Laparoscopic total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer: A systematic review and meta-analysis.

BACKGROUND: Laparoscopic total mesorectal excision (LaTME) and transanal total mesorectal excision (TaTME) are popular mid and low rectal cancer trends. However, there is currently no systematic comparison between LaTME and TaTME of mid and low rectal cancer. Therefore, we systematically study the perioperative and pathological outcomes of LaTME and TaTME in mid and low rectal cancer. METHODS: Articles included searching through the Embase, Cochrane Library, PubMed, Medline, and Web of science for articles on LaTME and TaTME. We calculated pooled standard mean difference (SMD), relative risk (RR), and 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42022380067). RESULTS: There are 8761 participants included in 33 articles. Compared with TaTME, patients who underwent LaTME had no statistical difference in operation time (OP), estimated blood loss (EBL), postoperative hospital stay, over complications, intraoperative complications, postoperative complications, anastomotic stenosis, wound infection, circumferential resection margin, distal resection margin, major low anterior resection syndrom, lymph node yield, loop ileostomy, and diverting ileostomy. There are similarities between LaTME and TaTME for 2-year DFS rate, 2-year OS rate, distant metastasis rat, and local recurrence rate. However, patients who underwent LaTME had less anastomotic leak rates (RR 0.82; 95% CI: 0.70-0.97; I2 = 10.6%, P = .019) but TaTME had less end colostomy (RR 1.96; 95% CI: 1.19-3.23; I2 = 0%, P = .008). CONCLUSION: This study comprehensively and systematically evaluated the differences in safety and effectiveness between LaTME and TaTME in the treatment of mid and low rectal cancer through meta-analysis. Patients who underwent LaTME had less anastomotic leak rate but TaTME had less end colostomy. There is no difference in other aspects. Of course, in the future, more scientific and rigorous conclusions need to be drawn from multi-center RCT research.

A systematic review and meta-analysis of minimally invasive total mesorectal excision versus transanal total mesorectal excision for mid and low rectal cancer.

Background: Minimally invasive total mesorectal excision (MiTME) and transanal total mesorectal excision (TaTME) are popular trends in mid and low rectal cancer. However, there is currently no systematic comparison between MiTME and TaTME of mid and low-rectal cancer. Therefore, we systematically study the perioperative and pathological outcomes of MiTME and TaTME in mid and low rectal cancer. Methods: We have searched the Embase, Cochrane Library, PubMed, Medline, and Web of Science for articles on MiTME (robotic or laparoscopic total mesorectal excision) and TaTME (transanal total mesorectal excision). We calculated pooled standard mean difference (SMD), relative risk (RR), and 95% confidence intervals (CIs). The protocol for this review has been registered on PROSPERO (CRD42022374141). Results: There are 11010 patients including 39 articles. Compared with TaTME, patients who underwent MiTME had no statistical difference in operation time (SMD -0.14; CI -0.31 to 0.33; I2=84.7%, P=0.116), estimated blood loss (SMD 0.05; CI -0.05 to 0.14; I2=48%, P=0.338), postoperative hospital stay (RR 0.08; CI -0.07 to 0.22; I2=0%, P=0.308), over complications (RR 0.98; CI 0.88 to 1.08; I2=25.4%, P=0.644), intraoperative complications (RR 0.94; CI 0.69 to 1.29; I2=31.1%, P=0.712), postoperative complications (RR 0.98; CI 0.87 to 1.11; I2=16.1%, P=0.789), anastomotic stenosis (RR 0.85; CI 0.73 to 0.98; I2=7.4%, P=0.564), wound infection (RR 1.08; CI 0.65 to 1.81; I2=1.9%, P=0.755), circumferential resection margin (RR 1.10; CI 0.91 to 1.34; I2=0%, P=0.322), distal resection margin (RR 1.49; CI 0.73 to 3.05; I2=0%, P=0.272), major low anterior resection syndrome (RR 0.93; CI 0.79 to 1.10; I2=0%, P=0.386), lymph node yield (SMD 0.06; CI -0.04 to 0.17; I2=39.6%, P=0.249), 2-year DFS rate (RR 0.99; CI 0.88 to 1.11; I2=0%, P = 0.816), 2-year OS rate (RR 1.00; CI 0.90 to 1.11; I2=0%, P = 0.969), distant metastasis rate (RR 0.47; CI 0.17 to 1.29; I2=0%, P = 0.143), and local recurrence rate (RR 1.49; CI 0.75 to 2.97; I2=0%, P = 0.250). However, patients who underwent MiTME had fewer anastomotic leak rates (SMD -0.38; CI -0.59 to -0.17; I2=19.0%, P<0.0001). Conclusion: This study comprehensively and systematically evaluated the safety and efficacy of MiTME and TaTME in the treatment of mid to low-rectal cancer through meta-analysis. There is no difference between the two except for patients with MiTME who have a lower anastomotic leakage rate, which provides some evidence-based reference for clinical practice. Of course, in the future, more scientific and rigorous conclusions need to be drawn from multi-center RCT research. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO, identifier CRD42022374141.

