Two-dimensional liquid chromatography measurement of meropenem concentration in synovial fluid of patients with periprosthetic joint infection.

Periprosthetic joint infection (PJI) is a catastrophic complication following joint replacement surgery. One potential treatment approach for PJI could be the combination of one-stage revision and intra-articular infusion of antibiotics. Meropenem is one of the commonly used intra-articular antibiotics in our institution. Determining the concentration of meropenem in the joint cavity could be crucial for optimizing its local application, effectively eradicating biofilm infection, and improving PJI treatment outcomes. In this study, we developed a simple, precise, and accurate method of two-dimensional liquid chromatography (2D-LC) for determining the concentration of meropenem in human synovial fluid. The method was then validated based on the guidelines of the Food and Drug Administration and the Chinese Pharmacopoeia. Meropenem showed good linearity in the range of 0.31-25.01 µg/mL (r ≥ .999). Selectivity, intra-day and inter-day precision and accuracy, extraction recovery, and stability validation results were all within the acceptance range. This method has been successfully applied to the determination of synovial fluid samples from PJI patients, providing a useful detection method for meropenem therapeutic drug monitoring (TDM) in PJI patients.

Novel antibacterial drug target against Gram-negative bacteria: lipopolysaccharide transport protein LptDE and its inhibitors / 药学学报

The outer membrane composed predominantly of lipopolysaccharide (LPS) is an essential biological barrier for most Gram-negative (G-) bacteria. Lipopolysaccharide transport protein (Lpt) complex LptDE is responsible for the critical final stage of LPS transport and outer membrane assembly. The structure and function of LptDE are highly conserved in most G- bacteria but absent in mammalian cells, and thus LptDE complex is regarded as an attractive antibacterial target. In recent 10 years, the deciphering of the three-dimensional structure of LptDE protein facilities the drug discovery based on such "non-enzyme" proteins. Murepavadin, a peptidomimetic compound, was reported to be the first compound able to target LptD, enlightening a new class of antibacterial molecules with novel mechanisms of action. This article is devoted to summarize the molecular characteristics, structure-function of LptDE protein complex and review the development of murepavadin and related peptidomimetic compounds, in order to provide references for relevant researches.

Efficacy and safety of Aprepitant-containing triple therapy for the prevention and treatment of chemotherapy-induced nausea and vomiting: A meta-analysis.

BACKGROUND: Most cancer patients suffer from the pain of chemotherapy-induced nausea and vomiting (CINV). This meta-analysis was performed to evaluate the efficacy and safety of a regimen consisting of aprepitant, dexamethasone, and 5-HT3 receptor antagonists in the prevention and treatment of CINV. METHODS: A systematic literature search was conducted across multiple databases, including PubMed, EMbase, Cochrane Library, MEDLINE, CENTRAL, HEED, CNKI, Wanfang, and VIP, to identify randomized controlled trials (RCTs) investigating the use of triple therapy (aprepitant, 5-HT3 receptor antagonist, and dexamethasone) to prevent and treat CINV. Meta-analysis was performed using RevMan 5.4 and Stata17 software, employing either a fixed-effect or random-effect model based on statistical heterogeneity. RESULTS: A meta-analysis of 23 randomized controlled trials (RCTs) involving 7956 patients was conducted. Efficacy: Results showed significantly improved complete responses (CRs) for CINV in the test group versus the control group in the overall, acute, and delayed phases. Furthermore, in the test group, substantial alleviation of nausea symptoms was observed in the delayed and overall phases but not in the acute phase. Safety: There was no statistically significant difference in the incidence of febrile neutropenia, diarrhea, anorexia, and headache between the 2 groups. The incidence of fatigue and hiccups in the test group was higher than that in the control group; however, the incidence of constipation was significantly lower. CONCLUSIONS: Aprepitant-containing triple therapy is highly effective in the prevention and treatment of CINV, with reliable medication safety.

