Research progress and prospects for the use of plant metabolomics in quality evaluation of traditional Chinese medicinal materials / 药学学报

The quality of traditional Chinese medicine has a direct impact on the effectiveness and safety of its use, and is the premise necessary to ensure the healthy development of the traditional Chinese medicine industry. Comprehensive and accurate control and evaluation of the quality of medicinal materials is of great significance to the traditional Chinese medicine industry, but the complexity and dynamics of the chemical composition of medicinal materials makes their quality evaluation a challenge. Plant metabolomics provides an integrated and comprehensive analysis that is consistent with the holistic approach of traditional Chinese medicine. Chemical information therein promotes the establishment of a traceable system and provides new ideas and methods for the quality evaluation of medicinal materials. Plant metabolomics in the quality evaluation of medicinal materials is gradually increasing, and the core is the screening and identification of differential metabolites or specific marker compounds by means of stoichiometry. This study focused on the main factors that affect the quality of medicinal materials, such as origin, environmental adversity, varieties, harvest time, commercial specification and TCM processing. We describe the research progress in plant metabolomics combined with chemometrics analysis for the quality control and evaluation of medicinal materials, summarize existing problems, identify trends, and propose future research directions. Metabolomics plays an increasingly important role in the quality evaluation of medicinal materials, but the absolute qualitative and quantitative information of metabolomics needs to be further developed, and a single 'omics' technique is not sufficient for an in-depth analysis of medicinal value. In the future, standardization of plant metabolomics methods and a more complete database should be actively promoted, and plant metabolomics should be integrated into quality marker exploration. Plant metabolomics will need to be integrated with other 'omics' methods to improve the quality and evaluation system of medicinal materials.

Perceived stress and associated factors among healthcare workers in a primary healthcare setting: the Psychological Readiness and Occupational Training Enhancement during COVID-19 Time (PROTECT) study

INTRODUCTION@#Disease outbreaks such as the COVID-19 pandemic significantly heighten the psychological stress of healthcare workers (HCWs). The objective of this study was to understand the factors contributing to the perceived stress levels of HCWs in a public primary care setting during the COVID-19 pandemic, including their training, protection and support (TPS), job stress (JS), and perceived stigma and interpersonal avoidance.@*METHODS@#This cross-sectional study using an electronic self-administered questionnaire was conducted at the National Healthcare Group Polyclinics in March 2020. Data was collected anonymously. Analysis was performed using regression modelling.@*RESULTS@#The response rate was 69.7% (n = 1,040). The mean perceived stress level of HCWs in various departments ranged from 17.2 to 20.3. Respondents who reported higher perceived stress were those who made alternative living arrangements, were more affected by the current pandemic, reported higher JS and were Muslims. Respondents who reported lower perceived stress were those who had been through the severe acute respiratory syndrome epidemic in 2003 and H1N1 pandemic in 2009 as HCWs, and those who had higher confidence in the organisation's TPS.@*CONCLUSION@#All HCWs, regardless of their scope of work, were similarly stressed by the current pandemic compared to the general population. Improving the confidence of HCWs in their training, protection and the support of personal protective equipment, and retaining experienced HCWs who can provide advice and emotional support to younger colleagues are important. Adequate psychological support for HCWs in the pandemic can be transformed into reserves of psychological resilience for future disease outbreaks.

Progress of multifunctional protein p62 in kidney disease / 国际儿科学杂志

p62 is a ubiquitous multifunctional protein with six domains in the body.p62 is mainly involved in selective autophagic degradation of ubiquitinated substrates.Hence, it has become an important biomarker of monitoring autophagic flux.p62 is also involved in oxidative stress.Additionally, p62 participates in series of cellular biological processes including nutrient sensing, apoptosis and metabolic reprogramming.The expression of p62 is regulated by some transcriptive factors such as TFEB.The mutations of p62 gene are associated with neurological and other disorders.It has been shown that p62 is necessary for maintaining normal function of glomerular podocytes, massangial cells and renal tubular cells.Based on the diversity and importance of p62 protein functions, it may turn to be a candidate of therapeutic target in renal diseases in future.

