OBJECTIVE: To evaluate the short-and medium-term efficacy of posterior medial branch block in the treatment of persistent pain after percutaneous vertebral augmentation. METHODS: From January 2018 to January 2023, a total of 1, 062 patients with osteoporotic vertebral compression fractures underwent percutaneous vertebral augmentation. Among them, 32 elderly patients who experienced persistent low back pain after surgery and subsequently received posterior medial branch block and cryoablation were included. Six patients died during follow-up, leaving 26 patients for final analysis (1 male, 25 females). The mean age was (82.96±5.66) years (ranged, 76 to 94 years). The mean body mass index was (23.76±3.08) kg·m^-2(ranged 18.1 to 27.2 kg·m^-2). The bone mineral density T-value ranged from -2.5 to -4.3 with a mean of (-3.09±0.56). The mean volume of bone cement injected was 6.00 (5.38, 7.00) ml. Fracture locations were T₁₁ (2 cases), T₁₂ (7 cases), L₁ (10 cases), L₂ (6 cases), and L₃ (1 case). The mean interval from vertebral augmentation to block treatment was (7.12±2.22) months (rangd 6 to 12 months). The vertebral augmentation procedures were percutaneous kyphoplasty(PKP) in 12 cases and percutaneous vertebroplasty (PVP) in 14 cases. At the 2nd week, 3rd month, and 6th month after the block, the numerical rating scale(NRS), Oswestry disability index(ODI), patient satisfaction, and pain relief rate at the 6th month were evaluated. Relationships between pain relief rate at the 6th month after the last treatment and possible influencing factors were analyzed. RESULTS: Compared with X-ray films after percutaneous vertebral augmentation, the X-ray films before block showed an increase in kyphotic angle and vertebral compression rate, with statistically significant differences(P<0.05). At the 2nd week, 3rd month, and 6th month after posterior medial branch block and cryoablation, NRS and ODI scores were significantly lower than before the block(P<0.05). Among the 26 patients, 5 received additional cryoablation. At the 6th month after the last treatment, 19 patients reported excellent or good satisfaction. Univariate binary Logistic analysis showed all P>0.05, and no independent factor affecting final satisfaction or pain relief at 6 months after the last treatment was identified. CONCLUSION Posterior medial branch block(with cryoablation) can effectively improve short-and medium-term symptoms and function in patients with persistent axial low back pain after percutaneous vertebral augmentation for osteoporotic vertebral fractures.
Humans ; Male ; Female ; Aged ; Spinal Fractures/surgery* ; Aged, 80 and over ; Osteoporotic Fractures/surgery* ; Vertebroplasty/adverse effects* ; Nerve Block/methods*

Objective:To evaluate the performance of high risk human papilloma virus (HR-HPV) E6/E7 mRNA in triaging women with atypical squamous cells of undetermined signification (ASCUS).Methods:The ASCUS cohort determined by liquid-based cytology test in the cervical cancer screening queue in Luoshan County, Xinyang City, Henan Province 2017 were selected. The population underwent colposcopy biopsy and pathological tests, combined with HPV16 or 18 (HPV16/18), HR-HPV DNA and HPV E6/E7 mRNA test. By using the pathological result as the gold standard, the sensitivity, specificity, positive predictor (PPV), negative prediction (NPV), referral rate and 95% confident interval ( CI) of HPV E6/E7 mRNA, HR-HPV DNA, HPV16/18 were calculated, respectively. Results:The average age of 312 ASCUS women was 52.6±7.3 years old. Among the 290 women diagnosed as normal by pathology, 64 (22.1%) were HPV E6/E7 mRNA positive, 86 (29.7%) were HR-HPV DNA positive, and 19 (6.6%) were HPV16/18 positive. All of the cervical intraepithelial neoplasia (CIN) cases determined by pathology were both HPV E6/E7 mRNA and HR-HPV DNA positive. The sensitivity, specificity, PPV, NPV and referral rate of HPV E6/E7 mRNA for predicting CIN2+ lesion in women with ASCUS were 100.0% (95% CI: 72.3, 100.0), 77.8% (95% CI: 72.8, 82.1), 13.0% (95% CI: 7.2, 22.3), 100.0% (95% CI: 98.4, 100.0) and 24.7%. Compared with HPV E6/E7 mRNA, the sensitivity of HR-HPV DNA was similar with HPV E6/E7 mRNA, but with a lower specificity [70.2% (95% CI: 64.8, 75.1), P<0.05], a higher referral rate (32.1%, P<0.05); while HPV 16/18 had a high specificity (93.4%, 95% CI: 90.0, 95.7) and a low sensitivity (30.0%, 95% CI: 10.8, 60.3). Based on the age stratification by age 45, the sensitivity of HPV E6/E7 mRNA in both age groups was 100.0%. The specificity of HPV E6/E7 mRNA in group of ≥45 years was a little higher than that in group of <45 years [79.0% (95% CI: 73.7, 83.5) versus 68.3% (95% CI: 53.0, 80.4)], but the difference was not statistically significant ( P>0.05). Conclusions:The ASCUS woman triaging effect of HPV E6/E7 mRNA detection is better than those of HR-HPV and HPV16/18 under certain conditions. The application of HPV E6/E7 mRNA detection to triage ASCUS population can avoid unnecessary colposcopy referral and reduce the missed diagnosis of cervical lesions.

