Risk prevention and treatment of implant-supported central screw fracture / 口腔医学

@#In the complications of dental implant treatment, the mechanical complications, such as central screw breakage, are often complex and serious. This article analyzes factors that affect the loosening of the central screw. Understanding relevant risk factors can prompt doctors to take corresponding strategies to reduce the possibility of complications in clinical operations. After encountering broken cases, this paper also gives some ideas and methods of treatment, and finally summarizes clinical suggestions for preventing the central screw fracture.

Immunomodulatory Biomaterials and Emerging Analytical Techniques for Probing the Immune Micro-Environment

After implantation of a biomaterial, both the host immune system and properties of the material determine the local immune response. Through triggering or modulating the local immune response, materials can be designed towards a desired direction of promoting tissue repair or regeneration. High-throughput sequencing technologies such as single-cell RNA sequencing (scRNA-seq) emerging as a powerful tool for dissecting the immune micro-environment around biomaterials, have not been fully utilized in the field of soft tissue regeneration. In this review, we first discussed the procedures of foreign body reaction in brief. Then, we summarized the influences that physical and chemical modulation of biomaterials have on cell behaviors in the micro-environment. Finally, we discussed the application of scRNA-seq in probing the scaffold immune micro-environment and provided some reference to designing immunomodulatory biomaterials. The foreign body response consists of a series of biological reactions. Immunomodulatory materials regulate immune cell activation and polarization, mediate divergent local immune micro-environments and possess different tissue engineering functions. The manipulation of physical and chemical properties of scaffolds can modulate local immune responses, resulting in different outcomes of fibrosis or tissue regeneration. With the advancement of technology, emerging techniques such as scRNA-seq provide an unprecedented understanding of immune cell heterogeneity and plasticity in a scaffold-induced immune micro-environment at high resolution. The in-depth understanding of the interaction between scaffolds and the host immune system helps to provide clues for the design of biomaterials to optimize regeneration and promote a pro-regenerative local immune micro-environment.

Mental Health Status and Its Influencing Factors among College Students during the Epidemic of Coronavirus Disease 2019:A Multi-center Cross-sectional Study / 中国医学科学院学报

Objective To measure the prevalence of mental health symptoms and identify the associated factors among college students at the beginning of coronavirus disease 2019(COVID-19)outbreak in China. Methods We carried out a multi-center cross-sectional study via snowball sampling and convenience sampling of the college students in different areas of China.The rates of self-reported depression,anxiety,and stress and post-traumatic stress disorder(PTSD)were assessed via the 21-item Depression-Anxiety-Stress Scale(DASS-21)and the 6-item Impact of Event Scale-Revised(IES-6),respectively.Covariates included sociodemographic characteristics,health-related data,and information of the social environment.Data pertaining to mental health service seeking were also collected.Multivariate Logistic regression analyses were performed to identify the risk factors. Results A total of 3641 valid questionnaires were collected from college students.At the beginning of the COVID-19 outbreak,535(14.69%)students had negative emotions,among which 402(11.04%),381(10.49%),and 171(4.90%)students had the symptoms of depression,anxiety,and stress,respectively.Meanwhile,1245(34.19%)college students had PTSD.Among the risk factors identified,male gender was associated with a lower likelihood of reporting depression symptoms(AOR=0.755,P=0.037],and medical students were at higher risk of depression and stress symptoms than liberal arts students(AOR=1.497,P=0.003;AOR=1.494,P=0.045).Family support was associated with lower risks of negative emotions and PTSD in college students(AOR=0.918,P<0.001;AOR=0.913,P<0.001;AOR=0.899,P<0.001;AOR=0.971,P=0.021). Conclusions College students were more sensitive to public health emergencies,and the incidence of negative emotions and PTSD was significantly higher than that before the outbreak of COVID-19.More attention should be paid to female college students who were more likely to develop negative emotions.We should strengthen positive and proper propaganda via mass media and help college students understand the situation and impact of COVID-19.Furthermore,we should enhance family support for college students.The government and relevant agencies need to provide appropriate mental health services to the students under similar circumstances to avoid the deterioration of their mental well-being.

