Chemical constituents of steroidal saponins in rhizome of Paris polyphylla var. yunnanensis cultured in vitro / 中国中药杂志

In this study, liquid chromatography-mass spectrometry(LC-MS) and high performance liquid chromatography(HPLC) were employed for qualitative and quantitative analysis of the steroidal saponins in rhizomes of Paris polyphylla var. yunnanensis from three different habitats cultured in vitro, in an attempt to explore whether the rhizomes of the medicinal herb cultured in vitro can synthesize the steroidal saponins, including polyphyllinsⅠ, Ⅱ, and Ⅶ, the quality markers specified in Chinese Pharmacopoeia(2020 edition). A total of 20 steroidal saponins were identified in the rhizomes from Changxin, Yunlong(S1), Fengyi, Dali(S2), and Niujie, Eryuan(S3): parisyunnanoside A and parisyunnanoside D or E, proto-polyphyllin Ⅱ, polyphyllins G and H, polyphyllinsⅠ, Ⅱ, Ⅴ, Ⅵ, and Ⅶ, dioscin, gracillin, prosapogenin A, Tg, isomer of Th, saponin Th, reclinatoside, proto-pairs D, pseudoproto-dioscin, and 23-O-glc-(23S,25R)-spirost-5-en-3β,23α,27-triol-3-O-rha-(1→2)-[ara(1→4)]-glc or 27-O-glc-(23S,25R)-spirost-5-en-3β,27α-diol-3-O-rha-(1→2)-[ara(1→4)]-glc. Among them, polyphyllinsⅠ, Ⅱ, and Ⅶ were detected in the rhizomes from S1, with the mass fraction of 0.109 1%, 0.165 2%, and 0.051 03%, respectively(total 0.325 3%). Polyphyllins Ⅱ and Ⅶ were identified in the rhizomes from S2 with the respective mass fraction of 0.192 2% and 0.074 23% and total content of 0.266 5%. Moreover, polyphyllins Ⅱ and Ⅶ were also found in the rhizomes from S3, which had the mass fraction of 0.207 7% and 0.186 9%, separately, with the total content of 0.394 6%. Thus, steroidal saponins, including the quality makers polyphyllins Ⅰ, Ⅱ, and Ⅶ recorded in Chinese Pharmacopoeia(2020 edition) can be synthesized in rhizomes of Paris polyphylla var. yunnanensis cultured in vitro, but their total content fails to meet the standard(0.60% in Chinese Pharmacopoeia). Therefore, in vitro culture of the Paris polyphylla var. yunnanensis is feasible, but the culture conditions need to be further improved.

Characteristics and clinical significance of wideband tympanometry of otitis media with effusion in young children / 中华耳鼻咽喉头颈外科杂志

Objective: To study the characteristics of wideband tympanometry(WBT) and its application value in the diagnosis of otitis media with effusion(OME) in young children. Methods: We compared wideband acoustic energy absorbance(EA) under peak pressure in young children with OME(190 ears) and healthy control subjects(121 ears) from Ninth People's Hospital of Shanghai Jiaotong University School of Medicine between January 2018 and June 2020. Both groups were divided into three groups, 1-6 months, 7-36 months and 37-72 months. SPSS 20.0 statistical software was used to analyze and compare the EA parameters between OME children of different months and the control group. Receiver operating characteristic (ROC)curve was used to analyze the diagnostic value of WBT in young children with OME. Results: There were significant differences in EA among three OME groups from 500 Hz to 2 000 Hz(P<0.05).Compared with the control groups, EA of 1-6 m OME group decreased significantly below 4 000 Hz(P<0.05), EA of 7-36 m OME group decreased significantly at 545-1 600 Hz(P<0.05), EA of 37-72 m OME group decreased significantly above 545 Hz(P<0.05).ROC curve indicated that EA at 1 000 Hz had the greatest diagnostic value (AUC was 0.890), followed by 1 500 Hz and the range of 500-2 000 Hz (AUC was 0.883 and 0.881, respectively).EA at 1 000 Hz with a cutoff value of 0.55 had the best diagnostic sensitivity of 90.8%, which was higher than conventional tympanometry (85.8%). The maximum AUC (0.932) could be obtained by combining EA, peak pressure and admittance amplitude of 226 Hz tympanometry as predictors. Conclusions: EA is significantly decreased in young children with OME. Compared with the conventional single frequency tympanometry, WBT is more accurate in the diagnosis of OME in young children, and the prediction accuracy would be better if combined with 226 Hz tympanometry.

