BACKGROUND:There is a lack of evidence about the application of extracorporeal shock wave therapy (ESVTr) in frozen shoulder contracture syndrome.OBJECTIVE:To systematically assess the effectiveness of EST for frozen shoulder.METHODS:A computer-based online search of PubMed,ScienceDirect,The Cochrane Library,Embase,Web of knowledge,CNKI,WanFang and CqVip databases was performed for articles related to ESWT for frozen shoulder published before May 10,2016.Randomized controlled trials or randomized controlled crossover trials were screened.The Meta-analysis was conducted using RevMan 5.0 software,and publication bias was assessed by Berg and Egger tests on Stata1 1.0 software.The continuous variables were expressed as standard mean difference (SMD) and 95％ confidence interval (CI),and binary variables were expressed as odds ratio (OR) and 95％ Cl.RESULTS AND CONCLUSION:Eleven trials were enrolled involving 816 participants.ESWT could effectively alleviate shoulder pain (P ＜ 0.05,/2=54％).When excluded the trials of which control groups were medical interventions,the direction of the outcome did not change.ESVVT was beneficial for the participants in terms of range of motion except extension,the changes in shoulder flexion (P ＜ 0.05,/2=28％),shoulder abduction (P ＜ 0.000 01,/2=17％),shoulder internal rotation (P ＜ 0.05,/2=0％),shoulder external rotation (P ＜ 0.05,/2=43％).However,there is no evidence of the effectiveness of ESWT versus control (conventional therapy) for improving the range of shoulder extension.ESWT could increase the efficiency of treating frozen shoulder (P ＜ 0.05,/2=0.0％) and efficacy of curing frozen shoulder (P ＜ 0.05,/2=0.0％) compared with other interventions,and with no significant difference in the drop rate.These results indicate that ESWT can effectively alleviate the pain of frozen shoulder,expand the range of shoulder flexion,abduction,internal and external rotation,as well as improve the therapeutic efficiency and cure rate in the treatment of frozen shoulder.

Objective To study the developmental changes of glutamic acid decarboxylase-67 (GAD-67, a GABA synthetic enzyme) in normal and hypoxic ischemic (HI) brain. Methods C57/BL6 mice on postnatal day (P) 5, 9, 21and 60, corresponding developmentally to premature, term, juvenile and adult human brain were investigated by using both Western blot and immunohistochemistry methods either in normal condition or after hypoxic ischemic insult. Results The immunoreactivity of GAD-67 was up regulated with brain development and significant difference was seen between mature (P21, P60) and immature (P5, P9) brain. GAD-67 immunoreactivity decreased in the ipsilateral hemisphere in all the ages after hypoxia ischemia (HI) insult, but, significant decrease was only seen in the immature brain. Double labeling of GAD-67 and cell death marker, TUNEL, in the cortex at 8h post-HI in the P9 mice showed that (15.6 +/- 7.0)%TUNEL positive cells were GAD-67 positive which was higher than that of P60 mice. Conclusion These data suggest that GABAergic neurons in immature brain were more vulnerable to HI insult than that of mature brain.

Objective·To explore the correlation of etomidate dose and bispectral index (BIS) in children with congenital heart disease shunting from left to right during anesthesia induction. Methods·After general anesthesia induction to 24 children with congenital heart disease shunting from left to right, sevoflurane inhaling was stopped in order to make the BIS value gradually return to 80. Intravenous injection of etomidate was sustained by 0.3 mg/(kg·min) until the BIS value reached 40. The heart rate (HR), arterial blood pressure (ABP) and central venous pressure (CVP) of the patients were recorded when BIS value was 80, 70, 60, 50,and 40, respectively.The correlation of etomidate dose and BIS value in the children during anesthesia induction was analyzed. Results·There were no significant hemodynamic changes when the BIS value were from 80 to 40. The amount of etomidate was highly negatively correlated with the BIS value (r=-0.769, P<0.01), the average dose of etomidate in children under 2 years of age was significantly higher than that in children over 2 years old (P=0.034). Conclusion·The etomidate dose is highly negatively correlated with the BIS value. Etomidate has less influence on hemodynamic parameters of children with congenital heart disease shunting from left to right. The BIS value may have relationship with patients'age.

