Prognostic value of AST/ALT ratio combined with APTT regimen in NVAF patients receiving rivaroxaban anticoagulant therapy / 国际生物医学工程杂志

Objective:To investigate the prognostic value of the ratio of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) combined with activated partial thromboplastin time (APTT) in elderly patients with non-valvular atrial fibrillation (NVAF) treated with rivaroxaban.Methods:One hundred and twenty-two elderly patients with NVAF who were anticoagulated with rivaroxaban from June 2020 to June 2021 in the Third Central Hospital of Tianjin were enrolled and divided into four groups based on the median method. The patients in the Q1 group ( n = 32) have low AST/ALT/low APTT. The patients in the Q2 group ( n = 27) have low AST/ALT/high APTT. The patients in the Q3 group ( n = 29) have high AST/ALT/low APTT. The patients in the Q4 group ( n = 34) have high AST/ALT/high APTT. The efficacy endpoint events, and safety endpoint events were analyzed in the four groups, and univariate and multivariate Cox regression analyses were performed for the composite endpoint events. Results:The effectiveness endpoint events were mainly cardiovascular deaths, the number of which in the Q1 to Q4 groups was 0 (0), 1 (3.70%), 4 (13.79%), and 5 (14.71%), respectively. The safety endpoint events were mainly non-major bleeding events, the number of which in the Q1 to Q4 groups was 5 (15.62%), 2 (7.41%), 6 (20.69%), and 5 (14.71%), respectively. Compared to the Q1 group, the Q4 group had an increased risk of composite endpoint events after incorporating traditional risk factor correction ( HR: 3.851, 95% CI: 1.167 to 12.704). Conclusions:AST/ALT ratio combined with APTT can provide risk stratification for distant bleeding and cardiovascular adverse events in elderly NVAF patients treated with rivaroxaban anticoagulation and has some predictive value for their prognosis.

Effect of acupuncture on HIF-1α/NLRP3 inflammatory signaling pathway in the rats with cerebral ischemia-reperfusion injury / 中国针灸

OBJECTIVE@#To observe the effects of Xingnao Kaiqiao (regaining consciousness and opening orifices) acupuncture therapy on the expression of hypoxia-inducible factor 1α (HIF-1α) and Nod-like receptor protein 3 (NLRP3) in cerebral ischemia-reperfusion rats, and to explore the mechanism of acupuncture against cerebral ischemia-reperfusion injury.@*METHODS@#Seventy-two male SD rats were randomly divided into a sham-operation group, a model group, an acupuncture group and a non-point acupuncture group, with 18 rats in each one. Using modified Longa thread embolization method, the rat model of acute focal cerebral ischemia was prepared; and after 2 h ischemia, the reperfusion was performed to prepared the model of cerebral ischemia-reperfusion. Immediately after reperfusion, Xingnao Kaiqiao acupuncture method was applied to bilateral "Neiguan" (PC 6) and "Shuigou" (GV 26) in the acupuncture group, while in the non-point acupuncture group, acupuncture was delivered at non-points and all of the needles were retained for 30 min in these two groups. The samples were collected 24 h after reperfusion in the rats of each group. Zea-Longa neurological deficit score was used to evaluate the degree of cerebral neurological impairment, TTC staining was adopted to observe the volume percentage of cerebral infarction, HE staining was provided to observe the morphological changes of brain, and Western blot was applied for detecting the expression of HIF-1α and NLRP3 proteins in the cerebral cortex on the right side.@*RESULTS@#Compared with the sham-operation group, neurological deficit score and volume percentage of cerebral infarction were increased in the model group (P<0.01), and HIF-1α and NLRP3 protein expression was elevated (P<0.01). Compared with the model group, neurological deficit score and volume percentage of cerebral infarction were decreased (P<0.01), and HIF-1α and NLRP3 protein expression was lower (P<0.01) in the acupuncture group. There was no significant difference in above indexes in the non-point acupuncture group compared with the model group (P>0.05). Compared with the sham-operation group, the brain tissue of the rats in the model group and the non-point acupuncture group was loose and edema, and the nuclei were shriveled. The brain tissue morphology in the acupuncture group was similar to that of the sham-operation group.@*CONCLUSION@#Acupuncture can alleviate cerebral ischemia-reperfusion injury, and its mechanism may be related to the regulation of HIF-1α/NLRP3 signaling pathway to attenuate inflammatory response.

