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Objective To investigate the therapeutic effect of Yudantong decoction in mice with α-naphthyl isothiocyanate (ANIT)-induced cholestasis, as well as its targets and mechanism based on intestinal flora and intestinal barrier function. Methods A total of 24 C57BL/6 mice were randomly divided into control group, model group, Yudantong decoction group (YDTF group), and ursodeoxycholic acid (UDCA) group, with 6 mice in each group. The mice in the model group, the YDTF group, and the UDCA group were given ANIT 35 mg/kg/day by gavage on days 1, 4, 7, 10, and 13, and those in the YDTF group and the UDCA group were given Yudantong decoction or UDCA by gavage for 15 consecutive days; related samples were collected on day 16. Liver histopathology was observed, and liver function parameters were measured; immunohistochemistry was used to measure the protein expression levels of caspase-1, interleukin-1β (IL-1β), and FXR in the liver, and flow cytometry was used to measure the percentages of CD11b + , CD86 + , and CD45 + immune cells in the liver; 16S rDNA sequencing and information analysis were performed for fecal microorganisms; immunohistochemistry was used to measure the protein expression of the intestinal FXR/NLRP3 pathway, and immunofluorescence assay was used to measure the protein expression of intestinal E-cadherin and occludin. A one-way analysis of variance was used for comparison of continuous data with homogeneity of variance between multiple groups, and the least significant difference t -test was used for further comparison between two groups; the Welch test was used for comparison of data with heterogeneity of variance between multiple groups, and the Games-Howell test was used for further comparison between two groups. Results HE staining showed that the model group had partial hepatocyte fatty degeneration, massive necrosis of hepatocytes in hepatic lobules, damage of lobular structure, and massive inflammatory cell infiltration, and the YDTF group and the UDCA group had alleviation of hepatocyte fatty degeneration and hepatocyte necrosis in hepatic lobules, with a reduction in inflammatory cells. Compared with the control group, the model group had significantly higher serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), total bilirubin (TBil), direct bilirubin (DBil), and total bile acid (TBA) (all P < 0.05); compared with the model group, the YDTF group had significant reductions in the serum levels of ALT, AST, GGT, ALP, TBil, DBil, and TBA (all P < 0.05), and the UDCA group had significant reductions in the serum levels of GGT, TBil, DBil, and TBA (all P < 0.05). Compared with the control group, the model group had significant increases in the levels of caspase-1 and IL-1β and a significant reduction in the expression of FXR in the liver (all P < 0.05); compared with the model group, the YDTF group had significant reductions in the levels of caspase-1 and IL-1β in the liver and the UDCA group had a significant reduction in the level of IL-1β in the liver, and both the YDTF group and the UDCA group had a significant increase in the expression level of FXR in the liver (all P < 0.05). The model group had a significant change in the composition of intestinal flora compared with the control group ( P < 0.05); there was a significant difference in the structure of intestinal flora between the YDTF group and the model group ( P < 0.05), and there was also a significant difference in the composition of intestinal flora between the UDCA group and the control/model groups ( P < 0.05). Compared with the control group, the model group had a significant increase in the abundance of intestinal Akkermansia muciniphila and a significant reduction in the abundance of Lactobacillus johnsonii (both P < 0.05); compared with the model group, both the YDTF group and the UDCA group had a significant reduction in the abundance of intestinal Akkermansia muciniphila , and the YDTF group had a significant increase in the abundance of Lactobacillus murinus , while the UDCA group had significant increases in the abundance of Lactobacillus murinus and Bifidobacterium pseudolongum (all P < 0.05). Compared with the control group, the model group had a significant reduction in the protein expression of intestinal FXR, a significant increase in the protein expression of intestinal NLRP3, and significant reductions in the expression of intestinal E-cadherin and occludin (all P < 0.05); compared with the model group, both the YDTF group and the UDCA group had a significant increase in the protein expression of intestinal FXR, a significant reduction in the protein expression of intestinal NLRP3, and significant increases in the expression of intestinal E-cadherin and occludin (all P < 0.05). Conclusion Yudantong decoction can alleviate liver injury in mice with ANIT-induced cholestasis, possibly by improving intestinal flora and enhancing intestinal barrier function.
