Long-term effectiveness of uncemented allograft-prosthesis composite for reconstruction of bone defects after proximal femur tumor resection / 中国修复重建外科杂志

OBJECTIVE@#To investigate the long-term effectiveness of uncemented allograft-prosthesis composite (APC) for reconstruction of bone defects after proximal femur tumor resection.@*METHODS@#Between June 2007 and March 2014, 21 patients who underwent uncemented APC reconstruction of proximal femur after tumor resection were retrospectively evaluated. There were 9 males and 12 females with an average age of 33.2 years (range, 19-54 years). There were 9 cases of giant cell tumor of bone, 5 cases of osteosarcoma, 4 cases of osteoblastic osteosarcoma, 2 cases of chondrosarcoma, and 1 case of undifferentiated pleomorphic sarcoma. Thirteen cases of benign bone tumors were all classified as stage 3 by Enneking staging; and 8 cases of malignant bone tumors were classified as grade ⅡB in 7 cases and grade ⅡA in 1 case according to the American Joint Committee on Cancer (AJCC) staging system. Among them, 7 patients underwent reoperation after recurrence, and the rest were primary operations; 8 patients presented with pathological fractures. The preoperative Harris hip score (HHS) and American Musculoskeletal Tumor Society (MSTS) score was 40 (30, 49) and 9.1±3.5, respectively. The length of osteotomy was 80-154 mm, with an average of 110 mm. At 1 year after operation and last follow-up, HHS and MSTS scores were utilized to evaluate the function of hip joint; the gluteus medius strength score was used to evaluation of the hip abduction function. Image examinations were taken at 1, 3, 6, 9, and 12 months after operation and every year thereafter to assess the union of allograft-host bone interfaces. Intra- and post-operative complications were also recorded.@*RESULTS@#All patients were followed up 84-163 months (mean, 123.5 months). At 1 year after operation and last follow-up, the HHS and MSTS scores significantly improved when compared with the preoperative scores ( P<0.05). However, there was no significant difference in the HHS score, MSTS score, and gluteus medius strength score between the two time points after operation ( P>0.05). Image examination showed that all allograft-host bone interfaces achieved union after 5-10 months (mean, 7.6 months). At last follow-up, all patients had bone resorption, including 11 severe cases, 4 moderate cases, and 6 mild cases; the bone resorption sites included Gruen 1, 2, and 7 regions. Complications included 10 fractures and 1 prosthetic fracture. Local recurrence occurred in 3 patients and pulmonary metastasis in 3 patients.@*CONCLUSION@#Uncemented APC is a reliable method for the reconstruction of bone defects after proximal femur tumor resection. It has the good long-term effectiveness and possesses obvious advantages in the union at the bone-bone surface.

Three-dimensional-printed hemi-pelvic prosthesis for revision of aseptic loosening or screw fracture of modular hemi-pelvic prosthesis / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of three-dimensional (3D)-printed hemi-pelvic prosthesis for revision of aseptic loosening or screw fracture of modular hemi-pelvic prosthesis.@*METHODS@#Between February 2017 and January 2020, 11 patients with aseptic loosening or screw fracture of modular hemi-pelvic prosthesis were revised using 3D-printed hemi-pelvic prostheses. There were 7 males and 4 females with an average age of 44 years (range, 25-60 years). In the first operation, all patients underwent total tumor resection, modular hemi-pelvic prosthesis reconstruction, and autologous femoral head transplantation. According to the Enneking pelvic partition system, 8 cases were resected in zones Ⅰ+Ⅱ and 3 cases in zones Ⅰ+Ⅱ+Ⅲ. The interval from the initial operation to this revision ranged from 14.3-66.2 months, with an average of 35.8 months. The operation time, the amount of intraoperative bleeding, and the occurrence of complications were recorded. At 6 months after the first operation, before revision, and at last follow-up, the American Musculoskeletal Tumor Society (MSTS) score and Harris score were used to evaluate the recovery of lower limb function. The pain-free walking distance of patients without brace assistance was recorded at last follow-up. X-ray films were taken at 1 month after the first operation, before revision, and at 1 month after revision, the acetabulum position was assessed by the differences in weight arm and cup height between bilateral hip joints. At last follow-up, the digital X-ray tomography was taken to evaluate the prosthesis-bone integration and the occurrence of aseptic loosening.@*RESULTS@#The operation time was 182.6-238.0 minutes (mean, 197.4 minutes). The amount of intraoperative bleeding was 400-860 mL (mean, 550.0 mL). All incisions healed by first intention with no infection, hip dislocation, nerve damage, or vascular-related adverse events. The MSTS score and Harris score at last follow-up were significantly higher than those at 6 months after the first operation and before revision ( P<0.05), while the score before revision was significantly lower than that at 6 months after the first operation ( P<0.05). At last follow-up, the patients were able to walk more than 1 000 meters painlessly without brace assistance. Imaging review showed that the difference of cup height at 1 month after revision was significantly lower than that at 1 month after the first operation and before revision, and at 1 month after the first operation than before revision operation, and the differences were significant ( P<0.05). There was no significant difference in the difference of weight arm among three time points ( P>0.05). All prostheses were well integrated, and no aseptic loosening of the prosthesis or screw fracture occurred.@*CONCLUSION@#Revision with 3D-printed hemi-pelvic prostheses benefited in reconstructing stable pelvic ring and natural bodyweight transmission for patients encountering the aseptic loosening or screw fracture of modular hemi-pelvic prosthesis. Early postoperative rehabilitation training can maximize the recovery of patient limb function, reduce pain during walking, and reduce the incidence of complications.

