Preparation of tanshinone Ⅱ_A-glycyrrhetinic acid solid lipid nanoparticles and its inhibitory effect on acne / 中国中药杂志

The optimal prescription of tanshinone Ⅱ_A(TSN)-glycyrrhetinic acid(GA) solid lipid nanoparticles(GT-SLNs) was explored and evaluated in vivo and in vitro, and its effect on acne after oral administration was investigated. The preparation processing and prescription were optimized and verified by single factor and response surface methodology. The in vitro release of GA and TSN in GT-SLNs was determined by ultra-performance liquid chromatography(UPLC). The effect of GT-SLNs on acne was investigated by the levels of sex hormones in mice, ear swelling model, and tissue changes in sebaceous glands, and the pharmacokinetics was evaluated. The 24-hour cumulative release rates of GA and TSN in SLNs were 65.87%±5.63% and 36.13%±2.31% respectively. After oral administration of GT-SLNs and the mixture of GA and TSN(GT-Mix), the AUC_(0-t) and AUC_(0-∞) of TSN in GT-SLNs were 1.98 times and 4.77 times those in the GT-Mix group, respectively, and the peak concentration of TSN in the GT-SLNs group was 17.2 times that in the GT-Mix group. After intragastric administration of GT-SLNs, the serum levels of testosterone(T) and the ratio of testosterone to estradiol(T/E2) in the GT-SLNs group significantly declined, and the sebaceous glands of mice were atrophied to a certain extent. The results demonstrated that obtained GT-SLNs with good encapsulation efficiency and uniform particle size could promote the release of GA and TSN. GT-SLNs displayed therapeutic efficacy on acne manifested by androgen increase, abnormal sebaceous gland secretion, and inflammatory damage.

Gene-lifestyle interaction on coronary heart disease in adult twins of China / 中华流行病学杂志

Objective: To explore the gene-lifestyle interaction on coronary heart disease (CHD) in adult twins of China. Methods: Participants were selected from twin pairs registered in the Chinese National Twin Registry (CNTR). Univariate interaction model was used to estimate the interaction, via exploring the moderation effect of lifestyle on the genetic variance of CHD. Results: A total of 20 477 same-sex twin pairs aged ≥25 years were recruited, including 395 CHD cases, and 66 twin pairs both had CHD. After adjustment for age and sex, no moderation effects of lifestyles, including current smoking, current drinking, physical activity, intake of vegetable and fruit, on the genetic variance of CHD were found (P>0.05), suggesting no significant interactions. Conclusion: There was no evidence suggesting statistically significant gene-lifestyle interaction on CHD in adult twins of China.

A descriptive analysis on coronary heart disease in adult twins in China / 中华流行病学杂志

Objective: To describe the distribution characteristics of coronary heart disease in adult twins recruited from Chinese Twin Registry (CNTR), and provide clues and evidence for the effect of genetic and environmental influences on coronary heart disease. Methods: By using the data of CNTR during 2010-2018, a total of 34 583 twin pairs aged ≥18 years who completed questionnaire survey and had related information were included in the current study to analyze the population and area distribution characteristics of coronary heart disease. Random effect models were used to compare the differences between groups. The concordane rate of coronary heart disease were calculated respectively in monozygotic (MZ) twin pairs and dizygotic (DZ) twin pairs to estimate the heritability. Results: The twin pairs included in this analysis were aged (34.2±12.4) years. The overall prevalence rate of coronary heart disease in twin pairs was 0.7%. Twin pairs who were women, older, obese and lived in northern China had higher prevalence of coronary heart disease (P<0.05). Intra-pair analysis in the same-sex twin pairs found that the concordane rate of coronary heart disease was higher in MZ twin pairs (25.3%) than in DZ twins (7.4%), and the difference was statistically significant (P<0.001). The overall heritability of coronary heart disease was 19.3% (95%CI: 11.8%-26.8%). Stratified by gender, age and area, the concordane rate was still higher in MZ twin pairs than in DZ pairs. Participants who were women, aged 18-30 years or ≥60 years and lived in northern China had a higher heritability of coronary heart disease. Conclusion: The distribution of coronary heart disease in twin pairs differed in populations and areas. The prevalence of coronary heart disease was affected by genetic factors, but the effect varied with age, gender and area.

