The timing of pericardial drainage catheter removal and restart of the anticoagulation in patients suffered from perioperative pericardial tamponade during atrial fibrillation catheter ablation and uninterrupted dabigatran: Experiences from 20 cases / 中华心血管病杂志

Objective: To investigate the timing of pericardial drainage catheter removal and restart of the anticoagulation in patients with atrial fibrillation (AF) suffered from perioperative pericardial tamponade during atrial fibrillation catheter ablation and uninterrupted dabigatran. Methods: A total of 20 patients with pericardial tamponade, who underwent AF catheter ablation with uninterrupted dabigatran in Beijing Anzhen Hospital from January 2019 to August 2021, were included in this retrospective analysis. The clinical characteristics of enrolled patients, information of catheter ablation procedures, pericardial tamponade management, perioperative complications, the timing of pericardial drainage catheter removal and restart of anticoagulation were analyzed. Results: All patients underwent pericardiocentesis and pericardial effusion drainage was successful in all patients. The average drainage volume was (427.8±527.4) ml. Seven cases were treated with idarucizumab, of which 1 patient received surgical repair. The average timing of pericardial drainage catheter removal and restart of anticoagulation in 19 patients without surgical repair was (1.4±0.7) and (0.8±0.4) days, respectively. No new bleeding, embolism and death were reported during hospitalization and within 30 days following hospital discharge. Time of removal of pericardial drainage catheter, restart of anticoagulation and hospital stay were similar between patients treated with idarucizumab or not. Conclusion: It is safe and reasonable to remove pericardial drainage catheter and restart anticoagulation as soon as possible during catheter ablation of atrial fibrillation with uninterrupted dabigatran independent of the idarucizumab use or not in case of confirmed hemostasis.

Commonalities and differences in myopia prevention and control beliefs among primary school teachers and students in Hangzhou / 中国学校卫生

Objective@#To explore the commonalities and differences between primary school students and teachers in beliefs of myopia prevention and control, in order to provide a theoretical basis for the education programs of myopia prevention and control.@*Methods@#Convenient sampling method was used to select 14 students and 16 teachers from grades 3 and 4 in two elementary schools in Hangzhou for one to one in depth interviews, and the results were coded and analyzed by using Nvivo 11.0 software.@*Results@#There were commonalities in the perceived severity, benefits and barriers of myopia prevention and control beliefs among students and teachers, and the common keywords had been mentioned for 114 times, the commonalities of perceived severity, benefits and barriers were more obvious among them; there were differences in the specific attributions of perceived susceptibility, severity and barriers among students and teachers，the difference keywords had been mentioned for 63 times, the differences of perceived susceptibility, severity and barriers were more obvious among them.@*Conclusion@#There were commonalities in the perceived susceptibility, severity, benefits and barriers of myopia prevention and control beliefs between students and teachers; there were differences in the aspects of perceived susceptibility, severity and barriers between students and teachers. Adverse health outcomes of myopia and associated prevention knowledge should be enhanced among students. schools should carry out health education activities to improve the ability of teachers and students to prevent and control myopia; the government should implement the "double reduction" policy and improve the safety insurance system for outdoor activities.

Efficacy and safety of catheter ablation in patients with new-onset atrial arrhythmia after surgical excision of left atrial myxoma / 中华心血管病杂志

Objective: To evaluate the safety and efficacy of catheter ablation in patients with new-onset atrial arrhythmia after surgical excision of left atrial myxoma. Methods: Nine patients with new onset atrial arrhythmia and a prior history of left atrial myxoma, who received surgical myxoma excision and catheter ablation between September 2014 and November 2019, were included in the present study. Baseline characteristics, procedural parameters during catheter ablation, severe perioperative adverse events, recurrence rate of arrhythmia and clinical prognosis were analyzed. Kaplan Meier survival analysis was used to define the maintenance rate of sinus rhythm after catheter ablation in this patient cohort. Results: Nine patients were included. The average age was (55.8 ± 9.1) years old (3 male), there were 3 patients (3/9) with paroxysmal atrial fibrillation (PAF) and 6 patients (6/9) with atrial flutter or atrial tachycardia (AFL or AT). Ablation was successful in all patients, there were no perioperative complications such as stroke, pericardial effusion, cardiac tamponade, vascular complications or massive hemorrhage. During a mean follow-up time of 40.0 (27.5, 55.5) months, sinus rhythm was maintained in six patients (6/9) after the initial catheter ablation. The overall sinus rhythm maintenance rate was 2/3. In addition, 1 out of the 3 AF patients (1/3) developed recurrence of AF at 3 month after ablation, and 2 out of the 6 AFL or AT patients (2/6) developed late recurrence of AF or AFL (19 months and 29 months after ablation), two out of three patients with recurrent AFs or AFL received repeated catheter ablation and one patient remained sinus rhythm post repeat ablation. Meanwhile, there was no recurrence of atrial myxoma, no death, stroke, acute myocardial infarction and other events during the entire follow-up period. Conclusions: Catheter ablation is a safe and feasible therapeutic option for patients with new-onset atrial arrhythmia after surgical excision of left atrial myxoma.