Mid-term effectiveness of hip preservation in the reconstruction of ultrashort bone segments in the proximal femur with three-dimensional printed customized cementless intercalary endoprosthesis with an intra-neck curved stem / 中国修复重建外科杂志

OBJECTIVE@#To explore the design points of a three-dimensional (3D) printed customized cementless intercalary endoprosthesis with an intra-neck curved stem and to evaluate the key points and mid-term effectiveness of its application in the reconstruction of ultrashort bone segments in the proximal femur.@*METHODS@#Between October 2015 and January 2021, 17 patients underwent reconstruction with a 3D printed-customized cementless intercalary endoprosthesis with an intra-neck curved stem. There were 11 males and 6 females, the age ranged from 10 to 76 years, with an average of 30.1 years. There were 9 cases of osteosarcoma, 4 cases of Ewing sarcoma, 2 cases of chondrosarcoma, 1 case of liposarcoma, and 1 case of myofibroblastoma. The disease duration was 5-14 months, with an average of 9.5 months. Enneking staging included 16 cases of stage ⅡB and 1 case of stage ⅢB. The distances from the center of the femoral head to the body midline and the acetabular apex were measured preoperatively on X-ray images. Additionally, the distances from the tip of the intra-neck curved stem to the body midline and the acetabular apex were measured at immediate postoperatively and last follow-up. The neck-shaft angle was also measured preoperatively, at immediate postoperatively, and at last follow-up. The status of osseointegration at the bone-prosthesis interface and bone growth into the prosthesis surface were assessed by X-ray films, CT, and Tomosynthesis-Shimadzu metal artefact reduction technology (T-SMART). The survival status of the patients, presence of local recurrence or distant metastasis, and occurrence of postoperative complications were assessed. The recovery of lower limb function was evaluated pre- and post-operatively using the Musculoskeletal Tumor Society (MSTS) scoring system, and pain relief was evaluated using the visual analogue scale (VAS) scores.@*RESULTS@#The patient's femoral resection length was (163.1±57.5) mm, the remaining proximal femoral length was (69.6±9.3) mm, and the percentage of femoral resection length/total femoral length was 38.7%±14.6%. All 17 patients were followed up 25-86 months with an average of 58.1 months. During the follow-up, 1 patient died of lung metastasis at 46 months postoperatively, and the remaining 16 patients survived tumor-free. There was no complication such as periprosthetic infection, delayed incision healing, aseptic loosening, prosthesis fracture, or periprosthetic fracture. No evidence of micromotion or wear around the implanted stem of the prosthesis was detected in X-ray and T-SMART evaluations. There was no significant radiolucent lines, and radiographic evidence of bone ingrowth into the bone-prosthesis interface was observed in all stems. There was no significant difference in the distance from the tip of the curved stem to the body midline and the apex of the acetabulum at immediate postoperatively and last follow-up compared with the distance from the center of the femoral head to the body midline and the apex of the acetabulum before operation, respectively (P>0.05), and there was no significant difference in the above indexes between immediate postoperatively and last follow-up (P>0.05). The differences in the neck-shaft angle at various time points before and after operation were also not significant (P>0.05). At last follow-up, the MSTS score was 26.1±1.2 and the VAS score was 0.1±0.5, which were significantly improved when compared with those before operation [19.4±2.1 and 5.7±1.0, respectively] (t=14.735, P<0.001; t=21.301, P<0.001). At last follow-up, none of the patients walked with the aid of crutches or other walkers.@*CONCLUSION@#The 3D printed customized cementless intercalary endoprosthesis with an intra-neck curved stem is an effective method for reconstructing ultrashort bone segments in the proximal femur following malignant tumor resection. The operation is reliable, the postoperative lower limb function is satisfactory, and the incidence of complications is low.

