Landmark vessel in membrane anatomy-based colorectal surgery / 中华胃肠外科杂志

The theory of membrane anatomy has been widely used in the field of colorectal surgery. The key point to perform high quality total mesorectal excision (TME) and complete mesocolic excision (CME) is to identify the correct anatomical plane. Intraoperative identification of the various fasciae and fascial spaces is the key to accessing the correct surgical plane and surgical success. The landmark vessels refer to the small vessels that originate from the original peritoneum on the surface of the abdominal viscera during embryonic development and are produced by the fusion of the fascial space. From the point of view of embryonic development, the abdominopelvic fascial structure is a continuous unit, and the landmark vessels on its surface do not change morphologically with the fusion of fasciae and have a specific pattern. Drawing on previous literature and clinical surgical observations, we believe that tiny vessels could be used to identify various fused fasciae and anatomical planes. This is a specific example of membrane anatomical surgery.

Comparison of cannulated screwing versus plating in combination with interlocking intramedullary nailing for ipsilateral discontinuous fractures of tibial shaft and plateau / 中华创伤骨科杂志

Objective:To compare the clinical effects between cannulated screwing and plating in combination with interlocking intramedullary nailing for the treatment of ipsilateral discontinuous fractures of the tibial shaft and plateau.Methods:A retrospective analysis was performed of the clinical data of 34 patients who had been treated for ipsilateral discontinuous fractures of the tibial shaft and plateau at Department of Orthopedics and Trauma, Honghui Hospital Affiliated to Xi′an Jiaotong University from January 2015 to January 2020. There were 17 males and 17 females, aged from 26 to 60 years (average, of 43.6 years). The left side was affected in 18 cases and the right side in 16. The patients were divided into 2 groups according to their internal fixation methods: a cannulated screw group of 16 cases treated with cannulated screwing and intramedullary nailing and a plate group of 18 cases treated with plating and intramedullary nailing. The 2 groups were compared in terms of operation time, intraoperative blood loss, incision length, tibial plateau collapse, consumables cost, hospital stay, fracture healing time, weight-bearing time, range of knee motion, reduction of tibial plateau fracture by Rasmussen radiology, Lysholm knee function score at the last follow-up and complications.Results:There was no significant difference in the preoperative general data between the 2 groups, showing the 2 groups were comparable ( P>0.05). All the 34 patients were followed up for 12 to 28 months (average, 17.4 months). There was no significant difference either in operation time, hospital stay, tibial plateau healing time, tibial fracture healing time, weight-bearing time or range of knee motion between the 2 groups ( P>0.05). In the cannulated screw group, the intraoperative blood loss [(89.4 ± 14.5) mL] and consumables cost [(2.0 ± 0.2) ten thousand yuan] were significantly less than those in the plate group [(120.8 ± 22.1) mL and (2.6 ± 0.4) ten thousand yuan], the incision length [(4.1 ± 0.8) cm] was significantly shorter than that in the plate group [(7.1 ± 0.9) cm], and the Lysholm knee function score at the last follow-up [(89.8 ± 4.5) points] was significantly lower than that in the plate group [(93.0 ± 4.2 points] (all P<0.05). The difference was statistically significant between the 2 groups in the quality of tibial plateau reduction ( P<0.05). The postoperative tibial plateau collapse in the plate group [0.5 (0, 2) mm] was insignificantly less than that in the cannulated screw group [1.0 (0, 2) mm] ( P>0.05). In the cannulated screw group, one tibial shaft fracture did not achieve union after operation and deep vein thrombosis occurred in 2 cases after operation; in the plate group, 2 cases suffered from delayed wound healing, one from delayed fracture healing, one from deep venous thrombosis of lower extremity, and one from knee discomfort which was relieved after removal of internal fixation. Conclusions:In the treatment of ipsilateral discontinuous fractures of tibial shaft and plateau, both cannulated screwing and plating in combination with interlocking intramedullary nailing can achieve good clinical effects. Although plating in combination with intramedullary nailing lead to more severe trauma and higher costs, it is conducive to improving the reduction quality of the tibial plateau and postoperative functional recovery of the knee joint.

