Standardized diagnosis and treatment of spinal infectious diseases / 中华骨科杂志

Infectious diseases of spine (IDS) refer to a series of infectious diseases in different parts of the spine (vertebral body, intervertebral disc, appendix of vertebra, spinal canal, and adjacent paravertebral tissues) caused by various pathogenic microorganisms, accounting for about 2%~7% of systemic musculoskeletal system infections. According to the classic classification IDS can be divided into two types: specific infection and non-specific infection. IDS often has an insidious onset, atypical clinical manifestations, and less-specific imaging and laboratory tests, which causes great difficulties for the accurate diagnosis and treatment, often leading to missed diagnosis, misdiagnosis, and even mistreatment. Problems such as disordered clinical diagnosis and treatment procedures, diverse treatment methods, and non-standard medication and course of treatment still affect the prognosis of IDS. This article reviews the current research progress of the diagnosis and treatment process of IDS, in order to further standardize the diagnosis and treatment process of IDS.

Application of digital PCR technology in the precise molecular diagnosis: opportunities and challenges / 中华检验医学杂志

Digital polymerase chain reaction (dPCR) is an absolute quantitative technique that has been rapidly developed in recent years. This technique assigns the reaction system containing DNA template to a large number of independent reaction units for PCR, and calculates the DNA copy number according to the Poisson distribution and statistical positive signals. In contrast to conventional qPCR, dPCR does not depend on amplification curves, is not affected by amplification efficiency, thus has high accuracy and repeatability, and can achieve the absolute quantification. This article reviews the development history of dPCR and its application in molecular diagnosis, tumor liquid biopsy and prenatal diagnosis of infectious diseases, and looks forward to the application prospect of this technology.

Mixed features in DSM-5： problems and solutions / 四川精神卫生

This study contests the mixed states in diagnostic criteria for bipolar disorder and major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， and attempts to propose possible solutions. At present， the DSM-5 defined “mixed feature specifier” in bipolar disorder faces a number of problems in clinical use， particularly with regard to the classification of incidental features， which poses some clinical difficulties. DSM-5 abandons the previous standard setting which conform to the strict diagnostic thinking that both depression and mania exist together， and primarily captures three or more non-overlapping symptoms of the opposite pole in clinical diagnosis， but the difficulty in diagnosing the states or features resulting from the coexistence of two diametrically opposed symptoms or symptom clusters has still not been effectively addressed. In practice， clinical features of depressive episodes across participants with maniac disorder and manic episodes in depressive disorder within bipolar disorder pedigrees become atypical. Therefore， this paper focuses on the psychopathological features of the mixed profile and conducts analysis in the context of clinical practice and selected research perspectives， so as to propose some potentially constructive ideas to inform the solution of the clinical problems of the mixed states.

Silencing LncRNA SNHG7 alleviates hypoxia/reoxygenation-induced cardiomyocyte damage by regulating the expression of miR-181b-5p / 中华医学遗传学杂志

OBJECTIVE@#To study the effect of silencing LncRNA SNHG7 on hypoxia/reoxygenation (H/R)-induced cardiomyocyte injury and its targeted regulation on miR-181b-5p.@*METHODS@#Rat cardiomyocytes H9c2 were cultured in vitro and randomly divided into control group, H/R group, H/R + si-NC group, H/R + si-SNHG7 group, H/R + si-SNHG7 + anti-miR-NC group and H/R + si-SNHG7 + anti-miR-181b-5p group. The content of lactate dehydrogenase (LDH), malondialedhyde (MDA) and the activity of superoxide dismutase (SOD) were detected. Flow cytometry was carried out to detect the rate of apoptosis. qRT-PCR was used to detect the expression of SNHG7 and miR-181b-5p. Dual luciferase report experiment was used to verify the targeting relationship between SNHG7 and miR-181b-5p. Western blotting was used to detect the expression of Bax and Bcl-2.@*RESULTS@#Compared with the control group, the H/R group showed significantly increased SNHG7 expression in cardiomyocytes, reduced miR-181b-5p expression, higher levels of LDH and MDA, reduced activity of SOD, increased cell apoptosis rate, higher level of Bax protein, and reduced level of Bcl-2 protein (all P< 0.05). Compared with the H/R and H/R + si-NC groups, the H/R + si-SNHG7 group had significantly reduced level of LDH and MDA, increased activity of SOD, reduced apoptosis rate, reduced level of Bax protein, increased level of Bcl-2 protein (all P< 0.05). The dual luciferase report experiment confirmed that SNHG7 could target miR-181b-5p. Interference with the expression of miR-181b-5p could reduce the effect of silencing SNHG7 on H/R-induced cardiomyocyte oxidative stress and apoptosis.@*CONCLUSION@#Silencing SNHG7 may inhibit H/R-induced cardiomyocyte oxidative stress and apoptosis by up-regulating the expression of miR-181b-5p, thereby exerting a protective effect on cardiomyocytes.

