Establishment of finite element model of anterior cervical transpedicular system for reconstruction of cervical stability after subtotal resection of two segments of lower cervical spine / 中国骨伤

OBJECTIVE@#To establish the fixation model of anterior cervical transpedicular system (ACTPS) after subtotal resection of two segments of lower cervical spine(C3-C7) in order to provide a finite element modeling method for anterior cervical reconstruction.@*METHODS@#The CT data of the cervical segment (C1-T1) of a 30-year-old adult healthy male volunteer was collected. Used Mimics 10.0, Rapidform XOR3, HyperMesh 10.0, CATIA5V19 and ANSYS 14.0 to establish the three-dimensional nonlinear complete model of lower cervical spine(C3-C7) as the intact group. The number of units and nodes of the complete model were recorded. After the effectiveness of the complete model was verified, the C5 and C6 vertebral subtotal resection was performed, and the ACTPS model was established as the ACTPS group. The axial force of 75 N and moment couple of 1N·m was loaded on the upper surface of C3 in intact group and ACTPS group, the range of motion(ROM)and stress distribution in states of flexion extension, lateral flexion, rotation was compared between two groups.@*RESULTS@#There were 85 832 elements and 23 612 nodes in the complete model of lower cervical spine(C3-C7) which was established in this experiment. The stress distribution of ACTPS internal fixation model was relatively uniform. Comparing with the intact group, the overall range of motion in ACTPS group was decreased in flexion extension, lateral flexion and rotation directions, and the corresponding compensation of adjacent C3,4 segment was increased slightly.@*CONCLUSION@#The stress distribution of ACTPS fixation system is uniform, there is no stress concentration area at the joint of screw and titanium plate, and the fracture risk of internal fixation is low. It is suitable for stability reconstruction after anterior decompression of two or more cervical segments.

Comparative study between 3D guide plate assisted and free-hand insertion of anterior cervical transpedicular screw / 中国骨伤

OBJECTIVE@#To compare accuracy of anterior cervical pedicle screws between assist of rapid prototyping 3D guide plate and free-hand insertion, and evaluate the safety of two methods.@*METHODS@#Eight adult cervical cadaver specimens after formaldehyde immersion, including 4 males and 4 females, aged 32 to 65(40.3±5.6) years old. After X-ray examination to exclude bone damage and deformity, 4 of them (3D guide plate group) randomly selected were for CT scan to obtain DICOM format data, and the data was imported into Mimics software for model, designed the ideal entry point and nail path for anterior cervicaltranspedicular screw (ATPS). After obtaining the personalized guide plate of the nail channel, it was exported as STL data, and the individual guide plate was printed by rapid prototyping and 3D printing technology. In turn, with the assistance of 3D guide plates, one-to-one personalized ATPS screws were placed on the four lower cervical cadaver specimens. Another 4 (free-hand group) lower cervical cadaver specimens were implanted with ATPS screws using free-hand technique. All specimens were performed CT thin-layer scanning and three-dimensional reconstruction after operation. The Tomasino method was used to evaluate the safety of the screws on the CT cross-sectional and sagittal images, to determine whether there was a cortical puncture of the lower and inner edges of the pedicle. According to the CT rating results, gradeⅠandⅡwere safe, and grade Ⅲ- Ⅴ were dangerous.And the accuracy of screws was recorded and analyzed between two groups.@*RESULTS@#Two screws were inserted in each segment from C@*CONCLUSION@#The 3D printing rapid prototyping guide plate assisted insertion of the anterior cervical pedicle screw can significantly improve the accuracy and safety, and provide a theoretical basis for further clinical application.

