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Magnesium and its alloys have been widely studied in the field of orthopaedics for their desirable mechanical properties, biodegradability and biocompatibility. However, the rapid degradation rate of magnesium and its alloys cannot match the healing process of bone itself, and may adversely affect the adhesion, growth and differentiation of surrounding cells, resulting in early loosening of implants, thus limiting their wide clinical application. Surface coating modification is a feasible and promising anti-corrosion solution to solve the problem of uncontrollable corrosion rate of magnesium implants. The surface coating modification technology can optimize the integration of the bone-implant interface by improving the bone induction ability of the implant surface (such as the bio-mimetic coating based on phosphate ceramics) or improving the corrosion resistance (such as the micro-arc oxidation coating with wear resistance and corrosion resistance, and the phytic acid coating with self-healing potential). While optimizing the degradation rate of magnesium implant, it can also realize multiple functions such as promoting osseointegration, drug delivery and photothermal therapy through composite component modification. In this paper, the advantages and disadvantages of different coating modification method on the surface of orthopaedic magnesium implants are comprehensively illustrated, and the key technologies in each preparation process are summarized and the composite modification methods are further discussed, so as to provide references for the preparation of multifunctional magnesium implants that meet the requirements of orthopaedic applications.
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BACKGROUND@#The hemoglobin glycation index (HGI) was developed to quantify glucose metabolism and individual differences and proved to be a robust measure of individual glycosylated hemoglobin (HbA1c) bias. Here, we aimed to explore the relationship between different HGIs and the risk of 5-year major adverse cardiovascular events (MACEs) by performing a large multicenter cohort study in China.@*METHODS@#A total of 9791 subjects from the Risk Evaluation of Cancers in Chinese Diabetic Individuals: a Longitudinal Study (the REACTION study) were divided into five subgroups (Q1-Q5) with the HGI quantiles (≤5th, >5th and ≤33.3th, >33.3th and ≤66.7th, >66.7th and ≤95th, and >95th percentile). A multivariate logistic regression model constructed by the restricted cubic spline method was used to evaluate the relationship between the HGI and the 5-year MACE risk. Subgroup analysis between the HGI and covariates were explored to detect differences among the five subgroups.@*RESULTS@#The total 5-year MACE rate in the nationwide cohort was 6.87% (673/9791). Restricted cubic spline analysis suggested a U-shaped correlation between the HGI values and MACE risk after adjustment for cardiovascular risk factors ( χ2 = 29.5, P <0.001). After adjustment for potential confounders, subjects with HGIs ≤-0.75 or >0.82 showed odds ratios (ORs) for MACE of 1.471 (95% confidence interval [CI], 1.027-2.069) and 2.222 (95% CI, 1.641-3.026) compared to subjects with HGIs of >-0.75 and ≤-0.20. In the subgroup with non-coronary heart disease, the risk of MACE was significantly higher in subjects with HGIs ≤-0.75 (OR, 1.540 [1.039-2.234]; P = 0.027) and >0.82 (OR, 2.022 [1.392-2.890]; P <0.001) compared to those with HGIs of ≤-0.75 or >0.82 after adjustment for potential confounders.@*CONCLUSIONS@#We found a U-shaped correlation between the HGI values and the risk of 5-year MACE. Both low and high HGIs were associated with an increased risk of MACE. Therefore, the HGI may predict the 5-year MACE risk.
