"Leverage pry-off method" for effective prevention of thermal injury during microwave ablation of benign thyroid nodules / 南方医科大学学报

OBJECTIVE@#To assess the safety and efficacy of"leverage pry-off method"for preventing thermal injury during microwave ablation of benign thyroid nodules.@*METHODS@#From July, 2017 to September, 2019, a total of 348 patients with benign thyroid nodules underwent ultrasound-guided microwave ablation. For protecting from thermal injury during the ablation, "hydrodissection technique" was used in 174 of the patients (admitted from July, 2017 to August, 2018) and "leverage pry-off method" in the other 174 patients (admitted from September, 2018 to September, 2019). All the patients were followed up for 1 to 12 months after the operation for observation of severe complications and nodular residues.@*RESULTS@#Ultrasound-guided microwave ablation was completed in all the 348 patients. The most common severe complication associated with the ablation was voice change, occurring in 3 cases (1.7%) in "hydrodissection technique" group and in 4 (2.3%) in the "leverage pry-off method" group, showing no significant difference between the two groups (P>0.05). During the follow-up, no significant difference was found in the rate of nodular residues between the "hydrodissection technique" group and "hydrodissection technique" group (9.8% vs 10.9% (P>0.05).@*CONCLUSIONS@#The "leverage pry-off method" is simple and effective for preventing thermal injury during microwave ablation of benign thyroid nodules.

Exploration and Practice of the "One Combination, Two Highlights, Three Combinations, Four in One" Innovative Talents Training Mode in Forensic Medicine / 法医学杂志

Talent is one of the basic and strategic supports for building a modern socialist country in all aspects. Since the 1980s, the establishment of forensic medicine major and the cultivation of innovative talents in forensic medicine have become hot topics in higher education in forensic medicine. Over the past 43 years, the forensic medicine team of Shanxi Medical University has adhered to the joint education of public security and colleges, and made collaborative innovation, forming a training mode of "One Combination, Two Highlights, Three Combinations, Four in One" for innovative talents in forensic medicine. It has carried out "5+3/X" integrated reform, and formed a relatively complete talent training innovation mode and management system in teaching, scientific research, identification, major, discipline, team, platform and cultural construction. It has made a historic contribution to China's higher forensic education, accumulated valuable experience for the construction of first-class major and first-class discipline of forensic medicine, and provided strong support for the construction of the national new forensic talent training system. The popularization of this training mode is conducive to the rapid and sustainable development of forensic science, and provides more excellent forensic talents for national building, regional social development and the discipline construction of forensic science.

Postmortem Distribution and Postmortem Redistribution of Carbofuran-7-Phenyl Glucuronic Acid in Rabbits / 法医学杂志

OBJECTIVES@#To establish a carbofuran intragastric administration death model in rabbits, and to observe the postmortem distribution and postmortem redistribution of carbofuran-7-phenyl glucuronic acid (Glu-7PH) in rabbits.@*METHODS@#The postmortem distribution: Rabbits were given an administration of 1/2LD50, LD50, 2LD50 carbofuran. Dead rabbits were dissected immediately. Rabbits that had remained alive 2 hours were sacrificed by carbon dioxide (CO2) inhalation and dissected immediately. The myocardium, cardiac blood, liver, spleen, lung, kidney, brain and right hindlimb muscle were collected. The postmortem redistribution: After giving an administration of 4LD50 carbofuran, the myocardium, cardiac blood, liver, spleen, lung, kidney, brain, and right hindlimb muscle were collected at 0, 12, 24, 48, and 72 h postmortem in supine position at 15 ℃ room temperature. The quantity of Glu-7PH was determined by LC-MS/MS.@*RESULTS@#The postmortem distribution: Among the three dose groups, there were significant differences in the quantities of Glu-7PH in different tissues. The postmortem redistribution: There was no significant difference in the Glu-7PH quantities in cardiac blood, mycardium, spleen, kidney, brain and right hindlimb muscle, but there was a significant difference in the Glu-7PH quantities in the liver and lung.@*CONCLUSIONS@#The mycardium, cardiac blood, liver, lung, kidney, brain and hindlimb muscle of rabbits can be used as appropriate samples for Glu-7PH detection. However, it should be noted that Glu-7PH was redistributed postmortem in rabbit liver and lung.

