Risk factors of acute kidney injury in children with biliary atresia after liver transplantation / 国际外科学杂志

Objective:To analyze the incidence and risk factors of acute kidney injury in children with biliary atresia after liver transplantation.Methods:The retrospective case-control study was conducted.The clinical data of 115 children with biliary atresia who received liver transplantation for the first time in Beijing Friendship Hospital Affiliated to Capital Medical University from December 2018 to November 2020 were collected.The patients were divided into AKI group ( n=39) and non-AKI group ( n=76) according to the diagnostic criteria of the Kidney Disease Improving Global Outcomes(KDIGO). The differences of clinical indicators between the two groups were compared, and multivariate logistic regression analysis was performed for statistically significant variables ( P<0.05) to further determine the independent risk factors for AKI after liver transplantation. The measurement data of normal distribution were expressed as mean±standard deviation ( ± s), and t-test was used for comparison between groups.Measurement data with non-normal distribution were represented by M( Q1, Q3), and Mann-Whitney U test was used for comparison between groups.Count data were expressed as cases and percentage, and comparisons between groups were made using Chi-square test or Fisher′s exact test. Results:The incidence of AKI in biliary atresia patients after liver transplantation was 33.9%. Univariate analysis showed that there were statistically significant differences in age ( OR=0.721, 95% CI: 0.553-0.938, P=0.014), preoperative infection ( OR=3.307, 95% CI: 1.294-8.468, P=0.013), PELD score ( OR=1.065, 95% CI: 1.031-1.101, P<0.001), serum creatinine numerical value ( OR=0.745, 95% CI: 0.657-0.858, P<0.001), intraoperative red blood cell transfusion ( OR=1.034, 95% CI: 1.028-1.051, P<0.001) and intraoperative plasma transfusion ( OR=1.055, 95% CI: 1.025-1.086, P=0.002) between the AKI group and the non-AKI group ( P< 0.05). Multivariate logistic regression analysis was performed on the selected indicators by univariate analysis, and the results showed that preoperative infection ( OR=3.763, 95% CI: 1.185-11.945, P=0.025) and low serum creatinine ( OR=0.685, 95% CI: 0.570-0.823, P<0.001), intraoperative red blood cell transfusion ( OR=1.033, 95% CI: 1.015-1.056, P=0.028) was independently associated with postoperative AKI ( P<0.05). The inpatient treatment time in ICU and in hospital between the two groups were statistically significant ( P<0.05). Conclusions:Preoperative infection, low creatinine numerical value and intraoperative red blood cell transfusion are independent risk factors for postoperative AKI in children with biliary atresia. AKI may prolong the time in ICU and in hospital.

The basic design of CBL teaching course in clinical practice on clinical treatment options / 中华医学教育探索杂志

Taking case discussion of clinical treatment options of primary liver cancer during clinical internship as an example, the course design of basic elements of case-based learning (CBL) was discussed. The purpose of clinical practice is to cultivate the clinical thinking ability of "selecting the best one from multiple treatment options", which is suitable for taking CBL teaching method. The design of CBL course includes 8 elements: teaching object, purpose, objectives, course content, implementation plan, key points for assessment, course evaluation and reference materials. The core points of the design of CBL course are that: ①The teaching objectives include knowledge, ability and professionalism; ②The course content should includes the training of decision-making organizations and clinical thinking ability of selecting the best one from multiple treatment options; ③The general CBL teaching procedure can be adopted in the implementation of the scheme that focuses on the decision-making issues defined in each decision-making step. The teaching practice of CBL on primary liver cancer cases discussion shows the basic design of CBL course is universal, which is helpful for teachers to design and implement CBL course on clinical treatment options.

