Protective Mechanism of Paeoniflorin on Mice with Ulcerative Colitis Based on AMPK/mTOR Autophagy Pathway / 中国实验方剂学杂志

ObjectiveTo explore the protective mechanism of paeoniflorin on mice with ulcerative colitis （UC） through the adenosine monophosphate-activated protein kinase （AMPK）/mammalian target of rapamycin （mTOR） autophagy pathway. MethodUC mouse model was established by allowing mice freely drink 4% DSS， and 56 BALB/c male mice were randomly divided into model group， AMPK inhibitor group （20 mg·kg-1）， paeoniflorin （50 mg·kg-1） + inhibitor （20 mg·kg-1） group， and high dose （50 mg·kg-1）， medium dose （25 mg·kg-1）， and low dose （12.5 mg·kg-1） paeoniflorin groups. After seven days of drug intervention， the protective effect of paeoniflorin on mice with UC was determined by comparing the body weight， disease activity index （DAI） changes， and Hematoxylin-eosin （HE） staining results. Enzyme linked immunosorbent assay （ELISA） was used to detect the levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6） in the serum of mice in each group， and immunofluorescence was utilized to detect microtubule-associated protein 1 light chain 3 （LC3） content in the colon， AMPK， mTOR proteins， and their phosphorylated proteins including p-AMPK and p-mTOR in the colon tissue were detected by Western blot， and the mRNA expression levels of AMPK， mTOR， Beclin1， LC3， and p62 were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. ResultCompared with the blank group， the model group showed a decrease in body mass， an increase in DAI score， and severe pathological damage to the colon. The levels of inflammatory factors including TNF-α and IL-6 increased in serum （P<0.01）， while the protein levels of LC3 and p-AMPK/AMPK were down-regulated in colon tissue， and those of p-mTOR/mTOR were up-regulated （P<0.01）. The mRNA expression levels of AMPK and LC3 were down-regulated， while the mRNA expression levels of mTOR and p62 were up-regulated （P<0.01）. Compared with the model group and the paeoniflorin + inhibitor group， the mice treated with paeoniflorin showed an increase in body mass， a decrease in DAI score， a reduction in pathological damage to colon tissue， and a reduction in the levels of inflammatory factors of TNF-α and IL-6 in serum （P<0.05）. The protein levels of LC3 and p-AMPK/AMPK in colon tissue were up-regulated， while the protein levels of p-mTOR/mTOR were down-regulated （P<0.01）. The mRNA expression levels of AMPK， Beclin1， and LC3 were up-regulated， while the mRNA expression of mTOR and p62 were down-regulated （P<0.01）. The colon tissue of the inhibitor group was severely damaged， and the trend of various indicators was completely opposite to that of the high dose paeoniflorin group. ConclusionPaeoniflorin can enhance autophagy and reduce inflammatory damage in mice with UC by activating the AMPK/mTOR signaling pathway and thus play a protective role.

Electroacupuncture alleviates water avoidance stress-induced irritable bowel syndrome in mice by improving intestinal barrier functions and suppressing the expression of inflammatory cytokines.

OBJECTIVE: To evaluate the effects and related mechanisms of electroacupuncture (EA) on irritable bowel syndrome (IBS). METHODS: Male C57BL/6 mice were randomly allocated into normal, model, and EA groups. Experimental IBS mice models were established by exposure to water avoidance stress (WAS). Mice in the EA group were treated with EA at bilateral Tianshu (ST 25) and Zusanli (ST 36) for 7 consecutive days, 15 min each day. Abdominal withdrawal reflex (AWR) tests and intestinal motility tests were performed to evaluate visceral sensitivity and intestinal motility of mice. Expression levels of tight junction proteins (TJPs) and inflammatory cytokines in colon tissues were determined through immunofluorescence, real-time polymerase chain reactions (PCR) and Western blot assays. RESULTS: EA alleviated visceral hypersensitivity and intestinal hypermotility in WAS-induced IBS mice. Moreover, EA promoted the expression of zonula occludens (ZO)-1, claudin-1, and occludin while suppressing the expression of interleukin (IL)-8, interferon (IFN)-γ, and tumor necrosis factor (TNF)-αin water avoidance stress (WAS)-induced irritable bowel syndrome (IBS) mice. CONCLUSION: EA alleviated WAS-induced IBS in mice by promoting intestinal barrier functions and suppressing the expression of inflammatory cytokines.

