Antiplatelet effect of ginkgo diterpene lactone meglumine injection in acute ischemic stroke: A randomized, double-blind, placebo-controlled clinical trial.

This study was designed to evaluate antiplatelet effect and therapeutic effect of ginkgo diterpene lactone meglumine injection (GDLI) in acute ischemic stroke (AIS) patients. In this randomized, double-blind, placebo-controlled trial, we randomly assigned 70 inpatients within 48 hr after the onset of AIS to combination therapy with GDLI and aspirin (GDLI at a dose of 25 mg/d for 14 days plus aspirin at a dose of 100 mg/d for 90 days) or to placebo plus aspirin in a ratio of 1:1. Platelet function, the National Institute of Health Stroke Scale (NIHSS), and the modified Rankin Scale (mRS) were evaluated. A good outcome was defined as NIHSS scores decrease ≥5 or mRS scores decrease ≥2. Results showed that arachidonic acid induced maximum platelet aggregation rate (AA-MAR) and mean platelet volume (MPV) of the GDLI-aspirin group were much lower than that of the aspirin group (p = 0.013 and p = 0.034, respectively) after the 14-day therapy. The combination of GDLI and aspirin was superior to aspirin alone, and had significant impact on the good outcome at day 90 (ORadj 7.21 [95%CI, 1.03-50.68], p = 0.047). In summary, GDLI has antiplatelet effect and can improve the prognosis of AIS patients.

Optimization of preparation technology and in vitro release of baicalin-glycyrrhizic acid solid nanocrystals / 中国药房

OBJECTIVE To optimize the preparation technology of baicalin （BCN）-glycyrrhizic acid （GA） solid nanocrystals （BCN-GA-SN）， to characterize them and investigate their in vitro release characteristics. METHODS According to the compatibility ratio of classic couplet medicinals “Scutellaria baicalensis-Glycyrrhiza uralensis”， the compatibility ratio of BCN and GA was determined as 6∶1 （m/m）； BCN-GA nanosuspension was prepared by precipitation method combined with high-pressure homogenization method. The preparation technology of BCN-GA nanosuspension was optimized by using mean particle size and polydispersity index （PDI） as indexes and with types and dosage of stabilizers， stirring speed and time， high-pressure homogenization pressure and frequency as factors. The freeze-dried consolidation process of BCN-GA nanosuspension was optimized to prepare BCN-GA-SN using average particle size， PDI and redispersibility index （RDI） as indicators， with the type and dosage of freeze-dried protective agents as factors； then， the physicochemical properties and in vitro release of BCN-GA-SN were investigated. RESULTS The optimal preparation technology of BCN-GA-SN was as follows： BCN-GA nanosuspension was prepared by using 15% sodium dodecyl sulfate as a stabilizer， stirring at 1 000 r/min for 15 minutes， and homogenizing at 100 MPa for 20 times； then， BCN-GA nanosuspension was freeze-dried and solidified with 5% mannitol （corresponding to the dosage of BCN）. The average particle size of prepared BCN-GA-SN was （442.2±5.7） nm with PDI of 0.225±0.015 and RDI of 1.055± 0.013. The prepared BCN-GA-SN presented as the irregularly spherical shape with more uniform size； the drug-loading amount of BCN in the nanocrystal was （62.5±0.7）%， and that of GA was （9.4±0.2）%； the in vitro release results showed that the cumulative dissolution of BCN-GA-SN was higher than that of the physical mixture of BCN and GA. CONCLUSIONS BCN-GA-SN is prepared successfully in this study with uniform particle size and even distribution， which can effectively improve the dissolution of BCN.

Application of meridian and acupoint diagnosis of three yin meridians of foot in the treatment for gynecological diseases with acupuncture and moxibustion / 中国针灸

With three representative types of gynecological diseases (dysmenorrhea, pelvic inflammation, polycystic ovary syndrome) as examples, the application methods of meridian and acupoint diagnosis for gynecological diseases treated with acupuncture and moxibustion are discussed. During clinical diagnosis and treatment, it is recommended to examine the patient's leg segment along the three yin meridians of foot, aiming to explore the positive reactions of the meridians and acupoints (color, shape, skin temperature, sensory abnormalities, etc.). Acupuncture and moxibustion treatment at this positive reaction place can improve the clinical efficacy. Meridian and acupoint diagnosis could provide basis for meridian syndrome differentiation, thus guiding the selection of acupoint prescriptions; it is also helpful to clarify the deficiency, excess, cold and heat of the disease nature, thus guiding the selection of acupuncture and moxibustion methods. In addition, it is an auxiliary method to estimate the prognosis and outcome of the disease.

