Noise Exposure and Stress Hormone Levels:A Review / 中国医学科学院学报

Noise is one of the most common environmental hazards to which people are exposed,and the exposure to noise can cause not only hearing but also non-hearing damage.Although noise under safety limits may not affect the auditory system,it can cause changes in stress hormone levels,which is harmful to health.However,the current studies about the impact of noise on health mainly focus on the auditory system,and little is known about the relationship between noise and stress hormone levels.Therefore,this paper reviews the studies involving noise exposure and stress hormone levels,aiming to provide ideas for strengthening the prevention and control of noise hazards.

Data Mining Study on Prescription Patterns of Different Dosage Forms of Chinese Herbal Medicines for Treating and Improving Immune-Inflammatory Indices in Patients with Rheumatoid Arthritis / 中国结合医学杂志

OBJECTIVE@#To explore the prescription patterns of different dosage forms of Chinese herbal medicines (CHMs) for the treatment of rheumatoid arthritis (RA) and their effects on immune-inflammatory indices.@*METHODS@#Clinical data were collected from patients with RA in 4 hospitals (3 Class A comprehensive hospitals and 1 Class B comprehensive hospital) in Anhui Province, China, from August 2012 to June 2018 via the electronic medical record gathering system. Following extraction of prescription information, each prescribed herb was quantified and standardized according to the knowledge base to establish a database of RA treatment formulae. The medical records were divided into the granules group and decoction pieces group. Core herbs and their combination patterns were obtained from the two groups of cases using Liquorice software. Changes in immune-inflammatory and hepatic and renal function indices were compared between the two groups using SPSS 23.0 software. The Aprior module of SPSS Clementine 11.1 software was applied to analyse the correlation between CHMs and improvement in indices. Finally, the ORACLE 10 g tool was used to evaluate the random walk model of the immune-inflammatory indices between the two groups.@*RESULTS@#(1) We retrospectively analysed 35,898 prescriptions for 6,829 patients with RA who received CHM treatment. There were 3,816 patients in the granules group and 3,013 in the decoction pieces group. (2) The core herbs were Pi (Spleen)-strengthening and dampness-resolving drugs, blood-activating and stasis-resolving drugs, wind/dampness-dispelling drugs and heat-clearing and detoxifying drugs. (3) Both dosage forms could improve immune-inflammatory indices in RA patients, with similar efficacy and no influence on hepatic or renal function. (4) Herba Siegesbeckiae and Oldenlandia had a stronger association with immune-inflammatory indices in the two groups. (5) The immune-inflammatory indices showed obvious improvement after treatment with granules and decoction pieces of CHMs, and there were long range correlations between the comprehensive evaluation indices and interventions.@*CONCLUSIONS@#The principal CHM treatment methods for RA in four hospitals in Anhui Province are strengthening Pi and resolving dampness, activating blood and resolving stasis, dispelling wind/dampness and clearing heat. Granules and decoction pieces of CHMs have similar efficacy in improving immune-inflammatory indices in RA patients and could be used as treatment options for RA.

Relationship between the macular retina vascular density and retinal circulation time in CRAO patients / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To observe the macular retina vascular density of patients with acute central retinal artery occlusion(CRAO)by optical coherence tomography angiography(OCTA)and to analyze the relationship with retinal circulation time of these patients on fundus fluorescein angiography(FFA).METHODS: Retrospective case analysis. A total of 43 patients(43 eyes)from January 2019 to March 2021 admitted to Shaanxi Eye Hospital with clinical diagnosis of acute CRAO(course of disease ≤7d)were included. All patients underwent FFA, OCTA, best corrected visual acuity(BCVA)examination and thrombolytic therapy. The patients with enhanced or unchanged retinal blood flow signal in the affected eye showed on OCTA before treatment compared with the contralateral healthy eye were assigned to group A, and the patients with retinal blood flow signal of the affected eye was lower than that in the contralateral healthy eye by OCTA were assigned to group B. Image J software was used for OCTA image processing to evaluate the macular retina vascular density before treatment, and FFA examination was performed to record the affected retinal circulation time before treatment.RESULTS: The retinal vascular density of patients in the affected eye and the contralateral healthy eye in group A was higher than that in group B(25.08%±4.40% vs 12.24%±3.41%, 25.72%±2.70% vs 17.89%±4.55%, all P<0.001), the filling time(FT)of retinal artery trunk to terminal in group B [96(20.50, 193.50)s] was longer than that in group A [11(5.00, 19.50)s](P<0.001). The course of disease, the retinal vascular density of contralateral healthy eye and FT were related factors of retinal vascular density of the affected eye(all P<0.05), and the influence strength order was FT, course of disease and the retinal vascular density of contralateral healthy eye, in which the course of disease and FT was negatively correlated with the retinal vascular density.CONCLUSION: OCTA retinal vascular density was correlated with FFA retinal circulation time in CRAO patients.