Healthcare cost of patients with multiple chronic diseases in Singapore public primary care setting

INTRODUCTION@#The rising prevalence of multiple chronic diseases is an important public health issue as it is associated with increased healthcare utilisation. This paper aimed to explore the annual per capita healthcare cost in primary care for patients with multiple chronic diseases (multimorbidity).@*METHODS@#This was a retrospective cohort study conducted in a cluster of public primary care clinics in Singapore. De-identified data from electronic medical records were extracted from July 2015 to June 2017. Only patients with at least 1 chronic disease were included in the study. Basic demographic data and healthcare cost were extracted. A list of 20 chronic diseases was considered for multimorbidity.@*RESULTS@#There were 254,377 patients in our study population, of whom 52.8% were female. The prevalence of multimorbidity was 62.4%. The median annual healthcare cost per capita for patients with multimorbidity was about twice the amount compared to those without multimorbidity (SGD683 versus SGD344). The greatest percentage increment in cost was when the number of chronic diseases increased from 2 to 3 (43.0%).@*CONCLUSION@#Multimorbidity is associated with higher healthcare cost in primary care. Since evidence for the optimal management of multimorbidity is still elusive, prevention or delay in the onset of multimorbidity in the general population is paramount.

Policies and Development of Assistive Technology Services for People with Disabilities in Australia / 中国康复理论与实践

Objective:To study the prevalence of people with disability, and the demand, service policies and service system for assistive technology (AT) services in Australia. Methods:Referring to policy recommendation and indicators in World Health Organizaion's Rehabilitation in Health Systems, Australia's assistive technology service policy framework, services development and trend of development were analyzed by the means of content analysis and development research. Results:There are about 4.4 million people with disability in Australia, of which 1.4 million (32%) with severe or profound disabilities. Federal, state and territorial governments have respectively issued legislation, policy and related service project, including the National Disability Strategy, National Disability Agreement, the National Disability Insurance Scheme, National Standards for Disability Services and others assistance programs to support disability services. There are about two million Australians with disabilities received AT services support from the mentioned programme and scheme. Australia provides more than ten thousands kinds of AT appliances per year, covering all kinds of products in WHO's Priority Assistive Products List. Conclusion:Australia has developed a federal National Disability Strategy, AT service policies and standards, and established federal and state AT insurance and financial support programs for people with disabilities based on the unmet needs of AT services, and federal and state networks for AT services have been established, and service coordination mechanisms at federal and state levels have been established through the National Disability Agreement, covering all types of people with demand of AT in Australia. It meets the requirements of the policy recommendations and assessment indicators in the WHO's Rehabilitation in Health Systems policy guidelines involving AT services. The future development areas in AT will focus on the fields of policy development, ICF implementation, service delivery system, upgrading of service quality and standard, and new technology application.

Framework and Core Content of International Policy on Service of Assistive Technology / 中国康复理论与实践

