Practical Value of Environment-friendly Sample Release Agent Combined with Ultrasound in the Preparation of Pathological Tissue Sections / 中山大学学报(医学科学版)

ObjectiveTo explore the practical value of environment-friendly sample release agent combined with ultrasound in the preparation of pathological tissue sections. MethodsFrom February 2013 to December 2022， 2 518 pathological specimens submitted by Foshan Municipal Hospital of Traditional Chinese Medicine were selected as the study objects. Two samples of the same specimen were randomly divided into two groups： the environment-friendly fast group， in which the pathological tissue sections were made by using the environment-friendly sample release agent combined with ultrasound； and the traditional group， in which formaldehyde， ethanol and xylene were used to make slices in the conventional way. The differences of hematoxylin （HE） staining effect， immunohistochemistry （IHC） staining effect and MDM2 gene detection result of atypical lipomatous tumor/highly differentiated liposarcoma （ALT/WDL） tissue sections between the two groups were compared. Results① The wax of the two groups' pathological tissues was dehydrated well and the tissue hardness was moderate. After HE staining， the sections of the two groups were intact， without cracks and tremor marks， and the contrast between nucleus and cytoplasm was appropriate， with good transparency， uniform staining， and no tissue loss. The excellent rate and score of HE staining in the environmental fast group were higher than those in the traditional group， but the difference was not statistically significant （χ2 = 3.125，P1 = 0.070；t = 0.965，P2 = 0.334）. ②After IHC staining of the two groups of sections， the positive location of the cells was accurate， the staining was specific and uniform， the staining intensity was moderate， the staining sensitivity was good， and there was no tissue loss. The excellent rate of IHC staining and the positive rate of IHC staining in the environmental fast group were lower than those in the traditional group， but the difference was not statistically significant （χ12 = 2.769，P1 = 0.092；χ22 = 0.800，P2 = 0.375）. ③The background and outline of the two groups of WDL tissue sections were clear， the staining was uniform， the cells were clear and visible， the nuclear boundary was clear， the hybridization signal was clear and bright under the background fluorescence， and there was no miscellaneous signal. The two groups of sections were hybridized successfully， and MDM2 showed positive amplification. The number of cells successfully hybridized in the environment-friendly fast group was lower than that in the traditional group， but the difference was not statistically significant （t = 1.414，P = 0.230）. ConclusionsThe tissue treatment method of using environment-friendly sample release agent combined with ultrasound can ensure the detection effect of HE staining， IHC staining and MDM2 gene detection of pathological tissue sections， and is more efficient and environment-friendly， suitable for promotion and use in hospitals at all levels.

Cost-benefit analysis of hepatitis B virus serological and nucleic acid testing in blood donors / 中国输血杂志

【Objective】 In an effort to prevent transfusion-transmitted hepatitis B infection, universal HBsAg screening, HBsAg+ MP nucleic acid test(NAT) for HBV and HBsAg + individual(ID) NAT were analyzed for cost-effectiveness. 【Methods】 On the basis of screening data and the documented parameter, the number of window period infections, chronic infections and occult infections was constructed, and cost-benefit analysis was conducted. 【Results】 Of 132 208 donations, the yield rate of ID NAT for HBsAg-/DNA+ (0.11%) was significantly higher than HBsAg+ MP NAT(0.058%). Furthermore, the predicted preventing transfusion transmitted HBV cases by ID NAT is 1.25 times as that by MP-6 NAT, so did the benefits. The cost-benefit of the three screening models were 1∶63.6、1∶28.6 and 1∶53.4. 【Conclusion】 Universal HBsAg in combination with ID HBV NAT screening was the most effective among all screening strategy. It is necessary to applied HBsAg and ID HBV NAT screening for the safety of blood transfusion.

Hashimoto's encephalopathy presenting with isolated cerebellar ataxia in 13 children / 中华儿科杂志

