Improvement effects of Runchang granules on the constipation in mice and its mechanism / 中国药房

OBJECTIVE To investigate the improvement effects of Runchang granules on the constipation in mice and its potential mechanism. METHODS The mice were randomly divided into normal control group， model group， Runchang granules low-dose and high-dose groups （5， 10 g/kg）， mosapride group （0.003 g/kg， positive control）， with 6 mice in each group. The latter 4 groups were given loperamide intragastrically （0.004 g/kg）， twice a day， for 3 consecutive days. Normal control group and model group were given purified water intragastrically， and administration groups were given relevant medicine intragastrically for 7 consecutive days. After the last medication， fecal moisture content and intestinal motility of mice were determined， while the structures of colon and ileum， and the secretion of colonic mucus were observed. Protein expressions of tyrosine kinase receptor （c-kit）， mucin 2 （MUC2） and stem cell factor （SCF） were determined in colon； meanwhile， the mRNA expression levels of inflammatory factors [tumor necrosis factor-α （TNF-α）， interleukin-6 （IL-6）， IL-1β， inducible nitric oxide synthase （iNOS）] as well as factors related to promoting intestinal motility [neuronal nitric oxide synthase （nNOS）， smooth muscle myosin light chain kinase （smMLCK）， 5-hydroxytryptamine 4 receptor （5-HT4R）， MUC2， SCF， c-kit] were determined. RESULTS Compared with model group， the fecal water content， intestinal propulsion rate， protein expression of c-kit in colon， relative expressions of MUC2 and SCF protein， and mRNA expressions of factors related to promoting intestinal motility （except for nNOS and SCF in Runchang granules low-dose group） were all increased significantly in Runchang granules low-dose and high-dose groups， and mosapride group （P＜0.05 or P＜0.01）. mRNA expression levels of inflammatory factors were decreased significantly（P＜0.05 or P＜0.01）. Both colon and ileum injuries improved， and the secretion of colon mucus was increased significantly in Runchang granules high-dose group （P＜0.01）. CONCLUSIONS Runchang granules have laxative effect and can improve constipation in mice， and its mechanism may be related to the promotion of the secretion of colon mucus and MUC2 expression， and the activation of SCF/c-kit signaling pathway.

Notch signaling pathway regulates proliferation and differentiation of mesenchymal stem cells / 中国组织工程研究

BACKGROUND:It was found that the ligands and receptors of Notch are both cell membrane surface proteins,which are important proteins to mediate intercellular communication,and the Notch signaling pathway plays a crucial regulatory role in the proliferation and differentiation of mesenchymal stem cells. OBJECTIVE:To review the regulatory mechanism of the Notch signaling pathway on the proliferation and differentiation of mesenchymal stem cells,summarize and clarify the research advance in how the Notch signaling pathway regulates the proliferation and differentiation of mesenchymal stem cells,and provide theoretical support for the future use of stem cells to treat various related diseases. METHODS:By using the computer,the first author searched the relevant studies involving Notch signaling pathway regulation of mesenchymal stem cell proliferation and differentiation on CNKI,Wanfang,VIP,PubMed,Web of Science,and Nature databases with Chinese search terms"mesenchymal stem cells,Notch,Notch signaling pathway,proliferation,differentiation"and the English search terms"mesenchymal stem cells,MSC,Notch,Notch signaling pathway,proliferation,differentiation".Part of the literature was searched in combination with the literature tracing method.Finally,87 articles were included in the review analysis. RESULTS AND CONCLUSION:(1)Notch signaling pathway is a conserved signaling pathway in multicellular organisms,which plays an important role in regulating cell differentiation,proliferation,apoptosis,and the cell cycle by mediating communication between neighboring cells through receptor-ligand binding.(2)Mesenchymal stem cells are a class of adult stem cells with self-proliferative and multi-directional differentiation potential,which can be regulated by external signaling pathways to affect their proliferation and differentiation.Notch signaling pathway,as one of them,when Notch ligands are activated,the Notch proteins will undergo two protein hydrolysis cleavages to release Notch intracellular structural domain NICD,which then enters the nucleus and thus promotes the transcription of target genes to regulate the proliferation and differentiation of mesenchymal stem cells from different sources,such as bone marrow,adipose,and umbilical cord.However,the specific mechanisms that regulate the proliferation and differentiation of mesenchymal stem cells from different tissue sources of the same species are different.(3)The Notch signaling pathway can regulate the differentiation of mesenchymal stem cells into different target cells,but due to different target cells,the expression levels of receptors or ligands in the Notch signaling pathway vary.(4)Clinical targeting of the Notch signaling pathway to promote mesenchymal stem cells for the treatment of various refractory diseases,such as aplastic anemia,severe joint injuries,ischemic strokes,and myocardial infarctions,has a promising application.(5)By exploring the Notch signaling pathway via regulating the expression levels of its receptors and ligands in bone marrow mesenchymal stem cells from rat,mouse,and human,it can be found that the Notch signaling pathway expression levels in the proliferation and differentiation of mesenchymal stem cells from different species origins are also different.(6)The role of mesenchymal stem cells in tissue engineering has been gradually highlighted due to their advantages of safety,low immune rejection,and wide therapeutic prospects.The Notch signaling pathway regulates the proliferation and differentiation of mesenchymal stem cells with a wide range of influencing factors,and subsequent studies should further optimize the influencing factor variables and explore the standardized studies of regulating the proliferation and differentiation of mesenchymal stem cells.

