Objective To explore the clinical effect of Haizhu-Chuanxidingtablet with MORA-super bio-resonance in bronchial asthma.Methods A total of 94 patients met the inclusion criteria in our hospital were divided control group and observe group by a random way, 47 in each group. The control group was treated with MORA-super bio-resonance while the treatment group withHaizhu-Chuanxiding tablet on the base of control group. The treatment time was 50 days in the 2 groups. After the treatment, the effects in the 2 groups were compared. Before and after the treatment, the levels of lung function (FVC, PEF, FEV1% and FEV1), inflammation index (hs-CRP, IL-8,TNF-α and IL-4), matrix metalloproteinase-9 (MMP-9), tissue inhibitors of metalloproteinase 1 (TIMP-1), toll like receptor 2 (TLR2) and eosinophil cationic protein (ECP) were detected in the 2 groups.Results After the treatment, the effect rate was 91.5% (43/47) in the observe group, significantly higher than 72.3% (34/47) in the control group (Z=4.201,P=0.037). After the treatment, the levels of FVC (2.45 ± 0.37 Lvs.1.93 ± 0.32 L,t=3.561), PEF(6.16 ± 1.25 L/svs. 5.56 ± 1.10 L/s,t=3.413), FEV1/FVC (68.39% ± 6.44%vs. 62.31% ± 5.97%,t=3.315) and FEV1 (2.61 ± 0.56 Lvs. 2.21 ± 0.47 L,t=3.672) in the observe group significantly higher than the control group (P<0.05). After the treatment, the levels of hs-CRP (8.14 ± 0.42 mg/Lvs. 12.41 ± 0.65 mg/L,t=3.424), IL-8 (113.47 ± 11.13 ng/Lvs. 153.81 ± 19.73 ng/L,t=3.692), TNF-α (0.31 ± 0.04 ng/Lvs. 0.70 ± 0.13 ng/L,t=3.923)], IL-4 (39.43 ± 6.23 ng/Lvs. 47.75 ± 8.23 ng/L, t=3.783) in the observe group significantly lower than the control group (P<0.05). After the treatment, the levels of MMP-9 (84.89 ± 9.19 ng/mlvs. 113.35 ± 11.35 ng/ml,t=3.671), TIMP-1 (91.53 ± 8.78 ng/mlvs. 131.15 ± 12.45 ng/ml,t=3.782), ECP (19.43 ± 1.33 ng/Lvs. 25.75 ± 2.13 ng/L,t=3.561) in the observe group significantly lower than the control group (P<0.05). The level of TLR2 (270.31 ± 7.01 ng/Lvs. 198.70 ± 10.13 ng/L;t=3.871,P=0.038) in the observe group significantly higher than the control group (P<0.05).ConclusionsHaizhu-Chuanxidingtablet with MORA-super bio-resonance in bronchial asthma showed a good effect on patients with bronchial asthma and could promote the inflammation and lung function in patients.

Objective To evaluate the effect and the incidence of adverse reaction of different chemotherapy combined with radiotherapy for the treatment of non-small cell lung cancer (NSCLC) complicated with type 2 diabetes.Methods A total of 123 midterm advanced NSCLC patients complicated with type 2 diabetes were randomly divided into A,B,C three groups through the random number generated by computer,and each group was 41 cases.Three groups of patients were treated with three-dimensional conformal radiotherapy and synchronous chemotherapy.Group A received gemcitabine and cisplatin,group B received paclitaxel and cisplatin,and group C received pemetrexed and cisplatin.The treatment efficiency,time to tumor progression,median survival time,survival rate and incidence of adverse reaction were observed and compared.Results The total effective rates of group A,B and C were 82.93％,78.05％ and 80.49％,with no statistically significant difference (x2 =0.365,P =0.357).The times to tumor progression of the three groups were (6.54 ± 1.23) months,(5.96 ± 1.27) months,(6.27 ± 1.08) months,with no statistically significant difference (F=1.235,P =0.314);the median survival times of the three groups were (16.54 ± 1.87) months,(15.36 ± 1.25) months,(16.29 ± 2.08) months respectively,with no statistically significant difference (F =2.226,P =0.245);1-year survival rates of the three groups were 80.49％,82.93％,85.37％ respectively,with no statistically significant difference (x2 =1.234,P =0.665);2-year survival rates were 48.78％,51.22％,43.90％,with no statistically significant difference (x2 =2.354,P =0.451).The incidence rates of radioactive pneumonia and bone marrow suppression in group C were 24.39％ and 24.39％,those were significantlylower than31.71％,53.66％ of group B (x2 =18.687 P=0.017;x2 =25.336,P=0.011) and 41.46％,31.71％ of group A (x2 =17.543,P=0.019;x2 =24.358,P =0.013).Conclusion The clinical efficacy of the three groups are similar,but the incidence rate of adverse reaction in pemetrexed and cisplatin plus radiotherapy group is the lowest.Therefore,pemetrexed plus cisplatin is the safe and effective treatment for the previously untreated patients with NSCLC.

