Research progress in cognitive function characteristics of children with tic disorder / 中华实用儿科临床杂志

The prevalence rate of tic disorder in Chinese children and adolescents is relatively high, and tic disorder is often co-occurring with psychiatric disorders such as attention deficit and hyperactive disorder and obsessive compulsive disorder.The cognitive impairments of tic disorder patients with different clinical types, course of disease and comorbidities are different, but all affect the learning and life quality of patients.Exploration of the cognitive function characteristics of tic disorder patients is conducive to further understanding of the disease and its etiological mechanism, and has guiding significance for clinical recognition, diagnosis and treatment.

Finite Element Analysis on Different Internal Fixations for Treating Proximal Humeral Fractures in Children / 医用生物力学

Objective To compare biomechanical characteristics of external fixator, Kirschner’s wire, elastic stable intramedullary nailing (ESIN) for fixing proximal humeral fractures in children by finite element method.Methods The CT scanning data from the healthy humerus of an 8-year-old patient with proximal humeralfractures were collected, and the image data were imported in Mimics 21. 0 to establish the rough humeralmodel, which was imported in Geomagic 2013 to construct the three-dimensional (3D) model of cancellous and cortical bones of the humerus. After the model was assembled with 3 fixators ( external fixator, Kirschner’swire, ESIN), it was imported in ANSYS 2019 to simulate the upper limb under quiet, abduction, adduction, flexion, extension, external rotation, internal rotation working conditions. The maximum displacement of the distal humerus, the maximum stress of the fixture, and the maximum displacement of the distal fracture surface were analyzed. Results The minimum values of the maximum displacement of the distal humerus in models fixed by external fixator, Kirschner’s wire, ESIN appeared under extension (2. 406 mm), external rotation (0. 203 mm), external rotation (0. 185 mm) working conditions, respectively. Conclusions External fixator is the most unstable fixation of proximal humeral fractures in children, and the biomechanical performance of ESIN is better than that of external fixator and Kirschner’s wire fixation

The action mechanism of glioblastoma cell-derived exosome: a review / 生物工程学报

Patients with glioblastoma (GBM) generally have a bad prognosis and short overall survival after being treated with surgery, chemotherapy or radiotherapy due to the histological heterogeneity, strong invasive ability and rapid postoperative recurrence of GBM. The components of GBM cell-derived exosome (GBM-exo) can regulate the proliferation and migration of GBM cell via cytokines, miRNAs, DNA molecules and proteins, promote the angiogenesis via angiogenic proteins and non-coding RNAs, mediate tumor immune evasion by targeting immune checkpoints with regulatory factors, proteins and drugs, and reduce drug resistance of GBM cells through non-coding RNAs. GBM-exo is expected to be an important target for the personalized treatment of GBM and a marker for diagnosis and prognosis of this kind of disease. This review summarizes the preparation methods, biological characteristics, functions and molecular mechanisms of GBM-exo on cell proliferation, angiogenesis, immune evasion and drug resistance of GBM to facilitate developing new strategies for the diagnosis and treatment of GBM.

Treatment of chronic ankle instability in children with ligament reinforcement and preservation of a large subfibular bone / 中华创伤骨科杂志

Objective:To investigate the effects of preserving a large subfibular bone and ligament reinforcement to treat chronic ankle instability in children.Methods:A retrospective study was conducted to analyze the clinical data of qualified 43 children with chronic ankle instability and a large subfibular bone (the maximum diameter greater than 8 mm) who had been treated at Children's Osteopathy Hospital, Honghui Hospital, Xi'an Jiaotong University from May 2019 to February 2022. There were 29 boys and 14 girls with an age of (9.5±1.2) years. According to treatment methods, they were divided into group A (19 cases) where the subfibular bone was excised and the ligaments were reinforced and group B (24 cases) where the subfibular bone was preserved and the ligaments were reinforced. The talar anterior displacement and talar inclination angle at preoperation and immediate postoperation, and the ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) at preoperation and the last follow-up were recorded in both groups to make comparisons between the 2 groups and between preoperation and postoperation. Wound healing and complications were also recorded.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). All patients were followed up for (11.6±5.8) months. In all patients, the talar anterior displacement and talar inclination angle at immediate postoperation were significantly improved compared with the preoperation, and the ankle-hindfoot AOFAS score and VAS at the last follow-up also significantly improved compared with the preoperation ( P<0.05). The talar anterior displacement at immediate postoperation in group B [5.0 (4.3, 5.0) mm] was significantly shorter than that in group A [6.0 (5.0, 6.0) mm] ( P=0.013). There were no significant differences between the 2 groups in the talar inclination angle at immediate postoperation, or in the ankle-hindfoot AOFAS score or VAS at the last follow-up ( P>0.05). Postoperative incision healing was good in all patients. Probably due to intraoperative pulling up of the incision, superficial peroneal nerve numbness occurred in 1 case but recovered spontaneously. The subfibula bones in group B healed within 1 year. Conclusion:For chronic ankle instability in children with a large subfibular bone, preservation of the subfibular bone and ligament reinforcement can better restore the ankle anteroposterior stability.

