Objective To explore the effect and mechanism of massage on skeletal muscle overuse injury in rats.Methods Thirty-two male Sprague-Dawley rats were randomly assigned to the blank(8 rats)and modeling groups(24 rats)using a random number table method.A model of skeletal muscle overuse injury was induced in the modeling group using downhill running centrifugal contraction exercise for 4 weeks.The successfully modeled rats were divided into a model group,a massage group,and a Yunnan Baiyao Aerosol group,with 8 rats in each group.The 4 groups of rats were subjucted to balance beam test.After 24 h of completing the modeling,the massage group was treated with a self-made massager,while the Yunnan Baiyao Aerosol group was treated with Yunnan Baiyao Aerosol twice a day for 3 consecutive days.Twenty-four hours after the end of treatment,the four groups of rats underwent behavioral evaluation again using the beam balance test.Hematoxylin-eosin staining was used to observe damage to the gastrocnemius muscle.The enzyme-linked immunosorbent assay was used to measure the concentrations of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and 5-hydroxytryptamine(5-HT)in plasma.Western blotting was used to detect the protein expression levels of phosphorylated p38 mitogen-activated protein kinase(p-p38 MAPK),phosphorylated c-Jun N-terminal kinase(p-JNK),and phosphorylated extracellular signal-regulated kinase 1/2(p-ERK1/2)proteins in the MAPK signaling pathway.Results Before treatment,compared to the blank group,the rats in the model group,massage group,and Yunnan Baiyao Aerosol group had a longer walking time on the balance beam and a higher number of sliding claws(P<0.05).After treatment,compared with the blank group,the model group showed longer walking time on the balance beam,increased number of sliding claws,significant infiltration of inflammatory cells in gastrocnemius muscle,increased levels of TNF-α,IL-6,5-HT,and p-p38 MAPK,p-JNK,and p-ERK1/2(P<0.05).Compared to the model group,the walking time of the balance beam in the massage group was shortened,the number of sliding claws was reduced,the number of inflammatory cells was reduced,TNF-α,IL-6,and 5-HT indices decreased,and p-p38 MAPK,p-JNK,p-ERK1/2 indices decreased(P<0.05).The Yunnan Baiyao Aerosol group showed a decrease in the number of sliding claws,fewer inflammatory cells,reduced IL-6 levels,and decreased p-JNK and p-ERK1/2(P<0.05).Compared to the massage group,the Yunnan Baiyao Aerosol group had more inflammatory cells,increased IL-6 levels,and elevated p-JNK and p-ERK1/2 levels(P<0.05).Conclusion Massage can improve chronic skeletal muscle fatigue injury,and its mechanism of action may be through inhibiting the MAPK signaling pathway,downregulating the p-ERK1/2,p-p38 MAPK,and p-JNK proteins in this pathway,indirectly affecting the release of inflammatory factors,thus reducing skeletal muscle cell damage,inhibiting the release of inflammatory mediators,and promoting skeletal muscle repair.

