1.Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine (version 2024)
Xiao CHEN ; Hao ZHANG ; Man WANG ; Guangchao WANG ; Jin CUI ; Wencai ZHANG ; Fengjin ZHOU ; Qiang YANG ; Guohui LIU ; Zhongmin SHI ; Lili YANG ; Zhiwei WANG ; Guixin SUN ; Biao CHENG ; Ming CAI ; Haodong LIN ; Hongxing SHEN ; Hao SHEN ; Yunfei ZHANG ; Fuxin WEI ; Feng NIU ; Chao FANG ; Huiwen CHEN ; Shaojun SONG ; Yong WANG ; Jun LIN ; Yuhai MA ; Wei CHEN ; Nan CHEN ; Zhiyong HOU ; Xin WANG ; Aiyuan WANG ; Zhen GENG ; Kainan LI ; Dongliang WANG ; Fanfu FANG ; Jiacan SU
Chinese Journal of Trauma 2024;40(3):193-205
Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.
2.Safety of early surgery for geriatric hip fracture patients taking clopidogrel: a retrospective case-control study of 120 patients in China.
Ming-Hui YANG ; Bo LI ; Dong-Chen YAO ; Yan ZHOU ; Wen-Chao ZHANG ; Geng WANG ; Ping ZHANG ; Shi-Wen ZHU ; Xin-Bao WU
Chinese Medical Journal 2021;134(14):1720-1725
BACKGROUND:
Geriatric hip fracture patients receiving clopidogrel are a surgical challenge. In China, most of these patients undergo delayed surgical treatment after clopidogrel withdrawal for at least 5 to 7 days. However, delayed surgery is associated with increased complications and mortality in the older adults. This retrospective paralleled comparison study investigated the safety of early surgery for geriatric hip fracture patients within 5 days of clopidogrel withdrawal.
METHODS:
Acute hip fracture patients (≥65 years) who were hospitalized in the orthogeriatric co-management ward of Beijing Jishuitan Hospital between November 2016 and April 2018 were retrospectively reviewed. Sixty patients taking clopidogrel before injury and discontinued <5 days before surgery constituted the clopidogrel group. The control group constituted 60 patients not taking antiplatelet or anticoagulant drugs and matched 1:1 with the clopidogrel group for sex, fracture type, operative procedure, and time from injury to operation (±10 h). The primary outcome was perioperative blood loss and the secondary outcomes were transfusion requirement, complications, and mortality. The Student's t test or Wilcoxon signed rank sum test was used for continuous variables and the Chi-square test was used for categorical variables.
RESULTS:
Age, body mass index, American Society of Anesthesiologists score, and percentage undergoing general anesthesia were comparable between the groups (P > 0.050). The percentages of patients with coronary heart disease (61.7% vs. 18.3%; P < 0.001) and cerebrovascular disease (45.0% vs. 15.0%; P < 0.010) were significantly higher in the clopidogrel vs. control groups, respectively. The median clopidogrel discontinuation time before operation was 73.0 (range: 3.0-120.0) h. There was no significant difference in the estimated perioperative blood loss between the clopidogrel group (median: 745 mL) and control group (median: 772 mL) (P = 0.866). The intra-operative transfusion rate was higher in the clopidogrel group (22/60, 36.7%) than that in the control group (12/60, 20.0%) (P < 0.050). However, there was no significant difference in the blood transfusion rate during the entire perioperative period (26/60, 43.3% vs. 20/60, 33.3%; clopidogrel group vs. control group, respectively; P > 0.050). There was no significant difference in perioperative complications, and 30-day and 1-year mortality rates between the groups.
CONCLUSIONS
Early hip fracture surgery is safe for elderly patients within 5 days of clopidogrel withdrawal, without increased perioperative blood loss, transfusion requirement, complications, and mortality compared with patients not taking antiplatelet drugs.
Aged
;
Case-Control Studies
;
Clopidogrel/therapeutic use*
;
Hip Fractures/surgery*
;
Humans
;
Platelet Aggregation Inhibitors/adverse effects*
;
Retrospective Studies
;
Ticlopidine/adverse effects*
3.Preparation of Periplaneta americana Thermosensitive Hydrogel and Investigation of Its Wound Healing Effect on Diabetic Rats
Yao-yao LUO ; Qian LIAO ; Ting WANG ; Xiu-ying MA ; Yang-yang GAO ; Jie LI ; Jin-feng SHI ; Chao-mei FU ; Jin-ming ZHANG ; Fu-neng GENG
Chinese Journal of Experimental Traditional Medical Formulae 2020;26(14):164-172
Objective:To prepare
4.Porcine circovirus 3 capsid protein induces autophagy in HEK293T cells by inhibiting phosphorylation of the mammalian target of rapamycin.
