Nutritional status and its related factors among primary and secondary school students in Beijing City / 中国学校卫生

Objective@#To assess the nutritional status of primary and secondary school students in Beijing City and to analyze the related factors, so as to provide a scientific basis for improving the nutritional status of primary and secondary school students in a targeted manner.@*Methods@#Based on the 2021 Beijing Student Common Diseases and Health Influencing Factors Surveillance Project, a stratified random cluster sampling method was used to conduct a physical examination and questionnaire survey on 25 487 primary and secondary school students from September to November 2021. The Chi square test was used for comparison of nutritional status detection rates, and disordered multi classification Logistic regression analysis was used to explore the factors associated with students nutritional status.@*Results@#The detection rates of malnutrition, overweight and obesity among primary and secondary school students in Beijing City were 4.7%, 18.0% and 23.8% respectively. The detection rates of malnutrition, overweight and obesity were higher among male students (5.1%, 20.4%, 29.7%) than female students (4.2%, 15.5%, 17.4%) ( χ 2= 12.23, 101.71, 526.99, P <0.01). The detection rate of obesity was higher in the suburbs than urban areas(26.6%, 19.8%), and the detection rate of malnutrition was lower in the suburbs than urban areas (4.2%,5.5%)( χ 2=157.25, 23.61, P <0.01). The results of disordered multi classification Logistic regression showed that the related factors for malnutrition, overweight and obesity were gender, residence, moderate to vigorous exercise ≥60 min per day and lack of sleep( OR =1.70, 1.88,2.48; 1.14, 0.87, 0.67; 0.85, 0.92, 0.81 ; 0.83, 1.08, 1.07); frequency of fried food intake daily was a related factor for overweight ( OR =0.70); whether eating breakfast daily or not was a related factor for overweight and obesity ( OR =0.91, 0.84); academic level (middle and high school) was a related factor for malnutrition and obesity ( OR =1.38, 1.37; 0.77, 1.40)( P <0.05).@*Conclusions@#The problem of overweight and obesity among primary and secondary school students in Beijing City continues to be serious, especially among boys and suburban areas. It is recommended that society, schools, families and individuals should work together to improve the nutritional status of primary and secondary school students by adopting a graded and classified approach.

Construction of iPSC-derived Inhibitory Neural Network Tissue with Synaptic Transmission Potentials / 中山大学学报(医学科学版)

ObjectiveDirected differentiation of human induced pluripotent stem cells （hiPSCs） into spinal cord γ-aminobutyric acid （GABA）-ergic progenitor cells were implanted into an decellularized optical nerve （DON） bioscaffold to construct a hiPSC-derived inhibitory neural network tissue with synaptic activities. This study aimed to provide a novel stem cell-based tissue engineering product for the study and the repair of central nervous system injury. MethodsThe combination of stepwise directional induction and tissue engineering technology was applied in this study. After hiPSCs were directionally induced into human neural progenitor cells （hNPCs） in vitro， they were seeded into a DON for three-dimensional culture， allowing further differentiation into inhibitory GABAergic neurons under the specific neuronal induction environment. Transmission electron microscopy and whole cell patch clamp technique were used to detect whether the hiPSCs differentiated neurons could form synapse-like structures and whether these neurons had spontaneous inhibitory postsynaptic currents， respectively， in order to validate that the hiPSC-derived neurons would form neural networks with synaptic transmission potentials from a structural and functional perspective. ResultsThe inhibitory neurons of GABAergic phenotype were successfully induced from hiPSCs in vitro， and maintained good viability after 28 days of culture. With the transmission electron microscopy， it was observed that many cell junctions were formed between hiPSC-derived neural cells in the three-dimensional materials， some of which presented a synapse- like structure， manifested as the slight thickness of cell membrane and a small number of vesicles within one side of the cell junctions， the typical structure of a presynatic component， and focal thickness of the membrane of the other side of the cell junctions， a typical structure of a postsynaptic component. According to whole-cell patch-clamp recording， the hiPSC-derived neurons had the capability to generate action potentials and spontaneous inhibitory postsynaptic currents were recorded in this biotissue. ConclusionsThe results of this study indicated that hiPSCs can be induced to differentiate into GABAergic progenitor cells in vitro and can successfully construct iPSC-derived inhibitory neural network tissue with synaptic transmission after implanted into a DON for three-dimensional culture. This study would provide a novel neural network tissue for future research and treatment of central nervous system injury by stem cell tissue engineering technology.