Objective To explore the effect and mechanism of massage on skeletal muscle overuse injury in rats.Methods Thirty-two male Sprague-Dawley rats were randomly assigned to the blank(8 rats)and modeling groups(24 rats)using a random number table method.A model of skeletal muscle overuse injury was induced in the modeling group using downhill running centrifugal contraction exercise for 4 weeks.The successfully modeled rats were divided into a model group,a massage group,and a Yunnan Baiyao Aerosol group,with 8 rats in each group.The 4 groups of rats were subjucted to balance beam test.After 24 h of completing the modeling,the massage group was treated with a self-made massager,while the Yunnan Baiyao Aerosol group was treated with Yunnan Baiyao Aerosol twice a day for 3 consecutive days.Twenty-four hours after the end of treatment,the four groups of rats underwent behavioral evaluation again using the beam balance test.Hematoxylin-eosin staining was used to observe damage to the gastrocnemius muscle.The enzyme-linked immunosorbent assay was used to measure the concentrations of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and 5-hydroxytryptamine(5-HT)in plasma.Western blotting was used to detect the protein expression levels of phosphorylated p38 mitogen-activated protein kinase(p-p38 MAPK),phosphorylated c-Jun N-terminal kinase(p-JNK),and phosphorylated extracellular signal-regulated kinase 1/2(p-ERK1/2)proteins in the MAPK signaling pathway.Results Before treatment,compared to the blank group,the rats in the model group,massage group,and Yunnan Baiyao Aerosol group had a longer walking time on the balance beam and a higher number of sliding claws(P<0.05).After treatment,compared with the blank group,the model group showed longer walking time on the balance beam,increased number of sliding claws,significant infiltration of inflammatory cells in gastrocnemius muscle,increased levels of TNF-α,IL-6,5-HT,and p-p38 MAPK,p-JNK,and p-ERK1/2(P<0.05).Compared to the model group,the walking time of the balance beam in the massage group was shortened,the number of sliding claws was reduced,the number of inflammatory cells was reduced,TNF-α,IL-6,and 5-HT indices decreased,and p-p38 MAPK,p-JNK,p-ERK1/2 indices decreased(P<0.05).The Yunnan Baiyao Aerosol group showed a decrease in the number of sliding claws,fewer inflammatory cells,reduced IL-6 levels,and decreased p-JNK and p-ERK1/2(P<0.05).Compared to the massage group,the Yunnan Baiyao Aerosol group had more inflammatory cells,increased IL-6 levels,and elevated p-JNK and p-ERK1/2 levels(P<0.05).Conclusion Massage can improve chronic skeletal muscle fatigue injury,and its mechanism of action may be through inhibiting the MAPK signaling pathway,downregulating the p-ERK1/2,p-p38 MAPK,and p-JNK proteins in this pathway,indirectly affecting the release of inflammatory factors,thus reducing skeletal muscle cell damage,inhibiting the release of inflammatory mediators,and promoting skeletal muscle repair.

Backgrounds::Inadequate sleep duration is associated with a higher risk of type 2 diabetes and the relationship is nonlinear. We aim to assess the curve relationship between night sleep duration and the incidence of type 2 diabetes in China.Methods::A cohort of 11,539 participants from the REACTION study without diabetes at baseline (2011) were followed until 2014 for the development of type 2 diabetes. The average number of hours of sleep per night was grouped. Incidence rates and odds ratios (ORs) were calculated for the development of diabetes in each sleep duration category.Results::Compared to people who sleep for 7 to 8 h/night, people with longer sleep duration (≥9 h/night) had a greater risk of type 2 diabetes (OR: 1.27; 95% CI: 1.01-1.61), while shorter sleep (<6 h/night) had no significant difference in risk of type 2 diabetes. When the dataset was stratified based on selected covariates, the association between type 2 diabetes and long sleep duration became more evident among individuals <65 years of age, male, body mass index <24 kg/m 2 or with hypertension or hyperlipidemia, no interaction effects were observed. Furthermore, compared to people persistently sleeping 7 to 9 h/night, those who persistently slept ≥9 h/night had a higher risk of type 2 diabetes. The optimal sleep duration was 6.3 to 7.5 h/night. Conclusions::Short or long sleep duration was associated with a higher risk of type 2 diabetes. Persistently long sleep duration increased the risk.

