Depression status of elderly patients with metabolic syndrome in three provinces of China / 中华流行病学杂志

Objective: To understand the depression status and its influencing factors in elderly patients with MS in China and to explore the correlation between various components of elderly MS and depression. Methods: This study is based on the "Prevention and Intervention of Key Diseases in Elderly" project. We used a multi-stage stratified cluster random sampling method to complete 16 199 elderly aged 60 years and above in 16 counties (districts) in Liaoning, Henan, and Guangdong Provinces in 2019, excluding 1 001 missing variables. Finally, 15 198 valid samples were included for analysis. The respondents' MS disease was obtained through questionnaires and physical examinations, and the respondents' depression status within the past half month was assessed using the PHQ-9 Depression Screening Scale. The correlation between elderly MS and its components and depression and its influencing factors were analyzed by logistic regression. Results: A total of 15 198 elderly aged 60 years and above were included in this study, with the prevalence of MS at 10.84% and the detection rate of depressive symptoms in MS patients at 25.49%. The detection rates of depressive symptoms in patients with 0, 1, 2, 3, and 4 MS abnormal group scores were 14.56%, 15.17%, 18.01%, 25.21%, and 26.65%, respectively. The number of abnormal components of MS was positively correlated with the detection rate of depressive symptoms, and the difference between groups was statistically significant (P<0.05). The risk of depression symptoms in patients with MS, overweight/obesity, hypertension, diabetes, and dyslipidemia was 1.73 times (OR=1.73, 95%CI:1.51-1.97), 1.13 times (OR=1.13, 95%CI:1.03-1.24), 1.25 times (OR=1.25, 95%CI:1.14-1.38), 1.41 times (OR=1.41, 95%CI:1.24-1.60), 1.81 times (OR=1.81,95%CI:1.61-2.04), respectively, more than those without the disease. Multivariate logistic regression analysis showed that the detection rate of depressive symptoms in patients with sleep disorders was higher than that with normal sleep (OR=4.89, 95%CI: 3.79-6.32). The detection rate of depressive symptoms in patients with cognitive dysfunction was 2.12 times higher than that in the average population (OR=2.12, 95%CI: 1.56-2.89). The detection rate of depressive symptoms in patients with impaired instrumental activities of daily living (IADL) was 2.31 times (OR=2.31, 95%CI: 1.64-3.26) higher than that in the average population. Tea drinking (OR=0.73, 95%CI: 0.54-0.98) and physical exercise (OR=0.67, 95%CI: 0.49-0.90) seemed to be protective factors for depression in elderly MS patients (P<0.05). Conclusions: Older patients with MS and its component abnormalities have a higher risk of depression than the average population. Sleep disorders, cognitive impairment, and IADL impairment are important influencing factors for depression in elderly MS patients, while tea drinking and physical exercise may help to reduce the risk of the disease.

Effect analysis of vertebroplasty combined with posterior decompression and internal fixation in the treatment of spinal metastases with neurological symptoms / 国际外科学杂志

Objective:To analyze the efficacy of vertebroplasty combined with posterior decompression and internal fixation in the treatment of spinal metastases with neurological symptoms.Methods:This study was a retrospective analysis of 32 cases with neurological symptoms caused by spinal metastatic tumor in the Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University from June 2016 to January 2022. All 32 patients (20 males, 12 females) aged between 39 to 85 years were enrolled in this study, with a mean age of (64.8±11.9) years. Surgery time, bleeding volume, modified Tokuhashi score, spinal instability neoplastic score (SINS) were collected. The visual analogue score (VAS), Oswestry disability index (ODI), Karnofsky performance scale (KPS) and American spinal cord injury association (ASIA) score before surgery, 1 month after surgery, 3 months after surgery and 6 months after surgery were collected and analyzed. Measurement data with normal distribution were represented as mean±standard deviation( ± s), and the comparison before and after surgery was conducted using repeated-measures analysis of variance test. Measurement data with skewed distribution were represented as M( Q1, Q3). Results:All 32 patients were followed up for 6 months. The operation time was (209.6±49.0) min, and the blood loss was (462.9±298.3) mL. 14 patients(43.8%) were treated with blood transfusion. The modified Tokuhashi score was 8.09±2.89, and the SINS was 8.81±1.97. The VAS score before surgery, postoperative 1, 3, 6 months were 7.47±0.98, 3.87±0.87, 2.91±0.73 and 2.34±0.60, respectively. ODI score before surgery, postoperative 1, 3, 6 months were 79.13±9.50, 39.14±6.31, 34.43±6.42 and 31.08±4.80, respectively. KPS score before surgery, postoperative 1, 3, 6 months were 49.69±14.70, 64.68±15.02, 71.88±12.81 and 75.63±10.76, respectively. The ASIA grading at 6 months follow-up was improved compared to preoperative baseline. Postoperative complications occurred in 4 cases, including nerve root injury (1 case), bone cement leakage in paravertebral soft tissue (1cases), bone cement leakage in paravertebral vein(1case) and acute thoracic epidural hematoma (1case).Conclusion:Vertebroplasty combined with posterior decompression and internal fixation can effectively relieve pain, relieve the compression of spinal cord and nerve, recover nerve functions, and improve the quality of life of patients with spinal metastatic tumor.