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Objective:To establish a new classification of lateral clavicle fractures and to evaluate its clinical value.Methods:The data of 67 patients with lateral clavicle fractures admitted from January 2016 to December 2020 were included. Thirty-seven cases were from Shanghai First People's Hospital, including 22 males and 15 females, with an average age of 49.1 years (22-78 years). Thirty cases were from the Second Upper Limb Ward of Tianjin Hospital of Tianjin, including 20 males and 10 females, with an average age of 47.6 years (19-76 years). The ligament injury was determined by measuring the coracoclavicular space on Zanca view X-ray and the distance between the fracture fragment on the inferior surface of the 3D-CT and the distal end of the clavicle. All patients were classified according to the new classification (based on the measurement on Zanca view X-ray and 3D-CT reconstruction, the relationship between the fracture and the coracoclavicular ligament footprint, coracoclavicular ligament injury, the injury of the acromioclavicular joint and the stability of the fracture), conservative treatment is preferable for stable fractures, and surgical treatment for unstable fractures. Three experienced orthopaedic surgeons and three radiologists independently observed the imaging data of 67 patients with distal clavicle fractures, determined the fracture type according to the new classification, and randomly reclassified after 4 weeks interval. Finally, 15 cases were randomly selected for internal control (2 junior orthopedic physicians), and the ICC value was used to assess the reliability. Results:The lateral clavicle fractures were divided into 5 types according to the Gongji classification. Type 1: isolated conical tubercle avulsion fracture, and the fracture line is located medial to the coracoid process; Type 2: complete involvement of the trapezoid & conical ligament at the clavicle insertion, and the fracture line extends to the middle of the clavicle, mean while the acromioclavicular joint is intact; Type 3: fracture fragments on the inferior surface involving the trapezoidal/conical ligament, respectively; Type 4: rupture of the conical ligament, and avulsion fracture of the trapezoid ligament; Type 5: conical ligament intact, and avulsion fracture of clavicle insertion of the trapezoid ligament. There were 18 cases of type 1, 4 cases of type 2, 8 cases of type 3, 32 cases of type 4, and 5 cases of type 5. The inter-observer and intra-observer agreement of all included cases was good (inter-group: first ICC=0.764, second ICC=0.778; intra-group: shoulder specialist ICC=0.782, radiologist ICC=0.750, internal control ICC=0.793). Types 1 and 2 fractures were fixed with anatomical plate and coracoid anchor. Type 3 and 4 fractures were fixed with clavicle hook plate and coracoid anchor. And type 5 underwent conservative treatment. At the last follow-up, all patients had no obvious shoulder joint instability and pain, and no internal fixation failure or fixation breakage was found. Conclusion:The Gongji classification has moderate reliability between observers and intra-observers, and the Gongji distal clavicle fracture classification has a good significance for evaluating the stability of the fracture and guiding the selection of the treatment.
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Objective:To investigate the correlation between multiple parameters of islet function evaluation and atherogenic index (AIP) in patients with type 2 diabetes mellitus (T2DM).Methods:A cross-sectional study was conducted to observe 216 T2DM patients hospitalized in Tianjin Medical University Chu Hsien-I Memorial Hospital in 2019. They were divided into non atherogenic phenotype group (N Group, AIP<0.06) and atherogenic phenotype group (A group, AIP≥0.06) with AIP=0.06 as the cut-off point. The general clinical indexes and evaluation indexes of oral glucose tolerance test (OGTT), such as insulin action index (IAI), quantitative insulin sensitivity check index (QUICKI), homeostasis model of insulin resistance index (HOMA-IR), homeostasis model assessment-β (HOMA-β), C peptide insulin resistance index (HOMA IR-CP) and C peptide islet function index suitable to diabetes patients (HOMA islet-CP DM) were compared between two groups. Pearson correlation analysis and multiple stepwise regression analysis were performed.Results:Compared with the N group, the very low density lipoprotein-cholesterol (VLDL-C), ln (HOMA IR-CP) and ln (HOMA islet-CP DM) in A group were higher ( P<0.01), while ln (QUICKI) was lower ( P<0.05), with statistical significance. AIP was positively correlated with VLDL-C ( r=0.765), ln (HOMA-IR) ( r=0.257), ln (HOMA-β) ( r=0.189), ln (HOMA IR-CP) ( r=0.418) and ln (HOMA islet-CP DM) ( r=0.377, P<0.01), and negatively correlated with IAI ( r=-0.145, P<0.05) and ln (QUICKI) ( r=-0.254, P<0.01). Multiple stepwise regression analysis showed that VLDL-C and ln (HOMA IR-CP) were independent influencing factors of AIP in type 2 diabetic patients ( P<0.01) . Conclusions:AIP is positively correlated with insulin resistance and negatively correlated with insulin sensitivity. VLDL-C and HOMA IR-CP are independent predictors of AIP.