This study was aimed to investigate 1 case of rare RHD845A/1227A genotype pedigree and analyse their characters. The D antigen was determined by saline method and indirect anti-globulin test (IAT), the RHD1227A, RHD845A alleles and RHD zygosity were detected by PCR-SSP assay, the RHD coding region was analysed by gene sequencing. The results showed that the serological result of RH(D) antigen was found to be negative in one sample by saline assay, but positive by IAT. The analysis of RHD gene sequence indicated that RHD genes in the 845th and 1227th location were G/A base heterozygosis, it was speculated that the individual genotype may be RHD845A/1227A. Family investigation demonstrated the proband's father was RhD negative, his mother was RhD positive, the results of PCR-SSP assay showed that his father carried the RHD1227A alleles, whose genotype was RHD1227A/RHD(-), however, his mother carried RHD845A alleles, her genotype was RHD845A/RHD(+), which proved that the proband's genotype was RHD845A/1227A, inheriting the RHD1227A and RHD845A alleles from his father and mother respectively. It is concluded that 1 case of rare RHD845A/1227A genotype is found, further study proved that this rare heterozygosis come from the hereditary of RHD845A and RHD1227A alleles, rather than the formation of individual gene mutation.
Alleles ; Female ; Genotype ; Humans ; Male ; Pedigree ; Rh-Hr Blood-Group System ; genetics ; Young Adult

OBJECTIVETo construct a breast cancer gene-drug network model for extracting and predicting the correlations between breast cancer-related genes and drugs.

METHODSWe developed an algorithm based on the ABC principle and the association rules to obtain the correlations between the biological entities. For breast cancer, we constructed 3 different correlations (gene-gene, drug-drug and gene-drug) and used the R language to implement the associated network model. The reliability of the algorithm was verified by ROC curve.

RESULTSWe identified 185 breast cancer-associated genes and 98 associations between them, 97 drugs and 170 associations between them. The breast cancer genes-drugs network contained 127 genes and 77 drugs with 384 associations between them.

CONCLUSIONSWe identified a large number of different correlations between the breast cancer-related genes and drugs and close correlations between some biological entity pairs that have not yet been reported, which may provide a new strategy for experimental design for testing personalized breast cancer treatment.

Algorithms ; Antineoplastic Agents ; pharmacology ; Breast Neoplasms ; genetics ; Female ; Gene Regulatory Networks ; Genes, Neoplasm ; Humans ; ROC Curve ; Reproducibility of Results

OBJECTIVETo investigate the effect of bear bile powder and ursodesxy cholic acid (UDCA) on peripheral blood, bone marrow megakaryocyte and immune organs in mouse model with thrombocytopenia, so as to provide a reference for studying the curative effects of bear bile powder and its succedaneum on thrombocytopenic purpura (TP).

METHODSThe mouse model with thrombocytopenia indued by cytosine arabinoside (Ara-C) was established, a total of 70 mice were randomly divided into normal group, model group, prednisone group, bear bile (middle and high dose) powder group and UDCA (middle and high dose) group. From the first day of making model mice in the each group, 0.4 ml/(20 g·d) corresponding drug was administered by infusion. At day 10 after treatment the peripheral blood, spleen and thymus organ index, the number of bone marrow megakaryocyte in each group were compared.

RESULTScompared with the normal group, the Plt, WBC and megakaryocyte counts in model group decreased, the spleen index increased obviously (P<0.05), but the WBC count returned to normal by 10 days; after treatment, compared with model group, the Plt, WBC and megakaryocyte counts of treated groups increased, spleen index decreased significantly (P<0.05), but the WBC count in prednisone group decreased, which in bear bile powder (high) group and UDCA (high) group were particularly significant.

CONCLUSIONThe bear bile powder and UDCA have been confirmed to have therapeutical effect on thrombocytopenia models induced by Ara-C, UDCA can substitute bear bile powder as a treatment drug for thrombocytopenic purpura.