Objective To investigate the safety and efficacy of nephron-sparing surgery (NSS)for selective T2 stage renal tumor.Methods The surgical database of 26 patients treated with NSS for clinical T2 stage renal cell carcinomas between March 2010 and May 2013 were collected and analyzed retrospectively.There were 17 males and 9 females,with a mean age of 52 years (39-74 years),mean tumor size of 10.3 cm(7.2-16.5 cm),and mean R.E.N.A.L score of 7.5 (6-10).Patients'demographics,clinical characteristics,oncologic outcomes,renal function were reviewed.Results The renal masses were removed successfully and the surgical margins were negative.There were 21 (80.8％) cases of clear cell carcinoma,4 (15.4％) papillary carcinoma and 1 (3.8％) chromophobe carcinoma.The mean ischemia time was (28.3 ± 12.5) minutes (7 patients were clamp-free).Three patients needed transfusion,one experienced urine fistula and cured by conservative treatment,and one patient's renal function got progressive worsening and required long-term hemodialysis.The average serum creatinine was 121 μ mol/L before and 136 μmol/L after surgery (P =0.06).After a period of 22-47 months' follow-up,no patient had local recurrence or metastasis.Conclusions NSS can be safely performed and provide effective oncologic outcomes for selective patients with clinical T2 stage renal cell carcinomas.R.E.N.A.L nephrometry is an important factor and should be used to evaluate the feasibility of NSS.

AIM:To explore the change of antithrombin Ⅲ( AT-Ⅲ) in the patients with atherosclerotic cere-bral infarction .METHODS:Chromogenic substrate assay was used to measure the activity of AT-Ⅲ in 55 patients with atherosclerotic cerebral infarction and 55 healthy controls , and the correlation analysis was applied to determine the AT-Ⅲactivity with the severity of damage in central nervous system and general biochemical parameters .The levels of TNF-αand IL-6 in the plasma were detected by ELISA .Immunocomplex in the plasma was measured by enzyme immunoassay (EIA). The number and phenotype of the monocytes in peripheral blood were analyzed by flow cytometry .ELISA was also applied to determine the secretion of TNF-αand IL-6 from the monocytes after the stimulation of immunocomplex .The expression of AT-Ⅲin human brain vascular endothelial cells after the stimulation of TNF-αand IL-6 was observed by Western blotting . RESULTS:The activity of AT-Ⅲsignificantly decreased in the patients with atherosclerotic cerebral infarction , and nega-tively correlated with the damage degree of nervous system function , systolic pressure , diastolic pressure , glucose , choles-terol, triglyceride, low-density lipoprotein cholesterol and homocysteine , while positively correlated with high-density lipo-protein.In addition, the plasma levels of TNF-αand IL-6 increased significantly , accompanied with the enhancement of immunocomplex level .The numbers of CD14 + CD16 + and CD14 + CD32 + monocytes in peripheral blood were not changed , while CD14 +CD64 +monocytes increased obviously .The secretion of TNF-αand IL-6 by monocytes were signifi-cantly enhanced after stimulated with immunocomplex , while the protein expression of AT-Ⅲ in the human brain vascular endothelial cells was down-regulated after co-incubated with TNF-αor IL-6.CONCLUSION:Decreased AT-Ⅲactivity in the patients with atherosclerotic cerebral infarction is one of the risk factors of cerebral infarction , and related with the dis-ease severity .The production of pro-inflammatory cytokines through immunocomplex from CD 14 +CD64 +monocytes may be involved in the mechanism .Improvement of AT-Ⅲactivity may protect against cerebral ischemia .

