Change laws of water absorption in Chinese herbal pieces and prediction model of relative density for Chinese medicine decoction / 中国中药杂志

This study aims to explore the change laws of water absorption in Chinese herbal pieces and establish the prediction model of relative density for Chinese medicine compound decoction. Firstly, fitted equations of water absorption and decocting time was established by observing the change laws of water absorption in 36 kinds of Chinese herbal pieces in 12 groups(according to the drug-parts) with decocting time. The r value of the mineral group and other type group was 0.691 2 and 0.663 3, respectively. The r value of the remaining 10 groups was 0.802 2-0.925 4. All P values were less than 0.05(n=21). The formula of the amount of water added was optimized by combining the fitted equations with determined water absorption, and the liquid yield could be controlled in a range of 100%±10%. Secondly, it was determined that the liquid density tester could be used for the rapid determination of relative density of Chinese medicine decoction after methodological study and comparison with the pycnometer method. The linear regression equation between the corrected relative density(y) and extraction ratio(%, x) was built by measuring and analyzing the related parameters such as liquid yield, relative density and extraction ratio in 46 kinds of Chinese herbal pieces. The established equation was y=0.041 3x+1.003 7, r=0.930 9(P <0.01, n=46), with linear range of 1.94%-65.75%. Based on this, the prototype model for predicting relative density of Chinese medicine decoction was established, and the relative densities of 8 Chinese medicine decoctions were within the prediction interval of this model in verification. This study lays a foundation for database construction of Chinese medicine decoction, implementation of personalized decocting mode and rapid quality control of Chinese medicine decoction.

Research Progress on Biopharmaceutics of Active Ingredients in Chinese Materia Medica Under Multi-component System / 中国实验方剂学杂志

The biopharmaceutical properties (solubility, permeability, etc.) of active pharmaceutical ingredients are playing an important role in understanding of disposition of drugs in the body, screening of drugs and evaluation of drug delivery system. The active ingredients of Chinese materia medica (CMM) are various and complex, the research on biopharmaceutics provides a train of thought and practical method for the prediction and research on the process of active ingredients from CMM in vivo. The multi-components system is one of the main differences between CMM and chemical medicine, and the study on biopharmaceutics of active ingredients in CMM under multi-components system has become a hot topic. The progress on biopharmaceutics of active ingredients in CMM under multi-components system was reviewed in this article, which may provide the reference for data integration, theoretical induction and system construction in this field, and provide new train of thought for the research on CMM theories and the development of CMM in the perspective of biopharmaceutics.

A retrospective study of epidural and intravenous steroids after percutaneous endoscopic lumbar discectomy for large lumbar disc herniation / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To assess the early curative effect of epidural or intravenous administration of steroids during a percutaneous endoscopic lumbar discectomy (PELD).</p><p><b>METHODS</b>28 consecutive patients who underwent PELD due to large lumbar disc herniation between November 2014 and January 2016 were followed up for 6 months. These patients were divided into two groups according to the treatment they received after PELD. 14 patients (Group A) were treated by PELD and epidural steroids, while the other 14 patients (Group B) were treated by PELD and intravenous steroids. We evaluated the effectiveness by the preoperative and postoperative visual analogue scale (VAS) scores for back and leg pain, and the postoperative Oswestry disability index (ODI) at 3 weeks after surgery via the clinical charts and telephone interview. Postoperative hospital stay and time return to work were investigated as well.</p><p><b>RESULTS</b>There is a significant decrease in VAS (back, leg), ODI, and time return to work (p < 0.05). For VAS (back), Group A showed a significant decrease compared with Group B at 1 day and 1 week after surgery (p = 0.011, p = 0.017). As for VAS (leg), Group A showed a significant decrease compared with Group B at 1 day, 1 week, 3 weeks, and 3 months follow-up examinations (p = 0.002, p = 0.006, p < 0.001, p < 0.001). For ODI, Group A showed a notable decrease compared with Group B (p < 0.001). The postoperative hospital stay in two groups was not statistically different (p = 0.636). But the time return to work in Group A was significantly shorter than that in Group B (p = 0.023).</p><p><b>CONCLUSION</b>Patients who underwent PELD with epidural steroid administration for large lumbar disc herniation showed favorable curative effect compared with those who underwent PELD with intravenous steroid administration.</p>