Differences in Active Ingredients of Steroid Saponins in Rhizomes of 9 Kinds of Paris / 中国实验方剂学杂志

Objective::To investigate the differences and correlations of active ingredients and principal ingredients of steroid saponins in rhizomes of 9 kinds of Paris. Method::The differences and correlations of active ingredients and principal ingredients of steroid saponins in rhizomes of 9 kinds of Paris. were qualitatively analyzed by liquid chromatography-mass spectrometry (LC-MS). Result::PolyphyllinⅠ, polyphyllin Ⅱ, polyphyllin Ⅵ, and polyphyllin Ⅶ, the quality control indexes of medicinal materials in Chinese Pharmacopoeia (2015 edition) were detected in rhizomes of 8 species, namely P. polyphylla var. yunnanensis, P. delavayi, P. mairei, P. polyphylla var. yunnanensis(kuoban), P. veitnamensis, P. axialis, P. thibetica, and P. polyphylla var. polyphylla, polyphyllin Ⅴ was also detected in the study. There were significant differences in active ingredients of polyphyllin Ⅲ (Dioscin), polyphyllin H and gracillin. Meanwhile, P. polyphylla var. yunnanensis (S1), P. delavayi (S2), P. mairei (S3), P. polyphylla var. yunnanensis (kuoban) (S4), P. veitnamensis (S5), P. axialis (S6) and P. polyphylla var. polyphylla (S9) could be classified into one category according to the principal component analysis (PCA) model of the LC-MS data under the positive ion mode of Paris. P. thibetica (S7) and P. forrestii (S8) were clustered as two separate categories, with a longest range from P. polyphylla var. yunnanensi. Conclusion::There are little differences in active ingredients and the principal ingredients of steroid saponins in rhizome of P. polyphylla var. yunnanensis, P. delavayi, P. mairei, P. polyphylla var. yunnanensis, P. veitnamensis, P. axialis and P. polyphylla var. polyphylla. However, further research is required to determine whether these could substitute P. polyphylla var. yunnanensis. as an alternative medicine.

Clinical trials of acupuncture of Jiaji (EX-B2) for treatment of gastrointestinal dysfunction in sepsis patients / 针刺研究

OBJECTIVE: To observe the clinical therapeutic effect of acupuncture of Huatuo Jiaji (EX-B2) in the treatment of gastrointestinal dysfunction in sepsis patients, aiming at providing new clinical approach and evidence for improving septic gastrointestinal activity. METHODS: A total of 40 patients with septic gastrointestinal dysfunction who met our inclusive criteria were randomly divided into control group and treatment group (n＝20 cases in each). Patients in the control group received routine treatment of nasogastric mosapride citrate (5 mg/time, three times a day) and tifidobacterium triple viable capsules (420 mg, twice a day), intravenous infusion of omeprazole (40 mg, twice a day), rational dose of antibiotics, maintenance treatment of functions of the heart, lung, brain, kidney and other important organs and water electrolyte balance, as well as symptomatic treatment. Patients of the treatment group were treated by acupuncture of EX-B2 on the basis of routine treatment mentioned above in the control group. The acupuncture needle was inserted into EX-B2, twirled for a while and retained for 30 min, once a day for 10 successive days. The acute physiology and chronic health evaluation (APACHE II) score was given according to Knaus and colleagues' method, the intra-abdominal pressure was detected by using a manometer which was connected to an inserted canal in the urinary bladder, and the intragatric residul volume detected by using an injection syriange pumping via a nasal feeding tube. RESULTS: After the treatment, the APACHE II score, intra-abdominal pressure and intragastric residual volume on day 10 were significantly decreased in both groups in comparison with their own pre-treatment (P<0.05), while the borborygmus levels on day 10 were considerably increased in both groups relevant to their own pre-treatment (P<0.05). The APACHE II scores, intra-abdominal pressure and intragastric residual volume on day 3, 6 and 10 were significantly lower in the treatment group than those in the control group (P<0.05), whereas the borborygmus levels at the 3rd , 6th and 10th day in the treatment group were apparently higher than those of the control group (P<0.05)．. CONCLUSION: Acupuncture stimulation of EX-B2 has a good curative effect in improving gastrointestinal dysfunction in sepsis patients.