Objective:To evaluate the performance of high risk human papilloma virus (HR-HPV) E6/E7 mRNA in triaging women with atypical squamous cells of undetermined signification (ASCUS).Methods:The ASCUS cohort determined by liquid-based cytology test in the cervical cancer screening queue in Luoshan County, Xinyang City, Henan Province 2017 were selected. The population underwent colposcopy biopsy and pathological tests, combined with HPV16 or 18 (HPV16/18), HR-HPV DNA and HPV E6/E7 mRNA test. By using the pathological result as the gold standard, the sensitivity, specificity, positive predictor (PPV), negative prediction (NPV), referral rate and 95% confident interval ( CI) of HPV E6/E7 mRNA, HR-HPV DNA, HPV16/18 were calculated, respectively. Results:The average age of 312 ASCUS women was 52.6±7.3 years old. Among the 290 women diagnosed as normal by pathology, 64 (22.1%) were HPV E6/E7 mRNA positive, 86 (29.7%) were HR-HPV DNA positive, and 19 (6.6%) were HPV16/18 positive. All of the cervical intraepithelial neoplasia (CIN) cases determined by pathology were both HPV E6/E7 mRNA and HR-HPV DNA positive. The sensitivity, specificity, PPV, NPV and referral rate of HPV E6/E7 mRNA for predicting CIN2+ lesion in women with ASCUS were 100.0% (95% CI: 72.3, 100.0), 77.8% (95% CI: 72.8, 82.1), 13.0% (95% CI: 7.2, 22.3), 100.0% (95% CI: 98.4, 100.0) and 24.7%. Compared with HPV E6/E7 mRNA, the sensitivity of HR-HPV DNA was similar with HPV E6/E7 mRNA, but with a lower specificity [70.2% (95% CI: 64.8, 75.1), P<0.05], a higher referral rate (32.1%, P<0.05); while HPV 16/18 had a high specificity (93.4%, 95% CI: 90.0, 95.7) and a low sensitivity (30.0%, 95% CI: 10.8, 60.3). Based on the age stratification by age 45, the sensitivity of HPV E6/E7 mRNA in both age groups was 100.0%. The specificity of HPV E6/E7 mRNA in group of ≥45 years was a little higher than that in group of <45 years [79.0% (95% CI: 73.7, 83.5) versus 68.3% (95% CI: 53.0, 80.4)], but the difference was not statistically significant ( P>0.05). Conclusions:The ASCUS woman triaging effect of HPV E6/E7 mRNA detection is better than those of HR-HPV and HPV16/18 under certain conditions. The application of HPV E6/E7 mRNA detection to triage ASCUS population can avoid unnecessary colposcopy referral and reduce the missed diagnosis of cervical lesions.

Objective:To evaluate the compliance of low-dose computed tomography (LDCT) screening for high-risk groups of lung cancer and influencing factors in urban area of Henan province during 2013-2017.Methods:Cluster sampling method was used to select the residents of 40-74 years old in Henan for cancer risk factor investigation and lung cancer risk assessment. Subjects with high risk of lung cancer received LDCT screening. The differences of LDCT receiving rates between groups were compared with χ2 tests, and the time trend of rates were tested with the Cochran- Armitage trend test. The potential factors correlating to the compliance of LDCT screening were identified with multivariate logistic regression models. Results:Overall, 35 672 participants who met the inclusion criteria were included in this analysis, and 13 383 of them received LDCT screening, the receiving rate was 37.52%. The receiving rate varied greatly across cities, ranging from 38.47% to 26.73% ( P<0.05). Moreover, the receiving rate varied greatly across periods, ranging from 29.22% during 2013-2014 to 43.30% during 2014-2015, and the receiving rate increases gradually as the screening year increases ( P<0.001). The multivariate logistic regression analyses showed that: being female, age 45-69 years, with education level of junior high school/high school, previous smoking, drinking or previous drinking, infrequent physical exercise, history of tuberculosis, history of chronic bronchitis, history of emphysema, history of asthma bronchiectasis and family history of lung cancer were positive factors for receiving LDCT screening (All P<0.05). Conclusions:The overall compliance of LDCT screening in high-risk population of lung cancer was still not high in urban area of Henan. Implementation of effective interventions targeting the specific high-risk populations might improve the overall compliance of LDCT screening in the future.

