A comparative study of three internal fixation techniques for comminuted fractures of humeral greater tuberosity / 中华创伤骨科杂志

Objective:To compare the clinical outcomes between anatomical locking plate, proximal humerus internal locking system (PHILOS) and anatomical locking plate combined with suture anchors in the treatment of comminuted fractures of humeral greater tuberosity.Methods:A total of 33 comminuted fractures of humeral greater tuberosity were surgically treated from October 2016 to October 2021 at Department of Orthopedics, Tongji Hospital Affiliated to Tongji University. There were 20 males and 13 females, with an age of (53.5±13.6) years. They were assigned into 3 groups according to different internal fixation techniques. Group A of 12 cases was subjected to fixation with anatomical locking plate via the deltoid approach, group B of 10 cases subjected to fixation with PHILOS via the pectoralis major and the deltoid approaches and group C of 11 cases subjected to fixation with anatomical locking plate combined with suture anchors via the deltoid approach. The operation time, intraoperative blood loss, range of shoulder motion, Constant-Murley shoulder score, visual analogue scale (VAS) and postoperative complications were compared between the 3 groups.Results:The 3 groups were comparable because there was no significant difference between them in the general clinical data ( P>0.05). The follow-up duration for all patients was (14.5±4.1) months. All fractures got united at the last follow-up. In groups A, B and C, respectively, the operation time was (57.9±7.8), (73.0±7.1) and (63.6±9.5) min, and the intraoperative blood loss (41.7±18.9), (82.0±22.9) and (46.4±13.6) mL, showing significant differences between the 3 groups ( P<0.05). The operation time and intraoperative blood loss in groups A and C were significantly less than those in group B ( P< 0.05). At the last follow-up, in groups A, B and C, respectively, the shoulder abduction was 144.0°±7.7°, 138.7°±10.7° and 148.5°±6.2°, showing significant differences between the 3 groups ( P<0.05). Group C was significantly better than group B ( P<0.05). There was no statistically significant difference in the forward flexion, external rotation, or internal rotation of the shoulder joint between the 3 groups ( P>0.05). The Constant-Murley scores in groups A, B and C, respectively, were (90.4±5.7), (86.1±6.6) and (93.1±3.4) points, showing significant differences between the 3 groups ( P<0.05). Group C was significantly better than group B ( P<0.05). The VAS scores in groups A, B and C, respectively, were 1 (0, 2), 1 (0, 2), and 1 (0, 1) point, showing insignificant differences between the 3 groups ( P>0.05). Group A had 1 case of shoulder joint stiffness and 1 case of fracture re-displacement complicated with acromial impingement syndrome, group B 1 case of shoulder joint stiffness and 3 cases of fracture re-displacement, but group C no post-operative complication. Conclusions:In the treatment of comminuted fracture of humeral greater tuberosity, all the 3 internal fixation techniques can lead to fine clinical outcomes. Conventional PHILOS may lead to relatively large trauma and a high incidence of postoperative complications. The anatomical locking plate may result in fine functional recovery of the shoulder due to advantages of less invasion, shorter operation time and fewer postoperative complications than PHILOS. The anatomical locking plate combined with suture anchors may lead to the best shoulder functional recovery and the least complications.

Long-term trend analysis of liver cancer survival rate in Qidong region, Jiangsu Province, 1972-2019 / 中华肝脏病杂志

