Identification Principle and Thought of "Medical Malpractice" Based on Theoretical Analysis / 法医学杂志

At present, medical disputes are still widely-concerned social problems and occasionally evolve into severe social events. In the dispute settlement mechanism, forensic identification opinion is the important technical support. Due to the high professionalism and complexity of medicine, the identification of medical malpractice has become major and difficult problem in the identification. This paper systematically analyze the concept of medical malpractice and five legal theories of malpractice determination, pointing out that China's forensic identification of medical damage should be led by the theory of "medical standards", supplemented by "prudent patient" standard and strengthen "peer review" in form. At the same time, seven main identification principles should be followed in practice: (1) take "obligation of diagnosis and treatment" as the basic principle of medical malpractice identification; (2) take whether to fulfill the obligation of diagnosis and treatment corresponding to current medical level as the specific principle; (3) take diagnosis and treatment routine, norms and guidelines as the main basis; (4) the principle of "peer review"; (5) the principle of "the generality of medical emergency action"; (6) the principle of "notification-informed-consent"; (7) the principle of "review of complications". This paper also puts forward the corresponding identification ideas in view of the above principles, hoping this helps standardize medical damage forensic identification activities.

Ferroptosis of airway epithelial cells in asthma: current and future / 药学学报

Ferroptosis is a novel cell death mode proposed in recent years, which is characterized by intracellular iron-dependent lipid peroxidation. Its mechanisms include lipid peroxidation, iron accumulation and the imbalance of antioxidant system. The crosstalk between ferroptosis and asthma is gradually deepening. Elucidating the specific mechanism of ferroptosis in regulating asthma is helpful to broaden the understanding of the pathology of asthma. This paper expounds the role of ferroptosis in airway epithelial cells in the occurrence and development of asthma from three perspectives: lipid peroxidation, iron accumulation and the imbalance of antioxidant system, hoping to find new targets and strategies for asthma treatment.

Comparison of the efficacy between open and arthroscopic Latarjet procedure in the treatment of anterior shoulder instability:a Meta-analysis / 中国骨伤

OBJECTIVE@#To compare the clinical efficacy between open and arthroscopic Latarjet procedure in the treatment of anterior shoulder instability by using Meta-analysis.@*METHODS@#Search PubMed, Medline, Embase, Cochrane, China National Knowledge Infrastructure(CNKI), Wanfang database, China Biological Literature system(CBM) and VIP database. Review all retrospective or prospective cohort studies and randomized controlled trials on open and arthroscopic Latarjet procedure for anterior shoulder instability. Binary variables (postoperative recurrence rate, incidence of intraoperative and postoperative complications) and continuousvariables [shoulder external rotation range of motion, Walch-Duplay score, Rowe score, WOSI score, postoperative visual analogue scale (VAS), postoperative anxiety degree and operation time] were selected for analysis. NOS bias risk assessment criteria (recommended by Cochrane collaboration Network) were used to evaluate the literature quality of retrospective or prospective cohort studies, and modified Jadad scale was used to evaluate the quality of randomized controlled trials. Literature screening, literature quality evaluation and data extraction were carried out independently by two observers. RevMan 5.3 software was used for Meta analysis.@*RESULTS@#(1)A total of 9 studies were included, including 8 retrospective cohort studies and 1 prospective cohort study. A total of 956 patients were included in this study, including open Latarjet procedure(@*CONCLUSION@#The arthroscopic Latarjet stabilisation shows satisfactory and comparable results to open procedure, and the postoperative recurrence and complication rates are low in both group. Both open and arthroscopic Latarjet procedure are reliable surgical procedures in the treatment of anteriorly shoulder instability. Arthroscopic procedure has longer learning curve than open procedure, the doctors may either choose arthroscopic or open Latarjet procedure based on personal skills and preference, as well as the patient's condition. However, all the literatures included in this study are cohort studies with low level of evidence. The research lack randomized controlled trials, and small sample size is small. In the future, randomized controlled studies with large sample size and high level of evidence are still needed to determine the efficacy difference between the two.

