The expression of miR-122 in the liver of rats infected with Clonorchis sinensis and its correlation with inflammatory cytokines / 中华地方病学杂志

Objective:To observe the expression changes of microRNA(miR)-122 in liver tissue of rats infected with Clonorchis sinensis and its correlation with expression level of inflammatory cytokines. Methods:Totally 24 SPF grade Wistar male rats were selected and randomly divided into a control group (100 μl physiological saline gavage), a 4-week infection group (100 Clonorchis sinensis metacercariae gavage), and an 8-week infection group (100 Clonorchis sinensis metacercariae gavage) based on body weight (100-120 g) using a random number table method, with 8 rats in each group. Starting from the third week of infection, rat feces were collected and directly smeared with physiological saline for identification of Wistar rat animal models infected with Clonorchis sinensis. After 4 and 8 weeks of infection, the rats in the 4- and 8-week infection groups were euthanized, while 4 rats in the control group were euthanized, respectively. The heart blood and left lobe liver tissue and serum samples were collected from each group of rats. Using hematoxylin-eosin (HE) staining to observe liver pathological damage under the light microscope, real-time fluorescence quantitative PCR to detect the expression level of miR-122 in liver tissue, and Luminex 200 liquid suspension chip to detect the expression levels of serum inflammatory cytokines [tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6 (IL-6)]. The correlation between miR-122 and inflammatory cytokines was analyzed using Pearson correlation. Results:Under the light microscope, the morphology of hepatocytes in control group was normal, and no inflammatory cell infiltration was observed. There was inflammatory cells such as lymphocyte, eosinophil and other inflammatory cell infiltration around the portal area in the 4-week infection group. The hepatocytes of the 8-week infected rats were arranged in a disordered manner, with varying degrees of swelling, loose and lightly stained cytoplasm, and some hepatocytes showed watery degeneration; additionally, bile duct dilation and thickening of the bile duct wall were observed in the liver tissue. There were statistically significant differences of liver miR-122 (1.00 ± 0.32, 2.57 ± 0.60, 3.63 ± 1.63), serum TNF-α [(0.14 ± 0.06), (0.43 ± 0.09), (0.61 ± 0.10) ng/ml], and IL-6 expression levels [(0.03 ± 0.01), (1.06 ± 0.24), (1.48 ± 0.33) ng/ml] in control group, 4- and 8-week infection groups ( F = 13.36, 69.99, 82.23, P < 0.001). There was no statistically significant difference in expression level of IL-1β between different groups ( F = 2.15, P = 0.141). The Pearson correlation analysis showed that the expression level of miR-122 was positively correlated with the expression levels of inflammatory cytokines TNF-α and IL-6 ( r = 0.67, 0.80, P < 0.001). Conclusion:Clonorchis sinensis infection can increase the expression of miR-122 in the host liver tissue, and the miR-122 is closely related to the expression levels of inflammatory cytokines TNF-α and IL-6.

Clinical study of high-frequency transcranial magnetic stimulation in thalamic pain / 中华神经医学杂志

Objective:To explore the short-term clinical efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in thalamic pain.Methods:A prospective study was performed; 41 patients with thalamic pain who received hrTMS in Department of Neurology, Anqing Medical Center Affiliated to Anhui Medical University from December 2022 to August 2023 were selected. According to different stimulation sites, these patients were divided into S2 group (intervening secondary sensory cortex of the unaffected side, n=21) and M1 group (intervening primary motor cortex of the unaffected side, n=20). Before treatment, at the 1 st weekend after pseudo-stimulation treatment and at the 1 st, 2 nd and 3 rd weeks after effective stimulation treatment, short-form McGill Pain Questionnaire (SF-MPQ) was performed, and N100 amplitude was monitored by myoelectric evoked potentiometer; adverse reactions during treatment cycles were observed. Results:(1) Compared with those before treatment, scores of sensory item, emotional item and visual analogue scale (VAS), and present pain intensity in S2 group were significantly decreased at the 2 nd and 3 rd weeks after effective stimulation treatment ( P<0.05). Compared with those before treatment, scores of sensory item and VAS, and present pain intensity in M1 group were significantly decreased at the 2 nd weeks after effective stimulation treatment, and scores of sensory item, emotional item and VAS, and present pain intensity in M1 group were significantly decreased at the 3 rd weeks after effective stimulation treatment( P<0.05). At the 3 rd weeks after effective stimulation treatment, compared with the M1 group, the S2 group had significantly decreased scores of sensory item, emotional item, and VAS, and present pain intensity (5.35±0.54 vs. 4.86±0.74; 3.55±0.69 vs. 3.14±0.57; 5.50±0.69 vs. 5.00±0.78; 2.20±0.42 vs. 1.81±0.41, P<0.05). (2) Compared with those before treatment, N100 amplitude in S2 group and M1 group was significantly increased at the 2 nd and 3 rd weeks after effective stimulation treatment ( P<0.05). At the 3 rd weeks after effective stimulation treatment, the S2 group had significantly higher N100 amplitude than the M1 group (3.43±0.60 vs. 3.00±0.65, P<0.05). (3) No adverse reactions such as seizure or scalp burning occurred in the 2 groups during the treatment cycles, without significant difference in headache or tinnitus incidences ( P>0.05). Conclusion:The hrTMS on secondary sensory cortex and primary motor cortex of the unaffected side can relief the short-term pain intensity in patients with thalamic pain, without obvious side effects; and hrTMS on secondary sensory cortex enjoys better effect.

