T helper cell and regulatory T-cell related cytokines changes in vaginal lavage fluid of patients with high risk-human papilloma virus 16 positive and the predictive effect on the development of cervical neoplasms / 肿瘤研究与临床

Objective:To investigate the changes of T helper cell (Th), regulatory T-cell (Treg cell) related cytokines in vaginal lavage fluid of patients with high risk-human papilloma virus 16 (HR-HPV16) positive and its predictive effect on the development of cervical neoplasms.Methods:A total of 200 cases of HR-HPV16 positive patients who admitted to Xingtai People's Hospital from January 2022 to December 2022 were selected as the experimental group. According to the results of pathological examination, all patients in the experimental group were divided into non pathological group (78 cases), low grade squamous intraepithelial lesion (LSIL) group (49 cases), high grade squamous intraepithelial lesion (HSIL) group (39 cases) and cervical cancer group (34 cases); and 100 healthy people undergoing the physical examination in the same period were taken as the healthy control group. Enzyme-linked immunosorbent assay (ELISA) double-antibody sandwich method was used to detect the levels of interleukin (IL)-2, IL-4, IL-6, IL-10, IL-12, IL-17, tumor necrosis factor α (TNF-α), interferon γ (IFN-γ) and transforming growth factor β (TGF-β) in vaginal lavage fluid of patients in different groups. Multivariate logistics regression was used to analyze the risk factors of cervical cancer, and a nomogram model was established. The receiver operating characteristics (ROC) curve was drawn with pathological results as the gold standard, and the area under the curve (AUC) was calculated to evaluate the predictive ability of the nomogram model.Results:The levels of IL-6, IL-10, IL-17, TNF-α, TGF-β in vaginal lavage fluid of patients in the experimental group were higher than those in the healthy control group, while the levels of IL-2, IL-12 and IFN-γ in the experimental group were lower than those in the healthy control group, and the differences were statistically significant (all P < 0.05); the difference in IL-4 level of both groups was not statistically significant ( P > 0.05). There were statistically significant differences in IL-6, IL-10, IL-17, TNF-α, TGF-β, IL-2, IL-12 and IFN-γ among non pathological group, LSIL group, HSIL group and cervical cancer group (all P < 0.05); the levels of IL-6, IL-10, IL-17, TNF-α, TGF-β in cervical cancer group were the highest, the levels of IL-2, IL-12 and IFN-γ were the lowest; the level of IL-4 in non pathological group, LSIL group, HSIL group and cervical cancer group had no statistically significant difference ( P > 0.05). Logistics regression analysis showed that low IL-2, high IL-4, high IL-6, high IL-10, low IL-12, high IL-17, high TNF-α, low IFN- γ and low TGF-β expressions in vaginal lavage fluid of patients with HR-HPV16 positive were independent risk factors for the development of cervical cancer (all P < 0.05). The results of nomogram analysis showed that IL-6, IL-10, IL-17, TNF-α, TGF-β in vaginal lavage fluid were the factors predicting the development of cervical cancer in HR-HPV16 positive patients. The ROC curve analysis showed that the AUC of nomogram model in predicting the development of cervical cancer in HR-HPV16 positive patients was 0.945 (95% CI 0.901-0.988), and the predictive efficacy was good. Conclusions:Th and Treg cell related cytokines levels in vaginal lavage fluid of patients with HR-HPV16 positive show pathological changes in cervical cancer patients and the above indicators have a high value in predicting the development of cervical cancer.

Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (version 2022) / 中华创伤杂志

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Improvement effect of acupuncture on locomotor function in Parkinson disease via regulating gut microbiota and inhibiting inflammatory factor release / 针灸推拿医学（英文版）