Cytokine Storm Related to CD4+TCells in Influenza Virus-Associated Acute Necrotizing Encephalopathy

Acute necrotizing encephalopathy (ANE) is a rare but deadly complication with an unclear pathogenesis. We aimed to elucidate the immune characteristics of H1N1 influenza virusassociated ANE (IANE) and provide a potential therapeutic approach for IANE. Seven pediatric cases from a concentrated outbreak of H1N1 influenza were included in this study. The patients’ CD4+T cells from peripheral blood decreased sharply in number but highly expressed Eomesodermin (Eomes), CD69 and PD-1, companied with extremely high levels of IL-6, IL-8 in the cerebrospinal fluid and plasma. Patient 2, who showed high fever and seizures and was admitted to the hospital very early in the disease course, received intravenous tocilizumab and subsequently showed a reduction in temperature and a stable conscious state 24 h later. In conclusion, a proinflammatory cytokine storm associated with activated CD4+T cells may cause severe brain pathology in IANE. Tocilizumab may be helpful in treating IANE.

Comparative efficacy of longitudinal outside-in versus transverse inside-out capsulotomy in arthroscopic intervention for femoral acetabular impingement: a clinical outcomes study / 中华骨科杂志

Objective:To compare the short-term clinical outcomes associated with longitudinal outside-in capsulotomy and transverse inside-out capsulotomy in arthroscopic surgery for femoral acetabular impingement (FAI).Methods:A retrospective cohort study was conducted encompassing 30 patients who underwent arthroscopic surgery to address FAI from August 2020 to June 2021. This group, comprising an equal distribution of 15 males and 15 females with a mean age of 40.9±10.7 years (range 15-63 years), was subjected to longitudinal outside-in capsulotomy without subsequent capsular closure. Patients of the longitudinal capsulotomy group (Group L) were 1∶1 matched with another 30 patients who underwentarthroscopic surgery for FAI between April 2018 and April 2019 as controls, including 10 males and 20 females, aged 40.6±9.2 years old (range, 25-60 years old). The control group (Group T) underwent transverse inside-out capsulotomy without capsular closure. The subjective functional outcomes within both groups were meticulously evaluated, including the modified Harris hip score (mHHS) and the visual analog scale (VAS). Additionally, the proportions of subjects achieving Grade A or B classifications and the patient acceptable symptomatic state (PASS) based upon the mHHS were scrupulously calculated.Results:The foundational data, encompassing pre-operative subjective functional scores, pre-operative radiological dimensions, and intra-operative discoveries, showed no significant differences between the groups ( P>0.05). At the one-year follow-up, Group L demonstrated a reduced post-operative VAS score of 1.3±1.6, a diminution from the pre-operative mean of 6.3±1.4, alongside a mHHS improvement from 63.8±15.1 pre-operatively to 93.5±5.1 post-operatively. Conversely, Group T revealed a post-operative VAS score of 1.4±1.5, ameliorated from a pre-operative mean of 7.0±1.6, and an mHHS improvement from 64.6±7.8 pre-operatively to 90.4±8.4 post-operatively. The improvements of VAS and the mHHS showed statistical significance in both groups ( P<0.001), yet no significant disparities were observable in the post-operative VAS and mHHS results between the two cohorts ( t=0.03, P=0.735 for VAS; t=1.75, P=0.082 for mHHS). Remarkably, every participant in Group L achieved Grade A or B in mHHS; however, only 83.3% of Group T attained these grades, a discrepancy manifesting statistical significance (χ 2=8.32, P<0.01). Correlatively, the attainment of PASS stood at 100% in Group L versus 90% in Group T, denoting a statistically significant difference (χ 2=6.54, P<0.01). Conclusion:Longitudinal outside-in capsulotomy in the arthroscopic management of FAI is vindicated as an effective technique, exhibiting parallel clinical outcomes to the traditional transverse inside-out technique.

Effect of acupuncture on pubertal development of rats and rabbits at different developmental stages.