Integrated Analyses of miRNome and Transcriptome Reveal the Critical Role of miRNAs Toward Heat Stress Response in Isochrysis galbana.

Isochrysis galbana is widely used in aquaculture as a bait microalgal species. High temperature (HT) can severely impair the development of I. galbana, exerting adverse effects on its yield. MicroRNAs (miRNAs) play an essential role in modulating stress-responsive genes. However, the role of miRNAs in response to HT in microalgae remains largely unexplored. In the present study, we identified several conserved and novel miRNAs in I. galbana through miRNome sequencing. Among these identified miRNAs, 22 miRNAs were differentially expressed in response to heat stress, and their target genes were predicted accordingly. Moreover, a comprehensive and integrated analysis of miRNome and transcriptome was performed. We found that six potential reversely correlated differentially expressed miRNA (DEM) and differentially expressed gene (DEG) pairs were associated with heat stress response (HSR) in I. galbana. The expressions of DEMs and DEGs were further verified using real-time quantitative PCR (RT-qPCR). Integrated analyses showed that miRNAs played fundamental roles in the regulatory network of HSR in I. galbana mainly by regulating some heat-responsive genes, including heat shock proteins (HSPs), reactive oxygen species (ROS) signaling-related genes, and specific key genes in the ubiquitination pathway. Our current study identified the first set of heat-responsive miRNAs from I. galbana and helped elucidate the miRNA-mediated HSR and resistance mechanisms in I. galbana. This new knowledge could provide ways to enhance its heat stress tolerance.

Research on the process planning and multi-method integration strategy of product conceptual design with cognitive mechanisms.

Innovative product design is essentially an activity involving creative cognitive thinking. Therefore, research on the innovative design process and of methods, computer-aided innovation tools should be conducted based on systematic exploration based on the principles of innovative cognitive thinking. We aim to uncover some general principles that can serve as a systematic thinking framework for product designers, provide a feasible framework and method of innovative thinking for designers, and provide theoretical and methodological support for further development of computer-aided innovation platforms. This paper summarizes the sources and content of studies on the idea generation and design processes behind product innovation. Specifically, we break down the general innovative design process of products, outlining the cognitive mechanisms and propose an integrated application strategy that incorporates multiple methods. And taking "the solution program to the coking of oily sludge pyrolysis equipment" as an example, this paper demonstrated and verified the effectiveness and practicability of the method and strategy proposed. Based on the results on improvements in the equipment, the designers put forward some creative and implementable design schemes. The entire thinking process was relatively smooth and efficient. The example presented in this paper shows that the proposed method can effectively guide/assist/motivate designers to think creatively.

Using genetic testing to diagnose Kennedy's disease: a case report and literature review.

Theoretical basis: Kennedy's disease (KD) is also known as spinal bulbar muscular dystrophy. Because the symptoms of KD are similar to most neuromuscular diseases, it is difficult to make a rapid clinical diagnosis. Patient case: We report the case of a 50-year-old man who was diagnosed with "lumbar disc herniation" five years ago because of progressive proximal limb weakness. After his initial diagnosis, his condition worsened gradually, and a muscle biopsy was performed 3 years ago, and he was then diagnosed with "motor neuron disease", but he had no such family history. His physical examination showed female breast development, erectile dysfunction, a weakness of the quadriceps femoris, a bilateral tendon reflex, and atrophy of the tongue muscle. One year ago, it was found that his blood sugar had increased, and when oral hypoglycemic drugs were given, his blood glucose control was not ideal. At the same time, it was found that his creatine kinase continued to increase significantly. He was admitted to the hospital again because of the aggravation of his walking difficulties. Diagnosis: A laboratory examination showed elevated creatine kinase, an impaired glucose tolerance, and abnormal lactate values. The diagnosis was confirmed using a genetic analysis, which showed a repeated amplification of CAG in the androgen receptor gene. Intervention measures and results: After this diagnosis, the patient had a good prognosis after receiving symptomatic treatment. Lesson: Genetic testing is the key to the diagnosis of KD. Clinicians should make a differential diagnosis, an early diagnosis, and provide treatment as soon as possible according to the patient's clinical manifestations and laboratory examination.