Clinical application of three-dimensional printing in the personalized treatment of complex spinal disorders / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To investigate the usefulness of three-dimensional (3D) printing in complex spinal surgery.</p><p><b>METHODS</b>The study was conducted from October 2014 to March 2015 in Shenzhen Second Peoples' Hospital and 4 cases of complex severe spinal disorders were selected from our department. Among them one patient combined with congenital scoliosis, one with atlas neoplasm, one with atlantoaxial dislocation, and the rest one with atlantoaxial fracture-dislocation. The data of the diseased region was collected from computerized tomography scans for 3D digital reconstruction and rapid prototyping to prepare photosensitive resin models, which were applied in the treatment of these cases.</p><p><b>RESULTS</b>The use of 3D models reduced operating time and intraoperative blood loss as well as the risk of postoperative complications. Furthermore, no pedicle penetrations or screw misplacement occurred according to the postoperative planar radiographic images.</p><p><b>CONCLUSION</b>The tactile models from 3D printing allow direct observation and measurement, helping the orthopedists to have accurate morphometric information to provide personalized surgical planning and better communication with the patient and coworkers. Moreover, the photosensitive resin models can also guide the actual surgery with the drilling of pedicle screws and safe resection of tumor.</p>

Endovascular Treatment of the Huge Dissecting Aneurysms Involving the Basilar Artery by the Internal Trapping Technique: Technical Note / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The endovascular strategy of the huge dissecting aneurysms involving the basilar artery (BA) is controversial and challenging. This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping (IT) technique.</p><p><b>METHODS</b>We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of Interventional Neuroradiology of Beijing Tiantan Hospital. Clinical and angiographic data were reviewed and evaluated.</p><p><b>RESULTS</b>All patients were treated by the IT technique. That meant the dissecting artery and aneurysm segments were completed occlusion. After the procedure, the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion. Follow-up angiography was performed at 3-6 months or 12-18 months after the endovascular treatment (median 8 months), 14 patients had a good recovery. Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA. After the second treatment, the patient died by the ventricular tachycardia.</p><p><b>CONCLUSIONS</b>The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms, but it is not necessarily the safest or most definitive treatment modality. The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis.</p>

Endovascular treatment of a giant internal carotid artery bifurcation aneurysm with drainage into cavernous sinus / 中华医学杂志(英文版)

This report documents the treatment of a giant aneurysm of the internal carotid artery bifurcation with a fistula to the cavernous sinus, which appeared following closed head trauma. A 39-year-old man suffered from a blunt head trauma in an automobile accident. Two weeks after the trauma, progressive chemosis of left eye was presented. Four months after the trauma, digital subtraction angiography showed an internal carotid artery bifurcation aneurysm, with drainage into the cavernous sinus. The lesion was successfully obliterated with preservation of the parent artery by using coils in conjunction with Onyx. Follow-up angiography obtained 3 months postoperatively revealed persistent obliteration of the aneurysm and fistula as well as patency of the parent artery. Endovascular treatment involving the use of coils combined with Onyx appears to be a feasible and effective option for treatment of this hard-to-treat lesion.

