WANG Ju-yi's meridian diagnosis method combined with Bobath rehabilitation training for post-stroke shoulder-hand syndrome typeⅠ / 中国针灸

OBJECTIVE@#To compare the clinical efficacy differences between WANG Ju-yi 's meridian diagnosis method combined with Bobath rehabilitation training and Bobath rehabilitation training alone for post-stroke shoulder-hand syndrome (SHS) typeⅠ.@*METHODS@#A total of 106 patients with post-stroke SHS typeⅠwere randomly divided into an observation group (53 cases, 2 cases dropped off ) and a control group (53 cases, 3 cases dropped off ). The patients in the both groups were treated with medications for basic diseases and conventional acupuncture at Waiguan (TE 5), Shousanli (LI 10) and Jianyu (LI 15) on the affected side. In addition, the patients in the control group were treated with Bobath rehabilitation training, 20 minutes each time; on the basis of the control group, the patients in the observation group were treated with WANG Ju-yi's meridian diagnosis method to adjust the abnormal parts in meridians of the hand taiyin and hand yangming on the affected side, 20 minutes each time. Both groups were treated once a day, 5 times a week for 8 weeks. The scores of visual analogue scale (VAS), upper-limb Fugl-Meyer assessment (FMA) and Barthel index (BI) were recorded before and after treatment as well as 6 weeks after treatment (follow-up), and the clinical efficacy of the two groups was evaluated after treatment.@*RESULTS@#Compared before treatment, the VAS scores were reduced and the scores of upper-limb FMA and BI were increased in the two groups after treatment and in the follow-up (P<0.05). The VAS score in the observation group was lower than that in the control group (P<0.05), and the scores of upper-limb FMA and BI in the observation group were higher than those of the control group (P<0.05). The total effective rate in the observation group was 82.4% (42/51), which was higher than 62.0% (31/50) in the control group (P<0.05).@*CONCLUSION@#WANG Ju-yi 's meridian diagnosis method combined with Bobath rehabilitation training could effectively treat post-stroke SHS typeⅠ, reduce pain symptoms and improve joint motor dysfunction, and improve the quality of life. Its curative effect is better than Bobath rehabilitation training alone.

Quality evaluation of Shirebi Tablets based on combinative methods of HPLC fingerprint, quantitative analysis of multi-components and chemometrics analysis / 中草药

Objective: To establish a quality evaluation method of Shirebi Tablet based on HPLC fingerprints, quantitative analysis of multi-components and chemometrics analysis. Methods: The chromatographic column was Waters Symmetry C18 column (250 mm × 4.6 mm, 5 μm), and the column temperature was set at 30 ℃. The detection wavelength was set at 303 nm (for mulberroside A, mulberroside F and moracin M) and 270 nm (for forsythoside B, forsythoside A, forsythin, atractylodinol, atractylenolide II, and atractylodin). The mobile phase was composed of acetonitrile-0.2% phosphate acid solution in gradient elution manner at a flow rate of 1.0 mL/min. The HPLC fingerprint of Shirebi Tablet was established, the common peaks were determined by similarity evaluation system for chromatographic fingerprint of TCM (Version 2012.130723), and the similarity was calculated. The content determination methods for mulberroside A, mulberroside F, moracin M, forsythoside B, forsythoside A, forsythin, atractylodinol, atractylenolide II, and atractylodin were validated. The chemometrics methods such as cluster analysis and principal component analysis were used to evaluate the quality of Shirebi Tablet from different batches based on the results of fingerprint common peak area. Results: The fingerprint of Shirebi Tablet was established. Sixteen common peaks were identified. The similarity of fingerprints of 10 batches of Shirebi Tablet was more than 0.95. Nine components had good linear relationship in the range of mass concentration (r2 ≥ 0.999 1), and the average recoveries were 98.87%, 97.44%, 97.94%, 98.39%, 100.13%, 99.06%, 96.80%, 98.44% and 99.15% with the RSDs of 1.42%, 1.17%, 1.30%, 0.91%, 0.86%, 1.23%, 1.08%, 1.37% and 0.79%, respectively. The concentrations of mulberroside A, mulberroside F, moracin M, forsythoside B, forsythoside A, forsythin, atractylodinol, atractylenolide II, and atractylodin in 10 batches were 0.192—0.289, 0.057—0.095, 0.113—0.158, 0.309—0.375, 1.537—1.916, 0.478—0.596, 0.049—0.072, 0.279—0.354, and 0.629—0.759 mg/g, respectively. The results of cluster analysis showed that 10 batches of Shirebi Tablet were clustered into two groups, and the results of principal component analysis showed that the principal components 1—6 were the main factor affecting the quality evaluation of Shirebi Tablets. Conclusion: The method is simple, accurate and reproducible, which can be used for the quality control and evaluation of Shirebi Tablet.

