OBJECTIVE:To observe the clinical efficacy and safety of lactulose combined with Bacillus subtilis bifarous via-ble bacteria in the treatment of functional constipation(FC). METHODS:In a randomized double blind controlled study,60 FC pa-tients were randomly assigned into treatment group(28 cases)and control group(32 cases). Both groups received lactulose orally. Treatment group additionally receive B. subtilis bifarous viable bacteria,and control group additionally received placebo continually. 2 weeks later,both groups stopped taking lactulose but continued to take adjunctive drug till 4th week. The defecate frequencies, stool property,constipation symptoms,quality of life and ADR were compared between 2 groups before treatrnent and 2nd,4th week cofter treatment. RESULTS:In the second week ,the defecate frequencies,stool property and constipation symptoms of both groups were significantly improved,with statistical significance (P<0.05). Compared with the control group in the fourth week, these constipation symptoms of treatment group were improved more significantly,with statistical significance (P<0.05). In the fourth week,aspects of quality of life in both groups were significantly improved,with statistical significance(P<0.05);physical discomfort scores,satisfaction scores and total scores of treatment group were improved significantly,compared with the control group,there was statistical significance (P<0.05). There were no severe ADR in both groups. CONCLUSIONS:Lactulose com-bined with B. subtilis bifarous viable bacteria can effectively relieve FC,improve abdominal symptoms and slow the recurrence of constipation,which is safe and reliable.

Objective To know the understanding of acupuncture and moxibustion and learning interest of students in western medical colleges and universities;To analyze the feasibility and possibility of establishing acupuncture and moxibustion course in western medical colleges and universities. Methods A survey was made among 535 medical students in five majors from grade one to grade three in Medical School in Nanchang University:clinical specialty, anesthesiology, medical imaging, prophylactic medicine and nursing. Data were statistically analyzed by analysis of variance and Kruskal-Wallis test. Results Among all the students, 46.2%of them did not know anything about acupuncture and moxibustion, but 97% of them were interested in learning it. 76.8% students wished to learn the acupuncture theories based on modern science and clinical research. In addition, 79.3%students chose elective course as teaching form. Compared with the freshmen and junior students, sophomores were more interested in accepting acupuncture and moxibution course, with statistical significance (P<0.05). There was no statistical significance in different medical majors (P >0.05). Conclusion Students of western medical colleges and universities are interested in learning acupuncture and moxibustion. The feasibility and possibility of establishing acupuncture and moxibustion course in western medical colleges and universities are affirmed.

Objective:To evaluate modified extended trochanteric osteotomy (ETO) applied in the revision of Vancouver B2/B3 periprosthetic femoral fractures (PFF).Methods:A retrospective study was conducted to analyze the 35 patients with Vancouver B2/B3 PFF who had been treated at Joint Disease Department Ⅱ, Zhengzhou Orthopedic Hospital from January 2012 to November 2020. There were 10 males and 15 females with an age of (74.3±7.8) years. The time from their primary replacement to revision was (120.3±28.6) months. By the Vancouver classification, 26 cases were type B2 and 9 ones type B3. The modified ETO was used in the revision surgery for all patients. The clinical efficacy was evaluated using Harris hip score, imaging evaluation was performed using the Beals and Tower criteria at the last follow-up, and complications were recorded.Results:The operation time for this cohort was (148±32) min and intraoperative bleeding (800±150) mL. All patients were followed up for (45.2±15.3) months. The Harris score increased significantly from preoperative (21.3±11.2) points to (86.2±5.2) points at the last follow-up ( P < 0.001). By the Beals and Tower evaluation, 9 cases were rated as excellent, 24 cases as good, and 2 as poor. All the fractures and sites of trochanteric osteotomy got healed after (4.4±2.8) months except for 1 case of nonunion. Prosthesis subsidence occurred in 3 cases, in 2 of which the subsidence stopped 6 months later and in only 1 of which revision was needed due to the subsidence. Upward block displacement of the greater trochanteric fracture occurred in 2 cases, but did not exceed 1 cm. One case of postoperative dislocation responded to manual reduction. Conclusion:In the revision of Vancouver B2/B3 PFF, the modified ETO can improve fracture healing, and reduce postoperative dislocations and complications, leading to satisfactory clinical efficacy.

