The accurate medical treatment is based on the information of the genome, which is the best treatment for the patients. Population pharmacokinetic study can be formulated according to the individual differences of patients to the dose, in the accurate medical model which has a unique advantage. At present, there are many problems such as adverse drug reaction in Chinese traditional medicine, and it is necessary to introduce a group of medicine on the basis of precise medical treatment. However, due to the different characteristics of traditional Chinese medicine and chemical medicine, it is necessary to combine the population pharmacokinetics, genetics and statistical methods to establish a research method which is in line with the characteristics of Chinese medicine. The key scientific problem is to make clear the active components of Chinese medicine metabolism of the drug metabolic enzyme gene, and pay attention to the analysis of the polymorphism of the overall role of drug metabolism enzymes in the human body. Clear key scientific issues and break through the bottleneck, so as to achieve the precise medical treatment, to international.
Humans ; Medicine, Chinese Traditional ; Pharmacokinetics

Th2 cytokines play a pivotal role in the pathogenesis of allergic rhinitis. To investigate the effect of p38 mitogen-activated protein kinase (MAPK) on the production of Th2 cytokines such as IL-4 and IL-5 in allergic rhinitis, a model of allergic rhinitis was established in SD rats. The expression level of p38 MAPK mRNA in PBMCs was detected by means of real time quantitative RT-PCR. The p38 MAPK activity in PBMCs was detected by Western blotting. PBMCs were cultured with various concentrations of p38 MAPK inhibitor SB 239063 or without the treatment, and then IL-4, IL-5 levels of the supernatant were determined by using sandwich ELISA. The results showed that mRNA expression and activity of p38 MAPK in PBMCs were significantly higher in allergic rhinitis rats than in control rats (P<0.05). The p38 MAPK inhibitor SB 239063 decreased the production of IL-4 and IL-5 in a dose-dependent manner. It is concluded that p38 MAPK plays an important role in the pathogenesis of allergic rhinitis which is associated with Th2 cytokines release.

Objective To evaluate of the clinical effect of triple arthrodesis and bone grafting combined with plat screw internal fixation for treatment of necrosis of talus. Methods The clinical data of 24 patients with necrosis of talus who were treated by triple arthrodesis and bone grafting combined with plat screw internal fixation from April 2011 to January 2015 in Xiangya Second Hospital of Central South Univer-sity were retrospectively analyzed. And the clinical effect were measured by AOFAS Ankle Hind-foot Scale System. Results The 24 patients were followed up for 26 months averagely (12~36 months). According to AOFAS Ankle Hind-foot Scale System, there were 4 cases of mod-erate and 20 cases of bad before treatment, and there were 18 cases of excellent, 4 cases of good, and 2 cases of moderate after the treat-ment. Conclusion It can achieve good clinical results in treatment of necrosis of talus through triple arthrodesis and bone grafting combined with plat screw internal fixation.

Aim To observe the protective effects of two flavone morphons on hypoxia/reoxygenation(H/R) injury in myocardial cells and explore the mechanisms.Methods The hypoxia/reoxygenation injury model of cultured neonatal rat cardiomyocytes was developed. The cell morphology,the spontaneous beating,the survival rate,the content of LDH,NOS,T-SOD,MDA and the activity of Na+,K+-ATP,Ca2+,Mg2+-ATP enzyme were determined in the cultured neonatal rat cardiomyocytes injuried by H/R.Results Compared with the model,preconditioning by two flavone morphons enhanced the spontaneous beating and the survival rate. Meanwhile,it increased the activity of T-SOD,Na+,K+-ATP,Ca2+,Mg2+-ATP enzyme and decreased the release of LDH,NOS,MDA(P

Objective To evaluate the role of combination of three-vessel views in ultrasound diagnosis of fetal aortic arch and pulmonary arterial branch anomalies.Methods The data of 66 cases of fetal aortic arch and pulmonary arterial branch anomalies were retrospectively analysed,including echocardiographic data,autopsy and operation records and postnatal follow-up results.Echocardiogaphic features and display frequencies on three vessels and trachea view(3VT),three vessels view(3VV)and three vessels and pulmonary arterial branches view(3VP)were summarized.Results There were 52 cases of aortic arch abnormalities,including 32 cases of right aortic arch with left ductus arteriosus,4 cases of double aortic arch,7 cases of aberrant right subclavian artery,6 cases of coarctation of aorta and 3 cases of interruption of aortic arch.Fourteen cases were diagnosed pulmonary aterial branch abnormalities,including 1 0 cases of crossed pulmonary arteries,2 cases of anomalous origin of left pulmonary artery from aortic arch and 2 cases of pulmonary artery sling.The display frequencies of fetal aortic arch and pulmonary arterial branch anomalies on 3VT,3VV and 3VP were 80.3%,19.7% and 39.4%.Conclusions The combination of three-vessel views is of great value in prenatal diagnosis of fetal aortic arch and pulmonary arterial branch anomalies.

