Objective To establish a mouse model of chronic gratt-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation using chemotherapy preconditioning regimens. Methods The donor mouse was BALB/ cH-2kd and the recipients mouse was C57BL/6H-2kb. The pretreatment of recipient mouse was performed using different doses of chemotherapy drugs, busulfan (BU) 20 mg/(kg • d) ×4 d + cyclophosphamide (CTX) 150 mg/(kg • d) × 2 d, or BU 20 mg/ (kg • d) ×4 d + CTX 100 mg/(kg • d) × 2 d, and then the recipient mouse was injected with different doses of spleen cells (6×107 or 4 × 107 cells) and/or same dose of bone marrow cells (2× 107 cells) to establish the model of chronic GVHD. Hematopoietic chimerism analysis, clinical score and histopathology were used to evaluate the model. Results The high level of recipient-donor mixture chimera was established by pretreated by BU 20 mg/ (kg • d) ×4 d + CTX 150 mg/ (kg • d) × 2d and 2× 107 bone marrow mononuclear cells +6×107 spleen mononuclear cells . The onset of GVHD was concentrated at the 30-90 d after injecting spleen cells of the donor mouse. The clinical scores and incidence rate of chronic GVHD were significantly increased in the large numbers of cells and high doses of chemotherapy transplantation group compared with those in smaller numbers of cells and lower doses of chemotherapy groups (P<0.05). Pathological changes such as cellular and structural abnormalities and inflammatory cell infiltration were noted in the intestines, liver, skin and spleen of the model mice. Conclusion Bone marrow mononuclear cells (2×107 cells) + spleenmononuclear cells (6 × 107 or 4 × 107 cells) can be used to establish a stable chronic GVHD mouse modll via preconditioning with BU and CTX, which paves a way for clinical treatment of chronic GVHD.

Objective To evaluate the efficacy and safety of ustekinumab in the therapy of plaque psoriasis.
Methods Literatures published up to November 2013 were collected from Cochrane library, MEDLINE, and PubMed which were related with ustekinumab for plaque psoriasis. The efficacy was estimated using relative risk of Psoriasis Area and Severity Index (PASI) 75 response rate at the week 12 endpoint in clinical trials, and adverse effects were also analyzed. Meta-analysis was carried out by using Review Manager 5.1.
Results Six randomized control trials consistent with the inclusion criteria were selected and reviewed. Ustekinumab 45 mg group and 90 mg group could get better therapeutic effect compared with the placebo group (all P<0.00001). Furthermore, ustekinumab 90 mg group was more effective than ustekinumab 45 mg group (P=0.01). Adverse effects in the 6 trials were mentioned including headache, upper respiratory tract infection, nasopharyngtis, infection, serious infection, cardiovascular events, and malignant tumors. There were no statistically significant differences of these adverse effects among three groups (all P>0.05), except that infection rate in ustekinumab 45 mg group was higher than the placebo group (P=0.02).
Conclusions Ustekinumab is an effective and safe therapeutic method for plaque psoriasis. However, further longer time analysis of safety is needed.

Objective:To observe the clinical effect of mild moxibustion for knee osteoarthritis (KOA) and to explore the role of mild moxibustion in relieving pain,reducing stiffness and improving joint dysfunction in patients with KOA.Methods:Eighty patients with KOA were randomly allocated into either a moxibustion group or a medication group by the random number table,with 40 cases in each group.The moxibustion group used mild moxibustion at Neixiyan (EX-LE 5),Dubi (ST 35),Xuehai (SP 10) and Liangqiu (ST 34),30 min each time,3 times a week;the medication group was given celecoxib capsule (celebrex),0.2 g each time,once a day.Both groups were treated for 4 weeks.The visual analog scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC)scores were evaluated before and after treatment.The efficacy of the two groups was compared after treatment.Results:After treatment,the overall efficacy of the moxibustion group was significantly different from that of the medication group (P＜0.05).The VAS and WOMAC scores of the two groups were lower than those before treatment (both P＜0.01).The changes in the VAS and WOMAC scores after treatment in the moxibustion group were significantly different from those in the medication group (both P＜0.05).After treatment,in single item of WOMAC,the changes in pain and joint dysfunction in the moxibustion group were more statistically significant than those in the medication group (both P＜0.05).Conclusion:Mild moxibustion and oral celebrex can reduce the VAS and WOMAC scores of patients with KOA.Mild moxibustion is superior to oral celebrex in relieving pain and improving joint function.