Objective: To analyze the clinical characteristics, treatment and prognosis of Hashimoto's encephalopathy presenting with isolated cerebellar ataxia in children. Methods: A retrospective analysis was performed on the clinical features, laboratory tests, neuroelectrophysiological examination, imaging, treatment and outcomes of 13 patients with Hashimoto's encephalopathy presenting with isolated cerebellar ataxia, who were admitted to the Department of Pediatric Neurology of Guangzhou Women and Children's Medical Center from January 2016 to May 2021. Results: Among the 13 cases, 6 were males and 7 were females. The onset age was 2.6 (2.0,3.3) years, 9 children had precursor infection or vaccination before the first course of disease. All the 13 children had gait abnormalities or unsteady sitting, 10 had intentional tremor, 6 had dysarthria, 3 had body tremor, 2 had nystagmus, 3 had fatigue, 3 had hypotonia, 2 had vomiting and 1 had irritability. Thyroglobulin antibody (TgAb) was 500.0 (298.9,587.2) kU/L and thyroid peroxidase antibody (TPOAb) was 621.9 (449.6,869.4) kU/L in 13 cases. Autoantibodies were positive in 9 cases, and cerebrospinal fluid leukocytosis was seen in 4 cases. Regarding electroencephalography result, 4 cases had background slowing and 1 case had occasional sharp waves. Among the 3 patients who had relapses, 1 had cerebellar atrophy shown on cranial magnetic resonance imaging (MRI) during the recurrence. All the patients received intravenous immunoglobulin (IVIG) and intensive methylprednisolone therapy during the first onset, followed by the disappearance of the symptoms, 1 patient had repeated episodes which was decreased after immunosuppressive treatment with Rituximab.Followed up for 25.0 (22.5,33.3) months after the last episode, 12 achieved complete remission and 1 had a wide base gait. Conclusions: Trunk ataxia is the common symptom of Hashimoto's encephalopathy presenting with isolated cerebellar ataxia in children.Children with cerebellar ataxia should be tested for TgAb and TPOAb to detect Hashimoto's encephalopathy, avoiding missed diagnosis and treatment delays; IVIG and intensive steroid therapy is effective, and immunosuppressive therapy for patients with multiple relapses could reduce the recurrence.

Factors influencing neurodevelopmental disorders in children with SCN8A-related early-onset epilepsy: a follow-up study of 21 cases / 中华实用儿科临床杂志

Objective:To explore the influence factors of neurodevelopmental disorders in children with SCN8A-related early-onset epilepsy through analyzing their clinical characteristics and following up their neurodeve-lopmental status. Methods:A retrospective analysis was carried out on 21 children (13 males and 8 females, the age ranged from 4 months to 8 years, average 31.6 months)with SCN8A-related early-onset epilepsy treated in Guangzhou Women and Children′s Medical Center and Kunming Children′s Hospital between January 2017 and February 2021.All patients underwent whole-exome sequencing and Sanger sequencing.The pathogenicity was estimated according to the American College of Medical Genetics and Genomics guidelines.The clinical data of all patients were also collected, including the age of onset of the disease, forms of seizures, seizure frequency, neurological development at onset, electroencephalogram (EEG) and brain magnetic resonance imaging (MRI). Besides, the patients were followed up to acquire the effect of sodium channel blockers after the onset of seizures, the process or improvement of neurodeve-lopment, EEG evaluation and neurodevelopmental outcomes.Patients were grouped based on data analysis results.The Fisher′s exact test was conducted to measure the effect of various factors on the neurodevelopmental process and outcome, and corresponding coe-fficients were calculated. Results:The average onset age of 21 patients was 0-9 months.The follow-up duration was 4 months-8 years.Three cases died.Sixteen cases (76.2%) had early infantile epileptic encephalopathy (EIEE), 5 cases (23.8%) had epilepsy without encephalopathy, and 1 case had benign infantile epilepsy.Fourteen cases (66.7%) belonged to drug resistant epilepsy.Only one child showed normal neurodevelopment.Eleven children showed delayed neurodevelopment, but improvement was observed.Nine children were retrogressed and stagnated in terms of neurodevelopment.Small age at onset ( Fisher=9.517, P=0.020, r=0.571), high seizure frequency ( Fisher=10.512, P=0.003, r=0.572), EEG background ( Fisher=10.512, P=0.003, r=0.572), epileptic discharges ( Fisher=8.288, P=0.008, r=0.542), and EEG changes before and after treatment ( Fisher=10.437, P=0.009, r=0.586) were important factors affecting the neurodevelopmental process.Neurodevelopmental outcome was normal in only 1 case, 1 child belonged to mild mental retardation (MR), 7 children belonged to moderate MR, 3 children belonged to severe MR, and 9 children belonged to profound MR.Statistical analysis indicated that the clinical phenotype ( Fisher=10.059, P=0.004, r=0.739) and drug resistance ( Fisher=13.706, P=0.001, r=0.640) were significantly correlated with neurodevelopmental outcomes.However, the forms of seizures, EEG findings at onset and mutation sites were not related to neurodevelopmental disorders. Conclusions:Most children with SCN8A-related early-onset epilepsy are accompanied with neurodevelopmental retardation of varying degrees.Epileptic encephalopathy and poor response to drug treatment will lead to severe neurodevelopmental disorders.