Chinese Medicine Involving Triple Rehabilitation Therapy for Knee Osteoarthritis in 696 Outpatients: A Multi-Center, Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To determine the effects of Chinese medicine (CM) involving triple rehabilitation therapy on the progression of knee osteoarthritis (KOA).@*METHODS@#A total of 722 patients recruited from 38 community health service centers located in China from March 2013 to March 2017 were randomly divided into treatment and control groups equally, using a cluster randomization design. Health education combined with CM involving triple rehabilitation therapy for KOA (electro-acupuncture, Chinese medicinal herb fumigating-washing, and traditional exercises) was administered in the treatment group while conventional rehabilitation therapy (physical factor therapy, joint movement training, and muscle strength training) was administered in the control group. Patients with a visual analog scale (VAS) scores ≽4 were treated with dispersible meloxicam tablets (7.5 mg, once daily). The Lequesne index scores, VAS scores, range of motion (ROM), lower limb muscle strength, knee joint circumference, quantitative scores of KOA symptoms, and the short-form 36 item health survey questionnaire (SF-36) scores were measured for each patient at 5 checkpoints (before treatment, at the 2nd week and the 4th week during the 4-week treatment period, at 1 month and 3 months after end of treatment), and adverse reactions were observed also.@*RESULTS@#A total of 696 patients completed the entire process, with 351 in the treatment group and 345 in the control group. At all treatment checkpoints, the treatment group demonstrated better outcomes than the control group with regard to the total Lequesne index scores, effective rate and improvement rate of the total Lequesne index scores, VAS scores, lower limb muscle strength, knee circumference, quantitative scores of KOA symptoms, and SF-36 scores as well (P<0.05 or P<0.01). No adverse reactions were encountered in this study.@*CONCLUSIONS@#CM involving triple rehabilitation therapy can alleviate KOA-related pain and swelling, improve lower limb muscle strength, promote flexion and activity of the knee and improve the quality of life in patients undergoing KOA. It is suitable for patients with early or mid-stage KOA. (Registration No. ChiCTR-TRC-12002538).

Regulatory effect of CCN3 on proliferation of mouse embryonic fibroblasts and its mechanism / 南方医科大学学报

OBJECTIVE@#To investigate the role of NOV/CCN3 in regulating the proliferation of mesenchymal stem cells (MSCs) and its regulatory mechanism and assess the value of CCN3 as a proliferative factor in bone tissue engineering.@*METHODS@#Mouse embryonic fibroblasts (MEFs) were used as the MSC model, in which CCN3 expression was up-regulated and downregulated by transfection with the recombinant adenovirus vectors Ad-CCN3 and Ad-siCCN3, respectively. Flow cytometry was used to analyze the changes in cell cycle and apoptosis of the transfected cells. Western blotting was used to detect the expression levels of the proliferation indicators (PCNA, cyclin E, and cyclin B1) and the apoptosis indicators (Bax and Bcl-2) to assess the effect of modulation of CCN3 expression on MEF proliferation and apoptosis. CCN3 protein secretion by the cells was detected using ELISA. RT-qPCR and Western blotting were employed to analyze the changes in the expressions of Notch1, ligand DLL1, the downstream key proteins or genes (Hey1, P300, H3K9) and MAPK pathway-related proteins ERK1+2 and p-ERK1+2.@*RESULTS@#Flow cytometry showed that compared with the control cells, MEFs transfected with Ad-CCN3 exhibited significantly increased cell proliferation index (@*CONCLUSIONS@#CCN3 over-expression promotes the proliferation and inhibits apoptosis of MEFs possibly by inhibiting the classical Notch signaling pathway and activating the MAPK pathway

Effects of dexamethasone on neutrophil airway inflammation and HMGB1 expression in asthmatic mice / 解放军医学杂志

Objective: To investigate the effect of dexamethasone intervention on neutrophil airway inflammation and high mobility group box 1 protein (HMGB1) expression in asthmatic mice. Methods: Forty healthy SPF grade female Balb/c mice were randomly divided into four groups (n=10): Control group, Asthma group, 1 mg/kg dexamethasone intervention group and 5 mg/kg dexamethasone intervention group. The asthmatic mice model was induced by egg-free ovalbumin. The airway hyper-responsiveness was measured by the invasive pulmonary function instrument; the number and classification of inflammatory cells in bronchoalveolar lavage fluid (BALF) were detected; lung pathological changes were observed by HE staining; HMGB1 expression was detected by immunohistochemistry and Western blotting. Results: Compared with Control group, the airway responsiveness of asthmatic mice was significantly enhanced (P0.05). Conclusions: The expression of HMGB1 in airway epithelium and lung tissue of asthmatic mice with neutrophilic airway inflammation was significantly increased. After dexamethasone intervention, asthmatic mice still showed higher neutrophilic airway inflammation and expression of HMGB1 in lung tissue, suggesting that HMGB1 may be associated with neutrophilic airway inflammation and glucocorticoid resistance in asthma.

