Research Progress of Forensic Diagnosis Approaches of Early Acute Myocardial Infarction / 法医学杂志

The postmortem diagnosis of acute myocardial infarction (AMI), especially the postmortem diagnosis of early AMI that died immediately after onset or within 1 hour, has always been a difficulty in forensic identification. This article reviews the forensic application of diagnosis and analysis methods for AMI postmortem diagnosis including autopsy imaging, histomorphology, immunohisto-chemistry, biochemical marker and molecular biology diagnosis, and explores the feasible scheme of early postmortem diagnosis in AMI.

Effect and Mechanism Study of Sodium Houttuyfonate on Ventilator-Induced Lung Injury by Inhibiting ROS and Inflammation

Purpose@#Ventilator-induced lung injury (VILI) is a serious complication of mechanical ventilation (MV) that increases morbidity and mortality of patients receiving ventilator treatment. This study aimed to reveal the molecular mechanism of sodium houttuyfonate (SH) on VILI. @*Materials and Methods@#The male mice VILI model was established by high tidal volume ventilation. The cell model was established by performing cell stretch (CS) experiments on murine respiratory epithelial cells MLE-15. In addition, the JNK activator Anisomycin and JNK inhibitor SP600125 were used on VILI mice and CS-treated cells. @*Results@#VILI modeling damaged the structural integrity, increased apoptosis and wet-to-dry (W/D) ratio, enhanced the levels of inflammatory factors, reactive oxygen species (ROS) and malonaldehyde (MDA), and activated JNK pathway in lung tissues. SH gavage alleviated lung injury, decreased apoptosis and W/D ratio, and reduced levels of inflammatory factors, ROS and MDA, and p-JNK/JNK expression of lung tissues in VILI mice. However, activation of JNK wiped the protective effect of SH on VILI. Contrary results were found in experiments with JNK inhibitor SP600125. @*Conclusion@#SH relieved VILI by inhibiting the ROS-mediated JNK pathway.

Kinesio Taping combined with electroacupuncture for the treatment of patellofemoral disorder in middle-aged and elderly exercise enthusiasts / 中国骨伤

OBJECTIVE@#To observe the clinical efficacy of Kinesio Taping combined with electroacupuncture in the treatment of patellofemoral disorder in middle-aged and elderly exercise enthusiasts.@*METHODS@#From April 2018 to April 2020, 62 middle-aged and elderly exercisers with patellofemoral disorder were selected and divided into observation group and control group. In the observation group, there were 30 cases:12 males and 18 females, aged from 35 to 66 years old, with an average age of (48.32±6.80) years old. The observation group was treated with Kinesio Taping and electroacupuncture . In the control group, there were 32 cases:12 males and 20 females, aged from 35 to 67 years old, with an averageage of (48.67±8.13) years old. The patients in the control group was treated with knee electroacupuncture. All the patients in both groups were treated once every other day, 3 times a week, for a total of 4 weeks. The VAS pain score and knee Lysholm score before and after treatment were compared between the two groups before and after treatment, and statistical analysis was conducted.@*RESULTS@#In the control group, 2 patients were not satisfied with the curative effect after 2 weeks of treatment and gave up treatment, while the remaining 60 patients completed all the treatments. After 4 weeks of treatment, the VAS and Lyshlom scores of the control group were 2.73±1.46 and 75.63±8.62 respectively;the VAS and Lyshlom scores of the observation group were 2.02±1.85 and 83.31±5.53 respectively;the VAS and Lyshlom scores of the observation group and the control group were better than those before treatment, and the Lyshlom scores of the observation group were better than those of the control group.@*CONCLUSION@#Kinesio Taping combined with electroacupuncture is aimed at patellofemoral disorderof middle-aged and elderly sports enthusiasts. It has little trauma, can relieve pain and has a fast onset speed, which is readily accepted by patients, and promotes the rehabilitation of knee joint function of patients, thus providing a favorable reference for the promotion in clinical application.

