Diurnal differences in acute gout attacks: A clinical study of male gout patients / 北京大学学报(医学版)

OBJECTIVE@#To observe the diurnal difference of acute gout attacks in men, and provide reference for accurate clinical prevention and treatment.@*METHODS@#Using a single-center, cross-sectional study design, the patients diagnosed with gout in the outpatient department of Rheumatology and Immuno-logy of PLA Joint Logistic Support Force No.980 Hospital from October 2021 to April 2022 were selected. The information about the patient's current/last acute gout attacks (less than 2 weeks from visit), date and time of attacks, joint symptoms and signs, medication use, and relevant biochemical tests on the day of visit was recorded. The diurnal time difference of acute gout attacks in male patients was analyzed, and univariate comparison and multivariate Logistic regression analyses were conducted to compare the diurnal difference of acute gout attacks with clinical characteristics and biochemical indicators.@*RESULTS@#A total of 100 male gout patients were included, and 100 acute attacks were recorded. Diurnal distribution of acute gout attacks: morning (6:00~11:59, 18, 18%), afternoon (12:00~17:59, 11, 11%), the first half of the night (18:00~23:59, 22, 22%), the second half of the night (0:00~05:59, 49, 49%); During the day (included morning and afternoon, 29, 29%) and at night (included the first half of the night and the second half of the night, 71, 71%). The rate of acute gout attack was significantly higher at night than in the day (about 2.5 ∶1). No matter the first or recurrent gout, no matter the duration of the disease, the number of acute gout attacks had the difference of less in the day and more in the night. Serum urate (SU) level was higher in the patients with nocturnal attack than in those with daytime attack (P=0.044). Comorbidities were significantly different in the day-night ratio of the number of acute gout attack (P=0.028). Multiple Logistic regression analysis showed that SU level (OR=1.005, 95%CI: 1.001-1.009) and comorbidities (OR=3.812, 95%CI: 1.443-10.144) were the correlative factors of nocturnal acute gout attacks.@*CONCLUSION@#No matter the first or recurrent gout, no matter the duration of the disease, it has a diurnal variation characterized by multiple attacks at night, increased SU level and comorbidities are correlative factors for nocturnal acute attack of gout.

Finite element analysis of 14-year-old adolescent after spinal foraminoplasty at L / 解剖学报

Objective To establish the three-dimensional finite element model of lumbar spine(L) 3-5 segments of the normal spine of 14-year-old adolescents to analyze the biomechanical changes of the lumbar spine after different degrees of lumbar foraminal plasty, and to provide reference for improvement of adolescent foraminoplasty. Methods A14-year-old female volunteer with no previous history of lumbar spine was selected to collect lumbar CT image data and we imported it into Mimics 16.0 software for modeling. ABAQUS software was used to conduct finite element model force analysis. Models M

Analysis of epidemiological characteristics and surveillance result of host animal on hemorrhagic fever with renal syndrome in Zibo City from 2015 to 2018 / 中华疾病控制杂志

Objective To analyze the epidemic characteristics of hemorrhagic fever with renal syndrome(HFRS), the distribution and virus-carrying status of host animals in Zibo City from 2015 to 2018, so as to provide references for prevention and control. Methods Descriptive epidemiological study was conducted on the incidence data of HFRS collected in Zibo City from 2015 to 2018. Results A total of 315 cases including one death were reported in Zibo, with the average incidence of 1.69/100000 and the fatality rate of 0.32%. The cases were distributed mainly in Zichuan District and Yiyuan Coutry, which accounting for 67.62%. The main groups of cases were middle-aged and elderly farmers,and people aged 45-69 accounted for 62.86% of total cases. Two peak seasons were observed in spring(March-May) and autumn-winter(October-December). The average rat density and virus-carrying rate were 3.04% and 3.87% respectively rattus norvegicus was the dominant species of rodents in the residential area,while in the field, apodemus agrarius was the dominant species.The virus-carrying rates of rattus norvegicus and apodemus agrarius were 6.48% and 0.75% respectively,which had significant difference in these two group ( 2=6.694,P=0.01). Conclusions The incidence rate of HFRS was declining in Zibo City, while the rat density and the virus-carrying rate were still high in the areas with high incidence, which indicating the outbreak risk of HFRS was existed.It is necessary to strengthen immunization, rodent control and health education in high-endemic areas.

