Preliminary application of a novel distraction reductor in the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution / 中华创伤骨科杂志

Objective:To evaluate a novel distraction reductor in the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution.Methods:From January 2019 to December 2020, 27 patients with unstable distal radius fracture complicated with metaphyseal volar comminution were treated at Department of Orthopaedics, Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences. They were 6 males and 21 females, with an age of (69.4±9.4) years. All fractures were unilateral and closed, involving the right side in 17 cases and the left side in 10 cases. All patients were treated by internal fixation with an anatomical locking plate through the volar approach and the novel distraction reductor was used to reduce the fracture ends. Regular imaging examinations were performed to evaluate the reduction, maintenance and union of fractures after surgery. One year after operation, the curative efficacy was assessed by evaluation of the range of wrist motion, Disabilities of the Arm, Shoulder and Hand (DASH) score, Gartland-Werley score and Bartra radiology score.Results:All the operations went on successfully with a duration of (92.3±8.9) min. All the incisions healed primarily. The follow-up time was (15.9±2.9) months. The radial height, palmar tilt, ulnar inclination and articular surface step-off immediately after operation [(11.23±1.51) mm, 12.10°±3.44°, 20.54°±3.44°, and (0.95±0.42) mm] were not significantly lost compared with those one year after operation [(11.22±1.55) mm, 12.07°±3.44°, 20.51°±3.33°, and (0.93±0.40) mm] (all P>0.05). One year after operation, the range of wrist motion was good with dorsiflexion of 59.7°±5.5°, palm flexion of 63.0°±9.1°, pronation of 66.5°±5.5°, supination of 61.2°±5.6°, radial deviation of 22.7°±4.8°, and ulnar deviation of 30.3°±6.1°; DASH score was 13.5±5.5; Bartra radiology score was 88.6±6.5, giving an excellent and good rate of 88.9% (24/27);Gartland-Werley score was 2.7±2.1, giving an excellent and good rate of 92.6% (25/27). Follow-ups observed no poor fracture healing, internal fixation failure, tendon or nerve injury or traumatic arthritis. Conclusion:In the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution, the novel distraction reductor can lead to ideal reduction of displaced fractures and effectively correct the shortening caused by volar cortex comminution to achieve satisfactory functional effects in clinic.

Cerebral small vessel disease and spontaneous cerebral hemorrhage / 国际脑血管病杂志

Spontaneous intracerebral hemorrhage (ICH) is the second common subtype of stroke, characterized by high morbidity, mortality, and disability. Cerebral small vessel disease (CSVD) refers to a series of clinic, imaging, and pathological syndromes caused by various causes that affect small arteries, arterioles, capillaries, and small venules in the brain. In recent years, there has been increasing research on the correlation between CSVD and ICH recurrence and outcomes. This article mainly reviews the relationship between CSVD imaging markers and ICH, in order to have a deeper understanding of ICH.

Imaging predictors of malignant cerebral edema in patients with acute ischemic stroke / 国际脑血管病杂志

Malignant cerebral edema can lead to increased intracranial pressure, rapid deterioration of neurological function, and even the formation of cerebral hernia. It has the characteristics of high mortality and disability rates, and is a common cause of poor prognosis in patients with acute massive cerebral infarction. Early decompressive craniectomy can effectively improve the neurological outcomes of patients with malignant cerebral edema. Therefore, early prediction of malignant cerebral edema is crucial. This article reviews the formation mechanism and related imaging manifestations of malignant cerebral edema, in order to provide reference and assistance for the early diagnosis and reasonable treatment of malignant cerebral edema after massive cerebral infarction.

Glymphatic system and cerebral edema after ischemic stroke / 国际脑血管病杂志

Glymphatic system is a fluid transport and material clearance system found in recent years. It promotes the flow and exchange of cerebrospinal fluid and interstitial fluid, remove metabolic waste, and maintain the stability of the internal environment of the brain through the perivascular space and aquaporin 4 on astrocytes. Recent studies have shown that the glymphatic system plays an important role in the intake and discharge of the fluid in brain, and the changes of glymphatic system may be an important reason for brain edema after ischemic stroke. This article reviews the pathophysiological mechanism and related therapeutic targets of glymphatic system in the formation of cerebral edema after ischemic stroke, in order to provide new ideas for the treatment of cerebral edema after ischemic stroke.