Effects of 5-azacytidine on DNA methylation and index components in patchouliol-type Pogostemon cablin / 中国中药杂志

This study aims to explore the relationship of DNA methylation with the contents of the index components as well as the growth and development of Pogostemon cablin. The demethylation reagent 5-azacytidine(5-azaC) was used to treat the tissue culture seedlings of patchouliol-type P. cablin. High performance liquid chromatography was employed to evaluate the changes of DNA methy-lation in P. cablin, and GC-MS to detect the contents of index components in P.cablin. The agronomic characters of P.cablin were measured using the common methods. The results showcased that DNA methylation of P.cablin was significantly reduced by 5-azaC in a concentration-dependent manner. Thirty days after treatment with 5-azaC at different concentrations, the content of patchouli alcohol changed slightly; compared with that in the control group, the content of pogostone in 50 μmol·L~(-1) and 100 μmol·L~(-1) 5-azaC groups was significantly up-regulated. The 100 μmol·L~(-1) 5-azaC group had the largest differences in contents of pogostone and patchouli alcohol compared with the control group, followed by the 50 μmol·L~(-1) 5-azaC group. Ninety days after disinhibition, the content of pogostone in the treatment group was significantly increased and the content of patchouli alcohol was significantly decreased. In addition, 5-azaC significantly inhibited the growth and development of P.cablin in a dose-dependent manner. These results indicate that DNA methylation regulates the biosynthesis of the index components in patchouliol-type P.cablin and proper demethylation can directly promote the synthesis of pogostone and indirectly affect the accumulation of patchouli alcohol.

Analysis of mortality surveillance of residents in Minhang District of Shanghai from January to April in 2016-2020 / 上海预防医学

Objective:To characterize the mortality rate of residents in Minhang District of Shanghai from January to April in 2016-2020， and to determine the change in the epidemic Coronavirus Disease 2019 （COVID-19） in 2020. Methods:Data of mortality surveillance was collected from the death registry of Shanghai residents. Cause of death was coded and classified per the International Classification of Diseases （ICD-10）. The standardized mortality rate was calculated based on the standard population of China in 1990. The analysis was performed by Excel 2016 and SPSS 20.0. Results:From 2016 to 2020， the average crude mortality rate of residents was 281.75/100 000 from January to April in Minhang District of Shanghai， and the standardized mortality rate was 66.57/100 000. The top five causes of death in the latest five years were cardiovascular diseases， tumor， respiratory diseases， endocrine diseases， and injury and poisoning. The mortality rate was the lowest from January to April in 2020 in the past five years； furthermore， the mortality rate of respiratory system diseases has decreased significantly. Conclusion:Sex， age， place and causes of death in residents are consistent from January to April across years in Minhang District of Shanghai. However， there are minor differences in 2020， which may be attributable to the epidemic of COVID-19.

Clinical observation on deep needling at Xiaguan (ST 7) with round sharp needle combined with plum-blossom needle for trigeminal neuralgia of wind and heat / 中国针灸

OBJECTIVE@#To compare the clinical therapeutic effect between deep needling at Xiaguan (ST 7) with round sharp needle combined with plum-blossom needle and conventional acupuncture in patients with trigeminal neuralgia (TN) of wind and heat, and explore its mechanism.@*METHODS@#A total of 60 patients with TN of wind and heat were randomized into an observation group (30 cases) and a control group (30 cases). In the observation group, deep needling with round sharp needle was applied at Xiaguan (ST 7), and tapping with plum-blossom needle was applied at Yangbai (GB 14), Quanliao (SI 18), Dicang (ST 4), Sibai (ST 2), etc. of affected side. In the control group, conventional acupuncture was applied at the same acupoints selected in the observation group. The treatment was given once a day, 5 times a week for 4 weeks in the both groups. Before and after treatment, the scores of short-form McGill pain questionnaire (SF-MPQ), TCM syndrome, patient global impression of change (PGIC) and comprehensive symptom were observed, the serum levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), vasoactive intestinal peptide (VIP) and β-endorphin (β-EP) were detected, and the adverse reaction was observed in the both groups.@*RESULTS@#After treatment, the scores of PRI, PPI, VAS, TCM syndrome, PGIC and comprehensive symptom and the serum levels of IL-6, TNF-α and VIP were decreased compared before treatment in the both groups (@*CONCLUSION@#Deep needling at Xiaguan (ST 7) with round sharp needle combined with plum-blossom needle can effectively treat the trigeminal neuralgia of wind and heat and relieve pain, its therapeutic effect is superior to conventional acupuncture. The mechanism may be related to the regulation of serum IL-6, TNF-α, VIP and β-EP.