Research Progress on the Application of Human Oral Microbiome in Forensic Individual Identification / 法医学杂志

The oral cavity is the second largest microbial bank in humans after the intestinal canal, colonizing a large number of microorganisms including viruses, bacteria, archaea, fungi and protozoa. The great number of microbial cells, good DNA stability, and individual has a unique microbial community, these characteristics make the human microbiome expected to become a new biomarker for forensic individual identification. This article describes the characteristics of human oral microorganisms and microbial molecular markers in detail, analyzes the potential application value of microorganisms in forensic individual identification, and reviews the research progress of human oral microorganisms in forensic individual identification.

Study on Anisotropy Properties of in vitro Pig Trachea and Numerical Simulation / 医用生物力学

Objective To study mechanical properties of the anisotropy for pig trachea and main bronchi, and determine the constitutive model of trachea deformation by finite element numerical simulation. Methods The pig tracheas were collected and cut through in their axial directions and expanded into two-dimensional planes. Then, by setting the length direction of the trachea aortas as 0°, each planar trachea was anticlockwisely cut into 6 samples with orientation of 30°,60°,90°,120°,150° and 180°, respectively. Uniaxial tensile tests were applied on the specimen in 6 angular directions by using the electronic universal test machine, to obtain stress and strain of the specimen in different directions. Nonlinear fitting to the experimental data was performed by using the Mooney-Rivilin hyperelastic model, in order to obtain the material characteristic parameters. Finite element models of the trachea and the main bronchi were established, and tensile numerical simulation was carried out.Results Samples at different angles showed different stress-strain curves. In the trachea, the stresses of samples with angle of 30°, 120° and 150° were in the range of 1.0-1.5 MPa, the stresses of samples with angle of 60° and 90° were in the range of 0.5-1.0 MPa, and the stresses of samples with angle of 180° were in the range of 2.5-3.0 MPa. In the main bronchi, the stresses of samples with angle of 30°, 120° and 150° were in the range of 0.8-1.0 MPa, the stresses of samples with angle of 90° and 180° were in the range of 1.4-1.8 MPa, and the stresses of samples with angle of 120° were in the range of 0.4-0.6 MPa. There was an obvious difference between the trachea and the main bronchi. The finite element simulation verified that the Mooney-Rivilin constitutive model was suitable for describing small deformation behavior of the trachea. Conclusions The pig trachea exhibits strong anisotropy. Meanwhile, the Mooney-Rivilin model can characterize small tracheal deformations. The results provide theoretical references for tracheal resection and reconstruction in clinical treatment and intervention with surgical instruments such as bronchoscopy.

Possible Risk Factors for Severe Complications Occurring after Primary Total Knee Arthroplasty / 中国医学科学杂志(英文版)

Objective Total knee arthroplasty is one of the most common orthopedic surgeries. Readmission due to severe complications after total knee arthroplasty is a grave concern to surgeons. In this study, we evaluated the risk factors for severe complications after primary total knee arthroplasty. Methods We retrospectively collected clinical data of 2,974 patients who underwent primary total knee arthroplasty from July 2013 to June 2019 in our hospital. Postoperative complication ≥ grade Ⅲ was defined as severe complication according to Clavien-Dindo classification system. Binary logistic regression was used to identify the predictive risk factors for severe complications. Results The complication rate after primary total knee arthroplasty was 6.8% and severe complication rate was 2.5%. Male (OR = 2.178, 95%CI: 1.324-3.585, P= 0.002), individuals above 75 years old (OR = 1.936, 95%CI: 1.155-3.244, P= 0.012), arrhythmia (OR = 2.913, 95%CI: 1.350-6.285, P= 0.006) and cerebrovascular disease (OR = 2.804, 95%CI: 1.432-5.489, P= 0.003) were predictive risk factors for severe complications after primary total knee arthroplasty. Conclusion Advanced age, male, arrhythmia, and cerebrovascular disease might be patients-related risk factors for postoperative severe complications after primary total knee arthroplasty. Special attention should be paid to patients with risk factors.

