Stakeholder research on hospice care under the “hospital-community” coordination / 中国医学伦理学

The “hospital-community” hospice care model involves multiple stakeholders，including demander，executor，leader，and fundraiser of medical and health services.The degree of benefit correlation，policy influence，and implementation willingness of various stakeholders were analyzed to provide reference for terminal cancer patients to obtain continuous，convenient，and high-quality hospice care.Health department and medical insurance department are the main driving forces for cross-institutional hospice care，but there are differences in their driving paths.The financial department is an important guarantor of policy implementation，and needs to ensure that its core interests are not lost.Community medical institutions are an important driving factor for policy implementation，but they require policy support and hospital drive. Medical staff in hospitals and communities，have weak willingness to implement policies，which can easily become obstacles to policy implementation in the absence of incentive and compensation mechanisms.Patients and their caregivers are important beneficiaries，but lack of publicity，education，and interactive communication can also lead to rejection and contradiction.Therefore，it is necessary to leverage the collaboration and coordination between policy enforcement departments，innovate the development model of hospitals，lead community medical institutions，and promote interactive communication and decision-making sharing of “doctor-doctor” and “doctor-patient”.

The characteristics and correlations of vaginal flora in women with cervical lesions / 中华肿瘤杂志

Objective: To explore the characteristics and correlations of vaginal flora in women with cervical lesions. Methods: A total of 132 women, including 41 women diagnosed with normal cervical (NC), 39 patients with low-grade cervical intraepithelial neoplasia (CIN 1), 37 patients with high-grade cervical intraepithelial neoplasia (CIN 2/3) and 15 patients with cervical squamous cell carcinoma (SCC), who came from the gynecological clinic of Second Hospital of Shanxi Medical University during January 2018 to June 2018, were enrolled in this study according to the inclusive and exclusive criteria strictly. The vaginal flora was detected by 16S rDNA sequencing technology. Co-occurrence network analysis was used to investigate the Spearman correlations between different genera of bacteria. Results: The dominant bacteria in NC, CIN 1 and CIN 2/3 groups were Lactobacillus [constituent ratios 79.4% (1 869 598/2 354 098), 63.6% (1 536 466/2 415 100) and 58.3% (1 342 896/2 301 536), respectively], while Peptophilus [20.4% (246 072/1 205 154) ] was the dominant bacteria in SCC group. With the aggravation of cervical lesions, the diversity of vaginal flora gradually increased (Shannon index: F=6.39, P=0.001; Simpson index: F=3.95, P=0.012). During the cervical lesion progress, the ratio of Lactobacillus gradually decreased, the ratio of other anaerobes such as Peptophilus, Sneathia, Prevotella and etc. gradually increased, and the differential bacteria (LDA score >3.5) gradually evolved from Lactobacillus to other anaerobes. The top 10 relative abundance bacteria, spearman correlation coefficient>0.4 and P<0.05 were selected. Co-occurrence network analysis showed that Prevotella, Peptophilus, Porphyrinomonas, Anaerococcus, Sneathia, Atopobium, Gardnerella and Streptococcus were positively correlated in different stages of cervical lesions, while Lactobacillus was negatively correlated with the above anaerobes. It was found that the relationship between vaginal floras in CIN 1 group was the most complex and only Peptophilus was significantly negatively correlated with Lactobacillus in SCC group. Conclusions: The increased diversity and changed correlations between vaginal floras are closely related to cervical lesions. Peptophilus is of great significance in the diagnosis, prediction and early warning of cervical carcinogenesis.

Correlation analysis for the lateral condylar tibial plateau fracture and complete medial collateral ligament rupture / 中华骨科杂志

