An animal research on the application of drag-and-bond anastomosis in the anastomosis between bladder and intestine / 中华泌尿外科杂志

Objective:To explore the feasibility of anastomosis between bladder and intestine of experimental rabbit by drag anastomosis.Methods:In this study 40 Japanese big-eared rabbits were randomly divided into two groups through random number table, the experimental group and the control group, each group with 20 rabbits. In the experimental group, the bladder neck was fixed to the catheter and then the catheter was drawn outward. With the traction of the catheter, the bladder neck was anastomosed with the distal intestinal tube by means of suture free. The control group was anastomosed by regular interrupted suture of bladder and intestine. The operation time, anastomosis time, intraoperative blood loss, postoperative urinary leakage rate and postoperative anastomotic healing of rabbits in the two groups were compared.Results:The operation time of the experimental group was shorter than that of the traditional interrupted suture anastomosis group [(33.26±2.79)min vs. (35.25±1.83)min, P=0.014]. The anastomosis time of the experimental group was significantly shorter than that of the traditional interrupted suture anastomosis group[(7.55±1.2)min vs. (8.65±1.03 min), P=0.005]. The intraoperative blood loss in the experimental group was similar to that in the control group[(6.47±2.41) ml vs. (6.75±1.83) ml, P=0.691]. The event of contrast media extravasation occurred in 2 of the 10 experimental rabbits after receiving cystography in the experimental group, and the urinary leakage rate was 20%(2/10). In the control group, contrast media extravasation occurred in 1 of the 9 experimental rabbits after receiving cystography, and the urinary leakage rate was 11.1%(1/9), and the difference of the two groups was not statistically significant ( P=0.348). Anastomotic healing score was (2.0±0.7) in the experimental group, and (2.1±0.74) in the control group ( P=0.767). Conclusions:The bladder-intestine drag-and-bond anastomosis technique, with significantly shorter anastomosis time, was feasible, easy and convenient. Our research provides an experimental and theoretical basis for the clinical application of drag-and-bond anastomosis technique in clinic.

The characteristics of distribution and drug resistance of urinary bacteria in patients with infectious stones / 中华泌尿外科杂志

Objective:To investigate the characteristics of distribution and drug resistance of urinary bacteria in the mid-stream urine of patients with infectious stones.Methods:The retrospective study analyzed the clinical data of 254 patients with infectious stones in the First Affiliated Hospital of Guangzhou Medical University from September 2016 to September 2018. All patients were treated with PCNL. Overall, there were 101 male and 153 female patients, with the mean age of(51.5±12.3) years, and the mean stone burden of 1443.5(660.8, 2837.5) mm2. There were 58 (22.8%) patients with hypertension, 17(6.7%) patients with diabetes and 195(76.8%)with hydronephrosis. The mid-stream urine samples were obtained for bacterial culture and susceptibility test, and the results of urine culture and antimicrobial susceptibility were recorded and analyzed.Results:Of 254 patients involved in this study, 89(35.0%) were positive and 165 (65.0%) were negative for urinary bacterial culture of the mid-stream. The proportion of patients with positive urine bacterial culture of the mid-stream who had positive urine leucocytes, positive urine nitrite and postoperative pyrexia were 86.5%(77/89), 64.0%(57/89), 25.8%(23/89), respectively, which was higher than that of patients with negative urine bacterial culture of the mid-stream [50.3%(83/165), 14.5%(24/165), 14.5%(24/165), P<0.05]. Four teen kinds of bacteria were detected from the mid-stream urine, and the three bacteria with the highest detection rate in turn were Escherichia coli of 38.2%(34/89), Proteus mirabilis of 15.7%(14/89), and Pseudomonas aeruginosa of 11.2%(10/89). The results of this study showed that three common bacteria had high resistance to drug including Cefazolin, Cefuroxime, Cefuroxime ester, Ampicillin and Co-trimoxazole (all resistance rate>40%). The resistance rates of Escherichia coli and Pseudomonas aeruginosa to Ciprofloxacin and Levofloxacin were higher than or equal to 40%. The resistance rates of Escherichia coli and Proteus mirabilis to meropenem, imipenem, ertapenem, piperacillin/tazobactam and amikacin were all lower than 10%. In addition, the resistance rates of Escherichia coli to nitrofurantoin and tigecycline and Proteus mirabilis to tobramycin, aztreonam and cefoxitin were all less than 10%. The resistance rates of Pseudomonas aeruginosa to ceftazidime, cefepime, gentamicin and aztreonam were less than 10%. Conclusions:The highest detection rate of urinary bacteria in culture of the mid-stream with infectious stones are Escherichia coli, Proteus mirabilis and Pseudomonas aeruginosa, all of which showed high resistance to Ampicillin, Cotrimoxazole, and some cephalosporins. Escherichia coli and Pseudomonas aeruginosa showe high resistance to Ciprofloxacin and Levofloxacin, and all of the three bacteria have low resistance rates to some β-Lactamase inhibitor complex and carbapenems, suggesting a reference for clinical empirical medical treatment.