Minimally invasive swine spine surgery training: technical aspects, benefits, and anatomical limitations

ABSTRACT Objective To describe the technical specificities and feasibility of simulation of minimally invasive spine surgery in live pigs, as well as similarities and differences in comparison to surgery in humans. Methods A total of 22 Large White class swine models, weighing between 60 and 80kg, were submitted to surgical simulations, performed during theoretical-practical courses for training surgical techniques (microsurgical and endoscopic lumbar decompression; percutaneous pedicular instrumentation; lateral access to the thoracic spine, and anterior and retroperitoneal to the lumbar spine, and management of complications) by 86 spine surgeons. For each surgical technique, porcine anatomy (similarities and differences in relation to human anatomy), access route, and dimensions of the instruments and implants used were evaluated. Thus, the authors describe the feasibility of each operative simulation, as well as suggestions to optimize training. Study results are descriptive, with figures and drawings. Results Neural decompression surgeries (microsurgeries and endoscopic) and pedicular instrumentation presented higher similarities to surgery on humans. On the other hand, intradiscal procedures had limitations due to the narrow disc space in swines. We were able to simulate situations of surgical trauma in surgical complication scenarios, such as cerebrospinal fluid fistulas and excessive bleeding, with comparable realism to surgery on humans. Conclusion A porcine model for simulation of minimally invasive spinal surgical techniques had similarities with surgery on humans, and is therefore feasible for surgeon training.

Changes in cardiovascular function and related psychophysiological pathways in a rat model of post-traumatic stress disorder / 生理学报

This study was aimed to investigate the cardiovascular function in rats with post-traumatic stress disorder (PTSD) and the potential association with the activities of the rostral ventrolateral medulla (RVLM) and the medial habenular nucleus (MHb). Multi-channel in vivo recordings were used to simultaneously acquire spontaneous neuronal firing and peripheral physiological indices, and FluoroGold (FG) retrograde tracing technique was used to observe the projections of labeled neurons in the MHb. The results showed that the discharge frequency of RVLM and MHb neurons, the systolic blood pressure (SBP), and the mean arterial pressure (MAP) in the PTSD group were all increased significantly compared with those in control group (P < 0.05). MHb neurons were retrogradely labeled by FG through microinjection (4% FG, 0.5 μL) into the RVLM. In the control group, electrical stimulation in the MHb increased heart rate (HR) at 100-300 μA (P < 0.05), elevated SBP and MAP at 200-300 μA (P < 0.05), and remarkably increased the RVLM neuronal discharge frequency at 100-500 μA (P < 0.05 or P < 0.01). In the PTSD group, however, only the discharge frequency of RVLM neurons was increased by the electrical stimulation at 100-300 μA (P < 0.05). These results suggest that cardiovascular activities of the PTSD model rat are enhanced, and this change may be related to the activity changes of RVLM and MHb and the potential connection between the two nuclei.

Epidemiological study of a family cluster of coronavirus disease 2019 in Fangshan District， Beijing / 上海预防医学

Objective:To conduct epidemiological investigation of a family cluster of coronavirus disease 2019 （COVID-19） in Fangshan District， Beijing， so as to provide reference and scientific basis for the strategy of prevention and control. Methods:Based on the "Prevention and Control Plan for COVID-19 （Third Edition）"issued by the National Health Commission of China， two cases from the same family were studied by field epidemiological investigation method. Sputum and/or throat swab specimens were collected and sent to the laboratory of Fangshan District Center for Disease Control and Prevention （CDC） for nucleic acid detection of 2019 novel coronavirus （2019-nCoV）. Tracking close contacts and isolation observation were conducted. Results:Both sputum and throat swab specimens of case 1 were positive for 2019-nCoV nucleic acid on February 3rd， 2020. Case 2 （wife of case 1） received screening as a close contact， and throat swab specimen was positive on February 4th， 2020. Therefore， it was determined to be a family cluster. The epidemic was effectively controlled after a series of measures， including isolation treatment， medical observation according to management of close contact and terminal disinfection of residence. Conclusion:The CDC professionals should strengthen monitoring of new findings， comprehensively analyze case data based on the latest research trends， improve professional sensitivity， and conduct timely screening to detect cases as soon as possible for the prevention of further epidemic spreading.