Effect of percutaneous coronary intervention on sleep quality of coronary heart disease patients with obstructive sleep apnea syndrome / 中华全科医师杂志

One hundred and nine consecutive coronary heart disease (CHD) patients with obstructive sleep apnea (OSA) undergoing percutaneous coronary intervention (PCI) during February 2016 to August 2018 were enrolled in the study. After treatment the quality of sleep was improved in 35 cases (observation group) and was not improved in 74 patients (control group). The basic characteristics, coronary lesions of patients were compared between two groups. Compared with the control group, patients in observation group had significant higher proportion of males [80.0%(28/35) vs. 59.5%(44/74), χ2=4.471, P=0.035], smoking history [85.7% (30/35) vs. 63.5% (47/74), χ2=5.647, P=0.018], lower body mass index [(25.8±3.1) kg/m2 vs. (27.4±3.2) kg/m2, t=2.461, P=0.033]. Compared with control group, the observation group had lower coronary Gensini score[(35.4±5.7) vs. (38.7±6.5), t=2.571, P=0.011], less number of stent[ (1.4±0.4) vs. (1.6±0.4), t=2.427, P=0.016]. And the lesions were mostly distributed in the right coronary artery in observation group (61.9%, 26/35) (χ2=11.759, P=0.003).Conclusion@#The improvement of sleep quality by PCI depends on the clinical features and coronary artery lesions of CHD patients with OSA.

Effect of Tongfengning on Expression of Renal Urate Transporter in Hyperuricemia Rats / 中国实验方剂学杂志

Objective:Study on the mechanism of Tongfengning in promoting uric acid excretion from the perspective of urate transporter and mRNA in renal of hyperuricemia （HUA） model rats. Method:The 80 sprague-dawley rats were randomly divided into two groups， the blank group with 20 rats and the model group with 60 rats. Rats in model group were established as hyperuricemia （HUA） models by intraperitoneal injection of oxonic acid potassium salt （OAPS） and intragastric administration ethambutol hydrochloride （EMB） once a day for 21 days. After successful modeling， rats in the model group were divided into the model group， Tongfengning group and benzbromarone group， with 20 rats per group. Tongfengning solution （15.3 g·kg-1·d-1） was administered to the Tongfengning group by gavage feeding. Rats in benzbromarone group were administered 5.2 mg·kg-1·d-1 benzbromarone suspension， whereas those in the blank group and the model group were administered the equivalent amount of normal saline for 21 days. On days 14th and 21st following intervention， urine， blood， and kidney were collected from rats， serum uric acid （SUA） and urinary uric acid （UUA） levels， blood urea nitrogenand（BUN） and creatinine（CRE） levels and the expression of urate transporter proteins and their mRNAs of all rats were detected by enzyme-colorimetric method， urease method， sarcosine oxidase method， Western blot and Real-time quantitative PCR（Real-time PCR）， respectively. Result:On days 14th and 21th following intervention， compared with blank group， SUA， CRE and BUN levels， and urate transporter 1（URAT1），glucose transporter 9（GLUT9） expression increased（P<0.05，P<0.01）， whereas UUA level， and adenosine triphosphate-binding cassette transporter protein G2（ABCG2）， organic anion 1（OAT1）， organic anion 3（OAT3） expression decreased in the model group（P<0.05，P<0.01）. Compared with model group， SUA， CRE and BUN levels， and URAT1， GLUT9 expression decreased in Tongfengning group and the benzbromarone group（P<0.05）， whereas UUA level， and ABCG2， OAT1， OAT3 expression increased（P<0.05）. Creatinine and BUN levels decreased in the Tongfengning group（P<0.05，P<0.01）， with the trend much better than the benzbromarone group（P<0.05）. On day 21st， except for the BUN level did not change much compared with day 14th， all the rest indicators got improved obviously. Conclusion:Intraperitoneal injection of OAPS and intragastric administration of EMB can cause HUA models with renal dysfunction. Tongfengning reduced URAT1， GLUT9 mRNA and protein expression， and upregulated ABCG2， OAT1， OAT3 mRNA and protein expression in the rat kidney， which may be one of the mechanisms of promoting uric acid excretion. Tongfengning has a certain protective effect on renal function.