Dammarane-type triterpenoid saponins isolated from Gynostemma pentaphyllum ameliorate liver fibrosis via agonizing PP2Cα and inhibiting deposition of extracellular matrix / 中国天然药物

Gypenosides, structurally analogous to ginsenosides and derived from a sustainable source, are recognized as the principal active compounds found in Gynostemma pentaphyllum, a Chinese medicinal plant used in the treatment of the metabolic syndrome. By bioactive tracking isolation of the plants collected from different regions across China, we obtained four new gypenosides (1-4), together with nine known gypenosides (5-13), from the methanol extract of the plant. The structures of new gypenosides were elucidated by one-dimensional (1D) and two-dimensional (2D) nuclear magnetic resonance (NMR) spectra, complemented by chemical degradation experiments. Through comprehensive evaluation involving COL1A1 promoter assays and PP2Cα activity assays, we established a definitive structure-activity relationship for these dammarane-type triterpenoids, affirming the indispensability of the C-3 saccharide chain and C-17 lactone ring in effectively impeding extracellular matrix (ECM) deposition within hepatic stellate cells. Further in vivo study on the CCl4-induced liver damage mouse model corroborated that compound 5 significantly ameliorated the process of hepatic fibrosis by oral administration. These results underscore the potential of dammarane-type triterpenoids as prospective anti-fibrotic leads and highlight their prevalence as key molecular frameworks in the therapeutic intervention of chronic hepatic disorders.

Intramedullary plus extramedullary fixation for fracture of distal radial diametaphyseal transition zone in children / 中华创伤骨科杂志

Objective:To investigate the efficacy of intramedullary plus extramedullary fixation in the treatment of fractures of distal radial diametaphyseal transition zone in children.Methods:The data were retrospectively analyzed of the 49 children who had been admitted to Pediatric Orthopedic Hospital, Honghui Hospital Affiliated to Xi'an Jiaotong University from July 2018 to April 2020 for fractures of distal radial diametaphyseal transition zone. There were 30 males and 19 females; 21 left sides, 27 right sides, and one case of bilateral sides. In the operation, an elastic intramedullary nail or Kirschner wire was used for intramedullary fixation while another Kirschner wire was used to fix the cortex at the distal and proximal ends of the fracture. The ranges of wrist motion and Disabilities of the Arm, Shoulder and Hand (DASH) scores at 1 and 9 months after operation were recorded and compared; the incidence of postoperative complications was also recorded.Results:The operation time for the 49 children averaged 45.0 min (from 39 to 51 min). The patients were followed up for 6 to 36 months (mean, 18.6 months). The fracture union time averaged 8.6 weeks (from 6.8 to 10.4 weeks). Needle tract infection developed in one case but the wound was healed after removal of the K-wire after callus formation and oral use of antibiotics for 3 days. Another case reported skin irritation the symptoms of which disappeared after the child reduced activities. The ranges of pronation, supination, flexion and extension of the wrist and DASH score were 47.9°±2.5°, 45.5°±3.0°, 51.2°±1.6°, 53.4°±1.7° and (36.7±4.5) points at one month after operation while they were 85.6°±3.1°, 87.6°±2.1°, 88.8°±2.0°, 88.0°±1.2° and (23.2±8.6) points at 9 months after operation. There were statistically significant differences in the above indexes between one and 9 months after operation ( P<0.05). Conclusion:In the treatment of fractures of distal radial diametaphyseal transition zone in children, intramedullary plus extramedullary fixation is simple in surgical techniques, easily repeatable, slightly invasive, and reliable in fixation.

Progress in MRI evaluation of hip development after closed reduction for developmental dysplasia of the hip / 中华骨科杂志

This article reviews the various studies of MRI in developmental dysplasia of the hip (DDH), focusing on the research progress of MRI in evaluating the developmental trend of hip joint after DDH closed reduction, in order to find reliable indicators for predicting the development of the hip joint after closed reduction of DDH. Due to the advantages of MRI in identifying cartilage and soft tissue, more and more studies have performed MRI before and after DDH treatment to evaluate its specific role. This article has made a corresponding summary, for example, using MRI to identify obstacles that affect the reduction of dislocated hip joints such as fibrofatty tissue hyperplasia/thickening, joint effusion, labrum inversion, iliopsoas muscle atrophy, etc; using MRI to observe the cartilage shaping of the femoral head before and after closed reduction treatment of DDH; using MRI to verify the validity of intraoperative arthrography in assessing the position of femoral head and socket or directly observe the relationship of femoral head and socket with MRI; using hip MR angiography to evaluate the acetabular labrum injury in DDH patients. In addition, the results of bias-corrected studies on MRI-assessed hip-related observations are also summarized. In general, the application of MRI in the diagnosis and treatment of DDH is becoming more and more mature and perfect, and has been advocated by many scholars as a routine auxiliary examination for DDH. However, there is still no consensus on how to evaluate and predict the developmental outcome of the hip joint after closed reduction of DDH. This article summarizes the current progress from three aspects. We summarize the results of many measurements on MRI, which represent cartilage acetabular coverage and are used to predict acetabular growth and development; the research results on the use of MRI to explore the impact of the labrum on the development of the hip joint are summarized; the related research results of MRI evaluation of avascular necrosis of the femoral head after closed reduction are summarized. The above content can provide some reference for the current clinical work and research.