Abstract: Objective　To explore the correlation between monocyte to high-density lipoprotein cholesterol ratio (MHR) and insulin resistance (IR) in male patients with type 2 diabetes mellitus (T2DM) combined with metabolic-related fatty liver disease (MAFLD). Methods A total of 454 male patients with T2DM combined with MAFLD in National Metabolic Management Center (MMC) of the Affiliated Hospital of Jiangsu University from May 2018 to July 2020 were enrolled. The general clinical data of subjects were collected, blood routine and biochemical indexes were tested, homeostasis model insulin resistance index (HOMA-IR) was calculated, visceral fat area (VFA) and subcutaneous fat area (SFA) were measured. Accordingtothe MHR quartile, patients were divided into group Q1 (MHR≤0.38), group Q2 (0.380.64) to compare the differences in measured indicators above. In addition, patients were divided into two groups according to HOMA-IR, HOMA-IR<2.5 and HOMA-IR≥2.5, and the differences in MHR were compared. Results The patients were divided into four groups according to MHR:group Q1 (n=115), group Q2 (n=110), group Q3 (n=120) and group Q4 (n=109). Fasting insulin (FINS) were respectively 6.17(4.20,9.76), 7.73(4.94,10.66), 8.92(5.32,11.33) and 9.13(5.25,12.27) mU/L, 2-hour postprandial insulin were 22.75(12.87,39.59), 27.55(16.44,39.77), 30.98(17.46,43.11) and 31.28(18.54,45.92) U/L. HOMA-IR were 3.12(1.63,4.25), 3.72(2.26,4.66), 3.87(2.48,5.44) and 3.95(2.42,5.31). Neutrophil (Neu) were 3.10(2.60,3.70), 3.20(2.50,3.93), 3.60(2.80,4.28), 4.20(3.30,5.00)×109/L. Subcutaneous fat area (SFA) were (181.27±53.60), (192.64±62.41), (199.53±61.40) and (203.69±71.51) cm2. They all increased gradually. However, the levels of high-density lipoprotein cholesterol (HDL-c) [1.18(1.06,1.35), 1.02(0.86,1.17), 0.96(0.80,1.03) and 0.80(0.69,0.92) mmol/L] and low-density lipoprotein cholesterol (LDL-c) [(3.00±0.79), (2.76±0.83), (2.67±0.85) and (2.59±0.92) mmol/L] decreased gradually. Pearson's or Spearman's correlation analysis showed that MHR was positively correlated with FINS, 2-hour postprandial insulin (2hINS), HOMA-IR, VFA and SFA (r=0.190, 0.153, 0.184, 0.114, 0.127, P<0.05). The coronary heart disease history, systolic blood pressure,diastolic blood pressure,fasting plasmaglucose (FPG), FINS, alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood uric acid (Ur), body mass index (BMI), VFA, SFA and MHR of patients in group HOMA-IR≥2.5 were higher than group HOMA-IR<2.5 (P<0.05). Conclusion　MHR is positively correlated with IR in male patients with T2DM combined with MAFLD, and as MHR increases, the degree of IR is higher.

This paper presents and discusses the liquid density sensing potential of a delay line Lamb-wave sensor configuration, where Lamb wave is excited only by interdigital transducer (IDT), without membrane when fabricated. An optimized cut orientation and the normalized thickness of substrate by using genetic algorithm is presented to improve the sensitivity of the sensor and to get low noise. Experimental measurements performed on Lamb-wave device fabricated from Y-Z LiNbO3 in a delay line configuration are found to be in agreement with theoretical calculations.
Algorithms ; Biosensing Techniques ; instrumentation ; methods ; Equipment Design ; Models, Theoretical ; Sensitivity and Specificity ; Transducers ; Ultrasonics ; Water ; analysis ; chemistry

