ObjectiveTo explore the typical syndromes and their characteristic of symptoms and signs with high diagnostic value in patients with metabolic syndrome （MS）. MethodsTraditional Chinese medicine （TCM） diagnostic information was collected from 135 MS patients. Syndrome element differentiation and latent class analysis （LCA） were applied to identify the major TCM syndromes in MS patients. Symptoms were analyzed based on the differentiated syndromes， and a binary logistic regression model was constructed to determine symptoms and signs with high diagnostic value. ResultsA total of 135 MS patients were included， involving 163 symptoms and signs with a total frequency of 1749； twenty-three syndrome elements were extracted， 367 times frequency in total， among which 8 syndrome elements occurred ≥10 times with 323 frequencies （88.01% of the total）. These included location-related elements such as kidney （48 times）， spleen （14 times）， and stomach （14 times）， and nature-related elements such as phlegm （71 times）， yin deficiency （64 times）， dampness （57 times）， heat （42 times）， and qi deficiency （13 times）. Based on LCA， the 135 patients were categorized into two groups distinguished by the syndrome elements of dampness and phlegm， forming the "phlegm-dampness syndrome" as the major syndrome type. Nine high-frequency symptoms and signs associated with the phlegm-dampness syndrome were identified，i.e. obesity （39 times）， greasy coating （38 times）， slippery pulse （33 times）， white coating （31 times）， preference for fatty and heavy foods （30 times）， excessive urination （30 times）， fatigue and lack of strength （29 times）， wiry pulse （25 times）， and dark red tongue （25 times）. A binary logistic regression model was constructed combining these nine symptoms and signs with the LCA classification results， ultimately identifying obesity， greasy coating， fatigue and lack of strength， and white coating as independent factors associated with the phlegm-dampness syndrome in MS patients （P＜0.05）. ConclusionThe major TCM syndrome in MS patients is phlegm-dampness syndrome， and obesity， greasy coating， fatigue and lack of strength， and white coating are the typical symptoms and signs for diagnosing phlegm-dampness syndrome in MS patients.

OBJECTIVE: To explore the effectiveness of Nice knot technique for wound closure in Gustilo type ⅢA and ⅢB open tibial fractures. METHODS: A retrospective study was performed on 22 patients with Gustilo type ⅢA and ⅢB open tibial fractures, who underwent wound closure using the Nice knot technique and were admitted between June 2021 and June 2022. There were 15 males and 7 females. The age ranged from 18 to 67 years, with an average of 41.9 years. The causes of injury included traffic accident in 11 cases, falling from height in 7 cases, and heavy object injuries in 4 cases. Fractures were located on the left side in 9 cases and on the right side in 13 cases. And 9 cases were type ⅢA fractures and 13 were type ⅢB fractures according to Gustilo classification. All patients had extensive soft tissue injuries, and no vascular or neurological damage was observed. The time from injury to debridement was 3-8 hours (mean, 6.5 hours). The sizes of wounds before operation and at 2 weeks after operation were measured and wound healing rate at 2 weeks after operation were calculated. The wound healing time and wound healing grading were recorded. The Vancouver Scar Scale (VSS) score was used to assess the wound scar after wound healed and the excellent and good rate was calculated. RESULTS: The wound area was 21.0-180.0 cm ² (mean, 57.82 cm ²) before operation, and it was 1.2-27.0 cm ² (mean, 6.57 cm ²) at 2 weeks after operation. The wound healing rate at 2 weeks after operation was 76%-98% (mean, 88.6%). After operation, 2 cases needed to adjust Nice knot due to skin cutting and 1 case occurred soft tissue infection on the wound. The other patient's wounds healed. The average wound healing time was 27.8 days (range, 18-44 days). And the wound healing were grade A in 13 cases and grade B in 9 cases. VSS score was 2-9, with an average of 4.1; 10 cases were rated as excellent, 10 as good, and 2 as poor, with an excellent and good rate of 90.9%. All patients were followed up 9-24 months (mean, 14.6 months). During follow-up, no deep infection or osteomyelitis occurred. Two cases experienced fracture non-union, and were treated with compression fixation and bone grafting. The fractures of the other patients all healed, with a healing time of 85-190 days (mean, 148.2 days). CONCLUSION Nice knot technique can be used in wound closure of Gustilo type ⅢA and ⅢB open tibial fractures effectively, which is easy to operate.
Male ; Female ; Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Cicatrix ; Retrospective Studies ; Treatment Outcome ; Tibial Fractures/surgery* ; Wound Healing ; Fracture Fixation, Internal/methods* ; Fractures, Open/surgery*

