Bone Marrow Adipocytes Promote the Survival of Multiple Myeloma Cells and Up-Regulate Their Chemoresistance / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of adipocytes in the bone marrow microenvironment of patients with multiple myeloma (MM) on the pathogenesis of MM.@*METHODS@#Bone marrow adipocytes (BMA) in bone marrow smears of health donors (HD) and newly diagnosed MM (ND-MM) patients were evaluated with oil red O staining. The mesenchymal stem cells (MSC) from HD and ND-MM patients were isolated, and in vitro co-culture assay was used to explore the effects of MM cells on the adipogenic differentiation of MSC and the role of BMA in the survival and drug resistance of MM cells. The expression of adipogenic/osteogenic differentiation-related genes PPAR-γ, DLK1, DGAT1, FABP4, FASN and ALP both in MSC and MSC-derived adipocytes was determined with real-time quantitative PCR. The Western blot was employed to detect the expression levels of IL-6, IL-10, SDF-1α, TNF-α and IGF-1 in the supernatant with or without PPAR-γ inhibitor.@*RESULTS@#The results of oil red O staining of bone marrow smears showed that BMA increased significantly in patients of ND-MM compared with the normal control group, and the BMA content was related to the disease status. The content of BMA decreased in the patients with effective chemotherapy. MM cells up-regulated the expression of MSC adipogenic differentiation-related genes PPAR-γ, DLK1, DGAT1, FABP4 and FASN, but the expression of osteogenic differentiation-related gene ALP was significantly down-regulated. This means that the direct consequence of the interaction between MM cells and MSC in the bone marrow microenvironment is to promote the differentiation of MSC into adipocytes at the expense of osteoblasts, and the cytokines detected in supernatant changed. PPAR-γ inhibitor G3335 could partially reverse the release of cytokines by BMA. Those results confirmed that BMA regulated the release of cytokines via PPAR-γ signal, and PPAR-γ inhibitor G3335 could distort PPAR-γ mediated BMA maturation and cytokines release. The increased BMA and related cytokines effectively promoted the proliferation, migration and drug resistance of MM cells.@*CONCLUSION@#The BMA and its associated cytokines are the promoting factors in the survival, proliferation and migration of MM cells. BMA can protect MM cells from drug-induced apoptosis and plays an important role in MM treatment failure and disease progression.

Intervention effect of Tuina pressing and kneading the Huantiao (GB30) acupoint on NF-κB p65 protein at spinal cord dorsal horn in sciatica rats / 中国骨伤

OBJECTIVE@#To observe the analgesic effect of Tuina by pressing and kneading the Huantiao (GB30) acupoint on rats with chronic constriction injury (CCI) and to explore the analgesic mechanism of Tuina on sciatica rats.@*METHODS@#Thirty-two SPF male SD rats weighing 180 to 220 g were randomly divided into fore groups:blank group (without any treatment), sham group (only exposed without sciatic nerve ligating), model group (sciatic nerve ligating) and Tuina group (manual intervention after lsciatic nerve ligating). The CCI model was prepared by ligating the right sciatic nerve of the rats, on the third day of modeling, the rats in the Tuina group were given pressing and kneading the Huantiao (GB30) point for 14 days, and the changes of paw withdrawal threshold(PWT), paw withdrawal latency(PWL) were measured before and on the 1st, 3rd, 7th, 10th, 14th and 17th days after modeling. The changes of sciatic functional index(SFI) were measured before and on the 1st and 17th day after modeling. The morphological changes of the sciatic nerve were observed by hematoxylin-eosin(HE) staining;and the differences in NF-κB protein expression in the right dorsal horn of the spinal cord of rats were detected.@*RESULTS@#Following modeling, there was no significant difference in PWT, PWL and SFI between the blank group and the sham group (P>0.05), but the PWT, PWL and SFI of the model group and the Tuina group decreased significantly (P<0.01). After manual intervention, the pain threshold of rats in Tuina group increased. On the 8th day of manual intervention (the 10th day after modeling), PWT in Tuina group increased significantly compared with that in model group (P<0.01). On the 5th day of manual intervention (the 7th day after modeling), the PWL of the massage group was significantly higher than that of the model group (P<0.01). The pain threshold of rats in Tuina group continued to rise with the continuous manipulation intervention. After 14 days of manipulative intervention, the sciatic nerve function index of rats in the Tuina group increased significantly(P<0.01). Compared with the blank group and sham group, the myelinated nerve fibers of sciatic nerve in the model group were disordered and the density of axons and myelin sheath was uneven. Compared with the model group, the nerve fibers of rats in the Tuina group were gradually continuous and the axons and myelin sheath were more uniform than those in the model group. Compared with the blank group and sham group, the expression of NF-κB protein in the right spinal dorsal horn of the model group was significantly increased(P<0.01). Compared with the model group, the expression of NF-κB protein in the right spinal dorsal horn of rats in Tuina group decreased significantly(P<0.01).@*CONCLUSION@#Pressing and kneading the Huantiao (GB30) point restores nerve fiber alignment;and improves the PWT、PWL and SFI in the CCI model by decreasing NF-κB p65 protein expression in the spinal dorsal horn. There fore, Tuina demmstrates an analgesic effect and improves the gait of rats with sciatica.