A family clustering of coronavirus disease 2019 caused by asymptomatic infection / 上海预防医学

Objective:To analyze a family clustering of coronavirus disease 2019 （COVID-19） associated with the exposure to an asymptomatic case， and to provide evidences of developing strategies for COVID-19 prevention. Methods:Epidemiological investigation was conducted on a COVID-19 family cluster （1 confirmed case and 2 asymptomatic cases）. The specimens of the cases were tested for 2019 novel coronavirus nucleic acid with real-time fluorescence quantitative polymerase chain reaction. Results:The clustering epidemic occurred in a family. Two asymptomatic cases B and C （B’s son） had Wuhan residential history. After arrival in Beijing on January 24， 2020， B stayed in his mother's house. One family member A （B’s mother） developed the disease on February 7， 2020， while the other two family members D and E （B’s wife and brother） did not develop the disease， and they were managed as close contacts. Conclusion:Thisfamily COVID-19 clustering is induced by the exposure to an asymptomatic case. Identification of asymptomatic cases is very important for the control of COVID-19 epidemic.

Effects of Bunao-Fuyuan decoction serum on proliferation and migration of vascular smooth muscle cells in atherosclerotic / 中国天然药物

Atherosclerosis (AS) is a chronic inflammatory disease, the main causes of which include abnormal lipid metabolism, endothelial injury, physical and chemical injury, hemodynamic injury, genetic factors and so on. These causes can lead to inflammatory injury of blood vessels and local dysfunction. Bunao-Fuyuan decoction (BNFY) is a traditional Chinese medicine compound that can treat cardiovascular and cerebrovascular diseases, but its effect on AS is still unknown. The aim of this study was to investigate the effect and mechanism of BNFY in proliferation and migration of vascular smooth muscle cells (VSMCs) on AS. At first, the expression of α-SMA protein in ox-LDL-induced VSMCs, which was detected by immunofluorescence staining and western blot. CCK-8 technique and cloning technique were used to detect the cell proliferation of ox-LDL-induced VSMCs after adding BNFY. Meanwhile, the expression of proliferating protein Ki67 was detected by immunofluorescence staining. Western blot was also used to detect the expression of proliferation-related proteins CDK2, CyclinE1 and P27. Flow cytometry was used to detect the effect of BNFY on cell cycle. The effects of BNFY on proliferation and migration of cells were detected by cell scratch test and Transwell. Western blot was used to detect the expression of adhesion factors ICAM1, VCAM1, muc1, VE-cadherin and RHOA/ROCK-related proteins in cells. We found that the expression of AS marker α-SMA protein increased significantly and cells shriveled and a few floated on the medium after induction of ox-LDL on VSCMs. The proliferation rate of ox-LDL VSMCs decreased significantly after adding different doses of BNFY, and BNFY can inhibit cell cycle. Meanwhile, we also found that cell invasion and migration rate were significantly inhibited and related cell adhesion factors ICAM1, VCAM1, muc1 and VE-cadherin were inhibited too by BNFY. Finally, we found that BNFY inhibited the expression of RHOA, ROCK1, ROCK2, p-MLC proteins in the RHOA/ROCK signaling pathway. Therefore, we can summarize that BNFY may inhibit the proliferation and migration of atherosclerotic vascular smooth muscle cells by inhibiting the activity of RHOA/ROCK signaling pathway.

Prevalence and Subtypes of Blastocystis in Alpacas, Vicugna pacos in Shanxi Province, China

Blastocystis, an enteric protist, has been reported to be an important cause of protozoal gastrointestinal manifestations in humans and animals worldwide. Animals harboring certain Blastocystis subtypes (STs) may serve as a potential source of human infection. However, information about the prevalence and genetic diversity of Blastocystis in alpacas is limited. In the present study, a total of 366 fecal samples from alpacas in Shanxi Province, northern China, were examined for Blastocystis by PCR amplification of the small subunit rRNA gene, followed by sequencing and phylogenetic analysis. The prevalence of Blastocystis in alpacas was 23.8%, and gender difference in the prevalence of Blastocystiswas observed. The most predominant Blastocystis ST was ST10, followed by ST14 and ST5. The detection of ST5, a potentially zoonotic genotype, indicates that alpacas harboring ST5 could be a potential source of human infection with Blastocystis. These data provide new insight into the prevalence and genetic diversity of Blastocystis in alpacas.

