Research progress on the application of wearable devices in foot monitoring and management of diabetic patients / 中国实用护理杂志

As the focus of public health work in the world, diabetic foot disease has aroused high public concern. This paper introduces the application of the diabetic foot wearable monitoring equipment types, including plantar pressure monitoring, temperature monitoring, monitoring of the biomechanics and multimode monitoring, and wearable devices application status in patients with diabetes, puts forward the existing problems and prospect, in order to carry out domestic related to diabetic foot wearable monitoring equipment research to provide the reference.

RGS16 regulated by let-7c-5p promotes glioma progression by activating PI3K-AKT pathway / 医学前沿

Gliomas are the most common central nervous system tumours; they are highly aggressive and have a poor prognosis. RGS16 belongs to the regulator of G-protein signalling (RGS) protein family, which plays an important role in promoting various cancers, such as breast cancer, pancreatic cancer, and colorectal cancer. Moreover, previous studies confirmed that let-7c-5p, a well-known microRNA, can act as a tumour suppressor to regulate the progression of various tumours by inhibiting the expression of its target genes. However, whether RGS16 can promote the progression of glioma and whether it is regulated by miR let-7c-5p are still unknown. Here, we confirmed that RGS16 is upregulated in glioma tissues and that high expression of RGS16 is associated with poor survival. Ectopic deletion of RGS16 significantly suppressed glioma cell proliferation and migration both in vitro and in vivo. Moreover, RGS16 was validated as a direct target gene of miR let-7c-5p. The overexpression of miR let-7c-5p obviously downregulated the expression of RGS16, and knocking down miR let-7c-5p had the opposite effect. Thus, we suggest that the suppression of RGS16 by miR let-7c-5p can promote glioma progression and may serve as a potential prognostic biomarker and therapeutic target in glioma.

Research progress on risk prediction models for the elderly frailty / 中国实用护理杂志

The research progress of the frailty risk prediction model for the elderly were reviewed in order to analyze its evaluation content, prediction effect and clinical application, so as to provide reference for the risk prediction model construction and application, reduce the risk of the elderly frailty.

Salvianolic acid C inhibits inflammation and induce apoptosis by regulating nuclear factor-erythroid 2-related factor 2 pathway in rheumatoid arthritis-fibroblast-like synoviocytes cells / 中华风湿病学杂志