Retrospective analysis of the pre-audit results for prescriptions of Chinese patent medicines in a second-level hospital / 药学实践杂志

Objective Analyze the pre-audit results of Chinese patent medicine prescriptions in a second-level hospital, suggest the risks of taking Chinese patent medicines and promote the safe and standardized use of Chinese patent medicines. Methods A total of 31542 outpatient and emergency prescriptions of Kongjiang hospital in April 2021 were collected, combined with the review of the instructions and relevant data, classify the toxic components of Chinese patent medicines, and summarize and analyze the problems of drug use. Results The types of problems in the prescription of Chinese patent medicine and chemical medicines were different, mainly including repeated medication and wrong usage and dosage. Insufficient warnings on toxic medicinal ingredients in the instructions of Chinese patent medicines and the imperfect knowledge base of audit software increased the risk of using Chinese patent medicines. Conclusion It is necessary to improve the knowledge base of the prescription audit system, strengthen the high-alarm management of Chinese patent medicines containing toxic ingredients, and improve the public's understanding of the rational use of Chinese patent medicines.

Treatment of senile lumbar spinal stenosis by unilateral approach and bilateral decompression with large channel endoscopy / 中国骨伤

OBJECTIVE@#To evaluate clinical effect of unilateral approach and bilateral decompression via large channel endoscopic system for the treatment of lumbar spinal stenosis.@*METHODS@#The clinical data of 32 patients with lumbar spinal tenosis treated by unilateral approach and bilateral decompression via large channel endoscopy from February 2018 to February 2019 were retrospectively analyzed. There were 18 males and 14 females, aged 65 to 84 years old with an average of (70.6± 8.4) years. The course of disease was from 1 to 12 years. All 32 cases were accompanied by numbness or pain in the lower limbs, of which 28 cases were accompanied by intermittent claudication. Narrow segments were L@*RESULTS@#All the patients were followed up for 12-24 (17.68±2.43) months and all operations were successfully completed with the operation time of 70-160(85.64±11.94) min. Spinal dural tear occurred in 1 case during the operation, and sensory disturbance in the other side of lower limb in a short period of time occurred in 2 cases, all improved after corresponding treatment. Postoperative imaging showed that the spinal canal was significantly enlarged and the nerve root was fully released. Before operation and 3 days, 3 months, 1 year after operation, VAS scores of low back pain were 4.62 ±1.41, 2.73 ±1.35, 1.21 ±1.17, 1.11 ±0.34, respectively;VAS scores of leg pain were 6.83 ± 1.71, 3.10±1.50, 1.08±0.19, 0.89±0.24, respectively. VAS scores of low back pain and leg pain each time point after operation were obvious improved (@*CONCLUSION@#It is a safe and effective way to treat lumbar spinal stenosis with unilateral approach and bilateral decompression via large channel endoscopic system. It has the advantages of sufficient decompression, less trauma, fast recovery, high safety and low incidence of postoperative complications. It can minimize the damage to the stable structure of the lumbar spine and is an ideal minimally invasive operation for the treatment of lumbar spinal stenosis.

