Objective:To evaluate effect of simvastatin on neurons autophagy in the hippocampus following intracerebral hemorrhage( ICH) in rats.Methods:All rats were divided randomly into sham group;ICH group and SIM group.The rat model of ICH was made by injection of Ⅶ type collagenase.The behavioral changes were evaluated with Garcia′s neurologic deficit score.Wet-dry weight method was used to evaluate brain edema.Additionally,localization of LC3 protein was determined by immunohistochemistry, and the expression of Beclin-1 in hippocampus was tested by Western blot methods.Results: Compared with ICH group,simvastatin treatment after ICH significantly improved neurologic deficit score ( P<0.05 ) , reduced the water content of brain tissue ( P<0.05 ) , inhibited the expression of LC3 and Beclin-1 protein(P<0.05).Conclusion:Our findings indicated that administration of simvastatin had neuroprotective effects in ICH rat model,which could be involved in inhibiting activation of autophagy in the hippocampus,finally reducing brain edema and neurobehavioral deficit.

AIM: To investigate peripapillary vessel density(VD)in primary open angle glaucoma(POAG)eyes and to compare them with normal control eyes, and to evaluate the diagnostic ability of peripapillary VD in POAG.

METHODS: Sixty consecutive POAG patients from March 2018 to December 2018 were enrolled in this study. Sixty age- and sex-matched healthy volunteer were also enrolled as a control group. Using RTVue-100 optical coherence tomography(OCT), the peripapillary VD of POAG eyes and normal control eyes were measured and compared. To assess the diagnostic ability of peripapillary VD in POAG, receiver operating characteristic curves(ROC)and areas under the ROC(AUC)were used.

RESULTS: The POAG eyes had a smaller peripapillary VD than the control eyes overall(P<0.001). The mean superior and inferior peripapillary VD of the POAG patients were 52.38%±5.31% and 52.58%±5.32%, respectively. The mean superior and inferior peripapillary VD in control eyes were 58.43%±4.11% and 58.36%±3.40%, respectively. Compared to the normal control subjects, the POAG eyes had a smaller superior and inferior peripapillary VD with a significant difference(P<0.001). Multivariable linear regression analysis showed that cup/disc ratio and the peripapillary VD were significantly thinner in association with the POAG diagnosis. The ROC and AUC analyses showed that the AUC value of peripapillary VD is 0.808(95% CI:0.730-0.887)with a good diagnostic value.

CONCLUSION:The peripapillary VD in POAG eyes was smaller than that of normal control eyes. Decreased peripapillary VD might therefore be associated with POAG. The peripapillary VD had a good diagnostic value.

The dried powder of cultural mycelium of ordyceps sinensis was extractedwith 1.25 mol ? L-1sodium hydroxide and precipitated with ethanol to afford the CsOH, in 2.58% yield. CsOH was consisted of 5 monosaccharide measured by paper chromatogra-phy (PPC) and gas- liquid chromatography (GLC). CsOH given intragastrically at the dose of 500 mg?kg-1and 250 mg?kg-1,ip at a dose of 100 mg?kg-1and 50 mg?kg-1had significant hypoglycemic activities in normal mice, alloxan-induced diabetes mice and streptozotocin-induced diabetes mice, and showed a dose-effect relation.

Objective To investigate the association between rs7744 polymorphism in the 3'?untranslated region(3'?UTR)of myeloid differen?tiation factor 88(MyD88)gene and the risk and severity of coronary artery disease(CAD)in a North Chinese Han population. Methods The CAD and control groups consisted of 540 patients and 270 subjects,respectively. The genotypes of rs7744 were detected by polymerase chain reac?tion?restriction fragment length polymorphism(PCR?RFLP),and clinical data were collected. Results The distributions of MyD88 rs7744 were in HWE(P>0.1). In the<50?year?old age group,a lower risk of CAD was observed for subjects carrying the variant AG genotype in comparison to subjects carrying the wild AA genotype(OR=0.38,95%CI:0.17-0.93,P=0.029). The MyD88 rs7744 polymorphism was also related to the modified Gensini score(P=0.011),which was lower in subjects carrying the variant GG genotype than the wild AA genotype(5.23±3.85 vs 7.49± 4.96). Conclusion Our results revealed that MyD88 rs7744 polymorphism in the 3'?UTR is correlated with the risk and severity of CAD.