Identification of core pathogenic genes and pathways in elderly osteoporosis based on bioinformatics analysis / 中华预防医学杂志

Objective: Using bioinformatics methods to analyze the core pathogenic genes and related pathways in elderly osteoporosis. Methods: From November 2020 and August 2021, eight elderly osteoporosis patients who received treatment and five healthy participants who underwent physical examinations in Beijing Jishuitan Hospital were selected as subjects. The expression level of RNA in the peripheral blood of eight elderly osteoporosis patients and five healthy participants was collected for high-throughput transcriptome sequencing and analysis. The gene ontology (GO) analysis Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed for the differentially expressed genes (DEGs). The protein-protein interaction (PPI) network was constructed using the STRING website and Cytoscape software, and the most significant modules and hub genes were screened out. Results: Among the eight elderly osteoporosis patients, there were seven females and one male, with an average age of 72.4 years (SD=4.2). Among the five healthy participants, there were four females and one male, with an average age of 68.2 years (SD=5.7). A total of 1 635 DEGs (847 up-regulated and 788 down-regulated) were identified. GO analysis revealed that the molecular functions of DEGs were mainly enriched in structural constituents of the ribosome, protein dimerization activity, and cellular components were mainly enriched in the nucleosome, DNA packaging complex, cytosolic part, protein-DNA complex and the cytosolic ribosome. KEGG pathway analysis showed that DEGs were mainly enriched in systemic lupus erythematosus and ribosome. Gene UBA52, UBB, RPS27A, RPS15, RPS12, RPL13A, RPL23A, RPL10A, RPS25 and RPS6 were selected and seven of them could encode ribosome proteins. Conclusion: The pathogenesis of elderly osteoporosis may be associated with ribosome-related genes and pathways.

Factors for and prevention of muscular calf vein thrombosis after unilateral total knee arthroplasty / 中华创伤骨科杂志

Objective:To investigate the factors for and prevention of muscular calf vein thrombosis (MCVT) after unilateral total knee arthroplasty (TKA).Methods:Between January 2018 and October 2020, 551 patients were admitted to Department of Orthopedics, The First Affiliated Hospital to Zhengzhou University for unilateral TKA. They were 187 males and 364 females, aged from 32 to 90 years (average, 64.6 years) and with 234 left and 317 right knees affected. They were assigned into a MCVT group ( n=77) and a non-MCVT group ( n=474) according to whether or not MCVT had happened at 7 days after operation. Recorded were the patients’ baseline information, tourniquet time, intraoperative blood loss, postoperative prothrombin time (PT), postoperative thrombin time (TT), postoperative fibrinogen (FIB), D-dimer, platelet count (PLT), postoperative bed time, knee society score (KSS), erythrocyte sedimentation rate (ESR) fall time, and C-reactive protein (CRP) fall time so as to analyze the risk factors for MCVT. Results:There were significant differences between the 2 groups in age [(66.8±7.0) versus (64.2±9.6) years], body mass index (BMI) [(28.7±2.2) versus (25.0±2.4) kg/m 2], smoking (20/57 versus 41/433), diabetes (56/21 versus 172/302), primary hypertension (45/32 versus 174/300), coronary heart disease (50/27 versus204/270), hyperlipidemia (33/44 versus 149/325), varicosity (50/27 versus 166/308), tourniquet time [(97.9±22.6) versus (83.1±10.6) min], intraoperative blood loss [(73.2±40.6) versus (62.4±11.5) mL], postoperative PT [(10.7±0.8) versus (11.9±1.0) s], TT [(15.2±1.3) versus (17.2±2.4) s], FIB [(3.7±0.8) versus (3.2±0.5) g/L], D-dimer [(1.1±1.0) versus (0.8±0.3) μg/L], PLT [(233.4±68.5) versus (178.5±27.8) 10 9/L], postoperative bed time [(17.3±2.6) versus (14.6±3.8) h], KSS [(3.32±0.7) versus (3.61±0.56) points], ESR fall time [(2.90±0.74) versus (1.55±0.64) d] and CRP fall time [(2.90±0.74) versus (1.55±0.64) d] (all P<0.05). Multivariate logistic regression analysis showed that old age (95% CI: 0.890 to 1.112, P=0.034), high BMI (95% CI: 1.012 to 1.214, P=0.046), diabetes (95% CI: 1.002 to 2.590, P=0.020), D-dimer (95% CI: 1.239 to 10.292, P=0.001) and postoperative PLT (95% CI: 1.012 to 1.112, P=0.014) were independent risk factors for MCVT. Reduced postoperative bed time (95% CI: 1.009 to 1.469, P=0.040) was a protective factor. Conclusions:As old age, high BMI, diabetes, and high postoperative levels of D-dimer and PLT may be independent risk factors for MCVT, patients with such characteristics should be alert to MCVT. Early ambulation should be encouraged in patients after unilateral TKA to reduce postoperative bed time for prevention of the disease.