Diagnosis and treatment of a head-neck separation type of Monteggia equivalent fractures in children / 中华创伤骨科杂志

Objective:To explore the clinical characteristics and treatment of a head-neck separation type of Monteggia equivalent fractures in children.Methods:From March 2016 to February 2019, 12 children sought medical attention at Pediatric Orthopedic Hospital, Honghui Hospital Affiliated to Xi'an Jiaotong University for a head-neck separation type of Monteggia equivalent fractures. They were 8 boys and 4 girls, aged from 3 to 14 years (average, 8.3 years). All cases were treated with closed reduction, deformity correction and plaster fixation at emergency department after X-ray examination. In line with the treatment principles for Monteggia fractures, after the ulnar length was first restored and stabilized, a proper fixation method was chosen according to the location and type of the ulnar fracture, followed by treatment of the radial neck fracture. The fracture union and complications were evaluated according to the X-ray films after operation, and the therapeutic efficacy was evaluated according to the Mayo elbow performance score (MEPS) at the final follow-up.Results:The head-neck separation type of Monteggia equivalent fractures in children was characterized by a fracture of ulnar diaphysis or metaphysis and a fracture of the radial neck with complete separation of the head and neck, a longitudinal axis of the radius off the capitellum center at the distal fracture end but normal proximal humeroradial relationship. The fractures were classified into 2 types depending on the angulation direction of the ulnar fracture and the direction of distal displacement of the radial neck fracture: 7 cases belonged to the extension-valgus type and 5 cases to the flexion-varus type. The 12 patients were followed up for 8 to 38 months (average, 16.0 months). Of the ulnar fractures, one was treated with closed reduction and Kirschner wire fixation, 4 with elastic intramedullary nail fixation, 5 with plate fixation, one untreated, and one with manual reduction only. Of the radial neck fractures, 11 were treated with closed reduction and elastic intramedullary nail fixation, and one with open reduction and K-wires fixation. All fractures got united after 8 to 12 weeks (mean, 9.6 weeks). The time for removal of internal fixation ranged from 12 to 50 weeks (mean, 31.2 weeks). Avascular necrosis occurred in one case and bulk formation of proximal metaphysis in another. By the MEPS at the final follow-up, the therapeutic efficacy was excellent in 10 cases, good in one and fair in one.Conclusions:The head-neck separation type of Monteggia equivalent fractures in children is different from common Monteggia fractures or radial neck fractures, because its clinical manifestations are characterized by a fracture of ulnar diaphysis or metaphysis and a fracture of the radial neck with complete separation of the head and neck, a longitudinal axis of the radius off the capitellum center at the distal fracture end but normal proximal humeroradial relationship. The treatment options for ulnar fractures include closed reduction with Kirschner wire fixation, elastic intramedullary nailing, open reduction and bone plate fixation or no fixation, while radial neck fractures are mostly treated by closed reduction and elastic intramedullary nailing. Early functional exercise can lead to satisfactory clinical outcomes.

Clinical characteristics and treatment of complex fracture-dislocations of the elbow in children / 中华骨科杂志

Objective:To summarize and discuss the concept and clinical manifestations of complex fracture-dislocations of the elbow in children, and compare its injury characteristics, treatment and clinical effect with adults.Methods:From September 2015 to January 2020, 34 patients seen and treated at our institution for complex fracture-dislocations of the elbow were identified, and their medical records and radiographs were reviewed retrospectively. The inclusion criteria were elbow dislocation combined with one or more fractures at the proximal ulna and radius. There were 25 boys and 9 girls, with an average age of 8.3±3.2 years. The left arm was involved in 27 cases, and the right arm was involved in 7 cases. The causes of injury included falling from a scooter in 16 cases, falling from height in 10 cases, cycling in 5 cases and traffic accident in 3 cases. All patients were treated with closed reduction and the application of plaster under local anaesthesia in the emergency room. Then, X-ray, CT and MRI were performed to evaluate the fracture-dislocation and ligament injury. The following treatment plan was comprehensively evaluated according to the size and displacement of the combined fracture block and the stability of the elbow, for example, open reduction with K-wires and tension band or plate fixation for olecranon fracture, open reduction with loop plate fixation for coronal process fracture, closed reduction or open reduction with K-wires or elasticstable intramedullary nail for radial neck fracture.Results:Among the 34 patients, there were 16 cases of transolecranon fracture-dislocation, 1 case of varus posteromedial rotational instability, 4 cases of valgus posterolateral rotatory instability and 13 cases of divergent dislocation of elbow. All patients were followed up for 13(8, 15) months, and the average fracture healing time was 3.5±0.8 weeks, with no failure of internal fixation. In 2 cases of elbow dislocation combined radial neck fracture, one case had ischemic necrosis of the radial head and one case had early closure of epiphyseal plate of the proximal radius. At the last follow-up, all patients had no subluxation, dislocation or instability of the elbow. The therapeutic efficacy was evaluated at the final follow-up by the Mayo elbow performance score (MEPS) as excellent in 25 cases, good in 5 cases, fair in 3 cases, and poor in one case, with excellent and good rate 88%.Conclusion:The complex fracture-dislocations of the elbow is rare in children. We have the opinion that the clinical characteristics are dislocation combined with one or more fractures of the proximal ulna and radius. Compared with adults, its pathological characteristics and the scope of injury are similar, but most of the injuries are mild. The clinical manifestations are mainly transolecranon fracture-dislocation and divergent dislocation of elbow. Good results can be achieved in most cases through open reduction with internal fixation for fractures.

