BACKGROUND:Compound Shengmai Chenggu capsule has good therapeutic effects on early steroid-induced osteonecrosis of the femoral head,but the exact mechanism of treatment is not fully understood. OBJECTIVE:To observe the effect of compound Shengmai Chenggu capsule on fucosyltransferase 8,osteogenic gene and Wnt/β-catenin in bone tissue of rats with steroid-induced osteonecrosis of the femoral head. METHODS:Sixty Sprague-Dawley rats were randomized into blank group,model group,low-,middle-,and high-dose drug groups(n=12 per group).In the latter four groups,animal models of steroid-induced osteonecrosis of the femoral head were established by subcutaneous injection of imiquimod(once every 2 weeks,2 times in total)and gluteal muscle injection of methylprednisolone(once a week,4 times in total).The low-,middle-and high-dose drug groups were given 1.89,3.78 and 7.56 g/kg per day compound Shengmai Chenggu capsule solution by gavage respectively on the second day after the last modeling.The same amount of saline was given by gavage to the model group.Administration lasted 8 weeks.After the administration,micro-CT scan,histological staining,compression test,RT-qPCR and western blot were performed on the femoral head. RESULTS AND CONCLUSION:Micro-CT scan results showed that compared with the blank group,trabecular volume fraction,trabecular number and trabecular thickness were significantly decreased(P<0.05),while trabecular separation was increased in the model group(P<0.05).Compared with the model group,the compound Shengmai Chenggu capsule could increase trabecular volume fraction,trabecular number and trabecular thickness(P<0.05),and decrease trabecular separation(P<0.05)in a dose-dependent manner.Hematoxylin-eosin staining results showed that compared with the model group,the rate of empty bone lacunae was reduced in a dose-dependent group in the low-,middle-,and high-dose compound Shengmai Chenggu capsule groups(P<0.05).Immunohistochemical staining results showed that compared with the blank group,the protein expression of fucosyltransferase 8,Runx2 and bone morphogenetic protein 2 was reduced in the model group(P<0.05);compared with the model group,the compound Shengmai Chenggu capsule increased the protein expression of fucosyltransferase 8,Runx2 and bone morphogenetic protein 2 in a dose-dependent manner(P<0.05).Results from the compression test showed that there was a dose-dependent increase in the maximum load and elastic modulus of the femoral head in the low-,middle-,and high-dose compound Shengmai Chenggu capsule groups compared with the model group(P<0.05).RT-qPCR and western blot results showed that the mRNA and protein expressions of fucosyltransferase 8,Runx2,alkaline phosphatase,osteocalcin,osteoblast-specific transcription factor and bone morphogenetic protein 2 were decreased in the model group compared with the blank group(P<0.05);compared with the model group,there was a dose-dependent increase in the mRNA and protein expressions of the above indicators in the low-,middle-,and high-dose compound Shengmai Chenggu capsule groups compared with the model group(P<0.05).Compared with the blank group,the mRNA and protein expression of Wnt2,low-density lipoprotein receptor-related protein 5 and β-catenin were decreased(P<0.05)and the mRNA and protein expressions of glycogen synthase kinase 3β were increased(P<0.05)in the model group;compared with the model group,there was a dose-dependent increase in the mRNA and protein expressions of Wnt2,low-density lipoprotein receptor-related protein 5 and β-catenin(P<0.05)but a dose-dependent decrease in the mRNA and protein expressions of lycogen synthase kinase 3β(P<0.05)in the low-,middle-,and high-dose compound Shengmai Chenggu capsule groups.To conclude,the mechanism by which the compound Shengmai Chenggu capsule treats steroid-induced osteonecrosis of the femoral head may activate the Wnt/β-catenin signaling pathway through the up-regulation of fucosyltransferase 8,thereby promoting bone formation.

