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1.
Acta Pharmaceutica Sinica ; (12): 200-210, 2022.
Article in Chinese | WPRIM | ID: wpr-913169

ABSTRACT

Chemoimmunotherapy has attracted much attention as an emerging therapy pattern for the treatment of cancers. Exploring effective drug combination schemes and reasonable delivery methods remained the key issue in current research. Herein, we designed sorafenib (SF) and anti-Tim-3 monoclonal antibody (Tim-3 mAb) co-loaded MMP2-responsive mesoporous silica nanoparticles (ST-MSNs) for combined chemoimmunotherapy of hepatocellular carcinoma (HCC). The shell of ST-MSNs was fabricated by Tim-3 mAb through matrix metalloproteinase 2 (MMP2) sensitive peptides as "gatekeepers" to prevent drug release during the blood circulation. In tumor microenvironment, the high levels of MMP2 caused the responsive shedding of Tim-3 mAb, leading to the triggerred release of SF and Tim-3 mAb. Then, SF could be delivered to tumor cells and Tim-3 mAb could be delivered to T cells, respectively. In vivo tumor inhibition study results demonstrated that ST-MSNs can significantly enhance synergistic antitumor activity compared with sequential administration of free SF solution and Tim-3 mAb solution. Meanwhile, the expression of antitumor cytokines IFN-γ, IL-12 and the percentage of CD3+CD4+ cells, CD3+CD8+ cells in tumors were upregulated after the administration of ST-MSNs, demonstrating good immunomodulatory ability. In addition, within the dosage range, the ST-MSNs had low cytotoxicity and hemolysis, and no obvious tissue toxicity was observed. All animal experiments were performed in line with national regulations and approved by the Animal Experiments Ethical Committee of Shandong University. In conclusion, this study provided a promising drug combination of chemoimmunotherapy with good application prospects for clinical HCC treatment, and exhibited a potential drug carrier for clinical chemoimmunotherapy.

2.
Acta Pharmaceutica Sinica ; (12): 627-637, 2022.
Article in Chinese | WPRIM | ID: wpr-922877

ABSTRACT

Exosomes are a kind of endosomal vesicles that are secreted by most if not all living cells. Due to their capability of delivering a variety of cargos, such as tissue- or cell-specific proteins, lipids, and genetic materials, and their broad biological activities, exosomes have gained substantial attention as emerging therapeutics. Exosomes derived from mesenchymal stem cells (MSCs) and dendritic cells (DCs) are two types of exosomes that are widely studied. Many preclinical and clinical studies have shown that they have a satisfactory treatment effect in lung diseases, liver diseases, nervous system diseases, tumors, and other diseases. In addition, exosomes from macrophages, tumor cells, plant cells, and many other cells are getting more attention due to their therapeutic potential. Besides natural exosomes, research on engineered exosomes has also made plenty of progress. There have been several engineering methods of exosomes, such as targeting modification and loading of active ingredients. In this review, we summarize the research progress of therapeutic exosomes from different sources, and further discusses the application prospects of exosomes and possible challenges in the future.

3.
Protein & Cell ; (12): 26-46, 2022.
Article in English | WPRIM | ID: wpr-922494

ABSTRACT

In vitro studies have established the prevalent theory that the mitochondrial kinase PINK1 protects neurodegeneration by removing damaged mitochondria in Parkinson's disease (PD). However, difficulty in detecting endogenous PINK1 protein in rodent brains and cell lines has prevented the rigorous investigation of the in vivo role of PINK1. Here we report that PINK1 kinase form is selectively expressed in the human and monkey brains. CRISPR/Cas9-mediated deficiency of PINK1 causes similar neurodegeneration in the brains of fetal and adult monkeys as well as cultured monkey neurons without affecting mitochondrial protein expression and morphology. Importantly, PINK1 mutations in the primate brain and human cells reduce protein phosphorylation that is important for neuronal function and survival. Our findings suggest that PINK1 kinase activity rather than its mitochondrial function is essential for the neuronal survival in the primate brains and that its kinase dysfunction could be involved in the pathogenesis of PD.

4.
Article in Chinese | WPRIM | ID: wpr-912647

ABSTRACT

Objective:To determine the prevalence situation of adult female acne (AFA) patients and to explore the risk factors related to AFA.Methods:From September 2019 to June 2020, 290 female acne patients aged from 25 to 48 (29.57±4.50) years were surveyed with a questionnaire of risk factors and the prevalence situation of acne in the acne clinic of the Department of Dermatology, Wuxi No.2 Hospital Affiliated with Nanjing Medical University.Results:AFA occured more frequently in the jaw (95.17%), cheek (93.79%) and forehead (89.66%). Recurrent acne (38.62%) and comedonal acne (50.34%) more commonly occured. Cosmetics, endocrine, diet, genetics and other factors aggravated AFA. Age ( H=7.286, P>0.05; F=0.122, P>0.05), gonadal hormone concentrations ( Z=-0.365, P>0.05; χ 2=0.276, P>0.05), menstrual cycle ( Z=-0.274, P>0.05; χ 2=0.217, P>0.05), genetics ( Z=-1.244, P>0.05; χ 2=1.771, P>0.05) made no difference to acne grading and types. Excessive use of cosmetics could lead to increased comedo (χ 2=7.097, P<0.05). Cosmetics had no difference to acne grading ( Z=-0.065, P>0.05). Gonadal hormone concentrations were uncorrelated with menstrual cycle (χ 2=1.397, P>0.05). Conclusions:The pathogenesis of AFA is related to a variety of factors, which affect the skin barrier function and require comprehensive treatment.