The research progress and prospect of anti-inflammatory antibacterial hydrogel applied to chronic wounds in diabetes / 西安交通大学学报(医学版)

Chronic wounds in diabetes mellitus is a common complication of diabetes mellitus with complex pathogenesis and long recovery time. At present, there are many kinds of dressings for chronic wounds in diabetes, among which synthetic dressings have obvious therapeutic advantages. As an emerging biomaterial, hydrogel has obvious advantages over traditional dressings in terms of water absorption, air permeability, biocompatibility, drug loading ability, and continuous controlled drug release, and has attracted much attention in the repair of chronic wounds in diabetes mellitus. Common hydrogels have anti-inflammatory, antibacterial, antioxidant, tissue-promoting, and hypoglycemic effects. This paper systematically summarizes the progress in research on anti-inflammatory and antibacterial hydrogels in chronic diabetic wounds. Among them, according to different anti-inflammatory and antibacterial mechanisms and materials, common anti-inflammatory hydrogels can be divided into hydrogels loaded with anti-inflammatory drugs, hydrogels based on anti-inflammatory materials, and hydrogels loaded with biological components. Hydrogels can be classified into antibiotic-loaded hydrogels, antibacterial material-based hydrogels, and inorganic nanoparticles-loaded hydrogels. Anti-inflammatory and antibacterial hydrogels have achieved certain research results in the treatment of chronic diabetic wounds, but there are still some technical problems waiting for further improvement. Meanwhile, this paper discusses the prospect of the future development of hydrogels applied in chronic diabetic wounds, aiming to provide systematic theoretical support for the treatment of chronic diabetic wounds in the future.

Research Progress of Quercetin in Treatment of Rheumatoid Arthritis / 中国实验方剂学杂志

Rheumatoid arthritis （RA） is a chronic and systemic autoimmune disease with aggressive and symmetrical polyarthritis as the main clinical manifestations. The exact pathogenesis is unknown. Its basic pathological changes include chronic inflammation of the joint synovium， increased joint cavity effusion， pannus formation， gradual cartilage damage and bone erosion， eventually leading to joint deformity and loss of function. It has been found that the onset and development of RA are related to heredity， environment and other factors. The drugs for RA mainly include non-steroidal anti-inflammatory drugs （NSAIDs）， corticosteroids， disease-modifying anti-rheumatic drugs （DMARDs） and biological agents. However， long-term use of these drugs can cause a variety of side effects and adverse reactions， such as myocardial infarction， peptic ulcer， poor wound healing， and liver and kidney dysfunction. In addition， natural medicines have a good application prospect because of their various pharmacological activities and few side effects. Quercetin is a flavonoid found in Morus alba and tetrandrine， with diverse pharmacological activities， including cardiovascular diseases， joint movement， tumor immunology and so on. Not only have the clinical trials shown good efficacy of quercetin， but the experimental studies have also proven that quercetin can improve RA by reducing inflammatory response， inhibiting the formation of synovial pannus， synovial hyperplasia， neutrophil NETs formation， osteoclast function， regulating Th17/Treg balance and other mechanism. In this article， we will briefly summarize the regulatory mechanism of quercetin and discuss the complexed effect of quercetin on rheumatoid arthritis.

Intelligence-aided diagnosis of Parkinson's disease with rapid eye movement sleep behavior disorder based on few-channel electroencephalogram and time-frequency deep network / 生物医学工程学杂志

Aiming at the limitations of clinical diagnosis of Parkinson's disease (PD) with rapid eye movement sleep behavior disorder (RBD), in order to improve the accuracy of diagnosis, an intelligent-aided diagnosis method based on few-channel electroencephalogram (EEG) and time-frequency deep network is proposed for PD with RBD. Firstly, in order to improve the speed of the operation and robustness of the algorithm, the 6-channel scalp EEG of each subject were segmented with the same time-window. Secondly, the model of time-frequency deep network was constructed and trained with time-window EEG data to obtain the segmentation-based classification result. Finally, the output of time-frequency deep network was postprocessed to obtain the subject-based diagnosis result. Polysomnography (PSG) of 60 patients, including 30 idiopathic PD and 30 PD with RBD, were collected by Nanjing Brain Hospital Affiliated to Nanjing Medical University and the doctor's detection results of PSG were taken as the gold standard in our study. The accuracy of the segmentation-based classification was 0.902 4 in the validation set. The accuracy of the subject-based classification was 0.933 3 in the test set. Compared with the RBD screening questionnaire (RBDSQ), the novel approach has clinical application value.