Safety of butylphthalide and edaravone in patients with ischemic stroke: a multicenter real-world study / 老年心脏病学杂志（英文版）

BACKGROUND@#Butylphthalide (NBP) and edaravone (EDV) injection are common acute ischemic stroke medications in China, but there is a lack of large real-world safety studies on them. This study aimed to determine the incidence of adverse events, detect relevant safety signals, and assess the risk factors associated with these medications in real-world populations.@*METHODS@#In this study, data of acute ischemic stroke patients were extracted from the electronic medical record database of six tertiary hospitals between January 2019 and August 2021. Baseline confounders were eliminated using propensity score matching. The drugs' safety was estimated by comparing the results of 24 laboratory tests standards on liver function, kidney function, lipid level, and coagulation function. The drugs' relative risk was estimated by logistic regression. A third group with patients who did not receive NBP or EDV was constructed as a reference. Prescription sequence symmetry analysis was used to evaluate the associations between adverse events and NBP and EDV, respectively.@*RESULTS@#81,292 patients were included in this study. After propensity score matching, the NBP, EDV, and third groups with 727 patients in each group. Among the 15 test items, the incidence of adverse events was lower in the NBP group than in the EDV group, and the differences were statistically significant. The multivariate logistic regression equation revealed that NBP injection was not a promoting factor for abnormal laboratory test results, whereas EDV had statistically significant effects on aspartate transaminase, low-density lipoprotein cholesterol and total cholesterol. Prescription sequence symmetry analysis showed that NBP had a weak correlation with abnormal platelet count. EDV had a positive signal associated with abnormal results in gamma-glutamyl transferase, alanine aminotransferase, aspartate aminotransferase, prothrombin time, and platelet count.@*CONCLUSIONS@#In a large real-world population, NBP has a lower incidence of adverse events and a better safety profile than EDV or other usual medications.

Effects of salidroside on proliferation, migration, invasion and apoptosis of 97H cells / 中国药理学通报

Aim To study the effect of salidroside on the proliferation, migration, invasion and apoptosis of human highly metastatic liver cancer cells ( 97 H cells) . Methods Multifunctional cell analyzer was used to determine the effect of salidroside on the proliferation of 97H cells. Scratch assay was used to determine the effect of salidroside on the migration ability of 97H cells. Transwell assay was used to determine the effect of salidroside on the invasion ability of 97 H cells. Inverted microscope was used to observe the effect of salidroside on the morphology of 97H cells. Transmission electron microscope was employed to observe the effect of salidroside on mitochondria in 97 H cells. Flow cytometry was used to analyze the effect of salidroside on apoptosis and cycle distribution of 97 H cells. q-PCR was used to determine the effect of salidroside on related apoptosis genes in 97H cells.Western blot was used to determine the effect of salidroside on related migration, invasion and apoptosis proteins in 97H cells. Results Compared to blank group, salidroside treatment inhibited the proliferation, migration and invasion of 97H cells, and induced apoptosis of 97H cells. Salidroside could up-regulate the relative expression of Caspase-3 (P <0.05). Salidroside could up-regulate the levels of E-cad, Bax, Caspase-3 and Caspase-9 proteins (P <0.05), and down-regulate the levels of N-cad, Girdin and Bcl-2 proteins (P < 0. 05 ). Conclusions Salidroside has inhibitory effects on the proliferation, migration and invasion of 97H cells, and induces apoptosis of 97H cells through mitochondrial pathway.

Efficacy and Safety of Pulse Magnetic Therapy System in Insomnia Disorder: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

Objective@#This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. @*Methods@#Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. @*Results@#The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. @*Conclusion@#PMTS is safe and effective in improving insomnia disorders.

Clinical treatment and observation of the endophthalmitis caused by Bacillus cereus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the clinical characteristics and antibiotic sensitivity of traumatic endophthalmitis caused by Bacillus cereus and discuss the early diagnosis and treatment measures.METHODS: The data of 15 patients(15 eyes)with Bacillus cereus endophthalmitis admitted to the Eye Trauma Center of Shaanxi Provincial Eye Hospital from January 2019 to December 2021 were collected. The injury time, injury condition, preoperative visual acuity, corrected visual acuity in the last follow-up, operation method, bacterial culture and drug sensitivity test results were recorded.RESULTS: Among the 15 patients(15 eyes), 5 eyes with simple corneal perforating wound were treated with wound debridement and suture combined with intraocular antibiotic injection. And another 10 eyes with penetrating injuries combined with traumatic cataract and intraocular foreign bodies were treated with debridement, cataract extraction, removal of intraocular foreign bodies, vitrectomy combined with silicone oil tamponade and intraocular antibiotic injection. Among the 15 patients, 11 patients(73%)were treated effectively and the eyeball was preserved, and 4 patients(27%)were treated ineffectively and ocular evisceration was performed. Among the 11 patients with eyeball retention, 1(9%)had decreased vision, 1(9%)had unchanged vision, 4(36%)had improved vision by 1 level, and 5(45%)had improved vision by 2 levels, and the postoperative visual acuity was significantly improved. Correlation analysis showed that the course of disease was negatively correlated with corrected visual acuity(rs=-0.762, P=0.001). The cultures of vitreous humor and aqueous humor samples of patients were all grown in Bacillus cereus, and susceptibility tests were sensitive to vancomycin.CONCLUSIONS: Vancomycin is an effective drug for the treatment of Bacillus cereus endophthalmitis. Vitrectomy combined with silicone oil tamponade and intravitreal injection of vancomycin are effective method for the treatment of Bacillus cereus endophthalmitis.