Identification of Hypertension Subgroups through Topological Analysis of Symptom-Based Patient Similarity / 中国结合医学杂志

OBJECTIVE@#To obtain the subtypes of the clinical hypertension population based on symptoms and to explore the relationship between hypertension and comorbidities.@*METHODS@#The data set was collected from the Chinese medicine (CM) electronic medical records of 33,458 hypertension inpatients in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine between July 2014 and May 2017. Then, a hypertension disease comorbidity network (HDCN) was built to investigate the complicated associations between hypertension and their comorbidities. Moreover, a hypertension patient similarity network (HPSN) was constructed with patients' shared symptoms, and 7 main hypertension patient subgroups were identified from HPSN with a community detection method to exhibit the characteristics of clinical phenotypes and molecular mechanisms. In addition, the significant symptoms, diseases, CM syndromes and pathways of each main patient subgroup were obtained by enrichment analysis.@*RESULTS@#The significant symptoms and diseases of these patient subgroups were associated with different damaged target organs of hypertension. Additionally, the specific phenotypic features (symptoms, diseases, and CM syndromes) were consistent with specific molecular features (pathways) in the same patient subgroup.@*CONCLUSION@#The utility and comprehensiveness of disease classification based on community detection of patient networks using shared CM symptom phenotypes showed the importance of hypertension patient subgroups.

Protective Effect of Naoxintong Capsule () Combined with Guhong Injection () on Rat Brain Microvascular Endothelial Cells during Cerebral Ischemia-Reperfusion Injury / 中国结合医学杂志

OBJECTIVE@#To investigate the synergistic effect of Naoxintong Capsule (NXTC, ) and Guhong Injection (GHI, ) on cerebral ischemia-reperfusion (I/R) injury.@*METHODS@#Forty-eight Sprague-Dawley rats were divided into 6 groups: control group, oxygen and glucose deprivation (OGD) group, nimodipine group (9.375 mg/kg), NXTC group (0.5 g/kg), GHI group (5 mL/kg) and NXTC+GHI group (0.5 g/kg NXTC+5 mL/kg GHI), after the onset of reperfusion and once per day for the following 7 days. Blood was collected 1 h after final administration, and the sera were collected. Cultured primary rat brain microvascular endothelial cells (rBMECs) were subjected to OGD to establish a cell injury model. Untreated rBMECs were used as blank control. The cell counting kit-8 assay was used to assess cell viability using the sera. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were assessed using an enzyme-linked immunosorbent assay. Apoptosis was evaluated after Hoechst33342 staining using fluorescence microscopy and flow cytometry. JC-1 staining was performed to assess changes in mitochondrial membrane potential.@*RESULTS@#Statistical analysis indicated that more than 95% of the cells were rBMECs. Compared with the OGD group, the cellular morphology of the all drug delivery groups improved. In particular, the combined drug group had the most significant effect. Compared with the OGD group, all drug intervention groups induced a decrease in the apoptotic rate of rBMECs, increased the SOD levels, and decreased the MDA levels (all P<0.01). Compared with the mono-therapy groups, the NXTC+GHI group exhibited a significant improvement in the number of apoptotic rBMECs (P<0.01). All drug intervention groups showed different degrees of increase in membrane potential, and the NXTC+GHI group was higher than the NXTC or GHI group (P<0.01).@*CONCLUSION@#The combinationa application of NXTC and GHI on cerebral I/R injury clearly resulted in protective benefits.

