Objective To explore the effect of the improved abdominal rotation card method in insulin injection. Methods A total of 100 hospitalized diabetes patients were randomly divided into control group (n=50) and observational group (n=50) according to the random number method. In the control group, insulin was injected to the subcutaneous tissue of abdomen with traditional method annular rotating method. Insulin was injected using improved abdominal rotation card method in the observational group. Compare accuracy and mastery rate of injection site rotation between the two groups. Compare fasting blood glucose (FBG), postprandial 2H blood glucose (PBG), HbA1c, the incidence of hypoglycemia and endermic induration between the two groups after three months. Results The nurses in the observation group had higher accuracy rate of the injection site rotation compared to the control group [98.6%(690/700) vs. 38.6%(270/700),χ2=584.66, P<0.01]. Mastery rate of the injection site rotation for the patients in the observation group were significantly higher than the control group [70.0% (35/50) vs. 20.0% (10/50), χ2=25.74, P < 0.01]. The incidence of endermic induration were significantly lower in observation group compared to the control group [2.0% (1/50) vs.16.0% (8/50), χ2=5.98, P < 0.01]. The incidence of hypoglycemia were significantly lower in observation group compared to the control group [4.0%(2/50) vs. 16.0%(8/50),χ2=4.00, P<0.01]. Conclusions The new abdominal rotation method in insulin injection can be a safe and effective therapy in patients with type 2 diabetes.

Objective To investigate the impacts of c.388A ＞ G polymorphism of the solute carrier organic anion transporter 1B1 (SLCO1B1) gene on lipid-lowering and anti-atherosclerosis effects of atorvastatin in Chinese patients with ischemic stroke.Methods The patients with ischemic stroke whose baseline low-density lipoprotein cholesterol (LDL-C) ＞ 1.8 mmol/L were enrolled prospectively.They received atorvastatin (20 mg/d) for 12 months.The lipid and bilateral carotid intima-media thickness (CIMT) were measured respectively before and after treatment.The CIMT differences between SLCO1B1 c.388A＞G genotype groups were compared.Results A total of 71 patients with ischemic stroke were enrolled,including 5 AA genotype,31 AG genotype,and 35 GG genotype.The A allele frequency was 28.9％ and the G allele frequency was 71.1％.After treatment,the total cholesterol (TC),triglyceride (TG),and LDL-C in all patients were significantly lower than those before treatment,and high-density lipoprotein cholesterol (HDL-C) was significantly increase (all P＜0.001),but CIMT did not have significant change (P=0.475).The proportion of patients whose LDL-C ＜ 1.8 mmol/L or LDL-C decreased ≥50％ in the GG genotype group was significantly higher than the AG + AA genotypes group (74.29％ vs.44.44％;x2 =6.540,P =0.011).Conclusions SLCO1B1 gene c.388A ＞ G polymorphism could influence the lipidlowering effect of atorvastatin,lipid-lowering effect in the GG genotype group was better than that in the AG+ AA genotype group.SLCO1B1 gene c.388A ＞ G polymorphism did not have effect on the antiatherosclerosis effect of atorvastatin,but it might be associated with too short follow-up time.