Research progress on the health effects of occupational noise exposure on cardiovascular system of workers / 中国职业医学

@#Noise is a common occupational hazardous factor in the workplace. In addition to the specific damage to the auditory ， system of workers it can also harm the cardiovascular system and cause a serious disease burden. The mechanism of ， occupational noise on the cardiovascular system of workers is mainly oxidative stress inflammation and vascular endothelial ， - - - damage. As a stressor noise mainly leads to the changes of sympathoadrenal medullary system and hypothalamic pituitary ， ， ， - ， adrenal axis. The substances that play an important role include catecholamines cortisol angiotensin Ⅱ endothelin 1 - endothelial nitric oxide synthase and interleukin 6. The population epidemiological studies have shown that occupational noise ， exposure can lead to elevated blood pressure abnormal electrocardiogram and elevated blood lipids in workers. The influencing （ ， ， ） factors include noise characteristics intensity cumulative noise exposure and frequency and noise combined with other （ ， ， ， - ， occupational hazards such as high temperature welding fumes organic solvents hand transmitted vibration and work ） ， ， ， shifts . However due to the influence of research conditions experimental design and other factors some research conclusions still have limitations. More prospective and comprehensive studies are needed to verify the relevant conclusions in the future.

Intravenous patient-controlled analgesia hydromorphone combined with pregabalin for the treatment of postherpetic neuralgia: a multicenter, randomized controlled study

Background@#Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders.In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. @*Methods@#Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. @*Results@#Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment.After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. @*Conclusions@#IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

Intravenous patient-controlled analgesia hydromorphone combined with pregabalin for the treatment of postherpetic neuralgia: a multicenter, randomized controlled study

Background@#Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders.In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. @*Methods@#Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. @*Results@#Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment.After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. @*Conclusions@#IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

Treatment of traumatic cerebrospinal fluid rhinorrhea via extended extradural anterior skull base approach / 中华创伤杂志(英文版)

OBJECTIVE@#To describe and assess the repair technique and perioperative management for cerebrospinal fluid (CSF) leak resulting from extensive anterior skull base fracture via extradural anterior skull base approach.@*METHODS@#This was a retrospective review conducted at the Department of Neurosurgery of the Shanghai Tenth People's Hospital from January 2015 to April 2020. Patients with traumatic CSF rhinorrhea resulting from extensive anterior skull base fracture treated surgically via extended extradural anterior skull base approach were included in this study. The data of medical and radiological records, surgical approaches, repair techniques, peritoperative management, surgical outcome and postoperative follow-up were analyzed. Surgical repair techniques were tailored to the condition of associated injuries of the scalp, bony and dura injuries and associated intracranial lesions. Patients were followed up for the outcome of CSF leak and surgical complications. Data were presented as frequency and percent.@*RESULTS@#Thirty-five patients were included in this series. The patients' mean age was 33 years (range 11-71 years). Eight patients were treated surgically within 2 weeks; while the other 27 patients, with prolonged or recurrent CSF rhinorrhea, received the repair surgery at 17 days to 10 years after the initial trauma. The mean overall length of follow-up was 23 months (range 3-65 months). All the patients suffered from frontobasal multiple fractures. The basic repair tenet was to achieve watertight seal of the dura. The frontal pericranial flap alone was used in 20 patients, combined with temporalis muscle and/or its facia in 10 patients. Free fascia lata graft was used instead in the rest 5 patients. No CSF leak was found in all the patients at discharge. There was no surgical mortality in this series. Bilateral anosmia was the most common complication. At follow-up, no recurrent CSF leak or meningitis occurred. No patients developed mucoceles, epidural abscess or osteomyelitis. One patient ultimately required ventriculoperitoneal shunt because of progressive hydrocephalus.@*CONCLUSION@#Traumatic CSF rhinorrhea associated with extensive anterior skull base fractures often requires aggressive treatment via extended intracranial extradural approach. Vascularized tissue flaps are ideal grafts for cranial base reconstruction, either alone or in combination with temporalis muscle and its fascia---fascia lata sometimes can be opted as free autologous graft. The approach is usually reserved for patients with traumatic CSF rhinorrhea in complex frontobasal injuries.

