Crystal structures of chemical drugs has been being investigated widely. But few attention has been paid to polymorphs-phenomena of active ingredients from Traditional Chinese Medicine(TCM). Taking anhydrous dehydroandrographolide and hydrousprim-O-glucosylcimifugin as example, differences between TCM reference substances (RSs) with different crystal structures were discussed by using microscopy, melting point determination, differential thermal analysis (DTA) and infrared (IR) methods. The results showed that different crystal structures could lead to change of melting points, thermal behaviors and IR spectrum. It's indicated that polymorphs may be considered if different physicochemical properties were obtained when applying TCM RS. Differences of chemical properties of active ingredients from TCM with different crystal structures need further investigation.
Crystallization ; Differential Thermal Analysis ; methods ; standards ; Drugs, Chinese Herbal ; chemistry ; standards ; Medicine, Chinese Traditional ; Molecular Structure ; Reference Standards ; Spectrophotometry, Infrared ; methods ; standards ; Transition Temperature

OBJECTIVETo evaluate the value of human fatty acid binding protein (h-FABP) in predicting myocardial ischemia and injury in the perioperative period of cardiac surgery, we observed the dynamic changes of h-FABP in perioperative period of patients underwent coronary artery bypass grafting and ventricular septal defects repairing surgery, and evaluated the relationship of h-FABP and ischemia modified albumin (IMA), CK-MB, cTnI.

METHODSPatients underwent coronary artery bypass grafting (n=30) and ventricular septal defect repairing (n=30) surgery between February 2008 and December 2008 were included in this study. Venous blood sample was obtained at preoperative, aortic clamping, aortic unclamping of 10 min, 2 h, 6 h, 12 h, 24 h for the measurements of h-FABP, IMA, cTnI and CK-MB.

RESULTSh-FABP and IMA changed in the same way at various examined time points, h-FABP changes also paralleled cTnI and CK-MB changes, h-FABP peaked early during myocardial ischemia and injury and returned to baseline level at 2 h post myocardial ischemia and injury. Linear correlation analysis showed that the peak value of h-FABP was positively correlated with IMA, CK-MB and cTnI in both CABG group (r = 0.948, 0.964 and 0.961, P < 0.05) and in the VSD group (r = 0.986, 0.978 and 0.957).

CONCLUSIONSh-FABP is an early diagnostic parameter reflecting perioperative myocardial ischemia and injury in cardiac surgery. Quantitative h-FABP monitoring could predict the severity of myocardial ischemia and injury early during cardiac surgery.

Aged ; Albumins ; analysis ; Biomarkers ; blood ; Creatine Kinase, MB Form ; blood ; Fatty Acid-Binding Proteins ; blood ; Humans ; Middle Aged ; Myocardial Ischemia ; diagnosis ; surgery ; Myocardium ; metabolism ; Perioperative Period ; Predictive Value of Tests ; Thoracic Surgery ; Troponin I ; blood

Objective To develop a minimally invasive operating technique for the treatment of hypertensive thalamic hemorrhage. Methods The clinical data of 15 patients with hypertensive thalamic hemorrhage performed neuroendoscope-assisted micro-invasive surgical treatment in our hospitals from July 2007 to June 2010 were retrospectively analyzed; their treatment efficacy were also concluded. Results The mean operation time of these patients was (1.5±0.4) h and the amount of blood loss was 30-40 mL; the mean clearance rate of hematoma in the thalamus was (86.2 ±7.9)percentage. Patients were followed up and evaluated by Glasgow outcome scale for at least 3 months.Three patients (21.4%) showed good recovery, 4 (28.6%) moderate disability, 4(28.6%) severe disability and 2 (14.3%) vegetative survival; 1 patient (7.1%) died. Conclusion Neuroendoscope-assisted micro-invasive surgical treatment is a fast and minimally invasive operating technique with little blood loss in the treatment of hypertensive thalamic hemorrhage.