Screening and grading of fundus images of diabetic retinopathy based on visual attention / 中华实验眼科杂志

Objective To construct an intelligent analysis system based on visual attention for diabetic retinopathy ( DR) assistant diagnosis and to realize the automatic screening and grading of fundus images of DR. Methods Total of 35126 DR fundus images were downloaded from the Diabetic Retinopathy Detection competition in the Data Modeling and Data Analysis Competition Platform (Kaggle),and 1200 fundus images were downloaded from the Messidor website. Firstly,according to the characteristics of DR fundus images,a series of preprocessing was carried out for retina images. Then,on the basis of VGG16 network,visual attention SENet module was introduced to improve the saliency of lesion features,and a deep convolution neural network SEVGG with complex network structure was generated. The network basically inherited some structural parameters of VGG16,and the parameters of SENet module were adjusted according to the basic network and training data set. Finally, the SEVGG network model was used to screen the DR fundus image,and the fundus image was divided into different levels according to the degree of lesions of DR in different periods. Configure the training platform and environment and perform algorithm performance verification experiments. Results The method proposed in this study was tested on different open standard datasets,and finally achieved high accuracy in image-based classification. The accuracy of 5 classification in Kaggle dataset was 83％,the sensitivity of lesion detection was 99. 86％ and the specificity was 99. 63％. The accuracy rate of the 4 classification in the Messidor data set was up to 88％,the sensitivity of the lesion detection was 98. 17％,and the specificity was 96. 39％. The introduction of visual attention was more significant for the focus of the lesion,which helped the accurate detection of DR. Conclusions This method effectively avoids some shortcomings of traditional artificial feature extraction and fundus image classification,and is more accurate for lesion recognition. It is not only superior to the previous method,but also shows better robustness and generalization.

Efficacy and safety of duloxetine for depression in China :a meta-analysis / 中华行为医学与脑科学杂志

Objective To systematically evaluate the efficacy and adverse effects of duloxetine in the treatment of domestic depression patients,and compare with those who were treated with SSRIs drugs in the same period to explore the difference between them to guide the clinical medication.Methods A search was conducted in CBMdisc,Wanfang database,CNKI,VIP,Pubmed.The double-blind randomized controlled trials on duloxetine for depression in China were collected.The quality of the included trials was assessed according to the Cochrane Handbook 5.0,and the systematic analysis was conducted by using RevMan 5.3 soft ware.Results Seven double-blind randomized controlled trials (two of duloxetine versus fluoxetine,five of duloxetine versus paroxetine) involving 1 193 patients were included.The results of rmeta-analysis showed that:①After 6-8 weeks of treatment,there were no significant differences in the effective rate (RR =1.02,95％CI=0.78-1.32,Z=0.12,P=0.90),and the final cure rate (RR=0.95,95％CI=0.75-1.19,Z=0.47,P=0.64) between the duloxetine and fluoxetine/paroxetine groups.②Adverse reactions:the incidence rate was not significantly different between duloxetine and fluoxetine/paroxetine groups (RR =1.03,95％ CI =0.86-1.23,Z=0.32,P=0.75).Conclusion After 6-8 weeks of treatment,there are no significant differences in the effective rate and the final cure rate between duloxetine and fluoxetine/paroxetine.There is no significantly difference in common adverse reactions.

Surgical site infection following abdominal surgery in China: a multicenter cross-sectional study / 中华胃肠外科杂志