Effect of the Connexin 43 Coupling to the Biobehavior of Multiple Myeloma Cells / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of gap junction intercellular communication (GJIC) combined by connexin43 (Cx43) and its signal to the biobehavior of multiple myeloma (MM) cells, and its possible mechanism.@*METHODS@#The mesenchymal stem cell (MSC) cells were isolated and cultured from patients with MM and normal donors. The expression of connexin43 (Cx43) in MSC cells from different sources was detected by RT-PCR and Western blot. The side population (SP) cells were sorted by flow cytometry (FCM). The effect of MSC cells from different sources to the cell cycle, Cx43 expression, colony formation in vitro, stem cell related genes expression, cytokines secretion and chemoresistance in MM SP cells as well as with or without Cx43 inhibitor 18α-glycyrrhetinic acid (18α-GA) was observed.@*RESULTS@#There was no significantly difference between the MSC isolated from normal donor and MM patients. Western blot showed that Cx43 expression in SP cells was up-regulated when the cells were incubated with MSC, and medium containing 18α-GA could partially inhibit it, moreover, it was more significant in MSC cells of MM patients. The ability of colony formation of SP cells in vitro was higher than those of MM cells and MM-MSC could promote the colony formation in a co-culture manner. The effect of MM-MSC to SP cells was down-regulated after 18α-GA was added. RT-PCR showed that there was several important stem cell-related genes including c-myc, Oct-4 Klf-4, and Sox-2 were found in RPMI 8226 cells, but those cells were up-regulated in SP cells (P0.05). Cytometry bead array assays showed that MM-MSCs could secrete high level of IL-6, but the levels of IL-6, IL-10 and TGF-β increased significantly when the MM-MSCs were co-cultured with SP cells (P<0.05), especially the levels of IL-6 and IL-10 were significantly higher than cultured alone. There was no significant change in the levels of bFGF and IL-17 before and after co-cultured. The levels of IL-6, IL-10 and TGF-β in supernatant decreased significantly after GJ inhibitor 18α-GA was added. PI/Annexin V assay showed that MM cells were sensitive to bortezomib (BTZ)-induced apoptosis, but the sensitivity for SP cells was weaker. The ratio of cell apoptosis was 75.2%±0.77% and 8.12%±0.86% (P<0.001), respectively. MM-MSC could down-regulate the cell apoptosis induced by BTZ, while the sensitivity of MM cells to BTZ could be partially recovered after GJ inhibitor was added.@*CONCLUSION@#MSC derived from MM patients can enhance GJIC to maintain its "hematopoiesis" by up-regulating the expression of Cx43 in MM cells, and at the same time promote cell proliferation and drug recistance by secreting multiple cytokines, which finally contributes to the relapse of MM.

High frequency ultrasound combined with ultrasound-guided core needle biopsy for the diagnosis of primary thyroid lymphoma / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the sonographic features of primary thyroid lymphoma (PTL) and to evaluate the clinical significance of ultrasound-guided core needle biopsy (US-CNB) in PTL. Methods: A total of 24 patients with suspected PTL in Sir Run Run Shaw Hospital from January 2013 to June 2018 were analyzed retrospectively. All cases were confirmed by pathology, of them 23 patients received US-CNB and 1 patient chose operation without US-CNB, including 5 males and 19 females, aged from 39 to 75 years old. The effectiveness and safety of 23 patients with US-CNB were evaluated, and the sonographic features of 20 patients with PTL diagnosed by pathology were analyzed. Descriptive statistical methods were used in the study. Results: In the 23 patients with suspected PTL underwent US-CNB, 18 patients were diagnosed as PTL, 4 patients were respectively diagnosed as subacute thyroiditis, anaplastic carcinoma, Hashimoto's thyroiditis, and fibro thyroiditis, and the another patient was hard to diagnose by US-CNB and then was diagnosed as PTL by surgical biopsy. The success rate of US-CNB for diagnosis of PTL was 18/19, and no severe complications occurred in the patients with US-CNB. The other case was diagnosed as PTL by surgical biopsy without US-CNB. Sonographic features of 20 cases with PTL (18 cases diagnosed by US-CNB and 2 cases by surgery or surgery biopsy) were as follows: (1) Most nodules had irregular shapes and unsmooth margins; (2) Hypoechoic or markedly hypoechoic nodules with honeycombed or cord structures were observed in most cases; (3) Calcification was rare; (4) Multiple lesions were common; (5) Abundant intralesional vascularization was commonly observed; (6) Most cases had intensification of posterior acoustic enhancement; (7) Thyroid gland enlargement or with irregular shape; and (8) PTL often accompanied with lymph nodes enlargement in lateral neck or central region. Conclusion: PTL has certain sonographic features, with assistance of US-CNB, more accurate diagnosis of PTL can be obtained.

