OBJECTIVE:To systematically review the efficacy and safety of reinforcing kidney and invigorating spleen princi-ple in the treatment of primary osteoporosis (POP) in middle and elderly aged patients,and provide evidence-based reference for clinic. METHODS:Retrieved from VIP,Wanfang Database,CJFD,Medline,PubMed,Elsevier,Springer,Web of Science and Ovid,randomized control trials (RCT) about reinforcing kidney and invigorating spleen principle (test group) versus other meth-ods(no reinforcing kidney and invigorating spleen principle,control group)in the treatment of POP were collected. Meta-analysis was performed by using Rev Man 5.3 software provided by Cochrane after data extraction and quality evaluation modified by Jadad scale. RESULTS:Totally 28 RCTs were enrolled,involving 2849 patients. Results of Meta-analysis showed,the total effective rate [OR=3.80,95%CI(2.76,5.23),P<0.001],BGP level [MD=2.23,95%CI(1.80,2.66),P<0.001],BMD level of femoral neck [MD=0.04,95%CI(0.00,0.08),P=0.05] and BMD level of lumbar spine [MD=0.07,95%CI(0.03,0.11),P=0.001] in test group were significantly higher than control group,ALP level [MD=-5.59,95%CI(-10.51,-0.66),P=0.03] and VAS score [MD=-1.38,95%CI(-1.87,-0.89),P<0.001] were significantly lower than control group,with statistical significance. There were no significant differences in U-Ca/Cr [MD=-0.07,95%CI(-0.17,0.02),P=0.12] and serum Ca2+ level [MD=0.16,95%CI (-0.07,0.39),P=0.17] in 2 groups. CONCLUSIONS:Reinforcing kidney and invigorating spleen principle can improve patients' osteogenesis during bone metabolism,reduce the activity of the osteoclastic process and relief patients'pain in the treatment of POP.

Objective To examine the advanced oxidation protein products (AOPP) in patients with acute coronary syndrome(ACS) and discuss the relationship between oxidative stress with the development of atherosclero-sis(AS). Methods Plasma were collected in 59 acute myocardial infarction (AMI) patients including 35 patients underwent selective PCI,24 patients underwent emergency PCI,43 unstable angina pectoris(UA) patients and 10 non-coronary artery disease (non-CAD) patients. All cases underwent coronary angiography (CAG). Plasma was collected immediately,post-24 hours and post-48 hours after admission. AOPP was determined by measurements of absorbance (A) at 340 nm under acidic conditions via spectrophotometry. Results AOPP was (236.42±30.41) ( n = 35 ), ( 207.84±29.50 ) mmol/L ( n = 35 ), ( 227.79 ± 35.18 ) mmol/L ( n = 31 ) respectively immediately, post-24 hours and post-48 hours after admission in AMI ( selective PCI ), ( 239.95 ±39.94 ) mmol/L ( n = 43 ), (175.92 ±29.46) mmol/L(n =38) ,and (156.54 ±28.29) mmol/L(n =35) in UA group and (57.41 ± 13.60) mmol/L( n = 9 ), (56.11 + 11.90) mmol/L ( n = 10 ) and ( 61.75 ± 12.28 ) mmol/L ( n = 8 ) in non-CAD group. Compared with normal group ( without CAD ) , significantly higher plasma AOPP was detected in AMI ( selective PCI) and UA patients ( P < 0.05 ). AOPP level was significantly increased in AMI selective PCI patients as compared with that of emergency PCI group immediately and post-24 hours after admission( P <0.01 ) ,and post-48 hours after admission( P < 0.05 ), but there was no statistical significance between emergency PCI and UA group( P > 0.05 ). Conclusions Oxidative stress is an important step in the development of atherosclerosis, and the higher levels of AOPP in ACS patients show that AOPP may be as good markers in these patients.