Objective:To investigate the relationship between the CT images of a lateral condylar tibial plateau fractures and complete medial collateral ligament (MCL) injury.Methods:Data of 59 patients with lateral condylar fracture of tibial plateau complicated with MCL injury admitted to Tianjin Hospital from January 2020 to November 2021 were collected, including 32 males and 27 females, aged 42.4±12.3 years (range, 19-65 years), there were 26 cases of extension injury and 33 cases of flexion injury. The patients were separated into two groups: those with partial MCL injury and those with total rupture based on preoperative MR examination and intraoperative valgus stress test following fracture fixation. According to the ABC fracture classification of lateral condyle tibial plateau proposed by Sun et al., the fracture locations were determined on CT images, and the lateral plateau collapse depth (LPD) was measured. The relationship between LPD and MCL complete rupture was analyzed by receiver operating characteristic (ROC) curve.Results:Among 59 patients with lateral condylar tibial plateau fracture and MCL injury, 42 had partial injuries and 17 had complete ruptures. According to the ABC fracture classification, there were 26 cases of extension injury (involving area A), 21 cases of AB type, and 5 cases of ABC type; and 33 cases of flexion type injury, 19 cases of B type, 12 cases of BC type, and 2 cases of C type. All the 17 cases of MCL complete fracture occurred in extension injury, including type AB (14 cases) and type ABC (3 cases). The difference between the mean LPDs of the MCL full rupture group and the partial injury group was not statistically significant ( t=0.11, P=0.567), and the mean LPDs of both groups were 11.7±5.3 mm (range, 4.3-28.1 mm) and 11.5±4.8 mm (range, 3.8-23.6 mm), respectively. The area under the curve (AUC) of the ROC curve analysis was 0.504, and there was no statistical correlation between lateral platform collapse depth and MCL injury. Among the 26 patients with extensional injury area, MCL was completely ruptures in 17 cases and partially injury in 9 cases, LPD was 11.7±5.3 mm (range, 4.3-28.1 mm) and 6.6±1.8 mm (range, 3.8-9.4 mm), respectively, and the difference was statistically significant ( t=3.57, P=0.009). The best predictive cut-off value of LPD was 7.25 mm, the sensitivity was 88.2%, the specificity was 77.8%, and the AUC was 0.868. Conclusion:When the lateral condyle fracture of the tibial plateau is located in the extensional injury area (involving the A area in the ABC fracture classification) and the LPD measured on the CT image is greater than 7.25 mm, the complete rupture of the MCL should be considered. Clinical MCL repair is required after the fracture fixation surgery for improved surgical outcomes.

Thoughts on the development of International Organization for Standardization standards for Traditional Chinese Medicine information models / 国际中医中药杂志

The development of the International Organization for Standardization (ISO) standard for Traditional Chinese Medicine (TCM) information model is needed to promote the coordinated development of TCM information research and application on a global scale, and it is of great significance to promote the use of TCM data. Based on the 13 years of experience in the development of the ISO standard for the TCM information model, we introduced and discussed the development background, development platform, internationality and classification of the standard development. We determined the necessity of the ISO standard of TCM information model to be independent of modern medical information model standard, the necessity of developing standards on a large scientific platform, and the necessity of health informatics experts participating in standard development. We summarized the main points of international and domestic coordination. We emphasized the balance between the overall layout and new areas development, and the importance of application and promotion.

Clinical analysis of 10 cases with extramedullary plasmacytoma of the head and neck / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the clinical characteristics, treatment methods and outcomes of extramedullary plasmacytoma of the head and neck. Methods: A retrospective analysis was conducted on 10 cases with extramedullary plasmacytoma of the head and neck who were admitted to Henan Tumor Hospital from January 2005 to January 2020. Among the 10 patients, 6 were male and 4 were female. The average age at diagnosis was 56.3 years old (34-74 years old). Among them, 3 cases were located in the nasal cavity, 2 cases in the nasopharynx, 1 case in the sinuses, 2 cases in the larynx, 1 case in the oropharynx, and 1 case in the cervical lymph nodes. Treatments were administered according to tumor size and resection extent. Complete surgical excision (negative margins) was preferred, followed by adjuvant radiotherapy or radiotherapy alone. The clinical characteristics, diagnosis, treatment and prognosis of EMP were analyzed. Results: The patients' symptoms were not specific, frequently with local obstruction symptom and localized masses. All patients were confirmed pathologically as suffering from monoclonal plasmacytoma, with negative bone marrow biopsy and negative skeletal survey. Five patients received surgery, 3 received radiotherapy, and 2 received surgery with additional radiation. The follow-up time was 16-125 months, with a median of 92 months. Two patients developed into multiple myeloma. One patient who received radiotherapy after surgery relapsed after 7 years of follow-up and again received surgical treatment, with no evidence of second recurrence. The remaining patients had no recurrence or progression. Conclusion: Extramedullary plasmacytoma of the head and neck has a good prognosis. Surgical treatment can be considered for completely resectable lesions.

