Rosuvastatin(RVS)is an excellent drug with anti-inflammatory and lipid-lowering properties in the aca-demic and medical fields.However,this drug faces a series of challenges when used to treat atherosclerosis caused by hyperhomocysteinemia(HHcy),including high oral dosage,poor targeting,and long-term toxic side effects.In this study,we applied nanotechnology to construct a biomimetic nano-delivery system,macrophage membrane(M?m)-coated RVS-loaded Prussian blue(PB)nanoparticles(MPR NPs),for improving the bioavailability and targeting capacity of RVS,specifically to the plaque lesions associated with HHcy-induced atherosclerosis.In vitro assays demonstrated that MPR NPs effectively inhibited the Toll-like receptor 4(TLR4)/hypoxia-inducible factor-1α(HIF-1α)/nucleotide-binding and oligomerization domain(NOD)-like receptor thermal protein domain associated protein 3(NLRP3)signaling pathways,reducing pyroptosis and inflammatory response in macrophages.Additionally,MPR NPs reversed the abnormal distribution of adenosine triphosphate(ATP)-binding cassette transporter A1(ABCA1)/ATP binding cassette transporter G1(ABCA1)/ATP binding cassette transporter G1(ABCG1)caused by HIF-1α,promoting cholesterol efflux and reducing lipid deposition.In vivo studies using apolipoprotein E knockout(ApoE-/-)mice confirmed the strong efficacy of MPR NPs in treating atherosclerosis with favorable bio-security,and the mechanism behind this efficacy is believed to involve the regulation of serum metabolism and the remodeling of gut microbes.These findings suggest that the synthesis of MPR NPs provides a promising nanosystem for the targeted therapy of HHcy-induced atherosclerosis.

Objective Compare the efficacy of superselective arterial embolization with observation in the treatment of HFP caused by trauma.Methods From Jan,2013 to Dec,2017,6 traumatic HFP patients were involved into the study,the age range from 18 to 44 years old,with an average age of 26.2 years.The fistula was measured by doppler ultrasonography before the treatment with its longest diameter,and which ranges from 0.8 to 1.4 cm,the average diameter is 1.14 cm.All patients are divided into two groups according to their treatment.Operation group:4 patients underwent the pudendal artery superselective gelatin sponge vascular embolization.Control group:2 cases were treated with local cold compressing under watchful waiting.In control group,patients are treated by local cold compress with ice bag for 3 weeks:15 mins × 10 times every day.The erectile hardness of the patients was observed and the fistula was evaluated by doppler ultrasonography 3 weeks later,and all the patients were reexamined by doppler ultrasonography 1 year later.The erectile hardness was divided into four grades according to the patient~ subjective feelings:grade Ⅰ,the penis was enlarged but not rigid;grade Ⅱ,the penis had hardness,but not enough to insert into the vagina;grade Ⅲ,the penis could be inserted into the vagina,but not to achieve complete erection;grade Ⅳ,the penis fully erect and firm.The erectile function was evaluated with the International Index of Erectile Function-5(IIEF-5) after 1-year's follow-up.Results 4 patients in the operation group were operated successfully without obvious complications after operation.Median follow-up time of all the patients was 21 months (5-50).In group operation,4 cases of surgical patients did not have the recurrence of priapism.There was no obvious abnormality in the color doppler ultrasound of penis.The score of IIEF-5 was 25,24,24 and 23,respectively.Postoperative erectile function made a complete recovery.In group observation,2 patients under watchful waiting still have grade Ⅱ-Ⅲ sustained priapism,IIEF-5 score is 21 and 19 respectively,the penis color doppler ultrasound scan still showed the change of arteriovenous fistula.Conclusion Superselective arterial embolization is effective in the treatment of HFP,and the recovery of sexual function is better after operation compared with watchful waiting.