Long-term effects of porcine small intestinal submucosa biologic mesh in inguinal hernia repair / 中华消化外科杂志

Objective:To investigate the long-term effects of porcine small intestinal submucosa (SIS) biologic mesh in open Lichtenstein tension-free hernia repair.Methods:The prospective randomized controlled study was conducted. The clinical data of 76 patients with unilateral inguinal hernia who underwent open Lichtenstein tension-free hernia repair in 2 medical centers (52 cases in Tianjin People′s Hospital and 24 cases in China-Japan Friendship Hospital) from August 2013 to March 2014 were selected. Based on random number method, patients were allocated into two groups. Patients undergoing Lichtenstein tension-free hernia repair using Biodesign Surgisis mesh were allocated into control group, and patients undergoing Lichtenstein tension-free hernia repair using SIS biologic mesh were allocated into experiment group. Observa-tion indicators: (1) grouping situations of the enrolled patients; (2) postoperative long-term effects. Follow-up was conducted using telephone interview, text message or mail to detect hernia recurrence or death due to other reasons as the end-point event of patients up to December 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented by M (range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Grouping situations of the enrolled patients: a total of 76 patients were selected for eligibility. There were 38 cases in the control group and the experiment group, respectively. The number of males and females, age, body mass index, cases with intraspinal anesthesia or local anesthesia (anesthesia method), cases with inguinal hernia on the left side or on the right side, cases classified as type Ⅰ, Ⅱ, Ⅲ, Ⅳ or Ⅴ of Gilbert classification, operation time of the control group were 35, 3, (56±15)years, (23.0±2.0)kg/m 2, 22, 16, 16, 22, 9, 16, 0, 11, 2 and (49±15)minutes, respectively. The above indicators of the experiment group were 34, 4, (54±13)years, (22.9±2.2)kg/m 2, 17, 21, 14, 24, 9, 21, 1, 7, 0, and (53±21)minutes, respectively. There was no significant difference in the above indicators between the two groups ( χ2=0.157, t=0.532, 0.367, χ2=1.317, 0.220, Z=-0.315, t=-0.765, P>0.05). (2) Post-operative long-term effects: 35 patients of the control group were followed up for (68.8±2.7)months, 4 cases of which died due to other reasons, 1 case had hernia recurrence, 1 case had chronic pain and no foreign body sensation and postoperative infection occurred. Thirty-one patients of the experiment group were followed up for (68.8±2.7)months, with no death or above complications. There was no significant difference in hernia recurrence or chronic pain between the two groups ( P>0.05). Conclusion:The long-term effects of biological mesh in open Lichtenstein tension-free hernia repair is satisfactory and there is no difference in the long-term effects between the domestic SIS biological mesh and Biodesign Surgisis mesh.

Effect of Er:YAG laser combined with ethylenediamine tetra acetic acid on three-walled periodontal intrabony defects adjacent to implant sites / 华西口腔医学杂志

OBJECTIVES@#To investigate the clinical effect of Er:YAG laser combined with ethylenediamine tetra acetic acid (EDTA) on three-walled periodontal intrabony defects adjacent to implant sites.@*METHODS@#A total of 30 patients with three-walled periodontal intrabony defects adjacent to implant sites were treated with the combination therapy. Patients with three-walled intrabony defects were divided into two groups according to the depth of the intrabony pocket between the implant and natural teeth. Evaluation of wound healing was performed 10 days after the operation, and bone augmentation was evaluated 6 months after the operation.@*RESULTS@#Primary healing in group 1 was 92.31%, primary healing in group 2 was 82.35%. No significant difference was observed between the two groups (@*CONCLUSIONS@#The effect of bone augmentation with combination therapy was more ideal in group 2 than in group 1. Implant placement with combination therapy may be a viable technique to reconstruct three-walled intrabony defects due to the space maintenance provided by implants and bone grafts and the good root surface biocompatibility provided by the Er:YAG laser and EDTA.

Advances in titanium dental implant surface modification / 华西口腔医学杂志

Titanium dental implants have wide clinical application due to their many advantages, including comfort, aesthetics, lack of damage to adjacent teeth, and significant clinical effects. However, the failure of osseointegration, bone resorption, and peri-implantitis limits their application. Physical-chemical and bioactive coatings on the surface of titanium implants could improve the successful rate of dental implants and meet the clinical application requirements. This paper reviews the characteristics of surface modification of titanium implants from the aspects of physics, chemistry, and biology. Results provide information for research and clinical application of dental implant materials.

Value of dual-energy CT-based volumetric iodine-uptake in the evaluation of chemotherapy efficacy in advanced gastric cancer / 中华胃肠外科杂志

