OBJECTIVETo explore the minimally invasive treatment for fresh acromioclavicular dislocation and the distal clavicle fracture.

METHODSThirty skeletons of human shoulder were measured and compared, and the normal data on healthy people were measured with the help of ultrasound-guided. So the invasion point was located at the cross between subclavian axis and the line from coracoid tip to apophysis behind cone ligament node. From January 2001 to January 2010, 127 patients with fresh acromioclavicular dislocation and distal clavicle fracture were treated with minimally invasive internal fixation after locating the invasive point at the body surface. Among the patients, 97 patients were male and 30 patients were female, ranging in age from 19 to 56 years, with an average of 43 years. According to Rockwood classification, among 93 patients with fresh acromioclavicular dislocation, 67 patients were type III, 11 patients were type IV and 15 patients were type V. All the 34 patients with distal clavicle fractures were associated with coracoclavicular ligament broken. The duration from injury to operation ranged from 1 to 8 days. The therapeutic effects were evaluated by using the of shoulder scoring system, University of California (UCLA).

RESULTSAfter the minimally invasive treatment, all the patients had completely reduction at early time. One hundred and thirteen patients were followed up,and the duration ranged from 13 to 15 months,averaged 14 months. Nine patients had screw loose slightly within 30 days, but the reductions and functions were acceptable. Seven patients had complications of frozen shoulder and recovered in 6 months. The average UCLA shoulder score was (32.0 +/- 4.7), and 87 patients got an excellent result, 20 good and 6 fair.

CONCLUSIONThis minimally invasive treatment has advantages such as little trauma and low cost, which is worthy of clinical applications.

Acromioclavicular Joint ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Adult ; Clavicle ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Female ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Joint Dislocations ; diagnostic imaging ; physiopathology ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult

External snapping hip(ESH) is a vague term used to describe palpable or auditory snapping with hip movements with or without pain. The pathogenesis of ESH is related to the specific anatomical structure and friction factor. The clinical symptom is auditory snapping during activities, physical examination, X-ray, magnetic resonance imaging(MRI), dynamic ultrasound and other imaging techniques can be used to diagnose. Conservative medical management includes rest, avoidance of aggravating activities, and antiinflammatory medications. Treatment Patients with mild symptoms can achieve good results by medication, rest and physiotherapy. Surgical treatment for patients with ineffective conservative treatment was performed. All kinds of open surgery method can achieve good clinical curative effect, arthroscopic surgery is gradually been promoted due to small trauma, less complications. Besides, there are some reports that traditional treatments such as massage, acupuncture and acupotomology have achieved good clinical results, which deserve further study and promotion.

Background and Aims:Currently,surgery remains the primary treatment for colorectal cancer,while neoadjuvant therapy can transform initially unresectable lesions into resectable ones,improving patient prognosis.Bevacizumab combined with chemotherapy has shown promising efficacy for advanced metastatic colorectal cancer;however,the routine use of bevacizumab in neoadjuvant therapy for potentially resectable metastatic colorectal cancer patients remains controversial.Therefore,this study was performed to investigate the efficacy and safety of bevacizumab combined neoadjuvant therapy in patients with locally advanced rectal cancer(LARC). Methods:The clinical data of LARC patients who received bevacizumab-combined neoadjuvant therapy in the Department of Colorectal and Gastrointestinal Oncology,Jilin Cancer Hospital,from 2021 to 2022,were retrospectively analyzed. Results:A total of 45 patients were included,of whom 26 received the XELOX(oxaliplatin combined with capecitabine)+bevacizumab neoadjuvant regimen(chemotherapy plus bevacizumab group),and 19 received radiotherapy concurrent with XELOX and sequential bevacizumab neoadjuvant treatment(chemoradiotherapy plus bevacizumab group).Preoperative imaging evaluations showed tumor response rates of 84.61％and 94.74％,respectively,with a disease control rate of 100.0％in both groups.The CEA and CA19-9 levels significantly decreased compared to their pre-treatment levels in both groups(both P＜0.05).In the chemotherapy plus bevacizumab group,all patients underwent Dixion resection with D2 lymphadenectomy,with 10 patients receiving preventive ileostomy.Postoperative pathology showed an average of 18.3 lymph nodes removed,with 2.1 metastatic nodes;tumor regression grade(TRG)was 0 in 2 cases(7.69％),1 in 8 cases(30.77％),2 in 10 cases(38.46％),and 3 in 6 cases(23.08％).In the chemoradiotherapy plus bevacizumab group,15 patients underwent Dixion resection with D2 lymphadenectomy,2 patients underwent Miles surgery,1 patient was unable to undergo surgery due to severe pelvic adhesions,and another was unable to have resection due to pelvic floor adhesions found during surgery.Preventive ileostomy was performed in all 15 patients who had Dixion surgery.Postoperative pathology showed an average of 18.5 lymph nodes removed,with 1.6 metastatic nodes;TRG was 0 in 2 cases(10.53％),1 in 7 cases(36.84％),2 in 6 cases(31.58％),and 3 in 2 cases(10.53％).Surgical specimens in both groups showed negative proximal and distal margins,with no tumor residuals.A total of 55 neoadjuvant therapy-related adverse events occurred,all graded 1-2,without affecting subsequent treatment. Conclusion:For LARC patients,bevacizumab-combined neoadjuvant therapy is safe and effective.Bevacizumab combined with chemotherapy can be selected,with radiotherapy as an option based on tumor location,to increase the probability of radical resection and sphincter-preserving opportunities.