Objective: To analyze the incidence and survival rate of liver cancer cases in the entire population in the Qidong region from 1972 to 2019, so as to provide a basis for prognosis evaluation, prevention, and treatment. Methods: The observed survival rate (OSR) and relative survival rate (RSR) of 34 805 cases of liver cancer in the entire Qidong region population from 1972 to 2019 were calculated using Hakulinen's method with SURV3.01 software. Hakulinen's likelihood ratio test was used for statistical analysis. Age-standardized relative survival (ARS) was calculated using the International Cancer Survival Standard. The Joinpoint regression analysis was performed with Joinpoint 4.7.0.0 software to calculate the average annual percentage change (AAPC) of the liver cancer survival rate. Results: 1-ASR increased from 13.80% in 1972-1977 to 50.20% in 2014-2019, while 5-ASR increased from 1.27% in 1972-1977 to 27.64% in 2014-2019. The upward trend of RSR over eight periods was statistically significant (χ (2) = 3045.29, P < 0.001). Among them, male 5-ASR was 0.90%, 1.80%, 2.33%, 4.92%, 5.43%, 7.05%, 10.78%, and 27.78%, and female 5-ASR was 2.33%, 1.51%, 3.35%, 3.92%, 3.84%, 7.18%, 11.45%, and 29.84%, respectively. There was a statistically significant difference in RSR between males and females (χ (2) = 45.68, P < 0.001). The 5-RSR for each age group of 25-34 years old, 35-44 years old, 45-54 years old, 55-64 years old, 65-74 years old, and 75 years old were 4.92%, 5.29%, 8.17%, 11.70%, 11.63%, and 9.60%, respectively. There were statistically significant differences in RSR among different age groups (χ (2) = 501.29, P < 0.001). The AAPC in Qidong region from 1972 to 2019 for 1-ARS, 3-ASR, and 5-ARS were 5.26% (t = 12.35, P < 0.001), 8.10% (t = 15.99, P < 0.001), and 8.96 % (t = 16.06, P < 0.001), respectively. The upward trend was statistically significant in all cases. The AAPC of 5-ARS was 9.82% in males (t = 14.14, P < 0.001), and 8.79% in females (t = 11.48, P < 0.001), and the upward trend was statistically significant in both. The AAPC of 25-34 years old, 35-44 years old, 45-54 years old, 55-64 years old, 65-74 years old, and 75 years old were 5.37% (t = 5.26, P = 0.002), 5.22% (t = 5.66, P = 0.001), 7.20% (t = 6.88, P < 0.001), 10.00% (t = 12.58, P < 0.001), 9.96% (t = 7.34, P < 0.001) and 8.83% (t = 3.51, P = 0.013), and the upward trend was statistically significant. Conclusion: The overall survival rate of registered cases of liver cancer in the Qidong region's entire population has greatly improved, but there is still much room for improvement. Hence, constant attention should be paid to the study on preventing and treating liver cancer.

GPRC5B protects osteoarthritis by regulation of autophagy signaling

Osteoarthritis (OA) is one of the most common chronic diseases in the world. However, current treatment modalities mainly relieve pain and inhibit cartilage degradation, but do not promote cartilage regeneration. In this study, we show that G protein-coupled receptor class C group 5 member B (GPRC5B), an orphan G-protein-couple receptor, not only inhibits cartilage degradation, but also increases cartilage regeneration and thereby is protective against OA. We observed that Gprc5b deficient chondrocytes had an upregulation of cartilage catabolic gene expression, along with downregulation of anabolic genes in vitro. Furthermore, mice deficient in Gprc5b displayed a more severe OA phenotype in the destabilization of the medial meniscus (DMM) induced OA mouse model, with upregulation of cartilage catabolic factors and downregulation of anabolic factors, consistent with our in vitro findings. Overexpression of Gprc5b by lentiviral vectors alleviated the cartilage degeneration in DMM-induced OA mouse model by inhibiting cartilage degradation and promoting regeneration. We also assessed the molecular mechanisms downstream of Gprc5b that may mediate these observed effects and identify the role of protein kinase B (AKT)-mammalian target of rapamycin (mTOR)-autophagy signaling pathway. Thus, we demonstrate an integral role of GPRC5B in OA pathogenesis, and activation of GPRC5B has the potential in preventing the progression of OA.

Application Progress of Plant Growth Regulator in Production of Chinese Medicinal Materials / 中国实验方剂学杂志

Plant growth regulator （PGR） is mostly a class of chemical synthesis substance with physiological activities similar to plant hormones，which can promote cell elongation，induce vascular differentiation or accelerate tissue aging via regulating the physiological processes such as photosynthesis，respiration，transpiration，signal transduction，substance absorption and operation. PGR has the advantages of small dosage，high efficiency，low toxicity and less residue，and it is widely used in the planting of Chinese medicinal herbs. By consulting the relevant literature published in recent years，this paper briefly summarizes the main types of PGR，e.g.auxins，gibberellins，cytokinins，abscisic acid and ethylene，etc. On the other hand，this article analyzes and sums up the specific applications of PGR in the manufacture of Chinese herbal medicine，for instance，promoting seed germination，improving seed setting rate or fruit setting rate，dwarfing plants，inhibiting reproductive growth，regulating gender differentiation，stimulating fruit falling，enhancing resistance and so on. The problems existing in the practical use of PGR are pointed out，non-differentiation of specific species，unreasonable combination，not paying attention to the operation method，arbitrarily increasing the dose，lack of residue limit standard and reducing the content of some effective components，for example.Meanwhile，some feasible suggestions are put forward.Not only the suitable types of PGR should be selected in a reasonable and standardized manner，but also the appropriate concentration，dosage and period of application should be chosen carefully； the dual effects of PGR on plant growth and active ingredients in medicinal organs should be concerned，so as to improve the yield and avoid the loss of effective components on the basis of ensuring the quality of Chinese medicinal materials； it is necessary to strengthen the registration of PGR in the production of Chinese medicinal materials and establish residue limit standards to provide a monitoring basis for ensuring the safety of Chinese medicine in the future.The scientific use of PGR can promote the increase of agricultural yield and farmers' income，and make the healthy development of Chinese herbal medicine planting industry.

