Electroacupuncture alleviates postoperative pain through inhibiting neuroinflammation via stimulator of interferon genes/type-1 interferon pathway / 中西医结合学报

OBJECTIVE@#This work explores the impact of electroacupuncture (EA) on acute postoperative pain (APP) and the role of stimulator of interferon genes/type-1 interferon (STING/IFN-1) signaling pathway modulation in the analgesic effect of EA in APP rats.@*METHODS@#The APP rat model was initiated through abdominal surgery and the animals received two 30 min sessions of EA at bilateral ST36 (Zusanli) and SP6 (Sanyinjiao) acupoints. Mechanical, thermal and cold sensitivity tests were performed to measure the pain threshold, and electroencephalograms were recorded in the primary somatosensory cortex to identify the effects of EA treatment on APP. Western blotting and immunofluorescence were used to examine the expression and distribution of proteins in the STING/IFN-1 pathway as well as neuroinflammation. A STING inhibitor (C-176) was administered intrathecally to verify its role in EA.@*RESULTS@#APP rats displayed mechanical and thermal hypersensitivities compared to the control group (P < 0.05). APP significantly reduced the amplitude of θ, α and γ oscillations compared to their baseline values (P < 0.05). Interestingly, expression levels of proteins in the STING/IFN-1 pathway were downregulated after inducing APP (P < 0.05). Further, APP increased pro-inflammatory factors, including interleukin-6, tumor necrosis factor-α and inducible nitric oxide synthase, and downregulated anti-inflammatory factors, including interleukin-10 and arginase-1 (P < 0.05). EA effectively attenuated APP-induced painful hypersensitivities (P < 0.05) and restored the θ, α and γ power in APP rats (P < 0.05). Meanwhile, EA distinctly activated the STING/IFN-1 pathway and mitigated the neuroinflammatory response (P < 0.05). Furthermore, STING/IFN-1 was predominantly expressed in isolectin-B4- or calcitonin-gene-related-peptide-labeled dorsal root ganglion neurons and superficial laminae of the spinal dorsal horn. Inhibition of the STING/IFN-1 pathway by intrathecal injection of C-176 weakened the analgesic and anti-inflammatory effects of EA on APP (P < 0.05).@*CONCLUSION@#EA can generate robust analgesic and anti-inflammatory effects on APP, and these effects may be linked to activating the STING/IFN-1 pathway, suggesting that STING/IFN-1 may be a target for relieving APP. Please cite this article as: Ding YY, Xu F, Wang YF, Han LL, Huang SQ, Zhao S, Ma LL, Zhang TH, Zhao WJ, Chen XD. Electroacupuncture alleviates postoperative pain through inhibiting neuroinflammation via stimulator of interferon genes/type-1 interferon pathway. J Integr Med. 2023; 21(5): 496-508.

In vivo delivery process and regulating mechanisms of lipid-based nanomedicines / 药学学报

Lipid-based nanocarrier is a classic drug delivery system with great biocompatibility and biodegradability. It can effectively reduce the toxicity of anti-tumor and anti-infective drugs in clinical practice. However, it has not yet met the clinical demand for enhanced therapeutic efficacy, and the clinical application is still very limited. The complex in vivo delivery process of lipid-based nanomedicine and the reciprocal interactions with body lead to unexpected changes in in vivo performance of nanomedicine and seriously hinder clinical translation. Therefore, the in-depth study of the relationships among intrinsic properties of lipid-based nanomedicine, the in vivo delivery process, and the regulatory mechanisms will not only provide guidance for the rational design of nanocarriers, but also promote the clinical translation and precision medicine of new lipid-based nanomedicine. In this review, we summarize the in vivo delivery process, regulating factors and intervention strategies for the in vivo delivery of lipid-based nanomedicine.

