Chemical Constituents of n-Butanol Extract Part of Akebia trifoliata Caulis / 中国实验方剂学杂志

<b>Objective::To study the chemical constituents from <italic>n</italic>-butanol extract of <italic>Akebia trifoliata</italic> caulis. <b>Method::The 100 kg caulis of <italic>A</italic>. <italic>trifoliata</italic> was extracted with 75% ethanol (EtOH) for three times by heating reflux. These 3 extracts were decompressed and concentrated, and then dissolved in water. The solvent was successively extracted with dichloromethane, ethyl acetate and <italic>n</italic>-butanol. The chemical constituents from the <italic>n</italic>-butanol fraction were isolated by macroporous, silica gel, sephadex LH-20 and ODS columns, and semi-preparative high performance liquid chromatography, and their chemical structures were determined through MS, NMR analysis (¹H and ¹³C-NMR) and spectroscopic data from literatures. <b>Result::Totally 14 compounds were isolated and identified as mutongsaponin B(<bold>1</bold>), mutongsaponin C(<bold>2</bold>), saponin PH(<bold>3</bold>), begoniifolide A(<bold>4</bold>), 2<italic>α</italic>, 3<italic>β</italic>, 23-trihydroxy-30-noroleana-12, 19-dien-28-oicacid-<italic>O</italic>-<italic>β</italic>-<italic>D</italic>-xylopyranosyl-(1→3)-<italic>α</italic>-<italic>L</italic>-rhamnopyranosyl-(1→4)-<italic>β</italic>-<italic>D</italic>-glucopyranosyl-(1→6)-<italic>β</italic>-<italic>D</italic>-glucopyranosyl ester(<bold>5</bold>), akemisaponins D(<bold>6</bold>), akemisaponins E(<bold>7</bold>), asiaticoside(<bold>8</bold>), saponin PJ1(<bold>9</bold>), scheffoleoside A(<bold>10</bold>), symplocosneolignan A(<bold>11</bold>), kalopanax-saponins D(<bold>12</bold>), leonticin E(<bold>13</bold>), ciwujianoside A₁(<bold>14</bold>). <b>Conclusion::Compounds <bold>1-4</bold>, <bold>11</bold>, <bold>13, 14</bold> were isolated from this plant for the first time. The discovery of these compounds further enriched the chemical constituents of <italic>A</italic>. <italic>trifoliata</italic>, and provided experimental and scientific basis for the comprehensive development and utilization of <italic>A</italic>. <italic>trifoliata</italic>.

Early mirror therapy and the functional recovery of hemiparetic stroke survivors / 中华物理医学与康复杂志

Objective To investigate the effect of early intervention with mirror therapy on hemiparetie survivors of ischemic stroke.Methods Thirty-six hemiplegic patients within one month after a stroke were randomly divided into a mirror therapy group (MT group,n=18) and a routine rehabilitation control group (RRC group,n=18).The participants in the MT group received MT for 45 min/d,5 d/wk for 3 weeks in addition to conventional stroke rehabilitation.Those in the RRC group received exercise therapy at the same frequency without the mirror protocol.The Fugl-Meyer assessment (FMA),Wolf motor function test (WMFT),functional ambulation category scale (FAC),Brunnstrom stages of motor recovery,and the modified Ashworth scale (MAS) were used to assess changes in the upper limb,gross hand dexterity and lower limb recovery before and right after the interventions,as well as one and two months after the treatment.Results Significant improvement was observed in the limb function of both groups after the treatment.Compared with the RRC group,there was significantly greater improvement observed in the MT group.This was true of the FMA ratings at all time points,the average WMFT scores one and two months after the intervention,the FAC ratings two months after the intervention,and the Brunnstrom stages at both one and two months after the intervention.However,no significant difference between the two groups in terms of the average MAS scores was observed at any time point.Conclusion Early intervention with MT can significantly accelerate the recovery of a paretic upper limb aud improve walking ability after stroke.Such intervention is worthy of promotion and application in clinical practice.

