Prevalence of nonalcoholic fatty liver disease in community-dwelling elderly women and its influencing factors / 中华全科医师杂志

Objective:To analyze the status quo and influencing factors of non-alcoholic fatty liver disease in community-dwelling elderly women.Methods:A total of 9 754 female residents aged 60-79 years who attended health check-up in Anting Town Community Health Service Center from June 2019 to December 2021 were enrolled in the study. According to the ultrasound diagnosis, there were 5 220 cases of non-alcoholic fatty liver disease (NAFLD group) and 4 534 cases without NAFLD (non-NAFLD group). The general information, physiological and biochemical indicators were compared between two groups with Mann-Whitney U test and Chi-square test; the influence factors of NAFLD were analyzed with logistic regression. Results:The overall prevalence of NAFLD was 53.52%(5 220/9 754), prevalence in the 65-69 age group was the highest and that in the 75-79 age group was the lowest. Body mass index ( Z=47.667), waist circumference ( Z=45.949), waist-to-hip ratio ( Z=30.805), systolic blood pressure ( Z=7.543), diastolic blood pressure ( Z=7.621), fasting blood glucose ( Z=20.298), glycated hemoglobin ( Z=23.588), alanine aminotransferase ( Z=29.624), aspartate aminotransferase ( Z=7.824), total bilirubin ( Z=4.441), triglyceride ( Z=34.597), low-density lipoprotein cholesterol ( Z=2.476) and blood uric acid ( Z=29.934) levels of NAFLD group were significantly higher than those in non-NAFLD group (all P<0.05); the mean age ( Z=-3.885) and high density lipoprotein cholesterol ( Z=-23.553) in NAFLD group were significantly lower than those in non-NAFLD group (all P<0.001); there were no significant differences in the levels of total cholesterol ( Z=1.762)and creatinine ( Z=1.453) between the two groups (all P>0.05). The proportion of patients had type 2 diabetes mellitus ( χ2=368.395), hypertension ( χ2=208.503), hypertriglyceridemia ( χ2=883.831), hyperuricemia ( χ2=228.562), central obesity ( χ2=1 506.580), high risk of stroke ( χ2=605.322) and high risk of ASCVD ( χ 2=309.434) in NAFLD group were significantly higher than that of non-NAFLD group (all P<0.001). Logistic regression analysis showed that age ( OR=0.937, 95% CI: 0.928-0.946), body mass index ( OR=1.224, 95% CI:1.194-1.255), waist circumference ( OR=1.072, 95% CI: 1.062-1.082), glycosylated hemoglobin ( OR=1.348, 95% CI: 1.275-1.426), alanine aminotransferase ( OR=1.032, 95% CI: 1.026-1.037), triglyceride ( OR=1.757, 95% CI: 1.646-1.875) and serum uric acid ( OR=1.004, 95% CI: 1.004-1.005) levels were the influencing factors for NAFLD in elderly women (all P<0.001). Conclusion:The prevalence rate of non-alcoholic fatty liver disease in the community-dwelling elderly women is high, which are associated with multiple influencing factors.

Exploration and practice of TEST teaching mode for general practice residency training in the community teaching base / 中华全科医师杂志

From November 2020 to November 2021, the TEST(Task-Experience- Supervise-Thinking) teaching model was adopted for general practice residency training in teaching clinic of Changfeng Health Service Center of Shanghai Putuo district. The satisfaction of mentors, residents and patients was surveyed with self-assessment questionnaire. The satisfaction scores of mentors, residents and patients were (79.89±0.40), (79.96±0.19) and (49.92±0.40). The adaption of model TEST in teaching clinic is more effective in training of clinical competency, communication ability, management ability and narrative ability for general practice residents. It is also beneficial for mentors to upgrade their teaching ability, as well as for patients to improve their experience and satisfaction for seeking medical service. It is worth popularizing in the community practice base of general resident training.