OBJECTIVETo establish the differential templates of the skeletal profiles for Shanghainese with normal occlusion in early permanent dentition.

METHODS71 lateral cephalometric radiographs of subjects with normal occlusion in early permanent dentition, aged from 11 - 15 years (37 females and 34 males) were traced. 23 skeletal landmarks were identified on the tracings, which afterwards were scanned on the computer. An x-y coordinate system was established: the tracing superimposed on sella rotated 7 degrees down from the sella-nasion line as the x axis and the vertical line through sella perpendicular to the x axis as the y axis. A special length/depth ratio was designed. The length/depth ratio of each graph were calculated. Steiner analysis was applied to check the difference between genders.

RESULTSThere was no difference between genders. The tracings were divided into three categories: short face, normal face and long face according to the mean and standard deviation of the ratio. The three types of tracings were superimposed on the x axis with sella registered. Three templates were created.

CONCLUSIONSThe differences were apparent when the three templates were superimposed.

Adolescent ; Cephalometry ; methods ; Child ; Dental Occlusion ; Face ; anatomy & histology ; Facial Bones ; anatomy & histology ; Female ; Humans ; Male

Objective:To study the role of neutrophil density and molecular mechanism in neutrophils-mediated inflammatory response induced by monosodium urate (MSU) crystals.Methods:Polymorphonuclear neutrophils (PMNs) isolated from healthy human peripheral blood were treated with MSU crystals at different density (5×10 6/ml, 20×10 6/ml, 100×10 6/ml) in vitro. The mean fluorescence intensity (MFI) of PMNs and production of reactive oxygen species (ROS) were detected by flow cytometry. The distribution of MSU crystals was observed by polarized light microscopy. The neutrophil extracellular traps (NETs) formation was detected by immune fluorescence. The cytokines in cell supernatant were measured by beads assay including interleukin 1β (IL-1β) , tumor necrosis factor α (TNFα) , interleukin 8 (IL-8) , interferon inducible protein 10 (IP-10) , macrophage inflammatory protein 1 (MIP-1) , monokine induced by interferon-γ (MIG) , macrophage inflammatory protein 1α (MIP-1α) , macrophage inflammatory protein 1β (MIP-1β) . Results:(1) After MSU crystal intervention, the side scatters (SSC) of neutrophils with medium-cell density (20×10 6/ml) and high-cell density (100×10 6/ml) were 128±13 and 93±9 respectively, both significantly lower than 170±19 in low-cell density (5×10 6/ml) group.(2) Similarly, compared with low-cell density group, the MFI (lucifer yellow) of PMNs with high-cell density was 1.8±0.2, also significantly decreased ( P<0.05). When co-treated with oxygenated adenosine triphosphate (oxATP), MFI of PMNs were all enhanced consistently. (3) In MSU crystals stimulated PMNs, after adding 2′,7′-dichlorodihydrofluorescein diacetate, the MFI values were 0.85±0.32, 2.49±0.78, 4.54±1.02 in low cell density groups, medium cell density groups, and high cell density groups respectively, indicating that the generation of ROS was positively correlated with the increase of PMN density ( P<0.05). After the intervention of oxATP, the ROS production was significantly reduced. (4) MSU crystal induced NETs formation, especially at high cell density. NETs formation promotes MSU crystal aggregation, which could be partially overcome by oxATP pretreatment. (5) The expression of cytokines were all significantly decreased in the supernatant of PMNs at high cell density exposed to MSU crystals compared with PMNs at medium cell density ( P<0.05) . Conclusion:The PMN-mediated inflammation induced by MSU crystals is cell density dependent, and ATP may play a role in partially overcoming the process.