Effect of a delay mode of a ventricular assist device on hemodynamics of the cardiovascular system / 生物医学工程学杂志

The implantation of biventricular assist device (BiVAD) is more challenging than that of left ventricular assist device for the interaction in the process of multiple input and output. Besides, ventricular assist device (VAD) often runs in constant speed (CS) mode in clinical use and thus BiVAD also faces the problems of low pulsation and imbalance of blood volume between systemic circulation and pulmonary circulation. In this paper, a delay assist mode for a VAD by shortening the support time of VAD was put forward. Then, the effect of the delay mode on cardiac output, pulsation and the function of the aortic valve was observed by numerical method and the rules of hemodynamics were revealed. The research showed that compared with VAD supported in CS mode, the VAD using delay mode in systolic and diastolic period proposed in this paper could meet the demand of cardiac output perfusion and restore the function of the arterial valves. The open ratio of aortic valve (AV) and pulmonary valve (PV) increased with the time set in delay mode, and the blood through the AV/PV helped to balance the left and the right cardiac volume. Besides, delay mode also improved the pulsation index of arterial blood flow, which is conducive to the recovery of the ventricular pulse function of patients.

Comparison of the Characteristics of Plantar Kinetics in Older and Young Male Adults during Walking / 医用生物力学

Objective To compare the differences in plantar kinetics between older male adults and young male adults during walking, and to explore the influences of aging on plantar kinetics. Methods The in-shoe plantar sensory measurement system was used to collect and compare left foot parameters of 13 older men and 14 young men during tandem walk, including contact time, beginning of contact in percentage of roll over process (%ROP), and end of contact in %ROP, peak pressure, instant of peak pressure in %ROP, maximum mean pressure, pressure-time integral, maximum force, instant of maximum force in %ROP, mean force and force-time integral. Results Beside media arch, the contact time on all regions of older men was longer, whereas, the beginning of contact in %ROP on lateral heel, lateral arch was greater, and the end of contact in %ROP on medial heel and 2nd-3rd metatarsal head was smaller compared with young men. The maximum force and mean force on the whole foot region, and the maximum mean pressure and maximum force on 2nd-3rd metatarsal head of older people were significantly lower; the pressure-time integral on the whole foot region, the 4th-5th metatarsal head, the 2nd -5th toes, and the force-time integral on the whole foot region, medial heel, lateral heel and 2nd -5th toes were significantly higher compared with young men. Conclusions During tandem walking, plantar fascia dysfunction might be one of the main reasons for the decline of postural control ability, and the contraction enhancement of flexor digitorum longus and flexor digitorum brevis could compensate for postural stability improvement in older men.

Interventional effect of Chinese herbal preparation Xi Fu Pai Chen in rats with silicosis / 中国职业医学

