OBJECTIVE:To establish the quality criteria of fever and cough syrup for children.METHODS:Thin-layer chromatography(TLC) was employed to make qualitative determination of herbba ephedrae,radix scutellariae,radix glycyrrhi-zae in fever and cough syrup for children,and high performance liquid chromatography(HPLC) was used to determine the con-tent of amygdaloside in its chief medicinal material,almond.RESULTS:The spots in the TLC of herbba ephedrae,radix scute-llariae,radix glycyrrhizae were in the same color with those in the chromatograms of control articles.The linear range of amygdaloside was 0.198?g～4.954?g(r=1.0 000).CONCLUSION:The present method is simple,accurate sensitiveness and highly reproductive,which can be used for the quality control of this preparation.

Objective To investigate the distribution and expression of adiponectin receptors in different tissues of normal Wistar rats. Methods The rats were euthanized and the total RNA was extracted from equal weight tissue samples of cardiac muscle, skeletal muscle, liver, kidney, testicle and fat. RT-PCR was employed to amplify the isolated cDNA, and the expression of adiponectin receptors in different tissues was semi-quantitatively analyzed. Results AdipoR1 was observed in rat cardiac muscle, skeletal muscle, liver, kidney, testicle and fat, with the highest expression in testicle and fat (P

BACKGROUND: Thawed allografts are usually discarded for various reasons. Whether these discarded allografts can be refrozen for later use and their histological changes in vivo have not been reported. OBJECTIVE: To investigate the histological characteristics of anterior cruciate ligament (ACL) reconstructed with the repetitive freeze-thawing allogenic Achilles tendon in New Zealand white rabbits. METHODS: Allogenic Achilles tendons were harvested from adult male New Zealand white rabbits, and were stored at -8 ℃ and thawed at 20 ℃ for 1, 2, 3 and 10 times, respectively, after sealed package and 60Co irradiation. Twenty-four adult male New Zealand white rabbits were enrolled: the left and right knees of 12 rabbits were respectively reconstructed with 1 (control group) and 2 times of freeze-thawing allogenic Achilles tendon, and another 12 rabbits underwent reconstruction with 3 and 10 times of freeze-thawing allogenic Achilles tendon, respectively. Three specimens from each group were evaluated with modified histology grading scores at 6, 12 and 24 weeks to assess the cell morphology, cell quantity, matrix staining intensity, fibrocartilage formation, new bone formation, tendon healing and cartilage injury. RESULTS AND CONCLUSION: The cell morphology, matrix staining intensity and total scores of the 10 times group were significantly higher than those of the other groups at 6 weeks (P < 0.05), but other parameters showed no significant differences among groups (P > 0.05). ACL reconstructed with 10 times of repetitive freeze-thawing allogenic Achilles tendons had higher histological scores at 6 weeks after modeling, but no significant differences were shown at 12 and 24 weeks after modeling. To conclude, our study only testifies better histological scores on the multiple times of freezethawing Achilles tendon than the less times of freeze-thawing Achilles tendon at the early period after operation.

OBJECTIVE To investigate the phenotype and genotype of plasmid-encoded AmpC and extended spectrum beta-lactamases in Klebsiella pneumoniae.METHODS 3-Aminophenylboronic acid(APB) test and ESBLs confirmatory test were used for phenotypic detection of AmpC and ESBLs.Conjugation was conducted in order to understand the spread of plasmid in bacteria.The size and genotype of ampC and ESBL genes were studied by extraction and purification of plasmid,PCR and sequencing analysis.RESULTS A plasmid of about 15kb was extracted from K.pneumoniae.This plasmid carrying resistance genes to antibiotics could be spread from K.pneumoniae to recipient Escherichia coli NK5449 through conjugation.DHA-type ampC gene and SHV-type ESBLs gene could be amplified from plasmids extracted from both K.pneumoniae and its conjugant in E.coli,they were DHA-1 ampC gene and SHV-12 ESBLs gene confirmed by sequencing analysis.CONCLUSIONS DHA-1 ampC gene and SHV-12 ESBLs gene are detected from the plasmid of K.pneumoniae.