Objective:To investigate the efficacy and safety of perioperative aspirin use in elderly patients with osteoporotic vertebral fractures(OVF)undergoing vertebroplasty(VP).Methods:This was a retrospective cohort study.Clinical data of 136 OVF patients treated with VP in our department from Jan.2016 to Dec.2020 were analyzed.Differences in clinical data, treatment efficacy, intraoperative and postoperative complications and hematomas were compared between the aspirin group(n=71, receiving aspirin100 mg/d before VP and not taking other anticoagulant drugs)and the control group(n=65, not taking aspirin).Results:There was no significant difference in the analgesic score or physical activity scale score between the two groups before, 1 week after surgery and at the last follow-up( P>0.05). There were significant differences in the visual analog score(VAS), the analgesic score and the physical activity scale score before, 1 week after surgery and at the last follow-up within the aspirin group(7.12±1.33, 2.37±1.01 vs.2.63±1.04, 3.01±0.95, 1.56±0.65 vs.1.61±0.57, 2.75±0.53, 1.32±0.63 vs.1.44±0.52, P<0.01). No surgical site infection, injury of large vessels, intraspinal hematoma or pulmonary embolism was found in the aspirin group or the control group during the follow-up period.There was no difference in intraoperative or postoperative blood loss(12±3.5 ml vs.11.0±3.6ml, t=1.60), cement injection volume for a single vertebral body(4.5±1.9 ml vs.4.0±1.7 ml, t=1.40), cement spillage(14 cases or 19.7% vs.9 cases or 17.0%, χ2=0.15), nerve root irritation(3 cases or 4.2% vs.1 case 1.9%, χ2=0.43), re-fractures(5 cases 7.0 vs.3 cases 5.7%, χ2=0.10)or spinal epidural hematoma(8 cases or 11.3% vs.5 cases or 9.4%, χ2=0.11)between the aspirin group and the control group(all P>0.05). Conclusions:In OVF patients taking perioperative aspirin, the postoperative pain score, pain medication administration and mobility are significantly improved after VP, compared with pre-treatment.Surgical efficacy and safety show no significant difference between patients with and without aspirin administration.

Objective To investigate the imaging characteristics of spontaneous cerebral artery dissection (CAD) causing cerebral infarction by analyzing the vascular imaging findings.Methods The neuroimaging and clinical data in patients with cerebral infarction due to spontaneous CAD were reviewed. The characteristic findings at different sites of CAD in all vascular imaging examinations were analyzed and summarized. Results A total of 43 patients (28 men, 15women; mean age, 45.1 + 12.3 years) with CAD were included in the study. Twenty-three patients with extracranial internal carotid artery dissection (ICAD), 5 with intracranial anterior circulation dissection, 7 with extracranial vertebral artery dissection (VAD), 6 with intracranial VAD, and 2 with basilar artery dissection (BAD). In patients with extracranial ICAD, occlusion (usually beginning about 1-2 cm above the bifurcation and tapering to a complete occlusion with a flame-like or mouse-tail appearance) was the common imaging findings, luminal stenosis (irregular, elongated, and tapered stenosis) and/or dissecting aneurysms were observed in partial patients, intimal flaps and double-lumen sign were found in a few patients, and vessel tortuosity of ipsilateral or bilateral ICA were observed in 6 patients. Characteristic signs of occlusion or stenosis of extracranial ICAD were observed in computed tomography angiography (CTA) or magnetic resonance angiography (MRA) in partial patients, and magnetic resonance imaging (MRI) could reveal the bright hyperintense crescent-shaped zone that represents the intramural hematoma, and resource imaging of CTA could reveal intimal flaps and double-lumen sign at the level of dissection. Occlusion (V1, V4 segment and V3 segment extending to V4 segment) was the common vascular imaging features in patients with VAD, V1 segment occlusion had a typical appearance: cut-off like or taped occlusion. MRA could reveal VA occlusion, and MRI could show the bright hyperintense of intramural hematoma at the level of VA occlusion. Concomitant dissecting aneurysms and stenosis of intracranial VA were found in 2 patients. Intracranial dissections of anterior circulation were verified mainly by digital subtraction angioraphy (DSA),if dissecting aneurysms or intimal flaps were observed, and intimal flaps were revealed by resource imaging of MRA in a patient. In patients with BAD, dissecting aneurysm was found in a patient, concomitant local stenosis in MRA and bright hyperintense of intramural hematoma on MRI were observed in another patients. Vascular imaging follow-up was performed in 7 patients, complete recanalization was found in a patient with extracranial ICA occlusion due to CAD, stenosis disappeared and dissecting aneurysm almost healed in a patient with extracranial ICAD, dissection lesions had no change in 2 patients with extracranial ICAD, dissecting aneurysm further expanded in a patient with extracranial ICAD, degree of stenosis reduced in a patient with intracranial ICAD, dissecting aneurysm healed after stenting in a patient with intracranial VAD. Conclusions Diagnosis of CAD mainly depends on vascular evaluations, and vascular imaging features of CAD, such as flame-like or taped occlusion, dissecting aneurysms,intimal flaps, irregular or/and elongated stenosis, MRI signals of intramural hematoma, doublelumen sign and so on, were the points for diagnosis of CAD. DSA was an important method for diagnosis of CAD, and MRA + MRA, or CTA and resource imaging were very valuable for diagnosis of CAD. CAD should be followed by methods of vascular imaging because the results of follow-up were very important for adjusting the treatment strategies in patients with CAD.