Animals ; Bile ; Bone Marrow ; Bone Marrow Cells ; Cytarabine ; Disease Models, Animal ; Megakaryocytes ; Mice ; Spleen ; Thrombocytopenia

Objective:To explore the value of lumbar plexus-sciatic nerve block combined with low-dose Remimazolam in elderly proximal femoral nail anti-rotation(PFNA)surgery.Methods:60 elderly patients with PFNA surgery were treated from September 2021 to March 2022 in our hospital.They were randomly divided into Propofol group receiving intravenous general anesthesia with laryngeal mask combined with Propofol(control group, n=30)and Remimazolam group with lumbar plexus-sciatic nerve block with laryngeal mask combined with low-dose Remimazolam anesthesia(experimental group, n=30). Mean arterial pressure(MAP)at different time points, heart rate, awakening quality[laryngeal mask removal time], vigilance / sedative observation(OAA / S)score at 15 min after surgery, observation time and various adverse reactions in anesthesia recovery room(in a postanaesthesia care unit, PACU), Montreal cognitive function scale(MoCA)1 day after operation, visual analog score(VAS)at different time points were compared between the two groups.Results:The levels of MAP and HR at the moments of T1, T2, T3, and T4 were lower in the observation group than in the control group(all P<0.05). The time of laryngeal mask removal was shorter in the observation group than in the control group[(8.7±1.3)min and(12.3±1.4)min, t=7.09, P<0.001]. The OAA/S scale value at 15 min after surgery was higher in the observation group than in the control group[(4.6±0.3)and(4.1±0.5), t=4.841, P<0.001]. The incidence of adverse reactions was lower in the observation group than in the control group(3.3% and 20%, χ2=4.043, P=0.044). Visual analogue scale(VAS)value at 3, 6 and 9 hour after surgery were lower in the observation group than in the control group(all P<0.05). The MoCA scores at 6 and 12 hours after operation were higher in the observation group than in the control group( P<0.05). Conclusions:Lumbar plexus-sciatic nerve block combined with low-dose Remimazolam in elderly PFNA surgery is effective and safe, which can reduce the intraoperative hemodynamic fluctuations, optimize the patient's recovery quality, facilitate the postoperative cognitive function recovery, reduce the various adverse reactions, and provide the good analgesic effect within 12 hours after operation.

OBJECTIVETo investigate the irregular antibody production and its relationship with Rh factor genotypes and the loci of thalassemia gene mutations for the β-thalassemic children with long-term transfusion, so as provide experimental basis for clinical safe and effective transfusions for thalassemic children.

METHODSThe peripheral blood from 246 children with β-thalassemia was collected in our hospital; the extraction of genomic DNA and Rh factor (C/c, E/e) genotypes were assayed by PCR-SSP method, the irregular antibodies were screened and identified by serological method, the genotypes for thalassemia and gene mutations were analysed by PCR-RD method.

RESULTSThe genotypes of Rh factors classified by PCR- SSP in the 246 cases of β-thalassemia children were as follws: Ce/Ce (143/246, 58.1%), CE/ce (59/246, 24%), cE/cE (14/24, 5.7%), Ce/ce (12/246, 4.9%); The positive rate of irregular antibody was 7.7% (19/246), including anti-E (7/19), anti-c (5/19), anti-C (2/19), anti-E and anti-c (2/19), anti-e (1/19), anti-D (2/19); Of the 19 cases with positive irregular antibody, the genotypings of Rh factor were: Ce/Ce (11/19), CE/ce (2/19), cE/cE (2/19), Ce/ce (2/19), cE/ce (2/19); the gene mutations location of thalassemia for 19 cases with positive irregular antibody: CD41-42M (13/19), CD71-72M (2/19), IVS-II-654M (3/19), -28M (1/19).

CONCLUSIONThe irregular antibody production for β-thalassemic children with long-term transfusion may have some relevance with Rh factor genotypes and thalassemia genetic mutations. This study possesses a certain significance for effective prevention of RBC alloimmune response of β-thalassemia children and improvement of efficacy and safety of clinical transfasion blood.

Blood Group Antigens ; Blood Transfusion ; Child ; Genotype ; Histocompatibility ; Humans ; Mutation ; Polymerase Chain Reaction ; Rh-Hr Blood-Group System ; Rho(D) Immune Globulin ; beta-Thalassemia

OBJECTIVETo explore the clinicopathologic features, differential diagnosis and therapy of myeloid sarcoma.

