An LC-MS/MS method for simultaneous determination of hosenkoside A and hosenkoside K from Semen Impatientis in rat plasma and its application to a pharmacokinetic study.

A rapid and sensitive liquid chromatography tandem mass spectrometry (LC-MS/MS) method was developed and validated for the simultaneous determination of two baccharane glycosides (hosenkoside A and hosenkoside K) of total saponins of Semen Impatientis in rat plasma using mogroside V as the internal standard (IS). The analytes were separated using a C18 RP Agilent XDB column (1.8 µm, 50 × 2.1 mm i.d.) and detection of the compounds was done using a TSQ Quantum triple quadrupole mass spectrometer coupled with a negative electrospray ionization source under selection reaction monitoring mode. According to the US Food and Drug Administration guidelines, the established method was fully validated and the results were proved within acceptable limits. The lower limits of quantification of both analytes were 5 ng/mL. The validated method was successfully applied to a pharmacokinetic study of orally administered the total saponins of Semen Impatientis in rats.

Evaluation of shoulder function in clavicular fracture patients after six surgical procedures based on a network meta-analysis.

Purpose Using a network meta-analysis approach, our study aims to develop a ranking of the six surgical procedures, that is, Plate, titanium elastic nail (TEN), tension band wire (TBW), hook plate (HP), reconstruction plate (RP) and Knowles pin, by comparing the post-surgery constant shoulder scores in patients with clavicular fracture (CF). Methods A comprehensive search of electronic scientific literature databases was performed to retrieve publications investigating surgical procedures in CF, with the stringent eligible criteria, and clinical experimental studies of high quality and relevance to our area of interest were selected for network meta-analysis. Statistical analyses were conducted using Stata 12.0. Results A total of 19 studies met our inclusion criteria were eventually enrolled into our network meta-analysis, representing 1164 patients who had undergone surgical procedures for CF (TEN group = 240; Plate group = 164; TBW group = 180; RP group = 168; HP group = 245; Knowles pin group = 167). The network meta-analysis results revealed that RP significantly improved constant shoulder score in patients with CF when compared with TEN, and the post-operative constant shoulder scores in patients with CF after Plate, TBW, HP, Knowles pin and TEN were similar with no statistically significant differences. The treatment relative ranking of predictive probabilities of constant shoulder scores in patients with CF after surgery revealed the surface under the cumulative ranking curves (SUCRA) value is the highest in RP. Conclusion The current network meta-analysis suggests that RP may be the optimum surgical treatment among six inventions for patients with CF, and it can improve the shoulder score of patients with CF. Implications for Rehabilitation RP improves shoulder joint function after surgical procedure. RP achieves stability with minimal complications after surgery. RP may be the optimum surgical treatment for rehabilitation of patients with CF.

The comparative risk of developing postoperative complications in patients with distal radius fractures following different treatment modalities.

In this study, we performed a network meta-analysis to compare the outcomes of seven most common surgical procedures to fix DRF, including bridging external fixation, non-bridging external fixation, K-wire fixation, plaster fixation, dorsal plating, volar plating, and dorsal and volar plating. Published studies were retrieved through PubMed, Embase and Cochrane Library databases. The database search terms used were the following keywords and MeSH terms: DRF, bridging external fixation, non-bridging external fixation, K-wire fixation, plaster fixation, dorsal plating, volar plating, and dorsal and volar plating. The network meta-analysis was performed to rank the probabilities of postoperative complication risks for the seven surgical modalities in DRF patients. This network meta-analysis included data obtained from a total of 19 RCTs. Our results revealed that compared to DRF patients treated with bridging external fixation, marked differences in pin-track infection (PTI) rate were found in patients treated with plaster fixation, volar plating, and dorsal and volar plating. Cluster analysis showed that plaster fixation is associated with the lowest probability of postoperative complication in DRF patients. Plaster fixation is associated with the lowest risk for postoperative complications in DRF patients, when compared to six other common DRF surgical methods examined.

Comparison of Risk of Carpal Tunnel Syndrome in Patients with Distal Radius Fractures After 7 Treatments.

