Humans ; Child ; Neurofibromatosis 1/drug therapy* ; Benzimidazoles/therapeutic use*

ObjectiveTo explore the guidance value of “treatment of disease in accordance with three conditions” theory in the prevention and treatment of corona virus disease 2019（COVID-19） based on the differences of syndromes and traditional Chinese medicine（TCM） treatments in COVID-19 patients from Xingtai Hospital of Chinese Medicine of Hebei province and Ruili Hospital of Chinese Medicine and Dai Medicine of Yunnan province and discuss its significance in the prevention and treatment of the unexpected acute infectious diseases. MethodDemographics data and clinical characteristics of COVID-19 patients from the two hospitals were collected retrospectively and analyzed by SPSS 18.0. The information on formulas was obtained from the hospital information system （HIS） of the two hospitals and analyzed by the big data intelligent processing and knowledge service system of Guangdong Hospital of Chinese Medicine for frequency statistics and association rules analysis. Heat map-hierarchical clustering analysis was used to explore the correlation between clinical characteristics and formulas. ResultA total of 175 patients with COVID-19 were included in this study. The 70 patients in Xingtai，dominated by young and middle-aged males，had clinical symptoms of fever， abnormal sweating，and fatigue. The main pathogenesis is stagnant cold-dampness in the exterior and impaired yin by depressed heat， with manifest cold， dampness， and deficiency syndromes. The therapeutic methods highlight relieving exterior syndrome and resolving dampness， accompanied by draining depressed heat. The core Chinese medicines used are Poria，Armeniacae Semen Amarum，Gypsum Fibrosum，Citri Reticulatae Pericarpium，and Pogostemonis Herba. By contrast，the 105 patients in Ruili， dominated by young females， had atypical clinical symptoms， and most of them were asymptomatic patients or mild cases. The main pathogenesis is dampness obstructing the lung and the stomach， with obvious dampness and heat syndromes. The therapeutic methods are mainly invigorating the spleen， resolving dampness， and dispersing Qi with light drugs. The core Chinese medicines used are Poria，Atractylodis Macrocephalae Rhizoma，Glycyrrhizae Radix et Rhizoma，Coicis Semen，Platycodonis Radix，Lonicerae Japonicae Flos， and Pogostemonis Herba. ConclusionThe differences in clinical characteristics， TCM syndromes， and medication of COVID-19 patients from the two places may result from different regions，population characteristics， and the time point of the COVID-19 outbreak. The “treatment of disease in accordance with three conditions” theory can help to understand the internal correlation and guide the treatments.

Objective: To investigate the effect of berberine on programmed necrosis of hepatocytes induced by metabolic-associated fatty liver disease (MAFLD) in mice and its related molecular mechanism. Methods: Twenty male C57BL/6N mice were randomly divided into four groups (n=5 in each group): control group (S), fatty liver group (H), berberine group(B), nuclear factor erythroid 2-related factor 2 inhibitor group (Nrf2), and all-trans-retinoic acid (ATRA) group (A). Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), triglycerides (TG), total cholesterol (TC), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) concentrations were detected at the end of week 12 to calculate fatty liver index (liver mass/body mass ratio). Liver tissue was stained with HE, Masson and Oil Red O, and SAF score was used to evaluate the degree of liver injury. The expression levels of hepatic programmed necrosis-related proteins, namely receptor-interacting protein kinase 3 (RIPK3), phosphorylated mixed series protease-like domain (p-MLKL) and Nrf2 were detected by Western blot method. One-way ANOVA was used for intragroup comparisons and LSD-t tests were used for intergroup comparisons. Results: Compared with S group, H group serum ALT, AST, LDH, TG, TC, TNF-α, IL-1β levels and fatty liver index were significantly increased. The liver tissue was filled with vacuolar-like changes and inflammatory cell infiltration. Numerous red lipid droplets were observed with oil red O staining. Collagen fiber hyperplasia was evident with Masson staining. SAF scores (6.60 ± 0.55 and 0.80 ± 0.45) were significantly increased. The expressions of RIPK3 and p-MLKL were up-regulated. Nrf2 level was relatively increased, and the differences were statistically significant (P < 0.05). Compared with H group, berberine intervention group liver biochemical indexes, lipid levels, pro-inflammatory mediator expression, fatty liver index, and SAF score were significantly reduced, and the expression of RIPK3 and p-MLKL were down-regulated, while Nrf2 levels were further increased, and the differences were statistically significant (P<0.05). Compared with B group, treatment with Nrf2 inhibitor had antagonized the protective effect of berberine on fatty liver. Serum ALT, AST, LDH, TG, TC and TNF-α, IL-1β levels, fatty liver index, and SAF scores were significantly increased and the expressions of RIPK3 and p-MLKL were relatively increased, and the differences were statistically significant (P < 0.05). Conclusion: Berberine can significantly improve the metabolic-associated fatty liver disease injury in mice, and its mechanism is related to activation of Nrf2 and inhibition of programmed necrosis of hepatocytes.
Animals ; Berberine/therapeutic use* ; Fatty Liver ; Male ; Mice ; Mice, Inbred C57BL ; NF-E2-Related Factor 2/metabolism* ; Necrosis