Long-term immunization and prognosis outcome of patients with occult hepatitis B virus infection / 中国输血杂志

【Objective】 To investigate the prognosis of blood donors with occult hepatitis B virus infection (OBI) by long-term follow-up and repeated testing of HBsAg and HBV DNA. 【Methods】 From January 1, 2010 to December 31, 2020, voluntary blood donors were screened by both serological and viral nucleic acid(NAT) testing, then samples were further confirmed as HBV DNA positive by manual nested-PCR amplification.A total of 306 cases were detected as HBsAg negative /HBV DNA positive, then followed-up for a long time and re-examined of HBsAg and HBV DNA to confirm whether they had infected with OBI.The prognosis of patients with OBI who experienced long-term immunization was determined by repeated testing. 【Results】 A total of 306 HBsAg negative/ HBV DNA positive blood donors had been followed up, and 40(13.07%, 40/306) were recalled frequently for re-examination.Among them, 90%(36/40), 57.5%(23/40), 40% (16/40)were anti-HBc + , anti-HBs + and anti-HBe + , respectively, and 50%(20/40), 40%(16/40), 7.5%(3/40) and 2.5% (1/40)were anti-HBs+ / anti-HBc + , anti-HBc + / anti-HBs -, anti-HBc -/ anti-HBs + and anti-HBc -/ anti-HBs -, respectively.Those 40 blood donors were followed-up for 1-13 times, with the duration of 8-108 months (0.6~9 years).1 donor (2.5%) was followed-up less than 1 year, 11 (27.5%)>1 year and ≤3 years, 23 (57.5%) 23(57.5%)>3 years and ≤5 years, and 5 (12.5%) for more than 5 years.After long-term following up and repeated testing, 50%(20/40)of OBI blood donors turned negative for HBV DNA (HBsAg negative / HBV DNA negative), 42.5% (17/40)were confirmed as OBI infection (HBsAg negative / HBV DNA positive), and 7.5%(3/40) were hard to determine (after repeated testing, the results were either positive or negative). 【Conclusion】 After long-term following up and repeated screening, we found that none of the OBI patients turned into acute or chronic HBV infection, and most of them maintained OBI.However, OBI blood donors carry very low load of HBV DNA for a long time, which could lead to false negative results of NAT and bring a great challenge to the safety of blood transfusion.

The clinical value of CT and SWI in evaluating the occurrence of CMBs in diabetic patients with hypertension / 中国辐射卫生

Objective With the help of computerized tomography (CT) and susceptibility-weighted imaging (SWI) examinations, to analyze and compare the incidence and the prevalent sites of microbleeds (CMBs) in control group, diabetes group, hypertension group and diabetic hypertension group with intracerebral CMBs. The risk factors for the onset of CMBs also will be explored, in order to provide a basis for the selection of clinical diagnosis and treatment options for CMBs. Methods A collection of 174 non-acute patients in the Department of Neurology of Shandong Electric Power Central Hospital from May 2019 to October 2020, including 101 males and 73 females, aged 45-89 years, with an average age of 72 ± 5 years. Divided into four groups according to disease types: Hypertension with type 2 diabetes group, Hypertension group, Type 2 diabetes group, Control group (no hypertension and type 2 diabetes). All patients underwent CT and MRI SWI sequence scans. The 4 groups of patients were matched in terms of gender and age, excluding the influence of gender and age. The incidence, number and distribution of CMBs in the four groups were counted, and the CT and SWI imaging manifestations of CMBs in the four groups were analyzed and compared. Results CT did not find the incidence of CMBs in the brain of patients. SWI imaging showed that CMBs were detected in 58 of 174 patients (incidence rate 33.3%), and CMBs occurred in 24 cases of diabetes and hypertension group (incidence rate 57.1%). CMBs occurred in 21 cases in the hypertension group (incidence rate 46.7%), 8 cases in the diabetes group (incidence rate 22.2%), and CMBs occurred in 5 cases in the control group (incidence rate 9.8%). The incidence of CMBs in the hypertension group and the diabetes combined with hypertension group was significantly higher than that in the control group (P < 0.05). There was no significant difference in the incidence of CMBs in patients with simple diabetes compared with the control group. Also, there was no significant difference in the incidence of CMBs between the diabetes combined with hypertension group and the simple hypertension group. Conclusion CT did not find the incidence of CMBs in the brains of patients in the non-acute phase. SWI could clearly show the CMBs of the enrolled patients. Diabetes is less likely to cause an increase in CMBs. Hypertension is significantly related to the occurrence of CMBs. CMBs associated with hypertension or/and diabetes are common in the basal ganglia and thalamus, which is different from cerebral amyloid angiopathy, which provides a basis for the choice of clinical treatment options.