Systematic review and Meta-analysis of clinical efficacy and safety of Ginkgo Leaf Tablets in treatment of acute cerebral infarction / 中国中药杂志

To systematically evaluate the clinical efficacy and safety of Ginkgo Leaf Tablets(GLT) in the treatment of acute cerebral infarction(ACI). Seven databases both at home and abroad were systematically retrieved from their establishment to March 2020. The data of the included studies were extracted after review and screening. The quality of the included studies was assessed with the Cochrane risk bias assessment tool, and then the included studies were put into Meta-analysis by RevMan 5.3 to evaluate the total cli-nical efficiency, neurological function score, blood lipids and incidence of adverse reactions in treatment of ACI by GLT. Finally, the GRADE system was adopted to evaluate the evidence quality of each outcome indicator and form recommendations. Ten studies involving 886 participants were included, all of which were of low quality. Meta-analysis results showed that,(1)in terms of the total clinical efficiency, GLT+Western medicine was superior to Western medicine alone(RR_(NDS)=1.20, 95%CI[1.06, 1.36], P=0.005; RR_(NIHSS)=1.35, 95%CI[1.09, 1.69], P=0.007), and there was no statistical difference between GLT+Xuesaitong Injection+Wes-tern medicine and Xuesaitong Injection+Western medicine(RR=1.16, 95%CI[1.00, 1.35], P=0.05).(2)In terms of improving neurological function score, GLT+Western medicine was superior to Western medicine alone(MD_(NIHSS[moderate(severe)])=-1.55, 95%CI[-2.22,-0.88], P<0.000 01; MD_(NIHSS(severe))=-7.51, 95%CI[-8.00,-7.02], P<0.000 01; MD_(NDS)=-1.36, 95%CI[-2.39,-0.33], P=0.01), and GLT+Danshen Injection+Western medicine was superior to Danshen Injection+Western medicine(MD_(NDS)=-3.09, 95%CI[-3.84,-2.34], P<0.000 01).(3)In terms of regulating blood lipids, GLT+Western medicine was superior to Wes-tern medicine alone(MD_(TC)=-1.40, 95%CI[-2.13,-0.66], P=0.000 2; MD_(TG)=-1.29, 95%CI[-1.86,-0.73], P<0.000 01; MD_(LDL-C)=-1.48, 95%CI[-2.91,-0.04], P=0.04; MD_(HDL-C)=0.07, 95%CI[0.02, 0.12], P=0.009).(4)In terms of incidence of adverse reactions, there was no statistical difference between GLT+Western medicine and Western medicine alone(RR=0.63, 95%CI[0.30, 1.32], P=0.22). The results of the evaluation showed that the evidence level of each outcome indicator was low, and the recommendation was at weak level. In conclusion, GLT+Western medicine could improve the total clinical efficiency, neurological function score, and blood lipid status, with a low incidence of adverse reactions. However, due to the small amount of included stu-dies, low study quality and low level of evidence, it is expected to carry out clinical studies with standardized design and large sample size in the future to further investigate the clinical efficacy and safety of GLT in the treatment of ACI.