Objective To explore the influence of negative lymph node count (NLNC) on the prognosis of patients with gastric signet ring cell carcinoma (GSRC) and develop a prognostic nomogram based on NLNC. Methods On the basis of the SEER database, 2 101 patients diagnosed with GSRC were collected and randomly divided into the modeling group and validation group to test the relationship between clinicopathological characteristics and the prognosis of GSRC. The multivariate Cox proportional hazard regression model was used to analyze the independent risk factors affecting overall survival and establish a prognostic prediction model. The consistency index (C-index), calibration curve, net reclassification index (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA) were used to evaluate the accuracy and clinical applicability of the nomogram. Results All patients were divided according to the ratio of 7:3, with 1 473 in the modeling group and 628 in the validation group. NLNC > 10 (HR=0.578, 95%CI: 0.504-0.662, P < 0.001) was a protective factor for the prognosis of patients with GSRC, and the nomogram model was established based on multivariate Cox proportional hazards model. The C-index values of the nomogram were 0.737 (95%CI: 0.720-0.753) and 0.724 (95%CI: 0.699-0.749) in the modeling and validation groups, respectively, showing good discrimination. The calibration curves showed high consistency of the model. NRI=17.77%, continuous NRI=36.34%, and IDI=4.2% indicated that the model had positive returns compared with the traditional model. The DCA was far from the baseline, indicating that the model had good clinical applicability. Conclusion The increase in NLNC is a favorable factor for the prognosis of patients with GSRC, and a relatively accurate nomogram was established to predict the prognosis of patients with GSRC and help clinicians conduct individualized prognostic evaluations.

A 55-year-old female patient with hyperlipemia received atorvastatin calcium tablets 20 mg,once daily orally.Two years later,the patient's legs appeared ecchymosis with distending pain and numbness.Laboratory tests showed serum myoglobin 682 μg/L and creatine kinase 1 007 U/L.She had not received any other drugs during the same period.Atorvastatin-induced rhabdomyolysis was considered.Atorvastatin was stopped,and the patient received symptomatic and supportive treatment.Twenty days later,her symptoms disappeared and her serum myoglobin and creatine kinase level turned to normal.A gene test of SLCO1B1 C521T polymorphism of organic anion transporting polypeptides associated with statin-induced muscle injury was detected after rhabdomyolysis,and the result showed TT genotype (non-mutant genotype).This suggested that the SLCO1B1 C521T genotypes could not predict the myotoxicity of statins accurately.

A 55-year-old female patient with hyperlipemia received atorvastatin calcium tablets 20 mg,once daily orally.Two years later,the patient's legs appeared ecchymosis with distending pain and numbness.Laboratory tests showed serum myoglobin 682 μg/L and creatine kinase 1 007 U/L.She had not received any other drugs during the same period.Atorvastatin-induced rhabdomyolysis was considered.Atorvastatin was stopped,and the patient received symptomatic and supportive treatment.Twenty days later,her symptoms disappeared and her serum myoglobin and creatine kinase level turned to normal.A gene test of SLCO1B1 C521T polymorphism of organic anion transporting polypeptides associated with statin-induced muscle injury was detected after rhabdomyolysis,and the result showed TT genotype (non-mutant genotype).This suggested that the SLCO1B1 C521T genotypes could not predict the myotoxicity of statins accurately.

OBJECTIVETo investigate the characteristics of haemodynamically significant patent ductus arteriosus (hsPDA), and the indications of percutaneous transcatheter PDA occlusion.

METHODThe data of a preterm infant admitted to West China Second Hospital in December. 2013, who finally underwent percutaneous transcatheter PDA occlusion were analyzed With the key words of"preterm"patent ductus arteriosus"transcatheter", Pubmed were searched and potentially relevant reports were retrieved and assessed by manual sorting from 2005 to 2015. Relevant reports in literature were reviewed.