Electroacupuncture Attenuates Surgical Stress-Induced Reduction of T Lymphocytes through Modulation of Peripheral Opioid System / 中国结合医学杂志

OBJECTIVE@#To investigate the action mechanisms of electroacupuncture (EA) on postoperative immunosuppression.@*METHODS@#Male C57BL/6 mice (5`-7 weeks old) were randomly divided into: the sham injury group, the surgical trauma stressed group, the EA group [surgery + 2/100 Hz EA at Neiguan (PC 6)], and the EA+ Nal (surgery + EA + intraperitoneal injection of naloxone). Abdominal surgical trauma stress mice model was established. EA was performed on bilateral PC 6 acupoints by an EA apparatus (2/100 Hz) for 20 min once a day for 3 days. The mRNA expressions of MOR, DOR, and KOR in thymus and L3`-L5 dorsal root ganglions (DRG) were determined by quantitative real-time polymerase chain reaction (qRT-PCR) and the protein expressions of MOR, DOR, and KOR in thymus were measured by Western blot. Flow cytometry assay was used to detect the levels of T lymphocyte subtypes in the peripheral blood.@*RESULTS@#Surgical trauma induced decreased the mRNA expression level of MOR in both thymus (P0.05). Furthermore, T lymphocyte population of CD3@*CONCLUSION@#EA may improve postoperative immunosuppression through the peripheral opioid system.

Treatment of femoral fractures (Lambiris type Ⅲ or Ⅳ) with antegrade interlocking intramedullary nails combined with less invasive stabilization system / 中华创伤骨科杂志

Objective:To evaluate antegrade interlocking intramedullary nails combined with less invasive stabilization system (LISS) in the treatment of femoral fractures (Lambiris type Ⅲ or Ⅳ).Methods:The clinical data of 27 patients were retrospectively analyzed who had been treated for femoral fractures of Lambiris type Ⅲ or Ⅳ at Department of Orthopedic Surgery, Wuhan Fourth Hospital from February 2015 to May 2019. They were 21 males and 6 females, aged from 22 to 57 years (average, 41.3 years). According to the Lambiris classification, 24 cases were classified as type Ⅲ (17 as type Ⅲa, 5 as type Ⅲb and 2 as type Ⅲc) and 3 cases as type Ⅳ. The time from injury to operation ranged from 2 to 9 days (average, 4.3 days). All the fractures were fixated with anterograde femoral interlocking nails and femoral LISS. Recorded were operation time, intra-operative blood loss, hospital stay, bone healing time, and Harris hip score, Hospital for Special Surgery (HSS) knee score and complications at the final follow-up.Results:In this cohort, operation time averaged 2.1 h (from 1.8 to 2.5 h), intraoperative blood loss 361 mL (from 310 to 480 mL), and hospital stay 15.1 d (from 11 to 18 d). All the 27 patients were followed up for 13 to 38 months (average, 25.3 months) after operation. All the fractures united well after an average duration of 29.2 weeks (from 28 to 36 weeks). By the Harris hip scores at the final follow-up, the hip function was evaluated as excellent in 18 cases, as good in 6 and as acceptable in 3, giving an excellent and good rate of 88.9%(24/27); by the HSS knee scores at the final follow-up, the knee function was excellent in 16 cases, good in 7 and acceptable in 4, giving an excellent and good rate of 85.2%(23/27). Follow-ups observed no fracture nonunion, malunion, refracture, internal fixation failure or other complications.Conclusion:In the treatment of femoral fractures of Lambiris type Ⅲ or Ⅳ, antegrade interlocking intramedullary nails combined with LISS has advantages of rigid fixation, a high rate of fracture union, limited complications, and good functional recovery.

Efficacy of robot-assisted percutaneous retrograde screw fixation for acetabular fractures involving the posterior column / 中华创伤杂志

Objective:To investigate the effect of robot-assisted percutaneous retrograde screw fixation in the treatment of acetabular fractures involving the posterior column.Methods:A retrospective case series study was conducted to analyze the clinical data of 13 patients with acetabular fractures involving the posterior column admitted to Wuhan Fourth Hospital from January 2019 to December 2020. There were 8 males and 5 females，aged 62-78 years［（69.7±1.5）years］. According to Judet-Letournel classification，fractures involved the posterior column in 4 patients，anterior column plus posterior semi-transverse column in 3 and double column in 6. According to AO classification，type 62-A2.1 was found in 2 patients，62-A2.2 in 2，62-B3 in 3 and 62-C in 6. All patients were treated with retrograde percutaneous screws assisted by orthopaedic surgery robot. The operation time，intraoperative blood loss，length of hospital stay and time of bone healing were recorded. The incision healing and complications were detected. Matta reduction standard was used to evaluate the fracture reduction quality at 2 days after operation，and Majeed function score was used to evaluate the functional recovery preoperatively，at 3 months after operation and at 6 months after operation.Results:All patients were followed up for 6-12 months［（9.3±1.7）months］. The operation time was 1.1-1.5 hours［（1.3±0.2）hours］. The intraoperative blood loss was 110-200 ml［（161.3±21.1）ml］. The length of hospital stay was 8-13 days［（10.7±1.3）days］. The time of bone healing was 14-18 weeks［（15.4±1.1）weeks］. All incisions were healed by first intention. One patient with sciatic nerve injury was treated with mecobalamin and recovered 3 months later. One patient with advanced heterotopic ossification had no obvious clinical symptoms. All patients had no complications such as incision infection，deep venous thrombosis of lower limbs，fat embolism，screw penetration into hip joint，fracture displacement after failure of internal fixation，traumatic arthritis，or necrosis of femoral head，etc. According to Matta reduction standard，there were 10 patients with anatomical reduction and 3 with satisfactory reduction. Majeed function score was（15.0±1.3）points before operation，（76.5±2.0）points at 3 months after operation and（85.1±1.9）points at 6 months after operation（ P<0.01），and there were 9 patients with excellent results，2 with good results and 2 with fair results，showing the excellent and good rate of 85%. Conclusion:For acetabular fractures involving the posterior column，robot-assisted percutaneous retrograde screw fixation has advantages of less surgical trauma，higher fracture healing rate，fewer complications，satisfactory anatomical reduction and good functional recovery.