Study and thinking of training system of obstetrics and gynecology residents in Taiwan region of China / 中华医学教育探索杂志

This paper introduces the historical development, training contents, the inspection mechanism and management regulations of obstetrics and gynecology residents training in Taiwan region, China. Drawing lessons from the experience and ideas of the standardized residency training system of obstetrics and gynecology in Taiwan region, combined with the present situation and deficiencies of the training system in the mainland China, this paper puts forward constructive suggestions for the standardized residency training of obstetrics and gynecology, so as to obtain more efficient and satisfactory training results and provide ideas for cultivating excellent obstetrics and gynecology specialists in mainland China.

Value of intraoperative frozen pathological examination in evaluating lymph node involvement in papillary thyroid carcinoma / 肿瘤研究与临床

Objective:To investigate the predictive effect of intraoperative selective lymph node frozen pathological examination on central lymph node metastasis in thyroid papillary carcinoma (PTC).Methods:A total of 721 PTC patients who underwent primary radical thyroidectomy and central lymph node dissection in Xuanwu Hospital of Capital Medical University from January 2015 to June 2019 were selected. All patients underwent intraoperative selective lymph node frozen pathological examination. According to the paraffin section pathological diagnosis results, there were 449 cases of thyroid micropapillary carcinoma (PTMC) and 272 cases of non-PTMC. The association of the frozen pathological examination results of intraoperative prelaryngeal lymph nodes, anterior tracheal lymph nodes and paratracheal lymph nodes with the pathological results of postoperative central lymph nodes was analyzed in all patients and those with central lymph node positive confirmed by postoperative pathological examination in different groups stratified by tumor long diameter, including 192 cases in PTMC group, 142 cases in long diameter >1 cm and <2 cm group and 55 cases in long diameter ≥2 cm group; postoperative paraffin pathological results were treated as the gold standard. The sensitivity and false negative rate of intraoperative frozen pathological examination in the diagnosis of central lymph node metastasis were calculated.Results:There were 42.8% (192/449) and 72.4% (197/272) of PTMC patients and non-PTMC patients with central lymph node metastasis, respectively. Among 192 PTMC patients with central lymph node metastasis, the sensitivity of prelaryngeal lymph nodes, paratracheal lymph nodes and anterior tracheal lymph nodes was 28.1% (47/167), 61.4% (70/114) and 53.8% (91/169), respectively based on the intraoperative frozen pathological diagnosis. The sensitivity and false negative rate of intraoperative frozen pathological examination in the diagnosis of central lymph node metastasis was 72.4% (139/192) and 27.6% (53/192), respectively. Among 197 non-PTMC patients with central lymph node metastasis, the sensitivity of prelaryngeal lymph nodes, paratracheal lymph nodes and anterior tracheal lymph nodes was 49.7% (82/165), 51.6% (96/186) and 64.7% (112/173), respectively based on the intraoperative frozen pathological results. The sensitivity and false negative rate of intraoperative frozen pathological examination in the diagnosis of central lymph node metastasis was 84.8% (167/197) and 15.2% (30/197), respectively. The sensitivity of intraoperative lymph node frozen pathological results in the diagnosis of central lymph node metastasis for patients with thyroid capsule involvement in PTMC group, long diameter > 1 cm and < 2 cm group and long diameter ≥ 2 cm group was 81.7% (116/142), 81.7% (103/126) and 92.2% (47/51), respectively.Conclusions:Cervical central lymph node metastasis of PTC is common. Intraoperative frozen pathological examination of prelaryngeal lymph nodes, anterior tracheal lymph nodes and paratracheal lymph nodes can effectively predict whether the central lymph nodes are involved, and this hint is more obvious when the tumor long diameter is more than 2 cm and the thyroid capsule is involved.