A descriptive analysis on type 2 diabetes in twins in China / 中华流行病学杂志

Objective: To describe the distribution characteristics of type 2 diabetes in twins in Chinese National Twin Registry (CNTR), provide clues and evidence for revealing the influence of genetic and environmental factors for type 2 diabetes. Methods: Of all twins registered in the CNTR during 2010-2018, a total 18 855 twin pairs aged ≥30 years with complete registration information were included in the analysis. The random effect model was used to describe the population and area distribution characteristics and concordance of type 2 diabetes in twin pairs. Results: The mean age of the subjects was (42.8±10.2) years, the study subjects included 10 339 monozygotic (MZ) twin pairs and 8 516 dizygotic (DZ) twin pairs. The self-reported prevalence rate of type 2 diabetes was 2.2% in total population and there was no sighificant difference between MZ and DZ. Intra-twin pairs analysis showed that the concordance rate of type 2 diabetes was 38.2% in MZ twin pairs, and 16.0% in DZ twin pairs, the difference was statistically significant (P<0.001). The concordance rate of type 2 diabetes in MZ twin parts was higher than that in DZ twin pairs in both men and women, in different age groups and in different areas (P<0.05). Further stratified analysis showed that in northern China, only MZ twin pairs less than 60 years old were found to have a higher concordance rate of type 2 diabetes compared with DZ twin pairs (P<0.05). In southern China, the co-prevalence rate in male MZ twin pairs aged ≥60 years was still higher than that in DZ twin pairs (P<0.05). Conclusion: The twin pairs in this study had a lower self-reported prevalence of type 2 diabetes than the general population. The study results suggested that genetic factors play a role in type 2 diabetes prevalence in both men and women, in different age groups and in different areas, however, the effect might vary.

Anatomical observation and clinical significance of the prostatic part of neurovascular bundle in total mesorectal excision / 中华胃肠外科杂志

Objective: To observe the anatomical architecture of the prostatic part of the neurovascular bundle (NVB) in total mesorectal excision (TME). Methods: A descriptive cohort study and an anatomical observation study were carried out. A total of 38 male patients with rectal cancer who underwent TME in the Department of Colorectal Surgery at the affiliated Union hospital of Fujian Medical University between November 2013 and March 2015 were included. A total of 4 hemipelvis were examined at the Laboratory of Clinical Applied Anatomy, Fujian Medical University. The following outcomes were observed: 1) the clinical significance of bleeding of the prostatic part of NVB: surgical videos were reviewed and the incidence of bleeding was recorded. The urogenital function was assessed using the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF) score. The correlation between prostatic part bleeding and postoperative urogenital function was evaluated. 2) anatomical observation: the vessels, nerve fibers, as well as their surrounding fatty tissue from the prostatic part were treated as a whole, namely, the fat pad of the prostatic part. The anatomical architecture of the prostatic part in the surgical videos was reviewed and interpreted with the cadaveric findings. Categorical variables were compared between groups using a Fisher exact probability. while continuous variables with skewed distribution were compared between groups using the Mann-Whiteny U test. Results: The median age of the included 38 patients was 57 years (range, 31-75), and the median tumor distance to the anal verge was 6 cm (range, 1-8). Of them, a total number of 21 (55.3%) patients had bleeding of the prostatic part of NVB (bleeding group), while the rest had not (17 cases, 44.7%, non-bleeding group). 1) the clinical significance of bleeding of the prostatic part of NVB. The urinary function significantly decreased in patients in the bleeding group according to IPSS score after the 3rd month and the 6rd month of the surgery [7 (0-16) vs. 2 (0-3), Z=-1.787, P=0.088; 2 (0-15) vs. 0 (0-2), Z=-2.270, P=0.028]. There was no difference regarding the IPSS score between the two groups after 1 year of the surgery (P>0.05). With a total of 23 patients with normal preoperative sexual activity included, 87.5% (7/8) of patients in the non-bleeding group can expect to return to their preoperative baseline, this incidence was significantly higher than that of only 40% (6/15) in the bleeding group (P=0.029). 2) anatomical observation: for cadaveric observation, the prostatic part of NVB was located in the narrow triangular space composed of anterolateral walls of the rectum, the posterolateral surface of the prostate and the medial surface of the levator ani musculature. The tiny vascular branches and nerve fibers from the prostatic part were hard to identify. The cavernosal nerves cannot reliably be distinguished from the neural supply to the prostate, rectum and levator ani. In the cross-section of levels of prostatic base and mid-prostate in cadaveric hemipelvis specimens, the boundary of the prostatic part fat pad was partly overlapped and merged with the boundary of the mesorectum. Intraoperative observation showed that the areas of overlap referred to the rectal branches from the prostatic part piercing the proper fascia to supply the mesorectum, which carried the largest tension and high risk of bleeding during circumferential dissection toward the perirectal plane. The ultrasonic scalpel was required to pre-coagulate the rectal branches at the point close to the proper fascia of the rectum to prevent bleeding. In the cross-section of the prostatic apex level, the prostatic part approached ventrally and its boundary was away from the boundary of the mesorectum. Conclusions: NVB prostatic part injury is one of the causes of urogenital dysfunction after TME. The nerve fibers from the prostatic part were tiny, and its functional zones cannot be distinguished during operation. Therein, the fat pad of the prostatic part should be protected as a whole. Understanding the morphology of the fat pad of the prostatic part provides invaluable surgical guidance to dissect this critical area. When dissecting around the anterolateral rectal wall, appropriate anti-traction tension should be maintained and the rectal branches from the prostatic part should be coagulated with an ultrasonic scalpel to prevent bleeding.

