Chinese expert consensus on emergency surgery for severe trauma and infection prevention during corona virus disease 2019 epidemic (version 2023) / 中华创伤杂志

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

The Molecular Mechanism of LncRNA HOTAIR Regulating the Proliferation, Invasion and Migration of Lymphoma Cells through Target Gene miR-20a-5p / 中国实验血液学杂志

OBJECTIVE@#To investigate the effects of lncRNA HOTAIR on the proliferation, invasion and migration of lymphoma cells through target gene miR-20a-5p and its molecular mechanism.@*METHODS@#After synthesizing HOTAIR siRNA and siRNA NC plasmids, they were transfected into lymphoma Raji cells, respectively. The expression of HOTAIR mRNA was detected by RT-qPCR. The proliferation, invasion and migration of lymphoma Raji cells were detected by CCK-8 assay, Transwell assay and cell scratch healing assay, respectively. The target gene of lncRNA HOTAIR was predicted by miRcode software, and the relationship between HOTAIR and target gene was analyzed by dual luciferase assay. After synthesis of miR-20a-5p inhibitor and inhibitor NC, Raji cells were transiently transfected. The expression of miR-20a-5p was detected by RT-qPCR, and the effects of down-regulation of miR-20a-5p on the proliferation, invasion and migration of Raji cells were analyzed. The overexpression plasmid of lncRNA HOTAIR and miR-20a-5p mimics were transfected into Raji cells simultaneously to analyze the proliferation, invasion and migration ability of Raji cells. After overexpression or down-regulation of miR-20a-5p, the expression of JAK/STAT3 signaling pathway related proteins was analyzed.@*RESULTS@#HOTAIR expression in Raji cells was decreased after transfection of HOTAIR siRNA (P<0.01), and miR-20a-5p expression was also decreased after transfection of miR-20a-5p inhibitor (P<0.01). HOTAIR had a targeting and negative regulation relationship with miR-20a-5p (r=-0.826). Silencing HOTAIR promoted the expression of miR-20a-5p and inhibited the proliferation, invasion and migration of Raji cells. Down-regulation of miR-20a-5p expression promoted the proliferation, invasion and migration of Raji cells. Effect of HOTAIR overexpression on the proliferation, invasion and migration of Raji cells could be reversed by up-regulation of miR-20a-5p. Down-regulation of miR-20a-5p expression activated the intracellular JAK/STAT3 signaling pathway.@*CONCLUSION@#HOTAIR affects the proliferation, invasion and migration of lymphoma cells by targeting miR-20a-5p, and its mechanism may be related to the activation of JAK/STAT3 signaling pathway.

The role of the gut microbiota in the pathogenesis of sarcopenia / 中华老年医学杂志

Sarcopenia is a progressive syndrome associated with aging, generalized loss of skeletal muscle mass, muscle strength and function.It is closely related to the occurrence of adverse events such as ambulatorydysfunction, falls and fractures in the elderly, and seriously affects the quality of life of the elderly.The etiology of sarcopenia has not been fully elucidated.Various pathophysiological mechanisms such as reduced exercise, genetic factors, age-related hormone changes, malnutrition and insufficient protein intake, decreased neuromuscular function, pro-inflammatory cytokines, and myocyte apoptosis are possible factors.Recent studies have found that intestinal microecological changes may be implicated in the occurrence and development of sarcopenia.In this article, we reviewed intestinal microecological changes and their possible role in the mechanisms underlying sarcopenia.

A clival-cervical plate fixation for the craniovertebral instability: a biomechanical study / 中华骨科杂志