Objective:To investigate the effect of salvianolic acid C (SalC) on fibroblast-like synoviocytes and through the role of nuclear factor-erythroid 2-related factor 2 (Nrf2) pathway.Methods:Rheumatoid arthritis-fibroblast-like synoviocytes (RA-FLSs) were exposed to different concentrations of SalC (0.1 μmol/L, 1 μmol/L, 5 μmol/L, 10 μmol/L, 20 μmol/L) for 24-72 h and measured for viability, proliferation, migration and invasion by Cell counting kit 8 (CCK-8) assay, wound-healing and transwell assay. The levels of Tumor Necrosis Factor-α (TNF-α), Interleukin-1 beta (IL-1β) and IL-6 were measured by enzyme linked immunosorbent assay (ELISA). Western blot was used to detect the expression of matrix metallopeptidase (MMP)-9, MMP-13, apoptosis-related proteins and Nrf2 mediated gene. Then we used ML385 to inhibit Nrf2 signaling pathway. RA-FLSs were measured for migration and invasion, and the expression of proteins related to apoptosis, inflammation and Nrf2 pathway.Results:Compared with the control group, SalC inhibited the cell migration significantly (0.1 μmol/L, 0.75±0.05, t=7.65, P<0.001; 5 μmol/L, 0.50±0.05, t=14.25, P<0.001; 10 μmol/L, 0.26±0.05, t=20.67, P<0.001) and invasion (0.1 μmol/L, 0.75±0.11, t=4.93, P<0.001; 5 μmol/L, 0.49±0.06, t=10.32, P<0.001; 10 μmol/L, 0.26±0.07 , t=14.96, P<0.001) of RA-FLs, reduced the levels of MMP-9 (0.1 μmol/L, 0.72±0.10, t=5.60, P<0.001; 5 μmol/L, 0.48±0.08, t=11.03, P<0.001; 10 μmol/L, 0.27±0.06, t=15.94, P<0.001) and MMP-13 (0.1 μmol/L, 0.77±0.06, t=8.66, P<0.001; 5 μmol/L, 0.58±0.06, t=11.03, P<0.001; 10 μmol/L, 0.32±0.13, t=14.22, P<0.001), and promoted apoptosis. SalC reduced the level of pro-inflammatory cytokines significantly ( P<0.001) and activated the expression of Nrf2 signaling pathway proteins Nrf2, CAT, NQO1, SOD1 and GSS ( P<0.001). After ML385 was used to interfere Nrf2, the levels of SalC on Nrf2 pathway proteins, such as Nrf2 (0.68±0.06, t=5.08, P<0.001), CAT (1.44±0.12, t=4.77, P<0.001), NQO1 (0.65±0.12, t=5.04, P<0.001), SOD1 (1.43±0.10, t=6.36, P<0.001) and GSS (1.42±0.10, t=7.60, P<0.001), as well as the levels of TNF-α [(260±22) pg/ml, t=13.75, P<0.001], IL-1β [(701±30) pg/ml, t=12.98, P<0.001], IL-6 [(180±10) pg/ml, t=16.38, P<0.001) were significantly reduced. In addition, ML385 inhibited the inhibition of SalC on cell migration and invasion (0.70±0.09, t=11.24, P<0.001; 0.64±0.04, t=8.03, P<0.001) and induction of apoptosis (24.4±1.8, t=23.02, P<0.001). Conclusion:SalC may inhibit cell activity and inflammatory response, promote apoptosis via the upregulation of Nrf2 signaling pathway. SalC may have therapeutic potential in RA. However, further investigation are needed in animal models and human.

Advances in arthroscopic microfracture technique for repairing articular cartilage injuries / 国际外科学杂志

Articular cartilage injury is common in orthopedics. Improper exercises and physical trauma can lead to the injury of cartilage. Since articular cartilage lacks blood supply, once damaged, it is difficult for the cartilage to repair itself. If not treated effectively, cartilage injuries will develop into severe osteoarthritis affecting the whole joint. Arthroscopic microfracture technique can achieve better therapeutic effects than regular joint debridement, with simple procedures, minimal invasion, and low cost. However, the microfracture technique is limited by the patients′ age (under 45 years old) and the size of the cartilage defect area (less than 4 cm 2) Additionally, postoperative patients need to conduct strict and long-term rehabilitation trainings. Generally speaking, the short-term prognosis of microfracture is satisfactory. However, the repair tissue is mainly composed of fibrocartilage, which is inferior to hyaline cartilage because of its poor mechanical properties and anti-wear abilities. Therefore, the long-term effect is controversial. To conclude, arthroscopic microfracture is a recommended method for young patients with small cartilage defect areas, but its exact long-term clinical effects still need to be verified by further research. This paper reviews the operation protocol, clinical efficacy, and the mechanism of arthroscopic microfracture surgery, and aims to provides theoretical basis for its application in clinical treatment.

Key Genes of Peripheral Blood Mononuclear Cells in Hepatocellular Carcinoma and Effective Chinese Herbs： A Bioinformatics Analysis and Systematic Review / 中国实验方剂学杂志

