BACKGROUND: Skin closure with surgical staplers has been widely used in total knee arthroplasty. In recent years, a new kind of skin closure tape has also achieved good results in total knee arthroplasty. There is no clear report on which method of skin closure is better. OBJECTIVE: To statistically analyzed the effect of two skin closure techniques in total knee arthroplasty. METHODS: The two researchers independently searched the relevant literature in PubMed, Cochrane library, EMBASE, Chinese Biomedicine Database, China National Knowledge Infrastructure, Wanfang Data and the VIP Chinese Sci-tech Journal Database. The retrieval time was from inception to April 2019. The literature was screened and finally included in the study. RESULTS AND CONCLUSION: A total of four studies were included, both of which were the literature in English. (1) In terms of the primary index, the re-admission rate of skin closure tape (RR=0.68, 95%C/:0.49-0.95, P=0.03) could be reduced compared with the staple. However, there was no significant difference in the incidence of complications between the two (RR=0.85, 95%C/:0.27-2.64, P=0.77). (2) In the aspect of secondary indexes, skin closure tape could relieve pain, save time and cost, and have good cosmetic effect though there was no significant difference in the removal time of closed materials between the two. (3) Results indicated that according to the existing literature, compared with surgical staples, skin closure tape is a less painful skin closure method with fewer complications in total knee arthroplasty. Because of the limited sample size, more studies and longer follow-up time are needed to confirm this conclusion.

Objective: To optimize the extraction process parameters of seven herbs in Xiaoruzeng Capsules (XC). Methods: The content of paeoniflorin, ferulic acid, hesperidin, imperatorin and ligustilide was determined by HPLC. The extraction rate of five kinds of index components, the dry extract yield of extracted herbs and the fingerprint similarity of extracts were comprehensively evaluated. The orthogonal experiment was carried out to investigate the effects of ethanol concentration, extraction solvent, extraction time and extraction times on the extraction process. The information entropy weighting method was used to determine the objective weight of each index, and the extraction process parameters of seven herbs in XC were optimized. Results: According to the comprehensive scoring results, it was determined that the best extraction process of the preparation was to add six times the amount of 50% ethanol, and decocted two times for 2 h each time. The average score of the three batches of verification scores was 99.72, and the RSD was 0.24%. Conclusion: The preferred process has high extraction rate, with good stability and repeatability, which is suitable for mass production of the preparation.

Objective: To investigate the immunological mechanism of cannabinoid receptor CB2 in ulcerative colitis (UC) by regulating macrophage polarization so as to provide new ideas for the development of new drugs and treatment of the disease. Methods: Human UC specimens were immunohistochemically stained with macrophage mark CD68. Male ICR mice were made into ulcerative colitis model by dextran sulfate sodium DSS. After treatment with CB2 receptor agonist JWH133, the weight of the mice and the inflammatory activity indexes (DAI) (diarrhea and bloody stool) of UC were recorded, and the intestinal tissues were collected. The degree of inflammation and polarity of macrophages of intestinal tract were analyzed with HE staining and Real-time PCR. Peripheral blood-derived macrophages (PBMs) were cultured in vitro and induced into M1 and M2 macrophages by LPS and IL-4, respectively. After intervention with JWH133, the polarity of macrophages was measured by Real-time PCR. Results: There were a large number of macrophages in the colonic tissues of UC patients. JWH133 transformed the polarity of macrophages from M1 to M2 in UC mice, improved the weight loss and DAI of mice, and significantly decreased the degree of intestinal inflammation. In vitro, JWH133 decreased the level of M1-PBM markers (TNF-α, IL-1β and IL-12) and elevated Arg1, Mrc2 and Mgl1 of M2-PBM. Conclusion :CB2 receptor can improve UC by regulating macrophage transformation to M2 type.

Objective: To observe the action characteristics of ferulic acid and isoferulic acid on cytochrome P450 isoenzymes1A1 and 3A4 (CYP1A1, CYP3A4) in HepG2 cells. Methods: MTT colorimetry was used to investigate the effects of ferulic acid and isoferulic acid at different concentration on the proliferation of in vitro cultured HepG2 cells. Flow cytometry was used to determine the effects of ferulic acid and isoferulic acid on cell cycle of human liver HepG2 cells; The expression of CYP1A1 and CYP3A4 mRNA was tested by real time quantitative PCR technology after drug treatment and then CYP3A4 protein expression was detected by protein immunoblot method (Western blotting). Results: HepG2 cells were inhibited by ferulic acid and isoferulic acid after 48 h action, with a clear dose-response relationship; Two drugs (50 μg/mL) blocked HepG2 cell cycle in G2-M phase; All of the concentration (100, 50, and 25 μg/mL) of the two drugs were CYP1A1 and CYP3A4 mRNA inhibitors; After cells were disposed by the two kinds of drugs (50 μg/mL) with 48 h, protein expression was significantly lower than that in the control group; And compared with the control group, the expression amounts of ferulic acid and isoferulic acid were 0.57 and 0.39. Conclusion: The proliferation of HepG2 cells is inhibited by the two drugs, and the cell cycle was arrested at G2/M phase, which that may be one of its mechanisms, so as to inhibit the mRNA expression of CYP1A1 and CYP3A4. At the same time, both of them could inhibit the protein expression of CYP3A4, as well as the effect degree of difference is bigger, which may be associated with its hydroxyl and the methoxyl isomerisation.