Physiological and endocrine studies on sexual development in animals and effects of acupuncture on sexual development are limited. Therefore, we investigated the effect of electro-acupuncture (EA) on the arcuate nucleus (Arc) and release of gonadotropin-releasing hormone (GnRH) in animals at different developmental stages. In Experiment 1, EA stimulation (30 Hz) was performed for 30 min per day in EA group of rabbits for 48 days, while the control group (mature rabbits) was not given EA. Arc discharges in those two groups were measured after the 48-day treatment. Arc discharge was also measured in the pre-pubertal group (as control) without EA treatment. Then, all three groups were treated with transient EA for 30 min and Arc discharges were determined again. In Experiment 2, EA (3 Hz) at the same acupoints or non-acupoints as that in the rabbits was performed for 20 min per day in different developmental group of Sprague-Dawley rats for 10 days. GnRH mRNA expression in the hypothalamus of rats was determined using RT-PCR and real-time PCR. The serum sexual hormone, sperm count, and body weight was measured. The results showed that the Arc discharge (P<0.01), testosterone (T) (P<0.01) and sperm count (P<0.01) in male rabbits were reduced by repeated EA. However, the body weight of rabbits was not changed after EA compared to the control in Experiment 1. In Experiment 2, GnRH mRNA expression in rats of the early pubertal group (EPG) and adult group (AG) were significantly depressed after repeated EA at acupoints (P<0.01). The sexual hormones were negatively influenced by repeated EA during puberty. Sperm count was reduced significantly after repeated EA at time of puberty (P<0.01). Repeated EA did not influence body weight of rats (P>0.01) and structures of the gonadial tissues during development. The results suggested that repeated EA is a good option that can be considered for regulating the function of the hypothalamus-pituitary-gonad (HPG) axis during puberty.

Cancer Progression Prediction Using Gene Interaction Regularized Elastic Net.

Different types of genomic aberration may simultaneously contribute to tumorigenesis. To obtain a more accurate prognostic assessment to guide therapeutic regimen choice for cancer patients, the heterogeneous multi-omics data should be integrated harmoniously, which can often be difficult. For this purpose, we propose a Gene Interaction Regularized Elastic Net (GIREN) model that predicts clinical outcome by integrating multiple data types. GIREN conveniently embraces both gene measurements and gene-gene interaction information under an elastic net formulation, enforcing structure sparsity, and the "grouping effect" in solution to select the discriminate features with prognostic value. An iterative gradient descent algorithm is also developed to solve the model with regularized optimization. GIREN was applied to human ovarian cancer and breast cancer datasets obtained from The Cancer Genome Atlas, respectively. Result shows that, the proposed GIREN algorithm obtained more accurate and robust performance over competing algorithms (LASSO, Elastic Net, and Semi-supervised PCA, with or without average pathway expression features) in predicting cancer progression on both two datasets in terms of median area under curve (AUC) and interquartile range (IQR), suggesting a promising direction for more effective integration of gene measurement and gene interaction information.

Advances in the study of intestinal flora for the treatment or prevention of spinal cord injury and complications / 中国医师杂志

Intestinal microorganisms are closely related to human health or disease status. Spinal cord injury is a serious traumatic disease of the nervous system. Recent studies have shown that intestinal flora can affect the progression of spinal cord injury. At the same time, intestinal flora is closely related to spinal cord injury complications such as anxiety, depression, aspiration pneumonia, malnutrition, constipation, neurocystitis and urinary system infection through intestinal-brain axis, intestinal-lung axis and oral-pulmonary axis. In this paper, the intestinal flora will be used as the starting point to explore the relationship between spinal cord injury, intestinal flora and spinal cord injury complications, providing new ideas for the treatment of spinal cord injury patients and the prevention of complications.

Effect and mechanism of interleukin 37 on the immune function of regulatory T cells in septic mice / 中华急诊医学杂志

Objective:To investigate the effect of interleukin (IL)-37 on the immune function of regulatory T cells (Treg) in sepsis.Methods:TTregs were isolated and purified from the spleen of C57BL/6J mice and cultured in vitro. The cells were divided into the control group, lipopolysaccharide (LPS) group, IL-37 group, LPS+IL-37 group, LPS+3-Methyladenine (3-MA) group, LPS+3-MA+IL-37 group, LPS+Rapamaycin group, and LPS+Rapamaycin+IL-37 group. Culture supernatants and cells were collected, respectively, after cell culture for 24, 48, and 72 h. The secretion of IL-10 and TGF-β by Tregs was detected by ELISA, expressions of forkhead wing-link transcription factor (Foxp3) and cytotoxic T lymphocytes antigen 4 (CTLA-4) were measured by flow cytometry. Formation and number of autophagosomes were observed by transmission electron microscope. Western blot was used to determine expressions of autophagy associated proteins, including LC3I/II and Beclin1. Cecal ligation and puncture (CLP) was used to construct septic mice model, and the differences in survival rates between the groups were recorded and compared.Results:IL-37 was given to Tregs at 24, 48, and 72 h after LPS stimulation. The function of Treg was significantly enhanced after 72 h of synergistically stimulation by both LPS and IL-37. After stimulation with LPS and IL-37, the formation of autophagosomes in Tregs was obviously increased under observation of transmission electron microscopy. Pretreatment with autophagy agonist Rapamycin and autophagy inhibitor 3-MA was applied for altering the activity of cell autophagy. It was noticed that immune function of Treg was significantly decreased in the 3-MA group compared with the control group, while it was enhanced in the Rapamycin group. Secretion of TGF-β in the 3-MA group presented with significant reduction, which showed a marked increase in the Rapamycin group. However, no significant differences were found in IL-10 levels among various groups. Administration of IL-37 improved the survival rates of septic mice, which was much more efficient by treatment prior to the onset of sepsis.Conclusions:IL-37 appears to be capable of augmenting immune function of Tregs in an autophagy-dependent pathway, which might contribute to maintaining homeostasis of immune response in the setting of sepsis, and further improves the survival and prognosis of septic mice.