Research progress in surgical methods for tibial plateau fractures / 中华创伤杂志

The tibial plateau fractures is basically characterized by the collapse and split of the articular surface, increasing the difficulty of surgical reduction and fixation.The complex soft tissue structure adjacent to the tibial plateau prevents the reduction and fixation of tibial plateau fractures. The injuries associated with the fracture and surgical approach also aggravate the loss of knee joint stability. Therefore, the bony reconstruction and soft tissue protection of the knee joint have been the difficulties during the operation of tibial plateau fractures. The authors review the literatures relevant to the progress in surgical management of tibial plateau fractures from aspects of surgical approach, internal and external fixation technology, application of arthroscopic technique, balloon angioplasty, total knee arthroplasty, digital orthopedic technology and repair of soft tissue injury, hoping to provide references for clinical treatment of tibial plateau fractures.

Risk factors for preoperative venous thromboembolism in lower extremity in patients with tibial plateau fracture / 中华骨科杂志

Objective:To analyze the risk factors of deep venous thrombosis (DVT) in patients with tibial plateau fracture during preoperative period.Methods:From July 2017 to October 2019, a total of 264 patients undergoing surgeries of tibial plateau fractures were enrolled. Duplex ultrasonography (DUS) during hospitalization was used to screen for DVT of the bilateral lower extremities. Patients were divided into DVT group and non-DVT group according to results of DUS. Data on demographics, comorbidities, injury-related data, fracture type, laboratory biomarkers were collected and compared between groups with and without DVT.Results:The incidence of preoperative DVT was 39.0% (103/264) among 264 patients with traumatic tibial plateau fractures, and distal thrombosis predominated in DVT group. There were 103 cases in DVT group. 55 were males and 48 were females. The average age was 54.00±11.12. According to the Schatzker classification of tibial plateau fractures, 7 cases belonged to type I, 37 to type II, 2 to type III, 11 to type IV, 29 to type V, and 17 to type VI. There were 161 cases in non-DVT group. 89 were males and 72 were females. The average age was 48.57±13.25. According to the Schatzker classification of tibial plateau fractures, 23 cases belonged to type I, 76 to type II, 2 to type III, 10 to type IV, 33 to type V, and 17 to type VI. Univariate analysis showed that age ( t=3.451, P=0.001), the type of tibial plateau fracture ( χ2=8.314, P=0.004), D-dimer ( χ2=18.552, P<0.001), APTT ( t=2.869, P=0.004), ALB ( t=2.292, P=0.023) and Hb ( t=1.983, P=0.048) were statistically different than those in non-DVT group. Multivariate analysis showed age ( OR=1.033, 95% CI: 1.009, 1.058; P=0.007), the type of tibial plateau fracture ( OR=1.829, 95% CI: 1.014, 3.299; P=0.045) and D-dimer ( OR=1.914, 95% CI: 1.057, 3.464; P=0.032) were independent risk factors. Conclusion:The incidence of DVT in patients with tibial plateau fractures during preoperative period is high, and distal thrombosis is the main part of venous thrombosis of lower extremity. The type of tibial plateau fracture, age and the level of D-dimer are independent risk factors of preoperative DVT in patients with tibial plateau fractures.

Therapeutic mechanism of Psammosilene tunicoides extract on rheumatoid arthritis based on NLRP3 inflammasome / 中国中药杂志

In this study, we investigated the mechanism of crude extract of Psammosilene tunicoides(CEPT) in the treatment of rheumatoid arthritis(RA) based on the Nod-like receptor protein 3(NLRP3) inflammasome. The collagen-induced arthritis(CIA) mouse model was established. On day 32 after the primary immunization, according to the arthritis score, the mice were randomly divided into model group, positive control(methotrexate) group, low-and high-dose CEPT groups, and normal group, with 10 mice in each group. According to the administration dose of each group, the mice were continuously administered for 21 days. Every four days during the administration, the paw edema degree, arthritis score, and spleen index of the mice were measured; histopathological examination was performed for the ankles of the mice; the contents of IL-1β and IL-18 in the serum were determined; the protein expression levels of NLRP3, caspase-1, and apoptosis-associated speck-like protein containing a CARD(ASC), as well as the mRNA expression levels of NLRP3 and caspase-1 in the ankle joints of the mice were detected. The results showed that compared with those in the model group, the mice in the positive control group and CEPT groups had significantly decreased the contents of IL-1β and IL-18 in the serum and spleen index(P<0.01), significantly lowered arthritis score and degree of paw edema(P<0.01), alleviated arthritic infiltration of the knee, and down-regulated protein and mRNA levels of NLRP3, ASC, and caspase-1 in the ankle joint(P<0.01). These results suggest that P. tunicoides may reduce the paw edema and arthritis score and alleviate the inflammatory response in CIA mice by inhibiting the expression of NLRP3. This study provides a basis for the study of immune regulation of P. tunicoides in RA.