Satisfaction of Patients with Above-the-knee Amputation following Periprosthetic Joint Infection / 中山大学学报(医学科学版)

ObjectiveThe purpose of this study was to evaluate the functional outcomes and satisfaction in periprosthetic knee infection patients after above-the-knee amputation （AKA）. MethodsA review was performed in 13 patients who underwent AKA due to periprosthetic knee infection from October 2010 to August 2022， there were 7 females and 6 males with the median age of 69 （45~ 73） years. The mean number of surgical procedures between primary total knee arthroplasty and AKA was 2.9 times （range： 1 ~ 6）. Patients were segregated into non-elderly group （including patients <65 years old） and elderly group （involving patients ≥65 years old）. Functional outcomes were evaluated by SF-12 and Barthel activities daily living index （Barthel ADL index）. Patient satisfaction was accomplished through a questionnaire. ResultsFour patients died within 6 months after the amputation. Three patients received surgical procedures for recurrent infections after AKA. In the remaining 9 patients，the median time from AKA to the final follow-up was 4.2 （1.9~8.2） years， three patients received surgical procedures for recurrent infections after AKA. Patients in non-elderly group showed better functional outcomes than elderly patients after AKA （both P<0.05）. All patients in non-elderly group were fitted with a prosthesis. Whereas， elderly patients reported a better satisfaction after AKA than young patients. ConclusionYoung PJI patients seemed to have better function and ambulatory ability with high expectation and demand， which made them feel less satisfied about AKA. Meanwhile，despite poor function outcomes due to the less healthy physical condition， the alleviation of financial and psychological burdens resulting from reinfections and multiple surgeries and the less demand in function and daily activities made elderly patients have a good satisfaction after AKA.

Mechanisms of triiodothyronine on maturation and differentiation of B cells / 医学研究生学报

Objective Higher expression of B-cell activating factor (BAFF) in patients with Graves' disease can activate B cells and increase proportion of plasma cells. However, the mechanism is still unclear. This study aims to investigate the effects of T3 on the BAFF level and plasma cell ratio in bone marrow, spleen and peripheral blood of mice, and to explore the mechanism of T3 in affecting the mature and differentiation of B cells. Methods 80 C57BL/6J mice were randomly divided into control group and T3 group, and were given isotonic saline or T3 5/10μg once a day for 6 weeks, respectively. The levels of T3 in peripheral blood of each group were measured with ELISA. Flow cytometry was used to detect the proportion of B220+CD138+ plasma cells and IgM, IgG and IgD expression of B cells in the spleen, bone marrow and peripheral blood. Immunohistochemistry, Western blot and PCR were performed to determine the expression of BAFF in spleen and thyroid. ELISA was used to determine the expression of BAFF in peripheral blood. Results Compared with control group, the levels of T3 in peripheral blood, diet and drinking water in the T3 group were significantly increased after 6 weeks T3 intervention. The mRNA and protein expression of BAFF in spleen mononuclear cells of T3 group (2.03±0.52, 0.50±0.03) were higher than those in control group (1.06±0.19, 0.05±0.01) (P<0.01). HE staining showed that the white medulla in the spleen of the T3 group increased and merged. Flow cytometry indicated that the proportion of spleen plasma cells and antibody expression of B cells in T3 group [(3.92±1.55)%, (75.76±8.88)%] increased compared with control group [(2.43±1.18)%, (65.26±8.38)%] (P<0.05); Proportion of bone marrow plasma cells [(8.48±3.62)%] and antibody expression [(40.63±18.96)%] in T3 group were significantly increased compared with control group [(4.96±3.11)%, (22.89±7.32)%](P<0.05); Peripheral plasma cell ratio [(8.56±4.27)%] and antibody expression [(76.15±9.44)%] were lower than those in control group [(14.70±4.76)%, (84.20±3.98)%](P<0.05); Compared with control group [(5.98±0.78) pg/mL], the BAFF level in peripheral blood increased [(7.61±1.72) pg/mL] (P<0.01). Immunohistochemistry showed that the expression of BAFF increased in mononuclear cells of thyroid of the T3 group. Conclusion T3 could activate BAFF expression in bone marrow, spleen, peripheral blood and thyroid mononuclear cells, and induce differentiation of bone marrow and spleen B cells, thus causing pathological changes in thyroid tissue. Such mechanisms might play an important role in the pathogenesis of thyroid autoimmune diseases.