5.
Article in Chinese | WPRIM | ID: wpr-912482

ABSTRACT

Objective:To examine the distribution of syphilis antibody in pregnant women and newborns and to explore how to optimize the existing syphilis screening process by setting the diagnostic gray area.Methods:The results of syphilis testing obtained from 119 531 pregnant women and 21 275 newborns from 2015 to 2018 by automatic chemiluminescent immunoassay (CLIA) and the re-examination results determined by Treponema pallidum particle agglutination (TPPA) and the rapid plasma reagin test (RPR) were retrospective analyzed. Data analysis was performed by Chi-square, Fisher′s exact test and Chi-square test for trend. Results:The positive rates of Syphilis specific antibody (TPAb) in clinical specimens from pregnant women and newborns were 0.69% (825/119 531) and 1.24%(264/21 275). The total re-examination positive rates were 0.32% (380/119 531) and 0.90%(191/21 275), and the suspicious syphilis prevalence rates in these specimens were 0.13% (161/119 531) and 0.31%(67/21 275), respectively. The suspicious syphilis prevalence rates in specimens of pregnant women from 2015 to 2018 and newborns increased year by year (χ 2=9.860, P=0.002; χ 2=5.311, P=0.021). With the elevation of the optical density value of samples to cut-off ratio (S/CO) value, positive coincidence rate of TPPA and TPAb in pregnant women and newborns increased significantly (χ 2=614.833, P<0.001; P<0.001). When the S/CO value in newborns exceeded 7.00 or the S/CO value in pregnant women exceeded 15.00, the effectiveness of TPAb results is equivalent to TPPA. The prevalence of suspected syphilis in pregnant women and newborns also increased with the increase of S/CO value (χ 2=323.059, P<0.001; P<0.001). When the S/CO value in newborns bellowed 3.00 or the S/CO value in pregnant women bellowed 5.00, the prevalence rate of suspected syphilis was 0%, which could preliminarily exclude syphilis infection. Conclusions:The prevalence rates of suspected syphilis in pregnant women was increasing during the recent years. It is necessary to further strengthen syphilis screening and intervention treatment in early pregnancy to improve the rate of eugenics. Being a primary screening method for syphilis in pregnant women and newborns, CLIA has high false positive rate. According to the gray area established in this study, the syphilis screening process can be optimized to prevent missed detection, which may reduce the false positive rate and avoid clinical misdiagnosis.

6.
Article in Chinese | WPRIM | ID: wpr-911740

ABSTRACT

A total of 280 patients with varicose veins of lower extremities who were prescribed stretch socks as pressure therapy in the outpatient clinic of Beijing Chaoyang Hospital from September 2019 to November 2019 were included in the study. Among 280 patients 208 were followed up for one year(74.3%), 139 cases (66.8%) gave up wearing stretch socks and 69 cases (33.2%) insisted to wear. The main reasons for giving up wearing were feeling too tight (23.1%), too much troubles (17.7%), symptom improvement (15.1%), poor effect (10.8%) and so on. The compliance of wearing stretch socks as pressure therapy in outpatients with varicose veins of lower extremities is poor with a variety of reasons, the data may provide a reference for improving clinical compliance in the future.

7.
Article in Chinese | WPRIM | ID: wpr-911635

ABSTRACT

Objective:To evaluate perioperative coagulatory parameters and transfusion rates of lung transplantation recipients.Methods:Clinical data were retrospectively reviewed for 178 lung transplant recipients at China-Japan Friendship Hospital from March 2017 to July 2019. According to whether extracorporeal membrane oxygenation(ECMO)was used during perioperative period, they were divided into two groups of ECMO(131 cases)and without ECMO(47 cases). Clinical data, laboratory examinations and blood transfusion status of two groups were compared. In ECMO group, excluding secondary thoracotomy for hemostasis(7 cases)and incomplete data(2 cases), the remainders were divided into the groups of no red blood cell transfusion(63 cases), red blood cell transfusion(59 cases), plasma transfusion <1 000 ml(99 cases)and plasma transfusion≥1 000 ml (23 cases), no platelet transfusion(93 cases)and platelet transfusion(29 cases). Clinical data, laboratory examinations and ECMO-related parameters of recipients were analyzed by Bary Logistic regression.Results:Statistically significant inter-group differences existed in body mass index(BMI), disease course, primary disease, bilateral lung transplantation, laboratory examinations, postoperative blood transfusion volume, postoperative red blood cell and plasma transfusion ratio between groups with and without ECMO( P<0.05). Bilateral lung transplantation, ASA grade, differences in BMI, disease course, postoperative hemoglobin<100 g/L, postoperative PT/APTT/INR abnormalities and postoperative PLT count <100×10 9/L were independent risk factors for postoperative transfusion during ECMO. Conclusions:The application of ECMO during lung transplantation may affect the perioperative transfusion volume and demand.Fully assessing blood transfusion requirements, optimizing coagulation monitoring and identifying the independent influencing factors of postoperative blood transfusion facilitate clinical scientific and rational blood transfusions.