Efficacy comparison of femoral neck dynamic system and cannulated screw fixation in the treatment of femoral neck fracture in the young and middle-aged patients / 中华创伤杂志

Objective:To compare the clinical efficacy of femoral neck system (FNS) and cannulated screw fixation in the treatment of femoral neck fracture in the young and middle-aged patients.Methods:A retrospective cohort study was conducted to analyze the clinical data of 76 young and middle-aged patients with femoral neck fracture admitted to Honghui Hospital Affiliated to Xi′an Jiaotong University from March 2018 to September 2020, including 45 males and 31 females, aged 23-63 years [(49.5±8.2)years]. Garden classification of the fracture was 25 patients with type II, 34 with type III and 17 with type IV. Pauwels classification of the fracture was 16 patients with type I, 31 with type II and 29 with type III. A total of 40 patients were treated with cannulated screw fixation (cannulated screw group) and 36 patients with FNS fixation (FNS group). Operation time, frequency of fluoroscopy, length of hospital stay, weight-bearing time and bone union time were compared between the two groups. Hip function was assessed by Harris hip score at 6, 12 months after operation. The incidence of postoperative complications was observed.Results:All patients were followed up for 12-20 months [(15.2±1.7)months]. The frequency of fluoroscopy [(13.4±1.9)times], weight-bearing time [(11.1±1.9)weeks] and bone union time [(13.8±1.6)weeks] in FNS group were lower or shorter than those in cannulated screw group [(18.2±2.6)times, (15.7±1.6)weeks, (14.6±1.6)weeks] (all P<0.05 or 0.01). There were no significant differences in operation time, length of hospital stay and Harris hip score at 6, 12 months after operation between the two groups (all P>0.05). No postoperative infection occurred in both groups. In cannulated screw group, there were 4 patients with femoral neck shortening, 3 with deep venous thrombosis, 2 with internal fixation loosening, 2 with nail withdrawal and 1 with fracture non-union, showing the incidence of complications of 30% (12/40). In FNS group, there was 2 patients with femoral neck shortening, 1 with deep vein thrombosis and 1 with internal fixation loosening, showing the incidence of complications of 11% (4/36) ( P<0.05). Conclusion:For femoral neck fracture in the young and middle-aged patients, both FNS and cannulated screw fixation can obtain satisfactory efficacy, but FNS has the advantages of decreased frequency of intraoperative fluoroscopy, early weight bearing, reduced time to bone union and low incidence of complications.

Reason for failed fixation with dynamic hip screws for intertrochanteric fracture: analysis based on the lever-balance-reconstruction theory / 中华创伤骨科杂志

Objective:To study the reason for failed fixation with dynamic hip screws (DHS) and the indications for DHS fixation in the treatment of intertrochanteric fracture based on the lever-balance-reconstruction theory.Methods:A retrospective analysis was performed of the data of 32 patients with intertrochanteric fracture who had been treated by DHS fixation at Department of Orthopaedic Trauma, Peking University People's Hospital from January 1999 to December 2019. There were 22 males and 10 females, aged from 34 to 91 years (average, 67.7 years). By the AO classification, 15 fractures were type 31-A1, 13 ones type 31-A2, and 4 ones type 31-A3. According to the lever-balance-reconstruction theory, after the position of postoperative fulcrum was determined depending on the relationship between fracture line and internal fixation, the medial and lateral force arms were measured after internal fixation. The 32 patients were divided into 2 groups according to the position of fulcrum after internal fixation. In group A of 13 patients, the fulcrum was located in or within the center of the medullary cavity; in group B of 19 patients, the fulcrum was located outside the center of the medullary cavity. The incidence of internal fixation failure was compared between the 2 groups.Results:Internal fixation failure occurred in 15 of the 32 patients: cutting out of the head and neck screws without penetration in 2 cases, screw withdrawal in 8 cases, hip varus deformity in 10 cases, and femoral neck shortening in 15 cases. The 2 groups were comparable because there were no statistically significant differences in their preoperative general data or types of internal fixation between them except AO classification ( P>0.05). The length of medial force arm (power arm) averaged 51.12 mm (from 39.4 to 57.9 mm) and the length of lateral force arm (resistance arm) 23.37 mm (from 15.1 to 31.0 mm) in group A where 3 patients experienced internal fixation failure after operation; the length of medial force arm (power arm) averaged 63.71 mm (from 52.3 to 74.5 mm) and the length of lateral force arm (resistance arm) 9.94 mm (from 3.1 to 18.3 mm) in group B where 12 patients experienced internal fixation failure after operation. There was a significant difference between the 2 groups in internal fixation failure ( P=0.036). Conclusions:In the DHS fixation of intertrochanteric fracture, the postoperative fixation failure is associated with the fulcrum position after reconstruction. DHS is only indicated for intertrochanteric fractures whose fracture line (post-reconstruction fulcrum) is near and inside the center of the medullary cavity, but not for those whose fracture line (post-reconstruction fulcrum) is outside the medullary cavity.