Effect of percutaneous coronary intervention on sleep quality of coronary heart disease patients with obstructive sleep apnea syndrome / 中华全科医师杂志

One hundred and nine consecutive coronary heart disease (CHD) patients with obstructive sleep apnea (OSA) undergoing percutaneous coronary intervention (PCI) during February 2016 to August 2018 were enrolled in the study. After treatment the quality of sleep was improved in 35 cases (observation group) and was not improved in 74 patients (control group). The basic characteristics, coronary lesions of patients were compared between two groups. Compared with the control group, patients in observation group had significant higher proportion of males [80.0%(28/35) vs. 59.5%(44/74), χ 2=4.471, P=0.035], smoking history [85.7% (30/35) vs. 63.5% (47/74), χ 2=5.647, P=0.018], lower body mass index [(25.8±3.1) kg/m 2vs. (27.4±3.2) kg/m 2, t=2.461, P=0.033]. Compared with control group, the observation group had lower coronary Gensini score[(35.4±5.7) vs. (38.7±6.5), t=2.571, P=0.011], less number of stent[ (1.4±0.4) vs. (1.6±0.4), t=2.427, P=0.016]. And the lesions were mostly distributed in the right coronary artery in observation group (61.9%, 26/35) (χ 2=11.759, P=0.003). Conclusion:The improvement of sleep quality by PCI depends on the clinical features and coronary artery lesions of CHD patients with OSA.

Standard Decoction of Saposhnikoviae Radix Pieces / 中国实验方剂学杂志

Objective:To prepare standard decoction of Saposhnikoviae Radix pieces,and conduct a study on the quality standards, in order to provide the scientific reference for the study of clinical application and other decoction standard decoctions. Method:By the traditional water decocting method,11 batches of standard decoction of Saposhnikoviae Radix pieces were prepared to determine pH,prim-O-glucosylcimifugin and 4'-O-β-D-glucosyl-5-O-methylvisamminol content,calculate the paste rate and transfer rate,and investigate the feasibility of the measurement method. An analytical method for HPLC fingerprint was established. Hypersil ODS2 column (4.6 mm×250 mm,5 μm) was adopted and eluted with methanol-water as the mobile phase in a gradient mode. The detection wavelength was 254 nm,the flow rate was 1 mL·min-1,and the column temperature was 25℃. The fingerprint analysis method was used to evaluate the similarity of the 11 batches of standard decoction of Saposhnikoviae Radix pieces. Result:Through the determination of 11 batches of standard decoctions of Saposhnikoviae Radix pieces,the average pH value was 5.5,the paste-out rates were between 34.3% and 46.3%,and the average paste-out rate was 41.4%,the standard deviation was 3.7%, the transfer rate of prim-O-glucosylcimifugin was 66.8%-93.5%,the average metastasis rate was 79.4%,the standard deviation was 12.1%, the transfer rate of 4'-O-β-D-glucosyl-5-O-methylvisamminol was 70.4%-98.2%,the average transfer rate was 83.40%,the standard deviation of 10.8%. The results of various methodological studies were consistent with the requirements of RSD. The fingerprinting analysis was performed using similarity evaluation software for traditional Chinese medicine fingerprints,and 9 principal common peaks were identified. The similarity was higher than 0.9. Conclusion:The quality evaluation method established in this study has a good stability,precision and repeatability. The fingerprints have a high similarity,which is suitable for the quality evaluation of standard decoctions of Saposhnikoviae Radix pieces, and can provide the scientific basis for the quality evaluation of other related preparations.

Effect of Tongfengning Serum Containing on Expression of Urate Transporter in HK-2 Induced by Uric Acid / 中国实验方剂学杂志

Objective: Study on the mechanism of Tongfengning in reducing serum uric acid from the perspective of renal urate transporter. Method: The human renal tubular epithelial cells(HK-2)was randomly divided into normal group, model group, Tongfengning low, medium and high dose group (7.65,15.3,30.6 g·kg-1) and benzbromarone group (50 μmo1·L-1),different culture media were given for intervention.HK-2 and cell supernatant were collected after 24 h of intervention. The expressions of urate transporter 1 (URAT1), glucose transporter 9 (GLUT9), organic anion transporter 1(OAT1), organic anion transporter 3(OAT3), and ATP-binding cassette superfamily G member 2 (ABCG2) protein and mRNA were detected in HK-2 of all groups by Western blot and Real-time PCR. Result: Compared with normal group, the expression of URAT1, GLUT9 protein and mRNA was significantly increased(PPPPPConclusion: Tongfengning can regulate the reabsorption and secretion of uric acid in renal tubules, promote the excretion of uric acid in kidney and reduce the level of serum uric acid by down-regulating the expression of URAT1, GLUT9 protein and mRNA in HK-2 and up-regulating the expression of ABCG2 protein and mRNA. It is suggested that the regulation of renal uric acid transporter protein may be one of the specific mechanisms of Tongfengning to reduce serum uric acid by promoting dampness and turbid removal. OAT1, OAT3 protein and mRNA were not expressed in HK-2 cultured in vitro.