This study was purposed to investigate the reversal effect of gambogic acid (GA) on multidrug resistance of K562/A02 cells and its mechanism. The IC(50) (half maximal inhibitory concentration) of adriamycin (ADM) was evaluated by MTT. Cell apoptosis was detected by flow cytometry. Morphological changes of K562/A02 cells were observed by fluorescent microscopy with DAPI staining. The expressions of Survivin and P-gp were determined by Western blot. The results showed that the IC(50) of ADM on K562 and K562/A02 cell proliferation were (1.42 ± 0.07) µg/ml and (28.42 ± 1.40) µg/ml respectively. GA ≤ 0.0625 µmol/L had no inhibitory effect on proliferation of K562 and K562/A02. 0.0625 µmol/L GA could enhance the sensitivity of K562/A02 cells to ADM (P < 0.05) and the reversal multiples was 1.53. The apoptotic rate was raised after treating with ADM combined with 0.0625 µmol/L GA for 48 h (P < 0.05). Morphological differences were typical and obvious between cells of control and treated groups under fluorescence microscopy using DAPI staining. After treating K562/A02 cells with ADM combined with 0.0625 µmol/L GA for 48 h, the expressions of Survivin and P-gp were down-regulated at protein levels. It is concluded that GA can enhance the sensitivity of K562/A02 cells to ADM, which may be related to increasing cell apoptosis and down-regulating expressions of Survivin and P-gp.
Apoptosis ; drug effects ; Doxorubicin ; pharmacology ; Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Gene Expression Regulation, Leukemic ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; K562 Cells ; Substance P ; metabolism ; Xanthones ; pharmacology

Mannitol-calcium chloride metal organic framework (MOF) cocrystal significantly improved the tabletability of β-mannitol and could be developed as a new tablet filler. However, mannitol monomer was found in the product during the scale-up production of the excipient, which significantly affected the functional properties of the excipient. In this study, we intend to quantify the multi-component eutectic system of mannitol-calcium chloride. In this experiment, the MOF cocrystal excipient mannitol-calcium chloride cocrystal was used as the model compound, and infrared spectrum was collected. Based on partial least squares regression (PLSR) method, the abnormal bands were removed and the spectrum was preprocessed by normalization. The quantitative correction model of mannitol-calcium chloride MOF cocrystal content in cocrystal excipients was established and compared by two different variable screening methods, genetic algorithm (GA) and competitive adaptive reweighting algorithm (CARS). Two different variable screening methods, GA method and CARS method, were used to screen out 160 and 14 variables, respectively. The mannitol-calcium chloride cocrystal model established by CARS-PLSR method had the best performance, and the average relative error (MRE) and corrected root mean square error (RMSEC) of the model were 0.008 8 and 0.892 5, respectively, the determination coefficient (R²) of the model was increased from 0.978 3 to 0.994 4. The quantitative method of eutectic system established in this study has high prediction accuracy, fast detection speed and good stability, which is of great significance for optimizing the preparation process conditions and quality control methods of such eutectic excipients.