In vitro fertilization-embryo transfer in patients with unexplained recurrent pregnancy loss / 中华医学杂志(英文版)

BACKGROUND@#Empiric therapy for patients with unexplained recurrent pregnancy loss (URPL) is not precise. Some patients will ask for assisted reproductive technology due to secondary infertility or advanced maternal age. The clinical outcomes of URPL patients who have undergone in vitro fertilization-embryo transfer (IVF-ET) require elucidation. The IVF outcome and influencing factors of URPL patients need further study.@*METHODS@#A retrospective cohort study was designed, and 312 infertile patients with URPL who had been treated during January 2012 to December 2015 in the Reproduction Center of Peking University Third Hospital were included. By comparing clinical outcomes between these patients and those with tubal factor infertility (TFI), the factors affecting the clinical outcomes of URPL patients were analyzed.@*RESULTS@#The clinical pregnancy rate (35.18% vs. 34.52% in fresh ET cycles, P = 0.877; 34.48% vs. 40.27% in frozen-thawed ET cycles, P = 0.283) and live birth rate (LBR) in fresh ET cycles (27.67% vs. 26.59%, P = 0.785) were not significantly different between URPL group and TFI group. URPL group had lower LBR in frozen-thawed ET cycles than that of TFI group (23.56% vs. 33.56%, P = 0.047), but the cumulative LBRs (34.69% vs. 38.26%, P = 0.368) were not significantly different between the two groups. The increased endometrial thickness (EMT) on the human chorionic gonadotropin day (odds ratio [OR]: 0.848, 95% confidence interval [CI]: 0.748-0.962, P = 0.010) and the increased number of eggs retrieved (OR: 0.928, 95% CI: 0.887-0.970, P = 0.001) were protective factors for clinical pregnancy in stimulated cycles. The increased number of eggs retrieved (OR: 0.875, 95% CI: 0.846-0.906, P < 0.001), the increased two-pronucleus rate (OR: 0.151, 95% CI: 0.052-0.437, P < 0.001), and increased EMT (OR: 0.876, 95% CI: 0.770-0.997, P = 0.045) in ET day were protective factors for the cumulative live birth outcome.@*CONCLUSION@#After matching ages, no significant differences in clinical outcomes were found between the patients with URPL and the patients with TFI. A thicker endometrium and more retrieved oocytes increase the probability of pregnancy in fresh transfer cycles, but a better normal fertilization potential will increase the possibility of a live birth.

Where are the theca cells from: the mechanism of theca cells derivation and differentiation / 中华医学杂志(英文版)

Mammalian follicles are composed of oocytes, granulosa cells, and theca cells. Theca cells form in the secondary follicles, maintaining follicular structural integrity and secreting steroid hormones. Two main sources of theca cells exist: Wilms tumor 1 positive (Wt1) cells native to the ovary and Gli1 mesenchymal cells migrated from the mesonephros. Normal folliculogenesis is a process where oocytes, granulosa cells, and theca cells constantly interact with and support each other through autocrine and paracrine mechanisms. The proliferation and differentiation of theca cells are regulated by oocyte-derived factors, including growth development factor 9 and bone morphogenetic protein 15, and granulosa cell-derived factors, including desert hedgehog, Indian hedgehog, kit ligand, insulin-like growth factor 1, as well as hormones such as insulin and growth hormones. Current research on the origin of theca cells is limited. Identifying the origin of theca cells will help us to systematically elaborate the mechanisms of follicular formation and development.

Etiology and epidemiological characteristics of gastroenteritis virus in food-borne diarrhea from three cities in Shandong Province, 2017 / 中华预防医学杂志

To analyze the etiology and epidemiological characteristics of gastroenteritis virus in foodborne diseases from three cities in Shandong. From January to December 2017, six sentinel hospitals in Jinan, Yantai and Linyi city of Shandong Province were selected as the research sites. Stool samples of 1 397 diarrhea patients were collected, as well as basic information and clinical symptoms. Duplex quantitative RT-PCR was used to detect Norovirus genogroupⅠ (Nov GⅠ) and genogroupⅡ (Nov GⅡ), Sapovirus (SAV) and Human astrovirus (HAstV), respectively, quantitative RT-PCR was used to detect group A Rotavirus (RVA), and quantitative PCR was used to detect Enteric adenovirus (EAdV). The specific gene of the virus were sequenced and typed. It was compared that the gastroenteritis virus rate in cases with different characteristics and the clinical symptoms difference between the virus positive and negative cases. The median age ((25), (75)) was 23 (1, 42) , mainly male, 57.48% with 803 cased and children under 5 years old, 36.36% with 508 cases. The positive rate of gastroenteritis virus was 33.93% (474 cases), and that of Jinan, Linyi and Yantai City were 32.03% (147/459), 41.54% (189/455) and 28.57% (138/483), respectively (0.001). Nov GⅡ had the highest positive rate, 16.54% (231 cases), which, mainly GⅡ.P16/GⅡ.2 (48.28%, 56/116), peaked in May (24.75%, 50/202) and June (19.59%, 38/194). In patients of gastroenteritis virus positive, 44.51% (211/474) had vomiting symptoms, higher than that of patients of gastroenteritis virus negative (34.13%, 315/923). The difference was statistically significant (0.001). In Shandong Province, the majority of gastroenteritis patients were male and children under 5 years old. Nov GⅡ possessed highest epidemic intensity, and peaked in spring and summer. Viral gastroenteritis had atypical clinical symptoms.