Objective:To compare the clinical effect of manual reduction and plaster fixation, closed reduction and percutaneous K-wire fixation, as well as open reduction plate and elastic intramedullary pin fixation in the treatment of unstable distal ulna and radius fractures in older children.Methods:The clinical data of 110 cases treated in Department of Orthopedics, Children′s Hospital of Nanjing Medical University from January 2014 to December 2017, for unstable fractures of the distal ulna and radius were retrospectively reviewed.There were 73 males, 37 females, aged from 10 to 14 years[(11.6±2.3) years old]. According to the different treatments, the 110 cases were divided into 3 groups which included manual reduction group (48 patients), closed reduction and percutaneous K-wire fixation group (35 patients, K-wire fixation group) and open reduction with plate and elastic stable intramedullary nail fixation group (27 patients, open reduction group). All cases were treated with plaster external fixation.After the fracture healing, the plaster was removed and then exercises were begun.The data of operative time, fracture healing time, displacement rate and wrist function after treatment were recorded in the three groups and compared statistically.Results:There was no significant difference in general data between 3 groups before operation (all P>0.05). For the manual reduction group, K-wire fixation group and open reduction group, the operation time was (20.2±8.4) min, (35.4±12.2) min and (68.5±20.4) min, respectively; the clinical fracture healing time was (42.1±3.8) d, (44.2±4.3)d and (48.4±5.3) d; the cost of treatment was (2 000.4±551.3) Yuan, (8 000.2±1 151.6) Yuan and (20 010.7±2 453.3) Yuan, respectively.There were significant differences in operation time and cost treatment among the 3 groups ( χ2=11.266, F=58.427, all P<0.05). The Berton score of excellent and good were 89.6% (43/48 cases), 91.4% (32/35 cases) and 92.6% (25/27 cases) 3 months later after surgery in the manual reduction group, K-wire fixation group and open reduction group.The mean follow-up was (11.2±3.7) months(range 6-18 months). In the manual reduction group, there were 6 cases with fracture displacement within 2 weeks after the manual reduction.There were 3 cases with symptoms of caudal irritation in K-wire fixation group, which happened in 1 case in the open reduction group.No complications such as nonunion and iatrogenic nerve injury were found during the follow-ups. Conclusion:There is no significant difference in the wrist function among the 3 methods for the treatment of distal radius and ulna fractures in older children.The manual reduction therapy has a high fracture displacement rate.The open reduction therapy causes maximal operative trauma and costs highly.The percutaneous K-wire method is minimally invasive and has shorter operative time and a lower fracture displacement rate.Therefore, percutaneous K-wire is the optimal treatment for distal ulna and radius fractures.

Since the outbreak of novel coronavirus pneumonia, the World Health Organization and the National Health Commission have issued multiple guidance documents.Medical facilities across the nation have actively implemented the countermeasures in response to the epidemic.However, in the real scenario of prevention and control, hospital infection remains a great concern.It is crucial to formulate measures and procedures based on standard prevention and transmission route prevention to avoid cross infection between medical workers and patients.Based on the practice, we summarize the institutional management, layout process, prevention and control of hospital infection in the emergency wards for further discussion and improvement.

OBJECTIVE: To study the influence of the number and position of anchor nails on the Bankart repair by the finite element analysis. METHODS: The 3D CT data of shoulder joints including normal adult volunteers were imported into Mimics 10.0 and Geomagic 2012 software to reconstruct the related tissues, and then meshed in Hypermesh 13.0 software to give material attributes. The position and number of MPC constraints were adjusted in Abaqus 6.14 to establish finite element model of shoulder joint under 6 working conditions including A model(normal control model), B model (Bankart damage control model), C model (1 anchor), D model (2 anchors), E model (3 anchors), F model (4 anchors). The humerus external rotation and forward load were added to simulate the fear test of the shoulder joint forward instability. RESULTS: (1)Normally, the inferior glenohumeral ligament complex accompanied by the external rotation of the humerus head has a wrinkle and a significant stress concentration around its anterior and posterior bundle terminations.(2)The stress of the anterior bundle and posterior bundle of the inferior glenohumeral ligament were increased by 52.33% and 45.67% respectively after Bankart's injury.(3)In each model of anchor repair, the stress concentration was obvious at the anchor site, and the stress of anterior and posterior bundle ligaments could be reduced; there were no obvious differences between C, D models and B model(>0.05), and there were significant differences between E, F models and B model(<0.05). CONCLUSIONS One or two anchors can reduce the stress of the anterior and posterior bundles of the inferior glenohumeral ligament in the repair of Bankart's injury, but when the angle of rotation is large, the stress concentration in the anchor position increases significantly, leading to the increases of the risk of failure. The application of three or four anchors can enhance the constraints on the inferior glenohumeral ligament and reduce the stress of the anchor itself through the "load sharing" effect between anchors, so as to ensure the stability of the shoulder joint and provide a mechanical environment for the early rehabilitation of patients.
Biomechanical Phenomena ; Cadaver ; Finite Element Analysis ; Humans ; Joint Instability ; Shoulder Dislocation ; Shoulder Joint

