Clinical effects of modified open elbow arthrolysis in the treatment of post-traumatic elbow stiffness / 国际外科学杂志

Objective:To study the clinical efficacy of modified open elbow arthrolysis in the treatment of traumatic elbow stiffness.Methods:A retrospective analysis was performed on 120 patients who underwent modified open elbow arthrolysis in Beijing Jishuitan Hospital from January 2018 to December 2020. The age of the included patients was (37.7±12.4) years (ranged 18-64 years), including 54 males and 66 females. The medical records were reviewed, the range of motion (ROM) and functional status of the patients before operation and at the last follow-up were compared including visual analogue scale (VAS), Mayo elbow performance score (MEPS), Disabilities of the arm, shoulder and hand (DASH) score. Complications and secondary operations were also recorded. Measurement data with normal distribution were presented as mean ± standard deviation( ± s) and comparison between groups was conducted using the t-test; Measurement data of skewed distribution were expressed as M ( Q1, Q3), and Rank-sum test was used for inter-group comparison. Results:The preoperative extension of 120 patients was 43.6° (33.8°, 60.1°), the flexion was 78.7° (59.8°, 98.1°), and the flexion-extension ROM was 25.6° (0.0°, 54.5°); the preoperative pronation was 51.8° (33.0°, 67.0°), the supination was 85.1° (65.7°, 90.0°), and the rotation ROM was 136.9° (99.1°, 157.5°). Postoperative extension was 14.2° (7.0°, 24.8°), flexion was 129.5° (120.0°, 138.1°), flexion-extension ROM was 115.5° (94.4°, 127.3°); postoperative pronation was 65.0° (47.1°, 75.0°), the supination was 88.3° (78.6°, 90.0°), and the rotation ROM was 151.9° (131.7°, 163.4°). Postoperative extension, flexion, flexion-extension ROM, pronation, supination, and rotation ROM were all higher than those before operation, and the differences were statistically significant ( P<0.001). The VAS of 120 patients was 1.0 (0.0, 3.0) scores before operation and 0.0 (0.0, 1.0) scores after operation. The MEPS was 60.0 (50.0, 75.0) scores before operation and 100.0 (85.0, 100.0) scores after operation. The preoperative DASH was 37.5 (20.1, 51.3) scores, and the postoperative DASH was 7.9 (3.3, 13.3) scores. The postoperative VAS, MEPS, and DASH were significantly improved compared with those before operation, and the differences were statistically significant ( P<0.001). Residual ulnar nerve symptoms occurred in 18 cases, recurrence of heterotopic ossification in 42 cases, and hematoma in 3 cases. Conclusions:Modified open elbow arthrolysis is a safe and effective surgical method for the treatment of traumatic elbow stiffness. It can significantly improve the function of the patient, reduce the occurrence of elbow instability, avoid the use of external fixators, and reduce the cost of the patient.

TiRobot navigation for hinged external fixation in elbow arthrolysis / 中华创伤骨科杂志

Objective:To investigate the efficacy of TiRobot navigation for hinged external fixation in elbow arthrolysis.Methods:The 11 patients were retrospectively analyzed who had been treated by elbow arthrolysis at Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital using TiRobot navigation for hinged external fixation. There were 9 males and 2 females with a mean age of 39.3 years (from 21 to 66 years). Their elbow range of motion (ROM) was compared between preoperation and the final follow-up. Their visual analogue scale (VAS) and Mayo elbow performance score (MEPS) and complications were documented at the final follow-up.Results:The rotation axis of the elbow joint was positioned with the aid of intraoperative robot navigation in 11 patients.The deviation of entry point averaged 0.21 mm (from 0.05 to 0.41 mm) and the deviation of exit point 0.23 mm (from 0.06 to 0.38 mm). The follow-up time for the 11 patients averaged 25.8 months (from 16 to 32 months). Their elbow flexion and extension was 133.0° (134.9°, 138.7°) and rotation 164.6° ±17.5° at the final follow-up, significantly improved compared with their preoperative values [0.8°(0°, 33.7°) and 122.9°±49.0°] ( P<0.05). Their VAS averaged 0.2 (from 0 to 1) and MEPS 96.8 (from 85 to 100) at the final follow-up, giving 9 excellent and 2 good cases. There was no case of radial nerve injury, pin instability, pin breakage, pin infection or peri-pin fracture. Conclusion:When TiRobot navigation is used for hinged external fixation in elbow arthrolysis, the axis of rotation can be accurately located, leading to satisfactory functional outcomes for the patients.

