Objective To explore the application value of nanocarbon parathyroid lymph negative development technique in the operation of the patients with chronic kidney disease(CKD) secondary hyperparathyroidism(SHPT).Methods Twenty cases of CKD stage 5 SHPT in our center from June 2014 to December 2015 were treated by parathyroidectomy(PTX) and forearm autotransplantation,using nanocarbon suspension local injection combined with preoperative parathyroid ultrasonography,enhanced CT and neck 99Tcm-MIBI and iPTH rapid determination.Results Thyroid and lymph node were quickly dyed black after nanocarbon suspension injection,while the target parathyroid did not develop with flesh color or pale yellow,clear vision in operation,fast stripping parathyroid and small surgical injury;postoperative serum calcium,phosphorus and iPTH were decreased significantly,postoperative follow-up lasted for 6 months,serum calcium,phosphorus,alkaline phosphatase and iPTH had statistically significant differences between before and after operation(P＜0.05).The symptoms of pain,myalgia and pruritus after operation were significantly relieved,and 20 cases had no reccurrence during follow up period.Conclusion The nanocarbon mixed suspension tracer agent can achieve real-time and accurate resection in the PTX of the patients with CKD stage 5 SHPT and can be used in clinic.

BACKGROUND:Dialysis membrane is the most important part of a dialyzer, which directly affects the therapeutic efficacy of hemodialysis.
OBJECTIVE:To study the permeability, adsorbability and biocompatibility of high- and low-flux hemodialysis membrane in maintenance hemodialysis process.
METHODS:Forty-six hemodialysis patients due to chronic renal failure were selected, including 24 males and 22 females, aged 26-78 years. These patients were randomized into two groups: FX8 and FX60 groups. Dialog+ dialyzer and bicarbonate dialysate (Braun, Germany) were used in the two groups, and polysulfone membranes FX8 and FX60 were respectively used in the two group. Al the patients received hemodialysis three times per week, 4 hours once. After 4 months of dialysis, blood levels of toxins and inflammatory cytokines were detected in the two groups.
RESULTS AND CONCLUSION:After dialysis, there were no differences in the blood urea nitrogen, serum creatinine, blood phosphorus levels between the two groups. The clearance rates of β2-microglobulin and parathyrin were significantly higher in the FX60 group than the FX8 group (P < 0.05); the plasma levels of albumin and hemoglobin were significantly higher in the FX60 group than the FX8 group (P < 0.05); but the serum levels of interleukin-8 and tumor necrosis factor-a were lower in the FX60 group than the FX8 group (P < 0.05). These findings indicate that high-flux polysulfone membrane FX60 is superior to low-flux polysulfone membrane FX8 in the clearance of macromolecule toxins and biocompatibility.

Chemotherapy completion rate can reflect the tolerance and compliance of patients to chemotherapy. Poor tolerance may result in delay or suspension of the comprehensive treatment plan, thus affect the efficacy of cancer treatment. Evaluating methods to improve the completion rate of chemotherapy and reduce the occurrence of delayed chemotherapy has gained increasing attention and is the significant area of study in the field of cancer treatment. Studies have shown that Chinese medicine combined with chemotherapy could improve the quality of life in patients with stage IIIB/IV non-small-cell lung cancer (NSCLC).

Objective Feitai Capsule,a compound of traditional Chinese herbal medicine,has been screened and refined repeatedly for many years and shown to have a good anti-tumor effect.Strict quality control and further screening of the efficacious components of the compound are of great clinical significance.The purpose of this study was to establish the methods for determining the isofraxidin content in Feitai Capsule.Methods We determined the content of isofraxidin in Feitai Capsule by high performance liquid chromatography (HPLC),using the chromatographic column Hypersil ODS-C18 (4.6 mm?150 mm,5 ?m),with the mobile phase as acetonitrile 0.2% phosphoric acid solution (21∶79),the flow rate of 1.0 ml/min,the detective wavelength of 344 nm and the column temperature at 30℃.Results Isofraxidin showed a good linearity,within the range of 2.00-10.80 ?g/ml (y=69 427x+15961,r = 0.999 9),with the average recovery of 97.89% and RSD of 1.64% (n = 6).Conclusion HPLC,accurate and reproducible,is suitable for the determination of the isofraxidin content in Feitai Capsule.

