OBJECTIVETo compare the effect,safety,and advantage of flexible fixation with paperboard and pad versus short leg plaster in treating the fifth metatarsal base fracture,and establish the standard of diagnosis and treatment of the fifth metatarsal base fractures in flexible fixation with paperboard and pad.

METHODSFrom June 2010 to March 2013,59 patients with the fifth metatarsal base fracture were treated with paperboard and pad fixation or short leg plaster. Patients were enrolled and divided into paperboard and pad treatment group (paperboard group) and short leg plaster treatment group (plaster group) randomly according to the random number table. In paperboard group,there were 29 cases including 9 males and 20 females with an average age of (51.79±11.40) years old; the average course of injury was (11.59±6.58) hours. In plaster group, there were 30 cases including 9 males and 21 females with an average age of (52.13+17.34) years old ;the average course of injury was (11.03±7.06) hours. According to whether the fracture line across the articular surface, in paperboard group there were 14 cases of type A,15 of type B; in plaster group,16 of type A, 14 of type B. According to the degree of dislocation,in paperboard group there were 16 cases of degree I ,13 of degree II ; in plaster group,20 were degree I ,10 were degree II. Fracture was restored according to the type in manual. Patients in paperboard group were treated with paperboard and pad, and patients in plaster group were treated with short leg plaster. Fracture was fixed for 4 to 6 weeks according to fracture healing. On the 2nd, 4th,6th, 8th week and 3rd, 6th month after fixation, patients were followed up, and the foot function score was used to evaluate the function of injured foot. X-ray of injured foot was taken on the 2nd, 4th, 6th and 8th week were used to assess fracture healing.

RESULTSAll patients got complete follow-up. The X-ray result showed that all fracture reached at clinical healing on the 8th week after fixation without skin ulcer,nonunion and displacement of fracture. From the 4th to 8th week after fixation, paperboard group had a higher X-ray score than plaster group, but the difference between two groups had no statistically significance. Repeated analysis result showed that there was interact at different time point and between groups,the difference had statistically significance (P<0.01). The foot function score showed that at all time point, paperboard group had a higher score than plaster group, and on the 2nd, 4th, and 6th week, it had statistically significant difference(P<0.01) between two groups. On the 6th months after fixation,the excellent and good rate of paperboard group was 93.10%, higher than that of plaster group, which was 86.67%. But it had no statistically difference(P=0.483) between two groups.

CONCLUSIONUsing paperboard and pad fixation to treat the fifth metatarsal base fracture has the advantage of simplicity operating,reliable fixation, satisfactory effects, easily obtainable material.

Adult ; Aged ; Casts, Surgical ; Female ; Foot Injuries ; physiopathology ; surgery ; Fracture Fixation ; instrumentation ; methods ; Fracture Healing ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Metatarsal Bones ; injuries ; physiopathology ; surgery ; Middle Aged

OBJECTIVETo observe the changes of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor subunit and related regulatory protein mRNA expression in the hippocampus and amygdala in immobilization stressed rats and effect of Xiaoyaosan (XYS) on them.

METHODSImmobilization model rats were established by binding for 3 h per day and intervened with XYS, the expression of AMPA receptor subunit (GluR1-4), N-ethylmaleimide sensitive factor (NSF) and protein interacting with C-kinase 1 (PICK1) mRNA expression in model rats' CA1 and CA3 regions of hippocampus, dentate gyrus and amygdala were detected on day 7 and day 21 after modeling.

RESULTSOn day 7, expression of GluR1 mRNA was significantly decreased in CA1 region (P < 0.05) and increased in CA3 region and amygdala (all P < 0.05); expression of GluR2 and GluR3 mRNA in amygdala (all P < 0.05) and GluR4 mRNA in CA1 region (P < 0.01) significantly increased, but the expression of NSF and PICK1 mRNA in amygdala only showed an increasing trend. XYS showed effective regulation on GluR4 mRNA in CA1 region (P < 0.01) and GluR1-3 mRNA expression (P < 0.05, P < 0.01) in amygdala. On day 21, the expression of GluR4 mRNA in CA1 region (P < 0.05) and GluR2 mRNA in dentate gyrus (P < 0.05) markedly lowered and expression of GluR1 mRNA in amygdala increased (P < 0.01); XYS significantly regulated the expression of GluR1 and GluR4 mRNA in CA1 region (all P < 0.05).

CONCLUSIONRepeated stress in a short time shows effect on expression of AMPA receptor subunit mRNA stronger than chronic stress. The regulation of XYS to AMPA receptor subunit mRNA expression were obvious in hippocampal CA1 region and amygdala.

