Study on risk factors of abnormal pulmonary function among dust-exposed workers and prediction model / 中华劳动卫生职业病杂志

Objective: To explore the influencing factors of abnormal pulmonary function in dust-exposed workers and establish the risk prediction model of abnormal pulmonary function. Methods: In April 2021, a total of 4255 dust exposed workers from 47 enterprises in 2020 were included in the study. logistic regression was used to analyze the influencing factors of abnormal pulmonary function in dust-exposed workers, and the corresponding nomogram prediction model was established. The model was evaluated by ROC curve, Calibrationpolt and decision analysis curve. Results: logistic regression analysis showed that age (OR=1.03, 95%CI=1.02~1.05, P<0.001) , physical examination type (OR=4.52, 95%CI=1.69~12.10, P=0.003) , dust type (Comparison with coal dust, Cement dust, OR=3.45, 95%CI=1.45~8.18, P=0.005, Silica dust (OR=2.25, 95%CI=1.01~5.03, P=0.049) , blood pressure (OR=1.63, 95%CI=1.22~2.18, P=0.001) , creatinine (OR=0.08, 95%CI=0.05~0.12, P<0.001) , daily exposure time (OR=1.06, 95%CI=1.10~1.12, P=0.034) and total dust concentration (OR=1.29, 95%CI=1.08~1.54, P=0.005) were the influencing factors of abnormal pulmonary function. The area under the ROC curve of risk prediction nomogram model was 0.764. The results of decision analysis curve showed that the nomogram model had reference value in the prevention and intervention of abnormal pulmonary function when the threshold probability exceeded 0.05. Conclusion: The accuracy ofthe nomogram model constructed by logistic regression werewell in predicting the risk of abnormal lung function of dust-exposed workers.

Research progress of traditional Chinese medicine in the prevention and treatment of COVID-19 / 中国热带医学

@#Abstract: The coronavirus disease 2019 (COVID-19) has become a global public health problem due to its highly contagious nature. This article aims to discuss the current situation of traditional Chinese medicine in the prevention and treatment of COVID-19, and to provide a basis for traditional Chinese medicine research and scientific and standardized treatment of COVID-19.In this article, the etiology, pathogenesis, treatment plan and research progress were summarized, analyzed and concluded by retrieving and reviewing the literature and clinical reports related to the prevention and treatment of COVID-19 with traditional Chinese medicine. Traditional Chinese medicine has obvious effects in the prevention and treatment of COVID-19, improvement of clinical symptoms, and control of disease progression, which had the unique advantages of mild curative efficacy and safety. It has important practical significance in relieving patients' early symptoms and reducing the incidence of progression from mild to severe, and had great potential for development in the treatment of COVID-19. The traditional Chinese medicine intervention and the formulation of diagnosis and treatment plans for the COVID-19 need to be continuously optimized and improved. Scientific and rational application of traditional Chinese medicine to prevent and treat COVID-19, optimization diagnosis and treatment programs, and in-depth exploration of pharmacological mechanisms, especially the provide reference for early intervention of new coronavirus pneumonia by traditional Chinese medicine, the control of disease progression in the middle stage, and improve prognosis in the late stage with Western medicine.

Efficacy and safety of alirocumab versus ezetimibe in high cardiovascular risk Chinese patients with hyperlipidemia: ODYSSEY EAST Study-Chinese sub-population analysis / 中华心血管病杂志