Efficacy of Hormone Combined with Cyclophosphamide in the Treatment of Connective Tissue Disease-associated Interstitial Lung Disease and Analysis of Its Influential Factors / 中国药房

OBJECTIVE：To investigate the efficacy of hormone combined with cyclophosphamide in the treatment of connective tissue disease-associated interstitial lung disease （CTD-ILD）and to analyze its influential factors. METHODS ：100 patients diagnosed as CTD-ILD in our hospital from Jan. 2018 to Jan. 2019 were randomly divided into observation group and control group ，with 50 cases in each group. Control group was treated with Compound cyclophosphamide tablets ，50 mg each time，3-4 times each day. Observation group was additionally treated with Prednisone acetate tablets ，10 mg each time ，3-4 times each day ，on the basis of control group. Treatment courses of 2 groups lasted for 6 months. The clinical efficacy ，the occurrence of ADR，lung function before and after treatment ，the levels of peripheral IL- 6，CRP and PCT and quality of life （SGRQ score ）were compared between 2 groups. According to the therapeutic efficacy ，all patients were divided into effective group and ineffective group. The related factors influencing the clinical efficacy of CTD-ILD were analyzed by univariate and multivariate Logistic regression analysis. RESULTS ：After treatment ，total response rate ，FVC，FEV1 and DLCO of observation group were significantly higher than those of control group ，while SGRQ score ，levels of IL- 6，CRP and PCT in peripheral blood were significantly lower than control group （P＜0.05）. There was no significant difference in the total incidence of ADR between 2 groups（P＞0.05）. Univariate analysis showed that there were no significant differences in gender ，age，past medical history and CTD type between effective group and ineffective group （P＞0.05）. However ，there were statistical significancant differences in the distribution of different levels of IL- 6，CRP and PCT in peripheral blood between 2 groups（P＜0.05）. Multivariate Logistic regression analysis showed that IL- 6 was an independent risk factor for therapeutic efficacy of combined therapy [OR （95％CI）＝ 4.537（3.668，10.352），P＝0.002]. CONCLUSIONS ：Hormone combined with cyclophosphamide can significantly improve the therapeutic efficacy of CTD-ILD patients ，improve their lung function and quality of life ，and reduce the expression level of inflammatory factors. The level of IL- 6 is an independent risk factor affecting the efficacy of the treatment ，and its changes should be paid close attention to during the treatment.

Change in the activity of glucosylceramide synthase in human hepatoma cell line with hepatitis B virus infection in vitro / 临床肝胆病杂志

ObjectiveTo investigate the change in the activity of glucosylceramide synthase, the key enzyme in glycosphingolipid metabolism and synthesis, in Huh7 cells infected by hepatitis B virus (HBV) in vitro. MethodsBlood samples were collected from nine previously untreated patients with acute hepatitis B who attended Department of Infectious Diseases, The First Hospital of Lanzhou University, from June to August, 2019, and the blood samples collected from seven healthy individuals who underwent physical examination were established as control. Huh7 cells were inoculated with the high-copy HBV particles (＞9.9×107 IU/ml) in the serum of patients with HBV infection (infection group), and Huh7 cells co-cultured with the serum of healthy individuals were established as control group. The expression levels of HBsAg and HBV DNA in the cytoplasm of HBV-infected Huh7 cells were measured, and the correlation between GCS activity and virus was analyzed. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups, and a Pearson correlation analysis was performed. ResultsCompared with the control group, the infection group had a significant reduction in the number of cells, an increase in cell volume, and cell membrane fragmentation. The infection group had a significant increase in the expression of HBsAg in cytoplasm at 4 hours, 8 hours, 2 days, and 5 days after infection (P＜0.05); the expression level of HBV DNA tended to increase significantly from 4 hours after infection to 8 hours, 2 days, and 5 days after infection (16.67±11.55 IU/ml vs 112.01±25.94 IU/ml/328.01±10350 IU/ml/101.60±49.84 IU/ml, P＜0.001), with the highest level at 2 days after infection. During HBV infection, the activity of GCS gradually increased with the increase in viral replication from 4 hours after infection (126.21±9.59 IU/ml) and reached a peak at 2 days after infection (226.53±36.27 IU/ml), with a significant difference between the infection group and the control group at 2 days after infection (226.53±36.27 IU/ml vs 136.50±1544 IU/ml, t=3.956, P=0.016 7). The activity of GCS was positively correlated with HBV DNA level (r=0.576 8, P=0047 1). ConclusionHuh7 cells are successfully infected with the high-copy HBV particles in the serum of patients with HBV infection, which mimics the characteristics of HBV infection in vitro to a certain degree. The activity of GCS may be associated with HBV infection, suggesting that glycosphingolipid synthesis and metabolism may be closely associated with HBV.

