Objective To research the clinical evaluation of potassium dehydroandrograpolide succinate injection in the treatment of COPD combined with CAP and its influence on plasma IL-33, PCT and hs-CRP levels.Method 91 patients with COPD combined with CAP in our hospital from April 2015 to August 2016 were selected and divided into the observation group (48 cases) and the control group (43 cases).The control group was given routine treatment, the observation group was given on the basis of the above treatment of potassium dehydroandrograpolide succinate injection.The clinical efficacy and plasma IL-33, PCT and hs-CRP levels were compared between the two groups after treatment.Results Before treatment, the IL-33, PCT, hs-CRP of two groups of patients had no significant difference.After treatment, the total effective rate of the observation group was 91.67% higher than that of the control group 74.42%, the difference was statistically significant (P<0.05).All the clinical symptoms time of the observation group was significantly lower than that of the control group, and the clearance rate of the observation group (85.42%) was significantly higher than that of the control group (67.44%), the difference was statistically significant (P<0.05), the indexes of the two groups of patients were decreased, the indexes of the observation group significantly lower than that in control group, the difference was statistically significant (P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group .Conclusion Potassium dehydroandrograpolide succinate injection can significantly improve their plasma IL-33, PCT and hs-CRP levels, the respiratory pathogen and inflammatory mediators are effectively removed, and has good clinical effect, and no serious adverse reactions during treatment.

OBJECTIVE:To observe the clinical efficacy of Shenkang injection,a new compound preparation for chronic renal failure(CRF).METHODS:A total of 84 CRF patients were randomly divided into two groups:the treatment group(n=54)was given routine antihypertensive therapy and infused(iv gtt)with Shenkang injection 60～ 100mL(dissolved in 10% GS 300mL or NS 300mL)q.d for 30d;the control group(n=30)was infused(iv gtt)with Compound danshen injection 250mL q.d for 30d.RESULTS:As compared with the control group,serum levels of creatinine and urea nitrogen(UN)in treatment group had a greater reduction(P

BACKGROUND: Differentiation of embryonic stem (ES) cells into cardiomyocytes in vitro has been studied in great detail in the world. However, much of what is currently known about cardiomyocyte differentiation from ES cells has been learned from studies on mouse in China, few studies are on human ES cells.OB JECTIVE: To investigate the differentiation effcacy of human ES cells into functional cardiomycytes with the human H14 ES cell line.DESIGN: Suspending method was used to form pseudo-embryo proper of human ES cells so as to observe ratio of pseudo-embryo proper with rhythmic contraction and expression of specific gene of myocardium in various differentiated phases.SETTING: Molecular Biology Laboratory of Stanley Ho Center for Emerging Infectious Diseases, School of Public Health, the Chinese University of Hong Kong.MATERIALS: Human ES cell line H14 was obtained from WiCell Research Institute (Wisconsin, USA) with a license agreement.METHODS: The experiments were carried out in the Molecular Biology Laboratory of Stanley Ho Center for Emerging Infectious Diseases, School of Public Health, the Chinese University of Hong Kong from August to December of 2006.The H14 ES cell colony was used to form embryoid bodies (EBs) by using suspending method. Four days later,pseudo-embryo proper was cultured in gelatin-coating 6-well culture plate (5-10 embryo proper/well) and spontaneously differentiated into moving pseudo-embryo proper. Rhythmic contraction was observed under microscope and RT-PCR was used to detect expression of special genes of myocardium.MAIN OUTCOME MEASURES: Ratio of pseudo-embryo proper with rhythmic contraction and expression of specific gene of myocardium in various differentiated phasesRESULTS: Spontaneously contracting cells appeared as cluster and were identified in approximately 2% of EBs at differentiation day 8 and increased to as many as 10% of the EBs by day 16. The beating rate of contracting cells arranged at 70-100 beats per minute. RT-PCR analyses demonstrated that cells isolated from spontaneous beating areas within the EB expressed the cardiac transcription factors GATA-4 and Nkx2.5, cardiac progenitor gene Isl-1 and cardiomyocyte marker gene α-MHC.CONCLUSION: This is the first time to report human ES cells can effectively differentiate into functional cardiomyocytes in China.

OBJECTIVETo study the biomechanical change of the craniovertebral junction in conditions of atlas assimilation.