BACKGROUND:The majority of studies on developmental dysplasia of the hip focus on hip malformations,but there are few reports on the effects of acetabular dysplasia on the spine. OBJECTIVE:To investigate the compensation of spinopelvic parameters in coronal and sagittal views in patients with developmental dysplasia of the hip,and to explore the correlation between acetabular development and spinopelvic parameters. METHODS:A total of 101 patients with developmental dysplasia of the hip admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2018 to June 2022 were selected as the trial group,and 114 healthy subjects were selected as the control group during the same period.The spinopelvic parameters of the subjects were measured through the full-length X-ray films of the coronal and sagittal spines:lumbar lordosis,anterior pelvic tilt,thoracolumbar kyphosis,Cobb angle,and the distance between the C7 plumb line and the center sacral vertical line,sacral slope,pelvic incidence,and thoracic kyphosis.The differences in spinopelvic parameters were compared between the two groups.In addition,the differences in spinopelvic parameters in patients with unilateral,bilateral and different Crowe classifications of developmental dysplasia of the hip were compared.Pearson correlation analysis was used to explore the correlation between Sharp angle and spinopelvic parameters. RESULTS AND CONCLUSION:(1)In the sagittal view,the lumbar lordosis in the trial group was significantly lower than that in the control group(P<0.05).The pelvic tilt and kyphosis angle of the thoracolumbar segment in the trial group were significantly greater than those in the control group(P<0.05).In the coronary position,the Cobb angle and the distance between the C7 plumb line and center sacral vertical line in the trial group were significantly greater than those in the control group(P<0.05).There was no significant difference in the remaining spinopelvic parameters between the two groups(P>0.05).(2)The lumbar lordosis of patients with bilateral developmental dysplasia of the hip was significantly lower than that of patients with unilateral developmental dysplasia of the hip(P<0.05).The pelvic tilt,thoracolumbar kyphosis,Cobb angle and the distance between the C7 plumb line and center sacral vertical line in bilateral developmental dysplasia of the hip patients were significantly greater than those in unilateral developmental dysplasia of the hip patients(P<0.05).(3)The lumbar lordosis decreased with the increase of Crowe classification severity(P<0.05).The pelvic tilt increased with the severity of the Crowe classification(P<0.05).(4)Pearson correlation analysis showed that Sharp angle was negatively correlated with lumbar lordosis(P<0.05),while Sharp angle was positively correlated with anterior pelvic tilt,Cobb angle,C7 plumb line and center sacral vertical line(P<0.05).(5)It is concluded that the pelvic tilt,thoracolumbar kyphosis,Cobb angle and the distance between the C7 plumb line and center sacral vertical line increase,while lumbar lordosis decreases in developmental dysplasia of the hip patients.The degree of acetabular dysplasia was significantly correlated with lumbar lordosis,pelvic tilt,Cobb angle,C7 plumb line and center sacral vertical line.

To investigate the clinical features and influencing factors for new-onset atrial fibrillation (AF) early after coronary artery bypass grafting. Methods    The clinical data of 339 patients undergoing coronary artery bypass grafting in our hospital from January 2012 to January 2019 were retrospectively analyzed. There were 267 males and 72 females with an average age of 37-83 (58.03±8.90) years. The clinical features and influencing factors for new-onset AF after surgery were investigated. Results    There were 234 patients of off-pump coronary artery bypass grafting (OPCABG), with 36 (15.4%) new-onset AF patients after operation, among whom 16.1% were males and 12.5% were females. There were 105 patients of on-pump coronary artery bypass grafting (CABG), with 39 (37.1%) new-onset AF patients, among whom 40.7% were males and 25.0% were females. The incidence was higher after the CABG surgery than that after the OPCABG surgery (37.1% vs. 15.4%, P<0.05). There was no statistical difference in the incidence rate between males and females (P>0.05). The incidence of new-onset AF after surgery was higher in ≥60 years patients for both  operations (18.9% and 45.8%), which was significantly higher than that in <45 years patients (P<0.05). For both operations, the incidence of new-onset AF after surgery was high on the second day (24-48 h) after surgery, and most of the AF lasted for 1 day (P<0.05). The hypertension (OR=4.983, P=0.036), frequent premature atrial contraction or atrial tachycardia (OR=17.682, P=0.002), postoperative creatine kinase isoenzyme MB (CKMB) (OR=0.152, P=0.042), left anterior and posterior diameters (OR=17.614, P<0.001) and preoperative ejection fraction (OR=7.094, P=0.011) were influencing factors for new-onset AF after OPCABG. Diabetes (OR=11.631, P=0.020), other cardiac malformations (OR=29.023, P=0.002), frequent premature ventricular contraction or ventricular tachycardia (OR=0.047, P=0.001), and postoperative CKMB (OR=3.672, P=0.040) were influencing factors for new-onset AF after CABG. Conclusion    The incidence of new-onset AF after CABG is higher than that after OPCABG, and it increases with age increasing. There is no difference in the incidence between males and females. The influencing factors for the two operations are different.