Objective To analyze the severe extracranial internal carotid artery (EICA)stenosis and occlusion caused the distribution patterns of cerebral infarction lesion and then to investigate the differences of stenosis and occlusion caused mechanisms of cerebral infarction in order to provide the basis for individual prevention and treatment strategies. Methods The clinical and imaging data of 61 patients with atherosclerotic severe EICA stenosis (70-99%) or occlusion caused acute cerebral infarction were analyzed retrospectively. They were divided into stenosis group (n =31) and occlusion group (n =30) according to the degree of stenosis. The distribution pattems of infarct lesion of both groups were compared. They were divided into good (n =31) and poor (n = 26) collateral flow compensation groups according to the middle cerebral artery (MCA) and magnetic resonance angiography (MRA) on the lesion sides of EICA.The distribution patterns of the infarct lesion in both groups were compared. Results The proportion of the patients with hypertension in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (22/26 vs.18/31, P = 0. 042). The proportion of the patients with multiple cerebral infarction in the occlusion group was significantly higher than thai in the stenosis group (15/30 vs. 24/31, P =0. 026),and the proportion of the patients with single cerebral infarction was significantly lower than that in the stenosis group (15/30 vs. 7/31, P =0. 026). The proportion of the patients with large cortical infarction was significantly higher than that in the stenosis group (7/30 vs. 1/31, P=0. 026). Among the patients with single cerebral infarction, the proportion of the patients with border-zone infarct (BZI) in the occlusion group was significantly higher than that in thestenosis group (8/15 vs. 5/24, P = 0. 036), and the proportion of the patients with cortical infarct (CI) was significantly lower than that in the stenosis group (15/24 vs. 4/15, P =0. 048).The proportion of the patients with BZI in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (8/15vs. 4/22, P =0. 036), and the proportion of the patients with CI was significantly lower than that in the good collateral flow compensation group (4/15 vs. 14/22, P =0. 045). The proportions of the patients with large perforating artery infarct (11/30 vs. 3/31, P=0. 016) and BZI (20/30 vs. 10/31, P =0. 010) in the occlusion group were significantly higher than those in the stenosis group, and among the patients with BZI, the proportion of the infarction involving only the patients with internal border zone was significantly higher than that in the stenosis group (15/30 vs. 6/31, P =0. 016). The proportion of the patients with BZI in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (19/26 vs.9/31, P =0. 001), and among the patients with BZI, the proportion of the infarction involving only the patients with internal border zone was significantly higher than that in the good collateral flow compensation group (14/26 vs. 6/31, P =0. 011). The proportion of the patients with incomplete anterior circle of Willis in the poor collateral flow compensation group was significantly higher than that in the good collateral flow compensation group (19/26 vs. 8/31,P =0. 001).Conclusions The lesion distribution patterns of cerebral infarction caused by severe EICA stenosis and occlusion are different, and it suggests that the cerebral infarction mechanisms caused by both are different. In patients with severe EICA occlusive disease, MRA showed that the developing signal change at the lesion sides of MCA may be a potential surrogate index for identifying the state of collateral circulation, but it needs to use the research means of quantitative determination of blood perfusion to verify.