Acute Pancreatitis Complicated by Sheehan's Syndrome: A Case Report and Literature Review / 中国医学科学杂志(英文版)

A 44-year-old woman was transferred to the ICU of the First Affiliated Hospital of Jinan University for 2 days of persistent epigastric pain and 7 hours of unconsciousness. Her admission diagnosis was severe acute necrotizing pancreatitis (hypertriglyceridemia type) with multiple organ dysfunctions. The results of CT revealed a small area of necrotizing pancreatitis, which was not consistent with the severe clinical manifestations. Considering lack of hair and history of postpartum hemorrhage, hormone examination was carried out. According to the results of the examination, she was further diagnosed as Sheehan's syndrome and pituitary crisis. After hormone replacement therapy, her condition improved rapidly.

Study on content of polysaccharide during processing of Polygonatum sibiricum by RSM and PMP-HPLC characteristic map technology / 中草药

Objective: To investigate the best extracting conditions of Polygonatum sibiricum polysaccharides by single and compound enzymatic methods, and to study on the change content of polysaccharide in processing of P. sibiricum by steamed and shined for nine times, which provide theoretical basis for processing of P. sibiricum and other Chinese herbal medicines. Methods: Response surface method (RSM) was used to optimize the extraction of polysaccharides in P. sibiricum. PMP precolumn derivatization and HPLC characteristic map technology were used to identify and analyze the changes of polysaccharide of P. sibiricum being steamed and shined for nine times and establish polysaccharide characteristic map of P. sibiricum by ancient processing and distillate. The effect of different enzymes on the extraction efficacy of P. sibiricum polysaccharides was also compared. Results: The extracting effect of cellulase in single enzyme was the best. Moreover, cellulose and pectinase were also the most significant factor for extracting polysaccharides from P. sibiricum in four complex enzymes. The best extracting conditions for polysaccharide obtaining by RSM as follows: Cellulase temperature was 51 ℃, cellulase dosage was 2%, and the total polysaccharide content was (675.34 ± 0.10) mg/g when the pH value of enzymolysis was 5.40. PMP-HPLC was used to detect four processed P. sibiricum, which contained mannose, ribose, rhamnose, glucose, and galactose. Glucose had a high proportion in P. odoratum, P. cyrtonema, and P. sibiricum polysaccharide, and P. filipes polysaccharide mainly composed of mannose. With the increase of processed times, the content of each monosaccharide increased first, then decreased, then increased and then tended to be stable. The content of mannose and galactose varied greatly. The content of monosaccharides in the distillate increased first and then stabilized, and the content changes of mannose and glucose were obvious. Conclusion: The extraction efficiency and purity of P. sibiricum polysaccharides can be improved by single and compound enzymatic extraction with cellulase, and the extraction yield of polysaccharide in P. sibiricum could be affected by steamed and shined for nine times. PMP-HPLC characteristic map technology can be used to determine the content of the polysaccharide in processing of P. sibiricum accurately and reproducibly, which can be used for the quality evaluation of P. sibiricum and other Chinese herbal medicines.

Protection Effect of Exogenous Fibroblast Growth Factor 21 on the Kidney Injury in Vascular Calcification Rats / 中华医学杂志(英文版)