Anatomical observation of the right retroperitoneal fascia and its clinical significance in complete mesocolic excision for right colon cancer / 中华胃肠外科杂志

Objective: To investigate the anatomic characteristics of the right retroperitoneal fascia and its surgical implementation while performing complete mesocolic excision (CME) for right colon cancer. Methods: A descriptive study was carried out. (1) Clinicopathological data and surgical videos of 17 non-consecutive patients undergoing laparoscopic right hemicolectomy (extended right hemicolectomy) with CME for right colon cancer at Department of Colorectal Surgery of Union Hospital, Fujian Medical University between January 2020 and October 2020 were retrospectively collected. The construction of right retroperitoneal fascia was observed from caudal dorsal direction and caudal ventral direction. (2) Three postoperative specimens from 3 cases undergoing laparoscopic right hemicolectomy with CME for right colon cancer in June 2020 were prospectively included to observe anatomy and examine histology. (3) Five abdominal cadaver specimens from the Department of Anatomy of Fujian Medical University were enrolled, including 3 males and 2 females. Anatomical observation and histological studies were performed from the cranial approach and the caudal dorsal approach. Masson staining was used to examine the histology. Results: (1) Surgical video observation: The typical structure of right retroperitoneal fascia could be observed in all the 17 patients. The fascia was a rigid barrier between the posterior space of the ascending colon and the anterior pancreaticoduodenal space behind the transverse colon. The right retroperitoneal fascia should be sharply cut to communicate between the two spaces to avoid entering the right mesocolon by mistake. The severed ventral stump of the right retroperitoneal fascia ran along the dorsal side of the right hemicolon to the lateral side, and the dorsal stump covered the level of the duodenum caudally, and continued to move downward, covering the surface of Gerota's fascia. (2) Observation of 3 surgical specimens: The dorsal side of the right mesocolon was smooth and intact, which could be anchored in the corresponding area of the lateral edge of the duodenum. The ventral stump of the right retroperitoneal fascia could be seen, which attached to the dorsal side of the right mesocolon semi-circularly. Masson staining observation: The ventral stump of the right retroperitoneal fascia ran cephalad, fused with the dorsal side of the right mesocolon tightly and curled. The caudal side of confluence and the dorsal side of the right mesocolon presented a bilobed structure. (3) Anatomy of 5 cadaveric specimens: The right retroperitoneal fascia was a thin fascia structure, which was a rigid barrier between the anterior pancreaticoduodenal space behind the transverse colon and the posterior space of the ascending colon. The ventral stump of the right retroperitoneal fascia (including the dorsal side of the right mesocolon), the dorsal stump of the right retroperitoneal fascia (including part of the duodenal wall) and the dorsal side of the right mesocolon were retrieved for histological examination. The ventral stump of the right retroperitoneal fascia fused with the dorsal side of the right mesocolon by the cephalic side, and the dorsal side of the right hemi-mesocolon on the fusion level by caudal side gradually separated into a double-layer loose fascial structure. The dorsal stump of the right retroperitoneal fascia covered the surface of the duodenum level, moved on from the ventral side to the surface of the prerenal fascia, and continued to the caudal side. Conclusions: The right retroperitoneal fascia is a rigid barrier between the anterior pancreaticoduodenal space behind the transverse colon and the posterior space of the ascending colon. The Toldt fascia formed by fusion with the dorsal lobe of the right colon travels to the edge of the descending and horizontal part of the duodenum and separates again. The right retroperitoneal fascia is attached to the edge of the duodenum, reversing and running on the surface of the prerenal fascia, while the dorsal lobe of the right colon runs in front of the pancreas and duodenum, and shifts to the pancreaticoduodenal fascia. During the operation, this fascia should be identified and cut to penetrate the anterior pancreaticoduodenal space behind the transverse colon and the posterior ascending colon space, which helps to ensure the integrity of the dorsal side of the right hemi-mesocolon.