Inhibitory effect of miRNA-126 on inflammatory response in mice with cerebral ischemia-reperfusion injury / 医学研究生学报

ObjectiveThe mechanism of cerebral ischemia-reperfusion injury is highly associated with the inflammatory response. MiRNA-126 plays a key role in vascular inflammation. This study aims to investigate the effect of miRNA-126 on the inflammatory response in mice accompanying cerebral ischemia-reperfusion injury through the NLRP3/NF-κB signal axis, and to explore the mechanisms involved.Methods A total of forty-eight male mice were randomly divided into four groups: the sham-operated group, cerebral ischemia-reperfusion model group, miRNA negative control group (miRNA-126 agomir NC group) and miRNA-126 overexpression group (miRNA-126 agomir group), and each group included twelve mice. The neurobehavioral score was recorded. The left-brain of the mice was sacrificed after anesthesia, and the water content of the brain tissue was measured. HE staining and light microscopy were used to identify the histopathological changes of the cerebral of the mice. The expression levels of inflammatory cytokines IL-1β and IL-6 in brain tissue and serum of mice were detected by ELISA. Western Blot method was used to determine the protein expression levels of NLRP3, ASC, caspase-1, NF-κB p65, NF-κB P50, p-NF-κB 65 and p-NF-κB 50 in brain tissues of mice in each group. RT-PCR was used to test the expression levels of miRNA126, NLRP3, ASC, caspase-1, NF-κB p65 and NF-κB P50 in brain tissue and serum of mice.ResultsIn the sham-operated group, the morphology, and structure of cerebral cortex were normal as healthy mice, being with the dense and orderly arrangement of nerve fibers, with no occurrence of impaired nerve function, and the neurobehavioral score was zero. In both of model group and the miRNA-126 agomir NC group, the ruptured cerebral cortex could be observed visually being with necrotic and disordered cells. The blurred pyknosis and interstitial edema occurred with increased water content of brain tissue. The nerve damage was observed with a significantly increased neurobehavioral score (P<0.05). Compared to the model group, the pathological morphology of the cerebral cortex in the miRNA-126 agomir group was significantly improved, and the number of necrotic cells was decreased, the arrangement of which was denser and more orderly. Reduced interstitial edema and the neurobehavioral score were identified. The significantly improved nerve injury and the decreased water content of brain tissue were observed as well (P<0.05). Compared to the sham-operated group A, the expression level of miRNA-126 mRNA in the model group and the miRNA-126 agomir NC group decreased significantly. The expression level of IL-1β and IL-6 increased, while the expression levels of NLRP3, ASC, caspase-1, NF-κB p65, NF-κB p50, p-NF-κB p65, p-NF-κB p50, and NLRP3, ASC, caspase-1, NF-κB p65, NF-κB p50 mRNA increased generally (P<0.05). Compared to the model group and the miRNA-126 agomir NC group, the expression level of miRNA-126 mRNA in the miRNA-126 agomir group increased. However, the expression level of IL-1β and IL-6 decreased, and the expression level of NLRP3/NF-κB signal axis related gene protein and mRNA decreased (P<0.05).ConclusionOverexpression of miRNA-126 can inhibit the expression of NLRP3/NF-κB signal axis related genes and the level of inflammation in brain tissue, and improve the neurological injury of cerebral ischemia-reperfusion in mice.

Wolffian Adnexal Tumor:Report of One Case / 中国医学科学院学报

This article reports a patient who suffered from Wolffian adnexal tumor.We also briefly elucidate the pathogenesis,clinicopathological features,diagnosis,differentiation,and treatment of Wolffian adnexal tumor,with an attempt to increase the awareness of the disease and reduce misdiagnosis.

Point electro-cauterization versus holmium laser cauterization in the treatment of post-ejaculation hematuria / 中华男科学杂志