Analysis of the effect of inter-spinal distraction fusion and fixation combined with limited decompression on the treatment of lumbar spinal stenosis in elderly patients / 国际外科学杂志

Objective:To analyze the effect of inter-spinal distraction fusion and fixation (ISDFF) combined with limited decompression on the treatment of lumbar spinal stenosis in elderly patients.Methods:A total of 32 elderly patients with lumbar spinal stenosis, aged from 80 to 87 years old (mean age: 82.0±2.0 years) including 10 males and 22 females, in the Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University from January 2016 to January 2020 were enrolled in this retrospective study. Clinical evaluation and imaging measurement were performed before operation, after operation, 6 months and 24 months after operation. SPSS software was used for statistical analysis. Measured data of normal distribution were expressed as means±standard deviation. One way analysis of variance was used for comparison between groups. Paired t-test was used to compare between preoperative and postoperative as well as between preoperative and 24 months′ follow-up. Results:All of the 32 patients had one or more common accompanying diseases, such as hypertension, diabetes, coronary heart disease, and so on. All patients were successfully completed the operation with a total of 32 segments. VAS score was decreased from (6.22±0.91) before operation to (1.94±0.76) at 24 months( t=16.52, P<0.001). ODI score was also demonstrated the similar trend, from (54.17±10.65) preoperatively to (19.91±4.20) at 24 months follow-up( t=15.89, P<0.001). JOA score was significantly increased from (11.69±3.36) before surgery to (23.44±1.66) at the last follow-up ( t=-19.90, P<0.001). In the change of imaging, the intervertebral angle was decreased from preoperation (9.12±4.65) to (6.77±2.70) at 24 months( t=3.53, P=0.001). The posterior disk height was increased from (0.68±0.19) cm to (0.76±0.19) cm at the last follow-up( t=-2.45, P=0.020). Conclusions:As a new type of minimally invasive internal fixator, the ISDFF combined with limited decompression can relieve the pain of elderly patients with lumbar spinal stenosis and improve the quality of life. It is suitable for the treatment of elderly patients with lumbar spinal stenosis.

Hygienic economic evaluation of inter-spinal distraction fusion and fixation for lumbar disc herniation / 国际外科学杂志

Objective:To analyze the clinical efficacy of inter-spinal distraction fusion and fixation and Posterior lumbar interbody fusion in the treatment of lumbar disc herniation with stenosis, and to evaluate the health economics of the two surgical methods.Methods:Retrospectivly analyzed the clinical data of 400 patients with lumbar disc herniation with stenosis, who were enrolled in Beijing Friendship Hospital, Capital Medical University from Jan. 2015 to Jan. 2019, including 190 male cases and 210 female cases, aged from 50 to 87 years old, with the average age of 67.97. All patients were divided into two groups according to different surgical methods. Among them, 200 patients used interspinous process fusion and distraction fixation (ISDFF group), the other 200 cases used posterior lumbar decompression and pedicle internal fixation (PLIF group). All patients completed the follow-up time of more than 1 year after operation. The basic information of patients′ age, gender, total number of days in hospital, intraoperative bleeding, operation time, surgical incision length and other basic information were observed. The Oswestry dysfunction index (ODI), the Japanese Orthopaedic Association Score (JOA) and the visual analog scale (VAS) were used to evaluate the relief of symptoms before and after the two groups of patients. Total medical expenses, anesthesia expenses, surgical expenses and other expenses were analysed. The software of SPSS 20.0 were conducted to analyze data.Results:The patients in the ISDFF group were (70.84±8.93) years old, and the PLIF group was (65.10±10.23) years old ( t=5.98, P=0.008). The operation time in the ISDFF group was (59.21±16.22) min, and the operation time in the PLIF group was (81.31±17.24) min( t=13.20, P<0.001). The bleeding volume of the ISDFF group was (33.24±11.31) mL, and the bleeding volume of the PLIF group was (67.30±17.61) mL ( t=23.02, P<0.001). The length of the surgical incision in the ISDFF group was (8.27±2.53) cm, and the length of the surgical incision in the PLIF group was (11.15±1.91) cm ( t=11.848, P<0.001). The total hospitalization time in the ISDFF group was (15.15±0.54) days, and the total hospitalization time in the PLIF group was (19.86±0.97) days( t=4.26, P<0.001). There was no significant difference in preoperative ODI, JOA and VAS between the two groups ( P>0.05). Symptoms of postoperative patients were significantly improved compared with preoperative. There were statistical differences in ODI, JOA and VAS between the two groups before and after operation ( P<0.05). However, ODI, JOA and VAS were no statistical difference between the two groups after operation. Complications occurred in 5 cases of the two groups of patients, including two cases of superficial infection in the PLIF group, two cases of dural tear in the PLIF group, one case of spinous process fracture in the ISDFF group. The total hospitalization fee for ISDFF was (57 450±8 670) (yuan), and the total hospitalization fee for PLIF was (75 770±1 640) (yuan), with statistical differences ( t=9.92, P<0.001). The cost of ISDFF operation was 1864±38.19 (yuan), and the cost of PLIF operation was 2352±41.39 (yuan) ( t=8.65, P<0.001). ISDFF antibacterial drug usage fee was 635.5±64.69 (yuan), PLIF antibacterial drug usage fee was 1449±307.1 (yuan) ( t=2.59, P<0.001). The one-time medical material cost during the ISDFF operation was (38 990±300) (yuan), and the one-time medical material cost during the PLIF operation was (52 110±150) (yuan) ( t=5.88, P<0.001). The excellent and good rate of ISDFF group was 92%, and that of PLIF group was 86%. In this study, the total cost of hospitalization was used as an indicator to measure the cost, and further cost-effectiveness evaluation was made. For every good patient, the cost of the ISDFF group was 62 450 yuan, and the cost of the PLIF group was 88, 100 yuan. Conclusions:ISDFF is beneficial to reduce the cost of medical insurance in China, which is in line with the direction of national reform to reduce medical expenditure. It is a surgical method worthy of wide promotion and has a good application prospect.