RESULTA preterm infnat at gestational age of 35 weeks with birth weight of 1 900 g was admitted to our department. Oral ibuprofen for closure of the patent ductus arteriosus failed, and the patient exhibited the features of"ventilator dependent"PDA of premature infants. On the 30th postnatal day, with the body weight of 1 950 g, under basal anesthesia, the infant underwent percutaneous transcatheter PDA occlusion, and the procedure successfully occluded the ductus with Amplatzer duct occluder (ADO). The ventilator was weaned 19 hours post procedure, and the child was discharged 7 days post operation with good recovery, and her growth and development was good. Follow-up for 13 months indicated that the intelligence and physical development evaluated by Bayley scales of infant development test were at the same level of normal age-matched infants. Fifty-two preterm infants treated with percutaneous transcatheter PDA occlusion in 8 reports were enrolled. The preterm infants were born at 23-35 gestational weeks, with PDA diameter of 1-4 mm. The occlusive device included coil, ADO, ADO Ⅱ, ADO Ⅱ AS, AVP Ⅱ and AVP Ⅳ respectively, with body weight of 870-2 610 g on operational days and age of 11-90 postnatal days. All those infants either failed or had contraindications to drug therapy, and exhibited as hsPDA cases. Percutaneous transcatheter PDA occlusions were performed successfully in all 52 cases, and there were no serious procedure-related complications.

CONCLUSIONPercutaneous transcatheter PDA occlusion in preterm infants is feasible and showed positive short-term and long-term effects, which provides an important alternative way for patients with the problem. The indications for transcatheter PDA occlusion include premature infants with hsPDA in whom drug therapy failed or is contraindicated.

Birth Weight ; Body Weight ; China ; Ductus Arteriosus, Patent ; surgery ; Female ; Gestational Age ; Humans ; Ibuprofen ; therapeutic use ; Infant ; Infant, Newborn ; Infant, Premature ; Septal Occluder Device

Objective To evaluate the clinical characteristics,diagnosis and treatment method of pancreatic sinistral portal hypertension caused by tumors in the body and tail of the pancreas.Methods A retrospective review of 40 patients diagnosed with pancreatic sinistral portal hypertension at Peking Union Medical College Hospital from January 2007 to December 2012 was performed.Results The Initial symptoms were epigastric pain and discomfort (n =12),emaciation (n =5),low-back pain (n =4),splenomegaly (n =2),hematemesis and melena (n =4),hypoglycemic coma (n =1).All 40 patients had splenomegaly and varices in the gastric fundus with normal liver function.8 had combined esophageal varices.24 had hypersplenism and 26 had elevated serum CA19-9 level.25 patients received surgical intervention and 15 were treated conservatively.Pathology confirmed malignancy in 29 patients and benign lesions in 11.Thirty-five patients (35/40,88％) were followed up for 12 to 72 months.For patients undergoing surgery,hypersplenism and varices in the gastric fundus were all relieved.There was no upper gastrointestinal bleeding occurred during follow-up.For patients treated conservatively,hypersplenism remained stable and among them 4 patients had upper gastrointestinal bleeding,and successfully treated by medication,therapeutic endoscopy and interventional therapy.Conclusions Patients with pancreatic sinistral portal hypertension caused by tumor in the body and tail of the pancreas can be cured successfully by surgery.In those patients portal hypertension can present as initial clinical manifestation.

Objective To investigated the potential influences of poly(lactic-co-glycolicacid)(PLGA)scaffold as a platform on the differentiation of mouse bone-marrow stem cells to islet-like cells.Methods Mouse bonemarrow stem cells were grown and differentiated in culture with or without PLGA scaffold,and cell morphology and functions were compared within these groups.Results The PLGA scaffold showed fine biological compatibility.Differentiated islet-like cells were dithizone (DTZ) positive,insulin and C-peptide double positive,glucagon positive and somatostatin positive in both groups.Under electron microscope there were ultrastructures similar to that of islet β cells in cells of both groups.Cells with PLGA scaffold secreted more insulin under high level glucose stimulation (P＜0.01).Conclusions PLGA scaffold was biologically compatible and improved function of the differentiated islet-like cells.