Analysis of psychological crisis vulnerability among rural college students and its related factors / 中国学校卫生

Objective@#To understand vulnerability to psychological crisis among rural college students and its related factors, so as to provide reference for the prevention or intervention of psychological crisis among rural college students.@*Methods@#A total of 3 560 rural college students from grade one to grade three from five universities were selected using convenient cluster sampling method from January to September 2022 in Nanyang City. General information, vulnerability to psychological crisis, parenting style and Scale of Perceived Social Self efficacy (PSSE) were collected and analyzed through questionnaire.@*Results@#Among the investigated rule college students, the score of psychological crisis vulnerability and spoiling dimension of parenting style were (10.76± 3.46 ) points and (2.68±0.55) points, while the score of trust encouragement dimension of parenting style and PSSE were (2.52± 0.62 ) points and (3.29±0.61) points. Pearson correlation analysis showed that vulnerability to psychological crisis of rural students was positively correlated with spoiling and neglect ( r =0.32, 0.49), and was negatively correlated with trust encouragement, emotional warmth and PSSE ( r =-0.38, -0.53, -0.51)( P <0.05). Multiple linear regression analysis revealed that single parent family or other families, poor students, left behind experience, high score of spoiling and high score of neglect revealed high psychological crisis vulnerability ( P <0.05). High score of trust encouragement, high score of emotional warmth and PSSE were associated with low vulnerability to psychological crisis ( P <0.05).@*Conclusion@#Vulnerability to psychological crisis among rural college students is higher, which is related to the family structure, students whether they are poor, leftover experience, parenting style and PSSE. Mental health among rural college students should be promoted by strengthening communication with students parents and cultivating students social self efficacy.

Scanning electron microscopic observation of the external morphology of Dermatophagoides farinae at different developmental stages / 中国血吸虫病防治杂志

Objective To investigate the morphological characteristics of Dermatophagoides farinae at different developmental stages. Methods The cultured D. farinae was isolated, and the external morphological features of mites at various developmental stages were observed using scanning electron microscopy (SEM), including egg, larva, nymph and adult stages. Results The D. farinae egg appeared a long oval shape, and the larval mites had three pairs of legs. The nymph had four pairs of legs and underdeveloped genital pores containing genital setae and anal setae, and adult mites appeared long and oval in shape, with decorative patterns on epidermis, and had four pairs of legs. In male adult mites, remarkable thickening of the leg I and thicker and longer leg III than the leg IV were seen, and ventral genital regions were found between the basal segments of legs III and IV; the anus was surrounded by a circular peri-anal ring, with a pair of anal suckers and anal setae within the ring. In the female adult mites, slender legs III and IV with an equal length were seen, and a “λ-shape” genital hole was observed on the ventral surface, with a crescent-like genital plate in the anterior part, and the anus appeared a longitudinal slit. Conclusions An SEM observation of the external morphology of D. farinae provides understandings of the morphological characteristics of D. farinae, which is of great significance for the classification and identification.

Immune mechanisms involved in the coexistence of oral lichen planus and autoimmune thyroid diseases / 浙江大学学报·医学版

Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease with unclear etiology. Autoimmune thyroid diseases (AITD) is a type of autoimmune disease characterized by increased thyroid-specific antibodies. In recent years, more and more studies have found that the incidence of AITD is increased in OLP patients. The occurrence and development of OLP and AITD may be related to the expression of thyroid autoantigen in oral keratinocytes, the imbalance of thyroid hormone （Th）1/Th2 and Th17/Treg cell subsets, the abnormal quantity and function of follicular helper T cells and chemokines and the specific killing ability of CD8 T cells to target cells. In this article, the possible immune mechanisms involved in the coexistence of OLP and AITD are reviewed to provide insights for the diagnosis, treatment and prevention of these two diseases from the perspective of immunology.