Objective:To develop a specialized clival-cervical plate fixation (CCPF) for anterior surgery to treat craniovertebral instability, and to compare it with a posterior occipitocervical fixation (POCF) in biomechanical validation.Methods:Based on the measurement of 40 adult dry bones and 30 volunteers CT images, the clival-cervical plate was designed and manufactured. 8 cadaveric specimens (occiput-C 3) were tested in five conditions including the intact status, the intact+CCPF status, the injury status, the injury+CCPF status, and the injury+POCF status. Specimens were applied a pure moment of 1.5 N·m in flexion, extension, lateral bending, and axial rotation. Calculating and comparing the range of motion (ROM) and neutral zone (NZ) for the occiput to C 2. The effects of different fixation methods on the distribution of ROMs at the occipitocervical region were compared. Results:The injury+CCPF status constrained ROMs to 1.7° in flexion ( q=4.68, P=0.055) , 1.2° in extension ( q=0.39, P=0.9922) , 2.8° in lateral bending ( q=1.25, P=0.814) , and 4.3° in axial rotation ( q=5.08, P=0.035) , resulted in larger ROM in axial rotation but similar ROMs in other directions ( P>0.05) when compared with the injury+POCF status. There were no significant differences between the above two fixation methods in flexion-extension ( q=1.94, P=0.554) , lateral bending ( q=1.79, P=0.611) and axial rotation ( q=2.14, P=0.478) for the NZs. For the flexion, extension,lateral bendingand axial rotation direction, the proportion of the C 1, 2 ROM to the overall ROM was 28%, 25%, 34% and 56% respectively in the injury+CCPF status, and it was 59%, 53%, 42% and 71% respectively in the injury+POCF status. Conclusion:CCPF is a biomechanically effective alternative or supplemental method of POCF for the craniocervical instability.

Cytotoxicity and underlying mechanism of evodiamine in HepG2 cells / 北京大学学报(医学版)

OBJECTIVE@#To investigate evodiamine (EVO)-induced hepatotoxicity and the underlying mechanism.@*METHODS@#HepG2 cells were treated with EVO (0.04-25 μmol/L) for different time intervals, and the cell survival rate was examined by cell counting kit-8 (CCK-8) method. After HepG2 cells were treated with EVO (0.2, 1 and 5 μmol/L) for 48 h, the alanine transaminase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), alkaline phosphatase (ALP) activities and total bilirubin (TBIL) content of supernatant were detected. A multifunctional microplate reader was used to detect the intracellular superoxide dismutase (SOD) activity and malondialdehyde (MDA) content in HepG2 cells to evaluate the level of cell lipid peroxidation damage. The interactions between EVO and apoptosis, autophagy or ferroptosis-associated proteins were simulated by molecular docking. The HepG2 cells were stained by mitochondrial membrane potential (MMP) fluorescent probe (JC-10) and annexin V-fluorescein isothiocyanate/propidium iodide (Annexin V-FITC/PI), and MMP and apoptosis in HepG2 cells were detected by flow cytometry. The protein expression levels of caspase-9, caspase-3, bile salt export pump (BSEP) and multidrug resistance-associated protein 2 (MRP2) were detected by Western blot.@*RESULTS@#The cell survival rate was significantly reduced after the HepG2 cells were exposed to EVO (0.04-25 μmol/L) in a time- and dose-dependent manner. The half maximal inhibitory concentration (IC50) of the HepG2 cells treated with EVO for 24, 48 and 72 h were 85.3, 6.6 and 4.7 μmol/L, respectively. After exposure to EVO (0.2, 1 and 5 μmol/L) for 48 h, the ALT, AST, LDH, ALP activities and TBIL content in the HepG2 cell culture supernatant, and the MDA content in the cells were increased, and SOD enzyme activity was decreased. Molecular docking results showed that EVO interacted with apoptosis-associated proteins (caspase-9 and caspase-3) better. JC-10 and Annexin V-FITC/PI staining assays demonstrated that EVO could decrease MMP and promote apoptosis in the HepG2 cells. Western blot results indicated that the protein expressions of cleaved caspase-9 and cleaved caspase-3 were upregulated in the HepG2 cell treated with EVO for 48 h. In contrast, the protein expressions of pro-caspase-3, BSEP and MRP2 were downregulated.@*CONCLUSION@#These results suggested that 0.2, 1 and 5 μmol/L EVO had the potential hepatotoxicity, and the possible mechanism involved lipid peroxidation damage, cell apoptosis, and cholestasis.