Effects of thyroid hormones on cardiac function in mice by inducing expression of B-cell activating factor in cardiomyocytes / 医学研究生学报

Objective　High levels of triiodothyronine (T3) can lead to hyperthyroid heart disease, but its mechanism is unclear. This study aims to investigate the effects of T3 on the expression of B-cell activating factor (BAFF) in cardiomyocytes and to explore its possible role in the pathogenesis of hyperthyroid heart disease.　Methods　Sixty healthy C57BL/6J mice were selected and randomly divided into two groups: the experimental group and the control group. The experimental group received intraperitoneal injection of T3 at 5 μg/ml, one time/d, for 42 consecutive days. The concentrations of serum T3 and tetraiodothyronine (T4) were detected by radioimmunoassay; ELISA was used to determine BAFF expression in peripheral blood, and the cardiac index and the transverse diameter of myocardial cells in each group were determined. Immunohistochemistry and Western blot were used to detect the expression of BAFF protein in myocardium and of myocardial tumor necrosis factor-α (TNF-α) protein; the expression of BAFF mRNA in myocardium was detected by Real-Time PCR; flow cytometry (FCM) was used to detect changes in the proportion of B-cells in the heart.　Results　Compared with the control group, the serum T3 concentration, cardiac index, BAFF and myocardial cell transverse diameter of the experimental group significantly increased (P<0.05), and the T4 concentration decreased (P<0.05). Under the light microscope, the cardiomyocytes of the control group were normal, while those of the experimental group were hypertrophied and disordered in structure. Compared with the control group (0.765±0.164), BAFF protein expression significantly increased in the experimental group (1.865±0.290) (P<0.05). Compared with the control group (0.537±0.089), the expression of TNF-α protein significantly increased in the experimental group (0.737±0.065) (P<0.05). Correlation analysis of T3 with BAFF gene expression in cardiomyocytes and BAFF level in peripheral blood showed that T3 was positively correlated with both the former with a correlation coefficient of 0.637 (P<0.01) and the latter with 0.778 (P<0.01). For FCM, compared with the control group [(12.40±1.09)%], the proportion of myocardial B-cells increased in the experimental group [(16.12±0.631)%] (P<0.05).　Conclusion　High concentration of T3 can promote the expression of BAFF in myocardial cells and lead to the activation of B-cells, thus increasing the inflammatory response and leading to myocardial hypertrophy.

Clinical analysis of severe acute pancreatitis complicated with acute acalculous cholecystitis:a 39 cases report / 中国实用外科杂志

OBJECTIVE: To summarize the clinical characteristics of severe acute pancreatitis(SAP)complicated withacute acalculous cholecystitis(AAC).METHODS: The clinical data of 141 SAP patients admitted in the First Affiliated Hospital of Harbin Medical University from September 2012 to August 2017 were analyzed retrospectively. Among them,39 SAP patients were complicated with AAC. The clinical characteristics and key points of diagnosis and treatment ofSAP complicated with AAC were analyzed and compared with the basic data and treatment of patients without AAC.RESULTS: The incidence of SAP complicated with AAC was 27.7%(39/141). Compared with the non-AAC group,theAAC group had statistically significant differences in age [(48.8±12.5)years vs.(41.4±10.9)years], Balthazar CTSIscore [(6.8±1.3)vs.(5.7±1.3)],diabetes mellitus(35.9% vs. 18.6%), fasting time [(16.9±9.5)h vs.(12.2±7.6)h],incidence of ARDS(74.3% vs. 54.9%)and ARF(43.6% vs. 23.5%),and length of hospital stay [(33.7±19.6)d vs.(21.9±12.9)d](P<0.05). In the AAC group,8 patients underwent conservative treatment. 31 patients underwent invasivetreatment for severe gallbladder inflammation,among them 20 patients received PTGD and their condition improved. Themortality rates of patients in the AAC group were also higher than that in the non-AAC group(20.5% vs. 8.8%),butthere was no statistical significance(P=0.106).CONCLUSION: The AAC is one of the common complications in the latecourses of SAP. Early diagnosis and individualized treatment are crucial to improve the curative effects. For the patients,the early use of PTGD is a safe and effectivetreatment method,which is worthy of promotion.