Objective To investigate the surgical effort of transurethral bipolar plasma kinetic resection (PKR-BT) on who cannot tolerate radical cystectomy in elderly patients with high-risk infiltration bladder urothelial cancer.Methods From 2010 January to 2013 September,data from 27 cases of elderly had been reviewed.The risk of invasive bladder urothelial cancer were treated with PKR-BT treatment.All patients met WHO elderly standards in this group of patients with severe diabetes was 7 cases,and other comlications.Results All 27 patients had been successful in operation and postoperative recovery.Patients were followed up for 4-45 months,8 cases occured recurrence,6 cases of PKR-BT again,2 cases missed,complete follow up 25 patients still survived,the median follow-up time was 23.6 months,the longest survival was 45 months.Conclusion PKR-BT in the treatment of invasive bladder urothelial cancer patients is safe and effective,it can be used as one of the alternate treatment for such patients.

[Objective] Preliminary clinical experience of Wang Zuoshun using Da Chaihu decoction contacts with other decoctions in the treatment of re-fractory hypertension in winter. [Methods] From the etiology and pathogenesis, syndrome differentiation and treatment, clinical treatment experience sum-mary of Professor Wang Zuoshun 's treatment of winter refractory hypertension academic ideas and clinical experience, also from the classical articles, the-ory of constitution etc to expound the omechanisationf the clinical experience.[Results] The etiology is phlegm, blood stasis, induced by cold pathogen, its pathogenesis are dysfunction of Shaoyang, accumulation of phlegm-heat and blood stasis, cold accumulation, according to the etiology and pathogenesis, forming a cardinal in Shaoyang, purging heat, resolving phlegm and removing blood stasis, slightly with temperature and the treatment. [Conclusions] In clinical work, Wang Zuoshun director using syndrome differentiation and treatment, researches the pathogenesis, flexibility in the use of traditional Chinese herbal soup recipe in treating winter refractory hypertension, the curative effect is remarkable, and has popularization and application value.

Twenty-one non-anthraquinones constituents were isolated for the first time from an ethanol extract of the roots of Knoxia valerianoides by using a combination of various chromatographic techniques including column chromatography over silica gel, Sephadex LH-20, and reversed-phase HPLC. Their structures were identified by their physical-chemical properties and spectroscopic analysis including NMR and MS. The compounds include ten triterpenoids: ursolic acid (1), oleanolic acid (2), 2-oxo pomolic acid (3), pomolic acid (4), maslinic acid (5), rotungenic acid (6), tormentic accid (7), rotundic acid 3,23-acetonide (8), arjungenin (9), and 2alpha, 3beta, 19alpha, 23-tetrahydroxy-urs-12-en-28-oic acid (10), four sitosterones: (24R)-24-ethylcholesta-4,22-dien-3-one (11), 3-oxo-4-en-sitosterone (12), 7-oxostigmasterol (13), and 7-oxo-beta-sitosterol (14), two lignans: eudesmin (15) and ciwujiatone (16), one coumarin: cnidilin (17), and four simple aromatic analogues: 5-hydroxymethylenefural (18), 3-hydroxy-4-methoxybenzoic acid (19), benzoic acid (20), and 2-hydroxy-5-methxoycinnamaldehydes (21). In the in vitro assays against human cancer cell lines (HCT-8, Bel7402, BGC-823, A549, and A2780), against deserum and glutamate induced PC12-syn cell damage, and against HIV-1 replication, and inhibiting protein tyrosine phosphatase 1B (PTP1 B), LPS induced NO production in macrophage, and Fe(2+)-cystine induced rat liver microsomal lipid peroxidation, at a concentration of 1 x 10(-5) mol x L(-1), no compound showed activity.
Animals ; Cell Line, Tumor ; Chromatography, High Pressure Liquid ; Humans ; Lignans ; analysis ; chemistry ; isolation & purification ; Mice ; Plant Roots ; chemistry ; Rubiaceae ; chemistry ; Sitosterols ; chemistry ; isolation & purification ; pharmacology ; Triterpenes ; chemistry ; isolation & purification ; pharmacology