The relationship between insulin resistance and plasma hs-CRP in patients with chronic schizophrenia / 中华行为医学与脑科学杂志

Objective To explore the relationship between insulin resistance and plasma hypersen-sitive reactive protein (hs-CRP) in patients with chronic schizophrenia. Methods A total of 247 inpatients with chronic schizophrenia ( patient group) and 166 cases of normal individuals( control group) were en-rolled. Their general demographic and clinical data were collected,fasting blood glucose,hs-CRP,c-peptide and insulin indexes were tested,and insulin resistance index (HOMA-IR) was calculated. The insulin resist-ance level of the patients group and the control group was compared by Mann-Whitney U test,and the rela-tionship between insulin-resistance and hs-CRP in patients group was analyzed using Spearman correlation a-nalysis. Results (1)The levels of C-peptide (2. 53(2. 06,3. 23)ng/ml vs 2. 24(1. 89,2. 87)ng/ml), in-sulin (7. 68(4. 66,11. 97)μIU/ml vs 7. 02(4. 31,9. 59) μIU/ml) and HOMA-IR (1. 75(1. 09, 3. 07) vs 1. 57(0. 97,2. 22)) in the patient group were significantly higher than those in the control group( all P<0. 05). ( 2) The levels of HOMA-IR( 1. 91( 1. 21,3. 74) vs 1. 70(1. 02,2. 72)) in patients with high hs-CRP(≥3 mg/L) was higher than those in the patients with low hs-CRP (<3 mg/L) (P<0. 05). ( 3) Spearman correlation analysis showed that HOMA-IR was positively correlated with plasma hs-CRP level in the patient group (r=0. 139,P<0. 05). (4)After logarithmic transformation of related variables,multivariate linear regression analysis showed that HOMA-IR was linearly correlated with hs-CRP level and boy weight in-dex. Conclusion The hs-CRP level in chronic schizophrenia has a positive predictive effect on insulin re-sistance. Detection of hs-CRP level in schizophrenic patients is helpful to assess metabolic risk of insulin.

The relationship between insulin resistance and plasma hs-CRP in patients with chronic schizophrenia / 中华行为医学与脑科学杂志

Objective@#To explore the relationship between insulin resistance and plasma hypersensitive reactive protein (hs-CRP) in patients with chronic schizophrenia.@*Methods@#A total of 247 inpatients with chronic schizophrenia (patient group) and 166 cases of normal individuals(control group) were enrolled.Their general demographic and clinical data were collected, fasting blood glucose, hs-CRP, c-peptide and insulin indexes were tested, and insulin resistance index (HOMA-IR) was calculated.The insulin resistance level of the patients group and the control group was compared by Mann-Whitney U test, and the relationship between insulin-resistance and hs-CRP in patients group was analyzed using Spearman correlation analysis.@*Results@#(1)The levels of C-peptide (2.53(2.06, 3.23)ng/ml vs 2.24(1.89, 2.87)ng/ml), insulin (7.68(4.66, 11.97)μIU/ml vs 7.02(4.31, 9.59)μIU/ml) and HOMA-IR (1.75(1.09, 3.07) vs 1.57(0.97, 2.22)) in the patient group were significantly higher than those in the control group(all P<0.05). (2) The levels of HOMA-IR( 1.91(1.21, 3.74) vs 1.70(1.02, 2.72)) in patients with high hs-CRP(≥3 mg/L) was higher than those in the patients with low hs-CRP(<3 mg/L)(P<0.05). (3)Spearman correlation analysis showed that HOMA-IR was positively correlated with plasma hs-CRP level in the patient group (r=0.139, P<0.05). (4)After logarithmic transformation of related variables, multivariate linear regression analysis showed that HOMA-IR was linearly correlated with hs-CRP level and boy weight index.@*Conclusion@#The hs-CRP level in chronic schizophrenia has a positive predictive effect on insulin resistance.Detection of hs-CRP level in schizophrenic patients is helpful to assess metabolic risk of insulin.