Study on Anisotropy Properties of in vitro Pig Trachea and Numerical Simulation / 医用生物力学

Objective To study mechanical properties of the anisotropy for pig trachea and main bronchi, and determine the constitutive model of trachea deformation by finite element numerical simulation. Methods The pig tracheas were collected and cut through in their axial directions and expanded into two-dimensional planes. Then, by setting the length direction of the trachea aortas as 0°, each planar trachea was anticlockwisely cut into 6 samples with orientation of 30°,60°,90°,120°,150° and 180°, respectively. Uniaxial tensile tests were applied on the specimen in 6 angular directions by using the electronic universal test machine, to obtain stress and strain of the specimen in different directions. Nonlinear fitting to the experimental data was performed by using the Mooney-Rivilin hyperelastic model, in order to obtain the material characteristic parameters. Finite element models of the trachea and the main bronchi were established, and tensile numerical simulation was carried out.Results Samples at different angles showed different stress-strain curves. In the trachea, the stresses of samples with angle of 30°, 120° and 150° were in the range of 1.0-1.5 MPa, the stresses of samples with angle of 60° and 90° were in the range of 0.5-1.0 MPa, and the stresses of samples with angle of 180° were in the range of 2.5-3.0 MPa. In the main bronchi, the stresses of samples with angle of 30°, 120° and 150° were in the range of 0.8-1.0 MPa, the stresses of samples with angle of 90° and 180° were in the range of 1.4-1.8 MPa, and the stresses of samples with angle of 120° were in the range of 0.4-0.6 MPa. There was an obvious difference between the trachea and the main bronchi. The finite element simulation verified that the Mooney-Rivilin constitutive model was suitable for describing small deformation behavior of the trachea. Conclusions The pig trachea exhibits strong anisotropy. Meanwhile, the Mooney-Rivilin model can characterize small tracheal deformations. The results provide theoretical references for tracheal resection and reconstruction in clinical treatment and intervention with surgical instruments such as bronchoscopy.

Comparison of curative effect between elective nodal irradiation and involved field irradiation combined with nedaplatin for cervical and upper thoracic esophageal cancer / 肿瘤研究与临床

Objective:To compare the efficacy and prognosis of elective nodal irradiation (ENI) combined with nedaplatin chemotherapy and involved field irradiation (IFI) combined with nedaplatin chemotherapy in the radical radiotherapy treatment of patients with cervical or upper thoracic esophageal cancer.Methods:Seventy-eight patients with cervical or upper thoracic esophageal cancer in Hai'an Traditional Chinese Medicine Hospital from February 2017 to February 2020 were selected and divided into ENI group and IFI group according to random number table method, with 39 cases in each group. The ENI group was treated with ENI combined with nedaplatin chemotherapy, while the IFI group was treated with IFI combined with nedaplatin chemotherapy. After 2 months of treatment, the therapeutic effect and the dose of lung irradiation were compared between the two groups, and the occurrence of adverse reactions and prognosis were compared.Results:The total effective rate and disease control rate were 69.23% (27/39) and 82.05% (32/39) in IFI group, and 64.10% (25/39) and 74.36% (29/39) in ENI group, there was no significant difference between the two groups ( χ2 = 0.23, P = 0.631; χ2 = 0.68, P = 0.411). The lung irradiation doses of V 5 Gy and V 20 Gy in IFI group were lower than those in ENI group (both P < 0.05). The incidence rates of bone marrow suppression and radiation lung injury in IFI group were lower than those in ENI group (all P < 0.05). By the end of follow-up, the survival rates of IFI group and ENI group were 76.92% (30/39) and 66.67% (26/39), respectively. There was no significant difference in overall survival between the two groups ( χ2 = 1.06, P = 0.300). Conclusions:ENI and IFI combined with nedaplatin chemotherapy in the radical radiotherapy treatment of cervical and upper thoracic esophageal cancer have similar efficacy and prognosis, but IFI can reduce the lung radiation dose and the incidence of adverse reactions.