Objective@#To explore the value of dual-energy CT-based volumetric iodine-uptake (VIU) in the evaluation of chemotherapy efficacy in advanced gastric cancer.@*Methods@#Inclusion criteria of subjects: (1) without previous systematic therapy; (2) with complete clinical information before and after chemotherapy; (3) without contraindications of chemotherapy. Exclusion criteria of subjects: (1) unfinished duration and times of chemotherapy; (2) unmeasurable primary lesions; (3) poor imaging quality or poor gastric filling. Clinical and image data of 52 patients with advanced gastric cancer who were diagnosed by pathology from gastroscopic biopsy, and needed chemotherapy evaluated by imaging and clinical information in the First Affiliated Hospital of Wenzhou Medical University from February 2017 to February 2018 were collected and analyzed. Of 52 patients, 38 were male and 14 were female with the median age of 65 (31-88) years old. All the patients underwent a dual-energy, dual phase-enhanced CT scanning before chemotherapy and after the third chemotherapy session. The parameters of the lesions measured before and after chemotherapy in portal vein phase were as follows: the maximum diameter (the largest diameter among those measured in the cross-sectional, coronal, and sagittal planes), average CT value (the regions of interest were manually pinpointed under cross-sectional planes with largest diameter of the tumor, which did not include regions less than 2 mm to the edge of the tumor) and VIU (lesion volume × iodine concentration). The change rates of maximum lesion diameter, average CT value and VIU before and after chemotherapy were calculated [(post-chemotherapy parameters-pre-chemotherapy parameters)/ pre-chemotherapy parameters]. The efficacy of chemotherapy was evaluated by RECIST 1.1 (the change of maximum tumor diameter after chemotherapy), Choi (the change of average CT value after chemotherapy) and VIU (the change of VIU after chemotherapy), respectively, which was categorized by complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Patients with CR, PR, and SD were assigned to the effective group, while those with PD were classified as the ineffective group. Paired t - test or Wilcoxon signed ranks test was used to compare the changes of parameters before and after chemotherapy, whereas Spearman correlation analysis and Kappa test were used for the correlation analysis and the consistency test between the three evaluation criteria (Kappa≥0.75 indicated good consistency).@*Results@#After chemotherapy, the average CT value [(74.01±16.75) HU vs. (81.06±15.87) HU, t=2.202, P=0.030] and median VIU (668.53×102 μg vs. 272.52×102 μg, Z=4.761, P<0.001) decreased significantly, while the difference of the maximum diameter was not statistically significant [(66.71±34.49) mm vs. (78.45±35.62) mm, t=1.708, P=0.091]. The median change rate of VIU (–53.33%) was greater than that of CT values (–5.75%) with significant difference (Z=-5.408, P<0.001). According to the RECIST 1.1 criteria, 47 patients (90.4%, including 19 with PR and 28 with SD) were effective and 5 patients (9.6%) were ineffective. According to the Choi criteria, 45 patients (86.5%, including 37 with PR and 8 with SD) were effective and 7 patients (13.5%) were ineffective. According to the VIU criteria, 46 patients (88.5%, including 41 with PR and 5 with SD) were effective and 6 patients (11.5%) were ineffective. Efficacy comparison among these three criteria showed no significant difference (χ2=0.377, P=0.828). As compared to RECIST 1.1 evaluation, the proportion of PR evaluated by Choi and VIU was significantly higher (χ2=16.861, P<0.001), whereas the proportion of SD was significantly lower (χ2=24.089, P<0.001). There was no significant difference in the proportions of PR and SD between VIU and Choi criteria (χ2=0.887, P=0.346). Consistency and correlation analysis showed that the VIU and Choi evaluation criteria presented the highest consistency and correlation (Kappa=0.912, P<0.001; r=0.916, P<0.001).@*Conclusion@#VIU is a feasible parameter for the evaluation of chemotherapy efficacy in advanced gastric cancer, and may be more sensitive than the evaluation criteria based on maximum diameter or change of CT value in the tumor.

Influence on radiation dose and image quality of bronchial artery CTA for high heart rate patients with single-cardiac dynamic volumetric scanning in 320-row CT / 中华放射医学与防护杂志

