AIM To study the chemical constituents from the methanol fraction of Premna fulva Craib leaves and their anti-inflammatory activities.METHODS The methanol fraction from P.fluva were isolated and purified by TLC,column chromatography,and HSCCC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.Their anti-inflammatory activities in vitro were evaluated by RAW264.7 model.RESULTS Twelve compounds were isolated and identified as vitexin(1),balanophonin(2),inotodisaccharide(3),4-allyl-2,6-dimethoxyphenol-β-D-glucopyranoside(4),dehydrovomifoliol(5),loliolide(6),(E)-4-((1S,3R,4R)-1-hydroxy-4,5,5-trimethyl-7-oxabicyclo[4.1.0]heptan-1-yl)but-1-en-3-o-ne(7),(E)-4-hydroxyphenylprop-7-ene 4-O-β-D-glucopyranoside(8),4-O-β-D-glucopyranosylbenzoic acid(9),vicenin(10),oleanicacid(11),sesamin(12),respectively.Compounds 1,2,5,7,10,and 12 showed good inhibitory activities against NO,and the IC50 values were(26.42±2.5)、(21.24±2.2)、(25.88±1.9)、(29.72±2.1)、(8.90±1.1)、(9.73±0.7)μmol/L,respectively.CONCLUSION Compounds 2,4-8 are isolated from Premna genus plants for the first time.Compounds 1,2,5,7,10,12 have anti-inflammatory activities.

Objective:To verify the effect and safety of low-intensity extracorporeal shockwave therapy(Li-ESWT)in improving the symptoms of ED,and provide some reference for further related large-scale clinical trials.Methods:Twenty-six patients diag-nosed with ED received Li-ESWT with an energy of 0.09 mJ/mm2 for 20 minutes once a week for 6 four-week courses.Before and at 3,6,9,and 12 months after treatment,we obtained the IIEF-5 and Erectile Hardness Scale(EHS)scores of the patients using question-naires,recorded the incidence of treatment-related adverse reactions,compared the erectile function of the patients before and after treatment,and evaluated the effect and safety of Li-ESWT in improving ED-related symptoms.Results:Compared with the baseline,the IIEF-5 scores of the patients were significantly increased(P＜0.01)while the EHS scores slightly increased at 3 months after Li-ESWT treatment(P＞0.05),both IIEF-5 and EHS scores were dramatically increased at 6 months(P＜0.01),and both signifi-cantly higher than at 3 months.At 9 months,EHS scores remained remarkably higher than the baseline(P＜0.01)although IIEF-5 scores slightly lower than at 6 months.At 12 months,however,IIEF-5 scores decreased,though still significantly higher than the base-line(P＜0.01),and EHS scores became lower than at 6 and 9 months(P＜0.05)but still markedly higher than before treatment(P＜0.05).Adverse reactions observed during the intervention mainly included pruritus(4.35％),pain(2.90％),paresthesia(2.17％),and petechiae/ecchymosis(2.90％).Conclusion:Li-ESWT can increase the IIEF-5 and EHS scores and improve the clinical symptoms of ED patients,with a low incidence of adverse reactions during the treatment.

AIM:To observe the clinical effect of ranibizumab combined with 577nm micropulse laser in the treatment of severe diabetic macular edema(DME). METHODS:There were 52 eyes of 52 patients diagnosed with severe DME who admitted to the People's Hospital of Guangxi Zhuang Autonomous Region from June 2016 to September 2019. The patients were randomly divided into the observation group(26 patients with 26 eyes, treated with ranibizumab combined with 577nm micropulse laser)and the control group(26 patients with 26 eyes, treated with ranibizumab alone). Patients in both groups received intravitreal injection of ranibizumab with “3+PRN” regimen. Followed up at 9mo after treatment to observe the central macular thickness(CMT), the best corrected visual acuity(BCVA)and the times of intravitreal injection of ranibizumab in the two groups.RESULTS:Compared with before treatment, the CMT and BCVA of the two groups were significantly improved at each time point after treatment(all P<0.001), but there was no difference between the two groups(P>0.05). During the follow-up period, the times of vitreous injection of ranibizumabin the observation group was significantly less than that in the control group(5.88±1.24 times vs 7.12±1.24 times, P=0.001). CONCLUSION:Both ranibizumab combined with 577nm micropulse laser and ranibizumab alone are effective in reducing edema and improving vision in patients with severe DME, but the combination therapy reduces the times of injection.