Locational distribution characteristics and risk factors of heterotopic ossification following traumatic elbow stiffness / 中华创伤骨科杂志

Objective:To study the locational distribution characteristics of the heterotopic ossification (HO) following traumatic elbow stiffness and the risk factors for HO development at different locations.Methods:Consecutively included according to our inclusion criteria in the present study were the patients who had been admitted to Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from January 2018 to December 2018 for elbow release due to traumatic elbow stiffness but developed postoperative HO. Their baseline data and CT data were collected and processed using Mimics 20.0. The HO distribution for each patient was characterized at the anteromedial, anterolateral, posteromedial, posterolateral, posterior, medial, lateral, and proximal radioulnar locations. The patient's original injury was categorized into 5 types: distal humerus fracture, olecranon fracture, radial head fracture, coronoid fracture, and elbow dislocation. After the univariate analysis with the HO occurrence at a specific location as the dependent variable and the original injury and baseline data as the independent variables, the factors with P value less than 0.1 were included in the logistic regression analysis to determine the risk factors for HO at each location.Results:A total of 91 patients were included in this study. Of them, 88 had posteromedial HO (96.7%, 88/91), 62 posterior HO (68.1%, 62/91), 60 posterolateral HO (65.9%, 60/91), 41 anteromedial HO (45.1%, 41/91), 26 anterolateral HO (28.6%, 26/91), 13 proximal radioulnar HO (14.3%, 13/91), 8 lateral HO (8.8%, 8/91), and 7 medial HO (7.7%, 7/91). Logistic regression analysis showed that presence of ulnar nerve symptoms ( OR=4.354, P=0.017) and presence of original elbow dislocation ( OR=2.927, P=0.042) were the independent risk factors for the anteromedial HO development and that presence of original olecranon fracture ( OR=0.277, P=0.023) was the protective factor for the anteromedial HO development. Presence of original radial head fracture was the independent risk factor for the anterolateral HO development ( OR=2.891, P=0.033) and the posterolateral HO development ( OR=3.123, P=0.043). Conclusions:HO development in patients with post-traumatic elbow stiffness is closely related to their original injury. Posteromedial HO may develop in almost all the patients. Patients with ulnar nerve symptoms and original elbow dislocation are more prone to anteromedial HO development, but patients with original olecranon fracture are less likely to develop anteromedial HO. Patients with original radial head fracture are more likely to develop anterolateral and posterolateral HO.

Application of esketamine in combination with butorphanol in endotracheal intubation guided by fiberoptic bronchoscopy with spontaneous breathing / 中国医师杂志

Objective:To observe the effects of esketamine combined with butorphanol in endotracheal intubation guided by fiberoptic bronchoscopy with spontaneous breathing.Methods:Forty patients suspected of having difficult airways during elective general anesthesia operations in Hunan Provincial People′s Hospital were prospectively selected and divided into control group and observation group by random number table. Propofol plus sufentanil, esketamine plus butorphanol were used for intravenous general anesthesia respectively. At the same time, they were assisted with cricothyroid puncture and surface anesthesia of nasopharynx and larynx, and then trachea intubation with spontaneous breathing was performed through the nose under the guidance of fiberoptic bronchoscope. The changes of heart rate (HR), mean arterial pressure (MAP), arterial partial pressure of oxygen (PaO 2), and the levels of serum cortisol, norepinephrine and adrenaline before and after endotracheal intubation were compared between the two groups. The number of body motions and coughing at the completion of endotracheal intubation was compared between the two groups. Results:In the control group, the HR and MAP at the completion of intubation were higher than those before intubation, and the PaO 2 was lower than those before intubation (all P<0.05); In the observation group, there was no significant difference in HR, MAP and PaO 2 at the completion of intubation and before intubation (all P>0.05). The HR and MAP at the end of intubation in the observation group were lower than those in the control group, and the PaO 2 was higher than that in the control group (all P<0.05). The number of body motion and coughing in the observation group was significantly less than that in the control group at the completion of endotracheal intubation (all P<0.01). At the end of endotracheal intubation, the serum cortisol, norepinephrine and epinephrine level in the observation group were significantly lower than those in the control group (all P<0.01). Conclusions:Esketamine combined with butorphanol has advantages over propofol combined with sufentanil in the application of fiberoptic bronchoscopy guided tracheal intubation in difficult airways that retain spontaneous breathing, and can better control the stress response caused by tracheal intubation.