Optimization of extraction technology for couplet medicinals of Astragalus membranaceus-Puerariae lobata by multi-index comprehensive scoring method combined with orthogonal experiment / 中国药房

OBJECTIVE To optimize extraction technology of couplet medicinals of Astragalus membranaceus-Puerariae lobatae. METHODS With contents of puerarin，daidzin，calycosin-7-O-β-D-glucopyranoside，daidzein，calycosin and formononetin and the yield of dry extract as index，the analytic hierarchy method was used to determine the weight coefficient of each index and calculate the comprehensive score. The effects of solid-liquid ratio， extraction times and extraction time on the comprehensive score were investigated by single factor test. The level of each factor was determined. By multi-index comprehensive scoring method， using comprehensive scores of above 7 indexes as indexes，the extraction technology of couplet medicinals of A. membranaceus-P. lobata was optimized by orthogonal experiment，and the validation tests were conducted. RESULTS The weight coefficient for the contents of puerarin，daidzin，calycosin-7-O-β-D-glucopyranoside，daidzein，calycosin and formononetin and the yield of dry extract were respectively 0.304 7，0.065 2，0.185 8，0.185 8，0.107 8，0.107 8 and 0.042 7. The optimal extraction technology was determined as follows： solid-liquid of 1∶8（g/mL），extracting 3 times and for 1 h each time. RSD of each evaluation index in the validation test results was lower than 3.00% （n＝3）. CONCLUSIONS The optimized extraction technology for A. membranaceus-P. lobata is stable and feasible.

Relationship between the level of inflammatory factors and disease state in patients with acute coronary syndrome / 国际生物医学工程杂志

Objective:To investigate the influence of infarct vessel diameter, blood flow before operation, blood flow status after operation, coronary artery disease, number of coronary artery lesions and other risk factors on the levels of inflammatory factors IL-1, IL-6, IL-10 in the coronary blood of patients with acute coronary syndrome (ACS), and to determine the relationship between inflammatory factors and ACS and its impact on clinical status.Methods:The peripheral blood and coronary blood of 54 patients with ACS underwent emergency interventional treatment were collected before the operation. The level of IL-1, IL-6, and IL-10 in the blood sample was detected by an automatic biochemical analyzer.Results:Postoperative adverse cardiac events were positively correlated with the patient's age, D-to-B time, and the number of coronary artery lesions (all P<0.05). The levels of IL-1, IL-6 and IL-10 in coronary blood of ACS patients were higher than those in peripheral blood (all P<0.05). The number of coronary artery disease branches (≥3), the onset time of myocardial infarction (>4 h), diabetes mellitus, ischemic post-treatment, preoperative blood flow level (<TIMI2 level) will increase the expression of IL-1 in serum (all P<0.05). For those who have no history of smoking, history of diabetes, infarct vessel diameter> 2.5 mm, coronary artery disease number ≥ 3, severe right coronary artery disease, preoperative blood flow <TIMI 2 level, postoperative CTFCs>22 frames, and cardiovascular events, the IL-10 levels are higher (all P<0.05). Conclusions:The levels of inflammatory factors IL-1, IL-6, and IL-10 in coronary blood of ACS patients are higher than those in peripheral blood, suggesting that acute coronary artery originates from local coronary inflammatory reaction, and the increase of inflammatory factors in peripheral blood belongs to "Erosion" effect. The level of inflammatory factors is significantly related to the diameter of the diseased blood vessel, preoperative blood flow, the number of coronary artery disease, the location of myocardial infarction, diabetes and smoking history.