Variations of glucose content in Massa Medicata Fermentata during processing based on quantitative proton nuclear magnetic resonance / 中国中药杂志

A quantitative proton nuclear magnetic resonance(qHNMR) method was established to determine the glucose content in commercially available Massa Medicata Fermentata(MMF) products and explore the variations of glucose content in MMF products during processing. The qHNMR spectrum of MMF in deuterium oxide was obtained with 2,2,3,3-d_4-3-(trimethylsilyl) propionate sodium salt as the internal standard substance. With the doublet peaks of terminal hydrogen of glucose with chemical shift at δ 4.65 and δ 5.24 as quantitative peaks, the content of glucose in MMF samples was determined. The glucose content showed a good linear relationship within the range of 0.10-6.44 mg·mL~(-1). The relative standard deviations(RSDs) of precision, stability, repeatability, and recovery for determination were all less than 2.3%. The glucose content varied in different commercially available MMF samples, which were associated with the different fermentation days, wheat bran-to-flour ratios, and processing methods. The glucose content in MMF first increased and then decreased over the fermentation time. Compared with the MMF products fermented with wheat bran or flour alone, the products fermented with both wheat bran and flour had increased glucose. The glucose content of bran-fried MMF was slightly lower than that of raw MMF, while the glucose content in charred MMF was extremely low. In conclusion, the qHNMR method established in this study is simple, fast, and accurate, serving as a new method for determining the glucose content in MMF. Furthermore, this study clarifies the variations of glucose content in MMF during processing, which can not only indicate the processing degree but also provide a scientific basis for revealing the fermentation mechanism and improving the quality control of MMF.

Effect of family doctor-specialist double-contract service on management of type 2 diabetic patients in community / 中华全科医师杂志

Objective:To explore the effect of family doctor-specialist dual-contract service model on the management of type 2 diabetic patients in the community.Methods:Two hundred patients with type 2 diabetes mellitus (T2DM)who were treated in Changfeng Community Health Service Center between February 2019 and January 2021 were selected as the study objects by cluster sampling method. Patients were randomly divided into study group and control group with 100 cases in each group. The control group was managed with the conventional family doctor contract service, and the study group was managed with the family doctor-specialist double contract service. After one year of management, the fasting blood glucose, 2 h-postprandial blood glucose, glycosylated hemoglobin, diet control, blood glucose monitoring, medication compliance, exercise and other health behaviors, quality of life and satisfaction of patients were compared between two groups.Results:After intervention, fasting blood glucose, 2 h-postprandial blood glucose and glycosylated hemoglobin in the study group were significantly lower than those in the control group ( t=10.29, 8.49, 7.99, all P<0.05); the health related behaviors such as diet control, exercise behavior, blood glucose monitoring, and medication compliance in the study group were significantly better than those in the control group ( t=9.78, 6.72, 39.81, 7.88, all P<0.05); the quality of life in patients of study group was higher than that of the control group ( P<0.05); the satisfaction rate in study group was higher than that of control group (90.0% vs. 69.0%, χ 2=6.39, P=0.031). Conclusion:Compared with conventional family contract service model, the double contract service improves patient self-management, helps to reduce the blood glucose level and gains high patients′ satisfaction, which is worth promoting and applying in the management of type 2 diabetic patients in the community.

Adiposity peak and rebound in early life among primary school students with different body mass index patterns / 中国学校卫生

Objective@#To explore the characteristics of the adiposity peak and rebound in early life among first year primary school students with different body weight measures, so as to provide scientific evidence for the development of prevention interventions to manage childhood overweight and obesity.@*Methods@#A total of 2 330 first year primary school students who received routine physical examinations from September to December in 2019 were selected. According to body mass index (BMI) status, participants were divided into three categories:healthy weight, overweight, and obese. The BMI growth trajectories of the three groups were fitted by gender using the generalized additive mixed model from 1 to 80 months, retrospectively. Each subject s age at the adiposity peak and rebound, and associated BMI values, were calculated.@*Results@#The prevalence of overweight and obesity was 16.31 % (380/ 2 330 ) and 16.09% (375/2 330), respectively. For first year students with obesity, the BMI value continued to be higher than their overweight or healthy weight counterparts during the first 80 months of life. The age at the adiposity peak for these students, whose BMI status varied, was about nine months. However, the BMI of children with overweight or obesity was much higher than that of healthy weight subjects. Age at adiposity rebound was 72 months for healthy weight children, 52 to 55 months in children defined as overweight, and 22 to 23 months in children with obesity. For healthy weight children, the fitted value of BMI at the adiposity rebound was less than that of overweight and obese children.@*Conclusion@#Age at the adiposity peak was largely similar among first year students with different BMI patterns; however, age at adiposity rebound was different. Age at adiposity rebound among children with obesity was much earlier than that of other subjects, and their BMI values were much higher.