AIM: To investigate the effects of manganese superoxide dismutase mimic (MnSODm) on 2, 4, 6-trinitrobenzene sulfonic acid (TNBS) induced ulcerative colitis (UC) in rats and to probe into its underlying mechanism. METHODS: Wistar rats were randomly divided into blank group, model group, sulfasalazine (SASP, 500 mg/kg) group, and different doses of MnSODm (10, 20 and 40 mg/kg) groups. Ulcerative colitis was induced in rats by rectal administration of 100 mg/kg TNBS dissolved in 50% ethanol. Rats were killed after SASP and different doses of MnSODm treatment 7 days. The disease activity index (DAI) was recorded, and then the colonic injury and inflammation were assessed by the colon weight/length ratio and microscopic damage scores. The serum and colon tissues activities myeloperoxidase (MPO) were detected by biochemistry method. The activities of glutathione peroxidase (GSH-Px), inducible nitric oxide synthase (iNOS), and the levels of glutathione (GSH) and NO in colon tissues were also detected. The levels of TNF-α, IL-4 and IL-10 in the colon tissues were measure by ELISA. Western blot was undertaken to determine the phosphorylation levels of AKT and PI3K. RESULTS: Compared with the model group, the colonic weight/length ratios, microscopic damage scores and colon tissues and serum MPO activity were significantly decreased in MnSODm groups (P<0.05 or P<0.01). INOS, NO, TNF-α, PI3K, p-AKT levels in colon tissues were also significantly decreased in MnSODm treatment groups; while the activity of GSH-Px and the concentration of GSH, IL-4 and IL-10 obviously increased (P<0.05, P<0.01). CONCLUSION: MnSODm is protective against colitis via antioxidant activity and by inhibiting inflammatory mediators and then down-regulating PI3K/AKT signaling pathways.

BACKGROUND: The separation injury of pubic symphysis is most commonly associated with severe pelvic fracture injuries. Because the anatomical position of the pubic symphysis is deep, and the curative effect is often unsatisfactory. Anatomical and biomechanical studies are necessary to better guide clinical diagnosis and treatment. OBJECTIVE: To summarize and analyze the anatomical characteristics and biomechanical research status of pubic symphysis, and to provide some benefits for the clinical treatment of pubic symphysis separation. METHODS: The authors retrieved CNKI, VIP, and PubMed with the key words of “separation of pubic symphysis” and “biomechanics” for articles published from April 1984 to February 2020. Relevant literature was selected by title and abstract, and the titles and abstracts of the references were read. The related literatures were selected again and the duplicate literatures were eliminated. RESULTS AND CONCLUSION: There were 57 eligible literatures, and 33 were finally included. (1) The present anatomical study mainly focuses on the structure of pubic symphysis and its adjacent ligaments. (2) Because of the position of pubic symphysis, no further study was carried out. The precise distribution of the starting and ending points of the peripheral ligaments and muscles, and the precise nerve and blood distribution need further study. (3) There have been relatively few studies of pubic symphysis biomechanics, and they vary widely. It needs to be deeply studied and agreed upon. (4) With the development of finite element, the biomechanics focus on the treatment of pubic symphysis. (5) Due to good mechanical stability, the reconstructed plate and the hollow screw are used as common fixation for pubic symphysis separation. However, percutaneous hollow screw fixation has become the trend in the future because of its minimal invasion.