Clinical Manifestation of Severe Cases with COVID-19 / 中山大学学报(医学科学版)

@#【Objective】To explore the clinical manifestation of COVID- 19 severe cases.【Methods】Clinical data of one severe case with COVID-19 including the clinical characteristic ，laboratory testing results，radiography，treatment，complication and outcome of the patient were retrospectively collected and analyzed.【Results】 The patient with COVID-19 was a 61-year old male，He suffered with underlying disease. His symptoms included fever，cough，myalgia， fatigue，and dyspnea. Laboratory testing results included normal WBC count，decreased lymphocyte cells，elevated LDH and hypoxemia. Radiography findings showed bilateral lung infiltration. His condition deteriorated after intensive treatment for one week. He was intubated and treated with mechanical ventilation because of complicating with severe acute respiratory distress syndrome（ARDS）.【Conclusion】COVID-19 is an emerging acute communicable disease，which lack specific and effective treatment. Most patients have a good prognosis but mortality in severe cases is high. More attention should be paid on the high risk of progression in COVID-19 cases.

Gamma 3 nails combined with hollow compression screw fixation for intertrochanteric fracture of risky external wall type / 中华创伤骨科杂志

Objective:To evaluate Gamma 3 nails combined with hollow compression screw fixation in the treatment of intertrochanteric fracture of risky external wall type.Methods:From November 2015 to December 2017, 60 patients with intertrochanteric fracture of risky external wall type were treated at Department of Orthopaedic Surgery, Wuhan Fourth Hospital. Of them, 27 ones, 15 males and 12 females with an age of 57.5 years±16.2 years (group A), were fixated with Gamma 3 nails and hollow compression screws, including 14 cases of AO type of 31-A2.2 and 13 cases of AO type of 31-A2.3. The other 33 patients, 18 males and 15 females with an age of 59.3 years±15.1 years (group B), were fixated with Gamma 3 nails alone, including 17 cases of AO type of 31-A2.2 and 16 cases of AO type of 31-A2.3. The 2 groups were compared in terms of operation time, hospitalization time, intraoperative blood loss, weight-bearing time, fracture healing time, complications and Harris hip scores at the final follow-up.Results:The 2 groups were comparable due to insignificant differences between them in preoperative general data ( P>0.05). The 60 patients obtained an average follow-up of 22.6 months (from 12 to 36 months). There were no statistically significant differences in operation time, intraoperative blood loss or hospital stay between the 2 groups ( P>0.05). Group A had a significantly lower incidence of external wall redisplacement [7.4% (2/27)], significantly shorter weight-bearing time(5.4 weeks±1.0 weeks) and fracture healing time(18.3 weeks±3.9 weeks), and significantly higher Harris hip scores at the final follow-up (89.3±7.1) than group B did [24.2% (8/33), 7.4 weeks±1.3 weeks, 21.7 weeks±5.6 weeks and 79.5±8.3, respectively] (all P< 0.05). Follow-ups revealed no complications like femoral head cutting, implant breakage, deep vein thrombosis of lower limb, fat embolism, hip varus deformity or nail breakage in either group. Conclusion:In the treatment of intertrochanteric fracture of risky external wall type, compared with Gamma 3 nails alone, Gamma 3 nails combined with hollow compression screw fixation can avoid external wall displacement or fixation failure after external medullary fixation or intramedullary fixation alone but does not increase operation time or intraoperative blood loss, leading to better functional recovery.