Anatomical observation of the left parietal peritoneum and its clinical significance in left retro-mesocolic space dissection / 中华胃肠外科杂志

Objective: To investigate the anatomic characteristics of the left parietal peritoneum and its surgical implementation while dissecting in left retro-mesocolic space. Methods: A descriptive case series research methods was used. (1) surgical videos of 35 patients who underwent laparoscopic radical resection (complete mobilization of splenic flexure) of colorectal cancer in Union Hospital of Fujian Medical University between January 2018 and December 2018 were reviewed; (2) four specimens after radical resection of rectal cancer performing in June 2020 were prospectively enrolled and reviewed; (3) five specimens of left parietal peritoneum from 5 cadaveric abdomen (3 males and 2 females) were enrolled and reviewed as well; Tissues of 3 unseparated regions, namely the root of the inferior mesenteric artery (IMA), the medial region and the lateral region (including kidney tissue), from above the 5 cadaveric abdominal specimens were selected to perform Masson staining and histopathological examination. Results: (1) Surgical video observation: "Staggered layer phenomenon" and typical left parietal peritoneum was found in 77.1% (27/35) of patients when the left retro-mesocolic space was separated from the lateral and central approaches. The left parietal peritoneum presented as a rigid fascia barrier between the lateral and central approaches, which was a translucent dense connective tissue fascia. After the splenic flexure were completely mobilized, the left parietal peritoneum stump continued to the cephalic side. (2) Observation of 4 surgical specimens: The dorsal side of the left mesocolon specimen was studied, and the left parietal peritoneum stump edge was identified. The outside of the stump edge was the left hemicolon dorsal layer, which was continuously downward to the rectal fascia propria. (3) Cadaveric abdominal specimens: The left retro-mesocolic space was separated through lateral and central approaches, and the rigid fascia barrier, essentially the left parietal peritoneum and Gerota fascia, was encountered. Cross-section view showed that the left parietal peritoneum could be further detached from the dorsal layer of the left mesocolon from the outside, but could not be further detached from the inside out. (4) Histological examination: There was no obvious fascia structure in the IMA root region, while outside the IMA root region, the left bundle of inferior mesenteric plexus penetrating Gerota fascia was observed. There were 4 layers of fascias in the medial region, including the ventral layer of the left mesocolon, the dorsal layer of the left mesocolon, left parietal peritoneum and Gerota fascia. Small vessels were observed between the dorsal layer of the left mesocolon and the left parietal peritoneum. In lateral region, renal tissue and renal fascia were observed. Three layers of fascia structures were observed clearly under high power field, including the dorsal layer of the left mesocolon, left parietal peritoneum, and Gerota fascia. Conclusions: The left parietal peritoneum is the anatomical basis of the "staggered layer phenomenon" from the lateral or central approaches during the separation of left retro-mesocolic space. The small vessels in the dissection plane are the anatomical basis of intraoperative microbleeding, which need pre-coagulation. The central part of Gerota fascia is penetrated by the branches of the inferior mesenteric plexus, which results in a relatively dense surgical plane. Thus, during the dissection through the central approach, it is easy to involve in wrong surgical plane by deeper dissection.

