BACKGROUND:Early diagnosis and accurate treatment of ligament injuries are the premise of avoiding chronic instability of knee joint and promoting functional recovery of knee joint.
OBJECTIVE:To investigate the clinical efficacy of limited incision with autologous tendon graft for knee ligament injury.
METHODS:Eighty patients with knee ligament damage were randomly divided into two groups. The cases of control group were given orthosis treatment, and the cases of observation group were treated with the limited incision plus autologous tendon graft.
RESULTS AND CONCLUSION:At 6 months post-treatment, the excellent efficacy rate and postoperative quality of life score were increased in the observation group, compared with the control group (P<0.05). The active and passive ranges of motion of knee joint in the observation group were significantly lower than that in the control group (P<0.05). At 3 months post-treatment, Lysholmp scores of the observation group was significantly lower than that in the control group (P<0.05). Limited incision plus autologous tendon graft treatment can significantly improve knee function after knee ligament injury.

Objective:To study the chemical components in the root of Asparagus cochinchinensis(Lour.)Merr.Methods:Chemical components of Asparagus cochinchinensis root were isolated by column chromatography on macroporous resin,Sil-gel,Sephadex LH-20,ODS,etc.and the structures of the components were identified by physiochemical and spectral analysis,such as MS,1HNMR,and 13CNMR.Results:The following 5 components were isolated and identified:diosgenin-3-O-?-D-glucopyranoside(Ⅰ),smilagenin(Ⅱ),26-O-?-D-glucopyranosyl-furost-3?,22,26-triol-3-O-?-D-glucopyranosyl(1→2)-O-?-D-glucopyranoside(Ⅲ),26-O-?-D-glucopyranosyl-furost-5,20-en-3?,2?,26-triol-3-O-\[?-?-rhamnopyranosyl(1→2)\]-\[?-?-rhamnopyranosyl-(1→4)\]-?-D-glucopyranoside(Ⅳ),and 26-O-?-D-glucopyranosyl-furost-3?,26-diol-22-methoxy-3-O-?-L-rhamnopyranosy(1→4)-O-?-D-glucopyranoside(Ⅴ).Conclusion:All the 5 compounds isolated from Asparagus cochinchinensis in this study is reported for the first time.

Objective:To establish an Ehrlich reaction-colorimetry method for determining furostanol saponins in saponins extract from Radix Asparagi.Methods: Based on the coloration reaction between furostanol saponins and p-dimethylaminobenzaldehyde,a colorimetry method was established to determine the content of furostanol saponins in saponins extract from Radix Asparagi at 510 nm.Saponins AC-9 was measured as reference in the determination.Results: The standard curve of saponins AC-9 showed good linearity in the range of 0.08-0.40 mg and the average recovery was 99.79%(RSD=(1.05%).) Conclusion: This method is rapid,accurate and easy to be carried out,and it can be used to control the quality of Radix Asparagi.

Objective: To compare the difference in somatic gene mutation of PTC subtypes between 114 patients with papillary thyroid carcinoma (PTC) and The Cancer Genome Atlas (TCGA) database. Methods: Totally 114 PTC patients admitted to The First Affiliated Hospital of Nanjing Medical University were recruited. The 18 hotspot genes associated with thyroid cancer were detected in thyroidectomy specimens were using next generation sequencing. PTC data were downloaded from the TCGA database in the cBioPortal website, and the difference in the somatic gene mutation was compared between 114 PTC patients and the TCGA database Results: The 114 PTC patients included 73 women (64.04%) and had a mean age of (39.23±13.18) years. The prevalence of BRAF V600E (66.67% vs. 48.68%), TERTp (3.51% vs. 0.41%), PDGFRA (1.75% vs. 0%), PTEN (3.51% vs. 0.41%) and TP53 gene mutations (4.39% vs. 0.61%) was significantly higher among the 114 PCT patients than in the TCGA database (P<0.05). The prevalence of BRAF V600E (80.88% vs. 54.99%), TP53 (7.35% vs. 0.57%) and TSHR gene mutations (2.94% vs. 0%) was significantly higher in classical PTC(CPTC) patients than in the TCGA database, and the prevalence of BRAF V600E (36.84% vs.13.86%) and TERTp gene mutations (10.53% vs. 0%) was significantly higher in follicular variant PTC (FVPTC) patients than in the TCGA database. According to the American Thyroid Association Risk Stratification of Thyroid Cancer Recurrence, the prevalence of BRAF V600E and TP53 gene mutations was 77.14% and 8.57% among moderate-risk CPTC patients, the prevalence of BRAF V600E gene mutation was 27.27% among low-risk FVPTC patients, and the prevalence of TERTp gene mutation was 33.33% among moderate-risk FVPTC patients, which were all higher than in the TCGA database (55.10%, 0%, 3.28%, and 0%, respectively; P<0.05). Conclusion There are significant differences in the type and rate of somatic gene mutations between 114 PTC patients and the TCGA database.

24 new cDNA sequences encoding cytochrome P450 were amplified respectively from deltamethrin susceptible and -resistant strains of the mosquito, Culex pipiens pallens, with a pair of degenerate primers according to the conservative amino acid sequences of CYP4 in insects by RT-PCR. Studies of molecular systematics show that the 24 new genes (alleles) belong to CYP4C, CYP4D, CYP4H and CYP4J subfamilies of the CYP4 family, and they were named by Cytochrome P450 Nomenclature Committee. Among the new genes (alleles), CYP4C23 may be a pseudogene, CYP4H13 has a retained intron 58 nucleotides in length, and CYP4J4V1 has a stop coden (TAG) in frame near the 3'-end.

