Application of 3D printing percutaneous guide plate in closed reduction and cannulated screw internal fixation of femoral neck fracture / 中国骨伤

OBJECTIVE@#To investigate the application of 3D printing percutaneous surgical guide plate in closed reduction and cannulated screw internal fixation of femoral neck fracture.@*METHODS@#The clinical data of 12 patients with femoral neck fracture from March 2019 to March 2022 were retrospectively analyzed. Patients were divided into observation group and control group according to different operation plans, with 6 cases in each group. The observation group received percutaneous operation guide plate assisted closed reduction and hollow screw internal fixation, while the control group received closed reduction and hollow compression screw internal fixation. The operation time, intraoperative blood loss, fluoroscopy times, and Kirschner needle puncture times were compared between two groups. The location of screws were recordedon postoperative X-ray films, follow-up time, time of complete fracture healing, Harris score of hip joint and the incidence of complications were recorded on postoperative X-ray films.@*RESULTS@#The operation time of observation group (32.17±6.18) min was shorter than that of control group (53.83±7.31) min (P<0.05). The amount of intraoperative bleeding in the observation group (18.33±2.94) ml was less than that in the control group (38.17±5.56) ml(P<0.05). The times of fluoroscopy in the observation group (7.50±1.05) were less than those in the control group (21.00±4.82) (P<0.05). The number of Kirschner needle punctures (8.00±0.63) in observation group was less than that in control group (32.67±3.08) (P<0.05). The follow-up time was(12.88±0.74) months in observation group and (12.83±0.72) months in control group, there was no significant difference between two groups (P>0.05). One year after operation, Harris score of hip joint in the observation group was(82.00±4.52) points, while that in the control group was(81.00±3.41) points, there was no significant difference between two groups(P>0.05). The time of complete fracture healing in the observation group was (7.50±1.05) months, while that in the control group was (7.67±1.21) months, there was no significant difference between two groups(P>0.05). The parallelism of the screws in the observation group was (0.50±0.11) ° and (0.76±0.15) °, which were lower than that in the control group (1.57±0.31) ° and (1.87±0.21) ° (P<0.05). The screw distribution area ratio (0.13±0.02) cm2 in the observation group was higher than that in the control group (0.08±0.01) cm2 (P<0.05). No complications such as necrosis of femoral head, nonunion of fracture, shortening of femoral neck and withdrawal of internal fixation occurred in both groups.@*CONCLUSION@#The application of 3D printing percutaneous surgical guide plate improves the accuracy and safety of closed reduction and cannulated screw internal fixation for femoral neck fracture. It has the advantages of minimally invasive, reducing radiation exposure, fast and accurate, shortening the operation time and reducing intraoperative bleeding.

Network pharmacological study and experimental verification of punicalagin in treatment of depression / 中国药理学通报

Aim To study and verify the effeet and po¬tential mechanism of punicalagin ( Pun) in the treat-ment of depression by preliminary experiments based on network pharmacology.Methods The intersection genes of Pun and depression were obtained through the database, and protein interaction ( PPI ), GO and KEGG were enriched and analyzed.Molecular docking technology was used to preliminarily verify the binding ability of Pun active components to core therapeutic targets.The depression model of CUMS mice was es¬tablished by chronic stress, and Pun was administered by gavage.Open field experiments were conducted to investigate behavior changes.The content of neuro¬transmitters in hippocampus was detected by liquid chromatography-mass spectrometry ( LC-MS / MS ).Results The results of network pharmacology showed that Pun had 76 targets involved in the occurrence of depression, and PPI network showed that the intersec¬tion genes were closely related.Proteoglycans, lipids and atherosclerosis enriched in cancer.The results of molecular docking showed that there was a good bind¬ing between the compound and the target protein.The results of animal experiments showed that Pun could in¬crease the exploration desire of open field experimental mice.The levels of DA and 5-HT in hippocampus in-creased ( P < 0.05, P < 0.01 ).Conclusions Pun can significantly reduce the depressive state of mice, and its mechanism may act on ALB and AKT1 targets, mediate proteoglycans, lipids and atherosclerotic path¬ways in cancer, so as to improve the secretion of neu¬rotransmitters.

