a none-metformin group according to whether the metformin was used. The demographic characteristics, clinical symptoms, laboratory parameters, treatment and clinical outcomes of the two groups were analyzed retrospectively. Results    There were 29 patients in the metformin group, 3 patients (12.0%, 3/25) suffered myocardial injury and 1 (3.4%) died of acute respiratory failure complicated by septic shock; 67 patients were in the non-metformin group and 24 (37.5%, 24/64) had myocardial injury but 15 died in hospital among whom 1 died of septic shock complicated by disseminated intravascular coagulation, 1 acute respiratory failure complicated by possible cerebral hemorrhage, 2 acute respiratory failure, 1 fulminant myocarditis, 3 acute myocardial infarction and 7 cardiac arrest. The incidence of myocardial injury (12.0% vs. 37.5%, P=0.019), hospital mortality (3.4% vs. 22.4%, P=0.034) and mortality of cardiovascular events (0.0% vs. 16.4%, P=0.049) in the metformin group were significantly lower than those in the non-metformin group. Multivariate analysis showed that the use of insulins (OR=11.235, P=0.003) was an influencing factor for in-hospital mortality of patients. The use of metformin (OR=0.154, P=0.013) was positively correlated with the myocardial injury. Conclusion    When patients with coronary heart disease and diabetes are infected with COVID-19, metformin can effectively reduce myocardial damage and has a certain effect on reducing hospital mortality. Combined with clinical considerations, it is worthy of popularization.

Electrical stimulation combined with manual massage can relieve myofascial pelvic pain / 中华物理医学与康复杂志

Objective@#To evaluate the clinical effectiveness of combining electrical stimulation with manual massage in treating women′s myofascial pelvic pain (MPPS).@*Methods@#A total of 93 MPPS patients were recruited and randomly divided into an infrared irradiation group (n=30), an electrical stimulation group (n=31) and a combination group (n=32). Those in the infrared group and the electrical stimulation group were given 30 minutes of infrared irradiation or electrical stimulation daily for 10 days, while the combined group was given a manual massage with electrical stimulation. The response to treatment was evaluated using a visual analogue scale (VAS) to rate discomfort, plus a physical examination, and surface electromyography results using Glazer′s protocol. The treatments′ efficacy and the recurrence of pain were evaluated 1 month after the treatment.@*Results@#The average VAS ratings, resting potentials and their variability of the three groups all improved significantly after the treatment. The average VAS scores of the combined and electrical stimulation groups after the treatment were significantly lower than that of the infrared group. Moreover, the total effective rates of the combined group (96.87%) and the electrical stimulation group (80.65%) were significantly higher than that of the infrared group (56.67%), and the resting potential and variability of the former two groups were also significantly better. All of the above measurements among the combined group after the treatment were significantly better, on average, than in the electrical stimulation group. A month later the recurrence rate in the combined group (6.25%) was significantly lower than in the electrical stimulation group (25.81%) and the infrared group (56.67%).@*Conclusion@#Electrical stimulation combined with manual massage is effective in relieving myofascial pelvic pain.

Electrical stimulation combined with manual massage can relieve myofascial pelvic pain / 中华物理医学与康复杂志