This study was aimed to establish an UFLC fingerprint of Tibetan medicine Pterocephalus hookeir samples from different habitats. UFLC-PDA was adopted to analyse 21 batches of P. hookeir samples from different habitats. The chromatographic condition was as follow: Agilent proshell 120 SB-C18 column (4.6 mm x 100 mm, 2.7 microm) eluted with the mobile phases of acetonitrile and 0.2% phosphoric acid water in gradient mode. The flow rate was 1.0 mL x min(-1), and the detection wavelength was set at 238 nm. The fingerprints of 21 batches P. hookeir were carried out by similarity comparation, and 15 chromatographic peaks were extracted as the common peaks of fingerprint, of which 5 peaks were identified as chlorogenic acid, loganin, sweroside, sylvestroside III, triplostoside A. The similarity degrees of 18 batchs of samples were above 0.9, and the other 3 batchs of samples were below 0.9. This is the first established fingerprint of P. hookeir by using UFLC-PDA. This method has good precision, stability and repeatability that it could provide basis for quality control and evaluation of P. hookeir.
Caprifoliaceae ; chemistry ; China ; Chromatography, High Pressure Liquid ; instrumentation ; methods ; Drugs, Chinese Herbal ; analysis ; Quality Control

OBJECTIVETo explore the therapeutic effect of acupuncture for hypertensive cerebral hemorrhage at the early stage.

METHODSFifty-four cases of small-amount cerebral hemorrhage were randomized into an acupuncture group and a conventional treatment group, 27 cases in each one. In the conventional treatment group, special care, oxygen therapy, nerve nutrition and symptomatic support were applied. In necessary, dehydrant and hypotensive drugs were prescribed for antihypertension, or surgery was given. In the acupuncture group, on the basis of the treatment as the control group, acupuncture was applied at Quchi (LI 11), Neiguan (PC 6), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3). Acupuncture was given at the admission, 4 h, 6 h and 12 h after disease onset respectively. Blood pressure was monitored in the whole procedure. 6 h and 24 h after disease onset, the cranial CT was re-examined. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), hematoma volume and neurological deficit score were compared at different time points between the two groups.

RESULTS(1) Blood pressure: from the admission to 12 h after disease onset, SBP, DBP and MAP were increased apparently in the conventional treatment group and increased slightly in the acupuncture group. The differences in SBP [(164.3 +/- 21.6) mmHg vs (158.6 +/- 21.5) mmHg] and MAP [(113.4 +/- 4.9) mmHg vs (106.7 +/- 6.1) mmHg] were significant between the two groups (both P < 0.05). From 12 h to 24 h after disease onset, compared with the conventional treatment group, SBP and MAP were decreased apparently in the acupuncture group [(147.3 +/- 21.6) mmHg vs (158.4 +/- 23.5) mmHg, (97.2 +/- 5.3) mmHg vs (106.6 +/- 5.1) mmHg, both P < 0.05)]. (2) Hematoma volume: from the admission to 6 h after disease onset, the volume was increased by (4.15 +/- 0.73) mL in the convertional treatment group and (2.67 +/- 0.33) mL in the acupuncture group, indicating the significant difference in comparison (P < 0.05). From the admission to 24 h after disease onset, it was increased by (5.57 +/- 1.26) mL in the convertional treatment group and (3.14 +/- 1.18) mL in the acupuncture group, indicating the significant difference in comparison (P < 0.05). (3) Neurological deficit score: the score was increasing gradually in first 3 days after disease onset in the two groups. The score (38.39 +/- 6.84) in the acupuncture group on the first day was different significantly as compared with that (42.37 +/- 7.46) in the conventional treatment group (P < 0.05). On the 10th days, the score (24.68 +/- 5.42) in the acupuncture group was different significantly from that (29.74 +/- 7.36) in the convertional treatment group (P < 0.05).

CONCLUSIONThere is no peak of blood pressure rising, and the continuous hemorrhagic volume is less in 24 h and neurological deficit score is improved in the acupuncture group. Acupuncture brings the positive significance in the treatment of cerebral hemorrhage at the early stage.

Acupuncture Therapy ; Adult ; Aged ; Blood Pressure ; Cerebral Hemorrhage ; physiopathology ; therapy ; Female ; Hematoma ; physiopathology ; therapy ; Humans ; Male ; Middle Aged

OBJECTIVETo observe the efficacy of He-wei Jie-gu (Chinese characters) decoction on femoral intertrochanteric fractures after internal fixation in elderly.