The glymphatic system can remove metabolic wastes from the brain, which plays a significant role in maintaining the homeostasis of the central nervous system. It is an important basis for advanced cognitive functions such as learning and memory. Studies have analyzed the function of glymphatic system by diffusion tensor imaging analysis along the perivascular space (DTI-ALPS) recently. Compared with other invasive examinations that require fluorescent tracer technique or the injection of contrast agents, DTI-ALPS can evaluate the hydromechanics of the glymphatic system via quantifying the diffusion rate of water molecules in different directions, which turns out to be a non-invasive in vivo neuroimaging method. The ALPS-index calculated by the DTI-ALPS method is significantly correlated with the cognitive function in diseases of central nervous system and other system and can reflect the dynamic changes of diseases. In general, ALPS-index is expected to become a novel neuroimaging biomarker for predicting prognosis and clinical effects.
Glymphatic System/diagnostic imaging* ; Diffusion Tensor Imaging ; Brain/diagnostic imaging* ; Central Nervous System ; Cognition

Objective To investigate the correlation between homocysteine (Hcy) and cerebrovascular hemodynamic accumulative scores in primary hypertension patients. Methods A cross-sectional survey was conducted in 2 767 patients with essential hypertension who were simultaneously tested for serum Hcy and cerebral vascular function in the health management/physical examination center in Chongqing General Hospital from October 2015 to March 2018. The prevalence of hyperhomocysteinemia (HHcy) was also explored. Differences between cerebrovascular hemodynamic accumulative scores and its abnormal rate among different Hcy levels were evaluated using the analysis of variance and χ2tests, and logistic regression was used to analyze the correlation between Hcy and cerebrovascular hemodynamic accumulative scores. Results The median level of Hcy in primary hypertension was 11.8 (9.3-15.0) μmol/L. HHcy prevalence was 25.15% (27.01% in men and 19.80% in women), which was higher in men than women (χ2=14.576, P<0.001) and was increasing with age (P<0.001). The proportion of stroke, proportion of taking hypotensive medications, age, fasting plasma glucose, systolic pressure, pulse pressure, and Hcy were significantly higher in the abnormal score (<75 points) group (P<0.001) than in the normal score (≥75 points) group. The average cerebrovascular hemodynamic accumulative score was 86.99±16.10 points. The score in the highest quartile of Hcy (77.91±16.10) was significantly lower than that in other quartiles. The abnormal score rate (<75 points) was 15.25% and was increasing with the Hcy level (χ2=13.986, P<0.001). Logistic regression showed that Hcy in the second, third, and highest quartiles observed in abnormal scores was, respectively, 1.913-fold, 2.045-fold, and 7.497-fold higher than that in the lowest quartile after adjusting the confounding factors. Conclusion Hcy may be an independent risk factor for abnormal cerebrovascular hemodynamic accumulative scores in primary hypertension. Cerebrovascular dysfunction should be closely monitored when Hcy was higher than 15 μmol/L.

Objective: To describe our experience with the surgical treatment of severe wooden foreign body (WFB) injuries in the head and neck region. Methods : A case series review of WFB injuries in the head and neck region that were managed at Sun Yat-sen Memorial Hospital between 2008 and 2014 was performed retrospectively. The clinical findings and surgical details of ten cases were reviewed. Results : The WFBs were integrally removed from all patients with the average age of 40.9 years. 8 cases dued to falling and 2 cases because of industrial injuries. All cases under-went general anesthesia (6 cases tracheal incision, 3 cases through nose intubation, 1 cases through oral intubation).The lengths of the WFBs ranged from 4.0 cm to 17.5 cm (average 9.96 cm). The procedures lasted 30 to 180 min. No se-vere bleeding was observed. Total blood loss ranged from approximately 3 to 200 mL (average 69 mL). The patients were followed for 11 to 38 months, and no postoperative complications, only 1 cases appeared open type deviation and 2 cases of scar discomfort after neck operation. Conclusion Surgical treatment of severe WFB injuries in the head and neck region is acceptably safe and effective. Endoscopic surgery can be used in patients with WFBs that are embedded in the maxilla.