The effect of stone urine bacteria culture on the treatment of postoperative infection in percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective:To assess the effect of stone and urine bacteria culture on the treatment of postoperative infection in percutaneous nephrolithotomy (PCNL).Methods:Between September 2016 and September 2018, 1060 patients with kidney stones treated with first-stage PCNL were included in the study. There were 614 male and 446 female patients, with the mean age (52.4±12.2) years. The mean stone burden was (1 499.6±1 435.3) mm 2. The midstream urine sample and the stone sample were sent for bacterial culture, identification of bacterial strain and antimicrobial susceptibility tests. The results of urine culture (UC), stone culture (SC) and their antimicrobial susceptibility, the details of perioperatively administered antibiotics and postoperative infections were recorded. The relationship between the postoperative infection and the SC was analyzed. Results:In 1 060 patients, 22 bacterial species were identified in UC and 52 bacterial species were identified in SC. The positive rate was higher in SC than in UC[31.8%(337/1 060)vs. 20.9%(222/1 060), P<0.001]. Escherichia coli was the most common bacteria in both UC and SC, but was more prevalent in UC than in SC [52.3%(116/222)vs. 43.6%(147/337), P<0.05]. E. coli cultured from UC and SC had high resistance to ampicillin, cefazolin, ceftriaxone, cefotaxime, levofloxacin, ciprofloxacin (all resistance rate >40%), but were sensitive to meropenem, cefoperazone/sulbactam, piperacillin/tazobactam, and amikacin (all resistance rate <10%). There was no statistical difference in the antibiotic resistance rates of E. coli from the UC and SC (all P >0.05). There were 111 (10.5%) patients who developed fever and 22 (2.1%) who developed urosepsis postoperatively. The incidences of postoperative fever and urosepsis were higher in the patients with positive SC than the patients with negative SC [23.7%(80/337)vs. 4.3%(31/723); 4.2%(14/337)vs. 1.1%(8/723), P<0.05]. Even in patients with negative UC, The incidence of postoperative fever was higher in the group with positive SC than the group with negative SC [17.9%(30/168) vs. 4.2%(28/670), P<0.05]. The incidence of postoperative fever in SC positive patients was lower if they were treated with sensitive antibiotics to the bacteria in stone than those treated with nonsensitive antibiotics [17.5%(22/126) vs. 27.5%(58/211), P<0.05]. Conclusions:The SC had high rate of culture positive, complicated bacterial species and high rate of multi-drug resistant. Positive SC was associated with increased incidence of postoperative infection even if the patients had negative UC. The SC might have a importance clinical value in the treatment of postoperative infection in PCNL.

Small splint external fixation combined with 3D printing brace for the treatment of Colles fractures / 中国骨伤

OBJECTIVE@#To explore the short-term clinical efficacy of manipulation reduction-combined with small splint and 3D printing wrist brace external fixation of wrist brace for Colles fracture and the advantages of using the brace.@*METHODS@#A total of 60 patients with Colles fractures who were treated in Zhongshan Hospital of Traditional Chinese Medicine from February to December 2017 were selected. Patients were randomly divided into 2 groups according to the order of treatment, with 30 patients in the control group, including 13 males and 17 females, aged from 16 to 66 years, with a mean of (49.46±12.63) years; the time from injury to consultation ranged from 3 to 18 h, averaged (6.86±3.15) h. In the experimental group, there were 30 cases, 12 males and 18 females, ranging in age from 14 to 68 years old, with a mean of (46.73±14.40) years old; the time from injury to consultation ranged from 3 to 19 h, averaged(7.06±3.45)h. All the patients in the experimental group and the control group were treated with the same doctor's manipulation to reduce the fracture. The small splints were applied for external fixation after the satisfactory reduction shown in the X-ray. After 1 week of fracture treatment, the small splints were removed from the patients in the experimental group and the 3D printing braces were replaced to maintain fixation until the fracture healed. In the control group, small splints were maintained until the fracture healed. Wrist joint X-ray films were taken before and after reduction and 4 weeks after reduction to observe the palmar inclination angle, ulnar deviation angle, radius height and compare; VAS score and swelling degree score were recorded before and after reduction for 1 and 2 weeks; Cooney and PRWE score of wrist joint were compared after 6 to 8 weeks of reduction.@*RESULTS@#The VAS score of 2 weeks after reduction was 2.40±0.49 in the experimental group and 2.43±0.50 in the control group. There was no statistical difference in the VAS score between the two groups before and after reduction(=0.364). The swelling degree of 2 weeks after reduction was 0.50±0.50 in the experimental group and 0.53±0.50 in the control group. There was no statistical difference in the swelling degree between the two groups before and after reduction(=0.746). The Cooney and PRWE scores of the experimental group were better than those of the control group 6 to 8 weeks after reduction (<0.05), and the anatomical characteristics of palmar inclination, ulnar deviation and radial shortening of the experimental group were better than those of the control group(<0.05).@*CONCLUSIONS@#3D printing braces are light and breathable, comfortable and beautiful, and convenient for dressing. The combination of small splint sequentially applied to Colles fracture has a definite clinical effect, which enriches the means of external fixation treatment. It is believed that with the deepening of clinical research, the design and materials of 3D printing braces as well as their application in future medical treatment will be further developed.