Efficacy of percutaneous transhepatic biliary drainage combined with balloon dilatation in the treatment of benign biliary-enteric anastomosis stricture / 中华肝胆外科杂志

Objective:To evaluate the curative effect, safety and feasibility of percutaneous transhepatic cholangio drainage(PTCD) combined with balloon dilatation in treating benign biliary-enteric anastomosis stricture(BBES).Methods:The clinical data of 33 patients with benign biliary-enteric anastomosis stricture, who were admitted to the First Affiliated Hospital of Zhengzhou University during the period from January 2013 to May 2019, were retrospectively analyzed. There were 23 cases of benign etiology and 10 cases of malignant etiology, benign strictures of which 15 cases were located in the hepatic hilum and of which 18 cases outside of it. All patients were considered as benign stenosis by at least two imaging examinations of magnetic resonance imaging of pancreatic or enhanced MRI or enhanced CT, laboratory examinations of tumor markers and other clinical data before operation. 10 cases of malignant etiology were confirmed by intraoperative biopsy and pathology. All patients were treated with balloon dilatation at an interval of 1 to 4 weeks after PTCD. The changes of clinical symptoms, bilirubin and liver function before and after operation were compared and analyzed, and the postoperative complications and anastomotic patency rate were followed up.Results:PTCD combined with balloon dilatation was performed successfully in all patients, and the success rate was 100%. After operation, the benign biliary-enteric anastomosis stricture was significantly improved in all patients, and the clinical symptoms were improved obviously. The liver function and bilirubin decreased significantly in all patients after operation, and there was significant statistical significance ( P<0.05). There is no serious complications such as biliary bleeding and biliary fistula were found after operation. At 3 months, 6 months, 12 months, 24 months and 36 months after operation, the anastomotic patency rates of all patients were 90.9%(30/33), 72.7%(24/33), 63.6%(21/33), 63.6%(21/33), 60.6%(20/33), respectively. During the whole follow-up period, anastomotic restenosis happened in 13 patients, of which 9 cases with restenosis, the benign stenosis site of the anastomosis was the hepatic hilum and of which 4 cases located on the outside of the hepatic hilum. After treatment, the incidence of benign restenosis of the anastomosis at the hepatic hilum (60.0%, 9/15) was higher than that at outside of the hepatic hilum (22.2%, 4/18) and it's statistically significant ( P<0.05). Among the 13 patients with recurrence of BBES, 4 cases underwent choledochojejunostomy for malignant causes and 9 cases with benign causes. The recurrence rates after the first balloon dilatation were 40.0% (4/10) and 39.1% (9/23), respectively, and the average recurrence time was 5.8 months and 6.8 months respectively, the difference was not statistically significant( P>0.05). Conclusion:For the treatment of benign biliary-enteric anastomosis stricture, percutaneous transhepatic cholangio drainage combined with balloon dilatation with reliable curative effect, with high safety and less trauma, with less operative complications, and with repeatability, so it is worth applying in clinic.

[Effects of Continuous Extreme Rainfall on Water Quality of the Dongjiang River Basin].

In order to research the impact of continuous extreme rainfall on the water quality of the Dongjiang River, which is a drinking water source, the characteristics of extreme rainfall events in the basin were analyzed for last 38 years. The impacts of these events on water quality are discussed by considering both hydrological data and water quality data. Using SWAT2012 software, a high-precision basin model was established for the flux of major pollutants during extreme rainfall and water quality. The results indicate that there were 173 extreme rainfall events in the Dongjiang River basin over the past 38 years. The annual frequency of extreme rainfall events in high-flow years was higher than in other years. During the year, rainfall was mainly affected by climate, particularly from March to September (80%), with the peak rainfall usually occurring in June. Spatially, the Zengcheng-Bolo-Huizhou-Longmen area had the highest frequency of extreme events. During the study period, rainfall was significantly positively correlated with the concentrations of cyanide, Pb, Fe, Mn, TP, and with turbidity, and the correlation coefficients for the concentrations of TP and turbidity with rainfall were relatively high. Rainfall was significantly negatively correlated with pH, conductivity, the concentration of Zn, as well as some other indicators. These observations show that water quality is affected by rainfall to some extent. Turbidity, TN, ammonia nitrogen, and TP concentrations all showed increasing trends, to different degrees, during rainstorm runoff periods. Turbidity and TP concentrations showed a significant and consistent relationship with flow rate, peaking earlier than the flow rate peak (by approximately 1 d), showing a significant initial flushing effect. The pH curve showed an opposite trend to the flow rate, forming a "V" shape, which may be affected by the rainfall, soil acidity, and confluence conditions in the upstream mountains. Ammonia nitrogen was subject to initial flushing in the early stages of extreme rainfall but was diluted by the clean rainwater; initially, ammonia nitrogen showed high values that declined during the middle and late stages. The variations in pollutant loads were consistent with that of runoff flux, and the peaks in TN, ammonia nitrogen, and TP flux appeared later than the flow peak (by approximately 1 d), thus differing from the pollutant concentration peak. The pollutant load mainly showed a significant increase during storm runoff periods. The proportion of pollutant COD, ammonia nitrogen, and TP transported by 59.48% of the runoff reached 68.42%, 54.68%, and 70.20%, respectively, demonstrating the characteristics of rapid and high-impact pollutant loads. These characteristics have a great influence on the quality of Dongjiang River drinking water and it is suggested that initial rainwater treatment should be strengthened to reduce the negative impact of rainstorm runoff periods on water quality.