Analysis on prognosis and influencing factors of postoperative low anterior resection syndrome for rectal cancer patients undergoing laparoscopic anus-preserving radical resection / 中华胃肠外科杂志

Objective@#To investigate the prognosis and influencing factors of postoperative low anterior resection syndrome (LARS) for rectal cancer patients undergoing laparoscopic sphincter-preserving radical resection.@*Methods@#A retrospective case-control study was used in this study. Clinical data of 268 rectal cancer patients undergoing laparoscopic sphincter-preserving radical resection at Department of Gastrointestinal Surgery of The First Affiliated Hospital of Bengbu Medical College from January 2016 to January 2018 were retrospectively collected. Inclusion criteria: (1) operation procedure was total mesorectal excision (TME) and sphincter-preserving radical resection; (2) rectal cancer was confirmed by postoperative pathology; (3) age of patient was ≥ 18 years old. Exclusion criteria: (1) patient who had history of pelvic surgery and pelvic fractures, which would affect the anorectal function; (2) patient who had history of preoperative chronic constipation and irritable bowel syndrome, which would affect defecation; (3) patient who developed postoperative complications, such as anastomotic leakage, which would affect defecation function; (4) patient who received long-term use of drugs, which would affect the function of gastrointestinal tract or anus; (5) patient suffered from mental illness, who was unable to communicate properly; (6) patient who was lack of clinical data or had incomplete clinical data. Patients were followed up at 3, 6 and 12 months postoperatively, and LARS was diagnosed and graded according to the LARS score scale. The LARS score ranged from 0 to 42 points, and 0 to 20 was difined as no LARS, 21 to 29 was mild LARS, and 30 to 42 was severe LARS. LARS score >20 points at any time point was defined as postoperative LARS. Severe LARS transferring into mild LARS and mild LARS transferring into no LARS was defined as symptom improvement. Incidence and outcomes of LARS were evaluated. The factors associated with LARS outcomes were analyzed using χ2 test and logistic regression model.@*Results@#A total of 268 patients were enrolled. The incidence of LARS was 42.9% (115/268), 32.5% (87/268) and 20.1% (54/268) at 3, 6, and 12 months postoperatively respectively, and no new case of LARS was found after 3 months postoperatively. The incidence of mild LARS was 25.7% (69/268), 17.2% (46/268) and 8.6% (23/268) at 3, 6, and 12 months postoperatively respectively, and mild LARS incidence at 6 months was significantly lower than that at 3 months (χ2=5.857, P=0.016), and was significantly higher than that at 12 months (χ2=8.799, P=0.003). The incidence of severe LARS was 17.2% (46/268), 15.3% (41/268) and 11.6% (31/268) at 3, 6, and 12 months postoperatively respectively, without significant difference among 3 time points (all P>0.05). The improvement rate within one year after surgery in patients with mild LARS diagnosed at 3 months was significantly higher than that in patients with severe LARS (88.4% vs. 32.6%, χ2=38.340, P<0.001). Univariate analysis showed that female, distance from anastomosis to anal verge < 5 cm and tumor diameter ≥ 5 cm were associated with unsatisfied LARS outcomes (all P<0.05). Logistic regression analysis showed that distance from anastomosis to anal verge <5 cm was an independent risk factor for LARS outcome (OR=3.589, 95% CI: 1.163 to 2.198, P<0.001).@*Conclusions@#The incidence of LARS after laparoscopic sphincter-preserving radical resection decreases with time. The improvement rate within postoperative 1-year of severe LARS is lower than that of mild LARS. Low anastomotic position may lead to impaired improvement of LARS.

The change of retinal microstructure and the correlation with visual outcome in central serous chorioretinopathy after laser treatment / 中华眼底病杂志