<p><b>Background</b>Chronic kidney disease (CKD) is closely related to the cardiovascular events in vascular calcification (VC). However, little has known about the characteristics of kidney injury caused by VC. Fibroblast growth factor 21 (FGF21) is an endocrine factor, which takes part in various metabolic actions with the potential to alleviate metabolic disorder diseases. Even FGF21 has been regarded as a biomarker in CKD, the role of FGF21 in CKD remains unclear. Therefore, in this study, we evaluate the FGF21 on the kidney injury in VC rats.</p><p><b>Methods</b>The male Sprague-Dawley rats were divided into three groups: (1) control group, (2) Vitamin D3 plus nicotine (VDN)-induced VC group, (3) FGF21-treated VDN group. After 4 weeks, the rats were killed and the blood was collected for serum creatinine, urea nitrogen, calcium, and phosphate measurement. Moreover, the renal tissues were homogenized for alkaline phosphatases (ALPs) activity and calcium content. The levels of FGF21 protein were measured by radioimmunoassay. The levels of β-Klotho and FGF receptor 1 (FGFR1) protein were measured by enzyme-linked immunosorbent assay (ELISA). The structural damage and calcifications in aortas were stained by Alizarin-red S. Moreover, the structure of kidney was observed by hematoxylin and eosin staining.</p><p><b>Results</b>The renal function impairment caused by VDN modeling was ameliorated by FGF21 treatment, inhibited the elevated serum creatinine and urea level by 20.5% (34.750 ± 4.334 μmol/L vs. 27.630 ± 2.387 μmol/L) and 4.0% (7.038 ± 0.590 mmol/L vs. 6.763 ± 0.374 mmol/L; P < 0.01), respectively, together with the structural damages of glomerular atrophy and renal interstitial fibrosis. FGF21 treatment downregulated the ALP activity, calcium content in the kidney of VC rats by 42.1% (P < 0.01) and 11.7% (P < 0.05) as well as ameliorated the aortic injury and calcification as compared with VDN treatment alone group, indicating an ameliorative effect on VC. ELISA assays showed that the expression of β-Klotho, a component of FGF21 receptor system, was increased in VDN-treated VC rats by 37.4% (6.588 ± 0.957 pg/mg vs. 9.054 ± 0.963 pg/mg; P < 0.01), indicating an FGF21-resistant state. Moreover, FGF21 treatment downregulated the level of β-Klotho in renal tissue by 16.7% (9.054 ± 0.963 pg/mg vs. 7.544 ± 1.362 pg/mg; P < 0.05). However, the level of FGFR1, the receptor of FGF21, kept unchanged under VDN and VDN plus FGF21 administration (0.191 ± 0.0376 ng/mg vs. 0.189 ± 0.032 ng/mg vs. 0.181 ± 0.034 ng/mg; P > 0.05).</p><p><b>Conclusions</b>In the present study, FGF21 was observed to ameliorate the kidney injury in VDN-induced VC rats. FGF21 might be a potential therapeutic factor in CKD by cutting off the vicious circle between VC and kidney injury.</p>

Effect of ABO-Incompatibility on Outcome of Allogeneic Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of ABO-incompatibility on the efficacy and complications of allogeneic hematopoietic stem cell transplantation(HSCT).</p><p><b>METHODS</b>The clinical data of 54 recipients who received ABO-incompatible allo-HSCT were retrospectively analyzed and were compared with 54 ABO-identical recipients as controls. Hematopoietic reconstruction and the blood type conversion time were dynamically observed and compared between 2 groups.</p><p><b>RESULTS</b>The time of erythrocyte reconstitution was prolonged to 24 d in ABO-incompatible group, compared with that of 19 d in ABO-compatible group (P<0.01). The difference of neutrophil and platelet reconstruction was not statistically significant (P>0.05). Major mismatch group and bidirectional mismatch group required more erythrocyte transfusions than that of ABO-compatible group. The surface antigen of erythrocyte change in major mismatch group was earlier than that of minor mismatch group (P<0.05). The incidence of cytomegalovirus (CMV) infection, acute graft versus host disease (aGVHD) and survival were not significantly different between 2 groups.</p><p><b>CONCLUSION</b>ABO-incompatibility can not influence the effect of allo-HSCT, but ABO-incompatibility delayed erythrocyte recovery, and required more RBC and platelet transfusions.</p>

The research and application on management system of cold chain facilities temperature control in the hospital / 中国医学装备

Objective:To have a research and application on management system of cold chain facilities temperature control in the hospital and real-time monitor the temperature and humidity changes of cold-chain facilities.Methods: Based on RFID radio frequency, Internet of things and computer technology to realize the construction of the system hardware and software platform, through commissioning and case analysis for system improvement, the system was popularized and applied comprehensively.Results: After one year’s trial run, it showed that the system could accurately and effectively monitor the abnormal temperature and humidity of the hospital’s cold chain facilities and give the acousto-optic hint and remote alarm in time, effectively improving the management level of cold chain temperature control.Conclusion: The system could guarantee the fine management of the cold chain facilities temperature control, provide safe and traceable historical data, and put forward a new solution for building the quality and safety of cold chain facilities temperature control system.