Objective@#To investigate the advantages and disadvantages of point electro-cauterization (PEC) and holmium laser cauterization (HLC) in the treatment of post-ejaculation hematuria.@*METHODS@#From January 2015 to December 2018, 73 patients with post-ejaculation hematuria, aged 24－63 (36.8 ± 4.2) years, underwent PEC (n = 35) or HLC (n = 38) after failure to respond to 3 months of conservative treatment. We compared the hospital days, total hospitalization expenses, maximum urinary flow rate (Qmax), average urinary flow rate (Qavg), Hamilton Anxiety Rating Scale (HAMA) score, postoperative duration of hematuria, and recurrence rate at 3 and 6 months after surgery.@*RESULTS@#All the patients experienced first ejaculation but no post-ejaculation hematuria at 1 month after operation. The recurrence rates were lower in the PEC than in the HLC group at 3 months (5.71% vs 2.63%, P > 0.05) and 6 months postoperatively (8.57% vs 5.26%, P > 0.05). Compared with the baseline, the Qmax was decreased from (18.56 ± 2.53) ml/s to (13.68 ± 3.31) ml/s (P < 0.05) and the Qavg from (14.35 ± 2.26) ml/s to (9.69±1.84) ml/s in the PEC group at 1 month after surgery (P < 0.01), but neither showed any statistically significant difference in the HLC group. Mild to moderate anxiety was prevalent in the patients preoperatively, particularly in those without job or regular income and those with a long disease course or frequent onset, the severity of which was not correlated with age, education or marital status. The HAMA score was decreased from18.65 ± 4.33 before to 12.35 ± 3.63 after surgery in the PEC group (P < 0.01), and from 16.88 ± 2.11 to 6.87 ± 4.36 in the HLC group (P < 0.01). The mean hospital stay was significantly longer in the former than in the latter group (［5.2 + 1.3］ vs ［3.4 ± 0.5］ d, P < 0.01), while the total cost markedly lower (［6.35 ± 1.20］ vs ［12.72 ± 2.15］ thousand RMB ¥, P < 0.05).@*CONCLUSIONS@#Both PEC and HLC are safe and effective for the treatment of post-ejaculation hematuria, with no significant difference in the recurrence rate at 3 and 6 months after operation, but their long-term effect needs further follow-up studies. PEC may increase the risk of negative outcomes of the postoperative urinary flow rate, while HLC has the advantages of better relieving the patient's anxiety, sooner discharge from hospital and earlier recovery from postoperative hematuria, though with a higher total cost than the former.

Recommendations for public health protection against flood disaster / 中华预防医学杂志

Flood disaster is one of the most serious natural disasters in the world, and it could pose an inestimable impact on the affected people. Based on existing laws, regulations, and emergency manuals in China, extensive literature review, epidemiological and related protection evidence, and expert consultation, this study analyzed different health risk factors of flood disaster and proposed a multi-stage, multi-population, and multi-phase comprehensive protection measures for the public in the perspective of pre-event prevention, in-event intervention and post-event rescue strategy, which could provide a scientific basis for improving the level of public health protection against the flood disaster and corresponding health outcomes.

Research Progress on Mechanism of Active Components of Traditional Chinese Medicine in Treating Rheumatoid Arthritis Based on Signaling Pathway / 中国实验方剂学杂志

Objective: Rheumatoid arthritis (RA) is one of the most common inflammatory arthropathy diseases, characterized by synovium hyperplasia and progressive destruction of articular cartilage, which is significantly associated with dysfunction and shortening of life span. Drug therapy is the main intervention for RA, but the glucocorticoid and immunosuppressant have many shortcomings in treatment, such as great side effect, slow onset and poor efficacy, while biological agents are too expensive. RA belongs to the category of "arthralgia syndrome" in traditional Chinese medicine (TCM). TCM treatment for RA has a well-established history and multiple advantages such as good curative effect and less side effects, but its mechanism needs to be further studied. Signaling pathway is involved in the pathogenesis and progression of RA, so it is one of the main targets in research on the pathogenesis of RA and related pharmacological research of therapeutic drugs. In recent years, a large number of studies have been carried out on the regulation effect of active components of TCM on RA signaling pathways. These signaling pathways include Wnt signaling pathway, Janus tyrosine kinase (JAK)-signal transducers and transcription activator (STAT) signaling pathway, mitogen-activated protein kinase (MAPKs) signaling pathway, phosphoinositide-3-kinase (PI3K)/serine/protein kinase B (Akt) signaling pathway, nuclear factor-kappa B (NF-κB) signaling pathway, Toll like receptor (TLRs) signaling pathway, receptor activator of the nuclear factor kappa B ligand (RANKL)/receptor activator of the nuclear factor kappa B (RANK)/Osteoprotegerin (OPG) signaling pathway and so on. By reviewing the research results in recent years, we hope to provide ideas and reference for the basic research, development of new drugs and clinical treatment of RA.