Establishment of rat heart-kidney insomnia model consistent with traditional Chinese medicine syndrome and its serum metabolomics / 中国中药杂志

Enzyme-linked immunosorbent assay(ELISA) and metabolomics were used to analyze and compare two animal models of heart-kidney insomnia, in order to explore a more ideal animal model and preliminarily explore the essence of heart-kidney insomnia. Based on the clinical symptoms and disease characteristics of heart-kidney insomnia, the animal model of heart-kidney insomnia was reproduced through intraperitoneal injection with p-chlorophenylalanine(PCPA) and multi-factor interaction. The animal model of disease-syndrome combination was evaluated by behavioral observation, ELISA and metabolomics. Wistar rats were randomly divided into normal group, PCPA group and compound model group(FH). The rats' behavior, body weight, adrenal index and spleen index were recorded. The levels of corticotropin releasing hormone(CRH) and adrenocorticotropin(ACTH) in serum were detected by ELISA, and the differential metabolites in serum were detected by UPLC-QE-MS. The body weight and adrenal index in FH group were significantly lower than those in PCPA group(P<0.05); whereas ACTH and CRH in FH group were significantly higher than those in PCPA group by ELISA; nine potential biomarkers were identified by serum sample statistics. There were four main metabolic pathways in cardiorenal insomnia: pentose phosphate metabolism, alanine, aspartic acid and glutamic acid metabolism, histidine metabolism, and taurine and subtaurine metabolism. PCPA and multi-factor interaction method can successfully replicate the insomnia model, but multi-factor modeling method is more similar to clinical traditional Chinese medicine syndrome. Animal behavior, ELISA and metabolomics were used to evaluate the rat model of cardiorenal insomnia from in vitro to in vivo, from macro to micro, and from individual to the whole.

Review of chemical constituents, pharmacological effects and clinical applications of Jiaotai Pills and predictive analysis of its quality marker(Q-marker) / 中国中药杂志

Jiaotai Pills is a traditional medical prescription to treat the incompatibility of heart and kidney. It has the distinctive functions of heart and kidney communication, sedation and hypnosis, anti-anxiety and depression, as well as the improvement of insulin resistance. However, this pill is broadly used to cure insomnia, anxiety, depression, and diabetes in the contemporary clinical trials. Based on the article, it illustrates the research progress of the chemical ingredients, pharmacological actions, and clinical applications of Jiaotai Pills. With respect to the "five principles" of Q-marker in Chinese medicine, the Q-marker of Jiaotai Pills is comprehensively predicted and analyzed, noting that berberine, epiberberine, coptisine chloride, palmatine chloride, berberine chloride, berberrubine chloride, ferulic acid, cinnamic acid, cinnamaldehyde, proanthocyanidin B2 can be treated as the Q-marker of Jiaotai Pills. In addition, these components of Q-marker have been selected as indicators to provide a significant reference for the quality control and surveillance research of Jiaotai Pills.

Exploration of the Role of Tumor Suppressor Genes Foxo1 and PTEN in the Tumorigenesis of Mouse Natural Killer-Cell Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To explore whether tumor suppressor gene Foxo1 and PTEN play a critical role in the tumorigenesis of mouse natural killer-cell lymphoma.@*METHODS@#NKp46-iCre mice were crossed with mice carrying floxed Foxo1 alleles (Foxo1) as well as floxed PTEN alleles (PTEN) to generate mice in which Foxo1 and PTEN in NK cells were knock-out, referred as Foxo1PTEN. The growth and development of the mice and tumor formation were observed. The flow cytometry was used to detect the percentages of NK cells in main lymphatic organs. B16F10 metanoma model of tumor metastasis was utilized to investigate NK cell-mediated tumor surveillance in vivo after NK cells special deletion of Foxol and PTEN.@*RESULTS@#The mouse model with NK cell-special Foxo1 and PTEN double knockout was established. Compared with control group (Foxo1PTEN mice), Foxo1PTEN mice were born alive and appeared to be healthy over a period of 46 weeks. No spontaneous tumor formation was observed at this stage. There were no significant differences in NK cell percentages of gated lymphocytes from various organs including blood, bone marrow, peripheral lymph node and spleen between Foxo1PTEN mice and Foxo1PTEN mice [PB: 4.76%±0.46% vs 4.17%±0.64% (P＞0.05, n=8); BM: 1.13%±0.23% vs 1.31%±0.10% (P＞0.05, n=8) ; LN: 0.50%±0.10% vs 0.85%±0.20% (P＞0.05, n=8); SP: 4.41%±0.65% vs 3.50%±0.24% (P＞0.05, n=8)]. B16F10 melanoma metastasis model of tumor was established, No differences in median survival time were observed in the 2 types of mice (P＞0.05, n=13).@*CONCLUSION@#The simultaneous deletion of the Foxo1 and PTEN genes may not plays significant role in the tumorigenesis of mouse natural killer-cell lymphoma and NK cell-mediated tumor surveillance in vivo.

