Robot-assisted core decompression combined with bone grafting in the treatment of early osteonecrosis of femoral head / 中华骨科杂志

Objective:To explore the clinical effect of robot-assisted core decompression combined with bone grafting in the treatment of early-stage osteonecrosis of femoral head.Methods:The data of 49 patients (84 hips) who attended the Department of Orthopedics and Joint Surgery of the Second Affiliated Hospital of Xi'an Jiaotong University from August 2019 to February 2021 were retrospectively analyzed. All the patients suffering Association Research Circulation Osseous (ARCO) II stage of osteonecrosis of femoral head underwent core decompression and bone grafting. Among the patients undergoing surgery, 30 patients (54 hips), including 19 males and 11 females, aged 44.3±5.4 years (range, 21 to 59 years) were treated with conventional surgical methods, and 19 patients (30 hips), including 12 males and 7 females, aged 41.4±7.2 years (range, 20 to 58 years), were assisted by the orthopedic robot navigation system. All operations were performed by the same operator. All patients were informed of the conventional and robotic surgical options by the surgeon at admission, and the patients made the decision. The baseline data of the two groups of patients, the time of unilateral operation, the number of unilateral X-ray fluoroscopy, the Harris hip score at the last follow-up after surgery, the visual analog score (VAS), and the collapse rate at the last follow-up were collected and compared.Results:A total of 41 patients (70 hips) were followed up, including 24 cases (42 hips) in the conventional surgery group and 17 cases in the robot-assisted group (28 hips). The average follow-up time of all cases was 14.6±4.8 months (range, 3 to 21 months). At the last follow-up, a total of 13 patients (13 hips) suffered femoral head surface collapse, including 11 patients in the conventional surgery group (11 hips) and 2 patients in the robot-assisted group (2 hips). The rate of femoral head collapse between the two groups had statistical difference ( P=0.045). The average operation time of unilateral hip in the conventional operation group was 21.3±5.4 min, and 16.8±3.3 min in the robot-assisted group, with significant difference ( t=3.94, P<0.001). The number of X-ray fluoroscopy of unilateral hip in the conventional operation group was 14.4±3.8 times, and 9.6±2.1 times in the robot-assisted group, with significant difference ( t=6.08, P<0.001). The Harris hip score before surgery in the conventional surgery group was 68.4±4.5 points, and 85.1±3.8 points at the last follow-up, while the preoperative Harris hip score of the robot-assisted surgery group was 67.2±3.9 points, and 86.5±4.4 points at the last follow-up. The Harris hip scores at the last follow-up of the two groups were significantly different from those before the operation, but there was no difference between the two groups after surgery ( t=1.09, P=0.283). The preoperative VAS of the conventional surgery group was 4.8±1.7 points, and 1.7±0.8 points at the last follow-up. The preoperative VAS of the robot-assisted surgery group was 5.1±1.5 points, and 0.9±0.3 points at the last follow-up. Τhere were significant differences between the two groups regarding the VAS in the last follow-up ( t=3.92, P<0.001). Conclusion:Core decompression combined with bone grafting have a definite effect in the treatment of osteonecrosis of ARCO II stage of osteonecrosis of femoral head. Compared with conventional surgery, robot-assisted surgery can achieve better short-term results and head preservation rate.

Effect of a blended learning mode of sleeping intervention for college freshmen / 中国学校卫生

Objective@#To explore the impact of sleep education programs on freshman sleep time, knowledge, attitudes, behavior and daytime sleepiness, so as to provide a reference for further improving the sleep status of college students.@*Methods@#By using the method of cluster sampling, freshmen were invited from a university in Beijing (288 at baseline, 187 at posttest and 108 at follow up for experimental group (EG); 207 at baseline and 105 at posttest for control group (CG). The sleep education content was embedded into other courses and implemented in a blending learning mode for EG, lasting 10 weeks, while the CG received no intervention. Both groups were assessed using questionnaires at both baseline and 2 weeks after the intervention, and reassessed at 9 months follow up after posttest for EG.@*Results@#After intervention, compared with CG, the weekday and weekend bedtime in EG was 21 min and 17 min earlier than that in CG respectively ( t=-2.78, -2.15, P <0.05). The sleep duration at night on weekday in EG was 19 min longer than that in CG ( t=3.51, P<0.01). In EG, the phenomenon of going to bed with electronic products before sleep, no delay in falling asleep, sleep knowledge, sleep attitude, sleep habit and daytime sleepiness were significantly better than those in CG ( χ 2/t =9.15, 2.82, 5.71, 3.98, 2.41, -4.90, P <0.05). After intervention, comparing with that at baseline, the weekday and weekend bedtime in EG were significantly earlier by 11 min and 17 min respectively ( t=3.50, 3.67, P <0.01), the sleep duration at nights on weekdays and weekend increased by 13 min and 18 min, respectively ( t=-3.01, -3.67, P <0.05), and the daytime sleepiness, going to bed with electronic products before sleep, no delay in falling asleep, sleep knowledge, sleep attitude and sleep habit were significantly improved ( χ 2/t =4.64, 15.19, -2.08, -9.31, -3.28, -2.14, P<0.05). At the 9 months follow up after the posttest, the bedtime on working day was significantly advanced by 8 min ( t =2.00), the sleep duration at night on working day was prolonged by 9 min ( t =-2.15), and the phenomenon of going to bed with electronic products before sleep and sleep knowledge were still significantly improved( χ 2/t =21.50, -6.26)( P <0.05).@*Conclusion@#Sleep education programs embedded in other courses and implemented in a blending learning mode can improve students sleep knowledge, sleep attitude and some habits, and reduce daytime sleepiness.