Feasibility and efficacy of percutaneous pulmonary vein stenting for the treatment of patients with severe pulmonary vein stenosis due to fibrosing mediastinitis / 中华心血管病杂志

Objective@#To evaluate the feasibility and safety percutaneous pulmonary vein intervention in patients with severe pulmonary vein stenosis (PVS) caused by fibrosing mediastinitis(FM).@*Methods@#This retrospective analysis included 5 FM patients (2 male, 3 female, 54-77 years old) confirmed by clinical presentation and chest computed tomography (CT) scan from January to June 2018 who were from Gansu Provincial Hospital and Shanghai Chest Hospital. CT pulmonary angiography (CTPA) further revealed severe PVS caused by fibrotic tissue compression in mediastinum. After selective pulmonary vein angiography, gradually balloon angioplasty was used to expand the pulmonary vein and then stents were implanted in the pre-dilated stenotic pulmonary veins. Evaluation of therapeutic effect was made at 6 months after the procedure.@*Results@#All of 11 serious compression PVS were treated with stent implantation (diameter: 7-10 mm, length: 17-27 mm). After stenting, degree of pulmonary vein stenosis decreased from (83±16)% to (12±4)% (P<0.01). The minimal diameter of the stenotic pulmonary vein was significantly increased from (0.8±0.5)mm to (7.5±0.8)mm (P<0.01). Trans-stenotic gradient decreased from (27.0±15.1)mmHg (1 mmHg=0.133 kPa) to (2.50±0.58)mmHg (P<0.05). Mean pulmonary pressure measured by cardiac catheter decreased from (45.0±9.0)mmHg to (38.7±8.4)mmHg (P<0.05). One patient experienced cardiac arrest due to vagal nerve reflex during big sizing balloon stent dilation and recovered after cardiopulmonary resuscitation. There were no other serious procedure related complications. During the follow-up, severe stenosis at end of proximal stent was evidenced in 1 patient due to fibrotic compression, and another patient developed in-stent thrombosis due to discontinuation of prescribed anticoagulant.@*Conclusion@#Percutaneous intervention for severe pulmonary vein stenosis caused by FM is feasible and safe, and can improve hemodynamic caused by the compression of mediastinal vascular structures in these carefully selected patients.

Clinical effects of nasal glabellar flap on reconstruction of nasal dorsal and tip / 中华医学美学美容杂志

Objective To introduce an excellent one-stage procedure for repairing defects of the middle and distal part of the nose:nasal dorsal glabellar flap.Methods According to the size,shape and location of nasal defect,homologous nasal dorsal glabellar flap was selected to cover the nasal defect in 17 cases.Among 17 cases,there were 7 men and 10 women,with age of 38 to 76 years.The locations were nasal tip in 9 cases and dorsum of nose in 8 cases,The area of the defect ranged from 15 mm× 15 mm to 30 mm× 26 mm.The nasal dorsal glabellar flap,which received a versatile axial blood supply from branches of the facial artery and ophthalmic artery,took tissue from the lax glabellar skin and might appear to be too aggressive for closure of a distal nasal or mid-nasal defect.However,because its design was primarily that of a rotation flap with a back-cut in the glabella region,it was greater than the primary defect in order to maximize tissue movement and decreased wound closure tension at the flap donor site.The secondary defect of donor site was directly sutured.Results The nasal defect was successfully repaired in all patients,and the all flaps survived.The patients were available for follow-up of 1 to 6 months,no tumor recurrence occurred,and the repaired tissue were good match with surrounding tissue in color,thickness and texture,good nasal contour was obtained and no secondary deformity occurred,and therefore the cosmetic results were satisfactory.Conclusions The nasal glabellar flap has evolved into a choice flap for nasal defects of cover since it provides local skin with an exact color,thickness,and texture match for the nasal skin.It allows large reconstructions for up to 30 mm defects leaving minimal scars.It represents an interesting alternative for the reconstruction of defects of the nasal tip or supra tip of the nose.

