Efficacy of Huangma Ding or autologous platelet-rich gel for the diabetic lower extremity arterial disease patients with foot ulcers.

BACKGROUND: Diabetes foot is one of the most serious complications of diabetes and an important cause of death and disability, traditional treatment has poor efficacy and there is an urgent need to develop a practical treatment method. AIM: To investigate whether Huangma Ding or autologous platelet-rich gel (APG) treatment would benefit diabetic lower extremity arterial disease (LEAD) patients with foot ulcers. METHODS: A total of 155 diabetic LEAD patients with foot ulcers were enrolled and divided into three groups: Group A (62 patients; basal treatment), Group B (38 patients; basal treatment and APG), and Group C (55 patients; basal treatment and Huangma Ding). All patients underwent routine follow-up visits for six months. After follow-up, we calculated the changes in all variables from baseline and determined the differences between groups and the relationships between parameters. RESULTS: The infection status of the three groups before treatment was the same. Procalcitonin (PCT) improved after APG and Huangma Ding treatment more than after traditional treatment and was significantly greater in Group C than in Group B. Logistic regression analysis revealed that PCT was positively correlated with total amputation, primary amputation, and minor amputation rates. The ankle-brachial pressure and the transcutaneous oxygen pressure in Groups B and C were greater than those in Group A. The major amputation rate, minor amputation rate, and total amputation times in Groups B and C were lower than those in Group A. CONCLUSION: Our research indicated that diabetic foot ulcers (DFUs) lead to major amputation, minor amputation, and total amputation through local infection and poor microcirculation and macrocirculation. Huangma Ding and APG were effective attreating DFUs. The clinical efficacy of Huangma Ding was better than that of autologous platelet gel, which may be related to the better control of local infection by Huangma Ding. This finding suggested that in patients with DFUs combined with coinfection, controlling infection is as important as improving circulation.

Rhein inhibits endometriosis by targeting microRNA-135.

Endometriosis is a serious human gynecological disorder of women of reproductive age. The present study was designed to explore the therapeutic implications of rhein in the management of endometriosis. The results showed that rhein significantly (p<0.05) inhibited the proliferation of endometrial stroma cells in a dose-dependent fashion. Besides, the rhein treated endometrial stroma cells showed significantly (p<0.05) lower migration and invasion, in vitro. Transwell and wound healing assays showed that rhein also suppressed the migration and invasion of the endometrial stroma cells. Rhein was shown to target miR-135 at the molecular level to exert its anti-proliferative effects against the human endometrial stroma cells. Conversely, overexpression of miR-135 could nullify the anti-proliferative effects of rhein. Taken together, the findings of the present study highlight the therapeutic utility of rhein against human endometriosis. However, more in vivo studies are required.

Prevalence of unintentional injury among left-behind children in mainland China: Evidence from epidemiological surveys.

BACKGROUND: Left-behind children have become a particular concern in mainland China, and unintentional injury among these children has attracted increasing attention. This review aims to present the prevalence of unintentional injury among left-behind children and subgroups in mainland China. METHODS: A systematic literature search was conducted using four Chinese and two English databases. The included publications were cross-sectional studies in mainland China, of which the population was recruited according to inclusion and exclusion criteria. Information was collected using self-administered questionnaires. The risk of bias was estimated using the Strengthening the Reporting of Observational Studies in Epidemiology, and pooled prevalence was estimated through the DerSimonian-Laird proportion method. RESULTS: This review included 34 cross-sectional studies consisting 58,348 left-behind children in mainland China. Results showed that the pooled prevalence of unintentional injury was 38.24% (95% confidence interval (CI): 28.40-48.08) among left-behind children. The prevalence was higher among left-behind children (38.76%) than among non-left-behind children (27.94%), with an odds ratio of 1.65 (95% CI: 1.47-1.85). Furthermore, the prevalence of injury was higher among boys (39.12%) than among girls (28.61%), with an odds ratio of 1.58 (95% CI: 1.41-1.77). Falls had the highest prevalence of 20.79% among the types of unintentional injury. Furthermore, home was the occurrence location with the highest prevalence (16.20%). No significant difference in injury prevalence was observed among left-behind children without accompanying parents and those with single parent accompanying them. CONCLUSIONS: This review showed a relatively high injury prevalence among left-behind children in mainland China. Boys had a higher prevalence than girls. Falls had the highest prevalence, and home was the most common occurrence location.