Efficacy of acupuncture for spastic cerebral palsy in infancy stage / 中国针灸

OBJECTIVE@#To explore the therapeutic effect of acupuncture for spastic cerebral palsy in infancy stage.@*METHODS@#A total of 62 children with spastic cerebral palsy were randomized into an observation group and a control group, 31 cases in each one. Both groups were given comprehensive rehabilitation therapy (sport therapy, electronic biofeedback therapy, speech cognitive training, massage therapy). On the basis of comprehensive rehabilitation therapy, the acupuncture group was treated with acupuncture at Baihui (GV 20), Sishencong (EX-HN1), motor area, Jiaji (EX-B 2), Weizhong (BL 40), Xuanzhong (GB 39), Zusanli (ST 36) and Hegu (LI 4), etc, the needles were retained for 15-20 min each time, once a day, 5 days a week, 45 days as a course with 10 days interval, a total of 3 courses were required. The Gesell development scale adaptive DQ scores, gross motor function measure (GMFM88) and muscular tension of adductor and gastrocnemius muscle were compared before and after treatment in the two groups.@*RESULTS@#The Gesell development scale adaptive DQ score after treatment in the observation group was increased (0.05), the change of the observation group was larger than the control group (0.05).@*CONCLUSION@#Acupuncture combined with comprehensive rehabilitation therapy can improve cognitive function, spasticity and motor function of children with spastic cerebral palsy.

Clinical observation on the inflammatory indexes in septic gastrointestinal dysfunction treated with acupuncture at Jiaji (EX-B 2) / 中国针灸

OBJECTIVE@#To evaluate the effect on the inflammatory indexes of septic gastrointestinal dysfunction treated with acupuncture at Jiaji (EX-B 2).@*METHODS@#A total of 118 patients of septic gastrointestinal dysfunction were randomized into an observation group and a control group, 59 cases in each one. In the control group, mosapride citrate was prescribed for oral administration, 5 mg each time, 3 times a day, bifidobacterium triple viable capsules, 420 mg each time, twice a day, intravenous drip with omeprazole, 40 mg, twice a day. Additionally, the antibiotics and the symptomatic treatment were selected rationally for maintaining the functions of the important organs, e.g. heart, lung, brain and kidney, and water-electrolyte balance. In the observation group, on the routine management as the control group, acupuncture at Jiaji (EX-B 2, T-T) was added, the needles were retained for 30 min in each treatment, once a day, 10 days as one course and 1 course was required. Separately, on the 1st, 3rd, 6th and 10th days of treatment, the white blood cell (WBC) count, the levels of hypersensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) were observed, the enteral nutrition feeding dose and gastrointestinal dysfunction score before and after treatment as well as the clinical effect were assessed in the two groups.@*RESULTS@#The differences were not significant in the indexes mentioned above on 1st and 3rd days of treatment between the two groups (>0.05). On the 6th and 10th days of treatment, regarding the gastrointestinal dysfunction score and inflammatory indexes count, the results in the observation group were lower than the control group (all <0.05), and feeding dose in the observation group was higher than the control group (<0.05). After treatment, the gastrointestinal dysfunction scores and inflammatory indexes count were all reduced and feeding dose was increased as compared with those before treatment in the patients of the two groups (all <0.05). After treatment, the total effective rate was 91.5% (54/59) in the observation group, higher than 76.3% (45/59) in the control group (<0.05).@*CONCLUSION@#Acupuncture at Jiaji (EX-B 2) points achieves the satisfactory effect on septic gastrointestinal dysfunction and reduces the inflammatory indexes count.