Study on Mechanism of Nephrotoxicity of Tripterygii Radix et Rhizoma Based on Network Pharmacology / 中国实验方剂学杂志

Objective: To explore the mechanism of renal toxicity of Tripterygii Radix et Rhizoma by establishing the active component-target, protein interaction, biological function and pathway network corresponding to the target, and using molecular docking technology. Method: The traditional Chinese medicine(TCM) systems pharmacology database(TCMSP) and the comparative toxicogenomics database (CTD) were used to screen The toxic candidate compounds.In PubChem database, convert all candidate compounds into standard Canonical SMILES format, SMILES format file import SwissTargetPrediction platform, target prediction, will be the target of the corresponding compounds in TCMSP supplement with uniprot converts protein antipodal gene name, and from the human genome database (GeneCards) seek to compare the renal related gene protein,overlapping proteins were screened as potential renal toxicity targets of Tripterygii Radix et Rhizoma.Cytoscape software was used to construct the candidate components-target network of Tripterygii Radix et Rhizoma.Cytoscape software was combined with String database to draw the protein interaction network, DAVID platform was used to analyze the biological function of the target and the pathways involved, and Glide software was used to verify the combination of the key protein and the candidate components of tripterygiumwildiitoxicity. Result: The screening of 30 kinds of candidates for toxic ingredients of Tripterygii Radix et Rhizoma, involving 209 renal toxicity targets, network analysis results showed that Tripterygii Radix et Rhizoma by amino acid metabolism,phospholipid metabolism, catecholamine metabolism, inhibiting renal organic anion transporter Oatl, Oat2, Oat3 function, and inducing apoptosis, and participate in the mitogen-activated protein kinase(MAPK) signaling pathways, JAK-STAT signaling pathway,vascular endothelial growth factor(VEGF)signaling pathways,Toll-like receptor signaling pathway,ERBB signaling pathway, FcεRI signaling pathway, peroxisome proliferators-activated receptors(PPAR) signaling pathway such as toxic to the kidneys. Conclusion: The mechanism of kidney toxicity of Tripterygii Radix et Rhizoma was explored by using the characteristics of multi-component, multi-target and multi-pathway of TCM, which provided new ideas and methods for further research on the mechanism of kidney toxicity of Tripterygii Radix et Rhizoma.

Cardiotoxicity of Aconiti Kusnezoffii Radix Based on Network Toxicology / 中国实验方剂学杂志

Objective:The mechanism of action of cardiac toxicity of Radix Aconiti Agrestis was explored by establishing the active components-targets network of Radix Aconiti Agrestis, protein interaction network, the biological function and pathway network of targets, and using molecular docking technology. Methods:The Traditional Chinese Medicine Systems Pharmacology(TCMSP) database and the Comparative Toxicogenomics Database(CTD) were used to filtrate the toxic candidates of Radix Aconiti Agrestis. Predicting the functional targets of toxic candidates of Radix Aconiti Agrestis by PharmMapper and compared with the cardiac related gene proteins found in the human gene database (GeneCards), and the overlapping proteins were selected as potential cardiac toxicity targets of Radix Aconiti Agrestis. The Cytoscape software was used to construct the network between toxic candidate components and targets. The protein interaction network was mapped by the String database combined with Cytoscape software. The biological functions of the targets and the involved pathways were analyzed with the DAVID platform.The binding of the key proteins with certain toxic candidate components of Radix Aconiti Agrestis was verified by Discover Studio software finally. Results:There were six candidates for toxic ingredients, which involving 27 cardiac toxicity targets. Network analysis results show that the targets were mainly by participating in the heart of phosphorus metabolism, regulation and other related phosphorus metabolism and regulation of phosphorylation and FKBP1A,TGF4-β2, INSR targets to have an important impact on the metabolism,development and form of the heart,and further to have cardiac toxicity. Conclusion:Based on the characteristics of the multi-component, multi-target and multi-pathway of traditional Chinese medicine, the mechanism of cardiac toxicity of Radix Aconiti Agrestis was explored and its possible toxicity was predicted, which provided a new idea and method for further research on the mechanism of cardiac toxicity of Radix Aconiti Agrestis.