Effects of community TCM health management on patients with chronic obstructive pulmonary disease at a stable stage / 中华健康管理学杂志

Objective:To observe the effects of community traditional Chinese medicine (TCM) health management of patients with chronic obstructive pulmonary disease (COPD).Methods:From June 2017 to June 2018, 79 patients were selected as study subjects. These patients were randomly divided into two groups. The TCM management group had 39 patients (of which 26 were male), with an average age of (70.77±5.91) years and the course of disease of (7.97±3.12) years. The control group had 40 patients (of which 25 were males), with an average age of (70.60±5.93) years and the course of disease of (7.70±3.01) years. Both groups were given conventional western medicine treatment. The TCM management group was administered TCM health management for 1 year on the basis of the conventional western medicine treatment. This management included establishing electronic archives for COPD patients, Hu Xi Tu-Na, Baduanjin, acupoint massage, acupoint plaster, and dietary guidance according to the TCM physique identification. Management and follow-up of patients was continuous. The TCM syndrome score, CAT score, number of acute exacerbations, and lung function of COPD patients were recorded before and after 1 year of treatment.Results:In the TCM management group, there were 6 cases of clinical control, with 8 and 19 cases displaying obvious and effective effects, respectively. The total effective rate was 84.61%. In the control group, there were 2 cases of clinical control, with 3 cases and 25 cases displaying obvious and effective effects, respectively. The total effective rate was 75.00%. The curative effect of the TCM syndrome in the TCM management group was better than that in the control group. In the TCM management group，the CAT score was (7.46±3.28) points and the number of acute exacerbations was (4.21±2.61) times, the forced expiratory volume (FEV 1) in the first second was (1.99±0.79) L, and the forced vital capacity (FVC) was (2.63±0.92) L. In the control group, the CAT score was (10.38±4.68), the number of acute exacerbations was (6.03±3.00), FEV 1 was (1.66±0.65) L, and FVC was (2.41±0.81) L. The CAT score and the number of acute exacerbations in the TCM management group decreased, while the number of FEV 1 increased, which was statistically significant compared to the control group. Conclusion:Community TCM health management can improve the symptoms of COPD patients at a stable stage, reduce the number of acute exacerbations, and improve lung function.

The association between high-grade pivot-shift and complete lateral meniscus posterior root tear after anterior cruciate ligament ruptures / 中华骨科杂志

Objective@#To investigate the association between high-grade pivot-shift and complete lateral meniscus posterior root (LMPR) tear in patients with anterior cruciate ligament (ACL) ruptures.@*Methods@#From January 2013 to December 2017, a total of 86 ACL injured patients with LMPR tears were reviewed retrospectively. There were 66 males and 20 females with an average age of 27.8±8.3 years (range 16-49 years) and an mean BMI of 25.1±3.2 kg/m2 (range 17.4-33.9 kg/m2). The average duration from injury to surgery was 33.5±79.4 weeks (range 3 days to 11 years). All patients were classified into high-grade pivot-shift group (60 patients of IKDC grade II-III) and low-grade pivot-shift group (26 patients of IKDC grade 0-I) according to the results of pivot-shift tests under anesthesia before ACL reconstructions. Predictive factors of high-grade pivot-shift were analyzed by multivariable Logistic regression, involving degree of LMPR tear, integrity of meniscofemoral ligament, width of lateral meniscal extrusion, KT-1000 arthrometer side-to-side difference, age, sex, and BMI.@*Results@#The prevalence of complete LMPR tear in high-grade pivot-shift group was higher than that in low-grade pivot-shift group. High-grade pivot-shift was associated to complete LMPR tear [OR=4.096, 95% CI(1.339, 12.371), P=0.013] and KT-1000 arthrometer side-to-side difference [OR=9.632, 95% CI (3.095, 29.975), P<0.001]. The association between high-grade pivot-shift and complete LMPR tear was more striking in patients with duration from injury to surgery ≥12 weeks [OR=8.343, 95%CI(1.224, 56.853), P=0.030]. High-grade pivot-shift did not associated with meniscofemoral ligament, lateral meniscal extrusion, age, sex and BMI (P>0.05).@*Conclusion@#In patients with ACL ruptures, complete LMPR tear was an independent risk factor of high-grade pivot-shift, especially for patients with 12 weeks at least duration from injury to surgery.