Objective To investigate the clinical efficacy of open reduction and internal fixation with dynamic anterior plate-screw system for quadrilateral area ( DAPSQ ) in the treatment of elderly patients with acetabular fracture involving medial displacement of the quadrilateral surface. Methods Between January 2007 and December 2014, a series of 18 senile patients with acetabular fractures involving medial displace-ment of the quadrilateral surface were treated at our department. They were 13 men 5 women, with a mean age 67. 8 years ( range, from 61 to 78 years ) . By the Judet-Letournel classification, there were 4 anterior column fractures, 5 anterior column plus posterior hemitransverse fractures, 8 double column fractures and one T-shaped fracture. The delay from injury to surgery averaged 6. 5 days. All were treated with the technique of DAPSQ. Screw internal fixation of the quadrilateral area followed plate moulding via a single ilioinguinal ap-proach. Fixation with lag screws for the posterior column was added if necessary. Results The 18 pa-tients were followed up for 12 to 35 months ( mean, 26 months ) . By the Matta criteria for fracture reduction, 9 cases were rated as excellent, 6 as good and 3 as poor. Bone healing was achieved within 2 to 4 months( mean, 3. 5 months ) . By the modified Merle d'Aubigné & Postel criteria, the affected hips scored 9 to 18 points ( mean, 16. 3 points ) at the final follow-ups, giving 7 excellent, 7 good, 2 fair and 2 poor cases. By the Harris evaluation, the affected hips scored 58 to 98 points ( mean, 87. 6 points ) , giving 7 excellent, 8 good, one fair and 2 poor cases. The postoperative complications included urinary tract infection in one, lesion of lateral femoral cutaneous nerve in one, heterotopic ossification ( Brooker Grade Ⅰ) in one, and traumatic osteoarthritis in 5 cases 2 of whom had to receive total hip arthroplasty. Conclusion The technique of DAPSQ is suitable for the treatment of acetabular fractures involving medial displacement of the quadrilateral surface in elderly patients, because it can provide and maintain stable fixation of the fracture in the quadri-lateral area and preserve hip joint function, leading to fine outcomes.

Objective To establish the gas chromatographic(GC) fingerprint of oleic acid of Whitmania pigra Whitman for its quality control. Methods Ten batches of Whitmania pigra from different sources and processed by different methods were analyzed with Agilent 6890N gas chromatography detector on DB-WAX(30 mm × 0.32 mm × 0.25μm)column at the vaporizing temperature of 270℃, column temperature of 130℃and flame ionization detector (FID) temperature of 280℃. We used a software of Similarity Evaluation System for Chromatographic Fingerprint of TCM(Version of 2004A) published by Chinese Pharmacopoeia Commission to calculate GC similarity. Results Oleic acid content of Whitmania pigra processed by different methods had significant differences (F2,7 = 7.350, P = 0.019). The oleic acid content of samples dried after washing with clean water significantly differed from that of the samples processed by alumen or the slices dried naturally(P = 0.021, P= 0.009). The similarity of the fingerprints was in the range of 0.458 - 0.998. The similarity of samples from Lipu of Guangxi Province was the lowest. Conclusion The fingerprints of most of the samples have very high similarity. The established GC fingerprints can be used to effectively identify the qualified or inferior Whitmania pigra products, which will provide some reference for the quality control of Whitmania pigra.

Objective:To investigate the effect of percutaneous kyphoplasty on the vertebral height and Cobb angle in elderly patients with osteoporotic thoracolumbar compression fractures.Methods:Seventy elderly patients with osteoporotic thoracolumbar compression fractures who were admitted to the Affiliated Hospital of Hubei University of Traditional Chinese Medicine from March 2019 to March 2020 were selected as the study objects. They were grouped according to the random number table method, with 35 patients in each group. The patients in the observation group were treated with multi-point balloon expansion percutaneous kyphoplasty, and the patients in the control group were treated with single balloon expansion percutaneous kyphoplasty. The Visual Analogue Scale (VAS) and Oswestry Dysfunction Index (ODI) score were compared between the two groups before and after treatment. The relative height of injured vertebrae, Cobb angle, bone cement diffusion volume ratio, operation time, radiation exposure time and bone cement injection volume were recorded.Results:There was no significant difference in VAS and ODI score between the two groups before operation (all P>0.05). At 12 months after operation, the VAS and ODI score of the two groups were lower than those before operation (all P<0.05), and the ODI score of the observation group was significantly lower than that of the control group ( P<0.05). At 12 months after operation, the relative height of injured vertebrae in the observation group was higher than that in the control group, and the local Cobb angle was significantly lower than that in the control group (all P<0.05). The total effective rate of the observation group was significantly higher than that of the control group (94.28% vs 82.86%, P<0.05). Compared with the control group, the observation group had higher proportion of grade Ⅱ in the diffusion volume ratio of bone cement and more bone cement injection, and longer operation time (all P<0.05), while there was no significant difference in the radiation exposure time between the two groups ( P>0.05). Conclusions:The treatment of percutaneous kyphoplasty with multi-point expansion of balloon under overextended posture can more effectively improve the relative height of injured vertebrae and improve local Cobb angle of elderly patients with osteoporotic thoracolumbar compression fractures, and does not increase the risk of bone cement leakage. It is worthy of clinical application and promotion.