Chlorella sp.-ameliorated undesirable microenvironment promotes diabetic wound healing

Chronic diabetic wound remains a critical challenge suffering from the complicated negative microenvironments, such as high-glucose, excessive reactive oxygen species (ROS), hypoxia and malnutrition. Unfortunately, few strategies have been developed to ameliorate the multiple microenvironments simultaneously. In this study, Chlorella sp. (Chlorella) hydrogels were prepared against diabetic wounds. In vitro experiments demonstrated that living Chlorella could produce dissolved oxygen by photosynthesis, actively consume glucose and deplete ROS with the inherent antioxidants, during the daytime. At night, Chlorella was inactivated in situ by chlorine dioxide with human-body harmless concentration to utilize its abundant contents. It was verified in vitro that the inactivated-Chlorella could supply nutrition, relieve inflammation and terminate the oxygen-consumption of Chlorella-respiration. The advantages of living Chlorella and its contents were integrated ingeniously. The abovementioned functions were proven to accelerate cell proliferation, migration and angiogenesis in vitro. Then, streptozotocin-induced diabetic mice were employed for further validation. The in vivo outcomes confirmed that Chlorella could ameliorate the undesirable microenvironments, including hypoxia, high-glucose, excessive-ROS and chronic inflammation, thereby synergistically promoting tissue regeneration. Given the results above, Chlorella is considered as a tailor-made therapeutic strategy for diabetic wound healing.

Anti-aging Mechanism of Chinese Medicinal Polysaccharides： A Review / 中国实验方剂学杂志

In the greying society， pension burden and high incidence of geriatric diseases have hindered social and economic development to a certain extent. Aging is a biological process involving multiple organs and factors， which leads to the occurrence of a variety of diseases. The occurrence of aging is related to a variety of signal pathways， such as nutrient sensing signal pathway and intracellular stress signal pathway， which attracts the interest of scholars in anti-aging drugs and poses a challenge to the development of such drugs. The anti-tumor， hypoglycemic， hypolipidemic， antioxidant， and antiviral activities of Chinese medicinal polysaccharides have been gradually confirmed， and they also have significant advantages in anti-aging. Thus， they are potential candidates for the development of anti-aging drugs. It has been verified that Chinese medicinal polysaccharides exert the anti-aging effect through a variety of mechanisms. To be specific， through dietary restriction， they promote the expression of longevity genes silencing information regulator 1 （Sirt1） and forkhead box O （FoxO） transcription factor， enhance the sensitivity to insulin， activate Sirt1 deacetylase or inhibit insulin/IGF-1 signaling （IIS） and mammalian target of rapamycin （mTOR） signal pathway， thereby exerting the anti-aging effect. In addition， they can inhibit the production of reactive oxygen species （ROS） and the release of pro-inflammatory mediators， enhance anti-inflammatory and antioxidant capacity， and regulate the immunity to inhibit inflammation and aging. Moreover， they can also inhibit apoptosis and delay aging through p53-mediated pathway. Despite the extensive research on anti-aging effect of Chinese medicinal polysaccharides， and the diverse effects and ideal efficacy of the polysaccharides， the anti-aging mechanism has not been systematically reviewed. Therefore， this paper summarizes the relevant literature in PubMed and CNKI and systematically expounds the aging-related signal pathways regulated by Chinese medicinal polysaccharides， which is expected to provide a reference for researchers and clinical workers.

Research progress on non-surgical treatment of ameloblastoma / 中华放射肿瘤学杂志

Ameloblastoma is a relatively common benign tumor that occurs in the dental epithelial tissues, which is characterized with local infiltration and growth, high-risk recurrence and metastasis, etc. At present, radical osteotomy is the main treatment of ameloblastoma, whereas it yields high recurrence rate and causes multiple postoperative complications such as facial and functional deformities, etc. For inoperable patients, non-surgical interventions, such as radiotherapy, chemotherapy and molecule-targeted therapy, are urgently needed to improve prognosis and retain organs. This article summarizes the current status and research progresses on non-surgical treatment of ameloblastoma, aiming to provide evidence for individualized treatment of ameloblastoma.

Relationship between the macular retina vascular density and retinal circulation time in CRAO patients / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the macular retina vascular density of patients with acute central retinal artery occlusion(CRAO)by optical coherence tomography angiography(OCTA)and to analyze the relationship with retinal circulation time of these patients on fundus fluorescein angiography(FFA).METHODS: Retrospective case analysis. A total of 43 patients(43 eyes)from January 2019 to March 2021 admitted to Shaanxi Eye Hospital with clinical diagnosis of acute CRAO(course of disease ≤7d)were included. All patients underwent FFA, OCTA, best corrected visual acuity(BCVA)examination and thrombolytic therapy. The patients with enhanced or unchanged retinal blood flow signal in the affected eye showed on OCTA before treatment compared with the contralateral healthy eye were assigned to group A, and the patients with retinal blood flow signal of the affected eye was lower than that in the contralateral healthy eye by OCTA were assigned to group B. Image J software was used for OCTA image processing to evaluate the macular retina vascular density before treatment, and FFA examination was performed to record the affected retinal circulation time before treatment.RESULTS: The retinal vascular density of patients in the affected eye and the contralateral healthy eye in group A was higher than that in group B(25.08%±4.40% vs 12.24%±3.41%, 25.72%±2.70% vs 17.89%±4.55%, all P&#x003C;0.001), the filling time(FT)of retinal artery trunk to terminal in group B [96(20.50, 193.50)s] was longer than that in group A [11(5.00, 19.50)s](P&#x003C;0.001). The course of disease, the retinal vascular density of contralateral healthy eye and FT were related factors of retinal vascular density of the affected eye(all P&#x003C;0.05), and the influence strength order was FT, course of disease and the retinal vascular density of contralateral healthy eye, in which the course of disease and FT was negatively correlated with the retinal vascular density.CONCLUSION: OCTA retinal vascular density was correlated with FFA retinal circulation time in CRAO patients.