METHODSMimics software was used to process CT data of the craniovertebral junction in a health adult to obtain the three-dimensional reconstruction and the cloudy points of C1, C2 and part of the occipital bone. Then the cloudy points were imported into the Abaqus 6. 8 software to establish the occipito-atlantoaxial finite element model in normal structure. According to the established model in normal structure, the model in conditions of atlas assimilation was set by changing the model parameters. Both models of normal structure and atlas assimilation were loaded with 1. 5 N . m static moment to simulate four motions of flexion, extension, lateral bending and axial rotation respectively. The movement characteristics,joint stress force and ligament deformation was analyzed.

RESULTSUnder 1. 5 N . m moment, in model of atlas assimilation the C1-C2 range of movement decreased from 13. 55° to 11.88° in flexion,increased from 13. 22° to 15. 24° in extension and from 4. 05° to 4. 23° in lateral bending and remained unchanged in axial rotation when compared with the normal model. In flexion movement, the contact force of the atlanto-dental joint increased from 1. 59 MPa to 3. 28 MPa and the deflection of apical ligament, tectorial membrane and alar ligament increased 129. 1%, 157. 6% and 75. 1% respectively when compared with the normal model.

CONCLUSIONSThe normal C1-C2 motion mode is destructed in conditions of atlas assimilation, leading to the changes of the range of movement,joint stress force and the ligament deformation at C1 C2 junction. The atlantoaxial instability will likely occur in flexion motion.

Atlanto-Axial Joint ; physiology ; Biomechanical Phenomena ; Cervical Atlas ; physiology ; Cervical Vertebrae ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Joint Instability ; Ligaments, Articular ; Occipital Bone ; Range of Motion, Articular ; Rotation

Objective To investigate the mechanisms of ureaplasma urealyticum(Uu)resistance to macrolide antibiotics.Methods Twenty strains of clinical isolates of Uu with variable resistance to macrolides and reference strain ATCC 27618 were examined for mutations in 23SrRNA.Results As compared with the sequence of reference strain ATCC 27618 and GenBank,three mutations were found in 23SrRNA of Uu clinical isolates.C2243N(TorC)was found in the 23SrRNA in 5 strains with the phenotype resistance to roxithromvcin and azithromycin.A2149C and A2181T were found in the 23SrRNA in 9 strains with the phenotype resistance to roxithromycin and midrange resistance to azithromycin,and 6 strains with the phenotype of sensitivity to roxithromyein and azithromycin.Conclusions The mechanisms of Uu resistance to roxithromycin and azithromycin may be related with the mutations in 23SrRNA.It may warrant further investigation.

Objective To explorer the effect of midnight-noon ebb-flow of five elements of music therapy on anxiety and depression in type 2 diabetic patients.Methods A total of 60 type 2 diabetic patients with anxiety and depression in our hospital were divided into the experiment group and the control group according to the order of admission,with 30 patients in each group.The control group received routine nursing care and general music therapy.The experiment group received routine nursing care and midnight-noon ebb-flow of five elements of music therapy.After four weeks,the results of the two groups were compared using HAMD and HAMA scales.Result Four weeks after intervention,there was improvements in the two groups ((P＜0.01) and the anxiety and depression levels in the experiment group were significantly improved than those in the control group (P＜0.01).Conclusion The midnight-noon ebb-flow of five elements of music therapy can alleviate the levels of anxiety and depression in patients with type 2 diabetes.

Based on the research history of the biomechanics of occipito-atlantoaxial complex, we have systematically summarized the use of finite element method for studying biomechanics of occipito-atlantoaxial complex. Then, combined with four basic principles of establishing an effective finite element model for mechanics, our comments are focused on the establishment of geometrical model, finite element model, finite element mechanics model, and on the method and implementation for validating the model. In addition, the developing trends, existing problems and future researching directions in this area are discussed.
Atlanto-Axial Joint ; physiology ; Atlanto-Occipital Joint ; physiology ; Biomechanical Phenomena ; Computer Simulation ; Finite Element Analysis ; Humans ; Models, Biological ; Range of Motion, Articular ; physiology

