BACKGROUND:Distal femoral fractures are mainly treated with less invasive stabilization system (LISS) plate or retrograde interlocking intramedul ary nail fixation, but choosing which method is controversial, and studies on their biomechanical properties are few. OBJECTIVE:To compare the biomechanical stability of retrograde interlocking intramedul ary nail and LISS plate fixation in the treatment of distal femoral fractures. METHODS:Twelve male cadaveric femurs were col ected, and the injured, with abnormal bone density and osteonosus specimens were excluded through X-ray examination, fol owed by randomly divided into two groups. Models of AO type A3 supracondylar fracture were prepared, and were fixed with LISS plate and retrograde interlocking intramedul ary nail, respectively. The compressive stiffness and displacement values under axial compression and loading of 100, 300 and 500 N, as wel as the bending strength of the specimens under bending load were observed. RESULTS AND CONCLUSION:(1) The resistance to axial deformation capacity (compressive stiffness) of the LISS plate was superior to the retrograde interlocking intramedul ary nail (P<0.05);while the resistance to bending deformation capacity (flexural strength) of the retrograde interlocking intramedul ary nail was not significantly greater than that of the LISS plate (P>0.05). (2) Under axial compressive loading of 100, 300 and 500 N, the displacement values of LISS plate were significantly less than those of the retrograde interlocking intramedul ary nail (P<0.05). (3) In conclusion, in the distal femoral fracture fixation, the stiffness of the retrograde interlocking intramedul ary nail is low. While the LISS plate not only has certain deformation, but also has strong rigidity with firm internal fixation, which provides excel ent biological environment for fracture healing;thus it is a reliable treatment for distal femoral fractures.

This paper was aimed to study the method of rapid determination of total flavonoids in Chrysanthemum of different processing methods by near infrared spectroscopy (NIRS). The Chrysanthemum was dried by three different processes. The three methods were directly drying, drying after steamed and drying after fry, respectively. The determination of total flavonoids in Chrysanthemum by different processing methods was produced by using UV-Vis spectrophotometry. Collecting the NIRS spectra of Chrysanthemum, the quantitative analysis model of total flavonoids content in Chrysanthemum of different processing methods was established by partial least square (PLS) and the model was validated. The correlation coefficient (R2), the root-mean-square error of calibration (RMSEC) and the root-mean-square error of prediction (RMSEP) were 0.996 19, 0.104 and 0.168, respectively. The correlation coefficient of predication (r) was 0.979 3 which state that the prediction was accurate. The method of NIRS had the advantage of fast determination, simple operation and high accuracy of prediction, and could be used for rapid determination of total flavonoids content in Chrysanthemum of different processing methods.

Objective: To elucidate the correlation between the single nucleotide polymorphism of CKLF-like MARVEL transmembrane member 5 ( CMTM5 ) gene rs723840 and the occurrence of high on aspirin platelet reactivity ( HAPR) . Methods:The present study is a case-control study. A total of 210 hospitalized patients in Peking University First Hospital were enrolled. Aspirin response was assessed by 0. 5 g/L arachidonic acid (AA)-induced platelet aggregation ratio (PR), and ≥3/4 quartile of PR of the population was defined as HAPR. Accordingly all the enrolled 210 coronary artery diseases ( CAD) patients were divided into HAPR group and No-HAPR group. The genotypes were determined by poly-merase chain reaction ( PCR) and sequencing analysis for rs723840 of CMTM5 gene. Results:The geno-type frequencies in rs723840 C>T of CMTM5 gene conformed well to the Hardy-Weinberg equilibrium in both HAPR group and No-HAPR group. Between the two groups, the genotypes frequencies in HAPR and No-HAPR groups were 48 . 4%, 51 . 6%, 0 . 0% and 73 . 7%, 22 . 9%, 0 . 034%, respectively ( P=0. 004). The C, T allele frequencies were significantly different in the two groups (P =0. 031,OR =0 . 501 , 95%CI:0 . 264-0 . 947 ) . Conclusion:Our study finds a significant correlation between CMTM5 gene rs723840 polymorphism and high on aspirin platelet reactivity.