Effect and Mechanism Study of Sodium Houttuyfonate on Ventilator-Induced Lung Injury by Inhibiting ROS and Inflammation

Purpose@#Ventilator-induced lung injury (VILI) is a serious complication of mechanical ventilation (MV) that increases morbidity and mortality of patients receiving ventilator treatment. This study aimed to reveal the molecular mechanism of sodium houttuyfonate (SH) on VILI. @*Materials and Methods@#The male mice VILI model was established by high tidal volume ventilation. The cell model was established by performing cell stretch (CS) experiments on murine respiratory epithelial cells MLE-15. In addition, the JNK activator Anisomycin and JNK inhibitor SP600125 were used on VILI mice and CS-treated cells. @*Results@#VILI modeling damaged the structural integrity, increased apoptosis and wet-to-dry (W/D) ratio, enhanced the levels of inflammatory factors, reactive oxygen species (ROS) and malonaldehyde (MDA), and activated JNK pathway in lung tissues. SH gavage alleviated lung injury, decreased apoptosis and W/D ratio, and reduced levels of inflammatory factors, ROS and MDA, and p-JNK/JNK expression of lung tissues in VILI mice. However, activation of JNK wiped the protective effect of SH on VILI. Contrary results were found in experiments with JNK inhibitor SP600125. @*Conclusion@#SH relieved VILI by inhibiting the ROS-mediated JNK pathway.

Zheng's massage combined with electroacupuncture in the treatment of reflex sympathetic dystrophy syndrome of the wrist / 中国骨伤

OBJECTIVE@#To observe the clinical effects of zheng's massage combined with electroacupuncture in the treatment ofreflex sensory dystrophy syndrome of the wrist.@*METHODS@#From October 2016 to September 2018, 48 cases of reflex sensory dystrophy syndrome of the wrist were divided into the observation group and the control group. In the observation group, there were 24 cases, including 10 males and 14 females, ranging in age from 54 to 76 years old, with an average age of (61.41 ±7.90) years old. The patients in the observation group were treated with massage combined with electroacupuncture. The control group consisted of 24 patients, including 9 males and 15 females, ranging in age from 52 to 75 years old, with an averageage of (58.71±8.11 ) years old. The patients in the control group were treated with electroacupuncture alone. All the patients in both groups were treated for 6 weeks. The clinical symptoms and signs, visual anglogue scale (VAS), Cooney wrist score and clinical efficacy evaluation were compared between the two groups before and after treatment, and statistical analysis was conducted.@*RESULTS@#After 6 weeks of treatment, VAS in the control group was 4.9±1.8, and Cooney wrist score was 74.63±1.72; VAS in the observation group was 2.2±1.4, and Cooney wrist score was 86.31±2.53. The comprehensive scores of VAS and Cooney wrist joint between two groups were improved after treatment, and the observation group was better than control group(<0.05). The curative effect of the observation group was better than that of the control group.@*CONCLUSION@#Zheng's massage combined with electroacupuncture has the following advantages in the treatment of reflex sympathetic dystrophy syndrome of the wrist, such as small trauma, patients' willingness promoting functional rehabilitation, which is worthy of clinical promotion.

Determination of hydroxylsafflower yellow A in safflower W/O cream by RP-HPLC / 中国药科大学学报