Objective To evaluate efficacy,safety and complication of percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF) in≥90 years patients.Methods Clinical data of 56 cases aged ≥ 90 years with osteoporotic vertebral compression fracture undergoing percutaneous kyphoplasty were retrospectively analyzed.Visual analog scale (VAS) score,analgesics administration score,locomotor activity score,bone cement leakage and incidence of refracture were evaluated before and 3 days after treatment,and at the last follow-up.Results The mean follow-up was 18.6 months (6-32 months) in all patients.The mean VAS score was (7.1 ±2.1) before treatment,(2.6±1.1) at 3 days after the procedure,and (1.8±0.7) at last follow-up,respectively (F=455.794,P＜0.001).Analgesics administration score were (2.0±1.7),(1.4±0.5) and (1.1±0.7) respectively before and 3 days after treatment,and at the last follow-up (F=9.631,P＜0.001).Locomotor activity score were (2.5±0.6),(1.2±0.5) and (1.0±0.3)before and 3 days after treatment,and at the last follow-up (F=63.254,P＜ 0.001) respectively.Bone cement leakage occurred in 10 cases(17.9％),recurrent fracture in 6 cases(10.7％),cerebrospinal leak in 3 cases (5.3％),and nerve root stimulation in2 cases(3.6％).Total complication rate was 33.9％(19/56),and all complications were transient and well tolerated.Conclusions Kyphoplasty for osteoporotic vertebral compression fracture in the very elderly is effective and safe.It alleviates fracture-induced pain,reduces analgesic drug use and improves spinal activity,and provides a better choice for minimal invasive treatment for nonagenarian OVCF patients.

The aim of this paper is to compare the cytotoxicity and cellular uptake efficiency of three kinds of poly(b-benzyl-L-amino) block-poly(ethylene glycol) nanoparticles (PXA-PEG-NPs) using Calu-3 cells, and select one as a nasal drug delivery vector for curcumin (Cur). Poly(gamma-benzyl-L-glutamate) block-poly(ethylene glycol) nanoparticles (PBLG-PEG-NPs), poly(gamma-benzyl-L-lysine) block-poly(ethyleneglycol) nanoparticles (PZLL-PEG-NPs) and poly(gamma-benzyl-L-aspartate) block-poly(ethylene glycol) nanoparticles (PBLA-PEG-NPs) were prepared by emulsion-solvent evaporation method. MTT assays were used to evaluate the cytotoxicity of PXA-PEG-NPs against Calu-3 cells. The cellular uptake of nanoparticles was visualized by an inverted fluorescence microscope and quantified by a flow cytometer. The results indicated that even at high concentration of 2 mg x mL(-1) the three nanoparticles had no cytotoxicity on Calu-3 cells. Compared to the curcumin solution, the three curcumin-loaded PXA-PEG-NPs showed significantly higher cellular uptake efficiency on Calu-3 cells (at equal concentration of curcumin with 5 microg x mL(-1) Cur solution), PBLG-PEG-NPs group was the highest. The cellular uptake increased with incubation time, and has positive correlation with nanoparticle concentration. In brief, PXA-PEG-NPs are conducive to delivery Cur into cells, and PBLG-PEG-NPs might be provided as a good nasal drug delivery carrier.

1,2,4-Butanetriol (BT) is an important non-natural chemical with a variety of industrial applications. A recombinant Escherichia coli biosynthesizing BT from D-xylose was constructed by heterologously expressing xdh and mdlC, and knocking out competing pathway genes including xylA, xylB, yjhE, yagH and ycdW. To optimize BT synthesis pathway, the third catalytic step that catalyzes the decarboxylation reaction of 3-deoxy-D-glycero-pentulosonic acid was identified as a potential bottleneck. Consequently, 2-keto acid decarboxylases from three different microorganisms were screened, and the kivD gene from Lactococcus lactis was found to increase BT titer by 191%. The improved strain BW-025 reached a final BT titer of 2.38 g/L under optimized transformation conditions. Attempts on synthetic pathway optimization were also made by fine-tuning the expression levels of each enzyme involved in the whole pathway based on BW-025. As a result, an xdh overexpressed recombinant strain, BW-074 was finally generated, with 48.62% higher BT production than that of BW-025.
Butanols ; metabolism ; Escherichia coli ; metabolism ; Gene Knockout Techniques ; Genetic Engineering ; Industrial Microbiology ; methods ; Metabolic Networks and Pathways

