Objective To prepare a biodegradable sckeral implant containing triamcinolone-acetonide-acetate(TAA) and polylactic acid(PLA) and investigate its release in vitro.Methods The TAA-PLA implant was prepared by melt-extrude technique.The drug release of TAA in vitro was determined by high performance liquid chromatography(HPLC).Results The implant was white pillar with 8 mm in length,8 mg in weight,and 0.8 mm in diameter.The drug loading was 30%.The drug was released at a steady and slow rate.Its accumulation release rate is 75.84% on the 30th day.Drug release profile in vitro was in accordance with Higuchi equation Q=0.137(t-0.752)1/2.Conclusion A sleral implant containing TAA-PLA is prepared,which has the evident feature in delaying the release of TAA and is biological degradable.It might be a novel vehicle for the topical use of TAA.

Objective To evaluate the diagnosis and management of ectopic pancreas.Methods The clinical data of 62 cases of ectopic pancreas,which were diagnosed by endoscopic uhrasonography (EUS)or pathologic findings between July 2006 and December 2007 were retrospectively analyzed.The cases were divided into 4 groups according to different ways of management.Group A included 37 patients,who were diagnosed as having ectopic pancreas(＜19mm)by EUS only and were followed up via phone call every 3 months.Eight patients in group B were diagnosed by EUS as having submucosal lesions suspected as ectopic pancreas,and underwent operation because of large size or difficulty in diagnosis.Eight patients in group C received operation for other diseases and the eetopic pancreases were found in operation.Group D included 9 patients who underwent surgery due to malignant tumors.ResultsEctopic pancreas were most commonly found as a single lesion in gastric antrum(35/62,56.5%)with mean size of 9.2±5.4 mm.All patients in group A were asymptomatic,of which 10 received followed-up endoscopy and no changes in size of the lesion were found.All patients in group B,C and D were diagnosed as ectopic pancreas pathologically.Conclusion Ectopic pancrea is relatively common and asymptomatic,only part of them could be diagnosed clinically.Carcinoma arising from the ectopic pancreas is rare and lesion of small size diagnosed by EUS could be followed up endoseopieally.

Objective To evaluate the therapeutic effect of endoscopic cryotherapy for Barrett's esophagus (BE). Methods A total of 22 consecutive patients, who were diagnosed as BE from January 2008 to May 2009, underwent endoscopic cryotherapy by using pressurized gas of C02. The data including effective rate, therapy courses and procedure related complications were retrospectively analyzed.Results Except for 2 cases of withdrawal, the other 20 patients completed the treatment with a total therapy number of 42 times (mean 2. 1 times/patient) and were followed up for 6 months. Complete histologic reversal of BE mucus was achieved in all 20 patients after 1-3 times of cryotherapy, among whom complete endoscopic reversal was obtained in 9 and effective endoscopic reversal in 11. Histologic recurrence was observed in 3 cases during the follow-up, including 2 of occult intestinal metaplasia and 1 of mild intestinal metaplasia, which achieved a BE mucosal reversal rate of 85% (17/20). Procedure related complications included 1 case of esophageal ulcer and 3 cases of mild or severe esophagitis, which were all cured after acid suppression treatment. Conclusion Endoscopic cryotherapy in BE is effective and safe, with the advantages of easy manipulation, less complications and good compliances.

Objective To improve the management of dyspepsia by evaluating the potential role of pretreatment gastric histology as predictive factors on the symptomatic response after Helicobacter pylori (H. pylori) eradication in patients with functional dyspepsia (FD).Methods 240 FD patients with H. pylori infection out of 920 consecutive patients receiving gastroendoscopy due to dyspepsia were investigated, including 190 patients enrolled as the therapy group and administered with anti-H. pylori triple therapy. In addition, 50 patients were enrolled as the control group, in which omeprazole was an alternative to the triple therapy. The course of therapy in both groups was 7 days. Pretreatment gastric histology was evaluated by the updated Sydney system. C~ 13 urea breath test was performed to evaluate the H. pylori eradication results one month (both therapy group and control group) and six months (therapy group) after therapy. For each patient, the baseline, month 1 and month 6 symptom scores were assessed by a questionnaire of dyspepsia, including 12 symptom items of dyspepsia with scoring of severity. The relationship between pretreatment gastric histology and good symptom responses after H. pylori eradication was then analyzed.Results Of 35.3% and 42.6% patients with successful H. pylori eradication in the therapy group had a good symptomatic response one month and six months after the triple therapy respectively, higher than those from the patients who failed H. pylori eradication (month 1:35.3% vs 12.2%, P