Objective:To explore the key gens of peripheral blood mononuclear cells in hepatocellular carcinoma（HCC-PBMC） and potentially effective Chinese herbs based on bioinformatics， and to verify the clinical efficacy of these Chinese herbs via a systematic review. Method:The chips GSE58208 and GSE36076 of HCC-PBMC were downloaded from the Gene Expression Omnibus （GEO）， followed by the identification of differentially expressed genes （DEGs） using RStudio. After protein-protein interaction （PPI） analysis by STRING， the DAVID was employed for gene ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） enrichment analysis. The DEGs of HCC-PBMC were visualized by Cytoscape. The key genes of HCC-PBMC were calculated by CytoHubba plug-in and mapped with those in Coremine Medical for screening out the potential Chinese herbs for the treatment of HCC， which were then included for subsequent systematic review. Result:A total of 203 DEGs were obtained （194 up-regulated and nine down-regulated）. As revealed by DAVID analysis， the DEGs were mainly enriched in such biological processes and signaling pathways as transcriptional regulation of DNA template， hydrolysis of ribonucleic acid phosphodiester bond， positive regulation of intranuclear mitosis and division， skeletal muscle fiber development， activation of mitogen-activated protein kinase（MAPK）activity， Fanconi anemia pathway， and metabolic pathway. The key genes of HCC-PBMC were calculated by Cytoscape to be<italic> </italic>GTPase IMAP family member 1 （GIMAP1）， GTPase IMAP family member 4 （GIMAP4）， GTPase IMAP family member 6 （GIMAP6）， GTPase IMAP family member 7 （GIMAP7）， GTPase IMAP family member 8 （GIMAP8）， interleukin-1<italic>β </italic>（IL-1<italic>β）</italic>， CX3C chemokine receptor 1 （CX3CR1）， C-C chemokine receptor type 2 （CCR2）， Toll-like receptor 7（TLR7）， and epidermal growth factor（EGF）. Through Coremine Medical analysis， it was concluded that Ginseng Radix et Rhizoma， Curcumae Longae Rhizoma， Centellae Herba， and Hedyotidis Herba were closely related to the key genes. Ginseng Radix et Rhizoma has the effects of tonifying and benefiting lung and spleen and enhancing strength， suitable for the liver depression and spleen deficiency syndrome or Qi-Yin deficiency syndrome of HCC. Hence， Si Junzitang with Ginseng Radix et Rhizoma as the sovereign medicinal was included for systematic review. It has been confirmed that Ginseng Radix Et Rhizoma was superior to western medicine alone in improving the overall clinical efficacy， alleviating TCM syndrome， elevating serum CD4⁺and CD4⁺/CD8⁺levels， and reducing the serum CD8⁺and TBIL levels （<italic>P</italic><0.01）， with high safety. Conclusion:This study conducted at the gene level has provided new ideas for clinical diagnosis and treatment of HCC. The systematic review of Ginseng Radix Et Rhizoma against HCC provides a basis for the clinical prevention and treatment of HCC with TCM.

The practice, experience and reflections of the establishment and management of a birth cohort with 500, 000 pregnant women / 中华医学科研管理杂志

Objective:To lay a foundation for the continuous improvement of the birth cohort management in the future, and provides references for other hospitals in establishing the birth cohort through sharing the practice, experience and reflection of the establishment and management of the birth cohort of 500, 000 pregnant women.Methods:The present situation and data of the establishment and management of the birth cohort of 500, 000 pregnant women were summarized to describing the practice, experience and reflection.Results:The specific work regarding the establishment and management of the cohort include personnel investment, standards development, implementation process and quality control. Three phases of the management experiences were summarized which including explorative process implementation; standardize project implementation, and quality improvement along with the fast development of the birth cohort. Generally, the attention of leadership was one of the most important factors for the establishment and management of birth cohort in each research site.Conclusions:It is important that comprehensive considerations of factors including the personnel, standards, practical management process, quality control and the attention of leadership plays important role in improving the quality and efficiency of birth cohort establishment and management.