@#A reversed phase HPLC method for determination of hydroxylsafflower yellow A in safflower W/O cream was established. The column was Zorbax Eclipse C18 column(4. 6 mm×250 mm, 5 μm), and the mobile phase was composed of methanol, acetonitrile and 0. 02% phosphoric acid solution(26 ∶2〓 ∶72). The flow rate of mobile phase was set at 1. 0 mL/min, and the column temperature was kept at 55 °C. The detection wavelength was 403 nm. Safflower W/O cream was successively demulsified with methanol at high temperature and followed by the addition of purified water for the extraction. The results showed that the excipients did not interfere with the chromatographic peak of hydroxylsafflower yellow A. Hydroxylsafflower yellow A presented a good linear relationship in the range of 1. 236- 12. 36 μg/mL(y=156. 17x+1. 198 3, r=0. 999 5), and the detection limit was 23. 6 ng/mL with the quantitative limit of 118 ng/mL. The percentage of extracting recovery was in the range of 99. 7% to 103. 3%. The precision RSD was 0. 12%(n=6), and the sample stability was acceptable when being stored at room temperature for 24 h. The developed method in this study was simple, rapid, accurate and reproducible, and can be used for the determination of hydroxylsafflower yellow A in safflower W/O cream.

Microencapsulation of immunoglobulin Y: optimization with response surface morphology and controlled release during simulated gastrointestinal digestion / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Immunoglobulin Y (IgY) is an effective orally administered antibody used to protect against various intestinal pathogens, but which cannot tolerate the acidic gastric environment. In this study, IgY was microencapsulated by alginate (ALG) and coated with chitooligosaccharide (COS). A response surface methodology was used to optimize the formulation, and a simulated gastrointestinal (GI) digestion (SGID) system to evaluate the controlled release of microencapsulated IgY. The microcapsule formulation was optimized as an ALG concentration of 1.56% (15.6 g/L), COS level of 0.61% (6.1 g/L), and IgY/ALG ratio of 62.44% (mass ratio). The microcapsules prepared following this formulation had an encapsulation efficiency of 65.19%, a loading capacity of 33.75%, and an average particle size of 588.75 μm. Under this optimum formulation, the coating of COS provided a less porous and more continuous microstructure by filling the cracks on the surface, and thus the GI release rate of encapsulated IgY was significantly reduced. The release of encapsulated IgY during simulated gastric and intestinal digestion well fitted the zero-order and first-order kinetics functions, respectively. The microcapsule also allowed the IgY to retain 84.37% immune-activity after 4 h simulated GI digestion, significantly higher than that for unprotected IgY (5.33%). This approach could provide an efficient way to preserve IgY and improve its performance in the GI tract.

Risk factors of renal function after radical nephroureterectomy for upper tract urothelial carcinoma / 中华泌尿外科杂志

Objective To investigate the risk factors which can lead to chronic kidney disease (CKD) after radical nephroureterectomy and guide adjuvant chemotherapy for the patients with upper tract urothelial carcinoma (UTUC).Methods 239 patients with UTUC,who were treated at our hospital from October 2010 to February 2015 was analyzed retrospectively.Serum creatinine levels were measured preoperatively and 1 month (range:21days to 35 days) after radical nephroureterectomy.129 males and 110 females patients were enrolled.Ages were from 41 to 94,and mean age was 66 years.All patients underwent radical surgery.The pathological stages included Ta/T1/T2/T3/T4,and grades included G1/G2/G3.We calculated GFR using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in consideration of age,sex,and serum creatinine level.The new-onset CKD after RNU was defined as when the calculated CKD-EPI GFR decreased to less than 60 ml/(min · 1.73 m2).These patients were divided into 2 groups which depended on whether they got CKD after RNU.Cohorts were stratified by gender,age,smoking,BMI,hypertension,diabetes mellitus (DM),tumor location,tumor size,multifocality,pathologic stage,grade,hydronephrosis and preoperative CKD-EPI GFR.The chi-square test was used to examine the relationship among the various cohorts and the CKD after RNU.The Kaplan-Meier method was adopted to identify the relationship between Overall survival (OS).Cancer-specific survival (CSS) and CKD.Univariate and multivariate analyses were performed to study the relationship between clinical factors and CKD after RNU using the Cox proportional hazards regression model and chi-square test.Results In our study,the median follow-up time was 41.3 (range from 2-82) months for 239 patients.Median CKD-EPI GFR for all patients before and after surgery was 71.4 (65.2-108.7) ml/(min · 1.73 m2) and 54.7 (37.6-93.8) ml/(min · 1.73 m2),meanwhile 105 cases became new-onset CKD.There was no significant difference in overall or cancer specific survival between CKD + and CKD-(P =0.137,P =0.190).However age (HR =1.825,95％ CI 1.203-2.768,P =0.017),hydronephrosis (HR =0.243,95 ％ CI 0.106-0.613,P =0.034) and preoperative CKD-EPI GFR (HR =0.237,95 ％ CI 0.109-0.524,P =0.021) were significantly correlative with postoperative new-onset CKD.Conclusion Age,absence of hydronephrosis and preoperative CKD-EPI GFR were independent risk factors predicting new-onset CKD.They can be the predictor of new-onset CKD.