Angiographic verifi cation and clinical predictors of anatomical variations of radial artery / 中国介入心脏病学杂志

Objective To discuss the incidence and clinical predictor factors of anatomical variation of radial arteries among patients in the XingJing province of China. Methods A total of 1731 patients who underwent transradial coronary intervention for the first time during the period of Jan.2016-June.2016 in the People‵s Hospital of Xin jiang Uyghur Autonomous Region were enrolled in this study. All relevant basic information and related medical history were recorded in detail.Right radial artery angiography was performed in all patients, According to the definition of radial artery variation, the patients were decided into the radial artery variation group and the normal radial artery group. Single factor and multiple factors logistic regression analysis were performed to evaluate the predictive value of variables factors in radial artery variations. Results The incidence of radial artery variation was 4.97%(86/1731).The incidence of radial artery spasm in the radial artery variation group33.72%(29/86),and 2.74% (45/1645) in the normal radial artery group (P<0.001).The failure rate of coronary intervanton by right radial artery in the radial artery variation group was 26.74%(23/86)and 1.51%(25/1645)in the normal radial artery group(P<0.001).The overall success rate of coronary intervention through right radial artery approach was 97.23%(1683/1731).Female gender,short statue、low body weight,history hyperlipidemia,smoking,drinking rabbit,occupation as farmer were found to be associated with the existence of radial artery variation (all P < 0.05).Diabetes,body mass index,hyperlipidemia and ethnicity were not associated with the existence of radial artery variation (all P >0.05). Multivariate logistic regression analysis showed age, gender, farmer occupation, hyperlipidemia were associated with the occurrence of radial artery variation. Increased in age by every 10 years would bring a 0.264 fold increase in risk of radial artery variation(OR 1.264,95%CI 1.006-1.587, P=0.044)and the risk of radial artery variation in females was 3.999 times to males(OR 3.999, 95%CI 2.241-7.136,P<0.001).The risk of radial artery variation in patients with hyperlipidemia was 1.776 times to patients without hyperlipidemia(OR 1.776,95%CI 1.011-3.122,P=0.046)and the risk of radial artery variation in farmers was 2.188 times higher than others(OR 2.188,95%CI 1.238-3.867, P=0.007). Conclusions For people in Xinjiang in China,anatomical variation of radial artery was uncommon. Advanced age, female gender, short states, low body weight, hyperlipidemia, smoking, drinking and farmer occupation were associated with the occurrence of radial artery variation. Multivariates logistic regression analysis showed advanced age, female gender, hyperlipidemia, farmers were associated whit the presence of radial artery variation. These factors have predictive value for the existence of radial artery variation.

1020 cases of pectus excavatum treated by a novel modified nuss procedure without turning over the steel plate / 中华胸心血管外科杂志

Objective Based on the disadvantages of NUSS procedure, we design a new type of funnel chest orthodontic steel bars for clinical application to simplify surgery operation , reduce the surgical trauma, improve operation effect, enhance the safety of operation, and relieve the suffering of the patients, etc.Methods From June 2010 to July 2015, 1020 patients used the new type of funnel chest orthodontic metal plates, including 706 cases of males and 314 cases of females, aged 3-40(aver-age age 11.38 ±5.31).Haller index of 3.36 to 15.45(average index 4.97 ±1.58).668 symmetrical funnel chest cases, 281 cases of asymmetry and 71 recurrent funnel chest cases are involved.Surgical steel bars, having 15 specifications, are arc-shaped, the lengths of which are from 12cm to 26cm.The two ends of steel bars have fixed piece, one end of the bar was fused with a stabilizer and the other end connected to an introducer or a stabilizer and use screws to fix two ends .Steel plates, as the design product, are finalized in the factory.Therefore we need not make intraoperative reprocess.Front tip of introducer and the back-end can be connected to the metal plate.Patients were placed supine position under general anesthesia.Two inci-sions, with length about 2cm and deep to the rib periosteum were made along axillary midline line on the both sides .In the di-rection of high blunt slightly medial free for subcutaneous tunnel to the highest point .Fixed wires were worn around the ribs on both sides.A thoracoscope to guide the bar was inserted from the highest point on the right side of the rear of the medial by sternum low into the chest from the left corresponds to the highest point of the medial , remove the introducer to connect another stator, use screws to fix the connection, with a fixed stator and steel plate stabilized.At the end of the surgery, the stabilizer on either side was secured with sutures.Results The median first operation time was 23 -45(32.31 ±3.57)min, second op-eration time was about 34-147(68.27 ±30.25)min..The bleeding volume(first operation) was 0-2(0.40 ±0.36)ml, the bleeding of second operation time was 1-630(144.00 ±57.00)ml.The hospital stay was 3-9(4.22 ±0.61)days after the operation.All the cases were followed up for 34-48(34.4 ±6.1)months.Steel plate was fixed at the bottom of the sternum in 957 of them,with slight shifting in 58 patients.There was another 5 cases who need re-operation because of the obvious shift-ing.Conclusion The new type of funnel chest orthodontic steel bars simplify surgery operation, reduce the surgical trauma, improve operation effect, relieve the suffering of the patients and enhance the safety of operation.