Objective To assess the influence on radiation dose and image quality of bronchial artery CT angiography for hemoptysis patients with high heart rate and free respiratory with single-cardiac dynamic volumetric scanning using 320-row CT.Methods During October 2016 and May 2017,totally 151 hemoptysis patients with heart rate ≥ 65 bmp and free-breathing were scanned for bronchial artery imaging with prospective ECG-gating 320-detector row dynamic volume CT.The patients were randomly divided into two groups,group A(81 cases) and group B(70 cases).Default multi-cardiac cycle scanning style was used for group A to generate multi-sector images A 1 which were reconstructed corresponding single-sector images A2.Single-cardiac periodic scanning was used to get single-sector images for group B.The effective doses (E) of two scanning types,the quantitative parameters of image quality [vascular CT value,image noise (SD),signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR)] and subjective scoring of group B and A1,A2 were compared.The detection accuracy of the systemic artery-pulmonary circulation shunts was evaluated by ROC curve against digital subtraction angiography (DSA).The measurement data was analyzed by independent sample t test while the grade data was tested by independent sample nonparametric test.Results The median value of radiation dose in group B was significantly lower than that of group A (1.42 mSv vs.3.06 mSv,Z=-8.724,P＜0.05).There were no statistically significant differences in quantitative parameters and subjective scoring points of image quality between group B and group A2 (P＞ 0.05).The median subjective scoring points of group B was 4,which was better than that of group A1 (Z =-10.584,P＜ 0.05).The differences of SD,SNR,CNR betweengroup B and group A1 were statistically significant(t =-0.983,7.898,7.695,P＜0.05),and group B had higher SD,SNR and CNR.There was no significant difference in the mean CT values of the aorta and pulmonary artery between the two groups (P ＞ 0.05).The detection accuracy of the systemic arterypulmonary circulation shunts was moderately high in group B and group A2.The area under the ROC curve (AUC) was 0.891 and 0.864,respectively (Z=7.210,7.430,P＜0.05).The accuracy of group A1 was poor.The area under the ROC curve was 0.626 (Z=2.434,P＜0.05).The sensitivity of group B and groupA2 were 80％ and 76.2％,respectively (P＜0.05),and 28.6％ of group A1 (P＜0.05).Conclusions The 320-row single-cardiac periodic dynamic volume CT can effectively improve the image quality and the detection accuracy of the systemic-pulmonary circulation on CT,and reduce the radiation dose of the bronchial artery CT angiography.

Criteria for success in dental implants / 华西口腔医学杂志

With the comprehensive application and development of implant dentistry in recent years, multi-institutional data have supported a large number of clinical research findings. A consensus was gradually reached on the evaluation of the state and effect of implants and types of indicators that were selected after restoration. This study aims to examine the frequently used criteria to define treatment success in implant dentistry.

A review of peri-implant microbiology / 华西口腔医学杂志

Dental implants represent the majority of treatment strategies used to replace missing teeth. However, peri-implant diseases caused by disturbance in peri-implant microbiological balance are among the reasons for implant failure. Since the 1980s, peri-implant microorganisms have been a hot research topic in dental microbiology. The bacterial ecology between the disease and health largely differs, which directly or indirectly increases the risk of peri-implant diseases. Accordingly, the determination of the 'core microbiome' of peri-implantitis and peri-implant mucositis is a key point of recent research.

Label-free quantitative proteomics reveals fibrinopeptide B and heparin cofactor II as potential serum biomarkers in respiratory syncytial virus-infected mice treated with Qingfei oral liquid formula / 中国天然药物

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections. Qingfei oral liquid (QFOL), a traditional Chinese medicine, is widely used in clinical treatment for RSV-induced pneumonia. The present study was designed to reveal the potential targets and mechanism of action for QFOL by exploring its influence on the host cellular network following RSV infection. We investigated the serum proteomic changes and potential biomarkers in an RSV-infected mouse pneumonia model treated with QFOL. Eighteen BALB/c mice were randomly divided into three groups: RSV pneumonia model group (M), QFOL-treated group (Q) and the control group (C). Serum proteomes were analyzed and compared using a label-free quantitative LC-MS/MS approach. A total of 172 protein groups, 1009 proteins, and 1073 unique peptides were successfully identified. 51 differentially expressed proteins (DEPs) were identified (15 DEPs when M/C and 43 DEPs when Q/M; 7 DEPs in common). Classification and interaction network showed that these proteins participated in various biological processes including immune response, blood coagulation, complement activation, and so forth. Particularly, fibrinopeptide B (FpB) and heparin cofactor II (HCII) were evaluated as important nodes in the interaction network, which was closely involved in coagulation and inflammation. Further, the FpB level was increased in Group M but decreased in Group Q, while the HCII level exhibited the opposite trend. These findings not only indicated FpB and HCII as potential biomarkers and targets of QFOL in the treatment of RSV pneumonia, but also suggested a regulatory role of QFOL in the RSV-induced disturbance of coagulation and inflammation-coagulation interactions.

Label-free quantitative proteomics reveals fibrinopeptide B and heparin cofactor II as potential serum biomarkers in respiratory syncytial virus-infected mice treated with Qingfei oral liquid formula / 中国天然药物