Construction of hiPSC-derived Excitatory Neural Network-like Tissue / 中山大学学报(医学科学版)

ObjectiveTo construct a neural network-like tissue with the potential of synaptic formation in vitro by seeding human induced pluripotent stem cell-derived neural precursor cells （hiPSC-NPCs） on decellularized optic nerve （DON）， so as to provide a promising approach for repair of nerve tissue injury. MethodsThrough directional induction and tissue engineering technology， human induced pluripotent stem cells （hiPSCs） and 3D DON scaffolds were combined to construct neural network-like tissues. Then the hiPSCs were directionally induced into human neural precursor cells （hNPCs） and neurons. Immunofluorescence staining was used to identify cell differentiation efficiency. 3D DON scaffolds were prepared. Morphology and cytocompatibility of scaffolds were identified by scanning electron microscopy and Tunnel staining. Induced hiPSC-NPCs were seeded on DON scaffolds. Immunofluorescence staining， scanning electron microscopy， transmission electron microscopy and patch clamp were used to observe the morphology and functional identification of constructed neural network tissues. Results①The results of immunofluorescence staining suggested that most of hiPSC-NPCs differentiated into neurons in vitro. We had successfully constructed a neural network dominated by neurons. ② The results of scanning electron microscopy and immunohistochemistry suggested that a neural network-like tissue with predominating excitatory neurons in vitro was successfully constructed. ③The results of immunohistochemical staining， transmission electron microscopy and patch clamp indicated that the neural network-like tissue had synaptic transmission function. ConclusionA neural network-like tissue mainly composed of excitatory neurons has been constructed by the combination of natural uniform-channel DON scaffold and hiPSC-NPCs， which has the function of synaptic transmission. This neural network plays a significant role in stem cell derived replacement therapy， and offers a promising prospect for repair of spinal cord injury （SCI） and other neural tissue injuries.

Effect of lidocaine on dose-effect relationship of remimazolam combined with alfentanil in inhibiting responses to gastroscope insertion in elderly patients / 中华麻醉学杂志

Objective:To evaluate the effect of lidocaine on the dose-effect relationship of remimazolam combined with alfentanil in inhibiting responses to gastroscope insertion in elderly patients.Methods:American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱelderly patients of either sex, aged 65-80 yr, with body mass index of 18-28 kg/m 2, undergoing painless gastroscopy under general anesthesia, were divided into 2 groups using a random number table method: remimazolam group (group C) and lidocaine combined with remimazolam group (group L). Alfentanil 6 μg/kg was given at anesthesia induction in all the patients, and then lidocaine 2 mg/kg was intravenously injected in the patients in group L. Modified Dixon′s up-and-down method was used for the study. Remimazolam was intravenously injected at a dose of 0.18 mg/kg in the first patient, and the gastroscope was placed when the eyelash reflex disappeared and the modified observational alertness/sedation assessment score ≤3. Gastroscope insertion response was defined as swallowing, bucking, body movement and other responses affecting the quality of examination during the gastroscope insertion. The dose of remimazolam was increased/decreased by 0.02 mg/kg in the next patient if the gastroscope response was positive or negative, and the process was repeated until 9 turning points occurred. The median effective dose (ED 50) and 95% confidence interval ( CI) of remimazolam were calculated by probit method. Results:The ED 50 (95% CI) of remidazolam in inhibiting responses to gastroscope insertion in elderly patients when combined with alfentanil was 0.158 (0.133-0.183) mg/kg in group C. The ED 50 (95% CI) of remidazolam in inhibiting responses to gastroscope insertion in elderly patients when combined with fentanyl was 0.139 (0.127-0.151) mg/kg in group L. The ED 50 was significantly lower in group L than in group C ( P=0.003). Conclusions:Intravenous lidocaine in combination with alfentanil increases the efficacy of remimazolam for painless gastroscopy in elderly patients.