Objective: To observe the effect of acupuncture on the intestinal flora in Parkinson disease (PD) model mice and explore the mechanism of acupuncture in improving the locomotor function in PD. Methods: Thirty-two C57BL/6 mice were randomly divided into a control group, a 1-methyl-4-phenyl-1,2,3,6- tetrahydropyridine (MPTP) group, a MPTP + acupuncture group (MPTP+A), and a MPTP + madopar group (MPTP+M), with 8 mice in each group. Except for the control group, the other groups were intraperitoneally injected [25 mg/(kg·bw)] with MPTP to establish PD mouse models. After successful modeling, the MPTP group received no intervention, the MPTP+A received acupuncture at Tianshu (ST25), Guanyuan (CV4), and Zusanli (ST36), and the MPTP+M was given madopar [125 mg/(kg·bw)] by intragastric gavage. After consecutive 10-day interventions, the intestinal function and behaviors of the mice were detected. The 16S rRNA gene sequence was used to analyze the composition of fecal intestinal flora in each group. Real-time fluorescence quantitative polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay were used to detect the expression levels of inflammatory cytokines in the brain and serum. The expression levels of tyrosine hydroxylase (TH) and α-synuclein in the substantia nigra (SN) were detected by immunohistochemical staining. Toll-like receptor (TLR) 2 and lipopolysaccharide receptor CD14 (CD14) in the SN were determined by RT-qPCR. Myeloid differentiation factor (MyD) 88, nuclear factor kappa-B (NF-κB) and Akt1 in the SN were detected by Western blotting. Results: After the intervention, compared with the control group, the intestinal motility, fecal water content, and the expression of TH in the SN were significantly decreased in the MPTP group (P<0.05), along with an increased α-synuclein expression (P<0.05). Additionally, the results of the fecal microflora test showed that the alpha diversity of the MPTP decreased, and the levels of inflammatory cytokines [tumor necrosis factor (TNF)-α, inducible nitric oxide synthase (iNOS), interleukin (IL)-1β, and IL-6] in the serum and SN, and the expression of NF-κB in the SN were significantly increased (P<0.05). Compared with the MPTP group, acupuncture intervention significantly enhanced the autonomous horizontal movement and coordination ability of PD mice (P<0.05); acupuncture and madopar interventions significantly reduced the levels of α-synuclein, inflammatory cytokines (TNF-α, iNOS, IL-1β, and IL-6) in the serum and SN, and the NF-κB expression in the SN, along with significantly increased alpha diversity richness index (P<0.05). In addition, the relative abundance of Bacteroides increased significantly in the MPTP+A (P<0.05), while the relative abundance of Firmicutes and Cyanobacteria decreased significantly (P<0.05). Conclusion: Acupuncture intervention can improve locomotor function, reduce α-synuclein aggregation and inflammatory factors expression, and increase the Akt signaling pathway in PD mice. In addition, acupuncture intervention can benignly regulate the intestinal flora of PD mice. Therefore, it suggests that acupuncture intervention can protect PD model mice probably by regulating intestinal flora and activating Akt signaling pathway.

Glutamine protects against oxidative stress injury through inhibiting the activation of PI3K/Akt signaling pathway in parkinsonian cell model

BACKGROUND@#Parkinson's disease is a neurodegenerative disorder, and recent studies suggested that oxidative stress contributes to the degeneration of dopamine cell in Parkinson's disease. Glutamine also has a positive role in reducing oxidative stress damage. In this study, we hypothesized that glutamine offers protection against oxidative stress injury in 1-methyl-4-phenylpyridinium (MPP)-induced Parkinson's disease cell model.@*METHODS@#MPP was used to induce PD models in PC12 cells and classified into control, M0 (MPP), G0 (glutamine), and M0+G0 groups. CCK-8 and AO/EB staining assays were used to examine cell proliferation and apoptosis, respectively. Western blotting was applied to examine the protein expression of PI3K, P-Akt, Akt, P-mTOR, and mTOR.@*RESULTS@#We showed that glutamine suppressed cytotoxicity induced by MPP in PC12 cells. MPP decreased the superoxide dismutase and glutathione peroxidase activity and increased the malondialdehyde content, which were restored by glutamine. Moreover, MPP increased the expression of PI3K, P-Akt, Akt, P-mTOR, and mTOR, which were inhibited by glutamine. And the antioxidant capacity of glutamine on PC12 cells could be improved by LY294002 and inhibited by IGF-1.@*CONCLUSION@#These results suggest that glutamine strengthens the antioxidant capacity in PC12 cells induced by MPP through inhibiting the activation of the PI3K/Akt signaling pathway. The effects of glutamine should be investigated and the protective mechanism of glutamine in PD must be explored in future studies.

Preliminary application of 3D printing navigation template in the screw insertion of the suprapubic fracture / 中国综合临床

Objective To introduce the method of using hollow pull screw insertion for the suprapubic fracture with 3D printing navigation template and to evaluate its clinical effect.Methods From March 2016 to August 2017,eighteen cases of suprapubic ramus fractures treated with hollow lag screw fixation in the Department of Orthopedics of Yanan University Affiliated Hospital were retrospectively collected was collected.Before operation,the thin slice CT scan of pelvis was used to get raw data,and the mimics17.0 software was used to reconstruction the model,to design and make the personalized navigation template assisting the suprapubic fractures surgery.The navigation template was printed out pre-operatively,and the nail was inserted via the assisted by the template intra-operatively.After the operation,the fracture reduction was evaluated by Matta imaging scores and the pelvis function was evaluated by Majeed scores.Results All the operations were successfully completed.The Matta scores were excellent in 11 cases,good in 6 cases,and fair in 1 case.The Majeed scores were excellent in 13 cases,good in 3 cases,and fair in 2 cases.Conclusion 3D Printing navigation template assisted the placement of the hollow screw on the suprapubic fracture could provide personalized treatment,reduce the difficulty of operation and satisfy the clinical effect.