Study on Clinical Application and Supervision of LC-MS in in Vitro Diagnosis Test / 中国医疗器械杂志

From the perspective of technical evaluation, this study reviewed the current situation of application and clinical application of medical device products were detected by liquid chromatography-tandem mass spectrometry in the market in recent years. The regulatory requirements of these products in China, USA, EU and Japan were compared and analyzed, and the monitoring situation of adverse events after listing, the standards for reference and the domestic and foreign regulatory documents were combined, the clinical application and regulatory risks of the product were analyzed. The problems such as pre-treatment, system matching, adequacy of performance index requirements, inter-room consistency, reference interval and registration unit were discussed and suggestions for supervision were given, with a view to the field of product R&D and production, review and approval of supervision to provide technical reference.

Preparation of static training animal models and research status analysis / 针灸推拿医学（英文版）

As a form of Tuina(Chinese therapeutic massage)Qigong exercises and an essential part of exercise therapy,static training has proven clinical efficacy.However,further evidence is required to reveal its mechanism of action provided by animal experiments.There are four major ways to establish static training animal models:pole climbing,hind-limb suspension,isometric-contraction weight bearing,and electrical stimulation.These models have been used to study diseases of the motor,circulatory,and endocrine systems,etc.,and the mechanism has got extensive exploration.It reviewed static training animal models and the research progress to provide theoretical evidence for static training's experimental research and mechanism exploration.

Electroacupuncture at Tianshu (ST25) and Zusanli (ST36) alleviates stress-induced irritable bowel syndrome in mice by modulating gut microbiota and corticotropin-releasing factor.

OBJECTIVE: To investigate whether electroacupuncture (EA) at bilateral Tianshu (ST25) and Zusanli (ST36) acupoints could alleviate stress-induced irritable bowel syndrome (IBS) and evaluate its effect on gut microbiota and corticotropin-releasing factor (CRF). METHODS: Thirty C57BL/6 mice were randomly divided into the normal, water avoidance stress (WAS), and WAS+EA groups (10 mice per group). An experimental model of IBS was established by exposing the animals to WAS. The mice were treated with EA at the bilateral Tianshu (ST25) and Zusanli (ST36) acupoints. The abdominal withdrawal reflex test was conducted to evaluate visceral sensitivity in IBS. Gut microbiota was analyzed using 16S rRNA sequencing and analysis. The expression of CRF was determined using immune-ofluorescence and quantitative real-time polymerase chain reaction. RESULTS: EA alleviated visceral hypersensitivity in a mouse model of WAS-induced IBS. It modulated the dysbiosis of gut microbiota induced by WAS. Moreover, it suppressed the WAS-induced overexpression of CRF in colon tissues. CONCLUSION: The findings of this study suggest that EA alleviated WAS-induced IBS mechanisms possibly involving the modulation of the dysbiosis of gut microbiota and suppression of CRF expression.