Multivariate analysis of varus after Oxford unicompartmental knee arthroplasty / 北京大学学报(医学版)

OBJECTIVE@#To analyze the preoperative influencing factors of varus after Oxford unicompartmental knee arthroplasty.@*METHODS@#A total of 660 patients (767 knees) undergoing Oxford unicompartmental knee arthroplasty in adult joint reconstruction surgery department of Beijing Jishuitan Hospital from January 2018 to December 2019 were retrospectively analyzed. Inclusive criteria: diagnosis was osteoarthritis, single compartment lesions in the medial side of the knee; preoperative flexion deformity was less than 10°, active range of motion was greater than 90°; preoperative X-ray full-length images of both lower limbs showed less than 15° varus (Noyes method); anterior cruciate ligament was well functioned, The cartilage of lateral compartment of knee joint was intact.@*EXCLUSION CRITERIA@#combined with other inflammatory arthropathy; combined with extraarticular deformity; previous knee surgery history. The average age of the patients was (64.4±8.1) years, including 153 males and 497 females. The degree of post-operative varus was measured with Noyes method. The total patients were divided into varus group (Noyes≥3 °) and normal group (Noyes < 3 °). Gender, age, body mass index (BMI), range of motion (ROM), preoperative flexion deformity (FD), American Knee Society pain score (AKS) and American Knee Society function score (AKS function) were recorded. The standard anteroposterior and lateral X-ray films of knee joint and full-length lower extremity kinematic line films were taken by Sonialvision Safine Ⅱ (Shimadzu, Japan) multi-function digital tomography system. The image was measured by picture archiving and communication system (PACS). The following angles were measured preoperative Noyes angle, lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA) and joint line converge angle (JLCA) were measured and analyzed.@*RESULTS@#Gender(P=0.346), operative side (P=0.619), age (P=0.746), BMI (P=0.142), preoperative ROM (P=0.102), preoperative knee pain score (P=0.131) and functional score (P=0.098) were not risk factors for postoperative varus. The influencing factors of postoperative varus were preoperative MPTA < 84 ° (P= 0.018, OR= 3.712, 95%CI: 1.250-11.027), preoperative Noyes > 5°(P=0.000, OR= 3.105, 95%CI: 1.835-5.254), preoperative FD > 5° (P= 0.001, OR=1.976, 95%CI: 1.326-3.234). Pre-operative LDFA (P=0.146) and preoperative JLCA (P= 0.709) had no significant effect on postoperative kinematic line.@*CONCLUSION@#Patients with severe preoperative varus, especially those with varus deformity mainly from the tibial side, and those with preoperative flexion deformity are more prone to get varus lower extremity kinematic line after Oxford unicompartmental knee arthroplasty.

Implantation of antibiotic calcium sulfate carriers in two-stage revision for periprosthetic knee joint infection / 中华创伤骨科杂志

Objective:To investigate the feasibility of replacing the femoral prosthesis and implanting antibiotic calcium sulfate carriers in a two-stage revision for periprosthetic infection following total knee arthroplasty (TKA).Methods:Between May 2017 and January 2020, 35 patients were admitted to Department of Orthopaedic Surgery, The First Affiliated Hospital to Zhengzhou University for periprosthetic infection after TKA. They were 12 males and 23 females, aged from 49 to 84 years (average, 67.9 years). The two-stage revision for periprosthetic infection was performed for all of them and replacement of femoral prosthesis and implantation of antibiotic calcium sulfate carriers were carried out in stage-one revision. Recorded were postoperative culture of micro-organisms, white blood cell count (WBC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) before stage-one and stage-two revisions; the Hospital for Special Surgery (HSS) knee score, range of motion (ROM) and American Knee Society Score (KSS) were compared between preoperation and the last follow-up.Results:Postoperative negative culture was found in 22 cases (62.9%), and positive one in 13 cases (37.1%) of which 4 were caused by Staphylococcus aureus, 2 by Staphylococcus epidermidis, 2 by Candida glabrata, 2 by Candida parapsilosis, one by Candida albicans, one by Mycobacterium tuberculosis and one by Escherichia coli. WBC, ESR and CRP decreased on average from 13.67×10 9/L, 49.71 mm/h and 45.13 mg/L before stage-one revision to 6.44×10 9/L, 18.79 mm/h and 7.82 mg/L before stage-two revision. All patients were followed up for an average of 22.4 months (from 8 to 41 months). At the last follow-up, ROM, HSS and KSS were significantly increased from preoperative 73.2°±15.9°, 59.5±14.6 and 36.1±6.0 to 105.6°±13.2°, 84.3±10.0 and 86.1±5.6, respectively ( P<0.05). None of the patients showed any sign of re-infection at the last follow-up. Conclusion:For patients with periprosthetic infection following total knee arthroplasty, replacing femoral prosthesis and implantation of antibiotic calcium sulfate carriers can well control infection, facilitating recovery of range of motion and function after surgery.