OBJECTIVE: To investigate the interventional effect of the Chinese herbal preparation Xi Fu Pai Chen(XFPC) on pulmonary inflammation and fibrosis in rats with silicosis. METHODS: A total of 144 adult specific pathogen free male SD rats were randomly divided into 6 groups: blank control group, silicosis model group, drug administration control group and groups of low-dose,medium-dose and high-dose XFPC, with 24 rats in each group. Lung silicosis model was established by single inhalation tracheal instillation method, which was treated with 50.0 g/L silica suspension, in groups except in the blank control group. On the 7 th day of modeling, the rats in the drug administration control group were orally given tetrandrine(5 mg/kg body weight), while those in the low-, medium-and high-dose groups were given 43, 86 and 192 g/L of XFPC by atomization inhalation once a day for 20 minutes, 5 days a week for 4 weeks. At the end of drug administration, the histopathological changes of the lung were observed. The number and classification of cells in bronchoalveolar lavage fluid(BALF)were examined, and the levels of malondialdehyde(MDA) and interferon-gamma(IFN-γ) in BALF were measured by enzyme-linked immunosorbent assay. RESULTS: On the 7 th day after modeling, the body weight in the drug administration control group and XFPC high-dose group decreased compared with the blank control group(P<0.05). On the 35 th day after modeling, the body weights of rats in the other 5 groups were lower than that in the blank control group(P<0.05). The pathological changes of lung tissue(infiltration of inflammatory cells, fibrosis and size of silicon nodule) in drug administration control group and XFPC low-dose group were better than those in silicosis model group by naked eyes and under light microscope. The lung coefficient, the proportion of neutrophils and the level of MDA and IFN-γ in BALF of the drug administration control group and XFPC low-dose group decreased(P<0.05), and the proportion of macrophages in BALF increased(P<0.05) compared with the silicosis model group. There was no significant difference in lung coefficients and the relevant indices of BALF between XFPC medium-, high-dose groups and silicosis model group(P>0.05). CONCLUSION: Low dosage XFPC can improve pulmonary fibrosis and inflammation in rats with silicosis, and its mechanism of action may be related to reducing the levels of IFN-γ and MDA in BALF.

Effects of Long-Term Tai Chi and Jogging on Neuromuscular Latency and Time to Peak of EMG in Older Males during Lateral Sudden Perturbation / 医用生物力学

Objective To compare the differences in long-term jogging and Tai Chi in terms of neuromuscular latency and time to peak of surface electromyography (EMG) in older males during lateral sudden perturbation. In addition, an effective means to enhance neuromuscular response and muscle contraction efficiency of older males during lateral postural challenges was investigated. Methods Postural reactions of young males, older sedentary male controls (without regular exercises), older male joggers (with long-term jogging practice), and older male Tai Chi participants (with long-term Tai Chi practice) were evoked by means of a sudden unpredictable lateral translation platform. Surface EMG signals of peroneus longus, anterior tibialis, gluteus medius, and erector spinae were collected by an EMG detection and analysis system. Results The latencies of peroneus longus, anterior tibialis, and gluteus medius were delayed in the older sedentary male controls compared with those in young males. The neuromuscular reactions of anterior tibialis and erector spinae in older Tai Chi male participants were faster than those of older sedentary male controls. The contraction speeds of peroneus longus, anterior tibialis, and gluteus medius in young males were higher than those in three older groups during sudden lateral perturbations. Conclusions Long-term Tai Chi practice can enhance the responses of ankle and trunk muscles of older males during lateral postural challenges, but it has little effect on the muscle contraction efficiency of older males.

Efficacy and safety of autohemotherapy at acupoint for acne: systematic review / 中国针灸

OBJECTIVE@#To evaluate the efficacy and safety of autohemotherapy at acupoint for acne.@*METHODS@#Randomized controlled trials (RCTs) regarding autohemotherapy at acupoint for acne were searched in CNKI, WanFang, VIP database and PubMed. According to the inclusion and exclusion criteria, two investigators performed the literature screening, data extraction and basis evaluation, independently. Meta analysis was performed by using Review Manager 5.3 software.@*RESULTS@#Eight RCTs were included, involving 573 patients. The combined effect of effective rate was 1.21 (95% : 1.12, 1.30); the combined effect of skin lesions improvement was -1.00 (95%: -2.14, -0.14, ＝1.73, =0.08); the combined effect of recurrence rate was 0.44 (95%: 0.09, 2.15, ＝1.01, =0.31).@*CONCLUSION@#The autohemotherapy at acupoint has better efficacy and skin lesions improvement for acne than control treatment, and autohemotherapy is safer.