2D guided robot assisted TESSYS surgery for lumbar disc herniation / 中华骨科杂志

Objective:To compare the clinical efficacy of two-dimensional (2D) fluoroscopic guided robot-assisted and conventional TESSYS surgery in the treatment of lumbar disc herniation, the feasibility and precautions of 2D fluoroscopic guided robot-assisted TESSYS surgery were discussed.Methods:A retrospective analysis was performed on 34 male and 36 female patients aged 44.57±6.10 years (range 27 to 60 years) who received 2D guided robot-assisted TESSYS surgery and conventional TESSYS surgery from July 2019 to April 2020. 2D guided robot assisted TESSYS surgery group (the robot group) 32 cases, conventional TESSYS surgery (the conventional group) 38 cases. The number of puncture, number of fluoroscopy, puncture-channel time, operation time, visual analogue scale (VAS) and Oswestry disability index (ODI) before and after surgery and at the last follow-up were compared between the two groups to verify the clinical efficacy, and the complications were analyzed.Results:There were no significant differences in age, gender, body mass index, surgical level, Michigan State University (MSU) grading and average follow-up time between the robot group and the conventional group (all P>0.05). All patients completed surgery. The number of puncture times was 1.22±0.79 in the robot group and 4.66±1.86 in the conventional group, and the difference was statistically significant ( t=10.320, P<0.001). The number of fluoroscopy in the robot group was 10.97±1.96 times, and that in the conventional group was 17.45±4.30 times, the difference was statistically significant ( t=8.313, P<0.001). The puncture-channel time of the robot group was 10.66±3.62 min and that of the conventional group was 20.21±5.47 min, and the difference was statistically significant ( t=8.446, P<0.001). The operation time of the robot group was 62.25±6.68 min, and that of the conventional group was 72.89±10.48 min, the difference was statistically significant ( t=4.956, P<0.001). VAS scores of the robot group were 6.91±0.93 points before surgery, 2.97±0.65 points 1 d after surgery, and 1.53±0.51 points at the last follow-up, while those of the conventional group were 7.29±1.14 points before surgery, 2.89±0.56 points 1 d after surgery, and 1.42±0.50 points at the last follow-up. The ODI index of the robot group was 40.13%±1.54% before surgery, 17.28%±1.69% 1 day after surgery, and 10.84%±1.25% at the last follow-up, while that of the conventional group was 40.03%±1.46% before surgery, 17.42%±2.45% 1 day after surgery, and 10.92%±1.17% at the last follow-up. There were no statistically significant differences (all P>0.05). Two patients (6.3%) in the robot group and four (10.5%) in the conventional group had residual disc, there was no significant difference ( P>0.05). Conclusion:2D guided robot assisted TESSYS surgical treatment of lumbar disc herniation, which can plan puncture path in the stage of percutaneous target puncture, rigid guidance and accurate puncture target, and has obvious advantages in reducing puncture times and fluoroscopy times.

Epidemiological characteristics of traumatic spinal cord injury in China in 2018 / 中华创伤杂志

Objective:To analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods:Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions，9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018. National and regional incidence rates were calculated. The data of cause of injury，injury level，severity of injury，segment and type of fracture，complications，death and other data were collected by medical record questionnaire，and analyzed according to geographical region，age and gender.Results:Medical records of 4，134 patients were included in this study，with a male-to-female ratio of 2.99∶1. The incidence of traumatic spinal cord injury in China in 2018 was 50.484 / 1 million （95% CI 50.122-50.846）. The highest incidence in the Eastern region was 53.791 / 1 million （95% CI 53.217-54.365）. In the whole country，the main causes of injury were high falls （29.58%），as well as in the Western region （40.68%），while the main causes of injury in the Eastern and Central regions were traffic injuries （31.22%，30.10%）. The main injury level was cervical spinal cord in the whole country （64.49%），and the proportion of cervical spinal cord injury in the Central region was the highest （74.68%），and the proportion of lumbosacral spinal cord injury in the Western region was the highest （32.30%）. The highest proportion of degree of injury was incomplete quadriplegia （55.20%），and the distribution pattern was the same in each region. A total of 65.87% of the patients were complicated with fracture or dislocation，77.95% in the Western region and only 54.77% in the Central region. In the whole country，the head was the main combined injury （37.87%），as well as in the Eastern and Central regions，while the proportion of chest combined injury in the Western region was the highest （38.57%）. A total of 32.90% of the patients were complicated with respiratory complications. There were 23 patients （0.56%） died in hospital，of which 17（73.91%） died of respiratory dysfunction. Conclusions:The Eastern region of China has a high incidence of traumatic spinal cord injury. Other epidemiological features include high fall as the main cause of injury cervical spinal cord injury as the main injury level，incomplete quadriplegia as the main degree of injury，head as the main combined injury，and respiratory complications as the main complication.