Application of Lester assessment package in general practice teaching clinic of tertiary hospital / 中华全科医师杂志

From September 2020 to August 2021, 34 general practice trainees in Xuanwu Hospital, Capital Medical University were were randomly divided into the control group and trial group with 17 in each group. The control group adopted the traditional clerkship method for outpatient clinical teaching; the trial group independently received patients with the supervision of clinical instructors, and the Leicester assessment package (LAP) was used for evaluation and training. The performance of two groups were assessed using the Beijing General Practitioner's Graduation Assessment and Admissions Patient Score Sheet. The LAP training was also given to control group at the late stage of the study, and the application of LAP was assessed with a questionnaire survey in two groups of trainees. The results showed that the performance of trial group was better than that of control group in terms of medical history collection [(23.12±1.05) vs. (21.18±0.88), t=-5.82, P<0.01 ], physical examination [(24.88±1.62) vs. (23.12±1.58), t=-3.22, P< 0.01 ], case analysis [(22.94±0.90) vs. (20.82±0.73), t=-7.55, P<0.01 ] and total score [(86.59±2.65) vs. (80.12±2.45) t=-7.40, P<0.01]. For assessment of LAP, all 34 trainees gave 5 points in items of improving patient care, knowledge and skills, communication skills, professional quality, reception skills, clinical thinking, clinical judgment, decision-making skills, and learning interest with the application of LAP in outpatient clinical teaching; the satisfaction of the trainees on the pertinence, teaching effect and LAP training method of the instructing physicians was 100% (34/34). It is suggested that the application of LAP for evaluation and implementation in general practice outpatient teaching will help to improve the teaching quality and the patient receiving ability of general practitioners.

Analysis of the Marketing Approval of Pediatric Drugs in the United States and Its Enlightenment to Pedia tric Drug Use Guarantee in China / 中国药房

OBJECTIVE：To provide sugge stions for improving the variety of pediatric drugs and ensuring the safety of pediatric drug use in China. METHODS ：The historical evolution of laws and regulations on the marketing approval of pediatric drugs in the United States and the implementation results of relevant policies were summarized. Combined with the current situation of the development of pediatric drugs in China ，some suggestions were put forward to ensure the accessibility and safety of pediatric drug use in China. RESULTS & CONCLUSIONS ：Since 1994，the United States had issued a series of laws and regulations to encourage the development of pediatric drugs. At present ，the marketing approval of pediatric drugs were mainly based on the two laws of Best Pediatric Drug Act（BPCA）and Pediatric Research Equality Act （PREA）. From 1998 to 2019，the amount of supplements of pediatric drug information in drug instructions of the United States showed a fluctuating growth. As of April 2020，854 kinds of drugs had been modified in pediatric instructions ，792 of which had been carried out post marketing pediatric clinical research ，and the problem of incomplete pediatric instructions had also been greatly improved. At present ，China’s policies on pediatric drugs mainly included encouraging R&D innovation ，giving priority to review and approval ，and strengthening R&D technical guidance. Although certain achievements had been made ，there were still some problems ，such as imperfect policies and regulations ，and great difficulties carrying out pediatric drug clinical trials. It is suggested that our country should draw lessons from the American regulations on pediatric drugs ，pediatric research and the catalogue of pediatric drugs ，and establish a system and catalogue of ped iatric drug use suitable for China ’s national conditions ，so as to improve the effectiveness ，safety and accessibilityof pediatric drugs.

Implementation and assessment of personalized incentive measures for standardized residency training in department rotation / 中华医学教育探索杂志

Incentive system is an indispensable means in the process of standardized residency training, which plays an important role in improving the work efficiency and service quality of residents, teachers and other participants. Based on the analysis of the problems existing in the holistic incentive system, we have implemented a set of personalized incentive measures for the training of residents in department rotation and achieved preliminary results, which provides ideas for exploring personalized incentive system for standardized residency training.

Research progress in effect of alendronate on healing of osteoporotic fracture / 中华创伤杂志

Fracture healing is a complex physiological process involving osteoblasts,osteoclasts and other cells and molecules.Typical fracture healing can be divided into four stages:inflammatory response,soft callus formation,hard callus formation,and bone remodeling.Osteoclasts play a leading role in hard callus formation and bone remodeling.Alendronate can inhibit osteoclast activity and bone loss in patients with osteoporosis,but it may also inhibit fracture healing.Therefore,whether alendronate can be used after osteoporotic fracture is controversial.In recent years,it has been found that alendronate can not affect the fracture healing,but also reduce the risk of secondary fracture and improve the prognosis of patients.In this article,the mechanism of alendronate and its effect on osteoporotic fracture healing by systemic and local use are reviewed,which can provide a reference for clinical selection of therapeutic drugs.