Tibialis anterior allograft versus hamstring tendon autograft for anterior cruciate ligament reconstruction:long-term clinical outcomes / 中国骨伤

OBJECTIVE@#To compare the clinical outcomes of arthroscopic anterior cruciate ligament (ACL) reconstruction (ACLR) with a tibialis anterior allograft (TAA)versus hamstring tendon autograft (HTA) after 10 years follow-up.@*METHODS@#A clinical data of 107 patients who underwent arthroscopic ACLR with a single bundle tendon between March 2007 and March 2010 was retrospectively analyzed. Among the patients, 48 patients were reconstructed with a tibialis anterior allograft (TAA group), including 26 males and 22 females, ranging in age from 16 to 38 years, with a mean of 27.2±6.2 years;59 patients were reconstructed with a hamstring tendon autograft (HTA group), including 31 males and 28 females, ranging in age from 16 to 40 years, with a mean of 28.0±7.6 years. The preoperative tibial anterior displacement and knee joint function, as well as knee joint stability, tibial anterior displacement and knee joint function at 10 years after operation were observed. Lachman test was used to evaluate the forward joint stability and pivot shift test to evaluate the rotational stability of the knee;KT-2000 side-to-side difference (SSD) was used to measure tibial anterior displacement;International Knee Documentation Committee(IKDC) score and Lysholm score were used to evaluate knee function.@*RESULTS@#The incisions of both groups were healed by first intention, and no early complications occurred after operation. All patients were followed-up 10 to 13 years, the mean time was 11.7 years. There was no graft failure were found during the follow up period. The KT-2000 SSD of the TAA group and the HTA group at ten years after operation were 1.9±0.7 and 1.8±0.6 respectively, which were significantly improved than 8.8±0.9 and 8.6±1.0 preoperatively(@*CONCLUSION@#The TAA and HTA have equal long term effect in ACL reconstruction, doctors and patients can choose the graft according to the actual situation.

Anatomical reconstruction of lateral ligament complex with singletunnel pullout stutrue fixation for chronic lateral ankle instability / 中国骨伤

OBJECTIVE@#To explore clinical effects of single-tunnel pullout structure fixation and anatomical reconstruction of lateral ligament complex in treating chronic lateral ankle instability.@*METHODS@#From January 2016 to December 2018, clinical data of 23 patients with chronic lateral malleolus instability who underwent anatomical reconstruction of lateral malleolus ligament complex with single-tunnel pullout structure fixation, were retrospectively studied. Among them, including 7 males and 16 females, aged from 17 to 33 years old with an avergae of (26.0±4.3) years old;16 patients classified to grage 0, and 7 patients classified to gradeⅠaccording to Kellgren-Lawrence(K-L) grading;the time of sprain ranged form 2 to 15 with an average of (5.7±2.9) times;the time from injury to operation ranged to 4 to 18 months with an average of (9.0±3.3) months. The range of movement of operative and uninjured ankle joints were measured at 24 months after opertaion, visual analogue scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) were used to evaluate ankle joint function and improvement of pain, K-L grading and MRI scoring of osteoarthritis of ankle (MSOA) were used to evaluate degree of cartilage degeneration of ankle joint.@*RESULTS@#All patients were followed up from 24 to 48 months with an average of (33.4±6.7) months. All the anterior talofibular ligaments and calcaneofibular ligaments were dissected and reconstructed by single-tunnel pullout structure fixation. The range of motion of dorsiflexion, plantarflexion, varus, and valgus on the operative side of ankle joint were smaller than those on the healthy side. There were no statistically differences in dorsiflexion and eversion between operative side and healthy side of ankle joint (@*CONCLUSION@#Treatment of chronic lateral ankle instability with reconstruction of lateral ligament complex with single-tunnel pullout structure fixation could provide better tendon and bone healing conditions, improve surgical safety and could achieve satisfactory clinical outcomes.