Catalpol Inhibits Tregs-to-Th17 Cell Transdifferentiation by Up-Regulating Let-7g-5p to Reduce STAT3 Protein Levels

Purpose@#Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease, and Th17 cells are key factors in the pathogenesis of human inflammatory conditions, such as RA. Catalpol (CAT), a component in Rehmanniae Radix (RR), has been found to regulate human immunity. However, the effects of CAT on Th17 cell differentiation and improvement of RA are not clear. @*Materials and Methods@#Collagen-induced arthritis (CIA) mice were constructed to detect the effects of CAT on arthritis and Th17 cells. The effect of CAT on Th17 differentiation was evaluated with let-7g-5p transfection experiments. Flow cytometry was used to detect the proportion of Th17 cells after CAT treatment. Levels of interleukin-17 and RORγt were assessed by qRT-PCR and enzyme-linked immunosorbent assay. The expression of signal transducer and activator of transcription 3 (STAT3) was determined by qRT-PCR and Western blot. @*Results@#We found that the proportion of Th17 cells was negatively associated with let-7g-5p expression in CIA mice. In in vitro experiments, CAT suppressed traditional differentiation of Th17 cells. Simultaneously, CAT significantly decreased Tregs-to-Th17 cells transdifferentiation. Our results demonstrated that CAT inhibited Tregs-to-Th17 cells transdifferentiation by up-regulating let-7g-5p and that the suppressive effect of CAT on traditional differentiation of Th17 cells is not related with let-7-5p. @*Conclusion@#Our data indicate that CAT may be a potential modulator of Tregs-to-Th17 cells transdifferentiation by up-regulating let-7g-5p to reduce the expression of STAT3. These results provide new directions for research into RA treatment.

The value of quantitative artificial intelligence measurement in evaluation of CT dynamic changes for COVID-19 / 中华放射学杂志

Objective:To investigate the value of artificial intelligence (AI)-assisted quantitative measurement in evaluation of the dynamic changes of CT for COVID-19 pneumonia.Methods:The clinical and chest CT dynamic imaging data of 99 patients with confirmed COVID-19 pneumonia who were hospitalized in Wuhan Central Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 15, 2020 to March 10, 2020 were retrospectively analyzed. According to the definitive diagnosis, the 99 patients were classified into common ( n=36), severe ( n=33) and critical ( n=30) type, the CT imaging findings of each type were analyzed, including CT basic signs, total volume of pneumonia lesions and percentage of pneumonia lesions of the total lung volume (volume ratio). AI software was used to quantitatively evaluate the dynamic changes of chest CT images. The quantitative indicators included CT peak time of lesions, total volume of lesions peak, volume ratio of lesions peak, maximum growth rate of total volume and maximum growth rate of volume ratio. Kruskal-Wallis rank sum test was used to compare the difference of quantitative indexes between the 3 types, and χ 2 test or Fisher exact probability test was used to compare the difference of qualitative indexes between the 3 types. Sequence measurement and scatter plots were used to show the evolution trend of the volume ratio of the three types of COVID-19 pneumonia lesions. The ROC curve was used to analyze the value of the volume ratio of pneumonia lesions and its maximum growth rate in predicting the conversion of common pneumonia to severe or critical pneumonia. Results:There were statistically significant differences in age and gender distribution among patients with common, severe and critical COVID-19 ( P<0.05), the age of severe and critical types were significantly higher than that of common type ( P<0.01). Compared with common [2.5 (1.0, 5.0) d] and critical type[2.5 (1.0, 4.0) d], the time from onset to the first chest CT scan of severe type was prolonged [5.0 (2.5, 8.0) d, P<0.01]. There were statistically significant differences in involvement of multiple lung lobes (20 cases, 29 cases, 25 cases, χ2=10.403, P=0.006) in patients with common, severe and critical COVID-19 at the first scan, the incidence of the involvement of multiple lung lobes in severe and critical types was significantly higher than that of common type ( P=0.002). The volume ratios of patients with common, severe and critical COVID-19 at the first scan were statistically significant [1.0% (0.2%, 4.7%), 9.30% (1.63%, 26.83%), 2.10% (0.64%, 8.61%), Z=14.236, P=0.001], and the volume ratio of severe type was significantly higher than that of common type ( P<0.001), there was no statistically significant difference between common type and critical type ( P=0.062). Follow-up CT showed that the pneumonia lesions showed a dynamic transformation of progress and recovery, and it was seen that the coexistence of multiphase lesions. The trend line in the scatter plot of the three types of COVID-19 pneumonia lesions showed that the lesions in the advanced stage developed from less to more. The lesion peak volume ratios of the common, severe and critical types were 9.75% (4.83%, 13.18%), 29.80% (23.99%, 42.36%) and 61.81% (43.73%, 72.82%), respectively, the difference was statistically significant ( Z=74.147, P<0.001). The maximum growth rates of lesion volume ratio were 1.27% (0.50%, 1.81%)/d, 4.39% (3.16%, 5.54%)/d and 6.02% (4.77%, 9.96%)/d, respectively, the difference was statistically significant ( Z=52.453, P<0.001). The peak times of lesions were 12.0 (9.0, 15.0) d, 13.0 (10.0, 16.0) d and 16.5 (12.0, 25.0)d, respectively, the difference was statistically significant ( Z=9.524, P=0.009). Taking the volume ratio of pneumonia lesion 22.60% and the maximum growth rate of the volume ratio 1.875%/d as the boundary value, the sensitivity of diagnosing common type to severe or critical type was 92.10% and 96.83%, and the specificity was 100% and 80.56%, respectively. The area under the curve was 0.987 and 0.925, respectively. Conclusions:The lesions of COVID-19 pneumonia show a similar parabolic change on CT imaging. The use of AI technology to dynamitcally and accurately measure the CT pneumonia lesion volume ratio is helpful to evaluate the severity of the disease and predict the development trend of the disease. Patients with a rapid growth of volume ratio are more likely to become severe or critical type.