Objective:To study the policy framework and core content of assistive technology (AT) services, compare the current status of AT in countries with different levels of development, and discuss the future development of international policies and services of AT. Methods:Based on the policy and theoretical framework of AT of the United Nations (UN) and World Health Organization (WHO), the policy framework and main contents of international AT services were analyzed; the policies, assistive products and service development of AT services in countries with different levels of development worldwide were compared; and the policy and innovative technology development hotspots of international AT were explored. Results:AT service is an important component of rehabilitation services, and the development of AT services is a key step toward achieving the UN Sustainable Development Goal 3, "Ensure healthy lifestyles and promote the well-being of people of all ages". UN and WHO advocated AT services policy. The framework is based on the UN Convention on the Rights of Persons with Disabilities (CRPD) on articles related to AT, and WHO documents of AT and rehabilitation, such as World Report on Disability, the Global Plan of Action on Disability, Rehabilitation in the Health System, and Rehabilitation in the Health System: A Guide to Action, as well as WHA 71.8 on Assistive Technology, Improving Access to Assistive Technology. The core elements of the international AT policy aim to build integrated, people-centered health services, emphasize the integration of AT into the health system and rehabilitation services, establish and develop AT services in six building blocks of WHO health system, thereby improving access to quality AT to achieve universal health coverage. Further in the fields of technology and service innovation, it proposed to establish a 5P model. High-income countries and low- and middle-income countries are facing many difficulties and large differences in AT service policies, assistive product provision, and service coverage. In the future, adoption of the 5P model proposed by WHO for policy and service delivery and technological changes, and the innovation of assistive product development and AT service models will be the hot spots of AT development. Conclusion:The policy on AT at international level is centered on the concept of UN CRPD and is based on prospect of policy documents issued by the UN and WHO on AT services, with the core objective of developing AT services to provide timely, appropriate, and affordable to persons with disabilities, aging, and people needed to improve their health, quality of life and well-being. It proposes to integrate AT into universal health coverage and to deliver AT service through primary health care in order to achieve the UN SDG 3 goal with full coverage of AT. It proposes to integrate AT into rehabilitation services, i.e. leadership and governance, financing, AT professionals, AT delivery, medicine and technology, and health information system monitoring AT services. There are differneces in AT products and AT delivery due to the globel differneces in economic and social development levels and challenges in access to AT services. It is necessary to develop relevant policies, planning and innovations in assistive products and AT services. AT development in the future will focus on the 5P model of AT to implement reforms in the field of product and service delivery as well as technological innovation in order to improve the coverage, availability, accessibility and affordability, integrate AT into the health system within the framework of universal health coverage, achieve full coverage of universal AT services, and enhance the quality of AT and improve consumers' well-being.

Primary liver cancer complicated by hepatic cystic echinococcosis: a case report / 中国血吸虫病防治杂志

A primary liver cancer patient complicated by hepatic cystic echinococcosis was reported. The case was admitted to the hospital due to intermittent upper abdominal discomfort for more than half a month, and an auxiliary examination revealed primary liver cancer complicated by hepatic cystic echinococcosis. Then, hepatic artery infusion and chemoembolization was performed, and no treatment was given to cystic echinococcosis lesions. Following treatment, the patient had remarkable improvements in the liver functions.

Clinical Effect of Tyrosine Kinase Inhibitors in the Treatment of P230 Chronic Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To observe the curative efficacy of tyrosine kinase inhibitors (TKIs) in the treatment of e19a2 transcript (P230) CML chronic phase (CML-CP) patients.@*METHODS@#The clinical data of 11 P230 CML-CP patients were collected from July 2008 to December 2019. Blood routine examination, bone marrow cytology, chromosome, and BCR-ABL qualitative and quantitative tests were performed at initial diagnosis. After TKIs treatment, BCR-ABL (P230)/ABL in peripheral blood was regularly detected to evaluate molecular response by real-time quantitative PCR.@*RESULTS@#There were 11 patients (7 males and 4 females) in chronic phase from 6 domestic hospitals enrolled, their median age was 46 years old (range from 19 to 56 years old). Among 4 patients treated with imatinib (400 mg, qd) firstly, 3 cases switched to nilotinib (400 mg, bid) and 1 case switched to dasatinib (100 mg, qd) due to failure to achieve best molecular response at the landmark time or mutation of ABL kinase. Then major molecular response (MMR) was obtained within 1 year. In addition, 5 patients were treated with nilotinib (300 mg, bid) and 2 patients with dasatinib (100 mg, qd) as first-line treatment, all of them got MMR within 6 months.@*CONCLUSION@#For intolerance or resistance to imatinib, second-generation TKIs can enable P230 CML patients to achieve deeper molecular response, and MMR in a short time.