OBJECTIVE@#To determine the incidence of surgical site infection (SSI) after abdominal surgery and to further evaluate the related risk factors of SSI in China.@*METHODS@#The multicenter cross-sectional study collected clinical data of all adult patients who underwent abdominal surgery from May 1, 2018 to May 31, 2018 in 30 domestic hospitals, including basic information, perioperative parameters, and incisional microbial culture results. The primary outcome was the incidence of SSI within postoperative 30 days. SSI was classified into superficial incision infection, deep incision infection, and organ/gap infection according to the US Centers for Disease Control and Prevention (CDC) criteria. The secondary outcome variables were ICU stay, postoperative hospital stay, total hospital stay, 30-day mortality and treatment costs. Multivariate logistic regression was used to analyze the risk factors of SSI.@*RESULTS@#A total of 1666 patients were enrolled in the study, including 263 cases of East War Zone Hospital of PLA, 140 cases of Affiliated Hospital of Qingdao University, 108 cases of The First Affiliated Hospital of Nanchang University, 87 cases of Central War Zone Hospital of PLA, 77 cases of West China Hospital, 74 cases of Guangdong General Hospital, 71 cases of Chenzhou First People's Hospital, 71 cases of Zigong First People's Hospital, 64 cases of Zhangjiagang First People's Hospital, 56 cases of Nanyang City Central Hospital, 56 cases of Lanzhou General Hospital of Lanzhou Military Command, 56 cases of Shandong Provincial Hospital, 52 cases of Shangqiu First People's Hospital, 52 cases of People's Hospital of Xinjiang Uygur Autonomous Region, 48 cases of The Second Xiangya Hospital of Central South University, 48 cases of Chinese PLA General Hospital, 44 cases of Affiliated Hospital of Xuzhou Medical University, 38 cases of Hunan Province People's Hospital, 36 cases of Dongguan Kanghua Hospital, 30 cases of Shaoxing Central Hospital, 30 cases of Northern Jiangsu People's Hospital, 29 vases of The First Affiliated Hospital of Zhengzhou University, 27 cases of General Hospital of Tianjin Medical University, 22 cases of Zigong Fourth People's Hospital, 21 cases of The Second Hospital of University of South China, 18 cases of Tongji Hospital, 15 cases of Nanchong Central Hospital, 12 cases of The 901th Hospital of PLA, 11 cases of Hunan Cancer Hospital, 10 cases of Lanzhou University Second Hospital. There were 1019 males and 647 females with mean age of (56.5±15.3) years old. SSI occurred in 80 patients (4.8%) after operation, including 39 cases of superficial incision infection, 16 cases of deep incision infection, and 25 cases of organ/interstitial infection. Escherichia coli was the main pathogen of SSI, and the positive rate was 32.5% (26/80). Compared with patients without SSI, those with SSI had significantly higher ICU occupancy rate [38.8%(31/80) vs. 13.9%(220/1586), P<0.001], postoperative hospital stay (median 17 days vs. 7 days, P<0.001) and total hospital stay (median 22 days vs. 13 days, P<0.001), and significantly higher cost of treatment (median 75 000 yuan vs. 44 000 yuan, P<0.001). Multivariate analysis showed that male rise(OR=2.110, 95%CI:1.175-3.791, P=0.012), preoperative blood glucose level rise(OR=1.100, 95%CI: 1.012-1.197, P=0.026), operative time (OR=1.006, 95%CI:1.003-1.009, P<0.001) and surgical incision grade (clean-contaminated incision:OR=10.207, 95%CI:1.369-76.120, P=0.023; contaminated incision: OR=10.617, 95%CI:1.298-86.865, P=0.028; infection incision: OR=20.173, 95%CI:1.768-230.121, P=0.016) were risk factors for SSI; and laparoscopic surgery (OR=0.348, 95%CI:0.192-0.631, P=0.001) and mechanical bowel preparation(OR=0.441,95%CI:0.221-0.879, P=0.020) were protective factors for SSI.@*CONCLUSIONS@#The incidence of postoperative SSI in patients with abdominal surgery in China is 4.8%. SSI can significantly increase the medical burden of patients. Preoperative control of blood glucose and mechanical bowel preparation are important measures to prevent SSI.

Posterior debridement, grafting and internal fixation for treatment of non-specific lumbar intervertebral infection / 中华骨科杂志