Clinical features of children with Cunninghamella spp. infection: a case report and literature review / 南方医科大学学报

We report a case of mucormycosis induced by Cunninghamella spp. infection in a ten-year-old girl with acute lymphoblastic leukemia, who developed fever and respiratory symptoms after chemotherapy and was diagnosed with invasive fungal disease. Peripheral blood DNA sequences were analyzed using metagenomic next-generation sequencing (mNGS), and by comparison with the Pathogens Metagenomics Database (PMDB), we identified Cunninghamella spp. with sequence number 514 as the pathogen. The patient was treated with amphotericin B combined with posaconazole and showed a favorable response. We searched Pubmed, Embase, CNKI, and Wanfang database for reports of cases of Cunninghamella spp. infection in children and retrieved 22 reported cases (including 12 males) with a median age of 13.5 (3-18) years. In these 22 cases, hematological malignancy was the most common underlying condition (19/22), and most of patients experienced an acute onset and rapid progression with respiratory symptoms (14/20) and fever (16/20) as the most common symptoms. CT imaging often showed unilateral lesions with varying imaging findings, including pulmonary nodules or masses, infiltrative changes, and pleural effusion. Definite diagnoses were established in 18 of the cases, and 4 had probable diagnoses; the lungs and skin were the most frequent organs compromised by the infection. A definite diagnosis of Cunninghamella spp. infection still relied on histopathological examination and fungal culture, but the molecular techniques including PCR and mNGS had shown potentials in the diagnosis. Almost all the cases received antifungal treatment after diagnosis (21/22), and 13 patients also underwent surgeries. Death occurred in 9 (42%) of the cases at a median of 19 (4-54) days after onset of the signs or symptoms. The patients receiving antifungal therapy combined with surgery had a high survival rate (9/13, 69%) than those with antifungal therapy alone (3/8, 37%). Invasive fungal disease is a common complication in immunoco-mpromised patients, but Cunninghamella spp. infection is rare and has a high mortality rate. In cases highly suspected of this disease, active diagnosis and early treatment are critical to improve the survival outcomes of the patients.

Angiotensin-converting enzyme 2 particapates in ozone-induced lung inflammation and airway remodeling in mice / 南方医科大学学报

OBJECTIVE@#To investigate the roles of angiotensin-converting enzyme 2 (ACE2) in ozone-induced pulmonary inflammation and airway remodeling in mice.@*METHODS@#Sixteen wild-type (WT) C57BL/6J mice and 16 ACE2 knock-out (KO) mice were exposed to either filtered air or ozone (0.8 ppm) for 3 h per day for 5 consecutive days. Masson's staining and HE staining were used to observe lung pathologies. Bronchoalveolar lavage fluid (BALF) was collected and the total cell count was determined. The total proteins and cytokines in BALF were determined by BCA and ELISA method. The transcription levels of airway remodeling-related indicators in the lung tissues were detected using real-time quantitative PCR. The airway resistance of the mice was measured using a small animal ventilator with methacholine stimulation.@*RESULTS@#Following ozoneexposure ACE2 KO mice had significantly higher lung pathological scores than WT mice (P < 0.05). Masson staining results showed that compared with ozone-exposed WT mice, ozone-exposed ACE2 KO mice presented with significantly larger area of collagen deposition in the bronchi [(19.62±3.16)% vs (6.49±1.34)%, P < 0.05] and alveoli [(21.63±3.78)% vs (4.44±0.99)%, P < 0.05]. The total cell count and total protein contents in the BALF were both higher in ozone-exposed ACE2 KO mice than in WT mice, but these differences were not statistically significant (P > 0.05). The concentrations of IL-6, IL-1β, TNF-α, CXCL1/KC and MCP-1 in the BALF were all higher in ozone-exposed ACE2 KO mice than in ozone-exposed WT mice, but only the difference in IL-1β was statistically significant (P < 0.05). The transcription levels of MMP-9, MMP-13, TIMP 4, COL1A1, and TGF-β in the lung tissues were all significantly higher in ozone-exposed ACE2 KO mice (P < 0.01). No significant difference was found in airway resistance between ozone-exposed ACE KO mice and WT mice after challenge with 0, 10, 25, or 100 mg/mL of methacholine.@*CONCLUSION@#ACE2 participates in ozone-induced lung inflammation and airway remodeling in mice.