Relationship of TLR2 and TLR4 expressions on the surface of peripheral blood mononuclear cells to small intestinal bacteria overgrowth in patients with hepatocellular carcinoma / 中华肝脏病杂志

Objective@#To investigate TLR2 and TLR4 expressional situation on the surface of peripheral blood mononuclear cells (PBMC) in patients with hepatocellular carcinoma (HCC) and their relationship with small intestinal bacterial overgrowth (SIBO).@*Methods@#Flow cytometry was used to detect TLR2 and TLR4 expressional situation on the surface of PBMC in 78 cases with HCC, 56 cases with cirrhosis and 33 healthy controls. Furthermore, lactose hydrogen breath test (LHBT) was used to detect small intestinal bacterial overgrowth.@*Results@#Of the 78 cases with HCC, 56 cases (71.8%) were SIBO-positive, 23 cases (41.1%) were SIBO- positive in 56 cases with cirrhosis, and 1 (3.0%) was SIBO-positive in 33 healthy controls. The incidence of SIBO in HCC patients was higher than cirrhosis patients (χ2 = 12.72, P < 0.05) and healthy controls (χ2 = 41.18, P < 0.05). The expression levels of TLR2 and TLR4 in HCC patients (100.55 ± 24.22, 42.76 ± 15.96) were significantly higher than cirrhosis (67.42 ± 18.36, 24.38 ± 8.68)and healthy control group (33.06 ± 11.72, 12.52 ± 4.46) (P < 0.05). Furthermore, the expression levels of TLR2 and TLR4 in SIBO-positive patients (108.75 ± 20.40, 48.1 ± 14.98) were higher than SIBO-negative patients (79.67 ± 20.60, 28.62 ± 7.36) (P < 0.05).@*Conclusion@#The expression of TLR2 and TLR4 and the incidence of SIBO in HCC patients are significantly higher than cirrhosis and healthy control group. Moreover, the high expressions of TLR2 and TLR4 in SIBO-positive HCC patients may promote the development of HCC.

Effect of Electroacupuncture on Spermatogenesis in Rats with Oligozoospermia of Insufficiency of Shen (Kidney) Essence Syndrome / 中国结合医学杂志

OBJECTIVE@#To assess the effect of electroacupuncture (EA) on expression of cytoskeletal proteins from Sertoli cells (SCs) and spermatogenesis in rats with oligozoospermia of insufficiency of Shen (Kidney) essence syndrome (OIKES).@*METHODS@#Twenty healthy male Sprague-Dawley rats were randomly assigned to four groups using a random number table: control, tripterygium glycosides (TG) treatment, sham and EA groups (n=5 in each group). A rat model of OIKES was established by oral gavage with TG. The EA group was treated with TG and received EA at Shenshu (BL 23) and Zusanli (ST 36) acupoints for 20 min, once daily for 30 days, while the sham group received EA at identical acupoints with skin penetration without stimulation. After 30 days, the final body weight and coefficients for the testis and epididymis were calculated and sperm parameters were measured. Immunohistochemical analyses were performed to detect expression of vimentin and α-tubulin in SCs and proliferating cell nuclear antigen (PCNA) immunoreactivity in germ cells. Apoptosis in germ cells was quantified by the transferase biotin-dUTP nick end labeling assay.@*RESULTS@#Compared with the control group, the final body weight and testis/epididymis coefficients of rats in the TG-treated group were not significantly different, but the sperm count and motility were lower (P<0.05). Expressions of vimentin and α-tubulin were also significantly weaker (P<0.01). The PCNA immunoreactivity of germ cells was decreased (P=0.059), whereas the apoptotic index of germ cells was increased significantly (P<0.01). In contrast, EA at BL 23 and ST 36 acupoints significantly improved the final body weight as well as the sperm count, concentration and motility (P<0.01 or P<0.05). EA increased expression of vimentin and α-tubulin in SCs markedly, and significantly enhanced PCNA immunoreactivity with decreased apoptosis in germ cells (P<0.01 or P<0.05).@*CONCLUSIONS@#EA at BL 23 and ST 36 acupoints has protective effects on spermatogenesis in rats with OIKES. This effect seems to be achieved by attenuating TG-induced disruption of cytoskeletal protein in SCs.

