Advances in snake venom studies: from lethal toxins to new drug development / 药学学报

Snake bite is a common acute and severe disease in tropical and subtropical regions, and its public health importance has been largely neglected. Snake venom is a complex mixture of active proteins, polypeptides, and other toxins. Many of these components can target multiple ion channels, cell receptors, and membrane transporters. Compared with traditional small molecule drugs, the proteins and polypeptides from snake venom have stronger specificity and affinity to targets and are especially suitable for novel drug design. The current studies show that snake venom and its components have great potential for development as leading compounds of new drugs. In this paper, the recent advances in main components, toxic effects, and detoxification strategies of snake venom, as well as its pharmacological activities and medical application are reviewed. The aim is to provide reference for clinical diagnosis and treatment of snake bite and development of new drugs based on snake venom.

Tooth loss and multivariable analysis after 5-year non-surgical periodontal treatment on molars with furcation involvement / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the tooth loss status of mandibular molars with furcation involvements after 5-year non-surgical periodontal treatment, and to analyze the factors that affected the tooth loss.@*METHODS@#A retrospective analysis was conducted in 79 patients with chronic periodontitis, who had received non-surgical periodontal treatment and 5 years of periodontal maintenance treatment in Department of Periodontology, Peking University School and Hospital of Stomatology from 1988 to 2012. Their clinical indexes, including probing depth (PD), bleeding index (BI), furcation index (FI) and tooth mobility were both evaluated before treatment and at the last time of the maintenance treatment. Bone resorption at furcation area was measured at the first visit by periapical radiographs taken by professional doctors of medical imaging. The status of tooth loss after 5-year non-surgical periodontal treatment on mandibular molars with furcation involvement, and the factors that affected the tooth loss were analyzed.@*RESULTS@#(1) Non-surgical treatment was significantly effective on the changes of PD in the patients of chronic periodontitis with furcation involvement, while the presence of furcation involvement could affect the improvement of PD here. (2) PD at the furcation area, tooth mobility, vertical bone resorption, and bone resorption area were all significant risk factors of mandibular molar missing (P<0.001), and the same with FI=3 and FI=4 (P=0.017, P=0.007), while age (P=0.703), gender (P=0.243) and smoking history (P=0.895) were not related to the tooth loss in this study. (3) The risk of tooth loss in mandibular molars with FI≥3 were significantly higher than those with FI≤2, and the survival rate of the former was less than 50%.@*CONCLUSION@#The loss of mandibular molars with furcation involvement was related to the furcation involvement, meanwhile the degree of furcation involvement and bone resorption can significantly increase the risk of tooth loss.

Finite element analysis on contact mechanics of cartilage in hips with Cam-type femoroacetabular impingement / 医用生物力学

Objective To compare contact mechanics of cartilage in normal hip and that in hip with Cam-type femoroacetabular impingement (FAI) using finite element method. Methods The 3D finite element models of normal hip and Cam-type FAI hip joints with varied Alpha angles were constructed. The contact pressures and stresses of intra-articular cartilages during routine daily activities, such as walking, sitting and standing, were calculated. Results During the whole gait cycle, the distribution of cartilage contact pressures on Cam-type FAI hip models with varied Alpha angles was similar to that in normal hip model, and no concentrated areas of high contact pressures and Von Mises stresses appeared. While during the motion of sitting and standing, the cartilage contact pressure on Cam-type FAI hip models was higher than that in normal hip model and increased with the Alpha angle increasing, and the contact area was mainly located at anterosuperior region of acetabular rim, where a concentration of high contact pressures and Von Mises stresses appeared. Conclusions Mode of motion is the key factor which causes changes of cartilage contact mechanics in Cam type FAI joints. Abnormally high cartilage contact pressures and Von Mises stresses might be the inducement to cartilage degeneration and eventually lead to osteoarthritis.

Expression of NF-κB and osteopontin of synovial fluid of patients with knee osteoarthritis

OBJECTIVE@#To explore the significance of osteopontin and nuclear factor κB (NF-κB) expression in patients with knee osteoarthritis.@*METHODS@#RT-PCR and enzyme-linked immunosorbent assay were used to measure the Osteopontin (OPN) and NF-κB concentration of knee joint synovial fluid of patients with knee osteoarthritis and trauma fractures, and analyze the relationship between the expressiones of them.@*RESULTS@#OPN and NF-κB expression at the mRNA and protein levels of patients with knee osteoarthritis were significantly higher than the control group. the result showed statistical significance (P<0.05). There was a positive correlation between the OPN levels in synovial fluid of patients with knee osteoarthritis and NF-κB expression levels (P<0.05).@*CONCLUSIONS@#The high expression of OPN and NF-κB are closely related to occurrence and development of knee osteoarthritis.

Release of gluteal muscle contracture by radiofrequency under arthroscopy / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the clinical therapeutic effect of the release of gluteal muscle contracture by radiofrequency under arthroscopy.@*METHODS@#From January 2004 to April 2005, 86 patients with gluteal muscle contracture were treated by radiofrequency release under arthroscopy.The patients were followed-up for 6-18 months(mean=12.6 months).@*RESULTS@#Getting carriage, squatting down while keeping their knees contacting, crossing leg test, and impact on movement were served as evaluation criteria. Of the 86 patients, 79 had excellent results, 5 good, and the rest 2 were acceptable. There was no recurrence at the last follow-up, and all the patients were satisfied.@*CONCLUSION@#For gluteal muscle contracture, radiofrequency release under arthroscopy has minimally invasion, good results and quick recovery.