Progress of IOL calculation formulas for cataract patients with high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

Cataract with high myopia is a kind of complicated cataract with highly blinding disease. Surgery has always been the only treatment, but there is always a difference between actual postoperative refraction and target refraction. The cataract patients with high myopia have increasing demands for postoperative refractive status and visual quality now. The intraocular lens(IOL)calculation formulas have been updating for higher predictive accuracy. A variety of alternative IOL calculation formulas can be applied to clinical practice. However, there is no consensus on the selection of a more suitable formula for cataract patients with high myopia. Based on the principles and clinical application of different formulas, this paper reviews the development of IOL calculation formulas and research progress of IOL calculation formulas for cataract patients with high myopia, in order to provide reference for clinical application.

Moxibustion alleviates decreased ovarian reserve in rats by restoring the PI3K/AKT signaling pathway / 中西医结合学报

OBJECTIVE@#Moxibustion, a common therapy in traditional Chinese medicine, has potential benefits for treating decreased ovarian reserve (DOR). The present study investigates the protective effect of moxibustion in a rat model of DOR and explores the possible mechanisms.@*METHODS@#Sixty-four female Sprague-Dawley rats were randomly divided into four groups: control, DOR, moxibustion (MOX), and hormone replacement therapy (HRT). The DOR rat model was established by intragastric administration of 50 mg/kg Tripterygium glycoside suspension (TGS), once daily for 14 days. MOX and HRT treatments were given from the day TGS administration was initiated. The ovarian reserve function was evaluated by monitoring the estrus cycle, morphological changes in ovaries, levels of serum estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and anti-Mullerian hormone (AMH), pregnancy rate and embryo numbers. Terminal-deoxynucleotidyl transferase-mediated nick-end-labeling staining was used to identify ovarian granulosa cell apoptosis, while the protein and mRNA expressions of Bax, B-cell lymphoma-2 (Bcl-2), phosphatidylinositol 3-kinase (PI3K) and protein kinase B (AKT) in ovarian tissues were examined by immunohistochemistry, Western blot and quantitative reverse transcription-polymerase chain reaction.@*RESULTS@#Compared with the DOR group, MOX improved the disordered estrous cycle, promoted follicular growth, reduced the number of atresia follicles, increased the concentrations of serum E2 and AMH, and decreased serum FSH and LH concentrations. More importantly, the pregnancy rate and embryo numbers in DOR rats were both upregulated in the MOX treatment group, compared to the untreated DOR model. Further, we found that the MOX group had reduced apoptosis of ovarian granulosa cells, increased Bcl-2 expression and reduced expression of Bax. Furthermore, the PI3K/AKT signaling pathway was triggered by the moxibustion treatment.@*CONCLUSION@#Moxibustion improved ovarian function and suppressed apoptosis of ovarian granulosa cells in a rat model of DOR induced by TGS, and the mechanism may involve the PI3K/AKT signaling pathway.

Effects of temperatures variation between neighboring days on mortality risk in Changsha 2010-2019: a time series analysis / 公共卫生与预防医学