Finite element analysis of biomechanical properties of bionic surface hip prosthesis / 中华骨科杂志

Objective:To compare the biomechanical properties of traditional surface hip prosthesis and bionic surface hip prosthesis.Methods:The Sawbone digital model (#3908, Left, Medium) was selected as the research object. Mimics 21.0 software was used to reconstruct the physical model of femur. Solidworks 16.0 software was used to build the model of prostheses, including the traditional and bionic (type 1-4) protheses and their assembly. The distances from the screw cross position to the top of pressure screw of type 1 to type 4 protheses were 20.22 mm, 30.12 mm, 32.17 mm and 37.76 mm, respectively. The mechanical distribution characteristics of the whole model were measured and the stress distribution cloud map was obtained.Results:The peak stresses at bone-stem junction of traditional prosthesis and type 1-4 hip prostheses were 32.18 MPa, 13.80 MPa, 15.01 MPa, 23.46 MPa and 34.51 MPa, respectively. With the fulcrums away from the top of the femur, the peak stresses at the fulcrums of type 1-4 hip protheses were 37.98 MPa, 48.60 MPa, 54.80 MPa, and 53.87 MPa, respectively. The maximum stress above femoral neck of traditional prosthesis and type 1-4 hip prostheses were 8.00 MPa, 7.80 MPa, 7.04 MPa, 7.03 MPa and 7.51 MPa, respectively. The maximum stresses under femoral neck was 15.38 MPa, 14.20 MPa, 11.11 MPa, 13.10 MPa and 12.18 MPa, respectively. The maximum stresses in the greater trochanter region of femur were 13.08 MPa, 11.61 MPa, 13.09 MPa, 11.02 MPa and 39.51 MPa, respectively.Conclusion:Compared with the traditional surface hip prosthesis, the type I bionic surface hip prosthesis is designed based on the lever balance reconstruction theory. With the bionic reconstruction of the tension trabeculae and compression trabeculae through reasonable screw placement angles and the inward movement of the fulcrum closer to the center of the femoral head, the new type prothesis make up for the design defects of the traditional surface hip prosthesis, optimize the stress distribution in the proximal femur, and improve the stability of the prosthesis after replacement, which help reduce the risk of femoral neck fracture and prosthesis loosening, and extend the service life of the prosthesis.

Efficacy comparison of proximal femoral nail antirotation with metaphyseal expansion and non-expansion in the treatment of severe osteoporotic intertrochanteric fracture in the elderly / 中华创伤杂志

Objective:To compare the efficacy of metaphyseal expansion and non-expansion when using proximal femoral nail antirotation（PFNA）in the treatment of severe osteoporotic intertrochanteric fracture in the elderly.Methods:A retrospective case-control study was conducted to analyze the clinical data of 66 elderly patients with severe osteoporotic intertrochanteric fracture admitted to Honghui Hospital, Xi'an Jiaotong University from January 2019 to January 2020, including 49 males and 17 females. The age ranged from 75 to 89 years［（80.9±3.3）years］. The AO types of fractures were 31-A1 in 23 patients, 31-A2 in 22 and 31-A3 in 21. A total of 34 patients were stabilized by the PFNA technique with metaphyseal expansion（metaphyseal expansion group）and 32 patients received PFNA fixation without metaphyseal expansion（metaphyseal non-expansion group）. The total blood loss, hidden blood loss, intraoperative blood loss, dominant blood loss, postoperative drainage, transfusion volume, transfusion rate, operation time, hospital stay and fracture healing time were compared between the two groups. The hip functional recovery was assessed by Harris hip score at 1, 3, 6 months postoperatively and at the last follow-up. The incidence of complications was observed.Results:All patients were followed up for 12-17 months［（13.5±1.1）months］. The total blood loss, hidden blood loss, intraoperative blood loss, dominant blood loss, postoperative drainage in metaphyseal expansion group were（976.3±210.1）ml,（712.4±224.4）ml,（139.4±21.0）ml,（263.8±36.3）ml,（124.4±29.5）ml respectively, significantly higher than those in metaphyseal non-expansion group［（799.0±119.5）ml,（603.0±136.4）ml,（94.1±18.8）ml,（195.9±35.4）ml,（101.9±27.5）ml］（ P<0.05）. The transfusion volume［2（0, 2）U］and transfusion rate［53%（18/34）］in metaphyseal expansion group ware increased compared to metaphyseal non-expansion group［0（0, 1.5）U, 25%（8/32）］（ P<0.05）. There were no significant differences in operation time, hospital stay, fracture healing time or hip Harris score at 1, 3, 6 months after surgery and the last follow-up between the two groups（ P>0.05）. No wedge-shaped distraction deformity, fracture nonunion, femoral head necrosis, wound infection, pulmonary embolism or fat embolism occurred in both groups. There was no significant difference in the incidence of iatrogenic lateral wall fracture, lower limb venous thrombosis or postoperative medical complications between the two groups（ P>0.05）. Conclusion:For elderly patients with severe osteoporotic intertrochanteric fracture, both PFNA with metaphyseal expansion and non-expansion can achieve satisfactory results, while the metaphyseal non-expansion is superior in perioperative blood loss and transfusion rate.