Triterpenoids from Galbanumofuygur medicine andtheir anticholinesterase activities / 药学学报

Eight triterpenes were isolated from the methanol extract of Galbanum by various chromatographic methods including silica gel, ODS opening column, recrystallization and semi-preparative HPLC. Their structures were determined by spectroscopic methods and physicochemical properties as 3β,19α,21α-trihydroxyl-12-en-28-oic acid (1), sumaresinolic acid (2), 3β,19α-dihydroxyl-12-en-28-oic acid (3), oleanolic acid (4), 3β,6β,19α-trihydroxyl-12-en-28-oic acid (5), 19α-hydroxy oleanonic acid (6), 6α-hydroxy oleanonic acid (7), and (11R,12R)-3α,6α-dihydroxy-epoxyolean-28α,13α-olide (8). Among them, compound 1 is a new compound, while compounds 2-8 were newly isolated from the Apiaceae family. The ability of compounds 1-8 to inhibit cholinesterase was determined with an improved Ellman method. Compound 1 showed strong inhibitory activity against butyrylcholinesterase. The molecular docking results indicated that Trp82, His438, Phe329 and Ala328 played an important role in the binding of compound 1 to butyrylcholinesterase.

Lung transplantation as therapeutic option in acute respiratory distress syndrome for coronavirus disease 2019-related pulmonary fibrosis / 中华医学杂志(英文版)

BACKGROUND@#Critical patients with the coronavirus disease 2019 (COVID-19), even those whose nucleic acid test results had turned negative and those receiving maximal medical support, have been noted to progress to irreversible fatal respiratory failure. Lung transplantation (LT) as the sole therapy for end-stage pulmonary fibrosis related to acute respiratory distress syndrome has been considered as the ultimate rescue therapy for these patients.@*METHODS@#From February 10 to March 10, 2020, three male patients were urgently assessed and listed for transplantation. After conducting a full ethical review and after obtaining assent from the family of the patients, we performed three LT procedures for COVID-19 patients with illness durations of more than one month and extremely high sequential organ failure assessment scores.@*RESULTS@#Two of the three recipients survived post-LT and started participating in a rehabilitation program. Pearls of the LT team collaboration and perioperative logistics were summarized and continually improved. The pathological results of the explanted lungs were concordant with the critical clinical manifestation, and provided insight towards better understanding of the disease. Government health affair systems, virology detection tools, and modern communication technology all play key roles towards the survival of the patients and their rehabilitation.@*CONCLUSIONS@#LT can be performed in end-stage patients with respiratory failure due to COVID-19-related pulmonary fibrosis. If confirmed positive-turned-negative virology status without organ dysfunction that could contraindicate LT, LT provided the final option for these patients to avoid certain death, with proper protection of transplant surgeons and medical staffs. By ensuring instant seamless care for both patients and medical teams, the goal of reducing the mortality rate and salvaging the lives of patients with COVID-19 can be attained.

Therapeutic effect on post-stroke spastic paralysis of upper extremity treated with combination of kinematic-acupuncture therapy and rehabilitation training / 中国针灸

OBJECTIVE@#To compare the clinical therapeutic effect on post-stroke spastic paralysis of the upper extremity between the combination of kinematic-acupuncture therapy and rehabilitation training and the combined treatment of the conventional acupuncture with rehabilitation training.@*METHODS@#A total of 60 patients of post-stroke spastic paralysis of the upper extremity at the non-acute stage were randomized into an observation group (30 cases) and a control group (30 cases, 1 case dropped off). On the base of the routine western medication and rehabilitation treatment, the kinematic-acupuncture therapy was added in the observation group and the conventional acupuncture was used in the control group. Baihui (GV 20), Dazhui (GV 14), Jiaji (EX-B 2) from T to T, Tianzong (SI 11), Jianzhen (SI 9), Jianyu (LI 15) and Quyuan (SI 13) were selected in both groups. The treatment was given once daily and the treatment for 14 days was as one course. The one course of treatment was required in this research. Separately, before treatment and in 7 and 14 days of treatment, the score of simplified Fugl-Meyer scale of the upper extremity (FMA-UE), the grade of the modified Ashworth scale (MAS) and the score of the modified Barthel index scale (MBI) were compared between the two groups.@*RESULTS@#Compared before treatment, in 7 and 14 days of treatment, FMA-UE score was increased obviously in either group (<0.01). In 14 days of treatment, FMA-UE score in the observation group was higher than that in the control group (<0.05). In 7 and 14 days of treatment, MAS grades of shoulder joint, elbow joint, wrist joint and metacarpophalangeal joint were all improved markedly in the two groups (<0.05). Compared with the grades in 7 days of treatment, MAS grades of elbow joint and metacarpophalangeal joint were improved markedly in 14 days of treatment in the two groups (<0.05). Compared with the control group, MAS grades of elbow joint and metacarpophalangeal joint were improved more markedly in the observation group in 14 days of treatment (<0.05). Compared with the score before treatment, MBI score was increased in 7 and 14 days of treatment respectively in the observation group (<0.05, <0.01). In 14 days of treatment, MBI score was increased in the control group (<0.01).@*CONCLUSION@#For the patients with post-stroke spastic paralysis of the upper extremity at the non-acute stage, the combined treatment with kinematic-acupuncture therapy and rehabilitation training obviously improves the motor function of the upper extremity and the muscle tone of elbow joint and metacarpophalangeal joint. The therapeutic effect of this combination is better than that of the combined treatment of the conventional acupuncture with rehabilitation training. Additionally, this combined therapy improves the ability of daily life activity.

