Osteoporosis （OP） and osteoarthritis （OA） are common bone diseases in clinic. OP is a systemic skeletal disease， and OA is a chronic degenerative joint disease with high prevalence and disability rates. With the advent of the aging population， the incidence rate of OA and OP is increasing year by year， and they have become common diseases of the elderly. The quality of life and physical and mental health of patients are severely affected by the above two bone diseases. Chinese medicine has a long history of treating bone diseases， with a good clinical effect on preventing and treating OP， OA， and other bone diseases with few side effects. It is one of the commonly used methods to treat bone diseases. Polysaccharides， as one of the active substances of Chinese medicine， have various pharmacological activities and a wide range of sources with low toxicity， and their effect cannot be ignored. The role of polysaccharides in the treatment of bone diseases has been deeply studied. It has been found that the mechanism of Chinese medicine polysaccharides in treating OP and OA involves multiple levels， targets， and pathways. Through the analysis and summary of the relevant literature on the mechanism of Chinese medicine polysaccharides in treating OP and OA， it was found that Chinese medicine polysaccharides mainly treated OP by regulating the bone dynamic balance between osteoblasts and osteoclasts and affecting bone marrow mesenchymal stem cells and bone microstructure. The mechanism of Chinese medicine polysaccharides in the treatment of OA is related to the regulation of chondrocyte growth， the increase in the proteoglycan and collagen content in the cartilage matrix， and the reduction of oxygen free radical content and inflammatory mediator level. This study aimed to further explore the internal relationship among mechanisms of Chinese medicine polysaccharides in the treatment of bone diseases， to provide relevant ideas for the study of Chinese medicine polysaccharides in the treatment of bone diseases.

Objective: To investigate the effects of interleukin ( IL) -10 on the proliferation of HaCaT cells and CaCl2 induced expression of differentiation markers and its possible molecular mechanisms． Methods: HaCaT cells were treated with various concentrations of IL-10 (0，3，10，30 ng / ml) for different time (0，24，48，72 h) ，cell proliferation was measured using MTS，and cell cycle was determined by flow cytometry．HaCaT cells were pretreated with IL-10 (final concentration 10 ng / ml) for 1 h，then incubated with or without CaCl2 (final concentration 1. 2 mmol / L) for 24，48，72 h ，Western blot was performed to detect the effect of IL-10 on the expression of HaCaT keratinocyte differentiation markers．After pretreatment of HaCaT cells with PD98059，an inhibitor of mitogen-activated kinase-ERK1 /2，and LY294002，an inhibitor of phosphatidylinositol kinase-serine / threonine kinase (PI3K-AKT) ，the total RNA and proteins were extracted separately，real time quantitative polymerase chain reaction (RT-qPCR) and Western blot were used to examine the influence of IL-10 on the expression of differentiation markers (Keratin1，Keratin5，Involucrin) . Results : MTS results revealed that IL-10 (30 ng / ml and lower doses) did not alter the proliferation of HaCaT cells in 72 h．Flow cytometry analysis demonstrated that IL-10 had no significant influence on cell cycle progression．The results of Western blot showed that IL-10 upregulated the expression of differentiation markers Involucrin，while there was no significant effect on Keratin1 and Keratin5 ．Mechanism research analysis demonstrated that IL-10 could activate ERK1 /2 and AKT ，increase their phosphorylation levels ; RT-qPCR and Western blot results showed that PD98059 and LY294002 partially blocked IL-10 induced Involucrin expression． Conclusion At a particular concentration range，IL-10 has little effect on HaCaT proliferation ，but it partially upregulates the expression of differentiation marker Involucrin via the MAPKs-ERK1 /2 and PI3K-AKT pathways.