Metabolomic Analysis of Serum Glycerophospholipid Levels in Eosinophilic and Neutrophilic Asthma / 生物医学与环境科学（英文）

OBJECTIVE@#To compare the serum glycerophospholipid levels in the inflammatory subtypes of asthma by using targeted metabolomic analysis.@*METHODS@#Demographic and clinical data were collected from 51 patients with asthma between January 2015 and December 2015. Routine blood and sputum induction tests were performed. Eosinophilic asthma was defined as induced sputum containing ⪖ 3% eosinophils, and neutrophilic asthma, as induced sputum containing ⪖ 71% neutrophils. Serum metabolic glycerophospholipid profile was determined by liquid chromatography-mass spectrometry. Differences in glycerophospholipid levels between eosinophilic and non-eosinophilic asthma and between neutrophilic and non-neutrophilic asthma were analyzed using partial least squares discriminant analysis.@*RESULTS@#The serum lysophosphatidylglycerol level was significantly higher in the group with ⪖ 3% eosinophils in sputum than in the group with < 3% eosinophils in sputum. The area under the receiver-operating characteristic curve was ⪖ 70%. There was no significant difference in the serum metabolic glycerophospholipid profile between the group with sputum neutrophils ⪖ 71% and the group with sputum neutrophils < 71%.@*CONCLUSION@#Serum lysophosphatidylglycerol is produced abundantly in eosinophilic asthma and may be a biomarker of eosinophilic asthma. This information is helpful for identifying and tailoring treatment for the common asthma subtypes.

Research progress on interactions among tissue renin-angiotensin system, vitamin D receptor and Wnt/β-catenin in chronic diseases / 中国药理学通报

This review discusses the mutual regulative effects of Wnt/β-catenin signaling pathway, tissue renin-angiotensin system (RAS) and vitamin D receptor (VDR) pathway in chronic non-infectious diseases (abbr. chronic diseases). The interaction between RAS and Wnt/β-catenin might induce the occurrence of multiple chronic diseases. The activation of VDR inhibits Wnt signaling transduction through blocking the action of β-catenin on down-stream genes via various pathways. Moreover, the agonists on VDR suppress the biological actions of RAS in whole circulation and local tissues. Thus, Wnt/β-catenin signaling pathway, RAS and VDR synergistically exert vital biological modulations on the pathophysiological process of chronic diseases.

Therapeutic effect of intradermal needling combined with rehabilitation intervention on knee osteoarthritis in the middle and early stages / 中国针灸

OBJECTIVE@#To observe the effect of intradermal needing combined with rehabilitation intervention on middle and early knee osteoarthritis.@*METHODS@#Seventy patients were randomly divided into an observation group and a control group, 35 cases in each group. Excluding the dropping cases, finally, 34 cases in the observation group and 32 cases in the control group were included in the statistics. Intradermal needing combined with rehabilitation intervention were given in the observation group, the intradermal needing was applied at Dubi (ST 35), Neixiyan (EX-LE 8), Xuehai (SP 10), Liangqiu (ST 34), Yanglingquan (GB 34), point, and retained for 24 h; the simple conventional rehabilitation intervention was given in the control group. The visual analogue scale (VAS) was used to evaluate knee pain before treatment, the end of initial treatment, 1 month after treatment, and 3 months after treatment. The Western Ontario and McMaster Osteoarthritis index (WOMAC) was used to assess the joint function of the knee, the active knee flexion range (ROM) was used to assess the joint mobility of the knee before treatment and 1 month after treatment, and the efficacy of the two groups was evaluated.@*RESULTS@#At the end of the initial treatment, the VAS score in the observation group were significantly improved as compared with that before treatment and the control groups (0.05). After 1 month of treatment, the VAS score, WOMAC score and ROM measurement in the two groups were significantly improved as compared with those before treatment (<0.05), and the observation group was superior to the control group (<0.05); the total effective rate in the observation group was 97.1% (33/34), which was better than 81.3% (26/32) in the control group (<0.05). At the follow-up, the VAS scores in the two groups were slightly higher than those after 1 month of treatment, but the difference was still statistically significant as compared with those before treatment (<0.05), and the observation group was still superior to the control group (<0.05).@*CONCLUSION@#The combination of intradermal needing combined with rehabilitation intervention can effectively alleviate knee pain and improve joint function. It has a beneficial effect on the rehabilitation of middle and early knee osteoarthritis.