Fumigaclavine C attenuates adipogenesis in 3T3-L1 adipocytes and ameliorates lipid accumulation in high-fat diet-induced obese mice

Fumigaclavine C (FC), an active indole alkaloid, is obtained from endophytic Aspergillus terreus (strain No. FC118) by the root of Rhizophora stylosa (Rhizophoraceae). This study is designed to evaluate whether FC has anti-adipogenic effects in 3T3-L1 adipocytes and whether it ameliorates lipid accumulation in high-fat diet (HFD)-induced obese mice. FC notably increased the levels of glycerol in the culture supernatants and markedly reduced lipid accumulation in 3T3-L1 adipocytes. FC differentially inhibited the expressions of adipogenesis-related genes, including the peroxisome proliferator-activated receptor proteins, CCAAT/enhancer-binding proteins, and sterol regulatory element-binding proteins. FC markedly reduced the expressions of lipid synthesis-related genes, such as the fatty acid binding protein, lipoprotein lipase, and fatty acid synthase. Furthermore, FC significantly increased the expressions of lipolysis-related genes, such as the hormone-sensitive lipase, Aquaporin-7, and adipose triglyceride lipase. In HFD-induced obese mice, intraperitoneal injections of FC decreased both the body weight and visceral adipose tissue weight. FC administration significantly reduced lipid accumulation. Moreover, FC could dose-dependently and differentially regulate the expressions of lipid metabolism-related transcription factors. All these data indicated that FC exhibited anti-obesity effects through modulating adipogenesis and lipolysis.

Photodynamic therapy guidelines for the management of oral leucoplakia / 国际口腔科学杂志·英文版

With recent developments in photosensitizers and light delivery systems, topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) has become the fourth alternative therapeutic approach in the management of oral leucoplakia (OLK) due to its minimally invasive nature, efficacy, and low risk of systemic side effects and disfigurement. This report presents step-by-step guidelines for applying topical ALA-PDT in the management of OLK based on both the clinical experience of the authors and a systematic review of the current literature. Studies using protocols with standardized parameters and randomized clinical trials at multiple centres with adequate sample sizes and both interim and long-term follow-ups are needed before universally applicable guidelines can be produced in this field.

The medium-term outcomes of three-dimensional printing uncemented prosthesis replacement for giant cell tumor of distal radius / 中华骨科杂志

Objective To explain the concept and surgical technique of 3D printing uncement radius distal prosthesis,evaluate and discuss the medium-term outcome of the prosthesis for giant cell tumor in distal radius.Methods From September 2015 to March 2017,13 patients diagnosed as giant cell tumor in distal radius were performed with en bloc resection combined with 3D print uncement prosthesis.All patients graded Campanacci Ⅲ or occurred local recurrence.Two patients with local recurrence had a local lesion curettage,inactivation and bone cement filling.There were 7 males and 6 females,with an average age of 37.8 years.Through the preoperative three-dimensional CT data,the 3D model of the distal radius was obtained based on the contralateral radius and the 3D printing uncemented distal radius prosthesis was made.Directly reconstrucion was conducted if the wrist joint ligament and joint capsule can be preserved.The surrounding soft tissue,remaining joint ligament and joint capsule were sutured to the prosthesis together combined with a brace if the wrist joint ligament and joint capsule can be only preserved partially.Radiocarpal joint was temporarily fixed by Kuntscher pin if the wrist joint ligament and joint capsule can't be preserved completely.Results In our series,the average resection length of the distal radius measured from the radial styloid process was 65.54±6.70mm.The length of prosthesis was consistent with the resection length and the length ratio of prosthesis to prosthetic stem is 1:1.The follow-up time was 17.77±4.97 months.There were no local recurrence and metastasis.At the end of the followup,except waist flexion,the wrist extension,wrist pronation,wrist supination,hand grip strength and Mayo wrist were significantly improved from 41.69°± 11.35°,41.92°± 11.09°,40.00°±7.64°,16.84±6.28 mmHg,47.69±9.27 points preoperatively to 57.46°±17.18°,55.00°±17.91°,53.46°±19.30°,23.08±6.29 mmHg,70.00±11.55 points,respectively.The DASH score was significantly decreased from 32.07±6.71 points to 19.15±8.41 points postoperatively.During surgery,there was one patient received temporary wrist fixation with kirschner's needle,which got a relatively poor postoperative function.Excluding this patient,comparing the resuits of 8 cases with directly suturing of wrist joint ligament and joint capsule and that of 4 cases with reconstructing by suturing and fixing with a brace,there were no statistical differences.There were no wrist dislocation or subluxation,aseptic prosthesis loosening,wrist joint degenerative changes or other prosthesis related complications.Conclusion 33D printing uncemented distal radius prosthesis is a good choice for the Campanacci grade Ⅲ or recurrent giant cell tumor in distal radius,because of its personalized design and uncemented fixation;in clinical application,we should pay attention to the evaluation of preoperative wrist joint capsule and surrounding ligament and the intraoperative soft tissue repair techniques.