【Objective】 To analyze the testing results of platelet antibody in peripheral blood of 266 pregnant women, so as to explore the correlation of platelet antibody between adverse pregnancy and the number of pregnancies. 【Methods】 A total of 266 pregnant women, admitted to Shaanxi Provincial People′s Hospital, were selected for platelet antibody detection. They were divided into two groups according to history of adverse pregnancy, and the positive rate of platelet antibody between two groups was compared. They were divided into group A (1 pregnancy), group B (2 pregnancies) and group C (≥3 pregnancies) in parallel, and the positive rate of platelet antibody among three groups was compared 【Results】 The yield rate of platelet antibody in groups with and without adverse pregnancy was 31.81% vs 14.86%, showing statistical significance(P<0.05). The yield rate of platelet antibody of Group A, B and C was 9.09%, 21.62% and 23.65%, respectively, with The significant differences(P<0.05). The statistical analysis of inter-group χ² test demonstrated a linear trend between the number of pregnancies and platelet antibodies yielding(χ²=7.056, P<0.05). 【Conclusion】 Platelet antibody was correlated with adverse pregnancy, and the yield rate of platelet antibody in the group with adverse pregnancy was higher than that in the group without adverse pregnancy. There was a linear trend between platelet antibodies yielding and the number of pregnancies. The yield rate of antibodies gets higher as the number of pregnancies increased. Taking platelet antibody test as a routine test during pregnancy is conducive to the early detection of clinical adverse pregnancy, as well as the early prevention, early detection and early intervention of fetal/neonatal homoimmune thrombocytopenic purpura and other diseases.

Objective:To understand the mastery of occupational hygienic knowledge and the implementing of occupational health protection measures in the group which were exposed to the procedure of manufacture and use in glass fiber company, and to explore the feasibility of the prevention of the skin injury by occupational health education in glass fiber workers.Methods:We selected 257 on-the-job employees as the research object in a ceramic enterprise in Nanjing from June 2018 to August 2019, with the method of cluster random sampling. According to Solomon's design, the intervention group in which we took measures with health education was divided into RG 1 (O 1XO 2) and RG 3 (XO 5) group, and the control group where we didn't take any intervention was divided into RG 2 (O 3-O 4) and RG 4 (-O 6) group. The intervention effect of health education on the occupational protection of glass fiber workers was evaluated by the results of questionnaire. Results:After training, the average score of occupational health knowledge in the intervention group was 27.34 points higher than that before training, the intervention index was 1.42, 23.62-27.73 points higher than the control glass fiber workers and 33.62-35.52 points higher than the control glass non-glass fiber workers; Compared with the control group, the positive attitude rate of fiber glass workers in the intervention group increased by 13.28%, 13.51%, 11.68% and 11.48%, and the intervention indexes were 1.18, 1.17, 1.14 and 1.15, which was corresponding to using protective cream, wearing gloves, wearing working clothes, washing hands and bathing after work, respectively; Compared with the control group, the implementation rate of occupational protection measures which were represented by wearing gloves、washing hands and bathing for glass fiber workers in the intervention group increased by 29.25% and 7.27% respectively, and the intervention indexes were 1.43 and 1.08 respectively; The skin injury rate of fiberglass workers in the intervention group was reduced by 11.43% comparing to the control group, the intervention index was 1.67.Conclusion:According to the occupational health education of fiberglass workers, it improves the mastery of occupational health knowledge, positive atti-tude rate and the implementation rate of occupational protection measures, meanwhile, it reduces the skin injury rate of the intervention objects to a certain extent.