Objective: To compare the efficacy and safety profile of alirocumab (PCSK9 inhibitor) versus ezetimibe on top of maximally tolerated statin dose in high cardiovascular risk Chinese patients with hyperlipidemia. Methods: The ODYSSEY EAST study was a randomized, double-blinded, double dummy, active-control, parallel group, multi-centers clinical trial, the Chinese sub-population included 456 patients with hyperlipidemia and high cardiovascular risk on maximally tolerated statin dose. Patients were randomized (2∶1) to receive the subcutaneous injection of alirocumab (75 mg Q2W; with dose up titration to 150 mg Q2W at week 12 if low-density lipoprotein cholesterol (LDL-C) was ≥1.81 mmol/L at week 8) or the oral administration of ezetimibe (10 mg daily) for 24 weeks. The primary endpoint was percentage change in calculated LDL-C from baseline to week 24. Key secondary efficacy endpoints included percentage change from baseline to week 12 or 24 in LDL-C (week 12) and other lipid parameters, including apolipoprotein (Apo) B, non-high-density lipoprotein cholesterol (non-HDL-C), TC, lipoprotein(a) (Lp(a)), HDL-C, fasting triglycerides (TG), and Apo A1, and the proportion of patients reaching LDL-C<1.81 mmol/L at week 24. Safety profile of therapeutic drugs was also assessed during the treatment period. Results: The mean age of 456 Chinese patients was (59.5±10.9) years, 341(74.8%) patients were male, 303 patients (66.4%) in alirocumab group and 153 patients (33.5%) in ezetimibe group. Demographic characteristics, disease characteristics, and lipid parameters at baseline were similar between the two groups. LDL-C was reduced more from baseline to week 12 and 24 in alirocumab group versus ezetimibe group, the difference of their least-squares mean (standard error) percent change were(-35.2±2.2)% and (-36.9±2.5)% (both P<0.001). At 12 weeks, alirocumab had significant reduction on Lp(a), Apo B, total cholesterol and non HDL-C, the difference of their least-squares mean (standard error) percent change were (-40.3±2.8)%, (-27.7±1.8)%, (-19.6±1.5)% and (-27.7±1.9)%, respectively (all P<0.001). At 24 weeks, the percent of patients who reached LDL-C<1.81 mmol/L and LDL-C<1.42 mmol/L was significantly higher in alirocumab group (85.3% and 70.5%) than in ezetimibe group (42.2% and 17.0%, both P<0.001), and alirocumab use was also associated with significant reduction on Lp(a), Apo B, total cholesterol and non HDL-C, the difference of their least-squares mean (standard error) percent change were (-37.2±2.8)%, (-29.1±2.0)%, (-21.6±1.6)% and (-29.6±2.2)%, respectively (all P<0.001). The incidence of treatment related adverse events was similar between the two treatment groups (223/302 patients (73.8%) in alirocumab group and 109/153 patients (71.2%) in ezetimibe group). Respiratory infection, urinary infection, dizziness and local injection-site reactions were the most frequently reported adverse events. Conclusions: In high cardiovascular risk patients with hyperlipidemia from China on maximally tolerated statin dose, the reduction of LDL-C induced by alirocumab is more significant than that induced by ezetimibe. Both treatments were generally safe during the observation period of study.

Effect of triptolide on cognitive dysfunction in vascular dementia rats through SIRT1/NF-κB signaling pathway / 中国中药杂志

To investigate the effect of triptolide on cognitive dysfunction in vascular dementia rats and its effect on SIRT1/NF-κB pathway,fifty healthy male Sprague-Dawley rats were randomly divided into 5 groups: Sham operation group( Sham group),vascular dementia model group( 2 VO group),triptolide intraperitoneal injection group( TR group),triptolide intraperitoneal injection + EX527 intracerebroventricular administration group( T+E group),EX527 intracerebroventricular administration group( EX527 group). After 4 weeks of modeling,Morris water maze test and object recognition test were used to evaluate the learning and memory ability of rats. The morphological changes of hippocampus in each group were observed in brain tissue. The chemical colorimetry was used to detect the activities of SOD and MDA in hippocampus. IL-6 and TNF-α levels were detected by ELISA. Western blot was used to detect the expression of SIRT1,NF-κB,IκBα and caspase 3 in hippocampus. The results showed that compared with the Sham group,the learning and memory ability of the vascular dementia model rats was reduced,the SOD activity in the hippocampus was decreased,the MDA activity and IL-6 level were increased,the neuronal degeneration changed significantly,the expression of SIRT1 and IκBα was decreased and the expression of caspase 3 and NF-κB was significantly increased. After intervention by triptolide,the level of oxidative stress and the degenerative changes in hippocampus were significantly slowed down. The expression of SIRT1 and IκBα protein was increased and the expression of caspase 3 and NF-κB was significantly decreased. While,after intervention by triptolide and EX527,the expression of SIRT1 was decreased,the levels of oxidative stress and neuronal degeneration in the hippocampus were aggravated,and the learning and memory ability was reduced. The results showed that triptolide could improve cognitive impairment in vascular dementia rats and its mechanism may be related to SIRT1/NF-κB signaling pathway.