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections. Qingfei oral liquid (QFOL), a traditional Chinese medicine, is widely used in clinical treatment for RSV-induced pneumonia. The present study was designed to reveal the potential targets and mechanism of action for QFOL by exploring its influence on the host cellular network following RSV infection. We investigated the serum proteomic changes and potential biomarkers in an RSV-infected mouse pneumonia model treated with QFOL. Eighteen BALB/c mice were randomly divided into three groups: RSV pneumonia model group (M), QFOL-treated group (Q) and the control group (C). Serum proteomes were analyzed and compared using a label-free quantitative LC-MS/MS approach. A total of 172 protein groups, 1009 proteins, and 1073 unique peptides were successfully identified. 51 differentially expressed proteins (DEPs) were identified (15 DEPs when M/C and 43 DEPs when Q/M; 7 DEPs in common). Classification and interaction network showed that these proteins participated in various biological processes including immune response, blood coagulation, complement activation, and so forth. Particularly, fibrinopeptide B (FpB) and heparin cofactor II (HCII) were evaluated as important nodes in the interaction network, which was closely involved in coagulation and inflammation. Further, the FpB level was increased in Group M but decreased in Group Q, while the HCII level exhibited the opposite trend. These findings not only indicated FpB and HCII as potential biomarkers and targets of QFOL in the treatment of RSV pneumonia, but also suggested a regulatory role of QFOL in the RSV-induced disturbance of coagulation and inflammation-coagulation interactions.

Role of H1R, PAR-2/TRPV1 itch signal pathway on acute eczema and mechanism study of Portulaca extracts / 中国免疫学杂志

Objective:To investigate the influence of Portulaca extracts on H1R,PAR-2 and TRPV1 in skins of rats and the regulation mechanism of H1R,PAR-2/TRPV1 itch signal pathway with atopic eczema.Methods:30 SD rats were randomly divided into normal control group,model group and Porulaca group,each group contained 10 rats.In addition to the normal group,2,4-dinitrochloro-benzene was used on the rest of group for making rat model with atopic eczema.After the success of the model manufacture,each group was given corresponding drugs.After the last administration,EASI was evaluated.The levels of H1R,PAR-2 and TRPV1 in rats skins were detected by immunohistochemical method.Ca2+concentration was analyzed by flow cytometry.Results: Compared with normal control group,EASI(P<0.01),the levels of H1R(P<0.05) and PAR-2(P<0.01),and Ca2+concentration(P<0.01) of rats in model group were significantly increased.The levels of TRPV1 were not increased obviously (P>0.05).Compared with model group,EASI (P<0.01),the levels of H1R(P<0.01) and PAR-2(P<0.01),and Ca2+concentration(P<0.05) of rats in Porulaca group were sig-nificantly reduced,and the levels of TRPV1 were not decreased obviously(P>0.05).Conclusion:Purslane could reduce the levels of H1R,PAR-2 and Ca2+concentration to treat the acute eczema.The mechanism may be to lose the activation of downstream molecule TRPV1 and reduce the inflow of Ca2+by reducing the levels of upstream molecules H1R and PAR-2,then to achieve the effect of anti itch.

The correlation research of the hidden blood loss during perioperative period of elderly patients with hip fracture / 中华骨科杂志

Objective To investigate the reason for hidden hemorrhage of hip fracture in elder.Methods All of 94 elder patients,who were diagnosed with intertrochanteric fracture or femoral neck fracture and received treatment in our department from October,2013 to September,2015,were included in this study.The time between injuries to admission was less than 4 hours of the two groups of patients.And the patients whose hemoglobin was less than 100 g/L were removed when admission,in order to avoid the interference of primary anemia.All information,including height,weight,and the value of hemoglobin (Hb) and hematocrit (Hct),were collected.Blood tests were performed immediately after admission,at daily morning preoperatively,and at the morning of the day of surgery.Preoperative blood loss (hidden hemorrhage) was recorded.With respect to blood loss of hidden hemorrhage,statistical analysis was performed at different times (immediate time after admission,and day 1,2,and 3 postoperatively)in the group of intertrochanteric fracture or in the group of femoral neck fracture,and subsequently performed between the two groups.Results The blood loss in the group of intertrochanteric fracture was 196.3 ml,310.1 ml and 418.3 ml in the 1st day,the 2nd day and the third day after admission.There was a significant difference among different time with respect to blood loss.The blood loss was 39.8 ml,65.7 ml and 82.9 ml in the 1st day,the 2nd day and the third day after admission in the group of femoral neck fracture.There was also a significant difference among different time with respect to blood loss.In experimental group,mean blood loss was 418.3 ml and mean Hb decreased by 23.7 g/L at day 3 postoperatively.In control group,mean blood loss was 82.9 ml and mean Hb decreased by 6.7 g/L at day 3 postoperatively.A significant difference was observed between the two groups.The blood loss in patients with intertrochanteric fracture was higher than that in patients with femoral neck fracture.Conclusion The blood loss was gradually increased in elder patients with intertrochanteric fracture over time.There was a significant difference in different time with respect to blood loss.Moreover,a significant difference was found in blood loss of hidden hemorrhage between intertrochanteric fracture and femoral neck fracture.