Service demand and capacity of HIV prevention of mother-to-child transmission in Guangdong / 中华疾病控制杂志

Objective To analyze the service demand and capacity for preventing mother-to-child transmission(MTCT) of acquired immune deficiency syndrome in Guangdong, as well as to find the weakness in the work. Methods The relevant data of service demands and intervention capacity of human acquired immunodeficiency virus(HIV)-infected maternal and their babies from 2014 to 2017 was collected, and SPSS 21.0 software was employed to analyze the differences among the pearl river delta area, western area, mountainous area and eastern area, and to explore the correlation between regional midwifery institutions or personnel numbers and the rate of HIV MTCT. Results The education of HIV-infected maternal wasn’t high, generally, mainly in middle school (54.49%). The service demand of HIV-infected maternal was different in each area. The ethnic minorities outside the pearl river delta region (12.96%) and non-local living maternal in mountainous area (43.75%) were high. The proportion of maternal in the eastern area who didn’t know the route of HIV infection was also high (77.78%). The service capacity varies in each area, and the proportion (mountainous area: 41.67%, eastern area: 44.44%) of the confirmation time in intrapartum /postpartum was high among those from the mountains and eastern areas, which lead to poor intervention (the proportions of starting to antiretroviral treatment time later than 36 weeks or untreated in mountainous and eastern areas were 43.75% and 55.56%, respectively), as well as a high proportion of untreated maternal and exposed-infant (mountainous area: 2.08%, eastern area: 33.33%), and a higher percentage (11.11%) of breastfeeding in eastern area. There was no significant correlation between the number of midwifery institutions or healthcare personnel and the rate of HIV MTCT in different regions. Conclusions The mountainous and eastern areas are the weak of HIV MTCT in Guangdong Province, and later detection, less-standard intervention, and lower quality of information management are the weak steps in those areas. Targeted measures should be urgently developed to strengthen the training of the key areas to eliminate the regional differences of service capacity, which is essential to achieve the elimination of HIV MTCT in Guangdong.

Effects of RGD peptides-grafted porous tantalum on morphological change of MG63 osteoblasts-tantalum conjunctive interface and expression of osteogenesis factors / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effects of the Arg-Gly-Asp polypeptedes (RGD) peptides-modified porous tantalum surface on osteoblasts morphology and expressions of osteogenesis factors, and to evaluate RGD peptides promotes junctura ossium of tantalum-bone interface in vivo.@*METHODS@#RGD peptides of different concentrations (1 g/L, 5 g/L, and 10 g/L) were loaded to porous tantalum slices with a diameter of 10 mm and a thickness of 3 mm by physical absorption. The 3rd generation of MG63 cells were co-cultured with tantalum and divided into 4 groups: Ta-cells (control) group, 1 g/L cells/Ta/RGD group, 5 g/L cells/Ta/RGD group, and 10 g/L cells/Ta/RGD group. Porous tantalum compo-sites and osteoblasts-tantalum interface were observed by scanning electron microscopy. The adhesion rate of osteoblasts was detected and immunocytochemistry was used to detect the expressions of filamentous actin (F-actin), osteocalcin (OC) and fibronectin (FN).@*RESULTS@#The scanning electron microscope (SEM) revealed that osteoblasts distributed on the surface of porous tantalum and secreted extracellular matrix on outside and inner of micro-pores. The osteoblasts adhesion rate on porous tantalum modified with RGD was higher than that in the unmodified porous tantalum at the end of 24, 48, and 72 hours. The best adhesion effect was got in 5 g/L cells/Ta/RGD group at hour 48 [(68.07±3.80) vs. (23.40±4.39), P<0.05]. The results of immunocytochemistry showed that the expressions intensity of F-actin, OC and FN in osteoblasts on porous tantalum modified groups with RGD were stronger than that in the unmodified groups, and the expressions of 5 g/L cells/Ta/RGD group were significantly higher than those in the 10 g/L group and 1 g/L group [OC: (18.08±0.08) vs. (15.14±0.19), P<0.05; (18.08±0.08) vs. (14.04±0.61), P<0.05. FN: (24.60±0.98) vs. (15.90±0.53), P<0.05; (24.60±0.98) vs. (15.30±0.42), P<0.05. F-actin: (29.20±1.31) vs. (24.50±1.51), P<0.05; (29.20±1.31) vs. (16.92±0.40), P<0.05]. Correspondingly F-actin in osteoblasts was showed in longitudinal arrangement, and the expressions intensity was stronger than those OC and FN.@*CONCLUSION@#The RGD peptides is beneficial to enhance adhesion of osteoblast, spreading and reorganization of cytoskeleton on porous tantalum surface and improve the interface morphology, further promoting osteoblasts-tantalum conjunctive interface osseointegration.