Shi-Chao GENG ; Xiao-Liang LI ; Wei-Huan FANG
Journal of Zhejiang University. Science. B 2020;21(7):560-570
Porcine circovirus 3 (PCV3) has been detected in major pig-producing countries around the world since its first report in the US in 2016. Most current studies have focused on epidemiological investigations and detection methods of PCV3 because of lack of live virus strains for research on its pathogenesis in porcine cells or even in pigs. We constructed a recombinant plasmid pCMV-Cap carrying the PCV3 orf2 gene to investigate the effects of capsid (Cap) protein expression on autophagic response in human embryonic kidney cell line 293T (HEK293T). We demonstrate that PCV3 Cap protein induced complete autophagy shown as formation of autophagosomes and autophagosome-like vesicles as well as LC3-II conversion from LC3-I via inhibiting phosphorylation of the mammalian target of rapamycin (mTOR) in HEK293T cells. The ubiquitin-proteasome pathway is also involved in the autophagy process. These findings provide insight for further exploration of PCV3 pathogenetic mechanisms in porcine cells.
5. Porcine circovirus 3 capsid protein induces autophagy in HEK293T cells by inhibiting phosphorylation of the mammalian target of rapamycin
Journal of Zhejiang University. Science. B 2020;21(7):560-570
Porcine circovirus 3 (PCV3) has been detected in major pig-producing countries around the world since its first report in the US in 2016. Most current studies have focused on epidemiological investigations and detection methods of PCV3 because of lack of live virus strains for research on its pathogenesis in porcine cells or even in pigs. We constructed a recombinant plasmid pCMV-Cap carrying the PCV3 orf2 gene to investigate the effects of capsid (Cap) protein expression on autophagic response in human embryonic kidney cell line 293T (HEK293T). We demonstrate that PCV3 Cap protein induced complete autophagy shown as formation of autophagosomes and autophagosome-like vesicles as well as LC3-II conversion from LC3-I via inhibiting phosphorylation of the mammalian target of rapamycin (mTOR) in HEK293T cells. The ubiquitin-proteasome pathway is also involved in the autophagy process. These findings provide insight for further exploration of PCV3 pathogenetic mechanisms in porcine cells.
6.Effects of Tc17 Cells on Disease Severity and HBV-DNA Elimination in Patients with HBV Related Acute-on-chronic Liver Failure
Geng-lin ZHANG ; Shi-cheng XU ; Ting ZHANG ; Chao-shuang LIN ; Liang PENG ; Zhi-liang GAO
Journal of Sun Yat-sen University(Medical Sciences) 2019;40(5):739-746
【Objective】To investigate the effects of Tc17 cells on disease severity and elimination of HBV-DNA in
patients with HBV related acute-on-chronic liver failure(HBV-ACLF).【Methods】Forty-three patients with HBV-
ACLF were enrolled. Twenty patients with chronic hepatitis B(CHB)and 12 healthy subjects(NC)were enrolled as
controls. Flow cytometry was used to detect the expression of peripheral Tc17 cells. HBV-DNA loads were measured,and
the MELD,MELD-Na,CLIF-C ACLF and AARC scores were used to evaluate the disease severity. The effects of Tc17
cells on disease severity and decline of HBV-DNA were analyzed.【Results】Compared with NC group and CHB group,
the expression of Tc17 cells in HBV-ACLF patients was significantly increased(P < 0.001 and P = 0.017). Correlation
analysis showed that Tc17 cells were positively correlated with AARC score,MELD score and MELD-Na score(r =
0.504,P = 0.001;r = 0.417,P = 0.005 and r = 0.382,P = 0.012),and a correlated trend was found with CLIF-C
ACLF score(r = 0.294,P = 0.055). And as the disease progressed,the expression of Tc17 cells gradually increased.In addition,Tc17 cells were positively correlated with HBV-DNA levels(r = 0.339,P = 0.026)at baseline,and the
HBV-DNA levels were significantly decreased in patients with higher expression of Tc17 cells than in lower group after 4
weeks of treatment(P < 0.001). Furthermore,it was found that baseline Tc17 cells and AST levels were associated with
the HBV-DNA decline by multivariate linear regression analysis.【Conclusion】Tc17 cells-mediated inflammatory
response helps clear the HBV-DNA,but excessive inflammatory response may aggravate the disease severity.
7.The Serum Exosome Derived MicroRNA-135a, -193b, and -384 Were Potential Alzheimer's Disease Biomarkers.
Ting Ting YANG ; Chen Geng LIU ; Shi Chao GAO ; Yi ZHANG ; Pei Chang WANG
Biomedical and Environmental Sciences 2018;31(2):87-96
OBJECTIVE:
MicroRNAs (miRs) are attractive molecules to be considered as one of the blood-based biomarkers for neurodegenerative disorders such as Alzheimer's disease (AD). The goal of this study was to explore their potential value as biomarkers for the diagnosis of AD.
METHODS:
The expression levels of exosomal miR-135a, -193b, and -384 in the serum from mild cognitive impairment (MCI), dementia of Alzheimer-type (DAT), Parkinson's disease with dementia (PDD), and vascular dementia (VaD) patients were measured with a real-time quantitative reverse transcriptase PCR (qRT-PCR) method.
RESULTS:
Both serum exosome miR-135a and miR-384 were up-regulated while miR-193b was down-regulated in serum of AD patients compared with that of normal controls. Exosome miR-384 was the best among the three miRs to discriminate AD, VaD, and PDD. Using the cut-off value could better interpret these laboratory test results than reference intervals in the AD diagnosis. ROC curve showed that the combination of miR-135a, -193b, and -384 was proved to be better than a particular one for early AD diagnosis.