Objective: To evaluate the clinical efficacy and safety of decitabine in combination with lower-dose CAG regimen (G-CSF, cytarabine and aclarubicin; D-CAG regimen) in the treatment of myelodysplastic syndromes with excess blasts (MDS-EB) and acute myeloid leukemia with myelodysplasia-related changes (AML-MRC), compared to standard CAG regimen. Methods: A total of 42 patients with newly diagnosed MDS-EB and AML-MRC from May 2011 to March 2017 were included in the retrospective study. 21 cases were initially treated with G-CSF for priming, in combination with cytarabine of 10 mg/m² q12h for 14 days and aclarubicin of 20 mg/d for 4 days (CAG regimen) and the other 21 cases were initially treated with decitabine of 20 mg/m² for 5 days and lower-dose CAG regimen (cytarabine of 10 mg/m² q12h for 7 days, aclarubicin of 10 mg/d for 4 days, and G-CSF for priming (D-CAG regimen). After two cycles of induction chemotherapy, the patients who obtained complete remission(CR) received consolidation chemotherapy or hematopoietic stem cell transplantation (HSCT). Results: Among a total of 42 patients, the median age was 52.5 years (18-65 years) and 64.3% of them were male. Baseline characteristics of patients between D-CAG group and CAG group showed no significant differences. The CR for patients in D-CAG group was 81.0% (17/21), compared to 52.4% (11/21) in CAG group after 2 cycles of therapy (χ²=3.857, P=0.050). The overall response rate (ORR) for patients in D-CAG group and CAG group was 85.7% (18/21) and 76.2% (15/21) respectively, without significant difference (χ²=1.273, P=0.259). By December 2017, the median follow-up of D-CAG group and CAG group was 13(6-32) months and 15(2-36) months respectively. Finally, 10 patients in D-CAG group and 7 patients in CAG group received HSCT respectively. Except patients receiving HSCT, the median leukemia-free survival (LFS) time for patients in D-CAG group and CAG group was 18.0 (95%CI 6.6-29.4) months and 11.0 (95%CI 0-23.9) months respectively. Probabilities of 12 months LFS for D-CAG group and CAG group were (63.6±14.5)% and (50.0±13.4)% respectively, without difference (χ²=0.049, P=0.824). Except patients receiving HSCT, there were 2 deaths in D-CAG group and 7 deaths in CAG group respectively. The cumulative probabilities of 12 months OS for non-HSCT patients in D-CAG group and CAG group were (90.9±8.7)% and (61.5±13.5)% respectively, without significant difference (χ²=1.840, P=0.175). The incidences of side effects between D-CAG group and CAG group did not show significant differences (P=0.479), and the main side effects included cytopenias, pneumonia, infections of skin and soft tissues, neutropenic patients with fever, liver dysfunction. Conclusion The decitabine in combination with lower-dose CAG regimen improved CR for patients with MDS-EB and AML-MRC, and was a promising choice.

Objective:To summarize our experience in prevention of COVID-19 infection in emergency and confined operations during the first 3 weeks after Spring Festival in 2020.Methods:From February 3rd to 23rd, 2020, 151 patients were admitted to Department of Orthopaedic Trauma, Beijing Jishuitan Hospital for emergency and confined operations. In this cohort, 125 patients were admitted to ordinary wards. They were 70 males and 55 females with an age of 51.1 years ± 14.9 years. Of them, 2 were subjected to emergency operation and 123 to confined operation. The mean time from injury to operation was 9.9 days ± 6.1 days. There were 26 cases in the senile wards, 7 males and 19 females with an age of 80.8 years ± 7.0 years all of whom underwent confined operations. The mean time from injury to operation was 8.4 days ± 6.3 days. The protocols for emergency diagnosis, admission, emergency and confined operations, postoperative rehabilitation and management of suspects with COVID-19 during the epidemic of COVID-19 were optimized according to Diagnosis and Treatment Protocols for Novel Coronavirus Pneumonia (Trial version 5), emergency responding pre-plans of our hospital, and our experience in Enhanced Recovery After Surgery (ERAS) as well.Results:The patients in the ordinary wards had a hospital stay of 6.8 days ± 4.6 days while those in the senile wards 5.1 days ± 2.0 days. Abnormal temperature (≥37.3 ℃) was observed perioperatively in 17 cases in the ordinary wards. It was absorption fever in all and appeared in 4 cases upon admission. Fever appeared in 11 patients in the senile wards and upon admission in 3 of them. One senile patient who had been diagnosed of normal pneumonia returned to normal temperature and remained stable conditions after antibiotic therapy. The other patients were free of complications related to COVID-19 during their hospital stay.Conclusion:The first-line medical staff working at emergency department, wards and surgical theaters must heighten their vigilance against COVID-19 infection and rigorously follow protocols for prevention of COVID-19 infection in their daily clinical practice.