Povidone-iodine versus the benzethonium chloride wipe for penile skin disinfection before semen collection from sperm donors / 中华男科学杂志

<p><b>Objective</b>To study the influence of povidone-iodine (PI) versus that of the benzethonium chloride wipe (BCW) on semen collection and semen quality of sperm donors undergoing penile skin disinfection and provide some evidence for the selection of disinfection methods for semen collection.</p><p><b>METHODS</b>We used PI from August to December 2015 and BCWs from January to July 2016 for penile skin disinfection before semen collection, with two samples from each donor, one collected with and the other without penis skin disinfection (the blank control group). After semen collection, we conducted a questionnaire investigation on the influence of the two disinfection methods on semen collection and compared the semen parameters between the two groups of sperm donors.</p><p><b>RESULTS</b>Totally, 185 sperm donors were included in this study, of whom 63 underwent penile skin disinfection with PI and the other 122 with BCWs before semen collection. Statistically significant differences were found between the PI and BCW groups in the adaptability to the disinfectant and rigid disinfection procedures (P <0.05), but not in the other items of the questionnaire (P >0.05). Compared with the sperm donors of the blank control group, those of the PI group showed statistically significant difference in the percentage of progressively motile sperm (PMS) (［63.02 ± 3.18］% vs ［61.45 ± 4.78］%, P<0.05), but not in the abstinence time (［4.97 ± 1.79］ vs ［4.7 ± 0.94］ d, P >0.05), semen volume (［4.11 ± 1.54］ vs ［4.15 ± 1.61］ ml, P >0.05), sperm concentration (［110 ± 29.6］ vs ［107.5 ± 31.79］ ×10⁶/ml, P >0.05), or total sperm count (［439.10 ± 170.13］ vs ［434.02 ± 186.91］ ×106/ejaculate, P >0.05), while those of the BCW group exhibited no remarkable difference in any of the above parameters (P >0.05). Among the samples with abnormal semen quality, significantly fewer were found with abnormal PMS in the BCW than in the PI group (1.64% ［2/122］ vs 9.68% ［6/62］, P <0.05). However, there were no significant differences between the PI and BCW groups in the abnormal semen volume, abnormal sperm concentration, or the rate of semen bacterial contamination (P >0.05).</p><p><b>CONCLUSIONS</b>Before semen collection from donors, penile skin disinfection with povidone-iodine may affect both the semen collection process and the quality of donor sperm, while the benzethonium chloride wipe can reduce the influence on the semen collection process and does not affect the semen parameters.</p>

A case of refractory hemophagocytic syndrome combined with multiple organ failure-ICU rescue experience / 天津医药

Hemophagocytic syndrome (HPS), also known as hemophagocytic lymphohistiocytosis (HLH), is a life-threatening condition of severe hyperinflammation caused by the uncontrolled proliferation of activated lymphocytes and histiocytic secreting high amounts of inflammatory cytokines. This article describes a case of refractory hemophagocytic syndrome combined with multiple organ failure. Through the review of medical history and treatment process, analysis of rescue occasion and details, and the practice on the concept of salvage therapy, our purpose is to discuss the strategy and experience that we have gained from rescuing severe refractory hemophagocytic syndrome in ICU. The key to the success rescue of this case is that we not only have carried out timely and effective early stage of initial treatment and salvage treatment, but also have had real-time monitoring and timely and effective treatment in ICU. Based on the effective infection control and comprehensive organ support, the phased treatment results of patients with HPS can be significantly improved, which provides possibility for HPS patients'survival.

Clinical significance of anatomic parameters of acetabular anterior column of normal male and female adults by digital measurement / 中国组织工程研究

BACKGROUND: Acetabulum anterior column shape is complex, and closed to femoral artery, and femoral nerve. Fixed screws easily went into the acetabulum. Currently, there was less data on quantitative anatomy data of pelvic acetabulum fracture with anterior column plate internal fixation. OBJECTIVE: To compare the pelvis gender differences by analyzing digital anatomical features of normal adult acetabulum anterior column section through digital three-dimensional reconstruction and measurement. METHODS: Totally 30 normal adults (half male and half female) received pelvic CT scans, and data were obtained. Using Materialise Mimics Innovation Suite 16.0 software, the boundary of the pelvis was used as reference line for sectioning. The obturator groove, iliopubic eminence, anterior inferior iliac spine, and the anterior superior iliac spine were used as a reference mark. In 15 males and 15 females (30 sides), the corresponding boundary line from obturator groove to the anterior superior iliac spine of acetabular anterior column was sliced into 5 mm-thick sections. The tangent line was vertical to the boundary line. The tangent plane was vertical to the upper plane of the anterior column. The angle and length of each section 5, 10, 15 mm points from the boundary line to the acetabulum, and the perpendicular distance from anterior and posterior edges of the acetabulum to anterior inferior iliac spine, iliopubic eminence and the pubic tubercle. RESULTS AND CONCLUSION: (1) Acetabular anterior column from the obturator groove to the anterior superior iliac spine section was not significantly different (P > 0.05). (2) No matter in males or females, the tangent angle of the fifth layer section was minimum, and the tangent length of the sixth layer section was longest. The length and angle of the second slice at 5 mm point were not significantly different between males and females. However, above indexes in others were significantly larger in females than in males (P < 0.05). (3) Results indicated that in different fracture ranges and different fixation plate positions, the angle and length of pedicle screws are dynamic, so we only selected in accordance with above range, but cannot fix in a certain value. The design of the most accurate and effective placement angle and length should be aimed at nailing design parameters for each individual patient. The use of Mimics software can be used for three-dimensional reconstruction of CT data of adult acetabular anterior column fracture, and can measure the number of indexes, and provide a theoretical reference for the clinical diagnosis and treatment of acetabular anterior column fracture.