Laparoscopic versus open surgery for colorectal cancer in elderly patients / 国际外科学杂志

Objective To compare the early outcomes of laparoscopic and open resection and evaluate the safety and feasibility of laparoscopic surgery in patients with colorectal cancer aged ≥ 70 years.Methods A total of 91 consecutive patients with colorectal adenocarcinoma underwent surgery in Yizheng City People's Hospital between Jan.2009 and Dec.2015.In 91 patients included in this study,38 received laparoscopic surgery and 53 underwent open surgery.Main outcome measures were clinical data,postoperative recovery status and short-term outcomes.Results There were no significant differences between two groups with respect to demographic indicators,clinicopathological results and chronic comorbidities had no significant difference between two groups.No death cases occured in both groups.One patient in the laparoscopic group required conversion to open surgery due to ureteral injury.Laparoscopic surgery was associated with significantly longer operating time [(238 ± 71.3) minutes vs (175 ± 60.8) minutes,P ＜ 0.001],less estimated blood loss [(145 ± 58 ml) vs (186 ± 45) ml,P ＜ 0.001)],a shorter postoperative hospital stay [(11.9 ± 3.9) days vs (14.5 ± 3.7) days],lower overall postoperative complication rate (23.7％ vs 45.3％,P =0.035),wound-related complication rate (2.6％ vs 22.6％,P =0.017) when compared with open surgery.Quality of surgical specimen,lymph nodes harvested were not significantly different between two groups.Conclusion Laparoscopic colorectal cancer surgery is safe and feasible in elderly patients,associated with better short-term outcomes when compared with open surgery.

The application of clinical management guidelines and expert consensus in the standardized resi-dents training / 中华医学教育探索杂志

The existing contents and standards for the standardized residents training are incomplete. Clinical management guidelines and expert consensus should be included in the standardized residents training, since they are very important for clinical decisions. Some guidelines and expert consensus have been included in the standardized residents training in our cardiovascular department,and with the problem-based teaching method, the quality of standardized residents training was improved in the cardiovascular department of ShengJing hospital.

Influence of neuregulin-1 on pacing threshold of low voltage area in rats after myocardial infarction / 心血管康复医学杂志

Objective:To explore the influence of neuregulin- 1 (NRG-1)intervention on pacing threshold of low voltage area in rats after myocardial infarction.Methods:Myocardial infarction model of rat was established via an-terior descending coronary artery ligation.The 34 rats with myocardial infarction were randomly and averagely di-vided into two groups:NRG-1 group (received NRG-1peritoneal injection)and control group (received peritoneal injection of normal saline of the same volume).After two weeks,pacing thresholds were tested in low voltage area related with infarct in rats after myocardial infarction,and Cx43 (an integral membrane protein of the connexin family)expression was measured in low voltage area.Results:After drug intervention two weeks,compared with control group,there was significant reduction in pacing threshold [(1.466±0.503)V vs.(0.7167±0.194)V,P =0.002]in NRG-1 group;there was significant rise in Cx43 expression [(0.30±0.15)vs.(0.95±0.20),P <0.001] in low voltage area in NRG-1 group.Conclusion:Neuregulin-1 significantly reduces pacing threshold of low voltage area in rats after myocardial infarction,the mechanism may be related to increase Cx43 expression and improve e-lectrical conductivity of myocardial cells.

The prognostic value of fragmented QRS in the recurrance of cardiac events in acute myocardial infarction patients underwent emergency percutaneous coronary intervention / 中国介入心脏病学杂志

Objective To study the prognostic value of fragmented QRS (fQRS) in the recurrence of cardiac events in acute STEMI patients underwent emergency percutaneous coronary intervention (PCI). Methods Ninety-two acute STEMI patients who underwent emergency PCI were enrolled. The presence of fQRS was evaluated by a 12-lead ECG in 72 h after PCI. Cardiac events (myocardial infarction, need for revascularization or cardiac death) and all-cause mortality were recorded in all patients during 12 months follow-up. Results Cardiac event rate[15 (31.3%) vs. 4 (9.1%)]were higher in the fQRS group (n=48) compared with the non-fQRS group (n=44) during a mean follow-up of 12 months. A Kaplan-Meier survival analysis revealed significantly lower event-free survival for cardiac events in the fQRS group (P < 0.004). The results of Cox regression model analysis revealed that signiifcant fQRS was an independent signiifcant predictor for cardiac events (HR 2.19, 95%CI 1.38-3.50, P=0.023). Conclusions The presence fQRS is an independent risk factor for poor prognosis in STEMI patients undergoing emergency PCI.