[Active components and mechanism of Taohong Siwu Decoction in treatment of primary dysmenorrhea based on network pharmacology and molecular docking technology].

This paper aimed to investigate the active components and mechanism of Taohong Siwu Decoction in the treatment of primary dysmenorrhea(PD) based on network pharmacology and molecular docking technology. Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP) was used to search the chemical compositions and targets of six herbs in Taohong Siwu Decoction. The targets for PD treatment were selected through the databases of DrugBank, OMIM, TTD and CTD, and gene annotation of the targets was conducted with UniProt database. Cytoscape 3.7.2 was then used to construct the drug-compound-target network. The protein-protein interaction(PPI) network was constructed based on STRING, and the core targets of Taohong Siwu Decoction in the treatment of PD were selected according to the topological parameters. David database was used for GO enrichment analysis and KOBAS 3.0 was used for KEGG enrichment analysis. The molecular docking technology was used to connect the components with higher medium values in the network with core targets. The results showed that the network contained 36 compounds such as quercetin, kaempferol, luteolin, myricanone and ferulic acid, and 99 targets such as PTGS2, PTGS2, PGR and PPARG. Totally 102 GO terms were obtained by GO functional enrichment analysis(P<0.01), and 228 signal pathways were obtained by KEGG pathway enrichment(P<0.05), mainly involving inflammatory factors, hormone regulation, central analgesia, amino acid metabolism and spasmolysis. The results of molecular docking showed that the main active components can spontaneously bind to the targets. This study preliminarily revealed the mechanism of Taohong Siwu Decoction for treatment of primary dysmenorrheal through multi-components, multi-targets and multi-pathways, providing theoretical references for further researches on mechanism of Taohong Siwu Decoction.

Preliminary exploration of robotic complete mesocolic excision for colon cancer with the domestically produced Chinese minimally invasive Micro Hand S surgical robot system.

OBJECTIVE: To summarize our initial experience with robot-assisted complete mesocolic excision (R-CME) using a domestically produced Chinese surgical robot by a short-term evaluation. METHODS: From March 2018 to December 2018, 25 patients with colon cancer underwent Micro Hand S R-CME. The operative findings, morbidities and oncological findings were analysed. RESULT: The median operative duration was 210 (range, 180-235) min, and the median estimated blood loss volume was 55 (range, 25-125) ml. The median number of lymph nodes harvested was 42 (range, 21-77), and the median length of hospital stay after the operation was 7 (range, 5-9) days. There were no severe complications except for seven cases of grade I complications and five cases of grade II complications. The conversion rate was 0%. There were no cases of 30-day readmission or 30-day mortality. CONCLUSION: R-CME using a domestically produced surgical robot for selected colon cancer patients is technically feasible and safe.

Treatment with ß-elemene combined with paclitaxel inhibits growth, migration, and invasion and induces apoptosis of ovarian cancer cells by activation of STAT-NF-κB pathway.