Arthroscopic denervation of patella combined with microfracture for patellofemoral arthritis / 中国骨伤

OBJECTIVE@#To explore the clinical effect of knee denervation combined with micro-fracture under arthroscope in the treatment of patellofemoral arthritis.@*METHODS@#From May 2015 to May 2018, 60 patients with knee joint degenerative patellofemoral arthritis were treated, including 28 males and 32 females, aged from 24 to 56(40.5±3.35) years old. Among them, 30 cases underwent arthroscopic debridement alone(control group), 30 cases underwent arthroscopic debridement, peripatellar denervation combined with cartilage cone and patellofemoral articular surface microfracture treatment (treatment group). VAS, Lysholm and Kujala scores were used to evaluate the therapeutic effect.@*RESULTS@#No complications such as wound infection, vascular nerve injury and deep venous thrombosis occurred in all patients. The patients were followed up for 7 to 36 months with an average of 12.5 months. The VAS scores of the two groups were improved 4 weeks after operation, and the improvement of the treatment group was significantly better than that of the control group, the difference was statistically significant (<0.05). Lysholm and Kujala scores were compared at the last follow-up of the two groups, the improvement of the treatment group was significantly better than that of the control group.@*CONCLUSIONS@#The treatment of patellofemoral arthritis with patellar denervation combined with microfracture can better relieve pain and improve knee function.

Urodynamic effects of elongated needle on patients with urinary retention after spinal cord injury / 中国骨伤

OBJECTIVE@#To explore the clinical significance of elongated needle in the treatment of urinary retention after spinal cord injury.@*METHODS@#From January 2016 to June 2018, 60 patients with urinary retention after spinal cord injury were divided into elongated needle acupuncture group and needle acupuncture group, 30 cases in each group. The Shuidao(ST28) and Zhibian(BL54) were selected as the treatment of acupoints. In the elongated needle group, there were 23 males and 7 females, with a mean age of(52±9) years old. The patients in this group were treated on both sides, and the electro-acupuncture apparatus was used for 30 minutes at frequencies of 3 Hz for 30 minutes. In needle group, there were 24 males and 6 females, with a mean age of (56±10) years old. After treatment, the needles were retained for 30 minutes. The treatment frequencies of both groups were once every other day and passed for 2 months. After 2 months of treatment, the clinical significances of the treatment of the disease were explored by analyzing the time between the two groups of patients to reach the equilibrium bladder, diary urinary diary, urodynamics and urinary tract infection between the two groups.@*RESULTS@#(1)Time to reach the equilibrium bladder:(39.5±1.2) days in elongated needle group and (46.5±2.1) days in needle group; the time to reach the equilibrium bladder in the two groups was significantly different(<0.05). (2)Comparison of urination diary between the two groups:the daily number of catheterization, the amount of each catheterization, the number of daily urination, and the amount of urine per urination after treatment were better than those before treatment by intra-group comparison(<0.05); the number of daily catheterization, the amount of daily catheterization, the number of daily urination, and the amount of urine output per patient in elongated needle group were better than those in needle group by comparison between two groups(<0.05). (3)Comparison of improvement of urinary tract infection between the two groups:the urinary tract infection were better than that before treatmant in each group by intra-group comparison; the improvement rate of urinary tract infection in awn needle group (1/3.3%) was higher than that in needle group(5/16.7%), with significantly differences. (4)Comparison of urodynamic index between two groups:by intra-group comparison, the VH2O, Pves, Pdet, Qave, Qmax, and BC of the two groups were better than those before treatment(<0.05); By comparison between two groups, the improvement of VH2O, Pves, Pdet, Qave, Qmax and BC were better than those of the needle group (all <0.05).@*CONCLUSIONS@#The elongated needle is better than conventional needle in improving urinary retention, urinary tract infection and urodynamic index in patients with urinary retention after spinal cord injury. It has positive significance in improving patients' quality of life and is worth applying to clinical.