OBJECTIVETo evaluate the clinical efficacy of YANG's pricking-cupping therapy for knee osteoar thritis (KOA). Methods This was a multi-center randomized parallel controlled trial. One hundred and seventy one patients with KOA were randomly allocated to a pricking-cupping group (89 cases) and a conventional acu puncture group (82 cases). Neixiyan (EX-LE 4), Dubi (ST 35) and ashi points were selected in the two groups. Patients in the pricking-cupping group were treated with YANG's pricking-cupping therapy; the seven-star needles were used to perform pricking at acupoints, then cupping was used until slight bleeding was observed. Patients in the conventional acupuncture group were treated with semi-standardized filiform needle therapy. The treatment was given for 4 weeks (from a minimum of 5 times to a maximum of 10 times). The follow-up visit was 4 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the visual analogue scale (VAS) were adopted for the efficacy assessments.

RESULTSThe pain score, stiffness score, physical function score and total score of WOMAC were all reduced after 4-week treatment and during follow-up visit in the two groups (all P<0. 0001). Except that the difference of stiffness score between the two groups was not significant after 4-week treatment (P>0. 05), each score and total score of WOMAC in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit (P<0. 0001, P<0. 01). After 2-week treatment, 4-week treatment and during follow-up visit, the VAS was all reduced compared with that before treatment (all P<0. 0001) ; with the increase of the treatment, the reducing trend of VAS was more significant (P<0. 0001). The scores of VAS in the pricking-cupping group were lower than those in the conventional acupuncture group after 4-week treatment and during follow-up visit (P < 0. 01, P <0. 0001). CONCLUSION The YANG's pricking-cupping and conventional acupuncture therapy can both significantly improve knee joint pain and function in patients with KOA, which are relatively safe. The pricking cupping therapy is superior to conventional acupuncture with the identical selection of acupoints.

Acupuncture Therapy ; Adult ; Aged ; Arthralgia ; physiopathology ; therapy ; Combined Modality Therapy ; Female ; Humans ; Knee Joint ; physiopathology ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Osteoarthritis, Knee ; physiopathology ; therapy ; Treatment Outcome

The study was aimed to investigate the optimum conditions of freeze drying preservation of amniotic membrane (AM). The AM from the health puerperal woman was preserved by freeze drying at optimized way. The key factors of freeze drying process, including abstersion aqua, conservation liquor, the curve of freezing temperature, and the ingredient of protective agent, were optimized. All their morphologic structure was observed by light microscope and scanning electron microscope. The degradation rates by collagenase IV and the characterization of biomechanics were analyzed. The radio-immunologic method was used to investigate the cytokines quantity. All properties of freeze dried AM were compared with those of fresh AM. Light micrographs showed that the five structure-layers exist both in the fresh AM and in those preserved by freeze drying, while the fibro-material was tight-structured in the fresh AM, but loose slightly; the thickness of fibro-material was larger slightly in freeze dried AM. Scanning electron micrographs show that the micro-hairs of epithelial cells in fresh AM were decreased slightly in optimized drying AM, the collagen fibre of fresh AM and of optimized drying AM were well in morphological structures and arranged tightly. The degradation rate by collagenase IV was faster in optimized drying AM,compared with that of the fresh AM. There were insignificant diversity in biomechanical characters (tensile strength, elongation at break and elastic modulus) of the optimized drying AM compared with fresh AM. The cytokines quantity in optimized drying AM decreased significantly compared with fresh AM. The improved freeze drying process has better advantage in keeping the morphological structure, preferable biomechanics and biological vitality of AM, compared with the early research.
Amnion ; metabolism ; ultrastructure ; Biomechanical Phenomena ; Collagenases ; metabolism ; Cytokines ; metabolism ; Female ; Freeze Drying ; methods ; Humans