Stabilization of dorsal intra-articular fragment in distal radius fracture after volar locking plate fixation / 中华创伤骨科杂志

Objective:To explore the risk factors that may affect the stabilization of dorsal intra-articular fragment in distal radius fracture after volar internal fixation.Methods:A retrospective analysis was performed of the patients with distal radius fracture who had been treated by volar internal fixation at Department of Traumatic Orthopedics, Tongji Hospital Affiliated to Tongji University from July 2016 to July 2020. After 3D reconstruction of their preoperative CT scans by software Mimics 20.0, 66 patients with a dorsal intra-articular fragment were screened out. They were 31 males and 35 females, aged from 23 to 78 years (average, 53.4 years). By the AO classification, there were 17 case of type C1, 22 cases of type C2, and 27 cases of type C3. The displacement of dorsal intra-articular fragment was judged by X-ray observation on postoperative day 2 and X-ray follow-up at the outpatient department. The 13 patients with displacement of dorsal intra-articular fragment>2 mm were assigned into a displacement group while the other 53 ones into a displacement-free group. The 2 groups were compared in terms of preoperative general data and anatomical data of the dorsal intra-articular fragment (total preoperative displacement, radius-ulnar length, dorsal-volar length, aspect ratio, proximal-distal length and volume) to analyze the correlations between them and displacement.Results:There was no significant difference in preoperative general data (age, gender, affected side, cause of injury or AO classification) between the 2 groups, showing comparability between groups ( P>0.05). All patients were followed up for 6 to 24 months (mean, 14 months) after surgery. There were no postoperative complications like neurovascular lesion or infection. None of the patients in the displacement group underwent revision surgery, and the fractures healed successfully during the postoperative follow-up. The total preoperative displacement in the displacement group was(10.0±1.3) mm, significantly larger than that in the displacement-free group [(7.8±1.5) mm]; the radius-ulnar length in the displacement group was (8.2±1.3) mm, significantly shorter than that in the displacement-free group [(10.8±2.3) mm]; the aspect ratio of the fragment in the displacement group was 1.2±0.2, significantly lower than that in the displacement-free group (1.4±0.2); the fragment volume in the displacement group was (690.5± 201.4) mm 3, significantly smaller than that in the displacement-free group [(995.8±295.0) mm 3]. There were significant differences in the above items between the 2 groups ( P<0.05). Conclusion:The total preoperative displacement, radius-ulnar length, aspect ratio and volume of a dorsal intra-articular fragment are important factors which may affect the displacement of the dorsal fragment after volar internal fixation.

Tanshinone IIA prevents acute lung injury by regulating macrophage polarization / 中西医结合学报

OBJECTIVE@#Acute lung injury (ALI) is a serious respiratory dysfunction caused by pathogen or physical invasion. The strong induced inflammation often causes death. Tanshinone IIA (Tan-IIA) is the major constituent of Salvia miltiorrhiza Bunge and has been shown to display anti-inflammatory effects. The aim of the current study was to investigate the effects of Tan-IIA on ALI.@*METHODS@#A murine model of lipopolysaccharide (LPS)-induced ALI was used. The lungs and serum samples of mice were extracted at 3 days after treatment. ALI-induced inflammatory damages were confirmed from cytokine detections and histomorphology observations. Effects of Tan-IIA were investigated using in vivo and in vitro ALI models. Tan-IIA mechanisms were investigated by performing Western blot and flow cytometry experiments. A wound-healing assay was performed to confirm the Tan-IIA function.@*RESULTS@#The cytokine storm induced by LPS treatment was detected at 3 days after LPS treatment, and alveolar epithelial damage and lymphocyte aggregation were observed. Tan-IIA treatment attenuated the LPS-induced inflammation and reduced the levels of inflammatory cytokines released not only by inhibiting neutrophils, but also by macrophage. Moreover, we found that macrophage activation and polarization after LPS treatment were abrogated after applying the Tan-IIA treatment. An in vitro assay also confirmed that including the Tan-IIA supplement increased the relative amount of the M2 subtype and decreased that of M1. Rebalanced macrophages and Tan-IIA inhibited activations of the nuclear factor-κB and hypoxia-inducible factor pathways. Including Tan-IIA and macrophages also improved alveolar epithelial repair by regulating macrophage polarization.@*CONCLUSION@#This study found that while an LPS-induced cytokine storm exacerbated ALI, including Tan-IIA could prevent ALI-induced inflammation and improve the alveolar epithelial repair, and do so by regulating macrophage polarization.