8.
Chinese Journal of Urology ; (12): 436-442, 2021.
Article in Chinese | WPRIM | ID: wpr-911046

ABSTRACT

Objective:To establish the urodynamic classification of middle-aged and elderly men with benign prostatic obstruction(BPO), and to analyze the efficacy of transurethral resection of the prostate(TURP) on various types of patients.Methods:A retrospective analysis of middle-aged and elderly male patients with non-neurogenic lower urinary tract symptoms(LUTS) who underwent urodynamic tests from January 2010 to December 2018, including 793 patients with BPO. Urodynamics examination of detrusor without contraction needs to complete cystoscopy to diagnose BPO. During urodynamic examination, the detrusor uninhibited contraction induced by spontaneous or stimulation during the bladder filling period is diagnosed as overactivity of the bladder detrusor(DO), and the LinPURR chart indicates the detrusor underactivity(DU). Based on the persistence of BPO leading to DO, DU, and decreased bladder compliance, 793 male patients with BPO with LUTS were divided into four types, including type Ⅰ(BPO: n=164, 20.7%), type Ⅱ(BPO combined with DO: n=333, 42.00%), type Ⅲ(BPO combined with DU: n=267, 33.7%), type Ⅳ(BPO combined with decreased bladder compliance: n=29, 3.7%). The preoperative comparison between groups showed that the age of type Ⅰ-Ⅳ gradually increased, and the age of type Ⅰ was significantly smaller than other types [(67.3±8.2)years, (69.7±7.7)years, (71.5±7.9)years, (72.4±7.1)years, P<0.05]. Compared with other types, the type Ⅰ’s IPSS-S[(9.1±3.6)points vs.(10.4±3.1) points, (9.2±3.3) points, (10.4±3.1)points, P<0.05], IPSS-V[(13.5±3.4) points vs. (14.2±3.5)points, (14.0±3.5)points, (14.2±2.9)points, P<0.05], IPSS scores[(22.6±5.4)points, (24.7±4.9)points, (23.1±5.3)points, (24.6±4.7)points, P<0.05] were significantly lower than other groups, the maximum bladder capacity [(332.6±83.2)ml vs.(221.4±80.8)ml, (286.7±108.2)ml, (242.3±103.4)ml, P<0.05], the functional bladder capacity was significantly higher than other types[(215.2±90.0)ml, (148.5±76.0)ml, (154.9±87.2)ml, (121.2±72.9)ml, P<0.05]. Type Ⅱ’s IPSS-S[(10.4±3.1)points vs.(9.1±3.6)points, (9.2±3.3)points, P<0.05], nocturia frequency[(3.7±1.8)times vs.(3.2±1.8)times, (3.2±1.6)times, P<0.05], IPSS score[(24.7±4.9)points vs.(22.6±5.4)points, (23.1±5.3)points, P<0.05], quality of life scores [(4.9±0.9) points, (4.6±0.9)points, (4.6±0.9)points, P<0.05] was significantly higher than type Ⅰ and type Ⅲ ( P<0.05). Type Ⅲ and Ⅳ had higher residual urine than type Ⅱ[(121.3±96.4)ml, (121.3±96.4)ml vs.(71.2±73.5)ml, P<0.05]. Type Ⅳ’s IPSS-S[(10.4±3.1)points vs. (9.1±3.6)points, (9.2±3.3)points, P<0.05], IPSS-V[(14.2±2.9) points vs.(13.5±3.4)points, (14.0±3.5)points, P<0.05], the frequency of nocturia[(3.8±1.9)times vs.(3.2±1.8)times, (3.2±1.6)times, P<0.05] was significantly higher than that of type Ⅰ and type Ⅲ, and the quality of life score was higher than type Ⅰ and type Ⅲ[(4.3±0.8)points vs.(4.7±0.9)points, (4.6±0.9)points, P<0.05]. type Ⅱ and type Ⅳ’s bladder compliance[(21.4±24.2)ml/cmH 2O, (11.0±11.4)ml/cmH 2O vs.(33.9±23.7)ml/cmH 2O, (33.1±32.7)ml/cmH 2O, P<0.05], maximum bladder capacity[(221.4±80.8)ml, (242.3±103.4)ml vs.(332.6±83.2)ml, (286.7±108.2)ml, P<0.05], functional bladder capacity[(148.5±76.0)ml, (121.2±72.9)ml vs.(215.2±90.0)ml, (154.9±87.2)ml, P<0.05] were significantly less than type Ⅰ and type Ⅲ( P<0.05). From November 2016 to November 2018, 60 middle-aged and elderly male patients with confirmed BPO and TURP were selected, including type Ⅰ( n=17, 28.3%), type Ⅱ ( n=23, 38.3%), and Ⅲ type ( n=11, 18.3%), Ⅳ type( n=9, 15.1%). Type IV patients are significantly older than other types ( P<0.05), bladder compliance is significantly worse than other types( P<0.05), the maximum bladder capacity is smaller than other types( P<0.05). The follow-up started 3 months after the operation. The content of the follow-up included IPSS, IPSS-S, IPSS-V, nocturia frequency, undisturbed sleep time, nocturia quality of life score, and life quality score. Results:The IPSS scores of type Ⅰ, type Ⅱ, and type Ⅲ after TURP were significantly improved compared with preoperative(19.8±6.2 vs.3.4±1.8; 21.9±5.2 vs.4.6±2.6; 21.5±6.2 vs.5.7±4.6, P<0.05), type Ⅳ urine storage symptom score (9.1±4.1 vs.4.3±3.7), nocturia frequency(3.6±1.5vs.2.3±1.6), nocturia quality of life score (25.3±6.9 vs.31.4±13.7) Compared with preoperatively, there was no significant improvement( P>0.05). The quality of life score improvement of type Ⅳ patients was significantly lower than that of type Ⅰ, type Ⅱ, and type Ⅲ (10.9±9.1 vs.12.2±9.0, 14.4±5.7, 12.7±5.8, P<0.05). The IPSS score of type Ⅳ patients was significantly higher than that of type Ⅰ(7.0±5.8 vs.3.4±1.8), and the nocturia quality of life score was significantly lower than that of each group (31.4±13.7 vs.37.5±4.2, 38.7±3.5, 37.8±3.8, P<0.05). Conclusions:For middle-aged and elderly men with BPO, we divide them into four types based on the results of urodynamic examinations, type Ⅰ(simple BPO), type Ⅱ(BPO combined with DO), type Ⅲ(BPO combined with DU), type Ⅳ(BPO combined with bladder compliance decline). Type Ⅰ patients have the best bladder function, and TURP has the best effect; type Ⅱ has a high symptom score and poor quality of life, and can benefit after TURP; type Ⅲ bladder function is poor, and surgery should be performed as soon as possible to prevent further deterioration of bladder function; type Ⅳ bladder function is the best poor, IPSS score and quality of life score are high, TURP surgery is not effective.