Objective To explore the value of iteration algorithm (AIDR 3D) and filter-back projection (FBP) combined with CT low dose scanning in evaluation of lumbar intervertebral disc hernia.Methods Totally 150 patients with lumbar degenerative osteoarthropathy were randomly divided into A＞E groups,with 30 cases in each group.Scanning parameters of A＞D groups were 120 kV of tube voltage,and 100 mAs,50 mAs,30 mAs,as well as 20 mAs of tube current.While parameters of group E were 80 kV of tube voltage and 100 mAs of tube current.Each group was reconstructed with FBP and AIDR 3D,respectively,and their noises,SNRs and CNRs of groups were compared.And 3-point evaluation method was used to score the imaging,while score ≥2 were acceptable image quantity for clinical imaging.Results Under different radiation doses,AIDR 3D reconstruction images were superior to FBP in noise,SNR,CNR and display of intervertebral disc hernia.Under the same reconstruction technology,with the reduction of dose,noise increased,SNR and display of intervertebral disc hernia decreased.Except for slightly lower in AIDR 3D reconstruction with 50 mAs than that with 30 mAs,CNR decreased with the reduction of dose.Two reconstruction technologies under the same dose,image quality of reducing the tube current were better than that of lowering the tube voltage.Conclusion It is valuable of AIDR 3D combined with CT low dose scanning in evaluation on lumbar intervertebral disc hernia.

ObjectiveTo investigate the association between the single nucleotide polymorphism (SNP) of miRNA-146a rs2910164 and recurrence after liver cancer surgery. MethodsA total of 89 patients with primary liver cancer who underwent radical resection for liver cancer in Maojian Hospital of Dongfeng Medical Group were enrolled, and according to the presence or absence of postoperative recurrence, they were divided into recurrence group and non-recurrence group. The TaqMan probe method was used to determine the genotypes (G/C) of miRNA-146a rs2910164. The frequency of each genotype was compared between the two groups to investigate the association between the SNP of MicroRNA-146a and recurrence after liver cancer surgery. The independent-samples t test was used for comparison of continuous data between the two groups, the chi-square test was used for comparison of categorical data between the two groups, and multivariate logistic regression analysis was used to determine the factors associated with the recurrence of liver cancer. ResultsThe three genotypes of miRNA-146a G/C in non-recurrence group conformed to the Hardy-Weinberg equilibrium law (P＞0.05). After the surgery for liver cancer, the frequency of miRNA-146a G/C genotype showed a significant difference between the recurrence group and the non-recurrence group (χ2=9.115, P=0.010), and compared with the non-recurrence group, the recurrence group had a significantly higher frequency of miRNA-146a (rs2910164) CG genotype (χ2=4.013, P=0.039) and a significantly lower frequency of GG genotype (χ2=9.046, P=0.003). The multivariate logistic regression analysis showed that tumor diameter (OR=1.075, P=0.003 9) and miRNA-146a (rs2910164) CG genotype (OR=6.215, P=0.001 4) were the risk factors for recurrence after the surgery for liver cancer, and that miRNA146a(rs2910164) GG genotype was the protective factor against recurrence after the surgery for liver cancer (OR = 0.382, P=0002 5). ConclusionThe SNP of MiRNA-146a (rs2910164 C/G) is associated with recurrence after the radical surgery for liver cancer, and the CG genotype of rs2910164 may be the risk factor for postoperative recurrence after the surgery for liver cancer.

BACKGROUND:There is a general consensus that patients undergoing joint arthroplasty surgery wil be in hypercoagulable state and easily to induce deep vein thrombosis. Thromboelastography is a new kind of method to monitor blood coagulation state, but not widely used in orthopaedics. No final conclusion has yet been reached on whether we can guide the clinical prevention of deep vein thrombosis and medication through using thromboelastography to monitor perioperative coagulation state of patients treated with joint arthroplasty. OBJECTIVE:To investigate the correlation between thromboelastography and routine coagulation functional tests, and evaluate the clinical application value of thromboelastography in monitoring the perioperative coagulation state of patients treated with joint arthroplasty.
METHODS:A total of 204 patients who treated with joint arthroplasty at First Affiliated Hospital of Soochow University from November 2014 to August 2015 were retrospectively analyzed. The thromboelastography, routine coagulation, platelet and other data before and after the replacement were respectively col ected. The correlative analysis was conducted between the thromboelastography result and the results of conventional coagulation test, that is, routine coagulation and platelet count. RESULTS AND CONCLUSION:In total knee arthroplasty group, activated partial thromboplastin time and reaction time showed good consistency (φ=0.713, Kappa value=0.647);Prothrombin time had moderate correlation and general consistency with reaction time (φ=0.392, Kappa value=0.362);Coagulation time and fibrinogen had moderate correlation and consistency (φ=0.392, Kappa value=0.488);Aggregates formation rate (αangle) and fibrinogen had moderate correlation and consistency;the remaining parameters had poor correlation and consistency. In total hip arthroplasty group, there was a weak correlation and consistency between the reaction time, activated partial thromboplastin time and prothrombin time;the other correlations were poor. However, there was a higher proportion of consistent clotting trend between some parameters of thrombelastography and routine coagulation. In total hip arthroplasty group, the consistent proportion of coagulation time and fibrinogen accounted for 67.6%;the consistent proportion of aggregates formation rate (αangle) and fibrinogen accounted for 78.3%. These results suggest that thromboelastography and routine coagulation tests have some correlations and consistency. Thromboelastography parameters have more consistent tendency on the data. Thrombelastography can serve as an auxiliary mean to monitor coagulation state of perioperative joint arthroplasty.

