Analysis of hidden blood loss after percutaneous kyphoplasty for osteoporotic vertebral compression fracture and its influencing factors / 中国骨伤

OBJECTIVE@#To investigate the hidden blood loss and related risk factors of osteoporotic vertebral compression fractures after percutaneous kyphoplasty.@*METHODS@#The clinical data of 153 patients with osteoporotic vertebral compression fractures who underwent percutaneous kyphoplasty from March 2015 to December 2017 were retrospectively analyzed, including 55 males and 98 females, aged 68 to 87(78.6±11.4) years old. Erythrocyte specific volume was collected before and after operation to calculate the hidden blood loss. The influence of sex, age, body mass index, bone mineral density, diabetes mellitus and hypertension, operation mode (unilateral or bilateral), operation time, operative segment and number, loss height of vertebral body and recovery height ratio on hidden blood loss was analyzed by multiple linear regression model.@*RESULTS@#Postoperative hidden blood loss was (287.7±68.5) ml. Multivariate linear regression analysis showed that the history of diabetes mellitus (β=2.405, =0.012), the mode of operation(β=3.042, <0.001), the time of operation (β=2.043, =0.038), the operative segment (β=1.993, =0.043), the number (β=0.374, <0.001), the loss of vertebral height (β=2.785, =0.003) and the recovery ratio(β=7.301, <0.001) were correlated with occult hemorrhage.@*CONCLUSIONS@#There is a certain degree of occult hemorrhage in kyphoplasty for osteoporotic vertebral compression fractures. The risk factors of hidden hemorrhage are diabetes history, operation method, operation time, operative segment and number, loss of vertebral height and recovery ratio.

Modulation effect of Acanthopanax senticosus polysaccharides through inflammatory cytokines in protecting immunological liver-injured mice / 中国中药杂志

The aim of this paper was to discuss the protective effect and mechanism of Acanthopanax senticosus polysaccharides( ASPs) on immunological liver injury caused by conanavalin A( Con A). BALB/c mice were randomly divided into seven groups: control group,model group( Con A),low-,medium-,and high-dose( 36. 25,72. 5,145 mg·kg~(-1)) ASPs groups,bifendate( 200 mg·kg~(-1),positive drug) group and pyrrolidinedithiocarbamate( PDTC,NF-κB inhibitor,200 mg·kg~(-1)) group. ASPs groups and bifendate group were given with corresponding drugs by ig administration once daily for 7 d. Control group,model group and PDTC group were given with normal saline by ig administration once daily for 7 d. After the last ig administration,PDTC was given in DTC group by iv administration( 200 mg·kg~(-1)); 0. 5 h after that,Con A( 20 mg·kg~(-1)) was injected via the tail vein to induce immunological liver injury in all the mice except normal control group. The mice were killed 8 h later and their liver tissues were collected for histopathological examination. The contents of nitric oxide( NO),superoxide dismutase( SOD),malondialdehyde( MDA),reduced glutathione( GSHPX),interleukin( IL-1β) and tumor necrosis factor( TNF-α) in liver tissues were detected by kit assay. Western blot method was used to detect TNF-α,intercellular cell adhesion molecule-1( ICAM-1),inducible nitric oxide synthase( i NOS) and nuclear factor( NF-κB) protein expression in liver tissues. As compared with model group,ASPs not only could reduce the activity of MDA,NO,IL-1β and TNF-α,but also increase the content of GSH-PX and SOD; at the same time,the protein expression levels of TNF-α,ICAM-1,i NOS and NF-κB were reduced in liver tissues; in addition,inflammatory cell infiltration was alleviated,hepatocyte cytoplasm was loose and swollen,and nuclear condensation and staining were improved. ASPs has a protective effect on immunological liver injury,and the mechanism may be associated with regulating secretion of inflammatory cytokines and the expression of adhesion factor through NF-κB signaling pathway.