Application of 18F-FDG PET/CT-guided percutaneous biopsy to differential diagnosis of peritoneal thickening diseases / 上海交通大学学报（医学版）

Objective • To investigate the clinical value of 18F-flurodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/ CT)-guided percutaneous biopsy in peritoneal thickening of unknown origin. Methods • Ten cases of peritoneal thicken of unknown origin including 4 males and 6 females were analyzed. After 18F-FDG PET/CT examination, the peritoneal thickening regions with high 18F-FDG uptake were selected for the target areas. Percutaneous biopsy was operated under the guidance of the same PET/CT machine. Results • All lesions were successfully obtained by one-time puncture without serious complications, and histopathological diagnosis revealed that 7 cases were malignant, including 4 cases of peritoneal metastasis and 3 cases of lymphoma. The remaining cases were 1 case of pseudomyxoma, 1 case of tuberculosis and 1 case of inflammatory lesions. The accuracy of biopsy was 100%. Conclusion • 18F-FDG PET/CT-guided peritoneal percutaneous biopsy is a safe and effective method, and may play an important role in differential diagnosis and treatment management.

Post-marketing Re-evaluation of Tongxiening Granules () in Treatment of Diarrhea-Predominant Irritable Bowel Syndrome: A Multi-center, Randomized, Double-Blind, Double-Dummy and Positive Control Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the efficacy and safety of Tongxiening Granules (, TXNG) in the treatment of irritable bowel syndrome with predominant diarrhea (IBS-D).@*METHODS@#A randomized, double-blind, double-dummy, and positive parallel controlled clinical trial was conducted from October 2014 to March 2016. Totally 342 patients from 13 clinical centers were enrolled and randomly assigned (at the ratio of 1:1) to a treatment group (171 cases) and a control group (171 cases) by a random coding table. The patients in the treatment group were administered orally with TXNG (5 g per time) combined with pinaverium bromide Tablet simulator (50 mg per time), 3 times per day. The patients in the control group were given TXNG simulator (5 g per time) combined with pinaverium bromide Tablets (50 mg per time), 3 times per day. The treatment course lasted for 6 weeks. The improvement of Irritable Bowel Syndrome Symptom Severity Score (IBS-SSS) was used to evaluate the primary outcome. Secondary outcomes included adequate relief (AR) rate, Irritable Bowel Syndrome-Quality of Life Questionnaire (IBS-QOL), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and the recurrence rate at follow-ups. Safety indices including the adverse events (AEs) and related laboratory tests were evaluated.@*RESULTS@#Primary outcome: IBS-SSS at baseline, weeks 2, 4, 6 showed no statistical significance in both full analysis set (FAS) and per protocol set (PPS, P>0.05). After 6 weeks of treatment, the total effective rate of IBS-SSS scores in the treatment group (147/171,86.0%) was higher than the control group (143/171, 83.6%) by FAS (P>0.05). In regard to secondary outcomes, after 6-week treatment, there was no significant difference in AR rate, total score of IBS-QOL, improvement of HAMD and HAMA total scores between the two groups (P>0.05). The recurrence rate at 8-week follow-up was 12.35% (10/18) in treatment group and 15.79% (12/76) in control group, respectively (P>0.05). A total of 21 AEs occurred in 15 cases, of which 11 occurred in 8 cases in the treatment group and 10 AEs in 7 cases in the control group. The incidence of AEs had no statistical significance between the two goups (P>0.05).@*CONCLUSION@#Tongxiening Granules could relieve the symptoms of patients with IBS-D and the treatment effect was comparable to pinaverium bromide. (No. ChiCTR-IPR-15006415).