Regional hemovigilance system for adverse reactions to blood donation / 中国输血杂志

【Objective】 To establish a regional hemovigilance system of adverse reactions to blood donation(ARBD) and to evaluate its operation effect. 【Methods】 A regional monitoring working group was established to improve the ARBD monitoring system in two phases [phase-ⅠJanuary-June, 2019 and phase-Ⅱ July-December, 2019). The suitability of monitoring standards and reporting approaches, as well as the running effect of this system were evaluated by comparing the accuracy of ARBD classification and severity grading, timely report processing and the contents of reports submitted in two phases. The incidence of ARBD and the number of different types of ARBD cases in the two phases were analyzed to compare the monitoring effect. 【Results】 7 and 17 blood banks joined the regional working groups in phase-Ⅰand phase-Ⅱ, respectively. In phase-Ⅰ, 565 cases of ARBD were reported, 72.04%(407/565)of them was accurately sorted and 80.95%(34/42)were timely reported. Over 99% of reports covered such monitoring items as blood donors′ gender, type of blood donation, place of blood donation, organization mode of blood donation, symptom of ARBD, type, severity grading and other related factors, and less than 20% of reports recorded the details concerning the treatment following ARBD. In phase-Ⅱ, 1098 cases of ARBD were reported, 94.54%(1 038/1 098)of them was accurately sorted and 96.08%(98/102)were timely reported. Over 97% of reports covered the monitoring items mentioned above, still less than 30%, though elevated in comparison with phase-Ⅰ, of reports recorded the details concerning the treatment following ARBD, and less than 20% tracked the ARBD. The overall incidence of ARBD reported was 0.87%, while 0.93%(1 098/118 565)in phase-Ⅱ and 0.77%(565/73 267)in phase-Ⅰ, with statistically significant differences (P<0.01). 【Conclusion】 The regional monitoring system for ARBD in Chongqing, with Blood Safety Hemovigilance Guidelines(T/CSBT 001-2019)as the standard and the Blood Safety Monitoring Management Information System as the reporting approach, has been basically established through two phases of development, and the reporting contents need to be further managed at specific levels.

Prognosis evaluation of ameloblastoma—A study based on SEER database / 中华放射肿瘤学杂志

Objective:Ameloblastoma (AM) is a rare tumor derived from dental epithelial tissues, which is prone to recurrence and infiltration. This study aims to identify the prognostic factors of AM.Methods:207 ameloblastoma patients were screened from the SEER database. A Cox regression model and nomogram were constructed to evaluate the factors on the overall survival. Clinical data of 61 patients admitted to Hunan Cancer Hospital were retrospectively analyzed. The independent factors of recurrence rate were analyzed by the Cox regression model.Results:The results on the SEER database showed that age, tumor size, type of surgery, radiotherapy were important prognostic factors of the overall survival. The nomogram was constructed and the C-index was equaled to 0.821, indicating this model was moderately accurate. The receiver operating characteristic (ROC) curve demonstrated that the area under the ROC curve (AUC) at 1, 3, 5, and 10 years were 0.852, 0.869, 0.856, and 0.879, indicating this model had relatively high sensitivity and specificity. Kaplan- Meier survival analysis suggested that overall survival in the high-risk group was significantly lower than that in the low-risk group ( P<0.001). Based on retrospective analysis, clinical symptoms and type of surgery were the independent factors of the local recurrence rate. Kaplan- Meier survival analysis found the recurrence rate of facial swelling and pain was lower compared to those of other symptoms. Compared with the palliative surgery, radical surgery could decrease the recurrence rate. Conclusions:Age, tumor size, type of surgery, and radiotherapy may be important factors of the overall survival. Type of surgery and clinical symptoms are probably the independent factors of the recurrence rate.