The association between high-grade pivot-shift and complete lateral meniscus posterior root tear after anterior cruciate ligament ruptures / 中华骨科杂志

Objective To investigate the association between high-grade pivot-shift and complete lateral meniscus posterior root (LMPR) tear in patients with anterior cruciate ligament (ACL) ruptures.Methods From January 2013 to December 2017,a total of 86 ACL injured patients with LMPR tears were reviewed retrospectively.There were 66 males and 20 females with an average age of 27.8±8.3 years (range 16-49 years) and an mean BMI of 25.1±3.2 kg/m2 (range 17.4-33.9 kg/m2).The average duration from injury to surgery was 33.5±79.4 weeks (range 3 days to 11 years).All patients were classified into high-grade pivotshift group (60 patients of IKDC grade Ⅱ-Ⅲ) and low-grade pivot-shift group (26 patients of IKDC grade 0-I) according to the results of pivot-shift tests under anesthesia before ACL reconstructions.Predictive factors of high-grade pivot-shift were analyzed by multivariable Logistic regression,involving degree of LMPR tear,integrity of meniscofemoral ligament,width of lateral meniscal extrusion,KT-1000 arthrometer side-to-side difference,age,sex,and BMI.Results The prevalence of complete LMPR tear in high-grade pivot-shift group was higher than that in low-grade pivot-shift group.High-grade pivot-shift was associated to complete LMPR tear [OR=4.096,95％CI(1.339,12.371),P=0.013] and KT-1000 arthrometer side-to-side difference [OR=9.632,95％CI (3.095,29.975),P＜0.001].The association between high-grade pivot-shift and complete LMPR tear was more striking in patients with duration from injury to surgery ≥12 weeks [OR=8.343,95％CI(1.224,56.853),P=0.030].High-grade pivot-shift did not associated with meniscofemoral ligament,lateral meniscal extrusion,age,sex and BMI (P＞0.05).Conclusion In patients with ACL ruptures,complete LMPR tear was an independent risk factor of high-grade pivot-shift,especially for patients with 12 weeks at least duration from injury to surgery.

Comparative analysis of lncRNA-mRNA co-expression between Keshan disease and dilated cardiomyopathy / 中华地方病学杂志

Objective By constructing the differential expression profile of lncRNA/mRNA in peripheral blood plasma of patients with Keshan disease (KSD) and dilated cardiomyopathy (DCM),to explore the commonality and characteristics of the two diseases in molecular mechanism.Methods Ten patients with chronic KSD were selected in the severe disease area of KSD in Shandong Province,and 10 cases of DCM and 10 healthy subjects (control group) were selected in non-KSD area.Blood of elbow vein was collected and plasma was separated.RNA-seq technology was used to construct the differential lncRNA/mRNA expression profile between KSD and control group,DCM and control group,and co-expression and specific expression of partial genes in KSD and DCM were analyzed through Wien analysis.The lncRNA-mRNA co-expression network maps of specific part of KSD,specific part of DCM and common part of the two diseases were constructed,and Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were applied to distinguish the biological function of the two diseases.Results Compared with control group,102 dysregulated mRNAs and 22 dysregulated lncRNAs showed the same trend in KSD and DCM.And 3 606 mRNAs and 451 lncRNAs were only differentially expressed in KSD group,217 mRNAs and 137 lncRNAs were only differentially expressed in DCM group.The differentially expressed lncRNA/mRNA shared between the KSD and DCM groups were mainly about viral transcription,immuno-inflammatory response,oxidative stress signaling pathways.The KSD specific lncRNA/mRNA mainly participated in cell membrane damage and viral myocarditis.The DCM specific lncRNA/mRNA mainly regulated mitochondrial structure and oxidative phosphorylation related enzymes.Conclusion The differentially expressed lncRNA/mRNA shared in KSD and DCM groups are mainly involved in viral transcription,oxidative stress signaling pathways;KSD specific lncRNA/mRNA are mainly related to cell membrane damage and viral myocarditis;DCM specific lncRNA/mRNA mainly regulate mitochondrial structure.

Comparison of Magnetic Resonance Imaging and Stress Radiography in Diagnosing Chronic Anterior Talofibular Ligament Injury / 中国运动医学杂志

Objective To compare Magnetic Resonance Imaging(MRI) and stress radiography in diagnosing chronic anterior talofibular ligament (ATFL) injury.Methods Among 45 patients undergoing ankle arthroseopy between October 2016 and December 2016,39 patients were included in this study.The ankle arthroscopy was used as the gold standard for diagnosing the chronic ATFL injury.The sensitivity,speciality and accuary of MRI and stress radiography were calculated according to the arthroscopic findings.Results The ankle arthroscopy revealed ATFL injury in 30 cases and intact ATFL in 9 cases,while MRI results found ATFL injury in 28 cases and intact ATFL in 11 cases with thesensitivity,speciality and accuary of 90.0％,88.9％ and 89.7％ respectively.The stress radiography results revealed ATFL injury in 21 cases and intact ATFL in 18 cases,with the sensitivity,speciality and accuary of 63.3％,77.8％ and 66.7％.Conclusion MRI was more reliable in diagnosing chronic ATFL injury compared with the stress radiography.