Effect and safety analysis of proximal femur locking compression plate for treatment of intertrochanteric frac-ture in 52 cases of old patients / 局解手术学杂志

Objective To investigate the effect and safety of proximal femur locking compression plate for treatment of intertrochanteric fracture in old patients. Methods Clinical data and visit records of 98 cases of intertrochanteric fracture old patients were analysed retro-spectively. According to the treatment of operative methods, these patients were divided into two groups: 46 patients in the control group were given the dynamic hip screw fixation; the other 52 cases in the observation group were given the proximal femur locking compression plate . Compared the therapeutic effect and safety of the two groups. Results The short-term and long-term therapeutic effect of observation group were significantly better than the control group,and the safety of observation group was higher than that of the control group,the differ-ences were statistically significant (P<0. 05). Conclusion Proximal femur locking compression plates is an effective surgical treatment for old patients with intertrochanteric fracture. It can significantly improve the function of hip joint and reduce the risk of postoperative complica-tions. As it is of significant effect and high safety, it is worthy of clinical popularization.

Early neurological deterioration in acute ischemic stroke / 国际脑血管病杂志

The incidence of early neurological deterioration in acute ischemic stroke is higher, and the clinical prognosis is poor. There is no effective specific prevention and treatment now. This article reviews the advances in research on early neurological deterioration in acute ischaemic stroke in recent years.

Treatment of intertrochanteric fractures by proximal femoral nail and proximal femoral nail antirotation: a comparative study / 中华创伤杂志

Objective To compare the treatment effectiveness of AO/ASIF proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA) in treatment of intertrochanterie fractures. Methods A retrospective study was done on 233 patients with intertroehanteric fractures treated from August 2004 to December 2006. The patients were divided into PFN group (188 patients) and PFNA group (45 patients) for comparing operative procedures and postoperative functional recovery. Results There was statistical difference in aspects of incision length, blood loss and operation time between two groups. The follow-up for 22.8 months showed excellence rate of 89.9% in PFN group and 91.1% in PFNA group, with statistical difference (X2 = 0.06, P > 0.05). There occurred hip varus in one patient and antirotation nail cutting-out in two in PFN group, which was not found in PFNA group. Conclusion PFN and PFNA are both good choices for treatment of intertrochanteric fractures. Compared with PFN, PFNA has more advantages in reducing operation time and blood loss especially for the eider patients with osteoporosis.

Construction and expression of secretary recombinant adenovis vectors carrying mPSMA / 基础医学与临床

Objective To construct secretary recombinant adenoviral vector carrying the mouse prostate-specific mem-brane antigen gene through AdEasy vector system and the immunological outcome was assessed. Methods mPSMA was amplified from plasmid pCR-BluntⅡ-TOPO by PCR and subcloned into transfer vector pAdeno Vator CMV5, The signal peptide DNA sequence of hIL-2 was fused to 5'terminal of mPSMA gene to construct a secretary Ad-mPSMA. pAdv-mPSMA was co-transformed with pAdeno Vator △E1/E3 through homologous recombination. The recombinant adenoviruses were packaged, amplified and purified in HEK293 cells. HeLa cell was infected by recombinant ade-novirus Ad-mPSMA and the expression of mouse prostate-specific membrane antigen gene was detected by RT-PCR and Western blot. The recombinant adenovirus had been immuned mice, sera antibody against mPSMA from immu-nized mice was detected by ELISA. Results The secretary pAd-mPSMA was constructed successfully and typical cytopathic effect (CPE) was observed. The titer of the recombinant adenovirus was 1.32 × 10~(11)IU/mL and expres-sion of mPSMA was confirmed by RT-PCR and Western blot. The specific antibody against mPSMA had been found in serum of the immunized mice. Conclusion mPSMA gene recombinant adenovirus was constructed successfully, which provide a basis for further study on the anti-tumor immunotherapy role of PSMA.

