Purpose　The aim is to investigate the rectal suppository of low molecular weight heparin（LMWH）.Methods　The suppository was prepared by way of heating and fusion，the drug release property was studied with the release test in vitro and the absorption of LMWH into blood was tested by the changes of rabbits blood coagulation time. Results　The drug release property in vitro followed Fick′s diffusion equation and LMWH could enter the blood through rectal medication. Conclusion　The absorption from the rectum was another route of LMWH into the blood.

To explore the rules of medication for diabetes and diabetic complications based on analysis on 755 traditional Chinese medicine (TCM) prescriptions. The information in 755 papers published from 1995 to 2016 was got including 755 herbal prescriptions, 367 herbs, 33 330 effective cases. Based on the above information, usage frequency of single herb, efficiency and the rules of formulating prescription for different types of diabetes were analyzed and compared using Microsoft Excel 2010 and Clementine 12.0 software. In the treatment of diabetes and its complications, the top four diabetes symptoms are about diabetes, diabetic neurological complications, diabetic nephropathy and diabetic cardiovascular complications, and accounting for 31.62%, 29.82%, 8.87%, and 6.47% of the total number of effective cases. Further analysis of the top four illnesses found that single herb commonly used in the treatment of diabetes was Astragali Radix, Dioscoreae Rhizoma, Rehmanniae Radix, Trichosanthis Radix, Ophiopogonis Radix, etc. The commonly used drugs categories were tonic herbs, heat-clearing herbs and blood activating herbs; The single medicine commonly used in the treatment of diabetic neurological complications was Astragali Radix, Angelicae Sinensis Radix, Chuanxiong Rhizoma, Radix Salviae Miltiorrhizae et Rhizoma, Cinnamomi Ramulus, etc. The commonly used drugs categories were tonic herbs, blood activating herbs and heat-clearing herbs; The single herb commonly used in the treatment of diabetic nephropathy was Astragali Radix, Dioscoreae Rhizoma, Salviae Miltiorrhizae Radix, Poria, Fructus Corni, etc., the commonly used drugs categories were tonic herbs, blood activating herbs and damp-clearing herbs. The single herb commonly used in the treatment of diabetic cardiovascular complications was Astragali Radix, Salviae Miltiorrhizae Radix, Angelicae Sinensis Radix, Carthami Flos, Chuanxiong Rhizoma, etc., the commonly used drugs categories were blood activating herbs, tonic herbs and heat-clearing herbs. The rules of medication of TCM for diabetes, diabetic neurological complications, diabetic nephropathy and diabetic cardiovascular complications showed similar characteristics, tonic herbs were used the most frequently, supplemented by blood activating herbs, heat-clearing herbs and damp-clearing herbs. However, the principle of formula is a little different for different types of diabetes and diabetic complications, specifically. The prescriptions for diabetes and diabetic neurological complications consist of tonic herbs as the principal, supplemented by blood activating herbs and heat-clearing herbs; The prescriptions for diabetic nephropathy are composed of tonic herbs as the principal, supplemented by blood activating herbs and damp-clearing herbs, as well as tonic herbs and blood activating herbs were equal components in the prescriptions for diabetic cardiovascular complications, supplemented by heat-clearing herbs.

Chronic obstructive pulmonary disease (COPD) is a prevalent chronic inflammatory disease of the lung in the worldwide. With the deeper development of the study, people gradually realized that COPD also with the characteristics of autoimmune diseases. However, the initiation mechanism of acquired immunity in COPD is still unclear. Chronic neutrophilic inflammation of the airways is a distinct feature of COPD. The latest research shows that neutrophils can form a reticular substance composed of DNA in the infected state-NETs, which can not only give full play to the anti infection effect, but also cause tissue damage. In some autoimmune diseases, it can even initiate the acquired immune responses. This paper will briefly review the recent advances of NETs in the pathogenesis of COPD and its potential role as an anti-inflammatory target for COPD, so as to provide new ideas for the anti-inflammatory treatment of COPD in the future.