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OBJECTIVE：To study the effects of limonin on immune function and apo ptosis-related factors expression in MFC gastric cancer bearing model mice. METHODS ：MFC gastric cancer bearing model was established by inoculating MFC gastric cancer cells into the right armpit of mice. After modeling ，model mice were divided into model group ，cyclophosphamide group （positive control ，25 mg/kg）and limonin high-dose ，medium-dose and low-dose groups （100，50 and 25 mg/kg），with 10 mice in each group. Other groups were given relevant medicine intragastrically ，once a day ，for consecutive 14 days，except that model group was given 0.5％ sodium carboxymethyl cellulose intragastrically. Before administration and after last administration ，the body weight of mice was measured ；spleen，thymus and tumor tissue were taken after the last administration to calculate the spleen index，thymus index and tumor inhibition rate. The percentage of CD 4+ and CD 8+ T lymphocytes ，CD4+/CD8+ ratio were detected by flow cytometry. The expression of immune function related indexes （IL-2，IL-10，IFN-γ）in serum were detected by ELISA. RT-PCR and Western blot assay were adopted to detect relative mRNA and protein expression of apoptosis-related factors [cytochrome C （Cyt-C），Bcl-2，Bax] in tumor tissue of mice. RESULTS ：There was no significant difference in body weight among the other groups except that of cyclophosphamide group was decreased significantly ，compared with model group （P＜0.05）. Inhibitory rate of tumor were （58.16 ± 7.07）％ ，（37.09 ± 4.26）％ ，（27.30 ± 3.64）％ ，（15.13 ± 2.95）％ in cyclophosphamide group ，limonin high-dose ，medium-dose and low-dose groups. Compared with model group ，spleen index ， thymus index ，the percentages of CD 4+ and CD 8+T lymphocyte cells ，CD4+/CD8+ ratio，serum levels of IL- 2 and IL- 10，relative mRNA and protein expression of Bcl- 2 in tumor of mice in cyclophosphamide group as well as the expression of IL- 10，relative mRNA and protein expression of Bcl- 2 in limonin groups were decreased significantly （P＜0.05）. The expression of IFN-γ，relative mRNA and protein expression of Cyt-C and Bax of cyclophosphamide group as well as spleen index （except for low-dose group ）， thymus index ， the percentage of CD 4 + and CD 8 + T lymphocytes，CD4+/CD8+ ratio，the expression of IL- 2 and IFN-γ，and relative mRNA and protein expression of Cyt-C and Bax in limonin groups were increased significantly （P＜0.05）. CONCLUSIONS ：Limonin can inhibit tumor growth in MFC gastric cancer bearing model mice ，and the side effects are relatively weak. Its mechanism is related to the improvement of immune function and the induction of apoptosis.