Risk factors of renal function after radical nephroureterectomy for upper tract urothelial carcinoma / 中华泌尿外科杂志

Objective To investigate the risk factors which can lead to chronic kidney disease (CKD) after radical nephroureterectomy and guide adjuvant chemotherapy for the patients with upper tract urothelial carcinoma (UTUC).Methods 239 patients with UTUC,who were treated at our hospital from October 2010 to February 2015 was analyzed retrospectively.Serum creatinine levels were measured preoperatively and 1 month (range:21days to 35 days) after radical nephroureterectomy.129 males and 110 females patients were enrolled.Ages were from 41 to 94,and mean age was 66 years.All patients underwent radical surgery.The pathological stages included Ta/T1/T2/T3/T4,and grades included G1/G2/G3.We calculated GFR using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in consideration of age,sex,and serum creatinine level.The new-onset CKD after RNU was defined as when the calculated CKD-EPI GFR decreased to less than 60 ml/(min · 1.73 m2).These patients were divided into 2 groups which depended on whether they got CKD after RNU.Cohorts were stratified by gender,age,smoking,BMI,hypertension,diabetes mellitus (DM),tumor location,tumor size,multifocality,pathologic stage,grade,hydronephrosis and preoperative CKD-EPI GFR.The chi-square test was used to examine the relationship among the various cohorts and the CKD after RNU.The Kaplan-Meier method was adopted to identify the relationship between Overall survival (OS).Cancer-specific survival (CSS) and CKD.Univariate and multivariate analyses were performed to study the relationship between clinical factors and CKD after RNU using the Cox proportional hazards regression model and chi-square test.Results In our study,the median follow-up time was 41.3 (range from 2-82) months for 239 patients.Median CKD-EPI GFR for all patients before and after surgery was 71.4 (65.2-108.7) ml/(min · 1.73 m2) and 54.7 (37.6-93.8) ml/(min · 1.73 m2),meanwhile 105 cases became new-onset CKD.There was no significant difference in overall or cancer specific survival between CKD + and CKD-(P =0.137,P =0.190).However age (HR =1.825,95％ CI 1.203-2.768,P =0.017),hydronephrosis (HR =0.243,95 ％ CI 0.106-0.613,P =0.034) and preoperative CKD-EPI GFR (HR =0.237,95 ％ CI 0.109-0.524,P =0.021) were significantly correlative with postoperative new-onset CKD.Conclusion Age,absence of hydronephrosis and preoperative CKD-EPI GFR were independent risk factors predicting new-onset CKD.They can be the predictor of new-onset CKD.

Recent Development of Wearable Microfluidics Applied in Body Fluid Testing and Drug Delivery / 分析化学

wearable microfluidics have wide applications in medical, sports and military field. with the help of wearable microfluidics, through the direct physical contact between the chip and skin, the pH, glucose, lactate, sodium/potassium, calcium and heavy metal in the body fluid can be detected from sweat, tear and saliva without puncture for blood. And these information are of great importance for the monitoring of vital signs and disease diagnosis. This paper introduced the most recent development and applications of the wearable microfluidics in the body fluid testing and drug delivery. The up-to-date research development for the drug delivery using wearable microfluidics was also briefly introduced in this article. The forecast of the emerging trend for wearable microfluidics and discussion of potential technique barriers was also provided at the end of this article.