The anti-TMV potency of the tobacco-derived fungus Aspergillus versicolor and its active alkaloids, as anti-TMV activity inhibitors.

Nicotiana tabacum (tobacco) has attracted interest as one of the most economically important industrial crops widely cultivated in China, whose dried leaves are popularly consumed medicinally and recreationally by human societies. In this study, five undescribed alkaloids derivatives, isoaspergillines A-E, together with eight known alkaloids, notoamide D, (1R,4S)-4-benzyl-1-isopropyl-2,4-dihydro-1H-pyrazino-[2,1-b]quinazoline-3,6-dione, protuboxepin K, notoamide C, notoamide M, deoxybrevianamide E, cyclo (D-Pro-L-Trp), and versicolamide B, were obtained from the culture of the Nicotiana tabacum-derived fungus Aspergillus versicolor. Their structures were mainly elucidated through comprehensive analyses of spectroscopic data. Bioactivity evaluation of all isolated compounds revealed that isoaspergilline A and notoamide M exhibited anti-TMV activities with IC50 values of 20.0 and 22.8 µM, respectively. Molecular docking suggested that isoaspergilline A and notoamide M were well located into the active site of anti-TMV by interacting with SER138, SER143, and ASN73 residues. This study enlightens the therapeutic potential of the endophytic fungus A. versicolor and it is helpful to find undescribed anti-TMV activity inhibitors, as well as searching for new anti-TMV candidates from natural sources.

Clinical efficacy of atezolizumab plus bevacizumab combined with local therapy for the treat-ment of recurrent hepatocellular carcinoma before liver transplantation / 中华消化外科杂志

Downstaging treatment by local therapy combined with systemic therapy before liver transplantation for patients with recurrent hepatocellular carcinoma (HCC) can control tumor progression and reduce tumor burden, which resulting in reducing the push-out rate of patients during the waiting period for liver transplantation, providing an oncological observation window, enabling patients of beyond Milan criteria downstaged with better survival benefit. The authors introduce the clinical experience of a case with recurrent HCC of beyond Milan criteria who under-went liver transplantation after receiving atezolizumab plus bevacizumab combined with local therapy. Results show the patient achieving pathological complete remission without postoperative rejection and obtaining a good prognosis with life status improved.

Comparative study of laparoscopic surgery and open surgery in the treatment of intrahepatic cholangiocarcinoma / 中华肝胆外科杂志