An UPLC-MS/MS method for simultaneous determination of multiple constituents in Guizhi Fuling capsule with ultrafast positive/negative ionization switching / 中国天然药物

Guizhi Fuling capsule (GFC), a traditional Chinese medicine (TCM) with effects of promoting blood circulation and dissipating blood stasis, has been widely used in the clinic. Because of the complex matrix and various chemical structure types, quality control of GFC remains great challenge. In the present study, an ultra performance liquid chromatography hybrid triple-quadrupole mass spectrometry (UPLC-QQQ MS) method with ultrafast positive/negative ionization switching was developed for simultaneous determination of 18 bioactive components in GFC, including methyl gallate, ethyl gallate, oxypaeoniflorin, benzoic acid, albiflorin, paeonolide, paeoniflorin, 1, 2, 3, 4, 6-pentagalloylglucose, mudanpioside C, benzoyloxypaeoniflorin, benzoylpaeoniflorin, pachymic acid, amygdalin, cinnamaldehyde, paeonol, cinnamic acid, 4-hydroxybenzoic acid, and gallic acid. Separation was performed on an Agilent Zorbax Extend-C18 column (2.1 mm × 50 mm, 1.8 μm), using a gradient elution with acetonitrile and water containing 0.1% formic acid. Cholic acid was selected as the internal standard. This newly developed method was fully validated for linearity, precision, accuracy, and stability, and then applied to quality assessment of GFC. Finally, the batch-to-batch reproducibility of GFC samples was evaluated by the cosine ration and Euclidean distance method, which showed high quality consistency. The results demonstrated that the developed method pro vided a reasonable and powerful manner for quality control of GFC.

An UPLC-MS/MS method for simultaneous determination of multiple constituents in Guizhi Fuling capsule with ultrafast positive/negative ionization switching / 中国天然药物

Guizhi Fuling capsule (GFC), a traditional Chinese medicine (TCM) with effects of promoting blood circulation and dissipating blood stasis, has been widely used in the clinic. Because of the complex matrix and various chemical structure types, quality control of GFC remains great challenge. In the present study, an ultra performance liquid chromatography hybrid triple-quadrupole mass spectrometry (UPLC-QQQ MS) method with ultrafast positive/negative ionization switching was developed for simultaneous determination of 18 bioactive components in GFC, including methyl gallate, ethyl gallate, oxypaeoniflorin, benzoic acid, albiflorin, paeonolide, paeoniflorin, 1, 2, 3, 4, 6-pentagalloylglucose, mudanpioside C, benzoyloxypaeoniflorin, benzoylpaeoniflorin, pachymic acid, amygdalin, cinnamaldehyde, paeonol, cinnamic acid, 4-hydroxybenzoic acid, and gallic acid. Separation was performed on an Agilent Zorbax Extend-C18 column (2.1 mm × 50 mm, 1.8 μm), using a gradient elution with acetonitrile and water containing 0.1% formic acid. Cholic acid was selected as the internal standard. This newly developed method was fully validated for linearity, precision, accuracy, and stability, and then applied to quality assessment of GFC. Finally, the batch-to-batch reproducibility of GFC samples was evaluated by the cosine ration and Euclidean distance method, which showed high quality consistency. The results demonstrated that the developed method pro vided a reasonable and powerful manner for quality control of GFC.

Static and gait finite element analysis on individualized titanium alloy pelvic prosthesis manufactured by 3D printing / 医用生物力学

Objective To evaluate the biomechanical properties of 3D printed individualized titanium alloy pelvic prosthesis in static and gait states by the method of finite element analysis. Methods Three patients with different types of pelvic tumors were treated by hemi-pelvic arthroplasty with resection of hemi-pelvis. CT and MRI were performed before the surgery, and the corresponding individualized titanium alloy pelvic prostheses were designed. The pelvic models were reconstructed with 3D reconstruction technique, and then assembled with the individualized pelvic prostheses. The human skeletal muscle model was established by AnyBody software to perform gait dynamics analysis. The stress distribution and stress concentration areas of 3 reconstructed pelvic models in static and gait states were obtained by ABAQUS. Results Under both static and gait conditions, the maximum stress of the 3 pelvic prostheses was smaller than the yield strength of the titanium alloy. The pelvic ring of the reconstructed pelvis could meet the rule of stress conduction. The patients’ daily life returned to normal condition after the surgery. Conclusions The effect of 3D prosthetic titanium prosthesis on recovery of pelvic ring is satisfactory, and its effectiveness and stability can meet the requirement of human biomechanics. The analytic results can provide references for clinicians and prosthesis designers.