Quality control for eight components in Guishao Zhenxian Tablets based on quantitative analysis of multi-components with a single-marker / 中草药

Objective To establish a quantitative analysis of multi-components with a single-marker (QAMS) method for the simultaneous determination of oxypaeoniflorin, albiflorin, paeoniflorin, benzoylpaeoniflorin, cinnamic acid, cinnamaldehyde, saikosaponin a, and saikosaponin d in Guishao Zhenxian Tablets (GZT). Methods The separation was performed on a Thermo ODS C18 column (250 mm × 4.6 mm, 5 μm), with the mobile phase consisting of acetonitrile-0.1% phosphate acid solution for gradient elution. The column temperature was 25 ℃, and flow rate was 1.1 mL/min. Using paeoniflorin as internal reference substance, the relative correlation factors of oxypaeoniflorin, albiflorin, benzoylpaeoniflorin, cinnamic acid, cinnamaldehyde, saikosaponin a, and saikosaponin d were calculated and established by HPLC. The results were compared with those obtained by the external standard method to verify the rationality, feasibility, and repeatability of QAMS method. Results Oxypaeoniflorin, albiflorin, paeoniflorin, benzoylpaeoniflorin, cinnamic acid, cinnamaldehyde, saikosaponin a, and saikosaponin d had good relations within the ranges of 2.63-65.75 μg/mL (r = 0.999 7), 9.67-241.75 μg/mL (r = 0.999 8), 13.59-339.75 μg/mL (r = 0.999 5), 1.79-44.75 μg/mL (r = 0.999 4), 2.45-61.25 μg/mL (r = 0.999 1), 7.98-199.50 μg/mL (r = 0.999 7), 2.79-69.75 μg/mL (r = 0.999 3), and 2.51-62.75 μg/mL ( r= 0.999 5), respectively. The recovery rates were 98.64%, 99.33%, 100.02%, 97.42%, 96.95%, 98.75%, 98.21%, and 97.81%, RSDs were 0.89%, 1.19%, 1.00%, 1.33%, 1.51%, 0.99%, 1.43%, and 0.80%, respectively. The relative correlation factors values of oxypaeoniflorin, albiflorin, benzoylpaeoniflorin, cinnamic acid, cinnamaldehyde, saikosaponin a, and saikosaponin d to paeoniflorin were 0.520 9, 1.086 9, 0.476 8, 0.626 1, 0.802 1, 0.713 8, and 0.367 0, respectively. There were no significant difference in assay results between QAMS and the external standard method. Conclusion The QAMS method is feasible and credible, and could be used to determine oxypaeoniflorin, albiflorin, paeoniflorin, benzoylpaeoniflorin, cinnamic acid, cinnamaldehyde, saikosaponin a, and saikosaponin d in Guishao Zhenxian Tablets for the quality control.

Clinical significance of epidermal growth factor receptor and thymidylate synthase expression in primary liver cancer / 中华肝脏病杂志

Objective@#To investigate epidermal growth factor receptor (EGFR) and thymidylate synthase (TS) expression in primary liver cancer, and analyze its clinicopathological features and prognostic significance.@*Methods@#Immunohistochemistry was performed using EnVision method to detect EGFR and TS expression in 41 cases of liver cancer. Correlation coefficient between EGFR and TS was calculated by Spearman method. Fisher's exact probability method or χ2 test was used to analyze the clinicopathological features of EGFR and TS. Kaplan-Meier method was used to calculate the survival rate of patients in conjunction with the log-rank test.COX proportional hazard regression model was used to analyze the prognostic factors of patients. ROC curve was used to analyze the predictive accuracy of EGFR and TS for prognosis.@*Results@#The positive rates of EGFR and TS in liver cancer tissues were 34.15% and 39.02%, respectively. There was a positive correlation between EGFR and TS expressions, and the difference was statistically significant (P < 0.05). EGFR was associated with tumor size and tissue differentiation (P < 0.05) in HCC patients, whereas TS was associated with tissue differentiation (P < 0.05). There was no significant difference in prognostic effect of EGFR on survival rate (P > 0.05). TS prognostic effect on survival rate was statistically significant (P < 0.05). HR of EGFR was 0.210 with 95% CI, 0.052-0.852, P = 0.029; indicating that the risk of death in patients with negative EGFR was 0.210 times higher than that in patients with positive EGFR. HR of TS was 2.496, with 95% CI, 1.325-4.701, P = 0.005, indicating that the risk of death increased by 2.496 times with the same level of EGFR. The area under the EGFR curve was 0.553 and its approximate reference confidence interval was 95% (0.355, 0.751), indicating that EGFR was a risk factor for death and the area under the TS curve was 0.695, and its approximate reference confidence interval was 95% (0.513, 0.878), indicating that TS was a risk factor for death.@*Conclusion@#EGFR and TS were equally expressed in primary liver cancer, and EGFR and TS expressions were positively correlated. EGFR and TS had an effect on the degree of tissue differentiation in patients with liver cancer. EGFR and TS were risk factors for prognosis, and TS may assist EGFR.