Expression and Clinical Significance of Late Endosomal/Lysosomal Adaptor,Mitogen-activated Protein Kinase and Mammalian Target of Rapamycin Activator 3 in Bladder Carcinoma / 中国医学科学院学报

Objective To investigate the expression and clinical significance of late endosomal/lysosomal adaptor,mitogen-activated protein kinase and mammalian target of rapamycin activator 3(LAMTOR3)in bladder carcinoma.Methods Oncomine and Expression Atlas were used to extract the useful mining gene chip database for analyzing the expression of LAMTOR3 in bladder carcinoma tissues and cell lines,and the correlation of LAMTOR3 with the clinicopathological features were analyzed.RT-PCR,Western blot,and immunohistochemistry were performed to detect the expression of LAMTOR3 in bladder carcinoma cell lines,specimens,and adjacent normal tissues for verifying the results exploited from the above databases.Results The Expression Atlas showed that LAMTOR3 had high expressions in Hs172.T,HT-1376,RT4,JMSU-1,and T24 cell lines among 20 bladder carcinoma cell lines,among which the LAMTOR3 expression was different.Oncomine reported that LAMTOR3 expression in bladder carcinoma,including invasive(=2.857,=0.005)and non-invasive carcinoma(=3.105,=0.003),was significantly higher than that in adjacent normal tissues.The expression of LAMTOR3 was positively correlated with pathological grade(<0.05).The expressions of LAMTOR3 mRNA in bladder carcinoma cell lines,including UMUC3(=10.84,=0.0084),J82(=21.75,=0.0021),5637(=45.88,=0.0005),and T24(=87.58,=0.0001)were significantly higher than that in normal bladder cell line SV-HUC-1,while its expression in bladder carcinoma tissues was significantly higher than that in adjacent normal tissues(<0.05),so was its protein level in tissues(<0.05).Immunohistochemistry showed that LAMTOR3 protein was over-expressed in bladder carcinoma tissues;its level in invasive carcinoma tissues was higher than that in no-invasive carcinoma tissues and was related closely with the clinical stages(=9.189,=0.002),pathological grades(=4.746,=0.029),and lymphatic metastasis(=6.210,=0.013)but had no significant correlation to sex(=0.965,=0.326),age(=2.126,=0.145),and distant metastasis(=1.261,=0.261).Conclusion LAMTOR3 is highly expressed in bladder carcinoma cell lines and tissues and plays a key role in the development and progression of bladder carcinoma.

Effect of Hei Xiaoyaosan on Expressions of Aβ1-42, GSK-3β, NEP, IDE in Hippocampus Area of Alzheimer's Dementia Mice / 中国实验方剂学杂志

Objective: To observe the effect of Hei Xiaoyaosan on expressions of β-amyloid 1-42 peptide(Aβ1-42),glycogen synthase kinase-3β(GSK-3β),neprilysin(NEP),insulin-degrading enzyme(IDE) in the hippocampus area of Alzheimer's dementia mice. Method: After weighing, 42 APP/PSI bivalent transgenic mice were randomly divided into 4 groups:10 mice in the model group, 10 mice in the positive drug control group, 11 mice in the high-dose Hei Xiaoyaosan group, and 11 mice in the low-dose Hei Xiaoyaosan group; 10 wild C57BL/6J mice of the same age and strain were used for negative control group. Drugs were administered to mice by gavage once a day for 12 weeks. Then the behavior of all the mice were detected by Morris water maze, the morphological changes in hippocampal neurons were observed by hematoxylineosin(HE) staining, the expressions of Aβ1-42, GSK-3β, NEP and IDE proteins in hippocampus were detected by immunohistochemistry. Result: After 3 months of treatment, compared with negative control groups, the average escaping latency periods prolonged significantly, and the number of cross-platform was decreased significantly in model group (Pβ1-42 and GSK-3β proteins in model mice hippocampus were significantly increased (PPPβ1-42 and GSK-3β proteins in the hippocampus of drug groups were significantly decreased (PPPConclusion: Hei Xiaoyaosan can significantly improve the learning and memory abilities of AD mice, which may be related to the reduction of cognitive impairment in AD mice by regulating abnormal deposition and degradating Aβ in the hippocampus.