Clinical features and surgical effectiveness of hyperextension bicondylar tibial plateau fractures / 中华骨科杂志

Objective To investigate the clinical features of patients with hyperextension bicondylar tibial plateau fractures (HEBTPs),and assess surgical effectiveness of HEBTP and non-HEBTP fracture patients.Methods From June 2014 to May 2017,82 patients with bicondylar tibial plateau fracture were included in this study.There were 63 patients with 63 knees (76.8％) that had sustained non-HEBTPs,and 19 patients with 19 knees (23.2％) that had HEBTPs,including 49 males and 33 females with a mean age of 48.3 years (range,22-76).Of the 19 HEBTPs patients,4 cases were hyperextension valgus injury,9 cases were hyperextension varus injury,and 6 cases were pure hyperextension injury.All patients were treated with open reduction internal fixation combined with bone grafting or non-bone grafting.All follow-up patients were evaluated clinically and radiographically,included the incidence of associated injuries,infection,posttraumatic osteoarthritis,range of motion (ROM) of knee,numeric rating scale (NRS) for assessment of pain,and Short Musculoskeletal Functional Assessment (SMFA) scores for assessment of knee function.The fracture healing and postoperative alignment were assessed with anteroposterior and lateral X-rays.Results All patients were followed up for 12-22 months,the mean follow-up time was 15.4 months.Bone union was obtained in all patients,and the bone union time was 12.6 weeks (ranged:12-16 weeks).At the last follow up,all patients had full range of motion.The incidence of significant associated injuries was 36.8％ in the HEVBTP group compared with 15.8％ in the non-HEBTP group.The incidence of popliteal artery injury,common peroneal nerve injury and ligament injury that needed repair in 19 HEBTPs patients was 21.1％,26.3％ and 31.6％,respectively,while the corresponding incidence of complications in 63 non-HEBTPs patients was 3.2％,4.8％,and 9.5％,respectively.The NRS pain score of HEBTPs and non-HEBTPs at 12 months after surgery was 3.89±1.9 and 2.76± 1.88,respectively.The value of HEBTPs patients was higher than that of non-HEBTPs patients,But the difference was not statistically significant.The SMFA scores of HEBTPs and non-HEBTPs patients at 12 months after surgery were 27.27± 19.44 and 17.09± 15.87,respectively.Patients with HEBTP had higher functional (SMFA) scores and a trend of higher pain scores than those with non-HEBTP,indicating associated soft-tissue damage and developed posttraumatic osteoarthritis.Conclusion The present showed that the HEBTP is a unique fracture.These injuries result in worse functional outcomes than non-HEBTP.Physicians must recognize the possible associated injuries (included ligaments,vessels and nerves),and the treatment effect of HEBTP is relatively poor.

Clinical features and surgical effectiveness of hyperextension bicondylar tibial plateau fractures / 中华骨科杂志