OBJECTIVETo explore the characteristics and therapies of patients with acute myocardial infarction (AMI) in Wuxi city, China.

METHODSA network was established to obtain information of patients with AMI who were admitted to 9 designated hospitals between 2011 and 2012. A total of 1 714 patients were enrolled (1 334 males, 754 smokers, 1 076 hypertension, 270 hyperlipidemia and 398 diabetes) including 1 410 patients with acute ST-segment elevation myocardial infarction (STEMI) and 304 patients with acute non ST-segment elevation myocardial infarction (NSTEMI). Patients' characteristics, therapies, the incidence of major adverse cardiovascular events (MACEs) and all-cause mortality were analyzed.

RESULTS(1) Medication therapy was as follows: antiplatelet therapy 98.3% (1 685 cases) , beta-blockers 59.1% (1 013 cases) , ACEI or ARB 67.6% (1 159 cases) , statins 98.1% (1 682 cases) , and nitrates 71.1% (1 218 cases) . Of the patients, 7.1% (132 cases) received temporary pacemakers, 34.0% (480 cases) with acute STEMI underwent reperfusion [direct PCI 18.4% (260 cases) and thrombolysis 15.6% (220 cases)]. (2) According to the hospital admission data, patients were divided into three groups: group A, transported to the hospital by ambulance (n = 361); group B, transported to the hospital by private vehicles (n = 1 318); and group C, AMI occurred in the hospital (n = 35). The median time of AMI onset to physician contact of the 3 groups was 178 min, 368 min, and 9 min, respectively. The median time from AMI onset to the first ECG was 181 min, 379 min, and 10 min, respectively. The median time from AMI onset to cardiology specialist consultation was 187 min, 431 min, and 69 min, respectively. AMI onset-to-physician contact, AMI onset-to-first ECG, and AMI onset-to-specialized treatment time was the shortest in group C, followed by group A and group B. For patients with STEMI underwent reperfusion therapy, the median AMI onset-to-reperfusion therapy time was significantly shorter in group A patients than group B patients [thrombolysis group: 224(171, 514) min vs. 378 (158, 785) min, PCI group: 318 (154, 674) min vs. 489 (143, 816) min, all P < 0.05]. (3) The total incidence of MACEs was 16.3% (279/1 714), the all-cause in-hospital mortality rate was 13.1% (224/1 714). According to the AMI onset-to-physician contact, patients were divided into 4 groups: <3 h, 3-6 h, 6-12 h, and >12 h. The incidence of MACEs [4.4% (23/517), 13.3% (60/451), 19.1% (77/404) and 34.8% (119/342),χ(2) = 114.36, P < 0.01] and all-cause in-hospital mortality rate [4.1% (21/517) , 10.4% (47/451), 18.6% (75/404), 23.7% (81/342), χ(2) = 84.36, P < 0.01] increased in proportion to the time of AMI onset-to-physician contact. Among STEMI patients, the incidence of MACEs [5.8% (15/260) , 12.3% (27/220) , 20.9% (194/930) ,χ(2) = 39.93, P < 0.01] and all-cause in-hospital mortality [1.5% (4/260) , 10.0% (22/220) , 18.2% (170/930) ,χ(2) = 50.90, P < 0.01] was the lowest in the primary PCI group, followed by thrombolysis group and was the highest in the early conservative treatment group.

CONCLUSIONSGuideline is well followed in terms of drug treatments of AMI in this cohort, but only a small proportion of AMI patients in Wuxi received reperfusion therapy. There is a considerable out-of-hospital time delay for AMI patients in this cohort which is shorter in group A than in group B. All-cause in-hospital mortality and MACEs is the lowest in AMI patients underwent primary PCI.

Adult ; Aged ; Aged, 80 and over ; China ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy

OBJECTIVETo explore the role of ZNF217 in regulating cell proliferation, migration and invasion in glioma cells.

METHDOSA lentivirus-mediated shRNA-ZNF217 vector was infected into glioma U251 cells, and the interference efficiency was examined by Western blotting. MTT assay, flow cytometry, Transwell assay, and Boyden chamber assay were used to analyze the changes in cell proliferation, migration and invasion. Western blotting was used to detect the changes in ZNF217-related genes in the cells.