A Multicenter, Randomized, Double-Blind, and Placebo-Controlled Study of the Effects of Tongxinluo Capsules in Acute Coronary Syndrome Patients with High On-Treatment Platelet Reactivity / 中华医学杂志(英文版)

<p><b>Background</b>High platelet reactivity (HPR) during clopidogrel treatment predicts postpercutaneous coronary intervention (PCI) ischemic events strongly and independently. Tongxinluo capsules (TCs) are a traditional Chinese medicine formulation used as antiplatelet treatment. However, its efficacy against HPR is not known. The aim of the present study was to evaluate the effects of TCs in acute coronary syndrome (ACS) patients with HPR.</p><p><b>Methods</b>This multicenter, randomized, double-blind, placebo-controlled study prospectively analyzed 136 ACS patients with HPR who underwent PCI. The patients were enrolled from November 2013 to May 2014 and randomized to receive placebo or TCs in addition to standard dual antiplatelet therapy (DAPT) with aspirin and clopidogrel. The primary end points were the prevalence of HPR at 30 days and the mean change in P2Yreaction units (PRUs) between baseline and 30 days. Survival curves were constructed with Kaplan-Meier estimates and compared by log-rank tests between the two groups.</p><p><b>Results</b>Both groups had a significantly reduced prevalence of HPR at 30 days versus baseline, but the TC group, compared with the placebo group, had greater reduction (15.8% vs. 24.8%, P = 0.013), especially among patients with one cytochrome P450 2C19 loss of function (LOF) allele (χ= 2.931, P = 0.047). The TC group also had a lower prevalence of HPR (33.3% vs. 54.2%, t = 5.284, P = 0.022) and superior performance in light transmittance aggregometry and higher levels of high-sensitivity C-reactive protein (hsCRP), but the composite prevalence of ischemic events did not differ significantly (χ= 1.587, P = 0.208).</p><p><b>Conclusions</b>In addition to standard DAPT with aspirin and clopidogrel, TCs further reduce PRU and hsCRP levels, especially in patients carrying only one LOF allele. The data suggest that TCs could be used in combination therapy for ACS patients with HPR undergoing PCI.</p>

Effect of Xinling Wan in treatment of stable angina pectoris: a randomized, double-blinded, placebo parallel-controlled, multicenter trial / 中国中药杂志

To evaluate the effectiveness and safety of Xinling Wan on patients with stable angina pectoris, a randomized, double-blinded, placebo parallel-controlled, multicenter clinical trial was conducted. A total of 232 subjects were enrolled and randomly divided into experiment group and placebo group. The experiment group was treated with Xinling Wan (two pills each time, three times daily) for 4 weeks, and the placebo group was treated with placebo. The effectiveness evaluation showed that Xinling Wan could significantly increase the total duration of treadmill exercise among patients with stable angina pectoris. FAS analysis showed that the difference value of the total exercise duration was between experiment group (72.11±139.32) s and placebo group (31.25±108.32) s. Xinling Wan could remarkably increase the total effective rate of angina pectoris symptom score, and the analysis showed that the total effective rate was 78.95% in experiment group and 42.61% in placebo group. The reduction of nitroglycerin dose was (2.45±2.41) tablets in experiment group and (0.50±2.24) tablets in placebo group on the basis of FAS analysis. The decrease of symptom integral was (4.68±3.49) in experiment group and (3.19±3.31) in placebo group based on FAS analysis. Besides, Xinling Wan could decrease the weekly attack time and the duration of angina pectoris. PPS analysis results were similar to those of FAS analysis. In conclusion, Xinling Wan has an obvious therapeutic effect in treating stable angina pectoris, with a good safety and a low incidence of adverse event and adverse reaction in experiment group.