Rapid Identification of Alkaloids in Evodia rutaecarpa by HPLC-Q-TOF-MS/MS / 中国实验方剂学杂志

Objective:To obtain the information of alkaloids in Evodia rutaecarpa by HPLC-Q-TOF-MS/MS. Method:Inter Sustain-C18 column (4.6 mm×250 mm,5 μm) was used with 0.2% formic acid water-acetonitrile as the mobile phase for gradient elution. The column temperature was 25℃,the volume flow rate was 1.0 mL·min-1,and the sample volume is 5 μL. The detection wavelength was 245 nm,and the chromatographic effluent was detected and analyzed by using both positive and negative ions. Result:According to molecular ion peaks and secondary mass spectrometry characteristic fragment ions,as well as the mass spectrometry information of reference substances and relevant literature reports,more than 40 major peaks were analyzed,and 21 alkaloids were identified from the methanol extract of E. rutaecarpa, including 10 kinds of indole alkaloids,10 kinds of quinolone alkaloids,and 1 kind of ephedrine. Main types of alkaloids in E. rutaecarpa were basically clarified. And the research found that the alkaloids have a good response mainly in the positive mode. Conclusion:Based on HPLC-Q-TOF-MS/MS technology, high-performance liquid chromatography (HPLC) separation,mass spectrometry determination of molecular mass,pyrolysis data,literature analysis and retrieval were performed to quickly,accurately and comprehensively identify alkaloids in E. rutaecarpa, so as to provide a scientific basis for the further extraction and separation of the chemical constituents of E. rutaecarpa.

Therapeutic effect of L‐carnitine combined cyclic adenosine monophosphate and its influence on serum levels of IFN‐γ and IL‐4 in patients with viral myocarditis／ / 心血管康复医学杂志

To observe therapeutic effect of L‐carnitine combined cyclic adenosine monophosphate and its influence on serum levels of IFN‐γ and IL‐4 in patients with viral myocarditis .Methods : A total of 132 VMC pa‐tients treated in our hospital from 2017 to 2018 were randomly and equally divided into L‐carnitine group and com‐bined treatment group (received cAMP based on L‐carnitine group ) , both groups were treated for two weeks .Pe‐ripheral serum levels of IFN‐γ , IL‐4 , cardiac troponin T (cTnT) and creatine kinase isoenzyme MB (CK‐MB) be‐fore and two weeks after treatment , therapeutic effect and incidence of adverse drug reactions were observed and compared between two groups .Results : Compared with before treatment , there was significant rise in serum IL‐4 level , and significant reductions in serum levels of IFN‐γ , cTnT and CK‐MB in two groups after two‐week treat‐ment , P＝0. 001 all ;compared with L‐carnitine group , there was significant rise in serum IL‐4 level [ (47. 43 ± 9.17) ng／ml vs.(55. 38 ± 10.23 ) ng／ml] , and significant reductions in serum levels of IFN‐γ [ (65.22 ± 11.82 ) ng／ml vs .(52.18 ± 10.06) ng／ml] , cTnT [ (0. 37 ± 0.09) ng／ml vs.(0.18 ± 0.03) ng／ml] and CK‐MB [ (28.56 ± 5. 34) U／L vs.(16. 22 ± 3. 47) U／L] in combined treatment group , P＝0.001 all.Total effective rate of com‐bined treatment group was significantly higher than that of L‐carnitine group (92.4% vs.80.3%) , P＝ 0.042. There was no significant difference in incidence rate of adverse drug reactions between two groups , P＝0. 784. Con‐clusion : L‐carnitine combined cAMP can significantly reduce peripheral serum IFN‐γ level and increase IL‐4 level , regulate Th1／Th2 imbalance with significant therapeutic effect in VMC patients .And its safety is good .