Clinical characteristics of invasive pulmonary aspergillosis in non-neutropenic patients / 医学研究生学报

Objective In recent years, the incidence of invasive pulmonary aspergillosis (IPA) in non-neutropenic patients has been increasing. Most previous studies have focused on the diagnosis and treatment of IPA in severely immunocompromised patients. The purpose of this study was to investigate the clinical characteristics of IPA in non-neutropenic patients. Methods We enrolled 183 IPA patients (including 46 proven IPA cases and 137probable IPA cases) admitted to our hospital from 2008 to 2018, after excluding possible IPA cases and neutropenic cases. The clinical and laboratory data were collected and analyzed. Results In this study, 164 (89.6%) patients had underlying diseases and risk factors, among which chronic obstructive pulmonary disease and prolonged steroid treatment were the most common. Cough (79.8%), dyspnea (71.0%), sputum (68.9%)and fever (61.2%) were the common symptoms. Chest CT findings were mainly consolidation (45.9%), nodule (32.8%), ground-glass opacity (29.0%) and cavity (26.8%). The halo sign (8.2%) and air crescent sign (7.1%) were relatively rare. The mean numbers of leucocyte and neutrophils were 14.6×109/L and 10.2×109/L, respectively. Positive rates of sputum culture and bronchoalveolar lavage fluid culture were 32.5% and 35.1%, respectively. Positive rates of galactomannan (GM) antigen test in serum and bronchoalveolar lavage fluid samples were 55.2% and 77.1%, respectively. Transthoracic needle biopsy and transbronchial lung biopsy were associated with positive rates of 45.3% and 20.6%, respectively. Conclusion The clinical and imaging features of IPA in non-neutropenic patients are atypical. Compared with sputum culture and GM antigen test in serum, alveolar lavage fluid GM test has higher sensitivity which can assist in definitive diagnosis.

Application of camouflage therapy in vitiligo / 中华皮肤科杂志

At present,specific targeted treatment of vitiligo is still lacking,and there are many limitations of current therapies,such as slow repigmentation process,long duration of treatment and frequent recurrence.As a therapeutic strategy for rapidly improving the appearance of patients,camouflage therapy has a unique advantage in the treatment of various skin diseases.Several studies in China and other countries have shown that the correct use of cosmetic camouflage can effectively improve the appearance and quality of life of patients with vitiligo.This review summarizes the knowledge about various camouflage therapies and related clinical researches on the relationship between camouflage therapies and quality of life of patients with vitiligo,and elaborates application prospects of camouflage therapies in the treatment of vitiligo.

Clinical Value of Minimally Invasive Bridging for the Lateral Malleolar Fractures in the Open Comminuted Ankle Fractures with Dislocation / 中国医学科学院学报

To evaluate the effectiveness of minimally invasive bridging for the lateral malleolar fractures in the open comminuted ankle fractures with dislocation. Methods The clinical data of 24 patients [19 males and 5 females aged 40 to 65 years,mean(47.5±8.6)years] with open comminuted ankle fractures with dislocation who were treated in the Second Hospital of Tangshan from September 2015 to June 2017 were retrospectively analyzed.All patients were treated with minimally invasive bridging for the lateral malleolar fractures.The ankle function after treatment was assessed with the Olerud Molander Ankle(OMA)score. Results All the 24 patients were followed up from 12-26 months [mean:(14.5±2.6)months].Good fracture union was achieved in all patients after 2 - 5 months(mean:3 months).No deep infection,skin necrosis,or bone nonunion occurred after 12 months of follow-up.Only one patient suffered from partial skin necrosis at lateral malleolus,which was cured after changing wound dressings.The OMA score was 93.5(range:85-100)after 12 months(excellent in 19 cases and good in 5 cases). Conclusions Minimally invasive bridging for the lateral malleolar fractures is effective in treating the open comminuted ankle fractures with dislocation.It can obtain good reduction and fixation,reduce complications,and achieve high union rate.

Successful simultaneous surgery for patient with insulinoma and parathyroid adenoma relevant to multiple endocrine neoplasia type 1: A case report / 中南大学学报(医学版)

Multiple endocrine neoplasia type 1 (MEN1) is an autosomal dominant disorder. A 44-year-old man visited second Xiangya Hospital, Central South University due to hypoglycemia. He was eventually diagnosed as MEN1. A novel homozygous frameshift for c.640-643delCAGA (p.V215Mfs*13) of MEN1 gene was identified in the patient. After MDT (Multiple Disciplinary Team), open bilateral exploration with total parathyroidectomy and autotransplantation as well as partial pancreatectomy excision of all the macroscopic pancreatic tumors were performed at the same time. The patient recovered well. Individualized diagnosis and treatment are important for MEN1 patients.