Efficacy and Safety of Teriflunomide in Chinese Patients with Relapsing Forms of Multiple Sclerosis: A Subgroup Analysis of the Phase 3 TOWER Study / 中华医学杂志(英文版)

Background@#Disease-modifying therapy is the standard treatment for patients with multiple sclerosis (MS) in remission. The primary objective of the current analysis was to assess the efficacy and safety of two teriflunomide doses (7 mg and 14 mg) in the subgroup of Chinese patients with relapsing MS included in the TOWER study.@*Methods@#TOWER was a multicenter, multinational, randomized, double-blind, parallel-group (three groups), placebo-controlled study. This subgroup analysis includes 148 Chinese patients randomized to receive either teriflunomide 7 mg (n = 51), teriflunomide 14 mg (n = 43), or placebo (n = 54).@*Results@#Of the 148 patients in the intent-to-treat population, adjusted annualized relapse rates were 0.63 (95% confidence interval [CI]: 0.44, 0.92) in the placebo group, 0.48 (95% CI: 0.33, 0.70) in the teriflunomide 7 mg group, and 0.18 (95% CI: 0.09, 0.36) in the teriflunomide 14 mg group; this corresponded to a significant relative risk reduction in the teriflunomide 14 mg group versus placebo (-71.2%, P = 0.0012). Teriflunomide 14 mg also tended to reduce 12-week confirmed disability worsening by 68.1% compared with placebo (hazard ratio: 0.319, P = 0.1194). There were no differences across all treatment groups in the proportion of patients with treatment-emergent adverse events (TEAEs; 72.2% in the placebo group, 74.5% in the teriflunomide 7 mg group, and 69.8% in the teriflunomide 14 mg group); corresponding proportions for serious adverse events were 11.1%, 3.9%, and 11.6%, respectively. The most frequently reported TEAEs with teriflunomide versus placebo were neutropenia, increased alanine aminotransferase, and hair thinning.@*Conclusions@#Teriflunomide was as effective and safe in the Chinese subpopulation as it was in the overall population of patients in the TOWER trial. Teriflunomide has the potential to meet unmet medical needs for MS patients in China.@*Trial Registration@#ClinicalTrials.gov, NCT00751881; https://clinicaltrials.gov/ct2/show/NCT00751881?term=NCT00751881&rank=1.

The Observation of Curative Effect on Leukotriene Receptor Antagonist Combined with Inhaled Hormone in the Treatment of Moderately Severe Asthma / 昆明医科大学学报

Objective To explore the clinical efficacy of Montelukast in the treatment of severe asthma. Methods A retrospective analysis was conducted in the Department of Respiratory Medicine from January 2016 to August 2017.A total of 168 patients with moderately severe asthma were randomly divided into control group and observation group. The control group was treated with leukotriene receptor antagonist Montelukast and the observation group was treated with both Montelukast and budesonide inhalation suspension. Then we compared the clinical effect, lung function and blood gas index before and after treatment between the two groups. Results Significant improvement was observed in the clinical symptoms and lung function in the two groups of patients after the treatment. Compared to the control group, a better improvement was seen in the observation group (P＜0.05) . The results of blood gas analysis were significantly different between the two groups before and after the treatment (P＜0.05) . Conclusion In the treatment of moderately severe asthma, Montelukast combined with budesonide inhalation suspension has good clinical effect and can significantly alleviate symptoms, which can be widely used clinically.

Research and application of the reamer-irrigator-aspirator / 中国组织工程研究

BACKGROUND:Large volume of bone can be harvested by the reamer-irrigation-aspirator (RIA), which can be used for autologous bone graft, because there are many stromal stem cells and a variety of osteogenesis factors in the harvested bone. OBJECTIVE:To introduce the application progress of the RIA. METHODS:PubMed database was retrieved by the first author for RIA-related articles published from January 2000 to May 2017 using the keyword of "reamer-irrigator-aspirator". A total of 87 articles were searched initially and finally 38 articles met the inclusion criteria. RESULTS AND CONCLUSION:Compared with harvesting bone tissues from the iliac bone, the RIA can harvest more autologous bone tissues with more bone marrow stromal stem cells. Moreover, the osteogenic effect of the harvested autologous bone is better and there are fewer complications. Therefore, the RIA has been widely used as a method of harvesting non-structural autologous bone tissues. Removal of intramedullary lesions by the RIA is used in the treatment of long bone infection, osteomyelitis and bone tumors, as well as in the removal of intramedullary cement. RIA was originally used as a special reaming during intramedullary nailing for femoral shaft fractures, which could reduce high pressure and high temperature so as to decrease the risks of fat embolism and osteonecrosis. To conclude, the RIA can achieve satisfactory outcomes and result in few complications, but the clinical use is still limited by high cost, frequent fluoroscopy, bleeding and limited indications, as well as risks for iatrogenic fractures and perforation.