Triterpenoids from Uygur medicine latex of Euphorbia resinifera / 中国中药杂志

Ten triterpenes compounds were isolated from the methanol extraction of the latex of Euphorbia resinifera by means of various chromatographic methods such as silica gel, ODS and semi-preparative HPLC, Their structures were identified by spectroscopic methods and physicochemical properties. These isolated compounds were identified as 3-hydroxy-25,26,27-trinor eupha-8-ene-24-oate (1), iso-maticadienediol (2), 25,26,27-trinorTirucall-8-ene-3-ol-4-acid (3), dammarendiol Ⅱ (4), eupha-8,24-diene-3-ol-26-al (5), lnonotusane C (6), eupha-8,24-diene-3-ol-7,11-dione (7), inoterpene A (8), inoterpene B (9), and eupha-24-methylene-8-ene-3-ol-7,11-dione (10). Among them, compound 1 was a new natural product, compounds 2-4 were firstly isolated from the Euphorbiaceae and compounds 5 and 6 were isolated from the genus Euphorbia for the first time. The cytotoxicity of the compounds 1-10 against MCF-7, U937 and C6 cancer cell lines was evaluated, but none of the compounds was active.

Correlation of tyrosine phosphatase-1/2 (SHP-1,SHP-2) with indoleamine 2,3-dioxygenase (IDO) in villi and decidua of early pregnancy / 中国免疫学杂志

Objective:To explore the correlation of tyrosine phosphatase-1/2 (SHP-1,SHP-2) with indoleamine 2,3-dioxygenase(IDO) in maternal fetal interface.Methods: The expression of SHP-1,SHP-2 and IDO were detected by Western blot method and the relationship of the proteins was analysed,in human chorionic villi and decidua tissues of 30 cases of artificial abortion patients.Results:The expression of SHP-1,SHP-2 were positively correlated withthe expression of IDO in human chorionic villi and de-cidua;the expression of SHP-1,SHP-2 and IDO in decidual tissues were higher than those in the villi.Conclusion: Normal physiological state of pregnancy,SHP-1 and SHP-2 may be involved in the regulation of immune tolerance by positive regulation of IDO expression at maternal fetal interface.

Effect of business process reengineering on multisectors' participation in prevention and control of multidrug-resistant organism infection / 中国感染控制杂志

Objective To investigate the effect of business process reengineering(BPR)on improving multisectors'participation in management of multidrug-resistant organism(MDRO)infection, and provide methodological guidance for hospital multisectors'collaborative management.Methods Related data about management and disposal of 672 cases of MDRO infection occurred from July 2015 to June 2017 were selected, 370 patients before BPR (from July2015to June 2016)were as control group, 302 patients after BPR(from July2016to June 2017)were as a trial group, BPR was used to improve the process of detection, report, cooperation, and disposal of MDROs in hospital, various quality evaluation indexes of healthcare-associated infection before and after BPR were compared. Results After the BPR was implemented, time of MDRO information transmitted from laboratory to clinical departments shortened from(240±30)minutes to(8±2)minutes;incidence of MDRO HAI decreased from2.39‰to 1.56‰, isolation rate of MDROs decreased from13.42％ to 11.09％, differences were all significant(all P＜ 0.05).Compliance rates and awareness rates of various MDRO prevention and control measures increased from 58.11％-71.89％to 84.11％-92.05％, usage rate of antimicrobial agents decreased from53.18％to 48.45％, defined daily doses(DDDs)of antimicrobial use density decreased from44.76 to 38.26, specimen submission rate before antimicrobial use increased from46.68％to 53.62％.Conclusion BPR can enhance the cooperation between different departments, give full play to the complementary advantages of interdisciplinary, and improve the efficiency of HAI management.