Effects of salidroside on expression of NeuN and Egr4 in ischemic side of MCAO rats by inhibiting expression of C3 / 中国药理学通报

Aim To investigate the effects of salidroside on NeuN and Egrs in the ischemic side of middle cerebral artery occlusion (MCAO) rats by inhibiting complement C3.Methods The rats were subjected to MCAO with suture-occluded method,and the neurologic injury was evaluated.The rats underwent l h ischemia/reperfusion with 1 d and 2d salidroside treatment,and the expressions of NeuN,Egr4,C3 and C1 were tested.Male Sprague Dawley rats were separately injected ventricle C3aR inhibitor and artificial cerebrospinal fluid with the help of ventricle stereotaxic apparatus.Thirty min later,the models of MCAO were finished with 1h reperfusion,drug administration and intracerebroventricular injection for 2d.The expressions of NeuN,Egr4,C3 were detected.Results Compared with models of MCAO,the expression of C3 in MCAO rats treated with salidroside 1 d and 2d decreased significantly,and the expression of NeuN increased markedly.Salidroside had no apparent effect on Egr4 and C1 of administration of 1d,but it could significantly enhance the expression of Egr4 after 2d,and reduce the expression of C1 significantly after 2d.The rats administrated with C3aR inhibitor into cerebral ventricle continueously showed the same result in accordance with the treatment of salidroside.And the treatment of salidroside and C3aR inhibitor did not show remarkable additive effects.Conclusion The neuroprotective effect of salidroside on acute cerebral ischemia/reperfusion injury may be related to the inhibition of the activation of the classical pathway of complement,the regulation of Egrs and the reduction of apoptosis.

Application of elastic stable intramedullary nailing for treating forearm fractures in children / 中华实用儿科临床杂志

Objective To summarize the application of elastic stable intramedullary nailing for treating forearm fractures in children and to evaluate its therapeutic effect.Methods A total of 98 cases of forearm fractures in children treated by elastic stable intramedullary nailing were analyzed,retrospectively.Eighty-seven cases were postoperatively followed up,but 11 cases were lost.Fifty-nine cases were male,39 cases were female,ageing from 3 to 16 yearold,and the mean age was 6.5 year-old.Sixty-seven cases were ulnar shaft fracture,23 cases were radial neck fractures and 8 cases were Monteggia fracture.Results Patients were followed up 4 to 36 months.Eighty-seven cases successfully achieved complete healing.Patients recovered with no pain,no deformity and obtained excellent functional recovery.One case achieved delayed healing,and skin irritation was found in 8 cases.Conclusions Elastic stable intramedullary nailing is a minimally invasive,approch easy to deal with soft tissue injury,quick in recovery,and has a good curative effect and fewer complications.Rationally using elastic stable intramedullary nailing for treating forearm fractures in children can achieve satisfactory postoperative outcomes.

Effects of intensive antiplatelet therapy for patients with high on-treatment platelet reactivity after coronary stent implantation / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the effects of intensive antiplatelet therapy for patients with high on-treatment platelet reactivity (HPR) after coronary stent implantation.</p><p><b>METHODS</b>Between March 2009 and February 2011, a total of 3316 consecutive acute coronary syndrome patients undergoing drug-eluting stent implanting from 3 hospitals were enrolled. Among them, 840 patients (25.3%) were identified as HPR (defined as 20 µmol/L adenosine diphosphate induced platelet aggregation of ≥ 55% at 24 hours after administration of 300 mg clopidogrel loading dose and 300 mg aspirin). The HPR patients were randomly assigned to receive standard (aspirin 300 mg/d and clopidogrel 75 mg/d, n = 280) or intensified (n = 560) antiplatelet therapy by the ratio of 1:2. Patients in the intensive group were initially treated with a double maintenance dose of clopidogrel (150 mg/d) and aspirin (300 mg/d). After 3 days, patients with unsolved HPR received additional cilostazol treatment (50 - 100 mg, bid). The reversion rate of HPR and clinical events were observed.</p><p><b>RESULTS</b>In the intensive group, HPR reversed in 304 out of 560 patients (54.3%) at 3 days post therapy and the remaining 256 patients with HPR were treated with additional cilostazol regimen for another 3 days and the total reversion rate of HPR was 81.1% (454/560). The reversion rate of HPR at 30 days in the intensified group was significantly higher than that of the standard group (69.9% vs. 55.7%, P = 0.000). At 30 days after percutaneous coronary intervention, 1 patient suffered from subacute stent thrombosis (0.2%) in intensified group and no stent thrombosis was observed in standard group (P = 1.000). There were no death, major or minor bleeding in both two groups. Minimal bleeding was also similar in the two groups (intensive: 4.28% vs. standard: 2.14%, P = 0.166).</p><p><b>CONCLUSIONS</b>The intensified antiplatelet therapy regimens could significantly increase the reversion rate of HPR in acute coronary syndrome patients undergoing coronary stenting without increasing the risk of bleeding. The clinic impact of this strategy needs to be elucidated by long term follow-up outcome studies.</p>