Comparative results of non-operative and operative treatment of humeral shaft fractures / 北京大学学报(医学版)

Objective:To compare the difference between non-operative and operative treatment of humeral shaft fractures.Methods:From March 2005 to October 2012,252 cases of humeral shaft fractures were treated and were adequately followed up.According to the treatment methods,the patients were divided into 2 groups:the non-operative group and the operative group.In the non-operative group,there were 76 cases treated with plaster/small splint fixation,meanwhile there were 176 cases treated with inter nal fixation either by plating or by nailing in the operative group.The follow-up parameters included:fracture healing rate,fracture union time,complications rate,Constant-Murley shoulder score and Mayo elbow score.Results:The mean follow-up period was (31.24 ± 20.06) months (ranging 6 to 103 months).There were no statistical differences in age,open fracture number,fracture site and Arbeitsgemeinschaft ftir Osteosynthesefragen (AO) classification between the non-operative group and the operative group.The fracture healing rate:the non-operative group:96.1％ (72/76),the operative group:97.7％ (172/176),P =0.46;the fracture union time:the non-operative group:(10.24 ± 2.93) weeks,the operative group:(10.69 ± 2.51) weeks,P =0.22;the complication rate:the non-operative group:5.3％ (4/76),the operative group:15.3％ (27/176),P =0.03.The complications included:nonunion:the non-operative group:3.95％ (3/76),the operative group:2.3％ (4/176),P =0.434;radial nerve palsies:the non-operative group:0％ (0/76),the operative group:5.7％ (10/176),P =0.035;bone split:the non-operative group:0％ (0/76),the operative group:1.7％ (3/176),P =0.556;elbow stiffness:the non-operative group:l.3％ (1/76),the operative group:0.6％ (1/176),P =1.000;shoulder pain:the non-operative group:0％ (0/76),the operative group:5.1％ (9/176),P =0.061.The Constant-Murley shoulder score:the non-operative group:97.37±4.94,the operative group:96.34 ± 6.88,P =0.244.The Mayo elbow score:the non-operative group:99.80 ± 1.72,the operative group:99.49 ± 2.73,P =0.923.Conclusion:The results of non-operative treatment of humeral shaft fractures appeared with excellent results with lower complications rate compared with that of the operative treatment.

Efficacy and safety of carotid endarterectomy in treatment of different neurological deficits / 局解手术学杂志

Objective To study the efficacy and safety of carotid endarterectomy ( CEA) in the treatment of carotid artery stenosis with different neurological deficits .Methods The clinical data of 59 patients with carotid stenosis treated by carotid endarterectomy in the department of neurosurgery of affiliated hospital of Xuzhou medical university from September 2015 to February 2017 were analyzed retrospectively ,a total of 62 operations were performed in these patients ( including 3 patients accepted bilateral operation ) .According to the preoperative 1 day nerve function which evaluated by the modified Rankin scale (mRS)score,they were divided into mRS <3 group(n=47),mRS≥3 group (n=15).They were followed up for 6 to 24 months,the neurological function of 62 patients was scored again by mRS at 6 months after sur-gery.The clinical data and the difference of surgical efficacy and safety of perioperative period between the 2 groups were analyzed and com-pared.Results The 62 times of operations were successful in patients .The neurological function of the 2 groups were significantly improved compared with the preoperative,the difference was statistically significant(P<0.05).In the mRS≥3 group,there were 1 patients with perio-perative cerebral infarction died of cerebral hernia ,1 case of consciousness disorder caused by high perfusion and 1 cases of postoperative in-tracranial hemorrhage caused by high perfusion .In the mRS<3 group,there was 1 case left contralateral hemiplegia caused by a large area of cerebral infarction .The incidence of cerebral apoplexy within 30 days after procedure in the mRS≥3 group was significantly higher than that in the mRS<3 group.There was no new stroke in 61 patients during the long-term follow-up.Conclusion Mild(mRS<3) and severe(mRS≥3) of patients has improved nervous function from CEA;perioperative risk of patients with severe neurological deficits is relatively higher , but the preventive effect for the prevention of ischemic stroke recurrence is worthwhile .

Efficacies of different meshes in Lichtenstein repair for inguinal hernia: a prospective study / 中华消化外科杂志