Application of G arm X-ray machine in minimally invasive treatment of thoracolumbar vertebral osteoporotic vertebral compression fractures / 中国综合临床

Objective To compare the clinical effects of G-arm X-ray machine and C-arm X-ray machine in percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF) of thoracolumbar spine.Methods The clinical data of ninety-five patients with thoracolumbar OVCF treated with PKP from May 2016 to August 2017 in Yanan University Affiliated Hospital were retrospectively analyzed.They were divided into two groups according to the different guiding fluoroscopy methods used during the operation.Forty-six cases in G arm group completed PKP under the guidance of G arm X-ray machine,Forty-nine cases in C arm group completed PKP under the guidance of C arm X-ray machine.The operation time,fluoroscopy times,cement leakage cases,the height of injured vertebral leading edge,Cobb angle of kyphosis,visual analogue score and Oswestry dysfunction index were recorded before and after operation,and the related indexes were analyzed and compared.Results Two groups of patients were successfully completed surgery,no complications of vascular and nerve injury.The operation time and fluoroscopy times in G arm group were less than those in C arm group (operation time:(29.6±4.5) min vs.(42.5±5.3) min,and fluoroscopy times in G arm group:(9.1±2.0) vs.(16.9±3.2));the difference was statistically significant (t =-12.747,12.870,P＜ 0.01).Postoperative height of injured vertebral leading edge(G arm group (22.3±5.3) mm),C arm group (22.4±5.1) mm),kyphosis Cobb angle (G arm group (9.2±3.8)°,C arm group (9.3±3.7) o),visual analogue score (G arm group (2.1±0.7)points,C arm group (2.2±0.9) points),Oswestry dysfunction index (G arm group (21.3±8.5) points,C arm group(21.5 ± 8.3)points),compared with preoperative(the hight of injured vertebral leading edge of G arm group (18.2 ±5.3) mm,C arm group (18.4±5.2) mm,Cobb angle of injured vertebra G arm group (15.7±4.4) °,C arm group (15.9±4.3) °,visual analogue score of G arm group (7.8± 1.2) points,C arm group (7.7± 1.1) points,Oswestry dysfunction index score of G arm group(41.2±8.3)points,C arm group (41.5±8.2) points),the difference was statistically significant (t =-3.709,-3.844,-7.582,-8.144,27.827,27.088,11.360,11.999,P＜0.01),but there was no significant difference between the two groups (P ＞0.05).Conclusion Using G-arm X-ray machine to assist PKP in the treatment of thoracolumbar spine OVCF can effectively shorten the operation time,reduce the intraoperative fluoroscopy time,and the clinical effect is satisfactory.

Preliminary application of 3D printing individualized plastic guide plate in the treatment of pelvic and acetabular fracture / 中国综合临床

Objective To introduce the application of 3D printing individualized plastic guide plate in the treatment of pelvic and acetabular fracture and to evaluate its application value.Methods From June 2016 to April 2017,the clinical data of eleven adult patients with pelvic and acetabular fracture was analyzed retrospectively.The pelvic CT scan was performed before operation to obtain the original data.Three-dimensional reconstruction performed by mimics 17.0 software with the data and the fracture reduction performed on the software.3D printing individualized plastic guide plate was designed and made to guide the pre-implantation plate bending and shaping.The pre implantation plate bending was completed according to the plastic guide.Postoperative Matta imaging score was used to evaluate fracture reduction,while the function of the hip joint was assessed by the Harris scores.Results All the operations were successfully completed.There were no adverse complications during or after the operation.Anatomical reduction was performed in 10 cases and functional reduction in 1 case.The excellent and good rate of Matta scores was 90.9%,excellent in 7 cases,good in 3 cases,fair in 1 case and no poor case.The excellent rate of Harris scores was 81.8%,excellent in 6 cases, good in 3 cases,fair in 2 cases and no poor case.Conclusion In the treatment of pelvic and acetabular fracture,the application of 3D printing individualized plastic guide plate may not only make mode simple and feasible and save time and materials,but also simplify the operation,reduce the difficulty of operation and hold satisfactory clinical effect.

Effects of treatment on ultrastructure of olfactory bulb and GFAP expression in mice with Parkinson's disease / 中国针灸