Taxus chinensis ameliorates diabetic nephropathy through down-regulating TGF-β1/Smad pathway / 中国天然药物

Diabetic nephropathy (DN) is one of the common microvascular complications of diabetes mellitus. Renal fibrosis is closely related to the deterioration of renal function. The present study aimed to investigate protective effect of Taxus chinensis on high-fat diet/streptozotocin-induced DN in rats and explore the underlying mechanism of action. The rat DN model was established via feeding high fat diet for 4 weeks and subsequently injecting streptozotocin (30 mg·kg body weight) intraperitoneally. The rats with blood glucose levels higher than 16.8 mmol·L were selected for experiments. The DN rats were treated with Taxus chinensis orally (0.32, 0.64, and 1.28 g·kg) once a day for 8 weeks. Taxus chinensis significantly improved the renal damage, which was indicated by the decreases in 24-h urinary albumin excretion rate, blood serum creatinine, and blood urea nitrogen. Histopathological examination confirmed the protective effect of Taxus chinensis. The thickness of glomerular basement membrane was reduced, and proliferation of mesangial cells and podocytes cells and increase in mesangial matrix were attenuated. Further experiments showed that Taxus chinensis treatment down-regulated the expression of TGF-β1 and α-SMA, inhibited phosphorylation of Smad2 and Smad3. These results demonstrated that Taxus chinensis alleviated renal injuries in DN rats, which may be associated with suppressing TGF-β1/Smad signaling pathway.

Taxus chinensis ameliorates diabetic nephropathy through down-regulating TGF-β1/Smad pathway / 中国天然药物

Diabetic nephropathy (DN) is one of the common microvascular complications of diabetes mellitus. Renal fibrosis is closely related to the deterioration of renal function. The present study aimed to investigate protective effect of Taxus chinensis on high-fat diet/streptozotocin-induced DN in rats and explore the underlying mechanism of action. The rat DN model was established via feeding high fat diet for 4 weeks and subsequently injecting streptozotocin (30 mg·kg body weight) intraperitoneally. The rats with blood glucose levels higher than 16.8 mmol·L were selected for experiments. The DN rats were treated with Taxus chinensis orally (0.32, 0.64, and 1.28 g·kg) once a day for 8 weeks. Taxus chinensis significantly improved the renal damage, which was indicated by the decreases in 24-h urinary albumin excretion rate, blood serum creatinine, and blood urea nitrogen. Histopathological examination confirmed the protective effect of Taxus chinensis. The thickness of glomerular basement membrane was reduced, and proliferation of mesangial cells and podocytes cells and increase in mesangial matrix were attenuated. Further experiments showed that Taxus chinensis treatment down-regulated the expression of TGF-β1 and α-SMA, inhibited phosphorylation of Smad2 and Smad3. These results demonstrated that Taxus chinensis alleviated renal injuries in DN rats, which may be associated with suppressing TGF-β1/Smad signaling pathway.

Euthyphoria reduction combined with percutaneous iliosacral screw fixation for irreducible sacroiliac dislocation / 中华创伤骨科杂志

Objective To evaluate euthyphoria reduction combined with percutaneous iliosacral screw fixation in the treatment of irreducible sacroiliac dislocation.Methods From March 2012 to May 2015,29 patients with irreducible sacroiliac dislocation were treated using euthyphoria reduction followed by percutaneous iliosacral screw fixation.They were 18 men and 11 women,aged from 25 to 68 years (average,37.9 years).According to the Tile classification,there were 7 cases of type Cl,9 cases of type C2,and 13 cases of type C3.The intervals from injury to surgery ranged from 6 to 32 days (average,11.3 days).Results The operation time for this cohort ranged from 40 to 125 minutes (average,76.2 minutes).The intraoperative bleeding ranged from 50 to 360 mL (average,148.6 mL).Their follow-ups ranged from 24 to 41 months (average,28.9 months).According to the Matta criteria for reduction,20 cases were rated as excellent and 9 as good,yielding an excellent to good rate of 100％.Their Majeed scores at the final follow-up averaged 90.1 points (range,from 67 to 100 points),giving 20 excellent,7 good and 2 fair cases (with an excellent to good rate of 93.1％).No screw loosening or lameness of the affected limb was observed during follow-ups.Conclusions Euthyphoria reduction combined with percutaneous iliosacral screw fixation can lead to satisfactory outcomes in the treatment of irreducible sacroiliac dislocation.Additionally it may improve operative safety.

Treatment of Seinsheimer type Ⅲ subtrochanteric femoral fractures with prolonged Gamma3 nails and titanium wire fixation in the aged patients / 中华创伤骨科杂志