METHODSThe clinical data including clinical manifestations, laboratorial tests, histopathologicical examination, immunohistochemistry and clinical prognosis of 10 patients with myeloid sarcoma were analyzed retrospectively. Among 10 patients, 5 male and 5 female, aged 23 to 71 years old (median = 36 years).

RESULTS2 cases of myeloid sarcoma were secondary from chronic myeloid leukemia, and 1 cases of myeloid sarcoma occurred after the allogeneic hematopoietic stem cell transplantation due to acute myeloid leukemia, and the others lacked the anamnesis of malignancies. The neoplasms occurred at bone, brain, skin, breast, epididymis, uterine cervix, small intestine, ovary and lymph nodes. Microscopically, the tumor cells were round or oval, which infiltrated diffusely or arranged in single-file. The cytoplasm was scarce and immature eosinophils were scattered. The nuclei were round, oval or focally irregular, and the mitosis was visible. The neoplasms were positive for MPO, CD34, CD43, CD45, CD99 and CD117 by immunohistochemical staining. 4 patients progressed into acute myeloid leukemia from 2 to 10 months after the diagnosis of myeloid sarcoma. All of them achieved complete remission after inductive chemotherapy, but 3 patients relapsed from 3 to 12 months after remission and only survived for 14 to 23 months. 4 patients were treated by using chemotherapy before bone marrow abnormality, and with the disease-free survival for 1 to 48 months.

CONCLUSIONMyeloid sarcoma needs to be distinguished from lymphoblastic lymphoma, Burkitt's lymphoma, blastic plasmacytoid dendritic cell neoplasms and so on. The diagnosis and differential diagnosis of myeloid sarcoma are dependent on the pathological and immunohisto-chemical features. The chemotherapy and allogeneic hematopoietic stem cell transplantation of acute myeloid leukemia are the main methods for treatment of myeloid sarcoma.

This study was purposed to compare the immunophenotypic and clinical characteristics of NPM1 mutated acute myeloid leukemia with a normal karyotype under the similar constituent ratio of FAB subtypes. Immunophenotyping and NPM1 gene mutation type-A,B and D and other leukemic related fusion genes were detected by multiparameter flow cytometry and real time RT-PCR or PCR, respectively. 77 AML patients with a normal karyotype (NK) and mutated NPM1 gene (NPM1m(+)AML) detected by immunophenotyping assay were included in this study. 55 cases without NPM1 mutation (NPM1m(-)AML) and with normal karyotype were served as negative control. The results showed that there was significant difference between NPM1m(+)AML and NPM1m(-)AML in terms of sex, white blood count, platelet counts, blast, WT1 expression level, FLT3-ITD mutation positive rate and response to treatment. The characteristic immunophenotype is lower expression of early differentiation-associated antigens (CD34, HLA-DR, CD117, CD38), lymphocytic antigens (CD7, CD4, CD19, CD2) and higher expression of CD33 and CD123 (P < 0.05). When above features was further analyzed between the M1/2 and M4/5 subgroups in NPM1m(+)AML patients, the M1/2 cases retained a higher frequency in women and a higher WT1 expression level (P < 0.05) . Monocytic differentiation-associated antigens including HLA-DR and lymphocytic antigens CD7 were higher expressed and CD117 was lower expressed in M4/5 subgroup (P < 0.05). It is concluded that under condition of similar constituent ratio of M1/2 and M4/5 subtype and normal karyotype, NPM1m(+)AML patients have higher WT1 expression level and better response to treatment. The major immunophenotype features of NPM1m(+)AML patients are lower expression of early differentiation antigens and lymphoid lineage antigens and higher expression of CD33 and CD123. Monocytic differentiation-associated antigens only higher are expressed in M4/5 cases when compared with M1/2 cases within NPM1m(+) AML patients.
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Flow Cytometry ; Humans ; Immunophenotyping ; Karyotype ; Leukemia, Myeloid, Acute ; diagnosis ; genetics ; immunology ; Male ; Middle Aged ; Mutation ; Nuclear Proteins ; genetics ; Young Adult