Objective: To establish HPLC fingerprints of Lagotis integra and Lagotis brevituba which were contained in National Drug Standard and compared to Lagotis ramalana, Lagotis alutacea and Lagotis brachystachya by the established method. Methods: The similarity of HPLC fingerprints of L. integra and L. brevituba was low, so the HPLC fingerprint methods were established for both. The HPLC analysis was performed on Waters X-Bridge C18 (250 mm × 4.6 mm, 5 μm), using acetonitrile and 0.2% formic acid solution as the mobile phase at a flow rate of 1.0 mL/min, the detection wave-length was 328 nm and column temperature was 35 ℃ (L. integra) and 25 ℃ (L. brevituba). Results: There were 14 common peaks in the fingerprint of L. integra, and plantamajoside, hemiphroside B, 10-O-trans-p-methoxycinnamoyl-catalpol and 10-O-[(E)-3,4-dimethoxycinna moyl]-catalpol were standardized. There were 13 common peaks in the fingerprint of L. brevituba, and echinacoside, plantamajoside and acteoside were standardized. The similarity of HPLC fingerprint was more than 0.9 between L. integra and L. alutacea, but the others had low similarity with them. The similarity of HPLC fingerprint was more than 0.9 between L. brevituba from different batches and L. ramalana, while the others had low similarity with them. Conclusion: The established method could effectively identify L. brevituba, L. integra and L. alutacea were advised to be recorded in Medical Standards of the Ministry of Health. Lagotis ramalana could be used as a new base for "Honglian" (origin: Lagotis brevituba).

MAIN OUTCOME MEASURES: Free running EMG and stimulus triggered EMG, including time, frequency, amplitude, muscle group were observed and recorded simultaneously. Never root functional injury and restoration after surgery were detected.RESULTS: 378 pedicle screws in 74 patients were monitored intraoperatively, and only 3 pedicle screw malposition (2 of L_4, 1 of L_5) was detected and then replaced with the help of C-arm fluoroscopic examination. Myoelectricity appeared when the current intensity was less than 10 mA. The correct rate of implantation was 99.2%. Nerve root impingement was found in two cases during laminectomy for L_5 and S_1 decompression and never root solution, which alerted the surgical team of critical neural structures. Nerve symptoms of the lower limb were aggravated after surgery and restored following 2-4 weeks of conventional treatment. The error injury rate of nerve root was 2.7%. In all reported cases, no irreversible neurological deficit was observed 2-4 weeks after operation.CONCLUSION: Intraoperative EMG monitoring can find improperly placed screws and detect impending nerve root injury promptly. Combined EMG and 3-D imaging modality monitoring is a reliable and practicable method that can be used to protect neural structures during complex lumbosacral surgery.

OBJECTIVEThe increasing number of aged patients with severe ascending aorta atherosclerosis who are undergoing coronary artery bypass graft (CABG) present high risk for ascending aortic cannulation, cross-clamping or partial occluding and proximal anastomosis. We reviewed the surgical experience in 22 patients of CABG with ascending aorta atherosclerosis and tried to find the way to minimize the complications.

METHODSTwenty-two patients with severe atherosclerotic and calcified ascending aorta underwent CABG in our hospital. Thirteen of them received CABG on beating heart. Nine patients had their CABG with extracorporeal circulation. With deep hypothermia, we reduced the flow rate and intermittently arrested the circulation for the proximal anastomosis on ascending aorta in 5 patients with neither cross-clamping nor partial occluding. The sequential grafts and "Y" type anastomosis between reversed saphenous venous grafts were employed.

RESULTSTwenty of the patients survived after surgery. One died of inhalation pneumonia in two weeks after surgery. Another died of right hemothorax in ten days after surgery. The complications include: pneumonia 4 patients (18%), angina 2 patients (9%), ventricular fibrillation 1 patients (5%), post-CABG myocardium infarction 1 case (5%) and hemothorax 1 case (5%). There is no neurologic complications or aortic dissection after CABG.

CONCLUSIONCABG on beating heart with pedicel arterial grafts is the best approach to performing the surgery without touching the diseased ascending aorta. Ventricular fibrillation under mild hypothermia cardiopulmonary bypass and left ventricular suction were employed for quiet and bloodless field while distal anastomosis had no cross-clamping the ascending aorta. Also deep hypothermia and intermittently circulatory arrest offer quiet and bloodless field for the proximal anastomosis on ascending aorta without cross-clamping or partial-occluding. Distal sequential anastomosis and proximal "Y" type anastomosis are the effective approach to minimizing the proximal anastomosis on the ascending aorta.