Objective:To compare the complications between breast-conserving surgery with free dermal fat graft (FDFG) and traditional breast-conserving surgery (TBCS) in breast cancer patients, and to analyze the influencing factors for the incidence of complications of breast-conserving surgery with FDFG.Methods:The clinical data of 120 breast cancer patients who underwent breast-conserving surgery with FDFG (FDFG group, 50 cases) or TBCS (TBCS group, 70 cases) in Liuzhou People's Hospital from June 2015 to September 2020 were retrospectively analyzed. The incidence of overall complications and various complications between the two groups were compared, the influencing factors of complications in the FDFG group were analyzed, and the cosmetic outcome was evaluated.Results:There was no significant difference between the two groups in age, lymph node status, clinical TNM stage, etc (all P > 0.05). In the FDFG group, the proportions of patients with the longest tumor diameter > 3 cm and tumor in upper inner quadrant were significantly higher than those in the TBCS group [52.0% (26/50) vs. 27.1% (19/70), χ2 = 7.69, P = 0.006; 38.0% (19/50) vs. 15.7% (11/70), χ2 = 7.73, P = 0.005]. The operation time, intraoperative blood loss, postoperative hospital stay and weight of resected tissues in the FDFG group were higher than those in the TBCS group [(251±69) min vs. (213±41) min, (107±29) ml vs. (68±26) ml, (8.8±2.5) d vs. (6.1±1.6) d, (81±26) g vs. (56±20) g], and the differences were statistically significant ( t values were 10.14, 30.58, 22.20, and 14.54, respectively, all P < 0.001). There were no significant differences in the incidence of overall complications, bleeding, infection, or poor wound healing between the two groups (all P > 0.05). The incidence rate fat liquefaction in the FDFG group was higher than that in the TBCS group [14.0% (7/50) vs. 1.4% (1/70), χ2 = 5.53, P = 0.019]. Multivariate logistic regression analysis showed that the weight of FDFG ( OR = 14.056, 95.0% CI 1.764-111.985, P = 0.013) and the thickness of FDFG ( OR = 19.599, 95.0% CI 1.743-220.345, P = 0.016) were independent influencing factors for the incidence of complications in the FDFG group. The percentage of 'excellent' or 'good' cosmetic outcome in the FDFG group was 90% (45/50). Conclusions:Breast-conserving surgery with FDFG can extend the resected area for tumor without increasing the incidence of overall complications and could provide patients a superior cosmetic outcome, but the incidence of fat liquefaction is higher than that of TBCS. The weight and thickness of FDFG are the influencing factors for the incidence of complications of breast-conserving surgery with FDFG.

Objective:To explore the curative effect of wide pedicled with double-vessel flap of posterior lateral calf in repair of soft tissue defect in hind foot.Methods:From January 2018 to June 2021, 12 patients with soft tissue defects on hind foot were reconstructed with double-vessel flaps pedicled perforator of peroneal artery and sural nerve nutrient vessels in the Department of Trauma Orthopaedics, No.940 Hospital of Chinese People's Liberation Army Joint Service Support Force. The patients were 8 males and 4 females, aged 9-45(27.17±12.14) years old. Time after injury to admission was 6-24(10.17±4.80) hours. Six patients were with simple soft tissue defects, 2 with tendon defects, 3 with bone defects and 1 with postoperative infection due to an open fracture. The sizes of soft tissue defect ranged from 4 cm×5 cm-8 cm×12 cm. Soft tissue defects were reconstructed by transfer of posterolateral calf flaps, and the bone defects were repaired by phase I or phase II bone grafts or antibiotic cement and membrane induction according to the wound surface. For larger bone defects, stage-II bone transport was carried out to restore the length of the hind foot. Defects of Achilles tendon were reconstructed by direct suture or tendon transposition. Foot functions were evaluated by American Orthopaedic Foot and Ankle Surgery(AOFAS) ankle-posterior sufficient scale, visual analogue scale(VSA) score and flap healing. All patients were included in postoperative follow-up regularly through outpatient clinic or via WeChat.Results:All 12 patients had postoperative follow-up that lasted for 6-24(12.92±6.22) months. One flap developed dark purple colour with swelling at the distal end of the flap 3 days after surgery. It eventually healed after removed some sutures from the pedicle together with blood-letting on the flap surface. Three flaps developed local infection, and they were cured after debridement, dressing change and the use of sensitive antibiotics. The remaining 8 patients had achieved good appearance of flaps and normal ankle function. According to AOFAS, scores of ankle-posterior sufficiency scale increased from 14-45(25.25±5.42) before surgery up to 65-96(75.92±7.73) at the final follow-up. Of the 12 patients, 8 were in excellent, 2 in good and 2 in fair. The VAS scores decreased from 5-8(6.55±1.13) before surgery down to 0-4(1.55±1.37) at the final follow-up. The difference had statistics significance( P<0.01). All patients had satisfactory recovery of ankle function, with the extension at 15-20 degrees and plantar flexion of 30-40 degrees. The donor site healed well and all skin grafts survived. Conclusion:The double-vessel flap pedicled with perforating branch of peroneal artery and nutrient vessels of sural nerve can be used for reconstruction of soft tissue defect of hind foot. It achieved good surgical effects with reliable blood supply, smooth venous return, strong anti-infection ability, satisfactory appearance at donor site and flap itself, as well as a good recovery of foot function.