Objective To assess the value of endorectal elastography in the diagnosis of malignant rectal adenoma. Methods Sixty patients referred to the department of basic surgery of Peking Union Medical College Hospital for the evaluation of rectal adenoma from January 2011 to May 2013 were included in this prospective cohort. All patients underwent elasticity score (ES) and strain ratio(SR) examine before operation. To evaluate the reproducibility of the strain-ratio measurements, the intraclass correlation coefficient (ICC) was calculated. Compared with final operational pathological results,the diagnostic values of elasticity score and strain ratio method were assessed. Results Histopathological result showed there were 20 adenomas and 40 adenocarcinomas. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ERUS was 68%(27/40), 40%(8/20), 58%(35/60), 69%(27/39), 38%(8/21), respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of elasticity score was 85%(34/40), 70%(14/20), 80%(48/60), 85%(34/40), 70%(14/20), respectively. The SR of adenocarcinomas was significantly higher than that of adenomas(2.82±1.81 vs 1.23±0.57, t=3.333, P < 0.05). The differences among the SR of benign adenoma, benign adenoma with severe atypical hyperplasia and completely malignant lesions were statistically significant (1.26±0.84 vs 2.94±1.95, 1.42±0.55 vs 2.94±1.95, t=2.619, 2.415, P=0.013, 0.021). When 1.240 was chosen as the best cut-off value of SR, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of strain ratio was 82%(33/40), 75%(15/20), 80%(48/60), 87%(33/38), 68%(15/22), respectively. Conclusion Endorectal elasotgraphy can accurately diagnose the malignant rectal adenoma, which can provide reliable preoperative imaging evidence for clinical operation mode.

BACKGROUND: With the aging of the society, the number of patients with osteoporotic vertebral fracture is increasing, mainly manifesting compression fracture of thoracolumbar body, which seriously affects the daily life of the elderly. Therefore, to study the relationship between the degree of external force and the performance of osteoporotic thoracolumbar body fracture on MRI STIR is to provide a better basis for clinical diagnosis and treatment. OBJECTIVE: To explore the relationship between the size of external force and a linear black signal area of STIR image in MRI of thoracic and lumbar osteoporosis vertebral compression fractures. METHODS: The hospitalized patients, who were diagnosed as thoracic and lumbar osteoporosis vertebral compression fractures, were retrospectively analyzed from September 2013 to September 2016 at the Department of Spine Surgery of The First Affiliated Hospital of Guangxi University of Chinese Medicine. All cases in the three groups were diagnosed as osteoporosis by quantitative CT (bone mineral density ≤80 mg/cm3). All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. The patients were divided into three groups according to the different trauma history: Non-obvious external force group (without apparent cause or external force), low energy group (sprains, bent down to lift heavy objects, and carrying heavy items), high energy group (flat road down hips touchdown, falls, and bruise). Gender, age, fracture site (thoracic lumbar segment and non-thoracic lumbar segment), the number of the vertebrae and the position where would they occur with a linear black signal area of STIR image in MRI were analyzed in each group. Age was analyzed by analysis of variance. Gender, fracture site and the number of the vertebrae and the position were analyzed by Pearson chi-square test. RESULTS AND CONCLUSION: (1) All the 782 cases were included in the three groups. There were 334 in the non-obvious external force group, which a linear black signal area of STIR image in MRI existed in 114 cases. There were 186 cases in low energy group, which a linear black signal area of STIR image in MRI existed in 124 cases. There were 262 cases in high energy group, which a linear black signal area of STIR image in MRI existed in 87 cases. (2) The age, gender, fracture site and the number of the vertebrae and the position in three groups were not statistically significantly different among the three groups (P > 0.05). (3) There were significant differences in a linear black signal area of STIR image in MRI among the three groups (P < 0.05) (α’=0.05/3=0.017). Significant differences were found as compared the low energy group with non-obvious external force group and high energy group (P < 0.017). No significant difference was determined between non-obvious external force group and high energy group (P > 0.017). (4) The occurrence rate of linear black signal area of STIR image in MRI was 66.7% and higher than other groups (43.1% and 33.2%). (5) In the history of trauma, low energy in external force has more opportunity to cause a linear black signal area of STIR image in MRI than non-obvious external force and high energy; and they often occur in thoracic and lumbar osteoporosis vertebrae.