A network pharmacology and molecule docking approach to investigating active compounds and mechanisms of gonglaoye-xianhecao herbal pair for ischemic stroke / 中国药理学通报

Aim To clarify the mechanism of Gonglaoye and Xianhecao herbal pair in the treatment of ischemic stroke so as to obtain the substantive evidence using network pharmacology data mining and molecular docking. Methods The main compounds of traditional Chinese medicine were obtained by TCMSP platform and consulting literature, the drug action targets were obtained by TCMSP, and the known genes about ischemic stroke were collected by searching Drugbank, Disgenet, TTD, Genecards, OMIM database, thus the drug-compound-target network map was constructed, and the common target proteins and main compounds were screened. The visual protein-protein interaction network map (PPI) was constructed by string. With the help of Cytoscape software, the original target network of active components was constructed and analyzed, and the gene ontology GO and Jingdu gene and genome encyclopedia KEGG analysis were carried out to analyze the GO function and KEGG pathway enrichment of the common targets of drugs and diseases. Finally, the molecular docking of the core protein and the core compound was carried out according to the relevant node parameters of the compound and protein. Results Seventeen active components and 296 potential targets of Gonglao leaf and crane herbs in the treatment of ischemic stroke were screened. GO enrichment was mainly concentrated in the response to oxides, cell response to chemical stimulation, positive regulation of cell metabolism, constant effect, active regulation of stimulus response, cell communication and so on. KEGG was mainly involved in signaling pathways such as PI3K-Akt, Ras, neuron ligand receptor interaction and so on. Molecular docking showed that quercetin and other active components had high affinity and tight connection with core targets such as AKT1. Conclusions The treatment of ischemic strokec is mainly through the mechanism of ursolic acid, hyperin and other active components, AKT1, cMAPK3 and other multi-targets, PI3K-AKT and other multi-pathway interaction mechanisms. Through this study the theoretical support can be provided for the further clinical application of Gonglaye and crane herbs, providing basic ideas for future experimental research and new drug research and development.

Cupping treatment combined with antibiotics for bacterial pneumonia in children: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical efficacy of cupping treatment combined with antibiotics and antibiotics alone for bacterial pneumonia in children.@*METHODS@#A total of 72 children with bacterial pneumonia were randomly divided into an observation group (36 cases, 1 case dropped off) and a control group (36 cases). The children in the control group were treated with intravenous drip of cefodizine sodium [80 mg/(kg•d)] for 7 days. Based on the treatment of the control group, the children in the observation group were treated with cupping treatment on the bladder meridian of the back on the first day and the fourth day of antibiotic treatment; each cupping treatment was given for 5-10 min; the treatment of observation group was given for 7 days. The days for complete fever reduction, TCM syndrome scores and Canadian acute respiratory illness flu scale (CARIFS) scores before and after treatment were observed, and the clinical efficacy was evaluated.@*RESULTS@#The days for complete fever reduction in the observation group were shorter than that in the control group (@*CONCLUSION@#Cupping treatment combined with antibiotics has similar efficacy with antibiotics alone for bacterial pneumonia in children, but shows better effect in shortening the duration of fever and improving pulmonary symptoms.

Arctigenin exhibits hepatoprotective activity in Toxoplasma gondii-infected host through HMGB1/TLR4/NF-κB pathway.

Toxoplasmosis is a parasitic zoonosis with the highest incidence in humans. Severe lesions due to acute toxoplasmosis have been recorded in the visceral organs including the liver, where hepatocytes and Kupffer cells are important innate immune cells. Arctigenin (AG) is a bioactive ingredient of Arctium lappa L. and increasing evidence suggests that AG exhibits anti-oxidant, anti-inflammatory and anti-Toxoplasma gondii (T. gondii) effects. However, the role of AG in acute liver damage induced by T. gondii infection remains unclear. In this study, we analyzed the effects of AG against T. gondii-induced liver damage by establishing an in vitro infection model using a murine liver cell line (NCTC-1469 cells) and an in vivo mouse model with acute T. gondii infection of virulent RH strain. In the current study, AG effectively attenuated hepatocytes apoptosis and inhibited the reproduction of T. gondii. The results of in vitro and in vivo studies showed that AG significantly reduced alanine aminotransferase/aspartate aminotransferase activities and lessened pathological damage of liver. Moreover, AG suppressed T. gondii-induced inducible nitric oxide synthase production. AG also attenuated liver inflammation by inhibiting T. gondii-induced activation of the high-mobility group box1/toll-like receptor 4/nuclear factor-kappa B (HMGB1/TLR4/NF-κB) signaling pathway. These findings demonstrated that AG exhibited prominent hepatoprotective activities in toxoplasmic liver injury with anti-inflammatory effects by inhibiting the HMGB1/TLR4/NF-κB signaling axis. Thus, this study provides the basis for the development of new drugs to treat toxoplasmic hepatitis.