Evaluation and clinical significance of coronal bone structure matching in distal radius fractures / 中华骨科杂志

Objective:To study the coronal bone structure matching of distal radius in normal population and some patients with postoperative distal radius fracture, and to explore the clinical significance of coronal bone structure reduction of distal radius fracture.Methods:CT scans of 80 asymptomatic wrists were performed. Mimics 20.0 and 3-Matic research software were used to measure the matching data of coronal bone structure of the distal radius. Total of 44 patients with distal radius fractures treated with open reduction and volar plate fixation were collected. According to the data coronal bone structure of the distal radius, the matching group was in the normal range, and the mismatching group was less than the normal range. X-ray films were used to evaluate fracture healing, humeral height, ulnar angle and palm tilt angle at 3 months and 12 months after operation. The clinical indexes of wrist pain, wrist function, grip strength and activity were recorded in 2 groups. The DASH score was used for evaluation, and statistical comparisons was made between the two groups of related indicators.Results:The coronal bone structure matching value of the distal radius in 80 normal adults was 45.0%±16.2%. All the 44 patients with distal radius fracture were followed up for an average of 16 months. The postoperative wound healing was good, and the bone healing standard was reached 3 months after the operation. 3 months after surgery, radius height, ulnar deviation angle and palmar inclination angle of the mismatched group were all smaller than those of the matched group, but the differences had no statistical significance. The pronation angle in the mismatched group (68.82°±11.62°) was lower than that in the matched group (76.91°±9.14°), and the difference was statistically significant ( t=2.567, P=0.014). The DASH score in the mismatched group (15.53±2.36) was higher than that in the matched group (13.62±2.52), and the difference was statistically significant ( t=2.591, P=0.013). 12 months after surgery, the VAS score of the matched group (2.08±2.95) was less than that of the mismatched group (2.95±1.24), and the difference was statistically significant ( t=2.348, P=0.024). There was no significant difference in wrist range of motion, grip strength and DASH score between the two groups. Conclusion:The coronal bone structure matching of distal radius is about 45.0% in normal population. Early wrist dysfunction, limited pronation, and wrist pain may occur when the postoperative matching degree of the distal radius fracture is not within the normal range.

Durability of neutralizing antibodies and T-cell response post SARS-CoV-2 infection / 医学前沿

The ongoing pandemic of Coronavirus disease 19 (COVID-19) is caused by a newly discovered β Coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). How long the adaptive immunity triggered by SARS-CoV-2 can last is of critical clinical relevance in assessing the probability of second infection and efficacy of vaccination. Here we examined, using ELISA, the IgG antibodies in serum specimens collected from 17 COVID-19 patients at 6-7 months after diagnosis and the results were compared to those from cases investigated 2 weeks to 2 months post-infection. All samples were positive for IgGs against the S- and N-proteins of SARS-CoV-2. Notably, 14 samples available at 6-7 months post-infection all showed significant neutralizing activities in a pseudovirus assay, with no difference in blocking the cell-entry of the 614D and 614G variants of SARS-CoV-2. Furthermore, in 10 blood samples from cases at 6-7 months post-infection used for memory T-cell tests, we found that interferon γ-producing CD4

Summary of combined orthodontic and implant treatment in the patients with the congenital absence of maxillary lateral incisors / 口腔疾病防治

Objective@#To summarize the treatment options for congenital maxillary lateral incisor agenesis (MLIA).@*Methods @#Review the literature, summarize the current treatment options and advantages and disadvantages of various methods of MLIA, and analyze cases. @*Results @#When a patient′s occlusion and other conditions are suitable for space closure and canine substitution, closure of the gap is the recommended method, as it has good aesthetic results and leads to good periodontal health. However, when closure cannot be performed, a dental implant has a strong advantage compared with other restoration methods. When planning implants for MLIA patients, doctors should carefully select the correct surgery time and take care with the implant position to obtain good results.@* Conclusion@#In the choice of a treatment plan for MLIA, we need to use the concept of multidisciplinary combined treatment to obtain a more satisfactory treatment effect with regard to aesthetics and function.