Objective:To investigate the efficacy of total ankle arthroscopy for resection of the talus os trigonum and debridement of the synovium of flexor hallucis longus (FHL) in the treatment of osteogenic posterior ankle impingement syndrome (PAIS) complicated with flexor hallucis longus tenosynovitis (FHLT).Methods:The 14 patients with osteogenic PAIS and FHLT were retrospectively analyzed who had been treated at Department of Hand-Foot-Ankle Microsurgery, Xuzhou Central Hospital from July 2017 to July 2019. They were 8 men and 6 women, aged from 29 to 53 years (mean, 42.4 years). The talus os trigonum and the giant posterolateral process of the talus were resected under total ankle arthroscopy in the prone position of the posterior ankle while the FHL was released and cleared. The efficacy was evaluated by comparing the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Maryland functional score, and pain visual analog scale (VAS) between preoperation and one year postoperation.Results:All patients were followed up for 12 to 24 months (average, 15 months). For all patients, their plantar flexion and dorsal extension were improved significantly from preoperative 19.2°±4.0° and 14.2°±2.7° to postoperative 42.9°±2.7° and 24.5°±3.2°, their AOFAS score increased significantly from preoperative 42.1±4.2 to 91.6±2.7 at one year postoperation, their Maryland score increased significantly from preoperative 43.9±4.1 to 91.9±3.5 at one year postoperation, and their VAS score decreased significantly from preoperative 6 (6, 7) to 0 (0, 0) at one year postoperation (all P<0.05). Conclusion:In the treatment of osteogenic PAIS complicated with FHLT, total ankle arthroscopy for resection of the talus os trigonum and release of FHL can lead to fine efficacy and limited surgical invasion, resolving the FHL pathological inflammation and PAIS at the same time.

Brain aging is closely related to cognitive decline,neurodegenerative diseases,and vascular dementia.Hydrogen sulfide(H2S)can delay brain aging by regulating protein homeostasis,anti-oxidative stress,inhibiting inflammation,reducing brain cell apoptosis and improving microcirculation.

Systematically combing the origin and characteristics of the classification style of contents in ancient traditional Chinese medicine （TCM） books through the ages， this article put forward that the emergence of the classification by category system for medical books in the Song Dynasty had become a reference for the classification medical book categories in later generations； under the influence of Neo Confucianism， the compilers of medical books in the Ming Dynasty applied the classification method of outline， which made the content of medical books well-organized and hierarchical， and according to the needs of systematic compilation of medical books and different compilation purposes， the classification logic of various medical books had been continuously improved， and breakthroughs had been made in the format， which improved perfecting the development of classification style in ancient comprehensive TCM books； the application of the body part classification method in the compilation of medical books in the Qing Dynasty made the classification of books more rigorous and organized， and the classification system of various medical texts became more mature. By systematically sorting out the characteristics and origins of the classification system of ancient TCM books throughout history is of great significance for comprehensively understanding of the development of ancient TCM books style and the promotion of the collation， protection and use of ancient books.

Chimeric antigen receptor T cell(CAR-T)therapy has produced remarkable results in the treatment of hematological tumors.The BCMA antigen is widely expressed on the surface of multiple myeloma cells and is a suitable,efficient target for CAR-T therapy.BCMA CAR-T cell therapy has a high response rate for relapsed or refractory patients in particular,and CAR-T cells are still detectable in most patients 1 year after infusion.However,drug resistance and disease recurrence remain key problems in clinical management.In this paper,we discuss the response factors and resistance induction mechanism of BCMA CAR-T cell therapy from several perspectives,such as the immune es-cape of multiple myeloma cells,CAR-T product factors,previous treatment regimens,and tumor immune microenvironment inhibition.We also propose possible optimization strategies in order to provide reference for future exploration.