Tenuifolin in Treatment of Dementia： A Review / 中国实验方剂学杂志

Tenuifolin， a main component in Polygalae Radix， is frequently used as an important indicator for quality control of Polygalae Radix and its processed products. Dementia is a serious and persistent cognitive disorder， and the number of dementia patients is increasing worldwide， which brings great economic burden and mental pressure to families and society. At present， cholinesterase inhibitor and other drugs can only alleviate the symptoms of dementia， and there are some toxic and side effects. It has been found that tenuifolin can significantly improve cognitive disorder， learning and memory and is expected to be a potential drug for treating dementia. Tenuifolin exerts protective effects on amyloid-β （Aβ） deposition， acetylcholine reduction， neuroinflammation， cellular oxidative damage and nerve cell apoptosis caused by neurodegenerative diseases via multiple mechanisms， and can be applied to various types of dementia. In addition， it can be quickly absorbed into the blood， mainly distributed in liver and kidney， and can enter into the brain through the blood-brain barrier. However， because of its large molecular mass and poor fat solubility， tenuifolin can be rapidly eliminated， generating some problems such as low oral absoBrbability and permeability of blood-brain barrier. Therefore， the information of chemistry， pharmacology， pharmacokinetics and toxicology of tenuifolin was summarized in this paper to provide reference and ideas for further research and application.

Screening of immune cell activators from Astragali Radix using a comprehensive two-dimensional NK-92MI cell membrane chromatography/C18 column/time-of-flight mass spectrometry system / 药物分析学报

Astragali Radix(AR)is a clinically used herbal medicine with multiple immunomodulatory activities that can strengthen the activity and cytotoxicity of natural killer(NK)cells.However,owing to the complexity of its composition,the specific active ingredients in AR that act on NK cells are not clear yet.Cell membrane chromatography(CMC)is mainly used to screen the active ingredients in a complex system of herbal medicines.In this study,a new comprehensive two-dimensional(2D)NK-92MI CMC/C18 column/time-of-flight mass spectrometry(TOFMS)system was established to screen for potential NK cell acti-vators.To obtain a higher column efficiency,3-mercaptopropyltrimethoxysilane-modified silica was synthesized to prepare the NK-92MI CMC column.In total,nine components in AR were screened from this system,which could be washed out from the NK-92MI/CMC column after 10 min,and they showed good affinity for NK-92MI/CMC column.Two representative active compounds of AR,isoastragaloside Ⅰ and astragaloside Ⅳ,promoted the killing effect of NK cells on K562 cells in a dose-dependent manner.It can thus suggest that isoastragaloside Ⅰ and astragaloside Ⅳ are the main immunomodulatory compo-nents of AR.This comprehensive 2D NK-92MI CMC analytical system is a practical method for screening immune cell activators from other herbal medicines with immunomodulatory effects.

Bone-filling mesh container plasty for spinal metastases with damaged posterior wall of vertebra / 中华骨科杂志

Objective:To study the efficacy and safety of bone-filling mesh container plasty in the treatment of posterior wall fracture of vertebra caused by spinal metastases.Methods:This study is a retrospective analysis of 65 patients with pathological fractures of the vertebra caused by vertebral metastases treated with bone-filling mesh container plasty from January 2015 to December 2019. There were 21 males and 44 females, 70.3±10.8 (46-90) (years). According to primary tumor, there were 25 cases of lung cancer, 14 cases of breast cancer, 11 cases of digestive system cancer, 13 cases of urinary system cancer, 1 case of lymphoma and 1 case of ovarian cancer. In the segment of vertebral metastases, there were 2 cases of T 2 vertebra, 1 case of T 5 vertebra, 1 case of T 6 vertebra, 2 cases of T 8 vertebra, 1 case of T 9 vertebra, 5 cases of T 10 vertebra, 4 cases of T 11 vertebra, 15 cases of T 12 vertebra, 12 cases of L 1 vertebra, 8 cases of L 2 vertebra, 8 cases of L 3 vertebra, 4 cases of L 4 vertebra, and 2 cases of L 5 vertebra. According to the CT images of the patient's vertebra before operation, the area of the damaged posterior wall of the vertebra is measured as s, and the area of the posterior wall of the intact vertebra is measured as S. The ratio of posterior wall damage is calculated as R= s/ S, and the value of R represents the degree of damage to the posterior wall of the vertebra. According to the size of the R value, the patients were divided into four groups, typeⅠ( R≤25%, 21 cases), typeⅡ(25%< R≤50%, 22 cases), typeⅢ (50%< R≤75%, 14 cases), typeⅣ( R>75%, 8 cases). The visual analog scale (VAS), Oswestry disability index (ODI) and activity of daily living (ADL) before and 1 day after surgery, 1 month after surgery, and 3 months after surgery were analyzed and compared to evaluate the efficacy of bone-filling mesh container plasty. Pairwise comparisons were performed to verify whether there is a difference in efficacy, bone cement leakage and postoperative complications. Results:All 65 patients were followed up for 3-6 months, with an average of 3.8 months. The VAS scores before surgery, postoperative day 1, postoperative 1, 3 months were 7.32±0.99, 4.14±1.06, 4.11±0.97, and 4.34±1.11, respectively, with a statistically significant difference ( F=149.20, P<0.001). ODI of preoperative, postoperative day 1, postoperative 1, and 3 months were 69.45%±4.15%, 36.65%±3.72%, 36.84%± 3.38%, 37.78%±3.45%, respectively, with a statistically significant difference ( F=840.88, P<0.001). ADL score of preoperative, postoperative day 1, postoperative 1, and 3 months were 71.31±12.81, 79.85±9.14, 78.92±8.95, and 78.31±8.67, respectively, with a statistically significant difference ( F=149.20, P<0.001). There was no significant difference in VAS, ODI and ADL scores between types I and IV (all P>0.05), but with the increase of R value, the leakage rate of intraspinal bone cement would increase correspondingly. Eleven cases occurred bone cement leakage with the rate of 17%. The leakage rate of type I and II was 0, type III was 7.1% (1/14), and type IV was 37.5% (3/8). All patients did not have systemic complications such as allergies, shock, decreased oxygen saturation, etc., and there were no bleeding, infection, nerve root symptoms or cement insertion syndrome after surgery. Conclusion:Bone-filling mesh container plasty can significantly improve the pain symptoms of patients with spinal metastases and recovery functions. The degree of damage to the posterior vertebra has no effect on the efficacy of the surgery. As the degree of damage to the posterior wall of the vertebra increases, the risk of complications of bone cement leakage in the spinal canal will increase.