Effect of G Protein Coupled Estrogen Receptor 1 on Angiotensin Ⅱ-induced Hypertrophy of Cultured Neonatal Rat Cardiomyocytes / 中国循环杂志

Objectives: To observe the effect of activated G-protein coupled estrogen receptor 1 (GPER1) on Angiotensin II (AngII)-induced hypertrophy of cultured neonatal rat cardiomyocytes and explore related mechanisms. Methods: Primary cardiomyocytes derived from 2-to 3-day-old neonatal rats were cultured in vitro. Tandem mass tags (TMT) protein mass spectrometry was used to examine protein expressions; relevant bioinformatics analysis was performed to screen the possible regulatory mechanisms. Cardiomyocytes were divided into 6 groups: (1)Blank control group, (2) AngII group, (3)AngII+G1 (GPER1 activator) group, (4)AngII+G1+G15 (GPER1 inhibitor) group, (5)AngII+G1+U0126 (extracellular ERK inhibitor) group and (6)AngII+G1+MK2206 (AKT inhibitor) group (n=3 for each group). Cardiomyocytes GPER1 expressions, mRNA levels of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP), protein levels of ERK, AKT with their interactions, autophagy-related proteins LC3II and LC3I were compared among different groups;impact of GPER1 on cardiomyocytes apoptosis was detected by flowcytometry. Results: AngII induced cardiomyocytes hypertrophy and upregulation of ANP and BNP mRNA levels in a dose-dependent manner (P<0.05). GPER1 expression could be detected on cardiomyocytes by Immunofluorescence technique. qRT-PCR results showed that GPER1 was activated by the specific activator G1 and mRNA expressions of ANP and BNP were inhibited in a dose-dependent manner by the specific activator G1 (P<0.05); mRNA levels of ANP and BNP were re-elevated in AngII+G1+G15 group (P<0.05). Western blotting results showed that protein expression of p-ERK and p-AKT was significantly higher in AngII group and AngII+G1 group than in blank control group (P<0.05), significantly reduced in AngII+G1+G15 group compared with AngII+G1 group (P<0.05); decreased expressions of p-ERK, p-AKT and mRNA levels of ANP,BNP were also detected in AngII+G1+MK2206 group (P<0.05). G1 induced protein expression was similar between AngII+G1 group and AngII+G1+U0126 group. Flowcytometry results indicated that cardiomyocytes apoptosis was similar between AngII+G1 group and AngII group (P>0.05). Ratio of LC3II/LC3I was significantly higher and autophagy levels were significantly enhanced in AngII group than in blank control group (P<0.01), these changes could be significantly reversed in AngII +G1 group (P<0.01 vs. AngII). Conclusions: Activation of GPER1 could inhibit neonatal cardiomyocytes hypertrophy, this effect might be related to AKT and ERK signaling pathway and cell autophagy.

Cell suspension examination versus histopathological technique in detecting sperm in the testis tissue of non-obstructive azoospermia patients undergoing testicular sperm aspiration / 中华男科学杂志

<p><b>Objective</b>To explore the clinical selection and application of cell suspension examination (CSE) or histopathological technique (HPT) in detecting sperm in the testis tissue obtained by testicular sperm aspiration (TESA) in patients with non-obstructive azoospermia (NOA).</p><p><b>METHODS</b>Totally, 1 006 NOA patients underwent TESA and their testis tissues were subjected to CSE or HPT for sperm detection. Based on the results of CSE, the testicular tissue samples were divided into groups A (with sperm, n = 567) and B (without sperm, n = 439) and the results were compared with those of HPT.</p><p><b>RESULTS</b>HPT showed 508 cases with but 59 without sperm in group A, and 403 with and 36 without sperm in group B. The consistency rate of CSE with that of HPT was 90.56% (Kappa =0.809), and CSE exhibited a significantly higher rate of sperm detection than HPT (56.36% vs 54.08%, P=0.023).</p><p><b>CONCLUSIONS</b>CSE combined with HPT for detecting sperm in the testis tissue of NOA patients undergoing diagnostic TESA helps clinical diagnosis and treatment. The results of CSE have a decisive significance for assisted reproductive therapy, while those of HPT may provide some definite etiological evidence for drug therapy or surgery.</p>

Podoplanin expression and clinical prognosis of patients with esophageal squamous cell carcinoma: A retrospective cohort study / 中国胸心血管外科临床杂志