The expressions of acid sensing ion channel 1a and activator protein-1 in hepatocellular carcinoma and their relationships with clinical features / 中华肝胆外科杂志

Objective To investigate the expressions of acid sensing ion channel 1a(ASIC1a) and activator protein-1 (AP-1) in hepatocellular carcinoma,and to analyze the relationship between expressions and clinical features.Methods At the transcription level,expression spectroscopy chips and bioinformatics were used to analyze the changes of signal pathways before and after ASICla interference in hepatocellular carcinoma cells.63 cases of HCC and 42 cases of tumor adjacent tissue samples were chosen from the Third People's Hospital of Wuxi,between January 2010 and December 2014.Immunohistochemical staining was utilized to detect the expressions of ASIC1 a,c-Jun,c-Fos.The relationships among the three were analyzed by the nonparametric Spearman rank correlation coefficient.Results After ASIC1a inhibition,the expression of AP-1 (c-Jun and c-Fox) decreased significantly.The expressions of c-Jun and c-Fox were greatly decreased in interference group compared with control group.The positive rates of ASIC1a,c-Jun and c-Fos in HCC tissues were significantly higher than that of the adjacent tissues,68.3％ vs.19.0％,55.6％ vs.11.9％,47.6％ vs.11.7％ (P ＜ 0.05).Correlation analysis showed that the expression of ASIC1a was positively correlated with c-Jun and c-Fos expression (r =0.404,0.309,P ＜ 0.05).The expressions of ASIC 1 a,c-Jun and c-Fos were not related to age,tumor diameter and gender (P ＞ 0.05),which were related to the clinical stage,AFP and lymph node metastasis of the tumor (P ＜ 0.05).Conclusion ASIC1a may.affect the development of hepatocellular carcinoma through the downstream gene AP-1.

Effect of ceramic on ceramic total hip arthroplasty in Crowe IV developmental dysplasia of the hip / 中国骨伤

<p><b>OBJECTIVE</b>To observe the clinical effect of ceramic on ceramic total hip arthroplasty(THA)in Crowe IV developmental dysplasia of the hip(DDH).</p><p><b>METHODS</b>From April 2008 to December 2015, 137 hips of 111 Crowe IV DDH patients received THA using Forte or Delta ceramic on ceramic by one senior surgeon, which consists of 85 unilateral hips and 26 bilateral hips. The average age of the patients was(38.88±10.83) years old ranging from 18 to 68 years old. The mean follow-up was(41.16±21.50) months ranging from 12 to 96 months. All the patients were evaluated by Harris Hip Score. Radiographic evaluations were made preoperatively and during follow-up. Harris scores, the incidence of complications such as ceramic fracture, squeaking, dislocation were observed.</p><p><b>RESULTS</b>The mean preoperative Harris score was 56.54±15.67, the mean postoperative Harris score was 88.30±6.86(=0.017). Periprosthetic osteolysis was not deteced around any cup. No ceramic fracture occurred. There were 3 cases of revision surgery due to infection, losening of the stem and limb length discrepancy, respectively; 3 cases of dislocation occurred. Seventy-seven patients were recorded the gait and the hip mobility, the hip flexion of 69 patients were above 120 degrees.</p><p><b>CONCLUSIONS</b>Ceramic on ceramic bearing showed an encouraging result in Crowe IV DDH total hip arthroplasty.</p>