Vibration test for evaluating the spinal stability following fixation of thoracolumbar burst fracture in pigs / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the feasibility of vibration test in evaluation of spinal stability after instrument fixation of thoracolumbar burst fracture in pigs.</p><p><b>METHODS</b>Twenty-one porcine spines (T11 to L5) were impacted longitudinally with different energy levels to simulate thoracolumbar burst fracture. The fractures were fixed by Luque, Harrington, Steffee and Kaneda techniques, and the anterior-posterior, lateral and vertical spinal stability was analyzed using vibration test.</p><p><b>RESULTS</b>In the mild injury group, vibration test showed that only the first order frequency showed marked anterior shift in the vertical direction (P<0.05) but the main frequency did not, suggesting loosening between the vertebrae. In moderate- or high-energy impact groups, the main frequency markedly shifted forward in the vertical and anterior-posterior directions (P<0.05 or P<0.01), and obvious lateral shift was observed only in high-energy impact group.</p><p><b>CONCLUSION</b>The dynamical characteristics of the spine indicate that the main frequency markedly shift after instrument fixation (except for Luque) of thoracolumbar burst fracture, suggesting the feasibility of vibration test for evaluating spinal injury severity and instrument fixation.</p>

Hemodynamic effects of stenting on wide-necked intracranial aneurysms / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Stent placement has been widely used to assist coiling in cerebral aneurysm treatments. The present study aimed to investigate the hemodynamic effects of stenting on wide-necked intracranial aneurysms.</p><p><b>METHODS</b>Three idealized plexiglass aneurismal models with different geometries before and after stenting were created, and their three-dimensional computational models were constructed. Flow dynamics in stented and unstented aneurismal models were studied using in vitro flow visualization and computational fluid dynamics (CFD) simulations. In addition, effects of stenting on flow dynamics in a patient-specific aneurysm model were also analyzed by CFD.</p><p><b>RESULTS</b>The results of flow visualization were consistent with those obtained with CFD simulations. Stent deployment reduced vortex inside the aneurysm and its impact on the aneurysm sac, and decreased wall shear stress on the sac. Different aneurysm geometries dictated fundamentally different hemodynamic patterns and outcomes of stenting.</p><p><b>CONCLUSIONS</b>Stenting across the neck of aneurysms improves local blood flow profiles. This may facilitate thrombus formation in aneurysms and decrease the chance of recanalization.</p>

Experimental study on treatment of systemic lupus erythematosus with langchuang-3 granule / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the mechanism of action of Chinese drug Langchuang-3 Granule (LC-3) in treating systemic lupus erythematosus (SLE) through observing its effects on body weight (BW), antinuclear antibody (ANA), spleen index and thymus index in BXSB SLE model mice, as well as the deposition of immune complex in mice' renal glomeruli.</p><p><b>METHODS</b>SLE model mice were randomized into 4 groups: the control group (A), the LC-3 treated group (B), the Western drug treated group (C), and the LC-3 combined Western drug treated group (D). BW of mice was dynamically observed; spleen index (SI) and thymus index (TI) were measured by weighting method; serum anti-ANA level was detected by ELISA; IgG and complement C3 in renal glomeruli were analysed by direct immunofluorescence.</p><p><b>RESULTS</b>BW of mice remarkably increased after treatment in Group B and D, showing a significant difference to that in Group A (P < 0.05). Lower TI level and higher SI level were found in the model mice. As compared with Group A, TI was higher in Group B and D, SI was lower in Group D, and both indices were lower in Group C (P < 0.05 or P < 0.01). Level of ANA decreased (converting from positive to negative) remarkably in all the three treated groups (P < 0.01). The fluorescence intensity of IgG and C3 in the renal tissue was weaker in Group B, C (both P < 0.05) and D (P < 0.01) than that in Group A.</p><p><b>CONCLUSION</b>Both LC-3 and Western medicine showed remarkable effects in treating SLE model mice, and the combination of the two could display an effect better than that of using either alone.</p>