Objective To investigate the feasibility of serum cardiac troponin T(cTnT) as a marker of cardiovascular events and hemodialysis (HD) adequacy in maintainence hemodialysis (MHD) patients.Methods Forty-seven cases of MHD patients were randomly divided into two groups (group A and group B).Group A received intermittent HD 4 h thrice one week,and group B received intermittent HD 4 h twice one week plus high-flux hemodiafiltration(HDF) 4 h once one week.Serum examination for blood biochemical indicator,cTnT and echocardiogram was performed every three months and at the time of recruitment.All the patients were followed up until the occurrence of death or cardiovascular events.Results After 3 months treatment,serum cTnT deceased significantly in group B compared with group A,and maintained the lower levels throughout the follow-up.E/A and LVEF had been reduced since 3 months treatment in group A,but stable in group B,E/A was lower in group A after 18 months treatment than that in group B,LVEF was lower in group A after 12 months treatment than that in group B.There were positive correlations between cTnT and E/A or LVEF in 42 cases who accomplished the follow-up of 12 months (r =0.54,0.66,P ＜0.05).Kaplan-Meier survival curve showed that the occurrence of cardiovascular events in patients with cTnT≥0.1μ g/L was higher than that with cTnT ＜0.1 μg/L in (28.5 ± 9.7) months' follow- up (Log-rank test: P =0.02).Both survival analysis and Cox analysis indicated that serum cTnT was a predictor of cardiovascular events in MHD patients.Conclusions Serum level of cTnT can be used as a marker of HD adequacy,and it is a predictor of cardiac events in MHD patients.Regular high-flux HDF increases the adequacy of HD treatment and improves the quality of life in MHD patients.

Aflibercept is a soluble fusion protein which combines ligand-binding elements taken from the extracellular components of vascular endothelial growth factor (VEGF) receptor-1 and receptor-2 fused to the Fc portion of IgG,and it is a novel antiVEGF drug,which can reduce vascular permeability and inhibit neoangiogenesis by binding VEGF tightly.A large number of phase Ⅲ clinical trials have demonstrated the satisfactory outcomes of aflibercept in the management of neovascular age-related macular degeneration,macular edema secondary to retinal vein occlusion or macular edema and other retinal vascular diseases.Moreover,intravitreal injection of afiibercept can improve the visual acuity and attenuate the fundus lesion,which provides a new drug option for physicians.The review will summarize the chemical properties of aflibercept and its application,safety and efficacy of aflibercept for the treatment of retinal vascular diseases.

OBJECTIVE To investigate the prevalence and resistance of extended spectram ?-lactamases(ESBLs) producers in Escherichia coli and Klebsiella pneumoniae.METHODS ESBLs producing strains were screened by double disk test and confirmed by the NCCLS confirmatory test.Susceptibility test to antimicrobial agents was performed by disk diffusion method and analyzed by WHONET 5.3 and Excel.RESULTS The isolated ratio of ESBLs producing E.coli and K.pneumoniae increased from 14% and 15% in 1999 to 30.1% and 30.4% in 2002.Bacteremia caused by the two kinds of ESBLs producers accounted for 30.2% and 30.4%,respectively.ESBLs producing K.pneumoniae and(ESBLs) producing E.coli were 19.8% and 14.0% for outpatient and 26.6% and 31.6% for inpatient.The resistance of(E.coli) to 17 kinds of agents was similar,no matter it was isolated from blood,urine or sputum.Susceptibility of(ESBLs) producing E.coli and K.pneumoniae in urine to cefoperazone/sulbactam,and piperacillin/tazobactam were 85% and 65.2%,66.6% and 29.4%,although to other 15 agents there were no difference.None of the(isolates) showed resistance to imipenem.CONCLUSIONS There is an increasing trend of ESBLs producing E.coli and K.pneumoniae(isolated) from various kinds of specimens and from different wards.It is important for clinical physicians to understand the distribution and the resistance characteristics of ESBLs producing E.coli and(K.pneumoniae) to antibiotics.

BACKGROUND: Platelet-rich plasma has been widely used in orthopedics, plastic surgery, maxillofacial surgery, sports medicine, and intractable wounds due to its advantages of simple preparation, autologous source, low cost, and good safety. OBJECTIVE: To analyze the existing research structure of platelet-rich plasma in recent 5 years worldwide by using CiteSpace software, and to analyze the research hotspots and the evolution trend of platelet-rich plasma by using the visual network map generated by the software, in order to explore the academic frontiers and provide the choice of research direction. METHODS: The Web of Science Core Collection and CNKI database were searched for platelet-rich plasma related literature records published between 2015 and 2020. We visually analyzed the enrolled studies in terms of countries/regions, institutions, authors, journals, and keywords based on the knowledge network maps generated by the CiteSpace software. RESULTS AND CONCLUSION: The average annual number of documents issued in China from 2015 to 2019 was 184.2; the high-yield institutions issued in cooperation were represented by the Department of Orthopaedics of the Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University; the high-yield authors issued in cooperation were represented by Shan Guiqiu; the keywords of hotspots were growth factors, bone marrow stem cells, osteoarthritis, etc. Internationally, the average annual number of documents issued in 2015-2019 was about 928.2; the countries with high yield of cooperative documents issued were the United States, China and Italy; the institutions with high yield of cooperative documents issued were New York Hospital for Special Surgery, University of Pittsburgh and Rush University; the author with high yield of cooperative documents issued was Anitua E; the keywords for hotspots were growth factors, stem cells and repair; and the influential journal was American Journal of Sports Medicine. According to the results of CiteSpace literature analysis, platelet-rich plasma has developed rapidly in the fields of orthopedics, sports medicine and tissue engineering, both at home and abroad.