Objectives To analyze the features on temperature and mortality of Changsha in 2009-2019, and to explore the association between temperatures variation between neighboring days (TVN) and mortality by using time-series analysis. Methods A Poisson generalized linear regression model combined with a distributed lag non-linear model was used to analyse the association between TVN and mortality. Results A total of 404 328 deaths were studied in Changsha during 2010-2019，the proportion of people aged over 65 years, males respiratory disease, and cardiovascular disease were 74.1761%, 58.9842%, 11.11% and 54.4671%, respectively. During the 3652-day study period, the daily mean maximum and minimum temperature were 35.8℃ -2.8℃. The TVN varied from -12.30℃ to 10.8℃,and a significant correlation was found between TVN and mortality risk, with 1.12% (RR=1.0112，95% CI：1.0061~1.0164) mortality risk increased for 1℃ rise in TVN, and the greatest effect of TVN on mortality was at 4 days lag. Based on age, gender and  group study For cardiovascular disease and respiratory disease，a 1℃ increased in TVN were associated with 2.97% and 1.52% death risk increase respectively. The effect appeared on the first day after exposure and lasted for 7 days, the maximum affection came on the fourth day. According to the analysis on age, gender and death-cause, the elderly man over 65 years old, respiratory disease people were more vulnerable to the temperature change between day by day. Conclusion This study provides a comprehensive picture of the non-linear associations between temperature variation and mortality, and there is a certain lag effect. The findings on vulnerability characteristics can help improve clinical and public health practices to reduce disease burden associated with current and future abnormal weather.

Risk factors of non-alcoholic fatty liver disease among elderly people in the community / 中华全科医师杂志

Objective:To analyze the risk factors of non-alcoholic fatty liver disease (NAFLD) among elderly residents in the community.Methods:A total of 1 894 patients aged 60-75 years with NAFLD visiting general practice clinic from March 2016 to March 2018 were enrolled in the study; 1 894 age and sex-matched subjects without NAFLD served as the control group. The data of gender, age, smoking status,body mass index (BMI), waist circumference, blood pressure, blood biochemistry,past medical history and other clinical and laboratory testing were collected in the two groups. Multivariate logistic regression analysis was performed to explore the related risk factors of NAFLD.Results:The BMI [(27±3) kg/m 2vs.(24±3) kg/m 2, t=-26.139], waist circumference [(89±8) cm vs.(82±8) cm, t=-24.398], heart rate [(75±11) bpm vs. (74±11) bpm, t=-2.370], and diastolic blood pressure [(87±10) mmHg vs. (85±10) mmHg(1 mmHg=0.133 kPa), t=7.898] in the NAFLD group were significantly higher than those in the control group(all P<0.05). The levels of fasting blood glucose (FBG) [(5.9±2.0)mmol/L vs. (5.3±1.5) mmol/L, t=10.438], glycated hemoglobin (HbA1c) [(6.2±1.2)% vs. (5.9±0.9)%, t=11.654], alanine aminotransferase (ALT)[(24±16) mmol/L vs. (18±15) mmol/L, t=11.915], aspartate aminotransferase (AST) [(23±11) mmol/L vs.(22±13) mmol/L, t=4.300], blood uric acid (UA) [(342±84) mmol/L vs. (307±80) mmol/L, t=13.189], total cholesterol (TC) [(5.3±1.1) mmol/L vs. (5.1±1.0) mmol/L, t=6.073], triglycerides (TG)[1.71(1.29,2.35) mmol/L vs. 1.17 (0.91,1.57) mmol/L, Z=37.261], and low-density lipoprotein cholesterol (LDL-C)[(3.4±0.9) mmol/L vs. (3.2±0.9) mmol/L, t=6.984] in NAFLD group were significantly higher than those in the control group (all P<0.01); and the levels of blood creatinine (Cr) [(70±17) mmol/L vs. (71±18) mmol/L, t=-2.712] and high-density lipoprotein cholesterol (HDL-C) [(1.3±0.3) mmol/L vs. (1.5±0.4) mmol/L, t==-16.726] in NAFLD group were significantly lower than those in the control group (all P<0.01). The proportion of people with hypertension [53.8% (1 019/1 894) vs. 43.4% (822/1 894)], type 2 diabetes [16.7%(317/1 894) vs. 11.3%(214/1 894)], metabolic syndrome [48.3% (915/1 894) vs. 18.0% (341/1 894)] in NAFLD group was significantly higher than that in the control group (χ 2=41.013, 23.237, 392.446, P<0.01). Logistic regression analyses revealed 13 independent risk factors of NAFLD, including 60-75 years-old female ( OR=2.348, 95 %CI: 1.917-2.876, P<0.01), high BMI ( OR=1.143, 95 %CI: 1.099-1.189, P<0.01), elevated TG ( OR=1.894, 95 %CI: 1.716-2.090, P<0.01), LDL-C ( OR=3.066, 95 %CI: 2.359-3.983, P<0.01) and HbA1c ( OR=1.276, 95 %CI: 1.175-1.386, P<0.01). Conclusion:The factors associated with NAFLD are complicated; and corresponding measures targeting the risk factors should be taken to reduce the occurrence and development of NAFLD among elderly people in the community.