In vitro induction studies of YouGui drink on culture of steroid induced necrosis of femoral head rat osteoblast / 中国骨伤

<p><b>OBJECTIVE</b>On the basis of YouGui drink ([Chinese characters: see text]) to act on the normal rats in vitro osteoblast proliferation and differentiation, further observe YooGui drink ([Chinese characters: see text]) inductive effect for steroid induced necrosis of femoral head rats in vitro on cultivation of osteoblast proliferation and differentiation.</p><p><b>METHODS</b>Prednisolone acetate 49 mg/kg x d were injected into gluteal of 20 male SD rats (body weight in 100-120 g), continuously 6 days for model. After 7 days, under sterile conditions from the model rats bone marrow stromal cells were induced and cultured to osteoblast, and then randomly divided into 4 groups, respectively, add the high, medium and low concentration YouGui drink ([Chinese characters: see text]) containing serum (group R1, R2, R3) and control serum (group R4). After 72 h, osteoblast proliferation, alkaline phosphatase activities (APA) were detected, and expression level of osteoprotegerin (OPG) and osteoclast differentiation factor (RANKL) were detected by real-time fluorescence quantitative PCR.</p><p><b>RESULTS</b>The high and medium concentration YouGui drink ([Chinese characters: see text]) containing serum group compared with the control group (R1, R2 vs. R4), the rate of osteoblast proliferation was significantly high (P < 0.01), APA significantly increased (P < 0.01), relative expression level of osteoblast OPG mRNA significantly increased (P < 0.01), and with the concentration of a certain dose was positively correlated; RANKL mRNA significantly was lower (P < 0.01). The low concentration YouGui drink (t 91 t) containing serum group compared with the control group (R3 vs R4), there was no significantly different in the rate of osteoblast proliferation, ALP and relative expression level of osteoblast OPG mRNA, RANKL mRNA.</p><p><b>CONCLUSION</b>The high concentration of YouGui drink ([Chinese characters: see text]) containing serum can obviously promote the proliferation and differentiation of steroid induced necrosis of femoral head rats in vitro osteoblast, and plays a clear role in promoting and enhance the relative expression of osteoblast OPG mRNA and an inhibitory effect on RANKL mRNA. The effect of YouGui drink ([Chinese characters: see text]) containing serum acting on induced in vitro cultured osteoblasts have relevance with dose, at a certain concentration range it can promote osteoblast differentiation and proliferation.</p>

Effect of acupuncture on the expression of Bcl-xl and BDNF of retina in rabbits with chronic intraocular hypertension / 中国针灸