Development and discussion of the collaborative mode of resident standardized training base / 中华医学教育探索杂志

Resident standardized training is the indispensable way to develop the medical and health services in China, and the construction of resident standardized training base is the basis of this work. Under the current situation of the supply and demand of the resident standardized training base and the resident who need to participate in the standardized training, the cooperative base development plays a very good auxiliary role in the work of the national standardized training base for residents. In the process of coordination, the hospital leaders should attach great importance to the development, and we also should promote effective communication among base managers, integrate the training base management system, improve the teaching quality, establish the mechanism of training and supervision, and build a systematic construction bridge between the bases. The most important part of the base coordination is to integrate the advantageous residential training base, professional base, department and professional group, explore the new management model, actively learn from the excellent experience of other bases, as well as increase the training quality and the number of residents.

Research progress in effect of alendronate on healing of osteoporotic fracture / 中华创伤杂志

Fracture healing is a complex physiological process involving osteoblasts, osteoclasts and other cells and molecules. Typical fracture healing can be divided into four stages: inflammatory response, soft callus formation, hard callus formation, and bone remodeling. Osteoclasts play a leading role in hard callus formation and bone remodeling. Alendronate can inhibit osteoclast activity and bone loss in patients with osteoporosis, but it may also inhibit fracture healing. Therefore, whether alendronate can be used after osteoporotic fracture is controversial. In recent years, it has been found that alendronate can not affect the fracture healing, but also reduce the risk of secondary fracture and improve the prognosis of patients. In this article, the mechanism of alendronate and its effect on osteoporotic fracture healing by systemic and local use are reviewed, which can provide a reference for clinical selection of therapeutic drugs.

Effect of FMS﹣like tyrosine kinase 3 mutations on prognosis of acute promyelocytic leukemia: a Meta﹣analysis / 白血病·淋巴瘤

Objective To systematically evaluate the effect of FMS﹣like tyrosine kinase 3 (FLT3) mutations on prognosis of acute promyelocytic leukemia. Methods The databases of CNKI, Wanfang, VIP, China Biology Medicine disc, PubMed, EMBase, and Cochrane Library were retrieved, and the cohort studies and case﹣control studies published from the establishment of the databases to December 2017 were selected according to the inclusion and exclusion criteria. The quality assessment and data extraction was performed and the statistical analysis was performed by using RevMan 5.3 software. Results Twenty﹣three studies were included, covering a total of 2 632 patients. Meta﹣analysis showed that patients with FLT3 internal tandem duplication (FLT3﹣ITD) mutation had lower complete remission rate ( RR＝0.92, 95% CI 0.86-0.99, P＝0.02), 3﹣year overall survival rate ( RR＝0.72, 95% CI 0.60-0.88, P＝0.001) and 5﹣year overall survival rate ( RR＝0.89, 95% CI 0.81-0.99, P＝ 0.03), while the proportion of high﹣risk group ( RR＝ 3.13, 95% CI 2.26-4.35, P< 0.01), the early mortality rate ( RR＝ 2.26, 95% CI 1.75-2.90, P< 0.01) and the recurrence rate ( RR＝1.50, 95% CI 1.11-2.02, P＝0.008) were relatively high, and the differences were statistically significant. The patients with FLT3 tyrosine kinase domain (FLT3﹣TKD) mutation had higher early mortality rate ( RR＝ 3.00, 95% CI 1.74-5.20, P< 0.01), and the difference was statistically significant. Conclusion The FLT3 mutations can influence the prognosis of acute promyelocytic leukemia, which contributes to the research direction of better prognosis stratification, perfect treatment regimen and improved prognosis.