@#Objective    To analyze the Podoplanin expression in patients with esophageal squamous cell carcinoma and to find out the relationship between Podoplanin expression and tumor embolus, lymph node metastasis, tumor differentiation as well as prognosis, and to provide clinical evidence for reducing the recurrence of esophageal squamous cell carcinoma and prolonging the disease-free survival and overall survival. Methods    A retrospective analysis of 70 patients with esophageal squamous cell carcinoma in our hospital from June 2010 to June 2012 was conducted, including 39 males and 31 females, with a mean age of 63.6 years. Positive diagnosis of tumor thrombus was achieved in 35 patients and negative in 35 patients. Postoperative pathological specimens were examined and normal esophageal tissues (esophageal tissue more than 5 cm from the edge of the tumor) of patients were excised as a control group. Results    The positive rate of Podoplanin was 34.2% in normal esophageal tissues and 62.8% in tumor tissues. The positive rate of Podoplanin expression was 77.1% and 48.6% in esophageal squamous cell carcinoma patients with or without tumor embolus, respectively. The positive rate of Podoplanin expression in tumor cells of patients with positive and negative lymph node metastasis was 71.9% and 23.1%, respectively (P<0.05). The mean disease-free survival of patients with Podoplanin expression-negative esophageal squamous cell carcinoma was 15.2 months, which was significantly longer than that of patients with Podoplanin expression-positive esophageal squamous cell carcinoma (P<0.05).  Conclusion    Podoplanin expression in the tumor cells and vessels can be an important reference index to the prognosis of patients with esophageal squamous cell carcinoma.

Correlation of Twist expression in esophageal squamous cell carcinomas with clinical prognosis / 中国胸心血管外科临床杂志

@#Objective    To observe the expression of Twist in esophageal squamous cell carcinoma (ESCC) and analyze the relationship between positive expression of Twist and disease-free survival, and to provide clinical evidence for reducing tumor recurrence, prolonging disease-free survival and improving prognosis. Methods    Retrospective analysis of 70 ESCC patients receiving thoracic surgery from June 2010 to June 2012 in the Department of Thoracic Surgery, Sichuan Cancer Hospital was done, including 39 males and 31 females with an average age of 63.6 years. The expression of Twist in normal esophageal tissue, tumor tissue and vascular tumor emboli was observed by immunohistochemical staining of paraffin specimens. Results    The positive rate of Twist in normal esophageal tissues was 42.9%, and in tumor tissue was 77.1% (P<0.05). The positive expression rate of Twist in tumor cells was 74.3% in patients with vascular tumor emboli and 80.0% in patients without vascular tumor emboli (P>0.05). The positive expression rate of Twist in tumor cells and in vascular tumor emboli was 74.3% and 71.4%, respectively (P>0.05). The expression of Twist in lymphatic vessels and blood vessels of patients with vascular tumor emboli was 56.0% and 72.0%, respectively (P>0.05). Conclusion    Twist expression in esophageal cancer tissues is significantly higher than that in normal tissues, but there is no significant difference in the positive expression of Twist between tumor cells and the mean disease-free survival (P>0.05). At present, Twist expression can not be used as a prognostic indicator of esophageal cancer, and more researches need be further implemented.

Effect of TRPV1 combined with lidocaine on cell state and apoptosis of U87-MG glioma cell lines

Objective: To study the effects of Transient receptor potential cation channel, subfamily V, member 1 (TRPV1) combined with lidocaine on status and apoptosis of U87-MG glioma cell line, and explore whether local anesthetic produces neurotoxicity by TRPV1. Methods: U87-MG cells were divided into control group, gene silencing group, empty vector group and TRPV gene up-regulation group. For cells in each group, flow cytometry was employed to detect the intracellular calcium ion concentration and mitochondrial membrane potential at different time point from cellular perspective. Cell apoptosis of U87-MG was assayed by flow cytometry and MTT from a holistic perspective. Results: Calcium ion concentration increased along with time. The concentration in TRPV1 gene up-regulation group was significantly higher than those in other groups at each time point (P < 0.05). After adding lidocaine, mitochondrial membrane potential in U87-MG significantly increased (P < 0.05). This increasing trend in TRPV1 gene up-regulation group was more significant than other groups (P < 0.05), while in TRPV1 gene silencing group, the trend significantly decreased (P < 0.05). Flow cytometry result and MTT result both showed that cell apoptosis in each group significantly increased after lidocaine was added (P < 0.05). This increasing trend in TRPV1 gene up-regulation group was more significant than other groups (P < 0.05), while in TRPV1 gene silencing group, the trend significantly decreased (P < 0.05). Moreover, apoptosis was more severe along with the increasing concentration of lidocaine (P < 0.05). Conclusions: In this study, it was proved that lidocaine could dose-dependently induce the increase of intracellular calcium ion concentration, mitochondrial membrane potential and apoptosis in U87-MG glioma cell line. The up-regulation of TRPV1 enhanced cytotoxicity of lidocaine, which revealed the correlations between them. Lidocaine might have increased intracellular calcium ion concentration by activating TRPV1 gene and induced apoptosis of U87-GM glioma cell line by up-regulating mitochondrial membrane potential.