Application of hypobaric ropivacaine spinal anesthesia and nerve block anesthesia in hip surgery ofelderly patients / 中国组织工程研究

BACKGROUND: The rational choice of anesthesia for the elderly patients with hip surgery not only ensures the smooth operation, but also significantly reduces the incidence of postoperative complications. OBJECTIVE: To compare the clinical anesthetic effects between combined lumbar plexus-sciatic nerve block and hypobaric ropivacaine spinal anesthesia in hip joint surgery of elderly patients. METHODS: Forty patients who were scheduled for hip joint surgery, at the age of 65-99 years old, American Society of Anesthesiologists grades II-III, were enrolled and randomly allocated to two groups: nerve block (n=20) and spinal anesthesia (n=20). In nerve block group, combined lumber plexus-sciatic nerve block was performed directed by a nerve stimulator under the guidance of ultrasound. In spinal anesthesia group, patients received single-dose hypobaric ropivacaine spinal anesthesia at L3-4interspace. Hemodynamic changes, anesthetic effects and perioperative adverse effects were recorded in both groups before and after anesthesia. RESULTS AND CONCLUSION: (1) The patients' heart rate and mean artery pressure in each group did not change significantly before and after anesthesia in the nerve block and spinal anesthesia groups (P > 0.05). (2) The onset time of anesthesia in spinal anesthesia group was significantly faster than that in nerve block group (P < 0.01). Hypobaric ropivacaine spinal anesthesia had a better analgesic effect during the surgery, which did not need extra intravenous anesthetics. The duration of motor and sense block was significantly longer in nerve block group than in spinal anesthesia group (P < 0.01). However, five patients in spinal anesthesia group needed extra intravenous anesthetics to finish the surgery. (3) No side effects were found in both nerve block and spinal anesthesia groups. (4) These indicated that compared to combined lumbar plexus-sciatic nerve block, hypobaric ropivacaine spinal anesthesia can provide a better analgesic effect during the hip joint surgery with stable hemodynamics. Moreover, hypobaric ropivacaine spinal anesthesia dose not increase the incidence of complications and has very good clinical application prospects.

Related factors of vision recovery after complex traumatic and non - traumatic retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To investigate the visual recovery factors in patients with complex traumatic and non-traumatic retinal detachment. ·METHODS: According to the history of ocular trauma before admission, 135 patients with complex retinal detachment were divided into traumatic group ( n=66, 66 eyes) and non-traumatic group (n=69, 69 eyes). The results of visual recovery and complications were compared between the two groups. Logistic regression was used to analyze the related factors of visual recovery in the two groups. ·RESULTS: There was no significant difference in the recovery rate between the two groups within 24h after surgery (77. 3% vs 78. 3%, P>0. 05), and there was no significant difference in the total incidence of complications at 3mo after surgery(18. 2% vs 17. 4%, P>0. 05). Multifactorial Logistic regression analysis showed significant correlation between age, injury type, time since retinal detachment, rage of retinal detachment, preoperative vitreous blood,proliferative vitreoretinopathy ( PVR ) and postoperative visual recovery in patients with complex traumatic retinal detachment ( P < 0. 05 ); age, time since retinal detachment, rage of retinal detachment and macular status were significantly associated with visual recovery in patients with complex non-traumatic retinal detachment (P<0. 05). ·CONCLUSION: Age, time since retinal detachment and rage of retinal detachment were significantly associated with traumatic and non-traumatic retinal detachment. The injury type, preoperative vitreous hemorrhage, PVR were significantly correlated with the visual recovery of traumatic retinal detachment patients. The condition of macular was significantly associated with the visual recovery of non-traumatic retinal detachment patients.