Aged ; Aged, 80 and over ; Aortic Diseases ; complications ; surgery ; Atherosclerosis ; complications ; surgery ; Coronary Artery Bypass ; methods ; Coronary Artery Disease ; complications ; surgery ; Female ; Humans ; Male ; Retrospective Studies ; Treatment Outcome

BACKGROUNDEstrogen as well as CD4(+)Foxp3(+) regulatory T cells were shown to have a protective role not only in maintaining maternal-fetal tolerance but also against autoimmune diseases. We aimed to investigate whether the pregnancy levels of estrogen are enough to induce transplant tolerance as to maintain fetal-maternal tolerance.

METHODSWe established H-Y skin graft transplantation in C57BL/6 ovariectomized mice that reconstituted with estrogen. Subsequently, consecutive daily estrogen injection was administrated. Tregs and the cytokines in the peripheral blood were detected by flow cytometry and ELISA pre- and post-transplant.

RESULTSThe results indicated that pregnancy levels of estrogen could promote Tregs in secondary lymphoid organs and peripheral blood (P < 0.05) but not thymus (P > 0.05). The estrogen-treated recipients accepted H-Y skin grafts for more than 35 days (median survival time (MST): (44.0 ± 1.2) days) compared with estrogen-untreated mice (MST: (23.0 ± 1.6) days) (P < 0.05). It was also observed that estrogen up-regulated the expression of Foxp3, but did not affect CD3(+)CD8(+) effector T-cells in non-transplant mice. While in the presence of H-Y antigens, the expression of Foxp3 was more significant and CD3(+)CD8(+) effector T cells were decreased significantly (P < 0.05). Meanwhile, the up-regulated IL-10 and IL-4, and down-regulated IFN-γ could be observed (P < 0.05).

CONCLUSIONSPregnancy levels of estrogen may promote the conversion of peripheral Tregs in secondary lymphoid organs, but show no effect on the natural Tregs production, differentiation and maturity in central lymphoid organs. Furthermore, pregnancy levels of estrogen could significantly prolong the survivals of H-Y skin grafts by the expansion of Tregs, suppression of CD3(+)CD8(+) effector T-cells and immune shift towards Th2 cytokines.

Animals ; Cytokines ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Female ; Flow Cytometry ; Forkhead Transcription Factors ; metabolism ; Graft Survival ; drug effects ; H-Y Antigen ; immunology ; metabolism ; Immunohistochemistry ; Interferon-gamma ; metabolism ; Interleukin-10 ; metabolism ; Interleukin-4 ; metabolism ; Mice ; Mice, Inbred C57BL ; Ovariectomy ; Pregnancy ; Skin Transplantation ; immunology ; T-Lymphocyte Subsets ; immunology

OBJECTIVETo analyze the periodicity of pandemic influenza A (H1N1) in Changsha in year 2009 and its correlation with sensitive climatic factors.

METHODSThe information of 5439 cases of influenza A (H1N1) and synchronous meteorological data during the period between May 22th and December 31st in year 2009 (223 days in total) in Changsha city were collected. The classification and regression tree (CART) was employed to screen the sensitive climatic factors on influenza A (H1N1); meanwhile, cross wavelet transform and wavelet coherence analysis were applied to assess and compare the periodicity of the pandemic disease and its association with the time-lag phase features of the sensitive climatic factors.

RESULTSThe results of CART indicated that the daily minimum temperature and daily absolute humidity were the sensitive climatic factors for the popularity of influenza A (H1N1) in Changsha. The peak of the incidence of influenza A (H1N1) was in the period between October and December (Median (M) = 44.00 cases per day), simultaneously the daily minimum temperature (M = 13°C) and daily absolute humidity (M = 6.69 g/m(3)) were relatively low. The results of wavelet analysis demonstrated that a period of 16 days was found in the epidemic threshold in Changsha, while the daily minimum temperature and daily absolute humidity were the relatively sensitive climatic factors. The number of daily reported patients was statistically relevant to the daily minimum temperature and daily absolute humidity. The frequency domain was mostly in the period of (16 ± 2) days. In the initial stage of the disease (from August 9th and September 8th), a 6-day lag was found between the incidence and the daily minimum temperature. In the peak period of the disease, the daily minimum temperature and daily absolute humidity were negatively relevant to the incidence of the disease.

CONCLUSIONIn the pandemic period, the incidence of influenza A (H1N1) showed periodic features; and the sensitive climatic factors did have a "driving effect" on the incidence of influenza A (H1N1).

China ; epidemiology ; Climate ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; epidemiology ; virology ; Regression Analysis ; Risk Factors ; Seasons ; Temperature

OBJECTIVETo explore the influence of landscape elements on the transmission of hemorrhagic fever with renal syndrome (HFRS) in Changsha.