Biomechanical Study of Posterior Dynamic Fixation at Atlantoaxial Joints / 医用生物力学

Objective To evaluate the influence of dynamic fixation (rotating and sliding pedicle screws) on stability of the atlantoaxial joint. Methods A series of in vitro biomechanical tests were performed using six fresh adult cervical spines (occipital bone-C4 segment) to simulate different conditions in surgery， including the intact state, the injury state, rigid fixation, rotating pedicle screw fixation, sliding pedicle screw fixation. The repeated measurement design was employed, and under intact, injury and different fixation states, the pure moment of 1.5 N·m in flexion-extension, left-right lateral bending, left-right axial rotation directions were applied using the spinal testing machine. The movement of atlantoaxial spine was measured consecutively by three-dimensional （3D） measurement system in order to analyze the range of motion (ROM) and neutral zone (NZ) of atlantoaxial joints. Results Under injury state, ROM of atlantoaxial joints was significantly larger than that under intact state during flexion, extension, lateral bending and rotation, leading to the instability of atlantoaxial joints. ROM of fixation segments was significantly reduced during flexion, extension, lateral bending and rotation after rigid and dynamic fixation. Compared with rigid fixation, dynamic fixation showed a significant ROM increase during lateral bending. NZs of fixation segments after dynamic fixation were significantly reduced. There were no significant ROM differences between rigid fixation and dynamic fixation. Conclusions The stability of atlantoaxial joints by dynamic fixation during flexion, extension and rotation was comparable to that by rigid fixation, but weaker during lateral bending. Dynamic screw fixation can maintain the relative stability of atlantoaxial joints.

Post-Marketing Surveillance of Qishe Pill () Use for Management of Neck Pain in a Chinese Patient Cohort to Determine its Safety, Tolerability and Effectiveness / 中国结合医学杂志

OBJECTIVE@#To evaluate the safety and effectiveness of Qishe Pill () on neck pain in real-world clinical practice.@*METHODS@#A multi-center, prospective, observational surveillance in 8 hospitals across Shanghai was conducted. During patients receiving 4-week Qishe Pill medication, Visual Analogue Scale (VAS) and Neck Disability Index (NDI) assessments have been used to assess their pain and function, while safety monitoring have been observed after 2 and 4 weeks.@*RESULTS@#Results from 2,023 patients (mean age 54.5 years) suggest that the drug exposure per unit of body mass was estimated at 3.41 ± 0.62 g/kg. About 8.5% (172/2,023) of all participants experienced adverse events (AEs), while 3.8% (78/2,023) of all participants experienced adverse reaction. The most common AEs were gastrointestinal events and respiratory events. The VAS score (pain) and NDI score (function) significantly decreased after 4-week treatment. An effect-quantitative analysis was also conducted to show that the normal clinical dosage may be consider as 3-4 g/kg, at which dosage the satisfactory pain-relief effect may achieve by 40-mm reduction in VAS.@*CONCLUSION@#These findings showed that patients with cervical radiculopathy who received Qishe Pill experienced significant improvement on pain and function. (Registration No. NCT01875562).

Metabonomics: A Useful Tool to Reveal Underlying Relationships between Altered Chinese Medicine Syndromes and Ultrafiltration in Treatment of Heart Failure / 中国结合医学杂志

OBJECTIVE@#To reveal the underlying relationships between Chinese medicine (CM) syndromes and ultrafiltration (UF) in the treatment of heart failure based on a metabonomic approach.@*METHODS@#Seventeen acute decompensated heart failure (ADHF) patients were enrolled, and their CM syndromes before and after UF were collected. In addition, their venous plasma collected before and after UF was used for liquid chromatographmass spectrometer-based metabonomic analysis. Both reversed phase liquid chromatography and hydrophilic interaction liquid chromatography were used to analyze the plasma samples. Partial least-squares to latent structure-discriminant analyses were used for data analysis.@*RESULTS@#An obvious difference was observed pre- and post-treatment. A total of 17 potential biomarkers associating with alterd syndromes with UF including hypoxanthine, 1-methylhistidine, phytosphingosine, O-decanoyl-R-carnitine, etc. were screened out, showing a significant change after UF. The major adjusted metabolic pathways were purine metabolism, histidine metabolism, leucine and isoleucine metabolism, arginine and proline metabolism, carnitine shuttle, sphingolipid metabolism and phospholipid metabolism.@*CONCLUSIONS@#Metabonomic approach is a useful tool to identify potential biomarkers of altered syndromes link to UF and could provide a theoretical basis for further research on the therapeutic mechanism of UF combined with CM.