Efficacy evaluation of combined anterior and posterior elbow approach and posterior median elbow approach for treatment of O'Driscoll type III b fracture of ulnar coronoid process / 中华创伤杂志

Objective:To compare the clinical effect of combined anterior and posterior approach and posterior median approach to treat O'Driscoll type III b fracture of ulnar coronoid process.Methods:A retrospective case control study was made on 67 patients with O'Driscoll type III b fracture of ulnar coronoid process treated in Honghui Hospital, Xi'an Jiaotong University from January 2015 to January 2019, including 35 males and 32 females, aged from 21 to 61 years [(38.0±9.4)years]. Among them, 31 patients were treated with combined anterior and posterior approach for reduction and internal fixation (combined approach group), and 36 patients with median posterior elbow approach group for reduction and internal fixation (posterior elbow approach group). The operation time, amount of intraoperative blood loss and fracture healing time were compared between groups. The visual analogue score (VAS), elbow joint range of motion and Mayo elbow performance score (MEPS) were assessed for pain and function evaluation at postoperative 1, 3, 6 months and at the last follow-up. The occurrence of complications were observed as well.Results:All patients were followed up for 12 to 28 months [(20.1±4.2)months]. There was no significant difference in operation time and VAS between the two groups ( P>0.05). The intraoperative blood loss [(133.6±20.3)ml] and fracture healing time [(12.3±1.7)months] in combined approach group were less or shorter than those in posterior elbow approach group [(144.4±22.1)ml, (13.2±2.0)months] ( P<0.05). The range of flexion and extension of elbow joint in combined approach group [(88.7±10.8)°, (111.1±13.9)°, (121.3±14.1)°, (127.1±13.3)°] was higher than that in posterior elbow approach group [(74.5±11.8)°, (97.6±12.6)°, (111.3±13.0)°, (115.2±12.7)°] at postoperative 1, 3, 6 months and at the last follow-up ( P<0.05). The MEPS in combined approach group [(31.7±8.6)points, (55.6±9.3)points, (84.6±10.5)points, (85.0±10.3)points] was higher than that in posterior elbow approach group [(27.2±8.2)points, (50.7±8.7)points, (77.4±11.2)points, (80.1±9.4)points] at postoperative 1, 3, 6 months and last follow-up ( P<0.05). The incidence of complications in combined approach group [10%(3/31)] was lower than that in posterior elbow approach group [31%(11/36)]( P<0.05). Conclusion:Compared with the simple posterior elbow median approach, the combined anterior and posterior elbow approach for treatment of O'Driscoll type IIIb fracture of ulnar coronoid process has lower intraoperative blood loss, faster fracture healing, lower incidence of complications and better elbow function.

Potassium iodide promotes the pyroptosis of thyroid follicular epithelial cells through the PARP1-NF-κB-NLRP3 inflammasome activation / 中华内分泌代谢杂志