Analysis of data of illness-induced absenteeism among primary and middle school students in the context of emergency response to COVID-19 / 上海预防医学

Objective:To understand the school absence due to illnesses in the context of emergency response to COVID-19 in Minhang District， so as to provide a basis for epidemic prevention and control in primary and secondary schools. Methods:Descriptive epidemiological analysis was conducted on the data of school absence due to illnesses in primary and secondary schools in Minhang District in the context of emergency response to COVID-19. Results:During the period of emergency response to COVID-19， the incidence of illness-induced absenteeism in Minhang District was 1.50%. Difference in absenteeism between different months was statistically significant （χ2=1 724.31， P<0.01）. The monthly absenteeism rate in 2020 was higher than that from 2016 to 2019， and the difference was statistically significant （P<0.01）. The rate of symptom-induced absenteeism was 1.28%. Fever was the most common symptom of school absence， and the rate of absence due to fever in 2020 was higher than that of the same period in 2019 and 2016-2018， and the difference was statistically significant （χ2=15 281.33， P<0.01）. Acute upper respiratory tract infection was the number one cause of illness-induced absence during the emergency response period， while infectious diseases were the primary causes of diseases from 2016 to 2018 and in 2019. The difference of infectious disease absence in different years was statistically significant （χ2=1 822.62， P<0.01）. Conclusion:The rate of school absence due to illnesses increased significantly in the context of emergency response to COVID-19 in Minhang District， while the rate of school absence due to infectious diseases decreased significantly. The prevention and control measures during the epidemic period can be used for reference in the future for preventing infectious diseases under normal conditions.

Treatment of rotator cuff tear in global stiff shoulder by arthroscopic 360° capsular release with concomitant rotator cuff repair / 中国骨伤

OBJECTIVE@#To evaluate the clinical effect of arthroscopic 360° capsular release with concomitant rotator cuff repair for patients with rotator cuff tears in global stiff shoulder.@*METHODS@#From December 2016 to December 2018, 247 patients full-thickness rotator cuff tear were treated with arthroscopic rotator cuff repair. Among them, 42 patients (17%) with global limitation of shoulder movement were treated with arthroscopic 360° capsular release operation at the same time of rotator cuff repair. The function of shoulder was evaluated by Constant-Murley score and visual analogue scales (VAS), flexion, abduction and external rotation on body side before and after operation. Sugaya classification was used to evaluatethe healing of rotator cuff. The number of shoulder dislocations during follow-up was recorded.@*RESULTS@#Thirty nine of the 42 patients were followed up for 12 to 36 (22±6) months. The patients were 43 to 73 (57±7) years old at the time of operation. The Constant- Murley score increased from (43.6±6.3) before operation to (87.5±2.8) at final follow-up (<0.001). VAS score decreased from (7.2±1.5) before operation to (1.0±0.9) at final follow-up (<0.001). The flexion of shoulder increased from (46±14)° before operation to (148±11)° after operation (<0.001), the abduction from (36±6)° before operation to (121±10)° after operation (<0.001), and the external rotation on body side from (5±10)° before operation to (42±8)° after operation(<0.001). One year after the operation, MRI showed thatⅠ-Ⅲ of Sugaya classification was clinical healing, 38 cases in total.@*CONCLUSION@#Arthroscopic 360° capsular release with concomitant rotator cuff repair was used to treat rotator cuff tear in global stiff shoulder. Themain observation indexes were improved after operation, and the clinical effect was definite.