Differentially expressed circular RNAs in human gastric cancer cells / 生理学报

The purpose of this study was to investigate the expression profile of circular RNA (circRNA) in gastric cancer cells MGC-803, SGC-7901 and NCI-N87 with different degrees of differentiation and normal gastric epithelial cells GES-1. High throughput circRNA microarray technique was used to detect the differential expression of circRNA between three kinds of differentiated gastric cancer cells and normal gastric epithelial cells. The interaction of microRNAs (miRNAs) with circRNAs was predicted by bioinformatics software, and circRNA, which might have great significance in gastric cancer, was identified by literature search. The results showed that there were 79 up-regulated circRNAs and 229 down-regulated circRNAs in gastric cancer cells with different degrees of differentiation compared with those in normal gastric epithelial cells. Through bioinformatics software analysis and literature retrieval, it was found that hsa_circ_0001897 was related to the staging and metastasis of gastric cancer, while the miR-150-5p, which combined with it, was closely related to many kinds of digestive tract tumors, such as colon cancer, liver cancer, and cholangiocarcinoma. The miR-16-5p, which has binding sites with hsa_circ_0008106 and hsa_circ_0060456, has been confirmed to be involved in the development of gastric cancer. The above results suggest that hsa_circ_0001897, hsa_circ_0008106 and hsa_circ_0060456 may be closely related to the occurrence and development of gastric cancer by interacting with miRNA.

Analysis of clinical characteristics and prognosis of patients with acute myocardial infarction complicated with ventricular septal perforation and formation of ventricular aneurysm / 中国介入心脏病学杂志

Objective To investigate the clinical characteristics,treatment and prognosis of patients with acute myocardial infarction complicated with ventricular septal perforation and ventricular aneurysm formation. Methods The clinical data,treatment methods and prognosis of 11 patients, who admitted between January 2012 and December 2016 in Xinjiang Uygur Autonomous Region People 's Hospital,with acute myocardial infarction complicated with ventricular septal perforation and ventricular aneurysm were analyzed retrospectively. Results the killip grading of the 11 patients were Grade Ⅱ in 1 patients. Grade Ⅱ in 2 patients and Grade Ⅲ in 8 patients .The infarction site was found at the anterior wall in 3 patients,diffuse anterior well in 1 patients,inferior wall in 1 patient, anterior-inferior infarction in 3 patients and diffuse anterior-inferior infarction wall in 1 patient. Septal perforation was found at posterior septum in 5 patients muscular septum in. Patient and at apex in 5 patients. Septal perforation was identified within 24 hours of infarction in 1 patient,within 1-7 days in 3 patients and beyond 7 days after infarction in 7 patients .4 patients with septal perforation chosed conservative medical management only and 2 of them died 1 month later.2 patients had PCI in addition to medical treatment but both of them died in 3 months after discharge. 2 patients had IABP supper,and 1 of then died within 1 week during hospitalzation and the other one died 1 week after discharge. 2 patients received PCI and electric amplatzer closure(4-6 weeks after AMI,and 1 patient received PCI plus elective surgical septal repair and ventricular aneurysm reshaping at 6 months after AMI. All 3 patients survived during follow up. Conclusions For patients with acute myocardial infarction complicated with ventricular septal perforation and ventricular aneurysm formation,aggressive intervention and treatment will improve the clinical prognosis.