Analysis of the Medication Rule of Glycyrrhiza uralensis -containing Antitussive Prescriptions Based on 2015 Edition of Chinese Pharmacopoeia （Part Ⅰ） / 中国药房

OBJECTIVE：To explore the medication rul e of Glycyrrhiza uralensis -containing antitussive prescriptions （GUAP）， and to provide reference for the research and development of new antitussive drugs. METHODS ：The GUAP were collected from 2015 edition of Chinese Pharmacopoeia （part Ⅰ）. The information of prescription name ，composition，flavor and meridian tropism，and functional indications were input into Excel 2018 software to establish the database. The frequency of traditional Chinese medicine （TCM）was analyzed statistically. Cluster analysis was performed for high frequency TCM （frequency≥15）in GUAP by using SPSS Statistics 23.0 software；Apriori algorithm and association rules of SPSS Modeler 18.0 software were used to analyze the drug combination of high-frequency TCM in GUAP （support degree ≥15％，confidence degree ≥70％，lift degree ≥1）. New GUAP was sorted. Totally 60 mice were divided into model group （normal saline ），positive group （Codeine phosphate tablet ， 5 mg/kg），New prescription low-dose ，medium-dose and high-dose groups （1.17，5.83，11.67 g/kg，by extractum ），with 12 mice in each group. They were given relevant medicine intragastricaaly once a day ，for consecutive 7 d. 1 h after last medication ，cough was induced by ammonia in mice for 30 seconds；the latent period of cough and the frequency of cough within 2 min were recorded，and the cough inhibition rate was calculated. RESULTS ：Totally 73 prescriptions involved 194 kinds of TCM ，with 11 ingredients of high-frequency TCM （G. uralensis ，Platycodon grandiflorus ，Semen Armeniacae ，Citrus reticulate ，Ephedra sinica ， Gypsum fibrosum ，Scutellaria baicalensis ，Mentha haplocalyx ，Pinellia ternate ，Poria cocos ，Peucedanum praeruptorum ），which were mainly pungent and mostly belonged to lung meridian. High-frequency TCM could be grouped into 5 categories. There were 7 two-item association rules （such as E. sinica →Semen Armeniacae ，G. fibrosum →Semen Armeniacae ）and 10 three-item association rules （such as G. fibrosum -Semen Armeniacae →E. sinica ，C. reticulate -P. grandiflorus →Semen Armeniacae ）. New GUAP contained G. uralensis ，P. grandiflorus ，Semen Armeniacae ，E. sinica ，C. reticulate ，G. fibrosum （mass ratio 1 ∶ 2 ∶ 2 ∶ 2 ∶ 3 ∶ 4）. Compared with model group ，the latent period of cough was prolonged and the frequency of cough within 2 min was decreased significantly in positive group and new prescription low-dose ，medium-dose and high-dose groups （P＜0.01）. Compared with positive group ，latent period of cough was shortened significantly in new prescription low-dose and medium-dose groups ，while the frequency of cough within 2 min was increased （P＜0.05 or P＜0.01）；but there was no significant difference in latent period of cough， the frequency of cough within 2 min， cough inhibitory rate of new prescription high-dose group （P＞0.05）. CONCLUSIONS：The new antitussive prescription was summarized by analyzing the medication rule of GUAP ，and was verified to have good antitussive effect ，which can provide reference for the development of new antitussive drugs.

Analysis on Application of Salviae Miltiorrhizae Radix et Rhizoma Related Health Food / 中国实验方剂学杂志