OBJECTIVE@#To observe the effects of treatment on the ultrastructure of olfactory bulb and the expression of substantia nigra glial fibrillary acidic protein (GFAP) in mice with Parkinson's disease (PD) induced by lipopolysaccharide (LPS), and to provide methods and evidence for early prevention and treatment of PD.@*METHODS@#Forty C57BL/6 male mice were randomly divided into a blank group, a model group, an electroacupuncture (EA) group and a medication group, 10 mice in each one. The mice in the model group, EA group and medication group were treated with 30-day nasal perfusion of LPS to establish PD model. From the first day of model establishment, the mice in the EA group were treated with electroacupuncture at bilateral "Yingxiang" (LI 20) and "Yintang" (GV 29) for 20 min, once a day; 5-day treatment was taken as one session, and 4 sessions were given with an interval of 2 days between sessions. The mice in the medication group were treated with intraperitoneal injection of L-DOPA, 10 mg/mL, once a day; 5-day treatment was taken as one session, and 4 sessions were given with an interval of 2 days between sessions. After treatment, the behavioristics changes were observed by using footprint analysis and swimming test score; the ultrastructure of olfactory bulb was observed by using transmission electron microscopy; the expression of GFAP in substantia nigra was measured by using western blot method.@*RESULTS@#① After model establishment, the mice in the model group, the EA group and medication group showed significant symptoms of quiver and fear of chill, and the BMI was significantly lower than that in the blank group (all 0.05). ③ After treatment, the footprint and swimming time in the model group were significantly lower than that in the blank group (both <0.01); the footprint and swimming time in the EA group and medication group were significantly higher than those in the model group (all <0.01).④ After treatment, compared with the blank group, the organelles and ultrastructure of olfactory bulb in the model group were significantly improved; the ultrastructure of olfactory bulb in the EA group was improved compared with that in the model group. ⑤ After treatment, the expression of substantia nigra GFAP in the model group was significantly higher than that in the blank group (<0.01); the expression of substantia nigra GFAP in the EA group and medication group was significantly lower than that in the model group (both <0.05).@*CONCLUSION@#The early treatment of can improve behavioral disorders in LPS-induced early PD mice, and the mechanism may be related to the regulation of olfactory disorders and the expression of GFAP in substantia nigra.

Percutaneous kyphoplasty treatment of osteoporotic vertebral compression fracture under the guidance of G-arm X-ray machine / 中国综合临床

Objective To explore the clinical application value of percutaneous kyphoplasty ( PKP ) under the guidance of G arm X ray machine in the treatment of osteoporotic vertebral compression fracture (OVCF). Methods The medical records of eighty-two patients (94 vertebral bodies) with OVCF treated with PKP were collected retrospectively. Thirty-nine cases ( 44 vertebral bodies ) were guided by G-arm X-ray machine to implement PKP,which were recorded as G-arm group. Forty-three cases (50 vertebral bodies) were guided by C-arm X-ray machine to carry out PKP,which were recorded as C-arm group. The operation time, intraoperative fluoroscopy times, bone cement leakage cases, preoperative and postoperative anterior height of injured vertebrae,Cobb angle of injured vertebrae,visual analogue scale scores and Oswestry disability index of the two groups were recorded. Results There was significant difference in operation time and intraoperative fluoroscopy times between the G-arm group and C-arm group (the operation time:(31. 6±5. 2) vs. (45. 8±6. 7) min,the intraoperative fluoroscopy times: (9. 5±2. 3) times vs. (18. 7±3. 5) times,t=-10. 64,-13. 91,P<0. 05) ,while there was no significant difference in the number of bone cement leakage ( P>0. 05) . Compared postoperative and preoperative anterior height of injured vertebrae, Cobb angle of injured vertebrae, visual analogue scale scores and Oswestry disability index scores of G-arm group and C-arm group respectively, the differences were significant ( t=-3. 41 vs. -3. 28, 6. 67 vs. 7. 66, 26. 63 vs. 25. 75 and 10. 41 vs. 11. 90, P<0. 05). There was no significant difference between the two groups (P>0. 05). Conclusion The treatment of OVCF with PKP guided by G-arm X-ray machine could significantly shorten operation time, reduce the intraoperative fluoroscopy times and the operative difficulty,and increase operation safety than PKP guided by traditional C-arm X-ray machine.

Clinical effect of clivo-axial angle in posterior approach for patients with unstable upper cervical spine / 中国综合临床

