Objective To investigate the effect of two different injection durations and four local pressing durations on the incidence of subcutaneous hemorrhage after low molecular weight heparin, and find a optimum injection duration and pressing time to reduce the incidence of subcutaneous hemorrhage associated with subcutaneous low molecular weight heparin. Methods 80 patients, who were deep venous thrombosis (DVT), pulmonary embolism (PE), and undergone inferior vena cava filter (IVCF) after the operation and received low molecular weight heparin (LWMH) for eight times were selected. The injection time and pressing duration after the injection were randomized into 30 s and 2 min, 30 s and 6 min, 30 s and 10 min, 30s and 14 min, 10s and 2 min, 10s and 6 min, 10 s and 10 min, 10 s and 14 min respectively. The incidence of subcutaneous hemorrhage were measured after 12 h. Single and multiple factor logistic regression analysis were used to analyze the data. Results The injection time and pressing duration after the injection were randomized into 30 s and 2 min, 30 s and 6 min, 30 s and 10 min, 30 s and 14 min, 10 s and 2 min, 10 s and 6 min, 10 s and 10 min, 10 s and 14 min respectively. The results of the incidence rate of subcutaneous hemorrhage were 46.25% (37/80), 22.50% (18/80), 23.75% (19/80), 25.00% (20/80), 71.25% (57/80), 43.75% (35/80), 50.00% (40/80), 50.00% (40/80) respectively. By the single factor test, the results showed that pressing duration and injection duration are associated with the incidence of subcutaneous hemorrhage after low molecular weight heparin. With regard to the incidence of subcutaneous hemorrhage, there was significantly difference between 2 min group and the other 3 groups (P<0.01), while other adjacent groups had no significant differences (P>0.05). By multiple factors logistic regression analysis, it was revealed that pressing duration and injection duration were significant factors (P<0.01), but the interaction term of pressing duration and injection duration had no significant. It was also revealed that the effect of injection duration was better than pressing duration (|b'(injection duration)|=|-1.8890|>|b'(pres ing duration)|=|-1.0729|). Compared with inject 10 s, there was a significantly lower incidence of bruising in inject 30 s. There was a significantly lower incidence of bruising in the longer pressing duration (b<0). By multiple factors logistic regression analysis, it was also revealed that pressing duration and injection duration were significant factors regardless of the interaction term of pressing duration and injection duration (P<0.01). The effect of injection duration was better than pressing duration (|b'(injection duration)|>|b'(pres ing duration)|). Compared with inject 10 s, there was a significantly lower incidence of bruising in inject 30 s (b<0). there was significantly difference between 2min group and the other 3 groups (P<0.01), while other adjacent groups had no significant differences. Compared with others, there was a significantly high incidence of bruising in pressing 2min and the pressing duration for at least 6 min. Conclusions It is suggested that inject 30 s with pressing for 6 min can effectively reduce the incidence of subcutaneous hemorrhage resulted from subcutaneous injection of LMWH.

BACKGROUND:Liposomes as a new drug delivery system are characterized by few adverse reactions, no immunogenicity and biodegradation. Furthermore, methotrexate-loaded liposomes can significantly reduce drug toxicity and improve anti-tumor effect. OBJECTIVE:To prepare long-circulating methotrexate-loaded liposomes and to evaluate its antitumor activity in MG-63 in vitro. METHODS:The methotrexate-loaded liposomes were prepared using the film dispersion method, and the long-circulating ones were prepared using the post-insertion method. The initial concentrations of methotrexate were 9.1, 1.82, 0.364 g/L. The ultracentrifugation method and spin column method with Sephadex G-10 or G-50 as packing were employed to separate free drugs from the methotrexate-loaded liposomes. Their recovery, size, morphology, encapsulation efficiency and drug-to-lipid ratio were evaluated. The cytotoxity of the long-circulating methotrexate-loaded liposomes purified with ultracentrifugation method and spin column G-50 method under three dose levels (0, 1, 5, 25 mg/L) were determined by MTS method. RESULTS AND CONCLUSION:According to the recovery rates of three methods, the spin column G-50 method was considered as optimal for the long-circulating methotrexate-loaded liposomes. The long-circulating liposomes were spherical or el ipsoidal under transmission electron microscope, about 200 nm in size. At the certain initial concentration of methotrexate, the encapsulation efficiency and drug-to-lipid ratio of the liposomes purified using the spin column G-50 method were remarkably higher than those purified using the other two methods. At the same mass concentration, the cytotoxity of the liposomes purified with ultracentrifugation or spin column G-50 was significantly higher than that of free methotrexate, and furthermore, the cytotoxity of the liposomes purified with spin column G-50 was higher than that of the liposomes purified with ultracentrifugation method. To conclude, the long-circulating methotrexate-loaded liposomes show a higher antitumor activity than free methotrexate in MG-63 cel s in vitro, providing the basis for further investigation of its antitumor effect on human osteosarcoma in vivo.