9.
Chinese Journal of Orthopaedics ; (12): 1324-1332, 2021.
Article in Chinese | WPRIM | ID: wpr-910719

ABSTRACT

Objective:To explore the clinical effect of open reduction in the treatment of Tile C pelvic fracture combined with acetabular fracture in a specific sequence.Methods:Retrospectively analyzed the clinical data of 53 patients with Tile C type pelvic fracture combined with acetabular fracture from January 2014 to January 2019, and were divided into specific sequence group and non-specific sequence group according to the sequence of intraoperative reduction. A total of 29 cases were observed in the specific sequence group, including 20 males and 9 females; aged 43.8±14.8 years old (18-71 years), and the fractures were reduced in the sequence of "inside and out, then up and down" during the operation. There were 24 cases in the non-specific sequence group, including 14 males and 10 females; aged 44.4±14.7 years old (18-69 years), and fracture reduction was not performed in this sequence during the operation. According to the type of pelvic and acetabular fracture injury, we choose the appropriate position and surgical approach. After open reduction, the fracture was fixed with internal plants. The intraoperative blood loss, operation time, visual analogue scale (VAS) score were compared between the two groups. The quality of fracture reduction was evaluated by Matta score, pelvic fracture function recovery was evaluated by Majeed score, and acetabular fracture was evaluated by hip joint modified Merle d'Aubigné-Postel score.Results:There was no statistically significant difference in general data between the two groups before operation ( P>0.05), which was comparable. The intraoperative blood loss of the specific sequence group and the non-specific sequence group were 1 031.1±513.7 and 1 406.3±738.1 ml, and the operation time was 3.5±1.0 and 4.8±1.4 h; The differences between the two groups were statistically significant ( P<0.05). 53 patients were followed up for 14.8±1.6 months (12-18 months) after operation. The average postoperative VAS scores of specific sequence group and non-specific sequence group were 1.3±1.1 and 1.5±1.3 respectively, and there was no statistically significant difference. The effectiveness of the pelvic fracture Matta score standard was evaluated in the specific sequence group: excellent in 22 cases, good in 5 cases, fair in 2 cases, excellent and good rate was 93.1%; non-specific sequence group excellent in 10 cases, good in 6 cases, fair in 5 cases, poor in 3 cases, excellent and good rate was 66.7%, the difference was statistically significant ( P<0.05). Matta score of acetabular fracture: 21 cases were excellent in specific sequence group, 5 cases were good, 3 cases were poor, excellent and good rate was 89.7%; 9 cases were excellent in non-specific sequence group, 8 cases were good, 7 cases were poor, excellent and good rate was 70.8 %, the difference is statistically significant ( P<0.05). The results of the last follow-up pelvic fractures were evaluated by Majeed score: 20 cases were excellent in the specific sequence group, 7 were good, 2 were fair, excellent and good rate was 93.1%; 10 were excellent in the non-specific sequence group, 5 were good, 5 were fair, and 4 were poor, excellent and good rate was 62.5%, the difference was statistically significant ( P<0.05). At the last follow-up, the modified Merle d'Aubigné-Postel score was used to evaluate the efficacy: 20 cases were excellent in the specific sequence group, 5 were good, 4 were fair, the excellent and good rate was 86.2%; In the non-specific sequence group, 9 cases were excellent, 7 cases were good, 4 cases were fair, and 4 cases were poor, excellent and good rate was 66.7%, the difference was statistically significant ( P<0.05). During the follow-up period, none of the patients in the two groups developed fracture nonunion, heterotopic ossification, iatrogenic neurovascular injury, and femoral head necrosis. Trauma arthritis occurred in 4 patients in the non-specific sequence group. Conclusion:"Inside and out, then up and down" sequential reduction of Tile C pelvis combined with acetabular fracture can significantly shorten the operation time and reduce the amount of intraoperative blood loss. The surgical procedure is reasonable, which helps to improve the quality of fracture reduction and promote the functional recovery of patients.

10.
Chinese Journal of Orthopaedics ; (12): 1066-1072, 2021.
Article in Chinese | WPRIM | ID: wpr-910692

ABSTRACT

Objective:To explore the clinical diagnosis and treatment experience of pelvic fracture complicated with anterior sacroiliac joint dislocation.Methods:The data of 19 patients with pelvic fracture and anterior sacroiliac joint dislocation admitted from June 2013 to September 2019 were retrospectively analyzed. There were 12 males and 7 females; aged 9-67 years, with an average of 28.0 years. There were 11 cases of traffic accident injury, 6 of falling injury and 2 of crashing injury caused by machine extrusion. According to the Tile classification, there were 8 cases of type C1, 2 of type C2, and 9 of type C3; 6 cases of modified mangled extremity severity score (MESS) were greater than or equal to 7, of which 2 cases underwent hip amputation, 4 cases underwent king-steelquis semipelvectomy. 13 cases underwent limb-salvage surgery, of which 3 cases underwent external fixation surgery, and the remaining 10 cases underwent open reduction and internal fixation with steel plate. The reduction quality was evaluated according to the Matta imaging criteria of pelvis, the pain was evaluated according to the visual analogue scale (VAS), and the pelvic function was evaluated according to the Majeed score.Results:The operation time was 2 to 4 hours, with an average of 3.2 hours; the intraoperative blood loss was 400 to 1 200 ml, with an average of 768.4 ml. The 18 surviving patients were followed up for 6 to 24 months, with an average of 11.6 months. One of the 6 amputation patients died one week after the operation due to septic shock and multiple organ failure. The overall survival rate of the patients was 94.7% (18/19), and the amputation rate was 31.6% (6/19). The pelvic fractures of the 18 surviving patients were all healed, and the fracture healing time was 3 to 6 months, with an average of 4.2 months. No delayed union or nonunion occurred. At the last follow-up of the 18 surviving patients, the VAS was 2.4±1.9 points (range, 0-6 points). Among them, there were no pain in 3 cases, mild pain in 9 cases and moderate pain in 6 cases. At the last follow-up, 13 patients undergoing limb salvage treatment evaluated the quality of reduction according to Matta imaging criteria. Among them, 6 cases were excellent, 4 were good, 2 were fair, and 1 was poor. The excellent and good rate was 76.9% (10/13). The Majeed functional score was 81.8±11.9 points (range, 53-95 points). Among them, 6 cases were excellent, 5 were good, 1 was fair, and 1 was poor. The excellent and good rate was 84.6% (11/13). In the limb salvage treatment group, 4 patients with lumbosacral nerve injury caused limited hip joint movement function, and unilateral lower limb sensation and movement were weakened. After neurolysis and nutritional support treatment, the patient's sensorimotor function was significantly improved.Conclusion:The mortality and disability rate of pelvic fractures combined with anterior sacroiliac joint dislocation is high. In order to save the patient's life, early diagnosis of limb injury and early surgical intervention should be performed. If necessary, hip disarticulation or king-steelquis should be selected.