Effect of Hei Xiaoyaosan on Expressions of APP，PERK in Hippocampus Area of Alzheimer's Dementia Mice / 中国实验方剂学杂志

Objective: To study the effect of Hei Xiaoyaosan on endoplasmic reticulum stress in hippocampal neurons of Alzheimer's disease (AD) model mice, including behavioral, histopathology and amyloid precursor protein (APP), protein kinase endoplasmic reticulum kinase (PERK) expressions. Method: The 42 4-month-old SPF-grade double transgenic (APP/PS1) mice were randomly divided into the high-dose group and the low-dose group, the donepezil hydrochloride group and the model group, and 10 C57BL mice of the same age were used as the blank group. Firstly, they were adapted to the environment for one week. After 2 months of treatment with different drug interventions, Morris water maze behavior was used to test the learning and memory abilities of each group of mice. After 1 month of treatment, histopathological changes in the hippocampus of each group of mice were observed by light microscopy. The expressions of APP, PERK protein and mRNA in the endoplasmic reticulum of hippocampus were detected by immunohistochemistry (IHC) and real-time fluorescent quantitative polymerase chain reaction (Real-time PCR). Result: After drug intervention, compared with the blank group, the escape latency of the AD model group was significantly prolonged (PPPPPConclusion: Hei Xiaoyaosan can significantly improve the learning and memory abilities of AD mice, which may be related to the reduction of the excessive stress response of endoplasmic reticulum to alleviate cognitive impairment in AD mice.

Bupleurum polysaccharides ameliorated renal injury in diabetic mice associated with suppression of HMGB1-TLR4 signaling / 中国天然药物

Bupleurum polysaccharides (BPs) is isolated from Bupleurum smithii var. parvifolium, a key traditional Chinese medicine. The study was to investigate the effects of BPs on diabetic kidney injury. After two intraperitoneal injections of streptozotozin (STZ) 100 mg·kg, renal injury in diabetic mice was induced and BPs was orally administrated at dosages of 30 and 60 mg·kg·d. The STZ injected mice developed renal function damage, renal inflammation and fibrosis known as diabetic kidney disease (DKD). BPs significantly reduced serum creatinine level and urinary albumin excretion rate, with the attenuated swelling of kidneys. BPs treatment obviously alleviated the pathological damage of renal tissue. The progression of renal injury in BPs treated mice was inhibited with less expression of type IV collagen (Col IV), fibronectin (FN) and α-smooth muscle actin (α-SMA). The inhibition of inflammation in kidney was associated with the reduced level of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). BPs administration suppressed the over-expression of toll like receptor 4 (TLR4) and high-mobility group box 1 (HMGB1) with lowered activity of nuclear factor kappa B (NF-κB) in renal tissue of diabetic mice. Oral administration of BPs effectively prevented the development ofrenal injury in diabetic mice. This study suggested that the protection provided by BPs might affect through the interruption of HMGB1-TLR4 pathway, leading to the inhibition of renal inflammation and fibrotic process.

Impact of target blood vessels angled with acoustic axis on peripheral mode scanning with pulse high intensity focused ultrasound ablation: An experimental study / 中国介入影像与治疗学

Objective To explore the impact of different angles between blood vessels and acoustic axis in the target area on pulse high intensity focused ultrasound (PHIFU) peripheral ablation.Methods Thirty New Zealand rabbits were selected,and the thoracic aortas were obtained.Models of tissue mimicking material were used via embedding the rabbit thoracic aorta into the center of the target barrier area.Then the models were divided into 0°,45° and 90° groups according to the angles with the acoustic axis,and the control group was set up as well (each n =10).Under B-ultrasound monitoring,PHIFU peripheral ablation was performed with the same parameters in each group.The temperature was measured during ablation.After ablation,the models were cut step by step for macroscopic and ultrasound observation.The total volumes (V) were calculated and compared,and the target blood vessels were sampled for pathological examination.Results The peripheral region in control group showed strong echo on ultrasound image,while in 0°,45° and 90° group the blood vessels showed low echo accordingly.The maximal temperatures in control group,0°,45° and 90° group was (98.60 ± 5.76) ℃,(98.90 ± 7.09) ℃,(71.10 ± 13.85) ℃ and (70.20 ± 9.14) ℃,respectively.Statisticaldifference was found between control group and 45°,90° group (all P＜0.05).The total volume in control group,0°,45° and 90° group was (40 709.70 ± 3 193.31) mm3,(40 029.02 ± 3 580.17) mm3,(34 562.59 ± 3 883.26) mm3 and (36 737.01± 3 278.68)mm3,respectively,while no statistical difference was found between control group and 0° group (P＞0.05).Pathological examination showed that the elastic fibers fractured partly,and disruption of cell nucleus were observed in 45° and 90° group.Conclusion When the angle between the blood vessel and acoustic axis is 0°,its impact on energy deposition is minimally,while the destruction of the vascular wall becomes stronger when the angle is 45°and 90°.