Accordion operation for the bone transport in treating tibial bone defect / 中国骨伤

<p><b>OBJECTIVE</b>To discuss clinical outcomes of accordion operation for the Ilizarov technique in treating tibial bone defects.</p><p><b>METHODS</b>From January 2014 to June 2016, 22 patients with tibial bone defects were treated by Ilizarov bone-transport technique, including 19 males and 3 females with an average age of 44.04 years old ranging from 23 to 60 years old;the length of the bone defects before the bone transport was 5 to 11 cm with an average 7.68 cm; Cause of injury invlved traffic accidents in 14 cases, fall injury in 3, smashing injury in 4, high drop injury in 1; 6 cases were on the left and 16 cases were on the right. The patients were divided into two groups: 11 cases in accordion group were treated by "accordion operation" after bone transport was completed;11 cases in control group were treated by the external fixator locked waiting for bone consolidation after bone transport was completed. All patients were followed up for 18 to 36 months with an average time of 27.9 months. There was no statistical significance between two groups, such as sex, age, length of bone defect(>0.05). Analysis of healing time, healing index and other indicators, and Paley's criterion was used to evaluate the healing effect of bone healing and function recovery of the limb.</p><p><b>RESULTS</b>The result of X-ray evaluation was all patients achieved bone healing. In accordion group, the bone healing time was (365±91) days, the bone healing index was (46.2±3.5) d/cm; in control group, the bone healing time was(435±108) days, the bone healing index was (57.8±3.5) d/cm. There was no statistical significance in the bone healing time between the two groups(=1.648, =0.115);There was statistical significance in the bone healing index between the two groups(=7.754, =0.000). At the final follow-up, according to Paley's criterion, the result in accordion group was excellent in 9 cases, good in 2 cases; in control group, excellent in 8 cases, good in 3 cases. Score was not statistically significant(=-0.479, =0.619). Complications involved nail infection (9 cases in accordion group, 10 cases in control group);local traction pain (2 cases in accordion group, 1 case in control group); axial malalignment>10°(4 cases in accordion group, 3 cases in control group);location difference of the junction of bone defects (3 cases in accordion group, 2 cases in control group);Complications were not statistically significant(>0.05).</p><p><b>CONCLUSIONS</b>Accordion operation for the Ilizarov technique in treating tibial bone defects can shorten the treatment time and consolidation time, and improve the healing index.</p>

Mirror therapy improves the upper limb function of hemiparetic stroke survivors: A meta-analysis / 中华物理医学与康复杂志

Objective To evaluate systematically the efficacy of mirror therapy for improving the upper limb function, daily life and pain of stroke survivors. Methods The PubMed, EBSCO, Web of Science, Ovid, Co-chrane Library, Open Gray, China Biological Medicine, China National Knowledge Infrastructure, GoogleScholar, VIP and Wan Fang Data databases were searched for reports of randomized and controlled trials ( RCTs) of mirror therapy for improving the upper limb function of stroke survivors. Only papers published before December 2015 were surveyed. The relevant references of the primary studies were also searched. The literature screening, data extraction and assessments were conducted by two reviewers independently. The meta-analysis was performed using version 5.2 of the RevMan software. Results A total of 22 RCTs involving 823 patients were discovered, some not dealing with mirror therapy. Comparing the studies with and without visual feedback, there were significant differences in upper limb motor function as measured by the Fugl-Meyer, ARAT and Brunnstrom instruments. The average Barthel indexes and visual analogue scale were also significantly different. Conclusion Mirror therapy can improve upper limb function and ability in the activities of daily living, and also relieve pain among stroke survivors to some degree, though its long-term efficacy is still unclear. Large-sample, multi-center, high-quality RCTs are required to verify these conclusions.

One-stage compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone for the treatment of chronic calcaneal osteomyelitis / 中国骨伤

<p><b>OBJECTIVE</b>To explore the treatment of chronic calcaneal osteomyelitis with bone defect after debridement and evaluate its clinical outcomes.</p><p><b>METHODS</b>From June 2009 to June 2011, 52 patients with chronic calcaneal osteomyelitis were treated with stage-one compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone,including 12 females and 40 males with an average age of 43 years old ranging from 18 to 67. According to Cierny-Mader classification, there were 34 cases with stage III and 18 with stage IV. There were 32 cases on right side and 20 on left,with a course of 6 months to 3 years. The area of soft tissue wound ranged from 3.0 cm x l.5 cm to 23.0 cm x l2.0 cm. The clinical effects were evaluated according to infection controlling, calcium sulfate absorption,bone defect repair and heel functional recovery.</p><p><b>RESULTS</b>All patients were followed up for 2 to 3.8 years (averaged 2.8 years). Primary healing was achieved in 52 patients. Two cases of recurrence were found post-operatively, 1 case in 3 months and another in 5 months,which were cured after a second operation. Bone repair healing was gained in 1.5 to 3.5 months (averaged 2.5 months). Complete radiological absorption of calcium sulfate was found in 1.2 to 3 months(averaged 2.2 months). Local exudation after removal of drainage tube had been persisting in 10 patients for 2 to 3 months, which was consistent with the time when cacium sulfate were totally absorbed. Flap had partial necrosis in 4 cases,and the wounds were closed after appropriate treatment finally. The mean Maryland score was 88.15±7.70. There were excellent results in 32 cases, good in 14, fair in 6.</p><p><b>CONCLUSION</b>A satisfactory short-term clinical results can be gained by one-stage compound grafting of antibiotic-impregnated calcium sulfate and autogenous cancellous bone in chronic calcaneal osteomyelitis, but the long-term results need further follow-up. And much more study is also demanded to reduce the exudation of calcium sulfate.</p>