Significance of the intact of the fascia propria in protection of pelvic plexus during total mesorectal excision / 中华胃肠外科杂志

Total mesorectal excision (TME) is the gold standard of surgical treatment for mid and low rectal cancer. It aims to improve the oncological outcomes as well as preserve anal sphincter, sexual and urinary function. Compared with sympathetic nerve injury alone, pelvic plexus and neurovascular bundle (NVB) injury has significant effect on postoperative sexual dysfunction, especially erectile function. Since the lateral surgical plane of TME is narrow and densely packed, dissecting outside the plane causes pelvic plexus injury, while dissecting inside it results in residual mesorectum. In this commentary, we review the research progress of lateral fascial anatomy of TME, and describe the anatomical characteristics of rectosacral fascia based on our previous research results. The prehypogastric fascia acts as a "fascia barrier" when dissecting the lateral space constantly from posterior to anterior. In addition, the pelvic plexus fuses with the prehypogastric fascia which is considered as the outer side layer of rectosacral fascia laterally. Thus, the rectosacral fascia should be dissected at the level of S4 vertebral body posterior to the rectum in an arc shape and then enter the superior-levator space. Before dissecting the lateral spaces, the anterior space of the rectum should be dissected first. After an "U" shape cutting of the Denonvilliers' fascia, the lateral space should be dissected from anterior to posterior. Finally, the lateral attachment of rectosacral fascia is transected to ensure the integrity of the mesorectum without damaging the pelvic plexus.

Intraoperative anatomical observation of mesentery morphology of colonic splenic flexure / 中华胃肠外科杂志

Objective: At present, surgeons do not know enough about the mesenteric morphology of the colonic splenic flexure, resulting in many problems in the complete mesenteric resection of cancer around the splenic flexure. In this study, the morphology of the mesentery during the mobilization of the colonic splenic flexure was continuously observed in vivo, and from the embryological point of view, the unique mesenteric morphology of the colonic splenic flexure was reconstructed in three dimensions to help surgeons further understand the mesangial structure of the region. Methods: A total of 9 patients with left colon cancer who underwent laparoscopic radical resection with splenic flexure mobilization by the same group of surgeons in Union Hospital of Fujian Medical University from January 2018 to June 2019 were enrolled. The splenic flexure was mobilized using a "three-way approach" strategy based on a middle-lateral approach. During the process of splenic flexure mobilization, the morphology of the transverse mesocolon and descending mesocolon were observed and reconstructed from the embryological point of view. The lower margin of the pancreas was set as the axis, and 4 pictures for each patient (section 1-section 4) were taken during middle-lateral mobilization. Results: The median operation time of the splenic flexure mobilization procedure was 31 (12-55) minutes, and the median bleeding volume was 5 (2-30) ml. One patient suffered from lower splenic vessel injury during the operation and the bleeding was stopped successfully after hemostasis with an ultrasound scalpel. The transverse mesocolon root was observed in all 9 (100%) patients, locating under pancreas, whose inner side was more obvious and tough, and the structure gradually disappeared in the tail of the pancreatic body, replaced by smooth inter-transitional mesocolon and dorsal lobes of the descending colon. The mesenteric morphology of the splenic flexure was reconstructed by intraoperative observation. The transverse mesocolon was continuous with a fan-shaped descending mesocolon. During the embryonic stage, the medial part (section 1-section 2) of the transverse mesocolon and the descending mesocolon were pulled and folded by the superior mesenteric artery (SMA). Then, the transverse mesocolon root was formed by compression of the pancreas on the folding area of the transverse mesocolon and the descending mesocolon. The lateral side of the transverse mesocolon root (section 3-section 4) was distant from the mechanical traction of the SMA, and the corresponding folding area was not compressed by the tail of the pancreas. The posterior mesangial lobe of the transverse mesocolon and the descending mesocolon were continuous with each other, forming a smooth lobe. This smooth lobe laid flat on the corresponding membrane bed composed of the tail of pancreas, Gerota's fascia and inferior pole of the spleen. Conclusions: From an embryological point of view, this study reconstructs the mesenteric morphology of the splenic flexure and proposes a transverse mesocolon root structure that can be observed consistently intraopertively. Cutting the transverse mesocolon root at the level of Gerota's fascia can ensure the complete resection of the mesentery of the transverse colon.

Effects of different fixing agents on tumor cell morphology and membrane permeability / 解剖学报