Clinical classification and surgical treatment of habitual dislocation of the patella in adult / 中华骨科杂志

Objective To explore the efficacy of the 3 types classification and the surgical technique included intensive lateral release,vastus lateralis oblique (VLO) tendon lengthening,tibia1 tubercle proximalization combined with MPFL reconstruction for habitual patellar dislocations in adults.Methods Date of 36 patients with habitual dislocation of patella who were operated between January 2011 and January 2016 were retrospectively analyzed.There were 12 males and 24 females,with an average age of 24 years old (range,15-44 years).All the cases were followed-up for more than 2 years,and 26 of which was primary surgery,while the other 10 was revision surgery.According to the flexion angle when the patella dislocation occurred and difficulty to reduce the patella,the patients were divided into 3 types.The mild type means patellar dislocation angle was more than 90°,and the treatment was lateral release (LR) combined with MPFL reconstruction.The moderate type means the patellar dislocation angle was about 60° to 90°,and the treatment was LR combined with VLO lengthening and MPFL reconstruction.The severe type means the patellar dislocation angle was less than 60°,and the treatment was LR+VLO combined with proximalization of tibial tubercle.Based on this surgical algorithm,all the patients reveived the surgical treatment.Results All 36 patients had been sucessfully followed up.The mean follow-up period was 38.6 (range,23-78) months.All the patients gained stable patella with no recurrence of dislocation.There was 1 patient in the mild group,6 patients in the moderate group and 29 patients in the severe group.The patient in the mild group showed that the congruence angle of was improved from 72° preoperatively to 5° postoperatively,with 0.82 of Caton-Deschamps index,and 28mm of tibial tubercle-trochlear Groove,and the sulcus angle was 150°.The 6 patients in the moderate group showed that the congruence angle of was improved from mean 82.2°±11.7° preoperatively to 6.9°±26.4° postoperatively.The changes of Caton-Deschamps index,TT-TG and the sulcus angle were not significantly.The 29 patients in the severe group showed that the congruence angle of was improved from mean 75.0°±27.3° preoperatively to 0.0°±21.0° postoperatively.The Caton-Deschamps index was improved from mean 0.76±0.24 preoperatively to 1.06±0.24 postoperatively.TT-TG was decreased form mean 22.9±5.1 mm preoperatively to 6.0±4.9 mm.The change of sulcus angle was not significantly.The Lysholm score was improved from 59 preoperatively to 100 postoperatively in the mild group,61 to 93 in the moderate group,and 66.0±8.0 to 93.7± 3.0 in the severe group.The Kujala score was improved from 55 preoperatively to 83 postoperatively in the mild group,55.0±4.1 to 83.8±1.9 in the moderate group,and 66.0±8.0 to 93.7±3.0 in the severe group.There was no flexion limited in the mild and moderate groups.The average flexion loss was 17.5°±7.6° in 6 patients postoperatively in the severe group.No extension limited.The consistency of the 3 types classification method by two observers was good (Kappa=0.918,P=0.000).Conclusion These results suggest that the 3 types classification provides an efficient method for habitual patellar dislocation.The surgical techniques included intensive lateral release,VLO lengthening,tibial tubercle proximalization combined with MPFL reconstruction are effective for treatment of habitual patellar dislocation in adults.In our opinion,lateral release and proximalization of tibial tubercle play an important role in the surgical treatment.

Simultaneous Determination of Ephedrine Hydrochloride and Amygdalin in Kangzhi Syrup by HPLC / 中国药师

Objective:To establish an HPLC method for the determination of ephedrine hydrochloride and amygdalin in Kangzhi syrup. Methods:The separation was performed on a Waters ODS2(250 mm×4.6 mm,5 μm) column. The mobile phase consisted of acetonitrile-0.2% phosphoric acid solution(containing 0.1% triethylamine) with gradient elution,the detection wavelength was at 205 nm,the flow rate was 1.0 ml·min-1,and the column temperature was 30℃. Results: Ephedrine hydrochloride and amygdalin was linear within the range of 0.169-3.380 μg(r=0.999 9)and 0.141-2.820 μg(r=0.999 7), respectively.The average recovery of e-phedrine hydrochloride and amygdalin was 98.8% and 99.1% with the RSD of 1.93% and 1.22%(n=6), respectively.Conclu-sion:The method is rapid and accurate for the simultaneous analysis of ephedrine hydrochloride and amygdalin, which can provide a reliable way for the quality control for Kangzhi syrup.