Objective To determine whether Tanshinone ⅡA(Tan ⅡA)has an effect on angiotensin Ⅱ(Ang Ⅱ)-induced prolifera-tion and migration of vascular smooth muscle cells(VSMCs),phenotypic switching,or autophagy.Methods In this study,murine aortic smooth muscle cell lines were treated with Ang Ⅱ to establish a model of cell proliferation.Different concentrations of Tan ⅡA were added and effects on cell proliferation and migration were determined by cell counting using a CCK-8 assay and a cell scratch assay,respectively.Alpha-smooth muscle actin(α-SMA),a marker of contractile VSMCs,was detected by Western blotting.Expression levels of osteopontin(OPN)and the autophagy-related proteins(p62,Beclin-1,LC3A/B)were assayed to determine the effect of Tan ⅡA on VSMC phenotypic transformation and autophagy.Cells were treated with the autophagy inhibitor 3-methyladenine(3-MA),combined with Tan ⅡA,and then cell proliferation,migration and expression levels of phenotypic markers and autophagy-related proteins were assessed.Results After Ang Ⅱ treatment,the proliferation and migratory capacity of VSMCs was significantly enhanced,and phenotypic transformation was sig-nificantly inhibited by Ang Ⅱ.Western blotting revealed that Ang Ⅱ reduced the expression of α-SMA,increased the expression of OPN,p62,Beclin-1,and LC3A/B,and that these effects increased with higher Tan ⅡA concentrations.After the addition of 3-MA to the treated cells,the proliferation and migration of VSMCs induced by Ang Ⅱ was inhibited,the expression of α-SMA was increased,and the expres-sion of OPN,p62,Beclin-1,and LC3A/B was decreased,which was consistent with the effect of Tan ⅡA.Conclusion Tan ⅡA may have inhibitory effects on phenotypic transformation,proliferation,migration,and autophagy of Ang Ⅱ-treated VSMC,suggesting that the inhi-bition of the proliferation and migration may be regulated by autophagy.

Recently the maintenance therapy of non-small-cell lung cancer (NSCLC) patients who completed required treatment cycles has caused widespread interests in the medical field. Traditional Chinese medicine may be a useful complement in maintenance treatment of mid-to-late stage NSCLC.

Objective:To explore the effect and mechanism of intracellular Zn2+ concentration ([Zn2+ ]i) in hypoxia‐induced regulation of metalloproteinases (MMPs) and extracellular matrix (ECM) expression in nucleus pulposus (NP) cells .Methods:NP cells from SD rats received plate culture at first and then three‐dimensional culture with sodium alginate gel .[Zn2+ ]i was assayed by FluoZin‐3 AM staining .Proteoglycan was assayed by Alcian blue staining .Glycosaminoglycan was detected by 1 ,9‐dimethylmethylene blue (DMMB) assay .And real‐time PCR were used to assay the mRNA expression of α1 type II collagen (COL2A1) ,matrix metalloproteinase 13 (MMP‐13) and a disintegrin and metalloproteinase with a thrombospondin motif 5 (ADAMTS‐5) .The expression of ZRT ,IRT‐like protein 8(ZIP8) was assayed by immunohistochemistry and Western blotting .Results:Interleukin (IL)‐1βand ZnCl2 could significantly increase the [Zn2+ ]i of NP cells ,however ,the effect could be inhibited by hypoxia .Hypoxia did significantly attenuate the decrease of proteoglycan ,glycosaminoglycan ,and COL2A1 mRNA ,which was induced by IL‐1βand ZnCl2 treatment ,in sodium alginate three‐dimensional culture . However ,ZnCl2 inhibited the protective effect of hypoxia .Both an intracellular Zn2+chelator and hypoxia could inhibit the increase of MMP‐13 mRNA expression .IL‐1βand ZnCl2 treatment promoted the increase of ZIP8 expression in NP cells ,however ,hypoxia inhibited ZIP8 expression .Conclusions:Hypoxia may regulate the Zn2+ influx in NP cells . Zn2+ mediates the regulation effect of hypoxia on ECM and MMP‐13 .Perhaps the changes of [Zn2+ ]i are involved in the process of intervertebral disc degeneration .