Comparison of surgical effects between extension and flexion type of distal radius fracture / 中国骨伤

OBJECTIVE@#To compare therapeutic effects of internal fixation with volar locking plate in treating extension and flexion type of distal radius fracture (DRF).@*METHODS@#From January 2015 to June 2018, 103 patients with DRF were retrospectively analyzed. According to original fracture displacement direction, patients were divided into extension fracture(Colles) group and flexion fracture (Smith) group. In Colles fracture group, there were 24 males and 44 females aged from 20 to 79 years old with an average of (59.0±13.4) years old;according to AO classification, 9 patients of type A2, 13 patients of type A3, 16 patientsof type C1, 17 patients of type C2 and 13 patients of type C3;the time from injury to operation ranged from 2 to 9 days with an average of (3.9±0.8) days. In Smith fracture group, there were 15 males and 20 females, aged from 27 to 87 years old with an average of (60.1±15.3) years old;according to AO classification, 4 patienst of A2, 7 patients of A3, 14 patients of C1, 5 patients of C2 and 5 patients of C3;the time from injury to operation ranged from 2 to 6 days with an average of (4.1±0.9) days. Operation time, fracture healing time and postoperative complications were recorded between two groups. Disabilities of arm, shoulder and hand (DASH) score at 6 and 8 weeks, 6 and 8 months were used to evaluate functional recovery of affected limbs during each follow up. Volar tilt, radial inclination and radius height were measured at 8 months after operation. Mayo score was measured at 8 months after operation to evaluate recovery of limb function.@*RESULTS@#All patients were followed up for 8 to 30 months with an average of (14.8±4.3) months, and no difference in follow up between two groups (@*CONCLUSION@#Patients with Colles fracture and Smith fracture could receive good reduction and fixation through volar locking plate. The radiographic parameters of both groups recovered satisfactorily after operation. Recovery of volar tilt of Smith fracture group is better than that of Colles fracture group, and early recovery function of Colles fracture group is better than that of Smith group, but there is no significant difference in long-term wrist joint function and incidence of postoperative complications between two groups.

Impact of artificial intelligence imaging optimization technique on image quality of low-dose chest CT scan / 中华放射医学与防护杂志

Objective:To investigate the impact of artificial intelligence imaging optimization technique on the image quality and radiation dose of low-dose chest CT scan.Methods:Eighty patients who underwent chest CT examination in the Jilin University 1st hospital from July to August, 2019 were randomly divided into two groups(A, B), with 40 patients in each. The voltage of group A was 100 kV, while the other was 120 kV. According to different reconstruction method , group A was divided into two subgroups, group A1 and group A2. The images of A1 were reconstructed by iterative algorithm (ClearView 50%), while A2 images were optimized A1 by NeuAI imaging optimization technique. Group B used iterative algorithm (ClearView 50%) to reconstruct the image. The CT dose index (CTDI vol), dose-length product (DLP) and effective radiation dose ( E) of group A and group B were recorded and compared.Objective the evaluation indicators were CT noise (SD), signal-to-noise ratio (SNR) and comparative noise ratio (CNR) of ROI. Subjective evaluation was done by 2 chief radiologists using double-blind method and image quality was graded by 5-point Likert scale. Results:The patient characteristics between group A and group B showed no significant differences( P>0.05). Compared with group B, the effective radiation dose in group A was reduced by 72.1% [(1.48±0.49) mSv vs. (5.30±1.40) mSv]. The SD in group A1 was higher than that in group B, while SNR and CNR were lower ( ZSD=-4.24, ZSNR=-2.54, tCNR=-2.27, P<0.05). The SD in group A2 was significantly lower than that in group B ( ZSD=-28.24, P<0.001), and SNR and CNR were significantly higher than that in group B ( tSNR=-26.04, tCNR=-36.88, P<0.001). There was no significant difference in subjective scores of image noise between group A2 and group B, while subjective scores of lung structure in group B were better than those in group A2( χ2=4.96、7.04, P<0.05). Conclusions:Although the radiation dose was reduced by 72.1%, the low-dose chest CT images optimized by AI could reach the image quality level of standard dose.