Clinical observation on the treatment of periprosthetic infection of coagulase-negative staphylococci by two-stage revision / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the risk factors for the failure in treating periprosthetic infection of coagulase-negative staphylococci by two-stage revision.</p><p><b>METHODS</b>From January 2005 to June 2015, 57 patients with periprosthetic hip and knee joint infection of coagulase-negative staphylococcus by two-stage revision were retrospectively reviewed with an average age of (61.3±11.9) years old. According to the drug resistance of methicillin, the patients were divided into methicillin sensitive group(MSCoN) and methicillin resistance(MRCoN) group, 25 cases in MSCoN group(9 knees and 16 hips) included 12 males and 13 females, 32 cases in MRCoN group(11 knees and 21 hips) included 14 males and 18 females. Follow-up for at least 2 years, the inflammatory markers, incidence rate of sinus and the duration of the symptoms, reinfection or persistent infection rate after two-stage revision were compared between two groups.</p><p><b>RESULTS</b>MSCoN group and MRCoN group were followed up(81.7±38.3) months and(65.9±33.8) months, respectively;23 cases and 27 cases were successfully treated;there was no significant difference between two groups(=0.643). The patients who had surgery history were 4.04 times higher of failure than the patients without a history of surgery[OR=4.04, 95%CI(0.62, 26.5)]. Patients who had sinus were 4.26 times higher of failure than the patients without sinus[OR=4.26, 95%CI(0.7, 25.9)].</p><p><b>CONCLUSIONS</b>Two-stage revision is an effective procedure in treating patients infected by MSCoN and MRCoN. There is no significant difference of treatment failure rate between MSCoN and MRCoN group by two-stage revision. Surgery history and sinus maybe the risk factors of treatment failure, while methicillin-resistance is not.</p>

Mechanical complications with self-made, antibiotic-loaded cement articulating spacers in the treatment of the infected hip replacement / 中国骨伤

<p><b>OBJECTIVE</b>To study the complications and efficacy of self-made, antibiotic-loaded cement articulating spacers in the treatment of the infected hip replacement.</p><p><b>METHODS</b>Between January 2006 and July 2016, 265 patients (266 hips) received a self-made, antibiotic-loaded cement articulating spacer as part of a two-stage protocol. Among those patients, there were 143 males(144 hips) and 122 females(122 hips). The cement articulating spacers with vancomycin and two Steinman pins were made by a self-made mold system. Meanwhile, another antibiotic was added to the spacers according to the drug sensitivity test. Record if the infected prosthesis was removed, related complication with spacer(breakage and dislocation), Harris score, and control rate of infection.</p><p><b>RESULTS</b>The mean age of two-stage revision operation was(57.4±14.2) years. Thirty-nine patients(14.7%) used extended trochanteric osteotomy(ETO) to remove the infected prosthesis. And 38 patients occurred mentioned complications(14.3%). Spacer breakage occurred in 28 cases(10.5%) and dislocation occurred in 10 cases(3.8%). The mean follow-up time was(83.4±14.6) months. The Harris hip score was from 47.56±14.23 preoperatively to 86.43±12.84 at final follow-up(<0.05). The infection of 256 cases(96.6%) got control after revision operation. However, during postoperative follow-up, 4 cases occurred re-infection, and they were reoperated, and the infections obtained effective control after the operation. Thus total infection control rate was 95.1%(252/265).</p><p><b>CONCLUSIONS</b>Antibiotic-loaded cement articulating spacer made by a self-made mold system is effective in controling infection caused by hip replacement. Related complication is less with spacer by a mould enclosing two Steinman pins. Using metallic internal fixation or allograft bone combined with spacer does not affect infection control.</p>

Clinical results in early and mid term of using the S-ROM femoral stem in revision / 中国骨伤