Objective@#To investigate the clinical features of patients with hyperextension bicondylar tibial plateau fractures (HEBTPs), and assess surgical effectiveness of HEBTP and non-HEBTP fracture patients.@*Methods@#From June 2014 to May 2017, 82 patients with bicondylar tibial plateau fracture were included in this study. There were 63 patients with 63 knees (76.8%) that had sustained non-HEBTPs, and 19 patients with 19 knees (23.2%) that had HEBTPs, including 49 males and 33 females with a mean age of 48.3 years (range, 22-76). Of the 19 HEBTPs patients, 4 cases were hyperextension valgus injury, 9 cases were hyperextension varus injury, and 6 cases were pure hyperextension injury. All patients were treated with open reduction internal fixation combined with bone grafting or non-bone grafting. All follow-up patients were evaluated clinically and radiographically, included the incidence of associated injuries, infection, posttraumatic osteoarthritis, range of motion (ROM) of knee, numeric rating scale (NRS) for assessment of pain, and Short Musculoskeletal Functional Assessment (SMFA) scores for assessment of knee function. The fracture healing and postoperative alignment were assessed with anteroposterior and lateral X-rays.@*Results@#All patients were followed up for 12-22 months, the mean follow-up time was 15.4 months. Bone union was obtained in all patients, and the bone union time was 12.6 weeks (ranged: 12-16 weeks). At the last follow up, all patients had full range of motion. The incidence of significant associated injuries was 36.8% in the HEVBTP group compared with 15.8% in the non-HEBTP group. The incidence of popliteal artery injury, common peroneal nerve injury and ligament injury that needed repair in 19 HEBTPs patients was 21.1%, 26.3% and 31.6%, respectively, while the corresponding incidence of complications in 63 non-HEBTPs patients was 3.2%, 4.8%, and 9.5%, respectively. The NRS pain score of HEBTPs and non-HEBTPs at 12 months after surgery was 3.89±1.9 and 2.76±1.88, respectively. The value of HEBTPs patients was higher than that of non-HEBTPs patients, But the difference was not statistically significant. The SMFA scores of HEBTPs and non-HEBTPs patients at 12 months after surgery were 27.27±19.44 and 17.09±15.87, respectively. Patients with HEBTP had higher functional (SMFA) scores and a trend of higher pain scores than those with non-HEBTP, indicating associated soft-tissue damage and developed posttraumatic osteoarthritis.@*Conclusion@#The present showed that the HEBTP is a unique fracture. These injuries result in worse functional outcomes than non-HEBTP. Physicians must recognize the possible associated injuries (included ligaments, vessels and nerves), and the treatment effect of HEBTP is relatively poor.

Effects of Vitamin D on Autophagy and Apoptosis in Hippocampus of Rats with Traumatic Brain Injury / 中国康复理论与实践

Objective To explore the effect of vitamin D hormone(VDH)on autophagy and apoptosis in hippocampus of rats with traumatic brain injury(TBI). Methods A total of 45 male Sprague-Dawley rats were divided into control group(n=15),model group(n=15)and VDH group(n=15).The TBI model was established in the model group and VDH group.VDH group was injected with VDH 1 μg/kg 30 minutes,24 hours and 48 hours after modeling,respectively.The expression of microtubule as-sociated protein 1 light chain 3(LC3)and p62 was detected with Western blotting,and the number of apoptotic cells were detected with TUNEL three days after modeling.All groups were tested with Morris water maze on the fifth,sixth and seventh days. Results The number of TUNEL positive cells in hippocampus was more in the model group than in the control group (P<0.05),and was lower in VDH group than in the model group(P<0.05),as well as the expression of LC3II/LC3I and p62(P<0.05).The escape latency was longer in the model group than in the control group(P<0.05),and was shorter in VDH group than in the model group (P<0.05). There was no significant difference in the swimming velocity on the fifth,sixth,and seventh days among three groups(F=0.530,P>0.05). Conclusion VDH has potential neuroprotective effects on TBI,which might be associated with its anti-apoptosis effect on the expression of LC3 and p62 proteins in hippocampus after TBI.

The value of cross raft screws technique to prevent postoperative collapse of tibial plateau fracture / 中华骨科杂志

Objective To assess the clinical value of cross raft screws technique in preventing postoperative collapse of tibial plateau fracture.Methods From September 2014 to November 2017,data of 14 patients with tibial plateau fracture who were treated by cross raft screws technique were retrospectively analyzed.There were 9 males and 5 females aged from 30-65 years old (average,44.4± 1.7 years).There were 8 patients that the thickness of subchondral cancellous bone measured preoperatively by CT data was less than 4 mm,and 6 patients that the thickness of subchondral cancellous bone measured intraoperatively was less than 4 mm.1/4 tubular plate was placed along the anterior rim of lateral tibial plateau,and the 3.5 mm cortical bone screws were fixed as bamboo raft from anterior to posterior through the plate.The collapse of tibial plateau after surgery were measured by CT scan after union of the fracture.The function of knee was evaluated by Rasmussen Anatomical and Functional Grading.Results The time of tubular plate procedure was 18 to 35 min (average,24.1±5.4 min).All 14 patients were successfully followed-up for 13.8±5.1 months.The height of collapse preoperatively by CT scan was 5-21 mm (average,8.00± 1.40 mm).3 days after the operation,the height between articular line and lateral articular surface was 0-2 mm (average,0.80±0.06 mm).Compared with CT data preoperatively,the collapse was corrected postoperatively that was proved by CT scan (P＜ 0.05).After the fracture was healed,according to CT data,the height between articular line and lateral articular surface was 0-2 mm (average,0.70±0.08 mm).Compared with CT data postoperatively,there was no postoperative collapse happened (P=0.466).The position and length of nails were placed appropriately.The average healing time of fracture was 3.6 months.There were no infection,nonunion and pain of tendon happened.The plate could be touched subcutaneously in 2 patients,who had no discomfort feelings.The patient's postoperative Rasmussen Anatomical Grading were 13-18 (average,16.7),including 8 cases excellent and 6 cases good.The postoperative Rasmussen Functional Grading was 18-28 (average,25.7),including 11 cases excellent and 3 cases good.Conclusion The cross raft screws technique is a good way to prevent the postoperative collapse of the lateral articular surface of tibial plateau.