Objective To investigate the clinical effect of clivo-axial angle(CAA)in the posterior approach for patients with unstable upper cervical spine.Methods Twenty-one patients with unstable upper cervical spine treated with posterior approach surgery from October 2014 to March 2016 were included in this study,and the patients were divided into the decompression group(11 cases)and the non-decompression group (10 cases)according to whether the intraoperative decompression was included.The clivo-axial angle(CAA) were measured by mobile three-dimensional before and after the surgery in order to estimate the reduction of spinal cord compression effect after the posterior cervical surgery combined with the reduction,fixation and bone graft fusion,then to guide the restoration.CT was used to measure the CAA and MR was used to measure the cervico-medullary angle(CMA)before operation and 3 months after operation.Japanese Orthopedic Association (JOA)scores was used to evaluate the neurological function 6 months after operation.Results All patients were followed up for 6-12 months.CMA((156.3±3.6°)vs.(155.9±2.7°))and CAA((154.3±5.1°)vs. (151.3±4.7°))of the decompression group and the non-decompression group at 3 months after surgery were improved significantly compared with those collected before the surgery(CMA:(131.5 ± 0.6°)vs.(131.1 ±0.5°);CAA:(133.2 ± 1.7°)vs.(132.4 ± 1.2°)),the differences were statistically significant(CMA: t=-21.81,P=0.00 vs.t=-28.54,P=0.00;CAA: t=-12.44,P=0.00 vs.t=-11.68,P=0.00).After operation,CAA((152.3 ± 1.3)vs.(132.6 ± 1.5))was significantly improved,compared with that before reduction((131.1±1.9)vs.(132.4±1.5°))(t=-30.09,P=0.00 vs.t=-35.93,P=0.00).JOA scores of the two groups at 6 months after operation((9.8±1.3)points vs.(10.3±1.7)points)were significantly lower than those before the surgery((7.1 ± 0.7)points vs.(7.6 ± 1.1)points),the differences were statistically significant(t=6.01,P=0.00 vs.t=4.36,P=0.00).No complications such as fixed failure,infection,spinal cord injury and vertebral artery injury were found in all patients.Conclusion For patients with upper cervical spine instability,the usage of intraoperative three-dimensional C arm scanning in CAA measurement to determine the effect of spinal cord compression can guide the reduction,simple and feasible,the clinical effect is satisfactory.

Value of 3D printing technique in the treatment of adult displaced clavicle fracture / 中国综合临床

Objective To investigate the clinical value of 3D printing technique in the treatment of adult displaced clavicle fracture.Methods The clinical data of forty adult patients with displaced clavicle fracture treated in Yan' an University Affiliated Hospital from January 2016 to December 2016 were retrospectively collected.According to different surgical methods,the patients were divided into group A and group B,with 20 cases in each group.The group A received the CT scan of the uninjured lateral clavicle before operation to obtain the original data.The mimics 17.0 software was used to perform 3D reconstruction and to generate the affected side mirror model.The 3D printer was introduced to print the affected mirror model.According to the model of preoperative planning,minimally invasive surgery was performed under model guidance.The group B(20 cases)was underwent minimally invasive surgery via conventional C arm fluoroscopy.The operation time,blood loss,fluoroscopy times and postoperative hospital stay in the two groups were recorded.The VAS scores of shoulder joint pain and Neer score of shoulder joint function at 3 days after operation and the last follow-up were recorded.Results All patients received postoperative follow-up for nearly 6 months.The operation time of the two groups were(35.8±11.6)min and(50.1+15.5)min(t=3.303,P=0.002),the intraoperative blood loss were(38.4±9.3)ml and(60.3±10.2)ml(t=7.095,P=0.000), respectively,the fluoroscopy times of the two groups were(5.2±1.6)times and(9.7±2.1)times(t=7.622,P=0.000)respectively,the postoperative hospitalization stay were(6.7±0.5)d and(7±0.6)d(t=1.717,P=0.093),the differences were statistically different.The VAS scores of shoulder joint pain and Neer score of shoulder joint function at 3 days after operation and the last follow-up in both two groups were improved significantly than those in preoperative(P<0.05),while there were no significant differences in the two scores between the two groups(P>0.05).Conclusion 3D printing technique assisting minimally invasive surgery for displaced clavicle fractures in adults has the advantages of shorter operation time,less intraoperative blood loss and less fluoroscopy.The clinical follow-up Results are satisfactory.

Value of 3D printing technique in the treatment of adult displaced clavicle fracture / 中国综合临床

Objective To investigate the clinical value of 3D printing technique in the treatment of adult displaced clavicle fracture.Methods The clinical data of forty adult patients with displaced clavicle fracture treated in Yan' an University Affiliated Hospital from January 2016 to December 2016 were retrospectively collected.According to different surgical methods,the patients were divided into group A and group B,with 20 cases in each group.The group A received the CT scan of the uninjured lateral clavicle before operation to obtain the original data.The mimics 17.0 software was used to perform 3D reconstruction and to generate the affected side mirror model.The 3D printer was introduced to print the affected mirror model.According to the model of preoperative planning,minimally invasive surgery was performed under model guidance.The group B(20 cases)was underwent minimally invasive surgery via conventional C arm fluoroscopy.The operation time,blood loss,fluoroscopy times and postoperative hospital stay in the two groups were recorded.The VAS scores of shoulder joint pain and Neer score of shoulder joint function at 3 days after operation and the last follow-up were recorded.Results All patients received postoperative follow-up for nearly 6 months.The operation time of the two groups were(35.8±11.6)min and(50.1+15.5)min(t=3.303,P=0.002),the intraoperative blood loss were(38.4±9.3)ml and(60.3±10.2)ml(t=7.095,P=0.000), respectively,the fluoroscopy times of the two groups were(5.2±1.6)times and(9.7±2.1)times(t=7.622,P=0.000)respectively,the postoperative hospitalization stay were(6.7±0.5)d and(7±0.6)d(t=1.717,P=0.093),the differences were statistically different.The VAS scores of shoulder joint pain and Neer score of shoulder joint function at 3 days after operation and the last follow-up in both two groups were improved significantly than those in preoperative(P<0.05),while there were no significant differences in the two scores between the two groups(P>0.05).Conclusion 3D printing technique assisting minimally invasive surgery for displaced clavicle fractures in adults has the advantages of shorter operation time,less intraoperative blood loss and less fluoroscopy.The clinical follow-up Results are satisfactory.