Objective: To compare the therapeutic effects between the anesthetic and non-anesthetic closed reduction protocols for distal radius fractures based on the concept of Enhanced Recovery After Surgery (ERAS). Methods: A prospective study was conducted in a cohort of 186 patients with distal radius fracture who had been admitted to the Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from September 2018 to January 2019. The patients were divided into 2 groups depending on the choice by themselves. Of them, 72 (intervention group) underwent the standardized closed reduction under brachial block anesthesia based on the concept of ERAS while the other 114 (control group) conventional closed reduction under no anesthesia. The 2 groups were compared in terms of emergency reduction times, swelling scores, reoperation rate, splint removal time, functional outcomes by the Patient-Rated Wrist Evaluation (PRWE) and radiographic outcomes by the Lidström criteria. Results: The patients in both groups were followed up for 6 months. The reduction times were fewer in the intervention group than in the control group (1.1±0.1 versus 1.6±0.1, P<0.05). The reoperation rate was significautly lower in the intervention group than in the control group [2.8%(2/72) versus 12.3%(14/114), P< 0.05]. Reduction deteriorated the swelling condition. Compared with the control group, the swelling was significantly less in the intervention group (2.0±0.1 versus 2.6±0.1, P<0.05). The splint removal time for the intervention group (5.3±0.2 weeks) was significantly shorter than that for the control group (6.9±0.2 weeks) (P<0.05). The intervention group had significantly better PWRE scores than the control group (23.4±1.0 versus 30.3±1.1, P<0.05), but there was no significant difference between groups in the Lidström evaluation (P>0.05). Conclusion Compared with conventional closed reduction, the closed reduction under anesthesia based on the ERAS concept is an effective method for the emergency treatment of distal radius fracture, because it may minimize the patients’ pain experience, increase the rate of successful reduction, decrease the rate of reoperation, shorten the splint fixation time and gain better functional outcomes.

Objective:To explore the short-term efficacy of fixation with a 3D printed individualized custom-made plate in the treatment of elderly patients with periprosthetic femoral fracture.Methods:Retrospectively analyzed were the 5 elderly patients with periprosthetic femoral fracture who had been treated by fixation with a 3D printed individualized custom-made plate from January 2022 to July 2022 at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital. There were 3 males and 2 females, aged 81, 86, 77, 91 and 87 years, respectively. One left and 4 right limbs were affected. Vancouver classification: type B1 ( n=3), type B2 ( n=1), and type C ( n=1). The time from operation to injury was 5, 6, 10, 5 and 7 days, respectively. Preoperatively, the femur affected, prosthesis and individualized plate with a greater trochanteric hook, loop cable channel and bone-like trabecular microporous structure were custom-made by 3D printing according to 1:1 models. Virtual operations were simulated to formulate surgical protocols. The operation time, length of surgical incision, intraoperative blood loss and transfusion, hospital stay, hip function and complications at the last follow-up were recorded. Results:The 5 patients were followed up for 12, 7, 10, 3 and 6 months, respectively. There were no events of superficial incision or deep prosthesis infection. Respectively, the operation time was 1.8, 1.7, 2.3, 2.0 and 3.3 h; the length of surgical incision 31, 30, 38, 27 and 30 cm; the intraoperative bleeding volume 400, 300, 300, 500 and 600 mL; the length of hospital stay 8, 9, 15, 14 and 11 d. Four patients received intraoperative blood transfusion of 300, 900, 150 and 1, 050 mL, respectively. One patient died of a heart attack 3 months after discharge; another patient developed dyskinesia at the contralateral limb 3 months after discharge due to cerebral infarction and died of recurrent cerebral infarction 7 months after discharge. At the last follow-up, the Harris hip scores of 3 patients were 86, 77 and 69 points, respectively. None of the patients had complications like breakage or loosening of implants.Conclusion:In the treatment of elderly patients with periprosthetic femoral fracture, fixation with a 3D printed individualized custom-made plate may lead to fine limb function and good short-term curative efficacy.