Objective: To investigate the incidence and treatment of perioperative anemia in patients with gastrointestinal neoplasms in Hubei Province. Methods: The clinicopathological data of 7 474 patients with gastrointestinal neoplasms in 62 hospitals in 15 cities (state) of Hubei Province in 2019 were collected in the form of network database. There were 4 749 males and 2 725 females. The median age of the patients was 62 years (range: 17 to 96 years). The hemoglobin value of the first time in hospital and the first day after operation was used as the criterion of preoperative anemia and postoperative anemia. Anemia was defined as male hemoglobin <120 g/L and female hemoglobin <110.0 g/L, mild anemia as 90 to normal, moderate anemia as 60 to <90 g/L, severe anemia as <60 g/L. The t test and χ² test were used for inter-group comparison. Results: The overall incidence of preoperative anemia was 38.60%(2 885/7 474), and the incidences of mild anemia, moderate anemia and severe anemia were 25.09%(1 875/7 474), 11.37%(850/7 474) and 2.14%(160/7 474), respectively. The overall incidence of postoperative anemia was 61.40%(4 589/7 474). The incidence of mild anemia, moderate anemia and severe anemia were 48.73%(3 642/7 474), 12.20%(912/7 474) and 0.47%(35/7 474), respectively. The proportion of preoperative anemia patients receiving treatment was 26.86% (775/2 885), and the proportion of postoperative anemia patients receiving treatment was 14.93% (685/4 589). The proportions of preoperative anemia patients in grade ⅢA, grade ⅢB, and grade ⅡA hospitals receiving treatment were 26.12% (649/2 485), 32.32% (85/263), and 29.93% (41/137), and the proportions of postoperative anemia patients receiving treatment were 14.61% (592/4 052), 22.05% (73/331), and 9.71% (20/206). The proportion of intraoperative blood transfusion (16.74% (483/2 885) vs. 3.05% (140/4 589), χ²=434.555, P<0.01) and the incidence of postoperative complications (17.78% (513/2 885) vs. 14.08% (646/4 589), χ²=18.553, P<0.01) in the preoperative anemia group were higher than those in the non-anemia group, and the postoperative hospital stay in the preoperative anemia group was longer than that in the non-anemia group ((14.1±7.3) days vs. (13.3±6.2) days, t=5.202, P<0.01). Conclusions: The incidence of perioperative anemia in patients with gastrointestinal neoplasms is high. Preoperative anemia can increase the demand for intraoperative blood transfusion and affect the short-term prognosis of patients. At present, the concept of standardized treatment of perioperative anemia among gastrointestinal surgeons in Hubei Province needs to be improved.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anemia/epidemiology* ; Blood Transfusion ; Female ; Gastrointestinal Neoplasms/surgery* ; Humans ; Length of Stay ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective:To compare Jefferson-fracture reduction plate (JeRP) and micro titanium plate in the transoral single-segment fixation of unstable atlas fractures.Methods:From January 2008 to December 2020, 45 patients with unstable atlas fracture were treated by single-segment fixation through an oral approach with a JeRP or a micro titanium plate at Department of Orthopedic Surgery, General Hospital of Southern Theatre Command. They were 24 males and 21 females, aged from 15 to 67 years. By the Gehweiler classification, 11 atlas fractures were type Ⅰ and 34 type Ⅲ; by the American Spinal Injury Association (ASIA) classification, the spinal cord injury was grade D in 7 cases and grade E in 38 cases; by the Dickman classification, the atlas transverse ligament injury was type Ⅰ in 4 cases and type Ⅱ in 11 cases. Of the patients, 26 were treated by transoral single-segment fixation with a JeRP and 19 by transoral single-segment fixation with a micro titanium plate. The 2 groups were compared in terms of baseline data, operation time, blood loss, hospital stay, visual analog scale (VAS) for neck pain and atlas lateral mass displacement (LMD) before operation and at the last follow-up, and intraoperative and postoperative complications.Results:The 2 groups were comparable because there was no significant difference between them in the preoperative general data ( P>0.05). All patients were followed up for 12 to 55 months (mean, 21.8 months). Wound dehiscence or infection was observed in none of the patients after operation. About 12 months after operation, all fractures achieved bony union, neck pain basically disappeared, and neck movement had no obvious limitation. The hospital stay was (13.9±2.2) d for the JeRP group and (14.2±2.9) d for the micro titanium plate group, showing no significant difference between the 2 groups ( P>0.05). The operation time was (203.5±173.4) min and the blood loss (167.3±138.6) mL in the JeRP group, significantly more than those in the micro titanium plate group [(121.5±50.5) min and (98.4±57.2) mL] ( P<0.05). In the JeRP group, the preoperative LMD was (6.7±1.7) mm and the preoperative VAS score (6.8±1.0) points, significantly higher than the last follow-up values [(0.7±0.6) mm and (0.7±0.6) points] ( P<0.05). In the micro titanium plate group, the preoperative LMD was (6.6±1.5) mm and the preoperative VAS score (6.7±0.9) points, significantly higher than the last follow-up values [(0.9±0.6) mm and (0.8±0.7) points] ( P<0.05). However, there was no significant difference in the preoperative or the last follow-up comparison between the 2 groups ( P>0.05). Implant loosening was observed in one patient in the JeRP group while foreign body sensation in the throat was reported in one patient after operation in the micro titanium plate group. Conclusions:Both JeRP and micro titanium plate in the transoral single-segment fixation can lead to effective treatment of unstable atlas fractures. Compared with JeRP, the micro titanium plate can effectively shorten operation time and reduce blood loss due to its smaller size and lower incision.