Factors associated with postpartum weight retention based on the generalized estimation equation in Kaifu Districtin Changsha / 中南大学学报(医学版)

To investigate the current status of the postpartum weight retention (PPWR) in Kaifu District of Changsha, and explore the influential factors with PPWR based on the generalized estimating equation model.
 Methods: A cluster sampling method was applied to select women who gave birth at the health service centers of 3 street communities in Kaifu District of Changsha during 2015. According to the inclusion and exclusion criteria, 783 cases were finally included in the study. Data on PPWR were collected prospectively by using the self-made questionnaire at 1, 3, 6 and 8 months after childbirth. Analysis were performed to investigate the associations between PPWR and its potential factors with generalized estimation equation model.
 Results: The mean PPWR of women was gradually decreased with the increase of postpartum time, and 34.6% of them have returned to the pre-pregnancy weight in the 8 months postpartum. Our findings revealed that gestation weight gain (GWG), pre-pregnancy body mass index, feeding patterns, and delivery mode were significantly associated with maternal PPWR (P0.05).
 Conclusion: GWG is one of the most important predictors for PPWR. The key to reducing PPWR is to control GWG systematically. Early targeted interventions and health education should be taken to prevent women from excessive PPWR at the first-year postpartum, in particular to the women who underwent cesarean deliveries and breastfed their infants. It is conducive to reduce the risks of overweight or obesity caused by PPWR.

Simultaneous Determination of Eight Kinds of Neurotransmitters in Rat Blood Serum by Ultra-high Performance Liquid Chromatograph- Tandem Mass Spectrometry / 分析化学

An ultra-high performance liquid chromatography tandem mass spectrometric ( LC-MS/MS ) method for simultaneous determination of 8 kinds of neurotransmitters (5-HT, GABA, Glu, ACH, NE, DA, 5-HIAA, HVA) in rat serum was developed.The blood samples were extracted by 0.1% formic acid in acetonitrile and separated on a Waters ACQUITY UPLC BEH C18(2.1 mm×100 mm, 1.7 μm) using gradient elution, with the mobile phase consisting of acetonitrile and 0.1% formic acid in water.The samples were then ioniZed with positive electrospray ( ESI+) , and detected under multiple reaction monitoring ( MRM ) mode.As a result, 8 kinds of neurotransmitters were determined accurately in 10 min with a limit of quantitation of 1.8 ng/mL and intra-day and inter-day precisions of ≤9.2% ( n=6 ).This method showed a good linearity in detection of neurotransmitters and the linear correlation coefficients were greater than 0.994.Also the stability, recovery and matrix effect were eligible for the analysis.This method showed high accuracy, sensitivity, strong specificity, good stability, small matrix effect and short time for analysis, and was suitable for the quantitative determination of monoamine, amino acids and acetylcholine neurotransmittes in rat serum.

Clinical effect of Bevacizumab combined with albumin binding paclitaxel in the treatment of platinum resistant recurrent ovarian cancer / 中国综合临床

Objective To explore the efficacy and safety of Bevacizumab combined with albumin binding paclitaxel in the treatment of platinum resistant recurrent ovarian cancer.Methods From June 2014 to January 2016,eighty-two recurrent ovarian cancer patients were selected in the study and randomly divided into the treatment group (41 cases) and the control group (41 cases),the control group was treated with albumin binding paclitaxel,and the treatment group was treated with Bevacizumab combined with albumin binding paclitaxel.The clinical efficacy (such as overall response rate,complete response rate,partial response rate,stability of disease,progression of disease),progression free survival (PFS),overall survival (OS) and the adverse reaction rate were compared.Results The total effective rate (ORR) of the experimental group was 85.37％ (35/41),which was significantly higher than that of the control group (65.85％ (27/41),and the difference was statistically significant (P=0.040).The median PFS and OS in the experimental group were 9 (1 ～16) months and 16 (4～26) months,significantly higher than those in the control group (6 (1 ～ 13)months (HR =0.624,95％ CI:0.367 ～ 0.899,P =0.023);12 (2 ～ 25) months (HR =0.603,95％ CI:0.324 ～ 0.791,P =0.009);subgroup analysis showed that the median OS of patienta without metastasis in the experimental and control group were 18 (8 ～ 26) months and 13 (2 ～ 25) months respectively (HR =HR =0.610,95％ CI:0.229 ～ 1.544,P=0.291),and the median PFS was 11 (5～ 16) months and 8 (1 ～ 13) months (HR=0.496,95％CI:0.160～1.046,P=0.089),there were no significant differences;the median P FS in patients with metastasis of the experimental group and the control group were 9 (3～14)months and 6 (1～ 10)months (HR =0.483,95％ CI:0.273 ～ 0.769 months,P＜0.001),the median OS were 14 (4～22) months and 11 (2～20)months (HR =0.556,95％CI:0.197～ 0.569,P=0.008).There was no significant difference in the incidence of adverse reactions between the two groups (12.20％,21.95％,P=0.240).Conclusion Compared with the treatment of albumin binding paclitaxel,in the treatment of platinum resistant recurrent ovarian cancer,the combined treatment of bevacizumab and albumin binding paclitaxel can significantly improve the clinical effect and improve the patients' survival and total survival time.

