Objective From the point of view of pharmaceutical economics,to analyze and compare the clinical efficacy,safety,compliance and economic effect of three kinds of scheme:1.moxifloxacin,2.moxifioxacin combined with ambroxol,3.azithromycin combined with levofloxacin in the treatment of acute exacerbation of chronic bronchitis (AECB).Methods Retrieval Chinese joumal full-text database,Wanfang medical database and Chinese science and technology periodical full-text database,included three options for the treatment of AECB randomized controlled trial (RCT) literature,through the analysis of the data to make drug economics evaluation.Results The total effective rates of three programs were 94.92％,95.08％,94.90％,the difference was not statistically significant (P ＞ 0.05).The cost-effectiveness ratios were 213.34,536.40,61.22.Conclusion The efficacy of three treatment options is similar,azithromycin combined with levofloxacin has economic advantages.

AIM To explore the effects and mechanism of cobra venom serum on the proliferation in HL60 cells. METHODS Established the HL60 cells as a target to study the growth feature by the action of cobra venom serum.The agarose gel electrophoresis and flow cytometry analysis were used to demonstrate apoptosis. RESULTS Compared with the control group, the cells were inhibited significantly by the action of cobra venom serum.A characteristic DNA "ladder" was detected by using agarose gel electrophoresis. By flow cytometry analysis,it was proved that most apoptosis of HL60 cells occurred when cultured with cobra venom serum. CONCLUSION Cobra venom serum inhibited the HL60 cells in vitro , which was related to apoptosis. This may introduce a new way to the treatment of leukemia.

Objective To investigate the distribution of in-stent recurrent stenosis (1RS) after balloon-angioplasty and stenting in elderly cerebral ischemic patient and its correlative factors.Methods Totally 158 elderly cerebral ischemic patients with extra-and/or intracranial artery stenosis were treated with 172 stents in our hospital.The inhibition of platelet function was assessed by using the thrombus elasticity chart system in perioperative period,and the anti-platelet agents were adjusted correspondingly.150 patients were followed up by digital subtraction angiography (DSA) and the other 8 patients were followed up by CT angiography,during an average follow-up duration of 8.3 months.Results There were 11 (6.4％) IRS lesions,among which 10 lesions were at the vertebral artery origin and 1 lesion was at common carotid artery bifurcation.23.8％ of IRS happened after vertebral artery origin stenting,and all in-stent recurrent stenosis were in the origin of non-dominant vertebral artery,whose IRS rate was 66.7％.Conclusions IRS are more common found in vertebral artery origin than in other parts of vertebral artery and are more common found in nondominant side than in dominant side.

BACKGROUND:Some studies have focused on bone marrow mesenchymalstem cells (BMSCs) combined with allograft bone or artificial bone substitute materials for bonedefect repair. But there is no report on BMSCs combined with Bio-oss for repair of rabbit skull defects as yet.OBJECTIVE:To observe the effect ofBMSCs combined with Bio-oss in repairing skull defects in rabbits.METHODS:BMSCs from male rabbits were isolated, cultured, and used as seed cells. In the skull of the female rabbits,three full-thickness bone defects with the same external diameter of 6 mm were made by a ring bone drill. Ninety-six female rabbits were randomly divided into four groups, and given Bio-oss/BMSCs in combination group, Bio-oss alone in Bio-oss group, BMSCs implantation in BMSCs group, and no intervention in blank group. All the implant surfaces were covered with guided tissue regeneration membrane.RESULTS AND CONCLUSION:The osteogenic effect in the combination group was better than that in the other three groups, and the Bio-oss group showed better osteogenesis in comparison with BMSCs and blank groups. But there was no significant difference between the BMSCs and blank groups. These findings indicate that the combined use of BMSCs as seed cells and Bio-oss as a scaffold material exerts overt osteogenic effects in rabbit skull defect area, which provides a new idea for the clinical treatment of bone defects.