Effects of Ringer's solution with different concentrations of alcohol on biphasic compound action potentials of frog sciatic nerve trunk / 中国应用生理学杂志

OBJECTIVE@#To quantitatively investigate the effects of Ringer's solution with different concentrations of alcohol (1%～80%) on biphasic compound action potentials (AP) from frog sciatic nerve trunk, and their recoveries from alcohol effects.@*METHODS@#Individual segments of frog sciatic nerve trunk with a length of 6 to 8 cm were prepared. Ringer's solution with different concentrations of alcohol (0%, 1%, 2%, 4%, 8%, 16%, 32%, 48%, 64% and 80%) was applied onto the segment of the trunk between the stimulus and ground electrodes via an agent reservoir which was newly armed in a nerve trunk shielded chamber for 5 minutes. The nerve trunk was respectively electro-stimulated to generate the biphasic compound AP which was recorded using the experimental system of BL-420F. This was followed by 5 times washout plus 5 min administration with Ringer's solution before recovery recording of AP.@*RESULTS@#Compared to normal Ringer's solution, Ringer's solution with alcohol at ≤4% did not have dramatic impacts on the AP amplitude and conduction velocity, while Ringer's solution with alcohol at ≥8% there was significant decrease in these two parameters. Ringer's solution with alcohol at the conentrations of 16%, 32% and ≥48% could prevent a small proportion (30%), a large proportion (90%) and all (100%) of sciatic nerve trunks, respectively, from generating AP. Washout with normal Ringer's solution after alcohol application at the concentration of ≤32%, AP could totally recover to normal status. While alcohol at the concentration of 48%, 64% and 80%, the probabilities to regenerate APs were 90%, 40% and 0%, and the AP amplitudes were decreased to 60%, 36% and 0%, respectively. After washout, AP conduction velocity showed no difference with alcohol at the concentration of ≤8% when compared with that before washout, while it could not be recovered to normal under alcohol at ≥16%.@*CONCLUSION@#Ringer's solution with different concentrations of alcohol exerts different effects on biphasic compound AP amplitude and conduction velocity. Hopefully, our findings could be helpful for the alcoholic usage and its recovery from alcoholic damage.

Study of the neuroprotective effects and mechanisms of Tianma Gouteng Decoction on retinal ganglion cells in rat optic nerve crush model / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the mechanism of Tianma Gouteng Decoction on the protein molecular level in the optic nerve crush model rats.METHODS:Totally 36 participants 36 male Wistar rats were divided randomly into six groups(6 in every group):normal control group,negative control group,Tianma Gouteng Decoction treatment groups (con-centrations were 0.6g/mL,1.2g/mL,2.4g/mL respictively) and ginkgo biloba tablets positive control group (concentrations was 1.2mg/mL).Nothing was done in the normal control group.The optic nerve of right eye in the other groups was done with the optic nerve crush model.Normal control group and negative control group was treated only with water.The average grey scale values of the N-methyl-D-aspartic acid receptor 2B (NMDA2B) receptor protein,beta-amyloid protein (Aβ) in the average grey scale values were detected.RESULTS:The average grey scale value of Tianma Gouteng Decoction in low,medium and high dose groups about NMDA2B receptor protein was significantly less than that of the negative control group (all P＜0.001),and there was no significant difference with the positive control group (P=0.092,0.411,0.676),the difference between normal control group and negative control group was significant (P＜0.001).The high dose group of betaamyloid's average grey scale value reduced significantly than the negative control group (P=0.030,0.001).The low dose group than the negative control group was not obviously (P=0.614).The high dose group was not significantly different from the positive control group (P=0.927),the difference between normal control group and negative control group was significant (P＜0.001).CONCLUSION:Tianma Gouteng Decoction can go through the decrease of the NMDA2B receptor protein expression and the control of beta-amyloid deposition to reduce the retinal ganglion cell injury and apoptosis.

Kidney-replenishing herb modulates phenotype of NK cells at fetal-maternal interface by up-regulating IDO expression of trophoblasts / 中国免疫学杂志

Objective:To study the mechanism of kidney-replenishing herb in regulating the tolerance of fetal-maternal interface and the effect of IDO on modulating the phenotype of decidual NK cells. Methods: Indoleamine-2,3-dioxygenase ( IDO) expression in villus tissues from normal pregnancies and recurrent spontaneous abortion (RSA) patients was monitored by immunohisto-chemistry (IHC). IDO expression in HTR-8/Svneo cells treated with control or herb serum medium was detected by flow cytometry (FCM). The influence of kidney-replenishing herb on modulating the phenotype of NK cells,CD16 and CD56 expression in peripheral NK cells co-cultured with control or herb serum medium in the presence or absence of 1-methyltryptophan (1-MT) treated HTR-8/Svneo cells were measured by FCM. Results: IDO expression was decreased in villus tissue of RSA patients compared to normal preg-nancies. Herb medium could increase the IDO expression of HTR-8/Svneo. Kidney-replenishing herb could enhance the regulatory function of trophoblasts on NK cells and further induce the immune tolerance at fetal-maternal interface in IDO dependent and independent manners. Conclusion: Kidney-replenishing herb can modulate the phenotype of peripheral NK cell by up-regulating IDO expression in trophoblasts and play a role in the treatment of RSA patients.