Objective:To compare the differences of short and long-term outcomes between laparoscopic surgery and open surgery treatment of intrahepatic cholangiocarcinoma patients.Methods:A retrospective cohort study was conducted to collect the clinical data of 118 patients with intrahepatic cholangiocarcinoma who underwent surgery in Qilu Hospital of Shandong University from January 2015 to June 2020. They were divided into laparoscopy group and open group according to the operation methods. The perioperative data, such as intraoperative surgical conditions, hospital costs, postoperative complications, postoperative blood biochemical tests, and the follow-up data of the two groups were compared.Results:In the laparoscopic group, there were 40 patients, 18 males and 22 females, aged (61.5±9.1) years. There were 78 patients in the open group, 48 males and 30 females, aged (61.2±8.3) years. The tumor size of the laparoscopic group was (4.4±1.8) cm, which was smaller than that of the open group (6.0±3.3) cm, and the differences were statistically significant ( P<0.05). In the laparoscopic group, 4 cases (10%) were converted to open surgery. The intraoperative blood loss, intraoperative blood transfusion proportion, 3 or more liver segments resection proportion and hospital costs of laparoscopic group were lower than those of open group [200.0(100.0, 261.8) ml vs. 300.0(100.0, 400.0) ml, 5.0%(2/40) vs. 26.9%(21/78), 37.5%(15/40) vs. 66.7%(52/78), (6.2±2.0) wan yuan vs. (7.2±2.3) wan yuan], the differences were statistically significant (all P<0.05). There were no significant differences in the incidence of postoperative complications between the two groups ( P>0.05). On the first post-operative day, ALT serum level and the third post-operative day TBil serum level in the laparoscopic group were lower than those in the open group [188.5(130.5, 274.0) U/L vs. 320.0(144.0, 427.0) U/L, 26.4(18.3, 26.4) μmol/L vs. 31.6(18.8, 37.5) μmol/l], the differences were statistically significant ( P<0.05). There were no significant differences in 1-year and 2-year overall survival rate and disease-free survival rate between the two groups ( P>0.05). Conclusion:Compared with open surgery, laparoscopic surgery in the treatment of intrahepatic cholangiocarcinoma has better short-term outcomes, and can achieve similar results in medium- or long-term outcomes.

Prevalence and factors associated with HIV testing uptake among sexual active college students in Zhuhai City / 中国学校卫生

Objective@#To understand the prevalence of HIV (human immunodeficiency virus) testing and associated factors among sexual active college students in Zhuhai City.@*Methods@#From November to December, 2019, an anonymous electronic questionnaire was administered among 12 235 students in six colleges and universities in Zhuhai City by multistage sampling. A total of 1 789 college students ever had sex were selected. Pearsons Chisquare test and nonconditional Logistic regression model were applied to analyze the factors associated with uptake of HIV testing.@*Results@#Among these students ever had sex, 7.55% (135/1 789) had been tested for HIV mainly through hospitals (71.85%). The main reasons for testing were regular testing (50.37%) and intending to know their infection status (23.70%). Multivariable Logistic regression showed that homosexual individuals (OR=4.62, 95%CI=1.07-19.95) and those who had heterosexual commercial sex in the past year (OR=3.77, 95%CI=1.96-7.26) were more likely to test for HIV, while female (OR=0.41, 95%CI=0.24-0.69) were less likely to test for HIV.@*Conclusion@#The proportion of HIV testing was low among sexual active college students in Zhuhai City. Interventions should be tailored including strengthening the HIV testing propaganda education and enhancing students awareness of HIV testing, and the influencing factors such as gender, sexual orientation and commercial sexual behavior should be taken into consideration, so as to improve the HIV testing coverage of this population.

Biomechanical Analysis of the Knee after Unicompartmental Knee Arthroplasty during Stair Ascent / 医用生物力学