Thoughts and practices on studies of membrane processes for Chinese materia medica based on data science / 中草药

Data science is a form of data-oriented science, which serves as a set of theories, methodologies and technologies for data exploration and analysis. Considering that membrane separation process for Chinese materia medica (CMM) manufacturing is a non-linear system, the data obtained regarding its process can be either multivariate, non-linear, strong noise, non-normally distributed, or non-evenly distributed. Due to the special features of data science, research has shed lights on its application in the scientific exploration and technological innovation in the complex membrane processes based on CMM system. There are a few key aspects of data science that are worth mentioning, making it competent as an analytical tool for CMM manufacturing integrated membrane processes. They can be recognized as the following, such as (1) the ability to precisely describe the mass transfer properties of CMM integrated membrane processes; (2) the dynamic description of membrane mass transfer process by molecular simulation; (3) the application of computational fluid dynamics simulation in membrane technology, and (4) the powerful and advanced data processing technology. This paper also reviewed some real case studies encountered by the authors during the investigation of membrane technology for CMM manufacturing based on data science.

Exploratory research into theories and system for membrane technology based on green manufacturing of Chinese materia medica-An emerging concept construction based on material-chemical engineering / 中草药

The implementation of membrane technology in the manufacturing of Chinese materia medica (CMM) plays a critical role in the strategic plan and demand from the perspective of national science and technology, and it is a new and high technology that needs to be popularized in Chinese medicine pharmaceutical industry. The manufacturing technology of CMM is primarily based on the theory and practices of chemical engineering in which the upgrade of its separation technology mainly relies on the advancement in chemical engineering. Our authors have been exploring and implementing membrane technology in the green manufacturing process of CMM in the past decade. Recently, we were granted funding in the topic of "The Modernization of Traditional Chinese Medicine" from The National Key Research and Development Program of China. In the research proposal, we introduced the emerging concept of "material-chemistry engineering", and suggested the concept of theoretical framework for "the process design and engineering of membrane-based green manufacturing of CMM". The framework included the establishment of analytical testing approach for precise analysis in aqueous CMM environment, a systematic testing and inspection method for the membrane and membrane process to guarantee the safety and effectiveness of the CMM products, as well as the integrated membrane process design and optimization for the CMM manufacturing process. The ultimate goal of the proposal is to achieve high flux and decent separation efficiency for CMM production in multi-scale range, in particular to understand the correlation between the aqueous CMM environment and the structure, property and preparation of the membrane. Furthermore, with the aid of computational modeling in process design and manufacturing, the theoretical foundation of membrane-based CMM green manufacturing can be assured. The innovation in the interdisciplinary of CMM production and material-chemistry engineering will help overcoming the current bottleneck encountered in the CMM manufacturing industry in China, resolving the urgent issues of energy, resources and environment, and providing a feasible solution to sustainable development.

Transcriptome analysis reveals key enzyme genes involved in lignin biosynthesis pathway in Arctium lappa / 中草药

Objective: To obtain the functional genes in Arctium lappa and analyze the key enzyme genes involved in biosynthesis pathway of lignin. Methods: The transcriptome dataset of roots of A. lappa was obtained by using the BGISEQ-500 sequencing platform. Unigenes were de novo assembled and annotated according to the existing nucleic acids and protein databases. The key enzyme genes involved in lignin biosynthesis pathway were analyzed and the three-dimensional model of phenylalanine ammonialyase (AlPAL) was generated by the SWISS-MODEL and PyMol. Results: A total of 54 215 Unigenes were obtained by de novo assembly, and 42 003 Unigenes were annotated in at least one public database. A total of 1 668 Unigenes were identified to be plant transcription factors (TFs), which belong to 54 TF families, and 423 Unigenes were found to be involved in the biosynthesis pathway of lignin. Structure model indicated that AlPAL was a homotypic tetramer, and each monomer was consisted of three domains, including 4-methyl-imidazole-5-ketone (MIO) domain, core domain and shield domain. The MIO domain contained three conserved amino acids (ASG), which formed the catalytic activity center of the enzyme. Conclusion: This study was the first de novo transcriptome assembly of A. lappa, which will lay the foundation for the identification of functional genes, secondary metabolic pathway and the study of regulation mechanism of biosynthesis pathway of lignin in A. lappa in the future.