Objective:To study the risk of refracture after osteoporotic vertebral fracture with changes in blood calcium and bone metabolism.Methods:260 patients with osteoporotic vertebral fracture treated in our hospital from Feb. 2018 to Feb. 2020 were selected for study. All patients were treated with kyphoplasty. The clinical curative effect, blood calcium, PINP, and β-CTX level changes were observed, postoperative recurrence was followed up. Clinical data of fracture patients were collected, risk factors of osteoporotic vertebral fractures in patients with postoperative recurrence of fracture were analyzed, receiver-operating characteristic curve was drawn to analyze the predictive value of blood calcium, PINP, andβ-CTX in postoperative recurrence of osteoporotic vertebral fracture.Results:The total clinical response rate was 95.77% (249/260) after treatment. After treatment, serum calcium, PINP, and β-CTX decreased with time, and the difference was significant ( P<0.05) . All patients were followed up for 6 months. There were 81 cases (31.15%) suffering postoperative fracture and 179 cases (68.85%) without fracture. According to univariate analysis, there were no statistically significant differences in age, sex, BMI, history of trauma, underlying disease, site of surgical vertebral body, segment of surgical vertebral body, correction angle of sagittal kyphosis, or amount of bone cement injection between the two groups ( P>0.05) . Long-term history of glucocorticoid use, preoperative fractured vertebra number, surgical vertebra number, blood calcium, PINP, β-CTX, fracture compression rate, vertebra height recovery rate, reinforced vertebra number, and bone cement leakage were correlated with postoperative recurrence of fracture in patients with osteoporotic vertebral fracture ( P<0.05) . Multivariate Logistic analysis showed that long-term history of glucocorticoid use, preoperative number of fractured vertebrae, surgical vertebra number, fracture compression rate, vertebral height recovery rate, enhanced vertebral body number, bone cement leakage, blood calcium, PINP, and β-CTX were all independent risk factors for postoperative recurrence of osteoporotic vertebral fracture ( P<0.05) . ROC curve results showed that AUC, 95%CI and truncation value were 0.820, 0.770-0.871 and 2.12mmol/L vs 0.915, 0.873-0.957 and 45.51 ng/mL vs 0.973, 0.957-0.988, and 463.29 for serum calcium, PINP, and β-CTX respectively in predicting the recurrence of osteoporotic vertebral fracture. Conclusion:Kyphoplasty has a significant effect on osteoporotic vertebral fracture, and it can effectively improve the serum calcium, PINP, and β-CTX, which have a certain monitoring value for postoperative recurrence of fracture.

Objective:To explore effects of different lower limb placement angles on venous drainage among patients undergoing thoracolumbar surgery in prone position.Methods:From January 2017 to January 2018, we selected patients underwent elective thoracolumbar surgery in prone position of Operating Room in Beijing Hospital as research objects. According to the need of surgery, it was divided into 51 cases in low-angle group and 54 cases in traditional-angle group. We compared effects of different lower limb placement angles on patients by taking the changes of lower limb venous blood flow under ultrasound before and after surgery as main observation indicators and taking changes of lower limb skin temperature and leg circumference as the secondary observation indicator.Results:There were statistical differences in the changes of blood flow on the left and right popliteal veins, the left and right posterior tibial veins of patients under ultrasound between two groups before and after surgery ( P<0.05) . There were no statistical differences in the changes of the leg circumference of 10 cm above the left and right ankles and the changes of the leg circumference of 15 cm above the left and right patellae of patients between two groups ( P>0.05) ; there was also no statistical difference in the change of bilateral skin temperature ( P>0.05) . Conclusions:The lower limb placement angles among patients undergoing thoracolumbar surgery in prone position may affect the venous drainage which nurses of Operating Room should pay attention to when placing positions.

Objective:To analyze the incidence of postoperative pulmonary complications and related factors in elderly patients after major abdominal surgery.Methods:Clinical data of elderly patients undergone major abdominal surgeries at Beijing Hospital were retrospectively analyzed.The incidence of postoperative pulmonary complications was studied, and related factors were analyzed using Logistic regression analysis.Results:A total of 96 cases were included.The incidence of postoperative pulmonary complications was 53.1%(51/96)in elderly patients after major abdominal surgery.Logistic regression analysis showed laparoscopy was a protective factor for postoperative pulmonary complications( OR=0.293, 95% CI: 0.100-0.865, P=0.026), while driving pressure > 18 cmH 2O(1 cmH 2O=0.098 kPa)( OR=3.300, 95% CI: 1.148-9.434, P=0.027)and intraoperative bleeding volume > 500 ml( OR=4.444, 95% CI: 1.091-18.180, P=0.037)were risk factors for postoperative pulmonary complications. Conclusions:Attention should be paid to the incidence of postoperative pulmonary complications in elderly patients after major abdominal surgery.Laparoscopy is a protective factor for postoperative pulmonary complications, while driving pressure more than 18 cmH 2O and intraoperative bleeding volume more than 500 ml can increase the risk of postoperative pulmonary complications.