Effects and mechanism of apolipoprotein A5 on adipogenic differentiation of human adipose-derived mesenchymal stem cells / 中华心血管病杂志

Objective@#To investigate the effect and related mechanism of apolipoprotein A5 (ApoA5) on adipogenic differentiation of human adipose-derived mesenchymal stem cells (AMSC).@*Methods@#Subcutaneous adipose tissue was obtained from 40 patients undergoing abdominal surgery at our hospital from February to July 2015. After induction of human AMSC by collagenase digestion, the adipose tissue was induced to differentiate into mature adipocytes and treated with ApoA5 at 600 and 1 200 ng/ml, respectively (ApoA5 intervention groups). Cells treated without ApoA5 protein were used as control group. The cells were harvested on the 7th and 14th day of differentiation, and the following assays were performed: (1) the effect of ApoA5 on TG content was measured by a TG assay kit; (2) RT-qPCR assay was used to detect the effect of ApoA5 on aP2 and FAS mRNA expression; (3) the effect of ApoA5 on the expression of CIDEC mRNA and protein was detected by RT-qPCR and Western blot; (4) the effect of ApoA5 on the expression of C/EBPβ mRNA and protein was detected by RT-qPCR and Western blot; (5) using lentiviral transfection technique, we overexpressed the gene of CIDEC in AMSC and cells were divided into lentiviral negative control group, lentiviral over-expressed CIDEC group and lentiviral over-expressed CIDEC+ApoA5 intervention group (the ApoA5 intervention concentration was 1 200 ng/ml). Thereby, we examined the effect of ApoA5 on the above indicators in adipogenic differentiation of AMSC in the case of CIDEC overexpression.@*Results@#(1) Effect of ApoA5 on TG content in AMSC: on the 7th and 14th day after the intervention, the TG levels were lower in ApoA5 600 and 1 200 ng/ml group AMSC than those in the control group (all P<0.05). (2) The effect of ApoA5 on the expression of aP2 and FAS mRNA in AMSC: on the 7th day after intervention, the expression levels of aP2 and FAS mRNA were significantly lower in ApoA5 600 and 1 200 ng/ml group than those in the control group (all P<0.05). On the 14th day after intervention, the expression levels of aP2 and FAS mRNA were lower in ApoA5 600 and 1 200 ng/ml group than those in the control group (all P<0.05). (3) The effect of ApoA5 on the mRNA and protein expression of CIDEC in AMSC: on the 7th day after intervention, the mRNA and relative protein expression levels of CIDEC were significantly lower in AMSC of ApoA5 600 and 1 200 ng/ml group than those of the control group (all P<0.05). On the 14th day after intervention, the mRNA and relative protein levels of CIDEC were further reduced in ApoA5 600 and 1 200 ng/ml AMSC groups than those in the control group (all P<0.05). (4) The effect of ApoA5 on C/EBPβ mRNA and protein expression in AMSC: on the 7th day after intervention, C/EBPβ mRNA and relative protein expression levels were significantly lower in ApoA5 600 and 1 200 ng/ml group than those in the control group (all P<0.05). On the 14th day after intervention, the levels of C/EBPβ mRNA and relative protein were lower in ApoA5 600 and 1 200 ng/ml group than those in the control group (all P<0.05). (5) The effect of ApoA5 on the content of TG in AMSC after CIDEC overexpression: on the 7th and 14th day after intervention, the TG contents in AMSC were higher in the lentivirus over-expressed CIDEC group than in the lentivirus negative control group (both P<0.05). However, TG contents in AMSC were similar between the over-expressed CIDEC group and the CIDEC+ApoA5 over-expression group (both P>0.05). (6) The effect of ApoA5 on the expression of aP2 and FAS mRNA in AMSC after CIDEC overexpression: on the 7th day after intervention, the expression levels of aP2 and FAS mRNA in AMSC were higher in the lentivirus over-expressed CIDEC group than in the lentivirus negative control group (both P<0.05). On the 14th day after intervention, the expression level of aP2 mRNA in the AMSC was higher in the lentivirus over-expressed CIDEC group than in the lentivirus negative control group (P<0.05). On the 7th and 14th day after intervention, the expression levels of aP2 and FAS mRNA in AMSC were similar between the lentivirus over-expressed CIDEC group and the lentivirus over-expressed CIDEC+ApoA5 group (all P>0.05). (7) The effect of ApoA5 on the expression of C/EBPβ mRNA and protein in AMSC after CIDEC overexpression: on the 7th day after intervention, the mRNA and relative protein expressions of C/EBPβ in AMSC were higher in lentivirus-overexpressed CIDEC group than in lentivirus negative control group (both P <0.05). On the 14th day after intervention, C/EBPβ mRNA and protein expression levels in AMSC were higher in the lentivirus over-expressed CIDEC group than in the lentivirus negative control group (both P<0.05). On the 7th and 14th day after intervention, the expressions of C/EBPβ mRNA and protein in AMSC were similar between lentivirus over-expressed CIDEC group and lentivirus over-expression CIDEC+ApoA5 intervention group (all P>0.05).@*Conclusions@#ApoA5 can inhibit the adipogenic differentiation of AMSC,and this effect may be mediated by down-regulating the expression of CIDEC. Furthermore, our results indicate that CIDEC could be considered as a key factor in adipogenic differentiation.