Botanical Therapeutics for Parkinson's Disease / 中国结合医学杂志

Parkinson's disease (PD) was first formally described by James Parkinson in 1817, but the shaking of limbs was described in the literature of several ancient civilizations, such as ancient Chinese civilization and ancient Indian civilization. Historically, botanical drugs were used as the main source for the treatment of such kind of disorders. In Western countries, plant extracts also occupied an important place in the earlier medications of PD. With the adventure of synthetic drugs, the role of plant-derived drugs in management of PD has been diminished. Nowadays, there is still no cure for PD, dopaminergic (DA) medication is the treatment of choice, which is just designed to ameliorate symptoms of PD, and long-term use of DA medication will result in reduced efficacy and severe adverse reactions. It is necessary to explore new methods for the treatment of PD. Chinese medicine (CM) developed a holistic and unique theoretical system, and botanical drugs are widely used in practice for more than two millennia. Modern pharmacological studies have proved that Chinese herbs have potential therapeutic effects on PD, such as enhancing neurotrophic activity, clearing protein aggregates, regulating neuroinflammation, etc. All the advances provide us with hope for developing CM as a mainstream medication for treating PD.

Anatomic study on safe insertion of acupuncture needle in Qiuhou (EX-HN7) acupoint / 针刺研究

OBJECTIVE: To explore the anatomical structure of acupuncture point Qiuhou (EX-HN7) area for safe insertion of acupuncture needle. METHODS: A total of 28 orbital specimens of adult corpses (14 men and 14 women) were randomly selected to be observed by anatomical sectioning and layering methods. The acupoint EX-HN7, located at the junction between the 1/4 of the outer boundary and 3/4 of the inner boundary of the infraorbital margin according to the "Standardization of Acupoint Position" implemented by the People's Republic of China, and marked first with a color pen, followed by cutting the head into horizontal sections along the cross line by using a cadaver cutter and measuring the distance between the skin and blood vessels and main nerves with a digimatic caliper. When the anatomic hierarchy was performed, the blood vessels and nerves in the orbit, the morphological characteristics of the structure around the needle body were particularly focused. RESULTS: When an acupuncture needle was vertically inserted into EX-HN7 region, the tissues through which the needle passes are skin, subcutaneous tissue, orbicularis muscle, orbital adipose body, inferior oblique muscle and inferior orbital wall, respectively. When an acupuncture needle was inserted obliquely upward and along the inferior orbital wall to a depth of (26.5±1.7)mm, the needle tip met the posterior ciliary artery; when to a depth of (41.4±1.3)mm, it reached the superior ophthalmic vein. When inserted to a depth of (40.4±1.5)mm, the needle tip may damage the ophthalmic artery and optic nerve. When the acupuncture needle was inserted inferiorly and closely along the orbital inferior wall to a depth of (13.2±1.4)mm, the infraorbital artery in the suborbital sulcus would be hurt. CONCLUSION: It is recommended that when insert vertically into a depth of 12.0 mm in EX-HN7, the acupuncture needle tip should be slightly inclined inward and posterior-upward, and the depth should not exceed 26.0 mm.

Determination of Escitalopram in Biological Samples by Dispersive Liquid-Liquid Microextraction Combined with GC-MS/MS / 法医学杂志

Objective To establish a method for determination of escitalopram in biological samples by ultrasound-assisted ionic liquid-dispersive liquid-liquid microextraction combined with gas chromatography-tandem mass spectrometry （GC-MS/MS） and provide evidences for forensic determination of cases related to escitalopram. Methods The 1-hexyl-3-methylimidazolium hexafluorophosphate （[C6MIM][PF6]） was selected as an extract solvent to process biological samples. Ultrasound-assisted extraction was used on the samples. Then the samples were detected by GC-MS/MS. Results The linear range of escitalopram in blood and liver were 5.56-1 111.10 ng/mL and 0.025-5.00 mg/g, respectively. The correlation coefficient （r） were greater than 0.999, limit of detection （LOD） were 4.00 ng/mL and 2.00 μg/g, limit of quantitation （LOQ） were 14.00 ng/mL and 6.00 μg/g, respectively. The extraction recovery rates were all greater than 50%, the interday and intraday precision were less than 20%. Escitalopram was detected in blood and liver samples from the actual poisoning case by this method with a content of 1.26 μg/mL and 0.44 mg/g, respectively. Conclusion The ultrasound-assisted ionic liquid-dispersive liquid-liquid microextraction combined with GC-MS/MS is environment friendly, rapid, has good enriching effect and consumes less organic solvent and can be used for forensic determination of escitalopram related cases.