Amygdala ; drug effects ; metabolism ; Animals ; Carrier Proteins ; genetics ; Drugs, Chinese Herbal ; pharmacology ; Gene Expression ; drug effects ; Hippocampus ; drug effects ; metabolism ; Male ; N-Ethylmaleimide-Sensitive Proteins ; genetics ; Nuclear Proteins ; genetics ; Protein Subunits ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, AMPA ; genetics ; Restraint, Physical ; Reverse Transcriptase Polymerase Chain Reaction ; Stress, Psychological ; physiopathology

KRAS is one of the most frequently mutated human oncogenes. In spite of mounting efforts on the development of direct or indirect inhibition targeting KRAS, little has been achieved because of insurmountable difficulties, titling KRAS "undruggable". Recently, subtype-specific inhibitors have shown great hope. Some KRAS^G12C inhibitors have entered clinical trials, including adagrasib and sotorasib, and have shown preliminary clinical effectiveness. Experiences from the inhibitors targeting the downstream factors of RAS pathways show that the anticancer activity of these drugs will be limited due to the development of drug resistance. Preclinical studies of KRAS^G12C inhibitors have revealed that the application of these agents might be hampered by the drug resistance issue. The current review aims to describe the current status of KRAS^G12C inhibitors, and discuss the mechanisms underlying KRAS^G12C inhibitor resistance, so as to provide the clues for the combat of drug resistance.

Zanthoxyli Radix is a traditional Chinese medicine. It can be used for the treatment of wind-cold-dampness arthralgia, muscle and bone pain, fall fracture, hernia, sore throat, toothache and other diseases. Due to possessing many excellent and mild pharmacological properties, there are lots of reports about Zanthoxyli Radix worldwide. At present, more than 100 bioactive components have been extracted and purified from Zanthoxyli Radix. Nitidine chloride (NC), one of the most important alkaloids in Zanthoxyli Radix, has the activities of anti-tumor, anti-inflammation, anti-bacteria, etc. In this review, we summarize the chemical components of Zanthoxyli Radix, pharmacological activity and mechanism of action of NC to provide references for further research and utilization of Zanthoxyli Radix.

AIMTo observe protein expression changes of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor and related regulatory protein in the hippocampus and amygdala in chronic immobilization stressed rat and Xiaoyaosan's regulatory effect.

METHODSRats were tied 3 h per day to establish immobilization stress condition and treatment with Xiaoyaosan. After 7 days and 21 days stress, the protein expression of AMPA receptor subunit (GluR2/3), N-ethylmaleimide sensitive factor (NSF) and protein interacting with C-kinase 1 (PICK1) in hippocampus and amygdala were detected by using Western blot techniques.

RESULTSThe expression of GluR2/3, NSF in dentate gyrus (DG) and amygdala were markedly attenuated (P < 0.05) and PICK1 in CA1 region were significantly increased (P < 0.05) in 7 d immobilization stressed rats while 7 days xiaoyaosan treatment showed an effective regulatory result to PICK1's changes. Under 21 days immobilization stressed condition, the expression of GluR2/3, NSF in CA1 region showed an increasing trend, and GluR2/3 showed a markedly increase (P < 0.01), but showed an significantly decreased trend in amygdala, Xiaoyaosan showed an effective result to such changes above (P < 0.05). The expression of PICK1 showed increasing trend in amygdala and xiaoyaosan could lower its expression (P < 0.05).

CONCLUSIONThere are different trends of the expression of AMPA receptor in repeat short-term stress versus chronic immobilization stress, and in hippocampal CA1 region versus amygdala. Xiaoyaosan has better regulation effect on the expression of AMPA receptors in the condition of chronic immobilization stress than those of repeat shortterm stress.

Amygdala ; metabolism ; Animals ; CA1 Region, Hippocampal ; metabolism ; Carrier Proteins ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Male ; N-Ethylmaleimide-Sensitive Proteins ; metabolism ; Nuclear Proteins ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptors, AMPA ; metabolism ; Restraint, Physical ; Stress, Psychological

Adult ; Aged ; Hemospermia ; diagnostic imaging ; therapy ; Humans ; Male ; Middle Aged ; Punctures ; Rectum ; diagnostic imaging ; Seminal Vesicles ; Therapeutic Irrigation ; Ultrasonography

BACKGROUNDBecause of the pivotal role of the human leukocyte antigen (HLA) class II molecules in regulating the immune response and their extensive polymorphism, it is not surprising that particular HLA class II alleles have been implicated in susceptibility to allergic diseases and in restriction of the IgE responses to a variety of allergens. We investigated the relationship between HLA-DRB genotype and allergies to various penicillins and explored HLA-DRB restriction of IgE responses to these derivatives of penicillin.

METHODSRadioallergosorbent test was used to examine 8 kinds of specific IgE antibodies (4 major and 4 minor antigenic determinants) in the sera of 248 patients with an allergy to penicillins and 101 healthy subjects without any allergic reaction. Some (113 patients and 87 healthy control subjects) were chosen from all subjects to type for HLA-DRB alleles by sequence specific primer-polymerase chain reaction.