Expression of Neuroligin1 after Spinal Cord Injury in Rats / 中国康复理论与实践

Objective To observe the change of expression of neuroligin1 (NL1) in injured spinal cord in rats. Methods A total of 60 adult female Sprague-Dawley rats were randomly divided into control group (n=30) and experi-ment group (n=30), and both groups were further arranged into three days, seven days, 14 days, 21 days, and 28 days subgroups. The control group accepted T9-11 laminectomy, while the experiment group was injured at T10 spi-nal cord hit by Allen's technique (10 g×25 mm). They were assessed with Basso, Beattie & Bresnahan locomotor rating scale (BBB scale), in their time-points, while Golgi-Cox staining was used to observe the variation of den-drites and density of dendritic spine in the white matter located at upper end of spinal cord injured center, and im-munofluorescence staining was used to detect the expression of NL1. Results The score of BBB scale reduced in the experiment group compared with that in the control group in every sub-group (P<0.001). Compared to the control group, both dendrites and density of dendritic spine in the white mat-ter decreased with time after injury (P<0.001), while the level of NL1 increased three days after injury, peaked on the 14th day after injury (P<0.05). Conclusion NL1 increases spontaneously after spinal cord injury, but it is not enough to promote synaptic regeneration.

Clinical significance of anatomic parameters of acetabular anterior column of normal male and female adults by digital measurement / 中国组织工程研究

BACKGROUND: Acetabulum anterior column shape is complex, and closed to femoral artery, and femoral nerve. Fixed screws easily went into the acetabulum. Currently, there was less data on quantitative anatomy data of pelvic acetabulum fracture with anterior column plate internal fixation. OBJECTIVE: To compare the pelvis gender differences by analyzing digital anatomical features of normal adult acetabulum anterior column section through digital three-dimensional reconstruction and measurement. METHODS: Totally 30 normal adults (half male and half female) received pelvic CT scans, and data were obtained. Using Materialise Mimics Innovation Suite 16.0 software, the boundary of the pelvis was used as reference line for sectioning. The obturator groove, iliopubic eminence, anterior inferior iliac spine, and the anterior superior iliac spine were used as a reference mark. In 15 males and 15 females (30 sides), the corresponding boundary line from obturator groove to the anterior superior iliac spine of acetabular anterior column was sliced into 5 mm-thick sections. The tangent line was vertical to the boundary line. The tangent plane was vertical to the upper plane of the anterior column. The angle and length of each section 5, 10, 15 mm points from the boundary line to the acetabulum, and the perpendicular distance from anterior and posterior edges of the acetabulum to anterior inferior iliac spine, iliopubic eminence and the pubic tubercle. RESULTS AND CONCLUSION: (1) Acetabular anterior column from the obturator groove to the anterior superior iliac spine section was not significantly different (P > 0.05). (2) No matter in males or females, the tangent angle of the fifth layer section was minimum, and the tangent length of the sixth layer section was longest. The length and angle of the second slice at 5 mm point were not significantly different between males and females. However, above indexes in others were significantly larger in females than in males (P < 0.05). (3) Results indicated that in different fracture ranges and different fixation plate positions, the angle and length of pedicle screws are dynamic, so we only selected in accordance with above range, but cannot fix in a certain value. The design of the most accurate and effective placement angle and length should be aimed at nailing design parameters for each individual patient. The use of Mimics software can be used for three-dimensional reconstruction of CT data of adult acetabular anterior column fracture, and can measure the number of indexes, and provide a theoretical reference for the clinical diagnosis and treatment of acetabular anterior column fracture.