Association of abnormal bone metabolism markers and risk of coronary heart disease in elder women patients / 重庆医学

Objective To explore the correlation of bone metabolism levels and risk of coronary heart disease in elder women patients .Methods A total of 163 elder women patients were divided into three group:CON group ,CAD group ,and CHD group .We explored related atherosclerosis risk factors and factors related to bone metabolism .Results Compared with CON group ,there was no statistical significance in CAD group in factors related to bone metabolism(P>0 .05) .In CHD group ,serum 25‐OH‐Vitamin D significantly decreased and β‐C‐terminal telopeptide of type Ⅰ collagen significantly increased compared with CON group(P<0 .05) .Compared with CAD group ,the serum 25‐OH‐Vitamin C also significantly decreased andβ‐C‐terminal telopeptide of type Ⅰcollagen significantly increased(P< 0 .05) .Spearman correlation analysis showed that BMI ,HDL‐C ,triglycerides ,LDL‐C ,blood glucose and 25‐OH‐Vitamin D were correlated with coronary heart disease .With coronary heart disease as the dependent variable , the results showed lower LDL‐C ,25‐OH‐Vitamin D had independent predictive value for the risk coronary heart disease .Conclusion Lower 25‐OH‐Vitamin D levels in elder patients were positively correlated with coronary heart disease ,and it might also be an in‐dependent predictor .

Preoperative neutrophil-lymphocyte ratio predicts clinical outcome in patients with high grade T1 bladder cancer / 中华泌尿外科杂志

Objective To assess the value of preoperative neutrophil-lymphocyte ratio ( NLR) for predict the prognosis in patients with high grade T1 bladder.Methods From January 2004 to December 2014, the data of 307 patients diagnosed as bladder cancer of Stage 1 and high grade after undergoing TURBT were analyzed, including gender, age, smoking status, tumor number and size, hydronephrosis, intravesical instillations and preoperative blood transfusion of 307 patients diagnosed as bladder cancer of stage 1 and high grade after undergoing TURBT were analyzed retrospectively.All patients were primary urothelial carcinoma.According to preoperative NLR,patients were divided into the low NLR group( NLR≤2.42,n=197) and the high NLR group(NLR >2.42,n =110).Recurrence-free survival (RFS) and progression-free survival ( PFS) were calculated according to the Kaplan-Meier model and compared by the log-rank model.Cox regression models were used for multivariate analyses of the association between NLR and bladder cancer, then the prognostic factors affecting RFS and PFS were evaluated.Result of these 307 patients, the low NLR group accounted for 64.2%(197/307), and the high NLR group accounted for 35. 8%(110/307).The mean follow-up period was 71(range, 1-123)months.The recurrence rate in the low NLR group and the high NLR group recurrence rate were 19.2%( 38/197 ) and 34.5%( 38/110 ) respectively, RFS were 73.0(range, 2-123)months and 67.5(range, 1-122)months respectively.The progression rates were 4.1%(8/197) and 10.9%(12/110) respectively.The recurrence and progression rates in the high NLR group is higher than those in the low NLR group(P2.42(P=0.007,HR=1.912)and hydronephrosis (P<0.01, HR =2.485 ) are associated with higher risk of recurrence.Conclusion Elevated preoperative NLR is an independent predictor of RFS and PFS in patients with high grade T1 bladder cancer.