Objective To describe the technique and therapeutic effect of modified unilateral laminotomy for bilateral decompression (M-ULBD) for lumbar spinal stenosis (LSS).Methods A total of 56 patients with LSS were randomly divided into group A and B.The 27 patients in group A (15 males and 12 females,with an average age of 59.4 years) underwent M-ULBD.The other 29 patients in group B (18 males and 11 females,with an average age of 61.6 years) received conventional laminectomy.JOA score of low back pain,VAS,CPK three days after operation,pre-and post-operative cross-sectional areas of multifidus were used to evaluate the clinical results.Results A total of 45 patients (21 in group A and 24 in group B) completed 2 years of follow-up.The preoperative VAS of low back pain,leg pain,numbness,JOA score and cross-sectional areas of multifidus were 5.6±1.7,7.1±0.4,11.6±2.6,5.8±1.8 cm2 in group A and 6.2±1.2,7.9±1.3,10.9±1.0,6.1±2.0 cm2 in group B.There was no significant difference in preoperative data between both groups.The union of split spinous process was observed in all cases 6months later according to computed tomography.The postoperative CPK was lower in group A.The postoperative JOA and VAS scores in both groups were improved significantly compared with the corresponding preoperative ones.The VAS of leg pain,numbness,JOA score,and JOA recover rate in latest follow-up were 1.3±0.2,1.5±0.7,26.7±2.1,86.1％±3.1％ in group A,and 1.7±0.3,2.0±1.3,24.3±2.5,83.6％±6.4％ in group B,respectively.All these data have no difference between group A and B.The VAS of low back pain and atrophy rate of multifidus were 1.0±0.5,6.4％±1.2％ in group A,and 2.6±0.7,15.7％±3.0％ in group B respectively.All these data are lower in group A.Conclusion Our two years follow-up shows that this method is efficient for lumbar spinal stenosis treatment,however,it still need long term follow-up and to compare with other modified methods.

Objective To review and analyze the clinical effect of combined posterior mini-invasive fixation with anterior debridement via small incision for the treatment of single segment lumbar vertebral tuberculosis. Methods Totally 31 cases with single segment lumbar tuberculosis (both borderline tuberculosis) without attachment involvement underwent one-stage anterior debridement, interbody fusion and posterior mini-invasive fixation from July 2010 to July 2015. Among these patients, 19 were male and 12 were female. The average age was (36.1±17.8) years old (ranged 21-61 years old). The average course of disease was 11(9, 12) months (ranged from 2 to 16 months). All were single segment involvement, and the involved segment was L2-3 in 7 cases, L3-4 in 10 cases, L4-5 in 6 cases, and L5-S1 in 8 cases. The clinical manifestations included lumbar back pain in 31 cases with an average pain visual analog score (VAS) of 7(6, 8) points. ASIA grade of spinal cord injury was E in 25 cases and D in 6 cases. Paravertebral abscess occurred in 22 cases and iliac fossa gravity abscess appeared in 9 cases. Kyphosis was observed in 12 cases and the average Cobb angle was 21° ± 6° . Quadruple anti-tuberculosis chemotherapy was used for at least 2 weeks preoperatively. Posterior mini-invasive fixation was fulfilled on prone position, including mini-invasive percutaneous screws in 18 cases and pedicle screw fixation via Wiltse approach in 13 cases. Posterior distraction and deformity correction were performed simultaneously for patients with kyphosis. Then the patients were changed to lateral position for anterior debridement, bone grafting and/or titanium mesh fusion. Results The average operation time was (204±54) min (ranged 160-240 min) in 31 patients, and the mean blood loss was (168±73) mL (ranged 100-300 mL). Delayed healing of anterior incision occurred in 1 case and the incision healed after two-week dressing of wound. The incision healed well in the rest 30 cases. No complications such as nerve function, blood vessel injury were found in patients. The VAS scores of the 3 days after operation were 1.3 ± 0.3 and 2.1 ± 1.4 in percutaneous group and Wiltse approach group, respectively, and the difference between them was statistically significant ( P<0.05). The VAS score of low back pain was 2(1, 3) points in all the 31 patients three months after operation, which was significantly lower than that before surgery (P<0.05). The six patients with neurological symptoms recovered to E grade after operation. The average Cobb angle correction was 15°±5° in 12 patients with kyphosis (P<0.05), which was significantly decreased compared with that before surgery (P<0.05). All patients were followed up for an average of (36.8 ± 9.3) months (ranged from 12 to 72 months). The clinical healing of tuberculosis was achieved at the final follow-up in all the 31 patients. No complications were observed, such as lumbar kyphosis, internal fixation loosening and breakage, dislocation and titanium mesh subsidence. Conclusion Mini-invasive posterior internal fixation and anterior debridement via small incision is effective for the treatment of single segment lumbar vertebral tuberculosis in lesion debridement and spine stability reconstruction by short segment fixation. This technique can reduce fused segments, surgical trauma of anterior approach and related complications.