To study chemical constituents contained in ethanol extracts from roots of Machilus yaoshansis. Fifteen compounds were separated from the roots of M. yaoshansis by using various chromatographic techniques. Their structures were identified on the basis of their physicochemical properties and spectral data as twelve lignans(+)-guaiacin (1), kadsuralignan C (2), (+)-isolariciresinol (3), 5'-methoxy-(+)-isolariciresinol (4), (7'S, 8R, 8'R)-lyoniresinol (5), meso-secoisolariciresinol (6), isolariciresinol-9'-O-beta-D-xylopyranoside (7), 5'-methoxy-isolariciresinol-9'-O-beta-D-xylopyranoside (8), lyoniresinol-9'-O-beta-D-xylopyranoside (9), (2R, 3R) -2, 3-dihydro-2-(4-hydroxy-3-methoxyphenyl)-7-methoxy-3-methyl-5-(E)-propenylbenzofuran (10), 3, 5'-dimethoxy-4', 7-epoxy-8, 3'-neolignan-4, 9, 9'-triol (11), nectandrin B (12), and three flavanes(+)-catechin (13), (-)-epicatechin (14), and bis-8, 8'-catechinylmethane (15). All of the compounds 1-15 were separated from M. yaoshansis for the first time.
Butylene Glycols ; chemistry ; Catechin ; chemistry ; Lauraceae ; chemistry ; Lignans ; chemistry ; Lignin ; chemistry ; Naphthols ; chemistry ; Plant Roots ; chemistry

Objective To establish an animal model with installation of gastrobiliary duct drainage (GBDD) in the primary suture after exploration of common bile duct, to assess the safety and feasibility of GBDD. Methods Thirty dogs were randomly divided into three groups: control group (n=5), primary suture group (n= 10) and GBDD group (n= 15). Serum TBil levels, bile leakage,and complications were observed and compared. Results No increase in serum TBil level was observed in the control group. However, serum TBil levels were significantly increased in the primary suture group compared to the GBDD group (P＜0. 01). GBDD were all successfully withdrawn at mean (7. 0±1.7) days after the operation. No bile leakage was found in the GBDD group, which was significantly different compared to 5/10 bile leakage cases in primary suture group (P＜0. 05). There were 3/10 cases of bile peritonitis, infection of incisional wound and splitted in the primary suture group, while there were no such complications in the GBDD group (all P＞0.05). Conclusions GBDD is safe and feasible. It can shorten biliary drainage time and prevent occurrence of bile leakage.Therefore, it has unique value in clinical application.

OBJECTIVETo investigate the chemical constituents of the roots of Knoxia valerianoides and their biological activities.

METHODThe anthraquinones were isolated by using a combination of various chromatographic techniques including column chromatography over silica gel, Sephadex LH-20, and reversed-phase HPLC. Structures of the isolates were identified by their physical-chemical properties and spectroscopic analysis including 2D NMR and MS. Antioxidant, anti-HIV, neuroprotective, and cytotoxic activities were screened by using cell-based models.

RESULTTwenty-two constituents were isolated from an ethanolic extract of the roots of K. valerianoides. Their structures were identified as nordamnacanthal (1), ibericin (2), rubiadin (3), damnacanthol (4), 2-ethoxymethylknoxiavaledin (5), 3-hydroxymorindone (6), knoxiadin (7), 2-formyl knoxiavaledin (8), lucidin (9), xanthopurpurin (10), 1, 3-dihydroxy-2-methoxy-9, 10- anthraquinone (11), lucidin(-methyl ether (12), digiferruginol (13), 3-hydroxy-2-methyl-9,10-anthraquinone (14), rubiadin-1-methyl ether (15), 6-methoxylucidin (-ethyl ether (16), 1,3,6-trihydroxy-2-methyl-9,10-anthraquinone (17), 1,3-dihydroxy-2-hydroxy methyl-6-methoxy-9,10-anthraquinone (18), 1,3,6-trihydroxy-2-methoxymethyl-9,10- anthraquinone (19), 3,6-dihydroxy-2- hydroxymethyl-9,10-anthraquinone (20), and 1,6-dihydroxy-2-methyl-9,10-anthra quinone (21). In the in vitro assays, at a concentration of 1 x 10(-5) mol x L(-1), no compounds were active against human cancer cell lines (HCT-8, Bel7402, BGC-823, A549, and A2780), deserum and glutamate induced PC12-syn cell damage, LPS induced NO production in macrophage, Fe2+-cystine induced rat liver microsomal lipid peroxidation, HIV-1 replication, and protein tyrosine phosphatase 1B (PTP1B).

CONCLUSIONCompounds 9-21 were obtained from the roots of K. valerianoides for the first time.

Animals ; Anthraquinones ; chemistry ; isolation & purification ; pharmacology ; Cell Line ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Humans ; Molecular Structure ; Plant Roots ; chemistry ; Rats ; Rubiaceae ; chemistry