Objective To explore the effect of posterior debridement, grafting and internal fixation for treatment of non-specific lumbar intervertebral infection. Methods Clinical data of 20 patients with non-specific lumbar intervertebral infection treated in General Hospital of Ningxia Medical University from October 2013 to June 2013 were retrospectively analyzed. There were 15 males and 5 females with an average age of 41 years (range, 36-51 years). All patients suffered from single lumbar inter-vertebral infection, including 3 cases at L2/3,4 at L3/4,10 at L4/5 and 3 at L5/S1. All 20 cases underwent one-stage posterior debride-ment, autogenous bone grafting and internal fixation, tissue samples in focus were collected for bacterial culture and pathological examination. The disease controlling statues were evaluated based on laboratory results of ESR and CRP. Imaging examinations were taken to evaluate the fusion of vertebral body. Clinical effects were evaluated using the visual analog scale (VAS) and the Jap-anese Orthopaedic Association scores (JOA) score of lumbar fumction. Results All patients underwent the surgery successfully. The surgery duration time was 90-160 min, average 125 min, and the blood loss was 200-700 ml, average 360 ml. Cerebrospinal fluid leakage occurred in one case. Postoperatively, all patients experienced significant reliefof back pain, improving in the func-tion of movement, and no fever. The lower back VAS score: average (5.35 ± 1.15) points before operation , average (2.76 ± 0.34) points one week after operation, and an average score of (0.85±0.65) points by the last follow-up time. JOA lumbar function score:all patients were effective after operation, the improvement rate was excellent in 65%(13cases), good in 25%(5 cases), and pass-able in 10%(2cases). Comparing with preoperation, the excellent and good rate was 90%. All patients ESR and CRP returned to normal levels at the last follow-up. Ordinary bacterial culture was positive in 8 cases and negative in 12 cases. The pathogens iden-tified were staphylococcus aureus (6 cases), Escherichia coli (2 cases) and staphylococcus epidermidis (2cases). All incisions achieved primary healing. All patients were followed up from 6-18 months (average,12 months), and the symptom of pain relieved significantly. No recurrent infection had happened. A solid bony fusion was found in all patients at 6-14 months (average, 8.5 months) after the surgery. Conclusion Posterior debridement, grafting and internal fixation are effective treatments for non-spe-cific lumbar intervertebral infection, can reduce the time of staying in hospital, this operation is safe and reliable.

Posterior debridement, grafting and internal fixation for treatment of non-specific lumbar intervertebral infection / 中华骨科杂志

Objective To explore the effect of posterior debridement, grafting and internal fixation for treatment of non-specific lumbar intervertebral infection. Methods Clinical data of 20 patients with non-specific lumbar intervertebral infection treated in General Hospital of Ningxia Medical University from October 2013 to June 2013 were retrospectively analyzed. There were 15 males and 5 females with an average age of 41 years (range, 36-51 years). All patients suffered from single lumbar inter-vertebral infection, including 3 cases at L2/3,4 at L3/4,10 at L4/5 and 3 at L5/S1. All 20 cases underwent one-stage posterior debride-ment, autogenous bone grafting and internal fixation, tissue samples in focus were collected for bacterial culture and pathological examination. The disease controlling statues were evaluated based on laboratory results of ESR and CRP. Imaging examinations were taken to evaluate the fusion of vertebral body. Clinical effects were evaluated using the visual analog scale (VAS) and the Jap-anese Orthopaedic Association scores (JOA) score of lumbar fumction. Results All patients underwent the surgery successfully. The surgery duration time was 90-160 min, average 125 min, and the blood loss was 200-700 ml, average 360 ml. Cerebrospinal fluid leakage occurred in one case. Postoperatively, all patients experienced significant reliefof back pain, improving in the func-tion of movement, and no fever. The lower back VAS score: average (5.35 ± 1.15) points before operation , average (2.76 ± 0.34) points one week after operation, and an average score of (0.85±0.65) points by the last follow-up time. JOA lumbar function score:all patients were effective after operation, the improvement rate was excellent in 65%(13cases), good in 25%(5 cases), and pass-able in 10%(2cases). Comparing with preoperation, the excellent and good rate was 90%. All patients ESR and CRP returned to normal levels at the last follow-up. Ordinary bacterial culture was positive in 8 cases and negative in 12 cases. The pathogens iden-tified were staphylococcus aureus (6 cases), Escherichia coli (2 cases) and staphylococcus epidermidis (2cases). All incisions achieved primary healing. All patients were followed up from 6-18 months (average,12 months), and the symptom of pain relieved significantly. No recurrent infection had happened. A solid bony fusion was found in all patients at 6-14 months (average, 8.5 months) after the surgery. Conclusion Posterior debridement, grafting and internal fixation are effective treatments for non-spe-cific lumbar intervertebral infection, can reduce the time of staying in hospital, this operation is safe and reliable.

Local recurrence after complete resection of primary retroperitoneal liposarcoma / 中华普通外科杂志

Objective To investigate factors impacting on local recurrence in cases of primary retroperitoneal liposarcoma (RPLS) after complete enbloc resection.Methods The clinical data of 47 cases of primary retroperitoneal liposarcoma were retrospectively analyzed.Results 3-year local recurrence rate was 62％.Single and multiple regression analysis showed preoperative needle biopsy,histological subtype,tumor size and capsular invasion were all risk factors related to postoperative local recurrence in primary retroperitoneal liposarcoma undergoing complete resection (P ＜ 0.05).Conclusion Preoperative aspiration biopsy,tumor poor differentiation,large tumor size tumor extracapsular spread all lead to high local recurrence rate after complete resection of primary retroperitoneal liposarcoma.