Analysis of varieties and standards of Composite medicinal plants used in Dai medicine / 中国中药杂志

The study aims to analyze the varieties and standards of compositae medicinal plants used in Dai medicine. The results showed that there were 78 species (including varieties) compositae plants recorded in literatures, which belongs to 63 medicinal materials varieties. And 47 original plants (60.25%) were recorded in Chinese medicinal material standards. In those standards and literatures of Dai medicine, there are great differences in translated Chinese names, original plants, medicinal parts, and efficacy of medicinal plants. Therefore, the variety systematization and the quality standards of Dai medicine should be strengthened.

Photosynthetic parameters and physiological indexes of Paris polyphylla var. yunnanensis influenced by arbuscular mycorrhizal fungi / 中国中药杂志

Through potted inoculation test at room temperature and indoor analysis, the photosynthetic parameters and physiological and biochemical indexes of Paris polyphylla var. yunnanensis were observed after 28 arbuscular mycorrhizal (AM) fungi were injected into the P. polyphylla var. yunnanensis growing in a sterile soil environment. The results showed that AM fungi established a good symbiosis with P. polyphylla var. yunnanensis. The AM fungi influenced the photosynthetic parameters and physiological and biochemical indexes of P. polyphylla var. yunnanensis. And the influences were varied depending on different AM fungi. The application of AM fungi improved photosynthesis intensity of P. polyphylla var. yunnanensis mesophyll cells, the contents of soluble protein and soluble sugar, protective enzyme activity of P. polyphylla var. yunnanensis leaf, which was beneficial to resist the adverse environment and promote the growth of P. polyphylla var. yunnanensis. Otherwise, there was a certain mutual selectivity between P. polyphylla var. yunnanensis and AM fungi. From the comprehensive effect of inoculation, Racocetra coralloidea, Scutellospora calospora, Claroideoglomus claroideum, S. pellucida and Rhizophagus clarus were the most suitable AM fungi to P. polyphylla var. yunnanensis when P. polyphylla var. yunnanensis was planted in the field.

Prevention effect of medical self-crosslinking sodium hyaluronate gel on epidural scar adhesion after laminectomy

OBJECTIVE@#To analyze the effect and medical self-crosslinking sodium hyaluronate gel on epidural scar adhesion after laminectomy.@*METHODS@#A total of 24 New Zealand L5 laminectomy rabbits were randomly divided into four groups, group A as the control group without any treatment; group B covered by sodium hyaluronate gel; group C and group D covered by 0.5 and 1.0 mL medical self-crosslinking sodium hyaluronate gel. All rabbits were scored at various time points after 2, 4, 6, 8, 12 weeks, then the formation of scar was observed.@*RESULTS@#In Groups B, C, D loose scar tissue occurred after 2 weeks of the operation, scar tissues were significantly less than that in group A, with mild inflammatory reaction. After 8 weeks, the scar tissues of group B were significantly more than that of groups C, D. After two weeks, group B, C were back to the preoperative level; After 4 weeks, group D was back to the preoperative level; After four weeks, the CSEP of group A was increased significantly, which was significantly higher than that in groups B, C, D. The motor function score of group A, group B and group C were the same as preoperative, but that in group D it was decreased significantly, and then it gradually recovered. After 4 weeks it kept a stable level. The motor function score of group A was decreased gradually after the operation, which kept a stable level after 4 weeks, the motor function score was significantly lower than that in groups B, C, D.@*CONCLUSIONS@#Determination of somatosensory evoked potentials is sensitive indicator of spinal cord injury; Application of medical self-crosslinking sodium hyaluronate gel is effective on epidural scar adhesion after laminectomy.