Digital screw path analog measurement of C4-6 posterior fixation parameters in adolescents aged 12-14 years and its clinical significance / 中国组织工程研究

BACKGROUND: For recent decades, there has been a younger tendency in age of occurrence of the cervical spondylosis, and posterior fusion is the main method for cervical degeneration and injury, but no relevant fixation parameters are available in clinical practice for adolescents. OBJECTIVE: To measure the anatomical parameters of C4-6posterior fixation in the adolescents aged 12-14 years after three-dimensional reconstruction. METHODS: Twenty-one adolescents aged 12-14 years, who underwent cervical examination at the Affiliated Hospital of Inner Mongolia Medical University and Department of Orthopedics of the Second Hospital of Ulanqab between January 2014 and December 2016 were randomly selected, and the CT data of the C4-6were collected, and then imported into Mimics16.01 software for three-dimensional reconstruction. We measured the anteroposterior and transverse diameters and the heights of the vertebral body, anteroposterior and transverse diameters of the transverse foramina, angles of the left and right pedicle axes to sagittal and horizontal axes, and left and right pedicle axis lengths. RESULTS AND CONCLUSION: (1) Both anteroposterior and transverse diameters of the transverse foramina were increased with vertebral level incveasing. Both angles of pedicle axis to sagittal and horizontal axes, and pedicle axis lengths were increased with vertebral level. The anteroposterior diameter of the vertebral body at C4-6was in the range of 6.0-8.0 mm, the transversal diameter was in 25.0°-30.0°, the angle between the posterior screw and the horizontal axis was 29.0°-35.0°; in the sagittal plane, the angle to the sagittal axis was no more than 5°; and the pedicle screw path length was in 6-7 mm. (2) These results show the anatomical parameters of C4-6posterior fixation in the adolescents aged 12-14 years are successfully obtained by three-dimensional reconstruction.

PIateIet-rich fibrin combined with tooth ash promotes bone repair / 中国组织工程研究

BACKGROUND: The tooth ash can be used as a scaffold for bone tissue growth and provide calcium and phosphorus components during bone regeneration. Platelet-rich plasma can promote the soft and hard tissue regeneration. However, either of them has its shortcomings.OBJECTIVE: To investigate the effect of platelet-rich plasma combined with tooth ash in repairing skull bone defects. METHODS: Nine healthy rabbits were selected to make bone defects on both sides of the skull. Rabbit platelet-rich plasma combined with tooth ash was implanted into the skull defect on the left side as experimental group, while rabbit platelet-rich plasma was implanted into the skull defect on the right side as control group. Skull samples were taken out at 4, 6, 8 weeks after implantation for soft X-ray detection, hematoxylin-eosin staining and modified Gomori staining. RESULTS AND CONCLUSION: (1) Soft X-ray: The trabecular bone area of the experimental group was larger than that of the control group at 6 and 8 weeks after implantation (P < 0.05 or P < 0.01). (2) Hematoxylin-eosin staining: With the duration of implantation, newly formed fibers with bone structure gradually reduced at the defect sites in both groups, and there was a orderly layered arrangement in the bone structure and increased calcification. Compared with the control group, relatively higher new bone maturity, better bone trabecular arrangement and more osteoblasts were observed in the experimental group. (3) Modified Gomori staining: With the prolongation of implantation time, the new bone became mature gradually in the two groups, and the bone maturity in the experimental group was higher than that in the control group. To conclude, platelet-rich fibrin combined with tooth ash is better to promote bone defect repair.

Protective effects and mechanism of Naoxintong Capsules on rat brain microvascular endothelial cells (rBMECs) induced by oxygen-glucose deprivation / 中草药

Objective: To investigate the protective effects and mechanism of Naoxintong Capsules (NXT) on primary cultured neonate rat brain microvascular endothelial cells (rBMECs) induced by oxygen-glucose deprivation. Methods: The primary cultured rBMECs model was established and the identification of rabbit anti-rat VIII factor was carried out. MTT was used to screen out the concentration range of NXT intestinal absorption solution to pretect rBMEC in vitro, three doses were selected for experiment. The experimental groups were divided into control group, model group, nimodipine group (200 μg/mL, NXT intestinal absorption solution group (62.50 mg/L, 125.00 mg/L, and 250.00 mg/L), and NXT intestinal absorption solution (250.00 mg/L) and LY294002 (20 μmol/L, PI3K/Akt pathway inhibitor) co-administration group. The morphology of rBMECs was observed under inverted microscope. The expression of lactate dehydrogenase (LDH) and matrix metalloproteinase 9 (MMP-9) in the cell supernatant was detected by ELISA kit. The apoptosis was observed by Hoechst33342 staining fluorescence microscope. The early apoptotic rate of rBMECs in each group was detected by FCM, and the expression of PI3K/Akt signaling pathway key proteins was detected by Western blotting. Results: Compared with model group, the administration of NXT could significantly improve the morphology of rBMECs, decrease the intracellular levels of LDH and MMP-9, significantly reduce the number of apoptotic cells and early apoptotic rate of rBMECs, and inhibit the expression of p-Akt, Bcl-2 upregulation, decrease the expression of Bax, and inhibit caspase-3 activity. The addition of LY294002, a specific inhibitor of PI3K/Akt signaling pathway, blocked the signal transduction of this pathway and significantly reduced the protective effect of NXT. Conclusion: NXT have protective effects on rBMECs induced by oxygen-glucose deprivation, and its mechanism is related to the PI3K/Akt signaling pathway.