Objective To investigate the treatment of subtrochanteric femoral fractures of Sein-sheimer type Ⅲ with prolonged Gamma3 nails and titanium wire fixation in the aged patients. Methods From October 2014 to December 2015, 23 old patients with subtrochanteric femoral fracture were treated with prolonged Gamma3 nails and titanium wire fixation. They were 7 men and 16 women, aged from 62 to 78 years ( 69. 3 years on average ) . By Seinsheimer classification, 14 cases were type ⅢA and 9 type ⅢB. The time from injury to surgery averaged 3. 4 days ( from 2 to 6 days ) . Their operation time, intraoperative bleeding, hospital stay, fracture union time and hip function at the final follow-up were documented. Results Their operation time averaged 1. 3 hours ( from 1. 0 to 1. 6 hours ) , intraoperative bleeding 161 mL ( from 115 to 215 mL ) , and hospital stay 10. 7 days ( from 9 to 12 days ) . They obtained follow-ups from 5 to 12 months ( 9. 3 months on average ) . All the fractures achieved bony union after an average of 15. 4 weeks ( from 12 to 20 weeks ) . The function of the affected hip assessed at the final follow-up according to the Harris scoring was excellent in 15 cases, good in 5 and fair in 3, resulting in an excellent to good rate of 87. 0％. Their follow-ups revealed no deep venous thrombosis of lower limb, fat embolism, coxa vara, refracture, cut-in of the femoral head by the lag screw, or implant breakage. Conclusions In the treatment of senile subtrochanteric femoral fractures of Seinsheimer type Ⅲ, prolonged Gamma3 nails and titanium wire fixation exhibits advan-tages of limited operative trauma, rigid fixation, a high rate of union and limited complications. Additionally, this treatment can increase the accuracy of inserting distal locking nails, shorten operation time and improve functional recovery.

Inhibition of the neutral sphingomyelinase-2 pathway protects against cerebral ischemia reperfusion injury in rats / 国际脑血管病杂志

Objective To investigate the roles of neutral sphingomyelinase-2 (nSMase2) pathway on cerebral edema and cerebral injury in cerebral ischemia-reperfusion injury in rats. Methods Seventy-six adult male SD rats were randomly divided into sham operation group (n = 12), modeling group (n = 16), vehicle group (n = 16), SB203580 (a p38 mitogen activated protein kinase [MAPK] inhibitor) treatment group (n = 16) , and MRS1754 (a selective adenosine A2B receptor [A2B AR] antagonist) treatment group (n = 16) according to the random number table. A suture-occluded method was used to induce a middle cerebral artery ischemia-reperfusion model. Vehicle, SB203580, and MRS1754 were injected into the lateral ventricles 30 min before model preparation, the neurological function score was performed after ischemia-reperfusion for 24 h. 2,3,5 triphenyltetrazolium staining was used to detect the infarct volume. The water content of brain tissue was detected by dry-wet weight method. Western blot analysis was used to detect the expression of nSMase 2 and p38 MAPK in ischemic brain tissue. Immunohistochemical staining was used to detect the expression of nSMase 2 in ischemic brain tissue. Results MRS1754 significantly decreased neurobehavioral score (P < 0. 05) and reduced cerebral infarction volume (P < 0. 05) in rats. Both MRS1754 and SB203580 significantly decreased the water content of ischemic brain tissue (all P < 0. 05). In addition, MRS1754 also significantly decrease the phosphorylation of p38 MAPK after ischemia-reperfusion and decreased the expression level of nSMase 2 (P < 0. 01). Conclusion Regulation of A2BAR and p38 MAPK of nSMase upstream may play a neuroprotective role after cerebral ischemia-reperfusion injury.

Effect analysis of improving the HIV positive detection rate by single sample nucleic acid amplification test in Shenzhen / 国际检验医学杂志

Objective To investigate the effect of improving the human immunodeficiency virus (HIV)posi-tive detection rate by single sample nucleic acid amplification test (SS-NAT) in Shenzhen ,and to explore the effect of SS-NAT on reducing the risk of HIV infection in transfusion .Methods 269 228 blood samples were performed parallel detection by SS-NAT (Procleix Tigris ) and two kinds of enzyme-linked immuno sorbent assay(ELISA)reagents ,and then the samples with nonreactive by ELISA and reactive by SS-NAT were tested by HIV identification assay .The blood donors with reactive HIV identification assay were made tracing tests . All the samples with reactive by ELISA or HIV identification assay were sent to the Shenzhen Center for Dis-ease Control and Prevention (CDC) for Western Blot (WB) diagnostic tests .Results The samples with reac-tive by the third generation ELISA reagents ,the fourth generation ELISA reagents ,both ELISA reagents and SS-NAT were 188 ,340 ,422 and 103 ,which reactive rate was 0 .698‰(188/269 228) ,1 .263‰(340/269 228) , 1 .567‰(422/269 228) and 0 .383‰(103/269 228) ,respectively .We found four samples with nonreactive by ELISA but reactive by SS-NAT .The four donors were found HIV reactive by both ELISA and SS-NAT after tracing .All the samples with reactive by ELISA or HIV identification assay were sent to CDC for confirmatory tests and 103 of them were positive .The positive detection rate of transfusion-transmissible HIV infection af-ter ELISA detection was 1∶67 307(4/269 228) .Conclusion The application of SS-NAT in blood screening can improve the HIV positive detection rate ,shorten window period of HIV detection and reduce residual risk of transfusion-transmissible HIV infection ,and then blood safety can be effectively improved .