Glycosyl isomerization based on the biosynthesis of natural-product sugar from microorganism / 药学学报

Glycosylation, one of the most common and important reactions in biological systems, results in diverse functions and is often found in biologically active small-molecule natural products produced by microorganisms. Furthermore, sugar moieties are generally critical for their activities. Alternating the sugar structures thus provides the potentials for enhancing the biological activities of natural products, which evokes researchers to study the sugar biosynthetic machinery and its application in the modification of sugar moieties with an aim of generating unnaturally glycosylated natural product drugs with better activities. This review will briefly outline current studies on sugar biosynthesis and glycosyltransferase, with a few selected experiments designed to alter natural-product sugar structures.

Relationship between HLA-A, B alleles and red blood cell parameters of patients with --(SEA/αα) subtype of α(0)-thalassemia of Han ethnic population of Wuzhou city / 中国实验血液学杂志

This study was purposed to investigate the relationship between HLA-A, B allele polymorphisms and red blood cell parameters of patients with --(SEA/αα) subtype of α(0)-thalassemia in Han ethnic population of Wuzhou city. The HLA genetic polymorphisms were determined by polymerase chain reaction-sequence-based typing (PCR-SBT) in 57 patients with --(SEA/αα) subtype of α(0)-thalassemia of Han ethnic population in Wuzhou city, Guangxi province, China. Mean corpuscular volume (MCV), hemoglobin (Hb), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) were detected by automatic blood analyzer system. HbA2 were detected by electrophoretic method. The statistical analysis was performed by ordinal polytomous logistic regression. The results showed that Hb and HbA2 levels were significantly lower in patients positive for HLA-A*33:03, B*15:01 or B*55:02, and were significantly higher in patients positive for B*15:02 (P < 0.05). It is concluded that several HLA alleles may be associated with Hb level of --(SEA/αα) subtype of α(0)-thalassemia of Han ethnic population in Wuzhou city. This result has the value for understanding phenotype-genotype relationships in thalassemia.

Case-control study on patellar fixed pin and Kirschner's nail with tension band for the treatment of patellar fracture / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical efficiency of patellar fixed pin and Kirschner's nail with tension band in treating patellar fracture.</p><p><b>METHODS</b>From November 2010 to January 2012, the clinical data of 42 patients with patella fracture were treated with patella fixed needle and Kirschner's nail with tension band. The patellar fixed needle group included 21 cases (14 males and 7 females,aged 26 to 65 with an average of 43.6 years old); The Kirschner's nail with tension band group included 21 cases (12 males and 9 females,aged 32 to 58 with an average of 41.5 years old). The operation time, intra-operative blood loss and healing time were compared between two groups. Böstman score was applied to compare the therapeutic effects.</p><p><b>RESULTS</b>All patients were followed up with an average of 11.5 months ranged from 6 to 14 months. The fractures healed well without complications such as nonunion and infection. According to Böstman score, there was no significant difference between two groups in clinical efficiency (Z = -0.83, P = 0.407). There was significant difference in operation time (t = 6.67, P = 0.00), while no difference in intra-operative blood loss, bone healing time (t = 1.90, P = 0.064; t = 0.612, P = 0.544).</p><p><b>CONCLUSION</b>Both methods can obtain good results. However, patellar fixed pin combined with tension band is one of the ideal methods for the treatment of patellar fracture, it has an advantage of simple with shorter operation time, rigid fixation, less complications and well recovery.</p>