RESULTSshRNA-ZNF217 transfection significantly inhibited the expression of ZNF217 in U251 cells and suppressed the cell migration, invasion, growth, and cell cycle transition. ZNF217 knockdown downregulated the expression of pPI3, pAKT, C-Myc, and the mesenchyme biomarker N-cadherin, and stimulated the expression of the epithelium biomarker E-cadherin.

CONCLUSIONZNF217 promotes cell migration, invasion, and growth by activating PI3K/AKT signal to upregulate C-Myc and by modulating the genes associated with epithelial-mesenchymal transition in glioma cells.

Cadherins ; metabolism ; Cell Cycle ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Epithelial-Mesenchymal Transition ; Genetic Vectors ; Glioma ; pathology ; Humans ; Lentivirus ; Neoplasm Invasiveness ; RNA, Messenger ; RNA, Small Interfering ; genetics ; Trans-Activators ; genetics ; Transfection

Objective To explore the application scope of small splint in the treatment of type-C distal radius fractures. Methods According to CT scan data from the right forearm of a healthy male volunteer, the three-dimensional model of normal distal radius was established. According to AO classification, the fracture line based on normal model was divided to establish nine kinds of high-order tetrahedral mesh models of the upper forearm with C-type fracture. Finite element analysis on nine kinds of fracture models was conducted in ANSYS 15.0 software to obtain the corresponding stress values, and then the stress distribution contours were generated. Results As soft tissues of the wrist were thin with more fracture blocks, after the splint was fixed, the stress on the wrist under 100 N maximum physiological axial load was significantly larger compared with that on the other parts, and the compressive stress was mainly concentrated on the wrist joint. The fixed effect of C2.2, C2.3, C3.2, C3.3-type fracture by small splint was relatively poor, as such comminuted fracture would cause too many and too small fracture blocks, while the fixed effect of C1.1, C1.2, C1.3, C2.1 and C3.1-type fracture was better. Conclusions Through the related finite element study on the treatment of C-type fracture distal radius with small splint, the application scope of small splint was preliminarily determined, which could provide some reference for clinical work.

Objective To study mechanical properties of porous scaffolds with lattice Weaire-Phelan (LWP) structure and precisely simulate the whole process of compression test using finite element method. Methods The Ti6Al4V (TC4) porous scaffolds with different porosities were manufactured by selective laser melting (SLM) technology, and their mechanical properties were measured by uniaxial compressive tests, and compared with those of human bones and porous scaffolds with other cellular structures. Four types of material models were verified for their effects on the simulation of porous scaffold compression. Results LWP samples presented the elastic modulus close to that of human cancellous bone and significantly higher yield strength than that of cortical bone in most parts of human body. Compared with other scaffold structures, LWP samples exhibited the lowest elastic modulus and highest yield strength. The simulated results derived from the proposed material model in this study, namely, Johnson-Cook constitutive model and failure model based on dynamic geometric strain (JCDG), were proved very consistent with the experimental data. Conclusions LWP scaffolds as the bone repair biomaterials exhibite more excellent mechanical properties than the scaffolds with other structures. JCDG is more beneficial for establishing the reasonable simulation model of porous scaffolds compression, compared with other reported material models.

Objective To quantitatively study the pressure of residual lateral displacement in distal radius AO C3.1 fracture after manual reduction corrected by dynamic airbag pad using finite element analysis and to verify its effectiveness for correcting the residual displacement of fractures. Methods Imageware 13.0, Mimics 15.0 and ANSYS Workbench were used to simulate 1 cm residual lateral displacement after manual reduction of distal radius fracture corrected by dynamic airbag pad. Then the correlation between the distance of residual lateral displacement and the adjustment of dynamic airbag pad pressure were quantitatively analyzed. Results In the case of constant load restrained by airbag ribbon, during the process of pressure adjustment by splint pad, the stress was mainly distributed in the fracture end where the airbag pad was located. About 2.4 kPa pressure was needed to correct 1 mm displacement on radial side, while about 1.3 kPa pressure was needed to correct 1 mm displacement on dorsal side. The dynamic airbag pad was depressurized after the restoration of residual shift. At this time, displacement could be effectively prevented due to the constant load of airbag ribbon and the frictional load at the fracture end. Conclusions In the case of constant load constrained by airbag ribbon, intelligent airbag splint can effectively correct the residual lateral displacement after the manual reduction of the distal radius AO C3.1 fracture and prevent it from being displaced by adjusting pressure of the dynamic airbag pad.