Objective To investigate the effect and mechanism of DADS in inhibiting the proliferation and inducing apoptosis of gastro-esophageal cancer cells in vitro.Methods The gastro-esophageal adenocarcinoma cells OE1 9 were treated by DADS of different concentrations in vitro.Morphologic changes were observed by the microscope and MTT assay was performed to test the growth-inhibitory effect of DADS on OE1 9 cells.Apoptosis rate of OE1 9 treated with different concentrations of DADS was measured by flow cytometry.Real-time PCR was used to detect DADS-induced effects on mRNA expressions of Caspase-3 ,Caspase-9 ,Bcl-2 ,Bax and NF-κB in OE1 9 cells.Results DADS inhibited the proliferation of OE19 cells in a dose-dependent manner.The apoptosis rate of OE19 cells was 14.0%,25.4% and 19.0% and 27.2%,respectively,when treated with 40 and 80μg/mL DADS for 24 h and 48 h.Real-time PCR assay showed that DADS could enhance mRNA expression levels of Caspase-3 and Caspase-9 and significantly decrease the mRNA expression levels of NF-κB and Bcl-2 and the ratio of Bcl-2/Bax. Conclusion DADS can significantly inhibit the proliferation and induce the apoptosis of gastro-esophageal adenocarcinoma cells via mitochondria-dependent pathways,which may be related to NF-κB and Bcl-2 families.

Objective:To investigate the impact of osteoporosis on clinical outcomes in elderly patients treated with short segment transforaminal lumbar interbody fusion.Methods:From May 2016 to May 2018, elderly patients who had undergone transforaminal lumbar interbody fusion(TLIF)in our hospital were retrospectively analyzed.Based on bone mineral density(BMD), patients were divided into the osteoporosis group(the OP group, n=75, T≤-2.5 in BMD)and the control group(the CO group, n=103, T>-1.0 in BMD). General patient information, clinical data and postoperative follow-up clinical results were compared between the two groups.Results:Eventually 178 cases were enrolled, including 68 with lumbar disc herniation and 110 with lumbar spinal stenosis.Preoperative Visual Analogue Scale(VAS)scores were 7.35±1.30 in the lower back and 7.32±1.30 in the leg for the OP group and 7.35±1.33 and 7.22±1.40, respectively, for the CO group, and there was no significant difference between the two groups( t=0.140 and 0.468, P=0.989 and 0.640). The proportions of cage collapse and internal fixation loosening were 70.7%(53/75)and 37.3%(28/75)in the OP group, which were higher than 22.3%(23/103)and 14.6%(15/103)in the CO group( χ2=41.440 and 12.280, both P=0.000). However, there was no significant difference between the OP group and the CO group in 1-and 2-year postoperative interbody fusion rates(postoperative 1-year rate: 89.3% or 67/75 vs.91.3% or 94/103, χ2=0.187, P=0.666; postoperative 2 year rate: 94.6% or 71/75 vs.95.1% or 98/103), χ2=0.021, P=0.885). There was no significant difference in VAS score and Oswestry disability index(ODI) between the OP group and the CO group at 6 months, 1 year and 2 years after surgery(all P>0.05). Conclusions:Although there are some osteoporosis-related complications such as cage subsidence and screw loosening, short-segment TLIF can still achieve good clinical results in elderly patients with osteoporosis.