BACKGROUND:Chitosan and sodium hyaluronate are two kinds of anti-adhesion materials commonly used, but there are relatively few reports on their anti-adhesion effects in obstetrics patients. OBJECTIVE:To explore the anti-adhesion effects of chitosan and sodium hyaluronate in obstetric patients. METHODS:Totaly 180 cesarean section patients, aged 23-39 years, were equaly divided into control group, chitosan group and sodium hyaluronate group according to treatment methods. Patients in the control group were given the routine cesarean section; patients in the chitosan and sodium hyaluronate group were respectively given local smearing of chitosan and hyaluronate sodium. At 1 day after operation, the levels of serum interleukin-6, interleukin-10, tumor necrosis factor-α and C-reactive protein were determined in the three groups. Then, the patients were folowed up for 1 month to observe the occurrence of postoperative adhesion and complications. RESULTS AND CONCLUSION:The incidence rate of postoperative adhesions was lower in the chitosan and sodium hyaluronate groups than the control group (P < 0.05). The levels of serum interleukin-6, interleukin-10, tumor necrosis factor-α and C-reactive protein were also lower in the chitosan and sodium hyaluronate groups than the control group (P < 0.05). In addition, the incidence rates of postoperative infection, bleeding and pain were lower in the chitosan and sodium hyaluronate groups than the control group (P < 0.05). However, there was no difference between the chitosan and sodium hyaluronate groups. These findings indicate that the chitosan and sodium hyaluronate are both effective against postoperative adhesions in cesarean section patients, and reduce the incidence of complications.

OBJECTIVE:To evaluate the improvement and rectification effects about prescription checking and intervention skills of pharmacists. METHODS:By retrospective investigation,2417 outpatient prescriptions and 1698 outpatient prescriptions were respectively selected from some one hospital during Oct.-Dec. 2015 (before improvement and rectification) and Jan.-Mar. 2016 (after improvement and rectification). According to standards,guidelines and references as Prescription Administrative Poli-cy,Prescription Review Management Standard(trial)and drug instructions,irrational drug use and prescription checking and inter-vention skills of pharmacists were compared before and after the implementation of rectification measures as optimizing hospital in-formation system,improving comprehensive skills of pharmacists,strengthening pharmacists'concept,establishing feedback mech-anism. RESULTS:After the implementation of rectification measures,unsuitable indications,clinical diagnosis inconsistent with medication,antibiotics use without indications,unsuitable usage and dosage,unsuitable drug combination and irrational drug use were all decreased,but repeated drug use was increased,without statistical significance (P>0.05). The number of non-standard prescriptions and unsuitable prescriptions checked by pharmacists were decreased,without statistical significance(P>0.05). The in-cidence of checking missing,excessive checking and checking error were all increased from 2.40%,0.99%,3.39% before im-provement and rectification to 0.47%,0.29%,0.77%,with statistical significance(P<0.05). CONCLUSIONS:The improvement and rectification measures of the hospital can improve comprehensive prescription checking and intervention skills of pharmacists. Ir-rational drug use should be further standardized.

To make further study on the mechanism of needling based on the concept of needle-acupointomics.This article aims to reveal the biologic basis and interpret the scientific methods of needling,and to optimize needling prescriptions.The article make a standardized and normalized study on key techniques in clinical therapeutic methods,for the purpose of putting scientific mechanism into the practical usage,and better serving for clinical practice.