Advances in Drugs for Microglia Polarization after Ischemic Stroke (review) / 中国康复理论与实践

Microglia cells are activated after ischemic stroke, and polarized phenotypes of M1 and M2. Some drugs, such as fingolimod, 3-N-butylphthalide, curcumin, sildenafil, exendin-4, celastrol, omega-3 fatty acids, malibatol A, salidroside, etc., can transfer the polarization from M1 to M2, and may benefit the outcome of ischemic stroke.

The surgical treatment strategies for thoracolumbar spine fractures with ankylosing spondylitis: a case report.

BACKGROUND: Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects spine and paraspinal soft tissue. Ankylosing spondylitis is one of the causes of osteoporosis and patients with ankylosing spondylitis tend to have spinal fractures due to limited mobility and osteoporosis. In recent years, due to the increase in the number of patients with AS, patients with AS and thoracolumbar spine fractures have gradually increased. In the past 1 year, we have treated 3 cases of AS with thoracolumbar spine fractures via simple posterior internal fixation and this paper aims to report its clinic effect. CASE PRESENTATION: All the three patients selected had a history of ankylosing spondylitis for nearly 30 years, and one of them developed a thoracolumbar spine fracture after falling when he walked, and the other two developed a thoracolumbar spine fracture without any reason. They were hospitalized for "low back pain" and were diagnosed as fractures after careful physical examination and imaging examinations such as X-ray, CT, and MRI. After the preoperative preparation was completed, all the three patients underwent surgery with simple posterior internal fixation-reduction of the fracture and pedicle screw fixation via posterior approach. All the implants-pedicle screws and connecting rods-are made of titanium alloy. For postoperative management, we asked all the patients to stay in bed for 3 weeks after the operation, and then slowly move down with the help of crutches. Fracture healing and neurological function recovery were observed postoperatively. All the three patients recovered satisfactorily after surgery, and the follow-up confirmed that the fracture healed successfully after 3 months. CONCLUSIONS: The 3 patients included 2 men and 1 women. All the 3 patients recovered well after surgery, and the follow-up confirmed that the fracture healed successfully after 3 months. One man developed urination dysfunction after operation and recovered to normal 3 months after rehabilitation exercise.

Optimization of preparation procedures for nano-sponges of flavonoids fromGlycyrrhizae Radix et Rhizoma by Box-Behnken response surface methodology based on CRITIC weighted evaluation / 中国中药杂志

In this paper, nano-sponges of flavonoids from Glycyrrhizae Radix et Rhizoma (LF-NSP) were prepared by agitation-freeze drying method. Box-benhnken design and response surface method based on the single factor experiment was used to optimize the preparation process, with the stirring temperature as well as stirring time and speed as the independent variables, while with drug loading, particle size and the generalized "normalized value" as the response values. In addition, the nano-sponges were characterized by scanning electron microscope (SEM), infraredspectroscopy (FT-IR) and differential scanning calorimetry (DSC), and its release in vitro was also investigated. The results showed that the optimum preparation conditions for glycyrrhizin nano-sponges were as follows：The proportion of main drug and auxiliary drug was 1:2; the proportion of crosslinking agent DPC and β-CD was 4:1; stirring temperature 45 °C for 4.8 h at 245 r·min⁻¹. The comprehensive score of LF-NSP prepared under these conditions was 94.78. FT-IR and DSC results indicated the formation of Glycyrrhiza flavonoids nano-sponges, and SEM showed that they were spherical particles in shape. In release experiment in vitro, the cumulative release of glycyrrhizin flavonoids nano-sponges for 240 min was 81.8%, while that of crude drug was only 31.5%. Nano-sponges can significantly improve the dissolution of flavonoids from Glycyrrhizae Radix et Rhizoma.