METHODSA total of 327 cases of HFRS diagnosed between year 2005 - 2009 were recruited in the study. Based on the demographic data, meteorological data and the data of second national land survey during the same period, a GIS landscape elements database of HFRS at the township scale of Changsha was established. Spatial-temporal cluster analysis methods were adopted to explore the influence of landscape elements on the spatial-temporal distribution of HFRS in Changsha during the year of 2005 - 2009.

RESULTSThe annual incidences of HFRS in Changsha between year 2005 - 2009 were 1.16/100 000 (70 cases), 0.95/100 000 (58 cases), 1.40/100 000(87 cases), 0.75/100 000(47 cases) and 1.02/100 000(65 cases) respectively. The results of poisson regression model analysis of principal component showed that the incidence of HFRS was positively correlated with farmland area (M = 29.00 km2) and urban and rural area (M = 6.12 km2; incidence rate ratios (IRR) = 1.34, 95% CI: 1.27 - 1.41); but negatively correlated with forestland area (M = 39.00 km2; IRR = 0.67, 95% CI: 0.55 - 0.81) and garden plot area (M = 0.99 km2; IRR = 0.74, 95% CI: 0.63 - 0.86). A significant cluster of the spatial-temporal distribution of HFRS cases was found in the study. The primary cluster (28.9 N, 113.37 E, radius at 22.22 km, RR = 5.23, log likelihood ratio (LLR) = 51.61, P <0.01, 67 cases of HFRS and incidence at 4.4/100 000) was found between year 2006 and 2007; and the secondary cluster (28.2 N, 113.6 E, RR = 10.77, LLR = 16.01, P < 0.01, 11 cases of HFRS and the incidence at 10.6/100 000) was found between year 2008 and 2009.

CONCLUSIONThe landscape elements were found to be closely related to the prevalence and transmission of HFRS.

China ; epidemiology ; Climate ; Geographic Information Systems ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; transmission ; Humans ; Regression Analysis ; Space-Time Clustering

Objective To evaluate the effect of personnel activities and air purifiers on airborne microorganisms and particulate matter in bronchoscopy room.Methods According to whether there was personal activity and air purifier in the bronchoscopy room,the experiment was divided into four groups:dynamic non-purification group,dynamic purification group,static non-purification group,and static purification group,indoor air samples were collected and analyzed at five different time points (0,0.5,1,2,4 h),microorganisms in the air were collected by planktonic method,then cultured and counted,concentration of particulate matter was determined by DT-9881M laser dust particle counter,variance analysis of factorial design was used for statistical analysis.Results Colony count/concentration of airborne bacteria,fungi,total microorganisms (bacteria + fungi),PM2.5,and PM2.5-10.0 in dynamic non purification group were (113.53 ± 7.78) CFU/m3,(89.67 ± 7.17) CFU/m3,(203.20 ± 10.92) CFU/m3,(86 557.20 ±4 158.29) counts/m3,and (659.69 ± 38.91) counts/m3 respectively,in static non-purification group were (84.33 ± 3.65) CFU/m3,(65.00 ± 2.65)CFU/m3,(149.33 ± 4.98) CFU/m3,(45 812.64 ±1 279.61) counts/m3,and (189.15 ± 4.64) counts/m3 respectively,in dynamic purification group were (84.80 ±8.08) CFU/m3,(90.40 ± 5.50) CFU/m3,(175.20 ± 9.22) CFU/m3,(49 336.38 ± 2 039.16) counts/m3,and (218.36 ± 7.02) counts/m3 respectively,in static purification group were (67.80 ± 5.63) CFU/m3,(38.27 ± 3.70)CFU/m3,(106.07 ± 6.76) CFU/m3,(29 772.53 ± 2 212.93) counts/m3,and (124.80 ± 7.16) counts/m3 respectively.Colony count/concentration of airborne bacteria,total microorganisms,PM2.5,and PM2.s 10.0 in dynamic group were all higher than those in static group,non-purification group were higher than purification group(both P ＜0.05),colony count of fungi in dynamic non-purification group was higher than static non-purification group,in static purification group was lower than static non-purification group(both P＜0.05),there was no significant difference between dynamic purification group and dynamic non-purification group (P =0.936).Conclusion Personal activities can increase colony count/concentration of microorganisms and particulate matter in bronchoscopy room,air purifier can reduce the bacteria,total microbial count,and particulate matter in the air of bronchoscopy room.