Inflammatory mechanism of hippocampal tissue injury induced by PM in nasal drip in mice / 中国应用生理学杂志

To investigate the inflammatory mechanism of nasal instillation of fine particulate matter (PM)on hippocampal tissue injury in mice. Thirty C57BL/6J mice were randomly divided into 3 groups(n=10):control group, low-dose group, high-dose group. The nasal instillation doses of PM in the low-dose group and the high-dose group were 1.5 mg/kg BW and 7.5 mg/kg BW, respectively, and the control group was given saline with an equal volume. Saline was sprayed once every other time for 12 times. The serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) were determined by ELISA method. HE staining and electron microscopy were used to observe the pathological changes and ultrastructure of lung tissue and hippocampus. The inflammatory cytokine levels in hippocampus were detected by antibody chip technique. There was no significant effect of PM nasal instillation on serum TNF-α, IL-1β and IL-6 levels (P＞0.05), and there was no obvious pathological changes in lung tissue structure. In hippocampus, low-dose and high-dose PM exposure could lead to disordered neuronal arrangement in the hippocampal CA3 region, and there were neurological changes around the neuron cells and ultrastructural changes such as edema around small blood vessels. Compared with the control group, the levels of inflammatory cytokines such as CX3CL1, CSF2 and TECK in the low-dose group were increased significantly (P ＜0.05), while sTNFR1 was decreased significantly (P＜0.05); the inflammatory factors CX3CL1, CSF2, and TCA-3 were significantly increased in the high-dose group (P＜0.05), while leptin, MIG, and FASLG were significantly decreased (P＜0.05). Nasal instillation of PM can induce tissue damage in the hippocampus of mice, and its mechanism of action may be the olfactory brain pathway. The increasing of TNF-α and IL-6 and the decreasing of sTNFR1 and FASLG may be involved in inflammatory mechanisms.

Effects of repeated immobilization stress on hypothalamic-pituitary- ovarian axis in female rats / 中国应用生理学杂志

To explore the effects of repeated immobilization stress on hypothalamic-pituitary-ovarian axis in female rats. Methods: Forty female SD rats were randomly divided into two groups: control group (n=20) and experimental group (n=20). One group was fed normally, the other group was subjected to incremental load restraint stress. Brake stress once a day in the retainer (starting at 9: 00 a.m.), braking for 2 hours on the first day, increasing load by 0.5 hours a day for two weeks. Body weight, estrous cycle, sex hormone, organ coefficient, pathology and expression of related genes were detected to explore the harm of hypothalamic-pituitary-ovarian axis. Repeated immobilization stress caused weight loss, prolonged estrous cycle, and changed the organ coefficient and morphology of ovaries and uterus. QPCR technique was used to detect the related genes. It was found that the expressions of gonadotropin releasing hormone, pituitary gonadotropin releasing hormone receptor, follicle stimulating hormone and luteinizing hormone mRNA were decreased significantly, while the expressions of ovarian follicle stimulating hormone and luteinizing hormone receptor mRNA were increased significantly. The expression of estrogen receptor mRNA in ovary and uterus was decreased significantly. Repeated immobilization stress may disrupt the estrous cycle by interfering with the endocrine regulation of the hypothalamic-pituitary-ovarian axis, thus damaging the gonadal and reproductive endocrine function of female animals.

Effects of acute ozone exposure on genotoxicity of lung cells in rats / 中国应用生理学杂志