The development of epiretinal membrane following rhegmatogenous retinal detachment repair: incidence, risk factors, and outcomes / Desenvolvimento da membrana epirretiniana após reparo do descolamento regmatogênico da retina: incidência, fatores de risco e resultados

ABSTRACT Purpose: To investigate the incidence, risk factors, and visual outcomes of epiretinal membrane development following rhegmatogenous retinal detachment repair. Methods: This was a retrospective study of 309 eyes that underwent initial surgery for primary uncomplicated rhegmatogenous retinal detachment. Examinations were conducted preoperatively and then postoperatively at 1, 3, 6, and 12 months. The study patients were categorized into two groups depending on the presence or absence of the epiretinal membrane. Results: The incidence of postoperative epiretinal membrane was 28.5%; 42.7% of these patients had severe epiretinal membrane development and therefore underwent the epiretinal membrane removal. Logistic regression analyses revealed that giant retinal tears (OR: 2.66; 95% CI: 1.045-6.792, p=0.040) and horseshoe tears (OR: 0.534; 95% CI: 0.295-0.967, p=0.039) were the significant predictors of postoperative epiretinal membrane. Triamcinolone acetonide staining was significantly associated with the prevention of epiretinal membrane (p=0.022). A total of 34 patients showed a better or an equal final best-corrected visual acuity; of which 4 eyes were evaluated at the final follow-up visit and exhibited a reduced best-corrected visual acuity. Conclusion: Our analysis demonstrated that horseshoe tears and giant retinal tears represent the risk factors for the postoperative epiretinal membrane. Triamcinolone acetonide staining had a significant preventive effect on the postoperative epiretinal membrane. Furthermore, a second round of pars plana vitrectomy, including membrane removal, led to a significant improvement in the final best-corrected visual acuity as per the last follow-up examination, albeit the recovery was limited.

RESUMO Objetivos: Investigar a incidência, fatores de risco e desfechos visuais do desenvolvimento da membrana epirretiniana após reparo do descolamento regmatogênico da retina. Métodos: Trata-se de um estudo retrospectivo de 309 olhos submetidos à cirurgia inicial para descolamento regmatogênico da retina primário sem complicações. Os exames foram realizados no pré-operatório aos 1, 3, 6 e 12 meses pós-operatórios. Os pacientes foram divididos em dois grupos, dependendo da presença ou ausência de membrana epirretiniana. Resultados: A incidência de membrana epirretiniana pós-operatória foi de 28,5%; 42,7% desses pacientes apresentaram desenvolvimento grave da membrana epirretiniana e, portanto, foram submetidos à remoção desta membrana. A regressão logística mostrou que as lágrimas retinianas gigantes (RC: 2,66; 95% IC: 1,045 - 6,792, p=0,040) e lágrimas em ferradura (RC: 0,534; 95% IC: 0,295-0,967, p=0,039), foram preditores significativos de membrana epirretiniana pós-operatória. A coloração com acetonida de triancinolona foi significativamente associada à prevenção da membrana epirretiniana (p=0,022). Trinta e quatro pacientes apresentaram acuidade visual melhorada, ou igual, ou acuidade visual final melhor corrigida; 4 olhos foram avaliados na consulta final de acompanhamento e apresentaram redução da acuidade visual melhor corrigida. Conclusão: Nossa análise demonstra que as lágrimas de ferradura e as lágrimas retinianas gigantes representam fatores de risco para a membrana epirretiniana pós-operatória. A coloração com acetonida de triancinolona teve um efeito preventivo significativo na membrana epirretiniana no pós-operatório. Além disso, uma segunda rodada de vitrectomia pars plana, incluindo remoção da membrana, levou a uma melhora significativa da acuidade visual final melhor corrigida na última consulta de acompanhamento, embora a recuperação tenha sido limitada.

A short half-life of cccDNA offer or ignite hope for hepatitis B cure under nucleos(t)ide analogues treatment / 中华肝脏病杂志

Covalently closed circular DNA (cccDNA) of hepatitis B virus (HBV) is the template for HBV replication. Currently, there is a lack of therapeutic drugs that directly target cccDNA. Therefore, blocking cccDNA supplements as fast as possible and reducing the existing cccDNA is the key to achieving a complete cure of chronic hepatitis B. Previous studies have suggested that cccDNA had a long half-life, but a recent study showed that it only took a few months to update cycle of cccDNA pool, and its number was much less than previously predicted. In the future, with the advent of new antiviral drugs that can completely inhibit HBV replication, it is expected that the cccDNA pool will be completely cleared due to its supplement complete blockade, so as to achieve virological cure of chronic hepatitis B.