Effects of 13-cis-retinoic acid combined with interferon-α2b in mantle cell lymphoma cell lines (Jeko-1) in vitro / 中华血液学杂志

Objectives@#To explore the effects of 13-cis-retinoic acid (13cRA) alone or combined with interferonα-2b (IFNα-2b) for the inhibition of cell growth and apoptosis induction of mantle cell lymphoma cell lines Jeko-1 cells.@*Methods@#Jeko-1 cells were treated by different concentrations of 13cRA alone or combined with IFN-α2b. CCK-8 was used to measure the inhibition effects by different treatments. Cell cycles were analyzed by flow cytometry. Effects on apoptosis were assessed by staining of Annexin Ⅴ/PI. And the levels of Cyclin D1, caspase-9 and Rb proteins were measured by Western blot method.@*Results@#13cRA alone at different doses and its combination with IFNα-2b inhibited Jeko-1 cells growth and induced apoptosis, but the combination had higher inhibition potential and significant apoptosis rate (P<0.05) . The growth inhibition and apoptosis induction in Jeko-1 cells increased significantly with the elevation of drugs concentration and treating duration (P<0.05) . As well as the percentage of Jeko-1 cells at G1/G2 phases increased (P<0.05) and cells at S phase decreased (P<0.05) , the levels of Cyclin D1 and Rb decreased with elimination caspase-9.@*Conclusion@#13cRA, IFN-α2b and their combined administration inhibited cells growth and induced apoptosis, decreased the cell populations at S phase and blocked the cells at G1/G2 phase. Combination of the drugs may have a cooperated action. The therapeutic synergistic effects of 13cRA and IFN-α2b were assumed to lower the expression of Cyclin D1 and Rb proteins, and induce apoptosis by activating caspase-9 pathway.

Clinical efficacy of preoperative osteotomy designs using paper-cut technology versus photoshop software for ankylosing spondylitis with kyphosis / 中国组织工程研究

BACKGROUND: There are various kinds of design methods about preoperative osteotomy of ankylosing spondylitis with kyphosis, but each has their own errors and limitations. A convenient, precise and available method needs to bedeveloped.OBJECTIVE: To compare the clinical efficacy of two different preoperative osteotomy designs using paper-cut andphotoshop software for ankylosing spondylitis with kyphosis.METHODS: Thirty-nine patients suffering ankylosing spondylitis with kyphosis undergoing osteotomy in the Departmentof Spinal Surgery, Affiliated Hospital of Yan'an University between June 2009 and January 2015 were enrolled, andrandomly allotted to paper-cut (n=19) and photoshop (n=20) groups, followed by the preoperative osteotomy design,respectively. All patients were followed for 12-40 months to compare the postoperative osteotomy angle error andcorrection efficacy at the last follow-up between groups.RESULTS AND CONCLUSION: (1) The postoperative osteotomy angle error in the photoshop group was significantly smaller than that in the paper-cut group (P 0.05). (4) To conclude, compared with the osteotomy design usingtraditional paper-cut splice, the photoshop software can achieve a smaller osteotomy angle error and better postoperative balance of spinal sagittal plane, thus providing precise osteotomy for surgeons to obtain proper correction.

Therapeutic effect observation of post-stroke shoulder pain treated with the touching-periosteum needling technique of the meridian muscle region theory / 中国针灸