Objective To observe the effect of different fixative solutions on cancer cell morphology and membrane permeability. Methods Human pancreatic acinar epithelial carcinona(HPAC) cells of human pancreatic cancer and HeLa cells of human cervical cancer were fixed with 4 fixation solutions: Freshly prepared 0.25% paraformaldehyde solution; Freshly prepared 4% paraformaldehyde solution; 75% ethanol solution; 90% ethanol solution. The fixation lime is 30 minutes. PBS solution and complete medium were used as the controls. Cell morphology of each group was observed under optical microscope. Changes in cell jncmbrane permeability were observed by fluorescence staining with 7-aminoactinomycin (7-AAD) , which is not cell membrane permeable in intact cells but permeable in damaged cells. Hoechst33342 was used for staining both intact and damaged cells. Results The cells in the complete medium group were similar to unfixed cells in morphology, and the fluorescence staining of 7-AAD was the weakest. The cells in the complete medium group have typical eel! morphology and low 7-AAD permeability. The 0.25% paraformaldehyde solution group had similar cell morphology to the complete medium group, and the 7-AAD fluorescence staining was weak. The morphology of cells in the 4% paraformaldehyde solution group was typical, but the fluorescence staining of 7-AAD was strong. The cells in the 90% ethanol solution group showed swelling, with a larger volume than the unfixed cells and a stronger fluorescence staining of 7-AAD. The cell swelling in 75% ethanol solution group was not as obvious as that in 90% ethanol solution group, and the fluorescence staining of 7-AAD was strong. The cells in PBS group were round, and the fluorescence staining of 7-AAD was strong. Conclusion 0. 25% paraformaldehyde solution can not only fix tumor cells, but also maintain the integrity of cell membrane.

The therapeutic effect of rh-aFGF carbomer 940 gel on wound healing in type I diabetic SD rat models / 中国药理学通报

Aim To study the therapeutic effect of re-combinant human acidic fibroblast growth factor (rh-aFGF) carbomer 940 gel in the treatment of skin wound healing in type I diabetic rats. Methods Two types of skin trauma models, namely, full-thickness wound and scalded wound,were established in a model of type I diabetes mellitus using STZ-induced SD rats. The rats were divided into control group, vehicle group,90 AU rh-aFGF gel group and 270 AU rh-aFGF gel group in each skin wound models. The wound area and wound healing rate were used to evaluate the thera-peutic effect. The growth of fibroblasts, fibrocytes, collagen fibers and vessel capillaries in the wound was observed using HE staining and analysed by semi-quantitative score. Results The rh-aFGF carbomer gel significantly reduced the traumatic area as well as promoted the wound healing rate of the skin trauma model of SD rats of type I diabetes mellitus (P <0.05). HE staining showed that rh-aFGF carbomer gel significantly promoted the pathological score of fibro-blasts and collagen fibers(P<0.05). Conclusions rh-aFGF carbomer gel might play a protective role in micro-environment of wound and rh-aFGF, which could benefit for proliferation of fibroblasts and colla-gen, therefore promoting the healing process of skin wound in SD rats with type I diabetes mellitus, and it might be expected to be a new preparation for the treat-ment of chronic trauma in diabetes mellitus.

Analysis on the Catastrophic Expenditure on Health and Its Influence Factors of Worker Households in Heilongjiang National Forest Areas / 中国卫生经济

Objective:To analyze the situation and influence factors of catastrophic health expenditure in national forest areas of Heilongjiang in 2015,and propose some measures to reduce the incidence of catastrophic health expenditure.Methods:The calculating method for international catastrophic health expenditure was used to estimate the catastrophic health expenditure rate,average gap and relative gap calculation method were estimated based on logistic regression analysis method.Results:In the standard definition of 15％,25％,30％ and 40％,the catastrophic health expenditure rates of Heilongjiang national forest areas in 2015 were 27.29％,14.79％,11.80％ and 8.27％;the average gap were 5.29％,3.25％,2.59％ and 1.61％;the relative gap were 19.38％,21.97％,21.95％and 19.47％.Family economic income and household cultural degree were the protective factors for catastrophic health expenditure.Low-insurance family,family with the elderly above 65 years old and family member hospitalization were risk factors for catastrophic health expenditure.Conclusion:The government should pay more attention to the poor,increase the family income in multi-channel;focus on prevention and timely medical treatment so as to reduce the risk of serious illness;increase investment in education,improve the education level of residents;pay attention to the elderly population and improve the medical security system.