Effect of oxycodone for postoperative analgesia of laparoscopic total hysterectomy / 临床麻醉学杂志

Objective To observe the effect of oxycodone for postoperative patient-controlled intravenous analgesia of laparoscopic total hysterectomy with or without background infusion.Methods Seventy five patients, aged 40-65 years, BMI 18-24 kg/m2, ASA physical statusⅠ orⅡ, scheduled for elective laparoscopic total hysterectomy surgery under general anesthesia were randomly assigned into 3 equal groups (n = 25 each) using a random number table:morphine group (group M), oxycodone with background infusion group (group O1) and oxycodone without background infusion group (group O2).The anesthesia was induced by intravenous fentanyl 4μg/kg, propofol 2-2.5 mg/kg and cisatracurium 0.2 mg/kg.Group M was given morphine 50 mg+ondanstron 8 mg in100 ml normal saline, groups O1 and O2 were given oxycodone 50 mg+ ondanstron 8 mg in 100 ml normal saline.The PCIA pump of group M and group O1 were set up with a 0.5 ml bolus dose, a 5 min lockout interval and background infusion at a rate of 2 ml/h.Group O2 was set up with a 4 ml bolus dose, a 5 min lockout interval and without background infusion.The NRS scores of three groups at 4, 8, 12, 24 and 48 hafter operation were recorded.The total morphine or oxycodone consumption, and the number of rescue analgesia within 48 hafter surgery were recorded.The adverse events within 48 hafter surgery were also observed.Results Compared with group M, the NRS scores at rest were significantly decreased at 4, 8, and 12 hafter operation (P<0.05), and the NRS scores at movement were significantly decreased at 4 and 8 hafter operation (P<0.05), and the number of rescue analgesia within 48 hafter surgery was significantly decreased in groups O1 and O2 (P<0.05).The total analgesic consumption and the incidence of adverse event within 48 hafter surgery in group O2 were significantly lower than those in groups M and O1 (P<0.05).Conclusion Compared with morphine, oxycodone for patient-controlled intravenous analgesia can obtain more satisfactory effects after laparoscopic total hysterectomy surgery.Meanwhile, the total consumption of oxycodone and the incidence of nausea and vomiting are significantly decreased.

Advances in the application of biological agents in juvenile idiopathic arthritis / 中华实用儿科临床杂志

Juvenile idiopathic arthritis (JIA)is a type of chronic rheumatism in children. It is mainly charac-terized by joint damage,accompanied by systemic symptoms and result in significant morbidity. The application of bio-logical agents has altered the traditional treatment pattern of JIA and significantly improved the condition of JIA pa-tients. JIA is a heterogeneous disease. Treatment recommendations issued by American College of Rheumatology(ACR) in 2011 have become an important reference for JIA treatment. There is a best response window for JIA treatment. Thus, the clinic application of biological agents should be used as soon as possible after the diagnosis of JIA. Meantime,it should be noted when a preparation is invalid,it need to use another possible biological agent in time to control disease progression.

The clinical and pathological features of capillary endothelial proliferative purpura nephritis in 50 children / 临床儿科杂志