OBJECTIVE@#To clarify the genotoxicity induced by acute exposure of ozone with different concentrations on pulmonary cells in rats.@*METHODS@#Thirty-six Wistar rats were randomly divided into control group (filtered air exposure) and ozone exposure group (0.12 ppm, 0.5 ppm, 1.0 ppm, 2.0 ppm, 4.0 ppm) with 6 in each group. After rats were exposed to different concentrations of ozone for 4 h, lung tissues were taken and single cells were isolated. Then, 8-hydroxydeoxyguanosine (8-OHdG) was quantitatively detected by enzyme-linked immunosorbent assay. Comet assay, micronucleus test and DNA- protein cross-linking assay were used to analyze DNA and chromosome damages.@*RESULTS@#Compared with the control group, the content of 8-OHdG in lung tissue was increased significantly from the ozone exposure concentration of 0.12 ppm, reaching the highest value at 0.5 ppm. With the increase of ozone exposure concentration, the tail rate of comets was increased gradually, and there was a significant dose-effect relationship. The cross-linking rate of DNA- protein was increased first and then was decreased with a maximum value at 2.0 ppm group. Although the micronucleus rate of lung cells showed an upward trend, there was no significant difference compared with the control group.@*CONCLUSION@#Acute exposure of ozone at low concentrations (0.12 ppm) could lead to DNA damage in the pulmonary cells of rats, while no significant chromosome damage was found even in the group with ozone concentration reached to 4 ppm.

Injury of rat blood vessels caused by acute ozone exposure and its mechanism / 中国应用生理学杂志

OBJECTIVE@#To investigate the vascular damage effects and possible mechanism of acute exposure to ozone (O) in male Wistar rats.@*METHODS@#One hundred and twenty male Wistar rats were randomly divided into six groups, 20 in each group. The experimental animals were placed in a gas poisoning cabinet, the control group was exposed to filtered air, and the treatment group was exposed to ozone at concentrations of 0.12 ppm, 0.5 ppm, 1.0 ppm, 2.0 ppm, and 4.0 ppm, respectively, for 4 hours. Arterial blood pressure data were obtained by PC-lab medical physiological signal acquisition system. Blood rheology indicators and blood biochemical indicators were detected by Tianjin Dean Diagnostic Laboratory. Serum endothelin-1 (ET-1), homocysteine (HCY), von Willebrand factor (vWF), 8-hydroxydeoxyguanosine (8-OhdG), interleukin (IL-6) and tumor necrosis factor alpha (TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA) microplate assay. Oxidative stress indicators superoxide dismutase (SOD) activity and malondialdehyde (MDA) were determined by xanthine oxidase method, thiobarbituric acid (TBA) method, reduced glutathione (GSH) and nitric oxide (NO) were tested by using microplate colorimetry. Paraffin sections were prepared from thoracic aorta tissue, and vascular structure was observed by HE staining.@*RESULTS@#Acute exposure to 0.12 ppm ozone could cause a significant increase in arterial systolic blood pressure (SBP). Exposure to different concentrations of ozone could cause a significant increase in plasma viscosity, and the K value of the ESR equation was significantly increased in the 1.0 ppm ozone exposure group. Both the relative and reduced viscosities were significantly reduced at ozone concentrations of 0.5 ppm and 4.0 ppm, while the red blood cell deformation index was increased significantly at ozone concentrations of 0.12 ppm, 0.5 ppm, 1.0 ppm, and 2.0 ppm. Acute ozone exposure resulted in the decrease of total cholesterol content. The content of high-density lipoprotein cholesterol (HDL-C) was significantly reduced in the 0.12 ppm ozone exposure group. When the ozone concentration was higher than 1.0 ppm, the body may also had an inflammatory reaction (increased TNF-α) and oxidative stress (increased MDA, decreased GSH). Acute exposure to ozone could lead to elevated levels of ET-1 in the blood, with significant differences in the 4.0 ppm concentration group, while HCY levels were decreased firstly and then increased, reaching the highest in the 1.0 ppm concentration group. No obvious pathological changes were observed in the thoracic aorta.@*CONCLUSION@#Acute ozone exposure can affect arterial blood pressure, blood rheology and cholesterol metabolism in rats. The possible mechanism is that ozone exposure leads to inflammatory reaction and oxidative stress reaction, causing vascular endothelial function damage, and vascular endothelial cells increase with ozone exposure concentration.