Physalin B reduces Aβ secretion through down-regulation of BACE1 expression by activating FoxO1 and inhibiting STAT3 phosphorylation / 中国天然药物

Physalin B (PB), one of the major active steroidal constituents of Solanaceae Physalis plants, has a wide variety of biological activities. We found that PB significantly down-regulated β-amyloid (Aβ) secretion in N2a/APPsw cells. However, the underlying mechanisms are not well understood. In the current study, we investigated the changes in key enzymes involved in β-amyloid precursor protein (APP) metabolism and other APP metabolites by treating N2a/APPsw cells with PB at different concentrations. The results indicated that PB reduced Aβ secretion, which was caused by down-regulation of β-secretase (BACE1) expression, as indicated at both the protein and mRNA levels. Further research revealed that PB regulated BACE1 expression by inducing the activation of forkhead box O1 (FoxO1) and inhibiting the phosphorylation of signal transducer and activator of transcription 3 (STAT3). In addition, the effect of PB on BACE1 expression and Aβ secretion was reversed by treatment with FoxO1 siRNA and STAT3 antagonist S3I-201. In conclusion, these data demonstrated that PB can effectively down-regulate the expression of BACE1 to reduce Aβsecretion by activating the expression of FoxO1 and inhibiting the phosphorylation of STAT3.

Effects of Intravitreal Injection of Anti-vascular Endothelial Growth Factor Drugs on Ocular Blood Vessels and Blood Flow in Patients with Diabetic Retinopathy / 中国医学科学院学报

Diabetic retinopathy(DR)is the major microvascular disease in diabetic patients,and it is also one of the main blinding eye diseases in the current population.The typical pathological change of DR in the eyes is vascular endothelial growth factor(VEGF)-mediated neovascularization induced by retinal ischemic stimulation.Therefore,anti-VEGF drugs have gradually become one of the mainstream methods to treat DR and DR-induced diseases such as diabetic macular edema.Recent studies have proved that anti-VEGF drugs have certain effects on ocular blood vessels and blood flow in patients with DR,while the specific mechanism has not been fully elucidated.This article summarizes the research progress on the effects of intravitreal injection of anti-VEGF drugs on the ocular blood vessels and blood flow in patients with DR.

Analgesic effect of electroacupuncture on chronic pelvic pain in patients with sequelae of pelvic inflammatory disease / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) on chronic pelvic pain in patients with sequelae of pelvic inflammatory disease.@*METHODS@#A total of 144 patients with chronic pelvic pain were randomly divided into an observation group (72 cases, 10 cases dropped off) and a control group (72 cases, 9 cases dropped off). The patients in the control group were treated with ibuprofen sustained-release capsules 10 days before menstruation, 0.3 g each time, once a day. On the basis of the treatment of the control group, the patients in the observation group were treated with EA at Guanyuan (CV 4), Shuidao (ST 28), Guilai (ST 29), Shenshu (BL 23) and Ciliao (BL 32), disperse-dense wave, 2 Hz/15 Hz of frequency, once a day. The patients in both groups were treated for 10 days per menstrual cycle for 3 menstrual cycles. The visual analogue scale (VAS) scores of lower abdomen and lumbosacral area, local sign score, quality of life scale score and pain disappearance rate were compared between the two groups before and after treatment.@*RESULTS@#The VAS scores of lower abdomen and lumbosacral area as well as each item score and total score of local signs in the observation group after treatment were significantly lower than those before treatment and those in the control group (@*CONCLUSION@#EA can relieve the pain symptoms in patients with chronic pelvic pain and improve their quality of life.