Clinical application of extended nursing in asthmatic children with allergic rhinitis / 中国实用护理杂志

Objective@#To evaluate the effects of extended nursing mode on the asthmatic children with allergic rhinitis (AR).@*Methods@#Totally116 children aged 6-14 years old with asthma and AR were enrolled to this study from November 2015 to October 2016 in our hospital. They were divided into the regular nursing group and the extended nursing group according to the voluntary principle. The patients in regular nursing group were received routine nursing care in or out of hospital, while the patients in extended nursing group received extended care besides routine nursing. The children were required to record diary about asthma and AR And participate in asthma action projects. Before and after intervention we observed the quantitative score of symptoms and signs, the times of acute attack, the times of oblivion medication, the average days of stay in hospital, the days of fail to School or kindergarten, the lung function and the fractional exhaled nitric oxide (FeNO) in children with asthma and AR within 1 year. These above marks were assessed five times respectively at starting (baseline) , 3 months, 6 months, 9 months and 12 months (1 year) The differences between two groups were compared with appropriate statistical methods.@*Results@#1 year later, out of 58 cases in extended nursing group, 40 patients (68.97%)were in good control and 18 cases (31.03%) in partial control. Out of 58 cases in regular nursing group, 22 cases (37.93%) were in good control and 36 patients (62.07%) in partial control. There were significant differences between two groups in the effect of disease (χ2=11.23, all P<0.01), the experimental group was significantly better than the control group. The symptoms and signs of allergic rhinitis average scores in regular nursing group were 1.88 ± 0.72, extended nursing group were 0.79 ± 0.71, the difference was statistically significant (t=8.080, P<0.01) with the extended nursing group much better that the regular nursing group. The symptoms and signs of asthma average scores in regular nursing group were1.83 ± 0.75, extended nursing group were 0.88 ± 0.67, the difference was also statistically significant (t=7.133, P<0.01) with the extended nursing group much better that the regular nursing group. In extended nursing groups within 1 year the numbers of acute attack (0.60±0.59), the times of oblivion medication (11.05±7.40), the average days of stay in hospital (8.83±2.79) days,the average days of failing to school or kindergarten (8.69±5.46) days, while in regular nursing group within 1 year the numbers of acute attack(2.94±1.52), the times of oblivion medication (35.28±8.84), the average days of stay in hospital(20.95±5.46 days), the average days of fail to school or kindergarten(24.72±5.92) days, the differences were also statistically significant (t=10.50-15.87, P<0.01). The lung function in extended nursing group (PEF: 82.02±6.04, FEVI: 88.19±5.10, FEV25: 80.67±4.88, FEV50: 80.07±3.73, FEV75: 81.52±3.85) and in regular nursing group (PEF: 79.02±6.12,, FEV1: 80.52±4.72, FEV25: 75.05±7.79, FEV50: 77.59±4.60, FEV75: 78.41±4.19) . The differences were also statistically significant (t=2.90-6.15, P<0.01).The FeNO(13.66±2.87) ppb in extended nursing group and (14.95±3.12) ppb in regular nursing group. There were statistical significant differences between the two groups (t=2.30, P<0.05) with extended nursing group much better than regular nursing group.@*Conclusion@#The effect of extended care group is better than that of regular nursing group, and extended care is much more benefit to control asthma and allergic rhinitis in children.

Role of neuropeptide Y in regulating hypothalamus-pituitary-gonad axis in the rats treated with electro-acupuncture.

Neuropeptide Y (NPY) is an important regulator of reproductive axis, which mainly plays some roles in regulating secretion of gonadotropin-releasing hormone (GnRH) in hypothalamus. In previous studies, we found that the repeated low frequency electro-acupuncture (EA) down-regulated hypothalamus-pituitary-gonad (HPG) axis of common rats and rabbits during puberty. In this study, we investigated the role of NPY in regulating the reproductive axis of common rats at different developmental stages and rats treated with the repeated EA. Low frequency EA (3 Hz) was performed at acupoints (treatment groups) or non-acupoints (control groups) for 20 min daily for 10 days in Sprague-Dawley (SD) rats at four developmental stages, which were juvenile stage, early puberty stage, later puberty stage and adult stage. NPY expression in the hypothalamus were determined using RT-PCR and real-time quantitative PCR (qPCR) after 10 days-treatments. The results showed that NPY expression in the early pubertal group (EPG) was significantly depressed after repeated EA (P<0.05). Compared with the results of GnRH expression and body weights, the change of NPY expression was similar with the fluctuation of GnRH expression after EA and the increase of body weights of rats was not influenced by the depression of NPY expression after EA during early puberty. The results demonstrated that repeated low frequency EA was an effective method on down-regulating not only the GnRH expression but also the NPY expression in the hypothalamus without reducing body weights of rats during early puberty.