Embolization of brain arteriovenous malformations with ethylene vinyl alcohol copolymer: technical aspects / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Endovascular therapy plays an important role in the treatment of brain arteriovenous malformations (BAVMs). Ethylene vinyl alcohol copolymer (Onyx) is a novel liquid embolic material. This study aimed to summarize our experience of using Onyx for embolization of BAVMs with the focus on embolization technique.</p><p><b>METHODS</b>From September 2003 to November 2007, 115 patients (43 women and 72 men, with a mean age of 29 years) with BAVMs were endovascularly treated with Onyx in our department. The following features of all AVMs were evaluated prior to treatment: type of nidus and shunt, draining veins, and feeding arteries. A total of 196 endovascular procedures were performed.</p><p><b>RESULTS</b>The course of endovascular treatment was completed in 88 patients. Additional sessions were planned in 27 patients. Of the 88 patients, total occlusion was obtained in 23 patients (26.1%), near-total (> 80% of the original volume) occlusion was obtained in 35 patients (39.8%) and partial occlusion (< 80% of the original volume) was obtained in 30 patients (34.1%) using embolization as the sole therapeutic technique. Mean volume reduction was 72% (range 30% - 100%) in 115 patients. Thirty four patients (38.6%, 34/88) underwent radiosurgical treatment. Additional embolization sessions were planned in 27 patients. Complications occurred in 19 patients (16.5%, 19/115), leading to death in one patient (mortality 0.9%) and permanent disabling in 3 patients (morbidity 2.6%).</p><p><b>CONCLUSIONS</b>Onyx was shown to be feasible and safe for embolization of BAVMs. Proper use of the Onyx injection technique largely improved the endovascular treatment of BAVMs. Large AVMs can be adequately reduced in size through the use of additional treatment.</p>

Endovascular treatment of wide-necked intracranial aneurysms using of "remodeling technique" with the HyperForm balloon / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Aneurysms with wide-necked or a large neck/fundus ratio, especially located on an arterial bifurcation or a small artery, are challenges for interventional neuroradiologist because of the risk of coil migration or coil protrusion into the parent vessels. Our study was designed to improve the efficacy and safety of the "remodeling technique" with the HyperForm balloon for these difficult aneurysms and was confirmed by a follow-up result.</p><p><b>METHODS</b>From June 2004 to September 2006, forty-two patients (20 men, 22 women) with wide-necked or large neck/fundus ratio aneurysms were treated by using the "remodeling technique" with the HyperForm balloon.</p><p><b>RESULTS</b>Forty wide-necked aneurysms were successfully treated with the HyperForm balloon remodeling technique with only two failed cases. Final results consisted of total occlusion in 34 cases (80.9%), subtotal in 4 (9.5%) and incomplete in 2 (4.8%). One aneurysmal rupture occurred, but no clinical consequence was shown. No thromboembolic events were observed during treatment. Final angiographic follow-up time ranged from 3 to 18 months.</p><p><b>CONCLUSIONS</b>The "remodeling technique" with the HyperForm balloon is a very useful tool in the treatment of wide-necked or unfavorable neck/fundus ratio intracranial aneurysms-located on an arterial bifurcation or a small artery and, especially, located on the bifurcation of a large artery and a small one. In our experience, this technique provided a safe and efficient treatment for difficult aneurysms when the standard remodeling technique might have failed.</p>

A novel arterial pouch model of saccular aneurysm by concomitant elastase and collagenase digestion / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>BACKGROUND</b>An ideal aneurysm model of cerebral aneurysm is of great importance for studying the pathogenesis of the lesion and testing new techniques for diagnosis and treatment. Several models have been created in rabbits and are now widely used in experimental studies; however, every model has certain intrinsic limitations. Here we report the development of a novel saccular aneurysm model in rabbits using an arterial pouch that is subject to in vitro pre-digestion with combined elastase and collagenase.</p><p><b>METHODS</b>A segment of right common carotid artery (CCA) was dissected out and treated with elastase (60 U/ml, 20 min) followed by type I collagenase (1 mg/ml, 15 min) in vitro. The graft was anastomosed to an arterial arch built with the left CCA and the remaining right CCA, while the other end of the graft was ligated. The dimension and tissue structure of the pouch were analysed immediately, 2 or 8 weeks after operation.</p><p><b>FINDINGS</b>Ten terminal aneurysms were produced. The gross morphology of the aneurysm resembles the human cerebral terminal aneurysms. We have observed the following pathological changes: (1) growth of the aneurysm (mean diameter increased from (2.0+/-0.1) to (3.2+/-0.3) mm at 2 weeks, P<0.001, n=7-10); (2) thinning of the aneurysmal wall (the mean wall thickness decreased to 44% at 2 weeks), which was accompanied by significant losses of elastic fibres, collagen and the cellular component; and (3) spontaneous rupture (3 out of 9, one aneurysm ruptured 24 h after operation with the other two at 2 and 4 weeks respectively).</p><p><b>CONCLUSION</b>This rabbit arterial pouch model mimics human cerebral aneurysms in relation to morphology and histology. In particular, this model exhibited an increased tendency of spontaneous rupture.</p>