Objective To study the effects and mechanism of Glyphosate induced cell cycle arrest and apoptosis in mouse spermatogenic cells(GC-2).Methods Morphology of the GC-2 cells was observed by optical microscope and Transmission Electron Microscopy.Flow cytometry were used to detect cell cycle arrest and apoptosis.Cell cycle arrcst and apoptosis related proteins were detected by Western blot.Results Glyphosate could inhibit cell proliferation and impair endoplasmic reticulum and mitochondria significantly,which was associated with G1 phase arrest and apoptosis in GC-2 cells.Glyphosate lead to cell cycle arrest and apoptosis by regulating the expressions of G1/S phase checkpoint regulatory factor proteins such as p21,CyclinD1,CyclinE and activating caspase3.Conclusion Glyphosate has adverse effects on male germ cells by inducing cell cycle arrest and apoptosis.

The content of ATP, ADP, AMP, sodium phosphate and sodium pyrophosphate were determined by 31P NMR, the linear range of ATP, ADP and AMP were found to be 0.004-0.080 mol x L(-1), sodium phosphate and sodium pyrophosphate were 0.005-0.100 mol x L(-1). The RSD were 0.40%-1.30%, the recovery were 96.9% - 105.2%. The method has been applied to the determination of ATP injection. The impurities of ATP injection were ADP and sodium phosphate. The content of ATP is in line with the requirement of the pharmacopoeia. The results indicated that the method is of good reproducibility, high accuracy, rapid and simple operation, without pretreatment and interference of other elements, 31P NMR is a new and reliable method of analyzing ATP, ADP, AMP and phosphate.
Adenosine Diphosphate ; analysis ; Adenosine Monophosphate ; analysis ; Adenosine Triphosphate ; analysis ; Chemistry, Pharmaceutical ; methods ; Diphosphates ; analysis ; Magnetic Resonance Spectroscopy ; Perfusion ; Pharmaceutical Preparations ; analysis ; Phosphates ; analysis ; Quality Control ; Reproducibility of Results

Adolescent ; Adult ; Dust ; analysis ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Occupational Exposure ; analysis ; Pneumoconiosis ; prevention & control ; Sentinel Surveillance ; Surveys and Questionnaires ; Welding ; Young Adult

BACKGROUNDDouble plate osteosynthesis is the standard treatment for intra-articular fractures of the distal humerus. However, there is still controversy concerning dual plate positions in terms of providing optimal stability. The purpose of this retrospective study was to compare the clinical outcomes in patients with type C intra-articular distal humeral fractures using perpendicular and parallel plating methods.

METHODSBetween March 2008 and June 2011, a total of 45 patients with type C distal humerus fractures were treated using two different dual plating methods. Of them, 24 patients were treated by perpendicular plating (group I) and 21 patients were treated by parallel plating (group II). The surgical time, blood loss, and union time were compared between the two groups. The flexion-extension arc, the total range of flexion and extension at the end of follow-up were compared between the two groups. The Mayo Elbow Performance Score (MEPS) was used to determine the elbow functional results.

RESULTSAll patients were followed up. The mean duration of follow-up was 16 months (range 12 - 25 months) in group I and 15.5 months in group II (range 12 - 25 months). There were no significant differences in the surgical time, blood loss, and the bone union time between the two groups. In group I, the mean elbow flexion-extension arc was 101° and the mean MEPS was 85 points. The rate of excellent and good results was 87.5%. In group II, the mean flexion-extension arc was 100° and the mean MEPS was 86.1 points. The rate of excellent and good results was 90.5%. There were no significant differences in the MEPS, flexion-extension arc, and the total range of flexion and extension between the two groups.

CONCLUSIONSPerpendicular and parallel plate configurations with the appropriate surgical techniques can provide anatomical reconstruction and stable fixation of type C intra-articular distal humeral fractures and allow early mobilization of the elbow after an operation. The occurrence of post-operative elbow stiffness can be reduced and good outcomes can be obtained.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged ; Retrospective Studies