Minimally-invasive internal fixation for mid-lateral 1/3 clavicle fracture with distal clavicular anatomic locking plate / 中国骨伤

OBJECTIVE@#To investigate clinical effects of minimally-invasive internal fixation for mid-lateral 1/3 clavicle fracture with distal clavicular anatomic locking plate.@*METHODS@#From February 2016 to March 2017, 32 patients with mid-lateral 1/3 clavicle fractures treated by minimally-invasive internal fixation with distal clavicular anatomic locking plate, including 24 males and 8 females with an average of (42.3±12.7) years old (ranged from 22 to 68 years old). According to Robinson classification, 6 patients were type 2A2, 18 patients were type 2B1 and 8 patients were type 2B2. No vessel and nerve injury occurred before operation. The time from injury to operation ranged from 0 to 6 days with an average of (3.1±1.4) days. Length of bilateral clavicule were compared before and after operation to evaluate fracture reduction. Constant score at 6 months after operation was applied to assess recovery of shoulder function.@*RESULTS@#Thirty patients were followed up from 11 to 18 months with an average of (13.3±2.2 ) months. No vessel and nerve injury, implant failure, nonunion or delayed union occurred after operation, and facture wound healed at stage I, the time ranged from 8 to 12 weeks with an average of(10.2±1.1) weeks. Shortened length of clavicle decreased from(11.2±3.6) % before operation to (0.4±0.3)% after operation at 2 days. Ten patients removed internal fixation at 8 months after operation without re-fracture occurred after remove plate. Constant score increased from 23.53±5.21 before operation to 94.30±5.60 after operation at 6 months, and 26 patients got excellent results, and 4 good. Patients were satisfied aesthetic degree of scar and shoulder joint function.@*CONCLUSIONS@#Minimally-invasive internal fixation for mid-lateral 1/3 clavicle fracture with distal clavicular anatomic locking plate, which has advantages of less trauma, rapid recover, less scar, could receive good clinical effects and not effect beauty.

Effect of Shugan Wendan Decoction on LXRα, NF-кB and Endothelial Function in Atherosclerosis Rabbits / 中国实验方剂学杂志

Objective:To investigate the mechanism of Shugan Wendan decoction in treating atherosclerosis based on liver X receptor α(LXRα)/nuclear factor-κB(NF-κB) signal. Method:A New Zealand rabbit model of atherosclerosis with liver-Qi stagnation was established by using calf serum albumin immune injury, high fat feeding and bondage emotional stress method. Theses rabbits are randomly divided into 6 groups, control group,model group, atorvastatin group, Shugan Wendan decoction low, medium and high dose group(2.18,6.54,19.62 g·kg-1·d-1). After successful modeling, the rabbits were treated by injecting drugs with Atorvastatin and low, middle and high dose Shugan Wendan decoction to gastric.The control group and the model group were given intragastric administration of saline in the same volume. The period of gavage is 6 weeks. The pathological changes of the rabbits were detected by hematoxylin-eosin(HE) staining.Serum levels of totalcholesterol(TC), triglyceride(TG),low density extremityprotein(LDL-C), high density extremity protein(HDL-C), nitric oxide(NO), and endothelin-1(ET-1) of the rabbits were detected by enzyme method, nitrate reductase method, and enzyme-linked immunosorbent assay(ELISA), respectively.The gene expression of CRP, IL-1β, IL-6 and MMP-9 in the aorta was detected by Real-time fluorescent quantitative polymerase chain reaction(Real-time PCR) method.The protein expression of LXRα/NF-κB signaling pathway wasdetected by Western blot. Result:Compared with normal control group, in model group, the lumen of the blood vessels was significantly narrowed, atheromatous plaques were formed, and a large number of intracellular foam-like changes were seen. In atorvastatin group and Shugan Wendan decoction group, the blood vessels in high, middle, and low concentration groups were narrowed. Atherosclerotic plaques and foam-like changes were all lower than the model group.Compared with the normal control group, the TG, TC, and LDL-C levels in the model groupincreased(PPPPβ, IL-6 and MMP-9 all increased(Pα protein in the model group was decreased(PκB was increased(PPPβ, IL-6 and MMP-9 in the atorvastatin group,the low, middle and high dose Shugan Wendan decoction groups all decreased(Pα protein in the group was increased(PκB was decreased(PConclusion:Shugan Wendan decoction can inhance the function of vascular endothelial cells and the stability of atherosclerotic plaque by regulating LXRα/NF-κB signaling pathway.