<p><b>OBJECTIVE</b>To investigate and the clinical effect of S-ROM modular stem in femur reconstruction in hip revision arthroplasty.</p><p><b>METHODS</b>From January 2008 to January 2016, 21 patients received revision hip arthroplasties using S-ROM stems. There were 5 males and 16 females with an average of 48.33 years old(range, 29 to 73 years old). There were 13 cases caused by aseptic loosening, 4 cases by infection, 2 cases by nonunion of sub-tuberosity osteotomy, 1 case for repeated dislocation, 1 case for traumatic great trochanter fracture. Primary THA reasons:12 cases for DDH(9 cases for Crowe IV), 5 cases for femoral neck fracture, 2 cases for necrosis of femoral head, 2 cases for proximal femoral deformity caused by early infection. The femur bone defects included Paprosky II in 11 cases, IIIa in 9, and IIIb in 1. Harris hip score , pain score and hip flexion were recorded before and after operation. The subjective satisfaction was recorded at the last follow-up.</p><p><b>RESULTS</b>The operation time and blood loss were 189 min(125 to 290 min) and 867 ml (200 to 2 000 ml). At the final followup, the pain score improved from (17.14±9.56) points preoperatively to (41.71±2.03) points (=11.42,=0.00). The function score improved from (24.01±11.02) points preoperatively to (49.95±5.38) points (=9.73,=0.00). Harris hip score improved from (41.15±14.81) points preoperatively to(91.67±5.83) points(=15.33,=0.00). The degree of hip flexion increased from (93.10±27.27) points preoperatively to (121.90±16.62) points at the last follow-up (=4.59,=0.00). The mean subjective satisfaction was 9.48(10 points system), 14 of which were completely satisfactory. The last follow-up hip X-ray showed 21 cases of bone ingrowth, and other femoral stem without loosening or sinking sign significantly. There were 5 cases with bone anchor syndrome around proximal femoral cuff. There were 5 cases of proximal femur fracture, 3 cases of lesser trochanter fracture, 2 cases of greater trochanter fracture intra-operatively. Due to femoral canal stenosis, there were 4 cases of pre-tied wire at lesser trochanter to prevent fractures. There was 1 case of traumatic femoral fracture around stems with a distal oblique fracture, open reduction and locking plate fixation was performed. Other patients had no nerve stretch injury, dislocation, infection and lower limb deep vein thrombosis and other complications at the final follow-up.</p><p><b>CONCLUSIONS</b>S-ROM prosthesis has satisfactory results in hip revision arthroplasty with Paprosky II and III femoral defects. Especially for patients with Crowe IV DDH and other proximal femoral deformities, it is possible to adapt to the medullary cavity morphology. Excellent initial stability, less complications and long-term biological fixation can be achieved with S-ROM in femur revision.</p>

Determination of six kinds of index components in Dieda Zhitong San by HPLC-DVD variable wavelength method / 中草药

Objective: To develop an HPLC-DVD wavelength switching combined with gradient elution method for the determination of the contents of hydroxysafflor yellow A, protodioscin, dioscin, methylprotodioscin, pseudoprotodioscin, and gracillin in Dieda Zhitong San (DZS) simultaneously. Methods: The chromatographic separation was achieved on a Diamonsil C18 (250 mm × 4.6 mm, 5 μm) with acetonitrile (A)-0.4% formic acid solution (B) as mobile phase at the flow rate of 0.9 mL/min for gradient elution; Hydroxysafflor yellow A was detected at 403 nm; Protodioscin, dioscin, methylprotodioscin, pseudoprotodioscin, and gracillin were detected at 203 nm; Sample quantity was 20 μL. Results: The six active components were well separated and showed good linearity, such as hydroxysafflor yellow A 3.46-69.20 μg/mL (r = 0.999 4), protodioscin 9.52-190.40 μg/mL (r = 0.999 7), dioscin 8.74-174.80 μg/mL (r = 0.999 6), methylprotodioscin 4.45-89.00 μg/mL (r = 0.999 9), pseudoprotodioscin 2.64-52.80 μg/mL (r = 0.999 5), and gracillin 3.28-65.60 μg/mL (r = 0.999 8). The precision and repeatability were good, and RSD values were less than 2.0%. The stability was good in 12 h. The average recoveries and the corresponding RSD values were 98.57% (1.59%), 97.64% (1.28%), 99.43% (1.07%), 97.98% (1.64%), 98.57% (1.16%), and 97.17% (1.37%), respectively. Conclusion: An HPLC wavelength switching combined with gradient elution method has been successfully established for simultaneous determination of six components in DZS. The method is simple, quick, accurate, and helpful for the quality control of DZS.

Value of High-frequency Ultrasound in the Diagnosis of Peripheral Nerve Compression in Rheumatoid Arthritis Patients / 中国医学科学院学报

Objective To evaluate the value of high-frequency ultrasound (HFUS) in diagnosing peripheral nerve compression in patients with rheumatoid arthritis (RA). Methods The upper limb nerves were evaluated by HFUS in 80 RA patients (RA group) and 60 non-RA patients (control group),then the incidence of peripheral nerve compression was recorded respectively. RA patients with/without neurological symptoms were compared in terms of age,disease course,Health Assessment Questionnaire Disability Index (HAQ-DI) score,and clinical disease activity index (CDAI). Results The incidence of upper limb nerve compression in RA group was significantly higher than that in control group(15.0% vs. 3.3%,P=0.046).The patients with nerve compression was older [(60.2±11.4)y vs.(49.2±7.9)y;t=2.343,P=0.039] and had longer disease course [(9.50±5.99) y vs. (5.88±3.87)y;t=2.639,P=0.023] and higher HAQ-DI score (1.58±0.75 vs.0.85±0.67;t=2.490,P=0.030). These two groups had no statistical differences in CDAI (14.50±11.68 vs.16.62±9.24;t=1.141,P=0.278).Conclusions Peripheral neuropathies are common extra-articular manifestations in RA patients. HFUS can be valuable in patients suspected of RA.