Objective:To investigate the possible association between Thr241Met polymorphism in the DNA repair gene X-ray repair cross-complementing group 3 (XRCC3) with genetic susceptibility to glioma in a Chinese Han population living in Shanghai and the surrounding provinces in east China. Methods: Genotyping by a TaqMan assay was performed in 771 brain glioma patients living in Shanghai and the surrounding provinces (Jiangsu.Zhejiang, Anhui.etc. )and in 752 control participants matched in age and gender. The genotyping results of TaqMan assay and the association between Thr241Met polymorphism in the DNA repair gene XRCC3 with genetic susceptibility to glioma were statistically analyzed. Results: Genotypes of 1 468 subjects (760 with brain glioma and 708 were cancer-free control) were successfully performed by TaqMan assay, with the successful rate being 96.4%. Statistical analysis result showed that gene(C/T) and genotype(C/CT/CT/T) frequencies of XRCC3 were not significantly different between the glioma and cancer-free groups. Compared with the CC genotype, the variant TC(P = 0. 909; adjusted by age and gender OR = 0. 981; 95%CI = 0. 701-1. 371) or TT(P=0. 642; adjusted by age and gender OR = 0. 7; 95%CI = 0. 156-3. 146) genotypes of XRCC3 Thr241Met were associated with a non-statistically significant increase of glioma risk. Conclusion: The variant TC or TT genotypes of XRCC3 Thr241Met may not be risk factors for brain glioma in Chinese Han population living in Shanghai and the surrounding provinces in east China.

Objective:To observe the effect of combined acupuncture and medication on hyperarousal state and serum copeptin(CPT)in patients with chronic insomnia(CI),and to explore its possible mechanism of action.Methods:A total of 70 CI patients meeting the inclusion criteria were divided into an observation group and a control group by the random number table method,with 35 cases in each group.The control group was given estazolam tablets before bedtime,1 mg/time,once a day.The observation group was treated with additional Yi Nao An Shen acupuncture therapy(acupuncture for benefiting the brain and tranquillization)on the basis of the medication treatment,4 times a week.After 4 weeks of treatment,the Pittsburgh sleep quality index(PSQI)score,insomnia severity index(ISI)score,pre-sleep arousal scale(PSAS)score,hyperarousal scale(HAS)score,and the change in serum CPT level were compared between the two groups.Results:During the study,there were 2 dropout cases in the observation group and 1 dropout case in the control group.After treatment,the PSQI,ISI,PSAS,and HAS scores and the serum CPT level in both groups decreased compared with the same group before treatment,and the intra-group differences were statistically significant(P<0.05).After treatment,changes in each above scale score and the serum CPT level in the observation group were much more significant and were statistically different from those in the control group(P<0.05).Conclusion:Acupuncture plus medication can improve sleep quality,reduce the degree of insomnia,and regulate hyperarousal state in patients with CI,and its mechanism of action may be related to the down-regulation of serum CPT level.