In this study, we aimed to analyze the anti-cancer effects of ß-elemene combined with paclitaxel for ovarian cancer. RT-qPCR, MTT assay, western blot, flow cytometry, and immunohistochemistry were used to analyze in vitro and in vivo anti-cancer effects of combined treatment of ß-elemene and paclitaxel. The in vitro results showed that ß-elemene+paclitaxel treatment markedly inhibited ovarian cancer cell growth, migration, and invasion compared to either paclitaxel or ß-elemene treatment alone. Results demonstrated that ß-elemene+paclitaxel induced apoptosis of SKOV3 cells, down-regulated anti-apoptotic Bcl-2 and Bcl-xl gene expression and up-regulated pro-apoptotic P53 and Apaf1 gene expression in SKOV3 cells. Administration of ß-elemene+paclitaxel arrested SKOV3 cell cycle at S phase and down-regulated CDK1, cyclin-B1, and P27 gene expression and apoptotic-related resistant gene expression of MDR1, LRP, and TS in SKOV3 cells. In vivo experiments showed that treatment with ß-elemene+paclitaxel significantly inhibited ovarian tumor growth and prolonged the overall survival of SKOV3-bearing mice. In addition, the treatment inhibited phosphorylated STAT3 and NF-κB expression in vitro and in vivo. Furthermore, it inhibited migration and invasion through down-regulation of the STAT-NF-κB signaling pathway in SKOV3 cells. In conclusion, the data suggested that ß-elemene+paclitaxel can inhibit ovarian cancer growth via down-regulation of the STAT3-NF-κB signaling pathway, which may be a potential therapeutic strategy for ovarian cancer therapy.

Diagnostic accuracy of LAMP assay for HBV infection.

BACKGROUND: Detection of hepatitis B virus (HBV) is vital for the diagnosis of hepatitis B infection. A novel test loop-mediated isothermal amplification (LAMP) has been successfully applied to detect various pathogens. However, the accuracy of LAMP in diagnosing HBV remains unclear. Therefore, in the present study, the accuracy of LAMP for HBV detection was evaluated systematically. METHODS: Embase, Cochrane Library, and PubMed databases were searched for studies using LAMP to detect HBV. Then, two researchers extracted data and assessed the quality of literature using the QUADAS-2 tool independently. I2 statistic and chi-square test were analyzed to investigate the heterogeneity, and Deek's funnel plot assessed the publication bias. The pooled sensitivity (SEN), specificity (SPE), positive LR (PLR), negative LR (NLR), diagnostic odds ratio (DOR), and 95% confidence intervals were displayed in forest plots. We calculated the area under the curve (AUC) to assess the overall efficiency of LAMP for HBV detection. RESULTS: A total of nine studies with 1298 samples were finally included in this evaluation. The pooled sensitivity and specificity of HBV detection were 0.91 (95% CI: 0.89 ~ 0.92) and 0.97 (95% CI: 0.94 ~ 0.99), respectively. The PLR, NLR, and DOR were 16.93 (95% CI: 6.15 ~ 46.55), 0.08 (95% CI: 0.05 ~ 0.14), and 397.57 (95% CI: 145.41 ~ 1087.07). Besides, the AUC was 0.9872, and Deek's plot suggested that there existed publication bias in the studies. CONCLUSION: Compared with PCR, LAMP is a simple, rapid, and effective assay to diagnose HBV. However, additional evidence is essential to confirm that LAMP can replace other methods in diagnosing HBV infection.

Treatment with ß-elemene combined with paclitaxel inhibits growth, migration, and invasion and induces apoptosis of ovarian cancer cells by activation of STAT-NF-κB pathway