Effect of TRPV1 combined with lidocaine on cell state and apoptosis of U87-MG glioma cell lines

OBJECTIVE@#To study the effects of Transient receptor potential cation channel, subfamily V, member 1 (TRPV1) combined with lidocaine on status and apoptosis of U87-MG glioma cell line, and explore whether local anesthetic produces neurotoxicity by TRPV1.@*METHODS@#U87-MG cells were divided into control group, gene silencing group, empty vector group and TRPV gene up-regulation group. For cells in each group, flow cytometry was employed to detect the intracellular calcium ion concentration and mitochondrial membrane potential at different time point from cellular perspective. Cell apoptosis of U87-MG was assayed by flow cytometry and MTT from a holistic perspective.@*RESULTS@#Calcium ion concentration increased along with time. The concentration in TRPV1 gene up-regulation group was significantly higher than those in other groups at each time point (P < 0.05). After adding lidocaine, mitochondrial membrane potential in U87-MG significantly increased (P < 0.05). This increasing trend in TRPV1 gene up-regulation group was more significant than other groups (P < 0.05), while in TRPV1 gene silencing group, the trend significantly decreased (P < 0.05). Flow cytometry result and MTT result both showed that cell apoptosis in each group significantly increased after lidocaine was added (P < 0.05). This increasing trend in TRPV1 gene up-regulation group was more significant than other groups (P < 0.05), while in TRPV1 gene silencing group, the trend significantly decreased (P < 0.05). Moreover, apoptosis was more severe along with the increasing concentration of lidocaine (P < 0.05).@*CONCLUSIONS@#In this study, it was proved that lidocaine could dose-dependently induce the increase of intracellular calcium ion concentration, mitochondrial membrane potential and apoptosis in U87-MG glioma cell line. The up-regulation of TRPV1 enhanced cytotoxicity of lidocaine, which revealed the correlations between them. Lidocaine might have increased intracellular calcium ion concentration by activating TRPV1 gene and induced apoptosis of U87-GM glioma cell line by up-regulating mitochondrial membrane potential.

Clinical observation on the effect of resection of eyelid tumor and stageⅠ recovery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate clinical effects of local resection of eyelid tumors and pathological examination or frozen section examination as well as the stage I recovery. METHODS: For all 92 cases 92 eyes of eyelid tumor patients who underwent local resection, reconstruction in stage Ⅰ and routine pathological examination ( 37 cases of suspected malignant tumors using frozen section examination. If it was malignant, excision by Moths surgery) . Using free palate mucosa autograft in stage I or reconstruction by Hughes surgery combined with eye flaps repaired eyelid defects. RESULTS: The postoperative pathological diagnosis:52 cases were benign tumors, and 40 cases malignant tumors. All cases of eye flaps and hard palate mucosa grafts were survived. Followed up for more than 6mo, no tumor were recurred. The appearance and function of eyelid were satisfactory. CONCLUSION: In this group of cases, nearly half of eyelid tumors are malignant tumors. It should be treated and operated as early as possible. For suspected malignant tumors, we use frozen section examination to confirm its properties in order to excision cleanly in stageⅠ, reducing the recurrence and metastasis. According to the eyelid defect after resection, we could do repair operation in stage Ⅰ. The inner larger defect is repaired by using hard palate mucosa transplantation or Hughes surgery. The outer layer of the eyelid defect is repaired by using eye flap glide, the free flap, the kite flap, the simple suture, etc. It should be careful when using the hard palate mucosa transplantation in the upper eyelid defect.