Objective:To explore the mechanism of potassium iodide-induced pyrolysis of thyroid follicular cells.Methods:Thyroid gland tissue was obtained from patients with thyroid cancer (TC) coexisting with Hashimoto′s thyroiditis, and the tumor-adjacent Hashimoto′s thyroiditis tissue was used as the control. ELISA was used to detect the concentration of the pyroptosis inflammatory cytokines interleukin (IL)-1β and IL-18 in the tissues, and Western blotting was used to detect the activation of gasdermin (GSDM) proteins, a biomarker for pyroptosis. Thyroid follicular cells treated with different concentrations of potassium iodide, and IL-1β, IL-18, lactate dehydrogenase (LDH), GSDMD were measured. Transcriptome chip analysis was used to explore the differentially expressed genes involved in pyroptosis of thyroid follicular cells induced by potassium iodide treatment.Results:The levels of IL-1β and IL-18 cytokines in the tissues of patients with Hashimoto′s thyroiditis and thyroid cancer were higher than control tissues ( P<0.01), and the activation of the pyroptosis executive protein GSDMD was significant increased, while GSDME was not activated. IL-1β, IL-18, and LDH secretion were significantly increased in response to potassium iodide stimulation in thyroid follicular cells ( P<0.01) and GSDMD was cleaved, which indicated that potassium iodide induced the pyroptosis of thyroid follicular cells. Moreover, potassium iodide could activate NLRP3 inflammasomes to promotethe pyroptosis of thyroid follicular cells. Transcriptome chip analysis further found that PARP1 protein was highly upregulated by the stimulation of potassium iodide, and then enhanced the activity of nuclear factor-κB (NF-κB) transcription factor to induce pyroptosis. Conclusions:The findings in this study reveal that potassium iodide promotesthe pyroptosis of thyroid follicular cells through activating NF-κB-NLRP3 inflammasome, which may be a novel mechanism that promots the development of Hashimoto′s thyroiditis under the condition of excessive iodine intake. PARP1 is a pivotal protein that mediates the pyroptosis induced by potassium iodide and may be a potential therapeutic target to control Hashimoto′s thyroiditis progression.

Advances in surgical treatment and research of fracture of coronal process of ulna / 国际外科学杂志

The coronal process of ulna is an important stable structure in front of the elbow joint, which is composed of the tip of the coronal process, towering tubercle and anterior medial face. The fracture of the coronal process is often accompanied by the fracture and dislocation of the elbow joint, which leads to the instability of the elbow joint. The coronoid process has the advantages of small size, special shape, complex surrounding soft tissue structure, and plays an important role in the stability of the elbow joint. The selection of safe, minimally invasive and well exposed surgical approach is a necessary condition for safe and effective internal fixation. The choice of surgical approach must comprehensively consider the concomitant injury and choose the best surgical approach. This article mainly describes the normal anatomical structure of the coronal process and around the elbow joint, analyzes the biomechanics and stability of the coronal process in the elbow joint, and reviews the latest progress in surgical treatment.

Application of intramedullary nail in tibial fracture / 国际外科学杂志

Tibial fracture is a kind of common long bone fracture of extremities, most of which are complex tibial fractures caused by high energy. Because of the special anatomical structure of tibia, the incidence of postoperative complications such as malunion and nonunion is higher. This brings some difficulties to the treatment. With the patient′s higher requirements for function, doctors have a deeper understanding of biomechanics, which promotes the further development of internal fixation materials. The indications of intramedullary nails have been expanded and gradually replaced the steel plate internal fixation for the treatment of tibial fractures and achieved good therapeutic effect. This article focuses on the application and new development of intramedullary nail in the treatment of proximal, middle, distal and open tibial fractures, providing more reference for the future clinical treatment.

Plant Identification of Different Growth Forms of Justicia procumbens and Comparison of Their Chemical Components Content / 中国实验方剂学杂志

Objective: To identify two different growth types vertical growth (V-class) and lateral growth (L-class)) of Justicia procumbens, and compare the contents of chemical compounds between upper part and different organs. Method: DNA was extracted from the leaves of two growth forms of J. procumbens. Internal transcriptional spacer 2 (ITS2) and psbA-trnH sequences were obtained by polymerase chain reaction (PCR) amplification and bidirectional sequencing. High performance liquid chromatography (HPLC) was used to determine the contents of justicidin B (JB) and chinensinaphthol methyl ether (CME) from the above-ground parts of V-class and L-class J. procumbens and their inflorescence,leaves,and stems. Independent sample T-test and Paired-sample T-test were used to compare the contents of JB and CME from two different growth forms of J. procumbens and their different organs. Result: The DNA sequences after shearing were shown to be identical between the V-class and L-class samples. Independent sample T-test showed no difference on the content of JB between the above-ground parts of V-class and L-class samples,but the content of CME was higher in V-class J. procumbens than L-class (PT-test showed that the content of JB and CME were different in the inflorescence,leaves,and stems of J. procumbens (PJ. procumbens was higher than that in L-class. Conclusion: DNA barcoding and comparison of JB and CME content indicated that the two different growth forms of J. procumbens belong to the same species. The contents of CME were different in J. procumbens between different growth forms,and was higher in V-class. Meanwhile,due to the little content of JB and CME in stems,the best picking time of J. procumbens is the flowering and fruiting period with more inflorescence and leaves.