Initial study on a comprehensive strategy for female patients with bladder pain syndrome / 现代泌尿外科杂志

【Objective】 To explore the efficacy of a comprehensive treatment strategy of bladder hydrodistension, transurethral resection of bladder lesions and triple drug instillation in patients with painful bladder syndrome (BPS). 【Methods】 A total of 15 female BPS patients treated during Jan.2020 and Oct.2021 were enrolled. All patients received bladder hydrodistension and transurethral resection. After operation, intravesical instillation of a triple-drug mixture (2% lidocaine hydrochloride 20 mL, heparin sodium 25 000 U, and dexamethasone 10 mg) was administered once a day for 5 days, and then once per week for 4 weeks. The Visual Analogue Scale (VAS) score, quality of sexual life, health-related quality of life, and self-rating anxiety scale score were compared before treatment and 1, 4 and 12 weeks after treatment. The complications were recorded. 【Results】 All patients completed the treatment. Of 14 patients, the VAS score and self-rating anxiety scale score were lower in week 1, 4 and 12 after treatment, while the health-related quality of life score increased. One patient’s symptoms remained unchanged. The VAS score decreased from (5.47±1.81) to (1.87±1.51) (P<0.05), and the self-rating anxiety scale score decreased from (18.13±8.64) to (6.33±8.22) (P<0.05). The score of health-related quality of life increased from (24.47±5.41) to (31.53±6.49) (P<0.05). 【Conclusion】 The comprehensive strategy is effective in the treatment of bladder pain syndrome, which can relieve pain symptoms and improve patients’ quality of life.

Transition rules of cognitive frailty and influencing factors in the elderly in China / 中华流行病学杂志

Objective: To understand the transition rules of cognitive frailty and its influencing factors in the elderly in China and provide evidence for the early intervention of cognitive frailty. Methods: Data were retrospectively collected from China Health and Retirement Longitudinal Study with 3 round consecutive survey (2011, 2013, 2015) and the state of the subjects were classified into four categories: robust-normal cognitive, cognitive impairment, physical frailty, and cognitive frailty. A multi-state Markov model was established to explore the transition rules of cognitive frailty and its influencing factors. Results: A total of 3 470 older adults were included, and 350 (10.09%) had cognitive frailty at baseline. After two years, the probability of cognitive frailty in the cognitive impairment population was higher than that in people with physical frailty (31.6% vs. 7.6%). Persons with cognitive frailty were more likely to become physical frailty (29.7% vs. 15.6%). Being women (HR=1.599, 95%CI: 1.058-2.417), comorbidity (HR=3.035, 95%CI: 1.090-8.450), and depression (HR=1.678, 95%CI: 1.153-2.441) were the risk factors associated with cognitive frailty in the elderly, while being educated (HR=2.367, 95%CI: 1.567-3.575) was a protective factor for the transition of cognitive frailty to physical frailty. Conclusions: The prevalence of cognitive frailty is relatively high in the elderly in China. Those with cognitive impairment have a higher probability of cognitive frailty. Gender, education level, comorbidity, and depression are the main influencing factors for the occurrence and transition of cognitive frailty.

Research Progress of Quercetin in Treatment of Rheumatoid Arthritis / 中国实验方剂学杂志

Rheumatoid arthritis （RA） is a chronic and systemic autoimmune disease with aggressive and symmetrical polyarthritis as the main clinical manifestations. The exact pathogenesis is unknown. Its basic pathological changes include chronic inflammation of the joint synovium， increased joint cavity effusion， pannus formation， gradual cartilage damage and bone erosion， eventually leading to joint deformity and loss of function. It has been found that the onset and development of RA are related to heredity， environment and other factors. The drugs for RA mainly include non-steroidal anti-inflammatory drugs （NSAIDs）， corticosteroids， disease-modifying anti-rheumatic drugs （DMARDs） and biological agents. However， long-term use of these drugs can cause a variety of side effects and adverse reactions， such as myocardial infarction， peptic ulcer， poor wound healing， and liver and kidney dysfunction. In addition， natural medicines have a good application prospect because of their various pharmacological activities and few side effects. Quercetin is a flavonoid found in Morus alba and tetrandrine， with diverse pharmacological activities， including cardiovascular diseases， joint movement， tumor immunology and so on. Not only have the clinical trials shown good efficacy of quercetin， but the experimental studies have also proven that quercetin can improve RA by reducing inflammatory response， inhibiting the formation of synovial pannus， synovial hyperplasia， neutrophil NETs formation， osteoclast function， regulating Th17/Treg balance and other mechanism. In this article， we will briefly summarize the regulatory mechanism of quercetin and discuss the complexed effect of quercetin on rheumatoid arthritis.