Clinical classification of gluteal muscle contracture under arthroscopy / 中国骨伤

<p><b>OBJECTIVE</b>To explore clinical effects of gluteal muscle contracture and minimum invasive surgery under the arthroscopy.</p><p><b>METHODS</b>Totally 358 patients with gluteus contracture were treated,which included 175 males and 183 females with an average age of (19.7 +/- 6.8) years old (ranged, 14 to 41). All patients have a history of repetitive intramuscular injection of penicillin with benzyl alcohol solvent. According to clinical characteristics and intraoperative situation, patients were classified into four groups:cable strip (118 cases), fanshaped (107 cases), mixed (87 cases), tensor fasciae latae contracture(46 cases). The curative effects were evaluated according to postoperative function evaluation standard of gluteus contracture.</p><p><b>RESULTS</b>All patients were followed up and 37 cases withdrew. The following up time ranged from 1.5 to 8 years with an average of 3.5 years. According to evaluation standard of gluteus contracture, 303 cases got excellent results, 13 cases good,and 5 cases fair at the final follow-up. No recurrence, infection and neurovascular injury occurred.</p><p><b>CONCLUSION</b>The classification of gluteal muscle contracture is beneficial for choose surgical strategy and improve curative effect. The advantage of plasma knife minimally invasive solution in treating gluteal muscle contracture with radiofrequency under arthroscopy is minimally invasive, safe, and benefit for early functional exercises.</p>

Diagnostic value of MRI and MR arthrography in the detection of injuries of anterior labrum in shoulder / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the diagnostic value of MRI and MR arthrography in the detection of injuries of anterior labrum in shoulder and to evaluate the accuracy of MR arthrography in the classification of anterior labrum lesion.</p><p><b>METHODS</b>Seventy-eight patients with arthroscopically proved anterior labrum lesions(study group) and 75 patients with arthroscopically proved intact anterior labrum (control group) from January 2007 to December 2010 were included to the study. All patients underwent MRI and MR arthrography at our institution prior to shoulder arthroscopy. All MRI and MR arthrography were analyzed by one musculoskeletal radiologists and one sports medicine surgeon who had no knowledge of the clinical histories and arthroscopic results. The same classification system of labrum lesions based on arthroscopy was used in image analysis. Imaging findings and arthroscopic findings were compared in all patients. With arthroscopy used as the standard of reference, the sensitivities, specificities and accuracies of MRI and MR arthrography in the detection of anterior labrum lesions were compared, and the sensitivities, specificities and accuracies of MR arthrography in the correct classification of anterior labrum lesions were calculated.</p><p><b>RESULTS</b>In arthroscopy, 78 anterior labrum lesions, 67 rotator cuff lesions and 8 SLAP lesions were diagnosed, for the detection of anterior labrum lesions, the sensitivity of MRI and MR arthrography was 80.8% and 92.3%,the specificity was 89.3% and 97.3%,the accuracy was 85.0% and 94.8% respectively. Seventy-eight patients with arthroscopically proved anterior labrum lesions included 39 Bankart lesions, 32 ALPSA lesions and 7 Perthes lesions, with MR arthrography, Bankart, ALPSA, and Perthes lesions were correctly classified in 84.6%, 84.4%, and 57.1% of cases, respectively.</p><p><b>CONCLUSION</b>MR arthrography has a higher sensitivity, specificity and accuracy than MRI in the detection of anterior labrum injuries. MR arthrography was useful in the classification of different variants of anterior labrum injuries before operations. It may directly influence the surgeon's strategy and is useful in preoperative planning of arthroscopic reconstructions.</p>

Surgical treatment for Müller-Weiss disease / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss operative methods and effects for Müller-Weiss disease.</p><p><b>METHODS</b>From March 2005 to May 2011, 15 patients were operated. There were 2 males and 13 females, with an average age of 51.8 years (range, 26 to 62 years). The preoperative American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was (42 ± 13) points. According to the Maceira Staging system, 1 foot was grade 2, 6 feet were grade 3, 4 feet were grade 4, and 4 feet were grade 5. The technique consisted of arthrodesis of the talonaviculocuneiform joints with plate, arthrodesis of the talonavicular joint and arthrorisis of naviculocuneiform joint with plate, or triple arthrodesis with screws, according to the preoperative evaluation.</p><p><b>RESULTS</b>Ten feet were treated with arthrodesis of the talonaviculocuneiform joints, 3 feet were treated with arthrodesis of the talonavicular joint and arthrorisis of naviculocuneiform joint and 2 feet were treated with triple arthrodesis. Two patients were lost to follow-up. The average follow-up after operation was 19.2 months (range, 9 to 38 months). All feet were solid fusion and the average duration of union was 13.3 weeks (range, 12-16 weeks). The AOFAS ankle-hindfoot score at the last follow-up was (83 ± 6) points. Two feet were excellent, 10 feet were good, and 1 foot was fair. The length of feet was (14.2 ± 1.0) cm before surgery and (15.7 ± 0.9) cm at the last follow-up (t = 11.570, P < 0.05). The Meary's angle was -6.1° ± 13.1°before surgery and 1.1° ± 3.0° at the last follow-up (t = 2.248, P < 0.05). The talocalcaneal angle was 4.5° ± 2.2° before surgery and 18.0° ± 4.0° at the last follow-up (t = 11.700, P < 0.05). One foot had breakage of the plate and screws at arthrorisis of naviculocuneiform joint and none had complications related to the incision.</p><p><b>CONCLUSION</b>Operations for Müller-Weiss disease, according to concrete conditions using different therapeutic program, may achieve a satisfactory outcome.</p>