CONCLUSION
Our results indicated that the exosomal miRs in the serum were not only potential biomarker of AD early diagnosis, but might also provide novel insights into the screen and prevention of the disease.
Aged
;
Alzheimer Disease
;
blood
;
Biomarkers
;
blood
;
Case-Control Studies
;
Cognitive Dysfunction
;
blood
;
Dementia, Vascular
;
blood
;
Diagnosis, Differential
;
Early Diagnosis
;
Exosomes
;
metabolism
;
Female
;
Humans
;
Male
;
MicroRNAs
;
blood
;
Parkinson Disease
;
blood
;
Sensitivity and Specificity
8.AZD9291-induced Acute Interstitial Lung Disease.
Ke-Ke NIE ; Xiao ZOU ; Chuan-Xin GENG ; Ling ZHANG ; Shi-Chao LIU ; Chun-Ling ZHANG ; You-Xin JI
Chinese Medical Journal 2016;129(12):1507-1508
9.Sorafenib in liver function impaired advanced hepatocellular carcinoma.
You-xin JI ; Zhong-fa ZHANG ; Ke-tao LAN ; Ke-ke NIE ; Chuan-xin GENG ; Shi-chao LIU ; Ling ZHANG ; Xing-jun ZHUANG ; Xiao ZOU ; Lei SUN ; Zong-chun ZHANG
Chinese Medical Sciences Journal 2014;29(1):7-14
OBJECTIVETo explore the efficacy and safty of sorafenib in Child-Pugh class B to class C hepatocellular carcinoma (HCC).
METHODSIn this three-center open-label study from November 2011 to May 2013, we randomly assigned 189 patients with advanced Child-Pugh class B or C HCC patients into two groups, one group with 95 patient to receive sorafenib (400 mg a time, twice a day) and the other group with 94 patients to receive best supportive care. The primary end points were progression-free survival and overall survival.
RESULTSThe median progression-free survival was 2.2 months and 1.9 months in the sorafenib group and best supportive care group respectively (Hazard ratio in the sorafenib group, 0.55; 95% confidence interval, 0.40-0.75; P=0.002). The median overall survival was 4.0 months and 3.5 months in the sorafenib group and best supportive care group respectively (Hazard ratio in the sorafenib group, 0.48; 95% confidence interval, 0.35-0.68; P<0.001). The main adverse effect of sorafenib was rash and acne of the skin (in 51.7% patients). The incidences of severe rash, diarrhea, and dry skin were 5.6%, 5.6%, and 2.2% in the sorafenib group. One patient reached partial response in the sorafenib group.
CONCLUSIONSSorafenib is safe in patients with liver function impaired advanced HCC. It is effective in terms of progression-free survival and overall survival compared with best supportive care. Liver functions are the important predictive factors.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; administration & dosage ; adverse effects ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; mortality ; pathology ; Cross-Over Studies ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Liver Function Tests ; Liver Neoplasms ; drug therapy ; mortality ; pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Niacinamide ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Phenylurea Compounds ; administration & dosage ; adverse effects ; therapeutic use ; Treatment Outcome ; Young Adult
10.Sorafenib in Liver Function Impaired Advanced Hepatocellular Carcinoma
Ji YOU-XIN ; Zhang ZHONG-FA ; Lan KE-TAO ; Nie KE-KE ; Geng CHUAN-XIN ; Liu SHI-CHAO ; Zhang LING ; Zhuang XING-JUN ; Zou XIAO ; Sun LEI ; Zhang ZONG-CHUN
Chinese Medical Sciences Journal 2014;(1):7-14
Objective To explore the efficacy and safty of sorafenib in Child-Pugh class B to class C hepatocellular carcinoma (HCC).
Methods In this three-center open-label study from November 2011 to May 2013, we randomly assigned 189 patients with advanced Child-Pugh class B or C HCC patients into two groups, one group with 95 patient to receive sorafenib (400 mg a time, twice a day) and the other group with 94 patients to receive best supportive care. The primary end points were progression-free survival and overall survival.
Results The median progression-free survival was 2.2 months and 1.9 months in the sorafenib group and best supportive care group respectively (Hazard ratio in the sorafenib group, 0.55; 95% confidence interval, 0.40-0.75;P=0.002). The median overall survival was 4.0 months and 3.5 months in the sorafenib group and best supportive care group respectively (Hazard ratio in the sorafenib group, 0.48;95%confidence interval, 0.35-0.68;P<0.001). The main adverse effect of sorafenib was rash and acne of the skin (in 51.7%patients). The incidences of severe rash, diarrhea, and dry skin were 5.6%, 5.6%, and 2.2%in the sorafenib group. One patient reached partial response in the sorafenib group.
Conclusions Sorafenib is safe in patients with liver function impaired advanced HCC. It is effective in terms of progression-free survival and overall survival compared with best supportive care. Liver functions are the important predictive factors.

Result Analysis
Print
Save
E-mail