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Aim of the Study: The role of direct-acting oral anticoagulants in the treatment of venous thromboembolism (VTE) in cancer patients compared with the current standard of low-molecular-weight heparin (LMWH) treatment remains unclear. This meta-analysis aimed to evaluate the efficacy and safety of direct factor Xa inhibitors compared with those of LMWH in the treatment of cancer-associated VTE. Materials and Methods: We systematically searched PubMed, EMBASE, Cochrane library, and Web of Science for potential randomized controlled clinical trials and retrospective cohort studies. Data on recurrent VTE (efficacy) and major and minor bleeding events (safety) were extracted, and the odds risks (OR) were analyzed using a random-effect model. Results: A total of nine studies involving 4208 cancer patients with VTE were included in these analyses. Pooled analysis showed that direct factor Xa inhibitors were significantly superior to LMWH in reducing the risk of recurrent VTE (OR = 0.67; 95% confidence interval [CI]: 0.54–0.82). There was no significant difference in the rate of major bleeding between the direct factor Xa inhibitor and LMWH treatments (OR = 1.25; 95% CI: 0.94–1.65). However, the rate of minor bleeding events was higher when a direct factor Xa inhibitor was used instead of LMWH (OR = 1.80; 95% CI: 1.05–3.07). Conclusions: Direct factor Xa inhibitors are superior to LMWH in efficacy in the treatment of VTE in cancer patients, and the safety between the two regimens is comparable except for a slightly higher rate of minor bleeding when the former is used
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Rotator cuff disease and degenerative osteoarthritis are caused by many factors. Several studies had shown that rotator cuff disease was related to lateral extension of the acromion and glenoid inclination. A new parameter, critical shoulder angle (CSA), which is defined as the angle between a line connecting the superior to the inferior margins of the glenoid and a line connecting the inferior margin of the glenoid to the inferolateral edge of the acromion measured on anteroposterior (AP) shoulder radiographs, is proposed to comprehensively reflect the relationship between abnormal anatomical structure and rotator cuff injury. There is a close relationship between CSA and the injury of rotator cuff and the osteoarthritis of glenohumeral joint: the injury of rotator cuff is often accompanied by a larger CSA (> 35 °), and a smaller CSA (< 30 °) is closely related to the occurrence of glenohumeral arthritis. Therefore, CSA is helpful for the diagnosis of rotator cuff injury and glenohumeral osteoarthritis. Correction of abnormal CSA by arthroscopic lateral acromial osteotomy also provides a new idea for the treatment of shoulder diseases. In this paper, we reviewed the research progress of the angle from five aspects: definition, measurement, biomechanical significance, treatment and ethnic differences.
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Objective@#To explore the operative strategy of distal clavicle fracture involving coracoclavicular ligament.@*Methods@#Data of 17 cases of distal clavicle fracture involving coracoclavicular ligament in our hospital from January 2013 to December 2018 were analyzed retrospectively. According to whether the coracoclavicular ligament was reconstructed or not, the patients were divided into two groups: non reconstruction group (10 cases), male (7 cases), female (3 cases), 19-60 years old (37.9±11.9). In the reconstruction group, 7 cases were male 5, female 2, 25-62 years old (44.9±13.0). Three dimensional CT was used to judge the ligament injury and X-ray was used to evaluate the fracture reduction and healing after operation. The time of fracture healing was compared between the two groups. The function of shoulder joint was evaluated by visual analog scale (VAS) and Constant score of shoulder joint.@*Results@#The patients in both groups were followed up for (18.7±6.7) months (range, 9-27 months). At the latest follow-up, the time of fracture healing in the reconstruction group was 12.6±0.7 weeks (range, 12-14 weeks); VAS score was 3.0±1.3 and Constant-Murley score was 85±11. While those in the non reconstruction group were 23.7±7.9 (range, 16- 48 weeks), 3.1±1.8 and 77±10 respectively. The time of fracture healing was statistically significant (t=3.361, P=0.004). There was no significant difference in VAS score and Constant score (P> 0.05). In the non reconstruction group, there were 1 case of delayed union of fracture (healed 48 weeks after operation), 1 case of loosening of clavicular hook plate, 5 cases of acromioclavicular joint dislocation (Rockwood type II) after removal of internal fixation, and the overall complication rate was 70% (7/10). Reconstruction group: 1 case of acromial fracture, the overall complication rate was 14.3% (1/7). There was significant difference between the two groups (χ2=5.13, P=0.024).@*Conclusion@#Reconstruction of clavicular insertion of coracoclavicular ligament can effectively reduce the postoperative complications of distal clavicular fracture involving the coracoclavicular insertion. Attention should be paid to the repair and reconstruction of coracoclavicular ligament injury during fracture treatment.