Objective To develop a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with hypertensive intracerebral hemorrhage (HICH).Methods Eighteen patients with HICH, admitted to our hospital from June 2008 to August 2010, were performed endoscopic minimally invasive surgery; CT three-dimensional reconstruction was employed to locate the intracerebral hematoma and select the appropriate endoscopic approach before the endoscopic surgery.The clinical data and treatmem efficacy were analyzed.Results According to the results of CT three-dimensional reconstruction, our neurosurgeons could design the best endoscopic approach; the three-dimensional relationship between intracerebral hematoma and scalp markers was shown directly and accurate positioning of the location of drilling was achieved; therefore, the time for preoperative preparation, anesthesia and operation was shortened. The mean operating time of these 18 patients was about 1.5 h; the volume of blood loss was only 30-40 mL; and the evacuation ratio was about 89.2%.After the elimination of hematoma, the brain tissues were flabby, so decompressive craniectomy was not needed. Conclusion CT three-dimensional reconstruction is a simple, fast and accurate preoperative planning method for endoscopic surgery of patients with HICH.

Objective To develop a three-dimensional visual neurosurgical tool enjoying simple,fast and accurate characteristics at moderate cost for visual positioning and imaging information storage and processing. Methods Seven patients with epidural hematoma or depressed fracture resulted from severe craniocerebral trauma, 8 patients with hypophysoma, 5 with glioma and 3 with meningeoma were chosen in our study; CT three-dimensional reconstruction of their imaging data were performed and used for preoperative planning before surgery assisted by neurosurgical station.According to CT three-dimensional reconstruction results, appropriate neurosurgical approach was planned and patients were treated by surgery. Results Neurosurgical station performed three-dimensional reconstruction could show three-dimensional quantitative relationship between the above lesions and anatomical landmarks directly,which could help direct positioning and designing the best-individualized approach to improve the surgical accuracy and efficacy. Neurosurgical station could improve the efficiency of scientific research and clinical work by managing,storing,editing and using the imaging and video of the patients. Conclusion Neurosurgical station, which can show three-dimensional quantitative relationship between the above lesions and anatomical landmarks directly, is a simple, fast and accurate preoperative planning and information processing tool for clinical neurosurgical practice.

OBJECTIVETo investigate the relationship between PPARdelta + 294T/C gene polymorphism and lipid profile, obesity and left ventricular hypertrophy (LVH) in patients with metabolic syndrome (MS).

METHODSThis study was conducted in 300 patients with MS and 174 patients with essential hypertension (EH) and 143 patients with type 2 diabetes mellitus (T2DM). MS was diagnosed according to 1999 WHO criteria. Fasting insulin (FINS), fasting blood glucose (FBG), plasma lipids levels were measured, LVH was examined by Doppler echocardiography. The PPARdelta + 294T/C gene polymorphism were analyzed using polymerase chain reaction and subsequently digested by BSLI restriction endonuclease.

RESULTSThe frequencies of the PPARdelta + 294T/C genotypes were not different among three groups. Compared with T2DM and EH, MS patients had significantly higher body mass index (BMI), plasma total cholesterol, TG and LDL-C levels (P < 0.01 or P < 0.05). LVM, LVMI and incidence rate of LVH were significantly higher in MS and EH patients than that in T2DM (P < 0.01). MS patients with CC genotype had significantly higher total cholesterol and LDL-C levels than those with TT and TC genotypes (total cholesterol in CC genotype: 6.13 +/- 1.86 mmol/L vs in TC genotype: 5.14 +/- 1.10 mmol/L, P < 0.05, and CC genotype: 6.13 +/- 1.86 mmol/L vs TT genotype: 4.99 +/- 1.42 mmol/L, P < 0.01; LDL-C in CC genotype: 3.82 +/- 1.52 mmol/L vs in TC genotype: 3.14 +/- 0.88 mmol/L, P < 0.05, and in CC genotype: 3.82 +/- 1.52 mmol/L vs in TT genotype: 2.90 +/- 0.87 mmol/L, P < 0.01). BMI and LVMI in MS patients with C allele carriers (CC + TC) were significantly higher than that of TT genotype (LVMI in CC + TC: 46 +/- 10 g/m(2.7) vs in TT: 44 +/- 10 g/m(2.7); BMI in CC + TC: 26 +/- 3 kg/m(2) vs in TT: 25 +/- 3 kg/m(2), P < 0.05).