TiO2 nanoparticles and multi-walled carbon nanotubes monitoring and bioremediation potential using ciliates Pseudocohnilembus persalinus.

In recent years, the release of nanomaterials pollutants to water bodies, to a great extent, attributed to anthropogenic activities. Their impacts on aquatic organisms as well as nanomaterial monitoring and bioremediation using organism have drawn much attentions. However, studies on relationship of nano-contaminants and aquatic organisms are very scarce. Our results showed that titanium dioxide nanoparticles (TiO2-NPs) and Multi-walled carbon nanotubes (MWCNTs) caused an obvious cell decreases on the whole, but a significant increase at 48 h TiO2-NPs exposure, indicating a resistant mechanism in ciliates for nano-toxic. Besides, MWCNTs was more toxic to Pseudocohnilembus persalinus than that of TiO2-NPs in terms of EC50 value. It is firstly found that P. persalinus ingested and released TiO2-NPs through cytostome and cytoproct, which might be the reason that TiO2-NPs less toxic than MWCNTs. The significantly increased superoxide dismutase (SOD) and glutathione S-transferase (GST) enzyme activities and expression levels were evaluated by reactive oxygen species ROS generation, which demonstrated that P. persalinus antioxidant defense enzyme played roles on nano-toxic resistant in ciliates. Moreover, the integrated biomarker response (IBR) was also determined, which demonstrated that MWCNTs had comparatively higher values than those of TiO2-NPs after higher concentration exposure to ciliates. In addition, it was confirmed by the present work that sod, gst and cat played different roles on immunity, and the sensitivity of cat gene expression to these two nanomaterials exposure was dissimilar. Damages of shrunk as well as losses of cilia on the cell surface caused by TiO2-NPs and MWCNTs exposure in P. persalinus using SEM revealed possible physical hazards of aggregated nanomaterials. Our findings will be helpful to understand the effect mechanisms of NPs on ciliates, and also demonstrated the possibility of P. persalinus as bio-indicator of nanomaterials in aquatic and potentials on bioremediation.

The clinical outcomes of percutaneous self-expanding forceful reduction screw system for the treatment of thoracolumbar fracture with severe loss of vertebral height / 中华骨科杂志

Objective To explore the safety and effectiveness of a novel percutaneous self-expanding forceful reduction screw system in the treatment of thoracolumbar fracture with severe vertebral height loss.Methods Thirty-eight patients of thoracolumbar fracture with more than 50％vertebral height loss were treated with the novel percutaneous self-expanding forceful reduction screw between March 2014 and June 2015.The screw system is a single plane screw with a reduction angle of 0,3,6,9 degrees.During the operation,the fracture vertebral body was automatically restored during the locking process of the top cap.All the patients were single vertebral fractures.Percutaneous screw fixation and reduction was used in the operation.Two groups of screws were used to fix the two adjacent vertebrae of the injured vertebra and to restore the injured vertebral body,without fusion treatment.The vertebral body index (VBI),height of the anterior margin of fractured vertebra (HAMFV),vertebral body angle (VBA),bisegmental Cobb angle (BCA),visual analog scale (VAS) and Oswestry disability index (ODI) of the patients before and after operation,6 months after operation,and at the end of the follow-up were compared.The scoring results were compared using a t test.Results The operation was completed successfully in 38 cases.A total of 152 screws were placed.The accuracy rate of CT evaluation was 98.7％.The average operation time was 90.7±21.9 min,and the average intraoperative bleeding amount was 89.2±31.9 ml.The patients' preoperative VBI,HAMFV,VBA,BCA,VAS and ODI scores were 0.38±0.07,0.38±0.06,25.45°±4.54°,18.66°± 8.57°,7.76± 1.02,and 44.58％±2.33％,respectively.The postoperative measurements were 0.93±0.03,0.95±0.02,3.71°± 1.35°,5.84°±6.80 °,4.29± 1.16 and 24.37％± 1.88％.At the last follow-up,the measurements were 0.92±0.03,0.94±0.02,3.89° ± 1.31 °,6.05°±7.00°,1.71 ±0.65 and 5.95％±2.67％.There was significant difference between the preoperative and postoperative data,as well as the preoperative and the last follow-up data (P＜0.05).Conclusion In the treatment of thoracolumbar fractures with severe loss of vertebral height,the novel percutaneous self-expanding forceful reduction screw system has achieved satisfactory vertebral height restoration and kyphosis correction.