With the improvement of living standard and enhancement of health consciousness, Salviae Miltiorrhizae Radix et Rhizoma, as a common medicinal material that can be widely used in health food, is focused an increasing number of scholars′ attention at home and abroad. Based on Salviae Miltiorrhizae Radix et Rhizoma health food published by the food website of National Medical Products Administration (NMPA), this paper combs and analyzes their dosage forms, functional components, health-care functions and prescriptions of traditional Chinese medicine (TCM). Meanwhile, the Apriori algorithm module in SPSS Modeler 15.0 is used to explore the formulation rules of Salviae Miltiorrhizae Radix et Rhizoma health food. The results showed that capsules was the most common (about 55.34%), and the infusions and beverages were rare. In the aspect of health-care function, it is mainly used to auxiliary hypolipidemic, auxiliary protective function to chemical liver injury, enhance immunity and dispel chloasma. Among 92 cases of the health food with auxiliary hypolipidemic, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Gynostemmatis Pentaphylli Herba-Puerariae Lobatae Radix. Among 55 cases of the health food with auxiliary protective function to chemical liver injury, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Puerariae Lobatae Radix-Schisandrae Chinensis Fructus. Among 54 cases of the health food with immune-enhancing, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Astragali Radix-Lycii Fructus. Among 46 cases of the health food with dispelling chloasma, the common combination of TCM was Salviae Miltiorrhizae Radix et Rhizoma-Angelicae Sinensis Radix-grape seeds. The selection of prescription compatibility of Salviae Miltiorrhizae Radix et Rhizoma health food with different health-care functions is basically consistent with the TCM treatment with syndrome differentiation theory and modern medical theory. This article interprets the application of Salviae Miltiorrhizae Radix et Rhizoma health food from the perspective of dosage forms, functional components, health-care functions and compatibility of prescriptions, which can provide a basis and reference for precise and efficient research and development of this kind of health food.

A survey on standardized training of trauma surgeons in Shanghai / 中华创伤骨科杂志

Objective:To investigate the current state of standardized training in trauma surgeons in medical institutions in Shanghai.Methods:Questionnaire surveys, focus discussions and expert conferences were conducted to investigate the professional background, status of standardized training on trauma care knowledge, training needs and suggestions in 236 trauma surgeons in 25 Shanghai medical institutions.Results:The investigation revealed that only 59.3% (140/236) of the trauma surgeons had received a standardized training on trauma care knowledge. Of them, those who participated in the training by an international, domestic and local medical institution accounted for 26.4% (37/140), 47.1% (66/140) and 84.3%(118/140), respectively. Only 83 surgeons (70.3%) received regular training and most of them 66.3% (55/83) did in a low frequency of 1-2 times a year. Only 12.7% (15/118) of the surgeons received a training course of ≥48 classes (45 min per class) in the past 3 years. The training courses by medical institutions were mostly lectures on theoretical knowledge and training of a single skill while the simulated scenario drills accounted for less than 48.3%(57/118). The surgeons who had received a standardized training on trauma care were more likely to use their training knowledge to grade and score the patients with trauma, significantly more than those who had not( P<0.05). Conclusions:The coverage, time or frequency of standardized training on trauma care was not enough in Shanghai. The standardized training of trauma care surgeons should be strengthened in all medical institutions and be supervised by the management administration. A set of standardized materials and assessment standards for trauma care training should be formulated as soon as possible which fits the domestic conditions in China. Training bases should be established in Shanghai for standardized care of severe trauma and trauma specialists. A training system for trauma specialists should be established to promote traumatology in shanghai.

Research progress on alkaloid monomer analgesic preparations / 中国中药杂志

Pain is one of the problems that seriously affect people's quality of life for thousands of years. The causes of pain are complex and varied,and long-term pain can also lead to depression. It has become a research hotspot to develop analgesic preparations with significant drug effects and small side effects. Recent studies have shown that certain alkaloid monomers have analgesic targets such as γ-aminobutyric acid,cannabinoids,and capsaicin. If their preparation is applied to the analgesic field,they can make up for the defects such as strong addiction and side effects of traditional opioid and non-steroidal analgesic drugs,but there is no relevant literature to summarize the research results in this field. This article first introduces the mechanism of pain production and the target of analgesia. Based on this,the application status of alkaloid monomer analgesic preparations approved by China Food and Drug Administration( CFDA)( number varieties,type of dosage form,drug description,analgesic mechanism and advantages) was analyzed,and the research dynamics of alkaloid monomer analgesic preparations( new formulation and new technology) were reviewed. Finally,some problems in this field were pointed out,such as imperfect medication information,inadequate transformation of research results,and too few kinds of analgesic components in developed alkaloids. The development direction was also pointed out for the above problems,with a view to provide reference for further development and in-depth research.