RESULTSCompared with control subjects, a significantly increased frequency of DR9 was present in 77 patients with allergic reactions, with immediate hypersensitive reaction and with urticaria (P = 0.011; P = 0.019; P = 0.005 respectively). Conversely, a significantly decreased frequency of DR14.1 was found in 80 patients with positive IgE antibodies, with immediate reaction and with urticaria compared with control group (P = 0.024; P = 0.038; P = 0.038). A possible excess of HLA-DR17 was found in subjects who were responsive to benzylpenicilloyl compared with those were not (chi(2) = 5.134, P = 0.023), and of HLA-DR4 was found in subjects responsive to phenoxomethylpenicillanyl (PVA, chi(2) = 4.057, P = 0.044).

CONCLUSIONHLA-DRB gene may be involved in allergy to penicillins through modulating specific serum IgE to penicillins.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Alleles ; Child ; Child, Preschool ; Drug Hypersensitivity ; genetics ; immunology ; Female ; Genotype ; HLA-DR Antigens ; genetics ; Humans ; Immunoglobulin E ; blood ; Male ; Middle Aged ; Penicillins ; adverse effects ; immunology

This study was amid to construct the pharmacophore model of L-type calcium channel antagonist in the application of screening Drugbank and TCMD. This paper repositions the approved drugs resulting from virtual screening and discusses the relocation-based drug discovery methods, screening antihypertensive drugs with L-type calcium channel function from TCMD. Qualitative hypotheses wre generated by HipHop separately on the basis of 12 compounds with antagonistic action on L-type calcium channel expressed in rabbit cardiac muscle. Datebase searching method was used to evaluate the generated hypotheses. The optimum hypothesis was used to search Drugbank and TCMD. This paper repositions the approved drugs and evaluates the antihypertensive effect of the chemical constituent of traditional Chinese medicine resulting from virtual screening by the matching score and literature. The results showed that optimum qualitative hypothesis is with six features, which were two hydrogen-bond acceptors, four hydrophobic groups, and the CAI value of 2.78. Screening Drugbank achieves 93 approved drugs. Screening TCMD achieves 285 chemical constituents of traditional Chinese medicine. It was concluded that the hypothesis is reliable and can be used to screen datebase. The approved drugs resulting from virtual screening, such as pravastatin, are potentially L-type calcium channels inhibitors. The chemical constituents of traditional Chinese medicine, such as Arctigenin III and Arctigenin are potentially antihypertensive drugs. It indicates that Drug Repositioning based on hypothesis is possible.
Animals ; Antihypertensive Agents ; chemistry ; pharmacology ; Calcium Channel Blockers ; chemistry ; pharmacology ; Calcium Channels, L-Type ; genetics ; metabolism ; Drug Repositioning ; methods ; Molecular Structure ; Myocardium ; metabolism ; Rabbits

Objective To investigate the palliative care cognition of medical workers and provide evidence for medical worker' s vocational education and treatment of patients with end-stage.Methods 280medical workers from seven different hospitals in five provinces were surveyed with self-designed questionnaire of their palliative care cognition from January to March 2011.Results 280 questionnaires were handed out and 269 were recovered,with the recovery rate of 96.1％.The palliative care cognition of medical workers was affected by work type,age,working years,and working departments.Doctors and medical workers with age between 36 and 45 years old and working years more than 10 years had higher palliative care cognition,and the scores were respectively (25.81 ± 5.51),(26.88 ± 4.40) and (26.23 ± 4.92).Nurses,medical workers with age under 25 years old,working years less than 5 years and in surgical department had lower palliative care cognition,and the scores were respectively (22.25 ± 6.31),(23.68 ± 6.56),(23.57 ± 5.78),(22.55 ± 6.49).The differences were statistically significant (F =6.989,3.961,5.877,2.677,respectively; P ＜0.01).Conclusions Education of palliative care for medical workers,especially for nurses,is needed to provide high quality medical service for patients.

Objective To investigate the related risk factors of cerebral microbleeds (CMBs) and their relations with leukoaraiosis and lacunar infarction in patients with cerebrovascular disease.Methods One hundred and sixty-four patients with cerebrovascular disease,admitted to our hospital from January 2015 and January 2017 were chosen;susceptibility weighted imaging (SWI) was performed,and the distribution and number of CMBs were recorded by Microbleed Anatomical Rating Scale (MARS).The demographic data,personal history,previous medical history,biochemical indices and imageological examination results of the patients were collected and multivariate Logistic regression analysis was carried out on the basis of these data.Spearman dependence analysis was used to analyze the relations of CMBs with leukoaraiosis and lacunar infarction.Results Age (OR=1.071,P=0.024,95％ CI:1.009-1.137),hypertension (OR=3.875,P=0.012,95％CI:1.347-11.148),leukoaraiosis(OR=2.080,P=0.005,95％ CI:1.245-3.475),lacunar infarction (OR=2.326,P=0.003,95％ CI:1.336-4.050) were independently associated with CMBs.And number of CMBs had positive correlation with severity of leukoaraiosis and number of lacunar cerebral infarcts (r=0.564,P=0.000;r=0.762,P=0.000).Conclusion Age,hypertension,leukoaraiosis,and lacunar infarction are the independent risk factors of CMBs;the severity of CMBs is positively correlated with severity of leukoaraiosis and lacunar infarction.