Acupuncture combined with western medication on chronic pelvic pain after pelvic inflammatory disease: a multi-center randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the therapeutic effect between acupuncture combined with ibuprofen sustained-release capsule and simple ibuprofen sustained-release capsule on chronic pelvic pain (CPP) after pelvic inflammatory disease (PID).@*METHODS@#A total of 144 patients were randomized into an observation group (72 cases, 10 cases dropped off) and a control group (72 cases, 9 cases dropped off). Ibuprofen sustained-release capsule was given orally in the control group, one capsule a time. On the basis of the treatment in the control group, acupuncture was applied at Guanyuan (CV 4), Shuidao (ST 28), Guilai (ST 29), Shenshu (BL 23) and Ciliao (BL 32), and Shuidao (ST 28), Guilai (ST 29), Shenshu (BL 23) and Ciliao (BL 32) were connected to electroacupuncture in the observation group. The treatment was given 10 days before menstruation, once a day for 3 menstrual cycles in both groups, and the follow-up was adopted 3 menstrual cycles after treatment. The visual analogue scale (VAS) scores of hypogastrium and lumbosacral region before treatment, after treatment, and at the follow-up, the score of local signs and the score of World Health Organization quality of life questionnaire-brief version (WHOQOL-BREF) before and after treatment were observed in the both groups.@*RESULTS@#After treatment and at the follow-up, the VAS scores of hypogastrium and lumbosacral region were decreased compared before treatment in both groups (@*CONCLUSION@#Acupuncture combined with ibuprofen sustained-release capsule can effectively improve the symptoms, signs and quality of life in patients with CPP after PID, the therapeutic effect is superior to simple ibuprofen sustained-release capsule.

Report Quality of Clinical Practice Guidelines of Rehabilitation Based on RIGHT / 中国康复理论与实践

@#Objective To evaluate the quality of reporting of clinical practice guidelines of rehabilitation.Methods A comprehensive retrieve was performed in electronic databases of PubMed, EMBASE, CNKI, China Biology Medicine disc, Wanfang data, etc., from January 1, 2017 to January 11, 2020. Supplementary searches had been done on relevant websites. Two researchers reviewed literatures and assessed the reporting quality independently by using Reporting Items for Practice Guidelines in Healthcare (RIGHT), and any disagreements needed to be discussed in a consensus meeting.Results A total of 16 guidelines were included, with an average reporting rate of (44.8±27.9)%. Among the seven domains of RIGHT, basic information was reported the highest (57.3%), and evidence (31.3%) and other information (31.3%) was the lowest. The reporting rate was less as the guidelines published in China than in foreign contries (OR = 0.80, 95%CI 0.56-1.16), in original version than in update version (OR = 0.79, 95%CI 0.54-1.16); and higher as developed by various societies or associations than developed by non-societies or associations (OR = 1.15, 95%CI 0.82-1.61), however, no statistically significant difference was found in above comparisons.Conclusion Current clinical practice guidelines of rehabilitation reported with low quality. It is proposed that future guideline developers should report guidelines after RIGHT statements, including key information and content, in order to improve the quality of reporting guidelines.

Distribution characteristics of Chinese medicine resources in Turpan Basin, Xinjiang / 中国中药杂志

Based on the results of the fourth national survey of traditional Chinese medicine resources in Turpan city, Xinjiang, this study counted the types of traditional Chinese medicine resources in Turpan Basin. The spatial distribution differences of traditional Chinese medicine resources in Turpan Basin of Xinjiang were analyzed by using grid technology, trend surface analysis, global spatial autocorrelation analysis, and local spatial autocorrelation analysis, so as to clarify the overall change trend and aggregation degree of traditional Chinese medicine resources in Turpan Basin in horizontal and vertical directions. The results showed the following: in the horizontal direction, the species richness of traditional Chinese medicine resources in the central part of Turpan Basin was high, and there were great differences in the species richness of traditional Chinese medicine resources in Turpan Basin under different grid sizes. The spatial scale effect of the richness of traditional Chinese medicine resources in Turpan Basin is obvious. Among them, under the 30 km×30 km scale, the richness of the types of Chinese medicine resources shows a high spatial correlation, and the richness of the types of Chinese medicine resources at 5 km×5 km scale presents a near random distribution state, and the richness of the types of Chinese medicine resources at 80, 90, and 100 km scale sits negatively related. Vertical direction, Chinese medicine resources appear rich at the range of-154-150 m and 900-1 050 m following by range of 1 050-1 200 m.