Objective To investigate the effect of medial unicompartmental knee arthroplasty (UKA) surgery on knee biomechanics during stair ascent. Methods Nine osteoarthritis patients who received fixed-bearing medial UKA participated in this study. All patients completed pre-surgical (3 weeks before UKA surgery) and post-surgical ［(7±2) months after UKA surgery］ test. Their synchronized biplane radiographs during stair ascent were collected. Motion of the femur, tibia, and implants were tracked using an automated volumetric model-based tracking process that matched subject-specific 3D models of the bones and prostheses to the biplane radiographs with sub-millimeter accuracy. Anatomic coordinate systems were created within the femur and tibia and used to calculate tibiofemoral kinematics. Additional outcome measures included the center of contact in the medial and lateral compartments, and the lateral compartment dynamic joint space. Results The UKA knee was in 4.8° varus compared with the pre-surgical contralateral knee. The post-surgical UKA knee was in 3.1°valgus compared with the pre-surgical knee. The post-surgical UKA knee was 4.4° externally rotated compared with the pre-surgical contralateral knee. However, the medial tibia contact center of the UKA knee moved posteriorly 2.5 mm compared with that of the contralateral knee (P0.05). Conclusions UKA can effectively improve varus of the knee joint and restore biomechanical characteristics of UKA knee rotation, without affecting lateral compartment joint space. However, changes are found in contact center of the medial tibia compartment of the UKA knee after surgery.

Is laparoscopic hepatectomy suitable for giant hepatic hemangioma larger than 10 cm in diameter?

BACKGROUND: Surgical treatment of giant hepatic hemangioma larger than 10 cm in diameter often requires major laparoscopic liver resection (LLR), which is very difficult and has a high risk of bleeding. There is no consensus as to whether giant hepatic hemangioma is an indication or a contraindication for laparoscopic surgery. METHODS: From 2011/09 to 2018/05, 58 patients with giant hepatic hemangioma larger than 10 cm underwent laparoscopic surgery. They were divided into high-difficulty (HD) group and low-difficulty (LD) group according to the operation difficulty score. The perioperative data of the two groups were analyzed and compared. RESULTS: There were 30 patients in the LD group and 28 in the HD group. No differences were showed in sex, age, ASA grade, tumor size, operation time, conversion rate, intraoperative and post-operative blood transfusion rate, and post-operative complications between the two groups. The amount of bleeding in the HD group was significantly higher than that in the LD group (285.7 ± 224.0 vs 189.6 ± 157.6 ml, p = 0.007). The time of hepatic hilar occlusion in the HD group was longer than that in the LD group (25.4 ± 8.8 vs 20.6 ± 7.3 min, p = 0.001), and the rate of hepatic hilar occlusion in the HD group was also higher than that in the LD group (71.4% vs 33.3%, p = 0.004). The incidence of hospitalization days and discharge time in the LD group were shorter than those in the HD group (6.3 ± 1.6 vs 8.2 ± 1.4 days, p = 0.000; 16.4 ± 5.5 vs 21.9 ± 4.6 h, p = 0.019). There was no significant difference in enzymatic parameters between the two groups after operation. CONCLUSIONS: Although there are great difficulties and risks objectively, laparoscopic treatment of giant hepatic hemangioma is safe and feasible.

Risk Factors of Acute Kidney Injury Complicating Adult Primary Nephrotic Syndrome / 中国医学科学院学报

To explore the risk factors of acute kidney injury(AKI)in adult primary nephrotic syndrome(PNS). Totally 185 patients with PNS were divided into AKI group(=51)and non-AKI group(=134).The demographic data and clinical and histological features at admission were compared between the two groups.The independent risk factors for AKI were evaluated by Logistics regression analysis. In 51 PNS patients with AKI,the common pathological types of AKI included minor glomerular abnormalities(29.4%),IgA nephropathy(25.5%),and membranous nephropathy(17.6%).The incidences of renal tubular casts and epithelial vacuoles in the AKI group were significantly higher than those in the non-AKI group(=0.004,=0.030).Males were more likely to suffer from AKI than females(=0.000).Patients in AKI group had significantly lower albumin level(=0.015)and higher levels of random urine protein,serum creatinine,uric acid,urea nitrogen,and triglyceride than non-AKI group(=0.030,=0.000,=0.000,=0.000,and =0.006),and polyserous and oliguria occurred more often in the AKI group(=0.000,=0.002).The AKI group had significantly higher incidences of high blood pressure and infections(=0.035,=0.000).Multivariate logistics regression analysis showed albumin(96 μmol/L),urea nitrogen(≥6.8 mmol/L),uric acid(≥400 μmol/L),diabetes,infection,and renal tubular casts were the independent risk factors for AKI. AKI complicating PNS is associated with a variety of factors.Its independent risk factors include the levles of albumin,serum creatinine,urea nitrogen,and uric acid,diabetes,infections,and renal tubular casts.