Objective:To understand the mastery of occupational hygienic knowledge and the implementing of occupational health protection measures in the group which were exposed to the procedure of manufacture and use in glass fiber company, and to explore the feasibility of the prevention of the skin injury by occupational health education in glass fiber workers.Methods:We selected 257 on-the-job employees as the research object in a ceramic enterprise in Nanjing from June 2018 to August 2019, with the method of cluster random sampling. According to Solomon's design, the intervention group in which we took measures with health education was divided into RG 1 (O 1XO 2) and RG 3 (XO 5) group, and the control group where we didn't take any intervention was divided into RG 2 (O 3-O 4) and RG 4 (-O 6) group. The intervention effect of health education on the occupational protection of glass fiber workers was evaluated by the results of questionnaire. Results:After training, the average score of occupational health knowledge in the intervention group was 27.34 points higher than that before training, the intervention index was 1.42, 23.62-27.73 points higher than the control glass fiber workers and 33.62-35.52 points higher than the control glass non-glass fiber workers; Compared with the control group, the positive attitude rate of fiber glass workers in the intervention group increased by 13.28%, 13.51%, 11.68% and 11.48%, and the intervention indexes were 1.18, 1.17, 1.14 and 1.15, which was corresponding to using protective cream, wearing gloves, wearing working clothes, washing hands and bathing after work, respectively; Compared with the control group, the implementation rate of occupational protection measures which were represented by wearing gloves、washing hands and bathing for glass fiber workers in the intervention group increased by 29.25% and 7.27% respectively, and the intervention indexes were 1.43 and 1.08 respectively; The skin injury rate of fiberglass workers in the intervention group was reduced by 11.43% comparing to the control group, the intervention index was 1.67.Conclusion:According to the occupational health education of fiberglass workers, it improves the mastery of occupational health knowledge, positive atti-tude rate and the implementation rate of occupational protection measures, meanwhile, it reduces the skin injury rate of the intervention objects to a certain extent.

Lung cancer has the highest morbidity and mortality among malignant tumors worldwidely. Targeted therapy related to non-small cell lung cancer (NSCLC) is the research hotspot in recent year. The emergence of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has brought a huge change in the treatment of patients with EGFR mutation. The patients with EGFR exon20 insertion are specific cohort in NSCLC. Reviewing the clinical researches to EGFR exon20 insertion mutation positive NSCLC, as well as summarizing character, testing methods and treatment, will provide a help for clinical application, bringing more benefits for patients at the same time.

Objective:To compare the tropism of different adeno-associated virus (AAV) serotypes in retinal cells.Methods:The plasmids pFastBacDual-inCap and pFastBacDual-ITR-CMV-EGFP were constructed for AAV packaging with the baculovirus expression system.Recombinant adeno-associated virus type 2(rAAV2), 6, 8 and 9 serotypes were packaged, and the infectivity of rAAV was evaluated by infecting HEK293T cells at multiplicity of infection(MOI)2000.Twenty-five C57BL/6 mice were divided into five groups, with five mice per group.In the three experimental groups, both eyes of each mouse were injected 1 μl rAAV intravitreally, and 1 μl phosphate buffered saline (PBS) for the eyes of the control group.Two weeks after injection, the retinal tissues were collected for preparing flat mounts and cryosections.Enhanced green fluorescent protein (EGFP) gene expression was observed via fluorescence microscopy and laser scanning confocal microscopy.The study protocol was approved by the Ethics Committee of Suzhou Institute of Biomedical Engineering and Technology.Results:The infection efficiency of the recombinant virus to HEK293T cells was rAAV2>rAAV6>rAAV8>rAAV9, and the transduction efficiency was 39.5%, 18.4%, 8.7% and 4.6%, respectively.In mouse retinal transduction, rAAV2 and rAAV6 were highly expressed in the ganglion cells, and rAAV8 and rAAV9 were highly expressed in the retinal pigment epithelium (RPE) and photoreceptor cells.rAAV2-mediated EGFP expression in retinas was stable within three months after injection.Conclusions:Different rAAV serotypes have varying tropism and transduction efficiencies in retinal cells through intravitreal injection, rAAV2 has a high transduction efficiency and it can be stably expressed in retinas within three months after injection.