11.
Chinese Journal of Orthopaedics ; (12): 1018-1024, 2021.
Article in Chinese | WPRIM | ID: wpr-910685

ABSTRACT

Objective:To investigate the application value of magnetic resonance neurography (MRN) in pelvic fractures with lumbosacral plexus injury.Methods:From January 2014 to June 2020, data of 9 patients with pelvic fractures combined with lumbosacral plexus injury who were diagnosed with MRN and were performed surgical treatment were analyzed retrospectively. Among them, there were 8 males and 1 female, aged from 18 to 54 years, with an average age of 40.6±11.0 years. There were 2 fresh fractures within 3 weeks and 7 old pelvic fractures in 9 patients. According to AO classification, there were 6 cases of C1.3 type, 3 cases of C3 type. According to Denis classification of sacral fracture, there were 8 cases of Denis II type, 1 case of Denis III. Gibbons classification of nerve injury: 2 cases of grade II, 4 cases of grade III, 3 cases of grade IV; According to the criteria by the Nervous Injury Committee of British Medical Research Council (BMRC): 2 cases of M1, 3 cases of M2, 2 cases of M3, 2 cases of M4. Before the operation, the MRN technology was used to accurately locate the location and extent of the lumbosacral nerve injury, and nerve exploration release or internal fixation combined with nerve exploration release was employed for treatment.Results:All 9 patients underwent surgery successfully. The operation time ranged from 150 to 360 min, with an average of 217.8±63.8 min; intraoperative blood loss ranged from 200 to 1 100 ml, with an average of 388.9±293.4 ml. All patients were followed up for 21.6±19.3 months. All the fractures were healed, and the healing time was 12.7±2.2 months (range, 10-18 months). At the last follow-up, Gibbons classification of nerve injury: 3 cases of grade I, 5 cases of grade II, and 1 case of grade III. According to the criteria of BMRC: the muscle strength achieved M5 in 6 cases, M4 in 2 cases, M3 in 1 case. One patient developed a urinary system infection 2 months after discharge and recovered after treatment.Conclusion:MRN technique can assist the surgeon to fully understand the compression and traction damage of the lumbosacral nerve by the fracture before the operation, and make clear qualitative and localized diagnosis of the nerve damage, making the operation more precise and minimally invasive, which is a supplement to the traditional diagnosis method of lumbosacral plexus injury.

12.
Article in Chinese | WPRIM | ID: wpr-910367

ABSTRACT

Objective:To investigate the application of therapeutic grade ionization chamber to rapid measurement of short pulsed and high-dose-rate X-ray.Methods:The half-value layer of pulsed X-ray caused by an electron accelerator was measured by interpolation method and its equivalent energy was estimated. The cumulative doses from a certain amount of pulsed radiation at different distances in the same direction around the equipment were compared using the therapeutic grade ionization chamber and thermoluminescence measurement method . The relationship between the measurement result by using ionization chamber dosimeter and the distances away from source was analyzed. The cumulative doses from a certain amount of pulsed radiation at the same location at different frequencies were compared.Results:In working condition, 100 pulses of radiation were received accumulatively at 1 to 12 meters away from the outer wall of the equipment. The range of air Kerma was 0.08-9.65 mGy measured by using thermoluminescence dometers and 0.08 - 9.85 mGy using the ionization chamber dosimeters, respectively. The difference between both is within 10%. At different frequencies (1-10 Hz), there was no significant difference in X-ray air Kerma from 100 pulses measured by ionization chamber dosimeter at 2 m away from the front of the equipment ( P>0.05). Conclusions:The therapeutic grade ionization chamber dosimeter can be used for the rapid measurement of short pulsed X-ray radiation dose in the range of dose rates and pulse frequencies involved in the experimental accelerator device.

13.
Article in Chinese | WPRIM | ID: wpr-909608

ABSTRACT

OBJECTIVE To explore the pathogenesis of depression according to the LC-MS/MS-based metabolo?mics in the mouse model which exhibits social avoidance state induced by the chronic social defeat stress model (CSDS). METHODS Twenty male C57BL/6N mice were randomly divided into control group and model group suffering CSDS, and the ICR retired breeder mice were used to attack the model group for 14 d of chronic social defeated stress. The open field test and source preference test were both used to observe depression-like behavior. Besides, the social inter?action test is used to observe the social interaction state, especially. After the stress, the serum samples of mice were collected, and the changes of endogenous metabolites were analyzed by LC-MS metabolomics technology, and the pathway analysis of the differential metabolites was performed to explore the pathogenesis of the CSDS induced depres?sive-like mouse model. RESULTS After the stress of CSDS was completed, the mice in the model group showed a significant slowdown in body weight growth, a reduction in the source preference rate, and a significant reduction in the total distance and the number of rearing in the open field test. Distinctively, the social interaction rate is remarkably decreasing. There are 24 differential metabolites found in the serum of CSDS model mice. CONCLUSION The mouse who suffered CSDS stress would show depressive-like behavior. Based on the LC-MS/MS metabolomics, 24 differential metabolites were found in the serum of CSDS model mice. The amino acid metabolism might be significant to the patho?genesis of the CSDS induced depressive-like mouse model.

14.
Article in Chinese | WPRIM | ID: wpr-908694

ABSTRACT

Objective:To investigate the significance and level of serum GRP78 and GRP94 in the early stage ofacute pulmonary embolism.Methods:Ninety APE patients (APE group) and forty healthy controls (control group) in Affiliated Zhongshan Hospital of Dalian University from January 2018 to March 2020 were recruited. The level of serum D-Dimer, GRP78 and GRP94 were compared between the two groups. The pulmonary embolism group was divided into three groups according to guidelines for the diagnosis and treatment of pulmonary embolism in ESC in 2019: low risk, medium risk, high risk, The level of serum D-Dimer, GRP78, GRP94, blood gas, pulmonary arterial pressure, PESI mark of three groups were compared.Results:Two groups had no significant difference in sex, age, body mass index ( P>0.05), but the level of serum D-Dimer, GRP78 and GRP94 in control group and APE group were higher than those in the control group: (3.86 ± 1.82) mg/L vs. (0.31 ± 0.15) mg/L, (2.68 ± 0.71) μg/L vs. (1.64 ± 0.38) μg/L, (1.31 ± 0.29) μg/L vs. (0.98 ± 0.13) μg/L ( P<0.05). The levels of serum D-Dimer, GRP78, GRP94, pulmonary arterial pressure, PO2, PESI score of different degree group (low risk, medium risk, high risk) were higher than those of low risk group and medium risk group: (5.63 ± 1.75) mg/L vs. (2.29 ± 0.51) and (3.64 ± 1.02) mg/L, (3.24 ± 0.76) μg/L vs. (2.17 ± 0.41) μg/L and (2.64 ± 0.47) μg/L, (1.57 ± 0.33) μg/L vs. (1.12 ± 0.13) and (1.26 ± 0.14) μg/L, (47.75 ± 6.98) mmHg (1 mmHg = 0.133 kPa) vs. (26.15 ± 4.63) and (35.21 ± 5.85) mmHg, (123.5 ± 20.59) scores vs. (85.5 ± 14.31) and (102.5 ± 13.32) scores ( P<0.05), and that of medium risk group were higher than those of low risk group ( P<0.05). But PO 2 of high risk group was lower than that of low risk group and medium risk group ( P<0.05), and PO 2 of medium risk group was lower than that of low risk group ( P< 0.05). pH of three group had no significant difference ( P>0.05). PCO 2 of high risk group was lower than that of low risk group and medium risk group ( P<0.05), and PCO 2 of medium risk group and low risk group had no significant difference ( P>0.05). The level of serum D-Dimer, GRP78, GRP94 were positively correlated withPESI score ( r = 0.610, 0.622, 0.627, P<0.01). After treatment, the levels of D-Dimer, GRP78 and GRP94 were significantly decreased ( P<0.05). Conclusions:The level of serum GRP78 and GRP94 are connected with acute pulmonary embolism, and it can reflect the severity of the disease.