Application risk and management strategy of infusion pumps / 医疗卫生装备

Objective To analyze the risk factors of the infusion pump to provide evidence-based basis for its safety management and monitoring.Methods Totally 1 000 pieces of questionnaires were issued for 100 infusion pumps from 9 grade-A tertiary hospitals in Beijing.The abnormalities and the correlation between the indexes were analyzed for the infusion pump,the indexes were compared on their effects on the abnormalities.Results Statistical analysis on data samples showed that the main factors included the manufacturer of infusion pump and pipeline,service time of infusion pump,compatibility between infusion pump and pipeline as well as the user department.Conclusion The management facility has to pose emphases on safety and utilization management as well as standardized application of the infusion pipeline so as to reduce adverse events efficiently.

Multi-index integrated evaluation of spectrum-effect relationship on immunocompetence of Radix Astragali / 药学学报

The study was aimed to investigate the correlation between the immunocompetence and the fingerprints of supernatant extracts from Radix Astragali by multi-index integrated evaluation, and reveal the material basis of Radix Astragali improving the immunological function. After oral administration 10 batch of supernatant extracts from Radix Astragali on immunosuppressed mice, phagocytic index, delayed type hypersensitivity (DTH) degree, organs index and the level of cytokines IFN-γ, IL-4 (ELISAs) were measured, and each common peak from HPLC-DAD/HPLC-ELSD fingerprints were correlated with the above data. A number of components in supernatant extracts of Radix Astragali display a substantial correlation with the immunocompetence. Supernatant extracts of Radix Astragali can significantly enhance immunological function on mice, which is related to various components in Radix Astragali.

Spinal serotonergic receptor is involved in descending inhibition of cardiac nociception by the lateral reticular nucleus in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the role of the lateral reticular nucleus (LRN) in descending inhibition of cardiac nociception in rats and the involvement of spinal serotonergic receptors in the descending inhibition.</p><p><b>METHODS</b>Male SD rats were randomly divided into 5 groups, namely bradykinin (BK) group, BK + glutamate group, BK + methysergide group, BK + glutamate + methysergide group, and BK + glutamate + vehicle group. The rats received glutamate microinjection in the LRN combined with the intrathecal injection of serotonergic receptor antagonist methysergide, and the changes in the cardiacsomatic motor reflex induced by intrapericardial BK injection were monitored by observing electromyogram (EMG) responses of the dorsal spinotrapezius muscle; c-Fos expression in the spinal dorsal horn was also tested.</p><p><b>RESULTS</b>Compared with BK group, intra-LRN glutamate administration produced a significant inhibitory effect on intrapericardial BK-induced EMG in a dose-dependent manner, and c-Fos expression was significantly decreased in the spinal dorsal horn (P<0.05). Compared with BK + glutamate group, intrathecal administration of methysergide significantly attenuated the inhibitory effect of chemical stimulation of the LRN on intrapericardial BK-induced EMG and increased c-Fos expression in the spinal dorsal horn (P<0.05). Intrathecal administration of the vehicle did not produce any effect on EMG or c-Fos expression (P>0.05).</p><p><b>CONCLUSION</b>The serotonergic receptors in the spinal cord are involved in LRN-mediated descending inhibition of cardiac nociception in rats.</p>

Mechanism in growth inhibition of quercetin on human bladder cancer cell line / 中国中药杂志

To investigate the inhibitory mechanism of quercetin on growth of human bladder cancer cell line(BIU-87). BIU-87 cells were cultured in vitro, and co-cultured with varying concentrations of quercetin, and the anti-proliferative activity was determined by CCK-8 assay. Apoptosis of quercetin-induced BIU-87 cells and cell cycle were determined by flow cytometry analysis. Expressions of Bal-2 and Bal-xL, and related proteins in TAK1/JNK signal pathway were measured using Western blot analysis. After treatment with quercetin for 24 h and 48 h, the proliferation of BIU-87 cells was significantly suppressed in a dose-dependent manner according to CCK-8 assay(P<0.05). The flow cytometry analysis indicated that each group of quercetin leads to a significant higher percentage of apoptosis of BIU-87 cells than control group after treatment with quercetin for 24 h and 48 h; In G₀/G₁ period, cells reduced, while the amount of cells in G₂/M period increased, and cells in S period remained the same amount. Expressions of Bal-2, Bal-xL, p-TAK1, p-MKK4/7, p-JNK decreased in BIU-87 cells after treatment with quercetin. Quercetin could inhibit the proliferation and promote the apoptosis of BIU-87 cells. The mechanism may be correlated with the inhibition of TAK1/JNK signaling pathway, which led to the further decrease in expressions of Bal-2 and Bal-xL.