Objective To study the effect of functional electrical stimulation(FES) with innovative static state combined assistance pattern on lower extremity muscle status,motor function and walking function in children with spastic diplegic cerebral palsy.Methods A total of 40 children with spastic diplegic cerebral palsy were randomly divided into a observation group (20 cases) and a control group (20 cases),which were selected from the Third Affiliated Hospital of Jiamusi University from March 2016 to July 2016.The observation group included 11 males and 9 females,aged 3 to 6 years old,on the average of (4.80 ± 1.06) years;the control group including 7 males and 13 females,aged 3 to 6 years old,with mean age (4.75 ± 0.96) years.The control group was only treated with conventional rehabilitation therapy such as kinesitherapy and occupational therapy.On the basis of routine rehabilitation therapy,the observation group was treated with functional electrical stimulation with innovative static state combined with intelligent assistance patterns.All the therapies including conventional and FES treatment were conducted once per day,5 times per week,total for 8 weeks totally.The outcomes before treatment,4 weeks after treatment and 8 weeks after treatment for all the subserved objects were evaluated by modified Ashworth scale(MAS),including joint range of motion(ROM),manual muscle assessment (MMT),gross motor function scale (GMFM-88 D and E regions),gait analysis and musculoskeletal ultrasound (measured muscle thickness).All the data were collected and analyzed by SPSS 17.0 statistical software.Results After 4 weeks to 8 weeks of treatment,2 groups of children with joint range of motion of lower limbs,muscle strength,muscle tension,GMFM-88 score of D and E regions,muscle thickness and gait in 2 groups of children were improved than those before treatment (P ＜ 0.05),after 4 to 8 weeks of treatment,2 groups of children with lower limb joint activity,muscle strength,muscle tension,GMFM-88 score,D and E regions of the muscle thickness and gait in 2 groups of children were improved than those before treatment,and the differences were significant (P ＜ 0.05).The evaluation index of the observation group,Ashworth [left (1.80 ± 0.52) scores,right (3.40 ± 0.88) scores],ROM [left (19.5 ± 2.8) °,right (19.4 ± 1.5) °],muscle strength [left (1.80 ± 0.52) grade,right (2.O0 ± 0.56) grade] and muscle thickness[left gastrocnemius (32.35 ± 1.79) mm,right gastrocnemius (32.95 ± 2.63) mm,left anterior tibial muscle (30.60 ± 1.00) mm,right anterior tibial muscle (30.05 ± 1.8) mm],were all significantly better than those of the control group (all P ＜ 0.05).Step length (23.75-3.19) cm and step speed (0.45 ± 0.01) m/s compared with the control group improved significantly compared with the control group (P ＜ 0.05),the GMFM scores [D regions (31.30 ± 1.46) scores,E regions (48.95 ± 1.40) scores] was significantly higher than those of the control group (P ＜ 0.05).Conclusions The FES with innovative static state combined with intelligent assistance pattern can effectively improve the lower limb muscle state and motor function in children with spastic diplegic cerebral palsy.

Objective: To evaluate the role of extracellular signal-regulated kinase (ERK) signaling pathway in intrathecal dexmedetomidine-induced reduction of spinal cord ischemia-reperfusion (I/R) injury in rats. Methods: Eighty clean-grade male Sprague-Dawley rats, aged 9-10 weeks, weighing 300-350 g, were divided into 4 groups (n=20 each) using a random number table method: sham operation group (group S), spinal cord I/R group (group I/R), dexmedetomidine group (group D), and dexmedetomidine plus ERK signaling pathway blocker PD98059 group (group P). Spinal cord ischemia was produced by cross-clamping of the abdominal aorta distal to the left renal artery for 25 min followed by reperfusion to establish the model of spinal cord I/R injury.Dexmedetomidine 1 μg/kg was intrathecally injected at 20 min before establishing the model in D and P groups, PD98059 2 mg/kg was given via the tail vein at the same time in group P, and the equal volume of normal saline was given instead in S and I/R groups.Five rats were selected at 6, 8, 10 and 12 h of reperfusion, and the modified Basso, Beattie, Bresnahan (BBB) scale was used to assess the hindlimb locomotor function.Five rats were sacrificed after assessing the locomotor function at 6 h of reperfusion, and the L_3-5 segments of the spinal cord were taken for determination of cell apoptosis (by TUNEL) and expression of phosphorylated ERK (p-ERK) (by Western blot). The apoptosis index was calculated. Results: Compared with group S, the BBB scores were significantly decreased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was up-regulated in the other three groups (P<0.05). Compared with I/R group, the BBB scores were significantly increased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was up-regulated in group D, and no significant change was found in the apoptosis index or p-ERK expression in group P (P>0.05). Compared with group D, the BBB scores were significantly decreased at each time point of reperfusion, the apoptosis index was increased, and the expression of p-ERK was down-regulated in group P (P<0.05). Conclusion The mechanism by which intrathecal dexmedetomidine reduces spinal cord I/R injury is related to activating ERK signaling pathway in rats.

Objective: To investigate the association between D-dimer levels and clinical events in patients with mechanical heart valve replacement under oral anticoagulation therapy. Methods: This prospective study included 640 consecutive patients underwent mechanical heart valve replacement in Wuhan Asia Heart Hospital between January 2013 and June 2014.Patients were assigned to abnormal D-dimer group (D-dimer level>cut off value, n=88) and normal D-dimer group (D-dimer level≤cut off value, n=552) according to D-dimer levels measured at 3 months after the initiation of oral anticoagulation therapy.All patients were followed up for 24 months or until the observation of the end points, which included thrombotic events, bleeding events and all-cause deaths.The anticoagulation therapy was monitored once per 1-2 months by the international normalized ratio (INR), and the target value was 1.8-3.0. Results: During a follow-up period of 24 months, rates of total clinical events (19.30%(17/88) vs. 5.8%(32/552), P<0.01), thrombotic events (11.4%(10/88) vs. 2.3%(13/552), P<0.01), and all-cause deaths (8.0%(7/88) vs. 2.0%(11/552), P<0.01) were all significantly higher in abnormal D-dimer group than in normal D-dimer group.There were no significant difference in bleeding events between the two groups (2.3%(2/88) vs. 3.1%(17/552), P=0.77). Multivariate Cox regression analysis showed that high D-dimer level was an independent risk factor of total clinical events (HR=3.86, 95%CI 1.92-7.76, P<0.01), thrombotic events(HR=5.29, 95%CI 2.12-13.10, P<0.01), and all-cause deaths(HR=5.32, 95%CI 1.71-16.60, P<0.01), but which was not correlated with bleeding events(HR=1.36, 95%CI 0.27-6.84, P=0.71). Conclusion Elevated D-dimer levels are linked with clinical events in patients with mechanical heart valve replacement under oral anticoagulation therapy.