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Humans , Cohort Studies , Longitudinal Studies , Diabetes Mellitus, Type 2/diagnosis , Maillard Reaction , Glycated Hemoglobin , Cardiovascular DiseasesABSTRACT
Cold-chain environment could extend the survival duration of SARS-CoV-2 and increases the risk of transmission. However, the effect of clod-chain environmental factors and packaging materials on SARS-CoV-2 stability and the efficacy of intervention measures to inactivate SARS-CoV-2 under cold-chain environment remains uncertain. This study aimed to unravel cold-chain environmental factors that preserved the stability of SARS-CoV-2 and disinfection measures against SARS-CoV-2 under the cold-chain environment. The spike gene of SARS-CoV-2 isolated from Wuhan hu-1 was used to construct the SARS-CoV-2 pseudovirus and used as model of the SARS-CoV-2 virus. The decay rate of SARS-CoV-2 pseudovirus in the cold-chain environment, various types of packaging material surfaces i.e., PE plastic, stainless steel, Teflon and cardboard, and in frozen seawater was investigated. The influence of LED visible light(wavelength 450 nm-780 nm) and airflow movement on the stability of SARS-CoV-2 pseudovirus at -18{degrees} C were subsequently assessed. The results show that SARS-CoV-2 pseudovirus decayed more rapidly on porous cardboard surface compared with the non-porous surfaces including PE plastic, stainless steel and Teflon. Compared with 25{degrees} C, the decay rate of SARS-CoV-2 pseudovirus was significantly lower at low temperature. Seawater preserved viral stability both at -18{degrees} C and repeated freeze-thawing cycles compared with deionized water. LED visible light illumination and airflow movement environment at -18{degrees} C reduced the SARS-CoV-2 pseudovirus stability. In conclusion, our results indicate cold-chain temperature and seawater as risk factors for SARS-CoV-2 transmission and LED visible light illumination and airflow movement as possible disinfection measures of SARS-CoV-2 under the cold-chain environment. ImportanceIt is widely recognized that low temperature is a condition for maintaining virus vitality, and cold-chain transportation spreads the events of the SARS-CoV-2 were reported. This study provides that the decay rate of the SARS-CoV-2 pseudovirus at low temperatures varies on different packaging materials, and salt ions present in frozen foods such as seafood may protect virus survival. These results provide evidence for the possibility of SARS-CoV-2 transmission through cold-chain transport and also suggest the importance for disinfection of items. However, the commonly used disinfection methods of ultraviolet radiation and chemical reagents are generally not suitable for the disinfection of frozen food. Our study shows LED visible light illumination and airflow movement as possible disinfection measures of SARS-CoV-2 under the cold-chain environment. This has implications for reducing the long-distance transmission of the virus through cold-chain transportation.
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Objective:To observe the relationship between inducible carbon monoxide synthase (iNOS) and delayed encephalopathy after acute carbon monoxide poisoning (DEACMP), and explore its mechanism of action in DEACMP.Methods:This study was designed as prospective cohort study. Patients with acute carbon monoxide poisoning who met the diagnostic criteria and were admitted to Emergency Intensive Care Unit(EICU) of our hospital from June 2019 to June 2021 were selected as subjects. Patients were divided into the DEACMP group and non-DEACMP group according to the occurrence of DEACMP. Serum samples were collected on the first 24 h after admission and on day 7 and 14 after admission, and the serum nitric oxide (NO), neuronal nitric oxide synthase (nNOS), inducible carbon monoxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS) level were measured by enzyme-linked immunosorbent assay. The generalized estimating equation was used to estimate the difference of NO, nNOS, iNOS and eNOS between DEACMP and non-DEACMP patients.Results:A total of 78 patients with carbon monoxide poisoning were included in our study finally, including 49 (62.82%) males and 29 (37.18%) females, with an average age of (53.96±14.95) years, 20 (25.64%) patients with DEACMP, and 1 (1.28%) death. Univariate analysis showed that patients with DEACMP had an average increase of 3 h (95% CI: 1.00, 5.00) in carbon monoxide exposure time and a 5-point decrease in GCS score (95% CI: 1.00, 6.00) than the patients without DEACMP, and the proportion of patients with severe carbon monoxide poisoning in the DEACMP group was higher than that of the non-DEACMP group (90.00% vs. 32.76%). According to the analysis of generalized estimation equation, on day 7 and 14 after admission, Compared with non-DEACMP patients, neither by performing unadjusted nor adjusted analysis with the iNOS of DEACMP patients was significantly higher than that in non-DEACMP patients regardless of whether exposure time, GCS score, coma time or severity of carbon monoxide poisoning were adjusted or not ( P <0.01 or P <0.05). Except for the level of nNOS in the GEE model adjusted with carbon monoxide exposure time, the levels of NO, nNOS and eNOS showed no significant difference between DEACMP and non-DEACMP patients ( P >0.05). Conclusions:The expression of iNOS level is increased in DEACMP patients, and its continuous expression may be involved in the pathogenesis of DEACMP.