Objective To investigate the clinical and pathological characteristics of Henoch-Sch?nlein purpura nephritis with diffuse capillary endothelial cell proliferation as pathological manifestation. Methods The clinical manifestations and pathology of capillary endothelial proliferative purpura nephritis (DEP-HSPN) diagnosed by renal biopsy were retrospectively analyzed in 50 children in recent 5 years. Results The pathological lesions in 50 cases included simple DEP-HSPN in 11 cases (7 males and 4 females) and capillary endothelial cell proliferation combined with crescents formation (non-simple DEP-HSPN) in 39 cases (27 males and 12 females). There was no significant difference in the course of disease and age between the two groups (P>0.05). The clinical type of 11 cases of simple DEP-HSPN was type Ⅲ. In 39 cases of non-simple DEP-HSPN, 16 cases were type Ⅲ and 23 cases were type Ⅴ. All of the children had hematuria and proteinuria. The incidence of gross hematuria, urine red blood cell count, 24 h urine protein, and serum creatinine levels in children with non-simple DEP-HSPN were significantly higher than those in simple DEP-HSPN group, but the plasma albumin level was significantly lower than that in simple DEP-HSPN group. It was easy to have crescent formation in DEP-HSPN, and the rate of crescent formation was 11.1％ (5.0％-27.6％). The incidence of segmental lesions and renal tubular interstitial damage was low. All children had non simple IgA deposits in the mesangial area. In the 50 children treated for 1 year, 22 had complete remission, 28 had asymptomatic hematuria, and none had active nephropathy and renal insufficiency. In 32 cases of non-simple DEP-HSPN, the 24 h urinary protein, plasma albumin level, and the incidences of gross hematuria and microscopic hematuria were statistically different before treatment and 1, 3, 6, 12 months after treatment (P<0.01). The 24 h urine protein and gross hematuria gradually decreased with the prolongation of treatment, while the level of plasma albumin was gradually increased. Conclusions DEP-HSPN is characterized by gross hematuria and proteinuria. The onset is acute and it is easy to have crescent formation. When combined with crescent formation, the clinical symptoms are more severe. The combination of strong immunosuppressive agents and long-term sequential follow-up treatment is effective in acute stage. The prognosis is good.

The study of the inhibition effects of SIRT1 on the apoptosis induced by Galangin in HepG2 cells / 医学研究生学报

Objective Galangin is a natural flavonoid with antineoplastic activity .SIRT1 is an important member of Sirtuin family which parcitipate in many physiological process .The aim of this study was to investigate the effect of SIRT 1 on HepG2 cell apop-tosis induced by galangin . Methods HepG2 cells were pre-treated with SIRT1 inhibitor EX-527 for 2 hours, and then galangin for 24 hours.DMSO solvent control group, EX-527 treatment group, galangin treatment group and EX-527 and galangin co-treatment group were established.Hoechst 33342 staining, flow cytometry and western blot were performed to detect the apoptosis of HepG2 cells.After regu-lating the expression of SIRT1 in HepG2 cells with RNA interference and transfection of exogenous genes , these cells were treated with ga-langin for 24 hours.Negative control group , vector control group , SIRT1 knock down group , blank control group , blank vector group ,and SIRT1 upregulation group were established .Western blot and Flow cytometry were performed to detect the apoptosis of HepG 2 cells. Results The apoptosis rate and the gray level ratio of shear band of PARP 1 and GAPDH that of galangin group [(11.62± 0.55) %, 0.89±0.01]and EX-527+galangin group[(25.75±0.61) %, 1.15±0.06] were all increased(P<0.01),when these were compared with DMSO solvent control group [(2.49±0.22) %, 0.06±0.00];and those in EX-527+galangin group were also markedly increased compared with galangin group (P<0.01).The result of western bolt was that the gray level ratio of PARP 1 and GAPDH of SIRT1 knocked down group(0.06±0.01) was markedly decreased compared with vector control group (1.11±0.05)and without adenovi-rus infection group (1.10±0.04)(P<0.01).The apoptosis rate and the gray level ratio of shear band of PARP 1 and GAPDH that of SIRT1 knocked down group were markedly increased compared with vector control group and without adenovirus infection group ( P<0.01).The gray level ratio of PARP1 and GAPDH of SIRT1 up-regulated group (1.63±0.04) was markedly increased compared with blank control group (0.89±0.02) and without plasmid transfection group (0.87±0.03) (P<0.01).The apoptosis rate and the gray lev-el ratio of shear band of PARP 1 and GAPDH that of SIRT1 up-regulated group were markedly decreased compared with blank control group and without plasmid transfection group (P<0.01). Conclusion SIRT1 inhibited galangin-induced apoptosis in HepG2 cells.