Short-term efficacy of CT-guided microwave ablation for solitary pulmonary nodules / 中国胸心血管外科临床杂志

@#Objective    To evaluate the clinical feasibility and safety of CT-guided percutaneous microwave ablation for peripheral solitary pulmonary nodules. Methods    The imaging and clinical data of 33 patients with pulmonary nodule less than 3 cm in diameter treated by CT-guided microwave ablation treatment (PMAT) in our hospital from July 2018 to December 2019 were retrospectively analyzed. There were 21 males and 12 females aged 38-90 (67.6±13.4) years. Among them, 26 patients were confirmed with lung cancer by biopsy and 7 patients were clinically considered as partial malignant lesions. The average diameter of 33 nodules was 0.6-3.0 (1.8±0.6) cm. The 3- and 6-month follow-up CT was performed to evaluate the therapy method by comparing the diameter and enhancement degree of lesions with 1-month CT manifestation. Short-term treatment analysis including complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) was calculated according to the WHO modified response evaluation criteria in solid tumor (mRECIST) for short-term efficacy evaluation. Eventually the result of response rate (RR) was calculated. Progression-free survival was obtained by Kaplan–Meier analysis. Results    CT-guided percutaneous microwave ablation was successfully conducted in all patients. Three patients suffered slight pneumothorax. There were 18 (54.5%) patients who achieved CR, 9 (27.3%) patients PR, 4 (12.1%) patients SD and 2 (6.1%) patients PD. The short-term follow-up effective rate was 81.8%. Logistic analysis demonstrated that primary and metastatic pulmonary nodules had no difference in progression-free time (log-rank P=0.624). Conclusion    PMAT is of high success rate for the treatment of solitary pulmonary nodules without severe complications, which can be used as an effective alternative treatment for nonsurgical candidates.

Comparison of clinical effects of different anterior surgical methods for the treatment of single segment cervical disc herniation / 中国骨伤

OBJECTIVE@#To compare the clinical effects of different anterior surgical methods in treating single segment cervical disc herniation.@*METHODS@#The clinical data of 46 patients with single-segment cervical disc herniation underwent surgical treatment from September 2013 to September 2018 were retrospectively analyzed. The patients were divided into three groups according to different surgical methods. Among them, 23 patients in the anterior percutanousendomic cervical dissection (APECD) group, there were 8 males and 15 females, aged (47±3) years old, prominent segments were C@*RESULTS@#All 46 patients were followed up for 12 to 24 (17.57±3.15)months. The follow-up time of APECD, CDR, ACDF groups were (17.30±3.25), (17.80±3.16), (17.85±2.88) months, and operation time were (95.48 ±13.85), (58.50±7.09), (76.00±15.72) min, respectively, there were no significant differences in follow-up time and operation time between two groups(@*CONCLUSION@#The three anterior surgical approaches can achieve satisfactory clinical results for the treatment of single-segment cervical disc herniation. However, the improvement rate of the CDR group and the activity of the retained responsibility segment are better than those of the other two groups. APECD surgery may have recurrence.

Effects of different root canal obturation techniques on apical sealing ability of iRoot SP / 中国医师杂志

Objective:The aim of this study was to evaluate different root canal obturation techniques on apical sealing ability of iRoot SP.Methods:Thirty-six single root mandibular premolar were collected. The root canals were mechanically instrumented with ProTaper rotary files to F3. The prepared samples were randomly divided into four experimental groups ( n=8) for root canal filling. The remaining four teeth were classified as a negative group ( n=2) and a positive control group ( n=2) respectively. The canals in the four experimental groups were obturated with gutta-percha and (or) iRoot SP, by either cold lateral compaction technique (CLC), continuous wave condensation technique (CWC), single-core technique (SC) or Sealer only backfill technique (SOB) respectively. The samples were then placed in a 37 ℃ water bath for 7 days to allow completely harden. All samples of experimental groups were sealed with nail polish except 1 mm from the apex and negative control group was fully enclosed while positive control group was fully open, then all root tips were immersed in 0.1% methylene blue solution for 7 days, then cut along the long axis of the tooth on a low-speed microtome, observed under a microscope (X10) and photographed. The software of image J was used to measure the apical leakage. Results:Apical microleakage were present in all filling techniques. SC technology showed higher apical leakage [(5.02±2.23)mm], while CWC showed lower [(3.59±1.76)mm], but there were no statistical difference ( P>0.05). Conclusions:All filling techniques can not completely seal the root apical, SOB technology has the similar apical sealing performance as other techniques.