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Objective:To detect the expression of iNOS and nNOS in delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and their correlation with hippocampal neuron degeneration and necrosis, and to explore iNOS and nNOS in DEACMP.Methods:Seventy-two adult male SD rats were selected and randomLy(random number) divided into the DEACMP group and normal group, with 36 rats in each group. The rats were given intraperitoneal injection of 99.99% CO gas without intervention. According to different time periods before and after dying and modeling, the two groups were divided into 6 subgroups: pre-modeling, 1 d modeling, 7 d modeling, 14 d modeling, 21 d modeling, and 28 d modeling. In 6 subgroups during the modeling time, HE staining was performed to observe neuron degeneration and necrosis in hippocampal CA3 area, and immunohistochemistry and Western blot were performed to detect the protein expression of iNOS and nNOS in hippocampus. Statistical analysis was performed using SPSS 21.0 software. The measurement data were expressed as Mean±SD, and normality test and variance analysis were performed on the experimental results of each group. The mean comparison between each group adopted the Student’s t test of two independent samples. Correlation analysis was conducted between the relative expression of iNOS and nNOS protein and the degenerative necrotic neurons, Pearson correlation analysis was used for normal distribution, and Spearman rank correlation analysis was used for non-normal distribution. A P<0.05 was considered as statistically significant. Results:There was no significant difference in the counts of hippocampal neuron degeneration and necrosis between the two groups before modeling, on 1 d, and 7 d modeling ( P>0.05), while there were significant differences between the two groups on 14 d, 21 d, and 28 d modeling ( P<0.05). There was no statistically significant difference in the expression of nNOS protein between the two groups of rats before modeling, on 21 d, and 28 d modeling ( P>0.05), while there were statistical differences between the 1 d modeling, 7 d modeling, and 14 d modeling ( P<0.05). There was no statistically significant difference in the expression of iNOS protein between the two groups of rats before and 1 day after modeling ( P>0.05), while there were statistically significant differences between the 7 d modeling, 14 d modeling, 21 d modeling and 28 d modeling ( P<0.05). Correlation analysis between the expression of iNOS protein and the count of degenerated and necrotic neurons showed a positive correlation ( P<0.05). There was no correlation between the expression of nNOS protein and the count of degenerated and necrotic neuron ( P>0.05). Conclusions:iNOS plays an important role in the pathogenesis of DEACMP; nNOS is not consistently highly expressed in the hippocampus of DEACMP, and has no correlation with neuronal degeneration and necrosis in the CA3 region of the hippocampus.
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This article reported a case of malignant pheochromocytoma and paraganglioma with cranial metastasis. The patient was a 25-year-old man. At the age of 10, he was diagnosed with retroperitoneal paraganglioma. He received radiotherapy after partial resection of the tumor. At the age of 15, when he consulted for headache and hypertension, a space occupying lesion was found on the right adrenal without further diagnosis and treatment. His headache and hypertension were aggravated at the age of 25. Then he visited our medical center and diagnosed with right adrenal pheochromocytoma. He undertook an operation to remove the right adrenal lesion, and his blood pressured could be controlled in the normal range with oral antihypertensive medication. One year after the surgery, a cranial lesion with positive 131I-metaiodobenzylguanidine imaging was found following the increase of norepinephrine and dopamine in both blood and urine. The diagnosis of malignant pheochromocytoma with cranial metastasis was confirmed. The cranial lesion was treated with cyberknife therapy for 4 times, and the lesion was slightly reduced. Four year after the removal of right adrenal tumor, he developed multiple bone metastasis in the right ribs and left ilium, and then he received 131I-metaiodobenzylguanidine radiotherapy. Additionally, the results of gene test indicated a pathogenic mutation of SDHB. During the follow-up period of one year after the treatment, his blood pressure fluctuated to about 140/90mmHg with 10mg of phenoxybenzamine once a day. The case is a malignant pheochromocytoma with multiple bone metastasis characterized by a long course with an ideal prognosis in a way. Consequently, we suggested the diagnostic pathway with genetic testing based on clinical phenotype to approach more timely diagnosis and reasonable evaluation of the prognosis in pheochromocytoma and paraganglioma. Furthermore, clinicians should pay more attention to the long-term surveillance.