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A case of acute posterior dislocation of shoulder with fracture of greater tubercle of humerus was reported. The patient came to hospital complaining pain and limited motion of left shoulder caused by traffic accident. The diagnosis of posterior dislocation of the left shoulder and fracture of the greater tubercle was confirmed by medical history, physical examination and imaging. After the failure of manual reduction under anesthesia, MRI was conducted which revealed that the biceps brachii longus and supraspinatus and infraspinatus muscle were embedded between the head of humerus and glenoid scapula. Then open reduction and internal fixation was performed. The biceps brachii longus was cut off and then fixed in the inter nodal groove. After the rotator cuff was relieved from the impaction, the dislocation of the humeral head was successfully reduced and the fracture of the greater tubercle was reduced and fixed. According to the operation process, the possible trauma mechanism is discussed as follows: the displaced fracture of the greater tubercle destroyed the integrity of the lateral wall of the inter tubercular groove, and the biceps brachii longus slipped out of the inter tubercular groove and shifted to the medial side, which was embedded between the humeral head and the scapular glenoid, thus forcing the humeral head to fall posteriorly, and causing the fracture of the greater tubercle to move anteriorly and inferiorly. Attention should be paid to the possible acute dislocation of shoulder joint for the patients with high energy injury. The only way to avoid missed diagnosis is to combine with multi-directional X-ray or CT examination of shoulder. MRI should be used to determine whether there is tendon incarceration of rotator cuff and/or biceps brachii longus in patients with acute posterior dislocation of shoulder. Anatomic reduction of tubercle fracture is the key to recover the range of motion and muscle strength of shoulder joint.
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Rotator cuff disease and degenerative osteoarthritis are caused by many factors.Several studies had shown that rotator cuff disease was related to lateral extension of the acromion and glenoid inclination.A new parameter,critical shoulder angle (CSA),which is defined as the angle between a line connecting the superior to the inferior margins of the glenoid and a line connecting the inferior margin of the glenoid to the inferolateral edge of the acromion measured on anteroposterior (AP) shoulder radiographs,is proposed to comprehensively reflect the relationship between abnormal anatomical structure and rotator cuff injury.There is a close relationship between CSA and the injury of rotator cuff and the osteoarthritis of glenohumeral joint:the injury of rotator cuff is often accompanied by a larger CSA (＞ 35 °),and a smaller CSA (＜ 30 °) is closely related to the occurrence of glenohumeral arthritis.Therefore,CSA is helpful for the diagnosis of rotator cuff injury and glenohumeral osteoarthritis.Correction of abnormal CSA by arthroscopic lateral acromial osteotomy also provides a new idea for the treatment of shoulder diseases.In this paper,we reviewed the research progress of the angle from five aspects:definition,measurement,biomechanical significance,treatment and ethnic differences.
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Objective To explore the operative strategy of distal clavicle fracture involving coracoclavicular ligament.Methods Data of 17 cases of distal clavicle fracture involving coracoclavicular ligament in our hospital from January 2013 to December 2018 were analyzed retrospectively.According to whether the coracoclavicular ligament was reconstructed or not,the patients were divided into two groups:non reconstruction group (10 cases),male (7 cases),female (3 cases),19-60 years old (37.9± 11.9).In the reconstruction group,7 cases were male 5,female 2,25-62 years old (44.9± 13.0).Three dimensional CT was used to judge the ligament injury and X-ray was used to evaluate the fracture reduction and healing after operation.The time of fracture healing was compared between the two groups.The function of shoulder joint was evaluated by visual analog scale (VAS) and Constant score of shoulder joint.Results The patients in both groups were followed up for (18.7±6.7) months (range,9-27 months).At the latest follow-up,the time of fracture healing in the reconstruction group was 12.6±0.7 weeks (range,12-14 weeks);VAS score was 3.0± 1.3 and Constant-Murley score was 85± 11.While those in the non reconstruction group were 23.7±7.9 (range,16-48 weeks),3.1± 1.8 and 77± 10 respectively.The time of fracture healing was statistically significant (t=3.361,P=0.004).There was no significant difference in VAS score and Constant score (P＞ 0.05).In the non reconstruction group,there were 1 case of delayed union of fracture (healed 48 weeks after operation),1 case of loosening of clavicular hook plate,5 cases of acromioclavicular joint dislocation (Rockwood type Ⅱ) after removal of internal fixation,and the overall complication rate was 70％ (7/10).Reconstruction group:1 case of acromial fracture,the overall complication rate was 14.3％ (1/7).There was significant difference between the two groups (x2=5.13,P=0.024).Conclusion Reconstruction of clavicular insertion of coracoclavicular ligament can effectively reduce the postoperative complications of distal clavicular fracture involving the coracoclavicular insertion.Attention should be paid to the repair and reconstruction of coracoclavicular ligament injury during fracture treatment.