Professor 's experience of acupuncture and moxibustion of regulating spleen-stomach and differentiating meridians-collaterals / 中国针灸

Professor - successively followed famous doctors of acupuncture and spleen-stomach disease, such as -, inherited their academic thoughts and clinical experience, and studied the classics to summarize and propose the clinical academic proposition regulating spleen-stomach differentiating meridians-collaterals. In clinical practice, professor focuses on individual differences of patients, carefully examines syndrome and refines acupoint selection; he pays attention to regulating spleen-stomach, and actively uses Zusanli (ST 36); he simultaneously uses acupuncture-moxibustion and acupoints with efficacy; he inherits traditional reinforcing and reducing methods, and extends the scope of acupoint diagnosis and treatment, while he emphasizes keeping spirit and treating spirit, and the combination of mind and , in order to improve clinical diagnosis and treatment effect.

Construction of a medical records management system based on document database / 中国医学装备

Objective:To construct a medical records management system based on document database so as to promote standardization of medical records management and improve management efficiency.Methods:Microsoft.Net platform and SQL SERVER database were selected, and three-tier framework of.Net webservic was adopted to design a medical records management system which contained three modules included filing, review and system management for medical records and which based on document database.Results:The application of this system significantly reduced the operational process of manual business of the staffs, and optimized the workflow, and extremely improved the work efficiency and significantly increased the utilization rate of medical records.Conclusion:The application of medical records management system based on document database not only can improve the work efficiency of staff but also can make better use of medical records, and better promote information construction and improvement of medical service quality of hospital.

Efficacy and related parameters of alteplase combined with low molecular heparin sodium ine treatment of sub-large area pulmonary embolism / 实用医学杂志

Objective To study and investigate the efficacy of alteplase combined with low molecular weight heparin sodium in the treatment of patients with submaximal pulmonary embolism and its influence on related indicators, and to guide clinical medication. Methods Eighty patients with large pulmonary embolism treated in our department from August 2013 to August 2017 were randomly divided into observation group and control group, with 40 cases in each group. The control group was treated with subcutaneous injection of low molecular weight heparin sodium. In combination with oral anticoagulation with warfarin, the observation group was treated with alteplase on the basis of the control group. After 1 week of continuous treatment, the clinical efficacy was compared between the 2 groups, and pulmonary function and arterial partial pressure of oxygen (PaO2) were compared before and after the treatment. The partial pressure of carbon dioxide (PaCO2) was used to compare the levels of serum B-type natriuretic peptide (BNP) , troponin Ⅰ (cTnⅠ) , homocysteine (Hey) , Ddimer (D-D) , and bleeding before and after the treatment in both groups. Results The total effective rate was97.50％ in the observation group, which was significantly higher than that in the control group of 75.00％ (P <0.05). There was no significant difference in terms of FEV1％, FEV1/FVC, PaO2 and PaCO2 between the two groups before the treatment (P> 0.05) , but FEV1％, FEV1/FVC, PaO2 in the observation group were significantly higher than those in the control group after the treatment, and PaCO2 was significantly lower (P <0.05); There was no significant difference regarding to serum BNP, cTnl, Hey and D-D levels between the two groups before the treatment (P> 0.05) , but after the treatment, the indexes of the observation group were significantly lower than those of the control group (P < 0.05). There was no statistical difference in the incidence of bleeding between the two groups (P> 0.05). Conclusion Alteplase combined with low-molecular-weight heparin sodium in the treatment of the next large-area pulmonary embolism can improve the efficiency of treatment, lung function and the prognosis, but will not inc-rease the risk of bleeding. It could be widely used in clinical practice.

Preoperativeevaluationofvisceralpleuralinvasionoflungadenocarcinomawith MSCT / 实用放射学杂志