BACKGROUND:Total hip and knee arthroplasty is widely used in the elderly population,but there is a lack of accurate prediction methods for unplanned readmission and postoperative complications. OBJECTIVE:To investigate the effect of the Rothman index on unplanned readmission and complications in elderly patients undergoing total hip and knee arthroplasty. METHODS:A total of 153 patients who underwent elective total hip and knee arthroplasty from December 2020 to December 2022 in Ward Area One,Department of Orthopedics,The First People's Hospital of Zunyi were selected as the study subjects.According to whether they were unplanned readmission within 90 days after discharge,they were divided into a readmission group(n=21)and a non-readmission group(n=132).The general data of all patients were collected through the electronic medical record system,including gender,age,body mass index,diabetes mellitus,hypertension,and surgical joint type.The Rothman index was evaluated according to the literature.Postoperative complications were counted. RESULTS AND CONCLUSION:(1)There was no significant difference in gender,body mass index,surgical joint type,and length of hospital stay between the readmission group and the non-readmission group(P>0.05).There were significant differences in the number of comorbidities,age,and Rothman score between the two groups(P<0.05).(2)The results of multivariate Logistics regression analysis showed that the number of comorbidities,age,and Rothman score were independent influencing factors for readmission 90 days after total hip and knee arthroplasty in elderly patients with hip and knee diseases(P<0.05).(3)The results of receiver operating characteristic curve analysis exhibited that the area under the curve of the Rothman index for predicting readmission 90 days after total hip and knee arthroplasty was 0.824;the sensitivity was 80.85%;the specificity was 78.85%;the maximum Youden index was 0.597,and the optimal cutoff value was 46 points.(4)The incidence of total complications in elderly patients with Rothman<46 was higher than that in elderly patients with Rothman≥46(P<0.05).(5)It is concluded that the Rothman index can accurately predict unplanned readmission after total hip and knee arthroplasty in elderly patients with hip and knee joint diseases.Simultaneously,patients with Rothman index of less than 46 points have a higher overall risk of complications and poor joint recovery,which can be used to improve postoperative management of patients in clinical practice.