Objective:To evaluate the clinical effectiveness of combining electrical stimulation with manual massage in treating women′s myofascial pelvic pain (MPPS).Methods:A total of 93 MPPS patients were recruited and randomly divided into an infrared irradiation group ( n=30), an electrical stimulation group ( n=31) and a combination group ( n=32). Those in the infrared group and the electrical stimulation group were given 30 minutes of infrared irradiation or electrical stimulation daily for 10 days, while the combined group was given a manual massage with electrical stimulation. The response to treatment was evaluated using a visual analogue scale (VAS) to rate discomfort, plus a physical examination, and surface electromyography results using Glazer′s protocol. The treatments′ efficacy and the recurrence of pain were evaluated 1 month after the treatment. Results:The average VAS ratings, resting potentials and their variability of the three groups all improved significantly after the treatment. The average VAS scores of the combined and electrical stimulation groups after the treatment were significantly lower than that of the infrared group. Moreover, the total effective rates of the combined group (96.87%) and the electrical stimulation group (80.65%) were significantly higher than that of the infrared group (56.67%), and the resting potential and variability of the former two groups were also significantly better. All of the above measurements among the combined group after the treatment were significantly better, on average, than in the electrical stimulation group. A month later the recurrence rate in the combined group (6.25%) was significantly lower than in the electrical stimulation group (25.81%) and the infrared group (56.67%).Conclusion:Electrical stimulation combined with manual massage is effective in relieving myofascial pelvic pain.

Randomized controlled trial ofYinggencaoformula on psoriasis vulgaris with blood-heat TCM syndrome / 国际中医中药杂志

ObjectiveTo evaluate the clinical curative effect and security by performing the clinical study ofYinggencao formula in treatment of psoriasis vulgaris with blood-heat TCM syndrome.MethodsA total of 75 patients, diagnosed with Psoriasis Vulgaris Blood-heat RCM syndrome, were randomizedly divided into the treatmeat group with 39 patients and the control group with 36. The treatment group tookYinggencao formula twice daily, while the control group tookQingdai capsules three times daily. All the patients were treated 12 weeks. PASI scores were used as the main outcome and to estimate the curative effect rates.ResultsThe PASI scores of patients in the treatment group (6.97 ± 2.02vs. 16.88 ± 2.91;t=14.380,P=0.009) and the control group (13.14 ± 3.18vs. 17.49 ± 2.32;t=7.780,P=0.013) after treatment showed significantly lower than the scores before. The PASI scores showed significant difference between the two groups after the treatment (P=0.027). The total effective rate of treatment group was significantly higher than the control group (76.9%vs. 61.1%;χ2=5.120, P<0.05).Conclusions TheYinggencao formula therapy showed better effect thanQingdai capsules therapy in treatment of psoriasis vulgaris with blood-heat TCM syndrome.

Type 2 diabetes mellitus and risk of malignant melanoma: a systematic review and meta-analysis of cohort studies

Epidemiology studies have demonstrated inconsistent associations between type 2 diabetes mellitus and the risk of malignant melanoma. To this end, the aim was to perform a meta-analysis of cohort studies. Medline, PubMed, Embase and the Cochrane Library were searched up to February 2014. Cohort studies addressing the relative risk of type 2 diabetes mellitus on malignant melanoma were included in this meta-analysis. The Newcastle-Ottawa Scale was applied for quality evaluation. The pooled relative risks with the corresponding 95% confidence intervals [95% CIs] were calculated by using random-effects or random-effects model. Heterogeneity and publication bias were evaluated by I[2] and funnel plot analysis, respectively. Data was analyzed using STATA 11.0. A total of 9 independent cohorts from 8 manuscripts were entered this meta-analysis. Type 2 diabetes mellitus was slightly associated with an increased risk of malignant melanoma, and the pooled relative risk was 1.15 [95% CI, 1.00-1.32] in diabetes compared with non-diabetes with significant evidence of heterogeneity among these studies [P=0.016, I[2] =57.6%]. For the studies adjusted for age, gender and obesity, the relative risks were 1.21[95% CI, 1.03-1.42], 1.17 [95% CI, 1.01-1.35] and 1.11 [95% CI, 1.00-1.24], respectively. For the population-based studies in which case cohort established, the relative risk was 1.85 [95% CI, 1.31-2.62]. Type 2 diabetes might be an independent risk factor for malignant melanoma. Further studies are needed to specifically test the effect, and fully elucidate the underlying pathophysiologic mechanisms

Dual channel real-time PCR melting curve analysis-based assay for detecting of anti-tuberculosis drug-resistant mutations in Mycobacterium tuberculosis / 中华检验医学杂志