The clinical outcomes of percutaneous self-expanding forceful reduction screw system for the treatment of thoracolumbar fracture with severe loss of vertebral height / 中华骨科杂志

Objective@#To explore the safety and effectiveness of a novel percutaneous self-expanding forceful reduction screw system in the treatment of thoracolumbar fracture with severe vertebral height loss.@*Methods@#Thirty-eight patients of thoracolumbar fracture with more than 50%vertebral height loss were treated with the novel percutaneous self-expanding forceful reduction screw between March 2014 and June 2015. The screw system is a single plane screw with a reduction angle of 0,3,6,9 degrees. During the operation, the fracture vertebral body was automatically restored during the locking process of the top cap. All the patients were single vertebral fractures. Percutaneous screw fixation and reduction was used in the operation. Two groups of screws were used to fix the two adjacent vertebrae of the injured vertebra and to restore the injured vertebral body, without fusion treatment. The vertebral body index (VBI), height of the anterior margin of fractured vertebra (HAMFV), vertebral body angle (VBA), bisegmental Cobb angle (BCA), visual analog scale (VAS) and Oswestry disability index (ODI) of the patients before and after operation, 6 months after operation, and at the end of the follow-up were compared. The scoring results were compared using a t test.@*Results@#The operation was completed successfully in 38 cases. A total of 152 screws were placed. The accuracy rate of CT evaluation was 98.7%. The average operation time was 90.7±21.9 min, and the average intraoperative bleeding amount was 89.2±31.9 ml. The patients' preoperative VBI, HAMFV, VBA, BCA, VAS and ODI scores were 0.38±0.07, 0.38±0.06, 25.45°±4.54°, 18.66°±8.57°, 7.76±1.02, and 44.58%±2.33%, respectively. The postoperative measurements were 0.93±0.03, 0.95±0.02, 3.71°± 1.35°, 5.84°±6.80 °, 4.29±1.16 and 24.37%±1.88%. At the last follow-up, the measurements were 0.92±0.03, 0.94±0.02, 3.89° ±1.31°,6.05°±7.00°, 1.71±0.65 and 5.95%±2.67%. There was significant difference between the preoperative and postoperative data, as well as the preoperative and the last follow-up data (P<0.05).@*Conclusion@#In the treatment of thoracolumbar fractures with severe loss of vertebral height, the novel percutaneous self-expanding forceful reduction screw system has achieved satisfactory vertebral height restoration and kyphosis correction.