Objective To compare the clinical efficacies of polypropylene-polyglactic composite mesh, polyester mesh, polypropylene mesh in Lichtenstein repair for inguinal hernia.Methods The clinical data of 1 080 patients with primary unilateral inguinal hernia who were admitted to the Tianjin People's Hospital from February 2012 to May 2013 were prospectively analyzed.A randomized controlled study was performed based on a random numble table.All the patients were allocated into the ProGrip group (Parietex ProGripTM Self-Fixating Mesh), PET group (ParietexTM Lightweight Monofilament Polyester Mesh) and PP group (BardTM Soft Mesh).Patients received standard Lichtenstein tension-free repair under local anesthesia and were followed up by outpatient examination and telephone interview till May 2014.The indexs observed during the follow-up included occurrence of complications, post-operative pain and postoperative health-related quality of life.The following indexes were recorded : time of mesh fixation, operation time, hernia recurrence, pain degree at postoperative week 1 and month 1, 6, 12 by numerical rating scale (NRS), quality of life at postoperative month 1 by SF-36 questionnaire survey including physical function, role physical, body pain, general health, vitality, social function, role emotional,mental health.Measurement data with normal distribution were presented as x ± s.Comparisons among groups were analyzed by ANOVA and pairwise comparison by t test.Measurement data with skewed distribution were presented as M (range) and repeated measurement data were analyzed using the repeated measures ANOVA.Count data were evaluated by the chi-square test and Fisher exact probability.Postoperative moderate and severe pain rates were evaluated by the Kaplan-Meier method and analyzed by the Log-rank test.Results There were 1 022 patients screened for eligibility including 367 patients in the ProGrip group, 346 patients in the PET group and 309 patients in the PP group.The time of mesh fixation and operation time were (1.3 ± 0.5) minutes and (30 ± 5) minutes in the ProGrip group, (4.9 ± 0.9) minutes and (45 ± 7) minutes in the PET group, (5.0 ± 0.9) minutes and (44 ± 7)minutes in the PP group, respectively, showing significant differences among the 3 groups (F =6.21, 4.33,P ＜ 0.05).There were significant differences in the time of mesh fixation and operation time between the ProGrip group and the PET group (t =1.36, 4.39, P ＜ 0.05), and also between the ProGrip group and the PP group (t =2.67, 2.99, P ＜ 0.05).There was no significant difference in the time of mesh fixation and operation time between the PET group and the PP group (t =0.98, 0.63, P ＞ 0.05).Nine hundred and nine patients were followed up for a median time of 13 months (range, 12-26 months) , with a follow-up rate of 88.943％ (909/1 022).The number of recurred hernia in the ProGrip group, the PET group and the PP group was 1, 0, 0,showing no significant difference (P ＞ 0.05).The NRS scores of pain from postoperative week 1 to postoperative month 12 were ranged from 0 (0-2) to 0 (0-0) in the ProGrip group, from 2(0-5) to 0(0-0) in the PET group and from 1 (0-4) to 0 (0-0) in the PP group.The number of patients with moderate and severe pain was ranged from 52(14.17％) to 0(0) in the ProGrip group, from 87 (25.14％) to 0 (0) in the PET group and from 89 (28.80％) to 0(0) in the PP group.There were no significant differences in the changing trends of NRS scores of pain and number of patients with moderate and severe pain among the 3 groups (F =1.66, x2=1.52, P ＞ 0.05).The scores of physical function in the ProGrip group, PET group, PP group at postoperative month 1 were 52 ± 4,50 ± 6, 50 ± 6, the scores of role physical were 50 ± 6, 50 ± 6, 50 ± 5, the scores of body pain were 52 ± 7, 52 ± 7, 52 ± 7, the scores of general health were 63 ± 4, 57 ± 9, 58 ± 8, the scores of vitality were 63 ± 5, 62 ± 6,63 ± 6, the scores of social function were 58 ± 4, 58 ± 8, 57 ± 8, the scores of role emotional were 59 ± 4, 57 ± 8,58 ± 8, and the scores of mental health were 65 ± 4, 63 ± 5, 63 ± 6, respectively, showing no significant differences in above indexes among the 3 groups (F =2.36,3.65,1.98,2.41, 6.32, 2.33, 4.21, 3.52, P ＞ 0.05).Conclusion Patients undergoing Lichtenstein repair for inguinal hernia with polypropylene-polyglactic composite mesh, polyester mesh and polypropylene mesh have comparative of incidence of postoperative complications, postoperative pain, quality of life, and present postoperative long-term low recurrence, low incidence of pain and relatively high quality of life.