Objective:To investigate the clinical efficacy of different grade transoral atlantoaxial release for the treatment of irreducible atlantoaxial dislocation.Methods:From January 2010 to December 2019, 297 patients with irreducible atlantoaxial dislocation treated by different grade releases were retrospectively analyzed, including 132 males and 165 females, aged 42.3±12.14 years (range, 10-63 years). All cases were treated by different grade releases, Grade I (196, 66.0%), Grade II (54, 18.2%), Grade III (28, 9.4%) and Grade IV (19, 6.4%). The American Spinal Injury Association (ASIA) grade and Japanese Orthopedic Association (JOA) score were recorded as the clinical evaluation index. The clivus-canal angle (CCA) and cervico-medullary angle (CMA) were measured to evaluate the reduction. The surgery time, blood loss, duration of bony fusion and complications were also analyzed.Results:The follow-up time was 14.8±10.2 months (range, 9-36 months). The surgery time of Grade I-IV were 2.02±0.35 min, 3.00±0.36 min, 4.07±0.96 min and 5.24±0.83 min, respectively ( F=385.43, P<0.001), blood loss was 84.08±27.21 ml, 153.61±31.36 ml, 268.93±48.94 ml and 444.21±109.51 ml, respectively ( F=582.39, P<0.001). The preoperative ASIA motor score of Grade I-IV were 83.85±6.68, 84.06±5.47, 84.07±5.99 and 85.00±4.11, respectively. The last follow-up were 98.34±2.38, 98.67±1.79, 98.86±1.58 and 98.32±2.11, respectively, with statistically significant differences from preoperative ( P<0.05). The preoperative JOA score of Grade I-IV were 11.44±1.73, 11.59±1.72, 11.61±1.47 and 11.32±1.80, respectively. The last follow-up were 16.22±1.00, 16.28±1.02, 16.14±1.04 and 16.16±1.07, respectively, with statistically significant differences from preoperative ( P<0.05). The preoperative CCA of Grade I-IV were 110.19°±8.76°, 112.48°±7.66°, 106.61°±6.54° and 109.05°±7.79°, respectively. The last follow-up were 140.22°±8.04°, 141.86°±7.04°, 142.35°±8.62° and 140.15°±6.49°, respectively, with statistically significant differences from preoperative ( P<0.05). The preoperative CMA of Grade I-IV were 113.48°±9.54°, 116.03°±8.38°, 109.55°±7.13°, and 112.46°±8.33°, respectively. The last follow-up were 144.28°±7.75°, 146.40°±6.98°, 145.81°±8.27° and 143.24°±6.36°, respectively, with statistically significant differences from preoperative ( P<0.05). Solid bony fusion was obtained except for 3 cases, the fusion time was 9.71±2.55 months (range 3-14 months). Altogether 33 complications occurred in all cases (11.1%), including 3 fusion failure, 3 cerebrospinal leak, 3 wound infection, 2 death (1 case caused by cerebrospinal leak), 11 pharyngeal discomfort, 4 postoperative pain surrounding iliac crest, and 8 malunion of iliac crest. Conclusion:Transoral stepped atlantoaxial release theory could provide guidelines for atlantoaxial dislocation treatment, and make the transoral release technique more effective and safer.