Massive pulmonary embolism similar to acute myocardial infarction rescued by ECMO: a case report / 中华危重病急救医学

Acute myocardial infarction (AMI) and acute massive pulmonary embolism can be characterized by no pulse electrical activity. Patients of cardiac arrest (CA) with no pulse electrical activity have a high mortality rate before the cause was corrected. Extracorporeal membrane oxygenation (ECMO), as a kind of artificial heart-lung support organ, provides treatment for CA patients. A case of massive pulmonary embolism similar to AMI was treated in the Third Central Hospital of Tianjin, who received interventional thrombolysis assisted by ECMO. Through the review of the overall development of the case, we aim to broaden the diagnosis and treatment of CA patients with no pulse electrical activity, and to improve the understanding of the complications secondary to ECMO.

Massive pulmonary embolism similar to acute myocardial infarction rescued by ECMO: a case report / 中华危重病急救医学

Acute myocardial infarction (AMI) and acute massive pulmonary embolism can be characterized by no pulse electrical activity. Patients of cardiac arrest (CA) with no pulse electrical activity have a high mortality rate before the cause was corrected. Extracorporeal membrane oxygenation (ECMO), as a kind of artificial heart-lung support organ, provides treatment for CA patients. A case of massive pulmonary embolism similar to AMI was treated in the Third Central Hospital of Tianjin, who received interventional thrombolysis assisted by ECMO. Through the review of the overall development of the case, we aim to broaden the diagnosis and treatment of CA patients with no pulse electrical activity, and to improve the understanding of the complications secondary to ECMO.

Effect of the ischemic post-conditioning on the prevention of the cardio-renal damage in patients with acute ST-segment elevation myocardial infarction after primary percutaneous coronary intervention / 中华心血管病杂志

Objective@#To evaluate the effect of the ischemic post-conditioning (IPC) on the prevention of the cardio-renal damage in patients with acute ST-segment elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI).@*Methods@#A total of 251 consecutive STEMI patients underwent PPCI in the heart center of Tianjin Third Central Hospital from January 2012 to June 2014 were enrolled in this prospective, randomized, control, single-blinded, clinical registry study. Patients were randomly divided into IPC group (123 cases) and control group (128 cases) with random number table. Patients in IPC group underwent three times of inflation/deflation with low inflation pressure using a balloon catheter within one minute after culprit vessel blood recovery, and then treated by PPCI. Patients in control group received PPCI procedure directly. The basic clinical characteristics, incidence of reperfusion arrhythmia during the procedure, the rate of electrocardiogram ST-segment decline, peak value of myocardial necrosis markers, incidence of contrast induced acute kidney injury(CI-AKI), and one-year major adverse cardiovascular events(MACE) which including myocardial infarction again, malignant arrhythmia, rehospitalization for heart failure, repeat revascularization, stroke, and death after the procedure were analyzed between the two groups.@*Results@#The age of IPC group and control group were comparable((61.2±12.6) vs. (64.2±12.1) years old, P=0.768). The incidence of reperfusion arrhythmia during the procedure was significantly lower in the IPC group than in the control group(42.28% (52/123) vs. 57.03% (73/128), P=0.023). The rate of electrocardiogram ST-segment decline immediately after the procedure was significantly higher in the IPC group than in the control group (77.24% (95/123) vs. 64.84% (83/128), P=0.037). The peak value of myocardial necrosis markers after the procedure were significantly lower in the IPC group than in the control group(creatine kinase: 1 257 (682, 2 202) U/L vs. 1 737(794, 2 816)U/L, P=0.029; creatine kinase-MB: 123(75, 218)U/L vs.165(95, 288)U/L, P=0.010). The rate of CI-AKI after the procedure was significantly lower in the IPC group than in the control group(5.69%(7/123) vs. 14.06%(18/128), P=0.034). The rate of the one-year MACE was significantly lower in the IPC group than in the control group(7.32%(9/123) vs. 15.63% (20/128), P=0.040).@*Conclusion@#The IPC strategy performed eight before PPCI can reduce myocardial ischemia- reperfusion injury, decline the rates of CI-AKI and one-year MACE significantly in STEMI patients, thus has a significant protective effect on heart and kidney in STEMI patients. Clinical Trial Registration Chinese Clinical Trials Registry, ChiCTR-ICR-15006590.