<p><b>OBJECTIVE</b>To evaluate the pain severity, the motor function of the upper limb and the quality of life in the patients of post-stroke shoulder pain treated with the touching-periosteum needling technique of the meridian muscle region theory.</p><p><b>METHODS</b>One hundred and six cases of post-stroke shoulder pain were randomized into an observation group and a control group, 53 cases in each one. In the observation group, the touching-periosteum needle technique and the rehabilitation training were used on the bases of the theory of meridian muscle region. The points were,,,, Quchi (LI 11), Shousanli (LI 10) and Waiguan (TE 5) on the affected side. The needles were inserted obliquely, at 45°degrees at those extra points to the tendon knots till the needle tips touching periosteum. The needles were manipulated to ensure thearrival and then retained for 30 min. The rehabilitation was applied, such as the anti-spasmodic posture, bridge-style movement on the bed, weight transition and balance training, joint activity maintenance training, passive and active movement of shoulder joint, the training for activities of daily living (ADL) and Bobath technique. In the control group, the routine acupuncture and the rehabilitation training were used. The acupints were Jianyu (LI 15), Binao (LI 14), Jianliao (TE 14), Jianqian (Extra), Quchi (LI 11), Shousanli (LI 10) and Waiguan (TE 5). The rehabilitation training was the same as the observation group. The treatment was given once every day, 6 treatments a week. After 20 treatments, the visual analogue scale (VAS), Fugl-Meyer (FMA) score and Barthel (MBI) score were adopted to evaluate the pain severity, the motor function of the upper limb and the ADL. The clinical therapeutic effects were evaluated in the two groups.</p><p><b>RESULTS</b>The VAS scores were reduced after treatment as compared with those before treatment in the two groups, and FMA and MBI scores were all increased as compared with those before treatment, indicating the significant difference statistically (<0.05,<0.01). After treatment, the improvements in the observation group were better than those in the control group (all<0.05). The curative and remarkably effective rate was 69.8% (37/53) in the observation group, better than 47.2% (25/53) in the control group (<0.05).</p><p><b>CONCLUSION</b>The touching-periosteum needling technique of the meridian muscle region theory obviously improves the pain severity, the motor function of the upper limb and the quality of life in patients of post-stroke shoulder pain. The therapeutic effects are better than the routine acupuncture.</p>

Drainage at different time points after tranexamic acid administration in total hip arthroplasty: a retrospective study / 中国组织工程研究

BACKGROUND:Topical tranexamic acid (TXA) administration has been described to be effective in decreasing blood loss in total hip arthroplasty (THA).Most of research focus on the postoperative total drainage,but the drainage at different time points after replacement is little reported.OBJECTIVE:To investigate the effect of topical TXA on the volume of drainage at different time points after THA.METHODS:Data of 79 cases of primary unilateral THA were analyzed retrospectively,and allotted to two groups.TXA group (n=38) was subjected to the reverse perfusion of 1.5 g of TXA (50 mL) by drainage tube after THA,and control group (n=41) was given 50 mL of normal saline in the same way.The postoperative drainage at 1,2 and 3 days,total postoperative drainage,and hemoglobin level at postoperative 3 days were collected and compared between two groups.RESULTS AND CONCLUSION:There was no significant difference in the baseline data between two groups (P ＞ 0.05).(1) The postoperative drainage at 1 day and total drainage in the TXA group was significantly lower than that in the control group,and the drainage showed no significant difference at postoperative 2 and 3 days between two groups (P ＞0.05).(2) The hemoglobin level was significantly increased in the TXA group compared with the control group at 3 days postoperatively (P ＜ 0.05).(3) To conclude,the topical TXA administration can reduce the postoperative drainage in primary unilateral THA,especially at the first day.

Analysis of high risk factors on femoral head necrosis after femoral neck surgery in adult patients / 局解手术学杂志

Objective To evaluate the potential high risk factors of femoral head necrosis after femoral neck surgery in adult patients. Methods From January 2009 to October 2014,390 patients with femoral neck fractures in our hospital were treated with multiple hollow compression screws. All patients were followed up for 12 to 60 months. Then retrospectively analyzed the incidence rates of femoral head nec-rosis and the clinical data about age,gender,fracture side,Garden index,fracture shift condition,internal medicine complications,whether to do lower limb preoperative traction,restoration method,postoperative load time and whether take out hollow compression screw internal fixa-tion,so as to explore the higher risk factors for femoral head necrosis. Results Among the 390 cases,352 cases got followed up. There were 45 cases of them ended with nonunionand 49 cases ended with femoral head necrosis. The univariate regression analysis results showed that the age,fracture shift condition,internal medicine complications,postoperative load time and Garden index,whether take out internal fixation were risk factors for femoral head necrosis (P<0. 05). The multi-factor results showed that aged from 40 to 60 years old,transfered fracture, seriously complications,time of loading less than 3 mouths,Ⅲ and Ⅳ Garden index,take out internal fixation were the high risk factors for femoral head necrosis (P<0. 05). Conclusion Patients who aged from 40 to 60 years old and having transfered fracture,seriously complica-tion,early weight bearing,high Garden index and internal fixation take-out would increase the risk of femoral head necrosis.