Distribution Characteristics of Traditional Chinese Medicine Syndromes for Abnormal Uterine Bleeding Associated with Ovulatory Dysfunction: A Clinical and Epidemiological Investigation / 中国实验方剂学杂志

Objective:To explore the distribution characteristics of traditional Chinese medicine （TCM） syndromes of abnormal uterine bleeding associated with ovulatory dysfunction （AUB-O）. Method:A clinical and epidemiological investigation was conducted in 6 688 patients with AUB-O from the provincial， municipal， and county/district hospitals in 29 provinces， autonomous regions， and municipalities across China to identify the distribution characteristics of their TCM syndromes. Result:The AUB-O patients nationwide were mainly differentiated into the kidney Qi deficiency syndrome （17.34%）， the spleen Qi deficiency syndrome （13.25%）， the Qi and blood deficiency syndrome （12.62%）， the Qi deficiency and blood stasis syndrome （8.45%）， and the kidney Yin deficiency syndrome （6.88%）. AUB-O resulted from Qi deficiency， Yin deficiency， and blood deficiency， often involving the kidney， spleen and liver. The analysis of the regional distribution of TCM syndromes in AUB-O patients revealed that kidney Qi deficiency， spleen Qi deficiency， and Qi and blood deficiency were the shared syndromes. However， due to regional discrepancy， the TCM syndrome varied widely from one geographic region to another. The kidney Qi deficiency syndrome was more frequently seen in North China， Northwest China， Southwest China， and East China， but less frequently in central China， Northeast China， and South China. The spleen Qi deficiency syndrome occurred most frequently in central China， while the East China had the highest frequency of Qi and blood deficiency syndrome. The spleen and kidney deficiency syndrome was mostly present in central China， North China， and Southwest China， the Qi deficiency （kidney deficiency） and blood stasis syndrome in Northwest China， South China， and North China， the kidney Yin deficiency syndrome in East China， Northwest China， and Northeast China， the deficiency-heat syndrome in Southwest China and East China， the kidney Yang deficiency syndrome in South China， the liver depression and blood heat syndrome in Northeast China， and the liver depression and spleen deficiency syndrome in central China. The diagnostic criteria for the kidney Qi deficiency， spleen Qi deficiency， Qi and blood deficiency， Qi deficiency and blood stasis， and kidney Yin deficiency syndromes were not significantly different from the previous ones. The distinctive symptoms for the kidney Qi deficiency syndrome were irregular vaginal bleeding， heavy menstrual flow， or shortened menstrual cycle， back soreness and pain， and forgetfulness， while those for the spleen Qi deficiency syndrome mainly included the shortened menstrual cycle， mental fatigue， lack of strength， poor appetite， loose stool， and white tongue coating. The Qi and blood deficiency syndrome were mainly manifested as the shortness of breath， laziness to speak， pale complexion， dizziness， and palpitation. The Qi deficiency and blood stasis syndrome were mainly judged by the scanty menstrual flow frequently or occasionally accompanied by blood clots， mental fatigue， lack of strength， and dark purple tongue. The ovulatory bleeding， dizziness， tinnitus， vexing heat in chest， palms and soles， and night sweat were the characteristic signs for the kidney Yin deficiency syndrome. Conclusion:There exist certain rules in the geographical distribution of TCM syndromes of AUB-O patients， which has provided a reference for the clinical treatment of AUB-O in accordance with the local conditions.

Experience in the diagnosis and treatment of a drug-induced pemphigus / 华西口腔医学杂志

Drug-induced pemphigus (DIP) is a special type of pemphigus, and its pathogenesis, characteristics of treatment, and prognosis are closely related to the inducing drugs. This article reports the diagnosis and treatment of DIP (pemphigus vulgaris) caused by the administration of rifampin to a patient with tuberculosis. Combined with the literature, we discussed the types, pathogenesis, differential diagnosis, and treatment principles of DIP. We propose that in the oral clinical practice for patients with pemphigus vulgaris, the importance of investigating suspected drugs that induce DIP should be emphasized.

A review of lignans from genus Kadsura and their spectrum characteristics / 中草药·英文版

Kadsura belongs to the Schisandroideae subfamily of Magnoliaceae. Plants from genus Kadsura are widely distributed in the South and Southwest of China. The plants of the genus are widely used as folk medicine for a long time in history, with the functions of relieving pain, promoting ‘qi’ circulation, activating blood resolve stasis, and applications in the treatment of rheumatoid arthritis and gastroenteric disorders. Lignans are the primary characteristic constituents with various biological activities of plants from genus Kadsura. This paper summarized 81 lignans isolated from the plants of genus Kadsura over the past eight years (from 2014 to 2021), which belong to five types: dibenzocyclooctadienes, spirobenzofuranoid dibenzocyclooctadienes, aryltetralins, diarylbutanes and tetrahydrofurans. Each type of these lignans possess typical characteristics in proton magnetic resonance (

Kadsura coccinea: A rich source of structurally diverse and biologically important compounds / 中草药·英文版

Kadsura coccinea belongs to medicinally important genus Kadsura from the Schisandraceae family. It has been used in traditional Chinese medicine (TCM) for the treatment of rheumatoid arthritis and gastroenteric disorders. The initial phytochemical work focused on the identification of some structurally novel and diverse natural products, which turned the attention of many researchers towards this plant. Thus far, 202 compounds have been reported in this plant. Lignans and terpenoids were found as the main chemical constituents of this plant. Some of the triterpenoids and sesquiterpenoids with novel structures are of particular interest for natural product researchers. The isolated compounds of this plant have shown different bioactivities including anti-tumor, anti-HIV, anti-inflammatory, nitric oxide (NO) production inhibitory and other pharmacological effects. This review systematically summarizes all the phytochemical and pharmacological work done so far on K. coccinea, and can be used as a reference for future research on this plant.