Effect of Comprehensive Treatments on Autism Spectrum Disorder / 中国康复理论与实践

Objective:To observe the effect of comprehensive treatments on autism spectrum disorders (ASD). Methods:From October, 2017 to October, 2019, 60 children with ASD were divided into control group (n = 30) and treatment group (n = 30) randomly. The control group received rehabilitation training and special education, while the treatment group received acupuncture, massage and Chinese Medicine, in addition, for twelve weeks. The scores of Austin Behavior Checklist (ABC) and Autism Treatment Evaluation Checklist (ATEC) were compared before and after treatment. Results:Before treatment, there was no significant difference in the scores of ABC and ATEC between two groups (t < 1.426, P > 0.05). After treatment, the scores of ABC and ATEC significantly decreased in both groups (t > 5.46, P < 0.001), and were better in the treatment group than in the control group (|t| > 3.304, P < 0.01). Conclusion:Traditional Chinese Medicine combined with rehabilitation training and special education is effective on ASD, which is superior to rehabilitation training and special education.

Quality Evaluation of Tremella fuciformis Polysaccharides from Different Sources / 中国实验方剂学杂志

Objective:To establish a method for the determination of polysaccharide and monosaccharide composition of Tremella fuciformis, and to analyze the difference of polysaccharide content in T. fuciformis from different sources and cultivation methods, so as to provide reference for the quality determination.Method:High performance size exclusion chromatography coupled with multi-angle laser light scattering and refractive index detection (HPSEC-MALLS-RID) was employed to determine the content and relative molecular weight distribution of T. fuciformis polysaccharides. The monosaccharide types and proportions of T. fuciformis polysaccharides were analyzed by 1-phenyl-3-methyl-5-pyrazolone (PMP) precolumn derivative high performance liquid chromatography (HPLC).Result:The weight-average relative molecular weight (Mw) and the content of polysaccharides in T. fuciformis cultivated by cut-log from different sources were distributed in 2.618×106-3.503×106 Da and 307.12-609.06 g·kg-1, respectively. These two parameters of polysaccharides in T. fuciformis with substitute cultivation from different sources were 2.723×106-3.886×106 Da and 366.38-647.37 g·kg-1, respectively. The T. fuciformis polysaccharides mainly consisted of mannose, glucuronic acid, glucose, galactose, xylose and fucose, their ratios in samples with cut-log and substitute cultivation were 4.4∶0.7∶1.0∶0.2∶1.4∶1.6 and 4.4∶0.8∶1.0∶0.1∶1.5∶1.5, respectively. The contents of the above six monosaccharides in 39 batches of T. fuciformis from different sources were mannose of 36.71-191.31 g·kg-1, glucose of 10.46-76.10 g·kg-1, galactose of 1.00-6.72 g·kg-1, xylose of 16.73-70.54 g·kg-1, glucuronic acid of 9.74-32.12 g·kg-1, fucose of 17.16-68.20 g·kg-1.Conclusion:The content of polysaccharides in T. fuciformis from different sources has a certain difference, the developed method can be used as a routine method for the quality evaluation of polysaccharides in T. fuciformis.

A novel technique to prepare a single cell suspension of isolated quiescent human hepatic stellate cells.