Unilateral external fixation assisted with closed reduction and interlocking intramedullary nail fixation for the treatment of comminuted fracture of femoral shaft / 中国骨伤

<p><b>OBJECTIVE</b>To introduce the use of single arm external fixation assisted reduction and closed complex intramedullary nail fixation for the treatment of femoral shaft fracture operation method and to study its effects.</p><p><b>METHODS</b>From June 2008 to October 2012, 24 patients with femoral shaft fractures were treated with unilateral external fixation assisted by closed reduction, interlocking intramedullary nail fixation. Among the patients, 19 patients were male and 5 patients were female, ranging in aged from 20 to 68 years,with an average of 45.6 years old. The fracture was caused by traffic accidents in 14 cases, by falling in 6 cases, by heavy bruising in 4 cases. Admission diagnosis was femoral shaft fracture. Operation was performed after traction from tibial tubercle for about 1 week.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 6 to 24 months, with a mean of 16.2 months. The X-ray showed fracture healing time ranging from 11 to 17 weeks, with an average of 13.8 weeks. All fractures healed without nails broken or close joint dysfunction. According to femoral shaft efficacy evaluation standards, 23 patients got an excellent result, 1 good.</p><p><b>CONCLUSION</b>Unilateral fixator assisted closed reduction and interlocking intramedullary nail fixation for the treatment of femoral shaft fracture has following advantages: less trauma, simple operation, effective reduction, high rate of fracture healing, and low complication rate.</p>

Strategy for keeping efficient expression and pharmacodynamics in reducing rAAV gene medicine immune response based on the decrease of vector dosage / 药学学报

How to reduce immune response is an unprecedented challenge for rAAV gene medicine. Recent studies suggested that lowering dosage of the vector used could reduce immune response caused by rAAV gene medicine. Nevertheless, it would also decrease the transgene expression, leading to failure of gene treatment. It is therefore important to take appropriate steps to maintain high gene expression level and pharmacodynamic, while the dosage of rAAV used is reduced. Here, steps to enhancing gene therapy, such as optimization of the administration, reconstruction of the viral vector and selection of the promoter, are discussed in order to achieve maximum outcome.

Progress in evidence-based medicine for the treatment of optic neuritis / 中华实验眼科杂志

Optic neuritis is a common optic neuropathy,which typically presents with sudden loss of vision.Visual deficit of optic neuritis varies in severity and generally can be improved spontaneously over several-month duration.The most convincing eight evidences from level Ⅰ and Ⅱ evidence of evidence-based medicine( EBM ) about the treatment of all the optic neuritis were collected by searching theCochrane Controlled TrialsRegister (CENTRAL),MEDLINE,EMBASE and reference lists of identified trial reports since the last decade.At present,the latest findings showed that there is no conclusive evidence of benefit in terms of recovery to normal visual acuity,visual field or contrast sensitivity with either intravenous or oral corticosteroids at the doses evaluated in trials included in this review.Either no treatment or intravenous corticosteroid therapy followed by oral corticosteroids is appropriate,and intravenous corticosteroid may benefit the patient in terms of faster recovery to normal vision.There may be of different treatment of optic neuritis in China compared to Western countries due to geographical,racial and genetic background that may cause different etiology and clinical features of optic neuritis.Therefore,in China,it is imperative to carry out a large randomized control trial(RCT) of optic neuritis as soon as possible to get the best evidence for the management of optic neuritis patients.

Clinical application of blocking screws and rooting technique in the treatment of distal tibial fracture with interlocking intramedullary nail / 中国骨伤

<p><b>OBJECTIVE</b>To introduce the clinical method of blocking screws and rooting technique in the treatment of distal tibial fracture with interlocking intramedullary nails.</p><p><b>METHODS</b>From June 2006 to March 2011, 26 patients with distal tibial fracture were treated with interlocking intramedullary nails using blocking screws and rooting technique, included 18 males and 8 females with an average age of 46.2 years old ranging from 24 to 64 years. According to AO classification: 10 cases of type A1, 4 cases of type A2, 8 cases of type B1, 4 cases of type B2. The average distance of the fractures end to the ankle joint was 85 mm ranging from 55 to 125 mm, the mean time between injured and operation was 4.5 days. The patients were evaluated with pain, range of motion, walking.</p><p><b>RESULTS</b>All cases were followed-up for 6 to 22 months (averaged 15 months). According to Iowa ankle joint grading system,the score was improved from preoperative (66.8 +/- 8.2) to postoperative (94.6 +/- 4.8). All fractures had united, and got satisfactory reduction and stable fixation with no complications had happen such as breakage of screw.</p><p><b>CONCLUSION</b>Fixation with interlocking intramedullary nail using blocking screws and rooting technique in treating distal tibial fracture, is a safe and effective technique for the improvement of stability.</p>

Effects of telmisartan on angiotensin II-induced cardiomyocyte hypertrophy and p-ERK1/2 phosphorylation in rat cultured cardiomyocytes.