Identification of Honeys and Syrups by Microwave Plasma Torch Mass Spectrometry / 分析化学

In this study, a method for rapid identification of three kinds of honey and four kinds of syrup by microwave plasma torch mass spectrometry ( MPT-MS) without sample pretreatment was established. Under the positive ion mode, honey and syrup were ionized by MPT-MS and analyzed by quadrupole mass spectrometry ( QMS). The MS data were analyzed with chemometrics methods. Consequently, principal component analysis ( PCA) showed that PC1, PC2 and PC3 had a total contribution rate of 91. 2％ , and cluster analysis (CA) indicated when the critical value was 7, this method could distinguish honey and syrup in addition to clover honey and inulin syrup. Partial least squares-discriminant analysis ( PLS-DA) also manifested that honey and syrup could be effectively distinguished. Discriminant analysis (DA) demonstrated that the discriminant accuracy of honey and syrup was 100％ . Accordingly, all the results showed that the method of MPT-MS combined with chemometrics could identify honey and syrup rapidly. In brief, this method has the advantages such as fast analysis speed, accurate information extraction, high recognition accuracy and without sample pretreatment, and can be used for the identification of honey and main adulterated syrup.

Oral anticoagulants for prevention of stroke in patients with atrial fibrillation / 国际脑血管病杂志

Atrial fibrillation (AF) is a common arrhythmia type. It affects more than 80％ of the elderly. The main hazards are stroke and other systemic thromboembolism. Compared with the strokes caused by other causes, the disability, mortality and recurrence rate of AF-related stroke are higher. Therefore, the prevention of stroke in patients with AF is critical. Anticoagulation is the core therapeutic strategy for stroke prevention in patients with AF. This article reviews various oral anticoagulants for stroke prevention in patients with AF.

Advances on ANCA-associated vasculitis / 复旦学报（医学版）

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) consists of autoimmune diseases characterized by necrotizing inflammation of small vessels and presence of ANCA.As a kind of life-threatening disease,AAV tends to involve a plenty of systems,and is subject to relapse even after complete remission.In this review,we focus on the latest progress of epidemiology,etiology,pathogenesis and clinical diagnosis of AAV.

Pathogenesis of neuromyelitis optica spectrum disorder / 中华神经医学杂志

Neuromyelitis optica spectrum disorder (NMOSD) is a kind of immune mediated inflammatory demyelinating disease of the central nervous system manifesting with optic neuritis and acute transverse myelitis,which takes a relapsing or progression course.The exact etiology and pathogenesis are not clear.There are a lot of researches on immune pathogenesis;in addition,the pathogenesis also involves genetic,environmental,oxidative stress and other factors.

Influence of epigallocatechin-3-gallate on myeloid macrophages polarization induced with IFN-γ/LPS in mice / 中国免疫学杂志

Objective:To investigate the effect of epigallocatechin-3-gallate ( EGCG) on the expression of pro-inflammatory cytokines in murine bone marrow-derived macrophages ( BMDM) induced by IFN-γ/LPS.Methods:The bone marrow cells were isolated from 6-8 weeks C57BL/6 mice,which cultured in RPMI1640 medium with 10%FBS and stimulated with 100 ng/ml M-CSF in vitro,and then exposed to 50 ng/ml IFN-γand 1 μg/ml LPS with various concentrations of EGCG (12.5-50 μmol/L) .The expression of pro-inflammatory factors,IL-1β,TNF-αand iNOS were detected,in murine myeloid macrophages stimulated by IFN-γ/LPS with qRT-PCR and ELISA.Results:IFN-γ/LPS remarkably up-regulated the expression levels of inflammatory cytokines ,IL-1β,TNF-αand iNOS,but EGCG effectively repressed these cytokines expression in IFN-γ/LPS-stimulated murine myeloid macrophages , in dose-dependent manner.Conclusion:EGCG attenuates the pro-inflammatory phenotype of murine myeloid macrophages stimulated with IFN-γ/LPS.