Construction and expression of secretary recombinant adenovis vectors carrying mPSMA / 基础医学与临床

Objective To construct secretary recombinant adenoviral vector carrying the mouse prostate-specific membrane antigen gene through AdEasy vector system and the immunological outcome was assessed.Methods mPSMA was amplified from plasmid pCR-BluntII-TOPO by PCR and subcloned into transfer vector pAdenoVator CMV5,The signal peptide DNA sequence of hIL-2 was fused to 5′terminal of mPSMA gene to construct a secretary Ad-mPSMA.pAdv-mPSMA was co-transformed with pAdenoVator ?E1/E3 through homologous recombination.The recombinant adenoviruses were packaged,amplified and purified in HEK293 cells.HeLa cell was infected by recombinant adenovirus Ad-mPSMA and the expression of mouse prostate-specific membrane antigen gene was detected by RT-PCR and Western blot.The recombinant adenovirus had been immuned mice,sera antibody against mPSMA from immunized mice was detected by ELISA.Results The secretary pAd-mPSMA was constructed successfully and typical cytopathic effect(CPE) was observed.The titer of the recombinant adenovirus was 1.32?1011IU/mL and expression of mPSMA was confirmed by RT-PCR and Western blot.The specific antibody against mPSMA had been foundin serum of the immunized mice.Conclusion mPSMA gene recombinant adenovirus was constructed successfully,which provide a basis for further study on the anti-tumor immunotherapy role of PSMA.

Expressions of Cyclooxygenase-2 and Hypoxia-Inducible Factor-1? in Hepatocellular Carcinoma / 中国普外基础与临床杂志

Objective To investigate the relationship of expressions of cylooxygenase-2(COX-2) and hypoxia-inducible factor-1?(HIF-1?) in hepatocelluar carcinoma(HCC) and the possible antineoplastic mechanism of selective COX-2 inhibitor.Methods The expressions of COX-2 and HIF-1? in 53 cases of HCC tissues were detected immunohistochemically.Western blot was employed to evaluate the effects of variant concentration of COX-2 inhibitor meloxicam on expression of HIF-1? in Cobaltchloride-stimulated SMMC-7721 cell.Results Of 53 tumor tissues,the expression of COX-2 was 22/53(41.5%) strongly positive stained,11/53(20.8%) positive stained,and 20/53(37.7%) negative stained.Meanwhile the expression of HIF-1? was 18/53(34.0%) strongly positive stained,18/53(34.0%)positive stained,17/53((32.1%)) negative stained.The expression of COX-2 was correlated positively with HIF-1? in HCC(r=0.440,P

Effect of MAPK inhibition on the hypoxia hypercapnia-induced pulmonary vasoconstriction / 中国病理生理杂志

AIM:To investigate isometric force displacement in isolated rat main pulmonary artery rings and right main branch pulmonary artery(second pulmonary artery)rings during hypoxia hypercapnia and the role of mitogen activated protein kinase(MAPK).METHODS:The main pulmonary artery rings were dissected from the male Sprague-Dawley rats and were randomly divided into control group and hypoxia hypercapnia group.The second pulmonary artery rings were also randomly divided into control group,hypoxia hypercapnia group,DMSO incubation group,U0126 incubation group and SB203580 incubation group.The tension changes of pulmonary artery rings were monitored in vitro.RESULTS:Under normoxia conditions,there was no statistically significant change between main pulmonary artery rings and second pulmonary artery rings.A biphasic pulmonary artery contractile response to hypoxia hypercapnia in the second pulmonary artery rings was observed instead of a sharp and transient increase in the main pulmonary artery tension.Both p38 MAPK inhibitor SB203580 and ERK1/2 inhibitor U0126 significantly attenuated the delayed,but not early,contractile phase of the biphasic pulmonary artery contraction.CONCLUSION:Acute hypoxia hypercapnia causes a biphasic pulmonary artery contractile response in the second pulmonary artery,and p38 MAPK and ERK1/2 may be two key mediators in the process.