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Objective@# To investigate the epidemic status and influencing factors of colorectal polyps among urban residents in Lanxi.@*Methods@# A representative urban community was selected from Lanxi. A total of 935 local residents aged 18-80 years received questionnaire survey,physical examination,laboratory tests and colonoscopy. Multivariate Logistic regression analysis was applied to exam the potential influencing factors for colorectal polyps.@*Results @#Eventually 880 residents were involved into the statistical analysis. Colorectal polyps were detected in 167 participants with a crude prevalence of 18.98% and adjusted prevalence for age and gender of 13.28%. The prevalence of colorectal polyps in men(28.70%)was significantly higher than that in women(12.92%,P<0.05). The results of logistic regression analysis showed that age(OR=1.038,95%CI:1.018-1.057),males(OR=1.919,95%CI:1.303-2.826),the middle school level of education(OR=2.443,95%CI:1.507-3.961)and constitution of Yin-Asthenia(OR=0.203,95%CI:0.057-0.720)were influencing factors for colorectal polyps;among male participants,hypertension(OR=1.721,95%CI:1.018-2.908)was a risk factor for colorectal polyps;among female participants,age(OR=1.076,95%CI:1.042-1.111),BMI(OR=1.099,95%CI:1.001-1.207),the middle school level of education(OR= 3.507,95%CI:1.794-6.856)and constitution of Yin-Asthenia(OR=0.160,95%CI:0.033-0.770)were influencing factors for colorectal polyps.@*Conclusion @#Age,sex,education level and constitution of Yin-Asthenia were associated with the risk of colorectal polyps among residents in Lanxi;hypertension was associated with the risk of colorectal polyps in males,while age,BMI,education level and constitution of Yin-Asthenia were associated with the risk of colorectal polyps in females.
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OBJECTIVE@#To investigate the prehospital intervention based on emergency medical services (EMS) in patients with acute ischemic stroke (AIS) for door-to-needle time (DNT) with intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) impact.@*METHODS@#112 emergency patients receiving rt-PA intravenous thrombolysis admitted to the First Hospital of Qinhuangdao City based on EMS from June 2016 to December 2017 were enrolled. According to whether or not to receive prehospital interventions, patients were divided into prehospital intervention group (n = 42) and routine treatment group (n = 70). Both groups followed the general principles of first aid, including assessment and support of the airway, respiration, and circulation, and blood glucose, electrocardiogram, and dynamic vital signs were monitored. Based on the general principle of EMS, first-aid personnel in the prehospital intervention group screened suspected acute stroke patients requiring prehospitalization according to Los Angeles prehospital stroke screening table (LAPSS), and established fluid ways, and got blood samples to evaluate rt-PA intravenous thrombolysis and risks. Factors influenced DNT compliance were analyzed through multivariate Logistic regression, which included the education level of the patient, whether there were risk factors related to cerebrovascular disease (hypertension, coronary heart disease, diabetes), visit time, National Institute of Health stroke scale (NIHSS) score, whether received EMS intervention or not. The average DNT, DNT ≤ 60 minutes compliance rate, communication time, and decision time for thrombolysis were compared between the two groups. NIHSS score was used to evaluate the effective rate of thrombolysis for 7 days. The modified Rankin score (mRs) was used to evaluate the neurological function after 3 months of thrombolysis (a mRs score of 0-2 was defined as a good nerve function).@*RESULTS@#Univariate analysis showed that the DNT of patients with NIHSS score > 5 was significantly shorter than those with NIHSS score ≤ 5, and DNT in patients received EMS intervention was significantly shorter than the non-receiver; but education level, visiting time, and risk factors associated with cerebrovascular disease had nothing to do with DNT. Multivariate Logistic regression analysis showed that NIHSS score and EMS intervention were the influencing factors of DNT compliance [NIHSS score: odds ratio (OR) = 0.452, 95% confidence interval (95%CI) = 0.162-1.263, P = 0.030; EMS intervention: OR = 3.077, 95%CI = 1.260-7.514, P = 0.014]. Compared with conventional treatment group, DNT of intravenous thrombolytic in prehospital intervention group was significantly shortened (minutes: 62.00±11.07 vs. 78.03±21.04), DNT ≤ 60 minutes compliance rate was significantly increased [35.7% (15/42) vs. 12.9% (9/70)], communication time [minutes: 4 (3, 6) vs. 6 (5, 9)] and decision-making thrombolytic time (minutes: 5.81±2.48 vs. 6.70±2.15) were significantly shortened, the differences were statistically significant (all P < 0.05). The 7-day effective rate in the prehospital intervention group [33.3% (14/42) vs. 14.3% (10/70), χ2 = 5.657, P = 0.017] and the 3-mouth good rate of nerve function [38.1% (16/42) vs. 14.3% (10/70), χ2 = 10.759, P = 0.001] were significantly higher than those in the conventional treatment group.@*CONCLUSIONS@#Prehospital interventions based on EMS can shorten DNT of intravenous thrombolysis in the patients with AIS, improve treatment efficiency, and improve prognosis.