BACKGROUND To compare risk of carpal tunnel syndrome (CTS) in distal radius fracture (DRF) patients after 7 treatments using bridging external fixation (BrEF), non-bridging external fixation (non-BrEF), plaster fixation, K-wire fixation, dorsal plating fixation, volar plating fixation, and dorsal and volar plating by performing a network meta-analysis. MATERIAL AND METHODS An exhaustive search of electronic databases identified randomized controlled trails (RCTs) closely related to our study topic. The published articles were screened, based on predefined inclusion and exclusion criteria, to select high-quality studies for the present network meta-analysis. Data extracted from the selected studies were analyzed using STATA version 12.0 software. RESULTS The literature search and selection process identified 12 eligible RCTs that contained a total of 1370 DRF patients (394 patients with BrEF, 377 patients with non-BrEF, 89 patients with K-wire fixation, 192 patients with plaster fixation, 42 patients with dorsal plating fixation, 152 patients with volar plating fixation, and 124 patients with dorsal and volar plating fixation). Our network meta-analysis results demonstrated no significant differences in CTS risk among the 7 treatments (P>0.05). The value of surface under the cumulative ranking curve (SUCRA), however, suggested that dorsal plating fixation is the optimal treatment, with the lowest risk of CTS in DRF patients (dorsal plating fixation: 89.2%; dorsal and volar plating: 57.8%; plaster fixation: 50.9%; non-BrEF: 50.6%; volar plating fixation: 39.6%; BrEF: 38.4%; K-wire fixation: 23.6%). CONCLUSIONS Our network meta-analysis provides evidence that dorsal plating fixation significantly decreases the risk of CTS and could be the method of choice in DRF patients.

The influence of MicroRNA-150 in Osteoblast Matrix Mineralization.

This study investigated the influence of miR-150 expression on osteoblast matrix mineralization and its mechanisms. The mouse osteoblast cell line MC3T3-E1 was used as an in vitro model of bone formation. On the fifth day of mineralization, transfection experiments using agomiR-150, agomiR-NC, antagomiR-150 antagomiR-NC, and mock groups were set up to test the effects of miR-150 in MC3T3-E1 model. The mRNA and protein levels of OC, ALP, type I collagen, and OPN were measured by qRT-PCR and ELISA. Matrix mineralization was detected by alizarin red S (ARS) staining and flow cytometry was employed to quantify apoptosis in each group. RT-PCR and Western blot were applied to detect the expression of target gene MMP14. Our results demonstrated that the endogenous expression levels of miR-150, OC, ALP, type I collagen, and OPN in MC3T3-E1 cells increased steadily. Exogenous expressions of agomiR-150 and antagomiR-150 can significantly up-/down-regulate, respectively, the expression level of miR-150 in MC3T3-E1 cells. Compared with the mock group, higher expression levels of OC, ALP, type I collagen, and OPN mRNA were observed in the agomiR-150 group, while lower mRNA expression levels of OC, ALP, type I collagen, and OPN were found in the antagomiR-150 group. Based on these results, potential miR-150 targeted genes are discussed. Our results showed that miR-150 supports the osteoblastic phenotype related to osteoblast function and bone mineralization. Thus, miR-150 may have potential therapeutic applications in promoting bone formation in certain disease settings, such as in osteoporosis and in elderly patients.

Clinical significance of hypoxia-inducible factor 1 and VEGF-A in osteosarcoma.

BACKGROUND: Although the function of hypoxia-inducible factor 1 (HIF1) in many kinds of solid tumor has been revealed, the significance of HIF1 in osteosarcoma is still controversial and not well understood. METHODS: Immunohistochemistry was used to detect HIF1 expression. The correlation between HIF1 and clinicopathology factors was analyzed by use of chi-squared tests. The prognostic value of HIF1 was evaluated by univariate and multivariate analysis. Moreover, the function of HIF1 in osteosarcoma cells was further investigated in in-vitro experiments by regulating HIF1 and vascular endothelial growth factor-A (VEGF-A) expression. RESULTS: Expression of HIF1 was high for 56.82 % of the samples in our investigation. HIF1 expression was significantly associated with positive metastasis (P = 0.037). By use of the Kaplan-Meier method, high expression of HIF1 was proved to be related to poorer overall survival (P = 0.007). By use of a Cox-regression model, HIF1 was identified as an independent prognostic biomarker (P = 0.019). We also proved that HIF1 can promote osteosarcoma invasion in hypoxia by inducing VEGF-A expression. CONCLUSIONS: HIF1 was identified as an independent prognostic biomarker in osteosarcoma. It can promote osteosarcoma cell invasion by inducing VEGF-A expression, indicating that HIF1 is a potential drug target in osteosarcoma.