Influence of metoprolol combined Wenxin granule on vascular endothelial function and levels of MCF-6 and PGI2 in patients with chronic heart failure / 心血管康复医学杂志

Objective: To observe influence of metoprolol combined Wenxin granule on vascular endothelial function, plasma levels of mitochondrial coupling factor-6 (MCF-6) and prostaglandin I2 (PGI2) in patients with chronic heart failure (CHF). Methods: A total of 164 CHF patients treated in our hospital were selected. They were randomly and equally divided into metoprolol group and combined treatment group (received metoprolol combined Wenxin granule treatment), both groups were treated for 10 weeks. Cardiac function, vascular endothelial function and levels of MCF-6 and PGI2 were measured and compared between two groups before and after treatment. Results: Compared with before treatment, after treatment, there were significant improvement in cardiac function and vascular endothelial function, significant reduction in MCF-6 level and significant rise in PGI2 level in two groups, P=0. 001 all; compared with metoprolol group, there were significant reductions in heart rate [(74. 6±3. 5) beats/ min vs. (67. 5±3. 2) beats/min], left ventricular end-diastolic dimension [(55. 3±5. 1) mm vs. (51. 3± 4. 2) mm], levels of resistin [(29. 5±2. 7) μg/L vs. (23. 3±1. 9) μg/L], endothelin 1 [(71. 0±6. 2) mg/L vs. (56. 7± 5. 3) mg/L]and MCF-6 [(305. 0±27. 7) pg/ml vs. (265. 8±25. 3) pg/ml], and significant rise in left ventricular ejection fraction [(46. 6±4. 4) ％ vs. (50. 7±5. 1) ％], levels of calcitonin gene related peptide [(42. 2±3. 6) mg/ L vs. (51. 4±6. 3) mg/L], nitric oxide [(73. 3±6. 9) mg/L vs. (89. 4±7. 6) mg/L]and PGI2 [(20. 6±3. 5) pg/ ml vs. (24. 3±3. 6) pg/ml]in combined treatment group, P=0. 001 all. Conclusion: Metoprolol combined Wenxin granule can significantly improve cardiac function and vascular endothelial function, inhibit release of plasma mitochondrial coupling factor-6 and increase prostaglandin level in patients with chronic heart failure.

Influence of L-carnitine combined coenzyme Q10 on hsCRP,cTnI and BNP levels in patients with chro-nic heart failure / 心血管康复医学杂志

Objective:To explore influence of L-carnitine combined coenzyme Q10 on levels of high sensitive C reac-tive protein(hsCRP),cardiac troponin I(cTnI)and brain natriuretic peptide(BNP)in patients with chronic heart failure(CHF).Methods:A total of 100 CHF patients were randomly and equally divided into routine treatment group(received metoprolol tartrate + losartan + spironolactone treatment)and combined treatment group(re-ceived L-carnitine + coenzyme Q10 based on routine treatment),and both groups were treated for four weeks. Levels of hsCRP,cTnI and BNP and heart function were compared between two groups before and after treatment. Results:Total effective rate of combined treatment group was significantly higher than that of routine treatment group(94.0% vs.70.0%,P=0.002).Compared with before treatment,there were significant reductions in levels of hsCRP,cTnI and BNP and left ventricular end-diastolic dimension(LVEDd),and significant rise in left ventricu-lar fractional shortening(LVFS)and left ventricular ejection fraction(LVEF)after treatment in two groups,P<0.01 all;compared with routine treatment group after treatment,there were significant reductions in levels of hsCRP[(3.44 ± 0.15)mg/L vs.(2.82 ± 0.31)mg/L],cTnI[(0.25 ± 0.03)μg/L vs.(0.17 ± 0.01)μg/L],BNP [(259 ± 34)ng/L vs.(215 ± 37)ng/L]and LVEDd[(57.9 ± 10.1)mm vs.(47.4 ± 9.2)mm],and significant rise in LVFS[(29.1 ± 4.7)% vs.(32.9 ± 8.9)%]and LVEF[(60.1 ± 9.7)% vs.(65.8 ± 4.9)%]in combined treat-ment group after treatment,P<0.05 or <0.01. Second hospitalization rate within one year of combined treatment group was significantly lower than that of routine treatment group(4.7% vs.18.6%), P=0.044.Conclusion:L-carnitine combined coenzyme Q10 can significantly reduce levels of hsCRP,cTnI and BNP,improve heart function with definite therapeutic effect and it can improve prognosis in CHD patients.