Analysis on the long-term effects of modified double endobutton technique in the treatment of Tossy type III acromioclavicular joint dislocations / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the long-term clinical effects of modified double Endobutton technique for the treatment of acromioclavicular joint dislocations of Tossy type III.</p><p><b>METHODS</b>A retrospective study was done in 42 patients with acromioclavicular joint dislocations of Tossy type III treated with modified double Endobutton technique from December 2008 to December 2010. There were 24 males and 18 females, ranging in age from 21 to 56 years old (averaged, 32.5 years old). All the patients were treated with open reduction, coracoclavicular ligament reconstruction using double Endobutton technique, and repair of acromioclavicular ligament. The Karlsson system was used to evaluate therapeutic effects. The distance from coracoid to clavicle was measured to evaluate reduction loss.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 2.0 to 3.2 years (averaged,2.4 years). According to Karlsson system, 32 patients got an A degree and 10 patients got a B degree at three months post-operatively; 26 patients got an A degree and 16 patients got a B degree at the latest follow-up; 6 patients got an A degree at 3 months after operation lowered to B degree at the latest follow-up. The coracoid-clavicle distance increased from (26.91 +/- 0.91) mm at 3 months after operation to (27.41 +/- 1.10) mm at the latest follow-up. Te patients treated with over-reduction during operation or with heavy physical labour work after operation had obvious widened coracoid-clavicle distance. Bone absorption was found around the plate in most cases, mainly in the clavicular side.</p><p><b>CONCLUSION</b>Treatment for acromioclavicular joint dislocations of Tossy type III with modified double Endobutton technique has satisfactory early clinical results. But with time passing, loss of reduction and bone absorption around the plate could be observed, and clinical outcomes of some cases downgrade during the long-term follow-up.</p>

Treatment of acute ankle fractures with arthroscopy-assisted open reduction and internal fixation / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical results of arthroscopy-assisted open reduction and internal fixation for the treatment of acute Lauge-Hansen stage IV ankle fractures.</p><p><b>METHODS</b>A prospective cohort of study was done in 42 patients of acute ankle fractures treated with arthroscopy-assisted open reduction and internal fixation from January 2008 to December 2009. According to Lauge-Hansen classification, there were 26 supination-eversion stage IV fractures, including 11 females and 15 males; with an average age of (36.8 +/- 11.7) years; and there were 16 pronation-eversion stage IV fractures, including 6 females and 10 males, with an average age of (37.6 +/- 11.2) years. All the patients were treated with arthroscopy-assisted open reduction and internal fixation,and intra-articular disorders were observed. Syndesmotic diastasis was treated with three-cortices syndesmotic screw, and osteochondral injuries were disposed by Cheng-Ferkel staging system. The clinical effects were evaluated according to AOFAS scores.</p><p><b>RESULTS</b>All the patients were followed up for 1 year. At the final review,the mean AOFAS score was (92.00 +/- 9.32). Twenty-eight patients got an excellent result, 11 good, 3 fair. Lesions of the cartilage were found in 31 cases. The AOFAS scores of patients with osteochondral lesions were higher than those of patients without osteochondral lesions. The AOFAS scores of patients with osteochondral lesions below C grade were higher than those of patients with osteochondral lesions above C grade. The AOFAS scores of patients with osteochondral lesions were higher than those of patients with osteochondral lesions above C grade. The AOFAS scores of patients with syndesmosis fixation were lower than those of patients without syndesmosis fixation.</p><p><b>CONCLUSION</b>Intra-articular disorders are common in Lauge-Hansen stage IV ankle fractures, and osteochondral lesion and sydesmosis diastasis are the most important prognostic factor that leads to unsatisfactory ankle functions. Arthroscopy-assisted open reduction and internal fixation for the treatment of acute ankle fractures is not only helpful to anatomical reduction of the articular surface, but also can improve the clinical results with effective diagnosis and treatment of combined intra-articular disorders.</p>