Clinical and pathological features and the misdiagnosis of childhood Alport syndrome: a retrospective analysis of 91 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To explore the clinical and pathological features and the diagnosis of childhood Alport syndrome (AS).</p><p><b>METHODS</b>A retrospective analysis was performed on clinical data of 91 children with AS.</p><p><b>RESULTS</b>Hematuria was observed in all 91 patients, of whom 86 were accompanied with proteinuria. Sixty-one children with X-Linked AS (XL-AS) had positive family history. Renal biopsy was performed on 82 children. Mild to moderate mesangial proliferation was observed in 74 cases. Small amounts of immune complexes deposits in the glomerular mesangial area were observed in 48 cases. Glomerular basement membrane (GBM) attenuation, thickening and layering were observed in 53 cases by electron microscopy (EM). In 63 cases receiving renal tissue type IV collagen α3 and α5 chain immunofluorescence detection, 58 were diagnosed with AS, including 53 cases of XL-AS and 5 cases of autosomal recessive AS. In 91 cases of AS, 58 were diagnosed as AS by renal tissue type IV collagen α3 and α5 chain immunofluorescence, 21 were diagnosed by EM, one was diagnosed by skin biopsy, and 12 were diagnosed by gene detection. Six novel mutations of COL4A5 gene were found. Forty-five cases were misdiagnosed before the diagnosis of AS. Forty-one of the 45 cases received steroids and/or immunosuppressant therapy.</p><p><b>CONCLUSIONS</b>The clinical manifestations and pathological changes are not specific in children with AS, resulting in a higher rate of misdiagnosis. Typical lesions of GBM under EM are only observed in a part of patients. There is a high novel mutation rate of COL4A5 in the detected AS children.</p>

Antiphospholipid Antibody Titers and Clinical Outcomes in Patients with Recurrent Miscarriage and Antiphospholipid Antibody Syndrome: A Prospective Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The management of patients with recurrent miscarriage (RM) and antiphospholipid antibody syndrome (APS) includes prolonged treatment with heparin and aspirin, starting from the confirmation of pregnancy and continuing until 6 weeks after birth. This study was conducted to determine the relationship between changes in antiphospholipid antibody titers and clinical outcomes. The effect of a shortened treatment regimen was also evaluated.</p><p><b>METHODS</b>A prospective study of 123 patients with RM and APS between March 2012 and May 2014 was conducted. Patients were pretreated with a low dose of prednisone plus aspirin before pregnancy, and heparin was added after conception. The levels of antiphospholipid antibodies and pregnancy outcomes were evaluated.</p><p><b>RESULTS</b>All patients were positive for anti-β2-glycoprotein 1 (anti-β2-GP1) IgM. After prepregnancy treatment with low-dose prednisone plus aspirin, 99 of 123 patients became pregnant, and 87 of those pregnancies resulted in successful live births, while 12 resulted in miscarriage, showing a success rate of 87.9%. In the live birth group, levels of anti-β2-GP1 were 56.8 ± 49.0 RU/ml before the pretreatment regimen, 32.1 ± 26.0 RU/ml after 2 months of pretreatment, and 24.1 ± 23.1 RU/ml during early pregnancy (P < 0.05). In the miscarriage group, antiphospholipid antibody titers were 52.8 ± 30.7 RU/ml before pretreatment, 38.5 ± 34.2 RU/ml after pretreatment, and 33.9 ± 24.7 RU/ml during early pregnancy; the decrease in antiphospholipid antibodies was lower in the miscarriage group than in the live birth group (P < 0.05). Of the 24 infertile patients, the average antibody titer did not decline after pretreatment (P = 0.802).</p><p><b>CONCLUSIONS</b>Anti-β2-GP1 IgM was the predominant form of antibody in patients with RM and APS. The decreases in antiphospholipid antibody titers correlated with better pregnancy outcomes. The shorter treatment regimen was effective and economical.</p>