The empirical study on the methodology of increasing the designated medical insurance drug-stores:Ideas,steps and effect forecasts / 中国卫生政策研究

Objective:Using an area in east of China as a case,the paper exploit the methodology to define and visualize the scope of the medical insurance pharmacy service through using ArcGIS and its function modules to analy-zing the basic data including this area's population distribution,address of drugstores,administrative districts,road network and soon.Plan A based on the 15-minute walk distance norm for defining the scopes, shows that this area need to increase 548 medical insurances designated drugstore,the effect of which was service area can be increased by 12.36%,service population can be increased by 10.82%, designated drugstore healthy competition rate can be increased by 8.36%;Plan B based on the 10-minute walk distance norm for defining the scopes, displays that this area need to increase 1197 medical insurance designated drugstore, the effect of which was service area can be in-creased by 15.23%,service population can be increased by 20.49%,designated drugstore healthy competition rate can be increased by 19%.

A layout planning methodology of increasing the designated medical insurance drugstores guided by fairness and efficiency / 中国卫生政策研究

Objective: This paper develops a methodology for steady and orderly expansion of the designated medical insurance drugstores. Methods:With the help of grid management ideology, the paper uses ArcGIS and its function modules to define and visualize the scope of the medical insurance drugs service with the guidance of fairness and efficiency through analyzing the basic data including population distribution, the physical distribution of drug-stores and soon. Results:In order to figure out the procedure of the methodology,the key problems were all solved, including defining and visualizing the scope of the medical insurance drugs service area,,checking and ratifying the scope that need to supplement or increase the medical insurance drugstores, making measures for the annual imple-mentation and confirming a selection principle for designated medical insurance drugstores. Conclusion:The Method-ology guided by fairness and efficiency of the medicare designated pharmacy layout planning is practical and feasible, which can probably provide a reference for increasing the designated medical insurance drugstores steadily and orderly.

Losses and gains of medical facilities induced by implementing the Essential Medicines System in a poverty-stricken county / 中国卫生政策研究

Objective:To analyze losses and gains (L&G) of basic medical institutions induced by the Essen-tial Medicines Policy.Methods: Choosing some poverty-stricken county in western China as sample area to conduct field research,using 2009 as baseline year,to calculate L&G and L&G ratio of basic medical institutions caused by adjustments of drug policy,medical services prices, and government subsidies from 2009—2015. Results: Medical facilities have gained after the implementation of the Essential Medicines Policy as a whole. Gains were on an upward trend from 2009—2015,and L&G ratio increased from -2.15% in 2009 to 47.70% in 2015. For medical facilities at different levels, their gains attributed to different causes. Gains for medical facilities at village and town levels mainly attributed to government subsidies;gains for medical facilities at county level mainly attributed to adjustment of medical services prices. Conclusions:Implementation of the Essential Medicines Policy has helped adjust composi-tion of losses and gains of medical facilities. Moving forward,functions and development of medical facilities should be strengthened with a focus on adjusting medical services prices for medical facilities at town level.

Inhibitory effect of pyridoxine hydrochloride combined with chemotherapeutics on mice hepatoma cell line H22 / 肿瘤研究与临床

Objective To observe the inhibitory effect of pyridoxine hydrochloride (PN) combined with common chemotherapeutics on mice hepatoma cells H22 in vitro. Methods MTT assay was used to determine the effects of PN in combination with 10 different antineoplastic agents on H22 cells, and immuno-histochemistry was used to observe the distribution of PN in H22 cells and morphologic changes of the cells before and after PN treatment. Results After 24 hours incubation with 5 mmol/L PN, the treated cells expanded apparently with nucleus chipping. PN entered the tumor cell and was mainly condensed in cytoplasma and H22 cells were sensitive to PN. When administered concomitantly with chemotherapic agents, most of the combinations showed antagonistic effects while a few of the combinations were additive. For instance, doxorubicin (ADM) used in combination with PN inhibited cell proliferation with an IR value (IR=0.63) much lower than ADM alone (IR=0.71, P0.9), and the IR value (IR=0.60) in combined group was higher than that (IR=0.40) in ICTX group (P<0.05). Conclusion PN treatment could increase the intracellular PLP level and result in growth inhibition and cell death, and combined administration of PN and ICTX might be a potential method to improve efficacy and to reduce toxic effects while a co-administration of PN and ADM should be avoided.