This study focuses on the microbial quality control of the Chinese herbal decoction pieces. In view of the shortcomings of traditional culture methods such as slow detection speed and inability to detect unculturable microorganisms, a new method based on ATP bioluminescence technology combined with statistical analysis methods was established to rapidly predict and quantitatively detect the total aerobic microbial count (TAMC) and total yeast and mold count (TYMC) contaminated Bupleurum chinense DC. decoction pieces. Based on the optimized ATP bioluminesence detection system, accurate detection of pure bacterial solution of Escherichia coli, Bacillus subtilis and Staphylococcus aureus can be achieved, with detection limits of 47.86, 89.13 and 1 862.09 CFU·mL^-1, respectively. The detection time was 6.5 h, and the detection cost was as low as 2 yuan/time. The upper and lower warning limits of TAMC were determined by the misjudgment rates of 10% and 20%, respectively. And the warning limit of TYMC was determined by the misjudgment rate of 20%. The proposed crossing method could quickly predict the amount of microbial contamination in Bupleurum chinense DC. decoction pieces. The constructed partial least squares regression (PLSR) model could accurately quantify the quantity of microbial contamination in Bupleurum chinense DC. decoction pieces. The optimal PLSR prediction model for TAMC had a correction coefficient (R²) of 0.826, a root mean square error of correction set (RMSE_E) of 0.468 and a root mean square error of cross-validation set (RMSE_CV) of 0.465. The R², RMSE_E and RMSE_CV in the prediction model of TYMC were 0.778, 0.543 and 0.541, respectively. The aim of this study is to establish a kind of rapid detection method and prediction models for the microbial limit of traditional Chinese medicine and Chinese herbal decoction pieces, and to provide a more convenient and sensitive detection technology for the microbial quality process control of traditional Chinese medicine products.

A new method for qualitative and quantitative analysis of Rhodobryum giganteum by using the nonlinear oscillating chemical was established for improving the quality control standard of R. giganteum. Its potential(E)/time(t) curve was recorded by electrochemical workstation in the oscillation reaction system of BrO~-_3-Ce(SO_4)_2-H_2SO_4-malonic acid/tartaric acid. The nonlinear oscillating chemical fingerprints were investigated for repeatability, and it was found that the RSD values of the four characteristic parameters of R. giganteum were less than 4.1%, indicating a good repeatability and high precision of this experiment. After optimizing the experimental parameters such as particle size, rotation speed and temperature, a new method based on nonlinear oscillating chemical was used for qualitative and quantitative analysis of R. giganteum. The results showed that there was a good linear relationship between the induction time/the period of oscillation and the dosage of herbs(0.1-1.1 g), with the relative coefficients of 0.978 and 0.975, respectively. Besides, the highest potential showed a nonlinear relationship with the dosage of herbs, with the relative coefficient of 0.999. This method was also used to discriminate the R. giganteum and R. roseum. They were similar in appearance, but their fingerprints were quite different. Independent sample t test results showed that there were significant differences in the oscillation time, the maximum amplitude and the induction time, providing a basis for the identification of the basic sources of Herba Rhodobryi Rasei.
Quality Control

Pathogenic bacterial infection is one of the main clinical symptoms. Antibiotics are widely used in clinical practice to inhibit or kill the bacteria， fungi and other pathogenic microorganisms. However， with the massive use of antibiotics， drug-resistant strains continue to appear that make the antibacterial situation is becoming increasingly severe. Due to the advantages of multiple targets， multiple pathways and multiple components， traditional Chinese medicine （TCM） have gradually attracted more attention and were used in antibacterial treatment. However， some antimicrobial TCM have problems such as low solubility， poor stability， and low bioavailability. Improving and enhancing the antibacterial activity of TCM through preparation technology is one of the effective solutions. Based on this， two aspects of unilateral antibacterial TCM preparation technology and combination antibacterial preparation technology are introduced， including inclusion technology， nanotechnology， electrospinning， 3D printing and others. Distinctive features and specific application effects of these preparation technologies are explained firstly， and then their advantages and disadvantages are compared and analyzed. The review can be a useful reference for improving the antibacterial activity of TCM.

Oscillating chemical fingerprint is a nonlinear dynamic fingerprint technology that reflects the overall redox activity of the entire system based on potential-time changes in multi-stage chemical reactions. This article summarizes the application of oscillating chemical fingerprint technology combined with mathematical analysis method in the qualitative and quantitative analysis of traditional Chinese medicine and food in recent years, including similarity analysis, principal component analysis, cluster analysis and other qua-litative analysis methods, as well as linear, logarithmic, exponential, polynomial, multivariate analysis and other quantitative analysis methods, so as to provide meaningful information for further quality control analysis of the oscillation chemical fingerprint technology in the field of traditional Chinese medicine and food.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Food ; Medicine, Chinese Traditional ; Principal Component Analysis ; Quality Control

Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.
Adult ; Humans ; Adolescent ; Imatinib Mesylate/adverse effects* ; Incidence ; Antineoplastic Agents/adverse effects* ; Retrospective Studies ; Pyrimidines/adverse effects* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy* ; Treatment Outcome ; Benzamides/adverse effects* ; Leukemia, Myeloid, Chronic-Phase/drug therapy* ; Aminopyridines/therapeutic use* ; Protein Kinase Inhibitors/therapeutic use*