An in vitro experimental study on the physical and elution properties of PMMA bone cement loaded with rifampicin, iso-niazid, pyrazinamide and moxifloxacin / 中华骨科杂志

Objective To investigate the feasibility of Antituberculotic?loaded bone cement (ATLBC) prepared by mix?ing the anti?TB drugs Rifampicin (RFP), Isoniazid (INH), Pyrazinamid (PZA), Moxifloxacin (MFX) with Palacos R PMMA bone cement in Total Joint Arthroplasty treatment for Joint Tuberculosis. Methods Forty grams of Palacos R bone cement powder without antibiotics was mixed with 1 or 2 grams of RFP, INH, PZA and MFX respectively. According to ISO 5833:2002 stan?dard, 8 groups of ATLBC standard test specimen were prepared as experiment group and Palacos R PMMA bone cement with?out antibiotics was prepared as control group. Physical properties (such as the average dough time, curing time, maximum tem?perature), mechanical strength (such as the compressive strength, the bending resistance strength, the modulus of elasticity) and the concentrations of eluant drug in different time points of ATLBC were detected. Results In RFP (1 g), RFP (2 g), INH (1 g) and INH (2 g) group, the average dough time and curing time were longer than those in control group, which exceeded the standard scope of ISO, while the average maximum temperature was significantly lower than that in control group. The INH ( 1 g) group and INH (2 g) group hardened after mixing for 14 days. The RFP (1 g) group and RFP (2 g) group hardened after mixing for 30 days. Twenty minutes after mixing and hardening, the compressive strength, bending resistance strength and modulus of elastic?ity were significantly lower than the specified values of ISO standard. The physical properties and mechanical strength in PZA ( 1 g) group, PZA (2 g) group, MFX (1 g) group, MFX (2 g) group and control group were in accordance with the specified values of ISO standard, and they hardened after 20 minutes. In RFP (1 g) group, RFP (2 g) group, INH (1 g) group, INH (2 g) group, PZA (1 g) group, PZA (2 g) group, MFX (1 g) group and MFX (2 g) group, the concentration of eluant could maintain for 3 days, 7 days, 90 days, 90 days, 45 days, 60 days, 60 days and 60 days respectively. Conclusion RFP and INH mixing with Palacos R PMMA bone cement can hinder the aggregation of bone cement so they are unsuitable for preparing ATLBC. PZA and MFX mixing with Palacos R PMMA bone cement do not affect the physical properties of bone cement, with excellent mechanical strength and elu?tion properties. Because the minimal inhibitory concentration of PZA is higher and its antimicrobial activity maintains shorter time, while MFX maintains longer time in antimicrobial activity, it's more suitable for the preparation of ATLBC.

The clinical efficacy of pathologic vertebral surgery for thoracic and lumbar tuberculosis / 中华骨科杂志