BACKGROUND:Insufficient oral soft tissues in the implant zone may have a negative effect on the wound healing and the aesthetic restoration in the late stage. Platelet-rich fibrin can promote the wound healing of soft tissue defects. But there is stil a lack of in-depth studies on the promotion of oral soft tissue defects in animal experiments.
OBJECTIVE: To compare the repairing effects of platelet-rich fibrin and colagen membrane on soft tissue defects of the hard palate in New Zealand rabbits.
METHODS:Fifty-four New Zealand rabbits were randomly divided into three groups (n=14 per group): platelet-rich fibrin group, colagen membrane group and blank control group. A 5 mm-diameter circular ful-thickness soft tissue defect was made in the front of the hard palate, 2 mm distant to the rear maxilary incisors and mucosal edge of the bilateral hard palates. Autologous platelet-rich fibrin membrane or colagen membrane were implanted into the defect in the platelet-rich fibrin group and colagen membrane group, respectively. No treatment was given in the blank control group. General observation of the wound and wound healing analysis were performed at days 3, 7, 14, 21, 28, 56 post operation. Hematoxylin-eosin staining, CD31 immunohistochemical staining and Masson staining were used to observe inflammatory reaction, angiogenesis and colagen formation in the surgical site.
RESULTS AND CONCLUSION:The wound healing rate was fastest in the platelet-rich fibrin group, and no obvious scar formed. At 3 days post operation, there was no difference in the wound healing rates among the three groups; at 7 days, the wound healing rate in the platelet-rich fibrin group was significantly higher than that in the colagen membrane group and blank control group (P < 0.05). At 3 and 7 days after operation, the inflammatory reaction in the platelet-rich fibrin group was less than that in the colagen membrane and blank control groups (P < 0.05); at 14, 21, 28 and 56 days, there was no significant difference between the three groups. At 7, 14, 21 days after operation, the average absorbance value of CD31 in the platelet-rich fibrin group was significantly higher than that in the colagen membrane and blank control groups (P < 0.05). The average absorbance value of colagen formation in the platelet-rich fibrin group was significantly higher than that in the colagen membrane and blank control groups at 7 days after operation (P < 0.05), significantly higher than that in the blank control group at 14 days (P < 0.05), but lower than that in the colagen membrane and blank control groups at 21, 28 and 56 days after operation (P < 0.05). These findings show that platelet-rich fibrin can reduce inflammatory reactions in the process of wound healing, accelerate the angiogenesis, regulate the metabolism of colagen, reduce the formation of scar and improve the quality of wound healing, thereby promoting the repair of oral soft tissue defects.

Objective To explore the application of 3D-printing rapid prototyping in classification of acetabular fractures and education of young surgeons.Methods The data of 20 patients with acetabular fracture were reviewed in this study who had been treated between January and June 2016.Three junior orthopedic surgeons and 3 senior ones were chosen as observers.The conventional radiographs (X-ray films of the pelvis and acetabulum,CT scans and 3D reconstruction images of the pelvis) and 3D-printing rapid prototyping models of the 20 patients(1∶ 1) were randomly numbered.All the observers were asked to make Letournel-Judet classification of each radiograph and 3D-printing model independently in the first assessment.Four weeks later in the second assessment,all the observers were asked to make the same classifications after all the conventional radiographs and 3D-printing models were randomly numbered again.The kappa statistics was used to evaluate inter-and intra-observer agreements among the recorded results.Results At the first assessment,the inter-observer agreement was 0.887 and 0.962 respectively for conventional radiographs and 3D-printing models in senior surgeons while 0.659 and 0.849 in junior surgeons.The second assessment showed the intra-observer agreement was 0.906 for radiographs and 0.925 for 3D-printing models in senior surgeons while 0.696 and 0.849 in the junior ones.Conclusions Compared with conventional radiographs,since 3D-printing models can effectively enhance the reliability of acetabular fracture classification,they may be more helpful for young surgeons in understanding acetabular fractures.