Objective Hypothermic machine perfusion may improve the outcome after transplantation of kidney donated after citizen's death (DCD),but few powered prospective studies have been reported,especially in China.The aim is to compare hypothermic machine perfusion (HMP) with simple cold storage (SCS) in Chinese DCD kidney transplantation,which can offer an optimal method for graft storage with better graft function and survival.Methods 54 kidney pairs from DCD donors were included in this controlled trial in one single center from December 2015 to March 2017.Every two kidneys from each DCD donor wavs randomly assigned to HMP and SCS group.One-year recipient and graft survival rate and endpoints containing the incidence of DGF,the duration of DGF,creatinine reduction ratio (CRR),estimated glomerular filtration rate (Egfr),primary non-function (PNF),acute rejection (AR),toxicity of the immunosuppressive drugs,nosocomial infections and the length of hospital stay were compared between HMP and SCS group.Results One-year recipient survival rate was 98.15 ％ and 96.23％ after DCD transplant in HMP and SCS group,and one-year graft survival rate was 90.74％ and 88.68％,respectively.DGF incidence was 9.62％ in total DCD kidney transplant,8.00％ in HMP group and 11.11％ in SCS group,which was no difference in two groups.22 DCD was from expanded criteria donor (ECD) donation,DGF happened in 15.91％ ECD kidney transplant.However,HMP reduced the incidence of DGF from 27.27％ to 4.55％ after ECD kidney transplant,which was significantly different (x2 =4.247,P =0.039).HMP group acquired significantly lower creatinine level (130.95 ± 46.60) μmol/L than SCS group (181.64 ± 72.94) μmol/L on day 14 after ECD transplant (t =-2.686,P =0.011).Conclusion There was a higher recipient and graft survival rate after DCD and ECD kidney transplant,which would be an effective method to expand donor pool for kidney transplant.HMP was not associated with lower DGF rate in DCD kidney transplant and more rapid recovery in early graft function.However,HMP preservation not only made renal function recover more rapidly but reduced the risk of DGF after ECD kidney transplant.

Objective To study the effect of high mobility group box B1(HMGB1)gene knockout on alleviating a-cute lung injury and inhibiting toll-like receptor 4(TLR4)/nuclear factor-KB(NF-κB)pathway of sepsis mice.Methods Wild-type(WT)mice were divided into WT-Sham group and WT-model group,and HMGB1 knockout(KO)mice were divided into KO-sham group and KO-model group.Sepsis ALI model was established by cecal ligation and perforation in WT-model group and KO-model group.Sham operation was performed in WT-Sham group and KO-Sham group.24 h after modeling,the partial pressure of arterial oxygen(PaO2)was detected,oxy-genation index(OI)was calculated,pathological changes of lung tissue were detected and lung injury score was calculated,the concentrations of tumor necrosis factor-α(TNF-α),interleukin-1 β(IL-1 β),interleukin-6(IL-6),reactive oxygen species(ROS),malondialdehyde(MDA),superoxide dismutase(SOD),in serum and lung tissues and the expression of HMGB1,TLR4 and nuclear NF-κB in lung tissues were detected.Results The PaO2,OI and the concentration of SOD in serum and lung tissue of WT-model group were lower than those of WT-Sham group,the lung injury scores,the concentrations of TNF-α,IL-1 β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of HMGB1,TLR4 and nuclear NF-κB in lung tissue were higher than those in WT-Sham group(P＜0.05).HMGB1 was not expressed in lung tissue of KO-model group,and the concentrations of PaO2,OI and the concentration of SOD in serum and lung tissue of KO-model group were higher than those of WT-model group,the lung injury scores,the concentrations of TNF-α,IL-1β,IL-6,ROS and MDA in serum and lung tissue,and the expression levels of TLR4 and nuclear NF-κB in lung tissue were lower than those of the WT-model group(P＜0.05).Conclusion HMGB1 gene knockout alleviates acute lung injury of sepsis mice,the re-lated molecular mechanism may be the inhibition of TLR4/NF-κB pathway mediated inflammation and oxidative stress.

Cationic liposomes,as non-viral vectors,are widely used in gene therapy and gene silencing.Although numerous cationic liposomes have various structures,they can all improve the per-formance of gene delivery.As gene therapy is increasingly studied,it may be foreseen that new cationic lipoplexes will be explored.In this review,we aim to discuss four constituent domains of cationic lipids(headgroup,hydrophobic domain,linker and helper lipids)in gene delivery.This article attempts to demonstrate that various lipid structures show different transfection efficiency and cytotoxicity by sum-marizing the similarities and differences between the four parts of cationic lipids.Furthermore,their major influencing factors are covered.Finally,three clinical cases of ionizable lipids are described to reveal their characteristics and differences from cationic lipids.This paper is intended to provide a conceptual framework for the design of cationic liposomes and for the selection of cationic lipids.