The survey on implementation of evidence-based nursing in preventing ventilator-associated pneumonia and the effect observation.

The objective is to survey the effect of evidence-based nursing (EBN) in preventing ventilator-associated pneumonia and to observe the effect, providing a reference for clinical nursing intervention. 146 patients with mechanical ventilator were included and randomly divided into control group (n = 73) and observation group (n = 73). Patients in control group received conventional nursing method, and patients in observation group received EBN according to the nursing principles. The questions were raised and the literatures were retrieved to formulate the optimum nursing strategy according to clinical experience and patient need. After nursing, morbidity of VAP in observation group was significantly lower than control group, and length of stay, length of stay in ICU, and the duration of mechanical ventilation were also significantly lower than control group; the differences were statistically significant (P < 0.05). After nursing, the physiological function, physical role, somatic pain, and mental health scores in observation group were significantly higher than control group (P < 0.05). Oral hygiene status in observation group was significantly better than control group; the difference was statistically significant (P < 0.05). After nursing, IL-1, IL-6, and TNF-α in two groups were both decreased (P < 0.05); IL-1, IL-6 and TNF-α in observation group were significantly lower than control group (P < 0.05). When patients were discharged, satisfaction degree in observation group was significantly higher than control group; the difference was statistically significant (P < 0.05). The implementation of EBN can effectively prevent the occurrence of ventilator-associated pneumonia and improve the clinical nursing quality, which is worthy of clinical application.

Oolong tea drinking could help prevent bone loss in postmenopausal Han Chinese women.

The aim of this study was to analyze the relationship between oolong tea drinking and bone mineral density in postmenopausal Han Chinese women, while living and diet habits, fertility, disease elements and other baseline conditions were controlled. One group included 124 cases who routinely drank oolong tea, and the other included 556 who did not drink tea. Data were collected on participant age, lifestyle habits, fertility condition, disease elements, and lumbar, and hip bone densities. It was found that the bone densities of the greater trochanteric bone in tea drinkers were higher (0.793 ± 0.119 kg/cm(2)) than that in non-tea drinkers (0.759 ± 0.116 kg/cm(2), F = 6.248, p = 0.013). Similarly, the bone density of Ward's triangular bone in tea drinkers was higher (0.668 ± 0.133 kg/cm(2)) than that in non-tea drinkers (0.637 ± 0.135 kg/cm(2), F = 6.152, p = 0.013). Oolong tea drinking could help prevent bone loss in postmenopausal Chinese women.

[Design and clinical application of the drilling guide in the treatment of acromioclavicular joint dislocation with closed reduction and Kirschner fixation].

OBJECTIVE: To investigate a drilling guide in the treatment of acromioclavicular joint dislocation with closed reduction and Kirschner fixation and explore the therapeutic effect. METHODS: From June 2008 to December 2009, 36 patients with acromioclavicular joint dislocation (Tossy III) were treated with closed reduction and Kirschner fixation using a self-designed drilling guide as well as percutaneous repair of acromioclavicular joint. Among the patients, 24 patients were male and 12 patients were female,ranging in age from 20 to 61 years, averaged 38.6 years. The duration from injury to operation ranged from 3.5 to 72 h,with a mean of 15.2 h. No clavicle fracture was found in all cases. The operative time, intra-operative bleeding and therapeutic effects were observed. RESULTS: There were no complications including neurovascular problems. The mean operating time were 20 min,mean blood loss were about 10 ml. According to the observation of postoperative X-ray examination, all Kirschners in acromioclavicular joint were in place. All Kirschners were removed in 6 postoperative weeks. All the patients were followed up ranging from 2 to 26 months (averaged 14.3 months). According to the Karlsson standard,22 patients got an excellent result, 13 good and 1 poor. CONCLUSION: This method has following advantages: easy operation and fixation; minimum injuries to articular surface; and which would be widely used in clinical practice.