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries-Update and systematic review / 中华创伤杂志(英文版)

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

Distribution characteristics and clinical significance of peripheral blood stem cell-like memory T cells in patients with gastric cancer / 中华微生物学和免疫学杂志

Objective To study the distribution characteristics of peripheral blood stem cell-like memory T cells ( TSCM) in patients with gastric cancer and to analyze their relationship to clinicopathologi-cal characteristics and clinical application value. Methods Thirty-two patients hospitalized with gastric cancer in our hospital from July to December, 2018 were selected as the case group. Twenty-three healthy volunteers recruited during the same period served as the control group. The percentages of TSCM, naive T cells ( TN) and memory T cells ( TM) were detected by flow cytometry and the differences between the two groups were compared. The relationship of clinicopathological features to TN, TSCM, TSCM/TN ratio and TM was analyzed. Results The percentages of TN and TSCM in peripheral blood of the patients were signif-icantly lower than those of the healthy control group, while the ratio of TSCM to TN was significantly in-creased in the case group (all P<0. 05). The proportion of TN was negatively correlated with tumor TNM stage and invasion depth, and positively correlated with the degree of tissue differentiation. The ratio of TSCM to TN was positively correlated with TNM stage, invasion depth and lymph node metastasis. Conclu-sions TN and the ratio of TSCM to TN in peripheral blood of patients with gastric cancer are closely related to clinical and pathological characteristics such as tumor stage and invasion depth, which could be used as a new way to evaluate the immune status of patients. TSCM might have important clinical application value in adoptive cellular immunotherapy of gastric cancer, but large-scale multi-center clinical studies are needed for further evaluation.

Prediction and partial verification of potential target proteins of saikosaponins and their metabolites / 中国药理学与毒理学杂志

OBJECTIVE To study saikosaponins (SSs) and their metabolites (a total of 30 compounds) in order to predict and verify partially potential target proteins. METHODS ①PharmMapper and Sybyl X were used to predict potential target proteins of SSs and their metabolites,and the binding model of saikosaponin a (SSa) and glutathione s-transferase A2 (GST A2) was investigated. ② In vitro experi?ments:HepRG cells were treated with SSa 0,0.03,0.06,0.13,0.25 and 0.50 mmol·L-1for 24 h,and cell viability was detected by CCK-8 analysis. HepaRG cells were treated with SSa 0, 0.03, 0.13 and 0.50 mmol·L-1for 24 h, and GST activity was detected. RESULTS ① PharmMapper and Sybyl X predicted the potential target proteins of SSs and their metabolites,including GST A2,phosphatidylcholine transfer protein, adenosine kinase, thymidylate synthase, estrogen receptor β, estradiol 17-beta-dehy?drogenase 1,proto-oncogene serine/threonine-protein kinase Pim1,bile acid receptor and cellular reti?noic acid-binding protein 2. The prediction results showed that SSa and GST A2 had the highest total score and a well-matched binding model, so they were most likely to interact. ② In vitro experiments:SSa could inhibit HepaRG cell viability in a concentration-dependent manner (R2=0.8848,P<0.05).Significant increases in activity of GST were observed after treatment with SSa. CONCLUSION The potential target proteins of SSs and their metabolites are GST, phosphatidylcholine transfer protein etc. GST may be one of the target proteins of SSa.

The therapeutic effects of total hip arthroplasty with combined anteversion angle of femoral neck-acetabu lam in Crowe Ⅳ developmental dysplasia of the hip / 实用医学杂志

Objective To evaluate the clinical efficacy of combined anteversion angle of femoral neck-acetabulam in Crowe Ⅳ developmental dysplasia of the hip (DDH) with Wagner Cone total hip arthroplasty. Methods From June 2013 to February 2016,45 cases of CroweⅣDDH were treated with no femoral shortening osteotomy in THA ,including 25 females and 20 males. The outcomes of anteversion angle of femoral neck and acetabulam were measured in CT scan of hip jiont. The outcomes of abduction angle ,hip center were measured radiologically in X-ray of pelvis. Postoperative function was scored by Harris scoring system. Results The mean follow-up time of the 45 patients was(3.2 ± 0.8)years. Using loosening or revision as the end point ,the survival rate was 100%. The outcomes of preoperative anteversion angle of acetabulam,femoral neck,acetabulam-femoral neck was(27.70 ± 5.35)°,(47.76 ± 7.25)°,and(74.90 ± 8.43)° in CroweⅣgroup,and those of postoperative anteversion angle was(19.82 ± 2.41)° ,(23.35 ± 3.84)° and(44.90 ± 5.18)° ,respectively. There was significant difference between the two groups(P < 0.05). The average height of preoperative dislocation in femoral head was (5.8 ± 1.2)cm and the postoperative average displacement of femoral lesser trochanter was (3.6 ± 0.8)cm. The Harris hip score was improved from preoperative(46.66 ± 7.28)to(90.36 ± 4.72). For most patients,hip pain were significantly relieved ,range of motion of the hip was improved ,and the gait returned to normal. Femoral nerve injury occurred in 2 cases and the case recovered after 3 months respectively. Conclusions The deformity of hip and the stability and matching degree of the prosthesis was evaluated with the combined anteversion angle of femoral neck-acetabulam in CroweⅣDDH. The Wagner Cone can effectively maintain the stability of the hip joint in the non-amputated total hip replacement.