Effects of Clostridium Butyricum Combined with Antibiotics on Postoperative Inflammatory Factors and Gastrointestinal Function of Patients with Acute Appendicitis after Laparoscopic Surgery / 中国药房

OBJECTIVE:To investigate the effects of clostridium butyricum combined with antibiotics on inflammatory factors and gastrointestinal function of patients with acute appendicitis after laparoscopic surgery. METHODS:A total of 102 patients with acute appendicitis undergoing laparoscopic surgery in our hospital during Jan. 2014-Jan. 2015 were divided into observation group and control group according to odd-even admission number,with 51 cases in each group. Control group was given Cefuroxime sodi-um for injection,Metronidazole injection and Cefixime dispersible tablets for anti-infective therapy after surgery. Observation group was additionally given Clostridium butyricum capsule 1260 mg,tid,for consecutive 3 d,on the basis of control group. The levels of serum inflammatory factors(TNF-α,IL-6),gastrin(GAS)and motilin(MTL)were compared between 2 groups before surgery and 3 d after surgery. The time of gastrointestinal function recovery(the time of bowel sounds,the time of first flatus,the time of postoperative first defecation)and the occurrence of compliance were recorded in 2 groups. RESULTS:Before surgery,there was no statistical significance in the levels of serum inflammatory and GAS,MTL factors between 2 groups (P>0.05). 3 d after sur-gery,the levels of TNF-α,IL-6 and CRP in 2 groups were decreased significantly,while the levels of GAS and MTL were in-creased significantly;above indexes of observation group were significantly better than those of control group,with statistical sig-nificance(P<0.05). The time of bowel sounds,the time of first flatus and the time of postoperative first defecation in observation group were significantly shorter than control group,with statistical significance(P<0.05). The incidence of complications in obser-vation group was 3.92％,which was significantly lower than 15.69％of control group(P<0.05). CONCLUSIONS:Clostridium bu-tyricum combined with antibiotics can effectively relieve inflammatory state of patients with acute appendicitis after laparoscopic sur-gery,promote gastrointestinal function recovery,and reduce the occurrence of complications.

Interaction and active components of traditional Chinese medicine with clopi-dogrel on platelet aggregation / 药学实践杂志

Clopidogrel is commonly used as an anti-platelet aggregation drug in the clinical treatment ,which is often used in combination with traditional Chinese medicine .Strengthening the study on the interaction mechanism of Chinese herbal medicine and its active components with clopidogrel ,to improve the effect of anti-platelet aggregation and the therapeutic effect of clopidogrel resistance .The research progress on the interaction of Chinese herbal medicine and its active components with clopidogrel were summarized in domestic and foreign literatures .Cytochrome P450 ,liver carboxylesterase ,P glycoprotein is a major part of the interaction of traditional Chinese medicine and its active ingredient of clopidogrel .Some active components in Chinese medicine have synergistic effect of clopidogrel on platelet aggregation .