Open reduction and internal fixation for OTA/AO-C open and closed fractures of distal humerus / 中华创伤骨科杂志

Objective:To compare the clinical outcomes between OTA/AO-C open and closed fractures of the distal humerus treated by open reduction and internal fixation.Methods:The clinical data were retrospectively analyzed of the 70 patients who had been treated at Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital for OTA/AO-C fractures of the distal humerus from January 2014 to June 2017. Of them, 22 suffered from open fractures (Gustilo types Ⅰ/Ⅱ) and 48 closed fractures. There were 18 males and 4 females with an age of (42.6±13.0) years in the open group and 21 males and 27 females with an age of (42.2±17.1) years in the closed group. Analyzed were interval from injury to surgery, hospitalization time, injury energy and functional outcomes which included range of motion (ROM) in elbow flexion and extension, ROM in elbow rotation, Mayo elbow performance score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH), complications and rate of secondary surgery.Results:There was no significant difference between the 2 groups in age, injury energy or interval from injury to surgery ( P>0.05), but there were significantly more males in the open group than in the closed group ( P=0.011). The follow-up time for all the patients averaged 34.0 months (from 25 to 54 months). There were no statistically significant differences between the 2 groups in hospitalization time [9.5(6.0, 13.0) d versus 8.5 (6.0, 11.0) d], ROM in flexion and extension [120.0° (100.0°, 137.8°) versus 128.5° (110.0°, 140.0°)], ROM in rotation [155.0° (151.3°, 155.0°) versus 155.0° (155.0°, 155.0°)], MEPS [95.0 (80.0, 100.0) versus 95.0 (80.0, 100.0)] or DASH [2.6 (0.63, 9.2) versus 1.7 (0.0, 8.5)] ( P>0.05). There were no statistically significant differences between the 2 groups either in rate of secondary surgery [36.4% (8/22) versus 33.3% (16/48)], ulnar nerve symptoms [54.5% (12/22) versus 60.4% (29/48)], local irritability in the region of internal fixation [9.1% (2/22) versus 6.3% (3/48)] or elbow stiffness [13.6% (3/22) versus 10.4% (5/48)] ( P>0.05). Conclusion:Open reduction and internal fixation can lead to similar clinical outcomes in the treatment of both open (Gustilo types Ⅰ/Ⅱ) and closed distal humeral fractures of OTA/AO-C, with no significant differences in postoperative ROM, functional scores or complications.

Establishment and Analysis of the Fingerprints of Adiantum capillusveneris from Different Producing Areas and Content Determination of Its Differential Components / 中国药房

OBJECTIVE：To establish the fingerprint of Adiantum capillusveneris from different producing areas ，and to conduct chemometric analysis and content determination of differential components ，so as to provide reference for quality control of A. capillusveneris . METHODS ：HPLC-DAD combined with Similarity Evaluation System of TCM Chromatogramtic Fingerprint （2004 A edition ）were used to establish fingerprint of 19 batches of A. capillusveneris from different producing areas （S1-S19）. Common peaks were confirmed and their similarities were evaluated. Chemometric analysis methods such as cluster analysis ， principle component analysis （PCA），orthogonal partial least squares discriminant analysis （OPLS-DA）were used to evaluate the quality of 19 batches of A. capillusveneris from different producing areas ，screen the differential components ，and determine the contents of some differential components. RESULTS ：Among 19 batches of A. capillusveneris from different producing areas ，22 common peaks were confirmed ；peak 9 was chlorogenic acid ，peak 17 was quercetin- 3-O-β-D-glucopyranoside，peak 20 was kaempferol-3-O-rutoside；the similarity of 19 batches of sample were 0.677-0.962. Through cluster analysis ，it was found that S 7 and S 10 were clustered into one category ；S15 and S 18 were clustered into one category ；and S 1-S6，S8，S9，S11-S14，S16，S17 and S 19 were clustered into one category. PCA and OPLS-DA found that S 7 and S 10 were clustered into one category ；S15 were clustered into one category ；S18 were clustered into one category ；S1-S6，S8，S9，S11-S14，S16，S17 and S 19 were clustered into one category. Chlorogenic acid ，quercetin-3-O-β-D-glucopyranoside，kaempferol-3-O-rutoside and chemical composition represented by peak 14 were the differential components of the〔2017〕2841）； medicinal material. Among 19 batches of A. capillusveneris ， average contents of chlorogenic acid and quercetin- 3-O-β-D- glucopyranoside and kaempferol- 3-O-rutoside were 0.10-4.25， 0.31-7.11，0.61-12.00 mg/g，respectively. CONCLUSIONS ： 电话：0851-86614212。 HPLC-DAD fingerprints of A. capillusveneris from different producing areas are establishe d in the study ，and three common peaks are identified. Four differential components affecting the quality of A. capillusveneris are screened ， and the contents of chlorogenic acid ， quercetin-3-O-β-D-glucopyranoside and kaempferol-3-O-rutoside in A. capillusveneris from different producing areas were significantly different.