Study on Fingerprint and in vitro Antiviral Activity of Lonicera japonica Polysaccharide / 中国药房

OBJECTIVE：To establis h the fingerprint of Lonicera japonica polysaccharide，and to investigate in vitro inhibitory effect of it on respiratory syndrome virus （RSV）. METHODS ：Polysaccharide from L. japonica was prepared by water extraction and twice alcohol precipitation method. After hydrolysis with trifluoroacetic acid ，derivatization with hydroxylamine hydrochloride and pyridine ，the fingerprint was established by GC method. The determination was performed on HP- 5 capillary column ，and the detector was flame ionization detector ；the temperature of the sample inlet was 250 ℃；the temperature of the detector was 300 ℃ （programmed temperature ）；the carrier gas was nitrogen （flow rate of 50 mL/min）；split sampling was adopted （split ratio of 60∶1）；the sample size was 2.0 μL. Using rhamnose as reference substance，GC fingerprint of 12 batches of L. japonica （S1-S12） was drawn ，and the similarity evaluation was performed with Similarity Evaluation System of TCM Fingerprint （2012 edition）. Cluster analysis and principal component analysis were conducted by using SPSS 21.0 software. Using ribavirin as positive control ， half effective concentration （EC50）and treatment index （TI）as indexes ，MTT assay was used to investigate in vitro inhibitory effect of L. japonica polysaccharide on RSV. RESULTS ：There were 12 common peaks in GC fingerprint of 12 batches of L. japonica. The similarity was greater than or equal to 0.994. Seven common peaks were identified ，such as rhamnose ，arabinose， fucose，mannose，glucose，galactose，inositol hexaacetate. According to the cluster analysis ，12 batches of samples could be divided into two categories ，i.e. S 1，S7，S10 and S 11 clustered into one category ，and others clustered into one category. In principal component analysis ，the eigen values of 3 principal components were all greater than 1 （5.659，2.745，1.724 respectively），and their cumulative contribution rate was 84.400％. The comprehensive score of S 12 was the highest ，the second was S 5，and the lowest was S 11. EC 50 of total polysaccharide ，80％ alcohol precipitated polysaccharide ，50％ alcohol precipitated polysaccharide and 20％ alcohol precipitated polysaccharide of L. japonica （No. S 12） were 0.76，0.61，1.03，3.04 g/L， respectively；TI were 15.36，18.51，11.69，4.22，respectively. EC 50 of 80％ ethanol alcohol precipitated polysaccharide was the lowest，and its TI was close to that of positive control （20.08）. CONCLUSIONS ：Established fingerprint provides reference for the quality evaluation of L. japonica . L. japonica polysaccharide has a certain inhibitory activity on RSV in vitro ，and the 80％ alcohol precipitated polysaccharide has the strongest activity.

Radiomics features of ascending and descending nasopharyngeal carcinoma / 中南大学学报(医学版)

OBJECTIVES@#To evaluate the application value of CT-based radiomics features for the ascending and descending types of nasopharyngeal carcinoma (NPC).@*METHODS@#A total of 217 NPC patients (48 ascending type and 169 descending type), who obtained CT images before radiotherapy in Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University from February 2015 to October 2017, were analyzed retrospectively. All patients were randomly divided into a training set (=153) and a test set (=64). Gross tumor volume in the nasopharynx (GTVnx) was selected as regions of interest (ROI) and was analyzed by radiomics. A total of 1 300 radiomics features were extracted via IBEX. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to choose the significant features. Support vector machine (SVM) and random forest (RF) classifiers were built and verified.@*RESULTS@#Six features were selected by the LASSO from 1 300 radiomics features. Compared with SVM classifier, RF classifier showed better classification performance. The area under curve (AUC) of the receiver operating characteristic (ROC) curve, accuracy, sensitivity, and specificity were 0.989, 0.941, 1.000, and 0.924, respectively for the training set; 0.994, 0.937, 1.000, and 0.924, respectively for the validation set.@*CONCLUSIONS@#CT-based radiomics features possess great potential in differentiating ascending and descending NPC. It provides a certain basis for accurate medical treatment of NPC, and may affect the treatment strategy of NPC in the future.

Catheter-directed thrombolytic therapy with endovascular angioplasty for TASC-D type aorto-iliac artery occlusive diseases / 中华普通外科杂志

Objective:To investigate the feasibility, indication selection and treatment of Catheter- directed thrombolytic therapy with endovascular angioplasty for TASC- D type aorto- iliac artery occlusive diseases.Methods:From Jan 2014 to Jun 2017, the clinical data of 27 patients (33 limbs) with TASC- D type aorto- iliac artery occlusive diseases were analyzed retrospectively.Results:After catheter embolization , 31 limbs were successfully treated with endovascular angioplasty, the success rate was 93.9% (31/33). ankle brachial index (ABI) of successful limbs improved from (0.47±0.09) preoperatively to (0.80±0.11) postoperatively ( P<0.01). The patency rates of 6、12、24 months were 90.32%, 80.65%, 77.42%. One case (3.85%)suffered hematoma.There were no other major complications such as iliac artery rupture, arteriovenous fistula, deep vein thrombosis or pseudoaneurysm. Conclusions:Catheter-directed thrombolytic therapy can effectively reduce artery lumen thrombosis volume. Catheter- directed thrombolytic therapy with endovascular angioplasty for TASC- D type aorto- iliac artery occlusive diseases is a safe and effective treatment.