Evaluation for the evolution of achilles tendinopathy and the feature of tendon biomechanics using quantitative analysis of tissue diffusion by ultrasound elastography / 中华超声影像学杂志

Objective To explore the application value of quantitative analysis of tissue diffusion by ultrasound elastography in evaluating the evolution of achilles tendinopathy and indirectly reflecting the feature of tendon biomechanics.Methods Rabbits underwent 0.1 ml (group M) or 0.3 ml (group S)collagenase or 0.2 ml saline (group C) injection.The percentage of area displaying blue (％AREA) in the area of interest was measured by the diffusion quantitative technique of ultrasound elastography at baseline and 1,3,7 and 14 days after model.The achilles tendon was obtained for pathological examination to observe the changes of collagen fibers and tested to measure the maximum tensile load by the universal testing machine.Results (1) The ％AREAs in group M and S at 1,3,7 and 14 days after model were smaller than those in group C (P ＜0.05),and reached its lowest value at 3 days after model.％ AREA in groupSwas significant lower than that in group M at 3 or 7 days after model (P ＜0.05).(2) The maximum tensile loads in group M at 1,3 and 7 days after model were smaller than those in group C (P ＜0.05),but there was no significant difference between group M and C at 14 days after model (P ＞0.05).The maximum tensile load in group S was significant lower than those in group M and C after model (P ＜0.05),and arrived its lowest point at 3 days after model.(3) The ％AREA was positively associated with the maximum tensile load of achilles tendon (r =0.87,P ＜0.001).Conclusions Ultrasound elastography can dynamically monitor the evolution of achilles tendinopathy and reflect the biomechanical state of achilles tendon.

Knee cartilage and synovial lesions：misconceptions and discrimination of ultrasonic diagnosis / 中国组织工程研究

BACKGROUND:The knee joint acts as the body’s largest and most complex joint, which is a commonly seen perplex in patients because of synovium and cartilage diseases. Moreover, clinical physicians are often confused on the ultrasonic diagnosis of synovium and cartilage diseases. OBJECTIVE: To review the ultrasound misdiagnosed cases of knee cartilage and synovial lesions and to summarize the common misconceptions and discrimination methods. METHODS: A retrospective analysis was performed in the ultrasound misdiagnosed cases of knee cartilage and synovial lesions reported from 2002 to 2014, and then the common misconceptions and corresponding identification methods were summarized. RESULTS AND CONCLUSION: High-frequency ultrasound is most likely to have six “mistaken ideas” addressing knee cartilage and synovial lesions: (1) cartilage degeneration; (2) synovial calcification; (3) echo intensity from synovial lesions; (4) blood flow in the synovium; (5) synovial effusion; (6) lesions involving intraarticular structures. High-frequency ultrasound runs through dynamical observation and contrast observation of bilateral knee joint lesions, which is a valuable imaging method for diagnosis of cartilage and synovial diseases based on vigilance at the “mistaken ideas” and mastery of the distinguishing ideas and methods.

Effect of Intravenous rhBNP on Regional Myocardium Deformability in Patients With Anterior Acute Myocardial Infarction After Primary Percutaneous Coronary Intervention / 中国循环杂志

Objective: To explore the effect of intravenous recombinant human brain natriuretic peptide (rhBNP) on regional myocardium deformability in patients with anterior acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI). Methods: A total of 35 patients with anterior AMI who received primary PCI within 12 hours of symptom onset in our hospital from 2013-06 to 2013-12 were enrolled in this study and randomized into 2 groups: rhBNP group, the patients received intravenous rhBNP,n=18, Control group, the patients received standard intravenous nitrates,n=17, and the intravenous pumping administration maintained for 72 hours in both groups. The echocardiography was conducted at immediately, 7 days and 1 month after PCI respectively to compare the relative parameters. The occurrence of major adverse cardiac events (MACE) were followed-up for 6 months in all patients. Results: The baseline condition was similar between the two groups,P>0.05 , the parameters of echocardiography as LVEF and WMSI at immediately and 7 days after PCI were similar between the two groups,P>0.05. Compared with Control group, rhBNP group had the increased LVEF and decreased WMSI at 1 month after PCI ,P0.05; SRs, SEe and Sra were increased at 1 month after PCI, allP0.05. Conclusion: Intravenous administration of rhBNP could improve the regional myocardium deformability and the systolic/diastolic function in patients with anterior AMI after primary PCI.