Effect of combined administration of intravenous and topical tranexamic acid on perioperative blood loss in elbow arthrolysis / 中华创伤骨科杂志

Objective:To explore the effect of combined administration of intravenous and topical tranexamic acid on perioperative blood loss in elbow arthrolysis.Methods:A retrospective analysis was conducted of 31 patients who had undergone elbow arthrolysis due to elbow stiffness from April 2019 to November 2020 at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital. An observational group of 15 patients were subjected to combined administration of intravenous and topical tranexamic acid while a control group of 16 patients to no administration of tranexamic acid. In the observational group, 15 mg/kg of tranexamic acid was injected intravenously 5 to 10 minutes before surgery and 1.0 g of tranexamic acid was injected locally in the area of anterior and posterior joint capsules after incision was closed while drainage tubes were clamped for 2 hours before release. In the control group, there was no special operative procedure while drainage tubes were also clamped for 2 hours before release. The 2 groups were compared in terms of blood loss on day 1 and day 3 after operation, drainage volume on day 1 after operation, total drainage volume, time for indwelling drainage tube, complications, and Mayo elbow performance score (MEPS) at 3 months after operation.Results:There were no statistically significant difference in preoperative general data between the 2 groups, showing they were comparable ( P>0.05).On day 1 and day 3 after operation, the blood loss was respectively (533.4±318.3) mL and (792.0±375.6) mL in the observational group, and respectively (866.4±480.5) mL and (1,403.0±636.5) mL in the control group, showing significantly differences between the 2 groups ( P<0.05). The drainage volume on day 1 after operation was (151.3±90.1) mL in the observational group and (235.0±126.1) mL in the control group, showing a significant difference between the 2 groups ( P<0.05). There was no statistically significant difference in total drainage volume or time for indwelling drainage tube between the 2 groups ( P>0.05). There were no such complications as thromboembolic events in either group. There was no significant difference in MEPS between the 2 groups at 3 months after operation ( P>0.05). Conclusions:Combined administration of intravenous 15 mg/kg and topical 1.0 g tranexamic acid may reduce blood loss on day 1 and day 3 after operation and drainage volume on day 1 after operation, and may not increase the risk of thromboembolic events, but cannot reduce total drainage volume or time for indwelling drainage tube. Application of tranexamic acid may not affect early elbow joint function after operation.

Emodin alleviates cardiac fibrosis by suppressing activation of cardiac fibroblasts upregulating metastasis associated protein 3

Excess activation of cardiac fibroblasts inevitably induces cardiac fibrosis. Emodin has been used as a natural medicine against several chronic diseases. The objective of this study is to determine the effects of emodin on cardiac fibrosis and the underlying molecular mechanisms. Intragastric administration of emodin markedly decreased left ventricular wall thickness in a mouse model of pathological cardiac hypertrophy with excess fibrosis induced by transaortic constriction (TAC) and suppressed activation of cardiac fibroblasts induced by angiotensin II (AngII). Emodin upregulated expression of metastasis associated protein 3 (MTA3) and restored the MTA3 expression in the setting of cardiac fibrosis. Moreover, overexpression of MTA3 promoted cardiac fibrosis; in contrast, silence of MTA3 abrogated the inhibitory effect of emodin on fibroblast activation. Our findings unraveled the potential of emodin to alleviate cardiac fibrosis upregulating MTA3 and highlight the regulatory role of MTA3 in the development of cardiac fibrosis.

Feasibility and acceptability of using Wi-Fi access points to provide smoking cessation help at 17 airports and 38 railway stations across China / 中华医学杂志(英文版)

BACKGROUND@#The use of mobile phone significantly improved the outcomes of tobacco cessation. However, its feasibility and acceptability were unclear in the Chinese population. This study was to explore the feasibility of using Wi-Fi access points (APs) as a platform to provide smoking cessation help at 17 airports and 38 railway stations across China.@*METHODS@#This study was divided into two stages: platform development and population survey. In the first stage, a survey platform was developed and incorporated into Wi-Fi service at airports and railway stations, which could provide survey content as a pop-up window when participants tried to access the Wi-Fi service. In the second stage, a population survey was conducted to explore the intention to receive tobacco cessation support.@*RESULTS@#A total of 20,199 users participated and 13,628 users submitted the survey, with a response rate of 67.47%. The smoking rate was 30.9%. A total of 86.58% of smoking participants and 2.44% of non-smoking participants wished to receive tobacco cessation support, respectively. The multivariate analysis showed intention to receive support did not differ in age, gender, and heaviness of smoking (P > 0.05).@*CONCLUSION@#Providing tobacco cessation support via Wi-Fi APs is feasible and efficient, and smokers have high intention to receive tobacco cessation support. It is suggested hospitals, academia, information technology industries, and government agencies must work together to provide tobacco cessation support via mHealth.