Objective To evaluate the setup errors of image guided radiation therapy (IGRT) for head-and-neck cancer using kilovoltage cone beam CT( kV CBCT).Methods 256 patients with head-and-neck cancer were treated with intensity modulated radiation therapy (IMRT) from March 2009 to October 2011.All patients were immobilized with head-and-neck mask and localized with final isocenter marking method using the Philips PQS CT or Philips Brilliance CT Big Bore scanners,which were equipped with LAP movable laser systems.The CT images were transferred to a Varian Eclipse V8.6 workstation for contouring and planning.A kV cone-beam CT scans was acquired,and registered before the treatment for every patient on a Varian iX linear accelerator via OBI system.The setup errors in the right-left ( RL),superior-inferior (SI),and anterior-posterior (AP) directions were recorded.Results The setup errors for the 473 datasets followed a Gaussian distribution.The systematic errors ± random errors in the RL,SI and AP were(-0.6 ± 1.3 ),(0.5 ± 1.6) and (0.9 ± 1.7 ) mm,respectively.The planning target volume (PTV) margins were calculated respectively as 2.4,2.4 and 3.4 mm according to the formula of M =2.5∑ +0.7δ The margins of 288 sets of data using the Big Bore CT scanner were calculated as 2.0,2.1 and 1.7 mm,respectively.Conclusions The setup errors using final isocenter marking method are smaller than those using reference point marking method.The result derived from this retrospective study could be used to set the margin between CTV and PTV.

Objective:To analyze the compliance with enhanced recovery after surgery (ERAS) protocol in geriatric patients with fresh fracture.Methods:A retrospective study was conducted on the data of the patients with fresh extremity fracture which had been included in the ERAS perioperative protocol database during May 2019 and January 2022 at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital. The patients ≥65 years were selected as a study group which was matched by a control group of the patients < 65 years in sex, fracture type and date frame of hospitalization at a ratio of 1∶1. The 2 groups were compared in the compliance with the 14 ERAS core perioperative elements.Results:The study group and the control group each included 66 patients who were matched in sex and fracture type. 62.1% (41/66) of the patients in the study group had combined diseases, significantly more than that [16.7% (11/66)] in the control group( P<0.001). Altogether, the compliance with the 14 ERAS core perioperative elements was 78.6 (71.4, 85.7) % in both groups, showing no significant difference between them ( P>0.05). Respectively, the compliance with the postoperative oral intake in the study group (80.3%, 53/66) was significantly lower than that in the control group (92.4%, 61/66) ( P<0.05); the compliance with the other 13 elements showed no statistically significant difference between the 2 groups ( P>0.05). Conclusion:The ERAS perioperative protocol can be carried out smoothly in geriatric patients with fresh fracture whose compliance may be comparable to that of the none-elderly patients.

Objective:To analyze the factors which may influence postoperative early ambulation in patients with fresh fracture so as to further optimize the perioperative protocol based on the concept of enhanced recovery after surgery (ERAS).Methods:A retrospective analysis was conducted of the patients who had been treated for a single fresh fracture at the extremity, pelvis or acetabulum from May 2019 to July 2019. Collected were the data concerning basic features of patients, perioperative ERAS management and surgery, as well as early ambulation on the day of surgery or the first day after surgery. The patients were divided into an early ambulation group and a non-early ambulation group according to the time of ambulation. Statistical analyses were performed of the relationships between early ambulation and 20 potential factors concerning basic features of patients, perioperative ERAS management and surgery. Logistic correlation analysis was performed to identify risk factors for postoperative early ambulation.Results:A total of 306 patients were included, including 96 upper limb, 203 lower limb, 5 acetabular and 2 pelvic fractures. Of them, 150 ambulaed from bed on the day of surgery or the first day after surgery while 156 did not. Significant differences were observed between the 2 groups in fracture site, intake of carbohydrate liquids the night before surgery and the day of surgery, catheter indwelling, intraoperative liquid transfusion volume and postoperative complications ( P < 0.05). Logistic correlation analysis of the relationship between the above factors and postoperative early ambulation found that fracture site and intraoperative liquid transfusion volume were significantly correlated with postoperative early ambulation ( P < 0.05). Conclusions:About half of the patients with a single fresh fracture may ambulate early after surgery. Fracture site and intraoperative liquid transfusion volume may be significantly correlated with postoperative early ambulation.