Application value of Toshiba 320-row dynamic volumetric CT angiography in the diagnosis of venous erectile dysfunction / 中华男科学杂志

<p><b>Objective</b>To investigate the application value of Toshiba 320-row dynamic volumetric CT angiography in the diagnosis of venous erectile dysfunction (VED).</p><p><b>METHODS</b>We enrolled in this study 33 patients diagnosed with ED by audiovisual sexual stimulation screening in the outpatient department. Penile erection was induced in the patients by injection of 2 mg phentolamine plus 30 mg papaverine into the corpus cavernosum, followed by that of contrast agent of iobitridol through the vein and corpus cavernosum successively. Then 320-row dynamic volumetric CT angiography was performed and the images of the corpus cavernosum in the arterial and venous phases were collected and processed.</p><p><b>RESULTS</b>Different degrees of abnormal venous drainage were observed in 29 of the patients, including 7 cases (24.1%) of back deep venous leakage, 6 cases (20.7%) of foot venous leakage, 3 cases (10.3%) of dorsal superficial venous leakage, 1 case (3.5%) of intervertebral venous leakage, 2 cases (6.9%) of cavernous venous leakage, and 10 cases (34.5%) of mixed venous leakage. Ten of the patients underwent surgery, dorsal deep penile vein ligation in 2 cases, dorsal deep vein embedding plus foot vein ligation in 4, and foot vein ligation in the other 4. Eight of the patients were followed up for 3－12 months post-operatively, during which 2 achieved obvious erectile improvement, while the other 6 gained normal penile erection.</p><p><b>CONCLUSIONS</b>Toshiba 320-row dynamic volumetric CT angiography is a reliable method for the diagnosis of VED, which displays the precise location of venous leakage for clinical treatment, with the advantages of clearer images, lower doses of contrast agent and radiation, and faster examination than X-ray penile angiography.</p>

[Analysis on nitrogen and phosphorus loading of non-point sources in Shiqiao river watershed based on L-THIA model].

Based on the Long-term Hydrological Impact Assessment (L-THIA) model, the effect of land use and rainfall change on nitrogen and phosphorus loading of non-point sources in Shiqiao river watershed was analyzed. The parameters in L-THIA model were revised according to the data recorded in the scene of runoff plots, which were set up in the watershed. The results showed that the distribution of areas with high pollution load was mainly concentrated in agricultural land and urban land. Agricultural land was the biggest contributor to nitrogen and phosphorus load. From 1995 to 2010, the load of major pollutants, namely TN and TP, showed an obviously increasing trend with increase rates of 17.91% and 25.30%, respectively. With the urbanization in the watershed, urban land increased rapidly and its area proportion reached 43.94%. The contribution of urban land to nitrogen and phosphorus load was over 40% in 2010. This was the main reason why pollution load still increased obviously while the agricultural land decreased greatly in the past 15 years. The rainfall occurred in the watershed was mainly concentrated in the flood season, so the nitrogen and phosphorus load of the flood season was far higher than that of the non-flood season and the proportion accounting for the whole year was over 85%. Pearson regression analysis between pollution load and the frequency of different patterns of rainfall demonstrated that rainfall exceeding 20 mm in a day was the main rainfall type causing non-point source pollution.

Biological limit value for occupational exposure to N, N-dimethylacetamide / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To establish Biological Limit Value (BLV) for N, N-dimethylacetamide (DMAC).</p><p><b>METHOD</b>201 workers in 3 spandex factories exposed to DMAC were recruited. Air samples were collected using personal air samplers, and urine samples from each works were collected at the end of shift at end of workweek. The urinary metabolite NMAC and air samples of DMAC were determined by gas chromatography (GC). Percentile and relative internal exposure (RIE) were analyzed and proposed a BLV for DMAC.</p><p><b>RESULTS</b>The number of workers who exposure to DMAC below OELs were 133 (66.2%) among 201 workers monitored. Geometric mean (range) concentration of DMAC in air was 19.4 (0.40 ∼ 300.12) mg/m(3), and that of NMAC in urine was 23.7 (1.30 ∼ 189.42) mg/g Cr. A linear correlation was found between the personal air DMAC and creatinine-adjusted NMAC levels in urine collected at the end of shift at end of workweek (F = 188.872, R(2) = 0.487,P < 0.001). The relationship can be described by the equation Log (NMAC mg/g Cr) = 0.685 + 0.455 log (DMAC mg/m(3)). According to the equation the current China OELs value of 20 mg/m(3) would lead to a mean NMAC concentration of 18.92 mg/g Cr. The 90th percentile biomonitoring result below 20 mg/m(3) 8-hour TWA is 23.9 mg MMAC mg/g Cr, and that of NMAC in urine calculated by relative internal exposure (RIE) was 19.0 mg/g Cr.</p><p><b>CONCLUSION</b>A BLV of 20 mg/g Cr NMAC in urine at the end of shift at end of workweek for DMAC was recommend by reference to official values from other countries.</p>

Effects of neural stem cells transplantation and FK506 on pathologic and ultrastructural changes of injured spinal cord / 中华创伤杂志