Objective Toimprovethepreoperativediagnosisoflungadenocarcinomaaccordingtotherelationshipbetweenthevisceralpleural invasion(VPI)andtheCTfeatures.Methods TheCTfeaturesandthepathologicalmanifestationsof351lungadenocarcinomasconfirmedby surgicalpathologywereretrospectivelyanalyzed.TworadiologistsindependentlyevaluatedtheCTfeatures,includingthelocationand maximumdiameterofthelesion,theminimumdistancefromthelesiontothepleura(DLP)inthree-dimensionalreconstructionimageandthe relationofthelesiontotheadjacentpleura(RAP).TheRAPwasdescribedas5types:(1)nocontactofthethelesionwiththepleura,(2)aline betweenthelesionandthepleurawithoutretractionoftheinvolvedpleura,(3)thelesiontightlyclosedtothepleurawithouttypical pleuraretraction,(4)oneormorelinearstrandsradiatedfromthelesiontothepleuralsurfacewithpleuralretraction,(5)broadcontactofthe lesionandpleurawiththecontactsurfaceoflesionover50% withpleuralretraction.Anexperiencedpathologistevaluatedthehistopathological patternsaccordingtothe7thEditionoftheTNMclassificationforlungcancer(PL0-PL2).AndthePL1andPL2weredescribed as VPI (+)group ,meanwhile the PL0 was as the VPI (-)group .Univariate analysis such as t test,χ 2 or One-W ay analysis of variance was performedtoidentifytheindependentpredictorsinpredictingVPI.Results Significantdifferenceswerefoundinpatientage,lesionlocation, maximumdiameter,andRAPbetweenVPI(+)andVPI(-)groups(P<0.05).Conclusion Whenthepatientwithlungadenocarcinomais over60yearsold,withthelesiondiameterover2.3cm,thepossibilityofvisceralpleuralinvasionwillbeconsideredaccordingtothe relationshipofthelesionandtheadjacentpleura(abuttingpleuralorpleuralindentation).

Clinicopathological features of minute meningothelial-like nodules in the lung / 中华病理学杂志

Objective@#To study the clinicopathological features of minute meningothelial-like nodule (MMLN) in the lung and its histological origin.@*Methods@#Clinicopathological data of 93 patients diagnosed with MMLN in Jiangsu Province Hospital(the First Affiliated Hospital of Nanjing Medical University) from September 2016 to September 2018 were collected and analyzed retrospectively, and the related literature was reviewed.@*Results@#Ninety-three MMLNs were identified from 5 239 patients undergoing pulmonary resection. There were 18(19.6%) males and 75(80.6%) females; age ranged 38-81 years, with mean age 58 years. The frequency of MMLNs was related to the site of origin, and single lesion most commonly (43%) arose in right lobe. There was no significant relationship with patients′ age, gender and the co-existing malignant tumors. Receiver operating characteristic (ROC) curve analysis showed that the area under curve (AUC) was 0.584 (P<0.05), and the best cut-off point was 11.5, indicating an appropriate increase in the number of slides to at least 12 would facilitate the discovery of MMLN. Histologically, MMLN cells showed bland morphology, located around the normal alveolar cavity or form nests or whorls centered on small veins. Immunohistochemistry was done in 55 cases, and all cells expressed vimentin; and a high proportion of cells expressed EMA, PR, CD56 and Calponin. They were all negative for TTF1, Syn, CgA, CKpan, SMA and CD34. The Ki-67 index was low in all cases (<2%). In addition odds ratio analysis showed that MMLN was not a risk factor for invasive carcinoma (including other malignant tumors in the lung, P=0.100).@*Conclusions@#MMLN closely resembles meningothelioma morphologically and immunophenotypically, although its origin remains uncertain. In the study, MMLN is considered as a reactive benign lesion around pulmonary pathology, functioning as an effector regulating small blood vessels caliber. MMLN probably provides nutritional support to the surrounding disease and affords a suitable environment for the development of tumor cells.

Effect of triptolide on cognitive dysfunction in vascular dementia rats through SIRT1/NF-κB signaling pathway / 中国中药杂志

To investigate the effect of triptolide on cognitive dysfunction in vascular dementia rats and its effect on SIRT1/NF-κB pathway,fifty healthy male Sprague-Dawley rats were randomly divided into 5 groups: Sham operation group( Sham group),vascular dementia model group( 2 VO group),triptolide intraperitoneal injection group( TR group),triptolide intraperitoneal injection + EX527 intracerebroventricular administration group( T+E group),EX527 intracerebroventricular administration group( EX527 group). After 4 weeks of modeling,Morris water maze test and object recognition test were used to evaluate the learning and memory ability of rats. The morphological changes of hippocampus in each group were observed in brain tissue. The chemical colorimetry was used to detect the activities of SOD and MDA in hippocampus. IL-6 and TNF-α levels were detected by ELISA. Western blot was used to detect the expression of SIRT1,NF-κB,IκBα and caspase 3 in hippocampus. The results showed that compared with the Sham group,the learning and memory ability of the vascular dementia model rats was reduced,the SOD activity in the hippocampus was decreased,the MDA activity and IL-6 level were increased,the neuronal degeneration changed significantly,the expression of SIRT1 and IκBα was decreased and the expression of caspase 3 and NF-κB was significantly increased. After intervention by triptolide,the level of oxidative stress and the degenerative changes in hippocampus were significantly slowed down. The expression of SIRT1 and IκBα protein was increased and the expression of caspase 3 and NF-κB was significantly decreased. While,after intervention by triptolide and EX527,the expression of SIRT1 was decreased,the levels of oxidative stress and neuronal degeneration in the hippocampus were aggravated,and the learning and memory ability was reduced. The results showed that triptolide could improve cognitive impairment in vascular dementia rats and its mechanism may be related to SIRT1/NF-κB signaling pathway.