Subject(s)
Humans , Brain Ischemia , Emergency Medical Services , Stroke , Thrombolytic Therapy , Tissue Plasminogen Activator , Treatment OutcomeABSTRACT
Objective@#To investigate the prehospital intervention based on emergency medical services (EMS) in patients with acute ischemic stroke (AIS) for door-to-needle time (DNT) with intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) impact.@*Methods@#112 emergency patients receiving rt-PA intravenous thrombolysis admitted to the First Hospital of Qinhuangdao City based on EMS from June 2016 to December 2017 were enrolled. According to whether or not to receive prehospital interventions, patients were divided into prehospital intervention group (n = 42) and routine treatment group (n = 70). Both groups followed the general principles of first aid, including assessment and support of the airway, respiration, and circulation, and blood glucose, electrocardiogram, and dynamic vital signs were monitored. Based on the general principle of EMS, first-aid personnel in the prehospital intervention group screened suspected acute stroke patients requiring prehospitalization according to Los Angeles prehospital stroke screening table (LAPSS), and established fluid ways, and got blood samples to evaluate rt-PA intravenous thrombolysis and risks. Factors influenced DNT compliance were analyzed through multivariate Logistic regression, which included the education level of the patient, whether there were risk factors related to cerebrovascular disease (hypertension, coronary heart disease, diabetes), visit time, National Institute of Health stroke scale (NIHSS) score, whether received EMS intervention or not. The average DNT, DNT ≤ 60 minutes compliance rate, communication time, and decision time for thrombolysis were compared between the two groups. NIHSS score was used to evaluate the effective rate of thrombolysis for 7 days. The modified Rankin score (mRs) was used to evaluate the neurological function after 3 months of thrombolysis (a mRs score of 0-2 was defined as a good nerve function).@*Results@#Univariate analysis showed that the DNT of patients with NIHSS score > 5 was significantly shorter than those with NIHSS score≤5, and DNT in patients received EMS intervention was significantly shorter than the non-receiver; but education level, visiting time, and risk factors associated with cerebrovascular disease had nothing to do with DNT. Multivariate Logistic regression analysis showed that NIHSS score and EMS intervention were the influencing factors of DNT compliance [NIHSS score: odds ratio (OR) = 0.452, 95% confidence interval (95%CI) = 0.162-1.263, P = 0.030; EMS intervention: OR = 3.077, 95%CI = 1.260-7.514, P = 0.014]. Compared with conventional treatment group, DNT of intravenous thrombolytic in prehospital intervention group was significantly shortened (minutes: 62.00±11.07 vs. 78.03±21.04), DNT≤60 minutes compliance rate was significantly increased [35.7% (15/42) vs. 12.9% (9/70)], communication time [minutes: 4 (3, 6) vs. 6 (5, 9)] and decision-making thrombolytic time (minutes: 5.81±2.48 vs. 6.70±2.15) were significantly shortened, the differences were statistically significant (all P < 0.05). The 7-day effective rate in the prehospital intervention group [33.3% (14/42) vs. 14.3% (10/70), χ2 = 5.657, P = 0.017] and the 3-mouth good rate of nerve function [38.1% (16/42) vs. 14.3% (10/70), χ2 = 10.759, P = 0.001] were significantly higher than those in the conventional treatment group.@*Conclusion@#Prehospital interventions based on EMS can shorten DNT of intravenous thrombolysis in the patients with AIS, improve treatment efficiency, and improve prognosis.
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Objective To compared hemostatic effect of agkistrodon haemocoagulase and other hemostatic agents in hepatectomy,and observe clinical safety.Methods From November 2014 to February 2016,122 patients undergoing hepatectomy of the department of hepatobiliary surgery in the hospital,according to the inclusion and exclusion criteria,were randomly divided into three groups,which was group A-haemocoagulase agkistrodon for injection,group B-ferdelance haemocoagulase for injection and group Cdesmopressin acetate injection.After drug administration,according to the clinical research plan,the indexes for therapeutic effectsbleeding time of wound,bleeding volume of wound,postoperative drainage volume for 24 h,preoperative and postoperative safety indices-Routine blood test,clotting function,liver and kidney function were compared among the three groups.Results The general data of the 3 groups were comparable.The bleeding time of wound,bleeding volume of wound,postoperative drainage volume for 24 h showed no significant difference(P>0.05).Routine blood test,coagulation function,liver and kidney function,pre-admi nistration and post-administration administration of the group on the third day between and within groups were compared and showed no significant difference(P>0.05).ECG and lower extremity ultrasound examination showed no abnormality in each group.No adverse events happened in the cases of groups for the clinical study.Conclusion Hemostatic effects of haemocoagulase agkistrodon for injection and other hemostatic drugs were similar in hepatectomy.No sinificant adverse effects on postoperative routine blood,coagulation function,liver and kidney function,with good efficacy and safety,being worthy of using widely worth in hepatectomy.