Serum antibodies to 25 myelin oligodendrocyte glycoprotein epitopes in multiple sclerosis and neuromyelitis optica: clinical value for diagnosis and disease activity / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Whether antibody to myelin oligodendrocyte glycoprotein (MOG) can be a diagnostic marker for multiple sclerosis (MS) is still controversial. Recent studies suggested that serum specific anti-MOG epitope antibody might be an MS specific marker. However, these studies did not include neuromyelitis optica (NMO) which might be proven to also have anti-MOG antibody. Hence, the present study was undertaken to investigate the clinical value of serum antibodies to 25 MOG epitopes in conventional MS (CMS) and NMO.</p><p><b>METHODS</b>Serum anti-MOG epitope IgG was detected in 61 CMS patients, 54 NMO patients, and 77 healthy controls, using enzyme-linked immunosorbent assay (ELISA).</p><p><b>RESULTS</b>Anti-MOG(27-38) IgG levels in both CMS and NMO patients were significantly higher than that in healthy controls (optical density (OD): 0.64 ± 0.38, 0.48 ± 0.23 vs. 0.19 ± 0.09; P = 0.000). CMS and NMO patients in relapse stage had significantly higher anti-MOG(27-38) IgG level than patients in remission stage (OD: 0.55 ± 0.14 vs. 0.24 ± 0.09, P = 0.027).</p><p><b>CONCLUSION</b>Although serum anti-MOG epitope IgG could not differentiate MS from NMO, it may be a useful marker for monitoring disease activity.</p>

Treatment of open calcaneal fractures / 中国骨伤

<p><b>OBJECTIVE</b>Review the series cases of open calcaneal fractures, to discuss the clinical outcome and evaluate the effective factors associated with the prognosis.</p><p><b>METHODS</b>Between 2004 and October 2009, 427 calcaneal fractures were treated, 22 of these fractures were open, 15 feet of 15 patients were available for the follow-up. There were 9 males and 6 females with a mean age of 34.7 years (range 18 to 66). According to the Sanders classification, there were 2 type I fractures, 3 type II, 6 type III and 4 type IV. According to the Gustilo classification, there were 1 of type 1, 4 of type II, 5 of type III A, and 5 of type III B open fracture. According to the open calcaneal injury subtypes (OCIS), there were 1 of type IA, 2 of type II A,7 of type II B, 2 of type IIIA and 3 of type III B. All patients were treated with intravenous antibiotics, immediate and repeat irrigation and debridement, temporary wound coverage, and initial stabilization of the limb. Clinical examination, radiographs and AOFAS ankle-hindfoot scores were used for outcome measurement.</p><p><b>RESULTS</b>The average follow-up time was 16.4 months (8 to 31 months). The mean AOFAS score was (74.6 +/- 10.4) (range 58 to 94). There were 4 feet required tissue transfer for wound coverage. An infection developed at the sites of 5 fractures,4 of witch were Gustilo type III, 2 deep infections with osteomyelitis developing at the site of 1 patient, no patient required amputation.</p><p><b>CONCLUSION</b>These findings do not reflect as high a deep infection and osteomyelitis rate for open calcaneal fractures as previously reported, if early and satisfying debridement, evaluate the soft tissue injury carefully, and choose the right time and indications for internal fixation. In addition, early internal fixation should be avoided for Gustilo type III and OCIS type B calcaneal fractures.</p>