Anaphylaxis effect and substance basis of honeysuckle extract / 中草药·英文版

Objective: To explore the anaphylaxis effect and anaphylaxis substances of honeysuckle. Methods: Rat peritoneal mast cells (PMC) were separated and purified, the cells were incubated with compound 48/80 (0.02 g/L), physiological saline and honeysuckle extract (120 g/L) at 37 °C for 0, 15, 30, 45 and 60 min. Degranulation were observed by optical microscope and transmission electron microscope. Annexin V positive cell rate was detected by flow cytometry to reflect the degranulation rate of PMC. SD rats were supplied with honeysuckle extract by intravenous injection at a dose of 2.25 g/L. After administration, different parameters were analyzed, including the symptoms, histamine (HIS) and tryptase (MCT) levels, which were determined to explore the effect of anaphylaxis. Regression analysis was used to calculate the relationships between the peaks and the pharmacological effects to explore potentially anaphylactoid components. Results: The percentage of Annxin V positive cells and the degranulation ratio were markedly elevated in PMC treated with honeysuckle extract for more than 15 min (P < 0.05). HIS and MCT level were significantly elevated after injection of honeysuckle extract for more than 15 min. Morphology of PMC and systemic symptoms were also changed compared with the controlled group (P < 0.05). Regression analysis was used to calculate the relationship between peaks and pharmacological effects, and to determine peaks 7, 10 and 13 as possible anaphylactoid ingredients. Conclusion: This study established a prospective method to clarify the anaphylactoid components of honeysuckle extract, which would provide guidance for screening anaphylactoid components in traditional Chinese medicine injections containing honeysuckle in the prescription.

One-stop strategy for treatment of atrial fibrillation: feasibility and safety of combining catheter ablation and left atrial appendage closure in a single procedure / 中华医学杂志(英文版)

BACKGROUND@#Catheter ablation is effective in restoring sinus rhythm and left atrial appendage closure (LAAC) is increasingly used for stroke prevention in patients with atrial fibrillation (AF). We aimed to observe the feasibility and safety of performing AF ablation and LAAC in a single (one-stop) procedure.@*METHODS@#Consecutive AF patients who underwent the combined procedure of AF ablation and LAAC with WATCHMAN device between March 2017 and September 2018 were prospectively enrolled. Baseline and intra-procedural parameters were evaluated. Three-month and subsequent 1-year follow-up were performed in all and earlier-enrolled subjects, respectively.@*RESULTS@#A total of 178 AF patients (94 males, 68.9 ± 8.1 years) underwent the one-stop procedure with CHA2DS2-VASc score 3.3 ± 1.5 and HAS-BLED score 1.6 ± 1.0, respectively. Pulmonary vein isolation was achieved in all patients while additional linear ablation was applied if the operator deemed necessary, yielding immediate ablation success rate of 98.9% (176/178). In the subsequent LAAC, satisfactory seal (residual leak <5 mm) was achieved in all patients. One stroke and four cardiac perforations occurred peri-operatively. At 3-month follow-up, sinus rhythm and satisfactory seal were maintained in 153/178 (86.0%) and 178/178 (100%) patients, respectively. One stroke and one delayed cardiac tamponade occurred, while no device-related thrombus or device migration was observed. During the 1-year follow-up for the earlier enrolled subjects, 52/72 (72.2%) of the patients maintained sinus rhythm. There was no stroke or systemic embolism observed.@*CONCLUSION@#Combining catheter ablation and LAAC in a single procedure can be successfully and safely performed in non-valvular AF patients of Chinese population.