Effect of tempol on NF-κB signaling pathway in the rat model of myocardial hypertrophy / 中国比较医学杂志

Objective To investigate the effects of 2, 2, 6, 6-tetramethyl-4-piperidinol (tempol) on NF-κB signaling pathway of myocardial hypertrophy in rats. Methods The rat model of myocardial hypertrophy was established by intraperitoneal injection of isoprenaline (ISO) (5 mg/kg, twice per day, 2 weeks). A total of 42 male SD rats were randomly divided into 3 groups, including the control group, myocardial hypertrophy model group (ISO + sterile saline) and tempol treatment group (ISO + tempol) [tempol 100 mg/ (kg·d), 8 weeks]. Eight weeks after the corresponding drug intervention, the heart weight index (HWI) and left ventricular weight index (LVWI) were determined. Morphology and fibrosis of the myocardium were observed by HE staining, and the myocardial fibrosis of the rats was observed by Masson staining. The mRNA levels of TNF-α and IL-6 in the rat myocardial tissues were detected by qRT-PCR, and the expression levels of IκBα, p-p65 and p65 were detected by Western blot. Results Compared with the control group, the HWI and LVMI, mRNA levels of TNF-α and IL-6, and expression of p-p65/p65 in the model group were significantly increased (P＜ 0. 05), while the expression level of IκBα, an NF-κB inhibitory protein was significantly decreased (P＜0. 05). The pathological examination of the myocardial tissues showed thickening and disordered arrangement of myocardial fibers, and increased cross-sectional area of the myocardial fibers. The pathology by Masson staining showed aggravated myocardial fibrosis and increased collagen fibers in the myocardial interstitium. Compared with the model group, the HWI and LVMI, the mRNA levels of TNF-α and IL-6, and the expression of p- p65/p65 of the tempol group were significantly decreased (P＜ 0. 05), while the expression level of IκBα was significantly increased (P＜ 0. 05). HE staining showed that the degrees of myocardial disarrangement and cardiomyocyte hypertrophy were decreased. Meanwhile, Masson staining showed that the extent of myocardial fibrosis was reduced, and the interstitial collagen fibers were decreased. Conclusions Tempol can improve the isoprenaline-induced myocardial hypertrophy, which may be closely related with the inhibition of the activity of NF-κB signaling pathway.

Effect of MiR-1264 on the proliferation and migration of Hep2 cell line / 医学研究生学报

Objective Previous study shows that the expression of mir-1264 is down-regulated in laryngeal carcinoma. This study aimed to investigate the effect of miR-1264 on the biological function of laryngeal carcinoma Hep2 cells and verify whether miR-1264 could down-regulate the expression of tumor suppressor gene la-ryngeal carcinoma related gene 1(LCRG1)in laryngeal carcinoma. Methods Real-time quantitative PCR was used to assess the miR-1264 expression in human laryngeal cancer tissues. There are three groups in the experiment:miR-1264 mimic/inhibitor group,mimic/inhibitor NC group and untransfected group. MTT and Transwell were applied to observe the effect of miR-1264 on the proliferation,migration and invasion capabilities of Hep2 cells. Luciferase experiment was used to verify the combination of miR-1264 and LCRG1 3'UTR.RT-PCR and Western blot were used to test the expression of miR-1264 and LCRG1 protein respectively. Results Compared with the adjacent laryngeal tissue,miR-1264 expression in human laryn-geal cancer tissues was significantly increased(P<0.05).Compared with NC control group and blank group,the proliferation,migration and invasion capabilities of Hep2 cells were significantly enhanced after they were transiently transfected with miR-1264 mimic(P<0.05);however,after Hep2 cells were transiently transfected with miR-1264 inhibitor,their proliferation,migration and invasion ca-pabilities were significantly inhibited(P<0.05). Luciferase experiment showed miR-1264 mimic could significantly decrease LCRG1 3'UTR luciferase activity,which was of statistical significance. After the verification of successful transient transfection,the results of further Western blot on LCRG1 protein expression showed that there was no significant difference between the experimental group and the mimic NC control group as well as the blank group(P>0.05). Conclusion miR-1264 is highly expressed in laryngeal cancer tissues. Though miR-1264 may not participate in down-regulating the expression of tumor suppressor gene LCRG1 in laryngeal carcino-ma,it can promote the proliferation,migration and invasion capabilities of Hep2 cells.