Static and gait finite element analysis on individualized titanium alloy pelvic prosthesis manufactured by 3D printing / 医用生物力学

Objective To evaluate the biomechanical properties of 3 D printed individualized titanium alloy pelvicprosthesis in static and gait states by the method of finite element analysis.Methods Three patients with different types of pelvic tumors were treated by hemi-pelvic arthroplasty with resection of hemi-pelvis.CT and MRI were performed before the surgery,and the corresponding individualized titanium alloy pelvic prostheses were designed.The pelvic models were reconstructed with 3D reconstruction technique,and then assembled with the individualized pelvic prostheses.The human skeletal muscle model was established by AnyBody software to perform gait dynamics analysis.The stress distribution and stress concentration areas of 3 reconstructed pelvic models in static and gait states were obtained by ABAQUS.Results Under both static and gait conditions,the maximum stress of the 3 pelvic prostheses was smaller than the yield strength of the titanium alloy.The pelvic ring of the reconstructed pelvis could meet the rule of stress conduction.The patients' daily life returned to normal condition after the surgery.Conclusions The effect of 3D prosthetic titanium prosthesis on recovery of pelvic ring is satisfactory,and its effectiveness and stability can meet the requirement of human biomechanics.The analytic results can provide references for clinicians and prosthesis designers.

Impact of smoking and platelet distribution width on clopidogrel resistance in patients with coronary ar-tery disease LI / 实用医学杂志

Objective To explore the influence of smoking on clopidogrel resistance in patients with coro-nary artery disease. Methods A total of 216 patients with coronary artery disease who accept selective percutane-ous coronary intervention in our hospital from May 2015 to December 2015 were selected as study subjects;their average age was 63 years old ,146 were male and 70 were female. All the patients were divided into clopidogrel resistance group (CR group) and normal clopidogrel response group (NCR group) according to the results of platelet aggregation test. History of smoking ,alcohol drinking and diabetes mellitus ,baseline medication uses , level of platelet counts,platelet distribution width,mean platelet volume,HbA1c,and results of echocardiogram and coronary angiography were compared between the two groups. Results The rate of smoking was significantly higher in CR group than in NCR group (P < 0.05). The changed value of PDW before and after treatment with clopidogrel was smaller in CR group than in NCR group ,the difference was statistically significant (P < 0.05). Conclusions Smoking may be a protective factor for clopidogrel resistance. The changed value of PDW before and after treatment with clopidogrel can reflect the level of clopidogrel resistance.

Petroleum ether sub-fraction of rosemary extract improves hyperlipidemia and insulin resistance by inhibiting SREBPs / 中国天然药物

