Objective To investigate the impact of hyponatremia on the short-term prognosis in patients with acute ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI).Methods The present study included 324 patients with acute STEMI treated with PCI within 12 hours after admission from March 2014 to May 2016.Patients were divided into three groups according to plasma sodium levels (Na+) at admission:group A with Na+ ＜ 130 mmoL/L,group B with Na + 130-134 mmol/L and group C with Na + ≥ 135 mmol/L (normal plasma sodium level).Clinical data and biochemical variables were compared among the three groups.Logistic regression analysis was used to examine the correlation between plasma sodium levels and short-term prognosis.Results There were significant differences in age,fasting glucose,NT-proBNP,LVEF (left ventricular ejection fraction) and hsCRP (high sensitive C-reactive protein) among the three groups (P ＜ 0.05).The mortality in group A was obviously higher than that in Group B (20.0％ vs.6.3％,P ＜ 0.05) and in group C (20.0％ vs.6.0％,P ＜ 0.05).In addition,there were significant differences in rates of cardiogenic shock and acute renal failure among three groups.Logistic regression analysis showed that old age,low LVEF and hyponatremia were independent risk factors for 30-day mortality (P ＜ 0.05).Compared with group B,patients in group A had significantly high risks of death (OR =3.058,95％ CI:1.339-4.358,P =0.003),suggesting that the high risk of 30-day mortality associated with the severity of hyponatremia.Conclusions At admission,the hyponatremia in patients with acute STEMI treated with PCI is an independent risk factor for 30-day mortality,and prognosis worsens with the severity of hyponatremia.

Objective To establish a method of SYBR Green Ⅰ FQ-PCR for detecting the expression of miR-202 in peripheral blood mononuclear cells ( PBMC ) and analyze the expression of miR-202 and its clinical significance in MM.Methods Reverse transcription was performed with specific stemloop primer for miR-202,and then FQ-PCR was used to detected the expression of miR-202 in 21 MM patients and 20 healthy people.Data was presented as mean ± standard deviation ( (x) ± s ).Non-parametric Mann-Whitney test was used to analyze the difference between MM group and control group.In addition,1∶ 125 dilution of one test sample was detected by repeated 5 times,and the same sample was tested one time a day for 3 days,repeated 5 each time.The assessment of repeatability of measurements was done by calculating standard deviation and variation coefficient from threshold cycle (Ct).Results FQ-PCR detection of miR-202 in PBMC was amplified by the standard S-curve,with a single melting curve peak and no complex peak,which showed good specificity.The assay showed good reproducibility (intra-assay coefficient 1.2％ and inter-assay coefficient 3.2％ ) and high sensitivity ( 12.8 pmol/μ1).The expression of miR-202 in MM was 0.014 ( 0.007 - 0.221 ) and 1.844 ( 0.162 - 3.966 ) in normal controls.The expression level of miR-202 was significantly higher in MM than in normal controls (U =48.000,P ＜0.01 ).Conclusions FQ-PCR provide us a rapid,sensitive and specific method for detection of miR-202.The expression level of miR-202 is higher in MM than in normal controls.It is possible to play a role in MM progress and may be a useful marker to evaluate the development and treatment of MM.

Objective To investigate the protective effect of the ethanol extract of Portulaca oleracea L. on acute liver injury induced by carbon tetrachloride in mice, and to analyze its effective components. Methods 80% ethanol purslane extract was centrifuged, vacuum distillated and vacuum dried into whole plant extract, supernatant extract and precipitated extract. Eighty ICR male mice were randomly divided into 8 groups: control group, liver injury model group, whole plant extract low-dose group, high-dose group, supernatant extract low-dose group, high-dose group, precipitation extract low-dose group, and high-dose group. After oral administration of distilled water or three kinds of purslane extract suspensions at different doses for 1 week, olive oil or CCl₄ olive oil solution were injected subcutaneously respectively. After 16 hours, serum was collected to detect the levels of ALT, AST and IL-6 to evaluate the protective effect of purslane on acute liver injury. Ultra-high performance liquid chromatography quadrupole time of flight mass spectrometry (UPLC-Q-TOF/MS) was used to analyze the effective components of purslane extract. Results Compared with the model group, the levels of serum AST, ALT and IL-6 in high-dose whole plant extract group were significantly reduced. The serum ALT level of mice in the high-dose precipitation extract group was significantly reduced (P<0.05). The serum IL-6 level was decreased, but there was no significant difference. There were no significant changes in the levels of serum AST, ALT and IL-6 in the other intervention groups. 15 main components such as malic acid, citric acid, leucine, isoleucine, adenosine, succinic acid, genistein, tyrosine and phenylalanine were identified by UPLC-Q-TOF/MS. Conclusion Purslane whole plant ethanol extract has hepatoprotective and anti-inflammatory effects on CCl₄ acute liver injury mice, which may be a combined effect of 15 active components.

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.