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Objective To explore the relationship of miR-34b/c gene polymorphisms and event-related potential P300 in major depressive disorder.Methods The design of case-control research was used,and 302 major depressive patients and 327 normal controls who were in age and gender matched with patients were measured auditory event-related potential P300 on the day when two groups were collected.Polymerase chain reaction(PCR) and direct DNA sequencing technology were used to detect miR-34b/c gene polymorphisms.Results (1) In the single locus analysis,the rs4938723,rs2187473 and rs28757623 had no significant difference in allele frequency and genotype frequency between depressive patients and controls (P> 0.05);Haplotype C-C-C in rs4938723-rs2187473-rs28757623 was statistically significant different in depressive patients and controls(x2 =3.96,P=0.046).The odds ratio (OR) was 1.322(95%CI=1.004-1.740).(2) Compared with normal controls,P300 of the patients with major depressive disorder had longer latency of N2 (P<0.01),P3a (P<0.01) and P3b (P<0.05).(3) The P300 targets of major depressive disorder had statistical difference(P<0.05)in rs28757623 between the individuals with the G allele genotype and C/C genotype.The latency of N1 ((90.80±28.62) ms),P3a((281.79±37.89) ms),P3b((323.87±41.17) ms) were longer thanC/C genotype ((77.40 ± 20.96) ms,(253.00 ± 34.36) ms,(297.30± 23.70) ms).Conclusion Rs4938723-rs2187473-rs28757623 haplotype CCC in miR-34b/c gene might be risk factor for the onset of depression,miR-34b/c gene rs28757623 polymorphism is associated with the principal component of P300 latency in patients with Major depressive disorder which suggest that genetic factors may have a certain impact on cognitive function in the patients with major depressive disorder.
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Aim To investigate whether the pain modi-fication by group I metabotropic glutamate receptors (mGluRs)required the involvement of Src homology-2 domain-containing phosphatase-2 (SHP-2 ).Methods Co-immunoprecipitation was performed to examine the possible interaction between SHP-2 and group I mGluRs in spinal cord dorsal horn of mice.By measur-ing the paw withdrawal thresholds,the effects of SHP-2 inhibitor NSC-87877 or its catalytically inactive SHP-2 (C459S ) mutant on allodynia induced by group I mGluRs agonist DHPG (50 nmol)were observed.Re-sults Anti-mGluR5 antibody was able to co-immuno-precipitate SHP-2 from spinal dorsal horn of mice, while no SHP-2 was precipitated by anti-mGluR1 anti-body.Inactivation of SHP-2 by NSC-87877 (6 nmol) or SHP-2 (C459S ) effectively attenuated allodynia caused by DHPG.Conclusion SHP-2 can physically interact with mGluR5.The activation of SHP-2 may be necessary for group I mGluRs to process the nocicep-tive information.
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BACKGROUND:Being used in senile intertrochanteric fracture, the third generation of Gamma nail may isolate fracture fragments and it is difficult to be secured in the rotor, so the stability is poor. Varus deformity easily appears, which is difficult to support or satisfactorily reset. OBJECTIVE:To compare the effects and stability of the proximal femoral locking plate and the third generation of the gamma nail in the treatment of stable intertrochanteric fracture. METHODS:(1) A total of 64 patients with intertrochanteric fractures were respectively treated with the third generation of the gamma nail fixation (n=32) and proximal femoral locking plate fixation (n=32). Fracture reduction and healing were assessed using anteroposterior and lateral radiographs. Femoral rotor varus angle and intertrochanteric medial inclination received biomechanical measurement. (2) Eight femoral specimens whose shape and size were approximated were selected to be randomly assigned to Gamma 3 group and proximal femoral locking plate group (n=4), which respectively received Gamma 3 fixation and proximal femoral locking plate fixation. After axial compression test and destruction test, load-displacement curve was drawn. The maximum yield load value was calculated by torsion test. RESULTS AND CONCLUSION:Operative time and intraoperative blood loss were significantly more in the proximal femoral locking plate group than in the Gamma 3 group (P < 0.05). The fracture quality assessment results were better in the proximal femoral locking plate group than in the Gamma 3 group (P < 0.05). The axial stiffness and corresponding torque of various torsion angles were smaler in the proximal femoral locking plate group than in the Gamma 3 group (P < 0.05). Experimental results indicated that in the course of fixating intertrochanteric fracture merged with greater trochanter fracture, the proximal femur locking plate has obtained more biomechanical stability.