Effect of chewing gum on the promotion of intestinal function recovery after colorectal surgery: a meta-analysis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To examine the safety and efficacy of chewing gum in promoting intestinal function recovery after colorectal surgery.</p><p><b>METHODS</b>A thorough search of PubMed, Cochrane Library, CNKI, CBM and Wanfang data was performed. Randomized controlled trials(RCTs) about efficacy and safety of chewing gum in promoting intestinal function recovery after colorectal surgery were collected and meta-analysis was carried out with RevMan 5.0 software.</p><p><b>RESULTS</b>Thirteen RCTs including 993 patients were enrolled in this study with 499 patients in the chewing gum group and 494 patients in control group. Meta-analysis revealed that chewing gum could significantly reduce the time to first passage of flatus(MD=-11.66 h, 95%CI:-17.26--6.07, P<0.05), the time to the first defecation (MD=-32.31 h, 95%CI:-56.89--7.73, P<0.05), and postoperative hospital stay(MD=-1.10 d, 95%CI:-1.93--0.27, P<0.05) after colorectal surgery. Patients in chewing gum group also experienced less discomfort from bowel distension(OR=0.52, 95%CI:0.35-0.80, P<0.05) due to postoperative paralytic ileus. No significant difference in the incidence of nausea and vomiting was found.</p><p><b>CONCLUSIONS</b>The addition of chewing gum, a well tolerated intervention, to standard treatment may facilitate intestinal recovery and contribute to a shorter hospital stay following colorectal surgery.</p>

Effects of recombinant human erythropoietin on neurointelligence development in very low birth weight infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effects of the early use of recombinant human erythropoietin (rhEPO) on the neurointelligence development in very low birth weight infants (VLBWI).</p><p><b>METHODS</b>Seventy-eight VLBWI were divided into rhEPO treatment group (n=35) and control group (n=43) according to the choice of their parents. Neonatal behavioral neurological assessment (NBNA) was performed at 40 weeks of corrected gestational age. The Gesell Developmental Schedules were used for neurodevelopmental evaluation at 3, 6, and 12 months of corrected age. The abnormal rates of auditory brainstem response (ABR) and cranial ultrasound were evaluated at 6 months of corrected age.</p><p><b>RESULTS</b>The rhEPO treatment group had significantly higher NBNA scores at 40 weeks of corrected gestational age than the control group (P<0.05). The adaptability at 3 months of corrected age, the gross motor, adaptability, and sociability at 6 months, and the gross motor, adaptability, fine motor, sociability, and language at 12 months were significantly better in the rhEPO treatment group than in the control group (P<0.05). The abnormal rates of ABR and cranial ultrasound in the rhEPO treatment group were significantly lower than in the control group at 6 months of corrected age (P<0.05).</p><p><b>CONCLUSIONS</b>Early use of rhEPO can promote the early recovery of neurological symptoms and improve the cognitive, motor, and language abilities in VLBWI due to its protective effects on the nervous system.</p>

Expression and significance of Twist1 and MMP-2 in endometrial endometrioid adenocarcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression of Twist1 and MMP-2 protein and their significance in endometrial endometrioid adenocarcinoma.</p><p><b>METHODS</b>The expression of Twist1 and MMP-2 protein in 70 cases of endometrial endometrioid adenocarcinoma was detected on tissue chips using immunohistochemical staining.</p><p><b>RESULTS</b>The positive rates of Twist1 and MMP-2 protein expression were 65.7% and 67.1%, respectively. Both of the high expressions of Twist1 and MMP-2 were positively correlated with FIGO staging and tumor myometrial invasion (P < 0.05, respectively). Also the high expression of Twist1 was positively correlated with ovarian metastasis and the expression of MMP-2 was positively correlated with tumor grading (P < 0.05). The patients' overall survival and relapse-free survival in the group of high Twist1 expression were shorter than that in the group of low Twist1 expression (P < 0.05). The expression of MMP-2 was positively correlated with Twist1 expression (P < 0.01, respectively).</p><p><b>CONCLUSIONS</b>The expression of Twist1 may be closely correlated with the tumor invasion, metastasis and prognosis in patients with endometrial endometrioid adenocarcinoma. The expression of Twist1 has a close relationship with MMP-2 in endometrial endometrioid adenocarcinoma.</p>

Randomized controlled study on influence of acupuncture for life quality of patients with chronic fatigue syndrome / 中国针灸