ObjectiveTo investigate the impacts of neural stem cells (NSCs) transplantation on spinal pathology and ultrastructure after spinal cord injury (SCI) in rats and probe into the protective role of tacrolimus (FK506) on neural regeneration.MethodsCompressive SCI at T8 was induced in the adult SD rats,which were randomly assigned to the control group,FK506 group,NSCs group and NSCs + FK506 group.The differences of neural regeneration in each group were compared at days 7,14,28 and 56 after injury by motor evoked potentials ( MEP),HE staining,immunohistochemical staining,ultrastructure observation and image analysis of the myelinated fiber. ResultsThe MEP latency in the NSCs + FK506 group was significantly shorter than that in other groups at day 28 ( P ＜ 0.05 ).HE staining revealed that only local necrosis presented in the NSCs + FK506 group at day 56.More BrdU and NF-200 positive cells were detected with immunohistochemical staining in the other three groups as compared with the control group.Moreover,the positive cells in the NSCs + FK506 group also outnumbered the FK506 group and NSCs group.Electron microscope scan showed edema under the membrane of large myelin sheath in the control group,and classic new myelin sheath and neuraxis in the NSCs + FK506 group at day 56.The regeneration of the nerve fiber in the NSCs + FK506 group was better than that of other three groups (P ＜0.01 ).ConclusionAfter NSCs transplantation for SCI rats,the early combination use of FK506 can improve the pathology and ultrastructure of the regenerative nerve fiber and is conducive to nerve regeneration.

Stereotaxic transplantation of bone marrow mesenchymal stem cells in treatment of spinal cord injury in rats / 中国组织工程研究

BACKGROUND:The key of stem cells for treating nervous tissue injury is the transplantation of stem coils that have regeneration capacity.The structure and function of central nervous system were re-established by multiple action mechanisms.OBJECTIVE:To explore the effects and mechanisms of bone marrow mesenchymal stem cells(BMSCs)locally transplanted into rats with spinal cord injury on neurological recovery.METHODS:BMSCs were separated with density gradient centrifugation and cell attachment.10 mg/L BrdU was used for labeling before cell transplantation.Adult female Wistar rats were used to establish spinal cord injury models using an aneurysm clip,and they were then randomly divided into control group,saline group and transplantation group.In the transplantation group,BMSCs were transplanted into the damaged spinal cord by stereotaxis at day 7 following damage.In the saline group,an equal volume of saline was utilized.In the control group,the rats were left intact.Basso,Beattie and Bresnahan(BBB)locomotor rating scale was used before and at 7,14,30,60 and 90 days following damage.Rats were sacrificed at day 90.BrdU-positive cells,Brdu+neuron specific enolase,Brdu+glial fibrillary acidic protein(GFAP),Brdu+basic fibroblast growth factor(bFGF),and Brdu+brain-derived nerve growth factor(BDNF)immunohistochemistry double-staining cells and simple staining positive calls were observed.RESULTS AND CONCLUSION:The recovery of BBB function score was better in the transplantation group than in the control group(P＜0.05).The recovery speed of BBB function score was slower in the saline group than in the control group at 30 days following damage(P＜0.05).No significant difference was determined at day 90 compared with the control group(P＞0.05).BrdU-positive cells and double-staining cells of immunohistochemistry could be found at the center of damage site and 1 cm from caudal end to damaged site in rats of the transplantation group.The number of NSE,GFAP,bFGF and BDNF simple staining cells was significantly greater in the transplantation group than in the control and saline groups(P＜0.05).Results indicated that BMSC transplantation can improve the recovery of nervous function of rats with spinal cord injury.Its mechanism may be correlated with the differentiation of transplanted cells into neuron-like and glial cell-like cells,secretion or promoting secretion of neurotrophic factors in host.

A method of controlling the X-ray generator with PLC technique / 中国医疗器械杂志

This text probes into the usage of PLC controller which controls the X-ray generator's basic parameters.

[Adaptive evolution of chemokines and their receptors genes].

Branch-Site Model is a statistical method for detecting molecular adaptation at individual along specific lineages. Not only the model could indicate whether genes in phylogeny under the positive selection or not, but also could forecast positive selection sites in these genes. The sites promote divergence and polymorphism of genes. Chemokines are chemotactic cytokines that can induce immune cells migration, conducting their functions via chemokine receptors. In the test, the molecular adaptation of chemokines and chemokines receptors genes had been analyzed by Branch-Site model. The results showed that only a few of genes, such as RANTES and CCR5, are in the course of positive selection. Several CCR5 positive selection sites are located in a region that involved in binding to receptor and its chemokine.