The classical auditory oddball paradigm is a commonly used experimental paradigm for evoking event related potentials (ERPs). The present study was aimed to explore the auditory cognitive processing mechanism of space perception of human brain. We employed an auditory oddball paradigm of binaural unbiased and biased sound intensity to compare and analyze the response characteristics of ERP. By focusing on the spatial lateralization characteristics of P300 and mismatch negativity (MMN) components, we analyzed their lateralization trends according to the laterality index. We found that both P300 and MMN components showed right-hemisphere lateralization phenomenon under the stimulation of asymmetric intensity of auditory acoustic. The results suggested that the right hemisphere of human brain played a key role in spatial information processing. The results also indicated that the hemispherical characteristics of the brain were not related to the actual spatial direction of the auditory stimulus, but were determined by the hemispherical functions of the brain. Furthermore, the results suggested that the MMN components induced by spatial differences were stronger in females than those in males.
Acoustic Stimulation ; Auditory Perception/physiology* ; Brain Mapping ; Electroencephalography ; Evoked Potentials ; Evoked Potentials, Auditory/physiology* ; Female ; Humans ; Male

OBJECTIVE: To explore the effect of lenalidomide on human fibroblast-like synovial cells (HFLS) and the therapeutic efficacy on hemophilic arthropathy in hemophilia A mice model. METHODS: In vitro, to remodel the inflammatory environment of synovial tissue after hemorrhage, ferric citrate and recombinant TNF-α were added into the cell culture medium of HFLS. Cell Counting Kit-8 (CCK-8), Enzyme-linked immunosorbent assay (ELISA), Quantitative Real-time PCR (RT-qPCR) and flow cytometry were employed for detection of the effects of lenalidomide on the proliferation ability, pro-inflammatory cytokines release and apoptosis of HFLS cells. In vivo, hemophilia arthropathy was remodeled in hemophilia A mice by induction of hemarthrosis. A series of doses of lenalidomide (0.1, 0.3 and 1.0 g/kg) was administrated intra-articularly. Tissues of knee joints were collected on the 14th day after administration, and the protective effect of lenalidomide on arthritis in hemophilia A mice were evaluated by RT-qPCR and histological grading. RESULTS: In vitro, compared with the untreated control group, lenalidomide could significantly inhibit the proliferation of HFLS cells (P<0.05), and the effect was the most significant when the concentration was 0.01 μmol/L (P<0.001). Compared with the control group, lenalidomide could significantly inhibit the expression levels of TNF-α, IL-1β, IL-6 and IFN-γ in HFLS cells (P<0.05). The flow cytometry results showed that lenalidomide could enhance the apoptotis of HFLS cells (P<0.05). The results of RT-qPCR showed that lenalidomide could significantly reduce the mRNA expression levels of TNF-α, IL-1β, IL-6,MCP-1 and VEGF in the joint tissues (P<0.05). Histological results showed that compared with the injured group, lenalidomide could significantly reduce the pathological sequela after hemarthrosis induction, e.g. synovial thickening and neo-angiogenesis in the synovium. The protection displayed a dose-response pattern roughly. CONCLUSION In vitro, lenalidomide can inhibit the proliferation of HFLS cells, promote their apoptosis, and inhibit the expression of pro-inflammatory cytokines. In vivo, lenalidomide can significantly decrease the expression of pro-inflammatory cytokines in the joints of mice, and prevent the development of inflammation and neo-angiogenesis. The results provide a theoretical and experimental basis for the clinical application of lenalidomide in the treatment of hemophilic arthropathy.
Animals ; Arthritis ; Cytokines/metabolism* ; Hemarthrosis/pathology* ; Hemophilia A/genetics* ; Humans ; Interleukin-6 ; Lenalidomide ; Mice ; Neovascularization, Pathologic ; RNA, Messenger ; Sincalide ; Tumor Necrosis Factor-alpha ; Vascular Endothelial Growth Factor A

A large number of protease inhibitors have been found from leeches, which are essential in various physiological and biological processes. In the curret study, a novel elastase inhibitor was purified and characterized from the leech of Hirudinaria manillensis, which was named HMEI-A. Primary structure analysis showed that HMEI-A belonged to a new family of proteins. HMEI-A exerted inhibitory effects on elastase and showed potent abilities to inhibit elastase with an inhibition constant (K
Amino Acid Sequence ; Animals ; Leeches/chemistry* ; Pancreatic Elastase/antagonists & inhibitors* ; Protease Inhibitors/pharmacology* ; Proteins