Objective Based on dual channel melting curve analysis-based assay,we developed a method to rapidly detect the drug-resistant mutations in Mycobacterium tuberculosis through real-time PCR.Methods According to the common first-line drug-resistant mutations of Mycobacterium tuberculosis,we designed six dual-labeled fluorescence probes to rapidly detect the drug-resistant mutations through realtime PCR melting curve after amplifications of drug-resistant related gene region of DNA.The targets include rpoB 81 bp core region,katG315,inhA promoter,ahpC promoter and embB306.To validate the sensitivity and specificity of our method,we performed real-time PCR assays to detect drug-resistant mutations in 76 clinical MDR-TB samples,which were collected by Shanghai CDC in 2008.Results In the validation,this method successfully detected drug-resistant mutations in all 76 clinical MDR-TB samples.The △Tm of mutations were from 1.8 to 14.4 ℃.Comparing with the sequencing data,all mutations covered by the six probes were detected with 100％ sensitivity and 100％ specificity (rpoB,80/80; inhA,7/7 ; katG315,59/ 59;ahpC,8/8;embB306,27/27).This method can successfully detect drug-resistant mutations from 100 copies/μl DNA samples.Conclusions A widely applicable real-time PCR assay to detect first line drug-resistant mutations of Mycobacterium tuberculosis has benn developed.This method has proven to have the advantages of high sensitivity,specificity and low risk of contamination.It can be used in rapid diagnosis of clinical drug-resistant tuberculosis and the evaluation of laboratory drug sensitivity test.

Studies on anti-platelet activation effect and partial mechanisms of Taohong Siwu decoction / 中国中药杂志

<p><b>OBJECTIVE</b>To explore the anti-platelet activation effect and partial mechanisms of Taohong Siwu decoction (TSD).</p><p><b>METHOD</b>The effect to venous thrombosis model and pulmonary thromboembolism model induced by vein injecting ADP and Adr was observed. The platelet adhesion rate was analyzed by using spinning glass bottle, and the platelet aggregation rate induced by ADP, Adr was analyzed by using turbidimetry. The acute blood stasis rat model was established to analyze the content of plasm TXB2 and PGI2 by RIA, and the content of VWF, GMP-14 by ELISA.</p><p><b>RESULT</b>TSD could effectively reduce platelet the adhesion rate of normal rat, inhibit the platelet aggregation of normal rat induced by ADP, Adr. It significantly reduced the plasma TXB2 VWF, and GMP-140 level of blood stasis rats. It also had significant tendency to increase 6-keto-PGF1alpha level.</p><p><b>CONCLUSION</b>TSD possessed obvious activity of inhibiting platelet activation. The mechanism related with the restraining of platelet adhesion, platelet aggregation and platelet releasion.</p>

The Effect of Tiaozhixin NO/ET、6-PGF_2/TXB_2 Hemorrhedoge of Rats with Hyperlipoidemia / 中成药

Objective: To study the influences of Tiaozhixin(TZX) on NO/ET, 6 keto PGF 1a /TXB 2 and hemorrheology rats with hyperlipoidemia. Methods: The rat hyperlipoidemia and early atheroscleorsis models were established by feeding high lipid diet for 40 days. Meanwhile TZX was taken by oral administration at the dosages of 40、80g/kg. The levels of NO、ET 1、6 keto PGF 1a and TXB 2 in serum were determind, and the hemorrheology markers were observed. Results: TZX could raise the levels of NO in serumobviourly ET 1 level of the normal and model rats. The large dose of TZX could increase 6 keto PGF 1a content remarkably which benefits maintenance of the balances of 6 keto PGF 1a /TXB 2. It could lower the whole blood specific viscosity, whole blood reduction specific viscosity, plasma specific viscosity; aggregation index of RBC; shorten RBC electrophoresis time; also decrease fibrinogen content; inhibit the platelet aggregation of normal rats induced by ADP. Conclusion: TZX can improve the abnormal hemorrheology and recover the balance of TXB 2/6 keto PGF 1a and NO/ET of rats with hyperlipoidemia, which might be one of mechanisms of antiatherosclerosis action.