Clinical effect of endoscopic transnasal sphenoidal approach with simple muscle packing for intrasellar arachnoid cyst / 中华外科杂志

Objective: To examine the clinical effect of simple muscle packing through transnasal sphenoid approach in the treatment of intrasellar arachnoid cyst. Methods: The clinical data of 11 patients with intrasellar arachnoid cyst treated by transnasal sphenoidal approach with simple muscle packing at the Neurosurgery Department of the First Affiliated Hospital of Zhengzhou University from January 2014 to February 2020 were retrospectively analyzed. There were 5 males and 6 females, with a median age of 48 years (range: 23 to 75 years). The clinical manifestations included headache in 6 cases, dizziness in 4 cases, hypo-libido in 1 case, disturbance of consciousness in 1 case, visual impairment in 7 cases and mixed pituitary dysfunction in 5 cases. The enlargement of the sellar fossa was seen in the preoperative MRI images. The enhanced MRI images showed that the cyst wall of the intrasellar arachnoid cyst was not enhanced, and the compression and thinning of the sellar base was seen in the CT images. In 9 cases, the cyst extended suprasellar and the sellar septum was "arched". In 7 cases, the cyst compressed the optic chiasm upward. The cyst walls of all patients were incised through the nasal sphenoid approach under the endoscope, and the muscle was packed after sufficient drainage. The postoperative symptoms, pituitary endocrine function and recurrence of patients were followed up. Results: MRI images of the sellar region in all patients showed significant reduction or disappearance of cysts. Intracranial infection occurred in 1 case and electrolyte disorder in 2 cases, which were relieved after symptomatic treatment. No cerebrospinal fluid rhinorrhea occurred. Postoperative clinical symptoms were completely relieved in 6 cases and partially relieved in 5 cases. Pituitary endocrine function recovered completely in 2 cases and improved significantly in 4 cases. All patients were followed up for 10 to 40 months. One patient found to have a partial recurrence of the cyst 3 months after surgery. Because there were no new symptoms appeared, the follow-up was continued without second operation. Conclusion: Transnasal sphenoidal approach is a feasible method for the treatment of intrasellar arachnoid cyst.

Scutellarin promotes autophagy, inhibits oxidative damage and apoptosis in microvascular endothelial cells during ischemia-reperfusion injury / 中国药理学通报

Aim: To investigate the effects of Scutellarin (Scu) on microvascular endothelial cells (MEC) with ischemia/reperfusion injury (I/R) and its mechanisms involved. Methods Microvascular endothelial cells were used to build model of I/R, and the protective effects of Scu were observed. Cell viability was determined by MTT assay; SOD. MDA and LDH levels were determined by biochemical method; ICAM-1, VCAM-1, caspase-3 and LC3 mRNA expressions were detected by RT-PCR; LC3, CREB and TLR4 expressions were detected by Western blot. Results MTT assay showed that the cell viability was rescued by 50 μmol • L

Clinical and Experimental Research Progress of Wulingsan in Treatment of Renal Diseases： A Review / 中国实验方剂学杂志

Wulingsan， a classic prescription first recorded in the Treatise on Cold Damage （Shang Han Lun） by ZHANG Zhong-jing for patients with water retention syndrome due to the disturbance of Qi transformation in bladder， has often been modified by ancient and modern doctors for the treatment of renal diseases. It produced satisfactory outcomes without inducing adverse reactions. The databases including China National Knowledge Infrastructure （CNKI）， Wanfang Data Knowledge Service Platform， and PubMed were searched for articles concerning the clinical application and pharmacological mechanism of Wulingsan in the treatment of renal diseases published by domestic and foreign scholars in recent years. The summary of the included articles revealed that Wulingsan has been widely employed for the treatment of renal edema， diabetic nephropathy， acute and chronic glomerulonephritis， nephrotic syndrome， renal insufficiency， abnormal urination， etc.， and the resulting outcomes were satisfactory. Wulingsan alone or in combination with western medicine yielded better clinical outcomes than the western medicine alone. In the exploration of its pharmacological mechanism， there existed some individual reports by Korean scholars， while Chinese scholars tended to work as a team. After years of research， each team has found that Wulingsan was superior to Wulingsan decoction in excreting water， which might be related to the absence of massive low-polarity and volatile components in the decoction that were responsible for regulating the expression of aquaporins （AQP） in kidney of saline-loaded rats. Wulingsan regulates the endocrine state of rats with kidney yang deficiency， inhibits the reabsorption of water， increases the activity of Na+-K+-ATPase， and reduces the expression of AQP 1， AQP 2， AQP 3， and AQP 4. Besides， it bi-directionally regulates the human water metabolism， which is achieved via the dual-directional regulation of purinergic P2X3 receptor expression on bladder detrusor. The efficacy of Wulingsan in treating chronic renal failure is attributed to its protection against the damaged renal tissue，structure and fanction. Hence， this paper summarized the research progress of Wulingsan in the treatment of renal diseases in recent years， aiming to provide a reference for the clinical and basic exploration of Wulingsan against renal diseases in the future.