<p><b>OBJECTIVE</b>To observe effects of acupuncture on quality of life of patients with chronic fatigue syndrome (CFS).</p><p><b>METHODS</b>Randomized, controlled and single-blinded study method was used, 70 cases were divided into an observation group and a control group, 35 cases in each group. The observation group was treated with acupuncture at Baihui (GV 20), Danzhong (CV 17), Zhongwan (CV 12), Qihai (CV 6), Guanyuan (CV 4), Hegu (LI 4), Zusanli (ST 36), etc.; the control group was treated with acupuncture at non-meridian points (2 cm to the acupoints), thrice a week. The treatment was given for 14 times. The World Health Organization Quality of Life (WHOQOL-BREF) scale was used to evaluate the patients' quality of life before and after treatment.</p><p><b>RESULTS</b>The physiological field, individuals own perception of his health condition and total score were significantly improved after treatment in the observation group (all P<0.05); there were no obvious changes in the psychology, social relationships, environment and subjective feelings about the quality of life (all P>0.05). The score of the environmental field in the control group was significantly decreased compared to that before treatment (P<0.05), and there were no significant changes in the other scores. There were no adverse effects in patients.</p><p><b>CONCLUSION</b>Acupuncture can improve the quality of life of CFS patients, especially in physiological field and the individual perception to his well being. Acupuncture has high safety, and the acupoints has high specific degree than non-meridian points.</p>

Analysis on morbidity rate of residents in Qinghai province in 2006 / 中华流行病学杂志

Objective The purpose of the study was to understand the epidemiological tendency and distribution of the disease across Qinghai province, so as to serve for the development of a scientific system for prevention and treatment. Methods Multi-stage lamination stochastic group sampling was applied in the study, with 6 counties randomly selected. The total sample size was 19 201 while the study was conducted in the format of indoor visit. For residents younger than 18 years of age, a questionnaire was distributed to them to obtain related basic information. While for those older than 18, an in-depth survey was conducted. In addition to the measurement of height, weight, blood pressure, 10% of the samples underwent a testing on blood sugar. A database was then developed via Epi Data 3.02 and all the data was processed and classified via Foxpro and SPSS 13.0 software. Results The overall morbidity rate was 67.76%, with females significantly higher than males. The morbidity rate was fixed at 65.85% after weighted by region. The morbidity rate increased significantly with age. The top 5 diseases identified would include those from digestive system (28.74%), heart cranial vascular (27.27%), rheumatism and bone joint (19.97%), respiratory system (12.46%), biography reproductive system (8.64%) and urinary system (7.39%). Data from by-region analysis showed that the morbidity rate was the highest in pastoral area (70.17%), followed by villages (66.32%) and cities (61.86%), while the kinds of top diseases in those regions were also different. Data from unhealthy lifestyle showed that 22.16% of the provincial population smoked cigarettes, 17.16% drank alcohol, and the rate of obesity was 3.41%. Conclusion Significant differences in morbidity rates among different regions and different genders were found while the prevalence rates of disease significantly increased along with age.

Development of radioimmunoassay for human sperm protein 17 / 中华男科学杂志

<p><b>OBJECTIVE</b>To develop a method of radioimmunoassay for human sperm protein 17(Sp17) determination.</p><p><b>METHODS</b>Anti-recombinant human Sp17 antibody was prepared, the labeling of 125I-rhSp17 performed by chloramine T method, and radioimmunoassay of Sp17 developed.</p><p><b>RESULTS</b>The assay range was 3.3 to approximately 800 microg/L, the sensitivity was 2.0 microg/L, and the intra- and inter-assay coefficients of variation (CV) were 7.5% to approximately 9.8% and 8.2% to approximately 13.2%, respectively. The serum Sp17 level in normal subjects was (15.60 +/- 7.66) microg/L (n = 59).</p><p><b>CONCLUSION</b>This radioimmunoassay of Sp17 fulfills the reasonable requirements of clinical routine and scientific studies in terms of specificity, sensitivity and practicability. Measurement of Sp17 concentration is useful for assessing its native distribution and aberrant expression.</p>

The study on three-dimension finite element analysis of the stress distribution in the mandible bone around dental implants / 华西口腔医学杂志

<p><b>OBJECTIVE</b>The aim of this study was to investigate how to model an accuracy 3-dimension Finite Element Analysis (3D-FEA) model.</p><p><b>METHODS</b>Based on computed tomography (CT) scan data of a woman, a 3D finite element model of the first molar on the left was rebuilt by computer imagines process and computer aided design (CAD). Analysis of the stress distribution on a cylinder dental implant and in the bone around it was conducted.</p><p><b>RESULTS</b>The stress distribution showed extremely asymmetry in bucco-lingual section: stress concentrated on the lingual side of the mandible; stress mainly was tensile in buccal side, and on the contrary compressive in lingual side.</p><p><b>CONCLUSION</b>The results were more reliable because this model more really displayed the mandible.</p>