Changes of Hcy,vWF and tissue factor procoagulant activity within 48h after onset in CHD patients and relationship between 3 indicators and coronary heart disease onset / 心血管康复医学杂志

Objective:To observe and compare differences of levels of homocysteine (Hcy),von Willebrand factor (vWF) and tissue factor procoagulant activity (TF-PCA) between patients with coronary heart disease (CHD) and healthy resi-dents,and analyze relationship between above 3 indicators and coronary heart disease onset.Methods:Clinical data of 95 CHD emergency patients (CHD group),who were treated in our department of cardiology from Apr 2013 to Dec 2015,and 95 healthy residents (healthy control group) were retrospectively analyzed.According to state of an illness,CHD group was further divided into stable angina pectoris (SAP) group (n＝33),unstable angina pectoris (UAP) group (n＝31) and acute myocardial infarction (AMI) group (n＝31).Levels of Hcy,vWF and TF-PCA were measured and compared among all groups and different time after onset in CHD patients.Multifactor Logistic regression analysis was used to analyze influ-encing factors of CHD types.Results:Compared with healthy control group,there were significant rise in levels of Hcy [ (9.22 ± 3.45) μmol/L vs.(17.80 ± 6.94) μmol/L],vWF [(122.40 ± 10.18)% vs.(160.13 ± 10.48)%] and TF-PCA [ (30.12 ± 10.49) s vs.(69.45 ± 8.26) s] in CHD group,P＝0.001 all.Compared with SAP group,there were signifi-cant rise in levels of Hcy [ (14.30 ± 3.15) μmol/L vs.(20.50 ± 4.97) μmol/L vs.(25.77 ± 6.10) μmol/L],vWF [ (141.56 ± 9.45)% vs.(168.23 ± 11.29)% vs.(185.56 ± 11.40)%] and TF-PCA [ (45.13 ± 11.52) s vs.(53.16 ± 18.45) s vs.(64.49 ± 11.59) s] in UAP group and AMI group,and those of AMI group were significantly higher than those of UAP group,P＜0.05 or ＜0.01.As onset time went by,there were significant reductions in levels of Hcy,vWF and TF-PCA in CHD patients,and all of them accorded with 1h＞12h＞24h＞48h,there existed significant difference be- tween any two time points,P＝0.001 all.Multifactor Logistic regression analysis indicated that Hcy,vWF and TF-PCA were independent risk factors for CHD type (OR＝2.586～5.058,P＝0.001 all).Conclusion:Levels of Hcy,vWF and TF-PCA significantly rise in CHD patients,the more severe disease is,the higher levels are.Along with time goes by,their levels significantly reduce.Combined detection of them can be used for predicting CHD type.The Hcy,vWF and TF-PCA are independent risk factors for CHD type.

Research progress in cellular and molecular mechanisms related to permeability alteration of blood-brain barrier / 中国药理学与毒理学杂志

Stable permeability of blood-brain barrier (BBB)is essential to maintaining the function of the central nervous system (CNS). The structure and permeability of BBB are changed during the development and progression of various neurological diseases such as Alzheimer disease and Parkinson disease,multiple sclerosis,lateral sclerosis,epilepsy,stroke and gliomas.Tight junctions and adherens junctions of BBB strictly limit the transportation of endogenous and exogenous compounds, making difficult the delivery of therapeutic drugs to CNS.The morphological and functional changes of the brain micro-vascular endothelial cells, astrocytes, microglial cells, pericytes and basement membrane, as well as the abnormal structure and expression of junctional proteins and transporters, affect the permeability alteration of BBB.New biotechnologies such as RNA interference,mimic peptides,nano materials and high-frequency focused ultrasound have been applied to study this phenomenon and explore its mecha-nism.This article summarizes the research progress in the permeability alteration of BBB.