In this study, we aimed to analyze the anti-cancer effects of β-elemene combined with paclitaxel for ovarian cancer. RT-qPCR, MTT assay, western blot, flow cytometry, and immunohistochemistry were used to analyze in vitro and in vivo anti-cancer effects of combined treatment of β-elemene and paclitaxel. The in vitro results showed that β-elemene+paclitaxel treatment markedly inhibited ovarian cancer cell growth, migration, and invasion compared to either paclitaxel or β-elemene treatment alone. Results demonstrated that β-elemene+paclitaxel induced apoptosis of SKOV3 cells, down-regulated anti-apoptotic Bcl-2 and Bcl-xl gene expression and up-regulated pro-apoptotic P53 and Apaf1 gene expression in SKOV3 cells. Administration of β-elemene+paclitaxel arrested SKOV3 cell cycle at S phase and down-regulated CDK1, cyclin-B1, and P27 gene expression and apoptotic-related resistant gene expression of MDR1, LRP, and TS in SKOV3 cells. In vivo experiments showed that treatment with β-elemene+paclitaxel significantly inhibited ovarian tumor growth and prolonged the overall survival of SKOV3-bearing mice. In addition, the treatment inhibited phosphorylated STAT3 and NF-κB expression in vitro and in vivo. Furthermore, it inhibited migration and invasion through down-regulation of the STAT-NF-κB signaling pathway in SKOV3 cells. In conclusion, the data suggested that β-elemene+paclitaxel can inhibit ovarian cancer growth via down-regulation of the STAT3-NF-κB signaling pathway, which may be a potential therapeutic strategy for ovarian cancer therapy.

[Analysis of surveillance results of schistosomiasis in Hexi reservoir area from 2012 to 2015].

OBJECTIVE: To understand the changes of schistosomiasis epidemic situation, so as to provide the evidence for formulating schistosomiasis control strategy in the Hexi reservoir area. METHODS: From 2012 to 2015, Xinyuan Village, Meishan Town in the north entrance of Hexi reservoir was selected as a monitoring site. According to the requirements of the monitoring program of schistosomiasis surveillance in Zhejiang Province, the Schistosoma japonicum infection was investigated by using the serological screening (IHA), and the basic situation of the surveillance site was also investigated. RESULTS: From 2012 to 2015, 167 environments (21.68 hm2) were surveyed, and 2 slices (0.1 hm2) were found with Oncomelania hupensis snails. The detection rate of frames with snails was 0.12%, and the living snail density was 0.0192 snails per 0.1 m2. Totally 374 snails were dissected and no schistosome infected snails were found. A total of 970 local residents and 8 748 mobile people were investigated with the serological tests, and no schistosome infected people were found. In addition, 3 085 cattle were investigated and no infected ones were found. CONCLUSIONS: The schistosomiasis epidemic situation is stable in the Hexi reservoir area, but we still should strengthen the monitoring of imported source of infection and snail status, and increase the efforts of environmental transformation.

Techniques for covering soft tissue defects resulting from plantar ulcers in leprosy: Part I - general considerations and summary of results

Recurrent plantar ulceration is a common and serious complication occuring consequent to impairment of the tibial nerve in leprosy patients. In spite of many therapies and long therapeutic course, it is extremely difficult to abolish this complication in many cases because of extensive skin and soft tissue cushion loss due to repeated infection. Since the early 70 we have been using microscopic surgical techniques to reconstruct the ulcerated area using eight types of the flaps. In this series of papers we review out experience. Post operatively, the flapes survived in all cases, the long term results have proved satisfactory, and recurrent ulceration occurred in only three patients

Techniques for covering soft tissue defects resulting from plantar ulcers in leprosy: Part II - first toe web and dorsal foot flaps

The first toe web flap consists of th skin and subcutaneous tissues of the contiguous sides between the great and second toes. It is based on the first dorsal metatarsal artery or the common plantar digital artery. This flap was used as artery pedicled island graft to reconstruct losses of skin and soft tissue cushion in the ball of the foot in the first and second metatarsal head region in 16 cases. Follow up examination revealed that ulceration had recurred in one case due to dehiscence of the flap margin 12 months post operatively. The other 15 patients have done well without recurrence at 48 to 124 months follow up examination. The dorsal flap of the foot based on the dorsalis pedis artery, the corresponding veins and the deep peroneal nerve was designed in 1974 to resurface skin and soft tissue defects in the sole of the foot. This flap was used in 30 cases of leprosy with excellent results. During follow up 36 to 120 months after surgery the plantar ulcer had recurred in only one case. All the orthers have done well. The long term curative effect has thus proved satisfactory