Objective To observe the change of retinal microstructures and the association between visual outcome with these microstructures in central serous chorioretinopathy (CSC) after laser treatment.Methods This is a retrospective study.From April 2016 to February 2017,a total of 52 eyes from 52 patients who underwent conventional laser treatment (27 eyes) or subthreshold laser treatment (25 eyes) for CSC and the sub-retinal fluid (SRF) absorbed completely were included in this study.The were 46 patients (46 eyes) and 6 males (6 eyes),with the mean age of 43.92± 8.62 years.The healthy fellow eyes (49 eyes) were selected as control.All patients were underwent BCVA and SD-OCT examination.According to the OCT images for all patients,the thickness of central foveal (CFT),outer nuclear (ONL),inner segment (IS),outer segment (OS) were measured.The status of ellipsoid zone (EZ),interdigitation zone (IZ) and RPE were also evaluated at fovea.Comparing the change of SD-OCT microstructures in two time points,the first visit after SRF absorbed and the last visit respectively.Spearman correlation analysis was used to analyze the relation between BCVA and ONL,IS,OS.Results At the first visit after SRF absorbed,compared with control eyes,the thickness of CFT (182.55 ± 24.14 μm),ONL (72.86 ± 17.39 μm),IS (41.23 ± 5.14 μm),OS (18.52 ± 10.26 μm) in CSC eyes were decreased (P＜ 0.001).Meanwhile,the mean BCVA of CSC eyes was 81.27± 6.39 letters,which was also significantly decreased comparing with control eyes (P＜ 0.001).At last visit,the thickness of CFT,ONL,IS,OS were 195.19±22.10,75.44±16.33,44.56±4.09,26.60± 11.39 μm,and the mean BCVA was 85.50±5.95 letters.All recovered significantly comparing with first visit (P＜0.05).At first visit,the BCVA of patients with integrate EZ (83.38± 5.78 letters) was significantly better than the BCVA of patients with unintegrated EZ (77.90± 5.97 letters) (P=0.003).And the BCVA of patients with smooth RPE (82.72± 5.95 letter) was also significantly better than the BCVA of patients with rough RPE (78.00± 6.31 letters) (P=0.020).The result of Spearman correlation analysis showed that the thickness of OS was positively correlated to BCVA at two time points (r=0.423,0.416;P=0.002,0.002).Conclusions In CSC,the thickness of ONL,IS,OS were decreased,and the integrality of EZ,IZ,the smooth of RPE were disrupted in different extent.After laser treatment,with retinal reattachment,those microstructures including ONL,IS,OS,EZ,IZ recovered slowly.The thickness of OS,the integrality of EZ and the smooth of RPE were associated with visual acuity.

Effects of oxycodone,sufentanil and fentanyl on immune function in patients with colon cancer under postoperative analgesia / 临床麻醉学杂志

Objective To compare the effect of oxycodone,sufentanil and fentanyl on immune function in patients with colon cancer under postoperative analgesia,provide guidance and basis for clinical medication.Methods Ninety patients 49 males and 41 females,aged <65 years,ASA physi-cal status Ⅰ or Ⅱ,were enrolled and randomly divided into 3 groups using a random number table (n=30):oxycodone group (group O),sufentanil group (group SF)and fentanyl group (group F).All patients underwent the same way to maintain anesthesia.The PCIA pump recipe were as follows:group O,oxycodone 2 mg/kg+granisetron 3 mg,added normal saline to 100 ml;group SF,sufen-tanil 0.002 mg/kg+granisetron 3 mg,added normal saline to 100 ml;group F,fentanyl 0.02 mg/kg+granisetron 3 mg,added normal saline to 100 ml;The background volume of PCIA electronic pump was 2 ml/h,the amount of each press was 2 ml,the lock time was 1 5 min,the pump time lasted for 24 h and maintained for 2 days after operation.The percentage of CD4+,CD8+and NK cells in venous blood were recorded at the end of surgery,6 h,12 h,24 h and 48 h after surgery.Results In CD4+,in the time points of 6 h,12 h,24 h after surgery,it was significantly higher in group O than that in groups SF and F (P<0.05);CD8+in group O was higher than that of group F,and CD8+in group F was higher than group SF at the time of 6 h after surgery.The group O was significantly higher than that of the groups SF and F at the times of 12 h,24 h after surgery (P<0.05);In NK cells,at the time points of 12 h,24 h and 48 h after surgery,it was significantly higher in group O than in groups SF and F (P<0.05).Conclusion Three analgesic drugs caused decline in immune function.Sufentanil and fentanyl have the similar effects on immunity,but oxycodone have a relatively small effect on immunity.Oxycodone is a more appropriate analgesic drug for colon cancer under postoperative analgesia.

Cytotoxicity of Ibuprofen Raw Material and its Part of Impurities / 中国药师

Objective:To evaluate the cytotoxicity of ibuprofen and its 6 kinds of impurities.Methods:Different concentrations of ibuprofen and the impurities were used to act on mouse fibroblasts (L929) for 72 h,and the cytotoxicity was observed under a microscope.Results:In ibuprofen raw material,the cytotoxicity of impurity B was the weakest with slight toxicity,the cytotoxicity of impurity N,D,J and V was moderate,and that of impurity E was severe.Conclusion:At the same concentration,the toxicity of impurity E is the strongest,and its content in ibuprofen preparations should be strictly controlled.