Objective:To investigate the effects of anterolateral wide pedicled double dynamic flap of the calf in repair of soft tissue defects of mid-and forefoot.Methods:From September 2015 to Septemler 2020, 15 cases with severe soft tissue defects of mid-and forefoot were repaired with the anterolateral wide pedicled double dynamic flap of the calf. There were 11 males and 4 females with an average age of 37(range, 22-53)years old. Of the 15 cases, the defects were caused by traffic accident in 6 cases and objects smash in 9 cases. Three cases were simple soft tissue defect, and 12 cases combined with fracture or dislocation and bone defect. The size of soft tissue defects ranged from 4 cm×5 cm to 7 cm×12 cm. All wounds of donor sites were repaired by skin grafting. All patients entered follow-ups at the outpatient clinic or through WeChat. The appearance of flaps and limb recovery were recorded after surgery.Results:All cases followed-up for 6-24 (mean, 16) months. Two days after surgery, 1 case had flap swelling and cyanosis, which was improved after pedicle suture removal and surface bloodletting. The pedicle of the flap was slightly bloated in 4 cases, and the texture and appearance were good in 11 cases. The ankle function of all cases recovered satisfactorily. The ranges of ankle motion were 15°-20° for dorsiflexion and 30°-40° for plantar flexion. The donor site healed well and all the skin grafts survived.Conclusion:The anterolateral wide pedicled double dynamic flap of the calf is one of the ideal flaps for repairing the soft tissue defects of the mid-and forefoot with reliable blood supply, sufficient venous return, simple operation and no require a vascular anastomosis.

Postzygotic mutations are acquired in normal tissues throughout an individual's lifetime and hold clues for identifying mutagenic factors.Here,we investigated postzygotic mutation spectra of healthy individuals using optimized ultra-deep exome sequencing of the time-series samples from the same volunteer as well as the samples from different individuals.In blood,sperm,and muscle cells,we resolved three common types of mutational signatures.Signatures A and B represent clock-like mutational processes,and the polymorphisms of epigenetic regulation genes influence the pro-portion of signature B in mutation profiles.Notably,signature C,characterized by C＞T transitions at GpCpN sites,tends to be a feature of diverse normal tissues.Mutations of this type are likely to occur early during embryonic development,supported by their relatively high allelic frequencies,presence in multiple tissues,and decrease in occurrence with age.Almost none of the public datasets for tumors feature this signature,except for 19.6％of samples of clear cell renal cell carcinoma with increased activation of the hypoxia-inducible factor 1(HIF-1)signaling pathway.Moreover,the accumulation of signature C in the mutation profile was accelerated in a human embryonic stem cell line with drug-induced activation of HIF-1α.Thus,embryonic hypoxia may explain this novel signature across multiple normal tissues.Our study suggests that hypoxic condition in an early stage of embryonic development is a crucial factor inducing C＞T transitions at GpCpN sites;and indi-viduals'genetic background may also influence their postzygotic mutation profiles.