Accuracy and outcome of computer-assisted navigation system for tunnel positioning in reconstruction of anterior cruciate ligament / 中华创伤杂志

Objective:To explore the accuracy and clinical effect of computer navigation system in locating the tunnel position in anterior cruciate ligament (ACL) reconstruction.Methods:A retrospective case-control study was conducted to analyze clinical data of 60 patients with ACL rupture treated in Daping Hospital of Army Military Medical University from March 2017 to March 2018, including 44 males and 16 females, aged 15-48 years (mean, 26.3 years). Computer navigation system was used to locate the internal orifice of intra-articular femoral and tibial tunnel in 30 patients (navigation group), and artificial location of intra-articular femoral and tibial tunnel in 30 patients (control group). The operation time and complications of two groups were recorded after operation. The tunnel position was evaluated by CT three-dimensional reconstruction, and the ratio of the tunnel position on the lateral surface of the femoral condyle to the tibial platform was evaluated by the grid method. The proportion sites from the deep posterior edge of lateral intercondylar surface of the femur to the shallow anterior edge (DS) and from the upper edge to the lower edge (HL) were used to represent the position of the femoral tunnel, and the proportion sites of the line connecting the anterior and posterior edge of the tibial plateau were used to represent the tibial tunnel position. The postoperative tunnel position was compared between the two groups. The knee joint stability (Lachman test, pivot shift test) and knee joint function score (Lysholm score, Tegner score) were compared between the two groups before operation and 12 months after operation.Results:All patients were followed up for 12-24 months (mean, 15 months). The operation time was (56.1±8.1)minutes in control group versus (76.0±6.7)minutes in navigation group ( P<0.05). In navigation group, 2 patients had skin edge necrosis at the place where the navigation needle was installed. The proportion of DS in femoral tunnel was (27.2±3.7)% in navigation group versus (33.9±4.4)% in control group ( P<0.05). HL proportion site was (36.6±4.8)% in navigation group versus (38.9±4.9)% in control group ( P<0.05). Proportion of the tibial tunnel at the anterior and posterior edge of the tibial plateau was (44.9±1.8)% in navigation group and (44.7±3.0)% in control group ( P>0.05). Both groups showed significant improvements in Lysholm score, Tegner score, Lachman test and pivot shift test 12 months after operation compared to the preoperative levels ( P<0.05), but the knee joint function score and knee joint stability score had no significant difference between the two groups 12 months after operation ( P>0.05). Conclusions:No significant differences are found between computer navigated and manually navigated ACL reconstruction with regards to knee joint stability, knee joint function, and tibial tunnel localization. However, computer assisted navigation enables the location of the lateral femoral tunnel closer to the anatomical position.

Identification of metabolites in rat plasma,bile,urine and feces after oral administration of Cinnamomi Cortex aqueous extract by UPLC-Qtrap-MS / 中国中药杂志

An ultra-performance liquid chromatography hybrid triple quadrupole-linear ion trap mass spectrometry(UPLC-QtrapMS) method was established to identify the metabolites in rat plasma,bile,urine and feces after oral administration of Cinnamomi Cortex(CC) aqueous extract. Several survey experiments,such as enhanced mass spectrum scan(EMS),precursor ion scan(PI),neutral loss scan(NL) and multiple ions monitoring(MIM) were applied to search target components,and two separate enhanced product ion(EPI) scans were triggered via information-dependent acquisition(IDA) method to generate the MS/MS spectra. According to the mass spectrometric data collected from reference standards and reported literature,the structures of metabolites were deduced. A total of76 metabolites and 5 original compounds were tentatively identified in rats after oral administration of CC aqueous extract. Deglycosylation,methylation,sulfonation,and glucuronidation were observed as the primary metabolic pathways for the chemical constituents of CC. These data are able to benefit the clarification of the therapeutic material basis,the clinical usage and further R&D of CC.