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Accumulating evidence suggest that microRNAs play crucial roles in the development and progression of bladder cancer(BC). Here, we found that miR-212-3p was significantly down-regulated and negatively correlated with nuclear factor IA(NFIA) in human BC tissues. Bioinformatics analysis predicted that NFIA was a target gene of miR-212-3p. Then BC celllines, T24 and J82 cells were transfected with miR-212-3p mimics or siNFIA to obtain miR-212-3p overexpression or NFIAknockdown cell lines, respectively. Quantitative real-time PCR was used to determine the expression of miR-212-3p andNFIA. Western blot analysis was utilized to detect NFIA expression. MTT assay showed either miR-212-3 overexpression orNFIA knockdown significantly inhibited the BC cell proliferation. Double staining with Annexin V-APC and 7-AAD showedthe total number of apoptotic BC cells were remarkably increased after miR-212-3p overexpression or NFIA knockdown.Collectively, our results indicated that miR-212-3p targeting NFIA might serve as a promising target for BC.
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@#Total synthesis of cyclodepsipeptide Hikiamides A-C was described. Fragment convergent condensation method was applied for the preparation of Hikiamides A-C, starting from Commercially available amino acid such as L-N-Boc-Phe-OH, L-N-Boc-Trp-OH, L-N-Cbz-Van-OH etc. Tripeptide fragments(compounds 5a/5b)and dipeptide fragments(compounds 8a/8b)were first prepared. The subsequent condensation of the resulted two fragments provided protected linear pentapetides(compounds 9a/9b/9c); Finally, the linear pentapetide was cyclized by a mixed condensing agents comprised of PyBOP and HBTU. Hikiamides A-C was obtained with total yields of 9%, 11% and 6. 5%, respectively. Compared with the natural source, this method has the advantages of low cost, convenient operation and high yield, which effectively solves the problem of low isolated yield of Hikiamides A-C from Fusarium sp.
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Objective To investigate the value of electromagnetic field real-time system (EFRTS) in the distal locking of intramedullary nailing for humeral shaft fractures.Methods From April 2015 to January 2017,data of 32 consequent patients with humeral shaft fracture (22 males,10 females;ranged from 18 years to 78 years old,average of 40.4 years;9 domestic falls,15 traffic accidents,6 fall from height,and 2 sports injury;AO12 A1:9 cases;A2:14 cases;A3:4 cases;B2:5 cases) were retrospectively analyzed.All were treated with Humeral Antegrade Locking Nail.For inserting the two distal locking screws,the SURESHOT Distal Targeting System was used.Results Accurate placement of the distal screws was accomplished in all 32 cases,which meant one drilling and one screw locking.The mean duration of the two distal screw locking was 197±30 s (range,156-253 s) in the preparation phase and 393±39 s (range,336-481 s) in the operation phase.The mean follow-up period was 18 months,ranging from 11 to 25 months.All the fractures were healed in an average time of 15.9 weeks,ranging from 12 to 20 weeks.The range of motion was:80° to 180° in abduction (155° in average),80° to 180° in anteflexion (160° in average),60° to 100° in external rotation (80° in average),and 17 cases internal rotation to L3 level,10 to T12 level and 5 to T7 level.The mean score of ConstantMurley was 89,ranging from 74 to 96.All the patients obtained good results.27 patients restored self-care ability within 3 months after surgery.Shoulder discomfort occurred in 2 patients because of nail tail outside the articular surface.The symptom recovered after removal of the nail as well as joint release in arthroscopy.Conclusion The distal aiming device can be used in humeral intramedullary nailing,by which the distal screw can be inserted by one time.Meanwhile,it has the advantages of short time-consuming,secure operation,and no X-ray radiation.
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Objective:To establish a method for the determination of the potential genotoxic impurities [ methyl chloroacetate and ( R, S) 4-ethyl chloro-3-hydroxybutyrate ] in oxiracetam raw material .Methods:GC-MS was conducted , and the potential genotoxic impurities were extracted by ethyl acetate .The column was a VF-1701 ms capillary column (30 m ×0.25 mm, 0.25 μm) with pro-grammed temperature and the inlet temperature was 220 ℃.The column flow was 1.0 ml· min-1 and the purge flow was 5.0 ml· min-1 .The split injection was used and the split ratio was 5:1 .The carrier gas was high purity helium and the detector was a mass spectrometer detector .The ion source temperature was 230℃and the interface temperature was 230 ℃.The delay time of solvent was 4 min and the ionization mode was electron impact .The scanning ( detection ) method was selective ion monitoring , the electron energy was 70 eV, and the injection volume was 1.0 μl.Results:The separation between the impurities met the requirements .The concen-tration linear range was 50-400 ng· ml-1 (r≥0.9995).The recoveries were 89.7％-96.3％ (RSD=2.3％, n=9) and 91.0％-105.3％(RSD=4.4％, n=9), respectively.Conclusion:The method is simple, accurate, sensitive and rapid, and can be used for the determination of two potential genotoxic impurities in oxiracetam raw material .