Objective To explore the effects of pharmaceutical intervention based on genotype detection on curative effect and safety in hospitalized patients receiving warfarin. Methods The medical records of patients hospitalized in the Department of Cardiology,First Hospital of Peking University whose dosages of warfarin were adjusted according to the results of CYP2C9*2,CYP2C9*3,vitamin K epoxide reductase complex subunit ( VKORC1 )G-1639A genotype testing from June 2013 to March 2014 ( experimental group ) and the patients received warfarin but did not carry the genotype testing( control group)from June to December 2012 were collected and analyzed retrospectively. The length of hospital stay, administration time of warfarin,proportion of patients whose international normalized ratio(INR)≥3. 0 had happened,incidence of bleeding associated with warfarin,INR values and warfarin dosage on discharging were compared between the patients in the two groups. The correlation of warfarin dosage on discharging and the suggested dosage proposed by clinical pharmacist,the above-mentioned parameters and the genotype in the experimental group were analyzed. Results There were 102 patients in the experimental group comprised 62 male and 40 female with average age of(63 ± 16)years(14-88). There were 140 patients in the control group comprised 89 male and 51 female with average age of( 64 ± 13 ) years( 21-85 ). The patients'primary diseases included auricular fibrillation,deep vein thrombosis,pulmonary embolism and renal vein thrombus,etc. There were no statistically significant difference between age and sexual distinction in the 2 groups. The average length of hospital stay and average administration time of warfarin in patients in the experimental group were obviously longer than those in the control group[(16. 7 ± 8. 4)d vs.(12. 6 ± 6. 0)d,(13. 2 ± 8. 2)d vs. (9. 9 ± 6. 1)d,all P <0. 001]. There were no statistically significant difference of the proportion of INR≥3. 0,incidence of bleeding associated with warfarin,and INR values on discharging between the 2 groups. The warfarin dosage on discharging in patients carried CYP2C9*1/ *3 (7 cases)were lower than those in the patients carried CYP2C9*1/ *1(95 cases)in the experimental group [(1. 79 ± 0. 57)mg/d vs.(3. 12 ± 1. 13)mg/d,P=0. 003]. The warfarin dosage on discharging in patients carried VKORC1-1639 GG(1 case)and VKORC1-1639GA(20 cases)were more than those in the patients carried VKORC1-1639AA(81 cases)in the experimental group[6. 00,(3. 55 ± 1. 63)mg/d vs.(2. 87 ± 0. 92)mg/d,P=0. 002]. The length of hospital stay and administration time of warfarin in patients who INR≥3. 0 were longer than those in the patients who INR<3. 0[(24. 7 ± 10. 9)d vs. (15. 2 ± 6. 9)d,(21. 8 ± 10. 9)d vs.(11. 6 ± 6. 4)d,all P<0. 001]and the dosages of warfarin on discharging was lower than that in the patients who INR<3. 0 in the experimental group[(2. 50 ± 1. 02)mg/d vs. (3. 13 ± 1. 15)mg/d, P=0. 042]. In the control group,the difference of length of hospital stay between the patients who INR≥3. 0 and <3. 0 was no statistically significant,the administration time of warfarin in patients who INR≥3. 0 was longer that in the patients who INR <3. 0[(12. 6 ± 6. 5)d vs. (9. 3 ± 5. 8)d,P=0. 015],and the warfarin dosages on discharging was lower than that in the in the patients who INR <3. 0[(2. 49 ± 1. 17)mg/d vs. (3. 11 ± 0. 99)mg/d,P=0. 007]. The cases of fecal occult blood positive,slightly higher of red blood cell in the urine,and gingival bleeding were 8 and 14 in the experimental group and the control group,respectively. No severe bleeding was appeared in both groups. The bleeding was significantly correlated with the length of hospital stay and the administration time of warfarin in the control group(P=0. 001,P=0. 008). There was no correlation between bleeding and warfarin curative indexes in the experimental group. Conclusions The pharmaceutical intervention based on genotype detection can eliminate the effect of genetic factors on warfarin curative effect,avoid prolonging hospitalization caused by adjusting the dose repeatedly,and have a positive role in determination of warfarin maintenance dose. The pharmaceutical intervention has no effect on safety. It is suggested that the patient who receives warfarin anticoagulant therapy should do the genotype detection.