Application Status and Research Progress of External Traditional Chinese Medicine Ointment for Rheumatism Treatment / 中国实验方剂学杂志

Due to the definite curative effect,stable drug properties and low incidence of adverse reactions,the external traditional Chinese medicine(TCM) ointment for rheumatism treatment has attracted more and more attention from scholars at home and abroad.Based on the external TCM ointment for the treatment of rheumatism approved by China Food and Drug Administration(CFDA),this paper would comb and analyze their dosage forms,varieties,specifications,etc.On the other hand,this article summarizes the application of the new formulation technology,prescription research,study on the forming process,pharmacodynamics and safety research,etc.The problems existing in this area were pointed out,such as lack of new preparations;less research on the penetration material basis,the penetration enhancing mechanism,and the penetration enhancing law;the selection of detection indicators of quality control standards is not comprehensive enough;qualitative and quantitative studies of pharmacokinetics are relatively scarce and so on.Meanwhile,proper measures and suggestions are put forward.Not only the formulation classification and specification description of external TCM ointment should be standardized,but also new dosage forms such as intelligentized,controlled release and targeted preparations of Chinese medicine should be actively introduced;the study of transdermal activity of transdermal enhancer itself should be strengthened,and investigating the correlation between the transdermal absorption of the agent itself and promoting transdermal absorption;the biological effect index or indicators that combine chemical and biological effects should be used,and learning from the latest research achievements of multidimensional spectroscopy of Chinese herbal medicine,thereby establishing scientific detection indicators and quality control methods that conform to modern transdermal concept.

Advances in matrix metalloproteinase 13 in cartilage remodeling and arthritis / 中国药理学通报

Arthritis is a common chronic disease characterized by the destruction of joint cartilage and inflammation in the sur-rounding tissues. Although it is known that the pathogenesis of arthritis is influenced by a series of factors, the underlying mechanisms remain unclarified. Recently, increasing attention has been paid to the increase of matrix metalloproteinases (MMPs) in articular cartilage,resulting in an inevitable degra-dation of cartilage and extracellular matrix (ECM). MMP-13, the major functioning enzyme during arthritis development,plays a vital role in the cartilage destruction, thus contributing to the decomposition of type Ⅱ collagen irreversibly. A variety of cellu-lar cytokines such as IL-1β and TNF-α,and Runx2 are assumed to affect the expression of MMP-13 in chondrocytes. The hypom-ethylation of the promoter region of the MMP-13 may induce its expression, while it can be reduced by inhibiting histone acety-lation. Meanwhile, microRNA can reduce the expression of MMP-13. In conclusion, MMP-13 can be used as an important therapeutic target in arthritis. In this review, we focus on the role of MMP-13 in arthritis and its underlying regulatory mecha-nisms.

Problem analysis and supervision strategy for infusion/syringe pumps / 医疗卫生装备

Objective To analyze the problems found during the sampling inspection of the infusion and syringe pumps. Methods The present situation of the supervision of medical devices was explored,and statistical analysis was executed on the sampling inspection results of medical devices in 2016 to evaluate completely their quality and application.Results The medical devices had problems in uneven quality,low rate of coverage of sampling inspection,unreferencing YY 0709—2009 Medical Electrical Equipment-Part 1-8:General Requirements for Safety-Collateral Stanalard:General Requirements,Tests and Guidance for Alarm Systems in Medical Eleatriail Equipment and Medical Electrical Systems when registering product standard and technical requirements,external labeling,instruction manual and packaging.The qualification rate for sampling inspection was kept at low level in the past few years.Conclusion The supervision strategy is put forward for medical devices to enhance their overall quality.

Treatment of coronal shear fracture of the distal end of the humerus by the olecranon osteotomy approach / 中国骨伤

<p><b>OBJECTIVE</b>To explore the effectiveness of olecranon osteotomy approach for the treatment of coronal shear fracture of the distal end of the humerus.</p><p><b>METHODS</b>A retrospective analysis was made on the clinical data of 34 patients with the coronal shear fracture of the distal end of the humerus treated by the olecranon osteotomy approach from January 2005 to January 2013. Of 34 cases, there were 15 boys and 19 girls, aged from 17 years to 84 years (mean, 54.9±10.2 years); 18 patients had fractures on the left and 16 patients had fractures on the right. Fractures were classified according to the Bryan and Morrey classification united Mckee classification: type Iinjuries occurred in 10 cases, type IIinjuries in 5 cases, type III injuries in 10 cases and type IV injuries in 9 cases. The Mayo elbow functional scores were evaluated for analysis.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 15 to 96 months, with a mean of (35.1±7.2) months. Average arc of motion was (132.1±11.2)° in flexion and (4.6±1.9)° in extension. The average Mayo score was 85.9±6.3(73 to 94 scores). Thirteen patients got an excellent result, 15 good and 6 poor. The average Mayo score was 88.6±3.7 in type Iinjuries, 85.8±4.6 in type IIinjuries, 81.8±5.8 in type III injuries and 87.5±9.1 in type IV injuries. There were no significant differences in outcomes.</p><p><b>CONCLUSIONS</b>The treatment for the coronal shear fracture of the distal end of the humerus by the olecranon osteotomy approach can achieve the satisfactory curative effect, maintain the reduction and improve the elbow function.</p>