15.
Article in Chinese | WPRIM | ID: wpr-908571

ABSTRACT

Objective:To investigate the damage effect of different concentrations of N-methyl-D-aspartic acid (NMDA) to retinal ganglion cells (RGCs) in mice and explore the expression of long noncoding RNA (lncRNA) Tsix in the retina of mice with excitotoxicity as well as the protective effect of lncRNA Tsix on retina and RGCs.Methods:A total of 105 C57B6/J mice at 7-8 weeks of age were selected and randomly divided into the normal control group, 2 mmol/L NMDA group, 10 mmol/L NMDA group, 20 mmol/L NMDA group and 40 mmol/L NMDA group using a random number table method, with 21 mice in each group.In the normal control group, the mice were intravitreally injected with 1 μl of sodium chloride solution in the right eye, and mice were given intravitreal injection of 1 μl of different doses of NMDA according to grouping.At one week after the injection, the thickness of each retinal layer, the number of ganglion cell layer (GCL) cells and the number of RGCs were analysed and compared among different groups through optical coherence tomography (OCT), hematoxylin-eosin staining, retinal whole mount staining and immunofluorescence staining.RNAscope in situ hybridization was used to verify the expression of lncRNA Tsix in the GCL of different groups.The quantitative real-time PCR was used to detect the transcript levels of Tsix in different groups.This study was approved by an Ethics Committee of Tianjin Medical University (No.SYXK2018-0004), and the use of experimental animals was in accordance with the regulations of Tianjin Medical University and ARVO statement. Results:The OCT results showed that the total retinal thickness of mice in the 2, 10, 20 and 40 mmol/L NMDA groups were (255.00±6.63), (252.40±6.41), (248.67±6.20) and (229.11±10.37)μm, respectively, which were thinner than (269.60±20.01)μm in the normal control group, and the differences were statistically significant (all at P<0.05). Hematoxylin-eosin staining showed that the cells in the GCL of the normal control group were uniform and compact, and arranged in a single layer with large and round nuclei.In the NMDA groups, the cells were uneven in volume with vacuoles and nuclear pyknosis.The cell density in the GCL was decreased significantly with the increasing NMDA doses in NMDA groups in comparison with the normal control group, and the differences were statistically significant (all at P<0.05). In the 20 mmol/L NMDA group, the cell density in the GCL was reduced to half of the normal control group.The results of retinal whole mount staining showed that the density of β3-tubulin-positive RGCs was decreased significantly as the dose of NMDA increased in NMDA groups, and the differences were statistically significant compared with the normal control group (all at P<0.05). The number of RGCs in the 10 mmol/L NMDA group was reduced to half of that in the normal control group.RNAscope results showed that lncRNA Tsix was mainly expressed in the cytoplasm of the GCL cells.The proportion of lncRNA Tsix-positive cells was significantly reduced with the increase of the NMDA dose ( F=13.670, P<0.01). The quantitative real-time PCR results verified that the trend of Tsix expression was consistent with the RNAscope result. Conclusions:NMDA exerts a dose-dependent damage to the layer thickness of mouse retina and RGCs.The expression of lncRNA Tsix in mouse retina is mainly enriched in the cytoplasm of the cells in the GCL, and the transcript level of Tsix is reduced with the increase of NMDA concentration and have a protective effect on RGCs.

16.
Article in Chinese | WPRIM | ID: wpr-906499

ABSTRACT

In this paper, a comparative analysis is carried out on the policy of listed drugs in Australia, the policy of over-the-counter drugs in Japan, the policy related to the conversion of Chinese patent medicines to over-the-counter drugs, and the policy related to health food. The focus is on one of the possible situations for the registration of over-the-counter traditional Chinese medicines (TCMs), namely new prescription-composed over-the-counter TCMs. This paper discussed separately from the three parts of the scope of Chinese medicinal materials in the prescription medicines, the scope of indications, and the technical requirements, in order to provide references for the technical requirements related to the registration of over-the-counter TCMs. Recommendations on the marketing and registration of new prescription-composed over-the-counter TCMs:①It is recommended to formulate a list of medicinal materials for the use of Chinese herbal medicines, and consider including raw materials of health food. On this basis, a batch of safe Chinese medicinal materials/decoction pieces was added. And consider dynamic supervision, such as allowing the addition or recall of Chinese medicinal materials/decoction pieces in the list of medicinal materials. ②The scope of indications is recommended to consider the scope of indications for the conversion of Chinese patent medicines to over-the-counter TCMs in China, and the selection of medium-risk indications can reflect the characteristics and advantages of TCM treatment. ③Efficacy evaluation needs to provide high-quality scientific evidence, including clinical research data, and consider relaxing the requirements for non-clinical pharmacodynamic trials.