As a culinary and medicinal herb, rosemary is widely used. The present work aimed to investigate the effects of rosemary extracts on metabolic diseases and the underlying mechanisms of action. Liver cells stably expressing SREBP reporter were used to evaluate the inhibitory effects of different fractions of rosemary extracts on SREBP activity. The obese mice induced by Western-type diet were orally administered with rosemary extracts or vehicle for 7 weeks, the plasma and tissue lipids were analyzed. SREBPs and their target genes were measured by quantitative RT-PCR. We demonstrated that the petroleum ether sub-fraction of rosemary extracts (PER) exhibited the best activity in regulating lipid metabolism by inhibiting SREBPs, while water and n-BuOH sub-fraction showed the SREBPs agonist-effect. After PER treatment, there was a significant reduction of total SREBPs in liver cells. PER not only decreased SREBPs nuclear abundance, but also inhibited their activity, resulting in decreased expression of SREBP-1c and SREBP-2 target genes in vitro and in vivo. Inhibiting SREBPs by PER decreased the total triglycerides and cholesterol contents of the liver cells. In the mice fed with Western-type diet, PER treatment decreased TG, TC, ALT, glucose, and insulin in blood, and improved glucose tolerance and insulin sensitivity. Furthermore, PER treatment also decreased lipid contents in liver, brown adipose tissue, and white adipose tissue. Our results from the present study suggested that petroleum ether fraction of rosemary extracts exhibited the best potential of improving lipid metabolism by inhibiting SREBPs activity.

Novel drug composition ameliorating thrombosis and its molecular mechanisms / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the antithrombotic effects and its molecular mechanisms of prazosin combined with anisodamine (Ani).</p><p><b>METHODS</b>Isolated rat tail artery rings model was employed to evaluate the vasodilative effects of drugs, mice tail thrombosis model induced by carrageenan was used to study the antithrombotic effects and its molecular mechanisms of the drug composition.</p><p><b>RESULTS</b>Among alpha1-adrenoreceptor antagonists, prazosin(Pra) had the greatest relaxation rate, which was (82.6 +/- 8.9)%, and the EC50 value was 0.44 micromol/L. The drug composition of anisodamine and prazosin of different doses could decrease the length of the tail thrombosis from (24.6 +/- 4.6)mm to (6.9 +/- 2.7)mm, and the rate of thrombosis was decreased from 86.6% to 50.0%. The drug composition could prolong the prothrombin time (PT) distinctively, but it had no effect on the activated partial thromboplastin time (APTT). It also could restrain the decrease of serum levels of tissue plasminogen activator (t-PA) and 6- Keto -PGF1alpha as well as the increase of type-1 plasminogen activator inhibitor (PAI-1) and thromboxane B2 (TXB2) in the mice.</p><p><b>CONCLUSION</b>The drug composition formed by anisodamine and prazosin has good effects of relaxing extremities tiny blood vessels and it can fight against thrombosis, its antithrombotic mechanisms may be related to the influence of the extrinsic coagulation pathway, inhibition of platelet activation functions and the promotion of fibrinolysis function.</p>

The effect of hypothermia on the vasoconstriction and vasodilatation and concerned with vasoactive drugs / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the changes of vasoconstriction and vasodilatation under different temperature conditions and the protective effects of Vitamin E (Vit E) against endothelial injury induced by hypothermia.</p><p><b>METHODS</b>The tail arterial rings were prepared for isometric tension recording using multi wire myograph system. The effect of temperature on relaxation and construction was evaluated. Incubate the arterial rings with different concentration of Vit E when they were exposed to hypothermia, then acetylcholine (ACh)-induced endothelium-dependent relaxation was investigated to evaluate the activity of endothelial.</p><p><b>RESULTS</b>(1) The hypothermia could enhanced the dose-dependent construction induced by PE in mice tail artery. (2) Exposure to hypothermia also resulted in increase of sodium nitroprusside (SNP)-induced re-After incubation with Vit E, the vascular relaxation responses to ACh increased in an endothelium-dependent manner, when compared with the hypothermia-treated group.</p><p><b>CONCLUSION</b>The vascular function of constriction was attenuated by hypothermia, while the relaxation was increased. Vit E could prevent the hypothermia-induced decrease in vascular endothelial cells.</p>

Blood glucose lowering effect of ophiopogonis tuber extract and mechanism of anti-insulin-resistance / 解放军医学杂志