Construction and in vitro functional evaluation on a new hybrid bioartificial liver / 中华肝胆外科杂志

Objective To design a new type of hybrid bioartificial liver (HBAL), evaluate its efficacy in vitro, and explore the feasibility in clinical application.Methods CL-1 human hepatocytes were cultured on microcarriers for 5 days, when cell count reached about 4.0 × 109 with cell density of about 4.0 × 107/ml.CL-1 cells cultured on microcarriers in home-made bioreactor constitute the biological part of the HBAL.The abiotic part included blood perfusion and bilirubin adsorption, and blood pump was employed as the circulation driver, which were parts of HBAL.The changes of the concentrations of indirect bilirubin (UBD), chenodeoxycholic acid (CDCD), cholic acid (CA), blood ammonia (AA), AST, ALT and LDH were observed under the condition of in vitro circulation.Meanwhile, the function, morphology and the cell activity of CL-1 cells were also observed.Results After in vitro circulation for 24 h, the concentrations of UBD, CDCD, CA and AA significantly decreased from (335.3 ± 6.0) μmol/L, (395.0 ± 5.6) μmol/L, (155.7 ± 4.5) μmol/L, (39.0 ± 2.6) μmol/L at 0 h to (106.0 ± 10.9) μmol/L, (131.8 ± 28.7) μmol/L, (42.2 ± 7.3) μmol/L, (3.5 ± 1.0) μmol/L, respectively.At 48 h, ALT, AST and LDH significantly increased from (25.9 ± 4.2) IU/L, (22.0 ± 3.6) IU/L, (0.28 ± 0.09) μmol/L to (31.0 ± 2.6) IU/L,(31.6 ± 8.0) IU/L, (0.41 ± 0.12) μmol/L, meanwhile the count and vitality of CL-1 cells were significant declined.Conclusions (1) In the new HBAL system, CL-1 cells can keep its viability and function in vitro;and (2) the HBAL appears to be effective in purifying the serum in liver failure simulation model by clearing out non-conjugated bilirubin, chenodeoxycholic acid, cholic acid and ammonium chloride, which seems to be a promising therapeutic option.

Clinical efficacy and safety of conversion from cyclosporine A to tacrolimus-based regimen for different pathological types of chronic allograft nephropathy patients / 中国组织工程研究

BACKGROUND: Recent studies have suggested that conversion from cyclosporine A (CsA) to tacrolimus (FK 506)-based regimen can improve renal allograft function and survival rate. But little is known about whether the conversion from CsA to tacrolimus(FK 506) plus mycophenolate mofetil (MMF)-based regimen exhibits the same or similar clinical efficacy. OBJECTIVE: To investigate the clinical efficacy and safety of converting CsA to FK506 plus MMF in treatment of different types of chronic allograft nephropathy (CAN). DESIGN, TIME AND SETTING: An observational and controlled trial was performed at the Center for Organ Transplantation, Zhujiang Hospital, Southern Medical University from January 2005 to October 2007. PARTICIPANTS: Fifteen-nine enrolled patients received CsA-based regimen after renal allografting. Following pathological confirm and typing, all patients were assigned to two groups: CAN with chronic rejection (CR, n = 31) and CAN without chronic rejection (non-CR, n = 28). FK 56 was purchased from Fujisawa Pharmaceutical Company, Ltd., Japan. MMF was sourced from Shanghai Roche Pharmaceutical Co., Ltd., China. METHODS: When patients were diagnosed CAN, the CsA regimen was conversed to FK506 plus MMF regimen. FK506 initiated at a dose of 0.08 mg/kg per day and then was adjusted to achieve steady-state whole blood trough levels of approximately 5-8 μg/L. MMF was used at a fixed dosage, 1.0 g/d, twice a day, only if relative adverse events occurred. All patients were followed up at least 6 months. MAIN OUTCOME MEASURES: Serum creatinine(Scr), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), 24-h proteinuria, glomerular filtration rate (GFR), and complications. RESULTS: All initial 59 patients were included in the final analysis. At 6 months after regimen conversion, the levels of Scr, TC, TG, LDL, and 24-hour proteinuria were significantly reduced in non-CR, in particular CR, groups, compared with prior to conversion (P< 0.05). GFR was markedly increased in both the CR and non-CR groups (P< 0.05). In the CR group, 20 patients obtained improved results, 7 got stable results, and 4 showed ineffective results. The effective rate of regimen conversion was 64.5% and 32.1% in the CR and non-CR groups, respectively, and significant difference existed between the two groups (P < 0.05). Compared with prior to conversion, the incidence of hypertension and hyperlipemia was significantly decreased after regimen conversion (P< 0.05). There was no significant difference in diabetes mellitus, opportunistic infection, and malignancy between prior to and after regimen conversion. CONCLUSION: FK506 plus MMF-based regimen can markedly improve the function of renal graft of CAN, in particular CR, patients.