Pharmacological Study on Chaigeshubiao Granules / 医药导报

Objective To study the antipyretic,anti-inflammatory and analgesic effects of Chaigeshubiao granules. Methods Animals were randomly divided into 6 groups:blank control group,indomethacin group,Fengreganmao granules group and the high, the medium and the low dosage groups of Chaigeshubiao granules ( 26, 13, 6. 5 g . kg-1 ) . Each group was administered via intragastric administration once a day for 5 days.Rat model suffering from fever by dried yeast,relieving fever of Chaigeshubiao granules was investigated;Rats with toe swelling by 1% carrageenin and mice with ear swelling by dimethylbenzene were applied to observe anti-inflammatory effects of Chaigeshubiao granules were observed;The pain models induced by 0. 6%acetic acid and the hot-plate tests in mice were used to observe the analgesic effects of Chaigeshubiao granules. Results Compared with negative control group,Chaigeshubiao granules in high dosage could obviously decrease the temperature of rat with fever induced by dried yeast 0.5 h later,and the medium dosage group decreased 4-6 h later. Moreover,Chaigeshubiao granules in high dosage could inhibit inflammatory reaction of rat with toe swelling caused by albumen at 1 h,2 h,3 h,when the medium dosage group inhibited at 2 h,3 h,4 h. The inhibition ratio of the mice with ear swelling induced by dimethylbenzene was 58.2%, 52.0% and 53.9%,respectively at the high,medium and low dose groups. And the inhibition ratio of retortion of mice by 0.6%acetic acid was 50.5%,68.8%,58.1%,respectively, at the high,medium and low dose groups. In addition,the high,medium and low dose groups reduced the pain reaction latency of mice in the hot-plate tests. Conclusion Chaigeshubiao granules have antipyretic,anti-inflammatory and analgesic actions.

Effect of hypoxic-ischemic time on reduction of hypoxic-ischemic brain injury by sevoflurane postconditioning in neonatal rats / 中华麻醉学杂志

Objective To evaluate the effect of hypoxic-ischemic time on reduction of hypoxic-ischemic brain injury by sevoflurane postconditioning in neonatal rats.Methods Two hundred and ten 7-day-old Sprague-Dawley rats (105 male,105 female),weighing 13-17 g,were randomly divided into 7groups (n=30 each) using a random number table:sham operation group (group Sham),hypoxia-ischemia group (group HI),and sevoflurane postconditioning at different hypoxic-ischemic time point groups (P0,P3,P6,P 12 and P24 groups).Immediately after ligation of the left common carotid artery,and at 3,6,12 and 24 h after ligation,the rats inhaled the mixed gas containing 2％ sevoflurane for 30 min in P0,P3,P6,P13 and P24 groups,respectively.The fatality was recorded within 7 days after establishment of the model.At 7 days after establishment of the model,the rats were sacrificed,the brains were removed,and the right and left cerebral hemispheres were weighed separately,and the left/right cerebral hemisphere weight ratio was calculated.The hippocampal CA1 region and posterior cingulate gyrus were isolated,and the ratio of density of normal neurons in the left to the right was calculated.Results Compared with group Sham,the left cerebral hemisphere weight,left/right cerebral hemisphere weight ratio,and ratio of density of normal neurons were significantly decreased,and the fatality rate was increased in the other six groups (P＜0.05).Compared with group HI,the left cerebral hemisphere weight,left/right cerebral hemisphere weight ratio,and ratio of density of normal ncurons were significantly increased in P0,P3 and P6 groups (P＜0.05),and no significant change was found in the parameters mentioned above in P12 and P24 groups (P＞0.05).Compared with group P6,the left cerebral hemisphere weight,left/right cerebral hemisphere weight ratio,and ratio of density of normal neurons were significantly increased in P0 and P3 groups (P＜ 0.05).There was no significant difference in the parameters mentioned above between group P0 and group P3 (P＞0.05).Conclusion Sevoflurane postconditioning performed within 6 h of hypoxia-ischemia can reduce hypoxic-ischemic brain injury,and it provides no cerebral protection if exceeding 12 h.

Value of Q-analysis real-time elasticity in differentiating between benign and malignant thyroid nodules / 中华医学超声杂志（电子版）

Objective To investigate the value of Q-analysis real-time elasticity in differentiating between benign and malignant thyroid nodules. Methods Eighty-six thyroid nodules in 62 patients with pathologic diagnosis were included in this study and were examined using Q-analysis real-time elasticity. The real-time elasticity features were observed and the quantitative index including the whole elasticity rate and the local elasticity rate were compared between benign and malignant nodules. Results There were 51 benign and 35 malignant nodules according to histopathological examination. The Q-analysis curve of real-time elasticity of benign nodules was smoother and with lower peak, compared with that of malignant nodules. The whole elasticity rate of malignant nodules were significantly higher than that of benign nodules (3.59±0.84 vs 2.32±0.56, P=0.000). And the local elasticity rate of malignant nodules were significantly higher than that of benign nodules (3.96±1.32 vs 2.39±0.58, P=0.000). The cutoff point of whole elasticity rate for the differential diagnosis was 3.25 with sensitivity, specificity and diagnostic accuracy as 71.4%, 96.1% and 86.0% respectively. The cutoff point of local elasticity rate for the differential diagnosis was 3.45 with sensitivity, specificity and diagnostic accuracy as 68.6%, 96.1% and 84.9% respectively. The diagnostic efficiency of whole elasticity rate and local elasticity rate had no significant difference (P=0.591).Conclusions Q-analysis real-time elasticity could provide the real-time elasticity features of thyroid nodules. The whole and local elasticity rate as the quantitative index contributed to the differential diagnosis of benign and malignant thyroid nodules.