Epalrestat inhibits PDGF-induced proliferation of rat PASMCs by inhibiting aldose reductase expression / 中国药理学与毒理学杂志

OBJECTIVE To explore the inhibitory effects of epalrestat (EPS) on platelet-derived growth factor (PDGF)-induced rat pulmonary artery smooth muscle cells proliferation by inhibiting aldose reductase (AR) expression.METHODS Primary rat pulmonary arterial smooth muscle cells (PASMCs) were prepared from the pulmonary artery of male 10-week-old Sprague-Dawley rats using explant method.PDGF 30 mg·L-1was given to induce cell proliferation.After PASMCs grew to 70%-80% conflu?ence, AR small-interferring RNA(ARsiRNA) was transfected with Lipofectamine 3000 into PASMCs. After 24 h,the expression and activity of AR were detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR),Western blotting and spectrophotometric method,respectively to investigate EPS on PASMCs proliferation and proliferating cell nuclear antigen (PCNA) and collagenⅠexpression induced by PDGF from in vitro. PASMCs (normal control, PDGF 30 mg·L-1, PDGF+EPS 1, 10 and 100 μmol·L-1,EPS 100 μmol·L-1)were treated according to groups.Cell proliferation was measured by BrdU marking and flow cytometry. The expressions of AR, PCNA and collagenⅠwere analyzed with RT-qPCR and Western blotting.RESULTS In cultured PASMCs,compared with normal control group, the application of exogenous PDGF-induced cell proliferation concomitantly up-regulated AR expres?sion and activity (P<0.01), and such effect was abolished by ARsiRNA. Compared with PDGF group, EPS attenuated PDGF-induced proliferation of PASMCs,expression of PCNA,and collagenⅠ(P<0.05, P<0.01),and the inhibitory effect of EPS was accompanied by inhibition of AR expression(P<0.05,P<0.01).CONCLUSION EPS inhibits PDGF-induced proliferation of PASMCs via inhibiting AR expression.

Therapeutic effects of comprehensive surgery for recurrent patellar instability in adults / 局解手术学杂志

Objective To analyze the clinical effect of medial patellofemoral ligament(MPFL)reconstruction combined with the com-prehensive surgery of anteromedial tibial tubercle transfer and distal shift in the treatment of recurrent patellar instability.Methods The clin-ical data of 60 patients(60 affected knees)with recurrent patellar instability who were admitted to the orthopedics department of Mianyang central hospital in Sichuan Province from April 2012 to September 2016 were retrospectively analyzed.All the patients were examined with knee arthroscopy,lower extremity X-ray,CT and MRI,and they were treated with MPFL reconstruction combined with anteromedial tibial tu -bercle transfer and distal shift comprehensive surgery.All patients were followed up for at least 1 year after operation.The physical indexes, imaging examination indexes and evaluation results of knee function were analyzed before operation and at the last follow -up.Results The follow-up of 60 patients showed that the results of fear test were negative,results of patellar tilt test were symmetrical,and the Q angle re-turned to normal.The activities of flexion and extension were significantly improved,and there was no fractures or dislocation of the patella. Imaging examination showed that the patellofemoral joint was well positioned.At the last follow-up,the patellofemoral congruence angle,de-gree of patellar out-shift and lateral patellar angle of the 60 patients were significantly decreased,and the tibial tuberosity-trochlear groove dis-tance(TT-TG)was also significantly decreased,the differences were significant(P<0.05),and they basically returned to the normal range. At the last follow-up,the Lysholm score and Kujala score were significantly higher than those before operation,the differences were significant (P<0.05).Conclusion The clinical effect of MPFL reconstruction combined with anteromedial tibial tubercle transfer and distal shift com -prehensive surgery is satisfying in the treatment of recurrent patellar instability,which has great significance for relieving symptoms and resto-ring the function of the knee.