Advances in the treatment of distal radius fractures in the elderly / 中国综合临床

Distal radius fractures often occur in the elderly.At present,there has not yet reached a consensus on how to take effective measures for the treatment of such fractures in clinical.There are many different therapeutic methods for this fracture with different effect.Based on the summary of the relevant literature,the epidemiological characteristics of fractures of the distal radius,treatment,implant selection,surgical procedure,complications and prevention were summarized,in order to provide references for clinical treatment.

Correlation between thyroid nodules and the components of metabolic syndrome / 西安交通大学学报(医学版)

ABSTRACT:Objective To investigate the prevalence of thyroid nodules in Xi’an City by ultrasonography and study the correlation between thyroid nodules and the components of metabolic syndrome.Methods We recruited 4 527 subjects in this cross-sectional study and divided them into thyroid nodules (TN)group and non-thyroid nodules (NTN)group.The height,weight,blood pressure,blood sugar,lipid,and serum uric acid were measured and analyzed.The relationship between thyroid nodules and thyroid function was assessed in the subjects who received TT3,TT4,TSH,TGAB,and TPOAB tests.Results ① The prevalence of thyroid nodules was 31.8% and was significantly higher in the female patients (38.4% vs.27.1%,χ2=64.44,P0.05).③ Age,systolic blood pressure,and TG,LDL-C and serum uric acid levels were remarkably higher in TN group than in NTN group (P<0.001 ). Conclusion The prevalence of thyroid nodules in Xi’an City is noticeably high.High systolic blood pressure level, dyslipidemia and elevated uric acid are associated with thyroid nodules.Therefore,screening and management of the individuals with aforementioned characteristics deserve more attention.

Clinical Study on Different Acupuncture and Moxibustion Methods for Prevention and Treatment of Nausea and Vomiting Caused by Chemotherapy / 中国中医药信息杂志

Objective To observe efficacy of different acupuncture and moxibustion methods for treatment of nausea and vomiting caused by chemotherapy. Methods One hundred and sixty-three cases were randomly divided into electroacupuncture group (42 cases), warm acupuncture combined with electroacupuncture group (37 cases), ginger moxibustion group (44 cases) and control group (40 cases). All groups received postoperative adjuvant chemotherapy. Three acupuncture and moxibustion groups received electroacupuncture, warm acupuncture combined with electroacupuncture, ginger moxibustion to stimulate bilateral Zusanli (ST36), Neiguan (PC6), respectively, once a day. The control group was given tropisetron hydrochloride 5 mg+normal saline 100 mL, 30 min before chemotherapy intravenously, once a day to the end of chemotherapy. The number and degree of vomiting and the serum 5-HT content were tested, and the safety test was conducted. Results The complete control rate and effective control rate of acute vomiting of electroacupuncture group and warm acupuncture combined with electroacupuncture group were higher than those of ginger moxibustion group and control group (P<0.05). The complete control rate of delayed vomiting in warm acupuncture combined with electroacupuncture group was significantly higher than that of electroacupuncture group, ginger moxibustion group and control group (P<0.05); The effective control rate was higher than that of ginger moxibustion group and control group (P<0.05); Electroacupuncture group and Ginger moxibustion group were higher than the control group (P<0.05). The scores of acute vomiting in electroacupuncture group and warm acupuncture combined with electroacupuncture group were lower than others (P<0.05). In delayed vomiting, warm acupuncture combined with electroacupuncture group's score was lower than other groups, with statistical significance (P<0.05); Electroacupuncture group and ginger moxibustion group were lower than that incontrol groups, with statistical significance (P<0.05). The levels of serum 5-HT in electroacupuncture group and ginger moxibustion group were higher than warm acupuncture combined with electroacupuncture group (P<0.05), but lower than the control group (P<0.05). No obvious adverse reactions were found in each group. Conclusion Different acupuncture methods had different clinical effects on acute vomiting and delayed vomiting caused by chemotherapy.