Objective: To evaluate the application value of fluorine-18-fludeoxyglucose (18F-FDG) PET/CT maximal standard uptake (SUVmax) in the diagnosis of lymphoma. Methods: A total of 103 patients with lymphoma which confirmed by pathological diagnosis in Gansu Provincial Hospital from January 2011 to December 2016 were collected. All patients underwent a whole body simultaneous18F-FDG PET/CT and had complete clinical data. The possible relationships of SUVmax with the different pathological subtypes, clinical stages and risk grades of lymphoma were analyzed. The correlations of SUVmax value with Ki-67 index, lactate dehydrogenase (LDH) and erythrocyte sedimentation rate (ESR) were analyzed. Results: There was no significant difference in SUVmax between Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) (P > 0.05). The SUVmax in patients with strongly invasive diffuse large B-cell lymphoma (DLBCL), T-lymphoblastic lymphoma (T-LBL), anaplastic large cell lymphoma (ALCL) and natural killer (NK)/T cell lymphoma was higher than that in patients with relatively weakly invasive mantle cell lymphoma (MCL), peripheral T-cell lymphoma (PTCL), small lymphocytic lymphoma (SLL), follicular lymphoma (FL) (grade 1-2) and marginal zone lymphoma (MZL) (P < 0.05). The SUVmax in the patients with DLBCL was higher than that in the patients with MCL, PTCL, SLL, FL and MZL, respectively (all P < 0.05). The SUVmax in the patients with ALCL was higher than that in the patients with FL (P < 0.05). The differences of SUVmax among other subtypes were not statistically significant (P > 0.05). The SUVmax had no significant difference between stage -Ⅱ and III- in the patients with lymphoma (P > 0.05). The SUVmax in the patients with high-risk NHL was higher than that in the patients with intermediate- and low-risk NHL (both P < 0.01). For 103 patients with lymphoma, the SUVmax obviously had a positive correlation with Ki-67 index (r = 0.67, P < 0.001). There was no significant difference in SUVmax between the ESR increasing group and the normal group as well as between the LDH increasing group and the normal group (both P > 0.05). Conclusion:18F-FDG PET/CT SUVmax can be used as a reference indicator for evaluating the invasive degree of lymphoma, predicting Ki-67 index, and judging the risk classification of NHL.

Objective: To explore the correlation of hippocampal MRS metabolites and neurocognitive function in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: Single voxel proton MRS was performed on 31 patients with OSAHS (OSAHS group) and 28 healthy volunteers (control group).NAA, Cho and Cr peak in bilateral hippocampus were detected, and NAA/Cr, Cho/Cr and NAA/Cho were calculated. Montreal cognitive assessment scale (MoCA) and simple intelligent state scale (MMSE) were used to assess cognitive function, then to analyze the correlation of NAA/Cr, Cho/Cr, NAA/Cho and MoCA, MMSE scores in bilateral hippocampus. Results: Cho/Cr in bilateral hippocampus were higher in OSAHS group than in control group, while NAA/Cho in OSAHS group were lower than in control group (all P<0.05). There was no significant difference of NAA/Cr between OSAHS group and control group in bilateral hippocampus (all P>0.05). Cho/Cr in bilateral hippocampus of OSAHS patients were negatively correlated with MoCA and MMSE scores (all P<0.05), while NAA/Cho were positively correlated with MMSE scores (all P<0.05). Conclusion: MRS metabolites of bilateral hippocampus in OSAHS patients are correlated with cognitive function, which can be used as neuroimaging markers for cognitive impairment in OSAHS patients.

OBJECTIVE To investigate the efficacy and safety of hetrombopag combined with low-dose prednison in the treatment of patients with refractory/recurrent primary immune thrombocytopenia(ITP). METHODS A total of 40 patients with ITP who failed to respond to previous treatment or relapsed in the Department of Hematology of Gansu Provincial People’s Hospital From July 2021 to August 2022 were selected. Used randomized controlled trial research methods, according to the treatment plan, they were divided into observation group and control group, with 20 cases in each group. The control group was treated with low-dose prednison alone. The observation group was combined with hetrombopag treatment on this basis. The efficacy and adverse reactions were compared between the two groups. RESULTS Treatment 6 weeks, patients who's proportion of platelet counts(PLT) reached≥50×109·L−1 and ≥30×109·L−1 in observation group were higher than control group with statistically significant differences in both groups[90%(18/20) vs 50%(10/20), P＝0.006; 90%(18/20) vs 65%(13/20), P＝0.130]; The study also indicated a statistically significant difference in favour of observation group compared with control group in the odds of achieving the outcome of a PLT≥50×109·L−1at least once during 6-week treatment[90%(18/20) vs 55%(11/20), P＝0.147], was more than placebo-treated one. The median time of PLT ≥ 50×109·L−1 for the first time within 6 weeks of treatment in the observation group was 3 weeks, which was the same as that in the control group. After 6 weeks of treatment, the median platelet count in the observation group was higher than that in the control group[97.50(58.25−166.75)×109·L−1 vs 45.50(13.25−82.50)×109·L−1 , P<0.05]. The median PLT count in the observation group was higher than that in the control group at week 1−6 after treatment, and the curative effect was significant. The two groups of patients tolerated the regimen well, and the degree of adverse reactions was mild, which improved quickly after symptomatic treatment. CONCLUSION Hetrombopag combined with low-dose prednison has a high effective rate in the treatment of refractory/recurrent ITP, which is better than that of single use, and the adverse reactions are tolerable, so it can be widely used in clinical practice.

Child ; Humans ; Tuberculosis, Spinal/diagnosis* ; Spondylitis/diagnosis* ; Thoracic Vertebrae ; Suppuration/diagnosis* ; Diagnostic Errors