Effect of Yizhi Cream on Brain Injury in Vascular Dementia Rats / 中国药师

Objective:To observe the effect of Yizhi cream on vascular dementia in rats.Methods:The rat model of vascular de-mentia was established by the double thread ligation of bilateral common carotid artery. The rats in each dose group were intragastrically given Yizhi cream at high,medium and low dose for 30 days. Morris water maze was used to observe the effect of Yizhi cream on learn-ing and memory impairment in rats. The biochemical method was used to observe the levels of acetylcholine (Ach) and nitric oxide (NO),and the activity of nitric oxide synthase(NOS) in serum was measured. The brain index was calculated to evaluate the state of cerebral edema. HE staining was used to observe the pathological changes of brain tissue.Results: Compared with that in the model group,the escape latency in each Yizhi cream group was significantly shortened(P<0.05),the number of sites found in 3 min signif-icantly increased (P<0.05),the Ach content significantly increased (P<0.05),the NO content and NOS activity significantly de-creased (P<0.05),the brain index was significantly lowered (P<0.05), and the brain histopathology was significantly improved. Conclusion:Yizhi cream can significantly improve the learning and memory ability of vascular dementia rats,and notably improve the cerebral edema and brain histopathology in the rats with vascular dementia. The mechanism of action is related to reducing the serum NO content and NOS activity,enhancing the ability of oxidative damage prevention,reducing brain injury,increasing the Ach content and enhancing the function of cholinergic nerve.

Association between single nucleotide polymorphism in exon 33 of thyro-globulin gene and Graves ’ disease relapse after antithyroid drug with-drawal / 中国病理生理杂志

AIM:To explore the association between single nucleotide polymorphism in exon 33 (E33SNP) of thyroglobulin gene and Graves ’ disease ( GD) relapse after antithyroid drug ( ATD) withdrawal .METHODS:The healthy controls (232 cases) and GD patients with discontinued treatment (243 cases) were selected.According to the time of re-lapse, the GD patients were divided into A, B and C subgroups.The A group contained 77 cases of relapse within 1 year, B group contained 86 cases of relapse 1~2 years after treatment and C group contained 80 cases without recurrence within 2 years.The genotypes of E33SNP were identified by RT-PCR.The genotype ratio of thyroglobulin between control group and observation group was comparatively analyzed , and the levels of thyroid-stimulating hormone ( TSH) , free triiodothyro-nine (FT3), free thyroxine (FT4) and thyrotropin receptor antibody (TRAb), ophthalmopathy and goiter size in A , B and C subgroups in different genotype GD patients were investigated .Moreover , cumulative efficiency for patients with different genotypes in the observation group after ATD treatment within 2 years were analyzed .RESULTS:The genotype of E33SNP between observation group and control group had no significant difference , but a significant difference between A , B and C subgroups was observed (P<0.05).The levels of TSH, FT3 and FT4, and goiter size of the patients with different geno-types had no significant difference , while the TRAb levels and ophthalmopathy presented a significant difference ( P <0.05).In addition, the cumulative efficiency within 2 years for GD patients with E33SNP T/T, E33SNP T/C and E33SNP C/C genotypes was 61.8%, 42.6% and 21.3%, respectively, all with significant differences (P<0.05).CONCLU-SION:The GD patients with E33SNP C/C genotype have significantly higher TRAb level and ophthalmopathy rate than those in the patients with E33SNP C/T and E33SNP C/C genotypes, and are more likely to relapse after ATD treatment . The GD patients with E33SNP T/T genotype show a lower recurrence rate .Therefore, combination treatment or other treat-ment modalities may be more reasonable for the GD patients with E 33SNP C/C genotype.

Analysis on external quality control results for iodine deficiency disorders laboratories in Shandong in 2016 / 中华地方病学杂志

Objective To evaluate the testing ability of iodine in the disease control and prevention institutes at all levels in Shandong,and to raise their testing ability.Methods The testing ability of salt iodine,water iodine and urinary iodine of iodine deficiency disorders laboratories at provincial,prefectural and county levels in Shandong in 2016 was evaluated.The testing results of salt iodine were evaluated by using reference value ± uncertainty.The testing results of water iodine and urinary iodine of all the participatory laboratories were evaluated by using standard Z score generated from laboratories participated in the examination.Results One provincial and 17 prefectural salt iodine,water iodine and urinary iodine laboratories and 30 county level salt iodine laboratories took part in the national examination.Both the feedback rate and qualified rate of the testing results were 100％.The 65 urinary iodine laboratories at the county level took part in the provincial examination.The feedback rate was 92.3％ (60/65),and the qualified rate was 75.4％ (49/65).Conclusions The results of the national examination have showed that the testing ability at all levels of the laboratory is maintained at a higher level;the results of the provincial examination have showed that the testing ability of most of the county level urinary iodine laboratories is relatively stable at a higher level.The testing ability of some county level urinary iodine laboratories is low.We should focus on strengthening the county level urinary iodine laboratory construction.