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Objective To determine the accuracy and accuracy of 4 cystatin C (CysC) reagents,to initially select a suitable detection system according to the Six Sigma parameters for the new development projects,and to evaluate the selected reagents comprehensively.Methods Imprecision (CV％) of 4 kinds of CysC reagents (A,B,C,D) were evaluated with mixed fresh serum of patients,the bias of each kit (Bias％) was evaluated by measuring 5 specimens of the CysC project 2016 Health Planning Commission interventricular quality assessment,the total allowable error (TEa) from Health Planning Commission interventricular quality assessment was used to calculate the Sigma value and quality target index (QGI),sigma verification diagram was rendered,and the results were compared.The linear range verification,interference experiment,clinical reporting range verification and biological reference interval validation were carried out for the highest sigma kit.Results The CV value of four kinds of CysC reagents(A,B,C,D)were 6.11％,5.39％,3.13％ and 3.66％.The value of bias were 4.63％,4.42％,5.38％ and 1.09％.The sigma value were 4.15σ,4.75σ,7.87σ and 7.90σ.The quality target index(QGI) of A and B were 0.50 and 0.55,The sigma performance verification diagrams indicated that the reagent A and B were at good performance level and reagent C and D were at the world class level,D was the best one.The linear range validation,interference test,clinical reportable range validation and biological reference interval validation of D reagent were carried out,which all accorded with the declaration and clinical needs of the instructions.Conclusion The performance verification of Sigma can directly reflect the difference of performance between different reagents,and can be used for the preliminary screening of the kit.
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Sauropunol A-D potentially with anti-inflammatory,anti-bacterial activities were recently isolated from traditional Chinese medicinal plant Sauropus rostratus.Herein,we report the total synthesis of sauropunol (A-D) starting from a commercially available 2-deoxy-D-arabino-hexopyranose.The trifluoromethane sulfonation of intermediates could simultaneously trigger intramolecular cyclization to afford 3,6-anhydro hexofuranoside scaffold.The following deprotection reaction could produce sauropunol A,B and C/D with total yields of 21％,5％,and 17％ (isomer sauropunol C/D),respectively.Structures of the target compounds were confirmed by comparison with NMR spectroscopic properties of those previously reported.
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DNA methylation is an important epigenetic modification mode , which plays a crucial role in gene expression , genome stability and development .DNA methylation is catalyzed and maintained in cell proliferation by the family of DNA methyltransferases.The ten-eleven translocation (TET) enzymes oxidize 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC), 5-formylcytosine (5fC), and 5-carboxylcytosine (5caC).Here, we briefly describe the TET enzymes and their role in cancer , and the distribution , the role and detection method of those three oxidation products of cytosine in genome .