Hematological toxicity of 89SrCl2 in patients with multiple bone metastases / 中华核医学与分子影像杂志

Objective To observe the hematological toxicity of 89SrCl2 in patients with multiple bone metastases of malignant tumors,and analyze the related-risk factors.Methods A total of 89 patients (63 males,26 females;age:(62.3±5.2) years) with multiple bone metastases and treated with 89SrCl2 were enrolled.Hematological data at 2 and 4 weeks after treatment with 89SrCl2 were analyzed.Common Terminology Criteria for Adverse Events (CTCAE) v4.03 was used to evaluate the hematological toxicity,and the influencing risk factors were analyzed.Logistic regression analysis was used to analyze the data.Results The incidences of grade Ⅰ-Ⅱ anemia,leukopenia and thrombocytopania at 2 and 4 weeks after treatment were 15.7％(14/89),18.0％(16/89),11.2％(10/89) and 18.0％(16/89),24.7％(22/89),18.0％(16/89),respectively.The incidences of grade Ⅲ-Ⅳ anemia,leukopenia and thrombocytopenia were 2.2％(2/89),0,0 and 2.2％(2/89),2.2％(2/89),3.4％％(3/89),respectively.Logistics multivariate analysis showed that the number of bone metastases and the Hb level before treatment were independent effect factors for hematological toxicity of 89SrCl2,with odds ratio (OR) values of 2.200(95％ CI:1.269-3.841) and 0.961 (95％ CI:0.932-0.991),respectively.Conclusions Serious hematological toxicity after 89SrCl2 treatment is rare.The number of bone metastases and the Hb level before treatment are independent effect factors for hematological toxicity.

Effects of definitive repair surgery on health-related quality of life in patients with bile duct injury after laparoscopic cholecystectomy / 中华消化外科杂志

Objective To investigate the effects of definitive repair surgery on health-related quality of life (HRQOL) in patients with bile duct injury after laparoscopic cholecystectomy (LC).Methods The retrospective case-control study was conducted.The clinicopathological data of 181 patients with bile duct injury caused by LC for benign gallbladder diseases who underwent definitive repair surgery and 50 patients without complications after LC for benign gallbladder diseases in the Mianyang Central Hospital from January 2000 to December 2017 were collected.There were 82 males and 99 females of 181 patients with bile duct injury,aged from 31 to 68 years,with an average age of 47 years.Definitive repair surgery was performed according to different types of bile duct injury,and questionnaire of HRQOL was conducted preoperatively and one year after operation.There were 18 males and 32 females of 50 patients without complications after LC,aged from 35 to 69 years,with an average age of 41 years.Questionnaire of HRQOL was conducted on LC patients without complications one year after operation.Observation indicators:(1) classification of bile duct injury;(2) intraoperative situations of definitive repair surgery;(3) postoperative situations of definitive repair surgery;(4) follow-up;(5) results of the SF-36 scale assessment.Follow-up was conducted by outpatient examination and telephone interview up to December 2018.Patients were reexamined liver function and color Doppler ultrasonography once every 6-12 months,and further magnetic resonance cholangiopancreatography (MRCP) or computed tomography examination to detect recurrence of anastomotic biliary stricture and cholangitis.Measurement data with normal distribution were expressed as Mean±SD,and comparison between groups was analyzed by the paired t test.Measurement data with skewed distribution were described as M (range),and count data were described as absolute numbers.Results (1) Classification of bile duct injury:of the 181 patients with bile duct injury,there were 64 cases of E1 type,70 cases of E2 type,35 cases of E3 type,9 cases of E4 type,and 3 cases of E5 type.(2) Intraoperative situations of definitive repair surgery:all the 181 patinets with bile duct injury underwent definitive repair surgery successfully,including 61 undergoing end-to-end biliary anastomosis,109 undergoing Roux-en-Y choledojejunostomy,11 undergoing hemi-hepatectomy combined with Roux-en-Y anastomosis.There were 52 patients combined with hilar cholangioplasty.The operation time and volume of intraoperative blood loss of 181 patients were (190±126) minutes and 601.5 mL (range,150.0-2 100.0 mL).There were 24 cases with blood transfusion and 18 cases with T-tube stent.(3) Postoperative situations of definitive repair surgery:40 of 181 patients had complications,including 14 cases of incisional infection,10 cases of bile leakage,8 cases of perihepatic effusion,7 cases of pulmonary infection,and 1 case of abdominal hemorrhage.The patient with postoperative abdominal hemorrhage underwent reoperation for hemostasis,and other patients with complications were cured after ultrasound-guided puncture and drainage or conservative treatment.Duration of postoperative hospital stay of 181 patients with bile duct injury was 12.6 days (range,6.0-34.0 days).There was uo perioperative death occurred.(4) Follow-up:157 of 181 patients were followed up for 8.2-201.3 months,with a median follow-up time of 92.7 months.Twenty-eight patients had anastomotic stricture recurred,16 of which were treated with reoperation,10 were treated with endoscopic stent implantation,and 2 cases were treated with balloon dilatation in interventional department;the stricture was repaired again in all cases.Thirteen patients had recurrent cholangitis,showing no obvious anastomotic stricture on MRCP,and symptoms can be effectively controlled after conservative treatment.(5) Results of the SF-36 scale assessment:181 patients with bile duct injury completed the SF-36 scales before definitive repair surgery,and 157 completed one year after definitive repair surgery.All the 50 patients without complications completed SF-36 scales one year after LC.The scores of HRQOL in physiological function,role functioning,somatic pain,general health,vitality,social function,emotional function,mental health,the scores of physical component summary,and mental component summary of 181 patients with bile duct injury before surgery were 79±15,65±12,40±17,42±14,59±20,27±15,48±23,56±22,60±11,and 56±11,respectively.The above indices one year after definitive repair surgery were 87±10,78±15,71±20,64±20、68± 19,70 ± 25,67 ± 21,69 ± 23,71 ± 13,68 ± 15,respectively.The above indices of 50 patients without complications one year after LC were 90±13,81±20,87±16,72±20,73±15,86±17,79±22,77±19,82±18,79 ± 18,respectively.The 181 patients with bile duct injury had significant elevation in above indices one year after definitive repair surgery (t=2.051,2.016,3.875,3.014,2.563,3.225,2.964,2.357,2.150,2.203,P＜0.05).The 50 patients without complications also had significant elevation in above indices one year after definitive repair surgery (t=2.817,2.206,3.641,3.112,3.202,3.310,3.011,2.899,2.150,2.118,P＜0.05).There were significant differences in the general health and mental health one year after definitive repair surgery between 181 patients with bile duct injury and 50 patients without complications (t =2.014,2.011,P＜0.05),and no significant difference in the physiological function,role functioning,somatic pain,vitality,social function,or emotional function between the two groups (t=0.852,0.915,0.907,1.102,1.284,1.120,0.863,1.109,P＞0.05).Conclusion Definitive repair surgery can significantly improve HRQOL in patients with bile duct injury caused by LC.