The new quality control mode for authorized distribution of traditional Chinese medicine pieces / 药学实践杂志

Objective To improve the quality for authorized distribution of traditional Chinese medicine pieces, reduce patient complaints and increase patient satisfaction. Methods Patient’s complaints against different drug dispensing modes were analyzed. PDCA cycle was used for quality improvements. Results The new quality control mode includes pre monitoring measures, such as pharmacist resident in pharmaceutical factories and unannounced factory inspections, the fast-track handing measures for the problems occurred in patients, pharmacies, pharmaceutical factories and express delivery companies, and retrospective measures, such as evaluation of pharmaceutical factories and quarterly pharmaceutical factory communication meetings. Conclusion Three years after the new quality control mode, patient’s complaints were significantly reduced. The authorized distribution quality for traditional Chinese medicine pieces was greatly improved.

Transforaminal percutaneous endoscopic lumbar discectomy combined with anchorage technique of pedicle for the treatment of high prolapse free lumbar disc herniation / 中国骨伤

OBJECTIVE@#To investigate the clinical effects of percutaneous spinal endoscopy (percutaneous endoscopy) in the treatment of high prolapse free lumbar disc herniation.@*METHODS@#From May 2016 to June 2018, 24 patients with highly prolapse free lumbar disc herniation were enrolled in this study, including 11 males and 13 females, ranging in age from 48 to 72 years old, with an average of (59.5±7.2) years old. There were 1 case of L, 5 cases of L, 18 cases of L. The course of disease ranged from 8 to 26 months, with an average of (16.2±6.3) months. All the patients were subjected to local infiltration anesthesia. The clinical outcomes were evaluated by visual analog scale (VAS) for leg pain, low backpain and Oswestry Disability Index (ODI) at preoperative, first day after operation and 6 month after surgery. All data were statisticed by SPSS 22.0.@*RESULTS@#All the patients were followed up, and the duration ranged from 12 to 24 months, with a mean of (17.5±5.3) months. The average operation time was(69.8±14.2) minutes. One patient had cerebrospinal fluid leakage, which improved after supine rest. VAS scores of lower back pain were 6.36±1.27, 3.94±1.03, 1.62±0.87, 0.44±0.27, 0.37±0.29. VAS scores of leg pain were 8.28±1.74, 3.16±1.24, 2.83±1.13, 0.83±0.31, 0.46±0.31, and the differences were statistically significant (<0.05). The ODI were (48.79±9.83)%, (36.51±11.24)%, (21.05±6.35)%, (9.83±4.62)% and (7.24±4.72)% 1 day before and 1 weeks, 3 months, 6 months and 1 year after the operation, respectively. One year after the operation, the modified Macnab evaluation system was used to evaluate the clinical efficacy of the patients, 19 patients got an excellent result, 3 good, 2 fair and 0 poor.@*CONCLUSION@#Percutaneous endoscopic pedicle anchoring technique for the treatment of high prolapse free lumbar disc herniation can effectively improve the clinical symptoms of patients, and has the advantages of less trauma, less bleeding, rapid recovery, complete removal of the nucleus pulposus, and less pain of patients, etc., its clinical efficacy is accurate, operability is strong, it is worth promoting in the clinical use.