Objective:To analyze clinical outcomes of myocardial incision and tearing for the treatment of myocardial bridge.Methods:A retrospective cohort study was conduct to review the clinical date of 29 patients who underwent surgical myotomy from January 2014 to January 2018 in the Second Hospital of Lanzhou University. A total of 11 patients(incision group) were experienced traditional myotomy on myocardial bridge that the myocardium was longitudinally incised along the direction of the coronary artery, while 18 patients(tearing group) were treated by myocardial incision combined with tearing that longitudinally incised myocardium and deeply tissue tearing. The operation time of surgical myotomy, the amount of bleeding, the number of branches of vascular injury and the number of ventricular ruptures during operation were compared between the two groups. After followed up half a year to one year, the clinical symptoms of angina pectoris, myocardial ischemia by electrocardiogram suggested, and coronary stenosis by coronary CT suggested were collected.Results:The operation time of surgical myotomy, the amount of bleeding patients and the number of branches of vascular injury during operation in the incision group were higher than those in the tearing group( P<0.05). There was no significant difference for the number of ventricular ruptures during operation( P>0.05). After followed up half a year to one year, there was no significant difference in the clinical symptoms of angina pectoris, myocardial ischemia by electrocardiogram suggested, and coronary stenosis by coronary CT suggested( P>0.05). Conclusion:Myocardial incision combined with tearing is a surgical procedure with short operation time and low bleeding risk, which is more beneficial than the traditional longitudinally incised for the myocardial bridge.

PURPOSE: To explore the molecular mechanism of the upregulation of multidrug resistance-associated protein 4 (MRP4) in cholestasis. MATERIALS AND METHODS: The mRNA and protein levels of MRP4 in liver samples from cholestatic patients were determined by quantitative real-time PCR and Western blot. In human hepatoma HepG2 cells, electrophoretic mobility shift assay (EMSA) was used to determine the affinity of nuclear factor-E2-related factor (Nrf2) binding to MRP4 promoter. Dual-luciferase reporter assay was used to detect the binding of tumor necrosis factor α (TNFα) to the promotor of E2F1. The bile duct ligation mouse models were established using male C57BL/6 mice. RESULTS: The mRNA and protein levels of MRP4 were significantly increased in cholestatic patients. TNFα treatment induced the expression of MRP4 and Nrf2 and enhanced cell nuclear extract binding activity to MRP4 promoter, as demonstrated by EMSA. Nrf2 knockdown reduced MRP4 mRNA levels in both HepG2 and Hep-3B cells. In addition, TNFα increased Rb phosphorylation and expression of MRP4 and Nrf2 and activated E2F1 and phosphorylated p38 in HepG2 and Hep-3B cells. These effects were markedly inhibited by pretreatment with E2F1 siRNA. Dual-luciferase reporter assay validated that TNFα induces the transcription of E2F1. Furthermore, the expression of MRP4, Nrf2, E2F1, and p-p38 proteins was improved with treatment of TNFα in a mouse model of cholestasis. E2F1 siRNA lentivirus or SB 203580 (p38 inhibitor) inhibited these positive effects. CONCLUSION: Our findings indicated that TNFα induces hepatic MRP4 expression through activation of the p38-E2F1-Nrf2 signaling pathway in human obstructive cholestasis.
Animals ; Bile Ducts ; Blotting, Western ; Carcinoma, Hepatocellular ; Cholestasis ; Electrophoretic Mobility Shift Assay ; Hep G2 Cells ; Humans ; Lentivirus ; Ligation ; Liver ; Male ; Mice ; Multidrug Resistance-Associated Proteins ; Phosphorylation ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; RNA, Small Interfering ; Tumor Necrosis Factor-alpha ; Up-Regulation