Molecular characterization of Vibrio parahaemolyticus collected from human infections in Shenzhen, between 2002 and 2008 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To determine the occurrence and distribution of specific clones of pathogenic Vibrio parahaemolyticus(VP)isolated in Shenzhen and to assess the relationship between serotype O3:K6 and the globally distributed pandemic clone.</p><p><b>METHODS</b>A total of 1005 VPs isolated from diarrhea patients in 2002-2008 were sero-typed. Real-time PCR was used to detect the virulence genes tlh, toxR, tdh, trh and orf8 in 281 isolates from 68 different serotypes. The main serotypes were typed by pulsed field gel electrophoresis(PFGE). Strains with dominant serotypes and PFGE patterns were assayed by GS-PCR and toxRS sequencing for the identification of pandemic clone. Multilocus sequence typing(MLST)analysis was reserved for exemplary 41 O3 : K6 and O1 : K25 isolates.</p><p><b>RESULTS</b>Seventy-nine serotypes were observed among the 1005 isolates, including O3 : K6(57.9%), O4 : K8(8.16%), O1 : KUT(5.87%), O1 : K25(5.27%), O4 : K68(1.39%), O1 : K56(1.39%) and O9 : K44(0.99%). Most of the strains(99.36%)showed PCR positive to tlh, toxR, and tdh but eleven strains were tdh negative. MLST showed that all the 36 O3 : K6 isolates belonged to ST3 and all the 5 O4 : K8 strains were ST189. These results matched the description of the pandemic VP clone.</p><p><b>CONCLUSION</b>A recognizable burden of diarrheal illness caused by VP had been seen in Shenzhen. Results from serotyping indicated that although there existing a large variety of diversities, the dominant serotype appeared to be O3 : K6. VP isolates identified in Shenzhen mainly showed as tdh positive but trh negative, in consistent with the current pandemic O3 : K6 clone. The pandemic O3 : K6 clone did appear to co-exist with other clones of O3 : K6, as well as O4 : K8,O1 : K25. Potential outbreak of VP could be monitored through the laboratory-based surveillance programs, suggesting that the strategies related to prevention and control of VP should be prioritized in Shenzhen.</p>

Effect of p-hydroxylcinnamaldehyde on differentiation of melanoma cells and its mechanism / 中草药

Objective: To explore the monomer compounds in the seeds of Momrodica cochinchinensis and to study the differentiation of mouse melanoma B16 cells induced by p-hydroxylcinnamaldehyde (PHC). Methods: After being treated by five kinds of compounds [PHC, coniferylaldehyde, p-hydroxylbenzaldehyde (PHB), 3-O-methoxyaniline-p-hydroxylbenzaldehyde, and ligballinol] for 48 h, the inhibitory rate of B16 cell growth was measured by sulforhadamine B (SRB); Morphological changes of B16 cells induced by PHC for 24, 48, and 72 h were observed by Giemsa staining and phase contrast microscope; Melanin content and the activity of tyrosinase in B16 cells 48 h after the administration were assessed by colorimeter. The expression of tyrosinase mRNA was detected by RT-PCR. Results: All the five compounds had the inhibitory effect on the B16 cells. Among them, PHC showed the strongest effect in the dose-and time-dependent manner; PHC could induce B16 cells dendritic growth 48 h after the treatment, and the morphological changes were typically differentiated; PHC also increased the melanin production and the activity of tyrosinase. There was a significant difference compared to the control group (P < 0.05). After treated by PHC for 6, 12, and 24 h, the expression levels of tyrosinase mRNA, tyrosinase 1 mRNA, and tyrosinase 2 mRNA were significantly increased (P < 0.01) in a time-dependent manner. Conclusion: PHC could inhibit the proliferation of B16 cells and the mechanism is related to the differentiation of B16 cells.

Experimental study of Xuefu Zhuyu Decoction induced participation of endothelial progenitor cells in the angiogenesis of the ischemic region / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effects of Xuefu Zhuyu Decoction (XFZYD) on the angiogenesis and injury repair in the ischemic region.</p><p><b>METHODS</b>The ischemic hind limb rat model was established using Bletilla embolization. Endothelial progenitor cells (EPCs) were labeled with DAPI and injected into the model rats from the vena caudalis. Then rats were treated with different doses of XFZYD by gastrogavage. Blood was withdrawn. The granulation tissue and the muscle tissues from ischemic and necrotic portion were taken on the 3rd and 7th day of the medication. The samples were frozen and sliced to analyze the fluorescent expressions. The necrosis of each sample was observed by routine pathological section. The vessels number was counted. The serum NO levels were detected using nitrate reductase method. The macro-morphological observation of ischemic lower limbs were lasted for 30 days.</p><p><b>RESULTS</b>After 3 and 7 days of medication, the fluorescence intensity of ischemic area and the number of granulation vessels were significantly more in the high dose XFZYD group than in the routine treatment group and the normal saline treatment groups. The aforesaid indices were significantly higher in the routine treatment group than in the normal saline treatment group after 7 days of medication. The serum NO concentrations were significantly lower in the normal saline group at other time points. On the 30th day of medication, the muscular atrophy of the ischemic hind limbs was the least significant in the high dose XFZYD group.</p><p><b>CONCLUSION</b>XFZYD could improve the ischemic necrosis by improving the NO level, inducing the EPCs' migration to the ischemic region, and promoting the angiogenesis.</p>