OBJECTIVE:To establish a method for the determination of 7 residual solvents(ethanol,n-hexane,benzene,tolu-ene,xylene,styrene,divinylbenzene)in Liuwei dihuang glycoside. METHODS:The column was DB-624 capillary column,carri-er gas was nitrogen,flow rate was 5.0 ml/min;detector was a hydrogen flame ionization detector with temperature of 250 ℃(pro-grammed temperature);equilibrium temperature was 80 ℃,sample loop temperature was 90 ℃,and transfer line temperature was 100 ℃;the equilibrium time of vial heating was 30 min,sample loop filling time was 0.05 min,injection time was 1.0 min;the carrier gas pressure was 95 kpa,and the vial pressure was 60 kpa. RESULTS:The linear range was 25-500 μg/ml for ethanol(r=0.998 7),0.025-10μg/ml for n-hexane(r=0.998 8),0.025-10μg/ml for benzene(r=0.999 9),0.1-40μg/ml for toluene(r=1.000 0),0.25-100 μg/ml for xylene(r=0.999 9),0.5-500 μg/ml for styrene(r=1.000 0) and 0.5-500 μg/ml for divinylbenzene (r=1.000 0);RSDs of precision,stability and reproducibility tests were lower than 4%;recoveries were 99.60%-102.70%(RSD=1.08%,n=9),90.70%-100.30%(RSD=4.51%,n=9),100.10%-109.80%(RSD=3.82%,n=9),99.50%-110.00%(RSD=4.40%,n=9),100.00%-109.10%(RSD=3.50%,n=9),93.40%-102.30%(RSD=3.73%,n=9) and 99.70%-101.70%(RSD=0.79%,n=9),respectively;the low limits of detection were 1.000,0.025,0.025,0.025,0.100,0.025,0.250 μg/ml respectively. CONCLUSIONS:The method is simple,stable and reproducible,and can be used for the determination of residual solvents(etha-nol,n-hexane,benzene,toluene,xylene,styrene,divinylbenzene)in Liuwei dihuang glycoside.

Described in this paper are the current situation of literature novelty assessment in hospitals and related problems, advantages of WeChat in literature novelty assessment, and how to use WeChat to improve the literature novelty assessment in hospitals.

Tanshinone II A, which was known unique to the salvia, was separated and purified by silica gel column chromatography and recrystallisation from an ethyl acetate-soluble portion (the anti-inflammatory active portion) of ethanol extract of Periploca forrestii. The diterpenoid quinone was obtained from the Periploca for the first time.
Diterpenes ; analysis ; isolation & purification ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Periploca ; chemistry ; Quinones ; analysis ; isolation & purification

GITRL (Glucocorticoid-induced tumor necrosis factor receptor ligand) has been recently identified as a novel inhibitor of osteoclastogenesis and hence called Osteostat. In this study, we expressed recombinant extracellular domain of GITRL protein in Escherichia coli and analyzed its bioactivity. Using an Eco31I enzyme-based restriction and ligation method, we obtained an E. coli-preferred DNA sequence coding for the extracellular domain of human GITRL. The DNA was cloned into expression vector pQE-30Xa that encodes a fusion tag of 6xHis before the insert. The resultant recombinant expression vector pQE/GITRL was subsequently transformed into E. coli strain M15[pREP4]. After induction with Isopropyl beta-D-Thiogalactoside (IPTG), the cells produced the fusion protein mainly in the form of inclusion bodies as identified by SDS-PAGE. The recombinant protein was purified by affinity chromatography through Ni-NTA column and recognized by anti-His polyclonal antibody using Western blotting analysis. Moreover, we established a simple, efficient and sensitive reporter gene-based method to detect the activity of the recombinant protein. The results showed that the target protein was biologically active.
Base Sequence ; Escherichia coli ; genetics ; metabolism ; Extracellular Space ; metabolism ; Humans ; Molecular Sequence Data ; Recombinant Proteins ; analysis ; biosynthesis ; genetics ; Tumor Necrosis Factors ; biosynthesis ; genetics

AIM　To investigate the structures and immunomodulation activity of four homogeneous polysaccharides: LBP 1a-1, LBP 1a-2, LBP 3a-1 and LBP 3a-2 isolated from Lycium barbarum L. brought from Zhongning County, Ningxia Province. METHODS　Their molecular weights, sugar component (constituents) and their linkages were determined by gel permeation chromatography, acid hydrolysis, periodate oxidation and NMR spectrum. The activity of immunomodulation was evaluated with splenocyte proliferation by ［3H］-TDR incorperation, in vitro. RESULTS　Four polysaccharides with molecular weights 11.5×104, 9.4×104, 10.3×104 and 8.2×104, were shown to enhance splenocyte proliferation induced by ConA. LBP 1a-1 and LBP 1a-2 were α-(1→6)-D-glucans. LBP 3a-1 and LBP 3a-2 were found to be α-(1→4)-D-polygalacturonans. CONCLUSION　The four polysaccharides were first isolated from this plant. Polysaccharides with main chain of α-(1→4)-D-polygalacturonans showed stronger immunomodulation activity.