Feasibility and perioperative safety of the combined procedure of catheter ablation and watchman left atrial appendage closure / 中华心血管病杂志

Objective: We aimed to explore the feasibility and perioperative safety of performing catheter ablation and left atrial appendage closure (LAAC) in a single (one-stop) session in patients with atrial fibrillation (AF). Methods: This study is an observational study. Consecutive AF patients who underwent the combined procedure of catheter ablation and LAAC with Watchman device of Xinhua Hospital in Shanghai between March 2017 and May 2019 were prospectively enrolled. Baseline, intra-and peri-procedural parameters were evaluated. Results: A total of 358 AF patients (189 males, (69.0±8.0) years) underwent the one-stop procedure. The CHA2DS2-VASc score was 3.2±1.5 and HAS-BLED score was 2.4±1.1, respectively in this patient cohort. Pulmonary vein isolation was achieved in all patients, while additional linear ablation was applied in 180 (50.3%) patients, yielding immediate success rate of 99.7%. Successful Watchman implantation was achieved in all patients. The perioperative serious adverse event occurred in 14 cases (3.9%). including 6 pericardial effusions (1.7%), 1 stroke (0.3%) and 5 vascular complications (1.4%), yielding procedure-related complication rate of 3.4%. In addition, 2 (0.6%) new-onset heart failures occurred postoperatively. There was no major bleeding or death during the perioperative period. Conclusions: Combined catheter ablation and LAAC can be successfully and safely performed in AF patients with high stroke risk. Follow-up data are needed to evaluate the outcome of this one-stop procedure.

Effect of Shenling Baizhusan on mTORC1/STAT3 Pathway in Hepatocytes of Nonalcoholic Fatty Liver Disease Rats / 中国实验方剂学杂志

Objective::To observe the effect of Shenling Baizhusan(SBS)on the mammalian target of rapamycin complex 1 (mTORC1)/signal transducers and activators of transcription 3 (STAT3) pathway in liver hepatocyte of nonalcoholic fatty liver disease(NAFLD)rats induced by high fat diet, in order to reveal the mechanism of SBS against rat NAFLD from the perspective of inflammation. Method::Totally 80 SD rats were randomly divided into 4 groups, normal control group, model group, high-dose SBP group(30 g·kg-1), and low-dose SBS group(10 g·kg-1), with 20 rats in each group. The rats of NAFLD model were established by being fed with high-fat diets for 8 weeks, and the treatment groups were fed with high or low dose of SBS respectively. After treatment for 8 weeks, blood and liver samples of rats were collected. Alanine aminotransferase (ALT), aspartate aminotransferase(AST), total cholesterol (TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C)levels in blood serum were detected with automatic biochemical analyzer. The liver tissues were observed by oil red O and hematoxylin-eosin (HE) staining. Hepatocytes were isolated by type Ⅳ collagenase perfusion in vitro. Tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-5 and IL-6 in hepatocytes were detected by enzyme-linked immunosorbent assay (ELISA), and the relevant gene and proteins expressions of mTORC1 and STAT3 in hepatocytes were detected by Real-time fluorescent quantitative polymerase chain reaction (Real-time PCR) and Western blot detection respectively. Result::Compared with the normal control group, the serum levels of TG, TC, AST, ALT and LDL-C were increased significantly, the levels of TNF-α, IL-1β, IL-5 and IL-6 in hepatocytes were increased significantly, and the expression levels of mTORC1, STAT3 mRNA and proteins in hepatocytes were increased significantly(P<0.01). Compared with the model group, the hepatic lipid accumulation of the medicine intervention group was relieved significantly, the serum levels of AST, ALT, TG and LDL-C were decreased significantly, the expression levels of TNF-α, IL-1β, IL-5 and IL-6 of hepatocytes were decreased significantly, and the expressions of mTORC1, STAT3 mRNA and proteins in hepatocytes were decreased significantly(P<0.05, P<0.01). In the high-dose SBS group, the effects in improving the lipid accumulation and inhibiting the inflammatory reaction were better than those of the low-dose SBS group, and the expressions of mTORC1 and STAT3 genes and proteins in hepatocytes were significantly decreased (P<0.05, P<0.01). Conclusion::SBS can improve the fat metabolism disorder and reduce liver lipid accumulation and inflammatory reaction in NAFLD rats induced by high-fat diet. The mechanism may be correlated with the inhibition of mTORC1/STAT3 pathway relating to genes and protein expression in hepatocytes.

Effect of volume rotation intensity-modulated radiotherapy on skin toxicity and pulmonary fibrosis of bilateral breast cancer / 中国医师进修杂志

Objective:To investigate the effects of volume-modulated intensity-modulated radiotherapy on acute and advanced skin toxicity and radiation-induced pulmonary fibrosis in patients with bilateral breast cancer after conservative surgery.Methods:The study period was from January 2017 to December 2018. A total of 236 patients with bilateral breast cancer who received treatment in Zhejiang Cancer Hospital were included in the study.All patients received volume-modulated arc light (VMAT/RapidArc ?) treatment. The treatment was performed during and after treatment. Clinical examination was performed to detect radiation-related skin toxicity, and pulmonary fibrosis was evaluated and analyzed by high-resolution computed tomography (HRCT) during follow-up. Results:A total of 220 patients underwent deep inhalation breath holding (DIBH) scans. The remaining 16 patients underwent free breathing (FB) scans due to poor adherence (patients could not tolerate holding for at least 20 s). There was a significant difference in lung capacity between DIBH and FB [right lung: (2 416.3 ± 550.8) cc vs. (1 278.6 ± 514.3) cc, P = 0.001; left Lung: (2 125.4 ± 428.6) cc vs. (1 058.9 ± 520.5) cc vs. P <0.001]. One hundred and sixty-nine patients (71.6%) had grade 1 skin toxicity, 56 patients (23.7%) were grade 2, 2 patients (0.8%) were grade 3, and 9 patients did not have any skin toxicity. There were no symptomatic radiation pneumonitis and pulmonary fibrosis cases during radiotherapy and 6 months after radiotherapy. Advanced skin toxicity evaluation showed that most patients had no obvious skin toxicity. The major skin toxicity reactions were capillary telangiectasia, breast edema, and skin atrophy. Pulmonary fibrosis appeared in 12 patients, and mean follow-up was detected. The time was 12-28 (12.5 ± 0.6) months. The average volume of pulmonary fibrotic lesions was 1.5-18.3 (6.6 ± 1.0) cc. Partial volumes (V 20, V 30, V 40, and V 50) were significantly associated with the risk of pulmonary fibrosis ( P < 0.01). Recurrence-free survival (RFS) during an average follow-up time was 12-33 (28.6 ± 1.2) months, and overall survival (OS) were both 100.0%. Conclusions:Based on the evaluation of acute and advanced skin toxicity and radiation-induced pulmonary fibrosis, volume-rotation IMRT is safe and effective for patients with bilateral breast cancer after conservative surgery, and it is worthy of clinical reference and application.