Objective To discuss the clinical efficacy of surgical treatment of pathologic vertebral surgery for thoracic and lumbar tuberculosis. Methods All of 322 cases of thoracic and lumbar spinal tuberculosis patients from December 2003 to June 2014 were retrospectively analyzed in our department. All patients were underwent debridement, fusion and nerve decompres?sion surgery. According to different fixed methods, patients were divided into pathologic vertebral surgery group (fixation complet?ed within lesions invaded motion unit) including 91 males and 100 females, with an average age of 41.53 years, and non?pathologic vertebral surgery group (long segments or short segment fixation) including 61 males and 70 females, with an average age of 42.72 years. We observed the tuberculosis cure rate, degrees of deformity, pain and neurological recovery, operative time, blood loss and complications by follow?up. Results The average follow?up time was 75.52 months in pathologic vertebral surgery group and 76.21 months in non?pathologic vertebral surgery group. The total number of pathologic vertebras in pathologic vertebral surgery group and non?pathologic vertebral surgery group were 277 and 218 respectively, and the average was 1.45 and 1.66. The total number of fixed segments was 277 in pathologic vertebral surgery group and 485 in non?pathologic vertebral surgery group, and the average fixed segments was 1.45 and 3.70. The cure rate was 85.86%in pathologic vertebral surgery group and 85.49%in non?pathologic vertebral surgery group at 6 months postoperatively, and 98.95%and 98.47%at the last follow?up time, with no signifi?cant difference between groups. Graft fusion rate was 89.00%in pathologic vertebral surgery group and 89.31%in non?pathologic vertebral surgery group 6 months postoperatively, 98.38%and 98.47%at the last follow?up time, without significant difference. In lumbar spine, the average correction of Cobb's angle was 12.4° in pathologic vertebral surgery group and 13.1° in non?pathologic vertebral surgery group, and the average angle loss was 1.3 and 1.4°, with no significant difference. In thoracolumbar, the average correction of Cobb’s angle was 10.9°in pathologic vertebral surgery group and 11.1°in non?pathologic vertebral surgery group, and the average angle loss was 1.7°and 1.5° respectively, without significant difference. However, in thoracic, the average correction of Cobb's angle was 10.2° in pathologic vertebral surgery group and 12.7° in non?pathologic vertebral surgery group, and the average angle loss was 3.6° and 2.5°respectively, with significant difference. The mean operation time was 210.45 min in pathologic verte?bral surgery group and 210.45 min in non?pathologic vertebral surgery group, with significant difference. The average blood loss was 726.12 ml in pathologic vertebral surgery group and 726.12 ml in non?pathologic vertebral surgery group, with significant dif?ference. The complication rate was 11.51%in pathologic vertebral surgery group and 11.45%in non?pathologic vertebral surgery group, with no significant difference. Conclusion Pathologic vertebral surgery surgery is a safe, effective and feasible method of operation for treatment of thoracic and lumbar tuberculosis, which can effectively preserve adjacent normal vertebral motion unit features. The thoracic surgery was less satisfactory than the lumbar and thoracolumbar surgery.

MiRNA-106a Induces Multidrug Resistance of Gastric Cancer Cells by Targeting RUNX 3 / 华中科技大学学报(医学版)

Objective To explore the effect of miRNA‐106a(miR‐106a) expression on multidrug resistance(MDR)of gastric cancer(GC)cells and the involvement of runt‐related transcription factor 3 RUNX3.Methods The expression of miR‐106a was detected in two human gastric adenocarcinoma cell lines with MDR by immunoblotting and apoptosis assay. The sensitivity of GC cells to anticancer drugs was observed by detecting the expression of miR‐106a by using immunoblotting and PCR ,and the relationship between miR‐106a and RUNX3 was determined by luciferase activity assay.Results miR‐106a was significantly in‐creased in GC cells with MDR ,and it suppressed the sensitivity of GC cells to anticancer drugs. It could modulate MDR by tar‐geting RUNX3.Conclusion miR‐106a can induce the MDR by targeting RUNX3 in GC.

Study of P300 in senile patients with depression: a meta-analysis of domestic literatures / 中华老年医学杂志

Objective To assess the latency and amplitude changes in P300 in senile patients with depression.Methods 13 domestic published study literatures meeting our criteria were searched from CBM,CNKI,and a meta-analysis on P300 latency and amplitude was performed with RenMan 4.1 soft ware.Results 1.The P300 latency in senile patients with depression was significant longer than that in senile normal controls in N1,P2,N2,P300 (N1:WMD=3.07,95 ％ CI:0.7～5.42,Z=2.55,P=0.010;P2:WMD=18.41,95％CI:15.11～21.71,Z=10.93,P＜ 0.01;N2:WMD=25.41,95％CI:12.80～29.02,Z=13.80,P＜0.01;P3:WMD=32.14,95％CI:24.14～34.88,Z=23.04,P＜0.01).2.The amplitude in senile patients with depression was significant lower than that in senile normal controls in N2,P2,P3 (P2:WMD=-0.83,95％CI:-1.07～-0.59,Z-6.78,P＜0.01; N2:WMD＝-0.34,95％CI:-0.59～-0.08,Z=2.57,P=0.01;P3:WMD=-2.54,95％CI:-2.75～-2.33,Z=23.99,P＜0.010).Conclusions P300 longer latency and lower amplitude are the statistically characterized features for senile depressive patients.