Systematic review and Meta-analysis of efficacy and safety of Ningxinbao Capsules in treatment of arrhythmia / 中国中药杂志

To systematically evaluate the efficacy and safety of Ningxinbao Capsules in treatment of arrhythmia by Meta-analysis. Randomized controlled trial(RCT) or quasi-randomized control trial(Quasi-RCT) on Ningxinbao Capsules treating arrhythmia were obtained by computer-based retrieval in CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Cochrane Library and EMbase as well as manual retrieval, with time limit from database establishment to April 7, 2020. According to the inclusion and exclusion criteria of trials, all RCTs were screened and evaluated. Then the effective data were collected and RevMan 5.3 Meta-analysis software was used for analysis. Thirteen trials were included, involving 1 379 patients in total. Ningxinbao Capsules combined with anti-arrhythmia Western medicine were adopted as the intervention, and the patients in control group were treated with the anti-arrhythmia Western medicine alone. Meta-analysis results showed that as compared to control group, Ningxinbao Capsules combined with anti-arrhythmia Western medicine group was superior in clinical efficacy, dynamic electrocardiogram and average heart rate in patients with bradycardia, with indicated statistically significant differences. Ningxinbao Capsules had fewer adverse reactions and could relieve the toxic and side effects of anti-arrhythmia medicine possibly. The study showed that Ningxinbao Capsules played a role in treatment of arrhythmia and was relatively safe. However, due to the limited quality of the included studies, high-quality clinical trials are needed to verify the conclusions.

Quantitative gait analysis of freezing of gait in patients with Parkinson's disease / 中华神经医学杂志

Objective:To analyze the gait characteristics of freezing of gait (FOG) in patients with Parkinson's disease (PD).Methods:One hundred and four patients with PD, admitted to our hospital from January 2019 to November 2020, were enrolled in our study. Based on whether patients were accompanied by FOG or not, these patients were divided into PD with FOG group ( n=46) and PD without FOG group ( n=58). "JiBuEn" gait analysis system was used in gait data collection. The gait performance of patients from PD with FOG group was analyzed from 4 perspectives, spatiotemporal parameters, kinematic parameters, and variability and symmetry analyses of gait parameters. Results:As compared with PD without FOG group, PD with FOG group demonstrated a decrease in stride length and gait velocity, an increase in stride length variability, stride time variability, stance-phase time variability and swing phase time variability, with significant differences ( P<0.05). In addition, the heel-strike angle, toe-off angle, range of motion of ankle joint, range of motion of knee joint and range of motion of hip joint in PD with FOG group were significantly decreased as compared with those in PD without FOG group ( P<0.05). Stride length asymmetry index in PD with FOG group was significantly increased as compared with that in the PD without FOG group ( P<0.05). Conclusion:PD patients with FOG mainly exhibit shorter stride length, slower gait velocity, more variable gait pattern and more significant impairment in kinematic parameters than those without FOG.

Characteristics of emergency renal arteriography and embolization strategies for renal hemorrhage / 中国介入影像与治疗学

Objective: To investigate the emergency renal arteriographic characteristics and embolization strategies of renal hemorrhage. Methods: Data of 63 renal hemorrhage patients who underwent emergency renal arteriography were retrospectively analyzed, including 43 cases of iatrogenic operation bleeding (iatrogenic group) and 20 cases of non-iatrogenic operation bleeding (non-iatrogenic group). The angiographic manifestations, embolic materials and hemostatic effects were compared between 2 groups. Results: Positive findings were noticed in 45 cases, while 18 cases were angiographically negative, the positive angiography rate in iatrogenic group (79.07% [34/43]) was higher than in non-iatrogenic group (55.00% [11/20], P=0.049). There were statistical differences of angiographic positive findings between 2 groups (P=0.001). In iatrogenic group, pseudoaneurysm was the most common positive finding. No significant difference of embolic material used was found between 2 groups (P=0.090). Among 45 cases with positive findings, bleeding stopped in 41 cases after single embolization, (91.11%, 41/45), while in 2 cases stopped after the secondary embolization, and the embolization success rate was 95.56% (43/45). Conclusion: Renal hemorrhage caused by iatrogenic operations are the main source of emergency renal arteriography with high positive rate mainly presenting as pseudoaneurysm. Selective renal artery embolization is the main and effective method for treatment of renal hemorrhage.