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<p><b>OBJECTIVE</b>To conduct the preliminary positioning and qualitative research of high-frequency ultrasonic imaging atpoints (including tender points and trigger points) in neck-type cervical spondylosis and explore the relevant law so as to provide the evidence for the selection of acupuncture scheme.</p><p><b>METHODS</b>Thirty patients in compliance with the diagnostic criteria of neck-type cervical spondylosis were selected. The trigger points, tender points and placebo points were positioned on any of the three available oriented lines. The point-to-point high-frequency real-time dynamic ultrasonic imaging technology was used to scan and position each point and record the changes in ultrasound gradation anatomy and two-dimensional ultrasound in perimysium, two-dimensional and color Doppler ultrasonography and blood flow. The ultrasound characteristics were analyzed.</p><p><b>RESULTS</b>①Regarding the changes in ultrasound gradation anatomy and two-dimensional ultrasound in perimysium, the anatomic gradation at trigger points and tender points was in the sequence as cutaneous layer, subcutaneous fat layer, shallow muscular tissue layer, deep muscular tissue layer and vertebrae. The linear high echo presented in cutaneous layer; the low echo in subcutaneous fat layer; the linear high echo in muscular fasciae; the low echo in muscular layer and the clear linear echo in its perimysium; the high echo and declined posterior echo in vertebrae. Compared with the placebo points, 93.3% of trigger points (28/30) presented enhanced or thickened perimysium echo (<0.05), and 96.7% of tender points (29/30) presented enhanced or thickened perimysium echo (<0.05). The differences were not significant between the trigger points and the tender points (>0.05). ②In the two-dimensional ultrasonography, the clear linear echo presented in perimysium, the enhanced or thickened echo in perimysium of trigger points and tender points. In the color Doppler ultrasonography, the blinking unstable dotted blood flow signal or stable short rod-like blood flow signal presented in the trigger points and tender points. ③Regarding the condition of blood flow, 56.7% of trigger points (17/30) presented Ⅱ degree of color blood flow signal and 83.3% of tender points (25/30) presented Ⅱ degree of color blood flow signal; 0% of placebo points presented Ⅱ degree of color blood flow signal. Compared with the placebo points, the differences in the rate of Ⅱ degree of color blood flow signal were significant statistically at both the trigger points and the tender points (both<0.05). The difference was not significant between the trigger points and tender points (>0.05).</p><p><b>CONCLUSIONS</b>In the high-frequency ultrasound imaging at trigger points and tender points in neck-type cervical spondylosis, the ultrasound imaging characteristics present, which are similar between the trigger points and the tender points. The high-frequency ultrasound imaging is valuable in positioning and quantitative research ofpoints in cervical spondylosis and has a certain significance to guide treatment.</p>
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Objective To investigate the value of CT guided 125 I seed implantation combined with chemotherapy in the treat-ment of unresectable non-small cell lung cancer .Methods The related data of 42 cases of middle and advanced non-small cell lung cancer treated in this hospital from January 2012 to December 2016 were retrospectively analyzed .The group A (23 cases) received the 125I seed implantation combined with chemotherapy ,while the group B(19 cases) adopted the simple chemotherapy .All cases conducted the chest CT re-examination at 1 ,2 ,6 months after treatment .The curative effects and complications were compared be-tween the two groups .Results The total effect rate (RR) at 1 ,2 ,6 months had statistical difference between the two groups (P<0 .05) .The adverse reactions in the group A were small ,large amounts of pneumothorax (26 .1% ,6/23) ,bone marrow suppression (26 .1% ,6/23) ,nausea and vomiting(30 .4% ,7/23) ,which in the group B were d 5 .3% (1/19) in the group B were bone marrow suppression (36 .8% ,7/19) ,nausea and vomiting (26 .3% ,5/19) .No severe complications were observed .The occurrence rate of adverse reactions had no statistical difference between the two groups (P>0 .05) .The adverse reactions were improved after symp-tomatic treatment .Conclusion CT guided 125 I seed implantation combined with chemotherapy has higher effective rate and more significant effect in treating unresectable non-small cell lung cancer .
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Objective] To explore and summarize clinical experience and academic characteristics of Lei Shaoyi on treating latent-qi leading to diarrhea. [Methods] By analyzing theory of“Impaired by wind in spring, one must get diarrhea containing undigested foods in summer”and related typical clinical cases in treatise on seasonal diseases clinical experience of Lei Shaoyi on treating latent-qi leading to diarrhea has been summarized. [Results] Lei Shaoyi put forward that the pathogenesis of latent-qi leading to diarrhea was wood restrains earth. There were two types of latent-qi leading to diarrhea: lienteric diarrhea and through-flux diarrhea. Due to suffering from disease for a long time, patients with latent-qi leading to diarrhea often were characterized by more asthenia syndrome and less sthenia syndrome, therefore, treatment was given priority to invigoration method.Lei Shaoyi was good at taking advantage of prescriptions and herbs with nature of light, clear and scattering for dispersing to expel inner delitescent pathogenic factors and emphasizing on protecting the spleen and stomach simultaneously. In clinical practice, Lei Shaoyi always adjusted treatments according to different clinical symptoms of diarrhea accompanied with other syndromes, which saved a lot of patients with critical illness.[Conclusions] The treatment methods created by Lei Shaoyi were not only inherited from The Yellow Emperor’s Inner Classic, but also the sublimation of his personal clinical experience, which was well worth learning by physicians of later generations.