Objective To study the hypoglycemic effect and insulin sensitization mechanism of ophiopogonis tuber extracts on the 3T3-L1-induced adipocytes, and also in rats with reproduction of type 2 diabetes mellitus (T2DM). Methods 3T3-L1 cells were induced and differentiated into adipocytes. After the intervention with ophiopogonpolysaccharide (OPSR) and ophiopogonin (OPG), glucose consuming rate was detected for screening the extracts which may have effective hypoglycemic effects. The insulin resistance (IR) adipocyte model was established by dexamethasone induction, and then it was treated with OPSR. The protein expression levels of leptin, adiponectin and resistin were detected by Western blotting. The T2DM rat model was reproduced and then treated with OPSR for 4 weeks. Body weight (BW), triglyeride (TG), fasting blood glucose (FBG) and fasting insulin (FINs) of the rats were measured respectively. Results OPSR in dosage of 0.5-50mg/L promoted glucose consumption of adipocytes in a dose-dependent manner, the glucose consumption ratios were 32.27%, 75.14% and 90.47% respectively. OPG of 50mg/L showed very weak activity with glucose consumption ratio of only 8.49%. OPSR could significantly promote the protein expression of leptin and adiponectin, and showed an inhibitory effect on the protein expression of resistin (P<0.05). After treatment with OPSR for 4 weeks, the BW of rats increased obviously, while TG, FBG and HOMA-IR decreased significantly (P<0.05 or P<0.01). Conclusions OPSR may promote glucose transport and utilization of adipocytes, decrease the level of FBG and TG, and improve the condition of IR in T2DM rats. The mechanism of blood glucose lowering effect may be attributed to secretion of adipokines, such as leptin, adiponectin and resistin by IR adipocytes.

Comprehensive treatment for gas gangrene of the limbs in earthquakes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Mortality rates for patients with gas gangrene from trauma or surgery are as high as 25%, but they increase to 50%-80% for patients injured in natural hazards. Early diagnosis and treatment are essential for these patients.</p><p><b>METHODS</b>We retrospectively analyzed the clinical characteristics and therapeutic results of 19 patients with gas gangrene of the limbs, who were injured in the May 2008 earthquake in the Wenchuan district of China's Sichuan province and treated in our hospital, to seek how to best diagnose and treat earthquake-induced gas gangrene.</p><p><b>RESULTS</b>Of 226 patients with limbs open injuries sustained during the earthquake, 53 patients underwent smear analysis of wound exudates and gas gangrene was diagnosed in 19 patients. The average elapsed time from injury to arrival at the hospital was 72 hours, from injury to definitive diagnosis was 4.3 days, and from diagnosis to conversion of negative findings on wound smear analysis to positive findings was 12.7 days. Anaerobic cultures were also obtained before wound closure. The average elapsed time from completion of surgery to recovery of normal vital signs was 6.3 days. Of the 19 patients, 16 were treated with open amputation, two with closed amputation, and 1 with successful limb salvage; 18 patients were successfully treated and one died.</p><p><b>CONCLUSIONS</b>In earthquakes, rapid, accurate screening and isolation are essential to successful treatment of gas gangrene and helpful in preventing nosocomial diffusion. Early and thorough debridement, open amputation, and active supportive treatment can produce satisfactory therapeutic results.</p>

Total hip arthroplasty for Crowe type-IV development dysplasia of hip in adults / 中华外科杂志

<p><b>OBJECTIVE</b>To determine the operation procedure of total hip arthroplasty (THA) for Crowe type-IV developmental dysplasia of hip and its relationship with nerve injury.</p><p><b>METHODS</b>A consecutive series of 39 THAs was performed for Crowe type-IV developmental dysplasia of hip in 35 patients (all female). The mean age of the patients at the time of surgery was 46 years (range 36 - 56 years). Thirty-five hips in 31 patients were followed up. The average follow-up period of the whole series was 4 years (range 1 - 8 years). All procedures were carried out through a lateral-posterior approach. In 33 of 35 hips, the cup was inserted in the "true" acetabulum. All the prostheses used were cementless, except for 5 cemented femoral stems in 5 patients. Each patient was evaluated clinically and by radiographs before the operation and during the follow-up period, according to the Harris hip score (HHS).</p><p><b>RESULTS</b>None of the cups and stems were revised for aseptic loosening, dislocation or infection during the follow-up period. The mean preoperative HHS was 43 compared with the postoperative HHS of 87. The mean amount of postoperative leg lengthening was 5 cm (range 4 - 6 cm).</p><p><b>CONCLUSIONS</b>The reconstruction of the hip at the level of the "true" acetabulum through a lateral-posterior approach is a safe and effective procedure of THA for Crowe type-IV developmental dysplasia of hip in adults. Acute leg lengthening of less than 6 cm could not cause nerve injury.</p>