Mini-open trans-spatium intermuscular versus percutaneous short-segment pedicle fixation for the treatment of thoracolumbar mono-segmental vertebral fractures / 中国骨伤

<p><b>OBJECTIVE</b>To compare the clinical effects and radiographic outcomes of mini-open trans-spatium intermuscular and percutaneous short-segment pedicle fixation in treating thoracolumbar mono-segmental vertebral fractures without neurological deficits.</p><p><b>METHODS</b>From August 2009 and August 2012, 95 patients with thoracolumbar mono-segmental vertebral fractures without neurological deficits were treated with short-segment pedicle fixation through mini-open trans-spatium intermuscular or percutaneous approach. There were 65 males and 30 females, aged from 16 to 60 years old with an average of 42 years. The mini-open trans-spatium intermuscular approach was used in 58 cases (group A) and the percutaneous approach was used in 37 cases (group B). Total incision length, operative time, intraoperative bleeding, fluoroscopy, hospitalization cost were compared between two groups. Visual analog scale (VAS) and radiographic outcomes were compared between two groups.</p><p><b>RESULTS</b>All patients were followed up from 12 to 36 months with an average of 19.6 months. No complications such as incision infection, internal fixation loosening and breakage were found. In group A, fluoroscopy time was short and hospitalization cost was lower than that of group B (P<0.05). But the total incision length in group B was smaller than that of group A (P<0.05). There was no significant differences in operative time, intraoperative bleeding, postoperative VAS and radiographic outcomes between two groups (P>0.05). Postoperative VAS and radiographic outcomes were improved than that of preoperative (P<0.05).</p><p><b>CONCLUSION</b>The mini-open trans-spatium intermuscular and percutaneous short-segment pedicle fixation have similar clinical effects and radiographic outcomes in treating thoracolumbar mono-segmental vertebral fractures without neurological deficits. However, in this study, the mini-open trans-spatium intermuscular approach has a short learning curve and more advantages in hospitalization cost and intraoperative radiation exposure times, and is recommendable.</p>

[Study on pharmacokinetics of geniposide in mice administrated by xingnaojing microemulsion and mPEG2000-PLA modified xingnaojing microemulsion].

An HPLC method for the determination of geniposide concentration in mouse plasma was developed and the pharmacokinetics after intranasal administration of Xingnaojing microemulsion (XNJ-M) and mPEG2000-PLA modified Xingnaojing microemulsion (XNJ-MM) were investigated. Eighty mice were treated by XNJ-M and XNJ-MM nasally. The plasma samples were collected at different times and the drug in samples was detected by HPLC. The pharmacokinetic parameters were calculated by the software of Kinetica. The pharmacokinetic parameters of geniposide of XNJ-M were C(max) (4.36 +/- 2.69) mg x L(-1), t(max) 1 min, MRT (29.73 +/- 4.54) min, AUC (53.63 +/- 14.03) mg x L(-1) x min. The pharmacokinetic parameters of geniposide of XNJ-MM were C(max) (9.75 +/- 4.14) mg x L(-1), t(max) 1 min, MRT(22.34 +/- 2.90) min, AUC (131.87 +/- 40.13) mg x L(-1) x min. Geniposide can be absorbed into blood in a higher degree after intranasal administration with XNJ-MM compared to XNJ-M, which maybe caused by its less irritating and more absorption.

Comparative pharmacokinetics of borneol in cerebral ischemia-reperfusion and sham-operated rats.

OBJECTIVE: This study was designed to investigate the pharmacokinetics of borneol in the pathological conditions of stroke and evaluate the pharmacokinetic differences of borneol caused by stroke after oral administration of borneol and Xingnaojing (XNJ). METHODS: The rats were divided into two groups, ischemia-reperfusion (IR) and sham-operated (SO) rats. Each group contained two subgroups: pure borneol and XNJ subgroups. After administration with the same dosages of borneol 162.0 mg/kg, plasma samples were collected. The cerebral ischemia-reperfusion model was created by reversible middle cerebral artery occlusion (MCAO). The blood samples were collected punctually after oral administration and a specific gas chromatographic system-flame ionization detector (GC-FID) method was developed and employed to determine the level of borneol in the plasma. The pharmacokinetic parameters were analyzed using non-compartmental methods with Kinetica. RESULTS: After administration of borneol, the maximum plasma concentration (Cmax) and area under the curve (AUC) values in stroke rats significantly increased by 302% and 275%, respectively, compared with the SO rats, and the same phenomenon appeared after administration of XNJ. In the rats with the same physiological conditions, the Cmax and AUC had higher values in the borneol subgroup (P<0.05). CONCLUSIONS: These results suggest that the pathological damages of ischemia-reperfusion have a significant impact on the pharmacokinetic traits of borneol and that there are some components in XNJ inhibiting the absorption of borneol.