Protective Effect and Mechanism of Every-other-day Fasting on Rats with Spinal Cord Injury / 中国康复理论与实践

Objective To observe the effect of every-other-day fasting(EODF)on pathology and functional recovery of rats with spinal cord clip-compression injury,and to explore the related mechanism. Methods A total of 36 Sprague-Dawley rats were randomly assigned to groups A(sham operation),B(sham operation and EODF),C(spinal cord injury)and D(spinal cord injury and EODF)with nine rats in each group.The spinal cord injury rat model in T10was established by using medical aneurysm clip in latter two groups.The motor func-tion was assessed by Basso-Beattie-Bresnahan(BBB)score one day before and one day,two,four,six,eight,ten, twelve weeks after operation;and toluidine blue staining was performed for pathological observation at twelve weeks after operation.Another 180 Sprague-Dawley rats were randomly assigned in same way.The level of tu-mor necrosis factor-α(TNF-α)and interleukin-10(IL-10)were detected with ELISA six hours,twelve hours,one day,three days and seven days after operation. Results The BBB score reached lowest on the first day in groups C and D(P<0.05),and gradually increased with time,and were higher in group D than in group C eight weeks,ten weeks and twelve weeks after operation(P<0.05). The pathology in spinal cord was less in group D than in group C.Compared with group A,the level of serum TNF-α increased twelve hours after operation(P<0.05),peaked one day after operation,and returned back seven days after operation;the level of serum IL-10 increased at each time point after operation(P<0.05).Compared with group C,the level of serum TNF-α was lower in group D one day after operation(P<0.05);the level of se-rum IL-10 was not significantly different at each time point after operation(P>0.05). Conclusion Long-term EODF can promote the hind limb motor recovery in rats with spinal cord clip-compression inju-ry,and alleviate pathological damage.EODF might inhibit acute inflammatory reaction at acute stage of spinal cord injury,which may be correlated with its neuroprotective effect.

A "Triple Trouble" Case of Facioscapulohumeral Muscular Dystrophy Accompanied by Peripheral Neuropathy and Myoclonic Epilepsy / 中华医学杂志(英文版)

<p><b>Background</b>Facioscapulohumeral muscular dystrophy (FSHD) is characterized by asymmetric muscular deficit of facial, shoulder-girdle muscles, and descending to lower limb muscles, but it exists in several extramuscular manifestations or overlapping syndromes. Herein, we report a "complex disease plus" patient with FSHD1, accompanied by peripheral neuropathy and myoclonic epilepsy.</p><p><b>Methods</b>Standard clinical assessments, particular auxiliary examination, histological analysis, and molecular analysis were performed through the new Comprehensive Clinical Evaluation Form, pulsed-field gel electrophoresis-based Southern blot, Multiplex Ligation-dependent Probe Amplification (MLPA), whole exome sequencing (WES), and targeted methylation sequencing.</p><p><b>Results</b>The patient presented with mild facial weakness, humeral poly-hill sign, scapular winging, peroneal weakness, drop foot, pes cavus, and myoclonic epilepsy. Furthermore, electrophysiology revealed severely demyelinated and axonal injury. The muscle and nerve biopsy revealed broadly fiber Type II grouping atrophy and myelinated nerve fibers that significantly decreased with thin myelinated fibers and onion bulbs changes. Generalized sharp and sharp-slow wave complexes on electroencephalography support the diagnosis toward myoclonic epilepsy. In addition, molecular testing demonstrated a co-segregated 20-kb 4q35-EcoRI fragment and permissive allele A, which corresponded with D4Z4 hypomethylation status in the family. Both the patient's mother and brother only presented the typical FSHD but lacked overlapping syndromes. However, no mutations for hereditary peripheral neuropathy and myoclonic epilepsy were discovered by MLPA and WES.</p><p><b>Conclusions</b>The present study described a "tripe trouble" with FSHD, peripheral neuropathy, and myoclonic epilepsy, adding the spectrum of overlapping syndromes and contributing to the credible diagnosis of atypical phenotype. It would provide a direct clue on medical care and genetic counseling.</p>