<p><b>OBJECTIVE</b>To explore the protection effects of acupuncture on glaucomatous optic nerve damage and its mechanism.</p><p><b>METHODS</b>Experimental glaucoma model was induced by intracameral injection of compound Carbomer solution in rabbits. After 28 days, ocular tension returned to normal by filtration surgery. Twenty rabbits (40 eyes) were randomly divided into a model group, an acupuncture group, a neurotrophy group and a nomal control group, 5 cases in each group. The acupuncture group was treated with acupuncture at bilateral "Qiuhou" (EX-HN 7),"Fengchi" (GB 20) and "Xingjian" (LR 2), twice a day. The neurotrophy group was treated with intramuscular injection of Vitamin B1 (100 mg) and Vitamin B12 (500 microg), once a day, and the other groups with no treatment. The expressions of Bcl-xl and BDNF in rabbits retina were observed after 4 weeks.</p><p><b>RESULTS</b>At the end of the experiment, the positive expression cells of Bcl-xl and BDNF were (31.20 +/- 5.97) per mm2 and (6.3 +/- 1.89) per mm2 in the acupuncture group, being significantly higer than (26.70 +/- 4.32) per mm2 and (4.0 +/- 1.89) per mm2 in the model group (both P<0.05).</p><p><b>CONCLUSION</b>Acupuncture can raise the expression of Bcl-xl and BDNF of retina, so as to prevent optic nerve damage caused by intraocular hypertension.</p>

Surgery for extraperitoneal pelvic neoplasms / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the methods of surgery for extraperitoneal pelvic neoplasms.</p><p><b>METHODS</b>Clinical data related to surgery of 84 cases of extraperitoneal pelvic neoplasms were extracted and retrospectively analyzed.</p><p><b>RESULTS</b>All 84 patients underwent operations, including one of them who received 4 operations within 6 months for resection of a single tumor. 58 abdominal, 16 buttock and 10 combined incisions were made in the series. Pelvic organs and structures were co-resected in 35 cases, including total pelvic exenteration in 2 cases and anterior pelvic exenteration in 2 cases. Common and/or external iliac vessels were resected and transplantations of artificial vessel were carried in 5 cases. Internal iliac arteries were ligated in 10 cases. The mean blood lose was 2 385 ml in our series and the largest was 15 000 ml. The complete resection rate of tumor was 81% for 84 operations and the largest resected tumor was 30 cm x 30 cm x 25 cm. There was no hospitalized death, and postoperative complication rate was 7% (6/84) in our series. Only 1 death were seen during the mean period of postoperative follow-up of 54 months, 22 operations were carried for 21 cases of recurrence, including 7 operations for 7 recurrences in a case within 12 years.</p><p><b>CONCLUSIONS</b>Making adequate abdominal or/and buttock incisions, exenterations of involved pelvic organs and structures, total pelvic exenteration if necessary, appropriate management of iliac vessels, planned re-operation for one tumor, and re-operation for recurrences are important methods for the treatment of extraperitoneal pelvic neoplasms.</p>

Construction of eukaryotic expression vector using neomycin-resistance gene mutant as selectable marker / 生物工程学报

Neomycin-resistance gene is widely used as a selectable marker in eukaryotic expression vector. It codes neomycin phosphotransferase II (NPT II) which confers resistance to various aminoglycoside antibiotic such as G418 and kanamycine. In this work, by site-directed mutagenesis the neo gene mutant was obtained. The expression vector pmDNA using the neo gene mutant as selectable marker has been constructed. After inserting interest luciferase gene, the expression plasmid pmDNAluc + was stably transfected CHO-K1 cells. As a result, the expression positive ratio reaches to approximate 95% and the ratio of high expression colonies is apparently higher than the controls.

The Determination of Serum IL-6 in Cholangiocarcinoma Significance / 中国医科大学学报

Objective: To explore the clinical significance. Methods: The double-antibody sandwich ELISA technique. Result: The serum interleukin-6(IL-6) levels of patients with cholangiocarcinoma are significantly higher than those in benign biliary disease and normal controls (P<0.05). Conclusion: Serum IL-6 levels of patients with cholangiocarcinoma are significantly increased ,it is one of the important parameters for clinical evaluation in patients of cholangiocarcinoma.

MRI diagnosis in meniscal tears:a Meta analysis / 中华放射学杂志

0.05).Conclusion MRI is a highly accurate diagnostic tool for detecting tears of the medial and lateral menisci.At present,there is no evidence to ascertain that higher magnetic field strength improves discriminatory power for meniscal tears.