Relationship of Subchondral Plate-Rod Structure and Cartilage Degeneration with Lower Limb Alignment / 医用生物力学

Objective To study the relationship of the tibial plateau subchondral trabecular bone (STB) microstructure and the cartilage degeneration with the lower limb alignment based on individual trabecula segmentation (ITS) and histology analysis in knee osteoarthritis (OA). Methods Hip-knee-ankle (HKA) angles were measured on the full-length lower extremity films of patients before total knee arthroplasty (TKA). The tibial plateau excised from the TKA were collected for micro-CT scanning and ITS analysis. The cartilage degeneration was evaluated by histology. The relationship between the HKA angle and the changes in microstructural parameters of STB and cartilage degeneration were analyzed. ResultsThe plate, rod and axial bone trabecular volume fraction (BV/TV, pBV/TV, pBV/TV), ratio of trabecular plate versus rod (P/R), plate trabecular number density (pTb.N), plate trabecular thickness (pTb.Th), trabecular plate surface area (pTb.S), trabecular rod length (rTb.L), and plate-plate and plate-rod junction density (P-P Junc.D, P-R Junc.D) of the subchondral bone of the tibial plateau were significantly related to the cartilage degeneration OARSI score and the HKA angle. The greater the deviation of the lower limb alignment, the greater the number of subchondral trabeculae, the thicker the trabeculae, the greater the bone mass, the stronger the connectivity, especially the plate trabeculae on the affected side of tibial plateau, and the higher the OARSI score of cartilage degeneration. Conclusions Abnormal lower limb alignment may cause abnormal microstructure of the plate and rod STB of the tibial plateau by changing the stress distribution of the knee, especially the significant increase and thickening of the plate trabecular and axial trabecular bone, which may be an important risk factor that further aggravates the degeneration of articular cartilage and the progress of OA. Therefore, lower limb alignment correction with surgical intervention and improving STB with bone metabolism agents may efficiently contribute to preventing cartilage damage and mitigate OA progression.

Clinical observation on electroacupuncture plus Yi Jin Jing (Sinew-transforming Qigong Exercises) for knee osteoarthritis / 针灸推拿医学（英文版）

Objective: To observe the efficacy of electroacupuncture (EA) plus Yi Jin Jing (Sinew-transforming Qigong Exercises) for knee osteoarthritis (KOA). Methods: A total of 60 patients with KOA were divided into an observation group and a control group according to the random number table method, with 30 cases in each group. Patients in the observation group received the treatment of EA plus Yi Jin Jing (Sinew-transforming Qigong Exercises), while patients in the control group only received EA treatment. Both groups were treated for 5 weeks. The changes of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) scores in the two groups were observed after treatment. Results: After treatment, the total effective rate in the observation group (92.3％) was significantly higher than that in the control group (70.0％), (P<0.05); the WOMAC and VAS scores in both groups were significantly lower than those before treatment, showing statistical significance (all P<0.01); there were significant differences in the post-treatment changes in the WOMAC and VAS scores between the two groups (P<0.05, P<0.01). Conclusion: EA plus Yi Jin Jing (Sinew-transforming Qigong Exercises) is clinically effective for KOA. This combined treatment can alleviate clinical symptoms.

Virtual reduction and personalized additional fixation by Mimics software in treatment of unstable external wall type intertrochanteric fracture with proximal femoral nail antirotation / 中国骨伤

OBJECTIVE@#To explore the effect of Mimics assisted virtual reduction and personalized additional fixation with proximal femoral nail anti rotation in the treatment of unstable intertrochanteric fracture of lateral wall.@*METHODS@#From January 2015 to June 2018, 11 cases of intertrochanteric fracture with unstable lateral wall injury were analyzed retrospectively, including 3 males and 8 females, aged 64 to 81 years old. There were 3 cases of A3.1, 6 cases of A3.2 and 2 cases of A3.3 according to AO classification. All patients underwent CT scanning, according to the CT scanning data, three-dimensional reconstruction of fracture was performed by Mimics soft. Virtual reduction was performed first, and PFNA was implanted after satisfactory reduction. According to the relationship between the fracture characteristics of the lateral wall and the position of the lag screw tail in the lateral wall, 4 cases were treated with PFNA and titanium cable or steel wire, and 7 cases were treated with PFNA and reconstruction locking plate.The quality of reduction and healing were evaluated by follow up, and Harris score of hip joint was performed in the last reexamination.@*RESULTS@#All patients were followed up for 12 to 18 months. No postoperative infection of incision and loosening of internal fixation occurred. The time of fracture healing was 12 to 20 weeks. At the final follow up, Harris score of hip joint was excellent in 6 cases, good in 3 cases and fair in 2 cases.@*CONCLUSION@#The treatment of intertrochanteric fracture of femur with Mimics assisted virtual reduction and PFNA is helpful to preoperative planning and improve the surgical effect.