Improving ultrasonic unit configuration in field medical team / 医疗卫生装备

Objective To improve ultrasonic unit configuration of the field medical team.Methods The problems of the ultrasonic unit were analyzed in operating platform setup,personnel and facility allocation,application of interventional ultrasound,cross infection prevention and etc,and some countermeasures were put forward accordingly.Results There were interdependence and interaction among the elements of the ultrasonic unit,and the rational configuration made the requirements satisfied for interventional therapy,massive casualty diagnosis,bed side application and etc.Conclusion Improved configuration enhances the efficacy of the ultrasonic unit of the field medical team.

Improving ultrasonic unit configuration in field medical team / 医疗卫生装备

Objective To improve ultrasonic unit configuration of the field medical team.Methods The problems of the ultrasonic unit were analyzed in operating platform setup,personnel and facility allocation,application of interventional ultrasound,cross infection prevention and etc,and some countermeasures were put forward accordingly.Results There were interdependence and interaction among the elements of the ultrasonic unit,and the rational configuration made the requirements satisfied for interventional therapy,massive casualty diagnosis,bed side application and etc.Conclusion Improved configuration enhances the efficacy of the ultrasonic unit of the field medical team.

Correlation between Ultrasound-guided Diffuse Optical Tomography and Hypoxia-inducible Factor-1Α of Breast Cancer / 中国医学科学院学报

Objective To investigate the correlation between ultrasound-guided diffuse optical tomography (US-DOT) and hypoxia-inducible factor-1Α (HIF-1Α) of breast cancer. Methods Totally 69 patients with pathologically confirmed breast cancer underwent preoperative conventional breast ultrasonography examinations and US-DOT at Peking Union Medical College Hospital From October 2007 to February 2010 were enrolled in this study.After surgery,immunohistochemical staining of HIF-1Α and CD34 were performed,and the differences of total hemoglobin concentration (THC) and microvessel density (MVD) between HIF-1Α positive and negative groups were analyzed. Results HIF-1Α was positive in 12 cases (17.4%) and negative in 57 cases (82.6%). The average THC and MVD of HIF-1Α-positive cases were (274.763±77.661) Μmol/L and (33.8±10.8)/0.2 mm(2) respectively. The average THC and MVD of HIF-1Α-negative cases were (228.059±65.760)Μmol/L and (28.4±7.4)/0.2 mm(2). MVD(t=2.049,P=0.04) and THC(t=2.167,P=0.034) of HIF-1Α-positive group were significantly higher than those of HIF-1Α-negative group. Conclusions HIF-1Α can promote tumor angiogenesis and thus increase the blood supply and THC. As an indicator of tumor blood supply,THC can indirectly reflect the angiogenic activity of breast cancer.

The acquisition of drug resistance plasmid in Pseudomonas aeruginosa induced by quinolones / 国际检验医学杂志

ObjectiveToinvestigatetheplasmidgenechangesinquinolone‐sensitivePseudomonasaeruginosa.Methods 31iso‐lates from January 2011 to December 2013 from various qualified clinical samples in the hospital were collected .In the 31 isolateds , 16 isolates proved sensitive to quinolones by using K‐B method were used as research objects in the study .The isolates growing ou‐side the sensitive ring of ciprofloxacin paper were selected to continuously transferred into other culture dishes until the resistance to quinolones were acquired .Plasmid transformation and extraction were performed on those isolates to confirm the existence of drug‐resistanceplasmidsacquired,andthroughPCRandgenesequenceanalysistodeterminethetypeofplasmids.Results 2iso‐lates of quinolone‐sensitive Pseudomonas aeruginosa acquired drug‐resistance plasmids qnrS and were resistant quinolones induced by continuous transferring for 9 times .Conclusion If antibiotics of inhibitory concentration were often used for the treatment of Pseudomonas aeruginosa infection ,drug‐resistance plasmids were acquired easily .