Aberrant maternal inflammation and oxidative stress are the two main mechanisms of pathological pregnancy. The silence information regulator (sirtuin) family is a highly conserved family of nicotinamide adenine dinucleotide (NAD)-dependent deacylases. By regulating the post-translational modification of proteins, sirtuin is involved in various biological processes including oxidative stress and inflammation. Nowadays, emerging evidence indicates that sirtuin may be closely related to the occurrence and development of pathological pregnancy. The down-regulation of sirtuin can cause spontaneous preterm delivery by promoting uterine contraction and rupture of fetal membranes, cause gestational diabetes mellitus through promoting oxidative stress and affecting the activity of key enzymes in glucose metabolism, cause preeclampsia by reducing the proliferation and invasion ability of trophoblasts, cause intrahepatic cholestasis of pregnancy by promoting the production of bile acids and T helper 1 cell (Th1) cytokines, and cause intrauterine growth restriction through inducing mitochondrial dysfunction. Moreover, the expression and activation of sirtuin can be modulated through dietary interventions, thus sirtuin is expected to become a new target for the prevention and treatment of pregnancy complications. This article reviews the role of the sirtuin family in the occurrence and development of pathological pregnancy and its influence on the development of the offspring.
Diabetes, Gestational ; Female ; Humans ; Pregnancy ; Premature Birth ; Trophoblasts

Objective:To explore the treatment of iatrogenic injury to the medial collateral ligament (MCL) in total knee arthroplasty (TKA).Methods:From January 2009 to December 2016, 14 patients were treated at Department of Arthropathy, Zhengzhou Orthopedics Hospital for iatrogenic MCL injury in primary TKA (injury group). They were 3 males and 11 females with an age of (72.6±3.9) years. The MCL injury was body rapture in 9 cases and avulsion of femoral insertion in 5 ones. Interlacing suture was used for body rapture and reparative reconstruction with wire anchors or nails was performed for avulsion of femoral insertion. A restrictive condylar prosthesis was used instead in the 4 patients whose medial stability failed to be restored after repair of body rapture. A control group of 21 cases was enrolled who had suffered from no iatrogenic MCL injury in primary TKA at the corresponding period. There were 5 males and 16 females with an age of (73.2±3.9) years. The 2 groups were compared in terms of American Knee Society Score (KSS) and knee flexion.Results:There was no significant difference between the 2 groups in preoperative general data, showing comparability between groups ( P>0.05). The injury group was followed up for 18 to 36 months (mean, 33 months). Joint loosening was observed at 18 months after operation in 3 patients with nonrestrictive prosthesis who had to receive secondary revision. At the 36-month follow-up of the remaining 11 patients, normal knee extension and flexion was observed, the stress test of valgus showed no inner relaxation, their KSS increased significantly from preoperative 50.0±22.7 to 93.3±4.7, and their knee flexion was improved significantly from 90.4°±10.3° to 110.7°±8.8° ( P<0.05). There were no significant differences in KSS score or knee flexion between the 2 groups at 3, 6, 12 or 36 months after operation ( P>0.05). Conclusion:Iatrogenic MCL injury in primary TKA should be repaired and reconstructed by one-stage surgery because the patients can achieve curative results similar to those for the patients free from iatrogenic MCL injury in primary TKA.

Objective To improve the rational use of human serum albumin(HSA)in cancer patients by the interventions of clinical pharmacists.Methods Literature search of HSA was performed by clinical pharmacists for clinical indications and appropriate usage.The HSA use protocol was implemented by clinical pharmacists and related clinical experts.The protocol adaptation was reinforced by clinical pharmacists.Results The rate of the rational use of HSA has been improved.Conclusion Clinical pharmacists play an important role in the clinical rational use of HSA based on evidence-based pharmacy.

Background/Aims: To evaluate the causal correlation between complement components and non-viral liver diseases and their potential use as druggable targets. Methods: We conducted Mendelian randomization (MR) to assess the causal role of circulating complements in the risk of non-viral liver diseases. A complement-centric protein interaction network was constructed to explore biological functions and identify potential therapeutic options. Results: In the MR analysis, genetically predicted levels of complement C1q C chain (C1QC) were positively associated with the risk of autoimmune hepatitis (odds ratio 1.125, 95% confidence interval 1.018–1.244), while complement factor H-related protein 5 (CFHR5) was positively associated with the risk of primary sclerosing cholangitis (PSC;1.193, 1.048– 1.357). On the other hand, CFHR1 (0.621, 0.497–0.776) and CFHR2 (0.824, 0.703–0.965) were inversely associated with the risk of alcohol-related cirrhosis. There were also significant inverse associations between C8 gamma chain (C8G) and PSC (0.832, 0.707–0.979), as well as the risk of metabolic dysfunction-associated steatotic liver disease (1.167, 1.036–1.314). Additionally, C1S (0.111, 0.018–0.672), C7 (1.631, 1.190–2.236), and CFHR2 (1.279, 1.059–1.546) were significantly associated with the risk of hepatocellular carcinoma. Proteins from the complement regulatory networks and various liver diseaserelated proteins share common biological processes. Furthermore, potential therapeutic drugs for various liver diseases were identified through drug repurposing based on the complement regulatory network. Conclusions Our study suggests that certain complement components, including C1S, C1QC, CFHR1, CFHR2, CFHR5, C7, and C8G, might play a role in non-viral liver diseases and could be potential targets for drug development.