Case-control studies on therapeutic effects for the treatments of tibial plateau fractures between arthroscopic technique in minimally invasion surgery and minimally invasive internal fixation with plates and screws / 中国骨伤

<p><b>OBJECTIVE</b>To investigate therapeutic effects of minimally invasive arthroscopic internal fixation with plates and screws in treating tibial plateau fractures.</p><p><b>METHODS</b>A retrospective study from December 2006 to June 2010 was done on 69 patients with tibial plateau fractures. According to Schatzker classification, 5 patients were type I, 5 patients were type II, 25 patients were type III, 20 patients were type IV, 9 patients were type V and 5 patients were type VI. Thirty-six patients were treated with arthroscopy-assisted reduction and internal fixation, including 21 males and 15 females, ranging in age from 17 to 59 years (averaged, 34.2 years); another 33 patients were treated with small incision and fixed with plates and screws,including 19 males and 14 females, ranging in age from 18 to 62 years (averaged, 35.4 years). The operation time, blood loss during operation,drainage volume of blood, healing time, weight-bearing time and function of effected knee were compared between the two groups.</p><p><b>RESULTS</b>All the patients were followed up,and the duration ranged from 6 to 12 months (averaged, 10.3 months). All the patients had no complications such as infection, articular collapse, re-fracture and joint stiffness. There were no significant differences in weight-bearing time, complications and Rasmussen scores between two groups (P>0.05); but there were significant differences in the operative time, blood loss, drainage volume of blood, hospital stay time, the healing time between two groups (P<0.05). The results showed that arthroscopy-assisted technique was better than minimally invasive internal fixation in operation duration, blood loss during operation and the healing time.</p><p><b>CONCLUSION</b>Different types of fracture of tibial plateau should be treated with different surgical treatments. Arthroscopic technique for reduction of fractures, which has less influence on bony union and minimally invasive, and can provide a good clinical outcome.</p>

Sperm chromosome analysis and preimplantation genetic diagnos is in an infertile male with mosaic trisomy 18 / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the numerical aberration rate of X, Y and chromosome 18 in sperms from an oligozoospermic male with mosaic trisomy 18 and to perform preimplantation genetic diagnosis (PGD) for the couple.</p><p><b>METHODS</b>G-banding and fluorescence in situ hybridization (FISH) were performed on metaphase chromosome. Sperm was analyzed in three-color FISH with a probe mixture containing CEP18, CEPY and Tel Xq/Yq. A healthy man with normal semen parameters was used as control.</p><p><b>RESULTS</b>Significant difference in the rates of disomy for chromosome 18 (0.63% vs. 0.16%) and the gonosomes (0.945% vs. 0.35%) and diploidy (0.87% vs. 0.31%) was found in the spermatozoa between the patient and the control. After four embryos were biopsied in one PGD cycle, two embryos with XY1818 and XX1818 were selected for implanting and clinical pregnancy was ongoing.</p><p><b>CONCLUSION</b>Sperm-FISH allows further understanding of aneuploidy rate and accurate genetic counseling. FISHPGD was effective for patient with mosaic trisomy 18.</p>