Compare of complete and incomplete radical debridement for thoracolumbar spinal tuberculosis / 中华骨科杂志

Objective To explore the compare of complete and incomplete radical debridement for thoracolumbar spinal tuberculosis.Methods Data of 296 patients with spinal tuberculosis from January 2000 to January 2011 were retrospectively analyzed.All patients were divided into two groups according to completeness of debridement:complete debridement group (group A) and incomplete debridement group (group B).There were 162 cases in group A including 86 males and 76 females,with an average age of 38.74± 17.26 years.There were 134 cases in group B including 73 males and 61 females,with an average age of 35.64± 18.21 years.All paticnts had undergone anterior debridement,focal graft implantation,anterior or posterior deformity correction,and internal fixation.Regular follow-up was required in the two groups.Results Residual sclerotic walls (36.54％),multipie cavities (34.62％),affected bony bridges (13.46％),sequestmm (3.37％),abscess (7.21％) and other lesionses (4.81％) were found in the group B.The first three factors were made up 84.62％ of the total.The mean follow-up time was 76.13±8.32 months in the group A and 79.24±5.49 months in the group B.The symptoms,C-reactive protein and erythrocyte sedimentation rate were improved more obviously in group A than those in group B.Six months after operation,tuberculosis healing rate in group A and group B was 29.01％ (47 patients) and 4.48％ (6 patients),respectively.The mean healing time was 4.36± 1.27 months in the group A and 9.15±2.53 months in the group B,with significant differences.The mean the time of chemotherapy was 5.21± 1.38 months in the group A and (10.45±2.15) months in the group B,with significant differences.Reoperation rate in group A and group B was 0.62％ (1/162) and 4.48％ (6/134),respectively.Conclusion Sclerotic bone,multiple cavities,and bony bridges are parts of foci in spinal tuberculosis.Clearing tuberculous foci with sclerotic bone,multiple cavities,and bony bridges can increase the curative effect,shorten the time of chemotherapy and reduce the side effects of drug,thus early resumption can be achieved.

Clinical study on the treatment of different type depressive patients with integrated western and traditional Chinese medicine / 国际中医中药杂志

Objective To observe the effect of SSRI combined with TCM on the treatment of depression of different TCM types. Methods 70 depressive patients of stagnation of liver qi (SLQ) were randomly recruited into a study (34 cases) and a control group (36 cases); 60 depressive patients of spleen deficiency and liver qi stagnation (SDLQS) were randomly recruited into a study (30 cases) and a control group (30 cases); and SO depressive patients of deficiency of both heart and liver (DBHL) were randomly recruited into a study (24 cases) and a control group (26 cases). Patients in the study group were treated with SSRI and TCM; with the control group was only treated with SSRI. All patients were assessed with HAMD, HAMA and CGI before treatment and after treatment at 1st weekend, 2nd weekend, 4th weekend and 6th weekend. Differences of effective rate and full remission rate were contrasted. Results ①Scores of depression scale decreased in both the study group and the control group of patients with SLQ and SDLQS at the 4th [SLQ study group: (9.01±3.45), control group (13.02±4.54); SDLQS study group (10.22±3.23)、 control group (14.12±3.87)] and 6th [SLQ study group (6.02±2.20), control group (10.22±2.10); SDLQS study group (7.25±2.20) control group (10.68 ± 3.45)] weekend, showing statistical differences; anxiety state has been improved since the 1st weekend; no obvious changes of HAMD and HAMA showed in both the study group and the control group of patients with DBHL; ②Therapeutic effects in the study group were higher than the control group of both patients with SLQ and SDLQS, showing statistical significance; while no difference can be seen between the two group of patients with DBHL; ③ No differences of full remission rate between the study group and the control group of 3 TCM types were found(SLQ:41.1%v30.6%,χ2=0.859,P>0.05; SDLQS:40.0%v33.3, χ2=0.287,P>0.05; DBHL: 33.3%v26.9%,χ2=0.244,P>0.05). ④Significant differences of HAMD and HMDA between the study and the control group of 3 TCM types were found before and after treatment Conclusion SSRI integrated with TCM may promote effective rate and decrease anxiety in patients with SLQ and SDLQS.

Clinical significance of heart-type fatty acid-binding protein in the early diagnosis of acute myocardial infarction / 中国医师进修杂志

ObjectiveTo explore the clinical significance of heart-type fatty acid-binding protein (H-FABP) in acute myocardial infarction(AMI) patients. MethodsThe level of H-FABP was assayed within 30 min, 1 h, 2 h, 4 h,6 h and 12 h by enzyme linked immunosorbent assay (ELISA) in 46 AMI patients, and cardiac troponin Ⅰ(cTnⅠ) and creatinine kinase(CK-MB) also was assayed by routine method.The diagnostic accuracy was compared among different methods. ResultsThe diagnostic accuracy of H-FABP[95.7％ (44/46)] was significantly higher than cTnⅠ[65.2％(30/46)] and CK-MB[41.3％ (19/46)](P ＜0.05). The levels of H-FABP, cTnⅠ and CK-MB significantly increased after AMI onset 4,6,12 hrespectively. ConclusionThe diagnosticaccuracy of H-FABP is higher and can be used as a parameter for the early diagnosis of AMI.