Risk factors for delayed breastfeeding initiation based on decision tree model and logistic regression model / 中南大学学报(医学版)

Objective:To determine influential factors for delayed breastfeeding initiation.Methods:Using questionnaires to collect the data of 950 pregnant women and infants' feeding practices in Changsha,Hunan,logistic regression and decision tree model were used to determine influential factors for delayed breastfeeding initiation.Results:Mothers with timely breastfeeding initiation were 594 (62.5％),and those with delayed breastfeeding initiation accounted for 356 (37.5％).Mothers with timely breastfeeding initiation were more likely to use exclusive breastfeeding than those with delayed breastfeeding initiation (P＜0.05).Four risk factors were found by logistic regression model and decision tree model,including cesarean delivery,using feeding-bottle before breastfeeding initiation,falling ill,and vomiting during pregnancy.Receiver operating characteristic curve showed no significant difference in the predictive effect of the 2 models (Z=0.142,P=0.889).Conclusion:Cesarean delivery,using feeding-bottle before initiation of breastfeeding,and poor physical condition during pregnancy exert negatively effects on breastfeeding initiation.Health workers should help mother to timely initiate breastfeeding and enhance their confidence in exclusive breastfeeding.

Micro-dissection testicular sperm extraction for non-obstructive azoospermia patients with the history of secondary testicular injury / 中华男科学杂志

<p><b>Objective</b>To investigate the value of micro- dissection testicular sperm extraction (micro-TESE) in the treatment of non-obstructive azoospermia (NOA) in patients with the history of secondary testicular injury.</p><p><b>METHODS</b>Totally, 121 NOA patients with the history of secondary testicular injury underwent micro-TESE in our hospital from September 2014 to December 2017. We analyzed the correlation of the sperm retrieval rate with the causes of testicular injury and compared the outcomes of the ICSI cycles with the sperm retrieved from the NOA males by micro-TESE (the micro-TESE group) and those with the sperm ejaculated from severe oligospermia patients (sperm concentration <1×10⁶/ml, the ejaculate group). Comparisons were also made between the two groups in the female age, two-pronucleus (2PN) fertilization rate, transferrable embryos on day 3 (D3), D3 high- quality embryos, D14 blood HCG positive rate, embryo implantation rate, and clinical pregnancy rate.</p><p><b>RESULTS</b>Testicular sperm were successfully retrieved by micro-TESE in 86.0% of the patients (104/121), of whom 98.4% had the history of orchitis, 75.5% had been treated surgically for cryptorchidism, and 63.6% had received chemo- or radiotherapy. No statistically significant differences were observed between the micro-TESE and ejaculate groups in the 2PN fertilization rate (59.4% vs 69.3%, P > 0.05), D14 blood HCG positive rate (44.6% vs 57.9%, P > 0.05), embryo implantation rate (31.8 %% vs 32.6%, P > 0.05) and clinical pregnancy rate (41.5% vs 48.7%, P > 0.05). However, the rate D3 transferrable embryos was significantly lower in the micro-TESE than in the ejaculate group (40.5% vs 52.2%,P < 0.05), and so was that of D3 high-quality embryos (32.5% vs 42.1%, P < 0.05).</p><p><b>CONCLUSIONS</b>Micro-TESE can be applied as the first choice for NOA patients with the history of secondary testicular injury, but more effective strategies are to be explored for the improvement of ICSI outcomes with the sperm retrieved by micro- TESE.</p>