Background: Cardiomyocyte hypertrophy is a common complication of hypertension, and is recognized as an important risk factor for cardiovascular diseases. Up to now, no study has been made on the effects of telmisartan on Ang II-induced cardiomyocyte hypertrophy. Objective: Investigate the effects of telmisartan on angiotensin II-induced cardiomyocyte hypertrophy and the phosphorylation of extracellular signal-regulated kinase (p-ERK1/2) in rat-cultured cardiomyocytes. Methods: Rat myocardial cells were cultured. Beating rates of the cardiomyocytes, cell volumes, total protein contents, protein synthesis rates, and ERK activity were measured. The phosphorylation of p-ERK1/2 was analyzed by Western blot. Results: Treatment of cultured cardiomyocytes with telmisartan inhibited angiotensin II-induced increases in cell volume, beating rate, total protein content and protein synthesis rate. Telmisartan markedly inhibited p-ERK1/2 phosphorylation in a dose- and time-dependent manner. Conclusion: Telmisartan could suppress cardiomyocyte hypertrophy induced by angiotensin II. The mechanism might be related to the inhibition of p-ERK1/2 phosphorylation.

Screening of differential expression genes of human skin epidermal stem cells at different development stages by cDNA microarray technique / 中华烧伤杂志

<p><b>OBJECTIVE</b>To analyze expression characteristics of human skin epidermal stem cell at different developmental stages, and to explore its biological significance.</p><p><b>METHODS</b>Health skin samples from 28-32 w fetuses (F group), 4-12 y children (C group), and 35-55 y adult (A group) were harvested, with 10 cases in each group. Epidermis were separated using trypsin digestion and EDTA, and human epidermal stem cells were isolated and purified with type IV collagen attachment method. The monoclonal antibody of integrin beta1 and keratin 19 were used for detection and identification of epidermal stem cells by immunohistochemical staining. Total RNA was extracted from above cells by Trizol one-step method, and were detected by formaldehyde denaturing agarose gel electrophoresis. Probes were prepared and hybridized into cDNA microarray for scanning fluorescent signals and analysis of images, with two-fold differential expression value for screening. Significantly up/down-regulated genes were selected for verification by real time RT-PCR.</p><p><b>RESULTS</b>By comparing expression profile between A and C groups, a total of 1808 genes with differential expression were detected, including 1089 up-regulated genes and 719 down-regulated genes, and they were classified into 128 categories. Among them, 1462 genes were known (found in GeneBank), 346 genes were unknown. A total of 4534 genes with differential expression were detected between C and F groups, in which 1783 genes were up-regulated and 2751 genes were down-regulated, and they were classified into 216 categories. Among them, 3577 genes were known (found in GeneBank), and 957 genes were unknown. There were 1104 genes with differential expression consistently detected in F, C and A groups, which were classified into 32 categories according to gene function. Among them, 94 genes were consistently up-regulated and 75 genes consistently down-regulated. Test results of real time RT-PCR were in accordance with above-mentioned results.</p><p><b>CONCLUSIONS</b>Gene expression profiles of epidermal stem cells cultured in vitro, harvested from fetuses, children, and adult, exhibit obvious difference. This may be closely related to different stages of proliferation and differentiation of human epidermal stem cell and self-repair ability of wound at different developmental stages.</p>