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Hot melt extrusion (HME) is an effective method to make the drugs form amorphous solid dispersions (ASD) in microstructure, through which we can improve the dissolution behavior so as to improve the bioavailability of hydrophobic drugs. This review mainly focuses on the screening of active pharmaceutical ingredients and polymer carriers, feasibility evaluation of the technique, and the control of key parameters of preparation process, summarizes the application of HME to develop drug delivery system.
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Objective To explore the clinical value of gonadotropin-releasing hormone analogue (GnRH-a) by analyzing the efficiency of GnRH-a treatment for moderate and severe endometriosis after laparoscopic conservative operations.Methods Two hundred and sixty-five females who accepted laparoscopic conservative operation were enrolled in this study,and they were confirmed by pathology for ovarian endometriosis cyst,in phase Ⅲ andⅣ,47 patients had fertility desire.According to whether use the drug and auxiliary species the postoperative cases were divided into 5 groups:102 cases without endocrinal therapy(untreated group),GnRH-a group of 3 months in 64 cases,GnRH-a group of 6 months in 31 cases;gestrinone group of 3 months in 38 cases,and gestrinone group of 6 months in 30 cases.All patients were followed up for 2 years,observed drug clinical effects,remission rate,improvement rate,recurrence rate,pregnancy outcomes and side effects.Results The remission rate in GnRH-a group of 6 months and gestrinone group of 6 months was significantly higher than that in untreated group [83.9% (26/31),73.3% (22/30) vs.52.9%(54/102)],the remission rate in GnRH-a group of 6 months was significantly higher than that GnRH-a group of 3 months [64.1% (41/64)],there was significant difference (P < 0.05).The recurrence rate in GnRH-a group of 3 months,GnRH-a group of 6 months,gestrinone group of 6 months was significantly lower than that in untreated group [12.5% (8/64),9.7% (3/31),10.0% (3/30) vs.27.5% (28/102)] (P < 0.05).The recurrence rate in gestrinone group of 6 months was significantly lower than that in gestrinone group of 3 months (P < 0.05).The recurrence time of GnRH-a group of 3 months,GnRH-a group of 6 months,gestrinone group of 6 months was significantly longer than that in untreated group [(14.05 ± 1.97),(16.76 ± 1.53),(16.12 ±2.15)months vs.(12.85 ± 1.80)months] (P <0.05).The recurrence time of gestrinone group of 3 months and untreated group had no significant difference(P > 0.05).The pregnancy rate of GnRH-a group and gestrinone group was higher than that in untreated group,but there was no significant difference (P > 0.05).The rate of menopausal symptom in GnRH-a group was higher than that in gestrinone group [50.5% (48/95) vs.16.2% (11/68)].The rate of abnormal bleeding in vagina,acne and side-effect of aminotransferase in GnRH-a group were significantly lower than those in gestrinone group [1.1%(1/95) vs.7.4%(5/68),0 vs.8.8%(6/68),0 vs.5.9%(4/68)](P< 0.05).Conclusions Laparoscopic conservative operations combined with GnRH-a on treatment of moderate and severe ovarian endometriosis can significantly improve remission rate,decrease recurrence rate.GnRH-a or gestrinone for 6 months,the pregnancy rate increases.In addition the side reactions of the two medicine have statistic difference,which of GnRH-a is lower.