Coiling method combined with bloodletting from the corpus cavernosum for penile incarceration with a metal ring: A case report and literature review / 中华男科学杂志

Objective@#To explore the treatment of penile incarceration with a metal ring.@*METHODS@#Based on our experience in the successful management of a case of penile incarceration with a metal ring by coiling and bloodletting from the corpus cavernosum, we reviewed the relevant literature and analyzed the indications, advantages and disadvantages of different methods for the treatment of penile incarceration with a circular foreign body.@*RESULTS@#The clamping and cutting methods were non-invasive, fast, effective, and with few complications, which could be applied to the treatment of penile strangulation at all levels. However, clamping was not desirable enough for a hard metal ring and the cutting method took a longer time and might increase the risk of unnecessary damage to the penile skin, urethra and cavernous body. Prepuce edema decompression and the thin tube-coiling method, with the advantages of minimal invasiveness, simple operation and no need of special tools, were suitable for penile strangulation injury under level 3, but might cause penile skin injury and potential postoperative erectile dysfunction. Surgical resection, as an invasive procedure, could be applied to severe penile strangulation at level 4 or 5.@*CONCLUSIONS@#The principle for the treatment of penile incarceration with a circular foreign body is to remove the foreign object as soon as possible and not to add secondary damage.

Morphological, microscopic, multiple-component assay and fingerprinting based systematic research on quality evaluation of Moutan Cortex(Paeonia suffruticosa) / 中国中药杂志

The purpose of this study was to combine morphological, microscopic, UHPLC multiple-component assay and fingerprinting studies in order to evaluate the quality of Moutan Cortex (MC) systematically. The root system of Paeonia suffruticosa was measured to compare the morphological variation and the chemical composition of different grades of MC was discussed according to previous studies. The difference between the main microscopic features of MC powder and the xylem powder is dramatic, the MC powder contains great amount of starch granules and clusters of calcium oxalate, while the xylem powder displays considerable vessels. Interestingly, the growth rings of P. suffruticosa was first reported in the xylem of the root transection, this can help to determine the growth years of the plant. Moreover, through the assay of 16 component, MC produced in Tongling and Bozhou in Anhui province were compared, content of PGG in MC produced in Bozhou was significantly higher than MC produced in Tongling (<0.01). MC with different growth years, MC with xylem and unprocessed MC and MC decoction pieces were compared respectively by combining the results of 16 compounds assay and fingerprinting. It is proposed that the quality evaluation standard include the assay of paeoniflorin. Above all, the holistic quality difference can be evaluated more comprehensively by combining multiple analytical methods.

Research on Quality Markers of Moutan Cortex: Quality Evaluation and Quality Standards of Moutan Cortex / 中草药·英文版

Objective To identify the quality markers of Moutan Cortex (MC) and establish the quality evaluation methods for multi-component assay and fingerprinting of MC. Methods The chemical constituents in MC were identified by HPLC-QTOF-MS. UPLC was employed for the multi-component assay and fingerprinting of MC. Furthermore, text mining was carried out to review the biosynthesis pathways and pharmacological and pharmacokinetic studies related to MC, and in silico target fishing was conducted to construct compound-target networks for MC. Results Sixteen compounds were clearly identified in MC and their structures were confirmed through comparison with literature data. In addition, the biosynthetic pathways and component specificities of the identified compounds were summarized and confirmed by text mining. Pharmacological activities, including traditional usage and modern pharmacological studies were summarized. A total of 282 targets from Homo sapiens were fished for 13 compounds. In addition, pharmacokinetic studies of different compounds were synopsized. Finally, multi-component assay and fingerprint of MC were established. Conclusion Eight major components are selected as quality markers of MC, such as oxypaeoniflorin, apiopaeonoside, albiflorin, paeonolide, paeoniflorin, 1,2,3,4,6-penta-O-galloyl-β-D-glucose, mudanpioside C and paeonol. These eight quality markers are successfully applied to the quality evaluation of MC, and could be useful in improving the current quality standards of MC.