Inguinal hernia repair with tension-free hernioplasty under local anesthesia

To evaluate the use of local anesthesia in tension-free hernioplasty in a local hospital. The study took place at Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China during the period from January 2007 to May 2008. All 110 patients who had undergone inguinal hernia repair with mesh under local anesthesia were included in the study. To increase the homogeneity of the sample, we excluded umbilical hernia repairs, parastomal hernia repairs, non-elective procedures, procedures not involving mesh, and repairs performed concurrently with another surgical procedure. We performed a retrospective review of all 110 patients' data. The average operating time was 45 minutes [30-70 minutes], and the average hospital stay was 3-4 days. There was no postoperative mortality in this study. No surgical site infection occurred. Two patients [18%] that suffered from a moderate scrotal hematoma had recovered after extract injection therapy was applied. The duration of incisional pain was 2-3 days, and no patient required post-operative analgesia. During the follow-up, no recurrence occurred. The use of local anesthesia in inguinal hernia repair with tension-free hernioplasty is a safe and effective alternative for inpatient treatment

Influence of therapeutic effect of acupoint sticking at Shenque (CV 8) for treatment of stroke patients / 中国针灸

<p><b>OBJECTIVE</b>To observe the therapeutic effect of acupoint sticking therapy for treatment of stroke.</p><p><b>METHODS</b>Two hundred and forty-six cases were randomly divided into a non-acupoint sticking group (control group, n=122) and an acupoint sticking group (n=124). The control group was treated with routine ward treatment of stroke (acupuncture combined with routine western medicine). The acupoint sticking group was treated with basis ward treatment of stroke (similar to the control group), and acupoint sticking therapy was applicated on Shenque (CV 8). The scores of Stroke-Specific Quality of Life (SS-QOL) and WHOQOL-100BREF were adopted to evaluate the therapeutic effects and the cysteine of patients were tested before and after treatment.</p><p><b>RESULTS</b>There were significant differences in scores comparison of SS-QOL and WHOQOL-100BREF before and after treatment in both groups (both P < 0.001); there was no significant difference after treatment between two groups (P > 0.05); there was a significant difference in thinking items of SS-QOL after treatment between two groups (P < 0.05), the acupoint sticking group was superior to that of control group; SS-QOL score of patients with abnormal cysteine of acupoint sticking group was superior to that of the control group after treatment, with a significant difference between the two groups (P < 0.05).</p><p><b>CONCLUSION</b>The acupoint sticking therapy can improve the thinking ability of stroke patients, and improve the life quality of high cysteine stroke patients.</p>

Effects of sepia on hematopoietic stem cells,granulocyte and monocyte progentior cells and peripheral WBC in mice / 中国海洋药物

Objective To investigate the effects of sepia on stem cells,granulocyte and monocyte progentior cells and peripheral WBC in mice.Methods Different dosages of sepia were given to normal and model mice with hematopoietic system impairment respectively.The numbers of CFU-S,CFU-GM and peripheral WBC in normal and model mice were measured respectively with the method of hematopoietic progenitor cells cultured in vitro and the technique of experimental hematology.Results Sepia could enhance the number of CFU-S,CFU-GM and peripheral WBC in normal mice significantly,resist the decrease of CFU-S,CFU-GM,and peripheral WBC in model mice of hemapoiecsis impaired effectively and promote the restoration of those indices mentioned above in model mice significantly.Conclusion Sepia has significant effects on stimulating granulopoiesis in bone marrow in mice.The mechanism may be related to regulating immunological function and inducement GM-CSF and other sorts of cellular factors,which in turn promote the multiplication differentiation of CFU-S and CFU-GM.