Effects of bletilla striata polysaccharideon on expression of vascular endothelial growth factor in rat ovaries and malondialdehyde in rat serum and endometrial morphology during perimenopause period / 局解手术学杂志

Objective To investigate the effect of the bletilla striata polysaccharide on the expression of ovarian vascular endothelial growth factor(VEGF) and serum malondialdehyde(MDA)and endometrial morphology in rat during perimenopause period.Methods The animal model of perimenopause rats was established by unforced aging.A total of 40 female SD rats(12~14 months old)were randomly divid-ed into four groups:Chinese medicine low(0.5 g/kg),medium(1 g/kg),high(2 g/kg) dosage group and the elder model group.The rats were given with corresponding drugs for 8 weeks.The content changes of ovarian VEGF protein was detected by western blot;serum MDA con-tent was detected by thiobarbituric acid;the morphology of endometrium in rats was observed by HE staining.Results Eight weeks later, compared with the elder model group,the VEGF protein expression in Chinese medicine low,medium,high dosage group increased,the serum MDA content in Chinese medicine low,medium,high,dosage group reduced,the differences were statistically significant( P<0.01),with dose dependence.Endometrial thickening and glandular increasing with the increase of dose.Conclusion Bletilla striata polysaccharide can upregulate the expression of VEGF protein,and down regulate the level of serum MDA,which improves the uterine function so as to delay the process of perimenopause in rats.

Research progress of acetyl-CoA carboxylase in cancer metabolism / 国际肿瘤学杂志

Abnormal fatty acid metabolism is one of the unique metabolic ways in which malignant cells maintain their growth needs and plays a crucial role in tumor progression.Acetyl-CoA carboxylase (ACC) is the rate-limiting enzyme in fatty acid synthesis and oxidative metabolism.More and more researches confirm that ACC is highly expressed in many tumors,and is closely related to tumor progression and prognosis of patients,which makes ACC as a potential marker for clinical diagnosis and prognosis.Tumor cell fatty acid synthesis can be blocked and fatty acid β oxidation can be stimulated by inhibiting the activity of ACC,resulting in serious lipid consumption of tumor,and then inhibit tumor growth and proliferation.Investigating the effect and molecular mechanisms of ACC in the genesis and development of tumors can provide a new insight into cancer targeted molecular therapy.

Urinary stone composition analysis of 15 269 cases from a single center / 中华泌尿外科杂志