Quantitative analysis of coronary artery ostia anatomy using three-dimensional trans-esophageal echocardiography / 中华医学超声杂志（电子版）

Objective To quantitatively analyze the coronary artery ostia by three-dimensional trans-esophageal echocardiography (3D-TEE).Methods The full-volume images of aortic root and coronary artery ostia were acquired by 3D-TEE in 95 adult patients.The Philips QLab 3DQ measurement technology was employed to determine three mutually perpendicular planes:(1) The transverse plane cross the bottom of three coronary artery sinus.(2) The sagittal plane perpendicular to sino-tubular junction.(3) The coronal plane perpendicular to the aforementioned two planes .The following relevant parameters were measured and recorded:(1) Length, width, height and area of bilateral coronary artery ostia .(2) The angle between coronary arterial outflow tract and aortic root in sagittal plane .(3) The spatial distribution of coronary artery ostia, aortic root and coronary artert sinus .Results The shape of left coronary artery ostia were more regular (round or oval) than right coronary artery ostia ( teardrop-shape or oval ).Calcification was more frequent in right coronary artery ostia (81/95, 85.26%) than that in left coronary artery ostia. There were statistical differences between left and right coronary artery in the parameters of ostial wide , area and height (t =3.85, 3.86, -4.49, all P<0.01).Most left coronary artery ostia were located inside the sinus (76/95, 80.00%), mainly in the upper third segment (69/95, 72.63%); while more than half of the right coronary artery ostia were found outside the sinus ( 53/95, 55.79%).The difference was statistically significant( χ2 =25.91, P<0.01).Conclusion The quantitative analysis of aortic root and coronary artery ostia based on the full-volume images originated from real-time 3D-TEE is feasible, which is helpful for further clinical research .

The expression and significance of SDF-1/CXCR4 biological axis in laryngeal squamous cell carcinoma and lymph node metastasize / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the correlation between the stromal cell-derived factor (SDF-1) and the receptor fusin (CXCR4) in carcinoma of larynx, and investigate some mechanisms of SDF-1/CXCR4 during the development, invasion and lymph node metastasis of laryngocarcinoma.@*METHOD@#Detecting the expression of SDF-1 and CXCR4 by immunohistochemical method (SP) in laryngocarcinoma, paraneoplastic tissues, normal laryngeal mucosa and cervical lymph node. Using Kruskal-Wallis H test, chi2 test, Spearman rank correlation analysis and so on to do statistical analysis.@*RESULT@#The positive expression rate of SDF-1 and CXCR4 in laryngocarcinoma was obviously higher than in paraneoplastic tissues and normal laryngeal mucosa tissues (P < 0.01). And the expression of two proteins was correlated with lymph node metastasis (P < 0.01), clinical stage (P < 0.01) and pathological grading of tumor (P < 0.05). The positive expression rate of SDF-1 and CXCR4 protein in metastasis lymph node tissue was higher than that in non metastasis lymph node tissue (P < 0.01). The expression of SDF-1 is correlated positively with the expression of CXCR4 in laryngocarcinoma.@*CONCLUSION@#SDF-1 and CXCR4 protein are highly expressed in laryngocarcinoma and in metastasis lymph node tissue. And they are correlated with lymph node metastasis, clinical stage and pathological grading of the tumor. According to the results, the two proteins may relate to infiltration and metastasis of laryngeal squamous cell carcinoma and play a role of synergistic action in the development and invasion of carcinoma of larynx.

Protective effect of intermittent hypobaric hypoxia on cardiomyocytes injury induced by hydrogen peroxide / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To observe the protective effect and mechanism of intermittent hypobaric hypoxia (IHH) on cardiomyocytes induced by hydrogen dioxide.</p><p><b>METHODS</b>Male guinea pigs were divided randomly into two groups (n = 10): intermittent hypoxia group (IHH), and control group (non-IHH). The IHH guinea pigs were exposed to a simulated 5,000 m high altitude and hypoxia in hypobaric chamber for 28 d, 6 h/d. The control guinea pigs were kept in the same environment as IHH except hypoxia exposure. Cardiomyocytes were enzymatically isolated from left ventricle of non-CIHH or CIHH guinea pigs. The contractile was assessed in guinea pigs by a video-based motion edge-detection system. The contents and activities of malondialdehyde(MDA), lactate hydrogenase(LDH) and antioxidant enzymes were evaluated by using biochemical methods.</p><p><b>RESULTS</b>1. Hydrogen peroxide could induce contractile and diastole dysfunction, the latent period was longer in IHH cardiac myocytes. 2. After hydrogen peroxide(300 micromol/L, 10 min) perfusion, LDH and MDA contents in supernatant increased significantly in non-IHH and CIHH cardiomyocytes (P < 0.01), Whereas the contents of MDA and LDH in IHH cardiomyocytes were lower than those in non-IHH cardiomyocytes (P < 0.01). 3. The activities of superoxide dismutase (SOD) and catalase (CAT) were significantly increased in the myocardium of IHH guinea pigs, after hydrogen peroxide (300 micromol/L, 10 min) perfusion, SOD and CAT activities decreased significantly in non-IHH and CIHH cardiomyocytes (P < 0.01), whereas the activities of SOD and CAT in CIHH cardiomyocytes were still higher than those in non-IHH cardiomyocytes.</p><p><b>CONCLUSION</b>IHH had a protective effect on cardiomyocytes injury induced by hydrogen peroxide, which might relate with its antioxidation effects.</p>