Recent Development of Droplet Microfluidics in Digital Polymerase Chain Reaction / 分析化学

Digital polymerase chain reaction ( PCR) has been experiencing a rapid development during the past few years. Comparing with the traditional real-time quantitative PCR ( RT-qPCR) , using the same primer and probe, the accuracy for the absolute quantification of target gene is significantly improved. The development of digital PCR is directly related to the development of microfluidics. The integrated fluid circuit is an early combination of the microfluidics and digital PCR, which has a complicated fabrication process with high cost. Recently, researchers are trying to apply the droplet microfluidics in digital PCR, and the droplet microfluidic chip is able to generate millions of droplets within a short time. Each of these droplets containing no more than one target gene is a reaction chamber during the amplification process. After amplification, each droplet is tested to achieve the absolute quantification of the target gene. This paper reviews the recent progresses of droplet digital PCR, and the applications of droplet digital PCR in biological, medical and environmental fields.

Correlations of plasma levels of brain natriuretic peptide and Meprin-α with the severity of coronary-artery stenosis / 中华老年医学杂志

Objective To explore the relationship of the severity of coronary-artery stenosis with plasma levels of brain natriuretic peptide (BNP) and Meprin-α.Methods Totally 237 patients in our hospital were divided into control group (CON group), stable angina group (SA group) and acute coronary syndrome group (ACS group), according to coronary artery angiography.Patients with acute coronary syndrome were divided into 3 subgroups: unstable angina (UA) group, non-ST segment elevation myocardial infarction (NSTEMI) group and ST segment elevation myocardial infarction (STEMI) group.Patients with coronary artery disease (CAD) were divided into 3 subgroups: low-score, medium-score and high-score groups, according to coronary angiography and Syntax score.BNP and Meprin-α levels were determined in patients with coronary artery disease, and the degree of coronary artery stenosis was evaluated.The differences in above indexes were analyzed and compared among the three groups.Results Plasma levels of BNP and Meprin-α were higher in ACS group than in CON group [(233.16± 78.22)ng/L vs.(33.48 ± 13.71)ng/L, (26.89 ± 6.45) nmol/L vs.(12.83±0.66)nmol/L, both P＜0.05].Compared with UA group, plasma levels of BNP and Meprin-α were increased in NSTEMI and STEMI groups (all P＜0.05).Compared with the control group, plasma levels of BNP and Meprin-α in the Syntax scores-divided subgroups were increased (all P＜ 0.05).The plasma levels of BNP and Meprin-α in CAD patients were significantly increased along with the increase of Syntax Score.Spearman correlation analysis showed that low density lipoprotein cholesterol, glucose, BNP and Meprin-α levels had positive correlations with the occurrence of coronary heart disease, while high density lipoprotein level was negatively correlated with the occurrence of coronary heart disease (all P＜0.05).Conclusions BNP and Meprin-α levels in peripheral blood are significantly elevated in patients with coronary heart disease, and they are correlated with Syntax score.The risk of ACS is increased along with the increased BNP and Meprinα levels.

Fatigue property analysis of prosthesis of hip joint with two different materials / 生物医学工程学杂志

Total hip replacement (THR) is replacing the prosthesis stem similar to human bone that takes advantage of the material with both good mechanical properties and biocompatibility to the damaged articular surface. Thus it can not only alleviate or even eliminate the pain but also effectively maintain the joint stability and freedom and restore its normal performance. Finite element analysis was used in this study to establish a 3D model of artificial hip stem, and explore its fatigue properties of different materials to ensure the safety and reliability. The calculating obtained two results of different metal hip prosthesis, including lifetime and deformation. The minimum service life of titanium prosthesis reaches 568 million times, which satisfies ISO standards, while the stainless steel does not suit to be a prosthesis material.