Effects of apolipoprotein A5 on adipogenic differentiation of human adipose mesenchymal stem cells / 中华心血管病杂志

Objective@#To verify whether Apo A5 could inhibit the adipogenic differentiation of adipose mesenchymal stem cells (AMSCs).@*Methods@#We isolated AMSCs by collagenase digestion method from the adipocyte tissue of patients underwent abdominal surgery in our hospital from February to July 2015. AMSCs were differentiated into mature adipocytes and incubated with Apo A5 (600 and 1 200 ng/ml) for 7, 14 and 21 days. Morphological changes, TG content, and gene expression levels of adipogenic differentiation markers were determined.@*Results@#(1) The results of detecting the oil red O absorbance by spectrophotometer are as follows: At the 7th, 14th and 21st days after intervention, the absorbance of oil red O with 600 and 1 200 ng/ml Apo A5 intervention was lower than that of the control group (Day 7: 145.6±21.1, 110.5±31.5 vs. 195.4±35.7; Day 14: 289.2±24.2, 250.4±45.2 vs. 341.6±34.5; Day 21: 431.9±33.2, 374.7±26.4 vs. 488.2±22.5, all P<0.05). (2) The intracellular TG content after Apo A5 intervention were detected by TG quantitative detection kit detection. At the 7th, 14th and 21st days, intracellular TG contents in 600 and 1 200 ng/ml Apo A5 groups were lower than that in the control group (Day 7:(203.1±22.6), (174.2±25.8)nmol/mg protein in Apo A5 intervention group vs. (266.25±23.7)nmol/mg protein in control group; Day 14: (332.5±23.2), (231.1±22.2)nmol/mg protein in Apo A5 intervention group vs. (452.2±16.4)nmol/mg protein in control group; Day 21: (482.8±21.2), (294.2±29.9)nmol/mg protein vs. (597.2±22.1)nmol/mg protein in control group, P<0.05). (3) aP2 gene expression detected by real-time PCR and intracellular fatty acid synthase and lipid droplets coated protein gene expression levels determined by Western blot on day 7, 14 and 21 were significantly lower in Apo A5 groups than in control group (all P<0.05).@*Conclusions@#Apo A5 significantly reduced intracellular TG content and modulated the gene expression levels of adipogenic differentiation marker, thus, Apo A5 treatment can inhibit the adipogenic differentiation of adipose mesenchymal stem cells.

Combination of ticagrelor and cilostazol for patients with acute coronary syndrome complicated with upper digestive tract diseases following percutaneous coronary intervention / 中华全科医师杂志

Objective To evaluate the efficacy and safety of combined use of ticagrelor and cilostazol for patients with acute coronary syndrome (ACS) complicated with upper digestive tract diseases following percutaneous coronary intervention ( PCI).Methods A total of 262 consecutive ACS patients complicated with upper digestive tract diseases followed-up for one-year after PCI were included in this study.The patients were allocated into control group (combined use of ticagrelor and aspirin , n＝184) and cilostazol group ( combined use of ticagrelor and cilostazol , n ＝78) for antiplatelet treatment.The basic characteristics of the patients , change of the treatment regimens , cardiovascular events and hemorrhagic events were compared between two groups .Results After one year of follow-up, 16.8%(31/184)patients in control group and 3.8%(3/78)in cilostazol group changed antiplatelet regimens (χ2＝8.200,P＝0.004).There was no statistical difference in use of statins and ACEI/ARB between two groups(P＞0.05).The rate of proton pump inhibitor use in control group was significantly higher than that in cilostazol group [82.1%(151/184) vs.52.6%(41/78), χ2＝24.35, P＝0.000].However, the dosage of β-blockers in cilostazol group was significantly higher than that in control group [(39.1 ±12.4) mg vs.(28.6 ±10.1) mg, t ＝7.174,P＝0.000].No statistical difference was found in total cardiovascular events between two groups [21.7%(40/184) vs.12.8%(10/78),χ2＝2.822,P＝0.121].The incidence of gastrointestinal hemorrhage in control group was significantly increased compared with cilostazol group [12.0%(22/184) vs.2.6%(2/78),χ2＝5.807,P ＝0.018], however, there was no significant difference in hemorrhagic events concerning the thrombolysis for myocardial infarction between two groups [17.4%(32/184) vs.9.0%(7/78), χ2＝3.063,P＝0.089].Conclusion Combined use of cilostazol and ticagrelor is effective and safe for ACS patients with gastrointestinal hemorrhage or a higher risk of hemorrhage .