Correlation analysis of serum interleukin 1β,C reactive protein and homocysteine levels in elderly patients with ischemic stroke after fatigue and ischemic stroke / 国际检验医学杂志

Objective To investigate the correlation between serum interleukin 1β (IL-1β) ,C reactive pro-tein (CRP) and homocysteine (Hcy) levels in elderly patients with ischemic stroke after fatigue and ischemic stroke .Methods 119 elderly patients with ischemic stroke were selected from our hospital from August 2016 to August 2017 .According to the fatigue severity scale ,40 cases were divided into fatigue group and 79 cases in non fatigue group .The peripheral blood samples were taken from the fasting blood in early morning ,and the serum levels of IL-1β ,CPR and Hcy were determined by enzyme linked immunosorbent assay (ELISA ) . Results The fatigue group ADL score ,Fugl-Meyer motor function of upper and lower limbs were lower than those of non fatigue group and control group ,the difference was statistically significant (non fatigue group :t＝23 .360 9 ,18 .203 6 ,9 .288 6 ,the control group :t＝39 .926 6 ,20 .260 3 ,21 .929 6 ,P＜0 .05) ;Non fatigue group ADL score ,Fugl-Meyer motor function of upper and lower limbs score lower than the control group ,the difference was statistically significant (t＝23 .021 4 ,6 .831 9 16 .810 3 ,P＜0 .05) .Fatigue serum IL-1β ,CPR and Hcy were higher than that in non fatigue group and control group ,the difference was statistically signifi-cant(non fatigue group :t＝14 .561 5 ,17 .029 6 ,13 .059 9 ,the control group :t＝31 .631 9 ,36 .998 3 ,33 .670 0 , P＜0 .05) ;Non fatigue group serum IL-1β ,CPR and Hcy were higher than that of control group ,the difference was statistically significant (t＝23 .866 0 ,28 .774 4 ,26 .135 4 ,P＜0 .05) .There was a positive linear correla- tion between fatigue and IL-1 beta ,CPR and Hcy in patients with ischemic stroke .Conclusion IL-1 ,CPR and Hcy levels in elderly patients with ischemic stroke fatigue were significantly elevated and it has obvious corre-lation .

Efficacy evaluation of modified lamina osteotomy replantation versus traditional lamina osteotomy replantation in treating lumbar disc herniation with lumbar instability / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of modified lamina osteotomy replantation versus traditional lamina osteotomy replantation in the treatment of lumbar disc herniation with lumbar instability.</p><p><b>METHODS</b>The clinical data of 146 patients with unilateral lumbar disc herniation with lumbar instability underwent surgical treatment from March 2008 to March 2013 were retrospectively analyzed. Patients were divided into two groups according to osteotomy replantation pattern. There were 77 patients in the traditional group (underwent traditional lamina osteotomy replantation), including 42 males and 35 females with an average age of (49.4±18.5) years;the lesions occurred on L₄,₅ in 46 cases, on L₅5S₁ in 31 cases. There were 69 patients in modified group (underwent modified lamina osteotomy replantation), including 37 males and 32 females with an average age of (49.8±17.9) years;the lesions occurred on L₄,₅ in 40 cases, on L₅S₁ in 29 cases. The operation time, intraoperative blood loss, complication rate during operation, lamina healing rate, recurrence rate of low back and leg pain were compared between two groups. Visual analogue scales (VAS) and Japanese Orthopadic Association (JOA) scores were used to evaluate the clinical effects.</p><p><b>RESULTS</b>The operation time and intraoperative blood loss were similar between two group (>0.05). There was significantly different in nerve injury rate(5.80% vs 16.9%) and dural injury rate(1.45% vs 9.09%) between modified group and traditional group(<0.05). The recurrent rate of low back pain of modified group was higher (91.30%, 63/69) than that of traditional group (76.62%, 59/77), and the intervertebral fusion rate of modified group was lower(8.70%, 6/69) than that of traditional group (29.9%, 23/77) at 3 years after operation. Postoperative VAS scores of all patients were significantly decreased at 6 months, 1, 2, 3 years, and JOA scores were obviously increased (<0.05). At 1, 2, 3 years after operation, VAS scores of modified group were significantly lower than that of traditional group(<0.05), and JOA scores of modified group were higher than that of traditional group(<0.05).</p><p><b>CONCLUSIONS</b>Modified lamina osteotomy replantation has better long-term efficacy(in the aspect of recurrent rate of low back pain, intervertebral fusion rate, VAS and JOA score at three years follow-up) in treating lumbar disc herniation with instability.</p>