Anterior corpectomy combined with intervertebral decompression and fusion for multilevel cervical spondylotic myelopathy / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the clinical outcomes of anterior corpectomy combined with anterior intervertebral decompression and fusion for multilevel cervical spondylotic myelopathy.</p><p><b>METHODS</b>The clinical data of 28 patients with multilevel cervical spondylotic myelopathy who underwent surgery from October 2012 to June 2014 were retrospectively analyzed. There were 18 males and 10 females, aged from 45 to 77 years old with an average of (60.11±9.37) years. Three levels were involved in 27 cases, while four levels were involved in 1 case. The preoperative JOA score was 8.89±1.87; the fusion segments angles was (4.87±4.56)°; and the cervical curvature was (11.68±1.25)°. Anterior hybrid decompression and fusion were performed in 28 patients. The fusion segments angles and the cervical curvature were assessed by X-rays at 1, 12 months after operation, respectively. JOA score was used to evaluate the clinical effect.</p><p><b>RESULTS</b>The operative time was 163 min on average (ranged from 120 to 205 min), and intraoperative bleeding was 198 ml on average(ranged from 100 to 300 ml). Hoarseness occurred in 1 case and got recovery at 3 weeks after operation and choke cough occurred in 1 case, and got improvement at 1 week after operation. All the patients were regularly followed for 12-24 months with an average of(18.46±3.20) months. Graft bone obtained fusion at 12 months after operation and the position of internal fixation was good. The fusion segments angles, the cervical curvature and JOA scores were significantly improved at 1, 12 months after operation(<0.05). The improvement rate of JOA score was(46.46±20.26)% at 12 months after operation, 12 cases got excellent results, 14 good and 2 fair.</p><p><b>CONCLUSIONS</b>Anterior corpectomy combined with anterior intervertebral decompression and fusion is safe and effective and can get satisfactory effects for multilevel cervical spondylotic myelopathy.</p>

Mechanism of hepatic transporters and metabolic enzymes in cholestatic liver injury / 药物评价研究

Cholestatic liver injury,which is mainly caused by the disruption of bile acids,is common in the clinic.The pathogenesis of cholestatic liver injury is directly related to the changes of bile acid-related transporters,synthetic and metabolic enzymes.Nuclear receptors play a crucial part in cholestatic liver injury by regulating the expression of transporters and metabolic enzymes that maintaining the homeostasis of bile acids.In this review,we focus on the role of hepatic transporters and metabolic enzymes in cholestatic liver injury and the mechanism of nuclear receptors on the regulation of transporters and metabolic enzymes.

Efficacy Observation of Sofre Injection Combined with Isosorbide Mononitrate in the Treatment of Refrac-tory Heart Failure / 中国药师