Techniques for covering soft tissue defects resulting from plantar ulcers in leprosy: Part III - use of plantar skin or musculocutaneous flaps and anterior leg flap

Anatomical studies suggest that five types of plantar flaps namely, the lateral and medial plantar flaps, the Abductor hallucis, the Flexor digitorum brevis, and the Abductor digiti minimi myocutaneous flaps, can be incised from the central section of the sole. The advantages of a plantar flap are recognizable neurovascular bundles of the sole, wide calibre of constantly located blood vessels, identical histological structure of the donor and the recipient sites, hidden donnor site and absence of functional deficit. We have used the palntar flaps in seven cases. There has been no recurrence of ulceration in any of them during the follow up period of 12 to 108 month. An anterior leg flap based on the cutaneous branches of the anterior tibial artery, with firmly anchored vessels, a long pedicle with wide vessels may used not only as a free flap graft for reconstruction of moderate degree distant defects but also as a retrograde island flap graft for the reconstruction of adjacent tibial artery in five cases of plantar ulceration with satisfactoryresults. there was no recurrence of ulceration during the follow up period of 48 to 72 months

Techniques for covering soft tissue defects resulting from plantar ulcers in leprosy: Part IV - use of medial leg flap and medial knee flap

The medial leg flap, based on the cutaneous branches of the posterior tibial artery is raised from the middle and lower regions of the medial aspect of the leg. It has a long pedicle, and it can be used as a free flap to reconstruct the distant soft tissue and also as an island flap. We have used this retrograde island flap for a surfacing ulcerated areas in six leprosy patients. The flap survived in all cases. At 24 to 60 months follow up examination, ulceration had not recurred in any for them. The medial knee flap consisting of the skin and subcutaneous tissu of lower part of the medial side of the thih and upper part the leg, is suitable for covering soft tissue cushion defects of the extremities because of the constant vessels, long pedicle, wide diameter, well recognizable sensory nerves and less subcutaneous fat. We have used the medial knee flap for the resurfacing sizeable raw areas due to ulceration in there leprosy patients. the flap survived in all cases there was no recurrence of ulceration duriong the 70-148 months follow up period

Techniques for covering soft tissu defects resulting from plantar ulcers in leprosy: Part V - use of the flap in the inguinal region and latissimus dorsi musculocutaneous flap

The area of distribution of the superficial cicunflex iliac, superficial epigastric and superficial external pudental arteries is large and flaps based on them can meet the requirement of different recipient sites. We have transplanted free flaps based on the superficial epigastric artery for repairing plantar soft tissue defects in six leprosy patients. During the follow up examination 58 to 118 months later there has been no recurrence of ulceration in any of these cases. The latissimus dorsi muscle, is mainly nourished by the thoracadorsal artery and the latissimus dorsi musculocutaneous flap is a large sized, composite structure with abundant blood provision and strong anti infectious property. The latissimus dorsi flap can be used as a muscle graft. because ofits constant vascular position, wide outer diameter of the vessels and long pedicle. It can therefore be utilized for repairing soft tissue defect or replacement of paralyzed muscle. We have used the latissimus dorsi musculotacutaneous free flap for repairing large skin and soft tissue defects resulting from plantar ulceration in three leprosy patients. During the follow up period, one patient who had complete drop foot and had refused corrective surgery had recurrence of the ulcer in the 12 post operative month. No ulcers had recurred in the other two cases during the follow up at 48 and 114 months

Transplantation of fibula with vascular pedicle for fusion of ankle in leprotic drop-foot

Devascularized bone grafts are pieces of dead bone they simply serve as scaffods for new bone to grow and fill the gap, taking a long time when they succeed in doing so. In constrast, vascularized grafts being living tissues have short healing time, great vitality and strong infection resisting capacity. We report here the successful use of vascularized grafts of the lower end of fibula for fusing the ankle in five leprosy patients