Objective:To study the mechanism of metastasis associated lung adenocarcinoma transcript 1 (MALAT1) targeting microRNA-142-3p (miR-142-3p) in ovarian cancer chemotherapy resistance.Methods:A total of 80 ovarian cancer tissues and paired normal tissues were collected in Shaanxi Provincial People′s Hospital from February 2016 to February 2019. The relative expression levels of MALAT1 and miR-142-3p in ovarian cancer tissues and paired normal tissues were detected by real-time fluorescence quantitative polymerase chain reaction (PCR), and the correlation between MALAT1 and miR-142-3p was analyzed. The effects of abnormal expressions of MALAT1 and miR-142-3p on proliferation and chemotherapy sensitivity of 5-fluorouracil (5-FU) and cisplatin of ovarian cancer Hey cells were verified by CCK-8 assay. Dual luciferase reporter gene experiment was used to detect the targeted relationship between miR-142-3p and MALAT1 (Hey cells were divided into four groups: MALAT1 wt, MALAT1 wt+ miR-142-3p mimic, MALAT1 mut, MALAT1 mut+ miR-142-3p mimic). RNA immunoprecipitation assay was use to confirm the binding site of MALAT1 and miR-142-3p.Results:In the ovarian cancer tissues and paired normal tissues, the relative expression levels of MALAT1 were 0.000 52 (0.002 56) and 0.000 47 (0.000 89), with a statistically significant difference ( Z=2.365, P=0.018); the relative expression levels of miR-142-3p were 0.001 19 (0.002 69) and 0.001 61 (0.008 48), with a statistically significant difference ( Z=2.935, P=0.003). The relative expression level of MALAT1 was negatively correlated with miR-142-3p in the ovarian cancer tissues ( r=-0.474, P<0.001). The relative expression level of miR-142-3p in the miR-142-3p mock group was statistically lower than that of MALAT1+ miR-142-3p mimic group (0.004 18±0.001 24 vs. 0.006 51±0.000 28; t=3.174, P=0.017). The relative fluorescence concentrations of MALAT1 wt group and MALAT1 wt+ miR-142-3p mimic group were 2.27±0.86 and 31.10±6.05 respectively, with a statistically significant difference ( t=8.172, P<0.001). After 48, 72 and 96 hours of ovarian cancer Hey cells being transfected with MALAT1 overexpression plasmid, the absorbance ( A) values of cells in the MALAT1 overexpression group were significantly greater than those in the control group (0.522±0.021 vs. 0.433±0.021; 0.644±0.012 vs. 0.544±0.051; 0.887±0.055 vs. 0.698±0.042), with statistically significant differences (all P<0.05). After MALAT1 being overexpressed in Hey cells, at 0.10 ng/μl concentration of 5-FU, the proliferation rate of cells in the overexpression group was significantly faster than that in the control group (0.615±0.036 vs. 0.506±0.042; t=4.432, P=0.002), and the cells at 1.00, 10.00, 100.00 ng/μl concentrations of 5-FU showed the same trends (all P<0.05). At 0.01 ng/μl concentration of cisplatin, the proliferation rate of cells in the overexpression group was significantly faster than that in the control group (0.777±0.015 vs. 0.733±0.039; t=2.355, P=0.023), and the cells at 0.10, 1.00, 10.00, 100.00 ng/μl concentrations of cisplatin showed the same trends (all P<0.05). After miR-142-3p being overexpressed in Hey cells, at 0.10 ng/μl concentration of 5-FU, the proliferation rate of cells in the overexpression group was significantly slower than that in the control group (0.512±0.051 vs. 0.744±0.119; t=4.028, P=0.004), and the cells at 1.00, 10.00, 100.00 ng/μl concentrations of 5-FU showed the same trends (all P<0.05). At 0.10 ng/μl concentration of cisplatin, the proliferation rate of cells in the overexpression group was significantly slower than that in the control group (0.520±0.043 vs. 0.674±0.096; t=3.441, P=0.009), and the cells at 1.00, 10.00, 100.00 ng/μl concentrations of cisplatin showed the same trends (all P<0.05). After ovarian cancer Hey cells being treated with 0.10, 1.00, 10.00, 100.00 ng/μl concentrations of 5-FU and cisplatin, the proliferation rates of cells in the MALAT1 overexpression group, MALAT1+ miR-142-3p group and control group showed statistically significant differences (all P<0.05). Further pairwise comparisons revealed that the proliferation rates of cells in the MALAT1+ miR-142-3p group were significantly slower than those in the MALAT1 overexpression group (all P<0.05). Conclusion:MALAT1 can reduce the sensitivity of ovarian cancer cells to 5-FU and cisplatin by targeted miR-142-3p, leading to chemotherapy resistance of ovarian cancer.

BACKGROUND:The reciprocal force generated by the molar distalization with clear aligners can lead to anchorage loss.The effect of arch shapes and missing second premolars on anchorage has not been reported. OBJECTIVE:To analyze the effect of arch shapes and missing second premolars on anchorage during molar distalization with clear aligners using the finite element method. METHODS:Cone-beam CT data from an adult male were acquired from the database to establish the maxilla-upper dentition-periodontium-rectangular attachment-clear aligner model.The distal movement amount designed on the bilateral second molars was set to 0.25 mm.First,there were two groups in the study:second premolar bilateral presence and absence groups.Then,four subgroups in each group were created:tapered arch,ovoid arch,square Class Ⅱ Division 1 arch,and Class Ⅱ Division 2 arch groups.The Ansys software was used to calculate the displacement of the anchorage tooth and the stress of the periodontal ligament. RESULTS AND CONCLUSION:Mesial tipping and extrusion of first molars and premolars,labial inclination and intrusion of anterior teeth occurred during the upper second molar distalization with clear aligners.When the bilateral second premolars were missing,the mesial displacement of first molars increased significantly while that of first premolars and anterior teeth decreased in all groups.The square Class Ⅱ Division 1 arch group showed the least anterior labial inclination,while the tapered arch group showed the most.There was no significant difference between the ovoid arch group and the tapered arch group.Moreover,the magnitude of tipping in the square Class Ⅱ Division 2 arch group was slightly higher than that in the Class Ⅱ Division 1 arch group.The stress of the periodontal ligament of the anchorage teeth was concentrated on the cervical and apical regions of the teeth.And the lowest stress level was detected in the square arch group.Compared with the other groups,the stress on the labial cervical area of the periodontal ligaments was also significantly relieved in the square arch group.To conclude,the square arch is more favorable in terms of anterior anchorage control and periodontal ligament stress distribution.Anterior labial inclination efficiency can be increased in cases of Class Ⅱ Division 2 by designing the anterior labial inclination in conjunction with molar distalization.If the second premolar is missing during molar distalization,it is not conducive to opening up the space in the area of the missing tooth.