Objective: To study the hemodynamic changes of fetal umbilical artery (UA) and middle cerebral artery (MCA) and its influence on fetal outcome using color Doppler ultrasound. Methods: Fifty pregnant women who underwent color Doppler ultrasound examination in Zhejiang Xin'an International Hospital from June to December 2018 with normal prenatal examination were selected as control group, and 80 pregnant women with oligohydramnios during the same period of pregnancy were selected as observation group. Color Doppler ultrasound examination was performed on both groups of pregnant women. The results of color Doppler ultrasound examination were compared between the two groups of pregnant women, and the fetal prognosis was followed up. Results: Compared with the control group, the peak systolic velocity/end diastolic velocity (S/D), resistance index (RI) and pulsatility index (PI) values of UA in the observation group were significantly increased, while the S/D, RI and PI values of MCA were significantly decreased, and there were significant differences (P < 0.05). In addition, UA of 34 cases (42.5%) in observation group had S/D ≥ 3, which was much higher than that of 8 cases (16.0%) in control group, and there was significant difference (P < 0.05). The difference between the two groups was statistically significant (P < 0.05). The incidence of fetal distress, intrauterine growth retardation (IUGR) and Apgar < 4 points in observation group were significantly higher than those in control group [26.2%(21/80) vs. 12.0%(6/50), 15.0%(12/80) vs. 2.0%(1/50), 7.5% (6/80) vs. 0], and the difference were statistically significant (P < 0.05). Conclusions Prenatal color Doppler ultrasound can accurately detect the hemodynamic indexes of UA and MCA, predict the fetal intrauterine development, evaluate the fetal outcome, and provide scientific basis for clinical diagnosis.

Objective To evaluate the efficacy and safety of compound Kushen injection as an adjuvant for chemotherapy in treatment of advanced digestive tract cancer. Methods A prospective, randomized, parallel controlled, single center clinical trial was conducted. One hundred and forty-four patients with advanced gastrointestinal cancer admitted to the Department of Oncology of Fangta Traditional Chinese Medicine (TCM) Hospital of Songjiang District in Shanghai from July 2014 to December 2016 were enrolled, and they were divided into a control group and an observation group, 72 cases in each group. The patients in control group received routine chemotherapy, and on the basis of routine chemotherapy, the patients in the observation group was given compound Kushen injection 20 mL having diluted with 250 mL sodium chloride for intravenous drip, once a day for 14 days constituting 1 therapeutic course. After consecutive 2 therapeutic courses, the clinical efficacy was observed, the differences in disease control rate (DCR), Karnofsky score (KPS), TCM syndrome curative effect and adverse reactions were compared between the two groups, follow-up was carried out for 7-24 months, survival rate and progression free survival (PFS) time was observed in the two groups. Results After treatment, the DCR, KPS score, total effective rate of TCM syndrome in the observation group were significantly higher than those of control group [DCR: 59.7% (43/72) vs. 43.1% (31/72), KPS score: 70.9±6.2 vs. 64.8±4.8, total curative effect of TCM syndrome: 63.89% (46/72) vs. 41.67% (30/72), all P < 0.05], and the adverse effect rate was significantly lower than that of control group [25.0% (18/72) vs. 41.7% (30/72), P < 0.05]. In the end of follow-up, there were 12 survival cases in the control group, and 22 survival cases in observation group, and survival rate and the PFS time in observation group were significantly longer than those in the control group [survival rate: 30.6% vs. 16.7%; PFS time (months): 15.3±4.0 vs. 13.2±4.2, P < 0.05]. Conclusions The therapeutic effect of using Kushen injection as an adjuvant for chemotherapy in treatment of patients with advanced digestive tract cancer is relatively good, can improve the life quality of patients, and lower the incidence of adverse reactions.

Objective To explore the anatomical features and the dissection technique of thyrothymic ligament (TTL),and to explore the clinical significance of protecting the inferior parathyroid gland (IPTG) with this structure.Methods Patients who received the initial thyroid surgery in the Department of Thyroid Surgery of the First Affiliated Hospital with Nanjing Medical University from May.2017 to Dec.2017 were prospectively analyzed.We dissected TTL,identified and located the IPTG,described the structural features of TTL,and investigated the position relationship of TTL and IPTG to evaluate the possibility and value of protecting IPTG in situ.Results About 121 patients underwent the dissection,totally 194 sides dissected that included 96 left sides and 98 right sides.TTL was found in 143 sides (73.7％),78 left sides (81.3％) and 65 right sides (66.3％).Nearly 70.6％ IPTG can be proactively identify and located by the TTL during the operation.TTL was a kind of adipose connective tissue that was wide at the bottom and narrow at the top,accompanying with the inferior thyroid vein,from the thymus to the thyroid.76.2％ TTL were attached to the lower pole and the lower 1/3 dorsal of thyroid,containing fat and vessels.33.5％ IPTGs were located in the area surrounding around the ends of the TTL.25.3％ IPTGs were located in the TTL.4.6％ IPTGs were located in the thymus and 7.2％ IPTGs surrounding around the TTL.The incidence rate of post-operation hypoparathyroidism was 14.9％.Conclusions TTL commonly exists and has significant relationship with IPTG.TTL connects thymus and IPTG,which would be considered a complex (thymus-thyrothymic ligament-IPTG complex,TLIC).The meticulous TTL dissection technique will help proactively identify,locate and protect IPTG during operation,and reduce the incidence rate of post-operation hypoparathyroidism.

Objective Isolation , purification and structure identification of phthalides from A pium graveolens L . Methods Silica gel column and preparative TLC chromatography were used to isolate and purify the phthalide compounds .The structures of those compounds were determined through spectral analysis .Results Three pure compounds were identified as 3-n-butylphthalide ,sedanenolide and sedanolide .Conclusion Three pure phthalide compounds can be used as analytical reference standard for quantitative analysis of A .graveolens .