17.
Article in Chinese | WPRIM | ID: wpr-906485

ABSTRACT

Objective:To observe the efficacy of Qingre Lishi prescription in treating children with acute bacterial lower urinary tract infection of bladder damp-heat syndrome, and to explore its mechanism of action. Method:Eighty children with acute bacterial lower urinary tract infection of late bladder damp-heat syndrome who were admitted to the Affiliated Hospital of Changchun University of Chinese Medicine were divided into control group and observation group, 40 cases in each group. Patients in control group were given Bazhengsan for oral treatment on basis of basic treatment, while patients in observation group were given Qingre Lishi prescription for oral administration plus external washing treatment. After two weeks of treatment, the clinical and etiological effect, traditional Chinese medicine (TCM) syndrome scores, antipyretic time and urinary negative time, adverse reactions, and urine pathogens (<italic>Escherichia coli, Enterococcus faecalis, Strange proteus, Klebsiella pneumoniae</italic>), serum inflammatory factor indicators [tumor necrosis factor-<italic>α</italic> (TNF-<italic>α</italic>), interleukin-6 (IL-6), interleukin-8 (IL-8), calcium lowering PCT, white blood cell count (WBC) and serum C-reactive protein (CRP)], immune function indicators [T cell subsets (CD3<sup>+</sup>, CD4<sup>+</sup>, CD8<sup>+</sup>) and complement (C3, C4)] were comapred between two groups. Result:The clinical efficacy of observation group was 92.50% (37/40), which was significantly higher than 65.00% (26/40) in control group (<italic>χ<sup>2</sup></italic>=9.038, <italic>P</italic><0.01), the etiological efficacy of observation group was 87.50% (35/40), which was significantly higher than 60.00% (24/40) in control group (<italic>χ<sup>2</sup></italic>=7.813, <italic>P</italic><0.01). After treatment, the scores of TCM syndromes of the two groups were significantly reduced (<italic>P</italic><0.05). The scores of fever, frequent urination, urgent urination, painful urination, difficulty urinating and abdominal pain in two groups were significantly lower than those before treatment (<italic>P</italic><0.05), and the TCM syndrome scores in observation group were lower than those in control group (<italic>P</italic><0.05), the antipyretic time and urinary bacteria turning negative time of observation group were significantly lower than those in control group (<italic>P</italic><0.05), the <italic>Escherichia coli, Enterococcus faecalis, Proteus mirabilis, Klebsiella pneumoniae</italic> pathogenic bacteria detected in both groups were both significantly lower than those before treatment (<italic>P</italic><0.05). After treatment, the levels of inflammatory factors such as TNF-<italic>α</italic>, IL-6, IL-8, PCT, WBC and CRP in two groups were significantly lower than those before treatment (<italic>P</italic><0.05), the immune function of the two groups was significantly improved, and the levels of CD3<sup>+</sup>, CD4<sup>+</sup>, C3, and C4 in observation group were higher than those in control group(<italic>P</italic><0.05), and the CD8<sup>+</sup> level was lower than that in control group (<italic>P</italic><0.05). The incidence of adverse reactions had no significant difference between two groups. Conclusion:Qingre Lishi prescription has good clinical effect in treating children with acute bacterial lower urinary tract infection with bladder damp-heat syndrome. It can improve TCM syndromes and clinical symptoms. Its mechanism is related to inhibiting pathogenic bacteria, reducing inflammation, and improving immune function, and it has good security.

18.
Article in Chinese | WPRIM | ID: wpr-906437

ABSTRACT

Objective:To establish a qualitative and quantitative method for the determination of aristolochic acids in <italic>Aristolochia cinnabarina</italic> dried root tubers. Method:The dried root tubers of <italic>A. cinnabarina </italic>was qualitative and quantitative analysis by ultra-performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry (UPLC-QTOF-MS/MS). The analysis was performed on Waters ACQUITY UPLC-BEH C<sub>18</sub> column ( 2.1 mm×100 mm, 1.7 μm) with the mobile phase of 0.1% formic acid aqueous solution (A)-acetonitrile (B) for gradient elution (0-1 min, 10%B; 1-9 min, 10%-30%B; 9-11 min, 30%-50%B; 11-15 min, 50%-90%B). The flow rate was 0.45 mL·min<sup>-1</sup>, column temperature was 35 ℃, and the detection wavelength was 250 nm. Mass spectral data was acquired in positive mode of electrospray ionization (ESI). At the same time, the UPLC fingerprints of aristolochic acids in 21 batches of <italic>A. cinnabarina</italic> dried root tubers were established, and the contents of 5 aristolochic acids in <italic>A. cinnabarina</italic> dried root tubers from different producing areas and different harvesting periods were determined. Result:A total of 17 compounds, including 8 aristolochic acids, 7 aristololactams and 2 4,5-dioxoaporphine alkaloids, were identified from <italic>A. cinnabarina</italic> dried root tubers by mass spectrometry data and bibliographic information. Ten common peaks were identified in the UPLC fingerprint, and they were tuberosinone-<italic>N</italic>-<italic>β</italic>-<italic>D</italic>-glucoside, aristolactam Ⅰa-<italic>N</italic>-<italic>β</italic>-<italic>D</italic>-glucoside, aristolochic acid Ⅳa-<italic>O</italic>-<italic>β</italic>-<italic>D</italic>-glucoside, aristolactam Ⅲa-<italic>N</italic>-<italic>β</italic>-<italic>D</italic>-glucoside, aristolactam Ⅰ-<italic>N</italic>-<italic>β</italic>-<italic>D</italic>-glucoside, aristolochic acid Ⅲa, aristolochic acid Ⅳa, aristolochic acid Ⅱ, aristolactam Ⅰ and aristolochic acid Ⅰ. According to the quantitative analysis, the results exhibited that aristolochic acid Ⅲa, aristolochic acid Ⅳa, aristolochic acid Ⅱ, aristolactam Ⅰ and aristolochic acid Ⅰ had good linear relationships in the linear range. The relative standard deviations (RSDs) of precision, stability and reproducibility tests were all less than 3.0%, the recovery was 97.06%-101.84% (RSD<3.0%). The contents of aristolochic acid Ⅰ, aristolochic acid Ⅱ, aristolochic acid Ⅲa, aristolochic acid Ⅳa, and aristolactam Ⅰ in 21 batches of <italic>A. cinnabarina</italic> dried root tubers were 0.938 6-3.567 5, 1.377 6-3.688 1, 0.056 3-0.527 7, 0.108 8-0.305 5, 0.021 0-0.081 7 mg·g<sup>-1</sup>, respectively. Conclusion:The content of aristolochic acids in <italic>A. cinnabarina</italic> dried root tubers has a certain difference, the contents of aristolochic acid Ⅰ and Ⅱ are higher than other aristolochic acids. The established method is rapid, simple, accurate and reliable, which can provide reference for the quality control and evaluation of <italic>A. cinnabarina</italic> dried root tubers.