Objective:To report our experience in diagnosis and treatment of posterior atlantoaxial dislocation with odontoid retrolisthesis.Methods:A retrospective study was conducted of the 5 patients who had been treated from July 2012 to August 2018 at Department of Orthopaedics, General Hospital of Southern Theater Command for posterior atlantoaxial dislocation. They were 4 men and one woman, aged from 34 to 67 years (average, 47 years). All of them had a history of trauma. Of them, 4 were complicated with odontoid fracture and one with congenital free os odontoideum. Their posterior atlantoaxial dislocation ranged from 3 to 9 mm (average, 6 mm). By the American Spinal Injury Association (ASIA) grading system, their preoperative spinal injury was rated as grade B in one, as grade C in 3 cases and as grade D in one. All the 5 patients underwent skull traction at 10° flexion. Surgical trans-oralpharyngeal atlantoaxial reduction and internal fixation was performed for the one patient whose reduction had not been achieved by traction while posterior atlantoaxial screw-rod fixation or anterior odontoid screwing was conducted for the 4 patients whose reduction had been achieved by traction. The distance of posterior atlantoaxial dislocation was measured to evaluate their reduction and ASIA grade system was used to assess their spinal function after operation.Results:The postoperative distance of posterior atlantoaxial dislocation was 0 mm, showing a reduction rate of 100%. The 5 patients were followed up for 6 to 36 months (average, 15 months). By the ASIA grade system, the postoperative functional recovery of the spine was grade D in 4 cases and grade C in one. No implant loosening or breakage occurred.Conclusion:As a kind of high-energy hyperextension injury, posterior atlantoaxial dislocation is rare in clinic, but an appropriate treatment can be adopted to deal with its different clinical types to achieve good outcomes.

Objective: To analyze the blood pressure changes of adults aged 18-59 years in rural area of Shanxi province based on a cohort study, and provide reference for the study of the blood pressure level of rural residents and hypertension prevention and control in rural areas in China. Methods: Data were obtained from Shanxi Nutrition and Chronic Disease Family Cohort from 2002 to 2015. Subjects aged <18 years or ≥60 years and individuals with hypertension at baseline survey in 2002, and those who had taken antihypertensive drugs for nearly two weeks during the follow-up survey in 2015 were excluded from the study. A total of 1 629 subjects aged 18-59 years were included in the analyses of the blood pressure level and its change from the baseline survey in 2002 to follow-up survey in 2015. Results: The systolic blood pressure (SBP) of the subjects increased from (122.7±10.4) mmHg in 2002 to (132.8±17.6) mmHg in 2015 and the diastolic pressure (DBP) increased from (72.7±6.9) mmHg in 2002 to (78.8±10.3) mmHg in 2015. The SBP in men and women increased with growth rates of 6.7% and 9.5%. While DBP in men and women increased with growth rates of 9.3% and 7.8%. The SBP levels of those aged 18-, 30-, 40- and 50-59 years increased with growth rates of 5.0%, 6.7%, 9.4% and 11.8%. While the DBP of these age groups increased with growth rates of 12.2%, 8.2%, 8.2% and 6.5%. Conclusions The blood pressure of adults aged 18-59 years old in rural area of Shanxi showed a substantially increasing trend. The mean increase level of SBP in women was higher than that in men, and increased with age. While the mean increase level of DBP in men is higher than that in women, and decreased with age.

Objective: To investigate the efficiency and safety of domestic tyrosine kinase inhibitor (TKI) dasatinib (Yinishu) as second-line treatment for patients with chronic myeloid leukemia in chronic phase (CML-CP). Methods: A retrospective analysis of clinical data of CML-CP patients who received domestic dasatinib as second-line treatment in the CML collaborative group hospitals of Hubei province from March 2016 to July 2018 was performed. The optimal response rate, the cumulative complete cytogenetic response (CCyR), the cumulative major molecular responses (MMR), progression free survival (PFS), event free survival (EFS) and adverse effects (AEs) of the patients were assessed at 3, 6 and 12 months of treatment. Results: A total of 83 CML-CP patients were enrolled in this study. The median follow-up time was 23 months. The optimal response rates at 3, 6 and 12 months in 83 CML-CP patients treated with dasatinib were 77.5% (54/71), 72.6% (61/75) and 60.7% (51/69), respectively. By the end of follow-up, the cumulative CCyR and MMR rates were 65.5% (55/80) and 57.1% (48/73), respectively. The median time to achieving CCyR and MMR was 3 months. During follow-up time, the PFS rate was 94.0% (79/83) and the EFS rate was 77.4% (65/83). The most common non-hematological AEs of dasatinib were edema (32.5%), rash itching (18.1%) and fatigue (13.3%). The common hematological AEs of dasatinib were thrombocytopenia (31.3%), leukopenia (19.3%) and anemia (6.0%). Conclusion Domestic dasatinib was effective and safe as the second-line treatment of CML-CP patients and it can be used as an option for CML-CP patients.