Retrospective Analysis of Clinical Features and Prognosis of 84 Patients with Extranodal NK/T Cell Lymphoma in One Center / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical characteristics, treatment and prognostic factors of patients with extranodal NK/T cell lymphoma.</p><p><b>METHODS</b>The clinical data of patients with extranodal NK/T cell lymphoma admitted in the Hospital Affiliated to the Academy of Military Medical Science from June 2006 to June 2016 were retrospectively analyzed. The clinical features, therapeutic efficacy and prognosis-related factors were clarified.</p><p><b>RESULTS</b>A total of 84 patients with extranodal NK/T cell lymphoma with complete clinical data were collected, with a median follow-up of 21 months (1-123 months), the overall survival (OS) and progression free survival (PFS) were 58.9% and 52.1% years, respectively. Univariate analysis showed that anemia, the copy number of EBV-DNA, LDH level, IPI score, ECOG score, Ann Arbor staging, complete remission after the initial therapy were statistically significant for both OS and PFS of the patients, and chemotherapy regimens were only statistically significant for PFS. Multivariate analysis showed that complete remission after the initial therapy, LDH level and ECOG score were statistically significant for both OS and PFS in patients with NK/T cell lymphoma.</p><p><b>CONCLUSION</b>LDH level, ECOG score and complete remission after the initial therapy are independent prognostic factors for patients with extranodal NK/T cell lymphoma.</p>

Application of quality control circle to improve the correct rate of hand hygiene of laboratory staff / 中国感染控制杂志

Objective To explore the application efficacy of quality control circle(QCC) in hand hygiene(HH)management of laboratory staff.Methods Laboratory staff in a hospital in Neijiang from January to December 2016 wvere selected as the studied objects,QCC group of HH management of laboratory staff was established,causes of correct rate of HH in laboratory staff were analyzed,corresponding countermeasures were formulated and implemented;data before and after performing QCC activity were compared and analyzed,efficacy of activities was assessed.Results After implementing QCC activity,correct rate of HH in laboratory staff increased from 29.73％ to 91.04％,difference was significant(P＜0.001).At the same time,circle members' ability in QCC skill,responsibility,sense of honor,self confidence,cohesiveness were all promoted with varying degrees.Conclusion The implementation of QCC activities can not only improve the correct rate of HH of laboratory staff,but also enhance team confidence and cohesiveness,it is worthy of further clinical application.

Capsular-enhanced repair with suture anchors in bipolar hemiarthroplasty for the treatment of femoral neck fractures in elderly patients / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the efficacy of capsular-enhanced repair with suture anchors in bipolar hemiarthroplasty for the treatment of femoral neck fractures in elderly patients.</p><p><b>METHODS</b>A retrospective study was designed. From June 2009 to June 2016, 53 senile patients (54 hips)with femoral neck fracture were treated operatively in Mianyang central hospital (Sichuan, China). There were 21 males and 32 females, ranging in age from 80 to 97.5 years old (mean, 84.7 years old). There were 11 hips of Garden type II, 26 hips of Garden type III and 17 hips of Garden type IV. All the patients underwent bipolar hemiarthroplasty with enhanced repair of hip capsular. The hip joint was opened by a T shaped incision over posterior capsule. The posterior hip capsular and short external rotators were repaired particularly after the bipolar prostheses were implanted. Surgical time, intra-operative blood loss, mean hospitalization time, deep venous thrombosis, mortality, hip dislocation, pain, periprosthetic fracture, and other complications were recorded. The functional outcome was evaluated using the Harris Hip Score at the last follow-up.</p><p><b>RESULTS</b>The 53 patients (54 hips) were evaluated during the hospitalization period and a mean follow-up period of 11.5 months(ranged, 3 to 36 months). No dislocation, incision infection and periprosthetic fracture appeared in this group. The mean surgical time was 65 minutes(ranged, 50 to 95 min). The mean intra-operative blood loss was 213 ml(ranged, 100 to 420 ml) and the mean hospitalization time was 13.3 days(ranged, 5 to 27 days). Two patients with deep vein thrombosis, one patient with pulmonary embolism and 10 patients with venous plexus thrombosis of calf muscle were diagnosed postoperatively. The rate of venous thrombosis was 24.53% (13/53). The patient with pulmonary embolism died 8 days after operation and the other 3 patients died from heart failure 4, 6 and 7 months after operation respectively. The mortality during first year after hemiarthroplasty was 7.55% (4/53). At the latest follow-up, 42 patients (43 hips)had no pain, 9 patients had mild pain, and 2 patients had moderate pain. No patients were non-ambulatory. The mean Harris Hip Score was 91.25±8.39, functional outcome was excellent in 44 hips, good in 5, and fair in 5.</p><p><b>CONCLUSIONS</b>The bipolar hemiarthroplasty with capsular-enhanced repair with suture anchors is effective in reducing postoperative complications of prosthesis dislocation.</p>