CONCLUSIONSIt is indicated that PPARdelta + 294T/C gene polymorphism in subjects with MS may be involved in the occurrence of obesity and dyslipidemia. MS patients with C allele had a predominant LVH than subjects with TT genotype.

Aged ; Body Mass Index ; Diabetes Mellitus, Type 2 ; genetics ; physiopathology ; Female ; Genotype ; Humans ; Hypertrophy, Left Ventricular ; genetics ; physiopathology ; Lipids ; blood ; Male ; Metabolic Syndrome ; genetics ; physiopathology ; Middle Aged ; Obesity ; genetics ; physiopathology ; PPAR delta ; genetics ; Polymorphism, Single Nucleotide ; Ventricular Remodeling

Purpose of this study was to establish an effective method in vitro to proliferate natural killer T (NKT) cells from umbilical cord blood (UCB) and peripheral blood (PB), and to study their different phenotype. Mononuclear cells (MNC) from UCB and PB were cultured in the presence of IL-2 (100 U/ml), with or without alpha-Galcer. TCR Valpha24 Vbeta11 double positive natural killer T-cells (NKT cells) and their other phenotypes were determined by flow cytometry. The results showed that after expansion for 7 days, TCRValphabeta(+) NKT cells from UCB-MNCs increased by (8.74 +/- 4.37) x 10(2) times as much, but most of them did not express NK1.1 and its TCR Vbeta11(+) was higher than TCR Valpha24(+). After expansion for 14 days, TCR Valphabeta(+) NKT cells from PB-MNCs increased by (3.72 +/- 2.01) x 10(2) times, the expression of NK1.1 was high and its TCR Vbeta11(+) was almost equal to TCR Valpha24(+). It is concluded that human TCR Valpha24 Vbeta11 double positive NKT cells can expand by addition of alpha-Galcer. The proliferation efficiency in UCB-MNCs is greater than that in PB-MNCs. Most of the UCB-NKT is NK1.1(-), while the PB-NKT is NK1.1(+), a new subset of NKT cells.
Cell Proliferation ; Cells, Cultured ; Fetal Blood ; cytology ; Galactosylceramides ; pharmacology ; Humans ; Interleukin-2 ; pharmacology ; Killer Cells, Natural ; cytology ; drug effects ; immunology ; Leukocytes, Mononuclear ; cytology ; Phenotype ; T-Lymphocytes, Regulatory ; cytology ; drug effects ; immunology