Feasibility and acceptability of using Wi-Fi access points to provide smoking cessation help at 17 airports and 38 railway stations across China / 中华医学杂志(英文版)

Background:@#The use of mobile phone significantly improved the outcomes of tobacco cessation. However, its feasibility and acceptability were unclear in the Chinese population. This study was to explore the feasibility of using Wi-Fi access points (APs) as a platform to provide smoking cessation help at 17 airports and 38 railway stations across China.@*Methods:@#This study was divided into two stages: platform development and population survey. In the first stage, a survey platform was developed and incorporated into Wi-Fi service at airports and railway stations, which could provide survey content as a pop-up window when participants tried to access the Wi-Fi service. In the second stage, a population survey was conducted to explore the intention to receive tobacco cessation support.@*Results:@#A total of 20,199 users participated and 13,628 users submitted the survey, with a response rate of 67.47%. The smoking rate was 30.9%. A total of 86.58% of smoking participants and 2.44% of non-smoking participants wished to receive tobacco cessation support, respectively. The multivariate analysis showed intention to receive support did not differ in age, gender, and heaviness of smoking (P > 0.05).@*Conclusion:@#Providing tobacco cessation support via Wi-Fi APs is feasible and efficient, and smokers have high intention to receive tobacco cessation support. It is suggested hospitals, academia, information technology industries, and government agencies must work together to provide tobacco cessation support via mHealth.

Relationship between microRNAs and myopia / 中华实验眼科杂志

MicroRNA (miRNA) is a kind of non-coding small RNAs,which can regulate target mRNA at post-transcriptional level and play an important regulatory role in a variety of biological processes in epigenetics field.Myopia is a complex disease caused by both genetic and environmental factors.Recently,epigenetic regulation has been found to be closely related to pathogenesis of myopia,in which miRNA play an important role.This article briefly introduced structure and function of miRNAs,differential expression of miRNA in ocular tissues (retina and sclera) and miRNA regulation of myopia-related genes,such as paired box 6 (PAX6),type Ⅰ collagen α1 chain (COL1A1) and matrix metalloproteinase 2 (MMP2).The progress of miRNAs research was reviewed.

Vascular endothelial growth factor antibody attenuates diabetic peripheral neuropathic pain in rats / 中南大学学报(医学版)

To explore the role of vascular endothelial growth factor (VEGF) in diabetic peripheral neuropathic pain in rats.
 Methods: Twenty-four adult male Sprague-Dawley rats aged 8 weeks were randomly divided into 3 groups (n=8 per group). The control group (C group): rats were intraperitoneally injected with sodium citrate solution at 10 mL/kg; the model group (M group): rats were intraperitoneally injected with streptozotocin at 65 mg/kg; the treatment group (T group): rats received intraperitoneal injection of anti-VEGF antibody (10 mg/kg) at the 1st, 3rd, 7th, 10th day after STZ treatment. Meanwhile, rats of C and M group were received with the same volume of sodium citrate solution. Blood glucose was measured before 1 day or at the 1st, 3rd, 7th or 14th day after receiving STZ. Body weight, paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) were measured before 1 day or at the 1st, 3rd, 5th, 7th, 10th or 14th day after receiving STZ. All lumbar spinal cords were dissected to examine the p-protein kinase B (p-Akt) and transient receptor potential vanilloid 1 (TRPV1) expression by Western blot.
 Results: After injection with STZ, the body weight showed significant differences at some time point between the M, T or C group (P<0.01); body weight of rat in the C group were increased gradually. Compared with the C group, the fast blood glucose in the M or the T Group at the same time points were increased significantly (P<0.01). The PWMT and PWTL of the M, T or C group were significant difference among various time points (P<0.01). The PWMT and PWTL in the M or T group were obviously reduced compared with those in the C group (P<0.01). Compared with the M group, the PWMT and PWTL in the T group were increased at the 10th or 14th day (P<0.01 or P<0.05). Compared with the C group, the p-Akt and TRPV1 levels in the M and T group were increased (P<0.01). Compared with the M group, p-Akt and TRPV1 levels in T group were decreased (P<0.01).
 Conclusion: VEGF is able to regulate the expression of TRPV1 through PI3K/Akt pathway, which contributes to diabetic peripheral neuropathic pain in rats. Anti-VEGF treatment may be useful for alleviation of diabetic peripheral neuropathic pain.