The comparative study on the effect of one-stage skin graft and VSD treatment of second-stage sugery after scar release / 中国医师杂志

Objective To investigate the difference of vacuum sealing drainage (VSD) on the effect of one-stage skin graft and second-stage sugery after scar release.Methods A total of 42 patients who wanted to undergo scar release and skin graft was randomly divided to control group (n =21) and VSD treatment group (n =21).The control group implemented skin graft immdiately after scar release while VSD treatment group were treated with VSD for 3 days after scar release and then implemented skin graft.The rate of subcutaneous blood stasis and the survival rate of skin graft were observed at 7 days after skin graft.The condition of grafted skin contracture and hyperplasia after half a year was also observed.Results The incidcnce of subcutaneous blood stasis was significantly lower in the VSD group than that in the control group (P ＜ 0.05).The survival rate of skin grafts was significantly higher in the VSD group than that of the control group (P ＜ 0.05).The score of Vancouver scar was significantly lower in the VSD group than that in the control group (P ＜ 0.05).Conclusions VSD treatment of second-stage sugery after scar release can reduce the occurrence of subcutaneous blood stasis,promotc skin graft survival,reduce postoperative skin graft contracture and improve the prognosis of patients compared to one-stage skin graft.

Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China

BACKGROUND/AIMS: Patients with active ulcerative colitis (UC) have elevated levels of activated myeloid-derived leukocytes as a source of inflammatory cytokines. The selective depletion of these leukocytes by adsorptive granulocyte/monocyte apheresis (GMA) with an Adacolumn should alleviate inflammation, promote remission and enhance drug efficacy. However, studies have reported contrasting efficacy outcomes based on patients’ baseline demographic variables. This study was undertaken to understand the demographic features of GMA responders and nonresponders. METHODS: This was a multicenter study in China involving four institutions and 34 patients with active UC. Baseline conventional medications were continued without changing the dosage. The treatment efficacy was evaluated based on the endoscopic activity index and the Mayo score. RESULTS: Thirty of the 34 patients completed all 10 GMA treatment sessions. The overall efficacy rate was 70.59%. The receiver operating characteristic analysis showed that the area under the curve was approximately 0.766 for a Mayo score of ≤5.5 with 0.273 specificity and 0.857 sensitivity (Youden index, 0.584) for GMA responders. No GMA-related serious adverse events were observed. CONCLUSIONS: The overall efficacy of GMA in patients with active UC who were taking first-line medications or were corticosteroid refractory was encouraging. Additionally, GMA was well tolerated and had a good safety profile.

Advances in the study of the effect of basal forebrain on sleep-wake regulation / 药学学报

The basal forebrain (BF) is known to participate in the control of motion, attention, learning and memory, and it also plays a key role in sleep-wake regulation. Although there is a strong heterogeneity among neurons in the BF, the main types are cholinergic, gamma-aminobutyric acid (GABAergic) and glutamatergic neurons. This review provided the research progress in the regulation of sleep-wakefulness behavior by the 3 neurons in the BF. The cholinergic neurons play roles in activation of cortex and promote phase transition between sleep and wakefulness. The cortical projecting GABAergic neurons, which accept the projections from the adjacent cholinergic and glutamatergic neurons, contribute to awakening and the maintenance of normal wakefulness. The GABAergic interneurons may promote sleepiness by inhibiting the wake-active neurons which excite the cortical neurons. The glutamatergic neurons regulate sleep and wakefulness by interacting with neighbor cholinergic and cortical projecting GABAergic neurons or through the direct projection to the cortex as well.