Evaluation of oxidative stress in experimental rabbit aneurysms / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the roles of oxidative stress in the generation and development of aneurysms.</p><p><b>METHODS</b>Five terminal aneurysms and 8 lateral aneurysms were rebuilt on rabbits, and 6 normal artery vessels were prepared as control. The levels of malondialdehyde (MDA), superoxide dismutase (SOD), and anti-reactive oxygen species unit (anti-ROS unit) were measured with chemical methods.</p><p><b>RESULTS</b>The levels of MDA in terminal and lateral aneurysms were (33.85 +/- 8.66) and (27.87 +/- 5.78) nmol/mg prot, respectively, which were significantly higher than (10.91 +/- 2.72) nmol/mg prot in control group (P < 0.01). The levels of SOD in terminal and lateral aneurysms were (28.30 +/- 3.58) and (33.00 +/- 8.09) U/mg prot, respectively, which were significantly lower than (127.27 +/- 38.72) U/mg prot in control group (P < 0.01). The levels of anti-ROS unit in terminal and lateral aneurysms were (47.86 +/- 5.00) and (62.64 +/- 13.87) U/ mg prot, respectively, which were significantly lower than (116.94 +/- 9.22) U/mg prot in control group (P < 0.01). No significant differences were shown between terminal aneurysm and lateral aneurysm in MDA and SOD except anti-ROS unit (P = 0.014). MDA had negative correlations with both SOD and anti-ROS unit, and the correlation coefficients were -0. 830 and -0. 852, respectively.</p><p><b>CONCLUSION</b>Oxidative stress may play an important role in the development of aneurysms. Oxidative stress seems similar among various aneurysms.</p>

Experimental study and clinical observation of minimum-contact plate in long bone fracture / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study the mechanical properties and the clinical results of minimum-contact plate in the treatment of fractures.</p><p><b>METHODS</b>Four-point bending and torsion tests were conducted to compare the new minimum contact plate (MCP) with dynamic compression plate (DCP) and limited contact dynamic compression plate (LC-DCP). The fracture healing time and growth of bony callus were observed in 29 cases of long bone fracture fixed with MCP to evaluate the advantages of this kind of plate.</p><p><b>RESULTS</b>The 29 patients who underwent MCP were followed up from 6 to 14 months. The average healing time for femoral, tibial and humeral fractures was 12, 13 and 10 weeks, respectively. All fractures were healed. No displacement of fracture, screw pullout, deformation or break of the plate were found.</p><p><b>CONCLUSIONS</b>The bending stiffness of MCP is significantly greater than that of DCP and LC-DCP (P<0.05). MCP can protect the periosteal blood supply against avascular osseous necrosis and accelerate bone healing. It is a kind of reliable and effective plate in treatment of fractures.</p>