Treatment of syndesmosis diastasis with screw fixation in ankle fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore the operative method for the treatment of syndesmosis injury in ankle fractures.</p><p><b>METHODS</b>A retrospective study was done on 21 ankles of 20 patients included male 11 and female 9;the range of age were from 27 to 52 years with an average of 36 years) with syndesmosis injury in closed ankle fractures from September 2005 to December 2007. All patients with ankle fractures and syndesmosis injury were diagnosed by the history, physical examination and radiology, then treated with open reduction, internal fixation, and syndesmotic stabilization with a three-cortices syndesmotic screw according to the Lauge-Hansen classification system. Radiological evaluation comprised tibiofibular overlap, total clear space and medial clear space. The clinical effects were evaluated according to modified Baird-Jackson standard.</p><p><b>RESULTS</b>All patients were followed up from 1.0 to 2.2 years with an average of 1.3 years. Radiographic measurements were detailed as follows: tibiofibular overlap averaged (0.46 +/- 3.56) mm in preoperative and (7.14 +/- 0.62) mm in postoperative; mean total clear space (5.69 +/-0.88) mm in preoperative and (3.28 +/- 0.39) mm in postoperative; medial clear space averaged (5.67 +/- 1.23) mm in preoperative and (3.12 +/- 0.33) mm in postoperative; tibiofibular overlap in mortise view averaged (-0.87 +/- 0.96) mm in preoperative and (2.91 +/- 0.30) mm in postoperative. There was significant difference above data between preoperative and postoperative (P < 0.01). Four cases were confirmed minor tibiofibular diastasis through CT scans during postoperative. The modified Baird-Jackson scoring was from 62 to 98 scores with an average of (86.24 +/- 13.26) score at the final review. Of them, 13 ankles had not pain; 16 ankles reported no instability complaints; 11 ankles gained normal walking ability; 8 ankles could run normally; 11 ankles could return work without any restrictions. Activity of ankle in dorsiflexion, plantar flexion, inversion and eversion were respectively (21.05 +/- 5.00) degrees, (33.57 +/- 5.76) degrees, (19.48 +/- 4.57) degrees and (24.05 +/- 4.86) degrees. Three cases had radiological and clinical manifestations of osteoarthritis, but no breakage of syndesmotic screw in all cases. There were excellent results in 12 cases, good in 2, fair in 4, poor in 3.</p><p><b>CONCLUSION</b>The treatment for the syndesmosis diastasis with a three-cortices screw fixation in ankle fractures is effective. Good functional outcome can be obtained with anatomical restoration of the tibiofibular syndesmosis. The repair of deltoid ligament is important for stability of the lower tibiofibular syndesmosis. Removal of the screw before weight loading should be performed to avoid possible screw breakage.</p>

Effect of aspirin plus clopidogrel on inflammatory markers in patients with non-ST-segment elevation acute coronary syndrome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Aspirin can inhibit inflammatory reactions and platelet aggregation, but little is known about the effects of the combination of aspirin plus clopidogrel, a new antiplatelet agent, on inflammation. The purpose of this study was to determine whether aspirin plus clopidogrel can further suppress inflammation in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS).</p><p><b>METHODS</b>One hundred and fifteen patients with NSTEACS were randomized into two groups: group A (aspirin alone, n =58) and group B (aspirin plus clopidogrel, n =57). Patients in group A received a loading dose of 300 mg aspirin, then 100 mg per day. The patients in group B received a loading dose of 300 mg aspirin and 300 mg clopidogrel, then 100 mg aspirin and 75 mg clopidogrel per day. Serum high sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-alpha (TNF-alpha) were measured in all patients at baseline prior to any drug treatment after admission, and at 7 and 30 days after beginning drug treatment. Thirty healthy volunteers on no medications were enrolled as controls (group C).</p><p><b>RESULTS</b>Baseline levels of hs-CRP and TNF-alpha in group A and group B were significantly higher than those in group C. Seven days after administration, the levels of hs-CRP in both group A and group B decreased significantly [Group A: (6.15 +/- 1.39) mg/L vs (9.18 +/- 1.62) mg/L, P <0.01; Group B:(4.99 +/- 1.62) mg/L vs (10.29 +/- 1.47) mg/L, P <0.01]. Similarly, levels of TNF- alpha in both groups decreased at 7 days compared to baseline [Group A: (90.99 +/- 28.91) pg/ml vs (117.20 +/- 37.13) pg/ml, P <0.01; Group B: (74.32 +/- 21.83) pg/ml vs (115.27 +/- 32.11) pg/ml, P <0.01]. Thirty days after administration, the levels of hs-CRP in both group A and group B decreased further to (3.49 +/- 1.53) mg/L, and (2.40 +/- 1.17) mg/L respectively (P <0.01 for both comparisons). Levels of TNF-alpha in groups A and B also decreased significantly between 7 and 30 days, to 63.28 +/- 29.01 pg/ml (group A) and (43.95 +/- 17.10) pg/ml (group B; P <0.01 for both comparisons). Significantly lower levels of hs-CRP and TNF-alpha were observed in group B compared to Group A at thirty days after initiating drug treatment (P <0.05).</p><p><b>CONCLUSIONS</b>Aspirin plus clopidogrel treatment reduced levels of serum hs-CRP and TNF-alpha in patients with NSTEACS significantly more than aspirin alone. Because both aspirin and clopidogrel produce important anti-inflammatory effects, these results suggest the possibility that long-term treatment with aspirin plus clopidogrel may produce greater clinical benefits compared to treatment with aspirin alone.</p>