Serological Characteristics of Patients with Autoimmune Hemoly-tic Anemia and Efficacy and Safety of Incompatible Transfusion of Red Blood Cells / 中国实验血液学杂志

OBJECTIVE@#To explore the serological characteristics of patients with autoimmune hemolytic anemia（AIHA） and analyze its clinical efficacy and safety of incompatible red blood cell transfusion.@*METHODS@#Sixty AIHA patients admitted in our hospital from January 2014 to January 2018 were selected. The blood type serological characteristics of 60 patients were analyzed retrospectively. According to the type of autoantibody and the composition of different red blood cells, the efficacy and safety of erythrocyte infusions were evaluated respectively.@*RESULTS@#The screen results of irregular antibody in 60 AIHA patients were positive, and the direct anti-human globulin test also was positive, including 8 cases of cold autoantibodies (13.33%), 49 cases of IgG warm autoantibodies (81.67%), and 3 cases of warm cold double autoantibodies (5%). The irregular anti-body identification test confirmed the existence of homoantiboby in 17 cases (28.33%). Out of 60 cases 34 received incompatible red blood cell (RBC) infusion for 108 time including ABO homotype non washing RBC (81 tirnes) and O type washing RBC (27 times). The infusion results showed that the total [JP2]effective rate was 57.41(62/108), total partial effective rate was 14.81% (16/108) and total ineffective rate was 27.78% (30/108).The infusion of ABO homotype non-washing RBC for 81 time showed that the effective rate was 58.02%[JP] (47/81) , partial effective rate was 12.35 (10/81) and ineffective rate was 29.67% (24/81); the infusion of O type washing RBC for 27 times showed that the effective rate was 55.56% (15/27), partial effective rate was 22.22% (6/27) and ineffective rate was 22.22% (6/27), there was no significant difference in effective rate between 2 kinds of infusion (P>0.05). The comparison of different antibody type infusion showed that in the infusion of IgM cold autoantiboay for 12 times, the effective rate was 41.67% (5/12), partial effective rate was 33.33% (4/12) and ineffective rate was 25% (3/12); in the infusion of IgG warm antoantibody for 93 times. The effective rate was 58.06% (54/93),partial effective rate was 12.90% (12/93) and ineffective rale was 29.04% (27/93), there was also no significant difference in effective rate between 2 kinds of infusion(P>0.05). However, in infusion of cold/warm double autoantibody for 3 times, the effective rate was 100% (3/3), moreover, the hemotytic reaction of infusion was not observed during the treatment .@*CONCLUSION@#The infusion of ABO homotype non-washing RBC and O type washing RBC both possess the high safely and efficacy for treatment of patients with AIHA, but the use of ABO homotype non-washing RBC can effectively avoid the excessive use of O type washing RBC.

A high level of high-density lipoprotein cholesterol is a protective factor against transplant renal artery stenosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the factors associated with the occurrence of transplant renal artery stenosis (TRAS).</p><p><b>METHODS</b>A retrospective analysis was conducted in 26 recipients who developed TRAS and 40 concurrent renal recipients without TRAS. We also conducted a nested case-control study in 14 patients with TRAS (TRAS-SD group) and another 14 non-TRAS recipients who received the allograft from the same donor (non-TRAS-SD group).</p><p><b>RESULTS</b>Compared with those in the concurrent recipients without TRAS, acute rejection (AR) occurred at a significantly higher incidence (P=0.004) and the warm ischemia time (WIT) was significantly longer (P=0.015) and the level of high?density lipoprotein cholesterol (HDL--C) significantly lower (P=0.009) in the recipients with TRAS. Logistic regression analysis suggested that AR (P=0.007) and prolonged WIT (P=0.046) were risk factors of TRAS while HDL-C (P=0.022) was the protective factor against TRAS. In recent years early diagnosis of TRAS had been made in increasing cases, the interval from transplantation to TRAS diagnosis became shortened steadily, and the recipients tended to have higher estimated glomerular filtration rate at the time of TRAS diagnosis.</p><p><b>CONCLUSION</b>Apart from the surgical technique, AR and prolonged WIT are also risk factors of TRAS while a high HDL-C level is the protective factor against TRAS. The improvement of the diagnostic accuracy by ultrasound is the primary factor contributing to the increased rate of early TRAS diagnosis in recent years.</p>

