Objective To compare the clinical effectiveness of whole blood derived platelets and apheresis platelets in children with hematological diseases.Methods Children were divided into two groups: apheresis platelet group(463 children) and whole-blood-derived platelet group(155 children).The platelet corrected count increment(CCI),percentage platelet recovery(PPR),the incidence rate of post-transfusion refractoriness to platelets(PTR) and adverse reaction were observed and assayed at 24,48 and 72hours after transfusion.Results In the apheresis platelet group,CCI and PPR at 24,48,and 72 hours after transfusion were significantly higher(P

Objective To investigate mechanism of cyclooxygenase-2 ( COX-2) in bone loss in a postmenopausal osteoporosis (PMOP) rat mode with ovarietomy (OVX).Methods Forty female Sprague Dawley adult rats at age of 3 months were randomly divided into 4 groups,10 in each group,including shamoperated (sham) group,OVX group,OVX treated with nilesteriol (OVX + E) group and OVX treated with aspirin ( OVX + P) group.All rats in OVX,OVX + E and OVX + P groups underwent ovarietomy under abdominal anesthesia with 10％ chloral hydrate.Rats in sham group were only taken with fat tissue with same weight under bilateral ovary.After surgery,penicillin was administered to prevent infection.At day 7 after surgery,agents were given by intragastric administration for 12 weeks.Nilestriol at 1.0 mg/kg was used in OVX + E group once a week,aspirin at 45 mg · kg - 1 · d- 1 was used in OVX + P group once a day.Saline with same volume was used in rats in sham and OVX groups.All agents were administered one time per day.Dose of agents were adjusted by weight per week.At end of study,bone mineral density (BMD) of right femurs and lumbar vertebrae 3 -5 (L3-5) were measured.Morphology of bone was detected by hematoxylineosin,and expression of COX-2 was determined by immunohistochemistry staining.Results ( 1 ) BMD:BMD of right femur and L3-5 was (0.209 ±0.010) g/cm2 and (0.230 ±0.012) g/cm2 in sham group and (0.181 ±0.008) g/cm2 and (0.201 ± 0.016) g/cm2 in OVX group,which reached statistical difference (P＜0.01).BMD of right femur and L3-5 was (0.203 ±0.009) g/cm2 and (0.224 ±0.028) g/cm2 in OVX + E group and (0.200 ± 0.011 ) g/cm2 and (0.204 ± 0.003 ) g/cm2 in OVX + P group,which were all higher than those in OVX group (P ＜0.01,P ＜0.05).However,there was no statistical difference in BMD between OVX + E and OVX + P group ( P ＞ 0.05).(2) Morphology of bone:bone trabeculae became fewer and degenerated in OVX group.However,bone trabeculae were regular and dense in OVX + P group and OVX + E group,which were similar to those in sham group.(3) Expression of COX-2:cells with COX-2 positive and expression of COX-2 around bone trabeculae in OVX group were more than those in sham,OVX + E and OVX + P group.Conclusion COX-2 plays an important role in PMOP.Aspirin could prevent bone loss by decreasing COX-2 expression in OVX rats.

BACKGROUND:Cryotherapy plays a positive role in the treatment of delayed-onset muscle soreness caused by high intense exercise. OBJECTIVE: To investigate the effects of different crypotherapy programs on the levels of interleukin-6 and prostaglandin 2 in long distance race-walkers after 15-day training, and to determine a rational treatment program for delayed-onset muscle soreness. METHODS:Sixteen male race-walkers in Liaoning Province were randomly divided into cryotherapy and cryo/heat therapy groups, and received 10-minute cryotherapy and 2.5-minute cryo/heat therapy (2.5-mintue cryotherapy and 2.5-minute heat therapy alternately for 10 minutes), respectively, after 15-day training. The serum levels of interleukin-6 and prostaglandin 2 were detected at six different time points to compare the efficacy between two methods. RESULTS AND CONCLUSION: Compared with the cryo/heat therapy group, the serum levels of interleukin-6 and prostaglandin 2 in the cryotherapy group were significantly decreased. That is to say, cryotherapy is more available for alleviating delayed-onset muscle soreness after intensive eccentric training or in intensive seasons.

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative patient-controlled intravenous analgesia in pediatric patients undergoing lower extremity orthopedic surgery.Methods:Sixty-eight pediatric patients of both sexes, aged 3-15 yr, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, undergoing elective lower extremity orthopedic surgery under general anesthesia, were divided into 2 groups ( n=34 each) by the random number table method: TEAS group (group T) and control group (group C). In group T, the bilateral Hegu and Neiguan acupoints were stimulated starting from 10 min before induction of anesthesia until the end of procedure, with the frequency of disperse-dense wave of 2/10 Hz, and the current intensity was gradually adjusted to the maximum intensity (10-15 mA) that children could tolerate. In group C, the electrodes were applied to the same acupoints, but electrical stimulation was not applied. The severity of pain was assessed by the Faces Pain Scale-Revised scale immediately after returning to the ward and at 2, 24 and 48 h after operation. The emergence agitation was evaluated using the Pediatric Anesthesia Emergence Delirium scale. The intraoperative consumption of propofol and remifentanil and time to extubation after stopping administration were recorded. The time to first pressing of patient-controlled analgesia (PCA), effective pressing times of PCA on 1st and 2nd days after surgery and postoperative adverse reactions such as postoperative nausea and vomiting, pruritus, drowsiness, and respiratory depression were recorded. Results:Compared with group C, the Faces Pain Scale-Revised scale scores were significantly decreased immediately after returning to the ward and at 2, 24 and 48 h after operation, the incidence of emergence agitation and intraoperative consumption of remifentanil were decreased, the time to extubation was shortened, the time to first pressing of PCA was prolonged, and the effective pressing times of PCA on 1st and 2nd days after surgery were decreased ( P<0.05). There was no significant difference in the intraoperative consumption of propofol and incidence of postoperative adverse reactions between the two groups ( P>0.05). Conclusions:TEAS can effectively enhance the effect of postoperative patient-controlled intravenous analgesia in pediatric patients undergoing lower extremity orthopedic surgery.