To explore a simple and easy-to-learn procedure for the isolation of human quiescent hepatic stellate cells (HSCs) that requires no advanced training. Thus reducing costs and increasing efficiency. This protocol will provide sufficient primary cells with minimal contaminants for future basic research on diseases associated with human HSCs. Normal liver tissues were isolated from patients undergoing hepatic hemangioma resection, and a single cell suspension of these tissues was prepared using the Gentle MACS tissue processor. By using this method, the difficulty of the procedure was reduced, fewer cells were lost during the preparation treatments, and the maximal activity of single cells was maintained. Following preparation of the cell suspension, the HSCs were further isolated using a Nycodenz density gradient. Cell viability was examined by trypan blue staining, and the purity of the quiescent human HSCs was determined by autofluorescence and oil red O staining. Activated and quiescent human HSCs were identified using immunofluorescence and Western blotting. The cell cycle distribution in activated and quiescent human HSCs was analyzed by flow cytometry.The recovery rate of the HSCs was approximately (2.1 ± 0.23) × 106 of tissue, with 94.43 ± 1.89% cell viability and 93.8 ± 1.52% purity. The technique used in this study is a simple, high-yield, and repeatable method for HSC isolation that is worthy of recommendation.

Evaluation of key production processes of Chan Taoren formula granules based on characteristic chromatogram and D-amygdalin transfer rate / 中国中药杂志

This study aimed to establish characteristic chromatogram and content determination method for Chan Taoren formula granules,evaluate the production processes of Chan Taoren formula granules based on the correlation of characteristic chromatogram and the transfer rate of D-amygdalin,and clarify the key control points. The optimized analytical method was carried out on a Waters CORTECS C18 column(4. 6 mm×150 mm,2. 7 μm) with acetonitrile-0. 1% phosphoric acid aqueous solution as the mobile phase at a flow rate of 0. 6 m L·min-1. The detection wavelength was 207 nm,and the column temperature was 20 ℃ ． As compared with the standard decoction of Chan Taoren,there were five characteristic peaks in the decoction pieces,extracts,concentrates,spray-dried powders and formula granules,basically consistent in relative retention time and peak pattern; in addition,the transfer rate of D-amygdalin from Chan Taoren pieces to the formula granules was within the transfer rate range of standard decoction. The average transfer rate of D-amygdalin was 56.65%,72.85%,94.58% and 99.29% respectively in the extraction,concentration,spray drying and granulation processes. Therefore,the factors affecting D-amygdalin in the extraction process were further studied. The results showed that D-amygdalin was easily converted to L-amygdalin in the water extraction process,leading to a low transfer rate of D-amygdalin in this process.D-amygdalin was unstable under alkaline conditions and prone to isomerization. Both liquid to solid ratio and extraction time had significant effects on the extraction rate of D-amygdalin. In this study,the key links in the production process of Chan Taoren formula granules was clarified based on the characteristic chromatogram and the quantity transmission of D-amygdalin,which provided a theoretical basis for production and quality control.

Quality evaluation of Moutan Cortex Formula Granules / 中国中药杂志

A scientific and perfect quality evaluation system for Moutan Cortex Formula Granules was established,including content determination method,characteristic chromatogram method and mass spectrometry method. The content of paeoniflorin and paeonol in Moutan Cortex Formula Granules was determined by high performance liquid chromatography( HPLC),and the average content was 1. 72% and 1. 42%,respectively. The characteristic chromatogram was used to characterize Moutan Cortex Formula Granules,which contained 7 characteristic peaks,namely gallic acid,p-hydroxybenzoic acid,oxypaeoniflorin,paeoniflorin,tetragalloyl glucose,1,2,3,4,6-penta-O-galloyl-β-D-glucose and paeonol. A total of 40 compounds in Moutan Cortex Formula Granules,including gallic acids,paeoniflorins,paeonols,flavonoids and benzoic acids,were identified by mass spectrometry. In this study,a variety of analytical methods were used to evaluate the quality system of Moutan Cortex Formula Granules,which could play a positive role in improving the level of quality evaluation and process quality control.