Surgical treatment of unstable pelvic fractures combined with acetabular fractures / 中国骨伤

<p><b>OBJECTIVE</b>To discuss the treatment strategy of acetabular fractures and unstable pelvic fracture of the hip and to evaluate its outcome.</p><p><b>METHODS</b>Retrospective analysis of clinical data in 32 patients with unstable pelvic fracture and acetabular fractures from January 2007 to June 2013 were collected. There were 18 males and 14 females aged from 18 to 62 years old (means 38 years old). According to Tile classification of pelvic fracture, 11 cases were type B1, 8 were type B2.1, 7 were type B2.2, 3 were type C1.1, 2 were type C1.2, 1 was type C3. According to Judet-Letournel classification, anterior column fracture was in 1 case, transverse fracture in 8, transverse plus posterior wall fracture in 6, T-type fracture in 1, anterior column plus half transverse fractures in 5, double column fracture in 11. Other combined injuries were treated early, the surgical operation were performed after stable condition. The hip joint function and the fracture reduction were assessed during follow-up.</p><p><b>RESULTS</b>The operative time was from 1.8 to 6.5 hours (averaged 3 hours). Two fat patients' incision occurred in fat liquefaction and healed after dressing, no incision infection happened. Only 1 case was lost to follow-up, 31 patients were followed up with a mean time of 23 months (6 to 42 months). The healing time of pelvic fracture was from 8 to 18 weeks (averaged in 10.6 weeks). The hip function was evaluated according to the Matta and Tornetta standard postoperatively, the result was excellent in 15 cases, good in 14 cases, fair and poor in 1 case respectively. The Majeed score of the hip function was 83.65? 7.67, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The healing time of acetabular fractures was from 8 to 16 weeks (averaged in 10.2 weeks). The fracture reduction was assessed by Matta standard, the result was excellent in 15 cases, good in 12 cases and fair in 4 cases. The heterotopic ossification was evaluated by Brooker standard, 4 cases were grade I, 1 case was grade II . There were no infection, nonunion and necrosis of the femoral head in all patients. The nerve damage symptoms in 5 patients disappeared during 4 to 6 months after operation.</p><p><b>CONCLUSION</b>Patients with unstable pelvic fractures and acetabulum fractures were in a critical condition early, using the concept of damage control to save lives in a timely manner. Grasp the operation time in the late treatment, acetabulum fractures reach anatomical reduction as far as possible, pelvic fractures are given priority to stable reconstruction. The operation order was fixed pelvic ring first, according to the condition to choose the appropriate surgical approach and fixed mode.</p>

Double minimally invasive incisions for surgical repair of the acute closed Achilles tendon rupture / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effect of a new surgical approaches for repairing the acute Achilles tendon rupture.</p><p><b>METHODS</b>From January 2009 to January 2014, 21 patients with Achilles tendon rupture were treated by 2 minimally invasive incisions and remaining skin bridge of achilles tendon end including 16 males and 5 females with an average age of 44.3 years old ranging from 21 to 57 years old. Postoperative complications, the range of movement of affected ankle joint, the circumference calf and ankle on both side, time of reture to work and sports activity were observed and recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) score was used to evaluate the functional recovery.</p><p><b>RESULTS</b>All patients were followed up for 6 to 36 months with an average of 13.5 months. No skin necrosis, wound infection, deep vein thrombosis,re-rupture and sensory disturbance with the ankle or foot in the sural nerve distribution were found. At 1 year after operation, there was no significant difference in the range of movement between affected foot (55.4 ± 6.5)° and unaffected foot (56.3 ± 3.7)° (t = 0.872, P = 0.325). There was significant difference in AOFAS between preoperative (65.1 ± 6.9) and postoperative (94.3 ± 5.5) (t = 7.672, P = 0.013). All patients returned to work and study at an average of 10 weeks (ranged from 6 to 15 weeks) and 15 patients returned to normal sports activities at 21 weeks (ranged from 18 to 24 weeks). Calf and ankle circumferences decreased by 0.45 cm (0.3 to 0.8 cm) and increased by 0.4 cm (0.2 to 0.7 cm), respectively in the injured leg as compared with the contralateral leg.</p><p><b>CONCLUSION</b>The simplicity of the technique of minimally invasive incision and skin bridge for acute closed Achilles tendon reconstruction is an effective and reliable method with low complication.</p>

Clinical translational research of chimeric antigen receptor-T (CAR-T) cells for the treatment of relapsed and refractory B-cell lymphoma/leukemia / 中国实验血液学杂志