Establishment of gene expression profile and regulation of genes expression during plasma cell differentiation / 第三军医大学学报

Objective To study the genes modulated during plasma cell development and their regulating network. Methods The changes of gene expression during differentiation from mature B cells to plasma cells were studied using cDNA microarray and RT PCR. Results The gene expression profile during plasma cell differentiation was established. During mature B cell plasma cell differentiation, numerous genes were modulated, including genes involving immunity, cell growth, survival, and signal transduction. The expressions of several molecules in the B cell antigen receptor (BCR) signaling pathways, such as Ig?, Ig?, Lyn, Syk, BLNK, SWAP 70, and SHP 1 were down regulated. The decreased expression of some of these molecules might be associated with the down regulation of the transcription factor BSAP. Conclusion During plasma cell differentiation, molecules involving BCR signaling pathways are down regulated.

Determination of binding ability of PaP3’s terminase large subunit to cos site / 第三军医大学学报

Objective To investigate the binding ability of the terminase large subunit of Pseudomonas aeruginosa bacteriophage PaP3 to the cos site. Methods The gene tls was amplified from the genome of bacteriophage PaP3 by PCR and subcloned into pMD18-T vector. Then the gene tls cut down from the vector was inserted into the plasmid pQE31 which could give a 6-His tag at the N-terminal of the expressed protein. The recombinant vector pQE-tls was transformed to E.coli. JM109, after induction with IPTG, the expressed bacteria were resuspended and sonicated, then after centrifugation, the inclusion body was obtained. The inclusion body was dissolved with lysis buffer, then the tagged protein was purified by Ni-NTA affinity chromatography and renatured by dialysis. Finally the DNA-binding ability of the fusion protein rTLS was determined by EMSA. Results The expression plasmid pQE31-tls was successfully constructed, and the target protein yield was up to 30% of the total bacterial proteins. After purification and renaturation, the fusion protein rTLS can partially bind the cos fragment. Conclusion The fusion protein rTLS was successfully expressed, purified and renatured. The rTLS has the specific DNA-binding activity. The present work lays the foundation for the further research of the gene tls.

Effect of tetramethylpyrazine on endothelin, von Willebrand factor and thromboxane A2 during cardiopulmonary bypass in patients of congenital heart disease with pulmonary hypertension / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the effect of tetramethylpyrazine (TMP) on the vascular endothelial cell (VEC) related humoral factors, including endothelin (ET), factor VIII related antigen (i.e. von Willebrand factor, vWF) and thromboxane A2(TXA2) in patients of congenital heart disease with pulmonary hypertension (CHD-PH) during cardiopulmonary bypass (CPB), and explore the clinical physiopathologic significance of them.</p><p><b>METHODS</b>Thirty non-cyanotic patients of CHD-PH were randomly divided into the control group and the treated group. TMP was given to the treated group by intravenous dripping 3 mg/kg after anesthesia induction and adding 1 mg/kg in oxygenator during CPB. Blood samples were collected from radial artery at the time points of after anesthesia induction, 15 min after beginning CPB, 5 min after opening aorta, 20 min, 6 hrs and 24 hrs after stopping CPB, to determine the plasma contents of ET and vWF, as well as TXB2, the stable metabolite of TXA2. The pulmonary vascular reactivity 6 hrs (6h-PVR) after CPB and the mechanical ventilatory support time (VST) after operation were calculated.</p><p><b>RESULTS</b>Levels of ET, vWF and TXB2 increased obviously during CPB, but the degree of increasing in the treated group was lower than that in the control group (P < 0.05), and the 6h-PVR and VST in the former were also lower than those in the latter respectively.</p><p><b>CONCLUSION</b>TMP could obviously reduce the production of ET, vWF and TXB2 during CPB and relieve the pulmonary vascular reactivity after operation, indicating that TMP could reduce the injury of CPB on VEC, and is benefit to enhance the efficacy of treatment.</p>