Research on quality standards of standard decoction of Fructus Corni piece / 中国中药杂志

This study aims to develop the quality standards of Fructus Corni piece standard decoction. Morroniside and loganin were considered as index components. The content determination method of morroniside and loganin were developed. The fingerprint analysis method was also established. The standard decoctions of 15 batches of Fructus Corni pieces from Henan, Zhejiang, and Shaanxi were analyzed. The similarity values of fingerprint were all above 0.99. The transfer rates of morroniside were all higher than 100%. The quality evaluation indices of standard decoction were discussed. The transfer rate of an index component was not easy to be measured accurately and its concept was not rigorous. Therefore, index component yield was suggested as an evaluation index of standard decoction. Two methods for setting quality standards of standard decoctions, which were the ■ method and the ■ method, were compared. It was found that the standard range of ■ method was wider and more suitable for smaller sample size of standard decoction. The quality standards of Fructus Corni standard decoction were as follows, dry matter extraction ratio 37.48%-69.60%; morroniside yield 8.719-16.19 mg·g~(-1) piece; loganin yield 4.342-8.064 mg·g~(-1) piece.

Sebaceous cell differentiation in a canine oral papilloma.

Papillomas caused by viral infection are well-known tumors in animals. Microscopic features typically include neoplastic epithelium with hyperkeratosis and koilocytes. An 8-y-old castrated male Shih Tzu dog was presented with a small exophytic mass on the external upper lip. The mass was diagnosed as a viral papilloma based on microscopic and immunohistochemical examination. Sebaceous cell differentiation was found in the neoplastic epithelium of the tumor, which is a rare finding in humans or animals.

Clinical observation of modified Shenqi Decoction in the treatment for patients with early-to-middle stage nontraumatic osteonecrosis of femoral head / 中成药

AIM To investigate the clinical therapeutic effects of modified Shenqi Decoction in treating earlyto-middle stage nontraumatic osteonecrosis of femoral head (NONFH) due to kindey deficiency and blood stasis syndrome,and its impacts on serum TNF-α,CRP,NO,SOD as well.METHODS Totally,104 cases of eligible patients were randomly divided into traditional Chinese medicine (TCM) group,chemical medicine group and TCM combined with chemical medicine group,38 cases in each group,for a three-month course of treatment.The TCM group was dosed with modified Shenqi Decoction,the chemical medicine group with sodium alendronate,and the TCM combined with chemical medicine group with both modified Shenqi Decoction and sodium alendronate.The Harris SF-36,SF-36,FPS-R and TCM symptoms assessment were applied to estimating the efficacy of three groups before and after the treatment.So were the check of the serum TNF-α,CRP,NO,SOD levels,and rates of efficiency after treatments and six-month follow-ups,and incidence of adverse reactions during the treatment among all the three groups.RESULTS The efficiency rates were found to be in the following sequence:the chemical medicine group (76.5％) ＜ the TCM group (83.8％) ＜ the TCM combined with chemical medicine group (97.2％) (P ＜ 0.05).The TCM combined with chemical medicine group had its post-treatment scores of Harris SF-36,FPS-R,FPS-R,TCM symptom and the serum TNF-α,CRP,NO,SOD levels significantly improved as compared with other two groups (P ＜ 0.05).And the revealed incidence of adverse reactions was ranked as the TCM group (2.7％) ＜ the TCM combined with chemical group (30.6％) ＜ the chemical medicine group (70.6％) (P ＜ 0.05).CONCLUSION Modified Shenqi Decoction is superior to sodium alendronate in the treatment of NONFH due to kidney deficiency and blood stasis syndrome for its better performance in both the efficacy and the incidence of adverse reactions,and its synergistic effect with use of sodium alendronate may associate with its capability in offsetting the adverse reactions of sodium alendronate.