Visualization Study on Hot Spots of Research on Siraitiae Fructus in Recent Ten Years Based on Double Clustering Analysis / 中国中医药信息杂志

Objective To use double clustering analysis and visualization method to analyze the research on Siraitiae Fructus in recent ten years; To know the hot spots and trend of research. Methods Relevant research about Siraitiae Fructus in CNKI from January of 2007 to December of 2016 was retrieved by computers, and the retrieval time was February 20th, 2017. BICOMB, NetDraw, gCLUTO and SPSS19.0 software were used to conduct double clustering analysis and visualization analysis for included articles. Keywords were analyzed, and social network graph, visualization matrix, peak image and multidimensional scaling analysis map were drawn. Correlation among high-frequency key words were analyzed. Results Totally 723 articles were included, among which 70 articles were issued during 2012–2016; 76 key words were obtained by key word co-occurrence network map, among which mogroside, MOG, extraction process, tissue culture, cultivation technology, varieties, growth and development were in the core position; visualization and the peak image showed that the topics in this research field could be divided into 6 categories; research hotspot dynamic evolution showed that Siraitiae Fructus flower, beverage, total flavonoids, gene expression, gene cloning, enzyme, apoptosis, and Siraitiae Fructus seed oil would be the hot spots of further study. Conclusion This study reveals that the research on Siraitiae Fructus in the recent ten years are becoming mature, and expand to deep level.

Characteristics of Balance and Surface Electromyography of Trunk Flexor and Extensor for Stroke Patients / 中国康复理论与实践

Objective To study balance function and surface electromyography (sEMG) activity of erector spinae (ES) and rectus ab-dominis(RA)in stroke patients.Methods From April,2015 to December,2016,17 stroke patients(test group)and 13 healthy subjects(con-trol group)were tested with balance platform:sitting with eyes open/close,with the platform swing of 10°,with trunk flexion and extension in maximum.The root mean square(RMS)of sEMG was recorded on both sides of ES and RA synchronously.The swing length and area of center of mass,the center of pressure on X and Y axes were also recorded as sitting with eyes open/close.Results For the test group,RMS of bilateral ES was significantly different as sitting with eyes open/close and with trunk flexion and extension in maximum (t>2.173, P<0.05).Compared with the control group,RMS of ES and RA in unaffected side increased as sitting with eyes open/close(t>2.175,P<0.05), as well as the swing length and area of center of mass(t>2.760,P<0.05).Conclusion The strength imbalance is found in ES in stroke pa-tients,which may associate with the balance function impairment,and need to be improved in rehabilitation.

Visualization Study on Hot Spots of Research on Siraitiae Fructus in Recent Ten Years Based on Double Clustering Analysis / 中国中医药信息杂志

Objective To use double clustering analysis and visualization method to analyze the research on Siraitiae Fructus in recent ten years; To know the hot spots and trend of research. Methods Relevant research about Siraitiae Fructus in CNKI from January of 2007 to December of 2016 was retrieved by computers, and the retrieval time was February 20th, 2017. BICOMB, NetDraw, gCLUTO and SPSS19.0 software were used to conduct double clustering analysis and visualization analysis for included articles. Keywords were analyzed, and social network graph, visualization matrix, peak image and multidimensional scaling analysis map were drawn. Correlation among high-frequency key words were analyzed. Results Totally 723 articles were included, among which 70 articles were issued during 2012–2016; 76 key words were obtained by key word co-occurrence network map, among which mogroside, MOG, extraction process, tissue culture, cultivation technology, varieties, growth and development were in the core position; visualization and the peak image showed that the topics in this research field could be divided into 6 categories; research hotspot dynamic evolution showed that Siraitiae Fructus flower, beverage, total flavonoids, gene expression, gene cloning, enzyme, apoptosis, and Siraitiae Fructus seed oil would be the hot spots of further study. Conclusion This study reveals that the research on Siraitiae Fructus in the recent ten years are becoming mature, and expand to deep level.