Research on clinical application of navigation bronchoscopy system / 中国医学装备

Objective:To analyze the clinical application of navigation bronchoscopy system, and improve the accuracy during routine use.Methods:Through discussing ENB, System composition, clinical application and environment, the paper presents the clinical application standard and working environment standard of the navigation bronchoscopy system.Results:Electromagnetic navigation bronchoscopy(ENB) combined with the advantages of electromagnetic technology, virtual bronchoscopy and 3D CT reconstruction, which can perform the accurate localization of peripheral pulmonary lesion and mediastinal lymph node to acquire tissue samples for pathological diagnosis. ENB-guided localization can be used in interventional therapy(local injection or radioactive seed implantation).Conclusion:Navigation bronchoscopy system shows the merit of minimally invasive technique and medical visualization. It is a great progress in interventional pulmonology history.

HPLC specific chromatograms of Xingnaojing injection / 中国中药杂志

To establish and analyze the HPLC specific chromatograms of Xingnaojing injection manufactured by different factories. The separation was performed on a Thermo BDS Hypersil C₁₈ column (4.6 mm×250 mm, 5 μm), with the mobile phase consisting of acetonitrile-0.02% formic acid aqueous solution for gradient elution. The flow rate was 1.0 mL•min⁻¹, and the column temperature was 35 ℃. The detection wavelength was set at 254 nm, and the sample size was 20 μL. Eleven chromatographic peaks were identified as characteristic peaks of HPLC specific chromatograms of Xingnaojing injection, after analyzing 29 batches of Xingnaojing injection samples. Compared with the reference substances, seven of them were identified as eucarvone, camphor, curcumenone, curcumenol, curdione, curzerenone and germacrone, respectively. HPLC specific chromatograms of Xingnaojing injection manufactured by three factories could be easily classified into three categories after investigation with computer-aided similarity evaluation system combined with principal component analysis. The established HPLC specific chromatograms provide a basis for scientific evaluation and effective control of the quality of Xingnaojing injection.

Predictive value of serum iron level for in-hospital acute heart failure after acute ST-elevated myocardial infarction / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the predictive value of serum iron level for in-hospital acute heart failure (AHF) after acute ST-elevated myocardial infarction (STEMI).</p><p><b>METHODS</b>This retrospective study involved 287 patients with STEMI stratified by quartiles of admission serum iron concentration. The incidence of AHF was assessed by serum iron quartiles. We evaluated the association of serum iron levels with B-type natriuretic peptide (BNP), cardiac troponin I (cTnI), and high-sensitivity C-reactive protein (hs-CRP) levels on admission, and analyzed the correlation of serum iron levels with in-hospital AHF, death, and duration of hospital stay.</p><p><b>RESULTS</b>The average serum iron level on admission of the 287 STEMI patients was 10.20 µmol/L (6.90-14.40 µmol/L), and the quartiles (Q) of serum iron levels were ≤6.90 µmol/L (Q(1)), 6.91-10.19 µmol/L (Q(2)), 10.20-14.39 µmol/L (Q(3)), and ≥14.40 µmol/L (Q(4)). The incidences of in-hospital AHF from Q(1) to Q(4) were 79.5%, 64.3%, 50.0% and 45.9%, respectively (P<0.001). Univariate logistic regression analysis showed that low admission serum iron level (Q(1)) was an independent predictor for in-hospital AHF (OR=3.358, 95%CI 1.791- 6.294, P<0.001), and multivariate logistic regression analysis showed a similar result (OR=2.316, 95%CI 1.205-4.453, P=0.012).</p><p><b>CONCLUSIONS</b>A lower admission serum iron level is an independent predictor of AHF in STEMI patients during hospitalization.</p>