OBJECTIVE: To investigate the effectiveness of sequential plate internal fixation in the correction of Madelung deformity after ulnar osteotomy and shortening. METHODS: The clinical data of 13 patients with Madelung deformity admitted between September 2015 and July 2021 were retrospectively analyzed. There were 5 males and 8 females with an average age of 18.3 years ranging from 17 to 23 years. The disease duration ranged from 12 to 24 months, with an average of 17 months. Three cases had a clear history of trauma. All patients had external radial deviation deformity and limited movement of the ulnar deviation, and the ulnar impact pain was significant during ulnar deviation movement; 9 patients had limited wrist joint supination movement, and the supination movement was normal. In the first stage, ulnar osteotomy and shortening combined with external fixator were used to correct wrist deformity in 13 patients. After operation, bone transfer was performed 6 times per day, with adjustments made every 4 hours, which was 1 mm per day. After the osteotomy was in place, the ulnar plate internal fixation was performed to reconstruct the ulnar stability in the second stage. The Cooney wrist joint score was used to assess the pain, function, range of motion, flexion and extension range of motion, and grip strength of the wrist joint before operation and before the removal of internal fixator. The subjective feeling and appearance satisfaction of patients were recorded. RESULTS: After the second-stage operation, all the 13 patients were followed up 10-22 months, with an average of 15 months. The deformity of wrist joint disappeared after operation, and the flexion, extension, and ulnar deviation were basically normal. There was no complication such as ulnar impingement sign, nonunion or infection. Wrist function, pain, and range of motion were significantly improved after operation, except for 1 patient who had no significant improvement in rotation and pain. The ulnar internal fixator was removed at 10-18 months after the second-stage operation. The scores of pain, function, range of motion, flexion and extension range of motion, and grip strength in the Cooney wrist score before removal of internal fixator significantly improved when compared with those before operation ( P<0.05). Subjective and appearance satisfaction of patients were excellent in 9 cases, good in 3 cases, and fair in 1 case. CONCLUSION Ulnar osteotomy and shortening with sequential plate internal fixation for correction of Madelung deformity, with mild postoperative pain, can effectively avoid bone nonunion, improve wrist joint function, and have significant effectiveness.
Male ; Female ; Humans ; Adolescent ; Retrospective Studies ; Ulna/surgery* ; Osteochondrodysplasias ; Radius Fractures/surgery* ; Wrist Joint/surgery* ; Osteotomy ; Range of Motion, Articular ; Treatment Outcome

To unravel the genetic mechanisms of disease and physiological traits, it requires comprehensive sequencing analysis of large sample size in Chinese populations. Here, we report the primary results of the Chinese Academy of Sciences Precision Medicine Initiative (CASPMI) project launched by the Chinese Academy of Sciences, including the de novo assembly of a northern Han reference genome (NH1.0) and whole genome analyses of 597 healthy people coming from most areas in China. Given the two existing reference genomes for Han Chinese (YH and HX1) were both from the south, we constructed NH1.0, a new reference genome from a northern individual, by combining the sequencing strategies of PacBio, 10× Genomics, and Bionano mapping. Using this integrated approach, we obtained an N50 scaffold size of 46.63 Mb for the NH1.0 genome and performed a comparative genome analysis of NH1.0 with YH and HX1. In order to generate a genomic variation map of Chinese populations, we performed the whole-genome sequencing of 597 participants and identified 24.85 million (M) single nucleotide variants (SNVs), 3.85 M small indels, and 106,382 structural variations. In the association analysis with collected phenotypes, we found that the T allele of rs1549293 in KAT8 significantly correlated with the waist circumference in northern Han males. Moreover, significant genetic diversity in MTHFR, TCN2, FADS1, and FADS2, which associate with circulating folate, vitamin B12, or lipid metabolism, was observed between northerners and southerners. Especially, for the homocysteine-increasing allele of rs1801133 (MTHFR 677T), we hypothesize that there exists a "comfort" zone for a high frequency of 677T between latitudes of 35-45 degree North. Taken together, our results provide a high-quality northern Han reference genome and novel population-specific data sets of genetic variants for use in the personalized and precision medicine.