Association of Bone Turnover Levels with MTHFR Gene Polymorphisms among Pregnant Women in Wuhan, China / 华中科技大学学报（医学）（英德文版）

Pregnancy is a critical stimulator of bone mineral resorption.We used to find the MTHFR gene polymorphisms are related with blood lead levels among pregnant women.Pregnancy-stimulated bone turnover may be associated with MTHFR gene polymorphisms too.In this article,we aimed to determine the relationship between MTHFR gene polymorphisms and bone turnover rates among the pregnant women.The participants including pregnant and non-pregnant women were selected and recruited during their routine prenatal or physical examination from July to October in 2012.A total of 1000 participants,including 250 pregnant women in the first,second,and third trimesters and 250 non-pregnant women,were enrolled in the study.Finally,after excluding 27 participants unable to provide blood samples,973 eligible participants (i.e.,234,249,and 248 pregnant women in the first,second,and third trimesters,respectively,and 242 non-pregnant women)were included in the research.The MTHFR gene 1298CC homozygote carriers were more susceptible to yield higher plasma homocysteine levels than the 1298AA/AC carriers,with standardized coefficients of 0.086 (P＜0.05) and 0.104 (P＜0.01) of all the participants and the pregnant women,respectively.The MTHFR gene 1793AA homozygote carriers more likely showed higher plasma osteocalcin levels (standardized β=0.091,P＜0.01) than the 1793GG/GA carriers among all the subjects.Plasma homocysteine levels were positively correlated with blood lead levels among the participants and the pregnant women with standardized coefficients of 0.320 (P＜0.01) and 0.179 (P＜0.01),respectively.Plasma osteocalcin levels were positively associated with blood lead levels among pregnant and non-pregnant women with standardized coefficients of 0.084 (P＜0.05) and 0.125 (P＜0.01),respectively.In conclusion,homocysteine and osteocalcin contents in plasma are associated with the MTHFR gene A1298C polymorphism and blood lead levels among pregnant women.The MTHFR gene A 1298C polymorphism-related homocysteine is a possible risk factor for increased blood lead levels among Chinese women.

Association of Bone Turnover Levels with MTHFR Gene Polymorphisms among Pregnant Women in Wuhan, China / 华中科技大学学报（医学）（英德文版）

Pregnancy is a critical stimulator of bone mineral resorption.We used to find the MTHFR gene polymorphisms are related with blood lead levels among pregnant women.Pregnancy-stimulated bone turnover may be associated with MTHFR gene polymorphisms too.In this article,we aimed to determine the relationship between MTHFR gene polymorphisms and bone turnover rates among the pregnant women.The participants including pregnant and non-pregnant women were selected and recruited during their routine prenatal or physical examination from July to October in 2012.A total of 1000 participants,including 250 pregnant women in the first,second,and third trimesters and 250 non-pregnant women,were enrolled in the study.Finally,after excluding 27 participants unable to provide blood samples,973 eligible participants (i.e.,234,249,and 248 pregnant women in the first,second,and third trimesters,respectively,and 242 non-pregnant women)were included in the research.The MTHFR gene 1298CC homozygote carriers were more susceptible to yield higher plasma homocysteine levels than the 1298AA/AC carriers,with standardized coefficients of 0.086 (P＜0.05) and 0.104 (P＜0.01) of all the participants and the pregnant women,respectively.The MTHFR gene 1793AA homozygote carriers more likely showed higher plasma osteocalcin levels (standardized β=0.091,P＜0.01) than the 1793GG/GA carriers among all the subjects.Plasma homocysteine levels were positively correlated with blood lead levels among the participants and the pregnant women with standardized coefficients of 0.320 (P＜0.01) and 0.179 (P＜0.01),respectively.Plasma osteocalcin levels were positively associated with blood lead levels among pregnant and non-pregnant women with standardized coefficients of 0.084 (P＜0.05) and 0.125 (P＜0.01),respectively.In conclusion,homocysteine and osteocalcin contents in plasma are associated with the MTHFR gene A1298C polymorphism and blood lead levels among pregnant women.The MTHFR gene A 1298C polymorphism-related homocysteine is a possible risk factor for increased blood lead levels among Chinese women.