Effect of Repetitive Transcranial Magnetic Stimulation Combined with Conventional Rehabilitation on Upper Extremity Function for A Patient with Complex Regional Pain Syndrome I after Distal Radius Fracture / 中国康复理论与实践

Objective:To summarize the development of a patient with complex regional pain syndrome (CRPS) after distal radius fracture and the effect of repetitive transcranial magnetic stimulation (rTMS) combined with conventional rehabilitation on it. Methods:One patient with CRPS after left distal radius fracture was treated with rTMS combined with conventional rehabilitation for three weeks. The pain degree was evaluated with Visual Analogue Score (VAS), the edema was assessed with volume of hand and circumference of finger, and motion of joint was measured with passive range of motion. The activities of daily living was assessed with modified Barthel Index (MBS). Results:Before treatment, the VAS score was 8, the volume of left hand was 330 ml, the temperature of skin was 36.8 ℃. The activity of flexion and extension of left elbow joint, pronation and supination of left forearm, the flexion, extension, ulnar deviation and temporal deviation of left wrist, and metacarpophalangeal joints (MCP), proximal interphalangeal joint (PIP) and distal interphalangeal joint (DIP) of left hand were all limited. The circumference of left finger was larger than right finger, and the score of MBI was 85. After three weeks of treatment, the VAS score was 2, the volume of the left hand was 310 ml, the temperature of the skin was 33.8 ℃. The activities of left elbow joint, left wrist joint and left MCP, PIP, and DIP were better than before. The score of MBI was 100. Conclusion:rTMS combined with conventional rehabilitation is effective on CRPS after distal radius fracture, in the range of motion and edema of upper extremity, and activities of daily living.

Exploring the mechanism of liver enzyme abnormalities in patients with novel coronavirus-infected pneumonia / 中华肝脏病杂志

To explore and analyze the possible mechanism of liver injury in patients with coronavirus disease 2019 (novel coronavirus pneumonia, NCP). The correlation between ALT, AST and other liver enzyme changes condition and NCP patients' disease status reported in the literature was comprehensively analyzed. ACE2 expression in liver tissue for novel coronavirus was analyzed based on single cell sequencing (GSE115469) data. RNA-Seq method was used to analyze Ace2 expression and transcription factors related to its expression in liver tissues at various time-points after hepatectomy in mouse model of acute liver injury with partial hepatectomy. -test or Spearman rank correlation analysis was used for statistical analysis. ALT and AST were abnormally elevated in some patients with novel coronavirus infection, and the rate and extent of ALT and AST elevation in severe NCP patients were higher than those in non-severe patients. Liver tissue results of single cell sequencing and immunohistochemistry showed that ACE2 was only expressed in bile duct epithelial cells of normal liver tissues, and very low in hepatocytes. In a mouse model of acute liver injury with partial hepatectomy, Ace2 expression was down-regulated on the first day, but it was elevated up to twice of the normal level on the third day, and returned to normal level on seventh day when the liver recovered and hepatocyte proliferation stopped. Whether this phenomenon suggests that the bile duct epithelial cells with positive expression of Ace2 participate in the process of liver regeneration after partial hepatectomy deserves further study. In RNA-Seq data, 77 transcription factors were positively correlated with the expression of ACE2 (r > 0.2, FDR < 0.05), which were mainly enriched in the development, differentiation, morphogenesis and cell proliferation of glandular epithelial cells. We assumed that in addition to the over activated inflammatory response in patients with NCP, the up-regulation of ACE2 expression in liver tissue caused by compensatory proliferation of hepatocytes derived from bile duct epithelial cells may also be the possible mechanism of liver tissue injury caused by 2019 novel coronavirus infection.