The survival analysis of metastatic prostate cancer / 中华外科杂志

<p><b>OBJECTIVES</b>To analyze the clinical and pathological informations of metastatic prostate cancer patients to find the predictive factors of the survival.</p><p><b>METHODS</b>To filter 364 cases of metastatic prostate cancer in the 940 cases of prostate cancer that were treated in Cancer Hospital Fudan University in Shanghai from March 1998 to June 2009, the cases had hormonal therapy and full clinical and pathological records. All the 364 cases were followed up and the clinical and pathological informations were analyzed, to find the predictive factors that related to the prognosis. Statistic software SPSS 15.0 was used for analysis. Cumulative survival was analyzed by the method of Kaplan-Meier. Cox regression was used for univariate and multivariate analysis. Log-rank method was used for the significance test.</p><p><b>RESULTS</b>The last follow-up date was 30th June 2009 and the median follow-up time was 24 months. At the final follow-up, 240 cases were alive, 109 cases were dead and 15 cases were lost to follow up. The median survival time of metastatic prostate cancer was 64 months, and the one-year, two-year, three-year, four-year, five-year survival rate was 92%, 78%, 66%, 60%, 54%. The univariate analysis indicated that Gleason score (P = 0.033), clinical stage (P < 0.001), the effectiveness of hormonal therapy (P < 0.001), the prostate specific antigen (PSA) nadir during hormonal therapy (P < 0.001) and the time from the start of hormonal therapy to the PSA nadir (P = 0.002) were predictive factors for the survival time of metastatic prostate cancer. The multivariate analysis indicated that the PSA nadir during hormonal therapy (P < 0.001) and the time from the start of hormonal therapy to the PSA nadir (P < 0.001) were independent factors that predict the survival time of metastatic prostate cancer.</p><p><b>CONCLUSION</b>The PSA nadir during hormonal therapy and the time from the start of hormonal therapy to the PSA nadir are independent factors that predict the survival time of metastatic prostate cancer.</p>

The study of electrical acupuncture stimulation therapy combined with pelvic floor muscle therapy for postprostatectomy incontinence / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the effectiveness and significance of whether electrical acupuncture stimulation combining with pelvic floor muscle therapy (PFMT) can improve the recovery of urinary continence.</p><p><b>METHODS</b>A total of 109 patients took part in the study of novel combination treatment for urinary continence from September 2008 to September 2009. Patients were divided into study group (n = 40) and control group (n = 69). The patients in study group received electrical acupuncture stimulation therapy combined with PFMT one week after removal the catheter. The patients in control group performed PFMT as the only treatment for post prostatectomy incontinence. The patients were followed up closely, with their clinical characteristics recorded, questionnaires of ICI-Q-SF filled up, and all the data for statistical analysis collected.</p><p><b>RESULTS</b>There was a significant difference between the study group and the control group in the urinary control curve (P = 0.029). The difference of continence probability between these two groups became greater from 4 weeks after surgery, and the difference reached the peak at 6 weeks (P = 0.023). Then the difference became smaller, and there was no difference at 16 weeks after surgery. ICI-Q-SF questionnaires showed the same results.</p><p><b>CONCLUSION</b>Electrical acupuncture stimulation therapy combining with PFMT can improve the recovery of patients' urinary continence after radical prostatectomy.</p>

External validation of the Partin tables 2007 in Chinese prostate cancer patients / 中华外科杂志

<p><b>OBJECTIVE</b>To validate the 2007 Partin tables externally, which are based on the population of United States, using a cohort of Chinese prostate cancer patients.</p><p><b>METHODS</b>All of the patients enrolled and underwent radical prostatectomy between January 2006 and February 2010 were reviewed. The cases without preoperative hormone therapy and pelvic lymph node involvement according to radiologic tests were used for the external validation of the 2007 Partin tables. A comparative analysis of the clinical and pathological parameters of this Chinese cohort and Partin tables cohort was performed. Values of areas under the receiver operating characteristic (ROC) curve were used to assess predictive accuracy for the Chinese cohort.</p><p><b>RESULTS</b>The mean age of the whole cohort was 67 years. The serum prostate specific antigen level, Gleason score and clinical stage of this cohort were higher than the Partin tables cohort. The pathological outcomes analysis revealed that the rates of organ confined disease, capsular penetration, seminal vesicle involvement and lymph node involvement were 62.3%, 16.7%, 12.3% and 8.8%, respectively. The area under the ROC curve (AUC) for organ confined disease, capsular penetration, seminal vesicle involvement and lymph node involvement were 0.735, 0.653, 0.601 and 0.845.</p><p><b>CONCLUSIONS</b>The Partin tables discriminate well for Chinese patients at risk for positive lymph node. The discrimination of organ confined disease is also acceptable and the discrimination of capsular penetration and seminal vesicle involvement is more limited.</p>