Stress distributions on the femur under different gaits before and after hip joint replacement / 医用生物力学

Objective To investigate biomechanical properties of the femur during slow walking and stair climbing before and after total hip replacement (THA), so as to provide theoretical basis for optimal design and manufacturing of the prosthetic hip. Methods The 3D finite element model of hip femur was established and validated first, and the stress distributions and stress shielding rates during slow walking and stair climbing before and after THA were calculated. Results During slow walking, the stress increased gradually from the proximal femur to the distal femur, reaching the maximum 90.6 MPa at the lower part of the femur before THA. A stress shielding phenomenon occurred on the femur after THA, but the stress amplitude decreased, with the maximum stress reaching 82.5 MPa. The maximum shielding rate appeared near the greater trochanter of the proximal femoral prosthesis and the total stress shielding rate reached 14.9%-99.0%. In addition, excessive stress concentration occurred at the prosthetic neck. Meanwhile, the stress distribution during stair climbing had a similar regular pattern as that appeared during slow waling, but with a more obvious stress shielding effect. Conclusions The greater stress shielding of the proximal femur and the excessive stress concentration on the prosthetic hip during stair climbing will both influence the THA surgery quality, so patients should minimize the movement involving large joint angle after THA.

Efficacy of different doses of dexmedetomidine mixed with ropivacaine for brachial plexus block / 中华麻醉学杂志

Objective To evaluate the efficacy of different doses of dexmedetomidine mixed with ropivacaine for brachial plexus block.Methods One hundred and twenty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 20-60 yr,weighing 40-70 kg,scheduled for upper extremity surgery under brachial plexus block,were randomly divided into 6 groups (n =20 each):ropivacaine group (group R) and different doses of dexmedetomidine groups (groups RD1-5).Brachial plexus block was performed using the interscalene approach.In group R,interscalene brachial plexus block was performed using 0.5 ％ ropivacaine 25 ml (single injection).In groups RD1.5,interscalene brachial plexus block was induced with a mixture (25 ml) of dexmedetomidine 0.25,0.50,0.75,1.00,1.25μg/kg and 0.5 ％ ropivacaine,respectively.The onset time and duration of sensory and motor block were recorded.The adverse effects such as adverse cardiovascular events,excessive sedation,and pneumothorax were also recorded.Results Compared with group R,the onset time was significantly shortened,and the duration of block was prolonged (P ＜ 0.05).Compared with groups RD1 and RD2,the onset time was significantly shortened,and the duration of block was prolonged in groups RD3 5 (P ＜ 0.05).There was no significant difference in the parameters mentioned above between groups RD1 and RD2 or among groups RD3,RD4 and RD5 (P ＞ 0.05).Some patients developed bradycardia,hypotension or excessive sedation in groups RD4 and RD5,while no adverse effects were observed in the other groups.Conclusion Dexmedetomidine 0.75 μg/kg mixed with 0.5 ％ ropivacaine 25 ml can be safely and effectively used for brachial plexus block in patients.

Association of vascular calcification and gremlin expression in radial arteries of patients with stage 5 of chronic kidney disease / 中华肾脏病杂志

Objective To study the association of the expression of bone morphogenetic protein (BMP) antagonist gremlin and vascular calcification in radial arteries of patients with stage 5 of chronic kidney disease (CKD).Methods Radial arteries of 40 patients with stage 5 of CKD were collected as specimens of the study group,which were trimmed off during arterial venous fistula operations.Splenic trabecular arteries were collected as specimens of the control group,which were removed from 38 patients with simple traumatic splenic rupture.All the arteries were examined histologically for calcification with yon Kossa stain.Expressions of gremlin and BMP-2,-7were detected by immunohistochemistry and their serum concentrations were detected by ELISA.Images of histological sections were semi-quantitatively analyzed by Image-Pro Plus 6.0.SPSS 19.0software was used to perform statistical analysis.Results Significantly positive von Kossa stain was found in radial arteries from 12 of 40 patients (30％) in study group,which located in the layer of medial smooth muscle cells.However,there was no obvious positive stain in control group.Additionally,in study group,significant expressions of gremlin and BMP-2 were detected in those radial arteries of positive yon Kossa stain,which also located in the layer of medial smooth muscle cells.Positive correlations were found among gremlin expression level,BMP-2 expression level and yon Kossa stain intensity.However,the BMP-7 expression intensity in arteries of study group was much weaker as compared to control group.Conclusions Both gremlin and BMP-2 may be involved in the process that the smooth muscle cells of radial arteries in patients with stage 5 of CKD phenotypically transform into osteoblast-like cells.However,BMP-7 possibly prevents this process.