Arthroscopic reduction and utilization of Suture Bridge tech reconstructing footprint area structure for the treatment of anterior cruciate ligament avulsion fracture / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the preliminary curative effect of arthroscopic reduction and utilization of Suture Bridge tech reconstructing footprint area structure for anterior cruciate ligament avulsion fracture.</p><p><b>METHODS</b>From March 2010 to September 2012, 6 patients suffered anterior cruciate ligament avulsion fracture were treated with arthroscopic Suture bridge fixation for anterior cruciate ligament tibial side footprint reconstruction. There were 2 males and 4 females, ranging in age from 14 to 52 years old. There were 2 cases of type III and 4 cases of type IV displaced fractures classified by Meyers-McKeever-Zaricznyj. Preoperative ADT and Lachman tests were positive.</p><p><b>RESULTS</b>All the patients was follow up more than 2 years. Postoperative ADT and Lachman tests were negative without limitation of knee extension. Postoperative X ray and MRI showed that displaced fracture with a good reduction and union, recovered normal shapeness of ACL. The postoperative Lysholm and IKDC scores at different time points(3 months, 1 year, 2 years after operation) improved significantly comparing with preoperative, and the differences were statistically significant (<0.01).</p><p><b>CONCLUSIONS</b>Suture Bridge tech reconstructing footprint area structure for ACL avulsion fracture is an effective and safe method, especially for adolescent patients with unclosed epiphysis and comminuted avulsion fracture.</p>

Total hip arthroplasty for patients with failed internal fixation of acetabular fractures / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical result and healing of meniscal suture under arthroscopy for the treatment of the middle aged patients with meniscal injury.</p><p><b>METHODS</b>From March 2014 to January 2015, 40 middle-aged patients included in the standard with injury of meniscus, which were repaired by meniscal suture technique under arthroscopy, involving 24 males and 16 females with an average age of (52.65±3.63) years ranging from 50 to 60 years; 28 cases were on left knee, 12 cases were on right knee. Average flexion angle averaged (117.50±7.16) ° ranging from 110° to 130°. Lysholm knee score averaged 54.30±14.72 ranging from 23 to 71; IKDC score averaged 50.65±15.95 ranging from 18 to 78; the WOMAC score averaged 23.80±19.39 ranging from 2 to 75. All-inside meniscus suture under arthroscopy was performed.</p><p><b>RESULTS</b>All operations were successful without serious complications. Postoperative follow-up was 6 to 12 months, none of the patients lost to follow-up. All patients maintain a category 5 degree muscle strength, normal knee joint mobility, can completely straight and completely buckling. Average flexion angle was (125.00±5.13) ° (110° to 130°) (=3.47,=0.003). Final Lysholm scale, IKDC scores and WOMAC scores averaged 79.50±8.70 (=7.790,=0.000), 79.40±10.40 (=8.431,=0.000), 8.15±6.77 (=3.988,=0.001) separately. Follow-up MRI showed that meniscus healed in 4 cases, partially healed in 22 cases, haven't healed in 14 cases. Failure rate of small lesion was 27.3%(6/22), and failure rate of large lesion was 44.4%(8/18).</p><p><b>CONCLUSIONS</b>Clinical effect of meniscal suture under arthroscopy for the treatment of the middle aged is good. The failing rate was 35% because of healing ability is poor in middle-aged adults. Failure rate of large lesion was higher than that of small lesion.</p>