Operative strategy of the thoracolumbar fracture dislocation / 中南大学学报(医学版)

OBJECTIVE@#To explore the operative strategy and clinical outcome of the thoracolumbar fracture dislocation.@*METHODS@#Forty-two patients with the thoracolumbar fracture dislocation were treated with anterior approach (10 patients), posterior approach (28 patients), and anterior combined with posterior approach (4 patients) in order to construct the stabilities of the spine. The ASIA grades were used to evaluate the recovery of the neurological function, and the improvement of the kyphosis deformities was evaluated by the cobb's angle post-operation.@*RESULTS@#All the patients had no complications of injury in the vascular and neurological system. The ASIA grades after the operation were superior to those of pre-operation, and the cobb's angle was rectified distinctly.@*CONCLUSION@#When appropriate operative strategies are adopted, thoracolumbar fracture dislocation can be treated with satisfactory outcome.

Evaluation and treatment of hemorrhage after hip and knee arthroplasty in the aged / 中南大学学报(医学版)

OBJECTIVE@#To analyze the evaluation and treatment of blood loss during total hip arthroplasty (THA) and total knee arthroplasty (TKA) in the aged .@*METHODS@#We retrospectively surveyed the blood loss and the rehabilitation of 46 cases of TKA and 146 cases of THA older than 60.@*RESULTS@#In the group younger than 70, the mean total blood loss of THA was 1425 mL and the hidden hemorrhage 729 mL (51%); following the TKA, the mean total loss was 1386 mL and the hidden hemorrhage was 890 mL (64%). In the group 70 and older, the mean total blood loss of THA was 1435 mL and the hidden hemorrhage was 769 mL (53%)û following the TKA, the mean total loss was 1380 mL and the hidden hemorrhage was 910 mL (65%). The difference of hidden hemorrhage between the THA and the TKA was both significant by different (p 0.05).@*CONCLUSION@#The aged have poor resistance to blood loss. Hidden hemorrhage in the TKA or THA perhaps is the primary part of the blood loss. Prompt treatment is helpful for the rehabilitation.

Diagnostic value of 2-dimentional ultrasonography and color Doppler flow imaging in primary bone tumor / 中南大学学报(医学版)

OBJECTIVE@#To explore the diagnostic value of 2-dimentional ultrasonography and color Doppler flow imaging (CDFI) in primary bone tumor.@*METHODS@#The hemodynamic parameters such as systolic maximum velocity (Vmax), diastolic minimum velocity (Vmin), resistance index (RI), and pulsatility index (PI) of intratumoral folw in 93 patients with primary bone tumors proved by histopathology were studied using 2-dimentional ultrasonography and CDFI techniques.@*RESULTS@#The bone destruction periosteum response and soft tissue mass were essentially revealed with 2-dimentional ultrasonography techniques. The intratumoral flow features were clearly shown by CDFI. The Vmax and Vmin in malignant bone tumor were significantly higher than those in benign one (P < 0.01). RI and PI in malignant bone tumor were lower than those in benign one (P < 0.01).@*CONCLUSION@#Observing the features of bone tumor and hemodynamic parameters by 2-dimentional ultrasonography and CDFI has a great clinical value in diagnosing primary bone tumor and distinguishing the malignant and benign bone tumors.

Pedicle screws in the posterior reconstructive operation of the lower cervical vertebra / 中南大学学报(医学版)

OBJECTIVE@#To explore the efficiency of the cervical pedicle screws in the posterior reconstructive operation of the lower cervical diseases.@*METHODS@#From November 2001 to July 2003, 31 patients suffering from the lower cervical diseases were treated with the posterior pedicle screws fixation. We put the screws in the inferior articular process of the upper centrum, the lateral of the intervertebral facet center (3 - 5 mm the medial edge of lateral mass). The angles of toe-in sagittal plane varied from 30 degrees to 45 degrees, and the screws were from 18 to 26 mm (22.3 mm) in average.@*RESULTS@#There were 193 pedicle screws in this group, and no one had spinal cord injury or vertebral artery injury. The improvement rate was 84.5%. Follow-up was from 9 to 28 months (17 months in average). The screws were fixed properly without being loose and broken, and the bone graft fusions within 9 to 12 months in the X-ray and CT scan examination were satisfactory. The Japanese orthopaedics association score (JOA) was 9.7 preoperatively, but it was raised to 16.3 postoperatively.@*CONCLUSION@#The posterior reconstructive operation with cervical pedicle screws is a good choice for patients with lower cervical diseases.

Application of ultrasound-guided percutaneous biopsy in the preoperative diagnosis and treatment of bone tumors / 中南大学学报(医学版)

OBJECTIVE@#To investigate the value of color Doppler ultrasonography (CDUS)-guided percutaneous biopsy in the diagnosis and treatment of bone tumors.@*METHODS@#Ultrasound-guided percutaneous biopsy was performed in 64 patients who was diagnosed by CDUS. Puncture instruments included automatic core biopsy device and 14 to approximately 18G crude needle. All cases were identified by the operation and pathological examination.@*RESULTS@#Tissue-obtained rate was 97% (62/64). Comparing preoperative pathological diagnosis with postoperative pathological diagnosis, we found the diagnostic correct rate was 97%. No complications resulted from this procedure. According to their pathological results, 33 patients were treated with preoperative chemotherapy. The tumor sizes decreased, and 26 patients saved their limbs and had normal functions.@*CONCLUSION@#CDUS-guided percutaneous biopsy is safe and quick for the preoperative diagnosis and selecting appropriate surgical procedure for bone tumor treatment.