B-cell lymphoma and leukemia are the most common subtypes of malignant lymphomas. Relapse and refractory to multiple therapy are the main reasons of treatment failure. As the classical anti-tumor methods, surgery, radiation, chemotherapy and palliative therapy have cured lots of cancer patients. However, each year many patients still died of different kinds of hard-to-treat cancers. Although the ratio of complete remission of B-cell lymphoma/leukemia patients particularly with CD20 positive mature B cell malignancies has been largely increased after the application of Rituximab in clinic, nearly 20%-40% patients still died due to relapse and refractory to the treatment. During last five years, the development of chimeric antigen receptor-T (CAR-T) cells, especially CD19 CAR-T cells, which can recognize CD19 specifically expressed on B cells and have been demonstrated to be significantly effective to relapsed and refractory B cell lymphoma/leukemia in clinical trials, has gradually attracted extensively concerning from researchers and clinicians. Many medical institutions all over the world (besides in China) have registered the clinical trials for B-cell lymphoma/leukemia patients by use of CAR-T cells. In this review, we summarize the developmental history, the main ongoing clinical trials and proved potential adverse affects of CD19 CAR-T cells for the treatment of patients with B-cell lymphoma/leukemia.

Molecular classification of colorectal carcinoma based on integration of gene expression profile and copy number variation / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To classify colorectal carcinoma (CRC) by TNM staging integrated with the gene expression profile and copy number variation (CNV).</p><p><b>METHODS</b>Profile data of gene expression and CNV of CRC were downloaded from public database and processed with batch bias adjustment, quartile normalization, missing value estimation and feature filtration. The processed profiles of mRNA and CNV were introduced into the codes of Bayesian consensus clustering (BCC) method and were used to calculate the subclasses of CRC. With the follow-up information of disease free survival of CRC patients, the prognostic values of the subclasses was investigated and the software of function enrichment analysis was employed to discover the major pathway signaling to each interesting subclass. All statistic analyses were performed under R-3.0.1 environment or by using SPSS 16.0 software.</p><p><b>RESULTS</b>Profile data of gene expression and corresponding CNV from 335 CRC patients with TNM stage Ⅱ-Ⅲ and followed-up information were obtained. After feature filtering, the profiles contained 1578 probes of mRNA and 345 location of CNV. Four CRC subclasses were identified by the integrative analysis with BCC, and the concordances of BCC subclasses and each of gene-based subclasses (Cramer's V=0.49), CNV-based subclasses (Cramer's V=0.51) and Marisa's subclasses (Cramer's V=0.32) were statistically significant (Ps<0.001). Among BCC subclasses, BCC-I had a favorable prognosis, while BCC-Ⅳ had more unfavorable prognosis. The differences of prognosis were significant among BCC-I, BCC-(Ⅱ+Ⅲ) and BCC-Ⅳ with an overall log-rank P<0.001. The top enriched function was DNA damage and repair signaling when BCC-I compared to BCC-Ⅳ, and the new subgroups classified by the genes associated with enriched signaling had the better prognostic value than BCC subclasses but both of them were significantly correlated (Cramer's V=0.39, P<0.001).</p><p><b>CONCLUSION</b>BCC method is effective to integrate multi-type genomic data for molecular classification of colorectal carcinoma, and the BCC-Ⅳ subclass has poor prognosis, which may be associated with the decreased repairing function of DNA damage.</p>

A new classification of duplex kidney based on kidney morphology and management / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The initial classic classification of duplex kidney into complete (two ureters) and incomplete ("Y" shaped ureter) types are based on the ureter status. At the meantime, the features of the upper and lower moieties of duplex kidney were very crucial for appropriate procedure of hemi-nephrectomy, which was most commonly used for addressing the issues caused by a duplex kidney; and recently more applications of laparoscopy were used. In this study, we aimed prudently to propose a new classification based on the features of the upper and lower moieties of duplex kidney.</p><p><b>METHODS</b>Sixty-five children with 83 duplex kidneys were reviewed retrospectively. Based on kidney morphology found in CT urography and surgical findings, duplex kidney was classified into five types.</p><p><b>RESULTS</b>The first was the appendant type (36/83) and its feature was that the mini upper moiety was located on top of the lower one, with a visualized shallow groove between them. The ureter was dilated with an ectopic orifice or ureterocele. The second was the embedded type (13/83), the feature of which was that mini upper moiety located in the interior top of the lower one within the same capsule. The upper ureter was dilated with an ectopic orifice or ureterocele. The third was the hydronephrosis type (12/83). The severe hydronephrotic upper moiety was almost as big as the lower moiety. The upper ureter was severely dilated and circuitous with an ectopic orifice. The forth was the dual-poor type (2/83). The two moieties were all very small with "Y" shaped ureters and ectopic orifices. The last was the dual-well type (20/83). The upper moiety was almost the same size as the lower one, without apparent dilation of "Y" shaped or double ureters.</p><p><b>CONCLUSION</b>Based on kidney morphology, duplex kidney can be mainly classified into five types which can be depicted by CT urography prior to management and can provide an aid in selecting a successful course of surgical correction.</p>