OBJECTIVE: It remains disputed whether percutaneous curved vertebroplasty and unilateral pedicle approach percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fracture. This study systematically analyzed the efficacy and safety of percutaneous curved vertebroplasty and unilateral pedicle approach percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fracture. METHODS: A computer-based online search of Wanfang, VIP, CNKI, PubMed, EMBASE, The Cochrane library, and CBM was performed to retrieve randomized controlled trial studies regarding percutaneous curved vertebroplasty and unilateral pedicle approach percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fracture published before January 2020. Related papers were manually searched. After two evaluators independently selected literature, data were extracted and the quality of methodology included in the study was evaluated. Meta-analysis was carried out by using Stata/SE 12.0 software. RESULTS: (1) A total of eight randomized controlled trials were conducted, including 628 patients, of whom 394 were treated with percutaneous curved vertebroplasty and 404 with unilateral pedicle approach percutaneous vertebroplasty. (2) The meta-analysis results showed that visual analogue scale score [MD=-0.20, 95%CI(-0.28,-0.12), P < 0.05], the leakage rate of bone cement [RR=0.30, 95%CI(0.15, 0.58), P < 0.05], and the total distribution rate of bone cement in the center of vertebral body [RR=1.27, 95%CI(1.12, 1.45), P < 0.05] were better in the percutaneous curved vertebroplasty group than those in the unilateral pedicle approach percutaneous vertebroplasty group. (3) There was no significant difference in Oswestry disability index score [MD=-4.83, 95%CI (-9.71, 0.05), P=0.052], operation time [MD=-1.45, 95%CI(-5.91, 2.82), P=0.488]and X-ray exposure times [MD=-0.70, 95%CI(-2.11, 0.71), P=0.33] between the two methods. CONCLUSION: Percutaneous curved vertebroplasty exhibits significant advantages in analgesic effect, low leakage rate of bone cement and the high total distribution rate of bone cement in the center over unilateral pedicle approach percutaneous vertebroplasty. Therefore, a large number of high-quality multicenter randomized controlled trials are needed to provide more evidence.

Background Exposure to heavy metals has potential adverse impacts on human health, and the concentration of heavy metals in abandoned mining areas may still be higher than that in general areas, so the health risk assessment in such areas cannot be ignored. Objective To explore the health risk of heavy metal exposure and the spatial distribution characteristics of associated main metals in a typical abandoned mining area. Methods Environmental samples of irrigated soil, rice, and drinking water were collected from 13 natural villages under the jurisdiction of a township in Liuzhou, Guangxi from November to December 2019, where a typical abandoned mining was located. Finally, 13 irrigation soil samples, 11 rice samples, and 13 drinking water samples were collected. The concentrations of six metals and metalloid elements in each environmental sample were detected by inductively coupled-plasma mass spectrometry (ICP-MS), including cadmium (Cd), arsenic (As), lead (Pb), chromium (Cr), copper (Cu), and zinc (Zn). At the same time, 251 local residents were recruited for health risk assessment. Model parameters such as body weight, rice intake, and drinking water intake of local residents were obtained through field survey, and the median metal concentration of each environmental sample was taken as the risk assessment parameter of the region. The health risk of heavy metal exposure of local residents was assessed by using oral health risk assessment model of U.S. Environmental Protection Agency. The spatial distribution characteristics of health risks associated with heavy metals were evaluated by empirical Bayes interpolation method using Geographic Information System (GIS) technology. Results The positive rates of Cd, As, Pb, Cr, Cu, and Zn in the irrigated soil samples were 100.00%. The positive rate of Pb was 63.64% in the rice samples, while the rates of other metals were 100.00%. The positive rates of Cd, As, Pb, Cr, Cu, and Zn in the drinking water samples were 53.85%, 76.92%, 92.31%, 15.38%, 84.62%, and 100.00%, respectively. The results of non-carcinogenic risk assessment of oral exposure to heavy metals suggested that the contribution of heavy metals causing non-carcinogenic risk from high to low was As (70.52%) > Cd (18.03%) > Zn (6.63%) > Cu (4.12%) > Pb (0.64%) > Cr (0.06%), and the corresponding estimated non-carcinogenic risk values were 3.54 × 10⁰, 9.05 × 10⁻¹, 3.33 × 10⁻¹, 2.07 × 10⁻¹, 3.23 × 10⁻², and 5.42 × 10⁻⁴, respectively. The results of carcinogenic risk assessment of oral exposure to heavy metals suggested that the contribution of studied metals from high to low was Cd (87.00%) > As (10.24%) > Cr (2.60%) > Pb (0.16%), and the estimated carcinogenic risks were 4.35× 10⁻³, 5.12 × 10⁻⁴, 1.30 × 10⁻⁴, and 3.08 × 10⁻⁷, respectively. Rice was the leading media associated with non-carcinogenic risk and carcinogenic risk (99.4% and 99.8% respectively). The spatial distribution characteristics of GIS showed no obvious regularity in the distribution of As in irrigated soil, rice, and drinking water. In rice and irrigated soil, the content of Cd in the villages adjacent to the mining area was obviously higher than that in the other villages, while in drinking water, the content in the villages far away from the mining area was higher. Conclusion As and Cd are the main heavy metals that increase the health risk of local residents in a typical abandoned mining area, and the distribution characteristics of the two heavy metals in different environmental media are not completely consistent.