Chemical constituents from green walnut husks and their antitumor activity in vitro / 中国中药杂志

Fourteen chemical constituents, including 5-hydroxy-4-methoxy-1-tetralone(1), 4,8-dihydroxy-1-tetralone(2), 4,5-dihydroxy-α-tetralone(3), blumenol B(4), dehydrovomifoliol(5), megastigm-5-ene-3,9-diol(6), juglanin B(7), blumenol C(8), loliolide(9), oleracone B(10), syringarsinol(11), pinoresinol(12), methyl 4-hydroxy-3-methoxybenzoate(13), and isovanillic acid(14), were isolated from the dichloromethane fraction of 95% methanol extract of green walnut husks by silica gel and MCI column chromatography, and Pre-HPLC. Their structures were determined by spectroscopic methods, such as NMR, MS and so on. Among them, compounds 1, 4-6, 8-13 were isolated from the green walnut husks for the first time, and compounds 4-6, 8, 10, 12, 13 were isolated from the Juglans genus for the first time. All of isolates were detected their inhibitory activities against HeLa, HGC-27 and Ht-29 cell lines by the MTT assay. The result showed that compounds 2, 3, 7, 9 and 11 exhibited inhibitory activity against the tested cell line. The IC_(50) of 7 were 26.5, 9.0, 25.4 μmol·L~(-1), respectively.

Clinical analysis of autoimmune hemolytic anemia after allogeneic hematopoietic stem cell transplantation in thalassemia major / 中华血液学杂志

Objective: To explore the diagnosis, treatment and prognosis of autoimmune hemolytic anemia (AIHA) after allo-HSCT in patients with thalassemia major (TM). Methods: A retrospective analysis of AIHA status after allo-HSCT in 291 TM patients from July 2007 to December 2017 was conducted. Results: Five of the 291 TM patients (1.72%) were diagnosed with post-transplant AIHA. The median time of AIHA was 7 (5-12) months after HSCT. All post-transplant AIHA patients were positive in direct and indirect Coombs test, the main clinical manifestations were dizziness, fatigue, pale complexion, skin and sclera yellow, and soy sauce urine. The incidence of AIHA was higher after unrelated donor transplantation (6.36%, 4/63) compared with that of sibling donor transplantation (0.43%, 1/228). One patient who received only prednison was dead. Four patients who received rituximab combined with prednisolone were alive, Coombs test in two of them were negative. Conclusions: AIHA after allo-HSCT developed in 1.72% patients with TM. Monitoring of Coombs test was important for diagnosis of post-transplant AIHA. The incidence of post-transplant AIHA was higher in unrelated donors compared with that of sibling donors transplantation. Treatment of rituximab combined glucocorticoid was effective strategy for post-transplant AIHA.

Retrospective analysis of 188 cases of parapharyngeal space tumors / 临床耳鼻咽喉头颈外科杂志

To explore the diagnosis,treatment,surgical approach and prognosis of parapharyngeal space tumors.The clinical data of 188 patients with parapharyngeal space tumor who were treated from January 2007 to December 2016 were analyzed retrospectively.All patients underwent imaging examination before operation.Surgical approach was as follows:transcervical approach applied in 159 cases,endoscopic-assisted transnasal approach in 9 cases,transcervical-transmandibular approach in 8 cases,transcervical-transparotid approach in 8 cases,transoral approach in 7 cases,and infratemporal fossa approach in 4 case.Of the 188 cases,the tumor was benign in nature in 168 cases(89%)and malignant in 20 cases(11%).Complications occurred in 28(15%)patients,with the most common symptom being hoarseness.168 cases of benign tumors were followed up for 10 months to 10 years,and 3 cases were lost and 4 cases had recurrence.All cases underwent re-operation.Patients with malignant tumors received combined treatment after surgery,and 3 cases were lost to follow-up,1 case died of recurrence 9 months after surgery,the rest survived.Surgery is the preferred method for treating parapharyngeal space tumors and postoperative recurrence rate is pretty low.Endoscopy provides a new surgical management method,helping to reduce postoperative complications and recurrence rate.