Pharmacokinetics of tramadol hydrochloride in the extracellular fluid of mouse frontal cortex studied by in vivo microdialysis / 药学学报

The paper aims to explore the studying method for the pharmacokinetics of drugs in target organs, the pharmacokinetic process of tramadol hydrochloride in the extracellular fluid of frontal cortex (FrCx) of mice was investigated. Six male mice (Kunming strain) were anaesthetized (urethane, 1.8 g x kg(-1), ip) and secured on a stereotaxic frame. A microdialysis probe was implanted into the FrCx and perfused with artificial cerebrospinal fluid at a flow rate of 2 microL x min(-1). One hour later, mice were administrated (ip) with tramadol hydrochloride (50 mg x kg(-1)) and dialysates were collected continuously at 12-min intervals (24 microL each) for 6 h. The tramadol concentration in dialysates was determined by HPLC-Ultraviolet detection method, and the concentration-time curve and pharmacokinetic parameters of tramadol were calculated with DAS software. The results showed that the pharmacokinetic process of tramadol in the FrCx extracellular fluid of mice was fitted to a two-compartment open model, and the main pharmacokinetic parameters t1/2alpha, t1/2beta, t(max), C(max) and AUC(0-infinity) were (0.27 +/- 0.05) h, (2.72 +/- 0.24) h, (0.50 +/- 0.10) h, (2 110.37 +/- 291.22) microg x L(-1) and (4 474.51 +/- 441.79) microg x L(-1) x h, respectively. In conclusion, a studying method for pharmacokinetics of drugs in the target organ is established, which is simple and feasible. Tramadol hydrochloride shows a two-compartment model in the extracellular fluid of the mouse FrCx, and the distribution- and elimination half-life are 0.5 h and 2.7 h, respectively.

Peoniflorin activates Nrf2/ARE pathway to alleviate the Abeta(1-42)-induced hippocampal neuron injury in rats / 药学学报

This study was to investigate the effect of peoniflorin on the expressions of nuclear factor erythroid 2-related factor 2 (Nrf2) and its downstream signal molecules in the hippocampus of Alzheimer's disease (AD) rats for exploring the mechanism of peoniflorin protecting hippocampal neurons. AD model rats were established by bilateral intrahippocampal injection of beta-amyloid(1-42) (Abeta(1-42)) and divided randomly into 3 groups: AD model group, peoniflorin low-dose (15 mg x kg(-1)) group and peoniflorin high-dose (30 mg x kg(-1)) group. The vehicle control rats were given bilateral intrahippocampal injection of solvent with the same volume. After peoniflorin or saline was administered (ip) once daily for 14 days, the hippocampuses of all animals were taken out for measuring the expressions of Nrf2, heme oxygenase-1 (HO-1) and gamma-glutamylcysteine synthethase (gamma-GCS) mRNA by reverse transcription PCR, determining the contents of glutathione (GSH), malondialdehyde (MDA) and carbonyl protein (CP) using colorimetric method, and for assaying the expressions of neuronal apoptosis inhibitory protein (NAIP) and Caspase-3 by immunohistochemical staining method. The results showed that peoniflorin markedly increased the expressions of Nrf2, HO-1 and gamma-GCS mRNA, enhanced the level of GSH and decreased the contents of MDA and CP in the hippocampus, as compared with the model group. Peoniflorin also improved the NAIP expression and reduced the Caspase-3 expression in the hippocampus neurons. In conclusion, peoniflorin protects against the Abeta(1-42)-mediated oxidative stress and hippocampal neuron injury in AD rats by activating the Nrf2/ARE pathway.