Objective:To evaluate the effects of physician skills on the success rate of the external cephalic version (ECV) and investigate the learning curve for ECV.Methods:A retrospective study of 97 pregnant women who underwent ECV at the First Affiliated Hospital of Nanjing Medical University from March 2019 to August 2021 was performed. Patients were divided into multipara and primipara groups. The success rate of ECV and morbidity were compared between the two groups, and the learning curve for ECV was evaluated using cumulative sum analysis (CUSUM).Results:(1) Patients in the multipara group were older than those in the primipara group [(33.0±3.4) vs (29.2±3.0) years, t=－5.57, P<0.001]. No significant difference was found in other baseline data between the two groups. (2) The overall ECV success rate was 61.9% (60/97), and a higher success rate was observed in the multipara group [93.3% (28/30) vs 47.8% (32/67), χ 2=18.24, P<0.001]. Fetal heart rate deceleration (5.2%, 5/97), vaginal bleeding (1.0%, 1/97), premature rupture of membranes (1.0%, 1/97), and fetal distress (1.0%, 1/97) were the main complications. (3) The CUSUM analysis showed that it needed 53 primiparas for a physician to obtain a 50% consistent success rate ( R2=0.91, H=－3.27, Y=52.16) and seven multiparas to achieve a 70% consistent success rate ( R2=0.99, H=－1.635, Y=6.60). Conclusions:Parity and operator skills have a significant influence on the success of ECV. A physician with standardized training will manage non-anesthesia ECV skillfully in full-term and near-term pregnancies after practice on 50 primiparae or approximately ten multiparae. It is recommended to start with the multiparae for learning ECV to build up confidence and promote the implementation of ECV.

BACKGROUND:Most of the biomechanical studies on kyphosis have focused on trunk muscle strength and sagittal plane balance,and little has been reported on the biomechanical response within the spine during kyphosis. OBJECTIVE:To investigate the biomechanical response of the spine during postural kyphosis by simulating the process of postural kyphosis. METHODS:A three-dimensional finite element model of the normal thoracolumbar segment(T1-S1 segment)was established by using the finite element method.10 groups of pure bending loads from 1.15-11.52 N·m were applied using a three-point force system on T1,T6,and T12 vertebrae to simulate the process of postural kyphosis in normal humans.The relationship between the loads and Cobb angle and the biomechanical responses of vertebrae,ribs,and intervertebral discs were analyzed. RESULTS AND CONCLUSION:(1)During postural kyphosis,the Cobb angle size of T1-T12 segments was linearly related to the load size.(2)The maximum stresses on the vertebrae,ribs,and intervertebral discs increased with increasing load.(3)Under the action of 11.52 N·m moment,the maximum stresses on the vertebral body,ribs,and intervertebral disc were found in the front of the T6 vertebral body,the rib head of the 10th pair of ribs,and the right posterior side of the intervertebral disc of the T5-T6 segments.(4)The results of this study suggest that postural kyphosis leads to increased stress on the vertebrae,ribs,and discs,with the most significant increase in stress on the anterior side of the T6 vertebrae,at the rib head of the 10th pair of ribs,and on the anterior side of the disc at the T5-T6 segment,as well as on the posterior side,which may increase the risk of injury to the vertebrae,ribs,and discs,which provides a biomechanical basis for the design of kyphosis orthoses.

Lipotoxicity is a pivotal factor that initiates and exacerbates liver injury and is involved in the development of metabolic-associated fatty liver disease (MAFLD). However, there are few reported lipotoxicity inhibitors. Here, we identified a natural anti-lipotoxicity candidate, HN-001, from the marine fungus Aspergillus sp. C1. HN-001 dose- and time- dependently reversed palmitic acid (PA)-induced hepatocyte death. This protection was associated with IRE-1α-mediated XBP-1 splicing inhibition, which resulted in suppression of XBP-1s nuclear translocation and transcriptional regulation. Knockdown of XBP-1s attenuated lipotoxicity, but no additional ameliorative effect of HN-001 on lipotoxicity was observed in XBP-1s knockdown hepatocytes. Notably, the ER stress and lipotoxicity amelioration was associated with PLA2. Both HN-001 and the PLA2 inhibitor MAFP inhibited PLA2 activity, reduced lysophosphatidylcholine (LPC) level, subsequently ameliorated lipotoxicity. In contrast, overexpression of PLA2 caused exacerbation of lipotoxicity and weakened the anti-lipotoxic effects of HN-001. Additionally, HN-001 treatment suppressed the downstream pro-apoptotic JNK pathway. In vivo, chronic administration of HN-001 (i.p.) in mice alleviated all manifestations of MAFLD, including hepatic steatosis, liver injury, inflammation, and fibrogenesis. These effects were correlated with PLA2/IRE-1α/XBP-1s axis and JNK signaling suppression. These data indicate that HN-001 has therapeutic potential for MAFLD because it suppresses lipotoxicity, and provide a natural structural basis for developing anti-MAFLD candidates.