Value of hypoxia-inducible factor 1α in diagnosis and prognosis of acute decompensated chronic heart failure / 上海交通大学学报（医学版）

Objective·To investigate the value of hypoxia-inducible factor 1α (HIF-1α) in diagnosis and prognosis of acute decompensated chronic heart failure (CHF).Methods·32 patients with acute decompensated CHF (Group A),33 patients with stable CHF (Group B) and 30 controls (Group C) were included.HIF-1α,B-type natriuretic peptide (BNP) and other biochemical indicators in blood were detected.Length of stay and readmission frequency within 3 months of Group A were recorded.Correlations between HIF-1α and other indicators were analyzed.ROC curves of HIF-1α and BNP were developed to compare their diagnostic values.Results·The HIF-1α and BNP levels of Group A were both significantly higher than those of Group B and Group C (P＜0.05).HIF-1α was positively correlated with serum creatinine,hemoglobin,BNP,length of stay and readmission frequency within 3 months (P＜0.05).Areas under curves of HIF-1α and BNP showed no statistically difference (P＞0.05).Conclusion·HIF-1 α has a certain value in diagnosis and prognosis of acute decompensated CHF.

Comparison between glibenclamide and insulin in the treatment of gestational diabetes mellitus / 中国生化药物杂志

Objective To analyze and compare the application results of glibenclamide and insulin in treating gestational diabetes mellitus (GDM). Methods The subjects of this study were selected from 68 cases of pregnant women with GDM admitted in our hospital from September 2015 to March 2017. They were randomly divided into the control group (insulin) and the observation group (glibenclamide), each with 34 cases. The clinical efficacy and adverse pregnancy outcomes were compared between the two groups. Results The fasting blood-glucose (FBG), 2 h postprandial plasma glucose (2 h PG), and glycosylated hemoglobin (HbA1c) levels of both groups after treatment decreased significantly (P<0.05), but there was no big difference in the above indexes between the two groups after treatment. The incidence of fetal macrosomia, fetal asphyxia and neonatal hypoglycemia in the observation group was 17.65%, 23.53% and 20.59% respectively, much higher than that in the control group (P<0.05). Conclusion In treating GDM, both glibenclamide and insulin are effective in enabling better blood-glucose control, but insulin has an advantage over the other in improving pregnancy outcomes. With the informed consent of some GDM patients, oral hypoglycemic agents can be used with caution.

Comparison between glibenclamide and insulin in the treatment of gestational diabetes mellitus / 中国生化药物杂志

Objective To analyze and compare the application results of glibenclamide and insulin in treating gestational diabetes mellitus (GDM). Methods The subjects of this study were selected from 68 cases of pregnant women with GDM admitted in our hospital from September 2015 to March 2017. They were randomly divided into the control group (insulin) and the observation group (glibenclamide), each with 34 cases. The clinical efficacy and adverse pregnancy outcomes were compared between the two groups. Results The fasting blood-glucose (FBG), 2 h postprandial plasma glucose (2 h PG), and glycosylated hemoglobin (HbA1c) levels of both groups after treatment decreased significantly (P<0.05), but there was no big difference in the above indexes between the two groups after treatment. The incidence of fetal macrosomia, fetal asphyxia and neonatal hypoglycemia in the observation group was 17.65%, 23.53% and 20.59% respectively, much higher than that in the control group (P<0.05). Conclusion In treating GDM, both glibenclamide and insulin are effective in enabling better blood-glucose control, but insulin has an advantage over the other in improving pregnancy outcomes. With the informed consent of some GDM patients, oral hypoglycemic agents can be used with caution.

The role of pharmacist in clinical pharmacogenomics / 药学实践杂志

The clinical practice of pharmacogenomics promotes the development of precision medicine .From the perspec-tive of a pharmacist ,the author analyzed the leading roles and specific responsibilities of pharmacists in pharmacogenomics ,dis-cussed the challenges to incorporate pharmacogenomics into patient cares and provided reference for the domestic pharmacists to carry out pharmacogenomics services in the future .