Effect of Regulatory Network of Exosomes and microRNAs on Neurodegenerative Diseases / 中华医学杂志(英文版)

<p><b>Objective</b>A comprehensive review of the network regulation of exosomes and microRNAs (miRNAs) in neurodegenerative diseases was done, centering on the mechanism of the formation of exosomes and miRNAs and the sorting mechanism of exosomal miRNAs, with the aim to provide a theoretical basis in the search of biomarkers and the treatment of neurodegenerative diseases.</p><p><b>Data Sources</b>The comprehensive search used online literature databases including NCBI PubMed, Web of Science, Google Scholar, and Baidu Scholar.</p><p><b>Study Selection</b>The study selection was based on the following keywords: exosomes, miRNAs, central nervous system (CNS), and neurodegenerative diseases. The time limit for literature retrieval was from the year 2000 to 2018, with language restriction in English. Relevant articles were carefully reviewed, with no exclusions applied to study design and publication type.</p><p><b>Results</b>Exosomes are the smallest nanoscale membranous microvesicles secreted by cells and contain important miRNAs, among other rich contents. In the CNS, exosomes can transport amyloid β-protein, α-synuclein, Huntington-associated protein 1, and superoxide dismutase I to other cells. These events relieve the abnormal accumulation of proteins and aggravating neurological diseases. In some neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis, miRNAs are pathologically altered as an inexorable course, suggesting that miRNAs may contribute neurodegeneration. Exosomes and miRNAs form a network to regulate the homeostasis of the CNS, both synergistically and individually.</p><p><b>Conclusion</b>The network of exosomes and miRNAs that regulates CNS homeostasis is a promising biomarker for the diagnosis and treatment of neurodegenerative diseases.</p>

Preoperative application of combination of portal venous injection of donor spleen cells and intraperitoneal injection of rapamycin prolongs the survival of cardiac allografts in mice

OBJECTIVE@#To investigate the effects of preoperative portal venous injection of donor spleen cells (PVIDSC) and intraperitoneal injection of rapamycin in the acute rejection of cardiac allograft in mice and the underlying mechanisms.@*METHODS@#Homogenous female B6 mice and BALB/c mice were used as recipients and donors of heart transplantation. These mice were randomly divided into different groups and received PVIDSC alone, rapamycin alone, or PVIDSC and rapamycin combined therapy. In addition, the underlying mechanism was studied by measuring a number of cytokines.@*RESULTS@#Preoperative combination of PVIDSC and intraperitoneal injection of rapamycin significantly prolonged the survival of heterotopic cardiac allograft in mice, but had no effects on the survival time of cardiac allografts in mice pre-sensitized by skin grafting. Preoperative combination of PVIDSC and intraperitoneal injection of rapamycin increased the expression of IL-10 and Foxp3 and reduced the expression of INF-. Short-term preoperative administration of rapamycin promotes the expression of CD4CD25Foxp3 regulator T cells. However, preoperative using alone of rapamycin, or combination of PVIDSC and rapamycin had no effects on the inhibition of proliferation of memory T cells.@*CONCLUSIONS@#Preoperative application of combination of PVIDSC and rapamycin significantly prolonged the survival time of cardiac allografts in mice but not in mice pre-sensitized by skin grafting. This may be explained by the fact that combination of PVIDSC and rapamycin inhibited the cellular immune response and induced the expression of IL-10 from Tr1 cells and CD4CD25FoxP3 regulatory T cells.

Research progress of brain-computer interface technology for the rehabilitation of the upper limb motor function after stroke / 国际生物医学工程杂志

The upper limb dysfunction resulted from stroke has a high incidence and is hard to recover,seriously affecting the daily life and life quality of patients.The nerve tissue damage caused by stroke usually leads to the injuries of movement,sensory,cognitive and etc.The effective rehabilitation therapy can promote the rebuilding of the surviving cranial nerves to enhance the function and ability.As a modem intelligent nerve rehabilitation technology,brain-machine interface (BCI) directly builds the exchange channel between the brain and the surrounding environment.BCI extracts the brain's neural activity information,and transfers into the command to drive external equipment.BCI does not rely on the peripheral nerve system and muscle tissue.BCI technology is well suited for neurological rehabilitation training,because the repeated training associated with external equipments and BCI feedback can induce a normal exercise mode,indirectly induced the generation of normal brain signal,and promote brain remodeling,so that improve the patient's athletic ability and exercise control level.In this paper,the research progress of BCI technology for the rehabilitation of the upper limb motor function after stroke was reviewed,including the application,the efficacy and the existing limitations.