Objective: To investigate the status and identify the influencing factors of smoking among residents in Shaoxing City, Zhejiang Province, so as to provide insights into tobacco control. Methods: Permanent residents aged 15 to 69 years in Shaoxing City were recruited using the stratified multistage random sampling method from June to December 2022, and smoking behaviors and health literacy were collected using the National Questionnaire for Surveillance on Healthy Literacy in Chinese Residents. Factors affecting smoking were identified using a multivariable logistic regression model. Results: Totally 4 156 questionnaires were allocated, and 4 055 valid questionnaires were recovered, with an effective recovery rate of 97.57%. There were 1 899 men (46.83%), 2 073 residents in rural areas (51.12%), and 3 256 married residents (80.30%). There were 805 smokers, and the rate of smoking was 19.85%. Multivariable logistic regression analysis showed that male (OR=169.861, 95%CI: 92.335-312.481), age (25-<35 years, OR=8.768, 95%CI: 2.964-25.937; 35-<45 years, OR=9.271, 95%CI: 3.077-27.933; 45-<55 years, OR=10.467, 95%CI: 3.498-31.327; 55-<65 years, OR=8.880, 95%CI: 2.964-26.608; 65-69 years, OR=6.115, 95%CI: 1.992-18.774), marital status (divorced, OR=2.035, 95%CI: 1.260-3.287; widowed, OR=2.317, 95%CI: 1.337-4.016), educational level (illiterate or semi-literate, OR=2.724, 95%CI: 1.515-4.898; primary school, OR=2.734, 95%CI: 1.823-4.100; junior high school, OR=2.003, 95%CI: 1.423-2.820; high school/vocational high school /technical secondary school, OR=1.625, 95%CI: 1.148-2.299), self-rated health status (general, OR=0.788, 95%CI: 0.623-0.996; relatively poor, OR=0.343, 95%CI: 0.191-0.617) and lack of basic health skills (OR=1.290, 95%CI: 1.007-1.653) were associated with smoking. Conclusions The smoking rate among residents in Shaoxing City is relatively low, and might be influenced by gender, age, marital status, educational level, self-rated health status, and basic health skills.

OBJECTIVETo compare the short-term clinical outcome between unilateral fixation fusion (ULF) and minimally invasive spine transforaminal lumbar interbody fusion (MIS-TLIF) in treating lumbar disc herniation (LDH).

METHODSThe clinical data of 39 patients with LDH were retrospectively analyzed from June 2008 to March 2013. There was 22 males and 17 females, aged from 45 to 75 years old with an average of 56.9 years. Therer were 3 cases in L3,4, 15 cases in L4,5, 21 cases in L5S1. Among them, 21 patients underwent unilateral fixation fusion (ULF group) and 18 underwent minimally invasive spine transforaminal lumbar interbody fusion (MIS-TLIF group). Operation time, blood loss, the times of radiographic exposure and hospital stay were noted and compared between two groups. Radiograph informations were regularily accessed and VAS, ODI scores were recorded at 3 days and 3, 6, 12 months after operation, respectively. According to modified Macnab criteria, the clinical effects were evaluated at final follow-up.

RESULTSAll operations were successful without severe complications. The averaged operative time and the times of radiographic exposure in ULF group [(95 ± 25) min and (4.2 ± 0.4) times] were less than that of MIS-TLIF group [(120 ± 35) min and (10.1 ± 3.9) times] (P < 0.05). But, the mean blood loss and hospital stay in MIS-TLIF group [(75 ± 45) ml and (7.2 ± 2.2)d ]were less than that of ULF group [(165 ± 60) ml and (11.0 ± 3.7) d] (P < 0.01). All patients were followed up from 12 to 45 months with an average of 29.5 months. The VAS and ODI score had significantly improved during the follow-up and no significant differences were found between two groups at the same time point (P > 0.05). The postoperative radiographs showed internal fixation position was good. And all patients obtained bone fusion by CT scan at 1 year after operation. There was no significant differences in modified Macnab criteria between two groups at the latest follow-up (P > 0.05).

CONCLUSIONFavorable short-term clinical effects can be achieved in suitable LDH patients with ULF or MIS-TLIF surgical procedures.