Predictors of chronic radial artery occlusion after transradial catheterization / 中国介入心脏病学杂志

Objective To investingate the possible predictory of radial artery occlusion(RAO) after transradial approach and its preventive measures.Methods We prospectively assessed the occurrence of RAO in 669 consecutive patients undergoing transradial approach and 63 patients were excluded from the final study (24of them did not meet the inclusion criterium,31 patients converted to other artery approaches,6 patients lost clinical follow-up and 2 patients died).Artery occlusion was evaluated with Doppler ultrasound in 2 days and 1 year after the intervention.The risk factors of RAO including sex,body mass index (BMI),smoking,hypertension,diabetes,dyslipidemia,puncture site,vessel spasm,and artery diameter/ sheath ratio were evaluated using a multivariate model analysis.Results Among the 606 patients,RAO occurred in 56 patients.There were no differences in sex,age,BMI,coronary lesions,rates of vessel spasm,vessel length,medication given and operation time between the 2 group of patients with vs without ROA (all P＞0.05).Univariate logistic analysis showed puncture site at 0 cm away from radial styloid and artery diameter/sheath ratio ≤ 1 were possible risk factory and puncture site ＞ 4 cm from radial styloid was possible protective factor.Further multivariate analysis showed the odds ratio (OR) for occlusion risk at 0 cm and 1 cm were 9.65 (P=0.033) and 8.90 (P=0.040),respectively.The RAO occurred in the ratio of the arterial diameter to the sheath diameter ≤ 1 (OR=2.45,P=0.004).Conclusions Distal puncture sites (0-1 cm away from the radius styloid process) can lead to a higher rate of RAO.

Research Progress of Sudden Cardiac Death in Forensic Medicine / 法医学杂志

Sudden death (SD) is a special kind of death owing to disease,which severely threatening the lives of community population.As the most common type of SD,sudden cardiac death (SCD) has always been a crucial content of identification and research in forensic pathology.This article reviews the research progress from the aspects of epidemiology,morphology,molecular pathology and virtual anatomy of SCD in forensic medicine,so as to provide a reference for the morphological identification,determination of cause of death,and integrated control of this kind of SD.

Clinical study on the treatment of lacrimal duct obstruction with lomefloxacin hydrochloride eye ophthalmic gel / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To study the clinical effect of silica gel drainage tube combined with lomefloxacin hydrochloride eye ophthalmic gel in the treatment of lacrimal duct obstruction.METHODS:Totally 86 cases (138 eyes) of lacrimal duct embolism treated in our hospital from February to December 2015 were divided into 43 cases (68 eyes) as control group and 43 cases (70 eyes) of the observation group according to whether they were treated with lomefloxacin hydrochloride eye ophthalmic gel.Patients in the control group were treated with silica gel drainage, while the observation group was treated with lomefloxacin hydrochloride eye ophthalmic gel on the basis of the control group.The total effective rate, serum hypersensitivity C-reactive protein (h-CRP) level, complications and recurrence rate were observed and compared between the two groups.RESULTS:The total effective rate in the patients with obstructive nasolacrimal duct, common lacrimal duct obstruction, and lacrimal duct obstruction in observation group were 95.2%, 100.0%, 96.7%, higher than those in control group (P0.05).The serum levels of h-CRP in patients in the observation group at 3d and 7d after operation respectively were 2.40±0.84g/mL, 1.94±0.84g/mL, lower than those of control group at the same time (P<0.05).The complication rate of the observation group was 1.4%, which was lower than that of the control group (P<0.05).Follow up for 6-18mo, the recurrence rate was 11.4% in the observation group, which was significantly lower than the control group (P<0.05).CONCLUSION:The combination of silica gel drainage tube and lomefloxacin hydrochloride eye ophthalmic gel in the treatment of obstruction of lacrimal duct has good clinical efficacy, low inflammatory reaction, low complication rate and low recurrence rate.