Improvement for the construction of renal interstitial fibrosis model with unilateral ureteral obstruction in rats / 中国组织工程研究

BACKGROUND: Unilateral ureteral obstruction (UUO) is a traditional surgical method that can cause renal interstitial fibrosis in rats in a short period of time (1-2 weeks), but it can develop many postoperative complications and result in a high mortality. OBJECTIVE: To optimize and improve the UUO operation in rats for reducing the incidence of postoperative complications and improving the survival rate of animals, and to detect the pathophysiological indicators of rats modeled by UUO, providing background data for the basic research on functional pharmacology. METHODS: Twenty male Sprague-Dawley rats were randomly divided into four groups, followed by traditional UUO ligation, improved UUO ligation, undissociated ureteral ligation, and opening the abdominal cavity with no ureter ligation (sham group), respectively. At 14 days postoperatively, the successful rate of renal interstitial fibrosis model, mortality rate, and the incidence of postoperative complications were compared between groups. Another 28 Sprague-Dawley rats, half male and half female, were randomly divided into improved UUO group and control group. Physiological indexes, including urine analysis, blood cells analysis, blood biochemical analysis, were tested as background information. Besides, the pathological changes of kidney tissues were compared between groups using hematoxylin-eosin staining and Masson staining at 14 and 21 days postoperatively. RESULTS AND CONCLUSION: Compared with the undissociated ureteral ligation group, the successful rate of modeling was higher in the traditional and improved UUO groups. The improved UUO surgery with double ligation of the middle ureter and no cutting of the middle ureter was characterized by easier operation, smaller surgical wound, faster modeling and higher successful rate of renal interstitial fibrosis model, lower postoperative mortality and lower incidence of complications in animals as compared with the traditional UUO surgery. The improved UUO group showed statistically significant differences from the sham group in blood biochemical indexes such as urea nitrogen, glutamate aminotransferase, and albumin (P < 0.05). Results from hematoxylin-eosin staining and Masson staining of the obstructed kidney revealed typical pathological features of renal interstitial fibrosis.

Optimization of pH response and mitochondrial targeting bifunctional hyperoside liposomes by central composite design response surface methodology and its in vitro evaluation / 中草药

Objective: To optimize preparation of mitochondrial targeting hyperoside liposomes (DLD/Hyp-Lip), and study its stability in fetal bovine serum, in vitro release behavior and mitochondrial targeting. Methods: DLD/Hyp-lip was prepared by film dispersion method. Single factor experiment was carried out with entrapment efficiency and drug loading as indexes to investigate the effects of the ratio of phospholipids to hyperoside (Hyp) and DSPE-PEG (distearoyl phosphoethanolamine-polyethylene glycol) to DLD on DLD/Hyp-Lip. The formulation of DLD/Hyp-Lip was further optimized by central composite design response surface methodology. The appearance, size and potential of liposomes were observed by transmission electron microscope and particle size analyzer. The stability and drug release rate of liposomes in fetal bovine serum were evaluated by serum stability test and in vitro drug release test. The drug delivery system was evaluated by mitochondrial targeting. Results: The optimal formula of DLD/ Hyp-Lip was as follows: the ratio of total phospholipids to hyperoside was 12.50:1, the ratio of total phospholipids to cholesterol was 6.00:1, and the dosage ratio of DSPE-PEG to DLD was 3:5, the encapsulation efficiency was (95.57 ± 0.56) %, the drug loading was (8.55 ± 0.57) %. The prepared liposomes had good appearance, the particle size of the lip was (124.9 ± 3.4) nm, and the potential was (-6.2 ± 1.9) mV. It was stable in fetal bovine serum and accumulated in vitro release medium for 24 h. Mitochondrial targeting experiments showed that DLD/Hyp-Lip could promote the accumulation of drugs in the mitochondria. Conclusion: This method is simple and convenient, and can accurately and effectively optimize the preparation process of DLD/Hyp-Lip. The prepared DLD/Hyp-Lip has high encapsulation efficiency, small particle size, uniform distribution and good sustained-release effect, which lays the foundation for further in vivo research of DLD/Hyp-Lip. DLD/Hyp-Lip with hyperoside has good mitochondrial targeting of liver cancer cells and is a potentially efficient mitochondrial targeted drug delivery system for liver cancer cells.