Objective: To investigate the epidemic status and influencing factors of colorectal polyps among urban residents in Lanxi. Methods: A representative urban community was selected from Lanxi. A total of 935 local residents aged 18-80 years received questionnaire survey,physical examination,laboratory tests and colonoscopy. Multivariate Logistic regression analysis was applied to exam the potential influencing factors for colorectal polyps. Results : Eventually 880 residents were involved into the statistical analysis. Colorectal polyps were detected in 167 participants with a crude prevalence of 18.98% and adjusted prevalence for age and gender of 13.28%. The prevalence of colorectal polyps in men（28.70%）was significantly higher than that in women（12.92%,P<0.05）. The results of logistic regression analysis showed that age（OR=1.038,95%CI：1.018-1.057）,males（OR=1.919,95%CI：1.303-2.826）,the middle school level of education（OR=2.443,95%CI：1.507-3.961）and constitution of Yin-Asthenia（OR=0.203,95%CI：0.057-0.720）were influencing factors for colorectal polyps;among male participants,hypertension（OR=1.721,95%CI：1.018-2.908）was a risk factor for colorectal polyps;among female participants,age（OR=1.076,95%CI：1.042-1.111）,BMI（OR=1.099,95%CI：1.001-1.207）,the middle school level of education（OR= 3.507,95%CI：1.794-6.856）and constitution of Yin-Asthenia（OR=0.160,95%CI：0.033-0.770）were influencing factors for colorectal polyps. Conclusion Age,sex,education level and constitution of Yin-Asthenia were associated with the risk of colorectal polyps among residents in Lanxi;hypertension was associated with the risk of colorectal polyps in males,while age,BMI,education level and constitution of Yin-Asthenia were associated with the risk of colorectal polyps in females.

Objective: To investigate the efficiency and safety of domestic tyrosine kinase inhibitor (TKI) dasatinib (Yinishu) as second-line treatment for patients with chronic myeloid leukemia in chronic phase (CML-CP). Methods: A retrospective analysis of clinical data of CML-CP patients who received domestic dasatinib as second-line treatment in the CML collaborative group hospitals of Hubei province from March 2016 to July 2018 was performed. The optimal response rate, the cumulative complete cytogenetic response (CCyR), the cumulative major molecular responses (MMR), progression free survival (PFS), event free survival (EFS) and adverse effects (AEs) of the patients were assessed at 3, 6 and 12 months of treatment. Results: A total of 83 CML-CP patients were enrolled in this study. The median follow-up time was 23 months. The optimal response rates at 3, 6 and 12 months in 83 CML-CP patients treated with dasatinib were 77.5% (54/71), 72.6% (61/75) and 60.7% (51/69), respectively. By the end of follow-up, the cumulative CCyR and MMR rates were 65.5% (55/80) and 57.1% (48/73), respectively. The median time to achieving CCyR and MMR was 3 months. During follow-up time, the PFS rate was 94.0% (79/83) and the EFS rate was 77.4% (65/83). The most common non-hematological AEs of dasatinib were edema (32.5%), rash itching (18.1%) and fatigue (13.3%). The common hematological AEs of dasatinib were thrombocytopenia (31.3%), leukopenia (19.3%) and anemia (6.0%). Conclusion: Domestic dasatinib was effective and safe as the second-line treatment of CML-CP patients and it can be used as an option for CML-CP patients.
Antineoplastic Agents ; Dasatinib/therapeutic use* ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy* ; Protein Kinase Inhibitors ; Retrospective Studies ; Treatment Outcome