Analysis of survival and prognosis in 409 newly diagnosed patients with diffuse large B-cell lymphoma / 中华血液学杂志

<p><b>OBJECTIVE</b>To Explore the poor prognostic factors of diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>The clinical data of 409 newly diagnosed patients with DLBCL from January 2000 to December 2010 were collected, and the prognostic factors by univariate and multivariate stratification were analyzed .</p><p><b>RESULTS</b>Of the 409 DLBCL patients, 244 were males and 165 females, the median age was 56(16-89) years old, the median follow-up time was 23(2-108) months. In univariate analysis, age, clinical stage, B symptoms, ECOG scores, the international prognostic index (IPI) scores, bone marrow involvement, low absolute lymphocyte count (ALC), high LDH, β2-MG>2 times of normal, regimen and therapeutic effect had significant influence on OS and PFS (P<0.05). Multivariate analysis showed that stage III-IV and high LDH were the poor prognostic factors of OS and PFS (P<0.05). When IPI scores were included, low ALC and IPI 3-5 scores were the poor predictors of OS and PFS in CHOP-like group (232 cases), revised IPI (R-IPI) was an independent poor predictors of OS and PFS in RCHOP-like group (177 cases).</p><p><b>CONCLUSION</b>Stage III-IV and high LDH have negative influence on OS and PFS in patients with DLBCL, low ALC and IPI 3-5 scores affect OS and PFS in CHOP-like group, R-IPI affects OS and PFS in RCHOP-like group.</p>

Levels for toxaphene in three categories of animal originated food in Pearl River Delta area / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the present contamination status and profile of toxaphene in fish, chicken and meat samples in Pearl River Delta area.</p><p><b>METHODS</b>Totally 60 independent samples including fish, chicken, meat were collected from Huizhou,Guangzhou,Dongguan,Jiangmen of Pearl River Delta area in Guangdong by purposive sampling from Oct 2010 to Jun 2011. Toxaphene monomer Parlar26, Parlar50 and Parlar62 levels in three various categories of foods were quantitatively and qualitatively analyzed referencing international authoritative standard methods by utilizing isotope dilution high-resolution gas chromatography/high-resolution double-focusing magnetic mass spectrometry (HRGC-HRMS). The levels of pollution and characteristics were compared.</p><p><b>RESULTS</b>The concentration of toxaphene median(M) in fish, chicken and meat were 12.87, 5.8 and 1.89 ng/kg (gross weight) , respectively and the difference was significant(H = 14.29, P = 0.001). The toxaphene level in seafish (M = 32.07 ng/kg) was significantly higher than that in freshwater fish (M = 10.63 ng/kg, Z = -2.52, P = 0.012). The profile analysis showed that Parlar50 and Parlar26 were the predominant characteristic monomers in fish, which contributed about 44% (9.91/22.60, ng/kg) and 39% (8.89/22.60, ng/kg) to total concentration, and Parlar62 and Parlar26 were the two predominant congeners in poultry products, the two congeners accounted for 42% (5.03/11.90, ng/kg) and 38% (4.58/11.90, ng/kg). Furthermore Parlar26 and Parlar62 made up about 57% (3.45/6.08, ng/kg) and 26% (1.58/6.08, ng/kg) of total concentration in livestock meat respectively.</p><p><b>CONCLUSION</b>Toxaphene levels in all tested food samples are far lower than the limited standard stipulated by the European Food Safety Authority (EFSA) in 2002, which was 0.1 mg/kg. The congener characteristic difference in the three categories food indicated that the different enrichment ability in Toxaphene in different animal species.</p>

Traditional Chinese Medicine Syndrome Differentiation of AIDS Patients on ARV Complicated with Anemia and Hyperlipidemia / 世界科学技术-中医药现代化

This study was aimed to analyze four diagnostic methods of AIDS patients with HAART complicated with anemia and hyperlipidemia. Characteristics of traditional Chinese medicine (TCM) and common pathogenesis were discussed in this article. This study was supported by Key Project of the National Eleventh-Five Year Research Program of China. This study was conducted through the retrospective analysis. This analysis was made on the four diagnostic methods of AIDS patients with HAART treatment. The results showed that the most frequent symptoms of AIDS patients with anemia or hyperlipidemia are fatigue, facial abnormalities, taste abnormalities, forgetfulness, backache, weakness of back, loss of appetite, insomnia. And the frequent tongue and pulse are white tough coating, pale tongue and fine pulse. The most frequent symptoms of the anemia group are facial abnormalities, backache, dizziness, palpitations, shortness of breath, pale complexion, abnormal state of mind, abnormal sweating, tinnitus, cold hands and feet, spontaneous sweating, white tongue coating, tooth-printed tongue, thin tongue coating and weak pulse (P < 0.05). The most frequent symptom of hyperlipidemia are lassitude, weakness, loss of appetite, abdominal distension, moisture tongue, thick and greasy tongue coating, slippery pulse. It was concluded that syndromes of AIDS patients on ARV complicated with anemia and hyperlipidemia are mainly deficient pattern, which affects the spleen, heart, liver and kidney. The most frequent syndrome type with anemia patients is blood deficiency, which is followed by spleen-kidney deficiency syndrome, liver-kidney deficiency syndrome. The most frequent syndrome type with hyperlipidemia patients is spleen qi deficiency and kidney essence deficiency, which are closely related to the spleen and kidney.