Lumbopelvic Fixation and Sacral Decompression for U-shaped Sacral Fractures: Surgical Management and Early Outcome / 华中科技大学学报（医学）（英德文版）

U-shaped sacral fractures are rare and often difficult to diagnose primarily due to the difficulty in obtaining adequate imaging and the severe associated injuries.These fractures are highly unstable and frequently cause neurological deficits.The majority of surgeons have limited experience in management of U-shaped sacral fractures.No standard treatment protocol for U-shaped sacral fractures has been available till now.This study aimed to examine the management of U-shaped sacral fractures and the early outcomes.Clinical data of 15 consecutive patients with U-shaped sacral fracture who were admitted to our trauma center between 2009 and 2014 were retrospectively analyzed.Demographics,fracture classification,mechanism of injury and operative treatment and deformity angle were assessed.All the patients were treated with lumbopelvic fixation or (and) sacral decompression.EQ-5d score was applied to evaluate the patients' quality of life.Of the 15 consecutive patients with U-shaped sacral fracture,the mean age was 28.8 years (range:15-55 years) at the time of injury.There were 6 females and 9 males.The mean followup time was 22.7 months (range:9-47 months) and mean full weight-bearing time was 9.9 weeks (range:8-14 weeks).Ten patients received lumbopelvic fixation and sacral decompression,one lombosacral fixation,and 4 merely sacral decompression due to delayed diagnosis or surgery.The post-operation deformity angle (mean 27.87°,and range:8°-90°) of the sacrum was smaller than that pre-operation (mean 35.67;range:15-90) with no significance difference noted.At the latest follow-up,all patients obtained neurological recovery with different extents.Visual analogue score (VAS) was reduced from preoperative 7.07 (range:5-9) to postoperetive 1.93 (range:1-3).All patients could walk without any aid after treatment.Eight patients were able to care for themselves and undertook some daily activities.Five patients had returned to work full time.In conclusion,lumbopelvic fixation is an effective method for stabilization of U-shaped sacral fractures with fewer complications developed.Effective reduction and firm fixation are the prerequisite of early mobilization and neurological recovery.Sacral decompression effectively promotes neurological recovery even in patients with old U-shaped sacral fractures.

Lumbopelvic Fixation and Sacral Decompression for U-shaped Sacral Fractures: Surgical Management and Early Outcome / 华中科技大学学报（医学）（英德文版）

U-shaped sacral fractures are rare and often difficult to diagnose primarily due to the difficulty in obtaining adequate imaging and the severe associated injuries.These fractures are highly unstable and frequently cause neurological deficits.The majority of surgeons have limited experience in management of U-shaped sacral fractures.No standard treatment protocol for U-shaped sacral fractures has been available till now.This study aimed to examine the management of U-shaped sacral fractures and the early outcomes.Clinical data of 15 consecutive patients with U-shaped sacral fracture who were admitted to our trauma center between 2009 and 2014 were retrospectively analyzed.Demographics,fracture classification,mechanism of injury and operative treatment and deformity angle were assessed.All the patients were treated with lumbopelvic fixation or (and) sacral decompression.EQ-5d score was applied to evaluate the patients' quality of life.Of the 15 consecutive patients with U-shaped sacral fracture,the mean age was 28.8 years (range:15-55 years) at the time of injury.There were 6 females and 9 males.The mean followup time was 22.7 months (range:9-47 months) and mean full weight-bearing time was 9.9 weeks (range:8-14 weeks).Ten patients received lumbopelvic fixation and sacral decompression,one lombosacral fixation,and 4 merely sacral decompression due to delayed diagnosis or surgery.The post-operation deformity angle (mean 27.87°,and range:8°-90°) of the sacrum was smaller than that pre-operation (mean 35.67;range:15-90) with no significance difference noted.At the latest follow-up,all patients obtained neurological recovery with different extents.Visual analogue score (VAS) was reduced from preoperative 7.07 (range:5-9) to postoperetive 1.93 (range:1-3).All patients could walk without any aid after treatment.Eight patients were able to care for themselves and undertook some daily activities.Five patients had returned to work full time.In conclusion,lumbopelvic fixation is an effective method for stabilization of U-shaped sacral fractures with fewer complications developed.Effective reduction and firm fixation are the prerequisite of early mobilization and neurological recovery.Sacral decompression effectively promotes neurological recovery even in patients with old U-shaped sacral fractures.