Effects of Bone Marrow Mesenchymal Stem Cells on the Biological Characteristics of Migrating and Homing in Multiple Myeloma Cells / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To construct a co-culture system for bone marrow mesenchymal stem cells (BMMSC) and multiple myeloma (MM) cells, and to investigate the effects of co-cultured BMMSC on the migrating and homing of multiple myeloma cells.</p><p><b>METHODS</b>The BMMSC from the transgenic mice with green fluorescent protein (GFP) fetal bone were cultured by adherent screening. A co-culture system of BMMSC and MM cell line XG-7 cells was constracted, the proliferation and apoptosis of cells were determined by trypan blue exclusion and Annexin V/PI, respectively, MDC staining was employed to detect the autophagy. The moving direction distribution of molecule in BMMSC and XG-7 cells labeled with PE-CD138 in co-culture process were observed dinamically by confocal microscopy.</p><p><b>RESULTS</b>After co-culture with GFP-BMMSC, the resistance of XG-7 cells to apoptosis and autophagy were enhanced; at the same time, their proliferation increased. Apoptosis rates of XG-7 cells directly and indirectly co-cultured with BMMSC were (6.23 ± 0.12)% and (6.97 ± 0.03)% respectively, which were lower than that of XG-7 cells cultured alone (17.90 ± 1.46)% (P < 0. 01). There was low level of autophagy in XG-7 cells co-cultured with BMMSC. XG-7 cells are highly polarized and contained a specialized membrane domain with specific protein and lipid components to contact with BMMSC under confocal microscope. After methyl-β-cyclodextrin treatment, the molecules were normally enriched in the specialized domain.</p><p><b>CONCLUSION</b>BMMSC can protect XG-7 cells from apoptosis and autophagy, and obviously promote the proliferation of XG-7 cells, and can influence the migrating and homing of multiple myeloma cells.</p>

Effect of lacrimal duct laser with lacrimal drainage tubes and stents for complexity dacryagogatresia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the effect of lacrimal duct laser with lacrimal drainage tubes and stents implantation for complexity dacryagogatresia. METHODS: There were 65 patients ( 82 eyes ) with compound tears nasolacrimal duct obstruction who received lacrimal drainage tubes and stents implantation after laser. The lacrimal duct stents were removed through nasal cavity after 1mo. Lacrimal drainage tubes were removed after 3-6mo. Follow-up periods were 6mo to 1a. RESULTS: In the 65 patients (82 eyes), 71 eyes were cured, 5 eyes improved, the efficient rate was 93%; there were 6 eyes (7%) with epiphora. CONCLUSION: Lacrimal duct laser with lacrimal drainage tubes and stents implantation was efficient for complexity dacryagogatresia.

The relationship between angle of puncture and distribution of bone cement of unilateral percutaneous kyphoplasty for the treatment of thoracolumbar compression fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore the relationship of bone cement distribution and the puncture angle in the treatment of thoracolumbar compression fractures with unilateral percutaneous kyphoplasty (PKP).</p><p><b>METHODS</b>The clinical data of 37 patients with thoracolumbar osteoporotic compression fractures underwent PKP between January 2013 to March 2014 were retrospectively analyzed, all punctures were performed unilaterally. There were 6 males, aged from 65 to 78 years old with an average of (71.83 ± 6.15) years; and 31 females, aged from 57 to 89 years old with an average of (71.06 ± 7.89) years. Imaging data were analyzed and puncture angle and puncture point were measured before operation. According to the measured data, the puncture were performeds during the operation. Distribution area of bone cement were calculated by X-rays data after operation. The effect of bone cement distribution on suitable puncture angle was analyzed; VAS score was used to evaluate the clinical effects.</p><p><b>RESULTS</b>The puncture angle of thoracic vertebrae in T8-T12 was from 28° to 33° with an average 30.4°; and the puncture angle of lumbar vertebrae in L1-L5 was from 28° to 35° with an average of 31.3°. Postoperative X-rays showed the area ratios of bilateral bone cement was 0.97 ± 0.15. Bilateral diffuse area were basic equal. Postoperative VAS score decreased significantly (1.89 ± 1.29 vs 7.03 ± 1.42).</p><p><b>CONCLUSION</b>Through measure imaging data before operation with PKP,the puncture point and entry point can be confirmed. According the measured data to puncture during operation, unilateral puncture can reach the distribution effect of the bilateral puncture in the treatment of thoracolumbar compression fractures.</p>