METHODSFrom January 2010 to January 2012, 90 elderly patients with osteoporotic intertrochanteric fracture were randomly divided into two groups. The patients in experimental group were treated with open reduction and internal fixation, He-wei Jie-gu decoction and Caltrate D in oral, including 18 males and 27 females with an average age of (77.8±11.3) years old ranging from 65 to 89 years old;the time from injured to operation was 2 to 9 days with an average of (6.6±2.1) days; according to Evans-Jensen classification, 17 cases were in type I, 8 in type II, 15 in type III, 3 in type IV, 2 in type V. Meanwhile, the patients in control group were treated with open reduction and internal fixation, Caltrate D in oral, including 16 males and 29 females with an average age of (81.2±9.6) years old ranging from 67 to 91 years old; the time from injury to operation was 2 to 10 days with an average of (6.8±2.6) days; according to Evans-Jensen classification, 15 cases were in type I, 10 in type II, 14 in type III, 4 in type W, 2 in type V. The VAS score, hip BMD value before and after treatment, fracture healing and the Harris function score after operation were recorded and compared.

RESULTSAll patients were followed up from 3 to 9 months with an average of (5.6±2.8) months. Compared with the control group, the VAS score of the experimental group had an obviously reduction (F=98.138, P<0.01) after treatment; the hip BMD value at 3 months after treatment in the experimental group was higher than that of the control group (P<0.05); the fracture healing rate of the experimental group was higher than that of the control group (P<0.05); Harris score in 3 months of follow-up in the experimental group was higher than that of the control group (t=2.542, P<0.05); all the differences between two groups were statistically significant (P<0.05).

CONCLUSIONHe-wei Jie-gu decoction can reduce postoperative pain and increase bone mineral density after internal fixation of femoral intertrochanteric fracture in elderly, promote the fracture healing and functional recovery in the hip joint.

Aged ; Aged, 80 and over ; Bone Density ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Femur ; injuries ; surgery ; Fracture Fixation, Internal ; Hip Fractures ; surgery ; Humans ; Male ; Osteoporotic Fractures ; drug therapy ; physiopathology ; surgery ; Pain, Postoperative ; drug therapy ; physiopathology

Objective To study the safety and efficacy of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients with biliary and pancreatic diseases under the concept of enhanced recovery after surgery (ERAS). Methods 320 patients were enrolled in ERCP operation. Both ERAS elderly group (experimental group A, n = 58, above 75 years) and young and middle-aged group (control group B, n=202,below 60 years)underwent enhanced recovery after surgery,meanwhile traditional elderly group(control group C, n = 60, above 75 years) received traditional perioperative management. It had compared multiple clinical indexes between group A with B and group A with C during the preoperative, intraoperative, and postoperative period. Results The incidence rate of cholangiocarcinoma, multiple complications, nutrition screening ≥ 3 points, ASA scored III degree and Child-Pugh scored A-level in preoperative ERAS elderly patients were higher than that of the young and middle-aged group (P < 0.05); And its incidence rate of nausea and vomiting and abdominal pain,nutritional screening < 3 points and ASA scored I degree were lower than that of the middle-aged group (P < 0.05);the fasting and water- deprivation time of the ERAS elderly group was shorter than that of the traditional elderly group (P < 0.05). The intraoperative operation time of the elderly ERAS group was slightly longer than that of the traditional elderly group (P < 0.05). The duration of electrocardiographic monitoring and the first aerofluxus time of the elderly patients with ERAS were longer than that of the young and middle-aged group (P < 0.05). The success, failure rate, and complication rate of the elderly patients with ERAS were 91.38% (53/58) and 8.62% (5 /58), 3.45% (2/58), meanwhile the young and middle-aged group were 96.53% (195/202), 3.47% (7/202), and 4.95% (10/202), and with no statistical difference (P > 0.05). The mild pain in ERAS elderly group was more than that of in traditional elderly group, while the moderate, and severe pain was less than that of traditional elderly group (P < 0.05); The opioid use rate, endoscopic nasobiliary indwelling, first-time ambulation and aerofluxus, total hospitalization, and postoperative hospitalization time of ERAS elderly group was less than the traditional elderly group (P < 0.05). Conclusions With ERAS, the treatment effect of ERCP in elderly patients is similar to that in young and middle-aged people, and it has good safety and effectiveness.

Objective Analyzing the construction process and application of health appropriate technology database in Zhejiang province and proposing related considerations and recommendations for the database construction.Methods To design and construct the technology database system,and using excel software to calculate statistic data.Results Established a health appropriate technology database,which contains 826 technologies that can be selected and promoted by the demonstration bases in the whole province.Conclusions The establishment of the technology database increased the efficiency of health appropriate technology transformation at the provincial level,and also provided a reference for the national-wide generalizing of health appropriate technology.