Objective:To elucidate the correlation between urinary 11-dehydro-thromboxane B2 ( 11 dhTxB2 ) and clinical efficacy of aspirin treatment in patients with type 2 diabete and coronary artery disease ( CAD) . Methods:In this prospective cohort study, 169 aged patients with type 2 diabete accom-panying CAD in Peking University First Hospital were enrolled. The level of urinary 11dhTxB2 was detec-ted using enzyme-linked immuno-sorbent assay. Low aspirin response or high on aspirin platelet reactivity (HAPR) was defined as urinary 11dhTxB2>1 500 ng/g. All the included patients were divided into two groups based on the results, HAPR group and No-HAPR group. Results:Baseline urinary 11dhTxB2 of the patients with type 2 diabete accompanying CAD was ( 3 687 ± 3 052 ) ng/g, while the urinary 11dhTxB2 was (1 954 ± 859) ng/g in patients after 100 mg/d aspirin treatment (P<0. 001). Preva-lence of HAPR in patients with type 2 diabete accompanying CAD were 32 . 5%. Within a mean follow-up time of 12 months, the outcomes occurred more frequently in HAPR group than in No-HAPR group ( P<0 . 05 ) . Conclusion:Urinary 11 dhTxB2 can be recognized as an effective indicator in evaluating aspirin clinical efficacy of patients with type 2 diabete accompanying CAD.

Nicotinamide adenine dinucleotide (NAD

Telomere is one of the basic functional elements for maintaining genome stability. Telomeres can become shorter due to cell divisions and environmental factors. Critically shortened telomeres eventually lead to cellular replicative senescence. Telomere length is an important parameter of telomere function, which determines the stability of chromosomes and the ability of cell proliferation. Currently multiple methods have been developed for the analysis of telomere length, including terminal restriction fragment (TRF) analysis, quantitative polymerase chain reaction (qPCR), single telomere length analysis (STE-LA), telomere shortest length assay (TeSLA) and telomere length combing assay (TCA) based on DNA, as well as quantitative fluorescence in situ hybridization (Q-FISH) based on cellular levels. Different analysis methods are applied to obtain different telomere relevant variables. In the review, we discuss the principle and application advantages of each telomere length analysis, which may help researchers select an optimal assessment approach to better address specific research questions about telomere in either model organisms or humans.

Objective: To investigate the clinical efficacy of needling Danzhong(CV 17) in the treatment of postpartum hypogalactia and provide clinical evidence for indications of the point. Methods: A multi-centre single-blind randomized controlled trial was carried out. Two hundred and seventy-six puerperal women with postpartum hypogalactia were randomly allocated into acupuncture group and herb group, and respectively treated for three consecutive days. The degree of mammary fullness, the amount of milk secreted, prolactin, baby weight, the frequency and volume of artificial feeding, the number of infant urination events, and the duration of baby crying were observed. The clinical curative effects on postpartum hypogalactia were compared. Results: Hypogalactia was effectively treated in both acupuncture and herb groups. There were statistically significant differences in degree of mammary fullness, amount of milk secreted, baby weight, the frequency and amount of artificial feeding, and the number of infant urination events between pretreatment and post-treatment, but no difference between the two groups. There was no significant difference in prolactin in the acupuncture group and there was a difference in prolactin in the herb group between pretreatment and posttreatment. Conclusion: Needling Danzhong(CV 17) can effectively promote lactation.

Objectives To investigate the image quality,influencing factors and radiation doses of prospectively ECG-triggered spiral acquisition mode (Flash spiral mode)coronary computed tomography angiography (CCTA) using high-pitch dual-source CT in patients with different heart rates.Methods One hundred and thirty-four consecutive patients with mean heart rate (HR) ＞ 65 beats per minute (bpm) and ≤ 100 bpm were included in this study as group A using Flash spiral mode setting at 20％ -30％ of the R-R interval and 134 consecutive patients with mean HR ≤65 bpm were enrolled as group B using Flash spiral scan mode at 55％ of the R-R interval; 134 consecutive patients with mean HR ＞ 65 and≤100 bpm using spiral scan mode were included as group C. The image quality scores, effective radiation dose and influencing factors of image quality in three groups were assessed. All statistical analyses were performed using SPSS.Results (1)The non-diagnostic coronary artery segments in group A (28/1842,1.52％) were more than in group B (8/1819,0.44％ ) ( x2 =10.97,P =0.001 ) and there was no significant difference between group A and group C (32/1838,1.74％) ( x2 =0.280,P =0.345).The number of patients with non-diagnostic coronary segments in group A( 10/134,7.5 ％ )was more than in group B (2/134,1.5 ％,x2 =5.52,P =0.018 ),while there was no significant difference between group A and group C (9/134,6.7％,x2 =0.057,P =0.812).(2)The average heart rate variability (HRV) of patients with different image scores in the three groups wcrc significantly different. In group A,the HRV of score 1,2 and 3 were (2.29 ± 1.06),(5.17 ± 1.37),(8.88 ± 1.53) bpm,respectively (F =170.402,P =0.001 ).In group B were (2.26±1.01),(5.97 ±1.82),(12.00 ±9.64) bpm,respectively (F=95.843,P=0.001).In group C were (2.61 ±1.85),(7.90 ±3.97),(11.22 ±5.62) bpm,respectively (F=68.629,P=0.001 ). (3) The average effective radiation doses in groups A and B were significant lower than in group C [ A group was 1.04 ± 0.16,B group was 1.03 ± 0.16 and C group was 7.05 ± 1.05,t =65.5 ( A vs C),P ＜0.01 ( A vs C) ].Conclusions Flash spiral mode of high-pitch dual-source provides high image quality with significant reduction of radiation exposure in patients with HR ≤ 65 bpm. Patients with heart rates ＞65 bpm and ≤100 bpm without cardiac arrhythmia can perform CCTA using Flash spiral mode with image acquisition time setting at 20％-30％ of the R-R interval.