19.
Article in Chinese | WPRIM | ID: wpr-906418

ABSTRACT

Objective:To investigate the effect of Buyang Huanwutang (BHT) on proliferation and differentiation in neural stem cells (NSCs) after oxygen-glucose deprivation/reoxygenation (OGD/R) injury. Method:NSCs isolated from the hippocampus of SD rats were cultured and randomly divided into a normoxia group, a model group, a BHT group, a rapamycin (Rapa) group, and a combination group [autophagy inhibitor 3-methyladenine (3-MA) combined with BHT]. The 20% blank serum was used in the normoxia group, and 20% BHT-medicated serum in the BHT group. The doses of Rapa and 3-MA were 1 μmol·L<sup>-1</sup> and 5 mmol·L<sup>-1</sup>, respectively. The cells were subjected to OGD/R except those in the normoxia group. The cell morphology was observed under a light microscope. NSCs were confirmed by immunofluorescence detection of nestin expression. The viability and proliferation of NSCs were assessed by cell counting kit-8 (CCK-8) assay and 5-ethynyl-2-deoxyuridine (EdU) labeling, respectively. Furthermore, Ad-mCherry-GFP-LC3B fluorescence assay was performed to investigate autophagy. The effect of BHT on autophagy-related protein expression was detected by western blot assay. Brain derived neurotrophic factor (BDNF), <italic>β</italic>-tubulin Ⅲ, and glial fibrillary acidic protein (GFAP) were evaluated by immunofluorescence assay. Result:OGD/R significantly reduced the cell viability of rat NSCs as compared with the normoxia group. Compared with the model group, the BHT group exhibited significantly improved viability of rat NSCs (<italic>P</italic><0.01). BHT induced the production of autophagosomes in NSCs after OGD. The BHT group showed increased expression of microtuble-associated protein 1 light chain 3Ⅱ (LC3Ⅱ) and Beclin-1 (<italic>P</italic><0.05,<italic>P</italic><0.01) and slightly changed p62 compared with the normoxia group, and significantly up-regulated LC3Ⅱ and Beclin-1 (<italic>P</italic><0.05,<italic>P</italic><0.01) and down-regulated expression of p62 (<italic>P</italic><0.01) compared with the model group. The Rapa group had similar effect as the BHT group (<italic>P</italic><0.05,<italic>P</italic><0.01), while the combination group inhibited the activity of autophagy (<italic>P</italic><0.01). As indicated by the results of ad-mCherry-GFP-LC3B, compared with the normoxia group, the model group showed increased fluorescence intensity (<italic>P</italic><0.01), and the BHT and Rapa groups could further increased the fluorescence intensity of autophagy (<italic>P</italic><0.01), while the combination group inhibited autophagy activity (<italic>P</italic><0.01). Immunofluorescence results revealed that compared with the normoxia group, the model group displayed significantly reduced positive cells of EdU, <italic>β</italic>-tubulin Ⅲ, GFAP, and BDNF (<italic>P</italic><0.01), and the BHT and Rapa groups exerted similar protective and promoting effects (<italic>P</italic><0.05,<italic>P</italic><0.01), while the combination group partially blocked the neuroprotection and differentiation ability of BHT (<italic>P</italic><0.05). Conclusion:BHT pretreatment can effectively protect rat NSCs against OGD-induced injury and promoted proliferation and differentiation by up-regulating autophagy.

20.
Article in Chinese | WPRIM | ID: wpr-906363

ABSTRACT

Objective:To evaluate the clinical efficacy of Zhiwei pill for bile reflux gastritis (BRG) with symptoms of disharmony of liver and stomach, evaluate the safety after treatment by three-arm study, and investigate the regulatory action to gastrointestinal hormones. Method:One hundred and eighty patients were randomly divided into placebo group (60 cases), control group (60 cases) and observe group (60 cases) by random number table. Patients in three groups got lifestyle intervention of non-drug therapy. Patients in control group got hydrotalcite tablets 1-2 hours after meal or untimely bedtime or in case of stomach pain, 2 tablets/time, 3 times/day. Patients in placebo group got simulated medicine of Zhiwei pill 1 hour after meal, 6 g/time, 3 times/day. Patients in observe group got Zhiwei pill 1 hour after meal, 6 g/time, 3 times/day. The treatment continued for 4 weeks in all 3 groups. Before and after treatment, scores were graded for symptoms of disharmony of liver and stomach and patient reported outcome (PRO) scale for patients with chronic gastrointestinal diseases. Gastroscopy was taken to grade the scores of bile reflux and mucosa under gastroscope. Levels of gastrin (GAS), motilin (MTL), cholecystokinin (CCK), substance P (SP) and gastrointestinal hormones were detected. Efficacy for traditional Chinese medicine(TCM) syndrome and efficacy under gastroscope were compared, and safety after treatment was evaluated. Result:After treatment, the total scores of the main symptoms and 7 secondary symptoms of disharmony of liver and stomach in observe group were all lower than those in placebo group and control group (<italic>P</italic><0.01), and scores of symptoms of disharmony of liver and stomach and PRO were all lower than those in control group and placebo group (<italic>P</italic><0.01). After treatment, scores of degree of bile reflux and mucosa under gastroscope in observe group were all lower than those in placebo group and control group (<italic>P</italic><0.01). Level of CCK was lower than that in placebo group and control group (<italic>P</italic><0.01), while levels of MTL, GAS and SP were higher than those in placebo group and control group (<italic>P</italic><0.01). Total effective rate of TCM syndrome was 91.38%(53/58), higher than 71.93%(41/57) in control group and 34.62%(18/52) in placebo group. The total effective rate in gastroscopy was 93.10%(54/58), higher than 78.95%(45/57) in control group and 28.85%(15/52) in placebo group (<italic>P</italic><0.05 or <italic>P</italic><0.01). No adverse reactions related to Zhiwei pill were found. Conclusion:Zhiwei pill can improve bile reflux, promote the healing of mucosa under gastroscope, regulate gastrointestinal hormones, improve gastrointestinal motor function, significantly alleviate clinical symptoms, and improve quality of life, with better efficacy for TCM syndrome and efficacy in gastroscopy, and it is safe for clinical use.

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