Protective effects on hippocampal neurons and the influence on hippocampal monoamine neurotransmitters with acupuncture for promoting the circulation of the governor vessel and regulating the mental state in rats with post-stroke depression / 中国针灸

OBJECTIVE@#To observe the effects on hippocampal neuronal structure and hippocampal monoamine neurotransmitters such as norepinephrine (NE), 5-hydroxytryptamine (5-HT) and dopamine (DA) with acupuncture for promoting the circulation of the governor vessel and regulating the mental state ( acupuncture) in rats with post-stroke depression and explore the underlying effect mechanism of acupuncture on post-stroke depression.@*METHODS@#A total of 48 clean-grade SD rats were randomized into a sham-operation group, a model group, a Tongdu Tiaoshen acupuncture group and a non-meridian-non-acupoint group, 12 rats in each one. In the model group, the Tongdu Tiaoshen acupuncture group and the non-meridian-non-acupoint group, the compound method of cerebral medial arterial occlusion and the chronic unpredictable mild stress was adopted to prepare the model of post-stroke depression. In the sham-operation group, skin was opened and the fascia muscle was separated, after artery exposed, no ligation was operated and the incision was sutured directly. In the sham-operation group and the model group, no any intervention was performed. In the Tongdu Tiaoshen acupuncture group, acupuncture was applied to "Baihui" (GV 20), "Shuigou" (GV 26), "Shenting" (CV 24) and "Dazhui" (GV 14) for 40 min in each treatment and the needles were manipulated at the acupoints once in 20 min. The treatment was given once a day, 6 times a week for 4 weeks consecutively. In the non-meridian-non-acupoint group, the depression between the 3rd and 4th metatarsal bones on the dorsum of the forelimb was selected in intervention and the needling technique was same as the Tongdu Tiaoshen acupuncture group. The behavioral changes were observed after intervention in each group. Using transmission electron microscopy, the ultrastructure of hippocampal CA 1 neurons was observed in the rats of each group. Using high performance liquid chromatography, the contents of NE, 5-HT and DA were determined.@*RESULTS@#Compared with the sham-operation group, the Zea-longa neurobehavioral score was increased (<0.01), the sucrose water consumption was reduced (<0.01), the number of times of horizontal movement and vertical movement in open-field test were reduced (both <0.01), the damage of the ultrastructure of hippocampal CA 1 neurons was aggravated and the contents of NE, 5-HT and DA were reduced in the model group (<0.01). Compared with the model group, the Zea-Longa neurobehavioral score was reduced (<0.01), the sucrose water consumption was increased (<0.01), the number of times of horizontal movement and vertical movement in open-field test were increased (both <0.01), the damage of the ultrastructure of hippocampal CA 1 neurons was alleviated and the contents of NE, 5-HT and DA were increased in the Tongdu Tiaoshen acupuncture group (<0.01, <0.05). Compared with the non-meridian-non-acupoint group, the Zea-Longa neurobehavioral score was reduced (<0.01), the sucrose water consumption was increased (<0.01), the number of times of horizontal movement and vertical movement in open-field test were increased (both <0.01), the damage of the ultrastructure of hippocampal CA 1 neurons was alleviated and the contents of NE, 5-HT and DA were increased in the Tongdu Tiaoshen acupuncture group (<0.01, <0.05).@*CONCLUSION@#The acupuncture improves the behavior of the model rats with post-stroke depression, repairs hippocampal neuronal damage, which is probably related to the contents of hippocampal monoamine neurotransmitters (NE, 5-HT and DA).