Expression of WW domain containing oxidoreductase gene in cholangiocarcinoma and its effect on the biological behavior of cancer cell line RBE / 中华外科杂志

<p><b>OBJECTIVE</b>To study the effects of anti-oncogene WWOX on cell growth of cholangiocarcinoma.</p><p><b>METHODS</b>The expression of WWOX protein was detected with immunohistochemical method-SP in 54 patients with cholangiocarcinoma from July 2005 to May 2010 and 12 samples of normal bile duct tissues. The recombinant WWOX eukaryotic expression plasmid was introduced into RBE cells by liposome-mediated transfection and positive cell clones were selected and amplified. The mRNA and protein expressions in RBE cells stably transfected with WWOX were investigated by quantitative RT-PCR and Western Blot before and after transfection. Cell proliferation was tested by MTT, cell apoptosis was assessed by FCM, the alteration of mitochondria membrane potential (ΔΨm) was detected by JC-1 staining method, cell invasion was determined by Transwell chamber assay. The expression change of bcl-2, bax, FasL, caspase-3 mRNA and protein was detected by quantitative RT-PCR and Western Blot.</p><p><b>RESULTS</b>The expression of WWOX protein was significantly lower in cholangiocarcinoma than that in normal bile duct tissues and loss of WWOX protein expression was found in 40.7% of cholangiocarcinoma specimens (P < 0.05). RBE cells with stable transfection of WWOX were established. Quantitative RT-PCR showed that the expression of WWOX mRNA was significantly enhanced and Western Blot demonstrated that WWOX protein expression was markedly increased. MTT showed that WWOX gene transfection significantly decreased the proliferation of RBE cells (P < 0.05). FCM analysis showed that the apoptosis rate after transfection was significantly promoted [(1.1 ± 0.6)% vs. (1.7 ± 0.5)% vs. (35.2 ± 4.4)%, P < 0.01], JC-1 staining method indicated that the experimental group was loss of ΔΨm [(12.6 ± 1.9)% vs. (13.6 ± 1.8)% vs. (48.7 ± 2.9)%, P < 0.01], transwell chamber assay showed that the number of transfected cells that passed the transwell membrane was significantly less than those of control groups (77 ± 6 vs. 72 ± 8 vs. 48 ± 6, P < 0.01). Quantitative RT-PCR and Western blotting showed that the expression of bcl-2 mRNA and protein was markedly decreased and the expression of bax, caspase-3 were significantly increased. There was no significant change in the expression of FasL.</p><p><b>CONCLUSION</b>WWOX exerts its antitumor effect against proliferation through inducing cell apoptosis in cholangiocarcinoma.</p>

Health care and disease prevention in Jiujing Tu (Illustration of moxibustion) of the Dunhuang caves / 中国针灸

Figure four of the Jiujing Tu (Illustration of Moxibustion) of the Dunhuang Caves is the earliest and the most complete recording of treatment for five kinds of strain and seven kinds of impairments in the history of acupuncture and moxibustion. Figure 12 is held as a mystery since it only provided illustrations without indications. Through analysis and approved by clinical experiences, it is held that the two figures are companion illustrations on prevention and treatment of five kinds of strain and seven kinds of impairments as well as health keeping with moxibustion. The point prescriptions in these two figures are defined according to the tri-gram in Yijing (The Book of Change), which allowed the maximization of harmony between the human and the nature. Recovery and health are thus fulfilled through regulation on points at the head, trunk and four extremities of the body. And it is considered to have great significance for promoting the development of the present acupuncture and moxibustion theory since it is effective in both preventing and curing diseases caused by deficient and stagnation conditions such as the wei (flaccidity) syndrome, bi (arthralgia) syndrome, paralysis, dementia, asthma and so on.