Objective To explore the predictive significance of platelet changes on deep venous thrombosis of the lower limbs after total knee replacement,and to guide the early clinical prediction and prevent the occurrence of thrombotic events.Methods A retrospective study was conducted of the 50 patients who had been treated by total knee arthroplasty for degenerative knee osteoarthropathy from January 2016 to June 2018 in the Department of Orthopedics and Traumaology,Xi'an Jiangtong University Medical College Red Cross Hospital.There were 10 males and 40 females,aged from 47 to 80 years (average age 65.1 years).According to the results of B ultrasound examination of the lower extremities,the patients were divided into the non embolic group (24 cases) and the embolic group (26 cases).The platelet counts and hemoglobin levels of the two groups were recorded before and after operation,and their respective differences were calculated.The difference of hemoglobin difference between the two groups was analyzed.At the same time,the difference of platelet count and total knee joint were examined.Whether the deep venous thrombosis of the lower extremity after replacement was statistically significant.If there was no statistical difference in the difference in hemoglobin between the two groups,and the difference in platelet count was statistically significant,the ROC curve was made to determine the optimal screening point.If obeying the normal distribution and the homogeneity of the variance,an independent sample t test was performed on the platelet count difference and the hemoglobin amount difference between the two groups,and the dose data in accordance with the normal distribution was expressed as (Mean ±SD).Results The difference of platelet count was (30.4 ± 14.8) ×109/L in thrombosis group and (53.5 ± 15.2) × 109/L in thrombosis group.The difference of platelet count between the two groups had statistical significance (P ＜ 0.001).The best screening point of platelet count difference was 34.0 × 109/L.The difference of hemoglobin count between thrombosis group and thrombosis group was (20.8 ± 9.3) g/L and (24.0 ± 10.7) g/L,there was no significant difference in hemoglobin between the two groups (P ＞ 0.05).Conclusions Preoperative and postoperative platelet count difference can effectively predict the incidence of lower extremity deep venous thrombosis after total knee arthroplasty.When the platelet count difference before surgery ≥34.0 × 109/L,early prevention of deep venous thrombosis should be avoided.The formation of the occurrence.

Objective:To compare the clinical effects robot navigation assisted and conventional proximal femoral nail antirotation (PFNA) implantation and fixation in the treatment of elderly femoral trochanteric fractures.Methods:A total of 86 elderly patients with tuberosity fracture of the femur were admitted as research samples from January to March in 2022 in the Department of Trauma Orthopaedic, Xi′an Honghui Hospital Affiliated to Xi′an Jiaotong University, including 37 males and 49 females, who aged from 63 to 92 years, with an average age of (79.6 ± 6.9) years. All patients were treated with intramedullary nails (PFNA), 32 with dimensity robotic-assisted therapy (robot group) and 54 with traditional methods (conventional group). The length of incision, the number of intraoperative fluoroscopy, the amount of intraoperative blood loss, and the operation time were recorded. The occurrence of postoperative complications in the two groups was observed. The rate of excellent hip Harris score at 3 month after surgery was compared between the two groups. Measurement data with normal distribution were represented as mean ± standard deviation( ± s), and the comparison between groups was conducted using the t-test; the comparison of count data were represented as [ n(%)], and was conducted by Chi-square test or Fisher exact probability between groups. Results:All patients were followed up for 9 to 12 months, with an average of (10.6 ± 0.9) months. The incision length and tip apex distance (TAD) of the robot group were (3.40±0.82) cm and (21.85±1.44) mm, which were smaller than (4.82±0.75) cm and (26.83±1.75) mm in the conventional group ( P<0.05 for all). The number of intraoperative fluoroscopy and guide needle adjustment [(14.53±3.26) and 0 times] in the robot group were less than those in the conventional group [(20.67±4.84) and (2.83±1.42)] ( P<0.05). The intraoperative blood loss and drainage rate of the robot group were (87.03±9.41) and (46.40±8.91) mL, which were smaller than that of the conventional group [(110.00±12.52) and (69.62±10.22) mL] ( P<0.05). There was no significant difference in the number of days of hospitalization and operation time between the two groups ( P>0.05). The postoperative complication rate in the robot group was 9.4%, which was lower than that in conventional group (42.6%), and the difference was statistically significant ( χ2=11.88, P=0.036). The excellent rate of postoperative hip joint function in the robot group was 75.0%, and the conventional group was 66.7%, and there was no significant difference between the two groups ( χ2=0.66, P=0.416). Conclusion:Robot-assisted navigation downward PFNA surgery can have good clinical effect in the treatment of femoral tuberosity fracture in the elderly, which can reduce the number of surgical incisions and intraoperative fluoroscopy, and reduce the incidence of postoperative complications, which is helpful to achieve minimally invasive surgery and rapid recovery of elderly patients with femoral tuberosity fracture.