Treatment of severe vertebral compressive fractures in the elderly with percutaneous vertebroplasty / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the efficacy of treating severe and chronic vertebral compressive fractures in the elderly with percutaneous vertebroplasty.</p><p><b>METHODS</b>Sixteen patients who suffered from severe back pain and whose daily living was badly affected were retrospectively reviewed. The average age was 72.5 years, the average disease history was 19 months, and the average compressive rate of the affected vertebral bodies was 74.1%.</p><p><b>RESULTS</b>Nineteen affected compressive vertebral bodies in 16 cases were treated with percutaneous vertebroplasty. All the procedures were successful without any complication. After 3.5-7 ml of cement was injected into the lesions, complete relief was achieved in 3 cases, remarkable relief was achieved in 11 cases, and improvement was observed in 2 cases. The scores of 6-point Behavioral Rating Scale and Activity of Daily Living (ADL) declined significantly after the treatment (P < 0.001).</p><p><b>CONCLUSION</b>Percutaneous vertebroplasty can significantly improve the symptoms and quality of life in the elderly patients with severe and chronic vertebral compressive fractures.</p>

Effect of rehabilitation nursing on patients with vertebral body tumor after operation / 中国康复理论与实践

@#ObjectiveTo observe the effect of rehabilitation nursing on patients with vertebral body tumor after operation.Methods12 patients with vertebral body tumor (5 cases of vertebral hemangiomas and 7 cases of vertebral malignant tumors) were operated with percutaneous vertebroplasty combined with psychological nursing,backing nursing,post-procedure function exercises.ResultsThe pain index and motive ability of patients was improved after treatment.ConclusionPercutanous vertebroplasty is effective in the treatment of vertebral benign and malignant tumors and rehabilitation nursing is also playing a important role.

Treatment of vertebral hemangioma with percutaneous vertebroplasty / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the efficacy of percutaneous vertebroplasty in the treatment of vertebral hemangioma.</p><p><b>METHODS</b>Seven patients with vertebral hemangiomas were treated by percutaneous vertebroplasty, including one case of cervical, three cases of thoracic, and three cases of lumbar hemangiomas. The average score of the 6-point behavioral pain rating scale was 2.67 +/- 0.41, and the average score of ambulation was 2.83 +/- 0.33. Guilty vertebral bodies were orientated with fluoroscopy. The procedures were performed under local anesthesia. The image features were also analyzed. Unipedicular or bipedicular approaches were used in 6 cases of thoracic and lumbar hemangiomas. The cervical anterior-lateral approach was adopted in one case of cervical hemangioma. 4-7 ml of 15%-20% bone cement was mixed and injected into the vertebral body to form a cast in the lesions. Re-examination of clinical symptoms, plain film, and CT were made for 1, 3, and 9 months of post-procedure follow-up.</p><p><b>RESULTS</b>Good results were achieved in all the seven cases. Pain was completely relieved in 5 cases and partially relieved in 2 cases. Symptom was also recovered in 2 patients with radiculopathy. No recurrence was found after 1-9 months of postoperative follow-up.</p><p><b>CONCLUSION</b>Treatment of vertebral hemangioma with percutaneous vertebroplasty is safe and effective with minimal invasion.</p>

Embolization of intracranial aneurysms with new mechanically detachable coils / 中国医学科学院学报

<p><b>OBJECTIVE</b>To primarily embolize intracranial aneurysms with new-developed mechanically detachable coils, which is called Detachable Coil System (DCS).</p><p><b>METHODS</b>Five intracranial aneurysms were embolized with DCS, in which 2 were giant aneurysms. DCS with J coils were initially used to make baskets in giant aneurysms, and then other kinds of coils were utilized to pact the aneurysmal cavity. Whereas, spiral coils were mostly used in smaller aneurysms. Coils of DCS were detached by rotating the delivering wire after the coils were satisfactorily positioned in aneurysms.</p><p><b>RESULTS</b>Two of the 5 cases were totally occluded with DCS. Two was sub-totally embolized. Pushing, withdrawal, and adjusting of DCS were safe and efficient. Detachment of DCS was fast. In one case of wide-necked giant aneurysm, coils could not stay inside the aneurysm, which was treated by occlusion of the parent artery.</p><p><b>CONCLUSIONS</b>DCS is a new addition to the interventional radiologist's armamentarium. Detachment is faster. J coils are suitable for giant aneurysms for its unique way of coiling. But more evaluation depends on accumulation of the clinical usage.</p>