Aged ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Spinal Fusion ; methods

The research on clinical efficacy evaluation of traditional Chinese medicine (TCM) is a hot and difficult issue in the field of TCM. However, the overall level of current related research also needs to be improved. There are still a lot of academic controversies in the field of TCM clinical efficacy evaluation. The author believed that before conducting research, it is necessary to sort out core issues of TCM clinical efficacy evaluation, which in-clude the concept of TCM clinical efficacy and its evaluation. In recent years, Chinese scholars have conducted a series of studies on these issues and have some achievements. To think and answer these questions will play an important role for the ultimate resolution of problem of TCM clinical efficacy evaluation.

OBJECTIVETo compare mid-term clinical outcomes between amputation and limb salvage in treating severe open tibial fractures with type Gustilo III B, III C.

METHODSFrom July 2007 to June 2010,68 patients with severe open tibial fractures with type Gustilo III B, III C treated by amputation and limb salvage were retrospectively analyzed. In amputation group, there were 26 males and 12 females with an average age of (44.9±16.3) years old; and 21 cases were type Gustilo (III B, 17 cases were Gustilo III C; amputation were performed in accordance with soft tissue injury degree of shank, fracture types and surgical exploration. In limb salvageg group, there were 21 males and 9 females with an average age of (43.5±14.7) years old; and 23 cases were type Gustilo III B, 7 cases were Gustilo III C; the method of internal fixation and and wound healing were performed in accordance with patients's specific condition. Operative time, blood loss, hospital stay and postoperative infection was compared between two groups; time of loading and rate of return to work was compared; VAS scoring was used to evaluate condition of pain; SF-36 health queationaire was used to assess postoperative life quality.

RESULTSTotally 60 patients were followed up (33 cases in amputation group and 27 cases in limb salvage group) with an average time of 49.1 months. Operative time, blood loss, hospital stay and postoperative infection in amputation and limb salvage group respectively was (109.0±25.7) min, (245.0±58.6) min; (168.0±49.0) ml, (311.0±137.0) ml; (13.8±2.7) d, (28.8±13.1) d; 7.9%, 36.7%. At the final following-up, there was no significance meaning between two groups in VAS scoring and rate of return to work, but time of loading in amputation group was shorter than that of in limb salvage group. Physiological function in amputation group was better than limb salvage group, while body pain was worse; and there was no signicance meaning in psychological health between two groups.

CONCLUSIONAmputation and limb salvage both can treat severe open tibial fractures, and mid-term clinical outcomes between two groups has equivalent efficacy.

Adolescent ; Adult ; Aged ; Amputation ; methods ; Case-Control Studies ; Female ; Humans ; Limb Salvage ; methods ; Male ; Middle Aged ; Tibial Fractures ; surgery

BACKGROUND: Effect of acellular surfactant and biological safety of bone graft materials highly correlated with selection of surfactant; therefore, a novel compound surfactant was used to prepare acellular bone graft materials in this study. OBJECTIVE: To evaluate acellular effect and biological safety of bio-derived bone tissue treated by a novel surfactant in order to obtain a safe and reliable bone graft material. METHODS: Surfactant was prepared with anionic surfactant sodium dodecyl benzene sulfonate (ABS), anionic surfactant sodium fatty alcohol ether sulfate (AES) and distilled water at the ratio of 13:7:80. Fresh bovine cancellous bone and surfactant which was used to remove cells and lipid by two-step flow were used to prepare a novel bio-derived bone graft material. The histological and microscopic observations of microstructure were made. Also acute body toxicity test, hematolysis experiment, cell toxicity test and biological safety were assessed on surfactant-treated bio-dedved bone graft material (STBB). A long-term animal experiment was conducted to observe the biocompatibility and biodegradability of STBB. The ultraviolet dispersion of light luminosity method was employed to measure the residual amount of surfactant in STBB. RESULTS AND CONCLUSION: STBB was a whitish porous cancellous bone. No cell was found in bone lacuna, bone canaliculus was empty, and the collagen fiber had an order arrangement. Acute body toxicity test was qualified according to GB/116886.11-1997 standard, hematolysis experiment was < 5%, and cell toxicity test was grade 0, confirming that STBB was safe. The remaining surfactant in STBB was lower than 0.1 g/L. The long-term animal experiment demonstrated that fiber was present at 4 weeks, bone lacuna had cellular growth and the fusion of STBB and host appeared. The STBB was partial absorbed by organism at 8 weeks and completely absorbed at 24 hours. The results indicated that STBB had an excellent biocompatibility and biodegradability. As a new bone implant material, STBB was safe and dependable for transplantation.