ObjectiveTo investigate the characteristics of surface electromyography (sEMG) of muscles in stroke patients with lower limb spasticity. MethodsFrom October, 2016 to July, 2020, a total of 32 stroke patients with hemiplegia and eleven healthy subjects (control group) were selected. The patients were divided into modified Ashworth Scale (MAS) 0 group (n = 13), MAS 1 group (n = 10) and MAS 1⁺ group (n = 9). All the groups were subjected to isokinetic passive movement at baseline, 90°/s, 150°/s, 210°/s and 270°/s, respectively. sEMG signals of rectus femoris muscle and lateral head of quadriceps femoris muscle including root mean square (RMS) and integrated electromyography (iEMG) were collected synchronically during isokinetic passive movement. ResultsThere was no significant difference in RMS and iEMG among baseline and the four angular velocities in the control group and MAS 0 group (P > 0.05). The RMS and iEMG of MAS 1 group at 270°/s were significantly different from baseline and the other angular velocities (P < 0.05), and no significant difference was found among the other velocities (P > 0.05). The RMS and iEMG of MAS 1⁺ group were significantly different among baseline and the four angular velocities (P < 0.05). ConclusionRMS and iEMG varies with angular velocity in hemiplegic patients with different muscle tension levels. In patients with the same muscle tension level, the changes of RMS and iEMG with angular velocity are consistent. RMS and iEMG can reflect the degree of spasm. The quantitative evaluation of spasm by sEMG in isokinetic passive movement mode is highly feasible and worthy of further clinical research and promotion.

BACKGROUNDThe Xpert MTB/RIF showed high sensitivity and specificity in previous studies carried out in different epidemiological and geographical settings and patient populations in high-burden tuberculosis (TB) countries. However, there were little data obtained by validation or demonstration study of the assay in China. In this study, the performance of Xpert MTB/RIF was investigated in two county-level laboratories in Hunan Province, China.

METHODSConsecutive patients with suspected pulmonary tuberculosis (PTB) and suspicion for multidrug-resistant tuberculosis (MDR-TB) were enrolled. For each patient suspected to have PTB, three sputum specimens (one spot sputum, one night sputum, and one morning sputum) were collected and each sputum was tested with smear microscopy, Löwenstein-Jensen (LJ) culture, and Xpert MTB/RIF test. For comparison across subgroups and testing methods, 95% confidence intervals were calculated. All analyses were done with SPSS 16.0, and P < 0.05 was regarded as significant.

RESULTSFor case detection, the sensitivity of Xpert MTB/RIF was 100% for smear- and culture-positive TB and 88.6% for smear-negative and culture-positive TB; the overall sensitivity was 94.5% for all culture-positive patients. The specificity was 99.8%. The sensitivity of Xpert MTB/RIF assay was 22.0% in clinical TB patients and the specificity reached 100.0% in the group of patients who are infected with nontuberculous mycobacteria. For the detection of rifampin resistance, the sensitivity of MTB/RIF RIF-resistance detection was 92.9%, and the specificity was 98.7%. Of the 26 Xpert MTB/RIF-positive and RIF-resistant patients confirmed by LJ proportion tests, 20 (76.9%) patients were infected by MDR-TB.

CONCLUSIONSThe Xpert MTB/RIF assay is a highly sensitive and specific method for diagnosis of TB and RIF resistance, which will enable it to have the potential to be used in county-level laboratories and lead to the reduction of the infectious pool and improvements in TB control in China. Further evaluations in county-level laboratories for implementing the assay are still required.

Adult ; Antibiotics, Antitubercular ; therapeutic use ; China ; Female ; Humans ; Male ; Middle Aged ; Rifampin ; therapeutic use ; Tuberculosis ; diagnosis ; drug therapy ; Tuberculosis, Multidrug-Resistant ; Tuberculosis, Pulmonary ; diagnosis ; drug therapy ; Young Adult