Effect of IL-8 on the Immune Function of Patients with Acute -Lymphoblastic Leukemia and Its Mechanism / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of interleukin -8 (IL-8) on immune function in acute lymphoblastic leukemia patients and its related mechanisms.@*METHODS@#Forty-five ALL patients were selected from January 2014 to September 2017 in our hospital. Out of them, 32 relieved patients were included in group A, 13 patients did not relieved patients after treatment and were included in the group B. The serum IL-8 level was detected by ELISA.Th1 and Th2 cells were measured by flow cytometry. After Th cells were treated with different concentration of IL-8, the Western blot was used to detect the translation levels of p-STAT3 and JAK in cells.@*RESULTS@#The difference of white blood cell count and clinical risk level between the 2 groups was statistically significant (P0.05).@*CONCLUSION@#IL-8 can interfere the balance of Th1/Th2 through STAT3 signaling pathway, and has effect on the immune function of ALL patients.

Impact of Smoking on Anal Abscess and Anal Fistula Diseases / 中华医学杂志(英文版)

<p><b>Background</b>Several studies have investigated the association between smoking and anal abscess and anal fistula (AA/F) diseases. However, the relationship between cigarette smoking and AA/F remains unclear. This study sought to assess the role of smoking in anorectal male patients in a Chinese population.</p><p><b>Methods</b>In this retrospective study, a questionnaire, including smoking history, was completed over a 3-month period by male inpatients in the Proctology Department of China-Japan Friendship Hospital. "Cases" were patients who had AA/F, and "controls" were patients with other anorectal complaints. Mann-Whitney U-test and Chi-square test were carried out to examine differences in baseline characteristics between groups. Subsequently, multivariate logistic regression was used to explore any related factors.</p><p><b>Results</b>A total of 977 patients aged from 18 to 80 years were included, excluding those diagnosed with inflammatory bowel disease or diabetes mellitus. Out of this total, 805 patients (82.4%) completed the entire questionnaire. Among the 805 patients, 334 (41.5%) were cases and 471 (58.5%) were controls. Results showed significant differences between cases and controls (χ = 205.2, P < 0.001), with smoking found to be associated with the development of AA/F diseases (odds ratio: 12.331, 95% confidence interval: 8.364-18.179, P < 0.001).</p><p><b>Conclusions</b>This study suggested smoking to be a potential risk factor for the development of AA/F diseases in a Chinese population. Consequently, current smoking patients should be informed of this relationship, and further research should be conducted to explore and investigate this further.</p>

Treatment of cervical ossification of the posterior longitudinal ligament by modified laminoplasty with C3 laminectomy and C7 spinous process retention / 中华骨科杂志

Objective To observe the clinical efficacy of modified laminoplasty with C3 laminectomy and C7 spinous process retention in the treatment of cervical ossification of the posterior longitudinal ligament(OPLL).Methods From February 2014 to March 2016,133 cases of OPLL were admitted,and 42 OPLLs were included according to the inclusion and exclusion criteria.A case-control study was conducted.Twenty-two cases were included in modified group and 20 cases in traditional group.There were 13 males and 9 females in the modified surgery group,and the average age was 56.2±9.75 years (39-77 years).Modified surgery was conducted with C3 laminectomy,C4-C6 laminoplasty,resection at the upper part of the C7 lamina and retaining the C7 spinous process.Meanwhile,there were 12 males and 8 females in the traditional surgery group,with an average age of 53.7± 8.23 years (41-75 years).Patients in the traditional surgery group were treated with standard C3-C7 laminoplasty.The mean followup was 22.9±4.5 (15-29) months.The JOA,NDI scores of the two groups were recorded preoperatively and postoperatively.The physiological curvature and activity of the cervical spine before and after operation were observed,and the incidence of axonal symptoms and postoperative complications in both groups were recorded.Results The follow-up period was 15-28 months,with an average of (23.2 ± 4.8) months.There was no significant difference between the base line of two groups before operation.At the last follow-up,the JOA and NDI scores of the two groups were significantly improved.There was no difference of JOA scores between the two groups at the last follow-up,while the NDI sores at the modified group(6.56±4.78) was superior to the traditional group(9.25±7.63).The VAS score at the first day after surgery in modified group was lower than that of the traditional group.The average cervical curvature of the patients in the modified surgery group and the standard surgery group were 12.32°±8.26° and 11.56°± 8.05°,respectively.There was no significant difference between the two groups.The postoperative range of movement (ROM) of cervical spine was 39.68°±9.52° in modified group and 33.51°± 10.39° in traditional group(P＜0.05).Eight patients (19％) had augmentation of axial symptoms,including 3 patients in the modified surgery group(13.6％) and 5 patients in the standard surgery group (30％).There was no significant difference between the two groups.During the follow-up period,there were no complications such as cerebrospinal fluid leakage,spinal cord injury,wound infection,laminar collapse,postoperative closure,internal fixation loss or fracture.Conclusion The modified laminectomy with C3 laminectomy and C7 spinous process retentionis minimally invasive,whichachieved satisfactory decompression effect,reduced the incidence of postoperative axial symptoms and maintained the cervical ROM.