PURPOSE: To assess the effectiveness and safety of acupuncture for erectile dysfunction (ED). MATERIALS AND METHODS: We searched six major English and Chinese databases included randomized controlled trials (RCTs) testing acupuncture alone or in combination for ED. Dichotomous data were presented as risk ratio (RR) and continuous data were presented as mean difference (MD) both with 95% confidence interval (CI). The Revman (v.5.3) was used for data analyses. Quality of evidence across studies was assessed by the online GRADEpro tool. RESULTS: We identified 22 RCTs, fourteen of them involving psychogenic ED. Most of the included RCTs had high or unclear risk of bias. There was no difference between electro-acupuncture and sham acupuncture with electrical stimulation on the rate of satisfaction and self-assessment (RR, 1.50; 95% CI, 0.71–3.16; 1 trial). Acupuncture combined with tadalafil appeared to have better effect on increasing cure rate (RR, 1.31; 95% CI, 1.00–1.71; 2 trials), and International Index of Erectile Function-5 scores (MD, 5.38; 95% CI, 4.46–6.29; 2 trials). When acupuncture plus herbal medicine compared with herbal medicine alone, the combination therapy showed significant better improvement in erectile function (RR, 1.68; 95% CI, 1.31–2.15; 7 trials). Only two trials reported facial red and dizziness cases, and needle sticking and pruritus cases in acupuncture group. CONCLUSIONS: Low quality evidence shows beneficial effect of acupuncture as adjunctive treatment for people mainly with psychogenic ED. Safety of acupuncture was insufficiently reported. The findings should be confirmed in large, rigorously designed and well-reported trials.
Acupuncture ; Asian Continental Ancestry Group ; Bias (Epidemiology) ; Dizziness ; Electric Stimulation ; Erectile Dysfunction ; Herbal Medicine ; Humans ; Male ; Needles ; Odds Ratio ; Pruritus ; Self-Assessment ; Statistics as Topic ; Tadalafil

OBJECTIVETo compare the difference of intra-abdominal infection between intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in patients undergoing laparoscopic right hemicolectomy within postoperative 30 days.

METHODSClinical date of right colon cancer patients undergoing laparoscopic right hemicolectomy at the Department of Colorectal Surgery, PUMCH from January 1st, 2013 to October 31st, 2016 were retrospectively analyzed. Patients with stage IV cancers which could not be radically resected, emergency operation and conversion to open surgery were excluded. The intracorporeal anastomosis and extracorporeal anastomosis were compared in the items of operation time, postoperative infection and postoperative hospital stay.

RESULTSA total of 194 patients were enrolled in the study, including 73 patients with IA and 121 patients with EA. No significant differences were found in gender, age, previous operation history, tumor site and T stage of the tumor between two groups (all P>0.05). There were also no significant differences in mean operative time (162.4 minutes vs. 167.7 minutes, P=0.257), time to first flatus (3.3 days vs. 3.4 days, P=0.744), number of harvested lymph nodes (30.3 nodes vs. 33.8 nodes, P=0.071) and postoperative hospital stay (7 days vs. 7 days, P=0.067) between two groups. The incidence of intra-abdominal infection in patients with IA was significantly higher than that in those with EA [13.7%(10/73) vs. 1.7%(2/121), P=0.001], while the differences of the incidence of wound infection [1.4%(1/73) vs. 3.3%(4/121), P=0.652], respiratory infection [1.4%(1/73) vs. 3.3%(4/121), P=0.652] and urinary tract infection [2.7%(2/73) vs. 0.8%(1/121), P=0.558] were not significant.

CONCLUSIONCompared with EA, IA may increase the risk of intra-abdominal infection in patients undergoing laparoscopic right hemicolectomy.

BACKGROUND: The key point of the displaced intra-articular calcaneal fractures is to accurately and effectively reset the intra-articular calcaneal fractures and effectively reduce the incidence of incision-related complications. Currently, the minimally invasive approach has been widely used in the treatment of calcaneal fractures. OBJECTIVE: To compare the clinical outcomes and safety of minimally invasive longitudinal approach and minimally invasive tarsal sinus approach for displaced intra-articular calcaneal fractures. METHODS: A prospective, single center, open-label, randomized, controlled clinical trial is conducted. 200 patients with displaced intra-articular calcaneal fractures will be randomly divided into minimally invasive approach group and tarsal sinus approach group, with 100 cases in each group, and treated with minimally invasive longitudinal approach and tarsal sinus approach repair, respectively. Follow-up time will be 5 weeks, 4, 8, 12, 36 months after surgery. The primary outcome is the excellent and good rate of American Orthopaedic Foot and Ankle Society score at 5 weeks, 4, 8, 12 and 36 months after operation. Secondary outcomes are operative time, CT and X-ray images preoperatively and 5 weeks, 4, 8, 12, 36 months postoperatively at the injury site, and the incidence of adverse reactions 5 weeks, 4, 8, 12, 36 months postoperatively. The trial has been approved by Ethics Committee of Wuxi Third People's Hospital.The study is in line with the Declaration of Helsinki developed by the World Medical Association.Participants will be informed and sign consent for the protocol and procedure. Trial ethics approval [Approved by: Wuxi Third People's Hospital, Approval No. 20140402-2] was conducted in April 2014. The sample and data collection will be from January 2018 to October 2019, and the indicator analysis time and test completion time will be December 2019. The results will be reported in scientific meetings or published in peer-reviewed journals. The trial has registered in China Clinical Trial Register (registration number: ChiCTR-IOR-17013697). DISCUSSION: The trial will compare minimally invasive tarsal sinus approach and minimally invasive longitudinal approach for the treatment of displaced intra-articular calcaneal fractures to clarify the characteristics and clinical application range of the two minimally invasive techniques.