Objective To investigate the distribution characteristics and changing tendency of urinary tract stones.Methods From January 2011 to May 2017,clinical data of 15 269 patients treated in our center was retrospectively reviewed.The stone components were detected by the automatic stone infrared spectroscopy system and the predominant components were recorded.There were 9 019 male patients and 6 250 female patients.The patients were divided into four groups according to their age,including group A ≤ 18 years;group B 19-40 years;group C 41-60 years;and group D ＞ 60 years.Compared the distribution characteristics of urinary tract stones of patient in different groups of sex,age and calendar year.Results Calcium oxalate stones were more prevalent in males than females [6 221 (69.0％)vs.3 582 (57.3％),P ＜ 0.001],but calcium phosphate stones [210 (3.4％) vs.210 (2.3％)],magnesium ammonium phosphate stones [230(3.7％) vs.165 (1.8％)] and carbonate apatite stones [1 328 (21.3％) vs.1 030 (11.4％)] were more common in females than males (P ＜ 0.001,respectively).The proportion of uric acid stones in group D [679(20.7％)] was higher than that in group A [23(9.1％)],group B[260(7.9％)],group C [1 163 (13.8％)] (P ＜0.001,respectively).The peak of carbonate apatite stones was showed in group B [652(19.7％)] (P＜0.001,respectively).Ammonium urate stones [9(3.5％)] and cystine stones [36 (14.2％)] were more frequent in group A(P ＜0.001,respectively).In adults,the percentage of uric acid stones increased with age,such as group B [260(7.9％)],group C [1 163(13.8％)],group D [679 (20.7％)].And the carbonated apatite stones decreased with age,such as group B [652 (19.7％)],group C [1 270(15.1％)],group D [416(12.7％)] (P ＜0.001,respectively).Further analysis showed the proportion of calc ium oxalate (OR =0.944,95 ％ CI 0.927-0.962,P ＜ 0.001),ammonium urate stones (OR =0.854,95％ CI 0.742-0.982,P =0.027) decreased,while calcium phosphate (OR =1.192,95％ CI 1.127-1.261,P ＜0.001),uric acid (OR =1.042,95％ CI 1.015-1.069,P =0.002) and ammonium magnesium phosphate (OR =1.078,95％ CI 1.019-1.141,P =0.009) stones increased with time.Conclusions The distribution of stones was different in genders and age.Calcium oxalate stones were more common in male patients,while ammonium magnesium phosphate and carbonate apatite stones were more common in female patients.Uric acid stones were more frequent in patients older than 60,while carbonate apatite were more frequent in the 19-40 age group.The proportion of calcium oxalate and ammonium urate stones showed a downward trend,whereas calcium phosphate,uric acid and magnesium ammonium phosphate stones increased with time.

Comparative Study on Mobilization of Endogenous MSCs in Treatment of Ulcerative Colitis Rats by Shenling Baizhu Powder and Tongxie Yaofang Decoction / 中国中医药信息杂志

Objective To compare mobilization effects of endogeneous MSCs in the treatment of ulcerative colitis rats by Shenling Baizhu Powder and Tongxie Yaofang Decoction. Methods Twenty SD male rats were randomly divided into blank group, model group, Shenling Baizhu Powder group and Tongxie Yaofang Decoction group. TNBS/ethanol method was used to build the ulcerative colitis model. Administration groups were given Shenling Baizhu Powder and Tongxie Yaofang Decoction for gavage and model group and blank group were given normal saline for gavage. After gavage, MSCs from peripheral blood and bone marrow were extracted for primary culture. MSCs of bone marrow and peripheral blood were detected by flow cytometry. Results MSCs from bone marrow showed: Compared with the blank group, the percentage of positive cells in the model group decreased (P<0.05); Compared with the model group, the percentage of positive cells in Shenling Baizhu Powder group and Tongxie Yaofang Decoction group increased, and the expression of Shenling Baizhu Powder group was more obvious (P<0.05). MSCs from peripheral blood showed: Compared with the blank group, the percentage of positive cells in the model group increased (P<0.05); Compared with the model group, the percentage of positive cells in Shenling Baizhu Powder group and Tongxie Yaofang Decoction group decreased, and the expression of Shenling Baizhu Powder group was more obvious (P<0.05). Conclusion Shenling Baizhu Powder and Tongxie Yaofang Decoction have the function of promoting the increase of bone marrow-derived MSCs and the reduction of peripheral blood source of MSCs in model rats, and Shenling Baizhu Powder is better than Tongxie Yaofang Decoction.

Systematic Review on Effects of Acupuncture Combined with Lifestyle Modification on Essential Hypertension / 中国中医药信息杂志

Objective To evaluate the effects of acupuncture combined with lifestyle modification for essential hypertension by Meta-analysis. Methods Clinical randomized controlled trial literature about acupuncture combined with lifestyle modification for essential hypertension in CNKI, WanFang Data, CBM, VIP, PubMed, Embase, and Web of Science since establishment to February 20, 2017 were retrieved. Data extraction and quality assessment of studies were conducted by two researchers independently, and the Meta-analysis was performed by the software of RevMan5.3. Results 5 articles involving 467 patients were included. The results of Meta-analysis showed that acupuncture combined with lifestyle modification had more significant effect than lifestyle modification alone in lowing SBP [SMD=-1.52(-2.40,-0.64)], in lowing DBP [SMD=-1.02(-2.01,-0.03)], total effective rates [RR=1.27(1.13, 1.43)]. Conclusion Compared with lifestyle modification alone, acupuncture combined with lifestyle modification have significant effects for patients with essential hypertension, but because of the fewer studies included, bigger heterogeneity between studies and the lower quality of included studies still exist, the results should be further verified, and clinical applications should be treated with caution.