History, current situation and trend of China's overseas health facilities aid / 中国卫生政策研究

This study conservatively estimates that the Chinese government invests about 267millions USD per year on health facilities aid,almost reaching the amount of Germany,and ranked fifth globally.Health facilities built by China mostly are general hospitals and health care centers located in Arica with unified model and standards,and are the "Turn Key" projects.These facilities have helped to alleviate the scarcity of medical and health resources and accessibility of residents to health services to some extent,as well as promoting the employment and the living standards of local people.However,due to the lack of guidance and coordination of the overall strategic planning and harmonization of health aid efforts,and the knowledge of partner countries' health systems,emphasis on demand driven and feasibility of infrastructure construction while ignoring the needs assessment and feasibility of functional fulfillment,it's hard to achieve the targeted assistance in China's health facilities aid projects.It was found that it's necessary to make three changes in the future:from "infrastructure assistance" to "functional assistance";from "'project assistance" to "program assistance";from a single government official assistance to a combination of official assistance and investment.

Health human resource development cooperation in China's foreign aid: Situation analysis and improvement strategies / 中国卫生政策研究

Health Human Resource Development Cooperation(HHRDC) is a critical component in Chinese foreign aid,which had cultivated thousands of health workers for Asian and Arican developing countries by on-job training,degree education,short-term exchange activities for more than 60 years.This paper systematically reviewed the management mechanism,mode and features of HHRDC via literature review,stakeholders interviews and field investigations,and it is found that the main mode of HHRDC is short-term on-job training,but its effect for capacity building is limited;although degree education account for a small proportion of HHRDC,it plays an important role for elite cultivation;the impact for medical team teaching and technical cooperation have become more obvious;the "going out" training have less invest,short period,but bigger social impact.The main challenges of HHRDC includes the deficiency of specific strategies and action plans;the lack of understanding on recipient countries' health human resource situation,characteristics and needs;the alignment with other aid programs;the lack of timely evalu ation towards current cooperation projects.According to the need analysis of undeveloped countries,it is suggested that a cooperation plan for HHDRC is required;the implementation of HHRDC should integrate into other aid programs;the follow-up mechanism and evaluation system need improved;the Chinese degree certification and qualification in local institutions need promoted;the aid to medical educational institutions should added,thereby strengthening developing countries' capacity and realizing common development.

Advances in the research of mechanism in prevention and treatment of scar with botulinum toxin type A and its clinical application / 中华烧伤杂志

Scar is a common complication in wound healing process, and how to effectively prevent and treat it is a hot and difficult problem in burns and plastic surgery field. Botulinum toxin type A is a neurotoxin that has been widely and effectively used in the cosmetic surgery field such as anti-wrinkle and thin face. In recent years, botulinum toxin type A has been applied in prevention and treatment of scar, which causes a great concern. Nowadays, the relevant reports have gradually increased, and the mechanisms have been explored more deeply. This article aims to summarize the possible mechanisms and clinical reports on the prevention and treatment of scar by botulinum toxin type A to provide a new way for the prevention and treatment of scar after surgery.