Simultaneous determination of eight constituents in Yuye Xiaoke Granules by QAMS / 中成药

AIM To establish a quantitative analysis of multi-components by single-marker (QAMS) method for the simultaneous content determination of 3'-hydroxy puerarin,puerarin,3'-methoxy puerarin,neomangiferin,mangiferin,calycosin-7-O-β-D-glucoside,astragaloside Ⅳ and batatasin Ⅰ in Yuye Xiaoke Granules (Astragali Radix,Dioscoreae Rhizoma,Puerariae lobatae Radix,etc.).METHODS The analysis of methanol extract of this drug was performed on a 30℃ thermostatic Kromasil C1scolumn (4.6 mm ×250 mm,5 μm),with the mobile phase comprising of methanol-acetonitrile (1 ∶ 1) and 0.4％ glacial acetic acid flowing at 0.9 mL/min in a gradient elution manner,and the detection wavelengths were set at 210,250,254,274 nm.With astragaloside Ⅳ as an internal standard,the relative correction factors of the other seven constituents were calculated,after which the con tent determination was made.RESULTS Eight constituents showed good linear relationships within their own ranges (r ＞ 0.999 0),whose average recoveries were 97.06％-99.95％ with the RSDs of 0.54％-1.44％.The results obtained by QAMS approximated those obtained by external standard method.CONCLUSION This stable and reliable method can be used for the quality control of Yuye Xiaoke Granules.

Dexmedetomidine attenuates acute kidney injury induced by hemorrhagic shock/resuscitation in rats / 中国病理生理杂志

AIM:To investigate the effects of dexmedetomidine on hemorrhagic shock /resuscitation(HS/R)-induced acute kidney injury(AKI)in rats,and to explore the possible mechanisms.METHODS:Wistar rats(n=32) were randomly divided into 4 groups(n =8): normal saline control group(NS group), dexmedetomidine group(D group),HS/R group and HS/R+D group.The animals were sacrificed at 6 h after resuscitation.The levels of serum creatinine(Cr)and blood urine nitrogen(BUN)were examined.The kidneys of all rats were removed for evaluation of histological characteristics,and the levels of malondialdehyde(MDA),tumor necrosis factor-α(TNF-α),interleukin-1β (IL-1β)and superoxide dismutase(SOD)were measured.The expression of nuclear factor-κB(NF-κB)and hemeoxyge-nase-1(HO-1)was determined by Western blot.RESULTS: Compared with NS group, the levels of Cr, BUN, MDA, TNF-αand IL-1βwere obviously increased in HS/R group, which were obviously decreased in HS/R+D group(P<0.05).Compared with NS group,the SOD activity was obviously decreased in HS/R group,which was obviously increased in HS/R+D group(P<0.05).Compared with NS group, the protein expression of NF-κB was obviously increased in HS/R group,which was obviously decreased in HS/R+D group(P<0.05).Compared with NS group, the protein ex-pression of HO-1 was increased in HS/R group.Compared with HS/R group,the protein expression of HO-1 was obviously increased in HS/R+D group.Compared with NS group,HS/R induced marked kidney histological injury,which was less pronounced in HS/R+D group.CONCLUSION:Dexmedetomidine effectively protects rats against AKI caused by HS /R, and its mechanism may be associated with the increase in HO-1 expression and the inhibition of NF-κB expression.

The risk factors affecting early recurrence and survival after surgical resection of hepatocellular carcinoma / 介入放射学杂志

Objective To analyze the risk factors that affect the early recurrence (recurrence occurring within 3 months after surgical resection) of hepatocellular carcinoma (HCC), and to discuss the risk factors influencing the survival after hepatectomy. Methods The clinical data of 257 HCC patients, who were admitted to authors' hospital during the period from January 1, 2007 to March 31, 2014 to receive cTACE within 3 months after surgical resection of hepatocellular carcinoma, were retrospectively analyzed. According to DSA findings (lipiodol CT scan was performed in part of patients with undetermined diagnosis), the patients were divided into recurrence group and non-recurrence group. By using univariate analysis and multiple logistic regression analysis, the correlation of the clinical and pathological data with the early recurrence was analyzed. The patients were followed up, the survival time was recorded. The relationship between patient's clinical data and postoperative survival was evaluated. Results ① Of the 257 patients, early recurrence was detected in 150 patients (58. 4％, recurrence group) and no recurrence was observed in 107 patients (41. 6％, non-recurrence group). ②The presence of satellite nodules and the integrity of tumor encapsulation were two independent factors associated with the postoperative residual lesions. ③The maximum diameter of the tumor, Edmondson grade and the vascular cancer thrombus were the independent risk factors affecting survival. ④The median survival time of patients in recurrence group was markedly shortened than that of patients in non-recurrence group (39 months vs. 93 months). Conclusion The early recurrence (within 3 months after resection) of hepatocellular carcinoma is associated with the presence of satellite nodules and the integrity of tumor encapsulation. The survival of patients after hepatectomy is related to the maximum diameter of the tumor, Edmondson grade and the vascular cancer thrombus. The median survival time in patients having early recurrence is significantly shortened than that in patients having no early recurrence. (J Intervent Radiol, 2018, 27: 215-222)