[Selecting solvent and solubilizer for puerarin nasal drops by solubility and irritation].

In order to test the equilibrium solubility of puerarin in different solvents and solubilizer,cilia toxicity and irritation of these excipient, the balance method, toad in the ciliary body toxicity and rat nasal mucosa irritation were used respectively. Results showed that puerarin solubility was 56.44 g x L(-1) in combined solvent of 30% PEG200 and 10% Kolliphor HS 15. With normal saline solution as negative control and sodium deoxycholate as positive control, the effects of 30% PEG200, 30% PEG 400, 10% Kolliphor HS 15 and combination of 30% of PEG200 and 10% Kolliphor HS 15 on toad palate cilium were observed and cilia movement duration was recorded. The results indicated that there was no significant difference in cilia movement duration among 30% PEG200, 10% Kolliphor HS 15 and normal saline group. The rats long-term nasal mucous membrane irritation of 30% PEG 400, 10% Kolliphor HS 15, which had no cilia toxicity, was studied, with normal saline solution as negative control. There were no significant difference revealed on rat nasal mucosa epithelial thickness among 30% PEG 400, 10% Kolliphor HS 15 and normal saline. Above researches showed 30% PEG 400, 10% Kolliphor HS 15 was ideal for solubility of puerarin nasal drops and showed a lower cilia toxicity and irritation, and can be used as the solvent and solubilizer of puerarin nasal drops.

Progress on atlanto-axial pedicle screw fixation through posterior approach / 中国骨伤

The present of atlanto-axial pedicle screw fixation through posterior approach provide a new remedy for treating instability of pillow and cervical. A lot of researches have reported feasibility of atlanto-axial pedicle screw fixation, the results showed that it had advantages of easily exposure, less blood loss, shorter operative time, especially in treating as remedy fixation for atlanto-axial joint screw, atlas lateral mass screws and pedicle screw caused by injuries of tumor,inflammation and trauma. If not done properly, it can cause serious complications, such as iatrogenic fracture,injuries of vertebral artery and cervical spinal cord. Therefore,the safty and effectiveness of atlanto-axial pedicle screw fixation may be focus of research.

The design and application of anterior cervical pedicle screw-plate system in lower cervical spine / 中国骨伤

<p><b>OBJECTIVE</b>To explore the applied feasibility of the anterior cervical pedicle screw-plate system in lower cervical spine,in order to provide basic data for clinical application.</p><p><b>METHODS</b>Total thirty-two units (functional spinal unit, FSU) were got randomly from 16 cervical speciments, 8 units in each group of C3,4, C4,5, C5,6 and C6,7. The anterior cervical pedicle screw-plate system was implanted to reconstruct the stability of FSU after discectomy and bone graft. The adaptability was measured between the screw-plate system and vertebral body. X-ray and CT were used to evaluate the accuracy of anterior cervical pedicle screws. The subject will be dissected to identify the situation of involvement if screw perforating the pedicle.</p><p><b>RESULTS</b>Sixty-four anterior pedicle screws were inserted smoothly in the 32 units. The screw and the plate were harmonious locked in the system. The position and length of all screws were satisfactory through X-ray views. However,6 screws perforated the transpedicular (degree 1) according to CT axial views,2 internally cortex and 4 laterally cortex. None perforation was degree 2 or more. None cervical sac compression and nerve root injury was observed in two internal perforation cadavers. One vertebral vein involvement was found in the four lateral perforation screws. The vertebral artery was not pinched though one screw near to the artery.</p><p><b>CONCLUSION</b>The anterior cervical pedicle screw-plate system is adapted to reconstruct in lower cervical spine and it deserved to be used for clinical application.</p>

[Comparative pharmacokinetic studies of borneol in brain and plasma of stroke or sham-operated rats after administration of Xingnaojing].