Meta-analysis of Aidi Injection Combined with S-1 for Advanced Gastric Cancer / 中国药房

OBJECTIVE:To evaluate therapeutic efficacy and safety of Aidi injection combined with S-1 for advanced gastric cancer systematically,and to provide evidence-based reference. METHODS:Retrieved from CJFD,Wanfang database,VIP, CBM,Cochrane Library,PubMed and EMBase,randomized controlled trials(RCTs)about Aidi injection combined with S-1(tri-al group) vs. S-1 alone (control group) for advanced gastric cancer were collected. Meta-analysis was conducted by Rev Man 5.3 software after data extraction and quality evaluation by risk bias evaluation tool of Cochrane Handbook Version 5.1.0. RESULTS:A total of 8 RCT were included,involving 690 patients. Results of Meta-analysis showed that there was no statistical significance in therapeutic efficacy of solid tumor between 2 groups [OR=1.19,95%CI(0.88,1.61),P=0.26]. The improvement rate of survival quality[OR=3.62,95%CI(2.48,5.30),P<0.001],immunoglobulin level [CD3:SMD=1.31,95%CI(1.06,1.56),P<0.001;CD4:SMD=1.71,95%CI(1.38,2.04),P<0.001;CD8:SMD=-1.46,95%CI(-1.68,-1.23),P<0.001;CD4/CD8:SMD=1.45,95%CI(1.14,1.76),P<0.001] in trial group was significantly higher than control group. The incidence of leukopenia [RR=0.52,95%CI (0.40,0.68),P<0.001],thrombocytopenia [RR=0.49,95%CI(0.36,0.67),P<0.001] and gastrointestinal disorder [RR=0.56,95%CI(0.43,0.71),P<0.001] in trial group were significantly lower than control group,with statistical significance. CONCLUSIONS:Compared to S-1 alone,S-1 combined with Aidi injection can not significantly improve therapeutic efficacy of solid tumor therapy, but can improve survival quality and immunity of patients,as well as reduce the occurrence of ADR.

Observation of curative effect of avulsion fracture of anterolateral ligament of knee joint / 中华骨科杂志

Objective To explore the clinical effect of periarticular knee fractures combined with anterolateral ligament (ALL) avulsion fracture.Methods From June 2014 to November 2015,13 patients with ALL avulsion fracture in periarticular knee fractures were fixed by the star plate,cannulated or screws suture anchor,including 9 male and 3 female with the mean age of 39.5 years (range from 28 to 51 years).6 patients were diagnosed distal femoral fracture,4 tibial plateau fracture,and 3 tibial intercondylar eminence avulsion fracture which all combined with ALL avulsion fracture.Postoperatively,all patients were treated with the adjustable knee brace for 3 months.Results All patients were followed up for 4-20 months,the mean follow-up time was 13.5 months.The average surgical time was 130 min (range from 90 to 210 min).In all 13 patients,ALL was found and identified.Bone union was obtained in all patients,and the bone union time was 11.4 weeks (10-12 weeks).7 cases were fixed with star plate,5 cases were fixed with hollow screw,and 1 case was fixed with anchor.All follow-up patients underwent anteroposterior and lateral X-rays.Pain,swelling and functional recovery of the knee joint were observed.Patients were assessed postoperatively with International Knee Documentation Committee (IKDC) score,Lysholm score,and Tegner activity scale to evaluate the clinical effect.At the last follow-up,all patients had full range of motion of the knee joint which from 0° to approximate 120°.The Lysholm,objective IKDC were 86.5 and 84.6 respectively.Among the 13 patients evaluated,9 patients were graded A,and 4 patients were graded B by subjective IKDC.The Tegner activity scale at the last follow-up was 6.7.Incision of poor healing in 1 case,and got healed after 32 d cleaning dressing.Conclusion This study confirmed the presence of the ALL.The fixation of ALL avulsion fracture in periarticular knee fractures can be an effective procedure at a minimum follow-up of 13.5 months.