Acupoint embedding for female functional constipation:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the effects between acupoint embedding and oral medication for female functional constipation.</p><p><b>METHODS</b>Fifty-six female patients were randomized into an embedding group and a medication group (1:1).There were 22 cases in the embedding group and 26 cases in the medication group with total 8 patients dropped out. The main embedding acupoints were Zhongwan (CV 12), bilateral Tianshu (ST 25) and Guanyuan (CV 4), combined with Xiawan (CV 10), Huaroumen (ST 24), Wailing (ST 26), Zhigou (TE 6) and Shangjuxu (ST 37). It was given once a week. Oral lactulose was applied in the medication group, 3 times a day. The treatment cycle was 8 weeks. The primary outcome was the percentage of patients whose weekly average number of complete spontaneous bowel movement (CSBM) was increased ≥ 2 compared with baseline during the last 6 weeks in the treatment period. The secondary efficacy indices were compared before and after treatment as well as at follow-up at the 12th week, including the weekly average number and increased number of CSBM, the quality of life of patients with constipation (PAC-QOL), the Bristol stool character score, and the assessment of difficulty in defecation.</p><p><b>RESULTS</b>The percentage of patients whose weekly average number of CSBMs were increased ≥ 2 in the embedding group significantly increased compared with that in the medication group (<0.05). The weekly average number of CSBM in the two groups increased after treatment compared with those before treatment (both<0.01); the score of Bristol stool character improved (both<0.01); the scores of PAC-QOL and difficulty in defecation decreased (all<0.01). The increasing time of weekly average CSBM in the embedding group was higher than that in the medication group (<0.01); the score of PAC-QOL in the embedding group after treatment was better than that in the medication group (<0.01); the Bristol stool character and difficulty degree in the embedding group after treatment were superior to those in the medication group (both<0.05).</p><p><b>CONCLUSIONS</b>The acupoint embedding significantly improve the CSMB, Bristol stool character, the difficulty of defecation, and the quality of life for female patients with functional constipation.</p>

Study on the mechanism of asporin in degeneration of intervertebral disc / 中华骨科杂志

Objective To explore the molecular regulation mechanism of asporin in the matrix synthesis and secretion of the intervertebral disc,and to clarify its role in degenerative lesions of intervertebral disc.Methods There were 8 cases of intervertebral disc tissue in patients with severe intervertebral disc herniation (including typical clinical symptoms,signs and Pfirrmann's grade Ⅲ).There were 6 male and 2 female with an average age of (20.25 ± 3.37) years old (ranged from 11 to 28 years).After primary culture and redifferentiation in alginate beads,cells were reseeded and treated with different concentrations of TGF-β1 for 6,12,18 and 24 h.Total RNA extracted from the cells and was subjected to real-time PCR analysis to examine the expression of asporin.After silencing the expression of endogenous asporin by siRNA,the cells stimulated 24 h with TGF-β1.Total RNA extracted from the cells and was subjected to real-time PCR analysis to examine the expression of asporin,collagen Ⅱ and proteoglycans.After treatment of specific p38 inhibitor or ERK inhibitor for 12 h,cells were stimulated with TGF-β1 for 24h.Protein extracted from the cells by protein extraction kit to examine the level of asporin.Results In the primary intervertebral disc cell experiment,TGF-β1 stimulation induced asporin transcription significantly in a dose and time dependent manner.After 24 h stimulation,a significant difference between different concentration groups (5,10 and 15 ng/ml) was observed,2.754±0.24,3.651 ±0.319 and 4.583±0.38,respectively (F=24.782,P=0.001).Knockdown of endogenous asporin led to the upregulated expression of aggrecan and collagen]Ⅱ (aggrecan:t=7.387,P=0.002,collagen Ⅱ:t=4.443,P=0.0113).Specific p38 inhibitor was used to block p38 phosphorylation,and TGF-β1 on asporin induction was significantly inhibited.Conclusion Our results have verified a functional feedback loop between TGF-β1 and asporin in human intervertebral annulus cells indicating that TGF-β1 can increase asporin expression,whereas asporin inhibits TGF-β 1 signaling pathway by negative feedback,thereby inhibiting TGF-β1 mediated synthesis of extracellular matrix,and TGF-31 can increase asporin expression by p38 in human intervertebral disc cells.