Effect of percutaneous coronary Intervention on coronary artery disease with complicated lesions / 中国综合临床

Objective To assess the clinical efficiency of percutaneous coronary intervention (PCI) on cor-onary artery disease patients with complicated lesions (CAD-CL). Methods A total of 252 patients of CAD-CL treated with PCI from August,2002 to September,2009 were enrolled in the study. Clinical data on prognosis e. g, success rate, complication occurrence and major adverse cardiac events were observed. Results Two hundred and forty-four patients with CAD-CL(including chronic obstruction, bifurcation lesion, long lesion and restenosis) were implanted stent successfully(96.83%), with no residual stenosis or residual stenosis less than 20%. There were col-lateral obstructions in 32 patients and artery secret compartment in 48 patients, and restenosis in 15 patients. One patient of acute anterior myocardial infarction complicated by cardingenic shock was in low blood pressure status after two anterior descending artery stent placement, and died after temporary pacemaker implantation and other positive rescue measures. One patient occurred subacute stent thrombosis on the third day, and was cured after occlusive vas-cular recanalization through emergency PCI. Conclusions Percutaneous coronary intervention for coronary artery disease patients with comphcated lesion is safe and effective.

Clinical significance of anti-β2glycoprotein I antibodies in systemic lupus erythematosus / 中华微生物学和免疫学杂志

Objective To investigate the clinical application of anti-β2 glyeoprotein Ⅰ antibodies (IgG, IgM, IgA)in systemic lupus erythematosus(SLE). Methods The anti-β2-GP Ⅰ antibodies and anti-cardiolipin antibodies(ACL) level were measured by ELISA in 100 SLE patients, 39 other rheumatoid arthri-tis patients and 30 healthy control people. Their clinical application was analyzed in SLE diagnose and thera-py. Results The level of anti-β2-GP Ⅰ (IgG, IgM, IgA)were significantly higher in SLE than that in healthy (P < 0. 01 ). Sensitivity, specificity, positive predictive value and negative predictive value were 17.2%, 95.7%, 85.0% and 44. 6%, respectively. There was a significant and positive correlation be-tween anti-β2-GP Ⅰ antibodies and ACL antibodies ( IgG, IgM, IgA) (r = 0.418, 0. 624, 0.518, 0. 583, P <0.01). In multivariate analysis the factors(anti-β2-GP Ⅰ antibodies, ACL antibodies, dsDAN, u1-RNP, Sm, SSA, SSB, Jo-1, Scl-70, P-protein, PT, APTT) associated with SLE disease activity index(SLEDAI) were anti-β2-GP Ⅰ (IgG) and dsDNA. Conclusion anti-β2-GP Ⅰ antibody has high specificity and positive predict value, also is associated with SLE's thrombosis. It has some values in the clinical application.

Effects of hypoxia-indudble factor 1α on the growth of subcutaneously implanted hepatocellular carcinoma in nude mice / 中华普通外科杂志

Objective To study the effects of HIF-1α expression on the growth of subcutaneously implanted human hepatocellular carcinoma (HCC) cell lines in nude mice. Methods A nude mouse model of subcutaneously implanted HCC cell line HepG2Tet-on-HIF-1α was established. This cell lines characterizes the inducible expression of HIF-1α by doxycycline (Dos). The impact of HIF-1α expression induced by Dox on the growth of subcutaneously implanted HCC cell lines in the nude mouse model was observed. Results The mRNA and protein expression of HIF-1α were significantly up-regulated in the nude mouse model by oral administration of Dox. Compared with that model in which Dox was not administrated ie Dos( - ) group, the tumor volume(513.545 ± 276. 229) mm3 vs. ( 166. 506 ± 110. 142) mm3 ( P < 0. 05 ), tumor weight ( 1.251 ± 0. 438 ) g vs. (0. 640 ± 0. 296) g ( P < 0. 05 ), and tumor growth velocity were significantly enhanced in Dox ( + ) group, while tumor necrosis was inhibited ( 31. 360% ±2. 728% vs. 36. 640% ± 3. 804% ) (P<0. 05). The weight loss of nude mice was larger in Dox( + )group( P < 0. 01 ). There was no liver or lung metastasis in either group. Conclusion The expression of HIF-1αin subcutaneously implanted HCC in a nude mouse model is up-regulated by oral Dox. High grade expression of HIF-1α promotes the growth of implanted HCC.