In order to research the pharmacokinetic characteristic of borneol in plasma and brain of stroke rats given XNJ and investigate the influence of stroke on the borneol passing through the blood-brain barrier, this study established the GC to determine the borneol in brain and blood, and made the stroke mode rats by middle carotid artery occlusion (MCAO) and set sham-operated group. After oral administration of Xingnaojing (XNJ) suspension, their blood and brain were collected at different time and detected by GC. The data was analysed by Kinetica. Results showed that in stroke group, the Cmax and AUC0-t of brain and plasma are (1.82 +/- 0.825), (1.35 +/- 0.43) mg x L(-1) and (123.39 +/- 55.82), (87.91 +/- 39.81) mg x L(-1) x min, Te (brain/blood drug ratio) was 70.93%; those pharmacokinetic values were larger than in sham-operated group. We can conclude that the pathological state of stroke can increase the amount of borneol permeating into brain.

Celastrus orbiculatus extract inhibits tumor angiogenesis by targeting vascular endothelial growth factor signaling pathway and shows potent antitumor activity in hepatocarcinomas in Vitro and in Vivo / 中国结合医学杂志

<p><b>OBJECTIVE</b>Celastrus orbiculatus Thunb. has been used for thousands of years in China as a remedy against cancer and inflammatory diseases. This study aims to investigate whether C. orbiculatus extract (COE) could inhibit angiogenesis, which is the pivotal step in tumor growth, invasiveness, and metastasis.</p><p><b>METHODS</b>In this study, the extract from the stem of C. orbiculatus was used. Mouse hepatic carcinoma cells (Hepa1-6) were treated with COE in different nontoxic concentrations (10, 20, 40, 80, and 160 μg/mL). The mRNA and protein expression levels of vascular endothelial growth factor (VEGF) were detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot, respectively; the active fractions were further tested on C57BL/6 mice and human umbilical vein endothelial cells (HUVEC) for any antiangiogenic effects.</p><p><b>RESULTS</b>COE significantly inhibited proliferation and induced apoptosis in Hepa1-6 cells and inhibited VEGF expression at both mRNA and protein levels. Furthermore, this agent inhibited the formation of the capillary-like structure in primary cultured HUVEC in a dose-dependent manner. In vivo, COE significantly reduced the volume and weight of solid tumors with low adverse effects and decreased tumor angiogenesis.</p><p><b>CONCLUSIONS</b>In summary, COE could be used to treat hepatic carcinoma. The mechanisms of the antitumor activity of COE may be due to its effects against tumor angiogenesis by targeting the VEGF protein.</p>

A meta-analysis for the efficacy and safety of tourniquet in total knee arthroplasty / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of tourniquet in total knee arthroplasty.</p><p><b>METHOD</b>Studies on comparison between with and without tourniquet in total knee arthroplasty were identified from Medline, PubMed, EMASE, Cochrane Library, CBM, Highwire, CNKI, VIP, Articles Digital Periodicals.All the randomized controlled trials were included for meta-analysis with RevMan 4.2.2 software.</p><p><b>RESULTS</b>Nineteen studies involving 15 in foreign languages, 4 in Chinese were identified. There were 1159 cases of knee replacement patients. The results of meta-analysis indicated that there were statistical difference between two groups on intraoperative blood loss (P = 0.000), the number of deep venous thrombosis (P = 0.020), thigh pain (P = 0.000), knee hematoma (P = 0.030), wound infection (P = 0.040), skin ecchymosis area (P = 0.000), and the increasing rate of knee circumference of 3 days after the operation (P = 0.000), while there were no statistical differences with respect to the total blood loss (P = 0.100), the number of blood transfusions (P = 0.150), operation time (P = 0.120), length of hospital stay (P = 0.350), the number of pulmonary embolism (P = 0.310), and skin blisters (P = 0.170).</p><p><b>CONCLUSIONS</b>The tourniquet for total knee arthroplasty can reduce intraoperative blood loss, but can not reduce total blood loss and the number of blood transfusions transfusion, can not improve operative efficiency, can not shorten the hospitalization time and promote the knee joint functional recovery. Furthermore the tourniquet increases the probability of occurrence on deep vein thrombosis, wound infection, hematoma and ecchymosis knee, it also causes knee swelling and thigh pain. It suggests minimize to use tourniquet in total knee arthroplasty.</p>