Objective:To compare the clinical efficacy of transperitoneal robot assisted laparoscopic radical prostatectomy (RARP) versus extraperitoneal single port RARP.Methods:A retrospective analysis was perfoumed on 142 cases of RARP from July 2019 to June 2020 in Robotic Minimally Invasive Center of Sichuan Provincial People's Hospital, including 82 cases(Group A) , aged 70.0(65.6-78.0), undergoing transperitoneal RARP and 60 cases(Group B), aged 68.2 years old(60.1-79.2), undergoing extraperitoneal single port RARP. For group A, PSA was 12.9(5.6-64.0) ng/ml, with 26 cases of less than 10 ng/ml(31.7%), 40 cases of 10-20 ng/ml(48.8%), and 16 cases of more than 20 ng/ml(19.5%), the Gleason score was 7.2(6.0-10.0), with 14 cases(17.1%) of ≤6, 56 cases(68.3%) of 7, and 12 cases(14.6%) of ≥8, and the prostate volume was 61.3(29.0-112.0) ml. There were 49 cases with BMI≤25 kg/m 2, accounting for 59.8%, and 33 cases with BMI>25 kg/m 2, accounting for 40.2%. There were 17 cases(20.7%) of T 1, 44 cases(53.7%) of T 2 and 21 cases(25.6%) of T 3. The proportion of lymph node dissection was 17.1%, and 4 cases(4.9%)had a history of operation. For group B, the PSA was 12.2(1.0-42.6)ng/ml, with 20 cases (33.3%) of <10 ng/ml, 31 cases(51.7%)of 10-20 ng/ml, and 9 cases (15%) of >20 ng/ml. Gleason score was 7.1(6.0-9.0), with 12 cases (20.0%) of ≤6, 42 cases (70.0%) of 7, and 6 cases (10.0%)of ≥8. Prostate volume was 42.4(31.2-72.8)ml on average. There were 37 cases (61.7%) with BMI≤25 kg/m 2, and 23 cases (38.3%)with BMI >25 kg/m 2 . There were 17 cases(28.3%)of T 1, 32 cases(53.3%)of T 2 and 11 cases(18.3%)of T 3.The proportion of lymph node dissection was 11.7% and 4 cases (6.7%) had a history of operation.There was no statistically significant difference in term of age, PSA level, Gleason score, BMI, clinical stage, proportion of lymph node dissection or history of operation between the two groups( P>0.05), but there was statistically significant difference for prostate volume( P<0.05). All operations were performed by the same operator. Four different ways of bladder neck and urethral dissociation was selected according to the intraoperative conditions in Group A, include VIP style, T-shape incision style, VIP plus T-shape incision style or the style along the lateral side of the bladder neck. Small and single anterograde incision stripping of bladder neck was routinely performed in the Group B. Postoperative follow-up was performed to compare the operation time, intraoperative blood loss, bladder neck and urethral anastomosis time, postoperative hospital stay, postoperative exhaust time, postoperative complications, positive rate of surgical margin, indwelling time of urinary catheter, urinary continence satisfaction rate of immediately after operation, 3 months and 6 months after operation, wound healing and aesthetics. Results:All of the operations were successfully completed under robot-assisted laparoscopy, and there was no conversion to open surgery. The operation time was 56.0(45.0-112.0) min in the Group A and 65.4(55.5-96.8) min in the Group B, and there was no statistically significant difference( P>0.05). The intraoperative blood loss was 76.2(30.0-120.5) ml and 55.6(45.5-114.6) ml, respectively, and the difference was not statistically significant( P>0.05). The time of bladder neck urethral anastomosis was 18.9(12.6-25.6) min and 16.2(10.7-19.3) min, respectively, and the difference was not statistically significant( P>0.05). The postoperative hospital stay days were 9.3(8.0-16.0) d and 8.4(7.0-13.0) d, respectively, and the difference was not statistically significant( P>0.05). The postoperative exhaust time was 1.3(0.7-3.0) d and 3.4(2.0-7.0) d, respectively, and the difference was statistically significant( P<0.05). There was 1 case of anastomotic fistula with ureteral injury in Group A, and no serious complication in Group B, and the difference was not statistically significant( P>0.05). The number of positive surgical margin in the two groups was 13(15.9%)and 9(15.0%)respectively, and the difference was not statistically significant( P>0.05). The indwelling time of urinary catheter after operation was 9(7-21) d and 6(4-8) d, respectively, and the difference was statistically significant( P<0.05). The number of patients with satisfactory urinary continence immediately after surgery, 3 months and 6 months after surgery in the two groups were 8(9.8%), 51(62.2%), 62(75.6%) and 17(28.3%), 43(71.7%) and 54(90.0%), respectively. The differences were statistically significant( P<0.05). The total incision lengths in the two groups were 12.1(10.4-13.4) cm and 5.6(5.0-6.0) cm, respectively, and the difference was statistically significant( P<0.05). Conclusions:The extraperitoneal single port RARP is safe and feasible, and the postoperative effect is similar to that of transperitoneal RARP. It has the advantages of shorter recovery time, higher urinary continence satisfaction rate, neater and more beautiful incision. The long-term therapeutic effect needs further confirming by prospective study.