OBJECTIVE: To observe the effect of flurbiprofen( FPA) combined with dexamethasone on preemptive analgesia for whole lung lavage in pneumoconiosis patients. METHODS: Ninety pneumoconiosis patients who underwent whole lung lavage under general analgesia were divided into three groups by random number table method: combine treatment group,FPA group and control group,30 cases in each group. Patients in combine treatment group were given 2 mg/kg body weight( bw) of flurbiprofen axetil injection and 10 mg of dexamethasone through intravenous injection before 2 hours of surgery. Patients in FPA group were given 2 mg/kg bw of FPA axetil injection intravenously. The control group was injected with 2 m L 0. 9% sodium chloride solution. Visual Analogue Scale( VAS) score,Bruggramann Comfort Scale( BCS) score,and adverse reaction of the three groups were recorded in 2,6,8,12 and 24 hours after operation. RESULTS: The postoperative VAS and BCS scores of combine treatment group at the 5 time points after operation were lower than that of control group and FPA group respectively( P < 0. 01). The VAS score between the 5 time points presented an decreasing tendency with the increase of time in the combine treatment group( P < 0. 05),and the BCS score presented an increasing tendency with the increase of time( P < 0. 05). The adverse reaction,such as nausea,vomiting dizziness and drowsiness,sore throat and skin itching in combine treatment group was lower than that of control group and FPA group 24 hours postoperatively( P < 0. 017). CONCLUSION: The therapy of FPA combined with dexamethasone on preemptive analgesia is a safe and effective method for reducing postoperative pain of whole lung lavage in pneumoconiosis patients.

Atherosclerosis is a chronic inflammatory disease commonly seen in clinical practice. It can lead to thickening of vascular intima, occlusion of lumen stenosis and thrombosis, leading to angina pectoris, hypertension, myocardial infarction and other diseases, posing a serious threat to human life and health. This study provides a method for removing shield needles from graphene oxide thrombus and its preparation. The graphene oxide shield needle mainly includes flexible rotating shaft, radial flexible rod, rotating needle, adsorption main pipe and dosing main pipe, laser measuring device, high definition camera and other structures, which has the following advantages:firstly, it achieves multi-angle rotation grinding thrombosis, precise rotation grinding, avoids vascular damage and infection; secondly, thrombolytic drugs can be applied in the process of rotary grinding and small thrombus can be adsorbed to effectively avoid secondary embolization of blood vessels; thirdly, it a coating of graphene oxide on a rotating needle, which protects against bacteria and infection. This study has practical reference value for the development of thrombotherapy and the application of graphene in the medical field.
Adsorption ; Graphite ; Humans ; Needles ; Thrombosis/prevention & control*

Aim To study the protective effect of Qingjie HuaGong decoction ( QJHGD) for severe acute pancreatitis ( SAP ) model rats induced by cerulein based on TLR4/NF-kB/MYD88 pathway.Methods The effective component groups and potential targets of QJHGD were collected by network pharmacology method , and we constructed the component-target network.The GO and KEGG of important targets were enriched and analyzed by metascape database, and we selected the targeted pathways related with SAP inflammation mechanism.The rat model of severe acute pancreatitis was established by cerulein combined with lipopolysac- charide, followed by QJHGD gavage.Pancreatic tissues were observed by hematoxylin and eosin staining.We verified the therapeutic effect of QJHGD on SAP rats and the regulatory effect on TLR4/NF-kB/MyD88 target pathway, by Enzyme linked immunosorbent and immunohistochemistry methods.Results A total of 105 active components and 148 key targets for SAP were screened; KEGG was enriched 320 different channels including toll like receptor and NF-kB classical pathways.Animal experiments showed that QJHGD harl protective changes in pancreatic pathological tissues, which was observed by HE staining; QJHGD reduced amylase, lipase, 1L-6 and TNF-a in SAP rat serum, inhibiting the positive expression of key proteins on TLR4/N F- kB/MyD88 inflammatory transduction j j pathways.Conclusion The mechanisms of QJHGD protecting pancreatic injury of SAP rat may be related to reducing the expression of key proteins on TLR4/ NF-kB/MvD88 pathway.