Objective:To observe the clinical efficacy and safety of Sofre injection combined with isosorbide mononitrate in the treatment of refractory heart failure. Methods:Totally 66 cases of patients with refractory heart failure in our hospital were randomly di-vided into the observation group and the control group with 33 cases in each. Each patient received the conventional treatment. On the basis of routine treatment, the control group was treated with isosorbide mononitrate injection (25mg,qd,ivd). On the basis of control group, the observation group was treated with Sofre injection (10ml, qd, ivd). The treatment course was 14 days. Before and after the treatment, the improvement degree clinical symptoms, left ventricular ejection fraction ( LVEF) , left ventricular end diastolic diameter (LVEDD), cardiac index (CI), stroke volume (SV) and 6-min walking distance (6MWD) were observed, and the rate of heart fail-ure hospitalization, heart failure mortality and 6MWT changes were followed up for 6 months in the two groups. The adverse drug reac-tions ( ADR) in both groups during the treatment were recorded as well. Results:After the 2-week treatment, the effective rate and the total effective rate of the observation group were significantly higher than those of the control group (P<0. 05); LVEF, CI, SV and 6MWD of the two groups after the treatment were significantly higher than those before the treatment, and LVEDD significantly de-creased (P<0. 05), and the improvement of the observation group was more obvious than that of the control group (P<0. 05). After the 6-month follow-up, 6MWD was significantly longer in the observation group than that in the control group (P<0. 05), while there were no statistically significant differences in the hospitalization rate and the mortality rate between the groups (P>0. 05). There were no adverse reactions in both groups during the whole treatment. Conclusion:Sofre injection combined with isosorbide mononitrate can significantly improve cardiac function in the patients with refractory heart failure with improved clinical efficacy and good safety.

Scientific research ability cultivation's status quo and reform suggestion of eight-year clinical medical education program / 基础医学与临床

Capcity building for scientific research ability cultivation is an important component of 8-year curriculum of clinical medical education .Research skills has increasingly become one of the important factors to evaluate medi-cal school and hospital .We summarized cultivation characters of the accredited schools , which has experimented 8-year clinical medical education program .And put forward suggestions for scientific research ability cultivation ,in or-der to provided reference for reformation of 8-year clinical medical education .

Risk Factor Analysis for In-hospital Mortality in Patients With Non-ST Segment Elevation Myocardial Infarction in China / 中国循环杂志

Objective:To explore the risk factors for in-hospital mortality in patients with non-ST segment elevation myocardial infarction (NSTEMI) in China.Methods:The information of 5816 NSTEMI patients from 2013-01 to 2014-09 by China Acute Myocardial Infarction (CAMI) registry were extracted.Our research included in 2 groups:In-hospital death group,n=352 and In-hospital survival group,n=5464.The baseline condition,laboratory examination,treatment and the in-hospital outcomes were collected;the independent risk factors for in-hospital mortality were studied by multivariable Logistic regression analysis.Results:6.05％ (352/5816) patients died during hospitalization.The baseline conditions were different between 2 groups.Multivariable Logistic regression analysis indicated that age,BMI,systolic blood pressure,Killip classification,heart arrest,ST-segment depression in ECG,new onset of Complete left bundle branch block,serum creatinine,white blood cells,Count nonsmoker,previous history of MI and PCI were the independent risk factors for in-hospital mortality in NSTEMI patients.Conclusion:The above 12 variables were the independent risk factors for in-hospital mortality in NSTEMI patients which should be helpful for identifying the high risk patients at the early stage in clinical practice.

Risk Factor Analysis for In-hospital Mortality in Patients With Non-ST Segment Elevation Myocardial Infarction in China / 中国循环杂志

Objective:To explore the risk factors for in-hospital mortality in patients with non-ST segment elevation myocardial infarction (NSTEMI) in China.Methods:The information of 5816 NSTEMI patients from 2013-01 to 2014-09 by China Acute Myocardial Infarction (CAMI) registry were extracted.Our research included in 2 groups:In-hospital death group,n=352 and In-hospital survival group,n=5464.The baseline condition,laboratory examination,treatment and the in-hospital outcomes were collected;the independent risk factors for in-hospital mortality were studied by multivariable Logistic regression analysis.Results:6.05％ (352/5816) patients died during hospitalization.The baseline conditions were different between 2 groups.Multivariable Logistic regression analysis indicated that age,BMI,systolic blood pressure,Killip classification,heart arrest,ST-segment depression in ECG,new onset of Complete left bundle branch block,serum creatinine,white blood cells,Count nonsmoker,previous history of MI and PCI were the independent risk factors for in-hospital mortality in NSTEMI patients.Conclusion:The above 12 variables were the independent risk factors for in-hospital mortality in NSTEMI patients which should be helpful for identifying the high risk patients at the early stage in clinical practice.