OBJECTIVE: To retrospectively assess the advantages of the modified Uhl technique in the treatment of Colles' fracture guided by the principles of Chinese osteosynthesis (CO) concept. METHODS: A retrospective study was conducted on 358 patients with Colles' fracture treated with the modified Uhl technique of closed reduction and percutaneous pin between January 2016 and June 2021. Out of these, 120 eligible cases were selected and categorized into two groups according to different surgical methods:the closed reduction and percutaneous pin group, and the open reduction group. Sixty-eight patients in the closed reduction and percutaneous pin group were treated with the modified Uhl technique, while fifty-two patients in the open reduction group were treated with open reduction and internal fixation using plates. The modified Sarmiento imaging score, Gartland-Werley wrist score, operation time, hospital stay, and treatment costs between the two groups were compared at a 6-month postoperative follow-up. RESULTS: There were no significant differences in terms of gender, age, affected side, injure factors, time of injury to surgery, Sarmiento imaging score, and Gartland-Werley wrist joint score (P>0.05). The closed reduction and percutaneous pin group exhibited an operation time of (35.88±14.11) minutes, hospitalization stay of (9.78±2.48) days, and treatment costs of (16 074.91±1 964.48) yuan, while the open reduction group demonstrated comparatively longer operation time of (65.48±14.26) minutes, hospitalization stay of (15.88±2.00) days, and treatment costs of (20 451.27±1 760.22) yuan (P<0.01). CONCLUSION The modified Uhl technique presents notable advantages in the management of Colles' fracture, including reliable fixation, less trauma, shorter operation time, less pain, shorter hospital stay, and cost-effectiveness. This technique exhibits promising potential for broader clinical application. However, it is important to note that the pin could potentially damage tendons, and in cases of Colles' fractures with osteoporosis and comminuted fragments, additional techniques may be required for reliable fixation.
Humans ; Retrospective Studies ; Colles' Fracture/surgery* ; Fracture Fixation, Internal ; Fractures, Comminuted ; Hospitalization

BACKGROUNDChronic dermal ulcers are also referred to as refractory ulcers. This study was conducted to elucidate the therapeutic effect of laser on chronic dermal ulcers and the induced expression of heat shock factor 1 (HSF1) and heat shock protein 70 (HSP70) in wound tissues.

METHODSSixty patients with 84 chronic dermal ulcers were randomly divided into traditional therapy and laser therapy groups. Laser treatment was performed in addition to traditional therapy in the laser therapy group. The treatment efficacy was evaluated after three weeks. Five tissue sections of healing wounds were randomly collected along with five normal skin sections as controls. HSP70-positive cells from HSP70 immunohistochemical staining were counted and the gray scale of positive cells was measured for statistical analysis. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting were performed to determine the mRNA and protein expressions of HSF1 and HSP70.

RESULTSThe cure rate of the wounds and the total efficacy in the laser therapy group were significantly higher than those in the traditional therapy group (P < 0.05, P < 0.01, respectively). Immunohistochemical staining revealed that the HSP70-positive cell count was significantly higher in laser therapy group than those in the traditional therapy group and controls (P < 0.01), and the gray scale of the cell signal was obviously lower than traditional therapy group and controls (P < 0.05). By contrast, the traditional therapy group and the control group were not significantly different. The RNA levels of HSF1 and HSP70 were higher in the laser therapy group by RT-PCR, but very low in normal skin and the traditional therapy group. The analysis on the gray scale of the Western blot bands indicated that the expression of HSF1 and HSP70 in the laser therapy group was significantly higher than in the traditional therapy group and the control group (P < 0.01), and the expression in the traditional therapy group was also higher than in the control group (P < 0.05).

CONCLUSIONLaser-aided therapy of chronic dermal ulcers plays a facilitating role in healing due to the mechanism of laser-activated endogenous heat shock protection in cells in wound surfaces.

Adult ; Aged ; Blotting, Western ; Chronic Disease ; DNA-Binding Proteins ; genetics ; metabolism ; Female ; Gene Expression ; HSP70 Heat-Shock Proteins ; genetics ; metabolism ; Humans ; Immunohistochemistry ; Laser Therapy ; methods ; Male ; Middle Aged ; Reverse Transcriptase Polymerase Chain Reaction ; Skin Ulcer ; genetics ; metabolism ; surgery ; Transcription Factors ; genetics ; metabolism