RON and MET Co-overexpression Are Significant Pathological Characteristics of Poor Survival and Therapeutic Targets of Tyrosine Kinase Inhibitors in Triple-Negative Breast Cancer / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Triple-negative breast cancer (TNBC) is highly malignant and has poor prognosis and a high mortality rate. The lack of effective therapy has spurred our investigation of new targets for treating this malignant cancer. Here, we identified RON (macrophage-stimulating 1 receptor) and MET (MET proto-oncogene, receptor tyrosine kinase) as a prognostic biomarker and therapeutic targets for potential TNBC treatment. @*Materials and Methods@#We analyzed RON and MET expression in 187 primary TNBC clinical samples with immunohistochemistry. We validated the targeted therapeutic effects of RON and MET in TNBC using three tyrosine kinase inhibitors (TKIs): BMS-777607, INCB28060, and tivantinib. The preclinical therapeutic efficacy of the TKIs was mainly estimated using a TNBC xenograft model. @*Results@#Patients with TNBC had widespread, abnormal expression of RON and MET. There was RON overexpression, MET overexpression, and RON and MET co-overexpression in 63 (33.7%), 63 (33.7%), and 43 cases (23.0%), respectively, which had poor prognosis and short survival. In vivo, the TKI targeting RON ant MET inhibited the activation of the downstream signaling molecules, inhibited TNBC cell migration and proliferation, and increased TNBC cell apoptosis; in the xenograft model, they significantly inhibited tumor growth and shrank tumor volumes. The TKI targeting RON and Met, such as BMS-777607 and tivantinib, yielded stronger anti-tumor effects than INCB28060. @*Conclusion@#RON and MET co-overexpression can be significant pathological characteristics in TNBC for poor prognosis. TKIs targeting RON and MET have stronger drug development potential for treating TNBC.

Research progress of PD-1/PD-L1 in small cell lung cancer / 中国肿瘤临床

Small-cell lung cancer (SCLC) has a high degree of malignancy and is characterized by strong invasiveness, rapid growth, and early metastasis. SCLC is sensitive to initial treatment with chemotherapy and radiotherapy, but it can easily relapse and has a poor prognosis. Both programmed death-1 (PD-1) and programmed cell death-ligand 1 (PD-L1) antagonists activate the immune response of tumor cells by activating T cells, and have shown exciting curative effects in clinical studies of SCLC, thereby becoming powerful po-tential agents to treat SCLC in the future. This article aims to illustrate the progress of PD-1/PD-L1 inhibitors in the treatment of SCLC, as well as the role of PD-L1 expression and tumor mutation burden (TMB) as a biomarker in SCLC.

Evaluation of the fabrication deviation of a kind of milling digital implant surgical guides / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the deviation of digital implant surgical guides during fabrication process in the Organical Dental Implant (ODI) system.@*METHODS@#This study included two parts. The first part was the in vitro study. A resin block with a diagnostic template was used for the planning. After cone beam computed tomography (CBCT) scanning, a surgical guide with eight implants was virtually designed using the ODI system. The guide was milled by a 5-axial numerical controlled milling machine, and an optical scanning was taken to digitalize the guide to a standard tessellation language (STL) form. The STL data were then imported into an ODI software and registered with the original design. The deviation of the sleeves between the design and the STL was measured in the ODI software and set as the golden standard. Then the ODI examination table was used to measure the deviation of the guide during fabrication. Examiners A and B measured 10 times separately. The reliability and the validity of the examination table was calculated. The second part was the in vivo study: The deviation during fabrication of 12 guides designed and fabricated by the ODI system were measured using the examination table.@*RESULTS@#The standard deviation of the deviation measured using the examination table by examiners A and B were all below 0.40 mm (for the shell reference points) and 0.71 degree (for the angles). No significant difference was found between the two examiners for any implant sites. The result of the examination table was larger than that of the software for the shell reference point (t-test, P<0.05), but no significant difference was found for the angle deviation (t-test, P>0.05). The 45 implants positions in the 12 guides for the in vivo study were examined using the examination table. The deviations at the shell reference points were (1.06±0.29) mm (0.42-1.75 mm), and at the implant tip were (1.12±0.48) mm (0.41-2.44 mm). The angle deviations were (1.42±0.70) degree (0.29-2.96 degree).@*CONCLUSION@#Deviation is unavoidable during the fabrication process of the guides. The examination table of the ODI system is a reliable and valid tool to measure the deviation during fabrication of the ODI guides. More studies should be designed to research the relationship between the fabrication deviation and the implant insertion deviation.