BACKGROUNDUnregulated commercial blood/plasma collection among farmers occurred between 1992 and 1995 in central China and caused the second major epidemic of human immunodeficiency virus type 1 (HIV-1) infection in China. It is important to characterize HIV-1-infected former blood donors and to study characteristics associated with disease progression for future clinical intervention and vaccine development.

METHODSA cross-sectional study was performed on HIV-1-infected former blood donors (FBDs) and age-matched HIV-seronegative local residents. Demographic, epidemiologic, clinical and key laboratory data were collected from all study participants. Both unadjusted and adjusted multivariate linear regressions were employed to analyze the association of the decrease of CD4(+) T-cell counts with other characteristics.

RESULTSTwo hundred and ninety-four HIV-1-infected FBDs and 59 age-matched HIV-seronegative local residents were enrolled in this study. The unregulated blood/plasma collection occurred more than a decade (10.8 - 12.8 years) ago, which caused the rapid spread of HIV-1 infection and the high prevalence of co-infection with hepatitis C virus (HCV, 89.5%); hepatitis B virus (HBV) co-infection was observed in only 11 HIV(+)participants (3.7%). Deterioration in both clinical manifestation and laboratory parameters and increase of viral loads were observed in parallel with the decrease of CD4(+) T-cell counts. The decrease of total lymphocyte counts (P < 0.001) and hemoglobin levels (P < 0.001) and the appearance of dermatosis (P = 0.03) were observed in parallel with the decrease of CD4(+) T-cell counts whereas viral loads (P < 0.001) and CD8(+) T-cell counts (P = 0.01) were inversely associated with CD4(+) T-cell counts.

CONCLUSIONSCo-infection with HCV but not HBV is highly prevalent among HIV-1-infected FBDs. CD4(+) T-cell counts is a reliable indicator for disease progression among FBDs. Total lymphocyte counts, hemoglobin level and appearance of dermatosis were positively associated with CD8(+) T-cell counts and viral loads were inversely associated with the decreased CD4(+) T-cell counts.

Adult ; Aged ; Blood Donors ; China ; epidemiology ; Cross-Sectional Studies ; Female ; HIV Infections ; complications ; epidemiology ; immunology ; HIV-1 ; Hepatitis C ; complications ; Humans ; Male ; Middle Aged

To explore the possible mechanism of liver injury, the effects of Ploygoni Multiflori Caulis and its extractive on the function of bilirubin-associated transporters were investigated in normal (N) and idiosyncratic (LPS) rats (M). The normal and LPS rats were respectively administrated powder of Ploygoni Multiflori Caulis, its extractive and same volume of 0.5% CMC-Na solution for 7 d. BSP, a substrate of the transporters of Oatp1a1 and Oatp1b2 was selected, and its pharmacokinetic parameters of intravenous injection were determined to examined the activity these transporters. Meanwhile the mRNA expressions of transporters were detected. Compared with N-blank control group, besides M-powder group, the Cmax has no significantly different from other groups, t1/2, AUC0-t and AUC0-∞ were significantly increased, and CL were significantly decreased. However, compared with N- blank control group, AST and ALT decreased significantly. The expression of Oatp1a1, Oatp1b2 and MRP2 mRNA was significantly decreased (P<0.05), but there was no act synergistically when Ploygoni Multiflori Caulis and extractive were combined with LPS. The function of Oatp1a1, Oatp1b2 and MRP2 in rats were significantly inhibited by Ploygoni Multiflori Caulis and extractive, which may be an important cause of hepatotoxicity.

Bone defects caused by different causes such as trauma, severe bone infection and other factors are common in clinic and difficult to treat. Usually, bone substitutes are required for repair. Current bone grafting materials used clinically include autologous bones, allogeneic bones, xenografts, and synthetic materials, etc. Other than autologous bones, the major hurdles of rest bone grafts have various degrees of poor biological activity and lack of active ingredients to provide osteogenic impetus. Bone marrow contains various components such as stem cells and bioactive factors, which are contributive to osteogenesis. In response, the technique of bone marrow enrichment, based on the efficient utilization of components within bone marrow, has been risen, aiming to extract osteogenic cells and factors from bone marrow of patients and incorporate them into 3D scaffolds for fabricating bone grafts with high osteoinductivity. However, the scientific guidance and application specification are lacked with regard to the clinical scope, approach, safety and effectiveness. In this context, under the organization of Chinese Orthopedic Association, the Expert consensus for the clinical application of autologous bone marrow enrichment technique for bone repair ( version 2023) is formulated based on the evidence-based medicine. The consensus covers the topics of the characteristics, range of application, safety and application notes of the technique of autologous bone marrow enrichment and proposes corresponding recommendations, hoping to provide better guidance for clinical practice of the technique.