Objective To observe the effect of electric-impulse stimulation to Jiaji points (EX-B2) on spinal cord injury (SCI). Methods Totally 126 eligible SCI patients were randomized into a treatment group and a control group, 63 cases in each group. The control group was intervened by conventional rehabilitation training plus acupuncture, while based on which the treatment group additionally received electric-impulse stimulation to Jiaji points (EX-B2). The spasticity, function, and activities of daily living (ADL) were evaluated 90 d later. Results The spasticity score was significantly changed after intervention in the treatment group(P＜0.01). Tendon reflex and spasticity score were significantly changed in the control group (P＜0.01). After intervention, there was a significant difference between the two groups in comparing spasticity score (P＜0.01). The changes of motor function and sensory function scores in the treatment group were significantly different from that in the control group (P＜0.01, P＜0.05). The Barthel Index (BI) scores were significantly changed in both groups after intervention (P＜0.05). There was a significant difference in comparing the BI score between the two groups after intervention (P＜0.05). Conclusion Electric-impulse stimulation to Jiaji (EX-B2) plus conventional rehabilitation training can significantly improve spasticity, and the motor and sensory functions, and promote the recovery of activities of daily living.

OBJECTIVETo study the clinical effect and surgical operating points of pararectus approach for the internal fixation of acetabular both-column fractures with concurrent displaced quadrilateral plate fractures.

METHODSFrom January 2012 to December 2013, in the Third Affiliated Hospital of Southern Medical University, 15 patients with acetabular both-column fractures and displaced quadrilateral plate fractures were surgically managed through the pararectus approach. There were 11 male and 4 female patients, with an average age of 40 years (from 19 to 61 years). According to Judet-Letournel classification, there were 9 anterior column plus posterior hemitransverse fractures, 6 both-column fractures, 8 cases involving the pelvic fracture. All these fractures were treated through the pararectus approach, in the horizontal position with general anesthesia. The pre-bended plate was placed in interior pelvic ring to fix the anterior wall, anterior column and quadrilateral plate in direct sight. Then, the posterior column was exposed and fixed with antegrade lag screw. Patients were followed up in 4 weeks, 12 weeks, 6 months, 1 year after the operation, and the anteroposterior radiograph of pelvis and the X-ray examination of the fractured hip was performed.

RESULTSAll the 15 cases underwent the operation successfully. Postoperative X-ray and CT exams showed excellent and good reduction of anterior column, posterior column and quadrilateral plate, with none surgical complication occurred. According to the Matta radiological evaluation postoperatively, reduction of acetabular fracture was rated as excellent in 9 cases, good in 3 cases and poor in 3 cases. The rate of excellent and good was 12/15. After 8 to 18 months' follow-up (median follow-up time was 14 months), all the patients gained bone union. According to the modified Merle D'Aubigne and Postel scoring system, 9 cases were excellent, 4 were good, and 2 were fair. The rate of excellent and good was 13/15.

CONCLUSIONSSurgical management of acetabular fractures through the pararectus approach can provide adequate exposure of reducing and fixing both-column acetabular fractures with concurrent displaced quadrilateral plate fractures, which has a good effect in clinical application.

Acetabulum ; pathology ; surgery ; Adult ; Anesthesia, General ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Hip Fractures ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Pelvic Bones ; pathology ; surgery ; Postoperative Period ; Spinal Fractures ; Treatment Outcome ; Young Adult

Objective To explore the effect of extracorporeal shock wave therapy (ESWT) combined with hyperbaric oxygen on nonunion after surgery. Methods 83 patients with nonunion were treated with ESWT combined with hyperbaric oxygen (treatment group), and 32 cases served as control group. ESWT application was conducted using a protocol totaling 3000 shocks per treatment. The treatment group received 3~5 times of treatment, at the same time hyperbaric oxygen therapy was performed. The control group received no treatment and was followed up at least 3 months after treatment. Results The overall success rate was 78.31% in the treatment group, while only 12.50% recovered in the control group (P<0.01). The complications of treatment group were less and negligible. Conclusion Treatment of nonunion by extracorporeal shock wave combined with hyperbaric oxygen is safe and effective.