Proximate clavicle fracture treated with anatomic locking plate / 局解手术学杂志

Objective To investigate the therapeutic effect and feasibility of proximate clavicle fracture treated by anatomic locking plate.Methods Seven patients with of proximate clavicle fracture who were admitted in orthopedics department of Xinhua hospital(Chongming) affiliated to medical college of Shanghai Jiao Tong University from May 2012 to May 2016 were all treated by open reduction and internal fixation with locking plate,included 1 case with floating clavicle.The therapeutic effect was observed after surgey.Results Seven patients were followed up for 12 to 24 months (with average 15.6 months).All patients had normal shoulder joint range except 1 case with discomfort feel after hard work.Postoperative imaging showed that the clavicles had all achieved good reset,the fractures got good healing,the average healing time was 3.5 months.Curative effect according to Rockwood score,excellent in 4 cases,good in 3 cases,the excellent and good rate was 100％.Conclusion The anatomic locking plate is safe and reliable for proximate clavicle fracture,which can provide good reduction and fixation,early function exercise,meanwhile it should be make appropriate adjustment according to different situation of individual patients so as to achieve the best curative effect.

Anatomical and biomechanical characteristics of sternoclavicular joint / 中国组织工程研究

BACKGROUND: The clinical experience of the treatment of the sternoclavicular joint dislocation and peripheral fracture is relatively lacking, but its incidence is increasing yearly. At present, there are few studies on the anatomy and biomechanics of the sternoclavicular joint in and outside China, and no systematic anatomical measurements of the sternoclavicular joint are reported. OBJECTIVE: To provide a biological reference for the clinical diagnosis and treatment of sternoclavicular joint dislocation or peripheral fractures by studying the anatomy and biomechanics of the sternoclavicular joint. METHODS: (1) A total of 16 specimens (32 sides) of adult antiseptic and moist cadaveric specimens were selected. The complete manubrium, bilateral clavicle and surrounding tissues of sternoclavicular joint were anatomically separated, and repair to bone-ligament-bone specimen models. (2) The areas of manubrium articular surface and the medial clavicular articular surface of all specimens were measured by the ink pattern combined with grid counting method. (3) The morphological features of the anterior and posterior sternoclavicular ligaments of the specimens in this group were observed, and the length, width and thickness were measured and analyzed statistically. (4) The left and right sternoclavicular joints of each specimen were randomly paired into A and B groups. Group A received simply cutting of anterior sternoclavicular ligament. Group B received simply cutting of posterior sternoclavicular ligament. Before and after cuting off the ligament, the anterior and posterior load experiments were performed on the anatomical sites with the same force arm length and perpendicular to the distal clavicle. The angles of joints and load-angle regression line slopes were compared between the two groups in the anterior and posterior directions load. RESULTS AND CONCLUSION: (1) The area of articular surface of manubrium (239.00±28.78 mm2) was smaller than the area of medial articular surface of the clavicle (482.56±44.89 mm2), and the difference was statistically significant (t=-40.105, P < 0.001). (2) The length, width and thickness of the anterior sternoclavicular ligament were (17.56±1.94 mm), (15.54±1.42 mm) and (1.93±0.32 mm), and the length, width and thickness of the posterior sternoclavicular ligament were (17.21±1.86 mm), (15.97±1.17 mm), and (2.07±0.29 mm) respectively;there was no significantly statistical difference in the length, width and thickness between them (P > 0.05). (3) Before cutting the ligaments, when the loads were 2, 4, 6, 8, and 10 N, the angle backwards of joint caused by loads in the forward direction was less than the angle of forwards of joints caused by loads in the backward direction, but only when the loads were 6, 8, and 10 N, the difference between them was statistically significant (P < 0.05). The slope of the regression line of load-angle for the loads in the forward direction was less than the slope of the regression line of load-angle for the loads in the backward direction, with statistical difference (F=31.413, P < 0.001). After the ligaments were cut, when the loads were 2, 4, 6, 8 and 10 N in the forward direction in group A and group B, the backward angulation of joint in group A was less than that in group B (P < 0.05). The slope of the load-angled regression line in group A was less than that in group B (F=52.224, P <0.001). When the loads in the backward direction in group A and group B were 2, 4, 6, 8 and 10 N, the forward angulation of joint in group A was greater than that in group B (P < 0.05), and the slope of the load-angled regression line in group A was greater than that in group B (F=12.503, P=0.008). (4) These results suggest that contact area between the articular surface of the medial clavicle and the articular surface of the manubrium is narrow, which determines the instability of the joint itself. The sternoclavicular ligament is extremely important for maintaining the joint stability. The forward angulation of joint restriction effect of sternoclavicular ligament was weaker than that of the backward angulation, also because of the joint in the anatomical position of the natural forward angulation, so the sternoclavicular joint was prone to anterior dislocation. It is necessary to pay attention to the repair and reconstruction of sternoclavicular ligament when sternoclavicular joint dislocation or peripheral fractures are treated by operations.