Over the past 30 years,nano-drug delivery systems(NDDS)have become a promising field of drug research.However,a poor knowledge of the in vivo process of NDDS,the limited methods of pharmacokinetic correlation,and the inability to effectively provide strong support for the construction of upstream drug as well as the evaluation of downstream pharmacology and toxicology have become the technical bottleneck for their clinical transformation.Lipid nanodrug(LND)is the most successful NDDS for industrial transformation with great biocompatibility.Taking LND as an example,this paper reviewed the delivery process and influencing factors in vivo,and summarized the regulatory mecha-nism of biological environments on drug release in vivo.Based on advanced spectroscopy and mass spectrometry techniques,the spatial and temporal distribution of the dynamic carrier particle/depolymer-ized molecule ratio and dynamic free/encapsulated drug ratio of LND in biological matrix were ana-lyzed.Finally,the existing problems and future developments in this field were summarized to provide references for the analysis of NDDS in vivo,and stimulate readers'interest in nanomedical research and development.

OBJECTIVETo observe the effects of electroacupuncture (EA) pretreatment at different times for heart arrest induced by bupivacaine poisoning in rats.

METHODSWith a randomized, blind, control study, 24 SD rats were divided into a control group, a EA for 60 min (EA 60) group and a EA for 30 min (EA 30) group, 8 cases in each one. Rats in the EA 60 group and EA 30 groups were treated with EA at bilateral "Neiguan" (PC 6), "Zusanli" (ST 36) and "Fenglong" (ST 40) for 60 min and 30 min respectively. While no treatment was given in the control group. Then rats were monitored by leadⅡelectrocardiograph; catheters were inserted into the femoral vein to open the vein access and into the carotis to monitor the arterial pressure. Three hours after EA, 10 mg/kg bupivacaine was injected through femoral vein. The mean arterial pressure (MAP) and heart rate (HR) were automatically recorded by PowerLab system. The time points when QRS widened by 20 percent and cardiac arrest and the survival rates were observed.

RESULTSAfter the injection of bupivacaine, five rats in the EA 60 group caught cardiac arrest,while all the rats in the other two groups caught it. The survival rates were not statistically significant among the three groups (>0.05). The time of QRS widening by 20 percent in the EA 60 group was (87.4±14.8) s,which was longer than (63.6±14.2) s in the EA 30 group and (51.2±12.4) s in the control group (both<0.05). From injection of bupivacaine to cardiac arrest, the time of (375.3±23.7) s in the EA 60 group and that of (328.3±47.7)s in the EA 30 group were more than (235.5±91.5) s in the control group (both<0.05). After the injection, MAP and HR in the EA 60 group were higher than those in the EA 30 group and control group at most time points (all<0.05).

CONCLUSIONSEA pretreatment apparently decreases the vulnerability of bupivacaine-induced heart arrest, with better protective effect of 60 min pretreatment than that of 30 min.

Objective     To analyze the clinicopathological characteristics of thymoma patients and the influencing factors for prognosis. Methods     Thymoma patients who received treatment in Sichuan Cancer Hospital from March 2015 to March 2021 were collected. Clinical data of the patients were analyzed using Kaplan-Meier and Cox regression analyses. Results     A total of 177 patients were included. There were 89 males and 88 females aged 17-88 (52.3±13.0) years, including 160 surgical patients and 17 non-surgical patients. There were 160 patients survived, 17 died of thymoma, and 5 had recurrence and metastasis. Overall, the 1-year, 3-year and 5-year progression-free survival rates were 94.4%, 88.7%, 88.1%, respectively; the 1-year, 3-year and 5-year overall survival rates were 94.9%, 91.5%, 91.0%, respectively. The Kaplan-Meier analysis showed that World Health Organization classification, clinical symptoms, Masaoka-Koga staging, treatment methods and surgery were statistically associated with progression-free survival; clinical symptoms, age, treatment methods and surgery were statistically associated with overall survival (P<0.05). Patients with younger age (P=0.018), without clinical symptoms (P=0.039), and with surgical treatment (P=0.004) had higher overall survival rates; those patients undergoing surgery had a higher progression-free survival rate (P=0.002). Conclusion     Age, clinical symptoms and surgical treatment are independent factors influencing the prognosis of patients with thymoma.