OBJECTIVETo observe the effect of oxymatrine (OMT) on calcification of humans umbilical vein smooth muscle cells and its underlying mechanism.

METHODHuman umbilical vein smooth muscle cells (HUSMCs) were calcified by beta-giycerophos-phosphate (beta-GP) and then divided into 6 groups: the control group, the calcification group, the pure OMT group, and lower, middle and higher-dosage OMT groups. Cell calcification were observed by Von Kossa staining, calcium content in HUSMCs were determined by the colorimetric method, the alkaline phosphatase (ALP) activity in HUSMCs were determined by phenyl diphosphate-2-sodium, the osteocalcin (OC) level in HUSMCs were determined by radioimmunossay, the transforming growth factor-beta1 (TGF-beta1) level in HUSMC culture medium and the content changes in psmad2/3 and smad2/3 were determined by the ELISA method, and the expression of Core binding factor alpha1 (Cbfalpha1) protein in HUSMCs were determined by western blot method.

RESULTCompared with the control group, the calcification group showed a great number of black granules among the smooth muscle cells and significant increase in the content of calcium and OC and the activity of ALP; OMT intervention can decrease the content of calcium, OC, TGF-beta1, psmad2/3 and Cbfalpha1 and the activity of ALP. And high-dosage OMT group had better effect than middle and low-dosage groups.

CONCLUSIONOMT can effectively inhibit beta-GP-induced HUSMC calcification and its effect on reducing TGF-beta1, psmad2/3 and Cbfalpha1 may be one of its mechanisms in inhibiting HVSMC calcification.

Alkaline Phosphatase ; metabolism ; Alkaloids ; pharmacology ; Calcification, Physiologic ; drug effects ; Cells, Cultured ; Core Binding Factor Alpha 1 Subunit ; metabolism ; Human Umbilical Vein Endothelial Cells ; drug effects ; metabolism ; Humans ; Quinolizines ; pharmacology ; Radioimmunoassay ; Transforming Growth Factor beta1 ; metabolism

OBJECTIVETo explore the effects of oxymatrine (OMT) on JAK/STAT iteral in rat lung tissue with sepsis.

METHODFifty-six male SD rats were randomly divided into 6 groups: sham operation group, model (CLP) group, CLP + OMT high, middle, low-dose groups (52, 26, 13 mg x kg(-1), vena caudalis bolus), and positive control group (dexamethasone, 10 mg x kg(-1), vena caudalis bolus) to observe the effects of oxymatrine on the ratio between wet weight of the lung and dry weight of the lung (W/D) and pulmonary coefficient, gross changes and pathological changes examined with lightmicroscope in the pulmonary tissue. Changes in JAK2 and STAT3 activity in the pulmonary tissue were determined by immunohistochemical method. Tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) levels in pulmonary tissue were determined by radioimmunoassay.

RESULTOMT could decrease significantly the JAK2 and STAT3 positive reaction and activity in the pulmonary tissue (P < 0.05). TNF-alpha and IL-6 levels in pulmonary tissue homogenate decreased markedly (TNF-alpha decreased 36%, 26%, 16% and IL-6 decreased 46%, 39%, 24% on CLP + OMT 52, 26 mg x kg(-1) and 13 mg x kg(-1) groups. P < 0.05 or P < 0.01). OMT could decrease the ratio between wet weight of the lung and dry weight of the lung and the pulmonary coefficient, improve the condition of pulmonary hyperemia, edema, infiltrate of heterophil granulocyte and emerge of asphyxial membrane, and alleviate the inflammatory reaction. And the results were equal to those of the positive control (CLP + dexamethasone) group.

CONCLUSIONOMT can inhibit JAK/STAT iteral activity and reduce the expression of proinflammatory factor (TNF-alpha, IL-6) and antagonize the lung injury in a rat model of sepsis.

Acute Lung Injury ; drug therapy ; metabolism ; Alkaloids ; therapeutic use ; Animals ; Immunohistochemistry ; Janus Kinases ; metabolism ; Lung ; drug effects ; metabolism ; pathology ; Male ; Quinolizines ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; STAT3 Transcription Factor ; metabolism ; Sepsis ; drug therapy ; metabolism