Effects of Tongqiao Huoxue Decoction on contents of CGRP、 ET、 IL-1?、TNF-? in the brains of rats of cerebral ischemia / 中成药

AIM: To investigate the protective effects and mechanisms of Tongqiao Huoxue Decoction on the rats of cerebral ischemia. METHODS: Cerebral ischemia madel was established on the basis of cerebral thrombus and at the same time ligaturing bilateral carotid arteries.These models were used to observe the protective effects of Tongqiao Huoxue Decoction on contents of CGRP、ET、IL-1?,TNF? in rats′ cerebral ischemica. RESULTS: The results showed that Tongqiao Huoxue Decoction decreased the contents of IL-1?、TNF-?、 ET,and increased the contents of CGRP. CONCLUSION: Tongqiao Huoxue Decoction had effects on anti-cerebral ischemia.The protective effects of Tongqiao Huoxue Decoction are related to decreasing the contents of IL-1?,TNF-?,ET,and increasing the contents of CGRP.

EXPERIMENTAL STUDIES ON THE EFFECTS OF TSCP, TSCC ON BLOOD PLATELET FUNCTION AND THEIR MECHANISM / 中国药理学通报

The effects of TSCP and TSCC on aggregation and adhesion of blood platelets were measured by turbidimetric method and salzman method respectively. TSCP and TSCC strongly increase mouse and rat platelet aggregation and platelet adhesion. These effects are important for blood coagulation. cAMP and TXB2 levels in plasma and platelet were determind by RIA TSCP significantly increased the TXB2 level in plasma and platelet. This effect may be the main mechanism of increasing platelet aggregation by TSCP.

ANTI-INFLAMMATORY EFFECT OF TOTAL ALKALOID OF LEONTICE KIAGNANENSIS AND ITS MECHANISM OF ACTION / 中国药理学通报

The anti-inflammatory of waterand fat-soluble alkoloids of Leon-tice Kiagnanensis (WSALK, FSALK ) were described after sc of WSALK (150, 300 mg/kg ) and FSALK (13, 26mg/kg ) . The increased capillary permeability in abdominal cavity and skin of mice induced respectively by 0.7% HAc and histamin were inhibited abviously. WSALK (75, 150, 300mg/kg, ip ) and FSALK (6.5, 13, 26mg/Kg, ip ) markedly inhibited the ear inflammation induced by xylene in mice, carrageenin-iaduces swelling of the ankle in normal on adrenalecto-mized rats, and carrageenin-induced pleurisy in rats. Both compound also inhibited the granuloma induced by cotton pellet after sc of WSALK 300, 600 mg/kg and FSALK 13, 26 mg/kg qd ? 7d.Both compound decreased the content of PGE in exudate formed after injecting carrageenin into the hind paw of rats. These results suggest that both compounds passesses the anti-inflammatory activity and their actions might be relatied to their inhibiting the synthesis or relase of pro-staglandin E. WSALK TI 9.35, FSALK TI 4.50.

Oridonin induces apoptosis in human leukemia HL-60 cells / 中国药理学通报

AIM To study oridonin induced apoptosis in human leukemia HL 60 cells. METHODS Cell morphology, agarose gel electrophoresis and flow cytometry were used. RESULTS Oridonin had significant apoptotic inductive effect on HL 60 cells in both concentration and time dependent fashion. The marked morphological changes including condensed chromatin, nuclear fragmentation and apoptotic body were observed. Typical DNA ladder in agarose gel electrophoresis and pre G 1 peak in flow clytometric analysis were also observed in the cells exposed to Ori. CONCLUSION Oridonin can induce apoptosis in human leukemia HL 60 cells.