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Objective:To investigate the feasibility and efficacy of focused ultrasound surgical clamp(FUSC)for partial hepatectomy,and find out the enhancement effect of SonoVue to FUSC.Methods:Twelve healthy goats were randomly divided into a FUSC group(n=6)in which FUSC was only used for the liver ablation,and a SonoVue + FUSC group(n=6)in which FUSC was performed immediately after iv injection of ultrasound contrast agent SonoVue.A FUSC was comprised of two ultrasound transducers fixed on a forceps-like handle.The directions of focused ultrasound beams produced by both transducers were opposite,with the same central axes.Ultrasound energy was continuously delivered by two transducers to ablate liver tissue located between both transducers.The frequency was 1.6 MHz,and the acoustic power was 150 W.All goats in both groups underwent laparotomy,and then the liver was totally exposed for an ablative procedure.Blood loss,FUSC exposure time,operation time required for the hepatectomy and the cross-section area of the resected liver were recorded.Histological changes were observed in the removed liver,and 10ml blood samples were collected in each goat to measure blood cells and hepatic functions after surgical procedure.All goats were followed up for complications and survival.Results:After surgical procedure,all animals survived well,and no complications were observed during follow-up period.Mean blood loss and mean exposure time were(16.9?4.2)ml and(174?9)s in the FUSC group,and(16.3?3.5)ml and(122?9)s in the SonoVue+FUSC group respectively.A statistical difference of average FUSC exposure time per unit area(P0.05)in both groups.Pathological examination showed coagulation necrosis of the targeted liver tissue,and small blood vessels were severely destroyed,with the occlusion of the ablated vessels.There was a transient increase of serum ALT,AST,TB and DB levels postoperatively in all goats,and they reduced to a normal level 7 days after surgical procedure.Conclusion:FUSC is feasible and effective for partial hepatectomy,which has advantage of convenience,less time and blood loss.FUSC combined with microbubble contrast agen(tSonoVue)can enhance the biological effects of FUSC and improve the efficiency of FUSC.
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OBJECTIVE: To observe the curative effects of haemocoagulase on patients with reduced coagulation after the transurethraal plasmakentic vaporization of prostrate(TUPKVP).METHODS: 132 cases were randomly divided into two groups,one treated with haemocoagulase,and the other as control group.Then two groups were compared for the time of operation,quantity of blood transfusion during the operation and the time difference in continuous bladder-washing after the operation.RESULTS: There was an obvious difference(P
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AIM: The role of cyclic adenosine monophosphate (cAMP)-dependent protein kinase (PKA) in the induction and maintenance of spinal long-term potentiation (LTP) was evaluated. METHODS: The C-fiber evoked field potentials were recorded at the superficial layers of spinal dorsal horn at the lumbar enlargement. RESULTS: (1) 8-Br-cAMP induced LTP of C-fiber evoked field potentials and 8-Br-cAMP-induced LTP occludes tetanus-induced LTP. (2) Rp-CPT-cAMPS, an inhibitor of PKA, blocked the induction of spinal LTP and reversed established LTP of C-fiber evoked field potentials in a time-dependent manner. (3) In the presence of anisomycin, a protein synthesis inhibitor, the potentiation induced by 8-Br-cAMP was completely blocked. (4) PD98059, a selective inhibitor of mitogen-activated protein kinase (MAPK),completely blocked the 8-Br-cAMP-induced LTP.CONCLUSION: Activation of PKA signal pathway in spinal dorsal horn may be crucial for the induction and the early-phase maintenance of LTP of C-fiber evoked field potentials.
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AIM: The role of protein kinase C (PKC) in th e induction and maintenance of spinal long-term potentiation (LTP) was evaluated . METHODS: The C-fiber evoked field potentials were recorded at t he superficial layers of spinal dorsal horn at the lumbar enlargement. RESULTS: (i) Chelerythrine (200 ?mol/L) or G 6983 (100 ? mol/L), a selective PKC inhibitor, completely blocked LTP induction. (ii) Chel eryt hrine or G 6983 reversed spinal LTP in a time-dependent manner. 15 min after L TP induction, chelerythrine (200 ?mol/L) and G 6983 (100 ?mol/L) depre ssed LTP to baseline in all tested rats. The same concentration of chelerythrine and G 6983, applied at 3 h after LTP induction, did not affect LTP. CONCLUSION: PKC in spinal dorsal horn may be crucial for the ind uction and the early-phase maintenance of LTP of C-fiber evoked field potentials .
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AIM To investigate the effects of levo phenoprolamine hydrochloride [ levo 1 (2,6 dimethylphenoxy) 2 (3,4 dimethoxyphenyl ethylamino) propane hydrochloride] [ l DDPH([?]D 25 1 08)]on experimental arrhythmias. on experimental arrhythmias. METHODS Intravenous administration of ouabain, aconitine or CaCl 2 induced arrhythmias in rats or guinea pigs; Microelectrode recording was used to record action potential; Whole cell patch clamp technique was used to record L type calcium current ( I Ca,L ). RESULTS ① l DDPH 50 mg?kg -1 inhibited the ventricular arrhythmias induced by intravenous injection of ouabain in guinea pigs or aconitine and CaCl 2 in rats. ② l DDPH 30 ?mol?L -1 shortened 50% action potential duration (APD 50 ) and prolonged effective refractory period (ERP) ( n =6, P