Advances in research on pericolonic tumor deposits in colorectal cancer / 国际外科学杂志

It has been a problem in clinical practice that recurrence and distant metastasis of patients with colorectal cancer undergoing surgery.Recently,pericolonic tumor deposits has attracted extensive attention of scholars,and they think pericolonic tumor deposits may be closely related with colorectal cancer postoperative recurrence and metastasis.This review aims to introduce concept of pericolonic tumor deposits,pathological characteristics and its important role in clinical staging and prognosis,so as to provide clinical doctors medical advice to set more reasonable treatment and achieve the purpose of reducing tumor recurrence or metastasis for patients with colorectal cancer.

Risk factors analysis on wound complications after closed calcaneal frature operation using lateral extensive L-shaped incision / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the risk factors of wound complications after closed calcaneal fracture operation using a lateral extensive L-shaped incision and to explore the effective interventions to reduce the complications after incision.</p><p><b>METHODS</b>Retrospective analysis of clinical data of 285 patients(315 calcaneal fractures) who underwent open reduction and internal fixation by using the lateral extensive L-shaped incision from January 2011 to January 2015. Eighteen factors which might cause the complications of calcaneal incision were compared by univariate analysis, and multiple Logistic regression analysis was performed for factors with statistically significances.</p><p><b>RESULTS</b>Twenty-nine patients(30 calcaneus) had wound complications among all the 285 patients(315 calcaneus) after surgery, including 9 patients with incision redness, swelling, oozing or nonunion;16 patients with skin necrosis or incision rupture, 3 patients with soft tissue superficial infection, and 2 patients with osteomyelitis. Univariate analysis showed that fall height(=0.017), diabetes (=0.026), smoking(=0.001), and operative time(=0.003) were correlated with incision complications after surgery. Multivariate analysis showed that diabetes(=0.029), smoking(<0.001), and operative time(=0.018) were risk factors for incision complications after operation.</p><p><b>CONCLUSIONS</b>Preoperative smoking cessation, actively control of blood glucose and shortening the operation time by practicing can effectively reduce the incision complication after fracture surgery with the lateral extensive L-shaped incision.</p>

Promoter structures and differential responses to viral and non-viral inducers of chicken melanoma differentiation-associated gene 5.

Melanoma differentiation-associated gene 5 (MDA5) is a member of the retinoic acid-inducible gene I (RIG-I)-like receptors (RLRs) family and plays a pivotal role in the anti-viral innate immune response. As RIG-I is absent in chickens, MDA5 is hypothesized to be important in detecting viral nucleic acids in the cytoplasm. However, the molecular mechanism of the regulation of chicken MDA5 (chMDA5) expression has yet to be fully elucidated. With this in mind, a ∼2.5kb chMDA5 gene promoter region was examined and PCR amplified to assess its role in immune response. A chMDA5 promoter reporter plasmid (piggybac-MDA5-DsRed) was constructed and transfected into DF-1 cells to establish a Piggybac-MDA5-DsRed cell line. The MDA5 promoter activity was extremely low under basal condition, but was dramatically increased when cells were stimulated with polyinosinic: polycytidylic acid (poly I:C), interferon beta (IFN-ß) or Infectious Bursal Disease Virus (IBDV). The DsRed mRNA level represented the promoter activity and was remarkably increased, which matched the expression of endogenous MDA5. However, Infectious Bronchitis Virus (IBV) and Newcastle disease virus (NDV) failed to increase the MDA5 promoter activity and the expression of endogenous MDA5. The results indicated that the promoter and the Piggybac-MDA5-DsRed cell line could be utilized to determine whether a ligand regulates MDA5 expression. For the first time, this study provides a tool for testing chMDA5 expression and regulation.