A Study of microRNA-124 Expression in blood Serum of Patients with Intracerebral Hemorrhage / 昆明医科大学学报

Objective To observe microRNA-124 expression in the serum of patient with intracerebral hemorrhage and explore the relationship between the expression and associated clinical factors. Methods Thirty serum specimen were collected among patients with intracerebral hemorrhage, who were checked up at the same time in the hospital. Relative expression of microRNA-124 in serum was detected. The variation of MicroRNA-124 expression between the two groups and clinical data of patients with intracerebral hemorrhage were analyzed. The relationship between microRNA-124 and clinical factors related to intracerebral hemorrhage was explored. Results Compared with healthy people, microRNA- 124 expression in serum increased among patients with intracerebral hemorrhage (P＜0.05) . The expression is related to the bleeding volume and onset time (P＜0.05) . Meanwhile, no obvious correlation is established between serum microRNA-124 expression and other factors in patients with intracerebral hemorrhage, such as gender, bleeding area, with or without surgical treatment (including minimally invasive and craniotomy), a history of high blood pressure, fasting venous blood glucose levels (FPG), and cerebrovascular disease history (P＞0.05) . Conclusion The serum microRNA-124 expression in patients with intracerebral hemorrhage is higher than that in healthy people. Bleeding volume positively increases expression. A higher expression is seen within one week at the onset of intracerebral hemorrhage compared to that one week after.

Pedicle Subtraction Osteotomy with a Cage Prevents Sagittal Translation in the Correction of Kyphosis in Ankylosing Spondylitis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Sagittal translation (ST) is an accidental event that surgeons commonly encounter during a spinal osteotomy in the correction of kyphosis in ankylosing spondylitis (AS). However, there is a paucity of effective techniques to prevent ST. The purpose of this study was to propose a pedicle subtraction osteotomy (PSO) with a cage as a method to prevent ST and to explore the efficacy and feasibility of this method in the treatment of kyphosis in AS.</p><p><b>METHODS</b>We retrospectively reviewed 89 consecutive patients with AS kyphosis who underwent a PSO (Group B, 46 patients) or a PSO with a cage (Group A, 43 patients) from February 2009 to December 2013. Pre- and post-operative radiographic results were reviewed. ST and complications were analyzed in both groups. Clinical assessment was performed using the Scoliosis Research Society-22 (SRS-22) outcomes metric. The patients were followed up for at least 2 years.</p><p><b>RESULTS</b>Group A achieved the same re-alignment of the kyphotic spine as Group B. Two (4.7%) of the 43 patients in Group A and 14 (30.4%) of the 46 patients in Group B had intraoperative ST (χ2 = 10.020, P = 0.002). Significant differences were identified between the two groups in the height change of the osteotomized column. SRS-22 scores improved significantly in both groups. Seven patients experienced neurologic complications (1 in Group A and 6 in Group B). Eight patients had cerebrospinal fluid leakage (2 in Group A and 6 in Group B).</p><p><b>CONCLUSION</b>PSO with a cage significantly avoided ST during the osteotomy procedure and might represent a new, safe, and feasible choice for treating patients with AS kyphosis.</p>