Effects of human amniotic epithelial stem cells-derived exosomes on healing of wound with full-thickness skin defect in rats / 中华烧伤杂志

Objective@#To investigate the effects of human amniotic epithelial stem cells-derived exosomes on healing of wound with full-thickness skin defect in rats.@*Methods@#(1) Human amniotic epithelial stem cells were isolated from the amnion tissue of 5 full-term pregnant women in Department of Obstetrics of our hospital by the method of trypsin digestion, and their morphology was observed. The third passage of cells were stained with rhodamine-phalloidin for cytoskeleton observation. The third passage of cells were identified with flow cytometry through the detection of expressions of cell surface markers CD29, CD31, CD34, CD90, CD105, SSEA3, SSEA4 and immunity-related marker human leukocyte antigen-D related site (HLA-DR). The third passage of cells were also assessed the ability of adipogenic and osteogenic differentiation. (2) The third passage of human amniotic epithelial stem cells were cultured in DMEM medium supplemented with 10% exosome-free fetal bovine serum. Exosomes were isolated from culture supernatant by the method of ultracentrifugation and represented with scanning electron microscope for morphologic observation. (3) Six adult SD rats were anesthetized, and four 1 cm×1 cm sized wounds with full-thickness skin defect were made on the back of each rat. The wounds on the back of each rat were divided into control group, 25 μg/mL exosomes group, 50 μg/mL exosomes group, and 100 μg/mL exosomes group according to the random number table (with 6 wounds in each group), and a total volume of 100 μL phosphate buffered saline, 25 μg/mL exosomes, 50 μg/mL exosomes, and 100 μg/mL exosomes were evenly injected around the wound through multiple subcutaneous sites, respectively. The wound healing rate was calculated based on measurement on post injury day (PID) 7, 14, and 21. On PID 21, the healed wound tissue of each group was collected and stained with HE to observe and count skin accessories, and the arrangement of collagen fibers was observed with Masson staining. Data were processed with analysis of variance for repeated measurement, analysis of variance of randomized block design, one-way analysis of variance, and Bonferroni test.@*Results@#(1) The cells, which were isolated and cultured, displayed typical cobblestone morphology with many microvilli on cell surface. Among the cells, the positive expression rates of CD29, CD90, SSEA3, and SSEA4 were above 50.0%, and the rate of CD105 was 8.0%, while the rates of CD31, CD34, and HLA-DR were almost 0. The cells could differentiate into adipocytes and osteoblasts. The above results revealed that the cells cultured were human amniotic epithelial stem cells. (2) Human amniotic epithelial stem cells-derived exosomes were round or oval vesicles with diameter from 50 to 150 nm. (3) On PID 7 and 21, wound healing rates of the four groups were close (with P values above 0.05). On PID 14, wound healing rates of 50 and 100 μg/mL exosomes groups were (89.8±4.3)% and (92.0±4.6)% respectively, significantly higher than the wound healing rate of control group [(80.3±6.4)%, P<0.05 or P<0.01]. Moreover, the wound healing rate of 100 μg/mL exosomes group was significantly higher than that of 25 μg/mL exosomes group [(83.3±5.1)%, P<0.05]. On PID 21, the numbers of skin accessories in 50 and 100 μg/mL exosomes groups were 4.3±1.4 and 5.1±1.6 respectively, obviously more than those of control group and 25 μg/mL exosomes group (respectively 1.4±0.5 and 1.8±0.6, with P values below 0.01). Well reorganized collagen fibers were observed just in the healed wound tissue of 50 and 100 μg/mL exosomes groups.@*Conclusions@#Human amniotic epithelial stem cells-derived exosomes can promote healing of wound with full-thickness skin defect in rats.

Role of miR-126 in effect of biological behaviour and epithelial to mesenchymal transition (EMT) in human colon cancer cells / 中国免疫学杂志

Objective:To investigate the expression of miR-126 in human colon cancer cell lines with different metastatic potential and its effect on the proliferation, invasion and metastasis of colon cancer cells, and to explore the possible mechanism.Methods:The expression of miR-126 in human colon cancer cell lines(SW480,SW620 and HCT116) was determined by Real-time fluorescence quantitative PCR.miR-126 mimics were transiently overexpressed in SW620 cells throuIgh liposome transfection and the negative control group was set up.The proliferation ability of cells was detected by CCK8 method and the mobility of cells was detected by wound healing assay and Transwell migration and invasion assay.The expression of E-cadherin,Vimentin was determined by Western blot.Results:The expression of miR-126 was decreased in SW620 and HCT116 cells with high metastatic potential compared SW480 cells with low metastatic potential.The overexpression of miR-126 significantly inhibited the proliferation,migration and invasion ability of SW620 cells and Western blot indicated that miR-126 overexpression increased the expression of E-cadherin and decreased the expression of Vimentin in SW620 cells,which was significantly different from that of negative control(P<0.05).Conclusion:Low expression of miR-126 is closely related to metastasis of colon cancer and the effect of miR-126 on the biological behavior of colon cancer cells may be mediated by the regulation of the EMT process.