High-energy extracorporeal shock waves in treatment of nonunion and delayed union:preliminary results / 中华创伤骨科杂志

Objective To observe the effects of the Ossatron high-energy shock waves on bone nonunion and delayed union.Methods Between October 2004 and October 2005,18 patients with nonunion and four patients with delayed union were treated with high-energy extracorporeal shock wave therapy(Ossatron,HMT Co., Swiss).Facture lines were located with C-arm X-ray before treatment.Parameters of shock waves were decided according to fracture sites.Patients with unstable fixation received plaster or bracing for 6 to 8 weeks after treatment. After therapy,follow-up radiography was performed at 6 and 12 weeks and monthly afterwards until the fracture united. Results The mean follow-up was 6.7 months(range,3 to 12 months).There were no complications except local petechial hemorrhage and local swelling in 10 patients.Thirteen patients(59.1%)got bony union,including 12 patients(66.7% )with stable internal fixation,and the average healing time was 4.3 months(range,6 weeks to 6 months).Nine fractures(40.9%)still suffered nonunion.Conclusion High-energy shock waves are a good alternative therapy for nonunion and delayed union,with obvious advantages of being non-invasive and safe.

Osteogenic potential of hBMP-2 gene transduced human adipose-derived stem cells / 中华创伤杂志

Objective To investigate the ostengenie potential of adipose-derived stem cells(AD- SCs)when exposed to adenovirns containing hBMP-2 cDNA(Adv-hBMP-2)and offer a choice of cell source for gene therapy and tissue engineering.Methods Human adipose tissues were obtained from patients who received orthopaedic surgery or liposuction.ADSCs were obtained by digesting the adipose tissues.Firstly,flowcytometric analysis was performed for the confirmation of mesenchymal stem cell ori- gin and the surface markers including CD34,CD44,CD68,CD71,CD90,and CD105.The ADSCs were transfected by Adv-hBMP-2 and the effects were tested in vitro,lmmunoprecipitation and Western blotting and ELISA were performed for confirming BMP gone transduction and its stable expression.The transform of ADSCs was assessed by extracellular ALP staining,intracellular ALP spectrophotometry,von Kossa staining and RT-PCR.In the in vivo experiment ADSC-Adv-hBMP-2 cells were injected into the hind limb of nude mice and analyzed radiographically and histologically.Results ADSCs were successfully isolated from human adipose tissues.The isolated ADSCs expressed CD44,CD71,CD90 and CD105 and CD34 and CD68 were absent.The result confirmed the mesenchymal stem cell origin of the cells.West- ern blotting and ELISA confirmed successful and persistent hBMP-2 production by ADSC-Adv-hBMP-2 cells.Extracellular ALP staining,intracellular ALP spectrophotometry,yon Kossa staining and RT-PCR revealed that ADSCs treated with Adv-hBMP-2 had a tendency of transfering into osteoblast.X-ray and H&E sections from hind limb of nude mice injected with ADSC-Adv-hBMP-2 cells confirmed bone forma- tion at 2 weeks.Conclusions Liposuction aspirates contain abundant ADSCs that can be transduced with hBMP-2 gene,and the tranduced ADSCs differentiate into the osteoblast.ADSCs may be an ideal source of mesenchyme-lineage stem cells for gone therapy and tissue engineering.