Prevalence and psychopathological characteristics of anxiety and depression in patients with chronic rhinosinusitis before endoscopic sinus surgery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the prevalence and psychopathological characteristics of anxiety and depression in patients with chronic rhinosinusitis (CRS) and to find the risk factors leading to psychological problems.</p><p><b>METHODS</b>Between August 2013 and April 2014, 117 consecutive patients with the diagnosis of CRS who had been scheduled for endoscopic sinus surgery were prospectively enrolled. Somatic and psychological symptoms were evaluated using a series of questionnaire instruments. The instruments included symptom checklist-90 (SCL-90), self-rating depression scale (SDS), self-rating anxiety scale (SAS) and the visual analogue scale (VAS) and the sinonasal outcome test 20 (SNOT-20) and Lund-Mackay computed tomography score. The results of SAS, SDS, SCL-90 were compared with the standard, obtained from healthy Chinese population. Multivariate Logistic regression was used to analyze the factors that might cause anxiety and depression. SPSS 19.0 software was used to analyze the data.</p><p><b>RESULTS</b>The scores of SAS and SDS (39.40 ± 11.55, 54.05 ± 10.96) were significantly higher than those of our country's normal standard (29.78 ± 10.46, 41.88 ± 10.57, t equals 5.648, 7.529, all P < 0.01). The SCL-90 scores were significantly higher than those of the normal standard population, including dimension of somatization, anxiety, depression, psychosis and total average score of the factors ( all P < 0.01), the result of somatization, anxiety, depression had positive correlation with the scores of SAS and SDS (r equals 0.681, 0.781, 0.531, 0.866, 0.674, 0.557, all P < 0.05). Multivariate Logistic regression showed that gender and CRS complicated with asthma or allergic rhinitis (AR) and the symptom of nasal obstruction were related to the incidence of anxiety depression comorbid. In addition, the gender and concurrent asthma had positive correlation with incidence of any anxiety or depressive disorder. To compare the abnormal psychological state group and healthy group, the SNOT-20 scores had no statistical significance (all P > 0.05).</p><p><b>CONCLUSIONS</b>High prevalence of anxiety and depression was found in CRS patients. Such factors as gender, nasal obstruction and concurrent with asthma or AR are high risk factors for anxiety and depression in patients with CRS.</p>

Role of noradrenalin in wake promotion effect of orexin-A on alcohol coma in rats / 解放军医学杂志

Objective. To study whether or not noradrenaline system participates in the process of orexin-A wakepromoting from alcohol coma. Methods Twenty-four adult female SPF SD rats were divided into four groups, 6 each, and the model of alcohol coma was reproduced. Experimental rats were then divided randomly into rats receiving injection of artificial cerebrospinal fluid (ACSF, control group), orexin-A (orexin-A group), noradrenaline α1 receptor antagonists--prazosin (prazosin group), or prazosin + orexin-A (prazosin-orexin-A group) into the lateral ventricle. The depth of coma was evaluated by the duration of loss of righting reflex (LORR) and δ wave in electrocorticogram (ECoG). Result The duration of LORR was significantly longer and the ratio of δ wave higher in the prazosin-treated rats than those in control group (P0.05). But the values were significantly different from those in the orexin-A group (P<0.01). Conclusion Noradrenaline system may participate in the wake-promoting process of alcohol coma by orexin-A.

Clinical research on curative effect of complete denture with two kinds of occlusion for temporomandibular joint disorders of aged edentulous patients / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To compare curative effect between complete denture with lingualized occlusion and anatomic occlusion on temporomandibular joint disorders (TMD) of aged edentulous patients with severe residual alveolar ridge resorption.</p><p><b>METHODS</b>Seventy aged edentulous patients with severe residual alveolar ridge resorption were recruited in this study and randomly assigned into two groups, thirty-five each. In Group A, patients received complete denture with lingualized occlusion, and in Group B, patients received complete denture with anatomic occlusion. The condition of TMD was examined and recorded by the same TMD specialist at baseline, 3 months and 6 months following denture delivery. The recovery effect of TMD was evaluated according to Fricton Index. Related data were analyzed statistically with t-test and rank sum test.</p><p><b>RESULTS</b>Three months following denture delivery, the craniomandibular index (CMI) decrease value was (0.064 ± 0.022) in group A, and was significantly higher than that in group B (0.043 ± 0.018) (P < 0.01). Six months following denture delivery, the CMI decrease value was (0.084 ± 0.020) in group A, and was significantly higher than that in group B (0.070 ± 0.021) (P = 0.011<0.05).</p><p><b>CONCLUSIONS</b>Complete denture with lingualized occlusion may be more conducive to the remission of TMD for aged edentulous patients with severe residual alveolar ridge resorption.</p>