Evaluation of Airway Obstruction at Soft Palate Level in Male Patients with Obstructive Sleep Apnea/Hypopnea Syndrome: Dynamic 3-Dimensional CT Imaging of Upper Airway / 华中科技大学学报（医学）（英德文版）

This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) by using dynamic 3-Dimensional (3-D) CT imaging.A total of 41 male patients who presented with 2 of the following symptoms,i.e.,daytime sleepiness and fatigue,frequent snoring,and apnea with witness,were diagnosed as having OSAHS.They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller's maneuver.The soft palate length (SPL),the minimal cross-sectional area of the retropalatal region (mXSA-RP),and the vertical distance from the hard palate to the upper posterior part of the hyoid (hhL) were compared between the two breathing states.These parameters,together with hard palate length (HPL),were also compared between mild/moderate and severe OSAHS groups.Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index (AHI) and the lowest saturation of blood oxygen (LSaO2)] was examined.The results showed that 31 patients had severe OSAHS,and 10 mild/moderate OSAHS.All the patients had airway obstruction at soft palate level.mXSA-RP was significantly decreased and SPL remarkably increased during Muller's maneuver as compared with the quiet breathing state.There were no significant differences in these airway parameters (except the position of the hyoid bone) between severe and mild/moderate OSAHS groups.And no significant correlation between these airway parameters and the severity of OSAHS was found.The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group.The patients in group with body mass index (BMI)≥26 had higher collapse ratio of mXSA-RP,greater neck circumference and smaller mXSA-RP in the Muller's maneuver than those in group with BMI＜26 (P＜0.05 for all).It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients.All the OSAHS patients had airway obstruction of various degrees at soft palate level.But no correlation was observed between the airway change at soft palate level and the severity of OSAHS.The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI＜26.

Low concentration of ouabain elevates intracellular free calcium in guinea pig ventricular myocytes: The possible signal transduction pathway / 第二军医大学学报

Objective: To study the effect of low concentration of ouabain MUM on intracellular calcium concentration ([Ca2+]i) in guinea pig ventricular myocytes and to understand whether low concentration of OUA can increase [Ca2+]i through Na+, K+-ATPase channel. Methods: The guinea pig ventricular myocytes were obtained by enzymatic digestion and the [Ca2+]i fluorescent density of individual myocytes was observed under confocal laser scanning microscope. The isolated ventricular myocytes were then incubated with different concentrations of ouabain(10-9, 10-8, 10-7, 10-6 mol · L-1). The sediment was subjected to Western blot analysis to assess the phosphorylation of Src by OUA. Results: In normal Tyrode' s solution and Ca2+-free Tyrode's solution, OUA (1 × 10-9 -1 × 10-6) mol · L-1 elevated [Ca2+]i in a concentration-dependent manner, with the elevation in normal Tyrode's solution more obvious (P < 0.05). Genistein (GST) (1, 10, 50, and 100 μmol - L-1) abolished the OUA-induced increases of [Ca2+]i in a concentration-dependent manner. There were two tyrosine-phosphorylated bands, with the molecular weights being 120 000 and 70 000. Compared with control group, the densities of the 2 bands in all OUA groups were significantly higher (P<0.05) and GST could obviously inhibit the elevating effect of OUA. Conclusion: Low concentration of OUA may promote opening of Ca2+ channel and release of intracellular Ca2+, and subsequently elevate intracellular free calcuim through phosphorylation of tyrosine and activition of OUA/Na+, k+-ATPase/Src signal transduction pathway.