Imatinib as Second-Line Treatment Drug for CML Patients Intolerant to Nilotinib / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the individualized treatment for patient with chronic phase chronic myeloid leukemia(CML-CP).</p><p><b>METHODS</b>The clinical data and treatment process of one CML-CP patient which intolerated to nilotinib were analyzed.</p><p><b>RESULTS</b>Nilotinib was given to the patient once the diagnosis of CML-CP was set. Although major molecular remission (MMR) and complete cytogenetic remission (CCyR) were obtained during treatment for 3 months, a grade 3-4 hepatotoxicity appeared in the course of treatment.With drug reduction and symptomatic treatment, nilotinib was discontinued after 3 withdrawals and replaced with imatinib in January 11, 2015. The patients achieved MMR and CCyR at 7 months after imatinib replacement. At present, the patient tolerated well without any adverse events.</p><p><b>CONCLUSION</b>Imatinib can be used as a second-line treatment drug for CML patients who was intolerant to nilotinib, and with less adverts, good effect and so on.</p>

Analysis of clinical effects in the treatment of single-segment lumbar degenerative disease by lamina osteotomy and former vertebral plates regraft / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical effect between the lamina osteotomy and former vertebral plates regraft method and total laminectomy and interbody fusion method in treating single-segment lumbar degenerative disease.</p><p><b>METHODS</b>The clinical data of 167 patients with single-segment lumbar degenerative disease underwent surgical treatment from January 2010 to December 2014 were retrospectively analyzed. There were 92 males and 75 females, aged from 45 to 75 years old with an average of (59.6±12.4) years. The patients were divided into lamina osteotomy and former vertebral plates regraft group(82 cases) and total laminectomy and interbody fusion group(85 cases) according to the different surgical methods used. The general conditions and clinical effects were compared between two groups. General conditions included the operation time, intraoperative blood loss, postoperative drainage, hospitalization time and the clinical effects included the visual analogue scale (VAS), Japanese Orthopaedic Association(JOA), Oswestry Dability Index(ODI), MacNab results, epidural fibrosis (EF), the incidence of adjacent segment degeneration (ASD).</p><p><b>RESULTS</b>All the patients were followed for 18 to 36 months with an average of (24.8±5.7) months, furthermore, there was no significant difference in the follow-up time between two groups. There was no significant difference in general conditions such as operation time, intraoperative blood loss, postoperative drainage, or hospitalization time between two groups. At final follow-up, the VAS, ODI, JOA, of all patients were significantly improved (<0.05);and the three factors above in the lamina osteotomy and former vertebral plates regraft group respectively were(2.0±1.1) points, (24.0±1.8) %, (19.8±8.2) point, while the results of total laminectomy and interbody fusion group were(2.5±1.6) points, (23.3±2.0)%, and(22.5±8.5) point;there was statistical difference between two groups(<0.05). According to the standard of MacNab, 59 cases obtained excellent results, 20 good, 3 fair results in the lamina osteotomy and former vertebral plates regraft group;while 47 cases got excellent results, 26 good, and 12 fair results in the total laminectomy and interbody fusion group;there was significant difference between two groups(<0.05). Sixteen patients(19.51%) with EF and 20 patients(24.39%) with ASD were found in lamina osteotomy and former vertebral plates regraft group;and 30 patients(35.29%) with EF and 37 patients(43.53%) with ASD were found in total laminectomy and interbody fusion group; there was significant difference between two groups(<0.05).</p><p><b>CONCLUSIONS</b>Both two methods can achieve the ideal effects for the treatment of single-segment lumbar degenerative disease, but the lamina osteotomy and former vertebral plates regraft method can reserve the integrity of posterior ligamentous complex, reducing the incidence of EF and ASD, and is a better surgical method.</p>