Effects of Angelica Polysaccharide on Learning and Memory Abilities and Aβ Metabolism in Model Rats with Alzheimer Disease / 中国中医药信息杂志

Objective To investigate effects of angelica polysaccharide on learning and memory abilities, Ach, ChAT, AChE, SOD, MDA in serum, APP and Aβ1-42 in hippocampus in model rats with Alzheimer disease (AD); To explore the mechanism of angelica polysaccharide for the treatment of AD. Methods Seventy SPF Wistar rats were selected for learning and memory ability by water maze. 10 rats were randomly selected (half female and half male) as sham-operation group, and the others were injected with Aβ25-35 by stereotatic techniques, copying AD model rats. 50 rats for learning and memory ability by water maze were successfully divided into model group, positive group, angelica polysaccharide low-, medium-, and high-dose groups, with 10 rats in each group. Rats in model group and sham-operation group were given normal saline for gavage, while rats in medication groups were given relevant medicine for gavage, 2 mL/(100 g?d), for 28 d. The learning and memory ability of rats in each group was tested by Morris water maze during 25-28 days, and the contents of Ach, ChAT, AChE, SOD, MDA in serum and APP and Aβ1-42 in hippocampus were determined. Results Compared with the sham-operation group, the escape latent period of model group was significantly prolonged in place navigation experiment; the target quadrant time was shortened; the latent time for the first time to reach the original escape platform was longer in spatial probe test; the residence time of crossing the original platform position and the target quadrant was shorter; the levels of Ach, the activity of ChAT and SOD in serum decreased; the levels of MDA, the activity of AChE in serum increased; the levels of APP and Aβ1-42 in hippocampus increased, with statistical significance (P<0.05, P<0.01). Compared with model group, the escape latent period of each medication group was shortened in different degrees after the intervention treatment; the residence time of target quadrant was prolonged; the latent time for the first time to reach the original escape platform was shortened; the number of cross platform increased; the levels of Ach, the activity of ChAT and SOD in serum increased; the levels of MDA and the activity of AChE in serum decreased; the levels of APP and Aβ1-42 in hippocampus significantly decreased, with statistical significance (P<0.05, P<0.01). Conclusion Angelica polysaccharide may effectively improve the learning and memory of ability of AD model rats to improve anti-free radical oxidation and promote Aβ metabolism and promote learning and memory ability of AD model rats, which have some preventive and therapeutic effects on AD.

Micro-dissection testicular sperm extraction for non-obstructive azoospermia patients with the history of secondary testicular injury / 中华男科学杂志

<p><b>Objective</b>To investigate the value of micro- dissection testicular sperm extraction (micro-TESE) in the treatment of non-obstructive azoospermia (NOA) in patients with the history of secondary testicular injury.</p><p><b>METHODS</b>Totally, 121 NOA patients with the history of secondary testicular injury underwent micro-TESE in our hospital from September 2014 to December 2017. We analyzed the correlation of the sperm retrieval rate with the causes of testicular injury and compared the outcomes of the ICSI cycles with the sperm retrieved from the NOA males by micro-TESE (the micro-TESE group) and those with the sperm ejaculated from severe oligospermia patients (sperm concentration <1×10⁶/ml, the ejaculate group). Comparisons were also made between the two groups in the female age, two-pronucleus (2PN) fertilization rate, transferrable embryos on day 3 (D3), D3 high- quality embryos, D14 blood HCG positive rate, embryo implantation rate, and clinical pregnancy rate.</p><p><b>RESULTS</b>Testicular sperm were successfully retrieved by micro-TESE in 86.0% of the patients (104/121), of whom 98.4% had the history of orchitis, 75.5% had been treated surgically for cryptorchidism, and 63.6% had received chemo- or radiotherapy. No statistically significant differences were observed between the micro-TESE and ejaculate groups in the 2PN fertilization rate (59.4% vs 69.3%, P > 0.05), D14 blood HCG positive rate (44.6% vs 57.9%, P > 0.05), embryo implantation rate (31.8 %% vs 32.6%, P > 0.05) and clinical pregnancy rate (41.5% vs 48.7%, P > 0.05). However, the rate D3 transferrable embryos was significantly lower in the micro-TESE than in the ejaculate group (40.5% vs 52.2%,P < 0.05), and so was that of D3 high-quality embryos (32.5% vs 42.1%, P < 0.05).</p><p><b>CONCLUSIONS</b>Micro-TESE can be applied as the first choice for NOA patients with the history of secondary testicular injury, but more effective strategies are to be explored for the improvement of ICSI outcomes with the sperm retrieved by micro- TESE.</p>